PMID- 3294153 TI - [The problem of need for psychiatric facilities: problem presentations and models]. AB - The article provides a viewpoint on the range of problems which must be met when planning institutions of psychosocial care. Definitions of needs for treatment (supplied by professionals, patients and their social environment) and characteristics of target groups (in terms of diagnosis, degree of impairment, symptoms, demographic variables, aptitude etc.) are presented. The applicability and usefulness of different epidemiological parameters and empirical approaches to estimate care requirements which have still not been fulfilled are discussed; influences on the dynamics of supply and demand are described. Planning is demonstrated as a feedback process in which the definition of participants, clarification of roles, demands and basic standards, agreement on procedures as well as implementation and evaluation are consecutive steps. PMID- 3294154 TI - Endocrine, paracrine and autocrine control of follicular development. AB - Development of a single follicle during the menstrual cycle is under control of hormones stimulating follicular maturation, ovulation and luteogenesis. Several factors intervene locally to prevent other follicles from developing at the same time as dominant follicle. These other follicles remain quiescent or evaluate to atresia. Atresia results from the action of several endocrine, paracrine and autocrine mechanisms which synergistically inhibit aromatase activity. The subsequent lack of estrogens reduces granulosa cell multiplication. The oocyte will not become fertilizable before the preovulatory peak of LH, after the resumption of meiosis and after reaching metaphase of the second meiotic division. Several factors are involved in the inhibition of spontaneous resumption of meiosis: cyclic nucleotides, sex steroids, somatostatin and oocyte maturation inhibitor(s) (OMI). Ovulation is related to breakdown of connective tissue synthesized by granulosa cells under the influence of FSH. Connective tissue lysis is dependent on proteolytic enzymes which are released and activated by FSH, LH and relaxin. A paracrine control could be involved in ovulation: LH induces the production of prostaglandin and relaxin by theca cells which, in turn, stimulate collagenase and proteoglycanase secretion by granulosa cells. PMID- 3294155 TI - Decreased insulin response to arginine after gastrectomy. PMID- 3294156 TI - Occasional elevation of immunoreactive LRH in plasma and cerebrospinal fluid in acute intracranial diseases. PMID- 3294157 TI - A simple guide to the terminology and application of leucocyte monoclonal antibodies. AB - This review aims to provide a simple guide and quick reference to the terminology and diagnostic applications of leucocyte monoclonal antibodies. The differentiation cluster terminology, where applicable, is used throughout. PMID- 3294158 TI - Giant cystic adenomatoid tumour (mesothelioma) of the uterus. PMID- 3294159 TI - The influence of a male's dominance status on female choice in Syrian hamsters. AB - This study evaluated the importance of dominance status on mate selection in Syrian hamsters. In one experiment, sexually receptive females were allowed to choose between tethered males which differed in status. The choice was consistently in favor of the dominant male. The female spent more time in lordosis in the presence of the dominant male. The dominant also obtained a significantly greater number of intromissions. A second experiment investigated whether prior familiarization was essential to permit a female to express mating preferences in a situation where she was free to interact with three males. Again, the dominants were most often preferred and obtained greater sexual access to the female. Prior familiarization or extensive contact with the males was not necessary to support the female's selection of the dominant as a mating partner. The choice occurred quickly, generally within 5 min after contacting the males. Although females did mate with the subordinates, this typically occurred late in the tests. The significance of these data with respect to mate choice and probable paternity effects are discussed. PMID- 3294160 TI - Dietary influences on growth and sexual maturation in premenarchial rhesus monkeys. AB - The effect of a high-fat diet on growth, sexual maturation, and developmental changes in serum levels of estradiol (E2), growth hormone (GH), somatomedin-C (Sm C), and insulin were examined in outdoor-housed premenarchial rhesus monkeys. From 16 to 32 months of age, females were fed either a high-fat diet (HFD, N = 5) with 31% calories from fat or a control diet (commercial laboratory chow, N = 10) with 12% of the calories from fat. Maintenance on a HFD did not accelerate physical growth, as all animals exhibited similar increments in body weight, crown-rump length, and weight/height ratios. In contrast, the HFD group exhibited an earlier onset of perineal swelling and menarche despite lower body weights during that time. Moreover, 80% of the HFD animals exhibited an early first ovulation (31-32 months of age) compared with 40% of control animals. These reproductive changes were associated with significant differences in the endocrine profiles of HFD animals. Fasting serum levels of insulin were significantly elevated within 2 months of diet treatment and remained elevated throughout the study period. Levels of Sm-C were elevated relative to those of controls after 3 months of diet treatment, but not thereafter. Serum GH increased after 6 months on the HFD and, overall, concentrations were higher in HFD animals. A significant rise in E2 was observed after only 45 days on the HFD treatment. These concentrations did not differ from 18 to 21 months of age but again were elevated at 27 months in the HFD females. Since these endocrine and physical changes associated with reproductive physiology occurred in the absence of enhanced growth, these data suggest that a high-fat diet may influence the rate of sexual maturation through changes in certain metabolic factors which may act on the developing neuroendocrine system. PMID- 3294161 TI - Regional localization of the interferon-beta 2/B-cell stimulatory factor 2/hepatocyte stimulating factor gene to human chromosome 7p15-p21. AB - The human interferon-beta 2 gene (IFNB2) is identical to the genes encoding the B cell stimulatory factor (BSF-2), the hybridoma growth factor (HGF), and the hepatocyte stimulating factor (HSF). This protein mediates major alterations in the secretion of a wide spectrum of plasma proteins by the liver in response to tissue injury (the acute-phase response). We have used a cDNA probe specific to the human IFNB2 gene in DNA hybridization experiments and report the regional localization of this gene to human chromosome 7p15-p21. Southern blot analyses of DNA extracted from a panel of mouse X human somatic cell hybrids localized this gene to human chromosome 7p. In situ hybridization of the IFNB2 cDNA probe to prebanded human metaphase chromosome spreads allowed the further localization of this gene to 7p15-p21. PMID- 3294162 TI - Genomic mapping by fingerprinting random clones: a mathematical analysis. AB - Results from physical mapping projects have recently been reported for the genomes of Escherichia coli, Saccharomyces cerevisiae, and Caenorhabditis elegans, and similar projects are currently being planned for other organisms. In such projects, the physical map is assembled by first "fingerprinting" a large number of clones chosen at random from a recombinant library and then inferring overlaps between clones with sufficiently similar fingerprints. Although the basic approach is the same, there are many possible choices for the fingerprint used to characterize the clones and the rules for declaring overlap. In this paper, we derive simple formulas showing how the progress of a physical mapping project is affected by the nature of the fingerprinting scheme. Using these formulas, we discuss the analytic considerations involved in selecting an appropriate fingerprinting scheme for a particular project. PMID- 3294163 TI - Monoclonal antibodies against caldesmon, a Ca++/calmodulin- and actin-binding protein of smooth muscle and nonmuscle cells. AB - Monoclonal antibodies, C2, C9, C18, C21 and C23, against chicken gizzard caldesmon have been prepared and characterized. These antibodies reacted with gizzard caldesmon (150 KDa) by enzyme-linked immunosorbent assay and protein immunoblotting. Immunofluorescence microscopy with these antibodies on cultured gizzard cells showed strong stress fiber and membrane ruffle stainings. Surprisingly, in addition to these cytoplasmic staining patterns, the C23 antibody also stained nuclei in these cells. Preabsorption of C23 with purified caldesmon abolished the staining of stress fibers and membrane ruffles as well as the staining of nuclei, suggesting that a common epitope existed in both gizzard caldesmon and the nuclear protein. Western blot analysis on the cell extract of chicken embryo fibroblast (CEF) showed that antibodies C2, C9, C18 and C21 recognized a nonmuscle caldesmon (66 KDa), whereas C23 reacted with a protein (60 KDa) different from nonmuscle caldesmon. Antibody C21 also crossreacted with a nonmuscle caldesmon (80 KDa) in normal rat kidney (NRK) cells, with a nonmuscle caldesmon (78 KDa) in human cells, and with a nonmuscle caldesmon (72 KDa) in gerbil fibroma cells. This antibody had broad-species specificity. Immunofluorescent staining of CEF cells with antibodies C2, C9, C18 and C21 showed some stress fibers and ruffles, but mostly diffuse staining. Antibody C23 crossreacted with 62 KDa and 55 KDa proteins in NRK cells, 63 KDa and 55 KDa proteins in gerbil fibroma cells and 66 KDa and 56 KDa proteins in human bladder carcinoma cells. These polypeptides were identified as nuclear lamins A and C by an anti-lamin antibody in immunoblots and two-dimensional gel analysis. Like the nuclear lamins, the C23 antigens also underwent a reversible disassembly during mitosis, as detected by double-label immunofluorescence with C23 antibody and a polyclonal anti-tubulin antibody. Tropomyosin-enriched microfilaments isolated from fibroblastic and epithelial types of NRK cells by monoclonal anti tropomyosin antibody contained an 80 KDa protein, which had the heat-resistant property of caldesmon. The polyclonal antiserum generated against this 80 KDa protein showed a crossreactivity with purified gizzard caldesmon and vice versa. The amount of this nonmuscle caldesmon associated with the microfilaments of Kirstein virus-transformed NRK cells was greatly decreased. PMID- 3294165 TI - Significance of culture granules of leprosy derived acid-fast chemoautotrophic nocardioform bacteria. PMID- 3294164 TI - Antiinflammatory and antiulcer effects of kaempferol, a flavone, isolated from Rhamnus procumbens. PMID- 3294166 TI - An extracellular protease derived from S-180 tumour cells in culture. PMID- 3294167 TI - Gastro-duodenitis: bits and bugs. PMID- 3294168 TI - Sonography in Caroli's disease. PMID- 3294169 TI - Use of murine neuroblastoma culture in rapid diagnosis of rabies. PMID- 3294170 TI - Screening of drug resistant strains of Mycobacterium leprae in lepromatous leprosy patients under multidrug treatment. PMID- 3294171 TI - Evaluation of various methods for production of serum opacity factor by group A beta haemolytic streptococci. PMID- 3294172 TI - Airway response to aerosol inhalations in leprosy. PMID- 3294173 TI - Comparative efficacy of three different oral rehydration solutions for the treatment of dehydrating diarrhoea in children. PMID- 3294174 TI - Rice powder oral rehydration solution as an alternative to glucose electrolyte solution. PMID- 3294175 TI - Hormonal induced changes in sialic acid & fucose contents of enterocytes across crypt-villus axis in rat intestine. PMID- 3294176 TI - Sexual dysfunction in hypertensive men. A critical review of the literature. AB - Sexual dysfunction is common in hypertensive men and often is first reported by patients while receiving hypotensive therapy, leading to a widespread belief by patients and physicians that the sexual dysfunction is caused by a specific antihypertensive medication. However, it is unclear from the literature whether this problem is related to hypertension or to its therapy. Further, whether the erectile failures reported during therapy are a result of 1) reduced penile blood flow secondary to reduction of blood pressure after antihypertensive treatment or to obstructive vascular disease (or both) or 2) specific drug effects has not been well studied. Because of these unresolved issues, this common problem is not well managed and contributes to noncompliance with therapy by hypertensive male patients, which impedes the attainment of satisfactory blood pressure control. The present article reviews the literature related to hypertension and sexual function in men and outlines a management strategy for clinicians that attempts to document normalcy of sexual function before initiating treatment in newly diagnosed hypertensive patients. Further, it does not ascribe causality to specific antihypertensive agents for the sexual dysfunction reported by treated hypertensive patients but attempts instead to delineate the pathogenesis of the dysfunction. Once the pathogenesis is established, treatment plans can be implemented to restore normotension and maintain adequate sexual function among treated hypertensive men. The article also discusses how applied research in this area may be performed. PMID- 3294177 TI - Intralymphocytic sodium and free calcium and plasma renin in essential hypertension. AB - Intracellular sodium, potassium, and free calcium concentrations were investigated in lymphocytes of 30 patients with essential hypertension and 30 normotensive controls. All subjects were placed on a diet containing 8 to 10 g of sodium chloride per day. Lymphocyte sodium concentration was higher in hypertensive patients than in normotensive controls (19.8 +/- 1.8 vs 18.4 +/- 1.8 mmol/kg wet weight; p less than 0.01), whereas lymphocyte potassium concentration was similar in both groups. Lymphocyte free calcium concentration was also higher in hypertensive patients than in normotensive controls (134.6 +/- 13.2 vs 120.2 +/- 16.4 nmol/L; p less than 0.01). There was a positive correlation between lymphocyte sodium and free calcium concentrations in normotensive controls, in hypertensive patients, and in the subjects combined (r = 0.59, p less than 0.01; r = 0.71, p less than 0.001; and r = 0.70, p less than 0.001, respectively). Lymphocyte potassium concentration was not related to lymphocyte sodium or free calcium concentration in each group. In patients with essential hypertension, intracellular sodium and free calcium concentrations were negatively correlated with plasma renin activity (r = -0.66, p less than 0.001; r = -0.60, p less than 0.001, plasma norepinephrine concentration. These results suggest that a considerable relationship exists between intracellular sodium and free calcium in lymphocytes and that, in essential hypertension, the alteration in cellular metabolism of sodium and calcium may be linked to the renin system but not to blood pressure, age, or adrenergic activity. PMID- 3294178 TI - Quantitation and purification of the Pasteurella multocida toxin by using monoclonal antibodies. AB - Pasteurella multocida toxin (PMT), derived from a toxigenic strain of P. multocida originally isolated from a pig with clinical atrophic rhinitis, was used to immunize BALB/c mice. Ninety-two hybridomas secreting monoclonal antibodies (MAbs) against PMT were produced by fusion of spleen cells from these mice with P3-X63-Ag8.653 myeloma cells. The specificity for PMT of the MAbs was ascertained by enzyme-linked immunosorbent assay and immunoblotting analysis. The interrelationship of a panel of 10 MAbs and their respective epitopes was characterized by a competitive enzyme-linked immunosorbent assay based on the biotin-avidin system and by an in vitro neutralization assay based on the cytopathic effect of PMT on embryonic bovine lung cells. In vivo neutralization of the lethal effect of PMT in mice was obtained by passive immunization with an anti-PMT MAb 2 days before challenge with PMT. PMT was quantified by a sandwich enzyme-linked immunosorbent assay with a lower detection limit of approximately 50 pg of PMT. Application of supernatant or bacterial extract from cultivation of toxigenic P. multocida to an affinity column containing immobilized MAb resulted in purification of PMT with a yield of 78 to 93% of the PMT applied. PMID- 3294179 TI - Affinity purification and characterization of Shiga-like toxin II and production of toxin-specific monoclonal antibodies. AB - Shiga-like toxin (SLT-II) was purified to apparent homogeneity from Escherichia coli K-12 strain NM522 containing the cloned toxin genes on recombinant plasmid pEB1. Purification was accomplished by a series of column chromatography techniques: anion-exchange, chromatofocusing, cation-exchange, and monoclonal antibody affinity chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of the pure toxin showed that SLT-II consisted of A and B subunits with apparent molecular weights of 32,000 and 10,200 +/- 800, respectively. A band of molecular weight 25,000 was also observed after sodium dodecyl sulfate-polyacrylamide gel electrophoresis and identified as the A1 subunit by Western immunoblot analysis with toxin-specific monoclonal antibodies (MAbs). The pI of the purified toxin was 5.2. Approximately 1 pg of pure SLT-II, but was not neutralized by polyclonal antibodies or MAbs to SLT-I. Five hybridomas against SLT-II were produced (BC5 BB12, DC1 EH5, EA5 BA3, ED5 DF3, and GB6 BA4). Culture supernatant fluids containing MAbs from these hybridomas did not neutralize the cytotoxicity of SLT-I or Shiga toxin. Western blot analysis showed that two MAbs (MAb DC1 EH5 and MAb GB6 BA4) recognized the A and A1 subunits of SLT-II and three MAbs (MAb BC5 BB12, MAb EA5 BA3, and MAb ED5 DF3) recognized the B subunit of SLT-II. MAb BC5 BB12 was used to prepare an affinity column for toxin purification. PMID- 3294180 TI - Scanning electron microscopy of epidermal adherence and cavitation in murine candidiasis: a role for Candida acid proteinase. AB - Adherence of blastoconidia to epidermal corneocytes is an early event in Candida colonization and infection of the skin. Pathogenic species adhere more avidly than nonpathogenic species, transform to hyphal growth, and invade the stratum corneum of the skin. Adherence was studied by scanning electron microscopy of experimental murine cutaneous Candida infections, using six species of Candida. Candida albicans and C. stellatoidea blastoconidia, applied to newborn mouse skin, adhered to the stratum corneum in greater numbers than other species tested, acquired fibrils and strands of amorphous mucinlike material ("cohesin") between spores and the corneocyte cell surface, formed cavitations in the corneocyte surface, and invaded the corneocyte envelope by hyphal growth at sites distant to the point of blastoconidia attachment. Other species showed little or no adherence, colonization, or cavitation of the corneocyte surface, except C. tropicalis, which showed intermediate results. Pepstatin, an inhibitor of Candida acid proteinase, did not alter adherence or cohesion formation, but inhibited formation of corneocyte cavitations about adherent blastoconidia, suggesting that this enzyme may facilitate adherence/invasion events on skin. Depletion of surface lipids did not alter the formation of cohesin material or the adherence process. Adherence and invasion of epithelium by pathogenic Candida species include the interaction of blastoconidia with an epithelial surface cohesin material that participates in the adherence process. Candida acid proteinase, a keratinolytic enzyme, may participate in the cavitation process of the corneocyte surface by C. albicans. PMID- 3294181 TI - Cloning of the gene encoding streptococcal immunoglobulin A protease and its expression in Escherichia coli. AB - We have identified and cloned a 6-kilobase-pair segment of chromosomal DNA from Streptococcus sanguis ATCC 10556 that encodes immunoglobulin A (IgA) protease activity when cloned into Escherichia coli. The enzyme specified by the iga gene in plasmid pJG1 accumulates in the periplasm of E. coli MM294 cells and has a substrate specificity for human IgA1 identical to that of native S. sanguis protease. Hybridization experiments with probes from within the encoding DNA showed no detectable homology at the nucleotide sequence level with chromosomal DNA of gram-negative bacteria that excrete IgA protease. Moreover, the S. sanguis iga gene probes showed no detectable hybridization with chromosomal DNA of S. pneumoniae, although the IgA proteases of these two streptococcal species cleaved the identical peptide bond in the human IgA1 heavy-chain hinge region. PMID- 3294182 TI - Adherence of Candida albicans germ tubes to plastic: ultrastructural and molecular studies of fibrillar adhesins. AB - Germ tubes of Candida albicans produced an additional fibrillar surface layer responsible for enhanced adherence to plastic. The correlation between germination of C. albicans and adherence of germ tubes to a plastic matrix led us to consider the existence of germ tube-specific adhesive components involved in the attachment process. Using concanavalin A-sensitized latex microspheres, we first detected extracellular molecules on the plastic surface after removal of the adherent germ tubes. Electron microscopy confirmed that fibrils of the germ tube involved in cell-substratum interconnections were retained on the plastic surface. Cytochemistry with concanavalin A-gold labeling demonstrated that these fibrillar structures contained mannoproteins. Dithiothreitol and iodoacetamide treatment of washed plastic allowed us to further characterize these fibrillar adhesins. Through analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, two components with molecular weights (MWs) of 68,000 and 60,000 were detected on the plastic surface. The 68,000-MW component appeared to be one of the major constituents of the germ tube surface layers. Biosynthetic labeling experiments performed with L-[35S]methionine revealed two additional proteins: a high-MW component (greater than 200,000), and a 200,000-MW component. These four proteins, strongly labeled on the plastic surface and on the germ tube cell wall layers, were in contrast slightly labeled or even nonidentified in the culture supernatant, suggesting their involvement in germ tube adherence. PMID- 3294183 TI - Stimulation of neutrophil actin polymerization and degranulation by opsonized and unopsonized Candida albicans hyphae and zymosan. AB - We previously showed that unopsonized Candida albicans hyphae stimulated a delayed rise in the putative neutrophil second messengers Ca2+ and inositol 1,4,5 trisphosphate and subsequent O2- release, as compared with opsonized hyphae or zymosan. Therefore, cytoskeletal and degranulation temporal responses to these stimuli were examined. Unopsonized zymosan elicited no neutrophil responses under the experimental condition used. Neutrophil actin polymerization (quantitated by fluorescent measurements of NBD phallacidin) was rapid after stimulation by opsonized hyphae or zymosan (peaking at 1 and 2 min, respectively). This corresponded to observed changes in microscopic actin polymerization, measured with rhodamine phalloidin, which progressed from initially diffuse to collarlike to cylinderlike staining patterns surrounding the hyphae. Compared with opsonized hyphae, unopsonized hyphae resulted in a delayed appearance of the last two visible patterns (P less than 0.05) and in quantitative actin polymerization despite similarly rapid initial contact and spreading over the hyphae by neutrophils. Unlike other neutrophil responses, degranulation did not follow the delayed patterns of responses to stimulation with unopsonized hyphae. In the absence of the release of the cytoplasmic marker lactate dehydrogenase, the release of beta-glucuronidase, an azurophil granule marker, gradually and progressively rose in response to all of the stimuli but unopsonized zymosan. The low but significant levels observed were within a range consistent with published results for degranulation responses to particulate stimuli without cytochalasin B. A quantitative immunoassay of lactoferrin, a specific granule marker, detected no release into supernatants, and immunofluorescent staining indicated concomitant depletion of lactoferrin from neutrophil granules and binding to hyphal and neutrophil surfaces after stimulation by unopsonized hyphae. Thus, the delayed actin polymerization response to unopsonized hyphae occurred subsequent to neutrophil attachment and spreading and resembled the temporal sequence of other neutrophil responses linked to the respiratory burst. In contrast, the degranulation responses to all stimuli appeared to begin and progress gradually after observed attachment and spreading of the neutrophil over hyphal surfaces without a clear temporal relationship to rises in cytoplasmic Ca2+ or F-actin. In addition, the avid binding of released lactoferrin to cell surfaces eliminates its value as a quantitative marker of enzyme release but raises the possibility that it might participate in fungicidal activity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294184 TI - Production and partial characterization of monoclonal antibodies to four Chlamydia psittaci isolates. AB - Monoclonal antibodies (MAbs) were produced to four Chlamydia psittaci isolates: NJ1 and TT3 from turkeys, VS1 from a parakeet, and B577 from an ovine abortion. MAbs were tested for reactivity with each isolate by the indirect immunofluorescent antibody technique and for neutralization by an inclusion reduction neutralization technique in tissue culture. Two genus-specific and 14 serovar-specific MAbs were produced. Genus-specific MAbs reacted with all avian and mammalian isolates; however, each failed to neutralize its homologous chlamydial isolate. Turkey isolates NJ1 and TT3 were antigenically similar; serovar-specific MAbs produced to each reacted equally with both isolates yet showed little or no reaction with other serovars. Serovar-specific MAbs to the parakeet and abortion isolates were distinct; no cross-reactions were seen with other serovars. None of the serovar-specific MAbs reacted with an ovine arthritis isolate. Of the 14 serovar-specific MAbs, 13 partially neutralized homologous strains with or without the addition of complement. Because of the high specificity, the serovar-specific MAbs used with the immunofluorescence technique provided a rapid and precise method to identify three serovars of C. psittaci. PMID- 3294185 TI - Inhibition of phagocytosis in Yersinia pseudotuberculosis: a virulence plasmid encoded ability involving the Yop2b protein. AB - Virulence plasmid-containing cells of Yersinia pseudotuberculosis had the ability to inhibit phagocytosis by mouse peritoneal macrophages cultured in vitro, but cells of its plasmid-cured derivative did not. Inhibition was most pronounced when the pathogen was incubated under Ca2+-deficient conditions, which allowed a high level of expression of outer membrane proteins (Yops). The addition of 2.5 mM Ca2+ to the growth medium reduced the degree of inhibition by the pathogen, but it was still significantly higher than that of the plasmid-cured strain. An avirulent mutant strain, from which the entire yopH gene was deleted, was impaired in its phagocytosis inhibition ability. This mutant could be trans complemented by the yopH+ gene back to the wild-type phenotype with respect to virulence, as well as the ability to inhibit phagocytosis, demonstrating that the ability to inhibit phagocytosis is an important virulence function. The mutant strain was still cytotoxic for HeLa cells, indicating that inhibition of phagocytosis can be genetically separated from the ability to cause a cytotoxic effect. PMID- 3294186 TI - Reduction of enterotoxic activity of Escherichia coli heat-stable enterotoxin by substitution for an asparagine residue. AB - The Escherichia coli heat-stable enterotoxins (STs) are small peptide toxins consisting of 18 (STp) or 19 (STh) amino acids. STp and STh share biologically active sequences which reside in the C-terminal 13 amino acid residues, but the role of each amino acid in the active sequences is not clear. We substituted in vivo Asp, Tyr, His, Gln, Lys, and Arg for the Asn residue at position 11 of STp by oligonucleotide-directed site-specific mutagenesis and examined the biological activities of the resulting mutants. All mutant STs reacted with both monoclonal and polyclonal antibodies, demonstrating that the amino acid substitutions at position 11 did not cause a significant change in the conformation of STp. However, the substitutions invariably caused a significant decrease in enterotoxic activities. The most remarkable decrease was observed with Asn-11--- Lys-11 and Asn-11----Arg-11 mutations; that is, enterotoxic activity could not be detected in the culture supernatant of either of these mutant strains. These results indicate that Asn-11 of STp plays an essential role in the enterotoxic activity. The amide group and the length of side chain of Asn-11 seem to be especially important for enterotoxic activity. PMID- 3294187 TI - Cloning and expression of the CAMP factor of group B streptococci in Escherichia coli. AB - The genetic determinant of the CAMP factor from a strain of group B streptococcus (GBS; Streptococcus agalactiae) was cloned in Escherichia coli. Total cell DNA from the GBS strain R268 was used to construct a gene bank with bacteriophage lambda EMBL4 in the E. coli K-12 strain LE392. Recombinant phage plaques were detected by immunoblots by using a specific antiserum raised against purified CAMP factor. Two hybrid phages showing expression of CAMP factor were identified. Subcloning the CAMP gene (cfb) into the high-copy-number vector pUC8 resulted in highly unstable plasmids. Therefore, subcloning was performed with the low-copy number vector pLG339 resulting in the stable recombinant plasmids pCO61 and pCO62 which lead to expression of CAMP protein first identified by colony immunoblotting. Western blot (immunoblot) analysis revealed a similar CAMP protein pattern in lambda EMBL4 recombinant phage lysates (molecular weight, 22,000 to 24,000) as compared to that obtained from a GBS culture supernatant (molecular weight, 22,000 to 26,000) but a different CAMP protein pattern (molecular weight, 20,000 to 23,000) from lysates of E. coli carrying pCO61 or pCO62. To study the excretion of the CAMP protein we performed a semi quantitative dot blot analysis of proteins recovered from cell fractions and supernatants of the E. coli recombinant clones. In contrast to GBS R268, where the CAMP factor is readily excreted, the CAMP protein is not excreted in E. coli clones containing pCO61 and pCO62 but is found associated with the cell fractions. PMID- 3294188 TI - Transfer of murine host protection by using interleukin-2-dependent T-lymphocyte lines. AB - We have demonstrated in this study that long-term, interleukin-2 (IL-2) dependent, salmonella antigen-specific T-lymphocyte lines, as well as peritoneal exudate-enriched T cells, could be developed from both the antigen-sensitized inguinal and periaortic lymph nodes. Only those lines (salmonella-specific lymph node cells or peritoneal exudate T cells) were capable of adoptively transferring significant host protection (P less than 0.01) compared with the immune reactions of lethally challenged naive controls or of mice that had ovalbumin-specific T cell lines transferred. Of particular interest was the finding that IL-2 dependent T-cell lines derived from the lymph nodes could only confer host protection to naive mice when both the transfer and challenge dose were administered via the intravenous route. Likewise, those T-cell lines derived from the peritoneal exudate were only capable of adoptively transferring significant protection when the cells and challenge dose of salmonellae were administered intraperitoneally. These studies indicate that systemic host protection can be transferred to naive mice, but depending on the source, the IL-2-dependent T-cell lines (lymph node or peritoneally isolated) functioned differentially upon challenge. Also, the results of this study indicate that the administration of greater numbers of IL-2-specific T cells may result in decreased, rather than enhanced, host protection. This may be due to the fact that the IL-2-dependent T cell population consisted of 20 to 25% Lyt-2,3+ cells, indicating that cells of the suppressor/cytotoxic phenotype were present. Thus, increasing the number of cells transferred may result in an abrogation of protection. PMID- 3294189 TI - Antianginal efficacy of gallopamil in comparison to nifedipine. AB - In a randomized double-blind crossover trial 30 patients with chronic stable angina were studied to compare the antianginal actions of gallopamil (150 mg/day) and nifedipine. With the initial nifedipine dose of 60 mg/day, the trial had to be stopped because of severe exacerbation of angina in 3 patients of the nifedipine group. Twenty-one patients were entered into a second protocol with the nifedipine dose reduced to 30 mg/day. Compared to the preceding placebo period, the exercise time to onset of angina (+ 30%, P less than 0.01) and the total exercise time (+ 18%, P less than 0.01) were prolonged by gallopamil but not by nifedipine (+ 20 and 13%, respectively, not significant) with no significant difference between the test drugs. Four patients became free of angina during exercise testing with gallopamil therapy and one patient with nifedipine. Both agents significantly reduced ST depression at maximal comparable workload by 77% (gallopamil) and 52% (nifedipine) compared with placebo; the difference between the drugs reached borderline significance (P = 0.055). The increase in heart rate and the rate-pressure product at maximal comparable workload was less with gallopamil than with nifedipine (P less than 0.01). In contrast to nifedipine, very few side effects were reported with gallopamil. Thus, gallopamil is an effective antianginal agent whose therapeutic to toxic ratio appears to be superior to that of nifedipine. PMID- 3294190 TI - Changes in myocardial ischaemia during isosorbide dinitrate or indoramin therapy in patients with stable angina using relations between the ST segment and heart rate. AB - The effect of isosorbide dinitrate or indoramin on myocardial ischaemia was examined in patients with stable angina pectoris. In a prospective trial, randomization resulted in 8 and 9 patients, respectively, given isosorbide dinitrate in a dose of 30-90 mg daily, and indoramin in a dose of 75-225 mg daily; 2 of these patients were serially examined during the two types of therapy. Changes in myocardial ischaemia were assessed by exercise testing using 12 standard electrocardiographic leads and a bipolar lead CM5. Individual and group comparisons showed that isosorbide dinitrate resulted in an increase in ST segment depression, the maximal ST/heart rate slope and the ratio of net ST segment depression to increases in heart rate (at least P less than 0.01). In contrast, with indoramin therapy there were no significant changes in these indices. The results in these patients suggest that isosorbide dinitrate leads more consistently to increases in the severity of myocardial ischaemia than indoramin, although this effect on ischaemia is apparently less than the benefit of these agents on exercise performance. PMID- 3294191 TI - Spontaneous splenic rupture as complication of infective endocarditis. AB - A case is reported of spontaneously ruptured spleen occurring as a fatal complication of Group B streptococcal endocarditis, despite control of infection with antibiotics and early surgery. PMID- 3294192 TI - The "Heather Index" in impedance cardiography. PMID- 3294193 TI - Time perspective, time attitude, and time orientation in alcoholism: a review. AB - It has been proposed that alcoholics may have a disrupted subjective sense of time. A review of empirical investigations of alcoholics' psychological time functioning is presented, attempting to carefully distinguish between the concepts of time perspective, time attitude, and time orientation. It is recognized that the label "alcoholic" is not a homogeneous diagnosis, and it is used here for individuals in treatment for problems related to alcohol abuse. Important questions raised by the previous investigations are listed along with speculations about the role of cognitive impairment in relation to time functioning of alcoholics. Suggestions are made for potential differential treatment according to the patients' time functioning as it relates to motivation, and for additional research needed in this area. PMID- 3294194 TI - The distribution of mucins, carcinoembryonic antigen, and mucus-associated antigens in endocervical and endometrial adenocarcinomas. AB - The presence and distribution of mucins, carcinoembryonic antigen (CEA), and mucus-associated antigens M1, M2, and M3 were investigated in 22 normal endocervices, 25 normal endometria, 25 endocervical adenocarcinomas, and 32 endometrial adenocarcinomas to determine their contribution in the differential diagnosis of endocervical and endometrial adenocarcinoma. Sections of formalin fixed paraffin-embedded tissues were stained with conventional histochemical stains such as d-PAS and Alcian blue to investigate the distribution of mucins. For the demonstration of CEA and the mucus-associated antigens an indirect immunoperoxidase technique was used. In the present study d-PAS and Alcian blue stains, as well as immunohistochemistry of CEA, did not contribute to the discrimination between adenocarcinomas of the endocervix and endometrium. Immunohistochemistry of mucus-associated antigens showed a positive reaction of M3 in the majority (68%) of the endocervical carcinomas. In contrast, if foci of endocervical-type metaplasia were excluded, M3 was absent in tumor cell cytoplasm of endometrial adenocarcinomas. Furthermore, the expression of M2 without the presence of the other mucus antigens in tumor cell cytoplasm, as seen in 24% of the endometrial adenocarcinomas, was never found in endocervical adenocarcinomas. PMID- 3294195 TI - Malignant mixed Mullerian tumors of the uterus. An immunohistochemical study. AB - Malignant mixed mullerian tumors (MMMT) of the uterus have been subdivided into two types: those with heterologous sarcomatous elements (e.g., rhabdomyosarcoma, and chondrosarcoma) and those with only homologous elements (e.g., stromal sarcoma). The distinction, which may have prognostic significance, was based on the identification by light microscopy of cells that exhibited definite cross striations, cartilage, or osteoid production. We studied 32 cases of uterine MMMT to assess the value of immunohistochemical markers in delineating the sarcomatous and epithelial components. Of 32 cases, 11 showed heterologous sarcoma (6, rhabdomyosarcoma, and 5, chondrosarcoma), and the remaining 21 were homologous MMMT. Six antigens--desmin, myoglobin, S-100, alpha 1-antichymotrypsin (ACT), epithelial membrane antigen (EMA), and monoclonal cytokeratin (AE1 and AE3), (to test for possible myogenic, chondroid, fibrohistiocytic, and carcinomatous differentiation)--were analyzed by the avidin-biotin-peroxidase method. EMA was found in neoplastic cells in all cases; 31 of 32 cases showed keratin. Desmin reactivity was detected in 14 of 32 cases, whereas myoglobin was present in 10 of 32. Three cases exhibited S-100 positivity (two in areas of chondrosarcoma, and one in some stromal sarcoma cells). Twenty-two cases (69%) exhibited ACT reactivity. Several cases displayed a malignant fibrous histiocytoma pattern. These demonstrated ACT positivity in both the neoplastic spindle and giant cells. We conclude that immunohistochemical staining for the above mentioned antigens is a useful diagnostic aid in delineating the sarcomatous and carcinomatous elements in MMMT. PMID- 3294196 TI - Adenocarcinoma in situ of the cervix. Clinicopathologic observations of 11 cases. AB - Adenocarcinomas in situ (AIS) of the cervix represent less than 1% of all primary adenocarcinomas of the cervix; 11 cases from the Magee-Women's Hospital (1969 1984) are described. The patients' ages ranged from 25 to 81 years (average 48.5 years). One patient was nulliparous and the others had one to five children. The most common presenting symptom was postmenopausal or other abnormal vaginal bleeding. The AIS were diagnosed as follows: a positive, suspicious, or dysplastic Pap smear in seven cases; in three, the AIS was an incidental finding during a hysterectomy; and one case was diagnosed in an endocervical curettage. Most of the AIS were in or near the transformation zone, having two distinct histologic glandular patterns with tall columnar or large ballooned cells (Types I and II respectively). In three cases an associated in situ squamous cell carcinoma or severe dysplasia of the cervix was seen. Two patients had associated well-differentiated adenocarcinoma of the endometrium and a third had endometrial hyperplasia. One lesion stained strongly positive for carcinoembryonic antigen and all others were negative. Eight patients underwent total abdominal hysterectomy and bilateral salpingo-oopherectomy (TAH-BSO), two had total abdominal hysterectomy (one with salpingo-oophorectomy), and one 25-year-old was treated by deep conization only. All patients, except one who died with associated adenocarcinoma of the cecum, were alive 8 to 127 months after treatment. PMID- 3294197 TI - The fate of the split thickness skin graft in neovaginas. A pathologic study of 21 cases and a review of the literature. AB - Twenty-one cases of congenital absence of the vagina corrected by McIndoe's procedure were examined. The longest follow-up was 21 years (average 10.5 years). Vaginal biopsies showed a spectrum of changes, ranging from an almost normal vaginal mucous membrane to a skin-like mucous membrane. Neither hormonal status nor postoperative complication, nor the time the graft had been in place, correlated to histology, and we suggest that the varied appearance of the graft epithelium depends on the amount of corium included in the transplant. PMID- 3294198 TI - Establishment of cell cultures from hydatid cysts of Echinococcus granulosus. PMID- 3294199 TI - Erythrocytic schizogony and invasion of Plasmodium vivax in vitro. PMID- 3294200 TI - Investigation of the effect of monocytes with Papua New Guinea sera on Plasmodium falciparum in culture. PMID- 3294201 TI - Review: drug induced akathisia in medical and surgical patients. AB - Drug-induced akathisia is a significant and common iatrogenic disorder. It involves both a subjective component of a disturbing sense of compulsion to move and an objective component of motor restlessness. Akathisia is being seen with increasing frequency in medical and surgical patients. This is due to the increased use of anti-emetics or novel adjuncts to pain control as well as more widespread use of the major psychoactive drugs throughout medicine. This review focuses on diagnostic features of the disorder as well as on possible treatment approaches. In addition, the disorder demonstrates the close anatomic and functional relationship between cortical and subcortical dopaminergic pathways. Akathisia is thus both an increasingly significant clinical problem and a fascinating glimpse at the relationship between brain function and behavior. PMID- 3294202 TI - Antidepressants not effective in headache associated with minor closed head injury. AB - The author compared the response to amitriptyline in headache associated with depression between twelve patients having primary depression (control group) and ten patients with depression after minor closed head injury. In the primary depression group, there was significant reduction in headache and improvement in depression. The minor closed head injury group did not show significant reduction in headache or improvement in depression. The latter group, upon further treatment with phenelzine also showed no reduction in headache or improvement in depression. Results of this study question the earlier reports of the usefulness of amitriptyline in chronic muscle contraction headache and depression associated with minor closed head injury. PMID- 3294203 TI - Streptococcal cell-wall-induced arthritis in rats: an overview. AB - The author summarizes research performed by himself and his colleagues to study chronic erosive arthritis by means of injecting fragments of streptococcal cell walls into rats. By study of rat strains resistant and susceptible to various stages of the disease, as well as the effects of therapeutic drugs, information has been obtained on the pathogenesis of the synovitis and on the role of cellular and humoral factors in regulating inflammatory disease. PMID- 3294204 TI - Influence of joint inflammation on chondrocyte function. AB - Chondrocyte metabolism changes dramatically during joint inflammation. This overview summarizes the potential mechanisms underlying cartilage destruction in experimental arthritis models and provides arguments for a role for various inflammatory mediators. The contributions of both proteoglycan breakdown and impairment of chondrocyte function are discussed. PMID- 3294205 TI - Muscarinic receptors on rat lymphocytes; internalization of receptor-ligand complex. AB - In the light of the data presented, the previously described explanation of the unusual shape of the kinetic curve of the muscarinic antagonist 3H-QNB binding to rat lymphocytes, with apparent maximum of bound radioactivity after 5 min of incubation, followed by decrease of specific binding, is not satisfactory. The kinetics of this binding carried out at 4 degrees C, 20 degrees C and 37 degrees C, or in the presence of the metabolic poison sodium azide, suggests involvement of an energy-consuming mechanism in this process. The surface receptors, sensitive to bacterial protease degradation before 3H-QNB binding, become somehow resistant to this protease action after 5 min of incubation of the cells with 3H QNB. A possible explanation for this phenomenon, based on internalization in cell endosomes, is presented. PMID- 3294206 TI - N-acetyl-beta-glucosaminidase (NAG) and alpha-glycosidase released by PAF in isolated perfused rat kidney. AB - The action of PAF is involved in various biological activities, including alterations at the renal level. Previous experiments of ours have shown that PAF is capable of inducing histamine release at this level, and causing histological damage in the isolated perfused rat kidney. On the basis of these observations, the same experimental model was used to evaluate the release of enzymes such as NAG and alpha-glycosidase, which are precocious markers of renal damage. Results show that both NAG and alpha-glycosidase increase after PAF administration. PMID- 3294207 TI - Studies on inflammation in mice: dynamics of inflammatory response induced by extract from Escherichia coli and influence of antiinflammatory drugs. AB - The intraperitoneal injection of E. coli extract in the mouse resulted in a biphasic accumulation of leukocytes. The first phase of leukocyte accumulation was based on neutrophil influx in the peritoneal cavity, which occurred 1-2 days after E. coli extract administration. The second phase was based on macrophage influx, which occurred 12 days after E. coli extract administration. Preceding the influx of neutrophils in the first phase, the exudation of plasma proteins in the peritoneal fluid occurred at 4 h. A slight increase in plasma exudation accompanied the macrophage influx in the second phase of leukocyte accumulation. These kinetics of the inflammatory response to E. coli extract were similar to those of the inflammatory response to lipopolysaccharide (LPS), suggesting that the inflammatory response induced by E. coli extract administration was mainly due to the effect of LPS, a component of the E. coli extract. Indomethacin reduced the plasma exudation at 4 h but had no influence on the leukocyte accumulation. On the other hand, dexamethasone suppressed the leukocyte accumulation in both phases. PMID- 3294208 TI - A new caverno-spongiosum shunt with saphenous vein patch graft for established priapism. AB - Caverno-spongiosum shunt is the procedure of choice to achieve detumescence in established priapism before fibrosis of erectile tissue causes impotence. The corpora cavernosum and spongiosum, however, possess different suture holding properties. This results in excessive stretch of the urethra postoperatively. This caused a localized urethro-cutaneous fistula in one of our patients. A new technique for constructing the caverno-spongiosum shunt using autogenous saphenous vein patch graft in the remaining patients has been found to be more satisfactory than the conventional procedure. The new procedure, its advantages and its only drawback of increased operating time are described. PMID- 3294209 TI - CT score and the severity of acute pancreatitis. AB - The CT findings in 28 patients with acute pancreatitis were compared with the severity of the disease. The pancreatic image, which demonstrates the pancreatic lesion, was studied with respect to 9 items, and fluid accumulation showing the peripancreatic status with respect to 13 items. According to Forell's classification, the lesion was mild in 8 patients, moderate in 11, and severe in 9. The detection rates of abnormal pancreatic images and fluid accumulation increase with the advance in the severity of the disease. The mean CT score according to severity was 0.9 +/- 0.6 for mild pancreatitis, 7.2 +/- 4.5 for moderate pancreatitis, and 13.4 +/- 4.2 for severe pancreatitis. Significant differences were observed among the groups, suggesting that the CT score is useful for evaluating the severity of acute pancreatitis. PMID- 3294211 TI - The chief scientist reports ... report of the Working Party on Care of the Dementing Elderly: a review of published research and recommendations for future research priorities. PMID- 3294210 TI - Prices of equitable access: the new Massachusetts health insurance law. PMID- 3294212 TI - Anticoagulant and antithrombotic therapy in deep venous thrombosis and pulmonary embolism. PMID- 3294213 TI - A double-blind trial of protriptyline in the treatment of sleep apnea syndrome. PMID- 3294214 TI - Enteric-coated fenoprofen in large-joint osteoarthritis. PMID- 3294215 TI - Malignant lymphoma presenting in gluteal muscles: case report and brief review of the literature. PMID- 3294216 TI - LHRH-immunoreactive structures in the sheep brain. AB - Neural structures containing luteinizing hormone-releasing hormone (LHRH) are characterized in adult ewe and female lamb brains. Three anti-LHRH antisera are used in an immunofluorescent or immunoperoxidase method. On our preparations, all three gave the same results, expressed as number of labelled cells (about 2500 in a whole brain). It was found that 95% of the LHRH-immunoreactive cells are located in the preoptico-hypothalamic area, where cell bodies are localized mainly (50%) in the area surrounding the organum vasculosum of the lamina terminalis (OVLT); they are also found in a more anterior section of the medial part of the olfactory tubercle and the medial septum (14%), in a more posterior situation in the anterior and lateral hypothalamus (16%), and in the mediobasal hypothalamus (15%). Fibres originating in various part of the whole preoptico hypothalamic group reach the OVLT and the median eminence. The remaining cells (5%) and fibres are found in various tel-, di-, and mesencephalic areas. PMID- 3294217 TI - Reflection contrast microscopy. Visualization of (peroxidase-generated) diaminobenzidine polymer products and its underlying optical phenomena. AB - Reflection contrast microscopy (RCM) has proven to be a useful tool for the study of living cells (Ploem 1975). Due to the effective suppression of aspecific reflected light by polarization optics combined with a quarter lambda plate at the front lens of the objective, low intensity reflection signals originating from minor amounts of precipitated diaminobenzidine (DABox) in immunocytochemically stained specimens, can be made visible. RCM has been successfully applied in demonstrating single copy nucleic acid sequences using in situ hybridization procedures (Landegent et al. 1984). We have systematically studied the aspects of image formation of DABox by RCM by using a model system consisting of glass slides coated with peroxidase containing protein layers to determine the conditions for optimal sensitivity of this detection method. Moreover, investigations were performed to study the relationship between the amount of reflected light and DABox depending on the thickness of the object. Both theoretical and practical evidence is obtained to show that DABox detection by RCM is based on interference phenomena occurring in the layer of DABox, and less on selective reflection. This restricts the type of specimen which can be used for sensitive detection of DABox by RCM. Consequently, in ultrathin (40 nm) sections osmificated DABox was visualized in peroxidatic positive cell organelles with high contrast and resolution. Similar results were obtained with immunoperoxidase stained material embedded in Lowicryl under conditions that did not allow visualization of the staining product by bright field microscopy. PMID- 3294218 TI - Ultrasonic assessment of fetal growth: a computer-assisted protocol. PMID- 3294219 TI - Ovarian carcinoma presenting as pneumoperitoneum: report of a case and review of the literature. PMID- 3294221 TI - Ten year index 1977-1986. Volumes 123-149. PMID- 3294220 TI - Spontaneous rupture of esophagus (Boerhaave's syndrome): case report and literature review. PMID- 3294222 TI - Angiotensin II-induced changes in cochlear blood flow and blood pressure in normotensive and spontaneously hypertensive rats. AB - Previous investigations in our laboratory have measured significant increases in the circulating levels of the potent vasoconstrictive hormone, angiotensin II (AII; 26 and 64 pg/100 microliters plasma, normal and noise exposed, respectively), during and following noise exposure in the alert rat (Wright et al., 1981). In the present study, these levels were approximated through intra arterial infusion in the anesthetized spontaneously hypertensive rat (SHR) and normotensive Wistar-Kyoto (WKY) rat. Laser Doppler flowmeter measurements of cochlear blood flow (CBF) indicated that despite equivalent AII-induced elevations in systemic blood pressure, CBF in the SHR did not increase to the levels measured in the WKY. Pretreatment with the specific angiotensin receptor antagonist sarile, (Sar1,Ile8-AII), reduced AII-induced elevations in systemic blood pressure in members of both strains, but did not change the overall pattern of CBF. These results indicate that SHRs may have a compromised cochlear circulation that is refractory to increases in systemic blood pressure. PMID- 3294223 TI - Effects of ionophores on cow herd production: a review. AB - Feeding ionophores to beef cows or replacement heifers fed harvested forages increases weight gain and improves feed efficiency. These responses are influenced by diet quality and body condition of the animal. These compounds may reduce postpartum interval to estrus, but this effect appears to be diminished if nutritional status is poor. Although ionophores do not alter fertility, they decrease age at puberty in the female. These changes in reproductive performance appear to be related to a hormonal response to an increased propionate:acetate ratio in the rumen characteristic of ionophore feeding. Responses to ionophores in milk yield and weight gain improvements in calves of ionophore-fed cows are variable. Length of gestation, incidence of dystocia, calf birth weights and percent calf crop are not altered by ionophore feeding. The potential to improve cow herd production through the use of ionophores depends primarily on forage quality and availability. PMID- 3294224 TI - Strategies to control internal parasites in cattle and swine. AB - The complex relationship between livestock and their parasites is now much better understood. The pattern of infection and reinfection is a dynamic, but predictable, phenomenon that varies with geographic region, production system and grazing system used. Preventive programs that use anthelmintics offer the most efficient approach for grazing animals and confined species. Control strategies have been designed to prevent worm egg production and to limit parasite contamination and infection at critical periods in animal growth cycles. PMID- 3294225 TI - Impact of internal parasites on beef cattle. AB - Internal parasitism is a pervasive constant that reduces returns in beef cattle production. Parasitism may influence production sufficiently so that data derived investigating performance response will be erroneous. The interaction of internal parasites of cattle with other facets of their lives makes it imperative that more parasite research be done on cattle to consider their impact. Results of trials designed to determine forage production at various stocking densities may not reflect the nutritive value of the forage, but instead the severity of parasite exposure. Relative resistance or susceptibility to certain parasites vary with the breed of livestock and the species of parasite. Extensive work to evaluate the ability of various breeds and sires to influence parasitic numbers has been conducted in sheep but not in cattle. Some parasite trials have ignored the effects of nutrition on the establishment and retention of parasites. This becomes especially important where multiple parasite exposure may occur. Susceptible cattle, even on an optimal diet, will become parasitized, but if reexposed to the same species of parasite, cattle on an optimal diet may be able to resist reinfection, whereas those on deficient diets will not. PMID- 3294226 TI - Control of angiotensinogen production by H4 rat hepatoma cells in serum-free culture. AB - A serum-free, hormone and attachment factor supplemented culture for rat H4 hepatoma cells was established. In the defined medium (Dulbecco's Modified Eagle's + Ham's F12 + insulin, transferrin, fibronectin liver cell growth factor, and sodium selenite), H4 cells grew equally well as in 10% fetal bovine serum supplemented medium. H4 cells in either defined or serum-containing culture conditions produce transferrin but not albumin or alpha-fetoprotein. In this paper we have studied the effect of various hormones and pressor peptides on the production of angiotensinogen by H4 cells cultured in defined conditions. Only glucocorticoid hormone had a significant effect on the production of angiotensinogen, whereas other hormones previously reported to exert their effect on angiotensinogen production had little or no effect. PMID- 3294227 TI - Uninfected red cells from malaria-infected blood: alteration of fatty acid composition involving a serum protein: an in vivo and in vitro study. AB - Alteration of uninfected erythrocytes from Plasmodium (the malaria parasite) infected blood remained an open question. In this study we compared the in vivo fatty acid compositions of control and uninfected monkey erythrocytes. A large (40%) increase in the linoleic acid level was observed, which was recovered mostly in neutral lipids. An in vitro system was developed to study medium mediated alterations of cultured erythrocytes by Plasmodium falciparum. The increase in the linoleate level was reproduced in vitro and was also localized in the neutral lipid fraction, especially in triacylglycerols. Studies using proteolytic digestion and heat denaturation showed that a heat-labile serum protein is indispensable for the increase in the linoleate level of red cells treated with the supernatant of P. falciparum cultures. Both the function and the mechanism of this modification of uninfected erythrocytes still remain unknown. PMID- 3294228 TI - Role of platelet factors and serum complement in growth of fibroblasts with high affinity Clq complement receptors. AB - Cultures of human diploid fibroblasts are heterogeneous in that a subpopulation interacts via high-affinity receptors with the globular head regions of the Clq complement protein. Growth and synthetic properties of these cells are characteristic of cells residing in healing wounds and inflammatory lesions. At these sites, fibroblasts are exposed to regulatory molecules such as complement components and factors released from blood platelets. We assessed the effects of native complement proteins and platelet-derived factors on proportions and phenotypic stability of high-affinity and low-affinity receptor cells generated from explants of adult and embryonic connective tissue, using radioligand binding assays and immunofluorescence analysis by flow cytometry. Fibroblasts expressing high-affinity Clq receptors could be generated from explants only when factors from platelets were present in the medium; native complement proteins were not essential. High-affinity receptor cells could be generated only from tissue; they could not be generated by incubating cultures of the low-affinity receptor phenotype in medium containing platelet-derived factors. High-affinity receptor cells, once established from explants in the presence of platelet-derived factors, persisted through many replications in the absence of platelets. We obtained the same fibroblast phenotypes from embryonic skin as from adult gingiva, but the proportion of high-affinity receptor cells from skin was much greater. We conclude that factors derived from platelets are essential for generating cultures containing fibroblasts expressing high-affinity Clq receptors, but not for their maintenance. High-affinity receptor cells may comprise a rapidly dividing subpopulation giving rise only to like progeny or to other, more differentiated cells. PMID- 3294229 TI - Brief overview of the mounting evidence that atherosclerosis is both preventable and reversible. AB - The major life-threatening events in advanced atherosclerosis are precipitated by the plaque. Thrombosis in the muscular arteries and rupture of the large elastic arteries usually follows rupture of the plaque's fibrous cap. The smooth muscle cell (SMC) participates in many aspects of the atherosclerotic process: lipid uptake, synthesis of plaque components, and cell proliferation. The latter is a particularly significant aspect of the disease. High serum cholesterol levels stimulate proliferation of arterial medial cells; low-density lipoproteins (LDL) from hyperlipidemic plaques induce ingress and storage of cholesterol ester. These effects are inhibited by high-density lipoproteins (HDL). Endothelial injury may be an important part of the pathogenesis of some atherosclerotic plaques because powerful growth factors actively stimulate SMC proliferation, even when other risk factors are absent. Utilization of animal models of atherosclerosis, especially nonhuman primate models, has led to great progress in understanding this disease process. In controlled feeding experiments, severe atherosclerosis has been produced in rhesus monkeys by means of a high fat, high cholesterol diet. Animals then placed on a low fat, low cholesterol diet, or given cholestyramine, or a combination of these two approaches, showed a remarkable decrease in the size of their atherosclerotic plaques. Many epidemiologic studies, as well as more recent prospective intervention studies involving bile acid sequestrants, indicate by imaging techniques that plaque regression takes place in humans. PMID- 3294230 TI - Treatment of familial hypocholesterolemia by means of specific immunoadsorption. PMID- 3294231 TI - Removal of low-density lipoproteins (LDL) and fibrinogen by precipitation with heparin at low pH: clinical application and experience. AB - The clinical application of a new extracorporeal procedure (HELP) for the selective elimination of low-density lipoproteins and fibrinogen by heparin precipitation at acid pH is described. Plasma, obtained by filtration of whole blood through a 0.2 micron filter is continuously mixed with an equal volume of an acetate buffer (pH 4.85) containing heparin. After removal of the precipitated heparin complex by filtration, excess heparin is adsorbed to a specially developed filter, and the clear plasma filtrate is subject to bicarbonate dialysis/ultrafiltration to restore physiologic pH and remove excess fluid. The calculated efficiency for the elimination of low-density lipoproteins and fibrinogen from plasma by HELP is 100% and is therefore comparable to conventional plasmapheresis. However, the HELP system shows a high degree of specificity, with over 80% of total protein being returned to the patient. A total of over 350 treatment procedures have now been performed. Patient compliance and acceptance have been excellent, and no major complications have been observed. The system is therefore suitable for the treatment of severe hyper beta-lipoproteinemia; its use for the treatment of coronary heart disease is currently under investigation in a prospective multicenter study in which treatment efficiency will be controlled by coronary angiography on 45 patients treated with HELP over a period of 2 years. PMID- 3294232 TI - Issues and trends affecting plasma selection for use in further manufacture: worldwide. PMID- 3294233 TI - [Evaluation of the activity of leukocytes during experimental periodontitis in the monkey]. AB - Polymorphonuclear leucocytes play an important role in the defense mechanisms and destruction of periodontal tissues. The leucocytes number and activity were compared during an induced periodontitis in 3 Cercopithecus cephus. On day 0, the 3 animals presented a localized marginal gingivitis. On 2 animals a severe marginal periodontitis was induced unilaterally: 42 days later leucocytes were sampled in the peripheral blood, in the gingival blood and in the gingival sulcus on the experimental and control sites as well as on the 2 hemijaws of the control animal. For each sample, a leucocyte count and a chemiluminescence test were done. Different results related to the disease severity were obtained with these tests for gingival blood and sulcular fluid. PMID- 3294234 TI - Thermotolerance induced by heat, sodium arsenite, or puromycin: its inhibition and differences between 43 degrees C and 45 degrees C. AB - When CHO cells were treated either for 10 min at 45-45.5 degrees C or for 1 hr with 100 microM sodium arsenite (ARS) or for 2 hr with 20 micrograms/ml puromycin (PUR-20), they became thermotolerant to a heat treatment at 45-45.5 degrees C administered 4-14 hr later, with thermotolerance ratios at 10(-3) isosurvival of 4-6, 2-3.2, and 1.7, respectively. These treatments caused an increase in synthesis of HSP families (70, 87, and 110 kDa) relative to total protein synthesis. However, for a given amount of thermotolerance, the ARS and PUR-20 treatments induced 4 times more synthesis than the heat treatment. This decreased effectiveness of the ARS treatment may occur because ARS has been reported to stimulate minimal redistribution of HSP-70 to the nucleus and nucleolus. Inhibiting protein synthesis with cycloheximide (CHM, 10 micrograms/ml) or PUR (100 micrograms/ml) after the initial treatments greatly inhibited thermotolerance to 45-45.5 degrees C in all cases. However, for a challenge at 43 degrees C, thermotolerance was inhibited only for the ARS and PUR-20 treatments. CHM did not suppress heat-induced thermotolerance to 43 degrees C, which was the same as heat protection observed when CHM was added before and during heating at 43 degrees C without the initial heat treatment. These differences between the initial treatments and between 43 and 45 degrees C may possibly be explained by reports that show that heat causes more redistribution of HSP-70 to the nucleus and nucleolus than ARS and that redistribution of HSP-70 can occur during heating at 42 degrees C with or without the presence of CHM. Heating cells at 43 degrees C for 5 hr after thermotolerance had developed induced additional thermotolerance, as measured with a challenge at 45 degrees C immediately after heating at 43 degrees C. Compared to the nonthermotolerant cells, thermotolerance ratios were 10 for the ARS treatment and 8.5 for the initial heat treatment. Adding CHM (10 micrograms/ml) or PUR (100 micrograms/ml) to inhibit protein synthesis during heating at 43 degrees C did not greatly reduce this additional thermotolerance. If, however, protein synthesis was inhibited between the initial heat treatment and heating at 43 degrees C, protein synthesis was required during 43 degrees C for the development of additional thermotolerance to 45 degrees C.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294235 TI - Extracellular matrix assembly of cell-derived and plasma-derived fibronectins by substrate-attached fibroblasts. AB - Using a previously described model system for the incorporation of plasma fibronectin into the extracellular matrix (McKeown-Longo, P.J. and Mosher, D.F., 1985. J. Cell Biol., 100:364-374), we compared the binding of cell-derived and plasma-derived fibronectins to human fibroblast cell layers. Binding was measured in time course experiments using metabolically labeled cell-derived, iodinated cell-derived, and iodinated plasma-derived fibronectins. The kinetics of matrix assembly of cell- and plasma-derived fibronectins were the same. Competitive binding curves using intact fibronectin or the 70-kD amino-terminal fragment of fibronectin suggested that cell surface binding sites have equal affinity for cell- and plasma-derived fibronectins. Iodinated fibronectins did not bind to isolated matrices containing collagen type I, fibronectin, and thrombospondin. These results suggest that fibroblasts do not distinguish between cell-derived and plasma-derived fibronectins when assembling exogenous fibronectin into extracellular matrix. PMID- 3294236 TI - Epidermal growth factor-dependent growth of human KB cells in a defined medium and altered growth factor requirements of KB mutants resistant to EGF-Pseudomonas exotoxin conjugates. AB - A serum-free culture system was established for human KB carcinoma (HeLa) cells that consisted of a chemically defined medium and several growth factors including epidermal growth factor (EGF), insulin, transferrin, hydrocortisone, and ethanolamine. EGF and insulin showed the greatest effects on the growth rate of KB cells. Insulin-like growth factor I (IGF-I) at the same concentration as insulin stimulated cell growth less than insulin. Transferrin, hydrocortisone, or ethanolamine had no growth-stimulatory effects alone but were stimulatory when combined with EGF and/or insulin. Transforming growth factor-beta inhibited growth and triiodothyronine stimulated growth. The growth factor requirements were established for several KB mutants with low EGF receptor levels that had been selected for resistance to a conjugate of EGF with Pseudomonas exotoxin (EGF PE). Three of five KB mutants did not respond to EGF; two other mutants responded to a lesser extent than the parental KB cells. Four mutants had a reduced response to insulin and responded to T3; one mutant (ET-30) responded to neither. These results indicate that KB cells selected for EGF-PE resistance have lost their growth response to EGF and illustrate the usefulness of serum-free medium for studying the growth factor requirements of mutants with altered receptor levels. PMID- 3294237 TI - Temperature-sensitive Chinese hamster cell mutant with a defect in glycoprotein synthesis: accumulation of the EGF receptor in the endoplasmic reticulum and the role of the glucose-regulated protein GRP78. AB - A temperature-sensitive mutant of Chinese hamster fibroblasts with a defect in glycoprotein synthesis is investigated after transfection and amplification of the gene for the human EGF receptor. We demonstrate that at the nonpermissive temperature a partially glycosylated species of the receptor accumulates in the endoplasmic reticulum. The oligosaccharides present are the high mannose types, since they can be removed completely by treatment with endoglycosidase H. Pulse chase experiments show that the abnormal species of the receptor cannot be chased to a form that is either resistant to endoglycosidase H, or altered in its mobility on SDS polyacrylamide gels. The abnormal species of the receptor appears within the first hour of a shift to the nonpermissive temperature, and no further changes are observed upon prolonged incubation of cells at 40 degrees C. However, after 3-4 hours immunoprecipitations of the receptor yield another protein, which has properties very similar, if not identical, to the glucose-regulated protein GRP78. The induction of this protein at 40 degrees C can be suppressed completely with an inhibitor of RNA synthesis, without any effect on the glycosylation defect, or on the accumulation of the EGF receptor in the endoplasmic reticulum. PMID- 3294238 TI - In vitro studies on adult cardiac myocytes: attachment and biosynthesis of collagen type IV and laminin. AB - The interactions between adult rat cardiac myocytes and the basement membrane components collagen type IV and laminin were investigated in attachment experiments and biosynthesis studies and by immunofluorescence staining. Adult myocytes attached equally well to native collagen type IV and laminin but did not attach to collagen type IV solubilized with pepsin (P-CIV) or to collagen type I. However, when laminin was used to coat P-CIV, attachment was enhanced. Affinity purified antibodies against laminin inhibited the attachment of myocytes to dishes coated with native collagen type IV, indicating that cell surface-bound laminin mediated attachment of the cells to this substrate. Immunofluorescence staining of freshly isolated myocytes, using antibodies against laminin or collagen type IV, revealed the presence of laminin but not of collagen type IV on the surface of freshly isolated cells, indicating that during the isolation procedure collagen IV was removed from the cell surface. Metabolic labeling followed by immunoprecipitation demonstrated synthesis of both laminin and collagen type IV in cardiac myocytes as they progressed into culture over a 14 day period. This synthesis was accompanied by the deposition of the collagen type IV and laminin into distinctly different patterns as revealed by immunofluorescence staining. As the cells progressed into culture, newly synthesized laminin formed a network radiating from the center of the reorganizing cell into the pseudopods. The laminin was redistributed and remodeled with time in culture to form a dense layer beneath the cell. Collagen type IV was also synthesized with time in culture, but the pattern was a much finer network as opposed to the denser pattern of laminin staining. These studies demonstrate that adult cardiac myocytes synthesize and remodel the basement membrane as they adapt to the culture environment. PMID- 3294239 TI - Sodium butyrate induces differentiation in breast cancer cell lines expressing the estrogen receptor. AB - Addition of sodium butyrate (NaB) to 6 cultured human breast carcinoma cell lines results in a dose and time-dependent growth inhibition. Kinetic evidence, related to the growth of a minority cell population which decreases in size with time of exposure, is presented to indicate that the NaB effect is reversible. In those cell lines that express the estrogen receptor (ER), growth inhibition is accompanied by a more differentiated phenotype, which is characterized by increased accumulation of lipid and milk-fat globule membrane glycoproteins. The potential for differentiation is not blocked by tamoxifen, indicating that the relationship to ER expression is likely secondary to the association of ER expression with a particular stage of secretory cell differentiation that is susceptible to NaB induction. Of the 3 lines shown to respond in this way (MCF-7, ZR-75-1, and MDA-134), ZR-75-1 is an extreme example that may serve as a model for studies of gene expression during human mammary epithelial cell differentiation. PMID- 3294240 TI - Biomechanics of tendon transfers. AB - There are just two variables that define the mechanical qualities of each muscle. One is its potential for generating tension, and the other is the distance through which tension can be exerted. Tension capability can be increased in a muscle by exercise. There is no way to increase potential for excursion except by reattaching a muscle at surgery with extra length and tension, at the risk of involuntary contractions during healing that may result in avulsion. Single muscle may control several joints in series but cannot selectively vary the torque delivered at each. Therefore, when working against distal opposing forces, it is necessary to have separate muscles to add torque to proximal joints; or it may be advisable to reduce the number of joints to be controlled by fusing one or more of them, or sometimes by depending on tenodesis or other passive support. PMID- 3294241 TI - Tendon transfer for median nerve palsy. AB - A large number of tendon transfers have been described that restore opposition to the thumb and provide thumb and finger flexion. To provide optimal results following tendon transfers, one needs to follow the principles of tendon transfer: normal tissue equilibrium, movable joints, and a scar-free bed. Once these are present, we must look to available tables to determine an appropriate tendon transfer, matching up the lost muscle mass, fiber length, and cross sectional area and then pick out muscle-tendon units of similar size, strength, and potential excursion. For low median nerve palsy (Table 4), we have found from our experimental and clinical studies that the FDS of the long and ring fingers or the wrist extensors (ECR or ECRL) best approximate the force and motion required for full thumb opposition and strength. These transfers are preferred in median nerve palsy or combined median ulnar nerve palsy when both strength and motion are required. In circumstances where only thumb mobility is desired, the EIP is an ideal transfer. Also, the extensor digitorum quinti (EDQ) and ADQ have sufficient mean fiber length (muscle excursion) to provide full thumb opposition. The palmaris longus transfer (Camitz transfer) is an abduction rather than an opposition transfer and should be reserved for selected cases of long-term carpal tunnel syndrome. For high median nerve palsy (Table 5), transfers of the brachioradialis or ECRL to restore lost thumb flexion (FPL) and side-to-side transfer of the FDP of the index finger are generally sufficient. A separate transfer to restore independent flexion of the index finger could be performed by utilizing the pronator teres or extensor carpi radialis ulnaris tendon muscle units. As they combine a proper direction of action, pulley location, and tendon insertion, tendon transfers for median nerve palsy are usually quite successful. In considering any of these elective procedures, however, it is important to remember that tendon transfers are muscle balance operations. The effect of transfer on restoring function must be carefully studied to assess the loss of function that such a transfer may endure. PMID- 3294242 TI - Tendon transfers for ulnar nerve palsy. Evaluation of results and practical treatment considerations. AB - Tendon transfers for correction of clawing deformity in ulnar nerve palsy are only consistently successful in young ligamentously lax individuals. Correction of deformity is most inconsistent in the intrinsically stiff hands of older individuals. Correction of clawing is more difficult in the little finger than in the ring finger. While use of the flexor digitorum superficialis for intrinsic transfer simply corrects clawing deformity and restores synchronous finger flexion, grip strength will be further decreased by approximately 21 percent, and total active range of motion by 7 percent. Correction is best achieved by transfer of a wrist motor with tendon graft into index, middle, ring, and little digits, despite limitation of clawing to the ring and little digits. Pinch should be augmented by metacarpophalangeal joint fusion rather than by interphalangeal joint fusion. When combined with extensor carpi radialis brevis adductor plasty, pinch strength can be doubled. PMID- 3294243 TI - Radial nerve palsy. AB - The anatomy of the radial nerve, functional loss from nerve damage at various levels, timing of tendon transfers, choices of tendon motors for transfer, and operative and postoperative management have been discussed. My preference of transfers for complete radial nerve palsy is: (table: see text). PMID- 3294244 TI - Tendon transfers for combined nerve injuries. AB - The patient with an upper extremity affected with multiple nerve injuries will require multiple surgical procedures for reconstruction by tendon transfer. Successful reconstruction will be based on a simple plan that adheres to the basic principles of tendon transfers, as well as the more detailed principles of combined nerve injuries. When completed, the reconstruction will only redistribute the few specific assets that are available and therefore cannot be expected to create normally functional hands. PMID- 3294245 TI - Management of the upper extremity in traumatic tetraplegia. AB - The management of the upper extremity in traumatic tetraplegia is complex and extremely important for the rehabilitation of the patient. The evolution of present management is reviewed. The evaluation and classification of the tetraplegic patient is discussed with general recommendations for treatment. PMID- 3294246 TI - Tendon transfers about the shoulder and elbow in the spinal cord injured patient. AB - Since the initial description of Moberg's technique for posterior deltoid transfer in the spinal cord injured patient, ever-increasing attention has been paid to the functional importance of elbow extension. Many different centers have reported consistently good results with the procedure and have repeatedly confirmed that relatively little donor site morbidity occurs from loss of the posterior fibers of the deltoid muscle. With expanding experience, the only consistent difficulties have been those related to the length of time required for postoperative immobilization and the slow rate of rehabilitation that must be enforced to avoid elongation of the interposed toe extensor tendon grafts. Modifications of the initial technique have been mentioned that attempt to address these postoperative factors. PMID- 3294247 TI - Surgical reconstruction of the upper extremity in cerebral palsy. AB - This article discusses surgical treatment of the upper extremity in cerebral palsy. Such treatment should provide a balanced grasp and release, a reasonable range of pronation and supination of the forearm, and should maintain sufficient strength for hand function. PMID- 3294248 TI - Tendon transfers for brachial plexus injury. AB - Brachial plexus injuries result in severe functional deficits in the upper limb. The authors review a group of 74 patients with brachial plexus injuries who underwent 160 tendon transfer operations, as well as 94 additional procedures, in an attempt to augment lost function. Following evaluation of functional recovery, 58 percent of the patients were rated Good, 34 percent Improved, and 8 percent Unimproved. The authors conclude that significant benefit can be obtained by peripheral reconstruction and tendon transfers in patients with brachial plexus injuries. PMID- 3294249 TI - Tendon transfers for elbow flexion. AB - This article reviews the causes of loss of elbow flexion. It outlines the necessary preoperative considerations for elbow flexorplasty. The techniques, advantages, and disadvantages of flexorplasty, including the Steindler, pectoralis major, triceps, sternocleidomastoid, and latissimus dorsi, are discussed. PMID- 3294250 TI - Tendon transfers in surgery of the rheumatoid hand. AB - Tendon transfer procedures are used in the reconstructive surgery of the rheumatoid hand in cases of tendon ruptures, deformities, and compression neuropathies with subsequent muscle atrophy. The prerequisites and essential principles for tendon transfers are discussed, including the following: 1) correction of contractures, 2) adequate power of the muscle, 3) sufficient amplitude, 4) straight line of pull, and 5) maintenance of the integrity of the muscle. PMID- 3294251 TI - Timing of tendon transfers in peripheral nerve injury. AB - The purpose of tendon transfers is not so much to gain strength as to gain the ability to place the extremity in position to fully utilize the remaining functional muscle-tendon units. PMID- 3294252 TI - Strengthening of the partially paralyzed shoulder girdle by multiple muscle tendon transfers. AB - Strength and stability of the shoulder girdle affect function of the entire upper extremity. Isolated muscle weakness may be compensated for by adjacent muscles; however, profound weakness of the deltoid muscle, for example, affects not only placement of the extremity, but also strength and endurance of the forearm and hand. Orthotic substitutes for weakened muscles are not successful. If the muscle weakness is nonprogressive and stable, then surgical treatment will improve glenohumeral stability, increase endurance, and provide more uniform strength for many activities of daily living. PMID- 3294253 TI - Monoclonal antibody 14E identifies the oligodendrocyte cell body in normal adult human and rat white matter. AB - A monoclonal antibody, 14E, which detects immunocytochemically the perikarya of interfascicular oligodendrocytes in sections of normal adult human and rat white matter, was obtained using isolated normal human oligodendrocytes as the immunogen. 14E is an IgM antibody that reacts with a polypeptide of approximate molecular weight 23,000 on immunoblots of the particulate fraction of normal white matter. In sections of active multiple sclerosis plaques and recent infarcts, 14E immunostained the cell bodies and processes of only a small number of hypertrophic glial cells which could be oligodendrocytes undergoing pathological changes or a subpopulation of reactive astrocytes. PMID- 3294254 TI - Primary cutaneous leiomyosarcoma. A histological and immunohistochemical study of 9 cases, with ultrastructural correlation. AB - Leiomyosarcoma (LMS) of dermal and subcutaneous tissues is an uncommon neoplasm. In order to analyze the specialized pathologic features of this tumor, we undertook a histological, ultrastructural, and immunohistochemical study of 9 superficial LMS, including 7 dermal lesions and 2 subcutaneous neoplasms. These were compared with 12 examples of "deep" extracutaneous LMS. Metastases to the skin from two of the latter neoplasms were also examined. Immunohistochemistry was found to be a useful diagnostic adjunct to light microscopic and ultrastructural studies in that all LMS coexpressed vimentin and desmin, regardless of site, and 90% also expressed muscle-specific actin. Variable expression of cathepsin B and myelin basic protein was noted in 8 and 10 tumors, respectively, whereas none contained cytokeratin. Weak cytoplasmic positivity for epithelial membrane antigen was seen in 1 dermal and 3 extracutaneous LMS. Of 7 dermal LMS, 4 contained S-100 protein, whereas this determinant was found in only 1 of 12 extracutaneous tumors. Conversely, Leu 7 reactivity was present in 7 of 12 extracutaneous LMS, but only 2 of 9 superficial lesions. Review of clinical features confirmed that subcutaneous LMS is capable of aggressive behaviour, whereas dermal LMS was more likely to behave in an indolent fashion. However, one example of dermal LMS exhibited aggressive local recurrences and distant metastasis, ultimately leading to the death of the patient. Therefore, careful clinical followup is indicated in all cases. PMID- 3294255 TI - Scrotal calcinosis: origin from dystrophic calcification of eccrine duct milia. AB - Scrotal calcinosis is a rare benign disorder considered idiopathic by most recent authors, although an origin from dystrophic calcification of epidermoid cysts has been proposed. In 3 of 4 cases which were otherwise typical of scrotal calcinosis, there was calcification of the contents of small cysts lined by stratified squamous epithelium. These structures were identified as eccrine duct milia because some of them communicated with eccrine ducts and there were ultrastructural features of eccrine duct differentiation in one case. The eccrine nature of the milia was confirmed using the immunoperoxidase technique for the demonstration of carcinoembryonic antigen (CEA) which serves as a marker of eccrine sweat glands. Since a transition could be seen between degenerating calcified milia and typical nodules, it appeared that the calcific deposits of scrotal calcinosis result from the breakdown of such lesions. Staining of deposits unassociated with cyst walls with the technique for the demonstration of CEA supported this conclusion. An advanced stage of evolution of the disease could account for the absence of visible cysts in many cases. We propose the term "hidrocalcinosis of the scrotum" for this distinctive form of cutaneous calcification. PMID- 3294256 TI - Rabbit model of disseminated syphilis: immunoblot and immunohistologic evidence for a role of specific immune complexes in lesion pathogenesis. AB - Circulating immune complexes (CIC) containing Treponema pallidum proteins have been preliminarily implicated as inducers of a neutrophilic vascular reaction in early human cutaneous lesions of secondary syphilis. To clarify the role of specific CIC in producing cutaneous and renal lesions, 12 rabbits were studied at the following intervals after induction of disseminated syphilis: 20 days (4 rabbits: biopsies of normal and lesional skin for direct immunofluorescence (IMF) for (IgG, IgM, IgA, Clq, C3, C4), fibrin, and T. pallidum proteins; routine histology; and immunoblots of serum for CIC containing T. pallidum proteins); 21 days (4 rabbits: as at 20 days without IMF for T. pallidum protein); 23 days (4 rabbits: as at 20 days without IMF); 30 days (same 12 rabbits restudied with routine histology of normal and lesional skin; kidneys from 4 rabbits removed for routine, IMF, and electron microscopy (EM). Treponemal polypeptide antigen (MW-87 kd) was demonstrated in CIC from rabbits. Routine cutaneous histology showed evolution of lesions from an early neutrophilic vascular reaction to the typical lymphoplasmacytic reaction. IMF showed vessel-based immunoreactants in 3 of the 4 rabbits tested at 20 days and 1 of 4 at 21 days, and T. pallidum proteins in 3 of 4 rabbits at 20 days. Routine histology, IMF, and EM studies of glomeruli showed glomerular abnormalities, but no evidence of immune deposits containing specific T. pallidum protein. Skin and kidney studies of 4 controls were all negative. These data indicate a role for specific immune complexes in the pathogenesis of cutaneous lesions in this rabbit model. PMID- 3294257 TI - Nonesterified fatty acids and glucose in lactating dairy cows: diurnal variations and changes in responsiveness during fasting to epinephrine and effects of beta adrenergic blockade. AB - To examine whether the typical nightly rise of nonesterified fatty acids in high yielding dairy cows is due to enhanced sympathoadrenal activity, the beta adrenergic blocker, propranolol, was infused from 1800 to 0805 h. Concentrations of nonesterified fatty acids continuously increased, whereas those of glucose and insulin decreased. Nonesterified fatty acid concentration decreased within minutes in response to concentrate feeding, starting at 0700 h, in association with an increase of insulin and glucose. In a second experiment, adrenaline (.82 mumol/kg/min) was infused from 1800 to 1810 h, 0600 to 0610 h, and 0600 to 0610 h on the 1st, 2nd and 3rd d. After the second infusion, food was withdrawn for 23 h. Concentrations of adrenaline increased similarly. Nonesterified fatty acids and glucose responses were higher during the second than the first infusion. During fasting, nonesterified fatty acid concentrations increased, whereas glucose and insulin concentrations decreased. During the third infusion nonesterified fatty acids responses were unchanged, whereas glucose responses were decreased. Thus, the nightly rise of nonesterified fatty acids was not the consequence of enhanced beta-adrenergic activity. Responses of glucose and nonesterified fatty acids to adrenaline exhibited diurnal differences. Responses of glucose to adrenaline were reduced within 1 d of fasting, whereas those of nonesterified fatty acids were not altered. PMID- 3294258 TI - Epidemiology of cardiovascular diseases. PMID- 3294259 TI - Smoking, stress, and coronary heart disease. PMID- 3294260 TI - Dietary risk factors and their modification in cardiovascular disease. PMID- 3294261 TI - Primary prevention of cardiovascular disease: communitywide strategies for youth. PMID- 3294262 TI - Occupational health promotion programs to reduce cardiovascular risk. PMID- 3294263 TI - Rehabilitation of patients following myocardial infarction. PMID- 3294264 TI - Health-related quality of life in cardiovascular disease. PMID- 3294265 TI - Two studies of the long-term follow-up of minimal therapist contact treatments of vascular and tension headache. PMID- 3294266 TI - Effectiveness of behavioral marital therapy: empirical status of behavioral techniques in preventing and alleviating marital distress. PMID- 3294267 TI - Impact of ozone depletion on skin cancers. AB - Because of recent growth in the uses and production of certain chlorofluorocarbon compounds, the ozone layer is at risk of diminishing. The major effect of a decrease in ozone will be an increase in the amount of UV-B radiation in sunlight. Even a small increase in UV-B radiation will almost certainly affect human health. The most obvious effect of increased UV-B radiation will be an increase in the incidence of basal and squamous cell carcinomas. Other possible effects include a contribution to the development of cutaneous melanoma, ocular changes leading to the formation of cataracts, and immunologic perturbations. PMID- 3294268 TI - Nonsurgical treatments for skin cancer: retinoids and alpha-interferon. AB - Retinoids, the natural and synthetic analogs of vitamin A, and alpha-interferon have been used effectively in the treatment of certain cutaneous premalignancies and malignancies. Retinoids have shown impressive activity against premalignant disorders of the skin (actinic keratoses, keratoacanthoma, epidermodysplasia verruciformis) and of other epithelial sites (oral leukoplakia, cervical dysplasia). In established basal cell skin cancers, topical retinoid treatment has produced a complete response rate of 33%, and systemic retinoids have produced an objective response rate of 51%. In advanced squamous cell skin cancers, systemic retinoids have produced a response rate of over 70%. Intralesional alpha-interferon has produced impressive responses and systemic alpha-interferon has produced a 50% objective response rate in basal and squamous cell carcinoma. Retinoid therapy and alpha-interferon have produced modest overall results in melanoma, although striking individual responses have been reported. In cutaneous T-cell lymphoma, which is notably refractory to chemotherapy, retinoids and alpha-interferon have produced responses in 60%+ and 70%+ of cases, respectively. Retinoids and alpha-interferon, either alone or in combination, offer exciting prospects for primary and neoadjuvant therapy for advanced malignancy. Retinoids also show promise as relatively nontoxic preventive and adjuvant therapy. Researchers should focus on integrating these drugs with other biological response modifiers, differentiation agents, and cytotoxic drugs for treating advanced malignancy. PMID- 3294269 TI - The biology of melanoma metastasis. AB - The process of cancer metastasis is sequential and selective and contains stochastic elements. The growth of melanoma metastases represents the endpoint of many lethal events that few tumor cells can survive. Primary tumors consist of multiple subpopulations of cells with heterogeneous metastatic properties, and the outcome of metastasis depends on the interplay of metastatic tumor cells with various host factors. This viewpoint is more optimistic than that of metastasis as a random process. A selective biological process is regulated by the interaction of tumor cells with their host, and these complex interactions can now be studied and manipulated. PMID- 3294270 TI - Prevention of skin cancer. AB - Our understanding of the carcinogenic process as it relates to human skin cancer is growing rapidly. As this understanding increases, so will our ability to alter the process in a positive fashion. Presently, sun exposure is known to be the major carcinogen in human skin. The use of sunscreens is, and will continue to be, the most effective method of preventing human skin cancer. As these agents become more effective, especially against long-wave UV radiation, and as patients begin to use them more conscientiously, we should experience a decrease in skin cancer rates. In addition, a number of chemical agents are presently being investigated as anticarcinogens, especially in those patients who are at high risk for the development of skin cancers. A number of these hold promise as safe and effective chemopreventatives in reducing the morbidity and mortality of cancer in human skin. PMID- 3294271 TI - The social mandate and historical basis for nursing's role in health promotion. PMID- 3294272 TI - 24th Lenna Frances Cooper memorial lecture: nutrition--policies and politics. PMID- 3294273 TI - Effects of fructose feeding on blood parameters and blood pressure in impaired glucose-tolerant subjects. AB - The effects of fructose and glucose on selected blood parameters and blood pressure after 4 weeks of oral ingestion were investigated in nine impaired glucose-tolerant subjects (IGTS) and nine normal glucose-tolerant subjects (NGTS). The criteria for IGTS were (1) 1- or 2-hour postprandial glucose levels between 160 and 200 mg/dL (8.8 to 11.1 mmol/L); (2) compliance with the diet; and (3) no cardiac or renal complication. The mean increment in the area under the plasma glucose and insulin curves after a glucose load was significantly greater following glucose than following fructose ingestion in both IGTS and NGTS (p less than .05). Glycosylated hemoglobin was greater after glucose than after fructose ingestion in IGTS and NGTS (71 gm/L vs. 61 gm/L in IGTS; 61 gm/L vs. 59 gm/L in NGTS). Serum triglyceride level in IGTS fed glucose was 173 mg/dL (1.90 mmol/L), whereas in those fed fructose, it was 154 mg/dL (1.69 mmol/L). Serum cholesterol was also greater after glucose than after fructose ingestion in all subjects. However, the differences were not statistically significant. Urate, pyruvate, and lactate levels were significantly greater in IGTS fed glucose than in IGTS fed fructose. Systolic and diastolic pressures were lower in IGTS fed fructose than in IGTS fed glucose. The present study shows that a 4-week oral ingestion of moderate amounts of fructose appears to have more benefits than an equivalent glucose ingestion in both IGTS and NGTS. However, greater benefits were found in IGTS than in NGTS. PMID- 3294274 TI - Aging and visual information processing: potential implications for everyday seeing. AB - A review of research examining the effects of aging on visual perception from the perspective of psychological theories of information processing shows that the average speed of processing for groups of older adults is slower than for groups of young adults in most stages of perceptual processes. However, studies examining the correlation of processing speed between separate stages within individuals shows little evidence of general slowing in the nervous systems of individual elderly subjects. The implications of performance decrements at each stage of visual processing are considered for a variety of everyday seeing activities. It is concluded that age-related decrements in visual selective attention processes offer the greatest threat of impairment to many everyday seeing activities. PMID- 3294275 TI - A geriatric optometry residency. AB - Increasing demands for vision care for the elderly will result in increasing needs for specialty skills in optometry. Examples of such skills include management of degenerative eye disease, rehabilitation of impaired visual functions, assessment of psychosocial dysfunction, and interdisciplinary health team participation. This article shows how a geriatric optometry residency differs from the general optometric curriculum, and from other types of residencies, in preparing the optometrist to meet the special needs of the geriatric population. PMID- 3294276 TI - Diagnosis and management of macular holes. AB - A macular hole is an important clinical entity which the practicing optometrist may encounter during the course of examination. The vast majority of macular holes are idiopathic, however, there is a wide array of macular disorders which may stimulate a true macular hole. A case report of bilateral idiopathic macular holes is presented with a discussion and differential diagnosis to assist clinicians in effectively managing this anomaly. PMID- 3294277 TI - The use of dye-ligand affinity chromatography for the purification of non enzymatic human plasma proteins. AB - Literature data are analysed in this review on the use of immobilized triazine dyes for the characterization, isolation and purification of non-enzymatic human plasma proteins in both conventional and high-pressure liquid chromatography systems. Attention is focused on the mode of interaction between the dyes and these proteins, as well as on the advantages over previously reported techniques. Future developments are discussed. PMID- 3294278 TI - [Perinatal bereavement. Psychopathology and counseling]. AB - Perinatal death entails bereavement for the family and confusion for the care givers. In the light of a brief theoretical study of grief, the present article reviews the difficulties and complications of parental grief and the propositions for support and counselling. The most recent works in the subject as well as topics for future research are emphasized. Perinatal bereavement is followed by severe complications: depression, psychosis for mothers, mainly following the next live birth; family disagreement; disturbances, running away, drug, suicide among already born or future children, especially for the replacement child. Professional behaviour: listening, letting see the dead baby, offering possibilities for the expression of the emotions, is followed by gratitude from the parents instead of annoyance due to the usual conspiracy of silence. Bereavement outcome is furthered by the new management. More research is needed about maternal risk factors and prevention of parental grief repercussions on their children. PMID- 3294279 TI - [Outcome of pregnancy in patients exposed in utero to diethylstilbestrol. Survey by the National College of French Gynecologists and Obstetricians]. AB - This study analyses the outcome of 110 pregnancies that occurred in 57 patients who were exposed to DES (DiEthylStilboestrol) during their fetal life. The quantities of Distilbene that were received in the first trimester of the pregnancy were the same in France and in the United States. The obstetrical complications of exposure in utero to DES were identically the same in France and in the United States. Of particular note is the high level of extra-uterine pregnancies (15%) and of 1st and 2nd trimester miscarriages (42%). Only 41% of the population exposed to DES delivered a live baby. It is estimated that 80,000 women were exposed to it in France. Exposure in utero to DES has given rise to a public health problem. PMID- 3294280 TI - [Placentocentesis, a new technic in the prenatal diagnosis of chromosome aberrations in the 3d trimester. A preliminary study apropos of 5 cases]. AB - The authors report 5 cases in which placentocentesis was used for late antenatal diagnosis between the 25th and 34th week of amenorrhoea. As the placenta was anteriorly placed, samples were obtained by aspiration through the abdominal route under ultrasound control. The fetal karyotype could be determined in 2 days using a direct method. It showed normal chromosome pictures in all 5 cases. There was no complication in any of these cases following the procedure. PMID- 3294281 TI - [Premature failure of the ovaries]. AB - The premature ovarian failure syndrome has been reviewed on the basis of existing data. The frequency, clinical picture and diagnostic procedures of premature ovarian failure are discussed. The disorder is characterized by secondary amenorrhea with constant estrogen deficiency and elevated gonadotropin levels in the post-menopausal range. Differential diagnosis is to be made with pituitary adenomas secreting gonadotropin, circulating gonadotropin antibodies, and biological profiles typical of the peri-menopausal years. Histopathology distinguishes two principal forms of premature ovarian failure: the premature menopause with complete follicular depletion of the ovaries, and the insensitive ovary syndrome. A correct ovarian biopsy is important for this diagnosis and can also help to point toward an immunological etiology. The following causes of premature menopause are analysed: chromosomal abnormalities, autoimmune disorders, viral infections and galactosemia. The toxic and iatrogenic causes are not developed. The factors eventually implicated in the insensitive ovary syndrome are discussed: deficient biological activity of gonadotropins, the presence of inhibitor substances preventing hormone action and the presence of antibodies toward FSH receptors. In the management of premature ovarian failure, a possible autoimmunization has to be considered. When an immunological disorder is suspected, other autoimmune glandular failures, that may develop secondarily, have to be detected. From the 26 pregnancies reported after a diagnosis of the insensitive ovary syndrome, only two occurred after a correct ovarian biopsy. Those cases seem to indicate that reducing endogenous gonadotropins to normal levels is important before considering induction of ovulation. PMID- 3294282 TI - [Lymphoceles and peritonization following lymphadenectomy for cancer of the uterus]. AB - Pelvic lymphocysts following lymphadenectomy in the management of cervical and corporeal uterine carcinoma are recorded in one third of the cases and require surgery in 2-3% of cases. In order to prevent these lymphocysts, peritoneal suturing in front of the lymph node dissection area was progressively abandoned in order to allow peritoneal resorption of the lymph. A retrospective study analysed 226 iliac lymphadenectomies between 1982-1986 for uterine cancer treated at the Institut Curie. 220 patients received peritoneal suturing, while 46 patients were not sutured. The incidence of lymphocysts was respectively 35.9% and 17.4%. The difference is statistically significant (p = 0.01). The "no suture" technique lowered the incidence and the severity of lymphocysts. No side effect of the "no suture" technique was recorded. Multivariate analysis demonstrated that lymphocysts were significantly related to the side of the cancer in the cervix (p = 0.0001), to the preventive use of heparin (p = 0.0025) and to suturing the peritoneum with suction drainage (p = 0.004). We conclude that after pelvic lymphadenectomy the "no suture" technique for the peritoneum reduces the incidence of lymphocysts in the majority of patients. PMID- 3294283 TI - [The risks of amniocentesis despite continuous ultrasonic guidance]. PMID- 3294284 TI - Dextro-amphetamine diminishes negative symptoms in schizophrenia. AB - Thirty schizophrenic patients received intravenous dextro-amphetamine while on and off pimozide. The results provide evidence that negative symptoms and depressed mood in schizophrenia respond in part to intravenous challenges of dextro-amphetamine. Improvement in negative symptoms while on d-amphetamine correlated significantly with subsequent improvement in the same negative symptoms while on pimozide. These results do not support the Type II model of irreversible negative symptoms in schizophrenia in our patient sample. Changes in negative symptoms may be related to state dependent changes in the dopamine system, but noradrenergic mechanisms cannot be excluded either. PMID- 3294285 TI - Attention deficit disorder and methylphenidate: a multi-step analysis of dose response effects on children's cardiovascular functioning. AB - The present study investigated the effects of methylphenidate (MPH) on the resting heart rate of 47 children with Attention Deficit Disorder/Hyperactivity. Children participated in a double-blind, placebo control, within subject (cross over) design and received each of 5 doses of MPH in a counterbalanced sequence. A multi-step analysis was used to examine the dose-response relationship, contribution of pre-stimulus levels of HR (i.e. the initial value), and potential interaction between dosage and time on resting HR. Results indicated that higher dosages are linearly related to increasing levels of HR and that these effects are dependent upon both the initial HR value and the time course of the medication. PMID- 3294286 TI - In memory of Professor Karel Raska, M.D., D.Sc. PMID- 3294287 TI - Salmonella carrier state and biological characteristics of the infectious agent. AB - Salmonella carrier state (42.6%-S. enteritidis and 34.4%-S. dublin) was demonstrated in subjects after acute salmonellosis as well as in healthy persons infected with salmonella as a result of occupational exposure to poultry (8.8% in humans exposed to chickens and 6.1% in those exposed to ducks) and sheep (2.8%). The carrier state was accompanied by intermittent pain in the epigastrium, diminished appetite, diarrhoea etc. Most of the carrier subjects with a history of salmonellosis exhibited, upon rectoromanoscopy, a varying degree of proctosigmoiditsi. The etiological role of S. typhimurium was proved beyond doubt, as well as its ability to cause salmonellosis outbursts, sporadic cases of the disease and the carrier state. When large industrial facilities specializing in poultry processing were investigated, the salmonella carrier state was revealed in practically healthy poultry--in 16% of chickens and 12% of ducks. The salmonella organisms isolated from carrier persons had, with some exceptions, typical properties, being virulent in that they caused death of experimental animals, seeded their internal organs and induced pathogenicity-associated enzymes. Multiple resistance to antibiotics was demonstrated in salmonella isolated from poultry; also determined was its plasmid nature. Pronounced resistance of the above salmonella subtypes to tetracycline-related antibiotics and streptomycin may be due to the fact that these drugs are used in poultry raising. PMID- 3294288 TI - Vladimir Bencko, M.D., D.Sc., managing editor of our journal--a man of 50. PMID- 3294289 TI - Increase of precursor frequency and clonal size of murine IgE-secreting cells by IL-4. AB - IL-4 is able to preferentially enhance murine IgE levels in the supernatant of LPS-stimulated T cell-depleted splenic B cell cultures. Clonal and quantitative analysis of this response revealed that this is due partly to a 14-fold increased IgE precursor frequency and partly to a three-fold increased clone size of IgE secreting cells. IL-4 increased the precursor frequency and the clone size of IgM secreting cells not more than twofold. Both the IgM and IgE response in LPS stimulated B cells were completely inhibited by the addition of anti-IgM mAb (M41) to the cultures, indicating that the IgE-secreting clones developed as subclones from precursors that express IgM. These cells lacked expression of membrane-bound IgE up to day 5 of the culture. Application of feeder cells in these cultures resulted in an increased precursor frequency of IgE-secreting clones among LPS-reactive B cells that is due, partially, to IL-4 produced by the feeder cells. PMID- 3294290 TI - Acquisition of Ig isotype diversity after bone marrow transplantation in adults. A recapitulation of normal B cell ontogeny. AB - To gain insight into the prolonged susceptibility to infections noted after allogeneic bone marrow transplantation (BMT), multiple parameters of the humoral immune system were serially monitored in ten bone marrow recipients. IgM B cells appeared in the circulation 2 to 4 mo after engraftment. During the first 6 mo, the IgM B cells expressed low levels of CD21 (C3d/EBV receptors) and were largely CD38+. IgG and IgA B cells were also found to coexpress surface IgM and IgD, indicating that they may be involved in a process of isotype switch. These features are characteristic of neonatal B cells. To explore the pattern of Ig isotype switch, the emergence of plasma cell precursors for each of the four IgG subclasses was examined by culturing blood lymphocytes with PWM or LPS and enumerating bone marrow plasma cells. A marked IgG2 and IgG4 plasma cell deficiency and a relative increase in IgG1 and IgG3 plasma cells were detected both in vitro and in vivo. Serum IgG2 and IgG4 levels were deficient for more than 18 mo after BMT, elevated IgG1 levels accounting for the normal or increased levels of total IgG. The data suggest that a selective unresponsiveness to polysaccharide Ag and IgG2 subclass deficiency may contribute to the late bacterial infections in BMT recipients. These features of gradual development of the humoral immune system in adults undergoing successful marrow engraftment reproduce some of the maturational steps that occur during normal B cell ontogeny over the first 1 to 2 yr of life. PMID- 3294291 TI - Structure-function studies of human granulocyte-macrophage colony-stimulating factor. Identification of residues required for activity. AB - Human granulocyte-macrophage colony stimulating factor (hGM CSF), a protein containing 127 amino acids, was chemically synthesized by using automated stepwise solid-phase methods. The unpurified synthetic hGM-CSF had the same range of actions on hemopoietic cells as the purified recombinant protein. The structural requirements for the activities of synthetic hGM-CSF were examined by the design and synthesis of fragments and analogs. The synthetic fragment, hGM CSF (54-127), containing all four of the cysteine residues found in the intact protein, lacked detectable activity. Assays of fragments shortened at the N terminus showed that the residues 1-13 were not required for activity, but that the integrity of residues 14-25, particularly residues 16, 17, and 18, was critical for biologic activity. The 14-25 region is predicted to form the first alpha-helix in hGM-CSF. Synthetic peptides within the N-terminal 53 residue region lacked detectable activity. The synthetic analog hGM-CSF (1-121), which lacks the C-terminal 6 residues, had similar activity to hGM-CSF (1-127) indicating that residues 122-127 are not required for activity. An analog, [Ala88] hGM-CSF (14-96), which lacks the hydrophobic C-terminal region and 2 cysteine residues, had low but readily detectable activity suggesting that residues 14-96 are sufficient for detectable synthetic hGM-CSF activity, although the presence of residues 97-121 are required for full activity. No dissociation of the multiple biological activities of hGM-CSF was detected. PMID- 3294292 TI - Regulation of idiotope expression. III. H-2 influences the magnitude and the idiotypy of a T-independent antibody response in mice of certain genetic backgrounds. AB - Antibody response to the phosphocholine (PC) epitope on Streptococcus pneumoniae R36a (Pn), a T-independent Ag type 2, was studied in H-2 congenic mouse strains. The PC-specific antibody plaque-forming cells (PFC) were enumerated in the spleen at various intervals after the primary Pn injection, and the proportion of PFC that produced antibody expressing the AB1-2 idiotope (Id) was determined by using the corresponding monoclonal anti-Id. AB1-2 is a cross-reactive Id, detectable on germline-encoded PC antibody of the T15 family, and on most, but not all, somatic variants of that antibody. The specific PFC responses in BALB/c (H-2d) and BALB.B (H-2b) strains were of comparable magnitude and most, if not all, PFC were ABl-1 Id-positive (AB1-2+). This was not the case in the responses of the B10D2 (H-2d) vs C57BL/10 (H-2b) strains and the D1.C (H-2d) vs D1.LP (H-2b) strains (on DBA/1 background). In each of these pairs, the H-2d mice were high responders, and the response was dominated by AB1-2 Id (greater than or equal to 80% AB1-2+ PFC at the peak, on day 5). The H-2b mice were low responders, and only a minor proportion of PFC (less than or equal to 30%) were AB1-2+; an increase of AB1-2+ was seen later in the response (d.10). The results of PFC assays were confirmed by measuring the PC-binding antibody and AB1-2 Id in the sera of D1.C and D1.LP mice immunized repeatedly with Pn. Moreover, D1.LP mice that had very low levels of AB1-2 Id had higher serum levels of antibody expressing two other T15 Id, B36 82, and B24-44. The B36-82 and B24-44 Id have been previously found on somatic variants of PC antibody expressed independently of the Ab1-2 Id. The concentrations of these two Id in D1.LP mice after repeated immunization approached those in D1.C. These results indicate that 1) the H-2 allelism may have a significant effect on TID antibody response in mice of a certain genetic background, but not in the BALB/c; and 2) the idiotypic repertoire of the response may be influenced by H-2 at the level of clonal variants of PC-reactive cells. PMID- 3294293 TI - Degradation of plasmodial antigens by human neutrophil elastase. AB - Human neutrophil elastase (HNE) has been well-studied with respect to its role in pathologic states, but less is known about the physiologic functions of this important granulocyte enzyme. In the present study, we show that HNE can degrade the major circumsporozoite protein of the infective (sporozoite) stage of Plasmodium vivax malaria, and that this enzyme can also interfere with the cytoadherence of human E infected with Plasmodium falciparum (strain K+ FMG-FCR3) (IE). Cytoadherence reactions are not only blocked by treatment of IE with as little as 10 fg HNE/IE, but already adherent IE are also removed by the enzyme. Normal E surface Ag are not extensively destroyed by these doses of HNE. This suggests that the effect of HNE on cytoadherence is selective and probably due to degradation of the malarial Ag exported to the IE surface and responsible for the formation of "recognition knobs" upon which the cytoadherence reaction depends. This conclusion, in turn, was supported by the results of Western blot analysis showing that HNE degrades a high m.w. Ag found exclusively in membrane extracts of IE. Our results suggest that one physiologic role of HNE may be degradation of parasitic antigens during host defense against malaria. PMID- 3294294 TI - Protease interference with immuno-blot techniques. PMID- 3294295 TI - Adamantinoma of the tibia. PMID- 3294296 TI - In memoriam Dr Prabodh Kumar Guha. PMID- 3294297 TI - Small-intestinal coccidiosis: an emergent clinical problem. PMID- 3294298 TI - Upgrading surgeons' autoclaves--a personal recollection. PMID- 3294299 TI - The Karpas AIDS Cell Test compared with an enzyme-linked immunosorbent assay for detecting antibody to the human immunodeficiency viruses (HIV-I and HIV-2). AB - We have compared the Karpas AIDS Cell Test for antibodies to the human immunodeficiency viruses (HIV) with a commercial enzyme-linked immunosorbent assay (ELISA) (Organon Teknika) by testing serum samples from 324 intravenous drug abusers in Turin. The cell test was found to be more sensitive and as specific as the ELISA with the serum samples from the drug abusers. In Lisbon, 30 samples were tested on slides containing cells infected with HIV-1 and/or HIV-2. All 15 samples, which were positive for HIV-2 alone (in the HIV-2 Elavia test and by the Western blotting technique), were also positive in the Karpas AIDS test. In contrast, only one of the 15 samples (7%) gave a positive reading in the ELISA for HIV-1. Results of 30 samples tested in Turin and Lisbon by the Western blotting technique agreed closely with those obtained with the Karpas AIDS Cell Test. We were also able to show that the entire test can be performed at room temperature and completed within 1 hour. Moreover, the cell test requires minimal skill and simple equipment and is inexpensive. It also includes non-infected cells as a control and the specificity of positive samples may be verified with a bench microscope. Furthermore, this test which detects antibodies to both HIV-1 and HIV-2 allows rapid typing of the infecting strain. PMID- 3294300 TI - Systemic mycosis due to Penicillium marneffei in a patient with antibody to human immunodeficiency virus. AB - Systemic mycosis due to Penicillium marneffei is described in a man infected with human immunodeficiency virus and who had travelled in S.W. China. He responded completely to treatment with amphotericin B and a prolonged course of ketoconazole. Problems of diagnosis are discussed and all previously reported cases reviewed. PMID- 3294301 TI - Epithelial differentiation of human skin equivalents after grafting onto nude mice. AB - Human skin equivalents were developed in vitro with a unidimensionally retracted dermal equivalent made of human type I + III collagen and human MRC5 fibroblasts, and a multilayered epithelium grown in liquid medium from normal human keratinocytes in suspension. We investigated the degree of epidermal differentiation that could be achieved after in vivo grafting onto nude mice by means of light and electronmicroscopy as well as by immunohistochemistry. All transplanted grafts showed a primary take. The grafts formed an epidermis with a stratum corneum and from day 7 to 14 after transplantation a distribution of a 56.5 Kd keratin protein, involucrin, profilaggrin/filaggrin, and MHC-I antigens that was similar to what is noted in normal human epidermis. These data indicate that a full terminal differentiation was only achieved after in vivo transplantation of the cultured epithelium. Pigmentation was present, but no marker of Langerhans cells was seen at 4 weeks. Although there was no evidence of the dermal equivalent after 2 weeks, we noted a strong adherence of the graft to the wound bed, with the presence of type-IV collagen, laminin, and bullous pemphigoid antigen at the dermo-epidermal junction (day 7) and hemidesmosomes, a lamina lucida and a lamina densa (day 30). No epithelial damage was noted in spite of an inflammatory infiltrate in the underlying tissue. This represents a preliminary step in the use of such a skin-equivalent in the treatment of human patients with wounds. PMID- 3294302 TI - Connective tissue alterations in the skin of ultraviolet irradiated hairless mice. AB - Connective tissue alterations were induced in hairless mouse skin by ultraviolet (UV) irradiation. Hairless mice were irradiated three times a week for 10 weeks with sunlamps (UVA and UVB) and the skin was examined using immunochemical and biochemical techniques. Indirect immunofluorescence was performed with antibodies directed against elastin, microfibrillar proteins, and fibronectin. Increased fluorescence was observed in the actinically damaged skin for elastin, microfibrillar proteins, and fibronectin. The elastic fiber components, elastin and microfibrillar proteins, were then isolated and quantified. Control skin contained approximately 0.1% by dry weight of elastic fiber components, whereas actinically damaged skin contained 0.2% by dry weight. These data are consistent with previous observations of elastic fiber hyperplasia in UV irradiated mice. In addition, irradiated mouse skin contained 1.12 mg of extracted fibronectin per gram wet weight as compared with 0.59 mg in control skin. Irradiated mouse skin contained increased quantities of hyaluronic acid and chondroitin sulfate (uronic acid content). These studies further support the validity of the UV irradiated hairless mouse as a model of human dermal photoaging. PMID- 3294303 TI - Sequential immunohistologic analysis of the skin following allogeneic bone marrow transplantation. AB - Graft-vs-host disease is generally viewed as an immunologically mediated disease. In search of additional tools for early diagnosis and an elucidation of the pathogenic mechanisms we investigated the expression kinetics of hemopoietic differentiation and class II alloantigens on both resident and passenger skin cells after bone marrow transplantation. HLA-DR antigens, which are found normally on the dendritic epidermal Langerhans cells only, are synthesized and expressed by keratinocytes within lesions of acute and chronic cutaneous graft-vs host disease. Within non-lesional skin, however, during the course of cutaneous graft-vs-host eruptions, no clear cut expression of keratinocyte-bound HLA-DR antigens can be identified, suggesting that this phenomenon is locally restricted rather than generalized. Furthermore, our data indicate that within lesions clinically suggestive of cutaneous graft-vs-host disease but lacking diagnostic histopathologic criteria, KC-bound HLA-DR antigens can be readily identified. The second class II alloantigens investigated within the epidermis, the HLA-DQ antigens, were seen on Langerhans cells only and were not or only rarely detectable on keratinocytes. Several subtypes of CD3+ T lymphocytes were present in the epidermis of acute graft-versus-host lesions: one portion of CD3+ T lymphocytes also displayed the CD8 antigen; one portion, mainly localized within the basal layer, displayed the CD8 and/or the CD4 antigen; and one portion did not allow identification of CD8, CD4, or Leu7 antigens. In chronic cutaneous graft-versus-host lesions CD3+/CD8+ T lymphocytes predominated. CD1+ epidermal Langerhans cells were reduced in number and appeared rounded with blunt dendrites both in acute and chronic cutaneous graft-vs-host disease, but also, though to a lesser extent, within normal appearing skin from bone marrow transplanted patients without cutaneous graft-vs-host disease. PMID- 3294304 TI - Keratinocyte derived T-cell growth factor (KTGF) is identical to granulocyte macrophage colony stimulating factor (GM-CSF). AB - Keratinocyte derived T-cell growth factor was initially described as a product of cultured neonatal keratinocytes and keratinocyte cell lines that induced the proliferation of HT-2 cells, a murine T-cell line that responds to IL-2 and IL-4 by incorporating 3H-Thymidine. Subsequently, KTGF has been purified to high specific activity and found to be distinct from IL-2 and IL-4 by a variety of biochemical, immunologic, and immunochemical criteria. Because it was found that certain HT-2 cell lines also proliferated in response to GM-CSF, the present study asked whether KTGF was related to GM-CSF. In this study, we demonstrate that antibodies to recombinant murine GM-CSF completely neutralize the capacity of KTGF to induce HT-2 proliferation without interfering with IL-2 or IL-4 induced HT-2 proliferation. Furthermore, poly-A+ RNA homologous to murine GM-CSF cDNA as judged by S1 nuclease analysis was detected in Pam 212 cells, and protein serologically homologous to GM-CSF was found in Pam 212 conditioned medium. We conclude that KTGF is identical to GM-CSF. The T-cell activating properties of GM CSF require further exploration. PMID- 3294305 TI - Serologic abnormalities in patients with endemic pemphigus foliaceus (Fogo selvagem), their relatives, and normal donors from endemic and non-endemic areas of Brazil. AB - Based on epidemiologic data, a current hypothesis states that Fogo selvagem (FS) may be triggered by environmental factors present in endemic areas of Brazil. Because the appearance of new cases is limited to those areas, we wanted to ascertain if the presence of the pemphigus autoantibodies was restricted to the patients. To further delineate the restriction of the autoantibody response in these patients we also investigated the presence of lupus-associated autoantibodies. Using indirect immunofluorescence (IF) we tested the sera of patients with FS (n = 196), their relatives (n = 138), their cohabitants (n = 13), and normal donors from endemic (n = 38) and non-endemic areas (n = 44) for pemphigus autoantibodies. Antinuclear antibodies (ANA) and anti-nDNA antibodies were determined by indirect IF against Hep-2 cells and Crithidia lucilliae, respectively. Autoantibodies against nRNP, Ro/SSA, La/SSB, and Sm were assayed by double immune diffusion in agarose gels. FS autoantibodies were present in the sera of all patients with active disease (n = 196, 100%, titers greater than 40 to 2560), but were not found in any sera from normal individuals in endemic or non-endemic areas. The titer of the FS autoantibody showed a rough correlation with the extent and activity of the disease. Furthermore, lupus-associated autoantibodies were not present in any of the tested samples. We conclude the FS antiepidermal autoantibodies are specific serologic markers of the disease and are not present in unaffected individual from the endemic areas. As such, they provide an important marker that should be useful in ongoing epidemiologic studies aimed at identifying putative etiologic agent(s). PMID- 3294306 TI - Cellular heterogeneity in human epithelial neoplasms. AB - Tumor cell heterogeneity has in recent years been the subject of numerous excellent review articles, but comprehensive reviews may not always distinguish between that which is known about tumors from direct observation and that which is inferred from the study of analagous systems. The purpose of this review is to describe what is known about cellular heterogeneity in human tumors and to discuss current models of the pathogenesis of cellular heterogeneity in light of the evidence available from the study of human cancer. PMID- 3294307 TI - [Twelve cases of invasive thymomas resected by vascular reconstruction]. PMID- 3294308 TI - [A successful case of supraarterial myotomy for a myocardial bridging using intra operative ultrasound technic to locate the intramural coronary artery trees]. PMID- 3294309 TI - [A case of closed transventricular aortic valvotomy in critical aortic stenosis in the newborn infant]. PMID- 3294310 TI - Extracellular matrix and the hematopoietic microenvironment. PMID- 3294311 TI - The forgotten contribution of Dr. Edmund Faustyn Biernacki (1866-1911) to the discovery of the erythrocyte sedimentation rate. PMID- 3294312 TI - Computed tomography in choanal atresia. AB - Computed tomography is replacing contrast radiography as the method of choice in evaluating congenital posterior choanal atresia. Careful preparation of the patient, however, is necessary prior to the examination in order to obtain the maximum of information pre-operatively. We present patients with inadequate preparation and illustrate their misleading scans. The proper method of examination is discussed, with a review of the literature; it is essential to remove nasal secretions by suction and instill vasoconstrictor nose drops, shortly before scanning. PMID- 3294313 TI - Giant cell tumour of the temporosphenoidal region. AB - A case of giant cell tumour of the temporo-sphenoidal region and superior part of infratemporal fossa is presented along with a brief review of the literature. The tumour mass was removed by curettage using a Weber-Fergusson incision with transection of the zygoma. There was no recurrence at three-year follow up. PMID- 3294314 TI - Angiosarcoma of maxillary antrum--association with vinyl chloride exposure. PMID- 3294315 TI - Lymphoplasmacytic lymphoma of the larynx, soft palate and nasal cavity. AB - Non-Hodgkin's lymphoma of the larynx is uncommon and when it occurs usually presents as a non-ulcerating supraglottic mass with a predilection for the ventricle. No case of the lymphoplasmacytic variety occurring in the larynx has been reported in the literature to date. We present such a case with distant lesions in the soft palate and nasal cavity, mimicking nasal polyps. PMID- 3294316 TI - Posterior cleft larynx associated with hamartoma: a case report and literature review. AB - Posterior cleft larynx associated with a local hamartoma is a rare malformation complex. Clinical diagnosis may be elusive. We report such a combination in a newborn infant dying soon after birth with upper airways obstruction. PMID- 3294317 TI - Otopathology of Egyptian mummy Pum II: final report. AB - Otoscopic examination of the ears of Egyptian mummy PUM II with the operating microscope revealed a small oval perforation of the right tympanic membrane in the posteroinferior quadrant. The smooth and concise margins suggested an etiology of middle ear infection. A method which allows decalcification of ancient specimens without disintegration of the eardrum and other soft tissues within the temporal bone was described. There was evidence of histological repair at the margins of the perforation consistent with sequela of otitis media. No other abnormalities were observed in the temporal bones of this individual. There was no evidence of otosclerosis bilaterally. To our knowledge, this is the first time that a pathological tympanic membrane perforation has been histologically documented in an ancient temporal bone. PMID- 3294318 TI - Medical management of active chronic otitis media: a controlled study. AB - About 2 per cent of adults have active chronic otitis media, the majority being managed by medical means. Previous controlled studies have been unable to show benefit from any medication, including systemic or topical antibiotics, but the effect of the addition of topical steroids to the latter has never been evaluated. One hundred and sixty three adults with active chronic otitis media were randomly allocated to receive either antibiotic/steroid ear drops or placebo therapy over a 4-6 week period. Fifty-two per cent of ears receiving active therapy, as opposed to 30 per cent on placebo therapy (p less than 0.05), became otoscopically inactive if compliance to medication was greater than 70 per cent. However, when there was an open mastoid cavity, active therapy was no more successful than placebo. Though gentamicin was the antibiotic used, there was no evidence of ototoxic inner ear damage. Surprisingly, correlation between clinical activity and patient report of a discharge was poor. Forty per cent of both treatment groups considered that their ear had become dry following therapy and these were not the same patients whose ears had become otoscopically inactive. PMID- 3294319 TI - Ototoxicity of ethacrynic acid (a persistent clinical problem). PMID- 3294320 TI - Nasal paraganglioma. PMID- 3294321 TI - Cat scratch disease: an unusual cause of acute parotid pain (a case report with a literature review). AB - CSD is a well recognised cause of cervical lymphadenopathy, and parotid involvement occurs in 3 per cent of cases. Parotid lymphadenopathy is usually asymptomatic or tender but acute parotid pain treated successfully by surgery is previously undescribed. In our case excision of the primary lesion with parotid biopsy provided an immediate diagnosis and decompression of the parotid capsule resulted in dramatic relief of the patient's pain. We would therefore recommend that, in all cases of obscure cervical lymphadenopathy, CSD should be considered and a documentation of domestic pets actively sought. We would also advise that in those cases of parotid CSD in which either the diagnosis is equivocal, CS antigen is unavailable or intense parotid pain is a predominant feature, excision of the primary lesion together with surgical decompression of the parotid capsule should be performed. PMID- 3294322 TI - A symptomatic venous anomaly of the parotid gland: case report and review of the literature. AB - A rare case of a symptomatic venous anomaly of the parotid gland is described in a 14-year-old female patient who presented with Turkey Wattle sign. A definitive diagnosis of this disorder requires venographic studies. Surgical treatment was successful, with a follow-up of four years. PMID- 3294323 TI - [A new technic of lymphatico-venous anastomosis for the treatment of lymphedema of the limbs]. AB - The authors introduce a new technique of lymphatic-venous anastomosis in cases of lymphedema of the limbs. The anastomosis is of buried type and is described in detail. The procedure is easy, practical and can be indicated for both the upper and lower limbs, and also for thoracic duct or anyone blocked lymphatic of the abdomen. In all cases, we did lymphangioadenography and phlebography and in some cases arteriography. Our experience consists of 81 patients with 89 operations with 302 anastomoses of lymphatic vessels blocked by some disease or surgical resection of benign tumors or consequent to plastic surgery (abdomen pendulous, resection of lipomas of the inguinal region of the thigh, plastic surgery of the thigh), orthopedic operations on the knee or to the stripping of varicose veins. The purpose of the procedure is to divert the lymph to the vein in cases of blocked lymphatic vessels, particularly when lymphographic findings demonstrate good functional and good permeability of lymphatic vessels. Six operations failed in five patients (in one patient: two operations); the anastomoses failure occurred in the first cases operated on, when we did one or two anastomoses and had not learned some faulty details of technique. An average reduction of 76% of the edema was achieved. The reduction is in proportion to the number of anastomoses. Anastomoses as a routine, whenever possible, must be over five in number. We insist in the number of anastomoses because we must consider that some of them can be lost by thrombosis or by faulty technique.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294324 TI - [Technic of the peroperative use of Doppler in neurosurgery]. AB - Intraoperative Doppler exploration during neurosurgery was used during treatment of intracranial aneurysms, arteriovenous malformations (AVM) and cerebral revascularization by extra-intra cranial anastomosis (EICA). It was also employed to study behavior of cortical arteries under different conditions. During treatment of aneurysms, Doppler can show, prior to clipping, whether blood flow through. The flow is regular--spasm of supply artery provokes acceleration of blood rate. After clipping it is possible to evaluate whether artery is still permeable without stenosis or torsion. In AVM, Doppler detects direction of blood. Flow and, in case of intraoperative embolization, confirms good exclusion of angiomatous nidus. Flow rate in cortical arteries was determined to verify reality of operative trauma under automatic retractors used in standard surgery. In EICA, Doppler provides precise data on exact localization of cutaneous incision centered on superficial temporal artery (STA) (longitudinal incision) and identifies its parietal branch. The artery in the cortical vessels with the lowest flow rate can be selected. After EICA it is possible to identify whether the donor artery is under spasm from the proximal clamp and whether or not the anastomosis is patent. When functioning is correct it can be defined whether there exists a preferential direction or a regular laminar distribution in T. In tumoral pathology, Doppler serves to identify arteries enclosed in lesion and therefore whether conservation is essential. PMID- 3294325 TI - [Transcranial Doppler pulse. Methodology, diagnostic value and limitations]. AB - Vessels of base of skull were inaccessible to conventional ultrasonic image until 1982, when the use of pulsed Doppler emitting a beam of 2 MHz coupled with a frequency analyzer allowed direct exploration of terminal branches of the internal carotid artery (ICA) and the basilar trunk. It is now possible to measure rate of flow in middle cerebral artery (MCA), anterior (ACA) and posterior (PCA) cerebral arteries, communicating arteries and those of basilar trunk. Practical applications of this new method are numerous in cerebrovascular disease: diagnosis of brain stem lesions, evaluation of effects of extracranial lesions, detection and follow up of arteriovenous malformations, functional value of the circle of Willis prior to carotid surgery. Despite certain limitations due to anatomic factors, angiographic confrontations attest the value and reliability of this new examination. PMID- 3294326 TI - [Ultrasonic tomography of the abdominal vessels]. AB - For a long time echotomography just was interested in big vessels as precious anatomic guide, to delimit pancreas, to cut up liver or to situate ganglion or tumour. The improvement of technics, and particularly real time sonography coupled with continuous wave or pulsed doppler, have permitted to step over the next stage which is to recognize the proper lesions of the vessels. The probes available to perform abdominal vessels investigations have a frequency between 3 and 7.5 MHZ, and are chosen according to the morphology of the patient; in our experience in most cases sectorial probes are preferred. Except emergency situations simple preparation as diet is desirable. Aorto-iliac and visceral arteries, vena cava, renal veins, subhepatic and portal veins are generally seen. The diagnosis of stenosis, obliteration or aneurysm of big abdominal arteries, thrombosis or compression of veins are permitted by association of the morphological information given by real time and hemodynamic findings of doppler. PMID- 3294327 TI - A simulation based decision support system for a health promotion center. AB - This study represents the financial and qualitative evaluation of a Health Promotion Center of a private hospital located in a medium-sized town located in a predominantly agricultural area. The major objective of this study was to evaluate the impact of various pricing, advertising, and service strategies on profitability. The result is a pricing strategy which allows the center to reach their financial goal of breaking even while maintaining their service policies. The hospital, which serves a community of 500,000 people, recently developed a new concept called a "Health Promotion Center" (HPC). The HPC provides services such as fitness programs, nutrition awareness, rehabilitation and therapy, and child and adult care. For this purpose, a new building was constructed and the center became operational in June 1983. A variety of management options available to the center are described with evaluations of their usefulness. Evaluation methods include scenarios, stochastic simulations, and analyses of how the decision makers use these methods. The inclusion of risk management, model flexibility, and user involvement are stressed throughout the paper and are critical in the decision process. PMID- 3294328 TI - Serum lipid levels in subjects with impaired glucose tolerance. PMID- 3294329 TI - Massive ST-segment elevation in precordial and inferior leads in right ventricular myocardial infarction. AB - This report describes a case of right ventricular infarction in which massive ST segment elevation in the precordial and inferior leads was observed. The maximum magnitude of the ST-segment elevation in the precordial leads was 21 mm in lead V2 and that in the inferior leads was 10 mm in lead II. Angiography revealed a reduction of 90% in the diameter of the right coronary artery in its proximal portion and a normal left coronary system. Recent reports have shown that precordial ST-segment elevation may reflect right ventricular infarction. However, no previously reported instance except our case has shown massive ST segment elevation in both the precordial and inferior leads. In right ventricular infarction, the current of injury is usually simultaneously present in the right ventricular free wall and left ventricular inferior wall, electrically opposed to each other. Thus, the diffuse and massive ST-segment elevation observed in this study seems to be a rare phenomenon. PMID- 3294330 TI - Class I transplantation antigens in solution in body fluids and in the urine. Individuality signals to the environment. AB - Classical class I transplantation antigens present in solution in the body fluids have been studied. These antigens have been found in a monomeric, soluble form in blood, lymph, and urine, and a major source is the hemopoietic system which gives rise to cells that secrete these molecules into the blood. The cell types most probably involved in their secretion are of the macrophage/dendritic cell lineage. The serum molecule is a heterodimer with a heavy chain of 39,000 mol wt associated noncovalently with beta 2-microglobulin and is present in serum at a concentration between 350 and 390 ng/ml. These molecules have a short half-life of 2.7 h and are excreted into the environment via the kidneys in the urine. In the urine, greater than 90% of the molecules are degraded into smaller fragments. This finding that normal metabolic processes lead to the excretion of classical highly polymorphic class I molecules in the urine provides a direct explanation in molecular terms of the ability of animals to identify individuals on the basis of urinary odor. Since intact class I molecules are unlikely to be the odoriferous component in the urine, two hypotheses have been suggested. Either small fragments of class I molecules are detected or the molecule acts as a carrier that transports volatiles from the serum into the urine where they are released, giving rise to the class I-associated odor. PMID- 3294331 TI - Protective immunity evoked by oral administration of attenuated aroA Salmonella typhimurium expressing cloned streptococcal M protein. AB - Attenuated strains of Salmonella have been used effectively as vaccines against typhoid fever. We have investigated the use of such strains to deliver cloned antiphagocytic virulence determinants of unrelated bacteria. The aroA strain of S. typhimurium SL3261 was transformed with a low-copy plasmid vector pMK207, which contains the cloned gene spm5 encoding streptococcal M protein, the major virulence factor of these organisms. The transformed SL3261 expressed type 5 M protein in the cytoplasmic fraction, and when fed orally to BALB/c mice, evoked both serum and salivary IgA, IgG, and IgM antibodies directed against type 5 M protein. The orally immunized mice were completely protected against both intranasal and intraperitoneal challenge infections with virulent S. typhimurium SL1344 or M5 streptococci. These studies provide evidence that an attenuated strain of Salmonella can be used effectively as a general vaccine vehicle to deliver antiphagocytic virulence determinants of unrelated bacteria. PMID- 3294332 TI - Complement receptor type 3 (CR3) binds to an Arg-Gly-Asp-containing region of the major surface glycoprotein, gp63, of Leishmania promastigotes. AB - The major surface glycoprotein of Leishmania promastigotes, gp63, was isolated and reconstituted into a lipid membrane immobilized on the surface of 5-micron diameter silica beads. These beads bound to the macrophage (MO), and the extent of binding correlated with the density of gp63 on the bead. The bead thus facilitated analysis of the binding specificity of a single ligand, gp63, without contribution from other molecules present on the surface of intact promastigotes. Plating of MO onto substrates coated with antibodies directed against several cell surface receptors indicated that the complement receptor CR3 was necessary for binding gp63. CR3 recognizes a portion of C3 that contains the sequence R G D. Since gp63 also contains such a sequence, we tested the ability of a synthetic peptide based on the R G D-containing region of gp63 to inhibit the binding of gp63 beads. The R G D-containing peptide from gp63 inhibited the binding of both gp63 beads and EC3bi to MO. Similarly, peptides previously shown to inhibit the binding of C3bi also inhibited the attachment of gp63 beads. The synthetic peptide from the R G D region of gp63 also reduced the binding of intact promastigotes to MO. These results indicate that gp63 binds directly to CR3. PMID- 3294333 TI - Human sperm carbohydrate antigens defined by an antisperm human monoclonal antibody derived from an infertile woman bearing antisperm antibodies in her serum. AB - The epitope structure of the human sperm antigen reacting with antibodies present in sera of infertile women has been studied using mAb H6-3C4, which produces immobilization of human sperm in the presence of complement. Another antibody, NUH2, which also induces human sperm immobilization, was used to substantiate the presence of a receptor on sperm involved in susceptibility to immobilization. Both antibodies defined type 2 chain polylactosamine structure. H6-3C4 is directed to internally located repetitive N-acetyllactosamine, i.e., sialyl-i, i, or fucosyl-i. NUH2 defines binary alpha 2----3 sialyl type 2 chain, i.e., sialyl I. Thus, the presence of antibodies in the sera of infertile women directed to sperm lactosaminoglycan or lactosaminolipid could be the basis for infertility in these cases. PMID- 3294334 TI - Deferoxamine inhibition of malaria is independent of host iron status. AB - The mechanism whereby deferoxamine (DF) inhibits the growth of malaria parasites was studied in rats infected with Plasmodium berghei. Peak parasitemia was 32.6% (day 14) in untreated controls and 0.15% (day 7) in rats receiving 0.33 mg/g in 8 hourly DF injections, subcutaneously. DF inhibition of parasite growth was achieved without any reduction in transferrin saturation or hemoglobin synthesis and with only a partial (56%) depletion of hepatic iron stores. Dietary iron depletion resulted in anemia (hematocrit 25 vs. 46%), microcytosis (MCV 54 vs. 60 fl), and reduced transferrin saturation (17 vs. 96%) without any effect on infection (peak parasitemia 30 vs. 36%). Similarly, parenteral iron loading with ferric citrate over 10 d (75 mg iron/kg) failed to aggravate infection. In a search for evidence of direct interaction between DF and parasitized erythrocytes, gel filtration and ultrafiltration was performed on hemolysates obtained from in vivo 59Fe-labeled parasitized erythrocytes. This showed that 1.1 1.9% of the intracellular radioiron was located in a chelatable, labile iron pool. Incubation of intact cells with 0-500 microM DF resulted in a proportional increase in intracellular iron chelation, and the chelation of all available labile intracellular iron was completed within 6 h. These observations indicate that the severity of P. berghei infection in rats and its in vivo suppression by DF are independent of host iron status and suggest that DF inhibition of malaria involves intracellular chelation of a labile iron pool in parasitized erythrocytes. PMID- 3294335 TI - Relationships between B cell and myeloid differentiation. Studies with a B lymphocyte progenitor line, HAFTL-1. AB - A cell line, HAFTL-1, derived by in vitro transformation of fetal liver cells with v-Ha-ras, was found to have molecular and phenotypic characteristics of pro B cells recently committed to the Ly-1+ B cell differentiation pathway. Stimulation of these cells with LPS resulted in their differentiation within either the B or myelomonocytic lineages. Thus, lines derived from LPS-stimulated HAFTL-1 cells were shown to be clonally related, as evidenced by common v-ras integrations, but to exhibit characteristics of pre-B cells (ThB expression, continuing DJ heavy chain rearrangements) or mature macrophages (expression of Mac-1 and Mac-2, lysozyme and nonspecific esterase production, phagocytosis) while maintaining their Ly-1+ phenotype. These results suggest that events resulting in the irrevocable commitment to a single lineage occur late in differentiation, at least within the pathway yielding Ly-1+ B cells and a proposed subpopulation of Ly-1+ monocytes and macrophages. Final commitment to these lineages is carefully orchestrated, as evidenced by restricted expression of Ly-5 isoforms and production of IgH transcripts. PMID- 3294338 TI - Health planners should be an endangered species. PMID- 3294336 TI - Retinoic acid induces the differentiation of B cell hybridomas from patients with common variable immunodeficiency. AB - Human-human B cell hybridomas constructed from B lymphocytes of common variable immunodeficiency (CVI) patients and the nonsecreting cell line WIL2/729 HF consistently secrete low levels of Ig and appear to retain a defect characteristic of the CVI patient's B cells. We assessed the differentiative capacity of retinoic acid (RA) on these hybridomas, as well as on hybridomas constructed from normal B cells and from patients with selective IgA deficiency. RA at concentrations varying between 10(-5) and 10(-9) M augmented IgM secretion 4-20-fold from four of four CVI hybridomas tested, but did not affect Ig secretion from normal or IgA-deficiency hybridomas. In support of this elevated Ig secretion, RA enhanced the de novo synthesis of biosynthetically labeled light (kappa) and heavy (mu) Ig (up to 4- and 15-fold, respectively) in the CVI hybridoma line JK32.1. The increase in IgM synthesis/secretion could not be accounted for by RA-induced alteration in the cell cycle. In inducing this increase in IgM production, RA was found to affect two aspects of Ig gene expression: (a) the steady-state levels of heavy and light chain mRNAs were enhanced, and (b) the processing of mu heavy chain transcripts to the secreted mRNA form became favored over the membrane mRNA form. We also show that expression of Leu-17 (CD38), a surface marker that is re-expressed in the late pre-plasma stage of B cell development, was increased by RA from less than 20% to greater than 90% of the total cell population, with a concomitant 4-10-fold augmentation in the mean fluorescence intensity. Changes in both Leu-17 expression and de novo Ig synthesis were prominent by 24 h, but could be observed as early as 8 h after induction. Taken together, our study demonstrates that RA affects a marked alteration in the differentiated state of the CVI hybridoma clones. This finding suggests that retinoids can enhance the functional capabilities of B cells with defects in maturation and support further studies to evaluate their clinical potential in CVI. PMID- 3294337 TI - Tolerance to tumor necrosis factor in rats and the relationship to endotoxin tolerance and toxicity. AB - Treatment of rats with recombinant human TNF initially causes a marked decrease in food intake, a loss of body weight, and a negative nitrogen balance. These alterations normalize with continued twice daily intraperitoneal injections of the same dose. Rats tolerized to TNF in this manner are refractory to a lethal dose of TNF. Also, TNF-pretreated and -tolerized rats have prolonged survival and reversed histopathologic changes after injection of a lethal dose of endotoxin compared with control animals. The TNF-tolerant state is dependent on the dose of TNF used and the length of TNF pretreatment. TNF-induced tolerance is relatively short lived, being present 2-4 d after TNF pretreatment and dissipating by 2 wk. Rats made tolerant to endotoxin are also tolerant to a lethal dose of TNF. A bidirectional crossreacting tolerance exists between TNF and endotoxin. The mechanism of TNF tolerance is unclear, but it does not appear to be due to a humoral immune response or a perturbation of the uptake and clearance of injected TNF. PMID- 3294339 TI - Pulmonary infection after bone marrow transplantation. PMID- 3294340 TI - Endoscopic local hemostasis with hypertonic saline-epinephrine solution injection for upper gastrointestinal bleeding. PMID- 3294341 TI - [Ultrasonic evaluation of Budd-Chiari syndrome]. PMID- 3294342 TI - [Reticulum cell sarcoma in the eye and central nervous system masquerading as uveitis: report of a case]. PMID- 3294343 TI - [Clinical aspects of cerebral hemorrhage]. PMID- 3294344 TI - Malignant lesions causing spinal compression: review of 139 cases. PMID- 3294345 TI - [Ultrasonic examination of thyroid disorders]. PMID- 3294346 TI - Antenatal diagnosis of conjoined twins. PMID- 3294347 TI - Bart's hydrops fetalis in one of the dizygotic twins: report of a case. PMID- 3294348 TI - Markov models of natural history. PMID- 3294349 TI - The screening of cognitive impairment in the elderly: a critical review of current methods. AB - The continued appearance of new screening tests for dementia suggests both the continuing need for a valid measure of pathological cognitive change and dissatisfaction with what is currently available. A brief review of current tests is presented which focuses on the major theoretical and methodological issues which have impeded the development of adequate screening instruments. Strategies for the management of such difficulties are also indicated, with a view to guiding prospective researchers in this field and increasing the critical perspective of those currently using these instruments. PMID- 3294350 TI - Cyclic seasonal variation in plasma lipid and lipoprotein levels: the Lipid Research Clinics Coronary Primary Prevention Trial Placebo Group. AB - Seasonal plasma lipid and lipoprotein cycles were studied in 1446 hypercholesterolemic 35-59 year-old men followed for 7 years as the placebo group of the Lipid Research Clinics (LRC) Coronary Primary Prevention Trial (CPPT). Separate periodic time series were calculated for each study participant; mean parameter estimates were obtained by vector algebra. Highly significant (p less than 0.001) synchronous sinusoidal seasonal cycles, peaking in the first month of winter, were demonstrated for plasma levels of total (TOT-C), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) cholesterol. Their mean seasonal changes (nadir to zenith) were 7.4, 6.4, and 0.8 mg/dl, respectively. An irregular but statistically significant seasonal pattern was also observed for plasma triglyceride (TG) levels, with peak levels in the autumn. The variation of these seasonal effects among subgroups and geographic locales and their correlation with seasonal weight and dietary patterns yielded few clues as to their underlying etiologic mechanisms. PMID- 3294351 TI - Medical image. PMID- 3294352 TI - Intracranial astrocytoma with diffuse bone marrow metastasis: a case report and review of the literature. AB - A 41 year old male presented with headache, lethargy, and ataxia and found to have a left temporal lobe mass and a leukoerythroblastic peripheral blood smear. The latter prompted an iliac crest bone marrow biopsy on which a diagnosis of metastatic glioma was made and verified by immunohistologic characterization. The patient was treated with cranial irradiation and simultaneous systemic BCNU (bis dichloroethylnitrosurea) with complete response. This case with diffuse bone marrow involvement demonstrates that a glioblastoma is capable of extracranial metastases without previous intervention. From a review of reported cases of gliomas of extraneural metastasis, it is concluded that untreated gliomas are capable of vascular spread although less frequently than previously manipulated tumors. PMID- 3294353 TI - A study of childhood brain tumors based on surgical biopsies from ten North American institutions: sample description. Childhood Brain Tumor Consortium. AB - The Childhood Brain Tumor Consortium has collected an extensive amount of neuropathologic and clinical information under rigorously controlled conditions about 3,291 children with brain tumors. In this overview of the entire sample, five observations are prominent: 1) many tumors involve more anatomic sites at the time of the first surgical exploration than previously recognized; 2) one third of infratentorial tumors involve both the brainstem and the cerebellum; 3) the spinal compartment is involved primarily, or in combination with the posterior fossa, in 11% of childhood brain tumors; 4) 43.2% of childhood brain tumors are limited to the posterior fossa; 5) only a few World Health Organization diagnoses account for most brain tumors in children, and 6) there is a male predominance over all ages for infratentorial tumors. Subsequent reports will describe observer variability of participating neuropathologists, correlates of clinical and histologic information, the search for homogeneous subtypes of tumors, and prognostic factors. PMID- 3294354 TI - Intra-arterial chemotherapy of malignant gliomas. PMID- 3294356 TI - Superficial temporal artery aneurysms. PMID- 3294355 TI - Stereotactic biopsy of the brain with the Leksell frame in the context of modern radiology. PMID- 3294357 TI - Closure of alveolar clefts with corticocancellous block grafts and marrow: a retrospective study. AB - A surgical technique is presented for maxillary alveolar cleft repair that includes a contoured iliac crest corticocancellous block graft and marrow packing, along with closure by a Y-vestibular mucosal advancement flap. A retrospective study of graft survival in 48 cleft sites showed a 94% success rate with no complications; the remaining 6% of the cases showed minor complications. PMID- 3294358 TI - Solitary neurofibroma of the maxilla: report of a case. PMID- 3294359 TI - Odontogenic myxoma: report of a case. PMID- 3294360 TI - Corticosteroids and growth. PMID- 3294361 TI - Corpus callosotomy for intractable generalized epilepsy. PMID- 3294362 TI - Diffuse leiomyomatosis in Alport syndrome. PMID- 3294363 TI - Treatment of neonatal hypertension with captopril. PMID- 3294364 TI - Neonatal thrombotic disease: prevention, diagnosis, and treatment. PMID- 3294365 TI - A plea for improved presentation of type material for coccidia. AB - The "true" coccidia (phylum Apicomplexa, suborder Eimeriina) constitute a large and heterogeneous group of parasitic protozoa. Despite the large number of described species (ca. 1,650) and the medical and veterinary importance of some (e.g., Toxoplasma), 2 facts are clear: (1) the majority of coccidia species are probably yet undescribed, and (2) the phylogenetic relationships of those described species are poorly known. Contributing to the latter dilemma is the lack of a tradition to provide type specimens by those who describe new species, even though the International Code of Zoological Nomenclature specifically recommends the designation of a type specimen with the description of a new species. With the publication of a new edition of the Code (1985), explicit provisions are made for the unique concerns of taxonomists working with Protozoa. Here we remind those interested in the taxonomy of coccidia of an already established method for preserving oocysts in resin and, as an alternative, suggest the standardization of a photographic procedure through which type specimens of coccidia oocysts might also be submitted to and maintained in accredited museums. Thus, coccidia taxonomists should no longer have an excuse for their failure to designate types. PMID- 3294366 TI - Sporozoite-induced infections of the Salvador I strain of Plasmodium vivax in Saimiri sciureus boliviensis monkeys. AB - Twenty Saimiri sciureus boliviensis monkeys from Bolivia were inoculated intravenously with sporozoites of the Salvador I strain of Plasmodium vivax. All animals were splenectomized 7 days after inoculation. Inoculation of 100,000 sporozoites resulted in prepatent periods averaging 16.6 days; all monkeys developed high-level parasitemias with an average maximum of 103,000 per mm3. Inoculation of 10,000 sporozoites resulted in average prepatent periods of 19.4 days; one of the resulting infections produced a transient low-level parasitemia. Of 5 monkeys inoculated with 1,000 sporozoites, 4 had prepatent periods of from 24 to 35 days and 1 failed to demonstrate any parasitemia; 1 monkey supported a low-level transient parasitemia, whereas the other 3 monkeys had high-level parasitemias. It is proposed that by using a minimum inoculum of 10,000 sporozoites, the model system may be useful in the testing of anti-sporozoite vaccines directed against P. vivax. PMID- 3294367 TI - Evaluation of immunodiagnostic antigens in the excretory-secretory products of Fasciola hepatica. AB - The metabolic antigens of F. hepatica have been shown to be a source of potential immunodiagnostic antigens. We have fractionated F. hepatica excretory-secretory (ES) antigens by conventional gel filtration and HPLC, analyzed these fractions in PAGE, and evaluated their immunogenicity by ELISA with sera from experimentally infected rabbits to identify potential serodiagnostic antigens for fascioliasis. A fraction enriched in high molecular weight components of ca. 150 160 kDa was found to be very reactive with sera from early fascioliasis. This fraction was successfully adapted to the DOT-ELISA, where titers up to 1:16,000 still appeared visually as positive. Both acute and chronic fascioliasis sera also recognized, in the enzyme-linked immunoelectrotransfer blot technique (EITB), prominent 25-30-kDa polypeptides that have previously been shown to be recognized by infected rabbits, cows, and sheep. We have therefore employed conventional gel filtration and HPLC gel exclusion chromatography as a 1-step procedure to obtain fractions enriched in antigens recognized in early fascioliasis. In addition, these antigens have been successfully applied to a sensitive, visual immunodiagnostic technique that can be easily employed in field studies. PMID- 3294368 TI - Monoclonal antibodies reveal antigenic differences in refractile bodies of avian Eimeria sporozoites. AB - Monoclonal antibodies were developed against refractile body antigens of 4 species of avian Eimeria, E. meleagrimitis, E. adenoeides, E. acervulina, and E. tenella. Although antibodies from 8 different cell lines were used in this study, all produced similar fluorescent and gold-labeling patterns. By immunofluorescent antibody techniques, 5 of the 8 antibodies cross-reacted with all 4 of the Eimeria species that were examined; the other 3 antibodies reacted only with the species against which they were produced or with a limited number of species. In Western blot analyses using SDS-solubilized sporozoites as antigen, 4 of the cross-reactive antibodies recognized multiple bands; the predominant bands had molecular weights of approximately 23, 45, and 90 kilodaltons (kDa). Two of the antibodies with more limited reactivity recognized either a single band at 23 kDa (91C7), or bands at 23 and 45 kDa (4115); another reacted only with several bands greater than 100 kDa (4D10). The molecular weights of the antigens did not decrease markedly after digestion with N-glycanase F, indicating that if the refractile body antigens contained significant amounts of N-linked carbohydrate it was refractory to the enzyme. Collectively, the data indicate that antigens of the sporozoite refractile bodies differ among the Eimeria species. Some antigens are conserved, whereas others differ in distribution or frequency among the individual species. PMID- 3294369 TI - Glutathione S-transferases in Fasciola hepatica. AB - Glutathione S-transferases (GST's) are widespread in the tissues of the liver fluke, Fasciola hepatica, and consist of multiple isozymes. Following purification to apparent homogeneity by affinity chromatography on glutathione agarose, fluke GST's were shown to comprise 2 components with molecular weights of about 25,000. Fluke GST's were immunogenic to rats, but when used as a vaccine conferred no protection on the animals against a challenge infection with F. hepatica metacercariae. PMID- 3294370 TI - Immunohistochemical findings in the intestine of IgA-deficient persons: number of intraepithelial T lymphocytes is increased. AB - We studied jejunal biopsy specimens of 13 IgA-deficient persons (IgAdp) and 12 controls. Four Ig-Adp had celiac disease, in the others the jejunal mucosa appeared normal. Monoclonal antibodies and the peroxidase technique were used to identify T lymphocytes, T-lymphocyte subsets, HLA-DR antigens, and IgE-containing cells in the lamina propria and epithelium. Intraepithelial lymphocytes (IEL); goblet cells; and IgA-, IgG-, and IgM-containing cells were counted in paraffin sections. Both IgAdp with normal jejunal structure and IgAd celiacs on gluten free diet (p less than 0.001 and p less than 0.01 versus controls, respectively) had decreased numbers of IgA-containing cells, and an increased number of IgM containing cells (p less than 0.01) was noted in the IgAdp with normal jejunal structure. The IgAdp with normal intestines had increased numbers of intraepithelial lymphocytes (mean 57 cells/mm versus 33 in controls, p less than 0.01) and so did the IgAd celiacs after gluten challenge (mean 74, p less than 0.001). The HLA-DR antibody stained the epithelial cells of the IgAd celiacs differently from those of controls and IgAdp with normal intestines: the whole cytoplasm was never stained in the celiacs, but in six of 12 controls (p less than 0.05) and during gluten challenge, the crypt cells of the IgAd celiacs showed strong staining, never seen in a normal intestine (p less than 0.05 compared with pre-challenge specimens). The increase in IEL number in the jejunal mucosa of IgAdp probably indicates ineffective antigen exclusion. PMID- 3294371 TI - Controlled clinical trial on the efficacy of rice powder-based oral rehydration solution on the outcome of acute diarrhea in infants. AB - We report a controlled clinical trial of rice powder-based oral rehydration solution (ORS) versus glucose ORS on the outcome of acute diarrhea in infants. The rice ORS group (n = 30) received ORS containing 50 g rice powder instead of standard WHO solution (20 g glucose, n = 30). Formula-fed male infants were enrolled to enable calculation of milk intake and excretion of urine. Patient allocation to either group depended on the method of random permuted blocks. Both groups were comparable regarding age (4-18 months), duration of diarrhea, number of bowel movements or vomiting per 24 h, rectal temperature, dehydration score, and nutritional status. Results revealed that the rice ORS group had a shorter duration of diarrhea (28.4 +/- 5.1 vs 34.3 +/- 2.3 h) and greater mean weight gain in the first 24 h as percentage of recovery weight (5.7 +/- 0.5% vs 4.1 +/- 0.6%). Furthermore, the mean amount of ORS intake, mean stool output, and mean number of episodes of vomiting were lower in the rice-ORS group as compared with the glucose ORS group. All differences were statistically significant. Due to its observed superiority and low cost, the widespread use of rice ORS should be considered for treatment of acute diarrhea. PMID- 3294372 TI - Ophthalmic findings of hydranencephaly. AB - Hydranencephaly is a rare developmental disorder in which the cerebral hemispheres are replaced by a cystic space filled with cerebrospinal fluid and covered by intact meninges. Ophthalmic findings include pupillary abnormalities, strabismus, nystagmus, ptosis, optic nerve hypoplasia, chorioretinitis, retinal vessel attenuation, and incomplete anterior chamber cleavage. PMID- 3294373 TI - Reoperation rate in adjustable strabismus surgery. AB - Adjustable suture strabismus surgery may reduce the frequency of reoperations by reducing immediate postoperative over- and undercorrections. We reviewed 290 strabismus procedures performed with an adjustable suture technique. Thirty-five patients required additional surgery, for a reoperation rate of 9.7%. Reoperation frequencies for patients undergoing non-adjustable procedures average approximately 20% in our experience and in reported series. Our low reoperation rate with adjustable strabismus surgery supports our clinical impression that more accurate results are possible with this technique in appropriate patients. PMID- 3294374 TI - Leiomyosarcoma. A case report and literature review. PMID- 3294375 TI - Sarcoidosis. A review and case report. PMID- 3294376 TI - In utero fetal lower extremity examination by diagnostic ultrasound. PMID- 3294377 TI - Congenital ectopic nail. A case study. PMID- 3294378 TI - Postoperative management of epikeratoplasty. AB - Epikeratoplasty is the surface implantation of devitalized human corneal tissue onto a recipient cornea for optical rehabilitation. Its postoperative management can be divided into three stages: (1) epithelialization, (2) suture management, and (3) restoration of visual function. Careful attention to each of the healing phases and the multiple potential complications that commonly arise is required for a satisfactory level of visual performance to be achieved in a high proportion of cases. PMID- 3294379 TI - Long-term course of surgically induced astigmatism. AB - We performed an analysis of surgically induced astigmatism in 229 cases of extracapsular cataract extraction and posterior chamber lens implantation. The average length of follow-up for patients in this study was 34.4 months (2.87 years). We found that surgically induced astigmatism continued to change for at least three years after surgery. The preoperative astigmatism was found to have only minimal effect on the postoperative astigmatism if the corneal curvature was controlled with keratometry at the time of surgery. The optimal amount of with the-rule astigmatism at three to five weeks postoperatively was found to be 0.75 diopter to 1.25 diopters for one surgeon and surgical technique. PMID- 3294380 TI - Effect of freezing on lens epithelial cell growth. AB - The effect of freezing on the growth of rat lens epithelial cells was studied in vitro. We found that 80% of the lens epithelial cells died after freezing at -45 degrees C for two hours and that the surviving cells could grow with the addition of growth factors or when placed on a sheet of type 4 collagen, but not when placed on a plain plastic culture dish. These results suggest that the surviving cells are at the Go phase of the cell cycle and that type 4 collagen or growth factors can initiate cell division. PMID- 3294381 TI - Postoperative complication in a patient with a silicone intraocular lens. AB - A 58-year-old white male patient developed corneal complications following cataract surgery and implantation of a silicone posterior chamber intraocular lens. At the time of penetrating keratoplasty, the implant was noted to be partially dislocated into the anterior chamber, surrounded by a dense fibrovascular membrane. Histopathological features were consistent with pseudophakic bullous keratopathy. PMID- 3294382 TI - Scleral fixation of a subluxated posterior chamber intraocular lens. AB - A surgical technique for the treatment of a subluxated intraocular lens is described. It consists of a scleral incision 2 mm from the limbus, hooking the loop haptic of the implant into the scleral wound, and imbricating the loop into the sclera for permanent fixation. Four eyes in which this technique was applied successfully are reported. PMID- 3294383 TI - Small incision cataract extraction and implantation surgery using a manual phacofragmentation technique. AB - The advantages of small incision cataract surgery may be obtained without relying on expensive and complicated instrumentation. A new technique which manually splits the nucleus and removes the fragments is described. PMID- 3294384 TI - The hypothalamus and gastric mucosal injuries: origin of stress-induced injury? AB - This paper reviews the role of the central nervous system in the genesis of gastrointestinal mucosal injuries. The discussion makes particular reference to the significance and mechanism of stress-induced injury of the gastroduodenal mucosa. It points out that in the rat, stress activates the hypothalamus, producing delivery of alpha-adrenergic stimulation to the stomach by the adrenergic hypothalamovagal pathway. This stimulation controls intragastric blood flow and 5-HT release. Low magnitude pharmacologically-induced stress enhances gastric acid secretion and, if this stress is maintained, it produces chronic duodenal ulceration. High magnitude pharmacologically-induced stress depresses acid secretion and injures the gastric mucosa. If such stress is maintained, it produces chronic gastric ulceration. The paper provides a detailed account of the mechanisms of these stress-induced gastroduodenal effects. PMID- 3294385 TI - The death of Paganini. PMID- 3294386 TI - Dr Mark Ridley's Terra Australis. PMID- 3294387 TI - Australia's bicentennial. PMID- 3294388 TI - Molecular analysis and diagnosis of Duchenne muscular dystrophy. PMID- 3294389 TI - Haemostasis in malignant disease. PMID- 3294390 TI - Wiskott-Aldrich syndrome: new perspectives in pathogenesis and management. PMID- 3294391 TI - The bicycle as a 'risk factor'. PMID- 3294392 TI - Infection with Campylobacter pylori. PMID- 3294393 TI - The contribution of recombinant DNA techniques to reproductive biology. PMID- 3294394 TI - Effects of age and parity on litter size and offspring sex ratio in golden hamsters (Mesocricetus auratus). AB - Golden hamsters that were mated repeatedly from 55 days of age produced 6-12 litters. Litter size at birth rose between the 1st and 2nd litters, peaked on the 3rd, and declined steadily after the 5th litter. Offspring sex ratio (% male) at birth followed a similar pattern: increasing between the 1st and 2nd litters, remaining high through the 3rd, and becoming increasingly female-biased thereafter. Weaning success decreased sharply after the 6th litter and most dams failed to raise any young to weaning after the 9th litter. These sequential effects on litter size, offspring sex ratio and weaning success were also observed in females mated once at different ages, but they occurred considerably later in life, i.e. increasing parity hastened the effects of advanced age. These age- and parity-related changes in litter composition are consistent with the Trivers-Willard hypothesis that physiologically-stressed females would skew offspring sex ratios to favour daughters. However, since the observed changes in sex ratio were probably due to differential prenatal mortality, their adaptive significance is unclear. PMID- 3294395 TI - Isolation, cell culture and immunocytochemical characterization of oviduct epithelial cells of the cow. AB - Incubation of cow oviducts flushed with 0.1 mg collagenase/ml, for 90 min helped to dislodge large numbers of ciliated and secretory cells. About 90-95% of the isolated epithelial cells were viable. The epithelial cells suspended in DMEM:F 12 + 10% serum attached to the plastic culture dish in 18-20 h after seeding. The ciliated cells which attached to the plastic dish lost their cilia after 4-5 days in culture. The attached cells, which proliferated to form a confluent monolayer 8-10 days after seeding in a 35-mm dish, could be subcultured at least 3 successive times. Some cell aggregates which did not attach to the culture dish proliferated into floating balls of cells. The ciliated cells in the unattached floating colonies maintained the ciliary movement for 9-10 days in the same culture medium. The primary cultures of the ciliated and the secretory cells maintained most of the histoarchitecture observed in intact epithelium. The secretory cells maintained their secretory activity of specific proteins in culture as indicated by immunocytology. The cultured cells contained keratin, a specific cytoskeletal component of epithelial cells. PMID- 3294396 TI - Contraceptive potential of antibodies to the zona pellucida. AB - The notion of a contraceptive vaccine based on gamete-specific surface antigens was first proposed over a decade ago, as the result of in-vitro and in-vivo studies, and in recent years has been the subject of intensive research. In particular, the zona pellucida has attracted much attention as a potential target for immunological intervention in the fertilization process. Such is the rapidly expanding nature of research into the biochemical and biological characterization of this structure, that a review of the implications for the development of a contraceptive vaccine seems timely. PMID- 3294397 TI - Effect of short-term elevations in plasma cortisol concentration on LH secretion in prepubertal gilts. AB - Prepubertal gilts were fitted with jugular vein and carotid artery catheters at 148 days of age. At 160 days of age the 24 gilts were allocated to treatment in a 2 x 2 factorial design involving intra-carotid infusion of cortisol (10 mg in 40 ml saline) or saline alone with or without i.v. injection of 5 micrograms synthetic GnRH midway through the 1 h infusion. Plasma cortisol concentrations were elevated in gilts infused with cortisol (P less than 0.05). The LH response to exogenous GnRH was reduced by cortisol infusion. Treated gilts released less LH (P less than 0.001) and had a lower mean LH peak (P less than 0.01) than did control gilts but the timing of the induced LH peak was not affected. In the absence of an exogenous GnRH challenge, cortisol infusion increased the endogenous secretion of LH (P less than 0.01). These results suggest that acute elevations in plasma cortisol concentration may be involved in mediating changes in pituitary responsiveness and the secretion of LH in the peripubertal gilt. PMID- 3294398 TI - Characterization of isolated acrosomal matrices from hamster spermatozoa. AB - The acrosomal matrix of hamster spermatozoa was enriched and characterized. Acrosomal matrices were released from spermatozoa with shaking in a pH 5.2 buffer containing Triton X-100 and protease inhibitors, and enriched on a glass-bead column. Phase-contrast microscopy indicated that 70-80% of the acrosomal matrices were released from the spermatozoa and only minor contamination from sperm heads was detected. Transmission electron microscopy confirmed the low level of contamination in the preparation and revealed a bilaminar structure similar but not identical to that of guinea-pig acrosomal matrix. One- and two-dimensional SDS-polyacrylamide gel electrophoresis (SDS-PAGE) showed the acrosomal matrix to be a complex structure enriched for several polypeptides. Proteinase activity was demonstrated by gelatin-SDS-PAGE. The major activity corresponded to bands of relative molecular masses (Mr) of 56,000, 51,000 and 48,000 with two minor bands of Mr 30,000 and 28,000. The lectin Pisum sativum agglutinin (PSA) bound to the anterior head of spermatozoa and isolated acrosomal matrix as judged by fluorescence microscopy using FITC-PSA. Western blots of spermatozoa and acrosomal matrices followed by overlay with biotinylated PSA indicated that there are at least two PSA-binding glycoproteins of Mr 60,000 and 72,000. PMID- 3294399 TI - Daylength influences pelage and plasma prolactin concentrations but not reproduction in the prairie vole, Microtus ochrogaster. AB - Short daylengths did not affect testes weight or spermatogenic index in male voles or uterine weight in female voles. Short daylengths did stimulate the growth of a winter pelage in both sexes; short-day voles had longer underhairs and guard hairs and a thicker, more dense pelage than did long-day voles. Plasma prolactin concentrations were five times higher in long-day than in short-day females and 25% higher in long-day males than in short-day males. The effect of short daylength on pelage was prevented by pinealectomy. We suggest that the growth of a winter coat is an obligate adaptation for winter survival, stimulated by exposure to short daylengths, but that changes in breeding activity are facultative and dependent to a greater extent on other cues for seasonal synchronization. PMID- 3294400 TI - Antibiotic usage in pelvic infections. An overview. AB - Postoperative soft-tissue pelvic infections in women most commonly are polymicrobial and mixed aerobic and anaerobic. Antibiotic prophylaxis has been advocated to reduce the risk of postcesarean endometritis and post-vaginal hysterectomy pelvic infection. The use of antibiotic prophylaxis has a tendency to select for resistant bacteria, and many of those bacteria produce beta lactamase. A new approach to the treatment of those infections is to employ beta lactamase inhibitors in conjunction with a broad-spectrum antibiotic, such as ticarcillin disodium plus clavulanate potassium (Timentin). PMID- 3294401 TI - Evolution of beta-lactamase inhibitors. AB - Beta-lactamase, the bacterial enzyme that can inactivate penicillins, cephalosporins and related antibiotics, can function outside the cell or in the periplasmic space. This resistance can be transferred between bacteria of the same or different species. Most strains of Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella, Enterobacter, Pseudomonas aeruginosa and Bacteroides species are beta-lactamase producers. Clavulanic acid is a beta-lactamase inhibitor that works by blocking the enzyme center. When it is combined with amoxicillin and ticarcillin, it expands those drugs' spectrum of activity to bacteria that are resistant to the single antibiotics as well as to anaerobic bacteria. PMID- 3294402 TI - Implications of beta-lactamase-inhibitor combinations. AB - Ticarcillin disodium/clavulanate potassium and other beta-lactamase inhibitor/penicillin combinations have been recognized recently as broad-spectrum drugs that have a major role in chemotherapy for serious surgical sepsis. Their spectrum of activity allows the economical substitution of ticarcillin disodium/clavulanate potassium for anaerobe-active cephalosporins and for the traditionally used combination of clindamycin and an aminoglycoside. Indeed, the ticarcillin disodium/clavulanate potassium spectrum was judged to be broader than that of the other agents while maintaining comparable or superior clinical efficacy and safety. The beta-lactamase inhibitor combinations have also proven their economical application to the prevention of infections after trauma and elective surgery, although those indications have not been well accepted. The timing seems to be right for the expanded use of these combinations in order to lower therapeutic and prophylactic costs. This concept is concurrent with the critical assessment of the cost effectiveness, safety and usable spectrum of older therapeutic regimens. However, some of the traditional nonpenicillin treatment modalities must be maintained for those patients with a penicillin allergy. PMID- 3294403 TI - Prophylactic antibiotics for cesarean section and surgical procedures. AB - Although prophylactic antibiotics are used frequently on women undergoing pelvic surgery, including cesarean section, they should be reserved for patients who have a significant risk of infection. Among such patients are those who have undergone vaginal hysterectomy or cesarean section after having been in labor with ruptured membranes. Prophylaxis should be limited to one to three doses of antibiotic, with the newer broad-spectrum antibiotics and combination antimicrobial agents reserved for more serious, established infections. PMID- 3294404 TI - Treatment of obstetric and gynecologic infections, with an emphasis on beta lactamase-producing organisms. AB - The ideal pharmaceutical treatment for pelvic infections in women should provide good antibacterial coverage, have proven efficacy and be associated with a good outcome in terms of fertility and organ preservation. In an open study, ticarcillin disodium/clavulanate potassium was used to treat upper genital tract infections in 91 women. The clinical success rate was 92% with outpatient acquired pelvic inflammatory disease; 50% with tuboovarian abscess, as confirmed by ultrasound; 85% with postpartum endometritis; 88% with endometritis plus chorioamnionitis; and 90% with postoperative infection, including cesarean section. The primary adverse reaction was diarrhea, in ten patients. Among the 129 aerobes isolated, 18 (14%) were beta-lactamase positive, as were 32% (20/63) of the anaerobes. PMID- 3294405 TI - Infection in women. Clinical experience with beta-lactamase inhibitors. AB - Because of the high incidence of beta-lactamase production among bacteria that are found commonly in pelvic infections in women, beta-lactamase-inhibiting antibiotics should prove effective in treating those infections. In a randomized, comparative study of 47 women with intraabdominal infections, 23 received ticarcillin disodium/clavulanate potassium, and 24 received cefoxitin. Among the infections treated were endometritis, pelvic inflammatory disease, amnionitis, salpingitis, septicemia, intraabdominal abscess and pelvic abscess. The bacteriologic response to ticarcillin disodium/clavulanate potassium was 88.8% success as compared with 87.5% for cefoxitin. Clinical cures were achieved in 98.8% of patients treated with ticarcillin disodium/clavulanate potassium and 90.9% of patients treated with cefoxitin. The adverse reactions were diarrhea, transient eosinophilia and transient thrombocytosis. PMID- 3294406 TI - Treatment of penetrating abdominal trauma and gynecologic infections. AB - Both penetrating abdominal trauma and gynecologic infections are polymicrobial and require antibiotics with broad-spectrum activity against both aerobic and anaerobic pathogens. In an open study, ticarcillin disodium/clavulanate potassium was used to treat patients with penetrating abdominal trauma, intraabdominal infection or gynecologic infection. Ticarcillin disodium/clavulanate potassium was administered at a dose of 3.1 g every four or every six hours, and therapy lasted for a minimum of three days. Among 20 patients with intraabdominal infections that involved abdominal organ perforation, ticarcillin disodium/clavulanate potassium was effective in 16. Eighteen of 19 aerobic isolates were susceptible to ticarcillin disodium/clavulanate potassium, as were all of 21 anaerobic isolates. Fifteen of 21 evaluable patients with gynecologic infections were cured. Among the infections were pelvic inflammatory disease, salpingitis, salpingitis with tuboovarian abscess, pelvic inflammatory disease with tuboovarian abscess, salpingitis/pelvic inflammatory disease and peritonitis, endomyometritis, cervicitis and pelvic inflammatory disease with peritonitis. A total of 32 aerobic and 15 anaerobic organisms were isolated, and 14 of the patients had more than one organism isolated. PMID- 3294407 TI - Ticarcillin disodium/clavulanate potassium versus clindamycin/gentamicin in the treatment of postpartum endometritis. AB - Ticarcillin disodium/clavulanate potassium was compared to clindamycin/gentamicin in the treatment of post-cesarean-section endometritis in 133 evaluable patients. All patients received three 1-g doses of cefazolin for prophylaxis. There was no statistically significant difference in the cure rates between the ticarcillin disodium/clavulanate potassium group (84%) and the clindamycin/gentamicin group (81%). Bacteremia occurred in 21% of the patients, with Mycoplasma the most frequent isolate. Ticarcillin disodium/clavulanate potassium was found to be as efficacious as clindamycin/gentamicin in the treatment of postpartum endometritis. PMID- 3294408 TI - Cerebral and valve lesions in SLE: association with antiphospholipid antibodies. PMID- 3294409 TI - Selective IgA deficiency developed during treatment of scleroderma kidney with captopril. PMID- 3294410 TI - Inherited deletion of subband Xp21.13 in a male with Duchenne muscular dystrophy. AB - The chromosomes of a male patient who suffers from Duchenne muscular dystrophy (DMD) with a molecular deletion were examined with an improved high resolution R type replication banding technique. High resolution cytogenetic analysis of the proband revealed a deletion of the Xp21.13 subband. His healthy mother was heterozygous for the deletion, which is subject to random X inactivation in lymphocytes. The X chromosomes of the proband's grandmother were normal, suggesting that the deletion of the Xp21.13 subband in the mother was a new mutation. The finding of a very small, cytologically visible Xp21.1 deletion in a male DMD patient with a molecular deletion emphasises the importance of resolving the fine structure in the Xp21 region. PMID- 3294411 TI - Type I Gaucher disease. PMID- 3294412 TI - John Dalton (1766-1844). AB - There is no doubt that John Dalton ranks among the great names in science, a position which rests on his enunciation of the Atomic Theory. However, his very first scientific paper in 1798 was concerned with his own affliction of colour blindness and was in fact the first clear description of the disorder. This publication stimulated much subsequent research into the pathophysiology and genetics of the condition. His recorded observations on colour blindness are detailed and precise and betoken the approach which was to characterise all his later research in chemistry. PMID- 3294413 TI - An unsuccessful experience with computerized medical records in an academic medical center. AB - Computerized medical records systems are used in only a small percentage of U.S. health care facilities, despite predictions that they would be widely used. The authors here report on their experience with the Computer Stored Ambulatory Record (COSTAR), a computerized medical records system, installed at a large primary care clinic at a university medical center. Although some equipment and computer resources were provided by the medical center, ongoing operations were financed by clinic revenues. After four months, use of the system was terminated because clinic revenues could not cover operating costs. The operating costs accounted for 17 percent of the average charge for an office visit. The major component of the operating costs was personnel expenses for data entry. PMID- 3294414 TI - Uses and advantages of interactive video in medical training. PMID- 3294415 TI - Exacerbation of experimental pyelonephritis by cyclosporin A. AB - An athymic rat strain lacking functional T cells was used to assess the role of cell-mediated immunity (CMI) in host defence against renal infection. CMI was ruled out as a relevant host defence component, but when cyclosporin A (CsA) was administered to athymic animals, renal infection was exacerbated. CsA is thought to affect T lymphocyte function and, in the absence of a target cell, cellular defences in the athymic animal were not expected to be compromised by CsA. An effect on non-cellular defence mechanisms was therefore considered but our studies did not support this explanation--rather they indicated a depression of either cellular defences or of a specific cellular component. The present experiments have provided additional information on the relationship between CsA administration and the depression of host defence mechanisms but further studies will be necessary to identify the components affected. PMID- 3294416 TI - Detection and semiquantitative determination of antibodies against Plasmodium falciparum in human blood serum: NBT-reduction by polymorphonuclear leukocytes. AB - Nitroblue tetrazolium (NBT) reduction by polymorphonuclear leukocytes (PMN) has been employed for the detection of specific opsonizing antibodies against Plasmodium falciparum in sera from individuals exposed to malaria parasites. Specific antibody-antigen complex is known to trigger the metabolic activation of normal PMN, as measured by NBT-test. In the sera from 16 out of 17 patients tested the NBT-reduction of normal PMN was, in the presence of P. falciparum antigen, significantly higher than that obtained with pooled normal serum from individuals without malaria background. This enhancement was more pronounced in the presence of complement. NBT-reduction was elevated to a lower extent when human anti-P. falciparum sera were substituted with anti-P. vivax or P. ovale sera. Furthermore, no enhancement was noted when red blood cells lysate was used as antigen. The results indicated the presence of specific opsonizing antibodies against P. falciparum in the patient sera. Oxygen-derived free radicals formed by PMN during the stimulation are suggested as the neutrophil mediated protection against malaria. PMID- 3294417 TI - Discrepancies between two procedures for ds-DNA antibody detection: Farr test and indirect immunofluorescence on Crithidia luciliae. AB - Of the 54,911 sera routinely tested for anti-double stranded-DNA antibodies (Ab), 2,297 gave a positive reaction with both indirect immunofluorescence (IIF) on Crithidia luciliae (CL) and the Farr test, or with only one of the two tests. Of the sera giving positive reactions, only 1,499 (65.3% of the positive sera) were positive with both reactions. Among the remaining 798 sera (34.7% of positive sera), 48.25% gave a positive reaction with the Farr test and 51.75% with the IIF reaction. Of the discrepant Farr test(+), IIF-CL(-) sera, slightly fewer than half corresponded to a false positive reaction of the Farr test due to the presence in the serum of proteins other than Ab which were able to bind to the labelled ds-DNA to form a complex precipitable by 50% saturated ammonium sulfate solution. Slightly more than half of the other Farr test(+) IIF-C'(-) sera corresponded to a defect in the IIF-CL reaction. Among the discrepant Farr test( ) IIF-CL(+) sera, 1/3 corresponded to false positive reactions IIF-CL and 2/3 of the remaining sera contained weakly avid anti-ds-DNA antibodies undetectable using the Farr test. PMID- 3294418 TI - Criterion-related versus non-criterion-related prompt training with severely mentally handicapped children. AB - Thirty-three severely mentally handicapped children were involved in a study to evaluate the effectiveness of three training programmes in teaching visual discriminations. Three matched sets of subjects each received both a size and an intensity discrimination with either: (1) size prompting; (2) intensity prompting; or (3) no prompting (trial-and-error training). The prompted groups therefore received both criterion-related (CR) and non-criterion-related (NCR) training. Order of presentation of the discriminations was counterbalanced across subjects. There was a significant main effect of training group with both size and intensity prompting groups making significantly fewer errors than the trial and-error group (P less than 0.05 in both cases), but not differing significantly from each other. Significant linear trends for increasing errors across CR, NCR and trial-and-error training programmes were found for both the size discrimination (P less than 0.01), and intensity discrimination (P less than 0.05). More children acquired the discriminations when trained with a CR prompt than with a NCR prompt or trial-and-error procedure, and all four children who failed to acquire discriminations with NCR prompts subsequently acquired them when trained with a CR programme. The results are discussed in relation to cue discriminability and theoretical explanations involving overshadowing are considered. PMID- 3294419 TI - Generation of a detailed physical and genetic map of the ilv-metE-udp region of the Escherichia coli chromosome. AB - The entire ilv-metE-udp region of the Escherichia coli chromosome has been cloned in two steps using the lambda replacement vector EMBL4. A detailed restriction map for approximately 70 X 10(3) bases of DNA has been generated. The gpp and udp structural genes have been identified, the cya and metE genes have been physically located, and the direction of recQ gene transcription has been determined. By examining a variety of plasmid subclones, 44 polypeptides have been detected using maxicell and minicell analysis, accounting for 70% of the maximum coding capacity of the entire region. On the basis of the observed gene density in the ilv-metE-udp region, a total number of 3000 genes is predicted for the entire E. coli chromosome. In addition, anomalies in cotransduction frequencies that have been observed in this region have been interpreted by employing a new formula that incorporates the effects of different transducing fragment representations and recombination probabilities. PMID- 3294420 TI - Cloning, overexpression and purification of the terminase proteins gp16 and gp17 of bacteriophage T4. Construction of a defined in-vitro DNA packaging system using purified terminase proteins. AB - Terminases of double-stranded DNA bacteriophages are required for packaging and generation of terminii in replicated concatemeric DNA molecules. Genetic evidence suggests that these functions in phage T4 are carried out by the products of genes 16 and 17. We cloned these T4 genes into a heat-inducible cI repressor lambda PL promoter vector system, and overexpressed them in Escherichia coli. We developed an in-vitro DNA packaging system, which, consistent with the genetic data, shows an absolute requirement for the terminase proteins. The overexpressed terminase proteins gp16 and gp17 appear to form a specific complex and an ATP binding site is present in the gp17 molecule. We purified the terminase proteins either as individual gp16 or gp17 proteins, or as a gp16-gp17 complex. The gp16 function of the terminase complex is dispensable for packaging mature DNA, whereas gp17 is essential for packaging DNA under any condition tested. We constructed a defined in-vitro DNA packaging system with the purified terminase proteins, purified proheads and a DNA-free phage completion gene products extract. All the components of this system can be stored at -90 degrees C without loss of packaging activity. The terminase proteins, therefore, may serve as useful reagents for mechanistic studies on DNA packaging, as well as to develop T4 as a packaging-cloning vector. PMID- 3294421 TI - Genetic analysis of the membrane insertion and topology of MalF, a cytoplasmic membrane protein of Escherichia coli. AB - MalF is an essential cytoplasmic membrane protein of the maltose transport system of Escherichia coli. We have developed a general approach for analysis of the mechanism of integration of membrane proteins and their membrane topology by characterizing a series of fusions of beta-galactosidase to MalF. The properties of the fusion proteins indicate the following. (1) The first two presumed transmembrane segments of MalF are sufficient to anchor beta-galactosidase firmly to the inner membrane. (2) Hybrid proteins with beta-galactosidase fused to a presumed cytoplasmic domain of MalF have high beta-galactosidase specific activity; fusions to periplasmic domains have low activity. We propose therefore, that periplasmic and cytoplasmic domains of integral membrane proteins can be distinguished by the enzymatic properties of such hybrid proteins. In general, it appears that cleaved or non-cleaved signal sequences when attached to beta galactosidase cause it to become embedded in the membrane, and this results in the inability of the hybrid proteins to assemble into active enzyme. Additional properties of these fusion proteins contribute to our understanding of the regulation of MalF synthesis. The MalF protein, synthesized as part of the malEFG operon of E. coli, is approximately 30-fold less abundant in the cell than MalE protein (the maltose-binding protein). Differential amounts of the fusion proteins indicate that a regulatory signal occurs within the malF gene that is responsible for the step-down in expression from the malE gene to the malF gene. PMID- 3294422 TI - Molecular dynamics simulation of despentapeptide insulin in a crystalline environment. AB - Despentapeptide insulin (DPI), an analogue of insulin, is the only analogue of insulin existing as a monomer in crystalline form so far discovered. A 31 picosecond molecular dynamics simulation of DPI was carried out in the unit cell that includes four DPI molecules, 398 water molecules, four Cd2+, eight Na+ and four Cl-. The molecular dynamics results were compared with the available X-ray structure in terms of atomic positions, backbone dihedral angles, hydrogen bonds and positional fluctuations. Good agreement was found between the molecular dynamics results and the X-ray data. The largest root-mean-square fluctuations were observed at the N-terminal part of the B chain. This fits with the experimental observation. PMID- 3294423 TI - Unexpected divergence and molecular coevolution in yeast plasmids. AB - Four closely related species of yeast possess multicopy nuclear plasmids whose shared molecular architecture demonstrates a common ancestor, despite their lack of discernible DNA sequence homology. Each plasmid encodes three proteins which have equivalent essential functions in plasmid maintenance. These three groups of proteins show markedly different degrees of conservation, so that although we have successfully aligned sequences for two groups, members of the third group have diverged to such an extent that they cannot be aligned. All the proteins are sufficiently different that they function only in conjunction with their encoding plasmid. These proteins have therefore conserved their functional interactions with the relevant DNA sequences of their particular plasmids, despite lack of amino acid sequence conservation. The maintenance of function in the face of DNA sequence divergence is analogous to the coevolution of ribosomal DNA promoters and RNA polymerase I, and suggests that molecular drive may be an important force in the evolution of these plasmids. This view is reinforced by the inconsistent phylogenetic relationships determined from the two alignment sets, and by the contradiction that the two plasmids known to be the closest related taxonomically and by their host interchangeability are suggested to be the most distant by their sequences. PMID- 3294424 TI - Specific components in the etiology, assessment, and treatment of male sexual dysfunctions: controlled outcome studies. AB - Controlled outcome studies investigating specific components in the etiology, assessment, and treatment of male sexual disorders are reviewed. Premature ejaculators appear just as accurate in assessing their levels of sexual arousal as are men not suffering from this condition. Absolute levels of sexual activity or desire do not seem to be as important for these individuals as has been suggested. Attempts to distinguish organic versus functional erectile failure using the MMPI or historical data have generally proved unsuccessful. Treatment effectiveness in premature ejaculation may be due to elevating the sensory threshold or may be an artifact of simply prescribing more frequent sexual activities. Removing performance demands through cognitive restructuring and sexual communication training shows promise in the treatment of erectile failure. PMID- 3294425 TI - Methods for projecting course of acquired immunodeficiency syndrome epidemic. AB - Three methods for projecting the short-term course of the acquired immunodeficiency syndrome (AIDS) epidemic are discussed: (a) empirical extrapolation, (b) the method of "back calculation," and (c) projections based on compartmental models. Extrapolation, which requires only data on AIDS incidence, is based on an assumed functional form and on the supposition that previous trends will continue. The method of back calculation incorporates both information on previous AIDS incidence and knowledge about the incubation period distribution. These calculations provide some evidence of how many infections occurred during previous time intervals. Although this information is not precise, particularly for the recent past, it is sufficient to produce stable short-term projections. Compartmental models can be used to project future prevalence of infection as well as future AIDS incidence. However, such projections are very dependent on assumptions about initial numbers of individuals infected, rates of transmission, changes in high-risk behaviors over time, and assumptions about transmission among subpopulations with differing transmission rates and initial prevalence of infection. Thus, compartmental models offer insights into the trends in an epidemic but do not currently provide a practical tool for obtaining quantitative projections. We present projections for various risk groups based on the method of back calculation and discuss the use of additional epidemiologic data to obtain accurate projections a decade in advance. PMID- 3294426 TI - Cocarcinogenicity of saccharin and N-alkylnitrosoureas in cultured human diploid fibroblasts. AB - Previous attempts to transform human foreskin fibroblasts in vitro with N methylnitrosourea (MNU) or N-ethylnitrosourea (ENU) have been unsuccessful, and concurrent treatment with cocarcinogens or tumor promotors and either MNU or ENU have also failed to produce a neoplastic response. The present study was undertaken to test the effect of sodium saccharin on MNU- or ENU-induced cell transformation. Saccharin alone was not effective in inducing the growth of colonies in soft agar (anchorage-independent growth). However, concurrent treatment with saccharin (50 micrograms/ml, nontoxic dose) and MNU or ENU (29 micrograms/ml or 44 micrograms/ml, respectively) was effective in inducing transformation (greater than 300 colonies/10(5) cells), but only when the cells were treated with saccharin after being released from a G1 block (amino acid deprivation) and followed by MNU or ENU treatment in early S phase. In contrast to results obtained with other chemical carcinogens, transformation frequencies induced by saccharin and MNU or ENU were only slightly decreased in the absence of insulin, which is normally required for growth in this system. Saccharin-MNU- or saccharin-ENU-treated cells that exhibited growth in soft agar also exhibited cellular invasiveness in 9-d-old embryonic chick skin in vitro. In addition, these cells reacted with a monoclonal antibody prepared against a molecular weight 115,000 sarcoma-cell surface-associated glycoprotein and also developed tumors in nude mice. These data demonstrate the cell-cycle-dependent cocarcinogenic potential of saccharin and MNU or ENU in cultured human skin fibroblasts. PMID- 3294427 TI - Hemorrhagic shock induces bacterial translocation from the gut. AB - Sepsis and multiple organ failure are common after hemorrhagic shock. The goal of the current experiments was to determine whether hemorrhagic shock would promote the translocation of bacteria from the gut to visceral organs. Twenty-four hours after being subjected to sham shock, or 30, 60, or 90 minutes of shock (30 mm Hg), rats were sacrificed and their organs quantitatively cultured for translocating bacteria. There was a direct relationship between the duration of hemorrhagic shock and the 24-hour mortality rate (p = 0.02). Bacteria did not translocate from the gut in the sham-shock rats, but did translocate to the mesenteric lymph nodes, livers, and spleens of the rats subjected to hemorrhagic shock (p less than 0.01). Rats subjected to 90 minutes of shock shock exhibited a greater degree of bacterial translocation than rats receiving 30 or 60 minutes of shock (p less than 0.05). The most common translocating bacteria were Escherichia coli and Enterococcus. Hemorrhagic shock injured the gut mucosa and caused subepithelial edema and focal areas of necrosis. Thus hemorrhagic shock followed by reinfusion of shed blood disrupts the gut barrier and allows indigenous bacteria normally contained within the gut to cause systemic infections. PMID- 3294428 TI - The "Pinocchio" nasal deformity--hemangioma vs. angiolipoma: esthetic correction and etiology. AB - The author presents the first reported case of a nasal angiolipoma presenting as "Pinocchio" nasal tip deformity. The two types of angiolipomas (infiltrating and non-infiltrating) are discussed as are two surgical approaches to this deformity. The author feels that the external rhinoplasty technique is an excellent way to approach this problem, especially in patients who are suffering severe emotional stress due to peer pressure. PMID- 3294430 TI - Hemostatic suture for septoplasty. PMID- 3294429 TI - The malignant lymphoepithelial lesion of the salivary glands. AB - Malignant lymphoepithelial lesion (MLEL) is a rare neoplasm of the salivary gland which has an exceptionally high incidence in the Eskimo. Eighty-four cases have been previously reported. Seven additional cases in six Eskimos and one Filipino patient are reported in this paper. The etiology, treatment and prognosis of these lesions is then discussed. PMID- 3294431 TI - Ultrasonic evaluation of cervical metastatic lymphadenopathy. AB - We investigated the location, size, and shape of cervical lymph nodes in head and neck cancer, using a 7.5-MHz ultrasound scanner. First, the different criteria for normal size were obtained for cervical lymph nodes in each region; lymph nodes greater than 9 mm in thickness in the internal jugular chain or greater than 7 mm in thickness in the submandibular and submental chains should be suspected of harboring metastatic foci. Second, metastatic nodes showed a more rounded configuration than nonmetastatic ones. Third, a comparative study of metastatic lymph nodes between the in vivo and in vitro ultrasonograms and the corresponding histopathological findings disclosed that an echogenic region in an ultrasonogram of a metastatic node was caused by coagulation necrosis, and a cystic area of liquefaction necrosis. PMID- 3294432 TI - Intraoperative spinal sonography in the evaluation of intramedullary tumors. AB - Seventeen intraoperative spinal sonographic examinations were performed in 14 patients with intramedullary spinal cord neoplasms. Results of the ultrasound exams were correlated with preoperative imaging studies, surgical findings, and histopathologic analysis of the tumors. Intraoperative spinal sonography accurately localized the intramedullary tumors, often revealing the need for extension of the initial laminectomy. The neoplasms appeared as expansile echogenic masses, with cystic components in over half. Ultrasound was as accurate as preoperative imaging in the evaluation of solid neoplasms, and was superior to computed tomography (CT) and magnetic resonance imaging (MRI) for delineating the cystic components of neoplasms. Intraoperative sonography should be used routinely in all surgical cases of intramedullary spinal cord neoplasms. PMID- 3294433 TI - Membrane thickness in ultrasound prediction of chorionicity of twin gestations. AB - A retrospective review of sonograms performed on 75 twin gestations was performed to evaluate the ability of sonography to distinguish monochorionic from dichorionic gestations based on the thickness of the membrane separating the fetuses. Clinical or pathologic evidence of chorionicity and amnionicity was available in all cases. A thick membrane had a predictive value of 83% for dichorionicity and was seen in 89% of the first sonograms obtained on dichorionic gestations. Of third trimester dichorionic pregnancies, a thick membrane was seen in only 52%. A thin membrane on the initial study had a predictive value for monochorionic diamniotic pregnancy of 83%, but was seen in only 54% of cases. There was 100% intraobserver and 91% interobserver concordance in interpretation of membrane thickness. Technical factors important in interpretation of membrane thickness are discussed. The appearance of the membrane can be useful in sonographic evaluation of chorionicity and amnionicity in twin gestations, but should be used in conjunction with all other information available. PMID- 3294434 TI - Ultrasonographic measurements of the fetal neck correlated with gestational age. AB - Ultrasonographic examinations were performed on 121 normal fetuses between 15 to 40 weeks of gestation to measure the fetal neck. The area (FN-A), circumference (FN-C), anteroposterior diameter (FN-APD) and transverse diameter (FN-TD) of the fetal neck correlated well with the gestational age, respectively. Ultrasonographic measurements of the fetal neck in utero are thus new parameters to evaluate the fetal growth and identify the abnormality of the fetal neck in utero. PMID- 3294435 TI - Fat necrosis simulating a primary tumor of the mesentery: sonographic diagnosis. PMID- 3294436 TI - In utero sonographic findings in fetal renal vein thrombosis with calcifications. PMID- 3294437 TI - Ultrasound findings of chronic intussusception in a patient with cystic fibrosis. PMID- 3294438 TI - A prototype device for nonimmersion shock wave lithotripsy using ultrasonography for calculus localization. AB - Extracorporeal shock wave lithotripsy has revolutionized the clinical treatment of renal calculi. A device was constructed with a spark gap for shock wave generation and a water-filled ellipsoidal reflector to focus the shock wave energy. A membrane coupled the device to the pig and an ultrasonic transducer was used for stone visualization. Initial in vitro experiments and in vivo studies using dwarf pigs demonstrated fragmentation of calculi. PMID- 3294439 TI - Bacteriuria following extracorporeal shock wave lithotripsy of infection stones. AB - Extracorporeal shock wave lithotripsy effectively pulverizes infected (struvite) renal calculi. However, after treatment minute residual fragments that may harbor bacteria and cause persistent bacteriuria remain in the renal collecting system for months. We investigated prospectively the incidence of persistent Proteus mirabilis bacteriuria after extracorporeal shock wave lithotripsy among 15 consecutive women with Proteus mirabilis urinary tract infections and struvite calculi. All patients received parenteral gentamicin for 3 to 8 days (mean 4.7 days) immediately before and after extracorporeal shock wave lithotripsy. Oral antimicrobials then were administered for 14 to 34 days (mean 25 days). Ten patients have maintained a sterile urine or experienced urinary reinfection by other organisms during 8 to 19 months (mean 13 months) of subsequent bacteriological surveillance. Of these 10 patients 9 had residual fragments. Five patients had Proteus mirabilis bacteriuria after 1 to 7 months of surveillance, including 3 with residual fragments. The mean stone size, methods and duration of renal drainage procedures, and duration of antimicrobial therapy were similar for the 2 patient groups. Proteus mirabilis was isolated from the cultures of only 3 of 11 retrievable stone fragments. In contrast to intact infected renal calculi, residual stone fragments after extracorporeal shock wave lithotripsy often are susceptible to sterilization with antimicrobials. PMID- 3294440 TI - Ureteroneocystostomy in renal transplantation: a simple transvesical technique. AB - A simple transvesical technique for transplant ureteroneocystostomy is described. The method has been used in 245 transplants during a 6-year period. Only 4 significant complications (1.6 per cent) were recognized and no kidney was lost owing to a complication of ureteroneocystostomy. PMID- 3294441 TI - Patient acceptance of and satisfaction with vasoactive intracavernous pharmacotherapy for impotence. AB - Patient acceptance of and satisfaction with a trial of vasoactive intracavernous pharmacotherapy for impotence among 372 men were retrospectively analyzed. Drop out from the dosage determination phase and the training for injection phase was similar, 9.7 and 8.4 per cent, respectively, while 31.4 per cent of the patients dropped out of the home injection phase. Tachyphylaxis, inconvenience of the procedure or the frequent followup visits required, side effects and concern about unknown long-term effects were the main reasons patients cited for dropping out of the trial. The degree of satisfaction among patients who entered the home injection phase was high. Only 55 patients who dropped out of the trial chose implantation of a penile prosthesis. Vasoactive intracavernous pharmacotherapy is an effective treatment for impotence of various etiologies, and in a carefully selected group of patients the acceptance of and satisfaction with this therapy are high. PMID- 3294442 TI - A randomized trial of acetohydroxamic acid for the treatment and prevention of infection-induced urinary stones in spinal cord injury patients. AB - Acetohydroxamic acid is known to inhibit bacterial urease activity, thus, reducing urinary ammonia levels. A double-blind placebo-controlled clinical trial of acetohydroxamic acid was conducted at 12 Veterans Administration spinal cord injury units. A total of 210 male spinal cord injury patients with chronic urea splitting urinary infection was enrolled for a scheduled followup of 2 years. The study data support the usefulness of acetohydroxamic acid in reducing urinary ammonia. At every followup visit the acetohydroxamic acid patients with stones had decreases in ammonia of 30 to 48 mg. per dh., while the placebo patients had increases in ammonia. Acetohydroxamic acid also retarded stone growth. Patients with stones treated with acetohydroxamic acid exhibited significantly longer intervals from randomization to first stone growth than patients treated with placebo (p less than 0.005, medians 15 versus 9 months). Acetohydroxamic acid reduced significantly the proportion of patients with stone growth at 12 months (33 versus 60 per cent, p equals 0.017). This decrease was diminished at 24 months (42 versus 60 per cent, p equals 0.260). Patient attrition was 31 per cent in the placebo group and 62 per cent in the acetohydroxamic acid group, the latter attrition being primarily owing to patient request because of mild symptoms. Of the acetohydroxamic acid and placebo patients 62 and 29 per cent, respectively, reported drug side effects but all were reversible and no unanticipated or life-threatening reactions occurred. PMID- 3294443 TI - Delayed bladder rupture after augmentation enterocystoplasty. AB - Delayed bladder perforation with peritonitis following augmentation enterocystoplasty in children with spina bifida is a serious and potentially life threatening complication. Our experience with 4 such cases is presented. All patients had spina bifida with a neuropathic bladder and they had undergone augmentation enterocystoplasty with a tubular colonic segment of large bowel as part of an undiversion procedure. All patients were being managed with intermittent self-catheterization. The interval from augmentation enterocystoplasty until presentation ranged from 6 months to 3 years. Diagnosis was delayed in all cases, including 3 in which cystogram studies were normal despite findings of extravasation of urine at exploration. In 1 patient generalized sepsis developed with the respiratory distress syndrome and, subsequently, she died. PMID- 3294444 TI - Salmonella urinary tract infection associated with ureteropelvic junction obstruction. AB - Although rare, urinary tract infections in children by salmonella species have been associated with a high incidence of structural anomalies. We report on a 5 year-old patient with Salmonella enteritidis urinary tract infection associated with ureteropelvic junction obstruction. PMID- 3294445 TI - Anuria secondary to percutaneous needle biopsy of a transplant kidney: a case report. AB - Unexplained deterioration of renal function after renal transplantation is often an indication for percutaneous needle biopsy of the allograft. This procedure, even when supplemented by modern radiographic techniques, is not without complications. We report a case of anuria secondary to subcapsular hematoma following an ultrasound-guided needle biopsy. Diagnosis, operative management and postoperative care are discussed. PMID- 3294446 TI - Retroperitoneal actinomycosis: a case report and review of the literature. AB - A 25-year-old Haitian man presented with a post-traumatic left retroperitoneal abscess. Culture of material obtained during surgical drainage yielded Actinomyces israelii. Retroperitoneal actinomycosis is a particularly unusual manifestation of infection with this organism. Because it may mimic subacute infections or malignant masses in terms of clinical findings, diagnosis of this entity may be difficult. Our diagnosis was based on the results of culture, and the patient responded to long-term penicillin therapy. PMID- 3294447 TI - Genitourinary coccidioidomycosis. AB - Symptomatic involvement of the genitourinary tract as a manifestation of disseminated Coccidioides immitis infection is uncommon. We report a case of a colovesical fistula secondary to Coccidioides immitis infection and review the pertinent medical literature. PMID- 3294448 TI - Adherence of urease-induced crystals to rat bladder epithelium following acute infection with different uropathogenic microorganisms. AB - Apart from urine supersaturation with respect to struvite and calcium phosphate, crystal retention is considered to be necessary for the formation of infection stones. This study was performed to investigate the role of the mucous coat in rat bladders in the adhesion of sterile urease-induced crystals and to determine to what extent the adhesion was influenced by infection. Elimination of the mucous coat with 0.1 M HCl increased the adherence of crystals six times compared to that in bladders with an intact mucous coat. Infection with Proteus mirabilis, Escherichia coli, enterococci and Ureaplasma urealyticum increased the adherence six, five, four and two times, respectively. Injury to the mucous coat may thus be one mechanism by which microorganisms can contribute to the formation of infection stones in the urinary tract. PMID- 3294449 TI - The role of preoperative radionuclide ejection fraction in direct abdominal aortic aneurysm repair. AB - Preoperative radionuclide ventriculography was performed in 60 patients to assess whether such testing could define those at increased risk after direct abdominal aortic aneurysm (AAA) repair. None of the patients had prophylactic coronary artery reconstruction to reduce the risk of AAA repair despite angina in 27% and previous myocardial infarction (MI) in 42%. The mean ejection fraction (EF) was 52% +/- 15% (range 14% to 78%). Low EF (normal greater than 50%) was present in 40%, whereas ventricular wall motion abnormalities were present in 39% of patients. The overall perioperative (30-day) mortality rate was 5%. MI occurred in 7% within 30 postoperative days; none was fatal. Life-table analysis revealed that overall survival after AAA repair was significantly lower in patients with an EF of 50% or less (p less than 0.025, Mantel-Cox) during a follow-up of 20.1 +/- 11.9 months. Overall survival differences were even more striking for those with an EF of 35% or less (p = 0.003, Mantel-Cox). There was a marked difference in the cumulative mortality rate during follow-up, being 50% in those patients with an EF of 35% or less (n = 10) compared with 14% in those with an EF greater than 35% (n = 50, p = 0.036, Fisher exact test). There was no statistical difference in the incidence of perioperative MI or perioperative death for those with an EF of 35% or less vs EF greater than 35%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294450 TI - Natural history and management of iliac aneurysms. AB - Fifty-five patients with 72 aneurysms of the iliac vessels were evaluated retrospectively during a 12-year period (1972 to 1985). Atherosclerotic vascular disease was found in all aneurysms. Marked male predominance (5:1) and advanced age (mean 74.6 years) characterized this population group. Two thirds of them harbored multiple aneurysms and isolated aneurysms were found primarily to involve the internal iliac artery (12 of 18 patients). Although symptomatic presentation varied with anatomic location and presence of rupture, most patients were either asymptomatic (45%) or had such nonspecific complaints (11%) that diagnosis was often delayed or erroneous. A mass detected during abdominal, rectal, or vaginal examination was found in 39 patients (70%). Aneurysm size ranged from 2.5 to 18 cm (mean 5.5 cm) for the entire group. Internal iliac aneurysms tended to be larger (7.7 cm) yet demonstrated no increased risk of rupture, which was encountered in 33% of patients. Elective operative management was undertaken in 26 patients with a mortality rate of 11%. When repair had to be performed as an emergency procedure mortality increased to 33%. Aneurysm ligation, resection, or endoaneurysmorrhaphy coupled with graft interposition when necessary did not seem to influence patient survival. Eleven patients treated nonoperatively demonstrated enlargement in three, rupture in one, and progressive ureteral obstruction in one patient. Iliac aneurysms demonstrate expansile growth with eruptive and erosive complications and therefore should be managed aggressively under elective circumstances. PMID- 3294451 TI - Massive gastrointestinal hemorrhage caused by rupture of a jejunal branch artery aneurysm. AB - Aneurysms located in the arterial tree that directly supplies the alimentary tract account for a small percentage of all aneurysms. Jejunal branch artery aneurysms are an uncommon component of this group, and gastrointestinal hemorrhage from such an aneurysm has rarely been described. We report a case of a jejunal branch artery aneurysm appearing as sudden and massive gastrointestinal bleeding in a 28-year-old man. Diagnosis was made by selective superior mesenteric artery angiography, and the patient underwent successful segmental resection of the involved area of jejunum. The pertinent literature is reviewed. PMID- 3294452 TI - Proposed new classification of postendarterectomy carotid duplex scans. PMID- 3294453 TI - 'Scientists' summer camp' turns to sea for answers to human biologic questions. PMID- 3294454 TI - A historical perspective of injuries in professional football. Twenty-six years of game-related events. AB - A professional football franchise was studied consecutively from 1960 through 1985 for injuries incurred during regular-season games. A "significant" injury was defined as one requiring the player to miss at least two consecutive games (N = 331) and a "major" injury as one that caused the player to miss at least eight games or the equivalent time (N = 130). Significant injuries averaged 0.89 per game and major injuries 0.35 per game for the entire 26 years. Following a high injury rate prior to 1965, significant injury rates were episodic. Major injuries declined (rs = -.68; P less than .01). Since the team's first games on synthetic surfaces in 1968, there was no difference in the rates of significant injuries per game (0.57 vs 0.67) or major injuries per game (0.22 vs 0.33) between games played on grass or artificial turf, respectively. Since 1969 there has been a decline in major knee injuries (rs = -.51; P less than .05) and a decline in major injuries incurred during special-teams play (rs = -.55; P less than .05). The data indicate that this team suffered fewer injuries with the passing of time, primarily in injuries that caused a player to miss at least eight consecutive games. Observations of short duration do not lend themselves to current media perception that injury rates are higher and more serious today in professional football. PMID- 3294455 TI - Cancer risk of pesticides in agricultural workers. Council on Scientific Affairs. AB - This report discusses some of the inherent limitations of cancer studies in animals and humans and presents a qualitative carcinogen risk assessment of a number of pesticides based on the judgment of national and international authorities who have reviewed the available experimental and epidemiologic evidence. A large number of pesticidal compounds have shown evidence of genotoxicity or carcinogenicity in animal and in vitro screening tests, but no pesticides--except arsenic and vinyl chloride (once used as an aerosol propellant)-definitely have been proved to be carcinogenic in man. Resolution 94 (1-86), which was referred to the Board of Trustees, calls for the American Medical Association, through its scientific journals and publications, to alert physicians to the potential hazards of agricultural pesticides, to provide physicians with advice on such hazards for their patients, and to urge that these substances be appropriately labeled. This report addresses the potential carcinogenicity of pesticides by review of the available literature. PMID- 3294456 TI - Consensus conference. Prevention and treatment of kidney stones. PMID- 3294457 TI - Sink or swim: training to be an obstetrician. PMID- 3294458 TI - [Halothane hepatotoxicity and hepatic circulation]. PMID- 3294459 TI - [The effects of nicardipine on renin-aldosterone level and renal function after hemorrhage]. PMID- 3294460 TI - [Unusual clinical course of accidental subdural block]. PMID- 3294462 TI - [Targets of action and structure-activity relationships of antibiotics]. PMID- 3294461 TI - [Structures and biological properties of enterotoxin and hemolysin of non-01 Vibrio cholerae]. PMID- 3294463 TI - [Depressed cellular immunity in prostitutes and male homosexuals predisposes to HIV (human immunodeficiency virus)]. PMID- 3294464 TI - Complete hemodynamic evaluation of patients with aortic regurgitation by outpatient right heart catheterization and digital subtraction angiography. AB - The aim of this study was to demonstrate that total hemodynamic evaluation of patients with aortic regurgitation can be performed on an outpatient basis by combining right heart catheterization with digital subtraction angiography (DSA). Thirteen patients with severe aortic regurgitation were catheterized as outpatients, without premedication. The pulmonary artery was entered percutaneously through the femoral vein. Cardiac output and stroke volume were measured by the indicator dilution method by injection into the inferior vena cava and sampling from the pulmonary artery. The regurgitant fraction was obtained by subtracting the indicator stroke volume from the angiographic left ventricular stroke volume. The following results are expressed as mean +/- SD. Ejection fraction (%) = 54 +/- 6; end diastolic volume index (ml) = 228 +/- 40; end systolic volume index (ml) = 198 +/- 51 and regurgitant fraction (%) = 59 +/- 7 while the pulmonary wedge pressure (mmHg) = 10 +/- 3. In 4 cases, comparison with recent catheterization data showed good agreement for all parameters (r = 0.90), except ejection fraction (r = 0.75). In conclusion, this simplified catheterization method using digital subtraction enables the procedure to be done on an outpatient basis. All essential hemodynamic data can be obtained by right heart catheterization. PMID- 3294465 TI - [Total body irradiation for bone marrow transplantation: results of a national survey]. AB - The fourth national survey concerning total body irradiation (TBI) was completed in July, 1987. Results reveal that bilateral TBI is utilized at most hospitals (70%), and that a fractionated TBI has been employed at 37 out of 40 hospitals. High dose-rate TBI treatments have been used at 5 hospitals, mid-dose rate at 27, and low-dose rate at 8. Dose compensating and the shielding of contour variations, inhomogeneities, and the critical organs, as well as in vivo dosimetry were undertaken in more than half of the hospitals. Since the variety of methods in practice makes it difficult to identify the optimal TBI, the standardization of TBI should be an aim of a future investigation. PMID- 3294466 TI - [A study involving early carcinomas of the gall bladder]. AB - In recent years, with the development of diagnostic procedures, the number of cases of early carcinoma of the gall bladder has been seen to gradually increase. In this paper, 8 cases of early gall bladder carcinoma have been evaluated, using a diagnostic approach. Cholecystolithiasis was the complication in 6 cases, and abdominal pain was seen as the most common symptom. Findings by various image diagnoses, such as ultrasonography, DIC, ERCP, and CT scan are described and discussed with a review of literature. Ultrasonography was considered to be the most useful tool for the detection and diagnosis of an early carcinoma of the gall bladder. A survey is thought to be required, involving the cases that have accumulated throughout the entire nation. PMID- 3294467 TI - [Two cases of a lipid-secreting carcinoma of the breast]. AB - Two very rare cases of a lipid-secreting carcinoma of the breast are reported, and a review of the pertinent literature. The patients were both women, aged 70 and 81, respectively. Both of their clinical stagings were T2aN1aM0, stage II., and radical mastectomies were performed. On examination of the resected specimens, the tumors did not differ from the general findings of breast cancer. Microscopically, H-E stain showed the tumor cells to have a foamy and vacuolated eosinophilic cytoplasm. Lipid stain and an electron microscopic study were performed and showed that the tumor cells contained large amounts of neutral lipid droplets in their cytoplasm. PMID- 3294469 TI - [A case of a probable "cancer family syndrome" presenting four synchronous malignancies of the colon]. AB - A 72-year-old male was admitted because of right lower quadrant pain, Barium enema and total colonoscopy disclosed multiple colon cancers and sequentially, a subtotal colectomy was performed. The resected specimen demonstrated 3 advanced carcinomas and an adenomatous cancer with additional multiple polyps. Investigation of his family history revealed that his mother and his elder sister had died of uterine cancer, and that his elder brother, his nephew, and his niece had been operated on for colorectal cancer. We thus supposed a case of "Cancer Family Syndrome" presenting multiple neoplasms of the colon. PMID- 3294468 TI - [A case of an exogastric developing-type carcinoma of the stomach and a review of thirty nine cases reported in Japan]. AB - One personally handled case of an exogastric developing-type carcinoma of the stomach and 39 other cases reported in Japan are discussed in this study. Twenty seven cases mainly involved an abdominal tumor. As to the developing region, it was frequently in the greater curvature of the antrum. By tissue type, many undifferentiated medullary cancers were noted. With regard to treatment, many researchers recommend the excision of the other complicated organs. Survival for more than postoperative 1 year were as few as 4 cases, including the case handled. PMID- 3294470 TI - [An autopsied case of a malignant lymphoma with a severe nephrotic syndrome overlapped by cirrhotic glomerulosclerosis]. AB - A 52-year-old man, who had been diagnosed as having alcoholic liver cirrhosis, presented a chronic nephritic syndrome due to hepatic glomerulosclerosis. Ten months before death, massive proteinuria exceeding 40 g/day was noted. A renal biopsy revealed diffuse mesangial sclerosis, associated with an IgA deposition consistent with hepatic glomerulosclerosis. Although the nephrotic syndrome subsided with immunosuppressive therapy, he died of hepatic failure. Postmortem examinations disclosed a diffuse, medium-size B-cell lymphoma, involving the peritoneal and retroperitoneal organs and an IgA-positive plasmacytosis. His massive proteinuria seems to have been caused by the paraneoplastic syndrome of a malignant lymphoma. PMID- 3294471 TI - [Allogeneic bone marrow transplantation in 91 patients with acute leukemia (Nagoya Bone Marrow Transplantation Group)]. PMID- 3294472 TI - [The survey of terminal transferase (TdT) in hematological malignancies by using CAPY KIT-TdT]. PMID- 3294473 TI - [Congenital hemolytic anemia caused by pyruvate kinase variants (PK 'Kasumi')]. PMID- 3294474 TI - [Acute lymphocytic leukemia with unusual azurophilic granules: case report and review of literature]. PMID- 3294475 TI - [MR imaging of spinal dysraphism]. PMID- 3294476 TI - [Demonstration of intra and extra hepatic abscesses by 111In labeled leukocytes with 99Tc-Sn-colloid subtraction scintigraphy]. PMID- 3294477 TI - [On the "Notes on Nursing" (2). Organizing the conditions necessary for the maintenance of health]. PMID- 3294478 TI - [Nursing of leukemic patients in isolation following bone marrow transplantation]. PMID- 3294479 TI - [A case of choriocarcinoma of the bladder]. PMID- 3294480 TI - [Establishment of percutaneous nephroureterolithotomy and its clinical experiences]. PMID- 3294481 TI - [Statistical analysis of clinicopathological profiles affecting prognosis of patients with bladder carcinoma by therapeutic modality]. PMID- 3294482 TI - [Experimental studies on the prostate epithelium. I. Establishment of primary cell culture of rat dorsolateral prostate epithelium]. PMID- 3294483 TI - [Heterogenicity of type 1 diabetes in childhood]. PMID- 3294484 TI - [125 years ago Adalbert Czerny was born]. PMID- 3294485 TI - [Clinical value of ultrasonic examination in the diagnosis of cancer of the rectum]. PMID- 3294486 TI - [Complications associated with sandimmune therapy]. PMID- 3294487 TI - [A new suture for skin wounds]. PMID- 3294488 TI - [A method of drawing together wound edges]. PMID- 3294489 TI - [Gunshot hand injuries and their treatment (review of foreign literature)]. PMID- 3294490 TI - [Use of local freezing in clinical surgery (review of the literature)]. PMID- 3294491 TI - [Toxicity of wound exudates in long-term proteolysis by immobilized enzymes]. PMID- 3294492 TI - [Treatment of patients with acute surgical diseases associated with diabetes mellitus]. PMID- 3294494 TI - [The symptom of vomiting]. PMID- 3294495 TI - [Iosif Abramovich Kassirskii (on the 90th anniversary of his birth)]. PMID- 3294493 TI - Chemistry, biochemistry, and pharmacology of HMG-CoA reductase inhibitors. AB - After an extensive searching for a microbial product that inhibits cholesterol synthesis, compactin and a series of related metabolites like monacolin K (mevinolin) have been isolated from molds as active agents. These compounds, which were structurally related to hydroxymethylglutaryl coenzyme A, were potent competitive inhibitors of hydroxymethylglutaryl coenzyme A reductase, the rate limiting enzyme in cholesterol synthesis. The inhibition was reversible and the inhibitor constant Ki for compactin was around 10(-9) M. Compactin inhibited cholesterol synthesis in mammalian cells at 10(-9) M. Sterol synthesis in vivo was also reduced when compactin was given orally to rats at a dose of 50 mg/kg. Hydroxymethylglutaryl coenzyme A reductase activity of both cultured cells and rat liver was elevated when sterol synthesis was strongly inhibited by compactin. Both the growth inhibition and reductase induction could be overcome by the presence of mevalonate. A compactin-resistant cell line of mouse FM3A cells, called CR200, was developed by stepwise selection. CR200-cells had an abnormally high level of reductase activity and amplified reductase gene. Compactin was not able to lower plasma cholesterol levels in mice, rats, and hamsters. However, it was highly effective in rabbits, dogs, and monkeys; plasma cholesterol of dogs was reduced by 30%-40% at a dose of 20-50 mg/kg. The low-density lipoprotein cholesterol, which is responsible for atherosclerosis, was preferentially lowered. Compactin was also highly effective in hypercholesterolemic patients at a small dose. The results of the current studies have proved that compactin and related compounds are far more effective in lowering plasma cholesterol than any other drugs available.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294496 TI - [Exchange transfusion of plasma in autoimmune diseases of the nervous system]. PMID- 3294497 TI - [The clinician, Prof. Khristian Salomon (on the 190th anniversary of his birth)]. PMID- 3294498 TI - [Effect of inhibitors of gastric secretion on the acid-proteolytic activity of the stomach in ulcer disease]. PMID- 3294499 TI - [Ultrasonic diagnosis of non-tumor diseases of the esophagus, stomach and duodenum in patients with chronic cholecystitis]. PMID- 3294500 TI - Asbestos exposure and lung cancer: the role of Kenneth M. Lynch and William Atmar Smith. PMID- 3294501 TI - The physicians' friend: user-friendly bibliographic and informational data bases. PMID- 3294502 TI - A manual of military surgery. PMID- 3294503 TI - A critique of continuous discourse tracking as a test procedure. AB - Continuous discourse tracking is a versatile aural rehabilitation procedure. However, it is frequently used as a test instrument to evaluate the effectiveness of communication aids and aural rehabilitation strategies or to compare communication performance using auditory and/or visual stimuli. In this report, shortcomings of this practice are reviewed. Continuous discourse tracking has numerous uncontrolled variables related to the sender (i.e., the tester), the receiver (i.e., the subject), the text materials, and repeated presentations. We suggest that tracking is inappropriate for across-subject designs. For within subject test designs, stringent guidelines are offered to minimize some of the problems. Test developers should focus their future efforts on devising a test that reflects a natural communication interaction--one that engages the subject in a conversational style of listening. PMID- 3294504 TI - A new perspective in evaluating clinical effectiveness: the UWO Clinical Grading System. AB - To improve assessment of the performance of speech-language pathology students in clinical practicum, faculty and students in the Department of Communicative Disorders at the University of Western Ontario developed a new evaluation instrument, the UWO Clinical Grading System (UWO-CGS). This article reports on the development and field-testing of the UWO-CGS and includes estimates of the instrument's intrasupervisor and intersupervisor reliability. Results of content related, construct-related, and criterion-related investigations are reported to support the inference that the UWO-CGS is a valid measure of the clinical effectiveness of student speech-language pathologists. PMID- 3294505 TI - Volumes and breathing patterns during speech in healthy and asthmatic subjects. AB - The lung volumes and ventilatory patterns used by 10 healthy subjects and 14 patients with varying degrees of asthma were studied. The protocol included conversation, monologue, and counting at two loudness levels. Lung-volume changes were measured with a Respitrace and recorded with associated speech sounds. Volumes, durations, and flows were analyzed for sequences of respiratory cycles. Asthmatics used a greater percentage of their reduced vital capacity. Their inspiratory flow rates were slower, and expiratory rates faster. Asthmatics spent a greater proportion of the total respiratory cycle time on inspiration, and expired a greater volume of gas without sound. Patterns of ventilation suggested that asthmatics favored respiratory over communication needs to a greater extent than healthy subjects. Activities that forced priority to communication needs (counting to a metronome) were inadequate for gas exchange in asthmatics and could be sustained for only a limited period of time. PMID- 3294506 TI - Clustering of disfluencies in the speech of stuttering and nonstuttering preschool children. AB - Cluster formation in speech disfluencies of 15 preschool stuttering children and an equal number of nonstuttering control subjects was studied and compared. Clustering was defined as the occurrence of two or more disfluencies on the same or adjacent words. A computer program, based on the Monte Carlo method, was used to generate sets of expected numbers of single disfluencies and disfluencies in various cluster sizes according to simulation models. Results indicate that disfluencies occurred in clusters more often than could have been expected by chance for both groups. The proportions of clustered disfluencies, as well as the size of clusters, in the speech of the stutterers were significantly greater than those of the nonstuttering subjects. PMID- 3294507 TI - Use of adaptive digital signal processing to improve speech communication for normally hearing and hearing-impaired subjects. AB - A two microphone adaptive digital noise cancellation technique was used to improve word-recognition ability of normally hearing and hearing-impaired subjects in the presence of varying amounts of multitalker speech babble noise and speech spectrum noise. Signal-to-noise ratios varied from -8 dB to +12 dB in 4 dB increments. The adaptive noise cancellation technique resulted in reducing both the speech babble and speech spectrum noises 18 to 22 dB. This reduction in noise resulted in average improvements in word recognition, at the poorest signal to-noise ratios, ranging from 37% to 50% for the normally hearing subjects and 27% to 40% for the hearing-impaired subjects. Improvements in word recognition in the presence of speech babble noise as a result of adaptive filtering were just as large or larger than improvements found in the presence of speech spectrum noise. The amount of improvement of word-recognition scores was most pronounced at the least favorable signal-to-noise ratios. PMID- 3294508 TI - Spondylolysis and spondylolisthesis in young athletes: 28 cases. PMID- 3294509 TI - Tracheo-innominate artery fistula: a potentially fatal complication of tracheostomy. PMID- 3294510 TI - [The 11th Congress of Gynecologists and Obstetricians of Yugoslavia (prospects from a historico-philosophical retrospect]. PMID- 3294511 TI - [The first trained midwives in the region of what is now Montenegro]. PMID- 3294512 TI - Molecular, biologic, immunohistochemical, and ultrastructural aspects of lymphatic spread of the human immunodeficiency virus. PMID- 3294513 TI - Human immunodeficiency virus associated changes in germinal centers of lymph nodes and relevance to impaired B-cell function. PMID- 3294514 TI - Kaposi's sarcoma: evidence supporting its origin from the lymphatic system. AB - The histogenesis of Kaposi's sarcoma (KS) remains a subject of dispute. The weight of evidence, however, favors derivation of the spindle cell of KS from the lymphatic system and very likely from lymphatic endothelium. This conclusion is based on light microscopic and morbid anatomical observations and is further supported by the unique distribution of lesions in the skin, and in the submucosa of the gastrointestinal tract, following the lines of lymphatics; by the remarkable predilection of KS for lymph nodes (often without skin lesions); by the absence of lesions in organs which are devoid of lymphatics, i.e. the brain and eyeball; and by observations made by the author and others, utilizing electron microscopy, enzyme histochemistry and immunohistochemistry. It is recognized nonetheless that reactive elements such as fibroblasts, myofibroblasts and histiocytes may also be involved in the proliferative process. PMID- 3294515 TI - Vascular remodeling in Kaposi's sarcoma and avian hemangiomatosis: relation to the vertebrate lymphatic system. PMID- 3294516 TI - Magnesium therapy in infants with postneonatal apnea. AB - Idiopathic postneonatal apnea is defined here as a sudden, unexpected attack of apnea that first occurs after the infant has been discharged from the neonatal nursery to his home. Little has been published concerning the patient's physical and clinical laboratory findings during the acute episode. The present report of 20 infants with postneonatal apnea retrospectively addressed these parameters, including all investigations conducted for magnesium deficiency. The first episode of apnea occurred at 48 +/- 12.5 days of age and was unpredicted, transient, and self-limited. In the sickest infants, the apneic attack was a form of shock, with apnea, bradycardia, and often with acute respiratory distress, and/or neuromuscular hyperirritability. Laboratory findings in such infants were compatible with shock, including: acidosis, hemoconcentration, and hyperkalemia. Some infants showed high retention of parenteral Mg loads and received Mg therapy. Those receiving 5 or more days of Mg supplements were called 'Mg treated'. Seven such patients were treated for 20.4 +/- 3.7 days. They were compared with 13 'Mg-untreated' patients who received less than 5 days of Mg therapy, 0.9 +/- 0.2 days. There was no known recurrence of apnea requiring resuscitation, or any rehospitalization for an apneic attack among the Mg-treated infants. Of the 13 Mg-untreated infants, 6 were readmitted for apnea at 90 +/- 37 days of age; 2 of these had a third admission for apnea. In conclusion, in its most severe form, postneonatal apnea is a shock-like episode that is self limited, with a propensity to recur. Mg therapy appears to be associated with a reduction in recurrent apnea. This conclusion is corroborated by the significant reduction in recurrent apnea in the follow-up of a parallel study of 61 Mg treated versus 139 Mg-untreated premature infants with idiopathic postneonatal apnea (p less than 0.001). Further study can be recommended. PMID- 3294517 TI - Ischemic heart disease and magnesium. AB - Globally, among mortality and morbidity indices for man, ischemic heart disease (IHD) ranks at the top of the list. In the industrialized world, IHD is the leading killer and accounts for approximately 35% of all deaths each year. This most common cause of death results from insufficient coronary blood flow. IHD is a general term used to describe a pathophysiologic state in which cardiac output is inadequate as a consequence of coronary blood flow deficits brought about when the latter cannot deliver enough O2 to meet the needs of the myocardium. This review is concerned with the etiology of IHD, special forms of IHD such as angina pectoris and variant angina, as well as sudden death ischemia heart disease. The diverse conditions that cause IHD are discussed. Important etiologic factors such as the pathogenesis of atherosclerotic obstruction as well as localized coronary vasospasm are reviewed. Implications of dietary and metabolic alterations in electrolytes are a special focus of this view. Evidence implicating Mg2+-K+ and Mg2+-Ca2+ alterations in the pathogenesis of IHD is reviewed. Special attention is devoted to the role of Mg in vascular tone, coronary blood flow and in clinical management of IHD. It is concluded that judicious use of Mg salts in IHD could be expected to reduce myocardial oxygen demand and influence the myocardial oxygen supply/demand ratio in a favorable manner. PMID- 3294519 TI - Magnesium and inflammatory bowel disease. AB - Mg deficiency is a frequent complication of inflammatory bowel disease (IBD) demonstrated in 13-88% of patients. Decreased oral intake, malabsorption and increased intestinal losses are the major causes of Mg deficiency. The complications of Mg deficiency include: cramps, bone pain, delirium, acute crises of tetany, fatigue, depression, cardiac abnormalities, urolithiasis, impaired healing and colonic motility disorders. Serum Mg is an insensitive index of Mg status in IBD. Twenty-four-hour urinary excretion of Mg is a sensitive index and should be monitored periodically. Parenteral Mg requirements in patients with IBD are at least 120 mg/day or more depending upon fecal or stomal losses. Oral requirements may be as great as 700 mg/day depending on the severity of malabsorption. PMID- 3294518 TI - Use of magnesium-ATP following liver ischemia. AB - The role of Mg in cardiomyopathies of different etiologies is well known; however, relatively little is known about the changes in hepatic Mg levels following ischemia to the liver. The available information indicates that tissue and mitochondrial Mg levels are altered following global hepatic ischemia and reflow and that such alterations may be responsible for the depressed cellular function during those conditions. Administration of MgCl2 alone following ischemia was ineffective in improving tissue and mitochondrial Mg levels and cellular functions. ATP administration alone following ischemia was also ineffective. However, administration of ATP complexed with MgCl2 increased tissue and mitochondrial Mg levels, tissue ATP stores and cellular functions and proved beneficial for the survival of animals. The potential mechanisms of the beneficial effects of ATP-MgCl2 are discussed. A multicenter clinical trial of ATP-MgCl2 in patients with various adverse circulatory conditions is being initiated in this country. PMID- 3294520 TI - Historical profiles of Mayo. The Surgeons Club and the Mayos. PMID- 3294521 TI - Mechanism of reduction of aortic valvular stenosis by percutaneous transluminal balloon valvuloplasty: report of five cases and review of literature. AB - Among five patients (69 to 93 years of age) in whom percutaneous transluminal balloon valvuloplasty was performed for severe aortic stenosis, fractures of cuspid calcium were observed in three, fractures and a cuspid tear in one, and no gross alterations in one. Aortic stenosis resulted from degenerative (senile) calcification of tricuspid aortic valves in two patients, calcification of congenitally bicuspid aortic valves in two, and postinflammatory (presumably rheumatic) fibrocalcific disease in one. Fractures of calcific lesions, by allowing hingelike motion along their sites, seemed to facilitate cuspid mobility and thereby provided the apparent morphologic substrate for reduction in functional stenosis. Among three cases with fused commissures (two bicuspid and one postinflammatory), however, mobility of the conjoined cusps was not achieved after valvuloplasty, despite fracture of calcific nodules in the adjacent valve pocket of one case, because the fused and calcified commissures were not split or fractured and therefore continued to act as rigid struts that impeded cuspid motion. In the current autopsy evaluation of the effects of aortic balloon valvuloplasty, greater cuspid mobility seemed to be achieved in subjects with degenerative calcific stenosis than in those with calcified bicuspid valves or distortion by postinflammatory disease. PMID- 3294522 TI - Potential incretins. AB - A greater plasma concentration of insulin after isoglycemic enteral than after parenteral administration of glucose is called the incretin effect. The primary mediator of this effect, gastric inhibitory polypeptide, may not account for the complete manifestation of this phenomenon. We evaluated other gastroenteric polypeptides with respect to a differential response to oral ingestion of glucose and intravenous administration of glucose at rates that achieved arterial plasma glucose concentrations matched to those from orally administered glucose. Gastrin, peptide histidine methionine, peptide YY, and neurotensin showed increases in plasma concentrations in response to oral ingestion of glucose but not to intravenous administration of glucose. Vasoactive intestinal polypeptide showed no increased concentration in response to either oral or intravenous administration of glucose. The differential responses to orally and intravenously administered glucose noted in the former gastroenteric polypeptides qualifies them as potential mediators of the incretin effect. PMID- 3294523 TI - Alcoholism in the elderly population. PMID- 3294524 TI - Aortic valvuloplasty: are balloon-dilated valves all they are "cracked" up to be? PMID- 3294525 TI - Statistics and the practicing physician. PMID- 3294526 TI - Augusto de Saint-Hilaire: French entomologist and botanist. PMID- 3294527 TI - A typology of Medicaid managed care. AB - This article presents a typology for use in classifying and interpreting the findings of the growing empirical literature on managed care initiatives in the Medicaid program. Six key program attributes are identified for use in examining similarities and differences among these programs. Several alternative arrangements for each attribute are described from among the more than 60 different programs attempted. The typology is illustrated with five specific program designs, and selected empirical results from them are used to demonstrate how the typology can be employed. PMID- 3294528 TI - [Physicians and tobacco]. PMID- 3294529 TI - [Serological markers of infection caused by human immunodeficiency virus]. PMID- 3294530 TI - [Tuberculosis in Barcelona. Analysis of 899 cases reported in 1986]. PMID- 3294531 TI - [Changes in hemostasis in chronic renal insufficiency]. PMID- 3294532 TI - [The inaccuracy of bibliographical citations: a cause of fraudulent publications?]. PMID- 3294533 TI - [Dynamic behavior of arterial pressure during exertion. Effects of treatment with 2 different calcium blockers: nifedipine and verapamil]. PMID- 3294534 TI - [Internal medicine and the internists]. PMID- 3294535 TI - [Dermatology and primary care]. PMID- 3294536 TI - [Nelson syndrome and Cushing syndrome: a rare association. Presentation of a case and review of the literature]. PMID- 3294537 TI - [Antithrombosis therapy in ischemic heart disease]. PMID- 3294538 TI - Angiolipoma of the parotid: case report and review. AB - An angiolipoma is a benign adipose tissue tumor that can occur as either a circumscribed or an infiltrating lesion and represents up to 17% of all lipomas. Most angiolipomas occur in teenagers and young adults, and are rarely described in younger children. Angiolipoma generally arises on the extremities or trunk, and it is unusual when found in the head and neck. An angiolipoma of the parotid region was suspected in an infant girl after contrast-enhanced computerized tomographic scan, and was confirmed when the mass was surgically excised. The clinical characteristics, radiological appearance, and histopathology of angiolipoma are discussed. PMID- 3294539 TI - Ultrastructure of human foetal Schwann cells in tissue culture infected with Mycobacterium leprae. PMID- 3294540 TI - Association of IgG and IgM antibodies to phenolic glycolipid-1 antigen of Mycobacterium leprae with disease parameters in multibacillary leprosy patients. PMID- 3294541 TI - Characteristics of the multiplication of dapsone-resistant strains of Mycobacterium leprae in mice. Subcommittee on Clinical Trials of the C hemotherapy of Leprosy (THELEP) Scientific Working Group of UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases. PMID- 3294542 TI - Are hypersensitivity reactions to dapsone becoming more frequent? PMID- 3294543 TI - Immunopathology of leprosy granulomas--current status: a review. PMID- 3294544 TI - [The collagen molecule. 1]. PMID- 3294545 TI - [Prostaglandins and cancer]. PMID- 3294546 TI - [Development of preventive health services in the northern Adriatic coast from the establishment of the Health Center in Susak to the beginning of World War II (1926-1941)]. PMID- 3294547 TI - Decreased insulin secretory response of pancreatic islets during culture in the presence of low glucose is associated with diminished 45Ca2+ net uptake, NADPH/NADP+ and GSH/GSSG ratios. AB - In isolated rat pancreatic islets maintained at a physiologic glucose concentration (5.6 mM) the effect of glucose on parameters which are known to be involved in the insulin secretion coupling such as NADPH, reduced glutathione (GSH), 86Rb+ efflux, and 45Ca++ net uptake were investigated. The insulinotropic effect of 16.7 mM glucose was decreased with the period of culturing during the first 14 days being significant after 2 days though in control experiments both protein content and ATP levels per islet were not affected and insulin content was only slightly decreased. Both NADPH and GSH decreased with time of culture. 86Rb+ efflux which is decreased by enhancing the glucose concentration from 3 to 5.6 mM in freshly isolated islets was not affected by culturing whatsoever, even not after 14 days of culture when there was no longer any insulin responsiveness to glucose. The 45Ca++ net uptake was decreased during culturing. The data indicate (1) that the diminished glucose-stimulated release of insulin during culturing is not due to cell loss or simple energy disturbances, (2) that more likely it is the result of a diminished 45Ca++ net uptake as a consequence of the inability of islet cells to maintain proper NADPH and GSH levels, and (3) that potassium (86Rb+) efflux may not be related to changes of NADPH and GSH. PMID- 3294548 TI - Effect of chronic administration of progesterone on the naloxone-induced LHRH release from hypothalami of ovariectomized, estradiol-primed prepubertal rats. AB - To test the hypothesis that progesterone (P) administered in a high dose and for a long duration would influence in vitro LHRH release by naloxone, silastic capsules containing P (50 mg/ml) or vehicle were implanted sc in ovariectomized, estradiol-primed (OVX+E) prepubertal rats. Following a 48 hr exposure to P, rats were sacrificed and mediobasal hypothalamic (MBH) fragments were obtained. In addition, in other OVX+E primed rats, a single injection of P (1 mg) was given sc 6 hr prior to decapitation. Naloxone or control medium were infused into superfusion chambers containing MBH fragments derived from these animals for 2 hr following a 1 hr control period. Infusion of naloxone (1 x 10(-4) M) markedly stimulated in vitro LHRH release from MBH from rats pre-exposed to P for 48 hr, whereas it was unable to do so in other groups examined. These data clearly indicate that the ability of naloxone (1 x 10(-4) M) to stimulate LHRH release is dependent on the duration of P administration. PMID- 3294549 TI - A comparative study of the accuracy of ultrasound imaging, X-ray computerized tomography and low field MRI diagnosis of ovarian malignancy. PMID- 3294550 TI - Citation analysis of the field of medical decision making: update, 1959-1985. AB - This article updates a prior citation analysis of medical decision making, published in this journal in 1984. Building on the original core list, decision making papers were added based on any of three criteria: citation of three papers already on the list, identification by a MEDLINE search (CATLINE for books) as relevant to the topic, or mention in a recent review article on decision analysis. The revised core list contains 105 articles and five books. The changes in the field of medical decision making from 1978 to 1981 are reviewed, and key areas of development are identified by co-citation clustering. PMID- 3294551 TI - Non-experimental methods in the assessment of efficacy. PMID- 3294552 TI - Physicians' diagnoses compared with algorithmic differentiation of causes of jaundice. AB - Clinical data were collected in 194 cases of jaundiced patients treated at the "Adolfo Lopez Mateos" ISSSTE Hospital in Mexico City from July 1985 to July 1986. A copy of the clinical history of each patient was given to each of four physicians--one recently graduated from medical school, another in his first year of gastroenterology, and two others who were experienced gastroenterologists. The same clinical data were processed by a computer set up to use a modified Danish COMIC algorithm. All physicians and the computer technician were blinded to the "gold standard" pathologic diagnoses, with which their diagnoses were compared. Accuracy rates of the physicians in distinguishing intrahepatic (medical) from extrahepatic (surgical) jaundice were 78%, 86%, 86%, and 91%, and the accuracy of computer-assisted diagnoses was 96%. Chi-squared analysis of the diagnoses of three of the physicians and those of the computer showed significant differences (p between 0.1 and 0.01). For the diagnoses of the remaining physician, however, no significant difference was found after chi-squared continuity correction. PMID- 3294553 TI - A general regression methodology for ROC curve estimation. AB - A method for applying generalized ordinal regression models to categorical rating data to estimate and analyze receiver operating characteristic (ROC) curves is presented. These models permit parsimonious adjustment of ROC curve parameters for relevant covariates through two regression equations that correspond to location and scale. Particular shapes of ROC curves are interpreted in relation to the kind of covariates included in the two regressions. The model is shown to be flexible because it is not restricted to the assumption of binormality that is commonly employed in smoothed ROC curve estimation, although the binormal model is one particular form of the more general model. The new method provides a mechanism for pinpointing the effect that interobserver variability has on the ROC curve. It also allows for the adjustment of ROC curves for temporal variation and case mix, and provides a way to assess the incremental diagnostic value of a test. The new methodology is recommended because it substantially improves the ability to assess diagnostic tests using ROC curves. PMID- 3294554 TI - Primacy effects in clinical judgments of contingency. AB - In contingency judgment a primacy effect exists when a conclusion about the relationship between clinical variables is inordinately influenced by cases seen earlier rather than later in a presentation sequence. In this study, medical and nursing trainees evidenced this behavior in a hypothetical clinical judgment situation. The behavior was tied to an attention decrement explanation, by which inattention to the later-presented cases leads to inaccurate recall of the relative frequencies of observed cases, which in turn induces a misjudgment of a disease-finding contingency. An explicit intervention based on this hypothesis, forcing attention to later cases by warning that recall of the case frequencies would be required, was effective in reducing primacy effects among medical students. A related, but less explicit, intervention was also tried. This intervention did not significantly reduce primacy effects among nursing students, but was somewhat effective among general undergraduate students performing a non clinical contingency judgment task. PMID- 3294555 TI - Single testing when two tests are available. PMID- 3294556 TI - Patient management problems: heuristics and biases. PMID- 3294557 TI - [Radiation therapy of pancreatic cancer]. PMID- 3294558 TI - [Thermo- and scintigraphy with 67Ga citrate in the diagnosis of oro- and parapharyngeal tumors]. AB - The authors analyzed the results of thermographic and scintigraphic (using 67Ga citrate produced in the USSR) investigations in 41 patients: 10 with tumors of the oral cavity, 12 with oropharyngeal tumors, and 19 with parapharyngeal tumors. Of the latter 10 had morphologically verified benign tumors, 5--mixed type tumors, and 4--malignant tumors (sarcoma in 2 patients, a thyroid cancer metastasis to the parapharyngeal lymph nodes in 1, malignant chemodectoma in 1). Thermography and scintigraphy positive results (the absence of hyperthermia and RP hyperfixation in a tumor) were obtained in 7 of 10 patients with benign parapharyngeal tumors. Thermography false-positive results were obtained in 3 patients, however 67Ga-citrate accumulation was undetectable in these patients' tumors making the diagnosis more accurate. Thermography and scintigraphy results were positive in all 22 patients with malignant oropharyngeal (the oral cavity and oropharynx) tumors. Thermography and scintigraphy positive results were also noted in all 5 patients with parapharyngeal mixed tumors which could be associated with raised tumor tissue biological activity. The data obtained suggested a possibility of the use of thermography and scintigraphy in the diagnosis of oro-and parapharyngeal tumors. PMID- 3294559 TI - Identification and characterization of two nitrogen fixation regulatory regions, nifA and nfrX, in Azotobacter vinelandii and Azotobacter chroococcum. AB - Five Tn5-induced Nif- mutants of Azotobacter vinelandii were characterized as regulatory mutants because they were restored to Nif+ by the introduction of constitutively expressed nifA from Klebsiella pneumoniae. The mutants fell into two different classes on the basis of hybridization to a Rhizobium leguminosarum nifA gene probe and by complementation with cosmids isolated from pLAFRI gene banks of A. vinelandii and Azotobacter chroococcum. One mutant, MV3, was located in or near a nifA gene. The others, MV12, MV16, MV18 and MV26, defined a new regulatory gene, which has been called nfrX. The lack of expression of different nif-lacZ fusions confirmed the regulatory phenotype of all five mutant strains. The ability of both nifA and nfrX mutants to grow on nitrogen-free medium with vanadium, but not on medium with molybdenum, suggests that neither gene is required for expression of the alternative V-containing nitrogenase of A. vinelandii. A fragment carrying Tn5 and flanking DNA from MV3 was used as a probe to isolate the nifA region of A. chroococcum. Ligation of two adjacent EcoRI fragments of A. chroococcum yielded an intact nifA gene that activated expression of nifH-lac fusions and also restored MV3 to Nif+. The four nfrX mutants were complemented by pLAFR1 cosmids pLV163 and pLC121. The nfrX gene was subcloned from pLV163 and located within a 3.2 kb fragment. To determine whether nfrX might be found in other nitrogen-fixing organisms, DNA from 13 different species was hybridized to an nfrX probe. The failure to observe hybridization suggests that nfrX may be specific to nif regulation in Azotobacter. PMID- 3294560 TI - Influence of magnesium on glucose tolerance. Acute hypermagnesaemia reduces the glucose tolerance independently on hormonal indicators. PMID- 3294561 TI - Effects of thyroidectomy and thyroxine replacement on the release of luteinizing hormone and gonadotropin-releasing hormone in vitro. AB - The effects of thyroidectomy and thyroxine (T4) replacement on the release of luteinizing hormone (LH) and gonadotropin-releasing hormone (GnRH) in ovariectomized (Ovx) rats were studied. Immediately after ovariectomy, rats were thyroidectomized (Tx) or sham-Tx. The Ovx-Tx rats were injected subcutaneously with either saline or T4 (2 micrograms/100 g body weight) daily for 30 days before sacrifice. Sham-Tx rats were treated with saline only. Twenty hours after the last injection, the blood sample was obtained by decapitation. The excised anterior pituitary gland (AP) was bisected and incubated in vitro with or without 0.1, 0.5, 2.5, and 50 ng GnRH at 37 degrees C for 4 h. The mediobasal hypothalamus (MBH) was bisected and incubated with or without the AP of Ovx donor rat in vitro. Concentrations of LH and GnRH in the medium and that of LH in the serum were measured by radioimmunoassay. LH in the serum of Tx rats was higher than that in the serum of sham-Tx and Tx-T4 rats. Thyroidectomy resulted in an increase of LH release by Ovx rat AP, stimulated with or without 0.1 and 50 ng GnRH, as well as in an increase of immunoreactive GnRH release from MBH of Ovx rats in vitro. After a 4-hour incubation with donor APs, the LH in the medium containing MBH obtained from Tx rats was significantly higher than that obtained from sham-Tx and Tx-T4 rats. LH concentrations, in both sera and media, as well as GnRH concentration in the media of euthyroid and T4-replaced Tx groups were nonsignificantly different. These results suggest that T4 is inhibitory to the basal and GnRH-stimulated LH release as well as to the release of GnRH in the absence of ovarian hormones. PMID- 3294562 TI - Critics: Medicare unfair to mentally ill. PMID- 3294563 TI - Outpatient PPS to cut pay to 80% of costs. PMID- 3294564 TI - Capital proposals reveal likely winners, losers. PMID- 3294565 TI - Payment denial proposals spark questions. PMID- 3294566 TI - Hospitals anxious over payment denials for quality. PMID- 3294567 TI - Copying cases far from over. PMID- 3294568 TI - Group B streptococci and vaginal discharge. PMID- 3294569 TI - Factors that inhibit adherence of Treponema pallidum (Nichols strain) to a human fibroblastic cell line: development in serum of patients with syphilis. AB - Serum samples from 25 patients at five different stages of syphilis were investigated for their ability to inhibit the adherence of pathogenic Nichols treponemes to cultured human fibroblasts. Serum taken from patients at the end of the primary stage showed an appreciable inhibition of treponemal adherence, and maximum inhibition of adherence was produced by serum from patients with secondary syphilis. Some freshly harvested treponemal suspensions were resistant to the adherence inhibition factors in serum from patients with syphilis; after incubation in vitro for 24 hours this resistance was lost. In vitro incubation almost doubled the number of adherent treponemes/fibroblast. These phenomena are discussed in terms of loss and reconstruction of the treponemal outer envelope. This leads to the suggestion that adherence occurs not only at the tips of the treponemes, but that surface components are also implicated, possibly as an initial contact mechanism. The composition of the outer envelope may in this way determine localisation versus dissemination of the treponemes. PMID- 3294570 TI - Effect of early and late syphilis on central nervous system: cerebrospinal fluid changes and neurological deficit. AB - Neurological examination and investigation of the cerebrospinal fluid (CSF) was performed on 24 patients with early and 180 patients with late syphilis. In 21 (12%) patients with late syphilis positive CSF treponemal test results and neurological deficits suggestive of symptomatic neurosyphilis were found. Concomitantly all but three patients with neurosyphilis showed one or more of the following abnormal CSF variables: CSF concentration of albumin X 10(3)/serum concentration (albumin ratio) greater than or equal to 7.9; mononuclear cells greater than 5 microliters: ratio of CSF to serum IgG concentrations/ratio of CSF to serum albumin concentrations (IgG index) greater than or equal to 0.7 or of IgM/albumin (IgM index) greater than or equal to 0.1; or oligoclonal CSF immunoglobulins. In 20 (95%) patients with neurosyphilis evidence of the production of treponemal antibodies within the central nervous system (CNS) was shown. Ten (48%) patients with neurosyphilis had been treated previously for late syphilis. These observations emphasise the need to screen for neurosyphilis in patients with late syphilis. Intrathecal production of treponemal antibodies was detected in six (25%) patients with early and 44 (28%) with late syphilis who did not show any neurological deficit. Intrathecal production of treponemal antibodies indicating that the CNS was affected led us to suspect asymptomatic neurosyphilis in these patients. Seventeen (11%) patients with late syphilis but no neurosyphilis and only one (4%) with early syphilis showed additional abnormal CSF variables. Surprisingly, six out of 22 patients with treated early and 20 out of 68 patients with treated late syphilis showed evidence of treponema antibody production within the CNS. We do not know whether these findings indicate that the CNS was affected because of inadequate treatment or merely reflect persistent synthesis of treponemal antibodies associated with cured infection. In one (4%) patient with early and in 21 (13%) with late syphilis but no neurosyphilis abnormal CSF variables in the absence of positive CSF treponemal test results were observed, which excluded syphilitic inflammation of the CNS. PMID- 3294571 TI - Multipoint mapping studies of six loci on chromosome 11. AB - The six loci, beta-globin (HBBC), parathyroid hormone (PTH), oncogene c-Ha-ras-1 (HRAS1), insulin (INS), calcitonin (CAL) and catalase (CAT) loci, have been mapped to 11p in the order: CAT-CAL-PTH-HBBC-(HRAS1-INS). The purpose of the current study was to examine the linkage relationships, especially the multipoint relationships of these loci in detail. In the 18 families studied, a significant sex difference in recombination was found for the HBBC: HRAS1 linkage with more recombination in the male parent than the female parent (22 vs. 2%). The results of the multipoint analyses provided further evidence for the order CAT-CAL-PTH HBBC-(HRAS1-INS); however, the order of the last two tightly linked loci is still not clear. PMID- 3294572 TI - The use of collagen materials in bone grafted defects to enhance guided tissue regeneration. PMID- 3294573 TI - Urinary excretion of hydroxyproline in diabetics under different modes of treatment. PMID- 3294574 TI - The ontogeny of germinal centre forming capacity of neonatal rat spleen. AB - In non-specifically immunized rats, bred under conventional conditions, the first 'spontaneous' germinal centres were observed by 21 days after birth. Deliberate antigenic stimulation led to an earlier appearance of germinal centres in neonatal spleen: immunization with sheep red blood cells as early as 7 days after birth resulted in germinal centre formation in the spleen as observed 7 days later. By that time the first primary follicles could also be observed, in both immunized and non-immunized rats. Although 3-day-old rats upon antigenic stimulation failed to generate germinal centres in their spleen, transfer experiments of 3-day-old spleen cells to lethally X-irradiated syngeneic adult recipients indicated that 3-day-old spleens at least contained all the essential lymphoid elements (B and T cells) needed for germinal centre formation. These results strongly suggest that the failure to induce germinal centres in 3-day-old rats is most probably due to an immaturity of their splenic microenvironment. Immunohistochemical staining of frozen sections of neonatal rat spleen using mAb ED 5 and MRC OX-2 showed that follicular dendritic cells (FDC) were found as soon as primary follicles were found (i.e. by 14 days after birth). The appearance of FDC in neonatal spleens was not influenced by deliberate antigenic stimulation nor by the administration of adult spleen cells. We postulate that, during the development of FDC, a splenic microenvironment is created that allows primary follicle formation and the generation of germinal centres. PMID- 3294575 TI - Fetal and neonatal development of human spleen: an immunohistological study. AB - Localization and immunophenotype of lymphocyte subsets in fetal human spleens were studied by employing a panel of monoclonal antibodies (McAb) in an immunoperoxidase staining procedure on frozen tissue sections. Spleens varied from 15 weeks of gestational age (gestational weeks, gw) to newborn. The white pulp consisted of intermediate-sized lymphocytes; no separate compartments could be discerned. Germinal centre development was not observed. Dendritic cells stained for B2, HB5, aC3bR, anti-DRC and OKIa, but in most cases not for immunoglobulin. Although low cellular immunity is observed in neonates, T cells showed adult phenotypes in proportions comparable to the adult situation; immature OKT6(+) lymphocytes were rarely seen. Very few cells stained with anti NK cell antibody Leu7. B cells all expressed B1, Leu14, aC3bR, T10 and OKIa, were strongly positive for BA1, and mostly stained very weakly for B2 and HB5. Almost all B cells expressed IgM and IgD simultaneously, and very few expressed IgG. IgA positive cells were absent. At 15 gw a considerable number of IgM(+) B cells showed Leu1 staining, but this decreased during development. These cells may represent the normal counterpart of Leu1(+) IgM(+) cells observed in B-CLL and immunocytic and centrocytic malignant lymphomas. After 25 gw only very few Leu1(+) IgM(+) cells were seen. Altogether, the morphology and immunophenotype of white pulp B cells were different from the predominating adult B-cell subsets, at least until birth. These 'immature' splenic B cells may be precursors for adult splenic B-cell subsets. Considering the presumed role of the marginal zone in the immunity against TI-2 antigens, the absence of a marginal zone at birth may be a main factor in the defective immunity against these antigens in neonates. PMID- 3294577 TI - Effect of cytokines on specific in vitro immunization of human peripheral B lymphocytes against T-cell dependent antigens. AB - The requirements for a primary, antigen-specific in vitro immunization of human peripheral lymphocytes using haemocyanin, a T-cell dependent antigen, have been studied. In order to obtain a specific response in vitro the peripheral lymphocytes had to be separated into B, T, accessory (A) and dendritic (D) cells. These cells were activated and reconstituted to give a population with a B:T ratio of 1:2. If the induction was supported by MHC-restricted, radioresistant T cells, this cell population could then be antigen-specifically activated using haemocyanin. The immunization had also to be supported by cytokines, such as B cell growth and differentiation factors, interleukin-2 and gamma-interferon. A 5 day in vitro immunization using 2 micrograms haemocyanin/ml resulted in 200-300 cells secreting anti-haemocyanin-specific antibodies per 10(6) B cells. PMID- 3294576 TI - Sialadenitis in the MRL-l mouse: morphological and immunohistochemical characterization of resident and infiltrating cells. AB - The MRL-lpr/lpr (MRL/l) mouse spontaneously develops an autoimmune disease associated with various rheumatic manifestations. We have studied the histological features of sialadenitis and utilized an immunohistochemical staining technique on frozen tissue sections to analyse the cellular composition of the salivary glands at varying stages of disease. Semiquantitative assessment of the infiltration disclosed a focal inflammation which started at 2 months of age and was progressive until 5 months of age in submandibular glands. A high frequency of Ly-1 and L3T4-positive cells was observed at all stages of sialadenitis, whereas Lyt-2 positive cells were found at a lower frequency. Ia expression was seen on a large proportion of the infiltrating cells and also on ductal and glandular epithelial cells in the vicinity of the inflammatory lesions. The presence of Ia antigens on many inflammatory as well as resident cells and the high frequency of lymphocytes with 'helper' phenotype may indicate a perpetuated immunological activation within salivary glands. PMID- 3294578 TI - Xid mouse lymphocytes respond to TI-2 antigens when co-stimulated by TI-1 antigens or lymphokines. AB - Spleen cells from male (CBA/N x DBA/2) F1 hybrid mice do not significantly respond to in vitro stimulation by trinitrophenyl-conjugated polyacrylamide beads (TNP-PAA), whereas the same antigen elicits high PFC responses in female F1 hybrid cells. Therefore, this antigen could be classified as a T-independent type 2 (TI-2) antigen. When male spleen cells were co-stimulated by TNP-PAA and TI type 1 antigen, either LPS or Brucella abortus, they produced vigorous anti-TNP responses. A similar increase of the in vitro responsiveness of male F1 hybrid spleen cells to TNP-PAA antigen was provoked by the addition of supernatants from P 388-D1 cells stimulated by muramyl-dipeptide (MDP) mainly containing interleukin-1 (IL-1) or supernatants from phorbol 12-myristate 13-acetate (PMA) stimulated EL-4 cells that contained T-cell factors. The PFC response to another TI-2 antigen, TNP-Ficoll, was also significantly enhanced after co-stimulation by P 388-D1 supernatants. The response to TI-2 antigens being macrophage dependent, the influence of supernatants of peritoneal macrophages from male and female F1 hybrids incubated with TNP-Ficoll on the PFC response of normal DBA/2 mouse spleen cells to sheep erythrocytes was assessed. It was found that macrophage supernatants from female hybrids regularly increased by more than two times this anti-SRBC PFC response, whereas macrophage supernatants from male F1 hybrids did not. Moreover, in a specific proliferation test measuring IL-1 activity, when macrophage supernatants from female F1 produced a 13-fold increase of thymidine incorporation, supernatants from male F1 only produced a three-fold increase. It is concluded that, in addition to the known defects of B cells from Xid mice, their macrophages are also defective. PMID- 3294579 TI - The origin of autoantibodies. AB - Autoimmune diseases are characterized by the appearance of autoantibodies (autoAb) which may participate in their pathogenesis, but autoAb have also been found in normals with a variety of other conditions. The production of hybridomas from lymphocytes of unimmunized normal mice and healthy humans and analysis of the monoclonal autoAb (m-autoAb) obtained, showed that many had polyspecific autoAb reactivity, binding to many seemingly unrelated self-antigens, or to several organs. Most m-autoAb were of the IgM class and shared a common cross reactive idiotype (CRI). Low levels of Ab with similar binding pattern and idiotype are continuously represented in the serum of mice and humans who have no evidence of autoimmune or other disease. Very similar Ab appear in autoimmune diseases. Studies of m-autoAb derived from lupus-prone mice and from patients with systemic lupus erythematosus (SLE) and other autoimmune diseases also revealed polyspecific binding, IgM isotype and CRI. Moreover, these CRI, which were almost identical with the idiotypes of natural autoAb in normals, may identify a group of pathogenic Ab in the lupus mice and SLE patients. Since the data clearly suggest that lymphocytes that make autoAb are common and are part of the normal B cell repertoire coded by widely dispersed germline genes, there remain the basic problems of the function of these autoAb in health, as well as the question of their regulation and activation in vivo. Several postulated functions and immunoregulatory mechanisms are discussed and the possible role of certain factors, especially viruses, in enhancing autoAb production and autoimmunity, is assessed. PMID- 3294580 TI - In vitro sensitization using thymocyte conditioned medium prepared from fetal calf, horse and rabbit sera. AB - Thymocyte conditioned medium (TCM) was prepared using 2 lots of fetal calf, and 1 lot each of horse and rabbit sera. The 4 TCM and the respective sera alone were compared in their ability to support primary in vitro sensitization to sheep red blood cells (SRBC) as assayed by direct plaque formation. As would be expected, only the fetal calf sera (FCS) supported the primary in vitro sensitization to SRBC, while the use of the TCM prepared from the FCS resulted in a doubling of direct plaque formation. TCM prepared from either the rabbit or horse sera did not provide adequate support for this primary antibody response to SRBC. These data indicate that only sera able to support primary in vitro sensitization is useful for the preparation of active TCM ultimately used in B cell sensitization for hybridoma formation. PMID- 3294581 TI - Functionally involved cell surface antigens on murine lymphokine activated killer cells. AB - To investigate the possible involvement of some cell surface structures on lymphoid cells in the functional activity of lymphokine activated killer (LAK) cells, a number of monoclonal antibodies (Mab) against such structures was studied for their ability to inhibit LAK activity in a standard cytotoxicity assay against the natural killer-insensitive target cell EL-4. Almost complete inhibition of LAK activity resulted from incubation with antibodies to the LFA-1 antigen, while blocking of the Lyt 2 antigen reduced cytotoxic activity about 50%. Mab to T-200 gave a weak and inconsistent inhibitory activity, while antibodies to Thy 1, L3T4, IL-2 receptor and MHC class I antigens were without effect. Mab to LFA-1 and Lyt 2 inhibited LAK activity towards EL-4, YAC-1 and differentiated F-9 teratocarcinoma cells, but did not affect LAK-mediated killing of undifferentiated F-9 cells. Experiments with separate preincubation of effector and target cells revealed that both LFA-1 and Lyt 2 inhibited LAK activity at the effector cell level only. PMID- 3294582 TI - Dose-dependent efficacy of vaccination against K. pneumoniae in high and low antibody responder lines of mice. AB - Innate and acquired resistance to Klebsiella pneumoniae infection were investigated in high (HI) and low (LI) antibody responder lines of mice. The two lines were very susceptible to infection since even small inoculum doses of a virulent strain provoked a 100% mortality within a few days. However the mean survival time was significantly longer in LI than in HI. (HI X LI) F1 hybrids were more resistant than both parental lines. Immunization with heat killed K. pneumoniae was able to confer full protection on the mice in the two lines. However there was a large difference in the number of killed bacteria required to induce the protective effect in HI and in LI mice. The dose-effect relationship for protection correlated with that of antibody production. The protective role of antibodies was confirmed by the survival of HI and LI mice, when antibodies were passively given prior to lethal challenge. The results are in agreement with the fact already demonstrated, that the defect of LI mice in antibody responsiveness is a quantitative one. Therefore a satisfactory immune protection against K. pneumoniae could be obtained in LI mice by adapting the vaccination procedure. PMID- 3294583 TI - Molecular interactions in the membrane phase: implications in biotechnology. PMID- 3294584 TI - Hepatic complications of bone marrow transplant. PMID- 3294585 TI - Sonography in emphysematous cholecystitis. PMID- 3294586 TI - Isolation & axenization of fresh strains of Giardia lamblia in India. PMID- 3294587 TI - Cystic teratoma in the bare area of liver. PMID- 3294588 TI - Ultrasound-antenatal diagnosis of urethral obstruction. PMID- 3294589 TI - Malignancies induced by drug therapy: a review. PMID- 3294591 TI - The opioid peptides. A role in hypertension? AB - This review is an attempt to highlight evidence that may implicate the endogenous opioid system in the pathogenesis of hypertension in humans. The evidence raised includes biochemical, physiological, pharmacological, and behavioral studies conducted in in vitro and in vivo systems, experimental models of hypertension, and humans with essential hypertension. While the compelling biochemical and pharmacological evidence in experimental animals clearly shows the presence of opioid peptides and their receptors in strategic sites of cardiovascular control and potent cardiovascular response to opioid peptides, opioid antagonists show no consistent blockade or reversal of hypertension in experimental animals or humans. One possible explanation for this phenomenon could be the vast redundancy in systems regulating blood pressure (i.e., the blockade of one system still leaves many other systems fully able to rapidly offset the eliminated system). Regarding the opioid system, the situation is much more complex, since some opioid receptors (mu-type) mediate pressor responses, while other receptors (kappa-type) mediate depressor responses. Therefore, nonselective opioid receptor antagonists (e.g., naloxone), which block both types of receptors, can be devoid of any cardiovascular activity, while a selective mu-receptor antagonist or a selective and potent kappa-receptor agonist may produce the desired antihypertensive effect. A combination of both actions (i.e., a drug that is both a mu-antagonist and a kappa-agonist) might be even more advantageous. Until such compounds are developed, this hypothesis will be hard to prove. PMID- 3294590 TI - Interactions of the antitumour drug cisplatin with DNA in vitro and in vivo. PMID- 3294592 TI - Differential pressor and renal vascular reactivity to angiotensin II in spontaneously hypertensive and Wistar-Kyoto rats. AB - The suggestion has been made that the Okamoto strain of spontaneously hypertensive rats (SHR) shares some features with a subgroup of patients with essential hypertension, called nonmodulators. One feature of nonmodulators is a renal blood flow response to angiotensin II (ANG II) that is blunted on a high salt diet; the blunted renal vascular response is corrected by converting enzyme inhibition. Renal blood flow (electromagnetic flowmeter) and pressor responses to graded ANG II doses (5-300 ng) were assessed in 24 SHR and 24 Wistar-Kyoto rats (WKY) ingesting 1.6% Na. In comparison to WKY, blood pressure was higher in SHR (155 +/- 4 vs 106 +/- 2 mm Hg; p less than 0.001), renal blood flow was lower (6.9 +/- 0.5 vs 8.2 +/- 0.4 ml/min/g; p less than 0.05), and the pressor response to ANG II was enhanced, (p less than 0.0005) but the renal vascular response was blunted (p less than 0.005). Captopril (1-30 mg/kg) reduced blood pressure more in SHR than in WKY but increased renal blood flow similarly in both strains. The blunted renal vascular response to ANG II in SHR was reversed by captopril, but inhibition of converting enzyme in the kidney did not parallel systemic inhibition. Maximum blockade of converting enzyme in the kidney appears to require a larger captopril dose than is required for systemic inhibition. These results suggest that the renal blood supply in SHR also shares some of the characteristics of nonmodulators and that the action of captopril on the renal blood flow probably reflects reversal of inappropriate intrarenal ANG II formation. PMID- 3294593 TI - Partial characterization of a renin-releasing factor from plasma and hypothalamus. AB - Previous studies have indicated that administration of the serotonin releaser p chloroamphetamine HCl produces a dose-dependent increase in renin secretion through a blood-borne renin-releasing factor. The present studies were designed to partially characterize this renin-releasing factor using an in vitro kidney slice method for the bioassay of renin-releasing activity. Plasma from p chloroamphetamine-treated, nephrectomized rats was used to obtain the renin releasing factor, which was fractionated by ultrafiltration into fractions of molecular weight ranges of 1000 to 5000, 5000 to 10,000, and 10,000 to 20,000. The molecular weight ranges of the renin-releasing factor was determined to be between 5000 and 10,000. Since previous studies have shown that lesions in the hypothalamus prevent the effect of p-chloroamphetamine on renin secretion, we tested whether a hypothalamic extract can release renin from kidney slices. Addition of extracts of boiled rat hypothalamic tissue to the kidney slices caused an increase in renin release. Addition of cerebellar extracts produced a smaller increase in renin release, whereas addition of pituitary extracts had no effect. Fractionation by ultrafiltration of bovine hypothalamic extract revealed that the fraction with a molecular weight range of 5000 to 10,000 possessed the highest renin-releasing ability. The 1000 to 5000 (molecular weight) fraction possessed a sizeable renin-releasing activity, but the 10,000 to 20,000 fraction had no renin-releasing activity. Both bovine hypothalamus fractions (molecular weights between 1000-5000 and 5000-10,000) and plasma fraction lost their renin releasing activity after digestion with pronase, suggesting that the renin releasing factor or factors are peptides. These results suggest that a renin releasing factor originate in the hypothalamus. PMID- 3294594 TI - Captopril and nifedipine in combination for moderate to severe essential hypertension. AB - The effects of the addition of a calcium entry antagonist, nifedipine (20-mg tablet twice a day), to an angiotensin converting enzyme inhibitor, captopril (25 mg three times a day), and the addition of captopril to nifedipine were observed in two separate studies in patients with essential hypertension. After 4 weeks of captopril therapy alone, mean arterial pressure fell by 12 mm Hg, and with the addition of nifedipine to captopril for a further month, blood pressure fell by an additional 10 mm Hg. In a separate group of patients treated with the same doses, mean arterial pressure fell by 17 mm Hg with nifedipine treatment alone; when captopril was added to the nifedipine therapy for an additional month, mean arterial pressure fell by a further 11 mm Hg. These blood pressures were measured 2 hours after the last dose; however, there was less of a fall in blood pressure when it was measured 12 hours after the last dose. This study confirms that captopril and nifedipine have a marked additive effect on blood pressure in whichever order they are given, but it shows that the combination is relatively short-acting. PMID- 3294595 TI - Radiographic interpretation of endodontic lesions--a shadow of reality. AB - The radiographic interpretation of pathological lesions which are endodontic in origin is relatively imprecise as so many variables are involved. Even the presence or absence of a lesion cannot be determined with accuracy and there is little agreement on the criteria which should be applied. Strict attention to the technique of exposing, processing and viewing radiographs is necessary if the information to be gained is to be optimal. The major problem of visual interpretation and the psychological factors involved have been subjected to a certain amount of study and recent work on the mental processes of clinical decision making provide further insight. There is considerable promise being shown by methods of computer analysis and image enhancement and it may be that further development in these fields will provide the degree of objectivity that is essential if improved accuracy in diagnosis is to be achieved. PMID- 3294596 TI - Orthodontic radiology: a review. AB - Before starting orthodontic treatment it is important to have status radiographs to ascertain the state of the patient's general dental health. A dental panoramic tomogram is very suitable in this respect, but right and left bimolar projections together with upper and lower occlusal films provide an appropriate alternative. Unerupted upper cuspids can be localized by means of parallax shift or by using the vertex occlusal projection. The cephalometric radiograph is an invaluable adjunct to the clinical examination and models of the dentition, which together form the basis for orthodontic diagnosis and treatment planning. However, the user should be aware of the various errors which can detract from the reliability of this technique. Cephalometric landmarks are identified and tracings of the radiograph are made. Angular measurements taken from the tracing enable the maxillary and mandibular bases to be related to each other and to the cranial base. Recent developments in computer science and information transfer offer the possibility that in the future cephalometric radiographs will be analysed with the aid of a computer at sites which may be remote from the dental office. PMID- 3294597 TI - Radiographic interpretation of chronic periodontitis. AB - There has recently been a substantial change in our concept of periodontal disease and particular attention is now focused on that small proportion of the population who appear susceptible to its more aggressive forms rather than the majority in whom bone loss progresses very slowly. It is also apparent that the presently available clinical parameters are of little value in predicting future destructive activity. Under these circumstances, the aim of this paper is to review the contribution of radiography to the diagnosis of chronic periodontitis as traditionally perceived and then reassess its status in the light of these newer concepts. Panoramic radiography, followed by the appropriate periapical radiographs (taken with the paralleling technique), is proposed as an alternative to complete mouth intra-oral surveys on grounds of both diagnostic yield and radiation thrift. The five areas to which radiography, despite its limitations, can make a significant contribution are in the assessment of bone loss, mobility, occlusal trauma, calculus and marginal overhangs and crown-root ratio. The validity of the three criteria that have been proposed for the radiographic assessment of early periodontitis, loss of crestal bone height, marginal widening of the periodontal ligament and crestal irregularity, is evaluated in detail and it is concluded that only the first is of any diagnostic worth, providing at least two sequential radiographs are available. While there is an urgent need to develop techniques of greater sensitivity for the early identification of periodontal bone loss, there must be some doubt as to the value of any bone imaging technique in predicting the susceptible patient. Follow-up radiography should be limited to these sites showing clinical evidence of further disease activity. PMID- 3294598 TI - The current status of panoramic radiography. AB - The current status of dental panoramic tomography (rotational panoramic radiography) is reviewed. This technique is based on a combination of tomography and slit-beam radiography to provide an image of both jaws on a single film. There is a greater degree of image degradation when compared with conventional radiographic techniques due to tomographic blurring, magnification and distortion, secondary images and burn-out. Meticulous patient position is essential to accommodate their jaws to the image layer determined by the manufacturers. The absorbed doses from panoramic radiography are of a similar order to that from bitewing radiography and lower than those from a full-mouth periapical series. The individual risk of 1.3 X 10(-6) is compared with that from other radiographic examinations and smoking. The collective risk, 1.04 deaths in the UK in 1981, is relatively insignificant as is the genetic dose. The risk to the dentist and his staff is also low compared to other risks. The methods of dose limitation currently available are reviewed. The clinical indications are considered in relation to the guidelines of the American Dental Association and the Dental Estimates Board in the UK. The problems associated with attempts to measure diagnostic yield are considered. In view of the world-wide public concern at the potential dangers of ionising radiation, dentists are urged to maximize the diagnostic yield from their panoramic radiography by taking such radiographs only when clinically necessary, ensuring meticulous positioning and processing, followed by scrupulous assessment of the radiography for any sign of pathological change. PMID- 3294599 TI - Apical sealing efficacy of endodontic obturation techniques. PMID- 3294600 TI - Detection of antigliadin antibodies in bullous diseases and their recognition of similar antigenic polypeptides. AB - The presence of antigliadin antibodies (AGA) in dermatitis herpetiformis (DH) has been associated with gluten-sensitive enteropathy. Because of the discrepancies in the specificity of AGA, we examined the sera of patients with DH, pemphigus and pemphigoid for AGA both by enzyme immunoassay and by immunofluorescence. Approximately 80-90% of sera of patients with DH had AGA. AGA were not disease specific, they also occurred in about 40-80% of patients with pemphigus and pemphigoid depending on the method employed. In addition, AGA were also present in normal subjects. The incidence of AGA increased with age. AGA from patients with various bullous diseases recognized the same polypeptides thus suggesting that the presence of AGA cannot be regarded as a serological marker of DH. PMID- 3294601 TI - Expression of heterophile, Paul-Bunnell and Hanganutziu-Deicher antigens on human melanoma cell lines. AB - Expression of heterophile antigens was studied on 6 human melanoma cell lines. Paul-Bunnell and Hanganutziu-Deicher (H-D) antigens, but not Forssman antigen, were demonstrated on these cell lines. H-D antigen was also demonstrated on melanoma cells isolated from primary and metastatic lesions. Evidence was also presented that HLA class I but not class II (DR and DQ) molecules are expressed on these cell lines. H-D antibodies of IgG class were detected in 10 of 23 (42%) melanoma patients suggesting the possibility that H-D antigen might have been expressed in an immunogenic form in the patients. PMID- 3294602 TI - Glycoprotein allergens in pollen of timothy. III. Immunochemical and biological properties of a basic glycoprotein. AB - Crossed immunoelectrophoresis (CIE) and tandem CIE indicated that a basic glycoprotein allergen isolated from pollen of timothy is immunochemically identical to the allergen formerly denoted as antigen 30. The glycoprotein gave one band in SDS-PAGE and agarose isoelectric focusing. After transfer to nitrocellulose by electroblotting or by capillary blotting, the allergen specifically bound IgE from persons allergic to timothy pollen. The single allergen inhibited about 15% of the IgE binding to radioallergosorbent test discs of whole timothy pollen extract. Sera from patients investigated also contained detectable amounts of IgG towards the allergen. In quantitative skin prick tests, the mean activity of 2 micrograms/ml purified allergen in 7 patients was equivalent to that of a timothy pollen extract containing 10,000 BU/ml (assayed relatively to histamine in skin prick test). The ability of the allergen to form a precipitate in rocket immunoelectrophoresis was lost when it was heated to 80 degrees C or incubated with 4 M guanidine hydrochloride. PMID- 3294603 TI - Monitoring of antibodies in patients on immunotherapy with insect venoms by immunoblotting. AB - A rapid nitrocellulose immunoblotting procedure based upon electrophoretic transfer has been used to monitor patient specific IgE and IgG antibodies before and after specific Hymenoptera insect venom therapy. The patients followed a conventional schedule for immunotherapy with Pharmalgen bee and yellow jacket venoms. The allergenic profiles of the patients before and after treatment were qualitatively similar in many patients, but some showed decreased IgE binding after treatment. On the other hand, there was a significant increase in specific IgG antibodies directed towards phospholipase and hyaluronidase in the bee-venom treated patients and towards antigen 5, phospholipase and hyaluronidase in the patients treated with yellow jacket venom. The immunoblotting is very useful for a rapid evaluation of patient specific antibody patterns without the prior isolation of allergens. PMID- 3294604 TI - Analysis of the autoimmune response in an 'in situ' carcinoma of the testis. AB - Immune response in a patient with an in-situ seminoma of the testis was studied. Immunohistochemical examination of the testicular biopsy demonstrated remarkable intracellular and membraneous accumulation of IgG antibodies in the atypical spermatogonia. Using FITC-conjugated Concanavalin A, an abnormally high binding of Concanavalin A was detected in the transformed cells. Circulating antibodies directed against an antigenic determinant (60 kD) which is expressed on normal human spermatozoa and lymphocytes were found only in the patient's serum and not in 500 control sera. The role and possible diagnostic value of this autoimmune reactivity in testicular malignancies are discussed. PMID- 3294605 TI - Immunohistochemical identification of macrophages, lymphoid cells and HLA antigens in the human testis. AB - The presence and distribution of macrophages, several subtypes of lymphocytes and HLA antigens in the human testis were studied using monoclonal antibodies and immunocytochemical staining. Cells identified as tissue macrophages were relatively abundant. They were dispersed individually in the interstitium and were often included in Leydig cell clusters. Occasional macrophages were observed in the tubular wall, but never in the seminiferous tubules. Very few lymphocytes were found in the testicular interstitium. These were mainly T lymphocytes. T helper/inducer and T cytotoxic/suppressor cells were extremely scarce. B1 + cells were not observed, but occasional Leu-14+ cells could be seen. NK cells were not found. The number of T lymphocytes in the tunica albuginea was considerably higher than in the interstitial tissue. HLA-ABC and HLA-DR antigens could be observed in the endothelial cells and macrophages which were both strongly positive. The myoid cells and the Leydig cells expressed these antigens only weakly. Neither of the HLA antigens was expressed in the germinal epithelium. PMID- 3294606 TI - Treatment strategies of testicular cancer in Europe. PMID- 3294607 TI - Measuring GFR. PMID- 3294608 TI - Continuous ambulatory peritoneal dialysis (CAPD): experience with the first 100 patients in a Hong Kong centre. AB - We treated 100 Chinese patients age 16 to 83 years by CAPD, using three 2-litre exchanges per day. The treatment was self-financed in 69 patients, by charitable organisations in 25 patients, and by government funds in 6 patients. Satisfactory biochemistry was maintained and there was no gross hyperlipidaemia, renal osteodystrophy, or loss of ultrafiltration capacity of the peritoneum. Rehabilitation was good and 62% of patients returned to full-time employment. The average duration of hospitalization was 11.3 days per patient year. Peritonitis usually due to Staphylococcus pyogenes occurred at a frequency of one episode per 12.3 patient-months. Sixteen patients were transplanted and had a 2-year graft survival of 78.5%. The cumulative patient survival was 97% at 1 year and 84% at 2 years. The corresponding technique survival rates were 87% and 76% respectively. PMID- 3294609 TI - Monoclonal antibody DLC-48: an effective reagent for use in the depletion of malignant lymphoma from human bone marrow. AB - A combination of large-cell lymphoma cell lines was used as immunogen in the production of DLC-48, a mouse monoclonal antibody (MAb) to a B-cell-associated antigen. This reagent identifies a protein found on a majority of peripheral blood B-cells, B-cell derived tumor cell lines, and lymphoma biopsy specimens. In reactive lymph-node sections, DLC-48 stains both germinal center and mantle zone B-lymphocytes when the immunoperoxidase technique is used. DLC-48 is an IgM, and is highly cytotoxic in the presence of human serum complement. The conditions for complement-mediated cytotoxicity were first optimized by utilizing the chromium release assay with 2 large-cell lymphoma cell lines, and were then applied to the treatment of the cell lines prior to cloning in agar. A single treatment with antibody and human serum eliminated 4 orders of magnitude of target cells. The cytolytic activity of this antibody was not inhibited by the presence of a 20 fold excess of normal human bone marrow. Treatment with antibody and autologous serum did not affect the growth of human hematopoietic progenitor cells (CFU-GEMM and CFU-GM). These results suggest that DLC-48, either alone or in combination with other MAb reagents, should be effective in eliminating malignant cells of B lineage from human bone marrow for purposes of autologous bone-marrow transplantation. PMID- 3294610 TI - Several murine metastasizing tumors possess a cysteine proteinase with cancer procoagulant characteristics. AB - Cancer Procoagulant (CP), a cysteine proteinase which triggers blood coagulation by directly activating Factor X (FX) in the absence of Factor VII (F VII), has recently been isolated from rabbit V2 carcinoma and biochemically characterized. We have studied the procoagulant activity of tissue extracts from 4 murine experimental tumors in order to define whether or not a F VII-independent activity with cysteine proteinase characteristics was present. The tumors studied were: Lewis lung carcinoma (3LL), B16 melanoma (B16), JW sarcoma (JWS) and the M4 variant of the mFS6 fibrosarcoma (M4). Extracts from 3LL, B16 and JWS tumor initiated coagulation in both the presence and absence of F VII, their procoagulant activity was sensitive to iodoacetamide (1 mM) and mercury chloride (0.1 mM). The procoagulant of M4 extract was dependent on the presence of F VII and was not significantly affected by the cysteine proteinase inhibitors. An Ouchterlony double immunodiffusion study showed immunological cross-reactivity of all but M4 extracts to a polyclonal antibody to purified CP. The present study suggests that the procoagulant(s) present in the murine tumors 3LL, B16 and JWS are enzymatically and immunologically indistinguishable from cancer procoagulant of the rabbit V2 carcinoma. PMID- 3294611 TI - On the clonal origin of tumors: a review of experimental models. AB - A number of current models of carcinogenesis postulate that rare events are critical in the formation of malignant neoplasms. The most fundamental prediction of the hypothesis that these events are rare is the clonality of neoplasms. Evidence from spontaneous neoplasms supports the contention that such neoplasms are clonal. However, there are a number of reasons to believe that spontaneous neoplasms are derived from large numbers of cells. The issue can be resolved with experimental cancer models. In order to determine whether experimentally induced neoplasms are derived from the clonal expansion of single cells, a variety of benign and malignant tumors can be induced in mosaic rodents. These animals comprise 2 genetically distinguishable cell lineages. If the neoplastic tissues obtained from mosaic animals are composed entirely of progeny of one or the other of the 2 cell lineages, it may be concluded that they are clonal. If, on the other hand, the neoplasms began from the proliferation of many cells, then neoplastic masses would be expected to contain cells of both lineages. The results from a number of these experiments have led to the conclusion that chemically induced neoplasms are clonal. Furthermore, malignant neoplasms are generally believed to develop in a stepwise manner. If they were derived from a single cell, then each of the stages leading to the formation of the cancer should be clonal. A variety of stages thought to be necessary precursors of cancer have been analyzed in mosaic rodents. These preneoplastic lesions have been determined to be clonal in origin. Thus, theories of carcinogenesis must account for the rarity of the events critical to the formation of cancer. PMID- 3294612 TI - Doppler ultrasound in the prediction of transvalvar pressure gradients in patients with valvar pulmonary stenosis. AB - Good correlation between Doppler-derived and catheterization-measured pulmonary valvar pressure gradients has previously been reported. The purpose of this paper was to present two groups of patients who did not show such correlation, namely those with very severe stenosis and those measured immediately following balloon pulmonary valvoplasty. Twenty-two patients, aged 4 months to 20 years, in whom Doppler and catheterization pressure gradients were measured within 24 hours of each other were included in the study. There were 35 pairs of such data. The correlation coefficient for the entire group was 0.61 which improved to 0.91 when the five patients with severe stenosis (gradients of 94 to 190 mm Hg) and one patient with severe right ventricular infundibular stenosis immediately following balloon valvoplasty were excluded from analysis. Although the possibility exists, technical aspects of Doppler recording did not appear to be causing this lack of correlation. Cone-shaped spray formation rather than a focused jet in patients with extremely severe pulmonary stenosis may be postulated to be responsible for poor prediction by Doppler of catheterization gradient. Once these two groups of patients are excluded, there is excellent correlation between Doppler and catheterization gradients in patients with pulmonic stenosis. PMID- 3294613 TI - Prevention of nephrotoxic cyclosporine peak concentrations by daily drug division in 3 equal oral portions. AB - Nephrotoxicity is the main side effect of cyclosporine therapy. In this study 2 groups consisting of 6 kidney transplant recipients were investigated. The oral cyclosporine daily dose was in the first group 13 mg/kg, in the second 11 mg/kg, respectively. In both groups, the daily dose was divided on the first day of investigation in 2 equal portions given at an interval of 12 hours. On the second day, the same dose was divided in 3 equal portions given at an interval of 8 hours. After cyclosporine administration twice a day very high blood cyclosporine peak concentrations (two to three times higher than the therapeutic range) were measured. These potential nephrotoxic cyclosporine concentrations could be prevented by cyclosporine application in 3 equal portions. A reduction of the daily dose in the early period after kidney transplantation to a starting daily dose of 12 mg/kg or even 10 mg/kg can be recommended. PMID- 3294614 TI - Life quality in patients under hypotensive treatment. AB - The authors studied the life quality in a group of 74 patients--31 males and 43 females--affected with essential hypertension of World Health Organization I or II degree. All patients began treatment with frusemide at a dose of 25 mg once a day. The 35 non-responsive patients to frusemide were then treated, by random selection, with captopril at a dose of 25 mg twice a day, or nadolol at a dose of 80 mg once a day, for three months. The results show no significant differences on the hypotensive effect with either drug; in view of the incidence of side effects of the two drugs, treatment with captopril is clearly better tolerated by the patients. PMID- 3294615 TI - Serum bactericidal activity against Klebsiella pneumoniae in volunteers receiving increasing doses of tobramycin with or without cefamandole. AB - Ten volunteers received intravenously in a randomly allocated order and on separate days the following regimens: cefamandole (15 mg/kg); tobramycin (1.5 mg/kg); tobramycin (3 mg/kg); cefamandole (15 mg/kg) + tobramycin (1.5 mg/kg); cefamandole (15 mg/kg) + tobramycin (3 mg-kg). Tobramycin serum levels were 3.7 +/- 0.7 micrograms/ml one hour after infusion of the 1.5-mg/kg and 7.8 +/- 1.6 micrograms/ml after the higher dose. Cefamandole serum levels were 26.0 +/- 5.2 micrograms/ml at the same time. Serum bactericidal activity and killing-rate studies were performed on a collection of 18 strains of Klebsiella pneumoniae. Against cefamandole-sensitive strains, all regimens were satisfactory (median serum bactericidal activity 1:16 to 1:64). Tobramycin (3 mg/kg) and both combinations were slightly more active on cefamandole-resistant strains (1:16 to 1:32) than cefamandole (1:2) and tobramycin low dose (1:8). Except for cefamandole alone, all regimens were equivalent in killing studies. PMID- 3294616 TI - Serum trace-element levels in piretanide-treated hypertensives: a double-blind trial against hydrochlorothiazide plus amiloride. AB - A double-blind parallel group study was carried out in patients with mild to moderate hypertension to assess the effects of 6 mg piretanide once or twice daily, in comparison to 50 mg hydrochlorothiazide plus 5 mg amiloride once daily, on serum trace-element levels over a period of three months. The results showed that for most of the trace elements investigated (zinc, iron, copper, manganese and cobalt) no relevant changes were seen. Only serum iron values (medians) showed a slight drop (p less than 0.05) with 6 mg piretanide twice daily. The results indicate that a three-months' therapy with piretanide or with a thiazide potassium sparer diuretic combination is safe without producing any disturbances in the serum levels of trace elements. PMID- 3294617 TI - Influence of thymopentin on postsurgical immune deficiency: a clinical pilot study. AB - The effect of a single dose (50 mg) of thymopentin, administered subcutaneously, on antigen-induced proliferation of peripheral blood mononuclear cells (PBMCs) was investigated in 25 volunteers (all over 50 years of age) and in nine patients undergoing major surgery. Blood samples from another nine patients having the same type of surgery were used as control in the second trial. A statistically significant increase in the proliferative response was observed in the group of volunteers two hours after thymopentin administration. This increment was not demonstrable as significant 24 h later. In contrast to this observation, the surgical procedure-induced significant decrement in the proliferation of PBMCs observed on the first and third postoperative days did not occur in the thymopentin-treated patients on the first postoperative day. This preventive effect of the single dose of thymopentin administered two hours before surgery was no longer demonstrable on the third postoperative day. Further studies are ongoing in order to establish a treatment regimen with thymopentin for the therapy of trauma-induced immune deficiencies. PMID- 3294618 TI - Haemodynamic and endocrine effects of digitoxin in healthy volunteers. AB - A study was conducted to evaluate the effects of a single oral dose of digitoxin on the circulatory function and the renin-angiotensin-aldosterone system. Seven doses of digitoxin and 6 of a placebo were given at random to 13 healthy volunteers, all of whom remained at rest, without smoking, throughout the study. Blood samples were taken initially after 1 h at rest, and at 1, 2 and 24 h after receiving the dose. Concentrations of serum digitoxin, aldosterone, angiotensin II (A II) as well as plasma renin activity (PRA) were determined by radioimmunoassay (RIA). In all subjects the blood pressure did not change throughout the study. Digitoxin decreased the heart rate significantly during the first and second hours, while in the placebo group the heart rate remained unchanged during the same period. The placebo had no detectable effect on PRA, A II and aldosterone. Digitoxin decreased PRA and A II levels, reaching its maximum effect 2 h after the administration. There was no correlation between the serum digitoxin concentration and PRA, A II or the aldosterone values. Digitoxin reached its maximum effect upon these parameters faster than what is generally accepted. PMID- 3294620 TI - Community care policies and gender justice. AB - The current approach in the United States to the provision of community care to the elderly interacts with the feminized structure of family care-giving to foster inequities for women, who provide the bulk of informal, unpaid care. The central concern of present policies with limiting eligibility and rationing benefits results in policies that reduce the choices of these carers, many of whom are already substantially disadvantaged by their economic position in society. What is necessary for gender justice is development of policies that address the needs and rights of carers and elders by providing necessary supports to families, including, when appropriate, adequate compensation to carers. We argue for an approach that takes into account the relationship of the adequacy of government support and the capacity of individuals to freely choose the caregiving role. PMID- 3294619 TI - Immunoreconstitution of T-cell impairments in asymptomatic male homosexuals by thymic humoral factor (THF). AB - The feasibility of using Thymic Humoral Factor (THF) for immunomodulation in asymptomatic male homosexuals was evaluated in a study on fifteen subjects with T cell impairments, selected on the basis of a 2SD reduction in T helper/inducer (T4+) cells and one additional lymphocytic defect. Following two biweekly courses of treatment, mean relative increments of T4+ (P less than 0.002), T3+ (P less than 0.02) and total lymphocyte (P less than 0.05) populations of the group receiving THF (n = 7) were significantly increased when compared to the placebo group (n = 8). In addition, a transient increase in T4+ lymphocytes was observed after the first course in the two individuals of the THF-treated group who were seropositive for HTLV-III/LAV but not in those who were seronegative. No difference was found between the groups in fluctuations of serum interferon (IFN) or proliferation of peripheral mononuclear cells to mitogens. The results of this limited trial demonstrate that THF is capable of correcting T-cell impairments that may predispose asymptomatic homosexuals to infection by HTLV-III, without affecting IFN production. These findings suggest that future strategies for AIDS prevention in high-risk groups should include institution of large controlled trials in immunodeficient, asymptomatic, HTLV-III/LAV-seronegative male homosexuals to study the potential of selective immunoreconstitution as a preventive measure against HTLV-III/LAV infection. PMID- 3294621 TI - Shades of difference: theoretical underpinnings of the medical controversy on black/white differences in the United States, 1830-1870. AB - The resonance between scientific theory and ideology is starkly revealed by the medical debate on slavery, alleged black inferiority, and racial differences in disease: opposing doctors invoked the same science, but relied on contrary assumptions, to reach antagonistic conclusions. Reductionist, biological determinist, and ahistorical premises underlay the dominant belief that innate racial differences led to black bondage and racial disparities in health; an anti reductionist and historical approach supported the minority view that social factors rooted in the planters' need for cheap labor explained both. From 1830 to 1850, doctors debated the accuracy, validity, and interpretation of their findings. In the 1850s, "apolitical" doctors sought to purge medicine of politics to regain scientific objectivity, yet the first generation of black physicians argued that politics inevitably affected medical inquiry. The Civil War and Emancipation spurred studies relating the health of blacks and poor whites to social conditions, while the destruction of Reconstruction led to the resurgence of racist medicine. Comprehending how politics set the terms and tempo of this polemic can provide insight into current controversies on racial differences in disease. PMID- 3294622 TI - The role of the hospital in the health policy of the German Social Democratic movement before World War I. AB - In this article, the author aims to contrast the traditional architecture oriented history of hospitals with an empirical sociohistorical approach. The main topic discussed is the hospital's role in health policy as seen by German Social Democrats in the late 19th and early 20th centuries. Social democratic hospital policy developed as a compromise between two extreme positions: the party theoretician's abstract ideals on the one side and the rank and file's pragmatic view on the other. Thus, the social history of the hospital can illustrate how, around the turn of the century, the political labor movement in Germany shifted from radical revolutionary aims to pragmatic social reform in everyday political practice. At the same time, the hospital underwent a fundamental social change from a charity institution to a municipal center of modern medical care. This implies that any static or one-sided interpretation of the hospital's history and sociology is inadequate: its social role constantly changes according to broader social change and different interests of social groups and organizations. As for the social history of medicine in general, modern medicine's development can not be adequately understood from the narrow perspective of medical institutions themselves. It has to be seen in the broader context of socioeconomic and sociocultural development. PMID- 3294623 TI - Malaria, agriculture, and development: lessons from past campaigns. AB - The author presents in this article a historical-epidemiological evaluation of several anti-malaria campaigns and of the relative contribution of various direct measures employed and indirect factors operating during these campaigns. Approaches and factors that may be essential or at least useful for successful malaria control are identified. The malaria story in Palestine/Israel and the experience of the Tennessee Valley Authority are analyzed in some detail. In both cases, direct anti-malaria measures were versatile and based mostly on reduction of mosquito breeding and elimination of Anopheles larvae. Efficient organization and coordination of anti-malaria efforts, strenuous research and understanding of the vector biology, and accompanying socioeconomic and agricultural development contributed to successful campaigns. Malaria control in other parts of the United States and in Italy is also considered. The World Health Organization global anti malaria campaign is discussed in the light of these earlier experiences. The study concludes that no single measure is sufficient to control malaria and that future anti-malaria campaigns need to adopt strategies that are flexible, incorporated into local health services, and interrelated with agricultural practices. Moreover, a certain threshold of socioeconomic development, health services infrastructure, and educational level may have to be reached for the successful application and maintenance of direct anti-malaria measures. PMID- 3294624 TI - Advances in parasitology: 1886-1986. PMID- 3294625 TI - Developmental aspects of metabolism in parasites. PMID- 3294626 TI - New anti-protozoal agents. PMID- 3294627 TI - New anthelmintics. PMID- 3294629 TI - The current status of drug resistance in malaria. PMID- 3294628 TI - Intestinal helminthiases and human health: recent advances and future needs. PMID- 3294630 TI - Prospects for malaria control. PMID- 3294631 TI - Arthropods--the pelage of mammals as an environment. PMID- 3294632 TI - The structure of helminth communities. PMID- 3294633 TI - Evolution in parasite communities. PMID- 3294635 TI - Moulting of parasitic nematodes. PMID- 3294634 TI - Post-embryonic development in Caenorhabditis elegans. PMID- 3294637 TI - Morphogenesis of the Acanthocephala. PMID- 3294636 TI - Early morphogenesis in the platyhelminthes with special reference to egg development and development of cestode larvae. PMID- 3294638 TI - Developmental processes in parasitic protozoa. PMID- 3294639 TI - Phylogenetic inference from adult morphology in the Nematoda; with emphasis on the bursate nematodes, the strongylida; advancements (1982-1985) and recommendations for further work. PMID- 3294640 TI - Phylogenetic inference from platyhelminth life-cycle stages. PMID- 3294641 TI - Analysis of host-parasite coevolution. PMID- 3294642 TI - Vaccination against schistosomes and other systemic helminths. PMID- 3294643 TI - Expression of parasite antigens in Escherichia coli. PMID- 3294644 TI - Intermediary metabolism in parasitic helminths. PMID- 3294645 TI - Intermediary metabolism in parasitic protozoa. PMID- 3294646 TI - Solving parasite-related problems in cultured freshwater fish. PMID- 3294647 TI - Solving parasite-related problems in cultured marine fish. PMID- 3294648 TI - Parasites as indicators of host populations. PMID- 3294649 TI - Pollution and parasitism in the aquatic environment. PMID- 3294650 TI - The effects of parasites on fish populations--theoretical aspects. PMID- 3294651 TI - Effects of parasites on fish populations: practical considerations. PMID- 3294652 TI - Effects of parasites on marine mammals. PMID- 3294653 TI - Effects of marine mammal parasites on human health. PMID- 3294654 TI - Production losses and control of helminths in ruminants of temperate regions. PMID- 3294655 TI - Production losses and control of helminths in ruminants of tropical regions. PMID- 3294656 TI - Pathophysiology of nematode infections. PMID- 3294657 TI - The impact on production and mechanisms of pathogenesis of trematode infections in cattle and sheep. PMID- 3294658 TI - A critical approach to the concepts of control and eradication of echinococcosis/hydatidosis and taeniasis/cysticercosis. PMID- 3294659 TI - The pharmacology of anthelmintics in livestock. PMID- 3294660 TI - Anthelmintics for ruminants. PMID- 3294661 TI - Development and control of resistance to anthelmintics. PMID- 3294662 TI - Anthelmintics for horses. PMID- 3294663 TI - Anthelmintics for dogs and cats. PMID- 3294664 TI - The role of mathematical models in helminth population biology. PMID- 3294665 TI - Population regulation in trichostrongylids of ruminants. PMID- 3294666 TI - The role of the immune response in helminth population regulation. PMID- 3294667 TI - Breeding for worm resistance: a perspective. PMID- 3294668 TI - Interactions between parasite and vector control, animal productivity and rural welfare. PMID- 3294669 TI - Interaction between parasite and vector. PMID- 3294670 TI - Interactions between ticks and their hosts. PMID- 3294671 TI - Host-parasite interaction of blood-feeding dipterans in health and productivity of mammals. PMID- 3294672 TI - Comparative epidemiology of coccidia: clues to the etiology of equine protozoal myeloencephalitis. PMID- 3294673 TI - Comparative epidemiology and control of trypanosomes. PMID- 3294674 TI - Comparative epidemiology of tick-borne diseases of cattle with emphasis on modelling. PMID- 3294675 TI - Control of tick-borne diseases. PMID- 3294676 TI - Integrated pest management of dipteran pests in the New World. PMID- 3294677 TI - Prospects for tsetse control. PMID- 3294678 TI - Immunological approaches to the control of ticks. PMID- 3294679 TI - Prospects for the management of arthropod resistance to pesticides. PMID- 3294680 TI - New approaches to the chemical control of arthropod pests of livestock. PMID- 3294681 TI - Changing patterns of parasitic disease: old enemies and new invaders--the battle wages on. PMID- 3294682 TI - Prospects for prophylaxis of parasitism. PMID- 3294683 TI - Epidemiological concepts and strategies for parasite control: what changes are likely to occur? PMID- 3294684 TI - The impact of future research on our understanding of parasitism. PMID- 3294685 TI - Lack of an acute effect of parathyroid hormone within skeletal muscle. AB - Secondary hyperparathyroidism is commonly present in patients with chronic renal failure. It has been suggested that elevated levels of parathyroid hormone (PTH) may be responsible for the glucose, amino acid and protein turnover abnormalities present in uremia. We utilized an in vitro muscle perfusion system to explore this possibility in more detail. We measured glucose uptake, muscle alanine and glutamine release, protein synthesis and both total and myofibrillar degradation rates, in the presence and absence of exogenous PTH and/or insulin. The addition of PTH either in the presence or absence of insulin had no effect on glucose uptake, protein synthesis or degradation or amino acid release by peripheral muscle tissue. Measurement of PTH revealed that 84% of the initial dose of immunoreactive hormone was still present at the end of the perfusion period. Our results suggest that PTH has no effect on skeletal muscle glucose or protein metabolism. PMID- 3294687 TI - Bereavement and its complications in medical patients: a guide for consultation liaison psychiatrists. AB - Bereaved individuals consult their physicians, including psychiatrists, at an increased frequency for the many symptoms of normal or pathological grief as well as related medical and psychiatric disorders. As many as 25 percent of patients seen by a consultation-liaison service may be suffering from recent unresolved grief. The consultation-liaison psychiatrist needs to be sensitive to the manifestations and course of bereavement in both its uncomplicated and pathological forms. This report provides an overview of these issues as a guide for the accurate assessment and treatment of this often unconsidered condition. PMID- 3294686 TI - Femoral neuropathy after renal transplantation. PMID- 3294688 TI - Suicide in the medical patient. AB - According to the statistical abstract of the United States for 1982-1983, there were 1,913,800 deaths in the United States in 1979. Twenty-seven thousand, or 1.4 percent of those deaths were by suicide, yielding a suicide rate of 11.9/100,000/year. The rate was highest (39.2/100,000) for white males sixty-five years and over and lowest (0.1/100,000) for black females between five and fourteen years. It is generally accepted that physical illness is a risk factor for suicide. If this is true, then in caring for persons with significant physical illness, physicians are dealing with a population at increased risk of suicide. In its opening section, this article will review the evidence that points to a positive correlation between suicide and physical illness. Next the association between specific illnesses, such as peptic ulcer and cancer, and suicide will be examined. Third, risk factors associated with the occurrence of suicide in medical-surgical hospitals will be reviewed. Fourth, the occurrence of suicide in relationship to medical procedures will be discussed. Fifth, the evaluation and management of suicidal patients in medical settings will be briefly considered. This review will not consider the relationship between physical illness and attempted suicide. PMID- 3294689 TI - Phantom limb pain. A review. AB - Phantom limb pain, which affects a majority of amputees, must be distinguished from phantom limb sensation, a universal consequence of limb amputation. Although the characteristics and time course of phantom limb pain are well described in the literature, no single theoretical approach can fully account for the contradictory aspects of this condition, thus its underlying mechanisms remain unclear. Theories concerning the etiology of phantom limb pain categorized as peripheral, central and psychological have given rise to a myriad of treatment approaches. PMID- 3294690 TI - The emergency treatment of the depressed patient with physical illness. AB - Approaching individuals in the emergency situation presenting with medical illness and depression requires an understanding of psychologic, biologic, social, and existential factors that converge to create alterations in mood, thought, and behavior. Clinicians must understand how these same factors may be used in managing patient response to treatment of both the depression associated with an illness and the physical illness itself. Whenever a physical illness is present, it is imperative to ascertain the degree to which physical illness and concomitant treatment may be responsible for the psychiatric symptoms. PMID- 3294691 TI - The epidemiology of depression in medical care. AB - Major depression may be the most common medical or psychiatric disorder seen in primary medical care clinics, occurring in approximately 6 to 10 percent of the clinic populations. Despite this high prevalence rate, patients with depression often go undiagnosed or are misdiagnosed. The evidence suggests a multifactorial etiology for this problem. Many patients with depression selectively focus on the somatic components of their depressive syndrome and minimize or even deny affective and cognitive symptoms. Depression and medical disorders also often occur concomitantly with depression causing amplification of somatic complaints. Due to the unidimensional focus on the biomedical model many physicians only evaluate and treat the physical illness and do not diagnose the depression. This often leads to aggressive medical testing and treatment that carries the risk of iatrogenic injury (polysurgery, multiple tests and procedures, prescription of opiates and benzodiazepines). Several interventions are suggested to improve the diagnostic acumen of primary care physicians. PMID- 3294692 TI - Interaction of nitroaromatic radiosensitizers with irradiated polyadenylic acid as measured by an indirect immunochemical assay with specificity for the 8,5' cycloadenosine moiety. AB - The relative reactivity of a series of nitroaromatic radiosensitizers toward the C(5') radical intermediate leading to 8,5'-cycloadenosine formation in deoxygenated solutions of irradiated polyadenylic acid (poly A) was assessed using standard competition kinetic analysis. Formation of 8,5'-cycloadenosine was assayed by an indirect, competitive, enzyme-linked immunosorbent assay (ELISA) described in an earlier report. In the absence of oxygen, the nitroaromatics inhibit 8,5'-cyclonucleoside formation in a way which generally increases with radiosensitizer electron affinity. Although hydroxyl radical scavenging by the nitroaromatics may account for a relatively small decrease in 8,5' cyclonucleoside formation, the data suggest that oxidation of the C(5') radical intermediate is the more plausible explanation for the decreased yield of the 8,5'-cyclonucleoside with increasing nitroaromatic electron affinity. PMID- 3294693 TI - Contribution of a photoreactivable component to the oxygen effect observed in certain rad mutants of Saccharomyces cerevisiae after exposure to high energy electrons. AB - It is shown that a fraction of damage induced by high energy electrons (25 MeV) in certain rad mutants of the yeast Saccharomyces cerevisiae can be photoreactivated. The photoreactivable damage contributes to the lethal effect of this type of irradiation and modifies the oxygen effect. Using photoreactivating light or nigrosin, the amount of photoreactivable damage is reduced and the oxygen enhancement ratio (OER) for yeast mutants increases approximately to the OER found in wild-type cells. PMID- 3294695 TI - The effect of movement, stress and mechanoelectric activity within the cranial matrix. PMID- 3294694 TI - The head-pad in art and medicine: a forgotten nasal protector. AB - From the beginning of the 16th century the use of the padded cap to prevent injuries of the middle-face and skull in infants during their period of learning to walk is documented in art and medicine. Especially the painters of the Dutch and Flemish schools left beautiful paintings and drawings showing children with head-pads. Till the end of the 18th century the use of the head-pad was widely spread over Europe. In the 19th century the educational concepts of Rousseau and Kant probably induced a rejection and an abolition of this useful protective cap, which has been rediscovered during the past 20 years. PMID- 3294696 TI - Resin-bonded etched cast extracoronal attachments for removable partial dentures: clinical experiences. PMID- 3294697 TI - Scanning electron microscope: an SEM study of periodontally instrumented root surfaces, comparing sharp, dull, and damaged curettes and ultrasonic instruments. PMID- 3294698 TI - Evaluation of the purposeful implantation of epithelium on root surfaces under periodontal flaps. PMID- 3294699 TI - Dimensional alteration of the periodontal tissues following therapy. PMID- 3294700 TI - Evaluation of the skin disinfecting activity and cumulative effect of chlorhexidine and triclosan handwash preparations on hands artificially contaminated with Serratia marcescens. AB - The initial and cumulative efficacy of two antiseptic handwash preparations in eliminating Serratia marcescens from hands was evaluated on volunteers. Two antiseptics with persistent skin antibacterial activity, 4% chlorhexidine gluconate in detergent and 1.5% triclosan in natural soap, were studied in a new protocol designed according to Food and Drug Administration guidelines. After a single handwash, both preparations exhibited a degerming action statistically superior to the mechanical elimination of the marker organism that was achieved by the nonmedicated controls. Following a further nine hand recontamination sequence with 10(9) colony-forming units (cfu)/mL S marcescens (mean predisinfection baseline, log10 6.6), the efficacy of chlorhexidine and triclosan was significantly augmented: the mean log10 reduction factors were 4.15 and 3.78, respectively. In the absence of internationally accepted testing standards for antiseptic handwash products, the significance of protocol variables is discussed. The advantages to preventative microbiology of antiseptics with persistent skin antibacterial activity are highlighted. PMID- 3294701 TI - Pseudomonas maltophilia. PMID- 3294702 TI - Endophthalmitis associated with filtering blebs. PMID- 3294703 TI - Traumatic endophthalmitis. PMID- 3294704 TI - Endophthalmitis of drug abuse. PMID- 3294705 TI - Vitrectomy in endophthalmitis. PMID- 3294706 TI - Causes and prevention of endophthalmitis. PMID- 3294707 TI - The pathogenesis of endophthalmitis. PMID- 3294708 TI - Clinical diagnosis of endophthalmitis. PMID- 3294709 TI - Laboratory diagnosis of endophthalmitis. PMID- 3294710 TI - Postoperative endophthalmitis. PMID- 3294711 TI - Psychic coping behaviour and the role of social support. AB - After defining the social support concept this article discusses some studies of its significance in relation to psychic functioning. Correct conception and operationlisation of social support is urged. Only then can some aspects of social support be studied in the clinical and the epidemiological perspective. PMID- 3294712 TI - The effect of E. coli infection on the prostaglandin synthesizing capacity of postobstructive rat kidney. AB - The PGE2, PGI2, PGF2 alpha and TxA2 synthesizing activities were studied in an isolated microsomal fraction of rat kidney after temporary, unilateral ureter obstruction and E. coli infection. In the early phase of regeneration the synthesis of vasodilatory PGI2 was increased, whereas that of vasoconstrictory PGF2 alpha was decreased. An increased PGE2 synthesizing activity was observed when renal obstruction was associated with infection. The role of these changes in regenerating the haemodynamics and function of postobstructive kidney is discussed. PMID- 3294713 TI - The pattern of plasma renin activity and aldosterone system in patients with sustained hydronephrosis. AB - Twenty-six patients with unilateral and bilateral hydronephrosis were subjected to investigation to identify the patterns of PRA-aldosterone system. The incidence of hypertension in the unilateral group was 28.5%, while in the bilateral group it was 50%; the overall incidence was 34.6%. In the hypertensive patients (9 cases), plasma renin activity and aldosterone were normal in one, and elevated in three. Aldosterone only was elevated in 3 cases, while PRA was elevated in 2. In the normotensive patients, the levels of PRA and aldosterone were normal in 5 patients, while in the remaining 12 cases one or both parameters were elevated. PMID- 3294714 TI - The effect of parenteral emepronium bromide (Cetiprin) on postoperative vesical tenesms after transurethral resection of the prostate. A randomized, placebo controlled study. AB - Sixty patients were randomized to treatment with either emepronium bromide (Cetiprin) 25 mg t.i.d. or placebo, both medications administered intramuscularly, after transurethral resection of the prostate. Postoperatively, the number of episodes with vesical tenesms and the need for adjuvant analgesic medication were registered. No significant differences in the number of episodes with vesical tenesms or the need for adjuvant analgesic medication were found between the patients treated with emepronium bromide and those treated with placebo. PMID- 3294715 TI - Psychological effects of chronic haemodialysis. AB - Ninety-four patients, partly on chronic haemodialysis, partly after successful kidney transplantation, were studied. Progress of perceptual performance was followed up by measurements of the reaction time. It is pointed out that accumulation of uraemic toxins causes permanent damage to the central nervous system. The psychological tests revealed behavioural and personality deviations typical of other chronic diseases, the main features being growing anxiety, neuroticitation, sense of inferiority, egocentric attitude, primitive defense reactions, social introversion, distorted image of the ego, etc. Dependence of the patients on the medical or nursing staff and on the dialysing system also favour these symptoms. The uncertain outcome of the illness and the "over protective" attitude of the close or the more distant milieu also add to the sense of insecurity and uselessness. The need for individual and group psychotherapy is emphasized. PMID- 3294716 TI - Structural and functional evolution of gonadotropin-releasing hormone. PMID- 3294717 TI - Excitons and solitons in molecular systems. PMID- 3294718 TI - The centrosome and its role in the organization of microtubules. PMID- 3294719 TI - Morphology and cytochemistry of the endocrine epithelial system in the lung. PMID- 3294720 TI - Intrinsic nerve plexus of mammalian heart: morphological basis of cardiac rhythmical activity? PMID- 3294721 TI - [Programmed ventricular stimulation in detecting malignant ventricular arrhythmia following myocardial infarct]. PMID- 3294722 TI - [Prognostic significance of ventricular arrhythmia in dilated cardiomyopathy]. PMID- 3294724 TI - [Significance of cardiac arrhythmia in mitral valve prolapse syndrome]. PMID- 3294723 TI - [Cardiac arrhythmia in hypertrophic cardiomyopathy. Diagnosis and therapy]. PMID- 3294725 TI - [Autoimmune hemolytic anemia as an initial manifestation of non-Hodgkin's lymphoma]. PMID- 3294726 TI - [Increasing weakness and weight loss in a 40-year-old patient with lung tuberculosis]. PMID- 3294727 TI - Inhibition of tumor cell induced platelet aggregation by prostacyclin and carbacyclin: an ultrastructural study. AB - Prostacyclin and its synthetic analog carbacyclin were compared as to their abilities to inhibit tumor cell-platelet interactions. Aggregation of rat platelets was induced in vitro by homologous rat Walker 256 carcinosarcoma cells. The extent of cellular interactions was examined ultrastructurally. The ultrastructural data presented here indicate that the tumor cell-platelet interactions began with individual platelets which initiated platelet chain formation in focal association with tumor cell surfaces. By mid-phase aggregation large homotypic platelet aggregates had formed with tumor cells positioned on the external surfaces of the emboli. Tumor cell-platelet interactions became progressively more extensive as tumor cells became enmeshed with growing platelet aggregates. Prostacyclin and carbacyclin inhibited tumor cell platelet interactions in a dose-dependent manner. Carbacyclin inhibition of tumor cell induced platelet aggregation was longer in duration but carbacyclin was 10-fold less effective than was prostacyclin. We report here that prostacyclin and carbacyclin inhibit both aggregation and the ultrastructural changes associated with tumor cell-platelet interactions. PMID- 3294728 TI - Distribution of laminin and collagen type IV in rat colon tumors induced by 1,2 dimethylhydrazine. AB - Immunofluorescent distribution of basement membrane components laminin and collagen type IV was studied in 51 rat colon tumors induced by 1, 2 dimethylhydrazine. In normal colonic mucosa, adenomas and carcinomas in situ continuous basement membranes were present, while in adenocarcinomas they were altered to different extents. An uncoordinated loss, or dissociation, of the two markers studied was found: the degree of collagen type IV loss was often much higher than that of laminin in the same tumor. These data suggest that a reliable determination of cancer invasion by monitoring basement membrane alteration requires the use of several basement membrane markers. PMID- 3294729 TI - Principles of modern urodynamic studies. AB - Modern urodynamic equipment should have at least three channels to record the cystometrogram, the electromyogram of the periurethral striated sphincter, and intrarectal pressure. The addition of simultaneous transrectal ultrasonography is helpful. The bladder should not be irritated when introducing the urodynamics catheter. Variables affecting the performance of the catheter used for measuring the urethral pressure profile include the size of the lumen, the size of the side hole, the speed with which the catheter is withdrawn, and the rate of infusion. The entire curve of the cystometrogram should be examined, not simply initial rise. Initial overshoots can occur if older apparatus is used or if the urodynamics catheter is partially blocked; such overshoots should be disregarded. PMID- 3294730 TI - Medication changes since the thirties. PMID- 3294731 TI - Captopril associated isolated thrombocytopenia. PMID- 3294732 TI - The Ring disaster. PMID- 3294733 TI - Biographical sketch: Orfila. PMID- 3294734 TI - Chemistry deconstructed. "Between the library and the laboratory: the language of chemistry in eighteenth-century France". By Wilda C. Anderson. Essay review. PMID- 3294735 TI - Dioscorides unriddled. "Dioscorides on pharmacy and medicine". By John M. Riddle. Essay review. PMID- 3294737 TI - Current status of the surgical management of severe acute pancreatitis. PMID- 3294736 TI - Postoperative acute acalculous cholecystitis. AB - A 5-year experience with postoperative acute acalculous cholecystitis is reported. The series concerns 9 male patients ranging in age from 28 to 69 years, with a mean age of 46 years. All underwent major surgical procedures and complications appeared in the postoperative course. Clinically, 89% of patients developed sepsis and 66% jaundice. Klebsiella pneumoniae was the microorganism most frequently isolated from the blood, intraabdominal and wound fluid collections. It is emphasized that the diagnosis of this form should be clinical and it should be immediately suspected whenever intraabdominal signs develop. A review of the international literature on the subject is presented. The etiology and pathogenetic mechanisms of postoperative acute acalculous cholecystitis are discussed. PMID- 3294738 TI - Gallbladder contraction in patients with irritable bowel syndrome. AB - Impaired gallbladder contraction has been previously shown in pregnant women, in people with diabetes, celiac disease, and cystic duct syndrome, and in postvagotomy patients. In this study gallbladder contraction was measured by real time ultrasonography in 32 subjects: 8 healthy controls, 12 diabetics and 12 with the irritable bowel syndrome. Contraction was expressed by four parameters: fasting gallbladder volume, residual gallbladder volume after maximal contraction, maximum percent of gallbladder emptied, and time elapsed until maximal contraction occurred. The main difference between the control subjects and the groups with diabetes and irritable bowel syndrome was found in the fasting and residual gallbladder volumes. Fasting volumes were twice as large in the irritable bowel syndrome (30.37 +/- 3.0 ml) as in the control subjects (15.15 +/- 0.69 ml, P less than 0.001). Residual volumes were also twice as great in those with irritable bowel syndrome, compared with the control subjects (12.91 +/ 2.18 ml vs. 5.6 +/- 0.58 ml, P less than 0.01). Similar, but less pronounced differences were found when the diabetic and the control subjects were compared. Fasting volumes were 21.7 +/- 2.62 ml for diabetic individuals vs. 15.15 +/- 0.69 ml for control subjects (P less than 0.05) and residual volumes were 10.87 +/- 2.69 vs. 5.6 +/- 0.58 ml (P = 0.1), respectively. The maximum percent emptied and the time elapsed until maximum contraction occurred were not statistically different. Also, no statistical difference was found between the diabetic individuals and those with irritable bowel syndrome in any of the parameters studied. Increased fasting and residual gallbladder volumes in the irritable bowel syndrome are changes that may promote sequestration and precipitation of cholesterol or calcium salts in the gallbladder of patients with lithogenic bile, as seen in diabetic individuals. PMID- 3294739 TI - Infected renal hematoma complicating anticoagulant therapy. AB - We describe a case of spontaneous infection of a renal hematoma complicating warfarin sodium anticoagulant therapy. The infected hematoma was successfully drained by sonar-guided fine-needle aspiration. All reported cases of renal hematomas complicating anticoagulant therapy are reviewed. PMID- 3294740 TI - Pseudocoarctation of the aorta--detection by digital subtraction angiography. PMID- 3294741 TI - The moral limits to federal funding for kidney disease. AB - In the current era of cost-containment, Congress may reconsider its support for the End-Stage Renal Disease Program. Substantial reductions in funding for this program could be made by eliminating non-beneficial, marginally beneficial, and relatively inefficient modes of treatment. These measures, however, will only postpone the inevitable day when clearly beneficial treatment must be withheld. PMID- 3294742 TI - False data & the therapeutic misconception: two urgent problems in research ethics. False data and last hopes: enrolling ineligible patients in clinical trials. PMID- 3294743 TI - False hopes and best data: consent to research and the therapeutic misconception. PMID- 3294744 TI - Tax Equity and Fiscal Responsibility Act of 1982: an incentive to improve productivity in health care. AB - The productivity incentives of TEFRA are compared, using a sample that includes ten patients, four on Medicare and the remainder being either private pay patients or patients covered by commercial insurance. The effect of a ten percent increase or decrease in productivity on Medicare reimbursement before and after TEFRA is examined. PMID- 3294745 TI - [Moritz Kaposi: further currency]. AB - In connection with the frequent appearance of Kaposi's sarcoma in AIDS, the biography of Moritz Kohn/Kaposi, a dermatologist of Hungarian origin in Vienna, is presented. The merits and failures of his morphologically oriented concept are discussed. Today his activity is high estimed by dermatologists all over the world. PMID- 3294746 TI - Images of fatherhood in antenatal literature: 1. PMID- 3294747 TI - An ABC of alternative medicine--hypnotherapy. PMID- 3294748 TI - Making history: the early days of the HVA. PMID- 3294749 TI - Education for motherhood at the turn of the century. PMID- 3294750 TI - Health visiting memories. PMID- 3294751 TI - Biblewomen and sanitary ladies. PMID- 3294752 TI - The development of health visitor education and training in England. PMID- 3294753 TI - Health visitors: the willing horses. PMID- 3294754 TI - Wasps have stings: examples of early health education. PMID- 3294755 TI - Hemoglobinopathies in Southeast Asia. PMID- 3294756 TI - [Meconium peritonitis: description of 3 cases with abnormal prenatal ultrasound findings]. AB - We describe three children with surgically confirmed meconium peritonitis. All had abnormal prenatal ultrasonographic examinations. The first child showed multiple cysts, the second had hydrops fetalis, and the third had dilated bowel loops. A polyhydramnion was common to all three cases. Of the two children who died, one had cystic fibrosis. It is remarkable that the ultrasonographic findings were different in the three children. PMID- 3294757 TI - No miracle remedies in sight for financing health care for the poor. PMID- 3294758 TI - Robert K. Nixon. PMID- 3294759 TI - Comparative study of lipid composition of Candida albicans in the yeast and mycelial forms. PMID- 3294760 TI - Polypeptide YY- and neuropeptide Y-immunoreactive cells and nerves in the endocrine and exocrine pancreas of some vertebrates: an onto- and phylogenetic study. AB - The occurrence of polypeptide YY- and neuropeptide Y-immunoreactive cells and nerves in the pancreas of some species from all the eight main vertebrate groups (cyclostomes, cartilaginous fish, bony fish, amphibia, reptiles, birds, and mammals) was investigated. In addition, an ontogenetic study of these neurohormonal peptides was performed, using the rat pancreas. The distribution of these two peptides was compared with that of the structurally closely related pancreatic polypeptide. Polypeptide YY-immunoreactive cells were found to occur in the endocrine pancreas and neuropeptide Y-immunoreactivity was observed both in neurons and nerve fibres. The polypeptide YY-immunoreactive cells were limited to mammals and reptiles only. Neuropeptide Y-immunoreactive neurons and nerves were observed in reptiles, birds, and mammals only. One reptilian species (out of three) and one mammalian (out of six) failed to show any kind of immunoreactivity for the polypeptide or neuropeptide. Pancreatic polypeptide-immunoreactive cells were found in all the species examined except in the hagfish islet. In rat foetuses, polypeptide YY-immunoreactive cells and neuropeptide Y-immunoreactive nerve elements were first demonstrated at the seventeenth day of gestation, whereas pancreatic peptide-immunoreactive cells did not appear until postnatally, namely in two day-old rats. The polypeptide-containing cells, a new cell type in the endocrine pancreas, are rare. In contrast to the pancreatic peptide cells, they do not seem to have any kind of regional distribution. PMID- 3294761 TI - GABA and GAD-like immunoreactivity in the primate retina. AB - GABA immunoreactivity was studied and compared with GAD immunoreactivity in the retinae of baboon, cynomolgus monkey and man. The central and peripheral parts of the retinae were investigated separately in cynomolgus monkey and in man. The same kinds of structures were stained with both antisera. Cells with a position corresponding to amacrine cells were stained, as well as processes in the inner plexiform layer and some cells in the ganglion cell layer. The outer plexiform layer and some cells with the position and configuration of horizontal cells also appeared immunoreactive. Staining was also observed in bipolar-like cells, in man most clearly when using the GABA antiserum in sections from the central parts of the retina. It is possible that horizontal cells, as well as bipolar-like cells, may play a previously unsuspected role in GABAergic transmission in the primate retina. PMID- 3294762 TI - Electron cytochemical study of the muscle cell surface. AB - The lectins wheat germ agglutinin and limulus polyphemus were used as cytochemical probes to study the ultrastructural localization of sialic acid at the cell surface of rat muscle fibers. In addition cytochemical studies employing strontium as an electron-dense marker were also carried out to investigate cation binding sites at the muscle cell surface. The results showed binding of the lectins to the glycocalyx, caveolae and the basal lamina of the muscle fibers. These binding sites matched the ones observed in the cytochemical studies using strontium as a marker. Based on these observations we suggest that the glycocalyx, caveolae and the basal lamina of the muscle fiber may be involved in the binding of Ca++ and that significant amounts of Ca++ may be normally present at the muscle cell surface. PMID- 3294764 TI - A comparison of perceptive and receptive fields in man and monkey. AB - We have measured the perceptive field, the psychophysical correlate of the physiologically determined receptive field, in man and monkey. Measurements were made using the Hermann grid illusion and the Westheimer paradigm. The following results were found: First, in both man and monkey, the size of perceptive fields and field centers increases from the fovea to the periphery. As with receptive fields, this increase is first rapid and then more gradual; and it is more pronounced on the temporal than on the nasal side of the retina. Second, monkey and human perceptive field centers are approximately the same size. But total perceptive fields (i.e., centers plus surrounds) tend to be smaller in monkeys. Third, in monkey, psychophysically measured perceptive field centers are about the same size as neurophysiologically measured receptive field centers. And as these, they are larger, by a factor 1.3-2, than histologically measured dendritic fields. These findings strongly indicate that in monkey all three measurements refer to the same underlying retinal mechanism. The same relationship is assumed to hold in man. PMID- 3294763 TI - An autoimmune antibody from scleroderma patients recognizes a component of the plant cell nucleolus. AB - An auto-antibody from human serum of patients with the autoimmune disease scleroderma was used to localize the nucleolus in meristematic cells of onion and soybean roots using indirect immunofluorescence microscopy. Similar lots of antiserum recognized a single 34 kD, nucleolar protein, fibrillarin, in a variety of animal cells (Ochs et al. 1984, 1985). In both plants, antibody linked fluorescence is associated with the one to several nucleoli present in the interphase nucleus. The fluorescence becomes diffuse around condensing prophase chromosomes and becomes more diffused at metaphase with slightly more intense fluorescence surrounding the chromosomes. At anaphase-telophase the fluorescence is localized in dense areas within the chromosomes, presumably representing prenucleolar bodies which will form the interphase nucleoli of the daughter nuclei. This antiserum provides a new, valuable tool for the study of the nucleolus and the highly conversed nucleolar antigen(s) that it recognizes. PMID- 3294765 TI - CT measurement of lung density: the role of patient position and value for total body irradiation. AB - To obtain more precise data on pulmonary doses in preparation for total body irradiation, the lung density of patients was systematically analyzed in treatment positions using data obtained by computed tomography (CT). With the patient supine, the lung density was not significantly different for the right and left lungs. In contrast, considerable differences were noted between the two lungs in lateral decubitus positions owing to variations in ventilation and perfusion. The relative electron density of lung was also found to decrease with age, dropping to pe = 0.160 at 71 years. PMID- 3294766 TI - Sullivan's influence on Sheppard Pratt. PMID- 3294767 TI - Use of the Eating Attitudes Test and Eating Disorder Inventory in adolescents. AB - The Eating Attitudes Test and the Eating Disorder Inventory were developed to measure abnormal eating attitudes and behaviors in patients with eating disorders. This report describes each of these self-report questionnaires and outlines their functions, limitations, and previous use with adolescent subjects. PMID- 3294768 TI - Microbiologic evaluation of canine urine: direct microscopic examination and preservation of specimen quality for culture. AB - Urine specimens were obtained from 115 dogs. Each specimen was divided into 2 aliquots; one aliquot was placed into a sterile container (non-preserved), and the other was preserved in a boric acid-glycerol-sodium formate at 4 C. Both aliquots were then transported to a laboratory, and specimens of each aliquot were bacteriologically cultured immediately upon arrival at the laboratory. Specimens of the preserved aliquot also were cultured after 24, 48, and 72 hours of preservation. In 47 specimens containing greater than or equal to 1 X 10(4) colony-forming units (CFU)/ml, the results of quantitative bacteriologic culturing of preserved urine at 0, 24, 48, and 72 hours were the same as the result of the immediate quantitative bacteriologic culture of non-preserved urine. In 2 of 5 specimens containing greater than or equal to 1 X 10(3) CFU/ml but less than 1 X 10(4) CFU/ml, the results of quantitative bacteriologic culture of preserved urine differed from the corresponding immediate culture of nonpreserved urine. Bacteria were not isolated from 63 specimens (less than 1 X 10(3) CFU/ml). Bacteriologic cultures of preserved urine were also negative for bacterial growth at 0, 24, 48, and 72 hours. Bacteriuria was detected by direct microscopic examination of gram-stained smears of uncentrifuged urine in 50 of 52 urine specimens from dogs with urinary tract infection. Bacteria were observed in 1 of 63 specimens that did not have bacterial growth when cultured. PMID- 3294769 TI - Anatomic, hoof, and shoeing considerations for the treatment of laminitis in horses. PMID- 3294770 TI - An analysis of journal citation frequency in the Consultant data base for computer-assisted diagnosis. AB - An analysis was done of a random sample of one third of the Consultant data base for computer-assisted diagnosis to determine the number of journals cited and the number of times each was cited. Although 86 journals were represented, 80% of citations for small animal practice were from 9 journals and 90% were from 14 journals. Eighty percent of citations for large animal diseases were from 17 journals and 90% were from 25 journals. The Journal of the American Veterinary Medical Association provided 20% of total journal citations. PMID- 3294771 TI - Telephone directory mistakes. PMID- 3294772 TI - Reversal of testicular function after prolonged suppression with an LHRH agonist in rhesus monkeys. AB - Using subcutaneously implanted osmotic pumps, four male rhesus monkeys were continuously infused for 18 months with 100 micrograms/day of [(imBzl)-D-His6 Pro9-NEt]-LHRH (LHRH-A), a potent agonist of LHRH. After an initial increase, serum testosterone levels declined to 10% of pretreatment levels in three monkeys and the response to electroejaculation was lost. There was a decrease in testicular volume. Androgen replacement in the form of subcutaneous SILASTIC implants releasing 7 alpha-methyl-19-nor-testosterone acetate led to a restoration of ejaculatory response and the electroejaculates were devoid of spermatozoa. Under this treatment regimen (100 micrograms LHRH-A + 100 micrograms androgen daily), azoospermia was essentially maintained in the three monkeys for about 8 months. Withdrawal of LHRH-A and androgen treatment led to a complete restoration of testicular function. Serum testosterone returned to control levels and spermatozoa reappeared in the ejaculates with sperm counts reaching the normal range. Testicular volumes showed a gradual increase. These results indicate that continuous administration of an LHRH agonist together with an androgen can induce an extended period of azoospermia in rhesus monkeys. These results also show that after prolonged suppression (more than one year) of testicular function complete recovery occurs after cessation of treatment. PMID- 3294773 TI - Paldimycins A and B and antibiotics 273a2 alpha and 273a2 beta. Synthesis and characterization. AB - Paldimycin (antibiotic 273a1) and antibiotic 273a2 as well as their individual components, paldimycins A (273a1 alpha) and B (273a1 beta) and antibiotics 273a2 alpha and 273a2 beta were synthesized from paulomycin, paulomycin A and paulomycin B, respectively, by reacting with N-acetyl-L-cysteine. The semisynthetic antibiotics had chromatographic behavior (TLC, HPLC) and physical and chemical properties identical to the properties of the corresponding antibiotics produced by Streptomyces paulus. PMID- 3294774 TI - Valanimycin acts on DNA in bacterial cells. PMID- 3294775 TI - Immunosuppressive activities of 15-deoxyspergualin in animals. PMID- 3294776 TI - Validoxylamines as trehalase inhibitors. PMID- 3294777 TI - Effects of estradiol-17 beta, naloxone and gonadotropin releasing hormone on postpartum secretion of luteinizing hormone in fall-lambing ewes. AB - The interaction among exogenous estradiol-17 beta, naloxone and gonadotropin releasing hormone (GnRH) in the control of luteinizing hormone (LH) secretion was studied in intact postpartum ewes nursing their offspring. One-half of 30 fall lambing ewes were implanted subcutaneously with an estradiol-17 beta containing Silastic capsule between postpartum d 1 and 12 which doubled their serum concentrations of estradiol (16.0 +/- .1 vs 8.4 +/- .1 pg/ml). Blood samples were collected from implanted and non-implanted ewes at 15-min intervals for 5 h on d 3, 8, 13, 20 and 28 postpartum. Pre-injection samples were collected for 1 h, and ewes were injected with saline, naloxone (NAL;1 mg/kg) or GnRH (100 micrograms/ewe). When averaged across all days and implant groups, serum LH in the three post-NAL samples was higher (P less than .05) than in the three pre-NAL samples (3.6 +/- 1.2 vs .6 +/- .2 ng/ml). Post-GnRH concentrations of serum LH were lower (P less than .05) in estradiol-implanted ewes than in non-implanted ewes on d 8 and 13, but there were no differences in any LH characteristics on d 20 and 28 after implant removal on d 12. In non-implanted ewes, serum LH responses to GnRH increased (P less than .05) eightfold from d 3 (3.8 +/- 1.4 ng/ml) to d 8 (31.6 +/- 1.4 ng/ml), remained elevated through d 20, but declined by d 28 (10.8 +/- 1.4 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294778 TI - Accumulation of newly synthesized myosin heavy chain during thyroxine-induced myofiber type transition. AB - Slow-tonic myofiber to fast-twitch myofiber conversion was induced in chickens by feeding thyroxine. Incorporation of newly synthesized myosin heavy chain (MHC) into myofibers and myofibrils was followed by immunofluorescence with antibodies specific for fast-twitch MHC and slow-tonic MHC. Presence of more than one type of myosin heavy chain was detected in thyroxine-induced transitional myofibers of chicken pectoralis. Myofibers undergoing a transition were histochemically identical to immunologically cross-reacting, transitional myofibers of normal anterior latissimus dorsi. Newly synthesized MHC appeared to be incorporated uniformly across the cross sectional area of transitional myofibers and incorporated homogeneously into each sarcomere of transitional myofibrils. These observations are consistent with a theory of continuous protein exchange between myofibrillar protein and a non-myofibrillar protein pool, such that every sarcomere of a myofibril, and every myofibril of a myofiber, would be turned over simultaneously. PMID- 3294779 TI - Efficacy of different dosing schedules of tobramycin for treating a murine Klebsiella pneumoniae bronchopneumonia. AB - The efficacy of different dosing schedules of tobramycin for treating a murine Klebsiella bronchopneumonia was compared. Therapeutic efficacy depended upon dosing intervals. In mice treated for four days with a daily dose of 48 mg/kg, dosing intervals of 4 and 8 h allowed cure of 10/10 animals, whereas dosing intervals of 12 and 24 h yielded survival rates of only 6/10 (P less than 0.05) and 2/10 (P less than 0.01) respectively. Although observed in vitro, a post antibiotic effect of tobramycin against K. pneumoniae was unlikely in vivo since residual concentrations of tobramycin were found in the lung tissue 12 h after dosing, when efficacy starts to decrease. Efficacy also depended to some extent upon the duration of therapy. PMID- 3294780 TI - Aerobactin-producing multi-resistance plasmids. PMID- 3294783 TI - Social interaction patterns of high, average, and low sociometric status children. PMID- 3294781 TI - Enrichment and characterization of clonogenic epithelial cells from adult rat liver and initiation of epithelial cell strains. AB - A highly efficient method is described for obtaining proliferative epithelial cells from adult rat livers for the reproducible establishment of liver epithelial cell strains. When cells were isolated from livers of 10- to 15-wk-old male Fischer 344 rats by a collagenase-perfusion method, collected by centrifugation at 50 X g for 5 min, and cultured in Williams' medium E containing fetal bovine serum and dexamethasone, colonies of epithelial cells different in size and morphology from hepatocytes were obtained. Sequential perfusion with collagenase and dispase yielded numerous epithelial cell colonies. When isolated cells were fractionated by differential centrifugation, the great majority of hepatocytes were sedimented at 50 X g for 1 min, whereas many non-hepatocytic cells remained in the supernatant and could be sedimented by a second centrifugation at 50 X g for 5 min. Culture of the two fractions revealed that almost all the epithelial cell colonies were derived from cells in the non hepatocytic cell fraction. The epithelial cells were cytochemically negative for gamma-glutamyl transpeptidase activity, whereas an increase in the activity was detected in hepatocytes with duration in culture. Ultrastructural characteristics of hepatocytes were not found in the cells of newly established cell strains. These results suggest that adult rat liver epithelial cells propagable in culture were derived from a cell type other than the hepatocyte. PMID- 3294784 TI - Calcium antagonists in cardiovascular therapeutics. PMID- 3294782 TI - Primary cultures of hepatocytes in serum and hormone-free medium: identification of conditions which stimulate an in vivo-like induction of G6PD. AB - Recent results from several laboratories suggest that complex interactions between hormones and dietary carbohydrate may be responsible for regulating the induction of several hepatic lipogenic enzymes. Elucidation of these interactions requires the ability to culture hepatocytes for several days in serum-free medium where the hormones or carbohydrate or both present is strictly controlled. The functional response of primary adult rat hepatocytes was examined in a medium without exposure to serum, hormones, or carbohydrates and on three substrata commonly used to culture cells in a defined medium. Hepatocytes cultured on a floating collagen gel in which is embedded a nylon mesh possess cell attachment and morphologic characteristics superior to either cells cultured on a collagen coated or fibronectin(Fn)-coated substratum. Cells cultured on the gel-mesh system retain insulin responsivity, as measured by protein synthesis rates and glucose-6-phosphate dehydrogenase (G6PD) induction, for at least 6 d in culture. Under these conditions, insulin, dexamethasone, and fructose increase G6PD specific activity to levels comparable to that seen in an induced animal. Hepatocytes cultured on the gel-mesh system tolerate restricted medium conditions better than cells cultured on collagen or Fn-coated substratum, and remain viable for sufficient times to allow, for the first time, full expression and maximal induction (i.e. like in vivo) of G6PD in cultured cells. This system represents a satisfactory model for in vivo liver metabolism and a superior system for studying the effects of hormones and metabolites on G6PD levels, as well as other nutritional-hormonally regulated enzymes. PMID- 3294785 TI - Management of falciparum malaria. PMID- 3294786 TI - Mutational alterations affecting the export competence of a truncated but fully functional maltose-binding protein signal peptide. AB - The wild-type maltose-binding protein (MBP) signal peptide is 26 amino acids in length. A mutationally altered MBP signal peptide has been previously described that is missing one of the basic residues from the hydrophilic segment and seven residues from the hydrophobic core; however, it still facilitates MBP secretion to the periplasm at a rate and efficiency comparable to those of the wild-type structure. Thus, this truncated signal peptide (designated the R2 signal peptide) must retain all of the essential features required for proper export function. In this study, alterations were obtained in the R2 signal peptide that resulted in an export-defective MBP. For the first time, signal sequence mutations were obtained that resulted in the synthesis of a totally export-defective MBP. As was previously the case for the wild-type signal peptide, the introduction of either charged residues or helix-breaking proline residues adversely affected export function. Despite these similarities, the position of these alterations within the R2 signal peptide, their relative effects on MBP secretion and processing, and an analysis of the ability of various extragenic prl mutations to suppress the secretion defects provide additional insight into the minimal requirements for a functional MBP signal peptide. PMID- 3294787 TI - Export of unprocessed precursor maltose-binding protein to the periplasm of Escherichia coli cells. AB - The Escherichia coli maltose-binding protein (MBP) R2 signal peptide is a truncated version of the wild-type structure that still facilitates very efficient export of MBP to the periplasm. Among single amino acid substitutions in the R2 signal peptide resulting in an export-defective precursor MBP (pMBP) were two that replaced residues in the consensus Ala-X-Ala sequence (residues -3 to -1) that immediately precedes the cleavage site. It was suggested that the functional hydrophobic core and signal peptidase recognition sequence of this signal peptide substantially overlap and that these two alterations affect both pMBP translocation and processing. In this study, the export of pMBP by the mutants, designated CC15 and CC17, with these two alterations was investigated further. The pMBP of mutant CC17 has an Arg substituted for Leu at the -2 position. It was found that CC17 cells exported only a very small amount of MBP, but that which was exported appeared to be correctly processed. This result was consistent with other studies that have concluded that virtually any amino acid can occupy the -2 position. For mutant CC15, which exhibits a fully Mal+ phenotype, an Asp is substituted for the Ala at the -3 position. CC15 cells were found to export large quantities of unprocessed, soluble pMBP to the periplasm, although such export was achieved in a relatively slow, posttranslational manner. This result was also consistent with other studies that suggested that charged residues are normally excluded from the -3 position of the cleavage site. Using in vitro oligonucleotide-directed mutagenesis, we constructed a new signal sequence mutant in which Asp was substituted for Arg at the -3 position of an otherwise wild-type MBP signal peptide. This alteration had no apparent effect on pMBP translocation across the cytoplasmic membrane, but processing by signal peptidase was inhibited. This pMBP species with its full-length hydrophobic core remained anchored to the membrane, where it could still participate in maltose uptake. The implications of these results for models of protein export are discussed. PMID- 3294788 TI - Photoreactivation in phr mutants of Escherichia coli K-12. AB - We have investigated the genetics of photoreactivation in Escherichia coli K-12. We found that strains with point mutations or deletions in the phr gene showed a significant residual level of photoreactivation after exposure to large fluences of photoreactivating light. It had been previously proposed that a gene in the gal-att lambda interval is also involved in photoreactivation and that the residual photoreactivating activity might be due to this so-called phrA gene located at this interval. We found that deletions of the gal-att lambda region had no effect on either the rate or the final extent of photoreactivation observed in phr+ cells or phr mutants; however strains carrying the delta (gal att lambda) deletions displayed increased sensitivity to near-UV radiation. PMID- 3294789 TI - Identification and expression of a copy number control gene in the IncFIII hemolytic plasmid pSU316. AB - A DNA fragment carrying both the IncFIII determinant and a copy number control gene of the hemolytic plasmid pSU316 has been cloned in pBR322. Deletion derivatives of the hybrid plasmid generated by Bal 31 digestion, which no longer exhibit the IncFIII phenotype, fall into two complementation groups when tested against a pSU316 miniplasmid derivative. Type 1 mutants exhibit the copy number control (Cop+) phenotype whereas type 2 mutants do not. Restriction analysis of type 1 and type 2 mutants allowed us to locate the cop gene of pSU316 in a 700 base-pair fragment adjacent to the IncFIII determinant. Plasmid expression in a minicell system suggests that the product of the cop gene of pSU316 could be a 13,000-dalton protein. PMID- 3294790 TI - Modulation of cell wall synthesis by DNA replication in Escherichia coli during initiation of cell growth. AB - Resting cells of Escherichia coli are able to initiate growth and murein biosynthesis in the presence of beta-lactam antibiotics binding to penicillin binding proteins (PBPs) 1a and 1b (E. J. de la Rosa, M. A. de Pedro, and D. Vazquez, Proc. Natl. Acad. Sci. USA 82:5632-5635, 1985). Under these conditions, cells elongate normally until they approach the first doubling in mass, the time at which cell lysis starts. Assuming that coupling between DNA replication and cell division both in cells starting growth and in growing cells is essentially similar, triggering of the lytic response in the beta-lactam-treated cells coincides with the termination of the first round of DNA replication. This coincidence suggests that both events are interrelated. We investigated this possibility by studying the initiation of growth in cultures of wild-type strains and in cell division mutants treated with beta-lactams inhibiting PBPs 1a and 1b and with the DNA replication inhibitor nalidixic acid. Addition of nalidixic acid, even late in the first cell cycle, prevented the lytic response of the cells to the blockade of PBPs 1a and 1b. The effect of nalidixic acid is more likely due to its action on DNA replication itself than to its indirect inhibitory effect on cell division or to its ability to induce the SOS system of the cell. These observations favor the idea that the cell wall biosynthetic machinery might be modulated by DNA replication at precise periods during cell growth. PMID- 3294791 TI - Selection of mutations that alter the osmotic control of transcription of the Salmonella typhimurium proU operon. AB - We isolated 60 independent mutations, designated osmX, in Salmonella typhimurium that result in constitutive expression of the normally osmoregulated proU operon. Each of the osmX mutations is closely linked to the proU locus and cis-dominant over the osmX+ allele in diploid strains. These results suggest that the mutations are probably in the 5' transcriptional control region of the proU operon. Our failure to obtain either recessive or unlinked mutations that altered the osmotic control of transcription of the proU operon suggests that transcriptional regulation of the gene is not under the negative control of a repressor protein that is dispensable for cell viability. We discuss possible models for the mechanism of osmotic regulation of transcription of the proU operon. PMID- 3294792 TI - Metabolism of L-glyceraldehyde 3-phosphate in Escherichia coli. AB - When either 3H-labeled L-glyceraldehyde or 3H-labeled L-glyceraldehyde 3 phosphate (GAP) was added to cultures of Escherichia coli, the phosphoglycerides were labeled. More than 81% of the label appeared in the backbone of the phosphoglycerides. Chromatographic analyses of the labeled phosphoglycerides revealed that the label was normally distributed into phosphatidylethanolamine, phosphatidylglycerol, and cardiolipin. These results suggest that L glyceraldehyde is phosphorylated and the resultant L-GAP is converted into sn glycerol 3-phosphate (G3P) before being incorporated into the bacterial phosphoglycerides. Cell-free bacterial extracts catalyzed an NADPH-dependent reduction of L-GAP to sn-G3P. The partially purified enzyme was specific for L GAP and recognized neither D-GAP nor dihydroxyacetone phosphate as a substrate. NADH could not replace NADPH as a coenzyme. The L-GAP:NADPH oxidoreductase had an apparent Km of 28 and 35 microM for L-GAP and NADPH, respectively. The enzyme was insensitive to sulfhydryl reagents and had a pH optimum of approximately 6.6. The phosphonic acid analog of GAP, 3-hydroxy-4-oxobutyl-1-phosphonate, was a substrate for the reductase, with an apparent Km of 280 microM. PMID- 3294793 TI - Alkylation of acetohydroxyacid synthase I from Escherichia coli K-12 by 3 bromopyruvate: evidence for a single active site catalyzing acetolactate and acetohydroxybutyrate synthesis. AB - Acetohydroxyacid synthase I (AHAS I) purified from Escherichia coli K-12 was irreversibly inactivated by incubation with 3-bromopyruvate. Inactivation was specific, insofar as bromoacetate and iodoacetate were much less effective than bromopyruvate. Inactivation was accompanied by incorporation of radioactivity from 3-bromo[2-14C]pyruvate into acid-insoluble material. More than 95% of the incorporated radioactivity coelectrophoresed with the 60-kilodalton IlvB subunit of the enzyme through a sodium dodecyl sulfate-polyacrylamide gel; less than 5% coelectrophoresed with the 11.2-kilodalton IlvN subunit. The stoichiometry of incorporation at nearly complete inactivation was 1 mol of 14C per mol of IlvB polypeptide. These data indicate that bromopyruvate inactivates AHAS I by alkylating an amino acid at or near a single active site located in the IlvB subunit of the enzyme. We confirmed that this alkylation inactivated both AHAS reactions normally catalyzed by AHAS I. These results provide the first direct evidence that AHAS I catalyzes both acetohydroxybutyrate and acetolactate synthesis from the same active site. PMID- 3294794 TI - Regulatory mutants of the aroF-tyrA operon of Escherichia coli K-12. AB - The regulatory region of the aroF-tyrA operon was fused to the chloramphenicol acetyltransferase (cat) gene on a plasmid vector. Expression of the cat gene was subject to repression by tyrR+. This fusion was used to isolate regulatory mutants with increased expression of the cat gene in which repression by tyrR+ was affected. Nucleotide sequencing of these mutants has led to the identification of three sites involved in the repression of aroF by tyrR+. The existence of a functional promoter divergently transcribing from the aroF regulatory region was also demonstrated by using the cat fusion vector. The expression of this promoter is also regulated by tyrR+. PMID- 3294795 TI - Labeling of binding sites for beta 2-microglobulin (beta 2m) on nonfibrillar surface structures of mutans streptococci by immunogold and beta 2m-gold electron microscopy. AB - As little detail is known about the surface structure of streptococci in the mutans group and the relationship of surface structure to host ligand-binding functions, the twofold purpose of this investigation was to examine in detail, by a range of electron microscopic techniques, the surface structures of streptococci in the different species of the mutans group and to investigate the distribution of beta 2-microglobulin (beta 2m)-binding sites on such structures. Strains representing Streptococcus mutans, S. cricetus, S. rattus, S. sobrinus, and four fresh isolates were studied by shadowcasting and histochemical staining of whole-mounted cells as well as by ultrathin and thick sectioning of embedded specimens. beta 2m-binding site distribution was visualized by indirect immunogold electron microscopy and by direct bacterial binding of beta 2m conjugated gold probes. Shadowcast preparations revealed binding of gold probes to the cell surface of known beta 2m-binding strains but not to their polar fibrillar appendages. These long fibrils, common to all strains, were trypsin and sonication sensitive and stained with lead citrate but not with uranyl acetate or ruthenium red. More gold particles were bound by the indirect technique. For grid mounted bacteria, the gold was mostly bound in clusters at the periphery of the cells. When gold probes were reacted in suspension with bacteria before mounting onto grids, a more even distribution of the gold was seen, but the bacteria were aggregated. Heating the bacteria eliminated beta 2m-gold binding but had no effect on the morphology of the fibrils. Thick sections of embedded bacteria prereacted with beta 2m-conjugated gold probes were analyzed by stereo imaging. A wispy, uranyl acetate-stained fuzzy layer, distinct from the fibrils seen by shadowcasting and extending up to one cell diameter from the cell wall, contained the gold probes. These findings introduce a concept that binding sites for some salivary ligands on mutans streptococci may be clustered on very delicate, nonfibrillar structures extending much further from the cell wall than previously appreciated. As for beta 2m, which composes part of the human histocompatibility antigens, part of the bacterial surface would be coated at a distance from its body with a protein not necessarily recognized as foreign by the host. PMID- 3294796 TI - Characterization of the sppA gene coding for protease IV, a signal peptide peptidase of Escherichia coli. AB - The sppA gene codes for protease IV, a signal peptide peptidase of Escherichia coli. Using the gene cloned on a plasmid, we constructed an E. coli strain carrying the ampicillin resistance gene near the chromosomal sppA gene and an sppA deletion strain in which the deleted portion was replaced by the kanamycin resistance gene. Using these strains, we mapped the sppA gene at 38.5 min on the chromosome, the gene order being katE-xthA-sppA-pncA. Although digestion of the signal peptide that accumulated in the cell envelope fraction was considerably slower in the deletion mutant than in the sppA+ strain, it was still significant, suggesting the participation of another envelope protease(s) in signal peptide digestion. PMID- 3294797 TI - Molecular cloning of invasion plasmid antigen (ipa) genes from Shigella flexneri: analysis of ipa gene products and genetic mapping. AB - Tn5-tagged invasion plasmid DNA (pWR110) from Shigella flexneri serotype 5 (strain M90T) was cloned into the expression vector lambda gt11. Recombinant phage (lambda gt11Sfl) expressing pWR110-encoded polypeptide antigens were identified by using rabbit antisera directed against S. flexneri M90T invasion plasmid antigens. Antigens encoded by lambda gt11Sfl recombinant phage were characterized by reacting affinity-purified antibodies, eluted from nitrocellulose-bound plaques of lambda gt11Sfl recombinants, with virulent, wild type S. flexneri M90T polypeptides in Western blot analyses. lambda gt11Sfl clones directing the synthesis of complete, truncated, and beta-galactosidase fusion versions of three previously identified outer membrane polypeptides (57-, 43-, and 39-kilodalton [kDa] antigens) were isolated. A fourth polypeptide, similar in size to the 57-kDa antigen (ca. 58 kDa) but unrelated as determined by DNA homology and serological measurements, was also identified. Southern blot analysis of S. flexneri M90T invasion plasmid DNA hybridized with lambda gt11Sfl insert DNA probes was used to construct a map of invasion plasmid antigen genes (ipa) corresponding to the 57-kDa (ipaB), 43-kDa (ipaC), and 39-kDa (ipaD) polypeptides. Genes ipaB, ipaC and ipaD mapped to contiguous 4.6-kilobase (kb) and 1.0-kb HindIII fragments contained within a larger (23-kb) BamHI fragment. The ipaH gene, which encodes the synthesis of the 58-kDa polypeptide, did not map in or near the ipaBCD gene cluster, suggesting a distinct location of ipaH on the invasion plasmid. PMID- 3294798 TI - Positive and negative regulation of the bgl operon in Escherichia coli. AB - We have analyzed the functions encoded by the bgl operon in Escherichia coli K 12. Based on the ability of cloned regions of the operon to complement a series of Bgl- point mutations, we show that the three bgl structural genes, bglC, bglS, and bglB, are located downstream of the regulatory locus bglR in the order indicated. Using a bgl-lacZ transcriptional fusion, we show that bglC and bglS are involved in regulating operon expression. The presence of the bglC gene in trans is absolutely required for the expression of the fusion, which is constitutive when only the bglC gene is present. When the bglC and the bglS genes are both present in the cell, expression of the fusion requires a beta-glucoside inducer. From these observations, we conclude that (i) the bglC gene encodes a positive regulatory of bgl operon expression and (ii) the bglS gene encodes a negative regulator of operon expression, causing the requirement for a beta glucoside inducer. These conclusions are supported by our observations that (i) a majority of bglC mutants exhibits a Bgl- phenotype, whereas rare trans-dominant mutations in bglC result in constitutive expression of the bgl operon and the fusion, and (ii) mutations in the bglS gene lead to constitutive expression of the fusion. Based on several lines of evidence presented, we propose that the bglS gene product has an additional role as a component of the beta-glucoside transport system. PMID- 3294799 TI - Ureidosuccinate is transported by the allantoate transport system in Saccharomyces cerevisiae. AB - The regulatory characteristics exhibited by ureidosuccinate transport in Saccharomyces cerevisiae led us to hypothesize that this biosynthetic intermediate was transported via the degradative allantoate transport system. The hypothesis was verified by the finding that neither dal5 nor urep1 mutant strains could transport allantoate or ureidosuccinate. Mutations in the two loci were tightly linked and failed to complement one another, suggesting that they were allelic. The use of a common transport system for accumulation of both biosynthetic and degradative metabolites explains the paradoxical characteristics observed for control of ureidosuccinate and allantoate transport. PMID- 3294800 TI - Operator sequences of the aerobactin operon of plasmid ColV-K30 binding the ferric uptake regulation (fur) repressor. AB - The promoter region of the pColV-K30-encoded operon specifying biosynthesis and transport of the siderophore aerobactin was subjected to deletion analysis to determine the smallest DNA sequence affording iron regulation of a iucA'-'lacZ gene fusion. A 78-base-pair (bp) region containing the main (P1) promoter retained the character of inducibility under iron starvation. A 250-bp fragment carrying this sequence was examined for protection against DNase I by the Fur protein, the product of a gene (fur) required for negative control of several iron-regulated functions. The DNase I footprints, in the presence of various divalent heavy-metal ions added as corepressors, revealed two contiguous binding sites with different lengths and affinities for Fur. Increased concentrations of the protein appeared to elicit formation of repressor oligomers which bind to the upstream and downstream regions of the P1 promoter in a metal-dependent fashion, but with a presently undefined stoichiometry. The primary site for Fur binding spans 31 bp and contains two overlapping symmetry dyads which share the sequence 5'-TCATT-3'. It also contains extensive homology with a 19-bp consensus sequence for iron-regulated genes as deduced from comparison with the fhuA and fepA putative promoter sequences. PMID- 3294801 TI - Isolation of Haemophilus influenzae genes that suppress Escherichia coli polA mutations. AB - Haemophilus influenzae was found to produce a DNA polymerase that was similar to polymerase I of Escherichia coli. E. coli polA mutants were used as backgrounds for the selection of H. influenzae polA suppressor genes. Six different H. influenzae fragments were isolated that could suppress E. coli polA mutations. None of the suppressors appeared to encode the H. influenzae equivalent of the E. coli polA gene. One type of clone, represented by pGW41, caused a polymerase I activity to appear in a suppressed polA1 mutant. Plasmids from the pGW41 class contained two genes (pol-2 and pol-3) that were both required for polA suppression. Mutated nonsuppressing derivatives of the pGW41 class were used to create H. influenzae mutants that were deficient in polymerase I. PMID- 3294802 TI - Association of thioredoxin with the inner membrane and adhesion sites in Escherichia coli. AB - The intracellular localization of thioredoxin in Escherichia coli was determined by immunoelectron microscopy and correlated to previous biochemical data which had suggested that thioredoxin resides at inner-outer membrane adhesion sites. Since a considerable amount of thioredoxin was lost during preparation of cells for electron microscopy, we immobilized the protein with the heterobifunctional photoactivatable cross-linker p-azidophenacylbromide before the cells were fixed with aldehyde and embedded in Lowicryl K4M. Thin sections were labeled with affinity-purified antithioredoxin antiserum and protein A-gold complexes. Densities of immunolabel in a designated membrane-associated area and in the rest of the cytoplasm were compared and the data were statistically evaluated. Wild type strain W3110 and strain SK3981, an overproducer of thioredoxin, exhibited increased labeling at the inner membrane and its adjacent cytoplasmic area. In contrast, the more centrally located cytoplasm of both strains showed much lower label density. This label distribution did not change with cell growth or in the stationary phase. Immunolabel was often found at bridges between the inner and outer membranes; this result is consistent with a model which places at least a portion of the thioredoxin at membrane adhesion sites, corresponding to an osmotically sensitive cytoplasmic compartment bounded by a hybrid inner-outer membrane (C.A. Lunn and V. Pigiet, J. Biol. Chem. 257:11424-11430, 1982; C.A. Lunn and V. Pigiet, J. Biol. Chem. 261:832-838, 1986). Specific label was absent in the periplasmic space. PMID- 3294803 TI - Nucleotide sequence of a gene cluster involved in entry of E colicins and single stranded DNA of infecting filamentous bacteriophages into Escherichia coli. AB - Mutations in fii or tolA of the fii-tolA-tolB gene cluster at 17 min on the Escherichia coli map render cells tolerant to high concentrations of the E colicins and do not allow the DNA of infecting single-stranded filamentous bacteriophages to enter the bacterial cytoplasm. The nucleotide sequence of a 1,854-base-pair DNA fragment carrying the fii region was determined. This sequence predicts three open reading frames sequentially coding for proteins of 134, 230, and 142 amino acids, followed by the potential start of the tolA gene. Oligonucleotide mutagenesis of each open reading frame and maxicell analysis demonstrated that all open reading frames are expressed in vivo. Sequence analysis of mutant fii genes identified the 230-amino acid protein as the fii gene product. Chromosomal insertion mutations were constructed in each of the two remaining open reading frames. The phenotype resulting from an insertion of the chloramphenicol gene into the gene coding for the 142-amino acid protein is identical to that of mutations in fii and tolA. This gene is located between fii and tolA, and we propose the designation of tolQRA for this cluster in which tolQ is the former fii gene and tolR is the new open reading frame. The protein products of this gene cluster play an important role in the transport of large molecules such as the E colicins and filamentous phage DNA into the bacterium. PMID- 3294804 TI - An aminoacyl-tRNA synthetase complex in Escherichia coli. AB - Aminoacyl-tRNA synthetases from several strains of Escherichia coli are shown to elute as a high-molecular-weight complex on 6% agarose columns (Bio-Gel A-5M). In contrast, very little synthetase activity was observed in such complexes on Sephadex G-200 columns, suggesting that these enzymes may interact with or are dissociated during chromatography on dextran. The size of the complex observed on Bio-Gel A-5M was influenced by the method of cell breakage and the salt concentrations present in buffers. The largest complexes (greater than 1,000,000 daltons) were seen with cells broken with a freeze press, whereas with sonicated preparations the average size of the complex was about 400,000 daltons. Extraction of synthetases at 0.15 M NaCl, to mimic physiological salt concentrations, also resulted in high-molecular-weight complexes, as demonstrated by both agarose gel filtration and ultracentrifugation analysis. Evidence is presented that dissociation of some synthetases does occur in the presence of higher salt levels (0.4 M NaCl). Partial purification of the synthetase complex on DEAE-Sephacel was accomplished with only minor dissociation of individual synthetases. These data suggest that a complex(es) of aminoacyl-tRNA synthetase does exist in bacterial cells, just as in eucaryotes, and that the complex may have escaped earlier detection due to its fragility during isolation. PMID- 3294805 TI - Suppressible base substitution mutations induced by angelicin (isopsoralen) in the Escherichia coli lacI gene: implications for the mechanism of SOS mutagenesis. AB - Angelicin- plus near-UV-induced mutations were umuC dependent in Escherichia coli K-12. Angelicin, a monofunctional psoralen derivative, is believed to damage DNA almost exclusively at pyrimidine bases. To broaden our knowledge about the mutagenic specificity of SOS-dependent mutagens, we determined the mutational specificity of 233 suppressible lacI mutations induced by angelicin. More than 90% of the nonsense mutations arose via transversion substitutions. The three most frequently mutated sites were at A-T base pairs and accounted for more than one-third of all induced nonsense mutations. The two hottest sites were at the only occurrences of the 5'-TATA-3' tetranucleotide in lacI, a sequence expected to be a preferred binding site for a psoralen. Both A-T-to-T-A and A-T-to-C-G transversions were well induced by angelicin treatment, but the frequency of each transversion depended on the particular site. We also detected significant induction of transversion mutations at G-C sites. The induction of transversions by an SOS-dependent mutagen that generates lesions at pyrimidines supports the idea that DNA lesions influence the selection of bases that are incorporated via the process of SOS repair. PMID- 3294806 TI - Flagella of a plant-growth-stimulating Pseudomonas fluorescens strain are required for colonization of potato roots. AB - The role of motility in the colonization of potato roots by Pseudomonas bacteria was studied. Four Tn5-induced flagella-less mutants of the plant-growth stimulating P. fluorescens WCS374 appeared to be impaired in their ability to colonize growing potato roots. PMID- 3294808 TI - Tetrahydrothiophene 1-oxide as an electron acceptor for Escherichia coli. AB - Escherichia coli used tetrahydrothiophene 1-oxide (THTO) as an electron acceptor for anaerobic growth with glycerol as a carbon source; the THTO was reduced to tetrahydrothiophene. Cell extracts also reduced THTO to tetrahydrothiophene in the presence of a variety of electron donors. Chlorate-resistant (chl) mutants (chlA, chlB, chlD, and chlE) were unable to grow with THTO as the electron acceptor. However, growth and THTO reduction by the chlD mutant were restored by high concentrations of molybdate. Similarly, mutants of E. coli that are blocked in the menaquinone (vitamin K2) biosynthetic pathway, i.e., menB, menC, and menD mutants, did not grow with THTO as an electron acceptor. Growth and THTO reduction were restored in these mutants by the presence of appropriate intermediates of the vitamin K biosynthetic pathway. PMID- 3294807 TI - Stability and replication control of Escherichia coli minichromosomes. AB - A stabilized minichromosome--a plasmid replicating from the chromosomal origin oriC--was constructed by cloning the sopA,B,C, genes from plasmid F. This minichromosome had a loss frequency of less than 10(-3), while that of the nonstabilized parental plasmid was 2 X 10(-2) to 4 X 10(-2). Both minichromosomes had the same average copy number per chromosomal origin, and the copy numbers were constant over an eightfold range of growth rates. Different mutations in the mioC gene and promoter, from which transcription enters oriC, were constructed, and their effects on minichromosome copy number and stability were tested. The results indicated that normal replication control at oriC was independent of the MioC protein and most of the sequences between the promoter and oriC, but required both transcription from the mioC promoter and probably also the presence of the DnaA box (DnaA protein-binding site) just upstream of the mioC promoter. Transcription from the mioC promoter was shown to be efficiently repressed in vivo after overproduction of DnaA protein and to be derepressed at the nonpermissive temperature in six different dnaA(Ts) mutants. PMID- 3294809 TI - Gene location affects expression level in Salmonella typhimurium. AB - Directed translocation of an expressed gene (hisD) provided strains to test for position effects on gene expression in Salmonella typhimurium. The predominant position effect seems to be caused by the gene dosage of a chromosomal site; the orientation of the translocated genes did not affect expression, and no deviant positions were found. PMID- 3294810 TI - In vitro transcription of the nitrogen fixation regulatory operon nifLA of Klebsiella pneumoniae. AB - In vitro transcription from the promoter for the nitrogen fixation regulatory operon nifLA of K. pneumoniae requires four protein fractions: the core form of RNA polymerase; NTRA, an alternate sigma factor; NTRC, an auxiliary DNA-binding protein; and NTRB, a bifunctional enzyme that controls the activity of NTRC by covalent modification (A.J. Ninfa and B. Magasanik, Proc. Natl. Acad. Sci. USA 83:5909, 1986). Two DNA-binding sites for NTRC lie approximately 150 base pairs upstream of the nifLA promoter. PMID- 3294811 TI - An inducible pathway is required for mutagenesis in Salmonella typhimurium LT2. AB - UV mutability of Salmonella typhimurium LT2 was eliminated in the presence of a multicopy plasmid carrying the Escherichia coli lexA+ gene. This result suggests that inducible, SOS-like functions are required for UV mutagenesis in S. typhimurium. S. typhimurium strains carrying either point or deletion mutations in topA had previously been shown to lose their mutability by UV or methyl methanesulfonate (K. Overbye and P. Margolin, J. Bacteriol. 146:170-178, 1981; K. Overbye, S. M. Basu, and P. Margolin, Cold Spring Harbor Symp. Quant. Biol. 47:785-791, 1983). Mitomycin C induction of the phi(mucB'-lacZ') fusion (a DNA damage-inducible locus carried on plasmid pSE205) in S. typhimurium topA was normal, suggesting that RecA is activated in topA mutants. These observations lead us to deduce that S. typhimurium has at least one DNA damage-inducible locus in addition to recA that is required for UV mutability. PMID- 3294812 TI - Common evolutionary origin of the ilvGMEDA attenuation locus and tRNA(1Leu) in Escherichia coli. AB - Published sequences of transcripts from ilvGMEDA leader regions of several enteric bacteria were compared with published sequences of the tRNAs from Escherichia coli. The analyses revealed homology between the ilvGMEDA leader peptide-coding region and tRNA(1Leu) in E. coli, Salmonella typhimurium, and Klebsiella aerogenes, whereas homology was not present in Serratia marcescens and Edwardsiella tarda. PMID- 3294813 TI - Acylation of glycerol 3-phosphate is the sole pathway of de novo phospholipid synthesis in Escherichia coli. AB - The inhibition of phospholipid synthesis engendered by starving glycerol 3 phosphate (G3P) auxotrophs of Escherichia coli (plsB or gpsA) for G3P is incomplete; 5 to 10% of the normal rate of phospholipid synthesis remains, even after prolonged starvation. We report that G3P starvation of a strain having lesions in both the gpsA and plsB genes resulted in essentially complete (greater than 98.5%) inhibition of phospholipid synthesis, indicating that all de novo glycerolipid synthesis in E. coli proceeds by acylation of G3P. PMID- 3294814 TI - Methylene blue: a reliable and practical marker for validating compliance on the DST. AB - Assurance of compliance (ingestion of dexamethasone) is crucial for interpreting plasma cortisol results on the DST. In this double-blind study of 13 subjects, methylene blue (MB) 50 mg was combined with dexamethasone 1 mg in single capsules, and the resulting blue-green urinary color after ingestion was found to reliably validate compliance in 100% of patients and controls. The addition of MB did not influence DST results (i.e., plasma cortisol, plasma dexamethasone). Adding MB to dexamethasone as a marker is a reliable and safe means of validating compliance on the DST and is considerably more practical than plasma dexamethasone level determinations. PMID- 3294816 TI - Isolation and characterization of deletion mutants of ompR and envZ, regulatory genes for expression of the outer membrane proteins OmpC and OmpF in Escherichia coli. AB - Expression of the ompC and ompF genes coding for the major outer membrane proteins, OmpC and OmpF, respectively, is known to be controlled by at least two regulatory genes, ompR and envZ, which together comprise a single ompB operon. We constructed chromosomal mutants with either ompR-envZ deletion or envZ deletion. Characterization of these deletion strains showed that the OmpR protein is necessary for transcription of the ompC and ompF genes, and the EnvZ protein is essential for normal regulation of the ompC and ompF expression, which is affected by the medium osmolarity. We also constructed several plasmids carrying different portions of the ompB operon. Characterization of these plasmids allowed us to identify the OmpR protein with an apparent molecular weight of 29 kilodaltons (kDa) and the EnvZ protein with an apparent molecular weight of 50 kDa. The initiation codon for EnvZ translation appeared to overlap with the termination codon for OmpR translation. It was also found that a truncated EnvZ polypeptide (44 kDa) which lacks the N-terminal 55 amino acid residues can complement the envZ deletion mutant. Based on these results, the structure and function of the ompB operon are discussed in relation to the regulation of ompC and ompF expression. PMID- 3294815 TI - Management of behavioral symptoms in disturbed elderly patients: comparison of trifluoperazine and haloperidol. AB - This double-blind trial compared the efficacy of trifluoperazine 1 mg b.i.d. and haloperidol 0.5 mg b.i.d. as initial doses in the treatment of behavioral symptoms associated with chronic brain syndromes and senile psychoses in 54 institutionalized elderly patients. Forty-four of the patients were followed through the entire 6-week trial. Improvement in symptoms as measured by Clinical Global Impressions (CGI) scores was observed in 86% (N = 19) of those who received trifluoperazine and 90% (N = 20) of those given haloperidol. Twenty seven percent (N = 6) of the trifluoperazine patients were rated at least moderately improved on the CGI, whereas only 9% (N = 2) of those treated with haloperidol exhibited such improvement. Marginally significant trends favoring trifluoperazine over haloperidol were observed in the ratings obtained on the Brief Psychiatric Rating Scale, the Nurses' Observation Scale for Inpatient Evaluation, and the Sandoz Clinical Assessment-Geriatric. The type and incidence of adverse reactions were similar for the two treatments, with sedation being the most common complaint. None of the patients developed any extrapyramidal motor symptoms. PMID- 3294817 TI - Preparation and some properties of giant liposomes and proteoliposomes. AB - Optimal conditions for formation of giant liposomes and proteoliposomes were investigated. A suspension of small unilamellar vesicles made of various phospholipids in a buffer of 0-3 M KCl, 0.1 mM EDTA, and 20 mM MOPS (pH 7.0) was subjected to a freeze-thaw treatment. Giant multilamellar liposomes of diameter ranging from 10 to 60 microns were found to form from phospholipid mixtures containing phosphatidylethanolamine as a major component and phosphatidylserine as a minor component. The concentration of KCl optimal for the giant vesicle formation was 30-500 mM. By applying a patch-pipette to a giant liposome, suitable conditions for obtaining a high-resistance (giga-ohm) seal were sought. It was found that use of a patch-pipette of relatively small tip diameter (less than 1 micron), the presence of divalent metal cations in the suspension medium and inflation of vesicles in a hypotonic solution facilitated giga-seal formation. In a suspension of asolectin (soybean phospholipid) vesicles which had been subjected to the freeze-thaw treatment, giant unilamellar vesicles were found. They could be held on the tip of a suction pipette and impaled with a microelectrode filled with an EGTA solution. Small unilamellar proteoliposomes were prepared by the cholate-dialysis method from asolectin and sarcoplasmic reticulum vesicles, and were subjected to a freeze-thaw cycle. When the ratio of exogenous phospholipid to protein was larger than 10, giant multilamellar vesicles were formed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294818 TI - New approaches for the high-level expression of human interleukin-2 cDNA in Escherichia coli. AB - We constructed several expression plasmids of human IL-2 gene, some of which directed high-level synthesis of mature IL-2 protein in E. coli. In all the plasmids reported here, we installed the E. coli trp promoter and SD sequence upstream of the IL-2 cDNA. When DNA sequences containing the rho-independent transcription terminator such as those involved in the trpA and lpp gene were inserted downstream of the IL-2 cDNA sequence, the expression level of the IL-2 gene increased up to 5-fold. Moreover, the deletion of either the whole region including A-T and G-C tails or a part of the 3' non-coding sequence resulted in further increase of the expression of the IL-2 gene up to 500-fold. The mature IL 2 produced in E. coli exhibited biological and immunological activities indistinguishable from those of purified IL-2 from a human T cell line, Jurkat 111. The manipulations described here may be useful for the high-level expression of eukaryotic genes in E. coli. PMID- 3294819 TI - Characterization of nystatin-resistant mutants of Saccharomyces cerevisiae and preparation of sterol intermediates using the mutants. AB - Analysis of sterols of Saccharomyces cerevisiae mutants N3, N15, N26, and N3H, defective in sterol biosynthesis, was performed. Strains N3, N15, and N26 were isolated from their mother strain, M10, by screening with nystatin (Nagai et al. (1980) Mie Med. J. 30, 215-224), and strain N3H was isolated from N3 as a doubly mutated strain. The main sterols of N3, N15, N26, and N3H were ergosta-7,22 dienol, ergost-8-enol, cholesta-5,7,24-trienol, and ergosta-7,22,24(28)-trienol, respectively. The former three strains were characterized as defective in delta 5 desaturation, delta 8--delta 7 isomerization, and C-24 transmethylation. Strain N3H was found to be defective in delta 5-desaturation as well as in delta 24(28) reduction. However, the defect of N26 and N3H was suggested to be leaky, since small amounts of ergosterol and ergosta-7,22-dienol were found in these mutants, respectively. In N15, an accumulation (2% in total sterols) of the compound likely to be hydroxylated sterol was found. By aerobic adaptation of these strains, the accumulation of these strains, the accumulations of ergosta-7,22 dienol (22 mg/g dry cells), ergosta-7,22,24(28)-trienol (24 mg), ergosta-8,24(28) dienol (18 mg), and cholesta-8,24-dienol (22 mg) reached a maximum in N3, N3H, N15, and N26 after 20, 20, 30, and 30 h, respectively. These strains appear to be useful for making 14C-labeled and non-labeled preparations of the above sterols. PMID- 3294820 TI - The relations between the chloride, calcium, and polypeptide requirements of photosynthetic water oxidation. PMID- 3294822 TI - Isolation of functional alpha beta heterodimers from the purified human placental alpha 2 beta 2 heterotetrameric insulin receptor complex. A structural basis for insulin binding heterogeneity. AB - To investigate the role of subunit communication in the insulin binding and tyrosine-specific protein kinase activities of the purified human placental insulin receptor, we have developed the methodology to isolate a functional alpha beta heterodimeric insulin receptor complex from the native alpha 2 beta 2 heterotetrameric disulfide-linked state. The dissociation of the alpha 2 beta 2 heterotetrameric insulin receptor into an alpha beta heterodimer was found to be approximately 50% efficient by treatment with alkaline pH (8.75) and dithiothreitol (2 mM). Removal of the dithiothreitol and pH neutralization (pH 7.60) by rapid Sephadex G-50 gel filtration resulted in the preservation of tracer insulin binding activity. The nondissociated alpha 2 beta 2 heterotetrameric and alpha beta heterodimeric insulin receptor complexes could then be effectively separated by Bio-Gel A-1.5m gel filtration. Scatchard analyses of insulin binding to the alpha 2 beta 2 heterotetrameric control or dithiothreitol-treated but nondissociated alpha 2 beta 2 heterotetrameric insulin receptor complexes demonstrated a curvilinear binding isotherm with a maximum of 1 mol of insulin bound/mol of alpha 2 beta 2 heterotetrameric complex. However, binding analyses performed on the isolated alpha beta heterodimeric complex yielded a nearly linear binding curve also, with 1 mol of insulin bound/mol of alpha beta heterodimeric complex at saturation. These data demonstrate that the insulin half-site binding reactivity observed in the alpha 2 beta 2 heterotetrameric insulin receptor complex results from either an asymmetric assembly of identical alpha beta heterodimers or from absolute negative cooperativity. PMID- 3294821 TI - Electron transfer in the water-oxidizing complex of Photosystem II. AB - An overview is presented of secondary electron transfer at the electron donor side of Photosystem II, at which ultimately two water molecules are oxidized to molecular oxygen, and the central role of manganese in catalyzing this process is discussed. A powerful technique for the analysis of manganese redox changes in the water-oxidizing mechanism is the measurement of ultraviolet absorbance changes, induced by single-turnover light flashes on dark-adapted PS II preparations. Various interpretations of these ultraviolet absorbance changes have been proposed. Here it is shown that these changes are due to a single spectral component, which presumably is caused by the oxidation of Mn(III) to Mn(IV), and which oscillates with a sequence +1, +1, +1, -3 during the so-called S0----S1----S2----S3----S0 redox transitions of the oxygen-evolving complex. This interpretation seems to be consistent with the results obtained with other techniques, such as those on the multiline EPR signal, the intervalence Mn(III) Mn(IV) transition in the infrared, and EXAFS studies. The dark distribution of the S states and its modification by high pH and by the addition of low concentrations of certain water analogues are discussed. Finally, the patterns of proton release and of electrochromic absorbance changes, possibly reflecting the change of charge in the oxygen-evolving system, are discussed. It is concluded that nonstoichiometric patterns must be considered, and that the net electrical charge of the system probably is the highest in state S2 and the lowest in state S1. PMID- 3294823 TI - Interactions of arterial cells. Studies on the mechanisms of endothelial cell modulation of cholesterol metabolism in co-cultured smooth muscle cells. AB - Fluid phase interactions between arterial endothelial cells (EC) and smooth muscle cells (SMC) have been studied in vitro to assess the regulation of lipid metabolism in SMC (Hajjar, D. P., Falcone, D. J., Amberson, J. B., and Hefton, J. M. (1985) J. Lipid Res. 26, 1212-1223; Davies, P. F., Truskey, G. A., Warren, H. B., O'Connor, S. E., and Eisenhaure, B. H. (1985) J. Cell Biol. 101, 871-879). To identify EC-derived agonists which may modulate cholesterol metabolism in co cultured SMC, we assessed the role of EC-derived eicosanoids and platelet-derived growth factor (PDGF) in the regulation of cholesteryl ester (CE) hydrolysis in SMC. The major eicosanoids synthesized by EC include PGI2 and 12-hydroxy 5,8,10,14-eicosatetraenoic acid (12-HETE) and, to a lesser extent, prostaglandin E2. Exogenously added PGI2 and 12-HETE stimulated CE hydrolytic activity in SMC by 49 and 35%, respectively, when co-cultured with aspirin-treated EC. Aspirin treated EC when co-cultured with SMC did not stimulate CE hydrolytic activity in SMC, as was the case with non-aspirin-treated EC, suggesting a role of eicosanoids in the regulation of cholesterol metabolism. Other humoral agents derived from EC such as PDGFc stimulated CE hydrolytic activity almost 2-fold in SMC cultured alone or co-cultured with EC. Aspirin-treated EC, incubated with 10 ng/ml PDGF, did not stimulate CE hydrolytic activity in co-cultured SMC. These results suggest that growth factor-promoting activity may enhance CE hydrolysis via the PGI2-cyclic AMP-CE hydrolysis cascade. This hypothesis supports our observations that PDGF stimulates PGI2 production in SMC. Elevated PGI2, in turn, can stimulate CE hydrolysis in these cells. Our findings suggest that the regulation of cholesterol metabolism in SMC can involve, at least in part, growth factors and EC-derived eicosanoids. These may play a central role in the regulation of hemostasis and the inflammatory response. PMID- 3294824 TI - Relationship of the 90-kDa murine heat shock protein to the untransformed and transformed states of the L cell glucocorticoid receptor. AB - Incubation of molybdate-stabilized L cell cytosol with a monoclonal antibody directed against the 100-kDa glucocorticoid-binding protein causes the immune specific adsorption to protein A-Sepharose of both the 100-kDa glucocorticoid receptor and the 90-kDa murine heat shock protein (hsp90) (Sanchez, E. R., Toft, D. O., Schlesinger, M. J., and Pratt, W. B. (1985) J. Biol. Chem. 260, 12398 12401). When the glucocorticoid receptor in cytosol is transformed to the DNA binding state, hsp90 dissociates. In this paper, we show that temperature mediated dissociation of hsp90 from the receptor is a hormone-dependent event in the same manner as temperature-mediated transformation to the DNA-binding state. In contrast to temperature-mediated transformation, ammonium sulfate causes both dissociation of hsp90 from the receptor and conversion of the receptor to the DNA binding form in a manner that does not require the presence of steroid. The untransformed form of the glucocorticoid receptor and the strongly negatively charged hsp90 protein behave similarly on DEAE-cellulose chromatography, suggesting that the hsp90 component may contribute significantly to the net negative charge behavior of the non-DNA-binding form of the receptor complex. PMID- 3294825 TI - L1210 dihydrofolate reductase. Kinetics and mechanism of activation by various agents. AB - Dihydrofolate reductase from a methotrexate-resistant subline (R6) of L1210 mouse leukemia cells is activated (i.e. has its catalytic activity increased severalfold) by treatment with (a) sulfhydryl-modifying agents (p chloromercuribenzoate (pCMB) or 5,5'-dithiobis(2-nitrobenzoic acid], (b) salts (KCl or NaCl), or (c) chaotropes (urea or guanidinium hydrochloride). With b or c activation is rapid (less than 10 s), but with a the process is much slower; at 25 degrees C, pseudo first-order rate constants for activation by excess pCMB or 5,5'-dithiobis(2-nitrobenzoic acid) are 0.45 and 0.08 min-1, respectively. Activation can also be monitored by conformational changes in the protein as indicated by enhanced fluorescence of 2-p-toluidinylnaphthalene-6-sulfonate or by increased intrinsic fluorescence of tryptophan residues in the enzyme. Pseudo first-order rate constants for the pCMB-induced conformational change, measured by these fluorimetric procedures (0.45 min-1 and about 0.4 min-1, respectively), are in good agreement with the value obtained from the increase in catalytic activity. The rate of modification of the single cysteine residue in the enzyme by excess 14C-labeled pCMB, however, is faster than the rate of activation, indicating that the conformational change follows derivatization and is the rate limiting step in the overall process. Activated forms of the enzyme are more labile to thermal denaturation or proteolysis than the untreated enzyme; the former process, however, is retarded by the presence of bovine serum albumin. Activation by the various agents is considered to involve a common mechanism in which interaction of the enzyme with the agents is followed by conformational changes in the enzyme, producing a series of forms that differ in microstructure, catalytic activity, and lability. PMID- 3294826 TI - The relationship between autophagy and the intracellular degradation of asialoglycoproteins in cultured rat hepatocytes. AB - The relationship between autophagy and the intracellular distribution of endocytosed asialoorosomucoid was studied in cultured rat hepatocytes. Overt autophagy was induced by shifting the cells to a minimal salt medium. Incubation in minimal salt medium led to the formation of buoyant lysosomes at the expense of denser lysosomes manifested as a dual distribution of these organelles in Nycodenz gradients. Asialoorosomucoid was labeled with 125I-tyramine cellobiose. The labeled degradation products formed from this ligand are trapped at the site of degradation and may therefore serve as markers for the subgroup of lysosomes involved in the degradation. In control cells the degradation of the ligand was initiated in a light prelysosomal compartment and continued in denser lysosomes. In cells with high autophagic activity, the degradation of labeled asialoorosomucoid took place exclusively in a buoyant group of lysosomes. These results suggest that degradation of endocytosed ligand takes place in the same secondary lysosomes as substrate sequestered by autophagic mechanisms. These light lysosomes represent a subgroup of active lysosomes which are gradually recruited from dense bodies. Data are also presented that indicate that insulin may prevent the change in buoyant density brought about by incubation in deficient medium. PMID- 3294827 TI - Rat ovarian angiotensin II receptors. Characterization and coupling to estrogen secretion. AB - Angiotensin II receptor agonist (125I-angiotensin II) and antagonist (125I [Sar1,Ile8]angiotensin II) bind in a specific and saturable manner to rat ovarian membranes. Agonist and antagonist binding affinity (KD approximately 0.5 nM) and the number of sites estimated (Bmax approximately 60 fmol/mg of protein) were similar. Dissociation of receptor-bound agonist was more rapid than the dissociation of receptor-bound antagonist, and agonist, but not antagonist, dissociation from the receptor was accelerated by GTP gamma S. A 0-150 mM increase in Na+ produced a 27% increase in the KD of agonist binding. Antagonist binding was not modified by Na+. These studies suggest that both agonist and antagonist identify putative angiotensin II receptors in the ovary but that the properties of agonist and antagonist binding are distinct. Angiotensin II antagonist binding sites are present on the granulosa cell layer of rat ovarian follicles (Speth, R. C., Bumpus, F. M., and Husain, A. (1986) Eur. J. Pharmacol. 130, 351-352). To determine the role of angiotensin II in ovarian function, we examined angiotensin II receptors and function during the onset of puberty. High affinity and low capacity angiotensin II receptors were present in ovaries from immature rats. After pregnant mare's serum gonadotropin induced ovulation in immature rats, antagonist binding to total ovarian membranes increased over 3 fold. In vitro incubation of peripubertal ovaries with 1 microM angiotensin II produced a stimulation of estrogen, but not progesterone, secretion. This steroidogenic effect of angiotensin II was most pronounced in the luteal phase of the estrus cycle. These studies point toward the involvement of angiotensin II in the regulation of ovarian function, possibly through modulation of follicular estrogen levels. PMID- 3294828 TI - Structure of the yeast valyl-tRNA synthetase gene (VASI) and the homology of its translated amino acid sequence with Escherichia coli isoleucyl-tRNA synthetase. AB - The VASI gene encoding the valyl-tRNA synthetase from yeast was isolated and sequenced. The gene-derived amino acid sequence of yeast valyl-tRNA synthetase was found to be 23% homologous to the Escherichia coli isoleucyl-tRNA synthetase. This is the highest level of homology reported so far between two distinct aminoacyl-tRNA synthetases and is indicative of an evolutionary relationship between these two molecules. Within these homologous sequences, two functional regions could be recognized: the HIGH region which forms part of the binding site of ATP and the KMSKS region which is recognized as the consensus sequence for the binding of the 3'-end of tRNA (Hountondji, C., Dessen, Ph., and Blanquet, S. (1986) Biochemie (Paris) 68, 1071-1078). Secondary structure predictions as well as the presence of both HIGH and KMSKS regions, delineating the nucleotide binding domain and the COOH-terminal helical domain in aminoacyl-tRNA synthetases of known three-dimensional structure, suggest that the yeast valyl-tRNA synthetase polypeptide chain can be folded into three domains: an NH2-terminal alpha-helical region followed by a nucleotide-binding topology and a COOH terminal domain composed of alpha-helices which probably carries major sites in tRNA binding. PMID- 3294829 TI - An accessory protein identical to mouse egasyn is complexed with rat microsomal beta-glucuronidase and is identical to rat esterase-3. AB - We report biochemical, immunological, and genetic studies which demonstrate that an accessory protein with the essential features of mouse egasyn is complexed with and stabilizes a portion of beta-glucuronidase in microsomes of rat liver. The accessory protein exists as a complex with beta-glucuronidase since it coprecipitates with beta-glucuronidase after treatment of extracts with a specific beta-glucuronidase antibody. The two proteins are associated by noncovalent bonds since they are easily dissociated at elevated temperatures. Only 20-25% of total liver accessory protein is complexed with microsomal beta glucuronidase. The remainder exists as a free form. The molecular weight of the accessory protein is 61 to 63 kDa depending upon the rat strain of origin. This protein, like mouse egasyn, has esterase catalytic activity and is concentrated in microsomes. The accessory protein is genetically polymorphic with at least four alleles. Combined biochemical and genetic evidence indicates it is identical with esterase-3 of the rat. Also, both mouse egasyn and rat esterase-3 react with antisera to egasyn and to rat esterase-3, indicating they are homologous proteins. Several inbred rat strains lack microsomal beta-glucuronidase. The same strains lack the accessory protein, suggesting that stabilization of beta glucuronidase in rat microsomes requires egasyn. PMID- 3294830 TI - Ca2+-binding parvalbumin in rat testis. Characterization, localization, and expression during development. AB - Parvalbumin, a Ca2+-binding protein, was isolated from rat testis. This is the first demonstration of the protein in endocrine glands. By using a rat parvalbumin cDNA probe, parvalbumin mRNA was demonstrated in the testis, indicating that the protein is synthesized in this tissue and that testis parvalbumin is a product of the same gene as the one encoding for muscle parvalbumin. Parvalbumin was localized by immunohistochemical methods in the Leydig cells and in the acrosome region of maturing spermatids (stages 1-15). The expression of parvalbumin during testis development was followed. High parvalbumin protein and mRNA levels were found at stages of highest Leydig cell activity, i.e. at late fetal stages until birth and again around postnatal day 50. This suggests that parvalbumin may be involved in the production of testosterone in Leydig cells, a process which is highly dependent on calcium. PMID- 3294831 TI - Identification of the genes in the Escherichia coli ileS-lsp operon. Analysis of multiple polycistronic mRNAs made in vivo. AB - The genes encoding isoleucyl-tRNA synthetase (ileS) and prolipoprotein signal peptidase (lsp) of Escherichia coli were previously shown to be co-transcribed (Miller, K. W., and Wu, H. C. (1987) J. Biol. Chem. 262, 389-393). However, the boundaries of this transcriptional unit have not been established. In this regard, DNA sequence determination has shown that ileS and lsp are closely flanked by four open reading frames, i.e. x-ileS-lsp-orf149-orf316-orf304. To define the boundaries of the operon, we applied Northern blotting hybridization and mRNA 5'-end mapping to analyze mRNA from a wild-type strain (SM31) and a mutant strain (SM31-2B4) that exhibits an increased expression of prolipoprotein signal peptidase. Four ileS-lsp co-transcripts were detected in RNA from the strain SM31. In addition to these four mRNAs, two new, highly abundant co transcripts were also detected in RNA from the mutant. Based upon the determination of the 5'-ends of the mRNAs and analysis of their coding sequences, we conclude that the six mRNAs actually are comprised of three pairs of related mRNAs. The two mRNAs in a given pair have the same 5'-termini (all located upstream of or within gene x), but vary with respect to the identity of their 3' terminal coding sequence (lsp or orf316). In conclusion, the ileS-lsp operon contains five genes, x-ileS-lsp-orf149-orf316, whose transcription probably is dependent upon promoter(s) located upstream of or within gene x. The next gene downstream, orf304, apparently does not reside in the operon. PMID- 3294832 TI - Role of amino-terminal positive charge on signal peptide in staphylokinase export across the cytoplasmic membrane of Escherichia coli. AB - Staphylokinase mutants having amino acid substitutions within the amino-terminal charged segment of the signal peptide have been produced by in vitro oligonucleotide-directed mutagenesis. When the processing of the gene products was analyzed in Escherichia coli cells, the rate of processing of the mutant staphylokinase precursor decreased as the net charge became more negative. A net positive charge, but not specific amino acid residues, was required on the amino terminal segment for efficient processing. Staphylokinase precursor having a net negative charge accumulated in the cytoplasm, tending to bind to the cytoplasmic membrane as determined by subcellular fractionation and immunoelectron microscopy. Although a mutant carrying an amino acid substitution in the hydrophobic segment and wild-type staphylokinases had an interfering effect on the processing of other normal secreted proteins, this effect was lost when they also contained charge-altering substitutions in the amino-terminal region. From these results, we concluded that a positive charge on the amino-terminal segment of the staphylokinase signal peptide is required for entrance into the protein export process. PMID- 3294833 TI - Molecular weight of recombinant human tumor necrosis factor-alpha. AB - Recombinant DNA-derived human tumor necrosis factor-alpha from Escherichia coli was examined by equilibrium ultracentrifugation under conditions similar to those where gel filtration experiments suggested an oligomeric structure. Short-column equilibrium experiments at concentrations in the range 0.015-0.12% at pH 8.5 in 0.04 M Tris/Tris-HCl gave molecular weights corresponding to 3 times the sequence molecular weight both in the presence and absence of 0.1 M NaCl. Long (2.6 mm) column experiments under the same solvent conditions indicated molecular weights of 51,900 +/- 900 in the absence of added NaCl and 52,600 +/- 700 in the presence of added 0.1 M NaCl. No evidence of any species other than the trimer was found. PMID- 3294835 TI - Mass spectrometrically derived amino acid sequence of thioredoxin from Chlorobium, an evolutionarily prominent photosynthetic bacterium. AB - The amino acid sequence of the thioredoxin isolated from the photosynthetic green sulfur bacterium Chlorobium thiosulfatophilum was determined chiefly by fast atom bombardment mass spectrometry combined with Edman degradation and tandem mass spectrometry. For this purpose, the protein was digested with trypsin, alpha chymotrypsin, thermolysin, and Staphylococcus aureus protease or combinations thereof. Chemical cleavage with cyanogen bromide was also used alone or in combination with trypsin. The resulting sequence of 108 amino acids is as follows: Ala-Gly- Lys-Tyr-Phe-Glu-Ala-Thr-Asp-Lys-Asn-Phe-Gln- Thr-Glu-Xle-Xle Asp-Ser-Asp-Lys-(Ala-Val)-Xle- Val-Asp-Phe-Trp-Ala-Ser-Trp-Cys-Gly-(Pro-Cys)- Met Met-Xle-Gly-Pro-Val-Xle-Glu-Gln-Xle-Ala-Asp- Asp-Tyr-Glu-Gly-Lys-Ala-Xle-Xle-Ala Lys-Xle-Asn- Val-Asp-Glu-Asn-Pro-Asn-Xle-Ala-Gly-Gln-Tyr-Gly- Xle-Arg-Ser-Xle-Pro Thr-Met-Xle-Xle-Xle-Ly s- (Gly-Gly-Lys)-Val-Val-Asp-Gln-Met-Val-Gly-Ala- Xle-Pro Lys-Asn-Met-Xle-Ala-Lys-Lys-Xle-Asp-Glu-His-Il e-Gly (where Xle represents leucine or isoleucine; sequences in parentheses are based on homology considerations). It exhibits less than 53% homology with Escherichia coli thioredoxin. PMID- 3294834 TI - Ethanol-metabolizing pathways in deermice. Estimation of flux calculated from isotope effects. AB - The apparent deuterium isotope effects on Vmax/Km (D(V/K] of ethanol oxidation in two deermouse strains (one having and one lacking hepatic alcohol dehydrogenase (ADH] were used to calculate flux through the ADH, microsomal ethanol-oxidizing system (MEOS), and catalase pathways. In vitro, D(V/K) values were 3.22 for ADH, 1.13 for MEOS, and 1.83 for catalase under physiological conditions of pH, temperature, and ionic strength. In vivo, in deermice lacking ADH (ADH-), D(V/K) was 1.20 +/- 0.09 (mean +/- S.E.) at 7.0 +/- 0.5 mM blood ethanol and 1.08 +/- 0.10 at 57.8 +/- 10.2 mM blood ethanol, consistent with ethanol oxidation principally by MEOS. Pretreatment of ADH- animals with the catalase inhibitor 3 amino-1,2,4-triazole did not significantly change D(V/K). ADH+ deermice exhibited D(V/K) values of 1.87 +/- 0.06 (untreated), 1.71 +/- 0.13 (pretreated with 3 amino-1,2,4-triazole), and 1.24 +/- 0.13 (after the ADH inhibitor, 4 methylpyrazole) at 5-7 mM blood ethanol levels. At elevated blood ethanol concentrations (58.1 +/- 2.4 mM), a D(V/K) of 1.37 +/- 0.21 was measured in the ADH+ strain. For measured D(V/K) values to accurately reflect pathway contributions, initial reaction conditions are essential. These were shown to exist by the following criteria: negligible fractional conversion of substrate to product and no measurable back reaction in deermice having a reversible enzyme (ADH). Thus, calculations from D(V/K) indicate that, even when ADH is present, non-ADH pathways (mostly MEOS) participate significantly in ethanol metabolism at all concentrations tested and play a major role at high levels. PMID- 3294836 TI - Reversibility of decreased insulin-stimulated glucose transport capacity in diabetic muscle with in vitro incubation. Insulin is not required. AB - The mechanisms by which insulin deficiency affects muscle glucose transport were investigated. Epitrochlearis muscles from rats with streptozotocin-induced diabetes and from controls were incubated in vitro for 0.5-14 h. The incubation was shown not to impair muscle energy stores or tissue oxygenation. Diabetes decreased basal 3-O-methylglucose transport by 40% (p less than 0.01), and insulin-stimulated (20 milli-units/ml) glucose transport capacity by 70% (p less than 0.001). In vitro incubation gradually normalized insulin responsiveness (3.77 +/- 0.38 before versus 8.97 +/- 0.65 mumol X ml-1 X h-1 after 12 h of incubation). Basal glucose transport remained significantly reduced. The reversal of the insulin responsiveness did not require the presence of rat serum and, furthermore, took place even in the absence of insulin. In fact, insulin responsiveness was higher after incubation (14 h) with no insulin than with 100 microunits/ml insulin (9.85 +/- 0.59 versus 8.06 +/- 0.59 mumol X ml-1 X h-1, p less than 0.05). Glucose at 30 mM did not affect the normalization of the insulin stimulated glucose transport capacity, whereas incubation in serum from diabetic rats resulted in a slightly (26%) blunted reversal (7.60 +/- 0.39 versus 8.89 +/- 0.45 mumol X ml-1 X h-1 with diabetic versus control serum for 14 h, p less than 0.05; before incubation the value was 3.87 +/- 0.40). Inhibition of protein synthesis by cycloheximide blocked the normalization by 80%. These results suggest the presence in diabetic serum of some labile factor that might inhibit the glucose transport system. The results indicate that the decreased insulin stimulated glucose transport capacity, in the insulin-deficient diabetic muscle, is not a direct consequence of the lack of insulin or of high glucose concentrations. PMID- 3294837 TI - Acetoacetyl-acyl carrier protein synthase, a potential regulator of fatty acid biosynthesis in bacteria. AB - The first condensation reaction in the fatty acid biosynthetic pathway in Escherichia coli was rate-limiting as judged by analysis of the relative pool sizes of acyl carrier protein (ACP) thioester intermediates in vivo. Comparable concentrations of acetyl-ACP, malonyl-ACP, and nonesterified ACP were present during logarithmic growth, whereas long-chain acyl-ACP comprised a minor fraction of the total ACP pool. The antibiotic cerulenin was used to irreversibly inhibit both beta-ketoacyl-ACP synthases I and II. However, acyl-ACP formation in vivo was not blocked by this antibiotic, and short-chain (4-8-carbon) acyl-ACPs increased to 60% of the total ACP pool in cerulenin-treated cells. These data suggested that existence of a cerulenin-resistant condensing enzyme that was capable of catalyzing the initial steps in chain elongation. A unique enzymatic activity, acetoacetyl-ACP synthase, that specifically catalyzed the condensation of malonyl-ACP and acetyl-ACP was detected in E. coli cell extracts. Acetoacetyl ACP synthase activity was not inhibited by cerulenin and was present in extracts prepared from a double mutant harboring genetic lesions in beta-ketoacyl-ACP synthases I and II (fabB20 fabF3). These data point to the condensation of malonyl-ACP and acetyl-ACP as the rate-controlling reaction in fatty acid biosynthesis and implicate acetoacetyl-ACP synthase as the pacemaker of fatty acid production in organisms and organelles that possess dissociated (Type II) fatty acid synthase systems. PMID- 3294838 TI - Tissue reactions to wear products from polyacetal (Delrin) and UHMW polyethylene in total hip replacement. AB - The tissue reaction to implanted materials and their wear products is important for the long-term fixation of a total hip replacement (THR). Recent reports indicate a relatively high incidence of aseptic loosening with Christiansen total hip prostheses. We examined tissue reactions to wear products in two groups of prostheses: 16 Christiansen prostheses with polyacetal (Delrin) sockets, and 18 Charnley-Muller total hip prostheses with ultrahigh-molecular-weight polyethylene (UHMWP) sockets. Specimens from these 34 patients were compared in a combined qualitative and semiquantitative morphological study. We saw similar histological changes in specimens of both groups, but specimens from the bone-cement interfaces of the acetabulum and femur shaft in the polyacetal group showed more inflammation and necrosis. PMID- 3294839 TI - Rupture of the calcaneal tendon. The early and late management. AB - We have reviewed 106 patients after treatment for spontaneous rupture of the calcaneal tendon, and assessed the clinical results including the power of plantarflexion. In patients treated within 48 hours of injury the result was very similar in conservatively and in operatively treated patients. The incidence of major complications was higher after operation (17%) than in those treated conservatively (4%). Patients who were treated more than one week after injury, however, had an inferior result with respect to power of plantarflexion after conservative management. It is therefore recommended that calcaneal tendon rupture is treated conservatively with a plaster in full equinus when it is diagnosed within 48 hours of injury, and by operation when diagnosis has been delayed for more than one week. PMID- 3294840 TI - Percutaneous intramedullary rod interchange in osteogenesis imperfecta. AB - This paper describes the design, development and early surgical experience with a stereotactic device to allow closed retrieval and interchange of intramedullary rods in children with osteogenesis imperfecta. This relatively atraumatic procedure may allow more frequent rod interchange than with other techniques, lessening the likelihood of deformity and fracture in the unsupported skeleton when the bone has outgrown the intramedullary rod. The procedure was developed by design studies in vitro followed by intramedullary rodding of tibiae of New Zealand white rabbits. It has been used in children 12 times, in six tibiae and six femora: 11 rods have been successfully retrieved, with rod interchange in eight of these cases. PMID- 3294841 TI - In memoriam Sir Henry Osmond-Clarke 1905-1986. PMID- 3294842 TI - Free skin flap transfer in repairing deep electrical burns. PMID- 3294843 TI - Epinephrine v thrombin for split-thickness donor site hemostasis. PMID- 3294844 TI - Ergonomics of support cane handles. PMID- 3294845 TI - Current status of cancer imaging with radiolabeled antibodies. AB - This editorial reviews the development, current status, and future prospects of cancer imaging with radioactive antibodies, termed radioimmunodetection (RAID). There has been a slow and steady development of this field for more than 35 years, with more recent activity and progress resulting from the identification of human tumor-associated antibodies and suitable human tumor xenograft models, the demonstration that circulating antigens do not prevent radioantibody localization in tumor, the development of computer-assisted and biological methods for reducing non-target background radioactivity, and the advent of hybridoma-produced monoclonal antibodies. At the present time, tumor sites in the range of 1.5 to 2.0 cm can be imaged, with the best resolution of 0.4-0.5 cm being reported with new chelates of 99mTc. A number of factors, including character of the radioantibody and its bioavailability, the tumor antigen site and bioavailability, the character of the radiolabel, and the target tumor's size, location and vascularization, contribute to the sensitivity, specificity, accuracy, and resolution of the method. Already at this early stage of development, RAID has been shown to have, in certain tumor types and with particular antibody and imaging systems, an accuracy of tumor site detection of over 90%, with the disclosure of occult lesions. Carefully designed prospective trials are needed to fully assess the role of this new modality in the management of cancer patients, particularly in early detection of primary and recurrent tumors. PMID- 3294847 TI - Evaluation of axillo-axillary artery bypass for the treatment of subclavian or innominate artery occlusive disease. AB - Because of the higher morbidity and mortality of transthoracic procedures, extrathoracic techniques to revascularize the subclavian or innominate artery, such as carotid subclavian and axillo-axillary artery bypasses have gained wide acceptance. The present work evaluates the results of axillo-axillary bypass in 33 patients who underwent this procedure in the past 13 years. There were 13 males and 20 females with a mean age of 61 years. The occlusive disease was present in the subclavian artery in 19 patients and in the right subclavian artery in 14 patients. Eleven patients presented with central nervous system symptoms and 10 patients complained of ischemic arm symptoms. The remaining 12 patients had both central neurological and upper extremity complaints. Twenty-one of these patients were followed for up to 5 years (mean follow-up 21 months). One patient died during the procedure from myocardial infarction (mortality of 3.03%). Patency of the bypass was determined by palpation of the graft pulse, doppler examination, and brachial arterial pressure determination. The patency rate, after 5 years, calculated by life table analysis, was 72%. In conclusion, axillo-axillary artery bypass can provide durable relief of symptoms with an acceptably high patency rate and low morbidity and mortality. It is the technique of choice in high-risk patients. PMID- 3294846 TI - Duplex scanning and the vascular surgeon. AB - Until the development of ultrasonic duplex scanning, the only diagnostic test that was able to study vascular disease wherever it occurred was angiography. Duplex scanning found its initial place for the evaluation of the carotid bifurcation. With improvements in technology, a range of transmitting frequencies, better transducers, and computer assisted algorithms, the application of this method has been greatly extended. We now have the capability of evaluating every major vascular bed of interest to the vascular surgeon. For the first time, we can now both screen and follow patients without resorting to angiography. PMID- 3294848 TI - Blood flow measurement in PTFE grafts. AB - In vascular surgery peroperative control of the result of reconstruction is essential. PTFE-grafts have been known to be "resistant" to flow registration with electromagnetic flowmetry because of the electrical isolation. Similarly, intraoperative Doppler registration has been impossible because of the attenuation of the ultrasound in the graft wall. The leading disturbances are obviously caused by air in the graft material and are not caused by the material itself. By squeezing the graft carefully between the thumb and forefinger, blood slowly penetrates the wall colouring it red. The squeezing is performed intermittently to avoid occlusion of the graft. Excellent flow registration is obtained after less than 2 min squeezing of the thin walled graft, while at least 5 min squeezing is necessary to obtain signals from thick walled grafts. To obtain satisfactory ultrasound signals more squeezing is necessary. PMID- 3294849 TI - Europe and the development of cardiovascular surgery. Presidential address given to the meeting of the European Chapter of the International Society for Cardiovascular Surgery at Brighton, July 1986. PMID- 3294850 TI - Vascular rings and slings. Diagnosis and surgical treatment of 49 patients. AB - Forty-nine infants with symptomatic vascular rings and slings, ranging in age from 20 days to 12 months, required surgical intervention between 1973 and 1984. The following anomalies were present in our patients: double aortic arch with left descending aorta (14), double aortic arch with right descending aorta (6), anomalous innominate artery (13), right aortic arch with aberrant left subclavian artery (4), left aortic arch with aberrant right subclavian artery (10), aberrant left pulmonary artery (pulmonary sling) (2). All the babies had symptoms related to compression of the trachea and/or esophagus. Four patients required temporary tracheostomy in the early postoperative period; 1 patient, affected by a pulmonary sling, required tracheal resection and anastomosis, for severe tracheomalacia. There was one hospital death in a patient with severe tracheal compression from an anomalous innominate artery and brain damage as a result of metabolic problems. Forty-eight patients survived and follow-up ranged from 3 months to 11 years. For each type of vascular anomaly encountered, and based on personal experience, we have outlined a diagnostic scheme allowing an accurate morphological definition and a subsequent surgical procedure. PMID- 3294851 TI - Non-invasive assessment of left ventricular function in coronary artery disease by Doppler stress testing. AB - Left ventricular (LV) function in 62 patients presenting with chest pain typical of angina was studied non-invasively at rest and at maximum-tolerated supine exercise using the continuous-wave Doppler technique of transcutaneous aorto velography (TAV). The signals were analysed to derive peak velocity (Vp), systolic velocity integral [an index of stroke volume or stroke distance (Sd)], and minute distance (Md; index of cardiac output = Sd X heart rate). Comparison was made with results obtained from 66 normal volunteers. The percentage change in stroke distance with exercise (% delta Sd) was significantly related to the resting ejection fraction (EF) calculated from left ventriculography (r = 0.84), and was below 6% (lowest value observed in normal volunteers) in all of the 23 patients with coronary artery disease (CAD) whose EF was below 60%. No significant difference was observed in the % delta Sd between normal individuals and the 12 patients presenting with chest pain but who had normal coronary arteriograms. However, the % delta Vp, delta % Sd and % delta Md in the 50 patients with CAD were significantly lower than the normal individuals and the 12 patients with normal coronary arteriograms. Lower TAV measurements were observed with exercise, rather than at rest, with increasing number of coronary arteries with significant stenoses and the presence of history of myocardial infarction (linear trend p less than 0.003). These results suggest that Doppler recording of aortic blood velocity with exercise is a clinically useful non-invasive technique for studying LV performance in patients with CAD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294852 TI - Non-invasive assessment of changes in aortic blood velocity and its derivatives with exercise in normal subjects by Doppler ultrasound. AB - Using the continuous-wave Doppler technique of transcutaneous aortovelography (TAV), aortic blood velocity was measured in 66 normal individuals at rest and during maximum voluntary supine exercise. Stroke distance (the systolic velocity integral: a measure of stroke volume), minute distance (a measure of cardiac output=stroke distance times heart rate) and peak velocity increased significantly with exercise, but flow time shortened slightly. Stroke distance was found to rise to a plateau of 24% above the resting value at low work rates during exercise. This relatively undemanding noninvasive technique for measuring haemodynamic response to physiological stress may prove valuable in the assessment of left ventricular function. Our results in normals are consistent with findings by other techniques and provide a basis for clinical comparisons. PMID- 3294853 TI - The covalent modification of eukaryotic proteins with lipid. PMID- 3294854 TI - Regulation of the mRNA levels of nimA, a gene required for the G2-M transition in Aspergillus nidulans. AB - The temperature-sensitive cell cycle mutation nimA5 causes nuclei of Aspergillus nidulans to be blocked in late G2 at restrictive temperature. Under these conditions the spindle pole body divides but does not separate and the mitotic index drops to zero. If nimA5 is blocked for more than one doubling time and then shifted from restrictive to permissive temperature, nuclei immediately enter mitosis, the mitotic spindle forms, and the chromosomes condense (Oakley, B. R., and N. R. Morris, 1983, J. Cell Biol., 96:1155-8). We have cloned the wild-type nimA gene by DNA-mediated complementation of the nimA5 mutant phenotype and have characterized nimA mRNA expression by Northern blot analysis. The transcript is 3.6 kb in length and is under tight nuclear cycle regulation. In synchronously dividing cells, the levels of nimA mRNA become elevated as cells enter mitosis and drop sharply as cells progress through mitosis. Cells blocked in S-phase with hydroxyurea have very low levels of nimA mRNA. Cells blocked in mitosis, either by the antimitotic agent benomyl or by the cell cycle mutation bimE7, maintain elevated levels of the nimA transcript. These data demonstrate not only that nimA is required for entry into mitosis, but because the transcript is normally expressed cyclically and is under tight cell cycle control, they suggest that nimA may play a regulatory role in the initiation of mitosis. PMID- 3294855 TI - Actin in the preprophase band of Allium cepa. AB - F-actin has been identified in the preprophase band of Allium cepa. Cells attached to subbed slides were obtained from formaldehyde-fixed root tips digested in EGTA and Cellulysin. The air-dried cells were extracted in Triton X 100, treated with rhodamine-phalloidin, rinsed briefly in PBS, and viewed in the fluorescence microscope. Interphase cells contain a network of actin fibers that extends into all areas of the cytoplasm. During preprophase, the network is replaced by a band of fibers aligned in the position of the preprophase band. Colocalization of F-actin with rhodamine-phalloidin and microtubules with tubulin immunocytochemistry confirms that the two bands are coincident. The actin appears to comprise a thin layer of fibers next to the plasmalemma. Like the microtubule preprophase band, the actin band narrows as preprophase progresses and disappears by midprophase. Fluorescent actin bands are not seen in fixed cells pretreated with excess unlabeled phalloidin before staining. They are also absent in roots exposed to cytochalasins B and D before fixation, but preprophase band microtubules at all stages of aggregation are still present. Colchicine treatment leads to the loss of both preprophase band microtubules and actin. The possible function of preprophase band actin is discussed. PMID- 3294857 TI - Posttranslational modifications of alpha-tubulin: acetylated and detyrosinated forms in axons of rat cerebellum. AB - The distribution of acetylated alpha-tubulin in rat cerebellum was examined and compared with that of total alpha-tubulin and tyrosinated alpha-tubulin. From immunoperoxidase-stained vibratome sections of rat cerebellum it was found that acetylated alpha-tubulin, detectable with monoclonal 6-11B-1, was preferentially enriched in axons compared with dendrites. Parallel fiber axons, in particular, were labeled with 6-11B-1 yet unstained by an antibody recognizing tyrosinated alpha-tubulin, indicating that parallel fibers contain alpha-tubulin that is acetylated and detyrosinated. Axonal microtubules are known to be highly stable and the distribution of acetylated alpha-tubulin in other classes of stable microtubules suggests that acetylation and possibly detyrosination may play a role in the maintenance of stable populations of microtubules. PMID- 3294856 TI - The Dictyostelium discoideum 30,000-dalton protein is an actin filament-bundling protein that is selectively present in filopodia. AB - The interaction with actin and intracellular localization of the 30,000-D actin binding protein from the cellular slime mold Dictyostelium discoideum have been investigated to analyze the potential contributions of this protein to cell structure and movement. The formation of anisotropic cross-linked filament networks (bundles) containing actin and the 30,000-D protein has been observed by electron microscopy, light scattering, viscometry, and polarization microscopy. Cosedimentation experiments indicate that a maximum of one molecule of the 30,000 D protein can bind to 10 actin monomers in filaments with an apparent association constant of 1 X 10(7) liters/mol. Inhibition of the interaction of the 30,000-D protein with actin by either magnesium or calcium was observed by viscometry, light scattering, polarization microscopy, and direct binding assays. However, the concentration of magnesium required to diminish the interaction is greater than 100 times greater than that of calcium. The association constant of the 30,000-D protein for actin is 4.2 X 10(6) liters/mol, or less than 1 X 10(5) liters/mol in the presence of increased concentrations of either Mg2+ or Ca2+, respectively. Enzyme-linked immunoassays indicate that the 30,000-D protein comprises 0.04% of the protein in D. discoideum. Extensive interaction of the 30,000-D protein with actin in cytoplasm is predicted from these measurements of the concentration of this protein and its affinity for actin. The distribution of the 30,000-D protein was analyzed by immunofluorescence microscopy using mono specific affinity-purified polyclonal antibody. The 30,000-D protein exhibits a diffuse distribution in cytoplasm, is excluded from prominent organelles, and is quite prominent in fine extensions protruding from the cell surface. The number, length, and distribution of these extensions containing the 30,000-D protein are similar to those of filopodia observed by scanning electron microscopy. To analyze the effects of cell thickness and the distribution of organelles on the immunofluorescence localization, fluorescein-labeled BSA was incorporated into the cytoplasm of living cells before fixation and staining using a sonication loading technique. The results indicate that the 30,000-D protein is selectively incorporated into filopodia. These results provide a clear distinction between the multiple actin-cross-linking proteins present in D. discoideum, and suggest that the 30,000-D protein contributes to organization of bundles of actin filaments in filopodia. PMID- 3294858 TI - Colocalization of microtubule-associated protein 1A and microtubule-associated protein 2 on neuronal microtubules in situ revealed with double-label immunoelectron microscopy. AB - Microtubule-associated protein 1A (MAP1A) and microtubule-associated protein 2 (MAP2) were shown to be colocalized on the same microtubules (MTs) within neuronal cytoskeletons by double-label immunoelectron microscopy. To investigate the electron microscopic disposition of MAP1A and MAP2 and their relationship to MTs in vivo, and to determine whether there are different subsets of MTs which specifically bind either MAP1 or MAP2, we employed a double-label immunogold procedure on rat cerebella using mouse monoclonal antibody against rat brain MAP1A and affinity-purified rabbit polyclonal antibody against rat brain MAP2. MAP1A and MAP2 were identified with secondary antibodies coupled to 10- and 5-nm gold particles, respectively. In Purkinje cell dendrites, both 10- and 5-nm gold particles were observed to be studded on the fuzzy structures attached to the same MTs. Many such structures connected MTs to each other. There was no particular MT which bound either MAP1A or MAP2 alone. Furthermore, there seemed to be no specific regions on MTs where either MAP1A or MAP2 was specifically attached. Hence, we conclude that MAP1A and MAP2 are colocalized on MTs in dendrites and assume that MAP1A and MAP2 have some interrelationship in vivo and that their interactions are responsible for forming the network of cross-bridges between MTs and MTs in neuronal cytoskeletons. PMID- 3294862 TI - Temporal requirement for epidermal growth factor and insulin in the stimulation of hepatocyte DNA synthesis. AB - Primary monolayer cultures of adult rat hepatocytes were used to study the temporal interaction of epidermal growth factor (EGF) and insulin in their stimulation of DNA synthesis. The hepatocytes were cultured both under defined conditions and with serum. EGF and insulin interacted synergistically. The entry into S phase (G1 exit) followed first-order kinetics both in untreated and hormone-stimulated cells. Addition of EGF and insulin at the time of plating did not alter the lag period before the DNA synthesis started (25-26 h), but the rate constant for the S phase entry increased five- to sixfold. Experiments where the time of hormone addition was varied indicated that insulin exerted its strongest effect at the time of plating, whereas the cells became more responsive to EGF after being cultured for up to 40-50 h. The responsiveness to EGF at these later stages required an early exposure of the hepatocytes to insulin. When the administration of EGF to insulin-pretreated hepatocytes was postponed for 44 h after plating in serum-free medium, the cellular sensitivity was increased as compared to EGF treatment at 0 h (a one-log shift of the dose-effect curve), the rate of S phase entry was more rapid, and the lag period for the onset of the EGF effect (i.e., shift of rate constant) was shortened (6-7 h vs. 26 h). PMID- 3294859 TI - A postsynaptic Mr 58,000 (58K) protein concentrated at acetylcholine receptor rich sites in Torpedo electroplaques and skeletal muscle. AB - In the study of proteins that may participate in the events responsible for organization of macromolecules in the postsynaptic membrane, we have used a mAb to an Mr 58,000 protein (58K protein) found in purified acetylcholine receptor (AChR)-enriched membranes from Torpedo electrocytes. Immunogold labeling with the mAb shows that the 58K protein is located on the cytoplasmic side of Torpedo postsynaptic membranes and is most concentrated near the crests of the postjunctional folds, i.e., at sites of high AChR concentration. The mAb also recognizes a skeletal muscle protein with biochemical characteristics very similar to the electrocyte 58K protein. In immunofluorescence experiments on adult mammalian skeletal muscle, the 58K protein mAb labels endplates very intensely, but staining of extrasynaptic membrane is also seen. Endplate staining is not due entirely to membrane infoldings since a similar pattern is seen in neonatal rat diaphragm in which postjunctional folds are shallow and rudimentary, and in chicken muscle, which lacks folds entirely. Furthermore, clusters of AChR that occur spontaneously on cultured Xenopus myotomal cells and mouse muscle cells of the C2 line are also stained more intensely than the surrounding membrane with the 58K mAb. Denervation of adult rat diaphragm muscle for relatively long times causes a dramatic decrease in the endplate staining intensity. Thus, the concentration of this evolutionarily conserved protein at postsynaptic sites may be regulated by innervation or by muscle activity. PMID- 3294860 TI - The influenza hemagglutinin insertion signal is not cleaved and does not halt translocation when presented to the endoplasmic reticulum membrane as part of a translocating polypeptide. AB - The co-translational insertion of polypeptides into endoplasmic reticulum membranes may be initiated by cleavable amino-terminal insertion signals, as well as by permanent insertion signals located at the amino-terminus or in the interior of a polypeptide. To determine whether the location of an insertion signal within a polypeptide affects its function, possibly by affecting its capacity to achieve a loop disposition during its insertion into the membrane, we have investigated the functional properties of relocated insertion signals within chimeric polypeptides. An artificial gene encoding a polypeptide (THA-HA), consisting of the luminal domain of the influenza hemagglutinin preceded by its amino-terminal signal sequence and linked at its carboxy-terminus to an intact prehemagglutinin polypeptide, was constructed and expressed in in vitro translation systems containing microsomal membranes. As expected, the amino terminal signal initiated co-translational insertion of the hybrid polypeptide into the membranes. The second, identical, interiorized signal, however, was not recognized by the signal peptidase and was translocated across the membrane. The failure of the interiorized signal to be cleaved may be attributed to the fact that it enters the membrane as part of a translocating polypeptide and therefore cannot achieve the loop configuration that is thought to be adopted by signals that initiate insertion. The finding that the interiorized signal did not halt translocation of downstream sequences, even though it contains a hydrophobic region and must enter the membrane in the same configuration as natural stop transfer signals, indicates that the HA insertion signal lacks essential elements of halt transfer signals that makes the latter effective membrane-anchoring domains. When the amino-terminal insertion signal of the THA-HA chimera was deleted, the interior signal was incapable of mediating insertion, probably because of steric hindrance by the folded preceding portions of the chimera. Several chimeras were constructed in which the interiorized signal was preceded by polypeptide segments of various lengths. A signal preceded by a segment of 111 amino acids was also incapable of initiating insertion, but insertion took place normally when the segment preceding the signal was only 11-amino acids long.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294863 TI - Hemorheological aspects of the pathophysiology of cerebral ischemia. AB - In summary, these considerations show that the hemodynamic role of blood rheology in cerebrovascular insufficiency or stroke is still not clear. However, the arguments and data presented allow some conclusions that are of practical and theoretical value in the process leading to further clarification: Changes of blood viscosity as determined by coaxial viscometry cannot be used to predict quantitatively the changes of cerebral blood flow occurring. It is likely that characteristic rheological phenomena such as red cell aggregation and deformability, plasma viscosity, and protein composition are more important for the rheological aspects of microcirculatory supply function than is reflected by their contribution to macroscopic viscosity of the blood. Further studies of blood rheology in stroke should therefore certainly include quantification of those rheological properties that are more closely related to the in vivo flow behavior of blood and thus the magnitude and distribution of flow in the cerebral microcirculation. PMID- 3294861 TI - Cleavage of membrane secretory component to soluble secretory component occurs on the cell surface of rat hepatocyte monolayers. AB - Rat liver secretory component is synthesized as an integral membrane protein (mSC) and cleaved to an 80-kD soluble form (fSC) sometime during transcellular transport from the sinusoidal to the bile canalicular plasma membrane domain of hepatocytes. We have used 24-h monolayer cultures of rat hepatocytes to characterize the conversion of mSC to fSC. Cleavage of mSC in cultured hepatocytes is inhibited by the thiol protease inhibitors leupeptin, antipain, and E-64, but not by other inhibitors, including disopropylfluorophosphate, pepstatin, N-ethylmalemide, p-chloromercuribenzoic acid, and chloroquine. Leupeptin-mediated inhibition of cleavage is concentration dependent and reversible. In the presence or absence of leupeptin, only 10-20% of mSC is accessible at the cell surface. To characterize the behavior of surface as opposed to intracellular mSC, cell surface mSC was labeled with 125I by lactoperoxidase-catalyzed iodination at 4 degrees C. Cell surface 125I-mSC was converted to extracellular fSC at 4 degrees C in the absence of detectable internalization. Cleavage was inhibited by leupeptin and by anti-secretory component antiserum. Cleavage also occurred at 4 degrees C after cell disruption. In contrast, 125I-mSC that had been internalized from the cell surface was not converted to fSC at 4 degrees C in either intact or disrupted cells. Hepatocytes metabolically labeled with [35S]cys also released small quantities of fSC into the medium at 4 degrees C. The properties of fSC production indicate that cleavage occurs on the surface of cultured rat hepatocytes and not intracellularly. Other features of the cleavage reaction suggest that the mSC cleaving protease is segregated from the majority of cell surface mSC, possibly within a specialized plasma membrane domain. PMID- 3294865 TI - The effect of pH and concentration on the rates of kill of benzoic acid solutions against E. coli. AB - Mathematical models were developed which related benzoic acid concentrations to their D-values at room temperature. Linear regression was used to determine D values (i.e. the time required for a particular concentration of preservative at specified pH, temperature and medium to cause a 90% reduction in the number of viable organisms, e.g. Escherichia coli. A number of concentrations of benzoic acid at either pH 3 or pH 4 were used. Linear regression of the log D-values versus the log of the concentration was used to derive power curves (a minimum of four points per pH were examined). Concentration exponents, eta-values (the logarithmic values relating changes in rates of kill to specified changes in concentrations) and A-values (extrapolated D-values at 1% concentration), were determined. The effect of pH on the eta and A-values of benzoic acid on E. coli was investigated. Benzoic acid was found to be more sensitive to pH changes than was anticipated from the Henderson-Hasselbalch equation which relates dissociated and undissociated fractions at the two pH levels investigated. However, the sensitivity of preservative activity to dilution at both pH values (3 and 4), as given by the eta-value, remained similar. PMID- 3294864 TI - Effects of insulin on local cerebral glucose utilization in the rat. AB - The effects of hyperinsulinemia on local cerebral glucose utilization were studied by the quantitative autoradiographic 2-[14C]deoxyglucose method in normal conscious rats under steady-state normoglycemic conditions. Hyperinsulinemia and a steady state of normoglycemia were achieved and maintained during the experimental period by a continuous intravenous (i.v.) infusion of insulin given simultaneously with a programmed i.v. infusion of D-glucose. Hyperinsulinemia under normoglycemic conditions did not change the average rate of glucose utilization in the brain as a whole, but significant increases in local glucose utilization were found selectively in the ventromedial, dorsomedial, and anterior hypothalamic nuclei. The results suggest that a known anatomical pathway linking the dorsomedial and anterior nuclei with the ventromedial nucleus of the hypothalamus may be physiologically activated in response to hyperinsulinemia. PMID- 3294866 TI - Drug assays--the role of modern voltammetric techniques. AB - Modern voltammetric techniques, e.g. differential pulse polarography and voltammetry, anodic/cathodic stripping voltammetry and electrochemical detection for high performance liquid chromatography or flow injection analysis, are reviewed with respect to their basic theory, design and usage of available instrumentation and applications to drug assays in formulation and body fluid matrices. PMID- 3294867 TI - Therapeutic progress--review XXIV. Are we making progress? The treatment of peptic ulcer disease by control of gastric acidity. PMID- 3294868 TI - Therapeutic progress--review XXV. Osteoarthritis--are we making progress? PMID- 3294869 TI - [Simultaneous aortic prosthesis implantation and renal transplantation]. AB - A 44 year old man with end-stage renal failure from nephro-angiosclerosis and with an abdominal aortic aneurysm involving also the common iliac arteries simultaneously underwent an abdominal aneurysmectomy using a standard Dacron graft and a living related renal transplantation. An original technic was used in order to prevent an anastomotic stenosis of the artery: the donor's renal artery was sutured end- to side on the Dacron prosthesis via a venous patch from the donor's renal vein. The post-operative course was uncomplicated; one year after the operation, the renal function is excellent (creatine: 1.6 mg/dl) and the blood pressure is normal. PMID- 3294870 TI - [Value of Deloyers' method. Apropos of a case of ruptured aneurysm of the splenic artery requiring colectomy]. AB - The authors report a new case of splenic artery congenital aneurysm. With regards to the surgical procedure, they insist on the necessity of a massive resection and remind a particular surgical procedure which allows to restore the colonic continuity with fittest conditions. PMID- 3294871 TI - [Splenic complications of chronic pancreatitis. Clinical and experimental study]. AB - Splenic complications of chronic pancreatitis appear to be less exceptional than is usually accepted, particularly since preoperative diagnosis has been facilitated by ultrasound and abdominal scan imaging. Complications noted in 37 cases were: infarcts (2 cases), hematoma or false blood cysts (26 cases) and rupture (9 cases). The splenic infarcts were revealed by digestive hemorrhage, the false blood cysts of spleen by a painful mass in left hypochondrium associated with pleural effusion and rupture of spleen by an acute hemoperitoneum. Treatment included splenectomy in 19 cases, splenectomy caudal pancreatectomy in 17 cases and drainage of a splenic hematoma in one patient. Operative mortality was 16.2% and the long-term prognosis was poor and related to underlying condition. Data from an experimental study suggest that the effect of an episode of acute pancreatitis on the splenic pedicle is the most important physiopathologic factor. A hemorrhagic infarct or infarction of splenic parenchyma are common starting points for all clinicopathologic forms described. PMID- 3294872 TI - Reversed-phase liquid chromatography of site-specific mutagenized staphylococcal nuclease. Gradient retention and correlations with amino acid-based predictive scales. AB - Comparison of the gradient reversed-phase chromatographic retentions of twelve Staphylococcal nuclease mutants and the naturally occurring protein showed that the chain location and the chemical nature of the substituted amino acid(s) were equally significant in determining the retention. Correlations between the retention times of these nuclease mutants and of previously published data for interleukin 2 mutants and insulin variants with nineteen amino acid-based predictive scales revealed retention time to be significantly correlated to several scales. The use of mutagenized proteins allowed a more sensitive analysis of the individual amino acid contributions to retention than can be achieved by utilizing a more diverse set of proteins. PMID- 3294873 TI - Uncoated capillary column inlets (retention gaps) in gas chromatography. AB - Uncoated but deactivated pre-columns have become a widely used tool in capillary gas chromatography (GC), serving strongly differing purposes. Pre-columns are often used as guard columns, reducing the effects of involatile sample by products on chromatographic performance and rendering exchange of contaminated column inlets simple. Wide-bore pre-columns facilitate introduction of the syringe needle and open the way for a relatively robust on-column autosampler. Other pre-columns are used for re-concentrating solute bands that are broadened due to the flow of sample liquid in the column inlet (retention gap). Long pre columns allow on-column injection of large sample volumes (e.g., 50-80 microliter when a 15 m X 0.32 mm I.D. pre-column is used). The background of the various uses of pre-columns is discussed, concluding with an evaluation of different deactivation methods for the internal wall of the pre-columns. Critical parameters are inertness, wettability and retention power. Press-fit connections are recommended for coupling pre-columns to the coated columns. PMID- 3294874 TI - Comments on enhanced peak responses due to solvent interaction. PMID- 3294875 TI - Determination of methylprednisolone in rat tissue by high-performance liquid chromatography. AB - Methylprednisolone was determined in various types of rat tissue following an intravenous injection of methylprednisolone sodium succinate. Two modes of tissue work-up were investigated: digestion with subtilisin Carlsberg, a proteolytic enzyme, and homogenization with methanol. The final determination was by reversed phase high-performance liquid chromatography with dexamethasone as internal standard. The extraction yields of methylprednisolone and dexamethasone from tissue homogenate and the extraction yield of methylprednisolone after incubation with viable tissue were determined. The experiments show that methylprednisolone and the internal standard are extracted in similar yields from tissue homogenates and that methylprednisolone can be recovered in a good yield after incubation with viable tissue, provided that the tissue does not have a high metabolic activity. There was a good agreement between the analytical results from the two different types of tissue work-up. The method of analysis proved feasible for pharmacokinetic work. PMID- 3294876 TI - Use of an image analyser for rubella radical haemolysis plates. AB - A method is described for the reading of rubella radial haemolysis plates using an image analyser. A quantitative assessment of rubella antibody is made by measuring the area of zones of haemolysis displayed on a video screen. When linked to a microcomputer, this reduces the time taken for the reading and reporting stages of testing. The majority (97.9%) of sera could be assessed by this method; problems relating to the remainder are discussed. PMID- 3294877 TI - Purification of infectious canine parvovirus from cell culture by affinity chromatography with monoclonal antibodies. AB - Immuno affinity chromatography with virus neutralizing monoclonal antibodies, directed to the haemagglutinating protein of canine parvovirus (CPV) was used to purify and concentrate CPV from infected cell culture. The procedure was monitored by testing the respective fractions in an infectivity titration system, in an ELISA, in a haemagglutination assay and by negative contrast electron microscopy to quantify CPV or CPV antigen. The degree of purification was further estimated by testing the fractions for total protein content in a colorimetric method, for bovine serum albumin content in an ELISA and by SDS-PAGE. Over 99% of the contaminating proteins proved to be removed, and 20% or 70-90% of infectious CPV or CPV antigen, respectively, was recovered. PMID- 3294878 TI - Sequential changes in plasma luteinizing hormone and plasma prorenin during the menstrual cycle. AB - Prorenin, the enzymatically inactive biosynthetic precursor of renin, is secreted by the kidneys. However, the ovaries appear to be the source of the cyclical increase in plasma prorenin that occurs in the middle of the menstrual cycle. In this study we examined the temporal relationship between changes in plasma prorenin and LH in normal women to determine whether ovarian prorenin secretion might be stimulated by LH. Blood was collected from nine normal women daily for 7 days in the midcycle period and from six of them every 8 h on 6 of these days. Time zero was taken as the highest plasma LH value. The initial rise in LH (-24 h) preceded the initial rise in prorenin (-8 h) and the LH peak preceded the prorenin peak by 8-16 h. These sequential increases in plasma LH and prorenin occurred in the presence of high plasma estradiol levels. While LH fell in parallel with estradiol, the prorenin peak was more sustained and plasma prorenin remained above baseline at 40 and 48 h, at a time when both estradiol and LH had reached a new basal level. These results suggest that gonadotropins stimulate ovarian prorenin release. The timing of the changes in plasma prorenin and its presence in high concentrations in ovarian follicular fluid suggest that prorenin may be involved in the process of ovulation. The results also suggest that changes in plasma prorenin may determine the activity of an ovarian renin system that functions independently of circulating active renin. PMID- 3294879 TI - Immunoreactive corticotropin-releasing hormone present in human plasma may be derived from both hypothalamic and extrahypothalamic sources. AB - Immunoreactive CRH concentrations were determined in human plasma using an immunoaffinity chromatographic extraction procedure and sensitive RIA. Immunoreactive CRH was detectable in the plasma of all normal subjects (mean +/- SD, 6.2 +/- 2.4 pg/mL; n = 15). Basal (0800-1000 h) plasma immunoreactive CRH levels were significantly lower in patients with Cushing's syndrome due to adrenal (2.8 +/- 1.1 pg/mL; n = 4) or pituitary adenomas (2.9 +/- 0.8 pg/mL; n = 5), in patients with hypothalamic hypopituitarism (3.2 +/- 0.9 pg/mL; n = 5), and in glucocorticoid-treated patients (3.9 +/- 1.9 pg/mL, n = 8). Basal plasma CRH levels were also low in patients with acromegaly (2.8 +/- 0.8 pg/mL; n = 14) and insulin-treated diabetic patients whose pituitary-adrenal function was normal (3.6 +/- 1.0 pg/mL; n = 12). In normal subjects plasma CRH levels increased after insulin-induced hypoglycemia; this response was abolished by the prior administration of dexamethasone. In contrast, basal plasma CRH levels were not affected by prior administration of metyrapone or dexamethasone. No evidence for diurnal variation in plasma immunoreactive CRH was found in normal subjects. In addition, in normal subjects oral glucose administration elicited a significant increase in plasma CRH (basal, 7.3 +/- 0.9 pg/mL; peak 30 min after glucose, 16.7 +/- 5.8 pg/mL; n = 5; P less than 0.05) without concomitant changes in ACTH. Gel filtration of extracts of pooled plasma from normal subjects revealed a major component of immunoreactive CRH in the position of synthetic rat CRH. Immunoreactive CRH-sized material had the same retention time as authentic rat CRH in a reverse phase high pressure liquid chromatography system. The content of immunoreactive CRH in human placenta, pancreas, and adrenal gland was much larger than that in hypothalamus. These findings suggest that immunoreactive CRH is present in peripheral plasma; the increase in plasma immunoreactive CRH after insulin-induced hypoglycemia may reflect stimulation of hypothalamic CRH release; the increase in plasma immunoreactive CRH after glucose administration may reflect extrahypothalamic CRH release; and the lack of diurnal variation in plasma immunoreactive CRH together with the lack of suppression of CRH by dexamethasone suggest that basal plasma CRH is of extrahypothalamic origin. PMID- 3294880 TI - Relationship of islet function to insulin action in human obesity. AB - To analyze B-cell mechanisms in obesity, we measured the relationship (slope of potentiation) between glucose levels and acute insulin responses (AIR) to isoproterenol or arginine in nondiabetic subjects ranging from lean to markedly obese. Obese men (n = 9) had higher AIRs to isoproterenol than lean men (n = 11) at basal glucose levels [52 +/- 9 (SEM) vs. 32 +/- 5 microU/mL; P less than 0.05], and the difference increased as the ambient glucose level was raised (at 230 mg/dL; 263 +/- 22 vs. 140 +/- 21 microU/mL; P less than 0.0008). The individuals' slopes of glucose potentiation of AIR to isoproterenol were positively correlated with their excess weight (r = 0.72; P less than 0.001). Similar results were found when arginine was used as the secretagogue in other men and in women; the slope of potentiation was positively correlated with excess weight in both men and women (both P less than 0.005), although the effect of excess weight on slope was 51% greater among men (P less than 0.03). An independent measurement of insulin sensitivity (the Bergman SI) was made in the women. The potentiation slope was inversely correlated with SI (P less than 0.0001), indicating that the effect of obesity on insulin secretion is correlated with insulin resistance. These results characterize one mechanism contributing to the hyperinsulinemia of obesity and highlight the importance of considering the prevailing insulin sensitivity when assessing islet function. PMID- 3294881 TI - Phase III clinical evaluation of fertility-regulating agents as viewed by the industry. PMID- 3294882 TI - Historical tribute: On the existence of specialized branching cells in the seminiferous canaliculi of the human testis. By Enrico Sertoli. 1865. PMID- 3294883 TI - Comparison of nasopharyngeal aspirate and nasopharyngeal swab specimens for respiratory syncytial virus diagnosis by cell culture, indirect immunofluorescence assay, and enzyme-linked immunosorbent assay. AB - Paired nasopharyngeal aspirate (NPA) and nasopharyngeal swab (NPS) specimens obtained from each of 32 hospitalized infants with X-ray-confirmed pneumonia (91%) or bronchiolitis were tested for respiratory syncytial virus (RSV) infection by virus culture, the indirect immunofluorescent-antibody (IFA) technique, enzyme-linked immunosorbent assay (ELISA; Ortho Diagnostic Systems, Inc.), and spot hybridization with a human genomic probe to quantitate cellular DNA. RSV was isolated in cell cultures from 72% (23 of 32) of patients by using NPA specimens compared with 47% (15 of 32) by using NPS specimens. With tissue culture positivity as the reference test, the sensitivities of the ELISA on NPA and NPS specimens were found to be 69% (16 of 23) and 61% (14 of 23), respectively, with a specificity and a positive predictive value from both sites of 100%. The sensitivities of the IFA technique compared with the cell culture on NPA and NPS specimens were 61% (14 of 23) and 52% (12 of 23) with specificities of 89 and 78% and positive predictive values of 96 and 92%, respectively. Despite the recovery of significantly more cells (as shown by detection of more cellular DNA by using NPA specimens), virus was detected by the IFA technique or ELISA at similar frequencies in paired specimens. However, virus was recovered more often from NPA than NPS specimens by cell culture, and ELISA optical density readings and the number of RSV-positive fluorescing cells were greater for NPA specimens. NPA specimen collection was less traumatic for the patient, was an easier procedure for the physician to perform, and provided a superior laboratory specimen for RSV diagnosis than the NPS technique. PMID- 3294884 TI - Evaluation of the syphilis Bio-EnzaBead assay for detection of treponemal antibody. AB - An enzyme-linked immunosorbent assay for Treponema pallidum antibody (Syphilis Bio-EnzaBead Kit; Organon Teknika Corp., formerly Litton Bionetics, Kensington, Md.) was compared with the standard fluorescent treponemal antibody absorption test for syphilis (indirect fluorescent-antibody confirmatory test; Zeus Scientific Inc., Raritan, N.J.). Six hundred specimens tested in the rapid plasma Reagin card test (Hynson, Westcott and Dunning, Inc., Baltimore, Md.) and microhemagglutination assay for antibodies to T. pallidum (Ames Division, Miles Laboratories, Inc., Elkhart, Ind.) were used for comparison testing. One hundred and sixty-two specimens were from either persons with syphilis or persons whose history was unknown but who showed reactive serology, whereas 438 were from persons without syphilis. The reactivity of each serum by the Bio-EnzaBead test was determined visually and from optical density readings. Excellent reproducibility of visual readings was obtained; all results were within +/- 1 gradation of the expected readings in all 60 coded sera tested. Overall agreement between the Bio-EnzaBead and fluorescent treponemal antibody absorption test results was 96.3% when read visually and greater than or equal to 95.7% when using optical density readings. Our data indicate that Bio-EnzaBead results read at 405 nm and determined by using the mean antigen optical density reading of the nonreactive control plus 0.025 as the cutoff value provide an overall sensitivity and specificity of 93.0 and 98.6%, respectively, along with the best agreement with the fluorescent treponemal antibody absorption assay. Ease of performance and objectivity also contribute toward the acceptability of this assay as an alternative confirmatory test for syphilis. PMID- 3294885 TI - Yield, clinical significance, and cost of a combination BACTEC plus Septi-Chek blood culture system. AB - A blood culture was performed by adding a vented Septi-Chek bottle (Roche Diagnostics, Div. Hoffmann-LaRoche Inc., Nutley, N.J.) to a standard BACTEC system (Johnston Laboratories, Inc., Towson, Md.) blood culture. The yield of bacteremic patients, the clinical significance of organisms detected, and the cost of the combination system were compared with those of the standard BACTEC system alone. Each culture included 20 ml of blood divided among a BACTEC 6B aerobic bottle (5 ml), a BACTEC 7D anaerobic bottle (5 ml), and a Septi-Chek bottle equipped with a slide subculture attachment (10 ml). Significant isolates grew in 9.6% of the 2,269 cultures evaluated. The combination BACTEC plus Septi Chek system detected 25% more bacteremic patients than the BACTEC system alone, 129 patients versus 103. The 26 bacteremic patients detected by only the added Septi-Chek bottle included 7 whose organism was isolated from blood alone and 19 whose organism was in mixed or pure culture from a second source. Detection of the organism resulted in alteration of antimicrobial therapy in 17 of these 26 patients. The combination system, which cultured a 20-ml blood volume, cost $11,000 more during the study period than the BACTEC system alone, which cultured a 10-ml volume. Reimbursement under the diagnosis-related group system was increased by $23,000 as a result of documentation of sepsis in these 26 patients. Blood volume and, possibly, the use of multiple blood culture systems are important factors when selecting a blood culture procedure for routine use. PMID- 3294886 TI - Correlation of cerebrospinal fluid endotoxinlike activity with clinical and laboratory variables in gram-negative bacterial meningitis in children. AB - Detection of endotoxinlike activity in cerebrospinal fluid by Limulus amebocyte lysate gelation has been suggested as a useful technique for the diagnosis of gram-negative bacterial meningitis. We prospectively screened 1,503 cerebrospinal fluid specimens with a Limulus amebocyte lysate microassay. The limit of sensitivity of the assay was 0.01 ng/ml. All specimens that were positive for endotoxinlike activity were subjected to confirmatory retesting, after which 38 (86%) remained positive. Comparison with available culture results revealed that 33 of 38 specimens (86%) were culture positive; 3 of the 5 culture-negative specimens were from patients on therapy for gram-negative bacterial meningitis, and 1 was from a neonate. The overall specificity of confirmed positive tests was 99.5%, with a positive predictive value of 97.3%. There was one false-negative specimen, giving an overall sensitivity of 97.3% and a negative predictive value of 99.9%. Endotoxinlike activities of greater than or equal to 150 ng/ml correlated with present illness of less than 2 days' duration (P = 0.024), elevated cerebrospinal fluid protein (P less than 0.05), and seizures (P = 0.004); levels of greater than or equal to 3,000 ng/ml correlated with neutropenia (P = 0.032), and levels of greater than or equal to 3.2 X 10(6) ng/ml correlated with death (P = 0.001). We conclude that the Limulus amebocyte lysate microslide gelation test has prognostic value as a sensitive, specific, simple, inexpensive screening test for gram-negative bacterial meningitis. PMID- 3294887 TI - Detection of galactomannan antigenemia by enzyme immunoassay in experimental invasive aspergillosis. AB - A sensitive enzyme immunoassay (EIA) for galactomannan antigenemia that avoids the use of radioisotopes was devised. Three carbohydrate-rich antigenic fractions were purified from Aspergillus fumigatus 2085: a cold alkali extract (CA) from mycelium, an acetone-precipitated pyridine extract (APSK-66) from mycelium, and a methanol precipitate from culture filtrate. CA and APSK-66 were further purified by gel filtration and ion-exchange chromatography, respectively. An acid hydrolysate of CA contained only mannose and galactose, as determined by gas liquid chromatography. Rabbit antisera were raised against conidia, mycelia, and cell walls of A. fumigatus. By indirect EIA, the best immunoglobulin G response (1/8,000) was obtained against CA in rabbits immunized intravenously with cell walls. Antigenemia was detected by indirect EIA inhibition in heat-dissociated sera of four immunosuppressed rabbits that were infected intravenously but was absent in two uninfected controls. The circulating antigen was resistant to pronase, was adsorbed onto concanavalin A, and had a molecular size of 50 to 100 kilodaltons. PMID- 3294888 TI - Diagnosis of chlamydial infection in women attending antenatal and gynecologic clinics. AB - Two antigen detection systems (MicroTrak [MT], Syva Co., Palo Alto, Calif.; and Chlamydiazyme [CZ], Abbott Laboratories, North Chicago, Ill.) were compared with semiquantitative culture for diagnosis of chlamydial infection in 1,059 patients. Cultures were done on microtiter plates and blind passaged once. Culture-negative but CZ- or MT-positive specimens were recultured. True positives were positive by either initial or repeat cultures. Of 827 nonpregnant and 231 pregnant patients, 9.1 and 12.1%, respectively, had positive cultures. Overall sensitivity of the initial culture was 48.5% without passage and 86.4% with passage. The sensitivity of CZ was 67%. The sensitivity of MT in our laboratory was 50%; however, further review of these specimens by Syva employees gave a combined sensitivity of 71.6%. MT and CZ were more sensitive for pregnant patients (MT, 84.6%; CZ, 85.7%) than for nonpregnant patients (MT, 65.5%; CZ, 60.0%). All the tests had specificities above 95%. Of the specimens that were positive after initial culture without subculture, MT-negative specimens had a mean of 3.7 inclusions in culture, and MT positive specimens had a mean of 24.8 (P = 0.002); CZ-negative specimens had a mean of 4.3 inclusions, and CZ-positive specimens had a mean of 20.0 (P = 0.026). In addition, cultures of specimens from pregnant patients had more inclusions than did those from gynecology patients, but this was not statistically significant (P = 0.096). No method is ideal; however, MT and CZ were less sensitive than was this culture system for detecting chlamydial infection in patients in gynecology clinics and were of comparable sensitivity for pregnant patients. PMID- 3294889 TI - Diagnostic efficacy of two rapid tests for detection of respiratory syncytial virus antigen. AB - With the availability of ribavirin therapy for serious respiratory syncytial virus (RSV) infections, rapid diagnostic tests for the detection of RSV antigen are increasingly important. Efficacies of a commercially available enzyme immunoassay (EIA) (Abbott Laboratories, North Chicago, Ill.) and a fluorescent antibody assay (FA) were evaluated in a study involving 135 specimens from children with respiratory symptoms. A nasal wash specimen was cultured immediately on RSV-sensitive A549 cells; the nasal wash was also used for EIA. FA was performed on a nasopharyngeal swab specimen with bovine anti-RSV and anti bovine immunoglobulin G antisera (Burroughs Wellcome Co., Research Triangle Park, N.C.). A total of 39 specimens (28%) were tissue culture positive, including 35 EIA-positive and 37 FA-positive samples (sensitivities, 90 and 95%, respectively). All 96 tissue culture-negative specimens were EIA negative (specificity, 100%); 94 of these 96 specimens were FA negative (specificity, 98%). Positive and negative predictive values for the tests were as follows: 100 and 96% for EIA, respectively, and 95 and 98% for FA, respectively. Other viruses, including influenza A virus, adenovirus, enterovirus, and herpes simplex virus, were isolated in nine cases. One adenovirus-positive specimen had a false positive RSV FA result; all nine specimens were RSV EIA negative. Both tests performed well in our study and provide cost-effective alternatives to tissue culture. The RSV EIA, in particular, uses standard serologic techniques and equipment and does not require expertise in virology. More widespread availability of rapid diagnostic tests for RSV will hopefully result in early and appropriate use of antiviral therapy in patients at risk for serious RSV infections. PMID- 3294890 TI - Screening and diagnostic performance of enzyme immunoassay for antibody to lymphadenopathy-associated virus. AB - In a multicenter cooperative study, an enzyme immunoassay (EIA) using purified antigen of lymphadenopathy-associated virus was compared with radioimmune precipitation (RIP) for detection of antibody to human immunodeficiency virus (HIV) in 634 patients with acquired immunodeficiency syndrome or related conditions, 687 apparently healthy persons at risk for HIV infection, 93 controls with cancer or autoimmune diseases, and 10,038 blood or plasma donors. Excluding the donors, the EIA was reactive in 875 (61.9%) of 1,414 subjects; compared with RIP, the sensitivity and specificity of EIA both were 99.8%. There was one false positive EIA among 148 intravenous drug abusers and two false-negative EIAs among 472 apparently healthy homosexual men; no other discordant results between EIA and RIP occurred in these subjects. The EIA was repeatably reactive in 20 donors (0.2%), among whom 13 (65%) were positive by RIP; none of 529 randomly selected EIA-negative donors was RIP positive. In addition to its utility as a screening test in low-risk populations, the EIA for antibody to lymphadenopathy-associated virus is useful as a diagnostic test in persons with clinical evidence of or at risk for HIV infection. PMID- 3294891 TI - Effect of buffers on testing of Candida species susceptibility to flucytosine. AB - Synthetic amino acid medium for fungi (SAAMF) is a totally defined, nutritionally adequate, macromolecule-free culture medium for fungi that is buffered with an organic weak acid-weak base pair: 2-(N-morpholino)-propanesulfonic acid (MOPS) and 2-amino-2-(hydroxymethyl)-1,3-propanediol (Tris). In 1984, it was reported that MOPS-Tris in SAAMF antagonized the activity of flucytosine against Candida albicans (D. L. Calhoun and J. N. Galgiani, Antimicrob. Agents Chemother. 26:364 367, 1984). Accordingly, we evaluated the buffering capacity of seven synthetic organic buffers and monobasic potassium phosphate, both singly and in pairs, over the pH range 7.4 to 6.0. Of these buffers, MOPS, BES [N,N-bis(2-hydroxyethyl)-2 aminomethanesulfonic acid], a BES-MOPS combination, and KH2PO4 provided the best buffering. Growth of C. albicans, in unbuffered SAAMF was equivalent overall to that in SAAMF containing buffers, singly or in pairs. Twelve strains of C. albicans and five strains of Candida lusitaniae were tested for susceptibility to flucytosine in SAAMF, with and without buffers. In the presence of Tris, the geometric mean MICs were 6.5- and 3.6-fold higher, respectively, for C. albicans and C. lusitaniae. We recommend replacing Tris with the nonantagonistic MOPS. PMID- 3294892 TI - Tissue homogenization with sterile reinforced polyethylene bags for quantitative culture of Candida albicans. AB - A simple method of tissue homogenization with sterile reinforced polyethylene bags for quantitative fungal cultures was evaluated with mice infected with Candida albicans. This new method correlated well with standard methods (P less than or equal to 0.01) for quantifying viable fungus in homogenates of brain, kidney, spleen, liver, and lungs and may be applicable in clinical and experimental mycology laboratories. PMID- 3294893 TI - Economical laboratory support system for influenza virus surveillance. AB - When increases in influenzalike illnesses were first detected during the 1984 to 1985 and 1985 to 1986 influenza seasons, throat swab specimens were mailed by physicians across the United States to one hospital laboratory, and each specimen was inoculated into a single tube of cell culture. Of 165 specimens, 52 (32%) were positive for influenza A or B virus within 3 days of receipt when tested by fluorescence microscopy, permitting positive results to be received by the physicians within 1 week on the average. Approximate direct cost was $16 per specimen. PMID- 3294894 TI - Anti-neurofilament protein antibodies in opsoclonus-myoclonus. AB - Opsoclonus-myoclonus (OM) is a neurological disorder usually occurring in infancy, clinically manifested by various involuntary movements. The pathogenesis of OM is unknown, but since the disease often is associated with viral infection or with neuroblastoma, an immunologic basis for OM has been postulated. We have studied two children with OM whose serum contained antibodies directed against the 210 kDa neurofilament protein; these antibodies were not seen in the serum of 21 children with other neurological disorders. Neurofilament proteins, which are found only in neurons, may be of prime importance in neuronal function, especially during development of the nervous system. Our findings suggest that generation of antibodies to the neurofilament proteins can occur in patients with opsoclonus-myoclonus; the role of the anti-NF210K antibodies in the pathogenesis of OM, however, is uncertain. PMID- 3294895 TI - Effect of sexual hormones on the electroencephalogram and seizures. AB - The role of hormones and reproductive function in electroencephalography (EEG) and epilepsy has long intrigued electroencephalographers. In this report, the relationship between the menstrual cycle and pregnancy and EEG changes and seizure frequency is reviewed. These neurophysiologic changes are likely secondary to hormonal effects. The effect of these hormones on experimental animal models is also reviewed. PMID- 3294896 TI - A transillumination technique for lingual bonding. PMID- 3294897 TI - Measurement of tibial torsion by ultrasound. AB - A method of measuring tibial torsion with ultrasound, using reference lines on the tibia, was developed and tested on dry adult tibiae. This technique was used for evaluation of a group of children with apparently normal tibiae and another group of children with spina bifida, cerebral palsy, or clubfoot. The study showed that it is possible to measure true tibial torsion (rather than tibiofibular torsion) with ultrasound. The technique was found to be reliable and accurate enough for routine clinical use and had advantages over clinical methods and other radiographic imaging techniques. Values obtained by this technique are higher than those obtained by methods using the bimalleolar axis as the distal reference line. PMID- 3294898 TI - Conversion of xanthine dehydrogenase to oxidase in ischemic rat tissues. AB - In response to global ischemia, tissue xanthine dehydrogenase was converted to xanthine oxidase in all tissues with half-times of conversion at 37 degrees C of approximately 3.6, 6, 7, and 14 h for the liver, kidney, heart, and lung, respectively. The time course of enzyme conversion at 4 degrees C was greatly extended with half-conversion times of 6, 5, 5, and 6 d for the respective tissues. Increases in xanthine oxidase activity were accompanied by the appearance of a distinct new protein species with greater electrophoretic mobility. The oxidase from ischemic rat liver was purified 781-fold and found to migrate with a higher mobility on native gels than the purified native dehydrogenase. Sodium dodecyl sulfate profiles revealed the presence of a single major band of 137 kD for the native dehydrogenase, whereas the oxidase had been partially cleaved generating polypeptides of 127, 91, and 57 kD. Polypeptide patterns for the oxidase resemble those seen following limited in vitro proteolysis of the native dehydrogenase supporting a proteolytic mechanism for the conversion of xanthine dehydrogenase to oxidase in ischemic rat liver. PMID- 3294899 TI - Kinetics of glucose disposal in whole body and across the forearm in man. AB - We reevaluated the concept that the in vivo glucose disposal rate in man is determined by the activity of the glucose transport system. Rates of glucose disposal were determined in whole body and across forearm at four insulin levels (approximately 9, approximately 50, approximately 160, and approximately 1700 microU/ml) and at each insulin level at four glucose levels (approximately 90, approximately 160, approximately 250, and approximately 400 mg/dl). At the lowest insulin level, the Michaelis constants (Ks:s) for glucose disposal in whole body (8.7 +/- 1.1 mM) and across forearm (7.4 +/- 1.4) mM) were compatible with a Ks determined in vitro for the transport system. At higher insulin levels, the apparent Ks increased significantly in whole body (16.2-37.7 mM) and across forearm (20.7-31.2 mM). We interpret the apparent increase of Ks by insulin to reflect a shift in the rate-limiting step from glucose transport to some step beyond transport. PMID- 3294902 TI - Reconstruction of orbital defects with autogenous bone from mandibular symphysis. AB - Autotransplant bone is superior to other bone, cartilage, or alloplastic materials for the reconstruction of orbital floor defects. The bone used for filling orbital floor defects is taken from the symphysis of the lower jaw. The piece of bone, up to 3.5 X 1.5 cm in diameter is strong enough to support the orbital contents, while at the same time it is easily modelled and positioned. This method is indicated for reconstruction of the orbital floor, with or without rim defects. Taking of the transplant, while retaining the lower margin of the mandibular symphysis, preserves the contour of the chin. PMID- 3294900 TI - Human granulocyte-macrophage colony-stimulating factor induces expression of the tumor necrosis factor gene by the U937 cell line and by normal human monocytes. AB - Human granulocyte-macrophage colony-stimulating factor (GM-CSF) exerts profound effects on the proliferation, differentiation, and effector function of myeloid lineage cells. In contrast to its growth-promoting effects on normal myeloid progenitor cells, we found that GM-CSF unexpectedly inhibited the colony growth of U937 cells in agar culture. Furthermore, medium conditioned by recombinant GM CSF(rGM-CSF)-treated U937 cells was found to exert an inhibitory effect on subsequent U937 colony growth that was partially due to the presence of tumor necrosis factor (TNF). By Northern blot analysis, rGM-CSF was shown to induce expression of the TNF gene in U937 cells and in T-lymphocyte-depleted, monocyte enriched peripheral blood mononuclear cells. Furthermore, rGM-CSF was observed to significantly enhance TNF secretion by monocytes stimulated with endotoxin and phorbol myristate acetate (PMA). These data suggest that some of the biological effects of GM-CSF may be amplified through the release of monokines such as TNF. PMID- 3294901 TI - Administration in vivo of recombinant interleukin 2 protects mice against septic death. AB - Administration in vivo of recombinant interleukin 2 (rIL-2) to mice induces a polyclonal IgM response. When co-administered with a specific antigen, rIL-2 can enhance concentrations of murine IgM antibodies specific for the antigen by fivefold within 7 d of initial treatment. IgM antibodies that are induced after injection of rIL-2 include antibodies specific for J5, a cell wall core lipopolysaccharide (LPS) antigen that is shared by the different members of the Enterobactericeae family. We report here that mice pretreated with rIL-2 or immunized with J5 antigen 7 d before bacterial challenge were protected from septic death that is caused by intraperitoneal challenges with Escherichia coli. Optimal protection was provided by a combined J5 antigen and rIL-2 treatment. Acquisition of the rIL-2 and J5 antigen-induced protection against lethal bacterial infection coincided temporally with maximal serum IgM titers that also contained IgM antibodies specific for the J5 antigen. In passive immunization experiments, the affinity-purified IgM fraction in sera of rIL-2-treated animals was identified as necessary and sufficient for protection. The IgM-depleted serum had no protective effect. The nonspecific augmentation of host-defense mechanisms without the induction of endotoxin manifestations makes rIL-2 a potential candidate to any alternative LPS-containing vaccines for the prevention of bacterial infections by gram-negative organisms since the core LPS antigen is shared among gram-negative bacteria. PMID- 3294903 TI - Effects of bone wax on rabbit cranial bone lesions. AB - The present study was designed to elucidate the reactions of cranial membranous bone to bone wax. In ten young rabbits, twenty parietal bone defects were created by drilling, the edges of which were partly extended using rongeur forceps to enable investigation of eventual thermal effects. Half of the marginal bone surrounding the lesions was covered by bone wax, the remainder serving as control. The animals were sacrificed 1 and 7 weeks after surgery, and block specimens prepared for light microscopy. Merely slight tissue reactions to the bone wax were discerned. Bony regeneration occurred mainly from the dura mater and the pericranium, but also from the bony rim. Reskeletalization was markedly impaired by the presence of bone wax. Heat generated by drilling caused reduced bone formation despite constant irrigation peroperatively. Clinical consequences are discussed. PMID- 3294904 TI - Mental health of adolescent mothers: the implications of depression and drug use. AB - Childbearing and child rearing during adolescence result in poor health and psychosocial outcomes for some mothers and their children. Whereas the mental health problems of adolescent mothers are common in clinical experience, they are infrequently investigated and discussed in the literature. Mental health problems such as depression and/or drug use may be key factors in determining which mothers and their children will have poor outcomes. The purpose of this paper is to explore how depression and drug use may affect the health and development of adolescent mothers and their children. Because of their relevance to adolescent motherhood, this paper brings together information from three research areas: adolescent depression, adolescent drug use, and maternal depression. PMID- 3294905 TI - The effectiveness of tactile stimulation as a form of early intervention: a quantitative evaluation. AB - The results of studies examining the effectiveness of tactile stimulation as a form of sensory enrichment for infants and young children were analyzed by the use of recently developed quantitative methods that treat research synthesis as a unique type of scientific inquiry. Nineteen studies meeting certain predetermined criteria were included in the review. The 19 studies contain 103 statistical hypothesis tests that evaluated the effectiveness of tactile stimulation programs. Analysis of these tests, based on the calculation of effect sizes, revealed that subjects receiving some form of controlled tactile stimulation performed better on a variety of dependent measures than subjects not receiving intervention. Larger treatment effects were associated with pre-experimental designs, and also with studies in which the internal validity was rated as poor. Several other study characteristics, such as how the subjects were assigned to conditions and how the dependent measure was recorded, were related to study outcome as measured by effect size. The results indicate that an accurate interpretation of tactile stimulation studies cannot be made without consideration of specific design variables and study characteristics. PMID- 3294906 TI - Evaluation of "CLO-test" to detect Campylobacter pyloridis in gastric mucosa. PMID- 3294907 TI - Histological identification of Campylobacter using Gimenez technique in gastric antral mucosa. PMID- 3294908 TI - Use of radionuclide scanning to estimate size of spleen in vivo. AB - Splenic ultrasound was performed and spleen scans obtained by a rectilinear scanner after injection of In-113m-labelled heat damaged red cells on 14 patients with various haematological disorders. Correlation was assessed between the measured volume of the operatively removed spleens, their volumes as calculated from the ultrasound data, and their preoperative dimensions of length, circumference, and area on the scans. The relation of scan to volume was best defined by an equation V = 9.88A - 534, where V = volume of spleen (cm3) and A = area (cm2) on posterior scan. The mean percentage difference between calculated and actual spleen volume was 0.2 (SD 6.7)%. Average spleen density was established as 1.04 g/cm3. The formula was shown to be reliable in the range of splenic area c 73-450 cm2--that is, volume c 185-4000 cm3. This range includes the average normal sized spleens and the splenomegalies that are most often found in clinical practice. The formula is not valid when the spleen is smaller than normal. As the method depends on measurement of the spleen image shown by scintigraphs, it cannot be used when there is functional asplenia. PMID- 3294909 TI - Heterogeneity of antibody response in infection with Legionella pneumophila serogroup 1. AB - The antibody response of patients infected with Legionella pneumophila serogroup 1 in a common source outbreak was investigated. Heat-killed antigens from L pneumophila serogroups 1-3 and 6-10, plus several other strains of L pneumophila, together with 13 other species of legionellas were used in an indirect fluorescence antibody test. Formolised yolk sac antigens made from L pneumophila serogroups 1, 6, and 7 were also used. Although antibodies were produced to several L pneumophila serogroups or Legionella species by individuals, there was no constant pattern, suggesting that the response is a characteristic of the infected individual and not of the infecting strain of Legionella. There is evidence that heat-killed antigen made from L pneumophila serogroup 7 may give unreliable results. PMID- 3294910 TI - Loctite UV 357 polymerised glass adhesive as a section mounting medium. PMID- 3294911 TI - The effect of different types of composite resin fillings on marginal gingiva. AB - Earlier studies of plaque accumulation on and gingival response around conventional composite resin fillings have produced conflicting results. No studies have been found in which the gingival reaction around newer types of resin fillings had been recorded. The aim of this study was to measure plaque retention and gingival conditions around in vivo, aged, subgingivally located, composite fillings of conventional, hybrid and microfiller types. This study was performed in 2 groups of patients. In the 1st group, there were 108 1-year-old class-III restorations of the 3 composite types and in the 2nd group, 228 3- or 4 year-old class-III or class-IV fillings. Plaque and gingival index scores and the amount of crevicular fluid were recorded. In the group with 1-year-old fillings, the composite resins did not adversely affect the health of the gingival tissues. The amount of plaque on and the degree of gingivitis around the composite fillings were not significantly higher than those for the enamel surfaces. Significant differences in the amount of crevicular fluid were found between both the conventional and hybrid composites and the enamel. In the groups with 3-4 year-old fillings, the indices for each material were significantly higher than those for the enamel surfaces and the fillings showed greater amounts of plaque and a higher degree of gingivitis than the 1-year-old fillings. Differences among the 3 types of composite resins were minimal in both groups and not statistically significant. PMID- 3294912 TI - Correlation of histometric, microbial, and clinical indicators of periodontal disease status before and after root planing. AB - Effective diagnosis and treatment of periodontal disease requires accurate evaluation of disease status before and after treatment. This study evaluated relationships among multiple parameters that have been used for periodontal disease evaluation. A total of 61 initially deep (greater than or equal to 6 mm) interproximal pockets from 16 patients examined before and after a 3-week course of root planing therapy were evaluated for probing depth, bleeding on probing, darkfield and cultural characterization of subgingival plaque, and histometric indices of infiltrated connective tissue (ICT) and mature plasma cell infiltrate. 36 sites were evaluated before treatment, and 25 after treatment. A comparison of mean scores for pre-treatment sites versus post-treatment sites indicated that there was an average improvement in most disease-related parameters. However, patterns of significant correlations among the parameters differed markedly. Motile bacteria enumerated by darkfield microscopy were significantly correlated with ICT and plasma-cell populations before, but not after treatment. In contrast, probing depth and populations of black pigmented Bacteroides (BPB's), principally B. gingivalis, were significantly correlated with ICT after, but not before, treatment. Bleeding on probing was not significantly correlated with ICT levels before or after treatment. This suggests that different sets of parameters should be used for evaluating periodontal disease status before or after treatment. Our data further suggest that B. gingivalis populations may be related to delayed healing of deep periodontal lesions after instrumentation. PMID- 3294913 TI - Microbial and clinical measurements of periodontal pockets during sequential periods of non-treatment, mechanical debridement and metronidazole therapy. AB - Microbial and clinical parameters were studied in 11 subjects with chronic inflammatory periodontitis. 2 periodontal pockets per subject were studied longitudinally. The microbial parameters included counts of different subgingival micro-organisms by dark field microscopy, counts of the total colony forming units (c.f.u.) on anaerobic blood agar, the facultative anaerobic counts and counts of black-pigmented Bacteroides, Fusobacterium and E. corrodens. The clinical parameters were probing pocket depth, bleeding after probing and crevicular fluid production. Clinical and microbial observations were compared during 3 consecutive periods of non-treatment, debridement and metronidazole therapy. The experimental sites were debrided by deep scaling while no debridement was carried out at the control sites. The effect of this treatment was studied over a period of 3 months. Then, at the experimental sites, a 2nd session of debridement was followed by administration of metronidazole. The effect of metronidazole alone and combined with mechanical debridement was studied during a subsequent 3-month period. The disease activity did not correlate with the microbial parameters and was evident in the presence as well as in the absence of black-pigmented Bacteroides. A single session of subgingival debridement resulted in significant reductions in probing depth, spirochetes, motile organisms, black-pigmented Bacteroides and E. corrodens. Repopulation of the subgingival sites was observed. However, the composition of the subgingival microbiota remained significantly changed during the 3 months after debridement. The re-isolation of the same Bacteroides-species and the same B. gingivalis type after treatment indicated an outgrowth of micro-organisms remaining at these sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294914 TI - Efficacy of mouthrinses in inhibiting dental plaque and gingivitis in man. AB - The aim of the present trial was to determine the effect of different mouthwash preparations used as supplements to regular oral hygiene measures on dental plaque and gingivitis in humans. 96 volunteers were recruited for the study. Following a baseline examination, each subject was given a careful prophylaxis, following which the mouthrinse regimens were initiated. During the 6 weeks of trial, the subjects continued to exercise their regular non-supervised, self performed plaque control measures. The 96 volunteers were assigned either to 1 or 3 different treatment groups or to a control group according to a randomized code. The members of the control group and the listerine group rinsed with 20 ml of the mouthrinse for 30 s, twice daily, while the members of the chlorhexidine groups (using either a 0.2% or a 0.1% solution) rinsed with 10 ml of the antiseptic solution for 60 s twice daily. Examinations regarding extrinsic stain and plaque were performed at baseline and after 3 and 6 weeks, while the conditions of the gingiva were examined at baseline and after 6 weeks. Extrinsic stain was evaluated using the Lobene index, plaque was assessed by the Turesky modification of Quigley-Hein index and the gingival condition was examined using the gingival index system of Loe & Silness. The results of the trial demonstrated that the 3 active mouthwash preparations used as supplements to regular tooth cleaning measures markedly improved both the oral hygiene status and the gingival conditions of the participating human volunteers, compared to the control rinse.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294915 TI - Effect of an air-powder abrasive system on root surfaces in periodontal surgery. AB - The purpose of this study was to compare the effectiveness of an air-powder abrasive technique to conventional root planing during periodontal surgery. 7 patients scheduled for multiple extractions of periodontally-involved teeth were selected. Full thickness mucoperiosteal flaps were reflected, and proximal surfaces of 32 teeth were either ultrasonically scaled and exposed to the air powder abrasive, or ultrasonically scaled and then manually root planed. Following extraction, teeth were stained for residual plaque and photographed, or prepared for scanning electron microscopy. The air-powder abrasive technique used for surgical root preparation was found to produce a root surface favorably comparable to manual root planing with regard to removal of plaque, calculus, and exposed cementum. A mean of 80 micron of cementum was abraded away after 40 s of exposure to the air-powder spray. The air-powder abrasive spray demonstrated an advantageous ability to remove plaque and cementum from areas of difficult access, such as furcations and root flutings. PMID- 3294916 TI - Bleeding on probing and probing depth as indicators of the response to plaque control and root debridement. AB - 19 adult periodontitis patients were treated with plaque control and a single episode of root debridement. Results of this treatment were monitored in non molar sites, molar flat surface sites, and molar furcation sites by probing attachment level measurements every 3rd month for 24 months. After 24 months, sites with probing attachment loss were identified using linear regression analysis. Clinical scores for supragingival plaque, bleeding on probing, suppuration on probing, and probing depth, obtained from these sites during the 24-month study, were analyzed to determine if they could be used diagnostically as indicators of probing attachment loss. The results demonstrated that the diagnostic accuracy for these clinical indicators was generally low at all 3 anatomical site locations. A possible explanation for this limited diagnostic accuracy may be that some areas of probing attachment loss following basic periodontal therapy are caused by factors other than the progression of an inflammatory periodontal disease of microbial etiology. PMID- 3294917 TI - The effect of plaque control and root debridement in molar teeth. AB - The healing response of non-molar sites, molar flat surface sites, and molar furcation sites was investigated in 19 adult periodontitis patients following a periodontal therapy of plaque control and root debridement. A total of 2472 sites were monitored by recordings of dental plaque, bleeding on probing, probing depth, and probing attachment levels every 3rd month for 24 months. The results demonstrated that in sites with initial probing depth of 4.0 mm or greater, molar furcation sites responded less favorably to the therapy as compared to molar flat surface sites or non-molar sites. This was demonstrated by higher mean scores for bleeding on probing, less reduction in probing depth, and a mean loss of probing attachment of 0.5 mm over 24 months. Site analyses using linear regression showed a higher % of deeper sites with probing attachment loss for the molar furcations than either molar flat surface or non-molar sites. Among sites initially 7.0 mm or deeper, 21% of molar furcations were identified as showing probing attachment loss as compared to 7% of the molar flat surface sites and 11% of the non-molar sites. PMID- 3294918 TI - Longevity: a critical factor in evaluating the effectiveness of periodontal therapy. AB - A 47-year-old male patient with an advanced form of adult periodontitis presented for evaluation and treatment in 1963. There were several angular bony lesions and 3 molar teeth had an extremely questionable prognosis. The patient was treated by scaling, root planing and gingivectomy, with no attempt to alter the existing morphology of the effected alveolar bone. 23 years following periodontal therapy, there were marked changes of the contour of the marginal bone crest throughout, minimal pocket depth and acceptable gingival form. The patient was seen at regular 5-6 months intervals for maintenance therapy and his home care regimen was exemplary. Advanced cases of periodontitis can be treated successfully by simplistic methods if the "repair potential" of the patient is good and if regular maintenance visits and meticulous plaque control are carried out. PMID- 3294919 TI - Verapamil in treatment-resistant mania: an open trial. AB - Fourteen patients with mania unresponsive to lithium were treated with verapamil in an open study. None of the eight patients treated for acute episodes of mania or hypomania showed improvement, although four patients experienced dysphoria, with two of the four switching into depression. Four patients were treated with verapamil prophylactically; one showed a mild improvement and one, a clear positive response. Two patients with persistent pharmacological hypomanias tolerated antidepressants and became euthymic while on verapamil. A case of pharmacological hypomania successfully treated with verapamil is presented in detail. A controlled trial using verapamil to prevent pharmacological mania/hypomania is indicated. PMID- 3294920 TI - Tiaspirone in schizophrenia. AB - It was predicted that tiaspirone, a novel compound, would benefit schizophrenic patients since in animal experiments it is a potent dopamine blocker. Following a placebo washout period of 1 to 2 weeks, 14 patients were treated for 28 days with the drug in a single-blind, dose ranging trial. GAS, NOSIE, and BPRS scores all showed significant improvement. No serious adverse effects were found. The absence of extrapyramidal symptoms was particularly encouraging since 10 of the 14 subjects had previously had them on other neuroleptics. Tiaspirone may represent a step forward in the search for a safer antipsychotic. PMID- 3294921 TI - A rebuttal: "The osseous/integration concept: 1987". PMID- 3294922 TI - Teaching clinic conferences: perceptions of supervisor and peer behavior. AB - Perceptions of supervisor and peer behavior during teaching clinic conferences, a group supervisory approach, were assessed. Four groups of graduate students participated in a total of 19 teaching clinics. Following each conference, they completed two Individual Conference Rating Scales to describe the supervisor and peer during the interaction. Peer behavior differed from that of supervisors. Differences were also found between supervisors and among groups of students participating in the conferences. A participant's role had no impact on the participants' perceptions of either the peers or supervisors. Variations in perceptions were noted as the number of clinics per group increased. PMID- 3294923 TI - Efferent projections of the suprachiasmatic nucleus: I. Studies using anterograde transport of Phaseolus vulgaris leucoagglutinin in the rat. AB - The efferent projections of the suprachiasmatic nucleus (SCh) in the rat hypothalamus have been reexamined with the anterograde tracer Phaseolus vulgaris leucoagglutinin (PHA-L), which displays labeled axons with the clarity of a Golgi impregnation. Fibers from the SCh can be divided into six pathways for descriptive purposes. By far the densest terminal field arising from cells in the SCh ends in a roughly comma-shaped zone between the SCh and paraventricular nucleus on the one hand and the periventricular nucleus and anterior hypothalamic area on the other. A few axons continue dorsally from this "subparaventricular zone" to pass through parvicellular parts of the paraventricular nucleus and the overlying midline thalamic nuclei to end in midrostrocaudal parts of the paraventricular nucleus of the thalamus, and a larger number continue caudally to end in the dorsomedial nucleus, dorsal parts of the cell-sparse zone surrounding the ventromedial nucleus, and the posterior hypothalamic area. The other five pathways all consist of relatively small numbers of fibers and give rise to relatively sparse terminal fields. The second pathway consists of rostrally directed fibers that end in ventral parts of the medial preoptic area and anteroventral periventricular nucleus. The third consists of anterodorsally oriented fibers that pass through the medial preoptic nucleus and adjacent regions to end ventrally in the intermediate lateral septal nucleus. The fourth consists of fibers just caudal to the third group that end in the preoptic continuation of the bed nucleus of the stria terminalis, as well as in the parataenial nucleus and rostral part of the paraventricular nucleus of the thalamus. The fifth consists of laterally directed fibers that course over the optic tract to end in the ventral lateral geniculate nucleus. And the sixth consists of fibers that course posteriorally through the anterior hypothalamic and retrochiasmatic areas to end in the cell-sparse zone between the arcuate nucleus and ventral parts of the ventromedial nucleus, as well as in adjacent parts of the lateral hypothalamic area. The distribution of projections labeled following PHA-L injections centered in the subparaventricular zone was also examined and was confirmed with retrograde tracer experiments (Watts and Swanson: J. Comp. Neurol. 258:230-252, '87). The results indicate that the subparaventricular zone projects to essentially the same regions as the SCh, only much more densely, and also sends fibers back to the SCh.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294924 TI - Localization of hydroxyindole-O-methyltransferase-like immunoreactivity in photoreceptors and cone bipolar cells in the human retina: a light and electron microscope study. AB - The localization of the melatonin-synthesizing enzyme hydroxyindole-O methyltransferase (HIOMT) was examined by light and electron microscopic immunocytochemistry in the human retina. HIOMT-like immunoreactivity was observed in the photoreceptor layers and the inner nuclear layer (INL). The immunoreactive cells in the INL were more numerous in the central retina than in the peripheral retina and sent processes to both the outer plexiform and inner plexiform layers. The HIOMT immunoreactivity in the inner plexiform layer (IPL) appeared as punctate terminals in the proximal and distal one-thirds of that layer. At the ultrastructural level, HIOMT-like immunoreactivity was localized to the cytoplasm of rod and cone photoreceptors and to a population of cone bipolar cells. HIOMT immunoreactive bipolar cell dendrites were observed to make both invaginating and flat synaptic contacts with cone pedicles. No immunoreactive invaginating contacts in rod spherules were observed. HIOMT immunoreactivity was observed in the bipolar cell cytoplasm in the INL, and in the bipolar synaptic terminals in the IPL. These terminals contained synaptic ribbons, which formed synaptic contacts with unlabeled cells in the IPL. HIOMT radioenzymatic assays confirmed the presence of HIOMT in the human retina. Average HIOMT activity of eight donors was determined to be 15.0 pmol/mg protein/hour +/- 7.2 S.D. The ultrastructural localization of HIOMT observed in this study, combined with reports from other laboratories, suggests that the cytoplasm of the photoreceptors and a population of cone bipolar cells may be the sites of melatonin synthesis in the human retina. PMID- 3294925 TI - The serotoninergic fibers in the dorsal lateral geniculate nucleus of the cat: distribution and synaptic connections demonstrated with immunocytochemistry. AB - The distribution, morphology, and synaptic contacts of serotoninergic fibers were studied with immunocytochemical methods in the lateral geniculate complex of the cat. The serotonin-immunoreactive fibers are diffusely distributed throughout the main laminae of the dorsal lateral geniculate nucleus (dLGN) and the perigeniculate nucleus (PGN) and reach a particular density in the ventral lateral geniculate nucleus (vLGN). The labeled fibers are in most cases very thin and sometimes varicose. There is no obvious order in their distribution pattern except that they sometimes partially encircle the unlabeled cell bodies of the dLGN. The synaptic connections of the serotoninergic fibers were investigated mainly in the A laminae of the dLGN. Few synaptic complexes were found, most of them with asymmetric morphology. The postsynaptic elements were small dendritic profiles. Perisomatic serotoninergic fibers were seen, but no convincing synaptic contacts were found between labeled fibers and cell somata. In the dLGN, serotoninergic profiles were almost exclusively confined to the extraglomerular neuropile. In the PGN serotoninergic fibers also contacted dendritic profiles and formed asymmetrical synapses, but as in the geniculate, synaptic specializations were very rare. PMID- 3294926 TI - Neuronal maturation in the normal and hypothyroid rat cerebellar cortex studied with monoclonal antibody MIT-23. AB - By immunocytochemistry we have studied the expression of the mitochondria associated polypeptide MIT-23 during the postnatal development of the normal and hypothyroid rat cerebellar cortex, in afferent fibers, and also in neurons of the cerebellar nuclei. The glial cells are never immunoreactive. In all neurons of the cerebellar cortex, MIT-23 expression always occurs after the final mitosis and migration are complete, and persists throughout adult life. Almost all MIT-23 expression begins postnatally. A few Purkinje cells are already immunoreactive at birth and the rest begin expression during the following two days. Immunoreactive Golgi and granule cells are found from postnatal day 4 (P4), basket cells from P10, and stellate cells from P16. Purkinje cells from different anteroposterior regions of the vermis express different levels of MIT-23 with higher staining intensities in lobules I to IV. These differences appear early in development and are retained in the adult. MIT-23 expression in the hypothyroid cerebellar cortex differs from that in control animals only in minor ways. However, sections immunoperoxidase-stained with anti-MIT-23 antibody reveal that, in addition to previously reported alterations in cerebellar development due to a shortage of thyroid hormones, Purkinje cell axonal development is slowed down in the hypothyroid condition, and occasional Purkinje cells in normal and especially in hypothyroid animals have their somata and or dendrites in ectopic locations. Analysis of these cells reveals a preferential direction of dendritic trunk growth in the direction of the molecular layer. Furthermore, secondary branching of ectopic dendrites is confined exclusively to the developing molecular layer, as in normal Purkinje cells, thus suggesting that neither the mature nor immature granule cell environment is sufficient to sustain normal dendritic development. PMID- 3294927 TI - Distribution of laminin and fibronectin along peripheral trigeminal axon pathways in the developing chick. AB - The trigeminal region of the chick was studied with indirect immunofluorescence in order to determine whether extracellular matrix components might be distributed in such a way as to guide trigeminal axons to their peripheral targets in the mandibular arch. Tissue sections from stages 13-15 and 21/22 were immunolabeled indirectly with affinity-purified antibodies raised against fibronectin and laminin, two extracellular matrix glycoproteins that support axon growth in vitro. Fibronectin was distributed ubiquitously throughout the head mesenchyme prior to and during initial axon growth from the brainstem (stages 13 15). Shortly after trigeminal axons reached their target tissues (stage 21/22), fibronectin immunolabeling was distributed throughout the head mesenchyme, but was present only at low levels in the trigeminal ganglion and motor nerve. Laminin immunolabeling was distributed in the lateral head mesenchyme at stage 13 as small specks and patches. At stage 14, when the motor axons first exit from the brainstem, short, linear arrays of laminin immunostaining were present from the basement membrane of the neural tube to the core of the mandibular arch, and many were parallel to the direction of axon growth. By stage 21/22 the trigeminal ganglion and motor root showed intense antilaminin immunofluorescence as did the central core of the mandibular arch. These studies suggest that the distribution of fibronectin within the head mesenchyme cannot give directional information to the growing trigeminal axons because of its homogeneous distribution. However, the initial distribution of laminin during the earliest stages of axon outgrowth may provide an extracellular matrix pathway that permits trigeminal axons to reach their targets. PMID- 3294928 TI - Gamma-aminobutyric acid- and glutamic acid decarboxylase-immunoreactive neurons in the retina of different vertebrates. AB - The localization of gamma-aminobutyric acid (GABA)- and L-glutamate 1 carboxy lyase (GAD)-immunoreactive neurons was compared in the skate, frog, pigeon, chicken, rabbit, and man. Horizontal cells show both GABA and GAD immunoreactivity in the skate, frog, and bird. Certain amacrine cells show GABA and GAD immunoreactivity in all species. The distribution of GABA- and GAD immunoreactive cell bodies and cell processes was very similar, if not identical, in the skate and man. In the other species, cell populations with GAD immunoreactivity also showed GABA immunoreactivity. However, in the bird, frog, and rabbit, the GABA-immunoreactive amacrine cells were at least twice as numerous as the GAD-immunoreactive cells. In birds, the distributions of the GAD and GABA immunoreactivities were different in the sublayers of the inner plexiform layer. The reason for the difference is currently unknown. GABA immunoreactive bipolar-like cells were seen in the frog. PMID- 3294929 TI - Distribution of GABA-immunoreactive neurons in the basal ganglia of the squirrel monkey (Saimiri sciureus). AB - The distribution of GABA-immunoreactive neurons was visualized in the basal ganglia of the squirrel monkey (Saimiri sciureus), by using a highly specific antiserum raised against GABA-glutaraldehyde-lysyl-protein conjugate and revealed by the indirect peroxidase-antiperoxidase immunohistochemical method. In the dorsal striatum, GABA-immunoreactive nerve cell bodies were small to medium in size (sectional area ranging from 90 to 125 microns2), but some larger ones (500 600 microns2) were also found. These cells displayed no obvious clustering but were significantly more numerous in the caudate nucleus than in the putamen; their number was also markedly greater at caudal than at rostral striatal levels. A moderate number of evenly distributed positive axon terminals were visible in both the caudate nucleus and the putamen. In the ventral striatum, GABA immunoreactive nerve cell bodies and axon terminals were seen in fair number within the nucleus accumbens and in the deep layers of the olfactory tubercle. Many positive terminals but no somata were found in the islands of Calleja. In the globus pallidus, virtually all nerve cell bodies were GABA-immunoreactive and the neuropil exhibited a multitude of positive terminals. In the substantia innominata, clusters of small, globular GABA-immunoreactive somata were scattered among aggregates of larger, nonimmunoreactive neurons belonging to the nucleus basalis, and the whole region showed a low to moderate number of evenly spread GABA-positive terminals. In the subthalamic nucleus, nerve cell bodies were generally surrounded by several GABA-positive terminals but were not themselves immunoreactive. The substantia nigra showed many GABA-immunoreactive somata, which predominated in the pars lateralis and diminished progressively in number along the lateromedial axis of the pars reticulata. These cells formed a rather pleomorphic group comprising round, fusiform, or polygonal elements of relatively large size (sectional area ranging from 200 to 800 microns2). In the pars compacta and ventral tegmental area, a few GABA-immunoreactive neurons of small size were dispersed among larger, unreactive neurons. In both pars lateralis and pars reticulata of the substantia nigra, the number of GABA-positive terminals was high and their distribution was rather uniform; a smaller number were visible in the pars compacta of the substantia nigra and in the ventral tegmental area. The present results demonstrate that GABA-containing neurons are widely and heterogeneously distributed in the various components of the squirrel monkey's basal ganglia.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294930 TI - The distribution of proenkephalin-derived peptides in the central nervous system of turtles. AB - The present study was carried out to examine if peptides similar to the various opioid peptide products of mammalian proenkephalin are present in the turtle central nervous system and to determine their distribution. Antisera against several enkephalin peptides were used: leucine-enkephalin (LENK), methionine enkephalin (MENK), methionine-enkephalin-arg6-phe7 (MERF), methionine-enkephalin arg6-gly7-leu8 (MERGL), Peptide E (PEPE), and BAM22P. Their specificity and cross reactivity were carefully examined. The results indicated that LENK, MENK, and MERF (or highly similar peptides) are present in the turtle central nervous system, and that a peptide showing immunological similarity to BAM22P and PEPE also appeared to be present. In contrast, MERGL did not appear to be present. The distributions of the immunoreactive labeling for LENK, MENK, MERF, BAM22P, and PEPE were indistinguishable, and double-label studies showed that LENK, MERF, and BAM22P were colocalized within individual neurons and fibers. Although all of the above substances were observed in the same cell groups, there was some regional variation, in terms of which enkephalin peptide appeared to be most abundant. The distributions of these enkephalin peptides were very similar to those previously described in mammals and birds. Enkephalin was more abundant in the basal ganglia than in overlying telencephalic regions. Within the basal ganglia, enkephalin was present in striatal neurons and fibers and in pallidal fibers, thereby suggesting the existence of an enkephalinergic striatopallidal projection. Sensory relay nuclei of the thalamus were generally poor in enkephalinergic fibers, whereas the hypothalamus was rich in enkephalinergic neurons and fibers. Enkephalinergic neurons and fibers were present in the midbrain central gray. As is true of neurons of the nucleus spiriformis lateralis of the avian pretectum, the neurons of the homologous cell group in turtles, the dorsal nucleus of the posterior commissure of the pretectum, were found to contain enkephalin and have an enkephalinergic projection to the deep layers of the ipsilateral tectum. Enkephalinergic neurons and fibers were also abundant in the entry zones of the trigeminal nerve and dorsal root fibers of the spinal cord.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294931 TI - Distribution and morphology of vasopressin-, neurophysin II-, and oxytocin immunoreactive cell bodies in the forebrain of the cat. AB - Experiments were done to provide a detailed map of the location and a description of morphological characteristics of vasopressin (AVP-IR)-, neurophysin II (NII IR)- and oxytocin (OXY-IR)-immunoreactive neuronal perikarya in the forebrain of the cat. In addition, the location of cells in the forebrain retrogradely labeled following injections of tracers into the neurohypophysis was determined. The distribution of AVP-IR and NII-IR was similar in all cases studied. Most of the cells containing AVP-IR and OXY-IR were observed in the hypothalamic paraventricular (PVH) and supraoptic (SON) nuclei. In addition, AVP-IR and OXY-IR cell bodies were found in the regions of the nucleus of the diagonal band of Broca, the dorsal chiasmatic nucleus, the anterior hypothalamic-preoptic area, the periventricular area, the nucleus circularis, the perifornical area of the lateral hypothalamus, the accessory SON, the area of the tuber cinereum (Tca), and the medial nucleus of the amygdala. The density of AVP-IR cells was greater than that of OXY-IR cells in these regions. Several forebrain areas were also observed to contain only AVP-IR perikarya: the suprachiasmatic nucleus (Sc), the bed nucleus of the stria terminalis, and the region of the substantia innominata and ventral globus pallidus (SI/GP). In addition, the dorsomedial nucleus of the hypothalamus only contained OXY-IR perikarya. Most of the cells immunoreactive to AVP were multipolar and had spinelike processes over their somata and proximal dendrites. In addition, the majority of cells in the PVH and SON were round or oval, whereas those outside these nuclei were fusiform or triangular. The mean somal area of AVP-IR cells in the region of the SI/GP was significantly (P less than 0.05) larger than that of AVP-IR cells in all other regions examined, whereas the mean somal area of Sc AVP-IR cells was significantly (P less than 0.05) smaller than that of all other groups of AVP-IR cells examined. Most OXY-IR cells were similar morphologically to those immunoreactive to AVP, except that OXY-IR cell bodies and their appendages did not have spinelike processes. In addition, OXY-IR perikarya were generally of uniform size. OXY-IR cells in the PVH and accessory SON were significantly (P less than 0.05) larger than AVP-IR cells in the same regions, but were not different from AVP-IR cells in the lateral hypothalamus and SON.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3294932 TI - GABAergic nonpyramidal neurons in intracerebral transplants of the rat hippocampus and fascia dentata: a combined light and electron microscopic immunocytochemical study. AB - Glutamate decarboxylase (GAD) immunocytochemistry was used to study GABAergic neurons and synapses in intracerebral allografts of the rat hippocampus and fascia dentata. Tissue blocks of regio inferior of Ammon's horn (hippocampal field CA3) or of the fascia dentata were taken from newborn rats and transplanted to the hippocampal region of young adult rats. After 6 1/2 months' survival the recipient brains were fixed by perfusion and serially sectioned on a Vibratome. Sections containing the transplant and/or the host hippocampal region were immunostained for GAD and flat-embedded in Araldite for a correlated light and electron microscopic analysis. Immunostained neurons and terminals in the transplants were compared to immunoreactive elements in the hippocampus and fascia dentata of the hosts and other, normal rats. As in the hippocampal formation in situ, GAD-immunoreactive neurons and terminals in the transplants were observed in all layers. In dentate transplants a preponderance of immunostained cells was found just beneath the granule cell layer. In both hippocampal and dentate transplants, immunoreactive terminals were most abundant in the cell layers where they formed characteristic pericellular baskets around the pyramidal and granule cell bodies. In the electron microscope, the transplant GAD-immunoreactive neurons exhibited numerous cytoplasmic organelles, deeply infolded nuclei, and nuclear rods. Immunoreactive terminals formed symmetric synaptic contacts on the cell bodies, dendritic shafts, and spines of transplant pyramidal cells, granule cells, and hilar neurons. These are normal characteristics of GAD-immunoreactive neurons and terminals as also observed in the hippocampus of the host rats and the normal controls. Our results demonstrate that GABAergic neurons survive transplantation and develop a cell-specific morphology that includes the axonal projections. PMID- 3294933 TI - Choline acetyltransferase-immunoreactive neurons and terminals in the rat septal complex: a combined light and electron microscopic study. AB - A monoclonal antibody against choline acetyltransferase (ChAT), the acetylcholine synthesizing enzyme, was used to determine the morphological characteristics of cholinergic neurons and axon terminals within the rat septum. Light microscopy revealed numerous large fusiform or multipolar ChAT-immunoreactive neurons in the medial septal nucleus/diagonal band complex (MSDB). In contrast, virtually no immunostained cells were found in the lateral septum (Nc. septalis dorsalis and Nc. septalis lateralis). Fine immunostained fibers were most abundant close to the midline in the MSDB mainly following an ascending course. A few thin ChAT immunoreactive fibers and terminallike pericellular punctate structures were observed in the inner part of the dorsal septal nucleus. Electron microscopy of ChAT-immunoreactive neurons revealed large cell bodies rich in cytoplasmic organelles. The cell nuclei regularly exhibited multiple invaginations of the nuclear membrane. Only rarely were terminals found that established synaptic contacts on the cell bodies of immunostained neurons. In contrast, numerous terminals formed synaptic contacts on immunoreactive dendrites. ChAT immunopositive terminals were studied in thin sections from the MSDB and from the dorsal septal nucleus. In both regions they appeared as heavily immunostained vesicle-filled boutons that established symmetric and asymmetric synaptic contacts. In the dorsal septal nucleus immunostained terminals often showed a basketlike arrangement around immunonegative cell bodies. Our fine structural study provides evidence that cholinergic neurons in the MSDB are similar to cholinergic neurons in the basal nucleus and neostriatum, which have been described by other investigators. The presence of cholinergic synapses in the septal complex indicates that this region not only contains cholinergic projection neurons, but receives a cholinergic input itself. PMID- 3294934 TI - Serotonin-containing structures in the nucleus raphe dorsalis of the cat: an ultrastructural analysis of dendrites, presynaptic dendrites, and axon terminals. AB - In the nucleus raphe dorsalis of the cat, an electron microscopic immunocytochemistry method was used to identify the fine structure of serotoninergic dendritic profiles and axon terminals analyzed in serial sections. Two classes of serotoninergic dendrites were distinguished in the nucleus. The first class was constituted by conventional serotonin (5-HT) dendrites that were contacted by unlabeled axon terminals containing differing populations of synaptic vesicles. The second class consisted of serotoninergic dendrites that contained vesicles in their dendritic shafts. Such 5-HT dendrites were further subdivided into two groups according to their synaptic contacts. In some 5-HT vesicle-containing dendrites, the vesicles were densely packed in small clusters and were associated with a well-defined synaptic specialization. These dendrites were classified as serotoninergic presynaptic dendrites and established synaptic contacts with unlabeled and labeled dendrites and were contacted by unlabeled axon terminals. In other 5-HT vesicle-containing dendrites, extensive serial section examination showed that the vesicles could be observed near the membrane but were never found to be associated with any synaptic membrane specialization. Serotoninergic axon terminals that were presumed to be recurrent collaterals of 5 HT neurons were present in the nucleus. Some of them were observed in synaptic contact with dendrites or dendritic protrusions whereas others did not exhibit synaptic specializations. The existence of serotoninergic dendrodendritic synaptic contacts and axon terminals suggests direct local interactions between serotoninergic neurons within the nucleus raphe dorsalis. PMID- 3294935 TI - Growth of axons into developing muscles of the chick forelimb is preceded by cells that stain with Schwann cell antibodies. AB - A study has been made of the development of limb and muscle nerves in relation to the first appearance of Schwann cells in the flexor digitorum profundus (fdp) and flexor carpi ulnaris (fcu) muscles of the avian forelimb. Schwann cells were identified by immunofluorescent techniques with antibodies to the glycoprotein HNK-1. Myotubes and nerves were identified by using antibodies to myosin and to neurofilament, respectively. At stage 24/25 the brachialis longus inferior (Bli n) and superior (Bls n) nerve trunks within proximal regions of the forelimb were surrounded by Schwann cells. These cells extended in a column for a distance of approximately 100 microns beyond the growing ends of nerves. At stage 26 both interosseus nerve (in n) and the medial-ulnar nerve (m-u n) had formed from the Bli n; each of these branches was surrounded by Schwann cells, which again extended approximately 100 microns beyond the growing ends of the nerves. By stage 26/27 the fdp and fcu muscles were clearly delineated by groups of myotubes. No nerves were detected within these groups; however, Schwann cells were observed between the myotubes. At stage 27 axons had left the in n and m-u n and grown into the fdp and fcu muscles, respectively. These axons were surrounded by Schwann cells. The present observations show that Schwann cells are located ahead of the main limb and muscle nerves as they grow into the fdp and fcu muscles of the limb. It is possible that these Schwann cells play a role in guiding nerves to their correct muscles in the developing chick forelimb. PMID- 3294936 TI - Nail changes associated with diabetes mellitus. AB - The varied systemic pathologic alterations that occur in patients with diabetes mellitus may result in profound changes that affect the nail unit. These findings vary from simple onycholysis to a spectrum of infectious processes, as well as extensive, irreversible destruction. The influence of the vascular and neurologic systems in producing these clinical findings is presented. The purpose of this review is to alert the physician to another aspect of diabetes mellitus, namely, its effect on the various components of the nail unit. PMID- 3294937 TI - Sterile eosinophilic pustulosis in dog and man: comparative aspects. AB - Sterile eosinophilic pustulosis is a rare dermatosis of dogs and humans. The clinicopathologic aspects of the disorder are similar in both species. In both the disease is characterized by a moderately generalized, pruritic, sterile, follicular and nonfollicular papulopustular dermatitis. Blood and tissue eosinophilia are usually present. Response to systemic glucocorticoids is better in dogs, probably because of the larger doses that can be used. The disorder is chronic and recurrent in both species. PMID- 3294938 TI - Hypervitaminosis A syndrome: a paradigm of retinoid side effects. AB - Retinoids have and will continue to revolutionize dermatologic therapy in a manner analogous to the development of topical corticosteroids. Isotretinoin, for example, has made nodulocystic scarring acne an eminently treatable condition. The dermatologic armamentarium now includes a powerful new agent, etretinate, which will radically change the approach to psoriasis (and other keratinizing disorders). Although each new retinoid is developed with the aim of maximizing specific therapeutic effects and minimizing toxicity, the fact remains that the major side effects of retinoid treatment are those of hypervitaminosis A syndrome. Optimal clinical utilization of new retinoids is best accomplished by an assessment of what is currently known about retinol absorption, metabolism and organ-specific effects, as well as by a thorough understanding of hypervitaminosis A syndrome. In this paper, hypervitaminosis A syndrome is reviewed as a paradigm of retinoid side effects. PMID- 3294939 TI - Genodermatoses. PMID- 3294940 TI - Pustular eruptions following administration of cefazolin: a possible interaction with methyldopa. PMID- 3294941 TI - Who is Nikolsky and what does his sign mean? PMID- 3294942 TI - A short history of German dermatology. PMID- 3294943 TI - Sir William Osler and the anatomical tubercle. AB - Tuberculosis of the skin resulting from direct inoculation of a tuberculin sensitive individual (tuberculosis verrucosa cutis) is a rare disease first described by Laennec. Various terms, including prosector's wart and the anatomical tubercle, have been used to describe these lesions, which were often acquired in the autopsy room. The disease usually remains local in those patients with acquired immunity from previous infection with tuberculosis. Sir William Osler possessed an abiding interest in pathology throughout his career and performed nearly 1,000 postmortem examinations. He describes the acquisition of numerous prosector's warts and their evolution and treatment. It is postulated that Osler was a tuberculin-sensitive individual at the time he acquired his anatomical tubercles. His contributions to dermatology are discussed. PMID- 3294944 TI - Bullous pemphigoid. AB - Bullous pemphigoid is an autoimmune blistering dermatologic disease characterized clinically by tense bullae that may develop on normal or erythematous skin. The major histologic feature is a subepidermal blister with variable degrees of dermal inflammation. Other immunologically mediated blistering skin diseases may mimic bullous pemphigoid, including herpes gestationis, cicatricial pemphigoid, dermatitis herpetiformis, and epidermolysis bullosa acquisita. These diseases will be discussed. Most patients with bullous pemphigoid demonstrate circulating autoantibodies reactive with an antigen located in the lamina lucida region of the basement membrane zone. Complement activation by these autoantibodies initiates influx and activation of mast cells along with other inflammatory cells. Tissue injury with damage and eventual destruction of the basement membrane occurs as a result of the release of inflammatory mediators. The final result is subepidermal blister formation. The course of bullous pemphigoid tends to be self-limited, and successful treatment is usually effected with systemic glucocorticosteroids. PMID- 3294945 TI - Effect of ultraviolet light on topical minoxidil-induced hair growth in advanced male pattern baldness. AB - Nine healthy men with type IVa or Va male pattern baldness completed a 4-month single-blinded controlled pilot study designed to assess the effect of ultraviolet light (UVL) on topical minoxidil-induced hair growth. Subjects applied 2% topical minoxidil solution twice daily to their balding scalps and to one target area on the upper arm. These men, all of whom had either skin type II or III, were randomized to also receive either incremental doses of UVB or PUVA (topical psoralen) twice weekly to one side of their scalp and to a 2.5 cm target area on the nonminoxidil-treated upper ipsilateral arm. Vellus, nonvellus, and total hair counts were done in two 1-inch in diameter circular target areas in symmetric regions of the scalp and on each upper arm at regular intervals. All nine subjects had an increase in target nonvellus hair and a net loss of vellus hair in scalp target area treated with topical minoxidil. Concomitant UVL did not have a significant synergistic nor adverse effect on topical minoxidil-induced hair growth. PMID- 3294946 TI - Comparative efficacy of two dosage forms of oral methoxsalen in psoralens plus ultraviolet A therapy of psoriasis. AB - Two alternate oral formulations of 8-methoxypsoralen, one liquid and the other crystalline, were evaluated in a double-blind trial for their comparative efficacy in combination with ultraviolet A (UVA) light in the treatment of severe psoriasis. With the liquid formulation a greater proportion of patients achieved a good clinical result within the 20 treatment sessions than patients receiving the crystalline formulation. This difference is even more striking using a more rigorous criterion of clearance. Among all patients who achieved clearance, no significant differences were seen in either the number of treatments required or in the total UVA energy employed between the two groups. The preceding clinical results are discussed in light of published pharmacokinetic data. PMID- 3294948 TI - Surgical cannulation of a hepatic vein in dairy cows utilizing diagnostic ultrasound. AB - Use of a diagnostic ultrasonography unit in the placement of hepatic vein catheters is described. Diagnostic ultrasound proved to be a safe and rapid means of identifying the hepatic venous circulation. It provided a clear visual guide in an otherwise blind surgical procedure and allowed for a precise determination of catheter placement. Thus, the method could be used to advantage in other types of catheterizations. Use of ultrasonography reduced the duration of surgery by 50 to 75%, thereby minimizing the risks associated with long-term general anesthesia and reducing recovery time. PMID- 3294947 TI - Multiple clear cell acanthomas. Case report and delineation of basement membrane zone antigens. AB - A case of multiple clear cell acanthomas is described with a review of the literature. This benign glycogen-rich epidermal tumor is generally unable to accept melanin and lacks phosphorylase or cytochrome oxidase activity. However, the basement membrane zone appears antigenically normal, as documented by the presence of epidermolysis bullosa acquisita antigen, bullous pemphigoid antigen, heparan sulfate proteoglycan, type IV collagen, and laminin by immunofluorescence microscopy. PMID- 3294949 TI - Natural protective factors in bovine mammary secretions following different methods of milk cessation. AB - Bovine mammary secretions were obtained during late lactation and early involution to determine if different methods of milk cessation influenced milk yield, composition, and in vitro growth of coliform mastitis pathogens. Cows (n = 8/group) producing about 13 kg of milk prior to experimentation were dried off by abrupt or intermittent milk cessation. An additional group was dried off by intermittent milk cessation and fed only hay during the last week of lactation. Cows milked intermittently produced significantly less milk during the last week of lactation than cows dried off by abrupt milk cessation. Mammary secretions from cows milked intermittently and fed only hay contained higher concentrations of somatic cells, lactoferrin, immunoglobulin G, and bovine serum albumin, a lower citrate:lactoferrin molar ratio, and were more inhibitory to in vitro growth of Escherichia coli and Klebsiella pneumoniae throughout most of the experimental period than mammary secretions from cows dried off by intermittent or abrupt milk cessation. Few differences in mammary secretion composition or in vitro growth of mastitis pathogens were observed between cows dried off by intermittent or abrupt milk cessation. Data suggest that growth of mastitis pathogens in mammary secretions may be related to natural protective factors, which can be manipulated by different methods of milk cessation. PMID- 3294950 TI - Direct bonded glass ionomer crowns. AB - After one year in function, the crowns appear to wear well, are well-retained, and remain esthetically pleasing. The glass ionomer filling materials show a great potential in restoring severely carious incisors with direct bond crowns. PMID- 3294951 TI - Nutrition and immunity: I. Basic considerations. II. Practical applications. AB - Nutrition, immunity and infection are intricately linked to one another. Nutritional deficiencies and excesses influence various components of the immune system. Early studies investigating the association between nutrition and immunity focused on generalized protein-energy malnutrition, particularly in children in developing countries. The extent of immunological impairment depends not only on the severity of malnutrition but on the presence of infection and on the age of onset of nutritional deprivation, among other factors. In industrialized nations, immune function has been shown to be comprised in many malnourished hospitalized patients, small-for-gestational-age infants and the elderly. Obesity also may adversely influence immune function. Imbalances of single nutrients are relatively uncommon in humans and investigations of protein and amino acids and specific vitamins, minerals and trace elements generally are carried out in experimental animals. Deficiencies of protein and some amino acids, as well as vitamins A, E, B6 and folate, and trace minerals are associated with reduced immunocompetence. In contrast, excessive intake of fat, in particular polyunsaturated fatty acids, iron and vitamin E are immunosuppressive. Knowledge regarding nutritional regulation of immunity is leading to many practical applications. PMID- 3294952 TI - Dental materials: 1984-85 literature review. Part 1. PMID- 3294953 TI - Microleakage of dentine-bonded posterior composite restorations. PMID- 3294954 TI - The effect of adherent oral streptococci on the subsequent adherence of Candida albicans to acrylic in vitro. PMID- 3294955 TI - Shear bond strength determinations on various kinds of luting cements with tooth structure and cast alloys using a new testing device. PMID- 3294956 TI - Contact angles: a note. PMID- 3294957 TI - The furcation involvement. Part I. Etiology and diagnosis. PMID- 3294958 TI - A look back at Abner Kurtin, M.D. PMID- 3294962 TI - References to contemporary papers on acoustics. PMID- 3294960 TI - Pneumoperitoneum as a sign of pulmonary barotrauma during artificial ventilation. PMID- 3294959 TI - Thoracic duct lymph and PEEP studies in anaesthetized dogs. I. Lymph formation and the effect of a thoracic duct fistula on lymph flow. AB - The effect of positive end-expiratory pressure ventilation (PEEP, 11-12 mmHg, 60 90 min without, 19 h with circulatory support) on fractional escape rate of plasma proteins (FER), and on thoracic duct lymph flow draining against jugular venous (LFJVP) or atmospheric pressure (LFAP) was studied in anaesthetized dogs. FER was 10.8%/h, 15.3%/h, and 8.5%/h before, during, and after PEEP, respectively, indicating augmented lymph formation probably due to the increase in venous pressure from 4.8 to 10.8 mmHg during PEEP. LFJVP was 39 microliter/min per kg before PEEP, decreased transiently during PEEP but the steady state value (up to 19 h) was not different from control, and increased transiently after PEEP. LFAP was 37, 80, and 38 microliter/min per kg before, during, and after PEEP, respectively. Long-term PEEP increased LFAP fourfold. Changing the drainage mode during PEEP yielded an immediate increase from LFJVP = 34 to LFAP = 79 microliter/min per kg and an instantaneous reduction from LFAP = 95 to LFJVP = 35 microliter/min per kg. Lymph protein concentration and protein lymph/plasma ratio increased concomitantly with LFAP during PEEP suggesting augmented hepatic contribution to LFAP, augmented intestinal contribution was revealed by labelling intestinal lymph using olive oil orally, muscular lymph flow was not increased as shown by i.m. Evans blue. In conclusion, the augmentation of venous pressure by PEEP promotes capillary filtration but obstructs lymph drainage from the thoracic duct into the jugular vein. PEEP imbalances formation and return of lymph and affects the development and removal of oedema. PMID- 3294961 TI - Use of phase contrast microscopy to determine the height of the organ of Corti in whole-mount preparations. AB - A technique has been developed to measure the height of the organ of Corti (OC) in the whole-mount preparations of the cochlear duct. The technique corrects for variations in the microscope system, such as the magnification of the objective lens and the mechanical properties of the fine-focus knob, as well as the refractive index of the embedding medium and the angle of specimens with respect to the optical axis of the microscope. At 11 percentage locations from apex to base, the height of the OC in ten chinchilla cochleas was measured at three positions: (1) the lateral edge of the inner hair cell (IHC); (2) the medial edge of the first row outer hair cell (OHC1); and (3) the lateral edge of the third row outer hair cell (OHC3). These measurements were compared to measurements made on radial sections from five other cochleas, with very good agreement at IHC and OHC3, and fairly good agreement at OHC1. The height at OHC3 varied almost linearly with percentage distance along the OC, ranging from 96 microns (apical end) to 51 microns (basal end). The height at the OHC1 varied from 77 to 49 microns, but did not vary linearly. The height of the IHC was relatively constant, from 50 to 60 microns, except at the basal end, where it decreased to 42 microns. PMID- 3294963 TI - Piracy: pirate or privateer. PMID- 3294964 TI - Strategic planning--outline of plan. PMID- 3294965 TI - The nature of the doctor of philosophy degree: evolving conceptions. PMID- 3294966 TI - A treasury of dentistry. PMID- 3294967 TI - Immunizations in college health: the remaining tasks. PMID- 3294968 TI - When should Doppler-determined valve area be better than the Gorlin formula?: Variation in hydraulic constants in low flow states. AB - In low flow states, underestimation errors occur when the Gorlin formula is used to calculate valve area. A model of valvular stenosis designed to examine changes in the hydraulic discharge coefficient (Cd) and coefficient of orifice contraction (Cc) may explain these errors. Unsteady flow was examined in a pulsatile pump model and in a dog model. Valve areas were calculated from pressure and flow data using: a modified form of the Gorlin formula (assuming constant values for Cd and Cc) and a corrected formula (with values of Cd and Cc obtained from steady state data). Valve area was also calculated using the continuity equation with velocity and flow data (constant Cc). Flow velocities were measured using a newly designed ultrasound Doppler catheter capable of resolving flow velocities of up to 5.5 m/s. Both the corrected formula and continuity equation were highly predictive of actual valve area (r = 0.99, slope or M = 0.96 and r = 0.99, M = 1.06, respectively). The modified Gorlin equation was less accurate and tended to underestimate valve areas (r = 0.87, M = 0.83). This underestimation was most notable at low rates of flow (Gorlin: r = 0.94, M = 0.53; continuity: r = 0.93, M = 0.81 and r = 0.94, M = 0.89, respectively) more accurately than the modified Gorlin formula (r = 0.69, M = 0.49). In patients with low cardiac output, hemodynamic formulas, such as the Gorlin formula, which assume a constant value for the hydraulic discharge coefficient (Cd), may be less accurate than formulas using either a corrected value of Cd or Doppler-determined flow velocity and mean systolic flow. PMID- 3294969 TI - In vitro color flow, pulsed and continuous wave Doppler ultrasound masking of flow by prosthetic valves. AB - On the hypothesis that Doppler ultrasound fails to penetrate prosthetic valves, an in vitro flow simulation system was constructed in a large water tank. Conventional pulsed, continuous wave and Doppler color flow systems were used to detect flow in tubing placed diagonally within the water and maintained by a continuous pump. After control periods of flow detection within the tubing, six different prosthetic valves were interposed on a stage between the transducer and the tubing. In comparison with control measurements, detection of flow within the tubing was impossible when the Doppler beam traversed the central occluding ball of the Starr-Edwards Silastic prosthesis by any modality. Marked reduction in the detection of the Doppler signal was noted for the Starr-Edwards stellite prosthesis with only slight improvement in the ability to detect the flow signals through the central occluding discs of the Bjork-Shiley, Hall-Kastor and St. Jude valves. In distinction to the other valves, the ability of Doppler ultrasound to detect flow behind the cusps of the Carpentier-Edwards heterograft was similar to that during the control period. An understanding of flow masking should improve the clinical utility of Doppler methods for investigating prosthetic valve dysfunction. PMID- 3294971 TI - The ionic basis of the anti-ischemic and anti-arrhythmic properties of magnesium in the heart. AB - The role of magnesium (Mg) in the prevention of ischemia-induced injury during cardioplegic arrest and in the treatment of cardiac arrhythmias has been considered. Although Mg possesses negative inotropic properties, potassium (K) is more effective than Mg in inducing cardiac arrest. The rationale for the inclusion of Mg in cardioplegic solutions therefore lies not in its cardioplegic properties, but in its ability to influence other cellular events such as the loss of Mg and K and perhaps to counter the detrimental effects of ischemia by antagonizing calcium (Ca) overload. Most of the Mg in the cardiac cell is complexed with high energy phosphate compounds and the loss of Mg during ischemia may restrict the repletion of ATP upon reperfusion and so impair the return of normal contractile function. The ability of Mg to limit K efflux from the cell is of importance not only in the prevention of ischemia-induced K loss but also in the treatment of digitalis-induced arrhythmias. Elevation of extracellular Mg has been shown to reduce the intracellular sodium ion activity ([Na]i) and this decline in [Na]i can be related to the negative inotropic properties of Mg. Mg may therefore exert some of its antiarrhythmic and antiischemic effects by limiting [Na]i-stimulated Ca influx (or facilitating Ca efflux) and hence preventing cellular Ca overload. PMID- 3294970 TI - Efficacy of propafenone in Wolff-Parkinson-White syndrome: electrophysiologic findings and long-term follow-up. AB - The efficacy and safety of intravenous propafenone was studied in 10 patients with Wolff-Parkinson-White syndrome and in 2 patients with a concealed accessory pathway. During electrophysiologic study, the effect of propafenone on the effective refractory period of the accessory pathway was determined, as well as its effect during orthodromic atrioventricular (AV) reentrant tachycardia and atrial fibrillation. Propafenone caused significant increases in the accessory pathway refractory period, both in the anterograde direction (290 +/- 19 versus 474 +/- 50 ms, p less than 0.05) and in the retrograde direction (238 +/- 15 versus 408 +/- 44 ms, p less than 0.05). Complete anterograde accessory pathway conduction block occurred in four patients. Sustained AV reentrant tachycardia was inducible in 11 patients before administration of propafenone. Drug infusion during AV reentrant tachycardia promptly terminated arrhythmia in 10 of these 11 patients and caused slowing of AV reentrant tachycardia in the remaining patient. Before propafenone, sustained atrial fibrillation was inducible in six patients and nonsustained atrial fibrillation in four patients. After propafenone, no patient had inducible sustained atrial fibrillation. Furthermore, propafenone caused a marked decrease in peak ventricular rate during atrial fibrillation. Eight patients have been treated with oral propafenone and followed up for 12 +/- 2 months. All have remained virtually free of recurrent arrhythmia and none has developed significant side effects. Propafenone is a very promising agent for emergency intravenous therapy as well as long-term oral therapy in patients with Wolff-Parkinson-White syndrome. PMID- 3294972 TI - Diet and diabetes, a brief overview: personal perspective. AB - Over the past several years there has been renewed interest in the dietary management of persons with diabetes. Many of the older concepts are being questioned and dietary recommendations are being revised. A uniform concensus regarding the best diet for insulin-requiring diabetic persons is not available. In my opinion, the best diet, considering our state of knowledge and the limitations imposed by current treatment modalities, is a diet that is most acceptable to the patient as long as it is nutritionally adequate. Once a diet is decided upon, constancy of carbohydrate (CHO) content for each meal is emphasized. A diet low in fat and containing approximately 50-60% CHO is desirable but is not as important as patient compliance. A stable reduction in the plasma glucose concentration in these patients should be the overwhelming objective. Dietary management of non-insulin requiring diabetic persons remains uncertain and controversial. Much more scientific data are needed before dietary recommendations can be made. Nevertheless, one can educate patients regarding CHO containing foods which have a large effect on the postmeal glucose concentration (cooked potatoes and cereal products such as bread and breakfast cereals) and those which produce a smaller effect (milk and milk products, fruits, vegetables, table sugar, and honey). With the interest in the dietary management of diabetic patients at the present time, I look forward to rapid progress in this field and resolution of the current controversies. PMID- 3294973 TI - Systemic and renal hemodynamic consequences of manipulation of serum calcium and/or parathyroid hormone in the intact conscious mongrel dog. AB - Studies were undertaken in conscious mongrel dogs to separate the systemic and renal hemodynamic effects of alterations in serum calcium (Ca) from those of parathyroid hormone (PTH) in an intact conscious animal. Blood pressure was measured intra-arterially, cardiac output was determined by dye-dilution or thermodilution, total peripheral resistance (TPR) was calculated from standard formulae, and renal hemodynamics were estimated by the clearance of inulin and para-aminohippurate. Measurements were made before and after a 2 hour calcium chloride (CaCl2) infusion in 10 dogs (group 1). These animals had previously received a dose of PTH to prevent suppression of PTH during the CaCl2 infusion. Ionized calcium (Ca++) and TPR increased significantly. Blood pressure increased but not significantly. Administration of EDTA did not significantly change any systemic hemodynamic variable in eight thyroparathyroidectomized dogs (group 2). Chelation in seven dogs with intact parathyroid glands (group 3) reduced mean arterial blood pressure and total peripheral resistance. Renal hemodynamic measurements were not affected. Isolated acute elevation of serum Ca++, independent of suppression of PTH, increased total peripheral resistance. Decreased serum Ca++ required normal activity of parathyroids to reduce total peripheral resistance. The renal circulation was resistant to acute manipulation of ionized serum calcium and PTH. CaCl2 infusion to intact dogs (group 1) decreased serum magnesium significantly, increased urine flow rate, and decreased urinary PGE2 excretion. Comparisons between group 2 and group 3 revealed a greater decline in serum Mg and urinary prostaglandin E2 excretion in group 2 vs group 3. Elevation of peripheral resistance due to acute Ca elevations was accompanied by decreased serum Mg and decreased renal prostaglandin excretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3294974 TI - Pulmonary reaction to environmental pollutants. PMID- 3294975 TI - Allergy to insects in Japan. III. High frequency of IgE antibody responses to insects (moth, butterfly, caddis fly, and chironomid) in patients with bronchial asthma and immunochemical quantitation of the insect-related airborne particles smaller than 10 microns in diameter. AB - After recognizing that moth, butterfly, caddis fly, and chironomid were the insects predominantly found in our environment, reaginic sensitivities to these insects in patients with asthma were investigated with extracts of silkworm wing for the detection of moth and/or butterfly allergy, caddis fly wing for caddis fly allergy, and chironomid whole body for chironomid allergy. At least 50% of 56 randomly selected patients with asthma had positive intracutaneous reactions to these insect extracts, and at least 80% of the skin reaction positive patients had specific IgE antibodies. An immunochemical assay of these insect-related aeroallergens in the dust collected 18.6 m above ground revealed the presence in the air of insect-related particles less than 10 microns in diameter with two peaks a year, one in the spring (silkworm wing, 3.18 ng protein equivalent to that of the crude extract per cubic meter of air; caddis fly wing, 3.08 ng/m3; and chironomid whole body, 5.21 ng/m3) and one in the autumn (silkworm wing, 8.24 ng/m3; caddis fly wing, 4.74 ng/m3; and chironomid whole body, 18.19 ng/m3). Although we have no idea whether or not such peak values are enough to cause asthmatic symptoms, seasonal fluctuations of specific IgE antibodies to these insects appeared to be similar to those of atmospheric insect allergens measured by this method. These findings suggest that insects are widespread and common inhalant allergens. PMID- 3294976 TI - Use of bronchial provocation with histamine to compare the pharmacodynamics of inhaled albuterol and metaproterenol in patients with asthma. AB - Because measurement of effects on airway responsiveness may have advantages over the study of bronchodilatation for the evaluation of the effects of inhaled beta 2-agents, we developed a method using airway responsiveness for the independent quantitation of the relative potencies and rates of decline in effect of these drugs. This methodology was applied to the evaluation and comparison of inhaled metaproterenol and albuterol. The effects of two different doses of each drug (one and two inhalations of albuterol and two and four inhalations of metaproterenol from commercially available metered-dose inhalers) were compared with a double-blind, randomized, placebo-controlled, crossover study of 13 subjects. The effects of metaproterenol and albuterol declined at rates that were not significantly different. However, based on the effects on activity ratio at 30 minutes, each puff of metaproterenol was an estimated 0.37 times as potent as each puff of albuterol (95% confidence limits, 0.22 to 0.52). In recommended two puff doses, measurable effects of albuterol persisted longer than effects of metaproterenol. However, this appears to be because of a greater initial effectiveness of two puffs of albuterol rather than differences in the rates at which the effects of the two drugs declined with time. Airway responsiveness thus appears to be a useful tool for evaluating inhaled beta 2-agonists and designing beta 2-agonist dosing regimens. PMID- 3294978 TI - Nifedipine treatment of patients with bronchial asthma. AB - Nifedipine, 30 mg/day for 4 weeks, was compared to placebo in a double-blind, randomized, crossover study, as an additional drug added to the usual treatment of 14 patients with bronchial asthma. Nifedipine did not significantly change peak expiratory flow rates or subjective symptoms like cough, sputum, wheezing, shortness of breath, or disturbed sleep. Nifedipine did not decrease the number of salbutamol rotacaps inhaled per day. Arterial blood pressure significantly decreased (p less than 0.01) after nifedipine treatment, and side effects (headache and flushing) were not uncommon. In this study, long-term treatment with nifedipine had essentially no effect on subjective symptoms at peak expiratory flow rates. PMID- 3294979 TI - Brown adipose tissue: regulation of thermogenesis and implications for obesity. AB - The role of brown adipose tissue in the development and maintenance of obesity has been a recent focus of research efforts. Brown fat serves as a heat-producing tissue, via nonshivering and diet-induced thermogenesis, because of a unique mechanism that uncouples oxidative phosphorylation. The importance of these forms of thermogenesis to energy balance has been characterized in animal models of obesity; increased metabolic efficiency has been attributed to impaired heat production and compositional and functional alterations in brown fat. Although the possibility exists that human obesity may partly result from inadequate thermogenesis, evidence that the defect is related to brown fat is tenuous. Currently, the contribution of brown fat to metabolic rate in human beings has been estimated as minor. However, even if it is found that differences in brown fat cannot explain differences in corpulence, interest in the tissue will likely continue. Because of its ability to waste calories, the potential for manipulating body weight by stimulation of brown fat remains a promising field of investigation. PMID- 3294977 TI - A dose-response study of the bronchodilator action of azelastine in asthma. AB - Azelastine is an orally effective inhibitor of mediator activity in allergic reactions and has also been demonstrated to have bronchodilator activity. In this randomized, double-blind, placebo-controlled, multicenter study, 150 patients, aged 12 to 60 years, with moderate to severe asthma, received a single oral dose of 2, 4, 8, 12, or 16 mg of azelastine or placebo. Theophylline was stopped 24 hours and other bronchodilators at least 8 hours before the study day. Patients were evaluated for 8 hours after dose by spirometry and were monitored for adverse effects. All doses of azelastine produced bronchodilation with 4 mg greater than 2 mg greater than placebo; higher doses did not increase magnitude or duration of effect. We conclude that azelastine produces significant bronchodilation of long duration. The optimal dose appears to be 4 mg for adolescent and adult patients with asthma. PMID- 3294980 TI - Breast cancer: incidence, nutritional concerns, and treatment approaches. AB - Breast cancer is the leading cause of cancer death in women in the United States. Western cultural factors, such as high socioeconomic status, early age of menarche, and late age at first pregnancy, may be risk factors in the development of breast cancer. A strong positive correlation exists worldwide between fat consumption and breast cancer. Case-controlled studies also support an association of a high-fat diet and breast cancer. Animal studies using rats or mice have verified that fat is a promoter of breast cancer after exposure to a known chemical carcinogen. A high-fat diet resulted in a higher incidence of breast tumors than a low-fat diet. Recent rodent studies further suggest that a reduction in calories alone reduces breast cancer incidence. Furthermore, studies reveal that the 5-year survival is about 80% after appropriate therapy (surgery, radiation, and/or chemotherapy) for breast cancer, with early detection by self examination as the first step to improve outcomes. Excision of the breast tumor (segmental mastectomy) and some surrounding normal tissue followed by radiation therapy can be as effective therapy for most small breast cancers as total or radical mastectomy. The authors strongly recommend obtaining medical evaluation for any lump or thickening in the breast and following good dietary practices. PMID- 3294981 TI - Symptomatic gastroesophageal reflux in the elderly. PMID- 3294982 TI - Medicare ... at last! PMID- 3294983 TI - Some tips for new Medicare providers. PMID- 3294984 TI - Journal of the American Psychoanalytic Association: a retrospective (1953-1972). PMID- 3294985 TI - The case of Anna O.: a neuropsychiatric perspective. AB - Previous interpretations have not adequately explained the presence of focal neurological signs, delirium, and a variety of highly specific disturbances of perception, language, and sensorium in the case of Anna O. Examination of the neurological details suggests that Anna suffered from complex partial seizures exacerbated by drug dependence, and that she developed conversion symptoms patterned after the preexisting organic pathology. Hysterical conversion symptoms that mimic ictal events are not uncommon in psychomotor epilepsy. Recent neuropsychiatric models of hysteria are remarkably similar to the hypnoid states theory Breuer formulated, based on his observation of Anna O. The hypothesis presented here does not conflict with previous psychodynamic interpretations. I submit that it was the development of a conversion disorder patterned on actual organic phenomena, which highlighted for Breuer and Freud the "psychical mechanism" of somatic symptoms, thus paving the way for the important psychodynamic discoveries for which the case is remembered. PMID- 3294986 TI - A comment on Frank R. Hartman's "A reappraisal of the Emma episode and the specimen dream". PMID- 3294987 TI - [Ultrasonic aspects of combined hamartoma of the pigment epithelium and retina]. AB - The combined hamartoma of the pigment epithelium and retina is a rare developmental tumor characterized by a plaque of thickened retinal pigment epithelium, gliotic and disorganized retina, tortuous retinal and disc vessels, preretinal fibrosis. The ophthalmoscopic and fluorescein angiographic features of the combined hamartoma of the pigment epithelium and retina are widely described in the literature, while the echographic findings are very rarely reported. In the case described here A-scan echography showed that, in the tumor area, the retinal peak was separated from the choroido-scleral peak by an acoustically silent space. B-scan echography revealed a thick and detached retina. The echographically silent subretinal space corresponds to a serous detachment of the macular retina. This lesion, infrequently reported in association with the combined hamartoma, probably depends on the exudation of the retinal vessels and the traction of the hamartoma on the macula. In addition, the echography allowed us to exclude an extension of the lesion to the choroid and the sclera. The electroretinogram and the electro-oculogram were normal as in such localized lesions of the fundus. PMID- 3294988 TI - [Malignant atrophic papulosis (Degos' disease): clinical review. Apropos of a case]. AB - Malignant atrophic papulosis was first described by Degos in 1942. It is an occlusive arteriopathy involving small caliber vessels in the whole organism. Ocular involvement was reported in 35 out of the 105 observations published so far. The ophthalmological symptoms were reviewed and compared to a personal case. They consist of either involvement of the eye tissues with a predominance of the conjunctiva (but also sclera, episclera, retina, choroid and optic nerve), or of neuro-ophthalmological lesions. Up to now, both etiopathogeny and appropriate treatment of the disease remain unknown. PMID- 3294989 TI - Residues and mutagenicity of captan applied to apple trees and potential human exposure. AB - The fungicide captan (cis-N-((trichloromethyl)thio) 4-cyclo-hexene-1,2 dicarboximide) was applied at the rate of 2.4 g/l to apple trees (c.v. Golden Delicious) individually or as part of a standard treatment program where it was applied eight times during the growing season together with several pesticides. Leaf samples (100 discs of 2.2 cm diameter) were collected from treated and control trees before treatment and at 0, 1, 3, 7, 14, 28, 56, 90 and 112 days after treatment. Fruit samples were taken at mid-season (56 days) and at harvest (112 days). The objective of this study was to determine the captan residue and mutagenicity of leaf and fruit extracts to ascertain the potential health hazard to agricultural workers in these orchards. Surface residues were extracted from leaves and fruits with methylene chloride. These extracts were subsequently analyzed for captan by gas-liquid chromatography (GLC) utilizing an electron capture detector, and for mutagenicity with two strains (TA98 and TA100) of Salmonella typhimurium, with and without microsomal enzyme activation. Positive mutagenic effects were observed with strain TA100 at 0-14 days post spray, even with extracts from one leaf disc's surface (3.8 cm2) of the single treatment. Captan residues in these samples indicated a decline from 9.3 micrograms/cm2 at 0 days to 0.80 micrograms/cm2 at 14 days and a trace after 112 days. With the standard treatment, in which captan was incorporated eight times in the program starting at the 7-day interval, leaf extracts showed mutagenic activity at 7, 14, 28 and 90 days. Captan residues at these intervals were 11.4, 5.0, 4.1 and 3.4 micrograms/cm2, respectively. Fruit sample extracts of the standard spray were mutagenic to the tester strains TA100 and TA98 both at mid-season and at harvest. Residues of captan on fruits declined from 10.4 micrograms/cm2 at mid-season to 1.1 micrograms/cm2 at harvest. No mutagenic activity was detected with extracts from fruit samples from the single captan application. PMID- 3294990 TI - The effects of paraquat on Escherichia coli: distinction between bacteriostasis and lethality. AB - Paraquat exerted a progressively more pronounced bacteriostatic effect on Escherichia coli as its concentration was raised in the range 0-1.0 microM. In contrast, concentrations of 100 microM or greater were required before significant lethality could be observed. This bacteriostatic effect of paraquat could be eliminated by supplementation of the glucose-plus-salts medium with either yeast extract or a casein hydrolysate. This protection was seen whether the supplement was added a few minutes prior to or following the addition of paraquat and was thus not due to the inhibition of active uptake of paraquat by the cells. The lethal effect of high levels of paraquat was not influenced by supplementation of the medium with yeast extract. It follows that the bacteriostatic and lethal effects of paraquat involve attack upon distinct targets within the cell. PMID- 3294991 TI - Delay of UV-induced eye lens protein damage in guinea pigs by dietary ascorbate. AB - Large accumulations of postsynthetically oxidized proteins are observed in the aged and cataractous eye lens. Ascorbate has previously been used to delay photooxidative damage in vitro. The goals of this study were to confirm that dietary ascorbate can be used to enhance lens ascorbate levels and to determine if lenses with enhanced ascorbate can better withstand photooxidative stress in the form of ultraviolet (UV) light exposure. Guinea pigs were placed on high dietary ascorbate (HDA), 50 mg/day, and low dietary ascorbate (LDA), 2 mg/day, for 21 weeks. Lenses from HDA animals were found to contain 3.3 times more ascorbate than LDA animals. Prior to irradiation, SDS-PAGE protein profiles and exopeptidase activity in HDA and LDA lens soluble proteins were indistinguishable. However upon exposure to UV light, more protein damage (e.g., high-molecular-weight aggregates and enhanced loss of exopeptidase activity) was seen in lens preparations from LDA as compared to HDA animals. These results suggest that ascorbate protects lens components against cataract-like and age related postsynthetic changes in vivo. As in previous tests on lens preparations, attenuated exopeptidase activity was observed before protein aggregation. PMID- 3294992 TI - Endogenous antioxidant defenses in neonates. AB - Deficiencies of antioxidant defenses have been postulated as possible mechanisms in the development of bronchopulmonary dysplasia (BPD). Neonates, especially prematures with respiratory distress syndrome (RDS), are exposed to high oxygen tensions for prolonged periods. To evaluate the neonates' ability to respond to an oxygen challenge with increased superoxide dismutase (SOD), 9 prematures were studied immediately at birth and on days 1, 3, 5, and 7. An increase in plasma levels was noted during the first week of life in the patients who were exposed to oxygen. The mean endogenous SOD level at birth was 1.28 microgram/ml. On day 1, plasma SOD rose to 1.53 microgram/ml and to 2.25 micrograms/ml on day 3 (P = .003). This trend continued into the fifth and seventh days. Whether this increase in SOD has clinical significance in the prevention of BPD requires further investigation. PMID- 3294994 TI - [Doppler examination of the umbilical arteries. Its role in the surveillance of pregnancy]. AB - Pregnancies with a high risk of fetal growth retardation are at present watched by using clinical observations and biological parameters including ultrasound and estimation of the fetal heart rate. The Doppler waveform in the umbilical arteries provides information about circulatory resistance in the placenta. An index of resistance "R" is evaluated on the Doppler trace. The purpose of this study is to describe the score (with its possibilities and limitations) for this parameter "R" to follow-up pregnancies with fetal growth retardation and to compare it with ultrasound, biological and clinical parameters that are commonly used. Two groups of pregnancies have been explored: pregnancies with hypertension and pregnancies with idiopathic fetal growth retardation. Abnormal values of "R" correlate well with failure of fetal growth. Furthermore pathological values of "R" do not correspond to the same population as abnormal values of the other parameters. In some cases "R" is disturbed before the others are. In conclusion, this study shows that the index increases the accuracy of detection and the follow-up of chronic fetal growth retardation, particularly in cases of pregnancies with vascular placental pathology. PMID- 3294996 TI - [Early detection of ureteral injuries associated with hysterectomy. A prospective echographic study]. AB - Among ureteral injuries that occur during hysterectomy some are neglected and remain asymptomatic. They occur even, although not particularly, during so-called easy operations. Their severity and their need for early treatment point to the use of effective screening. It is not possible to carry out intravenous urography routinely. Searching, however, for pyelo-calyceal dilatation by ultrasound of the kidneys can show ureterohydronephrosis and can detect ureteral trauma. The authors carried out such ultrasound controls in 150 consecutive patients the day before, and the fourth and ninth days after hysterectomy. On the fourth day pyelo calyceal dilatation is seen more frequently but is not large. Large dilatation appearing on the fourth postoperative day may be considered an early and reliable sign of suspect injury. The authors suggest that renal ultrasound should be carried out routinely on the day before and the fourth day after hysterectomy. The authors feel that when dilatation of the pyelo-calyceal area increases by 12 mm or more between the two examinations major ureteral injury must be suspected and urography carried out intravenously. PMID- 3294995 TI - [Doppler examination of the umbilical and cerebral arterial circulation of the fetus]. AB - Umbilical circulation can be explored by Doppler ultrasound methods very easily. The umbilical arteries spectrum provides information on the placental circulation. The diastolic flow is directly related to the vascular resistances of the placenta (Rp). In cases of pathological pregnancies with hypertension the decrease in the diastolic flow and the increase in the resistance index Rp have been correlated with intra-uterine fetal growth retardation. The specificity of this index Rp is of 95% but the sensitivity much more lower (approximately 70%). For that reason Doppler assessment of the fetal circulation in other areas has been recently carried out. Fetal cerebral arteries have been explored during normal pregnancies. The index of cerebral resistances as defined by Pourcelot Rc = S-D divided by S (with S systolic amplitude and D diastolic amplitude) show similar variations to the placental index but later in the pregnancy. During the pregnancy the cerebral index is higher than the placental one and the cerebro placental ratio (CPR) superior to 1. During pathological pregnancy (hypertension) with fetal growth retardation one of the index Rc or Rp may be out of the normal range but the cerebro placental ratio CPR is always lower than 1. The follow up of both the umbilical and cerebral circulation increases notably the accuracy of the Doppler method for the detection of intra-uterine fetal growth retardation. PMID- 3294997 TI - [Prenatal echographic diagnosis of iniencephaly. Apropos of a case]. AB - Iniencephaly is a rare lethal malformation. It is associated with a defect in the occiput, alterations in the spinal column that are variable and retroflexion of the fetus. Antenatal diagnosis by ultrasound is possible because of the typical appearance: the fetal head is hyperextended, with distortion and shortening of the cervical spine. The occiput can be fused with lower vertebrae. Many associated malformations may be found: polyhydramnios, neurologic, facial and visceral abnormalities. PMID- 3294993 TI - Plummer's disease: localized thyroid autonomy. PMID- 3294998 TI - [Intrauterine growth retardation. Changes in obstetrical practice in France]. AB - The change in practice in connection with fetal growth retardation was studied using two national enquiries on pregnancy and delivery carried out in 1976 and 1981. These showed important changes in practice between the two studies. Although ultrasound and fetal heart rate monitoring are widely used and are shown as being very important for pregnancies overall, they are not used more often in cases of fetal growth retardation. On the other hand, when they have been started these examinations are more often easily repeated. Recourse to hormonal essay has not changed in intra-uterine growth retardation cases (17%). The percentage of caesareans carried out for retardation rose from 9.4 to 17.4% and these caesarean operations were carried out earlier. 50% of this increase is due to the decision to carry out a caesarean before labour starts. This more aggressive tendency means that the number of premature babies in growth retarded infants was higher in 1981, although the difference not significant and this practice would need further study. There are improvements in neonatal health as a result of the changes although one cannot pinpoint for certain which procedure has caused this improvement. PMID- 3294999 TI - [Labeling of testicular biopsies with lectins. Value of Evonymus europaeus agglutinin]. AB - EEA was used to label testicular biopsies with 11 other lectins and three monoclonal antibodies anti blood group A, B, H substances. Although EEA's receptor chemical structure is still unknown and an electron microscopic control necessary, it is possible to use this lectin to label proacrosomic vesicles of spermatids in man and animal, allowing useful comparisons between species. The intensity of the reaction makes it interesting in the standard study, even automatized, of every testicular biopsy. PMID- 3295000 TI - [Renal ultrasonic diagnosis in pregnancy. Prospective study of pyelo-calyceal changes in the mother and their obstetric implications]. AB - An acute pyelonephritis is still a serious complication of pregnancy. Urinary stasis plays an important role in the pathogenicity of this infection. 232 patients without symptoms were studied to find out how much urinary stasis occurred by measuring dilatations of the pyelo-calices by ultrasound. The authors suggest that a correlation between the bacteriological examination of the urine and the ultrasound appearance of the kidney can be established. Asymptomatic urinary infection occurs more frequently when there is dilatation of the pelvis of the kidney greater than 12 mm in the right kidney and 7 mm in the left. This is why they suggest that an ultrasound examination of the hilum of the kidney should be carried out routinely to screen for patients who are at risk of having pyelonephritis in pregnancy. PMID- 3295001 TI - [Ruptured lutein cyst associated with undiagnosed contralateral tubal pregnancy]. AB - We are dealing with the case of a patient suspected of ectopic pregnancy. Laparoscopy showed a ruptured corpus luteum on the right side with haemoperitoneum. Four days after her discharge, she came back with a ruptured ectopic pregnancy in the outer third of the left tube. We emphasize the difficulties of an early diagnosis of ectopic pregnancy and its etiology. PMID- 3295003 TI - Repair of severe muscle belly lacerations using a tendon graft. AB - Fourteen patients with 58 severe forearm muscle belly lacerations had muscle repair using tendon grafts. At mean follow-up of 14 months, results of manual muscle testing (N = 58) were: grade 5, 42%, grade 4, 14%, grade 3, 9%, grade 2, 9%, grade 1, 12%, and grade 0, 15%. Mean grip strength of the injured extremity, in pounds per square inch, was 33.5 compared with 83.4 on the noninjured side. Tendon excursion and joint mobility were maintained, and there were no postoperative complications. Tendon grafting of severe muscle lacerations is an effective method to overcome extensive defects. PMID- 3295002 TI - [Twin pregnancy combining a hydatidiform mole and a normal ovum]. AB - It is rare for a twin pregnancy to consist of a normally growing fetus and a hydatidiform mole. A differential diagnosis between a partial mole and a degenerating fibroid together with a normal pregnancy has to be made. This can be made using ultrasound pictures but also using cultures from trophoblast samples, or cultures from amniotic cells obtained by amniocentesis. These will eliminate the possibility of the triploidy by showing that there is a normal caryotype present. The complications and the risk of degeneration are the same as with a plain hydatiform mole. The uterus has to be evacuated and a follow-up has to be carried out to screen for trophoblastic proliferation. PMID- 3295004 TI - Recurrent granulomatous synovitis due to Mycobacterium kansasii in a renal transplant recipient. AB - A 61-year-old woman received a cadaveric renal transplant in 1972 and was maintained on chronic immunosuppression. Nonspecific granulomatous synovitis of the left hand developed in 1982. After recurrence of synovitis in 1984, surgical exploration of the left hand demonstrated "rice bodies" in a region of chronic synovitis from which Mycobacterium kansasii was isolated. Despite therapy with isoniazid, rifampin, and ethambutol, to which the organism was susceptible in vitro, synovitis recurred. Recovery was completed after extensive synovectomies, decreased immunosuppression, and 24-months of therapy, with the drugs listed above; there was no evidence of mycobacterial infection at sites other than the left hand at any time. The occurrence of persistent Mycobacterium kansasii infection is distinctly unusual even in transplant recipients. In patients refractory to conventional antituberculous therapy, surgical management should be considered as an important therapeutic component. PMID- 3295005 TI - Typhoid and its control. PMID- 3295006 TI - Defederalizing Medicaid: fair to the poor, fair to taxpayers? AB - This paper explores the access and equity implications to the poor and taxpayers of further defederalizing Medicaid program administration. New data on enrollees and tax incidence indicates little horizontal, let alone vertical, equity in the system. Styles of cost control are also examined, showing a systematic bias towards providers and taxpayers at the expense of the poor in penurious states. PMID- 3295007 TI - Health care financing among the elderly: who really pays the bills? AB - This paper investigates the issue of who pays the health care bills of the elderly by considering the types of subsidized health insurance protection enjoyed by the noninstitutionalized elderly and the way that increased Medicare cost-sharing efforts in the 1980s are affecting those without additional health insurance subsidies. In making this examination we estimate the out-of-pocket health care expenditures of the elderly either directly or as nonsubsidized medigap premiums by income level, taking into account four types of health insurance subsidies received by elderly persons: Medicare, Medicaid, Veterans Administration health care, and subsidized health insurance from either current or former employers. We find that increased cost sharing is likely to fall most heavily on those elderly least likely to afford it: the poor and near-poor elderly who have only Medicare as a health insurance subsidy, particularly those who are older and sicker and who use Medicare services more heavily. These persons are caught between well-intentioned federal cost-cutting efforts and the often confusing panoply of health insurance programs for the aged, and they will bear an inequitably large portion of any future Medicare cost-sharing initiatives. PMID- 3295008 TI - The effect of state regulations on the quality and sale of insurance policies to Medicare beneficiaries. AB - This paper examines the effects of state regulations on the quality of insurance policies sold to Medicare beneficiaries and on the amount of sales abuse reported in the sale of such policies. State regulations regarding such policies relate to policy content and format, minimum rates of return, sale of these policies related to disclosure requirements, consumer information activities, and penalties for agent and company abuse. This paper examines the impact of specific regulations on the ratio of the expected policy benefits per premium dollars and on the number and kind of abusive sales practices reported by purchasers and nonpurchasers in agent and mail sales. The study finds that loss ratio floors, minimum benefit standards, and the development of states of consumer information guides for prospective policyholders have a positive impact on the quality of the policies purchased. In addition, the study finds that the amount of abuse reported is less when insurance companies routinely issue press releases concerning agent or company misrepresentation and when consumer guides are developed and available from the state. PMID- 3295009 TI - Case report: Brown-Sequard's syndrome associated with histiocytic lymphoma. AB - Brown-Sequard's syndrome is a rare spinal cord lesion usually produced by penetrating injuries in which ipsilateral hemiparesis and loss of position sense is associated with loss of pain and temperature sensation on the opposite side of the body. Reported here is an unusual cause of the syndrome, and a review of the pathophysiology of the syndrome is presented. PMID- 3295010 TI - The origins of the gauge system for medical equipment. AB - The gauge system for sizing medical catheters and equipment is used widely around the world. Yet both its origins and its interpretation, in terms of conventional measurements, have long been obscure. The gauge, formally known as the Stubs Iron Wire Gauge, was developed in early 19th century England. Developed initially for use in wire manufacture, each gauge size arbitrarily correlates to multiples of .0010 inches. This sizing system was the first wire gauge recognized as a standard by any country (Great Britain, 1884). It was first used to measure needle sizes in the early 20th century. Today it is used in medicine to measure not only needles, but also catheters and suture wires. However, owing to the potential confusion inherent in using a gauge system, the iron wire gauge is rarely used in manufacture of nonmedical equipment. PMID- 3295011 TI - The new black magic: activated charcoal and new therapeutic uses. AB - Activated charcoal has been used for centuries as antidotal therapy for poisonings. New variations of charcoal therapy have developed over the last two decades. These modifications include multiple-dose activated charcoal (MDAC) therapy, charcoal hemoperfusion, and a new "superactive" charcoal (SAC). Recent literature suggests using initial charcoal therapy instead of ipecac as a first line antidotal agent for many acute poisonings. The palatability of charcoal slurries has been enhanced by the addition of carboxymethylcellulose, sucrose, saccharin, chocolate syrup, or sorbitol. The new SAC has shown to adsorb 1.7 to 4 times the amount of substance tested compared with other activated charcoal preparations. Multiple-dose activated charcoal therapy has been shown effective in treating phenobarbital, digoxin, digitoxin, theophylline, and dapsone intoxications, among others. The problems associated with charcoal hemoperfusion therapy have been partially alleviated, and it is now alternative therapy for the seriously intoxicated patient. PMID- 3295012 TI - Phenytoin hypersensitivity syndrome. AB - The clinical manifestations of the phenytoin hypersensitivity syndrome are reviewed. The main symptoms of cutaneous eruptions, hepatitis, lymphadenopathy, as well as other manifestations, are described and discussed. Proposed theories as to the specific etiology of the syndrome are outlined. Finally, the review discusses the course, prognosis, and potential complications of the syndrome along with suggested therapeutic approaches. PMID- 3295014 TI - Cardiac dysrhythmias in the acute setting: pathophysiology or anyone can understand cardiac dysrhythmias. AB - Cardiac dysrhythmias are easy. Unlike the lung (which has formidable neuroendocrine, metabolic, and respiratory responsibilities), the heart is simple. It is an innervated muscular pump. A resting Purkinje or ventricular muscle cell membrane maintains a charge of about 90 millivolts. The five phases of a cardiac action potential are similar to the action potential in skeletal muscle, however, the cardiac action potential lasts a hundred times longer. When sodium specific "fast" channels and calcium specific "slow" channels open, positive ions rush into the myocardial cell, thus causing rapid membrane depolarization. In order to produce an action potential, some stimulus must decrease the membrane potential from -90 millivolts to "threshold" or -60 millivolts. Purkinje fibers do not have a stable phase for diastolic potential. These fibers continuously depolarize during diastole. Hypoxemia or hypokalemia may exacerbate this diastolic depolarization, thus promoting "hyperexcitability" or "automatic" ectopy. When myocardium is damaged, characteristically with myocardial ischemia, rapid conduction of cardiac impulses may be slowed dramatically. Very slow impulses may course through muscle such that by the time the activation wave front returns to the initiating site, this origin has had a chance to repolarize. This is the basis for re-entrant dysrhythmias. All cardiac dysrhythmias are automatic, re-entrant or both. PMID- 3295013 TI - Hydroxycobalamin/sodium thiosulfate as a cyanide antidote. AB - Severe, acute cyanide poisoning is uncommon and can be very difficult to diagnose if a history of exposure is unavailable. Victims of smoke inhalation may have significant cyanide poisoning as well as carbon monoxide toxicity. The Lilly Cyanide Antidote Kit currently available in America unfortunately has its own inherent toxicity. An efficacious antidote lacking toxicity is desirable, especially in cases where the diagnosis of cyanide poisoning cannot be made with certainty. Hydroxycobalamin/sodium thiosulfate has been used in France since 1970. Both components have been shown to be safe and efficacious in animal studies. Case reports of human cyanide poisoning treated with hydroxycobalamin/sodium thiosulfate have been published only in French. Animal and human data on the use of this antidotal combination are reviewed. Hydroxycobalamin/sodium thiosulfate is an efficacious cyanide antidote with little inherent toxicity. PMID- 3295015 TI - Cardiac dysrhythmias in the acute setting: recognition and treatment or anyone can treat cardiac dysrhythmias. AB - The two primary goals in dysrhythmia therapy are: to control the ventricular rate (between 70 and 100 beats per minute) and to maintain sinus rhythm. Maintenance of sinus rhythm is definitely secondary. If a patient is hemodynamically unstable, but has a ventricular rate between 60 and 100 beats per minute, the trouble is almost certainly not due to the cardiac rhythm. Normal conduction velocity is fast. An impulse is transmitted by healthy Purkinje fibers at 2 to 3 meters per second. This means that the entire ventricle, when activated by the Purkinje system, is activated in 80 milliseconds. When a superventricular impulse is transmitted to the ventricles via the A-V node, the ventricle should be activated (depolarized) in less than 80 milliseconds. Conversely, if an impulse is generated at an ectopic ventricular site, it does not access the high velocity Purkinje system as rapidly. A ventricular origin beat (PVC) thus, takes longer to activate the entire ventricle. The QRS is, therefore, longer (or wider). A wide QRS signifies aberrant ventricular conduction. When a dysrhythmia originates above the A-V node, the therapy is pharmacologic A-V nodal blockade (verapamil). When a dysrhythmia originates below the A-V node, therapy is pharmacologic (Lidocaine) or electrical (cardioversion). If uncertain or a patient is unstable, cardioversion is always acceptable. Thus; with an unstable patient, proceed immediately to cardioversion; with a narrow complex tachycardia (superventricular) proceed to verapamil; and with a wide complex (ventricular) tachycardia give Lidocaine and proceed to cardioversion. PMID- 3295016 TI - Subarachnoid hemorrhage: a review. AB - Subarachnoid hemorrhage from the rupture of a saccular aneurysm remains a major neurosurgical problem that affects 25,000 to 28,000 people yearly. Unfortunately, the mortality from this devastating disease process has not changed significantly in the last 30 years. For emergency physicians, the early detection and diagnosis of subarachnoid hemorrhage is critical to the potential of reducing the mortality from such an event. This article reviews and updates the natural history of subarachnoid hemorrhage, its incidence, presentation, diagnosis, and management from the standpoint of the emergency physician. It does not explore all controversial areas in exhaustive depth, but rather summarizes material that is of importance to emergency physicians in their approach to the problem. PMID- 3295017 TI - Performance of disposable needle syringe systems for local anesthesia. AB - The performance of different disposable needle syringe systems was determined by measuring needle-puncture pain, needle-bending forces, and the fluid dynamics of the systems. Thirty-gauge needles cause less needle-puncture pain than any other needle. The force required to bend the 30-gauge needle irreversibly was lower than that for the other needles. Studies of the fluid dynamics of different needle syringe assemblies demonstrated that the flow rate can be limited by using large-size syringes (30 mL) and needles with the smallest internal diameter. On the basis of the results of this study, 30-gauge needles attached to 10-mL syringes are recommended for infiltration anesthesia, and 25-gauge needles with 10-mL syringes are advocated for regional nerve blocks. In infiltration anesthesia, the local anesthetic agent should be injected slowly into the subdermal tissue over a 10-second period. When performing regional nerve blocks, it is also advisable to inject the local anesthetic agent over a 10-second time interval. PMID- 3295018 TI - Randomized trial of portacaval shunt, stapling transection and endoscopic sclerotherapy in uncontrolled variceal bleeding. AB - Seventy consecutive cirrhotic patients with persistent or recurrent variceal bleeding were included in a clinical trial to compare the efficacy and safety of portacaval shunt (PCS) and stapler transection (ST) in patients with low surgical risk, and of stapler transection and endoscopic sclerotherapy (ES) in patients with high surgical risk. To classify the patients into low- and high-risk groups a new scoring system was used, based on an analysis of factors influencing operative mortality in an earlier series of emergency portacaval shunt. Thirty eight low-risk patients were randomly allocated for treatment with portacaval shunt (19 patients) or stapler transection (19 patients), and 32 high-risk patients for stapler transection (17 patients) or ES (15 patients). The operative mortality of patients treated by PCS was close to that expected according to retrospective data, this indicating that the proposed scoring system is highly discriminant. In low-risk patients, portacaval shunt evidenced greater haemostatic efficacy and fewer complications than stapler transection. However, hepatic encephalopathy during follow-up was more frequent in the portacaval shunt group and there were no significant differences in operative mortality and long term survival between the two groups. In high-risk patients, stapler transection and sclerotherapy had a similar haemostatic efficacy, operative mortality and long-term survival. However, sclerotherapy occasioned fewer complications than stapler transection. Our results motivate us to recommend stapler transection for low-risk patients and to consider sclerotherapy as an alternative for high-risk patients in the emergency treatment of uncontrolled variceal bleeding. PMID- 3295019 TI - Liver haemodynamics and function in alcoholic cirrhosis. Relation to testosterone treatment and ethanol consumption. AB - Liver haemodynamics and liver function were measured in 34 alcoholic cirrhotic men before entry and after 12 months (median) in a double-blind, placebo controlled study on the effect of oral testosterone treatment (200 mg t.i.d.). Comparing data at entry with those at follow-up in the total patient group, a significant change in median values of portal pressure (-23%, n = 34, P less than 0.005), hepatic blood flow (-22%, n = 28, P less than 0.001), indocyanine green clearance (+16%, n = 29, P less than 0.01), and galactose elimination capacity (+8%, n = 31, P less than 0.05) was observed. However, testosterone-treated patients did not differ significantly from placebo-treated patients regarding any of the measured variables. No significant relationships could be demonstrated between ethanol consumption and liver haemodynamics and liver function, but the number of patients consuming more than 100 g ethanol per day decreased significantly (P less than 0.001) from 22 (65%) before entry to one (3%) during follow-up. In conclusion, oral testosterone treatment of men with alcoholic cirrhosis does not explain the significant improvement of liver haemodynamics and function observed in this study. However, the improvement may be due to reduced ethanol consumption. PMID- 3295020 TI - Lactitol versus lactulose in the treatment of chronic hepatic encephalopathy. A double-blind, randomised, cross-over study. AB - Lactitol is a disaccharide analogue of lactulose which is available as a pure crystalline powder. The efficacy of lactitol in the treatment of chronic hepatic encephalopathy was assessed in 9 cirrhotic patients in a randomised, double blind, cross-over comparison with lactulose. The sugars were dispensed in solutions, identical in taste and appearance and with similar physico-chemical properties, which contained either 66.7 g/100 ml of lactitol or 66.7 ml (44.5 g)/100 ml of lactulose syrup. Patients were treated for periods of 3 months with each sugar, during which time they were monitored frequently by use of a number of clinical, psychometric and laboratory variables. The sugar solutions were dispensed in an initial dose of 0.75 ml/kg which was adjusted, as necessary, in order to produce two semi-soft stools per day. An adequate catharsis was achieved with a mean (+/- 1 SD) equivalent daily dose of 31.9 +/- 11.2 g of lactitol or 32.9 +/- 16.7 ml (21.9 +/- 11.1 g) of lactulose syrup. Both sugars were equally as effective in the treatment of this condition, even though events likely to cause decompensation arose in 5 patients during treatment with lactitol but in only 1 during treatment with lactulose. Side effects appeared to be more frequent during treatment with lactulose, despite the fact that the parent sugar was diluted in the trial solution; thus 5 patients experienced excessive flatulence and 8 experienced diarrhoea on lactulose compared with only 2 and 4 on lactitol, respectively. In all cases the excessive flatulence occurred independently of sugar dosage whereas the development of diarrhoea was dose-related.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295021 TI - Current concepts on hepatic transport of drugs. PMID- 3295023 TI - Premenstrual syndrome. A critical review of the literature. PMID- 3295022 TI - Reexamination of the fate of Mendel's paper. AB - The usual account is that when Mendel gave his paper, no one understood what he said and there were no questions and no discussion. Examination of available evidence indicates that this is not true. Also, it is usually said that Mendel's paper was lost or ignored from 1866 to 1900. This is not true either. However, with the possible exception of one person, none of those citing the paper showed any interest in or understanding of Mendel's explanations of his results. PMID- 3295024 TI - Medical museum notes (William N. Wishard Sr.). PMID- 3295025 TI - Book review issue. PMID- 3295026 TI - Smallpox in Europe before the seventeenth century: virulent killer or benign disease? PMID- 3295027 TI - Medical care and evacuation during the Philippine Insurrection, 1899-1901. PMID- 3295028 TI - A gland in a search of a function: the parathyroid glands and the explanations of tetany 1903-1926. PMID- 3295029 TI - Immunohistochemical demonstration of a 44-KD phosphoprotein in developing rat bones. AB - Polyclonal antibodies against a 44-KD phosphoprotein (44K BPP) from rat bone were raised in rabbits, affinity-purified, and used as probes to study the protein's distribution in various types of developing bones from newborn rats. Three immunostaining procedures were applied utilizing indirect immunofluorescence, avidin-biotin-peroxidase complex, and avidin-gold complex with silver enhancement. All methods gave essentially identical and/or complementary results. Antigenicity for anti-44K BPP was detected in endochondral and membranous bone. In the latter, it was also demonstrated in the osteoid. In the woven bone of lower jaw, immunoreactivity for anti-44K BPP antibodies was found in fibroblast shaped cells (pre-osteoblasts) that were between the bone trabeculae but not in direct contact with bony extracellular material. In addition to these presumed osteoprogenitor cells, osteoblasts as well as osteocytes were strongly stained; the cytoplasmic staining was associated with the Golgi apparatus. Occasionally immunoreactivity was detected in osteoclasts, but in these cells immunostaining was either diffusely spread in the cytoplasm or present only at sites of bone erosion. These findings support the hypothesis that the 44K BPP is a protein made by osteoblasts and is localized predominantly in bone. Furthermore, the protein appears to be expressed early in histogenesis of the bone-forming cells. PMID- 3295030 TI - Immunocytochemical detection of anti-mullerian hormone in Sertoli cells of various mammalian species including human. AB - An immunocytochemical method, based on the use of a polyclonal antibody raised against purified bovine anti-Mullerian hormone (AMH), was used to detect AMH in Sertoli cell cytoplasm of various mammalian species, including human. Immunopurification of antiserum by AMH-affinity chromatography, although not mandatory, leads to better results and increased sensitivity. In human testicular tissue, AMH is detectable up to 6 years of age. In rats, AMH production is initiated at 13 days post coitum, peaks between 15 and 17 days, and is no longer detectable 1 week after birth. The reaction is strongest in Sertoli cells of calves, sheep, goats, and pigs, species characterized by a high degree of development of the rough endoplasmic reticulum. It is fainter in human, rat, rabbit, and cat Sertoli cells, in which the rough endoplasmic reticulum is not as abundant. This correlation is not unexpected, in view of the localization of reaction product in this cytoplasmic organelle. Preliminary results indicate that there may be a relationship between the amount of immunoreactive AMH present in testicular biopsies of intersex patients and the degree of regression of the Mullerian duct on the ipsilateral side. This may help to elucidate whether persistence of Mullerian ducts results from lack of testicular production of AMH or from peripheral resistance of the Mullerian primordia to the hormone. PMID- 3295031 TI - A new marker for identifying quail cells in embryonic avian chimeras: a quail specific antiserum. AB - The characterization of cell behavior in quail chick chimeras has greatly increased our knowledge of the ontogeny of embryonic cell populations and the role of cell-cell interactions in development. We sought to extend the value of avian chimeras by producing a marker that would recognize cell surface components and that could be used instead of the traditional nuclear marker to identify quail cells within chimeras. We describe here a quail-specific antiserum produced by injecting chickens with a membrane fraction of 6-10-day quail embryos. By use of peroxidase coupling of a second antibody, serum reactivity was tested in tissue sections of normal quail and chick embryos and of somitic mesoderm and neural tube chimeras. The primary time period examined was 6-10 days of development. At these stages, the antiserum recognizes only quail cells and stains both plasma membrane-associated and cytoplasmic cell components. The latter characteristics allow the identification of quail axons in chimeras and facilitate visualization of quail cells at low magnification. We show that antiserum staining can also be used to identify quail cells in culture and can be combined with orthograde HRP labeling of neurons. PMID- 3295032 TI - Electron microscopic localization of chromogranin A in osmium-fixed neuroendocrine cells with a protein A-gold technique. AB - An antibody (LK2H10) to chromogranin A has been recommended for use in ultrastructural identification of neuroendocrine secretory granules. Previous studies have demonstrated immunoreactive chromogranin A in specimens prepared for electron microscopy by glutaraldehyde fixation only. In this study, the effect of specimen post-fixation by osmium tetroxide on post-embedding localization of chromogranin A was evaluated. Human tissues from benign endocrine glands, neuroendocrine tumors, and non-neuroendocrine tumors were post-fixed in osmium, embedded in epoxy resin, and the sample thin sections immunolabeled using a protein A-gold technique. Chromogranin A-positive neurosecretory granules were detected in pancreatic islets, adrenal medulla, stomach, ileum, anterior pituitary, and parathyroid. Mid-gut carcinoids, bronchial carcinoids, pheochromocytomas, paragangliomas, carotid body tumors, and thyroid medullary carcinomas contained immunoreactive granules. Cytoplasmic granules in non neuroendocrine tumors did not react for chromogranin A. Tissues post-fixed in osmium tetroxide had optimally preserved ultrastructural features, and use of this fixative is compatible with postembedding localization of chromogranin A in neurosecretory granules. PMID- 3295033 TI - Noise-induced temporary threshold shifts: the effects of anticipatory stress and coping strategies. AB - Temporary Thresholds Shifts were assessed in five groups from before to after 5 minute exposure to 110 dB SPL white noise and in one additional group without noise exposure. In each group the baseline conditions were designed to elevate psychological stress via anticipation of the noise and venipuncture procedures. In the three experimental groups, procedures to reduce psychological stress were employed: Information, Relaxation, and Behavioral Avoidance. Manipulation checks supported the effectiveness of these arousal-reducing interventions. Temporary threshold shifts were considerably greater in two of the experimental conditions than in the noise-exposed control conditions. PMID- 3295034 TI - Sodium restriction and potassium supplementation in young people with mildly elevated blood pressure. AB - Forty young subjects, aged 18 to 28 years, with mildly elevated blood pressure participated in a double-blind randomized three-period crossover study of the effect of sodium restriction with and without potassium supplementation on blood pressure. Dietary sodium intake was restricted for 18 weeks in which the patients received in random sequence 'slow-sodium' (90 mmol/day), 'slow-potassium' (72 mmol/day), and placebo tablets, each for 6 weeks. Mean urinary sodium excretion was 129 mmol/24 h in the slow-sodium period, 57 mmol/24 h during placebo, and 69 mmol/24 h during slow-potassium. Mean supine systolic blood pressure in the sixth week of the slow-potassium period was 3.3 mmHg lower than that at the end of the slow-sodium period (P less than 0.05). There was no significant difference in systolic or diastolic blood pressure between the placebo and the slow-sodium periods. The fall in systolic blood pressure in the low sodium/high potassium period was accompanied by a fall in cardiac index of 0.4 l/min per m2 body surface area (BSA) (P = 0.03). Our observations suggest a small hypotensive effect of moderate sodium restriction combined with high potassium intake in young hypertensive subjects. Sodium restriction alone has little effect on blood pressure in this group. The combination of a low sodium/high potassium diet may lower blood pressure by affecting cardiac output. Reducing the dietary sodium:potassium ratio may therefore be useful in the management of early primary hypertension. PMID- 3295035 TI - The antihypertensive effect of captopril in essential hypertension: relationship to prostaglandins and the kallikrein-kinin system. AB - Two groups, each with nine essential hypertensive patients, were maintained on 10 mmol sodium daily over 14-17 days and treated in this sequence: placebo; captopril (25 or 50 mg given thrice daily) or indomethacin (50 mg given thrice daily) alone; captopril plus indomethacin, and (4) captopril alone. The initial fall in mean blood pressure induced by captopril (118 +/- 1 to 102 +/- 1 mmHg) was unaffected by the addition of indomethacin. However, if indomethacin treatment preceded captopril, the antihypertensive effect was attenuated (116 +/- 4 to 109 +/- 4), and was associated with significant reductions in urinary prostaglandin and kinin excretion. Addition of captopril to indomethacin returned kinin excretion to placebo levels but did not affect indomethacin-induced reduction in prostaglandin excretion. Captopril alone stimulated plasma renin activity (PRA) fivefold; aldosterone excretion was lowered by 25% and further reduced by indomethacin. Thus, when captopril and indomethacin are administered together, the order of administration is critical to the antihypertensive effect of captopril. PMID- 3295036 TI - Quantitative activation and determination of inactive renin by high performance liquid chromatography. AB - Assay of inactive renin in unfractionated mouse plasma is difficult and often impossible because of high concentrations of active renin and plasma protease inhibitors. Therefore, 0.025 to 0.05 ml of plasma or amniotic fluid from mice was separated by high performance liquid chromatography (HPLC) using a silica-based size exclusion column. The eluates were examined for enzymatically active renin before and after limited proteolysis with trypsin. Since inactive renin eluted as a single peak corresponding to a molecular weight of 38,000 daltons and the elution of active renin was markedly retarded, inactive and active renin were partially separated. compared with plasma, inactive renin in amniotic fluid eluted as a broader and sometimes diphasic peak, suggesting heterogenicity. The rapid and reliable separation by HPLC provided a more than 300-fold purification of inactive renin. Despite low concentrations of plasma protease inhibitors, a 1 000 000-fold molar excess of trypsin (1 mg/ml) was needed for optimal activation. The necessity for high trypsin concentrations for activation may partly be explained by enzyme kinetic considerations. By combining HPLC with trypsin activation, inactive renin was readily measured and found to be 9.4 (5.1-13.2) GU (Goldblatt units)/l in normal and 8.0 (5.1-12.2) GU/l in sialoadenectomized and nephrectomized mouse plasma, which is higher than previously determined in our laboratory. The concentration was 12.4 (8.8-16.1) GU/l in amniotic fluid. Thus, the concentration of inactive renin in plasma is almost as high as active renin in normal mice (17.6 GU/l) and is uninfluenced by the decrease of active renin to 0.3 GU/l after sialoadenectomy and nephrectomy. PMID- 3295037 TI - Does oral calcium supplementation lower high blood pressure? A double blind study. AB - Eighteen unselected patients with untreated mild to moderate essential hypertension, whose average supine blood pressure after 2 months' observation on no treatment was 154/103 mmHg, were entered into a double-blind randomized crossover study of 1 month's treatment with calcium lactate gluconate (40 mmol of elemental calcium/day) and treatment with placebo for a further month. Despite a significant increase in total plasma calcium (P less than 0.01) and in 24-h urinary excretion of calcium (P less than 0.025) while taking calcium lactate gluconate, there was no fall in blood pressure with calcium supplementation compared to treatment with placebo. PMID- 3295038 TI - Cell lineage segregation during bursa of Fabricius ontogeny. AB - The population dynamics of myeloid and lymphoid lineages during bursa of Fabricius ontogeny were analyzed by immunofluorescence by using two monoclonal antibodies (mAb). CL-1 mAb reacts with all chicken hemopoietic cells, except mature erythrocytes. L22 mAb reacts with bursa and bursa-derived lymphocytes, with a minor subset of macrophages and with some cells of the thymic medulla. The staining of embryonic bursas by these antibodies helps to distinguish between two different lineages of hemopoietic cells: CL-1+/L22+ cells represent B lymphocytes and a minor subset of macrophages, while CL-1+/L22- cells correspond to most of the macrophages and to the granulocytes, which disappear at the end of the embryonic life. CL-1+/L22- as well as CL-1+/L22+ cells were first observed outside the bursal rudiment. This indicates that there is a pre-bursal segregation between these two hemopoietic lineages and that two different kinds of precursors colonize the bursal rudiment at about the same time (day 9 for CL 1+/L22- cells and days 9 or 10 for CL-1+/L22+ cells). Moreover our data show that the colonization of the bursal epithelium by hemopoietic precursors is a two-step phenomenon. The first cells which enter belong to the CL-1+/L22- lineage, express Ia-like antigens at a high level, are dendritic in morphology, and represent cells of the macrophage/dendritic cell lineage. They are responsible for the formation of the epithelial bud which are then colonized by a small number of lymphoid precursors which belong to the CL-1+/L22+ lineage. Quail-chick bursa grafting experiments were also performed and the grafts were examined for CL-1 (restricted to chicken hemopoietic cells) and L22 reactivity. These observations confirmed our previous findings about the kinetics of the colonization of bursal rudiment by hemopoietic precursors and give support for a pre-bursal segregation between two hemopoietic pathways. PMID- 3295039 TI - Lack of expression of HLA [corrected] class I and class II molecules on the human oocyte. AB - The expression of histocompatibility leukocyte antigen (HLA) class I and class II antigens on human oocytes was investigated by the indirect immunofluorescence assay using well-defined monoclonal antibodies. Oocytes were obtained from an in vitro fertilization program or were studied on frozen sections from human ovaries. Neither HLA class I, beta 2-microglobulin, nor HLA class II molecules were detected on cultured oocytes or frozen sections. The zona pellucida also lacked these antigens, but granulosa cells expressed HLA class I molecules. Our results also indicate the presence of certain types of class II molecules on granulosa cells. The present experiments demonstrate that the human oocyte belongs to those few cell types in the human body which are devoid of both types of HLA molecules. PMID- 3295040 TI - Characterization of a factor produced by human T cell clones exhibiting eosinophil-activating and burst-promoting activities. AB - It has long been suggested that eosinophil response observed in certain immunological reactions depends on the release of soluble products from sensitized lymphocytes when exposed to the challenging antigen. We were able to show that alloreactive T cell clones (ATLC) obtained from human rejected kidney produced, when stimulated with specific antigen (kidney donor-B lymphoblastoid cell line) and interleukin 2, a factor triggering the proliferation of a subline (DA-2) of the interleukin 3 sensitive DA-1 murine cell line. The biochemical features of this factor called HILDA (human interleukin DA) and the DA-2 nonresponsiveness to several human T cell lymphokines and cytokines lead us to the conclusion that this 41,000 m.w. glycoprotein could not be likened to already known T cell lymphokines. Highly purified HILDA turned out to be a potent chemoattractant and activator of, respectively, mouse and human eosinophils. It also displayed burst-promoting activity on human marrow. PMID- 3295041 TI - Beta 2-microglobulin in neutrophils: an intragranular protein. AB - The subcellular localization of beta2-microglobulin (beta 2m) in human neutrophils was determined by an enzyme-linked immunosorbent assay on subcellular fractions obtained by Percoll density gradient centrifugation of neutrophils disrupted by nitrogen cavitation. The neutrophils were found to contain 160 ng beta 2m/mg protein. Approximately two-thirds co-located with the markers for specific granules and was released from intact cells during degranulation, whereas one-third of the beta 2m was located together with markers of the plasma membrane. This fraction was not further enriched during degranulation. These results indicate that beta 2m cannot be universally used as a plasma membrane marker as hitherto assumed, but beta 2m may serve as an indicator of neutrophil degranulation. PMID- 3295042 TI - Bacterial invasion of fibroblasts induces interferon production. AB - Although bacteria and/or bacterial products have been shown to induce interferon (IFN) production in cells of the immune system, the ability of non-lymphoid cells to produce IFN in response to bacterial products and/or bacterial invasion is currently unknown. In this study we examined murine and human fibroblasts for their ability to produce IFN in response to challenge with the invasive bacteria Shigella flexneri and enteroinvasive Escherichia coli. Both human and murine primary cell cultures produced high levels (500 to 1000 U/ml) of IFN-beta within 12 hr after Shigella invasion. The production of IFN appeared to be dependent upon bacterial invasion because no IFN was produced by cells pretreated with a non-invasive isogenic variant of S. flexneri. Furthermore, UV treated invasive S. flexneri, which lose the ability to invade cells, failed to induce IFN production in fibroblasts after bacterial challenge. In contrast to primary cells, most human and murine continuous cell lines did not produce IFN in response to Shigella invasion. The above results demonstrate that bacterial invasion of primary cultures of fibroblasts can induce IFN production. Taken together with previous findings, these results suggest that IFN may play an important front line host defense against invasive bacterial infections. PMID- 3295043 TI - An analysis of in vitro B cell immune responsiveness in human lymphatic filariasis. AB - The immunoregulatory mechanisms involved in B cell function in patients with varying clinical manifestations of bancroftian filariasis were examined by studying the ability of peripheral blood mononuclear cells (PBMC) or PBMC subpopulations from patients with elephantiasis, asymptomatic microfilaremia (MF), and acute tropical pulmonary eosinophilia (TPE) to produce polyclonal and parasite-specific antibody in vitro, both spontaneously and in response to a mitogen (PWM) and to parasite antigen. When the spontaneous or mitogen-driven polyclonal responses were examined, all groups produced significant amounts of IgM and IgG; those with TPE produced extremely high levels. However, when in vitro parasite antigen-specific responses were examined, those with MF were unable to produce filaria-specific antibody either spontaneously or in response to PWM or parasite antigen; in contrast, patients with chronic lymphatic obstruction or TPE produced large quantities. Removal of neither adherent cells nor T8+ T cells affected the parasite-specific B cell anergy seen in those with MF. This absent or severely diminished capacity to produce antibody on parasite antigenic stimulation in patients with MF is likely responsible for the low levels of parasite-specific antibody seen in this most common clinical manifestation of bancroftian filariasis. Its inability to be reversed by the removal of "suppressor elements" suggests a state of B cell unresponsiveness to the parasite. PMID- 3295044 TI - Characterization of the antitumor activities of human tumor necrosis factor-alpha and the comparison with other cytokines: induction of tumor-specific immunity. AB - We have investigated the in vitro and in vivo antitumor activities of recombinant human tumor necrosis factor-alpha (rHuTNF-alpha) against Meth A sarcoma. Meth A sarcoma cells were found to a) be relatively insensitive in vitro to rHuTNF alpha, and b) express low numbers of TNF-alpha receptors. Intraperitoneally implanted Meth A sarcoma was insensitive to the antitumor effects of rHuTNF alpha. In contrast, rHuTNF-alpha was highly efficacious against subcutaneously implanted Meth A sarcoma. Biodistribution studies with 125I- or 3H-labeled rHuTNF alpha demonstrated that, after intravenous administration, the majority of the labeled rHuTNF-alpha localized in the kidney, lungs, and liver. Only low levels of radiolabel were found in subcutaneous Meth A implants. These results support the in vitro data on the low number of TNF-alpha receptors on Meth A sarcoma cells. The ability of rHuTNF-alpha to induce regression of established (7 days) subcutaneous Meth A implants, positively correlated with the degree of both macroscopic and microscopic tumor necrosis. In addition, recombinant human tumor necrosis factor-beta (lymphotoxin) and recombinant murine tumor necrosis factor alpha induced similar levels of necrosis. Other lymphokines with known antitumor activities, recombinant human interferon-gamma, murine interferon-gamma, and human interleukin 1 alpha, failed to induce detectable necrosis of Meth A sarcoma. Mice which had rejected subcutaneous Meth A sarcoma implants after rHuTNF-alpha treatment and which were later challenged subcutaneously with Meth A sarcoma or other noncross-reacting chemically induced sarcomas were found to be specifically immune to Meth A sarcoma. In addition, low levels of cytotoxic antibodies reactive to Meth A sarcoma were detected in the sera of 21 of 30 Meth A immune mice. Histological evaluation of the hemorrhagic tumor necrosis induced by rHuTNF-alpha suggests that the primary lesion is vascular, possibly directly on the endothelial cells. The mechanisms involved in the generation of specific cell-mediated antitumor immunity in this model are at present unknown. PMID- 3295045 TI - Inactivation of the proteolytic activity of mouse nerve growth factor by human C1(activated)-inhibitor. AB - The interaction between the serine protease gamma subunit of NGF (gamma-NGF) and human C1(activated)-inhibitor (C1-Inh) has been studied. C1-Inh inactivates the protease activity of gamma-NGF as measured by its ability to cleave the synthetic substrate benzoyl-arginine-p-nitroanilide (L-BAPNA). Experiments in which gamma NGF and C1-Inh were mixed at differing molar ratios indicated that inhibition was due to the formation of a 1:1 stoichiometric complex. Analysis of the interaction of 125I-labeled gamma-NGF with C1-Inh by SDS-PAGE and autoradiography indicated that a covalent bond was formed between gamma-NGF and C1-Inh. The covalent bond was hydrolyzed by hydroxylamine, which suggested that the two proteins were linked via an acyl linkage. The formation of this complex was time dependent and required the proteolytic activity of the gamma-NGF. PMID- 3295046 TI - Deficiency of the tryptase-positive, chymase-negative mast cell type in gastrointestinal mucosa of patients with defective T lymphocyte function. AB - The distribution and concentration of human T (tryptase-positive, chymase negative) and TC (tryptase-positive, chymase-positive) mast cells were examined in Carnoy's-fixed specimens of the gastrointestinal tract of normal individuals, patients with inflammatory bowel diseases, and patients with immunodeficiency disorders. In normal specimens, T mast cells predominated in the mucosa (89%), with a mean concentration of 17,850 +/- 4,998 per mm3 (+/- SD, n = 16), whereas TC mast cells predominated in the submucosa (90%) with a mean concentration of 7,516 +/- 1,227 per mm3 (+/- SD, n = 16). The concentrations of T and TC mast cells in specimens of ileum from five patients with active Crohn's disease and of colon from three patients with active ulcerative colitis were not significantly different (p greater than 0.4) from normal values. Three patients with combined immunodeficiency disorders demonstrated a marked decrease in the concentration of the T mast cells in the intestinal mucosa, to 540 +/- 630, and a corresponding decrease in the percentage of T mast cells to 9%. Concentrations of TC mast cells were unchanged, both in the mucosa and in the submucosa. In three patients with acquired immunodeficiency syndrome, a similar deficiency of the T mast cell type was observed in the ileal mucosa, with a mean concentration of 788 +/- 534 T mast cells per mm3, but not in the appendiceal and colonic mucosa of one of the three patients. These findings indicate a role for functional T lymphocytes in the development of the T mast cell type in humans, and suggest divergent pathways for development of T and TC mast cells. PMID- 3295047 TI - Salmonella-typhimurium-specific difference in rate of intracellular killing by resident peritoneal macrophages from salmonella-resistant CBA and salmonella susceptible C57BL/10 mice. AB - The aim of the present study was to determine whether the difference between the rate of intracellular killing of Salmonella typhimurium by macrophages of salmonella-resistant CBA and salmonella-susceptible C57BL/10 mice also holds for other salmonellae and other bacteria species. After in vivo phagocytosis, the initial rate of in vitro intracellular killing of S. typhimurium phagetype 505, S. typhimurium phagetype 510, and S. typhimurium M206 by macrophages of CBA mice amounted always to approximately 1.7 times the value found for macrophages of C57BL/10 mice (p less than 0.001), indicating that the difference in killing efficiency between CBA and C57BL/10 macrophages holds for various strains of S. typhimurium. However, some other salmonella species, i.e., S. dublin and S. heidelberg, as well as E. coli 054 and 02K1+, Listeria monocytogenes EGD and L347, and Staphylococcus aureus were killed equally efficiently by macrophages of both mouse strains. These findings indicate that the difference between the rates of intracellular killing by macrophages of salmonella-resistant CBA and salmonella-susceptible C57BL/10 does not hold for several other bacteria species and thus might be specific for S. typhimurium. Subsequent experiments showed that the in vivo proliferation of S. typhimurium 510 in the first 2 days after i.v. injection was 2.0-fold to 3.0-fold higher in the spleens and livers of C57BL/10 mice than in those of CBA mice, whereas the in vivo proliferation of S. dublin and S. heidelberg was between 1.0-fold to 1.4-fold higher in the C57BL/10 mice. These findings suggest that the differences between the rate of in vitro intracellular killing of salmonella by CBA and C57BL/10 macrophages are reflected in differences in the rate of in vivo proliferation of these microorganisms in CBA and C57BL/10 mice. To gain insight into the involvement of the oxidative metabolism of CBA and C57BL/10 macrophages in the difference in the rate of intracellular killing of S. typhimurium, the O2 consumption and H2O2 release by resident peritoneal macrophages was determined. The amplitudes of the respiratory burst and the release of H2O2 was identical in macrophages of the two mouse strains after triggering by either preopsonized heat-killed S. typhimurium or phorbol myristic acetate. These findings indicate that the mouse species associated difference in the intracellular killing of S. typhimurium is not caused by a difference in the oxidative metabolism of CBA and C57BL/10 macrophages. PMID- 3295048 TI - Humoral response in Treponema pallidum-infected guinea pigs. II. Circulating immune complexes and autoimmune responses. AB - Guinea pigs of inbred strain 2 and of a strain deficient in complement component 4 (C4D) responded to intradermal infection with Treponema pallidum by production of antibodies to treponemal antigens, normal rabbit serum proteins, fibronectin, and creatine kinase and with formation of circulating immune complexes (IC). IC started to appear at low concentrations 1 mo after infection and increased between 3 and 5 mo post-infection. Antibodies to fibronectin appeared after the second month but were not detectable 30 days later. Antibody activity to creatine kinase was detectable at the fourth month and became significantly higher at 5 mo post-infection. Reinoculation with a dose similar to that used for primary infection caused a significant increase in all antibodies and IC. Dissociation products of IC formed after primary infection consisted predominantly of treponemal antibodies and antigens, whereas IC detected after reinfection consisted predominantly of antibodies and normal rabbit serum proteins. Antibodies to fibronectin and creatine kinase are considered autoantibodies, and the underlying mechanism responsible for their production in syphilis is discussed. PMID- 3295049 TI - Distinctive cellular immunity in genetically susceptible BALB/c mice recovered from Leishmania major infection or after subcutaneous immunization with killed parasites. AB - Genetically susceptible BALB/c mice are refractory to further infection after recovery from Leishmania major infection after a sublethal dose of gamma irradiation. In contrast, mice immunized with killed promastigotes s.c. develop exacerbated lesions after infection. Both groups of mice produce only a low level of specific antibody and no detectable cytotoxic T cells, but do have a strong antigen-specific DTH, which is adoptively transferable with Lyt-1+2-, L3T4+ T cells. Kinetic and histological studies revealed that mice immunized s.c. developed Jones-Mote hypersensitivity, peaking at 15 hr. with little mononuclear cell infiltration at the site of antigen administration; whereas mice that had recovered from infection developed tuberculin-type of reactivity, peaking at 24 to 48 hr, with intense mononuclear cell infiltration. Splenic T cells from recovered mice, when injected into the footpads of normal recipients together with live promastigotes, were able to retard lesion development; whereas T cells from s.c. immunized mice, when similarly transferred, accelerated disease progression. Antigen-specific culture supernatant of spleen cells from recovered mice also activated normal resident peritoneal macrophages to kill intracellular L. major amastigotes and tumor cells. Culture supernatants of spleen cells from s.c. immunized or normal mice were devoid of such activities. Part of the macrophage-activating potential can be inhibited by antibody specific for IFN gamma. These results therefore demonstrate that whereas the Jones-Mote reaction is correlated with disease exacerbation, the tuberculin-type of DTH may be protective. Furthermore, in vivo immunity is directly related to the capacity of T cells to produce macrophage-activating factor. PMID- 3295050 TI - Between two centuries: specificity and regulation in immunology. PMID- 3295051 TI - Phylogeny of C4b-C3b cleaving activity: similar fragmentation patterns of human C4b and C3b produced by lower animals. AB - Functional and structural studies of the activated proteins of the complement system C4b and C3b have led to the identification of cleavage products resulting from the effect of the regulatory proteins, factor I, H, and C4b binding protein (bp). In this paper we report the results of studies that investigated the capacity of plasma or serum from a wide range of phylogenetic species to yield similar cleavage products. Sera and plasma from mammals, reptiles, amphibia, and fishes are capable of cleaving fluid phase human C4b and C3b, generating apparently the same fragments as observed using normal human serum: alpha 2, alpha 3, alpha 4 from the alpha' chain of C4b: and alpha-68, alpha-46, alpha-43, and alpha-30 from the alpha' chain of C3b. When C3b bound to a cell membrane is used C3c and C3dg are generated. The generation of these fragments from C3bi is a dose-dependent reaction. There is no correlation between the evolution of the species and the quantitative capability to degrade the substrates. Birds possess only a limited capability to degrade the alpha' chain of C4b and have no cleaving activity for C3b, whereas sera from more primitive vertebrate species (chondrichthyes and agnatha) fail to participate in the reaction. Contrary to other species, the proteins in fish serum or plasma responsible for the degradation of C4b and C3b show a unique requirement for Ca2+ ions. Magnesium and barium are less effective, and in their presence a 65,000 dalton intermediate product is observed. These results demonstrate that protein(s) displaying proteolytic activity for products of complement activation, probably related to I, H, and C4bp, are present in plasma of species whose evolution have preceded humans by 300 million years. Moreover, the recognition of human substrates and the generation of fragments identical to those produced by human serum suggests that human C4b and C3b share structural characteristics with their evolutionary ancestors in the serum or plasma of the species studied. PMID- 3295052 TI - Stimulation of S-adenosylmethionine synthetase in human lymphocytes by streptococcal M protein. AB - The effects of the specific antigen M5 protein of group A streptococci on AdoMet synthetase activity and AdoMet levels in peripheral blood (PB) lymphocytes were studied and were compared with the effects of the nonspecific polyclonal T cell mitogen PHA. M5 protein stimulated AdoMet synthetase activity, whereas PHA had a biphasic effect with an early inhibitory effect and a later stimulatory effect on AdoMet synthetase activity. S-Carbamyl-L-cysteine (SCC), an inhibitor of human lymphocyte AdoMet synthetase, reduced AdoMet levels and inhibited the blastogenic response of PB lymphocytes to both M5 protein and PHA. Inhibition of the response to M5 protein was stronger than that to PHA. However, the inhibitory effects of SCC were totally reversible by washing the cells. It is our hypothesis that such differences in the biochemical events triggered by specific antigen as opposed to a polyclonal mitogen may determine the direction of the functional differentiation of T lymphocytes. PMID- 3295053 TI - The production and characterization of monoclonal antibodies to a human colonic antigen associated with ulcerative colitis: cellular localization of the antigen by using the monoclonal antibody. AB - We detected in human colon extracts a 40 kDa protein(s) that specifically reacts with tissue-bound IgG obtained from the colon of patients with ulcerative colitis or CCA-IgG. Using the hybridoma technology, we developed monoclonal antibodies to this 40 kDa protein. The specific immunoreactivity of one of the monoclonal antibodies (7E12H12, IgM isotype) against the 40 kDa protein was demonstrated both by ELISA and by immunotransblot. Competitive binding experiments showed that CCA-IgG inhibits the binding of 7E12H12 to the 40 kDa protein, suggesting the recognition of common epitope(s) on the 40 kDa protein by the monoclonal antibody and CCA-IgG. 7E12H12 was used to determine cellular localization of the 40 kDa protein. Biopsy tissue specimens from colon, esophagus, stomach, duodenum, jejunum, ileum, liver, pancreas, lungs, kidneys, salivary, and mammary glands were obtained. Tissue specimens were fixed in 4% paraformaldehyde or in 10% formalin. Sections were sequentially incubated with the hybridoma supernatant, biotinylated anti-mouse IgM, avidin-biotin-peroxidase complex, and 3,3' diaminobenzidine. An unrelated hybridoma supernatant was used as control. The monoclonal antibody exclusively recognized colonic epithelial cells both in the crypt and on the luminal surface. Immunoreactivity was present on the plasma membrane chiefly along the basolateral areas of the cells. Plasma membrane localization of the 40 kDa protein was confirmed by immunoelectron microscopy. All colonic mucosal biopsy specimens from both adult and fetal colon reacted with the monoclonal antibody. None of the biopsy specimens from stomach, duodenum, jejunum, ileum, liver, pancreas, or non-gastrointestinal tissue reacted with the antibody, confirming the organ specificity of the 40 kDa protein. The interaction between this colonic epithelial membrane protein and the CCA-IgG may play an important role in the pathogenesis of ulcerative colitis. PMID- 3295054 TI - Dot enzyme immunoassay. A simple, cheap and stable test for antibody to human immunodeficiency virus (HIV). AB - A dot enzyme immunoassay for antibody to HIV has been developed and tested with a panel of positive and negative sera. It has proved to be of equal or greater sensitivity compared with a commercial ELISA kit, is simple and quick to perform, requires neither sophisticated equipment nor highly trained technical staff. The reagents are stable enough for postal distribution in tropical countries and, other than for the antigen, the costs are low, making it an appropriate test for use in the developing world when funds for expensive commercial kits are not available. PMID- 3295055 TI - Clinical trial of drainage following cholecystectomy: suction versus static drainage. PMID- 3295056 TI - Fresh eye tissue offered for keratoplasty. PMID- 3295057 TI - A comparative evaluation of streptozyme test and antistreptolysin O test in acute rheumatic fever. PMID- 3295058 TI - Management of avulsion injuries of the scalp. PMID- 3295059 TI - Five years' experience of bacteraemia in sickle-cell anaemia. AB - In a review of all adults admitted with sickle-cell anaemia to Cook County Hospital between January 1980 and April 1985, 15 instances of bacteraemia were identified. In these patients, bacteraemia was characterised by slow onset, an identifiable focus of infection and lack of hypotension or abnormal coagulation of the blood. The organisms, most often isolated were Escherichia coli and Salmonella species. Two patients died, both with Salmonella enteritidis bacteraemia. Neither death could be attributed to the acute effects of infection. The outcome of bacteraemia in adults with sickle-cell anaemia appears to be more favourable than that in children. PMID- 3295060 TI - A nursery outbreak of group A streptococcal infection. AB - We report an outbreak of 23 neonatal group A streptococcal infections including two cases of septicaemia in a nursery for the newborn. At the same time, 19 mothers had puerperal endometritis. The outbreak lasted for about 2 months and could not be eradicated by ordinary hygienic measures. In a colonisation study, 19 of 90 umbilical stumps studied on the day of discharge from hospital harboured group A streptococci, all of the same epidemic strain T28 provisional M-type 2841/opacity factor positive (T28/MPT2841/OF+). Chlorhexidine gluconate was therefore applied daily to the umbilical stumps. The outbreak came to an end with the introduction of this procedure. The time interval between delivery and recognition of infection was shorter in infants than in mothers. There were also only two infected mother-infant pairs. Taken together, this suggests that infected umbilical stumps on symptomless infants were a likely source of the maternal infections. Throughout 1 year from the introduction of the chlorhexidine treatment, we have not seen a case of group A streptococcal infection in neonates. Surveillance cultures from umbilical cords after the outbreak have also been negative. We conclude that bacteriological surveillance of umbilical stumps is valuable in recognising an outbreak and should be seriously considered when a group A streptococcal infection has been recorded in a nursery. PMID- 3295061 TI - Fatal Serratia marcescens epiglottitis in a patient with leukaemia. PMID- 3295062 TI - [Study and treatment of erection disorders. Value of intracavernous injections]. AB - A multidisciplinary study of 57 patients with erection disorders included in addition to standard examinations: clinical, hormonal, vascular using Doppler and nervous with determination of latency time of bulbocavernous reflex, evaluation of effects of intracavernous papaverine injections completed by a manometric study of cavernous body filing by perfusion. A clear positive result of the papaverine test is considered to reflect integrity of vascularization of corpus cavernosum structure, and renders value less the continuation of vascular investigations. The appearance of an almost normal but delayed erection requiring high-dose papaverine administration is interpreted as being due to insufficiency of arterial origin without anomaly of venous return. The absence of erection after papaverine injection, whether in the presence or absence of an increase in penis volume, results from excessive venous return, insufficient arterial supply or both. Absence of erection despite a cavernous perfusion of more than 70 ml/min is due to excessive venous return that requires localization by cavernography. The onset of erection during cavernous body filling eliminates excessive venous return and results from arterial insufficiency that necessitates pelvic arteriography. A therapeutic attitude of logical consequence is proposed. PMID- 3295063 TI - Detection of macrophage migration inhibitory factor by monoclonal antibody in Sezary syndrome. AB - We have reported previously on the generation of a monoclonal antibody against human macrophage migration inhibitory factor (MIF), which is a mediator of cellular immunity. Macrophage migration inhibitory factor activity in the migration assay was closely correlated with antibody reactivity. Using this antibody called 1C5/B, we are now able to study the expression of MIF in situ. Here, we report on the detection of MIF in blood lymphocytes and skin of a patient with a leukemic cutaneous T-cell lymphoma with the characteristics of Sezary syndrome. Ninety percent of the patient's Ficoll Hypaque-isolated peripheral white blood cells were of the helper phenotype. By conventional immunoperoxidase method, 94% reacted strongly positive with the antibody 1C5/B. In contrast, using the immunofluorescence method only 25% reacted positive. This indicates that the majority of the tumor cells did not express the molecule on their membrane but only in the cytoplasma. No other marker, such as interleukin 2 receptor, HLA-DR antigen, or interferon-gamma could be related to the expression of MIF. Also the cellular infiltrate in the skin was composed mainly of T helper cells and reacted positive with 1C5/B. As less than 3% of normal blood lymphocytes reacted with 1C5/B we suggest that the conversion to positivity may be a characteristic feature of the leukemic T-cell phenotype in Sezary syndrome. PMID- 3295064 TI - A comparative study of Spitz nevus and nodular malignant melanoma using image analysis cytometry. AB - Image analysis cytometry can be used to estimate both nuclear DNA content and area in tissue sections. Since nodular malignant melanoma and Spitz nevus can show a remarkably similar light microscopic appearance, but may differ in behavior, we studied typical examples of these neoplasms to determine whether cytometric differences existed. Analysis of relative DNA content alone could not discriminate between these 2 entities in the 13 cases that we examined. However, Spitz nevi and nodular melanoma clearly differed in terms of maturation, which we defined as the difference between the mean nuclear size or mean nuclear DNA content of the uppermost and deepest melanocytes in each lesion. Maturation as defined by a decrease in mean nuclear DNA content proved highly significant (p less than 0.005). Only Spitz nevi showed a lesser DNA content in the deepest dermal cells as compared with upper dermal cells, suggesting that some Spitz nevi have an admixture of diploid and hyperdiploid cells in their upper portions, but mostly diploid cells in their deep portions. Only nodular melanoma showed higher mean DNA content in deep dermal cells as opposed to superficial dermal cells, suggesting that some nodular melanomas may either have clones of cells in their deep portions that have higher levels of ploidy, or more cells in the deep portion of melanomas may be in active phases of the cell cycle. Our study suggests that important cytometric differences exist between Spitz nevi and nodular melanoma, and that these could be exploited to develop cytometry into an adjunctive clinical technique. PMID- 3295065 TI - Regulation of c-myc RNA and its proteins in Daudi cells by interferon-beta. AB - It has been shown previously that interferons (IFNs) -alpha and -beta cause a reduction in the steady-state level of poly(A) c-myc RNA in the Burkitt lymphoma, Daudi. In this report we show that the c-myc RNA reduction is not mediated by simple changes in the poly-adenylation of either nascent or existing c-myc transcripts, since similar reductions of c-myc sequences were observed in poly(A) and total cellular RNA preparations from IFN-beta-treated cells. Furthermore, the first exon of c-myc RNA in Daudi cells contains several mutations, suggesting that the germ line configuration of the first exon is not essential for the IFN beta-mediated regulation. The c-myc RNA reduction was also detected in cells whose protein synthesis was inhibited by more than 95% with cycloheximide or emetine. We surmise that neither sustained nor IFN-induced protein synthesis is required for the c-myc RNA regulation. Antisera raised against either the carboxy or amino-terminal c-myc peptides precipitate in Daudi cells proteins of 66,000 and 63,000 daltons. In cells treated with IFN-beta, the amounts of these proteins are reduced by 46-74% which is in agreement with the reduction detected at the level of c-myc RNA. PMID- 3295066 TI - Clinical research: efficacy studies v basic research. PMID- 3295067 TI - Issues in pain research. Research perspectives: a response. PMID- 3295068 TI - Reflections on F.W.L. Kerr: a pain scientist. PMID- 3295069 TI - [Application of diaphragm pacing in two postoperative lung cancer patients]. PMID- 3295070 TI - [Biological function of polyamine covalently linked to a peptidoglycan in bacteria]. PMID- 3295071 TI - [Tetracycline-resistance plasmids widely dispersed among gram-positive bacteria, especially bacilli]. PMID- 3295072 TI - A simple Doppler test for haemodynamically significant carotid artery disease. AB - A 10 MHz directional Doppler velocimeter was used to assess carotid atherosclerosis in 41 patients with cerebro-vascular disease. There were 30 men and 11 women with a mean age of 58 years. The arterial waveform pulsatility indices of the common carotid (CC), temporal (T), supratrochlear (ST), and central retinal artery (CRA) were compared with triplanar arteriograms in detecting internal carotid artery stenosis. The results were that Doppler signal ratios were able to differentiate less than 70% from greater than 70% stenosis and complete occlusion. For the diagnosis of internal carotid stenosis the ratio ST/CC had a sensitivity of 90%, a specificity of 93.5% and an accuracy of 93%. The CRA/CC ratio showed a sensitivity of 90% specificity of 72% and accuracy of 76%, and central retinal artery signals were difficult to detect. The T/CC ratio diagnosed external carotid artery stenosis of greater than 70% with a sensitivity of 90%, a specificity of 87% and an accuracy of 96%. The ST/CC and T/CC ratios were easy to perform, and employed routinely available Doppler velocimeters. PMID- 3295073 TI - The development of an automated vascular laboratory. AB - Conventional vascular laboratory investigations such as Doppler ultrasound and photoplethysmography refilling tests produce results which require tedious cutting of chart recorder paper and calculation with the aid of ruler and pocket calculator. We have connected vascular lab equipment to a microcomputer which is able to record the data, generate reports and analyse the curves. PMID- 3295074 TI - Ultrasound screening in the management of abdominal aortic aneurysms. AB - Planned surgery for abdominal aortic aneurysms carries a low mortality (0-2%). Ultrasound examination of the abdomen can identify the aorta in 92% of patients. We have undertaken a study of the asymptomatic population based on a general practice (Family Doctor) register. The long term aims of this survey will be to identify a high risk group in which surgery is indicated, a low risk group were surgery can be avoided and a group of aneurysms in whom emergency surgery is contra-indicated. Arguments are put forward against improved treatment of aneurysms as emergencies as a way of improving overall survival and against the treatment of all cases detected by ultrasound as planned procedures. The current methods of selecting high risk cases are criticised and a possible method of selecting cases for planned surgery, based on screening and ultrasound follow-up is put forward. The advantages and disadvantages of an ultrasound screening programme are discussed. PMID- 3295076 TI - The intriguing problem of varicose veins. AB - New methods of investigation have given a fresh understanding of varicose veins. Aspects of this are described based on findings in patients investigated by Doppler flowmetry, functional phlebography and photoplethysmography. All observations refer to the upright position where various forms of failure in pumping blood upwards against gravity may arise. Simple varicose veins conduct flow from above a pumping mechanism to the low pressure area beneath it. Thus, saphenous incompetence allows downflow from the groin to below the musculovenous pumps of the calf and the foot. It is this reversed flow that creates tortuosity in the branch veins and sacculation beneath leaking saphenous valves. Perforator incompetence is often incidental and a concealed saphenous incompetence, without varicosites, is easily overlooked. Functional phlebography has shown that many patients with varicose veins also have inadequate deep vein valves so that the pumping mechanisms are soon overwhelmed and this may explain why some develop ulceration and others do not. Complex patterns of flow in superficial veins have been demonstrated, for example: strong collateral upflow past deformed deep veins whilst other veins allow spillage downwards: crossover incompetence with flow to the opposite limb and down its incompetent saphenous vein. The special investigations can accurately predict the outcome of surgery and are an important addition to successful management. PMID- 3295075 TI - Unrecognised aneurysmal disease in male hypertensive patients. AB - The risk of an aneurysm leaking is related to its size. The operative mortality of elective surgery should be less than 5% but is frequently more than 50% following rupture. Many patients previously undiagnosed present with rupture, yet are on long-term treatment for hypertension. Two-hundred hypertensive male patients over the age of 50 have been clinically examined, and subsequently undergone ultrasound examination of the abdominal aorta. Fourteen asymptomatic aneurysms were detected, 9 on clinical examination, confirmed by ultrasound and C.T., and a further 5 detected by ultrasound, and also confirmed by C.T. Twenty four patients were found to have carotid bruits, in 12 of whom the bruits were bilateral. Sixty-seven patients were found to have peripheral vascular disease. Routine abdominal ultrasound examination should be included in the regular assessment of hypertensive patients. PMID- 3295077 TI - Skeletal stability after inferior maxillary repositioning. PMID- 3295078 TI - [Immunohistochemical and biochemical investigations on glutathione S-transferases in the human placenta]. AB - GST-pi can be purified as a major molecular form of glutathione S-transferase (GST) in human placenta. In this paper, the localization of GST-pi as well as of neutral and basic GSTs in the first, second and third trimester placental tissues (10, 3 and 14 samples, respectively) was investigated immunohistochemically using antibodies to acidic GST-pi from the placenta, neutral GST-mu and basic GST-I from the liver. Total GST activity was assayed using 1-chloro-2,4-dinitrobenzene as a substrate, and the relative activity and content of GST-pi were determined by activity inhibition test and single radial immunodiffusion, respectively, on 4 first and 5 third trimester placental tissues. The results obtained were as follows. In early placenta, cytotrophoblasts were strongly stained by anti-GST-pi antibody, while in third placenta mainly syncytiotrophoblasts were stained. GST mu was stained only in syncytiotrophoblast in early placenta, while basic GST-I was weakly stained in the various cells in early to term placenta. Total GST activity in early and term placentas was 5.8 +/- 2.0 units/g of tissue (mean +/- S.D.) and 14.8 +/- 3.4 units/g, respectively. GST-pi relative activities were 90 +/- 4% and 85 +/- 6%, and GST-pi content was 41 +/- 31 micrograms/g and 106 +/- 29 micrograms/g, respectively. These results indicate that GST-pi is a major form of GST and localized mainly in trophoblasts at any developmental stage of the placenta, and it increases with development. PMID- 3295080 TI - [Physiological significance of the self-priming effect of LH-RH on the anterior pituitary glands]. AB - To investigate the intracellular mechanisms of the self-priming effect of LH-RH on the anterior pituitary gland, the responses of pituitary and serum gonadotropins to two administrations of this decapeptide at a 60 min, interval were studied in male rats. A clearly recognized self-priming effect in male rats was significantly suppressed by the administration of RNA synthesis inhibitor. Although the pituitary LH content decreased significantly after the first administration, the content increased to the control level immediately before the second administration. This recovery was prevented by the administration of RNA synthesis inhibitor. In spite of the large second response, the rate of the second LH depletion was low. The number of secretory granules in gonadotrophs showed similar changes to the pituitary LH content. The dilatation of the Golgi apparatus was observable at 60 min. after the first administration. These results of rat experiments indicate that the second response includes the newly synthesized gonadotropins, and a clinical LH-RH two step test could be employed to evaluate both pituitary gonadotropin synthesizing and secreting functions. PMID- 3295079 TI - [Production of monoclonal antibody against a newly established human endometrial cancer cell line SNG-II]. AB - A cell line designated SNG-II was established from the operation specimen of human endometrial adenocarcinoma, and by means of an immunization procedure using intact SNG-II cells, a monoclonal antibody (Mab) named MSN-1 which reacts immunohistochemically with endometrial cancers was obtained. The cell line grew well without interruption for over 5 years, and, SNG-II cells produced tumors of cell differentiated adenocarcinoma in nude mice. The modal chromosomal number was diploid without a marker chromosome. The production of human chorionic gonadotropin and its beta-subunit, CA-125, tissue polypeptide antigen, and placental proteins such as PP6 and PP7 in SNG-II was confirmed. MSN-1 was of IgM subclass. As the antigenic reactivity was unchanged by trypsin treatment, but lost by periodic treatment, it was suggested that the antigen corresponding to MSN-1 was a carbohydrate sequence. Immunohistochemically MSN-1 reacted with about 70% cases of endometrial adenocarcinoma, but seldom with normal endometrium. Furthermore, the staining pattern of MSN-1 was different in benign cells from that in malignant cells: only the luminal surface of the normal endometrium was positive, whereas the cytoplasma was also stained in many of adenocarcinoma cells. PMID- 3295081 TI - [A high-molecular-weight protease, ingensin, from human placental chorionic tissue--purification and studies of biochemical and physiological properties]. AB - Recently, the identification of several proteases of nonlysosomal origin has been reported. In this study, a high-molecular-weight protease, ingensin, was purified from human placenta, and the biological and physiological properties of this enzyme were investigated. The activity of ingensin was determined with a synthetic substrate, succinyl-leucyl-leucyl-valyl-tyrosine-methylcoumarinamide (SLLVT-MCA). The molecular weight of ingensin was calculated to be about 700,000 by HPLC gel filtration. Ingensin was separated into a major subunit of 70,000 and minor subunits of 105,000 and about 30,000, respectively, under the denaturating conditions. Maximum ingensin activity was observed in the presence of 0.06 to 0.08% sodium dodecyl sulfate (SDS). Ingensin was activated by linoleic acid and arachidonic acid. A subcellular fractionation study suggested that there was a large amount of ingensin activity in the microsome or cytosol fraction. An indirect immunofluorescent study showed that ingensin was localized in the trophoblast cell layer and epithelium of the vessel interstitial tissue. Ingensin hydrolyzed several proteins in human placental tissue, and had liberated ALP from the placental membrane. These results indicated that a new protease, ingensin, may be involved in protein turnover in placental tissue. PMID- 3295082 TI - [Studies on changes in the uterine cervix during pregnancy]. AB - The uterine cervix becomes increasingly soft during pregnancy and at parturition in comparison with the non-pregnant state. The purpose of the study is to evaluate the changes in consistency of the cervix during pregnancy by two methods. One is based upon the acoustical theory that the elasticity of the tissue correlates to the sound velocity (V). V = (E/rho)1/2 where E is an elastic modulus and rho is the density of the tissue. The ultrasonic velocities of 355 pregnant and 12 non-pregnant women were measured and the data are as follows: Sound velocities were 1587.5 +/- 6.0m/sec in controls, 1579.8 +/- 6.1m/sec in the first trimester, and 1572.8 +/- 5.4m/sec in the third trimester. The other study involved the quantification of collagenous fibers of the tissue sections stained by Masson's trichrome stain in the cervical stroma by means of an image processing technique. Area ratios of collagenous fibers in cervical stroma were 68.6 +/- 20.2% in non-pregnant, 46.3 +/- 14.0% in the first trimester, and 29.1 +/- 10.3% in near term. Two conclusions were reached based on these studies. The gradual decline in sound velocity with the progress of gestation reflects the softening of the cervix. Automatic image-analysis of sections stained by trichrome stain showed a decrease in collagenous fibers during gestation. The above results suggest that a decrease in collagenous fibers may be involved in the process of the ripening of the cervix. PMID- 3295083 TI - [Immunotherapy of the unexplained habitual aborter]. PMID- 3295084 TI - Computer-based instruction in clinical medical education: a pulmonary medicine self-assessment. AB - This computer assisted teaching program was designed to provide a comprehensive review of pulmonary medicine in the form of a self-assessment. The program consisted of 30 questions including multiple choice, true or false and matching questions. The questions were based on the respiratory chapter from a standard textbook of medicine. Forty students taking their mandatory medicine rotation at a major university teaching hospital used the program. Their scores ranged from 46.7% to 93.3% with a mean of 68.1%. The format enabled the student to answer the questions, to quickly determine which ones he got right and wrong and then he was provided with the correct answer and a reference in the respiratory chapter of the standard textbook of medicine on which the assessment was based. A score was given to each individual so that each student could be his own judge as to how well he did. After reading the references for the questions missed, the learner would decide for himself what area of pulmonary medicine deserved further study. PMID- 3295085 TI - The clinical application of synchronized independent lung ventilation (S.I.L.V.) in pulmonary disease with unilateral prevalence in pediatrics. AB - The authors report on their results in the clinical use of S.I.L.V. using two synchronized Siemens 900 C Servo Ventilators. The Mallincrodt Broncho-Cath 28 and 35 Fr was used for the independent bronchial intubation of children over five; while for children under three, we used both two separate cuffless tubes of suitable length, and the double lumen tube of our own manufacture (the Marraro bilumen tube). The new method was applied to 13 children aged between 4 hours and 11 years. Duration of S.I.L.V. was between 8 hours and 5 days. The advantages of S.I.L.V. compared to C.V. were increases of F.R.C. and of effective ventilation in the more damaged lung, with a reduction of hyperventilation and consequent barotrauma in the less damaged lung. It was also possible to apply different levels of PEEP in the two lungs, and to reduce the concentration of oxygen in the gases ventilated. In all the patients treated, the application of the new method provided rapid clinical, blood-gas analytical, and radiological improvement. The children electively treated all survived. PMID- 3295086 TI - Differential elaboration of prostaglandin E2 by cells of the hemopoietic microenvironment in response to endotoxin. AB - Eight daily intraperitoneal injections of endotoxin (LPS) induced hematologic abnormalities in mice like those previously observed with chronic inflammation, sterile abscess, and tumor bearing. By the ninth day, anemia, leukocytosis, hypocellularity of the bone marrow, and compensatory hemopoietic hyperplasia of the spleen had occurred. The suppressed hemopoietic recovery and impaired survival of mice with these abnormalities, after receiving an ordinarily sublethal dose of total body irradiation (600 cGy T.B.), confirmed their importance to the intact mouse and suggested that splenic hyperplasia was insufficient to compensate for a total body deficit of functional hemopoietic stem cells. Atrophy of hemopoietic tissue in the marrow with hyperplasia in the spleen implicated changes in the hemopoietic microenvironment to account for the different responses to endotoxin. Prostaglandin E2 (PGE2) serves as an important mediator of the inflammatory response and profoundly affects hemopoiesis. Previous studies had shown that low concentrations of PGE2 enhanced, and high concentrations suppressed erythropoiesis in vitro; therefore, we wondered whether stromal cells from the marrow's microenvironment produced more PGE2 in response to LPS than splenic stromal cells to explain the suppression of hemopoiesis in the marrow and its enhancement in the spleen. Indeed, synthesis of PGE2 in primary short-term cultures of adherent marrow stromal cells in response to LPS proved much greater than that observed in cultures of splenic stromal cells. Extending adherence times from 3 to 24 to 48 hours did not change the relationship. We believe that the results of our studies point to a role of PGE2 in the microenvironmental modulation of hemopoiesis in mice with activation of the inflammatory response. PMID- 3295087 TI - Blastomycosis--then and now. PMID- 3295088 TI - Alice Hamilton, M.D. (1869-1970). PMID- 3295089 TI - Deafness and cochlear implants. Results of clinical trials. PMID- 3295091 TI - Human peripheral blood mononuclear cells (PBM) cultured in serum-free medium. III. Morphological study of an in vitro microcytotoxicity model. AB - An in vitro tumor immunity model is suggested. Interactions between lymphocytes and macrophages in serum-free medium are being studied as well as the effect induced upon these interactions by the addition of heterologous and homologous tumor cells. In our model, the tumor cells seem to be approached by the lymphocytes before any contact with the macrophages and then presented to the latter. The macrophages may then acquire an "activated" structure and display cytotoxic properties. A pattern of in vitro cellular immunity is obtained. This description may serve as a model for further study and understanding of the process of tumor immunity. It is suggested that in contrast to generally accepted models of cellular immunology, lymphocytes can interact directly with antigen complexes and present them to macrophages. The latter would in turn be activated, become cytotoxic and produce or accumulate immune globulins. These cells seem to be an in vitro analog of the recently described tumor infiltrating lymphocytes (TIL) which reside in vivo within spontaneous tumors. PMID- 3295092 TI - Sinus tract in the neck: a rare complication of subtotal thyroidectomy for Graves' disease. AB - The present report demonstrates a complication not previously reported secondary to thyroid surgery as a treatment of hyperthyroidism. This complication of a sinus tract extending 6 cm from the thyroid to the skin appeared to be due to a foreign body reaction to the sutures utilized in the operation. This sinus tract which extruded some sutures became infected with Staphylococcus aureus which prevented spontaneous closure. The formation of a sinus tract in the neck after a subtotal thyroidectomy for hyperthyroidism appears to be a much less common complication than the previously reported complications of bilateral abductor vocal fold paralysis, unilateral recurrent nerve paralysis, permanent post operative hypoparathyroidism and thyroid storm secondary to this surgery, but the true incidence of sinus tract formation after thyroid surgery is unknown at present. PMID- 3295093 TI - Connection between varicella and herpes zoster. PMID- 3295094 TI - Toxoplasmosis: a review. AB - Toxoplasma gondii, the causative agent of toxoplasmosis, is one of the commonest protozoan parasites of man. It is found world-wide. Although the infection is common as indicated by a high prevalence of toxoplasma antibody among almost all human populations, the clinical disease is observed in only a small proportion of those infected. The most serious complications of infection are seen in infants of women who acquire the infection during pregnancy and in immuno-compromised patients. Clinical manifestations of the disease in the normal host, in compromised hosts including acquired immune deficiency syndrome (AIDS), in pregnancy, eye infection and the relationship of toxoplasmosis to abortion are discussed in detail. In addition, various serologic tests used in the diagnosis, their interpretation, and treatment regimens for various categories of patients are reviewed. Finally, the preventive measures and the serologic screening programs for pregnant women are discussed. PMID- 3295095 TI - [Has phlebography become useless in the diagnosis of deep venous thrombosis of the lower extremities?]. AB - It is now widely accepted that the clinical diagnosis of deep venous thrombosis (D.V.T.) is unreliable. Many venous thrombi are nonobstructive and not associated with vessel wall inflammation or inflammation of the surrounding tissues and consequently have no detectable clinical manifestations. Moreover, none of the symptoms or signs of venous thrombosis are unique to this condition and all can be caused by non thrombotic disorders. On the other hand, in most of the D.V.T., the calf is the site in the legs where a thrombus starts. This thrombus begins commonly in valve pockets throughout various deep veins of the leg and in saccules of soleal veins. Several non invasive techniques have been developed for diagnosing D.V.T.: 125I, fibrinogen, impedance plethysmography, Doppler ultrasound, Duplex scanning. Many publications document the correlation between venography and these non invasive tests for D.V.T. Unfortunately it appears that, excepted 125I. Fg, these techniques are poorly reliable at the level of the calf. Moreover the diagnosis of D.V.T. may occur in particular and difficult situations such as a recurrent deep vein thrombosis. Considering all above the authors believes that contrast venography remains the standard and that it is less dangerous to do unnecessary venography than not to recognize a deep vein thrombosis. PMID- 3295096 TI - [Evaluation of cardiac tolerance of intravenous digital angiography]. AB - Cardiac tolerance to intravenous digital subtraction angiography (ANVV) was evaluated by a prospective study in a continuous series of patients of both sexes investigated for various arterial diseases and classified initially into "cardiac" and "non-cardiac" cases. Ischemic and rhythmic electrocardiographic modifications were monitored, the contrast medium (PC) used being randomly selected between Ioxaglate and Iopamidol. Of the first 46 patients studied, 40% had had more than one auricular and/or ventricular extrasystole (ES), 18% had painless depression of the ST segment (greater than or equal to 0.5 mm) and 46.7% both effects. In the 17 "cardiac" patients, depression of ST and the ES were more frequent (p less than 0.02 and p less than 0.05 respectively) than in the 29 "non cardiac" cases. There was absence of difference between Ioxaglate and Iopamidol with respect to frequency of disorders of repolarization, but Ioxaglate appeared to provoke more ES than Iopamidol (respectively 13 of 23 and 5 of 22 cases, p = 0.02). Major cardiac complications were not reported, and it is concluded, after discussion of cardiovascular effects of PC injection, that intravenous digital subtraction angiography is generally well tolerated but requires some precautions in patients with cardiac affections. PMID- 3295098 TI - Chemical dependency: an overview and position. PMID- 3295097 TI - [Update on the treatment of systemic scleroderma]. AB - Renewed clinical trials of drugs used for many years and the availability of new symptomatic therapies allows selection of appropriate treatment for progressive systemic sclerosis. Colchicine damages intracytoplasmic microtubules and when administered at a dose of at least 1.5 mg per day during early stages of the disease reduces cutaneous sclerosis without improving other manifestations of scleroderma. D-penicillamine inhibits bridge formation during collagen maturation, acting mainly on cutaneous infiltration with more uncertain effects on visceral localizations of the disease. It can be effective against pulmonary lesions but, as with colchicine, must be prescribed early. Its action is delayed and its side effects limit its use. Corticoids are of very limited efficiency and although they may be useful for relief of muscular and articular localizations they have been accused of precipitating onset of renal insufficiency. Immunodepressants have until now been assessed as ineffective. The demonstration in patients with progressive systemic sclerosis of abnormal activation of immunity system cells suggested the use in this collagen disease of a new immunosuppressive agent, cyclosporine A, but clinical utility of this drug remains to be demonstrated. In systemic sclerosis efficacy of plasma exchange is mainly directed against vasomotor disorders and digital ulcerations, but study results are difficult to assess because of associated therapies. Constraints and risks of this treatment also considerably reduce its interest. The coagulation factor XIII acts as a stabilizing factor of collagen. It reduces cutaneous infiltration but its efficacy is based on results of a single controlled trial and its use is limited by the need for repeated intravenous injections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295099 TI - Insulin release from a cloned precursor beta cell line. AB - This paper describes the establishment in long-term tissue culture of a functional, clonal beta (B) cell line UMR 407/3 derived from neonatal rat pancreas. Immunofluorescence demonstrated specific and uniform staining for insulin. Transmission electron microscopy showed the presence of microvilli and cytoplasmic granules. The doubling time in culture was approximately 60 h in 2% (v/v) fetal calf serum with inhibition of growth at confluence. Biochemical studies demonstrated the incorporation of [3H]leucine into proinsulin and insulin, with insulin comprising 43.6% of the total radioactivity incorporated into immune complexes. When incubated at 37 degrees C for 30 min with Krebs Ringer bicarbonate buffer (pH 7.4), the amount of insulin released on stimulation by 16.7 mmol glucose/l, 20 mmol DL-glyceraldehyde/l or 20 mmol alpha ketoisocaproate/l was significantly higher compared with 5.6 mmol glucose/l. The mean insulin content was equivalent to 99 +/- 0.4 fmol (S.E.M.)/5 X 10(5) cells. Regulated insulin release was maintained through at least 15 passages in culture. The cells showed morphological evidence of senescence after passage 26 and this was associated with significant reduction in stimulated insulin release as well as insulin content. The ability of the cells of this clonal line to grow in soft agar suggests that it is a precursor cell line. The clonal B cell lines isolated so far may thus represent variably committed rather than fully differentiated B cells in culture. These clonal non-neoplastic cell lines will be useful models with which to study the regulation of maturation/differentiation of B cells and insulin gene expression.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295100 TI - Comparison of the effects on purified Leydig cells of four hormones (oxytocin, vasopressin, opiates and LHRH) with suggested paracrine roles in the testis. AB - Four hormones have been identified by various authors as possible paracrine regulators of testicular Leydig cells. The aim of this study was to evaluate their effects on purified adult rat Leydig cells under various conditions in vitro, and then to assess whether comparable effects occurred in vivo. In agreement with previous findings, an LHRH agonist (LHRH-A) exerted clear-cut effects on testosterone secretion by Leydig cells both in vitro and in vivo. On its own, LHRH-A stimulated testosterone production by Leydig cells for up to 24 h in culture but inhibited testosterone production stimulated by human chorionic gonadotrophin (hCG) between 24 and 72 h of culture. In-vivo, unilateral intratesticular injection of adult rats with 1 ng LHRH-A resulted 5 h later in a significant increase in testosterone concentrations in testicular interstitial fluid (IF). Vasopressin exerted effects in vitro which were similar to those of LHRH-A. On its own, vasopressin stimulated testosterone production for up to 5 h of culture, but not thereafter, while in the presence of hCG, vasopressin inhibited testosterone production beyond 24 h of culture. The initial stimulatory effect of vasopressin on testosterone production occurred with concentrations of 1 nmol/l and higher, but the magnitude of stimulation (threefold or less) was considerably less than that induced by LHRH-A (ninefold) over the same time period. In contrast to LHRH-A, unilateral intratesticular injection of vasopressin in high doses (20 and 2 ng) had no effect on IF testosterone levels 5 h later.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295101 TI - Preliminary investigations into the endocrine systems of subfertile cattle: location of a common lesion (rate-limiting step). AB - Dairy cows with a variety of clinical conditions were investigated in an attempt to identify the cause(s) of subfertility. Sequential or simultaneous injections of 20 micrograms gonadotrophin-releasing hormone (GnRH), 1 mg oestradiol benzoate and 0.06 mg ACTH(1-24) into five clinical cases of ovarian follicular cysts, two cases of poor body condition and one case of lameness and into control cows revealed a failure in the LH positive-feedback response to oestradiol in all eight clinical cases, but in only two out of twelve control cows. Two of the clinical cases and the two non-responding control cows had high or rising initial progesterone concentrations which would explain the absence of response. All cows studied responded similarly to GnRH and ACTH(1-24). It is suggested that hypothalamus-pituitary control of LH release may involve a rate-limiting step (in the oestradiol positive-feedback system) and that lesions at this point result in subfertility in a variety of clinical situations. PMID- 3295102 TI - Secretion of LH in spontaneously hypertensive rats. AB - Weights of testes, seminal vesicles, ventral prostate and pituitary, plasma testosterone and LH concentrations, pituitary LH content and concentration, the LH in-vivo response after LHRH administration (1 microgram), and basal and LHRH stimulated secretion in vitro were analysed in adult male spontaneously hypertensive (SH) and normotensive control (WKY) rats. Spontaneously hypertensive rats showed: testis and pituitary hypertrophy; seminal vesicle and ventral prostate atrophy; increased plasma testosterone and LH concentrations; increased pituitary LH content and concentration; unchanged net increase of plasma concentrations of LH 15 and 45 min after administration of 1 microgram LHRH; and increased basal LH secretion in vitro with a normal response to LHRH stimulation. These results provide evidence that SH rats show increased LH secretion with a normal response to LHRH stimulation. The coexistence of high plasma concentrations of testosterone with seminal vesicle and ventral prostate atrophy suggest a reduction in the effectiveness of testosterone in these structures. PMID- 3295103 TI - Effects of continuous intravenous infusion of an ovine placental extract enriched in placental lactogen on plasma hormones, metabolites and metabolite biokinetics in non-pregnant sheep. AB - Continuous intravenous infusions of saline or of a placental extract containing ovine placental lactogen were given to three non-pregnant, non-lactating ewes over periods of 36 h, 1 week apart. During saline infusion no placental lactogen was detected in jugular vein plasma. but infusion of the placental extract raised the placental lactogen concentration from undetectable to 40-50 micrograms/l, similar to concentrations in ewes with one fetus on day 90 of pregnancy. By comparison with the saline control period, infusion of the placental extract consistently increased both plasma concentrations and irreversible loss of nonesterified fatty acids. Plasma concentrations of glucose and urea, but not irreversible loss of these metabolites, were consistently increased. Although the placental extract was not subjected to extensive purification, it was enriched in placental lactogen and contained no detectable contamination with insulin, prolactin or growth hormone. The results are suggestive of a role for placental lactogen in modifying metabolism and acting during pregnancy to provide nutrients for fetal metabolism. PMID- 3295104 TI - Stimulation of intestinal epithelial cell proliferation in culture by growth factors in human and ruminant mammary secretions. AB - Samples of human and ruminant mammary secretions stimulated the proliferation of rat intestinal epithelial (RIE-1) cells in culture. The stimulation was dose dependent, and samples taken prepartum had greater potency than those taken after parturition. When various hormones and growth factors known to be present in milk were tested, only epidermal growth factor (EGF), insulin and insulin-like growth factor I (IGF-I) stimulated the proliferation of RIE-1 cells. IGF-I was effective at lower concentrations than insulin, and the maximal stimulation induced by each of these two polypeptides was greater than that induced by EGF. The maximal stimulation induced by samples of mammary secretions was similar to that induced by insulin or IGF-I. PMID- 3295105 TI - Effects of human placental lactogen and growth hormone on the production of insulin and somatomedin C/insulin-like growth factor I by human fetal pancreas in tissue culture. AB - We have investigated the ability of glucose, human GH and human placental lactogen (hPL) to alter the content and release of somatomedin C/insulin-like growth factor I (SM-C/IGF-I), and the biosynthesis, content and release of insulin from cultured human fetal pancreas. Fetal pancreatic explants obtained from glands following prostaglandin-induced abortion between 12 and 21 weeks of gestation were maintained in free-floating culture for 3-5 days before the experiments. The explants were then cultured for 3 days in medium containing either 2.7 or 16.7 mmol glucose/l with or without GH (4.5 or 45.5 nmol/l) or hPL (4.6 or 46.5 nmol/l). Serum-free medium from the final 24 h of culture was collected and SM-C/IGF-I and insulin were measured radioimmunologically in both conditioned medium and tissue explants extracted with acid ethanol. Insulin biosynthesis, determined by immunoprecipitation of [3H]leucine incorporated into insulin, was not significantly altered by any experimental variable. Incubation in the presence of 16.7 mmol glucose/l caused an increase of insulin release from explants, but had no consistent action on insulin content, compared with medium containing 2.7 mmol glucose/l. The pancreatic content and release of SM-C/IGF-I were independent of these glucose concentrations. Neither GH nor hPL altered insulin or SM-C/IGF-I content or release in the presence of the lower glucose concentration. At the higher glucose concentration, 45.5 nmol GH/l did not alter insulin release but caused a significant increase in SM-C/IGF-I content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295106 TI - A comparative retrofill leakage study utilizing a dentin bonding material. PMID- 3295107 TI - Alloantigen persistence in induction and maintenance of transplantation tolerance. AB - Infusion of parental bone marrow cells into F1 hybrids conditioned by total lymphoid irradiation (TLI) results in chimeras with a high percentage of donor type cells, and without clinical signs of graft-vs.-host reaction. In these chimeras, a state of tolerance has been shown to be associated with paucity of cytotoxic T lymphocyte percursors (pCTL) reactive with host-type alloantigens. To determine whether the presence of tolerizing alloantigens is essential for maintenance of unresponsiveness, lymphohematopoietic cells obtained from such tolerant chimeras were transferred into supralethally irradiated recipients of two different genotypes: in one case the adoptive recipients were syngeneic with host-type cells, and in the other they were syngeneic with donor-type cells of the original chimeras, thus providing the chimeric cells with a tolerogen-free environment. After "parking" for 4 d in syngeneic donor-type mice, the transferred cells displayed a marked increase in the frequency of pCTL directed against tolerizing alloantigens, whereas a low pCTL frequency directed against the same H-2 target cells was maintained in allogeneic tolerizing-type adoptive recipients. Multiple injections of adoptive donor-type mice with tolerizing-type cells of the original chimera reestablished a low level of cytotoxic precursors. Cytotoxic activity against unrelated alloantigens was independent of the presence of tolerogen-presenting cells in the adoptively transferred mice. Our experimental model suggests that persistence of cells bearing tolerizing alloantigens is an essential requirement for maintenance of previously established tolerance. PMID- 3295109 TI - Invasion of mouse erythrocytes by the human malaria parasite, Plasmodium falciparum. AB - Plasmodium falciparum malaria merozoites require erythrocyte sialic acid for optimal invasion of human erythrocytes. Since mouse erythrocytes have the form of sialic acid found on human erythrocytes (N-acetyl neuraminic acid), mouse erythrocytes were tested for invasion in vitro. The Camp and 7G8 strains of P. falciparum invaded mouse erythrocytes at 17-45% of the invasion rate of human erythrocytes. Newly invaded mouse erythrocytes morphologically resembled parasitized human erythrocytes as shown on Giemsa-stained blood films and by electron microscopy. The rim of parasitized mouse erythrocytes contained the P. falciparum 155-kD protein, which is on the rim of ring-infected human erythrocytes. Camp but not 7G8 invaded rat erythrocytes, indicating receptor heterogeneity. These data suggest that it may be possible to adapt the asexual erythrocytic stage of P. falciparum to rodents. The development of a rodent model of P. falciparum malaria could facilitate vaccine development. PMID- 3295108 TI - Lipopolysaccharide induces recurrence of arthritis in rat joints previously injured by peptidoglycan-polysaccharide. AB - Rat ankle joints injected intraarticularly with 5 micrograms of group A streptococcal peptidoglycan-polysaccharide (PG-APS) developed an acute course of arthritis. Recurrence of arthritis was induced in 100% of these joints by intravenous injection of as little as 10 micrograms of Salmonella typhimurium lipopolysaccharide (LPS) 3 wk after intraarticular injection. This reaction was similar in athymic and euthymic rats. Buffalo rats were less susceptible than Lewis or Sprague-Dawley rats. Neisseria gonorrhoeae, Yersinia enterocolitica, and Escherichia coli LPS, and S. typhimurium Re mutant LPS, were also active. Re mutant LPS activity was greatly reduced by mixing with polymyxin B. E. coli lipid A was weakly active. An acute synovitis of much less incidence, severity, and duration was seen in contralateral joints injected initially with saline, and in ankle joints of naive, previously uninjected rats after intravenous LPS injection. The intravenous injection of the muramidase mutanolysin on day 0 or 7 after intraarticular PG-APS injection prevented LPS-induced recurrence of arthritis. These studies suggest that the phlogistic activities of lipid A and peptidoglycan might interact in an inflammatory disease process, and that LPS may play a role in recurrent episodes of rheumatoid arthritis or reactive arthritis. PMID- 3295110 TI - Cardiac transplantation in private practice. PMID- 3295111 TI - The nonspecific sonographic nature of a chronic renal infarct. PMID- 3295112 TI - Initial depression and response to imipramine in agoraphobia. AB - Thirty-seven patients participating in a controlled treatment study with imipramine were classified as high or low depressed simultaneously on two depression measures. Analysis of variance by 2 (high-low depressed) X 2 (high-low imipramine dosage) groupings revealed significant dose but no depression main effects. The greater dose effect observed in the low depressed group and the greater response rates found among high-dose patients with low initial depression strongly suggest that the beneficial effect of imipramine in agoraphobia was not primarily antidepressant in nature. PMID- 3295113 TI - Perspectives in MAO: past, present, and future. A review. PMID- 3295114 TI - MAO inhibitors in mental disease: their current status. AB - Available MAOIs seem to be mainly indicated for the heterogeneous group of patients with depressive syndromes. Although groups of patients with all the recognized major subtypes of depression (including "endogenous depression") probably respond in varying degrees, MAOIs appear to be particularly indicated for out-patients with "neurotic depression" complicated by panic disorder or hysteroid dysphoria, which involves repeated episodes of depressed mood in response to feeling rejected. MAOIs can also be effective in several anxiety syndromes, in particular panic disorder. Other reports have claimed success in a variety of other syndromes including bulimia, anorexia nervosa, obsessive compulsive neurosis, atypical facial pain and some other types of chronic pain, childhood attention deficit disorder and delusions of infestation by parasites. The nature of any underlying personality disorder is an important response variable and the assessment of personality should be encouraged in further studies. The development of new drugs raises the prospect of a range of MAOIs targeted at specific patient populations. Tranylcypromine also merits further investigation as clinical experience suggests that it can produce a dramatic response in some patients with phenelzine-resistant disorders. This may be due, at least in part, to its amphetamine-like effects. PMID- 3295115 TI - The catalytic behaviour of monoamine oxidase. AB - Evidence concerning the kinetic mechanism of the reaction catalyzed by monoamine oxidase is reviewed with particular reference to the possibility that the double displacement mechanism followed by other substrates is not operative with benzylamine. The requirement for only one of the two products of the first half reaction to be released in a double-displacement mechanism indicates that the available evidence does not exclude such a mechanism with benzylamine as the substrate. Cases in which substrates also act as time-dependent inhibitors are considered. The mechanism that can describe the inhibition and product formation is similar for the compounds MD 780236 and MPTP whereas that describing the effects of high concentrations of 2-phenethylamine is best described by a scheme involving inhibition occurring via an abortive complex. PMID- 3295116 TI - Some properties of semicarbazide-sensitive amine oxidases. AB - The semicarbazide-sensitive amine oxidases (SSAOs) comprise a substantial but diffuse group of enzymes separable from classical monoamine oxidase in several respects. Differences in cofactor requirement, molecular weight and subcellular distribution are crucial for such a separation. Differential sensitivity to enzyme inhibitors, characterized by resistance to inhibition by acetylenic MAO inhibitors coupled with sensitivity to semicarbazide and some related compounds are characteristic of these enzymes. SSAO enzymes have been found in the plasma of man, ox, pig and horse, for example as well as in the solid tissues of many species. Extensive studies have so far failed to produce any conclusive evidence to indicate what the precise functions of many of these enzymes may be. Indeed in most cases there is no clear idea as to the nature of the preferred physiological substrate, although many amines with pharmacological activity have been shown to be substrates. The actions of these amines may be potentiated following inhibition of SSAO, but as yet little is known whether or not these actions can be important in vivo. An attempt is made in this review to bring together some of the evidence to see if there are indications for future endeavours. PMID- 3295117 TI - Processing of MPTP by monoamine oxidases: implications for molecular toxicology. AB - MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), a selective nigrostriatal neurotoxin, is bioactivated by MAO-B (and less effectively by MAO-A) to 2,3-MPDP+ and this intermediate undergoes further oxidation to MPP+, partly through the activity of MAO forms. MPTP and its two primary metabolites are competitive inhibitors of both A and B forms of MAO. MPTP and 2,3-MPDP+ are also mechanism based inactivators of both forms of the enzyme. A catalytic mechanism, involving the formation of radical intermediates, is proposed for the MAO-mediated oxidation of MPTP. Post-oxidation biochemical sequelae, possibly involved in the expression of neurotoxicity, include the active accumulation of MPP+ via dopamine reuptake systems, the energy-driven uptake of MPP+ by mitochondria and the inhibition of NADH dehydrogenase by pyridine derivatives. A scheme linking these events as steps in the molecular mechanism of action of MPTP is proposed and discussed in terms of the selective toxicity of the neurotoxin towards nigrostriatal cells. PMID- 3295118 TI - The functional coupling of neuronal and extraneuronal transport with intracellular monoamine oxidase. AB - "Metabolizing systems" are responsible for the quick inactivation of noradrenaline released from adrenergic nerve endings: a transport mechanism (uptake1 or uptake2) is arranged in series with the intracellular enzyme (monoamine oxidase, MAO; catechol-O-methyltransferase, COMT). In the perfused rat heart, kenzyme-values were determined, i.e., those rate constants which characterize the unsaturated intracellular enzymes. In the extraneuronal metabolizing system kcomt greater than kmao for noradrenaline and adrenaline, while rather similar rate constants were obtained for dopamine. However, for the neuronal deaminating system, kmao is considerably higher than kmao for the extraneuronal system. Second, in the rat vas deferens it is demonstrated that inhibition of neuronal MAO leads to very pronounced rises of the axoplasmic noradrenaline concentration--and this is again a reflection of the high activity of neuronal MAO. In a third series of experiments (with the rat vas deferens), the evidence indicates that the neuronal inward transport of substrates of MAO fails to saturate the enzyme. This is the functional consequence of the high activity of neuronal MAO. It is concluded that a) neuronal MAO activity is very high, and--as a consequence--b) axoplasmic noradrenaline levels are very low. PMID- 3295119 TI - Predecessors of modern black nurses: an honored role. PMID- 3295120 TI - 2-Amino-7-phosphonoheptanoic acid inhibits insulin-induced convulsions and striatal aspartate accumulation in rats with frontal cortical ablation. AB - Pretreatment of rats with the excitatory amino acid antagonist 2-amino-7 phosphonoheptanoic acid (2-APH; 0.5 mmol/kg, i.p.) protected against insulin induced clonic seizures. Complete protection was observed in 38% of the rats and partial protection in an additional 50%. Lesioning of the corticostriatal pathway by frontal cortical ablation caused decreases in the striatal levels of aspartate (-28%) and glutamate (-18%), an increase in striatal glutamine level (45%), and decreased high-affinity uptake of D-[3H]aspartate (-27%) in the lesioned dorsal neostriatum. Insulin-induced hypoglycemia caused a predicted sharp increase in aspartate level (165%) and decreased glutamate (-20%) and glutamine (-38%) levels in the intact striatum. Pretreatment of rats with 2-APH significantly reversed the insulin-induced changes in striatal aspartate, glutamate, and glutamine levels, especially in the intact hemisphere. In normoglycemic control rats, the "metabolic," i.e., concentration in the lesioned hemisphere, aspartate pool constituted 72% and the "synaptic," i.e., the concentration difference between the intact and lesioned hemispheres, 28% of the total striatal aspartate pool. 2 APH had no effect on the level of "metabolic" aspartate in the striata of normoglycemic rats but caused an almost complete suppression of "synaptic" aspartate. Following insulin-induced hypoglycemia, the "metabolic" aspartate pool doubled, whereas the "synaptic" aspartate pool increased 3.5-fold in the absence of 2-APH. The insulin-induced rise in "synaptic" aspartate level was almost completely blocked by 2-APH (a 5% rise instead of a 3.5-fold rise).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295121 TI - Cell adhesion molecule N-CAM is expressed by denervated myofibres in Werdnig Hoffman and Kugelberg-Welander type spinal muscular atrophies. AB - Immunocytochemical analysis utilising antibody to neural cell adhesion molecule (N-CAM) was carried out on skeletal muscle biopsies from patients with childhood spinal muscular atrophy. Children with both Werdnig-Hoffmann and Kugelberg Welander disease showed positive N-CAM reactivity. There were however differences in the N-CAM expression profiles in these two sets of patients. All myofibres were positive for N-CAM in the Werdnig-Hoffmann patients. This included both the normal sized fibres and the atrophic fibres. In contrast only the atrophic fibres were positive in the Kugelberg-Welander patients. No reactivity was found associated with the large hypertrophic fibres. It is likely that in the Werdnig Hoffmann patients the positive N-CAM reactivity reflects unstable innervation of myofibres that had been previously innervated. A similar mechanism may operate in the Kugelberg-Welander patients, but the innervation of the hypertrophic fibres is more stable as they are able to repress N-CAM expression. These results contrast with a lack of N-CAM expression found previously on muscle biopsies from adults with denervation disease. PMID- 3295123 TI - Vasoactive intestinal polypeptide immunoreactive neurons in the primary visual cortex of the cat. AB - When cat visual cortex (area 17) is reacted with an antibody to vasoactive intestinal polypeptide (VIP) a variety of neuronal types is labelled. Many of the labelled neurons are bipolar in form and are most common in layers II and III, although significant numbers of bipolar neurons are also encountered in layer V. Multipolar cells are also labelled. These are most frequent in layer IV and have a variety of shapes. In layer I, the labelled cells are of three varieties, i.e. horizontal bipolar cells, horizontal bitufted cells and multipolar neurons, while in layer VI the few VIP-positive neurons are horizontal bipolar cells. This suggests that all of the VIP-labelled neurons in cat area 17 are non-pyramidal in form, and this has been confirmed by electron microscopy. In these preparations, axon terminals are also labelled and under the light microscope it can be seen that these terminals occur both within the neuropil and around the cell bodies of some neurons, particularly neurons in layers II and III. Electron microscopy has shown that all of the labelled axon terminals form symmetric synapses and that those in the neuropil synapse with the shafts of smooth dendrites. These axodendritic synapses account for about 90% of the synapses formed by the labelled axon terminals. The remainder of the labelled axon terminals synapse with the cell bodies of pyramidal neurons. Parallels are drawn between these results and those previously obtained by examining those neuronal elements labelled with VIP antibodies in rat visual cortex. PMID- 3295122 TI - A double-blind controlled trial of high dose methylprednisolone in patients with multiple sclerosis: 1. Clinical effects. AB - A randomised double-blind, placebo-controlled trial of high-dose, pulsed intravenous methylprednisolone was carried out in 50 individuals with multiple sclerosis; 22 patients were in acute relapse and 28 had chronic progressive disease. After a baseline assessment using the Kurtzke functional and expanded disability status scales each patient was randomly allocated to intravenous treatment with methylprednisolone (500 mg) or a saline placebo administered as a single daily dose for 5 days. Clinical assessments were repeated at 1 and 4 weeks after starting treatment. The results from all 50 patients showed a highly significant effect in favour of methylprednisolone treatment (p less than 0.001). In patients with relapse, there was a significant decrease in clinical disability scores at 1 and 4 weeks in the methylprednisolone treated group compared with controls (p less than 0.05 for each comparison). In the chronic progressive group, disability scores at 4 weeks only were significantly lower after treatment with methylprednisolone (p less than 0.01), mainly attributable to improvement in pyramidal function. PMID- 3295124 TI - Pressure control to accommodate patient breathing efforts during volume ventilation. AB - Intermittent positive-pressure ventilation is used to support patients whose unassisted breathing is inadequate. Mechanical ventilators deliver pressurized gas to the patient's lungs by using a pattern of volume and timing that is preset by the clinician. A weakness of existing control methods is their emphasis on maintaining adequate gas exchange while poorly accommodating the patient's efforts to reassume control of the delivery pattern. A method is proposed to control airway pressure within a breath by making it respond to measurements of volume. This method using pressure as a function of volume, or P(V) method, permits the patient to have transient control over flow rate and delivered volume. In addition, an adaptive controller is included that modifies the applied pressure during subsequent breaths; it assures an average flow rate and delivered volume at the levels prescribed by the clinician, when sustained changes occur in airway resistance, lung-thorax compliance, or breathing efforts. Analyses and computer simulations suggest that the P(V) method will be better than conventional volume ventilation in accommodating, within a breath, transient breathing efforts without long-term degradation of the prescribed delivery pattern. The P(V) method can restore the delivery pattern, using the adaptive controller, within a few breaths after changes occur in the patient's lung mechanics. We conclude that the P(V) method is feasible, that it may represent an improved method of patient ventilation, particularly during fighting or weaning from the ventilator, and that it warrants further investigation. PMID- 3295125 TI - History of blood gas analysis. VII. Pulse oximetry. AB - Pulse oximetry is based on a relatively new concept, using the pulsatile variations in optical density of tissues in the red and infrared wavelengths to compute arterial oxygen saturation without need for calibration. The method was invented in 1972 by Takuo Aoyagi, a bioengineer, while he was working on an ear densitometer for recording dye dilution curves. Susumu Nakajima, a surgeon, and his associates first tested the device in patients, reporting it in 1975. A competing device was introduced and also tested and described in Japan. William New and Jack Lloyd recognized the potential importance of pulse oximetry and developed interest among anesthesiologists and others concerned with critical care in the United States. Success brought patent litigation and much competition. PMID- 3295126 TI - Adjuvant therapy of osteosarcoma. PMID- 3295127 TI - Grade 3 nausea, vomiting, and myelosuppression or progressive, metastatic sarcoma? PMID- 3295128 TI - Durable remissions in stage III follicular lymphoma: interpret with caution. PMID- 3295129 TI - Combination chemotherapy using adriamycin, DTIC, cyclophosphamide, and actinomycin D for advanced soft tissue sarcomas: a randomized comparative trial. A phase III, Southwest Oncology Group Study (7613). AB - The term soft tissue sarcoma refers to a large variety of malignant tumors arising in extraskeletal connective tissues that connect, support, and surround discrete anatomic structures. All visceral organs also contain a connective stroma that can undergo malignant transformation. Because of the histological similarities of this group of tumors and their relative rarity, treatment prescriptions for patients that have disseminated disease are most often uniform. In this study, we asked the question whether adding a third drug (cyclophosphamide or actinomycin D) to Adriamycin (Adr [Adria Laboratories, Columbus, OH])-(3,3-dimethyl-1-triazeno)- imidazole-4-carboxamide (DTIC) would improve the response rate and/or survival. A unique feature of this cooperative group clinical trial was the mandatory pathology review of the histological material. All patients of the Southwest Oncology Group between June 1, 1976, and November 17, 1979, who had a biopsy-confirmed diagnosis of a soft tissue sarcoma with convincing clinical or biopsy-documented evidence of metastatic disease were eligible for the study. Patients were randomized to receive (1) Adr, 60 mg/m2 intravenously, day 1, and DTIC, 250 mg/m2 every 3 weeks (104 patients); (2) Adr and DTIC as in (1) and cyclophosphamide, 500 mg/m2, day 1 (112 patients); or (3) Adr and DTIC as in (1) and actinomycin D, 1.2 mg/m2, day 1, (119 patients). There was no statistically significant difference in response rates (33%, 34%, and 24%) (P = .25). Median durations of response were 31 weeks in the Adr-DTIC arm, 26 weeks in the cyclophosphamide-DTIC-Adr arm, and 23 weeks in the Adr-DTIC Actinomycin D arm (P = .78). Median durations of survival were 37, 42, and 50 weeks, respectively. Again, no statistically significant differences were observed (P = .59). Toxicities from each of these treatment arms were formidable and were equivalent. Prognostic factor analysis showed a prognosis based on bone marrow reserve, sex, and pathology subtype favorable to patients. PMID- 3295131 TI - Biliary tract obstruction secondary to cancer: management guidelines and selected literature review. AB - Malignant biliary tract obstruction (MBTO) due to either primary biliary tract cancer or metastasis to the porta hepatis is a common clinical problem. The most common metastatic tumors causing MBTO in order of frequency are gastric, colon, breast, and lung cancers. Radiographic diagnostic procedures should proceed in a cost-effective sequence from ultrasonography, computerized tomography (CT), percutaneous transhepatic cholangiography (PTHC), and endoscopic retrograde pancreatography with the goal of establishing the site of the biliary tract obstruction. The identification of the site of obstruction could be established by ultrasound 70% to 80%, CT scan 80% to 90%, PTHC 100%, and endoscopic retrograde cholangiography (ERCP) 85%. Therapeutic intervention by radiographic decompression (PTHC or endoscopic prosthesis), surgical bypass, or radiation therapy with or without chemotherapy may be selectively used based on (1) the site of obstruction; (2) the type of primary tumor; and (3) the presence of specific symptoms related to the obstruction. ("Prophylactic" biliary tract decompression to prevent ascending cholangitis is not supported by the literature in that the frequency of sepsis in the face of malignant obstruction is small (in contrast to sepsis associated with stone disease). Furthermore, PTHC with drainage as a long-term procedure is associated with a substantial frequency of sepsis and is unnecessary and possibly problematic as a preoperative procedure simply to reduce the bilirubin level. The use of radiation therapy in conjunction with chemotherapy for patients not deemed suitable for a surgical bypass because of the presence of proximal obstruction is an important alternative to PTHC. PMID- 3295130 TI - Stage III follicular lymphoma: durable remissions with a combined chemotherapy radiotherapy regimen. AB - From 1975 to 1982, 74 patients with stage III follicular lymphoma were treated with a combined modality protocol which included chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP Bleo), and radiotherapy to involved regions. This program resulted in a complete remission (CR) rate of 81%, a 5-year survival of 75%, and 5-year relapse-free survival (RFS) of 52% for all patients. Analysis of potential factors affecting treatment outcome revealed a significantly better CR rate for patients with small cleaved cell type (97%) than for patients with mixed (73%) or large-cell (57%) histologies. The 5-year survival was significantly better for patients with small cleaved (91%) and mixed (84%) cell types than for large cell (40%). In addition, bulky abdominal disease and elevated serum lactate dehydrogenase (LDH) were significant adverse prognostic factors for CR and for survival. Toxicity was moderate. No secondary leukemias have occurred. This combined modality regimen resulted in prolonged remission and potential cure for over half of patients who achieved CR, and is particularly encouraging for those with follicular small cleaved and mixed histologies. PMID- 3295132 TI - Adjuvant chemotherapy of osteosarcoma. PMID- 3295134 TI - Inflammatory breast cancer. PMID- 3295133 TI - Whither carboplatin. PMID- 3295135 TI - Functional associations among simultaneously monitored lateral medullary respiratory neurons in the cat. I. Evidence for excitatory and inhibitory actions of inspiratory neurons. AB - Data were obtained from 45 anesthetized (Dial), paralyzed, artificially ventilated, bilaterally vagotomized cats. Arrays of extracellular electrodes were used to monitor simultaneously the activities of lateral medullary respiratory neurons located in the rostral and caudal regions of the ventral respiratory group. The average discharge rate as a function of time in the respiratory cycle was determined for each neuron and concurrent phrenic nerve activity. Most cells were tested for axonal projections to the spinal cord or the ipsilateral vagus nerve using antidromic stimulation techniques. Seven hundred and sixty-one pairs of ipsilateral respiratory neurons that contained at least one neuron whose maximum discharge rate occurred during the inspiratory phase were analyzed by cross-correlation of the simultaneously recorded spike trains. Twenty-three percent of the 410 pairs of inspiratory (I) neurons showed short time scale correlations indicative of functional association due to paucisynaptic connections or shared inputs. Eight per cent of the 351 pairs composed of an I cell and and expiratory (E) neuron were correlated. We found evidence for excitation of both bulbospinal I neurons and I cells that were not antidromically activated by stimulation of the spinal cord and vagus nerve (NAA neurons) by NAA I cells. We also obtained data suggesting inhibitory actions of cells whose maximum discharge rate occurred in the first half of the I phase (I-DEC neurons). These actions included inhibition of other I-DEC neurons, inhibition of cells whose greatest firing rate occurred in the last half of the I phase (I-AUG neurons), inhibition of E-DEC neurons, and inhibition of E-AUG cells. Sixty-two percent (31/50) of the correlations that could be interpreted as evidence for an excitatory or inhibitory paucisynaptic connection were detected in pairs composed of a caudal and a rostral ventral respiratory group neuron. Eighty-eight percent (14/16) of proposed intergroup excitatory connections involved a projection from the rostral neuron of the pair to the caudal cell, whereas 73% (11/15) of proposed inhibitory connections involved a caudal-to-rostral projection. These results support and suggest several hypotheses for mechanisms that may help to control the development of augmenting activity in and the timing of each phase of the respiratory cycle. PMID- 3295136 TI - Cell size, projection path, and localization of estrogen-sensitive neurons in the rat ventromedial hypothalamus. AB - Antidromic action potentials were recorded in and around the ventromedial nucleus of the hypothalamus (VMN) of the ovariectomized female rat following stimulation of the central gray matter of the mesencephalon (CG). The animals had either the lateral or caudal trajectory of the VMN efferent disrupted by a small knife cut. Changes in the polarity, peak-to-peak amplitude, and the duration of the initial positive deflection of the antidromic action potentials were recorded for each response as the recording electrode was advanced at 10-micron intervals from the point of detection of the potential until its deterioration. Seventy-four recordings in which potentials exceeded 2 mV at the maxima were subjected to further analysis. The mean spatial spread of the extracellular antidromic action potentials, which was measured by moving the recording electrode at 10-micron intervals, was significantly larger in responses in 17 animals bearing the posterior knife cut (n = 41) than those in 15 animals with the lateral knife cut (n = 33). Mean peak-to-peak amplitude was also significantly greater in responses from the posterior-cut animals than in those from the lateral-cut ones. In the former, action potentials were completed with a shorter time lapse than the latter. In the posterior-cut animals, estrogen treatment of the ovariectomized rats significantly lowered antidromic activation thresholds and shortened absolute refractory periods for CG stimulation. Estrogen had no detectable effect on the excitability of cells that survived the lateral cut. Histological analyses located antidromically driven cells in the posterior-cut animals in the rostral extremity of the VMN and the adjacent retrochiasmatic area; those in the lateral cut animals were scattered in and around the VMN, caudad to the former. These results suggest that rostral VMN neurons with large soma and laterally projecting axons are responsible for estrogen-dependent autonomic, neuroendocrine, and behavioral functions, such as reproduction and feeding. PMID- 3295137 TI - Thallium washout analysis: fact or fiction? PMID- 3295138 TI - Fast washout of thallium-201 from area of myocardial infarction: possible artifact of background subtraction. AB - A recent report described a pattern of "reverse redistribution" on poststreptokinase 201Tl studies which was believed to be due to rapid washout of 201Tl from the infarct area related to reperfusion of the infarct vessel. We have also observed the phenomenon of rapid washout of 201Tl from the area of infarction in the absence of thrombolytic therapy. This study was undertaken to test the hypothesis that rapid washout of 201Tl from an area of infarction is an artifact of background subtraction usually employed in analysis of washout. A total of 61 patients with previous myocardial infarction who underwent cardiac catheterization and exercise 201Tl imaging were examined. Thallium-201 images were analyzed using a validated quantitative method employing interpolative background correction. Abnormally increased 201Tl washout was noted in 11 infarct segments in 10 (18%) patients. Infarct segments with rapid washout had significantly less initial uptake, and more severe associated wall motion abnormalities than infarct segments with normal washout. When quantitative analysis was repeated without background subtraction, no segments with rapid washout were observed. A phantom model was constructed to further test our hypothesis. The frequency of observed rapid washout was directly related to the severity of the initial defect and was entirely dependent upon utilizing background correction during the quantitative analysis. Our study suggests that rapid washout of 201Tl in an area of previous infarction reflects an artifact of background subtraction involved with standard quantitative analysis. PMID- 3295139 TI - Salivary immunoreactive insulin in type I diabetic patients after subcutaneous injection of insulin. PMID- 3295140 TI - Purification of selectively labelled monoiodotyrosine insulins by reversed-phase high-performance liquid chromatography. PMID- 3295141 TI - Radionuclide evaluation of unilateral pulmonary vein stenosis. Correlation with chest roentgenogram and clinical profiles. PMID- 3295142 TI - Needs assessment: a Delphi approach. PMID- 3295143 TI - The secular trend in size and maturational timing and its implications for nutritional assessment. AB - For most westernized countries there has been a marked intergenerational increase in size and a decrease in the age at menarche, both interrupted or temporarily reversed during economic disruption or war-time deprivation. In some Third World countries such secular trends have not yet occurred or there have been actual decreases in body size. The presence or absence of secular trends can be used as a form of nutritional surveillance, and in the westernized world the magnitude of secular trends necessitates continual updating of dimensional and maturational standards used in nutritional appraisal. PMID- 3295144 TI - In vitro assessment of nystose as a sugar substitute. AB - Nystose represents a fructooligosaccharide with two fructose molecules linked via beta(1----2) bonds to the fructosyl moiety of sucrose. This tetrasaccharide was subjected to an array of in vitro tests designed for the assessment of potential sugar substitutes before animal or human studies. beta-Fructosidase from yeast cleaved nystose at about 5% of the initial rate observed with sucrose. The terminal fructose was released first. Glycosyltransferase from Streptococcus mutans #620 did not utilize nystose for the formation of a glucan-type polysaccharide. Anaerobic fermentation of nystose by a suspension of mixed dental plaque microorganisms and by S. mutans NCTC 10449 was about half as fast as with sucrose. Thin-layer chromatography at various reaction times with S. mutans NCTC 10449 indicated the terminal fructose as the site of first attack. Analyses for free monosaccharides confirmed these data because free fructose exceeded free glucose at early reaction times far more than would follow from the 3:1 ratio of fructose to glucose in the nystose molecule. High pressure liquid chromatography assays demonstrated lactic and acetic acids as the main fermentation products. Carbohydrases from human jejunal mucosa did not attack nystose. However, cecal anaerobic microorganisms of the rat fermented nystose rapidly into acids. PMID- 3295145 TI - Glucose tolerance, plasma insulin and immunoreactive glucagon in chickens selected for high and low body weight. AB - Relationships among glucose tolerance, plasma insulin and plasma glucagon were examined in chicks developed through selection for high (HW) and low (LW) body weight at 56 d of age and F1 crosses (HL) obtained from HW males mated to LW females. At 21, 42, 63 and 84 d of age, chicks from each population were intubated with glucose (2 g/kg body wt) following a 24-h fast. Blood was collected at 20-min intervals up to 100 min postadministration. At all ages, the LW chicks were better able to clear glucose from their blood than were their HW counterparts, and the HL chicks exhibited intermediate responses. Impaired glucose tolerance in the HWs and HLs was not associated with insulin insufficiency; the HWs and HLs, in comparison to the LWs, exhibited higher plasma concentrations of insulin at 42 and 63 d of age and plasma insulin levels did not differ significantly among populations at 21 or 84 d of age. Plasma immunoreactive glucagon responses to glucose intubation were inconsistent at the different ages; however, concentrations were consistently higher in the HWs and HLs than in the LWs. It was concluded that excessive fat deposition in chickens selected for rapid growth is associated with increased concentrations of insulin and glucagon in plasma and perhaps insulin resistance. PMID- 3295146 TI - Workplace video display terminals and visual fatigue. PMID- 3295147 TI - 1986 Gehrmann lecture. The strategic dimensions of occupational medicine. PMID- 3295148 TI - Initiation of warfarin therapy: comparison of physician dosing with computer assisted dosing. AB - In a prospective, randomized study at two university hospitals, the authors examined how effectively housestaff physicians (n = 36) managed the initiation of warfarin therapy compared with a computer-assisted dosing regimen (n = 39) using the software program Warfcalc, which was managed by one of the authors. Target prothrombin time ratios were selected by the physicians. Study endpoints included: the time to reach a therapeutic prothrombin ratio, the time to reach a stable therapeutic dose, the number of patients transiently overanticoagulated, the number of bleeding complications, and the accuracy of the predicted maintenance dose, which was assessed at steady-state 10-14 days later. Computer assisted dosing consistently out-performed the physicians: a stable therapeutic dose was achieved 3.7 days earlier (p = 0.002), fewer patients were overanticoagulated (10% versus 41%), and the predicted maintenance dose was in the therapeutic range in 85% of the computer-dosed patients versus 42% of the physician group (p less than 0.002). For physicians who did not routinely manage warfarin therapy, computer-assisted dosing improved the accuracy of dosing and shortened the time required to achieve a stable therapeutic dose. PMID- 3295149 TI - Monitoring and improving the content of medical residents' ambulatory care experience: a microcomputer-based method using diagnosis clusters. AB - Changing patterns of medical practice necessitate increased experience in ambulatory settings for internal medicine residents. Residency program directors must monitor the content and balance of the ambulatory care experience. Evaluation of ambulatory care educational programs requires a concise method of describing the illnesses seen in each outpatient setting and of monitoring individual resident activities. The authors present an easily applied, microcomputer-based method of analysis using diagnosis clusters that has been found to be useful in evaluating and modifying the ambulatory care curriculum at their institution. It provides a concise description of individual ambulatory settings, affords an opportunity to compare each setting with national norms, and identifies areas of inadequate exposure in each resident's experience. PMID- 3295150 TI - Systematic errors in medical decision making: judgment limitations. AB - Much of medical practice involves the exercise of such basic cognitive tasks as estimating probabilities and synthesizing information. Scientists studying cognitive processes have identified impediments to accurate performance on these tasks. Together the impediments foster "cognitive bias." Five factors that can detract from accurate probability estimation and three that impair accurate information synthesis are discussed. Examples of all eight factors are illustrated by reference to published articles. The authors suggest ways to minimize the negative influences of these factors. PMID- 3295153 TI - The International Society for Heart Transplantation: seventh annual scientific session. March 5-7, 1987, New Orleans, Louisiana. Abstracts. PMID- 3295154 TI - Cyrus Fay and the real origin of the modern day extraction forceps. PMID- 3295152 TI - Nongonococcal urethritis: diagnosis and management. PMID- 3295151 TI - Obesity: pathophysiology and practical management. PMID- 3295155 TI - Expression of c-myc in non-malignant and pre-malignant gastrointestinal disorders. AB - A monoclonal antibody 1-6E10 against the protein product p62c-myc of the c-myc oncogene was used to assess, by immunohistology, a variety of non-neoplastic and preneoplastic disorders of gastric and colonic mucosa. There were low levels of expression of the c-myc oncogenic product in normal gastric and colonic tissue. In gastric mucosa, increased expression was observed with inflammatory, metaplastic and dysplastic histological appearances. In the normal colon low levels of expression were observed, but there was increased expression in inflammatory disorders including Crohn's disease and ulcerative colitis. There was also increased expression in colonic dysplasia associated with ulcerative colitis. The oncogene product was localized in the cytoplasm, nuclei and Golgi apparatus. C-myc 1-6E10 may therefore be used as a marker to identify the cellular proliferative response in gastric and colonic mucosa that is associated with inflammation as well as potentially neoplastic hyperproliferative states. PMID- 3295156 TI - "More than medical significance": LSD and American psychiatry 1953 to 1966. PMID- 3295157 TI - Opium and Marcel Schwob: a historical note and translation. PMID- 3295158 TI - Fragile X syndrome. PMID- 3295159 TI - Persistent tubular resistance to aldosterone in infants with congenital hydronephrosis corrected neonatally. AB - Renal function of 18 infants who had undergone surgery in the neonatal period because of severe congenital hydronephrosis was followed up for 5 to 36 months (mean +/- SD 21 +/- 10 months). In all cases the diagnosis was made prenatally by sonography and confirmed at birth by intravenous urography. Creatinine clearance developed normally in all the children. Eight had a reduction in maximal urinary concentrating ability after intranasal DDAVP; this defect was transient and resolved after 4 to 5 months in all but one child, in whom it persisted. However, other tubular abnormalities were present. Throughout the observation period, patient serum potassium concentrations were significantly higher than normal, paralleled by a significant increase in plasma aldosterone concentration but with normal excretion fraction of sodium and potassium. There were no disturbances of acid-base balance. These findings may be accounted for by a persistent partial reduced sensitivity of the distal tubule to the action of aldosterone despite normal renal function. This alteration is usually mild, but may constitute a persistent metabolic risk despite successful surgical intervention. PMID- 3295160 TI - Risk factors for development of hemolytic uremic syndrome during shigellosis. PMID- 3295161 TI - Post-traumatic central sleep apnea in a child. PMID- 3295162 TI - Accuracy and reproducibility of clinical measures of testicular volume. PMID- 3295163 TI - Efficacy of trimethoprim-sulfamethoxazole in treatment of acute diarrhea in a Mexican pediatric population. AB - The efficacy of trimethoprim-sulfamethoxazole (TMP-SMX) and placebo were compared in a randomized double-blind study of 141 Mexican children with acute diarrhea. Patients who met specific entry criteria received TMP-SMX or an identical appearing placebo for 5 days. Stools were examined for bacterial, viral, and parasitic pathogens. Enterotoxigenic Escherichia coli were the most commonly isolated pathogens (22% of total). Patients given TMP-SMX had a significantly shorter time to "last illness stool" than did those given placebo, but no difference in number of unformed stools in 5 days was found between treatment groups. However, TMP-SMX significantly shortened the illness in patients with fever or many fecal leukocytes. When stool cultures positive for any bacterial pathogen or for enterotoxigenic E. coli were analyzed as separate groups, a significantly faster recovery was observed in patients given TMP-SMX. TMP-SMX is efficacious in the treatment of Mexican children with diarrhea and culture-proved bacterial infection or when the clinical signs and symptoms suggest bacterial enteritis. PMID- 3295164 TI - Chronic disease: effect on health cognition and health locus of control. AB - An assessment of health cognition and health locus of control (HLOC) was obtained in 85 healthy and 81 chronically ill children, using instruments adapted from Piaget's work and standard HLOC measures. A relationship between HLOC and compliance was sought in a subset of children with spina bifida taught self catheterization. Evidence of the developmental nature of health cognition and HLOC was documented. Contrary to the effect of experience in formal learning, experience with chronic disease did not alter developmental progression in these health-related areas. Our results suggest that in communicating with children about illness, the pediatrician's approach should not be altered by an appearance of superficial sophistication that some children may acquire as part of their experience with chronic disease. PMID- 3295165 TI - Growth hormone treatment and the short child: to treat or not to treat? PMID- 3295166 TI - Alteration of Trichostrongylus colubriformis egg permeability by Bacillus thuringiensis israelensis toxin. AB - A toxin from the bacterium Bacillus thuringiensis israelensis is lethal to nematode eggs. Exposure of eggs of the ruminant nematode Trichostrongylus colubriformis to the toxin significantly increased the eggs' permeability to radiolabeled phenylalanine within 2 hr. Calcium chloride inhibited the toxin induced change in egg permeability. Iodine staining of eggs that were exposed to the microbial toxin revealed that egg permeability was altered within 5 min and was dependent on the dose of toxin. Addition of 34 mM sucrose, 17 mM sodium chloride, or 17 mM potassium chloride to the eggs' medium increased the toxin's lethality. Exopeptidase activity in eggs of T. colubriformis was reduced significantly after exposure to the B. t. israelensis toxin. Tetrodotoxin, tetraethylammonium chloride, ouabain, 4-acetamido-4'-isothiocyano-stilbene 2,2'disulfonic acid (SITS), 4,4'-diisothiocyano-2,2'disulfonic acid stilbene (DIDS), valinomycin, and sodium vanadate, which affect membrane transport, had no significant effect on the activity of B. t. israelensis toxin for eggs. Likewise, a series of nucleotides and their derivatives had no effect on the toxin's activity. Ovicidal activity of the microbial toxin was increased by 4 aminopyridine (4.4 X), but was decreased by furosemide (97 X), nigericin (263 X), or monensin (125 X). Microscopic measurement of T. colubriformis eggs after treatment with the microbial toxin revealed no significant size change. PMID- 3295167 TI - Characterization and localization of Paragonimus westermani antigen stimulating antibody formation in both the infected cat and rat. AB - Applicability of the adult Paragonimus westermani antigen for detection of anti immature P. westermani antibodies in experimentally infected rats, a paratenic host of this lung fluke, was examined. The serum antibodies of the cats and rats infected with P. westermani metacercariae were detected by enzyme-linked immunosorbent assay (ELISA) with the adult-fluke antigen. The ELISA titers of serum samples of the rats infected with only immature flukes were as high as those of the cats infected with adult flukes. Sodium dodecyl sulfate polyacrylamide gel electrophoresis and the immunoblotting technique showed that a major protein band of 27,000 daltons was recognized in the sera of the infected cats and rats. Immunoperoxidase staining applied on the sectioned flukes provided evidence showing that the antigenic substance was located on the surface of the gut epithelium and in the luminal contents in both adult and immature flukes. The adult-fluke antigen containing the 27,000-dalton substance is applicable as a standard antigen for diagnosis of paragonimiasis westermani in not only definitive hosts but also in paratenic hosts. PMID- 3295168 TI - Cultivation of Plasmodium falciparum in commercially available sera depleted of natural antibodies reactive with human erythrocytes. AB - The efficacy of commercially available sera for the continuous in vitro cultivation of Plasmodium falciparum is controversial. In this study, various commercial animal and human sera are shown to support the in vitro growth of P. falciparum after their adsorption with erythrocytes to remove "natural" anti human erythrocyte antibodies. A simple and inexpensive method to accomplish cultivation is presented. PMID- 3295169 TI - In vitro invasion of host cells by Plasmodium berghei sporozoites in serum-free medium. PMID- 3295170 TI - Effects of clomipramine upon motility of Trypanosoma cruzi. PMID- 3295171 TI - Smoking prevention program for children: a review. PMID- 3295172 TI - Adjustable suture strabismus surgery. AB - We examined 333 patients between the ages of 11 and 70 years who underwent strabismus surgery with adjustable sutures over a ten-year period. The type of strabismus, the number and amount of adjustments, the postoperative drift, and complications were evaluated. A large percentage of patients required adjustment to obtain the desired postoperative position. The postoperative drift patterns were characteristic for each type of preoperative deviation and were similar to that reported for nonadjustable procedures. Adjustable suture techniques were especially helpful in selected horizontal deviations, vertical deviations, and the more complex strabismus problems. The complications from adjustable suture operations in this series were minimal. PMID- 3295173 TI - The modified Duhamel operation for Hirschsprung's disease performed entirely with mechanical sutures. AB - The Duhamel operation of retrorectal transanal pull-through is a widely used technique in the treatment of Hirschsprung's disease. Modifications of the technique have been made with the introduction of stapling instruments. The construction of a side-to-side colorectal anastomosis has been facilitated with the introduction of the GIA linear anastomosing instrument. The advent of the EEA stapling device has allowed us to perform a modified Duhamel operation in a 9 month-old boy with Hirschsprung's disease using mechanical sutures entirely. The technique for the procedure is described. PMID- 3295174 TI - Does fetal gut obstruction cause hydramnios and growth retardation? AB - In order to study the effects of impaired fetal intestinal absorption of amniotic fluid, two series of neonates (551 from Liverpool and 172 from Rome) with different types of congenital gut obstruction were divided into two groups and compared. Group A consisted of patients with complete obstruction at or above the proximal jejunum (within 15 cm of the ligament of Treitz). Patients of group B had either incomplete obstruction at group A level or either incomplete or complete obstruction at a lower level. Maternal hydramnios and fetal growth retardation rates were found to be significantly higher in group A than in group B. Maternal hydramnios was associated with an increased prematurity rate (P less than .001). Fetal growth retardation was not related to the presence of additional anomalies. In group A growth retardation was more frequent in babies born after 37 weeks of gestation (P less than .05). No differences were found between the Liverpool and Rome series of patients. These findings suggest that fetal gut function not only contributes to the control of amniotic fluid volume but also, in the final stages of pregnancy, to normal fetal growth. Maternal hydramnios may be the cause of premature delivery of fetuses with upper gut obstructions. PMID- 3295175 TI - The porcelain bonded to tooth restoration. PMID- 3295176 TI - Perinatal management of fetal hydronephrosis with normal bladder. AB - This report covers 30 cases of prenatal diagnosis of uni- or bilateral hydronephrosis not associated with an overdistended bladder. Oligohydramnios was observed only in four cases while polyhydramnios occurred in three affected fetuses. In no case was fetal urine aspirated or drained prenatally. Early delivery was performed in four cases with oligohydramnios. Sixteen newborns required surgical correction of the lesion as it was confirmed by urography, following at least two sonographic examinations which confirmed a moderate to severe hydronephrosis after birth. The most frequent lesion was pyelo-ureteric junction obstruction (12 cases). Thirteen cases were normal at follow-up, and in two of these the dilation cleared up during intrauterine life. One case of severe hydronephrosis proved to be a multicystic kidney. In this series isolated hydronephrosis, both uni- or bilateral did not result in fetuses being at high risk for survival (only one infant died after surgery) nor as regards to associated malformations and perinatal morbidity. Provided a properly timed surgical correction was performed, renal function resulted to be good at follow up. PMID- 3295177 TI - Oversized infant of diabetic mother: its cause and prevention. AB - In this study the birth weights of 431 infants of diabetic mothers of the Milan series have been compared with the birth weights of infants of a control group. The averages and the centile distributions of weights of infants of gestational diabetic mothers (Class A) and of diabetic mothers without vascular complications (Classes B and C) did not differ substantially from those of control newborns (table I, figure 1). This confirms the clinical indication, based on the hyperglycemia-hyperinsulinism theory that fetal macrosomia can be prevented provided maternal metabolism is strictly controlled. In this series insulin was administered at the maximal tolerated dose (MTD), a therapeutic regimen that provides excellent metabolic control of the mother. In multiparae, the birth weights of the infants of the latest pregnancy were drastically lower than the birth weights of the infants in their previous pregnancies (without MTD insulin) (table II). Our results do not confirm the recent hypothesis that pregnant diabetics with strict metabolic control during pregnancy generally give birth to growth retarded infants. The MTD of insulin has also been administered to gestational diabetic mothers, and fetal macrosomia was prevented (table I, figure 1). This confirms the opinion of those who believe that a diet-regimen must be accompanied by insulin administration to correct the slight metabolic abnormality of these patients. As would be expected because of placental insufficiency, infants of patients with vascular complications, including those who have only calcifications of the pelvic vessels (White' Class E), were growth retarded (table I, figure 1). The risk of fetal growth retardation in Class E has not been remarked upon in the literature, since pathology of pelvic vessels is usually disregarded and the patients remain undifferentiated among Classes A-C. The possibility to prevent fetal macrosomia with a strict control of maternal diabetes has been questioned because of the lack of correlation between fetal macrosomia and the degree of maternal hyperglycemia and of fetal hyperinsulinism. We postulate that, if fetal hyperinsulinism causes hypoxia, as it does in experimental animals, the lack of correlation may be due to the fetal hyperinsulinism itself. PMID- 3295178 TI - Maternal residual beta-cell function and the outcome of diabetic pregnancy. AB - Preservation of own insulin production (residual pancreatic beta-cell function) has been shown to have a beneficial effect on glycemic control in insulin dependent diabetic subjects, and its total lack has been suggested to be an independent risk factor during diabetic pregnancy. We studied the influence of residual beta-cell activity on the glucose control and the outcome of pregnancy in 29 diabetic women by sequentially measuring gestational postprandial plasma C peptide (CPR) levels, diurnal blood glucose curves and blood glycosylated hemoglobin (Hb A1c) and by analyzing the morbidity and mortality of the offsprings. The 9 diabetics with moderate own insulin secretion (CPR levels over 1.0 microgram/l, White classes B and C, later referred to as group I) had significantly better glucose control than the remaining 20 subjects with lower CPR values (White classes C, D and NF, later referred to as group II) (figure 1, table I). There were two intrauterine deaths, both in group II. These deaths (one caused by multiple congenital contracture syndrome and the other by severe intrauterine growth retardation without any evident cause) could not be straightly connected with diabetes. Respiratory distress syndrome was seen in group II only. There was no other significant difference in the neonatal morbidity between the two groups (table II). All mothers of RDS infants were in White class NF where the birthweight was also smaller than in classes B and C. These were the only differences in neonatal morbidity between the White classes (table III). In conclusion, moderate residual beta-cell function seemed to be clinically important in maintaining strict glucose control during gestation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295179 TI - Incidence of peri-intraventricular hemorrhage in premature neonates weighing more than 1500 g. AB - With the advent of modern methods of neonatal care, intracranial hemorrhage probably has become the most common neurological complication in premature infants weighing less than 1500 g at birth. This paper is a prospective study of 75 preterm infants of 34 weeks gestation or more and birth weight above 1500 g (range 1500 g to 2500 g). All neonates were screened by cranial ultra-sonography for evidence of peri-intraventricular hemorrhage (PIVH). Perinatal risk factors, incidence of PIVH and neurological outcome were studied. Sonographic abnormalities were detected in 16 (21.3%) of our patients. Intracranial hemorrhage was frequently associated with a low Apgar score, need of resuscitation and/or assisted ventilation immediately after birth (P less than 0.005). This study suggests, that ultrasound screening should be reserved to those large premature infants (greater than 1500 g) with high risk of hypoxic ischemic injury. PMID- 3295180 TI - Fenoterol depot and fenoterol in premature uterine contractions--a multicentric double-blind comparative study. AB - In a double-blind randomized study, the effect of a single dose of a fenoterol preparation with delayed release of active substance (designated as fenoterol depot) was compared with a fenoterol product with undelayed release of active substance (designated as fenoterol) in two groups respectively comprising 66 and 65 female patients with premature uterine contractions. The fenoterol depot was administered p.o. in a single total dose of 21 mg at the beginning of an investigation period of 360 minutes and the fenoterol was administered p.o. within 235 minutes in three identical consecutive doses resulting in a total dose of 22.5 mg. The increased uterine activity present at the beginning was markedly lowered by an initial intravenous infusion of Partusisten. After administration of the two oral preparations, the uterine contractions remained at the low level achieved. The fenoterol depot was slightly superior to fenoterol with regard to the reduction of the duration of contractions: the difference in the inhibition of the duration of the contraction between the two preparations was a maximum of 25.7% in favor of fenoterol depot. The frequency of uterine contraction was substantially reduced by both preparations, but to a greater extent by the depot form. The tocolytic efficacy and the tolerance were rated as "good" in 70% and 75% respectively with fenoterol depot and in 69% and in 71% respectively in the case of fenoterol. The maternal pulse rate remained at the level reached at the end of Partusisten infusion with the two preparation, and the blood pressure fluctuated slightly within the normal range.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295181 TI - Tooth loss in maintenance patients in a private periodontal practice. AB - A group of 162 maintenance patients, previously studied for compliance to suggested maintenance schedules, were surveyed for tooth loss over a 5-year period. The group was divided into those who complied to suggested maintenance schedules and those whose compliance was erratic. It was found that none of the patients who had complied to suggested maintenance schedules lost any teeth. In the erratic group, where all tooth loss occurred, it was found that the more often a patient presented for maintenance, the less likely he was to lose teeth. These findings are discussed in relation to current studies on efficacy of various therapies for periodontal diseases. PMID- 3295182 TI - Microvascularization of gingival wound healing using corrosion casts. AB - The healing process in a wound induced by removal of 6 X 6 mm of gingiva and periosteum from the maxillary attached gingiva of 48 adult mongrel dogs was observed to investigate the potential blood supply for grafts placed on denuded bone. Three-dimensional observations were performed over 12 weeks by scanning electron microscopy (SEM) following the manufacture of corrosion capillary casts by acrylic resin injection. Revascularization in the gingival wound was mainly through formation of new capillaries from those existing below the surrounding epithelium with little new capillary formation from the Volkmann canals. Moreover, the periodontium contributed greatly to the vascularization, which was fastest from the gingival margin. Further, simplification of new capillary loops was also fastest from this direction. Regeneration of the periosteum and periosteal vascular plexus was slow, taking about twice the time of connective tissue and capillaries below the epithelium. The results indicated that blood supply to grafts on denuded bone in the early postgraft period would mainly be provided by capillaries below the epithelium surrounding the recipient bed. PMID- 3295183 TI - A biochemical approach to periodontal regeneration. AFSCM: assays for specific cell migration. AB - Recent investigations on regeneration of the periodontium have attempted to define factors involved in the formation of a new connective tissue attachment. One essential biological event involved in tissue regeneration is directed cell migration (chemotaxis). Extracellular matrix proteins have been shown to influence chemotaxis, cell proliferation and differentiation. Recently, the extracellular matrix proteins, fibronectin (FN) and laminin (LM), and the polypeptide, endothelial cell growth factor (ECGF), have been shown to stimulate a variety of biological processes. Current assay systems which attempt to define cell migration are the Boyden chamber assay and a random cell migration assay. Neither assay system adequately defines in vivo cell migration. Here we present a new in vitro assay system that tests the capacity of several biological response modifiers applied on dentin to stimulate a chemotactic and proliferative response from various cell types. The assay system consists of two types of assays. Assay I measures the chemotactic activity of test substances bound to dentin. In this assay cells must actively move through a filter (Nuclepore) towards a factor bound to dentin. Assay II examines the ability of dentin-bound biological response modifiers to stimulate directed movement and proliferation of cells on dentin surfaces. We report that periodontal ligament (PDL) cells migrate towards FN and ECGF; that PDL cell migration is enhanced when dentin is preconditioned with tetracycline HCl; that PDL cells have an increased proliferative response when dentin is conditioned with both FN and ECGF; that gingival epithelial cells have increased migratory and proliferative responses when LM is used to condition dentin; and that there is a reciprocal utilization of biological response modifiers by gingival epithelial cells and PDL cells. PMID- 3295184 TI - The use of ultrasound for the determination of periodontal bone morphology. AB - The purpose of this study was to assess the value of ultrasound in the measurement of periodontal bone morphology. Four patients scheduled for periodontal surgery were selected for the study. The Ocu-Scan 400 machine was used and adjusted according to the manufacturer's instructions. Teeth involved in the study were measured on the facial aspect at three different points: mesial, midfacial and distal (except one tooth measured only at the mesial point). Two different presurgical measurements were made with the use of ultrasound. The distance between the gingival margin and the crest of alveolar bone was measured during the surgical procedure. No correlation could be made between the different measurements obtained. From the results the following was concluded: measurement of alveolar bone topography with the presently available ultrasound probe is not accurate, and ultrasound measurement is a fast and painless procedure. PMID- 3295185 TI - Supragingival root surface removal during maintenance procedures utilizing an air powder abrasive system or hand scaling. An in vitro study. AB - The purpose of this study was to determine the amount of root surface removal in vitro using an air-powder abrasive system or sharp curet on root surfaces simulating the cumulative effects of an every 3-month periodontal maintenance regimen over a 3-year period and to compare the amount of time spent in the utilization of each instrument. Fifty extracted teeth with fully formed roots were cleaned and mounted in one of 10 different artificial alveolar arches. Each arch contained one central incisor, one lateral incisor, one canine, one first and one second premolar. The buccal and mesial tooth root diameters were measured initially and after each treatment with a digital point micrometer. All teeth were stained with coffee and repositioned in their artificial alveolae and treated by the air-powder abrasive system or curet until all visible stain was removed. Time required for removal of stain in both treatment groups was recorded. Both groups were restained, retreated, and retimed 12 times to reproduce a 3-month maintenance interval for 3 years. The average root structure removed by the air-powder abrasive system following each treatment was 10.68 micron while the curet removed an average of 27.09 micron. Stain was removed 3.15 times faster by the air-powder abrasive system than with a curet. PMID- 3295186 TI - Metabolism of phthalidyl theophylline in rat liver. AB - Phthalidyl theophylline (PH-TH) in rat liver was metabolized by a hydrolase to theophylline (TH) and 2-carboxybenzaldehyde, and the latter was further metabolized to 2-hydroxymethylbenzoic acid by an nicotinamide adenine dinucleotide-dependent reductase. The hydrolase could be strongly inhibited by acetazolamide, therefore, urinary excretion of PH-TH metabolites was significantly retarded when PH-TH and acetazolamide were coadministered to rats. The results from in vivo experiments suggest that PH-TH was efficiently absorbed from the gastrointestines and metabolized extensively by the liver. PMID- 3295187 TI - [Metabolism of N-acetylcysteine conjugates and related enzymes]. PMID- 3295188 TI - Quantitative evaluation of brain edema by radionuclide imaging technique. AB - The objective of the present investigation was to quantify metabolic cerebral edema in dogs with impaired monoamine oxidase (MAO) function and liver disease using dynamic imaging of the brain with 99mTc-diethylenetriamine pentacetic acid (99mTc DTPA). Data acquisition was started following a rapid intracarotid injection of 99mTc DTPA (5 mCi), and sixty 0.5-s images of the left or right hemisphere were taken. First-pass time-activity curves were obtained by selecting regions of interest for the appropriate brain hemisphere. The results of this study demonstrated that in phenelzine-treated animals there was a 6 to 38% reduction in brain washout slopes of 99mTc DTPA (24.0 +/- 11.5% reduction). These washout slopes were further reduced (range 24.0-86.0; 50.6 +/- 18.5% reduction) following the oral administration of tyramine (1 mg/kg). A significant correlation was noted between changes in washout slopes and the development of coma in these animals. PMID- 3295189 TI - Tibialis posterior tendon rupture. PMID- 3295190 TI - Infection and immunosuppression. A case report. PMID- 3295191 TI - Informed consent and surgery of the foot and ankle. PMID- 3295192 TI - Historical perspectives. The Pedic Items (Official Organ of Chiropody) August 1912. PMID- 3295193 TI - Further discussion of the Stableflex lens. PMID- 3295194 TI - Regression of myopic epikeratophakia effects. PMID- 3295195 TI - Cutting sutures with the argon laser. PMID- 3295196 TI - Masseteric notch. PMID- 3295197 TI - A pulsed Doppler ultrasonic system for making noninvasive measurements of the mechanical properties of soft tissue. AB - In response to the need for a more precise means of predicting the interaction of a prosthetic socket with an amputee's residual limb, a gated Doppler ultrasonic motion sensing system was devised for making noninvasive measurements of the elastic modulus of soft tissue in vivo. Ultrasound was chosen for its ability to indicate the viscoelastic behavior of biological materials without damaging tissue. The system consists of a holding jig to support the limb being tested, a tissue vibrator, and an ultrasonic transducer to monitor the motion of the tissue. The ultrasonic transducer is controlled by an external computer to control the depth at which the sensor is measuring tissue displacement. This ultrasonic measuring technique provides as much information as more conventional techniques, but with more convenience and fewer restrictions. PMID- 3295198 TI - The cast glass-ceramic restoration. AB - The use of Dicor cast glass-ceramic material for fixed prosthodontic complete crowns has been described. The advantages of this material are chemical and physical uniformity, marginal accuracy, uncomplicated fabrication from wax-up to casting, ceramming, and coloring, ease of adjustment, excellent esthetics resulting from natural translucency, light absorption, light refraction, and natural color for the crown, and its inherent resistance to bacterial plaque. PMID- 3295199 TI - Restorative margins and periodontal health: a new look at an old perspective. AB - The indiscriminate placement of the margins of dental restorations into the gingival crevice for the purpose of esthetics or protection from decay can no longer be considered good practice. The junctional epithelium and the supracrestal fibers, together, have been called the biologic width, which is considered to have a length of 2 mm. A more accurate term for the biologic width, one that expresses the function and diversity of the component tissues while avoiding reference to dimension, is the "subcrevicular attachment complex." The most accurate anatomic structure from which to take measurements for margin placement is the healthy, stable gingival margin. It is clinically visible, unlike the biologic width, and should replace the latter as the landmark of choice for placing dental margins. Surgical crown lengthening will be necessary when restorations will end at or below the alveolar crest. PMID- 3295200 TI - Reinforced heat-processed acrylic resin provisional restorations. AB - A technique has been described for the fabrication of strong, esthetic, and periodontally considerable provisional restorations. The technique involves cast nonprecious metal frameworks and heat-processed acrylic resin. PMID- 3295201 TI - Comparison of compressive strength of solid and hollow pontic designs for ceramometal fixed partial dentures. AB - A total of 60 ceramometal frameworks were subjected to compressive loading. Half of the specimens had a hollow pontic design. After the addition of porcelain, it was found that there was no significant difference in the fracture resistance of the porcelain whether the pontic was solid or hollow. PMID- 3295202 TI - The maxillary complete denture opposing natural teeth: problems and some solutions. AB - The problems involved in providing comfort, function, proper esthetics, and retention for the maxillary complete denture patient with natural opposing dentition can be challenging. Careful preparation of the patient is important. It provides the new complete denture patient the opportunity to adapt to a complete denture and allows the dentist to evaluate his patient physically and emotionally before fabrication of the final complete denture. Methods for planning and fabrication of a denture that provide comfort, function, and stability have been described. PMID- 3295203 TI - A metal-based denture with soft liner to accommodate the severely resorbed mandibular alveolar ridge. AB - A technique is described for designing and making a mandibular denture, for patients with severely resorbed and compromised residual alveolar ridges. The denture base is stabilized by a mucostatic impression technique, myostatic denture base design, weight of a cast metal denture base, and noninterceptive occlusion with monoplane or Centrimatic posterior teeth. The hard metal denture base is made tissue-compatible by means of a soft denture liner attached to a specially relieved cast metal denture base. Over a 2-year period, this technique has successfully provided, in my practice, an alternative to residual alveolar ridge implants and other surgical interventions for 22 edentulous patients with severely resorbed and compromised mandibular residual alveolar ridges. PMID- 3295204 TI - Evaluation of the incisive papilla as a guide to anterior tooth position. AB - The incisive papilla provides a reference point on the edentulous cast that may be helpful in determining the anteroposterior position of the artificial incisors. The results of the study suggest that the labial surface of the maxillary incisors should be 12 to 13 mm from the posterior border of the incisive papilla. This measurement was significantly smaller in the sample of dentures examined, which suggests a tendency for the anterior teeth to be placed too far posteriorly in artificial dentures. PMID- 3295206 TI - Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. PMID- 3295205 TI - Surgical placement guide for use with osseointegrated implants. AB - The fabrication and use of the implant surgical guide allows two dentists to treat a patient with minimal communication loss and achieve a result desired by both. It also greatly facilitates planning and actual treatment for the same dentist by assuring that implants are surgically placed where originally planned (Fig. 6). PMID- 3295207 TI - The segmented framework removable partial denture. AB - The segmented framework removable partial denture is made of two cast metal individual segments joined with a resin major connector. The small individual framework segments can be made to fit well and the design permits ready correction of the tissue surface of the major connector through relining or an altered cast procedure. The dentist is offered a valuable alternative treatment approach in selected patients. PMID- 3295208 TI - Use of a specially formed drill in fixed prosthodontics. AB - A technique has been described that uses a specially formed drill in the fabrication of removable dies. This technique is efficient and inexpensive, and it produces high-quality removable dies that are strong, stable, and accurately positioned. PMID- 3295209 TI - Changes in urinary catecholamines and their metabolites in depressed patients treated with amitriptyline or imipramine. AB - The effects of treatment with amitriptyline (AMI) or imipramine (IMI) on changes in catecholamines and their metabolites in urine were studied in 95 unipolar and bipolar depressed patients. For the entire group, not separated by drug, substantial reduction in concentrations of all metabolites, but not catecholamines, occurred. Although catecholamine and metabolite change was similar for most substances assayed, there were some specific drug and diagnostic group differences. Vanillylmandelic acid (VMA) reduction was limited to bipolar patients; metanephrine (M) reduction to unipolar patients. Greater M and 3 methoxy-4-hydroxyphenylglycol (MHPG) reduction were associated with response in unipolar, but not bipolar patients. In bipolar, but not unipolar patients, norepinephrine (NE) rose in responders in contrast to reductions among nonresponding bipolar patients. The results suggest that effectiveness of blockade of reuptake of norepinephrine may be relatively more important for recovery in bipolar than in unipolar patients. Study of a battery of amine substances may contribute more information to our understanding of antidepressant drug effects on aminergic systems than analyses of MHPG alone. PMID- 3295210 TI - Eye-tracking, attention and amphetamine challenge. AB - Smooth pursuit eye movement (SPEM) performance has been linked to nonvoluntary attentional processes. Amphetamine is a psychotropic drug with documented effects on attentional performance. In order to evaluate the relationship between SPEM performance and amphetamine's attentional effects, SPEM performance was measured prior to and following amphetamine administration in five bipolar patients and eight obsessive-compulsive patients. In these 13 patients, amphetamine did not significantly alter the accuracy of SPEM in the two patient groups. However, significant negative correlations were observed in the obsessive-compulsive patients and in the combined patient groups between baseline SPEM impairment and changes in eye-tracking accuracy following amphetamine, i.e. individuals with poorer SPEM accuracy improved while better SPEM performers deteriorated in tracking accuracy during amphetamine treatment. PMID- 3295211 TI - Chemotaxis by Naegleria fowleri for bacteria. AB - Naegleria fowleri amebae demonstrated a chemotactic and chemokinetic response toward live cells and extracts of Escherichia coli and other bacterial species when experiments were performed using a blind-well chemotaxis chamber. The peptide N-formyl-methionyl-leucyl-phenylalanine acted as a chemokinetic rather than a chemotactic factor for N. fowleri amebae. Competition experiments in which nerve cell extracts or bacteria were placed on either side of the filter in chemotaxis chambers resulted in increased movement towards bacteria. A scanning electron microscopy study of the interaction of N. fowleri with different bacterial species confirmed that when the amebae were near ingestible bacteria they moved toward the bacteria by pseudopod formation. Naegleria fowleri appeared to respond to bacteria by three interrelated but distinct processes: chemokinesis, chemotaxis, and formation of food cups. PMID- 3295212 TI - A double blind study of 2 mg versus 4 mg nicotine-gum in an industrial setting. AB - In a double blind randomised trial to aid smoking cessation a 2 mg nicotine gum (n = 101) was compared with a 4 mg gum (n = 98), in smokers of at least 15 cigarettes/day. The trial involved blue and white collar workers and took place at their working place (industrial setting). Intervention during the one year follow-up period was minimal. At 3 months 36.2% of the 2 mg nicotine gum group reported to have stopped smoking, against 44.8% in the 4 mg group (non significant difference). At one year in the 2 and 4 mg groups respectively 22.3 and 32.2% reported smoking abstinence (non significant difference). However in a sub-group with a higher nicotine-dependence score, only 18.5% were abstainers at one year in the 2 mg nicotine gum group against 32.9% in the 4 mg nicotine gum, which is a significant difference at the p = 0.05 level. This is however a post hoc finding and should be taken with caution. PMID- 3295213 TI - Genes and cancer: a clinical perspective. PMID- 3295214 TI - Sclero-calcific mitral valve changes in patients with chronic renal failure on haemodialysis. PMID- 3295215 TI - Diuretics and potassium in the elderly. PMID- 3295216 TI - The health of Elizabeth Barrett and Robert Browning. PMID- 3295217 TI - Electronic information for physicians. PMID- 3295218 TI - Leiomyoma of the urinary bladder presenting with acute urinary retention. PMID- 3295219 TI - Toxic megacolon complicating shigellosis. PMID- 3295220 TI - Re: The use of prophylactic antibiotics in colorectal surgery: a prospective trial. PMID- 3295221 TI - Manual skills of trainee surgeons. PMID- 3295222 TI - Penile reconstruction using the lateral arm flap. PMID- 3295223 TI - [Ultrasonic pseudotumoral aspect of cirrhosis]. AB - Seven cases of cirrhosis with non-tumoral nodules on ultrasound imaging are reviewed. Comparison of ultrasound and histopathologic data provided information on mode of formation and pathologic significance of these images. They correspond usually to a particular distribution of fibrosis and steatosis, exceptionally to regenerating nodules. Nodule formations seen on ultrasound images are independent of histopathologic criteria defining micro- and macro-nodular cirrhosis. Ultrasound guided cytohistology is the only examination allowing their distinction from true tumoral lesions. PMID- 3295224 TI - [Amebic abscess of the liver. Contribution of ultrasonics to developmental diagnosis apropos of 983 cases]. AB - Diagnosis and course of acute single amebic abscess of liver were studied in 983 cases followed up regularly until recovery. A simple but very precise classification is proposed based on course of disease as determined by ultrasound imaging. Early appearances prior to ultrasound are emphasized, these involving pronounced reversible biliary and pancreatic modifications that should be recognized in patients presenting before development of an abscess evident on liver ultrasonography. Ultrasound assists follow up during medical treatment. It very effectively demonstrates the dissociation between pathologic and clinical findings characteristic of this course, with clinical recovery usually within 8 to 10 days contrasting with persistence of liver abscess over several months. PMID- 3295225 TI - [Hydatid cyst of the psoas muscle. Apropos of a case]. AB - Hydatid cyst of psoas muscle is scare, we report one case which had a non specific ultrasonography appearance. Before surgery it was thought to be a retroperitoneal inflammatory collection. PMID- 3295226 TI - [Role of digitalized angiography by venous route in the study of carotid bifurcation. Value in the diagnosis of ulcerated lesions]. AB - Intravenous DSA was performed in 149 patients with suspected arteriosclerotic disease of the carotid bifurcation. These patients were submitted to 163 endarterectomies. The radiological and surgical findings were correlated in a retrospective analysis. The sensitivity of the angiographic method in determination of the correct percentage stenosis was 79%, but only 36% for the diagnosis of ulcerated lesions. Sonography exhibited a sensitivity of 79% with respect to the degree of stenosis and 23% in the diagnosis of ulcerated plaques. The present paper demonstrates the limiting factors of DSA and sonography. Furthermore, it reveals the valuable complementary effect of both methods in detecting arteriosclerotic lesions of the carotid bifurcation. PMID- 3295227 TI - [Non-gynecologic fluid images of pelvis. Ultrasonic study]. AB - From a series of 6,573 echographic surveys of pelvis in male and female, the authors point out 789 liquid images among them 82 are non gynecologic lesions. A statistical study of the different observed etiologies is proposed and compared with those of the literature. The main cases observed are gathered under several items: abscess, hematomas, urinary, digestive and vascular images and studied semiologically. The discussion points out the low frequency in opposition to the etiological diversity of this type of image and precise the diagnostic procedures rules which include other imaging methods especially computed tomography. PMID- 3295228 TI - [Diagnostic difficulties of Parker-Jackson sarcoma. Apropos of 2 cases]. AB - The sarcoma of Parker and Jackson is a rarely tumor. It is a malign lymphoma primitive of the bone. His diagnostic is difficult. The only treatment is chemotherapy-radiotherapy association. PMID- 3295229 TI - A thermodynamic approach to hormone-receptor interaction; application to insulin binding to adipocytes, adipocyte plasma membranes and liposomes incorporating adipocyte insulin receptors. AB - The binding of insulin to its receptor in rat adipocyte and isolated plasma membranes has been measured. The adipocyte insulin receptor has been reconstituted in lecithin liposomes and the binding of insulin investigated. A method of interpreting binding data presented as binding vs. the logarithm of free insulin concentration (binding isotherms) in terms of the binding potential concept of Wyman (1965) is described, and the results are compared with the commonly used Scatchard analysis of binding. The binding potential approach enables binding constants and Gibbs energies of formation of the insulin-receptor complex to be determined as a function of insulin bound. The limiting Gibbs energies of binding at 15 degrees C to intact cells, membranes and liposomes were found to be -55, -52 and -49 kJ mol-1 respectively. The affinity of the receptor for insulin decreases smoothly with increase in binding in all three systems. For intact adipocytes the number of insulin receptors per cell is found to be approximately 43,000. PMID- 3295230 TI - Receptors for the malarial parasite. AB - During the erythrocytic cycle of Plasmodium, the parasite develops within an enclosed space, the parasitophorous vacuole, formed by endocytosis of an invasive stage, the merozoite. Among the erythrocyte membrane proteins possibly acting as a receptor for the attachment of P. falciparum merozoites to human erythrocytes is glycophorin A. Isolated glycophorin inhibits merozoite entry in a competitive manner, perhaps via association with a 155 kDa surface protein. Another protein that competitively inhibits merozoite invasion, is band 3, the erythrocyte anion transport protein. The protein bearing Duffy blood group antigens may act to modulate invasion, but does not behave as a receptor. PMID- 3295231 TI - Detection of histocompatibility-Y antigen: identification of sex of pre implantation ovine embryos. AB - Indirect immunofluorescence was used to detect the presence of a male-specific protein (H-Y antigen) on pre-implantation ovine embryos. Eight-cell to blastocyst stage embryos were surgically collected from superovulated ewes, classified as fluorescent (H-Y positive) or non-fluorescent (H-Y negative) and either transferred to recipient ewes or karyotyped to confirm embryonic sex. H-Y antigen was detected on eight-cell through blastocyst stage embryos. Overall, 88% (50/57) of the embryos (eight-cell to early blastocyst stage) classified as H-Y positive or H-Y negative were male and female, respectively. Survival after transfer of embryos subjected to the H-Y antigen assay was high (63%), which supports the use of this procedure in conjunction with embryo transfer in sheep to produce pregnancies in which sex of the fetus is known. PMID- 3295232 TI - Establishment and characterization of a human hybridoma secreting monoclonal antibody with high titers of sperm immobilizing and agglutinating activities against human seminal plasma. AB - Peripheral blood lymphocytes isolated from an infertile woman possessing strong sperm immobilizing and agglutinating antibodies were stimulated by culturing with poke-weed mitogen (PWM) and spermatozoa from a healthy donor for 5 days. The stimulated lymphocytes were fused with mouse myeloma NS-1 by PEG-1000. Fused growing hybrid cells were observed in 58 of 96 wells, and 22 of these showed the production of human immunoglobulin. Among the 22, one hybridoma clone (H6-3C4) was found to produce human IgM (lambda) with strong sperm immobilizing and agglutinating activities. The supernatant from the culture medium contained approximately 1.5 microgram IgM/ml and the antibody titers were 5000 SI50 units on sperm immobilization and 1:1600 dilutions on sperm agglutination. The hybridoma H6-3C4 has continuously produced high titers of antibody exhibiting sperm immobilizing and agglutinating activities over 8 months and contains chromosomes of acrocentric type from mouse and metacentric type from human. The monoclonal antibody (Mab) H6-3C4 reacted specifically to human seminal plasma, ejaculated spermatozoa and male accessory gland but not to testis, any other somatic tissues, or secreted fluids tested. Immunofluorescence staining indicated that the antigen corresponding to Mab H6-3C4 was present over the surface of ejaculated spermatozoa. The binding of Mab H6-3C4 to human spermatozoa was blocked by the serum of the patient from whom the lymphocytes were obtained for cell fusion. PMID- 3295233 TI - Pathophysiologic mechanism of hydramnios development in twin transfusion syndrome. A case report. AB - A case of prenatally diagnosed twin transfusion syndrome occurred. Early acute hydramnios at 18 weeks' gestation was the basis for sonographic evaluation. Follow-up observations and histopathologic findings on both twins suggested that excessive fetal micturition is responsible for the hydramnios in monozygotic twins with the transfusion syndrome. PMID- 3295234 TI - Pruritic urticarial papules and plaques of pregnancy. A review of 21 cases. AB - Twenty-one patients with pruritic urticarial papules and plaques of pregnancy (PUPPP) were reviewed. Direct immunofluorescence (DIF) examination was negative in all patients. DIF in patients with PUPPP is a useful and reliable laboratory aid in distinguishing this peculiar dermatosis from herpes gestationis. PMID- 3295235 TI - Clinical assessment of acupuncture in asthma therapy: discussion paper. PMID- 3295236 TI - Blood pressure and fat intake: a review. PMID- 3295237 TI - Hyperventilation syndromes in medicine and psychiatry: a review. PMID- 3295238 TI - Thomas Michael Nowell and his 'Matiere de Boulogne': a neglected figure in the history of smallpox vaccination. PMID- 3295239 TI - Renin inhibitors. Design of angiotensinogen transition-state analogues containing novel. (2R,3R,4R,5S)-5-amino-3,4-dihydroxy-2-isopropyl-7-methyloctanoic acid. AB - A highly stereoselective synthesis of 2(R)-[5(R)-[1(S)-[(tert butyloxycarbonyl)amino]-3-methylbutyl]-2,2- dimethyl-4(R)-dioxolanyl]-3 methylbutanoic acid is described. This is a suitably protected carboxylic acid useful as an intermediate for the preparation of renin inhibitory peptides. Angiotensinogen analogues such as peptides IX and X that contain the dipeptide isostere (2R,3R,4R,5S)-5-amino-3,4-dihydroxy-2-isopropyl-7-methyloctanoic acid residue at the scissile site are shown to be potent inhibitors of human plasma renin. The glycol moiety in this novel acid, dihydroxyethylene isostere, is suggested to act as a transition-state analogue and mimics the tetrahedral intermediate formed during the enzyme-catalyzed hydrolysis of the peptidic bond. PMID- 3295240 TI - Harry Hoogstraal (1917-1986): a bibliography. PMID- 3295241 TI - Paederus, sensu lato (Coleoptera: Staphylinidae): natural history and medical importance. PMID- 3295242 TI - A hemolymph test for the detection of African swine fever virus in Ornithodoros coriaceus (Acari: Argasidae). PMID- 3295243 TI - Role of small mammals in population dynamics and dissemination of Amblyomma americanum and Dermacentor variabilis (Acari: Ixodidae) at Land Between The Lakes, Tennessee. PMID- 3295244 TI - A previously undescribed syndrome of thoracic dysplasia and communicating hydrocephalus in two sibs, one diagnosed prenatally by ultrasound. AB - We describe two opposite sexed sibs, the offspring of consanguineous Pakistani parents, with a previously undescribed syndrome. The main features are short ribs with a narrow chest and thoracic dysplasia, mild shortening of the limbs, communicating hydrocephalus, and developmental delay. One sib was diagnosed prenatally by ultrasound at 18 weeks' gestation. The inheritance of the condition is presumed to be autosomal recessive. PMID- 3295245 TI - Prenatal diagnosis of X linked hydrocephalus without aqueductal stenosis. AB - The outcome of four successive pregnancies in a woman heterozygous for X linked hydrocephalus is described. The last two were scanned by ultrasound. In one, a good prognosis was given; the fetus was male but there was no evidence of dilated cerebral ventricles. In the other, hydrocephalus was diagnosed. The absence of aqueductal stenosis in this case supports the hypothesis that in this X linked condition communicating hydrocephalus is the primary defect and aqueductal stenosis is secondary. PMID- 3295247 TI - Disseminated Candida infection syndrome in heroin addicts--dominance of a single Candida albicans biotype. AB - Among 21 intravenous heroin abusers with cutaneous and ocular manifestations of disseminated Candida infection, a single C. albicans strain type (serotype A, biotype 153/7) was isolated from skin lesions in 14 cases. This suggests that central contamination of the heroin with C. albicans is less likely to be the source of infection than an endogenous source, and that one particular strain type is either better adapted than others to grow in the lemon juice used as a heroin solvent, or more likely than others to cause the specific pathology seen in these patients. PMID- 3295246 TI - Comparison of five assays for the heat-labile enterotoxin of Escherichia coli. AB - Enzyme-linked immunosorbent assay (ELISA), DNA-DNA hybridisation, Vero cell assay, the Biken test and a new membrane-filter method were compared in the detection of heat-labile enterotoxin (LT) of Escherichia coli. Six subcultures of each of 50 strains of E. coli from the Biken collection were evaluated "blind" in the laboratory. The combined results of the most reproducible tests (ELISA and DNA-DNA hybridisation) were used to calculate the sensitivity and specificity of the other assays. The Vero-cell assay had a high sensitivity (98%) but a lower specificity (91%). The Biken and membrane-filter assays had sensitivities of 58 71% and 77-84% respectively, depending on the type of antiserum used. Only one false positive result was obtained with the Biken test; specificity of the membrane-filter assay was 94-95%. The membrane-filter assay, with anti-cholera toxin, is specific and reasonably sensitive. It has particular advantages over DNA-DNA hybridisation and the Biken test, and it may prove suitable for screening large numbers of E. coli isolates in epidemiological studies in developing countries. PMID- 3295248 TI - Examination of enteropathogenic Escherichia coli strains for an adenylcyclase stimulating factor. AB - Enteropathogenic Escherichia coli strains are a common cause of infantile diarrhoea but do not produce recognised enterotoxins. Three strains of proven virulence were examined for toxins which may be missed in conventional tests. Cell lysates and concentrated culture supernates of organisms grown in five different media gave negative results when examined for adenylcyclase stimulating activity. The additions of zinc ions or lincomycin to these media or the use of iron-depleted media also gave negative results. The significance of these findings and the possible role of other toxins in diarrhoea due to enteropathogenic E. coli are discussed. PMID- 3295249 TI - An overview of biohazards associated with nonhuman primates. AB - Because of their close phylogenetic relationship, human and nonhuman primates share susceptibility to many pathogens which do not affect lower animals. This similarity, which makes them invaluable models for studying human infectious diseases, also makes primate animals potentially dangerous to work with. The biohazards inherent in the use of nonhuman primates in biomedical research are zoonoses, injuries, and infectious agents introduced by study protocols. This review addresses the various kinds of parasites, fungi, rickettsiae, spirochetes, and viral agents found naturally occurring, or experimentally induced, in nonhuman primates with reference to measures for preventing spread among the animals or to personnel. PMID- 3295250 TI - Intracellular pH and membrane potential as regulators in the prokaryotic cell. PMID- 3295251 TI - Biophysical analysis of novel transport pathways induced in red blood cell membranes. PMID- 3295252 TI - Studies on the rate of dehydration of histological specimens. AB - Pieces of liver, kidney and urinary bladder were fixed in 10% formalin. In order to study the velocity of the dehydration process tissue specimens of standardized size were rinsed and equilibrated with water containing 3H2O. The specimens were then put into vials with 100% ethanol or acetone; the vials were either shaken continuously or left stationary. The concentration of 3H in the dehydration medium was determined at frequent intervals. If the vials were shaken, steady concentrations of 3H were reached within about 50 min when ethanol was used, and about 30 min with acetone, indicating that dehydration was complete. With the vials left standing still the corresponding times exceeded 12 h. In other experiments dehydration was carried out with intermittent shaking in rising concentrations of ethanol or acetone; in these cases about 4 h were required. PMID- 3295253 TI - Normal yeast tRNA(CAGGln) can suppress amber codons and is encoded by an essential gene. AB - We have isolated a gene that can encode yeast tRNA(CAGGln). When present on a multicopy plasmid, this gene suppresses the phenotype of a number of amber mutants, but has no effect on the ocher mutants tested. We therefore conclude that the anticodon CUG in tRNA(CAGGln) can decode the amber codon UAG by G-U mispairing, possibly by wobble base-pairing in the first codon position. This represents the second example we have observed in this laboratory of nonsense suppression in yeast by natural tRNA(Gln), involving G-U mispairing in the first codon position. Replacing the genomic copy of the cloned gene with a disrupted tRNA gene results in recessive lethality in heterozygous diploids and is lethal to haploid cells. This lethality can be rescued by transformation of cells with a single copy plasmid containing the tRNA(CAGGln) gene. Thus, the gene encoding tRNA(CAGGln) is apparently essential for viability in yeast, suggesting that it is normally present as a single copy gene. PMID- 3295255 TI - A mutant that affects the function of autonomously replicating sequences in yeast. AB - We previously reported the isolation of a series of mcm mutants that are defective in the maintenance of minichromosomes in yeast. These minichromosomes are circular plasmids, each containing an autonomously replicating sequence (ARS) and a centromere. One of the mcm mutants, mcm2, has the following phenotype: at room temperature it affects the stability of only some minichromosomes depending on the ARS present, while at high temperature it affects all minichromosomes tested irrespective of the ARS present. Here we show that the mcm defect as well as its temperature-dependent specificity for ARSs can be demonstrated with circular as well as linear plasmids that do not contain centromeric sequences. Larger chromosomes containing multiple ARSs are also unstable in this mutant. Further analyses indicate that the mcm2 mutation causes the loss, rather than the aberrant segregation, of the circular minichromosomes. In addition, this mutation appears to stimulate mitotic recombination frequencies. These properties of the mcm2 mutant are consistent with the idea that the mcm2 mutation results in a defect in the initiation of DNA replication at ARSs, the putative chromosomal replication origins in yeast. PMID- 3295254 TI - Organization and expression of the satellite bacteriophage P4 late gene cluster. AB - The satellite bacteriophage P4 genes for capsid size determination (sid), transactivation (delta), and polarity suppression (psu) are cotranscribed at late times after infection from a single P4 late promoter (Psid) that lies to the left of the sid gene. While the -10 region of this promoter is similar to the consensus sequence for Escherichia coli RNA polymerase, the -35 region shares no homology with known classes of E. coli promoters. The -10 and -35 regions of Psid share no homology with the late gene promoters of helper phage P2. Nonetheless, P4 late transcription is stimulated by coinfecting P2, as well as by P2 prophage. This stimulation depends on the P2 encoded transcription factor ogr; transcription from Psid is stimulated following the induction of the P2 ogr gene carried on a plasmid. P4 late transcription in the absence of P2 requires the P4 delta product, which is partially homologous to the P2 ogr gene product. DNA sequence analysis shows that the psu gene codes for a protein of Mr = 21,314 that is unrelated to the antitermination gene products of the lambdoid phages. PMID- 3295256 TI - Expression of chimeric genes in Caenorhabditis elegans. AB - We have shown the expression of transformed genes in the nematode Caenorhabditis elegans using a new gene fusion system. Vectors consisting of the flanking regions of a collagen gene (col-1) or a major sperm protein gene of C. elegans fused to the Escherichia coli uidA gene, encoding beta-glucuronidase, were microinjected into worms and found to be propagated as high-copy extrachromosomal tandem arrays. We have detected beta-glucuronidase activity in transformed lines, and have shown that the activity is dependent upon the correct reading frame of the construction and on the presence of the worm sequences. The enzyme activity was shown to be encoded by the chimeric beta-glucuronidase gene by co-segregation analysis and by inactivation with specific antisera. Expression is at a very low level, and seems to be constitutive. We have used histochemical techniques to visualize the enzyme activity in embryos. PMID- 3295257 TI - Myosin degradation fragments in skeletal muscle. AB - Myosin heavy chain degradation fragments produced in vivo have been identified in chicken pectoralis muscle. The fragments were identified by electrophoresis of unfractionated extracts of chicken pectoralis muscle on sodium dodecyl sulfate/polyacrylamide gels followed by immunoblotting on nitrocellulose sheets. Monoclonal antibodies directed against the S2 and light meromyosin subfragments as well as type II myosin-specific polyclonal antibodies directed against the entire myosin heavy chain were used to characterize the fragments, which range in molecular weight from approximately 80,000 to 180,000. All fragments contain the extreme carboxy-terminal portion of the molecule and are distinct from the classical proteolytic fragments such as heavy and light meromyosin, S1, S2 or rod. These fragments appear to be produced in vivo by proteolytic cleavage of peptides from the amino-terminal (S1) end of the heavy chain while the myosin molecule is still embedded in the thick filament. Fragment concentrations are estimated to be approximately 5 to 10% of that of the intact myosin heavy chain. These fragments are not the result of artifactual damage to myosin, e.g. proteolysis or hydrodynamic shear. The techniques described in this paper provide a probe into the early stages of myosin and thick filament degradation in vivo. PMID- 3295258 TI - Sharp boundaries demarcate the chromatin structure of a yeast heat-shock gene. AB - In both induced and basally transcribed states, the chromatin structure of the yeast HSP82 heat-shock locus exhibits a remarkable degree of organization with respect to DNA sequence. The promoter region contains a constitutive DNase I hypersensitive site. The transcription unit is markedly sensitive to DNase I, and exhibits a sharp transition from a phased half- to a whole nucleosomal cleavage periodicity at the 3' end. Distant upstream and downstream regions are also organized into distinct arrays of phased nucleosomes. Each array is demarcated by DNase I hypersensitive sites that display internal protected regions, suggesting the presence of DNA binding proteins. In addition, since these sites are of mononucleosomal DNA length, they may acquire a nucleosomal structure under certain environmental conditions without disrupting flanking nucleosomal phasing frames. Thus, the HSP82 locus is organized into specific, phased, chromatin structures that appear to function in transcriptional initiation, RNA polymerase passage, transcriptional termination, and the establishment of chromatin-domain microenvironments. PMID- 3295259 TI - Effects of the Escherichia coli SSB protein on the binding of Escherichia coli RecA protein to single-stranded DNA. Demonstration of competitive binding and the lack of a specific protein-protein interaction. AB - The effect of the Escherichia coli single-stranded DNA binding (SSB) protein on the stability of complexes of E. coli RecA protein with single-stranded DNA has been investigated through direct DNA binding experiments. The effect of each protein on the binding of the other to single-stranded DNA, and the effect of SSB protein on the transfer rate of RecA protein from one single-stranded DNA molecule to another, were studied. The binding of SSB protein and RecA protein to single-stranded phage M13 DNA is found to be competitive and, therefore, mutually exclusive. In the absence of a nucleotide cofactor, SSB protein binds more tightly to single-stranded DNA than does RecA protein, whereas in the presence of ATP-gamma-S, RecA protein binds more tightly than SSB protein. In the presence of ATP, an intermediate result is obtained that depends on the type of DNA used, the temperature, and the magnesium ion concentration. When complexes of RecA protein, SSB protein and single-stranded M13 DNA are formed under conditions of slight molar excess of single-stranded DNA, no effect of RecA protein on the equilibrium stability of the SSB protein-single-stranded DNA complex is observed. Under similar conditions, SSB protein has no observed effect on the stability of the RecA protein-etheno M13 DNA complex. Finally, measurements of the rate of RecA protein transfer from RecA protein-single-stranded DNA complexes to competing single-stranded DNA show that there is no kinetic stabilization of the RecA protein-etheno M13 DNA complex by SSB protein, but that a tenfold stabilization is observed when single-stranded M13 DNA is used to form the complex. However, this apparent stabilizing effect of SSB protein can be mimicked by pre-incubation of the RecA protein-single-stranded M13 DNA complex in low magnesium ion concentration, suggesting that this effect of SSB protein is indirect and is mediated through changes in the secondary structure of the DNA. Since no direct effect of SSB protein is observed on either the equilibrium or dissociation properties of the RecA protein-single-stranded DNA complex, it is concluded that the likely effect of SSB protein in the strand assimilation reaction is on a slow step in the association of RecA protein with single-stranded DNA. Direct evidence for this conclusion is presented in the accompanying paper. PMID- 3295260 TI - Searching for potential Z-DNA in genomic Escherichia coli DNA. AB - The Clarke-Carbon library with Escherichia coli DNA cloned into plasmid ColE1 was partially screened for Z-DNA with the monoclonal antibody Z-D11 using the retardation of the covalently closed circular DNA-protein complex by nitrocellulose filters. About 85% of the plasmids tested at "natural" supercoil density bound to the filter. Together with binding studies of the iodinated antibody, one Z-DNA segment per about 18,000 base-pairs of E. coli DNA is observed. One clone containing the region around the lactose operon, pLC20-30, was studied in detail. Subcloning a partial Sau3A digest and selection with antibodies gave three different Z-forming sites. They were mapped to within about +/- 20 base-pairs by preparing unidirectional deletion clones, selection of protein binding plasmids on nitrocellulose filters and subsequent sizing on agarose gels. The size of the Z-DNA-forming segments was estimated from two dimensional gels of topoisomer mixtures. Together with results from sequencing of the plasmid DNA using exonuclease III to create single-stranded templates, stretches of alternating purine-pyrimidine tracts of 12 to 15 base-pairs were found to be responsible for Z-DNA formation. One of the sites was found in the middle of the lacZ gene, where it might be an obstacle for RNA polymerase. The methods used here should also be helpful for studying other DNA-protein sites, especially if they exist only in supercoiled DNA. PMID- 3295261 TI - Sequence comparison of single-stranded DNA binding proteins and its structural implications. AB - The primary sequences were compared among several proteins: gene product 5 protein (GP5) from phage M13; PIKE from phage Ike; gene product 32 protein (GP32) from phage T4; RecA, SSB and SSF from Escherichia coli. These proteins bind strongly and cooperatively to single-stranded DNA with no sequence specificity. GP5 is the smallest in this group and its three-dimensional structure is well characterized. Using the entire sequence of GP5 as a template we searched for the regions in other single-stranded DNA binding proteins yielding the best alignment of aromatic and basic residues. The identified domains show alignment of five aromatic and four charged residues in these proteins. The domains in PIKE, GP32 and RecA exhibit statistically significant sequence homology with GP5. These observations strongly favor the hypothesis that the protein-single-stranded DNA complex in this class of proteins is stabilized by the stacking interaction of the aromatic residues with the bases of the DNA, and by the electrostatic interaction of the basic residues with the phosphate groups of the DNA. We also find that the DNA binding domains of these proteins have similar secondary structural preferences, mainly beta structures. The triple-stranded beta-sheet may be a common motif in the DNA binding domains of these proteins. PMID- 3295263 TI - Interaction of nutrition and infection: macrophage activity in vitamin B12 deficient rats infected with Trypanosoma lewisi. AB - MACROPHAGE ACTIVITY WAS STUDIED IN RATS INFECTED WITH TRYPANOSOMA LEWISI IN THREE PROTOCOL GROUPS: one group was fed complete diet, a second group was given a vitamin B(12)-deficient diet, and a third group was fed a pair-fed control (calorically restricted) diet. Throughout the observational period, in animals fed complete and pairfed diets, marked increases in acid phosphatase levels in peritoneal macrophages were directly related to the degree of parasitemia. Acid phosphatase levels in rats deprived of vitamin B(12) were approximately one third that of animals with an adequate supply of the vitamin. Irrespective of the diets, the infection with T lewisi also elicited increased macrophage phagocytosis of polystyrene latex particles and macrophage spreading. Both of these activities occurred at a much slower rate in the vitamin B(12)-deficient animals. PMID- 3295262 TI - Investigation of the antimetastatic effects of agents that inhibit cell adhesion or protein glycosylation. AB - In this overview the authors describe their recent attempts to specifically interfere with the metastatic spread of B16-F10 melanoma cells. Using the experimental metastasis model system, inhibitory effects of (1) coinjection of cells with synthetic peptides derived from the glycoprotein fibronectin, which possess the ability to disrupt cell adhesion, and (2) treatment of cells with inhibitors of protein glycosylation and oligosaccharide processing have been examined. PMID- 3295264 TI - Substance abuse and the legacy of racism. PMID- 3295266 TI - Hypertension: a view from Detroit. PMID- 3295265 TI - Interaction of trace metal contaminants on hematological responses: influence of infection with Trypanosoma lewisi. AB - The influence of trace metal contaminants (lead, cadmium, and mercury) on Sprague Dawley rats was investigated to determine whether subclinical levels of these metals might have adverse effects on the host's ability to respond to an infective agent.In the present study, a trace metal contaminant-trypanosome system was employed to observe the hematological changes in rats infected with Trypanosoma lewisi. The animal groups were: (1) lead (Pb), (2) cadmium (Cd), (3) mercury (Hg), and (4) controls (animals not exposed to trace metals).Regardless of the trace metals, infected animals showed decreases in total erythrocyte counts and lower hematocrit values. Generally, infected animals also showed increases in total leucocyte counts, decreases in the percentages of lymphocytes and monocytes, increases in percentage of neutrophils, and no changes in percentages of eosinophils and basophils. PMID- 3295267 TI - Osseointegration vs fibro-osseous integration. PMID- 3295268 TI - The clinical evaluation of dental implants--a review of the literature, with emphasis on the radiographic aspects. PMID- 3295269 TI - The Praiss-Lew jig. PMID- 3295270 TI - Magnetic retention system for implant prosthodontics. PMID- 3295271 TI - Human clinical trials with the single crystal sapphire endosteal dental implant: three year results, statistical analysis, and validation of an evaluation protocol. PMID- 3295272 TI - Fundamentals for placing the bladevent implant. PMID- 3295273 TI - Prosthetic and laboratory procedures for the titanium plasma spray (TPS) screw implant system. PMID- 3295274 TI - Neurite-promoting activity from fetal skeletal muscle: immunological comparison with laminin. AB - Polycation-binding neurite-promoting factor (PNPF) from skeletal muscle of bovine fetuses has been compared to mouse tumor laminin by an immunological approach. Antiserum prepared against PNPF blocked the neurite-promoting activity in a dose dependent manner. The anti-PNPF antiserum bound to Mr = 200,000-195,000 bands as well as several components of higher molecular weight, as detected in immunoblots of reduced PNPF. The anti-PNPF antiserum did not inhibit the neurite-promoting activity of mouse laminin, although it did bind to native laminin. Antilaminin antiserum bound to PNFP and identified the same Mr = 200,000-195,000 bands and two other higher-molecular-weight bands, as did the anti-PNPF antiserum. The activity of PNPF was confirmed to be sensitive to treatment with heparitinase. It is concluded that PNPF from bovine fetal muscle contains a complex of heparan sulfate and high-molecular-weight components, particularly of Mr = 200,000 195,000, which share antigenic determinants with mouse laminin. However antilaminin antiserum fails to inhibit the activity of PNPF, suggesting that the active site, and/or adjacent regions, of PNPF are antigenically different from the neurite-promoting site of purified mouse tumor laminin. PMID- 3295275 TI - Heroin addiction: morals revisited. PMID- 3295276 TI - Conceptual crises and the addictions: a philosophy of science perspective. AB - This article examines the field of addictions and suggests that it is in the midst of a conceptual crisis. As a result of its immaturity, the addiction's field evidences energy, naivete, curiosity, intensely conflicting and polarized explanations of its identity and purpose, anomalous research findings, and few "facts." From a philosophy of science perspective, these characteristics are considered as indicators of the developmental stages that are associated with the evolution of scientific disciplines. A philosophy of science perspective is applied to the history of the substance abuse field and the consequent implications examined. A discussion of normal science, language, the role of paradigms, and scientific reductionism is included. PMID- 3295277 TI - Narcotic and other drug use: a spectrum. AB - Zinberg and Lewis foresaw developments in the substance abuse field in particular and in human services in general with the development of a "Spectrum of a Difficult Medical Problem." We believe this spectrum has far reaching implications and value for researchers, theoreticians, planners and practitioners currently in the substance abuse field both in conceptualizing drug involvement with its diversity of potential concerns, as well as planning treatment for drug involved clients. The application of a spectrum need not be limited to the category of drugs known as narcotics; this concept can also be applied to involvement with drugs from other categories, e.g., stimulants, sedative/hypnotics, hallucinogens, etc. PMID- 3295278 TI - Narcotic usage. I. A spectrum of a difficult medical problem. By Norman E. Zinberg and David C. Lewis. 1964. PMID- 3295279 TI - A study of the antigen, antibody and immunecomplex levels in Wuchereria bancrofti filariasis with reference to clinical status. AB - Circulating antigens, antibodies to somatic and sheath components of microfilariae (mf) and immune complexes were determined in parallel in different categories of Wuchereia bancrofti infection using, respectively, reverse indirect haemagglutination (RIHA), indirect haemagglutination (IHA), indirect immunofluorescent (IFA) and polyethylene glycol (PEG) precipitation assays. Rabbit hyperimmune anti-W. bancrofti mf serum and mf homogenates were used as reagents. Appreciable levels of antigens and antibodies were detected in all categories; endemic normals, asymptomatic carriers, acute and chronic filarial cases. For example, even amongst endemic normals, i.e. those with neither clinical nor parasitological evidence of infection, 66%, 71% and 74% had mf antigens, anti-mf antibodies and anti-sheath antibodies, respectively. Notably, only a small proportion (9.4%) of microfilaraemic individuals had detectable level of anti-sheath antibodies. The relationship of these parameters with the spectrum of filariasis is discussed. PMID- 3295280 TI - Immunization in childhood--current trends and new developments. PMID- 3295281 TI - Practical problems in protracted diarrhoea. PMID- 3295282 TI - Ultrasonic evaluation of the scrotum in lymphoproliferative disease. AB - Scrotal ultrasound examinations of 23 male adults and children with the diagnosis of lymphoproliferative disease (LPD) were performed. Diagnoses included acute lymphoblastic leukemia (ALL) (six patients); acute myelogenous leukemia (AML) (one patient); chronic lymphocytic leukemia (CLL) (nine patients); non-Hodgkin's lymphoma (four patients); Hodgkin's lymphoma (three patients). Sonography-biopsy correlation was 100% in identifying testicular infiltrates. Nine of ten patients with testicular involvement had bilateral disease. Six patients had nonpalpable disease correctly identified by sonography. Ultrasound has great potential value as a screening modality for testicular biopsy in ALL and for detecting subclinical or nonpalpable disease in adults with LPD. PMID- 3295284 TI - Sonographic biophysical profile in the postdate pregnancy. AB - One hundred thirty-one postdate pregnancies were evaluated by the sonographic biophysical profile. Results of prenatal testing were compared to neonatal condition. Predictive values were calculated in order to determine whether this testing scheme could be used to detect the fetus at risk for neonatal distress. The results of this study show that a normal biophysical profile score is highly predictive of normal outcome, but an abnormal test has only a 14% predictive value of poor neonatal outcome. PMID- 3295283 TI - Fetal gastric pseudomasses. AB - Discrete echogenic areas of 4-12 mm were observed in the fetal stomach on seven prenatal sonograms. The finding was incidental and solitary during the second trimester in six normal pregnancies. It was noted during the third trimester in a case of meconium peritonitis. These echogenic areas displayed a homogeneous texture. They disappeared on repeat prenatal examination in six patients who did not reveal any gastrointestinal symptoms on postnatal follow-up. Although their origin is not certain, these fetal gastric pseudomasses should be interpreted cautiously. PMID- 3295285 TI - Postasphyxial encephalopathy in term infants. Sonographic demonstration of increased echogenicity of the thalamus and basal ganglia. AB - Sonographic abnormalities secondary to postasphyxial encephalopathy in neonates are reviewed. This report emphasizes an additional finding, increased echogenicity of the thalamus and basal ganglia, demonstrated in four term infants. This abnormal finding is generally noted in the second week following asphyxia. In some cases, the increased thalamic echogenicity may be a temporary finding. A representative case is described and possible pathologic correlates are discussed. PMID- 3295287 TI - Ultrasound and computed tomographic findings in aggressive angiomyxoma of the uterine cervix. PMID- 3295286 TI - Pitfalls in femur length measurements. AB - The following study was performed to determine the precise anatomic correlate for the end points of sonographic measurement of the fetal femur. A cadaveric fetal thigh was dissected in layers and correlated with sonographic images. The margins of the osseous portion of the femur were determined on sonograms. Potential for underestimating femur length (oblique images) and overestimating femur length (including nonosseous portions of the femur in measurement) can be eliminated by requiring a view of the femur which includes the epiphyseal cartilages. In this way, the margins of the osseous portion may be accurately estimated, and there is assurance that the entire shaft has been visualized. Images of the dissected specimen indicate that the "distal femur point," which may cause confusion in measurement, is not a part of the osseous femur, but probably represents a specular reflection from the lateral surface of the distal epiphysis. PMID- 3295288 TI - Infarcted cystadenofibroma of the breast. Ultrasonic appearance. PMID- 3295289 TI - Sonographic preoperative localization of a foreign body in the hand. PMID- 3295290 TI - Cephalocentesis. Guidance with an endovaginal probe and endovaginal needle placement. PMID- 3295291 TI - Sonographic anatomy of the larynx, with particular reference to the vocal cords. AB - Sonographic images of the vocal cords were obtained in 41 healthy human subjects using a phased array realtime ultrasound scanner. The thyroid cartilage provides the acoustic window for sonographic visualization of the vocal cords. The false vocal cords appear as hyperechoic structures, while the true vocal cords are seen as hypoechoic structures. The symmetry of movement of the vocal cords during respiration becomes apparent on examination in real time. Sonography may prove to be a potentially useful technique for the examination of the vocal cords. PMID- 3295292 TI - Abdominal lymphadenopathy in sarcoidosis. AB - Medical records of 370 patients with sarcoidosis were reviewed. Of these, 32 had a computerized tomographic (CT) and/or ultrasound (US) examination of the abdomen. Two patients had extensive abdominal adenopathy: one was diagnosed by CT and the other by US. Both patients had conventional chest radiographic findings characteristic of sarcoidosis. In addition, five patients had hepatosplenomegaly; three had only hepatomegaly; three had only splenomegaly. There exists a small and previously unsuspected incidence of patients with extensive abdominal adenopathy in sarcoidosis. Although lymphoma and metastatic disease are far more common causes of extensive abdominal lymphadenopathy, sarcoidosis should be considered in the appropriate clinical setting. In many cases, correlation with conventional chest radiographs may be confirmatory. PMID- 3295293 TI - Diagnosis of autosomal dominant polycystic kidney disease in utero and in the young infant. AB - Autosomal dominant polycystic kidney disease (ADPKD), once thought to be a disease of the adult, is now being reported with increasing frequency in childhood. We report five cases and review eight cases from the literature of ADPKD diagnosed in the fetus or the young infant by sonographic evaluation and a positive family history. Renal enlargement (85%) was the most common and most helpful sonographic finding. Approximately 50% of the patients already had cysts large enough to detect by ultrasound. Increased renal echogenicity was present in nine of 10 cases. Although every case in this review had one parent affected with ADPKD, only five of 13 (38%) were aware of their disease prior to their pregnancy. Renal cystic disease diagnosed in the fetus and young infant should trigger an investigation of the family history and sonographic screening. PMID- 3295294 TI - Dilated fetal bowel. A sonographic sign of cystic fibrosis. PMID- 3295295 TI - Renal sonography in Bartter syndrome. PMID- 3295296 TI - Computed tomography and ultrasound in purulent ventriculitis. PMID- 3295298 TI - Prostatic acid phosphatase: its current clinical status. PMID- 3295297 TI - MC29 deletion mutants which fail to transform chicken macrophages are competent for transformation of quail macrophages. AB - A number of MC29 mutants with deleted myc genes have been previously characterized. Many of these mutants have been found to be defective for transformation of chicken macrophages in vitro and for tumor induction in chickens. Such mutants are capable of transforming Japanese quail macrophages in vitro and inducing a high incidence of tumors in Japanese quail. Thus, Japanese quail may contain a factor(s) capable of complementing the defective transforming proteins encoded by some deleted v-myc genes. PMID- 3295299 TI - Efficacy of glucagon in the relief of ureteral colic following treatment by extracorporeal shock wave lithotripsy: a randomized double-blind trial. AB - In a prospective, double-blind, placebo-controlled study 18 patients were evaluated in regard to the effectiveness of glucagon to treat ureteral colic following extracorporeal shock wave lithotripsy. The study groups were comparable. There was no significant difference between glucagon and placebo in relief of pain or in the amount of gravel passed within 48 hours of treatment. We conclude that despite its desirable physiological attributes, glucagon has no demonstrable benefit in the treatment of ureteral colic following extracorporeal shock wave lithotripsy. PMID- 3295300 TI - Continuing experience with the continent ileal reservoir (Kock pouch) as an alternative to cutaneous urinary diversion: an update after 250 cases. AB - The continent ileal reservoir as conceived by Kock produces a low pressure, high capacity reservoir with continent and nonrefluxing valves constructed from ileum. From August 1982 through August 1985, 250 patients underwent this type of surgery at our institution. Of these patients 171 underwent simultaneous radical cystectomy for cancer, 60 had had a previous urinary diversion of another type and 19 had a neurogenic bladder. Our experience represents a series of expected complications and ongoing modification to the surgical technique. A total of 42 patients (16 per cent) suffered early complication resulting in an operative mortality rate of 2 per cent (5 of 250). One or more late complications necessitating 85 revisions occurred in 77 patients (31 per cent). The end result has been an overwhelming success tempered only by the need for reoperation. It is believed that the surgical modifications described will decrease further the incidence of late complications. The basic surgical premise as conceived by Kock remains a low pressure, high capacity reservoir with continent and nonrefluxing valves that can be constructed from ileum. The concept is sound and offers a genuine alternative to the patient who requires cutaneous urinary diversion. PMID- 3295301 TI - Management of late complications of the Kock pouch form of urinary diversion. AB - Urinary diversion via the continent ileal reservoir has been performed at our institution since 1982. During a 3-year period 250 patients have sought this procedure as an alternative to other forms of cutaneous urinary diversion. We analyzed our data in terms of late complications resulting directly from the operation or from this form of urinary diversion. In this context 77 of the 245 patients who survived the operation have suffered 1 or more late complications, requiring 85 reoperations. The late complications mainly have involved problems with continence or ease of catheterization and they were detected within 6 months. We report our experience and describe the technical aspects of treatment. PMID- 3295302 TI - Is yohimbine effective in the treatment of organic impotence? Results of a controlled trial. AB - Yohimbine is an alpha-adrenoceptor blocker that has been used in the treatment of erectile dysfunction. Adequate trials of this substance in a clearly defined organically impotent population are not available. We conducted a randomized, controlled study with partial cross-over of yohimbine versus placebo in 100 organically impotent men. The first phase of the study showed a positive response in 42.6 per cent of the patients receiving yohimbine versus 27.6 per cent in the placebo group. Although favorable to the test medication these values did not reach statistical significance (p equals 0.42). A similar pattern was noted in the second phase of the study. The over-all response rate of 43.5 per cent was consistent with a previous noncontrolled trial but it was much lower than previous studies. The response rate of organically impotent patients to yohimbine is at best marginal. Owing to its ease of administration, safety and modest effect it still is used in those patients who do not accept more invasive methods. Adrenoceptors are involved in the erectile process, although other neurotransmitter systems also are putative modulators of penile erection, including cholinergic, dopaminergic and vasoactive intestinal polypeptide pathways. It is beyond reasonable expectation that a single agent be of value for all cases of organic impotence. However, yohimbine has shown modest effectiveness at the doses used in this trial (18 mg. per day). Higher doses or a different route of administration may produce different effects. PMID- 3295303 TI - Continent diversion in children: modification of Kock pouch. AB - Continent urinary diversion with the ileum was performed in 10 children. The techniques described by Kock and modified by Skinner were modified further to avoid use of staples and a polypropylene (Marlex) collar with their potential hazards. The afferent and efferent limbs were fixed at 2 points internally to the wall of the pouch and externally by apposed multiple incisions and sutures to prevent nipple dessusception. A continent, nonrefluxing reservoir was achieved in all children. The stoma is placed at the umbilicus, which is more pleasing aesthetically, is less compromising to the abdominal wall musculature and is easier to catheterize by chair-bound, obese girls and by children with limited fine finger movements or mild spasticity. PMID- 3295304 TI - Ejaculatory duct cyst: the case for effective use of transrectal longitudinal ultrasonography. AB - We report a case of an ejaculatory duct cyst. Although vasovesiculography showed insufficient differentiation from other cystic lesions, we were able to diagnose the entity by longitudinal transrectal prostatic ultrasonography with electronic linear scanning. On the basis of these findings transurethral unroofing of the cyst was performed successfully. PMID- 3295305 TI - Detection of onco-fetal bladder antigen in urine of patients with transitional cell carcinoma. AB - Studies of antigens associated with transitional cell carcinoma were extended by using murine IgM monoclonal antibody E7, developed earlier by this laboratory. These antibodies react preferentially with human bladder tumors and transitional cell carcinoma (TCC) cell line 647V. We now report that monoclonal antibody E7 detected the presence of antigen in midgestational and third trimester amniotic fluids, and in urine of patients with advanced transitional cell carcinoma. Western blot analysis showed that the antigen present in amniotic fluids consists of a sharp band with molecular weight greater than 200 kdaltons. A similar molecular weight pattern was seen with the solubilized membrane of 647V. A sensitive and convenient sandwich ELISA was developed and the urine of patients with bladder cancer was assayed for the presence of the E7 antigen. Antigen was detected in the urine of patients with advanced transitional cell carcinoma but not in the urine of normal adults or in urine from patients with prostate cancer, renal cell carcinoma, or benign prostate hyperplasia. An inhibition enzyme immunoassay was developed with monomeric forms of the E7 antibody and confirmed the presence of antigen in the urine of patients with TCC. We conclude that the E7 antigen is an onco-fetal antigen expressed in patients with transitional cell carcinoma of the bladder. PMID- 3295306 TI - The value of power frequency spectrum analysis in the identification of aortoiliac artery disease. AB - Prediction and localization of significant proximal occlusive disease in the lower extremities, whether in isolation or in combination with significant distal disease, still represent major problems to the noninvasive vascular laboratory. Power frequency spectrum analysis (PFSA) was done on continuous-wave Doppler signals in the common femoral artery of 86 limbs in 50 patients before and after postocclusive reactive hyperemia testing in an effort to differentiate hemodynamically significant from insignificant proximal occlusive disease, whether in isolation or in combination with hemodynamically significant distal disease. Limbs were assigned to four different categories according to their angiographic findings. With the use of a bandwidth at 50% peak amplitude (f50%) of 2000 Hz as the cut-off point between a positive and a negative examination, the test was 93% sensitive, 90% specific, and 92% accurate in distinguishing hemodynamically significant proximal lesions from hemodynamically insignificant lesions, regardless of distal disease. In addition, there exists a small group with significant disease at or close to the site of Doppler sampling, which produces f50% values of more than 3000 Hz. Diagnosis in this subgroup was much like that in carotid disorders. Finally, the predictive accuracy of standard noninvasive Doppler/segmental pressure measurement was compared with results of PFSA. In most patients, standard measurements were comparable; however, in the subgroup with hemodynamically significant proximal and distal disease, the PFSA technique accurately predicted hemodynamically significant proximal diseases in 93% of patients, where combined pressure/Doppler testing had an accuracy of only 61%. In all, spectrum analysis of common femoral artery velocity signals can greatly aid in determining the presence or absence of significant proximal disease in all situations. PMID- 3295307 TI - Effect of commercially available pantyhose on venous return in the lower extremity. AB - Although compression stockings have long been recognized as a physiologically significant tool for the promotion of venous return from the lower extremity, the role of nonprescription, commercially available support hose has not been assessed in this regard. The present study involved 100 consecutive women with no known prior history of vascular disease, who responded to an advertisement for free evaluation of the venous status of their legs. The subjects, all of whom wore commercial support hose routinely, were screened for the presence of venous disease by means of Doppler ultrasonography, phleborheography, and a detailed history focusing on risk factors and unrecognized symptoms of venous disease. Photoplethysmography (PPG) was then used to evaluate the efficiency of venous return from the lower extremity with and without the support hose in place. Worsening of PPG results occurred in 43% of the women with commercial stockings in place, whereas 23% improved and 34% showed no change. Women 50 years of age and older had a somewhat higher tendency toward poorer PPG results while wearing the support hose. Furthermore, measurements in women who showed evidence of venous disease by an abnormality in one or more of the screening tests were significantly different from the overall group (p = 0.025): 61% exhibited worsening of PPG results when wearing stockings, only 14% showed improvement, and 25% were unchanged. These results suggest that the use of a commercial support hose may be particularly deleterious to older women and is contraindicated in those with evidence of venous disease in the lower extremity. PMID- 3295308 TI - Proximal vein thrombosis secondary to hemodialysis catheterization complicated by arteriovenous fistula. AB - Innominate vein thrombosis as a result of previous hemodialysis catheter placement occurred in a patient with a functioning radial-cephalic fistula, resulting in massive edema with bleb formation. Diagnosis was confirmed by magnetic resonance imaging and the complication was successfully managed by subclavian vein-superior vena cava bypass. This experience suggests the need to consider the possibility of proximal vein occlusion in selecting arteriovenous fistula sites and, rather than abandoning the fistula, allowing it to serve to protect patency of a proximal bypass. PMID- 3295309 TI - Parasitism by helminths in the grey-sided vole (Clethrionomys rufocanus) in northern Finland: influence of density, habitat and sex of the host. AB - We have studied helminths from 532 grey-sided voles (Clethrionomys rufocanus) in two localities in northern Finland, representing different biogeographic zones, during 1978-1983. The helminth communities in the two study areas were similar, characterized by a small number of species (eight) compared to eastern Siberia and Japan, and by the dominance of a single anoplocephalid cestode Andrya kalelai. The prevalence of this helminth varied significantly among habitats, possibly because of differences in the distribution and abundance of the intermediate hosts, oribatid mites. Vole density did not explain the habitat differences in A. kalelai, nor did the prevalence of A. kalelai increase between 2 yr of sustained high density in the host population. A between-year increase in the prevalence of the larval cestode Taenia tenuicollis at Kilpisjarvi was probably due to a simultaneous increase in the abundance of its definitive hosts, mustelids. The prevalence of A. kalelai was always higher in males; no sexual differences were detected in the larval T. tenuicollis. PMID- 3295310 TI - Surveillance for naturally acquired leprosy in a nine-banded armadillo population. AB - Samples from 77 nine-banded armadillos (Dasypus novemcinctus) inhabiting a 16.7 km portion of the East Atchafalaya River Levee, Point Coupee Parish, Louisiana, were serologically tested and/or histopathologically examined for evidence of naturally acquired leprosy. Five of 67 (7.5%) armadillos tested sero-positive with ELISA test for IGM class antibodies to the phenolic-glycolipid-1 antigen of Mycobacterium leprae. One of 74 (1.3%) was histopathologically positive as determined by presence of acid-fast bacteria in nerves. PMID- 3295311 TI - The Thucydides syndrome. PMID- 3295312 TI - A multifactorial system for equitable selection of cadaver kidney recipients. AB - During 1986, a total of 270 cadaver renal transplantations were performed at the University of Pittsburgh. Kidneys were allocated by a point system that awarded points to recipients for waiting time, antigen matching, antibody analyses, medical urgency, and logistic practicality. Kidneys were given to patients with the highest point totals in 98% of cases. To our knowledge, this is the first such multifactorial system for cadaver kidney allocation. Possibly it may be modified for extrarenal organs. PMID- 3295313 TI - Nutritional management in acute respiratory failure. AB - Nutrition in the intensive care unit is receiving increased attention. Patients with acute respiratory failure from primary lung disease are often initially malnourished, or become malnourished secondary to increased metabolic demands or inadequate nutritional support. Adverse effects of malnutrition on lung function include decreased respiratory muscle function, decreased ventilatory drive, and altered lung defense mechanisms. Nutritional support should be strongly considered if the patient has evidence of malnutrition by nutritional assessment or has a high likelihood of becoming malnourished by virtue of severe, prolonged critical illness. General nutritional goals in the intensive care unit include maintenance of body weight and lean body mass. Proper nutritional therapy includes assessment of adequate caloric requirements and appropriate protein, carbohydrate, and fat composition of the nutritional support. Nutritional therapy should be closely monitored with body weight and nitrogen-balance measurements. PMID- 3295314 TI - Second cardiac xenograft predicted; questions remain on procedure. PMID- 3295315 TI - Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. AB - The Cholesterol-Lowering Atherosclerosis Study (CLAS) was a randomized, placebo controlled, angiographic trial testing combined colestipol hydrochloride and niacin therapy in 162 nonsmoking men aged 40 to 59 years with previous coronary bypass surgery. During two years of treatment there was a 26% reduction in total plasma cholesterol, a 43% reduction in low-density lipoprotein cholesterol, plus a simultaneous 37% elevation of high-density lipoprotein cholesterol. This resulted in a significant reduction in the average number of lesions per subject that progressed (P less than .03) and the percentage of subjects with new atheroma formation (P less than .03) in native coronary arteries. Also, the percentage of subjects with new lesions (P less than .04) or any adverse change in bypass grafts (P less than .03) was significantly reduced. Deterioration in overall coronary status was significantly less in drug-treated subjects than placebo-treated subjects (P less than .001). Atherosclerosis regression, as indicated by perceptible improvement in overall coronary status, occurred in 16.2% of colestipol-niacin treated vs 2.4% placebo treated (P = .002). PMID- 3295316 TI - DXplain. An evolving diagnostic decision-support system. AB - DXplain is an evolving computer-based diagnostic decision-support system designed for use by the physician who has no computer expertise. DXplain accepts a list of clinical manifestations and then proposes diagnostic hypotheses. The program explains and justifies its interpretations and provides access to a knowledge base concerning the differential diagnosis of the signs and symptoms. DXplain was developed with the support and cooperation of the American Medical Association. The system is distributed to the medical community through AMA/NET--a nationwide computer communications network sponsored by the American Medical Association- and through the Massachusetts General Hospital Continuing Education Network. A key element in the distribution of DXplain is the planned collaboration with its physician-users whose comments, criticisms, and suggestions will play an important role in modifying and enhancing the knowledge base. PMID- 3295318 TI - Pressure-volume relationships in the pulmonary "venous" system in living dogs. AB - In this study, we examined the pressure-volume (P-V) relationships of the pulmonary "venous" (P'V') system in anesthetized living dogs, and assessed compliance by fitting the derived data of the P-V relationships to the exponential function. By definition, the P'V' system consists of the pulmonary veins and the left atrium. The pulmonary "venous" volume (P'V'V) was determined with our modified double indicator dilution method using a single injection and double sampling technique. The mean left atrial pressure (PLA) was measured directly. To observe sequential changes over a wide range of the P-V relationships, dogs were studied from the control state through the volume-loaded state with dextran. The P'V'V ranged from 3.4 to 12.2 ml X kg-1 and the PLA from 3.2 to 40.6 mmHg. We fitted the data of the P-V relationships (n = 24) to the exponential function, yielding an equation: P'V'V (ml X kg-1) = 19(1-0.833(e 0.017PLA(mmHg)). We then differentiated an above equation to estimate the slope of this curve (static compliance), giving the equation: dV/dP (ml X mmHg-1 X kg 1) = 0.269(e-0.017PLA(mmHg)). Therefore, at PLA of 10 mmHg (normal level), the compliance is 0.227 ml X mmHg-1 X kg-1. The compliance, obtained with an application of the present results in dogs to man, (disregarding expected species differences), coincides well with that in man determined with our indirect method. PMID- 3295317 TI - Intravenous branched chain amino acid trial in marrow transplant recipients. AB - Branched chain amino acids (BCAA) improve nitrogen balance and end-organ function in surgical patients, but are untested in marrow transplant recipients. We compared nitrogen balance, urinary 3-methylhistidine-to-creatinine ratio, upper arm anthropometry, serum prealbumin, and day to peripheral engraftment in a randomized, double-blinded trial between 45% (high-leucine) and 23% BCAA intravenous solutions in 40 adult leukemia patients for 1 month following allogeneic marrow transplantation. Nutritional support, provided at approximately 30 nonprotein calories/kg and 0.21 g nitrogen/kg ideal weight, did not differ between groups. Despite greater nitrogen loss and muscle breakdown evidenced by increased 3-methylhistidine-to-creatinine ratio and loss of arm muscle area by study end in the 45% BCAA, no statistical differences were observed when nitrogen balance was compared by week and within stress level as defined by organ and infectious complications. It is likely the patients in the 45% BCAA experienced greater metabolic stress by study end. Serum prealbumin and day posttransplant to peripheral engraftment also did not differ between groups. The chances (power) of this study exceeded 85% in detecting a difference in nitrogen balance of 2.5 g during study week 1 and 4.0 g during week 2. The power during week 3 was 77% for detecting a difference of 4.0 g, and it is unlikely that the true difference exceeds this magnitude. Thus, we did not find any evidence that intravenous BCAA enriched solutions improved nitrogen balance during the first month after marrow transplantation. PMID- 3295319 TI - President lecture. Acute myocardial infarction: current status and prospective view. PMID- 3295320 TI - [Respiratory and hemodynamic effects of positive end-expiratory pressure (PEEP) with increased intra-abdominal pressure]. PMID- 3295321 TI - [A parallel comparative double blind study of cefixime with cefaclor in the treatment of acute suppurative otitis media in children]. AB - A double blind study was carried out to compare the efficacy and safety of cefixime (CFIX), a new oral cephem with cefaclor (CCL) in the treatment of 245 children weighing 10 approximately 30 kg, with acute suppurative otitis media. The daily dosages of CFIX and CCL were 3 approximately 6 mg/kg in 2 divided portions, and 20 approximately 40 mg/kg in 3 divided portions, respectively, and the drugs were administered for 7 days. The results obtained in this study are summarized as follows. Analyzed subjects were 211 patients (CFIX group: 108 patients, CCL group: 103 patients) for clinical efficacy. Efficacy rates judged by the doctor in charge were 88.9% and 83.5% in CFIX and CCL group, respectively, without significant difference between the 2 groups. Similar results were also obtained by the committee. When clinical effects were classified by clinical isolates, the efficacy rates against monomicrobial infections with Gram-negative bacteria were judged by the doctor in charge to be 100% in the CFIX group and 84.6% in the CCL group. Thus CFIX was judged to be significantly superior to CCL (P less than 0.05). The overall eradication rates of bacteria were 97.1% in the CFIX group and 90.3% in the CCL group. The eradication rate of CFIX was significantly superior to that of CCL (P less than 0.05). When improvements of individual symptoms were evaluated, regarding redness of the tympanic membrane and the tympanic cavity on the 3rd day of dosing, CFIX group (improvement in 84.1% of the cases) was significantly superior (P less than 0.05) to the CCL group (67.6%). Regarding purulent secretion on the 7th day of dosing, the CFIX group (improvement in 98.1% of the cases) was also significantly superior (P less than 0.05) to the CCL group (91.3%). Two hundred thirty eight patients were analyzed for side effects (CFIX group: 120 patients, CCL group: 118 patients). The incidence rates of side effects were 0.8% (1/120) in the CFIX group and 1.7% (2/118) in the CCL group, and there was no significant difference between the 2 drugs. From the above results, it is concluded that CFIX is a useful oral antibiotic in the treatment of acute suppurative otitis media in children. Furthermore, CFIX is expected to be equal or superior to CCL in clinical effects. PMID- 3295322 TI - [Evaluation of assay methods for isepamicin sulfate (HAPA-B) in body fluids. Bioassay, HPLC and EIA methods]. AB - Assay methods including microbiological assay (bioassay), high performance liquid chromatography (HPLC) and enzyme immunoassay (EIA) for isepamicin sulfate (HAPA B), a new aminoglycoside antibiotic, in body fluids were studied. The most suitable bioassay method was double layer agar-well method using Bacillus subtilis ATCC 6633 as the test organism on plate consisting of a seed-layer of nutrient agar at pH 8.0 and a base-layer of nutrient agar supplemented with 0.4% sodium chloride. Sensitivities in bioassay, HPLC and EIA methods for plasma concentration were 0.08 microgram/ml, 0.20 microgram/ml and 0.05 microgram/ml, respectively. Plasma and urinary concentrations after intramuscular administration of HAPA-B at the dose of 200 mg to healthy volunteers were measured with these 3 methods. The HPLC and the EIA methods yielded values which compared favorably to the bioassay method. Using the bioassay method, HAPA-B levels in human plasma and urine samples were found to be stable at least for 15 days at -20 degrees C. PMID- 3295324 TI - [Evaluation of the FAB classification of acute leukemia]. PMID- 3295323 TI - [A parallel comparative double blind study of cefixime with cefroxadine in the treatment of acute lacunar tonsillitis]. AB - The clinical efficacy and safety of cefixime (CFIX), a new oral cephalosporin, were compared with those of cefroxadine (CXD) in patients suffering from acute lacunar tonsillitis in a double blind study. Two hundred and fifty two patients were given each orally 100 mg of CFIX b.i.d. or 250 mg of CXD t.i.d. for, in principle, 7 days. Number of patients evaluated for clinical efficacy was 202 (103 treated with CFIX and 99 treated with CXD). As for the backgrounds of patients, more severe cases were found in the CFIX group than in the CXD group (P less than 0.01). Efficacy rates evaluated by individual doctors were 88.3% in the CFIX group and 91.9% in the CXD group. There was no significant difference between the 2 groups. Efficacy rates on the third day after the initiation of treatment evaluated by the committee were 40.8% in the CFIX group and 47.9% in the CXD group with no significant difference. Efficacy rate on the 7th day, however, was 79.8% in the CFIX group and 93.4% in the CXD group, showing a significant difference (P less than 0.05). Bacteriological effectiveness were satisfactory for both groups with eradication rates of 93.4% for the CFIX and 96.9% for the CXD group. Number of patients evaluated for safety was 226 (110 treated with CFIX and 116 treated with CXD). No significant difference was observed between the 2 drug groups in incidences of side effects; gastrointestinal disturbances or rashes were noted in 6 patients (5.5%) of the CFIX group and in 5 patients (4.3%) of the CXD group. As for the abnormal laboratory findings, elevation of GOT & GPT was observed in 1 patients of the CFIX group. From these results, it was concluded that 100 mg b.i.d. of CFIX was as useful as 250 mg t.i.d. of CXD in the treatment of acute lacunar tonsillitis. PMID- 3295325 TI - [Application of flow cytometry in hematological disorders]. PMID- 3295326 TI - [Immunologic reconstitution after bone marrow transplantation]. PMID- 3295327 TI - [Evaluation and diagnostic efficacy of synthetic-substrate methods for coagulation and fibrinolytic factors]. PMID- 3295328 TI - [Medical technology and tests--application for microbiological laboratory]. PMID- 3295329 TI - [Determination of Chlamydia trachomatis in male urethritis using chlamydiazyme]. PMID- 3295330 TI - [Low osmolality contrast media in excretory urography]. PMID- 3295331 TI - [Acute focal bacterial nephritis (AFBN)--diagnostic imaging and follow-up]. PMID- 3295332 TI - [Intra-arterial digital subtraction angiography in bone and soft tissue tumors]. PMID- 3295333 TI - [Hematoma of the internal capsule due to a venous angioma: a case report]. PMID- 3295334 TI - [A case of arteriovenous malformation of the head of the pancreas]. PMID- 3295335 TI - [Sonographic and radiographic features of the hemolytic-uremic syndrome: a case report]. PMID- 3295336 TI - [An analysis of the structure of gastric ulcer by endoscopic ultrasonography]. PMID- 3295337 TI - [Decreased insulin bindings to erythrocytes in acute hepatitis: correlation with the degree of hepatic damage]. PMID- 3295338 TI - [A case of focal nodular hyperplasia of the liver and review of previously reported 44 cases in Japan]. PMID- 3295339 TI - Cytotoxic and antitumor activity of a soluble fraction of Streptococcus pyogenes against S180 sarcoma cells. AB - A fraction (60F) having cytotoxic and antitumor activities was obtained from cell free extract of group A Streptococcus pyogenes by precipitating with 50% to 60% saturated ammonium sulfate. 60F showed cytotoxic activity inhibiting the uptake of 3H-thymidine by S180 sarcoma cells and enhancing 51Cr-release from 51Cr labeled cells. 60F showed also antitumor activity, depressing tumor growth and prolonging lives of mice bearing S180 sarcoma cells. PMID- 3295340 TI - [Reflection on the social and educational roles of nursing teachers--training of nursing instructors at Special Education (Nursing) Section, Department of Education at 4 National Universities in the past 20 years]. PMID- 3295341 TI - A newly established cell line of rabbit lens epithelium. AB - Rabbit lens epithelial cells have been cultured continuously for more than 24 months (200 generations) in monolayers. Their morphology resembled cobblestones when confluent and was spindle-shaped during growth. The doubling time was 40 hours. The cells were capable of colony formation and their plating efficiency was about 6%. They had immunoreactivity to antiserum to the crystalline-rich supernatant of rabbit lens homogenate. Therefore, it was concluded that they were a permanent cell line and they were named TOTL-86 cells. PMID- 3295342 TI - [Preservation for lung transplantation]. PMID- 3295343 TI - [Lung transplantation]. PMID- 3295344 TI - [Rejection after lung allotransplantation]. PMID- 3295345 TI - [An operative case of the migration of a needle into the thoracic aorta]. PMID- 3295346 TI - [Bronchial growth following sleeve lobectomy in puppies]. PMID- 3295347 TI - [A case report of mitral valve implantation preserving the whole mitral apparatus in a child]. PMID- 3295348 TI - [Vascular surgery of the kidney]. PMID- 3295349 TI - Biochemical characteristics of Klebsiella pneumoniae derived from horses. PMID- 3295350 TI - Preventive effect of estradiol on manifestation of purulent endometritis in rat uteri infected with Escherichia coli: with special reference to morphological changes of the endometrial epithelium. PMID- 3295351 TI - Morphological and immunohistochemical studies of juxtaglomerular cells in the carp, Cyprinus carpio. PMID- 3295352 TI - Detection of Tn antigen with Vicia villosa agglutinin in urinary bladder cancer: its relevance to the patient's clinical course. AB - Recently, several investigators have demonstrated that the MN blood group precursor antigens Thomsen-Friedenreich antigen (T-Ag) and Tn-antigen (Tn-Ag) are expressed on the cell surfaces of several cancers, including urinary bladder cancer. T-Ag is composed of a specific carbohydrate chain, galactose-beta-1-3-N acetylgalactosamine (GalNAc), which is specifically detectable through the immunohistochemical binding of peanut agglutinin (PNA). In normal cells, T-Ag is cryptic (cT-Ag) and can be unmasked by treatment with neuraminidase. Tn-Ag is composed of another carbohydrate chain, alpha-GalNAc-serine/threonine, and binds specifically to Vicia villosa agglutinin (VVA). With the use of both these lectins, VVA and PNA, the presence or absence of Tn-Ag and T-Ag was examined in 24 specimens of normal bladder epithelium and specimens from 53 cases of human urinary bladder transitional cell carcinoma of various histologic grades by staining paraffin sections by means of the avidin-biotin-immunoperoxidase technique. The correlation between the expression of these antigens and the patient's clinical course was then estimated. Out of 21 patients in whom the tumors expressed the phenotype Tn-Ag(+), T-Ag(+), or cT-Ag(-), 17 suffered from invasive recurrence. Although patients with tumors expressing the phenotypes T Ag(-) and cT-Ag(+) have been reported to show a good clinical course, in our studies some of them showed a switch to invasive recurrence. Thus it was not possible to estimate the patient's clinical course only by the presence or absence of T-Ag and cT-Ag. The expression of Tn-Ag was then examined with the use of VVA. Of 38 cases expressing the phenotypes T-Ag(-) and cT-Ag(+), 6 had tumors that carried Tn-Ag; 5 of them suffered from invasive recurrence. These results indicated that the detection of Tn-Ag with the use of VVA in combination with the examination of T-Ag and cT-Ag is useful for estimating the degree of malignancy of bladder cancer and the patient's clinical course. PMID- 3295353 TI - Heterogeneity of human natural killer cells with respect to lectin-binding ability. AB - The binding ability of peanut agglutinin (PNA), lentil agglutinin (LEN), soybean agglutinin (SBA), wheat germ agglutinin (WGA), and asparagus pea agglutinin (ASP) to human natural killer (NK) cells with the use of the double-marker immunofluorescence technique was studied. For identification of NK cells, VEP 13 (DC 16) monoclonal antibody was used. The receptor for PNA lectin was shown exclusively after neuraminidase treatment of cells, and VEP 13 antigen was neuraminidase resistant. The majority of VEP 13+ cells showed coexpression of lectin receptors for PNA, LEN, and WGA. Our results suggested that VEP 13 antigen and PNA receptor are two distinct membrane structures, whereas there is some competitive binding between LEN as well as WGA lectin and VEP 13 antibody. In double-marker experiments using PNA and LEN lectin, the small fraction of VEP 13+ cells lacking receptors for these lectins was found. In spite of neuraminidase treatment of the cells, no binding of SBA and ASP was shown. These results indicated apparent heterogeneity of NK cells with respect to lectin receptor expression. WGA lectin, which bound to all VEP 13+ cells, could probably be useful for isolation of NK cells. PMID- 3295354 TI - A review on antigens of milkfat globule membranes and their value for diagnosis and prognosis of breast cancer and other carcinomas. PMID- 3295355 TI - [Antagonistic effect of pyrazinamide against the antituberculosis activity of ofloxacin in mice]. PMID- 3295356 TI - [Effect of diabetes mellitus on the development of atherosclerosis (biochemical aspects of the problem)]. PMID- 3295357 TI - Autosomal dominant polycystic kidney disease in childhood: a longitudinal study. AB - One hundred fifty-four children aged eighteen years or younger from 83 families with autosomal-dominant polycystic kidney disease were studied by ultrasonography or excretory urography. Twenty-three children had bilateral renal involvement with at least five cysts (ADPKD), 28 children were classified as suspicious (SADPKD), and 103 children had no renal involvement (NADPKD) detected by ultrasound. Seventy-four percent of the ADPKD children had signs or symptoms compatible with the diagnosis of ADPKD, compared to 34% of the NADPKD and 36% of the SADPKD children (both P less than 0.05). Three of the 23 ADPKD children had elevated serum creatinines at the time of diagnosis, while all of the NADPKD and SADPKD children had normal renal function. Renal area by ultrasonography (width X depth) was greater among the ADPKD children compared to the SADPKD and NADPKD groups (P less than 0.05). On follow-up 30 of the 37 NADPKD children remained NADPKD, three were reclassified as SADPKD, and four progressed to ADPKD after 18 years of age. All of the NADPKD children had normal renal function on follow-up. Overall, 14 children had suspicious ultrasounds at some point with follow-up ultrasonography and ten (71%) progressed to ADPKD. All SADPKD children maintained normal renal function. Eight of 18 ADPKD children had progression of the disease manifested by development of hypertension and/or decreased renal function. Three children progressed to end-stage renal disease. Five ADPKD children were diagnosed before one year of age, two of them via prenatal ultrasonography. One fetus was aborted after documentation of oligohydramnios.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295358 TI - Glomerular response mechanisms to glycemic changes in insulin-dependent diabetics. AB - Glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured by constant inulin and PAH infusion during euglycemia and intravenous dextrose induced moderate hyperglycemia in seven insulin-dependent diabetics with persistently elevated GFR, seven diabetics with normal GFR, and in six normal control subjects. In euglycemia, RPF was higher and calculated renal vascular resistance (RVR) lower in the hyperfiltering than the normofiltering group (P less than 0.05 for both variables), but filtration fraction (FF) was similar in all groups. During hyperglycemia, mean GFR rose significantly from 157 +/- 20 to 174 +/- 30 ml/min/1.73 m2 (11.9%; P less than 0.05) in the hyperfiltering group only. There was no statistically significant change in mean GFR in the normofiltering diabetic (116 +/- 6 vs. 114 +/- 13 ml/min/1.73 m2) and the normal control groups (117 +/- 15 vs. 113 +/- 14 ml/min/1.73 m2). RPF and FF rose by 5.8% and 9.2%, respectively, in the hyperfiltering group only, with no change in the normofiltering or normal control groups. No change in RVR was found in any group. Total tubular sodium reabsorption was higher during euglycemia in the hyperfiltering diabetics (P less than 0.01), and rose significantly during hyperglycemia (P less than 0.05) in this group only. Overnight euglycemia did not remove the increased glomerular filtration and flow of hyperfiltering diabetics. Hyperglycemia further accentuated hyperfiltration by elevating renal plasma flow and filtration fraction. PMID- 3295359 TI - Hypertension in renal transplant recipients. PMID- 3295360 TI - The erythrocyte-immune complex-glomerulonephritis connection in man. PMID- 3295361 TI - Renal transplantation after prolonged dwell peritoneal dialysis in children. AB - Thirty-three children received a total of 38 renal transplants (18 living related donor, and 20 cadaveric) after being on CAPD and/or CCPD (PDPD). Ten patients (12 transplants) were converted to hemodialysis pre-transplant in order to be free of the risk of peritonitis and off antibiotics, whereas 23 patients (26 transplants) were on PDPD at the time of transplant. The latter group of patients are described in greater detail. Within this group there was one episode of catheter colonization with Flavobacterium, and only three patients developed ascites post transplant. Of the 26 transplants, catheters were removed at the time of transplant in the 13 LRD allografts but left in situ for a mean of 3.8 weeks in the 13 cadaveric transplant recipients. Peritoneal dialysis was required post transplant in seven patients (two LRD recipients requiring a new catheter placement) without complications. Our policy of removing PD catheters at the time of transplant in LRD recipients and prior to hospital discharge in cadaveric transplant recipients has resulted in the avoidance of additional hospitalizations in 19 of the 26 transplants and avoided extra surgery in 11 of the 13 LRD transplants. We conclude that children who have been on PDPD are suitable candidates for renal transplantation and that the early removal of PD catheters, including removal at the time of transplantation in LRD recipients, is associated with a significant reduction in operative procedures for the patients. PMID- 3295363 TI - [Diagnosis and therapy of a case of congenital hydrothorax caused by extralobar lung separation]. PMID- 3295362 TI - Influence of a low sodium diet on the renal response to amino acid infusions in humans. AB - In experimental animals, a high protein diet has been shown to accelerate end stage renal disease by inducing glomerular hyperperfusion. In this study, we found that intravenous administration of amino acid, used as one component of parenteral nutrition, to normal volunteers resulted in a significant increase in renal blood flow (from 517 +/- 29 to 754 +/- 60 ml/min) and glomerular filtration rate (from 106 +/- 6 to 165 +/- 12 ml/min) without altering systemic blood pressure, renal excretion of electrolytes, plasma renin activity, or plasma aldosterone concentration, and excretory rates of prostaglandins E2 were increased (from 665 +/- 61 to 1,034 +/- 153 pg/min). These amino acid-induced renal hemodynamic effects were abolished when the volunteers received a low sodium diet (20 mEq/day) for three days before the amino acid infusions. However, the hemodynamic effects were restored when the subjects receiving low sodium diets were pretreated with captopril. Under these conditions, amino acid infusions increased renal blood flow (from 388 +/- 11 to 597 +/- 27 ml/min) and glomerular filtration rate (from 80 +/- 4 to 118 +/- 9 ml/min). Reduction of prostaglandin synthesis with indomethacin in volunteers receiving a normal sodium intake was also capable of significantly decreasing the amino acid effects on renal hemodynamics. The results indicate that the renal hemodynamic effects of amino acid infusion are strongly influenced by angiotensin II and prostaglandin formation. PMID- 3295364 TI - [Transplantation of the intestines (review of the literature)]. PMID- 3295365 TI - [J. Wylie's contribution to the development of Russian surgery]. PMID- 3295366 TI - [Therapeutic tactics in injuries of the colon]. PMID- 3295367 TI - [Surgical treatment of inguinal hernia]. PMID- 3295368 TI - [Ultrasonic diagnosis of postoperative abscesses of the abdominal cavity]. PMID- 3295369 TI - [Surgical treatment of acquired defects of the aortic valve]. PMID- 3295370 TI - [Use of the AKA-2 apparatus in stomach surgery]. PMID- 3295371 TI - [Etiology of corneal ulcers with special reference to bacterial genesis]. AB - The authors report on 134 patients (141 eyes) seen between May 1982 and December 1985 with corneal ulcers with or without hypopyon. Eight patients (11 eyes) had a facial palsy, 7 (7 eyes) a varicella zoster infection, 1 (2 eyes) a marginal ulcer ("furrow keratitis") associated with collagenosis, 29 (29 eyes) an ulcerative keratitis with endophthalmitis, 1 (2 eyes) a pemphigoid-associated ulcer and 90 (92 eyes) a herpetic infection. Pathogenic bacterial strains were isolated from 20 patients: 10 coagulase-positive Staphylococcus aureus (4 coinfections), 3 Pseudomonas aeruginosa (1 coinfection), 2 Proteus mirabilis (1 coinfection), 2 Escherichia coli and Enterobacter cloacae, Citrobacter freundii and beta-hemolyzing streptococci as well as enterococci in one case each, and non hemolyzing streptococci and alpha-hemolyzing streptococci in two cases each as coinfections. A comparison of the range of bacterial strains of postoperative endophthalmitis and kerato-/conjunctivitis with bacterial corneal ulcers revealed a high percentage of gram-negative organisms in the latter. Laboratory work-up should include microscopy, agar plating and differentiation as well as antibiotic sensitivity testing and modern immunofluorescent direct techniques. Management includes bactericidal topical and systemic antibiotic regimens as well as surgical procedures if necessary, e.g., perforating tectonic and mini keratoplasty, and conjunctival flapping followed by lamellar keratoplasty. PMID- 3295372 TI - [A new seromarker: an aid in the differential diagnosis of unclear scleral processes]. AB - Ocular involvement occurs in 40% to 50% of patients with Wegener's granulomatosis. The frequent involvement of the eyes in Wegener's disease is largely based on the anatomical contiguity of the orbit and the upper airways. On the other hand, it is also attributable to an isolated ocular involvement in the form of a focal necrotizing vasculitis. In about 60% of patients suffering from Wegener's granulomatosis there are anticytoplasmic antibodies. There seems to be a correlation between the serum level of ACPA and disease activity. In 10 patients out of 12 with ocular vasculitis due to Wegener's granulomatosis positive ACPA titers were found. PMID- 3295373 TI - [In commemoration of the 700th anniversary of writing (1268-1272) and the 450th anniversary of the first printed edition (1535) of "The Perspective" by Witelo]. PMID- 3295374 TI - [A short biography of Witelo]. PMID- 3295375 TI - [Witelo--the precursor of physiological optics]. PMID- 3295376 TI - [Reconstruction of the lacrimal apparatus after injury. I. Methods]. PMID- 3295377 TI - [Malignant lymphoma of the eye: diagnostic difficulties]. PMID- 3295378 TI - [Sonographic and computerized tomography study of congenital choledochal cyst]. AB - In the neonatal period ultrasound and hepatobiliary functional scintigraphy are used to diagnose choledochal cysts. Initial sonography demonstrates hepatobiliary anatomy, hepatobiliary function is assessed by subsequent scintigraphy. The diagnosis can be confirmed by additional computed tomography as shown in this case report. PMID- 3295379 TI - Serum beta 2 microglobulin in psoriasis and psoriatic patients. PMID- 3295380 TI - Dose-response relationship in the treatment of idiopathic thrombocytopenic purpura with intravenous immunoglobulin. AB - The dose-response relationship in the intravenous immunoglobulin treatment of idiopathic thrombocytopenic purpura was studied in 20 adult patients in a multicenter prospective crossover trial. The rate of response increases from 3 out of 11 (27%) to 6 out of 10 treatment periods (60%) by raising the 7S-IgG dose given on 5 consecutive days from 164.50 +/- 24.55 to 359.65 +/- 58.62 mg/kg body weight. The onset and duration of response as well as the peak platelet count were found to be independent of the doses. A long-term benefit induced by intravenous immunoglobulin treatment could be achieved in 2 out of 14 patients with chronic idiopathic thrombocytopenic purpura. PMID- 3295381 TI - [Alcohol, emotions, stress and work]. AB - The uncompromising struggle against drunkenness and alcoholism can be successful provided that not only social but also biomedical nature of the phenomenon is adequately understood. It is important to note that alcoholism is the most widespread type of drug addiction which results in the mental dependence on the induced euphoria state and deceptive anti-stress effect. In fact, alcohol, even in low doses, causes erroneous assessment of current events, impairment of the performance level and degradation of normal relationships with other people. Euphoria which is subjectively perceived as a happy sensation develops as a result of the narcotic effect of alcohol on the central nervous system, atrophic degeneration of neurons in the dorso-lateral part of the frontal compartment and subsequent development of destructive processes in other brain compartments. The development of the domineering pathological need for alcohol invariably leads to changes in the scope and pattern of normal activities. It is however obvious that man's activities the purpose of which is to satisfy material and intellectual requirements act as a source of strong and natural emotions. As follows from the experience accumulated by American and Canadian airlines, prevention, treatment and rehabilitation of alcoholic pilots should be based on modern concepts about the mechanisms underlying the development of stable pathological systems and their elimination by producing stable functional-antagonistic antisystems. PMID- 3295383 TI - [On the death of Carl R. Rogers. Authentic as a person, a therapist and a researcher]. PMID- 3295382 TI - [Scientific-theoretical problems in the rationale for the system of sociopsychological selection of flight crews]. AB - A large number of flight accidents and catastrophes associated with the human factor, high nervous and psychic tension when being on duty, increasing trend towards a greater incidence of psychogenic diseases responsible for pilots to be grounded make it necessary to develop a system of primary psychoprophylaxis of the flying personnel and to help them with various social, psychohygienic and psychoprophylactic measures. This paper presents basic psychoprophylactic measures of medical expertise, professional training and psychological selection. Proper development of these measures will contribute to flight safety and pilot longevity. PMID- 3295385 TI - An ounce of prevention. PMID- 3295384 TI - Hematology, serum chemistry and urinalysis values of vesper mice (Calomys musculinus). PMID- 3295386 TI - The protective effect of hepatic dysfunction on vascularized allograft survival. AB - Recent studies have demonstrated that hepatic dysfunction, induced by experimental biliary ligation (EBL), impairs lymphocytic responsiveness to PHA stimulation in vitro and to cellular antigens in vivo. This suppression appears to be selective for T-cell mechanisms while B-cell-mediated functions remain intact. The purpose of this study was to determine whether coexisting hepatic insufficiency could exert a protective effect on vascularized or nonvascularized allograft survival in the transplanted recipient. Female Wistar-Furth (Rtlw) 225 g rats were assigned randomly to three groups: EBL, sham operation (Sham) and normal control (NC). Fourteen days following operation animals received heterotopic cardiac or skin allografts from Buffalo (Rtlb) donors. Cardiac and skin graft survival was determined daily, rejection was confirmed histologically, and technical failures were omitted from analysis. Allograft survival was expressed as median survival time +/- SEM. Serum total bilirubin (mean +/- SEM) was significantly elevated at Day 14 in EBL animals compared to Sham and NC groups (15.1 +/- 1.0 vs 0.1 +/- 0 and 0.2 +/- 0.1 mg/dl, respectively, P less than 0.01). Median cardiac allograft survival time by Probit was 10.6 +/- 2.6 vs 5.6 +/- 0.7 and 6.0 +/- 0.9 days, respectively (P less than 0.03). Skin graft survival (mean and range) was similar in all groups. These results demonstrate that EBL in the rat suppresses T-cell function and significantly prolongs vascularized allograft survival, but not skin allograft survival across the Rtl histocompatibility barrier. The mechanism whereby coexisting hepatic dysfunction exerts a protective effect on vascularized allograft survival warrants further investigation. PMID- 3295387 TI - Humoral presensitization in rat heart allotransplantation. AB - In these experiments an attempt was made to create a rat model of the past positive, current-negative lymphocyte crossmatch (PPCNCx) phenomenon currently of concern in clinical renal transplantation. Lewis rats were sensitized with three to four serial ACI heart fragment (HF) or skin grafts. Subsequent ACI heart graft survival in the presence of high titer LEW-anti-ACI antibody was markedly shortened with 4 of 10 surviving for 24 hr or less in HF-sensitized rats and 11 of 11 surviving less than 24 hr following skin graft sensitization. Thirteen sensitized LEW rats were transplanted with ACI hearts 18 months later when their anti-ACI antibody was nil. Control rats (N = 5) had graft survival of 4.4 +/- 0.6 days; cyclosporine (CsA) therapy prolonged this to 8.0 +/- 3.6 days (N = 4), while combined cyclosporine and cyclophosphamide (Cy) resulted in an MST of 4.3 +/- 0.4 (N = 3). LEW-anti-ACI antibody was present on Day 3 or 4 in the control rats but was absent at the time of rejection in the CsA-Cy treated rats. Adoptive transfer of splenocytes from sensitized LEW rats into naive LEW hosts produced animals with humoral immune memory but no anti-ACI antibody at the time of transplantation. Nonimmunosuppressed adoptively transferred LEW recipients of ACI hearts rejected their grafts in an accelerated fashion (MST of 4.5 +/- 0.5 days) and displayed an anamnestic antibody production with first appearance on Day 3 or 4. Immunosuppression with CsA or Cy prolonged graft survival (greater than 30 days) in all cases and Cy prevented an anamnestic humoral response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295388 TI - Pretransplant cytotoxic conditioning produces effects consistent with clonal deletion mechanisms. AB - A rat cardiac allograft model (ACl to Lewis) was used to investigate the clonal deletion theory. Twelve groups of Lewis recipients received various combinations of donor-specific blood transfusions (DSTs), immediate post-DST immunosuppression with azathioprine/prednisone, and low-dose cyclosporine (1 mg/kg/day) posttransplant. DSTs and cyclosporine together gave modest prolongation of graft survival (from 6.0 to 17 days). DSTs plus immediate post-DST immunosuppression followed by low-dose cyclosporine prolonged graft survival to an average of 45 days. Third-party transfusions alone and in combination with immunosuppression did not significantly prolong allograft survival. Postoperative cyclosporine was required for the expression of this effect suggesting that clonal depression rather than clonal deletion had occurred. Combining DSTs with brief but intense preoperative immunosuppression may be a more effective method of pretransplant conditioning than DSTs alone. PMID- 3295389 TI - Gastric emptying, glucose tolerance, and insulin response after duodenojejunostomy. AB - We investigated the impact of direct jejunal delivery of various meals on gastric emptying, glucose tolerance, and insulin response in a chronic dog model following duodenojejunostomy. Ten beagle dogs underwent duodenal transection 2 cm distal to the pylorus and end-to-side duodenojejunostomy 20 cm distal to the ligament of Treitz. Three months after operation each dog underwent gastric emptying studies using radiolabeled normal saline, 20% glucose solution, and standardized mixed solid meal. Glucose tolerance tests with plasma insulin determinations were obtained using the glucose meal. After duodenojejunostomy both the rapid exponential pattern of emptying of normal saline and the slower linear pattern of glucose emptying seen in intact dogs were preserved. The linear gastric emptying of the solid meal which was slower than gastric emptying of either of the liquid meals was also preserved. Although integrated plasma glucose levels over 2 hr were 484.8 +/- 40.4 and 456.6 +/- 30.4 mg X hr/dl in intact and duodenojejunostomy dogs, respectively (P greater than 0.05), the initial rate of rise of plasma glucose was significantly delayed in the duodenojejunostomy dogs. But integrated plasma insulin levels over 2 hr differed significantly (P less than 0.05) between the intact (71.6 +/- 9.2 microU X hr/nl) and duodenojejunostomy (48.3 +/- 6.2 microU X hr/nl) dogs. We conclude that duodenojejunostomy (jejunal delivery) preserved the patterns of gastric emptying of saline, glucose, and mixed solid meals; retarded initial plasma glucose response to the glucose meal; and blunted plasma insulin response to the glucose load. PMID- 3295391 TI - Changes in lower esophageal sphincter pressure (LES) after Stamm gastrostomy. AB - Previous clinical and experimental reports have implicated placement of a Stamm gastrostomy (SG) as a cause of gastroesophageal reflux (GER) in children. This study evaluates this problem by measuring alterations in the lower esophageal sphincter pressure (LES) after SG with and without maintenance of the esophagogastric angle of Hiss. In 20 cats (2.8-3.2 kg) general anesthesia was induced using 20 mg/kg ketamine im. Esophageal manometrics were measured using a continuous perfusion catheter and recording system, evaluating three measurements for each animal. Eight cats (Group I) underwent SG placement in the anterior stomach wall two-thirds of the way down from the fundus. This was tacked to the anterior abdominal wall 3 cm lateral to the midline at the appropriate level. Six cats (Group II) had standard SG tube placement and in addition, two interrupted sutures were placed between the fundus and the esophagus maintaining the gastroesophageal angle of Hiss. Six cats (Group III) had sham laparotomy. After awakening, the animals were fed cat chow and water ad libitum. At 7 and 14 days, the animals were reanesthetized with ketamine and manometrics were repeated. Preoperative LES pressure measured 11.3 +/- 4.7 Torr. LES pressure in Group I decreased to 6.61 +/- 1.6 Torr at 7 days (P less than 0.01) and 4.8 +/- 1.6 Torr at 14 days postoperatively (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295390 TI - Effect of blood transfusion and anesthesia on resistance to bacterial peritonitis. AB - Patients who undergo gastrointestinal operations and require prolonged anesthesia or blood transfusions have been reported to have a higher incidence of infectious complications. A rat peritonitis model was used to determine if the increased rate of infection was due to the severity of their underlying disease process or to possible immunosuppressive effects of transfusions and anesthesia. Four hundred adult Lewis rats were divided into four groups. Each group received either 0.5 ml of allogenic blood, 0.5 ml of syngeneic blood, metaphane anesthesia, or 1.5 ml of saline. They were challenged with either 1 X 10(8) or 1 X 10(7) Escherichia coli on the day of transfusion or 4 days after transfusion. Survival rates and mean survival times were determined. Syngeneic transfusions were found not to significantly impair survival. Anesthesia administration resulted in a moderate impairment in survival. Allogeneic blood transfusions caused the most severe impairment with a greater than 50% decrease in survival rates compared to controls in three of the four groups tested. Blood transfusions would thus appear to impair resistance to bacterial infections to an even greater degree than anesthesia. Unnecessary transfusions should therefore be avoided. PMID- 3295392 TI - Quantitative scintigraphy with deconvolutional analysis for the dynamic measurement of hepatic function. AB - A mathematical technique known as deconvolutional analysis was used to provide a critical and previously missing element in the computations required to quantitate hepatic function scintigraphically. This computer-assisted technique allowed for the determination of the time required, in minutes, of a labeled bilirubin analog (99mTc-disofenin) to enter the liver via blood and exit via bile. This interval was referred to as the mean transit time (MTT). The critical process provided for by deconvolution is the mathematical simulation of a bolus injection of tracer directly into the afferent blood supply of the liver. The raw data required for this simulation are obtained from the intravenous injection of labeled disofenin, a member of the HIDA family of radiopharmaceuticals. In this study, we perform experiments which document that the simulation process itself is accurate. We then calculate the MTT under a variety of experimental conditions involving progressive hepatic ischemia/reperfusion injury and correlate these results with the results of simultaneously performed BSP determinations and hepatic histology. The experimental group with the most pronounced histologic findings (necrosis, vacuolization, disorganization of hepatic cords) also have the most prolonged MTT and BSP half-life. However, both quantitative imaging and BSP testing are able to identify milder degrees of hepatic ischemic injury not reflected in the histologic evaluation. Quantitative imaging with deconvolutional analysis is a technique easily adaptable to the standard nuclear medicine minicomputer. It provides rapid results and appears to be a sensitive monitor of hepatic functional disturbances resulting from ischemia and reperfusion. PMID- 3295393 TI - Identification and expansion of human lymphokine-activated killer cells: implications for the immunotherapy of cancer. AB - Immunotherapy with lymphokine-activated killer (LAK) cells and interleukin 2 (IL 2) has been demonstrated to cause the regression of some human tumors. Expansion of peripheral blood lymphocytes (PBL) in recombinant or naturally produced IL-2, mitogens, and feeder cells results in a progressive expansion of cell number but a decline in lytic activity with time. Lytic activity for fresh tumor is best generated in IL-2 alone from specific purified subpopulations of lymphocytes. The precursor of the LAK cell has been isolated from a nonadherent, sheep erythrocyte receptor negative (E-) lymphocyte subpopulation by the selection of Leu 11+ and Leu 15+ cells by cell sorting. Separation resulted in a significant increase (P2 less than 0.05) in lytic activity against fresh tumor by the separated 11+15+ lymphocytes compared to the 11-/15- lymphocytes or PBL. Leu 11+/15+ lymphocytes could be expanded up to eightfold in IL-2 alone with maintenance of lytic activity. We identified two surface antigens on the LAK precursor cell, Leu 15 and Leu 11, and demonstrated a technique for obtaining purified populations of these cells. Purified and expanded LAK cells when administered to patients may have a role in increasing the potency and decreasing the toxicity associated with this therapy. PMID- 3295394 TI - Benefits of high-dose dopamine in experimental neonatal septic shock. AB - The benefits of dopamine resuscitation in neonatal shock are in doubt. To evaluate dopamine's effectiveness on regional perfusion and survival, neonatal pigs were subjected to fecal Escherichia coli peritonitis-induced septic shock and were randomly divided into equal groups. Control animals (Group I) were not resuscitated with dopamine. Dopamine resuscitation, as a continuous infusion of 5 micrograms/kg/min (Group II), 50 micrograms/kg/min (Group III), or 200 micrograms/kg/min (Group IV), began when cardiac output dropped 20% below baseline. Radiolabeled microspheres were used to assess regional perfusion. Survival was defined as no hemodynamic compromise at 24 hr. Increased survival time correlated with sustained increases in cardiac output and blood pressure in Group III, which were not observed in the other groups. Significant changes in multiorgan regional perfusion were also observed in Group III and correlate with the improved survival. These data suggest that higher than usual doses of dopamine may be beneficial in neonates with peritonitis-induced septic shock. PMID- 3295395 TI - Results of cardiac transplantation at St. Thomas Hospital. PMID- 3295396 TI - Multiplicity of progesterone 21-hydroxylase activities associated with constitutive forms of rabbit liver cytochrome P-450. AB - Constitutive cytochromes P-450 have been solubilized from untreated outbred New Zealand White rabbit liver microsomes. Gradient phosphate buffer elution of DEAE cellulose columns partially resolved six P-450 fractions. Progesterone 21 hydroxylase activity was reconstituted with several fractions and inhibited by an antibody towards P-450 Form 1. One fraction (LM3b) preferentially catalysed the 6 beta- and 16 alpha-hydroxylation of progesterone. SDS-PAGE indicated the presence of proteins with mobilities closely related to Form 1 in several fractions that were separated from this isozyme by DEAE-cellulose chromatography. These results suggest that several constitutive P-450 fractions may contribute to the regiospecific 21-hydroxylation of progesterone. PMID- 3295397 TI - Preparation of positional renal slices for study of cell-specific toxicity. AB - To reduce structural complexity, rabbit kidneys were sliced perpendicular to their cortical-papillary axis to isolate four distinct cell groupings. This positional orientation allows identification of each renal cell type based on its location within the slice. A mechanical slicer was used to make several precision cut slices rapidly from an oriented cylindrical core of renal tissue, with minimal tissue trauma. Slices were then submerged under a gently circulating oxygenated media in a fritted glass support system that maintains viability (intracellular K+/DNA ratio) and structural integrity (histology) for at least 30 h. A high dose of mercuric chloride (10(-3) M) was used to demonstrate the structural and biochemical changes of intoxicated slices. This method provides a controlled subchronic in vitro system for the study of the individual cell types involved in cell-specific renal toxicities and may also be a useful tool for addressing other pharmacological and physiological research questions. PMID- 3295398 TI - Comparison of isometric and isotonic responses of human small airway smooth muscle in vitro. AB - The difference between isometric and isotonic responses of human small airway smooth muscle to a number of pharmacological agonists was studied. The isotonically measured sensitivity to methacholine was 1.4 times less than the isometrically measured value (p less than 0.05), and similar small discrepancies were found for histamine, leukotriene, prostaglandin F2 alpha, isoproterenol, and theophylline. Maximal isometric force and isotonic shortening after methacholine were linearly related (p less than 0.01). The between-methods difference is relatively small. Because the difference was of similar magnitude and in the same direction in all tissues studied, it is of little practical importance for conventional pharmacological experiments. PMID- 3295399 TI - Nigerian flora and its pharmaceutical potential. AB - The use of plants by man came about through observation of their definite effects on man and animals. Herbalists employ both physical and psychological treatments and herbal medicines can be used in powders, concoction, decoction, soup or ointment. Various plants used as anti-infective agents, antimalarials, laxatives, cardiovascular and nervous remedies, or containing proteolytic ferments, steroid sources, sweeteners, anti-tumour substances and as source for materials for dosage forms are discussed. Generally, plants useful in pharmaceutical and food industries and those with substances of general economic importance are also described. PMID- 3295400 TI - Plant-derived alkaloids active against Trypanosoma cruzi. AB - Six plant-derived simple beta-carboline alkaloids and eight other plant derivatives were tested for activity against the protozoan parasite, Trypanosoma cruzi, the organism responsible for Chagas' disease. The plant alkaloids in this study were screened using an in vitro test against epimastigotes. Four beta carboline indoles, a complex indole and five other alkaloids significantly reduced population growth of T. cruzi (Costa Rica strain) epimastigote forms at a concentration of 50 micrograms/ml or less. PMID- 3295402 TI - Timing dialysis in chronic uraemia. PMID- 3295401 TI - The preparation and use of embryonic brain wholemounts. AB - Wholemounts of embryonic rat brain (E15) were prepared and immunocytochemically reacted to reveal the distribution of serotonergic neurons and pathways. Wholemounts were prepared by dissection of unfixed tissue by opening the neural tube dorsally. Following fixation and immunocytochemistry the embryonic brain wholemount provided a panoramic view of developing neurons and pathways. At low magnification the distribution of immunoreactive neurons and the extent of pathway development could be appreciated. At high magnification fine cellular detail of immunoreactive neurons was resolvable. PMID- 3295403 TI - Implantable segmented polyurethanes: controversies and uncertainties. PMID- 3295404 TI - Extracorporeal circulation material evaluation: microemboli. PMID- 3295406 TI - Continuing care for the preterm infant after dismissal from the neonatal intensive care unit. AB - As more low-birth-weight babies survive, primary-care physicians are facing the responsibility of providing continuing care for those who have been dismissed from neonatal intensive-care units. Premature infants often require outpatient care for bronchopulmonary dysplasia, apnea, retinopathy of prematurity, intraventricular hemorrhage, hearing loss, hypothyroxinemia, anemia, neurodevelopmental sequelae, assessment of growth and nutrition, immunizations, and psychosocial stress. In this review, we present guidelines for the primary care physician for the management of these conditions in preterm infants. PMID- 3295405 TI - Extracorporeal circulation materials: clinical evaluation. PMID- 3295407 TI - Paul-Ferdinand Gachet--van Gogh's physician. PMID- 3295408 TI - [Functional study of the endocrine pancreas in healthy people with a family history of insulin-dependent diabetes mellitus]. PMID- 3295409 TI - [Index Medicus: coverage and use]. PMID- 3295411 TI - [Use of flow cytometry in current oncology]. PMID- 3295410 TI - [Differences in the hormonal evaluation of 2 groups of acromegaly patients with different serum prolactin levels]. PMID- 3295412 TI - [Agranulocytosis and aplastic anemia induced by drugs]. PMID- 3295413 TI - [Carbohydrate intolerance in the elderly]. PMID- 3295414 TI - [Carcinoembryonic antigen. Current considerations]. PMID- 3295415 TI - [Very low calorie diets in the treatment of obesity]. PMID- 3295416 TI - [Bacteremia caused by Salmonella enteritidis]. PMID- 3295417 TI - Rapid detection methods in microbiology: are they right for your office? AB - This article discusses some of the direct test methods for diagnosing Group A streptococcal pharyngitis, urinary tract infection, and the three most common sexually transmitted diseases: gonorrhea, Chlamydia, and Herpes simplex virus infection. Emphasis is placed on their practicality for the office setting as well as the limitations of the test methods in various patient populations. PMID- 3295419 TI - Understanding laboratory test results. Conditions for appropriate use of laboratory tests. AB - The appropriate use of laboratory tests requires that valid, reliable, and reproducible data be obtained and that the clinician know both how to interpret the information provided by diagnostic tests and how to apply it to individual clinical situations. Appropriate interpretation and clinical use of diagnostic tests requires that clinicians understand the principles of laboratory testing, the information provided and not provided by laboratory tests, and how to evaluate the clinical efficacy of laboratory tests. As laboratory testing moves from regional and hospital laboratories into office laboratories, clinicians need to become more knowledgeable regarding the technical and quality control factors that affect diagnostic test accuracy. This will require the establishment of stronger, more effective links between clinicians and laboratory pathologists. PMID- 3295418 TI - The urinalysis: a critical appraisal. AB - The urinalysis, an inexpensive office test, is often performed unnecessarily. Improved chemical testing using reagent strips obviates the need for routine microscopy in many cases. More information is needed to make specific recommendations on the use of the routine urinalysis as a screening procedure. PMID- 3295420 TI - Measuring drug levels in the office: rationale, possible advantages, and potential problems. AB - New technologies allow plasma levels of several drugs to be measured in the physician's office. Although such assays have the advantage of increased convenience for both physician and patient, they have a number of potential problems as well. Regardless of where plasma assays are performed, the physician must understand the rationale and pitfalls of therapeutic drug monitoring. PMID- 3295421 TI - Variations in ambulatory test use: what do they mean? AB - This article discusses the meaning of variations in ambulatory test use with emphasis on practice setting, availability of testing services, financial incentives, and physician and patient characteristics. PMID- 3295422 TI - Utilization review and management of laboratory testing in the ambulatory setting. AB - Physicians are probably guilty of misusing the clinical laboratory by either ordering too many tests (overutilization) or ordering too few tests (underutilization). This article is concerned mainly with overutilization in terms of searching for asymptomatic disease, too frequent monitoring of tests, ordering of test clusters, and a failure to use available information. The strategies considered to decrease overutilization include educational strategies, audit with feedback, cost-awareness strategies, rationing strategies, financial incentives and risk-sharing strategies, changes in the test request procedures, and administrative mandates of set protocols for laboratory test ordering. PMID- 3295423 TI - Regulatory considerations in the establishment and expansion of office-based laboratories. AB - As a result of changing patterns of medical practice, technology, and reimbursement, office-based clinical laboratory testing is increasing substantially. This article reviews current federal and state regulations covering such laboratories and comments upon likely trends in these regulations. Various economic and political issues associated with office-based clinical laboratory regulation are also discussed. PMID- 3295424 TI - Changes in payment policies: impact on physicians' office testing. AB - Recent changes in payment policies include powerful pecuniary incentives to move care from expensive hospital settings to cheaper outpatient sites. Physicians face competition from a growing number of alternative providers in the diagnostic testing marketplace. Given that a concurrent trend involves aggressive utilization review with stiff penalties for noncompliance, physicians are challenged to practice appropriate restraint in ordering and performing tests. PMID- 3295425 TI - Home blood glucose monitoring: keystone for modern diabetes care. AB - Home monitoring of capillary blood glucose concentrations has changed diabetes care, giving physicians and patients a way to adjust their therapy and achieve better diabetic control. The practical strategies and equipment for home diabetic monitoring are discussed, including the changing role of urine testing and how inexpensive machines may enhance the value of blood glucose monitoring. PMID- 3295426 TI - An electrocardiogram database incorporated into the hospital information system. AB - A database system was developed for storing and retrieving electrocardiogram (ECG) interpretations made by the Bonner program. One ECG record consists of the patient identification information, measurement matrix, and interpretive statements made by the program and by the reviewing cardiologist. The logical structure of the database is 3-level hierarchy. An ECG record is automatically inserted into the database when an ECG signal is analysed by the program. Stored ECG records can easily be retrieved using any parameter and qualifier for review, research and education. The physician can gather statistics on the parameters and qualifiers of the extracted ECG records using statistical program packages (BDMP, SCSS) and a decision support system (AS). Since the database management system is DL/I, the newly developed system can be transferred to various computers, and the relationships between the ECG findings and clinical records stored in the DL/I form can easily be studied. PMID- 3295428 TI - [The cotton rat (Sigmodon hispidus) as an experimental model for studying viruses in respiratory tract infections. II. Influenza viruses types A and B]. PMID- 3295427 TI - [Evaluation of the effectiveness of selective-differentiating culture media and their sets used to isolate Shigella and Salmonella]. PMID- 3295429 TI - Pharmacological properties of besulpamide, a new diuretic, in rats and dogs. AB - Besulpamide, a newly synthesized compound, has demonstrated significant diuretic activity in rats and dogs, similar to that of chlorthalidone, clopamide and xipamide. Antihypertensive activity of besulpamide is similar to that of hydrochlorothiazide and was demonstrated in rat one-kidney desoxycorticosterone acetate (DOCA)-salt hypertension. In addition, besulpamide, like hydrochlorothiazide, potentiated the antihypertensive activity of captopril in spontaneously hypertensive rats (SHR). Doses of besulpamide exceeding those normally required for pharmacological activity did not evoke adverse reactions in rats and mice. PMID- 3295430 TI - [An unusual skin manifestation in lymphocytic malignant lymphoma]. PMID- 3295431 TI - [Liver transplantations at the Huddinge hospital--a review]. PMID- 3295432 TI - [Establishment of a liver transplantation center in the USA--experiences seen through Swedish eyes]. PMID- 3295433 TI - "Occult" posterior laryngeal cleft. AB - A previously undescribed deficiency of the posterior cricoid at the midline, wherein the mucosa overlying this deficiency is intact, is described. Clinically this presents as a variety of subglottic stenoses wherein the narrowing is primarily in the transverse subglottic diameter; the symptoms are, therefore, those of airway obstruction not laryngeal incompetence. It is suggested that this deformity has been previously overlooked by laryngologists and pathologists by virtue of a postmortem routine in which the larynx is routinely split in the posterior midline. Demonstration in these cases was by serial horizontal section of the intact, unsplit, whole larynx. PMID- 3295434 TI - Persistence of injectable collagen in the human larynx: a histopathologic study. AB - This is a report of the histologic findings in a human larynx that had undergone collagen injection for glottic insufficiency 14 months prior to autopsy. The patient's management before augmentation with collagen included extended supraglottic laryngectomy, radiation therapy, and Polytef injection. Connective tissue changes secondary to other forms of treatment were apparent bilaterally and changes limited to the site of collagen injection were identified. There have been reports of persistence of injected collagen in the canine larynx at 1 year but this is the only study documenting persistence in a human subject. The implant appeared homogeneous and was easily distinguished from host collagen and the reactive fibrosis associated with particulate Polytef. These findings are similar to those observed in the canine model and suggest that there is persistence of injected collagen in the human larynx. PMID- 3295435 TI - The beginning of ALERT (All Africa Leprosy and Rehabilitation Training Centre). PMID- 3295436 TI - The Kellersberger memorial lecture. PMID- 3295437 TI - Concepts behind the development of multiple drug therapy regimens in leprosy. PMID- 3295438 TI - Historical outline of ALERT (All Africa Leprosy and Rehabilitation Training Centre). PMID- 3295439 TI - [Early fetal cephalometry]. PMID- 3295440 TI - Phorbol esters, but not the hormonal form of vitamin D, induce changes in protein kinase C during differentiation of human histiocytic lymphoma cell line (U-937). AB - Human histiocytic lymphoma cells (U-937) undergo similar differentiation when incubated with the phorbol ester 12-0-tetradecanoyl phorbol-13-acetate (TPA) and 1,25-dihydroxycholecalciferol. In this action, TPA somehow implicates calcium sensitive and phospholipid-dependent protein kinase (protein kinase C), which is rapidly and significantly affected by this inducer. On the contrary, 1,25 dihydroxycholecalciferol in its differentiating action does not involve protein kinase C thus suggesting that the secosteroid induces monocytic differentiation possible through a different mechanism of that of phorbol ester. PMID- 3295441 TI - The melatonin message: duration versus coincidence hypotheses. AB - Whereas there is little doubt that melatonin is an important hormone which mediates the effects of the pineal gland, there is debate concerning the nature of the melatonin message which the animal interprets. This brief resume considers the two main features of the melatonin rhythm which the organism could "read" to determine whether it is in a long or a short day. The first scheme is what is referred to as the duration hypothesis. This hypothesis depends on the fact that the changing photoperiod likewise alters the duration of the daily melatonin peak and this signals the organism as to daylength and the appropriate endocrine adjustments are made. The second possibility depends on the synchronization of elevated melatonin levels with the sensitivity of a particular organ system to the melatonin peak; when this occurs the organ responds accordingly. Both the external and internal coincidence models are considered. The duration and coincidence models are fundamentally quite different. In the case of the former, the altered duration of the melatonin peak per se determines the response that will occur. In the case of the coincidence models, the elevated melatonin has a more passive role with the "decision" to respond being a function of end organ sensitivity. In the final analysis, it may be that organisms use a combination of absolute duration of the melatonin pulse, direction of change of the melatonin rhythm, and synchrony of peak melatonin with the increased sensitivity of the end organ before a response is forthcoming. PMID- 3295442 TI - Chromogranin A is present in and released by fish endocrine tissue. AB - Chromogranin A (CgA) is a protein that is present in many mammalian endocrine cells and co-secreted with their resident hormones. We have demonstrated the presence of CgA by immunohistology in the ultimobranchial glands and corpuscles of Stannius of rainbow trout. CgA was also detected by radioimmunoassay in the medium of incubated coho salmon ultimobranchial glands. Our observations demonstrate the presence of CgA in endocrine glands of evolutionarily divergent species. These observations are consistent with the hypothesis that CgA participates in the secretory process of a wide variety of hormones. PMID- 3295443 TI - Trypanocidal activity of the stearylamine-bearing liposome in vitro. AB - Liposome made of stearylamine and phosphatidylcholine showed the trypanocidal activity in vitro. Cytotoxicity of the liposome against Trypanosoma cruzi appeared to be the strongest in trypomastigotes followed by amastigotes and epimastigotes. Lysis of the human erythrocyte was undetectably low under the conditions that the liposome kills more than 95% of trypomastigotes. The liposome seems to damage the plasma membrane. PMID- 3295444 TI - Melanoma antigens as modified normal gene sequences. AB - Melanomas are highly aggressive tumors with a well-documented antigenic nature. Several melanoma antigens have been reported, four of which, p97, Ia-like antigen, B700, and A have been implicated as having regions in common with normally occurring proteins. P97 has partial sequence homology with transferrin and lactotransferrin, Ia-like antigen is immunologically cross-reactive with alpha and beta chains of Ia-like proteins, A is a variant of alpha actin, and B700 resembles a normal melanosomal membrane protein. In addition, B700 has partial sequence homology to serum albumins. These observations suggest that melanoma tumors can produce antigenic proteins by modification of normally occurring proteins. The possible mechanisms are discussed. PMID- 3295445 TI - Interleukin-1 (IL-1) depresses cytochrome P450 levels and activities in mice. AB - Endotoxin depresses cytochrome P450 levels when injected into animals. The purpose of this study was to determine whether endotoxin itself, or monokine(s) released in response to endotoxin administration are responsible for this effect. Cytochrome P450 levels and drug metabolizing activities were measured in endotoxin resistant C3H/HeJ mice 24h after single intraperitoneal injections of either lipopolysaccharide (LPS), a semipurified murine monokine preparation containing interleukin-1 (IL-1), or murine recombinant IL-1. In endotoxin sensitive C3H/HeN mice, LPS (0.5 mg/Kg) decreased total cytochrome P450 levels, benzphetamine demethylase activities, and ethoxyresorufin-0-deethylase activities. This dose of LPS did not alter cytochrome P450 levels or activities in the C3H/HeJ mice. However, after injection of the semipurified monokine preparation or the recombinant IL-1, there were significant decreases in cytochrome P450 levels and activities similar to the decreases observed with LPS in the C3H/HeN mice. These findings suggest that the alterations in hepatic cytochrome P450 seen with endotoxin injection are mediated, at least in part, by IL-1. PMID- 3295446 TI - The effect of magnetic resonance imaging on human cognition. AB - Potential effects of MRI exposure on aspects of human cognition were investigated out of concern that possible safety hazards associated with the procedure may exist. One hundred and fifty-seven volunteer subjects were randomly assigned to either an imaged, sham-imaged or nonimaged control condition. The following psychological tests were administered in a double blind procedure at pretreatment, post-treatment and follow-up time periods: the Wechsler Adult Intelligence Scale-Revised (Digit Span, Block Design and Digit Symbol), the Wechsler Memory Scale Paired Associate Learning test, the Benton Revised Visual Retention test, the Vandenberg Mental Rotation test, the Sternberg memory scanning paradigm and the State Anxiety Inventory. The overall analysis of results indicated that MRI at 0.15 T has no significant effect upon the cognitive functions assessed. PMID- 3295447 TI - Proteolysis and physiological regulation. PMID- 3295448 TI - [Chemoradiation pathomorphosis of Ewing's tumor and reticulosarcoma]. AB - The paper is concerned with the results of a morphological study following chemoradiotherapy in 25 patients with Ewing's sarcoma and 14 patients with reticulum cell sarcoma. The signs of therapeutic pathomorphosis were observed in the first 3 days, and substitution of the connective tissue for a necrotized tumor started by the 3rd-4th week after the initiation of therapy. In some cases tumor growth and recurrences at the site of a treated tumor were observed. PMID- 3295449 TI - [Automated evaluation of the central hemodynamic status using the RKA 3-01 Radiocardioanalyzer]. AB - The authors presented the results of a clinical use of a new radiocardioanalyzer RKA 3-01 (manufactured in the USSR) providing for automated measurements and computations of indices of the central hemodynamics during studies using a method of dilution of radioactive nuclides. The main technical potentialities of the device designed on the basis of microprocessor technology, were described. The authors also provided the results of automated computation of the circulating blood volume and the main hemodynamic indices in a group of patients. Values of the hemodynamic indices were shown to correspond to actual ones and comparable to control ones and clinical evidence. The comparison of automated processing with a manual method of calculation indicated a significant coincidence of index values. The clinical use of the radiocardioanalyzer RKA 3-01 for automated assessment of the indices of the cardiovascular system was shown to hold promise among various groups of patients. PMID- 3295450 TI - [Informativeness of scinti- and sonography in the diagnosis of thyroid adenoma]. AB - The informative value of scinti- and sonography was assessed in 78 patients operated on for thyroid adenoma. Both methods brought about no specific information for the diagnosis of thyroid adenoma and made it possible to choose adequate therapeutic methods in most cases and spot biopsy in doubtful cases. PMID- 3295451 TI - [Radionuclide study of the function of the kidneys and their hormonal regulation in cancer of the uterus]. AB - Methods of radionuclide renography with 131I-hippuran and a radioimmunoassay determining plasma renin activity, the level of aldosterone and cortisol were employed to study function of the kidneys and the system of the hormonal regulation of renal functions in 40 uterine body cancer patients in the time course of surgical treatment. A group of patients without a history of renal diseases was examined prior to operation 1, 3, 5, 14 days and 6-12 mos after extirpation of the uterus with appendages. It was established that the patients had basal intrarenal urodynamic disturbances and elevated renin activity. Unfavorable effects of surgical intervention occurred more frequently on the 1st day in the postoperative period when the presence of latent renal insufficiency could be detected by radionuclide methods. The process of renal function recovery was observed however it was determined by the level of preoperative disorders and did not reach the normal. There was correlation between an increase in renin activity and disturbances in intrarenal urodynamics in surgical treatment of uterine body cancer patients. PMID- 3295452 TI - [99mTc amines--new radiopharmaceuticals for studying regional cerebral blood flow]. PMID- 3295453 TI - [Contrast media for computed tomography of the liver]. PMID- 3295454 TI - [Dosimetric basis for joining large fields of complex configuration during total irradiation of the lymphatic collecting vessels]. AB - The paper is concerned with the results of experimental dosimetric studies on an anthropomorphic phantom using thermoluminescent dosimetry at the site of the joining of large fields of complex shape simulating total irradiation of the lymphatic collectors. The studies demonstrated the appropriateness of the joining at a distance of 1 cm between the fields. In such a variant adequate irradiation of the lymphatic system was achieved whereas an increase in a distance between the fields resulted in a risk of recurrence in under-irradiated areas without a significant decrease in radiation dose exposure to healthy organs and tissues. PMID- 3295455 TI - [Dosimetric basis for the use of radionuclide methods in obstetrics]. AB - The problem of a possible use of radionuclide methods of investigation (placentography and renography) in obstetrics was considered. Doses and permissible activities in pregnant women of the AP category belonging to groups at high risk of obstetric and perinatal pathology were worked out on the basis of the "Rules and standards of open radiopharmaceuticals in diagnostic purposes" (1984). The above investigations using the administration of short-lived radionuclides with total activity of 7.4 MBq (99mTc-albumin and DTPA) were shown to be safe for mother and fetus. PMID- 3295456 TI - [Plasma insulin in Hodgkin's disease]. PMID- 3295457 TI - [Total fractionated irradiation of the lymph nodes in stage III Hodgkin's disease]. AB - The aim of the study was a comparative analysis of the results of radiotherapy of 100 patients with stage III Hodgkin's disease: 54 patients--after a split course and 46 using routine methods. A possibility of the clinical use of the split irradiation methods for therapy of patients with stage III Hodgkin's disease was shown. A stable tendency to improving therapeutic results assessed by the survival criteria was noted. The use of split irradiation reduced a period of radiotherapy as compared to routine methods. PMID- 3295458 TI - [Active thermography methods in medicine: state of the art and perspectives]. PMID- 3295459 TI - [Medical workers in the fight for sobriety]. PMID- 3295460 TI - [Essay II. N. I. Pirogov and the development of medical care for women in the middle of the 19th century]. PMID- 3295461 TI - [Television medical endoscopes]. AB - The paper considers the present stage of development and ways of improving TV endoscopes for medicine. It has been shown that the most promising are the TV endoscopes which have sequential colour-separated transmission circuit and include impulse R, G, B light sources. The light is transferred through fibre optical conduit and matrices installed at the distal end of the endoscope. Digital converters convert the colour-separated image signals into simultaneous ones. This circuit makes it possible to avoid using expensive and complex equipment in manufacture of fibre optics. It provides a suitable for diagnosis image quality which can be additionally improved by electronic treatment of the image signal. PMID- 3295462 TI - [Analytical study of an epidemic of bacillary dysentery in Rwanda. Epidemiologic and bacteriologic aspects]. AB - From january 1985 to march 1985, an epidemic of bacillary dysentery stroke one of the region in north Rwanda. The area struck, only 160 km2, is densely populated (720 inhabitants/km2). Multiresistant Shigella dysenteriae n. 1 is the only responsible factor. The study of this epidemic shows that, from an endemic disease, burst out can occur in a narrow area and in a short interval of time (7 weeks). The main risk factors have been identified on individual as well as collective level. The authors demonstrate the interest of a Public Health Laboratory as technical support of an Epidemiology Monitoring Department. PMID- 3295463 TI - Temporary arteriovenous shunt prior to free myoosseous flap transfer. AB - The use of temporary arteriovenous shunt constructed in the lower extremity prior to a free microvascular transfer of an internal oblique/iliac crest flap, is described. The indications for the technique are presented. Conventional free flap transfer may require maturation of a suitable inflow source or outflow conduit, which is provided by a temporary shunt, subsequently used for recipient vessels. The two-stage procedure is applicable when local vessels are inadequate for immediate transfer. PMID- 3295464 TI - An alternative technique of microvascular anastomosis. AB - The femoral arteries and veins of rats were severed and reanastomosed, using either the conventional interrupted suture technique or an alternative interrupted technique that allows the lumen to remain visible throughout the reanastomosis procedure. The alternative technique involves placing the sutures in the posterior wall of the vessel, eliminating the necessity of rotating the microsurgical clamp during the anastomosis. Clinically, this method may be advantageous in cases where the anastomosis is being performed in a deep wound in which there is no room to turn over the microclamp. Additionally, this technique allows the posterior wall of the vessel to be observed throughout the anastomosis procedure, reducing the possibility of accidental placement of sutures through the posterior wall and resulting nonpatency. There was no significant difference between the two techniques in terms of operating time, patency rate, aneurysm formation, arteriography, and histological findings. PMID- 3295465 TI - Evaluation of long-term patency rates of different techniques of arterial anastomosis in rabbits. AB - The results of 160 arterial anastomoses performed with four different techniques are presented. The popliteal arteries (mean diameter 0.7 mm) of 40 rabbits in each of four groups were anastomosed using: I. End-to-end technique with assymetrical sleeving of the adventitia; II. end-to-end technique with symetrical sleeving of the adventitia and wrapping of the suture site with a collagen cuff; III. end-to-end technique with symetrical trimming of the adventitia; and IV. end in-end technique. Long-term patency rates for the above techniques were as follows: Group I, 92.5%; Group II, 87.5%; Group III, 92.5%; Group IV, 90.0%. Group IV anastomoses were completed in an average of 15 minutes compared with an overall average of 24 minutes for the other three groups. PMID- 3295466 TI - [Laboratory animals in toxicological studies]. AB - Basing on up-to-date knowledge on laboratory animals, a controversial problem of selection of inbred (homozygous) or outbred (heterozygous) animals for toxicological experiments has been presented. Source information on the requirements--mandatory in the world--related to animal breeding for toxicological experiments and description of animal material in publications have been included. PMID- 3295467 TI - Study of some parameters affecting the in vitro cultivation of Plasmodium falciparum within Saimiri sciureus red blood cells. AB - The in vitro growth and multiplication of the erythrocytic stages of Plasmodium falciparum within Saimiri sciureus (squirrel monkey) red blood cells have been studied. Various parameters, such as the origin of the red blood cells and serum supplement, nature of the buffer, influence of the final pH of the medium, role of proteose peptone and glucose addition, were investigated. The selection of the best culture conditions led to the obtention of a reproducible in vitro growth of two parasite cycles in Saimiri erythrocytes, which is an useful achievement for in vitro studies. Our failure to establish a continuous culture line for longer than 19 days, could be explained by a dramatic increasing of osmotic fragility of the Saimiri red blood cells related to their small size. PMID- 3295468 TI - [Biomorphogenetic changes caused by the application of precocene II in nymphs of Triatoma infestans (Klug, 1834) (Hemiptera, Reduviidae, Triatominae)]. AB - The morphogenetic effect of precocene II on 4th instar nymphs of Triatoma infestans was examined. Topical treatment with precocene II (200, 300 and 400 micrograms/nymph) induced the formation of adultoids with the following characteristics: rudimentary wings, three segmented tarsi, ocelli, deformed genitalia and mouth-parts and testes with intermediary development. Precocene II also increases the duration of the molting cycle. The survival of the adultoid insects was related to the inverse of the applied doses. These data extend our knowledge of the action of precocene II on triatominae species. PMID- 3295469 TI - [Very large trypomastigotes as a morphological pattern of strains of Trypanosoma cruzi in the southern region of Brazil]. AB - The morphological patterns of blood trypomastigotes from five sylvatic Trypanosoma cruzi strains from Santa Catarina, South Brazil, were studied during the course of infection in experimentally infected mice. A predominance of stout trypomastigotes (greater than 70%) was observed during all over the acute phase in four strains of medium virulence. With the remaining strain, of high virulence, the slender forms predominating at the early infection stage were soon also replaced by stout forms. Since almost all T. cruzi strains displaying predominance of this peculiar morphological pattern have been isolated in South Brazil (Rio Grande do Sul, Santa Catarina) and since there are evidences pointing out to the existence of biological differences among these distinct blood parasites, the authors suggest further investigations of possible correlations between the morphological markers and clinical-epidemiological aspects of Chagas' disease. PMID- 3295470 TI - RS virus diagnosis: comparison of isolation, immunofluorescence and enzyme immunoassay. AB - Two techniques for rapid diagnosis, immunofluorescence (IFAT) and enzyme immunoassay (EIA), have been compared with virus isolation in tissue culture for the detection of respiratory syncytial virus (RSV) in specimens of nasopharyngeal secretions. The specimens were obtained from children under five years of age suffering from acute respiratory illness, during a period of six months from January to June 1982. Of 471 specimens examined 54 (11.5%) were positive by virus isolation and 180 (38.2%) were positive by immunofluorescence. The bacterial contamination of inoculated tissue cultures unfortunately prevented the isolation of virus from many samples. Specimens from 216 children were tested to compare enzyme immunoassay and immunofluorescence. Of these 60 (27%) were positive by EIA and 121 (56%) were positive by IFAT. Our results suggest that the EIA technique although highly specific is rather insensitive. This may be because by the time these tests were done the original nasopharyngeal secretions were considerably diluted and contained more mucus fragments than the cell suspension used for IFAT. Of the three techniques, IFAT gives the best results although EIA may be useful where IFAT is not possible. PMID- 3295471 TI - Hepatic glucose extraction in normal and diabetic man. AB - Fractional hepatic extraction of glucose was determined from the appearance in the systemic circulation of ingested 3-[3H]glucose. Using the glucose clamp technique, studies were done under steady-state conditions of basal glycemia and insulinemia, normoglycemia (0.8 mg/mL) and mild hyperinsulinemia (approximately 40 microU/mL), hyperglycemia (2 mg/mL-1) and hyperinsulinemia (approximately 100 microU/mL). Based on previous results in the dog, an oral glucose load of 2 g was used to label the portal vein glucose; this amount was chosen so as to minimize disturbance of the portal steady state but still avoid excessive loss during absorption. Additional subjects with hyperglycemia and hyperinsulinemia received an oral load of 50 g of glucose. Fractional extraction in normal subjects under near-basal conditions of glycemia and insulinemia was 19% in normal subjects and in patients with noninsulin-dependent diabetes mellitus (NIDDM) elevation of serum insulin, with or without hyperglycemia, which led to an average extraction rate of 32% of the ingested glucose. Absolute hepatic glucose uptake, calculated from the fractional extraction the plasma glucose concentration, and hepatic plasma flow accounted for 50% to 72% of total glucose use during the various steady states and following ingestion of 50 g of glucose. It is concluded that hepatic uptake or extraction, as opposed to net uptake, proceeds actively even when plasma glucose and insulin are within the normal basal range; it is increased in the presence of hyperinsulinemia, with or without hyperglycemia; and it is unaltered in NIDDM. PMID- 3295472 TI - Effect of chlorpropamide on glucose transport in rat adipocytes in the absence of changes in insulin binding and receptor-associated tyrosine kinase activity. AB - In an attempt to elucidate the cellular mechanism(s) by which sulfonylureas exert their extrapancreatic hypoglycemic effects, various parameters of insulin action were examined in vitro, using rat adipocytes maintained in a biochemically defined medium. Cells were maintained for 20 hours in the absence or presence of 175 micrograms/mL chlorpropamide and insulin binding, hexose transport, glucose metabolism, and insulin receptor tyrosine kinase activity were compared. Chlorpropamide treatment had no effect on insulin binding, altering neither receptor number nor affinity. However, the sulfonylurea did enhance 2 deoxyglucose transport in both the absence (17%, P less than .01) and presence (20%, P less than .01) of insulin. Furthermore, glucose metabolism as measured by the conversion of glucose (0.2 mmol/L) to CO2 and total lipids was also significantly increased by chlorpropamide treatment in both the absence (30%, P less than .01) and presence (31%, P less than .05) of insulin. Potentiation of insulin-stimulated transport or metabolism was not explained by an increase in the basal state alone because the incremental responses to 40 ng/mL insulin were potentiated by 19% (P less than .01) and 25% (P less than .05), respectively. Activity of the insulin receptor kinase was unchanged as evaluated by autophosphorylation of partially purified receptors, phosphorylation of an artificial substrate and by phosphorylation of the receptor in situ. These studies demonstrate that the sulfonylurea, chlorpropamide, stimulates glucose transport and potentiates insulin's effect on this process by acting at a site(s) beyond insulin receptor binding and phosphorylation. PMID- 3295473 TI - Role of insulin in the stimulation of renal 25-hydroxyvitamin D3-1 alpha hydroxylase by phosphorus deprivation in rats. AB - The increase in serum 1,25(OH)2D concentration in response to dietary phosphorus (P) depreviation is dependent on the presence of insulin in rats. The present study was undertaken to clarify whether insulin exerts its effects by affecting the renal production of 1,25(OH)2D. The 25(OH)D-1 alpha-hydroxylase activity in kidney homogenates was markedly stimulated by P deprivation in control rats (0.20 +/- 0.06 pmol/g tissue/min in the rats on a normal P diet v 1.3 +/- 0.15 pmol/g/min in the rats on a low P diet; 6.5-fold increase). In contrast, in streptozotocin-diabetic rats, the increase in the renal 1 alpha-hydroxylase activity in response to P deprivation (0.25 +/- 0.01 pmol/g/min; 3.6-fold increase) as well as the enzyme activity in the rats on a normal P diet (0.07 +/- 0.01 pmol/g/min) was markedly suppressed. Furthermore, all the changes in the renal 1 alpha-hydroxylase activity in insulin-deficient rats disappeared by insulin replacement (0.16 +/- 0.01 pmol/g/min in the rats on a normal P diet v 1.3 +/- 0.01 pmol/g/min in the rats on a low P diet; eightfold increase). These results demonstrate that the stimulation of 1 alpha-hydroxylase in response to dietary P deprivation is blunted by insulin deficiency and is fully restored by insulin replacement. It is suggested that insulin, in addition to its direct stimulatory effect on 1 alpha-hydroxylase, alters the responsiveness of renal 1 alpha-hydroxylase to P deprivation. These effects of insulin on 1 alpha hydroxylase may be responsible for the change in serum 1,25(OH)2D concentration in response to dietary P deprivation, although the possibility cannot be ruled out that insulin also affects the metabolic clearance of 1,25(OH)2D. PMID- 3295474 TI - Comparison of body composition, adipocyte size, and glucose and insulin concentrations in Pima Indian and Caucasian children. AB - Pima Indian adults with normal glucose tolerance have higher plasma glucose and insulin concentrations than Caucasian adults. To estimate the age of onset of these differences, and to assess their relationship to abdominal and gluteal adipocyte size, we measured adiposity, adipocyte size, and glucose and insulin concentrations during a glucose tolerance test in lean (less than 20% body fat), prepubertal children from each race. The Pima (n = 13) and Caucasian (n = 10) groups were of similar age, percent body fat, and weight. Pima Indian children had higher fasting glucose (101 +/- 2 v 94 +/- 2 mg/dL, P = .01) and insulin (22 +/- 2 v 15 +/- 2 microU/mL, P less than .01) concentrations and larger abdominal adipocytes (0.49 +/- 0.03 v 0.37 +/- 0.04 microgram lipid/cell, P less than .05) than the Caucasian children. Postprandial glucose and insulin concentrations and gluteal adipocyte size were similar in the two races. The higher plasma glucose and insulin concentrations found in Pima adults are present in lean Pima children, and are associated with increased abdominal adipocyte size. These increases may precede the development of obesity in this racial group. PMID- 3295475 TI - Effects of chronic renal failure on the regulation of pyruvate kinase. AB - The effects of chronic renal failure on the enzyme activity of pyruvate kinase and the mRNA level of this enzyme were studied in 7 out of 8 nephrectomized rats. The mRNA level was measured by RNA-DNA dot blot hybridization, using cloned pyruvate kinase cDNA as hybridized probe. Neither the activity of M1-type pyruvate kinase nor the level of this enzyme in rat gastrocnemius muscle was affected by chronic renal failure, whereas L-type pyruvate kinase enzyme activity in uremic rat liver was lower than that in control at both fasted and refed states. The levels of L-type pyruvate kinase mRNA were not different between two groups at the fasted state. Induction of L-type pyruvate kinase mRNA after high carbohydrate diet refeeding was suppressed proportionally to the severity of chronic renal failure, which was expressed by the serum creatinine concentrations (r = -.876, P less than .005). These results indicate that the suppression of L type pyruvate kinase activity in uremia was partly reflected by the decreased accumulation of this enzyme mRNA. There was a significantly negative correlation between L-type pyruvate kinase mRNA levels and plasma glucagon/insulin ratios (r = -.719, P less than .05). Hyperglucagonemia in uremia might play a major role in this suppression. PMID- 3295477 TI - Novel Ca2+-binding proteins in tumor cells. PMID- 3295476 TI - Affinity labeling of the nucleotide-binding site of myosin light chain kinases. PMID- 3295478 TI - Isolation of the yeast calmodulin gene using synthetic oligonucleotide probes. PMID- 3295479 TI - Immunoperoxidase staining of S-100 and calmodulin in tissue sections and cultured cells. PMID- 3295480 TI - Immunolocalization of parvalbumin. PMID- 3295481 TI - N-methyl-N'-nitro-N-nitrosoguanidine-induced resistance to ionizing radiation. AB - N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) pretreatments increase the resistance of Escherichia coli to gamma-radiation. The increased resistance is dependent on functional polA, recA, recB, recC, and lexA genes and is partly dependent on recN. The MNNG-induced resistance is additive to resistance induced by pretreatment with gamma-radiation but not by increases induced by hydrogen peroxide. The MNNG-induced resistance occurs in adaptive response mutants and at pretreatment levels of MNNG that do not activate cells to reactivate UV inactivated lambda phage. The MNNG-induced resistance appears to be distinct from other inductions to gamma-radiation resistance. PMID- 3295482 TI - Cytoplasmic ribosomal proteins from Chlamydomonas reinhardtii: characterization and immunological comparisons. AB - Experiments were undertaken to characterize the cytoplasmic ribosomal proteins (r proteins) in Chlamydomonas reinhardtii and to compare immunologically several cytoplasmic r-proteins with those of chloroplast ribosomes of this alga, Escherichia coli, and yeast. The large and small subunits of the C. reinhardtii cytoplasmic ribosomes were shown to contain, respectively, 48 and 45 r-proteins, with apparent molecular weights of 12,000-59,000. No cross-reactivity was seen between antisera made against cytoplasmic r-proteins of Chlamydomonas and chloroplast r-proteins, except in one case where an antiserum made against a large subunit r-protein cross-reacted with an r-protein of the small subunit of the chloroplast ribosome. Antisera made against one out of five small subunit r proteins and three large subunit r-proteins recognized r-proteins from the yeast large subunit. Each of the yeast r-proteins has been previously identified as an rRNA binding protein. The antiserum to one large subunit r-protein cross-reacted with specific large subunit r-proteins from yeast and E. coli. PMID- 3295483 TI - Mutations affecting activity and transport of haemolysin in Escherichia coli. AB - Temperature-sensitive mutants that exhibit an altered haemolytic phenotype were isolated from Escherichia coli harbouring the plasmid pHly152. Complementation with recombinant plasmids carrying one of the four hly genes (C, A, B or D) allowed localization of the hly(ts) mutations. A ts mutation in hlyC leads to a pro----leu exchange in amino acid position 53 of HlyC. Two ts mutations in HlyA were found in positions 312 (ser----pro) and 315 (thr----ile). Both amino acid exchanges are located in the same hydrophobic domain of HlyA which extends from amino acids 299 to 327. Two different mutations were introduced by site-specific mutagenesis in this hlyA domain: one by an exchange of ala, val to asp, glu (positions 313, 314) altering the hydrophobicity of this region and another which removes most of this hydrophobic portion. Both mutants have entirely lost the haemolytic activity but the mutant haemolysins are still efficiently transported across both membranes when hlyB and hlyD are provided. Functional HlyC is not required for the transport of the mutant haemolysins. Two site-specific mutations at the N-terminal end of hlyA (one at amino acid position 2 leading to a thr--- pro exchange and another deleting ile and thr at positions 4 and 5) also do not affect the transport of the altered haemolysins. The thr----pro exchange enhances the haemolytic activity of the corresponding mutant, whereas the ile, thr deletion exhibits little or no effect on the haemolytic activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295484 TI - Cloning and expression of the exbB gene of Escherichia coli K-12. AB - The exbB locus of Escherichia coli is involved in the uptake of certain iron(III) siderophore compounds, of vitamin B12 and of certain colicins. Outer membrane receptor proteins are essential constituents of the corresponding uptake systems. The DNA carrying the exbB locus was cloned into pACYC184 and subcloned into pUC18. With the use of insertion mutagenesis employing transposon Tn1000 and by deletion analysis, the exbB locus was confined to a 1.9 kb DNA fragment. An in vitro transcription/translation system and minicells programmed by exbB+ plasmids expressed a protein with an apparent molecular weight of 26,000. One plasmid, designated pKE7, expressed this protein to an extent that it became a prominent band in the membrane fraction of transformants. In contrast, chromosomally encoded ExbB protein could not be detected. The plasmid-encoded ExbB protein was mainly localized in the cytoplasmic membrane. Ferrichrome transport in exbB mutants was restored by exbB+ plasmids. Moderate overexpression of ExbB resulted in an enhanced ferrichrome transport, strong overexpression reduced the transport rate compared to a wild-type strain. The ExbB function shares some properties with the TonB function. PMID- 3295485 TI - A newly discovered tRNA(1Asp) gene (aspV) of Escherichia coli K12. AB - We report a new tRNA(1Asp) gene near the dnaQ gene, which is located at 5 min on the Escherichia coli linkage map. We named it aspV. The sequence corresponding to the mature tRNA is identical with that of the two previously identified tRNA(1Asp) genes (aspT and aspU), but there is no homology in the sequences of their 3'- and 5'-flanking regions. PMID- 3295487 TI - Immunocytochemistry as a tool in cellular, molecular biology, and pathology: a review. PMID- 3295486 TI - A single base change in the extra-arm of yeast mitochondrial tyrosine tRNA affects its conformational stability and impairs aminoacylation. AB - The mitochondrial temperature-sensitive mutation tsm-8 maps on a 1.8 kb HpaII fragment of mitochondrial DNA (mt DNA) which contains genes for tRNA(Ala), tRNA(Ile) and tRNA(Tyr). The phenotype of this mutation is, among multiple pleiotropic defects, a temperature-induced reduction of mitochondrial translation. DNA sequencing of the HpaII fragment from the wild type and mutant tsm-8 revealed a single transversion from T to A in position 56 of the mutant tRNA(Tyr) gene. This nucleotide change disrupts a base pairing in the long extra arm of the tRNA cloverleaf. Revertants of the tsm-8 mutant restore correct base pairing in the extra arm by a second-site mutation in the tRNA(Tyr) gene. Analysis of the tRNA(Tyr) transcripts revealed that neither transcription nor processing of the tRNA is affected in the mutant. However, the base alteration destabilizes the conformation of the tRNA and affects its charging parameters. At the non-permissive temperature, the Michaelis-Menten constant of the mitochondrial tyrosyl-tRNA synthetase for the mutant tRNA is increased over 20 fold when compared to the wild-type tRNA. As a consequence, mitochondrial protein synthesis is drastically reduced at the restrictive temperature. Moreover, synthesis of apocytochrome b and of cytochrome oxidase subunit 3 is decreased relative to the other mitochondrially synthesized polypeptides. PMID- 3295488 TI - Antibiotic resistance and R plasmids in endemic strains of Salmonella typhimurium isolated in Sicily. AB - The characteristics of R plasmids in strains of Salmonella typhimurium isolated in Sicily during 1983 from apparently isolated cases of human infection have been determined. A plasmid of the Inc group 10-B-0, characterized by ApSm resistance markers and with a molecular weight of 70 Md, was found in strains belonging to different phage types (2, 3, 117, 135, NT). The data obtained suggest that strains of the same phage type harboring such plasmids come from the same bacterial clone which has continued to be endemic through interhuman contagion. Instead, the presence of the same plasmid in strains of different phage type could indicate its spreading in different bacterial clones. PMID- 3295489 TI - Beta-lactamase synthesis in Mycobacterium leprae. AB - Beta-lactam antibiotics are not active against Mycobacterium leprae. The enzyme beta-lactamase mediates the most common form of bacterial resistance to penicillins and cephalosporins. Cell-free extracts of purified suspensions of M. leprae were examined for beta-lactamase. The bacteria were prepared from the tissues of experimentally-infected nine-banded armadillos. Most of the suspensions were inactive. However, the bacteria obtained from the tissues of armadillos treated with penicillin G benzathine (bicillin) 6 months or more prior to sacrifice had beta-lactamase. If the organisms had been exposed to the antibiotic only for a few days, they were negative. Attempts to induce beta lactamase in the bacteria in vitro did not succeed. Interestingly M. leprae separated from untreated armadillos, infected with the bacilli derived from treated animals contained the enzyme activity. Apparently, the M. leprae genome contains the operon for beta-lactamase, and once it is stimulated to express the enzyme, it continues to do so, even after the inducer is withdrawn. PMID- 3295490 TI - Purification and characterization of Vibrio vulnificus protease. AB - A protease was purified from a strain of Vibrio vulnificus isolated from the blood of a septicemic human. The vibrio was cultured in bacto peptone-yeast extract medium, and the protease was purified by a purification procedure including ultrafiltration of the culture supernatant with an Amicon YM 5 membrane, diethylaminoethyl-Sephacel column chromatography, Sephacryl S-200 column chromatography and fast protein liquid chromatography on Mono Q column. The protease preparation revealed homogeneity on polyacrylamide gel electrophoresis and about 30,000-fold purification was achieved, with a yield of about 30%. The isoelectric point of the purified V. vulnificus protease was about 5.80 and its molecular weight was ca. 45,000 by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The optimum pH of the protease activity was 8.0. The V. vulnificus protease was inhibited by a metalloprotease inhibitor and zinc ion and/or ferrous ion were essential for its enzyme activity. No cysteine residue was detected in the V. vulnificus protease. The protease had caseinolytic, elastolytic and collagenolytic activities. PMID- 3295491 TI - [Electrophoretic properties of a population of Escherichia coli cells studied by microelectrophoresis]. AB - The technique of microelectrophoresis was used to measure the rate of E. coli cell motility under the action of a constant electric field, and the electrokinetic potential (xi-potential) was calculated from the experimental data. As was shown by analysing the results for a sample from 100 cells, the property varied within a wide range which exceeded several times the error of a single measurement. This variation was associated with the different electrosurface properties of microbial cell groups and is characteristic of a cell population. The empirical distribution of the parameter was shown to be consistent with the normal law. The results of determining the electrokinetic potential may statistically be processed with a computer, and the profile of an experimental curve will characterize the physico-chemical state of cells. PMID- 3295492 TI - [Effect of R-plasmids on the type of growth of Escherichia coli]. AB - The effect of plasmids belonging to four incompatibility groups on the lag phase duration and the growth rate of E. coli was studied. The lag phase was much longer in the presence of plasmids belonging to the IncP and IncI groups in E. coli cells. No correlation in growth rate changes was found between plasmid strains and those which did not contain plasmids. PMID- 3295493 TI - [Selection of mutants of microorganisms utilizing ethanol]. AB - Mutants of the bacteria Acinetobacter calcoaceticus 34 and Acinetobacter sp. 172 as well as of the yeast Candida requinyii 316 resistant to acetaldehyde grow better in a medium with ethanol than their parent cultures. In their specific growth rate and alcohol dehydrogenase activity, 28.7-66.7% of such mutants are superior to any clone isolated in a non-selective medium. A medium containing ethanol and acetaldehyde (0.5 to 1.0% by volume) is proposed to select and isolate highly productive mutants. PMID- 3295495 TI - Theory of adequate function of cells and the organism--the theoretical basis for contemporary medicine. AB - The theory of adequate function of the cells and the organism is introduced as the theoretical basis for contemporary medicine. In accordance with this theory, the organism tends to function adequately to the needs directed toward the maintenance of life under various conditions. Mechanisms responsible for adequate function include those of regulation, compensation and defense. Their interactions provide for adequate function in both steady and transient physiological conditions, as well as in pathological conditions. Examples of adequate function under various conditions are discussed. The notion of optimal adequate function of cells and the organism is introduced, which implies the complete satisfaction of the needs of the cells and the demands imposed upon these cells by the organism. The dual character of the cell's adequate function contributes to the possibilities for disease. Imbalance between the needs of the cell and the needs of the organism is proposed to be the general mechanism of chronic diseases. Maintenance of the optimal balance of adequate function throughout the life of an individual is considered to be the major objective through which the prophylaxis and early treatment of chronic diseases can be achieved. PMID- 3295494 TI - [Energy aspects of the growth of Escherichia coli synchronized by starvation]. AB - The quantitative determination of adenyl nucleotides based on the separation of their dansyl derivatives by thin layer chromatography has made it possible to study the dynamics of changes in the pool of ATP, ADP and AMP in Escherichia coli K-12 during its synchronous growth after glucose starvation. The energy parameters (the adenylate pool, energy charge, teh ATP/ADP ratio, the rates of oxygen uptake and ATP generation, the economic coefficients of oxygen and ATP utilization) were compared with changes in the growth characteristics (the rate of growth and biomass concentration). This comparison allowed the authors to draw the conclusion about the uncoupled constructive and energy metabolism and about the possible regulatory role of energy parameters in the synchronised culture growth. PMID- 3295496 TI - The sickle-cell trait modifies the intensity and specificity of the immune response against P. falciparum malaria and leads to acquired protective immunity. AB - It is proposed that the in vivo mechanism of protection against falciparum malaria in individuals of the Hb AS genotype is not due solely to the adverse influence of Hb AS erythrocytes on the intraerythrocytic growth and development of P. falciparum. Instead, the simple physiological effect of Hb S on parasite growth appears to trigger an in vivo process of enhancement of the intensity and/or specificity of the host immune response, leading to acquired protective immunity, in a process simulating vaccination. Testing the hypothesis may lead to the identification of plasmodial antigens that induce protective responses in the human host and distinguish them from non-protective, immunosuppressive or decoy antigens that promote parasite survival. This may ultimately help in the selection of candidate antigens for a malaria blood-stage vaccine. PMID- 3295497 TI - Therapeutic trials in mild hypertension. PMID- 3295498 TI - [Drug-induced kidney injuries. II. Cytostatics and antibiotics]. PMID- 3295499 TI - Methacholine for diagnosis of asthma. PMID- 3295500 TI - Siblings of paediatric cancer patients: a population at risk. AB - The psychosocial care of children with cancer has received increasing and welcome emphasis in the medical literature. However, the current and future status of siblings of such patients has been an underestimated area of concern. We examine the general importance of sibling relationships and present the literature regarding siblings of paediatric oncology patients. Donors and recipients of bone marrow transplants are considered specifically. Preliminary results of original research, supported by available published studies, suggest important disturbances in the mental health of siblings. Implications for paediatricians and other health professionals as well as prevention and intervention strategies are indicated. PMID- 3295502 TI - Radiation myelopathy: a review. AB - Radiation myelopathy is a serious potential complication associated with radiation therapy to the spinal cord. Its exact cause is unknown. It represents a spectrum of syndromes, the most common of which are acute transient radiation myelopathy and chronic progressive radiation myelitis. A review of the literature indicates that cord damage is related to a number of controllable factors including dose fraction size, treatment time, total dose, length of cord irradiated, technical and clerical errors. Other less well understood factors that appear to contribute to the risk such as combined chemoradiotherapy effects and hyperthermia should also be recognized. A better awareness and understanding of these factors should ultimately lead to safer and more effective treatments. PMID- 3295501 TI - A randomized study comparing high-dose methotrexate with moderate-dose methotrexate as components of adjuvant chemotherapy in childhood nonmetastatic osteosarcoma: a report from the Childrens Cancer Study Group. AB - Methotrexate (MTX) has demonstrated significant activity against relapsed and metastatic osteosarcoma. However, there is little published data to indicate the appropriate dose for MTX when given as a component of a multidrug regimen for the treatment of osteosarcoma. Therefore, the investigators at the Childrens Cancer Study Group undertook a randomized clinical trial that compared Adriamycin and vincristine given with either high-dose methotrexate or moderate-dose methotrexate as postoperation chemotherapy in the treatment of childhood osteosarcoma. We report here the results for 166 patients with completely resected nonmetastatic disease of an extremity. The two therapies demonstrated equivalent disease-free survival (DFS). Further, no therapy prejudices survival after relapse. Approximately 38% of patients remain disease free 4 years after diagnosis. Two relapses occurred in patients free of disease at least 36 months after initiation of treatment. Some factors found by other investigators to be prognostic of poorer DFS, namely, male sex, primary tumor in the humerus or femur, and larger primary tumors, demonstrated similar though not statistically significant trends. The presence of spontaneous necrosis in the tumor sample from the definitive surgery was associated with poor prognosis for DFS. We postulate that this feature represents rapidly growing tumors with increased potential for metastases. PMID- 3295503 TI - [Alivizatos and Hempt--their contribution to the study of rabies in Yugoslavia and the world]. PMID- 3295504 TI - [Dr. Antun Lobmayer and the beginnings of Yugoslav obstetrical textbook literature]. PMID- 3295505 TI - [Effect of the calcium antagonist diltiazem on acute kidney failure following kidney transplantation. Results of 2 prospective randomized studies]. PMID- 3295506 TI - [Major aspects of the development of naturopathy in Germany in the 1st half of the 20th century]. PMID- 3295507 TI - Thromboxane and prostacyclin in acute lung injury caused by venous air emboli in unanesthetized sheep. AB - In 4 unanesthetized sheep with lung lymph fistulas we studied the role of thromboxane A2 (TxA2) in the lung microvascular injury caused by 4 h of venous air embolism. In each sheep, we did paired air embolism experiments: control and after giving the TxA2-synthetase inhibitor, U63,557A. Inhibition of TxA2 synthetase did not affect the hemodynamic response to air emboli; lung lymph flow increased slowly but to the same final rate as with air alone. The pulmonary production of TxA2, estimated as the lymph concentration of thromboxane B2 (TxB2) X lymph flow, increased during air embolism in the control experiment but increased much less when TxA2-synthetase was inhibited. Similarly, prostacyclin (PGI2) production increased during air embolism but was reduced when TxA2 synthetase was inhibited. Our results suggest that TxA2 does not mediate the pulmonary hypertension caused by venous air emboli, but it might modulate the increase in lymph flow by acting on the lymphatic pump or affecting hemodynamics in the pulmonary microcirculation. Our results do not support that TxA2 mediates the injury caused by venous air embolism. Pulmonary production of PGI2 seems to depend on the pulmonary production of TxA2, as shown by the parallel changes of their metabolites during air embolization. PMID- 3295509 TI - A visit in Litchfield with Doctor Bill Nolen. PMID- 3295508 TI - Effects of glucagon on renal and extrarenal handling of inorganic phosphate in mice: evidence for inorganic phosphate mobilizing activity. AB - Glucagon administration is known to increase urinary inorganic phosphate (Pi) excretion. We have now confirmed that this effect also occurs in mice. While, at lower glucagon doses, phosphaturia was accompanied by a decrease in plasma Pi, at the highest dose of glucagon plasma Pi was not altered in spite of a massive increase in urinary Pi. This suggested that glucagon may additionally have another effect on phosphate homeostasis, i.e. of mobilizing Pi from body stores. In order to distinguish between the renal and extrarenal effects of glucagon, the animals were fed a low-phosphate diet, a procedure known to blunt the effect of several phosphaturic agents. Under these conditions, any Pi mobilized from body stores should be reflected by an increment of plasma Pi. Glucagon phosphaturia was indeed blunted under this condition. Furthermore, plasma Pi increased spontaneously by 0.82 +/- 0.14 mmol/l (mean +/- SEM) in an experimental period of 8 h during which the mice were fasted. In mice injected with zinc-protamine glucagon subcutaneously at 4 and 16 micrograms/g of body weight, plasma Pi increased by 1.45 +/- 0.17 and 2.38 +/- 0.14 mmol/l during 8 h, respectively. Thus, it appears that exogenous glucagon is a strong Pi-mobilizing hormone. Furthermore, during the recovery phase following insulin-induced hypoglycemia, in which glucagon is thought to play a primordial role, a similar Pi mobilization to that obtained after glucagon administration was observed. Thus, since glucagon is released during fasting to maintain the homeostasis of blood glucose, it is conceivable that the mobilization of Pi induced by fasting might also have been caused by endogenous glucagon and that this hormone might be involved in Pi homeostasis. PMID- 3295510 TI - [Assisted circulation after extracorporeal circulation]. PMID- 3295511 TI - [Comparison of wound healing of intestinal anastomosis by stapling devices and by Gambee's suture under normal and abnormal conditions in dog]. AB - We investigated the wound healing of canine colon anastomosis by stapling devices (EEA and Nakayama's curved shaft device) comparing with that by Gambee's suture with special reference to vascularity of staple line, local blood flow, endoscopical findings, pathological findings and fluorescein viability test under normal and abnormal conditions. Development of vascular network and communication at the suture lines by stapler using a silicon rubber injection observed on the following days after operation. The local blood flow at the anastomosis measured by hydrogen gas clearance method increased gradually after operation. Endoscopic examination showed mucosal agglutination at the suture line by staplers was delayed compared to that of Gambee's suture. Under normal condition, the vascular communication of suture line by Gambee's was observed on the 5th post operative day, whereas it was observed on the 7th day by Staplers. Stainless steel staples were considered to be less reactive to the tissue than the other suture materials. Under abnormal condition, wound healing was delayed because of the prolonged inflammation and edema. No remarkable difference was observed between manual anastomosis (Gambee) and stapled anastomosis under abnormal condition. PMID- 3295512 TI - [Liver tissue fragments transplantation to the spleen]. AB - Sliced liver tissue fragments of strained Wistar-Lewis rat were transplanted to the spleen. Most of transplanted liver tissues showed hyaline degeneration and epithelial ducts, similar to bile ducts, were observed on the seventh day. The liver tissue could not be identified one month after transplantation. But the masses of hepatic cells, having no sinusoid, were observed in some cases 12 months after transplantation. Macroautoradiographic studies with 99mTc-diethyl IDA, hepato-biliary agent, were performed. The yellowish white portions of the specimens on the seventh day, corresponded to the transplanted liver tissue, indicated the uptake of 99mTc-diethyl-IDA. This means the transplanted fragments were alive and had a role of detoxication. The density of the fragments were 20% to 50% of that of the host liver. The survival ratio in acute hepatic failure induced with carbon tetrachloride (CCl4) increased by the liver tissue fragments transplantation. The density of the transplanted fragments with hepatic injury by the CCl4 increased, compared with that of no injury. PMID- 3295513 TI - [Lipid metabolism in experimental acute pancreatitis]. AB - In order to study the changes of lipid metabolism in acute pancreatitis, the following experiments were performed in monogrel dogs. Bile-induced pancreatitis (severe type) and collagenase-induced pancreatitis (mild type) were prepared, and changes of FFA, TG, IRI and IRG were determined for one week. In addition, IVFTT and PHLA were determined at 24th hour, on the 3rd day and 7th day. A rise of FFA was observed during the first 24 hours, which was considered the lypolytic stage. On the 3rd day TG reached the maximal level, while K values in IVFTT and PHLA showed the lowest levels. The above results suggest that the elimination mechanism of TG was impaired on the 3rd day. Changes of FFA, TG, IRI and IRG showed marked differences between the two groups. Therefore it is thought that lipid metabolism in acute pancreatitis is regulated by balance of endogenous pancreatic hormones. PMID- 3295514 TI - [A case of retroperitoneal mucinous cystadenoma of borderline malignancy]. AB - Surgical experience of a rare case of malignant retroperitoneal cyst is reported. A 41-year-old female was admitted on Feb. 26, 1986, complaining of left lower abdominal tumor and mild abdominal pain. She underwent complete removal of an abdominal tumor located at the left flank lateral to the sigmoid colon on March 5. The tumor was well encapsulated, cystic and oval, 12 X 10 X 9 cm in size. Histologic feature of the tumor is classified as mucinous cystadenoma of low grade malignancy by WHO classification. PMID- 3295515 TI - [Inhibition of liver metastasis of hamster pancreatic cancer by intraportal administration of prostaglandins]. PMID- 3295517 TI - Malignant lymphoma. Introduction. PMID- 3295518 TI - Immunologic markers for acute leukemia: a morphologist's perspective. PMID- 3295519 TI - Classifying non-Hodgkin's lymphomas. PMID- 3295520 TI - Cytogenetics of leukemia and lymphoma. PMID- 3295521 TI - Diagnostic molecular biology of non-Hodgkin's lymphomas. PMID- 3295516 TI - The function of proteins that interact with mRNA. AB - Specific proteins are associated with mRNA in the cytoplasm of eukaryotic cells. The complement of associated proteins depends upon whether the mRNA is an integral component of the polysomal complex being translated, or, alternatively, whether it is part of the non-translated free mRNP fraction. By subjecting cells to ultraviolet irradiation in vivo to cross-link proteins to mRNA, mRNP proteins have been shown to be associated with specific regions of the mRNA molecule. Examination of mRNP complexes containing a unique mRNA has suggested that not all mRNA contain the same family of associated RNA binding proteins. The functions of mRNA associated proteins may include a role in providing stability for mRNA, and/or in modulating translation. With the recent demonstrations that both free and polysomal mRNPs are associated with the cytoskeletal framework, specific mRNP proteins may play a role in determining the subcellular localization of specific mRNPs. PMID- 3295522 TI - The lymphomas: biologic implications of therapy and therapeutic implications of the new biology. PMID- 3295523 TI - The immune system and lymphoid neoplasia. PMID- 3295524 TI - Recent advances in the epidemiology of leukemia and lymphoma. PMID- 3295525 TI - B-cell malignant lymphomas: an immunologic perspective. PMID- 3295526 TI - The "secret" of the islets: a footnote to history. PMID- 3295527 TI - Update on therapy of diabetes mellitus: diet, sulfonylurea agents, and insulin. PMID- 3295528 TI - Impotence in diabetic men. PMID- 3295529 TI - Peripheral vascular disease in diabetic patients: evaluation and treatment. PMID- 3295530 TI - Lipid disorders in diabetes mellitus. PMID- 3295531 TI - Infants of diabetic mothers: prenatal care and outcomes for the infant. PMID- 3295532 TI - Dependence on Salmonella typhimurium enzymes of mutagenicities of nitrobenzene and its derivatives in the presence of rat-liver S9 and norharman. AB - Dependence on S. typhimurium enzymes of mutagenicities of nitrobenzene (NB) and o , p-chloronitrobenzenes (o-, p-CNBs), which are only mutagenic in the presence of S9 and norharman (NOH), was investigated using a nitroreductase-deficient strain TA98NR and an esterifying enzyme-deficient strain TA98/1,8-DNP6. NB exhibited mutagenicity towards TA98 but did not towards TA98NR strain in spite of the presence of S9 in the assay system. The mutagenicity of o-CNB towards TA98NR was significantly lower than that of o-CNB towards TA98. In contrast to NB and o-CNB, synthesized phenylhydroxylamine (PHA) and o-chlorophenylhydroxylamine (o-CPHA) exhibited approximately the same mutagenicity towards both tester strains. These results indicate that the nitroreduction required for the appearance of mutagenicity of the nitrobenzene derivatives in the presence of S9 and NOH is dependent on the nitroreductase of the tester strain. In addition, the mutagenicities of PHA and p-CPHA were significantly higher towards TA98/1,8-DNP6 than towards TA98, suggesting that the esterification of their hydroxylamines produced inactivation rather than activation. From these results, it was concluded that S9 and NOH play a role in metabolic activation other than the reduction of the nitro group to hydroxylamine and subsequent esterification for the mutagenesis of NB and its derivatives. PMID- 3295533 TI - Hyper-mutation caused by the reml mutation in yeast is not dependent on error prone or excision repair. AB - The reml mutations of Saccharomyces cerevisiae confer a semi-dominant hyper recombination/hyper-mutation phenotype. Neither reml mutant allele has any apparent meiotic affect. We have examined spontaneous mutation in reml-2 strains and demonstrate that the reml-2 mutation, like reml-1, confers an average 10-fold increase in reversion and forward mutation rates. Unlike certain yeast rad mutations with phenotypes similar to reml, strains containing reml are resistant to MMS and only slightly UV sensitive at very high doses. To understand the mutator phenotype of reml, we have used a double-mutant approach, combining the reml mutation with radiation-sensitive mutations affecting DNA repair. Double mutants of reml-2 and a mutation in the yeast error-prone repair group (rad6-1) or a mutation in excision repair (rad1-2 or rad4) maintain the hyper-mutation phenotype. Since mutation rates remain elevated in these double-mutant strains, it appears as if the mutations which occur in the presence of reml resemble spontaneous mutation since they do not require the action of a repair system. PMID- 3295534 TI - An interlaboratory study of an EPA/Ames/Salmonella test protocol. AB - 7 laboratories participated in a collaborative study to evaluate an EPA standard protocol for the Ames test. The study utilized Salmonella typhimurium (strains TA98 and TA100) and 3 metabolic activation levels (0%, 2%, and 10% S9 in the S9 mix). 6 pure chemicals and 2 complex mixtures were tested as coded unknowns. Ability to obtain qualitative results in agreement with published data was less (% agreement) than that reported in an earlier study (% agreement) by de Serres and Ashby (1981) in which each laboratory used its own protocol. The conclusion from analysis of the quantitative data from this interlaboratory Ames study was that both intralaboratory and interlaboratory variations were substantial. Results for the same substance varied by an order of magnitude or more (CV of 115%) when the mutagenic response was measured as the slope of the dose response in revertants/microgram. Taking interlaboratory variation into account, one chemical must be more than an order of magnitude more mutagenic than another (ratio of slopes greater than 10) to have only an even chance of finding a statistically significant difference between the two chemicals at the 5% level. Such large variations must be taken into account when evaluating Ames/Salmonella data. PMID- 3295535 TI - Mutagen levels in urine from snuff users, cigarette smokers and non tobacco users -a comparison. AB - The mutagenic activity of concentrates of urine from snuff users, cigarette smokers and non tobacco users has been investigated. A concentration procedure involving use of Sep-Pak C18 columns and elution with methylene chloride was used. The concentrates were assayed for mutagenicity towards strain TA98 of Salmonella typhimurium, both in the presence and absence of a metabolic activation system, the post-mitochondrial liver fraction (S9) from Aroclor 1254 induced rats. The mean mutagenic activity of smokers' urine concentrates was 8.6 X 10(3) revertants per 24 h and significantly higher than the corresponding values for snuff users, abstinent snuff users and non tobacco users, which were (1.3, 1.3 and 0.9) X 10(3), respectively. No significant difference in mutagenic activity was found between urine from snuff users, whether using or abstaining from snuff, and urine from non tobacco users. It could thus be concluded that the level of urinary mutagens, isolated by adsorption on Sep-Pak C18 columns, is not elevated by habitual usage of Swedish wet snuff. PMID- 3295536 TI - Bacterial mutagenicity of some methyl 2-cyanoacrylates and methyl 2-cyano-3 phenylacrylates. AB - The mutagenic potential of three alkyl 2-cyanoacrylate adhesives, three commercial alkyl 2-cyanoacrylate adhesives and three methyl 2-cyano-3 phenylacrylates, was assessed using the Salmonella/microsome mutagenicity assay. Compounds were tested with and without Aroclor 1254-induced rat-liver homogenate (S9 mix). The methyl 2-cyanoacrylate adhesives were mutagenic in the standard plate test with S. typhimurium strain TA100 with and without S9 activation. Methyl 2-cyano-3-(2-bromophenyl)acrylate revealed a direct mutagenic action to S. typhimurium strain TA1535. The compounds most toxic towards the bacterium S. typhimurium, were the methyl 2-cyanoacrylate adhesives (greater than 500 micrograms/plate). All alkyl 2-cyanoacrylate adhesives were tested in a modified spot test for volatile compounds with tester strain TA100. Mutagenic and toxic effects were observed with the three methyl 2-cyanoacrylate adhesives. It can be concluded from the results that the bacterial toxicity and mutagenicity of methyl 2-cyanoacrylate adhesives may be due to the methyl 2-cyanoacrylate monomer. PMID- 3295537 TI - The pathogenicity of Beauveria bassiana in the rabbit cornea. PMID- 3295538 TI - A case of disseminated Scedosporium apiospermum infection after bone marrow transplantation. PMID- 3295539 TI - Fungal infections in birds in captivity--six case reports. PMID- 3295540 TI - Experimental chronic lingual candidosis induced in streptozotocin diabetic rats. PMID- 3295541 TI - High-dose therapy and autologous bone marrow transplantation after failure of conventional chemotherapy in adults with intermediate-grade or high-grade non Hodgkin's lymphoma. AB - Adult patients with advanced non-Hodgkin's lymphoma in whom conventional chemotherapy has failed are seldom cured thereafter. We studied 100 such patients with intermediate-grade or high-grade non-Hodgkin's lymphoma who were subsequently treated with high-dose chemotherapy (61 patients) or high-dose chemotherapy plus total-body irradiation (39 patients), with bone marrow transplantation used for hematologic support. Thirty-four patients had disease that had been refractory to primary chemotherapy, and 66 patients had had a complete remission with primary chemotherapy but later relapsed. Before autologous bone marrow transplantation and high-dose chemotherapy, the 66 relapsed patients had also received conventional salvage chemotherapy; 22 had had no response or had had disease progression (a response termed "resistant relapse"), and 44 patients had responded partially or completely (a response termed "sensitive relapse"). After high-dose therapy and bone marrow transplantation, the actuarial three-year disease-free survival was zero in the refractory group, 14 percent in the resistant-relapse group, and 36 percent in the sensitive-relapse group. Patients who had had a complete remission in response to initial chemotherapy had a higher disease-free survival rate than those who had not (P less than 0.001), and patients with sensitive relapse had a higher disease-free survival rate than those with resistant relapse (P less than 0.003). These results should be considered in the planning or interpretation of trials of salvage chemotherapy in adults with non-Hodgkin's lymphoma. PMID- 3295542 TI - Prolonged disease-free survival after autologous bone marrow transplantation in patients with non-Hodgkin's lymphoma with a poor prognosis. AB - Despite advances in the primary treatment of non-Hodgkin's lymphoma, relapse is common and treatment after relapse is unsatisfactory. Autologous bone marrow transplantation, although sometimes successful, has generally had disappointing results. We conducted a trial of such transplantation in patients with relapsed non-Hodgkin's lymphoma, using strict criteria in selecting patients; we included only those in whom disease was minimal after conventional treatment (nodal disease less than 2 cm and bone marrow involvement less than or equal to 5 percent on histologic examination) and whose tumor cells expressed the B1 antigen. Forty-nine patients meeting these criteria received cyclophosphamide and whole-body irradiation supported by transplantation of autologous bone marrow that had been treated in vitro with anti-B1 monoclonal antibody and complement. All patients had features of a poor prognosis, including relapse from primary chemotherapy, histologic conversion to more aggressive disease, and extra-nodal dissemination. Thirty-three patients had a history of bone marrow involvement--16 at the time that marrow was obtained. Hematologic and immunologic engraftment was achieved in all patients. Only two treatment-related deaths occurred, from venoocclusive disease of the liver and intracerebral hemorrhage, respectively. Disease-free remission without maintenance therapy has lasted from greater than 2 to greater than 52 months in 34 patients (median follow-up, greater than 11 months). These results are similar to those obtained in patients with advanced, high-grade non-Hodgkin's lymphoma treated with primary combination chemotherapy. This study demonstrates that autologous bone marrow transplantation has tolerable toxicity and high efficacy in a subset of patients who are otherwise incurable but still responsive to cytoreductive therapy. The results suggest a role for such transplantation in the treatment of selected patients with newly diagnosed non-Hodgkin's lymphoma. PMID- 3295543 TI - Congenital adrenal hyperplasia. (1). PMID- 3295544 TI - Complement in the pathophysiology of human disease. PMID- 3295545 TI - Autologous bone marrow transplantation in non-Hodgkin's lymphoma. PMID- 3295546 TI - Congenital adrenal hyperplasia (2). PMID- 3295547 TI - Multipolar electrocoagulation in the treatment of active upper gastrointestinal tract hemorrhage. A prospective controlled trial. AB - The benefit of nonsurgical therapy in the treatment of active nonvariceal upper gastrointestinal tract hemorrhage is uncertain. I performed a prospective controlled trial of endoscopic multipolar electrocoagulation for active upper gastrointestinal hemorrhage. Patients were considered for entry if they had a bloody nasogastric aspirate, melena, or hematochezia, and any of the following: unstable vital signs, a requirement of greater than or equal to 2 units of blood per 12 hours, or a drop in hematocrit of greater than or equal to 6 percent in 12 hours. Forty-four patients were randomly assigned to receive multipolar electrocoagulation or sham multipolar electrocoagulation if endoscopy revealed active bleeding from an ulcer (24 patients), a Mallory-Weiss tear (17), or a vascular malformation (3). The group receiving multipolar electrocoagulation did significantly better in terms of hemostasis (90 percent vs. 13 percent, P less than 0.0001), mean (+/- SE) transfusion requirements (2.4 +/- 0.9 vs. 5.4 +/- 0.9 U; P = 0.002), mean number of hospital days (4.4 +/- 0.8 vs. 7.2 +/- 1.1, P = 0.02), and percentage needing emergency surgery or another intervention (14 vs. 57 percent, P = 0.01). Although mortality was lower in the group receiving multipolar electrocoagulation (0 vs. 13 percent), this difference was not statistically significant. The mean cost of hospitalization for treated patients was less than half that for the controls ($ 3,420 +/- 750 vs. $ 7,550 +/- 1,480, P = 0.001). I conclude that multipolar electrocoagulation markedly improves the hospital course in patients with major, nonvariceal upper gastrointestinal hemorrhage. PMID- 3295548 TI - Laser photocoagulation for the treatment of acute peptic-ulcer bleeding. A randomized controlled clinical trial. AB - We tested the hypothesis that therapeutic endoscopy using the Nd:YAG (neodymium:yttrium-aluminum-garnet) laser would benefit patients with acute peptic-ulcer bleeding. Over 43 months, 174 patients with active bleeding (n = 32) or stigmata of recent bleeding (n = 142) due to peptic ulcers were randomly assigned during endoscopy to either standard treatment with laser photocoagulation or therapy without photocoagulation. There were no significant differences in a number of outcomes between the group treated with laser photocoagulation and the control group. Continued bleeding or rebleeding was observed in 22 percent of the laser-treated group and in 20 percent of the control group. Urgent surgery was necessary in 16 percent of the laser-treated patients and in 17 percent of the controls. Laser-treated patients spent a mean of 41 hours in the intensive care unit, and controls spent a mean of 32 hours. The mean hospital stay was 12 days in the laser-treated group and 11 days in the control group. One death occurred in each group. When patients with active bleeding were analyzed separately, there was no significant difference in outcome, even though laser photocoagulation stopped active bleeding in 88 percent of cases. Among patients with visible vessels, rebleeding occurred in 5 of 14 (36 percent) who received laser treatment and 2 of 15 (13 percent) who did not. Laser treatment precipitated bleeding in four patients and duodenal perforation in one. We conclude that Nd:YAG-laser photocoagulation does not benefit patients with acute upper gastrointestinal bleeding from peptic ulcers. PMID- 3295550 TI - Nitrate therapy in stable angina pectoris. PMID- 3295549 TI - Tryptase levels as an indicator of mast-cell activation in systemic anaphylaxis and mastocytosis. AB - Better methods are needed to assess mast-cell activation in vivo and to distinguish the activation of mast cells from that of basophils. Tryptase, a neutral protease selectively concentrated in the secretory granules of human mast cells (but not basophils), is released by mast cells together with histamine and serves as a marker of mast-cell activation. In 17 patients with systemic mastocytosis, concentrations of tryptase in plasma were linearly related to those of histamine (P less than 0.01). Eleven of the 17 patients had tryptase levels of 4 to 88 ng per milliliter, indicating ongoing mast-cell activation. In each of six patients who experienced corresponding anaphylactic reactions after penicillin, aspirin, or melon ingestion, a wasp sting, exercise, or antilymphocyte globulin injection, tryptase levels in serum ranged from 9 to 75 ng per milliliter, indicating mast-cell activation during each of these events. In contrast, serum tryptase levels were less than 5 ng per milliliter in all patients presenting with myocardial disease (n = 8, 6 with hypotension) or sepsis (n = 6, 3 with hypotension) and in the controls (n = 20). One patient had a myocardial infarction after anaphylaxis in response to a wasp sting and an elevated tryptase level of 25 ng per milliliter. Thus, the plasma or serum tryptase level is a diagnostic correlate of mast-cell-related events. PMID- 3295551 TI - Colon cancer, dysplasia, and surveillance in patients with ulcerative colitis. A critical review. PMID- 3295552 TI - Edouard Seguin and the social power of thermometry. PMID- 3295553 TI - Suppressive therapy with levothyroxine for solitary thyroid nodules. A double blind controlled clinical study. AB - Thyroid nodules are present in up to 50 percent of adults in the fifth decade of life. Patients are often treated with thyroxine in order to reduce the size of the nodule, but the efficacy of thyrotropin-suppressive therapy with thyroxine remains uncertain. In this study, 53 patients with a colloid solitary thyroid nodule confirmed by biopsy were randomly assigned in a double-blind manner to receive placebo (n = 25) or levothyroxine (n = 28) for six months. Before treatment, pertechnetate-99m thyroid scanning showed that 22 percent of the nodules were functional, 25 percent hypofunctional, and 53 percent nonfunctional. High-resolution (10-MHz) sonography was used to measure the size of the nodules before and after treatment. Suppression of thyrotropin release was confirmed in the levothyroxine-treated group by the administration of thyrotropin-releasing hormone; thyrotropin release was normal in the placebo group. Six months of therapy did not significantly decrease the diameter or volume of the nodules in the levothyroxine group as compared with the placebo group. We conclude that the efficacy of levothyroxine therapy in reducing the size of colloid thyroid nodules is not apparent within six months, despite effective suppression of thyrotropin. PMID- 3295554 TI - Changing aspects of the natural history of valvular aortic stenosis. PMID- 3295555 TI - The experimental pathogenicity in Swiss mice of various strains of Nocardia isolated in soil of Tucuman (Argentina). AB - The isolation of Nocardia pathogenic for man in soil of Tucuman revealed the convenience of undertaking a study of their virulence, to evaluate any potential danger it may imply. Thirty three strains were studied: 28 N. brasiliensis, 3 N. asteroides and 2 N. caviae by inoculating albino Swiss mice into the footpads and intraperitoneally. The results obtained revealed the existence of Nocardia of variable aggresiveness in the soil of Tucuman. PMID- 3295557 TI - Keeping well with diabetes. Diabetes in children. PMID- 3295556 TI - The attachment to human buccal epithelial cells by Candida albicans: an in vitro kinetic study using concanavalin A. AB - The early in vitro kinetics of Candida albicans attachment to human buccal epithelial cells was studied with the aid of an adhesion assay and solutions of concanavalin A (Con A), a lectin which is capable of inhibiting yeast adhesion. Various saccharides and putative receptor analogues were also tested. Solutions of each single reagent were added to tubes containing aliquots of mucosal cells and germinated yeasts at the beginning of a 1-hour incubation period (time O) or at 10 minute intervals during the assay. The number of yeasts attached to 200 mucosal cells was subsequently determined microscopically. Yeast adhesion remained constant following addition of phosphate-buffered saline (PBS) at time 0 or at any time thereafter. However, addition of Con A at 0, 10 or 20 minutes of incubation decreased adhesion significantly to 38%, 45% and 63% of control values. This inhibitory effect dwindled as time of incubation prior to lectin addition increased and Con A could not inhibit adhesion significantly after twenty minutes. Results obtained with Con A using live germinated yeasts were similar to those obtained with formalin-killed C. albicans. The other reagents tested failed to decrease adhesion significantly. These included the putative receptor analogues fibronectin, N-acetyl-d-glucosamine and d-galactose, and several non-specific saccharides such as alpha-d-methylglucopyranoside, d-ribose and d-xylose. It is suggested that in vitro attachment to human mucosal cells by C. albicans is inhibitable up to a defined point in time by a lectin with affinity for mannose-containing surface moieties, but becomes non-reversible thereafter. This experimentally-observed irreversibility is independent of yeast cell viability. PMID- 3295558 TI - Career woman! (Henrietta Stockdale). PMID- 3295559 TI - A modern scourge, an ancient history. PMID- 3295560 TI - Nucleoprotein complexes. DNA wrapping and writhing. PMID- 3295561 TI - High resolution X-ray analyses of renin inhibitor-aspartic proteinase complexes. AB - Inhibitors of the conversion of angiotensinogen to the vasoconstrictor angiotensin II have considerable value as antihypertensive agents. For example, captopril and enalapril are clinically useful as inhibitors of angiotensin converting enzyme. This has encouraged intense activity in the development of inhibitors of kidney renin, which is a very specific aspartic proteinase catalysing the first and rate limiting step in the conversion of angiotensinogen to angiotensin II. The most effective inhibitors such as H-142 and L-363,564 have used non-hydrolysable analogues of the proposed transition state, and partial sequences of angiotensinogen (Table 1). H-142 is effective in lowering blood pressure in humans but has no significant effect on other aspartic proteinases such as pepsin in the human body (Table 1). At present there are no crystal structures available for human or mouse renins although three-dimensional models demonstrate close structural similarity to other spartic proteinases. We have therefore determined by X-ray analysis the three-dimensional structures of H-142 and L-363,564 complexed with the aspartic proteinase endothiapepsin, which binds these inhibitors with affinities not greatly different from those measured against human renin (Table 1). The structures of these complexes and of that between endothiapepsin and the general aspartic proteinase inhibitor, H-256 (Table 1) define the common hydrogen bonding schemes that allow subtle differences in side-chain orientations and in the positions of the transition state analogues with respect to the active-site aspartates. PMID- 3295562 TI - A point mutation at codon 13 of the N-ras oncogene in myelodysplastic syndrome. AB - Patients with a myelodysplastic syndrome (MDS) which has a risk of leukaemic change exhibit a variable clinical course. It has been suggested that the development of leukaemia in patients with MDS may be related to chromosomal abnormalities or genetic alterations: somatic mutation of the N-ras gene is now considered to be a critical step in the genetic basis of human leukaemogenesis. Here we report that DNAs of bone-marrow cells from three out of eight patients with MDS contained an activated N-ras oncogene, as detected by an in vivo selection assay in nude mice with transfected NIH 3T3 cells. Molecular analysis revealed the same single nucleotide substitution at codon 13 in all three transforming N-ras genes. Each of the three patients showed a progression of the disease and a resulting leukaemic change within the following year. Our observation of the mutation at codon 13 in leukaemic cell DNAs from all three cases suggests that activation of the N-ras gene is important in the development of leukaemia in some MDS cases. PMID- 3295563 TI - AIDS drug trials to start amid controversy. PMID- 3295564 TI - Gene regulation: specificity and flexibility. PMID- 3295565 TI - [Hypoglycemic agents]. PMID- 3295566 TI - ['Flu' following a visit to the tropics, a pitfall]. PMID- 3295567 TI - [Tropical malaria is no longer simple to prevent]. PMID- 3295568 TI - [Diagnosis of hypertrophic pyloric stenosis using echography]. PMID- 3295569 TI - Ultrasound assessment of umbilical artery and vein blood flow. PMID- 3295570 TI - Cirrhosis and liver echogenicity. PMID- 3295571 TI - Therapy of acute leukaemia in adults. A retrospective study of a non-selected group of 146 patients. PMID- 3295572 TI - Tubuloglomerular feedback in chronic renal failure. PMID- 3295573 TI - [Evaluation of the biological availability of 2 carbamazepine preparations]. AB - The biological availability was determined of two carbamazepine preparations: Amizepin POLFA and Tegretol GEIGY in tablets. The study was carried out in 10 patients giving them the drug in doses of 400 mg by the crossover method at an interval of 3 weeks. The statistical analysis of the mean maximal values, mean times of reaching of maximal concentrations, and mean areas under the curve of serum carbamazepine concentration changes for both forms of the drug showed a comparable biological availability of Amizepin and Tegretol. The relative degree of bioavailability of Amizepin amounted to 98% of that of Tegretol. The values of pharmacokinetic parameters of both drugs were compared. The value of distribution volume was greater in the case of Tegretol, and the difference was statistically significant. No significant differences were found between the remaining calculated parameters. PMID- 3295574 TI - [Writer's cramp syndrome treated successfully by thalamotomy]. AB - In the literature the prevalent until now opinion was that writer's cramp was a disturbance of psychic origin or an occupational neurosis. However, the authors treated successfully three cases of this syndrome with thalamotomy in the years 1976-1982. Two cases were in subject with right-handedness who had graphospasm with evidence of increasing difficulty in writing until complete impossibility of further writing, after several years postural and intentional tremor appeared, and dystonic symptoms developed in the right foot. The third cases had a history of 16 years of writer's cramp and after years symptoms of right-sided dystonia with involuntary movements of the right upper extremity and continuous tics and spams of the facial muscles. After thalamotomy in all cases writer's cramp, tremors and involuntary movements disappeared, writing became again possible and the efficiency of right extremities returned. The described cases of writer's clamp were focal forms of dystonia which became generalized after years. The indications to stereotaxic treatment in these syndromes should be established much earlier. PMID- 3295575 TI - Effect of neonatal gonadectomy on the postnatal development of LHRH cell subtypes in male and female rats. AB - The total number of LHRH cells and the distribution of LHRH cell morphological subtypes (classified as smooth or irregular LHRH cells) was investigated in adult male and female rats that received neonatal gonadectomies using light- and electron-microscopic immunocytochemistry. An identical number of immunoreactive LHRH cells (about 1,200) was observed in both treated and control animals. Both LHRH cell subtypes were present in treated animals, and the total number of each LHRH cell subtype and their distributions were similar to that seen in the control animals. At the EM level, LHRH cell subtypes from gonadectomized animals had similar morphological characteristics as have been described for normal adult rats. Synapses were present on both smooth and irregular LHRH cells of treated animals. These data indicate that the removal of gonadal steroids shortly after birth does not alter the overall LHRH cell number and distribution, nor the development of characteristic LHRH cell morphologies. PMID- 3295576 TI - Vasopressin coexists in half of the corticotropin-releasing factor axons present in the external zone of the median eminence in normal rats. AB - Electron-microscopic immunocytochemistry of serial thin sections showed that, in normal rats, approximately 50% of corticotropin-releasing factor (CRF) axons in the external zone of the median eminence contained vasopressin (AVP) and AVP precursor-derived peptides coexistent in the same secretory vesicles as CRF. The other 50% of the CRF axons contained little or no detectable AVP or AVP precursor derived peptides. Differential activation of these subpopulations of CRF axons could provide a mechanism by which levels of CRF and AVP in portal plasma could be varied independently. PMID- 3295577 TI - Effects of barbiturates on responses evoked by excitatory amino acids in slices of rat olfactory cortex. AB - A study has been made of the effects of ranges of concentrations of phenobarbitone, pentobarbitone and thiopentone on responses evoked by gamma aminobutyric acid (GABA), L-glutamate, L-aspartate, N-methyl-D-aspartate, kainate and quisqualate in slices of olfactory cortex of the rat. All three barbiturates affected GABA-evoked depolarizations similarly in that responses were potentiated by small doses but markedly inhibited at greater concentrations. Responses to L aspartate and L-glutamate were little affected except at the largest dose of phenobarbitone tested (10 mM). The responses evoked by the selective agonists of excitatory amino acid receptors were inhibited by the barbiturates, the relative sensitivities being quisqualate greater than or equal to N-methyl-D-aspartate greater than or equal to kainate with phenobarbitone, quisqualate greater than or equal to kainate greater than N-methyl-D-aspartate with pentobarbitone and quisqualate greater than kainate = N-methyl-D-aspartate with thiopentone. The possible significance of these findings is discussed. PMID- 3295578 TI - Antinociceptive action of cholecystokinin octapeptide (CCK 8) and related peptides in rats and mice: effects of naloxone and peptidase inhibitors. AB - Cholecystokinin octapeptide (CCK 8) produced significant antinociception in the tail immersion test in the rat, paw pressure test in the rat and acetylcholine induced writhing test in the mouse after subcutaneous (s.c.) administration. In the hot plate test, CCK 8 (s.c.) showed antinociceptive activity if the latency to lick was used as the end point but if the latency to jump was recorded the antinociceptive effects were not evident. Cholecystokinin tetrapeptide (CCK 4) was shown to be antinociceptive in the writhing but not in the hot plate test after subcutaneous administration and appeared to be less potent than CCK 8 when tested under the same conditions. Antinociception induced by CCK 8 in the hot plate test (lick) could also be demonstrated after direct intracerebroventricular (i.c.v.) injection and this observation was also made with the CCK-related peptide FMRF amide. Antinociception induced by CCK 8 (which did not appear to be associated with reduced locomotor activity) was evident 5 min after intraventricular injection and was maximal at 10 min, the effect lasting over a 30-45 min period. The antinociceptive effect of CCK 8 was antagonised by naloxone and was potentiated by simultaneous administration of the peptidase inhibitors bestatin, thiorphan and captopril. PMID- 3295580 TI - Magnetic resonance imaging and intraoperative neurosonography in syringomyelia. AB - Treatment of syringomyelia remains a difficult and controversial problem. However, the recent advent of magnetic resonance imaging (MRI) and intraoperative ultrasound allows a more precise approach to the diagnosis and management of this disorder. Experience with 27 cases of syringomyelia has shown that MRI is superior to all other forms of diagnostic imaging for the exact anatomical delineation of syrinxes and other spinal cavities. One-third of the syrinxes demonstrated by MRI were either not adequately visualized or missed by myelography and/or computed tomographic scanning. Intraoperative ultrasound has been used to allow more precise operative approaches to the syrinx as well as to guide the exact placement of shunt tubes into syrinx cavities. A method has also been developed to allow intraoperative ultrasound of the spinal cord with patients in the sitting position. PMID- 3295579 TI - Sensitivity of neuronal dopamine response in the substantia nigra and ventral tegmentum to clozapine, metoclopramide and SCH 23390. AB - The activity of neurones in the substantial nigra and ventral tegmentum was recorded extracellularly in vitro. Dopamine produced depression of spontaneous firing in a dose-dependent manner. Antagonism of these neuronal responses to dopamine by metoclopramide, SCH 23390 and clozapine was examined. Metoclopramide antagonised the responses to dopamine in the manner expected; SCH 23390 had little effect on the response to dopamine as would be predicted for a selective dopamine "D1" antagonist. Clozapine did not produce the expected antagonism of the response to dopamine. The results at the single neurone level are compared with behavioural and biochemical data. PMID- 3295581 TI - External spinal orthotics. AB - A great variety of spinal orthoses are available to neurological surgeons involved in the evaluation and management of spinal disorders. Each of the orthoses has certain advantages and disadvantages, and enough information about the biomechanical principles of spinal instability and spinal orthoses exists to make possible rational application of the appropriate orthosis. Based on this information, recommendations have been formulated for selecting the proper orthosis for the control of each spinal region, depending on the results sought through the use of an external orthosis. PMID- 3295582 TI - Creativity in neurosurgical publications. AB - The publications of 50 of the first American neurosurgeons were studied, and a citation analysis was done for the period 1965 through 1979. Because creative authors and their papers influence the scholarship and technical course of a discipline such as neurosurgery, the number of citations to an author or publication is a good measure of creativity (the production of original ideas that are lasting and eminent). The 10 authors who had the largest number of citations of papers, chapters, and books were Penfield (3228), Cushing (2588), Dandy (1732), Bailey (1061), White (968), Matson (932), Ingraham (651), Scoville (604), Davidoff (540), and Elsberg (414). The most cited book was Epilepsy and the Functional Anatomy of the Human Brain, by Penfield and Jasper, and the most cited paper was Scoville and Milner's "Loss of recent memory after bilateral hippocampal lesions." Authors who wrote more papers were found to have a greater total number of citations for these papers, but did not average more citations per paper than less productive colleagues. Neurosurgeons with research experience were more productive but not more creative than were more clinically oriented authors. The 5-year creative peak of 7 of the 10 most creative neurosurgeons occurred after the age of 50. The subjects on which the 50 neurosurgeons wrote the most papers were central nervous system tumors, trauma, and the basic neurosciences; these subjects also were cited most frequently. The proximity of the date of publication to the period of citation analysis resulted in a moderately better chance of a paper being cited, but more recent papers did not average more total citations. PMID- 3295583 TI - Use of endogenous event-related potentials (ERP) in the evaluation of psychotropic substances: towards an ERP profile of drug effects. AB - Although endogenous event-related potentials (ERPs) have been successfully used in psychology, they have largely been neglected in the study of psychotropic substances. In the present paper an overview is given of the diversified concepts of ERP research and useful adaptations of these approaches to psychopharmacological questions are shown. In particular, the influence of drugs on the various stages of information processing and the description of individual differences in drug reactions seem suitable for the use of endogenous ERPs. Other possible uses of ERPs in psychopharmacological research are briefly discussed and the problems of the technique are pointed out. It is concluded that future research should aim at the recording of 'ERP profiles' of a drug, monitoring pharmacological effects on the different levels of cognitive functions by a set of selected paradigms. PMID- 3295584 TI - Iohexol 300 mg I/ml versus Iopamidol 300 mg I/ml for cervical myelography double blind trial. PMID- 3295585 TI - The nuclei of origin of brainstem enkephalin and cholecystokinin projections to the spinal trigeminal nucleus of the rat. AB - The sites of origin of brain stem enkephalin and cholecystokinin projections to the rodent spinal trigeminal nucleus were studied utilizing the combined retrograde transport-peroxidase antiperoxidase immunohistochemical technique. Several brain stem areas were found to contain enkephalin-like immunoreactive double-labeled neurons following injection of wheat germ agglutinin-horseradish peroxidase or horseradish peroxidase into the spinal trigeminal nucleus. The largest numbers of enkephalin double-labeled neurons were identified in the nucleus pontis oralis, nucleus raphe medianis, medial vestibular nucleus and the midbrain periaqueductal gray. Enkephalin projections to the spinal trigeminal nucleus were also found to originate from the nucleus solitarius, nucleus raphe pallidus, nucleus raphe magnus, nucleus raphe dorsalis, nucleus reticularis paragigantocellularis, nucleus reticularis gigantocellularis pars alpha and the deep mesencephalic nucleus. In contrast to the numerous sources of enkephalin input to the spinal trigeminal nucleus, cholecystokinin projections to this region were limited to four brain stem nuclei. These included the nucleus solitarius, raphe obscurus, nucleus paragigantocellularis and the ventral reticular nucleus of the medulla. The finding that only a small number of brain stem cholecystokinin-like immunoreactive neurons project to the spinal trigeminal nucleus supports the hypothesis that most of the cholecystokinin input to the spinal trigeminal nucleus arises from primary afferent trigeminal fibers. The spinal trigeminal nucleus is known to play a role in processing sensory information and in the transmission of orofacial nociception. The present study identifies several brain stem sites which provide enkephalin and/or cholecystokinin input to the spinal trigeminal nucleus. Several of these nuclei have been implicated as components of the endogenous pain control system and the present results raise the possibility that they may modulate incoming orofacial nociception by releasing the endogenous opioid, enkephalin. Cholecystokinin, on the other hand, has been demonstrated in other studies to attenuate the action of opiates and thus may play an opposing role in the spinal trigeminal nucleus. PMID- 3295586 TI - Behavioural, biochemical and histochemical effects of different neurotoxic amino acids injected into nucleus basalis magnocellularis of rats. AB - Lesions of the nucleus basalis magnocellularis in rats have been used to investigate functions of the extrinsic cortical cholinergic system which originates from these neurons. These lesions also produce extensive non-specific subcortical damage and associated regulatory and neurological impairments, causing doubt about the specificity of consequent functional impairments. Here, nucleus basalis magnocellularis lesions made with four different neurotoxic amino acids (kainic acid, ibotenic acid, N-methyl-D-aspartate, and quisqualic acid) have been compared. Quisqualic acid produced less subcortical damage and lesser neurological and regulatory impairments than the other toxins at doses that produced comparable cholinergic deafferentation of the neocortex, as assessed both histologically and biochemically. This suggests that these impairments are non-specific rather than specific consequences of cholinergic cell loss. The effects on learning a spatial navigation task were more ambiguous, suggesting the involvement of both cholinergic and non-cholinergic systems. Impairment of a passive shock avoidance task was as great following quisqualic acid as the other neurotoxins, which may suggest a more direct relationship specifically with the decline in cortical cholinergic activity. It is concluded that in the absence of availability of a specific cholinergic neurotoxin, quisqualic acid produces less non-specific neuroanatomical and neurological side effects than the more widely used toxins N-methyl-D-aspartate, kainic acid or ibotenic acid. PMID- 3295588 TI - Charcot at the Salpetriere: ambulatory automatisms. AB - Jean-Martin Charcot, as professor of neurology at the Salpetriere Hospital in Paris, delivered a series of dialogue case presentations on general neurology in 1887-1889. These cases, never before translated into English, provide a first hand view of Charcot's renowned teaching method and his opinions on many neurologic topics. One patient with bizarre ambulatory spells probably representing absence status was recognized by Charcot as an epileptic. This otherwise healthy young man, without a history of generalized epilepsy or hysteria, experienced multiple spells during which he suddenly became unaware of his surroundings, rambled throughout Paris and its outskirts, and had complex interactions with other people. As Charcot unraveled the diagnostic mystery, he traced the patient's wanderings and analyzed the differential diagnosis, treatment, and pathophysiology of these intermittent spells. PMID- 3295587 TI - Convulsant action of morphine, [D-Ala2, D-Leu5]-enkephalin and naloxone in the rat amygdala: electroencephalographic, morphological and behavioural sequelae. AB - Morphine hydrochloride (25-200 nmol), [D-Ala2, D-Leu5]enkephalin (10-200 nmol) and naloxone hydrochloride (100-1000 nmol) were injected unilaterally into the rat amygdala and the following electrographic, behavioural and neuropathological responses were studied. Microinjections of low doses of morphine (25-50 nmol) resulted in behavioural alterations characterized by staring, gustatory automatisms and wet shakes, whereas higher doses additionally produced motor limbic seizures and status epilepticus. The first changes in the electroencephalogram appeared in the amygdala immediately after the administration of morphine and rapidly spread to hippocampal and cortical areas. Electrographic alterations consisted of high voltage fast activity, spiking, bursts of polyspiking, electrographic seizures and periods of postictal depression. Neuropathological analysis of frontal forebrain sections by means of light microscopy revealed widespread, seizure-related damage confined to amygdala, olfactory cortex, thalamus, hippocampal formation, neocortex and substantia nigra. Pretreatment of animals with naloxone, 2-20 mg/kg s.c., as well as simultaneous microinjection of the non-convulsant dose of naloxone, 100 nmol, with morphine, 100 nmol, into the amygdala failed to block the development of convulsant activity and seizure-related brain damage produced by the opiate. In contrast, diazepam, 10 mg/kg i.p., when administered prior to the microinjection of morphine into the amygdala, abolished the epileptogenic effects of the drug. [D-Ala2, D-Leu5]Enkephalin, 10-200 nmol, elicited electrographic and behavioural responses similar to those seen after low doses of morphine, when administered into the amygdala. High voltage fast activity, single spikes, bursts of polyspiking, electrographic seizures and periods of postictal depression were seen in the electroencephalogram, but no behavioural signs of motor limbic seizures could be detected. The only behavioural correlates of epileptiform electrographic activity were wet shakes, myoclonic head twiches and gustatory automatisms. The examination of frontal forebrain sections from rats receiving [D Ala2, D-Leu5]enkephalin revealed no morphological changes. Pretreatment of rats with either naloxone, 2 mg/kg, or diazepam, 10 mg/kg, blocked the development of behavioural and electrographic sequelae of the peptide. Naloxone, 100-1000 nmol, when microinjected into the amygdala, produced electrographic, behavioural and morphological alterations resembling those seen after high doses of morphine.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3295589 TI - The epidemiology of Creutzfeldt-Jakob disease: conclusion of a 15-year investigation in France and review of the world literature. AB - During the 15-year period 1968-1982, a total of 329 patients dying of Creutzfeldt Jakob disease (CJD) were identified in continental France. Annual mortality rates stabilized at 0.5 to 0.6 cases per million (1.1 to 1.2 cases per million in Paris). Six percent of cases were familial. Although the frequency of CJD was related to population density, no contacts could be established among the great majority of patients. No association with socioeconomic factors, preceding trauma or surgery (excepting one iatrogenic neurosurgical case), or exposure to animal sources of infection was identified. Evidence from this and other epidemiologic studies suggests that CJD is a minimally contagious disease that may be principally acquired in early life from presymptomatic patients, asymptomatic carriers, or chance contamination by environmental sources. It is possible that CJD could also occur sporadically as a noncontagious disease by a mechanism akin to oncogenes in carcinogenesis. PMID- 3295590 TI - A controlled study of progabide in partial seizures: methodology and results. AB - The results of a multicenter, double-blind, placebo-controlled clinical trial of the efficacy and safety of progabide (PGB) in the treatment of partial seizures are presented. This study was performed with a number of rigorous controls not usually present in clinical trials. These included uniform co-medication in which all patients received only phenytoin and carbamazepine; concentrations of these two drugs were maintained within narrow, predefined concentration ranges. There was no statistically significant difference between PGB and placebo in seizure frequency and seizure duration for most of the analyses performed. One patient was withdrawn from the study because of hepatotoxicity. PGB was associated with a significant inhibition of phenytoin but not carbamazepine clearance. The results of this study indicate that PGB was not a potent antiepileptic drug in this population of persons with intractable epilepsy. PMID- 3295591 TI - [Transmissible spongiform encephalopathy. Natural diseases and experimental studies]. PMID- 3295592 TI - [Hiatal hernia. Clinical considerations and results of our adopted surgical technic]. PMID- 3295594 TI - [Ultrasonics in the study of latero-cervical metastasis of head and neck tumors]. PMID- 3295593 TI - [Erosion and intragastric migration of Angelchik's prosthesis. Presentation of a clinical case]. PMID- 3295595 TI - [Evaluation of the clinical effectiveness of tiropramide in various functional syndromes of the digestive track]. PMID- 3295596 TI - [Effect of dietary fiber (guar gum) on post-prandial blood glucose and blood insulin metabolism in the morning]. PMID- 3295597 TI - [Therapy of the hepatorenal syndrome]. PMID- 3295598 TI - [Evaluation of the delayed hypersensitivity response by the Multitest-IMC. Multicenter study for the definition of reference values in a sample population]. AB - The latest investigations in the field of clinical immunology have proposed ways of assessing immunological efficiency that have also been used to identify patients most susceptible to infectious complications. The assessment of delayed hypersensitivity response (DHR) using anamnestic antigens is currently the most common method. The results of a polycentric study are presented. The study was conducted on a group of healthy subjects from various Italian regions divided into three age classes. Positive responses to the MT were noted in 96.4% of the population studied. The incidence of energy was statistically higher among females than males, while the mean response to the MT expressed in millimetres was statistically higher in males. Though 7 antigens were administered, the responsive population reacted on average to 3. The highest incidence of positive responses was to Candida, with Trichophyton responsible for the fewest. PMID- 3295599 TI - [Prevention of deep venous thrombosis with defibrotide in chest surgery. Controlled multicenter study versus heparin]. AB - The effectiveness and tolerability of defibrotide in the prevention of post surgery deep vein thrombosis (DVT) were compared with those of heparin in a multicentric randomized controlled study. One hundred-eight-four both sexes patients submitted to thoracic surgery were randomly allocated to defibrotide (400 mg b.i.d. by IV route, n = 94) or to calcium heparin (5000 I.U. t.i.d. s.c., n = 90); both treatments were started the day before the operation and withdrawn when patients were allowed to stand up (i.e., after 7 days). No patients developed DVT in the defibrotide group, while a single case of DVT was detected in the heparin group; furthermore, a more prominent bleeding was observed in the latter, in the early post-operative period (normal bleeding: 2nd day: defibrotide 70/92 pts, heparin 53/90 pts, p less than 0.02; 3rd day: defibrotide 87/92 pts, heparin 76/90 pts, p less than 0.05, chi 2 test), while the healing rate of surgical wounds was similar in the two groups. No relevant modifications in laboratory parameters were seen throughout the observation period. Thus, these preliminary data suggest that defibrotide is at least as effective as heparin in the prevention of post-thoracic surgery DVT and that the former drug has a possibly better tolerability profile, due to a lesser tendency to bleeding. PMID- 3295600 TI - Urotensin I-like immunoreactivity in amacrine cells of the goldfish retina. AB - Urotensin I-like immunoreactivity (UILI), in different localization from that of corticotropin releasing factor-like immunoreactivity (CRFLI), in the goldfish retina has been demonstrated by means of radioimmunoassay, high-performance liquid chromatography (HPLC) and immunohistochemistry. Radioimmunoassay showed 350 +/- 40 pg/mg prot. of UILI in goldfish retina extracts. The immunoreactive material present in the retina was also characterized by reversed phase HPLC. Some of the UILI co-eluted with synthetic carp UI, though the HPLC experiments suggested the existence of other UILI substance(s) with less hydrophobicity than synthetic UI. By immunohistochemistry, UILI and CRFLI were seen in different amacrine cells of the goldfish retina. It is suggested that UI may be involved in the fish visual transmission system together with CRF and other neuropeptides. PMID- 3295601 TI - Evidence for the existence of ornithine decarboxylase-immunoreactive neurons in the rat brain. AB - By means of polyclonal antibodies against purified mouse kidney ornithine decarboxylase (ODC) and using the biotin-avidin immunoperoxidase procedure in combination with image analysis the cellular localization and distribution of ODC immunoreactivity (ODC IR) have been demonstrated in the rat brain. ODC IR was located in a large number of neuronal populations. A nuclear ODC IR was always present but in many neurons also a cytoplasmic localization of ODC IR was demonstrated (dendrites, axons and putative terminals). Based on the present findings central neurons may be mapped out not only on the basis of their transmitter contents but also on the basis of their contents of trophic factors. PMID- 3295602 TI - Monoaminergic fibers form conventional synapses in the cerebral cortex. AB - The morphological characteristics of the monoaminergic axon-terminals in the mammalian cerebral cortex have been the subject of controversy in recent years. Systematic analysis of serial ultrathin sections, immunocytochemically stained with antibodies against noradrenaline and serotonin, has shown that nearly all stained terminals form synapses characterized by specialized junctional appositions. These results suggest that, contrary to the widely held view, monoamines in the cortex are released at specialized junctions. PMID- 3295603 TI - Systemic administration of MK-801 prevents N-methyl-D-aspartate-induced neuronal degeneration in rat brain. AB - MK-801 is a novel, potent and selective non-competitive antagonist of the N methyl-D-aspartate (NMDA) subtype of excitatory amino acid receptors. Pretreatment of rats with MK-801 (1-10 mg/kg, i.p.) prevented neuronal degeneration in the hippocampus and striatum caused by direct intracranial injections of NMDA (20-120 nmol), but did not protect against the loss of neurones induced by kainate (2.5 nmol) injected into the striatum. Thus, MK-801 is a selective antagonist of neuronal degeneration caused by excessive stimulation of NMDA receptors in vivo. PMID- 3295604 TI - Advances in cancer: monoclonal antibody therapy of hematologic malignancies. PMID- 3295605 TI - Nutrition classics. Archives of Internal Medicine, Volume 64, October 1939: Angina pectoris in hereditary xanthomatosis. By Carl Muller. PMID- 3295606 TI - Polycystic kidney disease: a case study. PMID- 3295607 TI - Chronic renal failure: a personal account of life before and after transplantation. Interview by Susan M Goodinson. PMID- 3295608 TI - The role of building construction and ventilation in indoor air pollution. Review of a recurring problem. PMID- 3295609 TI - Arthur Donaldson Smith, MD. Physician, explorer, naturalist, and diplomat--Part III. PMID- 3295610 TI - Chemical perspectives in the design of a pediatric meningitis vaccine. PMID- 3295611 TI - Fatal hemoptysis in a patient with AIDS-related complex and pulmonary aspergilloma. PMID- 3295612 TI - On the cariogenicity of lactose. PMID- 3295613 TI - Luteal phase defects. PMID- 3295614 TI - Seat belts in pregnancy and the obstetrician. PMID- 3295615 TI - Infections and male fertility. PMID- 3295616 TI - [Biological and clinical aspects of crystalline lens regeneration]. PMID- 3295617 TI - [Lamellar transplantation of balsam-preserved corneas]. PMID- 3295618 TI - Oscar Wilde in Ohio. PMID- 3295619 TI - High-dose cytosine arabinoside and mitoxantrone (HAM) for the treatment of refractory acute lymphoblastic leukemia. AB - In a clinical phase-II study 11 patients with refractory ALL were treated with high-dose AraC and mitoxantrone in combination (HAM). Refractoriness was defined as: 1. primary resistance against the BMFT induction protocol; 2. first relapse with non-response to the B-ALL/NHL regimen as salvage treatment; 3. second and subsequent relapses. Therapy consisted of HD-AraC 3 g/m2 every 12 h by a 3-h infusion on days 1-4 and mitoxantrone 10 mg/m2/d on days 2-6. Seven of the 11 patients achieved a complete remission, 1 patient was refractory against 2 HAM cycles and 3 patients died during bone marrow aplasia. Toxicity was acceptable, consisting mainly of nausea and vomiting, mucositis and diarrhea. One patient who had completed the prophylactic CNS treatment with intrathecal MTX and cranial irradiation immediately before entering the HAM protocol developed severe signs of cerebral toxicity. These data indicate a significant activity of HAM in refractory ALL and suggest that the combination should be applied at earlier stages of ALL treatment. PMID- 3295620 TI - [Alternatives and further development of therapy of acute myeloid leukemia in adults. Update of West German multicenter studies]. AB - The 1982 randomized, multicenter trial on adult-AML in West Germany revealed a superiority of remission duration (p = 0.004) and survival (p = 0.06) for patients receiving monthly myelosuppressive maintenance chemotherapy after TAD9 induction and consolidation as compared to patients without maintenance. In the 1985 pilot study double induction as a new approach followed by consolidation and monthly maintenance in patients up to 60 years of age was found well practicable, with 77% complete remissions and 12% early deaths in 81 patients. In addition preliminary remission duration and survival at 1 1/2 years appear favorable. PMID- 3295621 TI - Combined chemotherapy with m-amsacrine in high-risk patients with acute non lymphocytic leukemia. AB - Thirteen patients (7 male, 9 female) aged 22-71 years (means = 55 years) with acute non-lymphocytic leukemia and contraindications for anthracyclin therapy were treated with combined chemotherapy using m-amsacrine primarily or in relapse. The main reasons for avoiding cardiotoxic substances were overt cardiac insufficiency and former administration of daunorubicin with more than 540 mg/m2 body surface area. Amsacrine was combined with 6-thioguanine, VP 16-213 and cytosine arabinoside in conventional or high dosage. Eight out of 13 patients (62%) achieved complete remission after one or two courses of chemotherapy. One patient showed partial remission and could be brought into complete remission with another chemotherapy using high-dose ara-C and mitoxantrone. Three patients died in aplasia after chemotherapy and 1 other patient had to be regarded as a complete non-responder. Remission duration and survival time for the 8 successfully-treated patients so far is 1-12 months; however, medians have not yet been reached, since only one of the eight patients relapsed after 6 months of complete remission. These data indicate a high efficacy of m-amsacrine in combined chemotherapy for acute non-lymphocytic leukemia in high-risk patients with contraindications for anthracyclins. PMID- 3295622 TI - [High dosage ARA-C in combination with mitoxantrone in therapy of acute myeloid leukemia in childhood. Initial results of the AML BFM-85 recurrence study]. AB - 19 children with AML were treated using the combination of high dose cytosine arabinoside and mitoxantrone. All children were initially treated according to protocol AML-BFM-83. 6 children with refractory AML, 9 children with bone-marrow relapse during or after maintenance therapy and 4 children with residual blasts (5-25%) after remission induction and consolidation therapy AML-BFM 83 were treated with the relapse protocol. 6 of 15 children with refractory AML and all 4 children with residual blasts achieved a complete remission. 2 children died in bone-marrow aplasia and 1 child did not respond. One child died after further mitoxantrone treatment due to toxic cardiomyopathy. All children went into severe bone marrow aplasia, which lasted in median 27 days. These data indicate a high antileukemic activity of HD-ARA C/mitoxantrone in childhood AML. PMID- 3295625 TI - [Primary treatment of hairy cell leukemia with low-dose human recombinant interferon-alpha-2c (Hr-IFn alpha 2c) in comparison with therapy following splenectomy. Interferon (IFn-alpha 2c) in HCL before or after splenectomy]. AB - Within less than 14 months of recruitment 32 centers enrolled 97 patients in a multicenter trial for low-dose treatment of hairy cell leukemia (1.2 X 10(6) IU/m2 X 28 days s.c. with dose reduction according to clinically judged improvement) or ultra-low dose treatment (1.2 X 10(5) IU/m2, s.c. daily increasing to a well-tolerated dose) with Hr IFn-2c (arg). Induction therapy was limited to 84 days. Patients who reached the clinical stage Jansen I or A were then randomized to 2 arms either to receive further IFn (1.2 X 10(6) IU/m2 s.c.) twice a week or to be taken off treatment. For both arms induction therapy was reinstituted whenever a patient lost the criteria of Jansen stage A or I. The study included obligatory central diagnostic procedures and several special investigations. During the first year of the study a special problem evolved in the group of 34 patients with recurrent disease after splenectomy. Ten of them died, 9 of septicemia and 1 of bleeding complications, whereas only 1 death occurred in those patients who received IFn before splenectomy. The risk factors and the response to therapy in the two groups will be analyzed in order to define the criteria that will be needed for the proper choice of primary treatment for HCL. It appears important to us to restrict splenectomy to selected patients. PMID- 3295623 TI - [Prospective controlled study of therapy of chronic myeloid leukemia (CML)]. AB - The current status of the prospective German multicenter study on the therapy of chronic myelogenous leukemia (CML) is reported. After three years 188 of the projected 300 patients have been randomized. The duration of the study will be 8 years. The clinical characteristics of the randomized patients correspond well to those reported in the literature. Risk factors are distributed equally in both arms. One problem is the relatively high drop-out rate of about 12% thus far. Survival curves for the two treatment arms will be presented, although at present the number of patients having reached the end of the chronic phase is too small to allow definitive evaluation. PMID- 3295624 TI - [Multicenter study of the treatment of highly malignant non-Hodgkin's lymphomas with polychemotherapy (CHOPV) and irradiation]. AB - In a multicenter study 46 untreated patients with highly-malignant non-Hodgkin's lymphomas stage II-IV received 6 courses of the following drug combination: cyclophosphamide 750 mg/m2 i.v. day 1, adriamycin 50 mg/m2 i.v. day 1, vincristine 2 mg i.v. day 1, prednisolone 100 mg p.o. days 1-5, and etoposide 100 mg/m2 i.v. days 3-5. Between courses 4 and 5 an involved field irradiation with a total dose of 25 Gy was employed. The overall response rate was 91%, with 38 patients achieving a complete remission (82%), 4 patients achieving a partial remission (9%), and 4 patients showing no response (9%). During a median follow up period of 34 months 16 out of 38 patients relapsed, 4 of them achieving a second complete remission with the same drug regimen. A maintained complete remission up to 52 months was seen in 51% of all patients initially achieving CR. The overall survival curve shows a plateau at 60% at 30 months, while disease free survival shows a plateau at 51% at 36 months. Mean side effects of this drug regimen were alopecia (89%), nausea/vomiting (76%), and leukopenia (61%). No therapy-related deaths were reported. The results of this study demonstrate that this treatment produces high complete remission rates and that the majority of these patients achieves long-term disease-free survival. PMID- 3295626 TI - Interferon alpha in the treatment of AIDS-associated Kaposi's sarcoma. AB - Twenty-three patients with biopsy-proven Kaposi's sarcoma and HIV infection were treated with recombinant interferon-alpha-2a (Roferon-A). Two dosage regimens were used: 21 patients received 18 X 10(6) units intramuscularly per day for 3 months, followed by injections of 18 X 10(6) units three times a week. The remaining 2 patients were treated with 2 X 18 X 10(6) units i.m. per day for 3 months. Three patients either refused further treatment or were lost to follow-up within the first few weeks. Thus, a median observation period of 7.5 months (range 1.5-17) was available for 20 patients. Within the first 3 months, 6 patients (30%) responded to treatment, 6 patients (30%) showed no progression, whereas in 8 cases (40%) progressive disease was noted. A similar rate of responders versus nonresponders was found after 6 months of observation. In progressive disease, interferon could be effectively combined with cytostatic drugs. Dose-dependent neurological and hematological side effects were observed in a few patients only. Opportunistic infections were diagnosed in 12 patients with a median onset of 6 months (range 1-10) after start of interferon treatment. The total number of lymphocytes expressing the CD4 antigen or the ratio of CD4 to CD8 positive cells were of prognostic value. These data suggest that interferon alpha is an active agent in the treatment of Kaposi's sarcoma, that it shows tolerable side effects and can be combined effectively with cytostatic drugs in case of progression. PMID- 3295627 TI - Phase-I study of intraperitoneal mitoxantrone--clinical and pharmacokinetic evaluation. AB - Mitoxantrone, a recent anthracenedione derivative is a potentially useful drug for direct intraperitoneal (i.p.) application because of its high tissue-binding and therapeutic index. We have carried out studies to establish maximum tolerated doses as well as pharmacokinetic studies with i.p. mitoxantrone in 21 patients (5 male, 16 female) with gastrointestinal (9), ovarian (6), unknown (2) and other (4) primary cancers and peritoneal carcinomatosis. Increasing doses (10-40 mg/m2) were given i.p. every 4 weeks. Five partial remissions (2-8+ months) and 7 stable disease courses (2-6+ months) were achieved. A reduction or disappearance of ascites was seen in an additional 3 patients. Severe toxicity (leukopenia) was observed in 4 patients only after 35 mg/m2 and 40 mg/m2 i.p. Pharmacokinetic analysis using high-performance liquid chromatography yielded the following data: The mean ratio of area under curve peritoneal fluid to serum was 1,108. The peritoneal clearance ranged from 2 ml/min to 9,617 ml/min and the disappearance half-life from 0.6-28.9 h. Mean urinary excretion within 24 h was 0.42% of the i.p. dose. These data indicate that mitoxantrone is sequestered in the intraperitoneal tissue compartment and only slowly released. Based on the outcome of this phase-I study we recommend phase-II studies at a dose of 30 mg/m2 i.p., repeated every 3-4 weeks. PMID- 3295628 TI - Chemoprophylaxis of bacterial infections in granulocytopenic patients with ciprofloxacin. AB - The trial was conducted to evaluate the antimicrobial prophylactic efficacy of ciprofloxacin in reducing the frequency of infections in granulocytopenic patients. The frequency of infections was evaluated in 34 patients with acute non lymphoblastic leukemia, acute lymphoblastic leukemia, blast crisis of chronic myelogenous leukemia and other malignancies. 46 courses of oral prophylactic treatment with 500 mg ciprofloxacin twice daily were administered. While there was no infection in 61% of treatment courses, fever over 38 degrees C (axillary) occurred in 39%. 6 patients had a fungal pulmonary infection, one patient a supposed viral pneumonia, and only two patients had a documented bacterial infection. There were no severe side effects. We conclude that ciprofloxacin is a potent drug in prophylaxis of bacterial infections in cancer patients with therapy-induced granulocytopenia. PMID- 3295629 TI - [Value of rapid biopsy studies in the intraoperative assessment of axillary lymph node involvement in breast cancer]. AB - In a prospective, randomized trial in breast-cancer patients, the surgical procedure and the adjuvant regimen were determined intraoperatively, depending on the axillary lymph node involvement. Therefore, it was necessary to perform frozen section examinations on axillary lymph nodes. In this context it was important to analyze the value of the frozen section technique of lymph nodes in predicting axillary node involvement. In 162 patients with primary breast cancer we compared the results of the frozen sections and the paraffin histology. In 96% the intraoperative diagnosis was correct and in 4% (7 cases) the results were wrong. In 6 cases we observed a sampling error and in one case a small metastasis was misinterpreted as sinus histiocytosis. In these 7 cases less than 4 lymph nodes were examined in frozen sections and the total axillary node involvement was small (less than 4 involved nodes). There was no false positive report in this series. We conclude that frozen section examinations of axillary lymph nodes are suitable for intraoperative lymph node assessment, if at least 4 of the macroscopically most suspicious lymph nodes are observed. The final histological axillary staging (number of involved lymph nodes) has to be performed on paraffin embedded material. PMID- 3295630 TI - [Nuclear receptors in estrogen receptor negative tumors with progesterone receptors]. AB - The nuclear estrogen receptors ERn were determined in 12 carcinomas whose cytoplasm contained progesterone receptors PRc but no estrogen receptors ERc. ERn were found in 9 of the tumors. Their concentration correlated to those of PRc and reached a mean of only 20% of the ERn concentrations found in ERc+/PRc + carcinomas. These results suggest that in carcinomas of the ERc-/PRc+-type, originally present cytoplasmic estrogen receptors induce the synthesis of progesterone receptors in a concentration corresponding to that of the nuclear receptors, following translocation by endogenous estradiol in the nucleus. PMID- 3295631 TI - [Combined intraductal and percutaneous radiotherapy of malignant bile duct obstruction with subsequent prosthetic management]. AB - Radiotherapy of the inoperable malignant bile duct obstruction is performed to prolong the survival time in comparison to the palliative drainage. The preferable method is a combination of intracavitary irradiation via a percutaneous transhepatic drainage (30-40 Gy at a distance of 1 cm) and a moving field technique (30-40 Gy). This combination allows a high local tumor dose and a relatively large treatment volume. After radiotherapy, the PTD is being exchanged by a large-bore biliodigestive prosthesis. PMID- 3295632 TI - [I. I. Shmal'gauzen's concept of the evolution of ontogeny]. AB - The concept of evolution of ontogenesis by I. I. Shmal'gauzen is presented as a result of reviewing some of his theoretical works. This concept appears to be the most consistent development of classical darwinism on the basis of a basically new (as compared with synthetic theory of evolution) evolutionary-synthetic approach. This latter has been based on the idea of the organism integrity in onto- and phylogenesis and the involvement of the organismic level (ontogenesis), together with the population and biocoenotic ones, in the evolutionary process as a whole. PMID- 3295633 TI - Proliferative sickle cell retinopathy: the disease and a review of its management. PMID- 3295634 TI - Antibiotic resistance of crystalline bacterial ingrowth in a corneal graft. AB - Four recent reports have described the clinical appearance of fine needle-like opacities in the corneal stroma of six patients. In five of these patients these developed in a corneal graft. Histologically, all the corneal buttons had bacterial ingrowth between the stromal lamellae, with a striking lack of inflammatory response. We report a patient in whom this process occurred following penetrating keratoplasty. Intensive topical antibiotic treatment failed, and she underwent a second, successful, penetrating keratoplasty. Postoperatively, this patient has maintained good vision with no recurrence for over three years. Histologic and ultrastructural study of the corneal button revealed viable and nonviable gram-positive cocci with a marked paucity of inflammatory infiltrate. PMID- 3295636 TI - Intraoperative adjustment of muscles in strabismus surgery. PMID- 3295635 TI - Combined penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber intraocular lens implantation. AB - We reviewed 22 cases of triple procedure in the last two years at our institution. Six months postoperatively 21 of the 22 transplanted corneas were clear. One graft for herpetic corneal scarring failed. Best corrected visual acuity was 20/40 or better in 14 patients. The average refractive error was--1.31 +/- 2.30 diopters. Refractive astigmatism was 4 diopters or less in 80% of patients. These results, which compare favorably with previous series, indicate the efficacy and safety of this procedure. PMID- 3295638 TI - Studies of ocular retinoblastomas with immunoperoxidase techniques. AB - 15 cases of ocular retinoblastomas, 10 differentiated and 5 undifferentiated, were studied with the following antibodies: neuron-specific enolase, S100, and tubulin. All cases turned out negative with S100 and tubulin labeling. The well differentiated retinoblastomas were NSE-positive, and only 2 of the 5 undifferentiated retinoblastomas were positive for the same antibody. The observed results let us conclude that S100 and tubulin are not useful in diagnosing this entity and that enolase, although it showed its value in the differentiated retinoblastomas, did not have the same effect in the undifferentiated retinoblastomas, as it was negative in 3 out of 5 cases. PMID- 3295637 TI - Contrast echography of the eye and orbit. AB - SH U 454 is a new echocontrast agent which was developed primarily for echocardiography. It seems that there is a further potential in ophthalmic ultrasound diagnostics. SH U 454 produces contrast enhancement in the orbit, choroid and ciliary body, and permits determination of intraocular blood flow parameters in dogs' eyes. The effects are measured with digital picture processing techniques. PMID- 3295639 TI - Constitutional karyotypes in retinoblastoma. AB - The improvement of chromosome banding techniques has much increased the frequency of detected forms of retinoblastoma. Ten rearrangements involving 13q14 were observed in a series of 105 retinoblastoma patients including: five de novo deletions, one of them with suspected mosaicism; one de novo apparently balanced translocation; four deletions due to three familial insertions. Such a mechanism could account for pedigrees showing transmission of the tumor through unaffected carriers. Apparently unrelated rearrangements were also observed. Clinical aspects of these constitutional rearrangements are briefly discussed. Comparison with the literature data is presented. PMID- 3295640 TI - Retinoblastoma, chromosome abnormalities and oncogene expression. AB - Recurrent chromosomal abnormalities in retinoblastomas involve numbers 13, 1, and 6, as well as homogeneously staining regions (HSR) and double minutes (DMS). Evidence suggesting that chromosome 13 contains a gene responsible for tumorigenesis has already been presented. We postulate that the genetic changes resulting from abnormalities of chromosomes 1 and 6 and the HSR/DMS provide a selective growth advantage to cells in which they occur. Support for this hypothesis, as it relates to the HSR/DMS and oncogene amplification, is discussed. PMID- 3295641 TI - Multifocal static creamy choroidal infiltrates. An early sign of lymphoid neoplasia. AB - Three patients, each more than 60 years of age at initial presentation, had early stage lymphoid infiltrates (formerly called reactive lymphoid hyperplasia) of the choroid and contiguous extraocular tissues. There were multifocal, confluent, and nonconfluent creamy patches in the choroid. These lesions changed very little over periods of observation ranging from 1 to 4 years and failed to produce ophthalmoscopically visible disturbances of the retinal pigment epithelium (RPE). Fluorescein angiography demonstrated dye collection within the lesions without leakage into the subretinal or subpigment epithelial spaces. Both ultrasonography and computed tomography (CT) showed thickening of the choroid with either anterior or posterior episcleral extensions of lymphoid tissue. Pathologic evaluation of biopsy specimens of extraocular portions of the lesions showed low grade tumors that were diffuse infiltrates of mature lymphocytes, which exhibited lymphoplasmacytoid features, Dutcher bodies, or small residual germinal centers (so-called borderline lesions). Two patients had uniocular localized disease, whereas the third had bilateral ocular lesions, hypogammaglobulinemia, and another extranodal chest wall lymphoid tumor. Therapy for the localized ocular condition consisted either of oral administration of corticosteroids or low doses of radiotherapy. PMID- 3295642 TI - Immunopathology of ocular onchocerciasis. 2. Anti-retinal autoantibodies in serum and ocular fluids. AB - Ocular fluids and sera from 12 onchocerciasis patients and nine age-matched controls living in Tamale, Ghana, were examined for the presence of anti-retinal autoantibodies by the indirect immunoperoxidase technique. Antibodies directed against autoantigens of the inner retina (nerve fiber, ganglion cell, and Muller cell) were found in the sera of 10 of 12 patients, but in only three of nine controls (P less than 0.003). Autoimmune antibodies against the outer segment of the photoreceptor were noted in 7 of 12 patients, in contrast to only one of nine controls (P less than 0.02). Findings with the ocular fluids generally mirrored those with the sera. These autoantibodies could not be absorbed by conventional techniques using either retinal S-antigen (S-Ag) or the interphotoreceptor retinoid binding protein, an observation suggesting that other ocular antigens are involved. Such anti-retinal antibodies, especially those directed against the inner retina, may play a significant role in the pathogenesis of the retinal degeneration and optic atrophy that occur as a consequence of onchocerciasis. PMID- 3295643 TI - Recent advances in non-neoplastic retinal and choroidal diseases. PMID- 3295644 TI - Eye care plan: principles and recommendations. PMID- 3295645 TI - Eye care: 1987. PMID- 3295646 TI - Control of induced infestations of adult Amblyomma hebraeum with sustained release ivermectin. AB - The efficacy of ivermectin, administered in a sustained release formulation by intraruminal pumps at approximate daily dose rates of 20, 40 and 60 micrograms/kg, was evaluated in 16 cattle against induced infestations of 3 strains of adult Amblyomma hebraeum. Engorged female ticks were mass-measured and incubated, and reproductive data recorded. There was an increase in mortality of male and female ticks compared to that of controls with increasing daily dose of ivermectin, and a decrease in the number of ticks engorging. Ticks fed on ivermectin-treated cattle had a smaller mass when engorged and laid smaller egg masses, both absolutely and as a proportion of engorged mass. Index of reproduction was reduced 100% at 60 micrograms/kg/day, greater than 99% at 40 micrograms/kg/day and 96% at 20 micrograms/kg/day. Differences occurred between the 3 strains of A. hebraeum used in the study, especially with regard to engorged mass and reproductive variables. Practical implications of the application of sustained release ivermectin for the control of A. hebraeum, specifically with reference to heartwater (Cowdria ruminantium), are discussed. PMID- 3295647 TI - Resistance to various antibiotics of Salmonella and Escherichia coli isolated from registrable farm feeds. AB - Resistance to 20 antibiotics of 128 Salmonella and 97 Escherichia coli isolates from various registrable farm feeds was determined. A high frequency of comparatively low levels of resistance was found in both the Salmonella and E. coli isolates. This, together with an elevated frequency of multiple resistance, indicates that problems related to an effective transfer in bacterial populations of resistance to certain antibiotics are a distinct possibility. The addition of antibiotics, such as penicillin and tetracyclines, to animal feeds can create conditions for rapid selection amongst bacteria resistant to antibiotics. The numbers of resistant bacteria in the animal environment may be increased and may lead to the development of veterinary and human health problems from the possible transfer of antimicrobial resistance from animal pathogens to human pathogens or spreading in the human population of animal pathogens resistant to antibiotics. There is a need for caution in the use of antibiotics, particularly in animal feeds. Extended survey of, and epidemiological research on, farm feeds, manufacturing mills and animal production units are emphasized. PMID- 3295648 TI - Ultrastructural morphology and cellular differentiation in acinic cell carcinoma. AB - Acinic cell carcinomas, in some instances, contain a component of intercalated duct cells. However, the manner in which this element is integrated within the more obvious acinar cells, as well as the role neoplastic intercalated duct cells play in determining morphologic patterns in acinic cell tumors, has not been fully investigated. Ultrastructural study and immunostaining with antibodies to cytokeratins and to S-100 protein carried out in nine cases of parotid acinic cell carcinoma suggest two basic differentiation patterns. In three cases, the lesions were essentially composed of acinar cells (with variation in the number and form of secretory granules), and one of these tumors was unique in having ultrastructural evidence of differentiated myoepithelial cells. In the second group of six cases, there was light microscopic, ultrastructural, and immunohistochemical evidence of a significant component of intercalated duct cells. By means of both immunostaining (intercalated ducts were positive for keratin and S-100 protein; acinar cells were negative for both antigens) and electron microscopy, flattened-to-cuboidal intercalated duct cells were noted to enclose and, presumably, to be involved in the formation of microcystic spaces. Acinic cell carcinomas with a more solid growth pattern contained groups of intercalated duct cells positive for keratin and S-100 protein. Ultrastructurally, these cells were organized into well-formed ducts related to nests of acinar cells. Acinic cell carcinoma is another class of salivary gland tumor in which there can be an integrated proliferation of intercalated duct and acinar cells and, infrequently, of myoepithelial cells, all organized in a simulation of the intercalated duct-acinar unit of the normal salivary gland. PMID- 3295649 TI - Ultrastructural study of initial calcification in the rat subcutaneous tissues elicited by a root canal filling material. AB - The ultrastructural aspects of initial calcification in the rat subcutaneous tissues elicited by the root canal filling material Vitapex, made up of calcium hydroxide and iodoform with the addition of silicone oil, were studied by means of electron microscopic and cytochemical techniques. The embedded paste caused heterotopic calcifications. These were divided into two types: dystrophic calcification and matrix vesicle calcification which resembled that of bone tissue. These data suggest that Vitapex may be an excellent root canal filling material for differentiation of osteoblasts or cementoblasts from mesenchymal cells in the periodontal ligament. PMID- 3295650 TI - Serum antimuscarinic activity after a single dose of oral scopolamine hydrobromide solution measured by radioreceptor assay. AB - Radioreceptor assay (RRA) was used to evaluate serum antimuscarinic activity in 10 healthy volunteers after a single dose of scopolamine hydrobromide (ScHBr) solution, 0.02 mg/kg, by a new oral administration method. Cardiac, antisialogogue, and subjective effects of the drug were also recorded. Although clinically useful antisialogogue and sedative effects were obtained 40 to 60 minutes after the administration of ScHBr, no reliable antimuscarinic activity was evaluated in serum samples for up to 3 hours. Clinically useful sedative and antisialogogue effects can be reached by gastrointestinal absorption of ScHBr solution. PMID- 3295651 TI - Surgical suction damage: a common tissue artifact. AB - The vacuum effect of a surgical suction tip can induce significant artifactual alterations in the connective tissue of specimens removed for diagnostic or therapeutic purposes. The alterations described in this article consist of a surgical suction artifact characterized by the formation of numerous, pleomorphic vacuoles that, on casual microscopic examination, resemble the morphology of traumatized adipose tissue. This artifact occurs when a vacuum draws air into connective tissue and mobilizes connective tissue mucins (acid mucopolysaccharides) that localize within the vacuoles that are formed. PMID- 3295652 TI - The synchronous occurrence of aspergillosis and myospherulosis of the maxillary sinus. Report of a case with review of the literature. PMID- 3295653 TI - Proliferative myositis of the buccinator muscle: a case with immunohistochemical and electron microscopic analysis. AB - A case of proliferative myositis of the buccinator muscle is reported. To our knowledge, the present case is the second reported in the oromaxillary region. From immunohistochemical and electron microscopic studies, it seems likely that the ganglion-like cells are derived from myofibroblasts or macrophages rather than from striated muscle cells. PMID- 3295654 TI - Balanced facial growth: a schematic interpretation. AB - Balanced facial growth is a complex process that involves maxillary, mandibular, dental, and cranial growth. Growth of the maxilla is due to special movements of translation, rotation, and elongation as well as to growth of its skeletal units and skeletal structures. Growth of the mandible is the sum of growth of all of its skeletal units. Cranial growth influences both maxillary and mandibular positions, which themselves can vary interdependently, in part because of the mutual influences of the maxillary and mandibular dentitions. PMID- 3295655 TI - Therapeutic use of chlorhexidine in bone marrow transplant patients: case studies. AB - Patients undergoing cytotoxic chemotherapy and radiation therapy often experience severe oral complications during and after treatment despite supervised oral hygiene and conventional antimicrobial regimens. The antimicrobial compound chlorhexidine is an effective topical prophylactic agent against oral mucositis and candidiasis. Oral mucositis developed in four patients who underwent bone marrow transplantation; the condition was severe enough to prompt use of chlorhexidine. In each case, there was clinical resolution of mucositis and a concomitant decrease in the oral microbial burden 1 week after chlorhexidine use began. This strongly suggests that, in addition to its value in protecting these severely immunocompromised patients from oral infection, chlorhexidine also offers a therapeutic benefit in the resolution of existing oral infections and of mucositis. PMID- 3295656 TI - Peripheral epithelial odontogenic tumors: a review. AB - Peripheral (extraosseous or soft tissue) odontogenic tumors are rare lesions that occur in the soft tissue overlying the tooth-bearing areas of the mandible and the maxilla. A review of the English-language literature revealed only 48 well documented cases of peripheral epithelial odontogenic tumors. Thirty-two were peripheral ameloblastomas; six were peripheral adenomatoid odontogenic tumors; nine were peripheral calcifying epithelial odontogenic tumors; and one was a peripheral squamous odontogenic tumor. An additional four cases were reported as peripheral ameloblastomas in extragingival locations, but their odontogenic origin is debatable. Although the peripheral ameloblastoma is histologically similar to its central counterpart, it differs in its clinical features and biologic behavior. It does not exhibit an aggressive, destructive behavior and does not invade the underlying bone. Conservative excision of the tumor with minimal but adequate margins is the treatment of choice and recurrences are uncommon. This benign biologic behavior appears to be true also for lesions diagnosed as peripheral calcifying epithelial odontogenic tumors and undoubtedly is true for the peripheral adenomatoid odontogenic tumors. PMID- 3295657 TI - [In memory of a teacher (Konstantin Mikhailovich Klimov)]. PMID- 3295658 TI - [The possibilities of restoring function after complete spinal cord break and the means of achieving this goal (a review of the problem. 2)]. PMID- 3295659 TI - [Prenatal diagnosis in the first trimester--beyond the first 100 cases]. PMID- 3295660 TI - [Origins and development of otorhinolaryngology in Hungary to the end of the last century]. PMID- 3295661 TI - [Prof. Bela Korpassy was born eighty years ago and died twenty-five years ago]. PMID- 3295662 TI - [Notes on the history of miners' disease in Hungary]. PMID- 3295663 TI - [Aurel Noszkay, M. D. (1900-1987)]. PMID- 3295664 TI - [Neurosonographic examination of neonates and infants with myelodysplasia]. PMID- 3295665 TI - [Effect of antihypertensive (captopril) therapy on proteinuria in diabetic nephropathy]. PMID- 3295666 TI - [Medical students in research]. PMID- 3295667 TI - [Maximilian Stoll died 200 ears ago]. PMID- 3295668 TI - [Ultrasonic observation of the evolution of periventricular cystic leukomalacia]. PMID- 3295669 TI - [Nobel Prize for medicine, 1986 (Rita Levi-Montalcini)]. PMID- 3295670 TI - [Pediatric neurology at the Pest Pediatric Hospital for the Poor 1839-1883]. PMID- 3295671 TI - [Analysis of the work of the national network of Genetic Counseling Services between 1978 and 1985]. PMID- 3295672 TI - [Ultrasonic morphological grouping of gallbladder cancers]. PMID- 3295673 TI - Jonathan Wainwright--pioneer in cancer control. PMID- 3295674 TI - Life imitates art. PMID- 3295675 TI - [Identification of group B streptococcal infection by the latex test]. AB - A commercial latex agglutination test (Wellcogen Strep B) has been prepared for testing body fluids. This test does not require a special equipment and is very easy to handle. Results are established within few minutes. We examined this method in unconcentrated urine specimens of 98 pre- and full term neonates suffering from RDS. In all 48 cultural proven cases of strep. B sepsis LAT was positive, the test was performed 2.5 h-19 h after onset of RDS. Four times we could not exclude false positive results definitively, but no false negative results were found. PMID- 3295676 TI - Objective changes in intrauterine pressure during placebo treatment of dysmenorrhea. AB - The paradoxical improvement of many subjective phenomena during placebo therapy is both well established and notorious for confounding many well designed studies. Consistently high placebo response rates of as much as 44% have been reported in subjective studies of dysmenorrhea. In an effort to evaluate the discordant role of objective uterine activity known to be associated with primary dysmenorrhea and the subjective sensation of discomfort, data from 18 patients undergoing meclofenamate therapy for primary dysmenorrhea were evaluated. In this study both the sum of pain intensity differences (SPID) and the total pain relief scores at each study time (TOTPAR) showed increases during both drug and placebo therapy with statistically significant differences favoring drug therapy. Ten percent of patients eventually reported 'complete relief' during placebo therapy. In contrast to this subjective placebo response, objective measures of intrauterine pressure showed consistent worsening in 13 out of 14 pressure parameters with 25% of patients experiencing a 2-fold or greater increase in the number of contractions while on placebo therapy. The ability to document unchanged or worsening objective parameters associated with the development of 'pain' in the face of reported subjective improvements may provide new insight into the mechanisms by which the 'placebo effect' occurs. PMID- 3295677 TI - Sampling of microorganisms associated with periodontal disease. PMID- 3295678 TI - Cultural methods for the identification and quantitation of Streptococcus mutans and lactobacilli in oral samples. PMID- 3295679 TI - Immunological assays for putative periodontal pathogens. PMID- 3295681 TI - Sampling of cariogenic microorganisms in human populations. PMID- 3295680 TI - Rapid identification of important periodontal microorganisms by cultivation. PMID- 3295682 TI - Use and interpretation of microbiological assays in periodontal diseases. PMID- 3295683 TI - Microbiological diagnosis in dental caries and periodontal disease. Considerations and conclusions. PMID- 3295684 TI - Pyruvate oxidase in Streptococcus sanguis under various growth conditions. PMID- 3295685 TI - Studies on the growth of Eikenella corrodens strain 23834. PMID- 3295686 TI - Processing of the precursor to the major merozoite surface antigens of Plasmodium falciparum. AB - Specific sequences derived from the gene for the precursor to the major merozoite surface antigens (PMMSA) of Plasmodium falciparum have been expressed in Escherichia coli and the products have been used to produce antibodies. These antibodies, together with monoclonal antibodies, have been used to investigate the form of the PMMSA protein associated with merozoites. Polypeptide fragments derived by processing from the PMMSA protein have been detected in extracts of merozoites and assigned to locations within the PMMSA coding sequence. PMID- 3295687 TI - Characterization of Trypanosoma congolense serodemes in stocks isolated from cattle introduced onto a ranch in Kilifi, Kenya. AB - A herd of 20 cattle was introduced on a ranch in Kilifi, Coast Province of Kenya, where they were in contact with Glossina austeni for 6 months. In total, 65 trypanosome isolates were made from these animals. Examination of the isolates revealed that 61 were Trypanosoma congolense and 4 were T. theileri. Out of the 61 T. congolense isolates, 55 were successfully passaged and cloned in mice to provide trypanosome populations for further analyses. The stocks and their clones were inoculated into goats on which teneral G. morsitans centralis were later fed in order to provide metacyclics for use in serodeme analysis. Identification of serodemes was carried out by indirect immunofluorescence and neutralization using antimetacyclic hyperimmune sera prepared in mice against metacyclics of cloned trypanosome populations. So far 4 serodemes have been identified in 8 stocks and 7 clones. Each of the 9 stocks contained a mixture of at least 2 of the 4 serodemes identified. Furthermore, stocks isolated sequentially from individual animals contained the same serodemes despite repeated treatment with a curative dose (6 mg/kg body weight) of Berenil between isolations. From the latter finding, it can be inferred that the 4 serodemes were present on the ranch throughout the study period. PMID- 3295688 TI - The Wellcome Trust lecture. Inflammatory responses to filarial connective tissue parasites. AB - The inflammatory responses to lymphatic filariae and to Onchocerca volvulus are reviewed with particular attention to evolutionary biology; inflammatory host spectrum; non-specific components; immunoregulation; immune evasion versus immunomodulation; chronic tissue damage and scarring and disease models. Basic principles of pathogenesis are emphasized, comparisons drawn with schistosome infection, and critical items of missing information are highlighted. PMID- 3295689 TI - Immunopathological mechanisms in the induction of parasitic diseases with particular reference to type III hypersensitivity reactions. PMID- 3295690 TI - Pathophysiology of parasitic infections. AB - Parasites can have a wide range of pathophysiological effects on the host. This review describes those associated with some parasites of major importance in man and animals. Haemoprotozoan diseases such as trypanosomiasis and malaria are primarily associated with anaemia. Such anaemias have a complex aetiology involving various mechanisms responsible for red cell destruction as well as possible defects in red cell production. In addition to these haematological effects these diseases are associated with marked disturbances in heart function and the nervous, immune and urinary systems. The other major groups of parasitic diseases are those associated with the gastrointestinal tract. The most advanced studies have been conducted on the pathophysiology of gastrointestinal nematode parasites of sheep and have revealed significant effects on feed intake, gastrointestinal function, and protein and energy metabolism. Similar studies have yet to be conducted in other hosts and parasitic diseases. There is also a need to examine in greater detail the factors which can modulate pathophysiological responses by the host to parasitic infections. PMID- 3295691 TI - Pathophysiology of severe falciparum malaria in man. PMID- 3295692 TI - Gastrointestinal mucus, a medium for survival and for elimination of parasitic nematodes and protozoa. PMID- 3295693 TI - Inflammatory responses to parasites. PMID- 3295694 TI - [Demyelination and autoimmunity]. AB - Autoimmune diseases are experimental models of human demyelinating diseases such as multiple sclerosis and idiopathic polyneuritis: experimental auto-immune encephalomyelitis (EAE) and experimental autoimmune neuritis. Demyelinating lesions occurring in chronic EAE could be due to the action of autoantibodies rather than to a cellular action involving lymphokines. An antibody-dependent cellular myelinotoxicity could also be the mechanism responsible for demyelination; these mechanisms are suggested by in vitro and in vivo demyelination experiments and by the presence of demyelinating autoantibodies against component(s) of myelin in EAE area. The demyelinating mechanisms could be the same in multiple sclerosis. However, they have not been proven so far. PMID- 3295695 TI - [Immunogenetics of multiple sclerosis]. AB - The interaction between environmental factors and genetic susceptibility causes multiple sclerosis. In some ethnic groups this disease is rare. The family incidence varies from 6 to 12%. Analysis of twins shows a concordance two fold higher in homozygous twins. The transmission of such a genetic susceptibility cannot be explained by means of an usual genetical model. In Caucasoids, an association exists between MS and HLA A3, B7 and DR2 antigens. However this association is not always found and can be different from one population to another one. The mechanisms of the association are unknown: either the HLA haplotype supports the disease susceptibility but family segregation studies are unconvincing, or this susceptibility is due to the interaction of several genic complexes, a few of which linked to HLA region. An etiological heterogeneity of MS has also been suggested. PMID- 3295696 TI - [Cytotoxic antibodies in multiple sclerosis]. AB - Serum cold cytotoxic activities against allocells: total lymphocytes, B lymphocytes and monocytes were detected in 12 of 21 multiple sclerosis (MS) patients at 15 degrees C using a microcytotoxicity technique. Cytotoxic activity was found at 37 degrees C in certain MS patients. This activity was weak or absent in non MS patients and in healthy controls. Tests with autocells were positive in 6 MS patients. Cerebrospinal fluid cytotoxic activity was found in MS as well as in non-MS diseases; at 37 degrees C CSF produced lysis of monocytes in the absence of complement. No correlation was found between cytotoxic activity and parameters of clinical disease. Our results suggest that there may be a wide variety of cytotoxic antibodies in MS. Their significance is unknown; it may be that they have an effect on certain lymphocyte subsets as it has been suggested in other diseases. PMID- 3295697 TI - [Binding of immunoglobulins of the cerebrospinal fluid of multiple sclerosis patients to oligodendrocytes in culture]. AB - There is often, in multiple sclerosis (MS) an intrathecal synthesis of immunoglobulin G (IgG) with an electrophoretic oligoclonal pattern. The target of those IgG, as well as their possible pathogenic role in the demyelinating process remain unknown and have led to many controversies. We have tested the hypothesis of an oligodendroglial target for those Ig, using a double labelling indirect immunofluorescent assay. Cerebrospinal fluid (CSF) Ig were collected from 28 MS patients (with either progressive or remitting-relapsing disease) and 25 patients with other neurological diseases. Ig binding has been tested on rat and human oligodendrocytes, isolated on a Percoll gradient and maintained 24 to 48 hours in culture. In our experimental conditions, we have never been able to detect any specific binding of MS CSF Ig on those oligodendrocytes, identified by double labelling immunofluorescence with an anti-galactocerebroside antibody. PMID- 3295698 TI - [Demyelination in in vitro culture in multiple sclerosis: facts and controversies]. AB - The myelinotoxicity of sera from multiple sclerosis (MS) patients was determined by the assessment of visible myelin damage in guinea-pig spinal cord-spinal ganglia and in rat cerebella cultivated on collagen-coated coverslips in Leighton tubes. No change was seen in 22 cases. These data show that serum myelinotoxicity is low in MS - as compared with that of Experimental Allergic Encephalomyelitis. It appears a little specific phenomenon, the mechanism of which remains unclear. It can be easily assessed only in very sensitive culture techniques and is best measured by biochemical methods. This does not preclude the pathophysiological significance of the serum myelinotoxicity in MS. Supernatants of cerebro-spinal fluid (CSF) cell cultures in 10 MS patients caused no demyelination. Pooled concentrated supernatants of CSF cell cultures from 13 to 20 MS patients- containing from 7.3 to 11.7 micrograms IgG/ml gave no patent in vitro demyelination in 3 different experiments. The released products of CSF cell cultures in MS are not very toxic for myelin. However these experiments have to be repeated with more sensitive culture techniques, biochemical assay of myelinotoxicity and more concentrated CSF cultures supernatants. PMID- 3295699 TI - [Chimeras of the spinal cord between quail and chicken. A new experimental model for studying demyelinating diseases]. AB - Avian chimaeras in which definite fragments of the neural primordium of chick embryos are isotopically and isochronically substituted, at the brachial level, by their counterpart from quail have been constructed at embryonic day 2 (E2) and allowed to hatch. Hatched chimaeras displayed seemingly normal motor behaviour (including feeding, running and flying) indicating that the establishment of the neuronal circuitry occurred normally. However, during the second or third month of life, the chimaeras developed a neurological syndrome characterized first by paralysis of the wings and then of the legs. The spinal cord and peripheral nerves and ganglia originating from the graft exhibited pathological signs including expression of class II MHC antigens by capillary endothelial cells, rupture of the blood-tissue barrier, leukocyte infiltration of the nervous tissue and demyelination. This can be interpreted as the rejection of the graft. Interestingly, this process resulted in sensitisation of host's T cells to neural antigens and in spreading of the lesions to the host's CNS, thus creating in the chick an autoimmune disease directed toward its own nervous system. PMID- 3295700 TI - [Intracerebral transplantation of oligodendrocytes in mice]. AB - We describe in this paper experiments in which oligodendrocytes (from newborn mouse, human embryonic brain, or isolated from adult rat brain) have been transplanted into the brain of the newborn mouse. Experimental conditions (Shiverer model) allowed the detection of myelin formed by transplanted oligodendrocytes into the Shiverer brain. The transplanted oligodendrocytes have been shown to survive, migrate over long distances and myelinate host axons. The maturation of transplanted oligodendrocytes depends upon the age of the brain tissue in which they differentiate. PMID- 3295701 TI - Prevalence of anti-Legionella antibodies in a healthy population and in patients with tuberculosis or pneumonia. AB - The prevalence of antibodies to 13 antigens of Legionellaceae were compared in three populations: 583 blood donors, 140 tuberculosis patients and 66 patients with acute non Legionellosis pneumonia. Antibody levels were determined by indirect immunofluorescence (IFA) using formalized antigens prepared from bacteria developed in embryonated hen yolk sac. The very weak prevalence of anti L. pneumophila antibodies in a healthy population [almost nil for serogroups 2, 3, 4 and 5; 1.5% for serogroup 6, maximum of 2.5% for serogroup 1 (titres of 16)] confirms the positive and presumptive criteria that have been recommended by Centers for Disease Control (CDC). But as regards the other Legionellae studied, these criteria cannot be applied owing to the prevalences that are higher in healthy populations (until 14.5% with levels of 16-32 and 1% with levels of 64 128 for L. bozemanii) and clearly amplified in tuberculosis patients and in acute pneumonia. Although the significance of these antibodies remains to be discussed, with formalized antigens, it seems reasonable as regards these species to assign a threshold of 256 for the presumptive and positive criteria following seroconversion. PMID- 3295702 TI - [Influence of the anti-HLA immunization profile before grafting on the outcome of renal transplant]. AB - A retrospective study of HLA immunization profile before a first graft of unrelated kidney in 212 immunized recipients (with an initial peak greater than or equal to 25%) shows that one can define at least 3 groups of responder with a different graft outcome. Recipients with either weak or strong variance of HLA antibody (VP) before graft (group I: VP less than 230 and group III: VP greater than 830) have a significantly lower graft survival: 54% (p = 0.006) and 45% (p = 0.002) respectively at 4 years, than recipients of group II (230 less than VP less than 830) for whom the prognosis is of 77% after the same time period. If similar results are observed on independent series, VP would be of a great interest for the definition of a new classification of responders, and on a practical level for the choice of renal transplant. PMID- 3295703 TI - [Reorganization of the electrical activity of the transverse colon after cholecystectomy. Study in humans with implanted electrodes]. AB - Electrical activity of the colon was investigated in the postoperative period in 12 patients, 1 to 6 days after cholecystectomy. The polygraphic records are obtained during 2 hours each day late in the morning (10-12 h) in a preprandial situation from serosal implantation of bipolar copper wires inserted into each circular and longitudinal layer in narrow portion of the middle part of the transverse colon. The time presence diagrams was built up after recognition of the basic patterns activity previously definite by Sarna as follows: Electro Control-Activity, with it slow waves (ECA), Electro-Response-Activity (ERA) with Discrete bursts (DERA) or Continuous ones (CERA). In the former postoperative period 1 to 3 days ECA is present with a low range frequency 1-5 c/min. The higher frequency (10-12 c/min) activity arises sporadically, in this case associated with DERA bursts. From the 4th day all activities ECA and DERA increase significantly. The continuous response activity CERA may be observed in all periods but more frequently from the 3rd day with the same mean duration (12.4 +/- 1.85 s for the circular fibers and 21.6 +/- 2.56 s for the longitudinal ones); the predominance of longitudinal activity duration is significative (p = .001). The complex CEC (26-40 c/min) associated with CERA is observed only in 3% of the time recording. Thus after the onset of colonic motility with DERA and CERA in the 3th day, the normalization is obtain the 6th day with the predominant rythm of 1-2 c/min. PMID- 3295704 TI - [Comparative value of immunoelectrophoresis and ELISA in the serological diagnosis of human hypodermyiasis]. AB - 186 sera of patients with hypodermatosis were comparatively studied by immunoelectrophoresis and ELISA. After establishing limits of certainty (2 distinct precipitating arcs with IEP and an optical density greater than or equal to 0.8 with ELISA), the comparison of obtained results shows that there is a good concordance between the two methods, but that the second, by its higher sensitiveness, allows to reveal residual antibodies during a delay after disease recovery longer than with the first. Consequently, this higher sensitiveness allows, first, retrospective diagnosis, then the more frequent settling, when border-lined serological positivities are obtained with IEP, therefore without possible conclusions. On the other side, importance of crossed reactions between Hypoderma bovis and H. lineatum revealed with ELISA, does not allow, contrarily to what is done frequently by IEP, much more specific method, to know the species of Hypoderma causing the disease and, therefore, to bring more to the prognosis. PMID- 3295705 TI - [Serum zinc and copper in hypercholesterolemia]. AB - For some authors, absolute or relative copper deficiency, with an elevated plasmatic zinc/copper ratio, could be a risk factor in the etiology of cardiovascular diseases by altering lipid metabolism. Animal or human studies carried out with zinc and/or copper supplemented or deficient diets on biochemical lipid parameters, led to inconsistent results. Nevertheless, no study was already done in hypercholesterolemic patients, concerning possible correlation between serum levels of these trace elements and cholesterol, HDL cholesterol and apolipoprotein B blood levels. 67 patients were distributed in three groups according to their hypercholesterolemia. The serum copper concentration was elevated, serum zinc concentration and zinc/copper ratio were decreased in the hypercholesterolemic group (cholesterol greater than 7.7 mmol/l). Serum zinc, copper and zinc/copper ratio were significantly correlated with HDL cholesterol (respectively r = + 0.56 p less than 0.05, r = - 0.68 p less than 0.01, r = + 0.76 p less than 0.001). PMID- 3295706 TI - [Assay of digoxin on dry-reagent strips]. AB - An automated immunoassay for Digoxin in serum using dry-reagent strips (Stratus Dade) was evaluated, and compared with two others immunoassays (TDX Abbott and ACA Du Pont). Precision, sensitivity and specificity were satisfying, as well as correlation study, but discrepancies observed for some sera proved that these techniques still pose serious problems of specificity or of standardisation. PMID- 3295707 TI - [Radioimmunological assay of plasma arginine-vasopressin in man. Comparison of 2 methods of extraction]. AB - Two methods of extraction, prior to radio-immunoassay (RIA) of human plasma arginine vasopressin (AVP) were tested: ethanol extraction (ETH), chromatography with ODS-Silica (ODS-Sil). Recovery of 125I AVP was higher when using ODS-Sil than when using ETH. Recovery of standard AVP and plasma enriched with standard AVP was found to be more efficient and reproducible for ODS-Sil. However, the RIA used, performed after chromatography with ODS-Sil, is not enough sensitive to detect low concentrations but is able to detect high concentrations and physiological variations of plasma AVP. PMID- 3295708 TI - [Study of salivary cortisol using radioimmunological assay. Diagnostic value]. AB - Salivary cortisol levels reflect the biologically active "free" fraction of blood cortisol. The authors describe the results obtained with the aim of a radio immunoassay commercial serum cortisol kit, without prealable extraction in different physiological and pathological situations. Salivary cortisol determination appears performant both in nycthemeral studies and in stimulation or freination tests. PMID- 3295709 TI - Microwave fixation in diagnostic renal pathology. AB - Microwave-fixed tissues were examined in 10 patients undergoing diagnostic renal biopsy. A small portion of renal tissue was fixed by microwave irradiation and subsequently processed by routine methods for light microscopic, immunofluorescent and electron microscopic studies. The remaining portion of specimen was fixed and processed by conventional methods. In light microscopic examination, the renal architecture and cell morphology were well-preserved. Pathological changes were identical to those seen with formalin-fixed tissue. The pattern, distribution and intensity of positive immunofluorescence in microwave fixed tissue were similar to those in tissues directly snap-frozen and stained. In electron microscopy, the normal and pathological features were well demonstrated and not different from those observed in glutaraldehyde-fixed specimens. Specific ultrastructural lesions were clearly demonstrated and, apparently, were not altered by microwave irradiation. Our preliminary data indicate that microwave fixation can be effectively applied in the processing of renal biopsies. As the fixation is rapid, this method may be valuable in circumstances when an urgent diagnosis is required. PMID- 3295710 TI - Transplanted isolated hepatocytes: effect of partial hepatectomy on proliferation of long-term syngeneic implants in rat spleen. AB - Proliferation of isolated hepatocytes in long-term splenic implants was assessed by flash labelling with a 1 pulse of tritiated thymidine (3H TdR). Cell kinetics showed that the basal labelling index was 0.9% which was greater than normal non regenerating liver. Twenty four hours following partial hepatectomy the labelling index was 2.0%, a significant rise. These results suggest that hepatocytes transplanted to the spleen constitute a suitable model for screening putative hepatotrophic factors, and are of relevance in establishing clinically useful models of hepatocyte transplantation. PMID- 3295711 TI - Glomerular epithelial cell lesions in rat renal isografts. AB - Visceral glomerular epithelial cell lesions--microvillus formation, loss of foot processes, osmiophilic inclusion droplets, balloon-like malformation of cell processes, degeneration, necrosis, and loss of cell processes from capillary basement membranes--are found in rat renal isografts 1 mth after transplantation. The lesions, which are most readily recognized in perfusion-fixed material, are essentially focal, affecting neither all glomeruli, nor all cells in any glomerulus, bear no relation to the degree of interstitial nephritis in the graft, and are associated with albuminuria and with focal capillary sclerosis in some glomeruli. They are not restricted to renal isografts but are found in aging rats, in different experimental models of glomerular disease and in clinical glomerular disorders, again in association with proteinuria and glomerulosclerosis. It is therefore proposed that glomerular epithelial cell damage increases capillary permeability and impairs maintenance of the integrity of the capillary wall, leading to proteinuria and focal glomerulosclerosis. PMID- 3295712 TI - Cancer of the breast and beta 2 microglobulin. AB - In carcinoma of the breast the disease stage at diagnosis determines therapy and is closely related to prognosis. To date no single biochemical marker of disseminated breast cancer has been described although beta 2 microglobulin values in the serum have been suggested as a discriminant between localized and systemic disease. Using a new method of beta 2 microglobulin estimation, we carried out a prospective study of levels in 53 patients with breast cancer who were studied repetitively over a 2 yr period. No relationship could be determined between beta 2 microglobulin values and the stage of the disease. Moreover beta 2 microglobulin levels, even when elevated, did not predict early metastasis. Repeated beta 2 microglobulin estimations during treatment of metastatic disease had limited usefulness in that patients with responsive disease usually showed a fall in beta 2 microglobulin, whereas there was generally no change in non responsive patients. These changes were, however, often within the normal range and seemed to offer a marginal improvement in assessment. PMID- 3295713 TI - Monoclonal antibody purified beta 2-microglobulin: heterogeneity revealed by radioimmunoassay. AB - A monoclonal antibody, CMRF1, to human beta 2-microglobulin (beta 2m) was used to purify antigen to develop an in-house beta 2m radioimmunoassay. This immunoadsorption purified material was used to prepare a rabbit anti-beta 2m serum and was radiolabelled for the radioimmunoassay. The assay compared favourably with a widely used commercial radioimmunoassay but the immunological potency of the in-house standard was lower than that of the commercial reagent. This potency difference was not accounted for by antigenic denaturation. Subsequent two-dimensional gel electrophoresis revealed a second 12,000 dalton protein with a higher isoelectric point than beta 2m in the immunoadsorption purified material, which was also present, although in lesser amounts, in the commercial product. The different relative content of the additional 12,000 dalton protein appeared to explain the immunological potency difference between the in-house and the commercial standard. These results strengthen suggestions that there may be some heterogeneity or polymorphism in human beta 2m. PMID- 3295714 TI - Biotyping as a method of screening for enterotoxigenic Escherichia coli. AB - A scheme of biotyping described originally for E. coli isolated from urine was used to investigate enterotoxigenic (ETEC) and non-enterotoxigenic (non-ETEC) fecal E. coli. Primary biotype was determined by fermentation of raffinose, sorbose and dulcitol and decarboxylation of ornithine. Failure to ferment sorbose correlated best with enterotoxicity; 95.5% of ETEC and less than 40% of non-ETEC did not ferment sorbose. The sensitivity compares favourably with reported results of the use of polyvalent antisera for recognition of serotypes associated with ETEC, although specificity was lower using biotyping. Strains included in our study were mainly from Australia, New Zealand or Indonesia and we do not know if our observations apply to E. coli isolated elsewhere. If failure to ferment sorbose proved to be a characteristic of most ETEC, this reaction offers the possibility of developing selective media to increase the yield of ETEC from primary plates for laboratories in which gene probe techniques for recognition of ETEC are not available. PMID- 3295715 TI - [Immunohistochemical study of the localization and quantity of carcinoembryonic antigen (CEA) in gastric cancer]. PMID- 3295716 TI - Breath tests as a diagnostic technique for malabsorption. PMID- 3295718 TI - Less commonly recognized features of childhood nephrotic syndrome. AB - This article reviews aspects in the clinical presentation of nephrotic syndrome that are not generally considered characteristics of the syndrome's definition. The importance of various general clinical aspects such as hematuria, hypertension, and other laboratory or histologic findings are discussed. The clinical relevance and management of other specific aspects such as lipid alterations, coagulation abnormalities, calcium and vitamin D metabolism, and nutritional complications derived from the nephrotic syndrome also are included in this review. PMID- 3295717 TI - Morphology of urinary red blood cells: a simple guide in localizing the site of hematuria. AB - The determination of whether urinary red blood cells originate from the kidneys or bladder allows the practitioner to evaluate children with hematuria more efficiently and economically. Recently, examination of the morphology of urinary red blood cells has proven to be a promising adjunct in the evaluation of hematuria. The application of this new office procedure is discussed. PMID- 3295720 TI - The dilemma of intrauterine diagnosis of congenital renal disease. AB - The value of improved intrauterine diagnostic capability is unquestioned; however, as with all new technologic advancements, the problems created by this new diagnostic tool need review. This article examines some of the more critical of these difficulties. PMID- 3295719 TI - Forms of nephrotic syndrome more likely to progress to renal impairment. AB - In this article, emphasis is placed on those conditions that appear as the idiopathic nephrotic syndrome but that are more likely to result in progressive renal failure. Four conditions, membranoproliferative glomerulonephritis (mesangiocapillary glomerulonephritis), mesangial proliferative glomerulonephritis, membranous nephropathy, and focal segmental glomerulocosclerosis, account for 12 to 15 per cent of cases of idiopathic nephrotic syndrome during childhood. The further aim of this article is to focus on recent progress in our understanding of these conditions and to remind readers that little is known regarding the etiology and pathogenesis of each, and that effective, clearly proven forms of treatment for each are not apparent currently. PMID- 3295721 TI - Potassium homeostasis and hypokalemia. AB - Potassium, largely an intracellular cation, contributes to the regulation of cellular volume, to tissue growth and metabolic synthesis of proteins and nucleic acids, and to the integrity of electrical properties of excitable tissues as well as nonexcitable, transporting epithelia. Potassium balance is closely regulated by a variety of nonrenal and renal mechanisms. When potassium losses are sufficient to induce hypokalemia, either through nonrenal or renal causes, profound adverse effects on neuromuscular, cardiac, vascular, and renal tissues may ensue. The diagnostic approach is straightforward, and therapy must be directed to replenish losses without inducing a rapid, excessive, and potentially fatal increase in the potassium concentration of the serum. PMID- 3295722 TI - Urolithiasis in childhood. AB - Urolithiasis occurs less frequently in children than it does in adults living in contemporary industrialized nations. However, renal calculi continue to be identified with greater frequency in certain children: those who live in some areas of North America (e.g., the Southeastern United States), in those with relatively common metabolic disorders such as idiopathic hypercalciuria or with congenital urinary tract malformations, and in patients who have remained immobilized for long periods. Evaluation of children with suspected urolithiasis should include a careful history and physical examination to identify associated symptoms and signs and factors known to predispose to calculus formation, appropriate radiographic and blood studies, and timed urine collections. Appropriate management varies with etiology but should include maintaining adequate fluid intake, and long-term monitoring of the activity of the stone disease. PMID- 3295723 TI - Noncalculi urinary tract disorders secondary to idiopathic hypercalciuria in children. AB - Pediatricians frequently have faced one or more of an array of lower urinary tract symptoms without obvious cause. Now, with increasing recognition, many of these diagnostic enigmas have been ascribed to idiopathic hypercalciuria. This article reviews this "new" clinical syndrome, attempts to clarify pathophysiology, and selects patients for therapeutic intervention. PMID- 3295724 TI - Enuresis. AB - Enuresis is often familial, usually disappearing in adolescence, with only 1 per cent of children suffering from it into adulthood. Functional enuresis is considered to be a variation in normal bladder control, rather than a disease, and most enuretic children do not exhibit any emotional problems. A small functional bladder capacity and a maturational delay appear to be the relevant causes, considering the high rate of spontaneous cure. Only some children with primary enuresis show evidence of emotional or behavioral problems. The physician caring for an enuretic patient should remember that in the absence of obvious clinical manifestations (which must be treated immediately) the best treatment for enuresis is giving reassurance, offering supportive counseling and allowing time for spontaneous remission. Only when the presence of enuresis interrupts the sequence of normal social, emotional, cognitive, or motor development, should the use of medication or devices be considered. PMID- 3295725 TI - Reflux nephropathy. AB - This article reviews current concepts of reflux nephropathy, including the pathophysiology, diagnosis, relationship to infection, role in causing end-stage renal disease, and appropriate treatment and management. The condition is defined from a epidemiologic point of view herein, and attention also is given to possible progressions this condition can take. PMID- 3295726 TI - Pathogenesis and treatment of acute renal failure. AB - This article reviews the current understanding of the pathophysiologic sequence of events that culminate in an acute renal insult. The use of urinary indices to differentiate the physiologic causes of oliguria, namely, diminished intravascular volume or renal perfusion, from an established acute renal failure, is discussed for children and adolescents, as well as for neonates. Treatment modalities for the support of children with acute renal failure are described in detail. PMID- 3295727 TI - The therapeutic approach to the infant, child, and adolescent with end-stage renal disease. AB - Factors involved in choosing a treatment modality for the infant, child, and adolescent with ESRD differ from those used when counseling an adult patient. Age at the time ESRD develops, mental status, psychosocial status, and the primary renal disease must be taken into consideration when contemplating the optimal therapeutic modality for the pediatric patient with ESRD. The ideal approach to optimize growth in the pediatric patient with ESRD remains to be delineated. PMID- 3295728 TI - Hemofiltration in children with renal failure. AB - Hemofiltration is a relatively new and interesting form of treatment for patients with end-stage renal disease. This review considers this new modality for the pediatric patient and compares it with hemodialysis. PMID- 3295730 TI - Sonographic renal parameters as related to age. AB - Four hundred and fifty-four kidneys were evaluated by real time ultrasound for appearance of renal cortical echogenecity, medullary pyramids and central sinus echoes. These renal parameters were correlated with age in 227 patients ranging in age from 0-15 years. The renal parenchymal echogenicity was observed to change not abruptly at a certain age but gradually over a period of years. PMID- 3295731 TI - Ultrasonography of the infant hip. Part III: Clinical application. AB - We report on our results of ultrasonography of the infant hip over 2 years. Twenty-three percent of patients with abnormal sonogram showed no clinical suggestion of hip disorder. Suspicion of dislocation based on mobility, asymmetrical trochanteric distance, click or snapping of the hip and inhibited abduction were the most useful clinical criteria predicting disease in 93%, 19% and 16%, respectively. Breech presentation and family history of hip dysplasia or dislocation were important anamnestic data (21% and 16% predictive value, respectively). The significantly shorter duration of therapy in early detected dislocation or dysplasia makes the need for early diagnosis of these disorders obvious. Special emphasis lies on the physiological maturation of the acetabulum and the femoral ossification center. Normal ranges of important diagnostic criteria and angles depending on chronological age are presented. PMID- 3295729 TI - Reliability of sonography in non-hemorrhagic periventricular leucomalacia. AB - Sonographic pictures of the brain of 19 newborn infants who died at a mean age of 4.2 days after birth (range 1-23 days) were examined independently by five experienced sonographers. In all infants information on postmortem brain pathology was available. Diagnoses made by the sonographers based on the sonographic pictures were compared with the gross postmortem findings. The results of the study show that except for one infant with a subarachnoid hemorrhage all cerebral hemorrhages were diagnosed accurately by all sonographers. Non-hemorrhagic periventricular leucomalacia (PVL), however, was missed on sonography in 2 of the 3 cases. Surprisingly, PVL was diagnosed on sonography in 1 (8%) to 6 (50%) of 12 infants in which postmortem examination of the brain revealed no PVL. It is concluded that non-hemorrhagic PVL cannot be diagnosed accurately using sonography in the first days of life, if a 5 MHz transducer is used. PMID- 3295733 TI - Non-surgical treatment of a congenital splenic cyst. AB - A congenital splenic cysts in a 5.5 year old girl was aspirated under ultrasonographic guidance and injected with 150 mg Tetracycline (intended for IV use). Septation and gradual resorption of the cyst occurred during the following weeks, leaving small residual cysts which have remained stable for the last 12 months. Splenectomy and its possible complications were avoided. PMID- 3295732 TI - High resolution ultrasound characterization of soft tissue masses in children. AB - Forty-two soft tissue masses in infants and children were examined with high resolution ultrasonography. Sonography was diagnostically specific in 17/42 (40%), useful but not diagnostic in 24/42 (58%), and misleading in 1/42 (2%) of soft tissue masses. Lesions with diagnostic sonographic features included cystic hygroma, fibromatosis colli, lymphadenopathy with abscess formation, and one case of osteomyelitis. PMID- 3295734 TI - Embryonal rhabdomyosarcoma of the biliary tree in children: a case report. AB - Embryonal rhabdomyosarcoma (ERS) in children is a very rare tumor. Jaundice is the capital symptom. Diagnosis can be made by echography, which shows echogenic formations without posterior conic shadows in a dilated biliary duct. The prognosis is bleak in spite of the combination of surgery, radiotherapy and chemotherapy. PMID- 3295735 TI - Granulomatous cystitis in chronic granulomatous disease: ultrasound diagnosis. AB - Chronic granulomatous disease (CGD) is a fatal hereditary disease of childhood characterized by chronic recurrent bacterial infections. Involvement of the genitourinary tract is uncommon. We report a child with CGD with granulomatous cystitis demonstrated by both ultrasound and computed tomography. PMID- 3295736 TI - Lung maturation in the hyperinsulinemic rat fetus. AB - Hyperinsulinemic rat fetuses were obtained either by repeated in utero injections of long-acting insulin (resulting in fetal hypoglycemia) or by chronically infusing intravenous glucose to the mother (resulting in fetal hyperglycemia). Fetuses were examined at term. In insulin-injected fetuses (n = 15), surfactant (S) fraction phosphatidylcholine (PC) and disaturated phosphatidylcholine (DSPC) were significantly decreased (3.6 +/- 0.1 nmol Pi/mg tissue; p less than 0.001 and 2.8 +/- 0.1 nmol/mg; p less than 0.025, respectively) as compared with their saline-injected controls (4.8 +/- 0.2 and 3.3 +/- 0.1 nmol/mg, respectively, n = 19). However, residual (R) fraction was unchanged, and there was no difference in whole-lung phospholipids (combined S and R fractions). These results are consistent with morphological data showing a lower lamellar body area per type II cell profile in insulin-injected fetuses as compared with their controls [1.41 +/ 0.13 micron 2 (n = 72) versus 1.99 +/- 0.14 micron 2 (n = 129) p less than 0.01]. Glycogen content was slightly higher in insulin-injected fetuses (18.5 +/- 1.0 micrograms/mg, n = 17) than in their controls (15.1 +/- 0.8 micrograms/mg, n = 18; p less than 0.05). In the second model, changes in S fraction PC and DSPC were similar to those observed after insulin-injections: 4.3 +/- 0.25 and 3.4 +/- 0.2 nmol Pi/mg in fetuses of glucose-infused rats (n = 10) versus 5.7 +/- 0.45 and 4.3 +/- 0.3 nmol Pi/mg, respectively, in controls (n = 10, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295737 TI - [Is there a causative relation between infectious degenerative encephalopathy and the use of growth hormone?]. PMID- 3295738 TI - Comparative efficacy of ceftazidime vs. carbenicillin and amikacin for treatment of neonatal septicemia. AB - The efficacy and safety of ceftazidime were compared with those of carbenicillin and amikacin in 60 neonates with proved invasive bacterial infections. The two treatment groups of patients were comparable with regard to sex, gestational and chronologic ages, associated risk factors, clinical condition on enrollment, focus of infection and bacteriology. Escherichia coli was isolated from blood cultures of 31%, Pseudomonas aeruginosa from cultures of 25%, Klebsiella sp. from cultures of 13% and other Gram-negative enteric bacilli from cultures of 17% of the patients. Staphylococcus aureus was isolated from 20% (12 of 60), and coagulase-negative staphylococci from 8% (5 of 60) of the patients. All Gram negative coliform bacilli were susceptible to ceftazidime whereas 10, 56 and 77% were resistant to amikacin, carbenicillin and ampicillin, respectively. Serum bactericidal activity against the offending pathogen was as much as 5-fold greater in ceftazidime-treated compared with conventionally treated patients. Seven patients with infections caused by organisms resistant to the study drugs were excluded from analysis. Case-fatality rates were 6.4% (2 of 31) and 21% (6 of 28) in the ceftazidime- and amikacin/carbenicillin-treated patients, respectively. Total failure rates, including deaths, were significantly higher in patients treated with amikacin/carbenicillin (8 of 28, 28.5%) compared with that of ceftazidime-treated patients (2 of 31, 6.4%). Thirteen percent (5 of 31) and 3% (1 of 28) of the ceftazidime- and amikacin/carbenicillin-treated patients, respectively, developed invasive Candida albicans superinfection while receiving treatment. In this study results of treatment with ceftazidime were superior to results of treatment with amikacin/carbenicillin for invasive bacterial infections of newborn infants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3295739 TI - Pimozide treatment of tic and Tourette disorders. PMID- 3295740 TI - Neonatal neurosonography. PMID- 3295741 TI - Wheezing in infants: the response to epinephrine. AB - There is significant controversy about the role of bronchodilator therapy for wheezing in infants. A double-blind, randomized trial of subcutaneous epinephrine upsilon normal saline was conducted in children less than 24 months of age evaluated at Yale-New Haven Hospital. Respiratory assessments using a newly developed Respiratory Distress Assessment Instrument were made at baseline and 15 minutes after each of two injections. Relief of respiratory distress was assessed using strict a priori criteria based on changes in respiratory rate, wheezing, and retractions as scored in the Respiratory Distress Assessment Instrument. Significantly more children improved their respiratory status with epinephrine (nine of 16) than placebo (one of 14) (Fisher exact test, P = .0067). Paired data in individuals receiving placebo and then epinephrine confirmed this (Wilcoxon signed ranks test, P less than .01). Sixty-three percent of patients less than 12 months and 92% of those 12 to 24 months improved with epinephrine, as did seven of ten children with respiratory syncytial virus bronchiolitis. In many children, response to the initial epinephrine injection was not indicative of final response. Results of this study demonstrate the effectiveness of epinephrine in the treatment of acute wheezing in children less than 24 months of age. PMID- 3295742 TI - Examination of the uterine cervix by ultrasound in normal and pathologic pregnancy. AB - New possibilities of examination of the uterine cervix are provided by sonography in normal and pathologic pregnancy. Basic data of the ultrasonographic anatomy of the non pregnant uterine cervix is presented first: the length of the cervix as well as the diameters at the levels of external and internal os. These data are compared then with those in normal, physiologic pregnancy, and contrasted with those obtained in cases of incompetent cervix. In this group shortening of the cervical length, opening of the internal os and the funnel, or hour-glass-like herniation of the fetal membranes were characteristic findings. The method seems to be suitable for the assessment of the effectivity of cerclage operations for cervical incompetence. PMID- 3295743 TI - Gonadotropin-releasing hormone (GnRH) physiology in men and women. AB - The combined approach used in studies of GnRH secretion provided a complimentary array of techniques with which to establish the program of amplitude (dose) and frequency of GnRH secretion in the physiologic state. Normative data in men and women were useful in formulating frequency estimates, which could then be applied to the task of replacement of GnRH in deficient (IHH) individuals. Comparison of the results of therapy with these 'ablation-replacement' models then allowed to arrive closer to the true amplitude or dose of exogenous GnRH required to duplicate the physiologic ideal. In addition to providing insight into the neuroendocrine control of reproduction, these applications provided treatment of various reproductive disorders in men and women. Further expansion of the efforts into other potential defects of endogenous GnRH secretion will ultimately uncover those disorders amenable to therapy. PMID- 3295744 TI - LHRH treatment of hypothalamic amenorrhoea. AB - Chronic intermittent intravenous administration of 13 micrograms LHRH every 88 minutes for 28 days, was successful in inducing ovulation in two patients with 3a type secondary hypothalamic amenorrhoea. A catheter phlebitis was the only side effect of the treatment and it could be easily prevented by more flexible, thin venous catheters. The minimum laboratory need for monitoring the treatment, and the absence of hyperstimulation of the ovaries suggested the superiority of this substance to hMG for ovulation induction in clomiphene negative patients. PMID- 3295746 TI - [Ultrasonics in extradural hematoma in newborn infants]. PMID- 3295745 TI - Effects on immune reactions of non-steroidal anti-inflammatory drugs and of two new pyrido-pyrimidine derivatives (CHINOIN 127 and CHINOIN 105). AB - The effect of three non-steroidal anti-inflammatory agents (NSAIs) and of two new pyrido-pyrimidine derivatives, CHINOIN 127 (1-6-dimethyl-4-oxo-1,6,7,8,9)a hexahydro-4H-pyrido (1,2-2)pyrimidine-3-carboxamide) and CHINOIN 105 (1-6 dimethyl-4-oxo-1,6,7,8-tetrahydro-4H pyrido (1,2-a) pyrimidine-3-carboxamide) was compared in immune tests using human cells in vitro including T and B lymphocyte proliferation induced with mitogens, spontaneous motility of polymorphonuclear leukocytes, lymphokine (LIF) production, antibody-dependent cell-mediated cytotoxicity (ADCC) and natural killer cell (NK) activity. Indomethacin (INDO) at therapeutic concentrations enhanced the proliferation of lymphocytes stimulated by both Con A and PWM. Acetylsalicylic acid (ASA) increased proliferation of lymphocytes stimulated by Con A and at high concentration inhibited DNA synthesis induced by PWM. Phenylbutazone (PhB) increased DNA synthesis induced by PWM but not by Con A. CHINOIN 127 and CHINOIN 105 inhibited the proliferation of T lymphocytes but failed to influence DNA synthesis of B cells. Indomethacin, ASA and PhB inhibited the spontaneous motility (migration) of polymorphonuclear leukocytes. LIF production of lymphocytes was inhibited by INDO, ASA, PhB, CHINOIN 127 and CHINOIN 105. Phenylbutazone and ASA inhibit ADCC and NK. INDO, Chinoin 127 and Chinoin 105 failed to influence the effector cells of ADC and NK cytotoxicity. PMID- 3295747 TI - [Liver transplantation: children]. PMID- 3295749 TI - Quack-quack-quack: Donald Duck dissents. PMID- 3295748 TI - References for motor tasks--gender differences across age in motor performance: a meta-analysis. AB - In 1985 we published a meta-analysis of gender differences across age in motor performance in Psychological Bulletin, but it did not include an indexing of each motor task to the references from which it was obtained. This paper provides a table listing the 20 motor tasks and the references from which data for each task were taken. The range of tasks was from fundamental movements (e.g., catching, jumping, running, throwing) to motor fitness (e.g., agility, arm hang, balance, grip strength) to perceptual-motor abilities (e.g., anticipation timing, fine eye motor coordination, pursuit-rotor tracking, reaction time). The arm hang was represented in the fewest papers (n = 2) while the dash and long jump were most frequently referenced (n = 21). PMID- 3295750 TI - I.L. Chaikoff, biochemical physiologist, and his students. PMID- 3295751 TI - The effecting of all things possible: molecular biology and Bacon's vision. PMID- 3295752 TI - Sherlock Holmes and "brain fever". PMID- 3295753 TI - Galen on Erasistratus. PMID- 3295754 TI - Founders of pediatric pathology: Frederick W. Wiglesworth, MD. PMID- 3295755 TI - Biology of human gliomas. PMID- 3295756 TI - Retinoblastoma. PMID- 3295757 TI - Naegleria and acanthamoeba. Free-living amebas pathogenic for man. PMID- 3295758 TI - Central nervous system tumors of childhood. PMID- 3295759 TI - Drug therapy in continuous ambulatory peritoneal dialysis patients. AB - Transport of solutes across the peritoneal membrane in continuous ambulatory peritoneal dialysis (CAPD) is determined by patient-related factors (concentration gradient, membrane surface area, blood flow and membrane permeability) and by drug-related factors (charge on the molecule, protein binding, molecular weight, lipophilicity). On the basis of the chemical properties of a drug a prediction of the peritoneal clearance rate in CAPD patients is given, by the formula CLCAPD = 75 square root free fraction/molecular weight. The implications of this formula are discussed. It is concluded that usually it is not necessary to change the dose as compared with end-stage renal disease patients who are not treated with CAPD. PMID- 3295761 TI - The metabolic function of the lung. AB - Whereas the respiratory function of the lung has been studied extensively, there are only scarce data available concerning the lung's drug clearance capabilities in man. Its metabolic function in hormonally active agents has been documented in animals. To gain insight in this non-respiratory function of the lung knowledge of the architecture of the alveolar-capillary unit and the histochemistry of its different cell types is necessary. Some examples of studies with drugs are presented to illustrate the methods that have been used in metabolic and uptake studies of the lung. PMID- 3295760 TI - Changed pharmacokinetics under the influence of age. AB - Age significantly affects therapeutics in both general and specific ways. In newborns and in infants various physiological processes are still developing, whereas in elderly there may be decreased efficiency or capacity of physiological processes. Unexpected or 'idiosyncratic' responses to drugs in the very old or in the very young often can be explained by age-related changes in absorption, distribution, metabolism, end-organ responsiveness and excretion. Adolescence is often associated with rapid growth and changing body composition. Special problems with adolescents are poor compliance and drug abuse. Adults show a rather stable pharmacokinetic profile, although the cardiac output diminishes and the peripheral resistance increases about 1% annually. Exposure to enzyme inducing agents (nicotine, cimetidine) influences the pharmacokinetic parameters of both adolescents and adults. PMID- 3295762 TI - The influence of binding to albumin and alpha 1-acid glycoprotein on the clearance of drugs by the liver. AB - The liver is a major site for synthesis and catabolism of plasma proteins. Albumin has various binding sites for anionic drugs, alpha 1-acid glycoprotein possesses a single binding site for cationic drugs. In spite of extensive protein binding, the liver can efficiently remove drugs from the circulation. Intrahepatic dissociation of the drug-protein complex may involve dissociation limited debinding under non-equilibrium conditions or surface interaction facilitated dissociation phenomena. During liver or renal disease and acute-phase conditions plasma protein binding of drugs may be affected. Changes in the unbound drug fraction do not always result in proportional changes in clearance or distribution volume. Potential changes in the unbound concentration in steady state as well as the fluctuations in total plasma levels depend on the extent of protein binding of a drug, the relative change in the unbound drug fraction type of clearance, the size of the distribution volume, route of administration as well as concomitant changes in intrinsic (cellular) clearance function. Optimization of dosage regimens for certain drugs and interpretation of liver function tests with diagnostic dyes may largely benefit from determination of the unbound rather than the total concentration of the drugs involved. PMID- 3295763 TI - Plasma protein binding of digitoxin and some other drugs in renal disease. AB - Plasma protein binding of most acidic drugs is decreased in uraemia, whereas the binding of basic drugs is usually unchanged or decreased. Decreased protein binding in patients with renal disease mainly relates to drugs binding to albumin. Digitoxin binds to a specific site on the albumin molecule. Conflicting reports exist on digitoxin-protein binding in patients with renal disease. In ten patients with end-stage renal disease treated with haemodialysis we found only a slightly increased free fraction of digitoxin. A heparin-induced increase of the free fraction of digitoxin during haemodialysis has been reported. However, this increase was caused by the generation of non-esterified fatty acids in vitro. If this in vitro lipolysis was blocked, no increase of free digitoxin could be detected. Alterations of digitoxin-protein binding in uraemic patients during haemodialysis and during the intervals between haemodialysis treatments are small. PMID- 3295765 TI - Variability in drug metabolism: importance of genetic constitution. AB - In man wide variability exists in the rate of metabolism of drugs and among factors which contribute to this phenomenon genetic constitution is of major importance. The metabolism of a number of drugs is subject to polymorphism and the frequency distribution of particular pharmacokinetic parameters shows bimodality, with poor (PM) and extensive metabolizers (EM). Acetylation of a number of drugs is known to be polymorphic and the incidence of poor metabolizers varies markedly among different populations. Debrisoquine and sparteine are frequently applied model substrates for the characterization of a polymorphism in oxidative metabolism. Polymorphic drug oxidation may have important clinical implications, because when standard dosage regimens are applied plasma concentrations will reach far above the maximum acceptable in poor metabolizers and consequently side effects may arise. Regarding the multiplicity of the drug oxidizing enzyme system (cytochrome P-450) it could be of interest to combine model substrates in a cocktail to be able to characterize human subjects simultaneously for a number of independent polymorphisms. PMID- 3295764 TI - Pharmacokinetics in liver disease. AB - Some general pharmacokinetic principles, relevant to understand and predict altered disposition of drugs in liver disease, are reviewed. It is appropriate to differentiate between high- and low-clearance drugs as to the influence of hepatic dysfunction. On intravenous administration high-clearance drugs generally show reduced systemic clearance predominantly caused by decreased liver blood flow, whereas on oral administration a considerable increase in systemic availability may occur caused by reduced enzyme activity and (in cirrhosis) bij portacaval shunting. Low-clearance drugs are sensitive to reduced enzyme activity and reduced protein binding. It seems that oxidative reactions are far more affected than conjugation reactions in liver disease. Large inter-patient variability exists in the kinetics of a drug in any type of hepatic disease. The conventional liver-function tests are of no value in predicting altered drug disposition. PMID- 3295766 TI - ["Table step-shift digital subtraction angiography" for peripheral angiography]. PMID- 3295767 TI - [A factor of increase of hepatic metallothionein content in normal and adrenalectomized rats induced by whole body irradiation]. PMID- 3295768 TI - [Selective cerebral intra-arterial digital subtraction angiography by transbrachial approach]. PMID- 3295769 TI - Baccalaureate education in nursing: key to a professional career in nursing 1986 87. PMID- 3295770 TI - Associate degree education for nursing 1986-87. PMID- 3295771 TI - [Increased use of bonded bridges, evaluation, case presentation]. PMID- 3295772 TI - [Mechanized calculus removal. An important adjunct to manual cleaning in periodontal therapy]. PMID- 3295773 TI - [Adhesiveness and membrane glycoproteins of human polynuclear neutrophils]. AB - Clinical and biological features of a recently recognized inherited syndrome are reported. This syndrome, Leukocyte Adherence Deficiency, is characterized by recurrent, life-threatening infections. The increased susceptibility to infectious agents is mainly related in the inability of the leukocytes to adhere to certain surfaces, because all adherence-related functions of the neutrophils that lead to bacterial killing are impaired. Adherence deficiency is due to moderate or severe deficiency of three structurally related glycoproteins (MO1, LFA-1 and gp 150,95). All three glycoproteins are heterodimers and share a common subunit whose absence is the cause of the disease. PMID- 3295774 TI - [Allogenic bone marrow grafts in chronic myeloid leukemia]. AB - Between August 1979 and April 1986, we treated 70 patients with chronic myeloid leukemia by supralethal chemoradiotherapy followed by bone marrow transplantation (BMT) from HLA identical sibling donors (65 patients) or from identical twins (5 patients). All patients were splenectomized before BMT. To prevent graft versus host disease Cyclosporin alone or associated with Methotrexate was given; in addition 13 patients received a T cell depleted marrow. All patients showed engraftment. Of the 5 patients treated by syngenic BMT, 2 patients relapsed but all are alive in remission, 2 of them after a successful second BMT. Of the 36 patients treated by allogeneic BMT in the chronic phase, 20 are alive in unmaintained remission after a median follow-up of 24 months (range 6 to 58). No patients have relapsed. The actuarial survival at 2 years was 60%. Of the 29 patients with more advanced disease, 19 have survived with the actuarial survival at 2 years 50%. We conclude that the probability of cure after BMT is very high, especially if BMT is performed while the patient remains in the chronic phase. Only 3 patients grafted in accelerated or blast phase died with relapse. The main cause of death was interstitial pneumonitis (15 patients) and 10 patients died from other transplant-related complications. PMID- 3295775 TI - [Setting-up a national file of bone marrow volunteer donors]. AB - The lack of HLA matched sibling donors has become a problem. Recent improvements suggest the feasibility of marrow transplantation from unrelated donors. A program to obtain volunteer bone marrow donors has been developed. A total of 3,853 HLA A B typings were performed. A search for 83 patients was initiated; 51 of them had one or more HLA A and B (61%), 8 HLA A, B and DR antigen identical donors, 2 did not react in mixed lymphocyte culture. This experience confirms the necessity of increasing the donor file but the size remains to be established. PMID- 3295776 TI - Regulation of the Escherichia coli excision repair gene uvrC. Overlap between the uvrC structural gene and the region coding for a 24 kD protein. AB - The UvrA, UvrB and UvrC proteins of E. coli are subunits of a DNA repair enzyme, the ABC exonuclease. In this paper we study the uvrC regulatory region. The uvrC structural gene is preceded by an open reading frame encoding a 24 kD protein. A uvrC promoter has been mapped within this gene. The transcription start of a second promoter located 5' of the 24 kD gene is mapped in vivo. We show that transcription from both promoters on the chromosome is not inducible by UV damage. The possible translation start codons of the UvrC and of the 24 kD protein are determined. Sequences encoding the N-terminal part of the UvrC protein overlap with sequences encoding the C-terminal part of the 24 kD protein. To examine a possible function of the 24 kD gene in repair, a 24 kD insertion mutant was created in the chromosome. The mutant however only slightly affects the UV sensitivity of the cell. Transcription of P3 alone provides sufficient UvrC protein for the normal repair of UV lesions. PMID- 3295777 TI - Nucleotide sequence of the DNA region immediately upstream of the human c-sis proto-oncogene. PMID- 3295778 TI - The sequence of the maize plastid encoded rpl 22 locus. PMID- 3295779 TI - Isolation and characterization of cDNA clones encoding pathogenesis-related proteins from tobacco mosaic virus infected tobacco plants. AB - Infection of the tobacco cultivar Samsun NN by tobacco mosaic virus (TMV) results in a hypersensitive response. During this defense reaction several host encoded proteins, known as pathogenesis-related proteins (PR-proteins), are induced. Poly(A)+ RNA from TMV infected tobacco plants was used to construct a cDNA library. Thirty two cDNA clones were isolated and after digestion with different restriction endonucleases, twenty clones were found to code for PR-1a, six clones for PR-1b, and four clones for PR-1c. Two independent cDNA clones of each class were further characterized by DNA sequence analysis. All clones analyzed contained the 138 amino acid coding regions of their respective mature proteins, but only partial sequences of the signal peptides. Minor differences between the nucleotide sequences for clones belonging to the same class were detected. Comparison of the amino acid sequence for PR-1a deduced from its nucleotide sequence with published data obtained by Edman degradation of the protein showed four differences. Analysis of the 3' ends of the cDNA clones indicates that various alternate poly(dA) addition sites are used. Southern blot analysis using these cDNAs as probes suggests the presence of multiple PR-protein genes in the genomes of tobacco and tomato plants. PMID- 3295780 TI - An electrophoretic karyotype for Schizosaccharomyces pombe by pulsed field gel electrophoresis. AB - The three chromosomal DNAs of S. pombe have been fractionated by pulsed field gel electrophoresis. The resulting molecular karyotype will greatly speed gene mapping in this organism, and it indicates that the separation range of the technique extends to DNA molecules as large as 9,000,000 base pairs. PMID- 3295781 TI - The bases of the tRNA anticodon loop are independent by genetic criteria. AB - We employed two methods to study the translational role of interactions between anticodon loop nucleotides. Starting with a set of previously constructed weakly suppressing anticodon loop mutants of Su7, we searched for second-site revertants that increase amber suppressor efficiency. Though hundreds of revertants were characterized, no second-site revertants were found in the anticodon loop. Second site reversion was detected in the D-stem, thereby demonstrating the efficacy of the search method. As a second method for detecting interactions, we used site directed mutagenesis to construct multiple mutations in the anticodon loop. These multiple mutants are very weak suppressors and have translational activities that are equal to or lower than that predicted for the independent action of single mutations. We conclude that although the anticodon loop sequence of Su7 has an optimal structure for the translation of amber codons, we find no evidence that interactions between loop bases can enhance translational efficiency. PMID- 3295784 TI - Complete nucleotide sequence and deduced amino acid sequence of the M5 polypeptide gene of Escherichia coli. PMID- 3295782 TI - Expression of porcine pancreatic phospholipase A2. Generation of active enzyme by sequence-specific cleavage of a hybrid protein from Escherichia coli. AB - The cDNA coding for the porcine pancreatic prophospholipase A2 (proPLA) has been cloned and expressed in E. coli. Expression of proPLA could only be obtained in the form of intracellular aggregates after fusing the 15 kDa proPLA to a large (greater than or equal to 45 kDa) bacterial peptide. The fusion protein was readily purified from cell lysates, and specifically cleaved. Cleavage of the fusion protein was achieved with either hydroxylamine (at Asn/Gly sequences in the denatured protein), or trypsin (between the pro- and the mature PLA in the renatured fusion protein). The former method releases a proPLA-like enzyme, while the latter directly yields PLA. Renaturation of the fusion protein was made possible by the use of a recently reported new S-sulphonation method. The released (pro)PLA was purified (yields of 2-3 mg/ltr of culture medium), and showed identical properties compared to native (pro)PLA. PMID- 3295783 TI - Nucleotide sequence of the deoxycytidylate hydroxymethylase gene of bacteriophage T4 (g42) and the homology of its gene product with thymidylate synthase of E. coli. PMID- 3295785 TI - pXmnATG: an E. coli vector for expression of unfused proteins. PMID- 3295786 TI - Nursing history: don't be ashamed of the past. PMID- 3295787 TI - Controlling nasal haemorrhage. PMID- 3295788 TI - Continence. Choosing the right garment. PMID- 3295789 TI - Living memories. PMID- 3295790 TI - Trial of a mattress for the chronically disabled. PMID- 3295791 TI - Hollenback Prize for 1987 (Gunnar Ryge). PMID- 3295792 TI - Award of Excellence (Paul T. Dawson). PMID- 3295794 TI - [New aspects of substitute treatment of primary and secondary immunologic deficiency syndromes]. PMID- 3295793 TI - [Primary pulmonary hypertension]. PMID- 3295795 TI - [Problems of pharmacotherapy in old age]. PMID- 3295796 TI - [Advances in endocrinology]. PMID- 3295797 TI - Bombesin-induced anorexia: sites of action in the rat brain. AB - To determine the brain sites at which centrally injected bombesin (BBS) may act to suppress feeding behavior, this peptide (1.0 micrograms/0.3 microliter) was microinjected into one of twelve brain regions in 6 hr food deprived rats, and food intake was measured 45 min postinjection. Bombesin produced its strongest suppression of feeding (47-65%) when injected into hypothalamic areas, namely, the paraventricular, dorsomedial, ventromedial nuclei and lateral hypothalamus, and also when administered into the amygdala and the periaqueductal gray. Insensitive areas included the septum, ventral tegmental area and reticular formation. In contrast to these somewhat site-specific effects on feeding behavior, observation of BBS' effects on other behaviors revealed that, in all brain areas tested, there was a significant increase in grooming behavior and decrease in time spent resting and sleeping. In conjunction with high levels of BBS-like immunoreactivity and BBS receptors in the brain areas where injected BBS suppresses feeding, these results suggest that the effects of centrally administered BBS on feeding behavior may be mediated by multiple hypothalamic and extra-hypothalamic brain regions. PMID- 3295798 TI - The distribution pattern of alpha-MSH-like immunoreactivity in the cat central nervous system. AB - The distribution pattern of alpha-melanocyte stimulating hormone-like immunoreactivity (alpha-MSH-Li) was studied in cats using avidin-biotin modification of immunocytochemical method. Cell bodies containing alpha-MSH-Li were observed in the medial basal hypothalamus, especially in the infundibular nucleus, the lateral hypothalamus and near zona incerta. Fibers with alpha-MSH-Li extended beyond the hypothalamus, into the paraventricular nucleus of the thalamus, rostral amygdala, periaqueductal gray, locus ceruleus, parabrachial nucleus and medial nucleus of the nucleus tractus solitarius. Axons with alpha MSH-Li were also seen diffusely in various cortical areas, but more extensively in the limbic cortical regions. The distribution pattern of the cell bodies and fibers containing alpha-MSH-Li bears several similarities to that seen in rats, but differs in that the alpha-MSH-Li was not observed in cell bodies in locations other than the medial basal and lateral hypothalamus. PMID- 3295799 TI - GnRH-prohormone-containing neurons in the primate brain: immunostaining for the GnRH-associated peptide. AB - The structure of the prohormone for mammalian gonadotropin releasing hormone (proGnRH) includes the GnRH decapeptide followed by a 56 amino acid GnRH associated peptide (GAP). In this study, we compared immunostaining of brain neurons and fibers for GAP and GnRH in fetal rhesus monkeys and juvenile baboons. We used antisera against different portions of human and rat GAP (proGnRH 14-24, proGnRH 40-53, and proGnRH 52-66) or against GnRH and the PAP technique. Liquid phase absorption with GAP or GnRH confirmed the specificity of these antisera. Major accumulations of GAP immunoreactive (GAP+) perikarya occurred in the medial septal and preoptic areas and the nucleus of the diagonal band of Broca (44.6% in rhesus, 49.6% in baboon), supraoptic region including the area dorsal to the optic tract (21.9% in rhesus, 23.0% in baboon), and the medial basal hypothalamus (15.7% in rhesus, 16.4% in baboon), especially at the infundibular lip. Occasional cell bodies were scattered throughout the hypothalamic and forebrain regions studied. GAP+ fibers were widely distributed, but formed well-defined pathways such as the periventricular and ventral hypothalamic tract. In addition, GAP+ nerve terminals with various densities occurred in the lamina terminalis, the zona externa of the infundibulum, and behind the infundibular stalk. Fetal rhesus macaques had more GAP+ cell bodies, denser fiber networks, and more distinct pathways than juvenile baboons. However, fiber and terminal immunostaining was somewhat less intense for GAP than GnRH in comparable regions. These results indicate that proGnRH (GAP) is present in the same population of neurons as GnRH in the primate brain. They also suggest that post-translational products of proGnRH are present in perikarya, axons and terminals, and that GnRH and GAP and/or further cleavage products are consecreted into hypophysial portal blood in the primate. PMID- 3295800 TI - [Value of computerized tomography in surgical treatment of aortic aneurysm]. PMID- 3295801 TI - [Value of computerized tomography in the diagnosis of tumors of the antero superior mediastinum]. PMID- 3295802 TI - [A model of nursing care for patients treated by embolization]. PMID- 3295803 TI - [Chronic pancreatitis in ultrasonographic examination]. PMID- 3295804 TI - [Isolated foci of fatty infiltration in the liver]. PMID- 3295805 TI - [Exposure to ionizing radiation during stomatologic roentgenologic examination]. PMID- 3295806 TI - [Compensatory foils in teleradiography of the skull]. PMID- 3295807 TI - [16 years' observation of renal calcinosis]. PMID- 3295808 TI - [A rare case of anomaly of renal vascularization]. PMID- 3295810 TI - The behavioral management of hypertension. PMID- 3295809 TI - [A dictionary of terms relating to nuclear magnetic resonance]. PMID- 3295811 TI - [Results of treatment of arterial hypertension using a pindolol preparation]. PMID- 3295812 TI - [Arterial hypertension in patients after kidney transplantation]. PMID- 3295814 TI - [Causes of recurrent thrombophlebitis in the light of new studies]. PMID- 3295813 TI - [Treatment of ischemic ulcers of the extremities with intravenous intermittent infusions of prostacycline]. PMID- 3295815 TI - [Mechanisms of lipid binding by the arterial wall in arteriosclerosis]. PMID- 3295816 TI - [Clinical trials of atenolol, a beta 1 selective adrenolytic drug in the treatment of arterial hypertension and rhythm disorders in patients with bronchial asthma]. PMID- 3295817 TI - [New studies using calcium channel blockers in diseases of the circulatory and respiratory systems]. PMID- 3295818 TI - [Use of prostacyclin in patients with stomach ulcer in a double-blind clinical trial]. PMID- 3295819 TI - [Current theories of the immunological etiology of peptic ulcer]. PMID- 3295820 TI - A journal looking to its second century. PMID- 3295821 TI - The enzymatic studies of the liver in acute experimental pancreatitis in dogs treated with prostacyclin (PGI2). AB - The liver affection in acute experimental pancreatitis (AEP) could be reflected by changes of enzymatic activity in the liver and in serum. The histoenzymatic studies of the liver of dogs with AEP of different severity and time of duration induced according to Elliott's method were performed and the constellation of serum enzymatic activities considering treatment with prostacyclin was estimated. The histoenzymatic reactions on succinic dehydrogenase, lactic dehydrogenase and alkaline phosphatase were depressed with progression of time and severity of AEP. In contrast, the reaction on acid phosphatase was augmented at the same time. Serum AspAT, AlAT and alkaline phosphatase were augmented in the later phase of AEP, but acid phosphatase and beta-glucuronidase were not significantly changed. The treatment with PGI2 limited both histoenzymatic reactions and alterations of serum enzymatic activities. These results support the significance of changes in enzymatic activities in the course of liver reaction on pancreatogenic noxa during acute pancreatitis, and suggest the protective effect of PGI2 against liver injury in this disease. PMID- 3295822 TI - Immunohistochemical demonstration of metallothionein in the rat prostate. AB - Metallothionein in the rat prostate was demonstrated by using an indirect immunoperoxidase technique. Strong staining was found mainly in the supranuclear area of the cytoplasm of the glandular epithelium in the dorsal and the lateral glands. Diffuse cytoplasmic staining and nuclear staining were found with less frequency. Secretory granules were found in the lumen with various intensities of staining. Most of the epithelial cells in the ventral lobes and the coagulating glands were negatively stained. Immunoreactive cells were found sporadically. Two types of immunoreactive cells, round cells and spindle-shaped cells, were scattered in the stroma. Vascular endothelial cells, red blood cells, and smooth muscle cells were negatively stained. These results suggest the synthesis and secretion of metallothionein in the rat prostate. PMID- 3295823 TI - The use of computerized thermography in the evaluation of non-traumatic anterior knee pain. AB - Computerized thermography was used to evaluate eight patients with the complaint of non-traumatic anterior knee pain. Computerized thermograms were recorded before and after subjects performed a specific rehabilitation program. Thermographic imaging was then repeated 4 weeks to 8 weeks after the initial thermogram. Among the subject group, thermal asymmetries were noted in the involved knees, but a specific abnormal thermal pattern could not be recognized. Changes in temperature and thermal patterns after exercise and over time were consistent within each subject, but were not consistent between subjects. Thermal asymmetries did not appear to resolve over time. It is felt that the pathology investigated by this study may involve many etiologies, therefore making it difficult to establish a single abnormal thermal pattern with regard to non traumatic anterior knee pain. PMID- 3295824 TI - Biostability and morphology of tissue reaction of some synthetic polymers. AB - Synthetic polymers as tissue substitute are more and more widely used in medicine today. Therefore it is necessary to continue to complete our knowledge on the subject of the mutual interaction of the organism and tissue substitutes of synthetic polymers. The influence of the organism on the degradation processe of some synthetic textile fibres made of polyester was studied polypropylene and polyamide, which are either suggested or already used in the production of vascular protheses and other tissue substitutes. The morphological picture of tissue reaction to implanted synthetic fibres, the mechanical properties of the fibres and changes in their surface structure after 4-360 days after implantation were also studied. PMID- 3295825 TI - Pseudomonas septicemia with nodules and bullae. AB - We examined a patient with systemic lupus erythematosus and sepsis due to Pseudomonas aeruginosa. Early in the infection, she developed skin lesions that consisted of indurated tender nodules and hemorrhagic and nonhemorrhagic bullae. Blister fluid contained gram-negative rods, which were identified as P. aeruginosa on culture. Bullae and nodules, as well as ecthyma gangrenosum, can be early cutaneous signs of pseudomonal sepsis. PMID- 3295826 TI - Group A beta-hemolytic streptococcal septicemia complicating infected hemangioma in children. AB - Septicemia complicating infected hemangiomas was diagnosed in two children aged 2 months and 2 years. The younger also developed bacterial meningitis. Group A beta hemolytic Streptococcus non-M protein typable was isolated in both patients. Neither had leukocytosis and in only one was the erythrocyte sedimentation rate elevated. The children recovered after intravenous antibiotic therapy. Use of systemic antibiotics should be considered in infected hemangiomas in childhood even in the absence of elevated acute-phase reactants. PMID- 3295827 TI - Chronic bullous dermatosis of childhood: immunopathologic studies. AB - Chronic bullous dermatosis of childhood (CBDC) is a distinctive subepidermal blistering disorder that characteristically involves the lower face, neck, lower trunk, and diaper area. Nearly all affected patients have a continuous linear band of IgA at the dermoepidermal junction by direct immunofluorescence and many have circulating IgA antibasement membrane antibodies. Few ultrastructural studies have been performed to determine the location of these IgA autoantibodies. We examined an infant with the typical clinical, histopathologic, and immunopathologic features of CBDC in whom a circulating, lamina lucida reactive IgA autoantibody was identified with a new, more sensitive, split-skin indirect immunofluorescence technique. PMID- 3295828 TI - Effect of insulin on the size of skeletal muscle fibers of fetal rhesus monkey. AB - Increased body weight of insulin-treated fetuses is largely attributed to increased muscle mass. Skeletal muscle from fetal rhesus monkeys was analyzed for differences in the sizes of muscle fibers from monkeys treated in utero with high or low doses of insulin and compared to control (non-insulin-treated) animals. The results indicate no significant difference among the various groups studied and suggest that hyperplasia, not hypertrophy, of skeletal muscle fibers is responsible for the observed increase in muscle mass. PMID- 3295829 TI - Pediatric pathology in the USSR. PMID- 3295830 TI - Giant-cell myocarditis in a newborn with congenital herpes simplex virus (HSV) infection: an immunohistochemical study on the origin of the giant cells. AB - Giant-cell myocarditis is a rare inflammatory disorder characterized by degeneration and necrosis of myocardial fibers and presence of chronic inflammatory infiltrates associated with multinucleated giant cells forming a granulomatous inflammatory reaction. The etiology of giant-cell myocarditis is unknown. Many conditions have been reported as associated with this phenomenon such as fungi, virus, sarcoidosis, and hypersensitivity or autoimmune reactions. We are reporting a case of giant-cell myocarditis discovered in a newborn with congenital herpetic sepsis. The myogenic origin of the giant-cells of this case is supported by the positivity for desmin and myoglobin and negativity for muramidase and alpha-1-antichymotrypsin after immunoperoxidase procedure. The presence of Herpes simplex virus type II was confirmed by indirect immunoperoxidase reaction in most of the viscera including the heart, but is not considered a factor in the production of giant cells. PMID- 3295831 TI - Case 8. Enteric duplication cyst of duodenum: cause of polyhydramnios in an 18 trisomic male fetus. PMID- 3295832 TI - Acute rheumatic fever in the 1980s. AB - Acute rheumatic fever (ARF) is an inflammatory sequela which occurs in 1-3% of children afflicted with group A beta-hemolytic streptococcal pharyngitis (strep throat). The major manifestations are carditis, migratory polyarthritis and chorea. ARF recurs with repeated strep throats and frequently leads to rheumatic heart disease (RHD), usually mitral and aortic regurgitation and mitral stenosis. ARF likely results from an abnormal host immune response with a host antibody/streptococcal antigen production in pharyngeal tissue and subsequent cross-reaction of host antibodies with host end organs. Treatment includes eradication of the streptococcus, use of high doses of salicylates and adrenal corticosteroids, and prolonged bed rest with gradual ambulation after clinical and laboratory signs of the disease are gone. While the incidence and mortality of ARF and RHD have decreased drastically in the affluent industrialized countries of Europe, North America, and in Japan, the disease is a major health problem in the less affluent, 'developing' countries of Latin America, the Middle East, Africa, India and Southeast Asia. The major risk factors for ARF are believed to be genetic or familial, inadequate medical care and crowded conditions. The last two factors are socioeconomic but may also be influenced by ethnic cultural behavior. Genetic propensity for ARF is supported by recent evidence of a specific DR-HLA marker in the majority of people with ARF or RHD. Finally, while ARF appears to be vanishing in most areas of the country, it is still prevalent in some affluent populations and in some disadvantaged minorities. PMID- 3295833 TI - Systemic lupus erythematosus. Controversies in management. AB - At the core of the controversy surrounding the management of systemic lupus erythematosus are the two issues of when to treat and what treatment to use. On the basis of a review of the recent medical literature, the following conclusions can be drawn: Patients with isolated serologic or histologic renal abnormalities in the absence of clinical disease activity probably should not be treated. Such abnormalities primarily serve to indicate the need for close follow-up and to heighten the physician's concern about the possible development of clinical symptoms. For those patients with systemic manifestations who require corticosteroids, a regimen of single daily doses is appropriate. The dose should be tapered as rapidly as the degree of symptomatic control allows; a switch to alternate-day therapy can be considered as symptoms become quiescent. Intravenous methylprednisolone therapy may be used for patients with very severe systemic disease, particularly acute nephritis. In addition, use of immunosuppressive agents should be considered for all patients with clinically serious renal disease. PMID- 3295834 TI - Neurology in 1947. A PGM retrospective. PMID- 3295835 TI - Travel medicine resources for the primary care physician. AB - Emporiatrics, or travel medicine, is not a part of everyday medical practice for most physicians, but with the growth in both domestic and international travel it makes sense to be prepared when the need arises. A number of useful resources are available to help in providing travel medicine services for both occasional and frequent travelers in need of accurate information about travel and health. A most useful aspect of the resources reviewed here is that they can be ordered or used according to the travel medicine needs of particular patients. PMID- 3295836 TI - Effects of fasting, water deprivation, and adrenal-blocking chemicals on resistance to Escherichia coli challenge. AB - Fasting for 2 days plus 1 day of feeding resulted in increased resistance to Escherichia coli challenge. If feed during the postfasting period contained metyrapone (a blocker of adrenal synthesis of corticosterone), resistance to E. coli challenge was reduced. Fasting for 1.75 days or water deprivation for 2 days resulted in decreased resistance to E. coli challenge. Deprivation of water for two days of chickens with blocked adrenals resulted in an E. coli challenge response similar to that of controls. PMID- 3295837 TI - Josephine Goldmark (1877-1950): a biographic sketch. PMID- 3295838 TI - Glucocorticoid levels and lymphocyte functions in kidney transplanted patients. AB - The in vitro lymphocyte response to mitogen stimulation and the in vitro lymphocyte sensitivity to glucocorticoid were examined in 72 kidney transplanted patients before and after administration of high or low doses of glucocorticoid. Administration of 10 mg of prednisone orally to 10 patients did not significantly change the mitogen responses or the lymphocyte sensitivity to methylprednisolone. Likewise, administration of 100-120 mg of methylprednisolone, intravenously to 62 patients did not significantly affect the mitogen responses, but, in contrast, the lymphocyte sensitivity to the immunosuppressive effect of methylprednisolone was clearly increased. This effect was highly significant in both cyclosporine A and azathioprine treated patients. These findings suggest that a change of the lymphocyte sensitivity to the immunosuppressive effect of methylprednisolone may occur after a high dose of glucocorticoid, anaesthesia and surgery, although no changes of the immunefunctions in vitro can be demonstrated by examining the mitogen response of the lymphocyte cultures. No relationship was found in the present study between the individual lymphocyte sensitivity to glucocorticoid and metabolic clearance rate. PMID- 3295839 TI - Binding of the aliphatic halides 1,2-dibromoethane and chloroform in the rodent vaginal epithelium. AB - Whole-body and light microscopic autoradiography were used to study the binding of 1,2-dibromo(14C)ethane (14C-DBE) and 14C-chloroform (14C-CF) in the mouse and rat vaginal epithelium in vitro and in vivo. In pregnant mice, mice pretreated with pregnant mare's serum gonadotropin (PMSG) or ovariectomized mice primed with medroxyprogesterone, a high level of bound 14C-DBE metabolites were present in the epithelium, while in ovariectomized oestradiol-primed mice or intact oestradiol-primed mice, the binding was low. Similar results were obtained with 14C-CF, although the level of binding generally was lower than that observed after 14C-DBE-exposure. No binding of 14C-DBE-metabolites was observed in the juvenile rat vaginal epithelium, whereas a high binding was present in the PMSG primed adult rat vaginal epithelium. Collectively, these data show that 14C-DBE and 14C-CF are transformed in situ to metabolites that are irreversibly bound to the vaginal epithelium. The results also suggest that the activating enzyme is under endocrine control and has a low activity in the juvenile and oestradiol primed adult animal. PMID- 3295840 TI - Chronic treatment with antidepressant drugs and ECT differentially modifies the hypothermic action of clonidine and guanfacine. AB - The hypothermia inducing action of clonidine and guanfacine was abolished by yohimbine and idazoxan pretreatment which suggests an alpha 2-adrenoceptor involvement in this effect. The effects of acute and chronic treatment with the antidepressant drugs desipramine (DMI), amitriptyline (AMI), maprotiline (MAP), mianserin (MIAN), iprindol (IPR), alaproclate (ALA) and electroconvulsive treatment (ECT) on the hypothermic action of the alpha 2-adrenoceptor agonists clonidine and guanfacine were studied. Acute administration of MIAN potentiated clonidine induced hypothermia whereas acute MIAN, IPR and ALA potentiated guanfacine induced hypothermia. Repetitive DMI, AMI and MAP treatment attenuated clonidine-induced hypothermia whereas guanfacine-induced hypothermia was potentiated by chronic treatment with DMI, AMI, MAP and MIAN, ECT applied without anaesthesia attenuated both clonidine and guanfacine hypothermia, however, under ethyl ether anaesthesia ECT was effective only towards guanfacine hypothermia. This discrepancy is discussed in terms of the relative selectivity of the agonists used, the reliability of agonist studies for indexing receptor function, and possible pharmacokinetic interaction. PMID- 3295841 TI - [Contemporary amalgams]. PMID- 3295842 TI - [Model technics in fixed dentures (I. Parallel course of leading pivots)]. PMID- 3295843 TI - [Evaluation of controlled clinical trials in chemotherapy of lung tuberculosis]. PMID- 3295844 TI - Early prenatal diagnosis of a lethal syndrome of multiple congenital contractures. AB - An ultrasonic diagnosis of a lethal, autosomally recessive syndrome of multiple congenital contractures was made in seven high-risk pregnancies on the 13rd to 17th gestational weeks. The diagnostic findings were the development of progressive subcutaneous oedema from the 13th gestational week on and the decrease of fetal limb movements. PMID- 3295845 TI - A prospective study of spontaneous miscarriage in ultrasonically normal pregnancies and relevance to chorion villus sampling. AB - A total of 1,068 patients were examined by ultrasound to ensure normality of pregnancy and followed prospectively from booking until 28 weeks. The spontaneous miscarriage rate was 2.7 per cent occurring within the first 16 weeks. Threatened miscarriage was associated with a 38 per cent fetal loss. Miscarriage was less likely as pregnancy advanced. The reduction in subsequent miscarriage rate before 11 weeks and from 11 weeks onwards is statistically significant (p less than 0.001). Gravidity, maternal age and a history of previous fetal loss did not contribute significantly to the miscarriage rate. Patients with a history of fetal loss were more likely to experience a threatened miscarriage. The relevance of these findings to chorion villus sampling is discussed. PMID- 3295846 TI - Listeriosis: a cause of non-immune hydrops fetalis. AB - A case of prenatally diagnosed non-immune hydrops fetalis, that was later shown to be caused by listeriosis, is presented, and the clinical course, as well as the appropriate diagnostic and therapeutic procedures are described. We conclude, that listeriosis should be excluded, whenever a non-immune hydrops fetalis is associated with septicemia, influenza-like illness and fever of unknown origin. PMID- 3295847 TI - Prenatal diagnosis of thalidomide syndrome. AB - A case of thalidomide syndrome diagnosed by ultrasound in the 17th week of pregnancy is presented. The pregnant woman had leprosy and received adjuvant treatment with thalidomide. The affected fetus was exposed to the drug until the 35th day of pregnancy and presented absent external ears, upper limb phocomelia and absent tibiae and fibulae. No internal organ abnormalities were noticed at autopsy. PMID- 3295848 TI - The importance of chorionic villus sampling after first trimester diagnosis of cystic hygroma. AB - The prenatal diagnosis of The Turner Syndrome is described at a menstrual age of 12 weeks. Detection of cystic hygroma was followed by vaginal chorionic villous sampling (CVS) which revealed a 45,X karyotype. Early documentation of fetal karyotype in the presence of a cystic hygroma is essential for accurate diagnosis and genetic counselling. PMID- 3295849 TI - [Immunohistochemical and electron microscopy findings of an unusual splenoma]. PMID- 3295850 TI - [Ludolf Krehl (1861-1937)]. PMID- 3295851 TI - [Alport syndrome, status following kidney transplantation, malabsorption syndrome; multilocular intestinal Kaposi sarcoma]. PMID- 3295852 TI - [Immunohistologic characterization of so-called nevus cell nests in lymph nodes]. PMID- 3295853 TI - [Tumor metastases in the spleen]. PMID- 3295854 TI - Fetal and newborn calf thymus as a source of chromatin proteins: purification of HMG-1 and HMG-2. PMID- 3295855 TI - Peroxidase-labelled lectin binding of human extravillous trophoblast. AB - The binding of four peroxidase-conjugated lectins, concanavalin A (Con-A), wheat germ agglutinin (WGA), peanut agglutinin (PNA) and soybean agglutinin (SBA), in both fixed and frozen tissue sections of human extravillous trophoblast (EVT) was determined. On the basis of its lectin binding properties the EVT cell population was found to be heterogeneous. PNA and SBA did not bind to any of the EVT cells. Con-A and WGA bound to most EVT cells, with the exception of the trophoblast of the chorion laeve. The trophoblast giant cells bound only Con-A and not WGA. The villous cytotrophoblast, from which the EVT cells are said to derive, does not express the sugar groups detected by the above lectin probes. The expression of mannosylated and di-N-acetylchitobiosyl residues by a fetally derived cell invites speculation that such expression enables it both to invade host maternal tissues and to avoid any adverse host immunological response. PMID- 3295856 TI - The influence of mode of fixation on morphometrical data derived from terminal villi in the human placenta at term: a comparison of immersion and perfusion fixation. AB - The placenta is a highly vascular organ which is subjected to a variable degree of compression during delivery. Partial collapse of the fetal capillary network inevitably results, and this has significant effect upon the maternofetal diffusion distance. Fixation via a dual perfusion system operating at physiological pressures can redistend the vascular tree to its antenatal state. Morphometrical analysis provides a volume fraction for the fetal capillaries within the terminal villi of 38.4 per cent, a figure which approximates closely to values obtained from in situ biopsy of the placenta. The harmonic mean diffusion distance was found to be 3.6 micron. Perfusion fixation resulted in a lower coefficient of variation for many parameters compared with traditional immersion fixation. By negating the unpredictable influence of the placental transfusion, it is considered that perfusion fixation will make true interplacental variations easier to detect. PMID- 3295857 TI - Biases and weak associations. AB - Bias is any systematic error in the design, conduct, analysis, or interpretation of a study that tends to produce an incorrect assessment of the nature of the association between an exposure or risk factor and the occurrence of disease. It is evident that a major emphasis in an epidemiologic study should be to minimize any biases that may occur at any stage of the study. Since by definition, biases will produce an incorrect assessment of the nature and magnitude of an association, avoidance of bias will be particularly important when the association under investigation is already presumed to be weak. The major biases important for evaluating weak associations are described in the context of how they may occur and how they may be avoided at each stage of an epidemiologic study. PMID- 3295859 TI - Tribute to Paul Dudley White. PMID- 3295858 TI - The use and abuse of subgroup analysis in epidemiological research. AB - Most epidemiology involves the analysis of subgroups. In observational studies, identification of associations within particular subgroups is the usual method of investigation, while in experimental studies the purpose is to compare the rate of occurrence of the outcome of interest in treated and control groups. Problems can arise through failure to specify the subgroups of interest a priori and through examining large numbers of subgroups after the fact, i.e., through multiple testing. Rules for interpretation of findings in subgroups are suggested, and the value of the systematic application of criteria for judgement of the causal significance of any associations that may be observed is noted. PMID- 3295860 TI - Cytochemical localization of NADH and NADPH oxidases during interaction of Trypanosoma cruzi with activated macrophages. AB - NADH- or NADPH-oxidase activity was cytochemically detected at the ultrastructural level during the process of interaction between Trypanosoma cruzi and activated mouse peritoneal macrophages. The reaction product, indicative of enzyme activity, was found in the portion of the plasma membrane of the macrophages to which the parasites attached. It was also found in the membrane which surrounds endocytic vacuoles containing ingested parasites. PMID- 3295861 TI - Purification of metacyclic trypomastigotes of Trypanosoma cruzi and Trypanosoma dionisii from culture using an epimastigote-specific monoclonal antibody. AB - Monoclonal antibodies which react with culture forms of Trypanosoma dionisii and Trypanosoma cruzi were tested for their agglutination capacity. In these studies developmental stage specificity for the epimastigote form could be observed. This specificity meant it was possible to develop a quick and simple method to isolate cultured metacyclic trypomastigotes of T. dionisii and T. cruzi group 2. After agglutination of the epimastigote form with the monoclonal antibody Dion 4.6 the purity of metacyclic trypomastigote developmental forms derived from culture was 96% to 99%. PMID- 3295862 TI - Immunocytochemical demonstration of 5-hydroxytryptamine (serotonin) in the nervous system of the liver fluke, Fasciola hepatica (Trematoda, Digenea). AB - The localisation and distribution of 5-hydroxytryptamine (5-HT or serotonin) in the nervous system of Fasciola hepatica has been determined by an indirect immunofluorescence technique. Cell bodies and nerve fibres immunoreactive to 5-HT are present in the anterior ganglia, and the longitudinal nerve cords and their commissures in the central nervous system. In the peripheral nervous system, similar immunoreactivity occurs in the nerve plexuses supplying the sub tegumental muscle layers and the muscular lining of various reproductive ducts, including the ootype, uterus and cirrus pouch. The significance of these results in the light of previous studies on the role of 5-HT in F. hepatica is discussed. PMID- 3295863 TI - Master's programs in nursing: cardiovascular nursing specialization. PMID- 3295864 TI - Cardiac transplantation for doxorubicin cardiotoxicity. PMID- 3295865 TI - The Lipid Research Clinics coronary primary prevention trial: a critical review. PMID- 3295866 TI - Expression of the Saccharomyces cerevisiae glycoprotein invertase in mouse fibroblasts: glycosylation, secretion, and enzymatic activity. AB - Oligosaccharide processing is controlled by host- and protein-dependent factors. To increase our understanding of the relative contribution of those factors we studied the glycosylation of yeast invertase expressed in a heterologous system. Invertase synthesized in psi-2 cells (an NIH 3T3-derived packaging line) is secreted efficiently, enzymatically active, and heavily glycosylated. It was estimated that the protein contains 8 or 9 carbohydrate chains. Two classes can be observed, of an approximate size of 100-110 kDa and 115-130 kDa, respectively. The size differences are due to differences in glycosylation. The smaller class contains two high-mannose carbohydrate chains; the remainder is of the complex type, sialylated and most likely tri- or tetraantennary. This profile parallels the situation observed with invertase glycosylation in yeast, where 2 of 9 or 10 chains remain unprocessed. The larger size class of invertase expressed in mouse fibroblasts has a different profile, since it contains probably only complex-type glycans. There are no apparent differences, however, in the size of the protein backbone between the two size classes. When invertase is synthesized in the presence of the mannosidase inhibitor 1-deoxymannojirimycin, processing is blocked completely, since all glycans are susceptible to endo-beta-N acetylglucosaminidase H. The glucosidase inhibitor 1-deoxynojirimycin does not inhibit processing completely. In both cases secretion of the protein is not affected. The glycosylation inhibitor tunicamycin prevents secretion of invertase completely when cells are cultured at 37 degrees C. At 26 degrees C, however, nonglycosylated invertase can be detected in the medium. These data suggest that glycosylation of invertase seems to be essential for the early steps of the secretory pathway but is less critical for later events. PMID- 3295867 TI - TUF, the yeast DNA-binding factor specific for UASrpg upstream activating sequences: identification of the protein and its DNA-binding domain. AB - The factor TUF interacts specifically with RPG or HOMOL1 sequences, which are present upstream of many genes coding for the yeast translational apparatus. Here we present evidence that the RPG and HOMOL1 motifs are variants of a consensus UASrpg (upstream activating sequence) recognized by the same factor. Factor TUF was identified by using two highly selective methods. The DNA-protein complex was isolated by pore-limit electrophoresis in polyacrylamide gradient gels and found to contain a single polypeptide of 150 kDa. In a two-step protein blotting/nuclease-protection ("footprinting") procedure, the same 150-kDa polypeptide blotted on nitrocellulose exhibited the same specific DNA-binding properties as TUF factor. A 50-kDa DNA-binding domain of TUF was isolated by selective proteolysis. This suggests a bipolarization of the TUF protein, with distinct functional domains. PMID- 3295868 TI - Soluble factors stimulating secretory protein translocation in bacteria and yeast can substitute for each other. AB - mRNA for prepro-alpha-factor (pp alpha), a yeast secretory glycoprotein, was translated in a wheat germ cell-free system that was posttranslationally supplemented either with inverted vesicles from the plasma membrane of Escherichia coli (INV) or with microsomes from Saccharomyces cerevisiae. A postribosomal supernatant (PRS) from E. coli was found to stimulate translocation of pp alpha across the INV membrane. A yeast PRS could substitute for its E. coli counterpart. Likewise, an E. coli PRS could substitute for a yeast PRS and stimulate translocation of pp alpha across yeast microsomal membranes. PMID- 3295869 TI - Insulin-like synergistic stimulation of DNA synthesis in Swiss 3T3 cells by the BSC-1 cell-derived growth inhibitor related to transforming growth factor type beta. AB - A cell growth inhibitor (GI), purified from BSC-1 cell-conditioned medium, has little if any effect on DNA synthesis when added alone to monolayer cultures of quiescent Swiss mouse 3T3 cells in serum-free medium. However, the inhibitor, which is closely related to transforming growth factor type beta (TGF-beta), exhibits a pronounced synergistic stimulation of DNA synthesis in combination with certain peptide (bombesin, vasopressin) or polypeptide (platelet-derived growth factor) mitogens. A similar synergistic response has been demonstrated for TGF-beta purified from human platelets. In the presence of 3 nM bombesin, a half maximal stimulation of DNA synthesis was obtained at a GI concentration of approximately 60 pg/ml, with a maximal response at approximately 600 pg/ml. The synergistic interactions demonstrated by GI or TGF-beta in stimulating Swiss 3T3 cells closely resemble those previously shown for insulin, and we have observed that GI does not synergize with insulin to stimulate DNA synthesis in these cells. Like insulin, and in contrast to bombesin, vasopressin, and platelet derived growth factor, GI does not activate cellular inositolphospholipid hydrolysis, calcium mobilization, or cross-regulation of epidermal growth factor receptor affinity. These results raise the possibility that the biochemical pathways activated by GI/TGF-beta and insulin converge at a post-receptor stage. PMID- 3295870 TI - Spectrum of cisplatin-induced mutations in Escherichia coli. AB - Using a forward-mutation assay based on the inactivation of the tetracycline resistance gene located on plasmid pBR322, we have determined the mutation spectrum induced in Escherichia coli by cisplatin [cis diamminedichloroplatinum(II)], a widely used antitumor drug. Cisplatin is known to form mainly intrastrand diadducts at ApG and GpG sites. We found that cisplatin efficiently induces mutations in an SOS-dependent way (i.e., dependent upon UV irradiation of the host bacteria). More than 90% of the mutations are single-base-pair substitutions occurring at the potential sites of cisplatin adducts (ApG and GpG). Taking into account the relative proportions of ApG and GpG adducts, we found that the ApG adducts are at least 5 times more mutagenic than the GpG adducts. Moreover, a strong mutation specificity was seen at the 5' side of the ApG adducts (A X T----T X A transversions). The observation that most mutations occur at the 5' end of the adduct at both ApG and GpG sites is discussed in relation to recent structural data. PMID- 3295871 TI - Corticotropin-releasing factor in the olivocerebellar tract of rats: demonstration by light- and electron-microscopic immunohistochemistry and in situ hybridization histochemistry. AB - The presence of corticotropin-releasing factor (CRF) in the olivocerebellar system was demonstrated in rats by light- and electron-microscopic immunohistochemistry, as well as by in situ hybridization histochemistry. CRF like immunoreactivity was present in each portion of the olivocerebellar system: In colchicine-treated rats, CRF-immunostained cells were found in each nuclei and subunit of the inferior olive. After surgical transection of the medullary portion of the olivocerebellar tract, CRF-immunostaining accumulated in inferior olive neurons contralateral to the lesion. In situ hybridization histochemistry indicated that CRF mRNA is transcribed in inferior olive neurons for translation to CRF precursor, whereas CRF mRNA was depleted contralateral to the lesion. CRF immunopositive fibers of the olivocerebellar tract were demonstrated ipsilateral to the transection due to an accumulation in the proximal portion of transected axons. CRF-immunopositivity was demonstrated in climbing fibers in the molecular layer of the cerebellum at both light- and electron-microscopic levels. CRF immunostained nerve terminals (climbing fiber varicosities) established synaptic contact with dendritic spines of the Purkinje cells. These three observations provide morphological evidence suggesting that CRF might serve as a neurotransmitter in the olivocerebellar system. PMID- 3295872 TI - Telencephalon-specific antigen identified by monoclonal antibody. AB - Immunohistochemical screening of monoclonal antibodies (mAbs) raised against fractions rich in the dendrodendritic synaptosomes of the rabbit olfactory bulb revealed that one of the mAbs (mAb 271A6) recognized a telencephalon-specific antigen or antigens. Thus, the stain with mAb 271A6 was observed throughout the gray matter of all regions of the neocortex, piriform cortex, hippocampus, striatum, septum, and the amygdaloid nucleus, in addition to the main and accessory olfactory bulbs. The mAb 271A6, however, labeled neither nontelencephalic regions of the central nervous system nor the peripheral nervous system so far examined. Dot-immunobinding assays of homogenates of various brain regions also showed the telencephalon-specific distribution of the antigen designated as 271A6. Antigen 271A6 is developmentally regulated. At birth, the antigen was expressed in a small quantity only in phylogenetically older telencephalic regions such as the olfactory bulb, piriform cortex, striatum, cingulate cortex, and hippocampus. It was hardly detectable in most areas of the neocortex. The densities and areas of 271A6-positive structures increased during the early postnatal period. These results demonstrate a molecular specificity of the most rostral brain segment, the telencephalon. mAb 271A6 may be a good tool for obtaining a better understanding of the molecular basis of the segmental organization or the segment-specific functions of the brain. PMID- 3295874 TI - Ubiquitous upstream repression sequences control activation of the inducible arginase gene in yeast. AB - Expression of the yeast arginase gene (CAR1) responds to both induction and nitrogen catabolite repression. Regulation is mediated through sequences that both positively and negatively modulate CAR1 transcription. A short sequence, 5' TAGCCGCCGAGGG-3', possessing characteristics of a repressor binding site, plays a central role in the induction process. A fragment containing this upstream repression sequence (URS1) repressed gene expression when placed either 5' or 3' to the upstream activation sequences of the heterologous gene CYC1. Action of the URS and its cognate repressor was overcome by CAR1 induction when the URS was situated cis to the CAR1 flanking sequences. This was not observed, however, when it was situated downstream of a heterologous CYC1 upstream activation sequence indicating that URS function is specifically neutralized by cis-acting elements associated with CAR1 induction. Searches of sequences in various gene banks revealed that URS1-like sequences occur ubiquitously in genetic regulatory regions including those of bacteriophage lambda, yeast, mammalian, and viral genes. In a significant number of cases the sequence is contained in a region associated with negative control of yeast gene regulation. These data suggest the URS identified in this work is a generic repressor target site that apparently has been conserved during the evolution of transcriptional regulatory systems. PMID- 3295873 TI - Relative roles of T7 RNA polymerase and gene 4 primase for the initiation of T7 phage DNA replication in vivo. AB - Initiation sites of T7 phage DNA replication in the presence and absence of T7 phage gene 4 primase have been analyzed by using Escherichia coli cells infected with T7 phage amber mutants, T73,6 and T73,4,6, respectively. Restriction analysis of the [3H]thymidine-labeled DNA, synthesized by the T73,4,6 phage infected cells in the presence of 2',3'-dideoxy-3'-azidothymidine, has shown that only the light (L) strand of T7 DNA has been synthesized from the primary origin area to the right. Transition sites from RNA to DNA have been located precisely in the primary origin region of the T7 phage genome. In the gene 4- condition, greater than 20 transition sites have been detected only in the L strand. They scattered widely downstream from the phi 1.1 promoters and mostly downstream from the phi 1.3 promoter. The same transition sites have been detected in the gene 4+ condition, suggesting that the transcripts started from these promoters are used as primers of the rightward L-strand DNA synthesis in the gene 4+ condition. In addition, many heavy (H)- and L-strand transition sites have been detected at gene 4 primase sites in the gene 4+ condition. The relative roles of T7 phage RNA polymerase and primase at the primary origin have been discussed. PMID- 3295875 TI - Separations of open-circular DNA using pulsed-field electrophoresis. AB - The effect of high electric fields on the gel-electrophoretic mobility of open circular DNA in agarose differs dramatically from that on linear molecules of the same molecular weight. At high fields, sufficiently large circular forms are prevented from migrating into the gel whereas linear molecules and smaller circular DNAs migrate normally. This effect is strongly field dependent, affecting circular molecules of decreasing size with increasing field strength. We have studied this effect with a series of plasmid DNAs ranging from 2.9 to 56 kilobase pairs using continuous and reversing-pulse electric fields. Application of reversing pulses abolishes the effect under certain conditions and supports the model for the gel electrophoresis of open-circular DNA where circular forms are trapped by engaging the free end of an agarose gel fiber. PMID- 3295876 TI - Import and processing of human ornithine transcarbamoylase precursor by mitochondria from Saccharomyces cerevisiae. AB - Expression of the subunit precursor of the human mitochondrial matrix enzyme ornithine transcarbamoylase (OTCase; EC 2.1.3.3) was programmed in Saccharomyces cerevisiae from a 2-micron plasmid by using an inducible galactose operon promoter. In the presence of the inducing sugar (galactose), two polypeptides were specifically precipitable with anti-OTCase antiserum: the human OTCase precursor (40 kDa); and the mature OTCase subunit (36 kDa). When yeast cells containing these species were lysed and fractionated, the OTCase precursor was found to be associated with mitochondrial membranes, while the mature subunit was found partly with mitochondrial membranes and partly in the soluble mitochondrial matrix-containing fraction. When OTCase enzymatic activity was assayed in fractions similarly derived from an S. cerevisiae strain devoid of yeast OTCase activity (an arg3 mutant) but expressing human OTCase, activity was detected specifically in the mitochondrial matrix fraction. A mutant human OTCase precursor containing an artificial mutation in the NH2-terminal leader peptide (arginine-23 to glycine) was similarly examined. As was previously observed with mammalian mitochondria, this precursor failed both to reach the matrix compartment and to be proteolytically processed; it also failed to exhibit OTCase enzymatic activity. Presence of OTCase enzymatic activity in an arg3 strain expressing wild-type precursor was utilized to obtain selective growth in a medium devoid of arginine but supplemented with the OTCase substrate ornithine. We conclude that, during evolution, the pathway of mitochondrial import utilized by the human OTCase precursor is conserved between yeast and humans, and that, by using selective growth conditions, it may be possible to examine genetically this pathway in S. cerevisiae. PMID- 3295877 TI - DNA polymerase III of Escherichia coli is required for UV and ethyl methanesulfonate mutagenesis. AB - Strains of Escherichia coli possessing the pcbA1 mutation, a functional DNA polymerase I, and a temperature-sensitive mutation in DNA polymerase III can survive at the restrictive temperature (43 degrees C) for DNA polymerase III. The mutation rate of the bacterial genome of such strains after exposure to either UV light or ethyl methanesulfonate was measured by its rifampicin resistance or amino acid requirements. In addition, Weigle mutagenesis of preirradiated lambda phage was also measured. In all cases, no increase in mutagenesis was noted at the restrictive temperature for DNA polymerase III. Introduction of a cloned DNA polymerase III gene returned the mutation rate of the bacterial genome as well as the Weigle mutagenesis to normal at 43 degrees C. Using a recA-lacZ fusion, the SOS response after UV irradiation was measured and found to be normal at the restrictive and permissive temperature for DNA polymerase III, as was induction of lambda prophage. Recombination was also normal at either temperature. Our studies demonstrate that a functional DNA polymerase III is strictly required for mutagenesis at a step other than SOS induction. PMID- 3295878 TI - Functional characterization of an antigen involved in an early step of T-cell activation. AB - An activation antigen, identified by the monoclonal antibody MLR3, is described that is present on activated T lymphocytes and thymocytes but not on resting T lymphocytes. Immunoprecipitation of radiolabeled membranes from an activated T cell line showed that the MLR3-binding molecule has a molecular size of 28-34 kDa. Immunofluorescence analysis showed that the appearance of the MLR3 antigen is an early event and precedes that of the interleukin 2 receptor both in T lymphocytes and thymocytes. The proliferative response of resting T cells to OKT3 Sepharose and interleukin 1 or accessory cells, but not the interleukin 2 dependent proliferation, was inhibited by the addition of MLR3 monoclonal antibodies. Similar results wer also obtained in an interleukin 1-dependent human thymocyte proliferation assay. In addition when MLR3-positive cells were cultured with purified interleukin 1, MLR3 surface antigen expression was not observed. Thus MLR3 monoclonal antibody appears to recognize an antigen involved in an early step of T-cell activation related to interleukin 1-dependent functions and on both T lymphocytes and thymocytes. PMID- 3295879 TI - Arginine decarboxylase inhibitors reduce the capacity of Trypanosoma cruzi to infect and multiply in mammalian host cells. AB - The capacity of blood (trypomastigote) forms of Trypanosoma cruzi to infect mouse peritoneal macrophages or rat heart myoblasts in vitro was inhibited by treatment of the trypomastigotes with DL-alpha-difluoromethylarginine (F2Me Arg), monofluoromethylagmatine, or (E)-alpha-monofluoromethyl-3-4-dehydroarginine--all irreversible inhibitors of arginine decarboxylase. Similar results were obtained when F2MeArg-treated parasites were incubated with rat heart myoblasts. The inhibitory effects were characterized by marked reductions in both the proportion of infected cells and the number of parasites per 100 host cells. The concentrations of the arginine decarboxylase inhibitors that affected infectivity had no detectable effect on either the concentration or motility of the parasite and, therefore, could not have affected the collision frequency. F2MeArg appeared to inhibit the ability of T. cruzi to penetrate the host cells since the drug had no significant effect on the extent of parasite binding to the surface of the host cells. The inhibitory effect of F2MeArg was markedly reduced or abrogated in the presence of either agmatine or putrescine, as would have been expected if F2MeArg acted by inhibiting arginine decarboxylase. Addition of F2MeArg to macrophage or myoblast cultures immediately after infection or at a time when virtually all of the intracellular parasites had transformed into the multiplicative amastigote form, resulted in a markedly reduced parasite growth rate. This effect was also prevented by exogenous agmatine. These results indicate the importance of polyamines and polyamine biosynthesis in the following two important functions of T. cruzi: invasion of host cells and intracellular multiplication. Furthermore, concentrations of the inhibitors tested that affected the parasite did not alter the viability of the host cells, the cellular density of the cultures, or the ability of uninfected myoblasts to grow. Thus, arginine decarboxylase inhibitors may have a potential application in chemotherapy against T. cruzi infection. PMID- 3295880 TI - Viruses in fungi: infection of yeast with the K1 and K2 killer viruses. AB - We demonstrate here that yeast killer viruses, previously thought to be transmitted only by cytoplasmic mixing during division, mating, or other induced forms of cell fusion, are capable of extracellular transmission. Viral particles from standard K1 and K2 killer strains were used to inoculate sensitive cells of Saccharomyces cerevisiae, rendered competent by spheroplasting, lithium acetate treatment, or by natural mating. Extracellular transmission of the killer viruses was judged by the following criteria and controls. Filter-sterilized virus inocula were shown to be free of viable yeast cells, and host cells treated in the absence of added virus did not yield killer progeny. Infected clones originating from spheroplasts or lithium acetate-treated cells were shown to possess the genotype of the host strain and the killer phenotype of the infecting virus. Infected clones derived from complementary mating pairs were found to be wild-type diploids, whose meiotic segregants exhibited 2:2 segregation for unlinked nutritional markers and 4:0 segregation for the killer phenotype. This technique is generally applicable to the study of interactions between yeast viruses and different hosts and suggests that extracellular transmission may be a natural route for the inheritance and dissemination of mycoviruses. PMID- 3295881 TI - Expression of the alpha-bungarotoxin binding site of the nicotinic acetylcholine receptor by Escherichia coli transformants. AB - Restriction fragments of DNA derived from a cDNA clone of the alpha subunit of the acetylcholine receptor were subcloned in Escherichia coli by using the trpE fusion vector, pATH2. Transformants expressing the amino acid sequences 166-315 or 166-200 are shown to produce a chimeric protein that bound alpha-bungarotoxin. Moreover, it is shown that sufficient amounts of toxin-binding proteins can be generated by individual colonies of bacteria. This provides a new approach for gene selection via functional expression--i.e., ligand overlays of colony blots. PMID- 3295882 TI - The Alexander technique. PMID- 3295883 TI - Adenosine: a clinical experience and comparison with verapamil for the termination of supraventricular tachycardias. AB - The efficacy and side-effects of adenosine for treatment of supraventricular arrhythmias were compared to verapamil therapy in patients presenting to the emergency room. Clinical variables and the time interval from the initiation of treatment to the termination of the supraventricular tachycardia, as well as the time from the initial effective dose of medication to the termination of supraventricular tachycardia were compared for adenosine and verapamil. Adenosine was given to a total of 44 patients, 16 patients in the electrophysiology laboratory, and 28 patients in the emergency room for evaluation and termination of their tachycardia. In the electrophysiology laboratory, 7 patients had AV node reentry, 5 had Wolff-Parkinson-White syndrome, 2 of whom had atrial flutter and fibrillation but no bypass tract reentry, 1 had concealed bypass tract reentry, 1 had Lown-Ganong-Levine syndrome, 1 had intraatrial reentry, and 1 had an automatic atrial tachycardia. Twenty-five patients received adenosine in the emergency room and 3 patients in the hospital for 31 episodes of supraventricular arrhythmias. In the emergency room, 11 patients had supraventricular tachycardia due to AV node reentry, 3 had Wolff-Parkinson-White syndrome, 6 had atrial flutter or intra-atrial re-entry, 2 had ventricular tachycardia, and 3 had sinus tachycardia. In the hospital, 2 patients had atrial flutter and one had sinus tachycardia. The group of 14 patients with supraventricular tachycardia due to Wolff-Parkinson-White syndrome or AV node reentry presenting in the emergency room were compared in a retrospective manner to the patients treated with standard verapamil therapy with respect to time from initiation of therapy to termination of supraventricular tachycardia and time from effective dose of medication to the termination of supraventricular tachycardia, as well as side effects. There was no significant difference between the two groups with respect to clinical variables. Adenosine converted 18 of 18 episodes of supraventricular tachycardia in 14 patients 24.6 +/- 9.6 seconds from the administration of the effective dose (0.104 +/- 0.024 mg/kg) and a mean of 4.4 +/- 2.0 minutes from the initiation of therapy. Verapamil converted 29 of 32 episodes of supraventricular tachycardia in 20 patients, 10.9 +/- 7 minutes from the administration of the effective dose, and a mean of 16.8 +/- 20 minutes from the initiation of therapy using a mean of 8.4 +/- 3.4 mg of IV verapamil.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3295884 TI - The relative activity of endotoxins of different origins in the LAL gelation method and in the LAL chromogenic substrate method. PMID- 3295885 TI - Comparison of E. coli endotoxin 055:B5 with U.S. Standard Endotoxin EC-5 using the Limulus amebocyte lysate assay. PMID- 3295886 TI - Measurement and calculation of endotoxin inactivation by dry heat. PMID- 3295887 TI - Fixing and removing of bacterial endotoxins from glass surfaces for validation of dry heat sterilization. PMID- 3295888 TI - Endotoxin neutralizing capacity of sera from different patient populations assessed by the Limulus lysate test. PMID- 3295889 TI - Structural requirements for gelation of the Limulus amebocyte lysate by endotoxin. PMID- 3295890 TI - A comparison of two quantitative assays for bacterial lipopolysaccharides. PMID- 3295892 TI - Identification of MHC-like molecules from lower vertebrates using crossreactive xenoantisera. PMID- 3295891 TI - Immunological aspects of snail-trematode interactions. AB - After penetration into its snail host the trematode not only has to find a suitable environment, it also has to circumvent the activities of its host's internal defence system to survive and to develop normally. Immunological compatibility of snails and trematodes is dependent on the capability of the parasite to evade and/or suppress the defence activities of its host. The possible role of physicochemical properties of the surfaces of the parasite and the host defence cells in evasion of host responses remains unknown; a role is indicated for molecular mimicry in the miracidium and the young mother sporocyst and for masking in the cercaria. Strong evidence exists that trematodes secrete substances which suppress anti-trematode activities of snail haemocytes. PMID- 3295893 TI - Interleukins and T-cell ontogeny in Xenopus laevis. PMID- 3295894 TI - Hemagglutinins and bacterial agglutinins of earthworms. AB - The biological roles of invertebrate agglutinins have been and remain an unresolved subject of controversy. Classical studies on agglutinins, beginning with the pioneer work of Noguchi (1903) on Limulus polyphemus and Homarus americanus have emphasized their hemagglutinating properties, an approach that has been criticized for its lack of biological relevance. While erythrocyte agglutination has proven useful for determining various properties of invertebrate agglutinins, it does not address the question of their natural function. More recently, invertebrate agglutinins have been investigated for their ability to interact with pathogenic agents such as bacteria (for review, see Pistole, 1982), yeast (Van der Knapp et al., 1982; Renwrantz and Stahmer, 1983) and parasitic protozoans (Ingram et al., 1984). In addition, the possible relationship of agglutinins to defense mechanisms of both vertebrates and invertebrates has been indicated by the observation that limulin, the major agglutinin of Limulus polyphemus, bears a number of similarities to vertebrate C reactive proteins (Robey and Liu, 1981). In annelids, there have been no studies on bacterial agglutinins prior to our work with Lumbricus (Stein et al., 1985; Stein et al., submitted). Earthworms are particularly appropriate for studying bacterial agglutinins since their coelomic fluid contains constant low levels of bacteria and fungal spores, and their agglutinins are both naturally occurring and inducible. Although our initial studies on Lumbricus agglutinins were directed toward their hemagglutinating properties, our recent observations using bacteria have allowed us to reach the following conclusions: 1) Lumbricus coelomic fluid normally contains agglutinins against both erythrocytes and bacteria. After injecting worms with either erythrocytes or bacteria, agglutinin titers increase in coelomic fluid. This increase appears to be due to both an increase in numbers of agglutinins as well as levels of specific agglutinins. 2) Absorption studies, temperature effects and sugar inhibition analyses suggest that agglutinins which bind to erythrocytes are identical to bacterial agglutinins, but there are additional agglutinins capable of reacting only with bacteria. 3) The inducibility and bacterial binding properties of Lumbricus agglutinins suggest that they serve an immune function by participating in the earthworm's defense against bacterial infection. In this sense, the agglutinins serve as a humoral surveillance system that entraps and prevents the multiplication of pathogenic bacteria. PMID- 3295896 TI - History of parkinsonism. PMID- 3295895 TI - Genetic and biochemical polymorphism of earthworm humoral defenses. PMID- 3295897 TI - Neurotoxins, parkinsonism and Parkinson's disease. PMID- 3295898 TI - The contribution of PET scanning to understanding metabolism and drug actions in the basal ganglia. PMID- 3295899 TI - Rapid three-dimensional treatment planning: I. Ray-tracing approach to primary component dose calculations. AB - Algorithms for fully three-dimensional divergent-beam radiotherapy treatment planning have been developed to achieve very high sampling of dose in heterogeneous (inhomogeneous density) tissue throughout an arbitrarily oriented patient volume, in clinically acceptable times of calculation. Dose is calculated at points along numerous rays which sample each beam. To display the dose distribution, the calculated dose values for each beam are interpolated onto rectilinear grids of (arbitrary) parallel planes, scaled for beam weight and finally merged with the weighted dose contributions of other beams. In this paper we describe and demonstrate the algorithm for the primary component of the three dimensional photon dose distribution delivered to a patient. PMID- 3295900 TI - Physical therapy for patients after bone marrow transplantation. AB - The purpose of this article is to provide an overview of bone marrow transplantation (BMT) as it relates to the practice of physical therapy based on experiences at a cancer research center. This overview includes information on the diseases treated with BMT, patient treatment regimens during hospitalization, and complications commonly encountered. Physical therapy guidelines are suggested for the evaluation of and therapeutic intervention for patients after BMT. PMID- 3295901 TI - [The future emerges from the past. From the memoirs of a woman activist. 1]. PMID- 3295902 TI - [The silver anniversary of a school]. PMID- 3295903 TI - [Worthy imitations (Leokardia Wanda Tarnawska, 1899-1981)]. PMID- 3295904 TI - [How our passion was born. From the memoirs of a woman activist. 2]. PMID- 3295905 TI - [Anna Stronska-Jadlowska (1922-1977)]. PMID- 3295906 TI - [Silver anniversary in Szczecin]. PMID- 3295907 TI - [The strength of community. From the memoirs of a woman activist. III]. PMID- 3295908 TI - Is there a place in plastic surgery for the past? PMID- 3295909 TI - The double-tipped needle. PMID- 3295910 TI - Proper surgical treatment of Bowen's carcinoma. PMID- 3295911 TI - Salvage of amputation stumps by secondary reconstruction utilizing microsurgical free-tissue transfer. AB - During a 2-year period, 15 lower and upper extremity amputees were treated by microsurgical free-tissue transfer in an effort to salvage their amputation stumps. Salvage of length and restoration of contour to aid in prosthetic rehabilitation were the two main indications for reconstruction. Included in the 15 transfers were 3 scapular free flaps, 11 latissimus dorsi musculocutaneous flaps, and 1 groin flap. Thirteen of the patients in this group were refitted with prostheses following reconstruction and did well with no pain or skin breakdown of the resurfaced stumps. The follow-up period on these patients averaged 16 months. One patient, in whom the flap succeeded, underwent stump soft tissue revision and myodesis. One patient, in whom the flap failed, continued to develop recurrent ulceration in his stump. This clinical experience followed an extensive laboratory study of 12 above-knee amputation patients using noninvasive Doppler ultrasound measurements to determine weight-loading and interface pressure distribution between the stump and the socket of the prostheses and their relation to stump length and circumference. PMID- 3295912 TI - Free flaps to preserve below-knee amputation stumps: long-term evaluation. AB - Five patients with insufficient soft-tissue coverage on below-knee amputation stumps have been treated with free-tissue transfer surgery to preserve a functional below-knee prosthetic level. The flaps employed include one latissimus dorsi myocutaneous flap, two latissimus dorsi muscle-skin graft flaps, one groin flap, and one foot-fillet flap. All five flaps survived; one patient required early venous anastomosis reexploration and revision. The patients have been followed for a mean duration of 5.5 years (range 3 to 8 years). The mean duration to first ambulation with a prosthesis was 3.6 months (range 2 to 7 months). Four of the five patients developed ulcerations on or adjacent to their flaps which required surgical revision. The patients required a mean of 1.28 prosthesis changes annually since surgery. The functional motion (mean active knee motion is 100 degrees) and ligamentous stability of the knee joints were well preserved in all patients. Five patients wear patella tendon-bearing prostheses, with one requiring an additional thigh corset. In two of the patients, nerve anastomoses to their flaps were performed. Both patients developed true cutaneous sensibility, but nevertheless experienced flap ulceration. All the patients are fully ambulatory on their free flaps. Free-tissue transfer can assist in preserving traumatic below-knee amputations so that patients can benefit from the functional advantage of a below-knee prosthetic device. PMID- 3295913 TI - The double-V urethral closure: a modification of Mustarde's operation for distal hypospadias. PMID- 3295914 TI - Free-flap salvage of a traumatic below-knee amputation. AB - A traumatic below-knee amputation with extensive soft-tissue loss and tibial bone exposure was salvaged by employing microsurgical free-tissue transfer to obtain stable soft-tissue coverage. The free flap covering the bony stump and knee function have done well with over 1 year follow-up. PMID- 3295915 TI - Heel reconstruction with the deep circumflex iliac artery osteocutaneous flap. AB - A patient with extensive loss of bone and soft tissue from the right heel is presented. The defect was reconstructed using an osteocutaneous flap based on the deep circumflex iliac vessels. Indications for this procedure include extensive loss of bone and soft tissue precluding the use of local flaps. A 30-month period has elapsed since her reconstruction. A single ulcer developed 13 months postoperatively that healed after flap revision. We feel that tailoring the flap to minimize redundancy at the initial operation, subsequent tissue excision if necessary, and reinnervation augment durability of the flap. PMID- 3295916 TI - Reversing the antilock braking system theory for suture removal. AB - A simple and extremely practical technique for removal of long subcuticular sutures is possible by simply interposing a rubber band between the suture and the traction source. We have likened the technique in a reverse manner to the pulsing application of brakes in the antilock braking system now commonly found in modern automobiles. We also suggest with this paper that Prolene at this time be tried as the suture of choice in pullout repairs of all types. PMID- 3295917 TI - Free radicals: basic concepts concerning their chemistry, pathophysiology, and relevance to plastic surgery. AB - This paper is an attempt to present important concerns in the rapidly expanding field of free radicals to a plastic surgical audience. Mechanisms and a systematic approach to free-radical pathology are presented, with several illustrative areas discussed more deeply. PMID- 3295918 TI - [Results of stereotactic treatment of drug-resistant epilepsy]. AB - After a brief review of results reported so far regarding the stereotactic treatment of seizures, the author describes the results achieved with eight patients on whom stereotactic coagulation was performed in the right or left amygdala-hippocampus complex between 1976 and 1983 on account of drug-resistant partial seizures. Except for one case, in which the indications were purely clinical and it proved impossible to influence the frequency of seizures, seizures either ceased or their frequency was reduced. With a mean duration of 15 years, the period of pharmacoresistance until surgery was indicated was far longer than reported in the literature. PMID- 3295919 TI - [Neurology--psychiatry in Dresden from E. Kraepelin through S. Ganser to J. Suckow]. AB - The broad outline of the psychiatric-neurological care of hospitalised patients in Dresden from 1885 to 1963 is sketched, with special reference to the work and achievements of E. Kraepelin (1885), S. Ganser (1886-1913), E. Reiss (1925-1933), H. Krisch (1933-1945), and J. Suckow (1955-1963). PMID- 3295920 TI - Multiple loop purification method for selective cultivation of Pentatrichomonas hominis. AB - It is always troublesome having protozoan cultures contaminated with other organisms in the laboratory. The method described here produces high efficiencies of purification for fast moving flagellate protozoa. A human strain Pentatrichomonas hominis was employed in the study to examine the effects of multiple loop tubes on the purification of flagellates. Trichomonads were harvested from a trypticase yeast extract iron-serum-33 (TYI-S-33) medium, adjusted to 2 X 10(5) organisms/ml, and mixed with an equal volume of 2 X 10(6) organisms/ml of bacteria. The isolation was performed at 37 degrees C in TYI-S-33 medium containing a suitable amount of antibiotics (1000 U/ml of penicillin, 1000 micrograms/ml of streptomycin, and 4 micrograms/ml of fungizone). Four days later, 10(6) organisms/ml of protozoa, free of bacteria, were observed at the other end of the single loop and the double loop tubes. About the same amount of flagellates could be found at the other end of the triple loop tube six days after incubation. The traditional U-shaped tubes were used as controls and 10(5) cells/ml of flagellates were recovered in the presence of bacteria two days after incubation. An axenic culture of P. hominis was successfully isolated from the feces of a Formosan rock-monkey, Macaca cyclopsis, by this method. Purified trichomonads were recovered from a double loop purification tube five days after incubation. PMID- 3295921 TI - Preparation of large temporomandibular joint specimens for pathological study. AB - Ten fresh temporomandibular joint (TMJ) specimens about 5 X 4.5 X 3.5 cm in size were removed at autopsy by 5 cuts according to appropriate anatomical landmarks. After routine formalin fixation, the whole-TMJ specimens were wrapped with a thin layer of self-curing resin and then cut with a low speed bone saw along the parasagittal plane predetermined by x-ray guidance. Each specimen was serially cut into 4 to 5 parallel slices of 3 mm thickness, which were then decalcified with 14% EDTA and embedded in paraffin. Histological sections of 5 microns were stained with hematoxylin and eosin. The procedures were accomplished within 20 to 24 days after autopsy. With this technique, the anatomical interrelationships among the various joint components could be maintained and the macroscopic and microscopic topography of the TMJ could be studied in the desired reference plane. Therefore, the corresponding changes among the joint components in a diseased TMJ could be thoroughly examined. This technique was also applicable for the study of large specimens containing both hard and soft tissues. PMID- 3295922 TI - [Diazepam and reaction time in patients with neuroses]. PMID- 3295924 TI - [Current theories on the etiopathogenesis and treatment of Alzheimer's disease]. PMID- 3295923 TI - [Delusional thinking--its definition and classification]. PMID- 3295926 TI - A critical analysis of the process of human choice. PMID- 3295925 TI - [Col. Jan Nelken, M.D]. PMID- 3295927 TI - Conflict resolution and inhospital therapeutic process. PMID- 3295928 TI - [The survivor: reflections on guilt and shame]. PMID- 3295929 TI - Sexual dysfunctions: a survey of Toronto health professionals. PMID- 3295930 TI - Assessment of depression in adolescent patients. PMID- 3295931 TI - Post traumatic stress disorder: a tri-modal approach. PMID- 3295932 TI - Secondary mania: aggravation of a sub-clinical condition. PMID- 3295933 TI - Treatment of vomiting with relaxation therapy. PMID- 3295934 TI - Sodium amytal and psychosocial withdrawal. PMID- 3295935 TI - A placebo-controlled crossover study of oral clonidine in acute anorexia nervosa. AB - The alpha 2-adrenergic agonist clonidine has been reported to increase feeding in several species. This study evaluated the effects of clonidine (500-700 micrograms/day), administered per os, to four treatment-resistant anorexia nervosa patients in a long-term placebo-controlled crossover trial. All patients increased their body weight significantly. Clonidine administration, however, did not influence the rate of weight gain, nor did clonidine affect hunger or satiety sensations. Similarly, 24-hour urinary 3-methoxy-4-hydroxyphenylglycol levels and levels of anxiety and depression were unchanged by clonidine. By contrast, clonidine showed significant hemodynamic effects; clonidine lowered systolic and diastolic blood pressure, reduced pulse rate, and produced sedation. Discontinuation of clonidine was associated with a small but significant weight loss compared to a small weight increase during the initiation of clonidine treatment. The results suggest that clonidine may not be indicated in the treatment of anorexia nervosa. PMID- 3295936 TI - Helene Deutsch: a life in theory. AB - Evaluations of Helene Deutsch's work on female psychology almost invariably focus on her idealization of motherhood and on her attribution of narcissism, passivity, and masochism to the "feminine" woman. The author suggests that identification plays a more important role in Deutsch's portrayal of feminine development than has hitherto been acknowledged. Deutsch treats identification as a reparative process that enables women to overcome major traumata by allowing them to re-experience the initial bliss of the mother-child relationship. The biographical origins of Deutsch's theory of feminine development are explored, and an assessment offered of how her reliance on personal experience both enhanced and inhibited its explanatory power. PMID- 3295937 TI - Permanent molar stainless steel crown restoration. PMID- 3295938 TI - [DAKI, a pressure equalizing cushion: a new aid in daily practice]. PMID- 3295939 TI - [Castable apatite: a new biocompatible material for prostheses. I: Theoretical views]. PMID- 3295940 TI - [Preparation of a smoother and powdered titanium-coated titanium surface with ultrasonic tooth scalers]. PMID- 3295941 TI - [Comparison of the amount of wear on adhesive clasps and on crowns]. PMID- 3295943 TI - [Intrasulcular preparation and impression technic]. PMID- 3295942 TI - [Castable apatite: a new biocompatible material for prostheses. II: Preparation of the artificial tooth]. PMID- 3295944 TI - [Crown and bridge prostheses]. PMID- 3295946 TI - [Preparation of grooves in root canal walls and their effect on the retention of root posts]. PMID- 3295945 TI - [Bonded bridges (Maryland bridges)]. PMID- 3295947 TI - [Practical application of individual anterior tooth concepts: manipulation of the contour curve former (CCF) (I)]. PMID- 3295949 TI - [Basic principles in prosthetics: complete dentures (XII)]. PMID- 3295950 TI - [Preventive care after insertion of prostheses]. PMID- 3295948 TI - [Root posts]. PMID- 3295951 TI - [Basic principles in prosthetics: prosthetic auxiliary elements (I)]. PMID- 3295952 TI - [Dental treatment in antiquity]. PMID- 3295953 TI - [Model preparation (I)]. PMID- 3295954 TI - [Model preparation (II)]. PMID- 3295955 TI - [Basic principles in prosthetics: prosthetic accessories (II)]. PMID- 3295956 TI - [Today, all that glitters is not gold!]. PMID- 3295957 TI - [Once again: the color of teeth]. PMID- 3295958 TI - [Basic principles in prosthetics: prosthetic accessories (III)]. PMID- 3295959 TI - [Model preparation (III)]. PMID- 3295960 TI - [Model analysis of anterior tooth arrangement using a biogenic pattern (II)]. PMID- 3295961 TI - [Fractures of a removable partial dentures on a framework of chromium-cobalt alloy]. PMID- 3295962 TI - [Preparation of galvanized silver models in inlay, crown and bridge technics]. PMID- 3295963 TI - [Composition of enamel-ceramic corresponding to natural color layer composition]. PMID- 3295965 TI - [Problems of color matching and color transmission]. PMID- 3295964 TI - [Comparative study of the use of butane and propane as the gas for the Silicoater method]. PMID- 3295967 TI - [Naturally efficient crown restorations (I)]. PMID- 3295966 TI - [Treatment of a female patient with Kennedy-Class III with an acid etch bridge (bonded bridge): a longitudinal study]. PMID- 3295968 TI - [Willis glass: a glass-ceramic synthesis to avoid dark and shadow zones on gingiva]. PMID- 3295969 TI - [Finishing a complete bar-joint denture on 2 IMZ implants in the mandible]. PMID- 3295970 TI - [A device for the uniform warming of a casting crucible]. PMID- 3295971 TI - [The Woga key]. PMID- 3295972 TI - [Naturally efficient crown restorations (II)]. PMID- 3295973 TI - [Combination of metal-ceramic veneers and jacket crowns: 20 points for patients (I)]. PMID- 3295975 TI - [Melting cobalt-chromium alloys with various flames and by induction]. PMID- 3295974 TI - [Perspective by contrast]. PMID- 3295976 TI - The subcellular distribution of 238Pu and 239Pu in primary cultures of rat hepatocytes. AB - The subcellular distribution of 238Pu and 239Pu after incubation of primary cultures of rat hepatocytes with the citrate complex of these metals was studied, and the results were compared with data from in vivo experiments. As in vivo, the lysosomes are the principal organelles in which 238Pu and 239Pu are accumulated. In contrast to in vivo studies, 239Pu is also detectable on the pericellular membranes and in the cell nuclei, where it is predominantly bound to a high molecular-weight component. The percentage of the total cellular 239Pu which can be recovered in the cell nuclei increased with incubation time from 10% at 1 h to nearly 30% at 5 h. Plutonium-238, an isotope with 270-fold higher specific activity than 239Pu, showed no association with the nuclei. The membrane-bound fraction of 239Pu, as determined using the exogenous chelator diethylenetriaminepentaacetic acid decreased from 30% at shorter incubation times to 15% at longer incubation periods. After incubation with 238Pu the membrane fraction and the cytosolic fraction contained higher concentrations of the radionuclide than after incubation with 239Pu. PMID- 3295977 TI - [B streptococcal infection--problems in neonatology and diagnostic value of roentgen thoracic images]. PMID- 3295978 TI - [Experience in the diagnosis and therapy of pediatric ureterocele]. PMID- 3295980 TI - Diagnosing AIDS radiographically. PMID- 3295979 TI - [Use of ultrasound tomography in nephrologic diagnosis in children (study of 780 intravenous urograms in children)]. PMID- 3295981 TI - [Occult and clinically suspected testicular tumor. Assessment using real-time sonography]. AB - The diagnostic value of real-time-sonography was evaluated in 62 patients with suspected and occult testicular tumors. In 28 patients intratesticular tumors were identified on real-time-sonograms. In addition 7 clinically occult tumors were diagnosed by real-time-sonography. It was not possible to differentiate between orchitis and tumors on sonograms (3 cases). There was correlation only between the morphologic appearance of tumors on sonograms and the corresponding histology. Using high frequency transducers sonography proved to be an useful diagnostic modality to identify or to rule out occult intratesticular tumors. PMID- 3295982 TI - [Sonography in cervical lymph node metastases]. AB - The value of high resolution real time sonography for the detection of cervical lymph-node metastases in head and neck cancers was assessed in 118 histological proven cases. The accuracy of sonography (89%) proved to be superior to palpation (80%). In 9 patients a thrombosis of the internal jugular vein was detected. The ability of sonography to detect tumorous infiltration of the arterial vessel wall is discussed in 12 patients. Regarding possible artefacts, sonography is the only imaging modality which can solve this problem. Sonography should be performed preoperatively in all patients with malignant head and neck tumors for cervical lymph-node staging. PMID- 3295983 TI - Colorectal carcinoma: a radiologic and clinical review. AB - A profusion of imaging techniques is currently used for evaluating patients with suspected or known colorectal carcinoma. In most institutions, the combination of flexible sigmoidoscopy and a well-performed barium enema study should be retained as a more cost-effective, safe, and complete method of examination than colonoscopy. Endosonography appears to be promising for evaluating preoperatively the local extent of rectal carcinoma. CT is being challenged by MR imaging as the most sensitive modality for detecting liver metastases, but CT currently remains the technique of choice for evaluating recurrent disease and its extent. The diversity of available modalities will ensure that the radiologist remains at the forefront in the clinical investigation of colorectal carcinoma. PMID- 3295984 TI - Development of the hypodysplastic kidney: contribution of antenatal US diagnosis. AB - Two cases of fetal perirenal uriniferous pseudocyst were diagnosed in utero with ultrasound studies. The perirenal collections resolved spontaneously in utero. Follow-up examination showed growth impairment of the affected kidney. At birth, no renal function was demonstrated in one case and only slight function in the other case. Pathologic examination showed a highly dysplastic kidney with extravasated urine in the case in which surgery was performed. Some hypodysplastic kidneys apparently result from acute in utero obstruction with secondary pyelocalyceal rupture. Renal dysplasia could render the kidney more vulnerable to such phenomena. PMID- 3295985 TI - Normal standards for kidney length in premature infants: determination with US. Work in progress. AB - In 52 healthy premature infants, 104 kidneys were sonographically examined and kidney length was measured. Kidney length was compared with four parameters: body weight, body length, body surface area, and gestational age. Scatter plots of these data demonstrated that kidney length versus body weight conformed well to a linear distribution with a high correlation coefficient. A nomogram for kidney length versus body weight in premature infants is also presented. PMID- 3295986 TI - Gastric ulcer disease in infants: US findings. AB - Among 600 infants examined with ultrasound for vomiting, seven (mean age, 3 months) had distinctive features that can be considered diagnostic of gastric ulcer. The findings are thickening of the mucosa (greater than 4 mm) in the antropyloric region, elongation of the antropyloric canal, persistent spasm, and delayed gastric emptying. Two of the infants had slight thickening of the pyloric muscle. Gastrointestinal series or endoscopy demonstrated thickened gastric mucosa and a deformed gastric antrum in all infants, as well as actual ulceration in five. PMID- 3295988 TI - Eigenimage filtration of intravenous digital subtraction angiograms of the heart. Work in progress. AB - The authors developed a postprocessing technique, eigenimage filtering, to extract phase-dependent information from digital subtraction angiograms of the heart. This technique suppresses the interference from the right ventricle and left atrium and produces an image of the left ventricle and aorta that is substantially free of these overlap artifacts. The resultant eigenimages of the heart appear more like conventional ventriculograms than do digital subtraction angiograms and matched filtered images. PMID- 3295987 TI - Bronchial artery embolization: monitoring with somatosensory evoked potentials. Work in progress. AB - Surgery remains the treatment of choice for massive and recurrent hemoptysis. In some instances, however, immediate surgical intervention is contraindicated. In these situations, bronchial artery embolization (BAE) has proved to be a successful definitive treatment for non-surgical candidates and a palliative therapy in patients requiring hemodynamic stabilization prior to surgery. The most serious complication of BAE is spinal cord ischemia. This relates directly to the potential anastomotic connections between the bronchial circulation and the anterior spinal artery. Somatosensory evoked potentials (SSEPs) have been used in the past to monitor spinal cord ischemia during procedures that threaten the vascularity of the spinal cord. The authors report two cases in which SSEPs were employed to monitor spinal cord ischemia during bronchial artery embolization. PMID- 3295990 TI - US-guided aspiration biopsy of the breast. PMID- 3295989 TI - Segmental biliary obstruction: false-negative diagnosis with direct cholangiography without US guidance. AB - Segmental intrahepatic ductal obstruction with calculi can be a significant cause of acute cholangitis that may remain entirely undetected on a routine, "blind" direct cholangiogram. Ultrasonography (US) or computed tomography can demonstrate isolated intrahepatic ductal dilatation with or without calculi. US, in particular, can be used to direct the needle puncture for percutaneous transhepatic cholangiography (PTC) and thus enable the differential diagnosis and appropriate therapy to be determined. Four cases are reported in which US-guided PTC enabled confirmation of the diagnosis of acute cholangitis secondary to segmental biliary obstruction and intrahepatic calculi. In two the correct diagnosis could not be made with initial blind direct cholangiography, and in the other two, US and US-guided PTC were performed initially. PMID- 3295991 TI - Striated intramural gallbladder lucencies on US studies: predictors of acute cholecystitis. AB - Ultrasound scans of 51 consecutive patients with gallbladder wall thickening were reviewed, and specific sonographic features were correlated with surgical and clinical follow-up. Two patterns of thickening were identified as specific indicators of the presence or absence of acute cholecystitis. "Striated" wall thickening, consisting of several alternating, irregular, discontinuous, lucent and echogenic bands, was seen in eight of 13 patients (62%) with acute cholecystitis. This pattern was not encountered in any of the patients who did not have acute cholecystitis. Conversely, "three-layer" thickening, consisting of a single circumferential lucent zone between two relatively uniform echogenic layers, was seen in only one of 13 patients (8%) with acute cholecystitis but in 11 of 38 patients (29%) with other diagnoses. Other abnormalities, including the presence of intramural echogenic foci and wall irregularities, were more frequently seen in patients with acute cholecystitis but were not as helpful. Use of these features may suggest or help exclude a diagnosis of acute cholecystitis in those patients in whom the cause of gallbladder wall thickening is otherwise not apparent. PMID- 3295992 TI - Targeted expression of cloned genes in transgenic mice. PMID- 3295993 TI - Nutrient intakes: cancer causation and prevention. AB - High intakes of the macronutrients--proteins, lipids, and carbohydrates in the form of excess energy-have some cancer stimulating properties. On the contrary, epidemiologic and animal laboratory data indicate that high-level supplementation of some micronutrients--certain vitamins, minerals, and lipotropes, as well as some non-nutrients, most notably various types of dietary fiber, may be useful in the prevention of cancer. A wealth of data exists for macronutrients whereas most micronutrients are almost unstudied concerning their role in cancer prevention. Vitamins A, E, and C and selenium are the most well-studied micronutrients, and are recognized as effective with significant anticancer effects, at least in animal models. There are minimal data to suggest that some other micronutrients may also exert varying degrees of incidence reduction on one or more types of cancer. This is most true for folic acid, manganese, molybdenum, copper, the amino acids phenylalanine and methionine, and the lipotrope choline. Zinc and vitamins B1, B2, B6, B12 and pantothenic acid have even less data, and some data are contradictory. Therefore, it is premature to make recommendations concerning their usefulness in cancer prevention at present. PMID- 3295994 TI - Skeletal fluorosis in humans: a review of recent progress in the understanding of the disease. AB - Endemic skeletal fluorosis is a chronic metabolic bone and joint disease caused by ingesting large amounts of fluoride either through water or rarely from foods of endemic areas. Fluoride is a cumulative toxin which can alter accretion and resorption of bone tissue. It also affects the homeostasis of bone mineral metabolism. The total quantity of ingested fluoride is the single most important factor which determines the clinical course of the disease which is characterized by immobilization of joints of the axial skeleton and of the major joints of the extremities. A combination of osteosclerosis, osteomalacia and osteoporosis of varying degrees as well as exostosis formation characterizes the bone lesions. In a proportion of cases secondary hyperparathyroidism is observed with associated characteristic bone changes. Contrary to earlier thinking, severe crippling forms of skeletal fluorosis are seen in paediatric age group too. Increased metabolic turnover of the bone, impaired bone collagen synthesis and increased avidity for calcium are features in fluoride toxicity. Osteosclerotic picture is evident when small doses of fluoride are ingested over a long period of time during which calcium intakes are apparently normal while osteoporotic forms are common in paediatric age group and with higher body load of the element. Alterations in hormones concerned with bone mineral metabolism are seen in fluorosis. Kidney is the primary organ of excretion for fluorides. Age, sex, calcium intake in the diet, dose and duration of fluoride intake and renal efficiency in fluoride handling are the factors which influence the outcome. Serum parameters rarely help in the diagnosis. Elevated urinary fluoride and increased bone fluoride content are indicators of fluoride toxicity. Fluorosis is a preventable crippling disease. No effective therapeutic agent is available which can cure fluorosis. Industrial fluorosis is on the increase on a global basis. Bone density measurement is a tool for early diagnosis. PMID- 3295995 TI - Effects of intrauterine and postnatal malnutrition on the ontogeny of gut function. PMID- 3295996 TI - Regulation of the microenvironment of peripheral nerve: role of the blood-nerve barrier. PMID- 3295997 TI - Physiological plasticity in auditory cortex: rapid induction by learning. PMID- 3295998 TI - Directions in neurogenetic gradients and patterns of anatomical connections in the telencephalon. PMID- 3295999 TI - [Biochemistry of glycoconjugates in the studies of cancer metastasis]. PMID- 3296000 TI - [Single cell origin of cancer]. PMID- 3296001 TI - [Expression and replication process of plant viral RNA genomes]. PMID- 3296002 TI - [Molecular biology of immunologic recognition]. PMID- 3296003 TI - [Acyltransferases]. PMID- 3296004 TI - Effect of taurine on arterial, uterine and cardiac PGI2 and TXA2 synthesis in the rat. AB - The influence of taurine (in drinking water for 6 weeks) on PGI2 and TXA2 synthesis by some female rat organs was investigated using radioimmunoassay and platelet antiaggregatory bioassay. Taurine 100 and 200 mg/kg/day increased aortic PGI2 release from 0.59 +/- 0.04 (control) to 0.85 +/- 0.05 and 1.01 +/- 0.06 ng/mg, respectively and that by the myometrium from 0.24 +/- 0.02 (control) to 0.38 +/- 0.01 and 0.50 +/- 0.04 ng/mg wet tissue, respectively (P less than 0.05, n = 6). It did not affect PGI2 and TXA2 production in the heart or TXA2 in the aorta. Taurine 200 mg/kg depressed uterine TXA2 synthesis from 148.6 +/- 9.8 (control) to 85.4 +/- 6.8 pg/mg (P less than 0.05, n = 6). Furthermore taurine 0.4 and 0.8 mM in vitro stimulated PGI2 release by the myometrial and aortic tissues from pregnant rats. The stimulant effect of taurine on PGI2 may be related to its antioxidant effect whereas its inhibitory effect on uterine TXA2 may result from direction of synthesis towards PGI2. It is concluded that endogenous taurine may participate in regulation of PGs synthesis and that prostanoids may contribute to its known actions. On broad basis, taurine-induced release of PGI2 may prove of potential value in those ailments characterised by deficiency in PGI2 release. PMID- 3296005 TI - Marked enhancement in antithrombotic activity of isocarbacyclin following its incorporation into lipid microspheres. AB - Isocarbacyclin, (+)-9(O)-methano-delta 6 (9 alpha)-PGI1 (TEI 7165) and its methyl ester (TEI 9090) were incorporated in lipid microspheres (LM) with a diameter of 0.2 micron, in an attempt to increase their efficacy, possibly by way of targeting the drugs to the site of vascular damage. When the two LM-preparations were incubated in 2% bovine serum albumin solution, it was shown that TEI 7165 was released rapidly from LM, while the release of TEI 9090 was slow. Thus, TEI 9090 in LM, injected intravenously, may not be released largely in plasma before the distribution of LM to the target sites. The antithrombotic activity of the LM preparation of TEI 9090 was then compared with that of TEI 9090 as such in the hamster cheek pouch model. It was found that TEI 9090 incorporated in LM was more than 500 times more potent as an inhibitor of ADP-induced thrombus growth. These data suggest that prostacyclin analogues incorporated in LM may be used safely as potent antithrombotic agents in the clinical application. PMID- 3296006 TI - Testing the "redirection hypothesis" of prostaglandin metabolism in the kidney. AB - Furosemide increases the synthesis of two major renal eicosanoids, prostacyclin (PGI2) and thromboxane A2 (TXA2), by stimulating the release of arachidonic acid which in turn is metabolized to PGG2/PGH2, then to PGI2 and TXA2. PGI2 may mediate, in part, the early increment in plasma renin activity (PRA) after furosemide. We hypothesized that thromboxane synthetase inhibition should direct prostaglandin endoperoxide metabolism toward PGI2, thereby enhancing the effects of furosemide on renin release. Furosemide (2.0 mg . kg-1 i.v.) was injected into Sprague-Dawley rats pretreated either with vehicle or with U-63,557A (a thromboxane synthetase inhibitor, 2 mg/kg-1 followed by 2 mg/kg-1 X hr-1). Urinary 6ketoPGF1 alpha and thromboxane B2 (TXB2), reflecting renal synthesis of PGI2 and TXA2, as well as PRA and serum TXB2, were measured. Serum TXB2 was reduced by 96% after U-63,557A. U-63,557A did not affect the basal PRA. Furosemide increased PRA in both vehicle and U63,557A treated rats. However, the PRA-increment at 10, 20 and 40 min following furosemide administration was greater in U-63,557A-treated rats than in vehicle-treated rats and urine 6ketoPGF1 alpha excretion rates were increased. These effects of thromboxane synthesis inhibition are consistent with a redirection of renal PG synthesis toward PGI2 and further suggest that such redirection can be physiologically relevant. PMID- 3296007 TI - Inhibition of complement-mediated hepatic thromboxane production by mepacrine, a phospholipase inhibitor. AB - Complement-mediated thromboxane production in the isolated, perfused rabbit liver has been shown to be calcium sensitive. The present study utilizes mepacrine, a phospholipase inhibitor, to investigate the involvement of phospholipases A and C in the mechanism of complement-induced arachidonate metabolism. Livers perfused in vitro in an open, nonrecirculating system were given either normal plasma or zymosan activated plasma at a rate of 1 ml/minute for 10 minutes. An additional group of livers was constantly perfused with 10 microM mepacrine while receiving the zymosan activated plasma infusion. Control group livers demonstrated a stable perfusion pressure, rate of release of lactic dehydrogenase and acid phosphatase, and stable rates of thromboxane and prostacyclin production for the entire experimental period. In contrast, treatment with zymosan-activated plasma resulted in significant increases in the rate of thromboxane B2 release at 1, 3 and 5 minutes of infusion when compared to the values of the control group. Neither prostacyclin release nor enzyme release changed significantly as a result of the zymosan-activated plasma administration. Treatment of the perfused livers with mepacrine abolished the complement-mediated production of thromboxane B2. In summary, this study has confirmed that plasma which has had its complement components activated by zymosan induces a transient, self-limiting production of thromboxane-like materials in the perfused rabbit liver. The mechanism of this stimulation is hypothetized to be a mepacrine-sensitive activation of phospholipase. PMID- 3296008 TI - [Diagnosis of Chlamydia trachomatis infection of the urogenital system by a rapid method of direct immunofluorescence using monoclonal antibodies]. PMID- 3296009 TI - [Lymphomatoid papulosis]. PMID- 3296010 TI - [Sneddon-Wilkinson disease in a 30-month-old child]. PMID- 3296011 TI - [Value of consultation studies of problem sera in the diagnosis of syphilis]. PMID- 3296012 TI - [Discovery of intention in chance. On an early step in the development of the psychoanalytic method]. PMID- 3296013 TI - Mandibular edentulous anatomy and modified impression technique. PMID- 3296014 TI - Custom characterization of the porcelain-fused-to-metal restoration. PMID- 3296016 TI - A method to develop provisional restorations. PMID- 3296017 TI - The effect of the posterior palatal seal on the strength of maxillary denture bases. PMID- 3296015 TI - A custom-shaded porcelain-fused-to-metal restoration on a maxillary RPD. PMID- 3296018 TI - Sprue design to minimize casting defects in base-metal castings. PMID- 3296019 TI - Time delay effects on the tensile bond strength developed by the Silicoater. PMID- 3296020 TI - The effect of progressive relaxation on Valsalva response in healthy adults. AB - The purpose of the study was to determine if the tensing portion of progressive relaxation initiates the Valsalva response in order to establish the safety of the procedure for acutely ill cardiovascular patients. Sixty healthy adult volunteers performed fist, chest, and abdominal tensing and relaxation while their heart rate was continuously monitored. Occurrence of the Valsalva response was determined by dividing peak tachycardia during tensing by maximum bradycardia during releasing the tension. A Valsalva ratio greater than 1.5 indicated presence of the Valsalva response. Forty-three percent of the sample exhibited the Valsalva response. Thus, progressive relaxation should not be used with acutely ill cardiovascular patients. PMID- 3296021 TI - Accuracy of references in nursing journals. AB - The purpose of this study was to quantify and classify errors in reference lists of randomly selected, recently published issues of nursing journals (n = 17) and to assess whether these errors prevented retrieval of the cited documents. Randomly selected references, 65 from clinical journals and 47 from non-clinical journals, were compared to the original sources for accuracy. Errors were classified as minor (not preventing retrieval) and major (preventing retrieval). Errors occurred more frequently in references in clinical journals, 38.4% of those reviewed, as compared to 21.3% in of non-clinical journals. Additionally, 4.6% of the clinical references contained major errors, but no major errors were located in references from the non-clinical journals. These findings have implications for all readers. PMID- 3296022 TI - [Cervical teratoma. Intrauterine ultrasonic diagnosis. Presentation of a case]. PMID- 3296023 TI - [Staining with acridine orange in the detection of microorganisms]. PMID- 3296024 TI - [Use of digital subtraction angiography in the study of thoracic outlet syndrome]. AB - Thoracic outlet syndrome (TOS) is characterized by neural and vascular symptoms of the upper extremity, caused by abnormal compression on the brachial plexus, subclavian-axillary artery and/or vein, when the patient makes some movements. Compression can occur on various anatomic levels: interscalene triangle, costoclavicular passage, pectoralis minor tendon. The authors describe the various stress position to point out the place of compression, etiology and the most common methods of study. They refer also their experience about TOS obtained using selective digital subtraction angiography (DSA) of both subclavian arteries in 6 patients. Thanks to DSA, that allows the dilution of contrast medium, it is possible to carry out all the stress maneuvers using a little amount of contrast medium. PMID- 3296025 TI - [Possibility of using B-mode echography in the early diagnosis of the carotid localization of atherosclerosis]. AB - B-Mode ultrasonography is an important complementary tool in the early diagnosis of carotid pre-atheromatous vascular disease. The authors report their personal experience concerning 86 patients affected or not by neurological transitory or persistent symptoms, and point out two main semeiological remarks of endoluminal pathologic conditions. The findings obtained are related to the more recent physiopathological and pathological-anatomical data related the growth and the evolution of atheromatous lesions of the carotid district. PMID- 3296026 TI - [Echographic identification of symptomatic gastric carcinoma and its lymph node metastases]. AB - The diagnostic capability of ultrasound in symptomatic gastric cancer is stressed, on the basis of a prospective study of 64 neoplastic and 19 non neoplastic patients. Aspecific signs are described which suggest the presence of five layers within the gastric wall as an index of absence of disease. The prospective importance of ultrasound investigation in 5 neoplastic patients with aspecific symptoms is emphasized. PMID- 3296027 TI - [Hemobilia: comparison of diagnostic technics. Considerations on 14 patients]. AB - Fourteen cases of hemobilia of traumatic (six), vascular (six) or neoplastic (two) origin were reviewed. Eleven patients obtained correct diagnosis only be integration of at least two diagnostic procedures out of Ultrasonography, Computed Tomography, arteriography and cholangiography. Although US and CT are extremely useful as screening procedures, correct diagnosis should be only possible by integration of more diagnostic technics. Arterial embolization represents a successful alternative to surgical intervention; moreover US may also be helpful for follow-up of treated patients. PMID- 3296028 TI - [Colpocystourethrorectography and echography. Comparison of 2 technics in the study of female stress urinary incontinence]. AB - Urinary stress incontinence has been examined in 42 women with a standard radiographic technique, such as CCURG (colpocystourethrorectography) and echotomography. With these techniques 6 parameters have been established and measured both at rest and under Valsalva's maneuver. Stress incontinence has been diagnosed through variation of the normal values above physiological limits during the passage from rest to stress. In particular, reliability of echotomography in measuring the six parameters has been established and advantages and disadvantages have been evaluated in comparison with CCURG. PMID- 3296030 TI - [The use of diagnosis by imaging in a case of Von Hippel-Lindau disease]. PMID- 3296029 TI - [Technic and dosimetry in total body irradiation with 18 MeV photons]. AB - Total body irradiation (TBI) is used in our Institution in the conditioning regimen for bone marrow transplantation. The fractionation pattern consists of two daily fractions of 1.65 Gy repeated for 4 days (total dose 13.20 Gy in 8 fractions). Lung dose is reduced by means of lead custom shaped shields directly strapped to the patient surface. TBI is delivered by a THERAC 20 linear accelerator with two opposing AP-PA photon beams with a maximum energy of 18 MeV. Treatment distance is 340 cm and the patient is treated in a semi-standing position. Dosimetry studies in a homogeneous phantom were performed in the treatment geometry and consisted in the determination of: tissue maximum ratios (TMR) at different depths, absorbed dose along the median axis and the diagonal of the field, variation of the absorbed dose in the prescription point with different volumes of scattering material, and transmission of shielding and compensating material. A semi-empiric formula for the calculation of absorbed dose in a point has been obtained. A subsequent study in a Rando phantom with termoluminescent dosimeters (TLD) has shown a +/- 5% agreement between calculated and measured values and a +/- 7% homogeneity. PMID- 3296031 TI - [Secondary eruption]. PMID- 3296032 TI - [Gerard Lairesse, Bidloo's collaborator, the baroque and anatomy of the face (1685-1985)]. PMID- 3296033 TI - [Contribution of ultrasound to the results of suprapubic vesical puncture in infants and newborn infants]. PMID- 3296034 TI - [In vitro adhesion of Escherichia coli 0111 to HEp-2 cells]. PMID- 3296035 TI - [From social epidemiology to the sociology of prevention: 15 years' research on the social etiology of disease]. AB - Social epidemiology is this field of inquiry that regards the role of social and psychological factors in the aetiology of chronic diseases. In his examination of the evolution of the field, the author stresses the reconceptualization efforts that have been done in the 70's and that gave meaning to research on stress, traits or types of personalities and social support. In conclusion, this research tradition is viewed as perhaps overemphasizing the identification of risk factors while underemphasizing the explanation of the conditions under which good health is maintained. PMID- 3296036 TI - Relationships between critical life events, job stress and cardiovascular illness. AB - The relationship between critical life events and the state of health has become the subject of a growing number of studies. Starting with a review of recent studies centered on coronary heart disease the paper gives an outline of the present state of research in this field. Methodological aspects are discussed and special emphasis is laid on the longitudinal approach which is illustrated by several studies conducted by the author. The use of life event information could play an important role in preventive action. There are by now psychophysiological and clinical findings to support this pathway, namely as regarding secondary prevention, e.g. after a first myocardial infarction, but an efficient application requires further exploration of this field. PMID- 3296037 TI - Indicators and designs in genetic epidemiology: separating heredity and environment. AB - The problems of separating highly confounded hereditary and environmental factors are reviewed from an epidemiological point of view. Once the fact rather than the appearance of familial aggregation is established, one can search for and analyze strong indicators of either genetic or environmental effects, and ultimately attempt their separation by strong design. Indicators of genetic effects are classified according to the presence or absence of family recurrence. In the presence of family recurrence, three analytic approaches are available: segregation analysis, linkage, and heritability estimates. In the absence of family recurrence, biological markers and endogamous groups can be used. Indicators of environmental effects are also classified according to the presence or absence of family recurrence of a disorder. In the presence of family recurrence, three environmental indicators are considered: non-Mendelian clustering, such as time of onset versus age in family clusters, and sex clusters; cohabitational effects; and maternal transmission. In the absence of family recurrence, environmental indicators include secular trends, migration, time and place clusters, family size, and birth order. Designs that aim to separate heredity and environment include twin studies, fixed clusters that include a variety of degrees of relatedness (particularly the family set-design), and comparisons of separately reared relatives. The strengths and weaknesses of twin studies and family set designs are reviewed. Separately reared relatives provide the most cogent tests of genetic and environmental hypotheses. Among these, separated twin pairs, half-sibs, and relatives separated through institutional placement or adoption are considered. Adoption strategies are illustrated by the Danish adoption studies of schizophrenia, criminality, and alcoholism, and these studies are reanalyzed from the perspective of epidemiological case-control and cohort studies. Finally, the potential uses of multiple family settings as they occur in the general population are briefly discussed. PMID- 3296039 TI - [French Language Society of Electroencephalography and Clinical Neurophysiology. List of members]. PMID- 3296038 TI - [Jet ventilation in pediatric bronchoscopy]. PMID- 3296040 TI - [Value and technic of translating the data from x-ray computed tomography into the stereotaxic coordinates of the Talairach system]. AB - The neuroradiological stereotactic examinations provide indispensable information to localize many intracranial lesions: the data obtained by the CT-Scan are complementary of the stereotactic ones. The transfer of the routine CT-Scan transverse axial slices into the Talairach stereotactic system needs a precise definition of the inclination of the plan of the slices and a correct evaluation of the mean magnification factor. The inclination of the slices is appreciated using the bony, vascular and ventricular landmarks clearly identified on the CT Scan and stereoscopic stereotactic images. We compared the spatial "reconstructed" CT-Scan data with the histopathological findings obtained by serial stereotactic biopsies in 48 tumor patients. The error varied from 1.5 to 4.6% (m: 2.7 +/- 1.2) on the sagittal plane; from 1.3 to 10% (m: 5.8 +/- 3.4) on the transversal plane; from 2.5 to 4.3% (m: 3.5 +/- 0.7) on the axial plane. The mean global error was 3.7% +/- 2.3. The CT-Scan directly performed under stereotactic conditions (acrylic frame) seems to be the more useful procedure. Nevertheless considering the good precision obtained with our methodology applied to the Talairach's system, we consider it suitable when: a) the gantry of the CT Scan apparatus is too narrow for the acrylic frame; b) the exploitation of previous CT-Scan examinations is necessary; c) patient refuses the discomfort of the acrylic frame. PMID- 3296041 TI - [Integration of digital angiography, magnetic resonance, x-ray computed tomography and positron emission tomography in stereotaxy]. AB - Consecutively to drastic changes which occurred in cerebral imagery techniques, we have developed a stereotactic apparatus and system based on the integration of several new techniques allowing visualisation of the brain: tomodensitometry (TDM), digital subtraction angiography (DSA), magnetic resonance (MR) and positron emission tomography (PET). TDM, DSA and MR can be performed in stereotactic conditions with the apparatus in situ. They give the computer the anatomic references necessary for all calculations. MR and PET images obtained without stereotactic apparatus can also be integrated into the stereotactic study at the condition that DSA was formerly performed in stereotactic conditions, i.e. with the apparatus in situ. The visualisation of the corpus callosum makes this integration possible. An optimal definition of cerebral tumors or target structures for intracerebral electrode recording is thus obtained. PMID- 3296042 TI - [Complementarity of x-ray computed tomography of staged stereotaxic biopsies and of stereo-electroencephalography in the spatial definition of intracranial lesions]. AB - This study concerns 180 patients (132 M; 48 F) (age: 2 to 69 years; m: 33 years) who underwent stereotactic procedures according to the methodology of Talairach and Szikla. Such procedures (stereotactic and stereoscopic angiography in all cases, and ventriculography in 81%) should permit a correct spatial definition of intracranial lesions. The informations provided by the angiography (normal in 7%) and by the ventriculography (normal in 11%) are complementary to those yielded by the TDM and permit an easier and safe stereotactic approach to the lesions. In 43% of patients the lesions were deep-seated (basal ganglia: 24; sellar region: 19; thalamo-peduncular: 13; brain stem: 6, etc.). The histological examination showed: low-grade gliomas in 43%; glioblastomas in 21%; non tumoral lesions in 17%. A precise diagnosis couldn't be obtained in 3.8%. The data provided by the stereo-EEG (in 11 patients suffering also of severe drug-resistant partial epilepsy) did not permit, alone, an histological diagnosis, excepted when electrodes explored a solid tumor. Two patients had a neurological impairment, and two died (one for extracerebral reasons). The authors consider that the TDM data and the informations given by the stereotactic procedures are complementary for obtaining valuable informations on the spatial organization of intracranial lesions and choosing the best treatment. PMID- 3296043 TI - [Spatial definition of cerebral tumors]. AB - The spatial definition of brain tumors can be obtained by CT and angiography carried out under stereotactic conditions. A standard CT software is used to obtain stereotactic coordinates of any intracranial point. Serial stereotactic biopsies provide a precise and detailed histologic diagnosis, including grading and volume estimation. The stereotactic approach is directed at a better understanding of the relationship between the brain and the lesion. It provides a rational basis for the choice among treatment modalities. Our experience so far with a series of 401 cases is reported on. PMID- 3296044 TI - [Methodology and prognostic reliability of stereotaxic biopsy in tumors of glial origin]. AB - Between 1978 and 1984, 227 patients affected from glial tumors underwent serial stereotactic biopsy. Correct prognostic indications have been obtained in 85% of the entire series. In 10.5%, the stereotactic procedure provided only the diagnosis of the nature of the tumor, while the histological grading and prognosis remained unknown. The operative mortality was 2.6% and the permanent morbidity included 3.9% of patients who complained about worsening of the preoperative neurological conditions. The methodology of stereotactic biopsy is described in detail. The results are discussed with particular reference to the prognostic value of serial stereotactic biopsies. PMID- 3296045 TI - [Dysplastic cyst of the diaphragm: limitations of diagnostic imaging]. PMID- 3296046 TI - [Adult respiratory distress syndrome: etiology, diagnosis and therapeutic notes]. PMID- 3296047 TI - Heat delivery and thermometry in clinical hyperthermia. AB - This chapter has discussed some recent technical developments and trends in clinical hyperthermia. Several techniques for the treatment of tumours within 3-4 cm of the body surfaces were described. Each technique has its minor advantages and disadvantages; all techniques employing a single applicator produce temperature distributions with considerable gradients. The introduction of microwave and ultrasound techniques using multiple applicators in which there is some control of the pattern of the energy deposition within the treatment area should improve superficial treatments in this respect. A number of electromagnetic devices for regional hyperthermia are being developed and evaluated. The theoretical predictions of their performances are beginning to suggest restrictions to their use; the limited clinical experience is in general agreement with these predictions. Scanned and focussed ultrasound beams may offer the unique possibility of non-invasive, deep, yet localised hyperthermia in some locations. Such systems are at an early stage of their development; if they prove successful, their controlled and safe use will require detailed information of the temperature distributions produced. Invasive methods for inducing hyperthermia can produce relatively good temperature distributions. The development of 'constant temperature seeds' is promising. Both RF and microwave interstitial systems offering individual control of power to several channels should lead to improved temperature distributions. In general, non-invasive thermometry in clinical hyperthermia remains a distant goal, although developments in microwave radiometry may lead to systems with suitable spatial, temporal and temperature resolutions for use in superficial treatments. Invasive thermometry techniques can provide temperature measurements from several points or from along tracks within the treatment volume. The development of computer models to infer temperature distributions from the limited information available will be a major step in quantifying hyperthermal treatments. PMID- 3296048 TI - The combination of hyperthermia and radiation: clinical investigations. PMID- 3296049 TI - Hyperthermia and drugs. PMID- 3296050 TI - The biological basis for tumour therapy by hyperthermia and radiation. PMID- 3296051 TI - Physiological effects of hyperthermia. PMID- 3296052 TI - Image quality in mammography: physical and technical limitations. PMID- 3296053 TI - Computed tomography scanning, transillumination, and magnetic resonance imaging of the breast. PMID- 3296054 TI - Recent trends in screen-film mammography: technical factors and radiation dose. PMID- 3296055 TI - Screening for breast cancer: an overview. PMID- 3296056 TI - Screening for breast cancer in Malmo: a randomized trial. PMID- 3296057 TI - The Guildford Breast Screening Project: 6-year assessment. PMID- 3296058 TI - Stereotaxic fine needle biopsy of nonpalpable breast lesions performed by the Mammotest. PMID- 3296059 TI - [Bibliographic review: quantitative variations and metabolism of lipids in adipose tissue and liver during the gestation-lactation cycle. 2: In the ewe and the cow]. AB - This comprehensive review describes changes in body lipids, energy balance and metabolic pathways and endocrine regulations in the adipose tissues and liver of ewes and cows during pregnancy and lactation. These profiles are discussed in relation to litter size, food intake and diet composition. The interactions between teleophoretic mechanisms (that direct nutrients to the gravid uterus or to the mammary gland) and homeostatic mechanisms (that ensure maintenance of the mother organism) have been emphasized. PMID- 3296060 TI - Effects of different compositions of diets and chronic ethanol administration on proteolytic and antiproteolytic systems in the pancreatic tissue of rats. AB - The effects of dietary composition in combination with chronic ethanol ingestion on pancreatic proteolytic-antiproteolytic systems were studied by submitting 192 male Wistar rats to a 12-week dietary period. The rats were fed with a standard (S), fat-rich (F), protein-rich (P), or carbohydrate-rich (C) diet after randomized division into four groups. Half of the animals in each dietary group received water and the other half a mixture of 15% (v/v) ethanol and water as their drinking solution. The C-diet caused a significant increase of BAPNA hydrolysis, which was even more pronounced in rats receiving ethanol. Casein hydrolysis was increased significantly by the C-diet, but ethanol did not have any significant effect on this. Hydrolysis of ATEE was decreased significantly by the P- and C-diets, and ethanol in combination with the S- and F-diets decreased hydrolysis of ATEE in comparison with the corresponding water-receiving groups. The trypsin-inhibiting capacity of the pancreatic tissue was significantly increased in the group receiving C- and F-diets as compared to the S-diet receiving group of animals. It seems that the composition of the consumed diet in combination with chronic ethanol ingestion may play a role in regulating the pancreatic proteolytic-antiproteolytic system. However, these changes were not parallel. The trypsin-inhibiting capacity of pancreatic tissue was also affected by the quality of the diet. PMID- 3296061 TI - Flow cytometry and its applications in veterinary medicine. AB - Flow cytometry is a technique for analysing and separating populations of cells (and subcellular components). The cells are generally stained with fluorescent markers (eg, fluorescent antibodies or DNA-binding dyes). Each cell is analysed individually, at high speed. Thus, assays may be performed on small samples (less than 10,000 cells). A subpopulation of interest can be separated from the remainder of the cells to a high degree of purity (up to 99 per cent). The application of flow cytometry to veterinary science is increasing and is discussed here. PMID- 3296062 TI - Analysis by ELISA and Western blotting of antibody reactivities in cattle infected with Mycobacterium paratuberculosis after absorption of serum with M phlei. AB - Preabsorption of cattle serum with Mycobacterium phlei was of value in eliminating falsely positive reactions in an enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies against M paratuberculosis. Specific antibody titres from 16 animals naturally infected with M paratuberculosis were unaffected by absorption. Analysis by Western blotting indicated that a different set of antigens of M paratuberculosis were recognised by serum from falsely positive reactors compared with that from animals with established infection. After experimental infection the time required for seroconversion in the ELISA in nine calves lay between 10 and 28 months, although one animal had not seroconverted after 30 months when the experiment ended. All animals shed M paratuberculosis in their faeces before seroconversion. PMID- 3296063 TI - Observations on the pathogenesis of experimental Salmonella typhimurium infection in chickens. AB - The virulence of Salmonella typhimurium strains for day-old chickens was examined. The mortality following oral inoculation varied from 0 to 100 per cent. Some breeds were more susceptible than others. There was no correlation between oral and parenteral virulence. Pathogenesis studies associated with one of the most virulent strains suggested that, after invasion, organisms multiplied in the liver and spleen and spread to other organs producing a systemic infection. The cause of death was probably a combination of anorexia and dehydration resulting from general malaise and diarrhoea. A virulent strain studied in detail spread through the body faster, persisted for a longer period and was more invasive than an avirulent strain. In the system studied invasiveness was the virulence determinant of overriding importance. PMID- 3296064 TI - R 8110, a new short-acting hypnotic in dogs. AB - The clinical, respiratory and cardiovascular effects of intravenous injections of R 8110, a fluor analogue of etomidate, were studied in unpremedicated dogs. Clinical observations were carried out after intravenous injections of 3 and 4 mg kg-1 of R 8110. Cardiovascular studies were conducted after an intravenous injection of 3 mg kg-1. The drug proved to be a safe and reliable agent for induction and produced a short-lasting hypnosis and some analgesia. Both induction and recovery were smooth and rapid. Heart rate and systolic and diastolic blood pressure decreased significantly (P less than or equal to 0.05) 10 minutes after injection; the influence on arterial blood parameters was minimal. PMID- 3296066 TI - [Regulation of peripheral circulation in the failing heart]. PMID- 3296065 TI - Lung-reactive antibodies in sera of patients with farmer's lung disease. AB - Lung-reactive antibodies were detected in sera of patients with farmer's lung disease and in sera of healthy persons. A solid-phase radioimmunoassay was adapted for measurement of titers of human antibodies to sodium-dodecyl-sulfate solubilized lung proteins. The titers of antilung antibodies in patients sera were 2-5 times as much as those of healthy persons. Using the immunoblotting technique, antibodies to individual lung polypeptides could be detected. Although the specificity patterns of antibodies to lung polypeptides differed from one serum to another, patients sera contained, in general, antibodies to larger numbers of lung polypeptides as compared to sera of healthy persons. The relationship between antilung antibodies and hypersensitivity pneumonitis is discussed. PMID- 3296067 TI - [Positive inotropic agents in the treatment of congestive heart failure]. PMID- 3296068 TI - [The evaluation of clinical efficacy of drugs for cardiac failure]. PMID- 3296069 TI - [Modifications of pulmonary residual volume measuring method using closed circuit helium dilution technic]. PMID- 3296070 TI - Differential diagnosis of multisystem sarcoidosis. PMID- 3296071 TI - In memoriam Theodor Langhans (1839-1915). PMID- 3296072 TI - [Epidemiological relation between Klebsiella pneumoniae isolated from feces and from hospital urinary infections]. PMID- 3296073 TI - Trypanosoma (Schizotrypanum) cruzi and Trypanosoma (Herpetosoma) rangeli. I. Comparative studies by polyacrylamide-gel electrophoresis. PMID- 3296074 TI - [Effect of substrate concentration on the kinetics and development of epimastigotes of Trypanosoma cruzi. Determination of the kinetic parameters]. PMID- 3296075 TI - Effect of temperature on the lipid composition of anaerobically grown Saccharomyces cerevisiae. PMID- 3296076 TI - [Experimental infection of Triatoma infestans (Hemiptera: Reduviidae) with Leptospira icterohaemorrhagiae and its transmission to laboratory mammals]. PMID- 3296077 TI - [The diagnostic value of anti-DNA antibodies depends on the technic used for their detection]. AB - Three anti-native DNA antibody detecting assays were compared using sera from 948 patients with clinical symptoms of connective tissue disease and 55 definite systemic lupus erythematosus patients. The Farr assay was more effective than the two other assays in the diagnosis of lupus. Anti-DNA antibody detection by ELISA was as sensitive as the Farr assay; in contrast indirect immunofluorescence on Crithidia luciliae had a significantly lower sensitivity, detecting less than one out of two cases of lupus detected. Particularly ELISA but also indirect immunofluorescence may give positive results in the absence of lupus, so that results obtained by each of these assays must be confirmed by the Farr assay if they are used in the diagnosis of lupus. The significance of antibodies detected by one assay but not by the others is discussed. PMID- 3296078 TI - [Tolerance to fructose and saccharose in non-insulin-dependent diabetic patients]. PMID- 3296079 TI - [Evaluation of 3 laboratory methods for the serological diagnosis of rubella]. PMID- 3296080 TI - [Dr. Agustin Nataniel Cox up to the founding of the University of Chile]. PMID- 3296081 TI - The three-decision problem in medical decision making. AB - Medical researchers and policy makers face decisions that require a choice from among two or more alternatives. Whereas traditional hypothesis tests cannot always serve the needs of the practitioner who needs to make a decision, a problem formulation that assigns losses to various incorrect decisions offers several advantages. With three possible decisions this approach offers a precise representation of the pragmatic and explanatory views of decision making. It enables the investigator to incorporate in the problem specification his attitudes about the seriousness of various errors by guiding him, before he sees the data, to a choice of asymmetric tail probabilities. It also suggests a reformulation of the P-value that can accommodate some of the difficulties practitioners face. PMID- 3296082 TI - Urinary tract infection in the elderly. AB - The elderly segment of the population is growing at a rapid rate; this "longevity revolution" is associated with an increasing prevalence of bacteriuria and UTI. Asymptomatic bacteriuria generally requires no treatment. In the absence of obstructive uropathy or infected calculi, asymptomatic bacteriuria in the elderly pursues a benign course. Prevention of UTIs is needed to avoid the risks of symptomatic infection, bacteremia, and urosepsis. Indwelling catheters should be left in situ for short periods of time, and alternative methods of bladder drainage should be used whenever possible. Coexistent chronic disease should be optimally managed and every effort made to avoid invasive procedures and limit GU instrumentation. PMID- 3296083 TI - [Morphogenesis and phylogenesis of the middle ear of mammals: some considerations]. PMID- 3296084 TI - [Liver transplant]. PMID- 3296085 TI - [Thalassemias in Belgium]. PMID- 3296086 TI - [Chronic vitamin A poisoning]. PMID- 3296087 TI - [Coronary thrombolysis in the treatment of acute myocardial infarct]. PMID- 3296088 TI - Carbohydrate and fluid needs of the soccer player. AB - Soccer is a game that demands a combination of repeated maximal sprinting wit with 10 to 11km of moderate running, sometimes performed under extremely warm conditions. Over the course of a match, there is partial to near complete depletion of glycogen reserves in the leg muscles (depending on the extent of initial reserves and the level of competition), with a resultant decrease in physical performance. Blood glucose levels also fall, sometimes to values likely to cause a deterioration of both tactical thinking and cooperation between players (3.0 to 3.8 mmol/L), while in tropical climates, fluid losses can amount to 4 to 5kg of bodyweight. The effectiveness of glucose solutions in correcting these problems is limited for 2 main reasons: concentrations greater than 2.5% slow the rate of gastric emptying and thus fluid absorption, while provoking a secretion of insulin with a resultant hypoglycaemia. Fructose solutions are less liable to increase insulin secretion, but they have an equal propensity for slowing gastric emptying; moreover, the ingested fructose is largely metabolised in the liver, without boosting blood glucose. However, glucose polymer preparations have a low osmotic pressure per unit content of glucose equivalent, so that substantial amounts of carbohydrate can be administered in this fashion before gastric emptying is inhibited. If polymers are given before and during a soccer game, they sustain blood glucose, sparing muscle glycogen stores and increasing game performance. If the concentration of polymer is too high, one possible complication is a movement of water from the plasma into the gut; nevertheless, with an appropriate choice of concentration (for example, 7% polycose, 360 mOsm/L, plasma volume is increased rather than decreased relative to that seen with administration of water. Probably because the intergame interval for competitive soccer players is short, replenishment of glycogen reserves proceeds quite slowly. Moreover, this process does not seem to be helped by ingestion of either glucose polymers or a high carbohydrate diet. PMID- 3296089 TI - Calcium antagonists and exercise performance. AB - Calcium antagonists lead to a relaxation of smooth vascular muscles and exert a cardiodepressive effect. They make up a heterogeneous group, with primarily substances of the nifedipine and verapamil type playing the most important role in the treatment of cardiocirculatory diseases. The principal indications include coronary heart disease and hypertension. During physical exercise, following the administration of calcium antagonists, VO2max and endurance performance are not impaired. The rate of perceived exertion does not increase to any greater extent in comparison with placebo. Nifedipine leads to an increase of noradrenaline (norepinephrine) as an expression of a reflex activation of the sympathetic system and to a slight increase in heart rate, while calcium antagonists of the verapamil type lower heart rate by 10 to 15 beats/min during physical exercise as a result of their intrinsic negative chronotropic effect. Cardiac output, in spite of the drop in heart rate, remains unchanged. Neither carbohydrate metabolism nor lipid metabolism, including lipolysis, which provide the essential energy-yielding substrates during exercise, are affected by calcium antagonists. Potassium likewise remains unchanged. The response of the hormones insulin, growth hormone and cortisol is the same with calcium antagonists both during incremental graded exercise and during prolonged exercise as with placebo. In comparison with the administration of only calcium antagonists, the combination of calcium antagonists and beta-blockers impairs physical performance. The diminishment in performance, however, is markedly less pronounced than with beta blocker monotherapy. Unimpaired performance is crucial for physically active patients. Especially for patients performing regular physical activity who suffer from mild hypertension, calcium antagonists provide a viable therapeutic alternative to beta-blockers. PMID- 3296093 TI - [Fetal intrauterine growth retardation: possibilities of antepartum diagnosis]. PMID- 3296092 TI - [Diagnosis and therapy of obstructive jaundice (a vanishing field for the surgeon?)]. PMID- 3296094 TI - [Esophagojejunostomy: problems of anastomosis insufficiency]. PMID- 3296095 TI - [Future developments in the therapy of diabetes mellitus]. PMID- 3296091 TI - Performance parameters in children and adolescent athletes. AB - Success in sports, as measured by competitive performance, is dependent upon a number of significant mental and physical components. Somatotype, motor skills, age, nutritional status, physiology, psychology, training level, genetic endowment, and injury risk are the major independent variables influencing performance. Unfortunately, the data available in this area of sports medicine are not always reliable or allow interstudy comparisons. This article reviews the historical and current information used to predict human performance in sports at the childhood and adolescent level. Although mesomorphy, and to a lesser extent ectomorphy, are positively associated with enhanced performance, successful athletes tend to have or acquire somatotypes characteristic of individuals already successful in a particular sport. For the most part, motor skills are age (chronological) and gender dependent. In general, the efficiency of movement progressively improves throughout childhood and into early adolescence and is highly dependent on environmental influences. A lower anaerobic and aerobic capacity reduces performance in the child and adolescent. Nonetheless, regular training can favourably improve motor skills and physiological fitness parameters. The relationship between endurance performance and aerobic capacity, however, is not strong at any age during childhood. Performance levels are reduced if nutrition is inadequate. A number of mental factors such as aggression, spirit, and self-confidence are also related to sports performance, although their correlation is unclear at present. Performance is influenced by the effect of genetic factors on specific traits in 30 to 85% of cases. Risk factors that negatively impact on performance levels include a history of previous injury, excessive training schedules, decreased fitness endurance, joint looseness or tightness, and certain personality traits. It is suggested that sport performance may be optimised by the early identification of individuals with positive genetic and somatotypic markers and negative risk factors. Motor skill development and physiological parameters can then be maximised by using regular, non-excessive training protocols, sound nutrition patterns, a safe environment and protective gear. Further investigations in this important area of sports medicine are essential in order to more fully characterise those criteria essential for successful sports participation. In particular, such studies should be purely longitudinal and should control for multiple confounding factors operating at different times. PMID- 3296090 TI - Neurological sequelae of boxing. AB - Blunt trauma to the head results in acceleration of the brain within the skull. This takes 2 forms: linear or translational acceleration which produces focal lesions, and rotational acceleration which results in 'sheering stresses' with stretching of nerves and bridging veins. Deceleration of the brain within the skull occurs when the head strikes a stationary object (e.g. floor, ring post). Cerebrovascular events are not infrequently encountered. The most common vascular sequalae is the subdural haematoma, which is also the most frequent cause of death in boxers. Epidural bleeds rare, and are generally due to deceleration of the brain. Subarachnoid bleeds have been rarely reported, but, like intraparenchymal haemorrhages, they do occur. Sudden flexion/extension of the neck is suggested as the mechanism of the occasional brainstem haemorrhage reported in boxing. Thrombosis of the internal carotid artery can occur secondary to direct blows to the neck or stretching of the contralateral carotid artery. The best known sequalae of boxing is traumatic encephalopathy--the 'punch drunk' syndrome. This is most common in second-rate and slugging type fighters. Severity correlates with the length of a boxer's career and total number of bouts, with an incidence of approximately 18%. Three stages of clinical deterioration are seen, the encephalopathy may be progressive or may remain clinically stable at any level. The first stage consists of affective disturbances with psychiatric symptoms being most marked. During the second stage an accentuation of the psychiatric symptoms occurs and signs/symptoms of Parkinsonism develop. The final stage consists of a decrease in general cognitive function together with pyramidal tract disease. Generally 2 to 3 years elapse between the first and final stages. Neuropathological studies reveal abnormalities of the septum pellucidum, scarring of the cerebellar and cerebral cortices, and loss of pyramidal neurons in the substantia nigra with neurofibrillary tangles in the absence of senile plaques. A 'groggy state' can occur in some fighters with confusion, impaired active attention and alteration of consciousness. During this period the boxer is at greater risk to suffer brain injury as defensive reflexes are frequently lost. Other neurological syndromes have been reported in addition to the 'groggy state'. These include a midbrain syndrome, headaches and cervical spinal injuries. Additionally, boxing appears to be a significant risk factor for the development of meningiomas.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3296096 TI - [Jean-Pierre Junod. Various ideas from life, a friend]. PMID- 3296097 TI - Pharmacokinetics of antimicrobial agents in the elderly. AB - Many elderly individuals are treated with antibiotics, but knowledge of the pharmacokinetic performance of the compounds in these patients is limited. Advanced age is accompanied by many physiologic alterations that may have secondary effects on absorption, distribution, metabolism, and excretion of drugs. Information on absorption and metabolism in the elderly is scarce and conflicting. Because renal excretion of penicillins and cephalosporins decreases with the physiologic signs of the kidneys, dose reduction is advisable in elderly patients. Monitoring of serum drug levels is recommended for the selection of correct dosages of renally eliminated antibiotics with a narrow therapeutic range -e.g., aminoglycosides and vancomycin. There is a considerable need for additional studies of the influence of age on the kinetics of antimicrobial agents. PMID- 3296099 TI - Long-term prophylaxis of infection by selective decontamination in leukopenia and in mechanical ventilation. AB - The autochthonous anaerobic bacterial flora in the mucosal layer of the gastrointestinal tract limits colonization by aerobic potential pathogens. This effect is called colonization resistance. Colonization of the digestive tract by potentially pathogenic microorganisms precedes infection in patients with leukopenia and in cases of mechanical ventilation and can be prevented by long term administration of antimicrobial agents that spare the autochthonous anaerobic bacterial flora of the mucous membranes, a concept known as selective decontamination. Antimicrobial agents active against anaerobic flora reduce colonization resistance, permitting colonization by and overgrowth of potentially pathogenic microorganisms and possibly leading to infections with resistant microorganisms. A distinction can be made between antimicrobial agents that reduce colonization resistance and those that leave it intact by examining the effect of antimicrobial agents on aerobic intestinal flora of mice and humans. PMID- 3296100 TI - Chronic enteroviral meningoencephalitis in agammaglobulinemic patients. AB - Patients with agammaglobulinemia are particularly susceptible to chronic enteroviral infections of the central nervous system. Data on 42 patients were obtained by literature review, communications with other physicians, and personal experiences. Thirty-eight patients had congenital immunodeficiencies, most frequently X-linked agammaglobulinemia. Most patients who could be assessed were receiving maintenance therapy with intramuscular gamma-globulin before their enteroviral infection. Seven patients had not been recognized as hypogammaglobulinemic before the onset of infection. The commonest pathogens were echoviruses (37 of 41 cases), especially type 11 (11 cases). Thus far, four patients have had sequential or simultaneous infections with a second enteroviral serotype. Other features of the disease have included weakness, lethargy or coma, headaches, hearing loss, seizures, ataxia, and paresthesias. Some patients have also had nonneurologic manifestations of chronic enteroviral infection, including fever, the dermatomyositis-like syndrome, edema, rashes, and hepatitis. Treatment has consisted primarily of antibody administration, either in intravenous immunoglobulin preparations or in immune plasma. Twelve patients have received intraventricular immunoglobulin through reservoir devices; six of these 12 have improved substantially, as judged by clinical criteria. PMID- 3296098 TI - Mycobacteria other than Mycobacterium tuberculosis: review of microbiologic and clinical aspects. AB - The rate of isolation of mycobacteria other than Mycobacterium tuberculosis (MOTT) has increased over the past several years; in some areas the isolation rate for Mycobacterium avium-Mycobacterium intracellulare has surpassed that for M. tuberculosis. Simultaneously, the spectrum of clinical manifestations with the various species has widened. Outbreaks of disease due to Mycobacterium chelonae have occurred in renal dialysis patients. New species have been described: Mycobacterium malmoense is primarily a pulmonary pathogen, and Mycobacterium haemophilum has been recovered from cutaneous lesions in immunosuppressed patients. In addition, reports of disease due to species generally considered saprophytic have become more numerous. In this review, the epidemiologic, pathologic, and clinical features of the individual MOTT species are discussed. A brief summary of mycobacteria isolated at the Cleveland Clinic foundation between 1982 and 1985 is also presented. PMID- 3296101 TI - Sporotrichosis: recurrent cutaneous, articular, and central nervous system infection in a renal transplant recipient. AB - A case of recurrent, disseminated sporotrichosis in a renal transplant recipient is reported in which two joints, the skin, and the central nervous system were involved. The disease recurred both eight months and three years after the initial treatment with amphotericin B. The second course of therapy with amphotericin B required systemic and intraarticular administration of the drug. The third course of therapy included systemic and intrathecal administration. The function of the cadaveric transplanted kidney was maintained throughout the first recurrence of disease by careful reduction of immunosuppressive therapy and attention to the level of antifungal therapy. The kidney could not be salvaged after the second recurrence because of continued amphotericin B nephrotoxicity; however, the patient was cured of his infection. Sporothrix (Sporotrichum) schenckii may be a difficult organism to eradicate in chronically immunosuppressed patients, but the disease it causes may be successfully treated with aggressive systemic therapy. PMID- 3296102 TI - Spontaneous gangrenous myositis induced by Streptococcus pyogenes: case report and review of the literature. AB - A 54-year-old man presented with gangrenous myositis caused by Streptococcus pyogenes. A review of the literature disclosed 10 similar cases. Their presenting manifestations were spontaneously occurring, localized, excruciating pain; mottling suggestive of ischemic changes; and signs of sepsis. The duration of illness ranged from two to six days, and the outcome was uniformly fatal. This rare but distinct entity resembles clostridial myonecrosis except that it lasts slightly longer and does not involve gaseous crepitus. A definitive diagnosis of myonecrosi scan be established by surgical exploration; early, radical debridement plus penicillin therapy should be undertaken after diagnosis in an attempt to alter the usual devastating outcome. PMID- 3296103 TI - In vitro antifungal susceptibility testing and measurement of levels of antifungal agents in body fluids. AB - Interpretation of in vitro susceptibility data for antifungal drugs is hindered by the absence of standardized test criteria. Thus, it is extremely difficult to identify a clear relation between minimal inhibitory concentrations and clinical outcome. The situation appears more readily resolvable for yeast-like than for filamentous fungi since the former are more easily quantified by standardized microbiologic techniques. Accordingly the National Committee for Clinical Laboratory Standards has initiated the process of developing standards for yeast susceptibility testing. A related issue concerns the measurement of antifungal agents in body fluids. Whereas there may be little value in measuring concentrations of amphotericin B (because of its predictable pharmacokinetics), there is value to measuring levels of flucytosine (serum concentrations may relate to bone marrow suppression and/or the development of drug resistance) and ketoconazole (which may be absorbed unpredictably from the gut). Laboratory standards for these measurements have not been established. PMID- 3296104 TI - Rapid diagnosis of candidiasis and aspergillosis. AB - Published studies support the hypothesis that at least two antigens of Candida albicans and Candida tropicalis circulate in the bloodstream of patients with severe candidiasis. One antigen (probably mannan) is stable and the other (probably protein) is labile. The stabile antigen can rarely be detected without prior dissociation from antibody. Dissociation treatment destroys the labile antigen, leaving in doubt whether any is antibody bound. Dissociation steps have also been necessary for detection of Aspergillus fumigatus antigen in sera from patients with invasive aspergillosis. Concentrations of the stable antigens of both Candida and Aspergillus appear to be in the nanogram-per-milliliter range, generally lying at the limits of detection by conventional assays. Improvements in sensitivity and practicality are needed, but the tests are clearly promising. PMID- 3296105 TI - Controversial areas in antifungal chemotherapy: short-course and combination therapy with amphotericin B. AB - Two of the most controversial topics in antifungal therapy are the value of short course therapy with amphotericin B and the use of amphotericin B in combination with other therapeutic agents. In each case, experimental data provide support for clinical use, but adequate clinical studies are sparse. Until more clinical studies are done, use of these regimens should be restricted to specific groups of patients. PMID- 3296106 TI - Prevention and mycoses in immunocompromised patients. AB - Invasive fungal infections remain a major complication in immunocompromised hosts. The prognosis in these infections is poor, particularly for neutropenic patients with cancer. Candidiasis and aspergillosis are common in these patients, and numerous attempts have been made to evaluate potential prophylactic methods. Despite the fact that various agents (polyenes and/or imidazoles) and various formulations have been tested, the reported data on their effectiveness are still controversial. No single regimen can be recommended at this time for prevention of invasive candidiasis. The potential emergence of fungal strains resistant to the polyenes and the selection of Torulopsis glabrata by the imidazoles should also be taken into consideration. Aspergillosis, which is an airborne infection, may be prevented by isolation of patients at risk in rooms equipped with high efficiency particulate air (HEPA) filters. In addition, the prophylactic administration of nasal sprays of amphotericin B has shown encouraging results, and this approach should be further investigated. PMID- 3296107 TI - [Occupational asthma in the rural environment]. AB - Occupational asthma is frequent among farmers. Allergens, physio-pathological mechanisms and respiratory disorders are varied. Medico-legal problems (diagram n. 45 of occupational diseases) are recalled. The authors then describe the main allergens (plants, animals and chemical substances) they have met among farmers. Finally, some special aspects that depend on the occupation are discussed. PMID- 3296108 TI - [Peritoneal fluid microbiology: etiopathogenic implications in acute pelvic inflammatory disease]. PMID- 3296109 TI - [Use of colchicine in liver cirrhosis]. PMID- 3296110 TI - [Oxygen carriers with fluorocarbon base. An introduction]. PMID- 3296111 TI - [Toward a second generation of fluorocarbon emulsions. Methodologies: synthesis of fluorocarbons, formulation, preparation and control of emulsions]. AB - The fluorocarbons to be used as intravascular gas carriers may be prepared: by fluorination of hydrocarbons, by means of gaseous fluorine or of metallic fluorides or by electrolysis in anhydrous hydrogen fluoride; by selective synthesis from small fluorinated molecules. Selective synthesis seems preferable because of the high purity of the compounds thus obtained, allowing fairly simple purification and detoxification procedures. The adequacy of fluorocarbons for intravascular use (limited by the values of some of their crucial physicochemical properties such as vapour pressure, gas dissolving power, viscosity) was found dependent of their molecular weight range, preferably between 460 and 540 dalton. Ionic balance, osmolarity, viscosity, mean particle size and particle size distribution are among the most important criteria to be respected in the preparation of biocompatible emulsions. Several physicochemical methods were developed for selecting the best ingredients and the best emulsification procedures and for evaluating the stability of the emulsions to storage and to thermal stress. The combination of these physicochemical measurements may be used as a methodology for the optimisation and control of fluorocarbon emulsions as well as a way of evaluating new ingredients and formulations. PMID- 3296112 TI - [Prions, Jakob-Creutzfeldt disease and human growth hormone]. PMID- 3296113 TI - [Use of a cell line for the direct identification of thermolabile (TL) enterotoxin in E. coli]. PMID- 3296114 TI - [Identification of several E. coli mutants with deficient sulfur metabolism]. PMID- 3296115 TI - [The Gh. Zotta centennial. Didactic and scientific activity of Prof. Gh. Zotta]. PMID- 3296116 TI - [Pasteur and Koch, controversy but also mutual homage]. PMID- 3296118 TI - Trends & Techniques salutes industry manufacturers. PMID- 3296117 TI - [Histopathology of tegumentary leishmaniasis caused by Leishmania braziliensis braziliensis. 2. Tissue humoral response]. PMID- 3296119 TI - Chordomas: a review. Early diagnosis and complete removal offer potential for cure. PMID- 3296120 TI - [Psychological aspects of pain]. PMID- 3296122 TI - [Determining the coefficient of disinfectant levels]. PMID- 3296121 TI - [Therapeutic effects of trazodone in the treatment of tremor. Multicentric double blind study]. AB - A 30 days therapeutical trial with trazodone has been performed in 47 patients suffering from different types of tremor. No significant improvement was detected in patients suffering from parkinsonian syndromes, multiple sclerosis, psycogenic tremor and hyperthyroidism. After the double-blind trial with trazodone, a significant improvement (p less than 0.025) was, instead, evident in 5 out of 6 patients with essential tremor, while the score did not change in the 3 patients with essential tremor who were treated with placebo. PMID- 3296123 TI - [The 3 stages of cancer of the testis. Extension, imaging and biological markers]. PMID- 3296124 TI - [Non-epidermotropic cutaneous lymphomas]. PMID- 3296125 TI - [Immunolabelling in cutaneous lymphomas]. PMID- 3296126 TI - Advances in the physicochemical, immunologic and cytologic investigation of the synovial fluid. AB - Investigations of the pathologic synovial fluid (SF), carried out by numerous research teams, have attempted to elucidate certain pathogenic mechanisms suggestive for diagnosis and treatment. Recent studies have tried to draw some biorheologic patterns of the SF, useful for diagnosis and for the evaluation of certain therapies (synoviorthesis). A systematization of the microcrystalline arthropathies has been possible by microscopic examinations of the SF. Enzymologic studies have demonstrated the properties of enzymatic inhibitors of some classical antirheumatic drugs, suggesting the introduction of new antienzymatic products, and have supported the indication for synoviorthesis. Studies of the SF oligoelements have established new criteria for differential diagnosis, have suggested new treatments (by zinc compounds) and have offered explanations for the good effects of some drugs, such as D-penicillamine. Knowing the role of the toxic oxygen radicals in the pathogeny of the rheumatoid synovial inflammation, drugs with a protective action against the effects of free radicals have been introduced in the antirheumatic therapy. Analyses of the various SF cellular populations, including complex immunologic, cytoenzymatic, optic and ultrastructural cytologic investigations, are opening new prospects of clinical application. The general review of the above-mentioned problems is based on the personal experience of the authors and on the latest data in the specialty literature. PMID- 3296127 TI - Ultrasonically guided fine needle aspiration biopsy for the diagnosis of abdominal tumors. AB - The authors report on the value of ultrasonically guided fine needle (0.6 mm = 23 gauge) biopsy in the morphological diagnosis of abdominal tumors. The method is characterized by a high specificity, resulting from the direct evidencing of the tumoral cells. The accuracy of the method bears on the ultrasonographist's experience, who must puncture the tumor in its peripheral, un-necrotized, zones. The method is rapid and only slightly invasive, involving low risk for the patients. Our results correlate well with the existing literature. PMID- 3296128 TI - [Cervicofacial arterial lesions. An unusual case and a review of the literature]. AB - A patient with a bullet wound developed an initially unrecognized vascular lesion revealed after five weeks by a cataclysmic hemorrhagic complication during drainage attempts. Literature on cervicofacial ballistic injuries is reviewed and the practical attitude to adopt with these lesions discussed. PMID- 3296130 TI - Hereditary tyrosinemia type I--an overview. AB - Hereditary tyrosinemia type I is a metabolic disorder of autosomal recessive inheritance. The disorder is characterized by progressive liver disease and renal tubular defects with accompanying hypophosphatemic rickets. It occurs in an acute and a chronic form. Hepatocellular carcinoma is frequently encountered in the chronic form of the disorder. The primary enzyme defect is a deficiency of fumarylacetoacetase (FAH) (EC 3.7.1.2), the last enzyme in the degradation of tyrosine. The enzyme defect results in accumulation of fumaryl- and maleyl acetoacetate which are thought to cause the cellular damage in tyrosinemia. Fumaryl- and maleyl-acetoacetate are reactive compounds and have not been identified in tyrosinemia patients. Succinylacetone, however, presumably derived from these metabolites by reduction and decarboxylation, is elevated in serum and urine from the patients. The diagnosis of tyrosinemia can be established by determination of succinylacetone in urine or serum and by assay of FAH in lymphocytes and fibroblasts. Heterozygotes for FAH can be identified by fumarylacetoacetase analysis in lymphocytes and fibroblasts. Prenatal diagnosis of tyrosinemia is possible by analysis of succinylacetone in amniotic fluid supernatant and by assay of FAH in cultured amniotic fluid cells or chorionic villus material. Genetic variants of FAH may interfere in the prenatal diagnosis of tyrosinemia by the FAH assay and in the detection of the carrier state. Immunoblotting technique has shown absence of immunoreactive protein in liver tissue from tyrosinemia patients. Liver transplantation is as yet the only definite treatment of the disorder. PMID- 3296129 TI - A pitfall in the evaluation of medical therapy for occlusive arterial disease using the xenon wash-out technique. AB - In a double-blind cross-over trial an oral thromboxane synthetase inhibitor (TSI) or placebo was given to 15 patients with severe foot ischaemia. After TSI therapy, rest pain remitted in nine out of 14 legs, while remission during placebo was seen in three out of 11 legs (NS). The ankle and toe systolic blood pressures remained constant during both study periods. Nocturnal adipose tissue blood flow in the forefoot was measured by the xenon wash-out method. A significant increase of the nocturnal perfusion rate constant during TSI therapy was found. A slight oedema developed during TSI therapy. This causes a change of the composition of the tissue under study and thus of lambda-xenon. The perfusion rate in the present study thus merely illustrates the latter and not a true increase in blood flow. PMID- 3296132 TI - Efficiency of composite tests in gastrointestinal cancer. Preoperative prediction of liver metastases by scintigraphy, alkaline phosphatase, and carcinoembryonic antigen. AB - The efficiency of composite tests (liver scintigraphy, serum alkaline phosphatase, and serum carcinoembryonic antigen) in finding or excluding liver metastases preoperatively was evaluated in 185 surgical patients with high probability for gastrointestinal cancer--142 with colorectal and 43 with gastric disorders. A pathoanatomic verification procedure showed liver metastases in 21 and 7 patients, respectively. For each test two cut-off levels were defined in accordance with the operational purpose of the test: either to diagnose metastases (no false-positive test results) or to exclude metastases (no false negative test results). Generally, composite tests increased overall efficiency; in the colorectal group 39% of the patients were correctly classified by the combined, triple test; in the gastric group 94% were correctly classified. In conclusion, we think composite tests are useful, and the operational approach described may be helpful in decision-making and test evaluation. PMID- 3296131 TI - The effect of splenectomy on Escherichia coli sepsis and its treatment with semisoluble aminated glucan. AB - Rats were subjected to sham laparotomy or splenectomy and were challenged with either 0.2 X 10(9) Escherichia coli intravenously or 1 X 10(9) E. coli intraperitoneally. By means of quantitative blood culturing asplenic animals were shown to have a significantly impaired ability to clear the bacteria in both forms of challenge. Treatment with intraperitoneally injected semisoluble aminated glucan (SAG), known to have strong macrophage-stimulatory properties, compensated completely for the asplenic state. The substance protected against postsplenectomy sepsis both when given before and when given after removal of the spleen. This protective effect of SAG seemed to last at least 3 weeks. PMID- 3296133 TI - Modified sham feeding test after parietal cell vagotomy for juxtapyloric ulcer disease in patients with and without recurrent ulcers. AB - The mean of individual coefficients of variation of acid output after modified sham feeding was 39% in 22 patients operated on with parietal cell vagotomy. The reproducibility of the interpretation of the sham feeding test as 'positive' or 'negative' was good. An intragastric infusion of a marker to correct for pyloric loss did not increase the accuracy of the test. The prognostic value of the qualitative estimation of the sham feeding test 2 months after operation to predict recurrent ulcer after parietal cell vagotomy was poor in 39 patients studied prospectively over 3 years. With the criterion sham feeding minus basal acid output over 1.0 mmol/30 min as a positive test, 63% of patients with a positive and 24% with a negative test later had recurrent ulcers. The consistency of the interpretation as either positive or negative was low in annual tests during the 3 years of follow-up study. After parietal cell vagotomy the sham feeding-stimulated acid output was higher in patients with duodenal than in those with prepyloric recurrent ulcers and also in those without recurrences. This indicates that the amount of vagal innervation left after parietal cell vagotomy is of special importance in the occurrence of duodenal ulcer relapse. PMID- 3296134 TI - Impaired early insulin response to intravenous glucose in alcoholic liver cirrhosis. AB - This study aimed at determining the release and action of insulin in liver cirrhosis. Eight non-diabetic patients with alcoholic liver cirrhosis and eight age-, sex-, and weight-matched controls were investigated. The clearance and hypoglycemic action of insulin were determined after a brief intravenous infusion of insulin (10 mU/kg). Glucose tolerance and insulin response were determined after rapid intravenous infusion of 25 g glucose. In the cirrhotic patients the decrease in glucose tolerance was associated with a) an unchanged insulin clearance, b) a decreased hypoglycemic action of insulin, and c) a marked impairment in the early insulin response and a slight, but not significant, increase in the late insulin response. In the cirrhotic group glucose tolerance varied with the early (and late) insulin response and with the hypoglycemic action of insulin. It is concluded that both insulin action and the early insulin response are impaired in alcoholic liver cirrhosis and that deterioration of the early insulin release plays an important role for deterioration of glucose tolerance. PMID- 3296135 TI - Pancreatic pseudocysts: a biochemical evaluation of proteases and protease inhibitors in plasma. AB - A biochemical evaluation was performed on plasma from eight patients developing a pancreatic pseudocyst during acute pancreatitis attacks and from six patients with a known pseudocyst. Patients developing an acute pancreatic pseudocyst had high levels of activated trypsin in complex with alpha 1-protease inhibitor, together with a probable activation of the kinin, complement, coagulation and fibrinolytic systems. Profound changes were also seen in several protease inhibitors, indicating consumption of the inhibitors. The changes did, however, not differ from those seen in severe acute pancreatitis attacks in which no pseudocyst developed. Patients with chronic pancreatic pseudocysts had biochemical changes similar to those seen in moderate pancreatitis attacks, without any overt cascade system activation. At convalescence, however, these patients had biochemical signs of leakage from the pancreas and an ongoing proteolytic activity. PMID- 3296136 TI - The effect of levamisole on the maintenance of remission of ulcerative colitis. A 2-year double-blind study. AB - The results of our study of 50 patients show that levamisole is ineffective in the treatment of patients with ulcerative colitis. The data presented here support our hypothesis that the only effective drugs in ulcerative colitis act as suppressors of both acquired and natural immunity. PMID- 3296137 TI - Upper gastrointestinal findings in chronic renal failure. AB - Twenty-nine patients with chronic renal failure were examined both during the predialytic stage and after active treatment (dialysis, transplantation) for upper GI diseases. They underwent a gastric dose-response secretion test, gastroduodenoscopy, radiologic upper GI series, and fasting serum gastrin determination. Upper GI diseases increased in the active treatment stage. At the time of examination, patients with these diseases had a positive ulcer history, duodenitis, duodenogastric reflux, and blood group O more often in the predialytic stage. Their stimulation sensitivity to pentagastrin and their acid secretion capacity were greater, and they were less achlorhydric. Their fasting serum gastrin level was also lower. They had less endoscopically discovered gastritis, but microscopically, with regard to gastritis, they did not differ from those who did not develop upper GI complications. In conclusion, in chronic renal failure upper GI findings increase after the active treatment. Secretion tests and endoscopy performed before active treatment give an indication of those who will develop upper GI complications during active treatment. PMID- 3296138 TI - Tissue specificity in nerve regeneration. AB - In 1944 Weiss & Taylor presented experimental evidence against "neurotropism" in nerve regeneration. We used a silicone Y-chamber system to repeat some of those experiments. The proximal stump of transected rat sciatic nerve was introduced into the proximal inlet of the Y. One of the distal outlets was left empty, plugged or occupied by a tendon graft, the other outlet being occupied by a nerve graft. Analysis after 4 and 12 weeks showed in all cases a preferential or exclusive axonal growth towards the nerve piece. The results, indicating the existence of "tissue specificity", are contradictory to the results reported by Weiss & Taylor (30). The findings are discussed with respect to possible influence of humoral, cellular and molecular factors associated with the distal nerve stump as well as the matrix, formed between both nerve segments. PMID- 3296139 TI - Streptococcal gangrene of the eyelids. Case reports. AB - Following a brief review of the literature, three patients with fulminating periocular infections resulting in necrosis of the eyelids are reported on. The case histories demonstrate certain common features, different aetiological factors and diverse end results. The pathogenesis, microbiology and treatment are discussed. PMID- 3296140 TI - The outcome of 48 renal transplantations immunosuppressed with cyclosporine-A as monotherapy. AB - The course of 48 consecutive cadaveric renal transplantations immunosuppressed with Cyclosporine-A (CyA) as monotherapy in 3 different doses was retrospectively analysed. CyA doses were based on clinical observations. Overall one-year graft survival was 52% and for grafts immediate diuresing 82%. A dosage schedule of 12 mg CyA/kg/day seemed to secure graft function without any side effects to the patient. PMID- 3296141 TI - Cleft lip: aesthetic results following a different skin incision. AB - In a revision of the cleft lip cases repaired in the past 20 years using the most common techniques, the most significant observation that has emerged is the alteration of lip anatomy due to the abnormal dislocation of tissue masses and scar direction. These may have negative consequences on the final development of the lip. In an effort to avoid some of these inconveniences the authors propose a very flexible technique that recalls Pfeiffer's concepts, consisting of a vertical line of incision interrupted at various points so as to obtain angles of different degrees. The method has been named the W-technique with variably sized angles. PMID- 3296142 TI - Orofacial clefts in Czechoslovakia. Incidence, genetics and prevention of cleft lip and palate over a 19-year period. AB - The precise value of incidence was calculated based on the sample of 3,660 probands with orofacial clefts born in Bohemia between 1964-1982, as all cases born in this region and time were registered. For non-syndromic cases, the incidence of cleft lip was 0.4396 per 1,000 live birth, 0.7684 for cleft lip and palate and 0.6024 for isolated cleft palate. The sample of 4,950 of our older probands born between 1886-1963 was added and the whole sample of 8,250 individuals was evaluated with respect to sex-ratio, laterality, clinical severity, seasonal incidence and age of parents. The risk of recurrence and value of heritability were calculated as well. Based on these evaluations, a four threshold multifactorial model for cleft lip and palate was suggested and also confirmed by our results of primary prevention of orofacial clefts using periconceptional supplementation with vitamins and folic acid. PMID- 3296143 TI - Bone grafting at the stage of mixed dentition in cleft lip and palate patients. AB - Our results of bone grafting to the alveolar process during the mixed dentition were investigated in 55 consecutively treated patients (66 clefts). The amount of remaining bone and gingival retraction at the tooth mesial to the cleft after 3 and 12 months was measured and correlated with the following anatomical conditions present during surgery: width of the cleft, rotation of the adjacent incisor, stage of eruption of the tooth distal to the cleft. It was also considered if any deciduous lateral incisor or canine was extracted during surgery and if any flap dehiscence took place postoperatively. It was found that flap dehiscence resulted in significantly less bone at 3 months and at 1 year after surgery. Furthermore, extraction of a deciduous tooth was found to be significantly correlated to less bone 1 year after surgery, in which cases there were also persisting gingival retractions. The other factors had no significant influence on the outcome of surgery. PMID- 3296144 TI - Henrik Sjogren and Sjogren's syndrome. PMID- 3296145 TI - Diagnostic significance of immunohistological skin examination in patients with primary Sjogren's syndrome and other chronic inflammatory connective tissue diseases. AB - Clinically unaffected skin from 57/84 (68%) patients with primary Sjogren's syndrome (primary SS) was found to contain intraepidermal in vivo deposits of IgG, using a direct immunofluorescence technique. Similar IgG deposits were found in only 4/26 (14%) patients with secondary SS, in 3/28 (11%) patients with rheumatoid arthritis without SS (RA), in 2/13 (15%) patients with systemic lupus erythematosus without SS (SLE), in 10/41 (24%) patients with other well-defined connective tissue disease (CTD) and in 2/65 (3%) of normal controls (p less than 0.001 for all groups compared to primary SS). Intraepidermal IgG deposits were found in 5/12 (42%) patients with incipient primary SS and in 6/15 (40%) patients with ill-defined CTD (NS). None of the patients with primary SS had immunoglobulin deposits in the dermo-epidermal junction zone, while this was observed in 12% of the patients with RA and in 20% of the patients with SLE. We conclude that the presence of intraepidermal IgG deposits is valuable in the differential diagnosis between primary SS and RA or SLE, even if RA and SLE are complicated with SS. Examination for intraepidermal IgG deposits should supplement the lupus band test. PMID- 3296146 TI - Characterization of intraepidermal IgG deposits in patients with primary Sjogren's syndrome. AB - In order to characterize the pathomechanisms behind intraepidermal in vivo deposits of IgG, which are found in 68% of patients with primary Sjogren's syndrome (primary SS), skin biopsies and serum from patients with epidermal IgG deposits were examined and compared to normal controls. Double-labelling experiments on skin biopsies, from 5 patients and 5 normal controls, showed that IgG deposits were predominantly located to surface membranes of OKT6 positive Langerhans cells. Only IgG1 and IgG3 were found deposited. Neither IgG2, IgG4, IgM, IgA, IgE, IgD, C1q, C3c, fibrinogen, albumin, beta-2 microglobulin nor C reactive protein were found deposited in the epidermis of patients. Sera from 6 other patients with primary SS were examined for in vitro and in vivo binding of IgG to normal human epidermis. Using the athymic nude mouse/human skin model we were able to show that serum IgG from patients can be experimentally deposited in vivo in human skin transplants, but in vitro binding could not be demonstrated. The Fc-fragments of epidermal IgG were accessible to binding of anti-Fc-fragment antibodies and protein-A. We suggest that IgG-containing immune complexes constitute the intraepidermal IgG deposits seen in patients with primary SS, and that the binding possible is mediated by Fc-receptors of Langerhans cells and keratinocytes. PMID- 3296148 TI - Dry eye and the Sjogren's syndrome. PMID- 3296147 TI - Xerostomia. PMID- 3296149 TI - Tear glycoprotein determinations in the diagnosis and differential diagnosis of dry eyes. AB - Lacrimal, conjunctival and serum glycoproteins were detected by tear glycoprotein electrophoresis in normal tears, and in tears of patients suffering from acute and chronic conjunctivitis, caustic injuries, aqueous tear deficient dry eyes (keratoconjunctivitis sicca and Sjogren's syndrome), and mucus deficiencies (ocular pemphigoid, and Stevens Johnson syndrome). The use of tear protein and glycoprotein electrophoresis is discussed in the diagnosis and differential diagnosis of dry eyes in different forms and stages of the diseases. The possible physiological role of different glycoproteins and the significance of glycoprotein determinations in the selection of various therapeutic procedures is discussed. PMID- 3296150 TI - Treatment of Sjogren's syndrome: an overview. AB - This review focus on the double-blind clinical investigations in patients with Sjogren's syndrome and describe the historical developments. It is divided into two passages--systemic and topically treatment. PMID- 3296151 TI - Essential fatty acid and prostaglandin metabolism in Sjogren's syndrome, systemic sclerosis and rheumatoid arthritis. AB - Evidence from biochemical studies and from experimental animals indicates that abnormalities of essential fatty acid (EFA) and eicosanoid metabolism could lead to salivary and lacrimal gland atrophy and to immunological and cardio-vascular defects. Measurements of EFA levels in erythrocytes from patients with primary Sjogren's syndrome have shown that abnormalities are indeed present. Controlled clinical trials of supplementation with gamma-linolenic acid (GLA) as evening primrose oil (Efamol) in both primary Sjogren's syndrome and systemic sclerosis have given positive results. There are strong arguments to indicate that sophisticated manipulation of EFA metabolism may have a role to play, not only in Sjogren's syndrome but also in other rheumatological disorders. PMID- 3296152 TI - Cyclosporin a therapy in patients with primary Sjogren's syndrome: results at one year. AB - We present our experience with small doses of cyclosporine A (CyA), 5 mg/kg/day, in patients with primary Sjogren's syndrome treated for up to 12 months. Subjective improvement in xerostomia occurred at 6 months of treatment, without objective improvement in any sicca parameters. At 12 months, xerostomia improved slightly, but minor salivary gland histology worsened. We conclude that small doses of CyA in patients with primary Sjogren's syndrome for up to 12 months are rather ineffective. PMID- 3296153 TI - A double-blind, cross-over, study of oral N-acetylcysteine in Sjogren's syndrome. AB - Twenty-six patients with primary or secondary Sjogren's syndrome were treated in a double-blind, cross-over trial for a four week period with oral N Acetylcysteine and placebo. Before treatment there were significantly elevated salivary lactoferrin levels in the patients when compared to 51 healthy controls (p = 0.0005), and significantly decreased levels of tear lysozyme when compared to 24 controls (p = 0.0003). Salivary sodium, potassium, inorganic phosphate, amylase and immunoglobulin G, A or M levels were not significantly different from control values. After treatment with N-Acetylcysteine, Sjogren's syndrome patients reported improvements in ocular soreness (p = 0.004), ocular irritability (p = 0.006), halitosis (p = 0.033) and daytime thirst (p = 0.033). N Acetylcysteine, but not placebo improved the van Bijsterveld score (p = 0.026), but neither agent improved the Schirmer test, the tear break up time or any of the laboratory tests. These results suggest that N-Acetylcysteine may have a true therapeutic effect on the ocular symptoms of Sjogren's syndrome and be worthy of a longer study. PMID- 3296155 TI - Experimental Sjogren's syndrome: a review. PMID- 3296156 TI - Salivary histopathology in diagnosis of Sjogren's syndrome. AB - Although the etiology of Sjogren's syndrome (SS) remains unknown, the histopathologic examination of affected organs provides tissue diagnosis, a way to assess severity, and clues to pathogenesis. A common feature in organs affected by SS is lymphocytic infiltration, which presumably causes the functional changes and the diverse clinical features associated with this disease. So far, the salivary glands are the best studied organs in SS. Biopsy of major salivary glands is not a clinically convenient nor a very effective way to diagnose SS and can have serious sequelae. For these reasons, the minor salivary glands in SS have been studied for the last 20 years and used in diagnosing the salivary component of SS for more than 10 years. However, minor gland specimens can present different patterns of inflammation, and in diagnosing SS it is critical to distinguish between these patterns. Furthermore, a minor gland biopsy specimen must be taken from clinically normal-appearing mucosa and must contain sufficient glandular tissue for assessment. PMID- 3296154 TI - Treatment of keratoconjunctivitis sicca with Lacrisert. AB - A double-blind cross-over comparative study on the effect of Lacrisert versus oculoguttae viscosae and saline has been conducted. Lacrisert is a soluble solid tear substitute which is applied once-a-day. The object was to compare the safety and patient acceptability of Lacrisert and oculoguttae viscosae, and to compare the efficacy of Lacrisert to oculoguttae viscosae and saline. Twenty-nine patients suffering from primary Sjogren's syndrome (Copenhagen criteria), 2 male and 27 female, age: median 56 years, range 32-79 years. Lacrisert was applied once-a-day, and saccharose crystals of similar appearance was used as placebo. All patients were treated for 4 periods of 3 weeks: Lacrisert + saline versus placebo + saline and Lacrisert + oculoguttae viscosae versus placebo + oculoguttae viscosae. The patients were examined before entering the study and after each of the 4 periods using: slit-lamp, corneal sensitivity, BUT, Schirmer 1-test and Rose-bengal staining. Comparing Lacrisert to saline a significant improvement in BUT (p less than 0.01) and in Rose-bengal staining (p less than 0.01) was found, whereas other patients were unchanged. Comparing Lacrisert with oculoguttae viscosae no significant difference in clinical parameters could be detected. The patients complained of minor discomfort. Most prominent was a tendency to loose the Lacrisert due to an inadequate solubilisation of the rod caused by the lack of aqueous tears. We conclude that Lacrisert may help patients with primary Sjogren's syndrome provided that they have some secretory capacity left in the tear glands. PMID- 3296157 TI - Pathogenesis of Sjogren's syndrome. PMID- 3296158 TI - Recent developments in the immunology of Sjogren's syndrome (autoimmune exocrinopathy). PMID- 3296159 TI - Low-dose heparin in the treatment of calcaneal peritendinitis. AB - A double-blind, controlled study is presented on the effect of low-dosage heparin on acute calcaneal peritendinitis crepitans in young men. Treatment consisted in exemption from physical work and subcutaneous injection of heparin. 5000 I.U., or placebo, once a day for 5 consecutive weekdays. During the first week the mean total symptom score showed a gradual fall to 32 and 34% of the baseline values in the heparin (n = 10) and the placebo group (n = 10), respectively. On day 15 the value was unchanged in the heparin group, whereas it had increased again to 45% in the placebo group. However, the symptoms and signs recorded never differed significantly between the two groups. No adverse reactions were observed. Consequently, further studies are needed to show whether a treatment of acute peritendinitis can be obtained with heparin in a dosage with less risk of bleeding than that involved in the previously reported regimen. PMID- 3296160 TI - Evaluation of patients with rheumatoid cervical spine. PMID- 3296161 TI - Reappearance of Hering-Breuer reflex after bilateral autotransplantation of the lungs. AB - In combined heart-lung transplantation the afferent nerve pathways inevitably are transsected. In previous studies with en bloc heart-lung transplantation in dogs, we found altered regulation of breathing-abolition of Hering-Breuer reflex and response to hypercapnia inhalation stimulus consisting of augmented tidal volume with no change in respiratory rate-shortly after the operation. The long-term effects of pulmonary denervation on breathing regulation were now studied in dogs after staged bilateral pulmonary autotransplantation. Mechanical and electrical activities of the respiratory muscles were recorded during spontaneous breathing and after deflation and inflation with varying volumes of air. Five months postoperatively the duration of the respiratory cycle increased 2.5 times on inflation with 600 ml of air and occlusion of the airways, compared with tenfold prolongation in intact control dogs, indicating a partial return of the Hering Breuer reflex after the autotransplantation. The duration of the EMG bursts in respiratory muscles increased in intact dogs and in those with bilateral lung autotransplants. In impulse frequency the response to stretching was less evident after autotransplantation. The mechanism mediating reappearance of Hering-Breuer reflex warrants further study. PMID- 3296162 TI - Colloidal gold--a powerful tool in scanning electron microscope immunocytochemistry: an overview of bioapplications. AB - Colloidal gold may be conjugated to a wide variety of macromolecules, provides a versatile system for immunocytochemical studies by various types of microscopy (light and fluorescent microscopy, scanning (SEM) and transmission (TEM) electron microscopy), and is significantly contributing to the development of SEM immunocytochemistry as a routine analytical procedure. A comprehensive overview has been compiled of the literature on SEM bioapplications of colloidal gold. This is illustrated through a selected series of studies focussing on a) cell surface receptor-ligand interactions; b) expression of cell surface lectin binding sites; c) surface distribution of extracellular matrix components; and d) visualization of gold-labelled cytoskeletal elements with emphasis on the use of backscattered electron imaging as a powerful analytical adjunct in the development of SEM immunocytochemistry. PMID- 3296163 TI - [Preventive preoperative antibiotic therapy in elective colon surgery. A controlled prospective randomized study]. AB - Antibiotic prophylaxis in elective colonic surgery is of established value and most authors have proposed an association of at least two drugs. We have compared the efficacy of classical prophylaxis (clindamycin and gentamicin, C + G) with that of the single drug cefoxitin (Ce). 101 consecutive patients were covered; 22 had to be excluded and 7 withdrawn after randomization; 72 cases were left for final analysis (C + G 35; Ce 37). Five C + G (14.2%) and 4 Ce cases (10.8%) developed septic complications, possibly caused by opening of the colon (wound infection, anastomotic failure, colocutaneous fistula): this difference is not statistically significant. Episodes of sepsis, urinary tract infection and pneumonia were similar in both groups. Although the number of patients included is relatively small, we conclude that prophylaxis with Ce alone appears to be as effective as double drug prophylaxis with C + G. PMID- 3296164 TI - [New aspects in the surgical treatment of hyperparathyroidism]. AB - As a result of routine serum calcium determinations an increasing number of primary hyperparathyroidism (pHPT) cases are detected. While surgical treatment of the symptomatic patient with pHPT is generally accepted, this may not be the case in asymptomatic and especially elderly patients. The value of preoperative localization of parathyroid tumors has not been clearly established. In our experience dual parathyroid imaging with thallium and technetium has provided the best results. With the growing number of dialyzed patients, secondary (sHPT) and tertiary hyperparathyroidism (tHPT) are assuming increasing importance. Patients suffering from symptomatic sHPT or tHPT should undergo parathyroid surgery. After respective follow-up of 3.8 years (pHPT) and 2 years (sHPT and tHPT), all the cases with pHPT showed a relevant fall in serum calcium levels and PTH. PMID- 3296165 TI - [Life-threatening apnea after midazolam administration in a patient with obstructive sleep apnea syndrome]. AB - In a 27-year-old patient with a severe obstructive sleep apnea syndrome documented by a polysomnographic study, an oral dose of 15 mg midazolam caused life-threatening obstructive apnea and excessive sedation. Therapy with nasal CPAP eliminated the pharyngeal obstruction, but marked central hypoventilation persisted. Benzodiazepines are known to aggravate the obstructive sleep apnea syndrome. Dangerous central hypoventilation occurring after this medication during treatment with nasal CPAP has not yet been reported. Excessive susceptibility to depression of chemoresponsiveness to pCO2 is suspected. The potentially dangerous and life-threatening side effects of sedatives in patients with obstructive sleep apnea syndrome are discussed. PMID- 3296166 TI - [Immunoadsorption of anti-B antibodies as preparation for an ABO-incompatible kidney transplantation]. AB - AB0-incompatible kidney transplantation involves major risk of early acute vascular rejection. We report for the first time the successful preparation for renal homografting of a recipient of an HLA-haplotype identical, AB0 blood group B-incompatible renal homograft from a living related donor by immunoadsorption for removal of B blood group antibodies at days -4, -2 and -1. The iso-agglutinin anti-B titer was 1:256 before and 1:8 after three adsorption sessions in extracorporeal circuit. Before and after transplantation the splenectomized recipient was given azathioprine, prednisone and cyclosporine A. After homografting the anti-B iso-agglutinin and the anti-B isoimmune titers were mostly below 1:8 and never exceeded 1:32 and 1:64 respectively. 111 days after transplantation the recipient had a creatinine concentration in plasma of 160-180 mumol/l and was free of infectious complications. Thus the introduction of specific and convenient immunoadsorption of blood group antibodies by pheresis for preparation of renal homograft recipients may in future extend the indications for kidney transplantation in AB0-incompatible subjects, who have so far been denied the benefit of a living renal homograft. PMID- 3296167 TI - [An incidental finding of renal cysts: routine occurrence or a finding deserving clarification?]. AB - Since the introduction of new non-invasive diagnostic techniques such as abdominal ultrasound and computerized tomography, simple renal cysts are diagnosed with increasing frequency. Over 30% of patients over 50 years of age are found to have simple renal cysts of different size. A cystic renal mass may represent a simple renal cyst without clinical relevance, a cystic renal carcinoma, early evidence of polycystic kidney disease in a young patient, a rare cause of renal hypertension, a source of infection in a symptomatic patient (infected renal cyst), or a manifestation of an infectious disease (renal abscess, echinococcus cyst). The differential diagnosis and management of a cystic renal mass therefore remain a clinical problem. In the past, surgical exploration of a cystic renal mass was frequently performed. Today, modern diagnostic techniques such as ultrasound-guided percutaneous cyst puncture with cytological analysis of the cyst content, or computerized tomography, are considered the methods of choice. They are particularly useful in case of doubt about the dignity of a cystic renal mass. The determination of renal venous renin levels may be useful in differentiating the causal role of a renal cyst in a patient with hypertension. The management of a cystic renal mass depends on the underlying disease. PMID- 3296168 TI - [Acquired cystic renal changes--a clinically relevant problem in long-term dialysis]. AB - While dialysis patients survive renal failure for years and even decades, multiple morphologic alterations take place in their kidneys. One of these (so to speak) "postmortem" changes is the formation of secondary renal cysts. A patient with end stage renal failure due to amyloidosis is described who was dialysed at home for 9 years. Intravenous pyelography and renal biopsy in the predialysis period likewise documented the presence of amyloidosis and the absence of cystic disease. Ultrasonography of both kidneys, a suspicious increase in hematocrit and the autopsy finding of numerous large cysts also showed the presence of acquired cystic disease. The frequency and complications of this newly recognized disease in longterm dialysed patients are discussed. Recommendations are given concerning follow-up of these patients, with a view to early detection of tumor development within the cysts. PMID- 3296169 TI - [Provisional extension bridges reinforced with Kevlar]. PMID- 3296170 TI - [The altered cast method. Casting in prosthodontics]. PMID- 3296171 TI - [Hemostatic disorders. The therapeutic consequences for oral surgical treatment]. PMID- 3296172 TI - [The wire/composite splint. The splinting of traumatically loosened permanent teeth]. PMID- 3296173 TI - The birth of the U.S. biological-warfare program. PMID- 3296174 TI - [Clinical use of sonography in neonatology]. AB - During the neonatal period, sonography mostly represents the primary imaging modality of choice. Noninvasiveness, no exposure to ionizing radiation and no harmful side effects in biologic tissues contribute to the advantages of this technique. Validity of ultrasonic imaging in the neonatal age group lies primarily in the detection of congenital anomalies. Intraacerebral (2.39 per 1000 live births) as well as intracardiac (6 per 1000 live births) and intraabdominal anomalies can be diagnosed sonographically. Anatomic sites of origin of neonatal abdominal masses are renal (55%), genital (15%), gastrointestinal (15%), non renal retroperitoneal (10%) and hepato-spleno-biliary (5%). Furthermore, changes of echogenicity reflect structural changes and thus impairment of function in various organs. Finally, Duplex sonography, the combination of real time imaging and Doppler flow measurement, can differentiate between vascular and avascular lesions and normal and abnormal flow patterns. The application of diagnostic ultrasound in the neonatal period is demonstrated. PMID- 3296175 TI - [Sonographic diagnosis of hip dysplasia. Principles, sources of error and consequences]. AB - Sonography of the hip in infants is being increasingly employed. This method of examination involves several specialist disciplines. The more widespread its use, the greater the likelihood of faulty diagnoses if one is not aware of its weak points. Faulty diagnoses are the order of the day if the method is employed by persons whose knowledge has not been updated to latest advances in the field; other sources of error are faulty scanning, unsuitable sonographic equipment and insufficient documentation. Hence, it is mandatory to describe the demands to be made on the equipment according to update standards and to draw up guidelines that will help to avoid quality loss. The criteria for assessing a hip sonogram are defined and the problem of age limit is considered. A review is given of disturbances of normal development of the hip. The possibility of effecting dynamic examination should not mislead one to neglect assessment of the hip joints as precisely as possible by means of an exacting measurement technique. The weak points of the technique of measurement and the valuation of the angles must be known. A review of the literature reveals many problems in hip sonography. A multitude of these problems is unnecessary and can be considered as solved if one would try to match modern quality demands and not be satisfied with a quality standard that is many years old. To achieve best possible hip examination via sonography it will often be necessary to considerably modify principles of general sonography of the soft parts. PMID- 3296176 TI - [Clinical results of sonographic functional studies of lesions of the capsule and ligaments of the knee and ankle joint]. AB - The authors conducted a clinical study to examine whether sonographic examinations of function would be a reliable alternative to x-ray films of the forced extreme joint position in lesions of capsule and ligament of the knee and ankle joints. Sonographic standard planes of section are defined and the results of the described examination methods in 200 patients are demonstrated. Ruptures of the external ligaments of the ankle joint as well as cruciate and collateral ligament instabilities at the knee joint are simple and safe to assess and document via sonography. PMID- 3296177 TI - [Sonography of the meniscus and its lesions]. AB - It is the considered opinion of the authors that meniscus sonography can largely replace arthrography. This opinion is based on their detailed examinations and studies. Sonographic visualisation of all lesions produced by a scalpel was demonstrated using knees of corpses. Even cracks having the fineness of a human hair were visualised by sonography. A comparison between sonographic and surgical findings in meniscus lesion yielded in 82 patients an agreement of 95.1%. In 47 patients it was possible to prove that sonography was more accurate than arthrography as far as diagnosis was concerned. A comparison of 94 sonographically and arthrographically established findings yielded agreement in 89% of the cases. Sonography is suitable for meniscus imaging especially on account of the good imaging reproducibility of meniscus morphology; through safe detection of a pathological process in the meniscus; through the safe presentation of lesions; through the accurate imaging of all parts of the meniscus; and, furthermore, through the invaluable advantage of noninvasiveness, freedom from pain and hazards; and, last but not least, rapid manipulation and unlimited repeatability. PMID- 3296178 TI - [Sonographic imaging of the anterior cruciate ligament]. AB - At the present time the cruciate ligaments can be demonstrated only via CT and arthroscopy. The typical clinical ligament signs (anterior and posterior drawer sign) cannot always be provoked. Especially in older ruptures the uncharacteristic knee pain and the feeling of instability are the most prominent symptoms. Experimentally the anterior cruciate ligament is well demonstrable via sonography both ventrally and dorsally, using a knee ligament preparation. In the patient, however, the anterior cruciate ligament can often be seen sonographically only in ventral longitudinal sections. PMID- 3296179 TI - [Sonographic detection of a cystic tumor originating in the hip joint (bursitis iliopectinea). Contribution to the differential diagnosis of tumors of the hip]. AB - In tumors of the soft parts of the hip area, sonography can contribute decisively to clarify the diagnosis by using the 5 mHz sound head for exploration. In the case reported here it was possible to correct the wrong diagnosis of femoral hernia and to establish the diagnosis of a cystic tumour communicating with the hip joint (iliopectineal bursitis). The diagnosis was confirmed both by operation and by histological examination. PMID- 3296180 TI - [Computer-assisted evaluation of ultrasonically obtained biometric data in pregnancy]. AB - Sonographic supervision of the baby's growth is an important technique in obstetrics in order to recognise foetal diseases at an early stage. A computer programme was designed to simplify analysis and classification of these data. The results show that computer analysis is more objective, less biased and simpler than the manual method. PMID- 3296181 TI - [Therapeutic percutaneous puncture and drainage of postoperative space-occupying lesions using permanent ultrasound and roentgen control]. AB - Ultrasonically guided, percutaneous fine-needle aspiration biopsy allows final histological and/or cytological diagnosis in patients with benign or malignant space-occupying growths even of small size. Therapeutic puncture and drainage of postoperative abdominal or retroperitoneal growths (haematoma, seroma, lymph cyst, abscess) however, requires 1.) dilatation of the percutaneously established puncture channel and 2.) continuous vacuum aspiration over a period of several days or weeks. We report on three therapeutic punctures in two patients with retroperitoneal lymph cysts following abdominal radical hysterectomy with lymphonodectomy and one patient with abscess formation following nephrectomy. The technique employed was as used in percutaneous nephrostomy. Under local anaesthesia and permanent ultrasound guidance the lesion is punctured with a 1.3 mm hollow puncture needle of three parts (Angiomed) and after aspiration of fluid a 0.9 mm wire guide with a curved, soft tap was inserted through the puncture needle in the lesion. The puncture channel is then dilated under x-ray visualisation with a Teflon-coated fasciadilatator (Cook) to Charr. 16 (20). Finally either a polyvinyl catheter with two lateral apertures (Cook) or a double barrelled Shirley Drain is inserted and fixed to the skin with a stitch. For diversion a closed system is used. Over a period of one to two weeks 50 to 200 millilitres of secretion are drained off per day in decreasing quantity. The patients returned to normal temperature and recovered entirely. The advantage of our method is the avoidance of dangerous and difficult secondary surgery. PMID- 3296182 TI - [Sonographic diagnosis of mesothelial cyst of the diaphragm]. AB - We present a case of a female patient of 65 years of age, who was referred to our clinic for surgery because of a suspected intrahepatic cyst, and who was suffering from upper abdominal complaints. Detailed sonographic examination revealed a cystic process outside the liver, the respiratory shift of structures during the sonographical examination being the criterion. However the final diagnosis of a mesothelial cyst of the diaphragm was possible only after laparotomy and histological examination. PMID- 3296183 TI - [Principles of sonographic examination of the hip]. AB - The advantages of ultrasound in the diagnosis of congenital dislocation and dysplasia of the hip, compared with other imaging diagnostical methods are obvious, since an exact and early diagnosis of hip immaturity can be made. Using realtime sonography, it is possible to directly visualise the motion of the femoral head in the acetabulum and verify any instability of the joint. Especially hips which are classified as being in the critical range should always be examined dynamically to judge their grade of instability. This is necessary because these hips often show no pathology when examined clinically. Unlike radiography, hip sonography can diagnose the grade of hip maturation from the day of birth. Newborn screening can thus result in early detection and treatment of pathological hip joints. Since introducing routine newborn screening at our hospital, we have been able to achieve an earlier onset of therapy in 80% of the cases, within the first four weeks of age. The percentage of CDH diagnosed before and after introducing the newborn screening did not differ. Babies which are classified as being in the "risk group" were followed up regularly. Subsequent to the dynamic examination of the hip, problems of describing the arthrosonographic anatomy of the hip are discussed. PMID- 3296184 TI - Application of polyurethane foam for sampling volatile mutagens from ambient air. AB - This paper reports the use of polyurethane foam (PUF) in the sampling of airborne mutagens too volatile to be retained by glass fibre filters. Air was sampled simultaneously with a glass fibre filter and PUF plugs, and the two extracts of the samples were tested for mutagenicity and analysed for polycyclic aromatic hydrocarbons (PAH). As PUF itself was found to contain mutagens, it was thoroughly rinsed, and a blank extract of the same PUF used for sampling was tested as a control. The resulting blank extracts were not mutagenic. In the first series of experiments, in which methanol was used as the extraction solvent, sampling induced clear-cut mutagenic effects in the PUF extracts. As the mutagenicity of the PUF itself appeared only with the use of methanol or other alcohols as extraction solvents, a second series of experiments was carried out in which acetone was used as the extraction solvent. In these experiments sampling induced no mutagenicity in the extracts. The discrepancy between the two series of experiments may be due to the absence of volatile mutagens in the second series, but another explanation may be an artefact induced by the solvent in the first series. Additional experiments suggest that sampling induces the formation, from PUF, of compounds mutagenic upon extraction with methanol. The study leads to the provisional conclusion that no volatile mutagens could be demonstrated in ambient air sampled by the use of PUF as an absorbent, notwithstanding the clear-cut effects of the filter extracts and the presence of volatile PAH in the PUF extracts. PMID- 3296186 TI - Radiotracers for the determination of the accuracy of trace element analyses. AB - Many analytical techniques for the determination of trace elements in environmental samples are plagued by ill-defined systematic errors. Investigations of analytical techniques with radioactively labelled analytes can identify systematic errors, lead to their elimination, and can improve the accuracy of the results. Radiotracers are directly detected with high sensitivity and great rapidity in most cases by gamma-ray counters. Examples of the use of radiotracer techniques for the investigation of the following steps of analytical procedures are presented: presampling events, sampling and sample handling, mineralization of samples, separation and preconcentration, and determination. Most of the examples discussed in the text were taken from the analytical chemistry of mercury, sulfur, lead, sodium, zinc and selenium. Other examples are summarized in tables. The results of these investigations clearly show the superiority of the radiotracer technique over other techniques. A more frequent use of the radiotracer technique in investigations aimed at improving the accuracy of analytical procedures is certainly desirable. PMID- 3296187 TI - Fredrickson resigns from Hughes Institute. PMID- 3296185 TI - Antimicrobial activity of electrolyzed saline solutions. AB - Electrolysis of solutions containing certain electrolytes, through the use of novel electrodes, produces significant levels of ozone, oxygen, and chlorine at the anode. The process works at ordinary temperatures, and with dilute solutions. These solutions, after electrolysis, can be much more effective, by a factor of several hundred, against microorganisms than solutions containing comparable hypochlorite solutions. PMID- 3296188 TI - NIH dedicates museum to DeWitt Stetten. PMID- 3296189 TI - Disease diagnosis by recombinant DNA methods. AB - Recombinant DNA procedures have now been applied to the problem of the identification of molecular defects in man that account for heritable diseases, somatic mutations associated with neoplasia, and acquired infectious disease. Thus recombinant DNA technology has rapidly expanded our ability to diagnose disease. Substantial advances in the simplification of procedures for diagnostic purposes have been made, and the informed physician has gained in diagnostic accuracy as a consequence of these developments. The wide application of recombinant DNA diagnostics will depend on simplicity, speed of results, and cost containment. PMID- 3296190 TI - The human hematopoietic colony-stimulating factors. AB - The complementary DNAs and genes encoding the four major human myeloid growth factors--granulocyte colony-stimulating factor, macrophage colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, and interleukin-3--have all been molecularly cloned. These DNA clones have proved valuable for studying the molecular biology of these important regulatory molecules as well as for the large-scale production of the recombinant growth factor proteins. These advances have led to a much better understanding of the role of the myeloid growth factors in regulating hematopoiesis in vivo that should soon find practical application in clinical medicine. PMID- 3296191 TI - Regulation of inducible and tissue-specific gene expression. AB - Molecular genetics approaches have been used to identify and characterize cis acting DNA sequences required for eukaryotic gene regulation. These sequences are modular in nature, consisting of arrays of short (10- to 12-base pair) recognition elements that interact with specific transcription factors. Some transcription factors have been extensively purified and the corresponding genes have been cloned, but the mechanisms by which they promote transcription are not yet understood. Positive and negative regulatory elements that function only in specific cell types or in response to extracellular inducers have been identified. A number of cases of inducible and tissue-specific gene expression involve the activation of preexisting transcription factors, rather than the synthesis of new proteins. This activation may involve covalent modification of the protein or an allosteric change in its structure. The modification of regulatory proteins may play a central role in the mechanisms of eukaryotic gene regulation. PMID- 3296192 TI - Tinkering with enzymes: what are we learning? AB - It is now possible, by site-directed mutagenesis of the gene, to change any amino acid residue in a protein to any other. In enzymology, application of this technique is leading to exciting new insights both into the mechanism of catalysis by particular enzymes, and into the basis of catalysis itself. The precise and often delicate changes that are being made in and near the active sites of enzymes are illuminating the interdependent roles of catalytic groups, and are allowing the first steps to be taken toward the rational alteration of enzyme specificity and reactivity. PMID- 3296193 TI - Fredrickson's bitter end at Hughes. PMID- 3296194 TI - A physical map of the Escherichia coli K12 genome. AB - A physical map of a genome is the structure of its DNA. Construction of such a map is a first step in the complete characterization of that DNA. The restriction endonuclease Not I cuts the genome of Escherichia coli K12 into 22 DNA fragments ranging from 20 kilobases (20,000 base pairs) to 1000 kilobases. These can be separated by pulsed field gel electrophoresis. The order of the fragments in the genome was determined from available E. coli genetic information and analysis of partial digest patterns. The resulting ordered set of fragments is a macrorestriction map. This map facilitates genetic and molecular studies on E. coli, and its construction serves as a model for further endeavors on larger genomes. PMID- 3296195 TI - Results of scaphoid non-union treatment by the Matti-Russe procedure using compressed cancellous bone. PMID- 3296196 TI - The efficacy of cardiovascular nuclear medicine exercise studies. AB - Radionuclide stress tests were initially introduced into medicine as new diagnostic tests for coronary artery disease (CAD). These tests are very effective for this purpose when applied to populations with an intermediate pre test probability of coronary artery disease. Radionuclide stress tests, however, also are used now in guiding many management decisions in patients with established CAD, based on the ability of these tests to assess the extent and severity of myocardial ischemia, the functional significance of coronary stenoses, and myocardial viability. Specific uses beyond diagnosis include decisions regarding whom to catheterize, send to coronary bypass surgery, or angioplasty; risk stratification following myocardial infarction or before noncardiac surgery; and evaluation of the results of therapy. This article reviews both the diagnostic efficacy of radionuclide stress tests and their efficacy in guiding management decisions in patients with known coronary artery disease. PMID- 3296197 TI - Pharmacologic intervention as an alternative to exercise stress. AB - Although thallium exercise imaging has served an important role in clinical cardiology, it is significantly limited by suboptimal sensitivity and specificity, particularly in asymptomatic man. The increasing recognition of silent myocardial ischemia, the significant prevalence of coronary artery disease in asymptomatic middle age men, and the frequent occurrence of myocardial infarction without preceding symptoms in 60% of cases emphasizes the need for a more definitive, noninvasive diagnostic test for the presence of coronary artery disease suitable for screening in asymptomatic or symptomatic patients. Intravenous dipyridamole combined with handgrip stress provides a potent stimulus for purposes of diagnostic perfusion imaging. Although planar and single photon emission computed tomography (SPECT) imaging also have played an important role, these techniques are seriously hindered by their inability to quantitate radiotracer uptake or image modest differences in maximum relative flow caused by coronary artery stenosis. Accordingly, the combination of dipyridamole-handgrip stress with positron imaging of myocardial perfusion has become a powerful diagnostic tool suitable for routine clinical use. With the availability of generator-produced rubidium-82, dedicated clinically oriented positron cameras, the routine application of positron imaging to clinical cardiology has become feasible. Based on published literature, the current clinical indications for positron imaging that may be carried out economically on a routine clinical basis include assessment of myocardial perfusion utilizing rubidium-82 or N-13 ammonia for purposes of reliable, accurate, noninvasive screening for coronary artery disease in symptomatic or asymptomatic patients; assessing noninvasively the physiologic severity of coronary stenoses; myocardial infarct imaging; assessing myocardial viability of reversibly injured or ischemic cells using N-13 ammonia combined with fluorine-18-deoxy-glucose or Rubidium-82 alone in experimental animals; assessing regional or global left ventricle (LV) function by 3 dimensional gated blood pool imaging and/or wall thickening by ECG gating; and assessing the functional significance of collaterals in man. PMID- 3296198 TI - Current status and prospects of new radionuclides and radiopharmaceuticals for cardiovascular nuclear medicine. AB - The rapid emergence of new imaging modalities like positron emission tomography (PET) and single photon emission computerized tomography (SPECT) and their advance into the clinical arena offered new opportunities for, but also stimulated research and development of new radiopharmaceuticals suitable for cardiac imaging. While tracers of myocardial blood flow remained in the center of interest, other trends heralded possibilities of studying more comprehensively cardiac physiology and pathophysiology as, for example, metabolism, the severity of tissue injury, neural activity and membrane function. N-13 ammonia and rubidium-82 became the primary tracers for evaluating and possibly quantifying regional myocardial blood flow with PET, while cationic Tc-99m isonitrile complexes have now reached a stage where high contrast images of the human heart are obtained on planar scintigraphy and SPECT. These radiopharmaceuticals hold considerable promise for routine clinical use. Tracers of metabolism, especially those labeled with positron emitting isotopes as for example, C-11 palmitate, F 18 2-deoxyglucose, are approaching the phase of clinical use and provide information on regional myocardial substrate metabolism and oxidative processes. Less successful and more limited were developments of single photon emitting tracers of metabolism which remained largely confined to radioiodinated fatty acid analogs. Exploration and characterization of the metabolic fate of the radiolabel in tissue and its relation to the externally observed signal have been truly impressive. Tested in humans primarily in western European countries, these tracers promise to yield metabolic information on a more limited scope. Most widely applied are iodohepta- and hexadecanoic acid and, more recently, the aromatic fatty acid analog, paraiodophenylpentadecanoic acid. Labeled monoclonal antibodies rapidly advanced to the point of clinical use. Accurate identification and sizing of acute myocardial infarction is now possible with Tc-99m or indium 111 labeled specific antimyosin antibody fragments. This success stimulated new research activities for use of labeled antibody techniques in other areas as for example, scintigraphic evaluation of formation and presence of vascular thrombi. While promising, these efforts have however remained in an early stage of development. The same holds true for single photon and positron emitting tracers that are suitable for assessing sympathetic neuron densities in myocardium as well as imaging of both cholinergic and adrenergic receptors.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3296199 TI - Radionuclide cineangiography in acute myocardial infarction: role in prognostication. AB - Radionuclide-based procedures have achieved frequent application in acute myocardial infarction (MI). While these methods can be employed in diagnosis and assessment of therapy, diagnosis usually can be made more easily and with less expense when other methods are employed. Assessment of therapy, while potentially of value, has not been evaluated in a manner which can provide practical guidelines for clinical application. Practical utility has been associated with the use of radionuclide-based techniques in prognostication after infarction; this application is crucial to the formulation and optimization of management decisions. While myocardial perfusion scintigraphy and infarct-avid-agent imaging have been employed in prognostication after infarction, the largest body of prognostic data are available in association with radionuclide cineangiography. When determined in the early hours after infarction, a left ventricular ejection fraction (LVEF) less than 30% indicates a high likelihood of in-hospital mortality, irrespective of the site of infarction. When determined shortly prior to hospital discharge, LVEF less than 30% indicates a high likelihood of posthospital mortality, perhaps as high as 25% during the first year, and reaching 30% by the end of 2 years after infarction. Conversely, LVEF greater than or equal to 30% indicates an 8% 2-year postinfarction mortality risk. While LVEF is a highly potent risk descriptor, considerable evidence suggests the LVEF determined during exercise prior to hospital discharge also provides risk stratification, and may be superior to, or at least additive to, LVEF at rest as a prognostic index.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296200 TI - Morphologic tumor markers. PMID- 3296201 TI - Cell surface markers in hematologic malignancies. AB - Cell surface markers have identified considerably more heterogeneity within human T, B, and myeloid neoplasms than was evident by standard morphologic and histochemical techniques. Using markers specific for the lineage and state of differentiation, it is now possible to correlate malignant lymphoid and myeloid cells to their normal cellular counterparts. Considering the complexity of the normal hematopoietic system with regard to ontogeny, differentiation, and function, it is not surprising that these malignancies reflect this diversity. Hopefully, with increasing characterization of the normal function of cell surface molecules, as well as the subpopulations of normal cells to which these malignancies correspond, we will have a better understanding of the biologic and clinical behavior of these malignancies. PMID- 3296202 TI - High-dose ara-C and VP-16 before conditioning for bone marrow transplantation in patients with high-risk leukemia. PMID- 3296203 TI - Bone marrow transplantation for acute leukemia and lymphoma with high-dose cytosine arabinoside and total body irradiation. PMID- 3296205 TI - Proto-oncogene transcript levels and acute nonlymphocytic leukemia. PMID- 3296204 TI - Proto-oncogene expression in HL-60 cells exposed to ara-C. AB - To verify the reported differentiation/maturation-inducing effects of cytosine beta-D-arabinofuranoside (ara-C, Sigma Chemical Corp, St Louis) on hematopoietic cells, we studied the morphologic changes and patterns of proto-oncogene expression in HL-60 cells that had been exposed to the drug. At the 1 X 10(-7) mol/L concentration of ara-C, approximately 10% of HL-60 cells became nitroblue tetrazolium (NBT) reduction test positive after four days exposure. However, no cells became nonspecific esterase-positive during the culture period. Doses less than 1 X 10(-8) mol/L had virtually no effect on maturation and proliferation of the target cells while doses greater than 1 X 10(-6) mol/L were lethal to HL-60 cells. Cells treated with 1 X 10(-7) mol/L and 1 X 10(-9) mol/L ara-C did not evidence any of the changes in c-myc, c-myb, c-fos, or c-fes that are noted when dimethyl sulfoxide (DMSO) or 12-0-tetradecanoyl phorbol 13-acetate (TPA, Sigma Chemical Corp, St Louis) are used to induce the differentiation of HL-60 cells. In both doses, temporary decreases of the S-phase specific and proliferation related histone H3 gene expression occurred. This phenomenon may be related to an increase in the tendency of these cells to spontaneously differentiate. Because of the possibility of drug inactivation during culture and because HL-60 cells have already matured to the promyelocytic stage, these kinds of experimental systems may be inadequate in in vitro models for low-dose ara-C therapy. PMID- 3296206 TI - Intensive postremission therapy in adults with acute nonlymphocytic leukemia using various dose schedules of ara-C: a progress report from the CALGB. Cancer and Leukemia Group B. PMID- 3296207 TI - Prolonged survival after high-dose cytosine arabinoside and amsacrine induction in patients with previously untreated de novo acute nonlymphocytic leukemia. PMID- 3296209 TI - Cytosine arabinoside for induction, salvage, and consolidation therapy of adult acute lymphoblastic leukemia. AB - During A-ALL induction treatment, HD-ara-C (2.5 g/m2 IV, day 1), does not produce any beneficial effect, whereas the hematologic toxicity is increased. A 3-month consolidation phase comprising intermittent MTX, ara-C and 6-TG is not significantly affecting either DFI or survival in A-ALL. The association of HD ara-C and m-AMSA appears to be a promising salvage therapy for the 20% A-ALL refractory to first induction therapy. The quality of autologous bone marrow graft, harvested after HD-ara-C, seems to be impaired as suggested by a delayed recovery of PMN and platelets. HD-ara-C (3 g/m2 X N) given the days before cyclophosphamide and TBI as conditioning treatment for BMT does not seem to induce prohibitory additional toxicity. Whether HD-ara-C was given four to six times or eight to 12 times gave no significant difference in early toxicity. PMID- 3296208 TI - Treatment of 218 adult acute lymphoblastic leukemias. PMID- 3296210 TI - The alpha interferons: clinical overview. AB - The clinical development of the recombinant alpha interferons has provided a prototype for the clinical development of biological compounds. With over 5,000 patients now treated with these compounds, some general principles have emerged that have wider implications for phase I-II strategies for testing other biologicals. There is a suggestion of dose-response relationships and a clearer picture of schedule dependence. The extent of tumor burden and identification of sensitive subtypes of patients also appear to be critical factors in evaluating the true potential activity of biological compounds. The toxicity profile of the alpha interferons is unusual. Fever and flu-like symptoms occur in all doses and schedules and are usually dose limiting. Somnolence and other CNS effects occur in a small percentage of patients. Hematologic toxicity occurs but is minimal at lower doses and is noncumulative and rapidly reversible at all doses. Gastrointestinal toxicity is mild. No other unusual or unexpected toxicities have been reported, and early reports of cardiovascular toxicity have not been confirmed in large trials. The use of these pioneer recombinant DNA products raised concerns about the potential development of antibodies and serum neutralizing factors. Reports with small patient numbers confirmed the occasional development of serum-neutralizing activity to some alpha interferons. The significance of this neutralizing activity and the reasons for an apparent higher incidence of this phenomenon with some alpha interferon preparations remain to be determined. The full role of alpha interferon by itself or in combination with other available therapies will be resolved in coming years. This review presents current safety, efficacy, and neutralizing antibody data. PMID- 3296211 TI - The use of interferon in the treatment of multiple myeloma. AB - Almost all patients with multiple myeloma still relapse or become refractory in 2 to 3 years. Interferon (IFN) therapy has clearly influenced the levels of abnormal serum proteins in some patients. A multi-institutional phase II clinical trial used alfa-2b recombinant interferon (Intron A, Schering, Kenilworth, NJ) in 38 evaluable patients with relapsing and refractory multiple myeloma; two thirds of the patient population had received extensive prior treatment. Seven responded, of whom three continued to do so beyond 1 year--one with an ongoing complete remission. An additional 13 had at least a 25% decrease in abnormal paraproteins. Of nine patients who were initially refractory to chemotherapy, two responded to IFN. Of nine relapsing patients returned to chemotherapy following IFN therapy, six then responded. Thirty previously untreated patients with multiple myeloma were treated with IFN followed by melphalan and prednisone; of 24 evaluable patients, 18 responded with a median duration of 10+ months. Alfa-2b IFN apparently does not antagonize melphalan or prednisone, nor does it appear to worsen the response of the two drugs alone. Effectiveness of recombinant alfa-2b IFN in pretreated relapsing patients suggests additional trials are needed to study its effects in previously untreated patients. A significant number of patients who relapsed on their original chemotherapy and subsequent interferon will apparently respond to the reinstitution of chemotherapy. PMID- 3296213 TI - Estrogens and progestins as tumor inducers. PMID- 3296212 TI - Alfa interferon: combinations with other antineoplastic modalities. AB - Early laboratory work demonstrated synergism from the combination of various cytotoxic agents and alfa interferon against various cell lines. In conjunction with anecdotal clinical reports of this synergism, multiple clinical trials were initiated to determine the tolerance and toxicity of the alfa interferons in conjunction with other antineoplastic agents/modalities. Phase I-II studies have been completed with alfa interferon and melphalan/prednisone, vincristine, vinblastine, etoposide (VP-16), cyclophosphamide, and radiation. In general, it may be stated that the toxicities are nonoverlapping and not unexpected. The tolerable doses of the interferons (IFNs) have generally been low. The future of research with interferon may be divided into three areas: Efforts must be made to determine how best to translate the in vitro synergy into clinically meaningful terms; in order to exploit the fullest potential of IFN, research is moving toward using this agent earlier in disease either as an adjuvant after tumor debulking or after initial diagnosis; the medical community must rethink the natural history of some diseases, because the fullest potential of the biologic agents will most likely manifest itself when these agents are used together. PMID- 3296214 TI - Hepatic vein thrombosis (Budd Chiari syndrome): possible association with the use of oral contraceptives. PMID- 3296215 TI - Acute fatty liver of pregnancy. PMID- 3296216 TI - Course and prognosis of pregnancy in women with liver disease. PMID- 3296218 TI - Cystic fibrosis: overview. PMID- 3296217 TI - Female sex steroids and cholestasis. PMID- 3296219 TI - Gastrointestinal manifestations of cystic fibrosis. PMID- 3296220 TI - Psychiatric emergency services: evolution, adaptation and proliferation. AB - This paper traces the dramatic rise of psychiatric emergency services (PES) and crisis intervention services over recent decades. It examines three processes- the evolution of such services, their adaptation to diverse settings, and the striking increase both in the number of programs and their utilization. PES first evolved along three disparate lines--makeshift psychiatric emergency care in the emergency room of the general hospital, ad hoc after-care services in the psychiatric hospital, and the community mental health movement. Community mental health legislation of the 1960s not only provided funds for PES but led to the merging of the three lines. PES have adapted to and are found in a great variety of settings. The latter include small general hospitals and huge medical centers; county, state, and private mental hospitals; free clinics; telephone hot-lines, and others. Their adaptability appears due to their flexible personnel requirements and lack of need for an elaborate technology. Although fewer than 160 facilities were known to offer PES in 1963, their number exceeded 2000 by the early 1980s. Available piecemeal data indicate constantly increasing utilization of PES. This is a result of many factors, including deinstitutionalization. Although PES were initially visualized as resources for acute mental health care and continue to serve as such, they have become increasingly chronicized, consequent on the deinstitutionalized abandonment of many chronically ill persons. Changes are also occurring in the social and demographic characteristics of persons utilizing PES and in the ways in which the services are perceived and utilized. The early development of unlabeled and makeshift psychiatric emergency care in the general hospital's emergency room and the psychiatric hospital were instances of 'evolutionary planning'.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296222 TI - Changing ideas: the medicalization of menopause. AB - This paper examines the intellectual roots of the medicalization of menopause in the 1930s and 1940s. An analysis of published papers written by prominent American medical specialists reveals three models that were developed to understand menopause--biological, psychological and environmental--and shows how each contributed to its medicalization. This transformation was made possible by the paradigm of sex endocrinology and the availability of a new drug (DES), which was produced in 1938. Exploring the medicalization of menopause illuminates some of the special and complicated ways that women's experiences are vulnerable to medical control. PMID- 3296221 TI - Background to the development of health services in Nigeria. AB - This paper concentrates on three main issues. First a brief overview of the nature of the politics, economy and health in Nigeria prior to colonialism. It is important to know, for instance, how medicine was organized prior to the advent of modern medicine. I think our understanding of pre-colonial Nigeria is important because it enables us a better grasp of the changes which were later introduced by imperialists. The second issue will be the imperial penetration of Nigeria by Britain. Imperialism took several forms ranging from the activities of Christian missionaries to the eventual colonial rule over the various kingdoms and empires which were in the region. The effects of the imperialist activities on the transformation of Nigerian society and particularly the introduction of the capitalist productive forces wil be discussed, with the view to examine changes in the organization of health and medicine. The last issue to be considered in this paper will be the role of imperialism in class formation in Nigeria. Emphasis will be first, on the social and economic condition of colonial physicians who came from England and then how they were related to the colonial state and colonial health policies. From this premise, we can examine the historically specific circumstances under which Nigerians were trained as physicians and how they (Nigerian physicians) got involved in the politics of nationalism. We will then discuss how the First and Second World War gave energy to Nigerian nationalist movements. The paper ends by stating that the Nigerian nationalists who had struggled and secured Nigeria's political independence eventually became Nigeria's ruling class which now controls the post-colonial state. PMID- 3296223 TI - The magnitude of the maternal mortality problem in sub-Saharan Africa. AB - Estimates of national levels of maternal mortality in sub-Saharan Africa are based on limited and defective data and subject to considerable discussion. In this paper, existing data from several sources are reviewed. The attempt has been made to assess the level of maternal mortality by studying the relative importance of maternal death, health services coverage data, perinatal mortality, causes of maternal death and traditional birth practices. It is concluded that national levels of maternal mortality in sub-Saharan Africa most likely vary from 250 to 700 per 100,000 live births, in proportion to the variation in overall levels of mortality in the countries. There is a need for more studies either based on data from peripheral hospitals or on community surveys. Such studies should analyse coverage of deliveries, coverage of maternal deaths, causes of maternal deaths, socioeconomic differentials, perinatal mortality and should pay special attention to the increasing problem of abortion-related mortality. PMID- 3296224 TI - [The diabetic foot and its complications. "Therapeutic prescriptions"]. PMID- 3296225 TI - Prophylactic treatment of asymptomatic patent ductus arteriosus in premature infants with respiratory distress syndrome. AB - Early treatment of premature infants with indomethacin has been proposed as a means of reducing the morbidity associated with respiratory distress syndrome complicated by symptomatic patent ductus arteriosus. We identified 26 infants less than 48 hours old with severe respiratory distress syndrome who had an asymptomatic patent ductus arteriosus. These infants were treated with either indomethacin or placebo. There was a significant difference in the frequency of ductal closure after receiving indomethacin treatment. No significant difference was observed in the time required for mechanical ventilation, time receiving supplemental oxygen, or time in the hospital, and there were no significant differences in the incidence of bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity, or death between the two groups. PMID- 3296226 TI - Delayed conjunctival closure in adjustable sutures. AB - We describe a technique for delayed conjunctival closure in adjustable strabismus surgery. It combines many of the advantages of the limbal and cul-de-sac approaches, while eliminating many of the disadvantages. PMID- 3296227 TI - Carcinoma of the thyroid: review of 304 cases. AB - From 1950 through 1976, 304 patients were treated for carcinoma of the thyroid at Sinai Hospital of Baltimore. This series clearly indicates that papillary cancer of the thyroid can be fatal, even after a five-year survival, even as long as 25 years later. This study also shows that a patient with solid cell or undifferentiated carcinoma of the thyroid might live as long as 17 years after operation. Twenty-three patients in this series had had previous operations, 13 of which were for malignancy of the thyroid. Of these 13 patients, four died of carcinoma of the thyroid. Three had had lobectomy, two for papillary carcinoma and one for follicular carcinoma, and one had had subtotal thyroidectomy for undifferentiated carcinoma. Early and complete resection of thyroid carcinoma is indicated because this disease can be fatal, even after long survivals, multiple foci of malignancy may be present in 27% of cases, the disease can recur in the contralateral lobe after previous lobectomy, death can occur even after secondary operation, and careful surgical treatment can yield an uneventful total thyroidectomy. PMID- 3296228 TI - Osler's nodes and the recognition of infective endocarditis: a lesion of diagnostic importance. AB - Osler's nodes are classic lesions strongly associated with infective endocarditis. Osler's original description placed them as a frequent finding (70%) in cases of endocarditis. Recent literature, however, has infrequently described these lesions, which in general are no longer found to be useful. We review the clinical syndromes of infective endocarditis and their association with these lesions. We also review the pathogenesis of the lesion that currently supports the embolic nature of Osler's nodes. Osler's nodes are helpful clues if they appear in patients with infective endocarditis, and biopsy and culture of the lesion may provide an etiologic diagnosis. PMID- 3296229 TI - Septic scarlet fever in 11th decade of life. PMID- 3296230 TI - Medical origins of Duke University. PMID- 3296231 TI - [Social-hygienic aspects of the problem of alcoholism in the works and activity of Russian medical scholars]. PMID- 3296232 TI - [Participation of Crimean medical personnel in revolutionary activities (on the eve of and during the 1905-1907 revolution)]. PMID- 3296233 TI - [E. B. Eshe--outstanding Penza physician, scholar and public figure of the 19th century]. PMID- 3296234 TI - [Physicians in literature and art]. PMID- 3296235 TI - Measurement of lumbar sagittal mobility. A comparison of methods. PMID- 3296236 TI - Chemonucleolysis versus surgery in lumbar disc herniations: correlation of the results to preoperative clinical pattern and size of the herniation. AB - A prospective study was carried out on the results of chemonucleolysis or surgery in 156 patients who had lumbar disc herniations. All patients were considered as potentially good candidates for chemonucleolysis. Seventy-two received a chymopapain injection and 84 underwent surgery. Based on computerized tomography (CT) scan and/or myelography the herniations were distinguished as small, medium, and large. Also distinguished were three types of preoperative clinical patterns, Type A, Type B and Type C, corresponding to slight, moderate, and severe nerve root compression, respectively. Follow-up evaluations were made 1 month, 3 months, and an average of 2.8 years after treatment. The patients with a small disc herniation, who underwent chemonucleolysis, did slightly better as a group than those treated surgically. At 1 month, the proportions of satisfactory results were 75% in the chemonucleolysis group and 62% in the surgery series. At final follow-up, the proportions were 84% and 82%, respectively, but the ratio of excellent-to-good results was higher in the chemonucleolysis group. In the latter, most patients with satisfactory outcomes had a Type A or Type B clinical pattern. In medium-size herniations the results of surgery were slightly better than those of chemonucleolysis. At 1 month, 55% of patients in the chemonucleolysis group had satisfactory results compared with 74% of those in the surgery series; at final follow-up the proportions were, respectively, 76% and 86%. In the chemonucleolysis group most satisfactory outcomes were found in patients with a Type A or Type B clinical pattern. The results of chemonucleolysis in patients who had large herniations were significantly inferior to those of surgery: at final follow-up the results were satisfactory in 50% of patients in the chemonucleolysis group and 89% of those in the surgery series. Chemonucleolysis appears to be the treatment of choice in most patients with small disc herniations and an effective alternative to surgery in most patients with medium-size herniations when the preoperative clinical pattern indicates a slight or moderate nerve root compression. In all large herniations and in small- or medium-size herniations causing a severe nerve root impingement, surgery should be preferred to chemonucleolysis. PMID- 3296237 TI - Use of cryopreserved bone in spinal surgery. AB - One hundred fifty-two consecutive spinal fusions were performed over a 4-year period in 143 patients. Autogenous bone was used in 62 patients and frozen cryopreserved bone in 90. A variety of anterior and posterior procedures with and without instrumentation were performed. The percentage of successful arthrodesis was 87 in those who received autogenous bone, and 86.6 in those who received allograft bone. Thirty-four spinal fusions were surgically explored. Histologic evaluation of the bone taken at the time of surgical exploration showed viable osteocytes laying down osteoid, woven and lamellar bone, and no inflammatory or foreign body reaction. The authors conclude that cryopreserved bone, harvested and processed as described, is advantageous, safe, and results in a rate of bone union comparable to that of autogenous bone. PMID- 3296238 TI - Lumbar laminectomy for herniated disc: a prospective controlled comparison with internal fixation fusion. AB - This is a controlled prospective study on a matched set of patients with herniated lumbar discs. Both groups received the same bilateral lumbar laminectomy and disc excision by the same surgeon. One group had the addition of an intertransverse fusion with internal fixation. Both groups were studied by an independent examiner at an average of 3 years postoperatively for success rate as determined by activity level, medication, subjective and objective evaluation. Both groups had similar age, sex, and occupational characteristics. No patient had prior surgical treatment or chemonucleolysis. Patients with associated lumbar spine problems such as stenosis, instability, or spondylolisthesis were excluded. Each patient had a positive clinical picture for a herniated lumbar disc, as well as a positive myelogram, venogram or computerized tomographic scan. Most had positive electromyograms. All patients received at least 3 months of conservative care. The 38 patients with fusion had a significantly longer mean time to return to work after surgery versus the 31 patients without fusion. Although the general success rate of both groups was 87%, the best results were in the nonfusion group. A total of 29% of nonfusions had excellent results whereas only 11% of the fusion group had excellent results. The conclusion is that fusions are not necessary and give less excellent results in simple laminectomy cases for herniated lumbar disc. PMID- 3296239 TI - [Kidney transplantation in children--report on the first 3 patients treated at the Pediatric Clinic in Belgrade]. PMID- 3296240 TI - [20 years' worldwide experience in kidney transplantation in children]. PMID- 3296241 TI - [Radiotherapy of Hodgkin's disease]. PMID- 3296242 TI - [Prof. Bohuslav Niederle, octagenarian--28 March 1987]. PMID- 3296243 TI - [The development of thoracic surgery in Czechoslovakia over the last 50 years]. PMID- 3296244 TI - [Primary sutures in the injured spleen]. PMID- 3296245 TI - Non-invasive assessment of lower limb ischaemia by blood velocity wave-form analysis. AB - Clinical examination combined with angiography is conventionally used to assess lower limb arterial disease. The shape of the blood velocity wave form in the common femoral artery varies with the extent of proximal arterial disease, suggesting that wave-form analysis may provide additional haemodynamic information of potential value in surgical decision-making. This paper studies the use of two methods of wave-form analysis, pulsatility index and Laplace transform analysis, to assess lower limb arterial disease. The blood velocity wave form was measured non-invasively at the common femoral artery using a locally developed mean frequency processor and a commercial 9.5 MHz bidirectional Doppler ultrasound unit. Wave forms from 70 limbs (35 patients) with suspected atherosclerotic arterial disease and from 20 normal limbs with no history or signs of disease were studied. Both methods of wave-form analysis provided a statistically significant separation between patients with severe and moderate disease as assessed angiographically (P less than 0.001). These results suggest that significant aorto-iliac disease can be virtually excluded by a normal common femoral wave form. Furthermore, wave-form analysis may have an important role in the follow-up of patients after bypass grafting or iliac angioplasty and in the detection of presymptomatic aorto-iliac disease. PMID- 3296246 TI - George Warwick Bampfylde Daniell, 1864-1937. AB - In 1907 Dr G. W. Bampfylde Daniell was the first doctor to be appointed an anaesthetist in a South African hospital. Little is known about his work, but due acknowledgement must be made to his pioneering efforts to place anaesthesia on a sound scientific basis, and to his various contributions towards making the specialty safe and comfortable. During his career in South Africa, he played an active role in the then Cape of Good Hope, Western Branch, of the British Medical Association. PMID- 3296247 TI - Conversion from cyclosporin to azathioprine 3 months after renal transplantation- is it safe? PMID- 3296248 TI - [Transrectal sonographic study in prostatic lithiasis]. PMID- 3296249 TI - [Immunoenzymatic methods: technical bases and applications in hematologic diagnosis]. PMID- 3296250 TI - Chronic duodenal and gastric ulcer. AB - During the past two decades, major advances have been made in our understanding of basic gastric physiology. Appreciation of cellular biology has contributed to rapid progress in gastric pharmacology. Clinicians may choose from a large and rapidly growing list of antiulcer drugs. The proper choice of medical or surgical therapy depends on knowledge of the pathophysiology of peptic ulceration and of the inherent limitations of each approach. Selective drug use, tailoring of medical regimens to individual clinical situations, and the combination of medical and surgical treatments will play prominent roles in the future management of peptic ulceration. PMID- 3296251 TI - Morbid obesity: use of vertical banded gastroplasty. AB - Vertical banded gastroplasty has evolved from gastric bypass and earlier forms of gastroplasty as a safe and effective gastric reduction procedure for the treatment of morbid obesity. This article provides a step-by-step description of the technique. Spatial orientation by use of landmarks such as an Ewald tube in the esophagus, the angle of His, and a Penrose drain around the esophagus is important in avoiding injury to adjacent structures. Careful measurement of the pouch volume at a pressure of 70 cm H2O is necessary. For patients between 170 and 225 per cent of ideal weight, a 5.0 cm circumference collar is used around the outlet. For heavier patients, a 4.5 cm collar is used. Bypass is not necessary because weight control depends on a small pouch and stoma. PMID- 3296252 TI - Small intestinal obstruction. AB - Small intestinal obstruction remains a frequently encountered problem in abdominal surgery. Although modern day surgical management continues to focus appropriately on avoiding operative delay whenever surgery is indicated, not every patient is always best served by immediate operation. Certain entities, such as SBO secondary to incarcerated abdominal wall hernia, and patients with clinical signs and symptoms suggestive of strangulation do require prompt operative intervention. Other conditions, however, such as postoperative adhesions and neoplastic-associated SBO, particularly in patients with numerous previous abdominal procedures, concomitant medical problems, or incomplete or partial obstruction, often justifiably benefit by a trial of nonoperative management. The risk of strangulation with adhesive and neoplastic SBO is relatively low as compared with incarcerated hernia and small bowel volvulus. Close and careful clinical evaluation, in conjunction with laboratory and radiologic studies, will usually dictate the proper course of management in any given case. If any uncertainty exists, prompt operative intervention is indicated. Because over 50 per cent of all cases of SBO are the direct result of postoperative adhesions, it is probably just as important as the actual management of SBO for all practicing abdominal surgeon to familiarize themselves with the widely accepted "ischemic theory" of adhesion formation. A number of intraoperative measures, many of which go against established surgical principles, are now encouraged during routine elective abdominal surgery to reduce the incidence of detrimental adhesions that might subsequently produce SBO. At the same time, surgeons should continue their aggressive attitude towards elective repair of any and all abdominal hernias, which continue to account for close to 15 per cent of all cases of small intestinal obstruction and still remain the most common cause of strangulation. PMID- 3296253 TI - Intra-abdominal abscess in the 1980s. AB - Prompt recognition, early localization, and adequate drainage have contributed to the decreased morbidity and mortality rates associated with intra-abdominal abscess in the last decade. The physical examination, ultrasonography, computed tomography, and radionuclide scans provide information that leads to early detection and localization of abscess in almost all patients. Percutaneous drainage should be the initial procedure unless specific indications for surgery exist. PMID- 3296254 TI - The hematologic effects of latamoxef sodium when used as a prophylaxis during surgical treatment. AB - Latamoxef sodium, a third generation cephalosporin antibiotic, has been shown to provide good prophylaxis against postoperative infection. It has, however, been implicated as causing disturbances of hemostasis particularly when used in treatment. We have studied 40 patients who required antibiotic prophylaxis prior to surgical treatment randomizing and stratifying them according to age and type of operation, to receive either latamoxef or piperacillin. Five hematologic parameters were studied, prothrombin time, activated partial thromboplastin time, plasma factor II concentration, plasma factor VII concentration and platelet count. Minor differences were noted with latamoxef producing mild persistant elevation of prothrombin time (0.7 second) associated with depression of factor II and factor VII. In our study, we found that, when used as three dose, single agent prophylaxis, there was no difference between latamoxef and piperacillin in producing clinical disturbances of hemostasis. However, attention is drawn to the importance of recognizing that hemostatic disturbances can occur after the use of broad spectrum antibiotics as prophylaxis for surgical treatment Mechanisms of hemostatic disorders are reviewed and alternative hypotheses are suggested. PMID- 3296255 TI - Results with cyclosporine in renal transplantation in patients who have lost two previous allografts. AB - We investigated the fate of the cadaver renal transplant done with cyclosporine and prednisone immunosuppression into a recipient who had suffered the loss of at least two prior allografts. Nineteen cadaver renal allografts were transplanted into 18 recipients. All 18 recipients had previously rejected at least two prior allografts. One of these rejected an allograft done at our institution with cyclosporine and prednisone and was included a second time in this series when a fourth allograft was received. Nine of 19 allografts were successfully transplanted. Average follow-up time was 39 months. Eight allografts were rejected. One graft was lost to technical complications. In one instance, the recipient died with a functioning graft. Duration of function of previous allografts was not found to be a critical determinant of third or fourth graft survival. Human leukocyte antigen matching was not a statistically significant determinant. Panel reactive antibody was higher in those who rejected the third or fourth allograft, but not with statistical significance. Recipients with the blood type A were less likely to enjoy successful third or fourth cadaver renal transplantation. We concluded that the "two time loser" renal allograft recipient should not be systematically denied subsequent transplantation. PMID- 3296256 TI - An atraumatic technique for protecting or retracting small vessel walls during vascular anastomosis. AB - A modified vascular dilator with a needle groove is presented. The dilator also serves as an atraumatic intraluminal retractor simultaneously allowing atraumatic passage of the vascular suture needle. PMID- 3296257 TI - A new technique for arterialization of the hepatic graft. AB - We believe that the new technique described herein for reconstructing the hepatic artery is the method of choice for arterialization of hepatic grafts. This technique is easily performed, even during retransplantation and even if the recipient or donor has double arteries. Since submission of this article, an additional 20 transplantations of the liver have been performed without graft loss using this technique. This includes five infant livers with donors as small as two days old and weighing 3.2 kilograms. PMID- 3296258 TI - The use of antibiotics in surgical treatment of the colon. AB - The judicious use of antibiotics seems to be indicated in operations upon the colon, although these procedures were performed with similar morbidity rates in the 1930's without the use of antibiotics. The results of recent studies indicate that systemic antibiotics administered preoperatively and for a short perioperative interval is the preferred method of treatment because it has little effect on intestinal colonization. Surgical principles have not materially changed over the years and antibiotics are not indicated merely to cover breaks in the operative technique. One must always be cautious of possible untoward reactions and complications. This may be another example of the principle--less is more. PMID- 3296259 TI - Interpretation and extrapolation of Lanfranchi's "Science of Cirurgie". PMID- 3296260 TI - [The effect of radio- and chemotherapy on survival in advanced head and neck tumors]. AB - Inoperable cases of advanced squamous cell carcinomas in the head and neck area which have a very poor prognosis are often treated by a combined radio- and chemotherapy. Tumor remissions up to 70% are induced by both radiotherapy and chemotherapy alone; an increase of the survival time is not reported. The present randomized study investigates the efficacy of two therapy schemes, i.e. chemotherapy alone and chemotherapy combined with irradiation. Tumor remissions of 75% were achieved in 80 evaluable patients, the median remission period was four months and the median survival period eleven months. The survival curves do not show any dependence of the survial time on the size of tumor or metastases. Only responders had a significantly longer survival time than non-responders. PMID- 3296261 TI - Effect of whole body gamma-radiation on glutathione reductase of rat tissues. AB - Adult female Sprague Dawley rats approximate ten months old were exposed to whole body gamma radiation of sublethal (4 Gy) and lethal (10 Gy) doses of radiation. Serum glutathione reductase enzyme values of 4 Gy exposed rats did not show any change on first and fourth day but significantly decreased on eighth day, while enzyme values in 10 Gy exposed group remained unaltered throughout. Heart glutathione reductase activities of sublethal group did not show any change on first and eighth day but significantly decreased on fourth day. Rats exposed to lethal doses of radiation, enzyme activities remained unchanged throughout. Liver glutathione reductase enzyme values of 4 Gy exposed group showed significant decrease on first and fourth day but arrived at control values on eighth day while the same in 10 Gy exposed group showed significant decrease from first day till the eighth day. An appreciable diminution was observed in spleen glutathione reductase enzyme activities of sublethal and lethal exposed rats from first day till eighth day. PMID- 3296262 TI - Intraoperative ultrasonography in screening for liver metastases from colorectal cancer: comparative accuracy with traditional procedures. AB - As a new screening procedure, intraoperative ultrasonography using high resolution real-time instruments was used routinely in 84 colorectal cancer operations to scan the entire liver for liver metastases. In 10 operations (11.9%), intraoperative ultrasonography identified 14 previously unrecognized metastatic tumors, all of which were less than 2 cm in size and were nonpalpable. The sensitivity of this technique in detecting metastatic liver lesions (97.8%) was significantly superior (p less than 0.01) to that of preoperative ultrasound (41.3%), computed tomography (47.8%), and surgical exploration (58.7%), while the specificity of each test was comparable (approximately 90%). High-resolution intraoperative ultrasonography is safe, simple to perform and more accurate than preoperative imaging and surgical exploratory methods. Therefore its use is encouraged during colorectal cancer surgery for screening of liver metastases. PMID- 3296263 TI - The effect of decreased caffeine consumption on benign proliferative breast disease: a randomized clinical trial. AB - A single-blind, randomized clinical trial of 56 female subjects was conducted to determine whether decreased consumption of caffeine decreases breast pain/tenderness or nodularity in patients with suspected benign proliferative breast disease. The subjects were randomly assigned to one of three groups--a control group (no dietary restrictions), a placebo group (cholesterol-free diet), and an experimental group (caffeine-free diet). At the initial examination, the subjects reported on the presence of breast pain, the degree to which pain affects daily activities, the frequency of pain, the degree of pain associated with breast examinations, and the degree of pain associated with close-fitting clothing. Subjects were then examined and the four quadrants of each breast were rated on a scale of 0 to 3 (0 = normal, fatty tissue, 1 = little seedy bumps or fine nodularity, 2 = discrete nodules or ropy tissue, 3 = confluent areas, hard or soft masses). Subjects in all three groups returned for 2- and 4-month follow up examinations. Total nodularity scores, degree of pain/tenderness, and compliance with dietary restrictions were analyzed. The data showed that decreased caffeine consumption did not result in a significant reduction of palpable breast nodules or in a lessening of breast pain/tenderness. PMID- 3296264 TI - Is pyloroplasty necessary in esophageal replacement by stomach? A prospective, randomized controlled trial. AB - A randomized, prospective, controlled trial compared the use of pyloroplasty (study group) with nonuse of the procedure (control group) in the treatment of 72 patients with carcinoma of the thoracic esophagus. In these patients, transthoracic esophagectomy was performed, and the whole stomach was used for reconstruction in the right side of the chest. No complications due to the pyloroplasty developed in any of the patients who underwent this procedure. Gastric emptying tests that were performed at the sixth postoperative month in 37 patients demonstrated a prolongation of emptying time in the control group (p less than 0.01). The patients' symptoms, however, did not correlate well with gastric emptying time. Follow-up assessment showed that a higher proportion of patients who did not undergo pyloroplasty suffered from symptoms of incomplete emptying while eating, but the difference was not statistically significant. Moreover, the proportion of patients who were free of postoperative symptoms gradually increased in both groups and reached 100% in the study group and 89% in the control group at 2 years. In the control group, two of the three patients with prolonged gastric emptying time complained of persistent regurgitation and distending discomfort after meals (18 and 24 months after surgery). They were the only two patients who might have benefited from a drainage procedure at the initial operation. Since there apparently were no reliable operative criteria by which to identify patients who might require drainage, and since the risk associated with pyloroplasty was negligible, it would seem reasonable to perform a pyloroplasty on every patient in whom the whole stomach was used for reconstruction after esophagectomy. This procedure would benefit the few patients who might manifest symptomatic gastric stasis. PMID- 3296265 TI - Hypermyoglobinemia after successful arterial embolectomy. AB - Myoglobin concentrations in serum and urine were measured in eight patients who underwent successful arterial embolectomy in the femoral or iliac arteries. Median serum myoglobin levels significantly increased after revascularization to a maximum of 4741 micrograms/L (reference range: 0 to 80 micrograms/L) 2 hours postoperatively, with a concomitant and correlated increase in the urine myoglobin concentration. Three days after the operation, serum myoglobin concentrations were still substantially elevated in three patients. None of our patients suffered permanent renal damage, but transient renal impairment was noted in five patients, as evaluated from the serum and urine beta 2 microglobulin concentrations. We found an association between the concentrations of myoglobin in serum and urine (Spearman's rho: 0.66; p less than 0.001) and between the concentrations of myoglobin in urine and beta 2-microglobulin in urine (Spearman's rho: 0.65; p less than 0.001). Our results indicate a transient renal impairment associated with hypermyoglobinemia and myoglobinuria, even after successful arterial embolectomy. PMID- 3296266 TI - Myoelectric assessment of bowel viability. AB - A device capable of quantitative measurement of intestinal ischemic damage has been designed. The device is called the electrical contractility meter and employs a clip-on strain gauge transducer that delivers a precisely controlled electrical stimulus to the bowel. Threshold stimulus level (TSL) is the stimulus current in milliamperes (mA) that is necessary to produce a clearly defined smooth-muscle contraction. In 30 dogs, TSL was used to establish viability boundaries in 40 cm ischemic bowel segments. Bowel viability was assessed with the use of TSL in comparison with gross features (color, peristalsis) and blood flow measured by means of Doppler ultrasound at 2 cm intervals in the ischemic small-bowel segments. The TSL scale ranges to 100 mA and varied from a low of 22 +/- 2 mA in normal bowel outside the ischemic segment to 97 +/- 4 mA in grossly gangrenous bowel. There was a consistent correlation between rising TSL and worsening bowel color, disappearance of visible peristalsis, and progressive disappearance of audible Doppler signals. Resection and anastomosis were performed in three groups of 10 dogs at TSL measurements of 30 mA, 40 mA, and 50 mA, respectively. Dogs were killed and anastomoses were inspected on the tenth postoperative day. There were no leaks at TSL = 30 mA, one leak at TSL = 40 mA, and four leaks at TSL = 50 mA. The number of leaks at TSL = 50 mA was significantly greater than at TSL = 30 mA (p less than 0.04, Fisher's exact test). These results show that the quantitative myoelectric parameters established by this device provide a reliable in vivo assessment of bowel viability. The electrical contractility meter is easy to use and may have clinical applicability. PMID- 3296267 TI - Tc-NGA imaging in liver transplantation: preclinical studies. AB - Tc-99m galactosyl-neoglycoalbumin (Tc-NGA) is a new liver-imaging agent which binds to hepatic binding protein (an hepatocyte-specific membrane receptor). This study evaluated the sensitivity of Tc-NGA kinetics and imaging anatomy to pathologic states that are encountered after liver transplantation. Studies were performed in adolescent pigs under control conditions (18 studies), and after orthotopic liver transplantation (nine studies), common bile duct ligation (three studies), hepatic artery ligation (one study), and hepatic resection (two studies). Anatomic and kinetic data were analyzed. Excellent liver images and minimal kinetic changes were noted after common bile duct ligation. Marked imaging defects and major kinetic alterations were observed after hepatic artery ligation and in the presence of preservation injury. Marked depression in hepatic Tc-NGA uptake was observed during acute rejection. Minor alterations in Tc-NGA kinetics were noted after a 25% hepatectomy. These studies indicate that minimal changes in Tc-NGA uptake occur after common bile duct ligation; Tc-NGA uptake is markedly sensitive to hepatic ischemia; decreased Tc-NGA uptake occurs during acute rejection; and hepatic infarcts are demonstrated promptly after preservation injury. Thus Tc-NGA imaging provides a novel means of evaluating hepatic ischemia, hepatic preservation, and hepatic allograft rejection. Tc-NGA imaging may also provide a means of evaluating hepatic regeneration and hepatocyte retrodifferentiation during regeneration. PMID- 3296268 TI - Autodigestion of the glans penis and urethra by activated transplant pancreatic exocrine enzymes. AB - A case of synchronous kidney and pancreas transplantation in which a whole pancreas graft had been drained to the urinary bladder is discussed. On the 137th postoperative day, the patient presented with symptomatic balanitis and urethritis. Documented enzymatic activation of the trypsinogen/chymotrypsinogen, which is not present in symptom-free control patients, was thus thought to be responsible for these symptoms. Conversion to enteric drainage by means of a Roux en-Y loop resulted in resolution of both symptoms and urinary enzymatic activation. Recurrent urinary tract infections were thought to be the most likely mechanism responsible for these findings. PMID- 3296269 TI - [Working environment. Danish Nursing Council's working environment information]. PMID- 3296270 TI - [Children's health. Conditions could be harsh for 1700-century children]. PMID- 3296271 TI - [Children's health. Children in destitute families often suffered a hard fate]. PMID- 3296272 TI - [Alternative treatment. Physical therapy and structural treatment]. PMID- 3296273 TI - [Children's health. Photographs of dead children were the language of grief]. PMID- 3296274 TI - [The Maryland Bridge--an alternative to conventional bridges]. PMID- 3296275 TI - [Therapia antiqua]. PMID- 3296276 TI - [The clinic 1914]. PMID- 3296278 TI - [The clinic 1914]. PMID- 3296277 TI - [Therapia antiqua]. PMID- 3296279 TI - [Therapia antiqua]. PMID- 3296280 TI - [The clinic 1917]. PMID- 3296281 TI - [The clinic 1922]. PMID- 3296283 TI - [Pulse-therapy in rheumatology]. PMID- 3296282 TI - [Captopril in the treatment of mild cardiac insufficiency in combination with arterial hypertension]. AB - The results of clinicoinstrumental investigations in 33 patients with coronary heart disease and coronary heart disease combined with essential hypertension complicated by stage I-II cardiac insufficiency showed that therapy with captopril at a daily dose of 25-75 mg resulted in the correction of cardiac insufficiency in 84% of the patients, with a hypotensive effect in 80%. Captopril improved myocardial contractility, decreased pressure in the pulmonary artery and total peripheral vascular resistance and produced no major side-effects. PMID- 3296284 TI - [Treatment of patients with autoimmune thyroiditis (review of the literature and personal data)]. PMID- 3296285 TI - [Immunological aspects of arterial hypertension]. PMID- 3296286 TI - [Methodological aspects of the determination of circulating immune complexes using polyethylene glycol]. PMID- 3296287 TI - [Serum proteolytic enzymes in different clinical variants of rheumatoid arthritis]. AB - A study was made of the activity of the blood serum proteolytic enzymes in 100 rheumatoid arthritic patients. Their noticeable activation well correlated with clinical types of disease, was revealed. Maximum proteolysis values were noted in parallel with high degrees of activity, seropositivity, systemic signs, rapid progression and multiple articular lesions. PMID- 3296289 TI - Thyroid sonography--first choice for diagnosis? PMID- 3296288 TI - [Treatment of Raynaud's syndrome with calcium entry blockers]. AB - The authors have presented the results of a 14-day open randomized trial of the efficacy of 3 calcium inlet blocking agents: nifedipine, verapamil and phendilin in 61 patients with Raynaud's syndrome. In the group of patients receiving 30-80 mg of nifedipine (20) there was a significant decrease in the frequency and expression of Raynaud's syndrome attacks, a positive effect of varying degree was noted in 19 patients. The drug raised slightly the skin and muscular blood flow and skin temperature. The use of 120-360 mg of verapamil in 21 patients caused no significant inhibition of Raynaud's syndrome and rise of hemocirculation. Phendilin (150-300 mg) though being comparable with nifedipine in efficacy, often produced side-effects resulting in the drug cancellation (8 out of 20). The efficacy of the calcium inlet blocking agents, especially nifedipine, for therapy of Raynaud's syndrome was emphasized. PMID- 3296290 TI - Intracoronary vs intrapulmonary arterial streptokinase infusion for MI. PMID- 3296291 TI - Indigent health care: a continuing dilemma. PMID- 3296292 TI - Evolutionarily [corrected] stable strategies: a review of basic theory. AB - Widely successful in applied population biology, the Evolutionarily Stable Strategy concept remains controversial because of the severe restrictions present in its original formulation. We review theory which explores and relaxes these restrictions, finding the concept to be quite robust and adaptable, incorporating considerations such as genetics, population diversity, environmental variability, and mutation. PMID- 3296293 TI - [Possibilities and limitations of photocoagulation treatment in diabetic retinopathy]. PMID- 3296294 TI - [Laser treatment of circulatory disorders of the fundus oculi]. PMID- 3296295 TI - Evaluation of positive expiratory pressure as an adjunct to chest physiotherapy in the treatment of cystic fibrosis. AB - It has been suggested that positive expiratory pressure may assist the clearance of bronchial secretions in the treatment of cystic fibrosis. It has been compared with currently used postural drainage techniques. Three treatment regimens were compared in 18 patients with cystic fibrosis. Treatment A consisted of breathing exercises emphasising inspiration, interspersed with the forced expiration technique in gravity assisted positions; treatment B comprised breathing exercises with positive expiratory pressure alternating with the forced expiration technique in the same gravity assisted positions; and treatment C comprised breathing exercises with positive expiratory pressure and the forced expiration technique in the sitting position. During treatment A a significantly greater quantity of sputum was produced than during treatments B and C (p less than 0.025 and p less than 0.001 respectively). Treatment B produced more sputum than treatment C (p less than 0.005). There were no significant differences in arterial oxygen saturation, FEV1 or forced vital capacity. Most adolescent and adult patients are able to carry out their treatment independently using gravity assisted positions, breathing exercises emphasising inspiration, and the forced expiration technique. Sputum clearance was less effective when positive expiratory pressure was included in the treatment regimen. PMID- 3296296 TI - Twice daily beclomethasone dipropionate administered with a concentrated aerosol inhaler: efficacy and patient compliance. AB - The efficacy of twice daily inhaled beclomethasone dipropionate administered by a concentrated aerosol inhaler (one puff twice daily-500 micrograms/day) has been compared with that of treatment four times daily with a standard dose inhaler (two puffs four times daily-400 micrograms/day) in 21 patients with stable asthma. Double placebo inhalers were used in a randomised crossover fashion during two four week treatment periods. Mean peak expiratory flow (PEF), mean symptom scores, and number of extra salbutamol inhalations required were not significantly different between the two treatment periods. Local side effects were more common during treatment with the four times daily active preparation; overt oropharyngeal candidiasis, however, was not found in either group during the study. On completion of the crossover study patients were transferred to the twice daily regimen. At the three month follow up all patients had remained stable and the outpatient PEF was significantly higher (mean 382 (SD 26)l min-1) than at entry into the trial (mean 345 (24)l min-1) (p less than 0.05). Twice daily beclomethasone administered by a concentrated aerosol inhaler appears to be as effective as the standard four times daily regimen in controlling stable asthma. PMID- 3296297 TI - Transvenous lung biopsy in the pig. AB - At present there is no satisfactory technique for repeated lung biopsy in recipients of heart-lung transplants. A new technique for lung biopsy, which might be adopted for this purpose, has been developed. A Teflon sheath is inserted through the jugular vein into the pulmonary artery with the aid of a balloon catheter. A flexible biopsy forceps is then introduced through the sheath into the pulmonary arterial tree and advanced into the periphery of the lung, where biopsy samples are taken. The procedure was attempted in 14 pigs. Initially crocodile jaw (two pigs) and fenestrated cups forceps (five pigs), which are currently in use for transbronchial lung biopsy, were used. Subsequently the biopsy forceps was modified and the jaws were replaced by a cutting needle mechanism (six pigs). Out of the 13 animals in which the procedure was technically possible, lung parenchyma was obtained from nine and pulmonary arterial wall from 11. One animal died shortly after the procedure. The cause of death could not be determined with certainty at postmortem examination. There was, however, a small tear on the surface of the lung, which could have produced a tension pneumothorax. The other 12 animals recovered from the procedure. They were killed 24 hours later and postmortem examination was carried out. One animal in which the crocodile jaw forceps had been used had a haematoma in the lower lobe (3 X 3 X 4 cm) and 100 ml of blood in the pleural cavity. In the other 11 animals, in which the fenestrated cups or the cutting needle forceps had been used, the intrapulmonary haematomas were 1-2 cm in diameter and the pleural surface was intact. It is concluded therefore that transvenous lung biopsy is feasible and that this procedure might find an application in monitoring rejection in recipients of heart-lung transplants. PMID- 3296298 TI - [Anticonvulsants. Therapeutic indications; secondary effects; drug interactions]. PMID- 3296299 TI - [Treatment of peritoneal infection in continuous ambulatory peritoneal dialysis with ceftazidime]. PMID- 3296300 TI - [Clinical pharmacology and bases of the treatment of orthostatic hypotension]. PMID- 3296301 TI - The animal models for hemorrhage and thrombosis in the neonate. AB - Animal models have added significantly to our understanding of adult hemorrhagic and thrombotic diseases. Few models, however, have been developed for studies of the hemostatic disorders in the fetus and newborn. This report reviews the current information on animal models of fetal and neonatal hemostasis. The requirements of a relevant model are addressed and previous studies using fetal and neonatal animal models are reviewed. A recommendation of a single animal for all studies of fetal and neonatal hemostasis is not possible. However, the lamb has been the most frequently studied and appears to provide relevant information regarding normal development and the factors which may adversely influence hemostasis in the fetus and newborn. Animal models, in contrast to in vitro experiments, provide a means of studying the entire spectrum of biologic consequences that results from a single experimentally induced alteration. In the "Introduction to the Study of Experimental Medicine" Claude Bernard commented "I not only conclude that experiments made on animals from the physiological, pathological, and therapeutic points of view have results that are applicable to theoretic medicine, but I think that without such comparative study of animals, practical medicine can never acquire a scientific character". In the area of blood coagulation, animal models have added significantly to our understanding of the pathophysiology of hemorrhage and thrombosis. There are animal models for both congenital and acquired bleeding disorders including factor VII, VIII, IX, X, XI, and fibrinogen deficiency; as well as von Willebrand's disease and disorders of platelet function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296302 TI - The single prostacyclin receptor of gel-filtered platelets provides a correlation with antiaggregatory potency of PGI2 mimics. AB - Gel-filtered human platelets (GFP) display only a single binding site for [3H] PGI2: KD = 61nM, 234 fmol/10(8) platelets (1410 sites/platelet). Platelet-rich plasma (PRP) displays the same receptor density but the KD value increases to 123 nM due to protein binding of PGI2 which lowers its effective concentration. The [3H]-PGI2/GFP binding assay has been used to evaluate the molecular basis of aggregation inhibition for prostacyclin analogs and mimics, three PGE type structures, and PGD2. Antiaggregatory IC50s and radioligand binding IC50s correlate for PGE2, E1, and six PGI2 analogs. PGD2, and to a lesser extent 6-oxo PGE1, display greater antiaggregatory potency than expected based on PGI2-binding site affinity data. PMID- 3296303 TI - [Cisordinol and Buronil in the elderly. A controlled multi-center double-blind comparison]. PMID- 3296304 TI - [Polymorphous light exanthema. Diagnosis, treatment and pathogenesis]. PMID- 3296305 TI - [Bronchopleural fistula after using a suture stapler]. PMID- 3296306 TI - [The significance of thrombocytes in the inflammatory process]. PMID- 3296307 TI - [Sulindac. Is it different from other non-steroidal anti-inflammatory agents?]. PMID- 3296308 TI - [Koch's discovery and its diagnostic value for veterinary medicine. By M.H.J.P.Thomassen, 1891]. PMID- 3296309 TI - [Dicor crowns]. PMID- 3296310 TI - [Respiratory infectious diseases in horses]. AB - Among all infectious diseases affecting horses, respiratory disease pose the greatest threat to horses kept in stables, horses used for breeding and race horses. Here a distinction should be made between the so-called monocausal infectious diseases (so-called Henle-Koch postulates) and multicausal infectious diseases which are the result of the synergistic interaction of different processes, that alone do not lead to disease. There is no clearcut distinction between the two groups. The most important monocausal respiratory infections of horses are caused by equine influenza virus (subtypes 1 and 2), equine rhinopneumonitis virus (equine herpes-virus type 1), equine arteritis virus and partially by Reoviruses. In addition, streptococcus equi (strangles, adenitis equorum, coryza contagiosa equorum) and mycobacteria tuberculosis can cause monocausal diseases. In multicausal infections, the first step usually is a virus infection. This is the basis for secondary infection by widespread, opportunistic agents such as bacteria, mycoplasms or fungi which lead to clinical disease. The method of choice for controlling monocausal respiratory infections of horses is prophylactic vaccination and chemotherapy. Measures to control multicausal infections include: vaccination with functional-synergistic combined vaccines; the use of herd-specific vaccines; medical stimulation of the non-specific part of immunity (immunmodulation, paramunization). Paramunization is a new concept in the prophylaxis and therapy of respiratory infections of horses and can be combined with prophylactic vaccination as well as with chemotherapy. In severe cases of respiratory disease paramunization can also be combined with corticosteroids. PMID- 3296311 TI - [Respiratory and non-respiratory functions of the lung]. AB - With the development of higher organisms, the problem of gas exchange of each single cell had to be resolved. Nature gave preference to the development of a specific organ for gas exchange (lungs, gills) as opposed to a system of gas exchange involving the whole organism. In vertebrates, the latter has been developed only in lungless salamanders (Desmognatus fuscus) and in the embryos of the oviparous species. Mammalian embryos also do not use their lungs during the prenatal period, however, in contrast to the oviparous species gas exchange is performed via the maternal respiratory apparatus. The transition from the pre- to the neonatal period is more problematic in mammals than in oviparous species. The critical situation is caused by the fact that mammalian lungs must be inflated within a comparatively short period of time. In oviparous species, however, the development of lung respiration lasts several hours. Several lines of evidence indicate that lungs are also involved in blood pressure changes occurring during the perinatal period. In this context the pulmonary regulation of bradykinin and prostaglandin metabolism has been emphasized. It has been recognized that lungs of adults serve not only as a gas exchange organ, but are involved in the synthesis, activation or inactivation of substances which exert an influence mainly on blood pressure. In this function, lungs are especially suitable due to their position between the venous and arterial circulation. Therefore, it is not surprising that disturbances in the pulmonary function result in manifold pathological processes. PMID- 3296312 TI - [The modified Johnson-Reid method--a practice model for coccidiosis monitoring in the fattening of young fowl?]. AB - Models of coccidiosis-monitoring known from literature are described. A suitable alternative of determining the coccidia status in a broiler population is the "modified Johnson-Reid method". This method makes a standardization of diagnostic finding and evaluation possible as well as a differentiated intestinal localization and the determination of coccidia incidence severity. In addition to the microscopic screening of the caecum contents--as described by Johnson-Reid- it appears necessary to take also swabs from parts of the duodenum and jejunum (near the Meckel's diverticulum). Subsequently this method is an important help for veterinarians working with broiler production, for diagnostic institutions as well as producers of anticoccidial agents, especially in regard to its documentation rate and the resulting consequences. In this way other diagnostic efficiency data in broiler production are significantly completed. PMID- 3296313 TI - [Ultrasonic studies of the liver in dogs and cats]. AB - Sonography of the liver is an easy and safe method for the evaluation especially of circumscribed liver lesions. The criteria for diagnosis and some indications are described. The findings of different liver diseases are discussed. PMID- 3296314 TI - [The congenital portosystemic shunt in dogs and cats. I]. AB - An overview of the circulation of the liver and of the pathogenesis of hepatic encephalopathy as a result of portal vascular anomalies is given. Clinical signs associated with portal systemic shunts are described on the basis of 16 cases, 14 dogs and 2 cats. These animals ranged in age at the time of presentation from 4 months to 7 years. The predominant abnormality observed were central nervous signs, which differed in severity. 15 animals showed a reduction in liver size. The different techniques of contrast angiography allowing demonstration of a portal systemic shunt are presented along with a discussion of the pros and cons of each. Additionally the significance of making portal venous pressure measurements prior to each angiography is also explained. In most cases mesenteric portography was chosen. Based on their location the anomalies could be categorized as intrahepatic (4 dogs) or extrahepatic (10 dogs, 2 cats). In both groups breeds of various size are represented. The extrahepatic shunts could be further described as portal-caval (n = 5), portal-phrenic (n = 4) and portal azygos (n = 3). In five of the older animals angiography showed in addition some hepatic perfusion by the portal vein. Laboratory evaluation revealed increased resting blood ammonia concentrations (greater than 200-912 micrograms/100 ml) in all animals. Seven dogs had definitely subnormal BUN concentrations (less than 10 mg%) and ten dogs low total plasmaprotein levels (less than 5.4 g%). Free amino acids (24) were determined in four dogs and a lowered hepatic encephalopathy index (less than 1.64) was found. Medical palliative therapy to control the clinical signs is discussed. The only effective long term therapy is, however, surgery. The shunt vessel is narrowed so that a greater volume of portal blood reaches the liver. Experience gained from the surgical therapy of 14 animals is presented. Ten of these survived well without requiring further therapy at a later time. Finally the etiology, prognosis, and differential diagnosis are summarized. PMID- 3296315 TI - [Fish and natural protection]. AB - Fish represent more than half of all vertebrates. They are the most important and most conspicuous creatures in the water. Their protection in the sense of the new animal protection law is therefore of course extremely difficult. Fish need protection just as much as other vertebrates. Fish suffer from harmful influences which should be eased or eliminated. They, like other vertebrates have highly sensitive sensory organs which react to stress through transport, encaging, pollution, and other similar factors. It is therefore an eminent task to protect them from these dangers. Possibilities are demonstrated to intensify the protection by a more thorough knowledge of their anatomy and physiology and their utilizationship with environment; cleaning the water, establishing natural protection areas, and controlling the situation within fish populations. PMID- 3296316 TI - Differences in rat liver enzyme-altered foci produced by chlorinated aliphatics and phenobarbital. AB - Nine chlorinated aliphatics (CAs)--1,1-dichloroethane, 1,2-dichloroethane, 1,1,1 trichloroethane, 1,1,2-trichloroethane, trichloroethylene, tetrachloroethylene, 1,1,1,2-tetrachloroethane, 1,1,2,2-tetrachloroethane, and hexachloroethane--were examined in a rat liver foci assay for evidence of initiating and promoting potential. Young adult male Osborne-Mendel rats (ten/group) were given partial hepatectomies, followed 24 hr later by a single i.p. dose of either diethylnitrosamine (30 mg/kg body weight) or CA, 1 wk later either a diet containing 0.05% (w/w) phenobarbital or daily oral gavage (5 X/wk) of CA in corn oil for 7 weeks, and sacrificed 1 wk later. Putative preneoplastic markers monitored were foci with increased gamma-glutamyltranspeptidase activity [GGT(+)]. CAs were without significant effect in the initiation protocol at the maximum tolerated dose. In the promotion protocol, 1,1-dichloroethane, 1,1,2 trichloroethane, tetrachloroethylene, 1,1,2,2-tetrachloroethane, and hexachloroethane induced significant increases in GGT(+) foci above control levels. Two variants of GGT(+) foci were distinguishable, one associated predominantly with phenobarbital promotion, resembling preneoplastic foci in other models, and the other associated with CA promotion, which was less intensely stained and exhibited branching, resembling foci undergoing redifferentiation. The marked differences in response may relate to differences in cytotoxic potential or mechanism of action of the two types of agents. PMID- 3296317 TI - Perspectives on reproductive and developmental toxicity. AB - Human reproduction and development is a cycle of interdependent events. Virtually all of its phases have been shown to be the primary target of one or more non mutagenic exogenous agents. Such agents interfere with certain of the countless epigenetic or ontogenic events essential for normal completion of the cycle. Mutagens disrupt this cycle at some points, but the overwhelming majority of reproductive and developmental toxins are not mutagenic. As in all aspects of toxicology, the reproductive and developmental effects of chemicals are determined by the intrinsic nature of the chemical, the quantity of the chemical exposure, the duration of exposure and the stage of the cycle at which it occurs. Signs of reproductive toxicity range from reduced fertility to spontaneous abortion. Adverse effects on the conceptus are categorized as functional deficits, developmental retardation, structural abnormality and death. One or more of these is anticipated to occur as a result of excess exposure to most chemicals. Although the degree of hazard and risk potential can be calculated in each instance, chemicals differ markedly in their ability to interfere with reproduction (Amann, 1982) and/or development (Johnson, 1984). Standardized methods for reproductive and developmental toxicity safety evaluation are available for detecting adverse effects upon any aspect of reproduction and development. Data currently available establish that these state-of-the-art tests conducted in laboratory animals are often highly predictive of the type of adverse effect a particular chemical will have in humans, as well as the exposure level at which it will occur. By adding a modest safety factor to the no-observed effect-level of well-executed animal studies, safe human exposure levels can be established. Responsibility for determining the intrinsic hazard potential and the risk estimate of exposure rests with manufacturers and major users of occupational and other environmental chemicals. As public awareness of reproductive and developmental hazards has increased in recent years, it has come to be understood that some chemicals have a predilection for causing reproductive impairment and/or disrupting development in the absence of other toxicity. Such substances must be identified to establish safe exposure levels and to determine the types of effects to be expected, should excessive human exposure occur. The setting of safe exposure levels is necessary both from the standpoints of ensuring public safety and avoiding product liability. PMID- 3296318 TI - Health-risk estimates for 2,3,7,8-tetrachloro-dibenzodioxin: an overview. AB - As has been abundantly noted by many investigators, the paucity of definitive knowledge of metabolism, pharmacokinetics and pathogenesis of the chlorinated dioxins, principally 2,3,7,8-TCDD, in human populations continues to severely limit our ability to evaluate the scope of the chronic and delayed effects of exposure to these agents. The marked qualitative and quantitative differences in the response of animals to TCDD plus the inability to validate a number of the critical assumptions and mathematical models relative to risk assessment make the extrapolation of data from intact animals to man particularly uncertain. Hence, it is vital to vigorously pursue the elaboration of the mechanism of action of TCDD at the molecular level. This should greatly contribute to our fundamental understanding of this agent and the potential danger that it may pose for man. PMID- 3296320 TI - Methemoglobinogenic potential of primaquine and its mutagenicity in the Ames test. AB - Single doses of primaquine did not produce methemoglobinemia in beagle bitches. Repeated daily administration for 12 days produced a gradually rising level of methemoglobin over that time period, unaccompanied by depletion of erythrocytic reduced glutathione. Primaquine was mutagenic in the Ames test in Salmonella typhimurium strain TA 1537, with or without S9, using a liquid preincubation assay. Primaquine was non-mutagenic in this assay to strains TA 1535, TA 1538, TA 98 and TA 100, regardless of the presence or absence of S9. In the standard overpour Ames test, the drug was non-mutagenic in all 5 Salmonella strains, both with and without S9 metabolic activation. PMID- 3296319 TI - Effect of liver enzyme inducers on metabolite excretion in rats treated with 1 nitropyrene. AB - Non-induced and phenobarbital (PB) or methylcholanthrene (MC) pretreated rats were injected with 1-nitropyrene (1-NP). Mutagenic activity of urine and feces samples were compared by the Salmonella/microsome assay. The highest, indirect acting mutagenicity was associated with urines from MC-induced rats; HPLC analysis of organic extracts of urine samples showed that the differences in mutagenic response can be ascribed to different amounts of hydroxy derivatives of N-acetylaminopyrene excreted. Monohydroxy derivatives of 1-NP, being detected in the HPLC profiles of urine from PB-induced rats only, could be responsible of the higher direct-acting mutagenic activity of these samples as compared to urine from non-induced or MC-induced rats. The excretion rate of aminopyrene, the main metabolite of 1-NP identified in rat feces samples, was not affected by inducer pretreatment. PMID- 3296322 TI - Cell proliferation in rat kidney induced by 1,2-dibromoethane. AB - The effect of a single intragastric injection of 1,2-dibromoethane was investigated in kidneys of male Wistar rats. DNA synthesis as measured by the incorporation of tritiated thymidine was found to be approximately 5 times greater than that of controls 20-30 h after treatment. DNA synthesis was followed by a striking increase in the mitotic activity with a maximum at 30 h. The labeling and mitotic activities, after an initial increase, fell rapidly 48 h after treatment even though they were still higher than those of control animals. 1,2-Dibromoethane-induced cell proliferation is not a regenerative response because at the dose used in this study, no tubular necrosis was observed by histologic examination. PMID- 3296323 TI - The fluoride content of root-planed dentine in pereiodontitis-exposed roots. PMID- 3296321 TI - Human erythrocyte glutathione S-transferase: a possible marker of chemical exposure. AB - We have explored the possibility of using glutathione S-transferase (GST) as a biological marker of chemical exposure. All the model compounds tested in the present study (acrolein, propylene oxide, styrene oxide, ethylene dibromide and ethylene dichloride) showed a dose-dependent inactivation of erythrocyte GST in situ as well as the inhibition of purified erythrocyte GST. PMID- 3296324 TI - [Experimental determination of the penetration patterns of composite filling materials into etched dental enamel]. PMID- 3296325 TI - [Study of the salivary glands using ultrasonics]. PMID- 3296326 TI - [Outcome evaluation of surgical prostheses and epitheses using phonetic functional analysis]. PMID- 3296327 TI - [Critic of the treatment of diastemas in the adolescent permanent dentition]. PMID- 3296328 TI - [Systematics of cavity and stump preparations on the basis of structure preserving principles]. PMID- 3296329 TI - [Micro-relief of the enamel as a retention element in bonded bridgework]. PMID- 3296330 TI - [Electrochemical corrosion of bonded bridges made from Gisadent NCA and their clinical use]. PMID- 3296331 TI - [Periodontal aspects of treatment with crowns and bridgework]. PMID- 3296332 TI - Single studies and overview analyses: is aspirin of value in cerebral ischemia? PMID- 3296334 TI - Superior sagittal sinus thrombosis with infarction in sickle cell trait. AB - An adolescent female with sickle cell trait presented with acute neurologic deterioration during treatment for pseudotumor cerebri. Cranial computed tomography, initially normal, subsequently revealed multiple hemorrhagic infarctions. Suspected superior sagittal sinus thrombosis was confirmed by cerebral angiography. Superior sagittal sinus thrombosis associated with sickle cell trait is exceedingly rare, and the accompanying increased intracranial pressure may require aggressive management. PMID- 3296333 TI - Indomethacin, prostacyclin, and heparin improve postischemic cerebral blood flow without affecting early postischemic granulocyte accumulation. AB - Six anesthetized dogs treated with indomethacin, prostacyclin (PGI2), and heparin were compared with 7 anesthetized controls (ischemia without treatment) to determine whether cyclooxygenase inhibition would lead to enhanced granulocyte accumulation because of preferential formation of lipoxygenase products. Cortical somatosensory evoked response, [14C]iodoantipyrine autoradiographic blood flow, and 111In-labelled granulocyte accumulation were compared 4 hours after a 60 minute exposure to multifocal brain ischemia. Treatment with indomethacin, PGI2, and heparin eliminated neuron-disabling brain blood flows without altering early postischemic granulocyte accumulation. Granulocyte accumulation after 4 hours of reperfusion was not significantly different in control and treated dogs. The final amplitude of the cortical somatosensory evoked response in the treated group averaged 38.0 +/- 13.6% (mean +/- SEM) of the corresponding baseline value compared with 21.0 +/- 4.6% in the control group, but this difference was not significant. PMID- 3296335 TI - The initial characterization of a thymus factor chemotactic to bone marrow cells. AB - Thymus supernatants were produced by cluturing minced newborn CBA/J mouse thymuses in serum-free media for 48 h. Supernatants thus obtained were chemotactic to a subset of bone marrow cells as assessed in blind well chambers, and enriched for immature lymphoid cells in the migrating cell population. The enriched population of cells was shown to be capable of homing to the thymus of an irradiated mouse in vivo in a significantly higher percentage than nonmigrated bone marrow cells. In this report, initial characterization of the factor(s) responsible for this in vitro migration is presented. Several well studied thymic factors were compared with the thymus supernatants for their ability to induce migration of bone marrow cells in vitro. Thymulin (FTS-Zn), FTS, and TP-5 (the pentapeptide fragment of thymopoietin) were used. None of these factors demonstrated chemotactic properties in the migration assay using concentration ranges in which other in vitro activities have been observed. The chemoattractive activity of the supernatant was unaltered by ultracentrifugation. The effects of temperature on the chemotactic properties of thymus supernatant were examined, and a fifty percent decrease in observed migration occurred with thymus supernatant heated to 100 degrees C for 1 h. In addition, incubation of the supernatant for 1 h at 37 degrees C with chymotrypsin, but not with trypsin, inhibited migration, presumably by inactivation of the active factor. Using Amicon microconcentrators, the supernatant was separated into several fractions based on molecular weight. Initial data suggest that the active fraction is in the less than 10,000 mw range. PMID- 3296336 TI - Ultrastructural studies of thymic reticulum: I. Epithelial [corrected] component. AB - In studying the epithelial component of the mouse thymic reticulum, we identified by their ultrastructural aspect three types of epithelial cells: type I, present in the cortical and medullary zones; and type II and type III, present only in the medulla. These cells form a network entrapping lymphocytes. In addition, some cells are regrouped and form two types of associations that are found in the medulla: cystic cavities and Hassall's corpuscles [corrected]. Comparisons are made between our observations and those described in older publications. The morphologies and roles of these cells as well as the terminologies used to describe them are discussed in light of the new knowledge acquired concerning the function of the thymus. PMID- 3296337 TI - [Recovery following CVA: caused by effective therapy or by the natural course of the disease?]. AB - The efficacy of treatment of cerebrovascular disorders is difficult to establish. Treatment effects may be confounded by the natural course of the disease, or they may be misjudged by bias and can not be compared with the results of treatments in other hospitals or with previous results. Pathophysiological knowledge does not always lead to the right or the most practical treatment, neither the results of in vitro or animal experiments, nor the experience with related disorders. The randomized clinical trial is the right method to investigate treatment effects, but is not faultless and explanatory experiments ought to be distinguished from pragmatic studies. PMID- 3296338 TI - [Is drug therapy possible in the acute stage of a cerebral infarct?]. AB - To assess the possibilities of treatment of acute cerebral infarction the results of clinical trials, performed during the past 30 years, are reviewed. Only a few studies fulfil basic requirements for a clinical trial, such as sufficient sample size. A therapeutic effect could not be proven in any of these studies. On the other hand, because of the small number of patients, therapeutic inactivity equally could not be established. In conclusion, present knowledge does not justify any treatment for acute cerebral infarction. In the near future well organized clinical trials will have to provide more definite results. PMID- 3296339 TI - [Secondary prevention of cerebral infarct]. AB - This article reviews current treatment in the secondary prevention of cerebral infarction. Treatment of risk factors, together with treatment of the primary cause of cerebral infarction will significantly lower the recurrence rate. Therefore, it is argued that in patients with ischemic stroke medical history should be taken carefully, thorough physical examination should take place, and proper complementary diagnostic tests should be used when indicated. PMID- 3296340 TI - Blood use in liver transplantation. AB - During the first 5 years (1981-1985) of the liver transplantation program in Pittsburgh, a total (preoperative, intraoperative, and postoperative) of 18,668 packed red cell units, 23,627 fresh-frozen plasma units, 20,590 platelet units, and 4241 cryoprecipitate units was transfused for the procedures. This represents 3 to 9 percent of the total of blood products supplied by the Central Blood Bank to its 32 member hospitals. Six hundred thirty-six (636) transplants were performed on 485 patients in two hospitals: the Presbyterian University Hospital (564 beds) and Children's Hospital of Pittsburgh (236 beds). All of the blood components used in the operations were procured and released by the Central Blood Bank. This report describes some of these findings. PMID- 3296343 TI - Neutralization of P blood group antibodies by synthetic solid-phase antigens. AB - P blood group system antibodies are encountered frequently in clinical transfusion practice. The authors describe an improved method for removing P antibodies from patient specimens without dilution. Solid-phase synthetic P antigens were used to neutralize serums containing P blood group system antibodies; 26 alloantibodies with specificity other than P were not inhibited. The synthetic P antigens are also used to characterize the heterogeneous immunochemical fine specificity of antibodies to P1 and P + P1 + Pk. PMID- 3296341 TI - Th activation in congenital hypoplastic anemia. AB - The authors identified persistent Th activation in five of seven children (71.4%) diagnosed as having Fanconi's anemia or Diamond-Blackfan syndrome. Th reactivity was no longer present in one patient after bone marrow transplantation. Tests on family members and other patients with bone marrow dysfunctions of childhood showed no Th activation. Less than 1 percent of healthy children or blood donors had Th activation. Patients with a variety of hemolytic and hypoplastic conditions also had a low incidence of Th activation. However, 13.5 percent of cord blood specimens demonstrated Th reactivity. This study indicates that Th activation may be a red cell developmental marker present in congenital hypoplastic anemias and also expressed on newborn red cells. PMID- 3296342 TI - Metabolite-specific (IgG) and drug-specific antibodies (IgG, IgM) in two cases of trimethoprim-sulfamethoxazole-induced immune thrombocytopenia. AB - Two cases of trimethoprim-sulfamethoxazole (TMP-SMX)-induced immune thrombocytopenia are reported in which unusual drug-dependent platelet antibodies were demonstrated by immunofluorescence and enzyme-linked immunosorbent assay. Whereas two distinct sulfamethoxazole-dependent antibodies of the IgG and IgM class were detectable in the serum of one patient, the serum of the other patient contained a platelet antibody exclusively reactive with N-4-acetyl sulfamethoxazole, a metabolite of sulfamethoxazole. Urine from a healthy volunteer collected after administration of therapeutic doses of TMP-SMX proved to be an appropriate source of ex vivo metabolites for antibody testing. The results of this study stress the role of metabolite-specific antibodies in drug dependent immune thrombocytopenia and underscore the necessity of including metabolite preparations of drugs in serologic analyses. PMID- 3296344 TI - Autologous donations from recently transfused patients. PMID- 3296345 TI - Extensive prolongation of rat renal allograft survival following donor or nonspecific transfusions and concomitant immunosuppressant. AB - We report here a marked beneficial effect upon rat renal allograft survival transplanted across a strong histocompatibility barrier (BN----LEW) by pretransplant concomitant donor-strain blood transfusion (DST) and CsA treatment. Comparisons between recipient groups treated with pretransplant nonspecific blood (NST) and concomitant cyclosporine (CsA) or azathioprine (Aza) administration were also made. LEW recipients receiving only a BN renal allograft survived for a geometric average time of 8.9 days. Recipients receiving 1 ml of donor blood at weekly intervals, each week for three weeks prior to transplantation, demonstrated a geometric mean survival time (GMST) of 40.5 days. Recipients receiving this same regimen and concurrent CsA cover (5 mg/kg/day) starting 7 days prior to the first transfusion with discontinuation 5 days prior to transplantation showed extensive prolongation (greater than 100 days). Recipients treated with only CsA cover survived for a GMST of 34.4 days. LEW recipients receiving 1 ml of nonspecific blood at weekly intervals (DA, BUF, WKY, respectively) each week for 3 weeks prior to transplantation were prolonged to 27.7 days. Recipients treated with this same regimen while under CsA cover also demonstrated extended prolongation (greater than 100 days). Recipients receiving multiple donor blood transfusions under Aza (2 mg/kg/day) cover demonstrated lesser prolongation (22.8 days). Recipients receiving the multiple nonspecific blood protocol under Aza cover showed similar prolongation (38.6 days). Recipients treated only with Aza did not show prolonged survival (9.3 days). These differences in survival were considered significant among the 9 transplant groups as determined by ANOVA (P less than 0.001). The majority of recipient groups showed relatively poor renal function over their life spans, independent of whether prolongation occurred. Yet, renal function in the NST or particularly the DST groups covered by pretransplant CsA, demonstrated the best renal function in our laboratory over many years of investigations using the BN----LEW combination. In conclusion, there was a dramatic synergistic beneficial effect of prior multiple DST or NST specific to CsA, as opposed to another immunopharmacologic agent, Aza. PMID- 3296347 TI - Engraftment of stem-cell-enriched bone marrow fractions in MHC-identical dogs after fractionated total-body irradiation. AB - Discontinuous albumin density gradients were used to obtain enrichment of hemopoietic stem cells and depletion of T lymphocytes in aspirated dog bone marrow. Colony forming units in agar (CFU-C) were determined to evaluate the degree of enrichment achieved. An average CFU-C concentration factor of 12.4 was obtained. All transplantations in the study were carried out between DLA identical sibling combinations. The number of CFU-C administered varied from 0.2 to 5.5 X 10(5)/kg and the number of nucleated cells transfused varied from 0.1 to 1.0 X 10(8)/kg. Stem cell concentrates were found more difficult to engraft than unmodified bone marrow following standard conditioning with a single total-body irradiation (TBI) dose of 7.5 Gy. The efficacy of different TBI-fractionation schedules for obtaining sustained engraftment of CFU-C-enriched grafts in identical bone marrow transplantation (BMT) was determined. A total dose of 12 Gy TBI delivered in two equal fractions of 6.0 Gy (72-hr interval) resulted in sustained engraftment of stem cell grafts in 7 of 7 evaluable dogs. A TBI dose of 9 Gy in two fractions of 4.5 Gy (72-hr interval) resulted in sustained engraftment in 5 of 7 evaluable dogs. The two dogs with engraftment failure received low total cell numbers (10(7) cells/kg) and low CFU-C numbers. 9 Gy of TBI in two fractions of 4.5 Gy (24-hr interval) resulted in sustained engraftment in 11 of 12 evaluable dogs. A significant improvement of engraftment was obtained by increasing the total dose of TBI, which necessitates fractionation into two fractions of TBI. The lower-total-dose TBI (9 Gy) produced less early and late toxicity than the total high-dose (12 Gy) TBI. The incidence of engraftment was similar for the two dosages, however the recovery of peripheral leukocyte counts was slower after 9 Gy TBI. In the dog, optimal conditioning for lymphocyte depleted hemopoietic stem cell grafts can be obtained by increasing the dose of TBI and concomitant fractionation. PMID- 3296346 TI - Pretreatment with lymphocyte subpopulations and renal allograft survival in the rat. AB - The induction of antigen-induced immunosuppression by highly purified lymphocyte populations of different phenotypes was investigated in a rat renal allograft model (LEW-to-DA). Lymphocyte populations were prepared from Lewis spleen cells by rosette depletion and flow cytometric separation. Rosette depletion was performed using appropriate monoclonal reagents. B cells were prepared from spleen lymphocytes by rosette depletion of T cells, using three monoclonal antibodies: MRC OX19 (anti-T-cell), MRC OX8 (anti-T-cytotoxic/suppressor) and MRC W3/25 (anti-T-helper). T cells were purified by rosette depletion of B cells with MRC OX12 (anti-rat-K-chain). After depletion the lymphocyte populations were analyzed by flow cytometry and the purity of each preparation determined. B cells were 93.6% pure and T cells were 92.4% pure. Intravenous injection of 5 X 10(6) of these LEW B or T cells one week before transplantation of a LEW kidney into a DA recipient resulted in was indefinite renal allograft survival (median survival time [MST] greater than 100 days). Purification of the enriched B and T cell preparations by flow sorting resulted in highly purified populations of spleen B cells (99.3%) and T cells (98.2%). Further fractionation of the T cells into cells of T helper (99.6%) (i.e., W3/25-positive) and T cytotoxic/suppressor phenotype (99.4%) (i.e., MRC OX8-positive) was performed. While purified B cells, T cells, and T helper cells, given at a dose of 10(6) cells intravenously one week before transplantation resulted in long-term renal allograft survival (MST greater than 100 days), cells of the T cytotoxic/suppressor phenotype did not prevent graft rejection at this dose (MST 10 days). PMID- 3296348 TI - Significance of thyroid dysfunction in human cardiac allograft procurement. AB - Twenty-two potential cardiac allograft donors had evaluation of thyroid function performed just prior to cardiectomy. Despite statistically significant abnormal thyroid function, no correlation to graft function or failure was observable. Multiple myocardial microinfarcts, undetected at the time of donor selection were detected in two hearts that were abandoned prior to transplantation and possibly another heart that failed as an allograft in a heart-lung transplant recipient. PMID- 3296349 TI - Graft rejection in recipients of T-cell-depleted HLA-nonidentical marrow transplants for leukemia. Identification of host-derived antidonor allocytotoxic T lymphocytes. AB - Clinical trials with bone marrow depleted of donor T lymphocytes indicate that both the incidence and severity of graft-versus-host disease (GVHD) in patients undergoing bone marrow transplantation (BMT) for treatment of leukemia are greatly reduced. However, there has been a concurrent increase in the incidence of graft rejection, particularly among recipients of HLA-nonidentical marrow grafts. In order to investigate the nature of graft failure, peripheral blood mononuclear cells (PBMC) present at the time of graft failure have been characterized by phenotypic and functional analyses in 5 recipients of HLA nonidentical marrow grafts. Rejection of HLA-nonidentical marrow grafts was associated with the emergence of host-derived T lymphocytes in all 5 patients. In 3 of these patients, the cells could be tested directly for cell-mediated cytotoxicity. Antidonor cytotoxicity was detected in each of these 3 patients. In one patient the target specificity of the cytotoxic lymphocytes was identified as the donor class I HLA antigen, HLA-B7. None of the patient PBMC mediated cytotoxicity against the natural killer cell target K562. PMID- 3296350 TI - Nosocomial Legionnaires' disease following renal transplantation. AB - A cluster of five cases of Legionnaires' disease in renal transplant patients is described. They were treated with erythromycin and rifampicin, and all five survived. Two of them had rejected their grafts prior to their Legionella pneumonia; two rejected their transplants after reduction of immunosuppressive therapy to combat the infection. L pneumophila was present in the water distribution system of the hospital. Eradication measures included flushing the water pipes to the transplantation ward with hot and hyperchlorinated water, raising the warm water temperature to 60 degrees C, and installing ultraviolet (UV) irradiation units on the warm and cold water pipes to the ward. These measures were successful in that no new cases of legionellosis occurred after wards. L pneumophila could subsequently not be demonstrated by culture in plastic shower hoses supplied with UV-irradiated water. L pneumophila could be demonstrated by direct fluorescent antibody technique, but nonspecific reactions cannot be excluded. A higher prevalence of elevated L pneumophila antibody titers was observed in patients nursed for more than four weeks in the hospital than in patients with a shorter hospital stay, in hospital staff members, or in the general population. It seems that, with appropriate control measures, transplantation activities need not be discontinued in the presence of a minor cluster of Legionnaires' disease in renal transplant patients. PMID- 3296351 TI - Hemodynamic and metabolic responses to hormonal therapy in brain-dead potential organ donors. AB - An evaluation of the beneficial effects of hormonal therapy, consisting of T3 2 micrograms, cortisol 100 mg, and insulin 20 units, administered at hourly intervals intravenously, was assessed in brain-dead patients referred for organ donation. Twenty-six conventionally treated donors (group A) showed a progressive hemodynamic deterioration requiring significant increments of inotropic support in order to maintain cardiovascular stability, necessitating a significant increase in bicarbonate requirements in order to maintain a normal acid-base balance. Of this group, 20% of the donors were considered unsuitable as cardiac donors due to progressive cardiovascular deterioration or sudden ventricular fibrillation. Hormonal therapy was administered to 21 donors (group B) resulting in a significant improvement of cardiovascular status, requiring less inotropic support and significantly less bicarbonate. A significant reduction of serum lactate-pyruvate followed the initiation of the hormonal therapy. In group B, organs from all donors (heart, heart and lungs, and kidneys) were suitable for transplantation, with excellent organ function following implantation of the graft. PMID- 3296352 TI - The role of interleukin-2 in proliferative responses in vitro of T cells from patients after bone marrow transplantation. Evidence that minor defects can lead to in vitro unresponsiveness. AB - We have studied lectin-induced interleukin-2 (IL-2) production and proliferation of peripheral blood mononuclear cells from patients who had undergone a successful allogeneic bone marrow transplantation. Shortly after transplantation, the T cells show a decreased proliferative response and a decreased IL-2 production. However, addition to the culture of exogenous IL-2 does not result in restoration of the proliferative response, which indicates that the low proliferative response is not due to decreased IL-2 production alone. Longitudinal studies show a substantial variation between patients in the time in which the capacity to produce IL-2 is restored; however, in all patients there is a period in which IL-2 production is still diminished, but the proliferative capacity, as measured upon addition of exogenous IL-2 to the culture, is almost within the normal range. Also during this period, the proliferative response of the T cells can be restored by the addition of irradiated "feeder cells" obtained from the bone-marrow donors, as these cells secrete IL-2 without consuming it. Because peripheral blood samples from patients after bone marrow transplantation show great imbalances in the distribution of T4/T8 subpopulations, we have studied the influence of an artificially produced "reverse T4/T8" ratio on the proliferative response to mitogen and (allos-)antigen stimulation of healthy donor T lymphocytes. Even at very low proportions of T4 cells, normal responses were obtained in the proliferation assays with polyclonal mitogens. Only the response to soluble antigens, such as tetanus toxoid, was impaired. However, a low proportion of T4 cells resulted in a low IL-2 production so that, when IL-2 is a limiting factor due to intrinsic defects of patient cells, an inverse T4/T8 ratio can cause a nonresponsiveness in in-vitro assays. PMID- 3296353 TI - Hypertension after renal transplantation. A comparison of cyclosporine and conventional immunosuppression. AB - Hypertension is a common complication after renal transplantation and is associated with increased mortality. Cyclosporine is known to be nephrotoxic and raises blood pressure in recipients of cardiac and bone marrow transplants, but there is conflicting data on the role of cyclosporine after renal transplantation. We have examined this question in patients entered into the second Oxford prospective randomized comparison of short-term cyclosporine treatment alone with conversion to azathioprine and prednisolone at 90 days (CsA group), and conventional therapy with azathioprine and prednisolone throughout (AP group). Blood pressure and antihypertensive medication were similar in the CsA and AP treatment groups during the first 90 days. Following conversion from cyclosporine, mean blood pressure fell from 155/94 to 142/81 within 7 days, and this fall correlated with the change in plasma creatinine over the same period (r = 0.44, P less than 0.05). Blood pressure was subsequently lower in the converted patients than in those treated with AP throughout. Six months after transplantation patients converted from cyclosporine not only had lower blood pressure but also required fewer antihypertensive drugs than AP patients. This study demonstrates that cyclosporine may elevate the blood pressure in recipients of renal transplants. This effect may either be direct or mediated through the effect of cyclosporine on renal function. Administration of corticosteroids during the first three months after transplantation is implicated as a possible cause of persisting high blood pressure. PMID- 3296354 TI - Regeneration of TdT+, pre-B, and B cells in bone marrow after allogeneic bone marrow transplantation. AB - In 15 children transplanted with allogeneic bone marrow for acute leukemia and in complete remission, regeneration of the early stages of the B cell system was studied. Bone marrow aspirates taken before and longitudinally after BMT were investigated for pre-B and B cells by immunofluorescence techniques; in some cases, TdT+ cells were also determined. Normal values were derived from bone marrow samples taken from 23 healthy individuals who served as bone marrow donors. In normal bone marrow, B cells outnumber pre-B cells and the latter are more numerous than TdT+ cells. Before BMT, the numbers of BM pre-B were outside the normal range in all cases; B cell numbers were abnormal in most of the 11 patients studied, probably due to the antileukemic remission induction/consolidation therapy. After BMT, two distinct patterns of regeneration of the B cell system were observed. In 9 patients, TdT+ cells were considerably increased early after BMT. This was followed by a rise in pre-B cells, with values well above the normal range, and resulting in ratios of TdT+:pre-B cells and of pre-B cells:B cells that were transiently greater than 1. In the other 6 patients, the regeneration of TdT+ cells varied and the reconstitution of the pre B cells was more gradual than in the first group, with pre-B-to-B cell ratios less than 1 during the whole observation period. The only consistent difference between the patients of the two groups, possibly relevant to the regeneration of the B cell lineage, was the duration of corticosteroid therapy, which was much longer in the 6 patients with slow-pace reconstitution. The pace of regeneration of the B cell system in the bone marrow was correlated with the recovery of the humoral immunity, as indicated by a significant increase in specific antibody titers after the second vaccination with diphtheria-tetanus-poliomyelitis vaccine in 7 of 9 patients in the rapid-pace group, versus 2 of 6 patients in the slow pace group. PMID- 3296355 TI - Venocclusive disease of the liver after chemoradiotherapy and autologous bone marrow transplantation. AB - We determined the incidence of venocclusive disease of the liver (VOD) in 96 recipients of autologous bone marrow transplants (BMT) to be 9.4%, a figure less than that reported for allogeneic transplantation. The development of VOD was compared in a cohort of 21 autologous BMT recipients and in 56 randomly chosen, comparably conditioned, concurrent allogeneic BMT recipients. One of these 21 (4.8%) autologous recipients developed VOD, versus 14 of 56 (25%) allogeneic recipients (P less than 0.05). Logistic regression analysis confirmed pretransplant hepatocellular dysfunction as a risk factor for VOD, and suggested that the use of methotrexate and/or cyclosporine contributes to the development of VOD after chemoradiation therapy. However, a graft-versus-host reaction cannot be excluded as a cause of the higher incidence of VOD in allogeneic recipients. PMID- 3296356 TI - An immunohistological study of the revascularization process in human skin transplanted onto the nude mouse. AB - The revascularization of human skin transplanted onto the nude mouse was studied by performing double-labeling immunofluorescence microscopy on human skin before transplantation and at different stages, ranging from one week to six months after grafting. With a crossreacting anti-factor-VIII antigen antibody used to identify the endothelial cells, and with human-specific monoclonal antibodies directed against vimentin or HLA-DR antigen, it appeared that the original human endothelial cells of transplanted skin progressively disappear, while murine endothelial cells invade the graft. Moreover, in double-labeling experiments with a crossreacting anti-factor-VIII antibody and a human-specific anti-type-IV collagen antibody, anastomosis between host and graft vessels and a constant codistribution of graft endothelial cells with human type IV collagen were observed. Finally, double staining with species-specific antibodies directed against murine or human type IV collagen showed that mouse type IV collagen appeared progressively in the graft and was constantly colocalized with human type IV collagen. From these observations, it was concluded that revascularization of human skin transplanted onto the nude mouse proceeds as follows: inoculation; disappearance of human endothelial cells and migration of mouse endothelial cells into the graft over the basement membrane of preexisting human vessels; and production of a new vascular basement membrane by mouse endothelial cells on the original basement membrane of human graft vessels. PMID- 3296357 TI - Crossreactions between an I-A allospecificity and the cytoskeleton of glomerular epithelium and of vascular smooth muscle. AB - During studies to investigate the localization of Ia antigens in normal mouse kidney, a monoclonal antibody (Mab) specific for I-Ab by microcytotoxicity criteria was found to crossreact with a tissue antigen present in the glomeruli and vasculature of murine tissues, irrespective of their Ia haplotype, as well as in human kidneys. Immunofluorescence and immunoperoxidase studies of frozen tissue sections revealed that the antigen responsible for the crossreaction was present in the cytoplasm of glomerular epithelial cells and of smooth muscle of blood vessels. The immunofluorescence pattern of primary cultures of human glomerular epithelial cells and of a glioblastoma cell line indicated that the crossreactive antigen forms part of the cytoskeleton, and resembled the pattern observed with a monoclonal against vimentin, one of the intermediate filaments. Thus this Mab, which is directed against mouse alloantigen Ia.20 in microcytotoxicity was found to crossreact with a cytoskeletal component present in the mouse, as well as in human glomerular epithelial and smooth muscle cells. PMID- 3296358 TI - Immunoadsorption and renal transplant in two patients with a major ABO incompatibility. PMID- 3296359 TI - Human cadaver renal transplantation in the presence of ABO blood group incompatibility. PMID- 3296360 TI - Subtherapeutic cyclosporine concentrations during nafcillin therapy. PMID- 3296361 TI - Successful regrafting of an explanted transplant kidney. PMID- 3296362 TI - Development of IgG2 deficiency in a bone-marrow-transplanted patient. Implication for generation of the anticarbohydrate antibody repertoire in subclass-deficient individuals. PMID- 3296363 TI - Diffuse herpes simplex virus colitis in a kidney transplant recipient successfully treated with acyclovir. PMID- 3296364 TI - Serum beta 2 microglobulin levels in renal transplant patients. PMID- 3296365 TI - [Modifying action of drug preparations on the effect of promutagen compounds]. AB - The Ames test has shown that the action of nitrosomorpholine and cyclophosphane promutagens on bacteria of Salmonella typhimurium TA 1950 increases while using S 9 liver fraction of rats treated with pharmaceuticals of amidopyrine, reserpine and pyrazidol and decreases while using those treated with phenazepam. PMID- 3296366 TI - [Genetic activity of sim-triazine herbicides on Saccharomyces cerevisiae yeast strains]. AB - Triazine chloro derivatives: atrazine, simazine manifest no mutagenic and recombinogenic properties in yeasts; triazine methylthio derivatives: prometryne, semeron (desmetryne) generate both genetic events with low concentrations of 0.5 and 5 mg/l. It is found that prometryne is more able to generate point mutations, while semeron--to generate mitotic recombinations. In this case frequency of experimental prototrophs is twice higher than the control level. PMID- 3296367 TI - [Cytochemical method for detecting dehydrogenase activity in the leukocytes of native blood smears]. AB - A cytochemical method of detection of dehydrogenases in blood leucocytes is proposed. Native smears are dried up in the air to be incubated at 37 degrees C in gel-containing medium composed of polyvinyl alcohol, sucrose, a corresponding substrate, cofactors and inhibitors of cytochrome oxidases activity. Using corresponding media, activities of succinate, malate, glutamate, lactate-, alpha glycerophosphate, alcohol, beta-oxybutyrate and glucoso-5-phosphate dehydrogenases were revealed. Half-reduced diformazan providing diffuse rosy staining of cells was removed after the incubation, and the incubation medium was washed out by rinsing the smears in 60% acetone solution. As a result monochromatic micropreparations may be received. Finally, smears are fixed in formalin. The above method provides a reduced loss of enzymes, preserves a good cell morphology and eliminates non-dehydrogenase effects of tetrazolium reduction into formazan. PMID- 3296369 TI - [Acute acalculous cholecystitis demonstrated by ultrasonography]. PMID- 3296368 TI - Ultrasonographic appearance of hydatic liver in children. PMID- 3296370 TI - [Diet and blood pressure. A review]. PMID- 3296371 TI - Bibliography of biomedical ultrasound. No. 62. PMID- 3296373 TI - Factors affecting the choice of preamplification for ultrasonic hydrophone probes. AB - This paper gives a systematic analysis of the effects of including an integrated (built-in) preamplifier into the ultrasonic piezoelectric probes (hydrophones) that are finding increasing use in biomedical applications. The design parameters considered include the end-of-cable sensitivity, gain, dynamic range, power supply requirements, construction intricacy, and cost. The rationale behind the inclusion of a preamplifier is given, and it is shown that the additional complexity introduced with the preamplifier into the measurement chain may not be warranted in all applications. Both the drawbacks and advantages of hydrophone preamplification are demonstrated, especially for the case of high pressure amplitude ultrasonic field measurements. Guidelines are developed for the potential user to identify the need for preamplification and the factors that influence the selection of the appropriate circuitry. PMID- 3296372 TI - Influence of pathological state on the acoustic attenuation coefficient slope of liver. AB - The acoustic attenuation coefficient slope (beta) of liver was estimated in vivo from the spectral difference of returned echoes. beta of normal young subjects was lower than that of older subjects (mean: 0.340 vs 0.418 dB/cm.MHz). Limited fluid withdrawal from the body by haemodialysis did not affect beta. In alcoholic liver disease beta was related to the amount of fat and of fibrous tissue in liver biopsy specimens. High values of beta were observed as soon as the degree of steatosis exceeded 5 vol%. There was a similar increase of beta in the presence of fibrous interlobular septa. In normal liver beta was related to the amount of triglycerides in the liver specimen. PMID- 3296374 TI - Bibliography of biomedical ultrasound. No. 63. PMID- 3296375 TI - Colour coded Doppler systems. PMID- 3296376 TI - Doppler examination of the periorbital arteries adds valuable hemodynamic information in carotid artery disease. AB - The periorbital flow direction and internal carotid artery (ICA) angiogram were compared to the ICA pressure gradient across the stenosis and the distal ICA pressure in 51 patients subjected to carotid endarterectomy. All 17 patients with inverted periorbital flow had stenoses exceeding 50%. The remaining 16 patients with the same degree of stenosis had antegrade flow, which was also observed in all patients with less than 50% stenosis. In 16 of 17 patients with inverted periorbital flow, the mean pressure gradient exceeded 10 mmHg, whereas 33 of 34 patients with antegrade flow had gradients of 12 mmHg or less. For diagnostic purpose, the periorbital Doppler test is inferior to direct Doppler examination or angiography. However, as an adjunct to direct techniques, patients can be classified into 3 groups: Patients with less than 50% stenosis, Patients with 50% stenosis or more and good collaterals and, Patients with 50% stenosis or more and insufficient collaterals. PMID- 3296378 TI - Cumulative bibliography of the world literature 1979-1982. PMID- 3296377 TI - Bibliography of biomedical ultrasound. No. 64. PMID- 3296380 TI - [Exercise and osteoporosis: what can we expect of them?]. PMID- 3296379 TI - [Osteoporosis: clinical approach and perspectives. General review]. PMID- 3296381 TI - Shadows. PMID- 3296382 TI - Duodenal ulcer, hyperacidity and J C Adams. PMID- 3296383 TI - Insulin receptor binding and metabolic effects of insulin in human subcutaneous adipose tissue in untreated non-insulin dependent diabetes mellitus. AB - Insulin action at the target tissue level in non-insulin dependent diabetes mellitus was investigated using human adipose tissue. Specific adipocyte receptor binding of insulin and the effects of the hormone on glucose oxidation and lipolysis were determined in subcutaneous adipose tissue. The study included 25 patients with untreated non-insulin dependent diabetes mellitus and 38 healthy control subjects matched for age, sex and body weight. Insulin stimulated adipose tissue glucose oxidation in a dose-dependent way in the control subjects. On the other hand, a marked inhibition of this insulin effect was observed in the diabetics. A weak stimulation was observed only at high unphysiological hormone concentrations [greater than or equal to 0.7 nmol/l] and the maximal insulin response was 6 times lower than that in the control subjects. However, neither specific insulin receptor binding nor the antilipolytic effect of insulin were inhibited in diabetes. Similar results with insulin binding and the metabolic effects of insulin were obtained in non-obese normoinsulinemic diabetics as compared to moderately obese hyperinsulinemic diabetics. It is concluded that adipose tissue insulin resistance in non-insulin dependent diabetes mellitus only involves glucose metabolism and not antilipolysis. Furthermore, it may solely be due to postreceptor defects in insulin action and seems not to be influenced by obesity or oversecretion of insulin. PMID- 3296384 TI - Validity of Hill's equation in an artificial actomyosin streaming system. AB - The rotation of an actomyosin motor, assembled from blades, one side onto which F actin of uniform polarity was attached, suspended in a solution of heavy meromyosin (HMM), was modelled as due to sliding of HMM over the margins of the blades, whereby the work resulting from ATPase activity is used for pushing bulk fluid containing HMM from the leading surface of the blade over the force generating filaments to the back surface, which leads to increased sliding velocity. The amount of HMM contributing to force-generation is divided into one component perpendicular to the filaments, which is diffusion-limited and regulated by a component parallel to the filaments, represented by the movement of the bulk fluid, the supply of new HMM and the observable velocity of rotation of the blade. Using Hill's equation which essentially states that the product of a virtual force and a virtual velocity is constant within the range of observable forces and velocities, the force can be expressed as velocity, giving a simple first order differential equation. A solution to this equation can be fitted to the observed data with physically meaningful constants in terms of mass, viscosity, the force-velocity constant and a constant expressing the quality of the preparation. Control experiments were performed, using fixed blades. In these experiments, bulk flow around the margins did not increase as a result of ATPase activity and no movement or streaming was observed. The results show that Hill's equation may be applicable to streaming caused by actomyosin irrespective of its confinement to skeletal muscle and independently of preferred molecular model, and leads to several verifiable predictions. PMID- 3296385 TI - Inverted papilloma of the ureter with malignant transformation: a case report and review of the literature. The importance of the recognition of the inverted papillary tumor of the ureter. AB - Inverted papilloma of the ureter is a rare tumor generally considered to be a benign lesion. We present a case of ureteral inverted papilloma with malignant transformation and review the literature. Ten cases of ureteral inverted papillary tumors in Japan and 13 cases of inverted papillary tumors associated with malignancy in the urinary tract in the world literature have been analyzed to define their features. Inverted papillary tumors of the ureter have distinct clinicopathological features, but most are discovered retrospectively after nephroureterectomy. From the standpoint of clinicopathological features, inverted papillary tumor of the ureter should be distinguished from its exophytic counterpart with respect to the treatment. If the tumor can be diagnosed macro- and microscopically during surgery as inverted papilloma or malignant inverted papillary tumor without invasion, partial ureterectomy including the lesion may be recommended. Furthermore, we propose the hypothesis that inverted papillary tumor could be a neoplasm of basal cell origin in the transitional epithelium, termed 'basal cell urothelioma'. PMID- 3296386 TI - Papaverine--injection and Doppler-sonographic examination in the diagnosis of vascular erectile dysfunction. AB - A second Doppler examination after intracavernous injection of papaverine provides more objective data in cases with questionable penile Doppler results and vascular impotence. PMID- 3296387 TI - Apalcillin treatment of complicated urinary tract infections. AB - In an open, prospective clinical trial, we evaluated the safety and efficacy of apalcillin in the treatment of complicated urinary tract infection. 21 hospitalized adult patients received apalcillin 2 g IV Q8-12 h for 5-17 days. There were 8 upper tract and 13 lower tract infections. Of 25 functional or anatomic abnormalities of the GU tract among these patients, 9 (36%) were corrected during the study period. Effectiveness of apalcillin was determined by clinical and bacteriologic response. 16 (76.2%) patients had clinical cures, 4 (19.8%) had clinical improvement, and 1 (4.8%) had clinical failure. Based on 26 pretreatment isolates, there were 16 (61.5%) bacteriologic cures and 10 (38.5%) failures. Failures were due to 6 (23.1%) relapses, 2 (7.7%) superinfections, and 2 (7.7%) relapses with superinfection. Adverse reactions were mild, transient, and did not require discontinuation of treatment. Apalcillin appears to be a safe, although marginally effective single agent antibiotic for the treatment of complicated urinary tract infections. PMID- 3296388 TI - [Morphometry of the ureter in children]. PMID- 3296389 TI - [Aluminum poisoning--a clinical problem in nephrology]. PMID- 3296390 TI - [2 variants of the vascular approach in hemodialysis]. PMID- 3296392 TI - [Endoscopic urethrotomy]. PMID- 3296391 TI - [The solitary kidney in children]. PMID- 3296394 TI - [The ileal neobladder]. AB - Currently we are witnessing an increase of interest in bladder substitution enterocystoplasty. The goal of this presentation is to describe operative technique and first clinical results of a ileal neobladder for total bladder replacement. Creation of a ileal neobladder for total bladder replacement is described in 11 patients. To achieve a low pressure system, disruption of directional bowel peristalsis with a longitudinal incision at the antimesenteric border of a 70 cm ileal segment is performed. A spherical pouch, the neobladder, is fashioned and anastomosed to the urethra. The ureters are implanted according to Le Duc and Camey. Videourodynamic studies during various postoperative phases demonstrate this neobladder to be a urinary reservoir with a capacity approximating that of a normal bladder, good compliance during filling by maintaining pressures lower than 30 cm water and no reflux. Eight of the 11 patients with the neobladder are completely dry day and night. Three are stress incontinent grade I. All 11 patients developed recognizable sensations of bladder distension closely simulating those of their earlier bladders. The use of this ileal neobladder in male patients undergoing radical cystectomy offers a stoma free alternative to urinary diversion resulting in a highly compliant low pressure bladder. A urodynamic comparison between the most recent developments (Kock-pouch, Camey, Mainz-pouch, "Le Bag") is made and this clearly shows the ileal neobladder to have several distinct advantages: the ileocolonic junction and the terminal ileum are saved; the operative technique is safe, simple and reliable (no Kock valve, no 180 degree rotation of the reservoir, simple antireflux technique); development of recognizable sensations of bladder filling in all cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296393 TI - [Retroperitoneal teratoma. A problem in pediatric urology]. AB - We report about diagnosis and therapy of a retroperitoneal teratoma in a six years old boy. Further we discuss the histogenetical origin as well as the histological classification. Considering other localisations, teratomas of the retroperitoneum are relatively (4%) rare. Most teratomas are diagnosed at school age either coincidently or because of a mass lesion. Size and localisation of the tumor do not give any information about its nature. Even with negative tumor markers (alpha1-fetoprotein, beta-HCG) the tumor should be considered malignant until histology proves the contrary. Due to these facts a careful en bloc extirpation and a thorough histological examination of the tumor are always necessary. PMID- 3296395 TI - [Current diagnosis of pediatric kidney trauma: consequences for therapy planning]. AB - For the therapy of pediatric renal trauma there is always the question of the appropriate diagnostic measures. The various procedures such as ultrasound, urography, scintigraphy, computed tomography, conventional angiography, arterial and venous digitalized subtraction angiography are discussed. By these new methods it is possible to judge the severity of renal trauma more accurately and to limit the indications for an operation. With stable circulation an operation should only be performed in the presence of a large, expanding retroperitoneal hematoma, extensive extravasation (urinoma), persistent massive hematuria or if large areas of devitalized renal tissue are found. PMID- 3296396 TI - A simple vas approximator. PMID- 3296397 TI - Simplified method of indwelling ureteral stent removal. PMID- 3296399 TI - Ileal conduit anastomosis using modified Javid shunt as temporary stent. PMID- 3296398 TI - Use of Foley catheter to obtain transvaginal tamponade. PMID- 3296400 TI - New technique for microscopic vasovasostomy. PMID- 3296402 TI - Officers and Council of the American Ophthalmological Society. PMID- 3296401 TI - Stenting techniques. PMID- 3296403 TI - Clinicopathologic correlation of orbital magnetic resonance imaging. PMID- 3296404 TI - The triple procedure: 2 to 10 year follow-up. PMID- 3296405 TI - The harderian gland: its tumors and its relevance to humans. PMID- 3296406 TI - Cicatricial pemphigoid. PMID- 3296409 TI - Remote optical systems for ophthalmic examination. PMID- 3296407 TI - Corneal allograft rejection in bilateral penetrating keratoplasty: clinical and laboratory studies. PMID- 3296408 TI - Investigations of the reasons for success and failure in the anterior shunt-to the-encircling-band procedure in the treatment of refractory glaucoma. PMID- 3296410 TI - [S. F. Shtein--one of the founders of Soviet labyrinthology]. PMID- 3296412 TI - [Early osteoplastic interventions in children with otofacial dysostosis]. PMID- 3296411 TI - [Invagination anastomosis of the large intestine in an operation for Hirschsprung's disease]. PMID- 3296413 TI - [Duodenogastric reflux before and after the surgical treatment of peptic ulcer]. PMID- 3296414 TI - [Treatment of recurrent ulcers after vagotomy]. PMID- 3296415 TI - [Combined complications of pyloroduodenal ulcer and their treatment]. AB - Associated complications took place in 68 cases (23.8%) among 286 patients operated upon for pyloroduodenal ulcer. A combination of stenosis and penetration was observed in 35.3%, hemorrhage with the penetration or stenosis was observed in 42.6%, perforation with stenosis or penetration in 22.1% of the patients. Choice of the operative intervention in the associated complications of pyloroduodenal ulcer was shown to mainly depend on the severity of the patient's state, character and degree of local pathological changes. Postoperative lethality was 5.9%. PMID- 3296416 TI - [Recurrent femoral hernias]. AB - Under analysis are results of treatment of 14 patients with recurrent femoral hernias. The state of anatomical elements in the field of hernia hilus was studied in 9 operations. The method used in operations for recurrent femoral hernias followed by considerable weakening and destruction of anatomic formations with the application of autodermoplasty is described. PMID- 3296417 TI - [Medical rehabilitation of patients after amputation of the leg in sarcoma]. AB - An analysis of data of 348 patients with malignant tumors of soft tissues has shown that 128 of them had been subjected to the amputation of extremities at different levels. The use of microsurgical techniques favours the improvement of the method of amputation of lower extremities, in particular the transplantation of a calcaneoplantar flap onto the stump end. In order to make the treatment of phantom limb pains more effective acupuncture should be included into the complex of therapeutic measures in addition to traditional methods. Close contacts with prostheses-makers can facilitate earlier prosthesis which can give positive effects on the following rehabilitation of such patients. PMID- 3296418 TI - [Treatment of the duodenal stump in perforating ulcer]. PMID- 3296419 TI - Diagnosis of pulmonary Mycobacterium bovis infection in a tiger. PMID- 3296420 TI - Increase in prevalence of a neomycin/kanamycin-sensitive variant of S typhimurium DT204c in cattle in Britain. PMID- 3296421 TI - Intramammary antibiotic preparations and cephalosporin resistance in Salmonella typhimurium 204c. PMID- 3296422 TI - Effects of infection with Enterobacteriaceae enteropathogens on subsequent infection with Ascaris suum in the laboratory mouse. AB - Prior to infection with Ascaris suum, ICR strain mice were inoculated with Salmonella typhisuis intraperitoneally or via gastric gavage. Similarly, Salmonella cholerae-suis var. kunzendorf, Salmonella typhimurium and enterotoxigenic Escherichia coli were administered to mice via gastric gavage 2 weeks prior to A. suum inoculation. Previous inoculation with S. typhisuis, via the intraperitoneal or gastric gavage routes and S. cholerae-suis var. kunzendorf decreased recovery of ascarid larvae from mice lungs. This effect appeared to be due to entrapment of migrating larvae by inflammatory reactions in the liver. This reaction was suspected to be due to non-specific resistance stimulated by the prior exposure to the bacterial pathogen. The number of A. suum larvae in the lungs of mice previously inoculated with S. typhimurium or enterotoxigenic E. coli (ETEC) was variable and in some cases greater in mice which had received the bacterial inoculation. PMID- 3296424 TI - The attachment sites of T5-host range temperate coliphages. AB - The attachment sites of 13 temperate coliphages were determined. Specialized transduction of proAB mutants was shown by eight isolates and of a his mutant by another two. Two isolates were concluded to integrate at atthtt and the integration site of one isolate remained undetermined. PMID- 3296425 TI - [The incidence of splenomegaly in the Slovak population]. PMID- 3296423 TI - A review of major histocompatibility complex-disease associations in man and dog. AB - The organization and biology of the Major Histocompatibility Complexes (MHC) of man (HLA) and dog (DLA) are reviewed, and a summary is presented of laboratory techniques used to define allotypes. The nomenclature of this field and the mechanisms of disease association with the MHC are discussed. Currently recognized HLA-disease associations are enumerated, with emphasis on the value of the complement C4 marker. DLA-disease association studies into autoimmune disease, allergy and neoplasia are reviewed. PMID- 3296427 TI - [Neurological syndromes of chronic alcoholism]. PMID- 3296426 TI - [Comparative evaluation of native and immobilized proteinases in treating suppurative wounds]. PMID- 3296429 TI - [From the work experience of the neurosurgical group of a separate medical reinforcements company]. PMID- 3296428 TI - [The role of Lenin in the organization and development of Soviet public health]. PMID- 3296431 TI - [Neurotoxic effect of drugs]. PMID- 3296430 TI - [Suppurative surgical diseases among the personnel of foreign armies]. PMID- 3296432 TI - [Modern methods of treating skin cancer]. PMID- 3296434 TI - [Concept and classification of recurrences of rectal cancer]. AB - A definition of rectal cancer recurrence and a relevant classification are given on the basis of the literature data and the authors' findings, thus providing a means for comparing treatment results and establishing rational procedures of rectal cancer recurrence therapy. PMID- 3296433 TI - [Histological assessment of the effectiveness of radiation therapy of prostatic cancer]. PMID- 3296435 TI - [Effect of adjuvant hormonotherapy on the results of the radiation treatment of patients with cancer of the corpus uteri]. AB - The paper discusses the results of treatment of endometrial cancer patients with high energy radiation (76 cases). Three-year survival rate was 78.3%. A combination of radiation and hormonotherapy was given to 34 cases. The control group (not receiving 17-hydroxyprogesterone caproate treatment) included 42. Survival rate for hormonotherapy group was higher than in controls (84.1 and 74.8%, respectively). Hormonal treatment was the most effective in patients with early stages of cancer and well- and moderately-differentiated tumors. PMID- 3296436 TI - [Antitumor immunity]. PMID- 3296437 TI - [Immunity and immunosuppression in tumor growth]. PMID- 3296438 TI - [Immunoreactivity in tumor growth]. PMID- 3296439 TI - [Nitrosating precursors of carcinogenic N-nitroso compounds in the environment and in the human body]. PMID- 3296440 TI - [Effect of 3-hydroxyanthranilic acid-antigen on the migration of peripheral blood leukocytes in patients with bladder tumors]. AB - The effect of 3-hydroxyanthranilic acid-antigen on peripheral blood leukocyte migration inhibition was studied in 75 patients with bladder malignancies. The antigen appeared to modify the said migration. A correlation was established between stage of tumor progression and the effect of 3-hydroxyanthranilic acid antigen on leukocyte migration. PMID- 3296441 TI - [History of the organization of 1st Russian societies for the prevention of cancer]. PMID- 3296442 TI - [Alimentary risk factors for ischemic heart disease]. PMID- 3296443 TI - [Standard setting and supply of the population's vitamin requirements during World War II and in the 1st few post-war years]. PMID- 3296445 TI - [Contribution of Academician V. N. Ivanov to the clinical picture of internal diseases]. PMID- 3296444 TI - [Duration of the bacterial carrier state in Escherichia diseases]. PMID- 3296447 TI - [Changes in the prostacyclin-thromboxane system at the early stages of arterial hypertension]. PMID- 3296446 TI - [On the 150th anniversary of the birth of Prof. E. I. Afanas'ev]. PMID- 3296448 TI - [Rheological properties of the blood in chronic cor pulmonale (a review of the literature)]. PMID- 3296449 TI - [The disseminated intravascular coagulation syndrome in the therapeutic clinic and its diagnosis]. PMID- 3296450 TI - [Morphological characteristics of the hematopoietic colony cells after the transplantation of cryopreserved bone marrow]. PMID- 3296451 TI - [Chronobiological research in urology and nephrology (a review of the literature)]. PMID- 3296452 TI - [Blood coagulation changes in neoplastic diseases. The effect of radio- and chemotherapy]. PMID- 3296453 TI - [Potentials of echography for diagnosing x-ray-negative calculi]. AB - The objective of the authors, with the present paper, is to specify the possibilities of echography in patients with "negative" renal lithiasis. A total of 54 patients were studied, grouped in two subgroups: subgroup A--33 patients with native-graphy, urography and echography, subgroup B--21 patients with chronic renal insufficiency and intolerance to X-ray contrast media, to whom only native-graphy and echography were performed. The authors concluded, on the base of the statistical calculations, that echography in the patients studied by them, has a higher percentage probability of differentiating the negative concrements than urography. PMID- 3296454 TI - [Ultrasonic Doppler sonography of patients with cardiovascular diseases]. AB - The object of the study were 129 patients (53 male and 76 female), with an average age of 59.3. The youngest patient was 34 years old and the oldest--86. Clinically and paraclinically diseases of the cardiovascular system were confirmed in them: 69 with hypertonic disease, 45 with ischemic heart disease (IHD) and 15 with a combination of both the diseases. The condition of the internal carotid and vertebral arteries was studied by ultrasound doppler sonography. Data for pathological main vessels were established in 91 of the patients (70.54%): sonographically established insufficiency in hemodynamics, stenoses and occlusions. Data about I main vessel affected were established in 49 patients, 2--in 24 patients and 2 and 4 vessels--in 18 patients. Most frequent proved to be the main cerebral lesions in subjects with hypertonic disease and IHD (80%), followed by those with IHD (75.5%) and hypertonic disease (65.2%). A correlation was performed between the sonographically established pathology of cerebral main vessels and the minor objective neurological symptoms. PMID- 3296455 TI - [Transvenous electrical destruction (ablation, fulguration) of the bundle of His]. PMID- 3296456 TI - Under deep hypothermia, circulatory arrest. Repair of traumatic arteriovenous fistula of the aortic arch. PMID- 3296457 TI - Serum potassium concentration in hyperglycemia of diabetes mellitus with long term dialysis. AB - Severe hyperkalemia (serum potassium level >6 mmol per liter [mEq per liter]), often with electrocardiographic disturbances, was noted at presentation in 30% of 73 hyperglycemic episodes (serum glucose concentration >25 mmol per liter [455 mg per dl]) observed in 15 in-hospital patients with insulin-dependent diabetes mellitus who were receiving long-term hemodialysis or peritoneal dialysis. Serum glucose concentration and total carbon dioxide content correlated significantly with the presenting serum potassium concentration. Treatment with parenteral insulin alone resulted in a decrease of the serum glucose value from 41 +/- 14 (standard deviation) to 11 +/- 5 mmol per liter (P <.001) and of serum potassium level from 5.2 +/- 1.2 to 4.0 +/- 0.6 mmol per liter (P <.001). The changes in serum glucose concentration and in carbon dioxide content and the serum potassium concentration at hyperglycemia were found to be independent correlates of the decrease in potassium concentration during treatment. Insulin alone resulted in correction of hyperkalemia in all instances. Posttreatment hypokalemia was noted in only two instances, each associated with both ketoacidosis and low-normal serum potassium concentration at hyperglycemia. Giving insulin is the only treatment usually needed for the hyperkalemia of hyperglycemia in patients on ongoing dialysis. PMID- 3296458 TI - Incidence of cough associated with captopril therapy. PMID- 3296459 TI - Survival following cardiac transplantation--what are acceptable standards? AB - In an 18-month period, 50 orthotopic cardiac transplantations were done in Utah in 48 patients with end-stage heart failure. The 12-month actuarial survival was 98%, indicating that successful cardiac transplantation can be done in a newly established program and that the intermountain West has an adequate supply of potential recipients and donors for a moderate- to high-volume program. Furthermore, the administration of cardiac transplantation in a setting of other treatment modalities of heart failure in a multi-institutional program that crosses private practice-academic barriers is feasible. Results such as these need to be considered by the federal government as it establishes eligibility criteria for centers to be approved for Medicare-funded cardiac transplantation. PMID- 3296460 TI - [Psychologic aspects of patients with bronchial asthma]. PMID- 3296461 TI - [Medical sciences during the period of the Saxon kings in Poland]. PMID- 3296462 TI - [Role of Lodz physicians in organizing social forms of health services at the turn of the 19th century]. PMID- 3296463 TI - [Arrhythmogenic effect of anti-arrhythmia drugs]. PMID- 3296464 TI - [Francois Rabelais--physician and writer]. PMID- 3296465 TI - [Clinical evaluation of Salbupart in the inhibition of uterine contractions in abortion and premature labor in comparison to Partusisten]. PMID- 3296466 TI - [Creutzfeldt-Jakob disease. Clinical aspects and diagnosis based on 2 cases]. AB - The case histories are presented of two patients with Creutzfeldt-Jakob disease. The clinical diagnosis was confirmed on autopsy. A 51-year-old man and a 63-year old woman developed--after a period of non-specific prodromal symptoms--a rapidly progressive dementia accompanied by cerebellar, pyramidal and extrapyramidal signs. The clinical features, the course of the disease and the results of investigations are discussed, as well as the differential diagnosis. PMID- 3296467 TI - [Hepatic and peripheral insulin resistance as a cause of hyperglycemia in non insulin-dependent (type 2) diabetes mellitus: a review]. AB - In diabetic patients, fasting hyperglycaemia is attributed to both, reduced clearance by peripheral tissues and augmented endogenous glucose release. In normal-weight, non-insulin-dependent diabetic patients, basal hepatic glucose production (HGP) was determined by means of tracer kinetic analysis. HGP was enhanced to 3.00 +/- 0.20 mg/kg X min as compared to 1.90 +/- 0.05 in healthy, non-diabetic subjects, even though hyperglycaemia and fasting hyperinsulinaemia prevailed. HGP correlated positively with fasting blood glucose (r = 0.577; P less than 0.01). Glucose clearance rate was reduced by 20%. Marked hyperinsulinaemia during an isoglycaemic (0.75 mU/kg X min) insulin clamp study suppressed HGP by only 82% as compared to greater than 95% in healthy subjects. Furthermore, significant residual HGP was also observed when hyperglycaemia was augmented by exogenous glucose administration. Thus, in the fasting state, HGP is increased and directly correlated with severity of hyperglycaemia. Due to a reduction in glucose clearance, blood glucose concentration rises until glucose utilization rate equals HGP. Under conditions of hyperinsulinaemia and hyperglycaemia, suppressibility of HGP is diminished. Thereby, HGP and diminished glucose clearance by peripheral tissues contribute to basal as well as postprandial hyperglycaemia in type 2 diabetic patients. PMID- 3296468 TI - [Allogeneic bone marrow transplantation in acute myeloid leukemia (AML): results in 14 patients]. AB - Between February 1982 and August 1986 14 patients with AML (median age 24 years, range 10-41) underwent allogeneic bone marrow transplantation. 9 patients were grafted in first complete remission, 4 in first relapse, 1 in second relapse and 1 patient with refractory AML. Conditioning consisted of cyclophosphamide (120 mg/kg) and total body irradiation (1000 rad). The patients received methotrexate (n = 12) or methotrexate and cyclosporine (n = 2) for prevention of graft versus host disease. Of the 14 patients, 7 are alive, 7 patients died. Causes of death were recurrence of leukaemia (n = 2), veno occlusive disease of the liver (n = 1), CMV-pneumonitis (n = 1), septicaemia (1), cerebral haemorrhage (1), acute graft versus host disease of the gut (1), necrotizing encephalopathy (n = 1). 7 patients are alive between 124 and 1784 days (median 671) in continuous complete remission. All patients but 1 have a Karnofsky-index of more than 80%. PMID- 3296469 TI - [Bone marrow transplantation in chronic myeloid leukemia--experiences in 16 patients]. AB - Between January 1983 and December 1986 16 patients (8 f, 8 m, median age 31.5 years, 14-41) with chronic myelocytic leukaemia (CML) received bone marrow grafts from their HLA compatible sibling donors. 11 patients were in the chronic and 4 in the accelerated phase. 1 patient was in lymphatic blast crisis. The patients were pretreated with busulfan (n = 15, total dose: 100-1000 mg, median: 225), mitobromitol (1 pat.), hydroxyurea (2 pats.), pre-irradiation of the spleen with 800 rad (1 pat.) and one patient had received 3 cycles of vincristin and prednisolone. The conditioning regimen consisted of cyclophosphamide (120 mg/kg) and total body irradiation (1000 rad, lung 800 rad). The prophylaxis against graft versus host disease (GVH-D) consisted of methotrexate (MTX) in 14 patients and of MTX in combination with cyclosporin-A in 2. At present (January 15th 1987) 9 patients survive 30 to 1210 days (median 1009) post graft (6/11 grafted in chronic, 2 of 4 in accelerated phase and 1/1 grafted in blast crisis. The causes of death were interstitial pneumonitis (CMV-associated, 2 pats.), venoocclusive disease of the liver (2 pats.), acute GVH-D and septicemia (2 pat.) and relapse (1 pat.). The Karnovsky score of 8/9 survivors is 100%, one patient has a score of 70% due to chronic GVH-D. Bone marrow transplantation for CML bears a high risk of early mortality but offers the unique option of permanent eradication of leukaemic haemopoiesis with subsequent long term survival. PMID- 3296471 TI - [New knowledge of the modifiability of QRS amplitudes of the surface electrocardiogram of the transplanted human heart]. AB - Applying immunosuppressive therapy with Ciclosporin A, the myocardium shows only little or no oedema in the cardiac rejection process. Thus the usefulness of electrocardiographic diagnosis using QRS-amplitudes of the surface electrocardiogram (unipolar precordial chest leads) for the early recognition of the (acute) cardiac rejection process, is considerably limited if not questionable when compared with the pre-ciclosporin period (63 cases with heart transplants). In a heart-lung transplant for instance a massive accumulation of fluid in the lungs (erroneously) can influence the QRS-amplitudes. In addition, the cardiac rejection index (KRI) obtained by unipolar chest leads and other electrocardiographic alterations should be watched continuously. With a high degree of reliance, the intra-myocardial electrogram (IMEG) permits a better diagnosis of the acute cardiac rejection process. For the early clinical diagnosis the use of additional noninvasive methods of examinations is advisable. PMID- 3296470 TI - [Type I diabetes mellitus and pregnancy: an interdisciplinary management program]. AB - The obstetrical management of pregnant women with pregestational diabetes has been significantly improved throughout recent years. In the past, efforts to maintain euglycaemia during pregnancy in the presence of a labile maternal metabolism led to repeated, long-term hospitalization. In an interdisciplinary joint effort a protocol was delineated to obtain euglycemia throughout pregnancy by functional insulin therapy aiming at "near-normoglycemic insulin substitution (NIS)". In order to achieve this goal, home glucose monitoring and, depending on the glucose levels, self-made adjustments to the insulin therapy (according to individual algorithm) are the essential parts of this protocol. Of our study group of 18 pregnant diabetic women, already eight of them (2 class B, 1 class C, 1 class D, 2 class R and 2 class RF) have been delivered. The mean maternal age was 27 years (21-39). All metabolic variables of consequence for a diabetic woman were within the normal limits. The mothers' mean weight gain was 16 kg (12-20), and the mean gestational age at delivery was 37.8 weeks (35-40). The mean birth weight was 3293 grams (2700-3700) and all newborns were within the 50th percentile. Five fetuses were delivered by caesarian section (indications: proliferative retinopathy 3, breech presentation 1, previous caesarian section 1). No congenital malformations were found, nor macrosomia, respiratory distress syndrome or postpartum hyperglycaemia in the newborn. These preliminary results are encouraging. We feel that functional insulin therapy aiming at "near normoglycaemic insulin substitution" promises to be very effective for women who are able and willing to follow the instructions received in the special education program. PMID- 3296472 TI - [Transitory tetraplegia following high-pressure ventilation]. AB - We present the case of a 22-year-old asthmatic woman, who had undergone high pressure servo-ventilation as part of the therapy of an otherwise untreatable asthmatic attack. Ventilation-pressures reached peaks of 80 mg H2O while under relaxation and sedation arterial blood pressure fell to 50/30 mm Hg. Treatment was complicated by pulmonary ruptures, pneumothorax and massive cutaneous emphysema. After successful completion of this treatment phase (day 14), the patient was allowed to regain consciousness and was found to be in a subtotal tetraplegic state: muscles of the neck, shoulders and left leg were slightly less atonic than others. Facial muscles, different qualities of sensitivity, intellectual functions and sense organs did not seem to be afflicted. Restitution of the tetraplegia was complete by day 50 of treatment, a neurological follow up six months after discharge from hospital showed no residual deficit. We hypothesize that the extreme ventilation-pressures together with the decrease of arterial blood-pressure have impaired the blood-flow in the system of the anterior spinal arteries. Together with concordant oedema this effected a localized dysfunction mainly of the ventral medullary areas corresponding to the functions of the anterior spino-cortical tract. Diagnostically we do not fully exclude steroid myopathia, but think in this case the cumulated steroid doses were too small and the course of remission indicates a localized haemodynamic lesion. PMID- 3296473 TI - A new approach to physiology, monitoring, and therapy of shock states. PMID- 3296474 TI - Pulmonary edema: current concepts of pathophysiology, clinical significance, and methods of measurement. PMID- 3296475 TI - Right ventricular function in the surgical patient. PMID- 3296476 TI - Current concepts in the management of the adult respiratory distress syndrome. PMID- 3296477 TI - High-frequency ventilation. PMID- 3296478 TI - Nutritional support in the management of critically ill patients in surgical intensive care. PMID- 3296479 TI - Adequacy and support of physiological functions in the acutely ill cirrhotic patient. PMID- 3296481 TI - Reintervention in abdominal surgery. PMID- 3296480 TI - Pharmacokinetics and pharmacodynamics in critically ill patients. PMID- 3296484 TI - Clinical characteristics and methacholine sensitivity in patients with suspected bronchial asthma. PMID- 3296483 TI - Prevention of postoperative wound infection after appendectomy by local application of tinidazole: a double-blind study. PMID- 3296485 TI - Ultrasound confirmation of splenic rupture in the newborn. PMID- 3296486 TI - [Changes in the renin-angiotensin-aldosterone system in the development of hypertension in aging. 2]. AB - The change of the reactivity of the RAAS during physiological aging of the organism implies the variety of forms of the course of hypertension: The RAAS is involved in stage I of the development of the disease. The progress of the disease (stage III) results in the "decay" of the RAAS. A dependence of the activity of the RAAS on the clinical course and on the hemodynamic variant of hypertension in old age could detected. PMID- 3296487 TI - [The history of the Berlin Pepiniere]. PMID- 3296488 TI - [The development of medical education in Berlin by the surgeon Ernst von Bergmann]. PMID- 3296482 TI - Immunotherapeutic advances in the treatment of gram-negative bacterial sepsis. PMID- 3296489 TI - [A short chronicle of forensic medicine in Berlin]. PMID- 3296490 TI - [From hospital to modern clinic. Historical aspects of the construction of Berlin hospitals]. PMID- 3296491 TI - [Jewish physicians in Berlin. A medical history sketch for the 1987 Berlin anniversary]. PMID- 3296492 TI - [Medical education in the history of the city of Berlin]. PMID- 3296493 TI - [Health monitoring in emergency care--a century of rescue services in Berlin]. PMID- 3296494 TI - [The Berlin Medico-Surgical University--an education and continuing education facility of the 18th century]. PMID- 3296495 TI - [The Berlin medical faculty and conflicts in changing civil educational privileges at the time of the antifascist-democratic revolution (1945-1949)]. PMID- 3296496 TI - [The therapeutic history of cholelithiasis]. PMID- 3296497 TI - [Was Sir Morell Mackenzie a failure]. PMID- 3296498 TI - [Chronic renal failure--classification and conservative treatment]. PMID- 3296499 TI - [Diagnosis of legionella pneumonia]. PMID- 3296500 TI - [General practice related significance of the cocard phenomenon in the ultrasound image]. PMID- 3296501 TI - [Berlin and the plague]. PMID- 3296502 TI - [Neural regulation of salivary gland secretion]. AB - Efferent nerves, involved in the regulation of salivary secretion, consist of secretory, motoric and vasomotoric fibers; afferent sensoric nerves are a further component of the salivary gland innervation. Cholinergic nerves regulate primarily the salivary flow rate and Na secretion. Salivary protein secretion (i.e. parotid amylase) is mediated by adrenergic mechanisms. Among physiologic stimuli regulating salivary secretion the taste plays a prominent role. Different taste constituents stimulate parotid secretion in a specific way: fructose increases amylase content in parotid saliva (beta-adrenergic pathway), citric acid increases salivary flow rate (cholinergic pathway). The role of gut and neuropeptides in the regulation of human salivary secretion deserves further investigation. PMID- 3296503 TI - [New aspects of the neural regulation of gastric acid secretion]. AB - The purpose of this short review is to reveal new aspects of nerval regulation of gastric acid secretion. The complex interactions between humoral, paracrine, neurocrine, neuroendocrine, vagal and sympathetic mechanisms are underlined. The finding that stimulation of the vagus nerves releases bombesin from peptidergic nerve fibers, which causes release of gastrin from endocrine cells in the stomach, demonstrates the complex interaction between nerves and hormones. The target organ, the parietal cell, has receptors for gastrin, acetylcholine and histamine, which potentiate each other regarding stimulation of acid secretion. New findings about the pathophysiology of acid secretion in duodenal ulcer patients are emphasized. PMID- 3296504 TI - [Interactions between the brain and gastrointestinal tract]. AB - Peptides have been implicated to subserve neurotransmitter function within the brain and the gastrointestinal tract. While the anatomical distribution of neuropeptides suggest that most neuropeptides identified in brain tissue are also present in the gastrointestinal tract and vice versa, the functional interrelationship of the central nervous system and the gastrointestinal tract are less well documented. Most studies examined the peripheral actions of peptide hormones on visceral functions. This paper summarizes the central nervous system actions of neuropeptides on various gastrointestinal entities (secretion, motility, blood flow, absorption and eating behavior). This paper also deliniates the efferent and afferent pathways that allow to occur communication of the brain and the gastrointestinal tract. From this summary it will become evident that over the past ten years progress has mainly been made in the understanding of how the brain regulates gastrointestinal functions and only little knowledge has been accumulated to improve the understanding of afferent information flow from the gut to the brain. PMID- 3296505 TI - [Value of liver transplantation--change in perspectives]. PMID- 3296506 TI - [Differential diagnosis and possibilities of conservative treatment of liver abscess]. PMID- 3296507 TI - [Lichen ruber planus--lupus erythematosus/overlap syndrome]. AB - Lichen planus/lupus erythematosus/overlap syndrome (OS) comprises those dermatoses which show the clinical, histologic, and immunopathologic characteristics of both diseases. On account of this heterogeneity, the diagnosis of OS may be difficult. About 35 cases have been reported on in the literature so far. We are going to discuss the clinical, histologic, and immunofluorescence findings in OS in detail. PMID- 3296508 TI - [Cold urticaria and purpura in cryoglobulinemia]. AB - Report on a female patient suffering from cold urticaria and cold purpura in cryoglobulinemia. The process of diagnosis and further clinical investigation (bithermotest) are described. PMID- 3296509 TI - [Cultivated epidermis as a skin replacement--improved technics using mesh silastic sheets]. AB - The cover of cutaneous wounds with cultured epidermis can be significantly improved by prior backing of the epithelium with meshed silastic sheets, whereas other materials, such as vaseline gauze, foam rubber etc., are not as satisfactory. Meshed silastic is affixed to the epithelium surface just before the enzymatic detachment from the culture flask is completed. Thus it protects the delicate epithelial membrane from injury during transplantation and helps to control its polar orientation. In addition, the silastic mesh prevents the graft, which initially does not possess any horny layer, from drying up and allows adequate drainage of wound secretions. Cultured epidermal grafts prepared by this method take very well (more than 90%) attaching to the wound bed quite firmly within a week. PMID- 3296510 TI - [The determination of creatinine--the Jaffe reaction 100 years later]. PMID- 3296511 TI - [Use of genetic technic procedures in the analysis of genetically induced diseases and their significance from the perspective of the development of laboratory diagnosis]. PMID- 3296512 TI - [Enzyme immunoassay in the detection of IgM rheumatoid factors]. PMID- 3296513 TI - [Prof. Karol Kapeller, D.Sc. on his 60th birthday]. PMID- 3296514 TI - [History of the development and consequences of biologizing world views in German medicine]. PMID- 3296515 TI - [Trends and new results in research on the status of medicine in Germany during the fascist dictatorship]. PMID- 3296517 TI - Surgical treatment of ureteroceles in childhood--a reappraisal. AB - For the treatment of ureteroceles several surgical procedures have been described. The results of surgical treatment of 21 ureteroceles in 19 children treated with various types of surgery are reported. Reviewing these results and some recent papers in the literature one can say that in small intravesical ureteroceles the preferred surgical technique should be as simple as possible. A transurethral inferior osteotomy, transurethral puncture, or partial excision of the ureterocele with remodeling of the intravesical ureter should be the procedure of choice. In case of a large intravesical ureterocele with a single kidney, total excision of the ureterocele and reimplantation of the ureter into the bladder has been recommended. In ectopic ureteroceles and intravesical ureteroceles with a duplex system, heminephrectomy with partial ureterectomy can be performed, as in most cases the upper pole is nonfunctioning and dysplasic. Because of the various types of ureterocele and associated anomalies it is advisable to make an individual plan for surgical treatment for each patient. PMID- 3296516 TI - [Thermal tolerance of yeasts and its ecological significance]. PMID- 3296518 TI - Xanthogranulomatous pyelonephritis in childhood: report on an unusual case. AB - A case of localised xanthogranulomatous pyelonephritis (XPN) in a 4-year-old female with an unusual radiological picture is reported. The young girl was suspected to have a liver tumour because of a hypervascularised area found by arteriography in the hepato-diaphragmatic region. Laparotomy disclosed a large mass in the upper pole of the right kidney which was adherent to the liver and to the diaphragm. Excision of the large mass including upper pole of the kidney was carried out. Recovery was uneventful. Pathological examination revealed the XPN disease pattern. PMID- 3296519 TI - [Ovarian pseudocysts in female newborn infants: prenatal ultrasonic diagnosis and surgical consequences]. AB - During the last year we diagnosed within the scope of preventive medical care of pregnant women in about the 30th pregnancy week, seven foetuses with abdominal cystic tumours by ultrasound examination. Postpartal ultrasound controls of the mature newborn confirmed the findings. After laparotomy we found ovarian pseudocysts with a volume up to 90 ccm. Histologically we could not identify ovarian tissue. In 66% of the cases we found small cysts on the contralateral ovary. Differential diagnosis and the possible complications must be considered. A laparotomy should be performed and only by high steroid serum level a conservative therapy with MPA should be considered. This is the case in premature newborn with an immature endocrine regulation mechanism. PMID- 3296520 TI - Paediatric anaesthesia--past, present and future. AB - On 27th August 1986, the 5th David Vervat Lecture was presented in Rotterdam by Professor emeritus Gordon Jackson Rees, M.B., Ch. B. (Liverpool). For his pioneering work Professor Jackson Rees may be called the father of paediatric anaesthesia, which is now conquering the world as a specialty of anaesthesia (Fig. 1). Mr. David Vervat is likewise a legend in his own lifetime for his pioneering work in paediatric surgery in the Netherlands, during which he felt so deeply the need for paediatric anaesthesia for his patients. As such this lecture represented a real tribute to David Vervat. PMID- 3296521 TI - [Intra-mobile cylinder implant system. Methods--clinical aspects--results]. PMID- 3296522 TI - [Is the osteointegration of dental implants dependent on the implant material?]. PMID- 3296523 TI - [Indications for dentures]. PMID- 3296524 TI - [Verification of various phosphate-bonded investing materials of standard design DIN 13919]. PMID- 3296525 TI - [Materials science study and utilization method studies in the practice readiness of an alginate impression paste]. PMID- 3296526 TI - [Concept of ceramic implants of polycrystalline aluminum oxide (Biolox)]. PMID- 3296527 TI - [Retention of anterior bridges of various constructions]. PMID- 3296528 TI - [Possibilities and long term results of use of Tubinger implants (Frialit)]. PMID- 3296529 TI - [14 years' experience with endosseous implants in dental practice]. PMID- 3296530 TI - [Recall of implant patients--significance and content of recalls as well as study results]. PMID- 3296531 TI - [Different indications for various implant systems]. PMID- 3296532 TI - [Melancholia and cancer: changes in the psychosomatic interpretation of cancer from the medico-historical viewpoint]. AB - Specialized literature and belles lettres have been dealing increasingly with psychographs and biographies of cancer victims for whom a psychopathological condition is assumed to have paved the way for illness. In support of this assumption, authors cite what is supposed to be an unbroken chain of reports on the relationship between melancholy and cancer since antiquity. The fact that the views of ancient medicine have little in common with current understanding of such key concepts as melancholy and hypochondria is revealed by comparing the explanations of these terms from different periods. "Melancholy", when defined as a risk factor in the development of cancer, comprehends the following: a psychosomatic syndrome, a particular personality type, mental suffering as a result of stress and strain, disturbances of personality of a depressive nature with echoes of a thymo-alexic syndrome. The evaluation of historical documented arguments in support of a theory of psychosomatic oncogenesis is designed to call attention to the danger of false interpretations on the one hand and to the need for critical examination of present-day utterances on the subject on the other. PMID- 3296533 TI - ["The overcoming of political parties by the youth"--an early political essay by Harald Schultz-Hencke]. AB - The presented paper shows an early publication of Harald Schultz-Hencke--one of the most disputed German psychoanalysts. It was written in 1921 and only recently rediscovered. Extraordinary political demands were listed such as a cut in working hours. PMID- 3296534 TI - [The determination of creatinine--the Jaffe reaction 100 years later. On the occasion of the 75th anniversary of the death of Max Jaffe, discoverer of the picric acid reaction of creatinine]. AB - In this article is called to mind that over 100 years ago Max Jaffe (1841-1911) for the first time described the picric acid reaction of creatinine, on which are based the at present performed methods of determination of this metabolic end product on the clinical diagnostics. A short biography of the researcher is given and his particular merits for biochemistry are appreciated in the light of the scientific subjects he dealt with. PMID- 3296535 TI - [A dentist in World War II. When the last machine departed, a horrible scene played itself out]. PMID- 3296536 TI - [Adhesives for the metal mounts of bonded bridges]. PMID- 3296537 TI - [An outsider to the profession presents: the history of dentistry and dental technology in pictures]. PMID- 3296538 TI - [Naturalism in literature makes toothache socially acceptable]. PMID- 3296539 TI - [Tisastift insures replantation]. PMID- 3296540 TI - [Dentalia: allegories of alienation, decay, protest and resignation]. PMID- 3296541 TI - [Abutment evaluation in fixed and combined dentures]. PMID- 3296542 TI - [Prevention of swelling with alph-intern: double blind study following surgical removal of the 3d molars]. PMID- 3296543 TI - [Coating of subperiosteal implants with glass-ceramics]. PMID- 3296544 TI - [Partial subperiosteal framework implants in the maxilla]. PMID- 3296545 TI - [Castable glass-ceramic--a new restoration technic]. PMID- 3296547 TI - [2-phase embedding in the histologic assessment of complete uncemented synthetic acetabuli]. AB - We describe a dual phase embedding method employing a routinely used methylmethacrylate mixture with a commercially available resin. Combination of both embedding materials provides fast and complete tissue penetration as well as the necessary hardness and stability for the consecutive grinding procedure. PMID- 3296548 TI - [Tooth extraction from the prosthetic viewpoint. Indications, contraindications, alternatives]. PMID- 3296546 TI - Granulomatous lung disease in children by aspiration of medications. AB - Post mortem examinations of 8 infants, 11 d to 5 months old and one 12 year old girl, demonstrated foreign bodies in the lungs which could be identified as orally administered drugs: cholestyramine (Questran) and phenobarbital (Luminal, Gardenal) or phenydantin-components. The microscopic changes caused by such deposits and the histologic methods of identifying medicines are presented. The authors point to the role of aspiration in deposit formation and to the pseudomiliary granulomatous nature of subsequent changes. It is proposed to define the alterations as a separate form of aspiratory lesion in children. PMID- 3296550 TI - [Experiences in the use of individually fabricated bonded brackets with the double-bar base]. PMID- 3296549 TI - [The work order as an information link between dentist and dental technician in regard to work regulations, professional work and management aspects in the optimization of prosthetic care]. PMID- 3296551 TI - [Guidelines for the individual arrangement of the anterior teeth in removable dentures]. PMID- 3296552 TI - [Experimental studies on changes in the design pattern of the Staegemann bridge]. PMID- 3296553 TI - [An extra-coronal attachment for non-precious alloys]. PMID- 3296555 TI - [Organ-saving therapy of epidermoid cysts of the spleen in childhood]. PMID- 3296554 TI - [Modification of the spectrum of neonatal surgery by prenatal diagnosis]. AB - Expansion of prenatal diagnosis will alter the spectrum of neonatal surgery. The ethos of the medical profession calls for decision in favour of the mother, whenever evidence can be produced to the effect that a severely damaged or nonviable foetus may endanger the health of the pregnant woman. Humanistically and legally warranted termination of pregnancy in such cases will reduce the number of severely malformed newborns on whom nothing can be done but palliative treatment. Early detection of foetal diseases will enable, on the other hand, well-timed preparation of acutely necessary life-saving interventions and will bring down the rate of emergency operations on newborns. PMID- 3296556 TI - [Sonography of the thyroid gland in surgery]. AB - 50 patients were sonographically examined by the surgeon prior to thyroidectomy. The sonographic findings were then compared with the intra-operative situation and with the goitre removed. Complete agreement was recorded from 80 per cent of the cases. Sonography was found to be superior to traditional thyroid diagnosis for its higher accuracy in indicating the positions of adenomas, cysts, and calcareous nodules as well as the relationship between goitre and vessels of the neck. PMID- 3296557 TI - [A rare bile duct injury]. PMID- 3296558 TI - [Surgical therapy of tumor-induced ileus of the large intestine]. AB - The principle of staged surgical approach to tumour-dependent colonic ileus is no longer justified in all situations. One single right-side hemicolectomy has proved to be superior to the staged approach in cases of colonic ileus on the right to transverse centre. Surgical treatment was applied to 22 patients with right colonic ileus, between 1983 and 1986. Seven of them died after surgery, including three of eight who had undergone palliative operations and four of 14 who had undergone radical surgery in one single session. Transversal colostomy as a first step of a staged approach has proved to be successful on patients with left colonic ileus, from transverse centre. It was found to be just as promising as one single approach. One single approach required intestinal evacuation, using a specific aseptic technique. Incontinence resection (Hartmann's operation) has proved to be an effective method. The majority of 31 patients with left colonic ileus underwent staged surgery. Hartmann's operation was performed on seven of them, and external defecation without resection was applied to 24. Twelve of them died after the first operation, including two after Hartmann's operation and ten of 23 after external defecation without tumour removal. PMID- 3296559 TI - [Hartmann incontinuity resection in emergency treatment of perforated sigmoid diverticulitis]. AB - Emergency operations were performed on 20 patients for perforated sigma diverticulitis with diffuse (n = 15) or locally delimited (n = 5) peritonitis, between 1979 and June 1986. The average age of the patients was 65.7 years. Sigma resection with closure of the rectosigmoid and colostomy, that is Hartmann's operation, was performed on all of them. The postoperative lethality was as high as 45 per cent (nine patients), but this was not attributable to complications for which the surgical method had to be blamed. Only one patient died of anastomosis dehiscence, following additional resection of part of the small intestine. All the other deaths (n = 8) had been caused by internal organic complications. Hence, lethality is believed to be controllable only by close cooperation from the very beginning between surgeon and specialist in intensive therapy. Re-anastomosis (generally three months from primary operation) can be simplified by means of mechanical staplers, with the risk being reduced to nearly nil. These are benefits that support the recommendation of Hartmann's operation as an emergency approach to perforated sigma diverticulitis. It can be performed even by the less experienced surgeon on night duty. PMID- 3296560 TI - [Our surgical heritage. Abulkasim--an important surgeon of the Middle Ages]. PMID- 3296561 TI - [The history of the treatment of asphyxia]. PMID- 3296562 TI - [Recommendations for the diagnosis and therapy of bacterial infections in premature and newborn infants]. AB - In a survey the authors present the most important facts of diagnostic and therapy of bacterial infections in term and preterm neonates. It is a synthesis of an extensive study of the literature and of own experiences. Besides microbiological diagnostic and antibacterial chemotherapy one can find also suggestions concerning hematological and chemical diagnostic methods as well as of parenteral and oral nutrition and immunotherapy. PMID- 3296564 TI - The significance of controls in Lyme arthritis of children. AB - In order to better define the specificity of Lyme disease (LD) seropositivity and seronegativity during a study of Lyme arthritis in a pediatric rheumatology population, three groups of controls are in the process of being developed. Children with other rheumatic disorders. Siblings and parents of children with Lyme arthritis. Individuals with intense environmental exposure to LD. Sera from each have been tested for antibody to Borrelia burgdorferi (Bb), by indirect immunofluorescence assay (IFA), enzyme linked immunosorbent assay (ELISA), or both. Of the 57 children with rheumatic disorders of whom 25 had JRA, 4 (7%) reached a border zone, non-specific level of 1:64 by IFA, and 53 sera were non reactive. 7 household relatives of LD cases had non-reactive sera. The 42 intensely Bb-exposed individuals all had non-reactive sera. The fact that none of the 106 controls attained a clinically significant level of antibody is a general indication of the specificity of the serologic tests. The use of selected control groups such as these might potentially solve the ambiguities in clinical laboratory correlations in Lyme arthritis. PMID- 3296563 TI - Early detection and persistence of antibodies to Borrelia burgdorferi in persons with Lyme disease. AB - An indirect immunofluorescence antibody (IFA) test and an enzyme-linked immunosorbent assay (ELISA) were used during 1984 to detect total immunoglobulins (Ig) or IgM and IgG antibodies to Borrelia burgdorferi. Of the 139 serum samples tested by IFA, representing 110 persons with erythema chronicum migrans (ECM), 84 (60%) had either or both class-specific immunoglobulins. Serologic confirmation was made for 64 (58%) patients; serum specimens from 54 (49%) of these had elevated levels of IgM antibodies. These immunoglobulins were usually present within 14 days after diagnosis of ECM and persisted for at least 30 days. Significant titers of IgG antibodies were recorded for 54 serum samples and remained elevated for at least 19 weeks after ECM was first observed. When utilizing polyvalent (Ig) conjugates, ELISA procedures verified antibody presence in 80 of the 84 serum samples positive by IFA. Similarly, samples negative in IFA tests were non-reactive by ELISA. Additional tests of 40 control samples, obtained from persons without Lyme disease, were also uniformly negative. Both methods were suitable for confirmation of Lyme disease infections. PMID- 3296565 TI - Antibodies against Borrelia burgdorferi in Bavarian forest workers. AB - The sera of 496 forest workers (fw), 44 customs officials and 20 other persons in outdoor professions from different areas of Bavaria were tested for antibodies against Borrelia burgdorferi (strain B 31) by indirect immunofluorescence. In sera previously absorbed with Treponema phagedenis ultrasonicate, significantly elevated IgG antibody titers were found in 69 cases, in 68 fw (13.7%) and 1 custom agent. In accordance with previous observations the distribution of positive results showed a distinct age dependance: under 24 years (y) 1.6% (n = 64), 25-34 y 0 (n = 30), 35-44 y 10.1% (n = 79), 45-54 y 17.4% (n = 190). Infections without manifest illness seem to predominate. In 1 area the number of positive persons was significantly higher than in the other: In Donauries near Illertissen 14 (45%) of 31 probands had elevated IgG titers. This area and the high level regions excepted, no significant differences were demonstrable amongst the 13 regions of Bavaria included in this investigation. PMID- 3296567 TI - Serodiagnostic of erythema chronicum migrans (Lyme disease) in cases initially suspected as caused by arboviruses. PMID- 3296566 TI - Serological diagnosis of Borrelia meningitis. AB - The antibody response against a Borrelia strain isolated from Swedish Ixodes ricinus ticks was determined by enzyme linked immunosorbent assay (ELISA) and indirect immunofluorescence assay (IFA) of cerebrospinal fluid (CSF) and serum specimens from 45 patients with chronic meningitis. Probable Borrelia etiology could be demonstrated in 41 of 45 (91%) patients with clinical symptoms of chronic meningitis. Approximately 25% of the patients had significantly elevated titer of antibody to the spirochete in CSF but not in serum. Patients with short duration of disease were especially prone to be antibody negative in serum but positive in CSF. Significant rise in serum antibody titers was seldom demonstrated in patients treated with antibiotics. PMID- 3296568 TI - Does Lyme borreliosis also occur in tropical and subtropical areas? PMID- 3296569 TI - Further studies on the use of Gal E mutants of Salmonella typhimurium in calves: oral vaccination and toxicity studies. PMID- 3296570 TI - [Aspergillosis in wild geese (Chloephaga poliocephala scl., 1857) in Chile]. PMID- 3296571 TI - Normal phallus flora of the gander. PMID- 3296572 TI - Assessment of the sensitivity and specificity of enzyme-linked immunosorbent assay (ELISA) for the detection of mycobacterial antibodies in bovine tuberculosis. PMID- 3296573 TI - [The development of experimental and clinical research on low-molecular RNA]. PMID- 3296574 TI - [The pool method for the isolation and signal identification of Yersinia]. AB - To study the ecology of Yersinia, culture media, the pool method and the algorithm for their isolation and identification are proposed. The correct selection of typical Yersinia colonies grown in special media is the major step. This permits the study of culture pools (their amount reaching 12 and more from each sample) and makes it expedient to use the economical dish method for obtaining pure cultures and identifying Yersinia by the minimal set of key signs. The use of these methods makes it possible to study a great number of cultures and to obtain valuable information on local Yersinia populations with the least expenditures. PMID- 3296575 TI - [Nonclostridial obligate anaerobes--the main causative agents of lung abscesses]. AB - The use of the anaerobic technique in bacteriological investigations has made it possible to establish the leading role of asporogenous anaerobes in the etiological structure of the causative agents of pulmonary abscesses. Asporogenous anaerobes have been isolated from 93% of all examined patients, and in 54.4% of such patients these microorganisms have proved to be an independent etiological factor. Among asporogenous anaerobes, the main causative agents of pulmonary abscesses have been found to belong to four genera: Bacteroides, Fusobacterium, Peptococcus and Peptostreptococcus. Pulmonary abscesses of purely aerobic etiology are rather rare (5.3%). The schemes of the antibacterial treatment of patients with pulmonary abscesses, developed with regard to the leading etiological role of asporogenous anaerobes and clinically approved, have permitted achieving a considerable improvement in the results of treatment and an essential economic effect. PMID- 3296576 TI - [Possible atypical course of tularemia (persistence) in the common vole Microtus arvalis Pall]. AB - The possibility of the atypical course of tularemia with the prolonged persistence of Francisella tularensis in common voles (M. arvalis), the twin species of East European voles (M. rossiaemeridionalis), was studied. Experiments were made on 33 animals grown in the laboratory. F. tularensis strain 165 was used. The animals were infected by feeding them according to the previously developed scheme. 7 out of 33 voles showed the atypical course of tularemia: in 3 voles the disease took a prolonged course with bacteriuria and death on days 25 34; 3 other voles with bacteriuria registered before days 33, 66 and 172 (the term of observation) survived. The surviving animals were killed on day 183, and the presence of bacteria in their organs and seroconversion were established. One vole excreted no bacteria with urine and had no bacteria in its organs (the animal was examined on day 156), but in its blood specific antibodies were detected. To determine bacteriuria, the immunofluorescence test was used together with biological assays. Thus, M. arvalis, like M. rossiaemeridionalis studied earlier, can harbor F. tularensis at the period between epizootics. When voles of the former species penetrate stacks of straw and hayricks, conditions appear for the transfer of the infection to the latter species, M. rossiaemeridionalis. Therefore, in the foci of the meadow-field type each of these two species of voles may be not only of epizootic, but also of epidemic importance. PMID- 3296578 TI - [Immunostimulant preparation made from the antigens of opportunistic microorganisms in the treatment of inflammatory lung diseases]. AB - The results of the trial of an immunostimulating preparation, consisting of Klebsiella pneumoniae, Proteus, Escherichia coli and Staphylococcus antigenic complexes, on 20 patients with acute pulmonary abscess and bronchiectasis are presented. The preparation was introduced subcutaneously in 5 injections. The preparation was found to have low reactogenicity, and in the course of immunotherapy the manifestations of systemic and local reactions became considerably less pronounced. Immunotherapy produced a good curative effect, objectively manifested by a decrease in coughing and in the amount of sputum gradually changing its character. After the fourth and fifth injections the patients no longer ejected purulent sputum. Fluoroscopic examination revealed a considerable decrease in the size of the pathological focus. The preparation stimulated immunological reactions, and immunization resulted in a considerable increase in the titer of antibodies to all components of the combined preparation, as well as in an increase in the number of functionally active T lymphocytes, in the blood of the patients. PMID- 3296577 TI - [Field trial of an immunoenzyme method using beta-lactamase as the monoclonal antibody marker for the capsular antigen of the plague microbe]. AB - Beta-lactamase (penicillinase) has been used as a marker of monoclonal antibodies in the enzyme immunoassay made with a view to the detection of Y. pestis capsular antigen and antibodies to it. The trial of the enzyme immunoassay with the use of the beta-lactamase conjugate in laboratories and under field conditions has revealed the advantage of this assay over hemagglutination tests commonly used for this purpose. PMID- 3296579 TI - [Quantitative characteristics of human antibodies to the peptidoglycans of different Staphylococcus species]. AB - The content of antibodies to peptidoglycans of 13 staphylococcal species was studied in the ELISA with the IgG fraction isolated from commercial human immunoglobulin. The content of antibodies to S. aureus peptidoglycan (calculated per mg of protein) was 3.0 micrograms and that of antibodies to peptidoglycans of other species amounted to 1.8-4.1 micrograms. The maximal value was obtained for S. xylosus and the minimal value, for S. lentus. No relationship between the content of antibodies to peptidoglycans and the degree of their antigenic affinity to S. aureus peptidoglycan was noted: the scatter of the values in species with relatively low and even minimal affinity did not exceed the range of variance in the group with a high degree of homology (2.2-2.4 micrograms). The production of antibodies to staphylococcal peptidoglycans was supposed to result from the action of a complex of antigenic determinants, both common and specific for each staphylococcal species. PMID- 3296580 TI - [Dynamics of bacterial polysensitization in acute dysentery in children depending on the species of the causative agent]. AB - Studies on polysensitization, evaluated by the neutrophil damage index, have been made with the use of dysenterin and the allergens of hemolytic staphylococci, enterococci and Escherichia coli. The studies have revealed that both specific and nonspecific sensitization to hemolytic staphylococci and enterococci is higher in dysentery caused by Shigella flexneri than in dysentery caused by S. sonnei and has the tendency to increase in the course of the disease. PMID- 3296581 TI - [Serological interactions and serological reactions]. PMID- 3296582 TI - [Toxin-mediated causality of infectious diseases]. PMID- 3296583 TI - [Imported cases of melioidosis and the epidemiological surveillance of its spread]. PMID- 3296584 TI - [Transformations of the traits of a population of the influenza type A virus via immunoselection]. PMID- 3296585 TI - [Systems approach to prognostic criteria for depression]. AB - In order to elucidate the prognostic criteria of depression in the structure of schizophrenia, manic-depressive psychosis, and psychogenias, the authors, using computer-based techniques, have identified groups of clinical symptoms of variable complexity (arbitrarily named as computerized syndromes) which determine the general outcome of the disease. Computerized syndromes of favourable and unfavourable prognosis with a high diagnostic accuracy can be used for individual prognosis. PMID- 3296586 TI - [Treatment of trigeminal neuralgia (review)]. PMID- 3296588 TI - [Use of iohexol for myelography]. PMID- 3296587 TI - [Combined surgical treatment of associated lesions of the major arteries of the head]. AB - Concurrent affection of the main arteries of the head is the cause of vascular cerebral insufficiency in more than half of the patients, which makes necessary combined operations on the extra- and intracranial arteries. The sequence of the operations is determined by the degree of the threat of occlusion of the stenosed artery or by the side on which the cerebrovascular insufficiency is manifested. Information on the regional cerebral blood flow and the results of ultrasonic dopplerography and computed tomography are additional criteria for determining the sequence and the terms of the operations. Experience in 61 combined operations allows the authors to consider them to be an effective method for the surgical management of concurrent affections of the main arteries of the head. PMID- 3296589 TI - Nasal sarcoidosis--a review and a case report. AB - The literature relating to the diagnostics and therapy of Boeck's sarcoidosis is reviewed. A patient with sarcoidotic alteration of the nasal mucosa is reported, and in connection with this case attention is drawn to the diagnostic importance of the otorhinolaryngological manifestations of the disease. For the treatment of sarcoidosis lasting administration of prednisolone in a single oral dose early in the morning every other day is recommended. PMID- 3296590 TI - [Royal Belgian Society of Surgery. List of members]. PMID- 3296591 TI - Imaging of splenic rupture. AB - Results from imaging of 30 splenic ruptures were analyzed. Radiography gave abnormal findings in 7/30 thoracic examinations and 8/19 plain abdominal films. Ultrasonography rarely revealed focal splenic lesions at primary examination, though intraperitoneal fluid was commonly found. Subsequently more focal changes were discovered, and none of the 19 examined patients ultimately had a normal ultrasonogram. There were focal splenic lesions in ten patients, subcapsular fluid in four and intraperitoneal fluid in 14. Computed tomography revealed abnormality in all ten studies patients--irregular splenic parenchyma in six, subcapsular fluid accumulation in five and intraperitoneal fluid in six cases. PMID- 3296592 TI - Proficiency testing in cytology laboratories in Ontario, Canada: a decade of experience. I. Introduction and description of the testing model. AB - There are few formally documented proficiency testing programs for cytology laboratories, and those that have been documented are not entirely comparable in format. The first of three papers documenting a mandatory universal proficiency testing program for cytology laboratories in the Province of Ontario, Canada, presents data on the structure and function of the participating laboratories (including a comparison of the data for 1974 and 1980) and on the organization of the testing model (including selection of terminology, construction and use of the survey and assessment of responses). In 1980, of the 463 medical laboratories in Ontario, 91 of 222 hospital laboratories and 65 of 216 nonhospital laboratories were licensed in cytology. In that year, the 156 cytology laboratories processed 1.48 million cytology specimens, 92% of which were gynecologic. Hospital laboratories processed 87.5% of the nongynecologic cytology specimens and 30% of the gynecologic cytology specimens. These proportions have been virtually constant for several years. Between 1974 and 1980, there was a trend in Ontario to fewer laboratories processing less than 5,000 cytology specimens per annum. Subsequent papers in this series describe the results of the initial surveys in this program and a precision study to evaluate the consistency of reporting by individual laboratories. PMID- 3296593 TI - Proficiency testing in cytology laboratories in Ontario, Canada: a decade of experience. II. Results of initial surveys. AB - The results of the initial surveys in the cytology proficiency testing of the medical laboratories in the Province of Ontario, Canada, showed a high correlation between the opinions of the testing committee and the participants in the categories of "no abnormal cells," "metaplasia" and forms of "benign atypia." The proportion of times that slides were tested in the categories of dysplasia and malignancy in the surveys increased from 38% by the end of survey 3 to 46% by the end of survey 5. A progressive improvement in the diagnostic accuracy was demonstrated in the categories of malignancy and severe dysplasia while results were more variable in the categories of moderate and mild dysplasia. Several educational activities were initiated following survey 3, including development and circulation of demonstration sets of marked glass slides for repeated circulation to participants as well as copies of a slide/tape presentation describing the program and specific case material. PMID- 3296594 TI - Proficiency testing in cytology laboratories in Ontario, Canada: a decade of experience. III. A precision study of consistency and reproducibility in cytology reporting. AB - The Ontario Laboratory Proficiency Testing Program's testing model and the results of early surveys of cytology laboratories have been previously described. To test consistency and accuracy, the same slides from one survey were recirculated to the same laboratory in the next survey. There was no statistical difference in either the accuracy or consistency in reporting by the various categories of personnel. Analysis of the data by category of diagnosis showed the reporting of "no abnormal cells" and "benign atypia" to be slightly more accurate and "moderate dysplasia" and "severe dysplasia" to be slightly less accurate than the reporting in other categories. Consistency in reporting appeared to be slightly less accurate in severe dysplasia than in the other categories. The analysis, which includes the results from all licensed cytology laboratories in Ontario, provides evidence that, in the reporting of cervical cytologic material, it is feasible to differentiate among the various categories within the spectrum of squamous epithelial abnormalities with a general level of accuracy and consistency that, although satisfactory, is not yet ideal. PMID- 3296595 TI - Decisive role of intermediate filament typing of tumor cells in the differential diagnosis of difficult fine needle aspirates. AB - Thirty-six diagnostically difficult fine needle aspirates from enlarged lymph nodes and malignant soft tissue tumors, containing tumor cells with scanty or no obvious light microscopic features indicative of their differentiation, were assessed by a panel of six cytopathologists. Their diagnoses were recorded and then compared with the definitive diagnosis established by combining the cytologic findings with the results of intermediate filament typing of tumor cells in the smears using monoclonal antibodies specific for each filament type. The results show that use of these antibodies can markedly improve the accuracy of the cytologic diagnosis of tumor type as well as revise or prevent erroneous cytologic diagnoses in difficult cases. This pertains especially to the differential diagnoses of carcinoma versus malignant lymphoma, carcinoma versus malignant melanoma, carcinoma versus sarcoma and squamous carcinoma versus carcinoma of simple epithelia. Intermediate filament typing of tumor cells in aspirates as an objective histogenetic criterium makes the differential diagnosis of the difficult aspirates much more reliable and reproducible, provided that appropriate questions are asked, monoclonal antibodies with well-defined specificities are used and the antigenicity of the intermediate filaments in smears is preserved. PMID- 3296596 TI - Cytodiagnosis of a spindle-cell tumor of the breast using antisera to epithelial membrane antigen. AB - A case of an unusual breast tumor is described in which the smear from a fine needle aspiration (FNA) biopsy caused difficulty in differentiating between a spindle-cell carcinoma and a sarcoma. The problem was resolved by the immunoperoxidase demonstration of epithelial membrane antigen (EMA) in the cells, thus enabling a definitive diagnosis of spindle-cell carcinoma to be made. This case further demonstrates the utility of demonstrating EMA in FNA specimens to distinguish between epithelial and nonepithelial neoplasms. PMID- 3296597 TI - Insulin, ketones, glucose and glucagon: effects on the arterial basement membrane in vitro. AB - The influence of insulin in physiological concentrations on basement membrane (BM)-like material from arterial smooth muscle cells was studied in cell cultures. BM-like material was isolated from the cell layer by a sonication differential centrifugation technique after a 24-h incubation period with insulin and [3H]leucine added to the culture medium. Insulin in concentrations of 50, 100, 200 and 500 mU/l was found to exert no influence on incorporation of amino acids into BM-like material. Neither glucose, 16 mmol/l, ketones, 1 mmol/l, nor glucagon 100 ng/l were able to induce altered accumulation of BM-like material. The effect of insulin on the carbohydrate units of BM-like material was studied by concanavalin A-Sepharose chromatography of glycopeptides and by analyses of neutral hexoses and amino sugars. The result showed that insulin, 200 mU/l, induced a shift in composition of neutral sugars by decreasing the amount of galactose relative to glucose and mannose. No changes in glycopeptide binding to the concanavalin A-sepharose column were observed. The results indicate that insulin induces only minor alterations in BM-like material of arterial smooth muscle cells and that the changes apparently are restricted to the carbohydrate units. PMID- 3296598 TI - Glucokinase in pancreatic B-cells and its inhibition by alloxan. AB - Characterization of glucokinase in pancreatic B-cells from ob/ob mice and from rat liver revealed identical characteristics. A narrow substrate specificity; high Km values for the two substrates, D-glucose and D-mannose, in the range of 10 and 20 mmol/l, respectively; higher Vmax values for D-glucose than for D mannose; inhibition of glucokinase activities by D-mannoheptulose and by a specific glucokinase antibody. These characteristics distinguish glucokinase in soluble cytoplasmic fractions of pancreatic B-cells and liver from low Km hexokinases. Alloxan is a pancreatic B-cell cytotoxic agent, which has been widely used as a tool for the elucidation of the mechanisms of insulin secretion, because its inhibitory action on insulin secretion has been presumed to be intimately related to the mechanism of glucose-induced insulin secretion. Alloxan inhibited glucokinase but not hexokinase activity in cytoplasmic fractions of pancreatic B-cells and liver. The half maximal inhibitory concentration of alloxan was 5 mumol/l. Glucokinase activity was protected from alloxan toxicity only by D-glucose and D-mannose; the alpha anomer of D-glucose provided significantly greater protection than the beta anomer. The non-metabolizable sugar 3-O-methyl-D-glucose did not provide protection of glucokinase activity against inhibition by alloxan. Thus, inhibition of pancreatic B-cell glucokinase may contribute to the inhibition of glucose-induced insulin secretion by alloxan. These results support the contention that glucokinase regulates the metabolic flux rate through the glycolytic chain in the pancreatic B-cell and thereby generates the signal for glucose-induced insulin secretion. PMID- 3296599 TI - Subcellular location of IGF-I in chondrocytes from rat rib growth plate. AB - Ultrathin cryosections of segments of growth plates from rat rib and isolated, gelatin-embedded chondrocytes from the same source were used to demonstrate the ultrastructural location of IGF-I in the different layers of the growth plate. Sections were incubated with a polyclonal rabbit antiserum to free IGF-I and colloidal gold coated with goat anti-rabbit IgGs. The gold label was present in all chondrocytes, localized almost exclusively to the cytoplasm. Particularly the cells in the proliferating zone displayed considerable amounts of gold label. In these cells, gold label was predominantly present over the rough endoplasmic reticulum and membrane bound vesicles, with only negligible gold label over the nuclei and cartilage matrix. The distribution of gold label in the chondrocytes from the proliferating zone, especially in the rough endoplasmic reticulum, strongly suggests that IGF-I can be synthesized by these cells. However, further studies are needed to verify whether there is a local synthesis of IGF-I in the chondrocytes and whether it is under control of growth hormone. PMID- 3296600 TI - Effect of transport stress on luteinizing hormone released by GnRH in dairy cows. AB - Stress is thought to reduce gonadotrophin secretion in ruminants. So far, only prolonged administration of ACTH or cortisol have been shown experimentally to reduce LH release. The present experiment studied the effects of an acutely stressful situation. Fifteen min after the start of a 30 min truck journey for dairy cows plasma cortisol values exceeded 55 nmol/l, as measured by RIA. Values began to decline 15-45 min after return to the barn and reached baseline (2.5 to 20 nmol/l) 1-2 h later. Responses to 20 or 40 micrograms GnRH administered on day 10 of the cycle, or 48 h after prostaglandin analogue, were significantly reduced on a within-animal basis when given during the truck journey. Hence acute endogenous stimulation of pituitary-adrenal activity can interfere with pituitary LH release. PMID- 3296601 TI - Effect of sham-feeding on glucose tolerance and insulin secretion. AB - Glucose, 25 g, was infused iv with or without sham-feeding in seven normal males. Sham-feeding improved glucose tolerance, incremental area of blood glucose being 63% (P less than 0.05) of that during iv glucose without sham-feeding. The actual insulin secretion evaluated from the total area under the C-peptide and insulin curves did not differ during iv glucose with or without sham-feeding. These results suggest that the cephalic-vagal reflex improves glucose tolerance during iv glucose, independent of changes in beta-cell function. PMID- 3296602 TI - [Hypereosinophilic syndrome: an etiologic or symptomatico-clinical concept?]. PMID- 3296603 TI - [Autologous blood transfusion: its role in hematologic therapy]. PMID- 3296604 TI - [In vitro purification of autologous bone marrow for removal of neoplastic and leukemic cells]. PMID- 3296605 TI - Benzodiazepines as oral premedication. A comparison between oxazepam, flunitrazepam and placebo. AB - Oxazepam 25 mg, flunitrazepam 1 mg and placebo were compared as oral premedication in 602 gynecological patients in a double-blind randomised parallel study. In 251 patients undergoing major surgery the same drug was also given as a hypnotic the night before the operation. Both active drugs shortened the sleep onset time, decreased the number of spontaneous awakenings at night and improved the quality of sleep when compared to placebo. The active drugs were significantly better than placebo as premedication when assessed by both the patients and the anesthesiologist. In 351 patients admitted for day-case minor surgery with no previous night medication, flunitrazepam was significantly better than placebo as premedication when assessed by both the patients and the anesthesiologist, while oxazepam was only better than placebo when judged by the anesthesiologist, not by the patients. PMID- 3296606 TI - Comparison between 0.5% bupivacaine with and without glucose in lumbar epidural block for knee surgery. AB - A double-blind study was performed in 41 patients (ASA I) to compare 0.5% bupivacaine with and without 8% glucose in epidural analgesia. There was no difference in the onset, spread, duration or intensity of the epidural anaesthesias. The absorption of bupivacaine to circulation was similar in both groups. No major complications were noted and the anaesthesias were satisfactory for surgery in all patients. PMID- 3296607 TI - Aminophylline reduces the depth and duration of sedation with barbiturates. AB - Aminophylline, an inhibitor of cyclic nucleotide phosphodiesterase, has for many years been used to relieve bronchospasm. Recent reports have shown that aminophylline antagonizes morphine and diazepam sedation. To see if aminophylline acts similarly on barbiturate sedation, we examined 24 women undergoing short general anaesthesia with thiopental (7 mg x kg-1), using a double-blind study design. Evaluated by continuous auditory reaction time measurements, aminophylline (5.6 mg x kg-1) reduces the depth and duration of sedation with thiopental. This suggests that aminophylline could be used to diminish an unwanted effect of barbiturate sedation. PMID- 3296608 TI - [Principles of medical treatment: objectives and recommendations]. PMID- 3296609 TI - [Combined treatments consisting of rifampicin in periodic doses: the experience in Niger]. PMID- 3296610 TI - [Indications for the use of lamprene in the treatment of leprosy]. PMID- 3296611 TI - [Recurrence and resistance in 1030 leprosy patients undergoing monotherapy with dapsone]. PMID- 3296612 TI - [5-year assessment of daily multi-drug therapy of leprosy in Guadeloupe since 1980]. AB - In Guadeloupe, from January 1980 to December 1984, 420 leprosy patients were put under daily multidrug therapy: 10 mg/kg RMP plus 100 mg DDS during six months for paucibacillary patients, 10 mg/kg RMP plus 100 mg DDS during 24 months supplemented during the 12 first months with 10 mg/kg of a thioamide, ethionamide or protionamide, for multibacillary patients. The approval to the treatment was satisfactory in all the patients with active leprosy, new cases and relapse cases, less in the inactive patients already treated with dapsone only. The patients's compliance to treatment was satisfactory too. The lepra reactions were observed with a 19% frequency which is not different of the 15% frequency of lepra reactions observed in patients treated with DDS only. Hepatitis were observed only in multibacillary patients treated with PTH and RMP with a 14% frequency. Discontinuing treatment with RMP and PTH but not DDS resulted in recovery. When RMP was resumed without PTH, the hepatitis did not recur. All patients responded favorably under multidrug therapy and no relapse was observed among the 45 paucibacillary patients after a four year-surveillance and among the 16 multibacillary patients after a three year-surveillance. PMID- 3296613 TI - [Multi-drug therapy trials for leprosy in Senegal: first observations relative to liver tolerance of multibacillary patients. Therapeutic consequences]. AB - The authors have studied tolerance of multibacillary patients to 4 MDT regimens. These 4 regimens consist of: One supervised part in which RMP-ETH combination in once-monthly administered; furthermore, in 2 of these regimens, is included one "starter phase" with daily doses of that combination for 2 months. One self administered part during which CLO is associated either to DDS for new cases, or to ETH for relapses. Clinical Supervision: Out to 310 multibacillary patients, 7 cases of hepatitis with or without icterus, but no death due to the treatment. Interruptions of MDT have been temporary and have been observed in 0.9 to 5.6% of the patients according to the therapeutic regimen. Checking SGOT: The SGOT were abnormally high in 16.3% of the patients before treatment. These pre-existing liver damages do not favour the appearance of intolerance disorders. During MDT, abnormal increases in SGOT are observed in 27% of the patients but there is no exact correlation between the absorbed doses of ETH and the frequency in SGOT increases. The clinical or biological evidence of liver damages occur rather early (1st, 2nd month) in regimens with "starter phase", and later (4th-8th month) in those without "starter phase". But introduction of "Starter phase" does not increase the global frequency of such intolerance accidents. ETH combined with RMP, must be used under steady clinical and biological supervision. Recalling the results of a previous survey, the authors consider that a long duration of MDT is not necessary. For the multibacillary leprosy treatment, they propose a diphasic regimen, more easily applicable in the field than the WHO protocols. In this diphasic regimen, the only part which must be supervised is the initial "starter phase" of 2 month. It consists of daily administration of 3 antibacillary drug among which RMP and ETH. The second phase is a relay treatment using 2 drugs, CLO combined with DDS or ETH, self-administered until smear negativity. PMID- 3296614 TI - [Efficacy of combined treatments comprising 6 months' administration of rifampicin in multibacillary leprosy]. AB - Ten patients infected with mouse proven DDS-resistant bacilli were treated with the following combined regimen: RMP 600 2/7 6 months, ETH 500 7/7 6 months and DDS 100 7/7 12 months. Follow up was for 27-54 months, without relapses. Added to patients from previous study (Int. J. Lepr. 1984, 52, 297-303) the 95% confidence limit decreases from 12 to 9%. PMID- 3296615 TI - [Comparison of 3 therapeutic regimens in paucibacillary leprosy. Preliminary note]. AB - Between 1980 et 1983 all PB patients presenting at the Institut Marchoux, Bamako, took part in a prospective randomized therapeutic trial and were allocated to one of the following regimens: DDS 100 mg 7/7 3 years, RMP 900 mg 1/7 8 doses, RMP 900 mg 7/7 12 doses. At this moment 24, 29 and 22 patients respectively have been followed for periods of 24 to 56 months. With the exception of some irregular drug intake in the DDS patients followed either by relapse or delay in improvement, the efficacity as judged by histopathological examinations did not reveal any difference between the regimens. The study continues. PMID- 3296616 TI - [A new plan in the campaign against leprosy in Anjouan. Preliminary results]. AB - Treatment of PB leprosy patients with 10 weekly doses of RMP 600 mg gave a cure rate of 88% or more at 3 years as judged by histopathology. There were no severe neurological complications. The future will show if this regimen also prevents relapses. In MB leprosy a 2 months regimen of daily RMP, ETH, DDS followed by 10 months of daily ETH, DDS with weekly RMP gave excellent clinical and bacteriological results. There were no relapses during 2 and 3 years after the end of therapy among 111 newly diagnosed and previously treated patients (95% confidence interval 3.3%) of whom 67 were new patients (95% confidence interval 5.3%). The hepatotoxicity of this regimen has to be followed closely. The results illustrate the possibility to cure MB leprosy by a treatment of finite duration. PMID- 3296617 TI - [Summary assessment of the research activities at the Marchoux Institute in Bamako]. PMID- 3296618 TI - [Clinical and bacteriological assessment 8 years after triple-drug therapy for multibacillary leprosy in Senegal]. AB - Increasing resistance to dapsone (DDS) leads to recommend triple drug chemotherapy (TCT) in multibacillary leprosy (ML). To determinate long term evolution, we evaluated patients who received TCT 8 years ago. Between 1974 and 1976, 30 patients with ML received TCT (rifampicin, prothionamid, and DDS) during 6 or 12 months. At this time satisfactory clinical and bacteriological findings were reported, and from then DDS was given alone. Twelve of the thirty patients have been evaluated in 1983. Six patients had bacteriological index greater than or equal to 2+, three of them had clinical relapse. Seven of the twelve patients did not take regularly DDS; the six relapses belong to this group. PMID- 3296619 TI - [Principle findings connected with the problems of implementing the multi-drug therapy for leprosy in West Africa]. AB - The Implementation of Multidrug Therapy (MDT) in the states of West Africa oblige to analyse new restraints, in order to modify the existing health structures. The planning of Hansen's programs based on MDT needs to consider the technical and logistic parameters. Solutions are proposed for health workers training course, flow chart, drug supply system and supervision system. The advocated method uses at the existing resources, and aims at the integration into general health services, reinforced by specialized teams. PMID- 3296620 TI - [Practical problems encountered in the multi-drug therapy of leprosy in Senegal]. AB - The authors make an inventory of the difficulties they have met while realizing the different stages of MDT treatment programmes in Senegal. Main problems were: Necessity of complementary training on theoretical, but even more on practical techniques for all the staff: Ridley and Jopling classification, neurological examination, bacteriological examination, data collection. Difficulty to maintain a true supervision. Necessity to settle a quality control of slit skin smears. Necessity to settle a system to trace irregular patients. Heaviness of centralized management, but its necessity to maintain "tightness" of the drugs distribution network. Difficulty to obtain a regular follow up of patients who are released for treatment. The evolution of anti-leprosy activities makes it necessary to adapt the "Service des Grandes Endemies". PMID- 3296621 TI - [How we have ensured the proper taking of medication in a multi-drug therapy program in Vietnam]. PMID- 3296622 TI - [Inadequate treatment in multibacillary leprosy and incubation times for relapses]. AB - Among a population of over 500 PB patients treated with different regimens, 6 multibacillary relapses were detected: 5 in patients erroneously classified as PB but in reality MB with a low bacterial load, one patient was PB at the start. Treatment regimens had been: 10 weekly doses of RMP either 600 mg (1 case) or 900 mg (1 case) two successive doses of RMP 1500 mg (1 case) a single dose of RMP 40 mg/K (3 cases). Four MB patients with proven DDS-R relapsed after a single dose of RMP either 20 mg/K (1 case) or 40 mg/K (3 cases). The two strains isolated were RMP sensitive. Seven of the 10 relapses appeared within 24 months after start of treatment. PMID- 3296623 TI - [Histological progression of paucibacillary leprosy during treatment with various therapeutic regimens]. AB - Histopathological examination of skin biopsies from PB patients during the first 12-18 months of treatment did not reveal any significant difference in the time necessary for disappearance of the lesions. The regimens studied were: DDS 100 mg 7/7, RMP 600 mg 1/30 6x, RMP 600 mg 6/6 6x, RMP 900 mg 1/7 8x and 12x, RMP 1500 mg 1x and 1 year of DDS, RMP 4 mg/K 1x. PMID- 3296624 TI - Organic brain syndrome treated with oxiracetam. A double-blind randomized controlled trial. AB - In a 12-week double-blind study, oxiracetam (CGP 21690 E), a new nootropic drug, at a dose of 2.4 mg per day, was compared to placebo in the treatment of 106 middle-aged patients suffering from mild to moderate organic brain syndrome due to prolonged exposure to organic solvents. At the beginning of the study and after 12 weeks treatment, the patients underwent a battery of neuropsychological tests to determine their mental and memory functioning. A symptom questionnaire consisting of 21 items was rated pre-treatment, and improvement or worsening of any of the symptoms recorded monthly. At the end of the study a global evaluation was performed by the patients themselves, their relatives, the psychologist and the doctor. The code was not broken until the final writing of this paper. No statistically significant differences were observed between the treatment groups in any of the above-mentioned evaluations; neither were any differences in the neuropsychological tests performance observed. Thus, oxiracetam seems to have no effect in the treatment of organic brain syndrome. PMID- 3296625 TI - Growth hormone treatment in girls with Turner's syndrome. A review of the literature. AB - Most girls with Turner's syndrome seemed to increase their growth rate during the first year of growth hormone treatment. The gain is rarely more than 3 cm/year. In 3 studies the combination of growth hormone and an anabolic steroid resulted in higher growth rates compared to those with each individual compound. The results of long-term treatment (more than one year) also appear to be positive. The impact of growth hormone therapy on final height has not yet been established, however. PMID- 3296626 TI - The effects of intermittent positive pressure ventilation on cerebral arterial and venous blood velocities in the newborn infant. AB - Cerebral arterial and venous blood velocities were measured using pulsed Doppler ultrasound in 25 newborn infants requiring intermittent positive pressure ventilation (IPPV). The aim was to investigate whether these velocities altered in relation to the peak inflation pressure (PIP) used. Continuous recordings were made on the superior sagittal sinus and an intracranial artery both at the clinically prescribed PIP, and while this was altered in steps. A majority of the infants had, at some stage of their illness, variations in their venous and arterial velocities in phase with IPPV and related to the PIP used. These variations could be reduced by lowering the PIP. This was done in 5 infants whilst we were still able to maintain adequate ventilation. PMID- 3296628 TI - Short-term effect of low and high protein intake on renal function in children with renal disease. AB - The short-term effect of different levels of protein intake on renal function was investigated in 18 children with moderately (51-85 ml/min/1.73 m2 BSA) or severely (9-50 ml/min/1.73 m2 BSA) reduced glomerular filtration rates (GFR). The GFR and effective renal plasma flow (ERPF), estimated as the clearances of respectively inulin and para-aminohippuric acid during uncontrolled (2-2.5 g/kg bw), low (1.2 g/kg bw for 12 days) and high (3-5 g/kg bw for 24 h) protein intake were determined by a standard clearance method employing continuous infusion and spontaneous voiding. There were no significant differences in GFR or ERPF during uncontrolled and low protein intake. During high protein intake the GFR and ERPF increased significantly in patients with GFRs above 50 ml/min/1.73 m2 BSA and ERPFs above 150 ml/min/1.73 m2 BSA. It is concluded that these findings might indicate a functional reserve capacity in children with only moderately reduced renal function. PMID- 3296627 TI - Elevation of cerebrospinal fluid sialic acid concentration in children with central nervous system leukemia. AB - We studied sialic acid in the cerebrospinal fluid (CSF) of 52 children with leukemia and 51 children with non-leukemic diseases. The CSF sialic acid concentration in the children with central nervous system (CNS) leukemia was significantly higher than that in the children with acute lymphoblastic leukemia without CNS involvement, acute non-lymphocytic leukemia without CNS involvement, non-hemopoietic diseases, non-suppurative meningitis, epilepsy, and other neurologic diseases. Serial determinations revealed a rapid decline in the CSF sialic acid concentrations in the patients with CNS leukemia who responded well to the therapy and who were free from relapse of CNS leukemia. The simultaneously determined CSF beta 2 microglobulin concentration did not show any significant changes. These results suggest that the CSF sialic acid may be a good indicator of CNS leukemia. PMID- 3296630 TI - High sodium rehydration solutions in well-nourished outpatients. AB - We studied the safety and efficacy of high-sodium oral rehydration solution in the out-patient management of children with diarrhea, with or without dehydration. We studied 68 outpatients with acute diarrhea; 32% had mild-to moderate dehydration; the rest were not dehydrated. They were treated at home for 24 h with either high-sodium (90 mmol/l) or low-sodium (30 mmol/l) solution. None of the patients given high-sodium solution became hypernatremic. Of those patients who were dehydrated, 55% did not take enough fluid at home to repair their dehydration. We conclude that patients must be closely supervised for the initial rehydration period, but that high-sodium rehydration solutions can be safely given to outpatients for up to 24 hours. PMID- 3296629 TI - A comparative trial of rapid oral and intravenous rehydration in acute diarrhoea. AB - 37 children under the age of 5 years hospitalized for acute diarrhoea and dehydration were randomized to receive oral or intravenous rehydration during 6 to 12 hours. Rehydration was satisfactory in both groups, with correction of dehydration, metabolic acidosis and sodium deficit at equal rates. The reintroduction of normal feedings was successful in most of the orally rehydrated children after 12 hours, but often unsuccessful in the i.v. therapy group. Consequently the orally rehydrated children showed a 2.9% weight gain by the time of discharge whereas the intravenously treated children did not gain weight in the hospital. The duration of diarrhoea was also shorter in the orally rehydrated children. Thus oral rehydration therapy was equal or superior to even rapid intravenous rehydration therapy in the management of acute diarrhoea in children. PMID- 3296631 TI - Haemophilus influenzae and genital tract infections in children. PMID- 3296632 TI - Human growth hormone produced with recombinant DNA technology: development and production. AB - The molecular basis of recombinant DNA technology is described, and the principles of genetically engineered proteins developed. The production of hGH by such methods utilizes a strain of Escherichia coli as host and a vector plasmid containing the appropriate information. Fermentation and purification of the hGH produced gives a preparation of high purity, containing only 1-2 ppm of E. coli polypeptide (ECP). This somatrem (Somatonorm) is identical to pituitary hGH except for an additional methionine residue at the N-terminal. Monoclonal antibodies fail to distinguish between pituitary hGH and somatrem. Preclinical studies of a variety of pharmacological and toxicological parameters indicate that the two hGH preparations have identical biological effects; no toxicological or mutagenic effects of somatrem have been detected. PMID- 3296633 TI - Pituitary growth hormone and Creutzfeldt-Jakob disease. PMID- 3296634 TI - Treatment of pituitary dwarfism with biosynthetic growth hormone. AB - Over 3 1/2 years, 54 previously untreated hypopituitary children were enrolled in three studies; 48 had idiopathic pituitary dwarfism. Three preparations of somatrem were used (SI, SII, Somatonorm). Growth velocities on all three preparations were similar, though SI and SII tended to produce slightly higher growth velocities. Serum somatomedin and alkaline phosphatase levels increased during treatment. Antibodies to Escherichia coli polypeptide (ECP) increased to a maximum Z score of about 0.7 with SI, but this was considerably lower with SII and below 0.1 with Somatonorm. Anti-hGH antibodies had the highest titre in children treated with SI and these antibodies also had quite high binding capacities. Anti-hGH antibody formation was negligible during Somatonorm treatment. PMID- 3296636 TI - Clinical experience of somatrem: UK preliminary report. AB - A total of 63 patients with hGH deficiency were recruited, of whom 59 are evaluable. Somatrem (Somatonorm), 4 IU three times/week, was given either subcutaneously or intramuscularly. Height velocity increased from a mean of 4.7 +/- 2.1 cm/year before therapy to 8.2 +/- 2.6 cm/year in the 15 patients who have been followed for 1 year. In patients with isolated hGH deficiency height velocity increased similarly to the whole group, but in those with multiple pituitary hormone deficiencies the pretreatment and on-treatment growth velocities were lower. Of four children who had previously received spinal irradiation, three experienced only a small increase in height velocity on Somatonorm treatment; the fourth showed a considerable increase in height velocity. Anti-hGH antibodies were present in about 80% of the children tested after 12 months of treatment, but the titres and binding capacities were low. Anti-ECP antibodies were also detected, but again the titres were low, and 39% of the children tested had anti-ECP antibodies before treatment commenced. PMID- 3296635 TI - Clinical experience with somatrem in Japan. AB - A total of 62 patients with pituitary dwarfism were treated with three different preparations of human growth hormone (hGH) produced by recombinant DNA technology (somatrem). They were given somatrem, 0.5 IU/kg body weight/week for 3-14 months. Their height velocity increased from 3.5 +/- 0.9 to 8.2 +/- 1.7 cm/year (mean +/- SEM) during treatment. There were no significant changes in physical, blood and urine examinations. Anti-hGH antibody was observed in 39 of 62 patients (62.9%) at the end of 3 months of treatment with three different preparations of somatrem and in 16 of 21 patients (76.2%) at the end of 12 months of treatment with highly purified Somatonorm. The presence of antibody to hGH did not affect the growth rate in 48 of 49 hGH deficient children who had measurable antibody. PMID- 3296637 TI - Clinical experience with Somatonorm. AB - A total of 21 patients with hGH deficiency was included in a double-blind, randomized, comparative multicentre trial of somatrem (Somatonorm) and pituitary hGH. Owing to the withdrawal of the latter product, only 6 months follow-up can be evaluated. Growth velocities on both preparations were similar, and patients with complete hGH deficiency responded better than those with only partial deficiency. No specific side-effects were noted, but antibodies to hGH were noted in two patients on Somatonorm. Antibodies to Escherichia coli polypeptide (ECP) were found in both groups. In an open study of 14 children treated with Somatonorm, growth velocity increased from a mean of 3.26 +/- 0.42 cm/year to 7.1 +/- 0.47 cm/year during the 1 year of follow-up; in this time, bone age increased by 10 months. No clinical or biological abnormalities were detected, though 50% of the children developed anti-hGH antibodies and 13 out of 14 developed Z scores greater than 0.1 for ECP antibodies, compared with 5 out of 14 before treatment. PMID- 3296639 TI - Experiences of Somatonorm in Sweden. AB - About 180 patients in Sweden are currently receiving treatment with somatrem; a majority of them have previously received pituitary hGH. A high incidence of antibody formation was noted in patients without prior pituitary hGH treatment, but growth velocity was not decreased in these patients. Antibodies developed in about 15% of patients previously treated with pituitary hGH. Adverse effects occurred in four patients within 3 weeks of commencing therapy, but were temporary and treatment could be continued. PMID- 3296640 TI - Growth hormone treatment in short children. AB - A study of 31 children with short stature was initiated in 1982. They received subcutaneous injections of pituitary hGH, 0.1 IU/kg/day; no adverse effects were seen and none of the patients acquired antibodies. Only the results of the first year are presented, as final height has not yet been attained. A high growth response was seen in 29 of the 31 children; they experienced an initial rise of IGF-1, IGF-2, alkaline phosphatase and procollagen III. The best response was obtained in the child with the lowest levels of endogenous pulsatile hGH secretion. PMID- 3296638 TI - Clinical experience with somatrem in growth hormone deficiency. AB - Three studies of human growth hormone (hGH) in hGH deficiency were initiated. In the first of these, adolescent patients were switched from pituitary hGH to somatrem (SI preparation) for 1 month. No significant differences were noted in any of the clinical parameters measured during treatment with either preparation. In the second study, nine patients (six of them naive) were treated with somatrem (SII preparation) for 9-12 months. The naive patients exhibited catch-up growth, and bone age developed in parallel to chronological age during the study period. Somatomedin activity increased and correlated positively with growth. Antibodies to hGH and Escherichia coli polypeptide (ECP) developed in some patients, but titres and binding capacities were low. In the third study, 21 patients are currently being treated with Somatonorm; the first 3-6 months are evaluable. Growth velocities increased to normal values. Antibodies to hGH and ECP were present in several patients, but again the titres and binding capacities were low, and Somatonorm was less antigenic than the SI and SII preparations. PMID- 3296641 TI - Treatment by hGH of constitutional delay of growth and adolescence. AB - In constitutional delay of growth and adolescence (CDGA), all growth and maturation parameters are delayed by 2-4 years. Provocation tests of hGH secretion give normal values, but spontaneous (endogenous) secretion is low. This can be assessed by measuring night-time hGH secretion, when the differences between normal subjects and CDGA patients are highly significant. Replacement therapy with hGH produced growth spurts in all but one patient, improving their growth prognosis. A new series of 16 CDGA patients has now been treated with hGH for 1-3 years. Catch-up growth was seen during the first year, which decreased to normal growth velocity by the third year. This normal growth rate is still faster than the pretreatment velocity. Although hGH therapy may be effective in CDGA, it may only be justified in cases with psychological problems arising from their short stature. PMID- 3296642 TI - Clinical experience with authentic recombinant human growth hormone. AB - Studies of authentic recombinant human growth hormone (rhGH) began very recently in Germany. In this study, one group of patients with hGH deficiency is naive (no previous hGH treatment), and the second group has been treated with pituitary hGH. The mean age of diagnosis of 17 naive patients so far accepted is about 8 years; patients who have previously received pituitary hGH are older and slightly taller. No other data are yet available for analysis. PMID- 3296643 TI - Current clinical trials with authentic recombinant human growth hormone in Japan. AB - Daily injections of methionine-free, recombinant hGH (rhGH), 8 IU, were administered in six healthy volunteers. Non-esterified fatty acid levels increased significantly from 0.45 +/- 0.06 to 1.08 +/- 0.05 mEq/litre (mean +/- SEM) at 4 hours after the first injection of rhGH (p less than 0.001). Plasma IGF 1 levels increased significantly at 24 hours after each of the four daily injections of rhGH (basal, 0.80 +/- 0.06 units/ml; 24 hours, 1.72 +/- 0.21 units/ml; 48 hours, 3.22 +/- 0.42 units/ml; 72 hours, 3.17 +/- 0.49 units/ml; 96 hours, 3.63 +/- 0.32 units/ml; p less than 0.001). Eleven patients with hGH deficiency were treated with rhGH, 0.5 IU/kg/week for 3 months. Their heights increased by between 1.1 cm and 4.1 cm during the 3 months of treatment, which was calculated to be equivalent to 4.4-16.4 cm/year, with a mean height velocity of 8.6 +/- 1.1 cm/year. Anti-hGH antibody was observed in one patient treated with rhGH and had a titre of 10. PMID- 3296645 TI - Intracranial Doppler flow velocimetry compared with extracranial carotid blood flow measurements. AB - The effects of changes in carotid blood flow on intracranial blood flow velocities were examined in six newborn lambs under general anesthesia. Carotid blood flow was measured using electromagnetic flow cuffs. A combined continuous and pulsed Doppler instrument was used to measure intracranial blood flow velocities on the base of the skull through artificially created fontanels. Baseline carotid blood flow was 96 +/- 18 ml X min-1 (mean +/- SD) and increased by 58 +/- 13% following contralateral occlusion. A close correlation between changes in carotid blood flow and intracranial blood flow velocity was found (y = -6.28 + 3.72x, Sy = 182.3, Sy/x = 0.30, r = 0.89, p less than 0.001). The closest estimate of changes in blood flow to the brain was the temporal mean of the cross sectional average velocity. PMID- 3296644 TI - Gaucher disease--Norrbottnian type (III). Neuropaediatric and neurobiological aspects of clinical patterns and treatment. AB - This investigation was undertaken to study the clinical manifestations, development and course of the Norrbottnian type of Gaucher disease--a type III variant--with emphasis on central nervous system symptomatology and function, to correlate clinical signs with laboratory, neuropathological and biochemical findings, to evaluate effects of splenectomy on the course and severity of the disease and to investigate the effect of bone marrow transplantation. Clinical methods applied were neuropaediatric follow-up examinations, psychometric tests and motor age tests. Conventional neurophysiological, haematological and clinico chemical methods were used. The investigation comprised 22 patients, 10 girls and 12 boys, in all of whom the clinical diagnosis was confirmed by enzymatic tests. The median age at diagnosis was 1.9 years. The clinical pattern at diagnosis was usually that of an alert child with normal intelligence, short stature, splenomegaly, a tendency to bleeding and ocular manifestations. The course was slowly progressive but varied considerably between patients. The median age at death in a representative group of patients was 11.8 years. Early motor development was delayed in the lower limbs but normal in the upper. Eight patients later developed ataxia and six patients signs of mild spastic paraparesis which usually appeared many years after splenectomy. IQ tended to decrease with age. Early splenectomy resulted in lower IQ scores than late splenectomy. With progression of the disease, EEG abnormalities became increasingly frequent, more markedly among splenectomized patients. Thirteen patients had abducens nerve weakness and ten had age dependent abnormalities of horizontal gaze. Retinal infiltrates were characteristic, mainly among splenectomized patients. At, autopsy, Gaucher cell accumulations were found in the adventitia of brain venules, most frequently in cerebral and cerebellar subcortical white matter. Intraneuronal storage of glucosylceramide was observed. The highest concentrations of glucosylceramide were in the cerebellum and cerebral subcortical white matter of splenectomized patients. The fatty acid composition of glucosylceramide from these regions indicated an extracerebral origin in splenectomized patients, but mainly cerebral in nonsplenectomized. Psychosine was found, the highest concentrations in cerebral and cerebellar cortex. Bone marrow transplantation was performed in a nine-year old girl. A three-year follow-up showed very encouraging results both biochemically and clinically. The Norrbottnian type of Gaucher disease is a well defined nosological entity with a characteristic course and clinical manifestations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3296646 TI - Reproducibility of intracranial Doppler flow velocimetry. AB - Doppler velocimetry for assessment of flow in deep cerebral arteries was investigated in 9 term and 11 preterm healthy infants. A combined range gated and continuous wave Doppler instrument was used. A satisfactory reproducibility was found with a variation coefficient of 8-10% between repeated measurements. No systematic difference between examiners or head positions was recorded. The term infants had significantly higher mean flow velocities, 21.1 (3.1) cm/s (mean and 1 SD), compared to the preterm infants', 15.1 (3.6) cm/s (p less than 0.01). Both systolic and diastolic flow velocities were higher in the term infants, whereas the pulsatility index was higher in the preterm infants. Recordings from the intracranial part of the internal carotid arteries were found to be easy to obtain with a satisfactory reproducibility. PMID- 3296648 TI - Acid and alkaline Campylobacter extracts in the demonstration of antibody response in hyperimmunized rabbits. AB - Acid and alkaline extracts from several Campylobacter strains were used as antigens in enzyme immunoassay (EIA). Antibodies were detected in rabbits immunized with formalin-treated, boiled, or autoclaved whole bacteria of different Campylobacter subspecies. For the preparation of the extracts, three Campylobacter fetus subsp. venerealis strains, three Campylobacter fetus subsp. fetus strains, four Campylobacter coli, and five Campylobacter jejuni strains were used. The acid extracts of Campylobacter fetus subsp. fetus and Campylobacter fetus subsp. venerealis were antigenically similar to each other but different from Campylobacter coli and Campylobacter jejuni strains. These acid extracts were found to be suitable antigens in enzyme immunoassay. However, when alkaline extracts were used as the antigen, fewer antisera reacted with them than with the acid extracts, and many pre-immune sera gave high values. PMID- 3296647 TI - Ductus closure in preterm infants. Effects on cerebral hemodynamics. AB - Intracranial arterial blood flow velocities were studied before and after ductus closure by surgery (n = 8) and indomethacin (n = 10) in very low birth weight infants. Blood flow velocities were measured non-invasively through the fontanel with a pulsed Doppler velocimeter. Ligation of the ductus was associated with a 62% increase in mean flow velocity 24 hours after surgery, mainly secondary to increased diastolic flow velocity. Indomethacin (0.2 mg/kg i.v.) induction of ductus constriction was associated with a 36% decrease of mean flow velocity one hour after administration. At 24 hours, the intracranial blood flow velocity had returned to the pretreatment level but was still significantly lower than after ligation. Ductus closure is associated with marked changes in cerebral hemodynamics. Ligation causes increased arterial blood flow velocities and indomethacin administration seems to reduce blood flow velocities to the brain. PMID- 3296649 TI - Anti-HIV seroconversion: initial appearance of antibodies to core proteins and rapid raise in antibody levels. Case report. AB - Anti-HIV seroconversion was recorded in a patient by means of Western blot, immunofluorescence and ELISA analysis on sera taken at one to five day intervals. Seroconversion was first detected in the Western blot by antibodies to p15 and p24 and was followed by a rapid increase in levels of antibodies during the following days and weeks. PMID- 3296650 TI - Colonization, diarrhoea and protective immunogenicity of a CFA-deficient, enterotoxin-producing Escherichia coli mutant in a non-ligated intestine experimental model. AB - A colonization factor antigen (CFA)-deficient mutant has been isolated that is as efficient as the CFA/I-carrying, enterotoxin-producing E. coli strain it was derived from in producing diarrhoea and colonizing the intestine in a rabbit non ligated intestine model, the RITARD model. Infection with 10(11) mutant bacteria induced diarrhoea in 15 of the 17 rabbits challenged; corresponding diarrhoeal attack rates after challenge with similar doses of the original CFA/I-positive strain and of a non-enterotoxinogenic, non-CFA control strain were 23/24 and 0/15, respectively. Whereas the mean time of excreting the challenge strain in faeces did not differ between the mutant and the CFA/I-positive strain (4.5 and 4.3 days, respectively), it was significantly longer (p less than 0.05) than for the control strain (2.5 days). Similarly, the magnitude of the serum antibody responses to homologous O-antigen was equally high after infection with the mutant and the CFA/I-positive strain and considerably higher than after challenge with the negative control strain. An initial infection in the RITARD model with the CFA-deficient mutant offered highly significant protection against diarrhoea (p less than 0.001) as well as colonization (p less than 0.01) on subsequent challenge with the original CFA/I-positive strain. No significant protection, either against colonization or disease, was induced by initial infection with a similar dose of the control strain. PMID- 3296651 TI - Chlamydia trachomatis immunotypes in Finland. AB - The distribution of different immunotypes of Chlamydia trachomatis in Finland was studied in the micro-immunofluorescence test by typing 51 isolates with immune sera produced in mice and by testing human sera from 397 individuals with various clinical diagnoses, mostly sexually-transmitted diseases. The immunotypes of the isolates as well the antibodies found were, in decreasing prevalence, BED, GF, CJ, K, H, and I. PMID- 3296652 TI - Toxic effects of lipopolysaccharide from Bacteroides intermedius and Escherichia coli assessed in the pre-implantation mouse embryo culture system. AB - A comparative study on the toxic effects of endotoxin (lipopolysaccharide, LPS) from the strictly anaerobic Bacteroides intermedius BM1 and from Escherichia coli 055 was performed. Pre-implantation mouse embryos at the 2-cell stage from LPS responder (C57BL/6J) and low responder (C3H/Hej) mouse strains were exposed to the endotoxins, and development was observed during 72 h in vitro. Toxic effects of both endotoxins on embryos from both mouse strains were demonstrated. B. intermedius LPS was less toxic than E. coli LPS. The C3H/Hej embryos were more susceptible to endotoxins than the C57BL/6J embryos. A biphasic dose-response relationship was observed, as 100 micrograms/ml LPS was less embryotoxic than 1, 10 or 500 micrograms/ml, suggesting more complex mechanisms of effect than non specific cell toxicity. PMID- 3296653 TI - Detection of group A streptococcal antigen from throat swabs by use of a latex agglutination test kit in general practice. AB - In 11 general practice offices, with a total of 29 general practitioners, throat swabs from 468 patients with acute pharyngotonsillitis were assayed for group A streptococci with a commercial antigen detection test kit (Culturette Brand Ten Minute Group A Strep ID; Marion Scientific, Div. of Marion Laboratories, Inc., Kansas City, MO 64114, USA). Compared to aerobic cultures carried out in our laboratory, the sensitivity of the antigen detection test was 73%; the specificity, 98%; the positive predictive value, 96%; the negative predictive value, 84%; and the overall agreement with laboratory findings, 88%. The prevalence of group A streptococci was 42%. Tests performed by assistants were significantly less sensitive (52%) than tests carried out by the physicians themselves (77%). The sensitivity of office cultures was 83% for blood agar plates supplemented with bacitracin discs, and 77% for Streptocult. We conclude that antigen detection tests should not presently be substituted for office cultures in the diagnosis of group A streptococcal throat infections. PMID- 3296655 TI - [Methods determining organic carboxylic acids]. PMID- 3296654 TI - [Development of a qinghaosu-resistant line of Plasmodium berghei ANKA and N strain]. PMID- 3296656 TI - [Advances in the study of polysaccharides]. PMID- 3296657 TI - [Use of high performance liquid chromatography in the analysis of body fluids]. PMID- 3296658 TI - Sex steroid hormones and adipose tissue metabolism in ovariectomized and adrenalectomized rats. AB - The effects of oestrogen and progesterone, alone or in combination, on regional adipose tissue metabolism and oestrogen binding were examined in rats which were not only ovariectomized but also adrenalectomized to allow a study under conditions such that no endogenous sex steroid production occurred. Under these conditions no effects on food intake of the sex steroid hormones were found. 17 beta-oestradiol plus progesterone tended to increase lipoprotein lipase in the parametrial but not retroperitoneal fat depot, but no effects were found of oestrogen or progesterone alone. Oestradiol alone or in combination with progesterone clearly increased basal and norepinephrine-stimulated lipolysis, most pronounced in the retroperitoneal depot. Progesterone alone had no effect. Cytoplasmic 17-beta-oestradiol binding was highest in the parametrial fat depot in non-substituted rats and decreased dramatically after oestrogen administration. It was concluded that in ovariectomized-adrenalectomized rats, oestrogen alone or in the presence of progesterone facilitates lipolysis, a clear effect which is thus possible to elicit without adrenal hormones. Both sex steroid hormones alone or in combination, have no or weak effects on food intake and lipoprotein lipase activity, respectively. These metabolic events as well as cytoplasmic oestrogen binding show regional variations. PMID- 3296659 TI - Miosis and plasma prostaglandin E metabolites during endotoxin fever. AB - The time course and intensity of miosis accompanying endotoxin (ET) fever was studied in goats concomitant with radio-immunoassay of plasma PGE metabolites. The i.v. injection of ET (E. coli lipopolysaccharide; 0.25 micrograms kg-1) induced a biphasic miosis correlated in time with the biphasic febrile response. Plasma PGE metabolites rose from an undetectable level to a mean of 2 nmol l-1 during the early fever phase, but fell to an undetectable level during the second fever phase in spite of persisting pronounced miosis. Like light-induced pupillary constriction, the ET miosis was antagonized by corneal application of atropine. A corresponding miotic response to ET was obtained also in the sheep. It is concluded that ET-induced miosis requires cholinergic nerve conduction, and that its direct cause is not systemic liberation of PGE. It is suggested that rather some nervous or humoral stimulus developing in conjunction with ET fever acts upon the same brain stem locus as that mediating the pupillary light reflex. PMID- 3296660 TI - Reflex changes in sympathetic nerve activity during mechanical ventilation with PEEP in sino-aortic denervated rats. AB - The aim of this study was to evaluate the role of cardiopulmonary receptors with vagal afferents in the reflex control of sympathetic nerve activity during mechanical ventilation with positive end-expiratory pressure (PEEP). Experiments were performed on 17 chloralose-anaesthetized rats. Changes in renal sympathetic nerve activity (RSNA), heart rate and mean arterial pressure were studied at zero end-expiratory pressure (ZEEP) and at 5 and 10 cm H2O PEEP in intact animals (n = 8), after sino-aortic denervation (n = 17) and after sino-aortic denervation plus vagotomy (n = 10). In the intact animals, 10 cm H2O PEEP induced a significant increase in RSNA (+66%) and heart rate (+10%) while the mean arterial pressure did not change significantly. Sino-aortic denervation increased baseline levels of RSNA, heart rate and mean arterial pressure. After sino-aortic denervation, 10 cm H2O PEEP still induced a significant increase in RSNA (+22%) and heart rate in 13 animals. In four animals, 10 cm H2O PEEP elicited a depressor reflex with a significant decrease in both RSNA (-32%) and heart rate. Bilateral vagotomy after sino-aortic denervation at ZEEP significantly increased RNSA (+15%) and heart rate, indicating an ongoing tonic inhibitory influence on RSNA from vagal afferents in sino-aortic denervated rats. The PEEP did not induce any significant change in RSNA or heart rate after sino-aortic denervation plus vagotomy. The results indicate that cardiopulmonary receptors with vagal afferents contribute to the reflex excitation of the sympathetic nervous system during mechanical ventilation with PEEP. Under certain circumstances, PEEP may also trigger powerful depressor reflexes, mediated by vagal afferents. PMID- 3296661 TI - L-vasopressin inhibits oxytocin-induced increases of plasma levels of insulin conscious dogs. AB - Oxytocin is known to increase plasma levels of insulin, glucagon and glucose in dogs. Plasma levels of vasopressin rise during stressful conditions. Since vasopressin counteracts several oxytocin-induced effects, it was decided to study how vasopressin influences the oxytocin-induced elevation of plasma levels of insulin, glucagon and glucose. Therefore oxytocin at 0.11 (which gives rise to physiological plasma concentrations) was infused i.v. for 10 min into fasted, conscious dogs either alone or in combination with 0.033 or 0.17 nmol kg-1 h-1 of L-vasopressin. Accordingly, 1.1 nmol kg-1 h-1 of oxytocin was infused alone or in combination with 0.67 or 1.7 nmol kg-1 h-1 of L-vasopressin. Repeated blood samples were drawn during and after the infusions and insulin and glucagon levels were determined by radioimmunoassay. Plasma levels of insulin increased three- and six-fold in response to 0.11 and 1.1 nmol kg-1 h-1 of oxytocin, respectively, and the elevations were inhibited by L-vasopressin. Slight (1.5-fold) increases in plasma levels of glucagon were observed following 0.11 and 1.1 nmol kg-1 h-1 of oxytocin, although the effect was significant only after the latter dose. Concomitant infusion with L-vasopressin did not markedly influence the effect caused by oxytocin. Small, insignificant increases in blood glucose levels were induced by both doses of oxytocin. These effects were not affected by concomitant infusions of L-vasopressin. The insulin levels rose before glucose levels suggesting that oxytocin stimulates the release of insulin without a previous rise in glucose levels. In conclusion, it has been shown that vasopressin, in amounts which give rise to physiological plasma concentrations, inhibits oxytocin induced effects on insulin levels, and that oxytocin stimulates the release of insulin via a mechanism which is independent of elevations in blood glucose levels. PMID- 3296662 TI - [Barba Jacob and the history of marihuana]. AB - The outstanding Latin-American poet Porfirio Barba-Jacob (1883-1942) was a heavy user of marihuana. In this paper the author provides some data concerning historical antecedents of marihuana--mainly in Latin America--and he discusses its influence upon Barba-Jacob's life and poetry. The hypothesis that consumption of marihuana is used by some hyperkinetic adults as self-induced pharmacotherapy is outlined. PMID- 3296663 TI - Causable mania (reactive, puerperal, secondary, life event related). The development of an idea. AB - This paper reviews the development of the concept of non-endogenous mania from myth to psychiatry and on to today. The varieties of causable mania are examined and an attempt is made to bring together the evidence which has been growing in the last few years from research in various different areas. As a result, a bridge appears between organic and psychoanalytical conceptualizations of mania, which may have important consequences for the management of manic patients in the future. Mania emerges as part of the depressive process rather than as its opposite. PMID- 3296664 TI - Psychological sequelae of kidney donation. A 5-10 year follow up study. AB - Twenty three out of 30 potential kidney donors were followed up after a period of 5-10 years. Fourteen were donors, and the other nine subjects who were refused from kidney donation on medical grounds constituted the control group (non donors). Psychiatric morbidity was assessed by using the Present State Examination (PSE) Interview Schedule. CATEGO-ID Program identified one case in the donor group and one case in the non-donor group. The psychiatric problems of both the cases were unlikely to be related to the kidney transplantation. The majority of the donors, irrespective of the outcome of the transplant procedure, expressed positive feelings towards kidney donation. This study suggests that the kidney donation does not cause long term adverse psychological sequlae. PMID- 3296665 TI - Sensorimotor interactions in space perception and action. In memory of Ivo Kohler (1915-1985). PMID- 3296667 TI - Noninvasive measurements of intracardiac blood flow velocities with Doppler ultrasound. PMID- 3296666 TI - Clinical research and the pharmaceutical industry. PMID- 3296668 TI - Ventricular dysrhythmias in middle-aged hypertensive men treated either with a diuretic agent or a beta-blocker. AB - The purpose of this study was to identify the frequency of cardiac dysrhythmias in two similar groups of hypertensive middle-aged males (age 45-66). They had previously been randomized either to a diuretic treatment (n = 42), or a beta blocking agent (n = 41). A 24-hour ambulatory Holter monitoring, and serum potassium, was obtained in all patients, serum magnesium was measured in 35 patients. The mean number of ventricular premature beats (VPBs) and the frequency of complex arrhythmias (19 vs. 5) was significantly higher in the diuretic group (p less than 0.01). The serum potassium was significantly lower (p less than 0.001) in the diuretic group, and there was a significant (p less than 0.005) inverse correlation between the number of VPBs and the serum potassium in all treated patients. The patients with complex arrhythmias were older (p less than 0.01) than the remainder of the patients. No correlation between serum magnesium and VPBs or complex arrhythmias was found. This study demonstrates increased frequency of VPBs in older hypertensive males, treated with diuretics, and that hypokalaemia predisposes to increased cardiac arrhythmias. We conclude that in older mildly hypertensive men hypokalaemia should be avoided. PMID- 3296669 TI - Sorbitol as a sweetener in the diet of insulin-dependent diabetes. AB - We compared sorbitol given alone and as part of a mixed meal to nine insulin dependent diabetics (IDD's) during continuous subcutaneous insulin infusion (CSII). Blood glucose, sorbitol and breath hydrogen + methane were measured following six test meals: Pure glucose, sorbitol and lactulose, a mixed meal alone, and sweetened with sorbitol and sucrose. Blood glucose increase was very small after lactulose and sorbitol, significantly larger after glucose. A considerable increase in breath hydrogen + methane appeared after sorbitol and lactulose, but not after glucose. No differences in blood glucose responses were found after the mixed meal alone or sweetened with sorbitol and sucrose. A sustained low level increase in breath hydrogen + methane occurred after all solid meals. Sorbitol was not detected in serum after any meal. CONCLUSION: Sorbitol ingested by IDD's during CSII in watery solution is not absorbed in the small intestine and causes osmotic diarrhoea. Ingested in a composite meal it does not affect blood glucose and does not cause osmotic diarrhoea. PMID- 3296670 TI - Insulin and C-peptide secretory responses to glucagon in man: studies on the dose response relationships. AB - The present study investigated the insulin and C-peptide secretory responses to glucagon in non-diabetic humans. Glucagon induced a transient increase in plasma insulin and C-peptide concentrations. At the dose level of 0.5 mg, glucagon elicited more efficient responses than at the dose level of 0.25 mg (p less than 0.05). However, the responses were not further potentiated by glucagon at 1.0 mg. Plasma glucose levels did not change during the first 2 min after glucagon injection, when already a marked increase in plasma insulin and C-peptide levels were observed. Thereafter, however, plasma glucose levels increased, to be maximal at 20 min after glucagon injection. Calculations of the minute-to-minute increase of plasma insulin and C-peptide levels revealed that plasma insulin levels increased by 32 +/- 7% of the increase in plasma C-peptide levels during the first 2 min, and by 36 +/- 6% of the increase in plasma C-peptide levels during the 3rd and 4th min after injection; the difference being the liver extraction of insulin. We conclude from this study in man that glucagon stimulates insulin secretion through both direct and indirect effects, that following glucagon injection, approximately 65% of the secreted insulin is extracted by the liver, and that the dose level of 0.5 mg glucagon is the optimal dose level for the stimulation of insulin secretion. PMID- 3296671 TI - Endogenous overnight creatinine clearance, serum beta 2-microglobulin and serum water during the menstrual cycle. AB - Endogenous overnight (22.00-08.00 hours) creatinine clearance and serum concentrations of beta 2-microglobulin and water were measured three times a week during 11 ovulatory menstrual cycles. In some of the women creatinine clearance changed more than 100% within a week from values below reference range to high normal levels. In all the women the creatinine clearance was higher during the luteal than during the follicular phase and correlated with the production of ovarian hormones. The urinary excretion rate of creatinine was highest during the luteal phase. Urinary volume, serum creatinine and serum water were not significantly influenced by the menstrual phases. An unexplained finding was a parallel change in the individual creatinine clearance and serum beta 2 microglobulin during the luteal, but not during the follicular phase. Our results suggest that ovarian hormones influence creatinine clearance during the menstrual cycle. One must therefore accept even considerable short-time variations in creatinine clearance in fertile women. It remains to be settled if these changes reflect true alterations in glomerular filtration rate or mainly changes in the urinary (tubular) excretion rate of creatinine. PMID- 3296672 TI - 5-Aminosalicylic acid in the treatment of inflammatory bowel disease. PMID- 3296673 TI - Primary aldosteronism. A follow-up study of 28 cases of surgically treated aldosterone-producing adenomas. AB - A follow-up examination was performed one month to 20 years after adrenalectomy in 28 cases with surgically treated primary aldosteronism due to adrenal adenoma. The mean age at diagnosis was 45, and the mean duration of hypertension seven years. Severe hypertension with a diastolic blood pressure of 130 mmHg or more was observed in 35%. Postoperatively cerebrovascular catastrophe developed in two cases, both of which belonged to the group of patients with severe hypertension. Normalization of blood pressure was observed in 70% and in the remaining subjects the blood pressure was lower than at diagnosis. The blood pressure response to adrenalectomy appeared unpredictable in view of such parameters as the initial blood pressure, age at diagnosis, and duration of the hypertensive state. Toxicosis during pregnancy and metrorrhagia was observed with unexpectedly high frequency in this study population. Low ambulatory plasma renin activity was recorded at the follow-up in 15 out of 18 subjects studied in the absence of evidence of hyperaldosteronism. PMID- 3296674 TI - Neutrophil-mediated vascular injury. PMID- 3296675 TI - Smooth muscle cells in the atherosclerotic process. PMID- 3296676 TI - Epithelial expression of HLA class II molecules: a new pathogenic factor in organ specific autoimmunity. PMID- 3296677 TI - Synovial class II antigen expression and immune complex formation in rheumatoid arthritis. PMID- 3296678 TI - Phospholipid antibodies in cardiovascular disease. PMID- 3296679 TI - Dietary cholesterol, serum cholesterol, and colon cancer: a review. AB - Observational and case-control epidemiologic data supported by experimental studies indicate that dietary cholesterol may contribute to colon tumorigenesis. A mechanism for this possible relationship is currently under investigation. Additional international epidemiologic data, although not uniformly consistent, indicate an inverse relationship between serum or plasma cholesterol levels and risk for colon cancer. This risk is greatest at serum cholesterol levels of less than 180 mg/dl. It has been suggested but not proven that individuals consuming diets high in dietary fat and cholesterol may have variations in cholesterol dynamics that account for lowered serum cholesterol levels and enhanced risk for colon cancer. Clinical evidence in both men and women indicates that age-sex adjusted, low serum cholesterol levels may precede the detection of colon cancer by more than 5 years. Preclinical colon cancer is associated with a further decrease in serum cholesterol levels. It is not clear whether progression of the disease before metastatic spread results in continued lowering of serum cholesterol levels. In men with markedly elevated serum cholesterol levels who have been placed on cholesterol-lowering drugs such as clofibrate or cholestyramine, there was no evidence that such regimens increased the risk for colon cancer. It is possible that reductions in serum cholesterol associated with the use of these drugs are insufficient to lower cholesterol levels to a range associated with an increased risk for colon cancer. PMID- 3296680 TI - Influence of caloric intake on experimental carcinogenesis: a review. AB - The effect of caloric intake on tumor growth has been recognized for over 70 years. Inhibition of tumor growth depends primarily on the extent of caloric restriction, but tumor type, animal strain, and dietary composition all exert some influence. Caloric restriction is most effective when maintained during both initiation and promotion, but if limited to one of these phases, restriction during promotion appears to be the more effective modality. The types of tumor that have been studied include spontaneous mammary and lung tumors as well as tumors induced by organ-specific carcinogens or irradiation with ultraviolet light. Numerous investigators have studied the effects of fat, and a diet low in calories but high in fat is generally significantly more effective in inhibiting carcinogenesis than is a diet high in calories but low in fat. Mice fed high fat, low calorie diets exhibited 48% fewer chemically induced skin tumors and 61% fewer tumors induced by ultraviolet irradiation than did mice fed low fat, high calorie diets. Mice fed a diet containing 2% fat exhibited a 66% incidence of skin tumors, whereas mice fed an isocaloric diet containing 61% fat showed a 78% incidence. Rats whose diet was restricted in calories by 40% exhibited no mammary tumors (coconut oil as primary dietary fat) or 75% fewer tumors (corn oil as dietary fat) compared to ad libitum-fed controls; they also exhibited 47% fewer colonic tumors. The mechanism by which caloric restriction exerts its tumor inhibiting effects remains to be elucidated. PMID- 3296681 TI - Dietary fat and experimental carcinogenesis: a summary of recent in vivo studies. AB - Diets high in fat have been demonstrated to enhance carcinogenesis in numerous models. Studies on the relationship between dietary fat and cancer in experimental animals have improved with the evolution in our knowledge of the carcinogenic process and with our ability to formulate better controlled diets. This paper summarizes studies conducted during the past 15-20 years on the effects of dietary fat on in vivo carcinogenesis. Relationships between skin carcinogenesis and dietary fat have received little attention during this time, but tremendous progress has been made in our understanding of mammary and colon carcinogenesis. Studies have been conducted of mammary carcinogenesis induced in various rat strains by several chemical carcinogens or by X-irradiation. Several colon carcinogenesis models have also been used to evaluate dietary fat effects. Recent studies in the lung, liver, and pancreas have shown relationships between the carcinogenic process at these sites and dietary fat; however, further studies are needed. The confounding between high fat intakes and low carbohydrate intakes and the difficulties of separating high fat intake from high caloric intake must be addressed in future research. The mechanism of the observed effects of dietary fat is unknown. PMID- 3296682 TI - The role of the LDL receptor in lipoprotein metabolism. PMID- 3296683 TI - The effects of diet, acute exercise and regular training on muscle lipoprotein lipase activity. PMID- 3296684 TI - Metabolism of apolipoprotein C: kinetic studies in human subjects: a critical review. PMID- 3296685 TI - Immunoglobulin A (IgA): molecular and cellular interactions involved in IgA biosynthesis and immune response. PMID- 3296686 TI - Methodological issues in psychosomatic research. PMID- 3296687 TI - Body image measurement in eating disorders. AB - The current paper reviews the methods used for assessing body image in anorexia nervosa and bulimia nervosa. A major concern in the assessment of body image in the area of eating disorders has been the apparent failure to recognize the complexity of the body image construct. The development of a range of standardized measures of body image has been an important advancement in recent years; however, it would be premature to assume that any of these methods assesses body image in its entirety. Rather, each provides an operational index of one aspect of this multidimensional construct. The relationship between different dimensions of body image and their respective operational measures remains a potentially valuable area for investigation. Few studies have employed multiple measurement techniques and it is recommended that future investigations incorporate convergent measures which tap perceptual, affective and cognitive elements of the broad body image construct. Factors such as reliability and validity of the different measures of body image must be considered in planning studies with eating disorder patients. Reliability is particularly important because it sets an upper limit on validity. Most studies may be criticized for not addressing the validity of measures employed. Concurrent, convergent, discriminant and predictive validity should be demonstrated for existing as well as new methods. The issue of construct validity which remains a more general concern in the area of body image applies to the investigation of eating disorders. There is the danger that 'body image disturbances' become reified based upon group differences on a particular operational measure. Therefore, conclusions must be cautious even when inferences are drawn from measures which appear to have 'face validity'. The literature on body image in eating disorders has expanded rapidly during the past several years. Generally, it has confirmed the clinical impression that these patients display serious distortions in the feelings, attitudes and perceptions related to their bodies. Hopefully, future research will clarify the mechanisms of action of these body image disturbances and provide insights which will lead to improved treatment. PMID- 3296688 TI - Methodology of life events research. PMID- 3296689 TI - Psychophysiological methods in psychosomatic research. PMID- 3296690 TI - An introduction to modern techniques of clinical neuropsychology. PMID- 3296691 TI - Mind and immunity. A review of methodology in human research. PMID- 3296692 TI - Observer rating scales of anxiety and depression with reference to DSM-III for clinical studies in psychosomatic medicine. PMID- 3296693 TI - Domains of virus glycoproteins. PMID- 3296694 TI - Disease induction by plant viruses. PMID- 3296695 TI - The dianthoviruses: a distinct group of isometric plant viruses with bipartite genome. PMID- 3296696 TI - Banana bunchy top: an economically important tropical plant virus disease. PMID- 3296698 TI - [Ocular surface. Physiological & pathological properties]. PMID- 3296697 TI - The autonomously replicating parvoviruses of vertebrates. PMID- 3296699 TI - [Visual acuity testing--basis and clinical application]. PMID- 3296700 TI - [Strabismus surgery]. PMID- 3296701 TI - [Fibronectin in cultured chick retinal pigment epithelial cells. 1. A specific antibody]. PMID- 3296702 TI - [An experience with nephrolithotomy under guidance of intraoperative ultrasonic scanning]. AB - A 50-year-old male with small renal stones and ureteral stones underwent nephrolithotomy under guidance of electronic linear array ultrasound scanning. We used 5 MHz. and 7.5 MHz. ultrasound probes (Aloka model UST-587 T-5, UST-556 T 7.5). This intraoperative guidance was very useful to locate and remove small renal calculi which were impossible to remove by fibrin coagulum pyelolithotomy. The ultrasonogram of the 7.5 MHz. probe was clearer than that of the 5 MHz. one. PMID- 3296703 TI - [Cholesteatoma of the ureter: a case report]. AB - A 68-year-old woman was hospitalized complaining of right flank pain. The excretory pyelogram revealed that the right kidney was hydronephrosis, and a retrograde pyelogram showed stringy filling defects in the middle portion of the right ureter. Suspecting a right ureter tumor, a right ureteronephrectomy was performed. The pathological diagnosis was ureteral cholesteatoma which is a rare condition with reports of only 9 cases in the Japanese literature. Although the possibilities of malignant change has been debatable, long term follow up would be mandatory. PMID- 3296704 TI - [Clinical evaluation of ofloxacin in the treatment of acute cystitis]. AB - Ofloxacin (OFLX) was administered to 236 female patients with acute cystitis. Of them 164 patients who satisfied the criteria proposed by the UTI Committee, Japan were examined for the efficacy of the treatment, but all cases were included in the study of the side effects of the drug. In the 65 patients who received 300 mg (3 divided doses) of OFLX per day, the overall clinical efficacy was excellent in 66.2% and moderate in 33.8% of the patients. In the 99 patients who received 600 mg (3 divided doses) of OFLX per day, the overall clinical efficacy was excellent in 79% (P less than 0.076) and moderate in 18.2% of the patients. No failure of the treatment was observed in the two groups. Of 164 bacterial strains isolated from the urine of the patients, 132 strains were identified as E. coli. All bacterial strains were eradicated in the urinary specimens by the treatment. Subjective side effects were observed in 8 (3.4%) of the 236 patients. Gastrointestinal disturbance was complained by 6 patients. No drug-related aggravation in the laboratory test was observed except for one patient who showed mild leukopenia reduced from 3700/mm3 to 2200/mm3. These results showed that the oral administration of OFLX was excellent and satisfactory in the treatment for acute cystitis. PMID- 3296706 TI - Bone-mineral screening for osteoporosis. PMID- 3296705 TI - Sonographic guidance in diagnostic and therapeutic interventions in the pleural space. AB - One hundred eighty-seven diagnostic and therapeutic interventional procedures in the pleural space were performed by using sonographic guidance. These consisted of diagnostic aspiration (118), drainage of malignant and nonmalignant effusions (41), empyema drainage (17), pleural sclerotherapy with tetracycline or bleomycin (7), and pleural biopsy (4). Diagnostic aspiration was performed with 20-gauge needles, and therapeutic and empyema drainages were performed by trocar technique with either a 7-French Sacks catheter or a specially designed empyema drainage catheter. Pneumothoraces were seen in 3% of the patients, and most of these were treated by the radiologist with placement of a Heimlich valve. We conclude that the use of sonography allows rapid localization of pleural fluid collections and instant monitoring of drainage of noninfected fluid collections and empyemas. PMID- 3296707 TI - Sonographic evaluation of renal stones treated by extracorporeal shock-wave lithotripsy. AB - Real-time sonography was performed on 94 patients the day before and at 24 and 48 hr after extracorporeal shock-wave lithotripsy (ESWL) therapy. The ability of sonography to detect renal stones before ESWL, changes in the calculi after ESWL, and the occurrence of pre- and post-ESWL hydronephrosis was evaluated. Abdominal radiographs and linear renal tomography were used as the standard of comparison. Six other patients had sonography only either before or after ESWL. One hundred patients had a total 105 kidneys treated; 18 kidneys with more than three stones were not included. The other 87 kidneys had 102 stones evaluated by sonography before having ESWL; 66 stones (65%) were identified and 36 were not. Of those calculi not seen, 10 were less than or equal to 5 mm in diameter. Nineteen of the other 26 stones were in the ureter or at the ureteropelvic junction. Comparison of sonograms of 80 kidneys obtained before and after ESWL revealed no change in 37 (46%), more stones or fragments detected in 23 (29%), fewer stones or a change in location in 12 (15%), and an apparent decrease in the size of the original stone in eight (10%). Hydronephrosis was detected by pre-ESWL sonography in 16 kidneys (20%) and was noted to develop after ESWL in 20 (31%) of the 64 other kidneys. These results indicate that the ability of sonography to detect renal calculi is related not only to stone size but also to location. The clinical significance of pre- and post-ESWL hydronephrosis found by sonography must be considered in conjunction with the patient's symptoms, laboratory data, and other radiographic studies. Therefore, the routine use of sonography in the post-ESWL patient does not seem warranted. PMID- 3296708 TI - Seminal vesicle abscess after vasectomy: evaluation by transrectal sonography and CT. PMID- 3296709 TI - Diprosopus: diagnosis in utero. PMID- 3296710 TI - Microcomputer applications for the academic radiologist. PMID- 3296711 TI - High-resolution sonography of acute appendicitis. AB - During a 7-month period high-resolution sonography was used in the evaluation of 68 patients with an equivocal clinical diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 32 cases and with clinical follow-up in the remainder. This technique was found to be accurate in the diagnosis of acute appendicitis with a specificity of 95%, a sensitivity of 80%, and an accuracy of 90%. The predictive value of a positive test was 91%; that of a negative test was 89%. The results show that high resolution sonography is indicated to establish the diagnosis of acute appendicitis in patients with equivocal clinical findings. PMID- 3296712 TI - Sonographic findings in pancreatic lipomatosis. PMID- 3296713 TI - Duplex Doppler examination in portal hypertension: technique and anatomy. AB - Three hundred fifty duplex Doppler examinations were performed in 195 patients (150 adults and 45 children) with radiologically and/or clinically proved portal hypertension. In this paper we describe this duplex Doppler technique for the qualitative assessment of splanchnic venous hemodynamics in these patients. The caliber of and the presence and direction of flow in the following veins are assessed: splenic, superior mesenteric, portal and intrahepatic portal, and portasystemic collateral. This examination can be performed on patients of any age without sedation and can establish the diagnosis of clinically significant portal hypertension. Technical success rate was 95%, although 10% of examinations were incomplete because of intestinal meteorism. We conclude that the combined use of Doppler and routine sonography permits precise evaluation of the vascular anatomy in portal venous hypertension. PMID- 3296714 TI - Comparison of pulsed Doppler sonography and angiography in patients with portal hypertension. AB - Pulsed Doppler sonography and liver panangiography were performed in 43 patients with cirrhosis. Fourteen patients were evaluated preoperatively, and 28 patients were evaluated after a variceal decompressive shunt. One patient was studied before and after undergoing a shunt. The direction of portal blood flow by Doppler sonography was compared with both the grading pattern and direction of flow by angiography. When portal blood flow was determined to be antegrade by Doppler sonography, angiography showed antegrade flow in 84% (grade I, II, or III portal venous pattern). Six percent had retrograde flow (grade IV), and 10% had portal vein thrombosis. When the portal blood flow was determined to be retrograde by Doppler sonography, angiography showed retrograde flow (grade IV portal venous pattern) in 80% and antegrade flow (grade I, II, or III) in 20%. When an inadequate Doppler tracing was obtained from the portal vein, angiography showed either grade I, II, or III in 38%; grade IV in 50%, and portal vein thrombosis in 13%. There was poor correlation between the calculated mean flow rates, as determined by Doppler sonography, and the angiographic grade. We conclude that pulsed Doppler sonography is accurate in determining the direction of portal flow when an adequate tracing is obtained (36 of 44 studies). When an inadequate tracing is obtained, retrograde portal flow or portal vein thrombosis is likely. PMID- 3296716 TI - Back to the future in Huntsville (Carl A. Grote, Jr.) PMID- 3296715 TI - Hepatic infarcts: new observations by CT and sonography. AB - Until recently hepatic infarcts were rarely diagnosed before autopsy and were nearly always fatal. Four cases of hepatic infarcts, three of them nonfatal, were diagnosed and followed by CT (three cases), sonography (two cases), arteriography (two cases), and sulfur colloid liver-spleen scan (one case). In three patients with multiple subsegmental hepatic infarcts, most of the lesions were round or oval and centrally located. Only a minority of the lesions were wedge-shaped and peripheral. The early lesion appears hypoechoic on sonography, and CT shows a poorly demarcated low-density region. Later, lesions become confluent with more distinct margins. Bile lakes are a late sequela of large infarcts. Gas formation within sterile infarcts is newly described in two cases. Hepatic infarcts have a variable appearance on CT and sonography and are not reliably distinguished from other lesions such as abscess or necrotic neoplasm. PMID- 3296717 TI - Medical practices of early settlers in Mobile. PMID- 3296718 TI - Limitations of digital subtraction contrast echocardiography in enhancing left ventricular endocardial definition. AB - The purpose of this study was to evaluate whether the digital subtraction technique, applied to contrast echocardiography of the left ventricle (LV), might improve endocardial edge identification by two-dimensional echocardiography. Injections of the polysaccharide agent SHU-454 were made into the LV of five closed-chest dogs. Data were obtained at different levels of ejection fraction (EF) induced by pharmacologic or mechanical interventions and were documented by left ventriculography (VGRAM) in the right anterior oblique projection. Contrast echocardiography was recorded in the apical four-chamber view. The echocardiographic images were digitized off-line into a 256 X 256 pixel matrix with 256 gray levels/pixel. Two end-diastolic frames prior to contrast appearance were averaged to obtain a mask that was subtracted from end-diastolic contrast frames corresponding to the two beats of peak intensity. The same procedure was repeated for the systolic frames. LV edges from echocardiographic images prior to contrast appearance, from digitally subtracted echo-contrast images, and from VGRAM were traced on two occasions by two different observers. LV volumes were calculated by single-plane Simpson's rule and EF was derived by the classical equation. The intra- and interobserver reproducibility in the measurement of EF was excellent for VGRAM (r = 0.95 and 0.94, respectively), it was good for two dimensional echocardiography (r = 0.87 and 0.73), and was fair for contrast-echo (r = 0.79 and 0.68).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296719 TI - Fist pacing, a forgotten procedure in bradyasystolic cardiac arrest. PMID- 3296720 TI - Coronary artery disease risk factor management in the hypertensive patient. AB - Recent advances in understanding the relation of risk factors to coronary artery disease (CAD) have initiated a change in the approach to managing the hypertensive patient. Reduction of elevated blood pressure still remains a major therapeutic priority. However, the risk of cardiovascular morbidity is also related to hypercholesterolemia, hyperuricemia, hyperglycemia, hyperfibrinogenemia and obesity; all aggravate the risk of CAD in the patient with high blood pressure. Life-style is also important: cigarette smoking, high alcohol consumption and lack of physical exercise all predispose to precocious atheromatous CAD. Thus, the most favorable prognosis in terms of reducing CAD risk is accomplished by reducing elevated systemic arterial pressure while simultaneously improving all other risk factors. The method by which blood pressure is lowered is an important consideration. The ancillary metabolic activities of antihypertensive drugs now available differ widely. Diuretics and beta blockers, for example, have potentially adverse metabolic effects, whereas agents such as selective alpha 1-adrenoceptor inhibitors appear to beneficially affect several metabolic cofactors influencing the CAD risk profile. The impact of such drug-induced metabolic changes on overall prognosis of the hypertensive patient remains to be clarified. In the absence of other contraindications, however, it is sensible to use drugs that do not increase the metabolic predilection to precocious CAD. PMID- 3296721 TI - Background and design of the new U.S. trial on diet and drug treatment of "mild" hypertension (TOMHS). AB - A multicenter, randomized, controlled, double-blind U.S. trial is comparing the combined effects of diet treatment and 1 of 5 active drug regimens with diet treatment alone, for the long-term management of middle-aged adults with "mild" hypertension. Factors stimulating this trial are data documenting the high prevalence of mild hypertension in the adult population; mild hypertension's responsibility for a high proportion of morbidity and mortality attributable to hypertension overall; data from long-term hypertension intervention trials showing reduced morbidity and mortality of people with mild hypertension with use of either diuretics or beta blockers as step-1 therapy, and other trials that failed to demonstrate beneficial impact on morbidity and mortality, possibly due to residual questions concerning aspects of benefit to risk ratios with these medications; recent data from trials showing long-term control of mild hypertension and other risk factors by nutritional means; lack of data from long term trials on benefit to risk ratios with newer drugs such as selective alpha 1 inhibitors, angiotensin converting enzyme inhibitors and calcium channel blockers; paucity of data from trials on long-term combined effects of diet and drug therapy, and of diet alone, for people with mild hypertension. During the next few years, phase 1 of the trial will study 6 groups of drugs. The step-1 drugs are angiotensin converting enzyme inhibitor (enalapril), alpha 1 inhibitor (doxazosin), beta blocker (acebutolol), calcium channel blocker (amlodipine), diuretic (chlorthalidone) and placebo. All participants are to receive vigorous sustained nutritional counseling to reduce obesity, moderate sodium intake and avoid heavy use of alcohol. Key endpoints for phase 1 of the study are the need for additional medication to control mild hypertension, side effects (i.e., clinical and biochemical) and consequent need to discontinue drug and quality of life. Phase-1 data are to be used to complete the phase-2 design, with the ultimate aim to assess effects on morbidity and mortality. PMID- 3296722 TI - Accuracy of digital angiography for quantitation of normal coronary luminal segments in excised, perfused hearts. AB - The accuracy of coronary artery diameter determination by digital angiography was assessed by imaging 39 coronary segments of excised dog and human hearts and comparing these segments with pathologic sections 0.76 to 3.31 mm in luminal diameter. Digital images were obtained postmortem both during contrast injection using a fixed-pressure coronary perfusion system and after fixation when the coronary size was maintained by injection of a barium-gelatin casting mixture. Digital data were analyzed with commercially available, automated edge-detection software using a coronary catheter as the calibration standard. Coronary diameter measured during contrast injection was not significantly different from that measured after casting and fixation. Digital data from both methods correlated well with diameters from pathologic sections (injected, r = 0.85; fixed, r = 0.91). Linear regression parameters comparing pathologic diameters with the contrast injection method were slope = 0.82, intercept = 0.42 mm, and standard error of the estimate = 0.27 mm. Parameters for the comparison of pathology with casted coronary data were slope = 0.95, intercept = 0.16 mm, and standard error of the estimate = 0.23 mm. Intra- and interobserver variability were 3% (0.05 mm) and 4% (0.07 mm), respectively. These data indicate that when a coronary catheter as a calibration standard is used, coronary artery dimensions can be accurately measured by automated digital angiography techniques. PMID- 3296723 TI - Color Doppler assessment of mitral regurgitation induced by supine exercise in patients with coronary artery disease. AB - Development of mitral regurgitation (MR) during acute myocardial ischemia is a well known occurrence. To assess the feasibility and clinical utility of detecting MR during exercise testing, color Doppler examinations were performed in 22 patients with angiographically proved coronary artery disease (CAD) and in 17 normal subjects before, during and after graded supine bicycle exercise. Not only was MR visualized using color Doppler during dynamic testing, but it was also slightly more sensitive (59% vs 54%) and specific (100% vs 88%) than the electrocardiographic response in identifying patients with CAD. When the appearance of MR or diagnostic electrocardiographic changes or both were used to identify patients with CAD, the sensitivity of exercise tolerance testing increased to 82%, although the specificity was 88%. In addition, exercise-induced MR was observed to be as sensitive and specific as exercise-induced wall motion abnormalities. Combining exercise-induced MR with wall motion abnormalities also increased the sensitivity to 82%, with the specificity remaining at 100%. With use of exercise-induced MR, wall motion abnormalities or electrocardiographic changes, the sensitivity and specificity of the exercise test in diagnosing CAD was 91% and 88%, respectively. The degree of MR as estimated by maximal area of regurgitation signals, as well as by its ratio to left atrial area, did not correlate with extent of CAD. However, the presence of exercise-induced MR suggested an increased likelihood of 3-vessel CAD because it was found in 9 of 11 patients with 3-vessel CAD, compared with 2 of 5 patients with 2-vessel and 2 of 6 patients with 1-vessel CAD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296724 TI - Comparison of bepridil with nadolol for angina pectoris. AB - Bepridil hydrochloride is a unique calcium channel-blocking drug with anti ischemic and type 1 antiarrhythmic properties. With a half-life of more than 40 hours, once-daily therapy is possible. Twenty-four patients (22 men, 2 women), mean age 58 years (range 43 to 72), with stable exertional angina were assigned to therapy with bepridil and nadolol in a randomized, double-blind, crossover trial. Antianginal efficacy was assessed by a diary of angina frequency and nitroglycerin consumption as well as by treadmill exercise testing. The effect of therapy on ventricular function was assessed by symptom-limited equilibrium gated exercise radionuclide angiography. During therapy with both nadolol and bepridil, the number of episodes of angina per week was significantly reduced and nitroglycerin consumption decreased compared with baseline evaluation. Exercise duration was prolonged by both therapies (baseline 281 +/- 122 seconds, nadolol 377 +/- 96 seconds, bepridil 400 +/- 109 seconds; p less than 0.005 for nadolol and bepridil vs baseline). Time to the onset of angina was similarly prolonged, 50% by nadolol and 65% by bepridil (p less than 0.005). Bepridil had no effect on PR and QRS durations, although QTc was significantly prolonged (baseline 0.43 +/- 0.03, nadolol 0.42 +/- 0.03, bepridil 0.45 +/- 0.04; p less than 0.005 for bepridil vs baseline and nadolol). By radionuclide angiography, neither nadolol nor bepridil had an adverse effect on left ventricular function at rest or during exercise. Bepridil therefore provides effective therapy for angina without adverse effects on left ventricular function, comparable to the effects of beta blockade with nadolol. PMID- 3296725 TI - Efficacy of oral and intravenous indecainide in ventricular arrhythmias. AB - To evaluate the efficacy of oral and intravenous indecainide, a new class IC antiarrhythmic agent, 3 separate protocols were performed in patients with benign or potentially lethal ventricular arrhythmias. An open-label intravenous trail in 10 patients was conducted using a dose of 1.7 mg/kg/min under constant monitoring. An oral short-term in-hospital trial in 20 patients (8 patients entered directly from the intravenous short-term trial) was conducted using a single-blind placebo dose titration protocol in which 50 mg of indecainide every 8 hours was increased at 3-day intervals to 75 mg, and then 100 mg every 8 hours depending on the observed change in ventricular arrhythmia frequency by Holter monitoring. Finally, an outpatient long-term oral trial was conducted in 17 of the 20 patients who completed the inpatient oral short-term trail. Two of the 10 patients from the inpatient intravenous trail did not enter the oral trial, because a proarrhythmic response developed in 1 and because of a lack of efficacy in the other. During the inpatient oral trial, 17 of 20 patients (85%) responded to indecainide and entered the long-term phase. Two of these patients were removed from the trial because of lack of efficacy at 3 and 10 months, respectively. In the oral therapy protocols, minor side effects of the central nervous system occurred in 4 of 17 patients (24%). Six of 20 patients (30%) each had more than a 25% increase in PR and QRS duration that was not associated with higher degrees of block.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296726 TI - Tricuspid regurgitation by Doppler echocardiography after orthotopic cardiac transplantation. AB - The incidence and severity of Doppler-detected tricuspid regurgitation (TR) and associated clinical variables was studied in 20 patients who underwent cardiac transplantation. Eighteen of the 20 patients had Doppler detectable TR after cardiac transplantation, 14 had moderate to severe TR and 4 mild TR. Echocardiographic evidence of right ventricular volume overload was present in 13 of 14 patients with moderate to severe TR and in none of the other 6 patients. Patient age, primary disease process, cold ischemic time of the transplanted heart, and the frequency or severity of organ rejection did not correlate with the development of TR. Two patients with significant TR had a torn or partially torn tricuspid chordae, indicating an organic etiology, and the remaining patients had functional TR. All 8 patients with a pulmonary artery systolic pressure of 55 mm Hg or more before transplantation had significant functional TR after transplantation (p less than or equal to 0.05). Pulmonary vascular resistance before transplantation was not predictive; however, after transplantation pulmonary vascular resistance was significantly greater in patients with moderate to severe TR (101.6 +/- 41.3 vs 50.2 +/- 16.6 dynes s cm 5, p less than or equal to 0.01). PMID- 3296727 TI - Lack of evidence of spontaneous reperfusion when ventricular fibrillation complicates early acute myocardial infarction. PMID- 3296729 TI - Relaxation-imagery (self-hypnosis) in Tourette syndrome: experience with four children. PMID- 3296728 TI - Hemodynamic effects of pirmenol and lidocaine: a placebo-controlled, double blind, comparative study. AB - The acute hemodynamic effects of pirmenol and lidocaine were studied in a double blind, placebo-controlled investigation. Thirty patients undergoing catheterization received one of the following: pirmenol as a 50-mg intravenous bolus injection followed by a 2.5 mg/min infusion, lidocaine as a 75-mg intravenous bolus injection followed by a 3 mg/min infusion or placebo administered in a similar fashion. Mean plasma pirmenol concentrations during steady infusion were 2.3 to 2.4 mg/liter, and mean plasma lidocaine concentrations were 16 to 24 mumol/liter. Pirmenol increased heart rate from baseline by 10 beats/min (p less than 0.001) and mean arterial pressure by 5 mm Hg (p less than 0.001), with similar increases in systemic (p less than 0.05) and pulmonary vascular resistance (p less than 0.01). Lidocaine induced a comparable increase in mean arterial pressure (6 mm Hg, p less than 0.001), but unlike pirmenol, it increased left ventricular and diastolic pressure by 2.8 mm Hg (p less than 0.05). Indexes of left ventricular work were not affected by either drug. Echocardiographic ejection fraction was reduced more by pirmenol (-0.05, p less than 0.0001) than by lidocaine (-0.03, p less than 0.05), a difference that may be related to the changes in heart rate. Side effects were not observed in any patient. The myocardial depressant effect of pirmenol is relatively slight and comparable to that of lidocaine. PMID- 3296730 TI - The hypnotherapy of Dr. Andries Hoek; uncovering hypnotherapy before Janet, Breuer, and Freud. PMID- 3296731 TI - Hypnosis and cancer: an annotated bibliography 1960-1985. PMID- 3296732 TI - Chemotherapy of advanced colorectal cancer. A randomized trial of sequential methotrexate and 5-fluorouracil. AB - Fifty-five patients with advanced colorectal cancer were entered into a randomized controlled clinical trial to evaluate order of administration and sequential methotrexate (MTX) and 5-fluorouracil (5-FU) therapy. Patients were randomized to receive either MTX, 250 mg/m2, followed 1 h later by 5-FU, 600 mg/m2, or 5-FU followed 1 h later by MTX in the same doses. Fifty-four patients were evaluable for response, of whom 15 (28%) achieved objective partial tumor response. There were no significant differences between the two sequences in response rate, time to treatment failure, or survival duration. The results of this study do not indicate a clinically significant difference between the two sequences tested, in which MTX preceded or followed 5-FU by 1 h. Determination of the value of these drugs given sequentially at longer intervals must await appropriate controlled trials. PMID- 3296733 TI - A randomized trial of high dose bolus metoclopramide versus low-dose continuous infusion metoclopramide in the prevention of cisplatin-induced emesis. AB - We compared the antiemetic efficacy of metoclopramide in a bolus low-dose infusion schedule to that of metoclopramide given in a conventional high-dose bolus schedule in a randomized crossover trial. Thirty-two treatment courses in 16 patients receiving cisplatin chemotherapy were evaluable. The metoclopramide regimen was either 2 mg/kg i.v. bolus, then 20 mg/h by infusion for 4 h, or 2 mg/kg i.v. bolus every 2 h for three doses. Dexamethasone 20 mg i.v. and diphenhydramine 50 mg i.v. were also given. Antiemetic efficacy was assessed by a questionnaire. There were no differences in antiemetic efficacy between the metoclopramide regimens. With either program, 75% of patients were emesis-free, 13% had mild symptoms, and 13% had moderate symptoms (greater than two emetic episodes). The infusion metoclopramide regimen was 30% less expensive than the bolus schedule in our pharmacy. Thus, we recommend low-dose metoclopramide infusion as a less expensive, equally effective alternative to high-dose bolus regimens for antiemetic treatment. PMID- 3296736 TI - Concerns about ovarian epithelial cancer management. PMID- 3296734 TI - High-dose oral and intravenous metoclopramide in doxorubicin/cyclophosphamide induced emesis. A randomized double-blind study. AB - Emesis remains a major side effect of cancer chemotherapy. High-dose intravenous metoclopramide has proved to be effective antiemetic therapy for cisplatinum induced emesis. It has not been rigorously tested in nonplatinum chemotherapy. This double-blind, noncrossover, randomized trial compared high-dose oral and intravenous metoclopramide to standard oral prochlorperazine in emesis caused by doxorubicin [70 mg/m2 body surface area (BSA)] and cyclophosphamide (700 mg/m2 BSA). Prochlorperazine (10 mg/dose), oral metoclopramide, and intravenous metoclopramide (2 mg/kg/dose each) were given 30 min before chemotherapy and then every 4 h for 24 h. Ten patients were randomized to prochlorperazine therapy, 10 to oral metoclopramide, and 9 to i.v. metoclopramide. Median number of emeses for the first chemotherapy cycle was 3, 3, and 7 for prochlorperazine, oral, and i.v. metoclopramide, respectively. Statistical analysis showed no significant advantage of any regimen (p greater than 0.4). For patients who continued the antiemetic study, frequency of emesis increased with each successive cycle of chemotherapy. Six of 19 patients treated with metoclopramide developed dystonic reactions compared with zero of 10 on prochlorperazine. High plasma metoclopramide levels were achieved with both metoclopramide regimens and did not correlate with frequency of emesis. High-dose oral and i.v. metoclopramide in an every 4 h regimen did not show any advantage over standard antiemetic therapy for doxorubicin/cyclophosphamide-induced emesis and were associated with significant toxicity. PMID- 3296735 TI - Methylprednisolone for the control of CMF-induced emesis. AB - Sixty-eight breast cancer patients for outpatient adjuvant chemotherapy (CT) with cyclophosphamide, methotrexate, and fluorouracil (CMF) on a 1-day schedule entered a randomized trial comparing the antiemetic-efficacy of different doses of methylprednisolone (MPN). Treatment was administered concomitantly with the first course of CT and consisted of MPN in either 375 or 120-mg doses divided into 3 equal parts, the first administered i.v. just prior to CMF and then i.m. 6 and 12 h after CT. Overall, antiemetic protection was appreciable: complete emetic protection (no emetic episodes) was observed in 71 and 66% of patients receiving MPN 375 and 120 mg, respectively. In 43 and 54% of patients receiving MPN 375 and 120 mg, respectively, nausea did not occur. Efficacy of the two treatment arms was not statistically different for either emesis or nausea. Antiemetic protection with MPN was reproducible over time at subsequent courses: 60% of patients in either treatment arm experienced less than 5 emetic episodes at their 12th CMF course. Facial flush was the most frequently observed side effect (36% with MPN 120 mg vs. 68% with MPN 375 mg). Other acute untoward effects consisted of headache, pyrosis, and edema. However, the latter was observed only with the higher dose. In patients receiving CMF, MPN alone provides effective and reproducible emetic protection. No dose-response relationship was observed. PMID- 3296737 TI - Distribution of a formalin-resistant myelomonocytic antigen (L1) in human tissues. II. Normal and aberrant occurrence in various epithelia. AB - L1 is an approximately 36-kd protein present in virtually all resting peripheral blood neutrophils and monocytes. It is particularly well preserved in formalin fixed and paraffin-embedded routine material. In a recent immunohistochemical study, the authors showed that L1 has a restricted distribution within the monocyte-derived cell lineage, being mainly confined to reactive histiocytes (infiltrating macrophages). A protein sharing physicochemical and antigenic properties with L1 was identified in extracts of epidermal scales obtained from patients with psoriasis. This epithelial L1 was generally not expressed by normal epidermis, but its production was abundant in several skin diseases. Moreover, mucosal squamous epithelium normally expressed L1. No other epithelia showed signs of L1 production, although occasional patchy uptake was indicated, particularly in kidney tubular epithelium. PMID- 3296739 TI - Failure of the Bactec 460 radiometer to detect Cryptococcus neoformans fungemia in an AIDS patient. AB - Cryptococcus neoformans fungemia occurred in a patient with the acquired immunodeficiency syndrome (AIDS). The BACTEC 460 radiometer failed to detect Cryptococcus neoformans in eight aerobic BACTEC 6B culture bottles inoculated with the patient's blood. The diagnosis of cryptococcemia was established by terminal (seven-day) subculturing of 6B broth to chocolate agar, which was positive for all eight radiometrically negative blood culture bottles. It appears that radiometric measurement is not optimal for the laboratory detection of cryptococcal fungemia. PMID- 3296740 TI - Concerning decalcification and fluoride protection. PMID- 3296738 TI - Persistent and generalized lymphadenopathy: a lesion of follicular dendritic cells? An immunohistologic and ultrastructural study. AB - An immunohistochemical and ultrastructural study of 14 cases of persistent and generalized lymphadenopathy (PGL), acquired immune deficiency syndrome (AIDS) related, revealed florid follicular hyperplasia, follicular dendritic cell (FDC) lysis, lymphoid follicle invaginations, increased presence of T8 cells in germinal center, immature sinus histiocytosis (monocytoid B-cells), and inversion of T4/T8 ratio in the paracortical area. Electron microscopic examination showed viral particles of morphologic characteristics consistent with human immunodeficiency virus (HIV) virions attached to the processes of FDC in three of the nine cases studied. Lesions of the germinal center dendritic cell network are the cardinal feature of PGL. This finding lends support to the idea of a viral aggression directed against FDC as the cause of disregulation of the B-cells. PMID- 3296742 TI - Should we abandon statistical modeling altogether? PMID- 3296741 TI - A comparison of combinations of diuretics in nephrotic edema. AB - The metolazone-furosemide combination of diuretics was compared with the thiazide furosemide combination in nephrotic patients with edema. Nine patients underwent a crossover, randomized study receiving furosemide (2 mg/kg per dose) and either metolazone (dose varied according to weight) or chlorothiazide (10 mg/kg per dose). An additive natriuretic and diuretic effect was observed after both metolazone and thiazide were combined with furosemide. The use of both types of diuretic combination was associated with marked kaliuresis. These combinations of diuretics seem equally effective in inducing natriuresis and diuresis in edematous nephrotic patients. PMID- 3296743 TI - Hepatitis B virus replication and tuberculin reactivity: studies in Alaska. AB - In a previous study in 1982-1984 of southeast Asian refugees in Philadelphia, the authors found that hepatitis B virus carriers who reacted to a tuberculin (purified protein derivative (PPD)) skin test were more likely to be negative for the hepatitis B e antigen (HBeAg) than carriers who did not react to PPD. Because it was not known whether the PPD reactivity was due to natural infection or vaccination with bacille Calmette-Guerin (BCG), the authors conducted a further study in 1985 in Alaskan Native hepatitis B carriers, a group not vaccinated with BCG. The inverse association of HBeAg and PPD reactivity was confirmed across all age groups and was similar in magnitude to that observed in the refugee population. The host response to tubercle bacilli may inhibit the replication of hepatitis B virus. If the host response to BCG is similar, BCG vaccination may be of therapeutic value in chronic hepatitis B infection. PMID- 3296744 TI - Cyclosporine toxicity: the effect of combined therapy using cyclosporine, azathioprine, and prednisone. AB - Forty-nine patients among 360 who received renal transplants under cyclosporine (CsA)/prednisone (Pred) immunosuppression required alteration of the immunosuppressive regimen because of intractable nephrotoxicity. Twenty-five patients, converted totally to azathioprine (Aza)/Pred, suffered intractable nephrotoxicity with no associated evidence suggesting ongoing rejection. The results with Aza/Pred conversion were disappointing because of an unacceptably high incidence of rejection and allograft loss. Twenty-four patients with intractable CsA nephrotoxicity were, therefore, treated using an alternative approach combining Aza with aggressive CsA dose reduction, and continued Pred therapy. All patients tolerated initiation of Aza without complication; allograft rejection was not common. Renal function improved for 23 of the 24 (96%) CsA/Aza/Pred patients with mean serum creatinine levels falling from 3.5 +/- 0.5 mg/dL to 2.2 +/- 0.4 mg/dL after a mean follow-up of 14 months (P less than .001). Among 18 patients observed at least 12 months, seven (39%) enjoyed serum creatinine values less than or equal to 2 mg/dL. Nine CsA/Aza/Pred-treated patients (37.5%) required hospitalization because of infectious complications, all of which resolved with temporary reduction of immunosuppression and specific antimicrobial therapy when indicated. One patient sustained acute allograft rejection as a result of patient noncompliance, and one patient on a seemingly appropriate CsA/Aza/Pred dose responded initially to steroid pulse antirejection therapy; however, renal function again worsened. Two patients developed progressive renal dysfunction due to chronic rejection, and returned to dialysis 13 and 17 months, respectively, following initiation of CsA/Aza/Pred. Overall, the actuarial graft survival for CsA/Aza/Pred-treated patients was 100% at 1 year, and 84% at 2 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296745 TI - Thrombotic complications of indwelling central catheters used for chronic hemodialysis. AB - A new double-lumen silicone-rubber dialysis catheter, designed to be placed surgically in central veins, is now available. There is little published data concerning the long-term use of this catheter for hemodialysis, but a review of the literature suggests that pericatheter thrombus formation with or without occlusion of major veins has been a complication of chronic central venous catheterization with a variety of catheters, in both dialysis and nondialysis settings. We had this catheter placed in four diabetic patients who had severe problems related to maintenance of adequate vascular access. Two of the four patients underwent venography within 3 months of catheter placement because of impaired catheter function and were found to have thrombi on the outside of their catheters. These thrombi could not be dissolved with fibrinolytic agents, and the catheters were removed surgically without incident. The other two patients have no radiologic evidence of thrombus formation 4 and 7 months, respectively, after catheter placement. We suggest that proper selection of patients for this type of vascular access should be the subject of future studies and that patients with malfunctioning catheters undergo venography to rule out the presence of significant catheter related thrombosis. PMID- 3296746 TI - Benzene toxicity: studying a subject to death. PMID- 3296747 TI - Legislative and educational alternatives to a judicial remedy for the transfer trauma dilemma. AB - Transfer trauma is alleged to be an increase in morbidity and mortality in institutionally relocated chronically ill elderly. Efforts by the legal profession to persuade courts that transfer trauma should be a legally recognized phenomenon invoking judicial protections against transfer (the "transfer trauma argument") have been unproductive. In O'Bannon v. Town Court Nursing Center, Inc., the United States Supreme Court denied standing to elderly persons claiming a property interest in remaining in alleged substandard facilities. The Court rejected the argument that the possibility of transfer trauma constituted a deprivation of life or liberty that would have required due process protections of notice and hearing. Despite the Court's preclusion of transfer trauma litigation in a constitutional context and the general unwillingness of lower courts to recognize the phenomenon, attorneys continue to burden the judicial system with frivolous transfer trauma arguments. The unfruitful pursuit of a judicial remedy for the ethical and social problems that arise with relocation of the elderly continues, in part, because of a misguided belief that this distressing social phenomenon is best remedied by the courts. Judicial unwillingness to recognize the transfer trauma argument, however, does not preclude legislative consideration of the humanitarian issues concerning the institutional relocation of elderly persons. This Article examines gerontological research in order to understand the judicial rejection of the transfer trauma argument and argues in support of legislative and educational solutions for the ethical and social problems attending transfer. PMID- 3296748 TI - The role of Medicare reimbursement in contemporary hospital finance. AB - A hospital, while performing its major function of providing health care, is also viewed as a business. It needs capital from a wide variety of sources, many of which are government regulated. Over the past few years, federal expenditures for Medicare have increased dramatically, as has regulation of hospital revenue sources. Congress enacted the Medicare Prospective Payment System (PPS) to curb hospital cost inflation. This Note examines historical trends in health care financing and analyzes the Medicare reimbursement system, with emphasis on PPS and its impact on hospital revenues. The Note suggests that hospitals, due to the effects of PPS, will be forced to reduce their levels of financial leverage and will have to look for corporate financial alternatives. PPS may signal a new era in hospital finance. Survival mandates an increased focus on efficient corporate, financial and managerial policies. PMID- 3296749 TI - Assessing the potential for buspirone dependence or abuse and effects of its withdrawal. AB - Benzodiazepine anxiolytics are known to pose risks associated with drug dependence, abuse, and withdrawal symptoms. Recently, a new antianxiety agent, buspirone, was introduced in the United States. Buspirone appears to lack abuse liability and does not lead to drug dependence or withdrawal symptoms. This article reviews the results of animal and clinical studies in which the potential for buspirone dependence or abuse and the effects of its withdrawal were assessed. PMID- 3296750 TI - Prevention, management, and control of influenza. Role of amantadine. AB - Amantadine, an oral antiviral agent, is effective in the prophylaxis and treatment of all strains of influenza A, preventing 70 to 90 percent of both experimentally induced and natural infections. Although not a substitute for vaccination, prophylactic amantadine can be particularly helpful in high-risk groups, including those with cardiovascular and pulmonary diseases and those in chronic-care settings. Adjunctive administration to previously immunized high risk persons enhances the vaccine's efficacy. If given to nonimmunized persons who are then vaccinated during an influenza out-break, it will protect them for the two to three weeks needed for vaccine-induced immunity to develop. If given to residents of a chronic-care facility early in an outbreak, it is helpful in controlling the outbreak. Used therapeutically within 48 hours of the onset of symptoms, amantadine will shorten influenza illness by up to 50 percent, reduce fever, and hasten the resumption of normal activities. Amantadine is particularly recommended for high-risk persons in whom influenza-like symptoms develop during a confirmed or suspected outbreak of influenza A. PMID- 3296752 TI - Breast diseases and the internist. AB - Benign breast disease affects almost all women, although only one out of 11 will eventually develop breast cancer. Fibrocystic disease or benign breast mastopathies have been associated with an increased propensity to progress to malignancy. However, the increased relative risk for women with benign breast disease developing breast cancer appears to be associated with proliferative benign disease in association with atypia. Their cumulative risk may be as high as 30%. These women represent 3-5% of women with benign disease. They clearly warrant more careful screening and follow-up. The etiology of benign breast mastopathies is unknown, but its incidence and relationship to hormonal events suggests that many of the histologic entities represent an endocrine response. Many hormonal manipulations have been shown to decrease mastodynia and reduce the incidence of breast aspirations and biopsies. However, these and other therapeutic interventions have not been shown to reduce the incidence of breast cancer in women who are at high risk. PMID- 3296751 TI - Nocardia pneumonitis and the adult respiratory distress syndrome. AB - This report describes the progression of an acute regional Nocardia pneumonitis to diffuse pulmonary parenchymal disease in a previously healthy man. The pathophysiologic manifestations of disease evolved from that of a severe bacterial pneumonia to the adult respiratory distress syndrome. This progression may be representative of pyogenic bacterial pneumonias, which are associated with the syndrome even when the infections are adequately treated. PMID- 3296753 TI - Studies in neural tube defects. I. Epidemiologic and etiologic aspects. AB - In the NIH Collaborative Perinatal Project, a prospective study of over 53,000 pregnant women and their offspring, 71 single-born children (13.33/10,000) were found to have a non-syndromal neural tube defect (NTD). A family history was present in only one case. The group of individuals with NTD was compared to a group of 400 randomly selected non-malformed control infants. Of over 50 maternal factors studied the following showed significant association with NTD in the offspring: diabetes mellitus; organic heart disease; lung disease; and diuretic, antihistamine, and sulfonamide use. The interval between the termination of the immediately previous pregnancy and the start of the proband pregnancy was significantly shorter in mothers of NTD children than in mothers of control infants. The risk for NTD was also significantly increased if the immediately previous pregnancy was a spontaneous abortion. There was no increased risk for NTDs among sibs of children with major malformations such as tracheo-esophageal "dysraphism," cleft lip/palate, or renal agenesis. NTDs are apparently etiologically heterogeneous. PMID- 3296754 TI - Use of genetic counselling services for neural tube defects. AB - Genetic counselling is recommended for parents of children with neural tube defects (NTDs) to inform them of the recurrence risks and the option of prenatal diagnosis. British Columbia provides an excellent site to examine the use by parents of genetic counselling services for NTDs. Genetic services for the entire province are centralized, and there is virtually complete ascertainment of all NTD births. The results from this study indicate that use of genetic counselling services is influenced by the type of NTD present and whether the index case was live or stillborn. Genetic counselling is most often sought after the birth of a liveborn infant with spina bifida. PMID- 3296755 TI - Hydrolethalus (Salonen-Herva-Norio) syndrome: further clinicopathological delineation. AB - Two brothers with severe CNS abnormalities, cleft lip/palate, polydactyly, and lung hypoplasia are reported as examples of the hydrolethalus syndrome, an autosomal recessive disorder. Death from cardiopulmonary arrest occurred in patient 1 at age 4 months and in patient 2 at age 17 days. Detailed radiological and neuropathological description is provided on patient 2. We recommend realtime ultrasonography and, when indicated, fetoscopy for antenatal detection of the craniofacial and limb malformations associated with this syndrome. PMID- 3296756 TI - Information-processing correlates of computer-assisted word learning by mentally retarded students. AB - Information-processing correlates of computer-assisted word learning by moderately and severely mentally retarded students were identified. Nineteen subjects completed 10, 15-minute computer-assisted instruction sessions and seven basic cognitive tasks measuring simple learning, choice reaction time, relearning, probed recall, stimulus discrimination, tachistoscopic threshold, and recognition memory. Stimulus discrimination, probed recall, and simple learning were significantly related to word learning. Results suggest that instruction should be modified to accommodate individual differences in these abilities. PMID- 3296757 TI - Surgery and diabetes. Minimizing the risks. PMID- 3296758 TI - Home with a new heart. PMID- 3296759 TI - Preventing posthysterectomy vaginal vault prolapse and enterocele during vaginal hysterectomy. AB - One hundred twelve vaginal hysterectomies were performed during a period of 2 years, 8 months. During the first year and a half, fourteen procedures were performed on patients referred to our institution because of posthysterectomy vaginal prolapse. We present our results of abdominal and vaginal repairs for vaginal prolapse. Moreover, we present and emphasize a modified surgical technique for the prevention of posthysterectomy vaginal prolapse and enterocele during vaginal hysterectomy. In all 112 patients no posthysterectomy prolapse has occurred. It is concluded that these procedures are acceptable ones to prevent an infrequent, yet tragic consequence of hysterectomy. PMID- 3296760 TI - Evolving concepts in the mechanism of steroid action: current developments. AB - The mechanisms of steroid action remain a poorly understood enigma. Although much effort has focused on the steroid receptor as a mediator of the steroid's effect in the cell, we are only beginning to understand the structure of steroid receptors. Development of monoclonal antibodies directed against both the steroid binding "receptors" and receptor-associated proteins has allowed novel approaches to the problem. They were important in determining the nucleotide sequences of several receptor genes and subsequently the amino acid sequence of three receptors. Surprisingly, receptors contain amino acid sequences common to v-erb A, a potentiator of oncogenic transformation. Two receptor-associated proteins have been found and their relationship to the receptors suggests the possibility of additional functions of receptors in addition to binding deoxyribonucleic acid. Thus the role of the receptor in the mechanism of steroid action is evolving from the "two-step mechanism" to one that includes the recently discovered receptor-associated proteins. PMID- 3296762 TI - Trial of progesterone vaginal suppositories in the treatment of premenstrual syndrome. PMID- 3296761 TI - Phasic contraceptive pills and functional ovarian cysts. AB - This seven-case anecdotal report is presented to alert physicians to the possibility of the formation of functional ovarian cysts during use of phasic contraceptive pills. The patients were studied by the combination of history, physical examination, ultrasound examination, and in two cases surgery. The occurrence of functional ovarian cysts during the use of phasic contraceptive pills is well established while not well appreciated by practicing physicians. This seven-case presentation strongly suggests that phasic contraceptive pills may be a threat to patient health and safety. It is suggested that further studies be undertaken to better understand the pathophysiology. PMID- 3296763 TI - Serologic markers after the transplantation of corneas from donors infected with human immunodeficiency virus. AB - Four corneas from two cadavers that later had positive test results on enzyme linked immunosorbent assays and Western blot analysis for antibodies against the human immunodeficiency virus were inadvertently transplanted to recipients who were without known risk of human immunodeficiency virus infection. We performed serial studies of serologic markers of human immunodeficiency virus infection in the cornea recipients and assayed reverse transcriptase levels of their mixed lymphocyte cultures. The four cornea transplant recipients were followed up for 130, 152, 397, and 440 days, respectively, and the results on all serologic tests and reverse transcriptase assays remain negative. PMID- 3296764 TI - Massive subretinal hemorrhage with acute angle-closure glaucoma in chronic myelocytic leukemia. PMID- 3296766 TI - Analysis of binocular visual function using tests made under binocular conditions. AB - Accommodation and vergence have a complex relation which occasionally breaks down, resulting in a loss of visual efficiency along with symptoms of discomfort associated with use of the eyes. Studies of accommodation/vergence interactions and tonic vergence disorders indicate that, using classical analysis techniques, separate methods are frequently necessary to determine whether existing binocular deficiencies are causing reported symptoms. The problem with current systems of binocular visual function analysis is that the vergence error which exists under binocular conditions is often not the same as that which is measured under monocular conditions. A rationale for, and technique of, analyzing binocular function using results of tests made under binocular conditions is described. This analysis incorporates the concepts of CA/C, proximal vergence (PV), and fixation disparity along with several accommodative measures (facility, lag, sustaining ability, and accuracy). By identifying relevant binocular components and the interrelations, the clinician should be better able to assess the contribution of each and examine which may be modified most easily by vision therapy, lenses, and/or prism intervention. PMID- 3296765 TI - Reduction of astigmatism after keratoplasty. PMID- 3296767 TI - Microbiological testing of the Blairex Water Purifier. AB - The Blairex Water Purifier (previously called The Blairex Deionizer) is a filtration unit designed to purify tap water for uses that require distilled or deionized water. The unit is intended to offer soft contact lens wearers a more convenient and safe method of obtaining distilled water when using salt tablets or enzymatic cleaning tablets. In this study, the safety of these units was analyzed from a microbiological point of view. The microbial starting state of 18 factory sealed Blairex Water Purifiers was evaluated by filtering sterile water through each unit and enumerating the organisms in the effluent. Then a known number of specific microorganisms was filtered through each unit. For the next 30 days, subsequent sterile distilled water filtrations were done each day. The effluent was collected with each filtration and enumerated for microorganisms. The results indicated that the majority of Blairex units tested were not sterile from the onset. Several Blairex units evaluated did support bacterial growth, as the bacteria that were passed through the unit on day 1 of the study were found in the effluent in increasing numbers with use. The clinical implications of our findings are discussed. Each time Blairex units were obtained for evaluation, the units appeared different in either filter attachments, plastic composition, or shape. The results varied according to which type of Blairex unit was tested. PMID- 3296768 TI - Islet amyloid in type 2 human diabetes mellitus and adult diabetic cats contains a novel putative polypeptide hormone. AB - Amyloid deposition is a very typical alteration in the islets of Langerhans in human Type 2 (non-insulin-dependent) diabetes mellitus and in feline diabetes mellitus. Amyloid infiltration is also commonly found in insulin-producing pancreatic tumors. It was shown recently that amyloid purified from an insulinoma was composed mainly of a novel polypeptide (insulinoma amyloid polypeptide, IAPP), which had partial identity with the neuropeptide calcitonin gene-related peptide (CGRP). Cat islet amyloid contained a similar polypeptide. This finding is verified in the present study, and it is shown that the cat IAPP differs from the human peptide only in two of the 16 elucidated amino acid residues. The authors now also show by N-terminal amino acid sequence analysis that human islet amyloid is of IAPP origin. Although the significance of IAPP is unknown, its occurrence in pancreatic endocrine tissue and partial identity with a known neuropeptide suggests an endocrine regulatory function. PMID- 3296769 TI - Monoclonal antibodies (MT1, MT2, MB1, MB2, MB3) reactive with leukocyte subsets in paraffin-embedded tissue sections. AB - The absence of reactivity on routinely prepared tissue sections has hampered the use of monoclonal antileukocyte antibodies in diagnostic histopathology. Here we describe five new antibodies reactive with leukocyte subsets in formaldehyde fixed, paraffin-embedded tissue sections. Antibody MT1 is reactive with mature and immature T cells and not with mature B cells. MT2 is reactive with mature T cells and B cells, but not with immature T cells, activated T cells, and germinal center B cells. Antibody MB1 is reactive with all B cells, with about 50% of mature T cells, and not with immature T cells. MB2 is reactive with all B cells and not with T cells. However, MB2 also stains endothelial cells and several types of epithelial cells. MB3 is reactive with B cells and histiocytes, but not with T cells. The antibodies were tested on a series of lymphomas that were also immunophenotyped with a panel of well-established reagents on frozen tissue sections. The results indicate that the MB and MT antibodies are useful tools in the study of reactive and neoplastic disorders of the lymphoid system. PMID- 3296770 TI - Activation of the intramyofibral autophagic-lysosomal system in muscular dystrophy. AB - Skeletal muscles obtained from myopathies with myofiber necrosis, including mdx dystrophic mice, plasmocid-induced myopathy in rats, and patients with Duchenne muscular dystrophy, were examined immunohistochemically with anticathepsin peroxidase conjugates. Strong reactions for lysosomal cysteine proteinases, which can degrade myofibrillar proteins, were demonstrated in macrophages invading and surrounding the necrotic areas and some degenerative myofibers and also in intramyofibral portions of atrophic fibers of dystrophic mice and humans. Apparently normal and regenerating myofibers did not stain for lysosomal cathepsins. Abnormal increases of cathepsins L and B were seen even in the early stage of plasmocid myopathy and in a 20-day-old young mdx mouse before infiltration of macrophages, suggesting that autodigestion by intramyofibral lysosomal proteinases is an important event before digestion of the necrotic fibers by macrophage proteinases. Activation of the intramyofibral lysosomal system, as in muscular dystrophy, was also observed in distal myopathy with rimmed vacuoles without macrophageal infiltration (Am J Pathol 1986, 122:193 198). Thus, this activation seems to be an important, early response to myocellular damage. PMID- 3296771 TI - Enhancement of chronic Trypanosoma cruzi myocarditis in dogs treated with low doses of cyclophosphamide. AB - An enhancement of chronic myocarditis was obtained in dogs chronically infected with Trypanosoma cruzi protozoa soon after they were submitted to treatment with low doses of cyclophosphamide (50 mg/sq m bs three times a week for 3 weeks). Such treatment did not cause immunodepression. Myocarditis varied in intensity, but was quite severe and diffuse in some animals, with focal fibrinoid, coagulative, and lytic necrosis and invasion of disintegrating myocardial fibers by the mononuclear inflammatory cells. Untreated infected controls exhibited mild focal myocarditis, usually represented by accumulation of lymphocytes in the interstitial connective tissue. It is suggested that the administration of low doses of cyclophosphamide interfered with the immunologic suppressor network that is thought to maintain the chronic indeterminate (or latent) phase of T cruzi infection. PMID- 3296772 TI - Filaments of Pick's bodies contain altered cytoskeletal elements. AB - Pick's disease, a form of progressive senile dementia, is distinguished by the presence of neuronal inclusions known as Pick's bodies. The Pick's body consists mostly of sparse 10-20-nm straight filaments admixed with other cytoplasmic elements. This ultrastructural study was undertaken to establish which components of the Pick's body share epitopes with the normal neuronal cytoskeleton and with Alzheimer's paired helical filaments. Vibratome sections from postmortem brains of patients afflicted with Pick's disease were immunostained by means of polyclonal and monoclonal antibodies to neurofilaments, an antiserum to microtubule proteins not cross-reacting with neurofilaments, and an antiserum to Alzheimer's paired helical filaments. All the antibodies have been shown previously to react with Alzheimer's paired helical filaments. The peroxidase antiperoxidase or indirect immunogold procedure was used for immunostaining. In addition, we used Bodian's silver stain, which has a high affinity for neurofilaments. At the electron-microscopic level the antibodies and Bodian's silver reacted with the straight filaments and some amorphous elements contained within the Pick's body. The following preadsorptions blocked the immunoreaction: neurofilament antibodies with neurofilaments; microtubule antibodies with microtubule protein or a preparation of the microtubule associate protein, tau; antibodies to paired helical filaments with Alzheimer's brain tissue. Treatment of brain tissue containing Pick's bodies with sodium dodecyl sulfate, a solvent of the normal neuronal cytoskeleton, did not dissolve straight 12-nm filaments. The detergent extracted filaments contained the same isotopes as the Pick's filaments in intact tissue. These results demonstrate that the straight filament components of the Pick's body contain the same neurofilament and microtubule epitopes as the Alzheimer's paired helical filaments and that the filaments share insolubility characteristics similar to those of the paired helical filaments. It is proposed that these two structures are related and are derived at least in part from altered components of the normal neuronal cytoskeleton. PMID- 3296774 TI - Stress, competence, and development: continuities in the study of schizophrenic adults, children vulnerable to psychopathology, and the search for stress resistant children. AB - The evolution of an ongoing research study into stress-resistant factors in children is traced from the early work on adult schizophrenia through the identification of risk factors in children vulnerable to stress. Future directions for the research are explored, including the necessity for defenses against possible politicization of the findings. PMID- 3296773 TI - Focal arteriolar insudation. A response of arterioles to chronic nonspecific irritation. AB - The subcutaneous insertion of sterile, inert plastic pellets over the cremaster muscles of rats induces characteristic focal lesions of the arterioles at a distance from the pellets. These lesions appear with a delay of about 6 hours; by light microscopy they are characterized by a focal dilatation accompanied by endothelial damage and increased permeability. They are more severe if the pellets are loaded with histamine and are inhibited if the pellets are loaded with serotonin. Electron microscopy shows interendothelial gaps; the media is massively infiltrated with blood components and fibrin. The medial smooth muscle cells are stretched and at times necrotic; inflammatory cells are scarce. On the basis of these features the lesion was named focal arteriolar insudation (FAI). Although its pathogenesis is not yet clear, the data at hand suggest that it is caused by endogenous mediators affecting the smooth muscle cells and/or the endothelium. FAI appears to be a specific arteriolar response to chronic nonspecific irritation. PMID- 3296775 TI - Do abused children become abusive parents? AB - The belief that abused children are likely to become abusive parents is widely accepted. The authors review the literature cited to support this hypothesis and demonstrate that its unqualified acceptance is unfounded. Mediating factors that affect transmission are outlined and the findings of several investigations are integrated to estimate the true rate of transmission. PMID- 3296776 TI - Methodological issues in childhood depression: a review of the literature. AB - Sources and types of information used to assess depressed children are identified in a survey of the diagnostic criteria, assessment methods, and instruments reported in relevant studies in six core journals. Children's self-reports are the most frequently used source of data; the reliability of information provided by classmates is gradually gaining acceptance. The need for development of consistent criteria and sound instruments is highlighted. PMID- 3296777 TI - Psychosocial preparation and follow-up for pediatric bone marrow transplant patients. AB - Bone marrow transplantation often necessitates relocation to a tertiary care hospital in a distant location. For child, family, and caregivers this adds to the stress implicit in the transplantation. The value of communication between centers and disciplines is illustrated. Psychological issues and interventions are described for each treatment stage. PMID- 3296778 TI - Facial nerve disorders: update 1987. PMID- 3296779 TI - How large is the drop in PO2 between cytosol and mitochondrion? AB - The subject of this brief review is the size of the local drops in PO2 around consuming mitochondria. We show that large drops (several Torr or more) are in conflict with the predictions of basic diffusion theory, when one uses accepted values for relevant parameters. In particular, oxygen diffusion coefficients must be reduced by at least a factor of 10 below measured values to reconcile Fick's law with large PO2 drops. Experimental evidence offered for large drops is often ambiguous because of system heterogeneities. In those cases where tractable models of heterogeneous systems can be developed, the experimental data are consistent with drops in PO2 on the order of a few hundredths of a Torr between cytosol and mitochondrion. PMID- 3296780 TI - Norepinephrine storage, distribution, and release in diabetic cardiomyopathy. AB - The ability of hearts to store, distribute, and release norepinephrine (NE) was investigated in rats 8 wk after the induction of diabetes by an injection of streptozotocin (65 mg/kg iv). Chronic diabetes was associated with increased content and concentration of NE in heart and in other tissues such as kidney, brain, and spleen. Reserpine or tyramine treatment resulted in depletion of endogenous cardiac NE in control and diabetic rats. The depletion of NE stores at different times after a dose of reserpine was greater in diabetic hearts. On the other hand, NE stores in diabetic hearts were less sensitive than control hearts to low doses of tyramine but were more sensitive to high doses. The uptake of [3H]NE was greater in diabetic hearts in isolated perfused preparations. In comparison with the control values, diabetic hearts showed a decrease in [3H]NE in the granular fraction and an increase in the supernatant fraction. Diabetic hearts also showed an accelerated spontaneous release of [3H]NE. The increased cardiac NE and the uptake and release of NE in diabetic animals were reversible upon treatment with insulin. These results are consistent with the view that sympathetic activity is increased in diabetic cardiomyopathy and indicate that cardiac NE in diabetic rats is maintained at a higher level partly due to an increased uptake of released NE by adrenergic nerve terminals. PMID- 3296781 TI - Insulin resistance and delayed clearance of peptide hormones in cirrhotic rat liver. AB - Clearance of porcine insulin, glucagon, and human growth hormone was measured in intact perfused cirrhotic and normal rat livers. Binding and degradation of 125I insulin by hepatocytes isolated from cirrhotic and normal livers were also studied. The half-lives (t1/2) of immunoreactive insulin and glucagon were 14.0 +/- 3.1 and 9.6 +/- 2.1 min in normal livers and 26.0 +/- 6.1 and 25.0 +/- 7.1 min in cirrhotic livers (P less than 0.001). Insulin binding and degradation by hepatocytes from control and cirrhotic livers showed no significant differences. Intraportal insulin infusion in perfusion studies suppressed glucagon-stimulated increases in glucose output from control livers but failed to suppress glucose production by cirrhotic livers, suggesting the presence of hepatic insulin resistance in cirrhosis. Impaired clearance of insulin and glucagon by the intact cirrhotic liver and normal binding and degradation of insulin by isolated hepatocytes suggest that factors such as intrahepatic fibrosis and shunting and postbinding defects may be responsible for the impaired hormone clearance and hepatic insulin resistance. PMID- 3296782 TI - Splanchnic hemodynamics in portal hypertensive dogs with portal fibrosis. AB - Splanchnic hemodynamics and portal systemic shunting were measured in eight dogs with experimentally induced portal fibrosis and splenomegaly and in six normal dogs by the radioactive microsphere technique. Portal fibrosis and splenomegaly were produced by repeated intraportal injections of a mixture of killed nonpathogenic Escherichia coli and dog anti-E. coli serum. All E. coli-treated dogs developed intrahepatic presinusoidal portal hypertension (portal vein pressure 15.8 +/- 5.4 vs. 7.5 +/- 0.9 mmHg in controls, P less than 0.005; intrahepatic pressure 6.8 +/- 2.1 vs. 6.2 +/- 1.4 mmHg in controls, NS) within 2.5 mo, but no portal systemic shunt was demonstrated at this time (2.1 +/- 1.5 vs. 0.7 +/- 0.4%, NS). Portal venous inflow, the total blood flow within the portal system, was increased in the treated dogs (27.6 +/- 6.6 vs. 18.2 +/- 2.5 ml X min-1 X kg body wt-1, P less than 0.005). Total splanchnic arterial vascular resistance was reduced in these dogs (26.0 +/- 10.4 vs. 40.9 +/- 4.6 dyn X s X cm 5 X 10(3), P less than 0.01) as a result of reduced arteriolar resistance in the spleen, jejunum and ileum, colon, and omentum, in all of which blood flow increased. In these animals both portal venous flow (27.0 +/- 6.5 vs. 18.1 +/- 2.5 ml X min-1 X kg body wt-1, P less than 0.005) and intrahepatic portal vascular resistance (1.9 +/- 0.7 vs. 0.7 +/- 0.3 dyn X s X cm-5 X 10(3), P less than 0.005) were increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296783 TI - Proteins are secreted from heterogeneous prestored sources in the exocrine pancreas. AB - Recent studies demonstrating nonparallel regulated secretion of prestored digestive enzymes in tightly linked groups consistent with the exocytosis mechanism led us to predict that digestive enzymes would be found to be secreted from heterogeneous sources within the exocrine pancreas (J. W. Adelson, and P.E. Miller, Science Wash. DC 228: 993-996, 1985). We explored whether the gland was heterogeneous with respect to its sources of prestored secretory proteins with a double isotopic label method not dependent on activity of secreted digestive enzymes. Rabbit pancreatic proteins were double labeled in vivo by injection of each animal with chemically identical but isotopically distinct mixtures of 3H- and 14C-labeled amino acids, which were administered separately or together on consecutive days after partial depletion of prestored proteins by administration of cholecystokinin (CCK), methacholine chloride, or saline in a protocol in which order of both isotope and secretagogue administration was varied. Three days after labeling, proteins were recovered by collection from cannulated pancreatic ducts of anesthetized animals after stimulation with alternating increasing doses of CCK and methacholine chloride. Pooled secretory data were analyzed to determine whether secretagogue pretreatment resulted in specific and heterogeneous sequestration of proteins after synthesis; data after final secretory stimulation with methacholine chloride and CCK were individually analyzed to determine whether presequestered proteins were mobilized from heterogeneous compartments during secretion. Correlation and regression analysis of isotopic outputs and variance analysis of specific radioactivities of secreted proteins showed sequestration into and secretion from heterogeneous pools of secretory proteins, directly confirming out hypothesis. These results provide a cell biological mechanism explaining regulated nonparallel secretion of digestive enzymes. PMID- 3296784 TI - Aldosterone is a physiologically significant kaliuretic hormone. AB - To study the role of aldosterone in the short-term control of potassium excretion, rats were gavaged with a liquid diet containing 10-20% of their daily caloric and potassium intake, with a range of sodium intakes. Levels of (effective) aldosterone at the time of gavage were manipulated by administration of spironolactone, aldosterone, and adrenalectomy. Urinary sodium, potassium, and creatinine excretion were measured in conscious unrestrained rats for 2 h after the food load, and then blood was collected for measurement of plasma potassium, aldosterone, and renin activity. Potassium excretion was dependent on both dietary potassium and a minimum dietary sodium content. Potassium excretion was reduced by spironolactone and adrenalectomy and increased by acute aldosterone treatment in most dietary groups. These results strongly suggest that the ambient levels of aldosterone are important in determining potassium excretion following food ingestion. Plasma aldosterone was higher with the higher potassium and lower sodium content diets. Changes in plasma aldosterone, with variations in dietary potassium or sodium, suggest a role for aldosterone in subsequent potassium excretion. PMID- 3296785 TI - In vivo measurement of tubular fluid ferrocyanide with carbon-fiber microelectrodes. AB - Techniques to construct carbon-fiber microelectrodes and to measure ferrocyanide ion concentration in single nephrons are described. The measurement involves polarizing an inert carbon-fiber microelectrode 500 mV positive with respect to a Ag-AgCl reference, while measuring the faradic current produced by the oxidation of ferrocyanide. A carbon fiber (5-7 micron diam) is heat sealed into a glass micropipette that is then sharpened, silanized, and electrochemically pretreated to minimize electrode degradation by protein. Circuit diagrams for an inexpensive voltage clamp-current monitor and a data sampling device are presented. The electrodes show a linear response to changes in ferrocyanide concentration in large and very small (20 nl) volumes in vitro. The electrodes were used in an electrochemical microassay to determine tubular fluid-to-plasma ferrocyanide concentration ratios and nephron filtration rates with proximal micropuncture samples. The results show excellent agreement with paired determinations using [3H]inulin. In vivo proximal tubule perfusion experiments show a rapid linear response to changes in tubular fluid ferrocyanide concentration. These electrodes permit rapid quantitative measurements of ferrocyanide concentration and water transport in the proximal tubule and may be useful in other biological systems. PMID- 3296786 TI - Metabolic aspects of the regulation of systemic pH. AB - Catabolism of protein produces CO2, NH4+, and HCO3-. Mammals readily lose CO2 through the lungs, but the bicarbonate produced in metabolism of a typical diet (in humans, approximately 1 mol/day from approximately 100 g of protein) would cause alkalosis if not disposed of. Air-breathing animals solve this problem by incorporating NH4+ into organic compounds in which N is not protonated; thus each NH4+ ion loses a proton in the course of the synthesis. These protons serve to titrate HCO3-. In mammals, ureagenesis is the pathway by which protons are liberated from NH4+. The rate of ureagenesis therefore determines the rate of disposal of bicarbonate, and must be an important factor in the maintenance of pH homeostasis. Ammonium ion that is not needed for urea synthesis is packaged into glutamine by the liver. Hepatic glutamine synthetase is localized in the last rank of cells around the pericentral venule; thus glutamine synthetase cannot compete for NH4+ or interfere with the control of pH by urea synthesis. Ammonium excretion in the urine does not represent excretion of acid, and is not stoichiometrically related to renal generation of bicarbonate. The quantitatively major processes by which the HCO3-/CO2 ratio, and hence the pH, is regulated in blood and interstitial fluid are excretion of CO2 through the lungs and disposal of HCO3- as a consequence of ureagenesis in the liver. PMID- 3296787 TI - Effect of high calcium intake on pressor responsivity in hypertensive rats. AB - Some proposed mechanisms for the hypotensive effect of high calcium intake involve reduction in vascular responsivity. To assess the effect of dietary calcium on vascular responsivity, spontaneously hypertensive rats (SHR) were placed on normal (N-Ca; 0.4%) or high (H-Ca; 2.8%) casein-based synthetic diet for 4 wk. Intraarterial pressure, pressor response to graded intravenous infusion of norepinephrine (NE) and angiotensin II (ANG II), and in vitro vascular reactivity of tail artery segments to NE and transmural nerve stimulation (TNS) were studied. Urinary electrolyte excretion, plasma renin activity (PRA), aldosterone, NE, and epinephrine (EPI) were also determined. H-Ca SHR had a lower intraarterial systolic and diastolic pressure. However, H-Ca SHR had greater in vivo pressor response to both ANG II and NE. Maximal contractile force developed by tail artery segments in vitro in response to NE and TNS was slightly, but not significantly, higher in H-Ca SHR. In vitro dose-response curves to NE and TNS were not significantly different. Although H-Ca SHR had increased urinary excretion of sodium throughout the study period, PRA and aldosterone levels were similar in both groups. Plasma NE and EPI levels in the two groups were also not different. Despite lowered intra-arterial blood pressure, H-Ca SHR exhibited enhanced pressor response to ANG II and NE in vivo and a similar in vitro vascular reactivity to NE and TNS when compared with N-Ca SHR. Our results do not support a role for alterations in vascular reactivity to NE or ANG II in the hypotensive effect of high calcium intake in SHR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296788 TI - Cardiac and arterial baroreceptor influences in release of vasopressin and renin during hemorrhage. AB - We studied the role of arterial and cardiac baroreceptors on mean arterial pressure (MAP) and release of arginine vasopressin (AVP) and plasma renin activity (PRA) during hemorrhage in conscious rabbits. Each rabbit was bled at 2% of its blood volume (BV) per minute until 35% had been removed, after which the blood was reinfused. Each rabbit was studied on three occasions, 7 days apart, and in each experiment, BV-MAP and BV-hormone response curves were constructed. The response to hemorrhage was examined when the input from arterial and cardiac baroreceptors were both intact; arterial baroreceptors only were intact (cardiac receptors were blocked with intrapericardial procaine); cardiac receptors only were intact (after sinoaortic denervation); neither receptor was intact. Resting AVP and PRA levels were unaffected by the various deafferentation procedures. AVP steeply increased only after more than 25% BV had been removed; this response was entirely mediated by cardiac baroreceptors. Increases in PRA occurred at BV loss greater than 15% and were largely independent of baroreceptor input. Maintenance of MAP during hemorrhage was mostly due to drive from the arterial baroreceptors. Thus AVP secretion during hemorrhage contributes little to the maintenance of MAP, and the hypovolemic stimulus to AVP release comes entirely from the cardiac baroreceptors. PMID- 3296789 TI - Nonisotonicity of simian eccrine primary sweat induced in vitro. AB - Na+, K+, Cl-, and HCO-3 concentrations were determined in both methacholine (MCh) induced and isoproterenol (ISO)-induced primary sweat collected directly from isolated and cannulated rhesus monkey palm eccrine secretory coils in vitro. Na+ concentration [( Na+]) of MCh-induced sweat was higher than that of the bathing medium by 4.2 mM, i.e., 155.4 vs. 151.2 mM. Sweat [Cl-] was consistently higher than that of the medium by 13.7 and 11.2 mM in both MCh- and ISO-induced primary fluid, respectively. The sweat-to-bath Cl- gradient increased as [Cl-] in the bath was lowered by substituting with less-permeable anions. In contrast sweat [HCO-3] was much lower in both MCh- and ISO-induced sweat than that of the bathing medium, i.e., approximately 6 mM in sweat vs. 25 mM in the bath. [K+] in MCh-induced primary sweat (mean of 6.63 mM) was consistently higher than that of the bathing medium (5 mM). Furthermore, [K+] tended to be the highest in the first sweat sample after MCh stimulation, reaching as high as 9 mM. In sharp contrast ISO-induced primary sweat showed [K+] that was almost always less than 5 mM with the mean of 4.03 mM. These electrolyte profiles of the primary fluid have been discussed relative to the transport model generally applied for Cl- secretory epithelia. PMID- 3296790 TI - Expiratory effects of cerebellar stimulation in developing opossums. AB - Positive-pressure breathing (PPB) causes expiratory activation of abdominal (ABD) and intercostal (IC) muscles in anesthetized opossums. Developmentally these responses begin to appear at about the 30th postnatal day and become prevalent over the next 3-4 wk. The purpose of the present study was to examine effects of constant-current cerebellar stimulation, applied over a single breath, on respiratory timing and expiratory electromyogram (EMG) activity in ABD and IC muscles during PPB in anesthetized opossums from 30-35 days of age to weaning. Electrode placements in the region of the deep cerebellar nuclei showed strong expiration-phased effects. For animals showing expiratory activation of both ABD and IC muscles during PPB, the response at low-current density consisted of suppression of the IC and ABD EMGs; relative inhibition often differed, with reduction of the ABD EMG being greater than for IC muscles. In animals of all ages tested, cerebellar stimulation prolonged the expiratory phase of the stimulated breath. Frequency of cerebellar stimulation needed to achieve maximum prolongation of the breath was significantly lower for younger vs. older animals. Pathways from deep cerebellar nuclei may differentially influence the activity of motor groups with comparable respiratory functions; this may be related to a cerebellar function of coordinating respiratory and nonrespiratory (i.e., movement and posture) functions of specific motor groups. PMID- 3296791 TI - Treatment of a patient with seasonal premenstrual syndrome. AB - The authors identified a patient who had premenstrual syndrome (late luteal phase dysphoric disorder) only in the fall and winter and was virtually asymptomatic during the spring and summer. On the basis of previous experience with seasonal affective disorder, they treated the patient with bright artificial light, which reversed her symptoms. On subsequent occasions they reversed this treatment effect with oral melatonin administration and found that propranolol and atenolol, beta-antagonists that inhibit the production of melatonin, had a therapeutic effect similar to that of light. They discuss the implications of these findings in relation to the importance of melatonin as a mediator of seasonal rhythms in biology. PMID- 3296793 TI - Treatment of hyperactive children with D-phenylalanine. AB - Eleven hyperactive boys were treated for 2 weeks with D-phenylalanine (20 mg/kg per day) and for 2 weeks with placebo in a double-blind crossover study. Tests included parent and teacher behavior ratings, cognitive measures, and blood and urine measures of norepinephrine, amino acids, and trace amines. No significant improvement or deterioration in behavior and no side effects were noted, and only serum phenylalanine was increased by the active treatment phase. This provides reassurance about the toxicity of aspartame, a food additive that contains phenylalanine, but argues against precursor loading treatment of hyperactivity. PMID- 3296792 TI - Trazodone in the treatment of panic disorder and agoraphobia with panic attacks. AB - Eleven patients with panic disorder or agoraphobia with panic attacks completed an 8-week single-blind trial of trazodone (300 mg/day) without concurrent behavioral instructions. The measures of change included ratings of generalized and panic anxiety, phobias, and depression and a behavioral avoidance test, which were administered during a baseline period of placebo administration and at 4 and 8 weeks of the trial. There was significant improvement on all symptom dimensions, which suggests that trazodone may have specific antipanic and antiphobic actions and underscores the importance of serotonergic mechanisms in these anxiety disorders. PMID- 3296794 TI - Stop smoking advice by physicians: a feasible approach? AB - To understand the effect of brief stop smoking advice by physicians, we conducted a randomized clinical trial in 258 smokers. After three months, 8.8 per cent of the intervention group and 6.8 per cent of the control group had become nonsmokers. The intervention group also reported significantly more attempts to quit and/or cut down. At follow-up, only 60 per cent recalled receiving a smoking message and only 85 per cent of these perceived it as a message to quit. PMID- 3296795 TI - Phosphate content of human amniotic fluid and its relationship to bacterial growth inhibition. AB - A sensitive method for assay of phosphate has been adapted for use with human amniotic fluid. The presence of an antibacterial factor in amniotic fluid inactivated by phosphate suggested that measurement of free phosphate may predict antibacterial activity and hence susceptibility to intrapartum infection. The intrinsic antibacterial activity of amniotic fluid was altered by addition of large amounts of phosphate, but the intrinsic concentration of free phosphate correlated poorly with antibacterial activity and organically combined phosphates did not appear to be related to the antibacterial property. PMID- 3296796 TI - Arthur Purdy Stout and papilloma of the breast. Comments on the occasion of his 100th birthday. AB - In 1951 Haagensen, Stout, and Phillips described a series of patients treated for benign intraductal papillary breast lesions. They emphasized the importance of distinguishing between "microscopic papillomas" and "gross papillomas." While the former tended to be multicentric and potentially precancerous, follow-up of 108 women who had solitary papillomas revealed no subsequent carcinomas. Four women had additional papillomas in the ipsilateral breast and one patient developed a papilloma of the contralateral breast. Review of the literature since 1927 reveals a total of 612 patients who reportedly had a papilloma treated by excision. Subsequent carcinoma was described in 23 cases (11 or 2% ipsilateral; 10 or 2% contralateral; two or 0.3% bilateral). These data indicate that excision of a solitary papilloma from the breast does not indicate that the breast is predisposed to develop carcinoma at a later date. PMID- 3296797 TI - Dr. Arthur Purdy Stout's bibliography, 1951-1964. PMID- 3296799 TI - Vascular neoplasms. PMID- 3296798 TI - Proliferative fibroblastic lesions. From hyperplasia to neoplasia. AB - It is rare to find a pathologist whose ideas and beliefs are so sound and pervasive as to influence our thinking decades after his writing. Yet such was the case with Dr. Stout, to whom we owe our basic classification of fibroblastic tumors, our concept of fibromatosis, and our diagnostic approach to fibrosarcomas. We need to continue the progress Dr. Stout made in these areas and to search for biochemical and molecular differences in these tumors with the hope that this knowledge will lead to new avenues for therapy. PMID- 3296800 TI - Arthur Purdy Stout and his times. With a history of the Laboratory of Surgical Pathology at the College of Physicians and Surgeons of Columbia University. PMID- 3296801 TI - Ewing's sarcoma and related small round cell neoplasms in children. PMID- 3296802 TI - Arthur Purdy Stout and the evolution of modern concepts regarding peripheral nerve sheath tumors. PMID- 3296803 TI - Kaposi's sarcoma. With special reference to its manifestations in infants and children and to the concepts of Arthur Purdy Stout. PMID- 3296804 TI - Smooth muscle tumors of the gastrointestinal tract. What we know now that Stout didn't know. AB - Arthur Purdy Stout and his co-workers, in several publications, raised two important issues concerning gut stromal tumors. First, they felt that all were of smooth muscle origin. Recent ultrastructural and immunohistochemical studies suggest that the component cells are basically undifferentiated, and there is only occasional emergence of smooth muscle features and, in some tumors, possibly features of other cell types as well, such as Schwann cells. Second, Stout felt that the high mitotic rate was the best predictor of malignancy, but he recognized that some tumors, even with low rates, could metastasize. Surprisingly, recent studies, even those covering large series, have done little to dispute these contentions. However, current data suggest that the diagnosis of malignancy can be made using multiple parameters, not all of which must be present in every sarcoma. These parameters include, in addition to mitotic rate, the size, gross invasion of adjacent organs, and cellularity, and all of these must be modified according to the location in the gut and the pattern of growth. PMID- 3296805 TI - Herniorrhaphy. A personal experience with 6,321 cases. AB - The results of 6,321 consecutive herniorrhaphies have been reported. Over 20 percent of the cases were referred recurrences when first seen. Ninety-one percent of the patients were followed from 2 to 14 years, with an overall recurrence rate of 0.7 percent. A low recurrence rate was not unfavorably affected by the prompt resumption of activity postoperatively. Some recurrences are unavoidable; however, it is essential to accept the dictum that all hernias can be cured. PMID- 3296806 TI - Diagnostic discriminants of thyroid cancer. AB - One hundred ten consecutive patients with histologically proved thyroid carcinoma were studied in relation to cell type, age, sex, presence of metastases, and results of thyroid scintiscanning and ultrasonography. Forty-four percent of these patients presented with a normally functioning, or warm, nodule on scintiscan. Nineteen percent presented with ultrasonographic findings of a cystic lesion. The physiologic circumstances that explain these findings have been discussed. On the basis of this study, as well as other reported series, it is concluded that both scintiscanning and ultrasonography are not reliable discriminants in the diagnosis of thyroid cancer. PMID- 3296807 TI - Angioaccess by reverse brachiocephalic fistula. AB - Reverse vascularization of the cephalic vein using the medial cubital vein was performed in 16 patients. No complications were found in a follow-up period that ranged from 2 to 47 months. In selected anatomic cases, this reverse fistula is preferable to the direct brachiocephalic fistula. PMID- 3296808 TI - Clinical orthotopic cardiac transplantation. AB - The results of orthotopic cardiac transplantation have improved dramatically since the early experiences in the late 1960s. After almost 20 years of research and experience and the introduction of cyclosporine, 1 and 5 year survival rates are now 80 percent and 60 percent, respectively. The number of potential recipients far exceeds that of available donors, which is the limiting factor in cardiac transplantation. Complications related to immunosuppressive therapy remain significant, and despite decreased length of hospitalization, costs remain high. The majority of patients have good functional rehabilitation and are free of cardiac symptoms. Moreover, orthotopic cardiac transplantation has finally become a therapeutic treatment of end-stage heart disease. PMID- 3296810 TI - [Role of prostaglandins in various forms of obstetrical and gynecological pathology]. PMID- 3296809 TI - The role of anaerobic bacteria in otitis media: microbiology, pathogenesis, and implications on therapy. AB - The current knowledge of the recovery of anaerobic bacteria from cases of acute and chronic otitis media is reviewed. Although techniques for cultivation of anaerobes were used in the studies presented, the methodologies of collection, transportation, and cultivation of the specimens varied. Consequently, there were differences in the rates of recovery of these organisms and the species isolated. Anaerobes, mainly gram-positive cocci, were recovered from a quarter of ear aspirates in acute otitis media in about one third mixed with aerobic and facultative bacteria. In a study of otitis media with effusion, anaerobic bacteria were recovered in 12% of the culture-positive aspirates. The predominant anaerobes were gram-positive cocci and Bacteroides melaninogenicus. Several studies reported the recovery of anaerobes in about half of the patients with chronic otitis media and in those with cholesteatoma. The predominant anaerobes were gram-positive cocci, Bacteroides sp, and Fusobacteria sp. Many of these organisms produced beta-lactamase and might have contributed to the failure of these patients to respond to penicillins. The potential synergistic relationships between the various aerobic and anaerobic bacteria and the role of the capsule of anaerobic bacteria as a virulence factor are discussed. PMID- 3296811 TI - [Nonspecific resistance factors of the reproductive system in the human female]. PMID- 3296812 TI - [Immunoenzyme study of interspecific embryonic antigens in the blood serum of ovarian cancer patients]. PMID- 3296813 TI - [Use of echography in diagnosing a number of gynecologic diseases of childhood and adolescence]. PMID- 3296814 TI - [Use of an ultrasonic method in the antenatal diagnosis of anomalies of fetal development]. PMID- 3296815 TI - [Sonographic and histological changes in the placenta in EPH gestosis and prolonged pregnancy]. PMID- 3296816 TI - [The role of ultrasonic research in multiple pregnancy]. PMID- 3296817 TI - [Echographic diagnosis of extrathoracic ectopy of the heart]. PMID- 3296818 TI - [Gardnerella vaginalis in nonspecific vaginitis]. PMID- 3296820 TI - The genetic implications of long-term survival of childhood cancer. Mutation epidemiology. AB - The evaluation of the genetic implications of increasing exposure to genotoxic agents poses one of the most difficult epidemiological issues faced by biomedical scientists. Mutation epidemiology is a term referring to studies aimed at estimating the rates of spontaneous as well as environmentally induced somatic and germinal mutations in humans and the assessment of their impact. In this article, studies of the mutagenic effects of ionizing radiation and chemotherapeutic agents are reviewed and discussed in light of the limitations inherent in these kinds of investigations. Estimating the risk of mutational damage is a young science. Further technological developments promise better assessments than can presently be offered. PMID- 3296819 TI - [Rare case of an improperly inserted contraceptive device]. PMID- 3296821 TI - Chediak-Higashi syndrome. AB - The use of cytochemical, electron microscopic, immunofluorescent, and tissue culture techniques has led to important advances in our understanding of the mechanisms underlying the pathogenesis of the Chediak-Higashi syndrome (CHS). This rare and fatal autosomal recessive disorder is clinically characterized by partial albinism, frequent pyogenic infections, and an accelerated lymphohistiocytic phase. The pathological hallmark of CHS is the presence in all white blood cells of massive lysosomal inclusions, which are formed through a combined process of fusion, cytoplasmic injury, and phagocytosis. The abnormal inclusions exhibit both azurophilic and specific granular markers, and are probably responsible for most of the impaired leukocyte and other cell functions in CHS patients. In addition, a selective profound natural killer (NK) cell function and platelet storage pool deficiencies have been described in these patients. Impaired microtubule assembly and functions, mediated by abnormal intracellular cyclic nucleotide levels, which could be corrected by treatment with ascorbic acid, were suggested to be the pathophysiological basis for CHS abnormalities. However, some recent studies have questioned this cytoskeletal model, which is suggested to be rather a secondary manifestation of CHS. PMID- 3296822 TI - The concept of cure in pediatric oncology. Altered realities. AB - Defining cure for a child with cancer is not simple. Such terms as "long-term disease-free survival" or "no evident disease" are expressions of our current clinical inadequacies. An equally important problem, however, is that the disease and its treatment are frequently associated with sequelae that prevent complete restoration of baseline health status or that alter subsequent growth and developmental patterns. This article describes the nature of cures that have been achieved for childhood cancer and reassesses current treatment goals, taking into consideration altered realities of survival. Tasks remaining include the construction of medical treatment regimens that minimize acute and late effects, the design of intervention strategies to reduce the psychological and social impact of the disease on children and families, and the modification of society's attitudes so that cancer survivors are more accepted in the community. PMID- 3296823 TI - Biological consequences of cancer and its treatment and their relationship to current treatment planning. AB - Advances in the treatment of childhood cancer have produced dramatic changes in survival. Unfortunately, many of the advances associated with this improvement have been accompanied by delayed sequelae induced by treatments such as surgery, radiotherapy, and chemotherapy. This article reviews published reports of treatment sequelae and examines their impact on the design of current forms of treatment. Recognition of the delayed effects of these treatment modalities has resulted in alterations in established therapies. This alteration is an ongoing process and demonstrates the concern of physicians with improving quality of life for long-term survivors of childhood cancer. PMID- 3296824 TI - Cerebral pathology and neuropsychological effects. Differential effects of cranial radiation as a function of age. AB - Cranial radiation therapy (CRT) has been associated with an increased incidence of neuropsychological impairments and pathologic changes in the CNS among children. However, findings regarding a causal relationship between CRT and neurobehavioral impairments and the differential impact of CRT as a function of treatment age have been equivocal. Inconsistent findings may be attributed to the current research focus on description of impairments to the neglect of a larger theoretical framework and the failure of investigators to integrate findings from the various disciplines involved in assessing CRT effects. Two theories regarding the etiology of CRT effects on neuropsychological functions have been proposed. The myelination hypothesis suggests that CRT effects are attributable to direct effects on myelin synthesis. Findings indicating that the child is in a state of particular vulnerability to teratogens due to the rapid growth phase of myelin during the first 48 months of life provide the basis for this hypothesis. The myelination hypothesis predicts a differential effect for CRT as a function of age/maturation. The vascular hypothesis proposes that CRT effects are due to pathological changes in vascular tissues. Results indicating prominent white matter changes among some CRT recipients provide the basis for this hypothesis. The vascular hypothesis predicts no age effect or an inverse age effect; it places more emphasis on the relationship between indices of cerebral blood flow and neuropsychological test performance. Two basic mechanisms underlying the effects of CRT are outlined to provide a theoretical framework on which future research may be based.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296825 TI - Psychosocial issues in childhood cancer. An ecological framework for research. AB - A number of psychosocial issues are evolving as childhood cancer becomes a chronic rather than a fatal condition. These include issues associated with extended hospitalization and social isolation, as well as long-term adjustment to survival that may involve recurrence of disease. Primary emphasis in current research and intervention is placed on how children and their families adapt to long-term survival. This article reviews the scope and limitations of previous research in this area, which focuses on the individual with little reference to the family, school, or social networks or to the interactions occurring among these arenas. An ecological model is suggested as the most useful perspective for enhancing our understanding of the impact of childhood cancer on the child, family, and community. Much of what is already known about how cancer and its treatment affect children and families is consistent with the propositions of an ecological model. The transactional, reciprocal, and interdependent nature of coping behaviors within a family system is perhaps the most obvious indicant of the need for multiple perspectives for understanding how families respond to the pressures of a chronic, but possibly life-threatening, illness. An ecological approach is timely, therefore, in that there is a need for psychological research and intervention directed beyond the immediate context of treatment to extended levels of social interaction and social systems. PMID- 3296826 TI - Socioeconomic considerations in childhood cancer survival. Society's obligations. AB - Children have the right to be given the opportunity to become responsible adults. But this right is not assured for children with cancer. They carry a stigma that is the basis for discrimination in education, in the armed services, in employment opportunities, and in the opportunity to receive fair treatment from health and life insurance companies. In this article, examples of discriminatory practices are reviewed, along with the steps being taken to alleviate the situation. The author emphasizes that the responsibility for correcting discrimination belongs to all groups in society--the government, families of children with cancer, and other private citizens--and suggests means by which citizens can end discrimination against cancer survivors. PMID- 3296829 TI - The effects of alcohol on renal function and excretion. PMID- 3296828 TI - Hypophosphatemia and hypomagnesemia result in cardiovascular dysfunction: theoretical basis for alcohol-induced cellular injury. AB - Although it has been known for many years that prolonged ingestion of ethanol may be associated with numerous side effects, among them cardiovascular alterations, e.g., hypertension, cardiac arrhythmias, strokes, and cardiomyopathy, a direct cause and effect between alcohol and injury to the cardiovascular system has only been accepted recently. However, what mechanism is responsible for these cardiovascular alterations remains to be determined. Since it is well known that chronic alcohol consumption leads to hypophosphatemia and hypomagnesemia, we designed experiments to determine if controlled depletion of either phosphorous or magnesium (Mg2+) lead, in themselves, to cardiovascular disturbances and what effects these mineral depletions exert on myocardial cellular bioenergetics. Biochemical studies were carried out on left ventricular muscle, including mitochondrial and myofibrillar preparations. With respect to phosphate depletion, myocardial creatine phosphate, ATP, and ADP levels were reduced. Phosphate depletion also reduced mitochondrial and myofibrillar creatine phosphokinase activities; significant alterations in mitochondrial oxygen consumption, acid extractable phospholipid precursors, and mitochondrial oxidation of long chain fatty acids were noted. With respect to magnesium depletion, significant reductions in inorganic oxygen consumption was also reduced. Utilizing these data, we have proposed several schemes for possible alcoholic-induced myocardial and vascular injury. PMID- 3296827 TI - The role of endothelium in tolerance to ethanol-induced contraction of the rat aorta. AB - After 2 days of intoxication an endothelium-dependent tolerance to ethanol induced contraction of the rat aorta develops. This study investigates the possibility that the observed tolerance may be due to the recently described endothelium-dependent vasodilator system which mediates the action of several potent vasodilators. The maximum response induced by ethanol in control and intoxicated aortic rings with endothelium was significantly increased by treatment with eicosatetraynoic acid and methylene blue. In addition, these agents significantly decreased the EC50 of ethanol in intoxicated but not control rings with endothelium. The response of control and intoxicated aortic rings without endothelium was unaltered by eicosatetraynoic acid or methylene blue. Indomethacin, nordihydroguaiaretic acid, and FPL 55712 did not alter either the maximum response or the EC50 of ethanol in control or intoxicated rings with endothelium. These observations support the hypothesis that the endothelium dependent tolerance observed in the aorta may be due to the release of an endothelium-derived relaxing factor. PMID- 3296831 TI - The effect of ethanol on the brain catecholamine systems in female mice, rats, and guinea pigs. AB - The effect of acute ethanol administration on the concentrations of dopamine (DA), norepinephrine (NE) and their metabolites (3,4-dihydroxyphenylacetic acid [DOPAC], homovanillic acid [HVA], 3,4-dihydroxyphenylglycol [DHPG] and 4-hydroxy 3-methoxyphenylglycol [HMPG]) in brains of female mice, rats, and guinea pigs were investigated. A subhypnotic dose (2 g/kg) or a hypnotic dose (4 g/kg) of ethanol was administered intraperitoneally and the animals were killed 45 min later. In the rat the DA levels were unchanged, while the NE concentrations were decreased after both doses of ethanol. The DA levels did not change in the mouse and guinea pig, while the concentrations of NE showed a minor decrease in the mouse but were unaffected in the guinea pig. After 4 g/kg of ethanol the DOPAC and HVA concentrations were elevated significantly in all three species, and after 2 g/kg the DOPAC levels were increased in the rat and guinea pig brains and the HVA levels in the mouse and guinea pig brains. In the mouse and rat brain the DOPAC + HVA concentrations indicated a dose response relationship: 4 g/kg was significantly more effective than 2 g/kg. The DHPG concentration increased in the rat brain after both 2 and 4 g/kg, while the HMPG concentrations increased significantly only after 2 g/kg. In the mouse and guinea pig the brain DHPG concentrations remained unchanged, while the HMPG concentrations increased after both 2 and 4 g/kg ethanol. These data suggest, that the turnover of both DA and NE was increased 45 min after a subhypnotic as well as after a hypnotic dose of ethanol in all three species studied.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296832 TI - Symptoms and diagnosis of depression in alcoholics. AB - We examined depressive symptoms, using the Beck Depression Inventory (BDI), in a group of 50 alcoholic patients, diagnosed according to DSM III criteria during active drinking, withdrawal (4 days after their last drink), and abstinence (24 days after their last drink). DSM III diagnoses of major depression were made in 16 (32%) of the patients. The diagnoses were made using the NIMH Diagnostic Interview Schedule (DIS) between the 10th and 24th day after the patients' last drink. Depressive symptoms decreased markedly as the patients progressed from active drinking to abstinence. Alcoholic patients having a diagnosis of major depression had higher BDI scores than those not having a diagnosis of major depression. Analysis of BDI items using a two-parameter logistic item response model confirmed that the BDI measured depressive symptoms in these alcoholics. We conclude that the BDI is valid for screening for depression in alcoholic patients. PMID- 3296830 TI - Alcohol, alcoholism, and biological rhythms. AB - Chronobiological rhythms contribute to our understanding of the effect of alcohol and of several features of alcoholism. The observation of infradian periodicities suggests preventive seasonal strategies aimed at reducing the consumption of alcohol and its consequences. Circadian variations in blood alcohol levels and behavioral impairment indicate a complex temporal rhythmicity with both physiological and psychosocial determinants. Circadian differences are noted among possible mediators of susceptibility towards alcoholism. Ultradian patterns may be of prognostic value in assessing risks such as that of relapse during withdrawal from alcohol. Recommendations for future animal and human investigations are suggested. PMID- 3296833 TI - Alcohol-dependent men and women in detoxification: some comparisons. AB - Alcohol-dependent women undergoing detoxification treatment in psychiatric wards are compared to men with respect to sociodemographic and treatment-oriented variables. For these comparisons, patient documentation from all psychiatric hospitals in one large West German city were analyzed. Representativeness is shown by data of the general population of corresponding age. Findings are presented in relation to data of long-term inpatient therapy. Results show that the detoxified women are socially less poorly integrated than men and suggest that our common ideas about a drinking career are based on experience with male alcoholics. PMID- 3296834 TI - Gangliosides of long sleep and short sleep mouse cerebellum and hippocampus and cerebellar and whole brain synaptosomal plasma membranes. AB - Gangliosides appear to be factors in CNS membrane responses to ethanol. Responses of membranes to ethanol might be influenced by the membrane concentration of gangliosides, the distribution of ganglioside molecular species, or the surface orientation of gangliosides at the plasma membrane surface. To determine the importance of these influences to the acute effect of ethanol, we have chosen to study them in long sleep (LS) and short sleep (SS) mice. This report presents our findings on the composition of gangliosides from LS and SS mouse cerebellum and hippocampus, the composition of gangliosides from synaptosomal plasma membranes (SPM) of LS and SS mice, and the molecular species of cerebellar gangliosides from the two lines. It has been found that GM1 is elevated in the cerebellum and in cerebellar SPM of LS mice compared to SS mice, but that there is no difference between the GM1 concentration in the whole hippocampus of the two lines. Further, there are no differences in the molecular species of the cerebellar gangliosides of LS and SS mice. PMID- 3296835 TI - Diethyl ether inhibits ethanol metabolism in vivo by interaction with alcohol dehydrogenase. AB - The ethanol disappearance rate was determined in fed rats given 20-40 mM ethanol and anesthetized with pentobarbital (control group) and diethyl ether. The control ethanol disappearance rate was 0.27 +/- 0.02 mM/min (+/- SD, n = 4). Rats anesthetized with diethyl ether (blood levels of 9-13 mM) revealed an ethanol disappearance rate of 0.13 +/- 0.05 mM/min (+/- SD, n = 7), i.e., 52% inhibition of the control rate. Kinetic studies on crystalline and lyophilized alcohol dehydrogenase from equine liver demonstrated that 20 mM diethyl ether inhibited the initial rate of ethanol oxidation by 55%. By using ethanol as the variable substrate the inhibition of alcohol dehydrogenase was described by a mixed noncompetitive/uncompetitive mechanism. PMID- 3296836 TI - Drinking patterns and drinking problems in 1984: results from a general population survey. AB - Findings on alcohol consumption and alcohol problems from a 1984 general population survey are presented and compared to previous survey findings. Eighteen percent of all men and 5% of all women were classified as frequent heavy drinkers; 6% of all men drinkers and 2% of all women drinkers reported that they got "drunk" as often as once per week or more. A system for measuring drinking problems, based largely on the work of Cahalan and Room, is presented and explained. As when interpreting any system of measuring drinking problems in a general population survey, readers must be aware that the resulting prevalence rates are strongly influenced by arbitrary decisions about where cutpoints should be drawn. With this caveat in mind, the results show that 9% of men drinkers and 4% of women drinkers reported problematic drinking behavior at what is defined as a moderate level of severity. Similarly, 14% of men drinkers and 6% of women drinkers reported adverse tangible consequences of drinking at a moderate level of severity. The age and sex distributions of drinking, heavy drinking, intoxication, and drinking problems were as expected, with greater proportions of men than women reporting these things and greater proportions of younger than older drinkers reporting them. PMID- 3296837 TI - The antisocial and the nonantisocial alcoholic: clinical distinctions in men with major unipolar depression. AB - Depressed, alcoholic men were divided into those with and those without antisocial personality (ASP). The ASP alcoholics had a more severe, cross sectional clinical picture; they had a higher rate of drug use disorder and more alcohol-related symptomatology. The medical complications of alcoholism were related to the duration of heavy drinking whereas the nonmedical complications (the psychosocial and pathologic-intake problems) were related to ASP, duration of heavy drinking, and their interaction. PMID- 3296838 TI - Alternatives to regression residuals as measures of change after the intake of alcohol. PMID- 3296839 TI - Peripheral and cerebrovascular actions of ethanol, acetaldehyde, and acetate: relationship to divalent cations. AB - Inasmuch as ethanol is thought to exert its major effects in the autonomic and central nervous systems, it is important to determine whether acute versus chronic ingestion of this abused substance exerts any direct actions on peripheral and cerebral blood vessels. Since the chronic effects of ethanol on the cardiovascular system appear to be pivotal in the etiology of hypertension, coronary heart disease, and strokelike events, it is important to elucidate and understand the effects of chronic ethanol abuse and its mechanism(s) of action on the peripheral and cerebral blood vessels. Data are reviewed which suggest that the peripheral vasodilation and hypotension which result from acute ingestion (or administration) of ethanol may, in large part, be a consequence of its direct actions on vascular smooth muscle cells, both at the macro- and microcirculatory levels. At least two mechanisms appear to contribute to this vasodilator effect: inhibition of the normal rhythm or vasomotion (spontaneous mechanical activity) of vascular smooth muscle, and depression of the contractile responses to endogenous neurohumoral substances that play a role in maintaining vascular tone and regulation of blood flow. The data acquired so far suggest that the dilator actions are related causally to interference with movement and/or translocation of Ca2+ across the vascular membranes. In addition, these actions appear to resemble the peripheral vascular effects of general anesthetics. Evidence is also reviewed which indicate that ethanol, in contrast to acting as a vasodilator in the splanchnic vasculature, is often a potent and concentration-dependent constrictor of arterioles and venules in the skeletal muscle vasculature. Direct in situ observations on the rat brain, using high resolution, quantitative TV image-intensification microscopy, indicates that administration of ethanol, irrespective of the route of administration (e.g., perivascularly, intraarterially, or systemically), produces graded concentration-dependent spasms of arterioles and venules. Concentrations of ethanol approximately equal to greater than 250 mg/dl produce intense spasms resulting in rupture of these vessels. Recent in situ studies in conscious dogs, using radiolabeled microspheres, also indicate that ethanol can produce deficits in regional brain blood flow. Studies with isolated canine middle cerebral and basilar arteries clearly demonstrate that low concentrations of ethanol (e.g., less than 10 mM) can produce concentration-dependent spasms by a direct vascular action.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3296841 TI - Methylprednisolone pulse therapy in severe acute asthma. AB - In a group comparative double blind pilot study six asthmatic patients with an acute exacerbation of their disease were randomly treated with either methylprednisolone pulse therapy (MPPT) (1000 mg daily for 3 days) (n = 2) followed by placebo tablets, or standard doses of methylprednisolone (MP) (50 mg daily gradually decreased to zero over 3 weeks) (n = 4). The results showed that the effect of MPPT did not differ from that of standard doses of MP. MPPT has, however, the potential of being preferable to standard treatment with MP, because of easy administration and optimal patient compliance. PMID- 3296840 TI - Results of biological standardization with standardized allergen preparations. AB - The aim of biological standardization (BS) is to equilibrate the activity (potency) of allergen extracts from different source materials. This was done by performing skin prick tests (SPT) on patients who were sensitive to one of the following 10 allergens: Birch, alder, hazel, timothy, rye grass, velvet grass, cultivated rye, mugwort, D. farinae and Cladosporium herbarum. Patient sensitivity varied within a range of three to four powers of ten for each allergen investigated. The weal size in each patient corresponding to that elicited by histamine 1 mg/ml was calculated using the model log (mean weal diameter) = a + b log (concentration). The correlation coefficients of the regression lines of the allergen dose response relationship were found to be greater than 0.85 in most cases. The median slope for all extracts was 0.24. The slope for Cladosporium was significantly steeper than that for pollens. The amount of material in microgram dry weight (d.w./ml) equal to 1000 biological units/ml (BU/ml) varied within a factor of three between species for all tested purified allergen preparations but Cladosporium. For Cladosporium, about 30 times more material was needed than for D. farinae. When using crude rather than purified material, it was necessary to use five to ten times more to elicit a reaction corresponding to 1000 BU/ml, but the difference was significant only for Cladosporium. The narrow range of allergen concentrations used by us as well as other investigators does not assure positive skin prick test results in all patients with clinical symptoms due to the allergen in question. Skin prick testing should therefore be done over a wide range of concentrations to improve the methods for BS. PMID- 3296842 TI - Granulocyte migration in vivo and in vitro in healthy children of parents with atopic asthma. AB - Healthy children of atopically asthmatic parents received in vivo and in vitro granulocyte migration tests. Eleven children whose parents were both asthmatic showed statistically significant inhibition of granulocyte migration compared with controls. PMID- 3296843 TI - Tree pollen allergy. III. Cross reactions based on results from skin prick tests and the RAST in hay fever patients. A multi-centre study. AB - 872 adult hay fever patients were investigated with skin tests, using 20 different tree pollen allergens, and Phadebas RAST, using eight different tree pollen allergens. Correlation between test results with the different allergens were studied employing the Spearman's correlation coefficient (Rho). Most combinations showed statistically significant correlations. The highest values of Rho (0.8-0.9) were found for pollen from combinations of trees belonging to the families Betulaceae, Corylaceae and Fagaceae (birch, alder, hazel, beech and oak). High values were also found between pollens from aspen and sallow (belonging to Salicaceae). With several of the trees a high degree of pollen cross sensitization was found, even with trees from a different plant family. Since most of the patients were allergic to birch pollen, some of the reactions to other pollens could be due to allergens shared by birch. To exclude this possibility, a separate analysis was performed for patients having no birch pollen allergy. Even in these patients evidence of cross sensitization was found. It is concluded that cross reactions are common among tree pollens and are most pronounced within botanical families. PMID- 3296844 TI - [Thrombophlebitis of the lateral sinus. Apropos of a case]. PMID- 3296845 TI - Directory of accredited organizations, approved programs/offerings, and accredited continuing education certificate programs preparing nurse practitioners: Spring 1987. PMID- 3296846 TI - Ondine's curse and the anaesthetist. AB - The central hypoventilation syndrome (Ondine's curse) is reviewed and discussed with emphasis on the clinical features and treatment of the disorder. It is a rare syndrome, but the anaesthetist working in a paediatric centre or in intensive care should be aware of its existence since advice and assistance in management may be required. PMID- 3296847 TI - Intercostal nerve blockade for children. AB - A modified technique of intercostal nerve blockade is described which is suitable for use in children. Ten patients received intercostal nerve blockade on a total of 29 occasions in order to provide analgesia following liver transplantation and to facilitate weaning from artificial ventilation of the lungs. The opioid requirement of patients who received intercostal nerve blockade was considerably lower than that of those who did not; 56% of the children who received intercostal nerve blockade required no additional analgesia. One child, the first to receive intercostal nerve blockade, developed a pneumothorax following the procedure. The technique has proved to be safe in skilled hands. It is an acceptable method of postoperative analgesia in children after liver transplantation and may be a useful technique in the management of other paediatric patients. PMID- 3296848 TI - [Postoperative disorders of cardiovascular function]. AB - Cardiovascular instability is the cause of almost 50% of postoperative complications and raises postoperative mortality far above that intraoperatively. The aged patient with pre-existing heart disease represents a high postoperative risk. These patients are very susceptible to hypoxia, anemia, hypovolemia, the negative inotropic effects of certain anesthetics, and increased oxygen consumption due to shivering. The reversal of anesthetic agents is also rather debatable in these cases. Hypertension and arrhythmias are common phenomena in the recovery room. They may be aggravated by a number of factors such as metabolic and respiratory imbalances, incorrect fluid substitution, pain, or excitation. The frequency of postoperative myocardial infarction (MI) depends upon pre-existing coronary artery disease and hypertension. A medical history of heart failure or previous MI also plays an important role hemodynamic course as do the surgical procedure and the intraoperative. Postoperative hemodynamic monitoring should be performed according to the standards suggested by the American Society of Anesthesiologists. Medical treatment basically consists of symptomatic therapy and the avoidance of risk factors. Specific treatment is rarely required. PMID- 3296849 TI - [The so-called venous air embolism: historical aspects and current diagnosis, prophylaxis and therapy]. AB - The so-called venous air embolism is known as a complication not only of surgical operations but also of other procedures. Two conditions must be fulfilled: a lesion of a non collapsible vein; and a pressure gradient from outside to inside the vein, as occurs for instance during puncture of a large vein in a hypovolemic patient. Air entry into veins is a frequent occurrence during neurosurgery in sitting patients, and thus most diagnostic, prophylactic, and therapeutic innovations were proposed by neuroanesthetists. Due to advances in technique, truly dangerous cases of so-called venous air embolism during neurosurgery in patients in the sitting position are very rare. PMID- 3296851 TI - Jumping to conclusions. PMID- 3296850 TI - [Future perspectives for equipment maintenance and servicing]. AB - Based on the Equipment Safety Law, the Medical Technical Regulations in force since 1 January 1986, and the German Standard DIN 13252: "Inhalational anesthetic Apparatus--requirements for safety and testing", a maintenance system for medical equipment is presented. The maintenance system comprises the check of the equipment by the user before clinical use, maintenance procedures when the equipment is in daily clinical use (maintenance system I), inspection of the equipment at fixed intervals (maintenance system II), and the repair of the equipment should it break down (maintenance system III). Possibilities and perspectives for rationalizing test procedures by means of test simulators are shown. The initial or repeated instruction on medical equipment with life supporting functions can be performed more systematically when appropriately designed test simulators are used. PMID- 3296852 TI - Fiber-optic chemical sensors for competitive binding fluoroimmunoassay. PMID- 3296853 TI - Flow injection analysis--use of immobilised enzymes for the determination of ethanol in serum. PMID- 3296854 TI - Epidural anesthesia and analgesia in high-risk surgical patients. AB - The authors conducted a randomized controlled clinical trial to evaluate the effect of epidural anesthesia and postoperative analgesia (EAA) on postoperative morbidity in a group of high-risk surgical patients. A total of 53 patients were admitted to the study, 28 received EAA, and 25 received standard anesthetic and analgesic techniques without EAA. Surgical "risk" was evaluated preoperatively and found to be comparable in the two groups. When compared to control patients, patients who received EAA had a reduction in the overall postoperative complication rate (P = 0.002) and in the incidence of cardiovascular failure (P = 0.007) and major infectious complications (P = 0.007). Urinary cortisol excretion, a marker of the stress response, was significantly diminished during the first 24 postoperative hours in the group receiving EAA (P = 0.025). Finally, hospital costs were significantly reduced for patients who received EAA (P = 0.02). The authors conclude that EAA exerted a significant beneficial effect on operative outcome in a group of high risk surgical patients. PMID- 3296855 TI - Epsilon-aminocaproic acid for treatment of fibrinolysis during liver transplantation. AB - In 97 adult patients receiving liver transplants, the coagulation system was monitored by thrombelastography and by coagulation profile including PT; aPTT; platelet count; level of factors I, II, V, VII, VIII, IX, X, XI, and XII; fibrin degradation products; ethanol gel test; protamine gel test; and euglobulin lysis time. Preoperatively, fibrinolysis defined as a whole blood clot lysis index of less than 80% was present in 29 patients (29.9%), and a euglobulin lysis time of less than 1 h was present in 13 patients. Fibrinolysis increased progressively during surgery in 80 patients (82.5%) and was most severe on reperfusion of the graft liver in 33 patients (34%). When whole blood clot lysis (F less than 180 min) was observed during reperfusion of the graft liver, blood coagulability was tested by thrombelastography using both a blood sample treated in vitro with epsilon-aminocaproic acid (0.09%) and an untreated sample. Blood treated with epsilon-aminocaproic acid showed improved coagulation without fibrinolytic activity in all 74 tests. When whole blood clot lysis time was less than 120 min, generalized oozing occurred, and the effectiveness of epsilon-aminocaproic acid was demonstrated in vitro during the pre-anhepatic and post-anhepatic stages, epsilon-aminocaproic acid (1 g, single intravenous dose) was administered. In all 20 patients treated with epsilon-aminocaproic acid, fibrinolytic activity disappeared; whole blood clot lysis was not seen on thrombelastography during a 5 h observation period, and whole blood clot lysis index improved from 28.5 +/- 29.5% to 94.8 +/- 7.4% (mean +/- SD, P less than 0.001). None of the treated patients had hemorrhagic or thrombotic complications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296857 TI - Precordial ultrasonic monitoring during cesarean delivery. PMID- 3296856 TI - The influence of continuous epidural bupivacaine analgesia on the second stage of labor and method of delivery in nulliparous women. AB - A randomized, double blind, placebo-controlled study was performed to evaluate the analgesic efficacy and influence of continuing an epidural infusion of 0.125% bupivacaine beyond a cervical dilatation of 8 cm in nulliparous women. When the cervix was greater than or equal to 8 cm dilated, coded study solution was substituted for the known 0.125% bupivacaine solution. The study solution for 46 patients was 0.125% bupivacaine; 46 patients received saline. During the first stage of labor, 44 (96%) women in the bupivacaine group, and 45 (98%) in the saline group, had analgesia of excellent or good quality. During the second stage, 36 (82%) women in the bupivacaine group, versus 18 (41%) women in the saline group, had analgesia of excellent or good quality (P less than .0001). Six (13%) women in each group underwent cesarean delivery after the start of the study solution. Among the women who delivered vaginally, the mean (+/- S.D.) duration of the second stage of labor was 124 (+/- 70) min in the bupivacaine group, versus 94 (+/- 54) min in the saline group (P less than .05). Twenty-one of 40 (53%) women in the bupivacaine group, versus 11 of 40 (28%) in the saline group, underwent instrumental vaginal delivery (P less than .05). Twenty-eight of 40 (70%) women in the bupivacaine group, versus six of 40 (15%) in the saline group; had surgical perineal anesthesia for vaginal delivery (P less than .0001). There were no significant differences between groups in Apgar scores or umbilical cord blood acid-base values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296858 TI - Epidural ketamine or morphine for postoperative analgesia. PMID- 3296859 TI - Fiberoptic assisted tracheal intubation under general anesthesia with IPPV. PMID- 3296860 TI - [Experience with the use of fibrin glue in vascular sutures]. PMID- 3296861 TI - Rheological and anticoagulant therapy of patients with chronic peripheral occlusive arterial disease (COAD). AB - In the course of a six-month study, a three-subgroup cohort of 113 patients (103 m, 10 f, mean age 58 +/- 8 years) with angiographically proven occlusive peripheral arterial disease (COAD) Fontaine stage II was analyzed regarding the therapeutic (improvement of walking performance) and prophylactic (prevention of new vascular events) effects of oral treatment with three different drug regimens. Group A (38 patients) was treated with the anticoagulants phenprocoumon or acenocoumarol; group B (32 patients), with the same anticoagulants plus pentoxifylline--800-1200 mg per day; and group C (43 patients) received irregular treatment with various vasodilators, such as xanthinolnicotinate, naftidrofuryl, pyridylmethanol, and others. At the end of the trial period a significant increase in systolic ankle pressure index and walking distance was observed in group B whereas the two other groups showed minor changes only. The elevated plasma fibrinogen concentration in group B was also significantly decreased. The percentage of atherosclerotic complications such as new arterial thrombosis in the lower limbs, newly appeared stenocardia, myocardial infarction, transient ischemic attack (TIA), and stroke was highest in group C (20%), relatively lower in group A (10%), and lowest in group B (3%). The percentage of hemorrhagic complications was minimal, with no significant differences between group A and group B. These complications were mild and disappeared quickly. The combined therapy with anticoagulants and pentoxifylline had a marked therapeutic and probably prophylactic effect as regards thromboembolic complications in patients with COAD and other localizations of atherosclerosis. PMID- 3296862 TI - Treatment of hypertension in the elderly with captopril. AB - Fifteen elderly hypertensives aged fifty-nine to seventy-four years received captopril either as a monotherapy (group I, n=7) or as an addition to other antihypertensive drugs (group II, n=8) for twelve to fourteen months. Both the mean supine and erect blood pressure fell from 173.3 +/- 3.4/93.3 +/- 6.6 to 143.3 +/- 3.4/78.3 +/- 1.7 and from 166.7 +/- 8.6/98.3 +/- 4.4 to 146.7 +/- 12.0/85.0 +/- 2.9 mm Hg, respectively, in group I, and from 165.6 +/- 10.5/104.9 +/- 4.4 to 128.8 +/- 4.7/84.1 +/- 1.7 and from 154.0 +/- 10.1/107.8 +/- 3.3 to 126.3 +/- 6.0/88.8 +/- 1.2 mm Hg, respectively, in group II. There was a slight but insignificant reduction in pulse rate and body weight. Side effects were minimal. All patients experienced a sense of well-being. There was no impairment of renal function in most patients and no reduction in serum K. This study suggests that, in elderly hypertensives, captopril reduces blood pressure safely and effectively without impairing perfusion to the brain, heart, and kidneys and without causing edema or hypokalemia. PMID- 3296863 TI - Patterns of fibrin deposits in carotid artery plaques. AB - We evaluated 40 consecutive carotid endarterectomy specimens for the presence of fibrin. Intraplaque hemorrhage was noted in 93% of specimens. At the plaque surface, there were two patterns of fibrin distribution. Type I, suggesting a lumen thrombus, was found in 7 specimens. Type II, suggesting an intraplaque hemorrhage at the lumen surface, was found in 15 specimens. These changes were not significantly associated with the presence of ischemic symptoms or the use of antiplatelet or anticoagulant medications. All specimens with Type I change had arteriographic evidence of at least 70% diameter stenosis. The frequent lack of fibrin at the plaque surface suggests that there may be inherent limitations of standard medical treatment for carotid artery disease. PMID- 3296864 TI - Internal mammary artery-innominate vein fistula--case report. PMID- 3296865 TI - Edward H. Angle--the growth and development of a man, an organization, and a specialty. PMID- 3296866 TI - The American College of Allergists. PMID- 3296867 TI - A comparison of albuterol and metaproterenol nebulizer solutions. AB - Metaproterenol (15 mg) and albuterol (5 mg) solutions were each nebulized and delivered to 20 patients with reversible airway obstruction utilizing intermittent positive pressure ventilation in a double-blind comparison. Ten subjects were randomly assigned to each group and they were examined at the start (day 0) and at the end of the study (day 7). There were no significant differences observed between the spirometric responses or the untoward effects of the two groups to either agent. Albuterol and metaproterenol, when administered by intermittent positive pressure ventilation, are essentially equivalent in terms of the magnitude and duration of the response. PMID- 3296868 TI - In vivo and in vitro granulocyte migration in patients with extrinsic and intrinsic bronchial asthma. AB - Sixty-five patients with atopic asthma, 54 with infectious asthma, and 30 healthy controls were evaluated by in vitro granulocyte migration and by the in vivo skin window method of Southam. Quantitative IgM, IgG, IgA, IgE serum concentrations were measured. In vivo migration of granulocytes was decreased in patients with atopic asthma and elevated levels of IgE as well as in patients with infectious asthma and elevated levels of IgG. In vivo migration of granulocytes showed significant decreases in both asthmatic groups only during asthmatic attacks. PMID- 3296869 TI - [Multiple-organ procurement for transplantation]. AB - In the last few years, the tremendous growth of clinical transplantations has greatly increased the need for grafts. Combined heart, liver and kidney harvesting in a same donor could provide an answer. The results are presented of multiple organ retrieval (MOR) carried out in an University hospital located in an area with 1,350,000 inhabitants. In addition to the usual problems of donor maintenance and legal aspects, it was necessary to carry out a specific work-up for each organ to be harvested. The job of the local coordinator was extremely important in the search for potential recipients and the organization of the procedure (time-table, air transport) in order to give optimal conditions. The priority given to retrieving the heart and in situ cooling of the liver and kidneys guaranteed the good quality of the harvested organs. Over a period of three years, 28 MOR have been carried out. Of the 94 organs harvested, 88 were transplanted in France or another European country (49 kidneys, 23 hearts, 16 livers); 75 are still functioning (47 kidneys, 19 hearts, 9 livers). As a result of this experience, and taking into account the need for organs, all brain dead patients should be considered as potential multiple organ donors, and not just as kidney donors. The intervention of several teams, often quite distant from the site of retrieval, requires careful planning. The surgical procedure, even when performed by a trained team, is often complex, perfect synchronization of the surgical steps of the operation being the most important point.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296870 TI - [Value of an isobaric bupivacaine-fentanyl combination for spinal anesthesia]. PMID- 3296872 TI - Distribution of transvascular pathway sizes through the pulmonary microvascular barrier. AB - Mathematical models of solute and water exchange in the lung have been helpful in understanding factors governing the volume flow rate and composition of pulmonary lymph. As experimental data and models become more encompassing, parameter identification becomes more difficult. Pore sizes in these models should approach and eventually become equivalent to actual physiological pathway sizes as more complex and accurate models are tried. However, pore sizes and numbers vary from model to model as new pathway sizes are added. This apparent inconsistency of pore sizes can be explained if it is assumed that the pulmonary blood-lymph barrier is widely heteroporous, for example, being composed of a continuous distribution of pathway sizes. The sieving characteristics of the pulmonary barrier are reproduced by a log normal distribution of pathway sizes (log mean = 0.20, log s.d. = 1.05). A log normal distribution of pathways in the microvascular barrier is shown to follow from a rather general assumption about the nature of the pulmonary endothelial junction. PMID- 3296871 TI - Lung liquid and protein exchange: the four inhomogeneities. AB - William of Ockham, 14th-century scholastic philosopher at Oxford and Munich, emphasized the principle of economy, "pleurality is not to be supposed without necessity" (Ockham's razor). Necessity is the key word. In the modeling of steady state lung liquid and protein exchange, the desire for simplicity has sometimes outweighed good judgment. In fact, we and others have shown that simple models do not work. It is necessary to include several forms of inhomogeneity. The air filled lung shows regional (top to bottom) variations of mass, microvascular pressure, and perimicrovascular protein concentration. Normally, the small longitudinal (arterioles to venules) gradient of microvascular and perimicrovascular pressures is not a major concern, but in nonuniform disease processes, such as microembolism, longitudinal inhomogeneity, and parallel inhomogeneity are dominant. Multiple pores should also be considered a form of inhomogeneity. The effect on liquid and protein exchange, when plasma protein concentration or microvascular pressure change, can be readily explained using pore heterogeneity. The model I am currently using consists of a large number of discrete compartments (18), rather than a continuous distribution. We have recently identified a fifth inhomogeneity, which is that lung lymph flow might not always represent steady-state transvascular filtration because interstitial liquid may leak through the pleura or along the bronchovascular liquid cuffs into the mediastinum. PMID- 3296873 TI - Pulmonary interstitial resistance. AB - The mechanical properties of the perivascular interstitium surrounding large pulmonary blood vessels are defined in terms of interstitial fluid pressure, interstitial compliance, and interstitial hydraulic resistance. Interstitial pressure is one of the main forces which determine liquid filtration across the microvascular barrier. Interstitial compliance is a measure of the ability of the interstitium to swell with hydration which increases interstitial pressure and reduces the filtration rate. Interstitial pressure and compliance are functions of the elastic properties of the surrounding lung parenchyma and the vessel wall. Solid continuum mechanics are used to describe the behavior of the lung parenchyma. The transport properties of the interstitium are described in terms of a porous material whose fluid resistance is determined by a permeability constant. The dynamics of interstitial fluid are governed by the coupling of the flow with the elastic environment. An electrical analog model is developed to predict the growth of interstitial fluid cuffs during edema formation. PMID- 3296875 TI - Kinetics of uptake and metabolism by endothelial cell from indicator dilution data. AB - Certain substrates are rapidly taken up and/or metabolized by pulmonary endothelial cells in a saturable process. When such a substrate and a reference indicator are included in a bolus which is injected into the blood flowing into the lung, the extraction ratio, E(t), curves measured in the pulmonary venous outflow are asymmetric with respect to the reference indicator curve. If a sufficient quantity of substrate is included in the bolus, the extraction curves are concave upward. The shapes of the E(t) curves contain information regarding the chemical-physical processes which govern the fate of the substrate during its single passage through the lung. To interpret the shapes, computer simulations are used to illustrate separately the effects of the uptake of substrate into the cell, the returning flux of the substrate from the cell, the saturation phenomena of the extraction process, and the perfusion heterogeneity of the capillaries. Lastly, a simple analytical method for estimating the organ kinetic parameters of the extraction process is presented. PMID- 3296874 TI - Measurement of endothelial metabolic functions in vivo. AB - Lung metabolic functions include the interaction of microvascular endothelium with blood-borne substances such as physiologically important amine, eicosanoid, and peptide hormones and drugs. This activity is mediated by endothelial transport systems and enzymes which either synthesize or degrade these substances. Because they can alter the hormone content of aortic blood, these functions play a role in homeostasis, and their disturbance has been implicated in the pathogenesis of several forms of lung injury and disease. Both steady state infusion and single injection, multiple indicator dilution techniques have been applied to measure endothelial metabolic functions in the intact lung. Considerable progress has been made in development of mathematical models for the processes, and their application has been tested both under normal conditions and also when the lung is perturbed experimentally. Unique experimental challenges are presented by measurement of metabolic functions in vivo, when steady-state infusion techniques cannot be used because systemic toxicity could result. In this case, the bolus injection approach has been used, with some success, both in laboratory animals and man. Although major challenges remain, their solution is essential if we are to apply knowledge of endothelial cell function in vitro to understanding lung microvascular physiology and pathophysiology in the intact animal. PMID- 3296876 TI - A clinical comparison of lidocaine and bupivacaine. AB - The drug of choice for local anesthesia in most emergency departments is lidocaine. However, it wears off shortly after suturing is complete and patients may experience pain after closure of the wound. We conducted a study to determine the degree of anesthesia obtained during and after repair of lacerations using lidocaine 1% versus bupivacaine 0.25%, a long-acting local anesthetic. Lidocaine and bupivacaine were administered in a double-blind, randomized fashion to 104 patients. Each patient was asked to rate his pain on a 0 to 10 scale (0, no pain; 10, severe pain) prior to administration of the anesthetic. They then rated pain on an identical scale at 30 minutes, and one, two, three, four, five, six, 12, 18, and 24 hours after completion of suturing. The mean baseline pain was 2.96 for the lidocaine group and 3.07 for the bupivacaine group. This decreased to less than 1.0 in both groups 30 minutes after infiltration. It remained low for the bupivacaine group for the next five hours, but increased almost to preanesthesia levels by two hours in the lidocaine group. A three-way analysis of variance revealed a significant difference (P less than .001) between the pain response of the two groups. There was no statistical difference (P greater than .05) between the age of the patients, size of laceration, and amount of drug used. The study shows that patients do experience pain after a wound is sutured and the anesthetic has worn off. It also demonstrates that bupivacaine significantly reduces the pain a patient may experience after repair of a wound. PMID- 3296877 TI - Prehospital advanced life support vs "scoop and run" in trauma management. AB - The question of attempted field stabilization versus the "scoop and run" approach in the management of trauma has no clear-cut answer. We have long been supporting a complex EMS system based on a hope for its effectiveness, rather than concrete proof. The data we need are not currently available. To make any scientific conclusions, we must have data generated from well-controlled, prospective, randomized studies. This involves a question of ethics. There exists a strong general feeling that randomizing prehospital care is unethical. We have reached a point where full resuscitative effort at the scene is not only expected by the general public, but anything less is considered inadequate by much of the medical community. Nevertheless, because the true influence of prehospital treatment is unknown, shouldn't the patient also be given the benefit of not receiving on-site stabilization effort in view of its potential harm? Prospective randomized studies undoubtedly will invite criticism. However, this is the only way to generate any meaningful conclusions. The essential questions remain unanswered. Can criticality be reliably assessed in the field, and if so, will advanced life support serve to reduce this criticality, or only further delay appropriate care? PMID- 3296878 TI - Annotated bibliography of trauma care systems transportation. PMID- 3296879 TI - Effect of jejunal loop location on the activity of Escherichia coli heat-stable enterotoxin in 4- to 5-week-old pigs. AB - Heat-stable enterotoxin (STa) from Escherichia coli strain 431 was injected into the jejunum of 4 pigs from each of 3 litters, using a ligated intestinal loop assay (with loops beginning 1 m caudad to the pylorus). The jejunum was divided into 4 contiguous areas, with 4 loops in each area. Doses of 0, 10, 100, or 1,000 ng of purified toxin (10 ng/mouse unit) were injected into the loops within an area, using a 4 X 4 Latin square design. Fluid accumulation in the loops increased (P less than 0.05) with increasing concentrations of STa in pigs in all litters, but the magnitude of the response varied across litters. Fluid responses to the STa varied in the different areas of the jejunum, with pigs in 2 litters having a decrease (P less than 0.05) in the response to STa in the caudal areas. These data quantitate the variability within the different areas of the jejunum of the young pig. PMID- 3296880 TI - Antimicrobial alternatives for calf diarrhea: enteric responses to Escherichia coli, deferoxamine, or gallium in neonatal calves. AB - Intestinal malabsorption or transferable resistance in enteric bacteria are potentially serious complications of routine oral administrations of antibiotics. On the basis of reports on antimicrobial effects of host iron sequestration and on synthetic iron chelators or competitors in vitro, 2 iron antagonists were studied for their potential as alternative antimicrobials for Escherichia coli diarrhea. Deferoxamine, a fungal iron chelator used to treat acute iron intoxication, and elemental gallium, a competitive inhibitor of iron activity in metabolic enzyme systems, were examined for their effects on enteric morphology and function in neonatal calves. Twelve male calves were allotted to 4 groups: (1) given nonpathogenic E coli (control); (2) given enterotoxigenic B44 E coli; (3) given deferoxamine (50 mg/kg, twice a day); and (4) given gallium (4 mg/kg, twice a day). Calves were studied for 8 days, including the conduct of oral glucose and lactose tolerance tests on days 1, 3, and 7. By day 7, according to oral glucose and lactose tolerance tests, peak plasma glucose concentrations in all calves of groups 2, 3, and 4 were lower than those values in controls. The frequency of diarrhea was significant in all treated calves, and disease was most severe in the deferoxamine-treated calves. Quantitative cultural examination on day 8 showed significant numerical increases of jejunal and ileal E coli and ileal lactobacilli in deferoxamine-treated calves (group 3) and of ileal streptococci in gallium-treated calves (group 4) and showed jejunal and ileal overgrowths of Saccharomyces yeast in deferoxamine-treated calves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296882 TI - Renal ultrasonography in healthy cats. AB - Serial ultrasonographic examinations were performed on the kidneys of 10 healthy cats during normal hydration and after administration of contrast medium. Differences in the appearance of anatomic structures or in the echo intensity were not detected between kidneys during normal hydration and after contrast medium administration. The appearance of scanning images was influenced by mode, frequency, and focal range of the transducer, topography and mobility of the kidneys, and adequate sound conduction. PMID- 3296881 TI - Feline renal ultrasonography: quantitative analyses of imaged anatomy. AB - Maximal kidney dimensions from serial ultrasonograms were measured in 10 healthy cats. Because clinical ultrasonographic examination is often performed in conjunction with excretory urography, the effect of radiographic contrast medium induced diuresis on dimensional change also was evaluated. Although a slight, statistically significant increase in size was observed (compared with kidneys scanned without contrast medium), this increase could not be detected on the basis of visual image evaluation alone. PMID- 3296883 TI - Efficacy of a streptomycin-dependent, live Pasteurella haemolytica vaccine against challenge exposure to Pasteurella haemolytica in cattle. AB - A streptomycin-dependent, live Pasteurella haemolytica vaccine was given in 1 or 2 doses to 2 groups of weaned calves; 2 other groups of calves were not vaccinated. All calves in the vaccinated groups and calves in 1 of the nonvaccinated groups were stressed by transport, intratracheally inoculated with bovine herpesvirus type-1 (Cooper strain), and then intratracheally inoculated with P haemolytica type A1. The 4th group of calves (nonvaccinated controls) was not stressed and were not intratracheally inoculated with virus or bacteria. Mean daily weight gains, total clinical sign scores, lung lesion scores, plasma fibrinogen concentrations, and antibody titers against P haemolytica were determined at various intervals. Calves that had been vaccinated twice had greater mean daily weight gains and lower total clinical sign scores and lung lesion scores than did nonvaccinated, challenge-exposed calves, but the difference was not significant (P greater than 0.05). Calves vaccinated once had the greatest mean daily weight gains, the lowest total clinical sign scores, and the lowest lung lesion scores when compared with the other 2 challenge-exposed groups of calves. Mean daily weight gains and total clinical sign scores of calves vaccinated once were significantly different (P less than 0.05) than those of calves vaccinated twice. Nonvaccinated, nonchallenge-exposed control calves did not develop clinical signs of disease, did not develop lung lesions, and had consistently positive daily weight gains, and had scores in these areas that were significantly different (P less than 0.05) from those of all challenge-exposed groups of calves. Increases in plasma fibrinogen concentrations corresponded to infection with P haemolytica.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296884 TI - Assessment of antibody response of swine infected with Mycoplasma hyopneumoniae by immunoblotting. AB - An immunoblot procedure was used to evaluate porcine antibody response to inoculation with Mycoplasma hyopneumoniae. Mycoplasmas solubilized with sodium dodecyl sulfate were used as antigens. Antibodies to 5 antigens, estimated to be of molecular weight (mol wt) 110,000, 64,000, 50,000, 41,000, and 36,000, were detected in sera collected during the course of induced mycoplasmal pneumonia. Mycoplasma hyopneumoniae antigens, mol wt 110,000, 50,000, 41,000, and 36,000, cross-reacted with M flocculare when antigen prepared from M flocculare or hyperimmune serum against it were used in the immunoblot procedure. The 36,000 dalton (D) antigen reacted with M hyopneumoniae and M hyorhinis convalescent sera. The 64,000-D M hyopneumoniae antigen was the only antigen that did not cross-react with M flocculare or M hyorhinis. Exposure of immunoblot strips with antigens to trypsin before reacting them with the convalescent sera abolished binding ability of the 110,000-D and 36,000-D antigens, but had no effect on binding by 64,000-D, 50,000-D, or 41,000-D antigens. None of the 5 antigens bound to 11 lectins. PMID- 3296885 TI - Effect of levamisole on the clinical and immunologic responses to oral vaccine of Treponema hyodysenteriae. AB - Conventionally raised crossbred Hampshire pigs were vaccinated orally with attenuated Treponema hyodysenteriae in combination with an anthelmintic, levamisole or dichlorvos. Pigs in group I (n = 9) were treated with levamisole and vaccinated with attenuated T hyodysenteriae and those in group II (n = 9) were treated with levamisole and permitted to commingle (contact exposure) with group I. Pigs in group III (n = 9) were vaccinated in a similar manner and were treated with dichlorvos. Pigs in group IV (n = 9) were treated with dichlorvos and permitted to commingle with group III. Control pigs (group V; n = 9) were not given any anthelmintic, nor were they vaccinated; they were housed separately. During the 8-week interval between vaccination and challenge inoculation, 4 total days and 8 total days of diarrhea were observed in pigs in groups I and II, respectively. Likewise, 5 total days and 10 total days of diarrhea were seen in groups III and IV, respectively. In all groups, the pigs tended to shed the organism in their feces after they were vaccinated or challenge inoculated, as determined by a fluorescent antibody technique (FAT) and culture procedure (CP). Overall mean shedding patterns of 5.5% and 24.5% identified by CP and FAT, respectively, were seen in the 2 levamisole-treated groups (I and II). In contrast, mean shedding patterns of 4% and 18% of the isolation attempts were detected by CP and FAT, respectively, in the 2 dichlorvos-treated groups. Diarrhea and shedding of T hyodysenteriae in the controls (group V) did not occur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296886 TI - Effect of yohimbine on xylazine-induced hypoinsulinemia and hyperglycemia in mares. AB - Serum insulin and plasma glucose concentrations were determined in 8 mares. Four IV treatments were studied: xylazine (1.1 mg/kg of body weight); yohimbine (0.125 mg/kg); yohimbine (0.125 mg/kg) followed 5 minutes later by xylazine (1.1 mg/kg); and 5 ml of isotonic saline solution as a control. Blood samples were collected before (time 0) and at 5, 15, 30, 60, 120, and 180 minutes after drug administration. Serum insulin concentration decreased and plasma glucose concentration increased in mares given xylazine. Plasma glucose concentration was unchanged in control mares and in mares given yohimbine or yohimbine followed by xylazine. Serum insulin concentration was unchanged in mares given saline solution, but transiently increased in mares given yohimbine alone. Treatment with yohimbine prevented xylazine-induced hypoinsulinemia and hyperglycemia. PMID- 3296887 TI - Ultrasonographic imaging to monitor fetal and placental developments in ewes fed locoweed (Astragalus lentiginosus). AB - Ultrasonographic imaging was used to monitor the effects of locoweed (Astragalus lentiginosus) on fetal, placental, and cotyledonary developments in pregnant ewes and proved to be a useful noninvasive method of monitoring the effects of locoweed poisoning on fetal and placental development. Ultrasonographic imaging may be a good research technique to observe the effects of toxicants on fetal movement, fetal heart action, and growth and development of the fetus and placenta. Known effects of locoweed poisoning in pregnant ewes, such as fluid accumulation in the placenta (hydrops allantois, hydrops amnii), altered cotyledonary development, and fetal death were observed with ultrasonographic imaging. A previously unknown effect of locoweed on fetal heart action also was observed. Locoweed decreased fetal heart rates, caused cardiac irregularity, and decreased the strength of heart contractions. All ewes, except No. 3525, fed locoweed aborted. At necropsy, aborted fetuses had hypertrophy of the heart, right ventricular dilatation, rounded at the apex of the heart, and generalized edema. PMID- 3296888 TI - Antimicrobial alternatives for calf diarrhea: sera trace element responses to Escherichia coli-, deferoxamine-, or gallium-induced diarrhea. AB - Aseptic and septic inflammatory diseases often are associated with marked changes in tissue and sera trace element kinetics. Iron and zinc sequestration by the host may serve as a protective effect against microbial proliferation, but may deprive host tissues of these necessary elements as well. Conversely, systemic iron administration has been shown to increase susceptibility to, and severity of, infectious diseases, although deficient iron stores may be repleted. Escherichia coli enteritis in calves provides a model wherein the effects of enteric iron antagonism and parenteral iron supplementation may be studied simultaneously. Male calves (n = 12) were given (IM injection) 300 mg of iron dextran after base-line blood samples were obtained, then the calves were allotted to 4 groups (each of 3 calves): group 1 (control)--orally given nonpathogenic E coli; group 2--orally given enterotoxigenic B44 E coli; group 3- orally given deferoxamine (50 mg/kg, twice a day); group 4--orally given gallium (4 mg/kg; twice a day). Calves were studied for 8 days; blood samples were obtained each day (day 1 through day 8) for hematologic and serum biochemical analyses. There were significant increases in serum iron concentration and % saturation in all calves within 24 hours of iron-dextran administration, which returned to base-line values in all but group 4 (given gallium) within 3 days. In the exceptional group (4), total iron-binding capacity decreased with time, as in the other groups, but serum iron concentration remained significantly increased, implying gallium interference with systemic iron assimilation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296889 TI - Shiga-like toxin production and attaching effacing activity of Escherichia coli associated with calf diarrhea. AB - Four hundred twenty-nine isolates of Escherichia coli from calves were tested for the production of HeLa cell cytotoxin(s). Isolates that produced enough cytotoxin to be detected in culture supernatants of iron-depleted broth were considered to produce increased amounts of cytotoxins. Isolates also were tested for homology with a DNA probe for a gene that encodes localized adherence of human enteropathogenic E coli. Four isolates produced increased amounts of cytotoxin that was neutralized by Shiga antitoxin (toxin designated as Shiga-like toxin-I [SLT-I]). A 5th isolate produced increased amounts of cytotoxin (SLT+) that was not neutralized by the Shiga antitoxin, but was neutralized by antitoxin against a variant of SLT (toxin designated as SLT-II). None of the isolates hybridized with the probe for the localized adherence gene. Three of the SLT+ isolates belonged to human enteropathogenic E coli serogroups O26 and O111. All 5 of the SLT+ isolates were from calves with diarrhea, but none of the 5 SLT+ isolates contained genes for classic heat-labile or heat-stable enterotoxins, for K99 fimbriae, or for invasiveness; neither did any of them adhere to HeLa cells in culture. Three of the 5 SLT+ isolates had attaching and effacing activities when inoculated into ligated intestinal loops of rabbits. One of the isolates with attaching and effacing activity in rabbits was originally isolated from a calf with lesions characteristic of those produced by attaching effacing E coli (AEEC). Calves inoculated with this SLT+ AEEC isolate developed focal colonic lesions characteristic of those produced by AEEC, but did not develop diarrhea.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296890 TI - Chronic urinary tract infection in dogs: induction by inoculation with bacteria via percutaneous nephropyelostomy. AB - Dogs were inoculated via percutaneous nephropyelostomy with bacteria isolated from canine patients with urinary tract infections (4 dogs were inoculated with Escherichia coli, 2 were inoculated with Proteus mirabilis, and 1 was inoculated with coagulase-positive staphylococci). At approximately monthly intervals after bacterial inoculation, bladder urine specimens were collected via antepubic cystocentesis, and renal pelvic urine specimens were collected via percutaneous nephropyelocentesis. Dogs were euthanatized between 89 and 294 days after bacterial inoculation. Extensive microscopic examination was conducted on the urinary tract of each dog. The dogs did not develop any of the common clinical signs of urinary tract infections (ie, increased frequency of urination, fever, craniodorsal abdominal [renal] pain, or malaise). Inflammation in the lower urinary tract of the dogs was more severe than that in the kidneys. Although pyelitis was present, extension into the outer medulla and renal cortex seemed to be confined to nephropyelostomy tracts. The most severe bladder lesion was found in the dog that developed cystic calculi after inoculation with coagulase positive staphylococci. PMID- 3296891 TI - Comparison of four serotests for the detection of Dirofilaria immitis infection in dogs. AB - Three hundred two dogs were tested with 4 serotests for heartworm antigen (AG) or antibody (AB) and with the Knott test. The 4 serotests evaluated were an enzyme linked immunosorbent assay (ELISA) for adult heartworm-specific AB (AB-ELISA), a quantitative, indirect immunofluorescent assay (IFA) for adult heartworm-specific AB (AB-IFA), an IFA test for microfilaria (MF)-specific AB (MF-IFA), and an ELISA for adult heartworm AG (AG-ELISA). The presence of heartworms was ascertained in all dogs by necropsy examination. Of 302 dogs, 20 (6.6%) had heartworms in the heart at necropsy. Of infected dogs, 9 (45%) had occult infections. Test sensitivities were 75%, 95%, 70%, and 75% for the AB-ELISA, AB-IFA, MF-IFA, and AG-ELISA, respectively. Test specificities were 85% (AB-ELISA), 77% (AB-IFA), 87% (MF-IFA), and 99% (AG-ELISA). The best agreement between serotest results and necropsy findings was obtained with the AG-ELISA (97%). The 4 serotests detected 86% (AB-ELISA), 100% (AB-IFA), 67% (MF-IFA), and 78% (AG-ELISA) of the dogs with occult heartworm infection. A significant (P less than 0.05) association between intestinal parasitism and positive heartworm test results was found with only AB IFA. Seemingly, the Knott test, or some other concentration method for detecting circulating MF should be the first heartworm test performed. If the examination for MF is negative, the dog has clinical signs, and radiographic findings are suggestive of occult heartworm infection, then a serotest for adult heartworm AG is recommended. PMID- 3296892 TI - Acute changes in pancreatic insulin secretion and hepatic glucose kinetics in endotoxemic miniature pigs. AB - We have proposed a misinformed B-cell hypothesis to describe the effects of increased glucose flux across the pancreatic B cell early in endotoxemia, whereby those cells might misinterpret the true glycemic state and thus induce increased insulin release. This hypothesis was supported by the observations that [6 3H]glucose-derived rates of glucose disappearance increased before systemic hyperinsulinemia appeared in endotoxemic Yucatan miniature pigs. Reevaluation of this hypothesis later showed that pancreatic insulin secretion increased before any changes in systemic glucose disappearance or insulin concentrations and, because of significant increases in hepatic insulin extraction, may have led to some local effects of insulin on hepatic carbohydrate metabolism. The present study was conducted with more frequent sampling periods early during endotoxemia to further characterize the effects of this initial acute increase in pancreatic insulin secretion on hepatic glucose uptake, concomitant to net hepatic glucose production, as well as to further clarify the temporal relationships between pancreatic insulin release and the onset of hypoglycemia. We found that an increase in pancreatic insulin secretion is, indeed, the first event to occur, 30 minutes after initiation of endotoxin infusion, coincidental to the onset of significant decreases in portal and hepatic venous blood flow. [3(3)H]Glucose derived rate of glucose disappearance first increased significantly at 60 minutes, and net hepatic glucose output increased significantly after 80 minutes of endotoxin infusion. Net [3(-3)H]glucose uptake by the liver occurred through 50 minutes of endotoxin infusion. After this, there was a significant reversal in transhepatic isotope kinetics, resulting in net release of [3(-3)H]glucose from the liver for the duration of endotoxin infusion (140 minutes).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296893 TI - The relationship of nonspecific bronchial responsiveness to the occurrence of respiratory symptoms and decreased levels of pulmonary function. The Normative Aging Study. AB - Nonspecific bronchial responsiveness was assessed by an abbreviated methacholine challenge test in 458 male participants of the Normative Aging Study, who also completed a respiratory questionnaire and spirometry. A positive response to the methacholine challenge test was defined as a greater than or equal to 20% decline in FEV1 during the test. Cigarette smoking was significantly associated with a positive methacholine response (p less than 0.001). Logistic regression analyses indicated that there was a significant association between a positive response to methacholine and both any wheeze (p = 0.002) and persistent wheeze (p less than 0.001) after taking into account smoking status and age; an association between responsiveness and chronic cough was of borderline significance (p = 0.06). Multiple linear regression analyses indicated that positive methacholine responsiveness was independently associated with lower levels of FEV1 (p less than 0.001) and FEF25-75 (p less than 0.001). Using the log of the dose-response slope rather than a dichotomous variable to characterize responder status yielded very similar results in the linear and logistic models. The findings of this cross-sectional study suggest that increased level of nonspecific responsiveness is significantly associated with wheeze and cough symptoms and decreased levels of pulmonary function in adult men. Longitudinal follow-up of these men should shed light on the importance of nonspecific responsiveness as a risk factor for the subsequent development of chronic obstructive pulmonary disease. PMID- 3296894 TI - High frequency ventilation. PMID- 3296895 TI - Interactions between alveolar macrophages, monocytes, and granulocytes. Implications for airway inflammation. AB - The pathology of bronchial asthma is characterized by airway inflammation. There is plugging of the airway lumen, epithelial damage, mucosal edema, and smooth muscle hypertrophy. In addition, there is substantial infiltration of the airways with inflammatory cells consisting of eosinophils, neutrophils, and mononuclear cells. The findings that these cell types can be activated by transmembrane stimuli to generate potent proinflammatory mediators and that monokines can augment the inflammatory potential of granulocytes support the view that these cells either alone or through their positive interactions may have an important role to play in the pathophysiology of the asthmatic condition. PMID- 3296896 TI - The role of mast cell-derived mediators in airway function. AB - The airway mast cell appears to play an important role in a number of pathophysiologic responses. Mast cells may be activated directly (e.g., by specific antigen) or indirectly (e.g., by an epithelial cell product such as 15 HETE). When activated, the mast cell releases mediators that may have direct effects or indirect effects. Mast cells and mediators undoubtedly play a role in specific airway responses. The data presented here are intended to serve only as examples of the complex way in which various cells and inflammatory mediators may interact to produce a physiologic response in the airways. Possibilities exist for numerous interactions between additional mediators as well as additional cell types. Because of the complexity of the system, characterization of activation and secretion by isolated pure cells, and studies of cell-to-cell interactions in vitro appear to be important first steps toward understanding the even more complex interactions that occur in vivo. PMID- 3296897 TI - Thrombolysis for acute transmural myocardial infarction. PMID- 3296898 TI - Brief chemotherapy and involved field radiation therapy for limited-stage, histologically aggressive lymphoma. AB - STUDY OBJECTIVE: To determine the efficacy and toxicity of brief chemotherapy and involved field radiation therapy for treatment of limited-stage, histologically aggressive malignant lymphoma. DESIGN: Single-arm prospective trial. SETTING: Comprehensive cancer treatment center serving the entire population of British Columbia. PATIENTS: Consecutive enrollment of 78 patients ranging in age from 21 to 82 years (median, 64) with limited-stage (no B symptoms, Ann Arbor stage I or II, tumors less than 10 cm in diameter), diffuse large cell, mixed or immunoblastic histologic characteristics of malignant lymphoma seen at our institution between May 1980 and December 1984. All eligible patients were evaluated for response and relapse-free and overall survival. INTERVENTIONS: Chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) for three cycles followed by involved field radiation therapy to the original site of disease in a dose equivalent to 3000 cGy in ten fractions. MAIN RESULTS: The complete response rate was 99% (77 of 78 patients). With a median follow-up off treatment of 30 months the actuarial relapse-free survival is 84% and the overall survival is 85%. No deaths due to toxicity occurred. CONCLUSIONS: Brief chemotherapy and involved field radiation therapy is highly successful treatment for patients with limited-stage, histologically aggressive malignant lymphoma. Toxicity of this approach is acceptable, even in the elderly. Staging laparotomy is not needed to select these patients. Future trials should incorporate more effective chemotherapy programs. PMID- 3296899 TI - Parathyroid imaging. AB - Advances in diagnostic imaging methods during the last decade have facilitated the identification of focal or diffuse parathyroid abnormalities. Major advances have included improvements in computed tomography and high-resolution ultrasonography, and the introduction of thallium-201-technetium-99m parathyroid subtraction scintigraphy. The more invasive methods of venous sampling and selective angiography have also been refined, but they have not been used as extensively because of the need for highly skilled personnel. The role of these diagnostic tools before surgery in the routine evaluation of patients with suspected primary hyperparathyroidism is unclear because a skilled surgeon should be able to achieve cures in 90% of these patients during exploratory surgery. However, most physicians would agree that, in those patients whose abnormalities go undetected during exploratory surgery of the neck, diagnostic imaging methods should be used before additional surgery is planned. Further prospective studies are needed to determine if routine localization before surgery is cost effective. PMID- 3296900 TI - Medical complications and medical management of bulimia. AB - The syndrome of bulimia is a common disorder and can be associated with serious psychological and physical morbidity. Unfortunately, many patients are reluctant to discuss their symptoms with their physicians and few clues can be found on physical examination to aid in the diagnosis. Possible physical signs include ulceration or scarring of the dorsum of the hand, salivary gland hypertrophy, and dental enamel erosion. In laboratory testing it is fairly common for patients with active bulimia to have fluid and electrolyte abnormalities, particularly hypokalemic alkalosis, and some also have elevated serum amylase levels. Rare complications include myopathies from misuse of ipecac, ruptured esophagus and pneumomediastinum associated with vomiting, and subtle abnormalities in neuroendocrine regulatory systems. Medical management including monitoring of fluid and electrolyte balance is essential during treatment. PMID- 3296901 TI - Progressive multifocal leukoencephalopathy associated with human immunodeficiency virus infection. A review of the literature with a report of sixteen cases. AB - Progressive multifocal leukoencephalopathy, a common complication of infections with human immunodeficiency virus (HIV), occurs in as many as 3.8% of patients with the acquired immunodeficiency syndrome (AIDS). We report 16 cases and review 12 previously reported cases of progressive multifocal leukoencephalopathy associated with HIV infection. This illness was the presenting manifestation of HIV infection in 8 cases. Limb weakness, gait abnormalities, visual loss, aand altered mental status were the commonest initial complaints. Computed tomography of the brain frequently showed hypodense, nonenhancing white matter lesions. Magnetic resonance imaging was more sensitive than computed tomography in detecting lesions. Cerebrospinal fluid analysis and electroencephalography were nondiagnostic. Impaired cell-mediated immunity was typically noted, even in the absence of other immunodeficiency-associated illnesses. Death occurred within 10 days to 18 months of the onset of symptoms in 22 patients. However, 4 patients remain alive at 3 to 23 months; of these 4, 2 have had significant improvement without treatment. Various therapies were unsuccessful. PMID- 3296902 TI - [Primary malignant lymphoma of the liver and cirrhosis: an unusual association]. AB - We report the seventeenth case of primary hepatic lymphoma. Its originality is an association with one cryptogenetic cirrhosis, which had never been described but does not seen fortuitous. We discussed the significance of such an association, one's being cellular immunity anomalies. PMID- 3296903 TI - [Ivermectin in the treatment and prevention of human onchocerciasis]. AB - Ivermectin is a synthetic derivative of a macrocyclic lactone produced by an actinomycete Streptomyces avermitilis. It has a broad spectrum antiparasitic activity against nematodes and certain acarians in animals. The microfilaricide action of this product against horse and cattle onchocercosis led to the study of its effects in human onchocercosis against O. volvulus. Several trials performed mainly in endemic zones of Africa showed that this drug was more effective than the reference microfilaricide, diethylcarbamazine. A single oral dose of 200 micrograms/kg of Ivermectin reduces the dermal microfilaria population to nearly zero within a few days and the effect is maintained for at least 6 months. Secondary ocular or systemic effects are rare, negligible and transitory. The prolonged elimination of dermal microfilariasis caused by sequestration followed by degeneration of the microfilaria in the uterus of females raises the hope that Ivermectin used in a single annual or bi-annual dose will contribute to the interruption of the transmission of this serious parasitic disease. PMID- 3296904 TI - [Eikenella corrodens infections]. AB - E. corrodens is an anaerobic facultative Gram-negative rod whose natural habitat is the oral cavity and the upper respiratory tract. This work describes four new cases of verified infections associated with this bacterium. A literature review of cases from 1975 to 1984 has been made. In this report, we discuss the pathogenicity of E. corrodens and predisposing factors for infections including underlying diseases. Successful antibiotic therapy can be achieved with benzylpenicillin or ampicillin which are the drugs of choice. E. corrodens is a slow growing bacterium of low virulence, rarely isolated in current practice because of its unusual association with conditions such as human bites, infections of the oral cavity or immuno-suppressive therapy. PMID- 3296905 TI - Mechanism of ascorbic acid regeneration mediated by cytochrome b561. AB - In summary, ascorbic acid serves as a one-electron donor for dopamine beta hydroxylase in chromaffin vesicles and probably for peptide amidating monooxygenase in neurohypophyseal secretory vesicles. It appears that the semidehydroascorbate that is produced is reduced by cytochrome b561 to regenerate intravesicular ascorbate. Cytochrome b561, a transmembrane protein, is reduced in turn by an extravesicular electron donor, probably cytosolic ascorbic acid. It will be interesting to see whether other ascorbate-requiring enzymes in other organelles use a similar ascorbate-regenerating system to provide an intravesicular supply of reducing equivalents. PMID- 3296906 TI - Chromogranins A, B, and C: widespread constituents of secretory vesicles. PMID- 3296907 TI - Molecular pharmacology of the monoamine transporter of the chromaffin granule membrane. PMID- 3296908 TI - Enkephalin uptake into cholinergic synaptic vesicles and nerve terminals. PMID- 3296910 TI - The life cycle of catecholamine-storing vesicles. PMID- 3296909 TI - Peptide precursor processing enzymes within secretory vesicles. PMID- 3296911 TI - The regulation of enkephalin levels in adrenomedullary cells and its relation to chromaffin vesicle biogenesis and functional plasticity. PMID- 3296914 TI - Cholinergic synaptic vesicles from the electromotor nerve terminals of Torpedo. Composition and life cycle. PMID- 3296913 TI - Similarities and differences among neuroendocrine, exocrine, and endocytic vesicles. AB - Secretory and endocytic vesicles have analogous functions as cyclic carriers between specific cellular compartments. The centrifugally functioning secretory system operates from the Golgi complex, whereas the centripetally functioning endocytic system operates from the cell surface. Further, within polarized epithelial cells the export traffic can be directed to a distinct plasmalemmal domain which distinguishes exocrine from endocrine secretion and import traffic can be directed transcellularly. These shuttle operations involve a special class of lipid-rich, protein-poor membranes that appear to use an inwardly directed H+ translocase activity to varying extents for pH-dependent sorting and for accumulation and concentration of transported molecules. Comparative analyses of purified membrane preparations from exocrine and endocrine sources identify compositional overlap between different types of shuttle membrane. However, the structural elements that specify a particular origin or destination for a given carrier or determine function in storage and stimulus-dependent shuttling remain unknown. PMID- 3296912 TI - Calmodulin and the secretory vesicle. PMID- 3296915 TI - From deferent to equant: a volume of studies in the history of science in the ancient and medieval Near East in honor of E.S. Kennedy. PMID- 3296916 TI - Multiple myeloma presenting with ocular inflammation. AB - We report an unusual case of intraocular myeloma that presented with signs and symptoms of endophthalmitis. The ocular findings in this case were the earliest indication of systemic myeloma associated with amyloidosis. Electrophoresis of the vitreous aspirate showed a monoclonal spike. PMID- 3296917 TI - Isolated coloboma of the optic nerve head: an echographic evaluation. AB - The echographic profile of the optic nerve was studied in ten eyes with coloboma of the optic nerve head. Optic nerve dimensions measured with A-scan ultrasonography revealed an increase in the overall diameter of the nerve; B-scan echography was performed in six patients and showed excavation of the optic discs with a double-walled lining posteriorly. Additional B-scan features included widening of the anterior angle of the nerve and random perpendicular echoes in the anterior part of the nerve head. The similarities and differences in echographic pictures observed in coloboma of the optic disc and glaucomatous optic atrophy are described, and the genesis of these ultrasonographic features is discussed. PMID- 3296918 TI - [Value of ultrasonic diagnosis in the study of metastatic cervical adenopathies. Clinical and anatomo-pathological correlation apropos of 266 lymph node excisions]. AB - Preoperative ultrasound exploration of the cervical node regions was performed for 207 patients; US findings were compared with data obtained by physical examination and histopathologic analysis. Ultrasonography offers multiple advantages: detection of subclinical lymph nodes, accurate measurement of node volume, facilitating classification, evaluation of vascular relations, and particularly diagnosis of internal jugular vein thrombosis. Despite the limitations of ultrasonography, the rapidity and noninvasiveness of this technique make it the procedure of choice for the initial workup of patients with a cervicofacial epithelioma. PMID- 3296919 TI - [Pediatric autoimmune enteropathies with anti-cytoplasmic enterocytic auto antibodies]. PMID- 3296920 TI - [Neonatal intrascrotal sepsis. Apropos of 2 cases]. PMID- 3296922 TI - Treatment of large xanthomas by the use of blepharoplasty island musculocutaneous flaps. AB - We used an orbicularis oculi muscular pedicle musculocutaneous flap to close the defect resulting from removal of a large xanthoma from an Oriental upper eyelid. This is an excellent method not only to save eyelid skin but also to make a superior palpebral fold at the same time. PMID- 3296921 TI - Improved ischemic island skin flap survival with continuous intraarterial infusion of adenosine triphosphate--magnesium chloride and superoxide dismutase: a rat model. AB - Neurovascular island skin flaps are still hampered by occasional necrosis of their most distal aspect. Cells subjected to prolonged hypoxic conditions become intracellularly depleted of needed metabolic substrates and eventually die. Once hypoxic conditions are improved, ischemic tissue suffers further injury from the rapid accumulation of oxygen free radicals. This study showed 53% survival of a standard random flap constructed on the inferior epigastric neurovascular bundle of a rat. Random flap survival increased to 65% after intraarterial infusion of adenosine triphosphate--magnesium chloride (ATP-MgCl2); to 75% after superoxide dismutase infusion; and to 98% after combined ATP-MgCl2 and superoxide dismutase infusion. Neither substrate appeared to act by increasing blood flow to the ischemic tissue. PMID- 3296923 TI - [Septic diaphyseal pseudarthrosis. Current therapeutic trends based on a series of 80 cases]. PMID- 3296924 TI - [380 cases of mechanical esophageal anastomosis: technics and results]. PMID- 3296926 TI - [Lesions of extensor tendons in the finger (zones I to V)]. PMID- 3296927 TI - [Prevention of postoperative infections by administration of a single dose of antibiotic: cefuroxime (Curoxime) in "flash" antibiotic prophylaxis]. PMID- 3296928 TI - [Efficacy and tolerance of propafenone in the treatment of cardiac rhythm disorders. Evaluation of a multicenter open trial on 3,687 patients]. AB - Propafenone, an anti-arrhythmic medication recently introduced in class lc, was tested in a multicentric open study including 3,687 patients (mean age: 60 years), presenting a supra ventricular (n = 2,146, 59 p. cent), nodal (n = 351, 10 p. cent) or ventricular (n = 1,613, 44 p. cent) arrhythmia, in order to study its efficacy and tolerance. After exclusion of the patients on whom there was a contra-indications to the use of anti-arrhythmic drugs, Propafenone was administered orally, on a long-term basis, at the usual dose of 600-900 mg per 24 hours. The efficacy and tolerance were evaluated according to the usual clinical and paraclinical criteria (EKG, Holter) on the 15th day, then every month during the treatment period. The efficacy of the treatment was evaluated as very good in 54 p. cent of the cases, good in 25 p. cent of the cases, average in 8 p. cent of the patients and non-existent or non significant for 13 p. cent of the patients. Electrocardiographic alterations under Propafenone are already described: CF, PR, QRS. A cardiac undesirable side effect occurred 102 times, most often a sinus bradycardia type (n = 26), atrio-ventricular conduction disorders (n = 22) or intraventricular conduction disorders (n = 26), disorders of cardiac decompensation (n = 10) or arrhythmogenic effect (n = 18). Other side effects are gastro-intestinal in nature (taste alterations, nausea, vomiting, gastralgia) for 23 p. cent of the patients treated, neuro-sensorial in origin (dizziness, visual disorders, tremors) for 13 p. cent of the patients or of another nature for 5 p. cent of patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3296925 TI - [Subcapsular hematoma of the liver complicating hepatic distomatosis: a case report. Value of diagnostic imaging methods and their therapeutic implications]. PMID- 3296929 TI - Cardioplegia: mechanisms of protection revisited. AB - A number of factors may influence the myocardial outcome after cardiac surgery, some of which are related to the actual handling of the patient during the perioperative period, and, in particular, to the absence or presence of protective procedures during periods of aortic occlusion. Cold chemical cardioplegia offers the present best alternative for ischaemic protection. The intermittent coronary infusion of cold cardioplegic solutions provides an effective low cost procedure that proves effective for the majority of surgical corrections. However, increasing knowledge to the ischaemic process and its amelioration and the continuing problem of poor postoperative cardiac function of patients in preoperative heart failure, should encourage further experimental and clinical research into perioperative myocardial protection. PMID- 3296930 TI - Myocardial energy metabolism. AB - Normal myocardial function is dependent on aerobic energy production. A wide variety of substrates, including free fatty acids, glucose, lactate and ketone bodies, may be used in the myocyte. Anaerobic metabolism is not sufficient to produce enough energy to maintain the normal concentration of high energy phosphates in the myocytes during cardiac ischaemia. PMID- 3296931 TI - Advantages of blood cardioplegic solutions. PMID- 3296932 TI - Optimal myocardial protection with oxygenated perfluorocarbon solution. Review of the literature. PMID- 3296933 TI - Intravenous prostaglandin E1, cold crystalloid flush and topical hypothermia for cardiopulmonary graft preservation. AB - For no organ is the need more acute than for the lung or heart-lung block. The new improved "freezing" technique with simultaneous use of intravenous prostaglandin E1 will result in reliable and adequate heart-lung block preservation. The lungs are flushed with high-volume (60 ml/kg), low-pressure (less than 20 mmHg), low-flow (15 ml/kg/min), using modified Euro-Collins solution (added 12 Meq/L of MgSO4 and 65 ml/L of 50% Dextrose). Additional topical cooling has been achieved by cold Physiosol and the excised graft is then placed in a plastic bag filled with Physiosol. This static hypothermia has been successfully used with extended ischemia times of more than six hours in primates and almost four hours in man. Forty heart-lung transplantations have been done from March 1981 to September 1986 and nine of them have been performed using this "freezing" technique with prostaglandin E1. Distant graft procurement has been used twice for heart-lung transplantation. All nine most recent patients who have received the graft harvested with this new "freezing" technique are doing well. PMID- 3296935 TI - Serum protein zone electrophoresis--an outmoded test? AB - The predictive value of plasma protein changes in disease is very largely unknown, as relevant clinical and laboratory studies are lacking. The usefulness of zone electrophoresis as a method of detecting a constellation of plasma protein changes is even less clear. With the advent of precise automated techniques for specific plasma protein measurement, zone electrophoresis has little to offer except in the identification and quantitation of paraproteins, where it is essential. PMID- 3296934 TI - The laboratory investigation of paraproteinaemia. PMID- 3296936 TI - Clinical and public health consequences of population ageing. AB - Those providing primary health care and referral services for the adult population should have the knowledge and positive attitudes that encourage persons, as they age, to maintain function and wellbeing. The WHO programme on Health of the Elderly is oriented to maintain wellbeing as men (and increasingly women) transit through the lifespan in increasing numbers. The key question, for clinical medicine and public health, is to identify the determinants of healthy ageing. The epidemiological thrust of the programme is designed to provide a rational basis for policy and programme development. For the countries of Asia, there is a "green field" situation with regard to knowledge about ageing. A major tool for identifying measures to prevent and control age-related disorders is the prospective, longitudinal study, although none has been conducted in ageing populations outside of industrialized countries. The top quality of evidence for assessing the efficacy of interventions directed at improving the health of the elderly is the randomized controlled trial: few such trials have been conducted outside Europe and North America. Teaching on ageing applicable to the Asian situation is just beginning, and self-health care guidance for the general public is beginning to appear in the popular press. There are moves to establish a better balance of care between hospital and community services and guides are available for assessing the quality of long term care services. The two pillars of the WHO programme on Health of the Elderly are prevention and development of alternatives to institutional care. PMID- 3296937 TI - Geriatric gynaecology. AB - The menopause is the physiologic cessation of normal, cyclic ovarian function. The development of vasomotor symptoms, atrophic changes in the genito-urinary system and osteoporosis are associated with oestrogen deficiency. Osteoporosis is the most important consequence of ovarian failure because it causes considerable morbidity and mortality. There is no simple screening test for detecting postmenopausal women who are at risk of developing osteoporosis. Oestrogen replacement therapy affects lipid metabolism and may be associated with the risk of developing endometrial cancer, breast cancer and thromboembolic disease. The addition of a progestogen regime have shown to reduce the risk of endometrial pathology. The most consistent and beneficial effect of oestrogen is the prevention of osteoporosis and subsequent fractures. Non-hormonal treatment regimes for postmenopausal osteoporosis include calcium, calcitonin and 1-alpha hydroxyvitamin D. It may be possible to use hormonal treatment for the optimal control of menopausal symptoms and non-hormonal treatment as long term prophylaxis. PMID- 3296938 TI - [Relapse of an amebic abscess of the liver after treatment with metronidazole]. AB - The authors report the observation of a twenty four years old soldier; subsequent to a stay in an endemic amoebic area, he showed several successive dysenteric episodes which were treated with metronidazole despite the absence of amoeba in the coprological examination. During one of these episodes, he presented a single rectal ulceration, then a hepatic abscess was observed four months later. The patient was treated with metronidazole and by contact amoebicides. In spite of that, amoeba were disclosed after a parasitological stool examination. PMID- 3296940 TI - Dietary minerals and colon carcinogenesis (review). AB - Variations in dietary exposure to several minerals may alter the risk of acquiring colorectal cancer. These minerals include selenium, zinc, calcium, sodium, potassium, iron and fluoride. The mechanism by which each of these minerals alters cancer risk is not established. However, as both the epidemiologic and experimental evidence for major calorie sources, fat and protein, being the primary determinants of colorectal cancer risk is weakening, micronutrients may prove to be the primary determinants of risk in human colorectal cancer. PMID- 3296939 TI - [Portal hypertension and cardiovascular drugs]. PMID- 3296941 TI - Nutritional status in cancer. AB - A decline in nutritional status is seen in many, but not all cancer patients. The factors leading to this decline are complex and include anorexia, malabsorption and alterations in energy expenditure. The end result of this decline is cachexia, but it is questionable whether this syndrome differs materially from that seen in severe undernutrition arising from other causes. Of the measurable changes in body composition taking place in cancer patients those of most importance are losses of lean tissue, which result in a reduced functional capacity for organ systems. Such losses are difficult to detect because accumulated water may mask many of the early changes in composition and make conventional assessment of nutritional status unreliable. Nutritional support should be provided for undernourished patients, irrespective of the primary cause of their poor nutrition, but there is no convincing evidence that the treatment of nutritional deficiencies alone improves the outcome in cancer patients. PMID- 3296942 TI - Dietary fat and human cancer (review). AB - Although there is good evidence that dietary factors, especially the amounts of fats, are important in the causation of many human cancers there is no concensus on the role of dietary fat in the causation of cancer at any site. An outline is given of the methods available for the study of such a relationship, together with some of their shortcomings and relative strengths. This is followed by a review of the evidence that dietary fat is an important etiological agent in the causation of cancers of the large bowel, breast, endometrium, prostate and in protection against cancer of the stomach. PMID- 3296943 TI - Diet and nutritional factors in the aetiology of colon cancer (review). AB - Epidemiological studies suggest that diet may be a major risk factor in the aetiology of colon cancer. Total fat, meat, animal protein and dietary fibre have received most attention. A high-fat - high-protein diet leading to increased faecal steroids has been implicated, but no active carcinogen derived from these has been isolated from human faeces. Alternatively, a refined, low fibre diet with decreased faecal bulk leads to increased large bowel concentration of carcinogens of co-carcinogens which contribute to the development of a malignant tumour. The aetiology of colonic cancer is probably multifactorial but a diet low in animal fat and protein and abundant in vegetables containing vitamin A and lignans may protect against colon cancer. PMID- 3296944 TI - Nutritional aspects in oesophageal carcinogenesis (review). AB - The role of diet in carcinogenesis has received much attention in recent years. The incidence of oesophageal cancer varies widely in different geographical regions and oesophageal cancer shows one of the greatest correlations between the diet type and eventual malignant development. Oesophageal carcinogenesis involves the combined action of predispositional, initiatory, and promotional factors. Specific dietary deficiencies (vitamins and minerals) may create a sensitized "environment" for the combined activities of initiatory and promotional factors. Other predispositional factors include physical abrasion (irritant vegetal components, thermal injury) and chemical injuries (alcohol, tobacco). Initiatory factors such as nitrosamines or their precursors in the diet are also considered. PMID- 3296945 TI - Alcohol and human cancer (review). AB - Epidemiological studies provide good evidence that alcoholic beverages are carcinogenic to the human liver, oesophagus, nasopharynx and larynx. There is some evidence that alcohol, when ingested in the form of beer, may be carcinogenic for the colon and rectum. Tenuous evidence exists for a link between cancer of the lung, urinary bladder, stomach and pancreas and alcohol consumption. The mechanism of action of alcohol as a carcinogen is not understood and it is likely that different mechanisms operate at different sites. Experimental models of alcohol carcinogenicity are largely unsatisfactory. However, it has been shown that alcohol can profoundly alter the metabolism of nitrosamines, which are known potent carcinogens, and may also act as a tumour promoter following initiation by nitrosamine. PMID- 3296946 TI - Central sleep apnea and partial obstruction of the upper airway. AB - Seven men with central sleep apnea underwent polygraphic monitoring during sleep for at least 3 nights, in combination with other tests. Five patients had complaints of disturbed sleep; the other 2 were selected because they had central sleep apnea caused by bilateral brainstem lesions. The first 5 had a small upper airway, documented by cephalometric roentgenograms. Nasal continuous positive airway pressure, administered to improve the suspected respiratory load during sleep, eliminated the central sleep apnea in the first 5 patients but had, as expected, no positive effect on the central apnea of the 2 patients with brainstem lesions. PMID- 3296947 TI - Neural cell adhesion molecule in normal, denervated, and myopathic human muscle. AB - The neural cell adhesion molecule (N-CAM) is a cell-surface glycoprotein that may mediate some intercellular adhesive interactions in the nervous system. In adult rat muscle, N-CAM is concentrated near neuromuscular junctions and on satellite cells, but is nearly undetectable in nonsynaptic portions of myofibers. However, N-CAM is abundant throughout myofibers in denervated and regenerating muscles. Using affinity-purified antibodies to N-CAM, we were able to demonstrate a similar distribution and regulation of N-CAM in human muscle. Myofiber N-CAM was not detectable immunohistochemically in any of 10 normal biopsies or in 4 biopsies that were abnormal but showed no evidence of fiber denervation or regeneration. N-CAM was present, however, at end plates, nerves, and satellite cells in normal human muscle. In contrast, myofiber N-CAM was detected in 16 of 16 patients with histological evidence of denervation and in 10 of 10 patients who had myopathy with degenerating/regenerating myofibers. In addition, 2 of 2 histologically nondiagnostic biopsies from patients with amyotrophic lateral sclerosis contained N-CAM-positive myofibers. Immunoblot analysis also detected N CAM in denervated and myopathic, but not normal, human muscle. These results suggest that N-CAM may play a role in muscle reinnervation or regeneration and that N-CAM immunohistochemistry may complement conventional techniques in the diagnosis of neuromuscular disease. PMID- 3296949 TI - Treatment of Bell's palsy. PMID- 3296950 TI - Tissue specificity of calspermin: a heat-stable Mr 32,000 calmodulin-binding protein. AB - We previously reported that rat testis and porcine testis contain a physicochemically indistinguishable Mr 32,000 calmodulin-binding protein, which we named "calspermin." In this study, antiserum against calspermin from porcine testis was raised in a rabbit, and a radioimmunoassay was developed. The antiserum reacted with calspermin from porcine testis but possessed little cross reactivity against calspermin from rat testis. Among various porcine tissues, this protein was found primarily in testis, sperm, and brain. Its concentration in the cytosol was higher than that in the particular fraction in testis, but the reverse was found in brain. In brain, its concentration was highest in gray matter of cortex and in cerebellum, and became lower in tectum, white matter of cortex, hypothalamus, midbrain, and pons, in this order, and was nondetectable in medulla oblongata. PMID- 3296948 TI - HIV antigen in the brains of patients with the AIDS dementia complex. AB - Human immunodeficiency virus infection was identified immunohistochemically in the brains of 8 patients with acquired immune deficiency syndrome dementia complex. Using a monoclonal antibody against a structural viral protein (p25), infection was detected in white matter and basal ganglia in a distribution paralleling that of the major neuropathological abnormalities. Viral antigen was identified principally in perivascular and parenchymal macrophages and in multinucleated cells of macrophage origin that were identified morphologically and by immunocytochemical staining for acid phosphatase isozyme. In 4 of the 8 patients, viral antigen was also detected in acid-phosphatase-negative, process bearing neuroglial cells; in 2 patients, antigen was detected in basal ganglion cells that were morphologically consistent with neurons and in alkaline phosphatase-positive cells with elongated nuclei that were most likely of endothelial origin. PMID- 3296951 TI - Highly efficient purification of the 33-, 24-, and 18-kDa proteins in spinach photosystem II by butanol/water phase partitioning and high-performance liquid chromatography. AB - The 33-, 24-, and 18-kDa proteins involved in photosynthetic oxygen evolution were purified from spinach photosystem II particles by butanol/water phase partitioning and high-performance liquid chromatography with a silica-based cation-exchange column. With this procedure a significant improvement was made in the time required for the purification and also in the amount and purity of the proteins. The N-terminal sequence of amino acid was determined for the purified proteins. Partial degradation of the proteins, which sometimes occurred in the purification, was not detected in the new procedure. PMID- 3296952 TI - On the role of sepiapterin reductase in the biosynthesis of tetrahydrobiopterin. AB - Rat erythrocyte sepiapterin reductase can catalyze the NADPH-dependent reduction of tetrahydropterin substrates with relative velocities of sepiapterin greater than lactoyltetrahydropterin greater than or equal to pyruvoyltetrahydropterin greater than 1'-hydroxy-2'-oxopropyltetrahydropterin; L erythrotetrahydrobiopterin is the product of the reduction of all three tetrahydropterins. The 1' position of the 1',2'-diketone, pyruvoyltetrahydropterin, is reduced first; the product of this first reduction is 1'-hydroxy-2'-oxopropyltetrahydropterin. Both steps are inhibited by N acetylserotonin. An antibody to sepiapterin reductase purified from rat erythrocytes was produced in rabbits, and the purified antibody is highly specific for sepiapterin reductase. This antibody is an inhibitor of both sepiapterin reductase activity and tetrahydrobiopterin biosynthesis in crude extracts of rat adrenal and brain. The antibody inhibits the production of both the biosynthetic intermediate, 1'-hydroxy-2'-oxopropyltetrahydropterin, and tetrahydrobiopterin. The results indicate that sepiapterin reductase is on the biosynthetic pathway to tetrahydrobiopterin, and catalyzes the complete reduction of pyruvoyltetrahydropterin to tetrahydrobiopterin. In contrast, homogenates of whole rat adrenal also produce large quantities of lactoyltetrahydropterin which suggests that in some tissues this compound may also be an intermediate in tetrahydrobiopterin biosynthesis. The synthesis of lactoyltetrahydropterin is not inhibited by the antibody to sepiapterin reductase and therefore does not appear to be catalyzed by sepiapterin reductase. However, sepiapterin reductase is responsible for the conversion of lactoyltetrahydropterin to tetrahydrobiopterin. The source of sepiapterin in biosynthetic reactions was found to be oxidative decomposition of lactoyltetrahydropterin. PMID- 3296953 TI - Mechanism of polyamine inhibition of a leaf protease. AB - The inhibition of a highly purified alfalfa (Medicago sativa) leaf protease by naturally occurring polyamines is reported. The tetraamine spermine shows the highest inhibitory effect, with the maximum inhibition at 0.1 mM. Kinetic data indicate an apparent hyperbolic competitive inhibition. CD measurements show that in the presence of 0.1 mM spermine the enzyme undergoes a conformational change with the loss of 16% alpha-helix secondary structure content. Both the inhibition and the conformational change are prevented by high ionic strength. These data suggest a novel control mechanism of proteolytic activity in the leaf. PMID- 3296954 TI - [Present status of studies on the application of immunology to the diagnosis and therapy of cancer, with emphasis on monoclonal antibodies and cytokines]. AB - This paper describes the present state of research on application of immunology for cancer diagnosis and therapy, especially with emphasis on the recent progress of monoclonal antibody and recombinant cytokines technologies. In the history of immuno-diagnosis and- therapy of cancer, a new era has been coming because of the progress of these technologies, in addition to an increase of our knowledges on host-defense mechanisms against cancer and development of new types of instruments and chemical synthesis technology. A number of approaches of cancer diagnosis and therapy with monoclonal antibodies and cytokines in Japan were introduced in this paper, and problems of these trials to be solved in the future were discussed. Together with almost established surgical treatment, chemotherapy and physicotherapy, including radiation and hyperthermia, biotherapy, including immunotherapy and therapy with hormones and various biological response modifiers (BRM) are required for the purpose of complete cure of cancer. Further energetic and systematic efforts should be made in the future. PMID- 3296956 TI - [Total body irradiation for bone marrow transplantation in the treatment of leukemia]. AB - The history of total body irradiation (TBI) is surprisingly old. Low-dose TBI was routinely employed for leukemia before the era of chemotherapy. Following the brilliant success of Thomas et al. in the 1970s, bone marrow transplantation (BMT) appeared to be the sole curative treatment modality for high-risk leukemia. In addition, a supralethal dose of TBI was widely accepted as a form of preparation for BMT. The records of 365 patients who underwent BMT between 1975 and 1985 were collected from 31 hospitals by the IVth national survey conducted in Japan. Of these, 264 patients (74%) were classified as having leukemia. As of September 1986, 157 of these leukemia patients had died, interstitial pneumonitis (IP) being the leading cause of death (32%). Using Cox's proportional hazard regression model, it was indicated that the status of the disease and clinical condition at the time of BMT as well as supportive treatment had a great impact on survival after BMT for acute leukemia. On the basis of the clinical condition at the time of BMT, 2-year survivals were 57% and 16% for patients in remission without infection and the remaining patients, respectively (p = 0.0001). Nonremission at the time of BMT (p = 0.0138), advanced age (p = 0.0115) and increased number of platelet transfusions (p = 0.0351) were found to be significant risk factors associated with IP, while TBI was also one of the most important factors in the development of IP. Two-year probabilities of developing IP were 81% and 49% in single-dose TBI and in fractionated TBI, respectively (p = 0.0002). In the single-dose TBI group, a dose rate of less than 5 cGy/min resulted in a low incidence of IP. In the fractionated TBI group, the incidence of IP was somewhat low in the 6-fraction group. According to my own experience, 4 field TBI of 12 Gy/6 frx/3 days with a carefully monitored lung dose of 8 Gy in total resulted in significant improvement in BMT for leukemia. PMID- 3296955 TI - [Autologous bone marrow transplantation in osteosarcoma]. AB - Four patients with osteosarcoma were treated with intensive chemotherapy and autologous bone marrow transplantation (ABMT). The patients received high-dose methotrexate (9-12 mg/m2) with citrovorum factor rescue, high-dose melphalan (60 mg/m2 X 3), actinomycin D (0.5 mg/m2 X 3), adriamycin (30 mg/m2 X 2) and high dose cyclophosphamide (60 mg/kg X 2) during 4 weeks. Bone marrow was aspirated and cryopreserved before treatment and reinfused 48 hours after the completion of chemotherapy. Two of four patients had advanced osteosarcoma with multiple pulmonary metastasis, one of whom had responded well and achieved partial response while the other had shown no response, and both patients died of disease progression 4 and 11 months after ABMT, respectively. The other two patients who received this regimen at an earlier disease stage for prevention of pulmonary metastasis, are alive and well without any evidence of metastasis 31 and 18 months after ABMT, respectively. This regimen was tolerated well in all patients except for mild nausea and vomiting. No infectious episodes were observed during the period of aplasia which continued for 19 to 38 days after marrow infusion. These results suggest that this supralethal combination chemotherapy is safe and tolerable when used with ABMT and effective for patients with osteosarcoma, especially when applied in the non-metastatic phase. PMID- 3296958 TI - [Analysis of liposarcoma]. AB - Liposarcoma is one of the most common soft tissue sarcomas, ranking with rhabdomyosarcoma and malignant fibrous histiocytoma. We have treated 47 cases of liposarcoma, comprising 35 males and 12 females ranging in age from 22 to 86 years, with a median age of 56 years. The most common site of primary tumor was the thigh, the most common primary tumor stage by the UICC classification was T2, and the most common histological subtype by the WHO classification was myxoid type. Xerography, CT and angiography are useful forms of examination for diagnosis before surgery. Naked eye findings of the tumor often show a lobular or nodular growth pattern. Surgical therapy for the primary tumor, especially curative wide resection (by the method of Kawaguchi, et al.) is most effective for preventing local recurrence. Radiotherapy is not as effective as for rhabdomyosarcoma and chemotherapy should be applied for occult micro-metastases. Ten of the 47 cases died due to distant metastases and the 5 year survival rate was 76.2%. PMID- 3296957 TI - [The effect of low-dose total body irradiation on tumor control]. AB - Total body irradiation (TBI) is considered to bring about an immunosuppressive effect on an organism, on the basis of data obtained from sublethal doses of TBI. However, there are no data on how low-dose TBI affects an organism. Over the last five years, we have been studying the effects of low-dose TBI on normal or tumor bearing mice and the immunological background of these effects. In experimental studies, an increase in the TD50 value (the number of cells required for a tumor incidence of 50%) in mice exposed to 10 rad was recognized and showed a remarkable increase at 6 hours to 15 hours after irradiation. TBI of 10 rad also showed an enhancement effect on tumor cell killing when given 12 hours before local tumor irradiation. In order to clarify the mechanism of this kind of effect, some immunological studies were performed using several immunological procedures, and the results suggested that 10 rad of TBI caused increasing tumor immunity in irradiated mice. Clinical trials in some patients with advanced tumors are now being undertaken on the basis of these experimental data, and the effect of TBI on tumor control appears promising, although it is too early to draw conclusions. PMID- 3296959 TI - [Bone marrow transplantation after intensive chemotherapy]. AB - Bone marrow transplantation (BMT) after intensive marrow-lethal chemotherapy and total body irradiation has made remarkable progress in recent years. In allogeneic BMT, HLA-matched marrow cells of siblings are used, while in autologous BMT, cryopreserved leukemia-purged marrow cells from patients are employed. In 1985, about 100 BMT cases were registered in the Japan BMT study group. Interstitial pneumonitis caused by cytomegalovirus, relapse of leukemia, graft versus host disease, and bacterial infection were major cases of failure, which have shown a markedly reduced tendency in recent years. The timing of BMT was found to be very important for the survival of patients. In cases with acute lymphoblastic leukemia, if BMT was performed in the first remission, the long survival rate was 76%, while this rate was low for second or subsequent remissions. It was also found in patients with chronic myelogenous leukemia, that the survival rate was high in the chronic phase and low in the accelerated or blastic phase. BMT seems to be a very promising therapy for leukemia and related malignant diseases with a very high possibility of complete cure. PMID- 3296960 TI - [Clinical significance of serum DU-PAN-2 surveyed by solid-phase sandwich EIA for DU-PAN-2]. AB - The clinical usefulness of DU-PAN-2 as a tumor marker was investigated. DU-PAN-2 antigen was detected by enzyme immunoassay based on sandwiching the antigen between monoclonal antibodies to DU-PAN-2. The EIA kit was supplied from Kyowa Medex Co. The mean DU-PAN-2 concentration in sera from 53 healthy donors was 51.8 U/ml and the mean plus 2 S.D. value was 156.2 U/ml. A level of 160 U/ml was used as the cut-off value. Serum DU-PAN-2 was positive in 7.5% of healthy donors, 16.9% of 83 patients with benign disease and 37.7% of 159 cancer patients. Of the cancer patients, those with pancreatic cancer, bile duct cancer and primary liver cell cancer had a high positive frequency of more than 70%. On the other hand, of patients with benign diseases, a high positive incidence of 40% or 50% was observed in patients with chronic hepatitis or liver cirrhosis. From this result, DU-PAN-2 appeared to be useful as a tumor for pancreatic cancer and bile duct cancer. Determination of the molecular weight of DU-PAN-2 in serum from a pancreatic cancer patient by Sepharose 4B gel filtration demonstrated the existence as a high-molecular-weight protein between about M.W. 500-10,000 K Da. PMID- 3296961 TI - Liver transplantation--a role for all paediatricians. PMID- 3296962 TI - Prediction and management of nocturnal hypoglycaemia in diabetes. AB - Blood glucose measurements were made at 2200, 0200, and 0800 h in 102 children with diabetes during a 24 hour planned admission to hospital. Nocturnal hypoglycaemia (less than 3.0 mmol/l) occurred in 24 of 71 (34%) children on twice daily insulin and in three of 31 (10%) children on once daily insulin. Predictive value modelling showed that a blood glucose concentration of less than 7 mmol/l at 2200 h was the best predictor of nocturnal hypoglycaemia, with a sensitivity of 63%, specificity of 94%, and positive and negative predictive values of 83%. Blood glucose measurement at 0800 h had no predictive value for nocturnal hypoglycaemia. The mean (SD) glycosylated haemoglobin concentration of children on twice daily insulin who had nocturnal hypoglycaemia was 55 (8) mmol HMF/mol Hb, which was significantly less than that of children on twice daily insulin who did not have hypoglycaemia (64 (11) mmol HMF/mol Hb) or those on once daily insulin (62 (11) mmol HMF/mol Hb). A controlled trial was then performed in which 29 children with diabetes who had a blood glucose concentration at 2200 h of less than 7 mmol/l measured by Reflocheck were randomised into two groups, one of which received 10 g carbohydrate supplement and the other of which did not. Thirteen of the 14 children in the control group had hypoglycaemia at 0200 h, whereas the snack prevented hypoglycaemia in 12 of 15 in the test group. Blood glucose values in the two groups at 0800 h were similar. We conclude that bedtime glucose measurement in children on twice daily insulin is a useful predictor for nocturnal hypoglycaemia, which can be prevented by a small carbohydrate snack in those at risk. PMID- 3296964 TI - Porcine corium sling in the treatment of urinary stress incontinence. AB - Porcine dermis was used for abdomino-vaginal urethroplasty in 53 women with urinary stress incontinence. The patients have been followed for periods ranging from 1.5 to 4 years; 47 of them were continent of urine both subjectively and on urodynamic testing. The postoperative complications were minimal and there has been no instance of foreign body reaction. PMID- 3296963 TI - Effect of orally administered aromatic retinoid on murine Langerhans cells. AB - The effect of orally administered aromatic retinoid (Ro 10-9359) on murine epidermal Langerhans cells (LC) was studied in vivo and in vitro. Daily administration of retinoid caused a transient increase in LC density, as determined by staining for Ia antigens, during the first few days of treatment and thereafter a continuing decrease that reached a maximum at 2 weeks. In addition, the morphology and location in the epidermis had been altered. When the treatment was continued to 4 weeks, the density of LC returned to normal. The Ia antigen-presenting function of epidermal cells to an allo-Ia-reactive cloned T cell line was elevated at all stages of retinoid treatment examined. This elevation did not correlate with the density of histochemically stainable Ia+ LC. These findings suggest that orally administered retinoid profoundly alters the functional capacity of Ia+ LC. PMID- 3296965 TI - [Treatment of disseminated renal adenocarcinoma. Review of the literature]. PMID- 3296966 TI - Incidence of cyclosporine side effects in renal transplant patients. PMID- 3296967 TI - Combination of methylprednisolone pulse therapy and remission inducing drugs in rheumatoid arthritis. AB - Thirty patients with rheumatoid arthritis were allocated to either methylprednisolone pulse therapy or placebo at the beginning of treatment with either gold salts, penicillamine, or azathioprine. Methylprednisolone pulse therapy produced an immediate but temporary anti-inflammatory effect lasting for a maximum of four to eight weeks. It also caused a lasting depression of serum IgG, but no effect was observed on the proportion of T and B lymphocytes, proliferative responses, or on concanavalin A induced suppressor cell activity, and there was no effect on the amount of circulating immune complexes. The bone mineral content decreased similarly in the two groups, and methylprednisolone pulses had no effect on the progression of erosions on x rays during an observation period of eight months. A single pulse of methylprednisolone can give a short lasting anti-inflammatory effect but is of little or no value in the long term treatment of rheumatoid arthritis. PMID- 3296968 TI - Hypertrophic osteoarthropathy related to end stage cholestatic cirrhosis: reversal after liver transplantation. AB - A case is reported of hypertrophic osteoarthropathy with recovery after a liver graft in a young man with end stage cholestatic cirrhosis related to non Wilsonian copper overload. To our knowledge this is the first case in the literature illustrating the curative role of liver grafting on hypertrophic osteoarthropathy associated with chronic cholestatic liver disease. PMID- 3296969 TI - Neutral metalloproteases and age related changes in human articular cartilage. AB - A decrease in proteoglycan (Pg) content and disturbances in the collagen network have been reported in aging cartilage. This study aims to determine whether these changes are associated with proteolytic enzymes such as neutral metalloproteases. Eighty lateral tibial plateaus were collected from subjects after death. The age, topographical area, and lesion severity (macroscopic grading) of each specimen were noted and the effects of neutral metallo-Pg-degrading and collagenolytic enzymes on these specimens were compared. The specimens were divided into two age groups: 20-50 years (group 1) and greater than 50 years (group 2). They were selected from both weight bearing and non-weight bearing areas. In some cartilage tissues the superficial layer was separated from the deep zone. Our data for the two neutral metalloenzymes examined showed: no correlation between enzyme activity and age when the specimens were of the same grade and a statistically significant rise in the enzyme levels of the older specimens, which increased as the lesions progressed. Neutral metallo-Pg-degrading enzyme activity was higher in non-weight bearing areas than in weight bearing areas, and this reached a statistical difference in the older cartilage with advanced lesions. The Pg degrading enzyme activity was raised in the superficial layers of damaged cartilage tissue. Our data suggest that neutral metalloproteases are closely associated with the appearance and progression of the changes seen in aging cartilage. PMID- 3296970 TI - Prostacyclin in systemic lupus and anticardiolipin syndrome. PMID- 3296971 TI - A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non-sweets eaters. AB - Vertical banded gastroplasty (VBGP) was compared with Roux-en-Y gastric bypass (RYGBP) in a randomized prospective trial that included preoperative dietary separation of "sweets eaters" versus "non-sweets eaters." Randomization was stopped at 9 months after 20 patients had undergone each procedure because a greater weight loss (p less than 0.05) was noted after RYGBP than VBGP. This difference became more significant (p less than 0.001) at each 3-month interval through 3 years, when patients who had VBGPs had lost 37 +/- 20% of excess weight compared with 64 +/- 19% for patients who had RYGBPs. The members of the groups were comparable with regard to age, sex, eating habits, morbidity rates before surgery, ideal body weight, and weight before surgery. Although there was no significant difference between the loss of excess weight in "sweets eaters" (69 +/- 17%) or "non-sweets eaters" (67 +/- 17%) after RYGBP at 1 year, "sweets eaters" who had VBGPs lost significantly less excess weight (36 +/- 13%) than did "non-sweets eaters" who had VBGPs (57 +/- 18%), p less than 0.02, or "sweets eaters" who had RYGBPs, p less than 0.0001. No significant differences were noted for electrolytes, renal or liver function tests, and most vitamins between patients who had VBGPs and RYGBPs; however, patients who had RYGBPs had lower (p less than 0.05) serum vitamin B12 levels (286 +/- 149 pg/dl) than did patients who had VBGPs (461 +/- 226 pg/dl) at 2 years. By 3 years, the vitamin B12 levels were equal in members of the two groups. Five patients who had RYGBPs required endoscopic stomal dilatation for stomal stenosis and one had a marginal ulcer develop, which responded to cimetidine. RYGBP was clearly superior to VBGP for "sweets eaters," probably because of the development of dumping syndrome symptoms. However, RYGBP was associated with a larger number of correctable problems. Thus, it is important to evaluate a patient's eating habits before surgery for morbid obesity; "non-sweets eaters" probably should be treated with VBGP and "sweets eaters" with RYGBP. PMID- 3296972 TI - A successful cardiac transplantation program using combined university and community resources. AB - From August 1984 to August 1986, 75 patients with end-stage heart disease and cardiac failure were evaluated. Twenty-five patients received orthotopic cardiac transplants from donors as far away as 1300 miles with an ischemic time of less than 4 hours. Seventeen of 25 patients are alive 3-24 months after transplantation. Evidence of rejection was seen in each patient. Twelve patients had mild, easily controlled rejection; 13 patients had severe rejection averaging 3.1 episodes per patient. The initial immunosuppressive regimen included cyclosporine and prednisone. To decrease complications related to high dose steroids, azathioprine has recently been added to our maintenance regimen to lessen steroid requirements. Acute rejection episodes were treated with 500-1000 mg of methylprednisolone for 3 days; antithymocyte globulin or the murine monoclonal antibody, OKT3, was added for severe or resistant rejection episodes. Three patients died of rejection, and two patients died of infection. Seventeen of 18 survivors are New York Heart Association (NYHA) Class I; 15 patients have returned to employment or full activity. Because of new developments in support of transplant candidates and treatment of complications, as well as the introduction of cyclosporine, orthotopic cardiac transplantation has become an effective treatment for end-stage heart disease. PMID- 3296973 TI - Preoperative saphenous and cephalic vein mapping as an adjunct to reconstructive arterial surgery. AB - B-mode ultrasound was prospectively evaluated for its ability to preoperatively assess the adequacy of venous conduit for arterial reconstruction. Fifty-one patients who had lower extremity revascularization had real-time imaging of the saphenous and cephalic veins. Veins were judged adequate based on size, compressibility, and absence of sclerosis or intraluminal echoes. All mapped veins were explored and assessed by the standard criteria for suitability. Vein size was determined from completion angiograms, and wound complications recorded and compared with patients who had similar procedures in the 12 months before the use of vein mapping. Preoperative mapping was found to be accurate in 50 to 51 patients (98%). Vein size as determined by B-mode ultrasound correlated well with angiograms, R = 0.8539 overall with R greater than 0.9 in the last 7 months of the study. Wound complications occurred in 2% of the patients who had preoperative mapping and in 17% of the historic controls. Preoperative vein mapping using B-mode ultrasound is an accurate method of determining vein suitability for use in arterial reconstruction. It improves operative planning and can contribute to a reduction in wound complications. Veins determined to be unusable by preoperative scanning need not be explored. PMID- 3296974 TI - Analysis of twenty-eight recurrent pseudarthroses of the carpal navicular after the Matti-Russe operation. AB - The authors present a review of 28 cases of failure of consolidation of the carpal navicular after the Matti-Russe operation (multicentric study of 106 cases). The causes of the failures are analysed. Among the non significant factors, we find the delay, the radiographic character of the pseudarthrosis, the donor site of the graft, the time of immobilization and the site of the fracture. The superior polar fractures do not have a bad prognosis in this series. Five causes seem to be in direct relation with the failure of consolidation: the age, the failure of an initial surgery procedure, the presence of radiologic "necrosis", the quality of the technical performance of the Matti-Russe operation, and finally dorsal carpal instability that seems to be a fundamental cause in the failure of bony union. The future of these pseudarthroses is analysed concerning: the functional results (64% of poor results); the evolution towards the pseudarthrosis (30%); the surgical reoperations (12 cases out of 28) with eight repeat Matti-Russe operations that finished in five consolidations. PMID- 3296975 TI - Present expectations in cardiac transplantation. AB - The clinical introduction of cyclosporine has resulted in increased enthusiasm for cardiac transplantation. Since July, 1983, 61 patients (50 male and 11 female) have undergone orthotopic cardiac transplantation for cardiomyopathy (48 patients), ischemic heart disease (11), or congenital heart disease (2). Mean age was 39 years (range, 1.5 to 57 years). Median hospital stay was 26 days (range, 4 to 60 days). Maintenance immunosuppression consisted primarily of prednisone and cyclosporine; it was modified in 9 patients because of a pre-existing clinical condition. The incidence of rejection was 0.44 episode/patient-month within 3 months of cardiac transplantation and 0.10 episode/patient-month subsequently. The incidence of infection was 0.05 episode/patient-month. Major side effects of cyclosporine included renal dysfunction (63%) and hypertension (61%). No recipient required dialysis for renal dysfunction. Ten patients died (rejection, 4; infection, 3; carcinoma, 1; lymphoma, 1; and pulmonary hemorrhage, 1); actuarial survival at 1 and 2 years was 84 +/- 6% and 76 +/- 8%, respectively. Patient follow-up (cumulative, 719 patient-months) revealed that 96% of recipients were rehabilitated and 50% had returned to work. With increasing understanding of cyclosporine immunosuppression, recipients can continue to look forward to an extended life with nearly complete rehabilitation. PMID- 3296976 TI - Senning's procedure for transposition of the great arteries. AB - The outlook for children with transposition of the great arteries (TGA) improved dramatically with the advent of the atrial repair. This procedure, first successfully performed by Ake Senning, followed years of unsuccessful attempts at correction by a number of surgeons using a variety of techniques. Senning's procedure expanded on the concept experimentally proposed by Albert of redirecting venous return at the atrial level to achieve physiological correction. The Senning procedure was largely abandoned when Mustard's technique was introduced in 1964, but has enjoyed a resurgence as a number of its potential advantages became more fully appreciated. Today, patients with TGA are increasingly undergoing repair by the arterial switch technique. Not all patients, however, are suitable candidates for this approach, and its success will be measured against the ingenious procedure described by Senning more than a quarter of a century ago. PMID- 3296977 TI - Surgery for thoracic hydatid disease: a North American experience. AB - The clinical course of 20 patients with 22 thoracic hydatid cysts operated on from 1957 to 1984, was reviewed. Follow-up extended to 27 years (mean, 11.6 +/- 1.5 years [+/- the standard error of the mean]) and was 90% complete. Most patients originated from countries in the Mediterranean region; 5 were native Canadians. The diagnosis was suspected in all but 3 patients preoperatively. Fourteen patients had 16 primary lung cysts, 4 had infected liver cysts with intrathoracic extension, 1 had synchronous unruptured liver and lung cysts, and 1 had a thymic cyst. Nine cysts were intact, whereas 13 had ruptured preoperatively. A variety of surgical procedures was performed, including eight wedge resections and nine lobectomies. There were no early deaths, and perioperative complications were infrequent. One patient with a hepatic cyst that had ruptured into the right pleural space and right lower lobe died at 7 months of massive echinococcosis of the liver and intraabdominal sepsis. There has been no evidence of thoracic recurrence in any of our long-term survivors, although 1 patient had undergone enucleation of a left lung cyst in Greece 15 years prior to her reoperation here for a lingular recurrence. We conclude that thoracic hydatid disease is a rare entity in northeastern North America. The prevalence of ruptured cysts and infected hepatic cysts involving the lung was higher than in most other series, thereby necessitating more aggressive surgical treatment. Nevertheless, morbidity was low, and recurrence of disease was uncommon in long term follow-up. PMID- 3296979 TI - Hydrochlorothiazide with or without amiloride for hypertension in the elderly. A dose-titration study. AB - The blood pressure response to increasing doses of hydrochlorothiazide with or without amiloride was examined in 130 elderly hypertensive patients. After four weeks of placebo, patients were randomly allocated to increasing doses of hydrochlorothiazide or hydrochlorothiazide with amiloride for 12 weeks using a parallel, double-blind study design. Both hydrochlorothiazide and hydrochlorothiazide with amiloride significantly reduced mean (+/- SEM) baseline supine and standing blood pressure (171 +/- 2/102 +/- 1 and 167 +/- 2/102 +/- 1 mm Hg) to 148 +/- 2/84 +/- 1 and 146 +/- 3/85 +/- 1 mm Hg, respectively, at week 16. Amiloride did not exert any additional antihypertensive effect. Only eight patients required hydrochlorothiazide at 100 mg/d, with the remainder responding to 25 to 50 mg/d. Hydrochlorothiazide decreased mean serum potassium level from 4.3 +/- 0.1 mEq/L (4.3 +/- 0.1 mmol/L) during placebo to 4.0 +/- 0.1 mEq/L (4.0 +/- 0.1 mmol/L) at week 16. Ten patients receiving hydrochlorothiazide developed hypokalemia compared with only two receiving hydrochlorothiazide with amiloride. Relatively low doses of hydrochlorothiazide (25 to 50 mg/d) effectively reduce blood pressure in elderly hypertensive patients. Hypokalemia may occur with hydrochlorothiazide alone but is much less common when hydrochlorothiazide is combined with amiloride. PMID- 3296978 TI - Influence of renin levels on the treatment of essential hypertension with thiazide diuretics. AB - Initial plasma renin activity (PRA) was measured in 213 patients with untreated hypertension before beginning thiazide (chlorothiazide and hydrochlorothiazide) therapy alone to test whether patients with low-renin hypertension exhibited a greater response to diuretic therapy. Diastolic blood pressure response to treatment in the low, mid-range, and high PRA groups did not differ significantly (delta diastolic blood pressure, -13.6 +/- 1.6, -11.6 +/- 1.5, and -10.8 +/- 2.6 mm Hg, respectively). Moreover, eight subjects with the highest PRA values exhibited the same magnitude of decrease in diastolic blood pressure as did the low PRA group (15.0 +/- 4.2 vs 13.6 +/- 1.6, respectively). This study thus provides no evidence for increased sensitivity to diuretic therapy among patients with low-renin essential hypertension. PMID- 3296981 TI - Diagnostic studies in patients with sickle cell anemia and acute abdominal pain. AB - Twenty-eight patients with sickle cell disease who presented with acute abdominal pain were evaluated with clinical laboratory, ultrasound, and biliary scintigraphic studies to determine their predictive capabilities for differentiating veno-occlusive disease (sickle cell crisis) from acute biliary disease. Eleven patients were treated surgically and 17 medically. Gallstones were demonstrated in 25 (90%) of the patients studied by ultrasound, and biliary scans were abnormal in nine patients (32%). Abnormal laboratory and radiological studies (ultrasound, biliary scintigraphy) were not significantly different in the two groups and had a low positive predictive value for detection of acute biliary disease. Nevertheless, normal biliary scintigraphy had high negative predictive value in that, if normal, it gave assurance that the cystic duct was patent and unnecessary surgery could be obviated in this high-risk category of patients. PMID- 3296980 TI - Abnormalities of carbohydrate and lipid metabolism in patients with hypertension. AB - Plasma glucose, insulin, and lipoprotein concentrations were determined in 20 men with hypertension, and compared with values in 20 normotensive men of comparable age and body mass index. The results demonstrated a significant increase in both the plasma glucose and insulin response to a 75-g oral glucose challenge (two-way analysis of variance). In addition, a significant correlation existed between the plasma blood pressure. Finally, the greater the plasma glucose insulin response to oral glucose and both systolic and diastolic and insulin responses to oral glucose, the lower the plasma high-density lipoprotein concentrations, and the higher the ratio of plasma low-density lipoprotein cholesterol to high-density lipoprotein cholesterol. Thus, abnormalities of plasma glucose, insulin, and lipoprotein metabolism exist in patients with untreated hypertension, and these changes may contribute to the increased risk for coronary artery disease associated with hypertension. PMID- 3296983 TI - Inhibitory activity of fecal flora against the multiplication of Clostridium difficile. PMID- 3296982 TI - Need for insulin therapy in type II diabetes mellitus. A randomized trial. AB - To identify patients with type II diabetes mellitus for whom insulin therapy is most beneficial, we conducted a randomized controlled trial in the general medicine clinic of a university hospital. Asymptomatic, obese, insulin-treated patients were given diet and diabetes education and, in half of these patients, insulin therapy was withdrawn. Over six months, patients developing hyperglycemic symptoms or acetonemia were counted as study failures. Failure criteria developed in 13 of 25 insulin-withdrawal patients, at a median of four weeks after withdrawal, compared with two of 24 control subjects. Elevated stimulated glucose levels predicted the need for insulin therapy. Hyperglycemia worsened in insulin withdrawal patients who did not meet study failure criteria, but it improved in control patients. Study patients were insulin deficient as shown by low baseline C peptide values (0.43 +/- 0.05 nmol/L). The prompt metabolic decompensation precipitated by insulin withdrawal suggests that insulin-deficient patients may benefit from insulin therapy and may need it to prevent symptomatic hyperglycemia. PMID- 3296984 TI - Bernardo Sepulveda. PMID- 3296985 TI - [Report of an outbreak of invasive amebiasis in children at a camp for victims of the Chichonal volcano]. PMID- 3296986 TI - Effect of ozone on ATP, cytosolic enzymes and permeability of Saccharomyces cerevisiae. AB - Treatment of a yeast suspension with ozone inactivates a number of cytosolic enzymes. Among 15 studied, the most drastic inactivation was found for glyceraldehyde-3-phosphate dehydrogenase and to lesser extents: NAD-glutamate dehydrogenase, pyruvate decarboxylase, phosphofructokinase-1 and NAD-alcohol dehydrogenase. Ozone treatment also effects the quantity of ATP and of other nucleoside triphosphates, reducing to about 50% of the initial value. The ATP missing in the cells appears in the medium. NAD and protein also accumulate in the medium suggesting that the yeast cells have been permeabilized. Permeabilization of the yeast cells by treatment with ozone precedes the inactivation of glyceraldehyde-3-phosphate dehydrogenase and other cytosolic enzymes. PMID- 3296987 TI - [Pancreatic function study in children]. PMID- 3296988 TI - Characterization of a new tumor in NMRI-mice suitable for chemotherapeutic experiments. AB - The tumor was found in the peritoneum of a 6-months old female NMRI-mouse. Histologically it can probably be classified as a less-differentiated reticulum cell sarcoma (histiocytic sarcoma). Following ip. or sc. transplantation metastases were only in some cases found. After im. inoculation of tumor brei lungs, livers, kidneys, spleens and lymph nodes were free of metastases, as a bioassay revealed. The im. transplantation was the most suitable technique for chemotherapeutic experiments: It resulted in a 100% take rate and a relatively narrow and well reproducible death range; tumor size and life span of the animals could be used as therapeutic parameters. The tumor was highly sensible against the cytostatic drugs Cyclophosphamide, Doxorubicin and Vincristine. A moderate activity showed CCNU, Cis-DDP and Bleomycin, while DTIC and a novel Benzochinonguanylhydrazon-derivative only reversibly influenced the tumor growth and not the life time of the animals. Liposomally encapsulated Daunorubicin and Bleomycin had in general similar effectiveness as the drugs in its free form. Because of its high sensitivity against a lot of cytostatics with different mechanisms of action the tumor can be recommended for the screening of novel antineoplastic substances. PMID- 3296990 TI - [Cytometry of premalignant states]. AB - The development of cancer in humans is considered as a multistep process ultimately leading to clinically detectable disease and further progression of the tumour. By use of cytometric techniques it has been possible to perform quantitative measurements and detect qualitative alterations in malignant tumours. This mainly applies to DNA aberrations and deviations in nuclear size and morphology. Such alterations may also be present for a long period prior to malignant, invasive growth, i.e. at a preneoplastic stage. A survey of available data on such preneoplastic changes is given. Since the type of aberrations is both dependent on the tissue of origin and the tumour type, this must always be taken into consideration. A particularly rapid expansion has taken place in the field of flow cytometry, where high resolution measurements of cellular DNA content as well as cell cycle distribution and other parameters can be performed shortly after sampling of the tissue. It is expected that cytometric methods will be used in future diagnostics of early cancerous growth in several organ systems, including the skin, the gastrointestinal tract, the urinary bladder, the breast and female genital organs. PMID- 3296989 TI - [Computer-assisted screening for cervical carcinoma--the results for a 10-year period]. AB - A report is given of 10 years experiences with a computer assisted mass-screening programme to detect pre-stages and early stages of cervical carcinoma in Rostock city. The participation in the age-groups up to 40 years was over 75%. With this programme it is possible to make statistical analysis, to control the quality of Pap-smears and colposcopical results and to identify the risk-group of unscreened women for special examinations. As a result of the programme a decrease of cervical carcinomas since 1980 of about 25% was noticed. The same situation was found in pre-stages. Inert of all registered cervical carcinomas the number of stage one-cases increased. PMID- 3296991 TI - Characterization of human mammary normal and neoplastic cells grown in culture. AB - The paper presented here describes cultivation and characterization of human mammary normal (NMC) and neoplastic (BO) cells. Characteristics: growth rate, colony growth in soft agar, nuclear overlaps, induction of multinucleation by Cytochalasin B and transplantation in vivo were compared between NMC- and BO cells. Normal (NMC) cells are characterized by a slow growth rate (cell doubling time less than 70 hours), no growth in soft agar, no induction of uncontrolled nuclear division and no development of tumors after transplantation of cells in nude mice in vivo. The two cell types do not differ with respect to the nuclear overlapping ratio. In contrast, neoplastic (BO) cells showed a lower doubling time (less than 20 hours), colony growth in soft agar (greater than 20 colonies/30,000 cells), induction of multinucleation by Cytochalasin B (greater than or equal to 3 nuclei/cell), and tumors in nude mice were observed. Both cell types were recommended as an in-vitro model for screening antineoplastic agents. PMID- 3296992 TI - Structure-activity relationship studies on selected iso-alpha-carbolines. I. AB - In the course of microbial transformation of the antitumor compounds, it has been found that iso-alpha-carbolines and their certain derivatives undergo N-1 methylation by Kitasatosporia setae. The resulting products, iso-alpha-carbolines exhibit antibacterial and antifungal properties in the concentration range of 0.2 2.5 mumol/ml. In the cytotoxicity test only derivatives substituted at C-2 and C 4 display moderate activity against KB cells. None of the compounds tested show a significant inhibitory effect against P388 lymphocytic leukemia. PMID- 3296993 TI - Humoral response in mice immunized with outer membrane proteins of Shigella flexneri. AB - Intraperitoneal immunization of mice with outer membrane proteins (OMP) of Sh. flexneri induced in the animals a synthesis of specific antibodies. Their level determined by ELISA test was found to be relatively low in the sera of animals immunized with a single dose (10 micrograms) of OMP; it was markedly higher in mice immunized with two doses of OMP, and very high after three fold immunization. The specific antibodies maintained in the animals for 8-16 weeks after immunization. Anti-OMP sera given to normal mice by intraperitoneal route protected them not only against challenge with homologous Shigella but also against Proteus and Escherichia. PMID- 3296994 TI - Cell invasiveness of Proteus mirabilis and Proteus vulgaris strains. AB - Cell penetration ability of haemolytic and non haemolytic Proteus rods was compared. Among four Proteus strains all were able to invade the tested cells (Vero 135, HeLa, L-929 and human blood lymphocytes) but the expression of this feature by haemolytic strains was markedly higher. The survival and multiplication of intracellular bacteria, especially in the case of fresh human blood lymphocytes may be of importance for the development of infection in higher organisms. PMID- 3296995 TI - Characterization of outer membrane proteins of virulent phase I Shigella sonnei strains and their avirulent phase I derivatives. AB - Comparison of polyacrylamide gel electrophoretic protein profiles of four isogenic sets of virulent phase I Sh. sonnei strains and their avirulent phase I cells revealed no differences in outer membrane protein composition between virulent and avirulent derivatives. However, significant qualitative and quantitative differences were found in composition of major outer membrane proteins between strains of different origin. All four strains tested contained one major protein of 33K. This protein was susceptible to proteolytic enzymes and was found to be heat modifiable. Other major proteins of 35K and 37K present in three strains and 36K present in one strain were identified as peptidoglycan associated proteins. PMID- 3296996 TI - Application of LS 7500 counter (Beckman) for measurement of phagocytosis of 14C labeled bacteria. AB - For determination of phagocytosis of Staphylococcus aureus 519 labeled with glycine-1-14C by guinea pig granulocytes, the third analytical program of LS 7500 counter was used. By measuring isotope radioactivity, the program enables evaluation of the percentage of a bound isotope in relation to the reference sample. In the present experiments the percentage of a bound isotope stands for the percentage of phagocytized bacteria calculated in relation to a reference sample, i.e. to radioactivity of bacteria added to the test. The program applied allows an automatic calculation of the percentage of phagocytized bacteria, the result being printed by a counter printer. PMID- 3296997 TI - Heterotopically induced bone does not develop functional periosteal membrane. AB - Heterotopic bone induced in mice by implantation of demineralized rat bone matrix does not respond to Moloney sarcoma. The biochemical and morphological parameters of osteogenesis (alkaline and acid phosphatase activity, 45Ca-uptake and total calcium content) are similar in the sites of Moloney sarcoma as in the contralateral, unexposed to the sarcoma, side. In contrast, periosteum of implants of syngeneic costal bone in response to Moloney sarcoma proliferates and produces new bone in the same manner, as orthotopic bones at the sites of Moloney sarcoma do. It is concluded that ectopically induced bones do not develop a true periosteum. PMID- 3296998 TI - Comparative analysis of the surface antigens of transplantable melanomas in hamsters. II. Examination of serologic reactivity of sera with isolated melanocytes by the cross-reaction and absorption test. AB - The reactivity of sera of hamsters bearing melanotic and amelanotic melanoma with isolated melanocytes was evaluated using immunoadherence test and cross reactions. Besides, the ability of neoplastic melanocytes to absorption of antibodies from these sera, was tested. The reactivity of cells of both melanomas with serum of hamsters bearing the original type--melanotic melanoma--appeared the same and twice as high in amelanotic cells with serum of animals bearing amelanotic melanoma. This suggests that in the course of spontaneous alteration, the new form--amelanotic, does not lose the original antigens but acquires new ones, not present on the melanotic cells. The above findings were confirmed by the absorption test. PMID- 3296999 TI - Conservative surgery and radiation therapy for early breast cancer. PMID- 3297001 TI - Duplication of the appendix mimicking adenocarcinoma of the colon. AB - Duplication of the appendix is a rare anomaly that has been reported fewer than 60 times. Three anatomic types of appendiceal duplications have been described- each the result of a different embryologic occurrence. A unique case of appendiceal duplication is presented, in which the duplication caused a constricting lesion of the colon and mimicked carcinoma. The anomalous appendix in this patient was not compatible with any of the previously described types of appendiceal duplications. PMID- 3297000 TI - Low-dose glucose infusion in patients who have undergone surgery. Possible cause of a muscular energy deficit. AB - To evaluate the effect of the glucose-induced insulin release on peripheral substrate metabolism, we studied muscle metabolism in seven patients after elective surgery and in four healthy volunteers combining the forearm and the euglycemic glucose clamp technique (insulin infusion, 0.2 mU/kg per minute). Arterial and deep venous concentrations of substrates and hormones were determined in the basal period and during steady state of the infusion period. After 90 minutes of insulin infusion, the whole-body glucose infusion rate was significantly lower in patients who had elective surgery, although plasma insulin concentrations were comparable. In both groups this was related to a reduced supply of free fatty acids and ketones in muscle. In controls the resulting lack of substrates in muscle appeared to be compensated by an enhanced uptake of glucose, not seen in the patients who had elective surgery. Surprisingly, as indicated by the significantly reduced lactate production (-0.15 +/- 0.05 vs 0.62 +/- 0.32 mumol/100 g per minute basal), in this group the glucose taken up was oxidized aerobically to a greater extent. However, the total resulting energy gain was small. Thus, a peripheral energy deficit might arise favoring increased oxidation of amino acids. To avoid this undesired side effect, only those substrates should be administered that minimize pancreatic insulin release. PMID- 3297002 TI - [Delayed-type hypersensitivity and lymphokine]. PMID- 3297003 TI - Diseases associated with the inhalation of asbestos dust. PMID- 3297005 TI - [Hemodynamic changes induced by high-frequency jet ventilation. Experimental study in dogs]. PMID- 3297004 TI - [Morphologic manifestations of intestinal lesions of bacterial and mycotic etiology developing in association with acute respiratory infections]. AB - By means of light and immunofluorescent microscopy the intestines of 34 children were studied, whose bacterial or mycotic enterocolitis most often combined with acute respiratory infections. Intestinal lesions were caused either by virus (sometimes by Mycoplasma), or by bacteria and fungi. Such changes developed in the debilitated children and their course was more severe, than in monoinfections because of the impaired systemic and local immunity, and probably due to formation of viral-bacterial complexes. Viral intestinal lesions were most often caused by a single virus, but not by multiple ones, as in pulmonary infections, which is explained by interferon production and the intensive therapy used. The alternative component in a viral lesion is enhanced due to the presence of lactic acid in the intestine and therefore it is inhibited when acute viral respiratory infection develops against the background of bacterial or mycotic enterocolitis due to dysbacteriosis. Changes in mucosal stroma and intestinal lymphatic system in different infections depend on the duration of the intestinal lesion. PMID- 3297006 TI - [Aneurysmal bone cyst of the orbit: report of a case]. AB - The authors report a case of aneurysmatic osseous cyst of the orbit in a 10 year old girl. The tumor was totally removed and the reconstruction of the orbital roof with acrylic was performed. PMID- 3297007 TI - Mediation of hypersensitivity reactions during hemodialysis by IgE antibodies against ethylene oxide. AB - Sera from 329 hemodialysis patients, 46 of whom had experienced a hypersensitivity-type reaction during hemodialysis, were screened by an enzyme allergosorbent test (EAST) for IgE antibodies specific for ethylene oxide (ETO). In seven of nine patients who had experienced a severe hypersensitivity reaction (type II or type III), high titers of IgE antibodies against ETO (greater than 3.0 PRU/mL) were found. However, plasma levels of IgE specific for ETO were in the normal range (less than 0.35 PRU/mL) in most (30/37) patients who had experienced a mild (type I) reaction. Selected sera from patients who had experienced severe reactions were further examined for IgE directed against isopropyl myristate (IPM), 2-chloroethanol, and extracts from unsterilized dialyzers. Importantly elevated serum levels of specific IgE against these substances could not be documented. Extracts of an ETO-sterilized, hollow-fiber dialyzer were positive, whereas extracts of an ETO-sterilized dialyzer containing a flat membrane were negative in the EAST. This difference can be explained by the different amounts of ETO present in the dialyzers. We conclude that ETO causes most severe hypersensitivity reactions by an IgE-mediated mechanism. On the other hand, the pathogenesis of mild (type I) reactions is less clearly associated with ETO allergy. Our results also suggest that other potentially allergenic substances in dialyzers (e.g., IPM, 2-chloroethanol) rarely induce specific IgE antibodies in dialysis patients. PMID- 3297008 TI - Thrombolysis and stroke. Past and future. AB - Investigators have tried to limit ischemic cerebral infarct size by pharmacologic and surgical means with mixed results. Thrombolytic (fibrinolytic) therapy has been used in the past with unfavorable outcome. With advances in clinical and radiologic assessment and new knowledge of the pathophysiology of brain ischemia, thrombolytic therapy has now become a feasible pharmacologic intervention in acute stroke. Central nervous system hemorrhage, the most dreaded complication of fibrinolytic therapy, is rare in patients with acute myocardial infarction favorably treated with these agents. Risk of hemorrhagic transformation of ischemic cerebral infarcts is related to size, location, and age of patient. Anticoagulation therapy may increase its size, but not its likelihood. The development of clot-specific agents, such as tissue-type plasminogen activator, and careful patient selection make fibrinolytic therapy safe and potentially effective in acute stroke. PMID- 3297009 TI - Current strategies for the management of aneurysmal subarachnoid hemorrhage. AB - Subarachnoid hemorrhage (SAH) from a ruptured intracranial aneurysm represents a major health issue. Although most people who experience an aneurysmal SAH survive to be admitted to a hospital, less than one third of these patients ever return to their premorbid status. Clearly, morbidity of this magnitude demands reevaluation of the clinical approach to this problem. This article reviews the natural history of aneurysmal SAH, and examines the current therapeutic strategies that have been suggested to improve the outcome. Careful evaluation of the existing data suggests that early aneurysm surgery and aggressive postoperative volume expansion therapy constitute the best presently available approach to patients with ruptured intracranial aneurysms. PMID- 3297012 TI - Osmotic pressure measurements on insulin: anomalous results indicate that the monomer is preferentially adsorbed. AB - The concentration dependence of the number average molecular weight of insulin at pH 2, ionic strength 0.05, and 20 degrees C as determined by osmotic pressure measurements indicates that the hormone is a homogeneous protein of molecular weight close to that of the dimer. Since sedimentation equilibrium experiments confirm what is well known, namely that insulin is a self-associating protein dissociating to monomer under these conditions, an explanation for the anomaly was sought in the possible loss of protein from solution by adsorption. Analysis of the results strongly supports this conclusion and consideration of the adsorption properties of insulin in terms of hydrophobic interactions shows them to be consistent with the behaviour of insulin as a self-associating protein. The monomer appears to be the primary molecular species responsible for insulin adsorption. PMID- 3297010 TI - Distribution of von Willebrand factor in porcine intima varies with blood vessel type and location. AB - The von Willebrand factor (vWF) has been generally accepted as a marker for endothelial cells. In a systematic immunolocalization study of porcine blood vessels that used indirect immunofluorescence with a monospecific polyclonal anti vWF and two monoclonal anti-vWFs, we observed that vWF is not universally distributed in intact, fresh endothelia. vWF is consistently localized in veins, with the exception of the pulmonic vein. In arteries, vWF is generally absent except for areas of the distal abdominal aorta, the vaso vasorum of the thoracic aorta, and the pulmonic artery. We conclude that there are regional differences in the distribution of vWF in the various endothelial beds of pigs. PMID- 3297011 TI - Primary culture of cells derived from human myometrium: both myometrium and cultured cells stained with desmin by the enzyme-labeled antibody method. PMID- 3297013 TI - Monoclonal antibodies to a subfraction of merino wool high-tyrosine proteins. AB - Monoclonal antibodies were prepared which react with members of the high-tyrosine type proteins from Merino wool. Specificity was confirmed by the use of Western transfer immunoassays and by enzyme-linked immunosorbent assay on purified fractions. Immunofluorescent staining of sections of wool follicles using the antibodies showed that the proteins were present in the developing wool shaft but that staining was asymmetric, indicating specific location of the proteins in the orthocortex of the fibres. Immunogold-electron microscopy confirmed that one of the antibodies bound to the keratin microfibril bundles. PMID- 3297014 TI - Response of pre-pubertally castrated rams and ewes to artificial photoperiod- changes in plasma LH and prolactin. AB - Castrate rams and ovariectomized ewes were maintained in the presence of entire rams and ewes and subjected to successive periods of alternating 6 h light:18 h darkness ('short' days) and 18 h light:6 h darkness ('long' days) preceded by a period of 12 h light:12 h darkness ('constant' light days). Plasma concentrations of LH and prolactin were measured in the castrate animals in order to determine how LH and prolactin secretion responded to the artificial light regime and corresponding periods of elevated or depressed testicular and ovarian activity in the entire rams and ewes. There was no variation in mean plasma LH concentrations or LH pulse frequency with either the changes in photoperiod or the phases of gonadal activity in the entire animals. However, there was a highly significant (P less than 0.001) relationship between prolactin secretion and the artificial photoperiod in both castrate groups with high and low levels coinciding with long and short days respectively. In addition, there was a marginally significant (P less than 0.1) relationship between prolactin secretion in the castrate ram and the stage of testicular activity in the entire rams with elevated levels associated with regressed activity. Prolactin secretion in the ovariectomized ewes was significantly (P less than 0.05) related to the phase of ovarian development with high levels associated with acyclic activity. It is concluded that LH secretion and pituitary responsiveness to exogenous GnRH were not modified by the artificial light regime. However, the changing light pattern was physiologically 'perceived' by the castrate animals as indicted by a concomitant variation in plasma prolactin concentrations. PMID- 3297015 TI - A comparison of the macrophage migration inhibition (MMI) assay and the semi automated leucocyte adherence inhibition (SALAI) assay. AB - The present study was undertaken in order to compare simultaneously the semi automated leucocyte adherence inhibition (SALAI) assay with the two-stage macrophage migration inhibition (MMI) assay in patients with colorectal disease. Eighty-six patients were assayed simultaneously in the MMI assay and the SALAI assays using patients' leucocytes and 83 patients were assayed simultaneously in the MMI assay and the SALAI assay using patients' serum. The SALAI assay using patients' leucocytes was more sensitive (70% vs 40%) and more specific (87% vs 73.3%) than the MMI assay. The SALAI assay was simple to perform, allowed many replicate samples and was more specific and sensitive in relation to the detection of colorectal cancer than other more commonly advocated tests. It may be useful as a screening test for colorectal cancer and it is suggested that further studies should be undertaken in this area. PMID- 3297016 TI - Prospects for the use of embryos in the control of disease and the transport of genotypes. AB - Transfer and low temperature storage of embryos are now proven techniques for a number of mammalian species. These techniques are useful in control of disease and in saving genotypes from infected animals. The place of embryos in the epidemiology of disease depends upon whether the causative organism can gain entry to the oocyte before or at fertilisation and on whether the young embryo can be invaded by organisms in the uterine environment. There is little evidence that important live-stock diseases are transmitted via gametes. The zona pellucida surrounding the embryo is an effective barrier against a number of important disease organisms; in some cases the embryo is susceptible once it has hatched from the zona pellucida. It is important therefore in considering the use of embryos in disease control, to ensure that virus is not attached to the surface of the zona pellucida from where it can infect the recipient and/or the embryo after hatching. Washing procedures have been devised together with the use of enzymes and antisera to remove virus from the surface of embryos. Some viruses enter pores and sperm tracks in the zona and removal of these may present a problem. African swine fever virus has been shown to resist removal by treatment with enzymes. There are no guidelines as to the likely interaction between a certain virus and embryos. Therefore each virus of interest must be tested to determine whether it can be transmitted via washed embryos. Nevertheless there are numerous instances of the use of embryo transfer to eradicate a specific disease or to save valuable genetic material from infected animals without transmitting disease. PMID- 3297017 TI - Plasma volume and endocrine responses to water immersion with intermittent positive-pressure breathing in men. AB - The effect of intermittent positive-pressure breathing (PB), induced by expiring against a resistance of 12.5 mm Hg, on plasma volume and endocrine responses to standing water immersion, was studied in seven male subjects, 28-49 years of age. The men were immersed to the neck (35 +/- 0.5 degrees C) for 90 min with PB from 30 to 60 min. Compared to control values, the hematocrit and hemoglobin concentration decreased (p less than 0.001) during immersion while plasma osmolality was unchanged, indicating an isotonic increase in plasma volume (hemodilution) which peaked after 75 min at +15.5% of the preimmersion plasma volume. This hemodilution was not significantly affected by PB. Plasma renin activity and vasopressin and aldosterone concentrations decreased progressively throughout immersion (p less than 0.001) and were unaffected by PB. The magnitude of these hormonal decreases was accentuated by preexisting, presyncopal symptoms in four subjects. It is concluded that intermittent PB as 12.5 mm Hg failed to compensate for the negative-pressure breathing of standing subjects immersed in water to the neck. PMID- 3297018 TI - The use of contact lenses by USAF aviators. AB - Contact lenses are an alternative method to spectacles for correcting refractive errors, but the U.S. Air Force prohibits the wearing of contact lenses by all aircrew members unless medically or optically indicated (AFR 167-3). USAFSAM has a clinical contact lens study consisting of 55 individuals wearing contact lenses for eye defects such as keratoconus, aphakia, anisometropia, and other special indications. Of these 55 individuals, 33 had medical conditions affecting their vision and were unconditionally grounded. Of these individuals, 31 (18 of 19 pilots, 8 of 9 navigators, 5 of 5 other categories) were visually rehabilitated and returned to full flight status by the use of contact lenses. Hard lenses were used in 70% of the cases and soft lenses in 30%. The large number of USAF aviators required to wear spectacles and new head-borne equipment has created compatibility problems with the standard USAF aviators' spectacle. For this spectacle compatibility problem, contact lenses appear as a viable alternative. However, for wide-spread use, concerns remain about the potential aviation hazards, such as +Gz effects, bubble formation, and corneal hypoxia. PMID- 3297019 TI - Pulsatility of reproductive hormones: physiological basis and clinical implications. AB - The secretion of LHRH from the median eminence, into hypophyseal portal blood provides a signal whereby the central nervous system interfaces with the endocrine system. The pulsatile nature of this system originates from phasic neural signals and, except in extreme cases where pulses are eliminated by the pituitary action of steroids, pulse frequency is determined by LHRH secretion. Steroidal feedback and other extrinsic influences that affect pulse frequency act via neural afferents to the LHRH neurons. Amplitude regulation may be by way of steroidal influence at the level of the pituitary gland, or indirectly via changes in LHRH pulse frequency. In this chapter, we have attempted to outline our current knowledge of factors regulating LHRH pulsatility and how this is transmitted into pulsatile gonadotrophin secretion. Regarding PRL secretion, we have outlined evidence that pulsatility is inherent in the lactotrophs, requiring no hypothalamic input. The possible roles of PRL releasing factors in circumstances like suckling and stress and of PRL inhibiting factors have been discussed with reference to the pulsatile nature of PRL secretion. PMID- 3297020 TI - Endocrine approaches to male fertility control. AB - As in the female, gametogenesis in the male is under the control of luteinizing hormone (LH) and follicle stimulating hormone (FSH). Their suppression should inhibit spermatogenesis. If a non-androgenic substance is used to suppress gonadotrophins, androgens must be supplemented to maintain virility, potency and metabolic processes. To avoid administration of several substances, testosterone and its esters were used to develop a male antifertility agent. Although azoospermia can be induced in a high proportion of men with administration of testosterone esters alone, this effect is not uniform. Even frequent injections with testosterone enanthate at weekly intervals fail to inhibit spermatogenesis in all participants. Combinations of gestagenic compounds with testosterone esters show a somewhat better effect, but again azoospermia is only achieved in around 50% of participants. LHRH analogues, although considered by many to offer a realistic potential for male fertility regulation, have not been proven to be successful for this purpose so far. Animal studies in monkeys and preliminary clinical trials demonstrate that agonistic analogues of LHRH have to be given continuously by pump or implant to achieve a pronounced effect on spermatogenesis. But even under these provisions, results in clinical trials have been worse than effects achieved with testosterone/gestagen combinations. Whether new antagonistic compounds offer a better potential awaits clinical trials. Studies in non-human primates demonstrate that testosterone by itself can maintain and initiate spermatogenesis. Based on these findings one could postulate an attenuating effect of high serum androgen levels after supplementation with available testosterone esters. Trials of alternative androgenic substances with slow-release characteristics and without high serum levels after single injections, like 19-nortestosterone hexyloxyphenylpropionate (19NT-HPP), tend to support this theory. With slow-release testosterone preparations under development by the WHO and more advanced delivery systems for LHRH analogues it is not unreasonable to speculate that an effective endocrine antifertility agent for the male will become available. PMID- 3297021 TI - Contributions of in vitro fertilization to knowledge of the reproductive endocrinology of the menstrual cycle. AB - The administration of ovarian stimulants to endocrine-normal women in IVF programmes gives the clinical endocrinologist an opportunity to modify natural folliculogenesis. Use of antioestrogens and/or gonadotrophins at the correct time has demonstrated that follicular atresia can be prevented and that multiple pregnancy-potent haploid ova can be obtained. Scrutiny of spontaneous menstrual cycles in patients who show unsatisfactory IVF responses has identified two new syndromes, premature follicle selection and occult ovarian failure, in these patients. The incidence of these disorders in fertile women is still unclear. Early results suggest that endocrine manipulations may overcome premature follicle selection and induce codominant folliculogenesis. Inhibin is a recently characterized ovarian protein which is increased in peripheral blood during IVF treatment. Results from IVF cycles suggest that plasma inhibin may be a new index of follicular function. Other potential indices of ovarian function, such as the luteal protein relaxin, may also develop from the application of basic research to IVF and advance knowledge of the human ovarian and menstrual cycles. PMID- 3297022 TI - Pathophysiological relationships between the biological and immunological activities of luteinizing hormone. PMID- 3297024 TI - Intragonadal control mechanisms. AB - On the weight of the evidence presented above, it is concluded that regulation at a local, intragonadal level is an integral part of the overall regulation of gonadal function in both sexes. The interaction between cells within a gonad extends beyond the same cell type to include germ cell-somatic cell interactions as well. We believe this local interaction between cell types facilitates the differing requirements of the various developmental stages of germ cells within the gonad, which would not be possible by simply varying the afferent pituitary hormone supply. We re-emphasize that the local factors responsible for these interactions are acting in conjunction with the pituitary hormones, and, in some cases, may be their proximate regulators. A more controversial phenomenon is the possibility of an interaction between the gonads which does not involve the hypothalamic-pituitary axis. The little evidence which is available to support this hypothesis comes mainly from studies on ovarian function, particularly recruitment and selection of follicles. More research on this phenomenon is warranted. Not surprisingly there are many parallels between the testes and ovaries with respect to the nature and action of local regulators. For example, the intragonadal action of steroids, the local modulation of the response of target cells to FSH, the influence of macrophages on steroidogenesis and the presence of mitotic and meiotic regulators are common to both sexes. It would not be surprising if the chemical nature of these factors in the ovary and testes are similar. If the ever-increasing list of factors and activities being discovered in the gonads is any guide, the phenomena outlined in this review are just the beginning of an extensive list of cell-cell interactions occurring within and between the gonads. No doubt the gonads will share with other organs the same interactions between cells which are required for normal cellular function. The uniqueness of the gonads lies in their protection and production of germ cells. The challenge of the future for reproductive biologists will be to discover and describe the interactions within and between germ cells which are obligatory for normal reproductive function, and to apply that information to devising ways of overcoming infertility and regulating fertility. PMID- 3297023 TI - The antiprogesterone steroid RU 486: a short pharmacological and clinical review, with emphasis on the interruption of pregnancy. AB - In this review we have briefly outlined the clinical applications and mechanism of action of the progesterone antagonist RU 486. RU 486 has been successfully used in a variety of conditions to regulate the reproductive cycle and to control fertility in women. We suggest that the mechanism by which RU 486 acts during the cycle and early pregnancy is probably by affecting mainly the endometrium. During late pregnancy, the compound has significant effects on the myometrium including the induction of gap junctions between myometrium cells, which is required for muscle contractility during labour. The use of RU 486 has helped to demonstrate that progesterone is required for maintenance of the late stages of pregnancy in women. PMID- 3297025 TI - Early myoblast differentiation in fast and slow types. AB - Serial sections of stage 18-27 HH (3-5 days of incubation) chick embryo myotomes were investigated by electron microscope. Two morphologically different types of contractile elements (myoblasts and myotubes) with an exact and constant localization were identified. Myotome sections of other chick embryos in the same stages were examined with the immunofluorescence technique, after treatment with antisera directed against fast and slow adult myosins. As from stage 24 HH, some contractile elements react positively with anti-fast adult myosin antiserum, others with anti-slow antiserum. A very precise correspondence was constantly found between the ultrastructural and immunohistochemical findings. An identical pattern was observed in the buds of the fast-twitching pectoralis major and posterior latissimus dorsi and slow-twitching anterior latissimus dorsi muscles. PMID- 3297026 TI - Vimentin-typing in diagnostic surgical pathology: a comparative study using four antibodies after different fixations. AB - Vimentin-typing was carried out on various normal and neoplastic tissues using four anti-vimentin antibodies in order to evaluate the effect of different fixation treatments on tissue reactivity in comparison to the results obtained on frozen sections. All antisera were reactive on frozen material; on paraffin embedded material staining of tissues depended on the type of fixation method applied (formalin, methacarn or absolute alcohol) and each antibody behaved differently in relation to the fixative used. Only mesenchymal normal structures were revealed on frozen material whilst on paraffin embedded material three of the four antibodies reacted also with non-mesenchymal normal structures (epithelia, central and peripheral nervous system cells). All four antibodies decorated, regardless of treatment, neoplastic cells of mesenchymal and non mesenchymal derivation, but not germ cells or germ cell tumors. The reactivity of vimentin to its specific antibodies depends on the fixative used: therefore, in routine pathology more than one antiserum should be available for testing. Furthermore, given the variety of non-mesenchymal structures stained by the anti vimentin antibodies, the differential diagnosis of undifferentiated tumors must not be based on vimentin positivity alone. The expression of vimentin by non mesenchymal neoplastic cells seems to parallel that of normal tissues during embryogenesis; therefore, this intermediate filament appears to be not only a marker of mesenchymal cells but also of many immature elements. PMID- 3297028 TI - [Plastic reconstruction following neglected damage of the medial collateral ligament of the knee joint]. PMID- 3297027 TI - [How modern is modern hand surgery?]. PMID- 3297029 TI - [Modification of flexor tendon transplantation in 2 sessions]. PMID- 3297030 TI - Detection and localization of antigens on the surface of mouse spermatozoa. Antigen synthesis in the epididymis. AB - Spermatozoa achieve functional maturity during their transit through the epididymis and this maturation process is accompanied by changes in the composition and proteins of their surface. The addition of secretory products from the epididymis to the plasma membranes of the spermatozoa is considered to be a prerequisite for the acquisition by the spermatozoa of the capacities for forward motility and ovum recognition. An antibody was purified from an antiserum raised in the rabbit against fluid from the cauda epididymis of the mouse. This antibody, in combination with fluorescein isothiocyanate-conjugated goat anti rabbit antibody, was used to demonstrate a progressive increase in the synthesis and secretion of antigens along the length of the epididymis. Immunoaffinity chromatography of [35S]methionine-labelled proteins, synthesized by segments of the epididymis maintained in vitro, showed that the predominant protein synthesized by the cauda, but not by the caput, epididymis, migrated on electrophoresis with an apparent Mr of 26,000. This same protein was the major antigen found on the plasma membrane of cauda spermatozoa that had been radioactively labelled with the non-penetrating probe isethionyl [1 14C]acetimidate. PMID- 3297031 TI - Catecholamine activation of pyruvate dehydrogenase in white adipose tissue of the rat in vivo. AB - Intraperitoneal injections of noradrenaline or adrenaline into rats increased the proportion of pyruvate dehydrogenase in the active state in white adipose tissue; this effect of catecholamines was also apparent in streptozotocin-diabetic rats, showing that it was not due to an increase in serum insulin concentration. The catecholamine-induced increase in pyruvate dehydrogenase of white adipose tissue in vivo was completely blocked by prior injection of either the beta-antagonist propranolol or the alpha 1-antagonist prazosin. Cervical dislocation of conscious rats increased pyruvate dehydrogenase activity of white adipose tissue, which was prevented by prior injection of propranolol. Adrenaline (30 nM) activated pyruvate dehydrogenase in white adipocytes in vitro; the maximum effect of adrenaline required activation of both alpha 1- and beta-receptors. The results show that catecholamines activate pyruvate dehydrogenase of white adipose tissue both in vivo and in vitro and that this effect is mediated by a combination of alpha 1- and beta-adrenergic receptors. PMID- 3297032 TI - Regulation of renal and hepatic pyruvate dehydrogenase complex on carbohydrate re feeding after starvation. Possible mechanisms and a regulatory role for thyroid hormone. AB - The work investigated the mechanisms for modulation of renal and hepatic pyruvate dehydrogenase complex (PDH) activities after carbohydrate re-feeding of 48 h starved rats, and identified a regulatory role for tri-iodothyronine. Glucose re feeding decreased blood concentrations of lipid fuels in both euthyroid and hyperthyroid rats. This treatment was not associated with re-activation of hepatic PDH in either group of rats, or of renal PDH in hyperthyroid rats (where activity was already high), but it increased renal PDH in euthyroid rats. Dichloroacetate (DCA), an activator of PDH kinase, increased renal PDH activities in euthyroid rats, but not hyperthyroid rats, and effects of glucose re-feeding or hyperthyroidism were no longer apparent. These treatments therefore exert their effects on renal PDH through changes in PDH kinase. DCA re-activation of hepatic PDH was more marked in hyperthyroid than in euthyroid rats, suggesting that, under conditions of inhibited kinase activity, PDH phosphatase is more active in livers of hyperthyroid rats. The limited effect of DCA on hepatic PDH in euthyroid rats was potentiated by glucose re-feeding or insulin, but not by inhibition of lipolysis, demonstrating a direct effect of insulin to increase hepatic PDH phosphatase. Glucose re-feeding, inhibition of lipolysis or insulin administration did not increase hepatic PDH in DCA-treated hyperthyroid rats, indicating that effects of hyperthyroidism and of insulin on PDH phosphatase are not additive. PMID- 3297033 TI - Glycophorin A interferes in the agglutination of human erythrocytes by concanavalin A. Explanation of the requirement for enzymic predigestion. AB - Human erythrocytes become agglutinable with concanavalin A (Con A) after treatment with various proteinases or neuraminidase. The extent of agglutinability achieved with different enzymes is, however, different: Pronase, papain, trypsin, neuraminidase and chymotrypsin enhance the agglutinability in decreasing order, the last being barely effective. The actions of the enzymes on band 3, the Con A receptor, do not correlate with their abilities to increase the agglutinability: Pronase, papain and chymotrypsin cleave the protein, but not trypsin or neuraminidase. No significant differences are found in the number of Con A-binding sites or the affinities for the lectin between the normal and trypsin- or Pronase-treated cells. Thus the receptor does not seem to play a role in determining the Con A-agglutinability of erythrocytes. On the other hand, the cleavage of glycophorins, especially glycophorin A, and the release of sialic acid (in the peptide-bound form) are well-correlated with the enhancement in agglutination after the action of proteinases. The release of sialic acid by graded neuraminidase digestion and the increase in Con A-agglutinability show a correlation coefficient of 0.88. The major inhibitory role of glycophorin A in the process is indicated by the agglutination of En(a) heterozygous erythrocytes; the cells, known to bear about 50% glycophorin A molecules in their membrane, are agglutinated approximately half as well without proteolysis as are the trypsin treated cells. Possible mechanisms by which glycophorin A could affect Con A mediated agglutination are discussed. PMID- 3297034 TI - Concanavalin A binding to human erythrocytes leads to alterations in properties of the membrane skeleton. AB - Three properties related to the erythrocyte membrane skeleton are found to be altered after the binding of concanavalin A (Con A) to erythrocytes or their isolated membranes. Con A binding to normal erythrocytes imparts resistance to heat (49 degrees C)-induced fragmentation of the cells. The fragmentation, due to denaturation of spectrin at 49 degrees C, is prevented by Con A in a dose dependent manner, but levels off at concentrations of Con A in excess of 100 micrograms/ml. The binding of Con A to ghosts isolated from normal, trypsin- or Pronase-treated cells prevents (completely or substantially) the elution of the skeletal protein complex when the membranes are extracted under low-ionic strength conditions in the cold. The Con A-agglutinated membranes of trypsin- and Pronase-treated, but not normal, cells show cross-linking of skeletal proteins and band 3 with dimethyl adipimidate, a 0.86 nm (8.6 A)-span bifunctional reagent. The extent of cross-linking is greater in the Pronase-treated membrane than in the less-agglutinable trypsin-treated membranes. The results show that, after Con A has bound, rearrangements occur in the membrane that alter properties of the skeletal proteins. Additionally, redistribution of the skeletal proteins and the Con A receptor occurs in the lectin-agglutinated membranes. PMID- 3297035 TI - Purification and kinetic properties of pyruvate kinase isoenzymes of Salmonella typhimurium. AB - Two forms of pyruvate kinase (ATP: pyruvate 2-O-phosphotransferase, EC 2.7.1.40) present in Salmonella typhimurium were purified to homogeneity from the same cultures by (NH4)2SO4 fractionation and gel filtration, anion-exchange and affinity chromatography. Mr values, subunit structure, amino acid composition and activity and stability conditions were determined for the two forms. Kinetic and regulatory properties of the two purified isoenzymes were studied. PMID- 3297036 TI - Yeast phosphoglycerate kinase: investigation of catalytic function by site directed mutagenesis. AB - A salt link buried in the domain interface of phosphoglycerate kinase has been implicated as being important in controlling the conformational transition from the open, or substrate-binding, to the closed, or catalytically competent, form of the enzyme. The residues contributing to the salt link are remote from the active site, but are connected to the substrate-binding sites through strands of beta-sheet. It has been suggested that these residues may also mediate sulphate and anion activation. These assumptions have been tested by examining the properties of a site-directed mutant (histidine-388----glutamine-388). The expression and overall structural integrity of the mutant, produced in yeast from a multicopy plasmid, remains essentially unaltered from the wild-type enzyme. However, the mutant enzyme has a kcat. reduced by 5-fold. The Km for ATP is lowered by 3-fold, and the Km for 3-phosphoglycerate is unaffected. The effects of sulphate on activity over a wide range of substrate concentrations appear to be the same for both the mutant and wild-type enzymes. These results lead to a reappraisal of the mechanistic role of the inter-domain histidine-glutamate interaction, as well as a refinement of the kinetic model of the enzyme. PMID- 3297037 TI - An investigation of transient intermediates in the reaction of 2-methylglutamate with glutamate decarboxylase from Escherichia coli. AB - Several intermediates in the reaction of 2-methylglutamate with glutamate decarboxylase from Escherichia coli were detected by stopped-flow spectrophotometry and by rapid-scanning spectrophotometry after conventional mixing. Structures were assigned to intermediates on the basis of kinetic and spectral evidence. In the early stages of the reaction an intermediate with the properties expected of a geminal diamine accumulated significantly. Changes consistent with the conversion of this species into the external aldimine were also observed. The course of product formation was determined and linked with spectral changes taking place in the bound coenzyme. The effect of the minor decarboxylation-dependent transamination that accompanies the major reaction was analysed. PMID- 3297038 TI - Specificity studies on enteropeptidase substrates related to the N-terminus of trypsinogen. AB - The specificity of the synthetic substrate Gly-[L-Asp]4-L-Lys 2-naphthylamide originally developed for the assay of enteropeptidase (EC 3.4.21.9), was investigated with partially purified aminopeptidase. Our results indicate that, not only enteropeptidase, but also the concerted action of the aminopeptidases of the rat small intestine, can rapidly release 2-naphthylamine from the substrate. A previously undescribed, highly active, dipeptidylaminopeptidase, which hydrolyses a Gly-Asp dipeptide from the N-terminus of the substrate, was detected in rat small intestine. The resulting [L-Asp]3-L-Lys 2-naphthylamide fragment is then degraded by a combination of aminopeptidase A and N to yield free 2 naphthylamine. Thus the present substrate cannot be regarded as being specific for enteropeptidase, and its use leads to an over-estimation of enteropeptidase activity in homogenates and extracts of intestinal tissue. In order to prevent this non-specific hydrolysis by aminopeptidases, stereoisomeric substrates with the sequence L-Ala-D-Asp-[L-Asp]3-L-Lys methyl ester, D-Ala-[L-Asp]4-L-Lys methyl ester and L-Ala-[Asp]4-L-Lys methyl ester were synthesized and tested as alternative substrates by their ability to inhibit the enteropeptidase-catalysed activation of trypsinogen. PMID- 3297039 TI - Metabolism of lysophospholipids in intact rat islets. The insulin secretagogue p hydroxymercuribenzoic acid impairs lysophosphatidylcholine catabolism and permits its accumulation. AB - Although recent studies implicate lysophospholipids (lyso-PLs) in stimulus secretion coupling in the pancreatic islet, almost no data on lyso-PL metabolism therein exist. Therefore, intact rat islets were loaded with insulinotropic and non-toxic concentrations of 1-[14C]palmitoyl-lysophosphatidylcholine (lyso-PC) via transbilayer movement, and its metabolic fate was studied. The time-dependent hydrolysis of lyso-PC to fatty acid (lysophospholipase activity), its conversion to phosphatidylcholine (putative acyltransferase activity) and, to a lesser degree, the appearance of label in phosphatidylethanolamine (putative transacylase or base exchange activity) were observed. p-Hydroxymercuribenzoic acid (PHMB) at 100 microM (a concentration previously demonstrated to elicit potent exocytotic insulin release) inhibited all three activities (by 56, 46 and 75%, respectively) and led to the intracellular accumulation of lyso-PC. Antimycin A inhibited phosphatidylcholine formation but not lysophospholipase activity; lyso-PC did not accumulate, implying that blockade of both of the major metabolic pathways is required to induce a detectable increment in lyso-PC levels. Calculations derived from data using the lowest effective insulinotropic concentration of lyso-PC suggested that increments in lyso-PC accumulation at critical membrane sites of less than 10-15% above basal values are sufficient to trigger insulin release. Since PHMB elicited increments of 50-100% in lyso-PC after its translocation into islets, support is provided for the earlier contention that lyso-PLs mediate the insulinotropic effect of PHMB. In addition, these studies may provide a more precise experimental paradigm for future studies of islet lyso-PL metabolism. PMID- 3297040 TI - A novel approach to study of the structural basis of enzyme polymorphism. Analysis of carboxylesterase B of Escherichia coli as model. AB - In order to understand the structural basis of charge differences among enzyme variants without undertaking purification and sequencing of the protein, an original approach was developed. The approach is applicable to any enzyme or protein provided that there is a specific staining procedure. This consists, as a first step, in the projection of electrophoretically obtained mobility values versus pI of all variants into a two-dimensional profile. In a second step, starting from the most common variant, various theoretical possibilities of substitutions are envisaged, taking into consideration the pH of the electrophoretic conditions, pI of the variants and range of variations of the pK values of several amino acid side chains. In a third step, verification of the theoretical data is obtained through comparative protein titration curves by combined isoelectrofocusing-electrophoresis of several pairs of relevant variants. The validity of this approach is tested on the highly polymorphic carboxylesterase B enzyme of Escherichia coli and is found to provide valuable information. PMID- 3297041 TI - Stimulation of adipocyte phospholipid methyltransferase activity by phorbol 12 myristate 13-acetate. Differential regulation of phospholipid methyltransferase and lipolysis. AB - The present studies demonstrate that treatment of rat adipocytes with the phorbol ester phorbol 12-myristate 13-acetate (PMA) causes a dose-dependent stimulation of phospholipid methyltransferase (PLMT) activity. The stimulatory effect of PMA was not additive with that of isoprenaline or forskolin. The sensitivity of stimulated PLMT activity to inhibition by insulin, however, was decreased in the presence of PMA. The inhibitory effect of a maximal concentration of insulin on PLMT was unchanged in the presence of PMA. In contrast with the effects on PLMT, the lipolytic response of adipocytes to isoprenaline and the anti-lipolytic response to insulin were unaffected by PMA. These data suggest that PLMT is, whereas hormone-sensitive lipase is not, an intracellular target for the action of PMA. The lack of effect of PMA on lipolysis suggests that PLMT and hormone sensitive lipase can be regulated by separate mechanisms. Furthermore, phorbol esters do not interfere in the regulatory pathway whereby insulin inhibits PMLT or lipolysis. PMID- 3297042 TI - Protein kinase C is not required for insulin stimulation of hexose uptake in muscle cells in culture. AB - The L6 skeletal muscle cell line has been identified as a suitable model to study the action of insulin on glucose uptake in muscle [Klip, Li & Logan (1984) Am. J. Physiol. 247, E291-E296]. The signals that transfer information from occupied insulin receptors to glucose transporters remain unknown. Here we report that activation of protein kinase C by exogenous phorbol esters results in stimulation of glucose uptake. Protein C kinase activity was induced to migrate from the cytosolic fraction to the microsomal fraction after 40 min of exposure of intact cells to 4 beta-phorbol 12,13-dibutyrate. In contrast, incubation with insulin did not alter the subcellular distribution of the kinase. Prolonged preincubation of L6 cells with phorbol esters resulted in depletion of kinase C activity, whereas neither the basal rate of glucose uptake nor its stimulation by insulin were affected. This suggests that protein kinase C is expressed in L6 cells, and that insulin stimulation of hexose transport does not involve protein kinase C. PMID- 3297043 TI - GTP mobilization of Ca2+ from the endoplasmic reticulum of islets. Comparison with myo-inositol 1,4,5-trisphosphate. AB - The effect of the guanine nucleotide GTP on Ca2+ release from the endoplasmic reticulum of digitonin-permeabilized islets was investigated. maximal and half maximal Ca2+ release were observed at 5 microM- and 2.5 microM-GTP respectively. GTP caused a rapid release of Ca2+ from the endoplasmic reticulum, which was complete within 1 min. GTP-induced Ca2+ release was structurally specific and required the hydrolysis of GTP. The combination of maximal concentrations of GTP (10 microM) and myo-inositol 1,4,5-trisphosphate (IP3) (10 microM) resulted in an additive effect on Ca2+ release from the endoplasmic reticulum. GDP (100 microM), which inhibits GTP-induced Ca2+ release, did not affect IP3-induced Ca2+ release. Furthermore, GTP-induced Ca2+ release was not independent on submicromolar free Ca2+ concentrations, unlike IP3-induced Ca2+ release. These observations suggest that mechanistically GTP-induced Ca2+ release is different from IP3-induced Ca2+ release from the endoplasmic reticulum. PMID- 3297044 TI - Catalytic irreversible inhibition of bacterial and plant arginine decarboxylase activities by novel substrate and product analogues. AB - Arginine decarboxylase (ADC) activity from Escherichia coli and two plant species (oats and barley) was inhibited by five new substrate (arginine) and product (agmatine) analogues. The five compounds, (E)-alpha monofluoromethyldehydroarginine (delta-MFMA), alpha-monofluoromethylarginine (MFMA), alpha-monofluoromethylagatine (FMA), alpha-ethynylagmatine (EA) and alpha allenylagmatine (AA), were all more potent inhibitors of ADC activity than was alpha-difluoromethylarginine (DFMA), the only irreversible inhibitor of this enzyme described previously. The inhibition caused by the five compounds was apparently enzyme-activated and irreversible, since the loss of enzyme activity followed pseudo-first-order kinetics, was time-dependent, the natural substrate of ADC (arginine) blocked the effects of the inhibitors, and the inhibition remained after chromatography of inhibited ADC on Sephadex G-25 or on overnight dialysis of the enzyme. DFMA, FMA, delta-MFMA and MFMA were effective at very low concentrations (10 nM-10 microM) at inhibiting ADC activity in growing E. coli. FMA was also shown to deplete putrescine effectively in E. coli, particularly when combined with an inhibitor of ornithine decarboxylase, alpha monofluoromethyl-putrescine. The potential uses of the compounds for the study of the role of polyamine biosynthesis in bacteria and plants is discussed. PMID- 3297046 TI - Limited proteolysis and sequence analysis of the 2-oxo acid dehydrogenase complexes from Escherichia coli. Cleavage sites and domains in the dihydrolipoamide acyltransferase components. AB - The structures of the dihydrolipoamide acyltransferase (E2) components of the 2 oxo acid dehydrogenase complexes from Escherichia coli were investigated by limited proteolysis. Trypsin and Staphylococcus aureus V8 proteinase were used to excise the three lipoyl domains from the E2p component of the pyruvate dehydrogenase complex and the single lipoyl domain from the E2o component of the 2-oxoglutarate dehydrogenase complex. The principal sites of action of these enzymes on each E2 chain were determined by sequence analysis of the isolated lipoyl fragments and of the truncated E2p and E2o chains. Each of the numerous cleavage sites (12 in E2p, six in E2o) fell within similar segments of the E2 chains, namely stretches of polypeptide rich in alanine, proline and/or charged amino acids. These regions are clearly accessible to proteinases of Mr 24,000 28,000 and, on the basis of n.m.r. spectroscopy, some of them have previously been implicated in facilitating domain movements by virtue of their conformational flexibility. The limited proteolysis data suggest that E2p and E2o possess closer architectural similarities than would be predicted from inspection of their amino acid sequences. As a result of this work, an error was detected in the sequence of E2o inferred from the previously published sequence of the encoding gene, sucB. The relevant peptides from E2o were purified and sequenced by direct means; an amended sequence is presented. PMID- 3297047 TI - Adipocyte insulin receptor. Generation of a cryptic domain of the alpha-subunit during internalization of hormone-receptor complexes. AB - The dynamics of the internalization of photoaffinity-labelled insulin-receptor complexes was investigated in isolated rat adipocytes by using tryptic proteolysis to probe both the orientation and cellular location of the labelled complexes. In cells that were labelled at 16 degrees C and not prewarmed, 150 micrograms of trypsin/ml rapidly degraded the labelled 125 kDa insulin-receptor subunit into a major proteolytic fragment of 70 kDa and minor amounts of 90- and 50-kDa fragments. With milder trypsin treatment conditions (100 micrograms of trypsin/ml, 15 s at 37 degrees C), the 90 kDa peptide (different from the 90 kDa beta-subunit of the insulin receptor) appeared as a major intermediate proteolytic product, but this species was rapidly and completely converted into the 70- and 50-kDa fragments with continued exposure to trypsin, such that it did not accumulate to appreciable amounts in cells that were not prewarmed before trypsin exposure. By contrast, trypsin treatment of cells prewarmed to 37 degrees C for various times showed that: first, a proportion of the labelled 125 kDa receptors was internalized (became trypsin-insensitive); secondly, the 90 kDa tryptic peptide was formed in large amounts, with proportionate decreases occurring in the amounts of the 70- and 50-kDa tryptic peptides. The increased accumulation of the 90 kDa tryptic peptide from cells preincubated at 37 degrees C, but not at 16 degrees C, indicated that trypsin cleavage sites within the 90 kDa segment of the insulin-receptor alpha-subunit that were exposed at 16 degrees C were made inaccessible by incubation at 37 degrees C, a finding that is consistent with generation of a cryptic domain of the receptor subunit. The tryptic generation of the 90 kDa peptide at 37 degrees C was rapid, becoming half maximal in 4.4 +/- 0.6 min and maximal in 15-20 min, preceded the intracellular accumulation of labelled receptors (half-maximal in 12.6 +/- 0.7 min and maximal in 30-40 min), was highly correlated with receptor internalization, and was not observed in cultured IM-9 lymphocytes, a cell line in which photolabelled insulin receptors are primarily lost by shedding into the incubation media. These results show that, in adipocytes incubated at 37 degrees C, rapid masking of a previously (at 16 degrees C) accessible domain of the insulin-receptor alpha-subunit occurs and that this dynamic process happens at an early stage in the internalization of insulin-receptor complexes. PMID- 3297045 TI - Biochemistry of the cell cycle. PMID- 3297048 TI - Protein synthesis and degradation in isolated muscle. Effect of omega 3 and omega 6 fatty acids. AB - The ability of derivatives of the essential fatty acids linoleic acid (C18:2, omega 6) and alpha-linolenic acid (C18:3, omega 3) to stimulate rates of protein synthesis and degradation was investigated in isolated intact muscles from fasted rabbits. Both omega 6 derivatives examined, arachidonic acid (C20:4, omega 6) and dihomo-gamma-linolenic acid (C20:3, omega 6), when added at concentrations up to 1 microM, stimulated the rate of protein synthesis and the release of prostaglandin F2 alpha (PGF2 alpha). Metabolites of the omega 6 series, namely eicosapentaenoic acid (C20:5, omega 3) and docosahexaenoic acid (C22:6, omega 3), were without effect on the rate of protein synthesis and resulted in a decrease in the release of PGF2 alpha. None of the fatty acids had a significant effect on the rate of protein degradation. Although insulin (100 mu units/ml) also stimulated rates of protein synthesis when added alone, none of the omega 3 or omega 6 fatty acids, when added with insulin at concentrations of 0.2 microM, potentiated the effect of the hormone. PMID- 3297050 TI - Control of macromolecular synthesis and degradation during terminal erythroid cell development. PMID- 3297049 TI - Molecular cloning and over-expression of the glyoxylate bypass operon from Escherichia coli ML308. AB - A recombinant plasmid carrying an 11 kb restriction-endonuclease-ClaI fragment of genomic DNA from Escherichia coli ML308 was constructed. This plasmid complements an aceA mutation. The plasmid encodes the structural genes of the glyoxylate bypass operon, namely malate synthase A (aceB), isocitrate lyase (aceA) and isocitrate dehydrogenase kinase/phosphatase (aceK), as judged by overexpression of enzyme activities and transcription/translation experiments in vitro. Subcloning confirmed that expression of the aceK gene is essential for growth on acetate. PMID- 3297051 TI - Erythrocyte shape dynamics: influence of electrolyte conditions and membrane potential. AB - The correlation of erythrocyte shape and transmembrane potential already published (J. Membrane Biol 51 (1979), 217 and 66 (1982) 79) has been confirmed by using glutaraldehyde fixation and experiments without ionophores. It is demonstrated additionally that the influence of amphipathic drugs on the shape formation depends on the membrane electric field. The results can be interpreted assuming a negatively charged membrane compound being distributed between the two leaflets by electrochemical equilibrium. PMID- 3297052 TI - Red cell clearance (a review). PMID- 3297053 TI - Are the red cell proteases a clock mechanism which turns on a signal of senescence? AB - The mammalian erythrocyte has a finite life span. In order to study the mechanism involved, a well-defined age group of erythrocytes must be obtained. Such cells are produced by a hypertransfusion system in mice. With this system, it was possible to show that the very oldest population of erythrocytes bind autoantibodies. This binding of the autoantibodies is not a gradual accumulation, but occurs primarily in the oldest red cells. The immunoglobulins bound are not isotype specific but reflect the isotype in the serum. The red cells with the oldest mean age are recognized and phagocytized most readily by peritoneal exudate macrophage in vitro. Earlier studies suggest that protein 3 may be involved in autoantibody binding. An investigation of protein 3 indicates that the human red cells contain well-defined catabolic products of this protein and there is little variation of these catabolic products among individuals both quantitatively and qualitatively. This suggests that there is a well-regulated catabolic system in the red cell. A study of the calcium-activated proteases, the only neutral proteases in the red cell, show that they do not directly generate the amino terminal catabolic fragments of protein 3 found in the erythrocyte. PMID- 3297054 TI - Purification and characterization of high molecular weight human epidermal growth factor from human urine. AB - High molecular weight human epidermal growth factor (HMW-hEGF) was purified to homogeneity from human urine. The purification was achieved exclusively by the use of immunoaffinity chromatography and reverse phase high performance liquid chromatography (HPLC). The purified HMW-hEGF is composed of a single polypeptide chain with an apparent molecular weight of 30,000 and has pI of 4.0. Its N terminal sequence was determined as Val-Ser-Asp-Gln-Asp-Asp-( )-Ala-Pro-Val-Gly-( )-Ser-Met-Tyr-Ala-Arg-( )-Ile- Ser-. The trypsin treatment of this protein gave hEGF like fragments. These results suggest that the obtained HMW-hEGF may play an important role in biosynthetic precursor of hEGF. PMID- 3297055 TI - A disbalance between beta-adrenergic and muscarinic responses caused by hydrogen peroxide in rat airways in vitro. AB - The effect of hydrogen peroxide on adrenergic and muscarinic responses of rat airway smooth muscle was studied. The trachea muscle and the lung parenchymal strip were contracted with methacholine and relaxed with (-)-isoprenaline. Recording of three (-)-isoprenaline curves on the trachea muscle and the lung parenchymal strip was followed by treatment for 30 min with hydrogen peroxide (H2O2) (1mM) after which a new dose response curve for (-)-isoprenaline was constructed. Using the trachea muscle this treatment with H2O2 resulted in a decrease of 61% of the maximum contraction by methacholine compared with the control and a complete inhibition of the relaxation by (-)-isoprenaline. In the lung parenchymal strip preparation we found, after the same treatment no reduction of the contraction by methacholine and 61% reduction of the relaxation by (-)-isoprenaline, compared with the control. The results demonstrate that the adrenergic response in rat airways is more susceptible to hydrogen peroxide than the muscarinic response. PMID- 3297056 TI - DAPI-pUC8 complex: a tool to investigate biological effects of nucleic acid-drug interaction. AB - A complex consisting of pUC8, a 1.8 Md plasmid, and 4'-6-diamidino-2 phenylindole, a DNA-binding agent, has been performed in vitro under different conditions of ionic strength, and used to transform competent cells. A strong interference with the plasmid-coded activities, related to the P/D ratio where at the DNA-drug complex was formed, was shown to occur. Since the compound does not inhibit the uptake process neither affects plasmid activity once dissociated at high ionic strength, it is likely to be acting from inside the cell while still in the form of a DNA-adduct. This system is proposed as a useful tool to investigate the effects on target genes of drugs endowed with DNA sequence specificity. PMID- 3297057 TI - An antibody purified with a lambda GT11 fusion protein precipitates enkephalinase activity. AB - An antiserum was raised against the neutral endopeptidase "enkephalinase" in guinea pig and used to probe a rabbit kidney cDNA expression library. A positive clone has been isolated and sequenced. The identity of the corresponding fusion protein was ascertained by its ability to select, from the crude antiserum, antibodies which specifically immunoprecipitate neutral endopeptidase enzymatic activity. This approach eliminates the uncertainty inherent to clone identification obtained from oligonucleotide probe derived from a partial sequence of the protein. PMID- 3297058 TI - Adenosine deaminase activity in recipients of bone marrow from immunodeficient mice homozygous for the wasted mutation. AB - Mice homozygous for the mutation wasted (wst/wst) have been postulated to be a model for the form of human severe combined immunodeficiency disease (SCID) that is secondary to a genetic deficiency of adenosine deaminase (ADA). To test this hypothesis more critically, we transplanted marrow from wst/wst and littermate control mice into lethally irradiated normal recipients. The Vmax and Km values for ADA in recipient's hematologic and non-hematologic tissues did not differ significantly. These results indicate that the wasted mouse is not a model for ADA deficiency and SCID. PMID- 3297059 TI - Localization of azidophencyclidine-binding site on the nicotinic acetylcholine receptor alpha-subunit. AB - Nicotinic acetylcholine receptors in receptor-rich membranes from Torpedo californica and from T. marmorata electric tissue were photolabeled with the non competitive inhibitor [3H]azidophencyclidine. The receptor subunits were separated on SDS-polyacrylamide gels and the alpha-subunits recovered from the gel, were subjected to Staphylococcus aureus V8 protease cleavage. The proteolytic fragments were resolved by SDS-polyacrylamide gel electrophoresis and were identified on protein blots by 125I-labeled alpha-bungarotoxin binding and by staining with concanavalin A. The site of specific azidophencyclidine labeling has been localized to the V8-18 kDa fragment which binds toxin. Labeling of the V8-18 kDa fragment was observed in the absence and in the presence of carbamylcholine. This was found for both the species of Torpedo used here. PMID- 3297060 TI - Dissociation between serine proteinases and proline related enzymes in spleen of MRL mouse as a model of systemic lupus erythematodes. AB - We investigated the changes in the activities of proteases and other hydrolytic enzymes in spleens of MRL mice as a model of systemic lupus erythematodes (SLE). Although there are various abnormalities in the activities of proteases in the spleens of such animals, a multivariate study helped to extract two important components. The first component, representing the activities of serine proteinases, tended to decrease with advancing age in MRL mice but not in control animals. The second component, representing Pro-IP and prolyl endopeptidase, tended to decrease with advancing age in control animals, but not in the MRL mice. The discrepancy between these two components may be related to the immunopathologic disturbances in this model. PMID- 3297061 TI - pHmetrical determination of the glucosamine-6-phosphate isomerase deaminase reverse reaction. AB - In the reverse direction, the reaction catalyzed by glucosamine 6-phosphate isomerase deaminase consumes ammonia and forms GlcN6P. As a consequence of the formation of a product with a lower pK than the substrates, a measurable pH drop in the reaction medium is produced. This property can be used to follow potentiometrically the course of the reaction. This property can be used to follow potentiometrically the course of the reaction. The usefulness of the method is demonstrated obtaining the inhibition pattern by GlcN6P when Fru6P is the varied substrate. PMID- 3297062 TI - NADP-linked dismutation and concentrations of citrate, cytosolic free Ca2+ and phosphoenolpyruvate in islet B-cells stimulated with glucose. AB - B-cells stimulated with glucose showed enhanced activities of NADP-isocitrate dehydrogenase, aconitase, ATP-citrate lyase and phosphoenolpyruvate carboxy kinase, elevated cytosolic [NADPH]/[NADP+] ratio, and increased concentrations of glucose 6-phosphate, 6-phosphogluconate, citrate, phosphoenolpyruvate and cytosolic free Ca2+. Phosphoenolpyruvate induced release of Ca2+ accumulated in isolated mitochondria. Glucose is suggested to stimulate a cytosolic NADP-linked dismutation and synthesis of citrate, associated with increased cytosolic free Ca2+ concentration. Subsequent breakdown of cytosolic citrate may yield Pi (possibly related to the "phosphate flush") and phosphoenolpyruvate which potentiates the release of Ca2+ accumulated in the B-cell mitochondria. PMID- 3297063 TI - Adenosine deaminase from Saccharomyces cerevisiae: purification and characterization. AB - Adenosine deaminase from Saccharomyces Cerevisiae was purified about 1600 fold by salt fractionation, ion exchange and affinity chromatography. Some physico chemical properties have been determined: the molecular weight of the enzyme by gel filtration is 85,000 daltons; one -SH is readily titrated by paramercuribenzoate per 78,000 mol. weight; optimum pH is 7; Km for adenosine is 40.7 microM; 2'-deoxyadenosine is not a substrate. Deazaadenosine analogues are good inhibitors, while erythro-9-(2-hydroxy-3-nonyl) adenine binds with low affinity. These properties are compared with those of other adenosine deaminases. PMID- 3297064 TI - Current concepts and new ideas on the mechanism of action of quinoline-containing antimalarials. PMID- 3297065 TI - Effects of opioid agonist drugs on the in vitro release of 3H-GABA, 3H-dopamine and 3H-5HT from slices of rat globus pallidus. PMID- 3297066 TI - Effect of 3-aminobenzamide on the frequency of antigen switching in Trypanosoma brucei in vitro. PMID- 3297068 TI - The comparative pharmacokinetics of carboplatin and cisplatin in mice and rats. AB - The plasma, urinary and biliary clearances of cisplatin and its non-nephrotoxic analogue, Carboplatin (cis-diammine-1,1-cyclobutane dicarboxylate platinum II, CBDCA, JM8) have been determined in mice and rats following intravenous administration of the compounds. The plasma concentration-time curves were biphasic during the time period studied (0-60 min), with t1/2 alpha of 2-3 min for both platinum complexes and t1/2 beta of 10-15 min for cisplatin and 25-26 min for Carboplatin. The kinetic rate constants, k12 and k21, were similar for both Carboplatin and cisplatin, indicating that there was no appreciable net accumulation of the compounds in the peripheral tissues. Immediately after administration, Carboplatin became reversibly bound to plasma proteins in vivo to the extent of about 20%. Appreciable irreversible binding appeared after the first 60 min and increased steadily, so that by 4 hr only 34% of the compound was present in the plasma as the free drug. In comparison, binding of cisplatin to plasma was exclusively irreversible and, after the first 10 min, free drug disappeared rapidly, such that by 60 min free platinum was not detectable. The plasma clearance of free cisplatin (26.1 ml/min/kg) was significantly greater than that of either Carboplatin (10.3 ml/min/kg) or insulin (10.1 ml/min/kg). The main route of excretion of the two platinum complexes was via the urine, with 80 90% of Carboplatin and 43-48% of cisplatin being excreted within 4 hr. In the rat, the Carboplatin excreted in the urine was predominantly as the unchanged compound. The renal clearance of cisplatin (12.3 ml/min/kg) was significantly greater than that of either Carboplatin (9.3 ml/min/kg) or insulin (9.6 ml/min/kg), suggesting that cisplatin was excreted by an active renal secretory mechanism whilst Carboplatin was eliminated by glomerular filtration alone. Biliary excretion of the two compounds was only 0.4-1.2% of the administered dose in 6 hr, with biliary clearance of cisplatin (0.27 ml/min/kg) being fivefold greater than that of Carboplatin (0.053 ml/min/kg). The results indicate that the major pharmacokinetic differences between Carboplatin and cisplatin relate to their renal handling and their reactivity with macromolecules. These differences may well underline the substantial lack of Carboplatin nephrotoxicity in comparison with cisplatin. PMID- 3297067 TI - Does deoxyglucose uptake in the brain reflect energy metabolism? PMID- 3297069 TI - Cytochrome P-450-mediated activation of procarcinogens and promutagens to DNA damaging products by measuring expression of umu gene in Salmonella typhimurium TA1535/pSK1002. AB - A simple and sensitive procedure for the determination of cytochrome P-450 (P 450)-mediated activation of chemical procarcinogens and promutagens to DNA damaging products has been developed using a method measuring the expression of the umu gene in Salmonella typhimurium TA1535/pSK1002, which is based upon the initial procedures as described by Oda et al. [Mutation Res. 147, 219 (1985)]. The chemicals examined were a variety of potent carcinogenic and mutagenic compounds including heterocyclic aromatic amines, aromatic amines, polycyclic aromatic hydrocarbons and aflatoxin B1. These chemicals were incubated with rat liver microsomes or a reconstituted monooxygenase system containing three forms of purified P-450 in the presence of a bacterial tester strain, and the induced umu gene expression was determined by measuring the beta-galactosidase activity produced by fusion gene in the cells. The activity was increased linearly for at least 2 hr with an initial lag time of 30 min and was dependent on the concentrations of P-450 in the reaction mixture. Thus, the metabolic activation of these compounds by P-450 could be compared on a basis of the specific beta galactosidase activity/min/nmol P-450. Among three forms of P-450, two isozymes induced by 3-methylcholanthrene were found to be more active in catalyzing the metabolic activation of most of the chemicals examined than a form of P-450 which is induced by phenobarbital. Data also showed that a high spin form of P-450 isolated from 3-methylcholanthrene-treated rats had a profound role in the activation of procarcinogens and promutagens. This conclusion was based on the results of catalytic activities by three forms of P-450 in a reconstituted monooxygenase system, and on the effects of specific antibodies against these P 450s on the reactions catalyzed by liver microsomes. PMID- 3297070 TI - Reversibility of disulfide formation. Comparison of chemical and enzyme-mediated reduction of penicillamine and captopril disulfides. AB - The reduction of penicillamine disulfide by reductants in aqueous solutions has been studied and compared with that for captopril disulfide. Whereas near quantitative reduction for captopril disulfide was achieved with tributyl phosphine (200 mM), no detectable penicillamine was formed from penicillamine disulfide. Thiol reductants (25 mM) were, however, partially able to reduce penicillamine disulfide with the most effective agent being glutathione (15% reduction) following by dithioerythritol (8%) and cysteine (5.1%). The reduction of penicillamine-cysteine disulfide by glutathione was 6-fold higher than for penicillamine disulfide. Kinetic analysis showed that the initial rate of reduction and equilibrium constant for the reduction of penicillamine disulfides by glutathione were 267- and 875-fold less than for captopril disulfide at pH 7.4. Biotransformation studies in the cytosol fraction of rat blood cells demonstrated that whereas 48% of the reduction of captopril disulfide was enzyme mediated only 19% of the penicillamine formed was enzyme-mediated for penicillamine disulfide. Accumulation of disulfides of penicillamine in patients taking penicillamine may therefore be a problem during chronic therapy. PMID- 3297071 TI - Lysis of malarial parasites and erythrocytes by ferriprotoporphyrin IX chloroquine and the inhibition of this effect by proteins. AB - Ferriprotoporphyrin IX(FP) lysed both erythrocytes and isolated Plasmodium falciparum as judged by decrease in turbidity of erythrocyte and parasite suspensions. The lytic effect of FP on erythrocytes was enhanced by chloroquine (CQ). In the presence of 2.5-20 microM CQ, 5 microM FP led to complete hemolysis within 45 min. However, the lytic effect of FP or FP-CQ on both erythrocytes and parasites was inhibited completely by proteins. The protein inhibition was non specific. This finding, the failure of FP and FP--CQ to cause hemolysis and lysis of malarial parasites in a protein-containing medium, does not support the "FP- CQ complex hypothesis" for the antimalarial action of chloroquine. PMID- 3297072 TI - [Effectiveness of substituting E. coli DNA-polymerase for DNA-polymerase A in oligonucleotide-directed mutagenesis]. AB - The possibility to use the E. coli intact DNA polymerase I in the oligonucleotide directed site-specific mutagenesis of DNA has been studied. Optimal conditions of the extension activity of this enzyme were found. We have shown that the substitution of the Klenow fragment of the E. coli DNA polymerase by the intact DNA polymerase I did not decrease the efficiency and fidelity of the oligonucleotide-directed mutagenesis. PMID- 3297074 TI - Antihypertensive effects of nisoldipine and reference drugs in certain types of hypertensive rats. AB - The hypotensive effects of nisoldipine (Bay K 5552), compared with those of nifedipine, nicardipine and hydralazine, in normotensive rats (NR), spontaneously hypertensive rats (SHR), DOCA-NaCl hypertensive rats (DNR) and renal hypertensive rats (RHR), were studied. The changes in plasma renin activity (PRA) after treatment with nisoldipine and these reference drugs were also studied. The results of this study revealed that: 1. Nisoldipine caused more potent antihypertensive effects in SHR, DNR and RHR than in NR. 2. The antihypertensive effects of nisoldipine in SHR were almost equipotent to those of nifedipine, nicardipine and hydralazine. However, in NR, DNR and RHR, the effects of nisoldipine were weaker than those of the reference drugs. 3. The positive chronotropic effects of nisoldipine were less remarkable than those elicited by nifedipine, nicardipine and hydralazine in all types of hypertensive rats, except SHR. 4. As did nifedipine and nicardipine, nisoldipine caused an increase of the plasma renin activity in NR and SHR, though its potency was weaker than those of nifedipine and nicardipine. PMID- 3297073 TI - Proteoglycan-degrading acid metalloprotease activity in human osteoarthritic cartilage, and the effect of intraarticular steroid injections. AB - Cartilage samples from both the immediate and remote lesion areas were obtained from the tibial plateaus of 21 patients with osteoarthritis, and were subjected to histologic and enzymatic study. There was a frequent loss of pericellular metachromatic staining in the OA cartilage. Seven patients had received intraarticular injections of steroids, and in 21% of those cartilage samples, a pericellular halo was seen. This halo was seen in 71% of patients who had not received steroid injections. The total acid metalloprotease activity was increased more than twofold in specimens from OA lesions and in those samples graded moderate, as compared with age-matched control cartilages. These differences were greater when the specimens from patients who had received steroid therapy were excluded from the data. The cartilage specimens from steroid treated patients were not significantly different from those of controls with respect to the enzyme activity in the lesions or in cartilage with moderate disease. The active form of the protease was suppressed by steroids. In samples from patients who did not receive steroid injections and who had a moderate grade of OA, a significantly elevated level of the active protease was present, as compared with control samples. Those samples graded moderate which came from patients who received steroid treatments showed no difference in the active protease level versus that of controls. Our results are consistent with the hypothesis that acid metalloprotease activity is involved in the degradation of the cartilage matrix in OA. Since the protease retains a significant fraction (40%) of its activity at neutral pH, its physiologic role might occur either at acid pH or at neutral pH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297075 TI - Continuous-plus-on-demand epidural infusion of buprenorphine versus morphine in postoperative treatment of pain. Postoperative epidural infusion of buprenorphine. AB - In a randomized, double-blind study, buprenorphine was compared with morphine in the treatment of pain after major abdominal operations by means of continuous plus-on-demand epidural infusion for constant analgesia. The patients received bolus epidural injections of 0.15 mg buprenorphine or 2 mg morphine-HCl prior to an on-demand epidural infusion of 0.03% buprenorphine or 0.25% morphine HCl at a basal rate of 0.06 ml/h. Over 50 h, mean buprenorphine consumption was 0.85 +/- 0.08 mg, and mean morphine consumption was 6.4 +/- 0.5 mg. Under the treatment, no discomfort or side-effects necessitating treatment occurred. We conclude that buprenorphine is a useful substitute for morphine in the treatment of pain after major abdominal operations by continuous-plus-on-demand epidural infusion, and that the relative analgesic potency ratio of epidural buprenorphine is 8. PMID- 3297076 TI - Determining quality of speech-language-hearing services. Program Evaluation System. PMID- 3297077 TI - 1985-86 National Examination scores in Speech-Language Pathology and Audiology: some new findings. PMID- 3297079 TI - Alcohol abuse in the New Testament. AB - The New Testament is similar to the Old Testament in terms of some fundamental attitudes towards alcohol. St Paul, for example, in the spirit of the Old Testament, unequivocally condemns drunkenness but recommends the consumption of wine in moderate amounts. Nevertheless, there are significant differences in emphasis between the two documents. Wine is referred to as God's gift in six of the books from the Old Testament, and no such description is offered in the New Testament. Total abstention seems acceptable only under exceptional circumstances in the Old Testament, while it is implicitly extolled through the exemplary role of John the Baptist in the New Testament. Finally, penalties for drunkards, including loss of salvation, are proportionally more frequent and comprehensive in the New Testament. PMID- 3297078 TI - Low density lipoprotein modulation of porcine coronary artery contractile response to histamine. AB - Right coronary artery ring segments from miniature swine contracted to histamine with a force and sensitivity comparable to that reported for human right coronary artery ring segments. When the ring segments were suspended in preparations of human low density lipoprotein (LDL) the contractility was reduced. With denuded rings the contractility was significantly lower in the LDL at 1.1 X 10(-4) M histamine. With intact rings significantly less tension was generated in the LDL at concentrations greater than 6 X 10(-5) M histamine. Thus LDL attenuates the contractile response of the porcine right coronary artery to histamine. PMID- 3297080 TI - Patient compliance in filling prescriptions after discharge from the emergency department. AB - Frequently, emergency department treatment consists of prescriptions given to a patient at discharge on the assumption that they will be filled promptly and the medications begun as directed. Although the plan depends on the validity of this assumption, many patients may be unable (or unwilling) to fill their prescriptions. This study was undertaken to determine the prevalence of and reasons for noncompliance in filling prescriptions among patients discharged from the emergency department and to determine if differences in compliance exist among various socioeconomic groups. Ninety-six consecutive patients who had been given prescriptions at discharge from the emergency department were contacted by telephone the following day to determine if their prescriptions had been filled and if not, the reasons for not filling them. Patients were stratified by payor classification groups as follows: insured by third-party payor (53 patients), covered by Medicaid (19 patients), noninsured "self-paying", (14 patients), covered by Medicare (four patients), and unknown payor status, (six patients). The percentages in each group who had not filled their prescriptions by follow-up the next day were as follows: insured, 21%; Medicaid, 21%; self-paying, 21%; Medicare, 25%; unknown, 50%. Differences between groups were not significant. The following reasons were given for not having filled prescriptions: insufficient funds, 36%; lack of transportation or assistance, 14%; negligence, 32%; and miscellaneous, 18%. Of the prescriptions not filled, 45% were for analgesics or muscle relaxants, 41% were for antibiotics, and 14% were for miscellaneous medications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297081 TI - Repetitive doses of activated charcoal in the treatment of poisoning. AB - Activated charcoal has found a renewed role in the management of overdosed patients. Routinely administered to reduce the gastrointestinal (GI) absorption of many drugs, growing evidence indicates that repeated doses of charcoal also may enhance drug elimination. Some drugs are excreted into the bile or gastric fluids (phencyclidine, digoxin) and are reabsorbed. Other drugs (theophylline, phenobarbital) can diffuse from the plasma into the lumen of the GI tract. Activated charcoal is administered at regular intervals to sequester these toxins in the GI tract, eventually causing their excretion in feces. This article reviews the evidence for the safety and efficacy of repetitive charcoal therapy. While supportive management remains the mainstay of therapy in poisoned patients, activated charcoal is inexpensive, effective, simple to administer, and may obviate the need for more invasive methods of toxin removal. PMID- 3297082 TI - Trauma: an annotated bibliography of the recent literature. PMID- 3297083 TI - Hot-air balloon evacuation. PMID- 3297085 TI - The thermodynamic stability of proteins. PMID- 3297084 TI - Conversations with Jeffries Wyman. Interview by Stanley J. Gill. PMID- 3297086 TI - Biophysical chemistry of metabolic reaction sequences in concentrated enzyme solution and in the cell. PMID- 3297087 TI - Absorption, scattering, and imaging of biomolecular structures with polarized light. PMID- 3297088 TI - Improving crystallographic macromolecular images: the real-space approach. PMID- 3297089 TI - Measurement of metal cation compartmentalization in tissue by high-resolution metal cation NMR. PMID- 3297090 TI - Thermodynamic efficiency in nonlinear biochemical reactions. PMID- 3297091 TI - Physical limits to sensation and perception. PMID- 3297092 TI - Peptides with affinity for membranes. PMID- 3297094 TI - Monosodium L-glutamate lesions reduce susceptibility to hypoglycemic feeding and convulsions. AB - Lesions of the circumventricular regions of the brain induced by neonatal administration of monosodium L-glutamate (MSG) are associated with chronic hypophagia and deficits in response to a variety of feeding challenges. These deficits occur despite the fact that, at least at high doses, MSG can produce obesity. The cause of the feeding deficits in MSG-treated animals is unknown. However, the circumventricular regions that are damaged by MSG contain high concentrations of insulin binding sites. In order to determine whether the MSG lesion alters responsiveness to circulating insulin, we have investigated the response of non-obese MSG-treated mice to doses of exogenous insulin designed either to stimulate feeding or to induce hypoglycemic convulsions. We report that MSG produces a dose-related decrease in hypoglycemic convulsions and glucoprivic feeding, suggesting that a loss in sensitivity to insulin may contribute to the MSG syndrome. PMID- 3297093 TI - Structure and dynamics of water surrounding biomolecules. PMID- 3297095 TI - How motile bacteria are attracted and repelled by chemicals: an approach to neurobiology. Lecture held on the occasion of the receipt of the Otto-Warburg Medaille 1986. PMID- 3297096 TI - Isoleucyl-tRNA synthetase from Escherichia coli MRE 600: discrimination between isoleucine and valine with modulated accuracy. AB - Discrimination between isoleucine and valine is achieved with different accuracies by isoleucyl-tRNA synthetase from E. coli MRE 600. The recognition process consists of two initial discrimination steps and a pretransfer and a posttransfer proofreading event. The overall discrimination factors D were determined from kcat and Km values observed in aminoacylation of tRNA(Ile)-C-C-A with isoleucine and valine. From aminoacylation of the modified tRNA species tRNA(Ile)-C-C-A(3'NH2) initial discrimination factors I1 and pretransfer proofreading factors II1 were calculated. Factors I1 were computed from ATP consumption and D1, the overall discrimination in aminoacylation of the modified tRNA; factors II1 were calculated as quotient of AMP formation rates. Initial discrimination factors I2 and posttransfer proofreading factors II2 were determined from AMP formation rates observed in aminoacylation of tRNA(Ile)-C-C A. The observed overall discrimination varies up to a factor of about four according to conditions. Under standard assay conditions 72,000, under optimal conditions 144,000 correct aminoacyl-tRNAs are produced per one error while 1.1 or 1.7 ATPs are consumed. A comparison with isoleucyl-tRNA synthetase from yeast shows that both enzymes act principally with the same recognition mechanism, but the enzyme from E. coli MRE 600 exhibits higher specificity and lower energy dissipation and does not show such high variation of accuracy as observed with the enzyme from yeast. PMID- 3297097 TI - Improved preparation of semisynthetic PheB1-tritiated insulin. AB - Semisynthetic [PheB1-3H]insulin was prepared. Each intermediate in the synthesis was characterised by HPLC, polyacrylamide gel electrophoresis and end group determination by dansylation. The end product had a specific activity of up to 59 Ci/mmol. Semisynthetic insulin proved indistinguishable from natural insulin in its chemical and immunological properties and was shown to be biologically fully active by in vivo and in vitro assays. PMID- 3297098 TI - Monoclonal and polyclonal antibodies against porcine mitochondrial aspartate aminotransferase: their inhibition modes and application to enzyme immunoassay. AB - Monoclonal and polyclonal antibodies against porcine mitochondrial aspartate aminotransferase (m-AST) were prepared in order to study their effect on the kinetics of the enzyme and their possible use as diagnostic reagents. The most stable hybridoma clone, designated MH-1, was selected and cultured for mass production of the monoclonal antibody MA-1. MA-1 was purified by affinity chromatography with m-AST as a ligand. The m-AST activity was inhibited uncompetitively by preincubation with MA-1, but preincubation with the polyclonal antibody uncompetitively by preincubation with MA-1, but preincubation with the polyclonal antibody raised in a rabbit resulted in noncompetitive inhibition of the enzyme. These results suggest the usefulness of a monoclonal antibody for studying the mechanism of catalysis. Sandwich enzyme immunoassay methods for m AST using both polyclonal and monoclonal antibody-coated polystyrene balls were established and permitted the determination of porcine m-AST on the order of 10( 11) and 10(-10)M, respectively. PMID- 3297099 TI - Folding and activation of recombinant human prorenin. AB - In vitro folding of mature renin, prorenin, and fused prorenin, all produced in denatured form in inclusion bodies in recombinant Escherichia coli, has been studied in order to evaluate the importance of prosequence in the folding of human renin. These studies have been compared with the in vivo folding and subsequent in vitro activation of recombinant human prorenin secreted by a nonbacterial expression system, namely Chinese hamster ovary (CHO) cells grown in serum-free medium. It is concluded that prosequence is essential in the folding of human renin and, therefore, the DNA coding for this sequence cannot be removed without affecting the recovery of active human renin from recombinant bacterial and nonbacterial systems. PMID- 3297100 TI - Enzyme-based electrodes as analytical tools. PMID- 3297101 TI - [Relation between sucrose and dental caries]. PMID- 3297102 TI - A peripatetic and personal view of molecular immunology for one third of the century. PMID- 3297103 TI - Disorders of phagocyte function. PMID- 3297104 TI - Specific cell-adhesion mechanisms determining migration pathways of recirculating lymphocytes. PMID- 3297105 TI - Genetically determined murine models of immunodeficiency. AB - We have discussed more than 30 mutant genes known to cause abnormalities in the development and regulation of the immune system. The loci defined by these deleterious alleles have been assigned to 13 different autosomal chromosomes in addition to X and Y. It is important to note that these single genes do not act alone but function in concert with the background genome. Studies of these mutations on different inbred strain backgrounds are contributing important information on the influence of background modifying genes. The development of stocks of mice carrying multiple mutations on an inbred strain background enables the use of a well-characterized mutation to explore a less-well-understood genetic model. Investigators are urged to assure proper conditions for studies with immunological mutants by using the appropriate methods of animal husbandry. A detailed guide for maintaining immunologically compromised rodents has been prepared. These experiments performed by nature provide a valuable resource for investigating the immune system in normal and pathologic states. As the gene products of the loci defined by these mutations become known, the information obtained will provide additional insight into mechanisms underlying normal immune function as well as immunologic disease processes in man. PMID- 3297107 TI - Histoincompatible bone marrow transplants in humans. PMID- 3297106 TI - B-cell stimulatory factor-1/interleukin 4. PMID- 3297108 TI - Biophysical aspects of antigen recognition by T cells. PMID- 3297109 TI - Genes of the T-cell antigen receptor in normal and malignant T cells. AB - In this review, the germline genomic and cDNA structures and the evolution of the human TcR-alpha-, TcR-beta-, and Tc gamma-chain genes have been reviewed and discussed. The estimated V-gene segment repertoires established for the human TcR alpha-, TcR-beta-, and Tc gamma-chain genes have also been summarized. The use of TcR and Tc gamma genes in the evaluation of hematopoietic malignancies and identification of chromosomal translocations has also been presented. It is hoped that such information will serve as a reference point from which the study of TcR genes can further progress. This will almost certainly include the use of TcR and perhaps Tc gamma genes in the study of the dual recognition of antigen and MHC gene products, the role of these genes in thymic education/selection, and the role(s) of these genes in oncogenesis processes and autoimmune settings. PMID- 3297110 TI - Hierarchy of prognostic factors for corneal allograft survival. AB - The results of analyses of 1218 consecutive corneal transplants performed in a single centre reveal that the most important prognostic factors for corneal allograft survival are recipient corneal vascularisation, graft diameter, HLA-A and B matching especially for high risk patients, organ culture storage of donor corneas prior to transplantation and donor age. PMID- 3297111 TI - Techniques and applications of adjustable sutures. AB - The 'rediscovery' of adjustable sutures some 10 years ago has given the ophthalmic surgeon much more confidence in his ability to correct strabismus. Three methods of use are described: during surgery under general anaesthesia with adjustment during the operation using the 'springback' test to centralise the eye; during surgery under general anaesthesia and subsequent adjustment under local anaesthesia using the patient's subjective responses to obtain optimal positioning; and performance of the operation and adjustment under topical local anaesthesia in one procedure. Full details are given of each technique and the indications for their application to particular problems are discussed. PMID- 3297112 TI - Oncogenes for the oncologist. PMID- 3297113 TI - Lymphangioleiomyomatosis. A case report with an immunohistochemical study. AB - A case of pulmonary lymphangioleiomyomatosis is presented, which occurred in a 50 year-old woman suffering from severe dyspnea of 7 year's duration and with a previous history of diseases (polycystic ovaries and endometrial adenocarcinoma) usually related to hyperestrogenism. The patient showed no signs or symptoms of tuberous sclerosis, a condition often associated with pulmonary lymphangioleiomyomatosis. Both the radiological pattern and histological findings had previously been interpreted at other hospitals as consistent with either nodular interstitial fibrosis with emphysematous changes or pulmonary siderosis. Correct diagnosis was suspected on critical review of histological slides and definitely achieved by immunohistochemistry in routine sections, which showed the presence of desmin in the elements constituting the nodular lesions scattered throughout the parenchyma. The criteria for the differential diagnosis are discussed, as well as the role of immunohistochemistry in assessing the muscular nature of proliferating cells. PMID- 3297114 TI - Cellular neurothekeoma. AB - The histological and immunohistochemical features of 3 cases of cellular neurothekeomas of skin are presented. Based on the findings in these cases and comparisons made with others reported in the literature, it is proposed that neurothekeomas may be divided into two distinct types: the myxoid and cellular variants. The relationship between these variants and a related entity, the Pacinian neurofibroma, is discussed. PMID- 3297115 TI - [General visceral afferent system--a hodological review]. PMID- 3297116 TI - New guidelines for B/TEC diploma. PMID- 3297117 TI - Masticatory performance before and after mandibular vestibuloplasty. PMID- 3297118 TI - Letter from California: growing old gracefully? PMID- 3297119 TI - Auscultation and phonocardiography: a personal view of the past 40 years. PMID- 3297120 TI - Twenty year follow up of patients in the Medical Research Council trial of anticoagulants in acute myocardial infarction. AB - A 20 year follow up of 1330 patients in the Medical Research Council trial of short term anticoagulant treatment in myocardial infarction showed no long term benefits; but it provided interesting data on the outcome in such patients. Sixteen per cent of the patients were alive 20 years later. The excess mortality rate in trial participants over that expected for England and Wales as a whole declined rapidly after the early months, but some excess persisted throughout the follow up. Three quarters of all the deaths were from coronary heart disease; 70% of these coronary deaths occurred after the patients had left hospital. This finding emphasises the importance of secondary prevention. PMID- 3297121 TI - Clinical, haemodynamic, and antiarrhythmic effects of long term treatment with amiodarone of patients in heart failure. AB - Twenty two patients with heart failure were studied in a double blind crossover trial to compare amiodarone (200 mg/day) with placebo. Each agent was given for three months. Extrasystoles and complex ventricular arrhythmias were common during ambulatory electrocardiographic monitoring and during exercise testing at entry to the study. Breathlessness and tiredness as assessed by visual analogue scores and duration of treadmill exercise did not become worse during amiodarone treatment. During the placebo and amiodarone phases of the study left ventricular ejection fraction and cardiac index determined by first pass radionuclide ventriculography were similar, both at rest and during upright bicycle exercise. Exercise induced ventricular tachycardia was abolished and simple and complex ventricular arrhythmias observed on 24 hour ambulatory monitoring were greatly diminished during amiodarone treatment. Three patients died, all suddenly, during the placebo phase. In two patients amiodarone was withdrawn after a further myocardial infarction in one and a worsening of symptoms of ventricular arrhythmia in the other. In contrast with other antiarrhythmic agents amiodarone is effective in suppressing ventricular arrhythmias in heart failure without causing adverse haemodynamic effects. Because frequent ventricular arrhythmias are known to be associated with a poor prognosis in heart failure, these data suggest that amiodarone may improve the poor prognosis in patients with heart failure. PMID- 3297122 TI - The pressor dose-response in clinical cardiovascular pharmacology. PMID- 3297123 TI - A pragmatic approach to the pressor dose-response as an index of vascular reactivity and adrenoceptor function in man. AB - In clinical pharmacological studies, where it is not possible to describe the full dose-response curve, the construction of dose-response relationships ideally depends upon achieving a reproducible and readily measurable response for each dose administered. This study investigates in normotensive males the technique of dose-response analysis for the blood pressure and heart rate increases with constant infusions of incremental doses of vasoactive drugs, particularly catecholamines. Steady state responses could be adequately obtained using 5 min infusion periods (at each dose level) for noradrenaline and alpha-methyl noradrenaline. At least 7 min was required for phenylephrine and 8 min for isoprenaline. There was an approximate correlation between the time to achieve the steady state response and the half-life of the offset of the agonist effect. For interindividual comparisons it is desirable to compare steady state responses and so the time at each dose level will vary according to which agonist is being used. For intraindividual comparisons it may not be essential that steady state responses are achieved. For example, assessment of the effect of prazosin on the responses to phenylephrine, by calculation of dose ratios, indicated that 5 min dose intervals were adequate. PMID- 3297124 TI - Effects of indomethacin and (+/-)-propranolol on the cardiovascular and renin responses to vasoactive intestinal polypeptide (VIP) infusion in man. AB - The mechanisms of the cardiovascular and renin responses to vasoactive intestinal polypeptide (VIP) are unclear. Rabbit studies suggest that VIP-induced tachycardia is largely beta-adrenoceptor mediated, but that the renin response may be partially prostaglandin-dependent. To examine the relative importance of prostaglandins and reflex sympathetic activation in the haemodynamic and renin responses to VIP infusion in man, we completed two randomised single-blind crossover studies in two groups of six healthy male volunteers (aged 24-35 years). We recorded the effects of indomethacin and propranolol pretreatment on VIP-related changes in heart rate (HR), blood pressure (BP), forearm vascular resistance (FVR), plasma renin activity (PRA), plasma noradrenaline (PNA) and plasma arginine vasopressin (AVP) concentrations. Intravenous VIP (calculated dose: 6 pmol kg-1 min-1) produced cutaneous flushing, increased HR and PRA, decreased FVR, but did not alter mean arterial BP or AVP levels. Indomethacin (375 mg over 3 days) lowered basal PRA and propranolol (circa 40 mg i.v. over 60 min) decreased resting HR and increased FVR. Although indomethacin and propranolol reduced the absolute rise in PRA and HR, respectively, during VIP infusion, the percentage changes were no different from control. Neither drug altered the flush response to VIP and propranolol did not affect the fall in FVR. We conclude that the measured cardiovascular responses to VIP infusion in man are probably direct and do not involve a significant contribution from reflex sympathetic stimulation, nor prostaglandin release. PMID- 3297125 TI - Captopril: 4 years of post marketing surveillance of all patients in New Zealand. AB - The Intensive Medicines Monitoring Programme (IMP), a specialised part of the New Zealand Post Marketing Surveillance system, has been used to monitor captopril since it was first approved for marketing for the treatment of hypertension and heart failure. Monitoring has consisted of (1) spontaneous reporting for which doctors have been encouraged to report all clinical events, (2) a specific event recording survey at the end of the first year and (3) a controlled patient survey of taste disturbance. The IMP gathers prescription information on about 85% of all patients. There were 4,124 patients at the end of the first 4 years. Reported events involved 4% of patients, the majority being cutaneous (1%) and gastrointestinal (0.7%). The event recording survey gave an overall rate of adverse events of 2.2 per patient year. The taste survey showed a remarkably high incidence of taste disturbance in the control population and only taste loss was significantly higher (P less than 0.01) for captopril. This ongoing study has so far demonstrated a low incidence of adverse effects due to captopril, which is reassuring in view of its increasing use for mild hypertension and early cardiac failure. PMID- 3297126 TI - Surveillance for skeletal toxicity of children treated with etretinate. AB - Following recent reports of the development of skeletal abnormalities in patients treated with etretinate (Tigason), we have examined 19 children and adolescents on long-term treatment with etretinate, using 99mtechnetium methylene diphosphonate (99mTcMDP) whole body bone scans and musculoskeletal assessment. No significant bony abnormalities were detected. We believe that the available evidence does not warrant alarm, and that long-term etretinate therapy can probably be given with a low risk of musculoskeletal toxicity if certain precautions are taken, in particular the use of low maintenance dose levels, early investigation of symptoms of musculoskeletal pain or stiffness, and regular 99mTcMDP bone scans. PMID- 3297127 TI - Alpha 2 interferon in chronic myeloid leukaemia following relapse post-allogeneic transplant. PMID- 3297128 TI - Autoimmunity in 28 patients after allogeneic bone marrow transplantation: comparison with Sjogren syndrome and scleroderma. AB - The occurrence of autoantibodies in 28 long-term survivors of allogeneic bone marrow transplantation (BMT) (21 with chronic graft-versus-host disease) was compared with 48 cases of idiopathic Sjogren syndrome and 82 cases of scleroderma. Antinuclear, anti-smooth muscle, and anti-mitochondria antibodies occurred respectively in 80%, 82% and 14% of the post BMT cases. Anti-native DNA, anti-soluble nuclear antigen and anticentromere antibodies were not found. Antiepidermal antibodies were present in 14% of the cases but their pathological role is unclear. Although the clinical manifestations of chronic graft-versus host disease are similar to Sjogren syndrome and scleroderma the autoantibody profile is significantly different. PMID- 3297129 TI - A randomized trial of 13-cis retinoic acid with or without cytosine arabinoside in patients with the myelodysplastic syndrome. AB - Ninety-eight consecutive patients with myelodysplastic syndrome were randomized to a treated or a control group, both receiving conventional supportive therapy. The treated group were given 13-cis-retinoic acid 20 mg/d if marrow blasts were less than or equal to 5% or cytosine arabinoside 10 mg/d subcutaneously on 6 d/week if marrow blasts were 6-30%, to which retinoic acid was added after 12 weeks. Serum levels of the drugs in the treated group were similar to those that would produce inhibition of CFU-GM growth in vitro. In patients in the low blast group receiving retinoic acid, myeloid surface antigens reverted from an abnormal to a normal pattern. Log rank analysis carried out after 25 months showed no significant difference in survival between the treated and control group, either in the total patient population or in the high and low blast groups considered separately. However, analysis of 39 non-sideroblastic patients with less than or equal to 5% blasts showed an increase in survival in the treated group. PMID- 3297130 TI - Semen quality in papaya workers with long term exposure to ethylene dibromide. AB - To examine whether long term occupational exposure to ethylene dibromide (EDB) affects semen quality a cross sectional study of semen quality was conducted among 46 men employed in the papaya fumigation industry in Hawaii, with an average duration of exposure of five years and a geometric mean breathing zone exposure to airborne EDB of 88 ppb (eight hour time weighted average) and peak exposures of up to 262 ppb. The comparison group consisted of 43 unexposed men from a nearby sugar refinery. Statistically significant decreases in sperm count per ejaculate, the percentage of viable and motile sperm, and increases in the proportion of sperm with specific morphological abnormalities (tapered heads, absent heads, and abnormal tails) were observed among exposed men by comparison with controls after consideration of smoking, caffeine and alcohol consumption, subject's age, abstinence, history of urogenital disorders, and other potentially confounding variables. No effect of exposure to EDB on sperm velocity, the overall proportion of sperm with normal morphology, or YFF bodies was observed. These data strongly suggest that EDB may increase the risk of reproductive impairment in workers at exposure levels near the National Institute for Occupational Safety and Health recommended limit of 45 ppb (as an eight hour time weighted average) and far below the current standard of the Occupational Safety and Health Administration of 20 ppm. PMID- 3297131 TI - RNA binding site of R17 coat protein. AB - The specific interaction between R17 coat protein and its target of translational repression at the initiation site of the R17 replicase gene was studied by synthesizing variants of the RNA binding site and measuring their affinity to the coat protein by using a nitrocellulose filter binding assay. Substitution of two of the seven single-stranded residues by other nucleotides greatly reduced the Ka, indicating that they are essential for the RNA-protein interaction. In contrast, three other single-stranded residues can be substituted without altering the Ka. When several of the base-paired residues in the binding site are altered in such a way that pairing is maintained, little change in Ka is observed. However, when the base pairs are disrupted, coat protein does not bind. These data suggest that while the hairpin loop structure is essential for protein binding, the base-paired residues do not contact the protein directly. On the basis of these and previous data, a model for the structural requirements of the R17 coat protein binding site is proposed. The model was successfully tested by demonstrating that oligomers with sequences quite different from the replicase initiator were able to bind coat protein. PMID- 3297132 TI - Definitive characterization of human thymine glycol N-glycosylase activity. AB - An N-glycosylase activity that released cis-[3H]-5,6-dihydroxy-5,6-dihydrothymine (thymine glycol, TG) from chemically oxidized poly(dA-[3H]dT) was unambiguously characterized both in extracts of HeLa cells and in purified Escherichia coli endonuclease III. This was accomplished by use of microderivatization procedure that quantitatively converted cis-TG to 5-hydroxy-5-methylhydantoin (HMH). The reaction products were analyzed by high-pressure liquid chromatography before and after derivatization by using cis-[14C]TG and [14C]HMH, which had been independently synthesized, as reference compounds. This technique facilitated construction of a v/[E]t plot for the enzyme activity in HeLa cells, permitting estimation of its specific activity. The results obtained prove the existence of both human and bacterial N-glycosylase activities that effect removal of TG from DNA. PMID- 3297133 TI - Identification and amino acid sequence of the deoxynucleoside triphosphate binding site in Escherichia coli DNA polymerase I. AB - We have labeled the large fragment of Escherichia coli DNA polymerase I (Pol I) with pyridoxal 5'-phosphate, a substrate binding site directed reagent for DNA polymerases [Modak, M. J. (1976) Biochemistry 15, 3620-3626]. A covalent attachment of pyridoxal phosphate to Pol I results in the loss of substrate binding as well as the polymerase activity. The inactivation was found to be strictly dependent on the presence of a divalent metal ion. Four moles of pyridoxal phosphate was found to react per mole of the enzyme, while in the presence of substrate deoxynucleoside triphosphate only 3 mol of pyridoxal phosphate was bound. To identify the substrate-protected site on the enzyme, tryptic peptides from enzyme labeled with pyridoxal phosphate and tritiated borohydride, in the presence and absence of substrate, were resolved on a C-18 reverse-phase column. A single peptide containing the substrate-protected site was identified and further purified. The amino acid composition and sequence analysis of this peptide revealed it to span residues 756-775 in the primary acid sequence of Pol I. Lys-758 of this sequence was found to be the site of the pyridoxal phosphate reaction. It is therefore concluded that Lys-758 is the site of binding for the metal chelate form of nucleotide substrates in E. coli DNA polymerase I. PMID- 3297134 TI - Structure refinement of a cyclic peptide from two-dimensional NMR data and molecular modeling. AB - The conformational and dynamic properties of a cyclic peptide designed to inhibit human renin have been examined by using NMR and molecular modeling. From a quantitative analysis of a series of two-dimensional NOE data sets, proton-proton distances were calculated. Several different methods were explored and compared to incorporate these distance constraints as well as those derived from vicinal spin-spin coupling constants into computer-generated three-dimensional structures. These methods included interactive manual manipulation of the structures to fit the NMR-determined distance constraints, distance geometry, constrained energy minimizations, and constrained molecular dynamics. The advantages and disadvantages of the methods are discussed. In addition, to gain insight into the conformations accessible to the cyclic peptide and the relative flexibility of the different parts of the molecule, molecular dynamics calculations were performed at three different temperatures. Average interproton distances and dihedral angles were obtained from the structures generated in the dynamics trajectories and compared to those obtained from the NMR experiments. Despite the four methylene groups and ether linkage contained in the cyclic portion of the peptide, our NMR results indicated a preferred conformation for the macrocyclic ring of the peptide and supported the presence of a cis Phe-Ala peptide bond. In contrast, both the molecular dynamics and NMR data indicated a considerable amount of flexibility for the remaining noncyclic portion of the molecule. These results are used to propose an explanation for the cyclic peptide's inability to inhibit human renin. PMID- 3297135 TI - 2'-Deoxy-2'-halonucleotides as alternate substrates and mechanism-based inactivators of Lactobacillus leichmannii ribonucleotide reductase. AB - The interaction of the ribonucleoside-triphosphate reductase of Lactobacillus leichmannii with various 2'-halogenated ribo- and arabinonucleoside triphosphates has been investigated. All analogues examined acted as mechanism-based inactivators of the enzyme, producing base, triphosphate, and halide. In all cases, the inactive enzyme had developed the distinctive chromophore at 320 nm that is characteristic of enzyme inactivated by 2-methylene-3(2H)-furanone. The striking similarities between these results and those previously reported for the inactivation of this enzyme by 2'-chloro-2'-deoxyuridine triphosphate suggest a common reaction path for all 2'-halonucleotides. In the pyrimidine series, it was found that 2'-fluoro- and 2'-chloronucleotides partitioned between inactivation and formation of the normal reduction product 2'-deoxynucleotide. Normal reduction predominated with 2'-fluoronucleotides, whereas it was a minor pathway for 2'-chloro-2'-deoxyuridine triphosphate. With 2'-chloro-2'-deoxyuridine triphosphate, the relative partitioning between the two modes was pH dependent: the amount of 2'-deoxyuridine triphosphate formed increased 2.8-fold upon changing from pH 6.1 to pH 8.3. The ability of 2'-arabinohalonucleotides to inactivate ribonucleotide reductase and the variation of partitioning of the pyrimidine analogues with leaving group and reaction pH are consistent with our radical cation hypothesis and support the proposal that the difference between normal catalysis and inactivation is related to the protonation state of the reductase. PMID- 3297136 TI - Glucosamine synthetase from Escherichia coli: purification, properties, and glutamine-utilizing site location. AB - L-Glutamine:D-fructose-6-phosphate amidotransferase (glucosamine synthetase) has been purified to homogeneity from Escherichia coli. A subunit molecular weight of 70,800 was estimated by gel electrophoresis in sodium dodecyl sulfate. Pure glucosamine synthetase did not exhibit detectable NH3-dependent activity and did not catalyze the reverse reaction, as reported for more impure preparations [Gosh, S., Blumenthal, H. J., Davidson, E., & Roseman, S. (1960) J. Biol. Chem. 235, 1265]. The enzyme has a Km of 2 mM for fructose 6-phosphate, a Km of 0.4 mM for glutamine, and a turnover number of 1140 min-1. The amino-terminal sequence confirmed the identification of residues 2-26 of the translated E. coli glmS sequence [Walker, J. E., Gay, J., Saraste, M., & Eberle, N. (1984) Biochem. J. 224, 799]. Methionine-1 is therefore removed by processing in vivo, leaving cysteine as the NH2-terminal residue. The enzyme was inactivated by the glutamine analogue 6-diazo-5-oxo-L-norleucine (DON) and by iodoacetamide. Glucosamine synthetase exhibited half-of-the-sites reactivity when incubated with DON in the absence of fructose 6-phosphate. In its presence, inactivation with [6-14C]DON was accompanied by incorporation of 1 equiv of inhibitor per enzyme subunit. From this behavior, a dimeric structure was tentatively assigned to the native enzyme. The site of reaction with DON was the NH2-terminal cysteine residue as shown by Edman degradation. PMID- 3297137 TI - Effect of drug-DNA interactions upon transcription initiation at the lac promoter. AB - We have examined the effects of six DNA binding drugs upon initiation at the lac UV5 promoter by Escherichia coli RNA polymerase. Experiments were directed at determining the influence of added drug on open complex formation, open complex stability, initiation from the open complex, and stability of the resulting initiated complex. The narrow groove binding drugs distamycin and 4',6-diamidino 2-phenylindole dihydrochloride were more effective in inhibiting initiation through their effect on the first three of these factors than were the intercalators ethidium bromide, daunomycin, and actinomycin. The bisintercalator bis(daunomycin) inhibited open complex formation better than its parent daunomycin. With the possible exception of actinomycin, the drugs tested were not able to disrupt preformed initiated complex, in contrast to their destabilizing effect upon the open complex. Combined with other results, the data suggest that the antitumor activity of daunomycin is unlikely to result from its effect on transcription. We compare the relative effectiveness of the drugs with the known physical properties of the corresponding drug-DNA interactions. The rate of open complex formation seems to be influenced by both the on and off rates of the drug, probably due to the relative slowness of open complex formation. This is in contrast to elongation, a much quicker process, which seems to be limited by the drug off rate alone; these considerations may possibly rationalize the difference in relative effect of particular drugs upon initiation and elongation. All drugs were able actively to disrupt open complex, although to substantially different extents; some possible mechanisms for this disruption, and the insensitivity of the initiated complex, are discussed. PMID- 3297138 TI - Anthracycline antibiotics. Interaction with DNA and nucleosomes and inhibition of DNA synthesis. AB - We report studies of the interaction of four anthracycline antibiotics, iremycin (IM), daunomycin (DM), aclacinomycin A (AM), and violamycin B1 (VM), with naked DNA, nucleosomal core particles, and 175 base pair (bp) nucleosomes lacking histone H1. In all cases the binding strength increases in the order IM less than DM approximately AM less than VM. The binding substrates increased in affinity for the drugs in the following order: core particles less than 175-bp nucleosomes less than DNA. The apparent DNA length increment per drug bound decreases in the progression IM greater than DM greater than AM greater than VM, the same serial order as is characterized by increasing binding affinity. Dichroism amplitude measurements show that for all drugs the long-wavelength absorbance transition moment is tilted by 26-29 degrees relative to the plane perpendicular to the helix axis; this angle probably corresponds to the long axis tilt of the intercalated chromophore. Finally, it was found that the ability of the drugs to inhibit DNA synthesis by Escherichia coli DNA polymerase I increases in the same order as their binding affinity. PMID- 3297139 TI - Measurement of interstrand cross-link frequency and distance between interruptions in DNA exposed to 4,5',8-trimethylpsoralen and near-ultraviolet light. AB - Bifunctional psoralens react photochemically with DNA to form single-strand adducts and interstrand, chemical cross-links. Cross-link formation is first order with [P], the concentration of added psoralen, when [P] much less than Kd, the psoralen-DNA dissociation constant. DNA molecules containing interstrand cross-links are reversibly bihelical and so are readily detected. It was not heretofore possible to determine cross-link frequency in polydisperse DNA from the mass F of DNA spared cross-linkage. We have derived a statistical relation to calculate cross-link frequency at fixed light exposure and variable [P]. We show here that S, the initial slope of the curve described by -ln F as a function of [P], is proportional to Mw, the weight-average molecular weight of nick-free DNA. The cross-link frequency at any [P] can be determined from k, a constant measured for DNA of known Mw at low cross-linkage. This relation is valid for DNA of any molecular weight distribution. In experiments with uniform length DNA, -ln F (cross-link frequency) increased in simple proportion to [P]. Intact and restriction endonuclease HindIII digested phage lambda DNA molecules have discrete lengths. S for each was proportional to Mw of the twin helix even though the molecular weight distribution of the restriction fragments was skewed. S was proportional to Mw and to the median molecular weight of sheared cellular DNA over a wide range. Also, we found that 1/S was linear with exposure of cellular DNA to gamma radiation. S can therefore be used to calculate L, the average distance between interruptions in the double helix. PMID- 3297140 TI - Binding of IKe gene 5 protein to polynucleotides. Fluorescence binding experiments of IKe gene 5 protein and mutual cooperativity of IKe and M13 gene 5 proteins. AB - Fluorescence studies of the binding of IKe gene 5 protein to various polynucleotides were performed to obtain insight into the question as to what extent the binding characteristics of the gene 5 proteins of the IKe and M13 phages resemble and/or differ from each other. The fluorescence of IKe gene 5 protein is quenched 60% upon binding to most polynucleotides. At moderate salt concentrations, i.e., below 1 M salt, the binding stoichiometry is 4.0 +/- 0.5 nucleotides per IKe gene 5 protein monomer. The affinity of the protein for homopolynucleotides depends strongly on sugar and base type; in order of increasing affinities we find poly(rC) less than poly(dA) less than poly(rA) less than poly(dI) less than poly(rU) less than poly(dU) less than poly(dT). For most polynucleotides studied, the affinity depends linearly on the salt concentration: [d log (Kint omega)]/(d log [M+]) = -3. The binding is highly cooperative. The cooperativity parameter omega, as deduced from protein titration curves, is 300 +/- 150 and appears independent of the type of polynucleotide studied. Estimation of this binding parameter from salt titrations of gene 5 protein-polynucleotide complexes results in systematically higher values. A comparison of the binding data of the IKe and M13 gene 5 proteins shows that the fluorescence quenching, stoichiometry, order of binding affinities, and cooperativity in the binding are similar for both proteins. From this it is concluded that at least the DNA binding grooves of both proteins must show a close resemblance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297141 TI - Effects of the mutation glycine-222----aspartic acid on the functions of elongation factor Tu. AB - We have studied the properties of a mutant elongation factor Tu, encoded by tufB (EF-TuBo), in which Gly-222 is replaced by Asp. For its purification from the kirromycin-resistant EF-Tu encoded by tufA (EF-TuAr), a method was developed by exploiting the different affinities to kirromycin of the two factors and the competition between kirromycin and elongation factor Ts (EF-Ts) for binding to EF Tu. The resulting EF-TuBo kirromycin and EF-TuAr EF-Ts complexes are separated by chromatography on diethylaminoethyl-Sephadex A-50. For the first time we have succeeded in obtaining a tufB product in homogeneous form. Compared with wild type EF-Tu, EF-TuBo displays essentially the same affinity for GDP and GTP, with only the dissociation rate of EF-Tu GTP being slightly faster. Protection of amino-acyl-tRNA (aa-tRNA) against nonenzymatic deacylation by different EF-Tu species indicates that conformational alterations occur in the ternary complex EF TuBo GTP aa-tRNA. However, the most dramatic modification is found in the EF-TuBo interaction with the ribosome. Its activity in poly(Phe) synthesis as well as in the GTPase activity associated with the interaction of its ternary complex with the ribosome mRNA complex requires higher Mg2+ concentrations than wild-type EF Tu (Mg2+ optimum at 10-14 vs. 6 mM), even if EF-TuBo can sustain enzymatic binding of aa-tRNA to ribosomes at low Mg2+. The anomalous behavior of EF-TuBo is reflected in a remarkable increase of the fidelity in poly(Phe) synthesis, especially at high Mg2+ concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297142 TI - Covalent aspartylation of aspartyl-tRNA synthetase from bakers' yeast by its cognate aspartyl adenylate: identification of the labeled residues. AB - Aspartyl-tRNA synthetase from bakers' yeast gives an unstable complex with the cognate adenylate, which reacts after dissociation with amino acid side chains of the protein. This leads to a covalent incorporation of aspartic acid into aspartyl-tRNA synthetase via amide or ester bonds formed between the alpha carboxyl group of activated aspartic acid and accessible lysines, serines, and threonines. This property is used to label the peptides at the surface of the enzyme. The main labeled residues have been identified, and their location in the primary structure is discussed in relation to structural properties of aspartyl tRNA synthetase. PMID- 3297143 TI - Identification and subcellular localization of a 21-kilodalton molecule using affinity-purified antibodies against alpha-transforming growth factor. AB - Monospecific antibodies were generated against each of six different peptide sequences derived from rat and human alpha-transforming growth factor (alpha TGF). The affinity-purified antibody to the 17 amino acid carboxyl-terminal portion of the molecule proved most useful in detecting alpha-TGF. When used in a peptide-based radioimmunoassay, it was possible to measure nanogram quantities of native alpha-TGF in conditioned cell culture media. When used to analyze cell lysate, these antibodies specifically recognized a 21-kilodalton protein species. Indirect immunofluorescence localization procedures revealed a high concentration of alpha-TGF in a perinuclear ring with a diffuse cytoplasmic distribution. These results suggest that a precursor form of alpha-TGF has a cellular role beyond that of an autocrine growth factor. PMID- 3297144 TI - Lipopeptides of the N-terminus of Escherichia coli lipoprotein: synthesis, mitogenicity and properties in monolayer experiments. AB - The N-terminal part of the lipoprotein from the outer membrane of Escherichia coli, tripalmitoyl-S-glyceryl-L-Cys-Ser and analogs with longer sequences, are polyclonal activators for B-lymphocytes. Triple-chain lipopeptides also constitute efficient low-molecular-weight carrier/adjuvant systems, which can be linked to antigens to yield immunogens for antibody production without further additives. This is the first report of monolayer experiments with chemically well defined, synthetic lipopeptide mitogens with the composition of the N-terminus of an important bacterial membrane protein. Various derivatives of the lipoprotein N terminus were synthesized. These lipopeptides differed in the length of the peptide moiety, the number of fatty acid residues, and protective groups. In order to obtain the surface areas for the lipopeptides in isotherms and hysteresis isotherms, monolayer experiments with a computer-controlled film balance were performed. To get some information about the interaction of these compounds with typical membrane lipids mixed monolayers were formed from triple chain lipopeptides with dipalmitoylphosphatidylcholine and cholesterol. A comparison of the mitogenic response of the compounds was made in an in vitro system with B-lymphocytes from Balb/c mice. PMID- 3297145 TI - Large scale transfection of mouse L-cells by electropermeabilization. AB - Mouse L-cells were transfected by electropermeabilization using the selectable plasmid pSV2-neo which confers resistance to G-418 (Geneticin). The DNA concentration used was 1 microgram/ml, the field strength was 10 kV/cm, the duration of the pulse was 5 microseconds. Transfection yield was optimal at a temperature of 4 degrees C when using a time in between consecutive pulses of 1 minute compared to shorter (of the order of seconds) or longer (3 minutes) time intervals. A more detailed study of the relationship between the number of pulses applied (up to 10) and transfection yield showed it to be almost linear in this range at 4 degrees C. The yield of transfectants in response to 10 pulses was up to 1000 per 10(6) cells (using 3.3 pg DNA per cell). The influence of the growth phase of the cells on the transfection yield and/or the subpopulation of the mouse L-cell line used was shown. Furthermore the clone yield depended on the DNA per cell ratio within a very small range. PMID- 3297146 TI - The effect of mercuric salts on the electro-rotation of yeast cells and comparison with a theoretical model. AB - The rotational spectrum of yeast cells changed after pre-treatment of the cells with HgCl2 or Hg(NO3)2 and became indistinguishable from that of ultrasonically produced cell walls. The spectrum of the affected cells contained a peak which could only be explained by attributing a conductivity to the cell walls that was higher than that of the medium. Theoretical models of the rotational response are fully in accord with the experimental spectra. It is shown that the rotation method is capable of measuring even the low cell wall conductivity of yeast cells (which was found to be 33 microS/cm at 10 microS/cm medium conductivity). Knowledge of the spectra allowed a field frequency to be selected at which untreated cells showed no rotation, but at which cells affected by treatment with Hg(II) identified themselves by rotating in the same direction as the field. Calculation of the percentage of cells showing this co-field rotation gave an index (termed the co-field rotation value) of the proportion of the cells that were affected. Using this technique, effects of 25 nmol/l Hg(II) could be demonstrated. In media of low conductivity (10 microS/cm) the change in the rotational spectrum was usually 'all-or-none', whereas at 200 microS/cm a graded Hg(II)-mediated change became apparent. The co-field rotation method showed that the action of small quantities of Hg(II) was still increasing after 3 h of incubation and paralleled the Hg(II)-induced K+ release. A rapid reduction of the effects of Hg(II) was seen when 3-30 mM K+ (or Na+) or when 1 mM Ca2+ were present in the incubation medium, or as the pH was increased. At high incubation cell concentrations the toxic effect of Hg(II) was reduced, apparently due to binding by the cells. PMID- 3297147 TI - Glucose transport in human red cell membranes. Dependence of age, ATP, and insulin. AB - Glucose self-exchange flux (Jex) and net efflux (Jnet) in human red cells and ghosts were studied at 25 degrees C and pH 7.2 by means of the combined use of the Millipore-Swinnex filtering method and the continuous flow tube method to show the dependence of time of storage after aspiration, ATP and insulin. In fresh cells (RBC), ghosts (G), ghosts with 2 mM ATP (G +), and cells stored at 4 degrees C greater than 60 days (OC) both Jex and Jnet follow simple Michaelis Menten kinetics where J = Jmax X Ci X (K1/2 + Ci)-1. Jmaxex and Jmaxnet (nmol X cm-2 X s-1), respectively, was: (RBC) 0.27 and 0.19, (G) 0.24 and 0.27, (G +) 0.23 and 0.24, (OC) 0.23 and 0.20. K1/2,ex and K1/2,net (mM), respectively, was: (RBC) 7.5 and 1.3, (G) 4.8 and 14.2, (G +) 11.6 and 6.8, (OC) 3.8 and 9.0. In ghosts, the ATP-dependent fraction of the permeability shows a hyperbolic dependence on glucose concentrations lower than 80 mM. Insulin up to 1 microM had effect on neither Jex nor Jnet in RBC. Based on reported values of cytochalasin B binding sites the turnover rate per site in RBC appears to be as high as in maximally insulin-stimulated fat cells. Our results suggest that the number of transport sites remains constant, independent of age, ATP and insulin. PMID- 3297148 TI - Cyclic glucans produced by Agrobacterium tumefaciens are substituted with sn-1 phosphoglycerol residues. AB - In a previous study (Miller, K.J., Kennedy, E.P. and Reinhold, V.N. (1986) Science 231, 48-51) it was reported that the biosynthesis of periplasmic cyclic beta-1,2-glucans by Agrobacterium tumefaciens is strictly osmoregulated in a pattern closely similar to that found for the membrane-derived oligosaccharides of Escherichia coli (Kennedy, E.P. (1982) Proc. Natl. Acad. Sci. USA 79, 1092 1095). In addition to the well-characterized neutral cyclic glucan, the periplasmic glucans were found to contain an anionic component not previously reported. Biosynthesis of the anionic component is osmotically regulated in a manner indistinguishable from that of the neutral cyclic beta-1,2-glucan. We now find that the anionic component consists of cyclic beta-1,2-glucans substituted with one or more sn-1-phosphoglycerol residues. The presence of sn-1 phosphoglycerol residues represents an additional, striking similarity to the membrane-derived oligosaccharides of E. coli. PMID- 3297149 TI - Influence of membrane-lipid composition on translocation of nascent proteins in heated Escherichia coli. AB - In studies using Escherichia coli we have shown that new protein species appear in the outer membrane fraction with concomitant losses of nascent proteins from the soluble and inner membrane fractions following heat exposure. Of the various explanations for this phenomenon, temperature-induced membrane disorganization appeared the most likely. It is suggested that heat mimics the action of the signal sequence of a protein on the lipid bilayer allowing non-signal-sequence containing proteins to be translocated. To test this hypothesis we grew E. coli K1060 cells, an unsaturated fatty acid requiring auxotroph, supplemented during growth with fatty acids of varying chain length in an attempt to determine whether biological membranes of varying ability to maintain their bilayer configuration could be constructed. The rationale being that such membranes would allow us to determine whether differences in translocation would occur in cells grown at the same temperature supplemented with either 16:1 or 20:1 unsaturated fatty acids when the cells were subjected to a series of thermal insults. Protein translocation occurred to a greater extent and at lower temperatures in cells supplemented with the longer chain fatty acid. Treatment of outer membranes with either 1 M salt, 6 M urea or high pH and studies determining fluorescent polarization values by scanning up and down through a series of temperatures ranging from 15 to 49 degrees C indicate that the proteins translocated by heat to the outer membrane are integral. Protein translocation may represent an adaptive response to an altered environment enabling the cell to respond to stress by stabilizing its outer membrane. PMID- 3297150 TI - L-malic-acid permeation in resting cells of anaerobically grown Saccharomyces cerevisiae. AB - The study of permeation of L-malic acid in cells of Saccharomyces cerevisiae at pH 3.0 was carried out with (U-14C)-labelled L-malic acid. Resting cells were used in these experiments. They were previously anaerobically grown on glucose. This study showed that this transport is the result of two competitive mechanisms, one for the uptake and one for the efflux. The uptake mechanism seems to be a simple diffusion of the L-malic acid in a non-dissociated form. The efflux mechanism seems to be an active transport of L-malic acid that is very dependent on the temperature. At the steady state, the result of uptake and efflux mechanisms leads to an intracellular concentration which is twice or three times the extracellular concentration. PMID- 3297151 TI - The physical properties of glycolipids. PMID- 3297152 TI - Oligosaccharyl transferase: the central enzyme in the pathway of glycoprotein assembly. PMID- 3297154 TI - Luminal and peritubular steps in renal transport of p-aminohippurate. AB - Why has the PAH transport system proven so difficult to characterize? The major problems appear to arise in three areas: species differences, differences in methodology, e.g., vesicle preparation techniques, and multiplicity of related transport systems. Species differences are certainly important in some areas, e.g., the luminal membrane where the same investigators have shown the presence of an anion exchanger capable of transporting PAH in rat and dog but not in rabbit. Since all of these species effectively secrete PAH, one must question whether or not the primary luminal component of the PAH secretory system has yet been identified. Other species differences have also been described. For example, the amphibian, Necturus, demonstrates bidirectional organic anion transport, including an uphill luminal step and the urinary bladders of certain species of crustaceans show net reabsorption, whereas the bladders of other species show net secretion of PAH. However, these differences may well prove to be important tools in assessing PAH transport, since amplification of specific pathways and the increased experimental control possible in intact tissue preparations from some of these species, e.g., flounder, snake and amphibian tubules or crustacean urinary bladder, may facilitate resolution of many of the remaining uncertainties. Species differences cannot explain the wide variety of results reported for the basolateral membrane transport step, since many of the conflicting studies were done in the same species. Difficulties inherent in vesicle techniques have been discussed above (Subsection III-A2), and emphasize the need to correlate such data with intact tissue preparations. However, the major source of confusion appears to be related to the ability of PAH to interact with several transport systems, directly or indirectly. Thus, despite the preponderance of evidence showing that the PAH transport system at the basolateral membrane is distinct from those for sulfate, mono- and dicarboxylic acids, acidic amino acids, and uric acid, there remains the real possibility that under physiological conditions: PAH may be a minor substrate for these other systems, substrates for other systems may inhibit PAH transport directly through competition for the PAH carrier or indirectly through competition for the same energy source, and entry of a substrate on one system may trans-stimulate PAH uptake on another. Furthermore, the existence of multiple systems may explain the inability of certain manipulations, e.g., Na gradient dissipation in vivo, to block PAH transport. PAH entry may simply increase via another pathway, e.g., anion exchange.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297153 TI - Mechanisms and consequences of cellular cholesterol exchange and transfer. AB - It is apparent from consideration of the reactions involved in cellular cholesterol homeostasis that passive transfer of unesterified cholesterol molecules plays a role in cholesterol transport in vivo. Studies in model systems have established that free cholesterol molecules can transfer between membranes by diffusion through the intervening aqueous layer. Desorption of free cholesterol molecules from the donor lipid-water interface is rate-limiting for the overall transfer process and the rate of this step is influenced by interactions of free cholesterol molecules with neighboring phospholipid molecules. The influence of phospholipid unsaturation and sphingomyelin content on the rate of free cholesterol exchange are known in pure phospholipid bilayers and similar effects probably occur in cell membranes. The rate of free cholesterol clearance from cells is determined by the structure of the plasma membrane. It follows that the physical state of free cholesterol in the plasma membrane is important for the kinetics of cholesterol clearance and cell cholesterol homeostasis, as well as the structure of the plasma membrane. Bidirectional flux of free cholesterol between cells and lipoproteins occurs and rate constants characteristic of influx and efflux can be measured. The direction of any net transfer of free cholesterol is determined by the relative free cholesterol/phospholipid molar ratios of the donor and acceptor particles. Cholesterol diffuses down its gradient of chemical potential generally partitioning to the phospholipid-rich particle. Such a surface transfer process can lead to delivery of cholesterol to cells. This mechanism operates independently of any lipoprotein internalization by receptor-mediated endocytosis. The influence of enzymes such as lecithin-cholesterol acyltransferase and hepatic lipase on the direction of net transfer of free cholesterol between lipoproteins and cells can be understood in terms of their effects on the pool sizes and the rate constants for influx and efflux. Excess accumulation of free cholesterol in cells stimulates the rate of cholesteryl ester formation and induces deposition of cholesteryl ester inclusions in the cytoplasm similar to the situation in the 'foam' cells of atherosclerotic plaque. Clearance of cellular cholesteryl ester requires initial hydrolysis to free cholesterol followed by efflux of this free cholesterol. The rate of clearance of cholesteryl ester from cytoplasmic droplets is influenced by the physical state of the cholesteryl ester; liquid-crystalline cholesteryl ester is removed more slowly than cholesteryl ester in a liquid state.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297155 TI - Glycosphingolipids and antitumor immunity. PMID- 3297156 TI - Manipulation of the intratumor infiltrate by anti-tumor antibody conjugates. PMID- 3297157 TI - Effects of ppGpp on transcription by DNA-dependent RNA polymerase from Escherichia coli: circular dichroism, absorption and specific transcription studies. AB - Concrete evidence is presented for conformational changes elicited in RNA polymerase upon binding ppGpp by circular dichroism measurements. In the presence of 100 microM ppGpp, the molar ellipticity of RNA polymerase at 220 nm is reduced by 14% from the initial value of - 11,100 deg X cm2 X dmol-1 at 25 degrees C. In vitro transcription on templates containing the beta-lactamase promoter and colicin E1 promoter on poly[d(A-T)] is inhibited by ppGpp. None of these templates had GC-rich nucleotide sequence near the transcription initiation site, and yet they were influenced by ppGpp. Comparison of the effect on the synthesis of mRNAs for beta-lactamase and colicin E1 and the synthesis of the proteins themselves indicates that the effect of ppGpp is at the level of transcription for the former case and involves coupled transcription-translation for the latter case. Difference absorption, polyacrylamide gel electrophoresis, and nitrocellulose filter-binding studies show that the binding of ppGpp to RNA polymerase does not impair the extent of the interaction between enzyme and DNA. Kinetic studies suggest that ppGpp affects transcription initiation on beta lactamase promoter. On poly[d(A-T)], ppGpp affects the rate of open complex formation and is a mixed inhibitor with respect to the incorporation of nucleotides. Our results are consistent with the idea that ppGpp acts as a regulator by binding at a site different from the active site and changes the RNA polymerase conformation, causing altered transcriptional behavior on different DNA templates. PMID- 3297158 TI - Expression of cell-cycle-dependent genes in serum stimulated cells whose entry into S phase is blocked by cytochalasin D. AB - A low concentration (0.6 micrograms/ml) of cytochalasin D inhibits the initiation of DNA synthesis after serum stimulation of growth-arrested GC-7 cells. Since actin-containing structures are suggested to be involved in the transfer of the growth signal to nuclei and in the synthesis and transport of nascent RNA, the effect of cytochalasin D on the expression of cell-cycle-regulated genes after serum stimulation was studied by Northern blot analysis. Cytoplasmic accumulation of such mRNAs as or c-fos, c-myc, beta-actin an ornithine decarboxylase occurred in serum-stimulated cells regardless of the presence of cytochalasin D, whereas that of thymidine kinase and histone H3 was blocked by the drug. PMID- 3297159 TI - Recognition of translational termination signals. AB - Ribosomes can specifically shift at certain codons so that the mRNA is read in two different reading frames. To determine if frameshifting occurs at the level of termination, polymers of defined sequence containing AUG, a coding sequence and an in- or out-of-phase nonsense codon were used to bind a termination substrate or to program synthesis and release of dipeptides in a highly purified in vitro translation system. fMet-tRNA bound to ribosomes with AUGUAA, AUGUAAn, AUGUUU, AUGUUA or AUGUAn was not a substrate for release factor RF-1. In contrast, AUGU1UAA, AUGU3UAAn, AUGU4UAAn, AUGU5UAAn effected RF-1-dependent release of fMet from ribosomes. This suggests that nonsense codons can stimulate release whether they occur in- or out-of-phase. Addition of exogenous UAA and RF 1 stimulated release with all oligonucleotides tested. Propagation restricted the RF-1-dependent recognition of out-of-phase nonsense codons but did not restrict recognition of in-phase UAA in AUGU3UAAn. Release of dipeptides from ribosomes programmed with AUGU4UAAn occurred without EF-G and with a mutant lacking EF-G activity, suggesting that out-of-phase termination can occur prior to translocation outside the ribosomal A-site. We propose that the ribosome X RF complex is required to complete proteins, but is also able to frameshift at a nonsense codon resulting in occasional out-of-phase termination of protein synthesis. PMID- 3297160 TI - A mutant pyruvate dehydrogenase complex of Escherichia coli deleted in the (alanine + proline)-rich region of the acetyltransferase component. AB - The acetyltransferase chains of the pyruvate dehydrogenase complex of Escherichia coli contain conformationally mobile (alanine + proline)-rich segments that link the lipoyl domains to each other and to the subunit-binding and catalytic domain, and facilitate the intramolecular coupling of active sites in the complex. A deletion of 12 of the 32 residues of the (Ala + Pro)-rich segment of an acetyltransferase containing only one lipoyl domain was made by deleting the corresponding segment of the aceF gene. A pyruvate dehydrogenase complex was still produced and the catalytic activity of the restructured complex, including active-site coupling, was not detectably impaired. PMID- 3297161 TI - Proline isomerization and the slow folding reactions of the alpha subunit of tryptophan synthase from Escherichia coli. AB - Previous studies on the refolding of the alpha subunit of tryptophan synthase from Escherichia coli assigned two slow refolding phases to rate-limiting isomerizations of two 'essential' proline residues, one in each of the two domains of the protein (Matthews, C.R., Crisanti, M.M., Manz, J.T. and Gepner, G.L. (1983) Biochemistry 22, 1445-1452). The double-jump experiment (Brandts, J.F., Halvorson, H.R. and Brennan, M. (1975) Biochemistry 14, 4953-4963) was used to further investigate this phenomenon. The reaction assigned to the carboxyl domain is consistent with the proline isomerization hypothesis. The amino domain process is more rapid than expected for proline isomerization and may reflect another type of slow folding reaction. The results permit a further refinement of the folding model for the alpha subunit and demonstrate the existence of a third unfolded species whose folding is not limited by either of these two reactions. PMID- 3297162 TI - The tertiary structure of salt-extracted ribosomal proteins from Escherichia coli as studied by proton magnetic resonance spectroscopy and limited proteolysis experiments. AB - Ribosomal proteins from Escherichia coli have been isolated by a mild purification procedure. Their tertiary structure has been explored by two techniques, proton magnetic resonance and limited proteolysis. A number of proteins when subjected to limited proteolysis produce resistant fragments in good yields. In most cases this does not depend on the specificity of the enzyme used. The proteins S15, S16, S17 and L30 are not degraded at all, whereas a few proteins are very susceptible to proteolysis. 1H-NMR experiments show that the majority of the ribosomal proteins have a uniquely folded tertiary structure. This is particularly pronounced in the four proteins mentioned above which resist proteolysis. In general, a good agreement is observed between the degree of proteolytic resistance and the amount of folding indicated by NMR spectroscopy. Similar studies on a few ribosomal proteins purified under denaturing conditions show that, in contrast, these protein preparations are not structurally homogeneous and that they contain a mixture of denatured and renatured molecules. The results are interpreted in terms of a compactly folded tertiary structure for the four proteinase-resistant proteins while the majority of the other proteins appear to have two domains, one compactly folded and resistant to proteinase and the other flexible and susceptible to proteolysis. A few proteins seem to have a completely flexible structure and can therefore be easily degraded. PMID- 3297164 TI - Alterations in the carbohydrate moiety of alpha-1-acid glycoprotein purified from human cirrhotic ascitic fluid. AB - The carbohydrate analysis of alpha 1-AGPc purified from cirrhotic ascitic fluid was performed by immunoaffinity chromatography. It showed a large increase in the fucosyl molar ratio and sugar content (47%). The molar ratio of the oligosaccharides which were released by hydrazinolysis and fractionated by high performance liquid chromatography confirms the marked increase in fucosyl residues in each fraction. A shift towards fractions with a high degree of branching was also observed. Moreover, the studies of sugar molar ratios and methylation of the tetrasialylated fraction indicated the simultaneous presence of sialyl and fucosyl residues on one of the outer branches. PMID- 3297165 TI - Purification and partial amino acid sequencing of rat bone tumor (UMR106) alkaline phosphatase. AB - Cultured rat osteosarcoma (UMR106) alkaline phosphatase was purified to apparent homogeneity by sequential application of polyclonal antibody affinity, DEAE cellulose, and Sepharose CL-6B chromatography. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of the enzyme preparation treated with sodium dodecyl sulfate and mercaptoethanol showed the presence of a dominant band (using silver staining) corresponding to a molecular weight of 80,000. The amino acid composition was similar to those of various alkaline phosphatases. The N-terminal amino acid sequence was determined as follows: Phe-Val-Pro-Glu-Lys-Glu-Lys- Asp Pro-Ser-Tyr-Trp-Arg-Gln-Gln-Ala-Gln-Glu-Thr-Leu- Lys-Asn-Ala-Leu-Lys-?-Gln-Lys-? Asn-Val-Asn-Ala-Lys. PMID- 3297163 TI - Inactivation of NAD-dependent dehydrogenases from shallow- and deep-living fishes by hydrostatic pressure and proteolysis. AB - Cytoplasmic malate dehydrogenase [L)-malate:NAD+ oxidoreductase, EC 1.1.1.37) and glyceraldehyde-3-phosphate dehydrogenase (D-glyceraldehyde-3-phosphate:NAD+ oxidoreductase, EC 1.2.1.12) homologues from two shallow-living and three deep living fishes were examined for the effects of hydrostatic pressure on enzyme activity and susceptibility to inactivation by proteinases. These studies were done to determine whether malate dehydrogenase and glyceraldehyde-3-phosphate dehydrogenase homologues show similar patterns of adaptation to hydrostatic pressure as seen in lactate dehydrogenase (L-lactate:NAD+ oxidoreductase, EC 1.1.1.27) homologues from the same species (Hennessey, J.P., Jr. and Siebenaller, J.F. (1987) J. Exp. Zool. 241, 9-15). Fish malate dehydrogenase and glyceraldehyde-3-phosphate dehydrogenase homologues are much less susceptible to inactivation by hydrostatic pressure than are lactate dehydrogenase homologues from the same species. This difference in susceptibility to inactivation by hydrostatic pressure may be due to the decreased number of intersubunit contacts in malate dehydrogenase and glyceraldehyde-3-phosphate dehydrogenase homologues relative to lactate dehydrogenase homologues. Inactivation of malate dehydrogenase and glyceraldehyde-3-phosphate dehydrogenase homologues by proteinases, both at atmospheric pressure and at elevated hydrostatic pressure, is less than for lactate dehydrogenase homologues from the same species. This suggests that the structural characteristics and conformational perturbations that are responsible for the susceptibility of lactate dehydrogenase to proteolytic inactivation are not found in malate dehydrogenase and glyceraldehyde 3-phosphate dehydrogenase homologues of the same species. PMID- 3297166 TI - Cholesterol metabolism in the genetically hypercholesterolemic rat (RICO). I. Measurement of turnover processes. AB - The rates of mobile cholesterol turnover processes were measured by the isotopic equilibrium method in normocholesterolemic (SW) and hypercholesterolemic homozygote (RICO) rats fed a semi-synthetic base diet containing 0.05% cholesterol. When the absorption rate is similar in SW and RICO rats, the internal secretion rate is 60% higher in RICO (25.3 mg/day) than in SW (16.2 mg/day). This increase is compensated by an increase in fecal excretion (RICO: 5 mg/day; SW: 3.8 mg/day), urinary excretion (RICO: 1.7 mg/day; SW: 1.1 mg/day) and above all the transformation of cholesterol into bile acids (RICO: 24.2 mg/day; SW: 15.3 mg/day). The fact that 70 minutes after [14C]acetate administration, the only variations obtained in RICO compared to SW rats are a doubled sterol radioactivity in the small intestine and a tripled one in the liver suggests that the increase in internal secretion of the RICO rat has both an intestinal and hepatic origin. This cholesterogenic stimulation in RICO rats takes place in the jejunum as well as in the ileum and in the crypt cells as well as in the villosities. It is concomitant with a doubled cholesterolemia, a doubled intestinal, caecal and colon bile acid pool and a 20% increase in the enterocyte protein content. PMID- 3297167 TI - Vibrio cholerae metalloproteinase degrades intestinal mucin and facilitates enterotoxin-induced secretion from rat intestine. AB - Mucin secretion in situ from rat intestinal loops was promoted more effectively by dialysed crude cholera filtrate than by an equivalent amount of purified enterotoxin. The filtrate could be rendered inactive by incubation with mixed gangliosides or passage through a GM1-affinity column, which indicated that the secretory action of the filtrate depended upon its enterotoxin component. In an effort to explain the greater potency of the filtrate, we established the presence of a metalloproteinase in the filtrate and demonstrated that this enzyme was capable of degrading purified rat intestinal mucin. Sufficient degradation occurred to cause a substantial decrease in viscosity (57% in 120 min). Biochemical analysis of the mucin before and after exposure to filtrate revealed a rise in the combined percentage of serine, threonine and proline (53-58%), suggesting that poorly glycosylated areas (which are less abundant in these amino acids) were being partly removed from the mucin. The carbohydrate composition was essentially unaltered. Inhibition of the filtrate metalloproteinase by Zincov and alpha 2-macroglobulin significantly (P less than 0.005) reduced the ability of cholera filtrate to degrade mucin or to stimulate mucin secretion from rat intestinal slices in vitro. Purified cholera enterotoxin added to enterotoxin depleted filtrate was a more potent secretagogue (secretory stimulant) in intestinal loops than an equivalent amount of enterotoxin alone. We therefore propose that mucin secretion induced by cholera filtrate is caused by cholera enterotoxin, but that degradation of the protective epithelial mucus layer by a constituent metalloproteinase may assist the toxin by allowing increased access to mucosal GM1 receptor sites. PMID- 3297168 TI - The effect of lysosomotropic detergents on the permeability properties of the lysosome membrane. AB - Compounds such as N-dodecylimidazole and N-dodecylmorpholine kill cells in culture. Their cytotoxicity has been attributed to accumulation in lysosomes where protonation confers detergent properties resulting in membrane destabilization. This hypothesis has been tested by examining the ability of N dodecylimidazole and N-dodecylmorpholine to decrease the latency of alpha glucosidase in isolated rat liver lysosomes. No effect was observed. Nor was N dodecylimidazole apparently able to increase the permeability of isolated rat liver lysosomes to L-alanine, as no diminution of the disruptive effect of L alanine methyl ester was seen. N-Dodecylimidazole (10-20 micrograms per ml) caused lactate dehydrogenase release from cystinotic fibroblasts, but marginally toxic concentrations failed to induce cystine release, as might have been expected if lysosome membrane damage had occurred. It is concluded that the cytotoxic effects of lysosomotropic detergents may be mediated by a non-lysosomal mechanism. PMID- 3297169 TI - Mitogenic and morphogenic effects of a bovine salivary gland extract on astrocytes and fibroblasts. AB - The presence of mitogenic and morphogenic activity in extracts of bovine salivary (parotid) glands is reported. The crude and partially purified extracts stimulated cultured rat cerebellar cells (astrocytes) and skin fibroblasts to undergo morphogenesis. The incorporation of [3H]thymidine was also stimulated in astrocytes, skin fibroblasts, and established fibroblastic cell lines. Growth promoting activity was also demonstrated. The expression of maximum mitogenic activity in skin fibroblast cultures, but not kidney fibroblast cultures, required the presence of serum. The biological activity had an apparent native molecular weight greater than 230,000, was heat-sensitive, trypsin-resistant, and slightly sensitive to the action of papain. PMID- 3297170 TI - Purification and characterization of enkephalinase B from rat brain membrane. AB - Enkephalinase B from rat brain membrane which hydrolyzes enkephalin at the Gly Gly bond was purified about 9400-fold to apparent electrophoretic homogeneity. The enzyme, which has a molecular weight of 82,000, consists of a single polypeptide chain. The enzyme has a pH optimum of 6.0-6.5 and is stable in the neutral pH region. The Km values of Met-enkephalin and Leu-enkephalin for this enzyme were 5.3 X 10(-5) M and 5.0 X 10(-5) M, respectively. The enzyme was inactivated by metal chelators, EDTA and o-phenanthroline and restored by the addition of divalent metal ions, Zn2+, Mn2+ or Fe2+, but was not inhibited by bestatin, amastatin, phosphoramidon or captopril. The enzyme hydrolyzed Met enkephalin and Leu-enkephalin effectively. Although the enzyme belongs to the dipeptidyl aminopeptidase class, enkephalin-related peptides such as Leu enkephalin-Arg, dynorphin (1-13) or alpha-endorphin and other biologically active peptides examined were hardly, or not at all, hydrolyzed. It was assumed that enkephalinase B functions mainly in enkephalin degradation in vivo. PMID- 3297171 TI - Purification and some properties of bound cysteine proteinase inhibitor from cornified cells of newborn rat epidermis. AB - Cysteine proteinase inhibitor exists in two forms in terminally differentiated keratinocytes. One is readily soluble in 20 mM sodium phosphate buffer but the other is bound to the plasma membrane and is poorly soluble. The cysteine proteinase inhibitor (CPI) from the membrane was extracted from cornified epidermal layers of 2-day-old rats and its properties were compared with those of soluble CPI. This CPI (bound CPI) was solubilized in alkaline 8 M urea containing 2-mercaptoethanol from the residual tissue exhaustively treated with buffered 4 M urea. CPI was separated from keratin by ammonium sulfate precipitation and purified by means of papain affinity chromatography, ion exchange column chromatography and gel filtration. Bound CPI had an Mr value of about 16,000, a pI value of 3.8 and was unstable at above 80 degrees C, while soluble CPI was of Mr 13,000 and stable at above 80 degrees C. Both CPIs were stable at 4 degrees C in the range of 3.0-9.0. Bound CPI contained half cystine and the ratio of acidic to-basic amino acids was 3.18. Bound CPI inhibited rat liver cathepsins B, H, and L but did not inhibit the activity of noncysteine proteinases. Papain activity was inhibited by bound CPI at three sites, noncompetitively, and the Ki value was calculated to be 0.11 nM. PMID- 3297172 TI - Cadmium-induced insulin release does not involve changes in intracellular handling of calcium. AB - A possible interaction between Cd2+ and Ca2+ as a component in Cd2+-induced insulin release was investigated in beta cells isolated from obese hyperglycemic mice. The glucose stimulated Cd2+ uptake was dependent on the concentration of sugar. This uptake was sigmoidal with a Km for glucose of about 5 mM and was suppressed by both 50 microM of the voltage-activated Ca2+ channel blocker D-600 and 12 mM Mg2+. In the presence of 8 mM glucose 5 microM Cd2+ evoked a prompt and sustained stimulatory response, corresponding to about 3-fold of the insulin release obtained in the absence of the ion. Whereas 5 microM Cd2+ was without effect on the glucose-stimulated 45Ca efflux in the presence of extracellular Ca2+, 40 microM inhibited it. At a concentration of 5 microM, Cd2+ had no effect on the resting membrane potential or the depolarization evoked by either glucose or K+. In the absence of extracellular Ca2+ there was only a modest stimulation of 45Ca efflux by 5 microM Cd2+. Studies of the ambient free Ca2+ concentration maintained by permeabilized cells also indicate that 5 microM Cd2+ do not mobilize intracellularly bound Ca2+ to any great extent. On the contrary, at this concentration, Cd2+ even suppressed inositol 1,4,5-trisphosphate (IP3)-induced Ca2+ release. The present study suggests that Cd2+ stimulates insulin release by a direct mechanism which does not involve an increase in cytoplasmic free Ca2+ concentration. PMID- 3297173 TI - Effect of insulin and glucagon on the uptake of carnitine by perfused rat liver. AB - The possible direct effects of insulin and glucagon on carnitine uptake by perfused rat liver were studied with L-[3H]carnitine of an initial concentration of 50 microM in the perfusate. Insulin (10 nM) did not significantly affect the uptake by livers from fed animals. However, insulin could reverse the stimulated transport by livers from 24-h fasted animals, reducing the uptake rate from 852 +/- 54.1 to 480 +/- 39.9 (mean +/- S.E.), P less than 0.01 (rates are expressed as nmol per h per 100 g body wt). Glucagon (50 nM) stimulated the uptake rate when livers were either from fed (551 +/- 40.1 vs. 915 +/- 55.3, P less than 0.01) or from fasted animals (852 +/- 54.1 vs. 1142 +/- 88.1, P less than 0.02). Based on these and earlier observations, we propose that the carnitine concentration in rat liver is controlled by insulin and glucagon via cellular transport processes. PMID- 3297174 TI - [Peptide synthesis catalyzed by proteases. Analysis of a kinetic model for enzymes with acyl-enzyme mechanism of action]. AB - The kinetics of peptide synthesis via transfer of the acyl moiety from activated derivatives of amino acids or peptides (S) to nucleophiles (N) catalyzed by proteases forming an acyl-enzyme intermediate, was analysed. A kinetic model assumes enzymatic hydrolysis of the formed peptide (P), so the kinetic curve for P has a maximum (denoted as pmax). Particular attention was given to the analysis of the effects of the initial concentrations and kinetic constants on pmax. Computer analysis demonstrated that at a given ratio of initial S and N concentrations pmax is affected only by the ratio of the second order rate constants for enzymatic hydrolysis of S and P (alpha) and the ratio of rate constants for an attack of the acyl-enzyme intermediate by nucleophile and water (beta). These conclusions apply regardless of the existence of enzyme forms other than a free enzyme and an acyl-enzyme intermediate. Thus, the kinetically controlled maximum yield of peptide (pmax) can be calculated a priori from the values of alpha and beta which can be readily evaluated from the reference data. Simple explicit expressions were obtained, allowing fairly accurate prediction of pmax for a broad spectrum of S and N initial concentrations. PMID- 3297175 TI - [Metabolic function of the lungs and regulation of homeostasis]. AB - Morphological, biochemical and pathophysiological data on the significance of the metabolic (non-respiratory) function of the lungs in the regulation of homeostasis have been summarized. The key "strategic" position of the lungs in the blood circulation system, the concentration of a unique set of biochemical regulatory factors in the lung endothelium, as well the presence of a multiple system of nervous and humoral control ensure the realization of a specific mission by lungs as a regulator of the functional integrity of the organism. The lungs serve as a barrier controlling the passage of deleterious substances into arterial blood and consequently into the brain and other organs and at the same time the lungs are responsible for the controlled synthesis and elimination of physiologically active substances essential for the work of the same systems. These functions attain special significance under stress-induced situations as a result of homeostatic disruptions and as a consequence of grave extrapulmonary injuries. The author's concept on a compensatory function of the lung kallikrein kinin system under extreme conditions of organism is given. This pathway opens up the prospects for search of ways of correcting functional disruption in organism. PMID- 3297176 TI - Clinical predictors of response to antidepressants in elderly patients. AB - A group of 42 patients, ages 55 and above, suffering from major depression were examined in an attempt to isolate clinical variables that would predict response to antidepressants. These patients were part of a placebo-controlled, double blind study and were given either nortriptyline or phenelzine for 5-7 weeks. There was no significant difference in response rates between patients subclassified as endogenous or nonendogenous by either RDC or Newcastle criteria. No difference in response rates was found between the DSM-III melancholic and nonmelancholic subtypes. Neither drug preferentially treated a subtype. None of the 21 variables representing symptoms, demographic traits, or characteristics of the depressive illness were found to be significant predictors of antidepressant response. PMID- 3297177 TI - Enhanced luteinizing hormone release by luteinizing hormone-releasing hormone in incubating female turkeys (Meleagris gallopavo). AB - To determine what role pituitary responsiveness plays in the suppression of gonadotropin level during incubation in the turkey, the ability of the pituitary to release luteinizing hormone (LH) in response to luteinizing hormone-releasing hormone (LHRH) was compared in incubating, laying, and photorefractory birds. In all three groups, the i.m. injection of LHRH (4 micrograms/kg) increased serum LH levels; however, the LH response was markedly enhanced in the incubating turkeys as compared with the laying (6.6-fold increase over preinjection levels vs. 1.9 fold; p less than 0.05) or the photorefractory birds (9.7-fold vs. 3.1-fold; p less than 0.05). The LHRH-induced LH release was also determined in turkeys as they shifted from the laying to the incubating phase of the reproductive cycle. This response increased (p less than 0.05) in magnitude as the birds started to incubate. The high prolactin level of incubating turkeys does not have a depressing effect on LHRH-stimulated LH release; thus, impaired LH response to LHRH is not a mechanism involved in the diminished gonadotropin secretion of incubating turkeys. PMID- 3297178 TI - Seasonal modulation of luteinizing-hormone secretion in female rhesus monkeys. AB - The seasonal restriction of ovulations in rhesus monkeys is thought to be due to enhanced estradiol (E2)-negative feedback suppression of luteinizing hormone (LH) during the spring and summer anovulatory months. This hypothesis was examined in seven ovariectomized monkeys housed in an outdoor environment and treated with various doses of E2 in a counterbalanced design during both the anovulatory season (May-Jul) and the breeding season (Sep-Nov). Subcutaneous implants of E2 produced levels that mimicked late follicular (LF-100 pg/ml) or periovulatory concentrations (PO-190 pg/ml). Analyses of twice weekly serum samples revealed that during the period of no E2 treatment (NT), basal levels of bioactive LH were significantly lower in the summer than the fall. Although treatment with both doses of E2 lowered basal LH levels during both seasons, the decrease in LH was significantly greater during the summer. Samples collected at 15-min intervals for 2 h revealed that during NT, LH pulses were significantly slower during the summer than in the fall, whereas pulse amplitude did not differ between seasons. Treatment with both doses of E2 either abolished or significantly reduced both LH pulse amplitude and frequency in the summer. In contrast, LH pulses during the fall were not affected by E2 treatment. Response to treatment with LH-releasing hormone (5 micrograms/kg i.v.) revealed that release was significantly reduced during E2 treatment in the summer. These data indicate that seasonal changes in the environment influence both nongonadal control and E2-negative feedback inhibition of LH secretion. The reduced ability of E2 to maximally suppress LH release in the fall can thus account for the seasonally delimited pattern of ovulations observed in rhesus monkeys. PMID- 3297179 TI - Evidence for insulin synthesis in normal mouse seminal vesicle based on in situ RNA-DNA hybridization. AB - Cultured seminal vesicle epithelial cells exhibited cytoplasmic immunoreactivity following treatment with anti-insulin antisera. In addition, these cultured epithelial cells were found, by in situ hybridization with a radiolabeled insulin complementary deoxyribonucleic acid (cDNA) probe, to contain an insulin or insulin-like messenger ribonucleic acid (mRNA). Autoradiograms of the hybridized cells exhibited heavy labeling over the cytoplasm and minimal distribution of grains over the nuclei and background areas. These observations indicate that cultured mouse seminal vesicle epithelium contains an insulin or insulin-like peptide as well as the mRNA that is required for its synthesis. PMID- 3297180 TI - Thermal denaturation of bacteriophage T4 lysozyme at neutral pH. PMID- 3297182 TI - Representing risks: supporting genetic counseling. AB - This paper discusses issues involved in decisions to bear a child given the knowledge that the child may be subjected to a genetic risk. It argues that the problem of whether to take the risk or not is predicated on the way the prospective parents have conceptualised this risk and its effects. Five levels of abstraction are described at which this risk can be represented and the implications of conceptualising the problem at each of these levels are outlined. Recommendations are made about how to explore the way--or different ways--parents conceptualise the problems involved and how to go about helping them make the decision which they will be least likely to regret subsequently, whatever the actual outcome. PMID- 3297181 TI - Comparison of high pressure liquid chromatography and fluorescence polarization immunoassay to assess quinidine pharmacokinetics. AB - High pressure liquid chromatography (HPLC) and fluorescence polarization immunoassay (FPIA) were compared in a quinidine pharmacokinetic study. Six healthy male subjects received single oral doses of regular release (RR) quinidine sulfate, sustained release (SR) quinidine bisulfate and the same dose of the SR product with food (SR-F). Serum was collected for 49 h after each dose and analysed for quinidine by HPLC and FPIA. Using HPLC, there were no statistically significant differences between dosing regimens with respect to area under the curve (AUC) or terminal rate constant (K). The RR dose resulted in a higher peak plasma concentration (Cp) and shorter time to peak (Tp) than either of the SR doses (p less than 0.01). Food had no apparent effect on the bioavailability of the SR product. When using FPIA, food administration was found to increase the AUC for the SR product (p less than 0.05) and all three dosage regimens resulted in a different Cp and Tp (p less than 0.001). When comparing all pharmacokinetic parameters determined by each assay, FPIA resulted in a significantly lower K (p less than 0.01). Orthogonal regression of all serum quinidine concentrations showed that FPIA = 0.926 (HPLC) + 0.06 (r = 0.971, p less than 0.001). Analysis of quinidine concentrations in different concentration ranges revealed that FPIA overestimated HPLC for concentrations less than 1 micrograms ml-1 (p less than 0.001) and underestimated HPLC for concentrations greater than 2 micrograms ml-1 (p less than 0.01). Although the use of FPIA is appropriate for quinidine therapeutic drug monitoring, HPLC is the preferred assay method for assessing pharmacokinetic parameters in single dose bioavailability studies. PMID- 3297183 TI - Chromosomal anomalies and autosomal syndromes. PMID- 3297184 TI - [Participation of leu-enkephalin in regulating carbohydrate metabolism]. AB - The experiments have been performed on 166 white male rats with a mass of 180-220 g. It has been revealed that leucine-enkephalin and its synthetic analogs prevent an increase in glucose blood levels and a decrease in glycogen liver levels caused by adrenaline and parathyroid hormone. At the same time the enkephalins inhibit the secretory activity of pancreatic beta-cells. The mechanisms of opioid peptide effect on carbohydrate metabolism are discussed. PMID- 3297185 TI - [Decreased sensitivity to the hypoglycemic action of insulin in animals with a lowered blood heparin concentration]. AB - It has been shown that in animals with reduced heparin blood concentration the hypoglycemic insulin action was considerably low. This was established for rats with alloxan diabetes and ageing rats with depressed anticoagulation system and atherosclerosis enhanced by prolonged atherogenic diet. With insulin injection (0.2-0.3 U/200 g), blood sugar concentration in such animals was 2-2.5 times lower than in normal ones. The compensation of endogenous heparin deficiency by an intravenous injection of heparin normalizes the reaction of animals to exogenous insulin. PMID- 3297186 TI - [Use of monoclonal antibodies for purifying the regulatory subunit of cAMP dependent protein kinase]. AB - Monoclonal antibodies against regulatory subunit of cAMP-dependent protein kinase, type II, were obtained from pig brain (R II). The immune-affinity sorbent has been synthesized on the basis of monoclonal antibodies against R II. The method was proposed for the purification of homogeneous R II with high cAMP binding activity using immune-affinity sorbent. PMID- 3297188 TI - [Collagen type IV of the basal membrane of the epithelium of the skin in certain forms of pathology]. AB - Using immunofluorescence, attenuation or complete disappearance of type IV collagen antiserum reaction were shown in the epidermal basal membrane zone of SLE patients. Some positive material was revealed in the intercellular spaces of the epidermis. There is an inverse correlation between the amount of immune complexes in the dermo-epidermal region and the intensity of anticollagen serum reaction in the basal membrane zone. This can be explained by the toxic effect of immune complexes on collagen-synthesizing cells and the disturbance of this protein fixation in the basal membrane followed by its sequestration from the affected regions. Complex therapy including hemoperfusion restores normal collagen location in the epidermal basal membrane. PMID- 3297187 TI - [Effect of SOS repair in enterobacteria on their interaction with the complement system]. AB - The interaction of E. coli (serovar 0124) and its rec A-mutants with serum complement resulting in the alternative pathway activation was studied. Bacteria VT1240 (original smooth strain), VT1241 (rough mutant) and VT 2240 (recA56 mutant) were shown to be complement-sensitive when treated with 1.5 X 10(8)--1.9 X 10(8) cells per ml of normal human serum, while the cells with SOS-activated system (recA441 mutant, strain VT3251) retained their viability. An alternative pathway of complement activation was minimal with E. coli VT1241, while VT3251 demonstrated intermediate activity. To decrease the level of complement components (AH50) and factor B (BH50) by 50%, 3.5 X 10(6)--4.5 X 10(6) cells of VT1240 and VT2240 strains were required. R-mutants and recA441 mutants caused a 50% reduction in AH50, when used in the amount of 6.4 X 10(7) and 2.6 X 10(7), respectively, the same degree of BH50 decrease was achieved with the amounts used equal to 1.1 X 10(8) and 4.3 X 10(6), respectively. C3 conversions caused by 4 X 10(8) cells in I ml of the normal human serum in the four strains tested accounted for 5-15%. PMID- 3297190 TI - [Method of identifying and separating organs of endocrine secretion in mice]. PMID- 3297189 TI - [Immunoenzyme demonstration of viruses and virus-specific antibodies by using conjugates based on gene engineering-produced beta-lactamase]. AB - Enzyme immunoassays for the detection of viral antigens and virus-specific antibodies in biological samples have been described. Molecular complexes of antibodies and beta-lactamase (penicillinase) have been used as anti-specific conjugates. To synthesize the conjugate, the enzyme obtained with the aid of genetic engineering has been used. Enzyme immunoassays have been tested for the indication of the influenza virus and virus-induced specific antibodies. Enzyme immunoassays were shown to possess certain advantages (e.g., the use of simple and nontoxic substrate) along with the sensitivity identical to that of other methods, employing peroxidase-based conjugates. PMID- 3297192 TI - [Inactivation of blood plasma alpha 1-proteinase inhibitor as affected by 2 splenic thiol proteinases active in a neutral medium]. AB - It has been found that two active in neutral medium thiol proteinases from bovine spleen, cathepsin L and cathepsin H, bring about rapid and irreversible inactivation of alpha 1-proteinase inhibitor (alpha 1PI)--one of the major plasma inhibitors of serine proteinases. The activity of the enzymes studied did not change upon the interaction with alpha 1PI. With stoichiometric proteinase/inhibitor ratio, the inactivation of alpha 1PI under the effect of cathepsin L was instantaneous, while under the effect of cathepsin H it occurred within 30-60 min. The products of alpha 1PI inactivation had an inhibitory effect on the rate of its reaction with cathepsin L. alpha 1PI inactivation under the action of cathepsin L and cathepsin H was accompanied by the decrease in the molecular mass of the inhibitor from 54 kDA to 46 kDa. This was, probably, caused by the hydrolysis of the peptide bond formed by NH2 group of threonine. The 46 kDa fragment did not undergo further degradation. It did not bind to immobilized trypsin but retained antigenic properties. The results obtained show that the limited proteolysis is a mechanism of the inhibitor inactivation. It is suggested that under some conditions thiol proteinases, upon their release from the cell, participate in the control of effective alpha 1PI concentration. PMID- 3297191 TI - [Isolation of monoclonal antibodies to horseradish peroxidase and their use in immunohistochemistry and immunoblotting]. AB - Monoclonal anti-peroxidase antibodies (McAb) were generated by means of hybridization of BALB/c immune splenocytes with X-63.653 cells. Peroxidase antiperoxidase (PAP) staining of fibroblast cultures with murine McAb against fibronectin was used for the detection of positive cultures. McAb AP-FC-2B4 were found to be highly efficient in different immunoenzyme tests, e.g., immunochemistry and immunoblotting. PAP method was used for histological diagnosis of invasive human breast cancer. PMID- 3297193 TI - [Influence of captopril on the in vitro and in vivo effects of leu- and met enkephalins]. AB - Captopril (10(-6) g/ml) enhanced and prolonged the inhibitory effect of leu- and met-enkephalins on the contractions of the isolated guinea-pig ileum section induced by electrical stimulation. In mice, the drug (25 mg/kg, subcutaneously) increased the degree and duration of the analgetic effect of enkephalins. It is concluded that the analgetic effect of captopril is related to the influence on the activity of the endogenous antinociceptive system. PMID- 3297195 TI - [Quantitative analysis of the mosaic formation of neurons of the neocortex and hippocampus of the mouse]. AB - Computer analysis of the maps of distribution of intensively labelled neurons (ILN) in the frontal sections of area 6 of the frontal neocortex and area CA 1 of the dorsal hippocamp was performed in 1-day-old mice who received a single injection of 3H-thymidine on the 13th-17th day of embryogenesis (E 13-E 17). It has been revealed that ILN are distributed in rather close, vertically oriented groups. In mice exposed to isotope in E 14-E 16, the average number of ILN in a group was 4.44 +/- 0.25 for area 6 and 4.35 +/- 0.16 for area CA 1. The data available have confirmed an earlier postulated hypothesis on the discrete arrangement of neurogenesis loci in the ventricular zone of the embryonic brain. Additional calculations have allowed to conclude that in E 14-E 16 period the locus of the ventricular neocortex during one mitotic cycle produces 7-9 cells starting the neuronal differentiation, while during the whole period of neurogenesis in the neocortex the column consisting of 84-108 neurons is formed, which is close to the number of neurons in a minicolumn of the neocortex (110 cells). PMID- 3297194 TI - [Contrary action of khingamin on the rejection of a skin allograft and on the level of antibody-producing cells in mice]. AB - The effect of antimalarial drug khingamin preinjection on skin allograft rejection and the level of antibody forming cells (AFC) in Jerne reaction has been investigated. The drug at the doses of 30, 40, 50 mg/kg inhibited skin allograft rejection. The dose of 20 mg/kg proved ineffective. A single preinjection at a dose of 20 mg/kg had a stimulating effect on antibody formation, whereas the dose of 40 mg/kg induced no effect. When the latter dose was injected simultaneously with sheep red blood cells, it caused a significant inhibition of AFC levels. Fourfold preliminary injection of khingamin at doses 40 and 20 mg/kg had a stimulating effect. The reverse effect of khingamin may be accounted for by the diverse action of the drug itself and its metabolites. PMID- 3297196 TI - [Morphofunctional characteristics of the regulatory systems of the large intestine in salmonellosis]. AB - Morphofunctional alterations occurring in the colon wall indicate complex interactions of the morphological structures participating in the regulation of the intestinal function in salmonellosis. In the early period (24 hours) of maximum decrease in the mediator activity in the nerve structures the number of enterochromaffin cells and the granulation index increased, while in the period of maximum tension of nerve elements (7 days) a decrease in the enterochromaffin cells and granulation index was noted. At later periods (21 days) a relative morphofunctional stabilization of the mucous components and the intramural ganglia has been revealed. PMID- 3297197 TI - [Histostereological analysis of the parenchyma and stroma of the atrophied myocardium in alimentary starvation]. AB - The sexually mature Wistar rats were placed in separated cages and totally deprived of food (but allowed water ad libitum) for 2, 4 and 8 days. Tissue stereological analysis of myocardium included the determination of volume and surface densities of cardiomyocytes, volume density of stroma, volume and surface densities of capillaries and interstitial cells, volume-to-volume and surface-to volume ratios of the basic components of parenchyma and stroma. The correlation and information analyses of the stereological parameters were carried out. It was shown that the development of myocardial atrophy (a decrease in heart weight and cardiomyocyte diameter) was accompanied by decreasing the volume density of parenchyma and increasing the volume density of stroma. A decrease in the surface of the exchange between the cardiomyocytes and microcirculatory bed was also revealed in alimentary starvation. PMID- 3297198 TI - The coagulation-kinin pathway of human plasma. PMID- 3297200 TI - Clonal immunoglobulin gene rearrangements in tissues involved by Hodgkin's disease. AB - The nature of Reed-Sternberg cells, the abnormal cells of Hodgkin's disease, is controversial. Morphological and immunologic marker studies suggested different cells of origin. To investigate a possible B or T cell origin, immunoglobulin and T cell receptor gene analyses were performed on tissues from 11 patients in early and late stages of Hodgkin's disease. In addition, the immunologic marker patterns of the Reed-Sternberg cells were determined. Rearrangements of immunoglobulin heavy- and light-chain genes were detected in tissues from five patients, particularly in late stages of the disease when lymphocyte depletion had occurred. No rearrangements of T cell receptor genes were found. The results indicate that clonal immunoglobulin gene rearrangements can be detected in tissues involved by Hodgkin's disease. PMID- 3297199 TI - Second marrow transplants in patients with aplastic anemia rejecting the first graft: use of a conditioning regimen including cyclophosphamide and antithymocyte globulin. AB - Sixteen (11%) of 146 consecutive patients with severe aplastic anemia prepared for engraftment with cyclophosphamide (200 mg/kg) rejected marrow grafts from their HLA-identical siblings. They were given a second marrow transplant from either the same (n = 13) or a second (n = 3) HLA-identical sibling between 23 and 743 (median 86) days after the first transplant. The preparation for the second transplant included cyclophosphamide, 50 mg/kg, on each of four successive days. Twelve hours after each of the first three doses of cyclophosphamide, antithymocyte globulin, 30 mg/kg/dose, was infused. One of the 16 patients died from infection too early after the second transplant to be evaluated, two had failure of engraftment and died with infection, one rejected the second graft and is surviving almost 5 years later with full autologous marrow recovery, and 12 had successful and sustained second grafts. Of these 12, six are surviving between 11 months and 7 3/4 years. Four of the six have no graft-v-host disease (GVHD), while two have chronic GVHD requiring treatment. Five have Karnofsky scores of 100% and one of 90%. Six of the 12 patients with sustained grafts died between 63 days and 38 months after transplantation, four with infections (related in two patients to chronic GVHD), one with acute GVHD, and one with hemorrhage. The average interval from first to second transplant was 308 days during the past five years, compared to 61 days in earlier patients. Five of seven recent patients are surviving, compared to two of nine earlier patients. In conclusion, successful second transplants after cyclophosphamide and antithymocyte globulin are possible in most patients with aplastic anemia who have rejected their first marrow grafts; however, mortality remains high, with only 40% of the patients becoming long-term survivors. PMID- 3297202 TI - Clinical experience with transfusion of leukocyte-poor platelet concentrates prepared by filtration with prostacyclin. AB - Repeated transfusions with platelets from randomly selected donors lead to HLA alloimmunization in about 50% of patients due to lymphocyte contamination of platelet concentrates. Attempts to remove the leukocytes from the platelet concentrates by additional centrifugation steps led to substantial loss of platelets. We report a new procedure for removal of almost all leukocytes with excellent platelet recoveries. Single donor concentrates are treated with 50 ng/mL prostacyclin to inactivate the platelets transiently. The concentrates are then passed through a cellulose-acetate filter to remove the leukocytes. In 30 concentrates this treatment reduced the contamination by leukocytes to less than 0.1 million per concentrate with a platelet recovery of 89% +/- 1% (mean +/- SEM). Thirty filtered platelet concentrates transfused to ten thrombocytopenic patients within one hour after filtration were well tolerated and led to corrected count increments of (22.0 +/- 1.1) X 10(6)/mL blood after one hour and normal survival thereafter. In four of five patients these concentrates reduced the bleeding time. We conclude that transient inactivation of platelets by prostacyclin enables optimal removal of leukocytes and may help to reduce alloimmunization during frequent transfusions with platelet concentrates. PMID- 3297201 TI - S-100 beta positive human T lymphocytes: their characteristics and behavior under normal and pathologic conditions. AB - The characteristics of human S-100 beta-positive T lymphocytes (S-100 beta+ T cells) and their fluctuation in peripheral blood under normal and various pathologic conditions were investigated. S-100 beta+ T cells were small lymphocytes with no particular subcellular structures and showed a proliferative response to mitogens. They were present mainly in peripheral blood under normal conditions but accumulated in T zones of lymph nodes with nonspecific T-zone hyperplasia, where numerous interdigitating reticulum cells existed. In healthy adults approximately 1% to 4% (mean 3.4%) of peripheral blood mononuclear cells were S-100 beta+ T cells. The proportion of S-100 beta+ T cells in peripheral blood tended to significantly decrease (less than 0.5%) in patients with neoplastic diseases; this tendency was apparently related to tumor progression. PMID- 3297203 TI - CFU-GM content of bone marrow graft correlates with time to hematologic reconstitution following autologous bone marrow transplantation with 4 hydroperoxycyclophosphamide-purged bone marrow. AB - Autologous bone marrow transplants (BMTs) can repopulate the hematologic system of patients treated with marrow-ablative chemotherapy and/or radiotherapy. However, treatment of the bone marrow graft to eliminate residual tumor cells prior to reinfusion can delay the return of peripheral blood elements, presumably from damage to or loss of hematopoietic stem cells responsible for hematologic recovery. To develop a model predictive of hematologic recovery, we studied the progenitor cell contents of 4-hydroperoxycyclophosphamide (100 micrograms/mL) purged bone marrow grafts of 40 consecutive patients undergoing autologous BMT at this center. Granulocyte-macrophage colonies (CFU-GM) were grown from all grafts after treatment with this chemotherapeutic agent, but erythroid (BFU-E) and mixed (CFU-GEMM) colonies were grown from only 44% and 33% of the grafts respectively. The recovery of CFU-GM after purging ranged from 0.07% to 23%. The logarithm of CFU-GM content of the treated grafts was linearly correlated with the time to recovery of peripheral blood leukocytes (r = -0.80), neutrophils (r = -0.79), reticulocytes (r = -0.60), and platelets (r = -0.66). The CFU-GM content of purged autologous bone marrow grafts may reflect the hematopoietic stem cell content of the grafts and thus predict the rate of hematologic recovery in patients undergoing autologous BMT. PMID- 3297204 TI - Detection of activated platelets in whole blood using activation-dependent monoclonal antibodies and flow cytometry. AB - Platelets may become activated in a number of clinical disorders and participate in thrombus formation. We developed a direct test for activated platelets in whole blood using flow cytometry. Whole blood was incubated with either biotin PAC1, a monoclonal antibody specific for the fibrinogen receptor on activated platelets, or biotin-S12, an antibody specific for an alpha-granule membrane protein that associates with the platelet surface during secretion. Platelet bound antibodies were detected with streptavidin conjugated with fluorescein isothiocyanate (FITC) or phycoerythrin (PE). Platelets were differentiated from the larger erythrocytes and WBCs by their light-scatter profile. Alternatively, platelets could be identified with FITC-AP1, an antibody specific for platelet membrane glycoprotein Ib, and analyzed further for PAC1 or S12 binding with PE streptavidin. No centrifugation or washing steps were required. With gel-filtered platelets, there was a direct correlation between ADP-induced biotin-PAC1 binding and binding determined in a conventional 125I-PAC1 binding assay (r = .99; P less than .001). Furthermore, as few as 0.8% activated platelets could be detected by flow cytometry when activated platelets were mixed with unstimulated platelets. In whole blood, unstimulated platelets demonstrated no PAC1- or S12-specific fluorescence, indicating that they did not bind these antibodies. On stimulation with agonists, however, the platelets demonstrated a dose-dependent increase in fluorescence similar to that observed for platelets in plasma or buffer. Low concentrations of ADP and epinephrine, which induce fibrinogen receptors but little secretion, stimulated near-maximal PAC1 binding but little S12 binding. On the other hand, a concentration of phorbol myristate acetate (TPA) that evokes full platelet aggregation and secretion induced maximal PAC1 and S12 binding. Activated platelets could also be analyzed in whole blood samples that had been fixed with paraformaldehyde. These studies demonstrate that activated platelets can be reliably detected in whole blood using activation-dependent monoclonal antibodies and flow cytometry. This technique may be useful to assess the degree of platelet activation and the efficacy of antiplatelet therapy in clinical disorders. PMID- 3297205 TI - Marrow transplantation for children with acute lymphoblastic leukemia in second remission. AB - Fifty-seven children between the ages of 3 and 17 years with acute lymphoblastic leukemia (ALL) in chemotherapy-induced second bone marrow remission were given cyclophosphamide, total body irradiation, and bone marrow transplants from HLA matched donors. Sixteen died of transplant-related complications. Eighteen relapsed between 56 and 833 days after transplantation, and 16 died of leukemia. Two survive in remission off treatment following chemotherapy. Twenty-three survive in continuous remission from 1.4 to 10.4 years after transplantation and the actuarial analysis shows disease-free survival of 40% with a plateau extending from 2.5 to 10.4 years. PMID- 3297206 TI - Analysis with antiidiotype antibody of a patient with chronic lymphocytic leukemia and a large cell lymphoma (Richter's syndrome). AB - A murine monoclonal antibody made against an idiotypic determinant (Id) of surface IgM/IgD lambda molecules on chronic lymphocytic leukemia (CLL) cells of a 71-year-old woman was used for clonal analysis by two-color immunofluorescence. The anti-Id antibody identified IgM+/IgD+/lambda+ B cells as the predominant cell type of her CLL clone. In addition, substantial proportions of the IgG and IgA B cells and most of the IgM plasma cells in her bone marrow and blood were Id+. Six years after diagnosis, the patient died of respiratory failure due to infiltration of lungs by malignant cells. Autopsy revealed a dramatic change in the tumor cell morphology. The lungs, hilar nodes, and liver were infiltrated by a diffuse large cell lymphoma admixed with the leukemic cells. By immunohistologic staining these anaplastic lymphoma cells were IgM+/IgD-/lambda+ B cells expressing the same Id noted earlier on the CLL cells. The immunoglobulin gene rearrangement pattern on Southern blot analysis was also the same in leukemic blood cells and in the tissues involved by the lymphoma. Thus, the combination of antiidiotype and immunoglobulin gene analyses in this patient with Richter's syndrome revealed that a CLL clone, seemingly "frozen" in differentiation, was actually undergoing isotype switching, differentiation into plasma cells, and evolution into a rapidly growing and fetal lymphoma. PMID- 3297207 TI - Cytoplasmic factor required for entry of malaria parasites into RBCs. AB - Resealed ghosts of human RBCs, containing diluted cytosol, are susceptible to invasion by Plasmodium falciparum. If ATP is present, a dilution of up to about 30-fold, corresponding to an intracellular hemoglobin concentration of approximately 10 mg/mL, can be tolerated without total loss of susceptibility to invasion. Up to a dilution of about one-half this, the parasites also develop normally. When the cytosol is diluted by more than the critical amount, invasion of the resulting resealed ghosts falls off abruptly. If the diluent buffer is replaced by extraneous concentrated hemolysate, an indefinite dilution is possible without loss of invasion. There is thus an intracellular constituent, which must be present at a concentration above some critical level if the parasite is to enter the cell. The factor in question is not dialyzable. It is largely inactivated when the hemolysate is kept for approximately 1 day in the cold or for approximately 20 minutes at 45 degrees C. The inability of a heat treated hemolysate to support invasion is not due to the generation of inhibitory products, because such a solution can be used as a diluent of a fresh hemolysate without inhibition of invasion. When the inactivated hemolysate is present as a major component, however, the parasites fail to develop to the trophozoite stage. The invasion-linked factor remains in the strongly adsorbed nonheme fraction when a batchwise separation from hemoglobin on an anion exchanger is made and is thus probably acidic in character; the adsorbed fraction, recovered from the ion exchanger, substantially restores capacity for invasion when sealed into ghosts. Its activity is destroyed by treatment with trypsin. The adsorbed fraction contains many proteins. When fractionated on a gel filtration column by fast liquid chromatography, active material eluted at a volume corresponding to a mol wt for a globular protein in the region of 10,000. A component of apparent subunit mol wt of 13,000 was observed in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of this eluate fraction. PMID- 3297208 TI - Immunophenotyping of acute myeloid leukemia using monoclonal antibodies and the alkaline phosphatase-antialkaline phosphatase technique. AB - The leukemic cells from 41 cases of acute myeloid leukemia (AML) and 17 cases of acute lymphocytic leukemia (ALL) were immunophenotyped by the alkaline phosphatase-antialkaline phosphatase (APAAP) immunocytochemical technique utilizing eight monoclonal antibodies (MoAb) reactive with cells of myeloid origin and seven MoAb reactive with lymphoid antigens. Ninety percent of the cases of AML reacted with one or more of the pan-myeloid MoAb, My7, My9, or 20.3. Reactivity of the myeloid panel of MoAb showed some correlation with the French American-British (FAB) classification of AML. Five of six cases of acute promyelocytic leukemia (APL) were HLA-DR negative; the one HLA-DR-positive APL had a minor population of HLA-DR-negative promyelocytes. OKM5 and/or My4 reacted with 16 of 16 monocytic leukemias. No specific marker of early erythroid development was identified. AP3, a MoAb reactive with platelet glycoprotein (GPIIIa), was specific for acute megakaryoblastic leukemia. Immunocytochemistry was also helpful in classifying seven cases of AML with equivocal or negative routine cytochemistry. Two cases of AML had minor populations of blasts detected by the APAAP technique that were immunologically distinct from the major blast population; these minor populations emerged as the predominant cell type at relapse. Two cases of ALL expressed multiple myeloid and lymphoid antigens. Two other cases that morphologically were ALL reacted with only myeloid MoAb; one consisted entirely of immature basophils on ultrastructural examination. Immunophenotyping results using the APAAP technique were comparable with those obtained with flow cytometry. The APAAP technique is a reliable method for immunophenotyping leukemia that complements other methods of immunologic evaluation. The primary advantages of this method include its use with routinely prepared blood and bone marrow smears and the ability to correlate immunocytochemical reactions with morphology. PMID- 3297209 TI - The gene located at chromosome 18 band q21 is rearranged in uncultured diffuse lymphomas as well as follicular lymphomas. AB - The karyotypic abnormality t(14;18)(q32;q21) is reported to occur in 75% of follicular lymphomas. This translocation results in the rearrangement of a putative oncogene bcl-2, which resides at chromosome 18 band q21 (the 18q21 gene). Using two human genomic DNA fragments cloned from the chromosome 18 band q21 as probes, we analyzed 65 uncultured human lymphoma samples by the Southern blot technique. The 18q21 gene was rearranged in 18 of 26 (69%) follicular lymphomas, 3 of 5 (60%) follicular lymphomas transformed to large cell lymphomas, 8 of 20 (40%) diffuse large cell lymphomas (DLCLs), and 2 of 7 (29%) small noncleaved cell lymphomas (SNCs). Our analysis detected rearrangement of the 18q21 gene in 10 of 13 (77%) cases in which the t(14;18)(q32;q21) translocation was found by cytogenetic techniques. Our analysis also proved helpful in difficult karyotyping situations: (a) identifying the donor chromosome fragment as chromosome 18 band q21 in 4 of 9 (44%) cases that cytogenetically displayed a 14q+ chromosome of unknown origin, and (b) identifying a rearrangement of chromosome 18 band q21 in 12 of 18 (67%) cases that cytogenetically yielded no cells in metaphase. We also demonstrated three cases of submicroscopic rearrangement of the 18q21 gene. In our studies, patients with DLCLs and rearrangement of the 18q21 gene had a significantly higher incidence of extranodal involvement when compared with patients with DLCLs and no 18q21 gene rearrangement (P = 0.03). PMID- 3297210 TI - Reduction of nerves containing vasoactive intestinal polypeptide and serotonin, but not neuropeptide Y and catecholamine, in cerebral blood vessels of the 8-week streptozotocin-induced diabetic rat. AB - The perivascular autonomic nerves of the major blood vessels on the ventral surface of the brain were studied in the streptozotocin-induced diabetic rat, an animal model for juvenile onset of diabetes. Histochemical and immunohistochemical techniques were used to determine the pattern and density of perivascular nerves containing catecholamine, 5-hydroxytryptamine (5-HT), vasoactive intestinal polypeptide (VIP) and neuropeptide Y (NPY). A significant reduction in the density and/or fluorescence intensity of 5-HT-immunoreactive nerves was observed in the circle of Willis and its main arterial branches namely: basilar, superior cerebellar, internal carotid, posterior communicating, middle cerebral and anterior cerebral arteries, while a significant reduction of VIP-immunoreactive nerves was observed in the internal carotid, middle cerebral and anterior cerebral arteries, but not in the basilar, superior cerebellar and posterior communicating arteries 8 weeks after the onset of diabetes. However, no changes were observed in the density of NPY- and catecholamine-containing nerves. The results are discussed in relation to autonomic neuropathy of the cerebral blood vessels in diabetes. PMID- 3297211 TI - Antiestrogen action of progesterone in breast tissue. AB - In normal breast, estrogen stimulates growth of the ductal system, while lobular development depends on progesterone. Thus, estrogen and progesterone, when secreted in an adequate balance, permit the complete and proper development of the mammary gland. Progesterone may also have an antagonistic activity against estradiol, mediated through a decrease in the replenishment of the estrogen receptor, and also through increased 17 beta-hydroxysteroid dehydrogenase which leads to accelerated metabolism of estradiol to estrone in the target organ. Thus, it can be inferred that long periods of luteal phase defect leading to an unopposed estrogen effect on the breast might promote breast carcinogenesis. PMID- 3297213 TI - Molecular biology of drug resistance. PMID- 3297214 TI - Aminophylline, respiratory muscle strength and exercise tolerance in chronic obstructive airway disease. AB - Fourteen patients with chronic obstructive airway disease participated in a randomized, double-blind, placebo controlled, cross-over study to assess the effect of acutely administered aminophylline on respiratory muscle strength and exercise tolerance. An increase in the distance walked in 6 min occurred following aminophylline (p less than 0.01). There was no improvement in respiratory muscle strength, assessed by maximal static mouth pressures, and no increase in maximal ventilation or oxygen uptake during a progressive exercise test. The ventilatory response to inhaled CO2 was increased (p less than 0.02), suggesting a central stimulatory effect of aminophylline. The mean increase in walking distance was 5.7%. In most cases, the change was small and unlikely to be of practical benefit. PMID- 3297212 TI - Review: biologic heterogeneity of cancer metastases. PMID- 3297215 TI - Immunohistological localization of immunoglobulins in pneumocystosis of adults. AB - We examined by direct immunofluorescence open lung biopsies from seven adult patients with Pneumocystis carinii pneumonia. In all of them, immunoglobulin deposits (especially IgA) were found in alveoli that exhibited by light microscopy the classical foamy exudate infested by Pneumocystis. These immunoglobulins were eluted at an acid pH and were able to fix complement fractions in vitro. Moreover, we could reproduce this fixation by incubating previously eluted tissue sections with concentrated immunoglobulins isolated from a bronchopulmonary lavage performed in another case of pneumocystis. This immunohistological pattern suggests the presence of a humoral response in pulmonary parenchyma of patients infected with Pneumocystis carinii, despite the consistent underlying immunocompromised status. Considering these results, we conclude that humoral immune mechanisms do not constitute the main barrier against the development of Pneumocystis carinii in human lungs. PMID- 3297216 TI - Positive end-expiratory pressure increases pulmonary clearance of inhaled 99mTc DTPA in nonsmokers but not in healthy smokers. AB - Positive end-expiratory pressure (PEEP) is widely used in the treatment of severe pulmonary oedema, although its effects on the clearance of water and small solutes from alveolus to blood are not well characterized. We studied the effect of the application of 10 cmH2O of PEEP on the flux of inhaled 99mTc-diethylene triamine-penta-acetic acid (DTPA) from lung to blood in six healthy smoking and six nonsmoking subjects. The rate of flux was corrected for possible changes in pulmonary blood volume during PEEP by use of an intravenous injection of 99mTc DTPA. The baseline clearance rate (K, % X min-1) for nonsmokers was 1.48 +/- 0.12 (mean +/- SE) and increased to 2.40 +/- 0.29 during PEEP (p less than 0.05). In contrast, the mean clearance rate for smokers was 3.26 +/- 0.82 at baseline and 3.03 +/- 0.82 during PEEP (p = NS). The application of positive end-expiratory pressure appears to increase alveolar solute flux in nonsmokers but not in smokers, suggesting that the pathway for solute clearance in smokers is governed by different rate-limiting steps to those of nonsmokers. PMID- 3297217 TI - Uptake of purine bases by Trypanosoma cruzi culture epimastigotes. AB - The uptake of adenine, guanine and hypoxanthine by Trypanosoma cruzi culture epimastigotes was studied over short time periods at 22 degrees C. The uptake process is concentrative, driven by the purine phosphoribosyltransferases and saturable at about 10 microM hypoxanthine and 1 microM adenine or guanine. Each purine base is apparently taken up by a separate route and the oxypurines are regulated in parallel. Adenine inhibits oxypurine uptake. When the material was incubated with guanine or hypoxanthine for more than 2 min, a decrease in the nucleotide/free base ratio was observed, indicating inhibition of the guanine and hypoxanthine phosphoribosyltransferases. The uptake rates during the ascending phase of uptake and of culture growth rates were of the order of 50 for hypoxanthine and 20 for guanine, relative to that of adenine. These rates were within the physiological range for cell growth in these cultures. During the phase of descending growth and decreased purine uptake activity rates, uptake was depressed to 20% of the rates required for the growth observed in the cultures. It is proposed that the decline in growth rate leads to an increase of the nucleotide pools in the cells which inhibit uptake. This depression may be a cause of the mitotic blockade which occurs during the stationary phase. PMID- 3297219 TI - Computer-assisted instruction for medicine and nursing: sources and programs. AB - A list of computer-assisted instruction (CAI) vendors and programs was compiled as a resource for medical librarians who are building a nonprint collection. It includes only computer-assisted instruction for clinical education in medicine and nursing. The very brief description of each program is followed by price, audience, and hardware requirements. PMID- 3297218 TI - Is a "low" dose of prednisone better than a "high" dose at the time of renal transplantation? AB - It has been suggested that a low dose of prednisone initially given post transplant, besides producing lower patient morbidity, is as effective as high dose regimens in providing positive graft and satisfactory patient outcome. In 1981 and 1982, we prospectively and randomly studied 77 cadaveric kidney recipients who received a high dose (2.0 mg/kg body weight) (H) and 66 who received a low dose of prednisone (0.5 mg/kg body weight) (L) at the time of transplant. Mean time to the first rejection episode was 9.7 +/- 13.8 and 13.3 +/ 12.9 days in the L and H groups, respectively; 10.6% and 15.6% of the patients in the L and H groups, respectively, never had a rejection episode. Among subjects younger than 45 years, graft and patient survival was better for those treated with the high dose (N = 60, 63.9% vs 32.2%, P = 0.032, and 100% vs 88.4%, P = 0.027, respectively) than for those treated with the low dose (N = 46). Patient and graft response to H and L was similar for patients older than 45. Morbidity was similar for both the L and H groups. PMID- 3297220 TI - Evolution of an end-user training program. AB - The University of Illinois at Chicago Library of the Health Sciences has taught end-user classes on the MEDLARS system since early 1985. Registration, class composition, and, most importantly, class organization evolved continuously during the first year of operation. Several feedback mechanisms were used. An examination of the past training and specialization of participants helped to determine teaching examples and pace; a more varied group of participants necessitated a broader range of examples and increased explanations. Participant evaluation forms and oral comments helped define scheduling, agenda, and the need for additional equipment and practice time. Further evaluation will center on the searching done by the program's alumni. PMID- 3297221 TI - Automating Veterans Administration libraries: I. National planning and development. AB - The Veterans Administration Library Network (VALNET) needed an automated library system that could interface with the agency's national automation activities. The Library Special Interest Users Group was established to oversee the selection of appropriate automated systems. The Massachusetts General Hospital Utility Multi Programming System (MUMPS) computer language and VA FILEMAN, a database management system, are being used to create new library software, which will be in the public domain. PMID- 3297222 TI - BiblioAerobics: group exercises for health sciences library meetings. PMID- 3297223 TI - Medical Subject Headings and medical terminology: an analysis of terminology used in hospital charts. AB - Terminology used by health professionals in everyday written discourse was compared with terminology in a standardized medical vocabulary, the Medical Subject Headings (MeSH). Fifty written hospital charts were selected at random and analyzed by a computer program that identified MeSH terms in the charts. The charts were analyzed against two related MeSH vocabularies--one containing MeSH terms and one containing both MeSH terms and backwards cross-reference terms. When small words such as articles and prepositions were disregarded, approximately 50% of the words in a medical chart were found to be MeSH-related terminology. In addition, about 40% of MeSH-related words in the charts were either MeSH terms or backwards cross-reference terms. PMID- 3297224 TI - Male infertility. AB - Male infertility can affect up to one in ten couples attempting a pregnancy. Careful history taking and thorough physical examination, supplemented by laboratory and clinical measurements, are important in reaching an accurate diagnosis of this increasingly complex subject. Available treatment options are outlined for a range of clinical conditions and their anticipated success rates are discussed. PMID- 3297225 TI - Inflammatory abdominal aortic aneurysms. AB - Inflammatory abdominal aortic aneurysms account for 10% of all abdominal aortic aneurysms. They are characterized at operation by their thick fibrotic walls which adhere to adjacent structures; this may present major technical difficulties requiring a modified surgical approach. Because they respond to treatment with corticosteroids, their management is controversial. PMID- 3297226 TI - The development of plastic surgery in the West Midlands Region. PMID- 3297227 TI - Recovery of prostacyclin synthesis by rabbit aortic endothelium and other tissues after inhibition by aspirin. AB - The effect of aspirin on prostacyclin (PGI2) and thromboxane B2 (TXB2) synthesis was studied in rabbits. Tissues were removed from animals killed at intervals after injection of aspirin, and incubated with Hanks' solution. PGI2 synthesis was monitored by radioimmunoassay of its hydrolysis product, 6-oxo-prostaglandin F1 alpha (6-oxo-PGF1 alpha). TXB2 production in clotted blood, also measured by radioimmunoassay, was determined as an index of platelet cyclo-oxygenase activity. 6-oxo-PGF1 alpha and TXB2 production 0.5 h after aspirin were similarly inhibited to less than 5% of control in all incubations. Subsequent recovery of PGI2 synthesis occurred more rapidly in aortic endothelium than in other tissues, including aorta denuded of endothelium. Recovery of TXB2 production was slower than that of PGI2. Intravenous cycloheximide prevented the partial recovery of PGI2 synthesis that otherwise occurred 6 h after aspirin, while intravenous epidermal growth factor increased recovery. It is concluded that in the rabbit, cyclo-oxygenase is synthesized more rapidly in aortic endothelium than in deep layers of aorta, or in the other tissues studied. PMID- 3297229 TI - Trials and tribulations in prostatic cancer. PMID- 3297228 TI - Effect of omeprazole on eicosanoid formation in and release from guinea-pig gastric mucosal cells. AB - Guinea-pig gastric mucosal cells isolated by collagenase and pronase digestion were used to study the release of prostanoids prostaglandin I2 (PGI2; measured as 6-keto PGF1 alpha), PGE2, PGF2 alpha and thromboxane A2 (TXA2; measured as TXB2). Lysophosphatide acyltransferase (LAT) and phospholipase A2 (PLA2) were measured in the microsomal fraction of isolated but not separated gastric cells and isolated and enriched parietal and mucous cells. In all cell preparations PLA2 activity was approximately 5 times higher than that of LAT. Acid-activated omeprazole inhibited LAT in a concentration-dependent manner with similar IC50 values in gastric, parietal and mucous cells. It had no effect on PLA2. Gastric cells constantly produced PGI2, PGE2, PGF2 alpha and TXA2. The main prostaglandins released were PGI2 and PGE2. PGF2 alpha and TXA2 were released in smaller quantities. Omeprazole dissolved in polyethylene glycol 400 (PEG) pH 2 inhibited spontaneous PGI2 release in a concentration-dependent manner with an IC50 of 14.3 +/- 4.8 microM. Only concentrations as high as 100 microM produced a significant reduction in PGE2 release by 60%. No significant changes could be detected in the spontaneous release of PGF2 alpha and TXA2. Omeprazole dissolved in PEG pH 7 had no effect on PGI2 release except at 100 microM which led to an insignificant decrease by 40%. These data suggest that omeprazole beyond its inhibitory effect on parietal cell K+/H+-ATPase also affects gastric mucosal prostanoid formation and release. The inhibitory effect on PGI2 does not support the view that omeprazole protects the gastric mucosa by increasing prostanoid formation. PMID- 3297230 TI - Intravenous indomethacin and oxycone-papaverine in the treatment of acute renal colic. A double-blind study. AB - In a prospective double-blind, cross-over study, 61 patients with acute renal colic were treated with either indomethacin (50 mg) or oxycone-papaverine (5 mg + 50 mg) administered intravenously. For those patients requiring a second injection the drugs were reversed. The intensity of pain was evaluated before and 20 min after each injection according to an analogue visual scale 0 to 100. Both drug regimens provided comparable and significant pain relief; a pain score of less than 20 appeared to be satisfactory and was achieved in almost all cases. PMID- 3297231 TI - Liver transplantation: a subtle revolution. PMID- 3297232 TI - Splenic trauma and overwhelming postsplenectomy infection. PMID- 3297234 TI - Congenital heart defects in small animals. PMID- 3297233 TI - Influence of sialomucin at the resection margin on local tumour recurrence and survival of patients with colorectal cancer: a multivariate analysis. AB - In a multicentre prospective trial 358 patients undergoing curative surgery for colorectal cancer were followed for a median 18.0 months (+/- 7.2 months). The presence or absence of sialomucin in either resection margin was studied using the high iron diamine-alcian blue stain. There was evidence of excess sialomucin at one or other resection margin in 106 patients (29.6 per cent). Apart from sigmoid carcinomas occurring more often in the sialomucin positive group, there were no significant differences in any histological or clinical parameters between groups. Survival analysis for the events 'death', 'local recurrence', and 'all recurrence' was undertaken using the Cox regression model. The best prognostic variables selected in a stepwise fashion for death and all recurrence were 'Dukes' classification', 'sialomucin present' and 'histological differentiation'. The best prognostic variables selected for local recurrence were 'sialomucin present', 'Dukes' classification' and 'histological differentiation'. Sialomucin in a resection margin is an important independent prognostic variable for the development of local tumour recurrence and of subsequent survival for patients with colorectal carcinoma. PMID- 3297235 TI - Isolation of Mycoplasma mycoides from outbreaks of caprine mycoplasmosis in Brazil. PMID- 3297236 TI - Distribution of antibody in different immunoglobulin classes in experimental Streptococcus agalactiae infection of the bovine udder. PMID- 3297237 TI - Pathophysiological effects of endotoxin infusion in young pigs. PMID- 3297238 TI - The effects of temperature and humidity on some animal diseases--a review. PMID- 3297239 TI - Endurance exercise in the horse--a review. Part I. PMID- 3297240 TI - Endurance exercise in the horse--a review. Part II. PMID- 3297241 TI - Veterinary work with non-domesticated pets. IV. Lower vertebrates. PMID- 3297242 TI - Treatment and control of cystic ovarian disease in dairy cattle: a review. PMID- 3297244 TI - Sonographic detection and three-dimensional localization of a metallic foreign body in soft-tissues in a dog. PMID- 3297243 TI - Escherichia coli serotypes in domestic fowl of Punjab. PMID- 3297245 TI - Immunocytochemical localization and immunological characterization of vitamin D dependent calcium-binding protein in the bullfrog cerebellum. AB - Antiserum prepared against rat renal calcium-binding protein (CaBP) was used with the unlabeled antibody peroxidase-antiperoxidase (PAP) technique to localize the 28,000 molecular weight CaBP in the cerebellum of the bullfrog, Rana catesbeiana. Whole brains of premetamorphic tadpoles and adults were fixed in Bouin's solution for 2 or 24 h and embedded in paraffin. 8-microns parasagittal sections were prepared and treated by the PAP method. Purkinje cells of the cerebellum in tadpoles and adults were specifically stained for CaBP. In the premetamorphic corpus cerebelli, the stained Purkinje cells corresponded to the precociously developed Purkinje cells described previously. In the auricular lobe region of the cerebellum mature Purkinje cells were stained. In addition, smaller stained cells were seen. The latter were presumed to be immature Purkinje cells that would mature at the time of metamorphosis. Immunoblot procedure demonstrated cross-reactivity for the ranid brains in the 28,000 molecular weight region. This immunoreactive band comigrated with the immunoreactive band observed with purified rat renal CaBP. Although the exact functional significance of CaBP is unknown at this time, our immunocytochemical and immunological findings indicate that CaBP is an excellent marker for studies of Purkinje cell maturation. PMID- 3297246 TI - The Golgi apparatus-complex of neurons and astrocytes studied with an anti organelle antibody. AB - An antiserum reacting with a 135-kDa antigen of rat liver Golgi apparatus-complex was used to stain, by light microscopic and ultrastructural immunocytochemistry, sections of rat cerebellum and by immunoblot homogenates of whole brain, isolated neurons and a fraction of enriched neuronal Golgi apparatus. In sections of rat cerebellum fixed with periodate-lysine-paraformaldehyde and immunostained with the direct peroxidase or peroxidase-antiperoxidase methods, the Golgi apparatus complex in perikarya of neurons and glia was stained. Occasionally, nuclear envelopes and cisternae of the rough endoplasmic reticulum of neurons and glia were stained. Immunostain was not observed in peripheral dendrites, axons and presynaptic terminals. In striking contrast, peripheral smooth cisternae of astrocytic perikarya and processes were stained. Immunoblots of whole-brain membrane fractions, homogenates of isolated neurons and an enriched neuronal fraction of the Golgi apparatus-complex showed a principal single band of 64-kDa apparent mol. wt. We have concluded that the putative 64-kDa antigen(s) is distributed in cisternae of the Golgi apparatus-complex and occasionally in the nuclear envelope and rough reticulum, within the perikarya of neurons and glia. A second important distribution of the 64-kDa antigen(s), involving peripheral cisternae in perikarya and processes of astrocytes, is consistent with the hypothesis that the Golgi apparatus-complex of these cells extends to the periphery of these cells. The functional implications of the peripheral localization of the 64-kDa antigen(s) in astrocytes are discussed. PMID- 3297247 TI - Convergence onto hamster medullary taste neurons. AB - Research has shown that gustatory afferents innervating different areas of the oral cavity converge onto single neurons in the nucleus tractus solitarii (NTS). However, most studies of gustatory physiology have only stimulated the receptors on the anterior tongue. No information exists on the responses of hamster NTS neurons to stimulation of receptors located in other areas of the oral cavity. The present investigation compared responses of hamster NTS neurons to stimulation of receptors on the anterior tongue and posterior oral cavity, and to stimulation of both receptor populations together. Of the neurons, 64% responded to both anterior tongue and posterior oral cavity stimulation. The remaining neurons responded exclusively to stimulation of one area. Cells responsive to both fields of stimulation were found throughout the rostral NTS. Cells responding to stimulation of only one field were anatomically separate. Most neurons (69%) were more responsive to anterior tongue than posterior oral cavity stimulation. The neural responses to stimulation of both fields simultaneously were complex. Frequently, a cell's response was intermediate between those produced by stimulation of either receptor population alone. In other cases the response was the same as the larger of the two individual responses. The breadth of responsiveness to the 4 basic taste stimuli (sucrose, NaCl, HCl and quinine HCl) was similar for both receptor populations, but the breadth of tuning of an individual cell for one field of stimulation was not correlated with its breadth of responsiveness for the other. In contrast, the breadth of tuning following stimulation of the entire oral cavity was correlated with that following stimulation of the anterior tongue. PMID- 3297248 TI - Monoclonal antibodies (2C5 and 4C9) against lactoseries carbohydrates identify subsets of olfactory and vomeronasal receptor cells and their axons in the rabbit. AB - Monoclonal antibodies (MAbs) against lactoseries carbohydrates were used to study immunohistochemically the olfactory and vomeronasal receptor cells and their axons in the rabbit. MAb 2C5, which recognizes Gal alpha 1----3Gal beta 1--- 4G1cNAc----R structure, selectively labeled a subset of olfactory receptor cells and the majority of vomeronasal receptor cells. MAb 4C9, which reacts with fucosyl poly-N-acetyllactosamine, identified a subset of vomeronasal receptor cells. The above two MAbs also labeled the axons of these chemosensory receptor cells and thus revealed their axonal projection sites in the main and accessory olfactory bulbs. PMID- 3297249 TI - Afferent and efferent enkephalinergic systems of the tegmental nuclei of Gudden in the rat: an immunocytochemical study. AB - We studied the afferent source of L-enkephalin-like immunoreactive (L-ENKLI) fibers in the ventral tegmental nucleus (VT) of Gudden, and efferent and afferent connections of L-ENKLI structures in the dorsal part of the dorsal tegmental nucleus (DDT) of Gudden in the rat, using immunocytochemistry combined with knife cut and lesion experiments. The VT had a dense plexus of L-ENKLI fibers but no L ENKLI cells. Destruction of the dorsal premammillary nucleus and medial mammillary nucleus pars medialis, which contained a large group of L-ENKLI neurons, markedly reduced L-ENKLI fibers in the ipsilateral VT, suggesting that most of these fibers originate in these nuclei. The DDT contained a large collection of L-ENKLI neurons together with dense L-ENKLI fibers. Destruction of the DDT caused a contralateral marked reduction of L-ENKLI fibers in the dorsolateral part of the interpeduncular nucleus (DL), suggesting that L-ENKLI neurons in the DDT project contralaterally to the DL. L-ENKLI fibers in the DDT may be of intrinsic origin. PMID- 3297250 TI - Survey of neuropeptide-like immunoreactivity in the lamprey spinal cord. AB - The distribution of neural elements immunoreactive to several peptides with a possible messenger role was studied in the lamprey spinal cord by using an indirect immunofluorescence method. Different patterns of immunoreactive (IR) fibers were detected by antisera raised against cholecystokinin, metorphamide, bombesin, galanin, corticotropin-releasing factor, somatostatin, peptide YY, neurotensin, calcitonin and FMRFamide. Somatostatin-IR cell bodies were located around the central canal. All immunoreactivity could be abolished by preabsorption with the corresponding peptide. The results suggest that the lamprey spinal cord has several fiber systems containing peptides sharing immunogenic properties with mammalian neuropeptides. PMID- 3297252 TI - The effect of axotomy and denervation on calmodulin content in the superior cervical sympathetic ganglion of the rat. AB - Calmodulin (CaM) in the superior cervical sympathetic ganglion (SCG) of the rat and its changes after transection of the pre- or postganglionic nerves were studied biochemically and immunohistochemically. The concentration of CaM in the SCG was assayed using the extent of activation of CaM-dependent adenylate cyclase from bovine neural retina. In the SCG, CaM concentration was 4.5 micrograms/mg protein, a level similar to that in another peripheral ganglion, the nodose ganglion (4.9 micrograms/mg protein). Following denervation of the SCG, the total amount of ganglionic CaM did not change significantly within a week. On the other hand, CaM content per ganglion increased gradually 3 days after axotomy. Immunohistochemical examination revealed that CaM in unoperated SCG is present both in the neuronal fibers and in the cell soma of sympathetic neurons. But the intensity of the staining with CaM-antibody in the cytoplasmic soma varied among cells. The gross profile of the CaM immunostaining seemed to be unchanged one week after either denervation or axotomy, but the immunoelectron microscopic study showed heavy staining of the innercellular membranes of irregular shape in the axotomized SCG. PMID- 3297251 TI - Demonstration of histaminergic neurons in horizontal cells of guinea pig retina. AB - The existence of L-histidine decarboxylase (HDC, EC 4.1.1.22)-like immunoreactive (HDC-I) cells in guinea pig retina was demonstrated using antiserum raised against HDC purified from fetal rat liver. The anti-HDC antiserum partially cross reacted guinea pig L-DOPA decarboxylase (DDC, EC 4.1.1.28), so the histaminergic neurons were carefully identified. Comparison of HDC-I and DDC-like immunoreactive (DDC-I) cell types in adjacent sections revealed that HDC-I structures were found in some horizontal cells and amacrine cells, and double staining procedures with anti-HDC antiserum and monoclonal anti-DDC antibody showed that HDC-I horizontal cells had no DDC-I structures, but all the HDC-I amacrine cells had DDC-I structures. From the results, some horizontal cells (with HDC-like immunoreactivities but without DDC-like immunoreactivities) were concluded to be histaminergic. PMID- 3297253 TI - A group of related surface glycoproteins distinguish sets and subsets of sensory afferents in the leech nervous system. AB - The distribution of 4 surface glycoproteins on axons of peripheral neurons was studied in the leech Hirudo medicinalis through monoclonal antibodies. All 4 glycoproteins have a similar molecular weight of 130 kDa. Immunohistochemical localization of these glycoproteins on tissue sections of nerves and neuropil reveals tracts of afferent axons organized as nested sets. Their distribution suggests a possible role for these molecules in mediating axon fasciculation. PMID- 3297254 TI - Reversible serotoninergic neurotoxicity of N-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) in mouse striatum studied by neurochemical and immunohistochemical approaches. AB - Effects of N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) on serotonin (5 HT) were studied in mouse striatum. The 5-HT level was significantly reduced at 1 week after MPTP, though returned at 4 weeks. The level of 5-hydroxyindoleacetic acid (5-HIAA) increased at both 1 and 4 weeks. The ratio of increase in 5-HT induced by pargyline administration was larger in MPTP-pretreated mice than in vehicle-pretreated controls at 1 week, although it was identical in both groups at 4 weeks. The 5-HT immunohistochemical study confirmed the biochemical change of 5-HT. These results suggest that MPTP functionally affects the 5-HT metabolism in mouse striatum. PMID- 3297255 TI - Intracerebroventricular dopamine attenuates sodium-induced but not angiotensin induced drinking in minipigs. AB - Drinking in response to dopamine (100 micrograms) injected into the lateral cerebral ventricles (i.c.v.), alone, or together with angiotensin II (AII, 300 ng) or hypertonic NaCl (1.4 Osm) was studied in water-replete minipigs trained to obtain their water under operant conditions. Dopamine itself was ineffective at producing drinking and it did not affect AII-induced drinking. Drinking in response to hypertonic NaCl was significantly attenuated by dopamine. Therefore in minipigs angiotensin-induced drinking does not appear to operate through a dopaminergic mechanism whereas sodium-induced drinking does. PMID- 3297256 TI - Glial filament protein expression in astroglia in the mouse visual pathway. AB - We have studied the onset of expression of glial filament protein (GFP) in astrocytes along a single axon trajectory, the mouse retinal axon pathway, and the relationship of GFP expression to maturation of astroglial morphology. In fetal optic nerve from embryonic day (E) 12 to E16, primitive glia (neuroepithelial cells) lack GFP, but express vimentin and contain intermediate filaments. GFP is expressed at E17 in two gradients: cells in the optic nerve become GFP-positive first in the borders of the nerve, then in the central nerve by postnatal day (P)0. The second gradient is a distoproximal one, with GFP appearing in the optic nerve at E17, in the optic chiasm by PO, and in the optic tract by P3. The expression of GFP in the optic nerve marks the transformation of radial neuroepithelial cells to multipolar astroglia, accomplished by outgrowth of filament-rich glial processes tipped by a growth cone. Several days after the onset of GFP expression in each portion of the pathway astrocytes exhibit a transient increase in staining, and resemble reactive astrocytes after injury. During this period, filaments are arranged in densely packed bundles, and appear coalesced at points. Thus, primitive glial cells in optic nerve express vimentin. In the retinofugal pathway, GFP is expressed in a distinct spatiotemporal sequence from optic nerve to optic tract. Finally, in contrast to neurons, the extension of astroglial processes is accompanied by the increased expression and assembly of intermediate filaments. PMID- 3297259 TI - The other Abraham: Flexner in Illinois. PMID- 3297258 TI - Distribution of immunoreactive glia maturation factor-like molecule in organs and tissues. AB - Using the monoclonal antibody G2-09 raised against bovine glia maturation factor (GMF), we screened various rat organs and tissues for GMF-like immunoreactivity. In the adult animal, with the exception of the heart, GMF was found exclusively in the nervous system, with the cerebellum exhibiting higher specific activity than other brain regions. The nature of the immunoactivity in the heart is presently unclear. None of the body fluids collected from humans, including serum and cerebrospinal fluid, possessed detectable GMF immunoactivity. A phylogenetic comparison revealed the presence of GMF in the brain of al vertebrates studied, from fish to primates. GMF was absent from bacteria and yeast. An ontogenetic study on rats showed the highest GMF level in the fetal brain, with a gradual but steady decrease after birth. However, a substantial amount of GMF persisted even in older animals. GMF was localized in astrocytes and Bergmann glia in the rat brain, using immunostaining at the light microscopic level. PMID- 3297257 TI - Endogenous immunoreactive glia maturation factor-like molecule in astrocytes and glioma cells. AB - Using the monoclonal antibody G2-09 raised against bovine glia maturation factor (GMF), we conducted a survey of GMF-like immunoreactivity in various cell types. Of all the normal and neoplastic cells tested, only extracts from astroblasts, gliomas, Schwann cells and schwannomas, but not their conditioned media, possessed endogenous GMF-like immunoreactivity. The presence of immunoreactive GMF correlated well with GMF bioactivity. Using the same monoclonal antibody, the GMF-like factor in astroblasts and C6 glioma cells was characterized by immunofluorescence, immunoadsorption and immunoblotting. Immunofluorescence confirmed the intracellular location of GMF. Immunoadsorption completely eliminated the GMF-like bioactivity from the cell extracts. Immunoblotting identified a protein band having a mol. wt. of 14,000 Da. Thus, the evidence strongly supports the argument that the GMF-like factor in astroblasts and C6 cells is identical with GMF from the bovine brain. In order to explain the fact that astroblasts and C6 cells are both the source and targets of GMF, we propose the hypothesis that GMF functions as an injury signal, being released from the injured glia and serving as a stimulant for gliosis in the neighboring intact glia. PMID- 3297260 TI - The Emmet F. Pearson Collection of Disinfected Mail. PMID- 3297262 TI - Modern surgery and the development of group practice in the Midwest. PMID- 3297261 TI - Microscopy and the Army Medical Museum. PMID- 3297263 TI - Medical history in the making: Marshfield Clinic's commitment to rural medical care. PMID- 3297264 TI - Portrayal of pathological symptoms in pre-Columbian Mexico. PMID- 3297266 TI - Reversible myocardial dysfunction following carbon monoxide poisoning. AB - A 22-year-old male had accidental carbon monoxide poisoning from a malfunctioning gas refrigerator, and aspiration pneumonia. Initial severe biventricular global dysfunction and hemodynamic instability was demonstrated and was at least partially due to carbon monoxide toxicity. The myocardial dysfunction normalized and the patient recovered. PMID- 3297265 TI - Comparison of propafenone and disopyramide in the treatment of ventricular premature complexes: a randomized double blind crossover placebo controlled trial. AB - To determine the efficacy of the newer antiarrhythmic drug propafenone and to compare it to disopyramide, sixteen patients--11 men and 5 women--participated in a randomized double-blind crossover placebo-controlled trial using 150 mg quid of propafenone or disopyramide. Twenty-four hour ECG's were performed at the end of the placebo period and each 2 weeks of drug therapy. Droupouts (2) because of adverse effects were not included in analysis. On placebo there were 485 +/- 535 (mean +/- SD) ventricular premature complexes (VPC's)/hour. Propafenone significantly (p = 0.010) reduced VPC's to a slightly smaller amount 182 +/- 298/hour. There was no significant difference between propafenone and disopyramide in suppressing VPC's, however, analysis of the circadian rhythm of VPC's showed a greater reduction in VPC's from 1600 to 2400 hour after propafenone compared to disopyramide using this dose regimen. Using a criterion of efficacy of greater than 80% reduction in VPC's, 8/14 patients had a good suppression with propafenone, 3 patients responded only to propafenone, 4 patients only to disopyramide, 5 patients to both and 2 patients to neither. Using a criterion of efficacy of greater than 65% reduction in VPC's 11/14 patients had good suppression with propafenone or disopyramide, 3 patients responded only to propafenone and 4 patients only to disopyramide. Side effects were more common with disopyramide. Two patients dropped out after disopyramide because of gastrointestinal symptoms. Side effects were found in 11/14 remaining patients on disopyramide, but in 6/14 on propafenone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297267 TI - Ultrasonography of pathologically proved choroidal melanoma with a high resolution small-parts scanner. AB - Between March 1983 and March 1985, 13 patients with choroidal melanoma underwent ultrasonography with a high-resolution small-parts scanner. The patients subsequently underwent enucleation, and the specimens were examined histopathologically. We reviewed the ultrasonograms for the presence of choroidal excavation, rupture through Bruch's membrane, retro-orbital fat shadowing, acoustic texture and retinal detachment. Comparison with the histopathological results showed that when conventional diagnostic criteria were used, most cases of rupture through Bruch's membrane were missed owing to the limits of resolution. No patients with homogeneous acoustic texture had pathological evidence of tumour necrosis or hemorrhage, while most of those with inhomogeneous texture did. The results suggest that high-resolution small-parts scanning may lead to reassessment of the conventional criteria for the diagnosis of intraocular melanomas. PMID- 3297268 TI - Mycobacterium chelonei keratitis following penetrating keratoplasty. AB - Atypical mycobacteria are responsible for an increasing number of skin and soft tissue infections. We present a case of Mycobacterium chelonei keratitis that developed 3 months after penetrating keratoplasty. Our case illustrates how early diagnosis of M. chelonei keratitis and aggressive therapy with appropriate antibiotics can lead to a complete cure, with excellent functional results. PMID- 3297269 TI - Quantum thermodynamics approach to phosphorylation and heterotrophic growth yields. AB - A model of cell growth is presented which is based on the double postulates of quantized loss of energy during phosphorylation and reversible biosynthesis of cell structure. An immediate consequence of the postulates is the identical value for the energy efficiency of the phosphorylation and for that of the whole growth process. Another consequence is the relationship between the energy level of the biomass and the phosphorylation potential as embodied in the equation: EO = gamma'M X EATP, where EO is the heat of transfer of a pair of electrons to oxygen, EATP, the molar heat of hydrolysis of ATP, and gamma'M, the degree of reduction of the biomass, gamma M being constant and equal to 5. The model predicts five levels of growth yields corresponding to five permissible values for the P/O ratio (r = 0, 1, 2, 3, and 4). Any growth process would be characterized by a set of two integers N and lambda; N is the maximal P/O ratio prescribed by the energy content of the substrate as compared with that of the biomass, and lambda the number of further downward quantum jumps of the P/O ratio resulting from the adversity of the growth condition (N - lambda = r). Under full aerobiosis, one has 0 less than or equal to lambda less than or equal to N less than or equal to 3. When growth is limited only by the energy content of the substrate (lambda = 0), the time-independent dispersion of N, owing to substrate level phosphorylations and (or) dephosphorylations, leads to effective values which are higher than the nominal ones for the yield per mole of oxygen and the heat of transfer of a pair of electrons. Under adverse conditions (lambda greater than 0), the apparent variations of the yields and the P/O ratio in function of the growth rate are shown to be an effect of the random dispersion of lambda and of the existence of a maximal rate of substrate consumption. Statistical evidence for the macroscopic quantum effect in heterotrophic growth is presented. PMID- 3297270 TI - Urease activity related to the growth and differentiation of swarmer cells of Proteus mirabilis. AB - Urease activity was measured using whole cells of both long (swarming) and short (nonswarming) populations of Proteus mirabilis from casein hydrolysate agar (CHA) and broth (CHB) cultures, and from brain heart infusion broth (BHIB) cultures. Urease is a constitutive enzyme for both long and short cells, but its activity was tremendously increased when urea was incorporated into the media. Urease production was also affected by culture age and media used. Before exponential phase, urease activity was very low, and it increased to its highest point after about 4 h in BHIB and 8 h in both CHA and CHB cultures at 37 degrees C. Long cells had higher urease activity than did short cells when grown on CHA, and was also expressed by two different strains cultured in BHIB. Strain PM23, in BHIB, was able to form long cells (swarming cells) to a maximum proportion after about 4 h, but strain IM47 could not differentiate in any of the liquid media. The former had more urease when swarming differentiation was initiated. PM23 grew relatively faster than IM47 when the former began to differentiate, but this fast growth could not be observed when nutrient broth or minimal medium was used. These observations suggest that long or swarming cells are "faster growing" rather than "nongrowing bacteria". PMID- 3297271 TI - Cell surface specific immunoglobulin inhibits alpha factor mediated morphogenesis in Saccharomyces cerevisiae. AB - Immunoglobulins raised from Saccharomyces cerevisiae a and alpha mating type cell envelope preparations inhibited alpha factor mediated morphogenesis of the a cell without inhibiting normal cell division. The Ig responsible for this inhibition was absorbed to both a and alpha whole cells and heat-killed cells, indicating that the immunoglobulin binding sites were exposed on the cell surface and not mating type specific. Additionally, alpha factor mediated cell cycle arrest was not affected by the immunoglobulin preparations, implying that the immunoglobulin was not preventing alpha factor from binding to its receptor. PMID- 3297272 TI - Infectious diseases in day-care centres: minimizing the risk. PMID- 3297273 TI - Neonatal outcome of fetuses with urinary tract abnormalities diagnosed by prenatal ultrasonography. AB - Between 1979 and 1986 an abnormality of the urinary tract was diagnosed by prenatal ultrasound examination in 93 fetuses. Postnatal investigation at a large teaching hospital showed a definite abnormality in 85 infants, 66 of whom were boys. An obstructed urinary tract, usually requiring surgery, was present in 46 infants. Other abnormalities included a multicystic kidney (in 15 infants), vesicoureteric reflux (in 9), prune-belly syndrome (in 5) and polycystic kidneys (in 5). Early recognition and treatment of urinary tract disorders in infants should be accompanied by informed prenatal counselling to minimize parents' anxiety. PMID- 3297275 TI - Occasional comment. Some immunological considerations in spontaneous and recurrent abortion. PMID- 3297274 TI - Severe falciparum malaria. PMID- 3297276 TI - Planned change: putting theory into practice. PMID- 3297277 TI - Research. PMID- 3297278 TI - The effect of intensive intermittent maintenance therapy in advanced low-grade non-Hodgkin's lymphoma. AB - One hundred and eleven patients with low-grade histology non-Hodgkin's lymphoma achieving a restaged complete response to one of three induction therapies on Eastern Cooperative Oncology Group (ECOG) protocol EST 2474 were randomized to receive either maintenance treatment with BCNU, cyclophosphamide, vincristine, and prednisone (BCVP) given every 6 weeks for an additional 18 months or no further therapy. Overall toxicity was moderate. The median progression-free survival (PFS) on maintenance therapy was 3.2 years versus 2.0 years for those observed without treatment (P = 0.02). Progression-free survival was significantly shorter for patients with nodular and diffuse pattern (ND), histiocytic or mixed histology compared with pure nodular lymphocytic, or poorly differentiated counterpart (P = 0.0007), thus confirming the prognostic significance of histologic subtypes. However, the overall survival of patients was not improved by maintenance treatment, suggesting that therapy upon relapse was an equally effective alternative clinical strategy. PMID- 3297279 TI - Malignant struma ovarii treated by ovariectomy, thyroidectomy, and 131I administration. AB - A 36-year-old woman presented with an intraperitoneally disseminated malignant struma ovarii, diagnosed by histopathology and 131I scintigraphy. The serum thyroglobulin level was elevated, and immunoperoxidase staining for thyroglobulin was positive for disease both in the tumor cells lining the follicles and in the colloid. The patient was treated successfully by a bilateral ovariectomy followed by a total thyroidectomy and administration of radioactive iodine. The clinical behavior and the presence of thyroglobulin in both serum and tumor tissue demonstrate the similarity between neoplastic thyroid tissue in the ovary and in the thyroid gland. PMID- 3297280 TI - A study of the histopathogenesis of carcinoid tumors of the small intestine and appendix. AB - A specimen from the small intestine with multiple (three) classic carcinoid tumors and one appendiceal carcinoid tumor displaying argentaffinity, argyrophilia (Grimelius stain), and serotonin and neuron specific enolase immunoreactivity was examined by light microscopy with regard to the tumor cell histopathogenesis. The smallest tumor (diameter 0.5 cm) from the small intestine was cut into 512 and the appendiceal tumor into 511 serial sections, which were stained with the argyrophil technique. In the small intestine an increased number of endocrine cells and small proliferating aggregates of endocrine cells were observed among nonendocrine enterocytes in the crypts of Lieberkuhn. They seemed to grow initially inside the crypts and to later infiltrate through the basement membrane into the lamina propria of the mucosa. This finding suggests that classic carcinoid tumors of the small intestine develop from mucosal endocrine (enterochromaffin) cells. Since proliferating argentaffin cells were also seen in the mucosal crypts in one of the other two carcinoid tumors (2 cm in diameter) in the same intestine specimen, it is suggested that when multiple carcinoid tumors occur in the small intestine they arise from multiple sites. There was no apparent connection between the mucosal crypts and the carcinoid tumor of the appendix. Thus in this particular case, the appendiceal carcinoid tumor did not appear to derive from the mucosal endocrine cells but from the subepithelial endocrine cells that are present in the lamina propria and submucosa of the appendix wall. Supporting this view is the fact that S-100 protein immunoreactive cells are found both in close relation to subepithelial endocrine cells and as an integral component of appendiceal carcinoid tumors. PMID- 3297281 TI - Squamous cell carcinoma of the tongue in children. AB - Only 14 case reports of squamous cell carcinoma of the tongue in children under 15 years of age had been published until 1980. One was reported in Finland as a second tumor in a patient with retinoblastoma. According to the Finnish Cancer Registry, which covers the whole population, three cases of squamous cell carcinoma of the tongue in children under 15 years of age have been diagnosed in Finland during the 20 years from 1961 to 1980; the age-adjusted annual incidence rate being 0.13 per 1,000,000 children per year. According to the available material, the prognosis of squamous cell carcinoma of the tongue in children is poor. The treatment has followed the guidelines for adults. PMID- 3297282 TI - Imipenem/cilastatin therapy of infections in cancer patients. AB - Imipenem/cilastatin was administered during 153 febrile episodes occurring in cancer patients and the response rate was 68%. Considering only documented infections the response rate was 71%. Patients who received imipenem as initial therapy had a higher response rate than patients who received it after failing other antibiotics (77% versus 68%). The overall response rates for septicemias and pneumonias were 75% and 58%. Among the 57 gram-negative infections 77% responded, but the response rate was substantially higher if imipenem was used as initial therapy (94% versus 69%). The poorest response rate was observed when imipenem was given as secondary therapy for Pseudomonas infections (50%), but most of these patients had failed to respond to other appropriate antibiotics. The only serious side effect was seizures which occurred in ten patients, although eight of them had other predisposing factors. Imipenem appears to be a useful antibiotic for treatment of infections, even in neutropenic cancer patients. PMID- 3297283 TI - Intensive cytoreductive therapy followed by autologous bone marrow transplantation for patients with hematologic malignancies or solid tumors. AB - Fifty patients were studied. Twenty patients with non-Hodgkin's lymphomas (NHL) of high-grade malignancy and 21 patients with acute leukemia (AL) were treated with high-dose cyclophosphamide and total body irradiation, and three patients with Hodgkin's disease (HD) and six patients with solid tumors were treated with high-dose cyclophosphamide and VP16-213. Those procedures were followed by autologous bone marrow transplantation (ABMT). All patients had received conventional chemo(radio)therapy before the ABMT procedure. Although remissions were obtained in patients with cytotoxic drug-resistant diseases (lymphomas and solid tumors), none has become a long-term survivor, as occurred also in patients with solid tumors in partial remission (PR). Two of five patients with NHL in PR at the time of ABMT have become long-term disease-free survivors (28+, 56+ months). Ten patients with NHL were treated in complete remission (CR) and seven are in unmaintained CR; four with long follow-up (14+ to 59+ months). All patients with AL were treated in CR; two patients received ABMT in second CR, and both relapsed. Ten of nineteen patients in first CR relapsed; eight are alive in CR, five with long follow-up. Four deaths were therapy-related, all were patients in poor clinical condition. Intensive cytoreductive therapy followed by ABMT can produce prolonged disease-free survival (and probably cure) in a fair number of patients with poor risk NHL in CR and PR and probably also in patients with acute myeloblastic leukemia in first CR. This procedure was not successful in achieving long-term disease-free survival in patients with refractory lymphomas or solid tumors. PMID- 3297284 TI - Staging of genitourinary cancers. The role of diagnostic imaging. AB - Computed tomography (CT) is currently the standard modality for staging of urologic cancer in most institutions. It is used for demonstrating nodal involvement, and for demonstrating invasion of the primary lesion into surrounding fat, muscle, or other tissues or organs. It is also useful for demonstrating hepatic metastases in renal and vesical carcinomas. The problem with computed tomography, however, is that it can only show whether the nodes are large or not; neither can it show the nodal architecture, nor can it detect metastases in normal-sized nodes. Intravesical sonography has been helpful for staging papillary bladder cancer. Transrectal sonography has been somewhat helpful for demonstrating seminal vesicle invasion in patients with prostatic carcinoma. Inferior vena cavography and renal venography can be helpful for demonstrating whether a renal, renal pelvic, or adrenal carcinoma has extended into either vein. Lymphography can show nodal architecture and metastases in normal-sized nodes, and can make possible needle biopsy of abnormal-appearing nodes even if they are normal sized. The examination cannot show very small or microscopic nodal metastases, and it can miss abnormal nodes totally if they have been completely replaced by metastases. It yields false positives when fatty or fibrous infiltration of the nodes has occurred. It is used primarily for staging patients with testis or prostatic carcinoma. Bone scans are essential for staging prostatic carcinoma. Magnetic resonance imaging (MRI) is helpful in some cases of renal cell carcinoma. Multiplanar imaging prevents overstaging. It is also accurate for showing whether the renal vein or inferior vena cava are involved. Enlarged lymph nodes are easily distinguished from vessels. For staging bladder carcinoma involving the fundus or base of the bladder, MRI is better than CT. Microscopic nodal metastases, such as are common in carcinoma of the prostate, currently are not detected by any imaging modality. PMID- 3297285 TI - Invasive bladder carcinoma. The importance of initial transurethral surgery and other significant prognostic factors for improved survival with full-dose irradiation. AB - This review covers recent observations (all retrospective) on useful prognostic indicators in patients treated by radiation for this heterogeneous disease, including presenting clinical characteristics, extent of conservative surgery, radiographic studies, and pathologic subtypes. Although imperfect and incomplete, this review offers some criteria to identify which patients will do well and which quite poorly if treated by bladder-preserving full-dose radiation therapy. Such criteria should help clinicians recommending full-dose radiation therapy, radical cystectomy, or innovative combinations of chemotherapy, radiation, and surgery. PMID- 3297287 TI - Prostate cancer. Chemotherapy. AB - Several chemotherapeutic drugs have been shown to be potentially effective in the patient with metastatic hormone refractory prostate cancer. Individual patients who respond to these chemotherapy agents survive longer than nonresponders, but overall objective response rates for the entire group have been disappointingly small, the length of response short, and there has been no overall survival advantage. Combination chemotherapy has not yet been shown to be superior to single-agent chemotherapy in controlled phase III clinical trials. If chemotherapy drugs are administered to such patients, it is desirable to give them as part of protocols designed to gather reliable data on their risks and benefits. PMID- 3297286 TI - Chemotherapy of urothelial tract tumors. AB - Recent data from Phase II trials in patients with advanced transitional cell carcinoma of the urothelial tract suggest combination chemotherapy regimens are inducing a higher number of complete remissions (CR), and an overall response rate between 50% and 70%. Most active combination regimens are cisplatin + methotrexate based or cisplatin + Adriamycin (doxorubicin) based. As single agents, cisplatin has a response rate of 30% in 320 patients, methotrexate, 29% in 236 cases, and Adriamycin, 17% in 248 cases. With each drug used singly, however, complete response is uncommon. Other active single agents include vinblastine (16% in 38 cases) and mitomycin C (13% in 42 cases). New agents being evaluated which show some promise include gallium nitrate, carboplatinum, and other antifols. In a trial by the Northern California Oncology Group which evaluated a combination of cisplatin, methotrexate, and vinblastine (CMV), 28% of 50 cases achieved a CR lasting 44 weeks, and 28% a partial remission (PR) sustained for 29 weeks. A limited number of cases required surgical debulking for obtainment of CR status. At the University of Michigan, a trial of cisplatin and dichloromethotrexate induced responses in over 60% of cases. The regimen of methotrexate, vinblastine, Adriamycin, and cisplatin (M-VAC) has been reported to induce CR in 37% of cases, and PR in an additional 31%. In the latter trial at Memorial Hospital in over 100 cases with bidimensionally measurable advanced disease, the median survival of CR has not yet been reached at 28 months, whereas those who achieve PR survive 12 months versus 6 months for nonresponders. Indirectly, the success of such combination regimens is apparent from the increasing number of central nervous system relapses, without systemic recurrence, in complete responders. Additional data indicate that cisplatin + methotrexate, without the addition of other drugs, is also an active regimen. The attainment of CR in 20% to 40% of cases given these multidrug regimens has led to adjuvant and neoadjuvant protocols. Although results of randomized prospective trials have not yet been reported, preliminary Phase II data are promising. PMID- 3297288 TI - Carcinoma of the prostate. Hormonal therapy. AB - A selective review of the literature regarding hormonal therapy for patients with carcinoma of the prostate is presented to assess the current status of the following: therapeutic advantages, disadvantages and risks of alternate approaches to hormonal therapy; observations to predict the magnitude and duration of response to therapy; indications for initiating hormone therapy; the short-term and long-term effects of therapy; and role of hormone therapy in patients with recurrent tumor activity after initial hormonal measures. PMID- 3297289 TI - Strategies for the management of recurrent and advanced urologic cancers. Quality of life. AB - The goal of any treatment strategy for cancer is to improve not only patient survival but also quality of that survival. Quality of life (QL) involves individual perceptions (physical, mental, social) which are particularly germane to management of recurrent and advanced urologic cancers. Cancer therapy ideally equally documents a patient's QL as well as tumor response and survival. The QL is best achieved by optimal therapy, defined as appropriate treatment of those patients who need it and avoiding unnecessary or overtreatment of those patients who are not expected to obtain significant benefit. Specific goals of management of urologic neoplasms should strive to eradicate all existing and/or palliate symptomatic disease with the least possible morbidity while attempting to preserve function. Some examples of positive advances in this regard include reduction of therapeutic burden in good-risk patients with germ cell neoplasms; preservation of bladder and sexual function in childhood, adolescent and adult pelvic sarcomas with initial chemoradiotherapy programs and conservative surgery; improved responses of metastatic bladder cancer with combination chemotherapy; pelvic nerve-sparing techniques to preserve sexual potency and continent external or internal urinary diversions should total cystectomy become necessary; prevent or delay cystectomy with intravesical therapy in high-risk patients with polychronotopic superficial bladder tumors and ureteropyeloscopic management (rather than nephroureterectomy) of selected upper tract urothelial tumors. On the negative side, no appreciable value can yet be ascribed to nephrectomy, adjunct radiation or chemotherapy, hormonal or immunotherapy for advanced locoregional or metastatic renal cell carcinoma, aggressive radiation or chemotherapy for nodal metastases from bladder or prostate cancer or hormonal and/or chemotherapy of the asymptomatic patient with metastatic prostatic cancer. Future treatment strategies will improve tumor responses that now prove refractory but they should not be applied at the expense of QL as assessed by the patient. Valid methods for objective measurements of QL need to be devised and incorporated into multimodality curative and palliative clinical trials. PMID- 3297290 TI - Chemoprevention of bladder cancer. AB - There is a growing body of basic science and epidemiologic evidence to support a research thrust to determine whether several natural or synthetic agents, given alone or together, can lower cancer incidence. Candidate agents include analogs of vitamin A and the vitamin A precursor, beta-carotene, vitamins C and E, and the trace metal selenium. Other agents now being studied in the laboratory include phenolic antioxidants, protease inhibitors, prostaglandin synthesis inhibitors, and indoles. Research in chemoprevention involves identifying and characterizing agents with reported activity, efficacy and toxicologic testing to select the most promising agents, and clinical trials to test those with the most potential in humans. Activities are underway in all the above areas, including 24 clinical trials, to evaluate selected compounds in preventing cancer at various cancer sites. Included are studies of individuals at high risk, individuals with precancerous lesions and individuals free of cancer but at risk to second cancers. A number of agents have shown activity in reducing bladder cancer incidence in animal models. The potential applicability of these agents for studies in human cancer risk reduction intervention studies is discussed. Cancer induction is postulated to be a multistage process involving initiation and promotion. Progress in cancer prevention may result from not only reducing exposures to initiators, but also suppressing promotional activity in initiated cells. Newly developed research technologies including cellular, animal, and epidemiologic procedures are being used for identifying, refining, and testing cancer prevention strategies. PMID- 3297291 TI - Monoclonal antibodies in urologic oncology. AB - The sensitivity and specificity of immune reactions have long been recognized. However, since the description of the monoclonal antibody technique certain technical hurdles have been overcome. Monoclonal antibody (mAb) technology allows far more precise understanding of the humoral immune response by allowing dissection of this response into its individual B-lymphocyte populations. Furthermore, the ability to select and expand a particular B-cell clone allows for production of unlimited amounts of a pure antibody "reagent." Each of these reagents may be readily used as a "probe" for its respective antigenic determinant. Panels of these reagents may be used to probe complex biologic structures (e.g., neoplastic cells) and thereby "dissect" them at a molecular level. Murine mAbs are produced by hyperimmunizing a mouse with the antigen of interest. The spleen provides a rich source of B-lymphocytes. These normal B lymphocytes are incapable of surviving in culture. However, mouse B-lymphocyte tumor cell lines (myelomas) have been previously immortalized in tissue culture. A hybridoma is formed by fusing the normal immunized B-cells with myeloma cells. The hybridoma combines the best features of its parent cells. The immunoglobulin product of each resulting clone is screened against a panel of antigens. This allows selection of those clones producing antibody to the desired antigens. The mAb may be used to purify and/or characterize its respective antigen including definition of the chromosomal site of its gene and factors involved in the regulation of its expression. A large number of mAbs have been produced against renal, bladder, and prostate cancer antigens. These mAbs are allowing a more precise, molecular subclassification of these cancers and providing improved predictability of the natural history of each patient's cancer. Evidence in experimental animals demonstrates that mAbs accumulate at the site of tumor and can lead to the destruction of tumor cells. These encouraging results have prompted clinical trials in patients with metastatic cancer. Such a clinical trial in patients with metastatic renal cancer is currently underway at New York Hospital and Memorial Sloan-Kettering Cancer Center. PMID- 3297292 TI - Methods of early diagnosis in genitourinary cancer. AB - The commonly employed methods for the early detection of urologic cancers remain the traditional techniques of a carefully performed history and physical examination. Newer developments include, among others, prostate-specific antigen and monoclonal antibodies in prostate cancer, flow cytometry in bladder cancer, computerized axial tomography (CAT) scanning in renal cancer, and ultrasound in testicular cancer. These and other new diagnostic techniques, with further testing and wider use, will hopefully permit the earlier diagnosis of genitourinary cancer. PMID- 3297293 TI - Urologic cancer. Methods of early detection and future developments. AB - Technologic advances in diagnostic imaging have significantly improved the detection and staging accuracy of urologic cancer. Intravenous urography (IVU) is not sensitive for the detection of renal lesions, and a normal IVU does not exclude the presence of renal cancer. At this time, computed tomography (CT) is the method of choice for the detection of renal tumors. Ultrasound (US) can be used for the differentiation of cystic from solid lesions, but CT is more accurate. Magnetic resonance (MR) imaging presently is inferior to CT for the detection of renal lesions. However, in the staging of known renal carcinoma, MR surpasses CT in the staging of large lesions or lesions of stage III and IV disease. In the detection of bladder tumors, cystoscopy and biopsy remain the most accurate diagnostic method. CT and MR imaging are indicated for the staging of bladder neoplasms. Transurethral US shows promise, but is still under investigation. At present, the combination of physical examination, transrectal US, and when needed, US-guided biopsy, are the optimal screening approaches for the detection of prostatic carcinoma. For the staging of diagnosed prostatic carcinoma, MR is superior to CT, but neither is accurate in assessing lymph node involvement. As compared with transrectal US, MRI is superior for the evaluation of extension to the bladder base and seminal vesicles. It is hoped that in the near future, localized tissue MR spectroscopy will be used clinically and will improve the specificity of diagnosis of prostatic carcinoma. PMID- 3297294 TI - Statistical and epidemiologic data on urologic cancer. PMID- 3297295 TI - Clinical, mammographic, and sonographic determination of preoperative breast cancer size. AB - Clinical, mammographic, and sonographic preoperative size measurements were correlated with the values obtained at pathologic examination in a series of 31 patients with pathologically T1 (n = 23) and T2 (n = 8) breast carcinomas. Sonographic measurements demonstrated the highest correlation coefficient (r = 0.84), with the lowest residual standard deviation calculated in relation to the regression line. As a result, real-time sonography yielded the most accurate determination of breast cancer size in this series. Sonographic tumor size determination has proved valuable when mammography failed to delineate the tumor, particularly in patients with dense breasts. It may also be recommended in the evaluation of tumor response to nonsurgical conservative treatment. PMID- 3297296 TI - Radiation-induced angiosarcoma. AB - A 47-year-old woman presented with an angiosarcoma of the terminal ileum 14 years after receiving adjuvant radiation therapy for ovarian dysgerminoma. Her clinical course is described, and the previously reported cases of radiation-induced angiosarcoma are reviewed. PMID- 3297297 TI - Patterns of expression of a tumor associated antigen, defined by the monoclonal antibody HMFG2, in human epithelial ovarian carcinoma. Comparison with expression of the HMFG1, AUA1 and F36/22 antigens. AB - Binding to the antigen defined by the monoclonal antibody HMFG2 was demonstrated in more than 94% of human epithelial ovarian carcinomas by the indirect immunoperoxidase technique. The extent of the expression of this antigen related to tumor differentiation; well-differentiated tumors expressed more antigen than poorly differentiated tumors. Marked variation of tumor grade and antigen expression was demonstrated in individual tumors and this may be a limiting factor in the use of radioisotope linked HMFG2 for tumor therapy. A similar prevalence was found in the expression of the antigens defined by the monoclonal antibodies HMFG1 and F36/22; whereas the AUA1 antigen was demonstrated in 68% of cases. The patterns of expression of the HMFG1, HMFG2, and F36/22 antigens suggest that they may be related antigens. PMID- 3297299 TI - Immunohistochemical demonstration of alpha-1-proteinase inhibitor in brain tumors. AB - Using light microscopy and immunoperoxidase methods (PAP), the presence of alpha 1-proteinase inhibitor (API) was studied in seventeen brain tumors and four normal brain samples. The brain tumors included four glioblastomas, five low grade gliomas, two metastatic lung carcinomas, two acoustic schwannomas, and four meningiomas. Normal brain displayed a finely granular intracytoplasmic staining confined to neuronal cells. Glial cells were negative for API. Fifteen of the 17 brain tumors were positive for API. Only two of five low-grade gliomas were negative for API. Glioblastoma and metastatic tumors exhibited the strongest positivity followed by acoustic neuroma, meningioma, and low-grade glioma. All positive samples exhibited finely granular intracytoplasmic API, and 50% exhibited extracellular API positivity. Metastatic and glioblastoma tumors demonstrated prominent extracellular API staining. Our results support the concept of a local production of API by brain tumors. PMID- 3297298 TI - T-cell prolymphocytic leukemia with an unusual phenotype CD4+ CD8+. AB - A patient with T-cell prolymphocytic leukemia (T-PLL) is described. The outcome was poor, with death 8 months after diagnosis, despite several therapeutic interventions. The cells carried both CD4 and CD8 epitopes, but other thymocytic markers were absent. The spleen showed infiltration of CD4+ CD8+ prolymphocytes in the red pulp and in T-cell-dependent areas of the white pulp. Immunologic function studies revealed proliferation after stimulation with mitogens and even several antigens. However, in the mixed lymphocyte culture the T-PLL cells did not proliferate. Cytotoxic T-cells could not be induced. In T-non-T recombination experiments neither helper nor suppressor cell function was found for pokeweed mitogen-dependent plasmablast generation of normal B-cells. Cytogenetically, many abnormalities were found. Among them, 14q+; absence of chromosomes 8, 11, and 22; and the presence of large marker chromosomes and fragments. PMID- 3297300 TI - Malignant mesenchymoma of the bladder. AB - A case of malignant mesenchymoma of the bladder, containing fibroleiomyomatous, myxomatous, osteoid, and cartilaginous components is presented. The primary pedunculated tumor measuring 18 X 10 X 9 cm and weighing 934 g, arose from the anterior wall of the bladder and was treated by partial cystectomy. Six months after surgery, cystoscopy revealed a recurrent tumor situated at the dome of the bladder. The patient received surgery, chemotherapy, and irradiation for recurrent tumor, but died of the disease 21 months after the first operation. Autopsy revealed extensive local recurrence with wide-spread metastases of malignant mesenchymoma of the bladder and an incidental finding of coexisting clear cell carcinoma in the right kidney (pTl, NO, MO). There have been no previous reports of association of malignant mesenchymoma of the urinary bladder and renal cell carcinoma. PMID- 3297301 TI - Ultrasonically guided staging splenic tissue core biopsy in patients with non Hodgkin's lymphoma. AB - Ultrasonically guided tissue core biopsy of the spleen was undertaken in eight patients with previously untreated non-Hodgkin's lymphoma in the staging procedure. In all cases, the tissue core specimens that were biopsied were sufficient to diagnose the presence of involvement of non-Hodgkin's lymphoma, and two of the eight were found to have histologic involvement. There was no complication in this series. It was concluded that this is a safe and reliable technique for the staging of malignant lymphoma. PMID- 3297302 TI - Lymphatic metastases with childhood rhabdomyosarcoma. A report from the Intergroup Rhabdomyosarcoma Study. AB - A review of 1415 patients without distant metastasis from the Intergroup Rhabdomyosarcoma Study (IRS) I and II revealed an overall 10% incidence of identified lymphatic spread at diagnosis, whereas 81 of 592 children with localized rhabdomyosarcoma who had grossly complete resection (and therefore with more complete pathologic data) had histologically proven lymphatic spread (14%). The percentage of patients in this latter group with nodal metastases was highest for the prostate (41%), paratesticular sites (26%), and genitourinary sites overall (24%). Sites with a small percentage of proven lymphatic involvement were the orbit (0%), nonorbital head and neck sites (7%), and truncal sites (3%), whereas the percentage of patients with nodal metastases from extremity lesions was 12%. The primary tumor mean diameter was significantly larger in the group with nodal metastases, but there was no evidence of a relationship between lymphatic spread and age, sex, or histologic subtype. Patients with lymph node metastases who had resection had a poorer survival rate (logrank P value = 0.001), with a 3-year survival estimate of 54%, compared with 78% for patients without lymphatic metastases. Patients with extremity lesions and positive lymph nodes also did poorly when compared with patients with normal nodes (P = 0.006), and a similar observation was made for patients with paratesticular sarcoma (P = 0.06). PMID- 3297303 TI - The molecular genetics of human non-Hodgkin's lymphoma. AB - There is increasing evidence to implicate oncogenes in the etiology of Burkitt's and non-Burkitt's non-Hodgkin's lymphoma. Some of these oncogenes have been identified because of their location at common breakpoints, some because they have been found by transfection assays to be activated, and some because they have been shown to be expressed in non-Hodgkin's lymphomas. So far there is no consistent pattern of involvement between specific oncogenes and specific subtypes of non-Hodgkin's lymphoma. This may be because more than one oncogene is necessary for transformation. PMID- 3297304 TI - Chromosomal abnormalities in indolent lymphoma. AB - Cytogenetic studies were performed on lymph node biopsies from 60 patients with indolent (low grade) non-Hodgkin's lymphoma. Thirty-two of the 39 successfully cultured biopsies had abnormal clones. The 32 abnormal clones represented the following histologies: seven small lymphocytic lymphoma (SL), eight follicular small cleaved cell lymphoma (FSC), 14 follicular mixed, small cleaved, and large cell lymphoma (FM), and three composite lymphomas. One of the composite lymphomas had FSC/DSC (diffuse small cleaved cell) and the other two FM/DM (diffuse mixed, small cleaved and large cell). Twenty-seven of the 32 biopsies were immunologically typed, and all were B cell. The clones all exhibited more structural than numerical abnormalities, and there was no difference in the modal chromosome number of the abnormal clones found in each histology. Biopsies with no normal cells were more frequently found in the SL histology (71%) than in the two follicular lymphoma groups (54%-55%). A translocation of the 14q32 segment was the most common abnormality found in all three histologies. In the follicular lymphomas a t(14;18)(q32;q21) was seen in 52% (13 of 25) of these patients, this translocation was not observed in the SL patients. Overall 84% (21 of 25) of the follicular lymphoma patients had abnormalities of 14q32 and/or 18q21. Other specific abnormalities included anomalies of chromosome #3 in FM, an abnormal 10q in FSC and FM lymphoma, and a high incidence of +18 and chromosome #1 abnormalities in patients with t(14;18). The presence of specific chromosome abnormalities in the indolent lymphoma patients suggests a relationship between certain karyotypic features and histology. PMID- 3297305 TI - The Moscow Cancer Research Institute. PMID- 3297306 TI - Effect of adenosine analogues on protein carboxylmethyltransferase, S adenosylhomocysteine hydrolase, and ribonucleotide reductase activity in murine neuroblastoma cells. AB - The noncompetitive S-adenosylhomocysteine (AdoHcy) hydrolase antagonist adenosine dialdehyde (AD) has been shown to suppress the growth of cultured C-1300 murine neuroblastoma (MNB) cells. The enzymatic sites at which AD and other nucleoside analogues exert their cytotoxic effects have been postulated to include protein carboxylmethyltransferase (PCM), AdoHcy hydrolase, and ribonucleotide reductase. AD (10(-5) M) increased PCM activity 350% in suspensions prepared from disrupted cells after 72 h of drug exposure; in contrast, 3-deazaadenosine (10(-4) M) increased PCM activity 57%, whereas AdoHcy and sinefungin had no effect. When intact MNB cells were incubated with AD for varying time periods up to 72 h and then pulse labeled with the S-adenosylmethionine precursor L-[3H]-methionine, AD (10(-8) to 5 X 10(-6) M) produced a concentration-dependent inhibition of protein carboxylmethylation which persisted for up to 6 h. Following extended periods of AD treatment (48 to 72 h), AD (10(-6) to 10(-5) M) produced a 250% increment in protein carboxylmethylation, similar in magnitude to that observed in disrupted cell preparations. This increase in carboxylmethylation was observed at timepoints when AdoHcy hydrolase activity remained suppressed. The inhibitory effect of AD on AdoHcy hydrolase activity was maximal within 4 h and still apparent after 72 h of incubation. In contrast, AD treatment had no effect on the ribonucleotide reductase activity of MNB cells. These data suggest that the cytotoxic effect of AD on MNB cells results directly from its inhibition of AdoHcy hydrolase activity and indirectly through its suppression of methyltransferase enzyme systems. The potential linkage between the observed long term elevations in PCM activity and AD-induced cytotoxicity remains to be defined. PMID- 3297308 TI - Growth and continuous passage of COMMA-D mouse mammary epithelial cells in hormonally defined serum-free medium. AB - Growth of the mouse mammary epithelial cell line designated COMMA-D has been studied in serum-free medium (SFM) formulated with Ham's F12 and Dulbecco's modified Eagle's medium (1/1) containing 15 mM 4-(2-hydroxyethyl)-1 piperazineethanesulfonic acid, 2 mM glutamine, gentamicin (50 micrograms/ml; basal medium) and supplemented with insulin (10 micrograms/ml), transferrin (10 micrograms/ml), selenous acid (10 ng/ml), epidermal growth factor (20 ng/ml; EGF), 10 nM 3,5,3'-triiodothyronine, 50 microM ethanolamine, 1.0 nM 17 beta estradiol, 65 microM glutathione, and ovalbumin (100 micrograms/ml). COMMA-D cells were able to undergo serial passage and continued to exhibit dome formation after 20 passages in SFM. Cells seeded at low density in SFM underwent four population doublings at low passage number in 1 week compared to six doublings for cells grown in medium containing insulin, transferrin, selenium, EGF, and 1% fetal bovine serum. After many passages in SFM, the growth rates of cells were similar to those in serum-supplemented medium used for stock culture. Deletion of insulin or EGF from SFM resulted in cell growth similar to that of cells seeded in basal medium alone. When cells were seeded in basal medium without added supplements, addition of insulin or EGF resulted in 29 and 22%, respectively, of the number of cells grown in SFM for 5 days. However, when insulin and EGF were combined in basal medium, the cell number at 5 days was 83% of that in SFM. When insulin was deleted from SFM, COMMA-D cells became responsive to insulin-like growth factors I and II. The growth-promoting characteristics of EGF and transforming growth factor alpha were compared in SFM and were not distinguishable, showing identical dose-response curves. When incorporation of [3H]thymidine was used as an assay of cell growth, saturating levels of basic fibroblast growth factor (20 ng/ml) showed a stimulation 1.35 times greater than EGF (20 ng/ml). When EGF and fibroblast growth factor were combined, the stimulation was 1.75 times greater than EGF alone suggesting that COMMA-D cells are responsive to multiple classes of growth factors. COMMA-D cells seeded in basal medium supplemented with insulin, transferrin, and selenous acid have been used to detect mitogenic activity present in extracts of hypothalamus, uterus, and pituitary. The results show that COMMA-D cells can be grown long term in a hormonally defined serum-free medium and that maximal mitogenic effects were seen only with the addition of two or more growth factors. PMID- 3297307 TI - Tumor growth modulation by a monoclonal antibody to the epidermal growth factor receptor: immunologically mediated and effector cell-independent effects. AB - A monoclonal antibody of IgG2a isotype (425) is described that reacts with the epidermal growth factor receptor on human cells of different tissue origins. Monoclonal antibody 425 mediates tumor cytotoxicity in vitro using mouse and human effector cells and suppresses in vivo tumor cell growth of epidermoid (A 431) and colorectal (SW 948) carcinoma-derived cell lines. The tumoricidal effects in vitro are proportional to the antigen density on target cells. At concentrations higher than 1 nM, monoclonal antibody 425 inhibits growth of epidermal growth factor receptor-bearing A 431 cells, showing an epidermal growth factor-like agonist activity on the growth properties of these cells. A 431 cultures grown in the presence of growth-inhibiting doses of antibody or epidermal growth factor reveal a clear decrease of the relative number of cells in S phase. Additionally, cells treated with the antibody show a decrease of G2-M phase cells in some, but not all, cultures tested. PMID- 3297309 TI - c-myc amplification and expression in newly established human osteosarcoma cell lines. AB - Three cell lines were isolated from a patient with osteosarcoma of the femur. These lines were obtained from the primary neoplasm before (HTLA145) and after (HTLA161) chemotherapy and from a metastasis of the lung (HTLA195) in the same patient. The three cell lines exhibited a similar morphology in culture and formed tumors in nude mice which demonstrated a histopathology similar to that which had been observed in the patient. High expression of the genes coding for the alpha-1 and alpha-2 chain of collagen Type I was found in vitro and in s.c. tumors growing in nude mice. The c-myc protooncogene was amplified in all three cell lines and extensive expression of c-myc was found in vitro and in vivo. No heterogeneity in regard to c-myc expression in vivo was detected by in situ localization in tumors growing in nude mice. PMID- 3297310 TI - DNA amplification in drug resistant cells and in tumours. AB - DNA amplification is a pervasive phenomenon in continuous cell lines and in tumours. It can occur in many different parts of the genome with high frequency, and a very large amount of DNA, probably including many genes, is often involved in a single amplification event. In tumours, it is likely that a common mechanism underlies the amplification of genes which confer drug resistance and genes which give a growth advantage to the tumour. DNA amplification may be caused by defects in the regulation of DNA replication, and similar defects may lead to other chromosomal abnormalities such as translocations, inversions and heteroploidy. Two recent observations should facilitate identification and study of the underlying defects: agents or treatments which damage DNA can increase the rate of amplification, and mutant cell lines can be selected which amplify their DNA at a greatly increased frequency. PMID- 3297311 TI - Circumvention of resistance to anthracyclines by calcium antagonists and other membrane-perturbing agents. AB - Resistance to a variety of naturally occurring antitumour agents, including the anthracyclines, vinca alkaloids and actinomycin D, is associated with an outward transport system which limits intracellular drug accumulation to sublethal levels. A series of agents of unrelated structure, including calcium and calmodulin antagonists, local anaesthetics and detergents, can impair this outward transport system, and thereby promote cytotoxicity of these antitumour agents. These effects are not related to alterations in calcium fluxes, but appear to derive from membrane perturbations which also affect other transport systems. There are additional modes of drug resistance not based on transport alterations which are apparently unaffected by these second agents. PMID- 3297312 TI - In vitro human tumour model systems for investigating drug resistance. AB - Studies aimed at elucidating mechanisms responsible for the expression of drug resistance, which in the past have centred largely on the use of experimental animal model tumour systems, have more recently employed human tumour material. The advantages and limitations of the two main approaches adopted for in vitro studies, which have involved either direct use of biopsy specimens or work with human tumours established as continuous cell lines, are reviewed here. Reference is made to the need for strict characterization of the tumour cell populations under investigation, and their potential instability and heterogeneity, particularly in terms of drug responses, are discussed. Studies using human tumour cell lines have been more extensive than those employing biopsy material directly. Examples of investigations analysing drug resistance using lines derived from gliomas and from carcinomas of the lung, ovary or colon are reviewed. The question of whether these human tumour model systems accurately reflect the types of resistance encountered clinically is considered. Finally, several potential areas for further study are proposed centering on current investigations that address the issues of whether different mechanisms of resistance might be involved depending not only on the order of resistance expressed but also on the way in which such resistance was developed or induced. PMID- 3297313 TI - Membrane transport alterations as a mechanism of resistance to anticancer agents. AB - An alteration in membrane transport is one of the most common mechanisms by which tumour cells become resistant to anticancer agents and represents one of the major obstacles in present cancer chemotherapy. A recent emphasis on understanding the mechanisms by which drugs are transported into cells should continue to assist attempts to overcome these problems. Resistance in certain instances can be overcome by modifications in the structure of a drug which increases lipophilicity. These successes have usually been obtained where well defined transport processes are present and specific deletions or modifications in the putative transport proteins are apparent, as in the case of classical antifolates. Simplicity, however, never seems to prevail and recent evidence indicates that cells can prevent transport of lipophilic drugs perhaps by modification of the chemical structure or properties of the plasma membrane, as in the case of trimetrexate. Some alkylating agents are transported by well defined carrier systems; for example, nitrogen mustard enters cells by the choline carrier, and melphalan uses two distinct amino acid carrier mechanisms. For both of these agents, tumour cell resistance is sometimes caused by transport defects. Resistance to antitumour nucleosides may be associated with impaired transport, and this has been demonstrated most clearly for cytarabine and fluorodeoxyuridine. In the case of antitumour antibiotics, although resistance is most often associated with a pleiotropic resistance phenotype in which the rate of drug efflux from the cell is increased, certain cases will be discussed in which resistance may be clearly attributed to defective drug uptake. PMID- 3297315 TI - Myoclonus. PMID- 3297314 TI - Clinical aspects of drug resistance. PMID- 3297316 TI - Early parkinsonism. AB - The early clinical diagnosis of parkinsonism has been reviewed, together with consideration of investigations that may be helpful in certain cases. The controversial issues of management in early Parkinson's disease have been addressed, and some newer concepts of early diagnosis and management have been discussed, deriving from the study of a population of patients exposed to MPTP. PMID- 3297317 TI - The focal dystonias. PMID- 3297318 TI - On chorea. PMID- 3297319 TI - Management of levodopa failures: the use of dopamine agonists. AB - In the past decade, dopamine agonists have emerged as important treatment options for patients with Parkinson's disease. Originally, dopamine agonists were used only in patients with advanced disease in whom the response to levodopa had decreased (levodopa failures). The decreased response to levodopa, usually associated with diurnal oscillations in performance and the 'wearing-off' and 'on off' phenomena, is secondary to disease progression with continued degeneration of the nigrostriatal neurons. In addition, chronic levodopa treatment itself may contribute to the decreased drug response and the diurnal oscillations in performance. Dopamine receptor agonists bypass the degenerating nigrostriatal neurons and directly stimulate the striatal dopamine receptors. Dopamine receptor agonists also permit a reduction in the dose of levodopa. Five ergoline dopamine agonists--bromocriptine, lergotrile, pergolide, lisuride, mesulergine, and the nonergoline agonist, ciladopa--have undergone clinical trials in Parkinson's disease. In 10 years, we treated a total of 278 patients with advanced Parkinson's disease, a declining response to levodopa, and diurnal oscillations in performance with five ergoline dopamine agonists (in addition to levodopa). The mean duration of treatment was one year (with a range of 1-60 months). Improvement was noted in 140 (50%) of our patients. Adverse effects necessitating discontinuation of the agonist occurred in 131 patients (46%). We compared our results with those of others who, unlike us, began treatment with a dopamine agonist earlier, using the agonist alone or adding it to levodopa before the response to levodopa had decreased. Many of the patients so treated had mild or moderate Parkinson's disease. A total of 1,599 patients were treated with ergoline dopamine agonists. Of these patients, 976 (61%) improved, while 407 (25%) experienced adverse effects. We believe that a greater number of these patients improved and fewer experienced adverse effects, in comparison to our patients, because the patients had less advanced disease. PMID- 3297321 TI - Optimizing drug delivery to brain tumors. PMID- 3297320 TI - Cognitive improvement in clinical trials with nootropic drugs: when can it be expected and how to clarify its meaning. AB - In order to have a correct evaluation of the activity of a nootropic drug, the criteria adopted for the choice of patients to be included in the clinical trials and the methods used to clarify the meaning of changes observed on cognitive tasks are reported. The results of a clinical trial with the nootropic oxiracetam carried out in line with the above-mentioned criteria and methods are related. PMID- 3297322 TI - Lymphatic metastasis and its treatment. AB - The treatment of lymphatic metastasis depends on an understanding of its basic biology. We are still uncertain as to how human cancer cells enter lymphatic vessels and as to what reactions if any in the draining lymph node inhibit metastasis. We are uncertain as to whether lymphatic metastasis is an indicator or a governor of rapid dissemination, and poor prognosis. We are uncertain as to whether it is worth attempting to treat lymphatic metastases by means supplementary to those used in treating systemic tumour dissemination. It may be possible to obtain local cure of a local lesion by local lymphatic therapy and to concentrate therapy locally by intralymphatic infusion of a chemotherapeutic agent or encapsulation in liposomes. This is at best accessory to obtaining systemic cure of systemically disseminated neoplasm. Optimal results could be expected from appropriate combinations of local and systemic immunotherapy, chemotherapy and radiotherapy, after appropriate surgical reduction in tumour bulk. PMID- 3297324 TI - [Acute ischemia of the sinus node. Preliminary observations of orthoptic heart transplant recipients]. PMID- 3297323 TI - A monoclonal antibody (Po66) directed against human lung squamous cell carcinoma immunolocalization of tumour xenografts in nude mice. AB - Po66, a mouse IgG1 monoclonal antibody, was produced by immunization against a patient lung squamous cell carcinoma. The tissue reactivity of the antibody was measured by a radioimmunological assay with enzymatically dissociated cells, by an immunofluorescence test on frozen tissue sections and by peroxidase-staining of paraffin sections. The antibody bound to lung squamous cell carcinoma, oesophagus carcinoma and, inconsistently to lung adenocarcinoma but not to the other tumours tested. Some normal tissues also reacted positively, in particular bronchial serous glands, oesophagus epithelium and renal distal and collecting tubules. In normal and malignant tissues showing epithelioid differentiation, Po66 bound to the intermediate maturation area. The antigen immunoprecipitated by Po66 from lung squamous cell carcinoma appeared as a single band with a molecular weight 47,000 to 50,000 daltons. Purified monoclonal antibody Po66 and an unrelated IgG1 immunoglobulin were labelled with radioactive iodine and injected i.v. into nude mice bearing subcutaneous xenografts of human lung squamous cell carcinoma. The localization index in the tumour was 3.3. Antibody labelled with 131I allowed gamma-scintigraphic imaging of the xenografts which were clearly outlined by days 9 to 11. PMID- 3297326 TI - Cell-mediated versus humoral immunity in autoimmune diseases and their pharmacologic control with particular reference to type I diabetes mellitus. PMID- 3297325 TI - Effects of captopril on the physical work capacity of normotensive patients with stable-effort angina pectoris. AB - Twelve normotensive patients with coronary artery disease and stable effort induced angina pectoris were selected: the antiischemic effect of captopril was studied. A maximal cycloergometer effort test was obtained before (base) and after administration of placebo or captopril (50 mg p.o.). The following parameters were measured: heart rate (HR), blood pressure (BP), maximal rate/pressure product (MRPP), maximal workload sustained, (MWS), maximal working time (MWT), and S-T depression at MRPP. The base and placebo were similar. Compared to them captopril augmented the MWT, increased the MWS, reduced S-T depression at MRPP, and decreased the number of patients with effort-induced angina pectoris. The antiischemic effect of captopril seems related both to its effect on HR and BP, and to a local enhancement of coronary blood flow. PMID- 3297327 TI - Auto-anti-idiotypic immunity and acetylcholine receptors. PMID- 3297328 TI - Drug-induced experimental autoimmune nephritis. PMID- 3297329 TI - Role of cytokines in T and B cell mediated immunity. PMID- 3297330 TI - Regulation of immune reactivity to self. PMID- 3297331 TI - Autoimmunoregulation and autoimmune disease. Dedicated to the memory of Jules Bordet (1870-1961), pioneer in immunology and complement research. PMID- 3297332 TI - Role of the third component of complement in immunoregulation. PMID- 3297333 TI - Multigenic basis of autoimmune disease in New Zealand mice. PMID- 3297334 TI - Antigenic mimicry between mycobacteria and cartilage proteoglycans: the model of adjuvant arthritis. PMID- 3297335 TI - Autoimmunity in rheumatoid arthritis. A qualitative and quantitative approach to the role of Ia antigens. PMID- 3297336 TI - Autoimmunity of the ear. PMID- 3297337 TI - Immunoregulatory defects associated with infection with the AIDS virus, HTLV-III. PMID- 3297338 TI - Immunotherapy of autoimmune disease with T cell subset specific antibodies. PMID- 3297339 TI - Origin and significance of autoantibodies. PMID- 3297340 TI - Natural cytotoxic (NC) cell activity in murine and human systems. Effector cells from multiple lineages with antitumor activity. PMID- 3297342 TI - [Ultrasound in the diagnosis of retroperitoneal and abdominal lymph node involvement in lymphogranuloma]. PMID- 3297343 TI - [Essential hypertension with low and high renin levels. Comparison of the results of long-term therapy]. PMID- 3297344 TI - [Therapy of arterial hypertension with captopril]. PMID- 3297345 TI - [The electroencephalogram and stereo-electroencephalogram in epileptic and psychotic patients]. PMID- 3297346 TI - [Use of digital subtraction angiography in maxillofacial surgery]. PMID- 3297341 TI - Responses of pyriform cortex neurons to excitatory amino acids: voltage dependence, conductance changes, and effects of divalent cations. AB - The actions of ionophoretically applied N-methyl aspartate (NMA), quisqualate, and kainate, thought to activate three different types of excitatory amino acid receptors, were studied on pyramidal neurons of the rat pyriform cortex, maintained in an isolated, submerged, and perfused brain slice. Intracellular recordings were made with either K acetate or CsCl electrodes. In most neurons all three agonists elicited monophasic responses which could be evoked at 20-sec intervals. Some neurons showed biphasic responses, most commonly to kainate but, on occasion, also for quisqualate. The slower component appeared to be correlated with excitotoxicity and, consequently, was difficult to study. As a result the kainate responses studied were from neurons selected for having a single component. In neurons selected for having a linear current-voltage relationship or neurons loaded with Cs to suppress K conductance and linearize the current voltage relationship, the average changes in resistance recorded during ionophoretic responses at resting potential were as follows: NMA, 131.2 +/- 6.7% of control; kainate, 104.7 +/- 5.8% of control; and quisqualate, 92.8 +/- 2.8% of control. The magnitude and direction of the conductance change were very reproducible in any one neuron, but especially for kainate some cells showed clear conductance increases, while others showed clear conductance decreases. Using CsCl electrodes it was possible to reduce K+ conductance and depolarize the neurons over a wider range. By passing depolarizing current it was possible to reverse the responses. The response to all three agonists reversed at the same depolarized potential. This observation indicates that while there are differences in the ionic channels associated with the three agonists at resting potential, the channels have similar properties at more depolarized potentials. Responses to all three agonists were influenced by the concentrations of divalent cations in the perfusion medium. The NMA responses were most sensitive to Mg, increasing in amplitude in the absence of Mg and being depressed by Mg elevation. All responses were sensitive to Ca, with discharges being greatly increased by low Ca and depressed by high Ca. The kainate response was most sensitive to Ca concentration changes. Unlike reports from other preparations the apparent conductance decreases to NMA were not altered by the perfusion of solutions with either no added Mg or no added Ca. The NMA response was very much reduced in either Co (1-2 mM) or Zn (100-200 microM).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297347 TI - Translational frameshifting: where will it stop? PMID- 3297349 TI - The carboxy-terminal 30 amino acids of GAL4 are recognized by GAL80. AB - In wild-type yeast the action of the transcriptional activator GAL4 is inhibited by GAL80, and galactose relieves this inhibition. We show that deletion mutants of GAL4 lacking 30 amino acids of the carboxyl terminus activate transcription constitutively, whereas other deletion mutants bearing the carboxy-terminal 30 amino acids are inhibited by GAL80. Moreover, GAL4 fragments bearing these 30 amino acids, when expressed from a strong promoter on multicopy plasmids, free the endogenous GAL4 from inhibition by GAL80. These and other results suggest that GAL80 recognizes the carboxy-terminal 30 amino acids of GAL4, forming a complex that, though bound to DNA, does not activate transcription. PMID- 3297348 TI - Molecular cloning of the cDNA for tissue factor, the cellular receptor for the initiation of the coagulation protease cascade. AB - We have isolated cDNA clones encoding the complete sequence of the heavy chain of tissue factor (TF), the high-affinity receptor responsible for cellular initiation of the coagulation protease cascade. An 885 bp open reading frame encodes a 295 amino acid polypeptide including a leader sequence with alternative cleavage sites. A single 2.3 kb mRNA is identified, and Southern blotting is consistent with a single gene. The coding sequence defines a protein with features characteristic of an integral membrane protein. This receptor appears novel, lacking significant homology with other proteins; however, TF contains the uncommon tryptophan-lysine-serine (WKS) sequence repeated three times, a sequence we find in some serine protease-binding proteins and suggest may represent a functional sequence motif. PMID- 3297350 TI - Interaction of positive and negative regulatory proteins in the galactose regulon of yeast. AB - Transcriptional regulation in the galactose regulon of yeast is determined by an interplay between a positive regulatory protein, GAL4, and a negative regulatory protein, GAL80. We show that derivatives of GAL4 missing as few as 28 carboxy terminal amino acids are not responsive to GAL80 regulation, implying that the carboxyl terminus of GAL4 is required for interaction with GAL80. Furthermore, a lesion in GAL4 that genetically defines the GAL80-interactive region maps to the 3' end of the gene. Since the carboxyl terminus of GAL4 has also been implicated in interaction with a transcriptional factor, we propose a model for negative regulation in which GAL80 and this factor compete for binding a common region of GAL4, and the on/off state of transcription is determined by the relative affinities of the negative regulator and the transcriptional factor for this region. PMID- 3297351 TI - Multiple exon-binding sites in class II self-splicing introns. AB - Partial deletion of the exon 5' to S. cerevisiae intron a5, a self-splicing mitochondrial class II intron, reveals the existence of several sites of intron exon interaction. We have identified two of the corresponding exon-binding sites in intron a5 by comparative sequence analysis and RNAase H digestion of the intron complexed to a DNA version of its 5' exon. Introduction of mutations in either the intronic sites or the complementary exonic sequences affects splicing in vitro, whereas double mutants in which intron-exon pairings have been restored show normal activity. Some of the mutants accumulate a product that was shown to be the intron-3' exon lariat, a postulated splicing intermediate. The possible role of one of the intronic sites in aligning exons for the ligation step is discussed. PMID- 3297352 TI - Additive and independent responses in a single receptor: aspartate and maltose stimuli on the tar protein. AB - The aspartate and maltose responses of E. coli are mediated through a single membrane receptor, yet the responses are independent and additive. Both stimuli cause methylation of the same 4 glutamic acid residues. More extensive methylation occurs when a cell that has adapted to one stimulus is exposed to the second, or when both stimuli are added simultaneously. The degree of methylation, as well as receptor migration on two-dimensional gels, demonstrates that only one type of protein is involved, rather than two different receptors arising from differential processing of a single gene. A conformational "push-pull" mechanism in which binding of stimulus and covalent modification, producing opposing stresses, can explain these diverse results. PMID- 3297353 TI - Identification of p34 and p13, human homologs of the cell cycle regulators of fission yeast encoded by cdc2+ and suc1+. AB - cdc2+ and CDC28 play central roles in the cell division cycles of the widely divergent yeasts Schizosaccharomyces pombe and Saccharomyces cerevisiae, respectively. The genes encode protein kinases that show 62% protein sequence identity and are capable of cross-complementation. Monoclonal antibodies were raised against p34cdc2, and a subset recognize p36cdc28. The cross-reacting antibodies detected a 34 kd homolog of the p34cdc2/p36CDC28, protein in HeLa cells. Human p34 was also recognized by an affinity-purified polyclonal anti p34cdc2 serum. Peptide mapping of p34cdc2, p36CDC28, and human p34 revealed complete conservation of four tryptophan residues in the three proteins. p34 thus appears to be closely related to the two yeast proteins. In addition, a p34 immune complex showed protein kinase activity in vitro, and HeLa cell p34 interacts with p13, the human homolog of the suc1+ gene product of S. pombe. PMID- 3297354 TI - Evaluation of alveolar macrophages in normals and individuals with active pulmonary sarcoidosis for the spontaneous expression of the interleukin-1 beta gene. AB - We have evaluated the hypothesis that the presence of large numbers of activated helper/inducer T lymphocytes in the lungs of individuals with active pulmonary sarcoidosis is associated with the exaggerated release of interleukin-1 (IL-1) by alveolar macrophages. Evaluation of media from unstimulated cultured sarcoid alveolar macrophages failed to detect IL-1 activity. When parallel cultures of sarcoid and normal alveolar macrophages were stimulated with lipopolysaccharide (LPS), they released similar amounts of IL-1 activity. Using a highly specific polyclonal anti-IL-1 beta antibody and flow cytometry to evaluate cell-associated IL-1 beta, analysis of fresh alveolar macrophages from patients with active sarcoidosis and normal individuals revealed no detectable cell-associated IL-1 beta, but IL-1 beta was present when macrophages from sarcoid patients and normals were stimulated with LPS. Similar observations were made using immunoblot analysis of cell lysates of the same unstimulated and stimulated macrophages. Finally, Northern analysis of alveolar macrophages for IL-1 beta mRNA transcripts demonstrated minimal, but equivalent, amounts of IL-1 beta in both normal and sarcoid macrophages, as compared to the much larger quantities present in LPS stimulated alveolar macrophages. Thus, while alveolar macrophages of individuals with sarcoidosis are clearly capable of expressing the IL-1 beta gene, these findings suggest that altered expression of the IL-1 beta gene by alveolar macrophages does not play a central role in the exaggerated lung T-cell activation characteristic of sarcoidosis. PMID- 3297355 TI - Evidence that MAP-2 may be involved in pigment granule transport in squirrel fish erythrophores. AB - We have demonstrated the presence of MAP-2 in squirrel fish erythrophores using SDS-PAGE, immunoblot, and immunoprecipitation techniques. The monoclonal antibodies used (AP-9, -13, -14) were raised against distinct antigenic sites on Chinese hamster brain MAP-2. Immunoprecipitation studies demonstrated that all three antibodies bind a 300 K protein found in crude cell extracts and in partially purified MAP fractions isolated from erythrophores of the squirrel fish Holocentrus rufus. Immunofluorescent studies confirmed that the 300 K protein was present in cultured erythrophores. Studies of cells induced to aggregate and disperse their pigment granules revealed that the 300 K protein comigrated with the pigment, suggesting that the 300 K protein may constitute part of the "alpha cytomatrix" involved in pigment translocations. PMID- 3297356 TI - Immunoelectron microscopy pinpoints glutathione-peroxidase (GSH-PO) in neonatal rat adrenal cortical cells. AB - Localization of glutathione-peroxidase (GSH-PO) in adrenal cortical cells of neonatal rats were determined by immunocytochemical analysis. GSH-PO first appeared 14 days after birth. Intracellular localization of GSH-PO was mainly in cytosol (cytosol GSH-PO) but no intramitochondrial localization of GSH-PO was detected. Twenty-one days after birth, intramitochondrial localization of GSH-PO (mitochondrial GSH-PO) was present. Mitochondrial GSH-PO depends on ACTH stimulation; therefore, its presence in the adrenal cortical cells of neonatal rats may be the morphologic expression of the gradual acquisition of adult metabolic features during steroidogenesis. The intracellular GSH-PO staining pattern in adrenal cortical cells therefore should be a useful marker for steroidogenesis. PMID- 3297357 TI - [Determination of theophylline in saliva]. PMID- 3297358 TI - Detection of periodontal defects by conventional and subtraction radiography. PMID- 3297359 TI - The present state of modern implantology: an overview. PMID- 3297360 TI - [Evaluation of fetal hypotrophy by examining placental structure using ultrasonography and urinary estriol levels]. PMID- 3297361 TI - [Modern views on the control of sexual maturation in the woman]. PMID- 3297362 TI - [Report on the present state of the dialysis-transplantation program for children and adolescents in Czechoslovakia]. PMID- 3297363 TI - Comparative pharmacokinetic parameters of new systemic fluoroquinolones: a review. AB - The recent piperazinyl-substituted mono-fluoroquinolones represent a family with some common characteristics on one side, and variable parameters on the other side. COMMON characteristics: same mechanism of action: DNA-gyrase inhibitors of the A subunit of topoisomerase; pH dependent antibacterial activity; a rather long post-antibiotic effect for both gram-positive and gram-negative bacteria; same physiochemical properties: organic acids, high pKa, lipophilicity. Some common pharmacokinetic parameters: low protein binding (less than 50%); high volume of distribution (greater than 1.5 l/kg) with good attainable tissue concentrations in lymph, blister fluid, renal tissue, prostate, bronchial secretions, saliva, aqueous humor, CSF, bone, bile; good intracellular penetration in macrophages, polynuclear neutrophils; high peak urinary concentrations markedly exceeding the MIC for virtually all bacterial urinary tract pathogens, even accounting for the increase in MIC in the urine, especially at lower (acidic) pH; low extraction ratio dialysis; similar adverse reactions; CNS, gastro-intestinal, photosensitivity, tendo-articular and cartilage toxicity. However, most other pharmacokinetic parameters are different from one fluoroquinolone to the other; oral bioavailability, peak serum levels (C max) as a measure of bioavailability, terminal half-life of elimination (t1/2) are all variable. The extent of metabolic biotransformation varies greatly, the two extremes being ofloxacin, showing a high metabolic stability, and pefloxacin, highly metabolized. The degree of antibacterial activity of different metabolites also varies greatly. The renal clearance of most fluoroquinolones, except pefloxacin, greatly exceeds normal glomerular filtration rate, suggesting additional renal tubular secretion. Renal elimination of most fluoroquinolones - except pefloxacin, is blocked by probenecid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297364 TI - Studies on prodrugs. VI. Preparation and characterization of (5-substituted 2-oxo 1,3-dioxol-4-yl)methyl esters of mecillinam. PMID- 3297365 TI - [Preliminary study of the effect of wurenchun for prolonging the survival time of cardiac tissue allografts in mice]. PMID- 3297366 TI - [Practice of Dr Zhang San Lai's combined use of Chinese and western drugs in infectious skin diseases]. PMID- 3297367 TI - [Advances in research on Chinese drugs for anti-myocardium ischemia]. PMID- 3297368 TI - [Survey of studies on xiao qinglong decoction in the treatment of bronchial asthma in children in Japan]. PMID- 3297369 TI - Interactions of insulin with sulfatide-containing vesicles of phosphatidylcholine at different pHs. AB - Positively charged insulin is described to induce aggregation of phosphatidylcholine vesicles containing 10 mol% sulfatide at acidic pH. Techniques including light-scattering, Sepharose chromatography, centrifugation, trapped volume determination, circular dichroism and fluorescence polarization, demonstrate that large amounts of negatively charged insulin remain firmly associated to the vesicles upon raising the pH to 7. This is surprising, since only trace amounts of insulin associate to the sulfatide-containing vesicles upon direct incubation at pH 7. The possible molecular explanation of the phenomenon and the relevance of these findings to the actions of insulin in vivo are discussed. PMID- 3297370 TI - Cell-contact and -architecture of malignant cells and their relationship to metastasis. AB - The interaction of metastatic cells with the host environment occurs, to a large extent, through the cell surface, and the cell cytoskeletal system controls the distribution and motility of cell surface receptors. During metastasis, tumor cells migrate from one organ to another, and the dynamic properties and mechanochemical deformability of disseminated cells play a central role in the process. The studies described here under suggest an interrelationship between the cytoskeleton and cell adhesion, which can control and augment the expression of the metastatic phenotype of neoplastic cells. PMID- 3297372 TI - The sources of heritable variation in cellular growth capacities. AB - Diverse genetic and epigenetic changes occur in cells in response to unfavorable environments. Most of these changes do not directly cause the malignant transformation. An occasional, rare change can lead to cancer, although it may be expressed only in the environmental context that gave rise to it. The variety of such changes is so enormous that it is impossible to derive unique, cellular mechanisms. A set of rules is derived for describing the interactions between cell and its surround which result in malignancy. It has often been said that 'nature is simple'--illusion! It is our mind which looks for simplicity to avoid effort. L. Brillouin, Scientific Uncertainty and Information 1964. PMID- 3297371 TI - Iron metabolism during infection and neoplasia. AB - Invasion of the vertebrate host by microorganisms or neoplastic cells triggers a variety of metabolic responses. One of them, the hypoferremic response, is the decrease in serum iron levels. This hypoferremia is observed not only during infections of various etiologies and neoplasia but also during trauma, myocardial infarction, surgery, and inflammation. The hypoferremic response thus appears to be a consistent and predictable biochemical response to pathogenesis. Hypoferremia has been shown to be of great protective value to the host against infection and neoplasia. Suppression of the iron-withholding ability of the host by excess iron is associated with a greater incidence and severity of infection and neoplasia. The potential therapeutic applications of the hypoferremic response are discussed. PMID- 3297374 TI - Prediction of normal tissue damage induced by cancer chemotherapy. AB - Cancer chemotherapeutic agents have a low therapeutic index and require a precise and safe prescription. Hematological toxicity is the most common dose limiting side effect of cancer drugs. Therefore, Hemopoietic Stem Cells (HSC) are the most relevant targets for dose determination. Studies of total body irradiation with or without autologous bone marrow transplantation showed that HSC concentrations differ between mouse, rat, rhesus monkey, dog and man. A highly significant correlation was found between bone marrow rescue dose and kg body weight and not between bone marrow rescue dose and BSA. Kg body weight appears to offer a better prescription unit for cancer chemotherapy than BSA, because it correlates better with dose limiting, normal tissue, target cells. This prediction is borne out by the results of chemotherapy in neonates. BSA has also been used as dose unit for drugs with non hematological side effects (e.g., cardiotoxicity of anthracyclines or neurotoxicity of methotrexate). The target for such drug side effects need to be determined before the proper dose unit can be selected. A review of available data shows that for at least some non hematological side effects BSA does not offer the proper prescription unit. The historical justifications for BSA as dose unit are re-examined (simplicity, correlation with blood volume, correlation with area under the curve) and considered invalid. The ultimate long term improvements from better prescription methods for cancer chemotherapeutic agents are less normal tissue side effects and better tumor control. The indiscriminate use of BSA as a universal dose unit for cancer chemotherapy would prevent such improvements and is discouraged. Instead, drug doses are to be expressed in units that correlate with dose limiting normal tissue cells. PMID- 3297375 TI - Amelioration of cytotoxic-induced emesis with high-dose metoclopramide, dexamethasone and lorazepam. AB - A double-blind randomised controlled trial comparing the antiemetic effects of sublingual lorazepam combined with high-dose, short course metoclopramide (3 mg/kg) infused twice 3 h apart with or without i.v. dexamethasone is reported. Sixty patients receiving a total of 209 cycles of potentially severely emetic cytotoxic chemotherapy were randomised to receive one or other antiemetic regimen. In those receiving platinum-based chemotherapy the addition of dexamethasone was associated with an improvement in freedom from nausea (P less than 0.01) and freedom from vomiting (P less than 0.05). In the non-platinum based chemotherapy group the addition of dexamethasone led to a reduction in the duration and severity of nausea, and duration of vomiting (P less than 0.05 in each case). Both antiemetic regimens were well tolerated with a low incidence of adverse effects and could be administered easily in an outpatient setting. PMID- 3297373 TI - Chemical xenogenization of experimental tumors. AB - Chemical xenogenization occurs when experimental tumors, treated in vivo or in vitro with selected chemicals, become immunogenic, i.e., able to induce a strong rejection response, immunological in nature, in the histocompatible hosts. Unlike modifications induced by haptens, changes in tumor cell immunogenicity associated with chemical xenogenization are heritable as a result of drug interference with the genetic code. Drugs endowed with potent mutagenic activity are known to be powerful xenogenizing agents, and their mechanism of action is traditionally regarded as involving changes in DNA nucleotide sequence. Triazene and nitrosoguanidine derivatives are among the best known examples of this type of compound, and a large body of information has been accumulated over the years regarding the immunogenic properties of the tumor variants obtained following treatment with those xenogenizing agents. The present paper reviews this information, and also discusses the therapeutic implications of xenogenization in experimental systems of tumor immunotherapy. Xenogenization of murine tumors has also been obtained by means of chemicals devoid of mutagenic activity but capable of affecting gene transcriptional activity. The characteristics of this 'new' type of xenogenization are also reviewed and compared to those of triazene xenogenization. PMID- 3297376 TI - A randomized trial comparing alizapride alone or with dexamethasone vs a metoclopramide-dexamethasone combination for emesis induced by moderate-dose cisplatin. AB - To evaluate the antiemetic effectiveness and toxicity of a novel congener of metoclopramide (MCP), alizapride (AZP), 29 patients receiving cisplatin (50 mg/m2) alone or with adriamycin (40 mg/m2) were entered into a randomized cross over trial comparing moderate-dose AZP (2 mg/kg for 4 doses) administered alone or with dexamethasone (DXM) (8 mg for five doses) vs a standard combination of MCP (1 mg/kg for four doses) and DXM (as above). With the dosage and schedule used, AZP provided only limited antiemetic protection, with less than 10% of the patients free of emesis. The AZP-DXM combination was significantly more effective than AZP alone in reducing the intensity of the emesis (P less than 0.03). The incidence, however, was statistically unaffected. The additional toxicity of DXM was negligible. Except for the patients' preference for MCP-DXM (P less than 0.01), no differences could be found between the DXM-based regimens, although a trend towards a better antiemetic effect with the MCP combination was evident. The benzamide-related dystonic reactions were equally distributed. Among the 11 patients affected there were 6 who required specific treatments. Unfavourable prognostic factors in the patient population could provide a reasonable explanation for the disappointing antiemetic protection obtained with all the regimens evaluated in this study. PMID- 3297377 TI - Humoral factors in primate endotoxin shock. AB - Many biologically active substances are released from the cell in endotoxic shock and thought to contribute to morbidity and mortality. Whether or not these substances are independently toxic or require endotoxin as a catalyst is uncertain; 20 mg/kg E. coli endotoxin was infused into seven rhesus (R) macaca monkeys (toxin donor). Seven R macaques received an equivalent volume of normal saline (control donor). Animals were monitored for 12 h and lactated Ringer's was infused to maintain a minimum MABP of 40 mmHg. Donor animals were exsanguinated; plasma was extracted and a Limulus lysate assay (LAL) was utilized to determine the approximate amount of endotoxin present in toxin donor plasma. This volume of endotoxin (0.125 mg/kg) was added to control donor plasma. Plasma was infused into seven toxin receivers and six control receivers. Receiver animals were monitored for 24 h and killed after 3 d. Lungs were evaluated histologically for evidence of acute injury. Five of the seven toxin receivers and no control receivers died within 3 d (P less than .005). Significantly more hemorrhage occurred in toxin receivers (P less than .01). Our data suggest a humoral factor present in the plasma of toxin donor capable of promoting tissue injury and death of recipient animals independent of endotoxin. PMID- 3297378 TI - Effects of vasodilators prostaglandin E1 and methylprednisolone on pulmonary hypertension and right ventricular performance during volume loading in porcine septic shock: a combined invasive and radionuclide study. AB - In 16 anesthetized pigs the cardiovascular effects of prostaglandin E1 and methylprednisolone (MPS) during E. coli sepsis were studied. Gated blood pool scans and hemodynamic studies were simultaneously performed. A control group, group I (n = 4), received volume loading alone; groups II, III, and IV received (each n = 4) volume loading after intravenous administration of MPS, prostaglandin E1, and both MPS and prostaglandin E1, respectively. Groups were formed by randomization, such that the effects of prostaglandin E1 (0.1 microgram/kg/min) and MPS (30 mg/kg) could be analyzed separately and in combination. Eight animals treated with prostaglandin E1 were compared with eight animals not receiving prostaglandin E1. The same method was applied to the MPS group. E. coli infusion resulted in an abrupt increase in pulmonary arterial pressure while systemic blood pressure gradually fell. Cardiac output decreased. Gated blood pool studies showed an increase in right ventricular end-diastolic volume and a decrease in right ventricular ejection fraction. Consequently, right to-left ventricular end-diastolic volume ratio increased. Pulmonary arterial pressure was lowered in the treatment groups compared to control group. During volume loading right ventricular ejection fraction improved in the prostaglandin E1 group but remained low in the MPS group. Compared to control group, cardiac output did not change and mean systemic arterial pressure significantly decreased in the prostaglandin E1 group. Treatment with prostaglandin E1, MPS, or both drugs and volume loading did not reveal any difference between the four groups with respect to cardiac output, right and left ventricular volumes, and left ventricular ejection fraction. The present study indicates that in a porcine model of E. coli septic shock with acute pulmonary hypertension, prostaglandin E1 and MPS treatment decrease pulmonary vascular resistance but also systemic vascular resistance. Prior to and during volume loading right ventricular ejection fraction increased in the prostaglandin E1 group. However, neither prostaglandin E1 nor MPS improved right ventricular performance and forward flow during volume loading. PMID- 3297379 TI - Dexamethasone alters glucose, lactate, and insulin dyshomeostasis during endotoxicosis in the rat. AB - This study examined the effects of dexamethasone on the glucose, lactate, and insulin dyshomeostasis of endotoxicosis in the rat. To assess the effects of dexamethasone on carbohydrate dyshomeostasis, sequential measurements of plasma glucose and lactate were made in vivo. The effects of dexamethasone on endotoxin induced portal and systemic hyperinsulinemia also were evaluated in vivo. The ability of dexamethasone to alter the insulin hypersecretory state of the endotoxic pancreas was evaluated by using the in vitro perfused rat pancreas. Endotoxicosis caused severe hypoglycemia and hyperlactacidemia in the pentobarbital-anesthetized rat. Dexamethasone prevented the hypoglycemia, significantly reduced the hyperlactacidemia, and prevented endotoxin-induced hyperinsulinemia in vivo. Dexamethasone reduced endotoxin-induced pancreatic hypersecretion of insulin when administered as a pretreatment 1 h prior to endotoxin treatment; however, when administered as a cotreatment with endotoxin, no significant reduction of insulin hypersecretion occurred. The results of this study suggest that the ameliorating effects of dexamethasone on glucose and lactate dyshomeostasis occur not only at the peripheral tissue level, but also through effects on insulin secretion. PMID- 3297380 TI - Pulmonary vascular response to live Escherichia coli: influences of different antiplatelet substances. AB - The aim of this study was to investigate whether pretreatment with drugs that interfere with platelet functions in different ways could modify the pulmonary vascular response in a porcine septic shock model. Septic shock was induced by i.v. infusion of live Escherichia coli bacteria. Bacteriemic animals were divided into five groups: untreated or pretreated with a thromboxane-A2 synthetase inhibitor (UK 38 485), a serotonin-receptor antagonist (ketanserin), a combination of these two drugs, or a platelet antiaggregating drug (dipyridamole). E. coli induced significant pulmonary hemodynamic and respiratory changes. The pulmonary responses to E. coli infusion were attenuated after pretreatment with UK 38 485 but unaffected by prior administration of ketanserin or dipyridamole. The combined pretreatment did not attenuate the pulmonary hypertension or other pulmonary responses to E. coli more than UK 38 485 alone. Dipyridamole did not alter the pulmonary circulation after bacterial infusion. It was concluded that thromboxane-A2 is an important, but not the only, mediator of the pulmonary vascular response in septic-shocked pigs and that factors such as serotonin and platelet aggregability seem to be of minor, if any, importance for the hemodynamic response. PMID- 3297381 TI - Functional properties of Salmonella minnesota Rb-bound and Rb-unbound cell fractions in elderly donors. AB - The capacity of Salmonella minnesota R345 (Rb) binding to human peripheral blood lymphocytes allows the recovery of Rb-bound and Rb-unbound cell populations that elicit different functions. Here, we have applied this method to lymphocytes from aged individuals to evaluate the possibility that such an approach could reverse the senescence-related impaired immune responsiveness. In this regard we show that Rb binding augments either spontaneous or T-dependent plaque-forming cell generation in Rb-unbound fraction. By contrast, Rb-bound cells are enriched for lymphocytes releasing several lymphokines. This experimental approach seems to represent a useful tool to elucidate better the age-related alterations of the immune function. PMID- 3297382 TI - Specificity of the hydrochloric-acid-modified Crithidia luciliae immunofluorescence assay for detection of antibody to native DNA. AB - The Crithidia luciliae immunofluorescence (CLIF) assay is widely used to detect antibodies to native dsDNA in the diagnosis and management of systemic lupus erythematosus (SLE). However, sera from patients with SLE, rheumatoid arthritis, systemic sclerosis, drug-induced lupus erythematosus, and Sjogren's syndrome have given false-positive CLIF results. The frequency was 5% for SLE, 16% for drug induced LE, and 5% for rheumatoid arthritis. Such false positivity was effectively eliminated by pretreatment of Crithidia luciliae smears with 0.1 N HCl. Hydrochloric acid pretreatment of Crithidia luciliae smears renders the CLIF test more specific for the detection of anti-dsDNA antibodies, without sacrificing its sensitivity and specificity. In the future, modification of routine Crithidia luciliae immunofluorescence with 0.1 N HCl pretreatment is recommended. PMID- 3297383 TI - Difficulties associated with serological diagnosis of Toxoplasma gondii infections. AB - Physicians often rely on serology to help determine whether a patient has had a recent infection with Toxoplasma gondii and as an aid in estimating the possible teratogenic effect on the fetus. For this reason the diagnostic laboratory should take every precaution to avoid misleading results. The best serological analysis is based on a rise in IgG titer with two appropriately spaced serum samples. Also, the presence of a high IgM titer in one serum sample is generally considered to be good evidence that infection has occurred recently. The indirect fluorescent antibody (IFA) test has been the most widely used test for detection of IgG or IgM. Recently enzyme-linked immunosorbent assays (ELISA) have also been developed for this purpose. In this study we reaffirm that false IgM positive results can occur with these tests because of the presence of rheumatoid factor in serum, and false negative results can also occur because of competitive inhibition by specific IgG. We show that a preabsorption of serum with a Staphylococcus/Streptococcus preparation (Staffinoc, MA Bioproducts, Walkersville, MD) removes IgG and IgA and eliminates many of the false reactions. We have also found that elevated levels of specific IgM can persist for at least several years in some women. This suggests that the presence of IgM alone is not always an indication of recent infection. PMID- 3297384 TI - L-platelet activating factor induces changes on renal vascular resistance, vascular reactivity, and renin release in the isolated perfused rat kidney. AB - Rat kidneys were isolated and perfused with a modified Krebs-Henseleit buffer containing 4% albumin. Perfusate recirculated except during L-platelet activating factor (L-PAF), angiotensin II (ang II), and norepinephrine (NE) infusions. L-PAF caused a dose-dependent decrease in renovascular resistance (RVR): -6 +/- 3% at 10(-9)M, -12 +/- 6% at 10(-8)M, -18 +/- 3% at 10(-7) and -20 +/- 7% at 10(-6)M. L PAF increased immunoreactive PGE (iPGE) and thromboxane (iTXB) release into the venous effluent from 2.4 +/- 0.2 to 3.9 +/- 0.4 ng/min (p less than 0.05) and from 2.1 +/- 0.4 to 3.5 +/- 0.5 ng/min (p less than 0.05), respectively. Vasodilation by L-PAF (10(-7) M) in the presence of indomethacin (INDO) (5 microM) was enhanced compared to the non-INDO response (RVR change: L-PAF = -18 +/- 3% vs. L-PAF = -26 +/- 3%; p less than 0.05). As a control for specificity, the was infused at 10(-9) M, 10(-8) M, and 10(-7) M. None of these concentrations changed renal vascular resistance. To study the vascular receptor responsible for L-PAF-induced vasodilation, dose-response curves to NE and ang II were established with and without L-PAF (10(-7) M). The NE dose-response curve was unchanged by L-PAF, whereas the ang II dose-response curve was shifted to the right by one order of magnitude. In kidneys pretreated with INDO (5 microM), the L-PAF-induced shift of the ang II dose-response relation was increased to 2-3 orders of magnitude.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297385 TI - Human neutrophils release serine proteases capable of activating prorenin. AB - Proteases from human neutrophils can generate angiotensin II directly from angiotensin I or angiotensinogen. We examined whether neutrophil protease also influences angiotensin formation by activating human prorenin (also called inactive renin). When incubated with partially purified plasma and amniotic prorenin, sonicates from 10(6) neutrophils resulted in 120 +/- 30% and 1,240 +/- 290% increase in renin activity, respectively. The pH optimum of neutrophil prorenin-activating enzyme(s) is 6.5-7.0, and the activity of the enzyme(s) is inhibited by a mixture of serine protease inhibitors but not by inhibitors of other proteases, suggesting that prorenin-activating enzyme(s) is a neutral serine protease(s). Stimulation of neutrophils by f-met-leu-phe in the presence of cytochalasin B resulted in release of prorenin-activating enzyme(s) in a dose dependent fashion. We attempted to isolate prorenin-activating enzyme(s) from neutrophil granules using aprotinin-affinity and carboxymethyl cellulose chromatographies. Prorenin-activating enzyme(s) coeluted with cathepsin G and elastase activities. Prorenin activation was greatly inhibited by anticathepsin G antiserum. Purified cathepsin G activated prorenin in a dose-dependent fashion. Elastase probably also contributes to prorenin activation since purified elastase also activated human prorenin. We speculate that this neutrophilic angiotensin generating system may play a role in the local generation and concentration of angiotensins by influencing multiple steps of the renin-angiotensin system. PMID- 3297387 TI - Role of thyroid hormone in regulation of isomyosin composition, contractility, and size of heterotopically isotransplanted rat heart. AB - The role of thyroid hormone on the heart in terms of contractility, induction of growth, and selective synthesis of cardiac isomyosins was studied. After transplanting rat hearts from inbred hypothyroid donors into the abdomen of hypothyroid recipients of the same strain, two hearts were obtained in the same animal, both having reduced heart rate (200-250 bpm), decreased maximum rate of force, and high predominance of V3 isomyosin. The heart in situ carried a full load, while the transplant was denervated, beat isovolumically with minimum external work. After surgery, the recipient rats were put either on normal diet only (controls) or injected with a daily dose of T3 (average 200 micrograms/kg), which increased the heart rate to 340 bpm in 3 days (euthyroid level) and to 450 bpm in 7 days (hyperthyroid level). In T3-treated rats, the contractility of both hearts normalized in 7 days and showed hyperthyroid pattern in 14 days, while the mass of the in situ hearts increased to normal values in 7 days (+130 mg) and hypertrophied in 14 days (+340 mg), in contrast to the transplanted heart, which underwent atrophy (-90 mg and -210 mg) similar to that of control group (-225 mg). The predominant V3 isomyosin was completely reversed to V1 in two weeks in both hearts. Thus, T3 can neither stimulate cardiac growth nor can it attenuate the rate of atrophy in the denervated "nonworking" heart in spite of its direct effect on contractility and synthesis of isomyosins, which was similar to that observed in the in situ heart. PMID- 3297386 TI - Regulation of angiotensin II in rat adrenal gland. AB - Levels of angiotensin II immunoreactivity in the rat adrenal gland are over one hundredfold higher than those in plasma. It is unclear, however, whether the major source of adrenal angiotensin II immunoreactivity is intracellular synthesis by a local renin-angiotensin system, uptake by angiotensin II receptors, or both. Our studies show that angiotensin II immunoreactivity in the adrenal gland is predominantly attributable to angiotensin II (greater than 75%). Angiotensin III (16%) and other angiotensin II fragments are also present. The majority of angiotensin II immunoreactivity (73%), renin activity (73%), and angiotensin II receptor binding activity (66%) in the adrenal gland is located in the capsular glomerulosa cell layers. Dehydration produced by 2% NaCl imbibition decreased these activities in the capsular-glomerulosa. In the fasciculata medullary regions of the adrenal gland, dehydration decreased renin activity but not angiotensin II immunoreactivity or angiotensin II receptor binding activity. Combined data from control and dehydrated rats showed a close correlation of the capsular-glomerulosa angiotensin II immunoreactivity with angiotensin II receptor binding activity (r = 0.94, p less than 0.001) and a weaker, nonsignificant correlation with renin activity (r = 0.66, p less than 0.1). In the fasciculata medullary cell layers, no significant correlations were found between angiotensin II immunoreactivity and either renin or angiotensin II receptor binding activity. These data demonstrate that functionally distinct layers of the rat adrenal gland differentially regulate angiotensin II receptors and the renin-angiotensin system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297388 TI - Frequency analysis of the surface electrocardiogram for recognition of acute rejection after orthotopic cardiac transplantation in man. AB - Recognition of acute rejection after heart transplantation has been based mainly on invasive methods until now. In this study we analyzed two well-defined surface electrocardiographic recordings by fast Fourier transform (FFT) (Blackman Harris window, 512 points) after low-noise, high-gain amplification (filter setting 0.5 to 300 Hz) each day for 4 weeks after cardiac transplantation in 27 patients. Twenty acute rejection crises requiring treatment were diagnosed by cytoimmunologic monitoring and endomyocardial biopsy. Single-beat analysis of the QRS complex by FFT revealed a progressive change of the spectral morphology (increase of the frequency content between 70 and 110 Hz) on the days of rejection in 19 of 20 patients. At that time there were no visible changes on the electrocardiogram in the time domain in most patients. At the same time, the frequency content of the ST segment decreased between 10 and 30 Hz in 16 of 20 patients. After successful treatment, the frequency spectra of the QRS complex and ST segment returned to control within 1 to 2 weeks in most patients. One false-positive result was seen in a patient with mediastinitis and large pericardial effusion. A drop in QRS amplitude (greater than 20%) occurred in 10 of 20 rejection crises and in 10 patients without rejection. Nine patients after cardiac transplantation without rejection and seven control patients after cardiac surgery (not transplantation) showed stable frequency plots from one day to the other after the first postoperative day, but with considerable changes in QRS amplitude.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297389 TI - Biochemical evidence of a chronic abnormality in platelet and vascular function in healthy individuals who smoke cigarettes. AB - Cigarette smoking is associated with increased mortality from cardiovascular disease that declines after cessation. This study extends the evidence regarding the effects of chronic smoking on platelets and the vessel wall in vivo. Excretion of a major urinary thromboxane metabolite, 2,3-dinor-thromboxane B2, is significantly (p less than .01) elevated in apparently healthy chronic smokers (20 cigarettes daily) compared with that in nonsmoking control subjects. This difference in excretion of 2,3-dinor-thromboxane B2 was abolished by the administration of 20 mg aspirin twice daily, a dose shown to selectively inhibit platelet cyclooxygenase. After aspirin, the return of the excretion of 2,3-dinor thromboxane B2 to pretreatment levels paralleled the recovery of platelet cyclooxygenase. These findings indicate that excessive thromboxane A2 generation in chronic smokers predominantly derives from platelets. The urinary excretion of the prostacyclin metabolite 2,3-dinor-6-keto-prostaglandin F1 alpha also is increased during chronic cigarette smoking, as is the case with other diseases associated with accelerated interaction of platelets with the vessel wall. We have found evidence of platelet and vascular dysfunction in vivo in chronic cigarette smokers before the manifestation of overt cardiovascular disease. The results would also be consistent with the hypothesis that in chronic smokers, the platelet defect is largely reflective of smoking-induced vascular injury. PMID- 3297390 TI - Blood velocity distribution in the human ascending aorta. AB - Mapping of blood velocities across the lumen of the ascending aorta was performed in eight patients during open-heart surgery. A Doppler ultrasound probe was constructed to measure velocities in 2 mm steps from the maximum convexity to the maximum concavity of aorta, 6 to 7 cm above the aortic valve. In five patients with angina and normal aortic valves, velocity profiles were very similar and showed the following main features: a skewed peak systolic velocity profile with the highest velocity along the left posterior wall, a bidirectional velocity profile in late systole and early diastole with retrograde velocities along the left posterior wall, and a sustained antegrade flow along the convexity well into diastole. The resultant mean velocity profile had the highest velocity at the convex side and a central minimum velocity. In patients with Medtronic-Hall tilting disc prostheses, where the larger opening was oriented backwards and to the right, mean flow velocity profile was skewed in the opposite direction of normal. Moreover, instant systolic velocity profiles were much more irregular and dependent on the exact orientation of the prosthesis. In one patient with aortic valvular disease, very irregular and different velocity profiles were found. Based on a symmetry assumption, overall mean velocity for the total cross section was computed, and the magnitude of error in estimation of total flow from measurement of velocities at different depths was calculated. To measure total flow in the aorta, i.e., cardiac output, by single-gated Doppler technique, the most representative sampling site was about one-third of the diameter from the convex wall. PMID- 3297392 TI - Nonpharmacologic approaches to the treatment of hypertension. PMID- 3297391 TI - Psychosocial and central nervous influences in primary hypertension. AB - A variety of "emotional" response patterns can be elicited at the limbic hypothalamic level by challenging environmental stimuli, and such mechanisms may contribute to the multifactorial etiology of primary hypertension. The "defense reaction" is of particular interest because of its widespread neurohormonal excitatory influences and frequent, although mild, engagement in daily life events. Evidence is presented showing how common genetic variants of primary hypertension, both in man and spontaneously hypertensive rats, are characterized by a genetically linked central hyperreactivity to psychosocial stimuli. As a result, the previously mentioned central response pattern--with its differentiated excitatory and tropic effects that also involve salt-volume regulation--is more commonly elicited by even trivial environmental stimuli, therefore constituting an important triggering influence in these variants of primary hypertension. Also discussed is the potential genetic nature of this central hyperreactivity and, further, how it interacts with other genetic environmental influences and with the early induction of structural cardiovascular adaptation, by which the entire system is gradually reset to operate at a raised pressure equilibrium. PMID- 3297393 TI - Coronary artery disease: a sociocultural perspective. AB - A sociocultural perspective on biobehavioral factors is important both for studies of the cause of coronary heart disease and for efforts to prevent the disease. One-to-one programs are limited because coronary heart disease is so prevalent and because people have great difficulty in changing their behavior to lower their risk. Data are now available regarding several psychosocial risk factors that shed light on possible environmental influences. These factors include social mobility, stressful life events, type A behavior, and social support. These factors are now being studied in bus drivers to illustrate the ways in which sociocultural interventions can be developed to prevent disease. PMID- 3297394 TI - Psychological factors in coronary artery disease: epidemiologic evidence. AB - This article reviews the epidemiologic evidence linking psychological factors and various indexes of coronary heart disease (CHD) that has been gathered since the Amelia Island Conference in 1978. In general, studies of populations not selected according to CHD risk support the conclusion that the global type A construct is predictive of increased risk of coronary events. In high-risk groups, including patients undergoing coronary angiography, the evidence with respect to global type A is much less clear. This stems from the fact that most of these studies, although generally failing to find statistically significant relationships between coronary events and type A behavior, are flawed in a number of ways, including inadequate statistical power of results, use of less than adequate instruments, and failure to take an apparent interaction between type A behavior and age into account. Nevertheless, taken together, these findings suggest that it may be possible to identify measures of coronary-prone behavior that are more powerful than the global type A measure. Extensive evidence suggests that such measures may be found in the domain of hostility and anger. Measures of hostility and anger coping styles have been found to be associated with coronary atherosclerosis in populations in which global type A was not related to disease, and measures of hostility have predicted increased coronary events and total mortality in prospective population samples followed for from 20 to 25 years. Preliminary evidence suggests that hostility/anger characteristics may account for the increased coronary risk associated with global type A behavior.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297395 TI - Primary prevention of coronary heart disease: a challenge for behavioral medicine. AB - Arteriosclerosis is importantly influenced by blood cholesterol level, blood pressure, and cigarette smoking. Each of these major risk factors is influenced by behavioral choices made by individuals and supported by societies. Behavioral medicine has a rich tradition of dealing with individuals and small groups. The public health perspective of disease challenges behavioral medicine to develop new strategies and tactics for behavioral modification for health promotion on a population-wide basis. Additional research is needed to test effective methods for influencing population behavior, population risk factors, and ultimately population morbid and mortal event rates. Several major community projects are now investigating the health promotion process targeting individuals, small groups, organizations, and the entire community. School, worksites, and churches are particularly conducive to health promotion programming. Each has unique advantages and disadvantages; each deserves careful experimentation to determine its efficacy for population-wide health promotion efforts. A public health dimension to behavioral change promises widespread impact, generalization to other health promotive behaviors, maintenance of new cultural behavioral norms, and significant reductions in the incidence of many chronic diseases. PMID- 3297396 TI - Behavioral approaches to secondary prevention of coronary heart disease. AB - Over the past 10 years behavioral approaches to the treatment of coronary heart disease (CHD) have become widely recognized as being a significant complement to traditional medical and surgical therapies. The success of approaches to secondary prevention now relate to quality, as well as quantity, of life. A multifaceted program, including dietary management, smoking cessation, physical exercise, modification of type A behavior, and psychological counseling are components of many cardiac rehabilitation programs. Behavioral interventions are effective in reducing traditional risk factors for CHD events, and for improving the quality of life among victims of a disease with significant psychological, as well as physical, consequences. However, the effectiveness of behavioral interventions for prolonging life is less certain and requires more careful evaluation. The mechanisms by which behavioral treatments may influence clinical CHD end points is also in need of further investigation. PMID- 3297398 TI - Psychological risk factors in coronary artery disease. PMID- 3297397 TI - Environmental risk factors in coronary artery disease. PMID- 3297399 TI - Biobehavioral mechanisms in coronary artery disease. Acute stress. PMID- 3297401 TI - Primary prevention of coronary heart disease. PMID- 3297400 TI - Biobehavioral mechanisms in coronary artery disease. Chronic stress. PMID- 3297402 TI - Environmental and psychosocial determinants of sudden death. AB - The risk factors for sudden coronary heart disease (CHD) death have been well described. Sudden CHD deaths should be classified as those occurring in individuals with and those in individuals without a prior history of clinical heart disease. The extent of coronary artery disease, left ventricular dysfunction, and cardiac arrhythmias are the primary pathophysiologic determinants of ventricular fibrillation and sudden death. Psychosocial factors influence the threshold of response to the numerous physical and social environmental stimuli that can precipitate sudden death. The degree of pathology is probably inversely related to the intensity of the stimuli necessary to precipitate sudden CHD death. In the presence of extensive disease the precipitants of sudden deaths are probably ubiquitous in the environment and unlikely to be prevented. Thus, prevention of the basic cardiac disease is of higher priority. PMID- 3297403 TI - Sudden cardiac death. Stress and cardiac arrhythmias. PMID- 3297404 TI - Some central neural mechanisms governing resting and behaviorally coupled control of blood pressure. AB - Systems in the brain control blood pressure by maintaining life-sustaining, resting (tonic) levels and adjusting blood pressure in association with changes in regional blood flow appropriately coupled to behavior or environmental stimulation. Tonic levels of blood pressure are mediated by neurons in the medulla oblongata. The critical neurons appear to correspond to the epinephrine containing cells of the so-called C1 group located in the rostral ventral lateral medulla. These also mediate baroreceptor reflex responses. Behaviorally coupled changes in blood pressure are often highly stereotyped and vary depending on the behavior being performed in both animals and humans. These reactive circulatory adjustments are largely mediated by forebrain regions working in concert with the medullary centers. Some of the largest increases in blood pressure occur in response to aversive emotional arousal. In hypertensive animals and humans, such changes, which are normally buffered by reflex mechanisms in the brainstem, are exaggerated. In the rat, the neural pathway mediating the coupling, through aversive emotional conditioning, of blood pressure responses to acoustic stimuli involves the transmission of sensory signals through the primary auditory projection system to the medial geniculate body, where the input is then relayed subcortically to the amygdala. The amygdala, presumably by way of connections with the hypothalamus, and from there to the brainstem or spinal cord, controls the learned emotional response. These findings, which implicate a largely unrecognized sensory relay to the amygdala in emotional learning, represent the first demonstration of a direct link between primary sensory system and autonomic control regions in the mammalian brain. PMID- 3297405 TI - Mechanisms of atherogenesis. AB - Recently the nature of the cellular and molecular events in atherogenesis have been elucidated better. Some of these findings may be important in explaining individual differences in susceptibility to atherosclerosis that are independent of known risk factors. Nonhuman primates are valuable models for the study of mechanisms of diet-induced atherosclerosis. Cynomolgus macaques are useful for studies of male-female differences in atherosclerosis, since they share with premenopausal white women a relative protection against coronary atherosclerosis compared with males. These animals are also useful for psychosocial atherosclerosis research since social status affects the extent of atherosclerosis, and experimentally induced social stress increases extent of coronary artery atherosclerosis. Nonhuman primates have also been useful for studies of individual differences in susceptibility to diet-induced atherosclerosis and its risk factors. These studies have indicated that about 75% of the variability in the plasma cholesterol response to dietary cholesterol is attributable to genetically determined differences in cholesterol absorption and lipoprotein catabolism. There is preliminary evidence suggesting the existence of "mesenchymal susceptibility" in nonhuman primates; i.e., differences in risk of atherosclerosis that are independent of exposure to known risk factors. Efforts are being made to establish colonies of rhesus monkeys that possess contrasting degrees of mesenchymal susceptibility. PMID- 3297406 TI - Sudden cardiac death. Nonpharmacologic interventions. PMID- 3297408 TI - Psychophysiologic factors in atherogenesis and coronary artery disease. AB - Studies conducted on animals indicate that biobehavioral variables and diet can interact to facilitate atherogenesis. An unstable or threatening environment and stable behavioral predispositions of the individual appear to be interactive variables that may be useful for understanding behavioral contributions to atherogenesis. The interaction of threat with stable behavioral predispositions is echoed in psychophysiologic experiments relating human behavior to physiochemical reactivity. These stable behavioral predispositions in humans include hostility and aspects of the type A behavior pattern. Possible interactions among genetic predisposition, reactivity, and atherogenesis are also discussed. PMID- 3297407 TI - Psychosocial influences on the pathogenesis of atherosclerosis among nonhuman primates. AB - Epidemiologic and clinical evidence derived from studies of human beings suggests that psychosocial phenomena may account for much of the variability in atherosclerosis extent and severity that is unexplained by the "traditional" risk factors (serum lipids, hypertension, and smoking). Animal preparations provide an opportunity to test hypotheses concerning the role of psychosocial phenomena in atherogenesis and to explore the mechanisms by which the effects of such phenomena are mediated. Here we review a relatively large series of studies of cynomolgus monkeys (Macaca fascicularis), a 5 kg animal having a complex social organization. The data indicate that, among male animals, individual behavior characteristics (social status and aggressiveness), physiologic responsiveness to psychological challenge, and stability of the social environment all interact to affect atherogenesis. Among female animals, individual patterns of aggressiveness appear to influence ovarian function, which in turn affects atherosclerosis. Future advances in the behavioral medicine aspects of atherogenesis are likely to arise through elucidation of the pathophysiologic pathways by which these behavioral responses and characteristics contribute to the events (endothelial injury, smooth muscle cell proliferation, lipid accumulation, calcification, and necrosis) associated with plaque pathogenesis. Such research can be pursued in studies utilizing nonhuman primates as well as in complementary studies involving human subjects. PMID- 3297409 TI - Mechanisms of behaviorally induced arrhythmias. AB - Significant progress has been made in the past few years in defining the role of behavioral stress in the precipitation of cardiac arrhythmias. This is largely attributable to the development of relevant biobehavioral models and the advent of quantitative methods for assessing myocardial electrical stability in conscious animals. Classic and instrumental aversive conditioning has been shown to decrease electrical stability even in the normal heart. During evolving myocardial ischemia or infarction, the stress states can precipitate major arrhythmias, including ventricular fibrillation. Natural emotions have also been shown to be capable of altering the propensity to fibrillation. Notably, provocation of an angerlike state has been shown to decrease the vulnerable period threshold by 40% to 50%. The poststress phase can be particularly hazardous, as suggested by the profound myocardial perfusion abnormalities that have been observed within 1 to 3 min after cessation of anger. Cryogenic blockade of the thalamic gating system or its output from the frontal cortex to the brainstem blunts significantly the profibrillatory influence of stress. This indicates that discrete pathways within the central nervous system mediate the deleterious influence of aversive states on heart rhythm. Adrenergic factors appear to constitute the major effector component. This is supported by the observation that pharmacologic or surgical sympathectomy is capable of annulling the arrhythmogenic influence of diverse types of stress. The generally deleterious influence of the adrenergic system appears to be counteracted by vagal activity. The underlying mechanism is a muscarinically mediated inhibition of norepinephrine release from sympathetic nerve endings and a blunting of the actions of the adrenergic transmitters at the receptor level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297410 TI - Psychosocial precursors of hypertension: a review of the epidemiologic evidence. AB - This article provides a selective overview of epidemiologic studies on the relationship between psychosocial factors and blood pressure elevation. The review focuses on English-language reports published since 1975 and emphasizes two broad areas of research: changes in mean blood pressures of third world populations undergoing modernization, and psychosocial correlates of elevated blood pressure in low socioeconomic status (SES) and black populations within the continental United States. The recent modernization studies provide additional evidence that rapid sociocultural change is associated with increased prevalence of hypertension. To account for these effects, several studies have advanced the general thesis that modernization impacts traditional value systems of third world populations in ways that frequently engender discrepancies between their newly acquired aspirations for a Western lifestyle and their socioeconomic resources to successfully pursue that lifestyle. There is overlap between this formulation and recent investigations of hypertension in low SES and black populations in the United States. The report concludes with a discussion of epidemiologic studies of anger and hypertension, emphasizing some of the complexities that characterize this area of research. PMID- 3297411 TI - Psychosocial precursors of hypertension: experimental evidence. AB - This article reviews key experimental studies concerning the possible contribution of behavioral stress to the development of primary hypertension. In animal preparations, chronic exposure to stressors in conjunction with predisposing genetic factors of high sodium/low potassium intake can lead to hypertension and cardiac pathology. Studies with human subjects are less definitive, but several lines of evidence suggest that high heart rate and blood pressure reactivity to behavioral stressors may indicate an increased susceptibility to hypertension, including an association between high reactivity and both borderline hypertension and a positive family history of hypertension, observations that stressors involving active coping evoke enhanced beta adrenergic myocardial activity, resulting in cardiac output that is excessive relative to overall tissue oxygen consumption, and observations of decreased short-term sodium and fluid excretion during stressors in some individuals and an association between high salt intake and increased peak blood pressure levels evoked by exposure to stress. Indicated directions for future animal research include studies of the interactive effects of chronic stress with other environmental factors, such as high and low calcium intake, while in humans, future studies should incorporate monitoring of cardiovascular responses to real life events, and should also include long-term follow-up investigations to evaluate more directly the predictive significance of high cardiovascular reactivity to stress. PMID- 3297412 TI - Strategies for the evaluation and treatment of hypertension and some implications of blood pressure variability. AB - The distinction between normotension and hypertension, which is traditionally based on measurements of blood pressure made in the clinic, is arbitrary. The situation is further clouded by the fact that blood pressure varies greatly from moment to moment in any one individual, as shown by ambulatory recordings. The fundamental pattern of diurnal blood pressure variations is governed by the sleep wakefulness cycle, on which the effects of different activities are superimposed. Although hyperreactivity of blood pressure to behavioral stimuli could in theory contribute to the elevation of blood pressure in hypertensive subjects, this would not by itself explain the sustained elevation of blood pressure that is usually seen throughout the day and night in such patients. It is not known how blood pressure variability contributes to the vascular changes associated with hypertension; three possibly relevant factors are the average level of pressure over time, the peaks of pressure, and the shape of the pressure waveform (dP/dt). Hyperreactivity of blood pressure occurring in the doctor's office may be of considerable practical importance in the evaluation of patients with mild hypertension and may confound the relationship between clinical and overall blood pressure and also the evaluation of the response to antihypertensive treatment. Recordings of blood pressure made outside the clinic may help to overcome these problems. PMID- 3297413 TI - Psychosocial factors in hypertension. PMID- 3297414 TI - Psychophysiologic factors in hypertension. PMID- 3297415 TI - Immunoblotting for detecting Bence Jones proteinuria. PMID- 3297416 TI - Benzathine interference in the EMIT-st urine amphetamine assay. PMID- 3297417 TI - The Abbott ER-EIA monoclonal kit. PMID- 3297418 TI - Assessment of urinary retinol-binding protein as an index of proximal tubular injury. AB - The urinary excretion of retinol-binding protein (RBP), beta 2-microglobulin (beta 2-m), and beta-N-acetyl-D-glucosaminidase was monitored in patients with renal tubular damage secondary to multiple injuries, rhabdomyolysis, antibiotic treatment, or poisoning by various chemicals such as solvents, heavy metals, or pesticides. In almost all cases, RBP proved to be a more sensitive index of renal tubular damage than was beta-N-acetyl-D-glucosaminidase and, being more stable in acid urine, a more practical analyte to measure than was beta 2-m. We corroborated this finding by studying the relationships between these three analytes in more than 150 patients. On the average, an increase in the urinary excretion of beta-N-acetyl-D-glucosaminidase becomes detectable when urinary RBP already exceeds the normal value by 50- to 100-fold. In urines with pH greater than 6, RBP and beta 2-m concentrations are well correlated (r = 0.93, n = 150), beta 2-m tending to be more frequently positive (i.e., greater than 311 micrograms/L). But in urines with pH less than 6 (about 30-40% of the samples), the RBP/beta 2-m concentration ratio increases as pH decreases, up to 500 in some patients with massive tubular injury. Because the renal uptake of proteins involves a saturable process, the urinary excretion of RBP, like that of beta 2 m, specifically reflects the reabsorption capacity of proximal tubules only when the glomerular filtration rate is normal or slightly impaired (i.e., serum creatinine less than 20 mg/L). Under these conditions the determination of RBP protein in urine appears the most appropriate test when early detection of tubular injury is desirable. PMID- 3297419 TI - Total cholesterol in serum determined by isotope dilution/mass spectrometry, with liquid-chromatographic separation. AB - We describe an accurate, precise method for determination of total serum cholesterol by isotope dilution/mass spectrometry (IDMS) with liquid chromatographic separation. After adding [3,4-13C]cholesterol to serum and hydrolyzing the cholesterol esters, we extract the total cholesterol. "High performance" liquid chromatography (HPLC) is used to separate the extracted cholesterol for measurement by electron-impact mass spectrometry with use of a direct-insertion device. To evaluate the specificity and the accuracy of this method, we also studied the conventional IDMS method, which involves converting cholesterol to the trimethylsilyl ether and assay by gas chromatography-mass spectrometry with use of a capillary column. The coefficient of variation for the HPLC method was a little larger than that for the conventional method, but mean values by each method agreed within 1% for all sera tested. PMID- 3297420 TI - Fluorescence polarization immunoassay evaluated for screening for amphetamine and methamphetamine in urine. AB - We studied the recently developed Abbott fluorescence polarization immunoassay (FPIA) for amphetamine and methamphetamine in urine and compared the results with those of the Syva enzyme-multiplied immunoassay technique (EMIT) and a gas chromatographic assay. The FPIA method showed a limit of quantification of 0.3 mg/L, comparable with the lower cutoff of the EMIT assay. FPIA demonstrated greater specificity than the EMIT assay: phenylpropanolamine and ephedrine showed extremely limited cross reactivity with the FPIA antibody. Analysis of 249 urine specimens by all three methods clearly demonstrated the FPIA method to be acceptable for screening for amphetamine and methamphetamine in urine. PMID- 3297421 TI - Interpreting results of coulometry and immunoprecipitation in diagnosing iron disorders. AB - Concentration of iron in plasma, total iron-binding capacity (TIBC), and transferrin saturation are often determined by standard spectrophotometric methods, but iron concentration may be quantified by immunoprecipitation or, electrochemically, by controlled-potential coulometry. Because these iron assays do not all measure the same form(s) of iron, we studied subjects in various states of iron nutriture: normal adults, iron-deficient patients, thalassemia patients with unsaturated transferrin or oversaturated transferrin, and patients with idiopathic hemochromatosis. The spectrophotometric and coulometric methods detected essentially all non-heme iron in plasma; results correlated well but showed a negative bias toward the coulometric method. Results by an immunoprecipitation procedure, which measures only transferrin-bound iron, correlated well with those obtained coulometrically but were slightly higher than the latter. The characteristics of the various methods for iron must be understood by the clinical laboratory if diagnosis of iron disorders is to be accurate. PMID- 3297423 TI - Opiates in poppy seed: effect on urinalysis results after consumption of poppy seed cake-filling. AB - We report the analysis of poppy seed filling for morphine and codeine content. Concentrations in the range 17.4 to 18.6 micrograms/g (morphine) and 2.3 to 2.5 micrograms/g (codeine) were found in different lots of the filling, which is widely used in baking. The effect of consumption of poppy seed filling on opiate urinalysis results is discussed. Morphine concentrations as high as 4.5 mg/L are reported, with persistence of concentrations greater than 0.3 mg/L as long as 35 h after consumption. PMID- 3297422 TI - Three commercial kits and one liquid-chromatographic method evaluated for determining 25-hydroxyvitamin D3 in serum. AB - The accuracy of three commercial kit methods and one liquid-chromatographic (HPLC) method for determining 25-hydroxyvitamin D3 in serum was evaluated by using isotope dilution-mass spectrometry as a reference technique. The kit methods were based on radioimmunoassay and radioreceptor assay. Serum samples were analyzed from male and female volunteers, some of whom had been exposed to ultraviolet B light or given vitamin D3 orally. Results obtained with the three commercial kits were less accurate than those by HPLC. The agreement between the HPLC method and the comparison method was relatively good: r = 0.99; slope = 1.23; intercept = -2.9 micrograms/L. We conclude that methods based on HPLC should be preferred in routine clinical work and that the accuracy of the three commercial kits tested is not sufficient for their intended use. PMID- 3297424 TI - An enzyme immunoassay method for HCG in serum evaluated. PMID- 3297425 TI - Effects of sample preparation on cyclosporin G (NVA2-cyclosporin) concentration. PMID- 3297426 TI - Isometheptene cross reacts in the EMIT amphetamine assay. PMID- 3297427 TI - Critical issues in cyclosporine monitoring: report of the Task Force on Cyclosporine Monitoring. PMID- 3297428 TI - Clinical application of enzyme immunoassay in the analysis of citrullinemia. AB - We have developed a sensitive enzyme immunoassay (EIA) for the quantification of argininosuccinate synthetase (ASS) in the range of 0.05-1 ng/tube using a Fab' peroxidase conjugate prepared with maleimide compound devised by Ishikawa et al. Amounts of hepatic ASS in control subjects were determined by this method with the purified enzyme as a standard and their specific activities were calculated to be 1.3-1.4 mumol product/min (U)/mg of ASS, which was quite similar to that of the purified enzyme. Amounts of ASS in the liver of patients with three types of citrullinemia, type I, II and III according to our arbitrary classification, were determined by the EIA method. The following results were obtained: hepatic ASS from a patient diagnosed as type I citrullinemia because of its abnormally large Km values for citrulline and aspartate was calculated to have a specific activity of 0.18 U/mg of ASS, indicating that the enzyme is a variant; specific activities of ASS in the hepatic extract of type II citrullinemic patients were 1.2-1.3 U/mg of ASS, confirming the finding obtained by single radial immunodiffusion method that the decrease of the activity in type II is caused by a decrease in the total amount of ASS protein; a very small amount of immune cross-reactive material was detected in the liver of a patient diagnosed as type III citrullinemia based on findings of undetectable ASS activity in the liver and cultured skin fibroblast. PMID- 3297429 TI - Rapid suppression of plasma alkaline phosphatase activity after renal transplantation in patients with osteodystrophy. AB - Plasma alkaline phosphate activity is a important marker of increased skeletal turnover (both resorption and formation) and bone disease in uraemia, but its value after renal transplantation is uncertain. The rate of fall of alkaline phosphatase was compared in three groups of uraemic patients with osteodystrophy and elevated serum alkaline phosphatase undergoing either renal transplantation, parathyroidectomy or therapy with 1a hydroxylated vitamin D derivates. Alkaline phosphatase fell after transplantation, irrespective of graft function, with a half-time significantly less than the other treatments (p less than 0.001). We suggest that this represents a direct inhibitory effect of steroids on osteoblasts and that alkaline phosphatase is thus an unreliable marker of bone resorption after transplantation. PMID- 3297431 TI - Colonic motility in health and disease. PMID- 3297430 TI - Isoenzymes of urinary N-acetyl-beta-D-glucosaminidase (NAG) in patients with renal transplants. AB - Renal transplant recipients were divided into five categories according to their clinical course from transplantation to their discharge from hospital. Total N acetyl-beta-D-glucosaminidase (NAG) activity in urine was determined using a chromogenic substrate 2-methoxy-4-(2'-nitrovinyl)-phenyl 2-acetamido-2-deoxy-beta D-glucopyranoside. The isoenzyme composition of the urine of each patient was determined by semi-automated DEAE-cellulose chromatography. Although raised NAG activity was found in stable transplant patients compared to controls, the level of activity was constant and no change in the isoenzyme profile was found. In reversible rejection there was a marked increase in the intermediate forms, particularly I2 and a concomitant fall in the relative amount of the A-form present but the profile became normal when the patient stabilised. Much more complex patterns were observed in patients who did not respond to treatment. Both the B and I forms were elevated with a fall in the A-form and in one case excretion of the serum As form was observed. The intermediate forms were always increased in rejection. PMID- 3297432 TI - Effects of ethanol on the gastric mucosa. PMID- 3297433 TI - Menetrier's disease. PMID- 3297434 TI - Pain of chronic pancreatitis: etiology, natural history, therapy. AB - The pain of chronic pancreatitis can be tremendously disabling. The pathogenesis of this pain is still poorly understood, but there is good evidence demonstrating an inverse relationship with the degree of pancreatic insufficiency. Pancreatic enzyme therapy of pain and celiac plexus blocks carry promise, but larger studies with these modalities are needed. Surgery for pain relief is the last resort and should be based on pancreatic duct anatomy. PMID- 3297435 TI - Diabetes and the gastro-intestinal tract. PMID- 3297436 TI - Immunoglobulin G class and subclass antibodies to pneumococcal capsular polysaccharides. AB - Enzyme immunoassays were developed to measure immunoglobulin G (IgG) and IgG1-4 subclass antibodies to pneumococcal capsular polysaccharides (PCP) types 4 and 7F. In healthy subjects, anti-PCP antibodies were predominately of the IgG1 and IgG2 subclasses. There was a significant increase in IgG, IgG1, and IgG2 anti-PCP antibody concentrations following immunization with pneumococcal vaccine. IgG and IgG2, but not IgG1, anti-PCP antibody concentrations correlated with total anti PCP antibody concentrations measured by the standard radioimmunoassay and with serum opsonic activity for serotype 7F Streptococcus pneumoniae. Such IgG and IgG subclass antigen-specific antibody assays may be useful to investigate the immune response to pneumococcal polysaccharides. PMID- 3297438 TI - Polycythemia in pediatric renal transplantation. AB - Post-transplant polycythemia is not uncommon in adult patients and is usually transient, responding to phlebotomy. Five pediatric patients developed erythrocytosis post-transplantation. Three patients had end-stage renal disease due to cystinosis, one had reflux glomerulopathy and one had focal glomerular sclerosis. The probable causes of the polycythemia were graft arterial stenosis in three patients. In one, polycythemia occurred with nephrosis. Polycythemia with hypertension may indicate the presence of arterial stenosis in children post transplantation. PMID- 3297437 TI - Natural killer cell activity and antibody-dependent cellular cytotoxicity in patients under various immunosuppressive regimens. AB - The influence of various modes of immunosuppression using cyclosporin A (CyA), corticosteroids (Cort), azathioprine (AZA), and antithymocyte globulin (ATG) alone or in combination with each other upon natural killer (NK) cell activity and antibody-dependent cellular cytotoxicity (ADCC) was assessed. CyA given alone did not influence either NK or ADCC activity; in contrast, the administration of Cort resulted in a significant decline (P less than 0.01) of ADCC but not of NK activity (P greater than 0.1). The combination of the two drugs led to a significant impairment of NK activity (P less than 0.01). The combination of AZA and Cort was found to produce an even more pronounced reduction in NK activity compared to both healthy controls (P less than 0.001) as well as patients from the CyA + Cort group (P less than 0.001). A similar decrease was found also after the addition of ATG to CyA + Cort (P less than 0.001, compared both with patients on CyA + Cort and with controls). In these instances, ADCC showed an overall similar pattern. We conclude that the administration of either CyA or Cort does not influence NK activity, while the combination of CyA with Cort and of AZA with Cort leads to a decrease in both NK and ADCC activities. The monotherapy with Cort only leads to a reduction of ADCC. These findings may explain the higher incidence of malignancies in patients undergoing combined immunosuppressive treatment. PMID- 3297439 TI - Behavior of beta 2-microglobulin in patients with chronic renal failure undergoing hemodialysis, hemodiafiltration and continuous ambulatory peritoneal dialysis (CAPD). AB - beta 2-microglobulin (beta 2-m) is the major component of a new form of amyloid deposit found in carpal tunnel syndrome and dialysis arthropathy of long-term hemodialysis patients. In 52 patients on maintenance hemodialysis, serum beta 2-m concentration was elevated to 37.9 +/- 1.4 (normal 1.2 +/- 0.6) mg/l. It was correlated with the time on hemodialysis (r = 0.43, p less than 0.01) and was inversely correlated with residual renal function (r = 0.87, p less than 0.001). In 20 patients on CAPD, beta 2-m likewise was increased to 31.6 +/- 2.3 mg/l; daily elimination by dialysate was only 34 mg (normal 150 mg). Hemodialysis with a cuprophane membrane caused a rise in serum beta 2-m, whereas hemodiafiltration with a polysulfone membrane performed in 5 patients over 2 1/2 months was accompanied by a decrease in serum beta 2-m from 39.5 +/- 0.7 to 29.7 +/- 1.0 mg/l predialysis (19.1 +/- 1.1 postdialysis). On the other hand, beta 2-m elimination reached only approximately 100 mg per day in spite of markedly elevated serum levels. It is concluded that serum beta 2-m is massively elevated in long-term hemodialysis and CAPD patients; contrary to routine hemodialysis with cuprophane membranes, newer more permeable membranes will permit some elimination of beta 2-m. However, based on quantitative considerations it seems difficult to obtain beta 2-m concentrations in the high normal or moderately elevated range with present day techniques. PMID- 3297441 TI - Captopril vs. nifedipine. PMID- 3297440 TI - Glomerulonephritis, B monoclonal small lymphocytic lymphoma and mixed cryoglobulinemia. AB - A novel association in the same patient with small lymphocytic lymphoma, type II cryoglobulinemia and glomerulonephritis is reported. This case is also characterized by a quite unusual sequence of glomerular alterations. A first renal biopsy showed severe endocapillary proliferative glomerulonephritis due to monocytic infiltration without any evidence of deposition of immune reactants. The immune deposits associated with type II cryoglobulinemia were only observed at a second renal biopsy performed five months later. This case shows that mononuclear cells can be responsible in and of themselves for severe glomerular damage, without deposition of immune material, and suggests that monocytic infiltration might be the first stage of type II cryoglobulinemia associated glomerulonephritis. PMID- 3297442 TI - Reproducibility of myocardial thallium-201 washout in studies applying a standardized dipyridamole stress protocol. AB - Thallium-201 (201Tl) washout analysis was proposed as an adjunctive tool to improve the detection of coronary artery disease (CAD). Since reproducibility of 201Tl washout in dipyridamole (DPM) stress studies is unknown, this item was evaluated in 32 patients (24 with CAD, 8 without CAD), who were scintigraphed twice within 1-2 weeks. At 2 minutes following DPM infusion (0.5 mg/kg/5 min), 2 mCi 201Tl were injected. Global and segmental washout were calculated by comparing circumferential profiles of respective background-corrected stress (left anterior oblique (LAO) 45 degrees: 8 min postinfusion (p.i.), 35 min p.i.; anterior (ANT): 17 min p.i.; LAO 70 degrees: 26 min p.i.) and redistribution (4 h p.i.) images. Whereas visual findings were comparable for study I and II, reproducibility of 201Tl washout was low, indicated by comparing variances among patients with variance between studies, which were 28.8 and 71.2% of total variance, respectively. Mean differences of segmental washout between the studies ranged from 9.75 to 19.24% with only minor differences with regard to the different views and segments evaluated. Variability was lower using the intermediate instead of the initial scintigram as reference for the redistribution image (12.87 +/- 11.64% vs. 18.59 +/- 14.43%, n = 85; p less than 0.01). Variability was higher for nonstenosed compared to stenosed segments (14.54 +/- 11.41%, n = 32 vs. 9.89 +/- 8.03%, n = 28, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297443 TI - Earl H. Wood: outstanding twentieth century investigator of the heart and circulation. PMID- 3297444 TI - Effect of captopril on left ventricular end-systolic pressure-volume and stress shortening relations in severe cardiac failure. AB - The effects of captopril on cardiovascular dynamics and left ventricular (LV) contractility were studied in 11 patients with severe congestive heart failure and very poor global LV function. Pressures were measured using a flow-guided catheter, cardiac output by thermodilution, and LV contraction and ejection fraction by simultaneous radionuclide angiography. Ventricular loading conditions were altered by sublingual isosorbide dinitrate to facilitate construction of LV pressure-volume and stress-shortening curves. Captopril decreased mean arterial pressure (p less than 0.02) and systemic vascular resistance, while stroke and cardiac index increased in most patients. Left ventricular ejection fraction increased from 18 +/- 5 to 22 +/- 7% (p less than 0.05), but contractility, assessed from end-systolic pressure-volume and end-systolic pressure-shortening relations, was unchanged or decreased slightly. Heart rate and double product also tended to decrease. In contrast, arteriovenous oxygen difference widened and calculated total oxygen consumption increased during captopril therapy (p less than 0.05). The study showed that captopril improved forward blood flow, total oxygen extraction, and LV ejection fraction following the decrease impedance to LV emptying but not at the expense of an increase in ventricular contractility. This makes captopril an attractive drug for patients with end-stage cardiac failure and a severely damaged myocardium. PMID- 3297445 TI - Magnesium infusion reduces the incidence of arrhythmias in acute myocardial infarction. A double-blind placebo-controlled study. AB - In a double-blind placebo-controlled study, 130 patients with verified acute myocardial infarction were given magnesium or placebo treatment intravenously immediately upon admission to hospital. The incidence of arrhythmias requiring treatment during the initial week of hospitalization was registered. Serum magnesium concentrations were increased from 0.7 mmol/l to 1.3 mmol/l as a result of the magnesium infusions. This pharmacologically induced hypermagnesemia resulted in a reduction in the incidence of arrhythmias from 47% in the placebo group to 21% in the magnesium group (p = 0.003). In the magnesium-treated patients, increments in serum concentrations of magnesium and potassium correlated positively (r = 0.47, p less than 0.001). It is concluded that magnesium infusion in the postinfarct period reduces the incidence of supraventricular tachyarrhythmias, and possible pathophysiological mechanisms involved are discussed. PMID- 3297446 TI - Hemopoietic cell dysfunction in murine lupus. AB - Irregularities have appeared through almost the entire detectable range of hemopoiesis, from stem cells to functional mature populations in several models of murine lupus. The documentation of widespread abnormalities in many cell lineages implies the existence of a common, defective ancestor, perhaps the pluripotential hemopoietic stem cell. Of major concern are the microenvironmental pressures that may be driving hemopoiesis to its pathological state. The studies to date have not isolated the hemopoietic components from their cellular surroundings. Hence, the existence of a primary defect in any particular cell compartment is as yet an unanswerable point. Additionally, maternal forces must be considered as environmental factors whose consequences may extend into postnatal life. Also, the possible existence of hemopoietic cell influences on their environs are always present, creating a cellular ecosystem. As new techniques become available for the analysis of these cells, such as long-term cell culturing, more complete pictures of these murine models of autoimmunity will emerge. PMID- 3297447 TI - Non-steroidal anti-inflammatory analgesics and oral corticosteroids in rheumatoid arthritis: do we need both? PMID- 3297450 TI - Examination by ultrasound of Legg-Calve-Perthes disease. AB - Eleven patients with Legg-Calve-Perthes disease (LCP) were examined ultrasonographically for their femoral head deformity. The outline of the cartilaginous femoral head was well demonstrated, and the image obtained corresponded to that observed by arthrography. Using ultrasonography, a simple method was developed to determine the rate of deformity due to LCP. Ultrasonography does not have the hazards of x-ray and is useful for the diagnosis of LCP. PMID- 3297451 TI - Cancellous bone support for patellar resurfacing. AB - The purpose of this study was to determine the compressive resistance of the cancellous bone in nine fresh specimens of human patellae. Standardized radiographic assessment and subsequent osteotomies were performed on each specimen. Grid patterns based on patellar anatomy enabled topographic compression on a material test system (MTS) Model 835 Bionix Universal Testing Machine (MTS Corporation, Minneapolis, MN) using a 4-mm diameter indentor. It was demonstrated that sacrifice of the patellar subchondral bone removes with it the strong cancellous bone support and topographic strength patterns of the cancellous bone on the surface of a patellar osteotomy does not have a consistent pattern in relation to the intracondylar eminence. Consequently, placement of fixation pegs is not critical with respect to strength of bony support. PMID- 3297449 TI - In vitro degradation of extracellular matrix by human ovarian carcinoma cells. AB - Better in vitro models are needed to elucidate the mechanisms underlying tissue destruction by human tumor cells. To address this matter recently isolated and characterized human ovarian carcinoma cell lines derived from either primary tumors, ascitic effusions or metastatic growths were plated in direct contact with extracellular matrix (ECM) previously deposited on culture dishes by bovine corneal endothelial cells. Light and electron microscopy of four of the five ovarian tumor cell lines demonstrated morphologic digestion with penetration of ECM by tumor cell microvilli, along with associated rarefaction. The ability of these same ovarian tumor cell lines to solubilize specific carbohydrate and protein moieties present in intact ECM was assessed with the use of metabolically prelabeled ECM employing tritiated fucose, galactose, glucosamine and proline. Results from these studies corroborated morphologic observations in which four of the five tumor cell lines tested extensively solubilized radiolabeled ECM. The kinetics of radiolabel release from ECM illustrated that three of the four invasive tumors released [3H]fucose, [3H]glucosamine and [3H]proline at high rates. Normal human ovarian fibroblasts and mesothelial cells were observed to be unable to digest ECM and this was consistent with their inability to release radiolabeled material from prelabeled ECM. The results from these studies suggest that some ovarian carcinomas have the ability to degrade basement membrane components. Knowledge regarding the mechanisms responsible for tissue degradation may eventually lead to the development of new chemotherapeutic modalities designed to restrict tumor cell invasion, growth and metastasis. PMID- 3297453 TI - The classic. On fracture of the metacarpal bone of the thumb. By Edward H. Bennett, 1886. PMID- 3297448 TI - Perspectives in the treatment of cancer metastasis. PMID- 3297452 TI - Reconstruction of a traumatic hallux amputation using a plantar V-Y advancement flap. AB - A plantar V-Y advancement flap is effective for reconstruction of a hallux amputation. The procedure provides adequate padding with good toe contour, maintains length, and preserves sensation. Technically, the reconstruction is not difficult. Recovery is rapid. PMID- 3297454 TI - Long-term complications of trapeziometacarpal silicone arthroplasty. AB - The trapeziometacarpal joint is often affected by arthritis and treated by surgical methods. The significant forces to which this joint is subjected challenge even the most sturdy prosthetic materials. Short-term complications of arthroplasty are caused by inadequate bony resection and instability. Serious long-term problems results from implant wear and the host tissues' response to the implant. Although silicone elastomer prostheses are generally well tolerated, wear-induced microparticles (15 micron or less) incite an intense inflammatory and destructive synovial response. This "silicone synovitis" typically presents more than two years after arthroplasty and is characterized by pain, swelling, and lytic lesions visible on roentgenogram. The silicone microparticles are generated by cyclic physiologic bearing, shear, and compression forces for which these implants have not been tested. The destructive synovitis is arrested by synovectomy, implant removal, and curettage of the lytic defects. Functional salvage requires conversion to resection arthroplasty or arthrodesis. Patients with silicone implant arthroplasty must be followed indefinitely, at frequent intervals, by clinical examination and roentgenograms. Overall, however, experience indicates that resection arthroplasty is the most predictable and functional procedure for the nonrheumatoid basal thumb joint. PMID- 3297455 TI - Mycotic aneurysm visualized on technetium-99m venogram. PMID- 3297456 TI - Acute tubular necrosis secondary to rhabdomyolysis with complete absence of renal perfusion. AB - Absent renal perfusion on a Tc-99m DTPA radionuclide study was observed in a patient with acute tubular necrosis following rhabdomyolysis. Complete recovery was achieved with conservative treatment. Absence of renal perfusion does not indicate a nonviable kidney. PMID- 3297457 TI - Significance of skeletal uptake detected on radionuclide renal perfusion studies. AB - Since the introduction of Tc-99m labeled radiopharmaceuticals, flow studies have become a useful and readily performed component of renal nuclear medicine examinations. In addition to detecting aberrations of renal perfusion, a number of extrarenal abnormalities may also be surreptitiously detected. Three cases of hyperperfused skeleton, an extremely unusual finding which complements two previous reports in the literature, have recently been observed. All three of the patients, as well as the two previously described, had underlying neoplastic abnormalities. The appearance of perfused skeleton should therefore be recognized as suggesting the presence of underlying neoplastic disease. Considerable interest as to the etiology and magnitude of the increased skeletal perfusion exists. Measurements of normal marrow and osseous perfusion have been reviewed in order to better appreciate the magnitude of increase required for skeletal visualization on renal flow studies. Some considerations as to the etiology of this increase are offered. PMID- 3297458 TI - Gallbladder visualization after hepatic washout. AB - Washout of hepatic activity on hepatobiliary scintigraphy has been used as a rationale to stop imaging during evaluation for acute cholecystitis. A case is presented that shows gallbladder visualization after the liver has washed out on analog images. The need for strict application of delayed imaging at hepatobiliary scintigraphy for acute cholecystitis is reemphasized. PMID- 3297459 TI - Phantom gallbladder. A variant of the rim sign. AB - Nonvisualization of the gallbladder is the primary finding in cholescintigraphy for acute cholecystitis. Recent investigators have described a useful secondary finding of increased pericholecystic hepatic activity (PCHA). A case of acute cholecystitis is presented in which the PCHA was round in configuration and appeared in the first 5 minutes of the study. This may be a source of diagnostic error if it is interpreted as visualization of the normal gallbladder. Appearance of the PCHA has not been previously described before 30 minutes. This case of early appearance raises the possibility that hyperemia may play a role as the cause in some forms of the PCHA. The phantom gallbladder was correctly identified as PCHA by observing the peak of activity of the PCHA occurring before the appearance of intrahepatic biliary radicals. PMID- 3297460 TI - Unexplained technetium-99m DTPA uptake by lung. PMID- 3297461 TI - Comparative imaging. Bile-plug syndrome. PMID- 3297464 TI - Ethical and legal issues in adolescent pregnancy. AB - A review of the health consequences of adolescent pregnancy indicates that pregnancy in adolescents has a higher mortality rate than that of legal abortions. The rights of minors to give consent to medical care is expressed in the mature minor doctrine and has been extended, with some limitations, to the abortion decision. Efforts to persuade adolescent patients that they should involve their parents in their medical care may be very beneficial; however, when this cannot be achieved, the adolescent should receive confidential medical care, with the adult professional assuming a protective role. PMID- 3297465 TI - Legal and ethical implications of surrogate mother contracts. AB - Numerous legal and ethical issues are raised by the use of surrogate arrangements as a reproductive alternative. The purpose of this article is to provide physicians and other health care professionals with a basic overview of the legal issues and to outline some of the ethical considerations so that they might make more well-informed decisions about their personal involvement in surrogate arrangements and to better counsel their patients who might be considering such arrangements. PMID- 3297462 TI - The clinical pharmacology of etoposide and teniposide. AB - Etoposide and teniposide are semisynthetic derivatives of podophyllotoxin and are increasingly used in cancer medicine. Teniposide is more highly protein-bound than etoposide, and its uptake and binding to cells is also greater. Etoposide and teniposide are phase-specific cytotoxic drugs acting in the late S and early G2 phases of the cell cycle. They appear to act by causing breaks in DNA via an interaction with DNA topoisomerase II or by the formation of free radicals. Teniposide is more potent as regards the production of DNA damage and cytotoxicity. Most studies show a biexponential decay following intravenous administration of etoposide and teniposide. The terminal elimination half-life of etoposide is less than that of teniposide, and the plasma and renal clearances of etoposide are greater. The peak plasma concentrations of drug and the area under the concentration versus time curve are linearly related to the intravenous dose of both drugs. Considerable interpatient variability of pharmacokinetic parameters exists following intravenous etoposide and teniposide. Various metabolites of etoposide and teniposide have been identified but their detection and quantitation are disputed. Approximately 30 to 70% of a dose of etoposide is accounted for by excretion, whereas the figure appears to be only 5 to 20% for teniposide. The bioavailability of oral etoposide is about 50% but its absorption is not linear with increasing dose within the range in clinical use. There is considerable inter- and intrapatient variability in the pharmacokinetics of oral etoposide. There is no evidence of accumulation of etoposide and teniposide after multiple consecutive doses by the intravenous or oral routes. The exact roles of the liver and kidney in metabolism and excretion of etoposide and teniposide are uncertain. Etoposide has been shown to be a highly schedule-dependent drug in clinical studies. This together with the phase-specific action of etoposide and teniposide and their increasingly widespread use in cancer medicine make the clinical pharmacology of these drugs of great clinical importance. PMID- 3297466 TI - Ethical aspects of prenatal diagnosis: views of U.S. medical geneticists. AB - This article presents data from a study of 295 qualified medical geneticists in the United States. The study's objective was to determine the degree of consensus and variation among practicing medical geneticists about the major ethical problems of prenatal diagnosis. Based on the data presented, the argument has been made that most medical geneticists share a dominant moral approach on three major problems: abortion choices, controversial indications for fetal diagnosis, and problems in disclosure of ambiguous or disputed results. Ethical problems in selective termination in high-risk twin and multiple pregnancies need more study. A preliminary evaluation of the strengths and weaknesses of prevailing standards in prenatal diagnosis was also made. Three weaknesses were noted: neglect of the demands for fairness in access to and distribution of prenatal diagnosis in the United States, unpreparedness for society's growing concerns about developing trends in human genetics, and need for changes in non-directive counseling in order to appreciate the complexities that will accompany the introduction of proven new treatments for genetic disorders. PMID- 3297467 TI - Antihypertensive effects of parenteral nicardipine alone and in combination with captopril. AB - We studied the safety and efficacy of intravenous nicardipine alone and in combination with oral captopril. Sixteen patients with essential hypertension received a single oral dose of captopril, 50 mg, to be certain that excessive hypotension would not occur. Nicardipine was given intravenously as a 2 mg bolus, followed by an infusion at a rate designed to lower the supine diastolic blood pressure at least 10 mm Hg; then oral captopril, 50 mg, or placebo was given. The next week, nicardipine was again infused, but the alternate oral treatment was given. Intravenous nicardipine reduced blood pressure from 156 +/- 15/101 +/- 5 mm Hg (mean arterial blood pressure 120 +/- 6 mm Hg) to 140 +/- 11/88 +/- 4 mm Hg (mean arterial blood pressure 105 +/- 5 mm Hg). When captopril was added to nicardipine, the mean arterial blood pressure fell an additional 8 mm Hg but the heart rate did not increase. The combination of angiotensin-converting enzyme inhibition and calcium channel blockage produces additive antihypertensive effects without additional reflex tachycardia. PMID- 3297469 TI - Time course of changes in hepatic metabolism in response to sepsis in the rat: impairment of gluconeogenesis and ketogenesis in vitro. AB - The time course (12, 24 and 48 h) of changes in blood metabolites, and in gluconeogenesis and ketogenesis, in isolated hepatocytes from rats made septic by caecal ligation and puncture was measured. Blood glucose was not significantly different in septic rats, but lactate was increased at 12, 24 and 48 h; pyruvate and alanine were increased at 48 h. The blood ketone body concentrations were decreased at all times studied after induction of sepsis. These changes were accompanied by increased plasma insulin in the septic rats. The rate of hepatic lipogenesis in vivo was increased at 24 and 48 h. There were appreciable increases in the hepatic concentrations of alanine (200%), lactate (200%) and pyruvate (100%) as well as other intermediates in the gluconeogenic pathway. The hepatic concentrations of acetyl-CoA and ketone bodies were decreased. The rate of gluconeogenesis from added lactate, pyruvate, alanine and glutamine was depressed in isolated hepatocytes from septic rats at 24 and 48 h. The basal rate of ketogenesis or the rate from butyrate in isolated hepatocytes was not significantly altered by sepsis, whereas the rate from oleate was decreased at all time points. It is concluded that there is an impairment of the capacity for gluconeogenesis and ketogenesis in livers of septic rats. The latter may be due to decreased entry of long-chain acyl-CoA into the mitochondria for oxidation. The possibility that these changes are in part brought about by the hyperinsulinaemia associated with the sepsis is discussed. PMID- 3297468 TI - A double-blind, randomized, controlled trial comparing pinacidil to hydralazine in essential hypertension. AB - Pinacidil is a direct vasodilator with good absorption, a half-life of 2 to 4 hours, and side effects similar to those of other vasodilators. We hypothesized that controlled-release pinacidil would be comparable to or better than hydralazine for blood pressure control and side effects. A double-blind, randomized trial comparing pinacidil with hydralazine when combined with hydrochlorothiazide or propranolol to control side effects or the diastolic blood pressure was performed. Pinacidil decreased systolic and diastolic blood pressure from 156/100 mm Hg to 132/81 mm Hg. The increase in heart rate and weight with both drugs was controlled with the additional drugs. There was 1/17 successes on monotherapy with both drugs. When combined with other drugs there were 15/18 successes with hydralazine and 16/20 successes with pinacidil. Side effects were typical of vasodilators. Both drugs acutely increased plasma norepinephrine and epinephrine during chronic therapy. PMID- 3297470 TI - Multiple forms of immunoreactive renin in human adrenocortical tumour tissue from patients with primary aldosteronism. AB - There is increasing evidence which suggests that the adrenal gland contains the renin-angiotensin cycle. The localization of renin has been reported to be mainly in the zona glomerulosa rather than the fasciculata medullary portion. In the present study we have investigated extracts from aldosteronomas (n = 3), which are believed to derive from the zona glomerulosa cells. In addition, we have attempted to characterize the biochemical properties of the adrenal renin. Sizable quantities of renin-like activity (32.0 +/- 7.7 ng of angiotensin I generated h-1 mg-1 of protein, mean +/- SEM) were detected in the extracts. This renin-like activity was inhibited by anti-renin antibody raised against pure renin (mean, 95% of the total renin-like activity), indicating that it was not due to the non-specific action of proteases such as cathepsin D. The optimum pH of the tissue renin-like enzyme was 6.0 for rat plasma substrate. Differences were found, however, in the molecular mass (36,000, 37,000, 44,000 and 48,000), binding to concanavalin A and isoelectric points (4.40, 4.68 and 5.00). These results confirm the existence of specific renin in aldosteronoma. Renin microheterogeneity could be evidence for local production of the enzyme. PMID- 3297463 TI - The pharmacokinetics of antiarrhythmic agents in pregnancy and lactation. AB - The pharmacokinetics of various drugs may be profoundly altered during different stages of pregnancy, parturition, and lactation. Gastrointestinal absorption or bioavailability of drugs may vary due to changes in gastric secretion and motility. Various haemodynamic changes such as an increase in cardiac output, blood volume, and renal plasma flow may affect drug disposition and elimination. The increase in blood volume and total body water which occurs during pregnancy can alter the volume of distribution for various drugs. Although exact quantifications are not easy, these changes in pharmacokinetic parameters should be considered when dosing antiarrhythmic agents in pregnant women. Plasma protein concentrations and drug binding capacity are altered in the mother and fetus as pregnancy advances. With highly protein bound drugs, these changes may be clinically significant, as the pharmacological efficacy and toxicity are presumed to be related to the concentration of free drug in both the mother and fetus. In some instances, the fetus may be susceptible to greater drug toxicity as free drug concentrations may be underestimated by measurement of total drug concentrations. Changes in maternal drug metabolism and metabolism by the fetoplacental unit also contribute to alterations in the pharmacokinetics of drugs. As the placenta contains many metabolising enzymes, biotransformation of drugs at this site could potentially convert a drug into an active metabolite, or prevent fetal exposure to a toxic drug. Placental transfer of drugs, leading to toxicity in the fetus, is a major concern in the pharmacological management of the pregnant patient. The passage of individual drugs will vary depending on their apparent volumes of distribution, degree of protein binding the rates of metabolic conversion and excretion within the placenta and fetus, the pH difference between the maternal and fetal fluids, and maternal haemodynamic changes. Drug properties such as lipid solubility, protein binding characteristics, and ionisation constant (pKa) also influence the placental passage of drugs. For weakly basic antiarrhythmic agents, the fetal drug concentration may potentially exceed the maternal plasma concentration when the fetal pH is lowered as in the case of fetal acidosis; this is due to 'ion trapping'. Additionally, higher free drug concentrations of these basic drugs may exist, due to decreased alpha 1-acid glycoprotein concentration and binding affinity in the fetus. Lignocaine (lidocaine) has been shown to enter fetal plasma rapidly with fetal-maternal concentration ratios in the range of 0.52 to 0.66.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297471 TI - The effect of insulin-induced hypoglycaemia on gastrointestinal motility in man. AB - The effect of insulin-induced hypoglycaemia on gastro-jejunal motility was studied in five, healthy, male subjects using tethered, pressure sensitive, radiotelemetry capsules. Thirty minutes after the intravenous injection of soluble insulin (0.15 unit/kg body weight), a significant reduction in blood glucose concentration (control: 5.26 +/- 0.19 SEM mmol/l; insulin: 1.48 +/- 0.44 mmol/l; P less than 0.001) was associated with a rise in heart rate (mean peak rise 29 +/- 8 beats/min, P less than 0.05), systolic arterial blood pressure (mean peak rise 28 +/- 4 mmHg, P less than 0.01) and plasma pancreatic polypeptide concentration (control: 20 +/- 7 pmol/l; insulin: 287 +/- 66 pmol/l; P less than 0.01). These events coincided with a short period of jejunal motor activity, which was not associated with gastric motor activity nor with raised plasma motilin concentrations. During the control study, there were no changes in blood glucose concentration, heart rate, arterial blood pressure or plasma pancreatic polypeptide concentrations, and there was no jejunal motor activity. The interval between successive gastric migrating motor complexes (MMC) was not significantly different in the insulin and control studies (control: median interval 110 min, range 108-148 min; insulin: median interval 124 min, range 115 125 min), suggesting that the fasting gastrojejunal MMC and jejunal motor activity arose independently. Insulin-induced hypoglycaemia is accompanied by jejunal motor activity, which may underlie the abdominal symptoms associated with hypoglycaemia. PMID- 3297472 TI - Renal and cardiovascular effects of caffeine: a dose-response study. AB - The effects of increasing oral doses of caffeine (45, 90, 180 and 360 mg) on effective renal plasma flow (ERPF), plasma renin activity (PRA), serum electrolytes, plasma noradrenaline, blood pressure and heart rate were studied in eight healthy male volunteers. Urine volume was increased by 360 mg of caffeine only. At caffeine doses greater than 90 mg urinary sodium excretion was significantly increased. There were no changes in ERPF. Serum potassium was significantly reduced by 360 mg of caffeine. Caffeine increased systolic pressure in a dose related manner. Diastolic pressure was also increased, but not in relation to dose. A 360 mg dose of caffeine produced a late increase in heart rate. These changes were not associated with any alterations in PRA or in plasma noradrenaline. PMID- 3297473 TI - The effect of fat on bone mineral measurements in normal subjects with recommended values of bone, muscle and fat attenuation coefficients. AB - Published data concerning the amount, distribution and composition of bone marrow and soft tissue fat in normal subjects are reviewed. Experimental studies of the effect of fat upon bone mineral measurement have been examined. Values of calculated and measured attenuation coefficients for bone, soft tissue and fat in the energy range of interest for bone mineral measurements have been collected and compared. For most measurement sites and in most normal subjects the thickness of fat within bone marrow is comparable with the thickness of the subcutaneous fat layer, although in obese individuals subcutaneous fat thickness can be twice the marrow fat thicknesses. In specific measurement sites there is also a contribution from deep-seated soft tissue fat which is of a similar magnitude to marrow fat. The presence of bone marrow fat alters measured values to the greatest extent in CT measurements of lumbar spine mineral, partly because the incident photon energy is higher than in single and dual photon absorptiometry but also because the fraction occupied by fat in the volume of tissue examined is larger. For scattering techniques the measured value is reduced by the volume fraction occupied by fat. The normal changes in marrow and soft tissue fat observed with aging have little influence on either scattering or transmission measurement. The values of measured and calculated linear attenuation coefficients given by previous workers show reasonable agreement despite considerable differences between measurement techniques and calculation procedures. PMID- 3297474 TI - Denture status and need for prosthodontic treatment among institutionalized elderly in Denmark. AB - The purpose of the present study was to estimate the realistic need for prosthodontic treatment among institutionalized elderly in Denmark. The study population comprised 486 elderly in nursing homes and 199 in hospital long-term care facilities. The realistic need for treatment was estimated on the basis of the normative and the perceived needs, taking into account the general mental and physical state of each individual as assessed by the charge nurses. The investigation revealed that the majority of the elderly were markedly handicapped, two-thirds were unable to care for themselves, and 15% were in poor mental condition. Among the residents of nursing homes 67% had a normative need for prosthodontic treatment, e.g. new dentures, relining and/or corrections of occlusion, as compared to 71% of the elderly in hospital long-term care facilities. However, only 19% of the nursing home residents and 32% of the elderly in long-term care facilities has a realistic treatment need. The differences between the two groups of elderly are explained by differences in age and general health status. It can be concluded that the realistic need for prosthodontic treatment among institutionalized elderly in Denmark is far from being met, and that this problem can only be solved if given higher priority by the political decision-makers. PMID- 3297475 TI - What is the function of protein carboxyl methylation? AB - The following functions of protein carboxyl methylation seem to be reasonably well established: Multiple, stoichiometric methylation of chemotactic receptors in bacteria at glutamyl residues serves as one (but not the only) adaptation mechanism of the transduction chain to constant background levels of chemotactic stimuli. Stoichiometric methylation of hormones and hormone carrier proteins plays a role in hormone storage and secretion by the pituitary gland. Substoichiometric methylation at D-aspartyl residues is involved in a repair mechanism of aged proteins. Stoichiometric methylation of calmodulin modulates the sensitivity of calmodulin-dependent processes to calcium. Research of the past 3 years has indicated that in order to demonstrate an involvement of methylation in the coupling of surface receptors to intracellular events three new criteria have to be met: (a) the cell should possess a protein carboxyl methylase with relatively narrow substrate specificity; (b) methylation should take place at L-amino acid residues; (c) the methyl accepting proteins should be methylated in a stoichiometric fashion. PMID- 3297476 TI - Occurrence, absorption and metabolism of short chain fatty acids in the digestive tract of mammals. AB - Short chain fatty acids (SCFA) also named volatile fatty acids, mainly acetate, propionate and butyrate, are the major end-products of the microbial digestion of carbohydrates in the alimentary canal. The highest concentrations are observed in the forestomach of the ruminants and in the large intestine (caecum and colon) of all the mammals. Butyrate and caproate released by action of gastric lipase on bovine milk triacylglycerols ingested by preruminants or infants are of nutritional importance too. Both squamous stratified mucosa of rumen and columnar simple epithelium of intestine absorb readily SCFA. The mechanisms of SCFA absorption are incompletely known. Passive diffusion of the unionized form across the cell membrane is currently admitted. In the lumen, the necessary protonation of SCFA anions could come first from the hydration of CO2. The ubiquitous cell membrane process of Na+-H+ exchange can also supply luminal protons. Evidence for an acid microclimate (pH = 5.8-6.8) suitable for SCFA-protonation on the surface of the intestinal lining has been provided recently. This microclimate would be generated by an epithelial secretion of H+ ions and would be protected by the mucus coating from the variable pH of luminal contents. Part of the absorbed SCFA does not reach plasma because it is metabolized in the gastrointestinal wall. Acetate incorporation in mucosal higher lipids is well-known. However, the preponderant metabolic pathway for all the SCFA is catabolism to CO2 except in the rumen wall where about 80% of butyrate is converted to ketone bodies which afterwards flow into bloodstream. Thus, SCFA are an important energy source for the gut mucosa itself. PMID- 3297477 TI - The Root effect. AB - Considering the presently available data it is clear that the Root effect represents an exaggerated alkaline Bohr effect which occurs in the absence of a normal acid Bohr effect and is associated with a loss of oxygen binding capacity at low pH. Undoubtedly at the molecular level the presence of a Ser residue at position F9(94) beta in these haemoglobin is of primary importance. No Root effect haemoglobin has yet been identified which lacks this substitution. On the other hand however many haemoglobins are known which possess this Ser residue and at the same time lack a Root effect. Other factors arising from interactions at other sites in the haemoglobin molecule are obviously sufficient to negate the otherwise stabilizing effect of this critical Ser residue. The loss of cooperativity of Root effect systems as the pH is lowered is readily explained as due to stabilization of the low affinity T state to such a degree that the switch to the high affinity R state is suppressed even in the fully liganded molecule. The observation of Hill coefficients of less than unity requires that within the T state chain heterogeneity exists such that the alpha and beta chain haems demonstrate significantly different affinities for ligand. The physiological role of Root effect haemoglobins is demonstrably not inevitably linked to the swim bladder but more probably arose from the need to oxygenate the poorly vascularized retina of many fishes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297478 TI - An editing method for computer-assisted ambulatory ECG review systems. AB - Editing of computer-assisted ambulatory ECG reviews is critical for accuracy and quantification of the arrhythmias present. This may be time consuming for high arrhythmia content types or tapes with noise interference. A system that combines probit analysis and principle components transformation coupled with maximum likelihood decision theory, through identification of the complexes most subject to classification error in the initial review process and by correcting residual errors automatically, can decrease the number of complexes which need to be overread by a human editor. Probit analysis assigns a statistically derived value, a z value, to complexes classified as normal sinus or ventricular premature complexes. This permits the grouping of complexes for which the likelihood of being normal sinus or ventricular premature is high and a group which has a greater likelihood of being incorrectly classified. This latter group can be shown to the human editor for verification or correction of classification. The complexes undergo principle components transformation which describes the QRS by a set of derived components. When a classification is approved or changed by the human editor, the computer, utilizing maximum likelihood decision rules, moves ahead in the tape to correct the classification of the remaining unedited complexes on the basis of the similarity of their principle components profile to the edited ones. The system reduced total errors, false positive or false negative, to less than one percent in all of the high arrhythmia and noise content tapes used for this study. PMID- 3297479 TI - A computational model of reasoning from the clinical literature. AB - This paper explores the premise that a formalized representation of empirical studies can play a central role in computer-based decision support. The specific motivations underlying this research include the following propositions: Reasoning from experimental evidence contained in the clinical literature is central to the decisions physicians make in patient care. A computational model, based upon a declarative representation for published reports of clinical studies, can drive a computer program that selectively tailors knowledge of the clinical literature as it is applied to a particular case. The development of such a computational model is an important first step toward filling a void in computer-based decision support systems. Furthermore, the model may help us better understand the general principles of reasoning from experimental evidence both in medicine and other domains. Roundsman is a developmental computer system which draws upon structured representations of the clinical literature in order to critique plans for the management of primary breast cancer. Roundsman is able to produce patient-specific analyses of breast cancer management options based on the 24 clinical studies currently encoded in its knowledge base. The Roundsman system is a first step in exploring how the computer can help to bring a critical analysis of the relevant literature to the physician, structured around a particular patient and treatment decision. PMID- 3297480 TI - [Description of the "Notes on nursing" by Nightingale. (9)]. PMID- 3297481 TI - Human safety study of body lotion containing Kathon CG. AB - The safety of Kathon CG biocide as a preservative in leave-on body lotions was assessed by 2 double-blind studies, using similar protocols. A total of 209 healthy male and female subjects aged 18 to 65 years, 100 in California (72 test subjects, 28 controls) and 109 in Florida (88 test subjects, 21 controls) completed the studies which included pre- and post-use phase diagnostic patch testing with Kathon CG 100 ppm active ingredient, and 13 weeks daily applications of either a test lotion containing Kathon CG 15 ppm active ingredient or a control lotion without Kathon CG. No evidence of irritation or sensitization attributable to use of the biocide was found during regular dermatological examinations during the use phase. Post-use phase patch testing produced negative results in all subjects with the exception of 1 control subject in Florida who had positive readings at the 2- and 4-week post-use phase patch testing. Overall, these studies show there is minimal, if any, risk of adverse effects associated with the use of Kathon CG 15 ppm active ingredient in a leave-on application. PMID- 3297482 TI - A clinical trial of Neo Sampoon vaginal tablets and Emko foam in Alexandria, Egypt. AB - Results are reported for a comparative 12-month study of Neo Sampoon foaming vaginal tablets containing 60 mg of the spermicide, menfegol, and Emko vaginal foam containing an 8.0% concentration of the spermicide, nonoxynol-9. Conducted in cooperation with the Family Planning Association in Alexandria, Egypt, the trial included 349 women who were randomly allocated to use one of the two contraceptive products. The twelve-month cumulative life-table rate for accidental pregnancy (per 100 women) was 2.8 for Neo Sampoon tablet users and 2.1 for Emko foam users. The 12-month continuation rates were 77.6 and 77.2 per 100 women for the tablet and foam groups, respectively. In both groups, the majority of discontinuations from the study were for personal reasons, including lack of confidence in the method, messiness, partner's objection and a burning sensation. Few women reported a product-related complaint while using their assigned contraceptive method. The most commonly reported complaint for both methods was that use of the product led to an uncomfortable burning sensation for the woman and/or her partner. This complaint, however, was cited by less than 5% of the women in each group. Thus, a combination of low pregnancy rates, few complications and complaints and high continuation rates confirm the relative acceptability, effectiveness and short-term safety of these methods of contraception among this sample of Egyptian women. PMID- 3297483 TI - Clinical experience with ethynodiol diacetate 0.5 mg daily as an oral contraceptive. AB - Femulen, a progestogen only oral contraceptive (ethynodiol diacetate 0.5mg), was evaluated for its contraceptive efficacy and safety in 425 women aged between 16 and 47 years. This was a multicentre open study carried out in General Practice and Family Planning clinics. Five pregnancies were reported, three of which were a result of patient failure. The net pregnancy rate at one year for method failure was 0.5%. No ectopic pregnancy was reported. The median length of the menstrual period was between four and five days and the average length of the non bleeding interval remained between 24 and 25 days throughout the study. Blood pressure on the whole remained within normal limits. However, there was a small decrease in both systolic and diastolic blood pressure which did not reach significant levels. Body weight was unaltered and no abnormality was found in cervical smears. Femulen was shown to be an effective and acceptable contraceptive in women of varying ages. PMID- 3297484 TI - The fate of patients who met the criteria for heart transplantation. AB - In the 1975-1986 period, the authors registered 26 male patients (mean age 42 +/- 12 years) with manifestations of severe heart failure refractory to any internal treatment currently available. The disease was not manageable by any conventional surgical intervention either. All patients met the criteria for heart transplantation. The overwhelming majority of them (88%) died within 6 months after inclusion in the study. The authors discuss the criteria, warranting responsible decision-making on indication for heart transplantation. PMID- 3297485 TI - Collagen peptidase in serum of patients with myocardial infarction. AB - Activity of collagen peptidase was measured in patients with myocardial infarction. Determinations were carried out 1, 3, 6, 9, 14 and 21 days after admission to the hospital. A decrease of activity was observed between the 6th 21st day of the disease. A low correlation with serum aminotransferases was found. It is concluded that estimation of serum collagen peptidase does not reflect accumulation of collagen in the healing heart muscle. PMID- 3297486 TI - Event-related potentials: a critical review of methods for single-trial detection. AB - The analysis of ERP data has followed several lines over the last 20 years. The most prevalent method is simply to average ERPs for a given class of stimuli. The ERPs are compared for differences across classes of stimuli. Little other special data processing is used. The ERP comparisons are usually performed using visual examination of the wave-shapes. Sometimes statistics are calculated such as means, variances, and confidence limits. Linear filtering is used to reduce interference. Another approach is to model or analyze the ERP as a sequence of vectors or frames of data samples. These samples may be of the ERP time waveform or they may be of the frequency transform of the ERP waveform. The frames of data vary in length from the entire ERP waveform (500 to 1000 msec) to frames as short as ten sample points (100 msec). Recognition of an event in the ERP is achieved by computing a distance measure between parameter vectors for one class of stimuli and corresponding parameter vectors for another class of stimuli. Recognition is achieved by selecting the ERP with the lowest distance score. This approach is "pattern matching" and relies on two assumptions: adjacent frames of data are uncorrelated, and the variability of the data can be accounted for by the distance measured for all stimuli in the classes presented. Subject variability is generally not accounted for, other than to assume it is the same for all classes of stimuli. The data are clustered into a variety of reference patterns that represent particular manifestations of a particular stimulus. Another approach is "feature-based" recognition. The idea is to identify and automatically extract features of the data that can provide a characterization of stimuli. The features selected may be abstract. They are calculated from the data or transforms of the data. PMID- 3297487 TI - Implantable pumps. AB - Implantable drug-delivery pumps are being developed to provide the external control of delivery rate or to deliver volumes of drug that are beyond the capabilities of conventional controlled-release formulations. The delivery of insulin to diabetics and chemotherapeutic agents to cancer patients represents the two major applications of such devices, but other applications (chronic pain control, Alzheimer's disease, spasticity, etc.) exist or have been proposed. The most popular device is the Infusaid which is driven by a fluorocarbon vapor liquid mixture to provide a constant delivery rate. Implantable peristaltic pumps have recently been developed to deliver drugs at variable rates according to a physician-preprogrammed schedule which is actuated with the aid of transcutaneous telemetry. Other devices are available in the literature, if not yet in clinical application. PMID- 3297488 TI - Measurements of electromagnetic fields in biomedical applications. AB - Electromagnetic fields can interact with biological systems. Under some conditions, such interactions result in biological effects that may be hazardous, while in some other situations they may be beneficial and lead to some new medical applications. Examples of the latter are electromagnetically induced hyperthermia, bone healing, and nuclear magnetic resonance (NMR) imaging. To quantify and assist in understanding the interactions, it is necessary to know the intensities of electromagnetic fields. In many cases, information abut the field strengths inside exposed biological bodies is equally or even more important than that about the strength of the external exposure fields. In this context, measurements of electromagnetic fields at frequencies from a few hertz to about tens of gigahertz are very important. Some classical measurement techniques used in electromagnetics are directly, or with certain modifications, applicable to biomedical applications. However, due to special requirements, new specifically tailored techniques have had to be developed. A review of measurement methods and instrumentation for probing external and internal electric and magnetic fields as relevant to biomedical applications is given. Specific requirements, limitations of existing methods, and future needs are discussed. PMID- 3297489 TI - Thromboxane synthesis inhibition reverses group B Streptococcus-induced pulmonary hypertension. AB - Group B Streptococcus (GBS) sepsis in humans may cause the persistent pulmonary hypertension syndrome. Infusions of GBS in animals elevate pulmonary artery pressure (PAP) and resistance and are associated with elevated thromboxane levels. We investigated the hemodynamic effects of the specific thromboxane synthesis inhibitor, dazmegrel, in a piglet model of GBS-induced pulmonary hypertension. PAP rose from 22 +/- 6 to 42 +/- 11 (SD) mm Hg during infusion of heat-killed GBS; pulmonary vascular resistance increased from 1440 +/- 400 to 4000 +/- 1040 dyne X sec/cm5. No significant changes in cardiac output, mean arterial pressure, or left atrial pressure were noted. Treatment with 1 mg/kg of dazmegrel resulted in a rapid return of PAP and resistance to control values. No other hemodynamic effects of either bacteria or drug were observed despite continued infusion of GBS. PMID- 3297490 TI - Influence of positive end-expiratory pressure on cardiac performance in premature infants: a Doppler-echocardiographic study. AB - Because determining cardiac output is difficult in premature infants, little is known about the hemodynamic effects of PEEP in this age group. We used pulsed wave Doppler echocardiography to assess the hemodynamic effects of PEEP increments in ten premature infants with respiratory distress syndrome. At a PEEP of 4 cm H2O, the systemic and pulmonary blood flow and the right (SVRV) and left (SVLV) ventricular stroke volume decreased slightly, while the systemic vascular resistance (Rs) increased slightly. At a PEEP of 8 cm H2O, cardiac performance was impaired significantly, with a profound decrease of the systemic and pulmonary blood flow, SVRV and SVLV and a reflectory increase of the Rs. Surprisingly, the heart rate and mean arterial BP remained constant. The effective left ventricular afterload, which takes into account the changing intrathoracic pressure, increased slightly with increasing PEEP. PMID- 3297491 TI - Minimizing work of breathing with continuous positive airway pressure and intermittent mandatory ventilation: an improved continuous low-flow system. AB - Minimizing work of breathing (WOB) during intermittent mandatory ventilation (IMV) and continuous positive airway pressure (CPAP) is important as it facilitates weaning from mechanical ventilation. To minimize WOB, we devised a simple, continuous-flow CPAP-IMV system that uses a weighted, partially filled reservoir bag and operates efficiently at low fresh gas flow (FGF). We compared both the pattern and WOB of our system (FGF at 15 L/min) with a conventional continuous-flow CPAP/IMV system (FGF at 15 and 30 L/min) as well as with two relatively efficient demand-value systems, the Servo 900 B and 900 C. Six healthy male subjects were studied; tidal volumes (VT), flow, mouth pressure, and pleural pressure (Ppl) were measured. Ten breaths, matched for VT, from each subject on each system were selected for analysis. Mechanical WOB was estimated by integrating Ppl with respect to VT. The conventional continuous-flow system was associated with a high work/breath relative to the other systems (p less than .001). The weighted reservoir system was associated with a significantly lower work/breath (p less than .001), its performance approaching that of the Servo 900B. Work/breath was least with the Servo 900C (p less than .001). As breathing frequency was higher with the demand valve than continuous-flow systems (p less than .001), the difference in work/time was minimal between the weighted reservoir bag and demand-valve systems. These systems were all associated with significantly (p less than .001) lower work/time than the conventional system at both FGF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297492 TI - Hemodynamic effects of continuous norepinephrine infusion in dogs with and without hyperkinetic endotoxic shock. AB - We compared, at constant preload maintained by polygeline (gelatin) infusion, the hemodynamic effects of continuous infusion of norepinephrine (0.5, 1, and 1.5 micrograms/kg X min) in anesthetized dogs with and without hyperdynamic endotoxic shock. In both groups, norepinephrine infusion increased systolic, diastolic and mean aortic BP, cardiac index, stroke index, index of myocardial contractility, and mean pulmonary artery pressure. No significant change in right atrial pressure, left ventricular end-diastolic pressure, heart rate, systemic vascular resistance, or pulmonary vascular resistance was observed. Oxygen consumption index and oxygen extraction ratio remained unchanged. Increases in systolic aortic BP were dose-related, whereas maximal effects on other variables were obtained at 0.5 to 1 microgram/kg X min. The rise in aortic pressure resulted from an increased cardiac index but not from an increased systemic vascular resistance. Stroke index increased as contractility improved. The slight alpha adrenergic effect of continuous, low-dose norepinephrine infusion did not impede the beneficial effects of the marked beta-adrenergic stimulation on cardiac function. The combination of these two effects improved hemodynamic disturbances of hyperdynamic endotoxic canine shock. PMID- 3297493 TI - Newer ventilation modes--temptations and pitfalls. PMID- 3297494 TI - Processing of sensory information in the hippocampus. AB - The functional significance of the mammalian hippocampal formation is considered within the context of specific neural circuits responsible for the processing of sensory information. The anatomic and physiologic features of the major input pathways from the hypothalamus, septum, and entorhinal cortex are reviewed with regard to sensory activation of hippocampal cell fields. A model is presented which interrelates the functional plasticity of hippocampal synaptic processes to reciprocal connections between input and output pathways. The manner in which sensory responsiveness is modulated in the rat dentate gyrus as a function of both cognitive and behavioral factors is described. The hippocampus is discussed with respect to its role as a short-term item-specific store of behaviorally relevant sensory information. PMID- 3297495 TI - Cerebral circulatory and metabolic effects of perivascular neurotransmitters. AB - In this article we review the most recent literature that concerns the various neurotransmitters that are known to innervate the cerebral circulation. The best characterized of these systems (the adrenergic and serotonergic pathways) are discussed extensively, but other putative neurovascular pathways (cholinergic and peptidergic nerves) was covered. The review will be divided into five major sections: the origin and nature of the perivascular nerve fibers in the cerebrovascular bed (this section encompasses both morphological and biochemical investigations); the response of isolated cerebral vessels to neurotransmitters and transmural nerve stimulation (covering the uptake and release of transmitters by brain vessels as well as the pre- and postsynaptic effects of these agents on cerebrovascular smooth muscle); the effects of neurotransmitter and other vasoactive agents on cerebral perfusion and metabolism in vivo. This section includes the effects of perivascular nerve stimulation or ablation on cerebral blood flow as well as on capillary (i.e., blood-brain barrier) properties. The regional metabolic effects of neurotransmitters are compared to their known effects on neuronal function; the involvement of various neurotransmitters in a number of cerebrovascular diseases (in particular, migraine, cerebral vasospasm following subarachnoid hemorrhage and cerebral ischemia, or stroke); and we attempt to synthesize the ever-increasing literature on the origin and function of the multiple innervation of two other noncerebral, intracranial tissues: the choroid plexus and the dura mater. PMID- 3297496 TI - Dispersed pancreatic graft cryopreservation in the dog: in vivo assessment of preservation protocols. AB - Dispersed canine pancreatic grafts were cryopreserved and the in vivo function was studied following intrasplenic autotransplantation. Four protocols were employed, examining the effects of cooling and thawing rates and cryoprotectant (dimethylsulfoxide) concentration on graft survival. The degree of graft injury by each protocol was assessed by examining the requirement for exogenous insulin following transplantation. Cooling at 5 degrees C/min and thawing at 80 degrees C/min allowed three successful grafts from seven when thawed at 80 degrees C/min using 1.4 or 2 M Me2SO but only one success from eight when thawed at 8 degrees C/min. Of the seven experiments where successful preservation was achieved graft injury was estimated as less than 50% in four but for three it was probably greater than 50%. Each protocol exhibited considerable variability of islet survival. When sufficient islet mass was transplanted to restore fasting euglycaemia, graft function, as assessed by glucose-stimulated insulin release and intravenous glucose disposal, was identical to fresh grafts. Successful graft implantation, however, does not guarantee indefinite survival as six of seven grafts in this study became exhausted within 13 months of implantation. PMID- 3297498 TI - Capsicum--production, technology, chemistry, and quality. Part IV. Evaluation of quality. AB - Capsicum fruits are popular worldwide and are used in the cuisines of both the developing and the developed countries. With its different varieties, forms, and uses, the spice capsicum contributes to the entire gamut of sensory experience- color as finely ground paprika powder or extract in sausages, goulash, cheese, and snacks; both pungency and color as the many varieties of chillies used in Mexican, African, Indian, and southeast Asian cuisines; color, aroma, and mild pungency as the fresh green chillies used in many of the growing countries; and appearance, color, aroma, and texture as fresh fruit in salads and as a pickled and canned product. In three earlier parts in this series, the varieties, cultivation, and primary processing; the processed products, world production, and trade; and the chemistry of the color, aroma, and pungency stimuli have been reviewed. In this part, the evaluation of quality through instrumental determination of the causal components and the sensory evaluation of color, aroma, and pungency are discussed. Several methods for quantitative determination of the stimuli and the sensory evaluation of the responses to the stimuli are reviewed. The problems of sensory evaluation of color, aroma, and pungency, the dominant attributes for validation of the instrumentally determined values for carotenoids, volatiles, or particular fractions, and total and individual capsaicinoids are specifically discussed. Summarized details of selected instrumental methods for evaluating the stimuli, which are either validated by correlation to sensorily perceived responses or to adopted standards, are given along with representative data obtained for discussing the adequacy and reliability of the methods. Pungency as a specific gustatory perception and the many methods proposed to evaluate this quality are discussed. A recommended objective procedure for obtaining reproducible values is discussed, and a method for relating different panel results is shown. With such a method, highly significant correlations have been shown between estimated total capsaicinoids and the determined pungency. The estimation of total capsaicinoids by any simple, reliable method is shown to be adequate for quality control of pungency of Capsicum fruits. PMID- 3297497 TI - The effects of oxygen free radicals on the preserved kidney. AB - This study evaluated the effect of specific scavengers of oxygen derived free radicals on the results of kidney preservation. The immediate function of rabbit kidneys preserved for 24 hr by hypothermic perfusion was studied on an ex vivo shunt. A significant improvement in creatinine clearance was seen when the perfusate was treated with superoxide dismutase (SOD) and catalase (CAT), with values of 261 +/- 82 ml/hr vs control values of 203 +/- 72 ml/hr, P less than 0.05. This effect was enhanced if a long-persistent polyethylene glycol-linked form of SOD, namely PEG-SOD, was used (330 +/- 58 ml/hr, P less than 0.01). Recipient treatment and other modifications designed to protect against free radicals resulted in similar improvement in function. In contrast, no effect of free radical scavengers could be demonstrated in kidneys which were preserved by flush cooling, whether the agents were added to the flushing solution, given to the recipient, or both. PMID- 3297499 TI - Phosphorylation of ribosomal protein S6 during lens cell differentiation: correlation with translational efficiency. AB - In vitro differentiation of embryonic chicken lens epithelial explants to form lens fiber cells is accompanied by an increase in protein synthesis without a corresponding increase in mRNA levels. This apparent increase in translational efficiency is correlated with a specific enhancement of phosphorylation of a 32K protein, which we identify as ribosomal protein S6 by two dimensional gel electrophoresis of purified ribosomal proteins. Serum, insulin, and chicken vitreous humor, three agents known to initiate differentiation in this system, all lead to enhanced S6 phosphorylation. Maximal enhancement of phosphorylation is reached within the first hour after the onset of differentiation, and is not blocked by inhibitors of RNA and protein synthesis. PMID- 3297500 TI - Genetic principles applied to skin disease. PMID- 3297501 TI - Altered skin basement membrane antigenicity in epidermolysis bullosa. PMID- 3297502 TI - Genetic diseases of connective tissues in animals. PMID- 3297503 TI - The collagens of skin. PMID- 3297505 TI - Neurological complications of cardiovascular therapy. PMID- 3297504 TI - Clinical and genetic heterogeneity of the Marfan syndrome. PMID- 3297506 TI - Angina pectoris: diagnosis, treatment, and prognosis. PMID- 3297507 TI - CT and MRI of masses of the deep face. AB - By applying these simple concepts of epicenter, vector of spread, and displacement pattern, it is possible in most cases to assign a space of origin to the mass lesions of the more cephalad aerodigestive tract. Once assigned, judicious application of the limited differential diagnostic considerations of the space can often lead to a correct preoperative diagnosis. At the very least, such an approach yields a short differential diagnosis and an accurate presurgical picture for the attending clinician. PMID- 3297508 TI - Treatment of burns. PMID- 3297509 TI - Duplex scanning for the detection of deep venous thrombosis of lower extremities in a community hospital. PMID- 3297510 TI - Chromosome localization of the human renin gene (REN) by in situ hybridization. AB - Previous studies by Southern blot analysis of human X mouse somatic cell hybrids localized the renin gene to region p21----qter of human chromosome 1. Using a DNA insert encoding exons 2-5, the renin gene was mapped to human chromosome bands 1q25----q32 by in situ hybridization. The sublocalization of the renin gene will facilitate subsequent detailed linkage analysis of human chromosome 1. PMID- 3297511 TI - Hypothalamic-pituitary-gonadal function in insulin treated diabetic women with and without amenorrhea. PMID- 3297512 TI - Mutagenicity of inhalation anaesthetics studied by the sister chromatid exchange test in lymphocytes of patients and operating room personnel. AB - Retrospective studies have indicated that operating room personnel may have increased risks of spontaneous abortion, congenital malformations in offspring, and cancer (Cohen et al 1980, Buring et al 1985). Occupational exposure to waste anaesthetic gases may be responsible for these possible adverse health effects, but a cause-effect relationship has never been proved. Induction of changes in the DNA in the chromosomes leading to mutations may play a role in teratogenicity and carcinogenicity. Along with an increasing concern in society regarding occupational diseases and working and living environment in general, cytogenetic methods have been developed for rapid detection of potential mutagenicity in vitro of chemical agents. One such method is the SCE test, which is based on examination of sister chromatid exchanges (SCEs), i.e. exchanges of chromatid segments between the two chromatids in a chromosome, during cell replication. SCEs are not mutations, but an increased frequency of SCE is a sensitive indicator of exposure to agents that are capable of producing damage to the DNA and thus possibly mutations. In vitro tests like the SCE test are very useful for evaluation of specific chemical agents, which may be added to the culture in known concentrations. In studies of possible hazards from chemical agents in the working or living environment, the exposure is often poorly defined. Also, biotransformation may be different in different species, and the duration and the level of the exposure may play a role. Examination of SCEs is, therefore, increasingly performed directly on human lymphocytes from peripheral blood. Thus, although the examination of SCEs is still performed in vitro, the exposure has taken place in vivo. Increased SCE levels are then regarded as a non-specific indicator that the donor has been exposed to potentially mutagenic agents in the environment. The author and his associates used the SCE test to investigate the possible mutagenicity of anaesthetic gases after exposure in vivo. From extensive methodologic studies of possible confounding factors it was concluded that each of the factors sex, age, and smoking habits contributed significantly to the interpersonal variation of SCE frequencies, whereas use of oral contraceptives did not influence the SCE rates. The potential mutagenicity of inhalation anaesthetics was studied after exposure in vivo in two settings: (1) Acute exposure to anaesthetic concentrations, and (2) Chronic occupational exposure to trace concentrations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297513 TI - Prostaglandins in the menstrual cycle of women. A review. AB - The changes of concentrations of prostaglandins (PG) are cyclic in the uterine tissues and related to steroid ovarian hormones. The role in normal menstruation is presumably related to a local haemodynamic effect. PGF2 alpha vasoconstricts the endometrial vessels during menstruation and contracts the smooth muscle of the myometrium. PGE2 vasodilates the vessels of the endometrium, and PGI2 relaxes smooth muscle, vasodilates the vessels of the myometrium and inhibits thrombocyte aggregation. The pathological conditions dysmenorrhea and menorrhagia relates to symptoms which seem to be exaggerations of normal activities, probably due to increased PG levels. Prostaglandin synthesis inhibitors (PGSI) in women have not been able to prevent ovulation, but animal experiments have shown that the bursting of the follicle demands prostaglandins. In vitro experiments with human tissue have shown that PG is necessary for the occurrence of dissociation of connective tissue around the apex. Luteolysis is due to PG in several species, but it has not been possible to find this direct effect of PG upon luteolysis in women. However, there are indications that the PG functions as a mediator for or is mediated by catecholamines and/or oxytocin. PMID- 3297514 TI - Evaluation of whole blood theophylline enzyme immunochromatography assay. AB - A new whole blood enzyme immunochromatographic (EIC) theophylline assay was evaluated in 18 low (25 to 37 percent) and 15 high hematocrit (49 to 56 percent) samples. A good correlation was observed between EIC and fluorescence polarization methods for plasma samples (r = 0.95). However, comparison of results between EIC whole blood and plasma values demonstrates a significant proportional bias that is inversely related to the sample's hematocrit. The EIC method for whole blood samples may substantially underestimate theophylline levels in polycythemic patients with theophylline values near or above the toxic range and underestimate levels in those with anemia, if a correction is not made for the sample's hematocrit. A correction formula to approximate plasma theophylline concentrations from whole blood measurements is described. PMID- 3297515 TI - Evaluating sepsis in critically ill patients. PMID- 3297516 TI - Idiopathic pulmonary fibrosis. A rational clinical approach. PMID- 3297517 TI - Intermittent positive pressure ventilation via nasal access in the management of respiratory insufficiency. AB - These are preliminary observations of the introduction of a new technique of noninvasive positive pressure respiratory support for patients with subacute or chronic respiratory failure. Clinical situations where intubation or tracheostomy may have been performed were managed by intermittent positive pressure ventilation via nasal access (NIPPV) with a CPAP mask, or a custom constructed Vel-Foam nose piece. Four patients were managed at home with the use of portable volume ventilators. One patient employed the technique while hospitalized with subacute respiratory failure. Two patients, otherwise dependent on mouth intermittent positive pressure ventilation (MIPPV) 24 hours a day, received necessary dental care with NIPPV support. In a large population with a decade or more follow-up, MIPPV was shown to be an effective noninvasive technique to support respiration in patients with the most severe paralytic respiratory failure. Preliminary observations suggest that NIPPV may compare favorably with MIPPV and deserves more widespread study and application. PMID- 3297518 TI - Using the lungs to measure cardiac output. PMID- 3297519 TI - Rest and exercise cardiac output and diffusing capacity assessed by a single slow exhalation of methane, acetylene, and carbon monoxide. AB - To study rest and exercise pulmonary capillary blood flow (Qc) and diffusing capacity (DLexh) assessed by the rapid analysis of methane, acetylene, and carbon monoxide during a single, slow exhalation, we evaluated 36 subjects during first pass radionuclide angiography (RNA). At rest (N = 36) and at exercise (N = 21) there was no difference in the respective measurements of cardiac output (Qc = 6.0 +/- 1.7 and CORNA = 6.9 +/- 2.5 at rest; Qc = 13.7 +/- 3.2 and CORNA = 14.5 +/- 4.1 at exercise, L/min, mean +/- SD, r = .80). Mild maldistribution of ventilation, as manifested by an increased phase 3 alveolar slope for methane (CH4 slope), did not significantly influence the results. CH4 slope and DLexh did increase significantly with exercise, while total lung capacity remained unchanged (CH4 slope: 6.2 +/- 5.0 vs 12.5 +/- 6.8% delta CH4/L, mean +/- SD, p less than 0.001; Dsb: 27.7 +/- 9.2 vs 42.0 +/- 17.9 ml/min/mm Hg, mean +/- SD, p less than 0.001; TLC: 5.47 +/- .20 vs 5.96 +/- 1.20 L, mean +/- SD). DLexh was related to CORNA (r = .68) and RNA stroke volume (r = .50). Qc was significantly less than CORNA in the subset of studies with valvular regurgitation (VHD) (N = 7). On the other hand, Qc was significantly greater than CORNA in the setting of coronary artery disease (CAD) and severe wall motion abnormalities (N = 7). These differences may be attributed to regurgitant fractions in VHD, and the influence of wall motion abnormalities on the estimation of left ventricular volume by the area-length method in CAD. These two noninvasive methods compare well at rest and exercise in clinical subjects and may provide complementary information in certain cardiopulmonary diseases. PMID- 3297520 TI - Mechanical cardiac support by synchronous, cardiac cycle-specific high-frequency jet ventilation. More than a matter of timing? PMID- 3297521 TI - Continuous positive airway pressure effect on functional residual capacity, vital capacity and its subdivisions. AB - Thirty-four otherwise healthy patients having to undergo elective upper abdominal surgery were randomly assigned to two equal groups. In the treatment group, constant positive airway pressure (CPAP) with an expiratory pressure of 12 cm H2O was applied at one hour following extubation, and at daily intervals for the first five days following surgery for a continuous period of three hours. The control group received no CPAP treatment. All patients were given postoperative physiotherapy. In patients who received postoperative CPAP with an end-expiratory pressure of 12 cm H2O, marked normalization of pulmonary function was noted. PMID- 3297522 TI - The role of theophylline in the treatment of dyspnea in COPD. AB - Dyspnea is influenced by both physiologic and psychologic factors. Breathlessness is common in patients with chronic obstructive pulmonary disease (COPD) and often is the reason that the individual patient seeks medical attention. In order to evaluate the different clinical studies involving the use of theophylline in COPD patients, it is important to consider the three distinct approaches for measuring dyspnea--psychophysical testing, clinical methods, and ratings during exercise. Four randomized, double-blind, placebo-theophylline trials from one to four weeks in duration have evaluated the impact of theophylline on lung function and breathlessness. In these studies, the overall improvement in forced expiratory volume in one second was quite consistent for theophylline compared with placebo therapy. When appropriate clinical methods for measuring dyspnea were used, theophylline showed a positive reduction in breathlessness. These reports suggest that theophylline provides modest objective and subjective improvement in patients with symptomatic chronic air flow obstruction. PMID- 3297524 TI - Effect of theophylline on diaphragmatic muscle function. AB - Recent investigations have shown that theophylline improves diaphragmatic contractility of the respiratory muscles in isolated muscle preparations in animals and in normal human subjects. It has also been demonstrated that theophylline can reverse diaphragmatic fatigue and prevent fatigue of the diaphragm when given prophylactically. These effects have also been demonstrated in patients with severe chronic obstructive pulmonary disease, all of whom retained CO2 (PaCO2 53 +/- 3 mm Hg) and had hypoxia (PaO2 57 +/- 8 mm Hg). Theophylline, which increases respiratory muscle strength and delays the onset of diaphragmatic fatigue therefore could be a very useful agent in the treatment of patients with chronic airway obstruction. PMID- 3297523 TI - Favorable cardiovascular effects of theophylline in COPD. AB - Theophylline has been utilized widely as a bronchodilator. However, recent studies have shown the potential for administering this drug to enhance cardiovascular performance in patients with chronic obstructive pulmonary disease (COPD). Administered to COPD patients orally as a sustained-action preparation or intravenously as aminophylline, theophylline enhances both right and left heart systolic pump function and lowers both pulmonary artery pressure and pulmonary vascular resistance. These favorable cardiovascular actions suggest an additional use for theophylline in COPD beyond its effects as a bronchodilator. PMID- 3297525 TI - The effects of theophylline on airway inflammation. AB - One of the important modes of action of theophylline in asthma and chronic obstructive airway disease may be the inhibition of airway inflammation. This hypothesis is based on in vitro and in vivo studies demonstrating that theophylline at therapeutic concentrations has an inhibitory activity on airway inflammation induced by allergic and nonallergic stimuli. Indirect evidence suggests that airway inflammation is an important determinant in the long-term outcome of chronic obstructive airway disease. The effect of theophylline on the long-term evolution of chronic obstructive lung disease remains to be proven. PMID- 3297526 TI - Theophylline and mucociliary clearance. AB - Abnormal mucociliary transport is improvement by the action of theophylline, and this effect can be attributed to several mechanisms. The drug may directly and indirectly mediate the increase in the secretory output of bronchial glands, and this effect is enhanced by the vagal gastropulmonary reflex which is stimulated by the irritant action of theophylline on the stomach. Theophylline can increase the transepithelial secretion of fluid into the respiratory tract lumen by stimulating the chloride pump which is controlled by cyclic AMP. Ciliary motility is stimulated by theophylline; most of this effect is confined to the proximal part of the respiratory tree. However, much of the improvement in mucociliary clearance may be a consequence of the bronchodilation induced by theophylline, since the improved airway patency is generally a prerequisite for enhanced mucokinesis. Nevertheless, the multiple sites of action of theophylline in the respiratory tract suggests that this drug should be considered to be of significant value in any disorder characterized by mucostasis. PMID- 3297527 TI - Outer membrane protein alterations in Serratia marcescens resistant against aminoglycoside and beta-lactam antibiotics. AB - Six isolates of Serratia marcescens were recovered sequentially from the respiratory tract of a single patient. The first three isolates were of the 'opaque' (wild-type) colony type and were susceptible to amikacin, cefotaxime, and lamoxactam. The following three isolates were of the small, 'gray' colony variety, significantly less susceptible to the three antibiotics, and revealed three altered outer membrane proteins, as determined with the SDS-PAGE procedure. PMID- 3297529 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3297528 TI - Pulmonary tuberculosis treated with isoprodian and rifampicin or pyrazinamide. AB - Three regimens of 9 months' duration, 2 containing Isoprodian (isoniazid, prothionamide and dapsone) and either rifampicin or pyrazinamide and the third, a former standard regimen, isoniazid, streptomycin and pyrazinamide, were allocated at random to 436 untreated African tuberculosis patients. In the course of the trial 83 were excluded for various reasons and 93 were lost. After 3 months of hospitalization, patients took either Isoprodian or isoniazid at home for 6 months and were then followed up for 24 months. The Isoprodian plus rifampicin regimen achieved 97% bacteriological cure, the Isoprodian plus pyrazinamide regimen 86% and the standard regimen 91%. Of 35 patients found to harbour drug resistant strains 22 were cured. There were 15 relapses in all. Absconding was the most common cause of failure. PMID- 3297530 TI - [The "saga" of the dental office. Study of the conceptual changes in dental operatory equipment]. PMID- 3297531 TI - [Restoration of anterior deciduous teeth using microfilled light cured composites and dentin adhesives: a savings in healthy tissue and time]. PMID- 3297532 TI - [The "De Affectibus Oris" of Vittorio Trincavella of Venice]. PMID- 3297533 TI - [Ceramic coating of a metal endosseous implant]. PMID- 3297534 TI - Inactivated Saccharomyces cerevisiae as virulence-enhancing agent in the toxicity test of Salmonella typhi and the immunity assay of typhoid vaccine in mice. AB - Mucin has been used as virulence-enhancing (VE) agent in estimation of the toxicity of bacteria to mice and the potency of bacterial vaccines such as typhoid vaccine. Discontinuance of the acceptable brand of mucin made it necessary to search for an effective alternative. Five percent inactivated Saccharomyces cerevisiae (IY) showed a significant higher VE effect on S. typhi in mice (132 colony forming units/LD50) with lower viscosity when compared to 5% mucin (740 colony forming units/LD50), and either one could promote bacterial lethal toxicity in mice more than 10(4) times. The strong correlation (r2 = 0.9765) between the immune dose and the ratio of mouse death was found by using 5% IY as VE agent in the active mouse protection test for typhoid vaccine. The relative potencies of a typhoid vaccine to the reference vaccine obtained by using 5% mucin or 5% IY as VE agent were not significant difference. Therefore, IY was a suitable substitute for mucin as a VE agent in the toxicity test of bacteria and in the immunity assay of typhoid vaccines. PMID- 3297535 TI - Drug resistance, R plasmids and pigmentation of Serratia marcescens isolated in Taiwan. AB - The Serratia marcescens isolates used in this study were resistant to ampicillin, tetracycline or cephalothin, streptomycin, tobramycin, kanamycin, carbenicillin, chloramphenicol and gentamicin in descending order. Nalidixic acid was the most effective antibiotic against S. marcescens, followed by amikacin and sulfamethoxazole-trimethoprim. The non-pigmented plasmid-carrying isolates displayed higher resistance to some antimicrobial agents than did the pigmented isolates and plasmid-free white isolates. Nine out of 12 resistant markers were coded by plasmids in S. marcescens. The average number of resistant markers per strain was seven for plasmid-containing white isolates as compared to four for other S. marcescens groups. About 73% of S. marcescens contained plasmids. Thirty eight percent of plasmid-carrying S. marcescens spread their R plasmids to E. coli. Conjugative R plasmids were identified in six out of 17 strains of S. marcescens, which apparently contained a single plasmid. PMID- 3297536 TI - [Ultrasound diagnosis in acute abdomen and blunt abdominal trauma]. PMID- 3297537 TI - [Value of ultrasound-controlled puncture in diagnosis and therapy]. PMID- 3297538 TI - [Significance of intraoperative sonography]. PMID- 3297539 TI - [Real-time controlled pleural puncture in surgical intensive care patients]. AB - The sensitivity of ultrasonographic diagnosis of pleural fluid accumulations and the value of ultrasonography guided thoracentesis were studied prospectively. 110 patients were investigated after abdominal operation and chest trauma. Most investigations were performed in a half sitting position. Pleural fluid of clinical relevance diagnosed by real time ultrasonography was treated by thoracentesis under ultrasonographic guidance in 38 cases. The amount of aspirated fluid ranged from 150 ml to 1350 ml. Sensitivity of the method was 97.1%, complication rate was 2.6%. From our view ultrasonography guided thoracentesis represents the method of choice in critically ill and immobile patients. PMID- 3297540 TI - [Continuous single-layer intestinal anastomosis]. PMID- 3297541 TI - [Difficult closure of the duodenal stump]. PMID- 3297542 TI - [Sonography in diagnosis of appendicitis]. PMID- 3297543 TI - [Sonographic findings of inflammatory and tumorous colonic diseases]. PMID- 3297544 TI - [Mediastinal pancreatic pseudocyst--treatment by cystojejunostomy]. PMID- 3297545 TI - [Vicryl cushion in the therapy of inguinal and hiatal hernia by induction of strong scar tissue]. PMID- 3297546 TI - The examination of sealing ability of temporary filling materials. PMID- 3297547 TI - [Intranasal LRH-A for contraception by inhibition of ovulation: observation of 10 cases]. PMID- 3297548 TI - [Prevention and therapy of nausea and vomiting caused by antineoplastic agents]. PMID- 3297550 TI - [Ranitidine in the treatment of duodenal ulcer]. PMID- 3297549 TI - [Hemodynamics associated with the changes in catecholamine, plasma renin activity and antidiuretic hormone in chronic congestive heart failure]. PMID- 3297551 TI - [Atherosclerosis of the extracranial portion of the carotid artery system in healthy persons]. PMID- 3297552 TI - [A modified K-ELISA for the detection of antigenic activity and antibody activity of the adult Clonorchis worm]. PMID- 3297553 TI - [Thromboxane A2-PGI2 balance and its clinical significance]. PMID- 3297554 TI - Onchocerca antigens in protection, diagnosis and pathology. AB - Characterization of the immune response to Onchocerca volvulus is important for the diagnosis, control and understanding of the disease it causes. The antibody response to surface, secreted and somatic antigens of the worm has therefore been examined at an individual immunoglobulin (Ig) class level, by using a panel of different human sera. Onchocerca-specific antigens tend to be of low molecular mass and preferentially recognized by IgG4 and IgE. There is considerable cross reaction between O. volvulus and O. gibsoni, so that the latter may be an alternative source of material for use in diagnosis. A surface-enriched fraction of low molecular mass appears to be a most promising diagnostic tool. Amongst somatic antigens, two were uniquely recognized by IgG3 antibodies in sera from sowda patients, thereby providing a molecular correlate for a recognized pathological condition. Improved diagnosis is needed for detecting infection in both humans and the vector. Our target for detection in humans is a continuously released, nonimmunogenic product, which is ideally stage and parasite specific. The excretions of adult worms do contain components not recognized by antibodies in infected serum, but we cannot rule out that these are of host, rather than parasite origin. Excretions of Litomosoides carinii contain both host and parasite molecules and, in addition, stage-specific and sex-specific components. Unfortunately, however, the rate of production of excretions varies during the life of L. carinii. This finding may be relevant to the detection of Onchocerca excretions if they are produced at a similarly uneven rate. Finally, for detecting infective larvae in the vectors, we are currently screening a genomic library of O. volvulus for an appropriate probe. To date, one DNA sequence has been cloned that shows promising specificity. PMID- 3297555 TI - The spectrum of disease in lymphatic filariasis. AB - Lymphatic filariasis affects predominantly the poorer sector of a community, who can least afford to have the disease. According to an estimate by the World Health Organization in 1984, more than 90 million people are currently infected. It is postulated that the different disease manifestations of filariasis are caused by different host immune responses. An understanding of the clinical spectrum of lymphatic filariasis is essential for the effective treatment and control of the disease, and for correctly correlating clinical status with host immune responses. The disease should be divided into lymphatic filariasis caused by adult worms and occult filariasis due to hyper-responsiveness of the host against microfilariae. The acute stage of filariasis is characterized by episodic adenolymphangitis, followed by obstructive lesions one or more decades later. In brugian filariasis, adenolymphangitis is most commonly observed at the inguinal region, and elephantiasis predominantly involves the leg below the knee. In bancroftian filariasis, the lymphatics of the male genitalia are frequently affected, leading to epididymo-orchitis and hydrocele. Lymphatic filariasis runs an accelerated clinical course in previously unexposed adult migrants. Occult filariasis is not a disease of public health importance. It is characterized by lymphadenopathy, asthmatic bronchitis, hypereosinophilia, and an increase in the production of antibodies, especially immunoglobulin, against microfilarial antigens. PMID- 3297556 TI - Antibody responses to human lymphatic filarial parasites. AB - The lymphatic filarial parasites, Brugia and Wuchereria, continue to present an immunological puzzle, particularly with respect to the development of natural resistance or damaging disease. We have approached this question by examining humoral responses to a few defined antigens of selected interest from these parasites, using sera from each category in the spectrum of filarial disease. Many antigens, such as the major adult surface protein of Mr 29,000 (29K), appear to be recognized at all stages of infection, but two components show interesting patterns of differential recognition. A triplet of proteins of Mr 65-75K associated with the microfilarial surface is preferentially bound by serum from patent microfilaraemic infections, whereas an unrelated 75K protein has been found to react only with antibody from amicrofilaraemic individuals. In general, however, the data obtained so far emphasize the importance of undertaking an antigenic analysis at the level of single epitopes. Such studies are now under way using recombinant proteins expressed in bacterial hosts. PMID- 3297557 TI - Antifilarials and their mode of action. AB - Diethylcarbamazine and suramin are the drugs of choice for the control of lymphatic filariasis and onchocerciasis respectively. Benzimidazoles, ivermectin, furapyrimidone, and isothiocyanates and their derivatives emerge as compounds of potential clinical interest as antifilarials. Diethylcarbamazine is predominantly a microfilaricide affecting the neuromuscular system of the parasites and promotes cellular cytotoxicity mediated by immune factors. Suramin is macrofilaricidal, has a narrow therapeutic index and damages the intestinal epithelium of the worms. Benzimidazoles bind to tubulins and inhibit their assembly to microtubules. Ivermectin is an extremely potent microfilaricide in onchocerciasis; it augments immune responses and impairs the neuromuscular function of the parasites, leading to paralysis. Isothiocyanates and their derivatives are both microfilaricidal and macrofilaricidal and affect the energy metabolism of the parasites. Although the precise mode of action of antifilarial drugs is not established, information is available on the responses listed above and also on the effects of the drugs on the carbohydrate and folate metabolism of the parasites. PMID- 3297558 TI - Description, mechanisms and control of reactions to treatment in the human filariases. AB - Since diethylcarbamazine at the dosages used to treat filarial infections has little direct toxicity, most of the post-treatment reactions (termed Mazzotti reactions in onchocerciasis) result from the immunological inflammatory mechanisms activated in the process of clearing and killing the skin-swelling or blood-borne microfilariae. These reactions may be either localized to the skin, eyes or lymphatics or generalized systemically (e.g. headache, fever, adenopathy, arthralgia, tachypnoea, tachycardia, hypotension and even death). The occurrence and intensity of such reactions can be shown to be related to the intensity of infection. It had previously been speculated that the best candidates for triggering these post-treatment reactions were activation of complement, immediate hypersensitivity responses mediated by immunoglobulin E, and degranulation of eosinophils with resultant inflammatory reactivity. Recent detailed studies have given little support to the primacy of either complement or immediate hypersensitivity responses in triggering such reactions, but eosinophil degranulation with the release of inflammatory mediators into the tissues and peripheral blood is extremely prominent in all patients undergoing post-treatment reactions and develops with a time course generally consistent with what would be required of an initiator of such reactions. Other inflammatory mediators and pathways may be involved (e.g. kinins, prostaglandins, immune complexes, leukotrienes, platelets and parasite-derived inflammatory molecules), but there is currently no evidence to implicate any of these mechanisms as initiators of the response. Symptomatic treatment of these post-treatment reactions with analgesics, antipyretics, antihypotensive agents etc. has been successful, but their prevention has been achieved only with the broadly anti-inflammatory corticosteroids. PMID- 3297559 TI - Some unsolved problems in the epidemiology of onchocerciasis. AB - The descriptive epidemiology of onchocerciasis is well understood in the major foci of infection; a great stimulus to epidemiological research has been the implementation of the first control programme, which led to the eradication of infection in Kenya and, more recently, the vast Onchocerciasis Control Programme in the Volta River Basin of West Africa. However, there are still significant gaps in epidemiological knowledge which hamper the planning of future control programmes and the evaluation of current programmes. The four most important unsolved problems are: the refinement of field diagnostic techniques to identify skin microfilariae at the ultra-low densities that will become common in the late stages of vector-control campaigns; the definitive identification of Onchocerca volvulus infective larvae in Simulium species; strain analysis in the field of microfilariae from humans and of developing stages from Simulium, to determine their potential for ocular pathogenicity; determination of the lifespan, or maximum fecundity span, of adult female O. volvulus after the interruption of transmission. Three other unsolved problems are of enormous interest epidemiologically, although less urgent in practical importance. They are the identification of factors causing severe disease as opposed to heavy infection; the effects of seasonal as opposed to perennial transmission; and the importance of transplacental transmission of microfilariae or soluble antigens. PMID- 3297560 TI - Clinical responses in human onchocerciasis: parasitological and immunological implications. AB - Onchocerciasis can cause severe dermal and ocular disease due, it is thought, to the events surrounding the destruction of the microfilarial stage. The evolution of papular pruritic dermatitis and punctate keratitis is clearly related to the killing of microfilariae. Other more chronic changes such as dermal and epidermal atrophy are probably due to repeated episodes of microfilarial killing. It is common to find that not all patients are, at any one time, mounting clinically obvious destructive host responses against the microfilariae, and such individuals can carry very high loads of parasites without any apparent adverse effects. The immunological basis of the differences between these types of patients forms one of the most important questions in the pathogenesis of onchocerciasis today. Various explanations are now emerging. These include immunosuppressive factors and variation in the form of Onchocerca volvulus antigens presented to the host. Clinical presentations of this disease appear to reflect variations in host responses and can be used to provide information concerning the protective immune responses an individual can mount against this parasite. PMID- 3297561 TI - Dynamics of the filarial surface. AB - The surface of the filarial worm consists of an extracellular cuticle which overlies the outer plasma membrane of the hypodermis. The cuticle is permeable to a wide range of molecules of low molecular weight, and L-amino acid and D-glucose uptake occurs transcuticularly by active transport and diffusion in physiologically significant amounts. Transport mechanisms are associated with the plasma membrane of the hypodermis, and the cuticle may be considered an 'unstirred layer' distal to the transport loci. The outermost layer of the cuticle, or epicuticle, consists of a lipid bilayer which differs from a typical plasma membrane. There is no conclusive evidence for turnover of the epicuticular materials between the larval moults and in the adult stage. It is proposed that the filarial surface does not show the dynamic properties associated with the surface membranes of parasitic cestodes and trematodes. PMID- 3297562 TI - [Advances in immunotoxicology]. PMID- 3297563 TI - Immunochemical analysis of the structure and function of chromosomal proteins. AB - Immunochemical approaches are useful in studying the nuclear organization and cellular function of chromosomal components. Antibodies specific to histones and to defined nonhistone proteins have been used to study nucleosome heterogeneity, to visualize the presence of histone in transcriptionally active chromatin, and to isolate DNA sequences associated with specific chromosomal proteins. PMID- 3297565 TI - Purification and analysis of rat hematopoietic stem cells by flow cytometry. AB - The monoclonal antibody OX7 recognizes an epitope expressed on the Thy-1 glycoprotein, OX22 recognizes the high molecular weight form(s) on leukocyte common antigen, and W3/13 recognized determinants found on certain sialoglycoproteins. Recently, the rat colony-forming unit spleen (CFU-S) was characterized as being OX7 upper 20% positive (OX7u20%), OX22 negative (OX22-), and W3/13 weakly positive (W3/13+). In the present study these observations have been extended to include the hematopoietic stem cell (HSC). Rat marrow cells were incubated with allophycocyanine-OX7 Fab' (APC-OX7 Fab') and phycoerythrin B-OX22 Fab' (Phy B-OX22 Fab'). The cells were sorted with a FACS-II instrument by using a Krypton laser tuned to the 530 nm spectral line for phycobiliprotein excitation. It was found that marrow cells capable of protecting lethally irradiated Lewis rats (9.5 Gy total body radiation, 0.4 Gy/min Co60) had the phenotype OXu20%, OX22-. The percentage of cells in the marrow with this phenotype was found to be 0.34 +/- 0.01 (mean +/- S.E.). Three thousand of these cells were required to rescue 50% of lethally irradiated recipients (30-d survival), while the number of unsorted bone marrow cells required was 1.05 X 10(6). Thus, a 350-fold purification of the HSC was realized. Although CFU-S copurified with HSC, purification of only 105-fold was obtained. This might indicate that purified HSC have a reduced capacity to generate splenic hematopoietic colonies. The OX7u20%, OX22- -enriched HSC population could be further divided into W3/13 dim and W3/13+ subpopulations by three-parameter immunofluorescence analysis with the use of a new optical bench arrangement. PMID- 3297564 TI - Quantitative analysis of a nuclear antigen in interphase and mitotic cells. AB - The quantification of an interchromatin-associated antigen, designated p 105, during cellular passage through mitosis is described. Indirect immunofluorescence microscopy and immunogold electron microscopy demonstrated a qualitative increase in p 105 within the mitotic cytoplasm. Multiparameter flow cytometric analysis was performed on fixed cells sequentially stained with anti-p 105 immunofluorescence and/or propidium iodide. This analysis demonstrated approximately a tenfold increase in intracellular p 105 content as a function of progression from the G2 to the M phase. This increase was corroborated by the quantitative immunoblot analysis of colchicine-treated cell cultures and of cells sorted on the basis of anti-p 105 immunofluorescence. The data reveal that the increased levels of anti-p 105 immunofluorescence in conjunction with flow cytometry may be used effectively to quantitate mitotic index and isolate mitotic cells. The function and modulation of p 105 throughout the cell cycle is discussed. PMID- 3297567 TI - Analysis of recurrence following curative low anterior resection and stapled anastomoses for carcinoma of the middle third and lower rectum. AB - In a series of 93 patients with middle and lower rectal cancer, who underwent potentially curative surgery by low anterior resection (LAR) with EEA stapled anastomosis or by abdominoperineal excision (APE) between January 1977 and December 1981, the incidence of recurrence and survival rate was compared. LAR with stapler was performed in 61 patients: 55 (90.2 percent) with tumors of the middle third and six (9.8 percent) for tumors of the lower third of the rectum. APE was performed in 32 patients: 13 (40.6 percent) with cancer of the midrectum and 19 (59.4 percent) of the lower rectum. Tumor site, Dukes' distribution, grade of malignancy, and extent of local spread were recorded. The tumor stages for LAR with stapler and for APE, respectively, were Dukes' A 7/1; Dukes' B 27/10; Dukes' C 25/18; Dukes' D 2/3. In a follow-up period of four years (range, 6 to 52 months) the overall recurrence rates were 20.4 percent in the LAR with stapled anastomosis group and 21 percent in the APE group. Local recurrence percentages were 9.8 percent after LAR and 14 percent after APE (P = N.S.). Distant recurrences were 12 percent and 14 percent, respectively. The four-year overall survival rates were 76.7 percent after LAR and 65.5 percent after APE (P = N.S.) The clinical and pathologic factors correlated with recurrence in low rectal carcinoma were reanalyzed and the controversial points of the surgical management for and against LAR with stapled anastomosis and APE were discussed. It is concluded that LAR with the EEA stapler can be carried out in the middle and lower rectum with the prospect of ultimate cure, when performed with proper technical skills in selected patients. PMID- 3297568 TI - Stapled anastomosis after right hemicolectomy using a "long" circular stapling device. PMID- 3297566 TI - Manual dilatation of the anus vs. lateral subcutaneous sphincterotomy in the treatment of chronic fissure-in-ano. Results of a prospective, randomized, clinical trial. AB - The results of a prospective randomized trial in 111 patients were recorded to compare manual dilatation of the anus with lateral subcutaneous sphincterotomy performed under general anesthesia. There was no significant difference in the clinical results nor in the incidence of complications. Persistent or recurrent fissure occurred in three of 59 patients after manual dilatation of the anus and two of 39 patients after lateral subcutaneous sphincterotomy, an incidence of 5.1 percent in each group. Only one patient developed serious impairment of continence, and this occurred following lateral subcutaneous sphincterotomy (5.1 percent). PMID- 3297569 TI - Sphincter repair for fecal incontinence after obstetrical or iatrogenic injury. AB - Forty patients with fecal incontinence underwent sphincter repair between 1975 and 1984. Divided sphincter musculature resulted from obstetrical injury in 23 and previous anorectal surgery in 17. Eighteen had undergone a previous attempt at repair. Fifteen patients experienced seepage of stool and 25 had gross incontinence. In nine patients, reconstruction of the external sphincter was by overlap of the muscle ends. Twenty-four others underwent accurate approximation of the external sphincter muscle and anterior plication of the levator muscles, and in seven the anal canal was made smaller by narrowing the anal orifice. Follow-up was an average of 67 months after operation (range, 2.4 to 166 months). Continence was objectively improved in 62 percent (P less than .01) when performance criteria were analyzed by Wilcoxon signed-rank test, although 85 percent of the patients reported subjective improvement. Requirements for protective pads were reduced in 57 percent (P less than .01) and fewer social limitations were experienced in 52 percent (P less than .01). There was no significant correlation between outcome and type of operation. PMID- 3297570 TI - Single or multiple doses of metronidazole and ampicillin in elective colorectal surgery. A randomized trial. AB - A randomized trial including 294 patients was performed to evaluate the prophylactic effect of single vs. multiple doses of antibiotics in elective colorectal surgery. All patients received 1.5 g metronidazole and 3.0 g ampicillin peroperatively and were randomized to: no further prophylactic antibiotic treatment, or ampicillin 1 g X 3 and metronidazole 0.5 g X 3 given intravenously during the second and third postoperative days. Deep wound infection was seen in 9/149 (6 percent) receiving a single dose and in 8/145 (6 percent) receiving multiple doses. No differences were found in the two groups between frequencies of anastomotic dehiscences, intra-abdominal abscesses, sepsis, and pulmonary infections. The two groups were similar according to distribution of sex, age, diagnosis, and type of surgery. A single peroperative dose of metronidazole and ampicillin is a simple and satisfactory antibiotic prophylaxis in elective colorectal surgery. PMID- 3297571 TI - Percutaneous drainage of appendiceal abscess. An alternative to conventional treatment. AB - Twenty-seven consecutive patients with ultrasonically verified appendiceal abscesses, measuring from 2 to 10 cm in diameter, were studied. Ultrasonically guided percutaneous drainage was performed in 19 by means of one to five punctures, and in eight with one or two catheters. In 16 and 7 patients, respectively, the abscesses resolved without further intervention. Four patients were operated on, two for suspected (but unverified) abscess perforation, one for bowel obstruction, and one because of failed drainage, resulting in a success rate of 85 percent. Hospitalization ranged from 3 to 23 days; however, normal sonograms were not obtained until after nine to 62 days. Follow-up revealed no diagnostic errors. Two patients (8 percent) had recurrent appendicitis, and late sequelae were observed in four patients, three of these after surgery. Ultrasonically guided percutaneous drainage of appendiceal abscesses with the technique described is indicated whenever feasible, as a safe, gentle, and relatively atraumatic procedure with few complications and late sequelae. PMID- 3297572 TI - The Bacon pull-through procedure. AB - Twenty-eight patients who underwent the Bacon pull-through procedure for carcinoma of the midrectum were reviewed retrospectively. The results were comparable to low anterior resection and abdominoperineal resection. Although the indications are limited, it is a viable option in a highly selected group of patients. PMID- 3297573 TI - Classic articles in colonic and rectal surgery. Percivall Pott 1714-1788. The chirurgical works of Percivall Pott, F.R.S. PMID- 3297574 TI - 4-Aminosalicylic acid retention enemas in treatment of distal colitis. AB - Forty-five of 47 patients with distal ulcerative colitis completed a two-week double-blind, randomized, controlled trial to determine if 4-aminosalicylic acid (4-ASA) enemas, 1 g bid or 2 g bid, were therapeutically effective compared to placebo. Forty-one patients enrolled because they were refractory to or had side effects during conventional therapy with sulfasalazine or corticosteroids. Proctoscopic examination was done before and after two weeks of treatment. Patients kept daily diaries assessing: blood in stools, mucus in stools, tenesmus, abdominal pain, loss of appetite, fatigue, weight loss, and malaise. Severity of each symptom ranged from 0 (absent) to 3 (severe). A total severity score was calculated from the above for each patient. At the end of the two-week study, 35 patients elected to take 4-ASA in an open-label trial for one year. 4 ASA enemas in the 1-g bid but not the 2-g bid dosage were significantly more effective in improving symptoms than placebo: P less than or equal to 0.05. Neither dose of 4-ASA enema was better than placebo in improving the sigmoidoscopic appearance at the end of two-weeks. Forty-six percent of patients had complete resolution of all signs and symptoms in the open-label trial and 31% were better but still had sigmoidoscopic evidence of disease, a total response rate of 77%. Side effects were similar in the placebo and 4-ASA groups. We conclude that 4-ASA enemas in a dose of 1 g bid are safe and effective in the treatment of distal ulcerative colitis. PMID- 3297576 TI - Longitudinal measure of glycemic control and diabetic retinopathy. AB - In a population-based study, 5431 diabetic people in southern Wisconsin who were mature at onset of diabetes were identified, and their charts were reviewed. Recent glycemic control was evaluated from these charts. An index of recent glucose control with at least three glucose determinations abstracted from the doctor's chart was constructed. A sample of 1370 of the 5431 individuals was examined as part of this study. An index of glucose control could be derived for 568 of 674 people using insulin and for 565 of 696 nonusers of insulin. Correlation of the index with the glycosylated hemoglobin obtained at the time of study was significant in insulin users and nonusers. Patients with the poorest blood glucose control as described by index of past control or by current glycosylated hemoglobin had higher rates of retinopathy compared with patients who had the best control. When both the index of past control and current glycosylated hemoglobin values were combined, rate ratios for retinopathy for people with poorest control compared with those with best control were slightly better than when each measure was used alone. These analyses suggest that in planning programs, health-care impact may be increased if past and current data are considered. PMID- 3297575 TI - Randomized, controlled trial of diabetic patient education: improved knowledge without improved metabolic status. AB - We randomized 749 insulin-treated patients on the rolls of the Mount Sinai Medical Center Diabetes Clinic in a controlled trial of diabetic patient education; 345 agreed to participate, of whom 165 were assigned to the education group and 180 to the control group. Cognitive scores increased from 5.3 +/- 1.6 to 5.8 +/- 1.6 in the education group, but there was no change in the control group, whose score was 5.3 +/- 1.7 before and after the intervention (P = .0073). HbA1c fell from 6.8 +/- 2.1 to 6.1 +/- 2.0% in the education group and from 6.6 +/- 2.0 to 6.3 +/- 2.0% in the control group, an insignificant difference (P = .1995). The fasting blood glucose decreased from 223 +/- 94 to 179 +/- 73 mg/dl in the education group and from 199 +/- 81 to 185 +/- 76 mg/dl in the controls (P = .1983). Triglycerides, high- and low-density lipoprotein cholesterol, and insulin dosage also failed to show significant variation among groups. The foot lesion score showed similar progression in the education and control groups. Neither diastolic nor systolic blood pressure showed significantly greater change in the education or the control group, with falls noted, particularly in diastolic pressures, in both patient groups. Differences between the groups were not significant for sick days, hospitalizations, emergency room visits, or outpatient visits. The sample sizes of the study and control populations were sufficiently large to detect a difference in means between the education and control groups in the HbA1c, the primary outcome variable, of greater than 1.0%, with alpha = .05 and a power of .95. Thus, our study suggests that patient education may not be an efficacious therapeutic intervention in most adults with insulin-treated diabetes mellitus. PMID- 3297578 TI - Effects of continuous subcutaneous insulin infusion versus multiple injections on insulin receptors in insulin-dependent diabetics. AB - We compared continuous subcutaneous insulin infusion (CSII) versus multiple injections (MI) in the treatment of insulin-dependent diabetes mellitus (IDDM) to assess the effect of glucose control on monocyte insulin receptors. Each IDDM patient (n = 8) was treated for 2 mo by MI (HS Ultralente and AC boluses of regular insulin) and for 2 mo by CSII in a randomized fashion. Prestudy preprandial/postprandial blood glucose levels were 199 +/- 33/261 +/- 28 mg/dl and improved to 124 +/- 12/156 +/- 13 mg/dl during MI and to 115 +/- 11/151 +/- 11 mg/dl during CSII. Glycosylated hemoglobin before the study was 10.1 +/- 0.5% and decreased to 8.8 +/- 0.4 and 8.3 +/- 0.3% during MI and CSII, respectively. The specific 125I-labeled insulin binding to circulating monocytes in a group of nonobese controls (n = 17) was 4.6 +/- 0.2%. In our poorly controlled diabetics during conventional therapy, the 125I-insulin binding was decreased to 3.7 +/- 0.3 (P less than .025). This was not significantly affected by MI despite good glucose control (4.0 +/- 0.3%). With CSII, however, good glucose control was associated with normalization of 125I-insulin binding to monocytes (4.7 +/- 0.27%). The affinity of the insulin receptors was normal before the study and was not affected by either MI or CSII. In conclusion, these observations demonstrate that in IDDM, intensive therapy by MI and CSII resulted in similar good glucose control, but only CSII resulted in normalization of insulin receptors on circulating monocytes. PMID- 3297579 TI - Stable insulin for implantable delivery systems: in vitro studies with different containers and solvents. AB - The stability of a new insulin formulation (lyophilized U100 insulin, Organon) was investigated in vitro in conditions reproducing those of in vivo implanted devices, i.e., constant horizontal agitation at 37 degrees C for 4 wk in various containers and 8 wk in different solvents. Physical stability was assessed by ultraviolet absorption, chemical stability by HPLC, and biological stability by hypoglycemia tests in mice. Insulin precipitated in glass vials but remained clear and active in polyethylene reservoirs and after passage through catheter and pumps in motion, although only 83-90% of insulin was delivered chemically intact. In acidic solvent, insulin showed a major gradual transformation into deamidized derivatives (up to 78% after 8 wk), although still fully active and clear, as expected from previously published excellent in vivo results with acidic insulins. Heparin addition to neutral insulin solution (500 IU/ml) did not alter the properties of the two compounds and might thus be tried to prevent in vivo catheter obstruction due to fibrin deposition. PMID- 3297577 TI - Biphasic patterns of peripheral insulin and glucose levels after lunch in normal subjects. AB - The dynamic relationship of glucose concentrations and insulin secretion during the postabsorptive state is complex and has been associated with a variety of cyclic rhythms. To study the pattern of insulin and glucose response immediately after a mixed meal, we collected blood every 15 min from 0730 to 1645 h from eight normal resting men (age 24.9 +/- 2.1 yr). They took identically constituted mixed meals at 0800 and 1145 h. Concentrations of glucose and insulin were measured in samples taken throughout the study, whereas levels of C-peptide, glucagon, and alpha-NH2 were determined in samples taken after 1130 h only. Computer-assisted analysis was used to identify significant increments and declines in concentrations and to quantify the coincidence of peaks of glucose, C peptide, glucagon, and alpha-NH2 with peaks of insulin. Coefficients of correlation between data points were calculated for each individual. The patterns of blood insulin and glucose after breakfast and lunch were different. After breakfast, a single simultaneous peak in insulin and glucose occurred approximately 60 min after starting the meal. In contrast, the pattern after lunch in seven of the eight subjects was clearly biphasic. There were secondary, significant coincident peaks in serum insulin, glucose, and C-peptide occurring 1.75-2.25 h after the meal was served. The secondary peak appeared unrelated to the late absorption of protein because it was not associated with consistent changes in serum alpha-NH2 concentration. Erratic variations characterized the postlunch pattern of glucagon levels, excluding a role for this counterregulatory hormone in the control of the biphasic insulin and glucose response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297581 TI - Psychosocial aspects of diabetic retinopathy. AB - Diabetic retinopathy, particularly in the more advanced stages, poses many difficult psychosocial problems and demands major adjustments by the patient. Our review of this literature has identified specific problems relevant to patient care, future research, and public policy. For example, proliferative retinopathy often leads to at least partial visual impairment, psychiatric symptoms, and difficulties with glycemic control. Partial visual impairment appears to cause as much psychosocial disruption as severe blindness. This suggests that most rehabilitation programs that serve the legally blind may come too late in the course of this illness. This review emphasizes the paucity of past research on psychosocial aspects of diabetic retinopathy and raises some questions for future research. PMID- 3297580 TI - Interaction between plastic catheter tubings and regular insulin preparations used for continuous subcutaneous insulin-infusion therapy. AB - In search of possible interactions between plastic tubings used for insulin-pump treatment and commercial regular insulin preparations, various catheter sets made from polyvinyl chloride (PVC), polyethylene (PE), and nylon plastics were perfused at 30 degrees C in a laboratory setting for up to 72 h. The perfused insulin solutions were analyzed by high-performance liquid chromatography and atomic absorption spectroscopy. Although no plasticizer, e.g., dioctyl phthalate, or nickel or chromium ions were found in the perfusates, substantial interactions between the plastics and the insulin solutions were detected, extraction of bacteriostatic additives from the insulin solutions in particular. The PVC retained up to 88% of the bacteriostatics from the insulin preparations, whereas PE tubings retained only 10-15%. Whether the loss of preservatives during perfusion through PVC catheters predisposes to cutaneous infections during insulin-pump therapy remains to be shown. PMID- 3297582 TI - IDDM treatment with single dose of mixture of three kinds of insulin: 2-yr follow up. PMID- 3297583 TI - Persistent negativity of ICAs during preclinical period and at acute onset in 2 cases of IDDM. PMID- 3297584 TI - Urinary C-peptide: unsuitable parameter of beta-cell secretion in pancreas transplantation. PMID- 3297585 TI - Expression and purification of native human granulocyte-macrophage colony stimulating factor from an Escherichia coli secretion vector. AB - The human granulocyte-macrophage colony stimulating factor (GM-CSF) was expressed and purified from a high-level Escherichia coli secretion vector. A cDNA fragment encoding mature GM-CSF was fused with the aid of a synthetic oligonucleotide to the E. coli outer membrane signal peptide (ompA) of the secretion expression vector pIN-III-ompA3. The primary construction, designated pLB5001, is under transcriptional control of the tandem lipoprotein promoter (lppP) lactose promoter-operator (lacPO), and is regulated by the lactose repressor. Upon induction, a polypeptide of MW = 14,600 was produced which had GM-CSF activity in a human bone marrow colony assay. The linker sequence between the ompA signal peptide and the amino terminus of the mature GM-CSF was removed by oligonucleotide-directed site-specific mutagenesis to produce GM-CSF with an authentic amino terminus. The resulting construct, designated pLB5001-4, expressed authentic GM-CSF with a specific activity similar to that observed for the pLB5001 specified GM-CSF. Both versions of GM-CSF were associated with the membrane fraction after osmotic shock, and were purified to homogeneity by DEAE Sephacel chromatography, followed by reversed-phase HPLC. Amino acid sequencing from the amino terminus of the purified GM-CSF established that the ompA signal peptide was cleaved at its normal processing site in both cases. PMID- 3297586 TI - [Clinical application of carcinoembryonic antigen (CEA) monoclonal antibodies (McAbs)]. AB - CEA McAbs, recognizing three different epitopes on CEA molecules, were used to measure serum CEA level in cancer patients by enzyme-immunoassay (EIA). The results, as compared with those using polyclonal antibodies, indicated that the positive rate was higher while the false positivity was lower. Immunohistochemistry of tumour sections showed that the CEA McAbs are bonded to 80-90% of gastrointestinal cancers. Although the normal colon epithelium occasionally reacted with CEA McAbs, other normal tissues did not. After in vivo administration of radio-labeled CEA McAbs to nude mice xenograft with human colon cancer, the radio-isotope was found to be concentrated preferentially in the tumour. The ratio of tumour and normal tissue was 3.6-11.8 after 48 hours following administration. Thus, the CEA McAbs can be used clinically not only for serum CEA determination but also for diagnostic imaging. PMID- 3297588 TI - [Preliminary evaluation of the combination of Chinese herbal medicine (destagnation) and radiotherapy for esophageal cancer]. AB - From May 1973 to March 1979, a prospective randomized clinical trial on 425 patients with esophageal cancer was conducted. 194 patients were allotted into the destagnation plus radiotherapy group, the other 231 into radiotherapy only group. The result shows that the combination of destagnation and radiotherapy does not give a result superior to radiotherapy alone. However, destagnation does not increase either hematogenous, lymphatic metastasis, perforation or hemorrhea of the esophageal cancer. PMID- 3297587 TI - [Effect of sodium selenite on the chromosomal aberration of V 79 cells induced in vitro by MNNG and MNU]. AB - Effect of sodium selenite on chromosomal aberration of V 79 cells induced by MNNG and MNU was studied. Na2SeO3 alone, at the concentration of 10(-7)-10(-4) M, increased the incidence of chromosomal aberration. However, Na2SeO3 at 10(-7)-10( 5) M, having been preincubated with the cells for 4 hours, could reduce the number of cells with chromosomal aberration induced by MNNG. Na2SeO3 at 10(-7) 10(-4) M inhibited mutagenic activity of chromosomal aberration induced by MNU. The same inhibition was observed even sodium selenite was added to the medium simultaneously with this carcinogen. The results indicate that sodium selenite alone, at the concentration range used in this experiment, is an aberration inducing agent. But when combined with the carcinogen, anti-cancer effect is obtained. PMID- 3297589 TI - [Invagination anastomosis of the esophagus--a new method of anastomosing after resection of esophageal or cardial carcinoma]. AB - A new method of anastomosis after resection of esophageal or cardial carcinoma was carried out in 141 patients in our hospital from Feb. 1983 to Sept. 1985. After resection of the tumor, the proximal end of esophagus was invaginated into the stomach lumen and a tight suture was applied between the outer wall of esophagus and stomach. Extroversion suture of the mucosa in the esophageal end, being free in the stomach lumen, was made to prevent bleeding and stenosis. The operative mortality was 0.7% (1/141) and no anastomotic leak was found. Our experiences indicate that this operative procedure is easy, simple and obviously reduces the complication in the anastomotic region. PMID- 3297590 TI - Non-selective inhibition of insulin and glucagon release by xenogeneic islet cell surface antibodies. AB - The influence of xenogeneic islet cell surface antibodies (ICSA) on the hormonal secretion of non-B islet cells has not been completely elucidated. Accordingly, we investigated the influence of xenogeneic antiserum on glucagon release from A cells, as representative of non-B islet cells, together with other characteristics of the antiserum. Anti-islet cell sera were produced in rabbits by xenogeneic immunization with dispersed hamster islet cells. Rabbit anti hamster islet cell surface antibodies were detected both qualitatively by indirect immunofluorescence analyses and quantitatively by 125I-protein A radioligand assay. However, antiserum did not induce cell surface immunofluorescence on rat or mouse islet cells. As a result of evaluation of the specific cytotoxicity using 51Cr release assay, antiserum was observed to induce a significantly higher release of 51Cr compared with that of normal rabbit serum in complement-dependent antibody-mediated cytotoxicity. Both glucose-stimulated insulin and arginine-stimulated glucagon release were suppressed by xenogeneic antiserum not only in the presence but also in the absence of complement. It is concluded, therefore, that xenogeneic antiserum has a relative species specificity and non-selectively binds to islet cells in contrast with the non species specificity and preferential binding to pancreatic B cells of human ICSA, although heterogeneity in ICSA-positive sera has been suggested. PMID- 3297592 TI - Glucose, insulin and C-peptide kinetics during intravenous glucose tolerance test in chronic liver disease. AB - To elucidate the mechanism of glucose intolerance in chronic liver disease (CLD), the kinetics of plasma glucose, insulin and C-peptide were studied after intravenous glucose loading in patients with CLD. Fasting plasma insulin levels were higher in patients with CLD than in normal subjects. This hyperinsulinemia was attributed primarily to an increased pancreatic secretion of insulin. Patients with CLD were divided into two groups, one with normal fasting plasma glucose (FBS less than 100 mg/dl (Group I) and the other with higher FBS (Group II). In Group I, the glucose disappearance rate was normal and a brisk acute insulin response (AIR) to glucose was noted. The glucose disappearance rate in Group II was lower than that in normal subjects, and AIR to glucose was blunted. It is suggested that normal glucose tolerance in Group I patients could be interpreted as a state of compensation by hypersecretion of insulin. On the other hand, the glucose intolerance in Group II patients could be due to inadequate insulin secretion to overcome insulin resistance of CLD. PMID- 3297591 TI - The treatment of poorly controlled non-insulin-dependent diabetic subjects with granulated guar gum. AB - The treatment of poorly controlled, non-compliant non-insulin-dependent diabetic subjects for one month with guar granules (Guarem) was associated with significant improvements in fasting serum glucose and insulin and urinary glucose excretion. No significant change was observed in either oral glucose tolerance, erythrocyte insulin receptor binding, serum calcium, cholesterol, triglyceride or HbA1. Subjects reported significant side effects including excessive flatus, increased bowel frequency and fullness. The limited advantages of Guarem treatment must be measured against the possibility of these side effects which to a large extent may be avoided by special attention to the means of administration. Prudent supplementation of the diet with Guarem has undoubted potential for diabetic control. PMID- 3297593 TI - Treatment of Raynaud's phenomenon with captopril. AB - The efficacy of captopril in the treatment of Raynaud's phenomenon was observed in an open study in 53 patients with primitive Raynaud's disease and in 18 patients with Raynaud's associated with scleroderma. Each patient was given captopril 25 mg three times a day for three months. The drug significantly decreased the frequency and the severity of ischaemic attacks in patients with Raynaud's disease, but did not affect the attacks in patients with scleroderma. These subjective ratings were supported by the results of digital strain gauge plethysmography during cold challenge. The therapy was discontinued in six patients (one because of an allergic skin reaction and five owing to orthostatic hypotension), but no serious side-effects were noticed. PMID- 3297594 TI - Intrahepatic cholestasis in acute viral hepatitis: a double-blind trial with dihydroxydibutylether in comparison with placebo. AB - The authors studied the effectiveness of a choleretic drug, dihydroxydibutylether (DHBE), 900 mg daily, in patients with acute viral hepatitis and intrahepatic cholestasis. The four-week, double-blind and placebo-controlled trial showed a more rapid return to normal bilirubin and fasting and post-prandial biliary acid values and plasma transaminases levels in the DHBE-treated group of patients. PMID- 3297595 TI - [Therapy of latent cardiomyopathy with verapamil]. AB - In an open, randomized cross-over trial lasting two months, 21 patients with latent cardiomyopathy were either untreated or received verapamil 120 mg three times daily. Angina and dyspnea improved in 14 of the 21 patients. These symptoms worsened in one, remained unchanged in six (P less than 0.05). During exercise the pulmonary artery diastolic pressure fell from a mean of 25.3 +/- 7.6 to 20.1 +/- 6.6 mm Hg (P less than 0.05); (at rest, from mean of 10.7 +/- 5.2 to 9.0 +/- 4.5 mm Hg - not significant). In nine patients with a raised resting PA diastolic pressure verapamil produced a significant reduction (from 15.4 +/- 2.7 to 11.1 +/ 4.1 mm Hg) (P less than 0.05). All other hemodynamic parameters remained unchanged. These clinically and hemodynamically favorable effects are possibly due to improved diastolic ventricular function by verapamil. In latent cardiomyopathy any impairment of diastolic relaxation may be more important pathogenetically than reduction in systolic ventricular function. PMID- 3297598 TI - [Therapy of acute adult respiratory insufficiency]. PMID- 3297596 TI - [Prostaglandin E1 in stage III and IV arterial occlusive diseases. results of a multicenter study]. AB - In a controlled randomized trial at four centers, using a common protocol, 57 patients with advanced chronic arterial occlusive disease (21 in stage III, 36 in stage IV) were treated with prostaglandin E1 (PGE1) or adenosine triphosphate (ATP) for three weeks. Both substances were administered intraarterially over 60 min. Daily dose of PGE1 was 20 micrograms, of ATP 30 mg. Both produced a significant reduction in resting pain at the end of the treatment phase, in stage III significantly better with PGE1. There was also a clear reduction in the use of analgesics, significantly more so with PGE1. Healing or improvement of ulcers was significantly better with PGE1, while there was no significant differences between the two drugs as regards stage improvement. Three amputations had to be performed in the PGE1 group, nine in the ATP group, a significant difference. Side effects in the form of reddening, pain and swellings occurred in 15 patients of the PGE1 group and six of the ATP group. Final verdict by the treating doctor about the success of treatment was significantly more favorable for PGE1. PMID- 3297597 TI - [Treatment of goiter with thyroid hormones or iodine?]. PMID- 3297600 TI - [Deep freezing of microsurgically split bovine embryos and the production of monozygotic twins of different ages]. PMID- 3297599 TI - [Tobacco smoke: the environmental air pollutant most dangerous to man]. PMID- 3297601 TI - [Qualitative and quantitative studies on Salmonellae in industrially obtained poultry meat (broilers)]. PMID- 3297602 TI - [Comparative studies on the demonstration of antigens of Chlamydia psittaci from deep organ samples using mouse assays and ELISA (preliminary report)]. PMID- 3297603 TI - Influence of gentamicin and rifamycin on toxicity and biotransformation of methyl parathione in rats. PMID- 3297604 TI - [Benzimidazole resistance in Haemonchus contortus in a south German sheep herd]. PMID- 3297605 TI - [The control of flies and the prevention of summer mastitis in grazing cattle using pyrethroids in different forms of application]. PMID- 3297606 TI - New ways how to control development of the house fly larvae (Musca domestica) in litter. PMID- 3297608 TI - [Physiologic and pathologic aspects of the immune system]. PMID- 3297607 TI - [Non-specific reactions in leukemia diagnosis with ELISA]. PMID- 3297609 TI - [Transplantation antigens]. PMID- 3297610 TI - [Mechanisms of the immune response]. PMID- 3297611 TI - [T-cell clones and monoclonal antibodies]. PMID- 3297612 TI - [Vaccination]. PMID- 3297613 TI - [Mechanisms of chronic arthritis]. PMID- 3297614 TI - [Myasthenia gravis--an autoimmune disease in the dog]. PMID- 3297615 TI - Lymphokines. Progress and promise. PMID- 3297618 TI - Management of bacteriuria in pregnancy. AB - Bacteriuria of pregnancy is a common condition which, although usually asymptomatic, may give rise to potentially serious sequelae. All pregnant women should therefore be screened for the presence of bacteriuria, which if detected should be treated with an antimicrobial agent believed to be safe for use in pregnancy. Appropriate antimicrobial drugs include penicillins, cephalosporins and nitrofurantoin. Nalidixic acid, aminoglycosides and sulphonamides may be used under certain circumstances and with some precautions. Tetracyclines, trimethoprim and co-trimoxazole (trimethoprim-sulphamethoxazole) should be avoided. There is some evidence that short-course therapy in pregnant women is less effective than longer courses, and we continue to recommend a 7-day course. Follow-up after completing a treatment course is an essential part of managing bacteriuria of pregnancy. PMID- 3297619 TI - The place of high-dose inhaled corticosteroids in asthma therapy. PMID- 3297617 TI - Ofloxacin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. AB - Ofloxacin is one of a new generation of fluorinated quinolones structurally related to nalidixic acid. It is an orally administered broad spectrum antibacterial drug active against most Gram-negative bacteria, many Gram-positive bacteria and some anaerobes. Ciprofloxacin is the only other quinolone with superior in vitro antibacterial activity. However, the pharmacokinetic profile of ofloxacin is superior to that of ciprofloxacin, with more rapid absorption and a peak serum concentration several times higher. Moreover, ofloxacin achieves high concentrations in most tissues and body fluids. The results of clinical trials with ofloxacin have confirmed the potential for use in a wide range of infections, which was indicated by its in vitro antibacterial and pharmacokinetic profiles. It has proven effective against a high percentage of infections caused by Gram-negative organisms, slightly less effective against Gram-positive infections, and effective against some anaerobic infections. Clinical efficacy has also been confirmed in a variety of systemic infections as well as in acute and chronic urinary tract infections, and ofloxacin has generally appeared to be at least as effective as alternative orally administered antibacterial drugs. Ofloxacin is well tolerated and, although experience with the drug in clinical practice to date is limited, bacterial resistance does not appear to develop readily. Thus, ofloxacin is an orally active drug which offers a valuable alternative to other broad spectrum antibacterial drugs. PMID- 3297616 TI - Nicardipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy, in the treatment of angina pectoris, hypertension and related cardiovascular disorders. AB - Nicardipine is an antagonist of calcium influx through the slow channel of the cell membrane and has been shown to be an effective and relatively well-tolerated treatment for stable effort angina and rest angina due to coronary artery spasm, and mild to moderate hypertension. Although its exact mechanism of action in these disease states has not been precisely defined, the potent coronary and peripheral arterial dilator properties of nicardipine, with concomitant improvements in oxygen supply/demand and reductions in systemic vascular resistance, are of major importance. Clinical studies have shown that nicardipine appears to be effective in the treatment of chronic stable exercise-induced angina pectoris and possibly in angina at rest due to coronary artery spasm. In the treatment of stable angina, nicardipine has proved to be equally as effective as nifedipine. However, haemodynamic and clinical studies indicate that nicardipine may have a further advantage of not depressing cardiac conduction or left ventricular function, even in patients with compromised cardiac pumping ability. Nicardipine also appears to be useful as initial monotherapy or in combination with other antihypertensive drugs when used in the treatment of mild to moderate hypertension, and may have some advantages over other vasodilators in this regard in that it may not be as frequently associated with fluid retention or weight gain as other similar drugs. In the treatment of hypertension nicardipine has been shown to be as effective as drugs such as hydrochlorothiazide, cyclopenthiazide, propranolol and verapamil in short term studies although confirmation of its long term usefulness in well-designed clinical trials is still required. Similarly, although the use of nicardipine in other disorders such as congestive heart failure and cerebrovascular disease has provided encouraging preliminary results, more studies are needed to clarify its place in their treatment. Side effects appear to be dose related and more frequent within the first few weeks of therapy. Most of these effects are minor and transient in nature and include headache, flushing and peripheral oedema. Thus, there is no doubt that nicardipine provides a suitable alternative to other drugs available for the treatment of angina and hypertension. However, further well-designed comparative clinical trials are needed to clarify its relative place in the long term management of these disorders. PMID- 3297620 TI - Buflomedil. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in peripheral and cerebral vascular diseases. AB - Buflomedil hydrochloride is a vasoactive drug with a variety of pharmacodynamic properties. Importantly, it seems to improve nutritional blood flow in ischaemic tissue of patients with peripheral and/or cerebral vascular disease by a combination of pharmacological effects: inhibition of alpha-adrenoceptors, inhibition of platelet aggregation, improved erythrocyte deformability, nonspecific and weak calcium antagonistic effects, and oxygen sparing activity. Therapeutic trials with buflomedil in patients with peripheral vascular diseases have shown that it increases walking distances in those with intermittent claudication and heals trophic lesions and reduces rest pain in many patients with more severe vasculopathies. In open clinical trials a good to very good clinical response was achieved in 57 to 87% of those treated. In comparative studies buflomedil 600 mg/day orally was shown to be significantly superior to placebo and comparable in efficacy to pentoxifylline (oxpentifylline) and naftidrofuryl. In patients with symptoms presumed to be due to cerebrovascular insufficiencies and elderly patients with senile dementia, buflomedil 450 to 600 mg/day alleviated symptoms associated with impairment of cognitive and psychometric function and was significantly superior to placebo and slightly more effective than drugs such as cinnarizine, flunarizine and co-dergocrine mesylate. Overall, buflomedil at dosages of up to 600 mg/day has been very well tolerated and discontinuation of therapy has rarely been necessary. Thus, buflomedil would seem to be a useful adjunct to conservative treatment in patients with mild-to moderate peripheral vascular disease and/or cerebrovascular insufficiency, and well worth a try in patients with more severe peripheral disease unable to undergo surgery. However, a few well-designed long term studies are needed to fully define its overall place in therapy. PMID- 3297621 TI - Proquazone. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in rheumatic diseases and pain states. AB - Proquazone is a non-steroidal anti-inflammatory agent (NSAID) which, unlike most other NSAIDs, does not have a free acid group in its structure. It is advocated for use in rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, musculoskeletal disorders, acute inflammatory conditions and acute pain states such as dysmenorrhoea, postoperative pain and headache. Published data in small groups of patients indicate that proquazone 300 to 900 mg/day in 3 divided doses is a possible alternative to aspirin, ibuprofen, indomethacin, and naproxen in rheumatoid arthritis, and to indomethacin and ibuprofen in ankylosing spondylitis. Similarly, proquazone 300 to 900 mg/day is as effective as aspirin, diclofenac, ibuprofen, indomethacin and naproxen in patients with osteoarthritis. Preliminary studies have confirmed the efficacy of proquazone in acute inflammatory disorders, and shown that it provides useful analgesic relief in acute pain states such as dysmenorrhoea, headache and after minor surgery. Evidence from small groups of patients with rheumatoid arthritis treated for a year or more suggests that proquazone may inhibit or arrest progression of bone erosions. However, these encouraging findings clearly need confirmation in a larger number of patients studied under well-controlled conditions. The overall impression from clinical trials to date is that proquazone at dosages of greater than or equal to 900 mg/day produces a high incidence of gastrointestinal symptoms such as diarrhoea (in approximately 30% of patients). However, these effects were usually of mild to moderate severity and transient in nature and in most comparative studies the overall tolerability of proquazone was assessed as being comparable to that of other NSAIDs tested. Similarly, withdrawal from therapy due to side effects was no greater with proquazone than with other NSAIDs evaluated. Initial experience with lower dosages of proquazone (300 to 450 mg/day) suggest that efficacy is maintained and tolerability markedly improved. Thus, at present, proquazone would seem to be as effective as other NSAIDs used in the management of rheumatoid arthritis and osteoarthritis. However, further studies are needed to fully evaluate the efficacy and tolerability of this agent, especially at the lower daily dosages currently recommended, and to clarify whether it does have significant 'disease modifying' potential. PMID- 3297622 TI - Newer positive inotropic agents in the treatment of chronic cardiac failure. Current status and future directions. AB - Heart failure is a serious worldwide health problem of major proportions. For many physicians, digitalis (an inotropic agent of limited proportions) and diuretics have proven the standard of treatment for heart failure. Vasodilators have also gained acceptance in recent years. Nevertheless, many patients remain symptomatic and therefore attention has been given to the development of pharmacological agents with mechanisms of action targeted to cardiac and vascular smooth muscle. The newer generation of inotropic agents have clearly been shown to improve the pumping function of the failing heart in patients who remain symptomatic despite digitalis, diuretics and vasodilators, while myocardial oxygen consumption is not enhanced. Several uncontrolled trials with the phosphodiesterase inhibitors enoximone, milrinone and piroximone have concluded that these agents improve exercise capacity and thereby hold promise to enhance quality of life. Large scale controlled trials currently in progress will determine the ultimate efficacy, as well as safety, of these agents. Results to date with several orally active beta-adrenoceptor agonists suggest that their efficacy may be limited by the induction of ventricular arrhythmias. PMID- 3297624 TI - New approaches in peroxisomal disorders. AB - The peroxisome is a subcellular organelle with important functions in plants and protozoa, which during the last decade has also been shown to have a role in mammalian lipid and amino acid metabolism. These functions include steps in the synthesis of ether lipids and bile acids and fatty acid beta-oxidation, particularly those of very long chain fatty acids. The proposition that the peroxisome carries out significant functions in man is highlighted by the fact that lack of this organelle is associated with severe abnormalities in many human organs. Human peroxisomal disorders are now grouped into three general categories. In the first group, peroxisomes are lacking or reduced in number. This group includes the Zellweger cerebro-hepato-renal syndrome, neonatal adrenoleukodystrophy, infantile Refsum's disease and hyperpipecolic acidemia. These patients lack the capacity to synthesize ether lipids and to oxidize very long chain fatty acids or phytanic acid, and they show abnormally high levels of pipecolic acid and bile acid intermediates. These patients rarely survive early childhood, have severe neurological deficits and multiple malformations. A second group includes the 'pseudo-Zellweger' syndrome and the rhizomelic form of chondrodysplasia punctata. Here the peroxisomal structure is intact, but there is deficient function of several peroxisomal enzymes. The third group includes X linked adrenoleukodystrophy, acatalasemia and 'adult' Refsum's disease. The peroxisomal structure is intact, and the defect in each instance is thought to involve a mutation which affects a single peroxisomal enzyme. Peroxisomal disorders are of current interest because they occur more commonly than had been recognized and show phenotypic and genotypic heterogeneity. Their study provides the opportunity to learn more about the role of the peroxisome in normal brain function and development. PMID- 3297623 TI - The role of arachidonic acid metabolites in cardiovascular homeostasis. Biochemical, histological and clinical cardiovascular effects of non-steroidal anti-inflammatory drugs and their interactions with cardiovascular drugs. AB - Derivatives of arachidonic acid may be involved in atherosclerosis and its clinical complications. There is much interest in pharmacologically manipulating the arachidonic acid cascade as a means of preventing cardiovascular disease. The development of atherosclerosis has been intensively studied and the consequences of cardiovascular or cerebrovascular vessel occlusion are too familiar. Many factors are probably involved, but the role of plasma lipoproteins and the interactions between various constituents of blood and blood vessel walls have received particular attention. The risk of cardiovascular disease associated with high plasma concentrations of the low density lipoproteins and the possible protective effects of high density lipoproteins have been well documented. Much is now known about lipoprotein biochemistry, and the importance of controlling the quantity and quality of dietary lipids has been demonstrated in epidemiological studies. In studies of patients with transient ischaemic attacks, aspirin reduced the risk of stroke and death in males, although these benefits were not as convincingly demonstrated in women. The majority of patients were given aspirin 1300 mg daily, but the optimum dosage was not properly evaluated. Administering aspirin in combination with another antiplatelet drug did not appear to offer any therapeutic advantage in these patients. Aspirin showed a positive, but non-significant trend towards reduced numbers of cardiac events, non-fatal infarcts and total mortality in patients who had experienced at least one myocardial infarction. In contrast, statistically significant beneficial effects were recorded when patients with unstable angina were administered aspirin. The risks of myocardial infarction or coronary death were reduced by 51% in 2 large studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297626 TI - [Microbiol colonization of the dentogingival region in healthy and periodontally diseased conditions]. PMID- 3297625 TI - Teratology of the antituberculosis drugs. AB - The teratogenic effects of twelve antituberculosis drugs in animal models and man are reviewed. A number of congenital malformations have been associated with the use of these agents; however, for the most part, the birth defect rate is not above that expected for the normal population. Isoniazid and ethambutol are considered the safest for maternal use. Although rifampicin appears to be more problematic, if the disease is severe or extensive, it may be added, preferably after the first trimester. Streptomycin and kanamycin are associated with eighth cranial nerve damage and should be avoided if possible during cyesis. At least five of these compounds have documented evidence of transplacental passage. In consideration of the number of drugs that are available for treatment, routine therapeutic abortions in pregnant females with tuberculosis is not medically indicated. PMID- 3297627 TI - [Stability of root pin systems in variable load tests]. PMID- 3297628 TI - [Stress distribution in crowns in the anterior region]. PMID- 3297629 TI - [Signs of corrosion on silver posts in root canals (I)]. PMID- 3297630 TI - [Scanning electron microscopy studies of the bond between silane-treated metal surfaces and the veneering plastics]. PMID- 3297631 TI - [Light-polymerizing veneer synthetics and light-hardening devices. A comparison of physical-technical properties]. PMID- 3297633 TI - [Prolactin, depression and antidepressive agents. Review of the literature]. AB - Different neurotransmitters (Dopamine, serotonin, GABA...) and hormones (TRH, oestrogenes...) are involved in the central regulation of prolactin synthesis and release. Under physiological conditions, prolactin levels are related to correlate with age, sex, sexual maturational changes (puberty, menopause...), menstrual cycling... In this review of literature there exists a great amount of data concerned with changes in prolactin in affective disorders illustrating the validity of the biochemical and neuroendocrinological approach specially in depression. Different research paradigms are presently reviewed: measurement of plasma levels of prolactin under basal conditions, in a circadian pattern or after pharmacological challenge with TRH and/or morphine (stimulation), L-dopa and/or dexamethasone (inhibition) and its response to antidepressant drugs. The authors emphasize the contradictory results reported in the literature and suggest the need for extreme caution before considering the validity of prolactin as a biochemical test in depression. PMID- 3297632 TI - [Effect of transferrin on the formation of active T-rosettes in healthy persons and in patients with autoimmune diseases]. PMID- 3297634 TI - Intracerebroventricular injection of cholecystokinin octapeptide elevates plasma prolactin levels through stimulation of vasoactive intestinal polypeptide. AB - We investigated the effect of cholecystokinin octapeptide (CCK-8) on plasma PRL levels in freely moving male rats. Intravenous injection of CCK-8 did not affect basal plasma PRL levels in doses up to 5000 ng/rat; however, plasma PRL increased significantly after intracerebroventricular (icv) injection of the peptide at a dose of 40 ng/rat. Proglumide (0.2 mg/kg, iv) and benzotript (0.2 mg/kg, iv), specific CCK receptor antagonists, blocked the icv CCK-8-induced increase in plasma PRL levels. There was no apparent effect of icv CCK-8 on the enhancement of PRL release by haloperidol (0.2 mg/kg, iv), sulpiride (0.1 mg/kg, iv), domperidone (0.1 mg/kg, iv), or RO22-1319 (0.1 mg/kg, iv). However, the apomorphine-induced inhibition of PRL secretion was significantly antagonized by icv CCK-8. Furthermore, icv CCK-8 increased plasma PRL levels in rats depleted of dopamine by pretreatment with reserpine and alpha-methyl-p-tyrosine. Finally, the elevation in plasma PRL levels produced by icv CCK-8 was substantially antagonized by vasoactive intestinal polypeptide antiserum (1:3; 10 microliter/rat, icv). These results suggest that CCK-8 increases plasma PRL through an interaction with a central CCK receptor, which stimulates the activity of vasoactive intestinal polypeptide, a putative PRL-releasing factor. PMID- 3297635 TI - Isolated gonadotropin-releasing hormone neurons harvested from adult male rats secrete biologically active neuropeptide in a regular repetitive manner. AB - Immunochemical treatments for the recovery of viable GnRH neurons from adult male rats have previously been described by this laboratory. In the present report, efforts were made to limit cellular adhesion, as well as the proteolytic and mechanical damage which occurred during isolation of the neurons, in order to determine if such damage may account for failure of the isolated cells to exhibit spontaneous neuropeptide release. These modifications prevented the loss of assayable GnRH during the isolation process, and neurons recovered from individual rats in this study contained 10.7 +/- 2.5 ng GnRH. Further, all isolated neuronal preparations exhibited spontaneous peptide release which continued in a regular repetitive manner. When maintained in closed chambers, these preparations released 105 +/- 42 pg/ml biologically active GnRH at 18.9 +/- 0.4-min intervals. In contrast, GnRH release from heterologous preparations was characterized by erratic low level pulses. The results from this work suggest that independent neuroendocrine properties of GnRH neurons may be responsible for tonic gonadotropin secretion in castrated adult male rats and that the erratic patterns of gonadotropin release in gonadally intact males may be related, in part, to coupling between GnRH neurons and unidentified neuronal factors. PMID- 3297636 TI - Steroid effects on the secretory modalities of gonadotropin-releasing hormone release. AB - GnRH neurons isolated immunochemically from the brain of adult male rats were used to determine whether testosterone (T), dihydrotestosterone (DHT), estradiol 17 beta (E(2)17 beta), 20H-estrone (OHE1), or progesterone (P4) have a direct effect on the spontaneous neurosecretion and/or cellular content of GnRH. Neurons harvested from individual rats were treated with a single steroid pulse; samples were collected before treatment, during the steroid pulse, and at 24 h post treatment. Androgen treatments of 100 pg/ml or 1 ng/ml media elicited an increase in GnRH pulse frequency 1-6 min after steroid exposure without affecting the amplitude of release; these modalities persisted at 2 h. The frequency of GnRH pulses was increased 24 h after the neurons received the brief 100 pg/ml or 1 ng/ml T or 1 ng/ml DHT treatments. Neurons exposed to androgen treatments also appeared to express large amplitude GnRH pulses infrequently at this time whereas there was no androgen affect on the cellular GnRH concentration. In contrast, E(2)17 beta, OHE1, and P4 treatments had no affect on the mean media GnRH concentration, baseline GnRH concentration, or on the frequency and amplitude of GnRH pulses at any time point. However, the 1 ng/ml P4 and the 1 ng/ml OHE1 treatments both reduced cellular GnRH content at 48 h post treatment. These results suggest that T and DHT may specifically interact with GnRH neurons to elicit immediate and/or long-term changes in the modalities of neuropeptide release and that under physiological conditions GnRH neurons of adult male rats are not directly influenced by E(2)17 beta, the catecholestrogen OHE1, or P4. PMID- 3297637 TI - Regulation of rat liver glycogen phosphorylase concentration by in vivo relative levels of glucagon and insulin. AB - The concentrations of glycogen phosphorylase protein were determined by rocket immunoelectrophoresis in liver extracts from rats that had artificially induced altered hormonal patterns. These levels were compared with measurements of total phosphorylase activity. Minipump-induced chronic hyperglucagonemia and streptozotocin-induced diabetes resulted in 47% and 67% decreases, respectively, in total phosphorylase activity along with corresponding 52% and 68% drop, respectively, in phosphorylase protein levels. Insulin replacement in diabetic rats returned both parameters to control values. Minipump-induced hyperinsulinemia or injection of glucagon antiserum, T3, or propylthiouracil had no effect. The results of this study indicate that conditions which lead to an elevation of the glucagon to insulin molar ratio to values higher than 1.0 cause a significant decrease in the liver phosphorylase protein level. PMID- 3297638 TI - Synthesis-secretion coupling of insulin: effect of aging. AB - Synthesis-secretion coupling of insulin was measured in four age groups of perfused pancreases taken from Sprague-Dawley rats ranging in age from 2-12 months. The effect of long term (6 h) near-maximal glucose stimulation (300 mg/dl) on both insulin secretion and net insulinogenesis demonstrated an age related increase in both parameters. Net insulinogenesis as well as total insulin secretion increased linearly as a function of aging. Compared to that in 2-month old rats, total net insulin synthesis was more than 3-fold greater in 12-month old rats, slightly less than 3-fold greater in 8-month-old rats, and twice as much in 4-month-old rats. Compared to that in 2-month-old rats, total glucose stimulated insulin secretion was 3-fold greater in 12-month-old rats, approximately 2.2-fold greater in 8-month-old rats, and about 1.7-fold greater in 4-month-old rats. A shorter term (90 min) glucose stimulation at 150 mg/dl produced an age-related increase in insulin secretion which was relatively comparable to the higher glucose stimulus. Of equal importance is that fact that pancreases from the older rats exhibited the same degree of secretory responsiveness to changing glucose levels as did pancreases from the younger rats. Regardless of age, first phase insulin secretion was approximately twice as much in response to the higher glucose level as to the lower. Similarly, second phase insulin secretion was almost 3 times greater regardless of age. When normalized and reported in terms of insulin content, total insulin secretion was no different as a function of aging during the first 1 h of glucose stimulation (i.e. the first two phases of secretion), but it was significantly elevated in the third secretory phase (2-6 h) by the older rat groups. Total 6-h net insulinogenesis was also greater in the older rat groups. When normalized and reported in terms of total body weight, both insulin synthesis and total insulin secretion became comparable and showed no specific age-related difference. Thus, there is no indication that aging results in an uncoupling of relatively long term (6-h) insulin synthesis-secretion, since both glucose-induced responses parallel one another as a function of aging. Furthermore, reporting insulin secretion and synthesis on the basis of body weight, rather than age, totally normalizes synthesis-secretion coupling of insulin. PMID- 3297639 TI - Glucocorticoids regulate insulin binding in a rat glial cell line. AB - We have examined insulin receptor regulation by glucocorticoids in the C6 rat glioma cell line. Dexamethasone decreased insulin binding to intact cell monolayers in a dose and time-dependent fashion. The effect is maximal between 48 and 72 h with 50 nM dexamethasone that decreased binding by 40-60%. The natural steroid corticosterone produced a similar effect although it was less potent, and the antiglucocorticoid 17 alpha-methyltestosterone was ineffective in lowering the receptor and partially antagonized the effect of dexamethasone. Total number of binding sites was decreased by glucocorticoids, and when analyzed with a two site model a 3-fold increase in the dissociation constant (Kd) of the low affinity site was also observed. In the absence of protein synthesis the receptor accumulates at the cell surface, since cycloheximide produced a large increase of insulin binding. Cycloheximide totally blocked the effect of dexamethasone when both compounds were added together to the cells suggesting that protein synthesis is necessary for the effect of the glucocorticoid. By contrast, in cells pretreated with dexamethasone, cycloheximide was unable to produce an increase in cell surface receptor, showing that glucocorticoids probably deplete not only membrane receptor but also total cellular receptor. PMID- 3297640 TI - Nuclear acceptor sites for progesterone-receptor complexes in rat placenta. AB - A cell-free system was used to characterize the binding reaction between the progesterone receptor and nuclear acceptor sites prepared from rat placenta. Two forms of receptor-acceptor complex were examined. One was extracted from nuclei by exposure to 0.6 M KCl; the other type was resistant to salt extraction. Kinetic analysis indicated that the binding reactions were saturable (3-4 pmol binding sites/mg DNA) and of high affinity (Kd = 3-6 nM). Acceptor binding was specific for placental nuclei and did not occur with nuclei prepared from spleen or with denatured nuclei from placenta. Acceptor sites were further characterized by their sensitivity to RNase, DNase I, and protease. RNase treatment had no influence on receptor-acceptor binding. However, DNase I reduced the number of KCl-resistant acceptor sites by 41%, but only a 19% reduction occurred in KCl extractable acceptor sites (P less than 0.05). Protease removed 34% and 48% of the KCl-resistant and -extractable acceptor sites, respectively, and combined treatment with DNase and protease eliminated 76% of acceptor-binding activity. The endogenous inhibitor previously described from rat placental cytosol blocked acceptor-binding sites in a concentration-dependent manner, a decrease of 1.15 pmol sites/mg inhibitor protein for resistant sites and 0.76 pmol/mg inhibitor protein for extractable sites. However, receptor-acceptor binding was not altered by treating nuclei with actinomycin D or chloroquine. Mercurial reagents reduced receptor-acceptor interaction by 80% and 94% in KCl-resistant and -extractable sites, respectively, whereas sulfhydryl alkylating agents reduced binding 35% and 76%. Pyridoxal phosphate destroyed 88-93% of acceptor binding. The results of these studies suggest that the progesterone receptor acceptor sites are composed of a complex of chromatin protein and DNA in rat placenta. Furthermore, the binding reaction requires the participation of sulfhydryl and terminal amino groups. PMID- 3297641 TI - Processing of luteinizing hormone-releasing hormone precursor in rat neurons. AB - Results of previous immunocytochemical studies indicate that in the rat brain proteolytic cleaving of LHRH precursors to generate the physiologically active decapeptide takes place within neuronal fibers and terminals and not within perikarya. A 69-amino acid (aa) LHRH precursor comprised of the decapeptide, a 3 aa cleavage and amidation site, and a 56-aa C-terminal extension has recently been characterized. Two antisera generated to specific aa sequences of the C terminal extension (RM 8/5, anti aa 14-26; PS 39A, anti aa 40-53) and two directed to specific regions of the LHRH decapeptide (RM 1076, anti aa 4-8; A 422 generated to the N-terminal pGlu and C-terminal amidated Gly) were used to further examine intraneuronal sites of precursor processing. Patterns of immunoreactivity revealed with antisera directed to non-LHRH sequences of LHRH precursor paralleled those observed with antisera to the decapeptide. Immunopositive perikarya, processes, and neurovascular terminals were observed with PS 39A. Antiserum PS 39A binds to an internal aa sequence of the C-terminal extension and would, therefore, be expected to detect intact precursor LHRH as well as products of proteolytic cleavage. In contrast, only immunopositive processes and neurovascular terminals were observed with RM 8/5, an antiserum directed to an initial aa sequence of the C-terminal extension. The pattern of immunoreactivity revealed with RM 8/5 resembled that observed with an antiserum that binds the fully processed decapeptide (A 422), indicating that proteolytic cleavage of the decapeptide from the C-terminal extension is required for binding by this antiserum. Furthermore, the restricted distribution of reaction product observed with RM 8/5 relative to A 422 suggests that additional processing of the C-terminal extension may be required for binding. Such additional processing appears to occur in neurovascular terminals of the median eminence. PMID- 3297642 TI - The effect of hyperprolactinemia produced by transplantable pituitary MtTW15 tumor cells in male rats on hypothalamic luteinizing hormone-releasing hormone release in vitro: effects of naloxone and K+. AB - Although hyperprolactinemia has been reported to decrease reproductive function in male rats, the mechanism of these effects is not fully understood. We examined the effects of chronic hyperprolactinemia and castration on the LHRH content of the medial basal hypothalamus (MBH) and on the basal and evoked in vitro release of LHRH from the MBH-preoptic area (POA). Adult Wistar-Furth male rats were inoculated with MtTW15 tumor fragments; 3 weeks later half of the rats were castrated. Hyperprolactinemic (H) and normoprolactinemic (N) rats were decapitated 2 weeks later to measure MBH LHRH and serum PRL and LH levels. Elevated PRL levels (greater than 2 micrograms/ml) resulted in significantly increased MBH LHRH stores. Castration caused a 57% depletion of MBH LHRH in N rats; in castrated H rats the MBH LHRH content was also reduced by 40%, a significantly lesser extent. Although serum LH levels in intact H rats were only slightly reduced, postcastration LH hypersecretion was significantly attenuated. In a parallel study, the LHRH release rate was assessed by in vitro perfusion of the MBH-POA. The basal LHRH release rates of intact N and H rats were similar. Castrated N rats released LHRH at a reduced rate (50%; P less than 0.01), whereas in castrated H rats the LHRH release rate was reduced by 20%, which corresponded with the partial depletion of the MBH LHRH content in these rats. To examine the possibility of opiate involvement, LHRH release evoked by two consecutive naloxone (NAL) infusions (1 mg/ml for 30 min) was studied. The two NAL infusions resulted in two similar significant increments of LHRH in the MBH-POA of intact N and H rats. However, castration produced different effects on the NAL-induced LHRH release. First, the second NAL pulse was not effective in stimulating LHRH release from the MBH-POA of N and H castrated rats. Further, the first NAL infusion elicited a significant increase in LHRH output from the MBH-POA of N and H castrated rats, but it was significantly lower in comparison with that in their respective intact counterparts. In addition, the NAL-induced LHRH response was higher from the MBH-POA of castrated H than that in castrated N rats. These studies show that neither basal nor evoked LHRH output in vitro is affected by severe and chronic hyperprolactinemia produced by MtTW15 pituitary tumor cells in intact male rats.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297643 TI - Sympathetic nerve stimulation versus pancreatic norepinephrine infusion in the dog: 1). Effects on basal release of insulin and glucagon. AB - We investigated whether pancreatic norepinephrine (NE) infusions could reproduce the inhibition of insulin secretion and the stimulation of glucagon secretion observed during sympathetic nerve stimulation in halothane-anesthetized dogs. Three minutes of stimulating the sympathetic nerves (8 Hz, 1 msec, 10 mA, n = 6) surrounding the pancreatic artery decreased both the blood flow in the superior pancreatic vein (SPV) (delta = -1.7 +/- 0.6 ml/min, P less than 0.05) and the basal pancreatic output of immunoreactive insulin (IRI) (delta = -79 +/- 5%, P less than 0.001). SPV levels of NE increased by 683 +/- 177 pg/ml (P less than 0.02). Infusion of NE into the superior pancreatic artery at the low dose of 12 ng/min (n = 6) reproduced this increase of SPV levels of NE (delta = +740 +/- 130 pg/ml; P less than 0.01) and caused a small reduction of SPV blood flow (delta = 1.0 +/- 0.4 ml/min, P less than 0.05), but did not change pancreatic IRI (delta = -26 +/- 16%, NS). The medium dose of NE (120 ng/min, n = 6) reproduced the nerve stimulation-induced decrease of SPV blood flow (delta = -1.5 +/- 0.2 ml/min; P less than 0.01) and increased the SPV NE levels by 6,306 +/- 1,839 pg/ml (P less than 0.02), yet did not decrease pancreatic IRI output (delta = +62 +/- 49%, NS). The high dose of NE (1,200 ng/min, n = 6) produced an extreme increment of SPV NE levels (delta = +180,000 +/- 44,000 pg/ml, P less than 0.001) and a much larger reduction of SPV blood flow (delta = -3.7 +/- 0.7 ml/min, P less than 0.01) than did nerve stimulation, yet still did not inhibit insulin output (delta = -13 +/- 46%, NS). Ten minutes of sympathetic nerve stimulation increased the pancreatic output of immunoreactive glucagon (IRG) by 1435 +/- 419 pg/min (P less than 0.02). Pancreatic IRG output increased as well during infusion of NE for 10 min at both 12 ng/min (by 575 +/- 205 pg/min, P less than 0.05) and 120 ng/min (by 718 +/- 231 pg/min, P less than 0.05). In marked contrast, during infusion of NE at 1200 ng/min, pancreatic IRG output decreased (by 400 +/- 190 pg/min, P less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297644 TI - Control of gonadotropin secretion in the ovine fetus: the effects of a specific gonadotropin-releasing hormone antagonist on pulsatile luteinizing hormone secretion. AB - To demonstrate the dependence of fetal pituitary LH secretion endogenous GnRH, we studied the effects of bolus iv administration of a specific GnRH antagonist analog [GnRH-Ant; (N-acetyl-D-p-chloro-Phe1,2,D-Trp3,D-Arg6,D-Ala10)GnRH] on pulsatile LH release in 10 chronically cannulated ovine fetuses of 104-129 days gestation (term, 147 days). Vehicle alone was given to 13 control fetuses of 107 125 days gestation. Blood samples for LH determination by RIA (NIH LH S16 standard) were taken after injection of either GnRH-Ant (175-300 micrograms dissolved in 1 ml 5% dextrose in water) or vehicle alone for 1.75-5 h. The efficacy of GnRH receptor blockade was then assessed by a bolus iv challenge with 50 micrograms synthetic GnRH. The mean (+/- SEM) observation period per animal was similar for the two groups (3.8 +/- 0.2 h for GnRH-Ant; 3.6 +/- 0.2 h for controls). The frequency of spontaneous pulsatile LH secretion was significantly decreased in the fetuses given GhRH-Ant (2 pulses over 38 h total observation vs. 13 pulses over 47.3 h in control fetuses; P = 0.006). The average interpulse interval was 19.0 h in the GnRH-Ant group compared to 3.6 h in controls. Although the mean pulse amplitude was lower in the GnRH-Ant group (2.8 +/- 1.2 vs. 7.6 +/- 1.1 ng/ml for controls), this difference was not statistically significant (P = 0.065, by one-tailed t test). The mean peak serum LH concentration in response to the GnRH challenge was significantly blunted in the GnRH-Ant group (4.6 +/- 0.8 vs. 20.6 +/- 1.8 ng/ml for controls; P less than 0.001). These results indicate that GnRH-Ant administration causes a virtual cessation of pulsatile LH discharge. As this GnRH-Ant blocks GnRH action at the receptor level, these data demonstrate that pulsatile LH secretion in the ovine fetus is dependent on endogenous GnRH release as early as 104 days gestation. PMID- 3297645 TI - Fluctuations of alpha cell calcium, potassium and sodium during amino acid perifusion of rat pancreatic islets. AB - Perifusion of rat pancreatic islets with a physiologic, 6-mM amino acid mixture resulted in typical acute and second phase glucagon secretion over 30 min. At various intervals, islets were acutely fixed and processed for scanning electron microscopy, identification of alpha cells, and measurements of single alpha cell content of calcium (Ca), potassium (K) and sodium (Na) with energy-dispersive x ray analysis. Biphasic glucagon secretion was attended by corresponding biphasic Ca accumulation and a reciprocal, biphasic suppression of K content and acute phase suppression of Na in alpha cells. All secretory and cellular events were preceded by an evanescent upward spike in alpha cell K at 1 min. These results indicate that alpha cell glucagon secretion in response to amino acid mixtures may be initiated by a K signal and is coupled subsequently to phasic changes in alpha cell Ca content. Fluctuations of alpha cell K and Na appear to relate inversely to Ca, suggesting that transmembrane fluxes of the three cations are interrelated. PMID- 3297646 TI - Estrogen induces premature luteal regression in rhesus monkeys during spontaneous menstrual cycles, but not in cycles driven by exogenous gonadotropin-releasing hormone. AB - Administration of exogenous estradiol during the mid- to late luteal phase of the menstrual cycle results in premature regression of the corpus luteum. The present study was initiated to identify the site of action of estrogen as well as to determine why administration of estrogen during the early luteal phase of the menstrual cycle does not result in luteolysis. Based upon extant literature, we hypothesized that estrogen and progesterone synergize to promote premature luteal regression. We tested this hypothesis in intact, spontaneously cycling rhesus monkeys by inserting estradiol, progesterone, or estrogen plus progesterone capsules on days 2 through 6 of the luteal phase. Insertion of estrogen or progesterone capsules alone did not advance luteolysis compared with the effect of control empty implants (n = 3). In contrast, insertion of estrogen plus progesterone implants on days 2 through 6 of the luteal phase resulted in a significant lowering of serum progesterone concentrations, and menses was advanced 5-6 days compared with control cycles. On the basis of these findings in spontaneously cycling monkeys, we speculated that estrogen treatment causes luteal regression only in the presence of a progesterone-mediated decrease in LH pulse frequency. To test this hypothesis, we used rhesus monkeys whose endogenous gonadotropin secretion was abolished by either placement of radiofrequency lesions in the mediobasal hypothalamus or transection of the hypothalamic pituitary stalk. Ovulatory menstrual cycles were restored by pulsatile administration of exogenous synthetic GnRH. Insertion of estradiol capsules during the luteal phase into animals whose gonadotropin pulse frequency was set at either one pulse per h or one pulse per 8 h failed to cause premature luteal regression (n = 4). These findings indicate that whereas estrogen promotes luteal regression in intact, spontaneous cycling rhesus monkeys, it does not do so in animals whose gonadotropin secretion is controlled by exogenous GnRH. On the basis of these observations, we conclude that the hypothalamus is a major site of action of estrogen in the initiation of luteal regression in macaques. PMID- 3297647 TI - Evidence that somatomedins mediate the effect of hypophosphatemia to increase serum 1,25-dihydroxyvitamin D3 levels in rats. AB - The present studies were undertaken in an effort to determine whether somatomedins (SMs) play a role in the elevation of serum 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] levels during dietary phosphate deprivation. Serum 1,25-(OH)2D3,SM C, and phosphate levels were measured in rats fed diets containing adequate or very low levels of dietary phosphorus under circumstances known to affect SM levels, including hypophysectomy with and without GH replacement, normal protein vs. low protein diets, and streptozotocin-induced diabetes with and without insulin replacement. In all circumstances, serum 1,25-(OH)2D3 concentrations were directly related to serum SM-C levels. However, the slope for the relationship was increased 2- to 10-fold in animals fed the low phosphorus diets. As observed previously, serum 1,25-(OH)2D3 levels were inversely related to serum phosphate levels, but the slope for this relationship was deceased in the presence of low SM levels and absent in animals with very low SM levels. These results suggest that SM are required for elevation of serum 1,25-(OH)2D3 levels in response to phosphate deprivation. PMID- 3297648 TI - Glucose and amino acid uptake by exercising muscles in vivo: effect of insulin, fiber population, and denervation. AB - The first series of experiments was performed on control rats. The animals were injected iv with trace amounts of 2-deoxy-D-[1-14C]glucose [( 14C]DG) or alpha-[1 14C] aminoisobutyric acid with or without 0.1 U insulin/rat, and calf muscles of the right hindlimb were electrically stimulated to induce 1 contraction/sec. The exercise was discontinued 25 min after the injection, and cellular uptakes of DG or aminoisobutyric acid by soleus, plantaris, and gastrocnemius muscles in disintegrations per min/mg dry tissue weight were determined. The results of these experiments demonstrated that basal, insulin-induced, and exercise-induced uptakes of glucose and amino acids by muscles are dependent on muscle fiber population, and the stimulatory effects of exercise and insulin on soleus and plantaris muscles, but not gastrocnemius muscles, are synergistic rather than merely additive when both stimuli act together. The second series of experiments was performed in the same manner as the first series, except that the right hindlimb of each rat was denervated 3 days before the experiment. Cellular DG uptakes were determined in soleus, plantaris, and gastrocnemius muscles of the left (sham) hindlimb, which was always resting, and in corresponding muscles of the right (denervated) limb, which was either resting or exercising. In the resting state, the denervated soleus muscle had normal basal DG uptake, but, unlike sham soleus muscle, did not respond to insulin stimulation. Denervated plantaris and gastrocnemius muscles exhibited 264% and 150% elevations in basal glucose uptake, respectively, compared with corresponding sham muscles. The latter two denervated muscles did respond to insulin, but the hormone-induced increments in DG uptake were 68% and 45%, respectively, lower than in corresponding contralateral sham muscles. Under basal conditions, exercise had no effect on DG uptake by the denervated soleus muscle, but increased uptake by denervated plantaris and gastrocnemius muscles 207% and 778%, respectively. Stimulation of exercising denervated muscles with exogenous insulin did not increase DG uptake by any muscle above the level observed with exercise alone. The results show that manifestations of insulin resistance in denervated muscles depend on muscle fiber population; denervated muscles, which still retain some ability to respond to insulin, increase DG uptake during exercise, whereas such an increase is absent in denervated muscles completely unresponsive to insulin; and exercise does not improve or restore the ability of denervated muscles to respond to insulin. PMID- 3297649 TI - Glucose-dose dependent characteristics of insulin secretion in obese and lean sheep. AB - We previously reported that obesity in sheep and cattle was associated with basal hyperinsulinemia, insulin resistance, and an exaggerated insulin response to a single dose (350 mg/kg) of glucose. In this study, the glucose-dose dependency of insulin secretion in obese and lean sheep was determined by 1) using jugular venous concentrations of insulin (Exp 1) and 2) arteriovenous differences in insulin concentrations across the pancreas together with plasma flow rates in the portal vein (Exp 2). Sheep were injected with glucose doses of 0 (water), 10, 30, 100, and 350 mg glucose/kg body weight in Exp 1 (six sheep per group) and with a low (20 mg/kg) and high (200 mg/kg) dose of glucose in exp 2 (four sheep per group). In Exp 1, mean (+/- SE) pretreatment plasma concentrations of insulin (22.0 +/- 1.7 vs. 9.4 +/- 0.4 microU/ml) and glucose (56.1 +/- 0.5 vs. 52.4 +/- 0.8 mg/dl) were greater (P less than 0.01) in obese than lean sheep fasted for 12 h. The glucose-induced rises in insulin concentrations above pretreatment levels were always greater (P less than 0.05) in obese than lean sheep regardless of glucose dose. Eadie-Scatchard plot analysis of the hyperbolic relationship between the acute insulin and acute glucose response areas (0 to +10 min) indicated that the maximum (Vmax) early phase insulin response was greater (P less than 0.025) in obese than lean sheep (568 +/- 148 vs. 156 +/- 33 microU ml-1 X min). In Exp 2, pretreatment concentrations of insulin (25.1 +/- 3.4 vs. 5.6 +/ 1.2 microU/ml) and glucose (58.3 +/- 1.8 vs. 45.5 +/- 1.1 mg/dl) in arterial plasma were greater (P less than 0.01) in obese than in lean sheep fasted 18 to 22 h. Similarly, pretreatment pancreatic secretion rates of insulin were greater (P less than 0.01) in obese (17.8 +/- 5.8 mU/min) than in lean (4.9 +/- 1.3 mU/min) sheep. Glucose-induced acute (0 to +10 min) increments in pancreatic secretory rates of insulin also were greater (P less than 0.05) in obese than in lean sheep after the low (215 +/- 73 vs. 11 +/- 15 mU) and high (881 +/- 281 vs. 232 +/- 66 mU) doses of glucose. It was concluded that insulin secretion in response to a range of stimulatory concentrations of glucose was greater in obese than in lean sheep because the obese sheep had greater maximum (i.e. Vmax) acute phases of glucose-induced insulin secretion. PMID- 3297650 TI - Multihormonal control of synthesis and secretion of prostatein in cultured rat ventral prostate. AB - The synthesis and accumulation of prostatein, a major secretory protein of the rat ventral prostate, was examined in organ culture conditions. For the quantitation of this protein in the medium, a sensitive enzyme immunoassay was developed. The rat ventral prostate could be maintained in organ culture in defined medium for at least 2 weeks. Morphologically the changes in explants cultured without hormones resembled those of castration. These involutive changes could be postponed by testosterone and totally prevented by a combination of testosterone, corticosterone, and insulin in the culture medium. Newly synthesized prostatein, studied by fluorography of [35S] methionine-labeled proteins, accumulated only in the presence of testosterone. Its synthesis also took place in cultured prostate derived from castrated rats. Neither corticosterone nor insulin alone could sustain prostatein synthesis. Insulin increased the testosterone-dependent prostatein synthesis in the beginning of culture, but later, inhibition, rather than stimulation, could be noted. Corticosterone increased the testosterone-dependent synthesis of prostatein throughout the culture. The results show that organ culture of adult rat ventral prostate provides an in vitro model for studies of differentiated prostatic function. PMID- 3297651 TI - Native and recombinant bovine growth hormone antagonize insulin action in cultured bovine adipose tissue. AB - The current study was undertaken to determine if pituitary bovine GH (pbGH) and recombinant bGH (rbGH) antagonized insulin action in bovine adipose tissue after acute (2-h) and chronic (48-h) exposure and whether this was an intrinsic property of bGH. Insulin action (measured as the effect on incorporation of acetate-carbon into long-chain fatty acids) was unaffected by bGH in short term incubations regardless of whether hydrocortisone (HC) was present. After 48 h of culture, however, both pbGH and rbGH similarly antagonized the ability of insulin to maintain lipogenic capacity. This antagonism was dependent upon the presence of HC and was dose dependent, with half-maximal inhibition of insulin action occurring at about 0.5 ng/ml bGH. Bovine PRL did not mimic the effects of bGH on insulin action. These results establish that bGH antagonizes insulin action in bovine adipose tissue and that this effect is dependent upon long term exposure and the inclusion of HC in the culture medium. The fact that both rbGH and pbGH acted similarly indicates that this is an intrinsic property of bGH. The effect of bGH on insulin-dependent maintenance of lipogenic capacity may play an important role in redirecting nutrients away from adipose tissue to other tissues, such as muscle or mammary tissue. It is speculated that this metabolic effect of bGH plays an important role in the adaptive response to chronic bGH treatment, which increases milk yield of dairy cows and growth performance of beef cattle. PMID- 3297652 TI - Ovarian thecal cells produce transforming growth factor-beta which can regulate granulosa cell growth. AB - Ovarian thecal cells in culture were found to synthesize and secrete transforming growth factor-beta (TGF beta). A component in thecal cell-conditioned medium was immunologically similar to TGF beta, as assessed with a RIA, and inhibited specific binding of TGF beta to its cell surface receptors. Thecal cell-secreted proteins also contained TGF beta biological activity, which was determined by stimulation of soft agar colony formation by AKR-2B indicator cells. Specific TGF beta antibodies precipitated a 25 K protein from radiolabeled thecal cell secreted protein that comigrated with purified platelet-derived TGF beta. Both bovine thecal cell and rat thecal/interstitial cell preparations produced TGF beta, which required acid treatment to obtain fully active samples. The physiological significance of TGF beta production by thecal cells was addressed through an analysis of the effects of TGF beta on bovine granulosa cell growth. TGF beta inhibited epidermal growth factor stimulation of granulosa cell growth, but alone it had no apparent influence. Observations indicate that ovarian thecal cells produce TGF beta, which can regulate granulosa cell growth and differentiation. Discussion of thecal cell-granulosa cell interactions and the possible functions of TGF beta in the ovary is presented. PMID- 3297654 TI - Intracellular compartmentation of metals in aquatic organisms: roles in mechanisms of cell injury. AB - The intracellular compartmentation of essential and toxic metals is of intense scientific interest because of its potential for adding to our understanding of both normal homeostatic mechanisms for metals and of the mechanisms which underlie metal-induced cell injury. High-affinity metal-binding proteins, lysosomes, and precipitates such as inclusion bodies or concretions, play major roles in the regulation of divalent-metal cation bioavailability. The contribution of a given compartment toward metal homeostasis is dependent upon the level exposure, cell type, organ, species, and life cycle of the organism. Toxic metals may move between these compartments, but the rates and determinants of such exchanges have not been characterized. Available data clearly indicate that sequestration of toxic metals in these specialized compartments can produce profound disturbances in the subcellular handling of essential metals. Further studies of the mechanisms by which metals partition and/or transfer among these compartments are essential to understand and predict toxicity of this important class of toxic agents. PMID- 3297655 TI - Oncozoons and the search for carcinogen-indicator fishes. AB - This essay attempts to bring into perspective the importance of hereditary as well as environmental factors as potential causes of neoplasms in feral fishes. Concepts delineated by Knudson regarding hereditary cancers in man and experimental animals will probably be found operative in certain demographic units (oncozoons) among feral fishes bearing neoplasms. Hereditary factors include: antioncogenes (regulatory genes), which act as suppressors of neoplastic expression in homozygous, heterozygous, or hemizygous states, as well as constitutional (structural) genes that influence carcinogen activation or deactivation through enzyme gene products, genes that influence immunologic responses, and gene abnormalities that favor spontaneous or induced mutations. The two major classes of genes (oncogenes and antioncogenes) that influence the manifestation of cancers appear to operate through different mechanisms, but conceivable interactions have not been widely investigated, especially in tumor enzootics among feral fishes. Some explorations have been undertaken in the laboratory by Anders and collaborators in studies of suppressor genes (antioncogenes) and the cellular sarc gene (an oncogene) in melanophoromas in platyfish-swordtail hybrids and backcrosses. Some feral fish oncozoons that exhibit features of hereditary oncodemes as seen in man have been tentatively identified here as candidate systems to be studied more intensively in laboratories, particularly using cytogenetic analysis and breeding methods. In the search for carcinogen-indicator fish species in feral habitats, the traditional approach has been to survey fish populations with the aim of first finding enzootics of fish neoplasia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297653 TI - Biotransformation and induction: implications for toxicity, bioaccumulation and monitoring of environmental xenobiotics in fish. AB - Biotransformation of xenobiotics in fish occurs by many of the same reactions as in mammals. These reactions have been shown to affect the bioaccumulation, persistence, residue dynamics, and toxicity of select chemicals in fish. P-450 dependent monooxygenase activity of fish can be induced by polycyclic aromatic hydrocarbons, but phenobarbital-type agents induce poorly, if at all. Fish monooxygenase activity exhibits ideal temperature compensation and sex-related variation. Induction of monooxygenase activity by polycyclic aromatic hydrocarbons can result in qualitative as well as quantitative changes in the metabolic profile of a chemical. Induction can also alter toxicity. In addition, multiple P-450 isozymes have been described for several fish species. The biotransformation products of certain chemicals have been related to specific P 450 isozymes, and the formation of these products can be influenced by induction. Exposure of fish to low levels of certain environmental contaminants has resulted in induction of specific monooxygenase activities and monitoring of such activities has been suggested as a means of identifying areas of pollutant exposure in the wild. PMID- 3297656 TI - Normal versus abnormal structure: considerations in morphologic responses of teleosts to pollutants. AB - Consideration of newer more quantitative morphologic approaches to the study of aquatic pollutants can provide opportunity for collaborative/integrated studies with other subdisciplines in toxicology. Current commonly employed morphologic approaches result largely in subjective findings difficult to analyze statistically and often are directed at levels of structural organization inconsistent with biochemical and physiological approaches. We review some of the methods and approaches available for correlated structure/function studies and present examples from normal and altered skin, gill, and liver of teleosts. PMID- 3297657 TI - Initiation, promotion, and inhibition of carcinogenesis in rainbow trout. AB - The identification of etiological agents in feral fish neoplasia epizootics has been hampered in part by the lack of suitable fish models, and complicated by the likely existence of environmental agents which can act to stimulate or reduce population responses to genotoxin insult. The response of fish to tumor inhibitors and promoters, and the underlying mechanisms of modulation, have been studied in the rainbow trout model. Dietary treatment of trout with the compounds indole-3-carbinol (I3C), beta-naphthoflavone (BNF), or the polychlorinated biphenyl (PCB) complex Aroclor 1254, before and during exposure to aflatoxin B1 (AFB1), was shown to reduce the final incidence of hepatocellular carcinoma after 12 months, compared to fish receiving AFB1 only. By contrast, treatment of trout with BNF or I3C following AFB1 initiation led to a significant enhancement of ultimate tumor response. Similarly, simultaneous treatment of trout with PCB and the carcinogen N-nitrosodiethylamine led to syncarcinogenic enhancement, rather than inhibition, of tumor response. Mechanisms of inhibition of AFB1 carcinogenesis by PCB, BNF, and I3C were investigated. PCB and BNF, but not I3C, are known to be strong inducers of trout cytochrome P448 and associated activities. Dietary induction by BNF or PCB was shown to be accompanied in isolated hepatocytes by considerably altered AFB1 metabolism, and by significantly reduced rates of DNA adduct formation for all three agents. All agents differentially altered in vivo AFB1 pharmacokinetics, enhanced bile elimination of AFB1 as the aflatoxicol-M1 glucuronide, and significantly reduced peak levels of liver DNA adduct formation. No effects were seen on repair of AFB1 DNA adducts, which was very slow in trout.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297658 TI - Chemical carcinogenesis in feral fish: uptake, activation, and detoxication of organic xenobiotics. AB - The high prevalence of liver neoplasms in English sole (Parophrys vetulus) and substantially lower prevalence of neoplasms in a closely related species, starry flounder (Platichthys stellatus) captured from industrialized waterways, provide a unique opportunity to compare biochemical processes involved in chemical carcinogenesis in feral fish species. Because levels of aromatic hydrocarbons (AHs) in urban sediments are correlated with prevalences of liver neoplasms in English sole, we have initiated detailed studies to evaluate the effects of endogenous and exogenous factors on uptake, activation and detoxication of carcinogenic AHs, such as benzo[a]pyrene (BaP), using spectroscopic, chromatographic, and radiometric techniques. The results obtained thus far show that sole readily takes up AHs associated with sediment from urban areas and that the presence of other xenobiotics, such as PCBs, in sediment increases tissue concentrations of BaP metabolites. Extensive metabolism of BaP occurred whether sole was exposed to this AH via sediment, per os, or intraperitoneally. Substantial modification of hepatic DNA occurred and persisted for a period of 2 4 weeks after a single exposure to BaP. The level of covalent binding of BaP intermediates to hepatic DNA was 10-fold higher in juvenile than adult sole and 90-fold higher in juvenile sole than in Sprague-Dawley rat, a species which is resistant to BaP-induced hepatocarcinogenesis. The level of chemical modification of hepatic DNA in juvenile flounder was 2-4 fold lower than that for juvenile sole and concentration of BaP 7,8-diol glucuronide in bile of sole was significantly higher than that in flounder bile, although the rate of formation of BaP 7,8-diol by hepatic microsomes was comparable for both species. Moreover, liver microsomes from both species, in the presence of exogenous DNA, metabolized BaP into essentially a single adduct, identified as (+)anti-7,8-diol-9,10-epoxy 7,8,9,10-tetrahydroBaP-dG. These results, along with our findings that hepatic GST activity in flounder was two times higher than in sole, demonstrate that microsomal metabolism of BaP does not accurately reflect the differences in the ability of these fish to form BaP-DNA adducts in vivo and also suggest that detoxication of reactive intermediates is an important factor in determining the levels of DNA modification by AHs and resulting toxic effects in feral fish. PMID- 3297659 TI - Aquatic versus mammalian toxicology: applications of the comparative approach. AB - The large body of literature and techniques generated by mammalian toxicity studies provides a conceptual and technical framework within which the absorption, fate, and disposition of xenobiotics in aquatic organisms can be studied. This review emphasizes the similarities and differences between mammalian and aquatic systems, e.g., lung vs. gill as site of absorption and toxicity. These must be taken into consideration when designing aquatic toxicity studies. Studies of phenol red in dogfish shark as an example show physiologic based pharmacokinetic modeling to be a useful tool for investigating and eventually predicting species differences in xenobiotic disposition and drug differences within the same species. This discussion demonstrates that both laboratory and modeling procedures are now available to carry out sophisticated studies of xenobiotic fate and disposition in fish. Such studies are needed to pinpoint sites and mechanisms of pollutant toxicity in aquatic organisms. PMID- 3297660 TI - Fish acute toxicity syndromes and their use in the QSAR approach to hazard assessment. AB - Implementation of the Toxic Substances Control Act of 1977 creates the need to reliably establish testing priorities because laboratory resources are limited and the number of industrial chemicals requiring evaluation is overwhelming. The use of quantitative structure activity relationship (QSAR) models as rapid and predictive screening tools to select more potentially hazardous chemicals for in depth laboratory evaluation has been proposed. Further implementation and refinement of quantitative structure-toxicity relationships in aquatic toxicology and hazard assessment requires the development of a "mode-of-action" database. With such a database, a qualitative structure-activity relationship can be formulated to assign the proper mode of action, and respective QSAR, to a given chemical structure. In this review, the development of fish acute toxicity syndromes (FATS), which are toxic-response sets based on various behavioral and physiological-biochemical measurements, and their projected use in the mode-of action database are outlined. Using behavioral parameters monitored in the fathead minnow during acute toxicity testing, FATS associated with acetylcholinesterase (AChE) inhibitors and narcotics could be reliably predicted. However, compounds classified as oxidative phosphorylation uncouplers or stimulants could not be resolved. Refinement of this approach by using respiratory-cardiovascular responses in the rainbow trout, enabled FATS associated with AChE inhibitors, convulsants, narcotics, respiratory blockers, respiratory membrane irritants, and uncouplers to be correctly predicted. PMID- 3297661 TI - Toxicological investigations of pollutant-related effects in Great Lakes gulls. AB - Reproductive failure of a number of fish-eating birds was observed on the Great Lakes in the mid-1960s to mid-1970s. The herring gull (Larus argentatus) has been used as the primary monitoring species. The low hatching success observed in this species on Lake Ontario in the mid-1970s was due to loss of eggs and failure of eggs to hatch. Egg exchange experiments demonstrated that this was due both to the incubation behavior of adults and to direct embryotoxic effects. Decrease of nest attentiveness was demonstrated using telemetered eggs, but attempts to reproduce the embryonic effects by injection of pollutant mixtures into eggs were not successful. Reproductive success improved rapidly during the late 1970s and was normal by the end of the decade. Recent studies have focused on cytogenetic and biochemical changes and detailed analytical chemistry of residues. No changes in the rate of sister chromatid exchange over values determined in coastal colonies were observed. Elevation of hepatic aryl hydrocarbon hydroxylase activity, levels of highly carboxylated porphyrins, and changes of thyroid function have been found. The geographic pattern of these changes indicates that they are caused by xenobiotics, but it has not been possible to relate the changes to a specific chemical. PMID- 3297662 TI - Chemoreceptors of crustaceans: similarities to receptors for neuroactive substances in internal tissues. AB - A description is given of crustacean chemosensory systems and the neurophysiological procedures used to study them. Their response properties and tuning characteristics are discussed. A review is then provided of specific crustacean chemoreceptors that are stimulated selectively by either purine nucleotides, taurine, glutamate, or glycine, all of which have neuroactive properties in internal tissues. Two distinctly different types of purinergic chemoreceptors occur on the antennules of the spiny lobster. P1-like chemoreceptors have a potency sequence of AMP greater than ADP greater than ATP greater than adenosine and show a strict structural requirement for the ribose phosphate moiety. P2-like chemoreceptors have a potency sequence of ATP greater than ADP greater than AMP or adenosine and show a broad sensitivity to nucleotide triphosphates with modifications in both the purine and ribose phosphate moieties. Sensilla containing the dendrites of chemosensory neurons also possess an ectonucleotidase(s) that inactivates excitatory nucleotides to yield adenosine which is subsequently internalized by a sensillar uptake system. Narrowly tuned taurinergic chemoreceptors are present on both the antennules and legs of lobsters. Although taurine itself is the most effective stimulant, the taurine analogs hypotaurine and beta-alanine are also very excitatory. Structure-activity studies indicate these chemoreceptors have marked similarities to taurine sensitive systems in internal tissues of vertebrates. By contrast, comparative studies of glutamatergic chemoreceptors on the legs of lobsters indicate response spectra different from those of the glutamate receptors in lobster neuromuscular junctions and the three classes of excitatory amino acid receptors identified internally in vertebrates. Crustacean chemoreceptors for glycine, ecdysteroids, and pyridine are also described. The hypothesis that receptors for internal neuroactive agents may have originally evolved as external chemoreceptors of primitive aquatic organisms is discussed. PMID- 3297663 TI - The fish gill: site of action and model for toxic effects of environmental pollutants. AB - The gill epithelium is the site of gas exchange, ionic regulation, acid-base balance, and nitrogenous waste excretion by fishes. The last three processes are controlled by passive and active transport of various solutes across the epithelium. Various environmental pollutants (e.g., heavy metals, acid rain, and organic xenobiotics) have been found to affect the morphology of the gill epithelium. Associated with these morphological pathologies, one finds alterations in blood ionic levels, as well as gill Na,K-activated ATPase activity and ionic fluxes. Such physiological disturbances may underly the toxicities of these pollutants. In addition, the epithelial transport steps which are affected in the fish gill model resemble those described in the human gut and kidney, sites of action of a variety of environmental toxins. PMID- 3297664 TI - Field and laboratory studies of the etiology of liver neoplasms in marine fish from Puget Sound. AB - A series of field studies was conducted between 1979 and 1985 in Puget Sound, Washington State, to investigate etiological relationships between prevalences of hepatic neoplasms in bottom-dwelling marine fish species, with emphasis on English sole (Parophrys vetulus), and concentrations of toxic chemicals in sediments and affected fish. Statistically significant (p less than or equal to 0.05) correlations have been found between the prevalences of hepatic neoplasms in English sole and the following parameters: sediment concentrations of aromatic hydrocarbons, and concentrations of the metabolites of aromatic compounds in the bile of affected sole. A significant difference (p less than 0.001) was also found between the relative concentrations of aromatic free radicals in the liver microsomes of English sole with liver lesions compared to sole without liver lesions. Laboratory studies designed to evaluate the etiology of the liver neoplasms in English sole have also yielded evidence that is consistent with the view that high molecular weight aromatic hydrocarbons, e.g., benzo[a]pyrene (BaP), are hepatocarcinogens in English sole. The current status of a series of long-term (up to 18 months) exposures of English sole and rainbow trout (Salmo gairdneri) to selected fractions of Puget Sound sediment extracts, enriched with aromatic hydrocarbons and nitrogen-containing aromatic compounds, and to individual carcinogens (e.g., BaP) is discussed. PMID- 3297665 TI - Aquatic models for the study of renal transport function and pollutant toxicity. AB - Studies of renal cell transport mechanisms and their impairment by xenobiotics are often limited by technical difficulties related to renal tubule complexity. Problems include the juxtaposition of multiple tubule segments with different transport functions and severely limited access to the tubular lumen. Some limitations can be overcome by the careful selection of an appropriate aquatic experimental system. Two aquatic models for the vertebrate proximal segment are discussed here. The first is the kidney from certain marine flounder, which offers the following advantages: long-term viability, little tissue of nonproximal origin, and easy tubule isolation. Data are presented to demonstrate how studies with flounder kidney can be used to elucidate cellular mechanisms whereby different classes of toxic pollutants may interact. Results from these experiments indicate that the excretion of certain anionic xenobiotics can be delayed by other anionic xenobiotics that compete for secretory transport sites and by compounds that disrupt cellular ion gradients and energy metabolism needed to drive transport. The second system is the crustacean urinary bladder, a simple, flatsheet epithelium. Bladder morphology and transport physiology closely resemble those of vertebrate proximal segment. Electron micrographs show a brush border membrane at the luminal surface, numerous mitochondria, and an infolded serosal membrane, while in vivo and in vitro transport studies show reabsorption of NaCl, nutrients and water and secretion of organic cations; organic anions are secreted in bladders from some species and reabsorbed in others. Moreover, since bladders can be mounted as flat sheets in flux chambers, studies with this tissue avoid the problems of complex renal tubule geometry and tissue heterogeneity that limit transport studies in proximal tubule. PMID- 3297666 TI - Advantages of using aquatic animals for biomedical research on reproductive toxicology. AB - Major advantages of the use of aquatic animals, such as trout, English sole, or sea urchins, for studying the mechanisms of reproductive toxicology are discussed. The remarkable synchrony of differentiation of gametes in large quantities for detailed morphologic and biochemical measurements enables research not readily done on mammalian nonseasonal breeders. Structural differences such as the absence of a fibrous sheath in the more simple structure of fish and sea urchin sperm flagella facilitates comparative study of the mechanism of action of microtubules in flagella movement and the coupling of mitochondrial energy production to microtubules movement. PMID- 3297667 TI - Pollutants as developmental toxicants in aquatic organisms. AB - Pollutants, by disrupting metabolic processes, can interfere with development, and, at critical periods of development, can act as teratogens. Such interference with normal development can be used as a bioassay. Some screening tests are based on this phenomenon. As teratogens, pollutants are fairly nonspecific. Many different classes may elicit the same developmental responses. Mechanisms of teratogenicity include disruption of mitosis, interference with transcription and translation, metabolic disturbances in energy utilization, and nutritional deficits. These in turn interfere with cell interactions, migration, and growth. In aquatic organisms, environmental conditions can be critical. Interactions of pollutant effects with salinity and with temperature have been reported. Interactions between toxicants have also been studied; both synergism and antagonism have been reported. Most reports of teratogenesis have been qualitative. Quantitation has usually been in the form of percentages of embryos affected, but when severity of effect is indexed, more critical analysis is allowed. When effects of other developmental processes such as growth are analyzed, quantitation is readily achieved. Regeneration is an especially useful model of both differentiation and growth. These two components of regeneration can be separately analyzed. Dose-response relationships are readily apparent. In comparison to mammalian embryos, the use of embryos of many aquatic species for testing toxicants has certain advantages, including lower cost and maintenance and shorter development times. They respond to many of the same teratogens. A special advantage is availability for continual examination during development so that abnormalities can be observed and recorded as they arise. PMID- 3297668 TI - Cytochrome P-450 isozymes and monooxygenase activity in aquatic animals. AB - The roles of different forms of cytochrome P-450 in activation and deactivation of toxic chemicals, synthesis and breakdown of steroid hormones, and other functions, indicate the significance of these enzymes. Monooxygenase systems have been studied in species from several phyla of aquatic organisms. However, cytochrome P-450, the dominant catalyst in xenobiotic monooxygenase activity, is best studied in fish. Forms of cytochrome P-450 have been purified from several teleost species, including scup (Stenotomus chrysops), rainbow trout (Salmo gairdneri), and cod (Gadus morhua). Cytochrome P-450E from scup, cytochrome P-450 LM4b from trout, and cytochrome P-450c from cod have properties similar to each other and appear to be homologous hydrocarbon or BNF-inducible isozymes. Partially purified cytochrome DBA-P-450-I from little skate, Raja erinacea, is possibly an elasmobranch counterpart of these teleost forms. Cytochrome P-450E from scup is immunochemically related to the major BNF-inducible isozyme (cytochrome P-450c or BNF-B) in rats, indicating homology between the fish and mammalian BNF-inducible isozymes. Several other cytochrome P-450 forms with interesting or unusual properties have been purified from aquatic species. Mammalian homologs are not yet known for these isozymes. Further studies of cytochrome P-450 forms in aquatic species should establish additional homologies and the regulation of these forms by chemical and biological variables, possibly providing fundamental insights into the function and evolution of these proteins. PMID- 3297669 TI - Conjugation of organic pollutants in aquatic species. AB - Aquatic organisms can take up organic pollutants from their environment and subsequently excrete the pollutant or its biotransformation products (metabolites). Phase II (conjugation) biotransformation products are almost always less toxic than the unmetabolized organic pollutant. For many organic pollutants, the extent to which conjugates are formed is extremely important in determining the rate of excretion of the pollutant. This is because most conjugates (glycosides, sulfates, amino acid conjugates, mercapturic acids) are organic anions which are readily water-soluble and are rapidly excreted by fish (and probably higher invertebrates) by a combination of glomerular filtration and tubular transport. In this paper, each major conjugation pathway is discussed with respect to what is known about its occurrence in fish and aquatic invertebrates, both from in vivo and in vitro data. Although limited data are available, this paper also considers what is known about how each conjugation reaction affects the toxicity and potential for renal and biliary excretion of organic xenobiotic substrates. PMID- 3297670 TI - The ATP requiring step in assembly of M13 procoat protein into microsomes is related to preservation of transport competence of the precursor protein. AB - M13 procoat protein is processed to transmembrane coat protein by dog pancreas microsomes after completion of synthesis and in the absence of the signal recognition particle (SRP)/docking protein system. ATP is required for fast and efficient processing of procoat protein by microsomes in a reticulocyte lysate. Requirement for ATP is also observed in the absence of ribosomes or docking protein. This indicates the existence of a unique assembly pathway for procoat protein into microsomes which depends on ATP but does not depend on the SRP/docking protein and ribosome/ribosome receptor systems. We suggest that the ATP requirement is linked to a so far unknown component of the reticulocyte lysate, acting on transport competence of precursor proteins. PMID- 3297671 TI - Self-splicing of a group II intron in yeast mitochondria: dependence on 5' exon sequences. AB - It has been previously suggested that self-splicing of group II introns starts with a nucleophilic attack of the 2' OH group from the branchpoint adenosine on the 5' splice junction. To investigate the sequences governing the specificity of this attack, a series of Bal31 nuclease deletion mutants was constructed in which progressively larger amounts of 5' exon have been removed starting from its 5' end. The ability of mutant RNAs to carry out self-splicing in vitro was studied. Involvement of 5' exon sequences in self-splicing activity is indicated by the fact that a mutant in which as many as 18 nucleotides of 5' exon remain is seriously disturbed in splicing, while larger deletions eliminate splicing entirely. Mutants containing a truncated 5' exon form aberrant RNAs. One of these is a 425-nucleotide RNA containing the 5' exon as well as sequences of the 5' part of the intron. Its 3' end maps at position 374 of the 887-nucleotide intron. The other is a less abundant lariat RNA probably originating from the remainder of the intron linked to the 3' exon. We interpret this large dependence of reactivity of the intron on 5' exon and adjoining intron sequences as evidence for base-pairing interactions between the exon and parts of the intron, leading to an RNA folding necessary for splicing. Possible folding models are discussed. PMID- 3297672 TI - Three-dimensional structure of the large ribosomal subunit from Escherichia coli. AB - The three-dimensional structure of the large (50S) ribosomal subunit from Escherichia coli has been determined from electron micrographs of negatively stained specimens. A new method of three-dimensional reconstruction was used which combines many images of individual subunits recorded at a single high tilt angle. A prominent feature of the reconstruction is a large groove on the side of the subunit that interacts with the small ribosomal subunit. This feature is probably of functional significance as it includes the regions where the peptidyl transferase site and the binding locations of the elongation factors have been mapped previously by immunoelectron microscopy. PMID- 3297673 TI - Base sequence-specific interactions of operator DNA fragments with the lambda-cro repressor coupled with changes in their conformations. AB - The mechanism of interaction of the operator DNA with the lambda-cro repressor protein was investigated using proton n.m.r. and photo CIDNP. Three kinds of DNA duplexes, the lambda-OR3 17-mer, phi80-OR2 19-mer and CRP binding site 22-mer, were prepared, and all of their imino proton resonances of the complexes with lambda-cro were assigned to individual base pairs. By monitoring the assigned signals of the DNA fragments and lambda-cro, it was found that in the complex of lambda-cro with lambda-OR3, two subunits of the cro dimer bind to the right and left halves of the OR3, respectively, and the bidentate binding induces a structural distortion in the middle of the 17-mer. lambda-cro itself also undergoes a conformational change including loosening of the dimeric form. In the complex of lambda-cro with phi 80-OR2, which has a 6-bp sequence common to that of lambda-OR3, one subunit of the cro dimer seems to bind specifically to the common part. However, there is only a slight conformational change in the cro dimer. In the mixture of the CRP binding site 22-mer and lambda-cro, soft contact without any conformational change was observed between them. PMID- 3297674 TI - Perforin is present only in normal activated Lyt2+ T lymphocytes and not in L3T4+ cells, but the serine protease granzyme A is made by both subsets. AB - We show that among the subsets of peripheral T lymphocytes (Lyt2+ L3T4- and L3T4+ Lyt2- cells) activated in short-term cultures by stimulation with H-2 incompatible leukocytes 97% of the cytolytic activity and all detectable perforin activity resides in the Lyt2+ cells. But both populations contain approximately equal amounts of a serine protease, granzyme A, the expression of which was previously thought to be restricted to cytolytic T lymphocytes. PMID- 3297675 TI - Complementary DNA for human T-cell cyclophilin. AB - Complementary DNA encoding human cyclophilin, a specific cyclosporin A-binding protein, has been isolated from the leukemic T-cell line Jurkat and sequenced. Comparison of the deduced amino acid sequence with the previously determined sequence of bovine thymus cyclophilin reveals only three differences: an additional amino acid at the carboxy terminus end and two internal changes. RNA transfer blot analysis indicates an mRNA size of approximately 1 kb for human T cell cyclophilin. Phytohaemagglutinin and phorbol myristate acetate induction of T cells treated or not with cyclosporin A affects only marginally the level of cyclophilin mRNA. Southern blot analysis of human genomic DNA digested with different restriction enzymes strongly suggests the existence of a multigene family for cyclophilin. PMID- 3297676 TI - Calcium regulates inositol 1,3,4,5-tetrakisphosphate production in lysed thymocytes and in intact cells stimulated with concanavalin A. AB - Lysed mouse thymocytes release [3H]inositol 1,4,5 trisphosphate from [3H]inositol labelled phosphatidyl inositol 4,5-bisphosphate in response to GTP gamma S, and rapidly phosphorylate [3H]inositol 1,4,5-trisphosphate to [3H]inositol 1,3,4,5 tetrakisphosphate. The rate of phosphorylation is increased approximately 7-fold when the free [Ca2+] in the lysate is increased from 0.1 to 1 microM, the range in which the cytosolic free [Ca2+] increases in intact thymocytes in response to the mitogen concanavalin A. Stimulation of the intact cells with concanavalin A also results in a rapid and sustained increase in the amount of inositol 1,3,4,5 tetrakisphosphate, and a much smaller transient increase in 1,4,5-trisphosphate. Lowering [Ca2+] in the medium from 0.4 mM to 0.1 microM before addition of concanavalin A reduces accumulation of inositol 1,3,4,5-tetrakisphosphate by at least 3-fold whereas the increase in inositol 1,4,5-trisphosphate is sustained rather than transient. The data imply that in normal medium the activity of the inositol 1,4,5-trisphosphate kinase increases substantially in response to the rise in cytosolic free [Ca2+] generated by concanavalin A, accounting for both the transient accumulation of inositol 1,4,5-trisphosphate and the sustained high levels of inositol 1,3,4,5-tetrakisphosphate. Inositol 1,3,4,5-tetrakisphosphate is a strong candidate for the second messenger for Ca2+ entry across the plasma membrane. This would imply that the inositol polyphosphates regulate both Ca2+ entry and intracellular Ca2+ release, with feedback control of the inositol polyphosphate levels by Ca2+. PMID- 3297678 TI - Hormonal response to captopril pre-treatment during sodium nitroprusside-induced hypotension in man. AB - To assess the hormonal response to captopril pre-treatment during sodium nitroprusside (SNP) -induced hypotension, 12 patients were studied during a spinal surgical procedure. Haemodynamic data, plasma-renin activity, aldosterone, adrenaline and noradrenaline levels were measured. Patients were randomly allocated to two groups: Group I, control patients; Group II, 3 mg kg-1 captopril pre-treated patients. SNP requirement for the same level (mean arterial pressure (MAP) = 55 mmHg) and duration of hypotension (88.5 +/- 28.7 vs. 95.2 +/- 22.5 min) was significantly lower in Group II than in Group I (16.5 +/- 14.2 mg vs. 39.3 +/- 16.7 mg; P less than 0.05) and a lower SNP infusion rate was required to induce and to maintain hypotension. In Group II patients, MAP remained significantly lower than the control and Group I values for 30 min after SNP withdrawal. Cardiac index (CI) remained stable in both groups. Heart rate was not modified in Group II during hypotension. Plasma-renin activity rose more dramatically in Group II patients than in Group I both during hypotension (13.9 +/- 7.5 vs. 2.8 +/- 0.9 ng ml-1 h-1; P less than 0.05) and after hypotension (23.4 +/- 15.4 vs. 2.2 +/- 0.8 ng ml-1 h-1; P less than 0.05). Plasma catecholamine levels increased in both groups during hypotension and remained raised in captopril patients after SNP withdrawal. It can be concluded that recovery from hypotension may be delayed when using captopril and that sympathoadrenal activity induced by hypotension is not substantially altered by captopril pre-treatment, suggesting that sympathetic blockade might not be the mechanism by which captopril reduces SNP requirement during controlled hypotension for surgical procedure in man. PMID- 3297677 TI - Regulated expression of the Ren-2 gene in transgenic mice derived from parental strains carrying only the Ren-1 gene. AB - The Ren-2 gene encoding the mouse submaxillary gland (SMG) renin was microinjected into the pronuclei of fertilized eggs from mice carrying only the Ren-1 gene. In addition to the whole transcription unit, the injected DNA contained 2.5 and 3 kb of upstream and downstream flanking sequences, respectively. Three independent transgenic mice lines were obtained; two of them had integrated one copy of the Ren-2 gene, the last one had integrated five and eleven copies at two independent sites. Independently of the number of Ren-2 copies integrated, the pattern of Ren-2 gene expression in all the transgenic mice was identical to that observed in wild-type animals in which Ren-1 and Ren-2 are closely linked on chromosome 1. In particular, the exogenous Ren-2 gene was only transcribed in the kidney and in the SMG. In the kidney, Ren-1 and Ren-2 mRNAs were present at a comparable level, whereas in the SMG Ren-2 mRNA was at least 100-fold more abundant than Ren-1 mRNA. Moreover, Ren-2 expression in the SMG was positively regulated by androgens. Only one difference between transgenic mice and wild-type mice carrying the Ren-2 gene has been observed: the basal level of Ren-2 transcription in the SMG of transgenic females was lower than in two-gene strain females. Androgen treatment of transgenic females induced SMG renin mRNA to a level identical to that of transgenic males. This suggests that the basal level of SMG renin mRNA is dependent upon cis-acting elements which are not present in the microinjected fragment. PMID- 3297679 TI - Fentanyl and bupivacaine mixture for extradural blockade in orthopaedic surgery: effects on haemodynamic responses and pain related to the use of thigh tourniquet. AB - Analgesic and haemodynamic changes due to tourniquet application were investigated in a prospective double-blind study on orthopaedic patients submitted to extradural lumbar blockade with a bupivacaine and fentanyl mixture. The study was carried out in 161 healthy patients undergoing limb surgery with a thigh tourniquet. Patients were randomly assigned to two groups: each group received treatment with bupivacaine 0.5% containing 1:200,000 adrenaline. Normal saline (B:F o group) or 200 micrograms fentanyl (B:F 200 group) was added to this solution. An immediate increase in systolic and diastolic blood pressure (SBP and DBP) was provoked by tourniquet application in all patients, whilst heart rate (HR) showed no modification and the rate-pressure product (RPP) was hardly influenced in the B:F 200 group. A dramatic reduction in intra-operative supplemental analgesic needs was observed in the B:F 200 group. This group of patients also complained less of tourniquet pain than their counterparts, for the first 30 min of application. Our study underlines the value of fentanyl addition to bupivacaine in extradural blockade in orthopaedic surgery. PMID- 3297680 TI - Comparison of enzyme immunoassays and an immunofluorescence test for detection of antibody to human immunodeficiency virus in African sera. AB - A total of 152 sera from African subjects were tested for presence of antibody to human immunodeficiency virus using four enzyme immunoassays (EIA) marketed by Abbott Diagnostics, Organon Teknika, Wellcome and Diagnostics Pasteur respectively, an indirect immunofluorescence assay (IFA) and an immunoblot assay (IBA) as reference test. The sensitivity (95% confidence limits, CL) of the EIAs and the IFA ranged between 80.9% and 99.1%. The specificity of the Abbott EIA was lower (95% CL: 38.1-72%) than that of the other assays (95% CL: 83.5-100%). The use of an IFA or the Wellcome competitive EIA as confirmatory test on initially EIA positive sera yielded a specificity of 85.5-100% (95% CL) compared with the IBA. The costs of screening by an EIA, followed by confirmatory testing of reactive sera with IFA or the Wellcome EIA and IBA on discrepant test results was similar for all combinations with the exception of initial screening with the Abbott EIA which was more expensive. Using a limited number of sera from African subjects no one test system yielded a significantly superior degree of specificity or sensitivity. PMID- 3297682 TI - Ability of enzyme-linked immunosorbent assays to detect early immunoglobulin G antibodies to Toxoplasma gondii. AB - Two ELISA procedures, one using sonicated antigen coated with carbonate buffer and the other formalin fixed trophozoites with dry coating, differ in their ability to detect early antibodies in toxoplasmosis. In order to identify factors responsible for this difference, seven ELISA systems differing from each other in antigen used and/or coating procedure were compared. Both fixation of the trophozoites with formalin and air-drying of the antigen in the microtiterplate were important factors determining the ability of the assay to detect IgG antibodies in the early stage of infection. Differences in the results of the two ELISA procedures can be used to distinguish between the acute and chronic stages of infection. PMID- 3297681 TI - Detection of antibodies to Candida albicans germ tube in the diagnosis of systemic candidiasis. AB - Sera from 109 subjects were tested for the presence of anti-Candida albicans antibodies by an indirect immunofluorescence assay. Aliquots of the sera were adsorbed with heat-killed blastospores to remove the antibodies against the surface of the yeast-phase cell wall and tested for anti-germ tube cell wall antibodies. Unadsorbed sera stained the entire cell wall of yeast and germ-tubes. Immunoglobulin G (IgG) antibodies were found in all patients with systemic candidiasis and in 81.2% of patients with Candida albicans isolated from skin and mucous membranes. IgA and IgG were found in 67.4 and 57.1%, respectively, of controls without evidence of candidiasis. After the adsorption only sera from patients with systemic candidiasis showed antibodies, predominantly IgA, against germ tube cell wall. Adsorption of the sera thus increased the specificity, efficiency, and positive and negative predictive values of the test. The test achieved the highest sensitivity in adsorbed sera for the combination of IgA and IgG. PMID- 3297683 TI - Rapid commercial test for direct detection of group A streptococci in throat swabs. AB - The Hybritech Strep A ICON was used for direct testing of 1016 throat specimens for group A beta-hemolytic streptococci. Both the test and culture were negative in 829 specimens (81.6%); both were positive in 164 cases (16.1%); the test was positive and culture negative in 9 cases (0.9%); and the test negative and culture positive in 14 cases (1.4%). PMID- 3297684 TI - Amikacin-containing regimens for treatment of nocardiosis in immunocompromised patients. AB - Eight patients with disseminated infections due to multi-resistant Nocardia asteroides were administered amikacin in combination with other effective antibiotics for a duration of 2 to 12 months. Seven patients were considered cured at follow-up after two years. PMID- 3297686 TI - Studies on the structure and conformation of brush border myosin using monoclonal antibodies. AB - We have produced and characterised five monoclonal antibodies against myosin isolated from chicken intestinal epithelial brush border cells. The binding sites of the antibodies on the rod portion of brush border myosin were localised using rotary shadowing/electron microscopy of myosin-antibody complexes. Two antibodies were shown to bind to the tip of the myosin tail, two antibodies to sites about two thirds down the length of the rod, and one antibody about one third down the length of the rod. Brush border myosin was digested with papain, trypsin and alpha-chymotrypsin, and they myosin fragments obtained were analysed by western blots with the monoclonal antibodies and polyclonal antiserum, and by gel overlay with 125I-labelled light chains. Using this approach we were able to identify and map the protease cleavage sites and thus characterise the proteolytic substructure of brush border myosin. Solid-phase assays, western blots and immunofluorescence were used to study the cross-reactivity of these monoclonal antibodies against a variety of myosins from different species and cell types, to assess the immunological relatedness between brush border myosin and homologous molecules present in different tissues and species. Finally, we used a competitive solid-phase assay to measure the 'relative affinities' of the antibodies towards the three possible conformational states of brush border myosin, i.e. filament, extended monomer and folded monomer. PMID- 3297685 TI - Significance of antibodies to Mycoplasma genitalium in salpingitis. AB - Indirect haemagglutination and indirect immunofluorescence tests of sera from 95 patients with acute salpingitis failed to confirm the report of other investigators regarding serological evidence implicating Mycoplasma genitalium in pelvic inflammatory disease. The pathological role of Mycoplasma genitalium in salpingitis, non-gonococcal urethritis, and other diseases has not been proven. PMID- 3297688 TI - The microheterogeneity of the crystallizable yeast cytoplasmic aspartyl-tRNA synthetase. AB - Yeast aspartyl-tRNA synthetase is a dimeric enzyme (alpha 2, Mr 125,000) which can be crystallized either alone or complexed with tRNAAsp. When analyzed by electrophoretic methods, the pure enzyme presents structural heterogeneities even when recovered from crystals. Up to three enzyme populations could be identified by polyacrylamide gel electrophoresis and more than ten by isoelectric focusing. They have similar molecular masses and mainly differ in their charge. All are fully active. This microheterogeneity is also revealed by ion-exchange chromatography and chromatofocusing. Several levels of heterogeneity have been defined. A first type, which is reversible, is linked to redox effects and/or to conformational states of the protein. A second one, revealed by immunological methods, is generated by partial and differential proteolysis occurring during enzyme purification from yeast cells harvested in growth phase. As demonstrated by end-group analysis, the fragmentation concerns exclusively the N-terminal end of the enzyme. The main cleavage points are Gln-19, Val-20 and Gly-26. Six minor cuts are observed between positions 14 and 33. The present data are discussed in the perspective of the crystallographic studies on aspartyl-tRNA synthetase. PMID- 3297687 TI - The peptidyltransferase centre of the Escherichia coli ribosome. The histidine of protein L16 affects the reconstitution and control of the active centre but is not essential for release-factor-mediated peptidyl-tRNA hydrolysis and peptide bond formation. AB - Modification of the Escherichia coli 50S ribosomal subunit with histidine specific diethyl pyrocarbonate affects peptide bond formation and release-factor dependent peptidyl-tRNA hydrolysis. Unmodified L16 can restore activity to a split protein fraction from the altered subunit but other proteins of the core also contain histidine residues important for the activity of the peptidyltransferase centre. When isolated and purified by centrifugation, particles reconstituted with unmodified proteins and modified L16 do not retain the altered L16. The modified protein does mediate the partial restoration of peptide bond formation and release-factor-2 activities to these particles. It must be exerting its effect during the assembly of the peptidyltransferase centre in the reconstituted particle. A particle could be reconstituted which lacks L16 and has significant activity in peptide bond formation and peptidyl-tRNA hydrolysis. L16 stimulates these activities. A tighter ribosomal binding of the release factor 2, dependent upon the absence of protein L11, can in part compensate for the loss of activity of the peptidyltransferase centre when it is assembled with either modified L16 or in the absence of L16. The protein and its histidine residue seem important, therefore, for the peptidyltransferase centre to be formed in the correct conformation but not essential for activity once the centre is assembled. PMID- 3297689 TI - Immunological evidence for the existence of H1-like histone in yeast. AB - In view of the controversies about the existence of histone H1 in yeast we have reinvestigated the problem by studying yeast proteins extracted with perchloric acid and salt. Perchloric-acid-extracted proteins from whole cells contain only two fractions which comigrate with 'authentic' yeast high-mobility-group proteins (HMG) in both SDS and acid urea gels. These extracts show a considerable cross reaction with anti-(calf thymus HMG) antiserum and do not react with antiserum to mouse liver H1. The isolation of 'authentic' yeast HMG by the standard salt/trichloroacetic acid procedure gives two types of preparations containing different numbers of protein bands. The poorer preparation reacts only with the anti-HMG antiserum whereas the richer preparation also gives considerable cross reaction with the anti-H1 antiserum. Immunoblotting analysis performed on the salt-extracted proteins reveals the presence of three protein bands giving positive immunoreaction with the anti-H1 antiserum. The immunoreactive bands have electrophoretic mobilities close to that of the marker calf thymus H1 and similar to the mobilities of the presumptive yeast H1 fractions found by other authors. PMID- 3297690 TI - Eucaryotic primase. AB - Eucaryotic primase, an enzyme that initiates de novo DNA replication, is tightly associated with polymerase alpha or yeast DNA polymerase I. It is probably a heterodimer of 5.6 +/- 0.1 S. The enzyme synthesizes oligoribonucleotides of about eight residues which are always initiated with a purine. In vitro the polymerase-primase complex initiates synthesis and pauses at preferred sites on natural single-stranded templates. The relative concentrations of ATP and GTP present in the reaction medium modulate the frequency of site recognition. Primase is strongly ATP-dependent in the presence of single-stranded DNA and of poly(dT). It also synthesizes oligo(rG) in the presence of poly(dC) very efficiently. PMID- 3297691 TI - Abortive and productive elongation catalysed by purified spinach chloroplast RNA polymerase. AB - Experimental conditions are reported under which purified spinach chloroplast RNA polymerase catalyses the abortive elongation reaction on a synthetic poly[d(A-T)] template. The reaction only occurs under very stringent conditions and absolutely requires Mn2+ as the metal activator. No reaction can be detected in the presence of Mg2+. Furthermore, the rate of abortive elongation with the chloroplast enzyme is extremely sensitive to the presence of added salts, such as KCl or (NH4)2SO4, in the reaction assays. In the combined presence of Mn2+ and Mg2+, a marked inhibition of abortive elongation is associated with an activation of productive elongation and an increased length of RNA chains. Thus, whereas Mn2+ is more active than Mg2+ for phosphodiester bond formation, it appears that Mg2+ favors the stabilization of the ternary transcription complexes. These results are compared with those obtained under similar conditions for wheat germ RNA polymerase II and Escherichia coli RNA polymerase. PMID- 3297692 TI - Polypeptides belonging to each of the three major chlorophyll a + b protein complexes are present in a chlorophyll-b-less barley mutant. AB - Polypeptides of the three major chlorophyll a + b protein complexes were detected in a chlorophyll-b-less barley mutant (chlorina f2) using immunological techniques. Antibodies to CP Ia, a photosystem I complex containing both the reaction center (CP I) and the chlorophyll a + b antenna (LHCI), detected substantial amounts of LHCI polypeptides in mutant thylakoids. Some polypeptides of the two photosystem-II-associated chlorophyll a + b complexes, CP 29 and LHCII, were also detected using antibodies raised against these complexes. The CP 29 apoprotein and the minor 25-kDa polypeptide of LHCII were present in amounts that could be seen by Coomassie blue staining. In contrast, the two major polypeptides of LHCII were greatly diminished in amount, and one of them may be completely absent. These data suggest that the absence of chlorophyll b may have differing effects on the synthesis, processing or turnover of the various chlorophyll a + b binding polypeptides. They also show that these polypeptides can be inserted into thylakoids in the absence of Chl b, and that significant amounts of some of them are accumulated in the mutant thylakoids. PMID- 3297694 TI - Amino acid sequence of the L-lactate dehydrogenase of Bacillus caldotenax deduced from the nucleotide sequence of the cloned gene. AB - The Bacillus caldotenax L-lactate dehydrogenase gene (lct) has been cloned into Escherichia coli, using the Bacillus stearothermophilus lct gene as a hybridisation probe, and its complete nucleotide sequence determined. The lct structural gene consists of an open reading frame of 951 base pairs commencing with an ATG start codon and followed by a TAA stop codon. Upstream of the gene are putative transcriptional promoter -35 and -10 regions; a ribosome binding site with a predicted delta G of -66.9 kJ/mol is also present six base pairs upstream of the ATG start codon. The B. caldotenax lct gene is highly homologous to the B. stearothermophilus lct gene displaying a DNA sequence homology of 89.7%. Examination of the DNA sequence 3' of the lct gene revealed the presence of two further open reading frames. This suggests that the lct gene may be the first gene of an operon. The deduced amino acid sequence of the L-lactate dehydrogenase (LDH) from B. caldotenax predicted a protein of 317 amino acid residues; comparison with the B. stearothermophilus enzyme revealed only 30 amino acid differences between the two enzymes; thus the enzymes are 90.4% homologous. These amino acid differences must account for the different thermostabilities of the two enzymes. The B. caldotenax lct gene was efficiently expressed in E. coli and the original lct-containing plasmid construct isolated (pKD1) induced the synthesis of LDH at a level of 4.5% of the E. coli soluble cell protein whilst a SmaI subfragment of this clone, (pKD2) produced LDH at a level of 6.9% of the E. coli soluble cell protein. LDH isolated from E. coli cells had the same thermal stability properties as LDH isolated from B. caldotenax cells. PMID- 3297693 TI - Purification and characterization of human interleukin-1 alpha produced in Escherichia coli. AB - The production of human interleukin-1 alpha (IL-1 alpha) in Escherichia coli is described together with a method for its purification. The isolated protein was shown to be pure and physically homogeneous. The in vitro biological activity of IL-1 alpha was tested with the mononuclear-cell factor and the lymphocyte activating factor assays. The specific activity determined with both assays was about 3 X 10(7) units mg-1 and is similar to that observed with recombinant human IL-1 beta. The purified protein was resolved by chromatofocusing into two species of isoelectric points 5.45 and 5.20 (75% and 25%, respectively, of the total protein). Both species had similar chemical properties and biological activities to the unfractionated protein. The charge difference between the species was attributed to the deamidation of a single Asn or Gln residue. PMID- 3297695 TI - Reversible activation of hydrogenase from Escherichia coli. AB - Hydrogenase from Escherichia coli exhibited low activity when assayed for hydrogen:methyl viologen reductase activity and no activity when assayed for hydrogen-uptake activity with acceptors of high redox potential (dichloroindophenol, methylene blue). Nor did the enzyme as isolated catalyse proton-tritium exchange activity. Incubation under hydrogen resulted in an increase in hydrogen-uptake activity with methyl viologen and the appearance of hydrogen-uptake activity with dichloroindophenol and methylene blue. Following such treatment, the enzyme also readily catalysed isotope exchange. This process is interpreted as the conversion of the hydrogenase from an inactive 'unready' state to an 'active' state. Oxidation of active hydrogenase with dichloroindophenol caused conversion to a state resembling that of the enzyme as isolated but capable of more rapid activation under reducing conditions. This form is termed the 'ready' state. Such interconversions have been reported for hydrogenases from Desulfovibrio gigas and D. desulfuricans, and the possibility that they constitute a regulatory mechanism suggested. PMID- 3297696 TI - Chemical synthesis, molecular cloning and expression of gene coding for a Bowman Birk-type proteinase inhibitor. AB - A gene coding for a Bowman-Birk-type proteinase inhibitor was synthesized chemically, cloned and expressed in Escherichia coli as a fusion protein with a beta-galactosidase fragment. The corresponding mutant inhibitor, carrying a P1 = Arg16 instead of Lys and an Ile27 instead of Met was obtained after cyanogen bromide cleavage, refolding and affinity chromatography on trypsin-Sepharose. Dissociation constants of complexes with trypsin of this mutant and wild-type Bowman-Birk inhibitor are identical within experimental error. This is explained by differential patterns of hydrogen bonds between side-chains of Arg or Lys in proteinase inhibitors and the primary specificity pocket of trypsin. PMID- 3297697 TI - Photochemical electron transfer reactions in the acceptor complex of reaction centers of Rhodopseudomonas spheroides treated with sodium dodecyl sulfate. AB - We have compared some photochemical properties of the reaction-center complex of Rhodopseudomonas spheroides (wild-type) treated with various amounts of either sodium dodecyl sulfate (SDS) or dodecyl dimethylamine N-oxide. In the presence of the latter, the native structure and activity of the reaction center are preserved even at high concentrations of detergent. In contrast, SDS denatures the protein. It does this by a cooperative process, as shown by the sigmoidal relationship between primary photochemical activity and SDS concentration. SDS binds to the reaction center at up to about 6 g SDS/g protein. The most notable modifications brought about by low SDS concentrations are: a slowing down of rereduction of P+ by Q-B from 1 s-1 to 0.25 s-1 and, to a lesser extent, of P+ by Q-A; the reoxidation of Q-A and Q-B by N,N,N',N'-tetramethyl-1,4-phenylenediamine is accelerated as an exponential function of SDS concentration. In this case Q-A become more accessible to external acceptors but not Q-B. It is thought that these changes are mainly due to progressive binding of SDS resulting in the unfolding of the protein, probably accompanied by the loss of the metal. Herbicides partly protect the reaction center against SDS denaturation, but their efficiency to block electron transfer between QA and QB is greatly reduced in the altered reaction centers present in the transition region of the denaturation curve. It is concluded that in the early region of the SDS denaturation curve, no dissociation of the reaction center in subunits occurs. In the transition region, it appears that the reaction center reaches the critical state in which mainly dissociation of polypeptide H from the complex of chains L and M and loss of QA take place. PMID- 3297698 TI - On the interaction of bovine seminal RNase with actin in vitro. AB - Ribonuclease from bovine seminal plasma (RNase BS) interacts with skeletal muscle actin in the following way: it binds to actin with an apparent binding constant of 9.2 X 10(4) M-1 in 0.1 M KCl, induces the polymerization of actin below the critical concentration in depolymerization buffer, accelerates the salt-induced polymerization of actin even at a molar ratio of RNase to actin lower than 1/100, and bundles F-actin filaments. In the bundles the molar ratio of RNase to actin is about 0.66. Actin inhibits the enzymatic activity of RNase BS. RNase A from bovine pancreas, which is structurally almost identical to the subunits of RNase BS as well as a monomeric form of RNase BS, do not cross-link actin filaments and have a much smaller effect on the polymerization of actin. We conclude that the dimeric structure of the RNase BS, which consists of two identical subunits cross linked by interchain disulfide bridges, is probably responsible for the bundling activity and the accelerating effect on the polymerization of actin. PMID- 3297699 TI - Ultrasonographic findings in thymic lymphoma in children. AB - The sonographic manifestations of thymic involvement by T lymphoblastic non Hodgkin's lymphoma/leukaemia in 6 children are presented. The criteria which may help in its differentiation from a normal thymus gland are reviewed. Hypoechoic and non-homogeneous large masses are the most typical presentation of thymic infiltration. Fixity of tumour and compression of surrounding structures are the most important associated signs with pleural and pericardial effusions. In children, ultrasonography of the mediastinum can play a role by establishing the nature of anterior masses. PMID- 3297700 TI - The sonographic evaluation of normal thymus in infants and children. AB - Sonography has been used to evaluate 50 "asymptomatic" infants (aged from birth up to two years) with typical appearing thymus on chest X-ray. The ultrasonic features of the normal gland are described. Moreover, the contribution of ultrasound is illustrated by five cases of partially ectopic thymus and by one case of prominent gland in a teenager. Ultrasound may help in differentiating normal gland from mediastinal masses by defining echogenicity, location and extension. PMID- 3297701 TI - Hepato-duodenal fistula. AB - A description of a rare case of hepato-duodenal fistula was demonstrated on barium meal examination and subsequently surgically proved. PMID- 3297702 TI - Acalculous cholecystitis as a complication of hepatitis. PMID- 3297703 TI - Kidney puncture revisited. PMID- 3297704 TI - Formation and maintenance of viroplasmic centers in Tipula iridescent virus infected mosquito cells with deranged cytoskeletons. AB - We have examined the role of cytoskeletal elements with respect to the formation and maintenance of viroplasmic centers (VCs) in Tipula iridescent virus (TIV) infected mosquito Aedes albopictus (C6/36) cells. Filamentous systems consisting of microtubules and microfilaments were detected by immunofluorescence microscopy. Inoculation of cells with TIV resulted in an alteration of microtubule and microfilament organization whether or not VCs developed. The formation of short arrays of microtubules induced by taxol or the depolymerization of microtubules by colchicine, as observed by immunofluorescence microscopy, had no apparent effect upon the development of VCs as detected by Hoechst staining and electron microscopy. The dissolution of the actin-containing filamentous system by cytochalasin B also had no effect upon development. We conclude from these results that microtubules and microfilaments are not involved in the formation or maintenance of VCs in TIV-infected A. albopictus (C6/36) cells. PMID- 3297705 TI - Direct and mediated Escherichia coli lipopolysaccharide action in primary hepatocyte cultures. AB - The biphasic behaviour observed in endotoxin-induced shock attributed to a direct interaction of bacterial lipopolysaccharides with the cell membrane and an indirect activation of multiple homeostatic regulatory mechanisms, cannot be completely elucidated with in vivo studies. In primary cultures of adult rat hepatocytes, lipopolysaccharide from Escherichia coli 0111:B4 affects the cytochrome P450 levels directly; however, albumin and aspartate aminotransferase secretion are induced by some mediators present in the sera of animals in acute phase shock. PMID- 3297706 TI - Autoantibodies to nuclear lamin B in a patient with thrombopenia. AB - We report the characterization of novel nucleus specific autoantibodies in the serum of a patient with systemic lupus erythematosus. Immunofluorescent staining of cycling cells and absorption experiments localized the antigen to the nuclear envelope. Two-dimensional gel electrophoretic analysis of immunoprecipitated nuclear proteins show the antigen to be an acidic polypeptide (IP approximately 5.4) of 68 kDa molecular mass. It has been identified as lamin B, one of the three major nuclear envelope polypeptides of mammalian cells. Antibodies shown to be polyclonal immunoglobulin Gs, were directed against determinant(s) of the protein that have apparently been conserved during evolution. They do not appear to be related to other autoantibodies present in the serum (anti-DNA and anti platelet). The nuclear specificity shown by these antibodies further demonstrates the antigenicity of proteins related to intermediate filament proteins in patients with autoimmune disorders. PMID- 3297707 TI - Bacterial meningitis: is there a "best" antimicrobial therapy? AB - The introduction of several cephalosporins into pediatric practice has provided the physician with a number of choices in the treatment of neonatal and childhood meningitis. Adequate studies are available to indicate that these new drugs are as effective as traditional treatments in terms of survival and major neurologic sequelae but it is not known whether the results are worse or better as far as the incidence of more subtle neurologic changes is concerned. The advantages of the cephalosporins in treatment of childhood meningitis are that they permit single drug therapy, the risks of drug toxicity are reduced, and the problems of penicillin-tolerant pneumococci and ampicillin/chloramphenicol-resistant H. influenzae are avoided. When used in the treatment of neonatal disease, the cephalosporins have the advantage of lower toxicity than the aminoglycosides, generally making blood drug level determinations unnecessary, and are effective against strains of bacteria that have become resistant to the latter drugs. PMID- 3297710 TI - Correlation between estrophilin immunoreactivity and androgen receptor-binding activity in meningiomas. AB - Estrogen receptor (ER) analysis was performed with an enzyme immunoassay using monoclonal antibodies against human ER protein (estrophilin) in 70 meningiomas. [3H]methyltrienolone, a synthetic androgen, was used for concurrent determination of the androgen receptor (AR)-binding activity. Low levels of ER immunoreactivity were detected in 36 cases (51%), whereas moderately high AR-binding activity was demonstrated in 33 (47%) tumors. A positive correlation between ER immunoreactivity and AR-binding activity is indicative for an estrogen regulation of AR via the ER system. The presence of gonadal steroid receptors in a large proportion of meningiomas and the tendency for a dependence of receptor concentrations on the histological subtype could have implications for tumor therapy. PMID- 3297711 TI - Cerebrospinal fluid tumor markers for the diagnosis and management of leptomeningeal metastases. PMID- 3297709 TI - "Peripheral" tetrahydrobiopterin deficiency with hyperphenylalaninaemia due to incomplete 6-pyruvoyl tetrahydropterin synthase deficiency or heterozygosity. AB - Four patients in three families with "peripheral" tetrahydrobiopterin deficiency were investigated. They were characterized biochemically by a tetrahydrobiopterin responsive hyperphenylalaninaemia, a high neopterin/biopterin ratio in urine and plasma, and normal or elevated concentrations of biopterin, homovanillic acid, and 5-hydroxyindole acetic acid in cerebrospinal fluid. From measurements of the activity of erythrocyte 6-pyruvoyl tetrahydropterin synthase (PTS, formerly called phosphate-eliminating enzyme) and phenylalanine loading tests in the patients and their parents, one patient was demonstrated to be heterozygous for PTS deficiency. The others were obviously genetic compounds (allelism) with incomplete PTS deficiency. Three of the children developed normally, two of them under treatment with tetrahydrobiopterin. In the latter two patients, significantly lower concentrations of biopterin, homovanillic acid, and 5 hydroxyindole acetic acid in cerebrospinal fluid were noted at age 7 months (when treatment was interrupted) than those observed at 3 and 5 weeks, respectively. The infant who is heterozygous for PTS deficiency was born small for gestational age and showed a moderately delayed psychomotor development. It is concluded that "peripheral" tetrahydrobiopterin deficiency is caused by a partial PTS deficiency with sufficient activity to cover the tetrahydrobiopterin requirement of tyrosine 3-hydroxylase and trytophan 5-hydroxylase in brain but not enough for phenylalanine 4-hydroxylase in liver. For therapy, tetrahydrobiopterin, 2-5 mg/kg in a single oral dose per day, is recommended to keep plasma phenylalanine normal. A careful observation of the mental development is indicated. PMID- 3297708 TI - Non-ketotic hyperglycinaemia: clinical and biochemical aspects. AB - Non-ketotic hyperglycinaemia is an autosomal recessive disorder of glycine metabolism characterized by elevated concentrations of glycine in plasma, urine and cerebrospinal fluid. The fundamental defect was found to lie in the glycine cleavage system. It is of significance that the major pathway for the catabolism of glycine was elucidated through the studies of hyperglycinaemia. The present knowledge about non-ketotic hyperglycinaemia is described in clinical and biochemical aspects. PMID- 3297713 TI - Expression of FMC7 antigen and tartrate-resistant acid phosphatase isoenzyme in cases of B-lymphoproliferative diseases. AB - A panel of different B-cell malignancies representing various stages of B-cell differentiation were analyzed for the expression of an antigen labeled by the monoclonal antibody FMC7 and of tartrate-resistant acid phosphatase (TracP) activity. The FMC7 antigen and TracP were not found on early immature pre B-cell proliferations, appeared at early and intermediate B-cell stages, reached their peak of expression in terms of both incidence of positivity and staining intensity at the late B cell stage (as represented by hairy cell leukemia) and were lost at the B-cell/plasma cell transition. Although detected at similar stages of B-cell differentiation, FMC7 and TracP appear to be independently expressed and were not related to a particular Ig class. The simultaneous detection of FMC7 and TracP represents a distinguishing parameter for the identification of hairy cell leukemia. PMID- 3297712 TI - Chemically unrelated tumor promoters induce identical morphological changes in cultured rat oral epithelium. AB - By use of phase contrast microscopy, transmission and scanning electron microscopy the cytomorphological effects of different known tumor promoters (TPA, teleocidin, mezerein and anthralin) were studied and compared to the cytomorphological effects of a variety of non- or weak promoting irritants (ethylphenylpropiolate (EPP), phorbol, acetone, ethanol and dimethyl sulfoxide (DMSO]. The studies were conducted in cultures of stratifying rat tongue epithelial cells. It was demonstrated that the tumor promoters induce characteristic cytomorphological alterations, the most striking changes being elongation of the cells and formation of long cytoplasmic extensions together with induction of so-called "dark cells". The non-promoting irritants exerted well-known cytotoxic reactions like cell rounding and cell sloughing. It is suggested that the characteristic tumor promotor induced cytomorphological effects partly reflects a block of the intercellular communication and thus should be paid more attention as an important characteristic event among the pleiotropic effects exerted by tumor promoters. PMID- 3297715 TI - Thyroid function in benign and malignant breast disease. PMID- 3297714 TI - Priming reduces the bone marrow toxicity of carboplatin. AB - A dose of 170 mg/kg of carboplatin is lethal in mice, death occurring through bone marrow failure. This lethality can be avoided by giving the animals 200 mg/kg cyclophosphamide 1 or 2 days before this dose of carboplatin. The improved normal tissue tolerance cannot be explained by altered pharmacokinetics of carboplatin. Increased survival appears to be associated with a more rapid regeneration of the haemopoietic stem cells. Tumour tissue is not protected in the same way and thus a therapeutic gain can be achieved using this protocol. PMID- 3297716 TI - Intraperitoneal chemotherapy: belly-bath or pain-in-the-side? PMID- 3297717 TI - Bone marrow transplantation for malignant lymphoma. PMID- 3297718 TI - Nitrosourea derivatives-induced pulmonary toxicity in patients treated for malignant brain tumors. Early subclinical detection and its prevention. AB - Nitrosourea derivatives, such as BCNU and CCNU, are considered useful chemotherapeutic agents in malignant brain tumors combined therapy. Pulmonary toxicity is one of the major side effects demonstrated both in experimental animal models and in human autoptic findings. Pulmonary fibrosis is the end point of progressive functional disorder of respiratory mechanism and alveolo-capillary gas exchanges. Authors present the results of a randomized, double-blind trial of 40 patients previously treated with surgery and radiotherapy and who subsequently underwent BCNU therapy for primary intracranial glioma. Patients underwent functional respiratory examinations at each chemotherapy course interval. Twenty patients received ambroxol (120 mg/day) for 40 days after chemotherapy course. Control patients received placebo with the same schedule and showed a significant reduction of pulmonary functional parameters (DLCO, MMEF, MEF 25%), whereas in the treated group there is no significant variation of these functional parameters. The mechanism of ambroxol is commonly related to the surfactant synthesis enhancement and to the action on bronchiolar pathways. PMID- 3297719 TI - EORTC trial non-Hodgkin lymphomas. AB - Results of an EORTC trial (20751) in non-Hodgkin lymphomas are presented. Patients were treated in the same way independent of the histological type. There were 468 patients in the study of whom 124 patients were in stage I (85% 5 year survival), 57 in stage II (55%), 121 in stage III (55%) and 166 in stage IV (45%). Using the Kiel classification the low grade lymphomas were subdivided into two categories: those with a follicular (80% 5 year survival) and with a diffuse cell pattern (50% 5 year survival) with an intermediate prognosis compared with the high grade lymphomas (35% 5 year survival). Treatment was stratified according to stage. In stage I regional radiotherapy was given followed by randomization for maintenance chemotherapy with Vincristine, Cyclophosphamide and Prednisone. No influence in survival was seen (85% at 5 years), although disease free survival was better in the maintenance chemotherapy group (75% vs 55% at 5 years). In stage II regional radiotherapy was followed, after randomization, by transdiaphragmatic irradiation, all patients received maintenance chemotherapy. The group was too small to draw conclusions about the effect of this treatment. Primary radiotherapy in stage II disease with diffuse histology gave bad results. Patients in stage III and IV were treated with 8 courses of chemotherapy with Adriamycin, VM26, Cyclophosphamide and Prednisone, given in two different time schedules. Iceberg radiation was then given to areas with initially large or slowly responding disease. All patients had maintenance chemotherapy. No difference was found for the 2 chemotherapy schedules in remission rate, disease free interval and survival. In stage III and IV patients with a follicular lymphoma have a longer relapse free interval and total survival (39% and 68% at 5 years) compared with those with a lymphoma diffuse histology (19 and 30% at 5 years). Patients with stage IV disease due to bone marrow involvement only had a better prognosis compared with stage IV disease for other reasons. PMID- 3297720 TI - Ultrasound and ultrasonically guided biopsy in hepatic lymphoma. AB - From August 1982 to December 1985, 125 patients with lymphoma in different periods of the disease, underwent abdominal ultrasound (US) examination. The value of US in detecting lymphomatous involvement of the liver was determined in 75 histologically proved patients, to improve the US accuracy rate we combined it with ultrasonically guided fine needle aspiration biopsy (UGFNAB), whenever a focal lesion was disclosed in the liver. US had a sensitivity of 61.5%, a specificity of 93.5% with an overall accuracy of 88%. No specific pattern of involvement was revealed by US. The UGFNAB allowing a cytological diagnosis avoided false positive results and improved overall accuracy from 88 to 93%. We therefore believe that US should be regarded as the first imaging method to detect hepatic involvement by lymphoma and when a focal lesion is disclosed the UGFNAB should be the first invasive procedure to obtain a definite cytological diagnosis. PMID- 3297721 TI - Muscle glycogen and exercise endurance: a twenty-year perspective. AB - The scientific revelations of 1967 regarding the relationship between glycogen and exercise endurance set in motion two decades of research mostly oriented toward the practical application of those early findings. It is surprising that, in spite of the considerable time that has elapsed between those initial studies and the wealth of knowledge accumulated since, we still do not know the biochemical mechanism that explains why carbohydrate is essential to the ability of the muscle fiber to maintain high force outputs. It may be that the discoveries of 1967 were so widely accepted and so essentially unchallenged that we narrowed our vision as to the potential mechanisms responsible for the observations reported. The time has come for us to lay this issue to rest and answer the question: Why is glycogen availability necessary to perform prolonged, heavy-intensity exercise? PMID- 3297722 TI - Controlling multijoint motor behavior. AB - Much can be learned about the central nervous system from a study of motor coordination, but its true richness and complexity become evident only in a multiarticular system. Despite the intrinsic complexity of multiarticular actions, they offer an unparalleled opportunity to learn about the central nervous system in a quantitative and experimentally testable way. For example, the observation that unconstrained, unperturbed arm movements are coordinated in terms of hand motion shows that motor control is organized in a hierarchy of increasing levels of abstraction. These arm motions are organized as though a disembodied hand could be moved in space; the details of how this is to be achieved must then be supplied by a different level in the hierarchy. The essence of human behavior is its adaptability. Just as the true complexity of coordination is evident only in multiarticular actions, the sophistication and subtlety of adaptive behavior are evident only in dynamic, interactive tasks. A study of movement alone is not sufficient to understand this behavior. The dynamic response of the limbs becomes the overriding concern and must be controlled by the central nervous system. The dynamic response of a limb is usually associated with its posture, rather than its movement, but in a functional task such as the use of a tool, the postural dynamics are an integral part of the action. This perspective on motor behavior leads to some useful insights. Coordination is not a problem for movement alone; in a multiarticular system, even posture requires coordination and control. Muscles do not merely act reciprocally to generate forces about the joints; the net mechanical impedance of the limb may be controlled by synergistic activation of all muscles, including antagonists. Controlling dynamic behavior is a far more demanding task than controlling motion. Consequently, features of the neuromusculoskeletal system that appear to be redundant or unnecessary for movement control can play a functional role in controlling dynamic behavior. Polyarticular muscles contribute to the mechanical impedance in a unique way. Skeletal redundancies have a profound influence on all aspects of dynamic behavior, including the apparent inertia of the limbs. Redundancies are commonly perceived as a complicating factor in the control of motion, a problem that must be solved by the central nervous system. Rather than presenting a problem requiring solution, they may present a solution to a problem. Posture is not merely the outcome of a motor act; it is one of the important preparatory stages in the production of motor behavior. PMID- 3297723 TI - Effects of hypoxia and hyperoxia on human performance. PMID- 3297724 TI - Aerobic fitness, endurance training, and orthostatic intolerance. PMID- 3297725 TI - Biophysical and physiological integration of proper clothing for exercise. AB - In this chapter, I have presented a potpourri of examples of proper clothing to wear during various exercise demands in different environments. These examples are not wholly exact for all persons. For example, during the 1984 Olympics in Los Angeles, clothing wear related to the particular environment was totally different. We have already described the aerodynamic necessities of cyclists and runners. At the other extreme, equestrians had to contend with a warm, moderately humid environment, plus a solar load that added to the effective heat stress, while wearing clothing having clo values of nearly 0.8-0.9, plus headgear that limited evaporative heat loss. Obviously, garments with high water vapor permeation and bellows properties were necessary. Runners in the marathon faced equal thermal challenges. In addition, they incurred variable levels of hypovolemia and cardiovascular strain. A. Salazar, for example, was advised to omit shower sprays, and he ran with a prototype high-permeability singlet. The excessive wetting plus time to maneuver to the spray was deemed of no value, since Mr. Salazar chafes easily from wet clothes (L. Armstrong, personnel communication). One interesting response to this advice is to consider the clothed runner as a wet globe thermometer under forced convection. A high-contact fabric, especially one like cotton, does allow evaporative cooling, provided that the skin-ambient vapor pressure gradient is not diminished by high relative humidity. Salts in sweat may reduce the skin's vapor pressure ; however, Woodcock and Breckenridge point out that "secreted sweat (especially with heat acclimation) is so dilute that no appreciable lowering of vapor pressure would occur unless sweat were concentrated many times by evaporation." Thus, the degree of "human" wet bulb depression simulated by a completely wet runner may or may not be an advantage, since all other variables are also constant (i.e., humidity, weight of clothing as in Figure 13, etc.) or the level of hypovolemia is not excessive and the person is fully heat acclimated. Problems such as these may be theoretical, but they serve to show that the thermal biophysics and physiology of exercise follow similar fundamental pathways that can be highly pertinent. As we sought to point out in this chapter, these pathways have merged in the last 30 years with developments such as warmth without bulk for backpackers (which is a welcomed contrast to heavy arctic wear), materials that allow athletes to remain somewhat comfortable while sweating, and other advances that luckily have replaced the less appealing sports apparel such as the old woolen baseball uniform.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297726 TI - The insulin-like effect of muscle contraction. AB - Muscle contraction results in an increase in membrane permeability to glucose. The actual mechanism by which contractile activity increases membrane permeability is unknown. However, kinetic studies suggest that this increase is due to an increase in the number of glucose transporters associated with the plasma membrane. This is also suggested by the recent finding that cytochalsin B, which competitively inhibits the binding of glucose to the glucose transporter in the plasma membrane, prevents activation of the glucose transport process by muscle contraction. Unlike insulin-stimulated glucose transport, in which permeability is reversed rapidly upon removal of the insulin, the increase in membrane permeability following contractile activity can persist for many hours. It has also been reported that the stimulatory effects of insulin and contraction are additive, and that prostaglandin E2 augments the effect of insulin on glucose transport but has no effect on contraction-facilitated glucose transport. Collectively, these findings suggest that insulin and contractile activity increase membrane permeability to glucose by independent mechanisms. An increase in membrane permeability is only partially responsible for the increase in glucose uptake during exercise in vivo. With an increase in muscle activity, there is an increase in delivery of glucose and insulin to the muscle as a result of an increase in muscle blood flow. Glucose uptake may also be facilitated by an increase in the insulin sensitivity of the muscle. The increases in muscle blood flow and insulin sensitivity may be associated with activation of the kinin prostaglandin system of the muscle. The increase in muscle insulin sensitivity may also involve an increase in insulin binding to its receptors on the sarcolemma. It should be noted that the increase in insulin binding associated with contractile activity requires the presence of epinephrine. Muscle glycogen may also affect the rate of glucose uptake during exercise. During prolonged, moderately intense exercise, glucose uptake increases as the muscle glycogen level declines. This increase in glucose uptake is inversely related to the glucose-6-phosphate concentration of the cell. During high-intensity exercise, the rate of glycogenolysis is rapid, resulting in the accumulation of glucose-6 phosphate and free glucose. Thus, it appears that the rate-limiting step in glucose uptake during exercise is shifted from transport to glucose phosphorylation, and that this shift is mediated by the intracellular glucose-6 phosphate concentration, which is influenced by the rate of muscle glycogen catabolism. PMID- 3297727 TI - Considerations pursuant to the rehabilitation of the anterior cruciate injured knee. PMID- 3297728 TI - Psychophysiology in exercise and sport research: an overview. PMID- 3297730 TI - Professional sports and community: a review and exegesis. PMID- 3297729 TI - Intrinsic motivation in sport. PMID- 3297731 TI - Influence of exercise and training on motor unit activation. AB - Human MUs vary considerably in twitch force, contractile speed, axonal conduction velocity, fatigue resistance, recruitment thresholds, firing rates, and firing patterns. These functional properties, together with the corresponding morphological characteristics such as soma size, axon diameter, and muscle fiber size, are interrelated. The smallest (soma size, axon diameter, muscle fiber size) MUs have the smallest twitch force, the slowest contraction speed, the slowest conduction velocity, the greatest resistance to fatigue, the lowest recruitment thresholds, and the lowest minimum and maximum firing rates. The converse applies to the largest MUs. Between the extremes are MUs with intermediate characteristics. MUs are generally recruited in order of size in voluntary contraction of increasing force or effort. Thus, units are recruited in order of increasing twitch force and contractile speed and decreasing resistance to fatigue. In some muscles MU recruitment occurs throughout the range of contraction force, whereas in other muscles most if not all MUs are recruited by about 50% of maximum contraction force. The latter pattern is characteristic of small muscles that perform precise movements. The recruitment order of MUs according to size is based on the inverse relation between susceptibility to discharge and motoneuron size. Thus, for evenly distributed and increasing excitatory synaptic input to a pool of motoneurons, smaller motoneurons will begin to fire before larger motoneurons. This arrangement ensures, for example, that the small, fatigue-resistant MUs will be preferentially activated in prolonged, low-intensity exercise, to which these units are most suited. In brief, intense exercise, the associated greater excitatory input will also recruit the large MUs, taking advantage of their greater strength and contractile speed. A frequent question is whether rapid, ballistic or explosive contractions and movements are associated with selective or preferential recruitment of large, fast twitch MUs. There is evidence of synaptic input systems that preferentially excite large, fast twitch MUs and inhibit small twitch MUs; however, the majority of evidence from human experiments indicates that the recruitment order is not reversed in ballistic contractions. For technical reasons, most studies have used isometric contractions, but recently successful recordings of single MUs have been made during locomotion. Future research must develop a successful recording arrangement for the study of recruitment and discharge properties of single MUs in large proximal muscles during activities such as kicking, jumping, and throwing.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3297732 TI - The effect of chronic captopril therapy on adrenergic receptors, plasma noradrenaline and the vascular responses to infused noradrenaline. AB - Adrenergic receptors (alpha 2, beta 2), plasma noradrenaline, heart rate and the pressor responsiveness to infused noradrenaline were examined in ten healthy male volunteers before and after 2 weeks of placebo or captopril therapy in a double blind cross-over study. No significant differences in these measurements were observed between the captopril and placebo treated groups. The study shows that in sodium replete normotensive subjects, long-term angiotensin converting enzyme inhibition does not lead to changes in adrenoceptor density. There is also no alteration in plasma noradrenaline levels nor in the pressor responsiveness to infused noradrenaline. These data suggest that the known interaction between the renin-angiotensin system and the sympathetic nervous system observed in animals is probably of little significance in man. PMID- 3297733 TI - The pharmacokinetics of captopril and captopril disulfide conjugates in uraemic patients on maintenance dialysis: comparison with patients with normal renal function. AB - We have measured the plasma concentrations of captopril and total disulfide conjugates of captopril after a 50 mg oral dose in 6 uraemic patients on maintenance dialysis and in 8 hypertensive subjects with normal renal function. The mean peak plasma concentration of captopril was 2.5 times higher (0.447 micrograms X ml-1 vs 0.181 micrograms X ml-1) and the concentrations of the disulfides 4 times higher (3.62 micrograms X ml-1 vs 0.924 micrograms X ml-1) in the uraemic patients. Moreover captopril disulfide conjugates in the uraemic subjects reached peak concentrations at 8 h after the dose and subsequently felt. The apparent plasma half-time was 46 +/- 19 h. Only 15% of these conjugates were removed by dialysis. This marked accumulation of captopril conjugates was associated with a sustained fall in both systolic and diastolic blood pressures. In uraemic patients the mean maximum reduction in systolic and diastolic blood pressures were 37 +/- 7 mmHg and 24 +/- 9 mmHg respectively, occurring 6 h after the dose, compared with 8 +/- 7 and 8 +/- 1 mmHg respectively at 30 min in normal renal function patients. These results are consistent with the results of animal experiments, which show that captopril disulfides can be converted back to free captopril and can contribute to the antihypertensive effect of the drug. They provide a reationale for reducing the dose and frequency of administration of captopril in patients with significant renal impairment. PMID- 3297734 TI - The urinary excretion of frusemide and its metabolites by kidney transplant patients. AB - Urine from 5 renal transplant recipients treated with frusemide was analyzed for unchanged frusemide (F), glucuronidated frusemide (G) and 4-chloro-5 sulfamoylanthranilic acid (CSA) by HPLC. In 3 recipients, whose renal function recovered steadily and whose hepatic function was normal throughout, the ratio of frusemide to its metabolites, F/(F + G + CSA), increased steadily in conjunction with the recovery of renal function. In one patient, who received frusemide 200 400 mg/day i.v., the urinary CSA concentration was 64-102 micrograms X ml-1. In 2 patients who experienced shock and/or hepatic dysfunction after transplantation, the F/(F + G + CSA) ratio fluctuated. PMID- 3297735 TI - The majority of "natural" immunoglobulin-secreting cells are short-lived and the progeny of cycling lymphocytes. AB - Treatment of mice with hydroxyurea to selectively kill all cycling cells has been used to study population dynamics and life expectancy of "natural" immunoglobulin secreting cells in the bone marrow and spleen of nonimmunized animals. The results show that 50 to 90% of those cells are eliminated 2 to 3 days after one cycle of hydroxyurea administration, demonstrating their recent origin from cycling precursors. Using a protocol of long-term hydroxyurea treatment which abrogates cell production from the cycling precursors compartments, it was shown that "natural" immunoglobulin-secreting cells have a very short half renewal time, in the range of 15-60 h. PMID- 3297736 TI - Limiting dilution assay for human B cells based on their activation by mutant EL4 thymoma cells: total and antimalaria responder B cell frequencies. AB - The analysis of human B cell responses at the clonal level (limiting dilution assay) is still technically difficult. In the present study we report on a culture system that leads to activation, proliferation and differentiation into antibody-secreting cells (ASC) of about 90% of B cells from peripheral blood or spleen. In this system, B cells are cultured in the presence of a mutant subclone of the mouse thymoma EL4 for B cell activation and human T cell plus macrophage supernatant as source of proliferation and differentiation factors. ASC precursors generating clonal responses of IgM only, IgM plus IgG, or IgG only occurred at a ratio of about 6:3:1. The mean clone size was 380 cytoplasmic Ig+ cells; the mean amount of Ig secreted per clone was 20 ng. Furthermore, it has been found using this system that a considerable proportion of peripheral blood B cells from individuals with a history of malaria infection could generate clones of anti-malaria (Plasmodium falciparum) ASC (range of 0.1 to 1%, n = 6). In a control group of blood donors the corresponding frequencies were 10 times lower (range of 0.01 to 0.1%, n = 9). These results show that the EL4 culture system can be applied to the investigation of the human B cell specificity repertoire and of priming effects such as result from infectious disease. PMID- 3297737 TI - Evidence for an inhibitory A1 subtype adenosine receptor on pancreatic insulin secreting cells. AB - The effects of L- and D-phenylisopropyladenosine (L- and D-PIA) were studied on glucose-induced insulin secretion from the isolated perfused rat pancreas. L-PIA at the low dose of 16.5 nM inhibited insulin secretion by 50%. In contrast, D-PIA at 16.5 and 82.5 nM was ineffective. D-PIA used at a 100-fold higher concentration (1.65 microM) than L-PIA induced a similar inhibition of insulin secretion. The inhibitory effect of L-PIA was abolished by 8-phenyltheophylline (1 microM), a potent P1 purinoceptor antagonist. The present experiments provide evidence for an adenosine receptor of the A1 subtype on the insulin-secreting pancreatic cell of rats. PMID- 3297738 TI - The N-methyl-D-aspartate antagonist, 2-amino-7-phosphonoheptanoate, produces phencyclidine-like behavioral effects in rats. PMID- 3297739 TI - Binding characteristics of the dopamine agonist/antagonist [3H]terguride (transdihydrolisuride) in the rat striatum. AB - The binding properties of [3H]terguride were studied in various regions of the rat brain. The highest density of [3H]terguride binding sites was found in the striatum and tuberculum olfactorium. In the striatum, the binding was saturable, stereoselective and of a high affinity. There was a good correlation between the inhibition of [3H]terguride and [3H]spiperone bindings by various dopaminergic agents. Drugs with affinity to another type of receptors did not displace [3H]terguride binding in the striatum; only SCH 23390 was effective. The experiments indicate a certain affinity of the ligand to D-1 receptors. Nevertheless, [3H]terguride appears to have an affinity to D-2 receptors in the striatum and, thanks to its dopamine agonistic/antagonistic profile, would be useful in the further study of dopamine receptors. PMID- 3297740 TI - An antigen expressed in proliferating cells at late G1-S phase. AB - A monoclonal antibody Pr-28 was prepared, which recognized an antigen present only in proliferating cells. Immunofluorescence analysis of Pr-28 antigen showed that the antigen was localized mainly in perinuclear cytoplasm. Although Pr-28 antibody was produced against a chicken cell antigen, it reacts not only with chicken cells but also other cells of murine origin, such as L-cells and NIH 3T3 cells. The molecular weight (Mr) of the antigen recognized by Pr-28 antibody was 45,000 D as determined by SDS-PAGE run under reducing conditions. The antigen disappeared in NIH 3T3 quiescent cells, reappearing in quiescent cells stimulated by fetal calf serum (FCS). The synthesis of Mr 45,000 protein occurred at late G1 phase, just before DNA synthesis in serum-stimulated quiescent NIH 3T3 cells and ceased in S phase. PMID- 3297741 TI - Collagen metabolism and basement membrane formation in cultures of mouse mammary epithelial cells. Induction of 'assembly' on fibrillar type I collagen substrata. AB - Collagen metabolism was compared in cultures of mouse mammary epithelial cells maintained on plastic or fibrillar type I collagen gel substrata. The accumulation of dialysable and non-dialysable [3H]hydroxyproline and the identification of the collagens produced suggest no difference between substrata in the all over rates of collagen synthesis and degradation. The proportion of the [3H]collagen which accumulates in the monolayers of cultures on collagen, however, markedly exceeds that of cultures on plastic. Cultures on collagen deposit a sheet-like layer of extracellular matrix materials on the surface of the collagen fibres. Immunoprecipitation of the labelled extracts, electrophoresis, indirect immunofluorescence and immunoperoxidase techniques reveal the presence of type IV collagen, along with laminin and heparan sulfate proteoglycan in this layer, in excess over the amounts detectable on cells cultured on plastic. Transformed cells on collagen produce and accumulate more [3H]collagen, yet are less effective in basement membrane formation than normal cells, indicating that the accumulation of collagen alone and the effect of interstitial collagen thereupon do not suffice. Thus, exogenous fibrillar collagen appears to enhance, but is not sufficient for proper assembly of collagenous basement membrane components near the basal epithelial cell surface. PMID- 3297742 TI - Monoclonal antibody with specificity to mitotic chromosomes of primates. AB - Fusion of a cell in mitosis with a cell in interphase results in the condensation of chromatin in the interphase nucleus into chromosomes. Premature chromosome condensation is caused by certain proteins, called mitotic factors, that are present in the mitotic cell and are localized on chromosomes. Extracts from mitotic cells were used to immunize mice to produce monoclonal antibodies specific for cells in mitosis. Among the antibodies obtained, the MPM-4 antibody defines a 125-kD polypeptide antigen located on mitotic chromosomes by indirect immunofluorescence. Although the polypeptide antigen is present in approximately equal concentrations in extracts of interphase cells and mitotic cells, as revealed by immunoblots, it cannot be detected cytologically in the former. Cell fractionation experiments showed that the 125-kD antigen is found in the cytoplasm of interphase cells and metaphase cells, but is concentrated in fractions containing metaphase chromosomes, although not detectable in interphase nuclei. Even though the antigen is apparently primate-specific, it binds to mitotic chromosomes and prematurely condensed chromosomes in human-rodent cell hybrids without regard to the species of origin of the mitotic inducer. The presence of the antigen in the cytoplasm of interphase cells and the chromosomes of mitotic cells suggests a relationship between the presence of the antigen on chromosomes and the process of chromosome condensation and decondensation. PMID- 3297743 TI - Differential immunoreactivity for Z-DNA in rat myoblast nuclei during their terminal differentiation. AB - L6 myoblasts in vitro accomplish the process of terminal differentiation from dividing mononucleated cells to quiescent plurinucleated myotubes, synthesizing muscle-specific proteins. They have been tested, using paraformaldehyde and acetic acid fixations and immunocytochemical techniques, for the presence of Z DNA at different stages: namely after 3, 5 and 8-9 days of culture. The nuclei of the actively dividing 3-day myoblasts were strongly Z-DNA and B-DNA-positive. The inhibition of replication by araC did not diminish the reaction. In the myotubes, the nuclei became Z-DNA-negative but were still B-DNA-positive. In contrast, the nuclei of a non-fusing alpha-amanitin-resistant mutant (Ama102) stayed Z-DNA positive. These results tend to show that during the process of terminal differentiation Z-DNA either becomes less accessible or is present in undetectable amounts. In circular DNAs, it has been shown that the presence of Z DNA depends on their negative supercoiling. In addition, the presence of closed superhelical loops of nuclear DNA has been demonstrated in several mammalian cell types; moreover, the density of DNA topological turns in these loops varies during cellular differentiation and malignant transformation. The relationship between these results and ours is discussed. PMID- 3297744 TI - Assessment of an enzyme immunoassay for the detection of salmonellas in foods and animal feeding stuffs. AB - The Salmonella Bio-EnzaBead Screening Kit, in its modified form with both the MOPC 467 and the 6H4 antibodies, was used for the detection of salmonellas in naturally contaminated foods and animal feeding stuffs in parallel with a traditional cultural procedure. Initial results showed an 82% agreement between the enzyme immunoassay (EIA) and cultural methods when using the criterion recommended by the manufacturer as a cut-off for all types of foods. By adjusting the cut-off for each type of food, the number of EIA positive, culture negative samples was reduced although the number of EIA negative, culture positive samples increased. The EIA may be more sensitive than the cultural methods as in many cases the EIA positive, culture negative results could be real positives which were not detected by the cultural methods. The screening kit provides a simple and convenient method for the detection of salmonella in foods and feeds and a presumptive positive result can be reported within 48 h. The advantages and disadvantages of the method are discussed. PMID- 3297745 TI - Factors affecting the toxicity of rotting carcasses containing Clostridium botulinum type C. AB - Mice killed shortly after receiving 1300-3000 spores of Clostridium botulinum type C per os were incubated at one of four 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 (10-20.8%, w/v) and pure cultures were then titrated for toxicity. A temperature of 37 degrees C produced less toxicity in most carcasses than in cultures. At 30 degrees C, however, toxicity (often 2 X 10(5) to 2 X 10(6) mouse intraperitoneal LD/g or ml) was roughly similar in both systems, and some carcasses and cultures were still toxic (2 X 10(4) to 2 X 10(5) LD/g or ml) after 349 days. Surprisingly, at 23 degrees C, through greatly reduced in the cultures, toxicity was high in many carcasses for at least 28 days. Little or no toxin was produced in either system at 16 degrees C. Unfiltered homogenates (17.8-22.5%, w/v; dose 0.25 ml per os) of toxic carcasses incubated at 30 degrees C for 7 days invariably produced death from botulism, often within as little as 4 h, but a 1 in 10 dilution produced less than 100% mortality. PMID- 3297746 TI - Antibiotic sensitivity and mutation rates to antibiotic resistance in Mycoplasma mycoides ssp. mycoides. AB - The antibiotic resistance of Mycoplasma mycoides ssp. mycoides strain T1 was investigated. This strain was resistant to high levels (greater than 100 micrograms ml-1) of rifampicin and nalidixic acid. It was sensitive to streptomycin, spectinomycin and novobiocin; however, single step mutants with high levels of resistance (greater than 100 micrograms ml-1) were readily isolated. With erythromycin and tylosin for which the minimum inhibitory concentration (MIC) for the parent strain was less than 0.1 microgram ml-1, mutants resistant to greater than 100 micrograms ml-1 were obtained in two and three steps respectively. The MIC of tetracycline in single step resistant mutants (0.6 microgram ml-1) was tenfold higher than the parent strain, but could not be increased further. There was only a twofold increase in resistance to chloramphenicol in single step mutants. The frequency of resistant mutants varied with the antibiotic and was between 4 X 10(-6) and 2 X 10(-8). The mutation rate to antibiotic resistance to streptomycin, spectinomycin, novobiocin, erythromycin and tylosin was between 3 X 10(-8) and 5 X 10(-9) per cell per generation. There was a fivefold decrease in mutation rate to resistance to 60 micrograms ml-1 streptomycin compared to that to 20 micrograms ml-1. PMID- 3297747 TI - Cholinergic neurons in the human retina. AB - Choline acetyltransferase (ChAT)-like immunoreactivity in the human retina can be demonstrated using a polyclonal antiserum to ChAT isolated from chick brain. There is a population of ChAT-like immunoreactive cells along both margins of the inner plexiform layer (IPL). The labeled cells have a morphology and position characteristic of the cholinergic amacrine- and displaced amacrine cells demonstrated by other workers in the mammalian retina. Non-immune rabbit serum or pre-absorbed antiserum, used in place of the primary antiserum, verified the specificity of the method. Human retinas can also be labeled with the fluorescent dye 4',6-diamidino-2-phenylindole (DAPI), which has been reported to bind selectively to DNA in the nuclei of cholinergic cells. The fluorescent cells are similar in morphology, position, and distribution to the cells which show ChAT like immunoreactivity. In addition, we have localized the presence of [3H]choline and [3H]choline metabolites in freeze-dried, vapor-fixed tissue using 'dry' autoradiographic techniques. Incubation in [3H]choline was followed by either stimulation or inhibition of calcium-dependent transmitter release during a 1-hr 'chase' period. Using tissue incubated in a chase designed to retain labeled neurotransmitters, silver grains were concentrated over a population of cell bodies at either margin of the IPL (i.e. in the same position as putative ChAT immunoreactive cells and DAPI-labeled cells). In contrast, tissue incubated in a chase designed to release labeled acetylcholine was labeled uniformly throughout the neural retina, with a heavy band of label over the pigment epithelium. Taken together, the results presented here indicate that three independent markers for cholinergic cells (i.e. ChAT immunoreactivity, DAPI binding, and choline uptake) are present in a population of cells in the human retina. This suggests that acetylcholine may be a neurotransmitter synthesized by amacrine and displaced amacrine cells in the retina. PMID- 3297749 TI - Uveoretinitis in rabbits following immunization with interphotoreceptor retinoid binding protein. AB - Interphotoreceptor retinoid-binding protein (IRBP) is a glycoprotein found in the interphotoreceptor matrix between the neurosensory retina and the retinal pigment epithelium and is thought to shuttle retinol among cells that border the interphotoreceptor space. Immunization of rabbits with bovine IRBP caused subsequent photoreceptor degeneration, as documented by light- and electron microscopy. Beginning on post-injection day 18, scattered regions had photoreceptor outer segments that were disorganized and shortened or absent. Macrophages were found between the retinal pigment epithelium and neurosensory retina and within choroidal interstitium and blood vessels. Labeling of these cells with a marker specific for monocytic macrophages (RAM11) and absence of labeling with a marker for retinal pigment epithelium (rabbit anti-bovine cellular retinaldehyde-binding protein) suggest that these macrophages were hematogenous in origin. Staining of retinas with fluorescein isothiocyanate (FITC)-conjugated sheep anti-rabbit IgG revealed leakage of rabbit IgG into the interphotoreceptor matrix on and after day 18 in experimental animals but not in controls, suggesting breakdown of the outer blood-retinal barrier. Indirect immunofluorescence with anti-glial fibrillary acidic protein revealed labeling of Muller cells in experimental retinas on and after day 18, but not in control or shorter survival experimental retinas. There were foci of increased cellularity in the choroid on days 18, 26 and 39. From days 26 through 67, the retinal pathology became more widespread. Varying degrees of outer-segment degeneration were present in all parts of the retina and in many areas there was total loss of outer segments and loss of some photoreceptor-cell bodies. The inner retina appeared unaffected in all experimental and control retinas. These results demonstrate that injection of rabbits with bovine IRBP causes retinal photoreceptor degeneration as anti-IRBP titers increase and breakdown of the outer blood-retinal barrier ensues. Further studies will be required to elucidate factor(s) that control accessibility of the neurosensory retina to circulating antibodies against IRBP and other intrinsic retinal proteins. PMID- 3297748 TI - Surface modification of retinal pigment epithelial cells: effects on phagocytosis and glycoprotein composition. AB - Proteases have been used as a tool to investigate the role of cell-surface molecules of cultured retinal pigment epithelial cells (RPE) in the phagocytosis of rod outer segments (ROS). Proteolytic digestion of RPE cells by pronase, thermolysin and Staphylococcus aureus V8 protease (V8 protease) inhibited the phagocytosis of ROS without affecting the viability of the RPE cells. A particular feature of RPE cell proteolysis was that those macromolecules responsible for ROS ingestion were susceptible, while those macromolecules that mediated ROS binding were resistant to cleavage by all three proteases. By taking advantage of this phenomenon, ROS were used as affinity particles to obtain a plasma membrane-enriched fraction of RPE cells before and after proteolytic digestion. All three proteases partially or completely removed several glycoproteins from the cell surfaces. Removal of these glycoproteins was correlated with a loss in phagocytic ability by RPE cells. Two high-molecular weight (MW) glycoproteins of MWs 160,000 and 214,000 were consistently removed by all proteases tested. Protease-treated RPE cells restored their phagocytic capabilities and normal glycoprotein composition within 24 hr after proteolytic treatment. These data suggest that glycoproteins located on the surfaces of RPE cells may be involved in mediating the phagocytosis of ROS by these cells. PMID- 3297750 TI - Immunohistological localization of calmodulin in feline rod outer segments. AB - The calcium-binding regulatory protein, calmodulin, was immunohistologically examined in feline rod outer segments. The peroxidase antiperoxidase technique was used for the immunohistological analysis and protein A-gold, to localize calmodulin electron-microscopically. Calmodulin was found to be located in the distal position of the rod outer segments. Most of the gold particles could be seen on the disk membranes. The same observations were obtained for retinas in either a light or dark environment. Thus, there is the possibility that calmodulin may have some influence on enzyme activity in the rod outer segments, particularly in the distal portion. PMID- 3297751 TI - Folic acid protects chick retinal neurons against the neurotoxic action of excitatory amino acids. AB - In this study we have examined the neurotoxic effects of folic acid (FA), alone or in combination with selected excitotoxins using in vitro preparations of chick retina. Folic acid alone at concentrations of up to 10 mM had no effect. Co incubation of 10 mM FA with 2 microM kainic acid (KA) protected all cell types susceptible to KA toxicity, namely amacrine and bipolar cells. At lower concentrations the protective effect of FA to susceptible cell types was found to be dose-dependent. The rank order of cells which are protected by FA, in order of the lowest concentration of FA required, was amacrine, inner bipolar and outer bipolar cells. The effect of FA against KA is a very weak one, as a 130-400-fold concentration of FA is required to protect amacrine cells from KA and a 1000-5000 fold dose of FA required to protect bipolar cells. However, FA (2 mM) also protects susceptible retinal neurons from the neurotoxic effects of 40 microM N methyl-DL-aspartic acid (NMDLA) and 60 microM quinolinic acid (QUIN); only requiring respectively 50 and 33 times the concentration of FA. Interestingly 10 mM FA had little effect against 40 microM quisqualic acid (QUIS). Thus FA antagonizes the effects of KA, NMDLA, QUIN and to a small extent QUIS. Although its action may be mediated through several receptor types, FA appears to be a more potent antagonist of the N-methyl-D-aspartic acid (NMDA)-preferring than the KA-preferring or QUIS-preferring receptor. PMID- 3297752 TI - Survival of fiber cells and fiber-cell messenger RNA in lens of rats maintained on a 50% galactose diet for 45 days. AB - Previous work from this laboratory has shown that in cataractous lens from rats fed a 50% galactose diet up to 32 days, synthesis of crystallin mRNAs was reduced while synthesis of mRNAs for the non-crystallin proteins appeared to be maintained at equivalent or higher levels than found in the controls. In this study, we find that the population of mRNA from the 45-day cataractous lens included all of the crystallin mRNAs and substantial amounts of mRNAs for the non crystallin proteins, in particular those proteins of molecular weights ranging from 45,000 to 92,000, and pIs from 5.5 to 7.0. At the 45-day cataractous stage, the observed mRNA products totaled between 100 and 120, while for the control they numbered between 40 and 50. In addition, hybrid-select measurements with a lambda gt11 MP26 clone established that MP26 mRNA persisted in the fiber cells of 11-, 20-, 32- and 45-day galactosemic lens. The data, therefore, suggest that continuous exposure of the lens to galactose apparently leads to significant fluctuations in mRNA synthesis and survival. Indirect immunofluorescence (with a monospecific polyclonal rabbit anti-MP26 antibody) and light-microscopy studies demonstrated that although the cortical fiber cells were swollen and structurally disoriented, they retained their nuclei, while the enucleated fiber cells were absent. The microscopy data also suggest that differentiation of the epithelial cells to fiber cells continued in the cataractous lens. Fiber-cell migration was backward as compared with the control, and the surviving cells were localized within the cortex and appeared to be surrounded by damaged cells or cell debris. It is suggested that persistent fiber-cell survival, and continued synthesis of various classes of mRNA by the nucleated cells in the cataractous lens could explain why reversal of cataracts results in recovery in both cell morphology and transparency in the non-nuclear portion of the lens. PMID- 3297753 TI - Why the neuroendocrine system is important in aging processes. PMID- 3297754 TI - Differential decrease in the rate of dopamine synthesis in several dopaminergic neurons of aged rat brain. AB - The purpose of this study was to investigate the in vivo rate of dopamine (DA) synthesis in dopaminergic neurons of the brain related to motor disturbances observed in aged rats. Aged rats of both sexes showed a decrease in spontaneous motor activity during a dark period as compared with those of mature rats. The in vivo rate of DA synthesis, as reflected in DOPA accumulation, in the striatum and nucleus accumbens, was slower in aged than in mature rats, whereas in the olfactory tubercle there was no significant difference between them. This suggests a differential vulnerability of dopaminergic neurons in the extrapyramidal motor areas of aged animals. After DA receptor blockade by haloperidol, increases in DA synthesis in the striatum, nucleus accumbens and olfactory tubercle were similar in both aged and mature rats, suggesting that there may be no age-related change in inhibitory regulation of in vivo DA synthesis mediated by presynaptic DA autoreceptors and/or a neuronal feedback mechanism via postsynaptic DA receptors in the striatum and mesolimbic DA regions. PMID- 3297755 TI - Half-life of plasma growth hormone in young and old conscious female rats. AB - The kinetics of disappearance of plasma GH was studied in young (3-4 months) and old (24-27 months) Sprague-Dawley female rats. Conscious, free moving animals carrying indwelling atrial and carotid cannulas received a single injection of 125I-rGH via the carotid cannula. Sequential blood samples were removed at intervals during the following hour, and total (TR) and immunoprecipitable radioactivity (IPR) were determined in the corresponding plasmas. Both TR and IPR displayed biexponential kinetics in vivo which did not differ significantly, for each variable, between young and old animals. The volumes of distribution of GH were also similar in both age-groups. The IPR/TR ratio, an estimate of GH inactivation within the plasma space, showed a decreasing sigmoid-shaped kinetics in vivo with a time of semi-inactivation (ti1/2) of 23.8 +/- 1.2 and 29.0 +/- 1.0 min (mean +/- SE) for young and old rats, respectively (P less than 0.02). The estrous status did not significantly affect ti1/2 values in vivo. The in vitro t1/2 was estimated by incubating plasma from the young and old animals at 37 degrees C with 125I-rGH for several hours. The IPR/TR ratio displayed a linear kinetics in vitro with t1/2 values of 23.7 +/- 1.7 and 25.8 +/- 1.9 h (NS) for young and old animals, respectively. The above results show that GH catabolism decreases slightly with age in the female rat, although it is unlikely that this change has a significant effect on plasma levels of GH. The data also suggest that GH is physiologically inactivated in the extravascular space. PMID- 3297756 TI - Alteration of the microtubule organization in aging WI-38 fibroblasts. A comparative study with embryonic hamster lung fibroblasts. AB - The microtubule organization in human WI-38 fibroblasts subcultivated in vitro has been investigated using nocodazole, a reversible inhibitor of the microtubules. Two phenotypes were observed. The typical fibroblast cells, called Type 1 cells, showed, after nocodazole treatment, a centripetal depolymerization wave of the microtubules and the giant Type 2 cells which have a more heterogeneous behaviour. Some of the cells clearly showed a centrifugal depolymerization of the microtubules, others a mixed behavior and less than 1% displayed the same behavior as the Type 1 cells. Confirming previous data obtained with Hamster fibroblasts (Raes et al., 1983, 1984), these results suggest a modification in the microtubule organization which could account for the aberrant division of some WI-38 cells in aged cultures. The relevance of this observation for the emergence of the morphologically different Type 2 cells and for cell division impairment in serially in vitro cultivated cells is discussed. PMID- 3297757 TI - Effects of ambient temperature on free radical generation, antioxidant defenses and life span in the adult housefly, Musca domestica. AB - Life spans of poikilotherms like the housefly are shortened by elevation of ambient temperature. The objective of this study was to examine the possible involvement of active oxygen species in temperature induced life-shortening of the adult male housefly. Effects of varied ambient temperature, 20 degrees C and 28 degrees C, on life span, cyanide-resistant respiration, H2O2 concentration, superoxide dismutase (SOD) and catalase activities and glutathione (GSH) concentration were examined. Average life span of flies raised at 28 degrees C was about 52% lower than those raised at 20 degrees C. Rate of cyanide-resistant respiration, an indicator of oxygen free radical generation, was higher in flies raised at 28 degrees C, whereas steady-state concentration of H2O2 was decreased at this temperature. Catalase activity and GSH concentration were lower at 28 degrees C while SOD activity was unaffected by the ambient temperature. Results of this study suggest that life-shortening effects of elevated ambient temperature may be due, in part, to increased oxidative stress. PMID- 3297758 TI - Abstracts. Sixteenth annual meeting: International Society for Experimental Hematology. 23-27 August 1987, Tokyo, Japan. PMID- 3297760 TI - Standardization of procedures for ectopic marrow grafting. II. Influence on recipients of radiation dose and field size. AB - The ectopic implantation of mouse marrow to the kidney capsule offers considerable scope as an assay of the hemopoietic microenvironment. Our previous work has shown that whole-body irradiation of the graft recipient prior to implantation results in superior ossicle formation in the kidney of the host. Here we report that a range of irradiation doses over a 4-Gy threshold are equivalent with respect to conditioning the graft recipient. We also show that two distinct and separable influences affect graft growth in the irradiated recipient, namely, a local effect brought about in the irradiated kidney (and restricted to it) and secondly, a systemic effect resulting from irradiation of sites other than the kidney, which nevertheless affects ossicle growth in the shielded renal capsule. PMID- 3297759 TI - Preferential differentiation of murine CFU-S toward granulopoiesis and megakaryocytopoiesis after in vitro incubation of bone marrow with ASTA-Z 7557. AB - We investigated the in vitro effect of ASTA-Z 7557 on the qualitative aspects of murine CFU-S differentiation, as assessed by the histological nature of day-9 colonies generated in the spleen of irradiated mice by bone marrow exposed to the drug at concentrations ranging from 0 to 150 micrograms/ml. The proportion of erythrocytic colonies declined linearly with the logarithm of the dose (a 22% decrease per log), whereas the granulocytic and megakaryocytic colony proportions increased linearly (a 10% increase per log for both cell lineages). This suggests a preferential channeling of CFU-S differentiation toward granulopoietic and megakaryocytic cell lineages as a consequence of the in vitro chemotherapy, and supports the hypothesis that some alteration of the qualitative potential of CFU S to differentiate after in vitro purging of bone marrow with ASTA-Z 7557 takes place prior to autologous bone marrow transplantation. PMID- 3297761 TI - Detection of residual murine LPC-1 myeloma cells from bone marrow cell mixture after purging by 4-hydroperoxycyclophosphamide. AB - Mixtures of BALB/c bone marrow (5 X 10(6) and LPC-1 myeloma (2 X 10(6) cells have been purged in vitro with 100 microM 4-hydroperoxycyclophosphamide (4HC) for 30 min at 37 degrees C. Elimination of tumor cells was assessed by monitoring newly synthesized tumor-specific IgG 2a kappa in vitro and by reinjecting the cells subcutaneously into the hindlegs of mice. Drug-treated LPC-1 cells had no detectable tumor production and did not reproduce tumors. Untreated cells regrew as solid tumors and killed the host within 3-4 weeks. Bone marrow cell suspensions purged of tumor cells were then used to reconstitute lethally pretreated mice injected 24 h earlier with 300 mg/kg cyclophosphamide (CY). Mice injected with CY alone died within 10 days. Those reconstituted with bone marrow cells or with purged bone marrow-tumor cell mixture lived longer than 7 months. Mice reconstituted with untreated bone marrow-tumor cell suspension grew tumors, had detectable tumor-specific IgG 2a kappa in their serum, and died by day 44. These studies demonstrate that the success of myeloma cell purging can be determined by monitoring newly secreted tumor protein and that 4HC successfully eliminates malignant plasma cells in vitro without impairment of normal bone marrow stem cell functions. PMID- 3297763 TI - Aspects of measurement and analysis of regulatory peptides. AB - Although almost all methods of mass measurement of regulatory peptides still depend on the high affinity antibody, the traditional Yalow and Berson radioimmunoassay technique is becoming outdated. Pure monoclonal antibodies allow excess antibody two site assay techniques with a variety of different labels (preferentially non-radioactive) of great sensitivity and speed. The large amounts of particular monoclonal antibodies available allow several different laboratories to use the same reagents and have increased comparability. Unfortunately many regulatory peptides exist in multiple molecular forms and attention must be paid to antibody region specificity. Improved methods of extraction of regulatory peptides from plasma tissue allow more accurate quantitation. New techniques for rapid high resolution chromatography make distinction of different molecular forms much easier than hitherto. Better education in techniques and/or attention to inter-assay standards are necessary to improve the comparability of regulatory peptide measurement in the future. PMID- 3297762 TI - Regulatory peptide immunocytochemistry at light- and electron microscopical levels. AB - Immunocytochemical techniques applied at both light- and electron microscopical levels are valuable in the study of regulatory peptide distribution in normal and diseased tissue, whether in the form of sections or whole cell preparations. Successful immunolocalization depends on adequate preservation of the peptide antigen and the tissue structure in which it resides; a suitably specific and sensitive labelled antibody detecting system. In general, peptides are stable molecules, most of which retain their antigenicity after conventional cross linking fixation and tissue processing, allowing standard immunocytochemical methods to be used for light- and electron microscopy. Regulatory peptides are derived from precursor molecules and several 'families' of structurally similar peptides are now generally recognised. Region-specific antibodies may be needed to overcome problems of cross-reactivity or to identify a bioactive form in the presence of its precursor. Multiple co-localisation of different related and unrelated peptides in the same cell or even storage granule is now recognised and can be identified by immunocytochemistry. PMID- 3297765 TI - Peptides and epithelial growth regulation. AB - There is now considerable evidence implicating several peptides in the control of gastrointestinal epithelial cell proliferation and cell renewal. While some of these may act directly, many may be involved in regulating the powerful trophic effects of the intake and digestion of food on the gut epithelium. Several peptides have been associated with the regulation of intestinal cell proliferation. There is little doubt that gastrin is trophic to the stomach, but, its role in the rest of the gastrointestinal tract is debatable. Enteroglucagon has often been associated with increased intestinal epithelial proliferation, but at the moment all the evidence for this is circumstantial. The effects of peptide YY and bombesin warrant further study. The availability of recombinant epidermal growth factor (EGF) has recently enabled us to demonstrate a powerful trophic response to infused EGF throughout the gastrointestinal tract. The increasing availability of peptides will eventually allow the rigorous in vivo evaluation of the trophic role of these potentially very important peptides. PMID- 3297764 TI - Hybridization histochemistry. AB - The location of gene expression by hybridization histochemistry is being applied in many areas of research and diagnosis. The aim of this technique is to detect specific mRNA in cells and tissues by hybridization with a complementary DNA or RNA probe. Requirements for optimal specificity, sensitivity, resolution and speed of detection may not all be encompassed in one simple technique suitable for all applications, thus appropriate procedures should be selected for specific objectives. With reference to published procedures and our own extensive experience, we have evaluated fixatives, probes, labels and other aspects of the technique critical to the preservation and hybridization in situ of mRNA and detection and quantitation of hybrids. PMID- 3297766 TI - Precursors to regulatory peptides: their proteolytic processing. AB - Precursors to regulatory peptides undergo maturation processes which include proteolytic processing. The enzymes involved in this process remove the hydrophobic peptide located at the amino-terminus of the precursor. Endoprotease cleavage also occurs at single and two adjacent basic residues, this is followed by a removal of basic residues located at the C-terminus of the peptides by a carboxypeptidase-like enzyme. PMID- 3297767 TI - Regulatory peptides in the eye. PMID- 3297768 TI - Neuropeptides in pelvic afferent pathways. AB - Neurochemical and pharmacological experiments have raised the possibility that several neuropeptides including, vasoactive intestinal polypeptide (VIP), peptide histidine isoleucine amide (PHI), substance P, calcitonin gene-related peptide (CGRP), neurokinin A, cholecystokinin (CCK) and opioid peptides may be transmitters in afferent pathways to the pelvic viscera. These substances are widely distributed in: 1) nerve fibers in the pelvic organs, 2) visceral afferent neurons in the lumbosacral dorsal root ganglia and 3) at sites of afferent termination in the spinal cord. Double staining immunocytochemical techniques have shown that more than one peptide can be localized in individual visceral afferent neurons and that neuronal excitatory (VIP, substance P, CCK) and inhibitory peptides (leucine enkephalin) can coexist in the same afferent cell. Studies with the neurotoxin, capsaicin, indicate that peptidergic afferent pathways are involved in the initiation of central autonomic reflexes as well as peripheral axon reflexes which modulate smooth muscle activity, facilitate transmission in automatic ganglia and trigger local inflammatory responses. PMID- 3297771 TI - Multinucleate foreign-body giant cell formation. AB - The formation of multinucleate giant cells (MGCs) was studied after the subcutaneous implantation of cellophane foil into 25 Wistar rats. Epitheloid cells fuse to form MGCs of the Langhans type, with nuclei at the cell periphery that later migrate to the central cell region (Touton's type). Both cell types fuse again to form the monstrous MGC (more than 1 mm in diameter) widely extended on the implant surface. These cells are characterized by enlarged nuclei which are significantly larger than those in MGCs of the Langhans type. The positivity of widely extended MGCs for acid phosphatase and sodium tetrazolium reductase seems to be lower than that in Langhans' or Touton's cells. Widely extended MGCs cover a large area of implant surface and represent a barrier-like structure which separates the surrounding tissues from foreign bodies or materials that cannot be eliminated or disintegrated. PMID- 3297772 TI - Protein loss during acute graft-versus-host disease: diagnostic and clinical significance. AB - In 31 consecutive patients who received an allogeneic bone marrow transplantation the loss of proteins during the period at risk for acute graft-versus-host disease (aGVHD) was studied in order to determine whether the quantity of protein loss could be used for grading the severity of aGVHD. It was shown that the grade classified on the basis of the severity of skin rash, the quantity of diarrhea and the seriousness of cholestasis, correlated with serum albumin loss, intestinal plasma loss (expressed by the intestinal alpha 1-antitrypsin clearance) and the occurrence of inflammatory cells (leukocytes) in feces. The quantity of albumin lost by intestinal route accounted for only one third of the total albumin loss. To investigate whether the remaining part of it could be explained by capillary leakage elsewhere in the body, leakage of antileukoprotease from the tissue of the respiratory tract into the blood was measured. It was shown that the serum concentration of this proteinase inhibitor correlated with albumin loss. This means that capillary leakage also occurs in the lung during aGVHD. In conclusion, the loss of proteins can be used as a parameter of the severity of aGVHD once the proper diagnosis has been established. It appears that a combination of the current 'familiar' grading system and SAL yields a more objective classification system with a greater prognostic value. PMID- 3297773 TI - Expression of a B-lymphoid differentiation antigen (CD 19) on acute non lymphoblastic leukaemia cells. AB - The expression of CD 19 (B4) surface antigen was investigated in 41 cases of acute myeloid leukaemia (AML), and 8 cases of acute undifferentiated leukaemia (AUL). Diagnosis was carried out by usual cytological and cytochemical means, and leukaemias were classified according to the FAB classification. CD 19 antigen is thought to be expressed on B lymphoid cells only. However, 2 cases out of 9 FAB M1, M2 and M3 subtypes were weakly stained (20 to 25%) by B4 antibody; 7 out of 11, and 17 out of 18 cases of M4 and M5 subtypes were markedly stained (25 to 70% of cells). 3 cases of AUL were also stained. Moreover, B4 expression was often correlated with expression of monocyte-associated antigens, as recognized by CRIS6, My9, KiM1 and UCHM1 antibodies. It is concluded that B4 antigen is probably expressed before B differentiation and is retained in early stages of monocytic differentiation. PMID- 3297770 TI - Endocrine cells producing regulatory peptides. AB - Recent data on the immunolocalization of regulatory peptides and related propeptide sequences in endocrine cells and tumors of the gastrointestinal tract, pancreas, lung, thyroid, pituitary (ACTH and opioids), adrenals and paraganglia have been revised and discussed. Gastrin, xenopsin, cholecystokinin (CCK), somatostatin, motilin, secretin, GIP (gastric inhibitory polypeptide), neurotensin, glicentin/glucagon-37 and PYY (peptide tyrosine tyrosine) are the main products of gastrointestinal endocrine cells; glucagon, CRF (corticotropin releasing factor), somatostatin, PP (pancreatic polypeptide) and GRF (growth hormone releasing factor), in addition to insulin, are produced in pancreatic islet cells; bombesin-related peptides are the main markers of pulmonary endocrine cells; calcitonin and CGRP (calcitonin gene-related peptide) occur in thyroid and extrathyroid C cells; ACTH and endorphins in anterior and intermediate lobe pituitary cells, alpha-MSH and CLIP (corticotropin-like intermediate lobe peptide) in intermediate lobe cells; met- and leu-enkephalins and related peptides in adrenal medullary and paraganglionic cells as well as in some gut (enterochromaffin) cells; NPY (neuropeptide Y) in adrenaline-type adrenal medullary cells, etc.. Both tissue-appropriate and tissue-inappropriate regulatory peptides are produced by endocrine tumours, with inappropriate peptides mostly produced by malignant tumours. PMID- 3297775 TI - Interleukin-2 can induce proliferation of leukemic B-cells in prolymphocytic leukemia. AB - In a case of prolymphocytic leukemia (PLL), receptors for interleukin-2 (IL-2R) were demonstrated by immunofluorescence with a monoclonal antibody against IL-2R. Highly purified leukemic B-cells, cultured in vitro with recombinant IL-2 (r-IL 2), responded to IL-2 with a marked increase of DNA-synthesis. Both spontaneous and r-IL-2-induced proliferation of leukemic cells were totally abrogated by the anti-IL-2R monoclonal antibody. PMID- 3297769 TI - Peptides in the mammalian cardiovascular system. AB - Ample immunocytochemical evidence is now available demonstrating that several peptides are present in the mammalian cardiovascular system where they are localised to nerve fibres and myocardial cells. The neuropeptides (neuropeptide Y, calcitonin gene-related peptide, tachykinins and vasoactive intestinal polypeptide) are localised to large secretory vesicles in subpopulations of afferent or efferent nerves supplying the heart and vasculature of several mammals, including man. Although they often exert potent pharmacological effects on the tissues in which they occur their physiological significance has still to be established. They may act directly via specific receptors and/or indirectly by influencing the release and action of other cardiovascular transmitters. In marked contrast, atrial natriuretic peptide is produced by cardiac myocytes and considered to act as a circulating hormone. PMID- 3297774 TI - Participation and interactions of neutrophil elastase in haemostatic disorders of patients with severe infections. AB - The prognosis of septicaemia depends on the occurrence of complications such as shock and coagulation defects. The damage to haemostasis is usually explained by the action of the main coagulation and fibrinolysis enzymes, thrombin and plasmin. This paper presents data concerning the role of a third protease, granulocytic elastase. 82 patients who had been admitted to our hospital with suspected septicaemia were examined. Septicaemia was proven in 22 patients by the growth of microorganisms in blood cultures, and was clinically diagnosed in 9 patients. The plasma levels of neutrophil elastase-like protease complexed to a1antitrypsin (a1AT-ELP) were measured by zone immunoelectrophoresis assay (ZIA). The a1AT-ELP values were significantly increased in the 31 septic as compared to the 51 non-septic patients. In patients with complicated septicaemia, negative correlations of a1AT-ELP with factor XIII and the coagulation inhibitor antithrombin III were demonstrable. Among the patients with septic complications, the 3 who survived exhibited a dramatic decrease of a1AT-ELP, whereas in the other 16 patients who died the levels remained elevated. It might be of therapeutic significance that in 9 patients receiving fresh plasma and AT III concentrate substitution for DIC the a1AT-ELP levels dropped, whereas they remained high in the other septicaemia patients. There were no correlations between a1AT-ELP and the a2antiplasmin-plasmin complexes (a2AP-P1), but strong correlations with signs of coagulation. The data suggest an interaction of coagulation and elastase release, probably involving the Hageman factor. PMID- 3297776 TI - Trends in health care financing: opportunities for family planning agencies. PMID- 3297777 TI - Structure, self-regulating sequences, and institutional third parties in therapy: the Veterans Administration as a model. AB - This article examines the structural organization and sequences of interaction among therapists, institutions, and patients and their families that contribute to the problem of institutional dependence. Our contention is that when patients have become dependent on an institution for the livelihood and/or for the stability it represents, they are only one part of a systemic relationship characterized structurally by enmeshed boundaries, and sequentially by self regulating feedback loops. We use this premise to outline the nature of the enmeshed transactions in patient-therapist, patient-institution, and therapist institution relationships. Family interfaces with this triad are also addressed. Sequentially, we outline the interactions among patient, family, therapist, and institution that lead to hierarchical incongruities. These sequences tend to produce self-regulating feedback loops that perpetuate and maintain the structure of the system and its patterns of interaction. The final part of this article demonstrates how we strategically use a therapy team to manipulate the hierarchical incongruities and, hence, the recursive complementarity, that characterize the interactions between and among the members of this suprasystem. Besides manipulating the role of the therapist through team intervention, we also present several paradoxical and structural interventions that have been helpful when institutions have become third parties to therapy. PMID- 3297779 TI - Role of glycosylation in secretion of yeast acid phosphatase. AB - The minimal glycosylation requirement for acid phosphatase secretion and activity was investigated using tunicamycin, an inhibitor of protein glycosylation, and a yeast mutant defective in the synthesis of oligosaccharide outer chains. The results obtained show that outer chain addition is not essential for secretion of active enzyme and that only 4 core chains, out of 8 normally attached to a protein subunit, are sufficient for enzyme transport to the periplasmic space. Enzyme forms with less than 4 chains were retained in membranes of endoplasmic reticulum. Secreted underglycosylated enzyme forms are partially or completely inactive. PMID- 3297778 TI - ras proteins enhance the phosphorylation of a 38 kDa protein (p38) in rat liver plasma membrane. AB - Phosphorylation of a 38 kDa protein (p38) present in rat liver plasma membrane has been shown for the first time to be enhanced by ras proteins. This increase in phosphorylation is about 3-16-fold depending on the incubation time and the type of ras protein used. Acid treatment removes phosphate from this protein suggesting that the phosphorylation involves phosphoramidate derivatives of basic amino acids. Experiments carried out in the presence of diethylpyrocarbonate suggest that the phosphorylation occurs on (a) histidine residue(s). It is probable that the function of p38 in the cell is modulated by ras proteins through phosphorylation. The significance of phosphorylation of p38 in terms of malignant transformation is presently known. PMID- 3297780 TI - Structural features in aminoacyl-tRNAs required for recognition by elongation factor Tu. AB - In bacterial polypeptide synthesis aminoacyl-tRNA (aa-tRNA) bound to elongation factor Tu (EF-Tu) and GTP is part of a crucial intermediate ribonucleoprotein complex involved in the decoding of messenger RNA. The conformation and topology as well as the affinity of the macromolecules in this ternary aa-tRNA X EF-Tu X GTP complex are of fundamental importance for the nature of the interaction of the complex with the ribosome. The structural elements of aa-tRNA required for interaction with EF-Tu and GTP and the resulting functional implications are presented here. PMID- 3297781 TI - Glucocorticoid antagonists. PMID- 3297783 TI - Some characteristics of hormone (pheromone) processing enzymes in yeast. AB - The KEX2 gene-encoded, membrane-bound Ca2+-dependent thiol endoproteinase, proteinase yscF, responsible for processing of the precursor protein of the sex pheromone alpha-factor of the yeast Saccharomyces cerevisiae was solubilized from the membraneous fraction and partially purified. Gel filtration revealed an apparent Mr of the native protein of around 150,000. Ca2+ concentration for half maximal activity was in the micromolar range and concentration of the substrate Cbz-Tyr-Lys-Arg-4-nitroanilide for half-maximal velocity was 0.05 mM. The enzyme able to cleave basic amino acids from the carboxy-terminus of peptides and probably involved in final maturation of the alpha-factor peptides generated by proteinase yscF is membrane-associated, active at neutral pH and responds strongly to the serine proteinase inhibitor phenyl-methylsulfonyl fluoride as well as to -SH group blocking agents. PMID- 3297782 TI - The fluorescence intensity of the lipophilic probe N-phenyl-1-naphthylamine responds to the oxidation-reduction state of the respiratory chain in everted membrane vesicles of Escherichia coli. 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 metabolic changes in everted inner membrane vesicles from this organism. NPN was bound to the vesicles to produce a steady-state level of fluorescence intensity. Addition of substrate or ATP did not alter the fluorescence. However, following complete removal of oxygen from the medium by oxidation of substrate through the respiratory chain, there was an increase in the fluorescence of NPN. Reoxidation of the components of the respiratory chain by the addition of oxygen, ferricyanide, fumarate or nitrate decreased fluorescence to the steady-state level until the oxidant had been completely reduced. The fluorescence changes were insensitive to the state of energization of the membrane. It is proposed that NPN responds to the state of reduction of components of the respiratory chain either directly by reacting with a component of the chain or indirectly through an effect transmitted to the membrane by a change in the conformation of respiratory chain components. PMID- 3297784 TI - Transcriptional enhancer activity in the variable tandem repeat DNA sequence downstream of the human Ha-ras 1 gene. AB - A short term transfection technique using the chloramphenicol acetyltransferase gene as an assay system has been employed to examine the presence of transcriptional regulatory sequences within the variable tandem repeat (VTR) DNA sequence located downstream of the human Ha-ras1 gene. Here we find that the VTR sequences possess an endogenous enhancer activity of both the normal and the T24 mutant Ha-ras1 gene. PMID- 3297785 TI - GTP-dependent ADP-ribosylation of a 22 kDa protein in the endoplasmic reticulum membrane. AB - Treatment of salt-stripped rough microsomal membranes from pancreas or liver with NAD and cholera toxin in the presence of GTP yields an ADP-ribosylated non ribosomal 22 kDa protein. Membranes containing the modified protein are less active in the co-translational processing of secretory preproteins translated from isolated mRNA in a reticulocyte translation system, but signal peptidase activity is unchanged, suggesting that the 22 kDa protein is involved in the targetting or translocation of secretory proteins at the membrane of the endoplasmic reticulum. PMID- 3297786 TI - Photolabelling of a mitochondrially encoded subunit of NADH dehydrogenase with [3H]dihydrorotenone. AB - Mitochondrial NADH dehydrogenase from bovine heart was photolabelled with the inhibitor [3H]dihydrorotenone. A constituent of the hydrophobic domain of the enzyme of Mr 33,000 was the major site of labelling. The identity of this protein with the mitochondrially encoded ND-1 gene product was established by immunoblotting and immunoprecipitation with an antiserum raised to the expected C terminal sequence of the human ND-1 gene product. PMID- 3297787 TI - Thyroid hormones regulate expression of the neural cell adhesion molecule in adult skeletal muscle. AB - Adult rat skeletal muscle does not express detectable levels of neural cell adhesion molecule (N-CAM) and membrane activity mediated by nerve appears to repress the N-CAM gene. N-CAM expression in skeletal muscle can however be reinduced by hypothyroidism. Thyroidectomised rats re-express N-CAM mRNAs of 5.2 and 2.9 kb and Western blot analysis showed protein bands of 125 and 155 kDa. Immunofluorescence analysis also showed high levels of N-CAM in the sarcolemma. These changes in N-CAM expression could be reversed by treatment of hypothyroid rats with thyroxine. Thus thyroid hormones as well as neural influences appear to control N-CAM expression in skeletal muscle. PMID- 3297788 TI - Increase of urate formation by stimulation of sympathetic hepatic nerves, circulating noradrenaline and glucagon in the perfused rat liver. AB - In the isolated rat liver perfused in situ stimulation of the nerve bundles around the portal vein and the hepatic artery caused an increase of urate formation that was inhibited by the alpha 1-blocker prazosine and the xanthine oxidase inhibitor allopurinol. Moreover, nerve stimulation increased glucose and lactate output and decreased perfusion flow. Infusion of noradrenaline had similar effects. Compared to nerve stimulation infusion of glucagon led to a less pronounced increase of urate formation and a twice as large increase in glucose output but a decrease in lactate release without affecting the flow rate. Insulin had no effect on any of the parameters studied. PMID- 3297789 TI - Studies with the Escherichia coli galactose operon regulatory region carrying a point mutation that simultaneously inactivates the two overlapping promoters. Interactions with RNA polymerase and the cyclic AMP receptor protein. AB - We report in vitro studies of the interactions between purified E. coli RNA polymerase and DNA from the regulatory region of the E. coli galactose operon which carries a point mutation that simultaneously stops transcription initiation at the two normal start points, S1 and S2. In the presence of this point mutation, transcription initiates at a third start point 14/15 bp downstream of S1, showing that inactivation of the two normally active promoters, P1 and P2, unmasks a third weaker promoter, P3. Transcription initiation in the gal operon is normally regulated by the cyclic AMP receptor protein, CRP, that binds to the gal regulatory region and switches transcription from P2 to P1. With the point mutation, CRP binding switches transcription from P3 to P1, although the formation of transcriptionally competent complexes at P1 is very slow. The results are discussed with respect to the mechanism of transcription activation by the CRP factor and the similarities between the regulatory regions of the galactose and lactose operons. PMID- 3297790 TI - Ca2+/calmodulin-dependent protein kinase in Saccharomyces cerevisiae. AB - Ca2+-dependent chromatography of soluble cytosolic proteins on calmodulin Sepharose gave a fraction that exhibited Ca2+- and calmodulin-dependent phosphorylation of several polypeptides, including 60, 56 and 45 kDa species. At 0.2 microM beef calmodulin the phosphorylation was optimal at 3 microM free Ca2+, and at 80 microM free Ca2+ it was half-maximal at about 0.1 microM beef calmodulin. It is concluded that the fraction contains calmodulin-dependent protein kinase(s) which is (are) autophosphorylated or associated with substrates. PMID- 3297791 TI - The processing and secretion of rat serum albumin by oocytes from Xenopus laevis. AB - Microinjection of rat liver mRNA into Xenopus oocytes led to the synthesis of intracellular proalbumin and the secretion of mature albumin into the incubation medium. The ionophore monensin abolished the secretion of albumin but not the processing of the precursor. A variety of protease inhibitors were added to the incubation medium but there was no detectable inhibition of proalbumin cleavage. PMID- 3297792 TI - European Society of Surgical Oncology. PMID- 3297793 TI - Primary non-Hodgkin's lymphoma of the liver. AB - A patient with irresectable primary non-Hodgkin's lymphoma of the liver (histiocytic type, Rappaport classification) is presented. Systemic chemotherapy combined with local irradiation were successful in achieving a disease-free interval in a follow-up of 36 months. Review of the literature disclosed 19 other patients previously reported, with considerable variations in extent of disease at presentation. Criteria for the diagnosis of primary non-Hodgkin's lymphoma are proposed, and 11 patients met these criteria. Hepatic resection is advocated for localized tumour, while systemic chemotherapy and local irradiation in patients with irresectable tumours were found effective in achieving local and systemic control in a mean follow-up of 37 months. PMID- 3297794 TI - Strides in the technology of systems physiology and the art of testing complex hypotheses. AB - Scientific understanding in physics or physiology is based on models or theories devised to describe what is known, within the limits imposed by observation error. Carefully integrated models can be used for prediction, and the inferences assessed via further experiments designed to test the adequacy of the theory summarizing the state of knowledge. This is the systems approach, the basis of theoretical physiology; the models, like those of theoretical physics, should be firmly based on fundamental reproducible observations of a physical or chemical nature, held together with the principles of mathematics, logic, and the conservation of mass and energy. Modern computing power is such that comprehensive models can now be constructed and tested. For this approach data sets should include as many simultaneously obtained items of information of differing sorts as possible to reduce the degrees of freedom in fitting models to data. By taking advantage of large memories and rapid computation, modular construction techniques permit the formulation of multimodels covering more than a single hierarchical level, and thereby allow the investigator to understand the effects of controllers at the molecular level on overall cell or organism behavior. How does this influence the research and teaching practices of physiology? Because the computer also allows a new type of collaboration involving the networking of ideas, data bases, analytical techniques, and experiment designing, investigators in geographically distributed individual laboratories can plan, work, and analyze in concert. The prediction from this socioscientific model is therefore that networked computer-based modeling will serve to coalesce the ideas and observations of enlarging groups of investigators. PMID- 3297795 TI - Modeling and artificial intelligence approaches to enzyme systems. AB - Modeling is a means of formulating and testing complex hypotheses. Useful modeling is now possible with biological laboratory microcomputers with which experimenters feel comfortable. Artificial intelligence (AI) is sufficiently similar to modeling that AI techniques, now becoming usable on microcomputers, are applicable to modeling. Microcomputer and AI applications to physiological system studies with multienzyme models and with kinetic models of isolated enzymes are described. Using an IBM PC microcomputer, we have been able to fit kinetic enzyme models; to extend this process to design kinetic experiments by determining the optimal conditions; and to construct an enzyme (hexokinase) kinetics data base. We have also used a PC to do most of the constructing of complex multienzyme models, initially with small simple BASIC programs; alternative methods with standard spreadsheet or data base programs have been defined. Formulating and solving differential equations in appropriate representational languages, and sensitivity analysis, are soon likely to be feasible with PCs. Much of the modeling process can be stated in terms of AI expert systems, using sets of rules for fitting and evaluating models and designing further experiments. AI techniques also permit critiquing and evaluating the data, experiments, and hypotheses being modeled, and can be extended to supervise the calculations involved. PMID- 3297796 TI - Reducing complexity in metabolic networks: making metabolic meshes manageable. AB - The dynamics of complex systems can be effectively analyzed by judicious use of intrinsic time constants. Order of magnitude estimation based on time constants has been used successfully to examine the dynamic behavior of complicated processes. The main goal of this paper is to introduce this approach to the analysis of complex metabolic systems. Time constants and dynamic modes of motion are defined within the context of well-established linear algebra. The order of magnitude estimation is then introduced into the systemic framework. The main goals of the analysis are: to provide improved understanding of biochemical dynamics and their physiological significance, and to yield reduced dynamic models that are physiologically realistic but tractable for practical use. PMID- 3297797 TI - Drug-receptor relationships, selection of therapeutic goals, and adaptive control of pharmacokinetic systems. AB - Drug-receptor relationships are governed by a host of environmental and physiological influences, which reduce the predictability of the therapeutic response to an administered dose of a drug. The management of patient therapy is aided by models that encompass the broadest aspects of the situation, from the probabilistic aspects of drug administration to the accuracy of the assay procedures for evaluating therapeutic efficacy. PMID- 3297798 TI - Sites of transendothelial liquid transport in lung microcirculation. AB - The widely held concept that the lung transmicrovascular liquid flux occurs primarily across septal vessels has not been experimentally verified. In fact, the recent literature suggests that much if not all of the flux may occur across extraseptal vessels. Support for this idea is available from morphological studies, from segmental filtration data, and from micropuncture data concerning lung microvascular and interstitial pressures. Recent split-drop measurements of lung venular hydraulic conductivity suggest that the surface area of filtration in the lung may be considerably smaller than presumed. The view is advanced that a major portion of lung filtration may occur in the preseptal microcirculation. PMID- 3297799 TI - Transendothelial transfer of macromolecules in vitro. AB - The transendothelial transfer of macromolecules has been difficult to study because of the complexities of the in vivo models. We have developed a model of an endothelium cultured on a permeable support and used it to characterize the transendothelial transfer of albumin. Porcine pulmonary artery endothelial cells form a single layer of cells lining the gelatin-impregnated polycarbonate micropore filters, and the cells develop junctional structures similar to endothelial tight junctions observed in vivo. The monolayer resists the flow of electrical current, and the resistance is sensitive to extracellular calcium concentrations. Albumin transfer across the cultured monolayers was found to be asymmetric, and the rate of transfer from interstitium to lumen was greater than that from lumen to interstitium. The asymmetric transfer occurred against a concentration gradient and was abolished by treating the monolayer with NaCN. Increasing albumin concentrations increased the rate of interstitial to luminal transfer, and the process demonstrated saturation at an interstitial albumin concentration of 725 microM. These data point out the usefulness of the in vitro preparation to identify potentially important aspects of transendothelial transport that would be difficult to detect in vivo. PMID- 3297800 TI - Endothelial monolayer permeability to macromolecules. AB - The barrier function of the endothelial monolayer has not been extensively investigated using the cultured endothelium. The in vitro approach may contribute to a more complete understanding of microvessel wall permeability. Our studies using an in vitro endothelial monolayer system have led us to the following conclusions: the endothelial monolayer is more permeable to small-molecular weight substances than to large molecules; the permeability of albumin is different for endothelial cells derived from different vascular sites (higher for pulmonary venous than pulmonary arterial endothelium); basement membrane components may have a significant role in the permeability of albumin across the endothelium; control of endothelial monolayer permeability is determined not only by the characteristics of the macromolecule (i.e., size and charge) but also by the shape of the endothelial cells and the size of interendothelial space. PMID- 3297802 TI - Formation of a barrier by brain microvessel endothelial cells in culture. AB - Endothelial cells (EC) isolated from bovine brain microvessels produce a continuous monolayer when grown in primary culture. The EC are joined together by tight junctions and contain few pinocytotic vesicles. Horseradish peroxidase (HRP) is unable to penetrate this in vitro barrier system. Exposure of the cells to 1.6 M arabinose produces a reversible separation of the tight junctions with penetration of HRP across the monolayer in a pattern similar to that observed in animals after infusion of hyperosmotic solutions into the carotid artery. The behavior of brain microvascular cells in culture suggest that they retain properties important to the formation of the blood-brain barrier. PMID- 3297801 TI - Correlation of permeability with the structure of the endothelial layer of pulmonary artery intimal explants. AB - Changes in vascular permeability are associated with structural damage to endothelial cells. These functional and structural changes can be produced experimentally and examined by using intimal explants from bovine pulmonary artery. Correlation of functional with structural changes allows us to dissect the mechanisms responsible for endothelial damage. We have shown that incubation of intimal explants with histamine causes transient formation of interendothelial dilatations and an increased rate of equilibration of tritiated water and [14C]sucrose across the intimal explant. Exposure to endotoxin also causes interendothelial dilatations but the endothelial damage is more severe than that with histamine, and in vivo experiments show a more prolonged increase in pulmonary vascular permeability. Leukocyte migration has also been suggested to result in a decreased barrier function of the endothelial layer. Experiments with the endothelial layer of intimal explants and separated bovine leukocytes suggest that transendothelial migration may depend on the chemotactic stimulus. Neither granulocyte migration toward zymosan-activated plasma nor lymphocyte migration toward lymphocyte-conditioned medium (RPMI in which lymphocytes were incubated with concanavalin A) leads to detectable increases in explant permeability, but granulocyte migration toward lymphocyte-conditioned medium does result in increased equilibration of [14C]sucrose. Finally, a theoretical model has been used to examine the permeability changes seen for the intimal explants exposed to histamine. The model consists of two compartments with radioactive tracers diffusing across a filter of known permeability. Such a model gives good agreement with data obtained in intact sheep, indicating that mathematical models allow quantitative estimates of barrier function in intimal explants that compare favorably with in vivo data. PMID- 3297803 TI - Highly sensitive immunological techniques for quantitating membrane antigens. PMID- 3297805 TI - Polyclonal and monoclonal antibodies as probes of rat hepatic cytochrome P-450 isozymes. AB - Cytochrome P-450 is the terminal oxidase of an electron transport system that is responsible for the oxidative metabolism of a large variety of endogenous and exogenous compounds. This broad substrate selectivity is caused by multiple isozymes of cytochrome P-450 and the wide substrate selectivity of many of these isozymes. We have isolated 11 isozymes of cytochrome P-450 from the livers of rats (cytochromes P-450a-P-450k). We have found both polyclonal and monoclonal antibodies increasingly useful to distinguish among these isozymes and to quantitate enzyme levels in liver microsomal preparations where as many as 15 or more cytochrome P-450 isozymes are present. Several of these isozymes show considerable immunochemical relatedness to each other, and operationally they can be grouped into families of immunochemically related isozymes that include cytochromes P-450b and P-450e in one family, cytochromes P-450c and P-450d in another, and cytochromes P-450f-P-450i, and P-450k in a third family. Immunoquantitation of some of these isozymes has revealed dramatic increases of over 50-fold in the levels of certain of these isozymes when exogenous compounds are administered to rats. PMID- 3297804 TI - Immunoassay of acetylcholinesterase. AB - There is a twofold rationale for assaying acetylcholinesterase (AChE) (EC 3.1.1.7) immunologically, rather than by conventional activity-based methods: to measure the amount of enzyme protein in samples that may contain AChE of uncertain intrinsic activity; to bypass cumbersome procedures for determining the individual molecular forms of the enzyme. We have developed an immunodisplacement assay and a two-site immunoassay for AChE that are sensitive enough to measure the enzyme in samples of biological interest (assay thresholds of 10 and 0.1 ng, respectively). We have also used immunofluorescence with quantitative cell sorting as a means of analyzing AChE immunoreactivity in normal and abnormal human red blood cells. The introduction of form-specific immunoassays awaits the identification of suitably selective antibodies. PMID- 3297806 TI - [Treatment of diabetes mellitus]. PMID- 3297807 TI - Donor eggs: their application in modern reproductive technologies. PMID- 3297808 TI - Human corpus luteum: immunocytochemical localization of epidermal growth factor. AB - Six corpora lutea (day 17 to day 25) of the menstrual cycle and four ovarian stromal tissues from seven cycling women were examined for the presence of epidermal growth factor (EGF) by immunocytochemistry with the use of the indirect peroxidase-antiperoxidase (PAP) procedure. After tissue sections of 4 micron were mounted, endogenous peroxidases were removed with hydrogen peroxide, and the sections were incubated for 1 hour at room temperature followed by 16 hours at 4 degrees C with a highly specific antisera for mouse EGF (mEGF), nonimmunized normal rabbit serum, or antiserum preadsorbed with excess antigen. After the reaction with the second antibody (goat antirabbit IgG) for 1 hour at room temperature, the peptide was localized by use of PAP and 3.3'-diaminobenzidine as the chromogen. EGF could be localized in the luteal cells of five corpora lutea (day 17 to day 25) but not in a corpus luteum of day 22 and all ovarian stromal tissue examined. The localization of immunoreactive EGF in the human corpus luteum demonstrates directly for the first time the presence of this growth promoting peptide in this tissue, which suggests its local production. PMID- 3297809 TI - The effect of an IgA1 protease on immunoglobulins bound to the sperm surface and sperm cervical mucus penetrating ability. AB - A major site of impaired fertility in men with autoimmunity to sperm rests at the level of restricted sperm entry and motion within cervical mucus. We studied the effects of a protease derived from Neisseria gonorrhoeae, whose substrate specificity is limited to human IgA1, on the ability of antibody-bound sperm to penetrate human cervical mucus in vitro. IgA on the sperm surface, but not IgG, was degraded by IgA1 protease. A correlation was seen between the levels of IgA bound relative to IgG and the improvement in sperm cervical mucus penetrating ability after IgA1 protease exposure. These results provide evidence that antisperm autoantibodies of both IgA and IgG classes impair the ability of spermatozoa to populate the female reproductive tract. They implicate the Fc region of the immunoglobulin molecule in mediating this effect and offer the potential to restore male fertility by treating antibody-bound sperm in vitro with immunoglobulin-directed bacterial proteases, before insemination. PMID- 3297810 TI - Tamoxifen citrate therapy in male infertility. AB - A prospective, randomized, double-blind study with crossover, using tamoxifen (TAM) (Nolvadex, ici Pharma, Missisauga, Canada) 20 mg/day and placebo (p) for 6 months each, was conducted in 16 infertile men with idiopathic oligozoospermia. Baseline sperm count was 17.092 +/- 3.09 (10(6)/ml). Hormonal profile was performed and included follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), thyroid-stimulating hormone (TSH), and luteinizing hormone-releasing hormone (LH-RH) stimulation tests. The sperm analysis and hormonal profile were repeated at 6 and 12 months of the study. A sperm penetration assay (SPA) was performed on zona-free hamster egg. Compared with the placebo group, the TAM group showed a significant increase in plasma FSH, LH, E2, and T levels (P less than 0.001), but not in PRL and TSH levels. However, LH-RH stimulation tests and SPA were found to be comparable in the two treatment groups, and there was no significant effect on sperm analysis. Tamoxifen appeared to be no more effective than the placebo in the treatment of idiopathic oligozoospermia. PMID- 3297811 TI - The stability of synthetic gonadotropin-releasing hormone in solution. AB - The stability of GnRH stored in solution under different conditions was assessed employing both immunoassay and bioassay techniques. No appreciable loss of activity was encountered after 4 weeks of storage at either 4 degrees C or room temperature. PMID- 3297812 TI - Pulsatile intravenous gonadotropin-releasing hormone for ovulation-induction in infertile women. I. Safety and effectiveness with outpatient therapy. AB - Pulsatile intravenous gonadotropin-releasing hormone (IV-GnRH) was used in 36 infertile patients with primary amenorrhea (n = 5), secondary amenorrhea due to hypothalamic chronic anovulation (HCA) (n = 22), hyperprolactinemia (n = 1) or polycystic ovary syndrome (PCOS) (n = 5), and oligomenorrhea (n = 3). Treatment was commonly initiated in the hospital but was then continued outside, with patients and local physicians accepting responsibility for maintaining IV-GnRH delivery systems. Twenty-eight of 113 treatment cycles (24.8%) resulted in pregnancy, with four spontaneous abortions (14.3%) and four twin pregnancies (16.7%) among 24 births. Probability of pregnancy per treatment cycle was significantly higher for primary amenorrhea (0.30) and for HCA (0.33) than for PCOS (0.07; P less than 0.05) and for oligomenorrhea (no conceptions; P = 0.01). Ovulatory cycles were not achieved in five patients (primary amenorrhea, n = 1; PCOS, n = 3; oligomenorrhea, n = 1). There were no serious complications; six patients recorded eight febrile episodes, which responded quickly to antibiotic therapy and cannula change. The authors conclude that outpatient IV-GnRH is safe, practical, and effective for follicular stimulation and ovulation induction in women presumed to have GnRH deficiency and in whom clomiphene therapy fails, and that less intensive monitoring is needed compared with gonadotropin ovulation induction therapy. PMID- 3297813 TI - Androgen and insulin response to an oral glucose challenge in hyperandrogenic women. AB - To further investigate the relationship between insulin and androgen secretion in hyperandrogenic women, the authors measured the response of serum insulin and androgen concentrations to an 8 A.M. oral glucose tolerance test (OGTT) in ten hyperandrogenic (HA) women and seven midfollicular phase control subjects. Significant positive correlations were demonstrated between fasting serum insulin concentration and both androstenedione (delta 4A) and testosterone (T) concentrations, which were independent of body mass index (kg/m2). A strong negative correlation was demonstrated between fasting insulin and dehydroepiandrosterone sulfate (DHEAS) levels within the HA group (r = -0.84, P = 0.003). Significant positive correlations were also demonstrated between the cumulative sum insulin response during OGTT and the percent change from fasting baseline to 3 hours in serum delta 4A (r = 0.65, P = 0.006), T (r = 0.51, P = 0.033), and dihydrotestosterone (DHT) concentrations (r = 0.75, P less than 0.001). Our data suggests that abnormalities in insulin secretion are common in HA women and that there is a strong correlation between changes in serum concentrations of insulin and androgens during an OGTT. PMID- 3297814 TI - Patients with pleural air leaks. PMID- 3297815 TI - Differences in the prolongation of skin graft survival by pretransplant blood injections in the model system of congenic lines of chickens. AB - The effect of pretransplant donor-specific blood injections on the survival of subsequent skin grafts was studied in the group of congenic chicken lines (CB, CC, CB.R1, CC.R1, CC.R2) disparate at the major histocompatibility complex (B complex) haplotype or at its individual regions (B-F and B-G). Different combinations of blood and skin donors and recipients were tested that were disparate either at the B-F region or at combined B-F and B-G regions. Significant differences between individual lines were found. In CC (B4) recipients, survival times of CB.R1 (B12r1, B-F disparity) and CB (B12, B-F + B-G disparity) skin grafts were prolonged by injections of CB.R1 blood, but not of CB blood. In CB recipients, the survival of CC.R1 (B4r1, B-F disparity) and CC (B4, B-F + B-G disparity) skin grafts was also prolonged by pretreatment with CC.R1 blood, albeit less prolonged than in CC recipients. The recipients from the recombinant lines CB.R1 and CC.R1 responded differently. In CB.R1 recipients, the survival of only CC.R1 grafts was prolonged by the injection of CC.R1 blood (B-F + B-G disparity). In CC.R1 recipients, differences between pretreatment with CB blood (B-F disparity) and CB.R1 blood (B-F + B-G disparity) and between survival times of CB and CB.R1 skin grafts were not found. The observed differences in graft survival may be due to the strength of antigenic difference between B-F4 and B-F12 products and to the different cooperation of B-F and B-G region antigens in the recombinant haplotypes. PMID- 3297817 TI - [Skillful dental technic. The way to the "Golden Parallelometer". 4]. PMID- 3297816 TI - [Hi-Ceram methods. Metal-free crowns on a ceramic framework]. PMID- 3297818 TI - AIDS and the dental team. PMID- 3297819 TI - Computers and dental health education--a trial project at the Liverpool Garden Festival. PMID- 3297820 TI - [The history of dermatology. Historical aspects of phototherapy. Hans Axmann (1862-1934) on his 125th birthday]. PMID- 3297821 TI - Resin bonded bridges: current techniques. PMID- 3297822 TI - Dicor castable ceramic veneers. PMID- 3297823 TI - Across disciplines: from orthodontics to endodontics. PMID- 3297825 TI - Predictable retention for removable partial dentures. PMID- 3297824 TI - The ELSAA: uses, design and a method of construction. PMID- 3297826 TI - Partial dentures with free-end saddles: the altered cast techniques. PMID- 3297828 TI - The effect of biotic and abiotic implants on the recognition of Blatta orientalis cuticular transplants by the cockroach Periplaneta americana. AB - The immune system of the American cockroach, Periplaneta americana, was activated to recognise as "non self" xenogeneic tissue normally treated as "self". Activation was accomplished by injecting into the insect haemocoele material known to elicit an encapsulation response such as Blaberus craniifer cuticular tissue and 6B-Sepharose beads. In these insects, cuticular skingrafts from Blatta orientalis, a closely related species of cockroach, were rejected by more than half of the recipients. There was no rejection of skingrafts by naive insects showing that the immune system of the cockroach had been triggered non specifically to recognise tissue previously treated as "self". PMID- 3297827 TI - Cells and molecules in molluscan immunology. PMID- 3297829 TI - Tissue changes induced by intraocular lenses. A histopathologic study. AB - The histopathologic findings in autopsy and surgically enucleated eyes are described. Tissue atrophy and inflammatory reaction can be demonstrated in every eye examined in our laboratory. Scanning electron microscopy was used to detect tissue formation on intraoccular lenses. PMID- 3297830 TI - Complications after modern filter operations in glaucoma. AB - As long as the indications and limitations of laser trabeculoplasty have not yet been established by follow-up over several years, conventional surgical filter operation will not be superfluous. The reduction of the complications brought about by introduction of the scleral flap technique is described. Apart from cicatricial obliteration of the filtering zone, bulbar hypotension due to overfiltration as well as to external fistula and above all the resulting ciliary body-choroid detachment still occurs after trephination with the scleral flap (goniotrephination, trabeculectomy). Attention is drawn to the tension of the scleral flap adapted to the normalized intraocular pressure and reliable preclusion of an external fistula by perfusion test at the end of the operation. The membrane formation probably deriving from the internal Tenon's capsule which leads to a 'pseudofiltering bleb' is discussed as a rare complication (1.5%) which is of basic interest. PMID- 3297831 TI - Relationships between insulin secretion, insulin metabolism and insulin resistance in mild glucose intolerance. AB - The aim of this study was to evaluate whether the correlation between insulin resistance and peripheral hyperinsulinaemia existing in mild glucose intolerance corresponds to a relationship between insulin resistance and insulin overproduction by the pancreas. In addition, the possibility that insulin resistance is related to insulin metabolism was examined. Twenty five subjects with fasting normoglycaemia and an abnormal glucose response to the oral glucose tolerance test (OGTT) were studied. Insulin secretion by the pancreas was estimated by means of fasting C-peptide levels in peripheral blood. Insulin resistance was estimated by the rate of glucose disappearance from plasma after i.v. insulin injection. Insulin metabolism was estimated indirectly by the C peptide: insulin molar ratio. A negative correlation was found between the glucose disappearance rate from plasma after i.v. insulin injection and fasting insulin levels (r = -0.677, p less than 0.001), but not fasting C-peptide concentrations (r = -0.164, p = NS). Glucose disappearance rate from plasma correlated positively with the C-peptide: insulin molar ratio (r = 0.626, p less than 0.001). These results suggest that in mild glucose intolerance insulin resistance and insulin secretion by the pancreas are not related phenomena, and that the defect responsible for insulin resistance might also be implicated in the impaired insulin metabolism. PMID- 3297832 TI - Identification of insulin receptors in epithelial cells from duodenum, jejunum, ileum, caecum, colon and rectum in the rat. AB - Specific insulin binding was demonstrated in isolated epithelial cells of rat intestine, from the duodenum to the rectum. In every segment tested, insulin binding exhibited similar properties relating to kinetics and specificity and could be interpreted in terms of two populations of receptors possessing different affinities and binding capacities. Insulin receptors were unequally distributed along the intestinal tract, suggesting that the hormone may have varying importance at different points along the intestinal axis. These observations together with previous data on insulin regulation of a number of intestinal epithelial activities suggest that the pancreatic hormone may play an important role in gut physiology from the duodenum to the rectum. PMID- 3297834 TI - [The cephalic phase of insulin secretion in man]. AB - In human subjects, a reflex secretion of insulin has been observed following the stimulation of cephalic sensory receptors by food. In animals, such a response is recognised and appears to contribute to energy regulation. In man, its amplitude is very variable and "negative responses" have been reported. Negative responses can be interpreted as, the descending phase of the spontaneous oscillations of insulinaemia which have been described in animals and humans. This observation shows that spontaneous oscillations should be taken into consideration when evaluating or describing the responses to meal stimulation. It thus becomes possible to attribute a significant part of the variability to the subjects' individual sensitivity and to the hedonic value of meals. The response can be conditioned to arbitrary stimuli and then be evoked without exposure to food. Its role in energy regulation has not been demonstrated in man, although certain studies suggest that it may augment the metabolic rate. Large responses are associated with large, palatable meals, but it is not known whether the insulin response is merely a reflection of the sensory characteristics of food or whether it contributes to the stimulation to eat. PMID- 3297833 TI - Lack of influence of residual beta-cell function on the glucagon and pancreatic polypeptide secretion in type I (insulin-dependent) diabetic patients. PMID- 3297835 TI - [Insulin and physical exercise]. AB - Secretion of some pituitary hormones and sympatho-adrenal activity increase very early during exercise. Sympathetic activation is of major importance in cardiovascular adaptation, thermoregulation, etc. Furthermore among the hormonal consequences of such activation those related to insulin are capital. In animal and human subjects basal insulin level decrease during prolonged and progressive exercise. With habitual exercise, both basal and stimulated insulin levels are reduced. It seems that the reduced basal level could be due to alpha-adrenergic inhibition of the islets of Langerhans, while the reduced stimulated response could be the consequence of increased clearance. In trained subjects, in spite of reduced insulin secretion tolerance to glucose is normal due to increased sensitivity to insulin. Sensitivity to insulin is particularly enhanced at the muscular tissue level; it is accompanied by increased hexokinase and glycogen synthetase activity. As a consequence glucose uptake remains optimal at the muscular level. In the liver, both insulin sensitivity and glucokinase activity are reduced, so that glucose is spared and the muscular glycogen store can be restored. At the adipocyte level, metabolic adaptations are such that triglyceride turnover is greatly increased, favouring fuel supply and resaturation of stores. PMID- 3297836 TI - Investigation of insulin resistance associated with Werner's syndrome. AB - The tissue sensitivity to insulin and the metabolic clearance rate of insulin were evaluated in a new case of Werner's syndrome, by means of the euglycemic clamp technique using an artificial endocrine pancreas. The possible contribution of pancreatic insulin secretion and of reduced hepatic insulin breakdown to the peripheral hyperinsulinism was also studied by simultaneous determination of C peptide and insulin levels and by analysis of the C-peptide/insulin molar ratio. The data obtained are consistent with the presence of marked insulin resistance and of reduced metabolic clearance rate of insulin in our patient, confirming what has been observed previously using other techniques. The finding of a reduced C-peptide to insulin ratio during the intravenous glucose tolerance test suggests that hepatic extraction of insulin could also be altered in Werner's syndrome, as found in several hyperinsulinism conditions, therefore contributing to peripheral hyperinsulinism. PMID- 3297837 TI - Effect of dietary cholesterol on the release of prostacyclin from the mesenteric vascular bed in diabetic rat. AB - Streptozotocin-induced diabetic female rats and age-matched control rats were fed a regular chow with or without the addition of 1% cholesterol in the diet. The release of 6-keto-PGF1 alpha, a prostacyclin metabolite, from the mesenteric vascular bed was significantly increased in diabetic rats. The production of PGI2 in diabetic rats was significantly reduced whereas that in the control was not affected by cholesterol feeding. The examination of the fatty acid composition of phospholipids from the mesenteric vascular bed indicated that proportions of stearic (18:0), linoleic (18:2n-6) and dihomo-gamma-linolenic (20:3n-6) acids were higher whereas those of oleic (18:1n-9) was lower in diabetic rats than those in the controls. Cholesterol feeding had no significant effect on the levels of arachidonic acid (20:4n-6) in the controls but it significantly decreased those in diabetic rats. It is suggested that cholesterol feeding lowers the release of PGI2 from the mesenteric vascular bed possibly because of a reduced level of arachidonic acid, the major precursor for prostaglandin synthesis. This could be due to an impairment of delta-5 desaturase. PMID- 3297838 TI - Circadian eating and drinking habits in alloxan diabetic rats. AB - Eating and drinking habits were studied in control and alloxan diabetic rats of up to 12 months' duration of diabetes, with emphasis on the hour-to-hour circadian pattern and the relationship between eating and drinking. In contrast to previous studies food and water intake started to increase immediately after alloxan injection possibly because of avoidance of alloxan induced acute renal insufficiency by kidney protection during alloxan injection. A biphasic circadian pattern of food and water intake was seen in both diabetic and control rats, but day-time eating and drinking were practically absent in controls in contrast to diabetic rats. The diabetic animals' meals and drinking bouts were significantly longer than the controls and the frequency of drinking bouts, but not of meals, was increased. Drinking was mainly associated with meals in both diabetic and control rats. Insulin treatment in diabetic rats partly normalized daily food and water intake. PMID- 3297839 TI - European Association of Gynaecologists and Obstetricians (EAGO) PMID- 3297840 TI - The influence of signal loss on the comparison between computer analyses of the fetal heart rate in labour using pulsed Doppler ultrasound (with autocorrelation) and simultaneous scalp electrocardiogram. AB - A comparison between the computer analyses of records of the fetal heart rate (FHR) obtained simultaneously by pulsed doppler ultrasound with autocorrelation and by fetal scalp electrocardiogram (ECG) in labour showed no statistical differences when signal loss was less than 2%. Increasing signal loss, due to maternal movement, correlated significantly with greater differences between ultrasound and ECG values for mean FHR variation (r = 0.58, p less than 0.005). With higher signal loss (average 15.6%) the mean FHR variation measured by ultrasound was significantly lower than that measured by ECG (T = 3.83, p less than 0.005) but this reduction was not of clinical significance. PMID- 3297841 TI - Epidemiology of vaginal Candida infection: significance of numbers of vaginal yeasts and their biotypes. AB - The prevalence, quantity and biotypes of vaginal yeasts were determined for 1082 randomly selected nonpregnant patients attending two genitourinary medicine clinics. The overall yeast prevalence was 22.1% with a geometric mean of 40 and a median of 75 yeast colonies per positive isolate (on 5-cm Petri dishes). There was no statistically significant variation in prevalence, quantity or biotype of yeasts with the patients' age, season of the year, stage of the menstrual cycle, recent antibiotic history, contraceptive use or main diagnosis (excluding candidosis). A clinical score for Candida infection, based on symptoms of pruritus and signs of Candida vulvovaginitis, showed significant variation with the prevalence and quantity of yeast isolates. Unequivocal clinical evidence of candidosis was strongly associated with high concentrations of vaginal yeasts. There was also some association between certain groups of Candida albicans biotypes and the clinical score. These observations reemphasize the need for consideration of both clinical and mycological factors in establishing a diagnosis of vulvovaginal Candida infection. It is suggested that isolation of fewer than 10 yeast colonies from a vaginal swab is usually unlikely to indicate an infection requiring treatment. PMID- 3297843 TI - On the heterogeneity of serum albumin. PMID- 3297842 TI - Evidence that protein kinase C is involved in regulating glucose transport in the adipocyte. AB - The role of protein kinase C in the mechanism of stimulation of glucose transport in rat adipocytes was investigated. Glucose transport was stimulated by dioleoylglycerol (DOG), tetradecanoyl phorbol acetate (TPA) and phospholipase C (PLC). Agents that inhibit protein kinase C (polymyxin B, gossypol and quercitin) also inhibited glucose transport that had been stimulated by DOG, TPA, PLC and insulin. PMID- 3297844 TI - Multifunctional activities of yeast glutathione reductase. AB - Yeast glutathione reductase exists in a single molecular form which exhibits preferred NADPH and weak NADH linked multifunctional activities. Kinetic parameters for the NADPH and NADH linked reductase, transhydrogenase, electron transferase and diaphorase reactions have been determined. The functional preference for the NADPH linked reductase reaction is kinetically related to the high catalytic efficiency and low dissociation constants for substrates. NADP+ and NAD+ may interact with two different sites or different kinetic forms of the enzyme. The active site disulfide and histidine are required for the reductase activity but are not essential to the transhydrogenase, electron transferase and diaphorase activities. Amidation of carboxyl groups and Co(II) chelation of glutathione reductase facilitate the electron transferase reaction presumably by encouraging the formation of an anionic flavosemiquinone. PMID- 3297846 TI - Some observations on the inhibition and activation of a thermophilic protease. AB - The activity of Caldolysin, the extracellular protease from the extreme thermophile Thermus aquaticus strain T351, was reduced in the presence of high protein concentrations. The absence of this effect after enzyme immobilization, or when using chromogenic substrates, suggests that a steric mechanism is involved. The apparent activation of caldolysin under certain conditions was shown to be related to both temperature and the ionic strength of the aqueous environment. The effects on activity, substrate affinity and thermostability of chemical modification with various reagents are also discussed. PMID- 3297845 TI - Glucose kinetics in the oestrogen-treated male chicken (Gallus domesticus), measured after administration of [6-3H]glucose and [U-14C]glucose in vivo. AB - Male chickens (Gallus domesticus) were treated with 17 beta-oestradiol then injected with a mixture of [6-3H]glucose and [U-14C]glucose. Subsequently, blood samples were taken to determine plasma lipid levels and several parameters of glucose metabolism, including entry rate, carbon recycling, mean transit time, the total body glucose mass, the mass of the sampling pool and the rate of outflow from this pool. Oestrogen-treated birds exhibited typical hyperlipidaemia, with significantly elevated plasma levels of triacylglyerol and nonesterified fatty acids. Oestrogen administration significantly decreased the glucose entry rate, the total body glucose mass and the rate of outflow from the sampling pool. PMID- 3297848 TI - In vitro demonstration of a TSH-specific growth desensitising mechanism in rat thyroid epithelium. AB - Sustained elevation of serum thyrotropin (TSH) induces an initial proliferation of rat thyroid follicular cells, leading to goitre formation followed by a 'plateau phase' in which the growth response to TSH is lost. To investigate this growth desensitisation mechanism, we have compared the sensitivity to growth factors of normal and 'plateau phase' rat thyroid epithelium in primary follicle cultures. Insulin at supraphysiological concentrations stimulates growth (DNA synthesis) in both cell types. TSH at a concentration found in 'plateau phase' animals (0.1 mU/ml) is maximally growth stimulatory for normal, but not significantly stimulatory for 'plateau' epithelium. At much higher concentrations however (greater than or equal to mU/ml) an equal response is obtained from both. We conclude that the growth desensitising mechanism is intrinsic to the follicular cell, is at least partly specific to TSH, and is effective only over the range of TSH concentrations found in vivo. PMID- 3297847 TI - Control of human thyroid follicular cell proliferation in suspension and monolayer culture. AB - We have used both suspension and monolayer cultures to investigate the in vitro control of normal human thyroid follicular cell proliferation as assessed by both [3H]TdR incorporation and autoradiography. In suspension cultures, whilst TSH alone produced no effect, inclusion of two permissive factors, namely a supraphysiological concentration of insulin (80 micrograms/ml) and a low concentration of FCS (1%) (which, in the absence of TSH, gave only a weak proliferative response) permitted a highly significant response to TSH at 0.1 mU/ml. A higher concentration of TSH (10 mU/ml) resulted in a reduced response. In monolayer cultures in contrast, insulin and FCS were themselves highly growth stimulatory, with no super-added effect on addition of TSH. Our data indicate that suspension culture provides a more valid in vitro model for the investigation of growth factor control of normal and neoplastic human thyroid epithelium. PMID- 3297849 TI - A monoclonal antibody against a synthetic fragment of bombyxin (4K prothoracicotropic hormone) from the silkmoth, Bombyx mori: characterization and immunohistochemistry. AB - Monoclonal antibodies were produced by immunizing mice with a synthetic decapeptide corresponding to the N-terminal portion of the A-chain of bombyxin, a peptide from Bombyx mori which activates the prothoracic glands of the saturniid moth, Samia cynthia ricini, and was previously called 4K-PTTH. We obtained a hybridoma clone secreting an antibody that recognized specifically bombyxin after treatments for disulfide-bond reduction but did not when untreated. Immunoblotting studies demonstrated the presence of highly heterogeneous immunoreactive components in Bombyx brain homogenates. Immunohistochemistry using this antibody indicated that bombyxin was produced by four pairs of mid-dorsal neurosecretory cells of the brain and transferred to and released from the corpora allata of Bombyx. PMID- 3297851 TI - A change of the hepatocyte population is responsible for the progressive increase of vitellogenin synthetic capacity at and after metamorphosis of Xenopus laevis. AB - Synthesis of the egg yolk precursor protein, vitellogenin, can be induced in adult, but not in larval, amphibian hepatocytes by estrogen treatment. The transition process for this inducibility of hepatocytes during development of Xenopus laevis was examined, using primary cultures of hepatocytes. This was found to occur at about the metamorphic climax of stage 62, although the level of vitellogenin production was very limited at this stage. This low level seemed due neither to insufficient estradiol-17 beta nor to high estrogen-degrading activity. The level of synthesis gradually increased following metamorphosis. Immunohistochemical analysis showed that fewer than 5% of the hepatocytes at stage 62 could be stained with antivitellogenin antibody and that the stained cell fraction subsequently increased gradually for several months after metamorphosis. These findings indicate that adult-type cells capable of synthesizing vitellogenin appear at metamorphosis and then expand their population in the liver during postmetamorphic maturation. PMID- 3297850 TI - A laminin substrate promotes myogenesis in rat skeletal muscle cultures: analysis of replication and development using antidesmin and anti-BrdUrd monoclonal antibodies. AB - Cells from newborn rat hindlimb show greatly enhanced myogenicity when grown on surfaces coated with poly-L-lysine followed by laminin (PLL/Lam) instead of the collagens routinely used. Coating with poly-L-lysine (PLL) alone or with PLL followed by collagen does not enhance myogenicity. Both myogenic and nonmyogenic cells, as distinguished by a monoclonal antibody specific for desmin, attach equally well to collagen- and laminin-coated surfaces, but there is a two- to five-fold increase in the number of myogenic cells on PLL/Lam by 72 hr, followed by increased myotube formation. To determine whether this increase in myogenic cells was a consequence of a selective increase in proliferation on PLL/Lam, incorporation of 5-bromodeoxyuridine into DNA followed by labeling with anti BrdUrd antibody was used as an index of cell proliferation. The results indicate that desmin is expressed in replicating rat myoblasts, and that replication of myogenic cells is greatly enhanced on laminin compared to collagen. The rate of replication of nonmyogenic cells is the same on both substrates. Addition of 10 micrograms/ml laminin to the medium of cells seeded on PLL or collagen has no effect on myogenicity. We conclude that a laminin substrate enhances skeletal myogenesis in vitro by promoting selectively the replication of myoblasts. Cultures prepared from fetuses at 17 and 19 days gestation also show enhanced myogenicity when grown on PLL/Lam, while those from 15-day fetuses do not. Growth and development of fetal myoblasts on collagen were very poor, whereas myoblasts from the newborn rat do proliferate and differentiate on this substrate. Thus myogenic cells at different stages of fetal and neonatal development may require and respond to different extracellular environments. Myotube formation in the E63 clone of L8 rat myoblasts is inhibited by PLL/Lam. PMID- 3297852 TI - Developmental expression and spatial distribution of dopa decarboxylase in Drosophila. AB - Regulation of the dopa decarboxylase gene of Drosophila has been studied at the genetic and molecular levels. Here we report a direct assay for the tissue and temporal regulation of Ddc. A dopa decarboxylase (DDC) peptide was obtained by bacterial expression of a portion of the DDC gene in a pUC plasmid. Antisera raised against this biologically purified DDC peptide react specifically with Drosophila DDC in histological preparations and protein blots. The levels of DDC cross-reacting material closely parallel the levels of enzyme activity observed during development, indicating that DDC is degraded during periods of declining activity. We find that DDC is expressed in only two tissues, namely, the epidermis and the nervous system of the larva and adult. Epidermal DDC was found within the epidermal cells and was not detected in the overlying cuticle. DDC containing neurons were observed in the central as well as in the visceral nervous system. Paired and unpaired midline neurons in the ventral ganglia are arranged in a segmental pattern. A subset of the DDC-positive neurons appears to correlate with the serotonin-positive neurons suggesting that the others are producing only dopamine. We find that the DDC activity associated with the proventriculus and ovary is due to the presence of DDC in the stomatogastric and caudal system neurons specifically associated with those structures. PMID- 3297853 TI - Glycolipid core structure switching from globo- to lacto- and ganglio-series during retinoic acid-induced differentiation of TERA-2-derived human embryonal carcinoma cells. AB - We have analyzed the glycolipid markers of a recently cloned human embryonal carcinoma (EC) cell line, NTERA-2, which differentiates extensively into a variety of somatic cell types when exposed to retinoic acid. These tumor cells provide a model system that can be used to study the ontogeny of glycolipid diversity during human embryonic development. Glycolipid antigens were identified by cell surface immunofluorescence and thin-layer chromatography immunostaining using a comprehensive set of anticarbohydrate monoclonal antibodies. Undifferentiated NTERA-2 cells were found to express predominantly globo-series glycolipids, including Gb3, Gb5 (IV3GalGb4), globo-ganglioside (IV3NeuAc alpha 2- --3GalGb4), globo-H (IV3Fuc alpha 1----2GalGb4), and globo-A (IV3GalNAc alpha 1-- -3[Fuc alpha 1----2]GalGb4). When NTERA-2 cells were induced to differentiate by culturing in the presence of 10(-5) M retinoic acid, a remarkable shift of cellular glycolipids from globo-series to lacto- and ganglio-series was observed: Globo-series structures declined, particularly during the period 7-20 days after first exposure to retinoic acid, while lacto-series structures, including fucosyl alpha 1----3 type 2 chain (Lex) and sialosyl type 2 chain, and ganglio-series structures, including GM3, GD3, 9-O-acetyl-GD3, GM2, GD2, and GT3, increased. The presence of globo-A and globo-H as the major ABH blood group antigens in undifferentiated NTERA-2 cells suggests that globo-series blood group antigens are embryonic antigens, synthesis of which switches to lacto-series during human development. Two-color immunofluorescence analysis indicated preferential expression of several ganglio- and lacto-series antigens on different subsets of differentiated cells and permitted the relationship of these subsets to the development of neurons in NTERA-2 cultures to be determined. The results suggest that glycosyltransferase, particularly those involved in controlling glycoconjugate core structure assembly, are key enzymes regulated during the differentiation of human EC cells and, by implication, during human embryogenesis. PMID- 3297854 TI - Specific cell surface labels in the visual centers of Xenopus laevis tadpole identified using monoclonal antibodies. AB - Monoclonal antibodies (MAbs) against the optic tectum of Xenopus tadpoles were generated and screened by the immunofluorescent staining of frozen sections of tadpole brains. MAb-A5 stains the 8th and 9th plexiform layers of the optic tectum, whereas MAb-B2 stains all but the eighth and ninth plexiform layers of the optic tectum. MAb-A5 antigen is also detectable in the nucleus of Belonci, the corpus geniculatum thalamicum, the pretectal area, and the basal optic nucleus, all targets of the optic nerve, but is not detectable in the optic nerve or the optic tract. On the other hand, MAb-B2 does not stain any of these visual centers, though many fibers surrounding them are stained. Eye-enucleation experiments showed that MAb-A5 antigen is expressed in the optic tectum even when it is not innervated by optic nerves. Staining of viable brains with these MAbs indicates that these antigens are cell surface molecules. Immunoadsorption followed by SDS-PAGE suggests that proteins are constituents of these antigens. The MAb-A5 antigen in the diencephalon and the mesencephalon is not detectable at stage 35/36, but is detectable at stage 39 when the optic nerves begin to innervate the optic tectum. The spatial as well as the temporal patterns of the expression of the MAb-A5 antigen suggest that this molecule may be involved in the target recognition of optic nerve fibers. PMID- 3297855 TI - An appreciation. Dame Honor B. Fell, F.R.S. (1900-1986). PMID- 3297856 TI - Developmental expression of a cell-surface protein involved in calcium uptake and skeleton formation in sea urchin embryos. AB - The developmental expression of a cell-surface protein involved in Ca2+ accumulation and skeleton formation in sea urchin embryos has been studied. In Strongylocentrotus purpuratus, this protein is present in the egg and in all cell types of the early embryo. After gastrulation, its synthesis and expression are restricted to the skeleton-forming primary mesenchyme cells. In Lytechinus pictus, the protein cannot be detected in eggs or in embryos until the mesenchyme blastula stage. Hybrid embryos demonstrate a pattern of expression indistinguishable from that of the species contributing the maternal genome, which suggests that early expression of the protein in S. purpuratus embryos is due to utilization of maternal transcripts from the egg. Later expression of this protein in primary mesenchyme cells is the result of cell-type-specific synthesis, likely encoded by embryonic transcripts. This cell-type-specific expression in primary mesenchyme cells correlates temporally with Ca2+ accumulation during skeleton formation in the embryo. PMID- 3297858 TI - Studies on the biological activity of two strains of BCG: influence of production conditions. AB - Batches of freeze-dried BCG vaccine were produced by using two different substrains--Moscow (SL 374a) and Paris (SL 1173 P2). The biological activity of the vaccines was studied by the following tests: In the laboratory--viability, heat stability, homogeneity, skin reactivity, allergenic potency and immunogenicity in guinea pigs. In the field--local lesions and postvaccination tuberculin sensitivity. All the batches were produced by using the same technique and production methods. The Paris substrain vaccines showed less viability, but higher heat stability and skin reactivity. It is to be noted that when the VKL medium was used (instead of Sauton) the Paris substrain vaccines showed much lower immunogenicity in guinea pigs and, at the same time, much higher skin reactivity. In the field studies the Moscow substrain vaccines showed higher local lesions and tuberculin sensitivity. In other experiments vaccines produced from the same substrain (Moscow) but in different production centers were compared. It was found that the vaccines differed (according to the production methods used) in terms of some laboratory tests (viability, heat stability, homogeneity) but these differences were not associated with significant differences when studied in the field. PMID- 3297857 TI - A monoclonal antibody specific for avian early myogenic cells and differentiated muscle. AB - A monoclonal antibody raised in mouse in response to homogenates of Remark ganglia and dorsal mesentery of chicken embryos was found to exhibit a unique reactivity towards myogenic cells, heart, striated muscles, and smooth muscles in chicken and quail. Indirect immunofluorescence assays were performed at different stages of chicken and quail embryonic development and, after hatching, on tissue sections and cultured cells. They revealed that the cytoplasmic marker recognized by 13F4 is expressed in early embryonic heart, in somitic myotome (from stage 14 onward), in the skeletal muscles in limbs and trunk, in all muscles in the head and the branchial arches, in the smooth muscles of the digestive tract and blood vessels. In myofibrils of striated muscles, the antigen is localized in the Z lines. The antigenicity of the molecule recognized by 13F4 is not associated with a glycolipid or a glycoprotein. It is of peptidic nature and its molecular weight is 54 kDa. We stress the value of this cell-type-specific marker in studies on ontogenesis and differentiation of all muscular structures, namely, of myocardium and striated muscles, which express 13F4 antigenicity from an early developmental stage. PMID- 3297859 TI - Long-term stability of BCG vaccine sealed in ampoules under nitrogen with reference to its short-term heat resistance. AB - 11 batches of BCG vaccine were each distributed into two kinds of ampoules, lyophilized, and sealed under vacuum or nitrogen, respectively. Their viability during storage at +4 degrees C was followed for up to 10 years. The number of culturable particles decreased after that period to approximately 70% of the initial values, irrespective of the mode of preparation. Generally, the figures after 10 years storage at +4 degrees C were close to those after 4 weeks storage at +37 degrees C for the individual lots. Recommendations for sealing of BCG vaccine preferentially under vacuum instead of under nitrogen are no longer valid, therefore, if appropriate techniques for the sealing and gassing operations are used. PMID- 3297860 TI - Selection of a BCG population with increased freeze-drying resistance. PMID- 3297863 TI - The effects of dispersed or surface grown cultures, manufacture and control methods on BCG standardization. PMID- 3297861 TI - An interlaboratory comparative assay of viability and heat stability control of different BCG vaccines on two solid culture media. PMID- 3297862 TI - BCG-induced anaemia in mice relates to number of viable units injected intravenously. PMID- 3297864 TI - Clinical trials with low dose BCG vaccine strain Copenhagen 1331. PMID- 3297865 TI - A quarter of a century in the field of BCG. PMID- 3297866 TI - [BCG vaccination in Hungary between the two World Wars]. PMID- 3297867 TI - BCG vaccination in leprosy. PMID- 3297868 TI - Evaluation of the effectiveness of BCG vaccination using the case control method. PMID- 3297869 TI - [Homage to Albert Calmette]. PMID- 3297870 TI - Significance of the number of viable units in BCG vaccines. AB - The objective of the study was to establish the incidence of suppurative lymphadenitides in newborns vaccinated with BCG vaccines of different strength and to investigate the postvaccination tuberculin positivity of the children involved in the study. Lyophilized vaccines prepared from the Pasteur strain were used. Altogether 51,000 children were included in the study. One group, consisting of 30,000 newborns was vaccinated with a BCG lot containing 2 X 10(5) viable units (VU) per dose. The other group, consisting of 21,000 newborns, was given a BCG lot containing 0.5 X 10(5) VU per dose. The incidence of suppurative lymphadenitides per 1,000 vaccinated infants was 6.84 and 0.87 in the two groups, respectively. Tuberculin tests were carried out 2 years after the vaccination. Two units of RT-23 tuberculin were used. In 3,821 children vaccinated with the stronger vaccine the rate of tuberculin positivity was found to be 19.8 per cent, while it was 16.4 per cent among 5,035 children who had been given the weaker lot. PMID- 3297871 TI - BCG dissemination in chronic granulomatous disease (CGD). PMID- 3297872 TI - Strain to strain variation in the immunogenicity of BCG. AB - BCG strains differ in their ability to elicit immune reactions in mice manifesting as increases in foot pad thickness following challenges with BCG ultrasonicate antigen at different times after vaccination. When we know more about the relevance to protection of these three reactions, such timed skin testing may prove of value for determining the efficacy of BCG in man. PMID- 3297873 TI - Nonspecific immunomodulating effects of BCG vaccine on antibody-dependent cell mediated cytotoxicity. AB - The effects of BCG vaccine on antibody-dependent cell mediated cytotoxic (ADCC) activity of spleen lymphocytes were examined after BCG treatment. A modified plaque assay method, using sheep red blood cells (SRBC) as targets and IgG antibodies from rabbit anti-SRBC serum, was applied. The changes of ADCC activity were different in spleen lymphocytes according to the route and the timing of the administration of the vaccine. Following i.p. administration we observed an immunosuppressive effect in mouse and rat spleen effector cells within the first seven days. The ADCC activity level returned to normal by the 14th day. The cytolytic activity was maximal at the 21st day after treatment, and decreased slowly thereafter. The ADCC activity of mouse spleen lymphocytes did not change within the first seven days after i.v. BCG administration while the maximal cytolytic activity was induced on the 14th day but it was lower than the peak value found after i.p. treatment. PMID- 3297874 TI - BCG immunostimulation in primary pulmonary cancer (a clinical, immunological and radiological study). AB - The authors reported the results of a clinical, radiological and immunological study of 147 primary pulmonary cancer cases who were immunostimulated with BCG vaccine over a period of three years between 01.01.76 and 31.12.78. Compared with the same number and stage of cancerous patients treated with the same cytostatic drugs and/or surgically without BCG immunostimulation, the survival rate of the immunostimulated group was higher than that of the control group. The radiological picture did not change during the study time in 45% of the patients, regression was observed in 34%, and progression in 21% in the Stage I vaccinated group, while in the control Stage I group regression was only noticed in 21%, and progression was observed in 50%. In the Stage II vaccinated group regression was noted in 48%, in the control group in 23%. No favourable changes were noted in Stage III groups, neither in the vaccinated nor in the nonvaccinated cases. The more favourable prognosis of the immunostimulated group was reflected in the results of the skin tests and in the cellular and humoral immunological responses too. The modification of the BCG immunostimulated pulmonary cancer patients gives a statistically significant prolongation of survival time and a beneficial improvement of life quality and expectation. PMID- 3297876 TI - Experience with BCG vaccination treatment in lung tumour patients. PMID- 3297875 TI - [Immunologic characterization of fractions of the BCG strain of M. bovis isolated by chromatofocusing]. PMID- 3297877 TI - Experiences in adjuvant immunotherapy of melanoma with BCG substrain Jena S 4. PMID- 3297878 TI - Evaluation of representative BCG strains by special methods using experimental animals. PMID- 3297879 TI - Some effects of nutritional components on the morphology of BCG colonies. AB - Under appropriate conditions of growth colonies showing fine wrinkling (rugosity) of their surface and characteristic of certain BCG strains can be distinguished from colonies with a smoother non-rugose morphology that are characteristic of some other BCG strains. This study has been concerned with the influence of nutritional and other media constituents on the evolution of these colonies. In a preliminary investigation nutritional components such as enzymic digest of casein, asparagine and salts were systematically eliminated from an agar medium, separately and together, and in the presence or absence of glycerol. From this and supplementary experiments, it appeared that the nutritional element with most effect on the size and morphology of colonies is the carbohydrate. Small inocula of BCG will normally grow on simple agar media only in the presence of enrichments such as blood or albumin, or if charcoal has been added. However, in a second investigation it was found that individual colonies would develop from such inocula placed 2 cm or more away from a concentrated inoculum that had been seeded onto the medium approximately 7-14 days earlier. It appears that a diffusible agent is produced from multiplying bacilli within a colony which counteracts toxic factors in the medium and may also assist nutrition within the colony. To examine the effects of carbohydrate on the evolution of colonies, in a third investigation glycerol was added in increasing quantities to an agar medium enriched with increasing quantities of bovine albumin and/or 5% of blood, and suspensions of French (Pasteur) and British (Glaxo) BCG vaccines were seeded onto it. Individual colonies cultured from these two strains have a rugose and non rugose morphology respectively, and to highlight the effects in question, the evolution over a prolonged period of concentrated 'drop-colonies' seeded onto the medium from each strain was studied. There was a very marked difference between the two strains in the evolution of such 'drop-colonies', and it appeared that the lateral spread of fine rugosity from those of the Pasteur strain represented an enhanced ability of small numbers of bacilli to take up the nutrient. PMID- 3297880 TI - Ultrastructural mutants in BCG strains and their relation to immunogenicity. PMID- 3297881 TI - Carmichael's insight. PMID- 3297883 TI - Hyperglycemia decreases glucose uptake in type I diabetes. AB - It has recently been postulated that hyperglycemia per se may contribute to insulin resistance in diabetes. To examine this possibility directly, we measured glucose uptake after 24 h of hyperglycemia (281 +/- 16 mg/dl) and normoglycemia (99 +/- 6 mg/dl) in 10 type I (insulin-dependent) diabetic patients (age 33 +/- 3 yr, relative body wt 102 +/- 3%) treated with continuous subcutaneous insulin infusion. Hyperglycemia was induced by an intravenous glucose infusion, whereas saline was administered during the control day. During both studies the patient received a similar diet and insulin dose. After hyper- and normoglycemia, a primed continuous infusion of insulin (40 mU X m-2 X min-1) was started, and plasma glucose was adjusted to and maintained at 142 +/- 2 and 140 +/- 2 mg/dl, respectively, during 60-160 min of insulin infusion. The rate of glucose uptake after hyperglycemia averaged 8.3 +/- 1.1 mg X kg-1 X min-1, which was lower than the rate after the normoglycemic period (10.1 +/- 1.2 mg X kg-1 X min-1, P less than .001). In conclusion, short-term hyperglycemia reduces glucose uptake in type I diabetic patients. Thus, part of the glucose or insulin resistance in these patients may be caused by hyperglycemia per se. PMID- 3297882 TI - Influence of lactation on morphometric and secretory variables in pancreatic beta cell of mildly diabetic rats. AB - In nondiabetic rats, lactation accelerates the restoration of pancreatic beta cell function after the period of increased secretory activity associated with pregnancy. To investigate whether a comparable situation prevails in mildly diabetic animals, streptozocin (22.5 mg/kg body wt) was administered to female rats at the onset of pregnancy. Plasma glucose and insulin concentrations, content and release of insulin in isolated islets, total mass and volume density of both the endocrine pancreas and granulated beta-cells, and ultrastructural prevalence of light and dark secretory granules were measured on the 20th day of pregnancy and in lactating and nonlactating animals 20 days after delivery. In the mildly diabetic animals, the changes in endocrine pancreatic function normally associated with pregnancy and lactation were greatly attenuated, albeit not completely eliminated. We propose that the increased biosynthetic and secretory activity imposed on surviving beta-cells after streptozocin administration tends to mask the adaptative changes in beta-cell function otherwise seen during the postpartum and lactation period. PMID- 3297884 TI - Relationships between plasma lipoprotein concentrations and insulin action in an obese hyperinsulinemic population. AB - Relationships have been observed between lipoprotein concentrations and insulin action. These relationships may be important in explaining the association of insulin resistance and abnormalities of lipoprotein metabolism found in obesity, diabetes, and hypertriglyceridemia. We have measured plasma lipoprotein concentrations and indices of insulin action in 85 men and 56 women, all of whom were normolipidemic and had normal glucose tolerance. The subjects were obese Southwestern American Indians (body mass index 34 +/- 1). Insulin action was measured via the hyperinsulinemic clamp with simultaneous indirect calorimetry. Triglyceride concentrations were inversely related to rates of total insulin mediated glucose disposal (in men and women, respectively, r = -.37, P less than .01; r = -.24, P less than .10), glucose storage (r = -.31, P less than .01; r = .25, P less than .10), increase in glucose oxidation (r = -.29, P less than .01; r = -.24, P less than .10), and, in men only, suppression of endogenous glucose production (r = -.32, P less than .01). High-density lipoprotein (HDL) cholesterol concentration was positively related to rates of total insulin mediated glucose disposal (r = .35, P less than .01; r = .33, P less than .05), increase in carbohydrate oxidation (r = .40, P less than .001; r = .39, P less than .001), suppression of endogenous glucose production (r = .24, P less than .05; r = .29, P less than .05), and, in men only, glucose storage (r = .35, P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297885 TI - Morphometric studies of secretory granule distribution and association with microtubules in beta-cells of rat islets during glucose stimulation. AB - Morphometric studies of beta-cell granule positions and interactions with microtubules in areas of exocytosis were performed on islets of rats injected with tolbutamide for 72 h. This treatment depleted granules 85% below normal control values and rendered mapping of their positions and visualization of microtubules more feasible during electron microscopy. Islets were perifused with 2.8 or 16.7 mM glucose and were fixed at 4 min (acute phase) or 20 min (second phase). Photomicrographs of beta-cell sections were digitized, and computer replicas were compared to computer-simulated cells of similar size and shape into which an identical number of granules was inserted randomly. Margination of granules into a zone within 1.5 micron of the plasma membrane was examined. At both 2.8 and 16.7 mM glucose, real cells marginated significantly more secretory granules than did simulated cell pairs. Within the zones of margination during 16.7 mM glucose perifusion, the number of secretory granules associated with microtubules was less than 6% in the acute phase and less than 1% in the second phase. These data suggest that glucose stimulation promotes movement of secretory granules into the beta-cell periphery to a greater extent than can be attributed to chance alone. The role of microtubules in peripheral granule movement into regions of exocytosis appears to be minimal. PMID- 3297886 TI - Estimation of endogenous glucose production during hyperinsulinemic-euglycemic glucose clamps. Comparison of unlabeled and labeled exogenous glucose infusates. AB - Tracer methodology has been applied extensively to the estimation of endogenous glucose production (Ra) during euglycemic glucose clamps. The accuracy of this approach has been questioned due to the observation of significantly negative estimates for Ra when insulin levels are high. We performed hyperinsulinemic (300 microU/ml)-euglycemic glucose clamps for 180 min in normal dogs and compared the standard approach, an unlabeled exogenous glucose infusate (cold GINF protocol, n = 12), to a new approach in which a tracer (D-[3-3H]glucose) was added to the exogenous glucose used for clamping (hot GINF protocol, n = 10). Plasma glucose, insulin and glucagon concentrations, and glucose infusion rates were similar for the two protocols. Plasma glucose specific activity was 20 +/- 1% of basal (at 120-180 min) in the cold GINF studies, and 44 +/- 3 to 187 +/- 5% of basal in the hot GINF studies. With the one-compartment, fixed pool volume model of Steele, Ra for the cold GINF studies was -2.4 +/- 0.7 mg X min-1 X kg-1 at 25 min and remained significantly negative until 110 min (P less than .05). For the hot GINF studies, Ra was never significantly less than zero (P greater than .05) and was greater than in the cold GINF studies at 20-90 min (P less than .05). There was substantially less between-(78%) and within- (40%) experiment variation for the hot GINF studies compared with the cold GINF studies. An alternate approach (regression method) to the application of the one-compartment model, which allows for a variable and estimable effective distribution volume, yielded Ra estimates that were suppressed 60-100% from basal. In conclusion, the one-compartment, fixed pool volume model of glucose kinetics is inadequate for the estimation of Ra during euglycemic glucose clamps. Two new strategies for estimating Ra from the one-compartment model, the hot GINF protocol and the regression method calculation, yielded more accurate and physiologically plausible estimates of Ra than currently used methodology. PMID- 3297888 TI - Effects of insulin and glucose on cultured rat hepatocyte gene expression. AB - We previously used isolated adult rat hepatocyte cultures to study the ability of glucose to induce several hepatic mRNAs. However, we found that the optimal insulin concentration required to obtain the glucose effect was greater than 10,000 microU/ml. To test the hypothesis that the requirement for high concentrations of insulin in the culture was due to rapid loss of insulin in hepatocyte cultures, serial measurements of insulin were made at different media insulin concentrations (0-500,000 microU/ml) and glucose concentrations (5.5 and 2.75 mM). In addition, a dose-response relationship was established between media insulin concentrations and the pattern of mRNAs present in the hepatocytes determined by two-dimensional gel electrophoresis of in vitro translation products. We found that at low insulin concentrations (less than 1000 microU/ml), greater than 80% of the insulin was lost to the glassware, whereas at high initial insulin concentrations, approximately 23% of the insulin was lost to the glassware. Placement of media into the hepatocyte culture led to further insulin disappearance with a half-life for insulin of 41.5 h at 10,000 microU/ml and 13.8 h at 100 microU/ml. We found 16 mRNAs were altered by insulin at 5.5 mM glucose and 9 mRNAs were changed by insulin at 27.5 mM glucose. After taking into consideration the distributional and metabolic losses of insulin, all but one mRNA responded to insulin within the physiologic range of portal insulin (less than 1-94 microU/ml). Our data indicate that the hepatocyte culture is an excellent model to study the physiologic effects of insulin on hepatic gene expression. PMID- 3297887 TI - Reversal of insulin resistance in diabetic rat adipocytes by insulin therapy. Restoration of pool of glucose transporters and enhancement of glucose-transport activity. AB - To determine the role of insulin in reversing the insulin resistance associated with depletion of the intracellular pool of glucose transporters, streptozocin induced diabetic rats were treated with 5 U/day s.c. of insulin for 0, 8, or 14 days. At each time point, adipose cells were isolated, and 3-O-methylglucose transport was measured in the absence and presence of 1000 microU/ml insulin. With the cytochalasin B-binding assay, concentrations of glucose transporters in the plasma and the low-density microsomal membrane fractions were determined. Eight-day insulin therapy enhanced glucose transport rate (mean +/- SE) from 0.2 +/- 0.0 to 1.1 +/- 0.1 fmol X cell-1 X min-1 in the basal state and from 0.8 +/- 0.1 to 5.5 +/- 0.4 fmol X cell-1 X min-1 in the insulin-stimulated state in untreated and treated diabetic rats, respectively; this is a 3-fold increment of glucose transport rate in both states compared with control rats. After 14-day insulin therapy, glucose-transport activity declined toward normal but still remained approximately 1.5- and 4-fold higher than control and diabetic rats, respectively. Despite the persistent enhancement of glucose transport rate, concentration of glucose transporters in the intracellular pool was restored only to its prediabetic state. Likewise, the increased concentration of glucose transporters in the plasma membranes after insulin stimulation was similar to that of control rats. Thus, we suggest that 8-14 days of insulin therapy reversed the insulin resistance in diabetic rat adipocytes by at least two mechanisms: restoration of the intracellular pool of glucose transporters and enhancement of glucose-transport activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297889 TI - Role of cyclosporin A in macromolecular synthesis of beta-cells. AB - Wistar rats developed hypoinsulinemia and hyperglycemia within 7 days when treated daily with 40 mg/kg body wt of cyclosporin A (CsA) and recovered from the metabolic alteration within 1 wk when CsA treatment was terminated. By light microscopy, there was no lymphocytic infiltration, but cytoplasmic vacuolization in the islets of Langerhans from the CsA-treated rats was seen. By electron microscopy, severe degranulation, cytoplasmic vacuolization, and dilation of endoplasmic reticulum were clearly seen in the pancreatic beta-cells. Islet cells isolated from the CsA-treated rats showed greater than 50% reduction in mRNA synthesis. A similar inhibitory pattern of mRNA synthesis was observed in in vitro CsA-treated (10 micrograms/ml) human pancreatic islet cells from one biopsy sample and in similarly treated rat insulinoma cells (RINm5F). The inhibitory effect of CsA on mRNA synthesis in RINm5F cells was dose dependent, with a 50% inhibiting dose of 5 micrograms/ml. In addition to the inhibition of mRNA synthesis, CsA also inhibited protein and DNA syntheses, although the inhibitory effect on these macromolecular syntheses was significantly less than that on mRNA synthesis. However, there was only a minor effect of CsA on in vitro transcription and translation compared with that on RINm5F and islet cells. It is concluded that CsA-induced degranulation of the beta-cells in Wistar rats, accompanied by hypoinsulinemia and hyperglycemia, may be due to indirect, reversible interference of the cellular function primarily involved in mRNA synthesis. PMID- 3297891 TI - Interleukin 1 is potent modulator of insulin secretion from isolated rat islets of Langerhans. AB - The effects of interleukin 1 (IL-1) on glucose-induced insulin secretion from isolated rat islets of Langerhans have been examined. IL-1 both inhibits and stimulates glucose-induced insulin secretion depending on the experimental design. Inhibition of glucose-induced insulin secretion was observed after a 15-h treatment of islets with either purified IL-1, murine recombinant IL-1 (rIL-1), or human rIL-1, rIL-1 inhibition of glucose-induced insulin secretion was dose dependent with half-maximal inhibition observed at 25 pM human rIL-1. Basal insulin secretion was not affected by rIL-1 treatment. Mannose- and leucine induced insulin secretion was also inhibited by a 15-h treatment with human rIL 1. Islets treated 15 h with inhibitory concentrations of murine IL-1 were morphologically intact, well granulated, and retained normal concentrations of insulin compared with control islets. Furthermore, human rIL-1 treatment did not affect the islet plasma membrane permeability as assessed by the measurement of the islet intracellular volume. Finally, the viability of islets treated 15 h with murine rIL-1 was demonstrated by the observation that the inhibitory effects of murine rIL-1 on glucose-induced insulin secretion were reversible. In addition to the inhibitory effects of IL-1 on glucose-induced insulin secretion, purified IL-1 and human rIL-1 had stimulatory effects on glucose-induced insulin secretion under the following conditions: a 90-min incubation with purified IL-1 (10% vol/vol) or in the presence of human rIL-1 (1400 pM) or a 15-h incubation with relatively low concentrations of human rIL-1 (0.5 or 5 pM).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297890 TI - Insulin suppresses its own secretion in vivo. AB - This study addressed the controversial question of whether a negative-insulin feedback loop exists in vivo. We utilized prehepatic insulin production, calculated by computerized deconvolution analysis of peripheral C-peptide concentration, as a measure of endogenous insulin secretion. Prehepatic insulin production was determined in 10 normal men who randomly underwent a control study and two additional studies involving different insulin infusion rates that achieved circulating insulin concentrations within the physiologic range during euglycemic clamps. The results demonstrate a dose-dependent suppression of prehepatic insulin production from 5.8 +/- 1.4 mU/min during the control study to 4.0 +/- 1.2 and 3.2 +/- 0.9 mU/min during plasma insulin levels of 34 +/- 4 and 61 +/- 6 microU/ml, respectively (P less than .05). Therefore, in contrast to recently reported results in vitro, insulin inhibits its own secretion in humans. PMID- 3297892 TI - Insulin treatment improves glucose-induced insulin release in rats with NIDDM induced by streptozocin. AB - Insulin-deficient diabetes in humans, as well as in the neonatal streptozocin induced rat model of non-insulin-dependent diabetes mellitus (NIDDM), are associated with islet beta-cell insensitivity to glucose. We hypothesized that the chronic hyperglycemia-hypoinsulinemia pattern causes this impairment of the glucose influence on insulin secretion. This study was designed to determine whether the glucose defect could be counteracted by normalizing the diabetic state in rats with NIDDM after insulin therapy. Mixte lente insulin (5 U X kg-1 X day-1) was given daily at 1700 h over 24 h or 5 consecutive days. Insulin secretion was studied the morning after the last insulin injection with the isolated perfused pancreas preparation. Fed basal plasma glucose levels decreased in diabetic rats from 183 +/- 8 to 136 +/- 10 mg/dl after the 1-day insulin treatment and to 135 +/- 5 mg/dl after the 5-day insulin treatment (vs. 116 +/- 3 mg/dl in control rats). Pancreatic insulin stores were not affected by insulin therapy. Although the 1-day insulin treatment did not modify the lack of glucose response in the diabetic rats, the 5-day insulin treatment improved their glucose induced insulin secretion. Moreover, insulin therapy improved the priming effect of glucose on a second stimulation with glucose. The return of this glucose effect was hardly detectable after the 1-day insulin therapy but was clearly present after the 5-day treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297893 TI - Empty sella syndrome. PMID- 3297894 TI - Newborn stepping: a review of puzzling infant co-ordination. PMID- 3297895 TI - Presenting characteristics of patients with duodenal ulcer and outcome of medical treatment in controlled clinical trials using cimetidine and diethylamine persilate to treat ulcer attack and diethylamine persilate and placebo to prevent relapses. AB - A double-blind controlled clinical trial on the medical treatment of the acute episode of duodenal ulcer and the prevention of symptomatic relapses was performed. A total of 164 patients with active duodenal ulcer were either treated with cimetidine 1 g/day (70 patients), diethylaminepersilate (DAP) 1.5 g/day (64 patients) or DAP 2.5 g/day (30 patients). DAP is an allegedly protective agent stimulating mucosal prostaglandin synthesis. Cumulative healing rates after 4 weeks in the 3 groups were 66, 28 and 28% and after 8 weeks 94, 70 and 63%, respectively. One hundred and five patients with healed duodenal ulcer received, in a second double-blind study, either DAP 0.5 g/day or placebo. Thus, ulcer healing was more rapid with cimetidine than with DAP. DAP did not prevent relapses. No presenting characteristic was associated with slow healing. Three presenting characteristics--smoking, teetotalling and bleeding episode in the past--were associated with early symptomatic relapse. The present study was compared with a previous study performed by the same group of investigators using a similar study protocol. In both trials, an early relapse was associated with smoking. No other presenting characteristic was identified which in both trials was associated with slow healing or early symptomatic relapse. Thus, smoking appears to be the only one of the commonly available presenting characteristics which allows a prediction of the course of duodenal ulcer disease. PMID- 3297896 TI - Residual insulin production, glycaemic control and prevalence of microvascular lesions and polyneuropathy in long-term type 1 (insulin-dependent) diabetes mellitus. AB - The aim of the present study was to evaluate the role of residual insulin production in long-term Type 1 (insulin-dependent) diabetes mellitus. Ninety seven patients with a disease duration of 9-16 years and onset before the age of 30 years were studied. C-peptide excretion in 24-h urine samples was measured as an indicator of residual insulin production. Thirty-five patients (36%) excreted C-peptide (greater than or equal to 0.2 nmol); as many as possible of them were carefully matched with a non-excretor patient with regard to age at onset of diabetes and disease duration. Twenty-nine pairs were obtained, and 22 of them agreed to participate in further investigations of glycaemic control and microangiopathic lesions. The patients who excreted C-peptide had significantly lower HbA1c than the non-excretor group, 6.9 +/- 0.3% vs 7.9 +/- 0.3%, (p less than 0.025). Moderate-to-advanced background retinopathy was found in 2 patients in the excretor group and in 7 patients in the non-excretor group. Microalbuminuria [ratio of albumin: creatinine (mg/l:mmol/l) greater than or equal to 5] was found in 1 and in 5 patients, respectively, while proteinuria [ratio of protein: creatinine (mg/l:mmol/l X 10) greater than or equal to 136] was found in 0 and in 4 patients, respectively. Microalbuminuria and/or proteinuria was found in 7 of the non-excretor group as compared to 1 in the excretor group (p = 0.046).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297897 TI - Effect of high sucrose diet on insulin secretion and insulin action: a study in the normal rat. AB - The effects of chronic high sucrose feeding for 1 month on in vivo and in vitro insulin secretion and on in vivo insulin action were studied in normal male rats. As compared to the standard chow diet, the high sucrose diet induced excess in vivo insulin response to an intravenous glucose load; the high sucrose diet also slightly improved glucose tolerance, as demonstrated by significantly higher rate of glucose disappearance (p less than 0.02). The increased insulin secretion in response to glucose in vivo seems to be related to an hyper-reactivity of the pancreatic B cell to glucose, since it was still observed in vitro with the isolated perfused pancrease preparation. By contrast, B cells of sucrose-fed rats exhibited in vitro a normal response to arginine and a significantly lowered (p less than 0.05) response to acetylcholine. The insulin action in the sucrose-fed rats was quantified in vivo with the insulin-glucose clamp technique. The effects of different concentrations of insulin on glucose production and glucose utilization were studied in anaesthetized rats while in the postabsorptive state. The basal glucose utilization was found significantly higher (p less than 0.001) in sucrose-fed rats. During the clamp studies the glucose utilization induced by submaximal (400 microU/ml) or maximal (7500 microU/ml) insulin levels was significantly more important (p less than 0.02) in the sucrose-fed rats than in the chow-fed rats. This suggests that insulin-mediated glucose uptake is enhanced over a large range of plasma insulin levels in the sucrose-fed rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3297899 TI - [Agustin Andrade (1836-1886)]. PMID- 3297898 TI - Skills for the beginning family medicine investigator. AB - The purpose of this study was to identify the necessary skills for a beginning researcher in family medicine, utilizing the views of those currently conducting research in the specialty. A Delphi study, involving three questionnaires, was conducted to determine skills needed in the following areas: designing a research project, conducting a research project, statistical knowledge and/or skills, and computer skills. Participants were 32 family physicians who had published at least one article in the Journal of Family Practice (1983-84) or Family Medicine (1983-84). The Delphi technique was successful in achieving consensus among study participants. A total of 77 skills were identified in the four areas as being at least somewhat important to the beginning family medicine investigator. Thirty eight of these skills were identified as important to extremely important. PMID- 3297900 TI - [Contributions of a genetics service to the study of patients in a pediatric hospital]. PMID- 3297903 TI - [Panorama of medicine in Mexico]. PMID- 3297902 TI - [Metabolic relations between lipolysis and oxygen consumption in rat epididymal adipose tissue. Changes caused by fasting, adrenaline, triiodothyronine, glucose and insulin]. PMID- 3297904 TI - [Standardization of the size of the diencephalon in the stereotaxic localization of subcortical structures in man]. PMID- 3297905 TI - Calcification in the portal and collateral veins wall: CT findings. AB - We report an uncommon case of calcification of the portal and collateral vein wall, in a patient with thrombosis of the portal vein secondary to cirrhosis, demonstrated by computed tomography. PMID- 3297907 TI - Comparison of paracentesis and diuretics in the treatment of cirrhotics with tense ascites. Results of a randomized study. AB - To investigate whether paracentesis could be an alternative therapy for ascites, 117 cirrhotics with tense ascites were randomly allocated into two groups. Fifty eight patients (group 1) were treated with paracentesis (4-6 L/day until disappearance of ascites) and intravenous albumin infusion (40 g after each tap). Fifty-nine patients (group 2) were treated with spironolactone (200-400 mg/day) plus furosemide (40-240 mg/day). Patients from group 2 not responding to diuretics were treated with a LeVeen shunt. After disappearance of ascites, patients from both groups were discharged from hospital and were instructed to take diuretics. Patients developing tense ascites during follow-up were readmitted to hospital and treated according to their initial schedule. Paracentesis was effective in eliminating the ascites in 56 patients from group 1 (96.5%) and did not induce significant changes in renal and hepatic function, plasma volume, cardiac index, peripheral resistance, plasma renin activity, plasma norepinephrine and antidiuretic hormone concentration, and urinary excretion of prostaglandin E2 and 6-keto-prostaglandin F1 alpha. Diuretics were effective in eliminating the ascites in 43 patients from group 2 (72.8%) (p less than 0.05). Ten patients in group 1 and 36 in group 2 developed complications during their first hospital stay (p less than 0.001). This difference was due to the significantly higher incidence of hepatic encephalopathy, renal impairment, and electrolyte disturbances occurring in patients treated with diuretics. The duration of hospital stay was 11.7 +/- 1.5 days for patients from group 1 and 31 +/- 2.8 days for patients from group 2 (p less than 0.001). The two groups did not differ significantly with respect to the probability of requiring readmission to hospital during follow-up, reasons for readmission, survival probability after entry into the study, and causes of death. These results indicate that paracentesis associated with intravenous albumin infusion is a fast, effective, and safe therapy for ascites in patients with cirrhosis. PMID- 3297906 TI - Dietary estrogens--a probable cause of infertility and liver disease in captive cheetahs. AB - The cheetah in the wild is "racing towards extinction" mostly due to habitat destruction. Its survival will probably depend on accelerated captive breeding. At this time, however, reproductive failure and liver disease threaten the future of the captive cheetah population. Histopathological evaluation of more than 100 cheetah livers identified venocclusive disease as the main hepatic lesion responsible for liver disease in this species. Analysis of the commercial feline diet by high-performance liquid chromatography and gas-liquid chromatography-mass spectrometry revealed large amounts of two phytoestrogens identified as daidzein and genistein. These compounds were found to be derived from a soybean product that was a component of the cheetah diet, and their concentrations both ranged from 18 to 35 micrograms/g diet. The adult cheetah consequently consumes approximately 50 mg/day of these weak estrogens. When extracts of the diet were tested for estrogenicity using a bioassay, a dose-related increase in uterine weight was observed. In 4 cheetahs studied, withdrawal of this feline diet by substitution with a chicken diet resulted in an improvement in conventional liver function tests and a normalization in the appearance of hepatic mitochondria. We conclude that the relatively high concentrations of phytoestrogens from soybean protein present in the commercial diet fed to captive cheetahs in North American zoos may be one of the major factors in the decline of fertility and in the etiology of liver disease in this species. The survival of the captive cheetah population could depend upon a simple change of diet by excluding exogenous estrogen. PMID- 3297908 TI - Fatal liver disease associated with alpha 1-antitrypsin deficiency PiM1/PiMduarte. AB - A 53-yr-old man with a rare form of partial alpha 1-antitrypsin deficiency, PiM1/PiMduarte, died of endstage cirrhosis. Typical cytoplasmic alpha 1 antitrypsin globules were present in the hepatocyte cytoplasm. Initial protease inhibitor phenotyping on the patient was reported as normal PiM1 in more than one laboratory. This case emphasizes the diagnostic importance of alpha 1-antitrypsin and illustrates the point that protease inhibitor phenotyping without family genotyping may be misleading in heterozygous patients with liver disease. PMID- 3297909 TI - Progressive bile duct injury after thiabendazole administration. AB - A 27-yr-old man developed jaundice 2 wk after exposure to thiabendazole. Cholestasis persisted for 3 yr, at which time a liver transplant was performed. Two liver biopsy specimens and the hepatectomy specimen were remarkable for almost complete disappearance of interlobular bile ducts. Prominent fibrosis and hepatocellular regeneration were also present; however, the lobular architecture was preserved. This case represents an example of "idiosyncratic" drug-induced liver damage in which the primary target of injury is the bile duct. An autoimmune pathogenesis of the bile duct destruction is suggested. PMID- 3297910 TI - Sonographic appearances in biliary ascariasis. AB - Biliary ascariasis is as frequent a cause of adult biliary disease as gallstones in Kashmir Valley, India. In the present study, we prospectively evaluated the role of sonography in the diagnosis of biliary ascariasis and its utility in monitoring the exit of worms from the bile duct. Sonography was performed on 28 patients with biliary ascariasis proven by endoscopic retrograde cholangiopancreatography. The bile ducts were dilated on sonography in 26 patients. The characteristic sonographic features of worms in the bile duct were as follows: (a) a single, long, linear or curved echogenic structure without acoustic shadowing (2 patients); (b) multiple, long, linear, parallel echogenic strips, usually without acoustic shadowing (15 patients); (c) a thick, long, linear or curved, nonshadowing echogenic strip containing a central, longitudinal anechoic tube, probably representing the digestive tract of the worm (7 patients); and (d) characteristic movement of these long echogenic structures within the bile duct (8 patients). One patient with pancreatic ascariasis exhibited long, linear, nonshadowing echogenic strips in a dilated pancreatic duct. Other sonographic changes observed in these patients were (a) gallbladder distention (10 patients), edema of the gallbladder wall (8 patients), sludge within the gallbladder (11 patients), a coiled echogenic structure within the gallbladder (1 patient); (b) multiple liver abscesses (1 patient); and (c) edematous pancreatitis (4 patients). Sonography detected worms in the biliary tree in 24 of 28 patients (85.7%). Serial sonograms accurately demonstrated the spontaneous exit of worms in 18 patients and the persistence of worms in 3 patients. Sonography is a simple, rapid, and noninvasive method for diagnosis and follow-up of patients with biliary ascariasis. PMID- 3297911 TI - Gastric Campylobacter-like organisms, gastritis, and peptic ulcer disease. AB - Although the presence of gastric bacteria has been long established, the recognition and isolation of Campylobacter pylori and similar organisms has opened a new era in the understanding of inflammatory gastroduodenal conditions. Visualization or isolation of gastric Campylobacter-like organisms (GCLOs) is significantly associated with histologic evidence of gastritis, especially of the antrum. Correlation with peptic ulceration also exists but probably is due to concurrent antral gastritis. Outbreaks of hypochlorhydria with concomitant gastritis have been attributed to GCLO infection, and a human volunteer became ill after ingesting C. pylori. Despite rapid microbiologic characterization of the organisms and the epidemiology, pathology, and serology of infection, the pathogenetic significance of GCLOs remains unknown. Whether GCLOs cause, colonize, or worsen gastritis must be considered an unanswered question at present. The efficacy of antimicrobial treatment of GCLO infection on the natural history of gastritis is not presently resolved. Nevertheless, GCLOs are at the least an important marker of inflammatory gastroduodenal disease, and attempts to ascertain their clinical significance are clearly warranted. PMID- 3297912 TI - Therapeutic paracentesis. Have we come full circle? PMID- 3297913 TI - Training and education in gastroenterology. List of available training programs. PMID- 3297914 TI - Gastroscopic localization of a microencapsulated KCl preparation in the human stomach. AB - A slow release polymer-coated preparation of potassium chloride granules (Micro-K Extencaps) was initially thought not to be associated with gastric mucosal damage. Recent studies have shown that acute gastric ulcers occur with approximately the same frequency as in patients taking wax matrix KCl formulations. The development of acute gastric ulcers was not consistent with the proposed dispersion characteristics of the microencapsulated KCl preparation. The authors therefore endoscopically evaluated the dispersion characteristics of microencapsulated KCl in a double-blind, placebo-controlled study. Subjects received four capsules of Micro-K or matching placebo and endoscopy was performed 30, 60, or 120 min after each drug ingestion. The material was identified with the Olympus HM (high magnification) endoscope and then quantitatively aspirated using the 3.5-mm biopsy channel of the Pentax 34JA endoscope. Microencapsulated KCl particles dispersed poorly and were found adhering to the mucosa and to one another, as a semisolid mass, most frequently in the gastric antrum. In contrast, the placebo (ethyl cellulose) was widely dispersed throughout the stomach. The authors concluded that gastric emptying must be considered in three phases: liquids, solids, and solids which adhere to the mucosa. No unique dispersion characteristics of Micro-K Extencaps were identified, and adherence of the KCl to the gastric mucosa may explain its ability to cause occasional acute gastric ulceration. PMID- 3297915 TI - Invasive candidiasis does not complicate short-term cimetidine treatment of duodenal ulcer. AB - The purpose of this study was to record the frequency of invasive candidiasis of duodenal ulcer and to determine whether or not it is enhanced by cimetidine treatment. Our multicenter prospective trial involved 99 patients with endoscopically proven duodenal ulcer who were undergoing a 4- or 8-week cimetidine (800 mg/day) treatment program. At the endoscopic examination, performed before and after the 4- or 8-week treatment, three biopsy samples were taken from the ulcer edge or from the healed tissue. Ulcer infiltration by Candida was presumed by the presence of mycetes in stained tissue samples. Healing rate was 76% at 4 weeks and 89.9% at 8 weeks. Candida infiltration was not seen in any biopsy specimen. Short-term treatment with cimetidine does not promote invasion of mycetes into the duodenal ulcer lesion. PMID- 3297916 TI - [Sonographic studies of the correlation of cystopyelitis gravidarum and kidney pelvis hydronephrosis]. AB - Ultrasound monitoring of the urinary tract was performed three times in 158 pregnant women (before the 20th week, between the 20th and 30th weeks, and after the 30th week). Dilatation of the kidney was found in 82 women (51.9 percent). All patients with pyelitis gravidarum were found to have dilatation of the kidney. Patients with hydronephrosis are a high-risk group for infection of the urinary tract. Recurrences are common among these women. PMID- 3297917 TI - [Erythrocytes and alcohol]. PMID- 3297918 TI - [Action of single and fractionated whole-body irradiation of various intensities on hematopoiesis in dogs]. PMID- 3297919 TI - Alexander Hollaender (1898-1986). PMID- 3297920 TI - Four genes responsible for a position effect on expression from HML and HMR in Saccharomyces cerevisiae. AB - Mating type interconversion in Saccharomyces cerevisiae occurs by transposition of copies of the a or alpha mating type cassettes from inactive loci, HML and HMR, to an active locus, MAT. The lack of expression of the a and alpha genes at the silent loci results from repression by trans-acting regulators encoded by SIR (Silent Information Regulator) genes. In this paper we present evidence for the existence of four SIR genes. Inactivation of any of these genes leads to expression of cassettes at both HML and HMR. Unusual complementation properties are observed for a number of sir mutations. Specifically, some recessive mutations in different genes fail to complement. The correspondence between SIR1, SIR2, SIR3, SIR4 and other genes with similar roles (MAR, CMT, STE8 and STE9) is presented. PMID- 3297921 TI - Possible new genes as revealed by molecular analysis of a 5-kb Escherichia coli chromosomal region 5' to the rpsU-dnaG-rpoD macromolecular-synthesis operon. AB - The complete nucleotide sequence of 5-kb DNA fragment immediately 5' to the rpsU dnaG-rpoD macromolecular-synthesis operon in Escherichia coli has been determined. It encodes for six open reading frames. Transcriptional and translational analysis have shown that three of them (orfx, orfz1 and orfz2) are expressed in exponentially growing E. coli cells. The orfx, directly 5' to the rpsU gene but transcribed in the opposite direction, may be part of the rpsU-dnaG rpoD macromolecular-synthesis operon. PMID- 3297922 TI - Two promoters from the Streptomyces plasmid pIJ101 and their expression in Escherichia coli. AB - An RNA polymerase-binding restriction fragment from the small, high-copy-number Streptomyces plasmid pIJ101 has been shown to have promoter activity in vivo using a promoter-probe vector. The nucleotide sequence of the promoter (the pIJ101B promoter) and the approximate position of the transcription start point as identified by in vitro run-off transcription are presented. Both the pIJ101B promoter and the previously characterised pIJ101A promoter were found to promote transcription in Escherichia coli. The transcription start point in E. coli for the pIJ101A promoter has been determined using high-resolution S1 mapping. Initiation occurs at the same point or within 1 or 2 nucleotides of the transcription start point previously identified in Streptomyces lividans, indicating that the same transcriptional signals are recognised in both genera. The data support the idea that one type of RNA polymerase holoenzyme in Streptomyces recognises a class of promoters similar to the major consensus promoters of E. coli, and that the manner of promoter recognition is similar in both genera. PMID- 3297923 TI - Comparison of the cis-acting control regions of two coordinately controlled genes involved in ethanol utilization in Aspergillus nidulans. AB - The alcA and aldA genes of Aspergillus nidulans are regulated in exactly the same manner, being subject to positive control by the product of the alcR gene. We report the complete nucleotide sequence of the alcA gene and its 5' non-coding region, preliminary localization of the region involved in the regulation of alcA expression, and a detailed comparison of this region to the 5' non-coding region of aldA (Pickett et al., 1987). The 5' flanking regions of the genes contain six similar sequence elements. Three of these elements are located upstream from the messenger RNA start points and one is related to a sequence element found in the region responsible for ethanol induction of the yeast ADH2 gene (Beier et al., 1985). The other homologous elements are located within the messenger RNA leader and may be associated with selection of messenger RNA start points. The amino acid sequence of alcohol dehydrogenase I (348 residues) shows a significant level of homology with analogous sequences in other organisms. Gene alcA contains introns which are similar in size and structure to other fungal introns. We discuss the positions of the introns in alcA of A. nidulans with particular reference to the conservation of intron position in and the evolutionary assembly of enzymes which possess NAD-binding domains. PMID- 3297924 TI - Analysis of sequences from the extremely A + T-rich genome of Plasmodium falciparum. AB - The genome of the human malaria parasite Plasmodium falciparum has an A + T content of about 82%, higher than any other organism whose DNA has been characterized. Computer analysis of 36 kb of available nucleotide sequences from this species showed that the coding regions, with an A + T content of 69.0%, are flanked by more A + T-rich regions of 86.0% A + T. Within the coding sequences, the A/T ratio was 1.68 in the mRNA sense strand, and overall A + T content in the three codon positions increased in the order 1st-2nd-3rd position. Codons with T or especially A in the third position were strongly preferred. Codon usage among individual parasite genes was very similar compared to genes from other species. Dinucleotide frequencies for the parasite DNA were close to those expected for a random sequence with the known base composition, except that the CpG frequency in the coding sequences was low. PMID- 3297925 TI - Evolution of the enterobacterial sulA gene: a component of the SOS system encoding an inhibitor of cell division. AB - The LexA-regulated sulA (sfiA) gene of Escherichia coli encodes an unstable protein which inhibits cell division. By determining the nucleotide sequences of the corresponding genes from the related bacteria Salmonella typhimurium, Enterobacter aerogenes and Serratia marcescens it was found that the regulatory region and the LexA binding site (SOS box) have been better conserved during evolution than the coding sequence. The N terminus of the SulA protein [amino acid (aa) residues 1-30] has diverged extensively during the evolution of Enterobacteriaceae, whereas the central region (aa residues 31-149) has been well conserved. At the C terminus a sequence showing some homology to the N protein of phage lambda was detected that may represent a recognition site for the Lon protease, which is known to degrade both polypeptides. When expressed in E. coli, the foreign sulA genes did not block cell division suggesting that their products are inactive. This may indicate that the N terminus of the SulA protein is involved in recognizing the cell division apparatus. PMID- 3297926 TI - Expression of Bacillus amyloliquefaciens extracellular ribonuclease (barnase) in Escherichia coli following an inactivating mutation. AB - An inactivated gene for Bacillus amyloliquefaciens extracellular ribonuclease (barnase) has previously been cloned and sequenced following transposon mutagenesis. The intact gene could not be assembled in Escherichia coli and is presumed to be lethal. Therefore, we introduced specific mutations into the barnase gene to prevent its lethal effect. A Gln-73 mutant gene was stable in E. coli but only produced low amounts of barnase antigen. Mutants containing Asp, Gln or Arg, instead of His-102, at the active site were identified by immunological screening for barnase antigen. None of the mutant proteins with alterations at aa residue 102 possessed RNase activity. The level of barnase (Asp 102) was higher in E. coli than in B. subtilis but the protein was not processed to the correct size in E. coli. To obtain correct processing, the barnase (Asp 102) structural gene was fused to the E. coli alkaline phosphatase promoter and signal sequence (phoA). Cells containing this construct secreted correctly processed barnase (Asp-102) into the periplasmic space and culture supernatant at a level of 20 mg/l. Barnase (Asp-102) was purified and found to have an identical N-terminus and a thermal unfolding curve that was nearly identical to that of active barnase (His-102). The cloning and expression of barnase in E. coli will allow detailed analysis of barnase protein folding by molecular genetic approaches. PMID- 3297927 TI - Nucleotide sequence of the insecticidal protein gene of Bacillus thuringiensis strain aizawai IPL7 and its high-level expression in Escherichia coli. AB - A DNA fragment carrying the insecticidal protein gene of Bacillus thuringiensis subsp. aizawai IPL7 was cloned from a 78-kb plasmid. The nucleotide sequence revealed that the cloned DNA fragment contained a 3465-bp protein-coding region with 156-bp 5'-flanking, and 168-bp 3'-flanking regions. The open reading frame encoded a 130,690 Da protein consisting of 1155 amino acid residues. Nucleotide sequence comparison of the aizawai gene with the published berliner 1715 gene showed only 8 nt changes in the coding regions. It was found that 72 bp of the 5' flanking sequence of the cloned aizawai gene was responsible for constitutive expression of the 130-kDa protein gene in Escherichia coli. The expression was greatly enhanced by introducing the tac promoter upstream from the 72-bp 5' flanking region of the aizawai gene. Under optimal conditions, the 130-kDa insecticidal protein amounted to 38% of the total cellular protein. PMID- 3297928 TI - Cardiac drugs: adjusting their use in aging patients. AB - Reduced drug metabolism, both renal and hepatic, occurs with aging. Algorithms for dose adjustments of renally excreted drugs are available, but dose adjustments must be empiric for drugs which undergo hepatic metabolism. Decreased drug clearance in combination with potentially increased sensitivity to drugs in the elderly means that, as a general rule, drug dosages should be reduced as the age of the patient increases. The frequent need for multi-drug therapy may also lead to adverse effects in the elderly compared with younger cardiac patients. Managing the geriatric patient requires careful drug monitoring and a heightened awareness of the potential for adverse drug effects. PMID- 3297929 TI - Teaching intergenerational communication as a speech/communication elective. PMID- 3297930 TI - [A. G. Bakherakht on scurvy]. PMID- 3297931 TI - [Determination of Shigella sonnei in milk using the coagglutination reaction]. PMID- 3297932 TI - [Viability of Staphylococcus aureus and Escherichia coli in the open pit waters of the Kama Fuel and Energy Complex]. PMID- 3297933 TI - [Anti-cancer drugs: potential and actual risk of occupational exposure]. PMID- 3297934 TI - Preparation of the tooth surface to receive a pit and fissure sealant. PMID- 3297935 TI - Cellular aspects of growth and catch-up growth in the rat: a reevaluation. AB - The effect of nutritional perturbations upon growth and catch-up growth in mass in the rat have been reevaluated by interpretation of published data. The earlier described cellular mechanisms involved were prematurely reported to be invalid. Hypertrophy and hyperplasia have been separately assessed by employing studies providing DNA content of the body or organs permitting calculation of number of "DNA units" and mean size of the units. Changes in unit number and size accounted for reported changes in gross mass. Perturbation during the periods of gestation and/or nursing decreased or increased the number of units without changing the size of the units, and in these cases the change in body or organ mass persisted into maturity. Perturbation during adulthood changed size of the units without changing their number, and in these cases catch-up occurred. Post-weaning was a transitional period with perturbation sometimes changing unit number after which the change persisted and sometimes unit size after which catch-up occurred. Failure in most cases of DNA unit number and unit size to change simultaneously led to speculations about the mechanisms involved. Besides perturbations resulting from experimental interventions, the rat is influenced also by circumstances with unpredictable nutritional impact encountered during the ontogeny of free-living individuals, for example, interactions between pups and mother and between siblings. Presumably the generalizations arrived at above also apply in these cases. PMID- 3297936 TI - Postnatal development of dependence on thyroid hormones for growth and differentiation of rat skeletal structures. AB - We have studied the development of thyroid hormone dependence for growth and differentiation of rat skeletal tissues. The radius, tail tip or xiphoid process from 1-day-old rats was transplanted in its entirety under the kidney capsule of euthyroid or hypothyroid (TX) adult syngeneic virgin rats and grown there for 3, 6, 9, 12 or 15 days. Pieces of the sternum or calvarium were treated similarly. Growth of transplanted radius and sternum in TX hosts showed significant retardation by day 3, and that of transplanted calvarium, tail tip and xiphoid showed significant inhibition by day 6 post transplantation. Tissue differentiation of all of the transplants was inhibited in TX hosts and the appearance of epiphyseal ossification centers was significantly delayed. Injection of Propylthiouracil (PTU) in solvent into the neonatal rats from day 1 to day 15 post partum inhibited tail length increase by day 7, and body weight gain by day 9, as compared to the growth of solvent injected littermate pups. Our results indicate that the growth and differentiation of endochondral bones are more dependent on TH levels than are those of membranous bones and cartilage. Endochondral bones develop TH dependence for growth and differentiation before day 4 post partum, while the membranous bones and cartilage develop this dependence at the end of the first week. PMID- 3297937 TI - Transpyloric fluid movement and antroduodenal motility in patients with gastro oesophageal reflux. AB - The pattern of transpyloric fluid movement and associated antroduodenal motility was compared in patients with gastro-oesophageal reflux (GOR) and healthy controls using real time ultrasonic imaging. A similar number of cyclical periods of antroduodenal motor activity (GOR 94 and control 91) was studied in each group. Mean antral cycle times and the frequency of occurrence of related proximal duodenal contractions (antroduodenal coordination) were similar. Transpyloric fluid movement occurred as a number of discrete episodes in each cycle. Gastroduodenal flow was more frequent in the GOR group (mean 2.7 +/- 0.4 episodes per cycle) than in controls (mean 1.7 +/- 0.3). The mean duration of these episodes in both groups was similar at around 2.5 seconds. Duodenogastric flow (reflux) was observed in many cycles (GOR 63%; controls 54%), but there was no difference in the mean number of episodes per cycle (GOR 0.79; control 0.74) or their mean duration (two seconds for both). Transpyloric fluid flow only occurs when a pressure gradient is created across the open pylorus. These observations indicate that in GOR the gastroduodenal pressure gradient is positive more frequently than in normal controls. Gastroduodenal liquid flow but not duodenogastric reflux differs in GOR patients and controls. PMID- 3297938 TI - Relationship of erosive gastritis to the acid secreting area and intestinal metaplasia, and the healing effect of pirenzepine. AB - The extent of acid secreting areas and the distribution of intestinal metaplasia in patients with erosive gastritis, and the healing effects of pirenzepine were examined. Studies were done with the endoscopic Congo red-methylene blue test developed in our hospital. Compared with control patients with no gastroduodenal disease, erosive gastritis was associated significantly more frequently with large acid secreting areas, but little or no intestinal metaplasia was detected in the stomach. A double blind trial was carried out, using 100 mg pirenzepine tablets or placebo for three months in 43 patients with erosive gastritis. Endoscopically, complete healing was significantly more frequent in the pirenzepine treated groups three months after the start of the treatment, as compared with the placebo treated group (p less than 0.05). PMID- 3297939 TI - Immunohistochemical Cal9-9 in primary colonic polyps and polyps synchronous with colorectal cancer. AB - A prospective study was undertaken to examine the immunohistochemical expression of tumor antigen Cal9-9 in 56 colorectal cancers and 95 colonic adenomas, divided into 65 primary polyps and 30 polyps synchronous with colorectal cancer. Seventy five per cent of tumours were positive for Cal9-9. Antigen was expressed more frequently in advanced Duke's C and D and poorly differentiated colorectal cancer. Overall 51% of adenomas were positive for Cal9-9. Antigen expression correlated significantly with increasing size (p less than 0.001), synchronicity with colorectal cancer (p less than 0.001), severe dysplasia (p less than 0.001) and villous typing (p less than 0.003). Discriminate analysis using the first three variables correctly classified 79% of positive and 89% of negative Cal9-9 results. The similar frequency of antigen expression seen in colorectal cancers and their synchronous adenoma suggests a field change in the tumour bearing colon. Adenomas positive for Cal9-9 may have a greater malignant potential for carcinomatous change. PMID- 3297940 TI - Randomised controlled trial of lymphoblastoid interferon for chronic active hepatitis B. AB - Thirty male patients (27 homosexual) with biopsy proven chronic active hepatitis B were randomised to receive lymphoblastoid interferon (Wellferon) or no treatment. All patients were HBeAg positive and had continuing viral replication. Patients receiving treatment were given a single daily intramuscular injection of interferon for 28 days at a starting dose of 2.5 MU/m2 increasing to a maximum of 7.5 MU/m2/day. Transient side effects of malaise and influenza like symptoms occurred in all patients and resolved rapidly after treatment. Hepatitis B viral replication was suppressed during interferon treatment in all patients but the effect was limited to the period of therapy. After one year there was no appreciable difference in viral markers between the two groups of patients and this treatment schedule appears less effective than the thrice weekly, three month regimes recently reported from other centres. PMID- 3297942 TI - High-dose systemic streptokinase and acylated streptokinase-plasminogen complex (BRL 26921) in acute myocardial infarction: alterations of the fibrinolytic system and clearance of fibrinolytic activity. AB - We report the results of two consecutive studies using intravenous bolus injections of streptokinase (SK) or acylated plasminogen-SK complex (BRL 26921) in patients with acute myocardial infarction (AMI). In the first study, 20 patients received either 750,000 units (U) SK (group IA, n = 10) or 1,500,000 U SK (group IB, n = 10) within 5-10 min intravenously. In the second study 10 consecutive patients received 750,000 U SK within 15 min (group IIA) intravenously. The following 10 consecutive patients received 30 mg BRL 26921 within 2 min (group IIB). Early reperfusion was found in 16 patients in the first study (8 in each group) and in 18 patients in the second study (9 in each group). The decrease of fibrinolytic activity was biphasic with a half-disappearance time of 112.5 min for BRL 26921 and 31 (IA) and 18 (IB) min for SK. alpha 2 Antiplasmin depletion and a decrease of fibrinogen was observed with no differences after bolus injections of SK and of BRL 26921. PMID- 3297944 TI - [Closed traumatic rupture of the insertion of the flexor digitorum profundus tendon]. AB - The rupture of the insertion of the flexor digitorum profundus tendon is very uncommon, apart cases due to polyarthritis. Most cases are soccer, football or rugby players; the ring finger is the most affected. The traumatic agent is the sudden extension while the finger is holding an object and the flexor digitorum profundus is strongly contracted: the tendon retracts and the stump can be found either at the distal pulley, at the bifurcation of the superficialis tendon, or in the palm of the hand. Because of retraction, the trophic balance of the tendon is compromised: and this is very important in cases of delayed diagnosis, such as happens in 75% of cases. As a result, the treatment can be difficult and sometimes arthrodesis of the distal interphalangeal joint is the only possible therapy. PMID- 3297943 TI - Corynebacterium parvum, but not BCG, induces elevations in plasma proteinase activity similar to those observed in tumor-bearing mice. AB - Intraperitoneal administration of Corynebacterium parvum to BALB/c, C57Bl/6 or C3H/HeJ mice lead to the induction of elevated levels of neutral proteinase activity (125I-caseinolytic activity) similar to those observed previously in animals bearing the BCL1 leukemia or the B16-F10 melanoma. Enhanced activity reached a peak at 7-14 days postinjection of the C. parvum and then gradually returned to normal levels by 20-25 days postinjection. Increased plasma proteinase activity could be induced by C. parvum whole cells or the pyridine extract residue of C. parvum but not by BCG or the pyridine extract of C. parvum. BCG did not interfere with the induction of elevated levels of activity by C. parvum. Splenectomized animals responded the same as normal mice indicating that the splenomegaly accompanying the onset of increased plasma proteinase activity was not responsible for the changes. Administration of C. parvum via a subcutaneous site rather than intraperitoneally failed to induce systemic changes in proteinase activity while still inducing splenomegaly. Treatment of animals with C. parvum before or after transplantation of the BCL1 leukemia or the B16 F10 melanoma failed to alter the course of the disease or enhance the increased proteinase activity of plasma over that observed in plasma from animals bearing tumors alone. These observations support the hypothesis that the induction of disturbances in plasma proteinase activity in tumor-bearing animals is due to alterations in host systems and that C. parvum, in contrast to BCG, contains components which can mimic the effect of some tumors on host systems. PMID- 3297945 TI - [Subcutaneous profundus tendon rupture--reconstruction or primary arthrodesis]. AB - Subcutaneous rupture of the flexor tendon is not as rare as described. Between 1972-1982 14 patients with ruptured flexor tendons were treated at the accident hospital in Linz. The average age was 34.8 years. In most of the cases we use primary arthrodesis with the Harrison-Nicolle-Peg, because the external fixation is very short and the method gives secure ankylosis or arthrodesis of the distal finger joint. PMID- 3297946 TI - [Bulimia nervosa: a new clinical entity]. PMID- 3297947 TI - [Tubulo-interstitial involvement of the kidney in systemic lupus erythematosus]. PMID- 3297949 TI - [Anticholinergic bronchodilators]. PMID- 3297948 TI - [Ultrasonography for lower urinary tract assessment]. PMID- 3297941 TI - Problems of bacterial infection in patients with liver disease. PMID- 3297950 TI - Experimental infection of the squirrel (Sciurus vulgaris) and the muskrat (Ondatra zibethica) with Tahyna virus (California group, Bunyaviridae). AB - Two squirrels aged 16 weeks and three muskrats aged 24 weeks were subcutaneously infected with a dose of 400 SMicLD50 of the extraneurally passaged "236" strain of Tahyna virus. Viremia was detected in one squirrel (48 and 96 hours post infection) and in two muskrats (24 and 48 hours p.i.). Seroconversion was demonstrated by plaque-reduction neutralization test (PRNT) 21 days p.i. in all animals. PMID- 3297951 TI - Group-specific component: a review of the isoelectric focusing methods and auxiliary methods available for the separation of its phenotypes. AB - This review compares the major isoelectric focusing methods that have been published for the separation of group-specific component (Gc) phenotypes since 1978. The various parameters of gel composition, size, electrical and running conditions and sample application points are listed. More current auxiliary methods are also listed. These relate to the extraction of Gc from bloodstains and its identification after isoelectric focusing. Protocols are then recommended for the forensic analysis of Gc phenotypes. PMID- 3297952 TI - Alcohol loss arising from microbial contamination of drivers' blood specimens. AB - This paper describes the circumstances in which some drivers' blood specimens containing added sodium fluoride (1% w/v concentration) deteriorated as a result of microbial contamination, accompanied by a decrease of alcohol concentration. Strains of the bacteria Serratia marcescens and a Pseudomonas sp. were isolated from the specimens and proven capable of growing at ambient temperature in blood containing sodium fluoride at 1% w/v concentration. They were shown to be active in alcohol degradation in preservatised blood, the activity being dependent on sodium fluoride concentration and storage temperature. Blood diluters were assumed to be a source of microbial cross contamination from one blood specimen to the next. It is recommended that postmortem blood specimens be analysed in separate batches from drivers' specimens when automated blood diluters are used, that the content of fluoride ions be increased to an equivalent of 2% w/v sodium fluoride, and that storage of specimens at temperatures above 4 degrees C be minimised. PMID- 3297953 TI - The ABO blood grouping of a minute hair sample by the immunohistochemical technique. AB - The unlabeled antibody (PAP) immunoperoxidase technique was applied to the ABO blood grouping of human scalp hairs. Hair samples were subjected to longitudinal- or cross-sectioning, thus obtaining suitable samples for subsequent immunostaining. The immunostaining was carried out using rabbit anti-A and anti-B sera as the primary antibodies. With this technique, the group-specific staining which is revealed as a dark brown precipitate was clearly observed within the medullae of the hair shaft, and depending on the presence or absence of these precipitates, respective blood groups of unknown hair samples were determined. At the hair root, on the other hand, positive stainings were observed not only in medullary cells but also in some cortical cells of the keratogenous zone. From the present study, it can be safely said that this technique is of practical use for the ABO blood grouping from a minute (less than 3 mm) hair sample. PMID- 3297954 TI - [Comparison of various new mechanisms for retaining metal bracket bases]. PMID- 3297956 TI - [Regulation of hypoglycemia. Insulin, the central hormone for regulating intermediary metabolism]. PMID- 3297955 TI - [Keratoplasty and immune reactions: clinical picture--differential diagnosis]. PMID- 3297958 TI - [Computer-assisted diagnosis of depressive syndrome. Experiences with 150 patients]. PMID- 3297957 TI - [Treatment of drug-induced gastrointestinal disorders. Double-blind study of the effectiveness of Iberogast compared to placebo]. PMID- 3297959 TI - The FNS Courier/Volunteer program. Tradition--service--adventure. I. PMID- 3297960 TI - New ideas in thyroid autoimmunity. AB - Endocrine epithelial cells do not normally express human leukocyte antigen (HLA) class II molecules, but do so in a variety of autoimmune diseases. This finding suggests the hypothesis that such inappropriate class II-positive expression may enable these cells to present autoantigens and thus contribute to autoimmune pathogenesis. Indeed, class II-positive thyrocytes can present both exogenous antigenic peptides and intrinsic autoantigens to the appropriate T cells. Class II expression by thyrocytes can be induced by interferon-gamma, and is positively and negatively regulated by thyroid-stimulating hormone and epidermal growth factor, respectively. Furthermore, heterogeneity of thyrocyte class II subregion expression appears to be related to the nature of the inducing stimulus. The complexity of regulatory signals is underlined by findings in type I diabetes: islet beta cells aberrantly express class II in this disease, but class II cannot be induced in normal beta cells by interferon-gamma. PMID- 3297962 TI - Ultrasound evaluation of thyroid diseases. AB - Ultrasound is very sensitive in evaluating the size of the thyroid gland and the presence of nodules within it. There are no specific signs indicative of malignancy though the majority of the differentiated carcinomas and all anaplastic tumors present as a hypoechoic mass. Since autonomous and 'cold' adenomas may show a similar echo pattern, a scintigraphic study is mandatory as part of the basic examination, except for euthyroid subjects without any nodularity on the ultrasound scans. Scintigraphically cold, echo-poor solid lesions require additional diagnostic procedures like aspiration cytology or biopsy until malignancy is definitely excluded. Monitoring of the thyroid volume during suppressive hormonal therapy is highly valuable for the early detection of 'non-responders' who probably will benefit from another management. PMID- 3297961 TI - Fetal and maternal thyroid hormones. AB - It is well known that insufficient production of thyroid hormones during the fetal and neonatal period of development may result in permanent brain damage unless treatment with thyroid hormone is instituted very soon after birth. But congenital hypothyroidism is not the only situation in which brain damage may be related to insufficient thyroid function. Cretinism is the most severe manifestation of iodine deficiency disorders found in areas where iodine intake is greatly reduced. Some of the manifestations of cretinism suggest that the insult to the developing brain starts earlier than in the case of congenital hypothyroidism. Hypothyroxinemia of mothers with adequate iodine intake may also leave permanent, though less severe, mental retardation. For these reasons the possible role of maternal transfer of thyroid hormones during early fetal development have been reinvestigated, using the rat to obtain various experimental models. It has been shown that thyroid hormones are found in embryonic tissues before onset of fetal thyroid function and that thyroidectomy of the mother results in delayed development of the concepta. The concentrations of T4 and T3 in embryonic tissues from thyroidectomized dams were undetectable before the onset of fetal thyroid function, and still reduced in some tissues near term, despite the onset of fetal thyroid function. Treatment of control and thyroidectomized dams with methyl-mercaptoimidazole to block fetal thyroid function reduced thyroid hormone concentrations in fetal tissues near term, but this decrease could be partially avoided by infusion of physiological doses of thyroxine to the mothers. Iodine deficiency of the mothers resulted in thyroid hormone deficiency of the developing embryo, which was very marked until term in all tissues including the brain. The results strongly support a role of maternal thyroid hormones in fetal thyroid hormone economy both before and after the onset of the fetal thyroid function, at least in the rat. They also support a role of the hypothyroxinemia of iodine-deficient mothers in initiating the brain damage of the endemic cretin, a damage which would not be corrected once the fetal thyroid becomes active, as iodine-deficiency of the fetus would impair adequate production of hormones by its own thyroid, and maternal transfer would continue to be low. PMID- 3297963 TI - Clinical usefulness of thyroid imaging by means of X-ray fluorescence. AB - Iodine storage is an important thyroid function which has been difficult to estimate by simple means up to now. The introduction of the X-ray fluorescence technique makes this assessment possible on a large scale, with a minimum radiation burden and no more discomfort for the patient than classical imaging with radioisotopes. Its implementation has resulted in the better understanding of some aspects of thyroid physiopathology. This paper deals with the clinical utility of the method: the visualization of stable iodine and, most important, its quantification contribute significantly, sometimes fundamentally, to a better diagnosis with its therapeutic implications. PMID- 3297964 TI - Metabolism of the thyroid hormones. AB - This review covers the current knowledge about the various metabolic pathways involved in the conversion of thyroid hormones to the thyromimetically active and inactive iodothyronines. The concerted mechanism of systemic and local production of iodothyronines by tissue-specific iodothyronine deiodinase isozymes will ultimately determine the expression of thyroid hormone action. This is exemplified for the regulation of synthesis and release of TSH by iodothyronines at the pituitary level. Iodothyronine metabolites, e.g. Triac, rT3 and T3 amine may modulate TSH secretion, and alterations of local pituitary deiodination (e.g. iopanoate inhibition) influence diurnal TSH secretion without changing TRH dependent episodic TSH secretion pattern. A summary of structure-activity relationships of greater than 200 naturally occurring and synthetic ligands of rat liver type I iodothyronine deiodinase isozyme propylthiouracil-sensitive) in vitro allows the design of iodothyronine analogues which either serve as specific substrates or antagonists of iodothyronine binding and metabolizing proteins. Furthermore, a complete picture of the ligand-complementary active site of the type I isozyme can be derived. A synthetic 'structurally optimized' iodothyronine analogue flavonoid inhibitor of the type I deiodinase is able to displace T4 from binding to thyroxine-binding prealbumin and leads to unexpected organ-specific alterations of thyroid hormone metabolism and expression of thyroid hormone actions in an animal model. Therefore, for a complete understanding of thyroid hormone metabolism and action, thyroid hormone transport, cellular compartmentalization, and alternate pathways also have to be considered. PMID- 3297965 TI - Inappropriate secretion of thyrotropin by the pituitary. AB - Inappropriate secretion of thyrotropin (IST) is characterized by elevated serum free thyroid hormone and unsuppressed thyrotropin (TSH) levels, and results from either a TSH-secreting pituitary tumor (nIST) or a selective resistance to thyroid hormone action (nnIST). Although in most patients TSH levels are definitely high, in a quarter of the cases they are within the 'normal range'. In some of these cases, TSH had an elevated biologic activity and an apparent molecular weight smaller than in normals. The current availability of ultrasensitive TSH immunoradiometric assay, able to distinguish suppressed from unsuppressed TSH levels enables the recognition of the disease. The distinction between nnIST and nIST rests on clinical, neuroradiological, and biochemical criteria, the most useful of which are the alpha-subunit:TSH molar ratio (increased in nIST), and the evaluation of the TSH responses to thyrotropin releasing hormone and high doses of 3,5,3'-triiodothyronine, both qualitatively normal in nnIST, while absent in nIST. The therapy of choice for patients with nIST is pituitary surgery, followed by irradiation in case of surgical failure. Chronic administration of bromocriptine is effective in a minority of cases. The long-acting somatostatin analogue SMS 201-995 has given promising results in 2 patients. In nnIST, bromocriptine is frequently uneffective, while small doses of 3,5,3'-triiodothyronine or 3,5,3'-triiodothyroacetic acid, a thyroid hormone derivative with a strong inhibitory effect on TSH secretion but poor thyromimetic activity on peripheral tissues, are effective in controlling TSH hypersecretion. PMID- 3297966 TI - Normal and defective expression of the thyroglobulin gene. AB - Molecular studies of the thyroglobulin (Tg) gene have progressed significantly in recent years. Cloning and sequencing the complete bovine Tg cDNA led to the knowledge of the primary structure of the Tg subunit. This large polypeptidic chain displays a repetitive structure, especially in its amino-terminal half, and bears a striking homology with the acetylcholinesterase molecule of Torpedo californica in its carboxy-terminal portion. The four specific domains known to be involved in the formation of the thyroid hormones have been assigned to both terminal parts of the polypeptide, a location which could play a role in the process leading to hormone release. The very large (greater than 250 kb) Tg gene has been localized on the long arm of chromosome 8 in man, in close linkage with the c-myc oncogene. The study of its structure allowed the characterization of the molecular defect responsible for a congenital flaw in Tg gene expression in a herd of South-African cattle. This work led to the unexpected finding that the Tg pre-mRNA undergoes alternative splicing in normal animals, too. A DNA segment involved in the transcriptional control of Tg gene expression by cAMP has been identified by transfecting primary cultured thyrocytes with recombinant genes. PMID- 3297967 TI - Gastrointestinal lymphoma in Chinese: a retrospective analysis. AB - Eighty-four Chinese patients with gastrointestinal lymphoma were reviewed. There were 45 gastric and 39 intestinal lymphomas. The median age was 45 years and the male to female ratio 1.14:1. Diffuse histiocytic (60 per cent) or diffuse large cell (53.5 per cent) lymphoma comprised a majority of the cases. A high incidence of gastrointestinal bleeding at presentation was observed in our patients. According to a modified staging classification, a larger proportion of patients with intestinal lymphoma had advanced disease (Stage III and IV) than those with gastric lymphoma (82 per cent versus 55 per cent, p less than 0.02) and gastric lymphoma carried a better prognosis. The modified staging classification used in this study appeared to stratify better the patients into 2 sub-groups of localized (Stage I and II) and advanced (Stage III and IV) disease, which correlated very well with the prognosis. Good treatment results were obtained following intensive therapy in our patients with localized disease (Stage I and II). The poorer treatment results of patients with advanced disease (Stage III and IV) call for better chemotherapy regimens and earlier diagnosis. Surgical resection of the primary gastrointestinal lesion is recommended to prevent haemorrhage and perforation following chemotherapy, which occurred in 38 per cent of our patients whose gastrointestinal lesions were not resected. PMID- 3297968 TI - Malignant osteoclastoma-like giant cell tumour of the renal pelvis. AB - We report the fourth case of an osteoclastoma-like giant cell tumour of the renal pelvis. A special feature was that although thorough sampling of the tumour showed an osteoclastoma-like pattern throughout, it was intimately associated with carcinoma in situ change of the adjacent transitional epithelium and this provides further support for the view that these tumours are of epithelial derivation. However, immunohistological and ultrastructural studies failed to reveal epithelial features within the tumour cells and the possible significance of this finding is discussed. PMID- 3297969 TI - Chronicity in schizophrenia: fact, partial fact, or artifact? AB - Clinical experience has appeared to support the view that persons with repeated episodes of schizophrenia can expect to have a chronic course with residual symptoms and lasting deficits in such areas as work, social relations, and self care. However, the authors' review of recent long-term follow-up studies and of the clinical experiences of early researchers strongly challenges this pervasive expectation. This report suggests that there is considerable heterogeneity in the long-term outcome of schizophrenia, with marginal or deteriorated states more the exception than the rule. Among the contributors to the misperception of chronicity are biased sampling, both past and present, as well as a multitude of environmental and psychosocial factors that affect patient outcome. PMID- 3297970 TI - Late-life depression and delusions. PMID- 3297971 TI - States, Congress focus on Medicare assignment. PMID- 3297972 TI - HCFA: ambulatory surgery rates may hurt hospitals. PMID- 3297973 TI - Humana: where will its strategic plan lead it? PMID- 3297974 TI - Will payment control technology diffusion? PMID- 3297975 TI - Hospitals, HHS to end labor/delivery room dispute. PMID- 3297976 TI - Freestandings bound to gain under new PPS plan. PMID- 3297977 TI - Grass roots support to fight Medicare cuts. PMID- 3297979 TI - Conflicting data greet Congress in reconciliation. PMID- 3297978 TI - Community nurses' organizations: the new HMOs? PMID- 3297980 TI - HCFA's capital proposal, projections unrealistic. PMID- 3297981 TI - Prompt payment for Medicaid: does it exist? PMID- 3297982 TI - WA Medicaid study challenges HMO care myths. PMID- 3297983 TI - Managed care Medicaid programs on the rise. PMID- 3297984 TI - Who will finance graduate medical education? PMID- 3297985 TI - Average PPS rate to increase 3.5% in FY '88. PMID- 3297986 TI - Medicare cost report needs major overhaul. PMID- 3297987 TI - "Self-disallowed" costs: issue to High Court? PMID- 3297988 TI - Some aspects of the criterion methods for the measurement of body composition. PMID- 3297989 TI - Molecular biology and genetics and our understanding of disease. PMID- 3297990 TI - In situ viral DNA hybridization in diagnostic surgical pathology. PMID- 3297991 TI - Endomyocardial biopsy: an overview. PMID- 3297992 TI - Myocarditis: the Dallas criteria. PMID- 3297993 TI - Renal lipidoses: a review. PMID- 3297994 TI - Functionally important disorders of the placenta, umbilical cord, and fetal membranes. PMID- 3297995 TI - Mycobacterial antigen detection by immunohistochemistry in pulmonary tuberculosis. AB - A preliminary diagnosis of tuberculosis can be established by the detection of acid-fast bacilli (AFB) and confirmed by culture of the microorganism. To evaluate an alternative method of diagnosis, the distribution of mycobacterial antigens in lung tissue specimens was characterized by an indirect peroxidase antiperoxidase method and was compared to the detection of AFB by Ziehl-Neelsen stain. Histologic specimens were obtained from 59 hospital patients. Of nine patients with mycobacterial disease, seven had antigen detected in tissue. In two patients with tuberculous pneumonia, the distribution of mycobacterial antigens was approximately the same as that of AFB. In contrast, in four patients with caseating pulmonary granulomas, clumps of mycobacterial antigens were demonstrated in necrotic areas of the granulomas where there were few or no AFB. In one patient with Mycobacterium intracellulare infection, cross-reactive antigens stained weakly. Antigen was not found in tissue from two patients; one had miliary lung granulomas, and the second had mediastinal lymph node granulomas. Mycobacterial antigens were not detected in specimens from 50 control patients with nonmycobacterial diseases. On the basis of this study of 59 cases, immunohistochemical detection of microbial antigens appears to be useful for establishing the mycobacterial etiology of caseating pulmonary granulomas. PMID- 3297996 TI - Idiopathic retroperitoneal fibrosis (sclerosing retroperitonitis). AB - Three cases of idiopathic retroperitoneal fibrosis, one of which was localized to the perirenal area, are presented. The predominance of plasma cells, which may be difficult to recognize because of distortion unless methyl green-pyronine staining is done, and the character of the fibrous tissue indicated the non neoplastic nature of the processes. This diagnosis was confirmed by immunoperoxidase studies that demonstrated polyclonality of the lymphoplasmacytic component. Immunologic studies, which may be performed on paraffin-embedded tissue, are helpful in differentiating this lesion from the sclerosing lymphomas that also occur in the retroperitoneal area. PMID- 3297997 TI - Concurrent neocortical borreliosis and Alzheimer's disease. AB - Borrelia spirochetes were directly visualized in autopsy brain tissue from a patient with Alzheimer's disease and were cultured from cerebral cortex in artificial media. The authors propose that, as occurs in tertiary neurosyphilis and general paresis of the insane, Borrelia species may invade the brain, remain in a latent state for many years, and cause dementia in the absence of other focal neurologic deficits. An undetermined fraction of patients with Alzheimer's disease may be shown to have late tertiary neuroborreliosis. PMID- 3298000 TI - Cigarette smoking and inflammatory bowel disease: a review. PMID- 3298001 TI - Direct evidence for a primary immune response of murine B-lymphocytes after in vitro immunization of dissociated splenocytes. AB - Monoclonal antibodies against human thyroglobulin were generated using splenocytes cultured in vitro with the antigen. When splenocytes from non immunized mice were used, about 90% of the hybridomas obtained produced immunoglobulins of the IgM class. In contrast, when splenocytes from mice previously immunized in vivo with human thyroglobulin were cultured in vitro with the antigen about 85% of the hybridomas obtained produced immunoglobulins of the IgG class. The properties of the monoclonal antibody produced by hybridoma 3D12, obtained after culturing splenocytes from non-immunized mice with human thyroglobulin, were examined in detail. Monoclonal antibody 3D12 reacted only with human thyroglobulin and not with the murine homologue in an enzyme-linked immunosorbent assay, in immunoblotting experiments and in an immunohistochemical test. These results provide direct evidence that a primary response to an antigen can be elicited by adding the antigen to cultures of splenocytes from non immunized mice. PMID- 3297999 TI - A method for nucleic acid hybridization to isolated chromosomes in suspension. AB - A procedure was developed to provide differential fluorescent staining of metaphase chromosomes in suspension following nucleic acid hybridization. For this purpose metaphase chromosomes were isolated from a Chinese hamster X human hybrid cell line. After hybridization with biotinylated human genomic DNA, the human chromosomes were visualized by indirect immunofluorescence using antibodies against biotin and fluoresceine-isothiocyanate-(FITC)-labeled second antibodies. This resulted in green fluorescent human chromosomes. In contrast, Chinese hamster chromosomes revealed red fluorescent staining only when counterstained with propidium iodide. Notably, interspecies chromosomal rearrangements could be easily detected. After hybridization and fluorescent staining, chromosomes still showed a well-preserved morphology under the light microscope. We suggest that this procedure may have a useful application in flow cytometry and sorting. PMID- 3297998 TI - Facts and considerations about sex-specific antigens. AB - The status of the present knowledge on the mammalian sex-specific antigens ("H-Y antigens") is reviewed and critically discussed. Special weight is given to problems related to three major topics, i.e., the immunology, genetics, and biological function(s) of these antigens. Current hypotheses as to the function(s) and the genetic control of the sex-specific antigens are individually scrutinized. Finally, some prospects for further H-Y research which seems especially urgent are briefly suggested. PMID- 3298002 TI - Characterization of several monoclonal antibodies generated against ferret tracheal epithelial cells. AB - Monoclonal antibodies have been generated to ferret tracheal epithelial (FTE) cells. Four of the antibodies exhibiting positive reactivity in a fluorescence activated cell sorter were further characterized. In tracheal sections, three of the antibodies reacted with submucous gland cells and material intermeshed in the cilia while the fourth antibody failed to react with epithelial cells. The three antibodies which reacted in tracheal sections also reacted with void volume fractions following Sepharose CL-6B chromatography of a solubilized FTE cell preparation. Reactivity of the void volume fractions to these antibodies was sensitive to periodate oxidation, and unaffected by heating (100 degrees C X 30 min) or methanol extraction suggesting a carbohydrate epitope. The fourth antibody recognized periodate-insensitive antigen in the void volume and included column fractions. Binding of one of the antibodies to periodate-sensitive antigen was completely blocked by 10 mM N-acetyl galactosamine as demonstrated in an ELISA with fixed FTE cells. In a western blot analysis, two of the antibodies which recognized periodate-sensitive antigen also reacted with a large heterogenous macromolecule. PMID- 3298004 TI - Collaboration in developing a research program grant. PMID- 3298003 TI - A computer model of acoustic wave scattering in soft tissue. PMID- 3298005 TI - Nursing's window of opportunity. PMID- 3298006 TI - Evolution of antibody variable region structure during the immune response. AB - The results reviewed above reveal that during the anti-Ars immune response of strain A mice a somatic process that results in the evolution of V region structure occurs. This process involves both the selection of V regions encoded by particular gene segment combinations as well as the selection of structural variants of these V regions produced by somatic mutation as the immune response progresses. As a result, both quantitative and qualitative changes in the V region population initially elicited by immunization take place. The structural and functional character of the immune V region repertoire appears to be largely determined by this process of "somatic evolution" occurring in the primary response. PMID- 3298007 TI - Mutation drift and repertoire shift in the maturation of the immune response. PMID- 3298008 TI - Somatic mutation in human B-cell tumors. PMID- 3298009 TI - Timing, genetic requirements and functional consequences of somatic hypermutation during B-cell development. AB - While somatic antibody mutants are rare in the preimmune repertoire and in primary immune responses, they dominate secondary and hyperimmune responses. We present evidence that somatic hypermutation is restricted to a particular pathway of B-cell differentiation in which distinct sets of B-cell clones are driven into the memory compartment. In accord with earlier results of McKean et al. (1984) and Rudikoff et al. (1984), somatic mutation occurs stepwise in the course of clonal expansion, before and after isotype switch, presumably at a rate close to 1 X 10(-3) per base pair per generation. At this rate, both selectable and unselectable mutations accumulate in the rearranged V region genes. The distribution of replacement mutations in the V regions shows that a fraction of the mutations in CDRs is positively selected whereas replacement mutations are counterselected in the FRs. By constructing an antibody mutant through site specific mutagenesis we show that a point mutation in CDR1 of the heavy chain, found in most secondary anti-NP antibodies, is sufficient to increase NP binding affinity to the level typical for the secondary response. Somatic mutation may contribute to the immune repertoire in a more general sense than merely the diversification of a specific response. We have evidence that clones producing antibodies which no longer bind the immunizing antigen can be kept in the system and remain available for stimulation by a different antigen. Somatic mutations are 10 times less frequent in DJH loci than in either expressed or non-expressed rearranged VDJH or VJ loci. We therefore conclude that a V gene has to be brought into the proximity of the DJH segment in order to fully activate the hypermutational mechanism in these loci. PMID- 3298010 TI - Somatic mutation in anti-phosphorylcholine antibodies. AB - A detailed analysis of the genes and proteins that participate in the murine immune response to PC has provided key insights at the structural level into the phenomenon of somatic mutation in B cells. Most anti-PC antibodies are encoded by 1 VH gene of the S107 subfamily, and 3 VK genes, VKT15 of the VK22 subfamily, VKM3 from the VK8 subfamily, and VK167 from the VK24 subfamily. No mutation was detected in these genes until the 2nd wk after immunization, indicating that mutation is under developmental control. The protein sequences of 73 heavy and light chains derived from the secondary response support the concept of developmental activation of mutation after antigen stimulation. No mutation was found in the IgM antibodies, whereas half of the IgG and IgA antibodies had mutation. Most of the mutated antibodies had higher affinity for antigen than their germline counterparts, which suggests that the major role of somatic mutation is to increase affinity rather than to create new specificities. Nucleotide sequencing established two hallmarks of mutation in immunoglobulin genes: mutations are targeted to a 1 kilobase region surrounding and including the rearranged variable gene, and they occur at an extraordinary frequency of 10( 2) nucleotide substitutions. Mutation is probably caused by DNA repair, and may occur during error-prone repair of nicked DNA around the variable gene or during mismatch repair of misaligned structural intermediates. The elucidation of this remarkable mechanism clearly requires studies of a more dynamic character. Two major questions that need to be answered are: what targets mutation to the variable gene, and what enzymes are involved? PMID- 3298012 TI - Measurements of mutation rates in B lymphocytes. AB - It is established that somatic mutation is an important source of antibody diversity in vivo. It is also established that Igh-V gene segments are hypermutable in vitro. This is not a completely satisfactory situation. While there is no reason to believe that Igh-V genes are not hypermutable in vivo as well, direct experimental evidence is lacking. Perhaps experiments with transgenic mice will soon fill this gap. It is not so clear how much higher than normal the rate of hypermutation is. As far as we are aware, there are no direct measurements of mutation rates per base pair per cell generation in mammals, certainly not for lymphocyte cell lines. For a variety of reasons, it is difficult to measure very low mutation rates. The general consensus is that the normal rate should be somewhere between 10(-10) and 10(-12) mutations per base pair per cell generation. Therefore, an experiment designed to directly determine a rate using the compartmentalization test would involve hundreds of cultures, each containing at least 10(9) cells. It is not a trivial problem to find one or a few mutants among so many cells. It is simple to study mutation to resistance to a drug, for example, ouabain or azaguanine, but, as we discussed, there are technical and conceptual pitfalls. The vast excess of dead cells influences the growth of a few mutant cells, particularly in lymphocyte cell lines. Even if this problem could be solved, the mutation rate so obtained would be "per gene(s)" and not "per base pair". The problems associated with cytotoxic agents can be avoided by immunofluorescence methods in conjunction with selective cloning or cell sorting. Using these techniques, we have carried out extensive experiments to determine whether the immunoglobulin mutator system acts, at least partially, on genetic elements other than those in or near the heavy chain variable region gene segment. For an opal termination codon in a heavy chain constant region gene segment, the rate of reversion was less than 10(-7) per base pair per cell generation. This upper limit was fixed by the high rate of small deletions at the heavy chain locus. For an allotype mutation at B2m, the gene encoding beta 2 microglobulin, the rate of mutation was less than 10(-8). This upper limit could be lowered by at least two orders of magnitude by using a high-speed cell sorter. PMID- 3298013 TI - Preparation of O4-ethylthymine containing synthetic DNA and its possible repair by E. coli extracts. PMID- 3298011 TI - Studies on the somatic instability of immunoglobulin genes in vivo and in cultured cells. AB - We have examined the molecular mechanism and impact of somatic diversification on the T15 heavy chain variable region gene in vivo and in vitro. Somatic point mutation appears to be responsible for the changes we have observed in both hybridomas from early and late in the immune response and in the S107 myeloma cell line in culture. By identifying S107 mutants with decreases in antigen binding, we have shown that a single point mutation can cause the loss of binding to the eliciting antigen and the acquisition of binding to another antigen. Furthermore, in this case a point mutation of the T15 heavy chain variable region gene caused the conversion of an important protective antibody to an autoantibody. While the S107 cell line frequently generates both constant and variable region mutants, hybridomas appear to have relatively stable variable region genes and unstable constant region genes which in some cases result in mutants with increased binding. PMID- 3298014 TI - Purification and characterisation of a cytosolic protease from S-180 cells and its effect on WGA binding. PMID- 3298015 TI - Maintenance of pancreatic endocrine cells of the neonatal rat: Part IX--Reversal of 2-deoxyglucose effects by mannose. PMID- 3298016 TI - [Immunologic aspects of sterility and infertility]. AB - In the complex field of reproductive immunology, related disciplines overlap. Beyond the normal projects of family planning and sterility diagnosis and treatment, new possibilities of population control and early detection of chromosomal and genetic anomalies are pointed out. After a short introduction to the topic of sterility and infertility, the immunoregulatory mechanisms during physiological and pathological pregnancies are discussed. The antigenicity in the female and male reproductive tract and of the gametes themselves are described in detail. Various methods for sperm-antibody detection are compared, especially, a radioimmunoassay developed by the authors. PMID- 3298017 TI - [Immunologic aspects in disorders of male fertility]. AB - The spermatozoa may in some circumstances induce immunological response mechanisms and evoke sperm autoimmunization. Different types of sperm antigens can be found in the seminal fluid and on the spermatozoa. New techniques: the radio-immunoassay (RIA) and the enzyme linked immunosorbent assay (ELISA) become more and more significant in the detecting of spermaantibodies. In some cases genital infections presented at the same time can be treated. Common use is the empirical therapy with steroids, successful in about 30%. May be in future a specific immunotherapy with allergenic extracts is possible. PMID- 3298018 TI - [Autoantibody diagnosis in Wegener's granulomatosis]. AB - Anticytoplasmic antibodies (ACPA) against myelomonocytic cells were demonstrable in 54 of 72 patients with Wegener's granulomatosis (WG). Other autoantibodies (including ANA, AMAb, RF and anti-ENA) were only found in a low frequence and titre. The presence of ACPA correlated with the severity and activity of the disease. These results demonstrated that ACPA is a valuable tool to establish the diagnosis and to monitor disease activity in WG. PMID- 3298019 TI - [Myeloid antigens on human cloned natural killer cells]. AB - Cloned human natural killer cells express T-cell antigens and membrane molecules which are found on myeloid cells. Both the LFA-1 antigen (CD 11a, CD 18) and the IgG Fc-receptor Fc gamma Rlow (CD 16) are functionally relevant for the activation of these cells. PMID- 3298020 TI - [Justinus Kerner (1786-1862)]. PMID- 3298021 TI - [100 years ago: the discovery of Escherichia coli (Bacterium coli commune)]. PMID- 3298022 TI - Modulation of polyclonal activation by plasma fibronectin and fibronectin fragments. AB - Modulation of activation of polyclonal IgM, IgG and IgM anti-DNA antibodies by plasma fibronectin (Fn) was studied because in some autoimmune diseases there appears to be a correlation between the increased level of Fn in the affected tissues and increased polyclonal B-cell activation. Fn caused a dose-dependent polyclonal activation of IgM, IgG and IgM anti-DNA antibody-secreting cells in cultures of mouse splenocytes. Fn significantly inhibited the generation of polyclonal antibodies by Fn-binding stimulants and did not significantly change the generation of polyclonal antibodies by the stimulants that do not bind Fn. Plasmin or trypsin digestion of Fn abolished both the polyclonal activating properties of Fn and the inhibitory effects of Fn that were selective for the Fn binding polyclonal activators. Digestion of Fn with trypsin also generated immunosuppressive Fn fragments that inhibited polyclonal activation by both Fn binding and non-binding bacteria. Under our culture conditions Fn or Fn digests were not mitogenic and had no effect on the mitogenicity of Fn-binding and non binding stimulants. These results indicate that Fn can act as a polyclonal activator and that it can also modulate lymphocyte activation induced by other activators. PMID- 3298024 TI - [The Italian Group for Epidemiological Studies in Dermatology and the pilot project on the etiology of lichen planus]. PMID- 3298025 TI - [Mycologic findings in persons wearing dental prostheses]. PMID- 3298023 TI - The expression of class II MHC gene products by fallopian tube epithelium in pregnancy and throughout the menstrual cycle. AB - The expression of HLA class II antigens by human fallopian tube epithelium was investigated in ectopic tubal pregnancy, in normal early and full-term intrauterine pregnancy, and during the menstrual cycle. Monoclonal antibodies directed against non-polymorphic (DA6.231, CR3/43, B7/21) and polymorphic (DA6.147, DA6.164, anti-leu-10) determinants of the HLA-D locus were used in a standard indirect immunoperoxidase method on fresh cryostat sections of fallopian tube. In ectopic pregnancy the tube epithelium showed uniform, intense reactivity for DR, DP and DQ. A similar reaction pattern was observed in normal first trimester pregnancy. At term, most epithelial cells were DR-, DP- and DQ positive, but a few were DP- and DQ-negative. In fallopian tubes from non pregnant individuals, a variable number of epithelial cells labelled for DR alpha and DR beta but there was essentially no reactivity for DP or DQ. These results suggest differential regulation of class II MHC gene expression by tube epithelial cells, possibly mediated by hormones and/or a trophoblast product. PMID- 3298026 TI - Effect of anti-insulin antibodies on glycemic control in insulin treated diabetic patients. AB - In order to examine the effect of anti-insulin antibodies on serum insulin concentration and glycemic control, sera from 49 insulin-treated diabetic patients (20 males and 29 females) were examined for their titer of anti-insulin antibodies, and concentrations of total insulin (TIRI), free insulin (FIRI) and hemoglobin A1c. Titer of anti-insulin antibodies correlated only with TIRI (r = 0.72, p less than 0.001) and did not correlate with duration of insulin treatment, FIRI concentration, daily dose of insulin, or HbA1c concentration. These results indicate that elevated titer of anti-insulin antibodies in patients under insulin therapy, increases total serum insulin concentration but does not affect serum free insulin level, and has little effect, if any, on glycemic control and the required daily dose of insulin. PMID- 3298027 TI - Adhesion of urinary Escherichia coli to human, mouse & rat uro-epithelial cells. PMID- 3298028 TI - Cellular unresponsiveness in patients with soluble circulating antigens in bancroftian filariasis. PMID- 3298029 TI - Low dose ketamine infusion & stress response. PMID- 3298030 TI - "Multiple drug resistance in Salmonellae isolated at Shimla". PMID- 3298031 TI - Hexachlorobenzene: uses and occurrence. PMID- 3298032 TI - Hexachlorobenzene: an ecotoxicological profile of an organochlorine compound. AB - Most data on hexachlorobenzene (HCB) in the environment concern its occurrence in the aquatic environment, i.e., in marine and fresh-water ecosystems in which the HCB build-up and increased concentrations in sediments and food-chain organisms are well documented. Food-chain bioaccumulation is also known in terrestrial ecosystems, but data on atmospheric contamination seem scarce and unreliable. However, it is likely that HCB is transported by the atmosphere in low concentrations which are sufficient to make significant contributions to the global distribution of HCB. HCB is of low or moderate acute toxicity, and is not an immediate or acute cause for concern. Nevertheless, it should be classified as a hazard to the environment due to its persistence and its high rate of bioaccumulation. PMID- 3298033 TI - Factors determining hexachlorobenzene distribution and persistence in higher animals. PMID- 3298034 TI - Subacute toxicity of hexachlorobenzene. PMID- 3298035 TI - Immunotoxicity of hexachlorobenzene. AB - Histopathological studies in rats and dogs have indicated that hexachlorobenzene (HCB) has immunotoxic properties. Rats exposed to low doses of HCB showed proliferation of high endothelial venules in lymph nodes and accumulation of macrophages in lung alveoli, while lymphoid hyperplasia of the splenic white pulp occurred at higher doses. In dogs, HCB administration produced hyperplasia of lymphoid tissue in the stomach. Functional assessment showed that cell-mediated immunity (delayed-type hypersensitivity response), and humoral immunity (primary and secondary antibody responses to tetanus toxoid) even more, were enhanced in the rat, while macrophage function was unaltered. Stimulation of these immune responses occurred at a dietary level as low as 4 mg/kg HCB following combined pre- and postnatal exposure; at this dose, conventional parameters for hepatotoxicity were unaltered. The developing immune system of the rat therefore seems particularly vulnerable to HCB. In contrast to the immune stimulation observed in the rat, HCB has been reported to suppress the humoral and cell mediated immunity as well as the resistance to protozoan (malaria and leishmania) infections and to tumour-cell challenges in the mouse; effects have been observed at a dietary HCB level of 5 mg/kg. However, recent data have suggested that HCB has some potential to stimulate the immune system of the mouse also, since increased resistance was shown to a viral infection and to a tumour-cell challenge. Strain differences or the presence of immunosuppressive contaminants in the HCB preparations used do not seem to explain these apparently contrasting results. Although further studies are needed to resolve this discrepancy, current data provide strong enough evidence to classify HCB as a potent immunotoxic chemical. PMID- 3298036 TI - Carcinogenic activity of hexachlorobenzene in mice and hamsters. AB - Hexachlorobenzene (HCB) has been used as a fungicide, is a contaminant of various pesticides and is a by-product in the manufacture of many other chlorinated hydrocarbons. In Turkey, HCB caused an epidemic of toxic porphyria involving several thousand people between 1955 and 1959. The aim of the present studies was to determine the chronic toxicity of HCB after prolonged oral administration and we report here that HCB is carcinogenic in mice and hamsters. Mice and hamsters were given dietary HCB at doses of 50, 100 and 200 ppm for life, with deaths due to toxic manifestations of HCB occurring in group HCB 200. All survivors were killed after 120 weeks. In both mice and hamsters, exposure to HCB increased the incidence of liver-cell tumours but no such tumours were observed in the controls. A significant increase in the incidence of thyroid tumours and liver haemangioendotheliomas was observed in hamsters treated with HCB. Our findings that HCB is carcinogenic in mice and hamsters, together with other results showing the same effect in rats, provide sufficient experimental evidence to recommend great caution in the use of this material. PMID- 3298037 TI - Porphyria: genetic and acquired. AB - The porphyrias can be grouped conveniently by their presenting symptoms. Acute intermittent neurological symptoms of neuritis, abdominal pain and psychoses may occur in acute intermittent porphyria, hereditary coproporphyria and variegata porphyria. Increase of the porphyrin precursors delta-aminolaevulinic acid and porphobilinogen may be observed in the urine during attacks (Watson-Schwartz test). Patients with acute symptoms of photosensitivity with burning pain and oedema within short exposure periods may have erythropoietic protoporphyria, with high erythrocyte and stool protoporphyrins, erythropoietic coproporphyria, and in the last few years of life the more recently described hepatoerythropoietic porphyria. Symptoms of chronic photosensitivity include; hyperpigmentation, hypertrichosis, easy fragility of the skin with bullae and subsequent scarring in porphyria cutanea tarda (PCT), with increased uroporphyrin in the urine and stool; variegate porphyria with increased protoporphyrin and coproporphyrin in the stool; congenital erythropoietic porphyria with an increased copro- and uroporphyrin (isomer I) in the erythrocytes, urine and stool; and hepatoerythropoietic porphyria in later life, in which the chronic features are similar to PCT. In 1913 Meyer-Betz injected himself with 200 mg haematoporphyrin. Initially, at the higher levels, the symptoms were those of solar urticaria as observed in erythropoietic porphyria, but after several months became identical to PCT. A comparison of quantitative porphyrin analysis (performed on 323 patients with porphyria) and chromatography provides additional confirmation for the diagnosis. PMID- 3298038 TI - A review of porphyria and cancer and the missing link with human exposure to hexachlorobenzene. AB - A literature review shows that porphyria cutanea tarda (PCT), and possibly acute intermittent porphyria also, tend to occur more often than expected among cases of primary liver cancer, especially when cirrhosis is present. Lymphomas and PCT may be related also, although this is less well documented. Furthermore, there is an interesting report on a case of PCT, sarcoma and probable exposure to 2,3,7,8 tetrachlorodibenzo-para-dioxin. Exposure to hexachlorobenzene (HCB) as a cause of cancer in humans does not seem to have been reported, however, but exposure to this compound and other chlorinated aromatics should be included in future observations of PCT and cancer. The possibilities for good epidemiological studies of HCB exposure in relation to cancer and other effects seem to be limited although some guidelines can be given. PMID- 3298039 TI - Stimulation of faecal excretion of hexachlorobenzene: a review. PMID- 3298040 TI - Environmental health risk assessment: hexachlorobenzene. AB - The process of environmental health risk assessment may be described as a series of distinct stages, ranging from hazard identification and risk estimation to the selection and implementation of an appropriate risk management strategy. An important step in this process is the estimation of health risks at low levels of exposure. The toxicological and epidemiological data base on which such estimates are based are reviewed in the case of hexachlorobenzene (HCB), a persistent organochlorine pesticide, along with data on human exposure. This information is used to assess the potential human health risks attributable to HCB. PMID- 3298042 TI - Regulated systemic activation of rat plasma prorenin. AB - Nephrectomized rats have above-normal plasma prorenin levels, presumably of extra renal origin, but essentially no renin, suggesting a lack of "convertase" for prorenin activation. Adrenalectomized rats have low plasma prorenin levels accompanied by high renin activity, suggesting enhanced prorenin activation by the action of a stimulated "convertase" mechanism. Cross-circulation between adrenalectomized and nephrectomized rats for 15 or 30 minutes, dramatically lowered prorenin and raised renin levels in both types of rats, suggesting extensive activation of prorenin to renin. Similarly, in vitro mixing of these bloods (without cross-circulation) raised renin activity over five times the expected calculated level, while prorenin essentially disappeared. In both cases, prorenin from nephrectomized rat plasma apparently was activated to renin by the enhanced action of "convertase" in the adrenalectomized rat plasma. This newly generated renin activity was, like normal plasma renin, almost completely inhibited by a monoclonal antibody against hog renin and generated an immunoreactive angiotensin I. In contrast, cross-circulation or in vitro mixing of blood from normal control and nephrectomized rats produced little detectable activation of prorenin and only modest increments of renin, suggesting relative inactivity of the "convertase" mechanism in normal plasma. Our data suggest that activation of plasma prorenin is a significant regulated pathway for renin production, as it is greatly stimulated after adrenalectomy and deficient after nephrectomy, thereby implicating the kidney as an important contributor to the "convertase" mechanism operating within the circulation. PMID- 3298041 TI - Renal function curve in patients with secondary forms of hypertension. AB - The causative mechanisms of hypertension were investigated by studying the renal function (pressure-natriuresis) curve in patients with primary aldosteronism (n = 6) and renovascular hypertension (n = 6). Before and after radical operation (removal of adenoma in primary aldosteronism and percutaneous transluminal angioplasty in renovascular hypertension), dietary NaCl intake was altered from 10 to 13 g/day in Week 1 to 1 to 3 g/day in Week 2. Mean arterial pressure (MAP) and urinary sodium excretion were measured on the last 3 days of each week. By restricting sodium intake before operation, MAP was reduced from 122 +/- 7 to 113 +/- 7 mm Hg (p less than 0.025) in primary aldosteronism but not in renovascular hypertension (130 +/- 6 to 128 +/- 5 mm Hg). The renal function curve was drawn by plotting urinary sodium excretion on the ordinate and MAP on the abscissa before and after operation. The slope of the curve was analyzed between the plotted points, and each curve was extrapolated to zero sodium excretion as an estimate of the degree of shift of the curve along the MAP axis. Before, as compared with after operation, the extrapolated x-intercept of the curve was shifted rightward in both primary aldosteronism (111 +/- 7 vs 87 +/- 4 mm Hg; p less than 0.025) and renovascular hypertension (128 +/- 5 vs 95 +/- 2 mm Hg; p less than 0.025) and the slope was depressed in primary aldosteronism (16 +/- 1 vs 40 +/- 17 [mEq/day]/mm Hg; p less than 0.025) but not in renovascular hypertension (130 +/- 75 vs 40 +/- 13 [mEq/day]/mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298043 TI - The inhibitory role of 12- and 15-lipoxygenase products on renin release. AB - Release of arachidonic acid from membrane phospholipids is a limiting step in the synthesis of both cyclooxygenase products and lipoxygenase products. The direct effects of prostacyclin and some lipoxygenase products on renin release were studied using rat renal cortical slices. Prostacyclin, at concentrations of 10( 5) M, stimulated renin secretion, but this effect was short-lived. Leukotrienes or their precursor, 5-hydroperoxyeicosatetraenoic acid, did not affect basal renin release. In contrast, 10(-9) M 12-hydroperoxyeicosatetraenoic acid and 10( 8) M 12-hydroxyeicosatetraenoic acid were potent inhibitors of renin secretion. Similarly, 15-hydroperoxyeicosatetraenoic acid and its hydroxy derivative, 15 hydroxyeicosatetraenoic acid, at somewhat higher molar concentrations (10(-6) M) also reduced basal renin. These studies confirm prostacyclin as a potential renin secretagogue; however, its action in vitro is transient, probably because of its rapid degradation. Our studies provide new evidence that products of the 12 lipoxygenase and 15-lipoxygenase pathways, reported to be present in renal vascular tissue, are potent inhibitors of renin secretion and much more active on a molar basis on renin secretion than is prostacyclin. These studies suggest the potential presence of a dual system of stimulation and suppression that may regulate renin secretion in normal and clinical states. PMID- 3298044 TI - Cyclosporin A-induced hyperreninemic hypoaldosteronism. A model of adrenal resistance to angiotensin II. AB - We studied the effects of cyclosporin A on the renin-aldosterone axis in Sprague Dawley rats. Two weeks of intragastric administration of cyclosporin A (5 mg/kg/day or or 20 mg/kg/day) resulted in large increases in plasma renin concentration (23 +/- 5, 70 +/- 12, and 79 +/- 11 ng/ml/hr in control rats and rats receiving 5 mg and 20 mg of cyclosporin A, respectively), with no parallel increments in plasma aldosterone. In vitro angiotensin II (ANG II)-stimulated aldosterone secretion by zona glomerulosa cells obtained from cyclosporin A treated rats was also reduced (4.8 +/- 0.5, 1.5 +/- 0.2, and 0.2 +/- 0.2 ng/10(5) cells in control rats and rats receiving 5 mg and 20 mg of cyclosporin A, respectively). In contrast, in vitro aldosterone response to graded increments of potassium (3.7-10.7 mmol/L) or adrenocorticotropic hormone (ACTH) (10(-11)-10(-8) M) was preserved in cyclosporin A-treated rats. When added in vitro to zona glomerulosa cells from untreated rats, cyclosporin A also attenuated ANG II stimulated aldosterone secretion, but did not affect potassium or ACTH-mediated aldosterone production. Thus, cyclosporin A-induced hyperreninemic hypoaldosteronism in the rat depends on opposing renal and adrenal effects, with a direct or feedback stimulation of renin secretion and a specific blockade of ANG II-mediated aldosterone production. PMID- 3298045 TI - Tissue-specific regulation of renin expression in the mouse. AB - Increasing biochemical evidence suggests that the renin-angiotensin system may be present in may extrarenal tissues. We have employed the mouse submandibular gland renin complementary DNA (pDD-1D2) and the rat liver angiotensinogen complementary DNA (pRang 3) to demonstrate that renin and angiotensinogen messenger RNAs are expressed in the mouse kidney, submandibular gland, heart, adrenal, brain, and testis. To elucidate the factors that influence local tissue renin-angiotensin expressions, we studied tissue renin messenger RNA and enzymatic levels of male mice in response to sodium depletion and castration. Sodium depletion resulted in increased renin expression in the kidney, heart, and adrenal, but not in the submandibular gland and testis. Castration lowered renin levels in all extrarenal tissues but appeared to increase renin level in the kidney. Taken together, the above data demonstrate tissue-specific regulation of renin expression and imply different functions for the sodium responsive and nonresponsive systems. PMID- 3298046 TI - Obesity-induced hypertension in the dog. AB - To study the relationship between body weight and blood pressure, we have developed an animal model of obesity-induced hypertension. Nine adult mongrel dogs were chronically instrumented with aortic and vena caval catheters. After a 2-week control period, all dogs were made to gain weight by adding 2 lb/day of beef fat to their diet for 5 weeks. Blood pressure, heart rate, and body weight were measured daily before the addition of dietary fat, during the 5 weeks of the high fat diet, and for 6 weeks after the fat supplement was stopped. Plasma volume and cardiac output were measured prior to and after 5 weeks of the fat diet. During the 5-week high fat diet, the dogs' body weight increased from 22.2 +/- 2.1 to 27.4 +/- 3 kg (p less than 0.001); mean blood pressure increased from 90 +/- 5 to 112 +/- 6 mm Hg (p less than 0.01); and heart rate increased from 70 +/- 7 to 85 +/- 5 beats/min (p less than 0.05). Blood pressure, heart rate, and body weight returned to near control values after the fat diet was stopped. Over the 5-week fat diet, the dogs' plasma volume increased from 920 +/- 130 to 1059 +/- 195 ml (p less than 0.05); cardiac output increased from 2.5 +/- 0.4 to 3.1 +/- 0.3 L/min (p less than 0.05); and systemic vascular resistance increased from 35.3 +/- 8 to 38.9 +/- 9 mm Hg/L/min (p less than 0.1). Weight gain in the dogs was also associated with hyperinsulinemia and insulin resistance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298047 TI - Multicenter clinical trials. Potential influence of consumer education. AB - Multicenter therapeutic trials have demonstrated clearly the efficacy and safety of antihypertensive therapy. Such studies were designed initially to demonstrate the effectiveness of antihypertensive therapy in preventing complications and fatalities from hypertensive disease. Over the three decades since these studies were instituted, succeeding trials have become more sophisticated in design, and those of us who observe and interpret their results have similarly become more sophisticated and more demanding. However, we should not expect more from the studies than their designers intended. Let us neither overinterpret the results nor ascribe failure to studies simply because they do not answer the questions that remain. This discussion concerns primarily three recent multicenter clinical trials: the Hypertension Detection and Follow-up Program (1979), the Australian National Blood Pressure Study (1980), and the Multiple Risk Factor Intervention Trial (1982). PMID- 3298048 TI - Implications of the clinical trials on the management of hypertension. AB - All of the major clinical trials that employed diuretics as initial monotherapy or as one of several first-step drugs have demonstrated a marked reduction in overall cardiovascular events and stroke deaths in treated patients. Benefit has been demonstrated in all trials in patients with initial diastolic pressures of 95 mm Hg or above and in the Hypertension Detection and Follow-up Program, the only study to test the hypothesis, benefit of treatment was noted in patients with pretreatment diastolic pressures of 90 to 95 mm Hg. Although several of the trials failed to show a significant decrease in coronary events in treated patients, the two studies (Hypertension Detection and Follow-up Program and European Working Party on Hypertension in the Elderly) that treated either elderly patients or patients with pretreatment target-organ involvement, reported a reduction in deaths from ischemic heart disease following effective lowering of blood pressure. The long-term benefits of effective treatment of hypertension appear to justify the use of pharmacological intervention if nondrug treatment proves ineffective. PMID- 3298049 TI - Rectal trauma. AB - Rectal trauma, although uncommon, may result in severe morbidity and even in mortality. Proper treatment plans, including the management of the rectal injury, the use of intravenous antibiotics and drains, rectal washout, and careful closure of surgical wounds, will usually lead to a favorable outcome. PMID- 3298050 TI - Current management of epidermoid carcinoma of the anal canal. AB - Treatment with a combination of radiation therapy and chemotherapy currently allows about 80 per cent of patients with epidermoid carcinomas of the anal canal to retain anorectal function, with about a 70 per cent likelihood of cure at 5 years. In these programs, radical surgery is reserved for the management of residual cancer or of radiation- or chemotherapy-induced anorectal toxicity. Several different schedules of combined modality therapy are in use, but an important common element in most schedules appears to be the concurrent administration of radiation and 5-fluorouracil. The improvement in local control rates with combined radiation and chemotherapy, as compared to most series treated by either radical radiation or radical surgery, has not been matched by a marked improvement in survival rates, and the risk of distant metastases does not appear to have been altered by these combinations. The success of the combinations in improving local control has allowed the indications for local excision to be defined more narrowly, and should reduce the risks of local recurrence associated with conservative surgery. PMID- 3298051 TI - The surgery of idiopathic constipation. AB - This paper has described the methods of patient evaluation and treatment that have been developed at the Cleveland Clinic Foundation for patients with idiopathic constipation. An orderly concise work-up should identify the small group of patients that will benefit from surgical therapy and assist the surgeon in selecting the type of therapy for the greatest success. Patients with outlet obstruction appear to benefit from anorectal myectomy while those with slow colonic transit should undergo a subtotal colectomy and ileorectal anastomosis. Additional investigations will hopefully increase our knowledge of the best way to manage these patients. PMID- 3298052 TI - Nonspecific ulcerative proctitis. AB - Nonspecific (ulcerative) proctitis/proctosigmoiditis has been recognized as a clinical entity for many years. Based on clinical data accumulated over the past 25 years it can be considered a form of ulcerative colitis, indistinguishable from that extending more proximally throughout the large intestine and characterized primarily by extent of disease. PMID- 3298053 TI - Perianal Crohn's disease. AB - Various approaches to the management of perianal Crohn's Disease are discussed. In general, surgically, a conservative approach is taken because of the concern that wounds associated with the disease tend to heal poorly. PMID- 3298054 TI - Pathogenesis and management of fecal incontinence in the adult. AB - In the author's opinion, post-anal repair remains the procedure of choice for patients with levator neuropathy and loss of anorectal angle. The operation is minimally invasive and relatively free of major complications. A knowledge of the anatomy of the perineum and in particular of the intersphincteric space is mandatory before undertaking such surgery. Any surgeon who is accustomed to performing internal anal sphincterotomy will already be accustomed to identifying the plane and the internal sphincter. Progression to performing post-anal repair is only a small step. On the other hand, gracilis transposition seems to be a procedure of considerable technical complexity. Also it must be difficult to gauge the tension of the repair correctly. Presumably it can be all too easy to make the repair too tight and cause a stricture or create a lax repair by leaving too long a length of tendon. However, in patients whose pelvic floor has failed to develop (e.g., in patients with rectal atresia) it is hard to imagine any procedure other than gracilis transposition which can possibly be considered. Clearly, post-anal repair in this case would be contra-indicated. Finally, it is always relevant to remember that colostomy has a creative role to play in the management of anorectal incontinence. In the elderly patient who has a severe atrophy of the pelvic floor the incontinent abdominal wall stoma may be considerably easier to manage than a perineal "stoma." Patients with fecal incontinence are depressed and embarrassed. They have often been told by friends, relatives, and their family doctor that there is little that can be done and not to complain. It is essential in the initial consultation with the patient that this defeatist attitude be countered. Much can be done to restore full function by relatively simple measures which may include surgery. For the surgeon they represent a very gratifying group of patients to treat. PMID- 3298055 TI - Internal and overt rectal procidentia. AB - The etiology and treatment of rectal procidentia remain controversial despite its longtime recognition. In this article, the clinical manifestations, etiology, and therapeutic options of both forms of rectal prolapse and the associated syndromes of colitis cystica profunda and solitary ulcer of the rectum are reviewed. PMID- 3298056 TI - The levator syndrome and its variant. AB - The levator syndrome is an entity characterized by pain high in the rectal area that can be elicited by pressure applied to the levator ani. The etiology, diagnosis, and treatment of this disorder are described. Its importance lies in its misdiagnosis or in the failure to diagnose. PMID- 3298058 TI - Complex anal fistulae. AB - Complex anal fistulas challenge the judgment and operative skills of the surgeon in effecting a cure without compromise of anorectal function. This chapter outlines the classification, pathogenesis, methods of investigation and alternatives of management of a variety of complex fistulas. Also reviewed are the advantages and disadvantages of both traditional and newer methods of management, with special reference to staged fistulotomy and advancement rectal flap procedures. PMID- 3298057 TI - Hemorrhoids. A review of current techniques and management. AB - Most physicians see many patients with the chief complaint of hemorrhoids. The usual presentation is bleeding with bowel movements and prolapse. Of course, if there are no symptoms, invasive treatment should not be entertained. If the symptoms are due to hemorrhoids, the degree of prolapse should be established in order to guage the treatment. Mild symptoms of first- and second-degree hemorrhoids may be treated by diet modification or a fixation process such as rubber band ligation or infrared photocoagulation. Moderate prolapse as with large second-degree and third-degree hemorrhoids need the more certain fixation of rubber band ligation or an excisional technique. Large third-degree hemorrhoids and fourth-degree hemorrhoids require removal of a portion of the prolapsing tissue to achieve a stronger fixation within the proximal anal canal. PMID- 3298059 TI - [Thrombocyte transfusion: increase in platelets in relation to clinical and immunologic prerequisites]. AB - We determined in 35 patients with severe thrombocytopenia (AML n = 10; ALL n = 4; CML = 1; idiopathic myelofibrosis n = 1, aplastic anemia n = 1; undergoing bone marrow transplantation n = 17) factors influencing the corrected count increment (CCI) after platelet transfusions. Out of 195 transfusions 86 (44%) failed to increased platelet counts (CCI less than 5 X 10(9) platelets/l). A significant percentage of transfusion failures occurred in patients with splenomegaly and/or fever (54% vs. 29%; p less than 0.002). Antibodies directed against donor platelets were found only twice. No correlation between reactivities demonstrable by the lymphocytotoxic test (n = 144) or the radioimmune antiglobulin test (n = 67) and the CCI was obvious. HLA antigen identity was also not predictive. Thus, transfusion failures in patients with low alloimmunization will not be predicted by in vitro antibody screenings. The patients' clinical condition has the most important influence on posttransfusion increment. PMID- 3298060 TI - Two-dimensional gel electrophoresis and immunoblotting of Campylobacter outer membrane proteins. AB - We characterized outer membrane proteins (OMPs) from selected Campylobacter jejuni, C. coli, and C. fetus strains by two-dimensional gel electrophoresis (2DGE), using isoelectric focusing and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and by immunoblotting with immune rabbit serum. The flagellar band with a molecular mass of 63 kilodaltons (kDa) demonstrated previously by one-dimensional SDS-PAGE was shown by 2DGE to consist of one or several charge trains, depending upon the species, strain, and type of preparation studied; each of the individual peptides was found to be antigenic by immunoblotting. In contrast, in all of the strains studied, the major OMP (43 to 44 kDa) of C.jejuni and C. coli consisted of a single isomeric form which was weakly immunogenic. Several minor proteins (29 to 31 kDa) were found to be strongly immunogenic by immunoblotting. C. fetus strains possessed two major OMPs of 45 to 47 kDa, each of which consisted of either a single isomer or a major isomer comprising at least 90% of the major OMP. Serum-resistant strains of C. fetus possessed an acid-labile 100-kDa glycoprotein (pI, 4.1) which was markedly diminished or absent in serum-sensitive strains. These 2DGE analyses provide information that is useful in taxonomic and epidemiologic studies and for the purification of surface antigens for the development of campylobacter vaccines and may also facilitate the identification of specific virulence factors. PMID- 3298061 TI - Analysis of major antigens of Haemophilus (Actinobacillus) pleuropneumoniae and related organisms. AB - Outer membrane protein (OMP)-enriched extracts and whole-cell protein preparations of Haemophilus (Actinobacillus) pleuropneumoniae and related organisms were examined by polyacrylamide gel electrophoresis and immunoblotting. Both the OMP-enriched and whole-cell protein profiles of Actinobacillus suis, A. pleuropneumoniae (NAD-independent biovar), A. lignieresii, and Pasteurella haemolytica were very similar to those of H. pleuropneumoniae serotypes 1 to 8. Antisera prepared against H. pleuropneumoniae typically recognized three major OMP antigens with approximate molecular weights of 17,000 (17K), 32K, and 42K in immunoblots of H. pleuropneumoniae serotypes 1 to 8, Actinobacillus spp., and P. haemolytica. Antisera prepared against Actinobacillus spp. and Haemophilus sp. "minor group" also recognized these 17K, 32K, and 42K antigens. Using absorbed sera, we demonstrated that the 17K antigen had an epitope (or epitopes) common to all the gram-negative organisms examined, including Escherichia coli. The 32K and 42K antigens had epitopes common to members of the family Pasteurellaceae but, in the case of the 32K antigen, also contained unique epitopes. These results provide a basis for understanding the lack of specificity of serodiagnostic tests for H. pleuropneumoniae infection and provide another line of evidence for the association of H. pleuropneumoniae with the genus Actinobacillus. PMID- 3298062 TI - Discrepancy in assessment of phagosome-lysosome fusion with two lysosomal markers in murine macrophages infected with Candida albicans. AB - Phagosome-lysosome fusion (P-LF) was studied in cultured mouse resident peritoneal macrophages after phagocytosis of Candida albicans. The macrophages were labeled with acridine orange (AO), the electronopaque colloidal Thorotrast, or both markers. After phagocytosis of heat-killed C. albicans, both markers were delivered to more than 95% of phagosomes. After ingestion of viable C. albicans by labeled cells, delivery of AO to phagosomes was highly suppressed (90%), and yet Thorotrast delivery was almost universal. After phagocytosis and 60 min of incubation, about 10 to 20% of the yeasts were killed, and a similar fraction of phagosomes was stained by the fluorescent marker. The evidence from Thorotrast transfer and assessment of yeast viability indicates that C. albicans largely resists intracellular killing by resident macrophages in the face of entirely uninhibited P-LF. We infer that AO must transfer to nearly all of the phagosomes but that it is evidently recognizable only in those in which the yeasts have been killed or possibly severely injured. This conclusion constitutes yet another limitation in the usefulness of AO for studying P-LF. PMID- 3298063 TI - Endotoxin neutralization with rabbit antisera to Escherichia coli J5 and other gram-negative bacteria. AB - To study the mechanisms of protection against endotoxin challenge offered by antisera to smooth and rough gram-negative organisms, we have developed an assay to quantitate endotoxin neutralization based on inhibition of the Limulus amoebocyte lysate test. Dilutions of different bacterial lipopolysaccharides (LPSs) were incubated with hyperimmune rabbit sera against Escherichia coli O113, E. coli O18, and rough mutants E. coli J5 and Salmonella minnesota Re595 and were then combined with limulus lysate. The gelation reaction induced by LPS in the lysate was monitored spectrophotometrically, and the concentration of LPS resulting in a 50% lysate response was determined and correlated with antibody titers measured by enzyme-linked immunosorbent assay. Antisera to smooth organisms neutralized homologous LPS markedly and heterologous LPSs only minimally relative to neutralization by preimmune serum. Neutralization of homologous LPS occurred immediately without preincubation of serum and LPS. Antisera to rough mutants neutralized more heterologous LPS than did antisera to smooth organisms. However, this heterologous neutralization required preincubation of serum and LPS and did not appear to be correlated with antibody concentrations. We conclude that antisera to LPS rapidly neutralize the biological activity of the homologous LPS, as detected by limulus lysate, and that neutralization is at least in part antibody mediated. Antisera to rough mutant organisms slowly neutralized the activity of heterologous LPSs, but this effect appeared not to be correlated with concentrations of antibody to the LPS of the rough mutant, as measured by enzyme-linked immunosorbent assay. PMID- 3298065 TI - Mycobacterium bovis BCG-induced protection against cutaneous and systemic Leishmania major infections of mice. AB - We examined the protective effects of Mycobacterium bovis bacillus Calmette Guerin (BCG) administration on Leishmania major infections of BALB/c and P/J mice. There were two treatment protocols. In the first, the footpads of naive animals were inoculated with mixtures of L. major and BCG (viable or heat killed) or the soluble mycobacterial antigen, purified protein derivative. Viable BCG, but not heat-killed BCG or purified protein derivative, inoculated with L. major amastigotes into the footpads of naive BALB/c or P/J mice protected these animals from the metastatic spread of parasites to the viscera and from ensuing lethal systemic infection. This treatment also induced cures of the cutaneous lesions of P/J mice but not of BALB/c mice. In the second protocol, we induced an immune response to BCG before inoculation of L. major. BCG given intraperitoneally 10 days before infection of footpads with leishmania offered protection against the metastatic spread of amastigotes in both P/J and BALB/c mice, regardless of intralesional treatment, and modulated the severity of cutaneous infection by 30 to 50%. Inoculation of a mixture of viable BCG and L. major amastigotes into BCG immune mice completely protected both BALB/c and P/J strains from cutaneous disease; we recovered no parasites from the inoculated footpads of these animals. Furthermore, each of the nonspecifically protected mice of both the BALB/c and P/J strains developed immunity to rechallenge with viable L. major. Injection of amastigotes at a site remote from the original lesion, the contralateral footpad, resulted in the complete clearance of parasites in the inoculum with no evidence of either cutaneous or systemic disease over an extended observation period. PMID- 3298064 TI - Comparison of the ability of enteroinvasive Escherichia coli, Salmonella typhimurium, Yersinia pseudotuberculosis, and Yersinia enterocolitica to enter and replicate within HEp-2 cells. AB - Salmonella typhimurium, enteroinvasive Escherichia coli, Yersinia pseudotuberculosis, and Yersinia enterocolitica possess the ability to enter intestinal epithelial cells. We used a quantitative tissue culture model employing HEp-2 cells to compare the abilities of these bacteria to enter epithelial cells. S. typhimurium and Yersinia species were highly infective for HEp-2 cells but were unable to replicate extensively intracellularly. Enteroinvasive E. coli exhibited low infectivity but replicated extensively intracellularly. The growth of enteroinvasive E. coli led to destruction of the HEp-2 monolayer, whereas Yersinia spp. and S. typhimurium were maintained intracellularly for prolonged periods without damage to the monolayer. The ability of enteroinvasive E. coli to enter HEp-2 cells required prior growth at 37 degrees C; neither S. typhimurium nor Yersinia spp. exhibited this temperature dependence for cell entry. An E. coli K-12 derivative containing a 230-kilobase plasmid from enteroinvasive E. coli was constructed. This derivative shared all the invasive characteristics of the parental enteroinvasive strain, suggesting that determinants required for cell entry and intracellular multiplication were at least partially plasmid encoded. An HB101 derivative containing a cloned invasion determinant from Y. pseudotuberculosis was constructed in our laboratory. HEp-2 monolayers were coinfected with these two K-12 derivatives to compare invasion determinants from enteroinvasive E. coli with those of Y. pseudotuberculosis in a common genetic background. Results from these experiments suggest that these organisms reside within separate intracellular compartments. PMID- 3298066 TI - Enhanced endotoxin effects in plasma fibronectin-deficient rats. AB - Immunoreactive plasma fibronectin depletion has been associated with the presence of collagen-fibronectin complexes in patients after trauma and in animal models of traumatic and burn injuries. However, the role of plasma fibronectin in the development of sepsis after traumatic and burn injuries in patients is unknown. Treatment of patients and animals with purified human plasma fibronectin ameliorates some of the clinical and metabolic effects of systemic endotoxemia. We report that the induction of immunoreactive plasma fibronectin deficiency by gelatin infusion is associated with enhanced effects of intraperitoneal Escherichia coli endotoxin injection. We have observed a significant increase in the concentrations of ammonia in plasma of treated rats compared with those in control rats administered the same dose of endotoxin. PMID- 3298068 TI - Diagnosis of streptococcal tonsillitis in general practice by clinical assessment and by office culture of throat swabs on Streptocult. AB - In a one-year study 274 general practitioners performed office cultures on Streptocult of throat swabs from 2,699 patients with acute pharyngotonsillitis in order to identify those with beta-haemolytic streptococci in the throat. The finding of group A beta-haemolytic streptococci by laboratory culture of corresponding throat swabs was used as a reference when determining the diagnostic value of either clinical assessment or Streptocult culture for the identification of patients with streptococcal pharyngotonsillitis. Based on 2,150 cases, sensitivity was 70% and 84%, respectively; specificity, 63%, respectively 77%; positive predictive value, 38%, respectively 53%; and negative predictive value, 87%, respectively 94%. Compared to the clinical assessment of the etiology, use of Streptocult resulted in the additional identification of 14% of the patients with group A streptococci and 13% of the patients without this organism present in the throat, as judged by laboratory culture. Overall, 78% of the patients were correctly diagnosed by the use of Streptocult, compared to 65% by clinical assessment. It is concluded that the use of Streptocult in general practice may be of substantial benefit in the identification of patients with group A streptococcal tonsillitis. PMID- 3298067 TI - Tumor necrosis factor does not induce Plasmodium falciparum crisis forms. AB - Mouse and rabbit sera from animals treated with Mycobacterium bovis BCG and lipopolysaccharide contained tumor necrosis factor (TNF) and induced malaria parasite crisis forms. However, neither purified mouse- nor recombinant DNA produced human TNF induced crisis forms in cultured Plasmodium falciparum. Furthermore, rabbit polyclonal and mouse monoclonal antibodies against human TNF did not block the parasite inhibitory activity of human malaria crisis form factor serum from Sudan. PMID- 3298069 TI - [Antibodies to lipoid A in the treatment of septic shock]. AB - The protective effect of high-titer anti-lipid A hyperimmune globulin with respect to the course of the disease and the mortality rate was studied in patients with septicemia verified by positive blood cultures. Six patients were treated with anti-lipid A in an open study. Dramatic improvement in fever curves and clinical condition in some of the patients encouraged us to start a randomized double blind study. So far, 17 patients have entered the study, 16 of whom were evaluable. Immediately after a positive blood culture was found, patients received either high doses of anti-lipid A or placebo (saline solution) on two subsequent days. Before and after each infusion blood samples were taken in order to assess serum bactericidal activity and anti-lipid A titers. Because of the still small numbers of patients the results of both studies were summarized. In all patients treated with anti-lipid A clear-cut increases in anti lipid A titers were shown. Patients with repeated gram-negative infections showed higher median anti-lipid A titers than patients without such a history. The patients treated with anti-lipid A immune globulin ran a significantly milder course than the placebo group. The severe signs of septic shock were reversed in seven of 15 patients on anti-lipid A compared to two of seven patients treated with placebo. In the anti-lipid A-treated group, three of 15 patients died, and in the placebo group two of seven. This difference is not statistically significant. PMID- 3298070 TI - Factors indicative of outcome in a comparative trial of acyclovir and vidarabine for biopsy-proven herpes simplex encephalitis. AB - A total of 208 patients underwent brain biopsy for presumptive herpes simplex encephalitis and were randomized to receive either vidarabine, vira-A, at 15 mg/kg/day, or acyclovir, at 30 mg/kg/day for ten days. 69 patients (33%) had biopsy-proven disease; 37 received vira-A and 32 acyclovir. With the exception of age, patient populations were balanced for demographic characteristics. Overall survival for acyclovir recipients was 72% compared with 46% for vira-A-treated patients 18 months after therapy (p = 0.008). After adjustment for differences of age between treatment populations by multivariant regression analyses, acyclovir treatment remained superior to vidarabine therapy (p = 0.041). Mortality varied according to the level of consciousness at the onset of therapy. For lethargic, semicomatose and comatose patients, mortality was 42%, 46%, and 67%, respectively, for the vira-A-treated patients and 0%, 25% and 25%, respectively, for acyclovir-treated patients. Six months post-therapy morbidity assessments revealed five (14%) vira-A versus 12 (38%) acyclovir recipients who had returned to normal function, while eight (22%) and three (9%), respectively, had moderate debility. Outcome differences were significant (p = 0.02; Wilcoxon, 2-sample test) using an adapted scoring system. Age and Glasgow coma scale greater than 10 predicted the best outcome following acyclovir treatment. Disoriented patients who flex and respond by eye to pain had no mortality and 50% returned to normal. These data indicate that acyclovir is the treatment of choice for biopsy-proven herpes simplex encephalitis. PMID- 3298071 TI - Oral acyclovir for acute herpes zoster infections in immune-competent adults. AB - Previous studies have shown that intravenous acyclovir does modify rash development, reduce viral shedding and alleviate acute pain in herpes zoster. To assess the clinical efficacy of an oral dosage regimen with 800 mg acyclovir five times daily, double-blind, placebo-controlled studies were carried out at three centres within the U.K., using a common protocol. According to inclusion criteria (immune competent patients over 60 years of age with a clinical diagnosis of herpes zoster with rash of no more than 72 h duration, no previous systemic antiviral treatment, no history of renal insufficiency) 205 patients were recruited after they had given their informed consent. Patients were randomly assigned to receive either two 400 mg tablets acyclovir (41 men, 59 women) or matching placebo (46 men, 59 women) five times daily for seven days. Treatment was predominantly domiciliary based. According to clinical assessment and pain score acyclovir recipients showed a significant benefit in terms of reduction in rash progression if treatment was started within 48 h of the onset of rash, and alleviation of pain during the acute phase of herpes zoster. Overall, the number of patients developing extradermal lesions was significantly lower in the acyclovir group than in the placebo group (p = 0.02). However, there were no significant differences in rash progression and pain response in patients with herpes zoster affecting the ophthalmic division of the trigeminal nerve in patients who received acyclovir (n = 21) compared to those who received placebo (n = 32). 12 acyclovir and 13 placebo recipients reported symptoms, predominantly gastrointestinal in nature, possibly or probably related to therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298072 TI - Ectophospholipase A2 activity of the rabbit peritoneal neutrophil. AB - Intact rabbit neutrophils were found to express phospholipase A2 activity against [14C]oleate-labeled autoclaved Escherichia coli. Cells obtained 12-14 h rather than 4 h after intraperitoneal injection of glycogen had approximately threefold higher activity. The higher activity was due neither to contaminating mono nuclear cells nor to the degranulation associated with the prolonged inflammatory response in the peritoneum. Of the phospholipase A2 activity of the intact 12 hour cells, approximately one half remained cell-associated, but the other half was released from the neutrophils during incubation. The cell-associated activity was not due to phagocytosis of substrate and subsequent release of [14C]fatty acid. The cell-associated activity was inhibited by the membrane-impermeant diazonium salt of sulfanilic acid. The results indicate that the cell-associated activity of intact neutrophils is due to an ectophospholipase A2. PMID- 3298073 TI - Primary biliary cirrhosis: antigenic specificity of IgM-type mitochondrial antibodies analyzed by immunoblotting and ELISA. AB - The antigenic reactivities of circulating IgM- and IgG-type antimitochondrial antibodies (AMA) from 18 patients with primary biliary cirrhosis (PBC) were compared by the use of immunoblotting and enzyme-linked immunosorbent assay (ELISA). In immunoblotting, the binding patterns of IgM and IgG were very similar when F1-ATPase and mitochondria were used as antigens. The major PBC-specific IgM reactive antigen was identical with the dominating IgG-reactive antigen, sharing the same molecular weight of 70 kD and the same requirement for reduced thiol groups for expression of antigenicity. Other PBC-related mitochondrial proteins with variable antigenicity had the molecular weights of 60 and 43 kD. Depending on the IgM and IgG reactions in F1-ELISA, PBC patients can be grouped into three categories: patients with IgG and IgM (12/18), IgG alone (5/18) and IgM alone (1/18). By serum fractionation, the IgM reactivity was shown to be a true PBC related antibody antigen reaction, and not due to interference of rheumatoid factors. PMID- 3298074 TI - Tryptase and kinin generation: tryptase from human mast cells does not activate human urinary prokallikrein. AB - The effect of tryptase, a neutral protease released from human lung mast cell secretory granules, on the tissue prokallikrein present in human urine was examined. Tryptase has been shown previously to lack activity against plasma prokallikrein. Purified tryptase was incubated with a concentrated preparation of urinary prokallikrein. No increase in kallikrein-like enzymatic activity or immunoreactive tissue kallikrein was detected. Activation of urinary prokallikrein with trypsin served as a positive control. Furthermore, preincubation of urinary prokallikrein with tryptase did not diminish the subsequent activation of urinary prokallikrein by trypsin. Therefore, tryptase neither activates nor destroys human tissue or plasma prokallikreins. PMID- 3298076 TI - Procedural and methodological parameters in behavioral-gerontological research: a review. AB - This article analyzes the behavioral-gerontological research published before 1984. The 151 studies located were classified into three main categories: observation, assessment, and intervention. Each study and each category were examined for variations in the behavioral procedures employed, and in the scientific research methods used to collect and analyze data. The survey indicated several serious problems in the research. Much of the behavioral gerontological research focuses on institutionalized elderly, and tends to perpetuate a passive, helpless role on the part of the elderly in the treatment process. Less than 20 percent of the studies focused on observation or assessment, and most of these were found to be flawed. The intervention studies were also problematic; the majority of them were of short duration and had only one treatment phase which did not vary substantially during the study period. Most also failed to provide for interobserver agreement, generalization, maintenance, and follow-up assessments. Finally, the implications of these findings for future psychological research with the elderly are discussed. PMID- 3298075 TI - Voltaire's portrayal of old age. AB - A survey of Voltaire's fifty plays, written over a period of sixty-six years, was made to ascertain the traits and roles assigned to the elderly, the influence of genre and the author's age on the way they are portrayed, and the factors to which the traits associated with the elderly are attributed. The elderly have an important role in the plays, but they are portrayed more favorably in tragedy than in comedy. The period of life at which Voltaire wrote the plays did not appear to affect his treatment of old age. Psychological traits attributed to the elderly derive from character rather than age, though age is shown to tone down the emotions. The only trait consistently and specifically ascribed to old age is wisdom. PMID- 3298077 TI - Defective expression of MHC class I antigens is frequent in B-cell lymphomas of high-grade malignancy. AB - An unselected series of 66 immunohistologically proven B-cell lymphomas was examined for the expression of MHC class I antigens with monoclonal antibodies directed against non-polymorphic determinants of HLA-A,B,C heavy chain and beta 2 microglobulin. The tumors were classified according to the Kiel classification. No significant differences were observed in the reaction for HLA-A,B,C and beta 2m which may be indicative of a coordinate expression in our lymphoma series. In 37 cases (56%), all tumor cells exhibited strong staining for class I antigens as observed in normal B cells. The remaining 29 cases (44%) showed abnormally low or undetectable class I expression in varying tumor cell subsets; 13 cases were completely devoid of HLA-A,B,C. Twenty-two out of 30 lymphomas of high-grade malignancy but only 7/36 lymphomas of low-grade malignancy presented defective class I expression. This difference in proportion is highly significant (p less than 0.00002). Eleven of the 13 class I-negative lymphomas belonged to the group of high-grade malignancy. Centrocytic lymphoma, which has the poorest prognosis among the B-cell lymphomas of low-grade malignancy, was defective in 40% of the cases examined. The lymphoblastic type represented an exception within the lymphomas of high-grade malignancy as no defective expression was observed. In addition to the correlation between the high-grade malignancy and defective class I expression, defects occurred more frequently in lymphomas with an extra-nodal primary manifestation (p less than 0.05). The grade of malignancy, however, was not correlated with the primary site of the lymphoma. PMID- 3298078 TI - An immunohistological study of cells infiltrating progressive and regressive tumors induced by two variant subpopulations of a rat colon cancer cell line. AB - In order to understand the mechanisms leading up to progression or regression, tumors resulting from the s.c. inoculation of progressive or regressive variants of a cell culture established from a chemically-induced rat colonic carcinoma were subjected to sequential histological study. As immunological factors have been previously described in this system of progressive or regressive tumors, special interest was given to inflammatory cells, T and B lymphocytes and macrophages, located inside and outside the tumor. Immunohistological methods using monoclonal or polyclonal antibodies and enzyme histology were performed to identify different populations of infiltrative cells. In both variants of tumors an accumulation of these cells were seen at the periphery of the tumor, surrounding the nodules. In contrast, very few inflammatory cells, macrophages or T lymphocytes were seen inside the clumps of tumor cells where cytolytic cells could have a contact-dependent tumoricidal effect. Only small differences were found between progressive and regressive tumors in the density of the various populations of T helper, T cytotoxic/suppressor, B lymphocytes or macrophages inside or around the tumor nodules. On the other hand, progressive and regressive tumors clearly differ in the relationship between tumor cells and the fibroblastic reaction they induce. Regressive tumors were rapidly encircled by a fibroblastic reaction isolating them from the peripheral tissues. The fibroblastic reaction was less dense around the progressive tumor cells which were able to migrate and invade the periphery. This suggests that immunological factors leading to tumor progression or regression could act indirectly through a control of the fibroblastic reaction, rather than through a direct cytotoxic effect on the tumor cells. PMID- 3298079 TI - Calcium antagonists and the ischemic myocardium. AB - Recent laboratory studies have shown that the calcium antagonists (slow channel blockers) can protect the myocardium against the consequences of experimentally induced ischemia and reperfusion. With one recent exception, however, clinical trials relating to the effectiveness of these drugs in the management of patients with myocardial infarction have been disappointing. This paper explores this apparent discrepancy. PMID- 3298080 TI - Metoprolol in acute myocardial infarction reduces ventricular arrhythmias both in the early stage and after the acute event. AB - Fifty three of the 5778 patients included in the MIAMI (Metoprolol in Acute Myocardial Infarction) trial were investigated with long-term ECG recordings in order to evaluate the effect of acute beta-blockade on premature ventricular complexes in and after acute myocardial infarction. Twenty five patients were given placebo and 28 metoprolol in a double-blind randomized fashion for 15 days. After this period the patients were put on open beta-blockade without breaking individual study codes. The mean number of premature ventricular complexes during the inclusion day (day 0) was the same in the two groups. The median numbers were also similar in the two groups: 190 and 154 in the placebo and metoprolol groups, respectively. Metoprolol significantly reduced the median number of premature ventricular complexes in the randomized period. The median numbers on days 1, 2 and 15 were 146, 101, 84 in the placebo group and 73, 59 and 10 in the metoprolol group, respectively (P less than 0.05). Also during the further follow-up, when investigated 1, 3 and 6 months after the infarction, the median number of premature ventricular complexes was lower in the metoprolol group (74, 257, 142 in the placebo group and 7, 5 and 11 in the metoprolol group, P less than 0.05). This indicates that metoprolol treatment in the acute phase of myocardial infarction reduces ventricular arrhythmias both in the early stage and also after the acute event. PMID- 3298081 TI - Semisynthetic human insulin: biological and pharmacokinetic effects in normal subjects. AB - The assessment of pharmacokinetic and pharmacodynamic properties of semisynthetic human insulin produced by enzymatic conversion was done in normal subjects, and compared to those of highly purified pork insulin. Ten healthy volunteers were submitted to an intravenous injection of 0.06 U/kg of regular insulin, semisynthetic (Actrapid HM) and monocomponent pork insulin (Actrapid MC) in succession. No significant differences were pointed out as far as the pharmacokinetic parameters, immunoreactivity and hypoglycemic effect of both types of insulin are concerned. Only a stronger inhibition of endogenous insulin secretion, expressed by a significantly lower plasma-C-peptide levels, was observed after PPI. Stimulation of glucagon secretion was similar with both types of insulin. PMID- 3298082 TI - Use of ceftazidime in the treatment of otorhinolaryngoiatric bacterial infections. AB - Within the framework of an investigation into otorhinolaryngoiatric bacterial infections in Italy conducted in 1159 patients (607 with otitis media, 354 with pharyngo-tonsillitis and 198 with sinusitis), 124 ceftazidime-treated subjects (92 with otitis media, 22 with pharyngo-tonsillitis and 10 with sinusitis) were observed. The authors report the examination of a number of microbial isolates obtained in the various forms of otorhinolaryngoiatric bacterial infection. Gram negative organisms were found as causative agents in such diseases, particularly in otitis media. Bacterial resistance to ceftazidime was assessed in all 1159 cases and proved relatively infrequent (3.6%) and markedly less than the detected resistance to other antibiotics (10.7% resistance to cefotaxime, 35% resistance to ampicillin, 43% resistance to penicillin). Ceftazidime, used mainly in otitis media, showed very substantial clinical efficacy with positive results in as many as 97% of cases treated, which is particularly significant, if one considers that roughly 64% of the infections were caused by "difficult" gram-negative bacteria (49% by Pseudomonas). PMID- 3298083 TI - Comparative pharmacokinetic parameters of new systemic fluoroquinolones. AB - The recent piperazinyl-substituted mono-fluoroquinolones represent a family with some common features on the one hand, and some variable parameters on the other. Some of the common features are: same mechanism of action (DNA-gyrase inhibitors of the A subunit of topoisomerase); pH-dependent antibacterial activity; a rather long post-antibiotic effect for both Gram-positive and Gram-negative bacteria; same physicochemical properties (organic acids, high pKa, lipophilicity). Common pharmacokinetic parameters include low protein binding (less than 50%); high volume of distribution (greater than 1 l/kg) with good tissue concentrations attainable in lymph, blister fluid, renal tissue prostate, bronchial secretions, saliva, aqueous humour, CSF, bone and bile; good intracellular penetration in macrophages and polynuclear neutrophils; high peak urinary concentrations, markedly exceeding the MIC for virtually all bacterial urinary tract pathogens, even accounting for the increase in MIC in the urine, especially at lower (acidic) pH; low extraction ratio dialysis; similar adverse reactions (CNS, gastrointestinal, photosensitivity, tendo-articular and cartilage toxicity). However, most other pharmacokinetic parameters are different from one fluoroquinolone to the other: oral bioavailability, peak serum levels (Cmax) as a measure of bioavailability, terminal half-life of elimination (t1/2) are all variable. The extent of metabolic biotransformation varies greatly, the two extremes being ofloxacin, showing a high metabolic stability and pefloxacin, highly metabolized. The degree of antibacterial activity of different metabolites also varies widely.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298084 TI - Efficacy and safety of ofloxacin in elderly patients. AB - A total of 325 patients all older than 65 years (45 of more than 80 years of age) were treated with ofloxacin during phase II studies. The relative efficacy of ofloxacin in the comparative studies in the elderly patients was comparable to that in the younger patients. However cure rates in the elderly patients were generally lower than in the younger patients both for ofloxacin and other comparative treatments, probably reflecting a higher incidence of complicating factors. Ofloxacin was well tolerated in the elderly patients. PMID- 3298085 TI - In vitro activity of aztreonam, cefuroxime and ceftazidime against gram-negative rods isolated from hospital patients with urinary tract infection. AB - The in vitro activity of aztreonam, cefuroxime and ceftazidime was determined against 2,372 Gram-negative rods (including Pseudomonas spp.) isolated from hospital patients with urinary tract infections during 1985. Minimum inhibitory concentrations (MICs) were determined using an agar incorporation technique in Mueller-Hinton agar. The inoculum used was approximately 10(5) colony forming units (cfu) contained in 10 microliter Mueller-Hinton broth, which was applied to the surface of the agar plates using a multipoint inoculator. Following inoculation plates were incubated aerobically at 37 degrees C for 18 h. The MIC of each antimicrobial for each organism examined was determined as the lowest concentration of the antimicrobial which completely inhibited growth of the inoculum. The minimum concentration required to inhibit the growth of 90% (MIC90) of the bacterial isolates in each genus or species examined was also determined. In general the antibacterial spectrum of aztreonam was comparable to that of ceftazidime and superior to that of cefuroxime. Against Escherichia coli, which accounted for 72% of the isolates examined, aztreonam (MIC90 less than or equal to 0.25 microgram/ml) was slightly more active than ceftazidime (MIC90 0.5 microgram/ml) and considerably more active than cefuroxime (MIC90 8 micrograms/ml). Aztreonam was active against Pseudomonas spp. (MIC90 16 micrograms/ml), although somewhat less so than ceftazidime (MIC90 4 micrograms/ml). Cefuroxime showed low activity against this genus (MIC90 greater than 128 micrograms/ml). PMID- 3298086 TI - Cefoperazone therapy of bacterial meningitis: a preliminary report. AB - Eleven hospitalized patients with bacterial meningitis were treated with cefoperazone at daily dosage ranging between 3 and 8 g intravenously. Seven patients had proven Gram-negative bacterial infections, but in four patients the aetiological agent remained unknown. Eight patients completely recovered from infection and the pathogens were eradicated, in one patient the treatment failed and in two patients only some improvement was registered. Furthermore in five patients cefoperazone serum and cerebrospinal fluid levels were determined four times in the first week of treatment (1st, 3rd, 5th and 7th day). No side-effects were recorded. Cefoperazone can be considered as effective antimicrobial agent in the therapy of bacterial meningitis. PMID- 3298087 TI - Cefotetan in the treatment of serious intra-abdominal sepsis: a controlled clinical trial. AB - Cefotetan has been compared with two regimens of combination antibiotic therapy in the treatment of peritonitis and serious intra-abdominal sepsis. One hundred predominantly elderly patients (median age 66 years) were entered into a prospective randomized surgical trial. Sixty-two per cent had peritonitis. There were seven non-septic deaths. Side-effects were similar in each group and generally of a minor, self limiting nature. Haematological and biochemical factors were closely monitored, and though there were increases in the prothrombin time, there was no statistical difference between cefotetan and comparators. Cefotetan is as effective as combination therapy in the treatment of surgical patients with serious intra-abdominal sepsis. PMID- 3298088 TI - Influence of liquid and solid meals on muscle glycogen resynthesis, plasma fuel hormone response, and maximal physical working capacity. AB - The effect of forced liquid (L) or solid (S) carbohydrate (CHO)-rich feedings on plasma glucose, insulin, and glycogenesis after glycogen depletion was investigated. The relationship between glycogen restoration and maximal physical working capacity (MPWC) was studied as well. Eight males performed two experiments, with 2 weeks interval, on a bicycle ergometer. In each experiment, MPWC was determined in a graded test, which was immediately followed by interval work until exhaustion. After exercise cessation (EC), the subjects started to consume a standardized amount of concentrated L or CHO-rich food. Insulin and glucose concentration in blood were determined. Muscle glycogen was determined before, immediately after, 5 h after, and 22 h after EC. MPWC was determined again 22 h after EC. Four subjects performed a third experiment, in which solid food consumption was left ad libitum (AL). A rapid glycogen repletion was found 5 h after EC, i.e., from 72 +/- 40 to 198 +/- 38 mmol/kg in the S, and from 69 +/- 39 to 192 +/- 40 mmol/kg in the L experiment. The higher plasma glucose and insulin levels (P less than 0.05) during the 5 h after EC in the S experiments did not elicit a difference in glycogen repletion. Glycogen synthesis rate in the AL experiment was lower (P less than 0.05) than in the L and S experiments. Glycogen restoration in the L and S experiments was complete 22 h after depletion. However, despite repletion of glycogen, MPWC was decreased (P less than 0.05) in both experiments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298089 TI - Nonmelanotic skin cancer and solar keratoses. The quiet 20th century epidemic. PMID- 3298090 TI - Cutaneous manifestations in Ixodes-borne Borrelia spirochetosis. PMID- 3298091 TI - Immunologic testing in the dermatologic patient. PMID- 3298092 TI - Esophageal injection sclerosis. AB - Hemorrhage from esophageal varices is a serious complication of portal hypertension and cirrhosis, as evidenced by a 50-60% mortality rate and a 40-60% rate of recurrent hemorrhage. Esophageal injection sclerosis (EIS) has emerged as the preferred mode of therapy for esophageal hemorrhage and in most respects is superior to surgical portacaval shunt and medical therapy. EIS controls variceal bleeding acutely in 85-95% of cases and results in the long-term obliteration of varices in 60-80% of patients. EIS decreases the time the patient spends in the hospital, reduces the amount of blood transfused, and may prolong the patient's survival. Complications of ulceration and stenosis can be minimized by proper choice of agent and by manipulating the volume and concentration of sclerosing agent, the interval between sessions, and the pattern of injections within the esophagus. EIS is both effective and reasonably safe for the acute and long-term management of esophageal variceal hemorrhage and can easily be performed at most medical centers in this country. PMID- 3298093 TI - Pediatric dermatology: chronologic excursions into the literature. Part I. Pediatric dermatology in general medical texts. PMID- 3298095 TI - Photoreactivity of histidyl residues in subtilisins Novo and DY. Photooxidation of subtilisins. AB - Subtilisins Novo and DY were photoinactivated in the presence of methylene blue according to first order kinetics. The competitive inhibitor N alpha-benzoyl-L arginine protected significantly against inactivation. Under the conditions employed in this study a selective photooxidation of the active site histidine 64 was achieved. Rate constants of 0.32 X 10(-2), s-1 and 0.35 X 10(-2), s-1, were calculated for the Novo enzyme and subtilisin DY, respectively. Apparent pKa values of the catalytically important imidazole group of 7.0 +/- 0.1 (s. Novo) and 7.1 +/- 0.1 (s. DY) were directly determined. The histidyl residues in the two proteases, except the active site histidine, which is the first target of photooxidation, are "buried" in the interior of the protein globule. Conformational studies suggested that the photoreactive histidine is not involved in the stabilization of the protein conformation. PMID- 3298096 TI - Synthesis of conjugates between luteinizing hormone releasing hormone (LH-RH) and N-acetyl-muramyl-L-alanyl-D-isoglutamine (MDP) models of totally synthetic vaccines. AB - Two glycopeptides associating the aminoacid sequence of LH-RH with MDP were prepared, using a Lys residue as a linker. These conjugates, N alpha MDP N epsilon (LH-RH)-Lys and N alpha MDP N epsilon (LH-RH)-Lys-NH2 obtained by condensation of fragments were synthesized by liquid as well as solid phase methods. Both compounds were able to induce anti LH-RH antibodies and immunological castration. They retained the immuno-adjuvant activity of MDP. Such antigen-adjuvant constructs, devoid of carrier and obtained by chemically defined and reproducible synthetic methods could offer suitable tools for structure activity relationship studies aiming at defining synthetic vaccines. PMID- 3298094 TI - Analytical chemistry of chromium species in the environment, and interpretation of results. AB - Valence-selective species determination of chromium in environmental and biological material presents intricacies primarily due to the complex nature of the samples and the instability of the oxidation states of chromium. In particular organic matter ubiquitously present in environmental samples introduces the risk of chromium(VI) reduction during analysis which takes place preferably in acidic solution. Also chromium(III) oxidation may occur in alkaline medium. Hence analytical methods should be adequately adapted to the reliable determination of chromium(VI) in blood, natural water, effluents, sediments and soil. It can be shown that polarography is most effectually suitable to the determination of chromium(VI) compounds. Chromium(VI) is electrochemically active over the entire pH range, so that medium pH can be selected for measuring, thus protecting samples most effectively from undergoing redox reactions during the analytical procedure. Other established methods such as spectrophotometry or valence-specific extraction are more crucial, because these generally require acidic medium. In some cases sample pre-treatment can be employed to eliminate reductants prior to final measurement. Very few methods are available to selectively measure chromium(III). Indirect determination is therefore preferred. Optimum conditions for the determination of total chromium by AAS are shortly outlined. PMID- 3298097 TI - Digestion by pancreatic juice of a beta-casomorphin-containing fragment of buffalo beta-casein. AB - Degradation by pig pancreatic juice of a beta-casomorphin-containing fragment (tryptic peptide corresponding to residues 49-68 of buffalo beta-casein) was investigated. The FAB/MS (fast atom bombardment mass spectrometry) technique was used to identify the fragments produced by the concerted action of pancreatic proteases. Pancreatic juice, under our experimental conditions, is not able to release beta-casomorphins or morphiceptin from the tryptic peptide sequence. Furthermore, the present report shows that the rapid hydrolysis of a peptide bond by a single protease can prevent the cleavage of peptide bonds by a different protease. Therefore the formation of some peptides in the gastrointestinal tract can depend on the protease ratio. PMID- 3298099 TI - 90 years of x-rays--a celebration. PMID- 3298098 TI - Lensectomy and vitrectomy in the presence of filtering blebs. AB - We describe a technique for preserving a filtering bleb in glaucoma patients undergoing pars plana lensectomy and vitrectomy. It involves making a conjunctival incision away from the filtering site and injecting the anterior chamber and bleb with (hyaluronic acid) Healon before vitreous surgery is begun. PMID- 3298100 TI - Rontgen's discovery--how and why it happened. PMID- 3298101 TI - Early protection and radiological physics. PMID- 3298102 TI - Diagnostic radiology. PMID- 3298103 TI - Therapeutic uses of X-rays. PMID- 3298104 TI - Effects of radiation and other influences on chemical lymphomagenesis. AB - Methylnitrosourea (MNU) or butylnitrosourea (BNU) was used to induce T cell lymphomas (thymomas) in BDF1 mice. In addition to the chemical, X-rays in various dose schedules were applied. An effect of the irradiation (shortening of the latency period) was seen with 12 X 0.25 Gy in protocols with a prolonged median induction time in the controls as a result of a dose reduction of the chemical (median induction time 27-36 weeks instead of 16-18 weeks under 'optimal' conditions using 50 mg kg-1 of MNU). Preirradiation 2-5 weeks before 40 mg kg-1 of MNU resulted in enhanced leukaemogenesis. Also, mice with regenerating lympho haemopoiesis after lethal irradiation and bone marrow transplantation were more sensitive to the effect of both chemicals than were the controls. Treatment with anti-thy 1.2 and with corynebacterium parvum during the latency period had no influence. PMID- 3298105 TI - Late effects of cyclophosphamide and total body irradiation as a conditioning regimen for bone marrow transplantation in rats (a preliminary report). AB - The longterm survival and occurrence of neoplastic and nonneoplastic lesions following total body irradiation (TBI), 8.5 Gy, with or without additional cyclophosphamide (Cy; 100 mg kg-1 i.p.) treatment as a conditioning regimen for bone marrow transplantation (BMT) were studied in male BN/BiRij rats. The two groups of rats that were treated with Cy (Cy and Cy + TBI) that survived beyond 100 days after treatment, had a severely decreased median (post treatment) survival time (Cy + TBI: 14.5 months and Cy: 14.1 months). Survival time in the TBI group was moderately decreased (18.5 months) as compared with the untreated controls (27.2 months). All treatment modalities were carcinogenic according to the raw data. After Cy-treatment a high incidence of, frequently multiple, malignant nerve-sheath tumours (Cy: 66 per cent, Cy + TBI: 31 per cent, controls: 2 per cent) was observed. TBI induced an increased occurrence of a great variety of tumours, especially mesenchymal tumours. This effect was more pronounced in animals receiving TBI alone as compared to animals receiving the combined treatment of Cy + TBI; an effect that most likely resulted from the longer median survival after TBI. The multi-target effect of TBI was also reflected in the occurrence of nonneoplastic effects in a variety of tissues, including high incidences of biliary cysts in the liver and severe testicular atrophy. The most important Cy-induced nonneoplastic lesion was incisor dysplasia, which resulted in feeding problems that could only be partly overcome by administering powdered food. Early mortality in the Cy-treated groups was associated with emaciation and generalized organ atrophy. A more definitive estimate of the late effects of supralethal chemoradiotherapy as part of a treatment of malignant disease has to await the results of various conditioning regimens for BMT in rats employing the acute BN myelocytic leukaemia (BNML) as a rat model for human acute myelocytic leukaemia (AML). PMID- 3298106 TI - Carcinogenic and co-carcinogenic effects of radiation in rat mammary carcinogenesis and mouse T-cell lymphomagenesis: a review. AB - The importance of the promotion stage and of the physiological condition of target cells at the time of initiation is illustrated in both the rat mammary carcinogenesis and the mouse T-cell lymphomagenesis. In the former, prolactin was shown to be a powerful promoter regardless of the initiating agent. Prolactin was also found to be useful in detecting the carcinogenicity of the small doses of carcinogens; a high r.b.e. of 2.0 MeV fission spectrum neutrons was demonstrated by the application of prolactin to radiation-initiated mammary carcinogenesis in rats. In the latter, total-body irradiation involving both bone marrow and thymus facilitates chemically-initiated T-cell lymphomagenesis in mice. This could be attributed to the amplification of the cell population susceptible to a chemical carcinogen in the target tissue during the recovery phase after irradiation. The dual effect of a carcinogen, acting in the different phases of carcinogenesis was suggested by the split administration of N-nitrosoethylurea (NEU) in the induction of T-cell lymphomas. It is emphasized, through these findings, that besides the initiation by a genotoxic agent, the availability of a promoter or an inhibitor determines the fate of initiated cells, and that a modifier of target cells also plays a crucial role in the efficient induction of a tumour. PMID- 3298107 TI - Dose-effect relationships and general mechanisms of combined exposures. AB - Organisms are exposed to a multitude of physical, chemical and biological agents. Many data are available on the risks associated with these agents when applied individually. However, an assessment of the overall risk has to take into consideration the possibility of unexpected risks after combined exposures. There is no way of testing all conceivable combinations of agents. Thus, we have to look for general mechanisms that permit extrapolations to situations not yet tested. The study of mechanisms requires the knowledge of the shape of the dose response relations for all agents participating in the combined exposure. Possibilities for the analysis of effects after combined exposures are described. It emerges that very specific processes in the chain of events must be affected in order to influence radiation risk by another agent. Two such specific processes of importance are recovery phenomena and cell proliferation. PMID- 3298108 TI - Cellular responses to ionizing radiation: effects of interrupting DNA repair with chemical agents. AB - This review is concerned with the influence of different classes of chemical agents on cellular repair of DNA damage induced by ionizing radiation. Single strand break rejoining is little affected by inhibitors of DNA synthesis; however, such inhibitors do lead to a persistence of double-strand breaks in the DNA, and this correlates with an enhancement of chromosome aberrations and cell killing. Experiments with antagonists of topoisomerase II suggest an intriguing role for this DNA unwinding enzyme in double-strand break repair. Interference with poly(ADP-ribose) synthesis, by means of the inhibitor 3-aminobenzamide, does not have a clear-cut effect on recovery from ionizing radiation damage. Various substances (for example, caffeine and trypsin) affect DNA repair via a modulation of the cell cycle, altering the time available to the cell for repairing potentially lethal DNA damage before such damage is 'fixed' by the process of DNA replication. Finally, disturbing cellular energy metabolism, and depressing the level of ATP, can inhibit the repair of radiation damage. PMID- 3298109 TI - Genetic effects of combined chemical-X-ray treatments in male mouse germ cells. AB - Several studies have shown that the yield of genetic damage induced by radiation in male mouse germ cells can be modified by chemical treatments. Pre-treatments with radio-protecting agents have given contradictory results but this appears to be largely attributable to the different germ cell stages tested and dependent upon the level of radiation damage induced. Pre-treatments which enhance the yield of genetic damage have been reported although, as yet, no tests have been conducted with radio-sensitizers. Another form of interaction between chemicals and radiation is specifically found with spermatogonial stem cells. Chemicals that kill cells can, by population depletion, substantially and predictably modify the genetic response to subsequent radiation exposure over a period of several days, or even weeks. Enhancement and reduction in the genetic yield can be attained, dependent upon the interval between treatments, with the modification also varying with the type of genetic damage scored. Post-treatment with one chemical has been shown to reduce the genetic response to radiation exposure. PMID- 3298110 TI - Risk to preimplantation mouse embryos of combinations of heavy metals and radiation. AB - The influence of arsenic, cadmium, lead or mercury on radiation risk to preimplantation mouse embryos in vitro was studied under various conditions. Morphological development, cell proliferation, and formation of micronuclei were used for assessment of risk after combined exposure to these metals and X-rays. No conditions were found under which arsenic altered radiation risk; the effects were merely additive. Cadmium acted similarly, though a few results indicated that morphological development might be impaired more strongly after combined exposure than expected from the addition of the single effects. Lead enhanced radiation risk with regard to micronucleus formation, but had an additive effect only in the case of morphological development and cell proliferation. Of all four metals, mercury had the greatest potential for enhancement of radiation risk, when morphological development and cell proliferation were studied. The observed combination effects exceeded even those effects which were calculated by taking into account the shape of the dose-effect curves (isobologram analysis, envelope of additivity). Mercury neither induced micronuclei nor enhanced their formation in combination experiments. PMID- 3298111 TI - Possible occurrence of DNA double-strand breaks during repair of u.v.-induced damage in yeast. AB - The yeast mutant rad54-3, which is temperature conditional for dsb rejoining, is sensitive to u.v. light when held at the restrictive temperature following exposure. We propose that this is attributable to the enzymatic formation of dsb in DNA containing u.v. lesions and a subsequent lack of dsb repair in this mutant. PMID- 3298112 TI - Cold-shock modification of the oxygen enhancement ratio of Escherichia coli cells. PMID- 3298113 TI - The Malpighi lecture. From 'Porositates carnis' to cellular microcirculation. AB - After Malpighi's discovery of the capillaries almost 200 years elapsed before clear concepts about their main function, solute transport between blood and tissue, were formulated. The German physiologist Carl Ludwig played a significant role in this development because of his will to seek physico-chemical explanations of physiological phenomena. Ludwig's pupil Christian Bohr formulated the first (and almost definitive) mathematical model of transcapillary diffusion, later extended by Bohr's pupil August Krogh, to describe blood-tissue exchange in peripheral tissues. In the 1950s the two-pore model of transcapillary transport became the main paradigm (Pappenheimer, Grotte). The morphological substrate for this concept is found in tortuous pathways in the interendothelial junctions together with a small number of 'leaks' or focal openings in the capillary wall. The concept makes transcapillary transport of hydrophilic molecules a paracellular phenomenon. Recent studies in the author's laboratory based on electrophysiological methods on single capillaries have disclosed the rapidity of changes in microvascular permeability in response to many different substances- indicating reactions elicited in the endothelial cells. It is almost certain that in many cases, these changes are mediated via a transitory increase in cytosolic free calcium concentration. The overlap between permeability-increasing substances and agents that induce formation of endothelial-derived relaxing factor, EDRF, is so striking that a possible connection between vasodilatation and subtle increase in permeability should be considered. It is likely that the endothelial system of plasmalemmal invaginations ('vesicles') plays a role in the control of cytosolic calcium concentration. PMID- 3298114 TI - Nonsudorific skin potential level: current hypothesis and psychophysiological significance. AB - Skin potential level has two mechanisms of generation: that due to sweat gland activity (sudorific) and that due to other causes (nonsudorific). These mechanisms have, in the past, been frequently confounded. This paper addresses the importance of discriminating between the two mechanisms and describes two kinds of nonsudorific skin potentials. There is reason to except nonsudorific skin potential level to be an important factor in embryogenesis, tissue regeneration and atypical growth. Early work that associated these potentials with changes in consciousness (e.g., sleep and hypnosis) is inconclusive. The literature concerning physiological and psychological correlates of skin potential levels that have been attributed to nonsudorific mechanisms is reviewed, and the methodological problem of measuring these potentials is considered. PMID- 3298115 TI - A role for platelet activating factor and platelets in the induction of bronchial hyperreactivity. AB - Platelet activating factor (PAF) is able to induce a long-lasting non-specific increase in bronchial hyperreactivity in both experimental animals and man. In the guinea-pig, PAF-induced bronchial hyperreactivity is secondary to platelet activation and associated with a recruitment of platelets into the lung. As platelets have been shown to be activated in clinical asthma and platelet abnormalities are a feature of this disease, it would seem justified to evaluate further the role of PAF and platelets in the induction of the bronchial hyperreactivity which characterizes asthma. PMID- 3298116 TI - Clinical review of ribavirin. AB - The recent approval of ribavirin aerosol for the treatment of severe respiratory syncytial virus (RSV) in infants and young children is a significant addition to the antiviral drugs available today. When administered as an aerosolized form by face mask or mist tent for 20 to 21 hours per day, ribavirin effectively decreases the symptoms of RSV infection and the shedding of RSV virus. Studies of other viral infections such as viral hepatitis, influenza A and B, Lassa fever, genital herpes, and herpes zoster have demonstrated promising, but inconclusive results. Further studies are needed to justify ribavirin therapy for these indications. PMID- 3298118 TI - Is the patient asleep? AB - Patients awareness while under general anesthesia has been noted since shortly after Morton's 1846 public demonstration. Only since 1950, however, has the phenomenon received the attention of researchers. Such awareness can be caused by insufficient anesthesia due to carelessness or equipment malfunction; or by the light levels of anesthesia allowed by the use of muscle relaxants. Members of the anesthesia and surgical teams should be alert to the possibility of awareness and conduct themselves in the operating room accordingly. PMID- 3298117 TI - Coronary artery bypass surgery in a cadaver kidney transplant recipient. AB - A review of the literature revealed that reports on coronary bypass operations in post renal transplant patients are rare. Here a case of successful coronary by pass operation in a renal transplant patient is reported. PMID- 3298119 TI - [Epidemiology of diabetes mellitus]. PMID- 3298120 TI - [Genetics of diabetes mellitus]. PMID- 3298121 TI - [Modern concepts of the etiology and pathogenesis of type II diabetes mellitus]. PMID- 3298122 TI - [Clinical aspects of the immunopathogenesis of type I diabetes mellitus]. PMID- 3298123 TI - [New methods of insulin therapy]. PMID- 3298124 TI - [Oral antidiabetic agents including glucosidase inhibitors]. PMID- 3298125 TI - [Diabetic microangiopathies]. PMID- 3298126 TI - [Myocardial infarct as the initial manifestation of myocardial involvement in asymptomatic Boeck disease]. PMID- 3298127 TI - [Increasing somnolence in a patients with previous appendectomy]. PMID- 3298128 TI - Surface glycoconjugates on rat photoreceptor cilium. Effect of neuraminidase digestion. AB - In retinal photoreceptors the connecting cilium constitutes a boundary between the inner and outer segments. In previous studies we demonstrated that, while opsin could be localized in abundance in the distal ciliary membrane, very little opsin was detected in the proximal ciliary plasma membrane. In the present study we extended our view of molecular specialization on the ciliary membrane with respect to glycoconjugates. Saccharide moieties of ciliary glycoconjugates were studied in immature and mature rat photoreceptors. Surface saccharides were detected and localized by means of ferritin-labeled lectins and electron microscopy. Dense labeling of the ciliary membrane surface with wheat germ agglutinin (WGA) was observed. In immature photoreceptors the labeling was restricted to the proximal ciliary membrane, in a region where opsin molecules could not be detected. Neuraminidase digestion abolished WGA binding to the proximal ciliary membrane surface, indicating that sialic acids mediate WGA binding to this domain. Peanut agglutinin (PNA) did not label the ciliary surface, nor did it bind to the surface of other photoreceptor domains. Neuraminidase digestion exposed numerous PNA binding sites on the ciliary membrane surface. In view of the carbohydrate specificity of PNA, we suggest that a terminal trisaccharide sequence, sialic acid-galactose-(beta 1----3)-N-acetyl galactosamine, is present in high density on the proximal ciliary membrane surface. PMID- 3298129 TI - Clearance of chlamydial elementary bodies from the conjunctival sac. AB - The rate of disappearance of inactivated Chlamydia trachomatis elementary body (EB) preparations from the conjunctival sac was studied in monkeys. Direct fluorescent antibody (DFA) cytology showed that the majority of EB had been cleared from the eye within 24 hr of the inoculation of 1 X 10(6) inactivated EB, although small numbers of EB could be detected for up to 144 hr. The rate of clearance in normal and ocular immune animals did not differ, and formalin-killed and UV-inactivated EBs disappeared at a comparable rate. These studies suggest that chlamydial EB are cleared relatively quickly from the eye and support the notion that EBs detected by DFA cytology indicate the presence of current infection. PMID- 3298130 TI - Is the P388 murine tumor no longer adequate as a drug discovery model? PMID- 3298131 TI - Combination trial of subcutaneous interferon alfa-2b and oral cyclophosphamide in favorable histology, non-Hodgkin's lymphoma. AB - Patients with follicular non-Hodgkin's lymphoma (NHL) respond well to chemotherapy but frequently relapse and progress with conversion to more aggressive histology lymphomas. In a prior Cancer and Leukemia Group B (CALGB) trial, oral cyclophosphamide, given as a single agent, was found to be equivalent to a five-drug regimen in remission induction in patients with follicular NHL who had not received prior chemotherapy. Recently, interferon alfa-2b (Intron A; Schering Plough) has been demonstrated to elicit complete or partial responses in up to 50% of patients with nodular NHL who had received prior chemotherapy. In the current CALGB pilot trial, oral cyclophosphamide (100 mg/m2 daily) combined with interferon alfa-2b (2 X 10(6) IU/m2 s.c. on alternate days) is being evaluated, both in previously treated and untreated patients with stage III or IV follicular NHL, for toxicity, safety and efficacy in remission induction. A total of 68 patients have been entered into this study. Four patients are ineligible on pathology review, and 60 have on-study data currently available. Forty-one (60%) had not received prior chemotherapy and 19 (32%) had previously received some form of chemotherapy. Leukopenia was found to be the single, most common toxicity experienced by all patients. Previously untreated patients experienced leukopenia of less than 2,000 WBC/microliter at a significantly higher rate (53% versus 14%) than a similar patient population receiving oral cyclophosphamide as a single agent in the prior CALGB trial. Leukopenia was found to be promptly reversible, however, by dose suspension or adjustment, and other toxicities were demonstrated to be mild and tolerable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298132 TI - Interferon alfa-2b and chlorambucil in the treatment of non-Hodgkin's lymphoma. AB - Twenty-two patients with non-Hodgkin's lymphoma (NHL) were treated with a combined regimen of interferon alfa-2b (Intron A; Schering-Plough) and chlorambucil to evaluate the response and efficacy in pre-treated or relapsed patients. Ten patients were classified as having follicular lymphoma and 12 diffuse lymphoma. The treatment schedule consisted of interferon alfa-2b 3 X 10(6) IU/m2 thrice-weekly and chlorambucil 10 mg daily for three weeks, with a week's rest between each cycle. Treatment continued for upto six cycles. We obtained two complete remissions (CR), 12 good partial remissions (GPR), seven no remissions (NR) and one stable disease. On histologic examination we observed a response in 8 of 10 patients with follicular lymphoma (2 CR and 6 GPR); three of five patients with diffuse mixed lymphoma, and three of seven patients with diffuse lymphoma showed GPR. The major toxicity consisted of fever and nausea and, in one case, lethargy. In one patient the treatment was stopped at the second cycle because of poor compliance. Hematologic toxicity was generally mild and occurred between the third and fourth cycle. We observed hepatic toxicity i.e. a transient increase of transaminase levels, in three patients. We consider this regimen to be effective in the treatment of relapsed or resistant NHL and no more toxic than single agent therapy. A randomized study to verify this therapeutic approach versus conventional therapy with chlorambucil alone in first line treatment is recommended. PMID- 3298134 TI - The treatment of hairy cell leukemia with recombinant alfa interferon: a multi institutional study. AB - This report expands on previous work with interferon alfa-2b (Intron A; Schering Plough) in the treatment of hairy cell leukemia (HCL). Sixty-four patients were treated, with 89% achieving a response (either CR, PR or MR). The percentage of hairy cells in the peripheral blood decreased dramatically within one month and in the marrow, progressively over nine months. Normalization of blood counts was associated with a marked decline in serious infections and in the need for red cell or platelet transfusions. Preliminary results with a further group of patients confirm these satisfactory results. PMID- 3298133 TI - Overview of preclinical and clinical studies of interferon alfa-2b in combination with cytotoxic drugs. AB - Both in vitro and in vivo studies have demonstrated antiproliferative effects of interferon alfa-2b (Intron A; Schering-Plough) when tested with human tumor cells. A clonogenic assay has been widely used to determine its direct antiproliferative effects on human tumor cells in vitro using colony reduction as a reproducible endpoint. As a single agent, interferon alfa-2b shows maximum tumor cell colony reduction when used in high concentrations with continuous cell exposure. Short-term exposure to interferon alfa-2b does not produce significant tumor cell colony reduction. Clonogenic assays have also been used to test combinations of interferon alfa-2b with cytotoxic drugs. Variations in drug scheduling, sequencing and concentrations have indicated the best combinations which maximize tumor cell colony reduction. Combinations of interferon alfa-2b with doxorubicin, cisplatin, vinblastine, melphalan and cyclophosphamide have been shown to have at least additive and occasionally synergistic antiproliferative effects. In clinical trials, optimal pairs of agents have been identified frequently combining either doxorubicin, cisplatin or vinblastine with interferon alfa-2b. Pretreatment with interferon alfa-2b has been adopted from in vitro studies and applied to most clinical trials. One study has enrolled 135 patients having a variety of advanced or recurrent solid tumor types, using a schema which combines interferon alfa-2b and doxorubicin administration, both given on a weekly basis for three weeks, followed by treatments every two weeks in responding patients. Clinical responses have been seen using this regimen in patients with ovarian, cervical, colorectal and pancreatic carcinomas and in one lymphoma patient. Another study has been designed combining melphalan, prednisone and interferon alfa-2b for the treatment of patients with relapsing multiple myeloma. This is also based upon preclinical data. New methods of administration are being studied giving interferon alfa-2b as a single agent or in combination with cisplatin by the intraperitoneal route to patients with relapsing ovarian carcinomas limited to the peritoneal cavity. This method can maximize both the levels of interferon alfa-2b as well as the tumor cell exposure time. PMID- 3298136 TI - Interferon alfa-2b in the treatment of chronic granulocytic leukemia. AB - Studies of the effect of interferon on the growth of colonies of myeloid leukemic blasts, myeloma colony-forming cells and normal hemopoietic precursor cells have shown that interferon does not specifically inhibit the growth of the malignant cells in culture, i.e. the growth of the malignant and the normal precursor cells are inhibited equally. However, interferon markedly reduces the self-renewal capacity of acute myeloid leukemic blasts and myeloma cells. This observation suggested that interferon should be tested for its ability to prolong remissions rather than as a remission-inducing agent. We have tested the ability of interferon alfa-2b (Intron A; Schering-Plough) to prolong remissions induced by busulfan in patients with chronic granulocytic leukemia (CGL). The leukocyte doubling time (Td) and remission duration on no therapy was compared to the values observed during interferon alfa-2b maintenance therapy. Fourteen patients have been started on study and seven have received interferon alfa-2b for three months or more. All seven have shown slowing of the leukocyte Td and prolongation of the remission duration after interferon alfa-2b therapy. A larger study, with longer follow-up, will be required to determine whether interferon alfa-2b therapy will slow or prevent progression of CGL to the blast phase and prolong survival. PMID- 3298135 TI - Alpha interferon: a look to the future. AB - The alpha-interferons have been explored in a wide variety of clinical applications in cancer. Significant activity has been demonstrated in AIDS related Kaposi's sarcoma, ovarian carcinoma, bladder carcinoma, malignant glioma, non-Hodgkin's lymphoma, chronic granulocytic leukemia, the carcinoid syndrome and hairy cell leukemia. Although these leads are promising, the research has only just begun. PMID- 3298137 TI - Peptic ulcer disease. PMID- 3298139 TI - Sonographic assessment of foetal health: antenatal identification of the structurally anomalous foetus. PMID- 3298138 TI - Adriamycin: review of clinical pharmacology and toxicity of an effective anticancer drug. PMID- 3298141 TI - Edward Worth (1688-1733). PMID- 3298140 TI - Biographical sketches--87. B.A. Houssay. PMID- 3298142 TI - Biographical sketch. Vulpian. PMID- 3298143 TI - Isozymes and the regulatory structure of the genome. PMID- 3298144 TI - Alpha-thymosins: relationships in structure, distribution, and function. PMID- 3298145 TI - Structure and expression of human and rat aldolase isozyme genes: multiple mRNA species of aldolase A produced from a single gene. PMID- 3298146 TI - Tissue-specific and developmentally specific controls involved in rat aldolase B gene expression. PMID- 3298147 TI - The antioxidant enzyme genes Cat and Sod of maize: regulation, functional significance, and molecular biology. PMID- 3298148 TI - Isozymes and the micro-organization of the glycolytic sequence. AB - A study of the ontogenic characteristics of glycolytic enzymes in mammalian tissues has demonstrated an extensive degree of association between these enzymic components and cellular structure in all tissues during development. Furthermore, these associations tended to be highly isozyme specific. In reviewing these data, a model has been developed which describes the novel features of this compartmentation-by-binding. The glycolytic sequence in vivo is depicted as a number of segments, each formed by a cluster of isozymes, many of which can interact with the actin-containing filaments of the cytomatrix. Evidence is provided that this form of compartmentation plays a key role in meeting the different types of energy requirement in the cytoplasm, with the wide selection of isozymes in this system providing increased flexibility and control in this important area of metabolism. PMID- 3298149 TI - Genes and proteins of chicken creatine kinase isozymes: developmental regulation and functional significance. PMID- 3298150 TI - Species differences in isozyme tissue patterns: their utility for systematic and evolutionary analyses. PMID- 3298151 TI - Comparison of chloroplast and cytosolic Cu/Zn superoxide dismutase isozymes from tomato in relation to superoxide dismutase evolution. PMID- 3298152 TI - Escherichia coli and Saccharomyces cerevisiae adenylate cyclases: a case of phylogenetic convergence? PMID- 3298153 TI - Reactions of Drosophila enzymes to temperature. Potential adaptive regimes. PMID- 3298154 TI - Genetic map of the American mink: gene conservation and organization of chromosomes. PMID- 3298155 TI - Chromosomal assignment of human genes coding for DNA repair functions. PMID- 3298157 TI - On the relation between heterozygosity and heterosis: an evaluation of the evidence from marine mollusks. PMID- 3298156 TI - X-linked gene expression and X-chromosome inactivation: marsupials, mouse, and man compared. AB - The existence of paternal X inactivation in Australian and American marsupial species suggests that this feature of X-chromosome dosage compensation is not a recent adaptation, but probably predates the evolutionary separation of the Australian and American marsupial lineages. Although it is theoretically possible that the marsupial system is one of random X inactivation with p greater than 0.99 and q less than 0.01 and dependent on parental source, no instance of random X inactivation (p = q or p not equal to q) has ever been verified in any tissue or cell type of any marsupial species. Therefore, we conclude that the most fundamental difference in X inactivation of marsupials and eutherians is whether the inactive X is the paternal one or is determined at random (with p = q in most but not all cases). The only other unequivocal difference between eutherians and marsupials is that both X chromosomes are active in mice and human oocytes, but not in kangaroo oocytes. Apparently, the inactive X is reactivated at a later meiotic stage or during early embryogenesis in kangaroos. X-chromosome inactivation takes place early in embryogenesis of eutherians and marsupials. Extraembryonic membranes of mice exhibit paternal X inactivation, whereas those of humans seem to exhibit random X inactivation with p greater than q (i.e., preferential paternal X inactivation). In general, extraembryonic membranes of marsupial exhibit paternal X inactivation, but the Gpd locus is active on both X chromosomes in at least some cells of kangaroo yolk sac. It is difficult to draw any general conclusion because of major differences in embryogeny of mice, humans, and marsupials, and uncertainties in interpreting the data from humans. Other differences between marsupials and eutherians in patterns of X-linked gene expression and X-chromosome inactivation seem to be quantitative rather than qualitative. Partial expression of some genes on the inactive X is characteristic of marsupials, with species variation in the behavior of specific loci; some X linked human genes on the inactive chromosome also are known to exhibit partial activity in vivo and in cultured cells. The X chromosomes of marsupials do not behave as units with respect to transcriptional activity, nor does the human X chromosome. In addition, Barr bodies have recently been detected at interphase in some marsupials, establishing that this manifestation of X chromosome inactivity is not restricted to eutherians.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3298158 TI - Allelic isozymes as probes of the evolution of metabolic organization. PMID- 3298159 TI - Expression of the Cat2 catalase gene in different cell types of maize. PMID- 3298160 TI - Mapping of isozyme and protein loci in barley. PMID- 3298161 TI - Continuous positive airway pressure improves the quality of sleep and oxygenation in obstructive sleep apnea syndrome. AB - We tested the effects of continuous positive airway pressure (CPAP) in 8 patients with obstructive sleep apnea syndrome (OSAS). The comparison of a nocturnal polygraphic study performed during spontaneous breathing with a study during CPAP administration performed the following night showed a significant reduction in stage 1 and increase in REM, the abolition of obstructive apneas and a significant increase in mean oxyhemoglobin saturation. Most patients reported marked relief of symptoms after the first night of treatment. However 3 patients, though confirming the improvement refused further CPAP. We conclude that CPAP is an effective measure for prevention of apneas in OSAS and that in compliant patients it may be regarded as a short-term measure when a permanent correction of the causes is planned, or as a long-term treatment when the latter is not feasible. PMID- 3298162 TI - A comparative study of biofeedback and progressive relaxation in anxious patients. PMID- 3298163 TI - Amelioration of ergotamine withdrawal symptoms with naproxen. PMID- 3298164 TI - Fenoprofen in the prophylaxis of migraine: a double-blind, placebo controlled study. PMID- 3298165 TI - Workplace health promotion: a commentary on the evolution of a paradigm. AB - Reports of workplace health promotion programs are reviewed in light of Kuhn's views on paradigmatic advances in science. Such reports fall into two categories: those which describe single health-habit interventions (e.g., smoking cessation, weight control, or stress management) and those which describe comprehensive efforts to incorporate many single health-habit interventions into integrated programs. Common to virtually all of these programs in their focus on the modification of the health behavior of individuals. Consideration of such organizational-level factors as work design or climate which are beyond the control of the individual, yet may contribute heavily to illness and absenteeism of employees, is typically omitted. It is concluded that workplace health promotion in the United States has achieved the status of a paradigm and that this paradigm is associated with several limitations and ethical problems in light of the programs' objectives: to reduce organizations' medical-care costs and improve productivity. PMID- 3298166 TI - Alcohol, tobacco and marijuana use among youth: an overview of epidemiological, program and policy trends. PMID- 3298167 TI - Patient with coronary artery spasm and role of the critical care nurse. AB - Review of the literature reveals that coronary artery spasm exhibits a wide variation in clinical presentation. This variation makes accurate diagnosis and management difficult; however, precise diagnosis is essential so that appropriate therapy can be given. Critical care nurses are in an excellent position to assess patient findings that may help suggest or exclude the presence of coronary artery spasm as the cause of the myocardial ischemia. Critical care nurses also can play an important part in suggesting and carrying out appropriate management of coronary artery spasm. PMID- 3298168 TI - Cardiac tamponade resulting from pneumopericardium: case report and implications for the critical care nurse. AB - Pneumopericardium resulting in cardiac tamponade may be caused by a variety of phenomena. The onset of cardiac tamponade can indicate the presence of a rare underlying condition. As a rare complication of mechanical ventilation and PEEP, our patient experienced pneumopericardium that resulted in cardiac tamponade. Perhaps the most crucial therapy of all is astute critical care nursing assessment of patients at risk of developing the life-threatening complication of cardiac tamponade. All critical care nurses should know the signs and symptoms of cardiac tamponade. Through accurate data collection, frequent monitoring, and immediate referral to the critical care team for medical diagnosis and treatment, a patient's death can be prevented. PMID- 3298169 TI - Pitfalls of computer use in acute care. PMID- 3298170 TI - A comparison of monoclonal antibodies against distinct colon tumor-associated antigens in immunohistochemistry and in tumor localization. AB - Monoclonal antibodies to colon/ovary tumor antigen (COTA), carcinoembryonic antigen (CEA), colon-specific antigen (CSA), and colon-specific antigen "protein" (CSAp) were evaluated for specificity, reactivity with normal tissues, and tumor localizations using athymic rats bearing xenografted human colon tumors. Radioiodine labeled anti-CSA and anti-COTA retained immunoreactivity and effectively localized the tumors; anti-CSAp retained immunoreactivity, but localized less effectively; and anti-CEA lost most of its immunoreactivity and localized poorly. Of the antibodies tested, anti-COTA showed potential for human colorectal tumor radiolocalization. PMID- 3298171 TI - Use of radiolabeled monoclonal anti-B1 antibody for B lymphocyte imaging in rhesus monkeys. AB - Imaging tissues rich in B lymphocytes in man using a radiolabeled monoclonal anti B cell antibody would be extremely useful in the clinical staging of non-Hodgkins lymphomas. Studies were done in rhesus monkeys using radiolabeled monoclonal anti B1 antibody to determine the feasibility of such an approach. Immunohistologic studies demonstrated that infused monoclonal anti-B1 binds in vivo with specificity to B cells in lymph nodes and spleen. The kinetics of clearance of 131I-labeled anti-B1 were determined. The B lymphocyte-rich spleen could be readily visualized by gamma camera scanning without significant background and without the need for image intensification or blood background subtraction techniques. These data support the feasibility of using anti-B1 for staging B cell lymphomas in man. PMID- 3298172 TI - Antibiotics literature index--a select bibliography. PMID- 3298174 TI - The contribution of Andrew Taylor Still to medicine: 1986 Scott Memorial lecture. PMID- 3298175 TI - Nursing the family after the birth of a child with spina bifida. PMID- 3298176 TI - Fractionation and dose rate effects in mice: a model for bone marrow transplantation in man. AB - This study was designed to compare several fractionation and dose rate schedules to optimize the therapeutic ratio for total body irradiation (TBI). C3H/HeJ mice were given TBI and the bone marrow survival fraction was calculated using the CFUS assay. Irradiation was given at two dose rates: low dose rate (LDR) at 5 cGy/min or high dose rate (HDR) at 80 cGy/min in single fraction and fractionated regimens. The fractionated regimens were given as either 120 cGy three times daily, 200 cGy twice daily, or 200 cGy daily. The Do was 80 cGy for the single fraction, HDR group and 85 for the LDR group. For the fractionated regimens, the apparent Do's ranged from 55-65 indicating no sparing effect of fractionation for the normal bone marrow stem cells. Indeed, the Do's were smaller suggesting an increased sensitivity to irradiation with fractionation. Low dose rate (LDR) and fractionation were also studied for their influence on normal tissue toxicity following upper half body irradiation (UHBI). All the fractionated regimens had higher LD50/30 and LD50/30-180 values than those achieved by single fraction LDR alone. There was no significant dose rate effect for LD50/30 when 120 or 200 cGy fractions were used. However, dose rate was important for LD50/30-180 with 200 cGy but not with 120 cGy fractions. These results demonstrate protection of non hematopoietic tissues with fractionation and low dose rate without protecting hematopoietic stem cells and may have implications for human bone marrow transplantation. PMID- 3298173 TI - Immunocytochemical localization of nerve growth factor in mouse salivary glands. AB - The submandibular glands of female mice and the sublingual and parotid glands of adult male and female mice have been examined by light microscopical immunocytochemistry for nerve growth factor (NGF). In female submandibular glands, staining for NGF was observed in granular convoluted tubule and striated duct cells. Sublingual glands of the mouse contained relatively few granular cells staining for NGF compared with submandibular glands. However, such granular cells appeared to be more numerous in male sublingual glands than in female glands. The remainder of the intralobular duct cells in both male and female sublingual glands exhibited apical subluminal staining for NGF as well as light basal plasmalemmal staining. Parotid glands in both male and female mice exhibited a similar pattern of staining for NGF in striated duct cells. However, the glands did not contain granular cells nor did they exhibit any pattern of staining which reflected a sexual dimorphism. Immunodot staining of salivary gland extracts confirmed the presence of immunoreactivity for NGF in all three of the major salivary glands. PMID- 3298177 TI - Ralston Paterson. PMID- 3298178 TI - In memoriam. Professor J. Robert Andrews. 1906-1986. PMID- 3298179 TI - [Study days on ultrasound in Karolinska Hospital, 17-18 October 1986]. PMID- 3298180 TI - [From maternal-infant to long-term care--a midwife's way of life]. PMID- 3298181 TI - Endocrine and body growth traits in heifers exposed to testosterone-propionate during early fetal development. AB - This study was conducted to determine the effects of testosterone-propionate exposure during fetal development on sexual differentiation and growth rates in heifers. Ten pregnant cows were given subcutaneous injections of testosterone propionate (250 mg/injection) every other day during d 40 to 60 of gestation. Four cows aborted after the end of testosterone treatment, while four heifers (androgenized females) and two bulls (androgenized males) were produced from the six remaining pregnant, testosterone-propionate treated cows. Calves from cows that did not receive exogenous hormone treatment were used as controls. At 8 mo of age, the androgenized heifers and control heifers and control steers were challenged with 1 mg estradiol-17 beta to induce a preovulatory luteinizing hormone (LH) surge. Two weeks later, pituitary responsiveness to exogenous luteinizing hormone releasing hormone (LHRH; 75 micrograms) was evaluated in androgenized heifers and in control heifers and control steers. To monitor growth rates, all animals were weighed at 28-d intervals from birth to 380 d of age. Androgenized females exhibited a partially masculinized phenotype as well as internal male reproductive structures. Treatment with estradiol-17 beta first depressed (P less than .05) serum LH concentrations in all animals, then induced (P less than .05) a preovulatory-like LH surge in control and androgenized females. Control steers did not (P greater than .05) exhibit a preovulatory-like LH surge following administration of estradiol-17 beta. Exogenous LHRH treatment stimulated peak LH concentrations (P less than .05) to a greater extent in control and androgenized females than in control steers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298182 TI - Incidence of infantile diarrhoea due to enteropathogenic Escherichia coli in Port Harcourt metropolis. AB - Five hundred diarrhoeal stool samples from the University of Port Harcourt Teaching Hospital were investigated for enteropathogenic Escherichia coli. Results showed that the organism was endemic in Port Harcourt metropolis and was responsible for about 15% of the incidence of infantile diarrhoea in the community. Detailed analysis revealed that 13 serotypes were involved. It was also observed that babies aged between 0 and 18 months were more susceptible than those aged between 19 and 36 months. Male infants were also shown to be more at risk than females. Antibiotic sensitivity tests showed that the enteropathogenic E. coli isolated were highly resistant to most common antimicrobial drugs but were highly sensitive to genticin and cefotaxime. PMID- 3298183 TI - Effect of alternating current exposure on the resistivity of resting Escherichia coli B cells to crystal violet and other basic dyes. AB - Phosphate buffer suspensions of resting Escherichia coli B cells at pH 7.0 were anaerobically exposed to alternating current (a.c.) of 50 Hz at a current density of 600 +/- 60 mA/cm2 and 34 degrees +/- 3 degrees C. The minimum inhibitory concentrations of eight basic dyes: crystal violet, malachite green, brilliant green, fuchsin, methylene blue, toluidine blue, safranin and acriflavine for exposed cells were decreased to about the half values of those for unexposed ones when both cells were grown in the minimal medium including one of the dyes. The integrated viabilities of exposed cells tended to decline with increasing concentration of the dyes markedly more than those of unexposed ones, whereas the exposed cells took up the dyes less readily than the unexposed cells. These results suggested that a.c. exposure may serve as an agent which renders E. coli cells susceptible to the basic dyes. PMID- 3298184 TI - Influence of specific growth rate and nutrient limitation upon the sensitivity of Escherichia coli towards chlorhexidine diacetate. AB - The sensitivity of Escherichia coli to chlorhexidine has been assessed for cells grown in a chemostat at a variety of specific growth rates, under conditions of carbon, nitrogen, phosphorus and magnesium limitation. At slow rates of growth (ca 0.08/h) little difference in sensitivity was observed. As growth rate was increased, however, the sensitivity of nitrogen- and carbon-limited cells increased whilst that of magnesium- and phosphate-limited cells decreased. It was not possible to correlate the observed patterns of chlorhexidine sensitivity with any single measure of cell envelope composition (phospholipid content, lipopolysaccharide, envelope proteins, etc.). The results presented are not consistent, therefore, with any simple model for chlorhexidine binding or action and more probably reflect subtle interaction between chlorhexidine, phospholipid lipopolysaccharide complexes and cations within the envelope. PMID- 3298185 TI - Reduced adherence of micro-organisms to human mucosal epithelial cells following treatment with Taurolin, a novel antimicrobial agent. AB - Taurolin, a non-antibiotic antimicrobial agent, significantly reduced the adherence of buccal and vaginal strains of Candida albicans blastospores and urine isolates of Escherichia coli and Staphylococcus saprophyticus to epithelial cells. Light microscopy and radio-isotopic counting methods were used to quantify the adherence of the micro-organisms to either uroepithelial or buccal epithelial cells. A maximum reduction in adherence of approximately 65% was obtained. The anti-adherence capacity was time-dependent, requiring a contact time of 30 min to achieve maximum effect. Taurolin at sub-minimum inhibitory concentrations (MIC) significantly reduced the adherence of Candida and E. coli. A concentration slightly higher than the MIC was required for Staph. saprophyticus. Treatment of either epithelial cells or micro-organisms with Taurolin resulted in reduced adherence of microorganisms. PMID- 3298186 TI - Affinity purification of tetanus toxin using polyclonal and monoclonal antibody immunoadsorbents. AB - Tetanus toxin has been immunopurified on immunoadsorbent columns derived from equine polyclonal antitoxin coupled to cyanogen bromide-activated Sepharose CL4B. Desorption of bound toxin in active form was achieved only when the immunoadsorbent was mixed with Sephadex G15 and this mixture overlaid on a further volume of Sephadex G15. With equine antibody, 64% of adsorbed toxin was recovered with a specific activity of 2400 limiting flocculation units (Lf)/mg protein N (1.2 X 10(8) minimum lethal doses (MLD)/mg protein N). Similarly prepared immunoadsorbent derived from murine monoclonal antitoxin of low affinity had improved desorption with less acidic desorbents, without the requirement for Sephadex G15; greater than 80% of adsorbed toxin was recovered with a specific activity of 3000 Lf/mg protein N (1.6 X 10(8) MLD/mg protein N). PMID- 3298187 TI - A comparative study of the formation of extracellular proteins by Aeromonas salmonicida at two different temperatures. AB - Aeromonas salmonicida was grown in a supplemented 3% (w/v) tryptone soya broth medium at 10 degrees C, a temperature at the lower end of the range over which furunculosis has been observed to occur in the field, and 25 degrees C, the optimum temperature for growth. Similar bacterial densities in the range 2.35 +/- 0.05 mg dry wt/ml were achieved in the two cultures at the beginning of the stationary phase of the growth cycle, after 125 h at 10 degrees C and 18 h at 25 degrees C. At this point, at the higher temperature 1.5 times more exoprotein was formed, 80 +/- 2.8 micrograms/ml compared with 54 +/- 1.7 micrograms/ml. Exoprotein contained the same proportion of haemolysin at both temperatures and twice as much protease at the higher temperature. The most marked difference was in an unidentified 100 kD protein which was formed in a 10-fold greater amount at 10 degrees C. PMID- 3298188 TI - Incidence of Staphylococcus aureus, coliforms and antibiotic-resistant strains of Escherichia coli in rural water supplies in Port Harcourt. AB - The bacteriological quality of some rural water supplies in Port Harcourt was monitored over a 3 month period. The supplies were unsatisfactory as judged by standard plate counts (10(3)/ml) and the presence of presumptive and faecal coliforms and Staphylococcus aureus. The recovery of potentially pathogenic bacteria (e.g. Pseudomonas aeruginosa) further substantiated the existence of health hazards. The most frequently isolated coliforms were Escherichia coli, Enterobacter aerogenes and Klebsiella pneumoniae. Coliform contamination was greater in well water than in river or stream water samples. An antibiotic sensitivity test revealed that 17.5-27.2% of E. coli strains were resistant to three or more antibiotics. Escherichia coli isolated from well water samples exhibited the greatest degree of multiple resistance. Some strains were resistant to all the six antibiotics tested. The danger of an epidemic of waterborne diseases in the communities as a result of drinking water from these non-potable sources is noted. PMID- 3298189 TI - Evaluation of a fluorescent antibody technique for the rapid enumeration of Bacteroides fragilis group of organisms in water. AB - The Bacteroides fragilis group has been evaluated as a prospective rapid indicator of faecal contamination of water. Fluorescent antibody (FA) stained B. fragilis group bacteria were enumerated microscopically and compared with faecal coliform or Escherichia coli counts as indicators of faecal contamination. Environmental samples included surface waters (raw drinking water and known contaminated water). Laboratory disinfection experiments with ozone, chlorine and u.v. radiation were also performed. Bacteroides FA counts specifically detected recent human faecal contamination in field samples in 2-3 h. Samples with a high content of particulates or debris limited the sensitivity to about 10 FA counts/ml. Viable counts showed that the sensitivity to all three disinfection agents was essentially the same for Bacteroides and E. coli. Fluorescent antibody counts of Bacteroides, conversely, were not altered by any of the agents. Therefore, the Bacteroides FA method is not recommended for routine monitoring but may be useful for cases where extensive human faecal contamination is suspected (e.g. pipeline rupture or pollution of recreational water) and where rapid remedial action must be taken to protect the public health. PMID- 3298190 TI - Effects of norepinephrine and fluid administration on diaphragmatic O2 consumption in septic shock. AB - The effects of norepinephrine infusion and fluid administration on diaphragmatic O2 consumption during endotoxic shock were assessed in spontaneously breathing anesthetized dogs. Blood flow was measured with the microsphere technique, and diaphragmatic venous blood was obtained via a catheter inserted into the left inferior phrenic vein. One group of dogs (n = 6) received 10 mg/kg Escherichia coli endotoxin intravenously (E group). In the second and third groups, blood pressure after endotoxin injection was restored by continuous infusion of norepinephrine tartrate (N group) or by infusion of normal saline and dextran infusion (F group). The animals were observed for 2 h after endotoxin injection. Cardiac output fell significantly in the E and N group, whereas it was restored in the F group. Minute ventilation and diaphragmatic pressure-time index rose twofold in the three groups of dogs. Diaphragmatic O2 consumption (VO2 di) increased substantially in the E group to a mean value of 3.46 ml X 100 g-1 X min 1, which was achieved by higher blood flow and by an increase in O2 extraction. In the N group, VO2 di was higher than control but was lower than that of the E group (mean value of 1.43 ml X 100 g-1 X min-1), which was achieved solely by increasing O2 extraction. In the F group, VO2 di was also lower than that of the E group (mean value of 1.51 ml X 100 g-1 X min-1), which was achieved by high diaphragmatic blood flow. Thus, at any given diaphragmatic task, the diaphragm consumed less O2 in the N and F group than in the E group. PMID- 3298191 TI - Sepsis in sheep reduces pulmonary microvascular sieving capacity. AB - The changes in pulmonary microvascular permeability in sheep, after infusion of live Escherichia coli, were studied using estimations of the osmotic reflection coefficients (sigma) for total protein, albumin, immunoglobins (Ig) G and M and based on these estimations equivalent pore dimensions were calculated. A chronic lung lymph fistula was prepared in seven sheep. After a base-line period, left atrial pressure (Pla) was increased. E. coli (10(9) X kg body wt) were given after attaining filtration independent L/P values. The sigma's for the normal lung were calculated to 0.73 for total protein and to 0.65, 0.76, and 0.91 for albumin, IgG, and IgM, respectively. The equivalent pore radii were determined to 50 and 175 A with 35% of the filtration accounted for by the large pores. After bacterial infusion, the sigma's for total protein, albumin, IgG, and IgM decreased significantly from preseptic values to 0.58, 0.50, 0.64, and 0.83, respectively. After sepsis the small pores were 50 A and the large pores 200 A with 49% of total volume flow at maximum lymph flows occurring through the large pores. Assuming a constant small-pore population the large-pore number increased 32% after bacterial infusion. These results indicate that pulmonary microvascular permeability may have increased due to the sepsis. PMID- 3298192 TI - Epinephrine, glucose, and lactate infusion in exercising adrenodemedullated rats. AB - The purpose of this study was to determine the metabolic function of the marked increase in plasma epinephrine which occurs in fasted rats during treadmill exercise. Fasted adrenodemedullated (ADM) and sham-operated (SHAM) rats were run on a rodent treadmill (21 m/min, 15% grade) for 30 min or until exhaustion. ADM rats were infused with saline, epinephrine, glucose, or lactate during the exercise bouts. ADM saline-infused rats showed markedly reduced endurance, hypoglycemia, elevated plasma insulin, reduced blood lactate, and reduced muscle glycogenolysis compared with exercising SHAM's. Epinephrine infusion corrected all deficiencies. Glucose infusion restored endurance run times and blood glucose to normal without correcting the deficiencies in blood lactate and muscle glycogenolysis. Infusion of lactate partially corrected the hypoglycemia at 30 min of exercise, but endurance was not restored to normal and rats were hypoglycemic at exhaustion. We conclude that in the fasted exercising rat, actions of epinephrine in addition to provision of gluconeogenic substrate are essential for preventing hypoglycemia and allowing the rat to run for long periods of time. PMID- 3298193 TI - Effect of sodium depletion on peripheral vascular responses to heat stress in baboons. AB - The cutaneous vasodilation and renal vasoconstriction in baboons during environmental heating (EH) appear to be produced predominantly by sympathetic vasoconstrictor withdrawal and activation of the renin-angiotensin system, respectively. Since these mechanisms may be influenced differently by sodium depletion, this study examined the hypothesis that sodium depletion would have a differential effect on cutaneous and renal vascular responses to EH. Sodium depletion was produced in chronically instrumented baboons by placing them on low salt intake for 8-19 days along with diuretic administration. EH consisted of exposing the baboon to an ambient temperature of 40-42 degrees C until core temperature (Tc) reached 39.8-40.0 degrees C. Both control plasma renin activity (PRA) and the rise in PRA with Tc during EH were considerably larger in sodium depleted baboons. However, the magnitudes of the progressive increases in iliac vascular conductance (used as an index of hindlimb cutaneous vasodilation) and renal vascular resistance with rising Tc during EH were unaltered by sodium depletion. Therefore, neither cutaneous nor renal vascular responses to EH are influenced by elevated PRA and other changes accompanying sodium depletion in the baboon. PMID- 3298195 TI - Relationship between ozone exposure and pulmonary function changes. AB - A detailed comparison of literature-reported averaged decrements in pulmonary function of normal subjects exposed to O3 has been undertaken. The data base was formed by including data published during the past 20 yr from studies that reported at least one of the pulmonary function variables (forced vital capacity, forced expiratory volume at 1 s, mean forced expiratory flow between 25 and 75% of forced vital capacity, and airway resistance) acquired at 2 h of exposures utilizing either original or modified Bates-Hazucha (intermittent exercise) protocol and that satisfied selection criteria. The final set of data (24 studies involving 299 subjects) was divided by ventilation rate (exercise loads) into four categories: light, moderate, high, and very high ventilation level. For each pulmonary function variable and ventilation level a quadratic function has been fitted to the data using regression procedures. The curve parameter estimates have been computed, tabulated, and statistically evaluated. The slope (quadratic coefficient) for each variable within a group and almost all variables between groups were significantly different from zero and from each other at P less than or equal to 0.0001. PMID- 3298194 TI - Pulmonary clearance of inhaled 99mTc-DTPA: effects of surfactant depletion by lung lavage. AB - The influence of surfactant depletion on clearance from the lungs of inhaled technetium-99m-labeled diethylenetriamine pentaacetate (99mTc-DTPA) was studied in rabbits. Surfactant was removed by repeated lung lavage with isotone saline. To minimize structural damage to the lungs, pressure generated insufflation with short expiration was utilized. Aerosolized 99mTc-DTPA was administered via a bag in-bottle system. Radioactivity was measured with a gamma camera and time activity curves were obtained over the base of the right lung. Six nonlavaged rabbits served as controls. In six lavaged rabbits clearance of 99mTc-DTPA was significantly faster than in controls. In three rabbits given natural surfactant into the trachea after lung lavage, 99mTc-DTPA was eliminated faster than in controls but slower than in surfactant-depleted animals. The results indicate a role of surfactant on clearance rate of 99mTc-DTPA from rabbit lungs. Measurements of 99mTc-DTPA clearance may be useful in studying the function of the surfactant system in different lung disorders. PMID- 3298196 TI - Effect of endogenous prostaglandins on acetylcholine release from dog trachealis muscle. AB - We used a radioenzymatic technique to measure effects of the prostaglandin synthesis inhibitor indomethacin and of exogenous prostaglandin E2 (PGE2) and prostaglandin I2 (PGI2) on acetylcholine (ACh) efflux from canine tracheal smooth muscle (TSM) during sustained electrical field stimulation (EFS; 2 Hz, 2 ms pulse duration, 50 V for 15 min). ACh efflux from indomethacin (INDO, 10(-6) M) pretreated and control TSM increased with consecutive stimulations. However, efflux of ACh was greater in INDO-treated than control muscles. INDO increased the tension produced by TSM in response to EFS. Neither PGE2 (10(-8) M) nor PGI2 (10(-6) M) had any effect on ACh efflux from INDO-pretreated TSM during the first of three periods of EFS. However, PGI2 and PGE2 prevented the progressive increase in ACh efflux observed on subsequent stimulations. PGE2 but not PGI2 decreased contractions of TSM caused by EFS. Our results demonstrate that endogenous prostaglandins, probably PGE2, do inhibit EFS-evoked ACh release from canine TSM in vitro, but suggest that these prostaglandins modulate EFS-evoked contractions predominantly by postsynaptic mechanisms. PMID- 3298197 TI - Airway responses to methacholine in asymptomatic nonatopic cigarette smokers. AB - We prospectively performed methacholine bronchoprovocation challenges on 46 young smokers to examine the effects of cigarette smoking on airway responsiveness. The subjects, ages 18-35 yr, had no past or present history or physical examination findings of asthma or other lung diseases, rhinitis, allergic diseases, or respiratory infections; were skin test negative to 29 common aeroallergens; and had base-line pulmonary function values greater than 80% predicted. Sixteen of 46 (35%) subjects had a 20% or greater drop in forced expiratory volume in 1 s at a provocative methacholine concentration less than or equal to 25 mg/ml. The degree of methacholine responsiveness was not dependent upon base-line pulmonary function values or the amount of cigarettes consumed, and there was no association between the amount of cigarettes consumed and base-line pulmonary function values. These data suggest that many young asymptomatic nonatopic smokers have increased airway responsiveness to inhaled methacholine without clinically significant hyperreactive airway disease. PMID- 3298198 TI - Effects of continuous positive airway pressure on upper airway and respiratory muscle activity. AB - To study the effects of continuous positive airway pressure (CPAP) on lung volume, and upper airway and respiratory muscle activity, we quantitated the CPAP induced changes in diaphragmatic and genioglossal electromyograms, esophageal and transdiaphragmatic pressures (Pes and Pdi), and functional residual capacity (FRC) in six normal awake subjects in the supine position. CPAP resulted in increased FRC, increased peak and rate of rise of diaphragmatic activity (EMGdi and EMGdi/TI), decreased peak genioglossal activity (EMGge), decreased inspiratory time and inspiratory duty cycle (P less than 0.001 for all comparisons). Inspiratory changes in Pes and Pdi, as well as Pes/EMGdi and Pdi/EMGdi also decreased (P less than 0.001 for all comparisons), but mean inspiratory airflow for a given Pes increased (P less than 0.001) on CPAP. The increase in mean inspiratory airflow for a given Pes despite the decrease in upper airway muscle activity suggests that CPAP mechanically splints the upper airway. The changes in EMGge and EMGdi after CPAP application most likely reflect the effects of CPAP and the associated changes in respiratory system mechanics on the afferent input from receptors distributed throughout the intact respiratory system. PMID- 3298199 TI - A phrenic nerve-actuated electronically controlled positive-pressure ventilator. AB - We have constructed an electronically controlled positive-pressure ventilator actuated by phrenic neural activity for use in open-chested or paralyzed experimental animals for the study of breathing pattern. A Bird Mark 14 positive pressure ventilator was modified such that flow is a linear function of a command signal. Flow is delivered by advancing an air valve with a servo-motor that is controlled by one of three different operational modes. In two of the modes, the difference between the electronic average of inspiratory phrenic activity (moving average) and a feedback signal determines the inspiratory flow. The feedback signal is derived from either tracheal pressure or an electronic measure of inspired volume. In the third mode, the moving average is differentiated to provide control of inspiratory flow and volume. Physiological flow profiles were created using all three operational modes. Integration of an air-valve position signal provides an electronic measure of tidal volume. An additional feature of this ventilator allows inspiratory flow and duration to be predetermined for a given breath. PMID- 3298200 TI - Fenfluramine response in high and low functioning autistic children. PMID- 3298201 TI - Effects of methylphenidate on adolescents with a childhood history of attention deficit disorder: I. Clinical findings. PMID- 3298202 TI - Effects of methylphenidate on adolescents with a childhood history of attention deficit disorder: II. Information processing. PMID- 3298203 TI - [Complicated appendicitis in children: contribution of echography to diagnosis and treatment]. PMID- 3298204 TI - Ultrasonographic presentation of a benign peritoneal cystic mesothelioma. PMID- 3298205 TI - Seminal vesicle cyst: report of a case. PMID- 3298206 TI - Echographic investigation of renal pelvic tumors. PMID- 3298207 TI - Glucose transport in a kinaseless Saccharomyces cerevisiae mutant. AB - Wild-type Saccharomyces cerevisiae organisms contain three kinases which catalyze the phosphorylation of glucose: two hexokinase isozymes (PI and PII) and one glucokinase. Glucose transport measurements for triple-kinaseless mutants, which lack all three of these kinases, confirm that the kinases are involved in the low apparent Km transport process observed in metabolizing cells. Thus kinase positive cells containing one or more of the three kinases exhibit biphasic transport kinetics with a low apparent Km (1 to 2 mM) and high apparent Km (40 to 50 mM) component. Triple-kinaseless cells, however, exhibit only the high apparent Km component of kinase-positive cells (60 mM). Kinetic analysis of glucose transport in the triple-kinaseless cells shows that glucose is transported by a facilitated diffusion process which exhibits trans-stimulated equilibrium exchange and influx counterflow. PMID- 3298209 TI - Structural role for a conserved region in the CTP synthetase glutamine amide transfer domain. AB - Site-directed mutations were introduced into a conserved region of the Escherichia coli CTP synthetase glutamine amide transfer domain. The amino acid replacements, valine 349 to serine, glycine 351 to alanine, glycine 352 to proline, and glycine 352 to cysteine, all increased the lability of CTP synthetase. The proline 352 replacement abolished the capacity to form the covalent glutaminyl-cysteine 379 catalytic intermediate, thus preventing glutamine amide transfer function; NH3-dependent CTP synthetase activity was retained. In CTP synthetase (serine 349), both glutamine and NH3-dependent activities were increased approximately 30% relative to that of the wild type. CTP synthetase mutants alanine 351 and cysteine 352 were not overproduced because of apparent instability and proteolytic degradation. We conclude that the conserved region between residues 346 and 355 in the CTP synthetase glutamine amide transfer domain has an important structural role. PMID- 3298208 TI - Mutagenesis and stress responses induced in Escherichia coli by hydrogen peroxide. AB - Killing of Escherichia coli by hydrogen peroxide proceeds by two modes. Mode one killing appears to be due to DNA damage, has a maximum near 1 to 3 mM H2O2, and requires active metabolism during exposure. Mode two killing is due to uncharacterized damage, occurs in the absence of metabolism, and exhibits a classical multiple-order dose-response curve up to at least 50 mM H2O2 (J. A. Imlay and S. Linn, J. Bacteriol. 166:519-527, 1986). H2O2 induces the SOS response in proportion to the degree of killing by the mode one pathway, i.e., induction is maximal after exposure to 1 to 3 mM H2O2. Mutant strains that cannot induce the SOS regulon are hypersensitive to peroxide. Analysis of the sensitivities of mutants that are deficient in individual SOS-regulated functions suggested that the SOS-mediated protection is due to the enhanced synthesis of recA protein, which is rate limiting for recombinational DNA repair. Specifically, strains wholly blocked in both SOS induction and DNA recombination were no more sensitive than mutants that are blocked in only one of these two functions, and strains carrying mutations in uvrA, -B, -C, or -D, sfiA, umuC or D, ssb, or dinA, -B, -D, -F, -G, -H, -I, or -J were not abnormally sensitive to killing by H2O2. After exposure to H2O2, mutagenesis and filamentation also occurred with the dose response characteristic of SOS induction and mode one killing, but these responses were not dependent on the lexA-regulated umuC mutagenesis or sfiA filamentation functions, respectively. Exposure of E. coli to H2O2 also resulted in the induction of functions under control of the oxyR regulon that enhance the scavenging of active oxygen species, thereby reducing the sensitivity to H2O2. Catalase levels increased 10-fold during this induction, and katE katG mutants, which totally lack catalase, while not abnormally sensitive to killing by H2O2 in the naive state, did not exhibit the induced protective response. Protection equal to that observed during oxyR induction could be achieved by the addition of catalase to cultures of naive cells in an amount equivalent to that induced by the oxyR response. Thus, the induction of catalase is necessary and sufficient for the observed oxyR-directed resistance to killing by H2O2. Although superoxide dismutase appeared to be uninvolved in this enhanced protective response, sodA sodB mutants, which totally lack superoxide dismutase, were especially sensitive to mode one killing by H2O2 in the naive state. gshB mutants, which lack glutathione, were not abnormally sensitive to killing by H2O2. PMID- 3298210 TI - Isolation and characterization of Salmonella typhimurium glyoxylate shunt mutants. AB - Growth of Salmonella typhimurium on acetate as a sole carbon source requires expression of the glyoxylate shunt; however, the genes for the glyoxylate shunt enzymes have not been previously identified in S. typhimurium. In this study, we isolated transposon insertions in the genes for the two unique enzymes of this pathway, aceA (isocitrate lyase) and aceB (malate synthase). The aceA and aceB genes were located at 89.5 min on the S. typhimurium genetic map. Genetic linkage to nearby loci indicated that the relative gene order is purDJ metA aceB aceA. Transposon insertions in aceB were polar on aceA, suggesting that the genes form an operon transcribed from aceB to aceA. Transcriptional regulation of the aceBA operon was studied by constructing mini-Mu d(lac Kan) operon fusions. Analysis of these fusions indicated that expression of the aceBA operon is regulated at the level of transcription; the aceBA genes were induced when acetate was present and repressing carbon sources were absent. Although glucose represses expression of the aceBA operon, repression does not seem to be mediated solely by cyclic AMP cyclic AMP receptor protein complex. Mutants with altered regulation of the aceBA operon were isolated. PMID- 3298211 TI - Maltotriose is the inducer of the maltose regulon of Escherichia coli. AB - In a cell-free system programmed with a plasmid bearing a malP'-'lacZ gene fusion under the control of malPp, beta-galactosidase synthesis was strictly dependent on the presence of both the MalT activator protein and the inducer of the Escherichia coli maltose regulon. We show that, among all maltodextrins tested (from maltose to maltoheptaose), only maltotriose was able to induce beta galactosidase synthesis. Likewise, in an in vitro transcription system, initiation of transcription at malPp required the presence of the MalT protein and maltotriose along with the RNA polymerase holoenzyme; neither maltose nor maltotetraose could substitute for maltotriose. PMID- 3298212 TI - Two distinct transpeptidation reactions during murein synthesis in Escherichia coli. AB - Murein synthesized in ether-permeabilized cells of Escherichia coli deficient in individual penicillin-binding proteins (PBPs) and in the presence of certain beta lactam antibiotics was analyzed by high-pressure liquid chromatography separation of the muramidase split products. PBP 1b was found to to be the major murein synthesizing activity that was poorly compensated for by PBP 1a. A PBP 2 mutant as well as mecillinam-inhibited cells showed increased activity in the formation of oligomeric muropeptides as well as UDP-muramylpeptidyl-linked muropeptides, the reaction products of transpeptidation, bypassing the lipid intermediate. In contrast, penicillin G and furazlocillin severely inhibited these reactions but stimulated normal dimer production. It is concluded that two distinct transpeptidases exist in E. coli: one, highly sensitive to penicillin G and furazlocillin, catalyzes the formation of hyper-cross-linked muropeptides, and a second one, quite resistant to these antibiotics, synthesizes muropeptide dimers. PMID- 3298213 TI - Synthesis of linear multimers of OriC and pBR322 derivatives in Escherichia coli K-12: role of recombination and replication functions. AB - Inactivation of RecBCD nuclease (exonuclease V) and SbcB nuclease (exonuclease I) in Escherichia coli K-12 diverts most of plasmid replication activity from circular monomer production to the synthesis of linear multimers. Linear multimer synthesis has been demonstrated in plasmids of diverse origins and copy numbers, including E. coli minichromosomes. The effect of dnaA, dnaB, recF, and recJ mutations on the rate of linear multimer synthesis in sbcB cells after gam inactivation of RecBCD nuclease was investigated. Results are consistent with the hypothesis that homologous recombination, but not activities at the plasmid origin of replication, is involved in initiation of linear multimer synthesis. PMID- 3298214 TI - Physical mapping of the K+ transport trkA gene of Escherichia coli and overproduction of the TrkA protein. AB - The position on the Escherichia coli chromosome of trkA, a gene coding for a membrane protein involved in K+ transport by the constitutive uptake system Trk, was determined. We observed that the gene is transcribed in a clockwise direction and that it is located at 72.4 min on the chromosome in a 1.75-kilobase NruI EcoRV DNA fragment 1.0 kilobase upstream of rplQ. We localized an additional gene encoding a 17,000-molecular-weight protein of unknown function between the trkA and rplQ genes. A plasmid, pDB3, was constructed in which the transcription of the trkA gene was put under the control of the lambda pL promoter. pDB3 containing cells of a strain, which contained the temperature-sensitive lambda repressor cI857 in the chromosome, overproduced the 53,000-molecular-weight TrkA protein at the nonpermissive temperature to such an extent that TrkA became the major cell protein. From cell fractionation studies, we conclude that the overproduced TrkA protein forms aggregates. PMID- 3298215 TI - NAD-linked aldehyde dehydrogenase for aerobic utilization of L-fucose and L rhamnose by Escherichia coli. AB - Mutant analysis revealed that complete utilization of L-fucose and L-rhamnose by Escherichia coli requires the activity of a common NAD-linked aldehyde dehydrogenase which converts L-lactaldehyde to L-lactate. Mutations affecting this activity mapped to the ald locus at min 31, well apart from the fuc genes (min 60) encoding the trunk pathway for L-fucose dissimilation (as well as L-1,2 propanediol oxidoreductase) and the rha genes (min 88) encoding the trunk pathway for L-rhamnose dissimilation. Mutants that grow on L-1,2-propanediol as a carbon and energy source also depend on the ald gene product for the conversion of L lactaldehyde to L-lactate. PMID- 3298216 TI - S-adenosylmethionine may not be essential for signal transduction during bacterial chemotaxis. AB - We previously showed that a mutant strain of Salmonella typhimurium completely deficient in both the chemoreceptor methylating (CheR) and demethylating (CheB) enzymes can still exhibit chemotaxis to aspartate and other attractants (J. Stock, A. Borczuk, F. Chiou, and J. E. B. Burchenal, Proc. Natl. Acad. Sci. USA 82:8364-8368, 1985). We used this cheR cheB mutant to examine the possibility of an additional requirement for S-adenosylmethionine in chemotaxis besides its role in chemoreceptor methylation. A metE mutation was transduced into a cheR cheB double mutant, and the cells were starved for methionine. Despite the fact that intracellular S-adenosylmethionine dropped from approximately 100 microM to less than 0.2 microM, chemotaxis was largely unaffected. In contrast, a corresponding cheR+ cheB+ metE mutant completely lost its chemotaxis ability after being starved for methionine. We conclude from this observation that the primary requirement for S-adenosylmethionine during bacterial chemotaxis is in the methylation of receptor proteins. PMID- 3298217 TI - Purification and characterization of the CheZ protein of bacterial chemotaxis. AB - The cheZ gene is the most distal of five genes that comprise the Meche operon of the Salmonella typhimurium chemotaxis system. We have determined the sequence of the cheZ gene along with an 800-nucleotide flanking region at its 3' end. The flanking sequence contains an open reading frame that probably corresponds to the 5' end of flaM. The cheZ coding sequence predicts an extremely acidic, hydrophilic protein with a molecular weight of 23,900. We have purified and characterized this protein. N-terminal analysis of pure CheZ yields an amino acid sequence identical to that predicted by the nucleotide sequence except that the amino-terminal methionine residue is modified by N methylation. The purified CheZ protein exhibits a native molecular weight of 115,000, but in cell extracts the majority of CheZ exists as a much larger aggregate (Mr greater than 500,000). Under these conditions, CheZ appears to be a homopolymer composed of at least 20 monomeric subunits. PMID- 3298220 TI - Misrepresenting uncontrolled clinical observations as "research". PMID- 3298219 TI - Similarities in control of mini-F plasmid and chromosomal replication in Escherichia coli. AB - In Escherichia coli, concentrations of a mini-F plasmid with two origins of replication (oriV and oriS) were 50% lower in fast-growing cells than in slow growing cells. By contrast, a mini-F plasmid deleted for oriV maintained a uniform concentration in both fast- and slow-growing cells, and in this behavior the plasmid mimicked the control by the host of chromosomal origin (oriC) concentration. PMID- 3298221 TI - Purification of a lectin from the hemolymph of Chinese oak silk moth (Antheraea pernyi) pupae. AB - A lectin with affinity to galactose was purified to homogeneity from the hemolymph of diapausing pupae of the Chinese oak silk moth, Anteraea pernyi. The molecular mass of this lectin was 380,000 and it formed an oligomeric structure of a subunit with a molecular mass of 38,000. The hemagglutinating activity in the hemolymph was found to increase with time after immunization with E. coli. Studies with antibody against the purified lectin showed that increase in the hemagglutinating activity was due to the same lectin, suggesting that the amount of the lectin increased in response to intrusion of foreign substances. The function of this lectin in the defence mechanism is discussed. PMID- 3298218 TI - Regulation of Escherichia coli fumarate reductase (frdABCD) operon expression by respiratory electron acceptors and the fnr gene product. AB - The fumarate reductase enzyme complex, encoded by the frdABCD operon, allows Escherichia coli to utilize fumarate as a terminal electron acceptor for anaerobic oxidative phosphorylation. To analyze the expression of fumarate reductase, protein and operon fusions were constructed between the frdA and the lacZ genes and introduced onto the E. coli chromosome at the lambda attachment site. Expression of beta-galactosidase from either fusion was increased 10-fold during anaerobic versus aerobic cell growth, increased an additional 1.5-fold by the presence of fumarate, the substrate, and decreased 23-fold by nitrate, a preferred electron acceptor. The addition of trimethylamine-N-oxide as an electron acceptor did not significantly alter frdA'-'lacZ expression. Control of frd operon expression is therefore exerted at the transcriptional level in response to the availability of the electron acceptors oxygen, fumarate, and nitrate. Anaerobic induction of frdA'-'lacZ expression was impaired in an fnr mutant and was restored when the fnr+ gene was provided in trans, thus establishing that the fnr gene product, Fnr, is responsible for the anaerobic activation of frd operon expression. Nitrate repression of frdA'-'lacZ expression was observed under either aerobic or anaerobic cell growth conditions in both wild-type and fnr mutant strains, demonstrating that the mechanism for nitrate repression is independent of nitrate respiration and oxygen control imparted by Fnr. Studies performed with a fnr'-'lacZ protein fusion confirmed that the fnr gene is expressed both aerobically and anaerobically. A model is proposed for the regulation of frdABCD operon expression in response to the availability of the alternate terminal electron acceptors oxygen, nitrate, and fumarate. PMID- 3298222 TI - Calcium-induced weakening of Z-disks in postmortem skeletal muscle. AB - The reaction mechanism of calcium ion in the postmortem weakening of Z-disks was studied in myofibrils prepared from fresh or stored muscles. The alpha-actinin content in myofibrils remained almost unchanged within 10 days postmortem, showing very limited proteolysis of myofibrils during postmortem storage of muscles at 10 degrees C. The postmortem weakening of Z-disks was markedly dependent on muscle pH, showing a minimum at pH 6.5. These results agree well with the calcium-induced weakening of Z-disks of freshly isolated myofibrils, indicating that no protease participates in the postmortem weakening of Z-disks. Z-Disks of myofibrils prepared from stored muscles split into halves after treatment with 0.1 N NaOH for 5 min. The identical splitting of Z-disks was induced by a calcium ion concentration of 10(-4)M, which is of the same order of magnitude as that in the sarcoplasm in postmortem muscle. We therefore conclude that the postmortem weakening of Z-disks is non-enzymatically induced by the raised sarcoplasmic calcium ion concentration of 10(-4) M. Calcium ions probably solubilize the amorphous cementing material of Z-disks, leaving unchanged the two sets of Z filaments composed of alpha-actinin. PMID- 3298224 TI - Primary structures of and genes for new ribosomal proteins A and B in Escherichia coli. AB - We determined the partial primary structures of and identified the genes for new basic proteins A and B in Escherichia coli ribosomal 50S subunits, found by means of an improved two-dimensional gel electrophoresis method. The sequence up to the 17th amino acid of protein B was in agreement with that of the X gene in the spc operon. The gene for protein A was searched for in the GenBank data base using the sequence up to the 35th amino acid, and was found at a locus between infC and rplT. The base sequence indicated that protein A contained 64 amino acids and had a molecular weight of 6,984. We conclude that proteins A and B are intrinsic ribosomal proteins, and propose calling their genes, rpmI and rpmJ, respectively. PMID- 3298223 TI - Overproduction and preliminary X-ray characterization of aspartate aminotransferase from Escherichia coli. AB - The aspartate aminotransferase of Escherichia coli was overproduced in cells after genetic manipulation, and was crystallized from a polyethylene glycol solution, pH 7.0. The crystals obtained were of good quality and had diffractions extending beyond 2.4 A. The space group and unit cell dimensions were determined with a precession camera and a four-circle diffractometer to be C222(1), and a = 157.1 A, b = 85.5 A, and c = 79.7 A, respectively. Only one protein subunit is contained in an asymmetric unit. PMID- 3298225 TI - A second type of protein methylation reaction in bacterial chemotaxis. AB - CheZ is the product of one of six genes required for sensory processing in Escherichia coli and Salmonella typhimurium chemotaxis. This 24-kDa cytoplasmic protein is modified by a posttranslational methylation reaction. The modified residue has been identified by analysis of radioactively labeled protein from two dimensional electrophoretograms and Edman degradation of CheZ protein isolated by immunoaffinity chromatography using anti-CheZ monoclonal antibodies. The methylated group is an N-monomethylmethionine residue at the amino terminus of CheZ. L16, a ribosomal protein that is required for peptidyltransferase activity during protein synthesis, is also methylated at its amino-terminal methionine (Chen, R., Brosius, J., and Wittmann-Liebold, B. (1977) J. Mol. Biol. 111, 173 181). Homologous sequences at the amino termini of L16 and CheZ raise the possibility that a single S-adenosylmethionine-dependent methyltransferase modifies both proteins. PMID- 3298226 TI - Structure and stability of gamma-crystallins. Denaturation and proteolysis behavior. AB - The denaturation behavior of bovine lens gamma-crystallin fractions II, III, and IV and their susceptibility to proteolysis in vitro was compared to determine whether differences in their stability could play a role in cataract formation. Tertiary and secondary structure changes induced by increasing concentrations of urea, guanidine hydrochloride, and sodium dodecyl sulfate and by increasingly alkaline pH were followed by near-UV and far-UV circular dichroism, Trp fluorescence emission, and exposure of sulfhydryl groups. Major differences were found in the denaturation and proteolysis behavior of the three gamma-crystallin fractions. In general, the unfolding of gamma-II and gamma-III crystallins is rather gradual, suggesting the presence of intermediate unfolding states; in contrast, the order-disorder transition of gamma-IV crystallin is abrupt. The gamma-IV crystallin fraction is the most stable in urea and guanidine hydrochloride, but is most susceptible to nonspecific proteolysis and alkaline pH denaturation. Differences in denaturation and proteolysis behavior are attributed to the inherent differences in the tertiary structures of these crystallins. PMID- 3298227 TI - Carbon isotope effects on the pyruvate dehydrogenase reaction and their importance for relative carbon-13 depletion in lipids. AB - A method has been developed for the positional 13C isotope analysis of pyruvate and acetate by stepwise quantitative degradation. On its base, the kinetic isotope effects on the pyruvate dehydrogenase reaction (enzymes from Escherichia coli and Saccharomyces cerevisiae) for both of the carbon atoms involved in the bond scission (double isotope effect determination) and on C-3 of pyruvate have been determined. The experimental k12/k13 values with the enzyme from E. coli on C-1 and C-2 of pyruvate are 1.0093 +/- 0.0007 and 1.0213 +/- 0.0017, respectively, and, with the enzyme from S. cerevisiae, the values are 1.0238 +/- 0.0013 and 1.0254 +/- 0.0016, respectively. A secondary isotope effect of 1.0031 +/- 0.0009 on C-3 (CH3-group) was found with both enzymes. The size of the isotope on C-1 indicates that decarboxylation is more rate-determining with the yeast enzyme than with the enzyme from E. coli, although it is not the entirely rate-limiting step in the overall reaction sequence. Assuming appropriate values for the intrinsic isotope effect on the decarboxylation step (k3) and the equilibrium isotope effect on the reversible substrate binding (k1, k2), one can calculate values for the partitioning factor R (k3/k2: E. coli enzyme 4.67, S. cerevisiae enzyme 1.14) and the intrinsic isotope effects related to the carbonyl C (k1/k'1 = 1.019; k3/k'3 = 1.033). The isotope fractionation at C-2 of pyruvate gives strong evidence that the well known relative carbon-13 depletion in lipids from biological material is mainly caused by the isotope effect on the pyruvate dehydrogenase reaction. In addition, our results indicate an alternating 13C abundance in fatty acids, that has already been verified in some cases. PMID- 3298228 TI - Structure and immunochemistry of an oligosaccharide repeating unit of the capsular polysaccharide of type III group B Streptococcus. A revised structure for the type III group B streptococcal polysaccharide antigen. AB - We have derived oligosaccharides from the capsular polysaccharide of type III group B Streptococcus by enzymatic hydrolysis of a specific backbone glycosidic bond utilizing an endo-beta-galactosidase from Flavobacterium keratolyticus. Enzymatic digestion of the polysaccharide produced oligosaccharide fragments of one or more pentasaccharide repeating units. On the basis of 13C NMR, 1H NMR, and methylation analyses, it was established that the smallest digestion fragment was alpha-D-NeupNAc-(2----3)-beta-D-Galp-(1----4)-[beta-D-Glcp-(1----6 )]- beta-D GlcpNAc-(1----3)-beta-D-Gal. The isolation of this oligosaccharide is consistent with the susceptibility of the beta-D-Galp-(1----4)-beta-D-Glcp linkage in the backbone of the type III group B streptococcal polysaccharide and confirms that the polysaccharide is composed of a pentasaccharide repeating unit. High resolution 13C NMR spectroscopic studies indicated that, as in the case of the pentasaccharide, the terminal sialic acid residues of the type III group B streptococcal polysaccharide were linked to O-3 and not to O-6 of its branch beta D-galactopyranosyl residues as had been previously reported (Jennings, H. J., Rosell, K.-G., and Kasper, D. L. (1980) Can. J. Chem. 58, 112-120). This linkage was confirmed in an independent methylation analysis of the type III group B streptococcal polysaccharide. Thin layer chromatogram binding assay and radioactive antigen binding assays with radiolabeled oligosaccharides demonstrated the single repeating unit pentasaccharide oligosaccharide to be poorly antigenic. Increasing oligosaccharide size to a decasaccharide consisting of two repeating units resulted in an 8-fold increase in antigen binding in the direct radioactive antigen binding assay. The results suggest that a region of the immunodeterminant site critical for antibody binding is located in the backbone of the polysaccharide and involves the beta-D-galactopyranose-(1----4) beta-D-glucopyranose bond. PMID- 3298229 TI - Purification of two high molecular weight proteases from rabbit reticulocyte lysate. AB - We have purified two high molecular weight proteases approximately 400-fold from rabbit reticulocyte lysate. Both enzymes hydrolyze 125I-alpha-casein and 4 methylcoumaryl-7-amide peptides with tyrosine, phenylalanine, or arginine at the P1 position. Both are inhibited by hemin, thiol reagents, chymostatin, and leupeptin. They differ, however, by other criteria. Degradation of 125I-lysozyme ubiquitin conjugates and succinyl-Leu-Leu-Val-Tyr-4-methylcoumaryl-7-amide by the larger 26 S protease is stimulated by ATP. Based on sedimentation, gel filtration, and nondenaturing polyacrylamide gel electrophoresis, the ATP dependent protease has a molecular weight of 1,000,000 +/- 100,000 and is a multisubunit complex. The smaller 20 S protease has a molecular weight of 700,000 +/- 20,000 and is composed of 8-10 separate subunits with Mr values between 21,000 and 32,000. It does not require nucleotides for degradation of protein or peptide substrates. This smaller enzyme is similar, if not identical, to the "multicatalytic proteinase complex" first described by Wilk and Orlowski (Wilk, S., and Orlowski, M. (1983) J. Neurochem. 40, 842-849). PMID- 3298230 TI - Phosphorylation of thylakoid proteins by a purified kinase. AB - A simplified method is given for the purification of a 64-kilodalton protein kinase from spinach or pea thylakoid membranes (Coughlan, S., and Hind, G. (1986) J. Biol. Chem. 261, 11378-11385). In a heterogeneous reconstitution system comprised of purified kinase and washed thylakoids (having their intrinsic kinase inactivated or removed), endogenous light-harvesting pigment protein of photosystem II could serve as a substrate. Its phosphorylation did not require rebinding of kinase to the thylakoid membrane and, like the phosphorylation of solubilized pigment protein, was not under redox control. No reconstitution was observed upon replacing 64-kilodalton protein kinase with 25-kilodalton protein kinase (Coughlan, S., and Hind, G. (1986) J. Biol. Chem. 261, 14062-14068). Tryptic digestion of phosphorylated membranes removed the site of phosphorylation; the phosphorylated amino acid present in light-harvesting pigment protein and its tryptic peptide was threonine. Immunoglobulin from a polyclonal antiserum, raised against the purified enzyme, fully inhibited kinase activity toward solubilized and endogenous pigment protein. At higher titers, the antibody was effective in totally inhibiting the redox-sensitive phosphorylation of thylakoid proteins by endogenous kinase; inhibition profiles for phosphorylation of pigment protein and thylakoid proteins of 32, 16, and 9 kilodaltons were essentially identical. The 64-kilodalton protein kinase would thus appear to be responsible for all of the observed phosphorylation of thylakoid phosphoproteins. PMID- 3298231 TI - The signal sequence of an Escherichia coli outer membrane protein can mediate translocation of a not normally secreted protein across the plasma membrane. AB - The distal part of the long tail fibers of the Escherichia coli phage T4 consists of a dimer of protein 37. A fragment of the corresponding gene, encoding 253 amino acids, was inserted into several different sites within the cloned gene for the 325-residue outer membrane protein OmpA. In plasmid pTU T4-5 the fragment was inserted once and in pTU T4-10 tandemly twice between the codons for residues 153 and 154 of the OmpA protein. In pTU T4-22 two fragments were present, in tandem, between the codons for residues 45 and 46 of this protein. In pIN T4-6 one fragment was inserted into the ompA gene immediately following the part encoding the signal sequence. The corresponding mature proteins consist, in this order, of 605, 860, 835, and 279 amino acid residues. All precursor proteins were processed and translocated across the plasma membrane. Hence, not only can the OmpA protein serve as a vehicle for export of a nonsecretory protein, but the signal sequence alone can also mediate export of such a protein. Export of the pro-OmpA protein depends on the SecA protein. Export of the tail fiber fragment expressed from pIN T4-6 remained SecA dependent. Thus, the secA pathway in this case is chosen by the signal peptide. It is proposed that a signal peptide can mediate translocation of nonsecretory proteins as long as they are export-compatible. The inability of a signal sequence to mediate export of some proteins appears to be due to export incompatibility of the protein rather than to the absence of information, within the mature part of the polypeptide, which would be required for translocation. PMID- 3298232 TI - Preparation and characterization of nucleotide-free and metal ion-free p21 "apoprotein". AB - p21 isolated under nondenaturing conditions is obtained as a complex with guanosine nucleotides and magnesium ions. We have developed a high performance liquid chromatography method which removes greater than 95% of bound nucleotide and the metal ion very rapidly under mild conditions. At the same time, p21 is purified from minor protein impurities. The protein thus prepared is thermally much less stable than the complexed p21, but can be used for studying its interaction with nucleotides and metal ions at low temperatures. The association rate constant for p21 and GDP is 1.47 X 10(6) M-1 s-1 and for GTP is 2.9 X 10(6) M-1 s-1 at 0 degree C. By using appropriately determined dissociation rate constants we have determined the binding constant for p21.GDP and p21.GTP in the presence of excess Mg2+ to be 5.7 X 10(10) M-1 and 6.0 X 10(10) M-1, respectively, at 0 degree C. PMID- 3298233 TI - Heavy isotope labeling study of the turnover of forskolin-stimulated adenylate cyclase in BC3H1 cell line. AB - We have used the method of heavy isotope labeling to study the metabolic turnover of adenylate cyclase in a nonfusing muscle cell line, the BC3H1 cells. These cells contains an adenylate cyclase coupled to beta-adrenergic receptors and highly stimulated by forskolin, a potent activator of the enzyme. After transfer of the cells from normal medium to heavy medium (a medium containing heavy labeled amino acids, 2H, 13C, 15N), heavy isotope-labeled adenylate cyclase molecules progressively replace pre-existing light molecules. In sucrose gradient differential sedimentation, after a 5-day switch in heavy medium, the enzyme exhibited a higher mass (s = 8.40 +/- 0.03 S, n = 13) compared to the control enzyme (s = 7.40 +/- 0.04 S, n = 36). Indeed, the increase in the sedimentation coefficient of the heavy molecules was due to the synthesis of new molecules of adenylate cyclase labeled with heavy isotope amino acids since in the presence of cycloheximide, an inhibitor of protein synthesis, no change in the sedimentation pattern of the forskolin-stimulated adenylate cyclase occurred. After incorporation of heavy isotope amino acids in the adenylate cyclase molecules, the kinetics parameters of the enzyme (i.e. Km for ATP and EC50 for Mn2+ or Mg2+) did not change. However, adenylate cyclase from cells incubated with heavy medium exhibits an activity about 2-fold lower than control (cells in light medium). After switching the cells to the heavy medium, the decrease of the activity of the enzyme occurred during the first 24 h and thereafter remained at a steady state for at least 4 days. In contrast, 24 h after the switch, the sedimentation coefficient of forskolin-stimulated adenylate cyclase was progressively shifted to a higher value indicating that the heavy isotope-labeled enzyme replaced the pre-existing light form of the molecule. These observations show that the rapid decrease in adenylate cyclase activity and the synthesis of heavy adenylate cyclase molecules are two separate events. The relative amounts of heavy and light components of forskolin-stimulated adenylate cyclase obtained in sucrose gradient differential sedimentation were determined as a function of time beginning 24 h after the transfer into the heavy medium. The decrease of the pre existing light form could be represented by simple first order kinetics with a half-time of 40 h. This result suggests that the metabolic renewal of forskolin stimulated adenylate cyclase is comparable to that of most plasma membrane proteins. PMID- 3298234 TI - Transfer RNA(5-methylaminomethyl-2-thiouridine)-methyltransferase from Escherichia coli K-12 has two enzymatic activities. AB - The tRNA(5-methylaminomethyl-2-thiouridine)-methyltransferase, which is involved in the biosynthesis of the modified nucleoside 5-methylaminomethyl-2-thiouridine (mnm5s2U) present in the wobble position of some tRNAs, was purified close to homogeneity (95% purity). The molecular mass of the enzyme is 79,000 daltons. The enzyme activity has a pH optimum of 8.0-8.5, is inhibited by magnesium ions, and stimulated by ammonium ions. Two different intermediates in the biosynthesis of mnm5s2U34 are present in tRNA from the mutants trmC1 and trmC2. Unexpectedly, the product present in tRNA from trmC1 cells was identified by mass spectrometric and chromatographic analyses as 5-carboxymethylaminomethyl-2-thiouridine (cmnm5s2U), i.e. a more complex derivative than the final product mnm5s2U. The product present in tRNA from trmC2 cells was identified as 5-aminomethyl-2-thiouridine (nm5s2U). In the presence of S-adenosylmethionine the most purified enzyme fraction converts both cmnm5s2U34 and nm5s2U34 into mnm5s2U34. In the absence of S-adenosylmethionine, however, cmnm5s2U34 is converted into nm5s2U by this enzyme fraction. We conclude that the purified polypeptide has two enzymatic activities; one actually demodifies cmnm5s2U to nm5s2U and the other catalyzes the transfer of a methyl group from S-adenosylmethionine to nm5s2U, thus forming mnm5s2U. The sequential order of the biosynthesis of mnm5s2U34 is suggested to be: (Formula: see text). The molecular activity of the methyltransferase activity (nm5s2U34--- mnm5s2U34) is 74 min-1, and the steady state concentration of the enzyme is only 78 molecules/genome equivalent in cells growing at a specific growth rate of 1.0/h. PMID- 3298235 TI - Purification and characterization of the S-adenosylmethionine:glutamyl methyltransferase that modifies membrane chemoreceptor proteins in bacteria. AB - The enzyme (EC 2.1.1.24) from Salmonella typhimurium that catalyzes the S adenosylmethionine-dependent methyl esterification of glutamyl residues in membrane chemoreceptor proteins has been purified to homogeneity, and the nucleotide sequence of the gene coding for this protein, cheR, has been determined. The molecular weight, amino acid composition, and N-terminal amino acid sequence of the purified protein correspond to the values predicted from the sequence of the gene. The pure protein is a 33-kDa monomer. Kinetic studies indicate that, at levels of receptor and S-adenosylmethionine present in wild type cells, the transferase is nearly saturated. The enzyme has a relatively low turnover number, approximately 10 mol of methylester formed per mol of enzyme per min; and there appear to be only approximately 200 methyltransferase monomers per wild type cell. PMID- 3298236 TI - Activation and cleavage of the carbon-cobalt bond of adeninylethylcobalamin by diol dehydrase. AB - Adeninylethylcobalamin (AdeEtCbl) underwent cleavage of the C-Co bond by interaction with apoprotein of diol dehydrase from Klebsiella pneumoniae ATCC 8724, although this analog was quite inactive as coenzyme. Spectroscopic observation indicates that AdeEtCbl was converted to the enzyme-bound hydroxocobalamin without intermediates. The conversion was stoichiometric (1:1) and obeyed the second-order reaction kinetics (k = 0.027 min-1 microM-1 at 37 degrees C) depending upon concentrations of apoprotein and AdeEtCbl. This suggests that the complex formation is the rate-determining step and that AdeEtCbl undergoes rapid C-Co bond cleavage once it binds to the apoenzyme. Substrates and oxygen did apparently not affect the rate of the C-Co bond cleavage. The experiments using [adenine-U-14C]AdeEtCbl and [1(3)-3H]glycerol demonstrated that 9-ethyladenine was the only product formed from the adeninylethyl group of AdeEtCbl during the conversion and that an additional hydrogen atom in the 9-ethyladenine is not derived from the substrate. 1H NMR measurement of the 9-ethyladenine formed enzymatically from AdeEtCbl and DL-1,2 [1,1,2-2H3]propanediol also led to the same conclusion. All of these results indicate that the C-Co bond of AdeEtCbl is activated by diol dehydrase and undergoes heterolysis forming Co(III) and a carbanion or a carbanion-like species, in clear contrast to the homolysis of the C-Co bond of adenosylcobalamin in the normal catalytic process. 9-Ethyladenine formed remained tightly associated with the enzyme. Longer chain homologs, i.e. adeninylpropylcobalamin, adeninylbutylcobalamin, and adeninylpentylcobalamin did not undergo such cleavage of the C-Co bond by diol dehydrase. PMID- 3298238 TI - Structural studies on equine glycoprotein hormones. Amino acid sequence of equine chorionic gonadotropin beta-subunit. AB - The complete amino acid sequence of the beta-subunit of equine chorionic gonadotropin (eCG beta) has been established by both automated Edman and manual 5 dimethylaminonaphthalene-1-sulfonyl-Edman degradations. Specific fragments were produced by cleavage with Staphylococcus aureus V8 protease, trypsin, or dilute HCl. For the sequence analyses of the heavily glycosylated COOH-terminal portion, a chemical deglycosylation procedure with trifluoromethanesulfonic acid was employed. The peptide chain of eCG beta consists of 149 amino acid residues. Five or more oligosaccharide chains are attached to the protein, 1 unit linked by an N glycosidic bond to asparagine at residue 13 and four or more units linked by O glycosidic bonds to serine or threonine at residues in the COOH-terminal portion. The carbohydrate-bearing hydroxy amino acids have not yet been rigorously established. As compared to the beta-subunits of the pituitary gonadotropin hormones, lutropin, follitropin, and thyrotropin, eCG beta possesses a glycosylated COOH-terminal extension of about 30 amino acid residues, as does the human chorionic gonadotropin beta-subunit (hCG beta). When the comparison is restricted inside the disulfide bond-containing core (residues 1-110), the beta subunit of eCG is highly homologous to hCG beta (66%). On the other hand, although the overall structural features closely resemble each other, much less homology exists in the COOH-terminal extensions of eCG beta and hCG beta. PMID- 3298239 TI - Structural studies on equine glycoprotein hormones. Amino acid sequence of equine lutropin beta-subunit. AB - The amino acid sequence was determined for equine lutropin beta (eLH beta). Large fragments were derived from reduced, carboxymethylated eLH beta by digestion with Staphylococcus aureus V8 protease, by cyanogen bromide cleavage, and by cleavage of acid-labile Asp-Pro bonds. The fragments were purified by gel filtration and high performance liquid chromatography (HPLC). The fragments were sequenced by automated Edman degradation to establish the primary structure of eLH beta. Some peptides were further digested with chymotrypsin and the resulting peptides purified by HPLC. In addition to sequencing by automated Edman degradation, these were also sequenced by the complementary 5-dimethylaminonaphthalene-1-sulfonyl Edman procedure which enabled us to directly identify glycosylated amino acids. The eLH beta subunit is a glycoprotein of 149 amino acids containing both N- and O-linked oligosaccharides. It possesses a COOH-terminal extension similar to that seen in human chorionic gonadotropin. Carboxypeptidase Y digestions suggest that the COOH terminus is blocked by glycosylation. Interestingly, the amino acid sequence of eLH beta is identical to that of equine chorionic gonadotropin beta (Sugino, H., Bousfield, G. R., Moore, W. T., and Ward, D. N. (1987)J. Biol. Chem. 262, 8603-8609). PMID- 3298240 TI - Structural studies on aspartate aminotransferase from Escherichia coli. Covalent structure. AB - The amino acid sequence of aspartate aminotransferase from Escherichia coli was established by sequence analysis and alignment of 39 tryptic peptides and 7 cyanogen bromide peptides. The total number of amino acid residues of the subunit was 396, and the molecular weight was calculated to be 43,573. A comparison of the primary structure of the E. coli enzyme with all known sequences of the two types of isoenzyme (mitochondrial and cytosolic enzymes) in vertebrates revealed that approximately 25% of all residues are invariant. The amino acid residues which were proposed from crystallographic studies on the vertebrate enzymes to be essential for the enzymic action are well conserved in the E. coli enzyme. The E. coli enzyme shows a similar degree of sequence homology to both the mitochondrial and cytosolic isoenzymes (close to 40%). The finding that the positions of deletions introduced into the sequence of E. coli enzyme to give the maximum homology agree well with those of the mitochondrial enzymes supports the endosymbiotic hypothesis of mitochondrial origin. PMID- 3298237 TI - Optically detected magnetic resonance of tryptophan residues in Escherichia coli ssb gene product and E. coli plasmid-encoded single-stranded DNA-binding proteins and their complexes with poly(deoxythymidylic) acid. AB - Optically detected magnetic resonance (ODMR) spectroscopy has been applied to several single-stranded DNA-binding (SSB) proteins encoded by conjugative plasmids of enteric bacteria. Fluorimetric equilibrium binding isotherms confirm their preferential binding to single-stranded DNA and polynucleotides and reveal a limited protein solubility at low ionic strength. The plasmid SSB-like proteins show the highest affinity for polydeoxythymidylic acid; these complexes are the least sensitive to disruption by salt. ODMR data on these complexes suggest the existence of stacking interactions between tryptophan residue(s) and thymine bases, as evidenced by spectral red shifts of the tryptophan phosphorescence 0,0 band, reduction of the magnitude of D zero field splitting parameter, and a dramatic reversal of the polarity of the ODMR signals. Wavelength-selected ODMR results point to the existence of two distinct tryptophan sites in these complexes. The triplet state properties of the red-shifted site are drastically altered by its interaction with the thymine bases. The chromosomal Escherichia coli SSB protein-poly(dT) complex shows an additional tryptophan site with zero field splitting parameters similar to those of the free protein. This site can be attributed to Trp-135, which is missing in each of the other plasmid SSB proteins, suggesting that this particular residue is not involved in the interaction with polynucleotides. PMID- 3298241 TI - Nitrogenase MoFe protein subunits from Klebsiella pneumoniae expressed in foreign hosts. Characteristics and interactions. AB - The expression of selected nitrogen fixation (nif) genes from Klebsiella pneumoniae in foreign hosts provides an approach to determine the pathway, minimal genetic requirements, and host dependence of nitrogenase assembly. In this study, we investigated the assembly of the alpha 2 beta 2 MoFe protein, responsible for substrate binding and reduction, by introducing nifD and nifK (encoding respectively, the alpha and beta subunits) into Escherichia coli and the yeast Saccharomyces cerevisiae. In E. coli, both genes were expressed from the nifHDKY operon; in yeast, the genes, separately fused to the yeast ADH1 promoter, were introduced on two different plasmids. Denaturing immunoblot analyses demonstrated the presence of significant amounts of NifD and NifK in both hosts. In E. coli, the level or perhaps modification of NifD depended on the growth medium of the bacteria. Nondenaturing, anaerobic immunoblot assays revealed in E. coli, nif-specific antigens of lower electrophoretic mobility than Kp1, which may represent assembly intermediates. In yeast, no putative assembled products were evident, and the predominant antigens corresponded to the monomeric forms of the polypeptides. These results indicate that, unlike NifH, the Fe protein subunit (Berman, J., Gershoni, J. M., and Zamir, A. (1985) J. Biol. Chem. 260, 5240-5243), NifD and NifK are insufficient for the assembly of an electrophoretically Kp1-like structure. Homodimerization of nifK and probably of nifD primary gene products does not appear to occur spontaneously and hence is unlikely to represent the initial step in the assembly. The difference between the two hosts suggests that the cellular environment or mode of expression could affect the interaction between the two subunits. PMID- 3298242 TI - Incorporation of six additional proteins to complete the assembly map of the 50 S subunit from Escherichia coli ribosomes. AB - In the course of 50 S ribosome assembly in vitro, the L-proteins associate consecutively with the rRNA in two main groups. The first assembly group is found on the reconstitution intermediate particle RI50(1), the second group being added to form the RI50(2) particle. The analysis presented here allows for the first time all the ribosomal proteins to be assigned to one or the other of these groups. The following 22 proteins are found in the RI50(1) particle: L1, (L2), L3, L4, (L5), L7/12, L9, L10, L11, (L13), L15, L17, (L18), L20, L21, L22, L23, L24, (L26), L29, (L33), (L34). The assembly map has been arranged accordingly. The assembly interdependences of six proteins (L28, L30, L31, L32, L33, and L34) were assessed and that of L14 revised by means of a large number of assembly mapping experiments, the final decisive steps of which are documented here. The interactions of these latter seven proteins and the incorporation of five additional assembly interdependences are integrated into the 50 S assembly map, which now contains all the components of the 50 S subunit, with the exception of protein L26; this protein is known to be the same as protein S20 and is predominantly associated with the 30 S subunit. PMID- 3298243 TI - Glycolipid binding of purified and recombinant Escherichia coli produced verotoxin in vitro. AB - Escherichia coli verotoxin (also known as Shiga-like toxin) has been implicated in the aetiology of the hemolytic uremic syndrome and hemorrhagic colitis. The glycolipid binding specificity of verotoxin purified from E. coli H30 and verotoxin cloned from bacteriophage H19B has been examined. Verotoxin from both sources binds specifically to globotriosyl ceramide containing the carbohydrate sequence galactose alpha 1-4galactose beta 1-4glucose-ceramide. Removal of the terminal galactose or substitution with N-acetylgalactosamine in beta 1-3 linkage deletes toxin binding activity. A ceramide trihexoside species, consistent with a globotriosyl ceramide structure was shown to be the major verotoxin-binding glycolipid of cultured vero cells which are routinely used to measure the cytotoxicity of toxin samples. PMID- 3298244 TI - Processing of concatemers of bacteriophage T7 DNA in vitro. AB - The T7 chromosome is a double-stranded linear DNA molecule flanked by direct terminal repeats or so-called terminal redundancies. Late in infection bacteriophage T7 DNA accumulates in the form of concatemers, molecules that are comprised of T7 chromosomes joined in a head to tail arrangement through shared terminal redundancies. To elucidate the molecular mechanisms of concatemer processing, we have developed extracts that process concatemeric DNA. The in vitro system consists of an extract of phage T7-infected cells that provides all T7 gene products and minimal levels of endogenous concatemeric DNA. Processing is analyzed using a linear 32P-labeled substrate containing the concatemeric joint. T7 gene products required for in vitro processing can be divided into two groups; one group is essential for concatemer processing, and the other is required for the production of full length left-hand ends. The products of genes 8 (prohead protein), 9 (scaffolding protein), and 19 (DNA maturation) along with gene 18 protein are essential, indicating that capsids are required for processing. In extracts lacking one or more of the products of genes 2 (Escherichia coli RNA polymerase inhibitor), 5 (DNA polymerase), and 6 (exonuclease), full length right hand ends are produced. However, the left-hand ends produced are truncated, lacking at least 160 base pairs, the length of the terminal redundancy. Gene 3 endonuclease, required for concatemer processing in vivo, is not required in this system. Both the full length left- and right-hand ends produced by the processing reaction are protected from DNase I digestion, suggesting that processing of the concatemeric joint substrate is accompanied by packaging. PMID- 3298245 TI - The DNA sequence specificity of stimulation of DNA polymerases by factor D. AB - The mechanism of enhancement of DNA polymerase activity by the murine DNA-binding protein factor D was investigated. Extension by Escherichia coli DNA polymerase I and calf thymus DNA polymerase-alpha of 5'-32P-labeled oligodeoxynucleotide primers that are complementary to poly(dT) or to bacteriophage M13 DNA was measured in the absence or presence of factor D. With 5'-[32P](dA)9.poly(dT), factor D enables E. coli polymerase I to fill approximately 15-nucleotide gaps between adjacent primers; whereas in the absence of the stimulatory protein, poly(dT) is not copied significantly. In order to study the nucleotide specificity of synthesis enhancement, we used M13mp10 DNA containing 4 consecutive thymidine residues downstream from the 3-hydroxyl terminus of an oligonucleotide primer. Upon addition of factor D, both polymerase I and polymerase-alpha can traverse this sequence more efficiently and thus generate longer DNA products. Densitometric analysis of nonextended and elongated 5'-32P labeled M13 primer indicates that, without changing the frequency of primer utilization, factor D enhances the activity of these DNA polymerases by increasing their apparent processivity. By positioning oligonucleotide primers 4, 8, and 12 bases upstream from the (dT)4 template sequence, we show that the enhancement of synthesis by factor D is independent of the position of the oligothymidine cluster. We hypothesize that factor D interacts with oligo(dT).oligo(dA) domains in DNA to alter their conformation, which may normally obstruct the progression of DNA polymerases. PMID- 3298246 TI - [19F]-1H heteronuclear nuclear Overhauser effect studies of the acyl chain binding site of acyl carrier protein. AB - [19F]-1H heteronuclear difference nuclear Overhauser effect experiments are performed on a sample of 5,5-difluorohexanoyl acyl carrier protein from Escherichia coli. Interaction of the fluorines at the 5-position of the acyl chain with protons on methyl groups of isoleucine 54 and alanine 59 is clearly indicated. The covalent attachment of the acyl chain via a prosthetic group to serine 36 and the known alpha-helix which exists from residues 36 to 51 greatly restrict the structural models which would allow acyl chain contact with residues 54 and 59. PMID- 3298247 TI - Insulin elicits a redistribution of transferrin receptors in 3T3-L1 adipocytes through an increase in the rate constant for receptor externalization. AB - Incubation of 3T3-L1 adipocytes with insulin at 37 degrees C resulted in a 2-fold increase in specific binding of transferrin to cell-surface receptors, as measured by a subsequent incubation of cells at 4 degrees C with 125I transferrin. The insulin concentration required for half-maximal effect was 10 nM, and the half-time for insulin action was 40 s. By comparison, insulin stimulated hexose transport in 3T3-L1 adipocytes with a half-maximal effect at 8 nM and a half-time of 105 s. Scatchard analysis of 125I-transferrin binding to cells at 4 degrees C showed that the insulin-induced increase in transferrin receptor binding was due to an increase in the number of surface transferrin receptors. When cells were incubated for 2 h at 37 degrees C with 125I transferrin to achieve steady-state binding and then exposed to insulin, there was a 1.7-fold increase in surface-bound transferrin (acid-sensitive) and a corresponding decrease in intracellularly bound transferrin (acid-insensitive). Thus, insulin elicits translocation of intracellular transferrin receptors to the plasma membrane. Concomitant with the 2-fold increase in surface receptors in response to insulin, there was a 2-fold increase in the rate of 59Fe3+ uptake from 59Fe3+-loaded transferrin. The rate of externalization of the intracellular 125I-transferrin-receptor complex at 37 degrees C was determined for basal and insulin-treated cells. Insulin increased the first-order rate constant for this process 1.7-fold. The effect of insulin on the rate of externalization is sufficient to account for the increase in surface transferrin receptors. PMID- 3298248 TI - Photoaffinity labeling of the recBCD enzyme of Escherichia coli with 8 azidoadenosine 5'-triphosphate. AB - The recB and recD subunits of the recBCD enzyme (exonuclease V) from Escherichia coli were covalently photolabeled with the ATP photoaffinity analogue [alpha 32P]8-azido-ATP. The labeling was specific for ATP binding sites by the following criteria. Saturation occurs at high 8-azido-ATP concentrations with dissociation constants of 30 and 120 microM for the recD and recB subunits, respectively; ATP strongly inhibits the photolabeling; 8-azido-ATP is hydrolyzed by the recBCD enzyme and supports its double-stranded DNA exonuclease activity; and the label is largely confined to two peptides obtained by tryptic digestion of the photolabeled holoenzyme; one is derived from the recB subunit and the other from the recD subunit. PMID- 3298249 TI - Photoaffinity labeling of rat liver carbamoyl phosphate synthetase I by 8-azido ATP. AB - 8-Azido-ATP has been found to serve as a photoaffinity label for two distinct ATP sites on rat liver carbamoyl phosphate synthetase I and to allow preliminary localization of these sites. In the dark, 8-azido-ATP acted as a competitive inhibitor with respect to ATP. Ultraviolet irradiation of carbamoyl phosphate synthetase I in the presence of 8-azido-ATP led to an irreversible loss of activity. ATP specifically protected against this inactivation. The incorporation of 2 mol of 8-azido-ATP per mol of enzyme was required for complete inactivation. To localize the 8-azido-ATP-binding sites to discrete regions of carbamoyl phosphate synthetase I which appear to be structural domains, the enzyme was photolabeled with [gamma-32P]8-azido-ATP and subjected to limited proteolytic digestion. The resulting model for the functional roles of the domains is that there is one ATP site on each of the two large internal structural domains of the enzyme. Each of these domains was found to contain the consensus sequences A and B common to many other nucleotide-binding proteins (Walker, J.E., Saraste, M., Runswick, M. J., and Gay, N. J. (1982) EMBO J. 1, 945-951). In addition, there is extensive structural and possibly functional interaction of the smaller N terminal domain with one of the internal ATP-binding domains, analogous to a subunit interaction observed with the evolutionarily related Escherichia coli carbamoyl phosphate synthetase. PMID- 3298250 TI - Cytoplasmic Ca2+ during differentiation of 3T3-L1 adipocytes. Effect of insulin and relation to glucose transport. AB - The cytoplasmic concentration of ionized Ca2+ [( Ca2+]i) was determined in 3T3-L1 cells during their differentiation from fibroblasts to adipocytes, suspended and loaded with the fluorescent Ca2+ indicators quin2 or indo-1. In undifferentiated fibroblasts, as well as in differentiated adipocytes up to day 9, [Ca2+]i was steady around 170 nM, and it increased significantly only in old adipocytes (day 12). During differentiation, stimulation of glucose uptake by insulin increased from a few percent to severalfold. Stimulation of uptake was already apparent after 10 min of addition of the hormone, and 10 nM insulin produced maximal stimulation in 30 min. Insulin (10(-6) M) added to quin2- or indo-1-loaded, suspended adipocytes had no detectable effect on [Ca2+]i for at least 10 min. In contrast, addition of the general anesthetic halothane increased [Ca2+]i from 172 to 251 nM in 3 min. In EGTA solution, the Ca2+ ionophore ionomycin elicited release of Ca2+ from intracellular stores that resulted in a transient increase in [Ca2+]i. A smaller but measurable Ca2+ release from intracellular stores (increasing [Ca2+]i by 20 nM) resulted upon addition of 20 micrograms/ml phosphatidic acid. In contrast, insulin did not produce any detectable release of Ca2+ from intracellular stores. Incubation of 3T3-L1 adipocytes with insulin in the presence of EGTA (the latter in excess over the Ca2+ concentration of the medium) did not prevent the stimulation of hexose uptake by the hormone, indicating that extracellular Ca2+ does not play a role in the insulin response. Furthermore, incubation of cells with quin2/AM in EGTA medium during exposure to insulin did not prevent stimulation of hexose uptake. Under these conditions it is demonstrated that intracellular quin2 suffices to chelate cytoplasmic Ca2+ even if releasable Ca2+ from intracellular stores were to pour into the cytoplasm. Thus, quin2 effectively lowers [Ca2+]i without impairing insulin action. It is concluded that insulin does not produce changes in [Ca2+]i and that chelating intracellular Ca2+ does not prevent stimulation of hexose uptake by insulin. These results suggest that it is unlikely that changes in [Ca2+]i may play a role in the transduction of information in insulin stimulation of glucose uptake in 3T3-L1 adipocytes. PMID- 3298251 TI - Translocation of Escherichia coli recA protein from a single-stranded tail to contiguous duplex DNA. AB - Duplex DNA with a contiguous single-stranded tail was nearly as effective as single-stranded DNA in acting as a cofactor for the ATPase activity of recA protein at neutral pH and concentrations of MgCl2 that support homologous pairing. The ATP hydrolysis reached a steady state rate that was proportional to the length of the duplex DNA attached to a short 5' single-stranded tail after a lag. Separation of the single-stranded tail from most of the duplex portion of the molecule by restriction enzyme cleavage led to a gradual decline in ATP hydrolysis. Measurement of the rate of hydrolysis as a function of DNA concentration for both tailed duplex DNA and single-stranded DNA cofactors indicated that the binding site size of recA protein on a duplex DNA lattice, about 4 base pairs, is similar to that on a single-stranded DNA lattice, about four nucleotides. The length of the lag phase preceding steady state hydrolysis depended on the DNA concentration, length of the duplex region, and the polarity of the single-stranded tail, but was comparatively independent of tail length for tails over 70 nucleotides in length. The lag was 5-10 times longer for 3' than for 5' single-stranded tailed duplex DNA molecules, whereas the steady state rates of hydrolysis were lower. These observations show that, after nucleation of a recA protein complex on the single-stranded tail, the protein samples the entire duplex region via an interaction that is labile and not strongly polarized. PMID- 3298252 TI - Structure-function studies on bacteriorhodopsin. I. Expression of the bacterio opsin gene in Escherichia coli. AB - To express the bacterio-opsin (bop) gene in Escherichia coli, we have employed the inducible expression vectors pIN-II-A, -B, and -C (Nakamura, K., and Inouye, M. (1982) EMBO J. 1, 771-775). The vectors contain three cloning sites early in the E. coli lipoprotein gene (lpp) which is transcribed from tandem lpp and lac promoters. The bop gene was modified so as to delete the N-terminal leader sequence and then cloned into each of the three cloning sites to encode three different lipoprotein/bacterio-opsin fusions. Expression of the fusions was demonstrated both in vitro and in vivo. The fusion protein was estimated to be about 0.05% of the total cell protein. The cause for the low level of expression apparently was neither an inadequate level of mRNA nor degradation of the protein. However, expression of the fusions caused inhibition of the growth of the host to varying extents. One fusion protein was purified from E. coli membranes to homogeneity by immunoaffinity chromatography followed by preparative gel electrophoresis. The purified fusion protein generated a bacteriorhodopsin like chromophore on treatment with defined lipid/detergent mixtures and retinal. When reconstituted into vesicles, the protein pumped protons on illumination comparably to the reconstituted native bacterio-opsin. PMID- 3298253 TI - Structure-function studies on bacteriorhodopsin. II. Improved expression of the bacterio-opsin gene in Escherichia coli. AB - The aims of this work have been to express bacterio-opsin with minimal variation from the native primary structure and to improve the level of expression in Escherichia coli. We describe the construction of plasmids in which the bacterio opsin gene contains only an additional methionine residue at the N terminus and in which the C-terminal aspartic acid encoded in the gene has been deleted to conform to the mature protein. In attempts to improve bacterio-opsin expression, a variety of expression plasmids were constructed in which the promoters and the ribosome-binding sequences were varied. Invariably, in these plasmids, translation but not transcription of the bacterio-opsin gene was limiting. A striking increase in expression of the gene occurred when the codons for several of the N-terminal amino acids were changed to increase the A = T content. Bacterio-opsin expressed in E. coli was degraded with a half-life of 8-10 min. The addition of hydrophobic signal sequences at the N terminus increased the half life and overall yield of the protein. Bacterio-opsin thus produced regenerated the native bacteriorhodopsin-like chromophore and carried out light-dependent proton translocation at a rate comparable to that of the native bacterio-opsin prepared from the purple membrane. PMID- 3298254 TI - Structure-function studies on bacteriorhodopsin. IV. Purification and renaturation of bacterio-opsin polypeptide expressed in Escherichia coli. AB - Expression of the bacterio-opsin gene in Escherichia coli has been described in the accompanying papers. We now describe rapid and efficient methods for the purification of the E. coli-expressed bacterio-opsin. Bacterio-opsin can be extracted from E. coli membranes in a denatured form by using an organic solvent containing chloroform, methanol, water, and triethylamine. The bacterio-opsin, enriched to 30-50% in the extract, can be further purified to 90% by ion-exchange chromatography on DEAE-Trisacryl or hydroxylapatite chromatography in organic solvents or by preparative sodium dodecyl sulfate gel electrophoresis. In appropriate aqueous phospholipid/detergent mixtures, up to 80% of purified protein refolds and binds retinal covalently to regenerate the bacteriorhodopsin chromophore. When reconstituted into phospholipid vesicles, bacteriorhodopsin from E. coli shows the expected proton pumping activity in response to illumination. PMID- 3298255 TI - Product of SEC53 is required for folding and glycosylation of secretory proteins in the lumen of the yeast endoplasmic reticulum. AB - Yeast secretory mutant sec53 cells accumulate inactive secretory glycoprotein precursors that remain associated with the endoplasmic reticulum (ER) at the restrictive temperature (37 degrees C). The possibility that precursor polypeptides fail to penetrate completely into the ER lumen was tested by examining the protease accessibility of accumulated invertase, mating pheromone precursor prepro-alpha-factor and the vacuolar protein precursor procarboxypeptidase Y in cell lysates. In all three cases, the secretory protein precursors are protected from the action of exogenous protease unless the membrane is permeabilized by including Triton X-100 or saponin in the incubation. These results suggest that the sec53 defect allows complete polypeptide translocation. Consistent with this interpretation, the precursor of invertase accumulates in a signal peptide-processed form. In addition, invertase and prepro alpha-factor precursors contain a small amount of possibly aberrant carbohydrate. In mutant cells or in wild type cells treated with tunicamycin, a 10-kDa fragment of the N terminus of mature invertase assumes a conformation that is resistant to trypsin with or without detergent. This domain may be associated with an ER protein or may simply assume an unusual conformation as a consequence of deficient glycosyl modification. PMID- 3298256 TI - Radiation inactivation analysis of enzymes. Effect of free radical scavengers on apparent target sizes. AB - In most cases the apparent target size obtained by radiation inactivation analysis corresponds to the subunit size or to the size of a multimeric complex. In this report, we examined whether the larger than expected target sizes of some enzymes could be due to secondary effects of free radicals. To test this proposal we carried out radiation inactivation analysis on Escherichia coli DNA polymerase I, Torula yeast glucose-6-phosphate dehydrogenase, Chlorella vulgaris nitrate reductase, and chicken liver sulfite oxidase in the presence and absence of free radical scavengers (benzoic acid and mannitol). In the presence of free radical scavengers, inactivation curves are shifted toward higher radiation doses. Plots of scavenger concentration versus enzyme activity showed that the protective effect of benzoic acid reached a maximum at 25 mM then declined. Mannitol alone had little effect, but appeared to broaden the maximum protective range of benzoic acid relative to concentration. The apparent target size of the polymerase activity of DNA polymerase I in the presence of free radical scavengers was about 40% of that observed in the absence of these agents. This is considerably less than the minimum polypeptide size and may reflect the actual size of the polymerase functional domain. Similar effects, but of lesser magnitude, were observed for glucose-6-phosphate dehydrogenase, nitrate reductase, and sulfite oxidase. These results suggest that secondary damage due to free radicals generated in the local environment as a result of ionizing radiation can influence the apparent target size obtained by this method. PMID- 3298257 TI - Molecular oxygen controls nitrate transport of Escherichia coli nitrate-respiring cells. AB - Escherichia coli cells grown anaerobically in the presence of nitrate reduce the nitrate as a terminal electron acceptor in place of molecular oxygen by an induced respiratory-type electron transferring system residing in the inner membrane structure. When oxygen is introduced to a suspension of nitrate respiring cells, the oxygen is immediately reduced preferentially and the cellular uptake of nitrate ceases abruptly. In contrast, we found that the cells exhibited no oxygen control on uptake of chlorate, a competitive substrate analogue, indicating operation of an oxygen-sensitive transport system specific to nitrate. This was further evidenced by the fact that chlorate inhibition of reduction of nitrate was brought about only when the transport of both chlorate and nitrate was facilitated by the aid of carrier-type chlorate (or nitrate) ionophore. We demonstrated that oxygen inhibition on reduction of nitrate was abolished within the cells treated by octyl glucoside resulting in a removal of permeability barrier specific to nitrate. We conclude that the transient control by molecular oxygen is primarily due to the inhibition of nitrate transport into the cytoplasmic side. Since nitrate induces the nitrate-respiring system, the repression of the nitrate reductase operon by molecular oxygen is consistently interpreted on the basis of the "inducer exclusion mechanism." PMID- 3298258 TI - Wild type and mutant signal peptides of Escherichia coli outer membrane lipoprotein interact with equal efficiency with mammalian signal recognition particle. AB - The signal peptide of the outer membrane lipoprotein (OMLP) of Escherichia coli was shown to be capable of promoting protein translocation across mammalian microsomal membranes in vitro. We assayed translocation of a fusion protein containing the OMLP signal peptide and nine amino acids of OMLP fused in frame to beta-lactamase. The efficiency with which the mammalian translocation machinery recognizes and accepts the OMLP signal peptide as substrate is indistinguishable from that of mammalian secretory proteins. Upon translocation mammalian signal peptidase processes the pre-OMLP-beta-lactamase protein at different sites than are utilized in vivo by E. coli OMLP signal peptidase (signal peptidase II) but that can be predicted as mammalian signal peptidase cleavage sites. Mutants in the OMLP signal peptide were tested for their ability to promote translocation of the fusion protein in this assay system. It has been shown previously that mutants in the positively charged amino acids at the amino terminus of the signal peptide severely delay the translocation of OMLP in vivo in E. coli. However, these mutants had no detectable effect either on signal recognition by mammalian signal recognition particle or on the efficiency of translocation itself. PMID- 3298259 TI - Ferrate oxidation of Escherichia coli DNA polymerase-I. Identification of a methionine residue that is essential for DNA binding. AB - Treatment of Escherichia coli DNA polymerase-I with potassium ferrate (K2FeO4), a site-specific oxidizing agent for the phosphate group-binding sites of proteins, results in the irreversible inactivation of enzyme activity as judged by the loss of polymerization as well as 3'-5' exonuclease activity. A significant protection from ferrate-mediated inactivation is observed in the presence of DNA but not by substrate deoxynucleoside triphosphates. Furthermore, ferrate-treated enzyme also exhibits loss of template-primer binding activity, whereas its ability to bind substrate triphosphates is unaffected. In addition, comparative high pressure liquid chromatography tryptic peptide maps obtained before and after ferrate oxidation demonstrated that only five peptides of the more than 60 peptide peaks present in the tryptic digest underwent a major change in either peak position or intensity as a result of ferrate treatment. Amino acid analyses and/or sequencing identified four of these affected peaks as corresponding to peptides that span residues 324-340, 437-455, 456-464, and 512-518, respectively. However, only the last peptide, which has the sequence: Met-Trp-Pro-Asp-Leu-Gln-Lys, was significantly protected in the presence of DNA. This latter peptide was also the only peptide whose degree of oxidation correlated directly with the extent of inactivation of the enzyme. Amino acid analysis indicated that methionine 512 is the target site in this peptide for ferrate oxidation. Methionine 512, therefore, appears to be essential for the DNA-binding function of DNA polymerase-I from E. coli. PMID- 3298260 TI - Probing ribosome function and the location of Escherichia coli ribosomal protein L5 with a monoclonal antibody. AB - A monoclonal antibody specific for Escherichia coli ribosomal protein L5 was isolated from a cell line obtained from Dr. David Schlessinger. Its unique specificity for L5 was confirmed by one- and two-dimensional electrophoresis and immunoblotting. The antibody recognized L5 both in 50 S subunits and 70 S ribosomes. Both antibody and Fab fragments had similar effects on the ribosome functions tested. Antibody bound to 50 S subunits inhibited their reassociation with 30 S subunits at 10 mM Mg2+ but not 15 mM, the concentration present for in vitro protein synthesis. The 70 S couples were not dissociated by the antibody. The antibody caused inhibition of polyphenylalanine synthesis at molar ratios to 50 S or 70 S particles of 4:1. The major inhibitory effect was on the peptidyltransferase reaction. There was no effect on either elongation factor binding or the associated GTPase activities. The site of antibody binding to 50 S was determined by electron microscopy. Antibody was seen to bind beside the central protuberance or head of the particle, on the side away from the L7/L12 stalk, and on or near the region at which the 50 S subunit interacts with the 30 S subunit. This site of antibody binding is fully consistent with its biochemical effects. PMID- 3298261 TI - Half-site reactivity of the tyrosyl radical of ribonucleotide reductase from Escherichia coli. AB - A C-terminally truncated form of protein B2, the homodimeric small subunit of ribonucleotide reductase from Escherichia coli, was found as the result of an apparently specific proteolysis. Truncated homodimers contain an intact binuclear iron center and a normal tyrosyl radical but have no binding capacity for the other ribonucleotide reductase subunit, protein B1, and are consequently enzymatically inactive. Heterodimers, consisting of one full-length and one truncated polypeptide, formed spontaneously during a chelation-reconstitution cycle and were easily separated from the two homodimeric variants. The heterodimeric form of B2 shows a weak interaction with the B1 subunit resulting in low enzyme activity. Using heterodimers containing deuterated tyrosine on the full-length side and protonated tyrosine on the truncated side, we could demonstrate that the tyrosyl radical was randomly generated in one or the other of the two polypeptide chains of the heterodimeric B2 subunit. The small subunit of ribonucleotide reductase thus conforms to a half-site reactivity. PMID- 3298263 TI - Human rabies immunoglobulin assayed by the rapid fluorescent focus inhibition test suppresses active rabies immunization. AB - The rabies antibody content of each of ten lots of human rabies immunoglobulin was titrated by both the mouse neutralization test and the rapid fluorescent focus inhibition test. The two tests did not give comparable results, the antibody titres obtained by the mouse neutralization test being 1.4-9.6 times higher than those obtained by the rapid fluorescent focus inhibition test. This titre difference was associated with a consistently lower antibody response in human volunteers who had received post-exposure rabies vaccine treatment which included the administration of RIG assayed by the RFFIT. PMID- 3298262 TI - Effect of phenylarsine oxide on insulin-dependent protein phosphorylation and glucose transport in 3T3-L1 adipocytes. AB - We have reported previously that phenylarsine oxide (PAO) blocks insulin stimulated glucose transport in 3T3-L1 adipocytes (Frost, S. C., and Lane, M. D. (1985) J. Biol. Chem. 260, 2646-2652). As shown in the present study, the locus of inhibition is post-receptor. Insulin stimulated the extent of receptor autophosphorylation in solution and in the intact cell by approximately 4-fold. PAO had no effect on this activity. Using reduced and carboxamidomethylated lysozyme as a substrate for the tyrosine-specific receptor, insulin stimulated the rate of receptor kinase-catalyzed substrate phosphorylation by 2-fold; PAO had no effect on this stimulation. However, the insulin-stimulated, serine specific phosphorylation of two endogenous phosphoproteins (pp24 and pp240) in the intact cell was blocked by 25 microM PAO. These complementary in situ and in vitro studies demonstrate that the inhibition by PAO must be distal to the insulin receptor's protein tyrosine kinase activity. PMID- 3298264 TI - Bone grafts. The basic science rationale for clinical applications. PMID- 3298265 TI - A new technique for passing tendon through bone. Brief note. PMID- 3298266 TI - Eikenella corrodens as a cause of osteomyelitis in the feet of diabetic patients. Report of three cases. PMID- 3298267 TI - Cryopreservation of skin tissue. PMID- 3298268 TI - Effect of microvascular hydrostatic pressure and local prostanoid production on early and late postburn edema formation. PMID- 3298269 TI - Excisional therapy of facial burns. PMID- 3298270 TI - Facial resurfacing in the pediatric burn patient: a comparison of scar excision with dermabrasion. PMID- 3298271 TI - Improved surgical care of posterior burns and donor sites using air-fluidized support. PMID- 3298272 TI - Temporary wound closure after burn excision. PMID- 3298273 TI - Postoperative splinting of the lower face and neck. PMID- 3298274 TI - Burn care protocols--donor site care. PMID- 3298275 TI - Testing for homograft viability. PMID- 3298276 TI - Management of the extensive third-degree burn wound. PMID- 3298277 TI - The use of tissue expansion techniques in burn reconstruction. PMID- 3298278 TI - Head splint for immobilization of the neck postgrafting. PMID- 3298279 TI - Postgraduate course: respiratory injury. Part IV. Bedside management and weaning of the burn patient on mechanical ventilation. PMID- 3298281 TI - Technical aspects of valvular replacement with the St. Jude prosthesis. AB - Technical aspects for the implantation of the St. Jude Medical prosthesis are discussed. In our experience with 588 implants, the most important considerations are removal of residual calcium and preparation of annular and subvalvular areas, correct assessment of annular size, selection of proper prosthetic size, and placement of the sutures avoiding the use of pledgets on the ventricular side of the prosthesis. A special valve orientation is not needed in the great majority of patients, but necessary guidelines for individual patients were discussed. Using these technical guidelines, implantation of this prosthesis is simple, results in a low incidence of complications, and avoids damage to the prosthesis during implantation. PMID- 3298280 TI - Experimental toxicology of formaldehyde. AB - Formaldehyde is a reactive chemical which undergoes spontaneous reactions with various cellular constituents. Mutagenicity data may be interpreted on the background of this behavior. Mice are better able to reduce the irritating effect of formaldehyde than rats and to reduce their ventilation rate when formaldehyde acts on the respiratory tract. Subacute exposure of rats to concentrations higher than 2 ppm inhibits mucociliary clearance of the nasal epithelium and leads to progressive histological and ultrastructural lesions at this site. The occurrence of squamous cell carcinomas of the nasal epithelium of rats after 2 years inhalation of 14.3 ppm formaldehyde (CIIT study) is probably the result of chronic and recurrent local toxicity; this is supported by species differences in susceptibility to the tissue damaging and carcinogenic effect of formaldehyde (rat, mouse, hamster). Data on formaldehyde-DNA interaction further support the argument that a direct risk extrapolation from the formaldehyde effects in rats to those expected for man is not possible. PMID- 3298282 TI - Renal autotransplantation and extracorporeal reconstruction for complicated benign and malignant diseases of the urinary tract. AB - Renal autotransplantation was performed in five patients and extracorporeal vascular reconstruction was required in two of these cases. One had a carcinoma of the mid-ureter with a solitary kidney. Two patients had ureteral injury. One was iatrogenic from a prior operation, and the other had intrinsic ureteral disease secondary to schistosomiasis. The fourth patient had renovascular hypertension with disease extension into the interlobar renal arteries and a single kidney. The final patient had a large, renal arteriovenous malformation and polycystic kidneys. All have functioning grafts at follow-up ranging from 10 to 36 months. There is no evidence of tumor recurrence after 30 months in the patient with ureteral malignancy. The patient with renovascular hypertension has adequate blood pressure control with medication 12 months after surgery. His creatinine which had risen in the post-operative period to 4.2 mg/dl, has returned to its pre-operative valve of 1.8 mg/dl. None of the other four patients had any post-operative decline in renal function. These cases illustrate that the technique of nephrectomy, extracorporeal surgery, and renal autotransplantation can be applied to a variety of benign and malignant diseases of the kidney and ureter not amenable to conventional in-situ correction, thus allowing maximal preservation of renal parenchyma. We also have demonstrated that the procedure can be successfully performed in the presence of significant infectious risk (Case 2: indwelling nephrostomy), and retroperitoneal infection (Case 3: schistosomiasis). We feel that this procedure is currently underutilized.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298283 TI - Physiological flow variations in the periorbital arteries in Zambian Africans. A screening with bidirectional Doppler ultrasound. AB - Directional Doppler sonography with direct evaluation of the extracranial carotid artery system and scanning of the periorbital arteries has been performed in 49 black Zambian hypertensive patients and in 19 controls without cardiovascular risk factors. Direct evaluation of the extracranial carotid artery system did not show any abnormalities. In contrast to this periorbital Doppler examination revealed positive findings with retrograde flow direction in the supratrochlear artery in 19% and 21% of all examined carotids in the hypertension and control group, respectively. Compared to direct carotid angiography, 66% of the positive supratrochlear and 13% of the positive supraorbital findings in the hypertensive patient group could be shown to be false positive results. As a possible explanation of this high incidence of a retrograde flow direction in periorbital arteries a different flow physiology in the ophthalmic artery of black Zambians compared to Caucasians is discussed. PMID- 3298284 TI - Gram-negative bacterial infection of aortic aneurysms. AB - Widespread use of antibiotics and change in pathogenesis altered the bacteriology of infected aortic aneurysms. In the past, bacterial endocarditis was the major source of emboli infecting the aorta. Now, gram-negative sepsis in elderly patients is often the initiating event of infection in atherosclerotic aneurysms. Four cases of gram-negative infection in aortic aneurysms were treated. The etiology, presentation, and surgical management are reviewed. Three abdominal aortic aneurysms were infected during urinary tract sepsis and one infection occurred with Salmonella septicemia. The clinical triad of fever, abdominal pain, and a pulsatile abdominal mass led to a preoperative diagnosis in three of four patients. Debridement of infected tissue and bypass through non-infected tissue planes remain the cornerstones of modern surgical management. Despite prompt diagnosis and proper surgical management, the mortality of gram-negative aortic infection remains high because of early rupture and extensive atherosclerotic disease. PMID- 3298286 TI - Recombinant murine granulocyte-macrophage (GM) colony-stimulating factor supports formation of GM and multipotential blast cell colonies in culture: comparison with the effects of interleukin-3. AB - We studied the effects of murine recombinant granulocyte-macrophage colony stimulating factor (GM-CSF) on murine hemopoiesis in methylcellulose culture. The GM-CSF was purified from cultures of Saccharomyces cerevisiae transfected with a cloned murine GM-CSF cDNA. In cultures of spleen cells from normal mice, only granulocyte-macrophage (GM) colonies were supported by GM-CSF. Blast cell colonies were the predominant type in cultures of spleen cells from 5 fluorouracil (5-FU)-treated mice. Dose-response studies revealed that maximal GM and blast cell colony formation is achieved with 100 U/ml GM-CSF. Blast cell colonies revealed variable but high replating efficiencies, and the secondary colonies included multilineage colonies. Serial replating of washed blast cell colonies in cultures with GM-CSF provided evidence for the direct effects of GM CSF on the proliferation of multipotential blast cells. A combination of GM-CSF and interleukin-3 (IL-3) did not increase the number of blast cell colonies over the level supported by IL-3. This observation indicates that the progenitors for blast cell colonies that responded to GM-CSF are a subpopulation of multipotential progenitors that are supported by IL-3. Cytological studies of colonies derived from GM-CSF and/or IL-3 suggest that the eosinophilopoietic ability of murine GM-CSF is less than that of IL-3. PMID- 3298285 TI - Apical trehalase expression associated with cell patterning after inducer treatment of LLC-PK1 monolayers. AB - Trehalase, a differentiation-specific marker of renal proximal tubule brush border membrane, is expressed in confluent long-term cultures of the renal epithelial cell line LLC-PK1. The level of trehalase is greatly increased after treatment of cultures with differentiation inducers such as hexamethylene bisacetamide (HMBA), accompanied by increases in other apical membrane-associated differentiated functions (Yoneyama and Lever: J. Cell. Physiol. 121: 64-73, 1984). In the present study, we utilize a polyclonal antibody specific for renal trehalase to demonstrate that trehalase expression induced in LLC-PK1 cultures after HMBA treatment is localized in cells forming a three-dimensional network of strands across the confluent monolayer. The antitrehalase antibody recognized an apical membrane antigen of apparent molecular weight 100-110 kD both in LLC-PK1 cultures and in the corresponding pig renal brush border membranes. Strand formation and total trehalase activity increased in parallel as a function of inducer concentration and duration of exposure. Strand formation and trehalase expression were also greatly enhanced in monolayers grown on a Nuclepore filter support even in the absence of inducer. Strand formation was not a prerequisite for induced trehalase expression in culture, since strands did not develop in cultures treated with N, N'-dimethylformamide (DMF) and equally potent inducer of trehalase expression. In this case, cells which expressed increased levels of trehalase were dispersed at random over the monolayer. Induction of strand formation and trehalase expression by HMBA required a minimum exposure period of 48 hr and persisted up to a week after removal of inducer. By contrast, the response to DMF required continuous presence of inducer. Levels of trehalase declined even in the continuous presence of inducer in local regions of low cell density created by wound-repair of the monolayer. In addition to the membrane bound form, trehalase activity was also recoverable from the culture medium, but release of trehalase was not affected by inducers. These observations are consistent with the view that a cell type committed to express a program of differentiation after HMBA treatment or growth on a permeable support is organized in specific cell patterns visible as strands over the confluent cell monolayer. PMID- 3298287 TI - Cell cycle parameters of adult rat hepatocytes in a defined medium. A note on the timing of nucleolar DNA replication. AB - Hepatocytes, isolated from adult (250-350 g) rats, attached and survived well in primary culture on highly diluted (less than 1 microgram/cm2) collagen gel in a synthetic medium without serum or hormones. About 20% of the cells "spontaneously" entered S phase during the first 4 days of culturing, and mitoses were easily demonstrated at the near physiological concentration (1.25 mM) of Ca++ prevailing in the medium. Cultures given 9 nM epidermal growth factor (EGF) and 20 nM insulin 20 h after inoculation showed vigorous DNA synthesis and mitotic activity. Autoradiography of such cells exposed to [3H]thymidine allowed the determination of the following cell cycle parameters: Lag period from EGF/insulin stimulation till onset of increased DNA synthesis, 17 h; rate of entry into S phase (kG1/S), 0.028/h; duration of S phase, 8.4 h; duration of G2 phase, 2.7 h. The peak DNA synthesis (pulse labelling index, 24%) and peak mitotic activity (mitotic index, 1.7%) occurred 35 and 43 h, respectively, after the stimulation with EGF/insulin. These values are comparable to those reported during the in vivo compensatory hyperplasia following partial hepatectomy of adult rats. A marked variation of the intranuclear [3H]thymidine pulse labelling pattern was noted: During the first 1.5 h of the S phase, the labelling was extranucleolar and during the last 1.5 h chiefly nucleolar. The cells survived well in the absence of glucocorticoid, whose effect on cell cycle parameters therefore could be studied. Dexamethasone (25-250 nM) did not appreciably affect the durations of S phase and G2 phase or the pattern of preferential extranucleolar and nucleolar DNA synthesis within the S phase. PMID- 3298288 TI - Induction and decay of thermotolerance in rainbow trout fibroblasts. AB - Thermotolerance was studied in the rainbow trout fibroblast cell line RTG-2. RTG 2 cultures that had been incubated at 28 degrees C for 24 h were better able to withstand ultimately lethal temperatures above 28 degrees C than RTG-2 cultures that had been maintained at the routine growth temperature of 22 degrees C. This thermotolerance developed rapidly between 3 and 6 h and was fully developed by 24 h at 28 degrees C. After development for 24 hr at 28 degrees C, thermotolerance showed little change over 72 h at 0 and 5 degrees C but approximately a 40 and 60% reduction at 10 and 22 degrees C, respectively. This is the first demonstration of heat-induced thermal resistance in the cells of a poikilothermic vertebrate. PMID- 3298289 TI - Regulation of DNA synthesis in human fetal hepatocytes by placental lactogen, growth hormone, and insulin-like growth factor I/somatomedin-C. AB - Hepatocytes were isolated by gentle collagenase digestion of liver fragments from human fetuses of 8-16 weeks gestation obtained following prostaglandin-induced pregnancy terminations. They were maintained on collagen-coated tissue culture dishes in selective arginine-free medium for up to 72 hr, and the action of hormones and growth factors on DNA synthesis was studied by autoradiography following incubation with 3H-thymidine. The labeling index of hepatocytes was consistently enhanced by 25-250 ng/ml human placental lactogen (HPL), 25-250 ng/ml human growth hormone (HGH), 10-50 ng/ml insulin-like growth factor I/somatomedin-C (IGF I/Sm-C), and 10% dialyzed fetal calf serum, reaching a maximum of three- to four-fold greater than in basal medium alone. Under basal conditions, 30% of hepatocytes stained positively for the presence of IGF peptides using a monoclonal antibody raised against purified human IGF I/Sm-C. Although this proportion did not change following treatment with HGH and HPL, IGF I/Sm-C released by cells into culture medium was considerably increased in the presence of both hormones. Incubation with the SmC 1.2 monoclonal antibody abolished the increase in labeling index in response to IGF I/Sm-C and partially blocked the response to both HPL and HGH. These results indicate that both HPL and HGH stimulate DNA synthesis in human fetal hepatocytes and suggest that this effect is at least partly indirect through the release and paracrine action of IGF I/Sm-C. PMID- 3298290 TI - Rapid isolation of Escherichia coli beta-galactosidase by fast protein liquid chromatography. PMID- 3298291 TI - Subfractionation of the dansylated derivatives of glucosyl galactosyl hydroxylysine by liquid chromatography and its application to a specific alpha 1,2-glucosidase assay. AB - The dansyl derivative of glucosyl galactosyl hydroxylysine (GGH) was separated into two components, as GP-I (monodansyl GGH) and GP-II (didansyl GGH) by paper chromatography. GP-I was further fractionated into four peaks (a, b, c and d) by reversed-phase liquid chromatography. These peaks corresponded to the dansyl derivatives at the alpha-amino (a and b) and epsilon-amino (c and d) groups of their hydroxylysine residues. There is the possibility that the fractions for b and d are diastereoisomers of a and c, respectively, since the monodansyl derivative from human urine consists of a and c. GP-II was fractionated into two peaks, e and f, which may possibly be diastereoisomers of each other. Treatment of the a, b, c and d fractions with crude chicken liver enzyme resulted in the preferential cleavage of a and b and the production of monodansyl galactosyl hydroxylysine. Components c and d were also cleaved slowly, resulting in the production of monodansyl hydroxylysine by the successive action of beta galactosidase on dansyl galactosyl hydroxylysine. The detected alpha-glucosidase activity was strongly inhibited by free mannosamine. The method developed using the monodansyl GGH fraction a (or b) and high-performance liquid chromatography facilitated the detection of alpha-1,2-glucosidase, which acts specifically toward GGH even in a crude enzyme preparation. PMID- 3298292 TI - Standards for validating health measures: definition and content. AB - Adherence to standards for judging the content validity of health measures and for labeling them is needed for the field of health assessment to proceed in an orderly fashion. This paper discusses the dimensionality of health and the range of health states that can be measured within each dimension. These two attributes of published definitions of health are used to derive minimum standards for judging the validity of health measures in terms of their content. Five generic health concepts are defined: physical health, mental health, social functioning, role functioning, and general health perceptions. Items from widely used health measures are presented to clarify distinctions among these concepts and the different health states they encompass. It is recommended that labels be assigned to health measures in a manner consistent with their content and other evidence of validity. PMID- 3298293 TI - Quality of life variables in surgical trials. AB - Clinical trials are commonly performed in surgery to assess the efficacy of one or more treatments. Many therapies result in only partial or temporary improvement, rather than cure. Others sharply affect the quality of patients' lives or of their deaths. For most interventions, it is important to document effects on quality of life as well as morbidity and mortality rates. yet, a review of the literature reveals that very few surgical trials consider quality of life variables as outcome measures. Surgical investigators in areas like cancer, inflammatory bowel disease, end stage renal disease, and cardiac disease have examined quality of life issues extensively using a variety of scales and indices. However, most studies on quality of life are hampered by poor design and inadequate methods of assessment. Failure to evaluate quality of life variables prevents the recognition and full use of potentially beneficial therapies and the rejection of potentially harmful ones. PMID- 3298294 TI - Quality of life: an important endpoint both in surgical practice and research. AB - Surgery asks patients to trade present discomfort and risk for future gains. Although research reports on the effectiveness of surgery have largely focused on mortality, length of hospital stay, major complications, and laboratory analyses, the principal criteria guiding surgeons' clinical decisions and patients' acceptance of treatment are most often the patients' subjective feelings and capabilities, the quality of their lives. This is true for both major and minor surgical procedures. We discuss the role of information on functional capacity, overall well-being, and quality of life in the assessment of surgical outcomes. Broadening the choice of endpoints beyond traditional, so-called "hard" variables in surgical studies has advantages for both surgeons and patients. PMID- 3298295 TI - Evaluation of quality of life in clinical trials of cardiovascular disease. AB - There is an increasing interest in the use of quality of life methods to assess the benefits of treatment in cardiovascular disease. When selecting dimensions of quality of life and the instruments to measure these dimensions, the key issue is the detection of a response to treatment during the trial. The sensitivity of a variety of instruments appropriate to hypertension, angina and congestive heart failure is reviewed. Quality of life should be assessed in double blind randomized controlled trials. A Health Index must be included to take into account any mortality and morbidity occurring during the trial. Data are presented on the measurement of quality of life in patients taking placebo prior to entering trials of antihypertensive treatment. The variation with age, sex and nationality is discussed. Also reported are the results arising from observer bias in a single-blind trial. PMID- 3298297 TI - Utility approach to measuring health-related quality of life. AB - Quality of life is a broad concept that incorporates all aspects of an individual's existence. Health-related quality of life is a subset relating only to the health domain of that existence. The utility approach can be used to measure a single cardinal value, usually between 0 and 1, that reflects the health-related quality of life of the individual at a particular point in time. The utility approach is founded in modern utility theory, a normative rational model of decision-making under uncertainty. The measurement techniques that have been used include standard gamble, time trade-off, and rating scales. The techniques are described in the paper and compared in terms of their acceptability to subjects, reliability, precision, validity, and ease of use. It is concluded that the utility approach is beyond the experimental stage, and is now a viable alternative for investigators to use in measuring health-related quality of life. PMID- 3298296 TI - Health status and utility measurement viewed from the right brain: experience from the rheumatic diseases. AB - Questionnaires for measuring function, health status, and quality of life have been developed for the rheumatic and musculoskeletal disorders. These new measures are as valid and as reliable as traditional measures of clinical status in clinical trials and health services research and add a valuable dimension to outcome assessment. However, they have limitations for use in patient care. Questionnaires cannot determine the etiologic basis of functional disability; nor cover any one function in enough depth; nor deal with the relative nature of function; nor account for the differences in functional priorities. Questionnaires are statistical approaches and based on normative model; patient care is humanistic emphasizing differences. Nevertheless, the interaction between psychometric approaches and concerns of patient care is a necessary and desirable goal for all we seek to accomplish with clinical investigation. PMID- 3298298 TI - Prescription drug use among diabetics--a population study. AB - Diabetes mellitus is a multifaceted disease which intervenes in the personal lives of those afflicted in many different ways. In this study prescription drug use among diabetics was analyzed in order to shed light on the characteristics of diabetic morbidity. Prescription drug use among diabetics and non-diabetics in a total population of 21,000 inhabitants in a defined geographic area were studied. The diabetic population was categorized according to the type of treatment received: insulin treatment, oral anti-diabetic treatment or dietary treatment or dietary treatment only. The pattern of prescription drug use differed between diabetics and non-diabetics and important differences were observed also between diabetics according to type of treatment. Drug use among those treated with insulin and those treated orally was substantially higher than among non diabetics while the difference between diabetics on dietary regimen and non diabetics was much smaller. All three treatment groups had considerably higher consumption of cardiovascular drugs than non-diabetics. Additional findings include more frequent antibiotic use among diabetics treated orally and on diet only than among non-diabetics. The use of these drugs was also common among insulin treated diabetics but did not differ significantly from among non diabetics. Use of psychotropics was more common among diabetics treated with insulin and orally than among non-diabetics. PMID- 3298299 TI - Postmenopausal osteoporosis--intervention and prophylaxis. A review. AB - Postmenopausal osteoporosis is a common disorder associated with significant morbidity and mortality through fractures of the femoral neck, vertebrae and distal forearm. The national cost of this illness is measured in billions of dollars annually. Although the etiology of postmenopausal osteoporosis is unclear, specific effective therapies are available if initiated early in the course of the disease. A large body of information concerning this illness has been generated but many questions remain. The epidemiology, etiology, diagnosis and therapy of postmenopausal osteoporosis are discussed in this review with emphasis on prophylactic and interventional therapy as related to subpopulations of women at risk for osteoporosis. PMID- 3298300 TI - Urinary and serum electrolytes in untreated black and white hypertensives. Veterans Administration Cooperative Study Group on Antihypertensive Agents. AB - Twenty-four hour urinary excretion of sodium (Na), potassium (K), Na/K ratio and creatinine (Cr), serum Cr, Na, and K, and plasma renin activity (PRA) were evaluated in 623 untreated hypertensive men. Blacks (n = 407) and whites (n = 216) were similar in weight, heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), 24-hour urine Cr excretion, and Cr clearance. Twenty-four hour urine Na excretion was the same in blacks and whites, but whites excreted 62% more K than blacks: 73 +/- 41 (mean +/- SD) vs 45 +/- 40 mEq/24h (p less than 0.001). Urinary Na/K ratio was 4.51 +/- 2.18 in blacks and 2.85 +/- 1.40 in whites (p less than 0.001). Serum K and PRA were also lower in blacks. Serum and urine Na/K ratios, serum Na and age were positively associated with SBP; serum K and PRA were negatively associated with SBP. Serum Na/K ratio, heart rate and weight were positively associated with DBP; serum K was weakly negatively associated with DBP. The racial difference in urinary K excretion and serum K is believed to reflect a difference in dietary K intake between blacks and whites. This difference may be an important factor in the greater prevalence of hypertension among blacks. PMID- 3298301 TI - The problems of taste in placebo matching: an evaluation of zinc gluconate for the common cold. AB - A recently published randomized, controlled, double-blind, study has reported efficacy of zinc gluconate lozenge treatment of the common cold. Because of a higher rate of side effects in the zinc group and the lack of any confirmatory evidence of blinding efficacy, we are concerned about the possible contribution of bias to the study result. Unflavored zinc gluconate tablets can be easily distinguished from the relatively tasteless, unflavored calcium lactate tablets, which were used as placebo in the cited study, increasing our concern about bias. In order to be able to test zinc lozenges in a second trial of common cold therapy, we developed a matching placebo containing denatonium benzoate (a bitter substance used to prevent thumb sucking in children) and then undertook a formal evaluation of blinding efficacy. This article reports the results of this evaluation, encompassing two randomized, controlled taste trials; the first trial of the placebo matching showed zinc recipients to exhibit a higher rate of side effects and also a significantly higher proportion of subjects believing they were on "active" treatment. Alterations in dosage before the second taste trial yielded comparability of the placebo and zinc lozenges. This study illustrates the pitfalls which may sometimes be encountered in performing and publishing studies in which placebos are either not tested at all or tested in too small a subject population to detect a significant subjective difference between the placebo and the active medication. PMID- 3298302 TI - The functional status of ESRD patients as measured by the Sickness Impact Profile. AB - This study describes and compares the perceived sickness-related behavioral dysfunction of 859 end-stage renal disease (ESRD) patients from 11 centers according to treatment modality via the Sickness Impact Profile (SIP). The unadjusted functional status of ESRD patients differed significantly by treatment modality. Transplantation patients were least functionally limited followed in order by home dialysis, continuous peritoneal dialysis, and in-center dialysis patients. The largest overall differences were for the sleep and rest, work, recreation and pastimes, and home management SIP categories. Regression analysis revealed that many of the large observed intermodality differences in functional status may have resulted from casemix variations (e.g. age and comorbidity differences). Only SIP score differences between transplantation and other treatment modality patients remained significant following the introduction of casemix controls. Results do not justify choosing one dialysis modality over another because of differences in perceived dysfunction. PMID- 3298303 TI - Measuring the effectiveness of heart transplant programmes: quality of life data and their relationship to survival analysis. AB - This paper explores the problems of benefit measurement in the economic evaluation of heart transplant programmes. We present data from our evaluation of the U.K. heart transplant programmes on both survival and quality of life and we examine the relationship between the two. The quality of life measure used, the Nottingham Health Profile (NHP), is described and results presented. We attempt to aggregate this profile measure into a single index score and combine these data with life expectancy gains to produce estimates of Quality Adjusted Life Years (QALYs) gained for heart transplantation. In addition we examine the extent to which pre-transplant NHP scores can be used as predictors of post-transplant survival. PMID- 3298304 TI - Development of a functional assessment questionnaire for geriatric patients: the Comprehensive Older Persons' Evaluation (COPE). AB - Several sources of data were used to identify questions worthy of inclusion in a functional assessment questionnaire for older patients. Community hospital use of the Functional Assessment Inventory was reviewed to identify questions that discriminated between inpatients and outpatients. Repeated administrations of the Older Americans Resources and Services questionnaire with elderly patients were reviewed to identify questions that discriminated between community and nursing home status and predicted nursing home placement. Twenty clinicians providing geriatric care identified clinically important questions in a modified Delphi survey. Questions were retained if they: were considered clinically essential; discriminated between inpatients and outpatients and between independent living and nursing home status; predicted nursing home placement; and showed changes in responses over 6 months that predicted subsequent nursing home placement. These questions were organized into a brief, clinically relevant functional assessment questionnaire, known as the Comprehensive Older Persons' Evaluation (COPE), that may facilitate the efficient provision of geriatric care. PMID- 3298305 TI - Glomerular filtration rate is increased in man by the infusion of both D,L-3 hydroxybutyric acid and sodium D,L-3-hydroxybutyrate. AB - A high glomerular filtration rate (GFR) is often found early in insulin-dependent diabetes mellitus (IDDM). It has been suggested that high circulating glucose, glucagon, and GH levels could play a role in this increase in GFR. On the other hand, patients with IDDM in poor metabolic control also have high circulating ketone body levels. This study was undertaken to determine whether exogenous D,L 3-hydroxybutyric acid at two infusion rates (40 and 30 mumol kg-1 min-1) for 180 min altered renal plasma flow (RPF), GFR, and the excretion rate of total protein, beta 2-microglobulin, and albumin in 11 normal (N) subjects and 11 IDDM patients in whom euglycemia was achieved and maintained using the insulin-glucose clamp technique. RPF and GFR were measured by a priming-continuous infusion of [125I]hippurate and [51Cr]EDTA, respectively. The 40 mumol kg-1 min-1 D,L-3 hydroxybutyric acid infusion increased RPF and GFR in both N and IDDM subjects. Mean RPF increased from 588 +/- 78 (+/- SD) to 706 +/- 129 mL min-1 1.73 m-2 in N and from 671 +/- 101 to 781 +/- 99 in IDDM. GFR increased from 121 +/- 11 to 151 +/- 15 ml min-1 1.73 m-2 in N and from 136 +/- 11 to 191 +/- 16 in IDDM. The filtration fraction also was significantly higher in IDDM than in N during the D,L-3-hydroxybutyric acid infusion. The 30 mumol kg-1 min-1 D,L-3-hydroxybutyric acid infusion increased RPF and GFR to a somewhat lesser extent in both groups. D,L-3-hydroxybutyric acid infusions increased the tubular reabsorption rate of ketone bodies and sodium. The increase in tubular sodium reabsorption rate was correlated significantly to that in the tubular ketone body reabsorption rate. A significant decrease in urinary pH was found during the D,L-3-hydroxybutyric acid infusion. D,L-3-Hydroxybutyrate sodium salt (30 mumol kg-1 min-1) also was infused in 5 of the 11 diabetic patients. A similar increase in GFR and RPF occurred. Both total protein and beta 2-microglobulin, but not albumin, excretion rates increased during D,L-3-hydroxybutyric acid (40 mumol kg-1 min-1) infusion in N and IDDM subjects. D,L-3-Hydroxybutyric acid infusion did not change plasma glucagon, GH, or renin activity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3298306 TI - Immunocytochemical localization of prolactin and relaxin C-peptide in human decidua and placenta. AB - The production of PRL by the human decidua is generally accepted, but the production of relaxin by this tissue is not. The two hormones were localized in decidual tissue using the avidin-biotin immunoperoxidase procedure with antisera to human PRL and to a synthetic 14-amino acid sequence of the connecting peptide of human relaxin (hCp14). The object of using the hCp14 antiserum was to verify relaxin production by the detection of C-peptide and/or prorelaxin. Cells of the parietal decidua adherent to the fetal membranes stained with both antisera, and immunostaining for both hormones in the same cell was seen. Also, the decidua like cells of the placental basal plate stained with both antisera. The chorionic cytotrophoblast stained with the antiserum to hCp14, but not the antiserum to human PRL, whereas the placental syncytiotrophoblast stained for PRL and/or human placental lactogen (hPL), but not hCp14. The PRL staining in all tissues was lost when anti-PRL serum absorbed with human placental lactogen (hPL) was used. This finding suggests that the antiserum to PRL could not distinguish between PRL and hPL. It appears, therefore, that the parietal decidua cells and the decidua-like cells of the placental basal plate may be capable of producing both relaxin and PRL, while the syncytiotrophoblast produces hPL and possibly PRL. PMID- 3298307 TI - Monitoring of clomiphene citrate stimulation by means of plasma 17 beta oestradiol determinations and ultrasonographic follicle measurements in in-vitro fertilization treatment cycles. AB - In 57 in-vitro fertilization (IVF) cycles stimulated with clomiphene citrate the relationship between plasma 17 beta-oestradiol (E2) and ultrasonographic measurements of follicle diameter was assessed. Under both monofollicular and multifollicular conditions a wide range in plasma E2 values was observed in the late follicular phase. No significant correlation could be established between the dimensions of the dominant preovulatory follicle and plasma E2 values, in mono-follicular or multi-follicular cycles. Pregnancies and conceptions occurred in cycles with both low and high circulating E2 levels. In pregnancy cycles a slight increase in plasma E2 values was found on the day following administration of human chorionic gonadotrophin (HCG). In conceptional cycles not leading to a clinical pregnancy, plasma E2 profiles varied considerably, whereas in cycles in which no oocytes were fertilized, plateauing or a distinct decrease occurred during this particular period. The present study suggests that the relative daily increase in plasma E2 values may be the most relevant aspect of plasma E2 monitoring. PMID- 3298309 TI - Survival of Serratia marcescens in benzalkonium chloride and in multiple-dose medication vials: relationship to epidemic septic arthritis. AB - In an epidemic of septic arthritis due to Serratia marcescens, the intra articular injection of contaminated methylprednisolone may have played a key role. The epidemic strain was found in used multiple-dose vials of methylprednisolone and in a canister of cotton balls soaked in benzalkonium chloride. The cotton balls had been used for antisepsis and disinfection. Growth characteristics of the epidemic strain of S. marcescens were compared with those of control strains of S. marcescens which had been obtained from unrelated nosocomial outbreaks. The epidemic strain was able to survive in 1:100 dilutions of benzalkonium chloride and was able to grow to greater than 10(5) CFU/ml in multiple-dose vials of methylprednisoline; control strains could not be recovered after 24 h in the same solutions. The preservative in methylprednisolone is gamma myristyl picolinium chloride, a compound chemically related to benzalkonium chloride. We speculate that the epidemic strain of S. marcescens, which was resistant to benzalkonium chloride, had cross-resistance to gamma-myristyl picolinium chloride. If the cotton balls were used to disinfect the tops of the multiple-dose vials of methylprednisolone, small numbers of organisms subsequently introduced into the solution could have grown to high concentrations. PMID- 3298308 TI - Epidemic septic arthritis caused by Serratia marcescens and associated with a benzalkonium chloride antiseptic. AB - During a 6-week period, 10 patients were admitted to a hospital for treatment of knee or shoulder joint infections due to Serratia species. Isolates from eight patients were identified as Serratia marcescens with identical biochemical characteristics and antibiotic susceptibility patterns. Before the onset of infections, all patients had been treated by two orthopedic surgeons who shared an office. Studies revealed that infections were associated with previous joint injections (P = 4.44 X 10(-5] of methylprednisolone and lidocaine. Environmental cultures revealed that a canister of cotton balls soaked in aqueous benzalkonium chloride and two multiple-dose vials of methylprednisolone previously used by office personnel were contaminated with the epidemic strain of S. marcescens. The canister may have served as a potential reservoir for contamination of sterile solutions and equipment used for joint injections, of skin at the injection site, and of hands of personnel. No further cases occurred after the use of aqueous benzalkonium chloride was discontinued. PMID- 3298310 TI - Laboratory investigation of outbreak of hemorrhagic colitis caused by Escherichia coli O157:H7. AB - A severe outbreak of hemorrhagic colitis occurred in London, Ontario, during the month of September 1985. A total of 55 residents and 18 employees of a nursing home developed diarrhea, and 17 residents (age range, 78 to 99 years) died. Specimens from 38 patients, 37 employees and contacts, and 10 autopsies were investigated for all enteric pathogens. Specimens were also planted on MacConkey sorbitol agar. Fecal extracts were tested on Vero cells for cytotoxin (FVT). Escherichia coli isolates were serotyped and tested for verotoxin and beta glucuronidase production. Of the 38 symptomatic patients, 26 were positive for FVT, verotoxin-producing E. coli (VTEC), or both. Of the 105 specimens that were examined from these 38 patients, FVT and VTEC were both positive in 30 specimens, FVT only was positive in 13 specimens, and VTEC only was positive in 4 specimens. None of the 27 specimens from 10 autopsies was positive for FVT or VTEC. No other enteric pathogen was found in any of the cases. All asymptomatic individuals were negative for both FVT and VTEC. Of 19 VTEC strains that were isolated, 18 belonged to serotype O157:H7. These 18 strains and 2 more strains that were obtained from sporadic cases that had occurred within the 2 previous months were found to give similar biochemical reactions in a 36-test identification system. All isolates of serotype O157:H7 were beta-glucuronidase negative and susceptible to the antimicrobial agents that are used to treat E. coli infections. Testing for FVT and VTEC was found to be the most sensitive and specific technique for the laboratory diagnosis of this disease. Negative sorbitol, positive raffinose, and negative beta-glucuronidase tests appeared to be consistent markers for aiding in the detection of E. coli O157:H7. PMID- 3298312 TI - Comparison of rapid identification method and conventional substrates for identification of Corynebacterium group JK isolates. AB - In an effort to identify Corynebacterium group JK isolates rapidly, Rapid Identification Method (RIM series; Austin Biological Laboratories, Inc., Austin, Tex.) substrates were tested in parallel with conventional substrates. RIM reactions agreed with conventional substrate results, respectively, as follows: urea, 38 of 38; nitrate, 35 of 38; glucose, 35 of 38; maltose, 28 of 38; sucrose, 37 of 38; and o-nitrophenyl-beta-D-galactopyranoside, 24 of 26. As a supplement to initial screening tests, the RIM tests offer a rapid method for identifying group JK isolates. PMID- 3298311 TI - Comparison of enzyme-linked immunosorbent assay and complement fixation and indirect fluorescent-antibody tests for detection of Coxiella burnetii antibody. AB - An enzyme-linked immunosorbent assay (ELISA) was developed to detect immunoglobulin G to Coxiella burnetii phase II. Serum samples from 213 patients who had had Q fever 1 year previously and from 301 blood donors from six localities in Switzerland were tested by ELISA and by indirect fluorescent antibody (IFA) and complement fixation (CF) tests. The ELISA and the IFA and CF tests detected antibody to C. burnetii in 202 (94.8%), 193 (90.6%), and 166 (77.8%) of the 213 Q fever patients, respectively. With the serum samples from blood donors, the ELISA yielded a higher percentage of positive sera than did the IFA and CF tests. The high specificity of the three tests was confirmed by analyzing paired serum samples from 36 patients suffering from acute pneumonia of viral or bacterial origin. In these cases, the serological results were negative by the three tests, except for three Q-fever cases included as positive control. PMID- 3298313 TI - Cryptosporidium species, a protean protozoan. PMID- 3298314 TI - Anti-bovine antibody in human sera as a cause of nonspecificity in enzyme immunoassay. AB - Much nonspecific activity in enzyme immunoassay is due to reactions between anti bovine antibodies which are commonly present in human serum samples and residual calf serum in viral antigens. Calf serum is used in cultured cells which are used to produce viral antigens. Addition of bovine proteins to serum samples to be tested for viral antibodies reduces this activity. PMID- 3298316 TI - Analysis of T cell receptor-gene rearrangement in T cells from the cerebrospinal fluid of patients with multiple sclerosis. AB - Characterization of T cells present in the cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) may contribute to an understanding of the immunopathologic role of these cells. To analyze the T cells in the CSF of MS patients, 30 cloned T cell lines from each of two MS patients were surveyed for their patterns of T cell receptor (TcR) beta-chain gene rearrangement. DNA from the (CSF-derived) T cell clones was digested with a number of restriction endonucleases and the gene rearrangement patterns were analyzed with a T cell receptor beta-chain probe. Southern blot analysis of the DNA of these T cell clones indicated that all had rearrangements of the TcR beta-chain genes, but none of the rearrangements were identical. These results suggest that, if a few clones of specific T cells are involved, they must form a tiny minority in comparison to the total number of T cells in the CSF of MS patients. PMID- 3298315 TI - Fluorescence resonance energy transfer measurements of distances in actin and myosin. A critical evaluation. AB - The contractile proteins actin and myosin are of considerable biological interest. They are essential for muscle contraction and in eukaryotic cells they play a crucial role in most contractile phenomena. Over the years since the first fluorescence resonance energy transfer (FRET) paper appeared, an extensive body of literature has accumulated on this technique using actin, myosin and the actomyosin complex. These papers are reviewed with several aims in mind: we assess the reliability and consistency of intra- and inter-molecular distances measured between the fluorescent probes attached to specific sites on these proteins; we determine whether the measurements can be assembled into an internally consistent model which can be fitted to the known dimensions of the actomyosin complex; several of the FRET distances are consistent with the available structural data from crystallographic and electron microscopic dimensions; the modelled FRET distances suggest that the assumed value of the orientation factor (k2 = 2/3) is reasonable; we conclude that the model has a predictive value, i.e. it suggests that a small number of the published dimensions may be incorrect and predicts the magnitude of a larger number of measurements which have not yet been reported; and finally (vi) we discuss the contribution of FRET determinations to the current debate on the molecular mechanism of contraction. PMID- 3298317 TI - Development and characterization of five monoclonal antibodies against neuronal cell surface antigens--evaluation of their use in cell separation by affinity chromatography. AB - Five monoclonal antibodies directed against rat neuronal cell surface proteins have been isolated and characterized following fusion of mouse SP2/O-Ag-14 myeloma cells and spleen cells from BALB/c mice immunized with neuron-specific membrane proteins. The antibodies displayed cell specificity in binding and elicited precipitation of different polypeptides from total neuronal cell surface proteins. These antibodies are of potential use in the isolation of a neuronal subpopulation by immunoaffinity chromatography. The work represents the application of hybridoma technology for the isolation of specific types of neuronal populations. PMID- 3298319 TI - Effects of reduced acid concentration and etching time on bond strength and enamel morphology. PMID- 3298318 TI - [3H]thymidine labeling of astrocytes in experimental allergic encephalomyelitis. AB - In acute experimental allergic encephalomyelitis (EAE), astrocytes in spinal cord tissue hypertrophy and stain intensely with antibody to the glial fibrillary acidic protein (GFAP). We attempted to determine if this activation is a result solely of hypertrophy of existing astrocytes or if astrocyte division might also occur. Lewis rats in various stages of acute EAE were injected with [3H]thymidine, the spinal cord sections were prepared, immunostained for GFAP and processed for radioautography. In spinal cords from rats administered thymidine on days 11-15 after sensitization a large number of mononuclear cells showed radioactive label. Many of these labeled cells, most likely monocytes and lymphocytes, were associated with inflammatory lesions, but others were located in the CNS parenchyma at great distances from the lesions. Most cells staining for the GFAP were hypertrophied with greatly extended cell processes, and the nuclei of some of these cells identified as astrocytes were overlaid with silver grains, indicating uptake of [3H]thymidine. In addition a few ependymal cells appeared to be labeled. No GFAP-stained cells from the Freund's adjuvant controls contained radioactive label. Similar studies using SJL/J mice with chronic relapsing EAE yielded very few labeled inflammatory cells or astrocytes. This study indicates that division takes place in some astrocytes in acute EAE, but occurs much less frequently in chronic EAE. Probably most of the increase in GFAP stained material is a result of hypertrophy of astrocytes rather than of massive cell division. PMID- 3298320 TI - Effect of physiologic hyperinsulinemia on skeletal muscle protein synthesis and breakdown in man. AB - Although insulin stimulates protein synthesis and inhibits protein breakdown in skeletal muscle in vitro, the actual contribution of these actions to its anabolic effects in man remains unknown. Using the forearm perfusion method together with systemic infusion of L-[ring-2,6-3H]phenylalanine and L-[1 14C]leucine, we measured steady state amino acid exchange kinetics across muscle in seven normal males before and in response to a 2-h intraarterial infusion of insulin. Postabsorptively, the muscle disposal (Rd) of phenylalanine (43 +/- 5 nmol/min per 100 ml forearm) and leucine (113 +/- 13) was exceeded by the concomitant muscle production (Ra) of these amino acids (57 +/- 5 and 126 +/- 9 nmol/min per dl, respectively), resulting in their net release from the forearm ( 14 +/- 4 and -13 +/- 5 nmol/min per dl, respectively). In response to forearm hyperinsulinemia (124 +/- 11 microU/ml), the net balance of phenylalanine and leucine became positive (9 +/- 3 and 61 +/- 8 nmol/min per dl, respectively (P less than 0.005 vs. basal). Despite the marked increase in net balance, the tissue Rd for both phenylalanine (42 +/- 2) and leucine (124 +/- 9) was unchanged from baseline, while Ra was markedly suppressed (to 33 +/- 5 and 63 +/- 9 nmol/min per dl, respectively, P less than 0.01). Since phenylalanine is not metabolized in muscle (i.e., its only fates are incorporation into or release from protein) these results strongly suggest that in normal man, physiologic elevations in insulin promote net muscle protein anabolism primarily by inhibiting protein breakdown, rather than by stimulating protein synthesis. PMID- 3298323 TI - Five new personality scales: their location in the factor space of personality measures. AB - Five scales from a picture-preference test (PPT; Auld, 1981) and a sixth, provisional scale from this test, along with some of the best established factorial tests of personality and ability, were administered to 182 university students. The marker tests included the Eysenck Personality Questionnaire, Cattell's 16 Personality Factor Questionnaire, the Hakstian-Cattell Comprehensive Ability Battery, and measures of authoritarian personality traits, obsessionality, and Machiavellianism. In order to determine the factorial composition of the five PPT scales, we computed the correlations among the 53 variables, extracted the 12 significant factors by the principal axes method, and did a direct oblimin rotation. It was shown that three of the PPT scales loaded on a single factor, which was identified as P, Eysenck's "psychoticism." We concluded that the three PPT scales may prove useful as a non-questionnaire approach to measurement of P. PMID- 3298324 TI - Effects of perceived sophistication and test validity on acceptance of generalized feedback. AB - Forty-eight undergraduate females completed a psychological test after they had received instructions that concerned the validity of the test and their sophistication as test takers. Subjects were told that the test was either valuable or worthless in assessing personalities. Subjects also were told that they were either experienced or naive with regard to tests and psychology. Subjects received identical Barnum interpretations, which they rated for accuracy. While the high sophistication subjects rated the interpretation as accurate across validity conditions, the low sophistication subjects rated the interpretation according to the validity instructions they received. These results run counter to previous assertions that validity and sophistication have little or no effect on acceptance of generalized personality feedback. PMID- 3298321 TI - Acute tropical pulmonary eosinophilia. Characterization of the lower respiratory tract inflammation and its response to therapy. AB - Although acute tropical pulmonary eosinophilia (TPE) is well recognized as a manifestation of filarial infection, the processes that mediate the abnormalities of the lung in TPE are unknown. To evaluate the hypothesis that the derangements of the lower respiratory tract in this disorder are mediated by inflammatory cells in the local milieu, we utilized bronchoalveolar lavage to evaluate affected individuals before and after therapy. Inflammatory cells recovered from the lower respiratory tract of individuals with acute, untreated TPE (n = 8) revealed a striking eosinophilic alveolitis, with marked elevations in both the proportion of eosinophils (TPE 54 +/- 5%; normal 2 +/- 5%; P less than 0.001) and the concentration of eosinophils in the recovered epithelial lining fluid (ELF) (TPE 63 +/- 20 X 10(3)/microliter; normal 0.3 +/- 0.1 X 10(3)/microliter; P less than 0.01). Importantly, when individuals (n = 5) with acute TPE were treated with diethylcarbamazine (DEC), there was a marked decrease of the lung eosinophils and concomitant increase in lung function. These observations are consistent with the concept that at least some of the abnormalities found in the lung in acute TPE are mediated by an eosinophil-dominated inflammatory process in the lower respiratory tract. PMID- 3298322 TI - Alport familial nephritis. Absence of 28 kilodalton non-collagenous monomers of type IV collagen in glomerular basement membrane. AB - Alport-type familial nephritis (FN), a genetic disorder, results in progressive renal insufficiency and sensorineural hearing loss. Immunochemical and biochemical analyses of the non-collagenous (NC1) domain of type IV collagen isolated from the glomerular basement membranes (GBM) of three males with this disease demonstrate absence of the normally occurring 28-kilodalton (kD) NC1 monomers, but persistence of the 26- and 24-kD monomeric subunits derived from alpha 1 and 2 (both type IV) collagen chains, respectively. PMID- 3298325 TI - 5-Hydroxytryptophan: a review of its antidepressant efficacy and adverse effects. AB - Alterations in serotonin metabolism may be an important factor in the etiology and treatment of depression. In this regard, 5-hydroxytryptophan (5-HTP), a serotonin precursor, has been given to patients with depression. Although a review of these studies suggests that 5-HTP possesses antidepressant properties, additional trials are clearly indicated. Following a discussion of the pharmacology of 5-HTP, the authors highlight adverse effects associated with its administration to depressed patients, neurologic subjects, and normal individuals. Relatively few adverse effects are associated with its use in the treatment of depressed patients. PMID- 3298326 TI - Desipramine plasma levels and clinical response: evidence for a curvilinear relationship. AB - Twenty-six outpatients with major depression completed a 6-week, fixed dose trial of desipramine and provided plasma samples. Recovery after 6 weeks, defined in either of two ways, corresponded to lower desipramine levels, while clinical status at 4 weeks bore no apparent relationship to plasma levels. Upper limits of 140 or 155 ng/ml emerged depending on the outcome measure used. Patients with endogenous depression, those with primary depression, and those with abnormal dexamethasone suppression test results yielded similar therapeutic thresholds, while the sharpest blood level/response relationship emerged in the subgroup with an abnormal escape from dexamethasone. PMID- 3298329 TI - Neurosecretory neurons and their projections to the serotonin neurohemal system of the cockroach Periplaneta americana (L.), and identification of mandibular and maxillary motor neurons associated with this system. AB - The neuroanatomy of a serotonin neurohemal system in the head of Periplaneta americana was studied by means of immunohistochemistry, cobalt backfilling, transmission electron microscopy, and nerve transection. This neurohemal system is supplied by bilateral groups of two or three neurons whose somata are located ventrally in the subesophageal ganglion, near the root of each mandibular nerve. Axons of these serotoninergic neurons extend into all of the nerves of the mouth parts but reach most of these nerves by a very circuitous route. Initially the axons extend from the subesophageal ganglion, through the ipsilateral mandibular nerve trunk, and into the third branch of the mandibular nerve. From here the axons extend into the second branch of the maxillary nerve by way of a link nerve, and then they project retrogradely to reenter the subesophageal ganglion. In the ganglion, branches of these axons extend into the labial nerves, and the axons run dorsally through the subesophageal ganglion, circumesophgeal connectives, and tritocerebrum to reach the labral nerves. In the nerves of the mouth parts the serotoninergic axons give rise to numerous secondary branches that form an extensive neurohemal system at the surface of these nerves. The relatively large surface and cephalic location of this system probably indicate that the timely release of relatively large amounts of serotonin plays an important role in the physiology of feeding in this insect. The somata, neurites, and dendritic fields of the serotonin neurohemal neurons and those of the motor neurons of the mandibular abductor muscle occur together, and some of the mandibular abductor motor neurons also stain for serotonin. In order to distinguish clearly between these neurohemal and motor neurons, the anatomy of the mandibular abductor motor neurons has also been determined. Similarly, in the course of this study it has been necessary to work out the anatomy of the motor neurons of the maxillary retractor and cardo rotator muscles in order to distinguish them from the serotoninergic neurons. A nonserotoninergic peripheral neuron is associated with the serotonin neurohemal system, and its soma is located on the mandibular-maxillary link nerve. This link nerve neuron appears to be neurosecretory. PMID- 3298328 TI - Flupenthixol in chronic schizophrenic inpatients: a controlled comparison with haloperidol. AB - Two neuroleptics having different effects at dopamine receptors were administered to chronic schizophrenic inpatients to compare their therapeutic efficacy and ability to produce side effects. Haloperidol appeared to produce lower levels of psychopathology than flupenthixol but similar levels of side effects. No evidence was found that flupenthixol is specifically useful in "activating" chronic patients or in alleviating affective symptoms. Although these are preliminary results, they support the view that D2 receptors may mediate the antipsychotic effects of neuroleptic drugs. PMID- 3298327 TI - Adinazolam--a new antidepressant: findings of a placebo-controlled, double-blind study in outpatients with major depression. AB - Adinazolam mesylate, a new triazolobenzodiazepine with antidepressant properties, was significantly superior to placebo based on the following efficacy measures: number of subjects who completed the study; number of subjects whose total score on the 21-item Hamilton Rating Scale for Depression (HAM-D) decreased by 50% or more; and number of subjects who reported that the drug helped them. Mean scores on three HAM-D clusters (anxiety/somatization, sleep disturbance, and an endogenomorphic cluster) also showed significant differences in favor of adinazolam. Side effects were generally mild and transient; however, a seizure of moderate intensity occurred during rapid tapering of adinazolam from 90 to 40 mg/day. There were no significant anticholinergic effects, and no mania or hypomania was reported in any subject. No consistently significant differences were observed between subjects whose primary diagnosis was major depression and those with a diagnosis of bipolar II depression. PMID- 3298330 TI - Somatostatin-like immunoreactivity in the midbrain of the cat. AB - Somatostatin (SS) immunoreactivity was localized in cat brain sections with an immunoperoxidase technique. Cell bodies in the midbrain containing SS immunoreactivity were found in the superficial and intermediate gray layers of the superior colliculus, the interpeduncular nucleus, the raphe, the inferior colliculus and nucleus of its brachium, the nucleus of the optic tract, and the lateral tegmental field. Additional positive neurons were seen in the parabigeminal nucleus and in the dorsal periaqueductal gray in kitten material. Immunoreactive fibers were observed in the periaqueductal gray and in the midbrain tegmentum, with particularly dense labeling just dorsal to the substantia nigra and in the parabrachial nuclei. This is the first report of the distribution of SS immunoreactivity in the midbrain of the cat. It is concluded that somatostatin has a distribution compatible with a role as a major neurotransmitter/neuromodulator within certain midbrain nuclei, especially the interpeduncular nucleus and the superior colliculus. PMID- 3298332 TI - The effects of Escherichia coli endotoxin as a trigger for hepatic infection of rabbits with Fusobacterium necrophorum. AB - To evaluate the effects of endotoxin in hepatic infection with Fusobacterium necrophorum, rabbits were given several combinations of F. necrophorum and Escherichia coli endotoxin. Severe hepatic necrosis with multiplication of F. necrophorum was induced by inoculation of endotoxin via the bile duct and following inoculation of both endotoxin and F. necrophorum. Inoculation with F. necrophorum alone, preceded by inoculation of endotoxin via the bile duct, also induced hepatic necrosis, whereas rabbits which received a single inoculation of endotoxin or F. necrophorum had only slight necrotic lesions. The pathogenetic mechanism of experimental hepatic infection with F. necrophorum is discussed. PMID- 3298331 TI - Short axon cells of the rat olfactory bulb display NADPH-diaphorase activity, neuropeptide Y-like immunoreactivity, and somatostatin-like immunoreactivity. AB - Several types of short axon cells of the mammalian olfactory bulb have been described after Golgi impregnation. Two of these types have been observed in our material after treatment with the NADPH-diaphorase procedure or after immunohistochemistry for neuropeptide-Y (NPY). The cells stained by the two procedures have similar morphologies and distributions. A less extensive series of observations confirms that similar cells also display somatostatin (SS)-like immunoreactivity. One of these cell types corresponds to the superficial short axon cell of Golgi and electron microscopic studies. The dendrites of this cell lie within the periglomerular region and in the superficial external plexiform layer (EPL), generally lying parallel to the glomerular layer. In some cases the axon has been traced across the EPL into the granule cell layer (GCL). This cell may provide another route of interaction between the periglomerular region and the granule cells in addition to the influences conducted by basal dendrites and axon collaterals of some mitral and tufted cells. A type of deep short axon cell is also visible with these two procedures. It lies deep in the granule cell layer, frequently near the ventricular layer and its dendrites lie parallel to that layer. This deep short axon cell is stained with much greater frequency by the NADPH-diaphorase and NPY procedures than is the superficial short axon cell. It corresponds most closely to the Blanes or Golgi cells of the Golgi impregnation literature, but it appears to differ from these cells in the position and orientation of its dendrites. No spines have been observed on either the superficial or deep cells in this series. Many glomeruli are also stained by the NADPH-diaphorase procedure, but are not NPY or SS immunoreactive. This may provide additional evidence for functional differences between glomeruli in local regions of the olfactory bulb. PMID- 3298333 TI - The pathogenesis of dermatitis herpetiformis: recent advances. AB - Over the last two decades a rapid expansion of our knowledge regarding dermatitis herpetiformis has occurred, including the discovery of IgA in the skin, the discovery of an associated gluten-sensitive enteropathy, the noting of an increased prevalence of the human lymphocyte antigens (HLA)-B8 and -DRw3, and the documentation that the skin disease of many dermatitis herpetiformis patients can be controlled by a gluten-free diet. It has also been noted that two distinct forms of dermatitis herpetiformis occur, those with granular deposits of IgA at the dermoepidermal junction (85%-95% of dermatitis herpetiformis patients) and those with linear IgA deposits (10%-15% of dermatitis herpetiformis patients). These findings are reviewed with particular emphasis on the form of dermatitis herpetiformis associated with granular IgA deposits. The current findings regarding the nature and origin of the cutaneous IgA deposits, the role of the gluten-sensitive enteropathy, and the spectrum of both the immunologic and the nonimmunologic abnormalities associated with dermatitis herpetiformis are presented, and from these data pathophysiologic mechanisms are proposed that may be involved in dermatitis herpetiformis. PMID- 3298334 TI - Treatment of depressed cutaneous scars with gelatin matrix implant: a multicenter study. AB - Twenty-two centers participated in a study to determine the efficacy and safety of gelatin matrix implant (GMI; Fibrel) in the elevation of depressed cutaneous scars. Gelatin matrix implant is an implant consisting of absorbable gelatin powder and epsilon-aminocaproic acid, which is reconstituted with the patient's plasma before being injected intradermally beneath the scar. A total of 321 patients were evaluated after a skin sensitivity test; six of the patients (1.9%) had a positive response. After a skin test with negative results, 27 patients dropped out of the study for unrelated reasons. The remaining 288 patients were treated with the implant (total of 840 scars), many of whom have been followed up for more than 1 year. Preliminary results show that approximately half of the treated scars showed improvement of greater than 65%. The current data suggest that the improvement lasts at least up to 1 year. Adverse reactions to gelatin matrix implant injections were local and transient, and none of the patients developed major hypersensitivity responses to the treatment. The data indicate that intradermal injections of gelatin matrix implant are safe and effective in correcting the depressed scars selected for this study. PMID- 3298335 TI - Dermatologic therapy: December 1985 to December 1986. AB - I have reviewed the significant therapeutic changes reported in the English literature between December 1985 and December 1986. Readers should review the original articles in toto before attempting any new experimental or controversial therapy summarized. PMID- 3298336 TI - Pityriasis rosea of Gibert. PMID- 3298337 TI - "A ring around the rosie" (the rash that was). AB - The history of smallpox is recounted through the eyes of those who bore witness to its terrors. A suggestion is made that the nursery rhyme, "A Ring Around the Rosie," may represent a depiction, in the old oral tradition of communication, of a smallpox epidemic. PMID- 3298338 TI - Acute renal allograft rejection: difficulty in diagnosis of histologically mild cases by MR imaging. AB - To determine the ability of magnetic resonance (MR) imaging to diagnose various degrees of acute allograft rejection (AR), 33 MR examinations in 28 patients were obtained. Surface coils were used in 21 examinations. Seventeen examinations were correlated with biopsy results, which were graded as absent (n = 7), mild (n = 6), or severe (n = 4) AR. Corticomedullary differentiation (CMD) on T1 weighted images was graded as absent/poor versus distinct, and images were also evaluated for visibility of intrarenal vessels. For serial examinations, renal volume was measured and compared. The MR results were correlated with radionuclide interpretations in 22 cases. Diminished CMD was most common with AR (7 of 12) but was also seen with acute tubular necrosis (2 of 6) and cyclosporin toxicity (2 of 3). All four cases of severe AR had diminished CMD. In contrast, only one of six cases of mild AR had diminished CMD (p less than 0.05). Four of five cases of mild AR by radionuclide scan were correctly diagnosed. Visualization of intrarenal vessels was best with surface coils, but this did not contribute to differential diagnosis. Renal volume was increased in rejecting allografts. Magnetic resonance is a promising modality for investigation of renal allografts but is not a sensitive or specific modality for the diagnosis of mild AR. PMID- 3298339 TI - Parapelvic lymph cyst in a renal allograft mimicking hydronephrosis: CT diagnosis. AB - Lymphoceles are common complications of renal transplantation and usually arise between the bladder and the transplant kidney. A rare case of a parapelvic lymphocyst in a renal allograft is presented that sonographically mimicked hydronephrosis but was correctly diagnosed by CT. PMID- 3298340 TI - Computed tomography of an ancient Egyptian cat. AB - The use of CT in the documentation of ancient Egyptian mummified human remains has previously been described in this and other journals. We recently applied this technique to a collection of ancient Egyptian mummified fauna and sarcophagi. We selected an example to illustrate that CT is also uniquely suitable for the study of such specimens in a noninvasive way. PMID- 3298341 TI - Supplying the protein needs of dairy cattle from by-product feeds. AB - Several by-product feeds are relatively high in crude protein and exhibit relatively low ruminal degradability, which make them desirable proteinaceous feeds for dairy cows. Therefore, by-product feeds have been and will continue to be important feeds for dairy cows. Factors are discussed that affect ruminal degradability of protein in distillers grains, distillers grains with solubles, brewers grains, corn gluten feed, corn gluten meal, meat meal, meat and bone meal, blood meal, and fish meal, and the potential of these feeds to provide supplemental amino acids needed by lactating dairy cows. The importance of maximizing synthesis of microbial protein and digestion of organic matter in the rumen is emphasized in relation to total amino acid passage to the small intestine. For these feeds to be used most successfully, they must be available from a dependable source at an economical cost and should supply amino acids that complement other amino acids passing to the small intestine. Benefits that should be realized from the successful use of by-product feeds include increased milk production from feeding proteins that have greater ruminal escape potentials and a reduced cost per unit of milk produced because of decreased use of expensive supplemental protein. PMID- 3298342 TI - Growth inhibition of mastitis pathogens by long-chain fatty acids. AB - Staphylococcus aureus, Staphylococcus hyicus, Streptococcus agalactiae, and Corynebacterium bovis were tested for sensitivity to long-chain fatty acids predominant in teat canal keratin. Antibacterial activity of free fatty acids on each bacterial species was measured after 12 and 24 h in chemically defined media. Polyene C18:2 and C18:3 acids were bactericidal to each species at less than or equal to 10(5) ng/ml-1. The most bacteriostatic saturated fatty acids were C12 and C14. Streptococcus agalactiae growth was inhibited more by fatty acids after 24 h than after 12 h. No incubation time effect on growth responses of other species was determined. Polyoxyethylenesorbitan monooleate had a neutralizing effect on the bactericidal activity of polyene acids on C. bovis. Corynebacterium bovis were unable to grow in synthetic media containing individual free fatty acids as the sole source of preformed fatty acids. A relationship between bacterial species commonly isolated from bovine teat canals with resistance to fatty acids predominant in keratin was not evident. PMID- 3298343 TI - Role of vitamin D in the immune system. AB - Classically, the only roles attributed to vitamin D have been regulation of intestinal calcium absorption and maintenance of skeletal homeostasis. This review examines the new evidence describing a regulatory role for vitamin D (1,25 dihydroxyvitamin D) in immune cell functions along with research that has linked immune cell functions with skeletal homeostasis. The possible significance of this evidence with respect to the parturient dairy cow is discussed. PMID- 3298345 TI - [Fundamental principles of hemostasis--oral antiplatelets and anticoagulants]. PMID- 3298344 TI - [Retention and effectiveness of sealants on dental caries in a community program]. PMID- 3298347 TI - Chemosurgical debridement of osteomyelitic bone by zinc chloride fixative. AB - Zinc chloride fixative (as described in fixed-tissue Mohs surgery) is useful as a chemical debridement method for osteomyelitic bone. We describe a case of an 86 year-old female with a 67-year history of an osteomyelitic ulcer of the anterior tibia. Previous attempts at surgical extirpation of the bone followed by immediate or delayed repair by orthopedic and plastic surgery services had eventuated in recurrence of the basic osteomyelitic process. Below-the-knee amputation was recommended as the only alternative to treatment. However, we chose to apply zinc chloride fixative which penetrated the full thickness of cortical bone and revealed a wider and deeper extent of the infectious process than previously recognized. Following removal of the fixed bone, a muscle flap repair followed by split-thickness skin grafting was done by plastic surgery. The patient remains ulcer and symptom free 31 months postoperatively. We feel zinc chloride fixative is useful as an adjunct to other surgical means of extirpation of bone as it is tissue sparing and more accurately determines the extent of involved bone when infected. PMID- 3298346 TI - Sunscreens and their use in the preventive treatment of sunlight-induced skin damage. AB - In this brief review, clinically relevant practical aspects of topical protection against the harmful effects of solar radiation on human skin are discussed. The article covers information in the following areas of photo-protection: nature of solar radiation; classification of normal individuals into sun-reactive skin types I-VI; minimal erythema doses of UVB and UVA radiation for individuals of skin types I-VI; classification of sunscreens and SPF values of brand-name sunscreens; a list of UVB- and UVA-absorbing chemicals used in sunscreen formulations in the USA; guidelines for recommending topical sunscreens for the prevention of sunburn, skin photoaging, and skin cancer; and concerns about the harmful effects of UVA radiation and tanning parlors on human skin and the methods used to minimize the potential damaging effects of UVA. PMID- 3298348 TI - Urinary incontinence--pathophysiology and treatment. PMID- 3298349 TI - [Role of the cytoskeleton and homologs of retrovirus genes in yeast cell division]. PMID- 3298350 TI - The Queen's Nursing Institute: 1887-1987. PMID- 3298351 TI - The presidents. James Porter Hollers 1963-1964. PMID- 3298352 TI - Retention of pit and fissure sealant on the primary molars of 3- and 4-year-old children after 1 year. AB - An investigation of pit and fissure sealant retention in 1,871 children in the Head Start program was conducted in Tennessee in September 1985 to determine the retention of the sealant after application to the occlusal surfaces of primary molars of 3- and 4-year-old children. The investigation shows pit and fissure sealants are retained on primary molars at a rate comparable to that expected on permanent molars. PMID- 3298353 TI - Findings from the Dental Care Supplement of the National Health Interview Survey, 1983. AB - This report describes the prevalence of edentulism, problems associated with use of dentures, and reported use of fluoride products in the civilian noninstitutionalized population of the United States. The statistics reported are based on a sample of 105,182 people about whom information was collected using the 1983 Dental Care Supplement to the National Health Interview Survey (NHIS), conducted by the National Center for Health Statistics. PMID- 3298354 TI - A variation in the anatomic position of the pterygomandibular raphe: report of case. AB - A literature review of the anatomic position of the pterygomandibular raphe discloses no reports of possible variations in the attachment of this structure. A case study is presented describing such a variation from the typical anatomic description. The treatment regimen and factors related to denture retention are discussed. PMID- 3298355 TI - Ultrasonic endodontics: a clinical review. AB - Ultrasonic endodontic therapy, first introduced in 1957, is rapidly gaining popularity as a means of root canal debridement and enlargement. The most recent literature regarding the clinical and experimental work done with ultrasonic endodontic devices is presented, as well as clinical considerations relative to the use of ultrasonic endodontic treatment. PMID- 3298356 TI - Operative dentistry in the second century BCE. AB - An archaeological excavation by the Israel Department of Antiquities and Museums recovered the skeletal remains of 25 people buried in a mass grave dated to approximately 200 BCE. Subsequent analysis of the dentition showed one skeleton with a 2.5-mm bronze wire implanted in the maxillary lateral incisor. This is the first archaeological evidence of operative dentistry in ancient Israel, as well as the earliest date for this specific treatment in the world. PMID- 3298358 TI - Quantitative assessment of the hemodynamic consequences of aortic regurgitation by means of continuous wave Doppler recordings. AB - The purpose of this study was to evaluate the ability of continuous wave Doppler ultrasound recordings to reflect the magnitude and hemodynamic effects of aortic regurgitation. Forty-five patients with angiographically proved aortic regurgitation had Doppler studies performed within 24 hours of cardiac catheterization. High quality spectral recordings of the regurgitant jet were obtained in 31 patients, whereas 14 patients exhibited dropout of high velocity signals precluding measurement of maximal velocities. The slope of the peak to end-diastolic velocity decrease measured by Doppler examination was compared with the decay in the aortic to left ventricular diastolic pressure gradient by catheterization and was found to correlate well (r = 0.86). The Doppler velocity decay slope was generally higher in patients with angiographically severe rather than mild or moderate aortic regurgitation, but considerable overlap was present among groups. However, a diastolic velocity decay slope of greater than 3 m/s2 was seen only in those patients with advanced (3 or 4+) aortic regurgitation. Left ventricular end-diastolic pressure was estimated from the Doppler recordings by subtracting the end-diastolic pressure gradient obtained by the modified Bernoulli equation from the cuff diastolic blood pressure. A correlation was observed (r = 0.84) between Doppler and catheterization left ventricular end diastolic pressure in the 31 patients with high quality spectral data, although the SEE was substantial (5.5 mm Hg). These data demonstrate that continuous wave Doppler recordings of the regurgitant jet can be useful in assessing the angiographic severity and hemodynamics of aortic regurgitation. PMID- 3298357 TI - Contrast echo washout curves from the left ventricle: application of basic principles of indicator-dilution theory and calculation of ejection fraction. AB - Time-intensity curves can be obtained from contrast echocardiography of the left ventricle. The purposes of this study were: 1) to verify whether these curves conform to the basic principles of indicator-dilution theory; and 2) to derive indexes of left ventricular ejection fraction from curve analysis. In seven closed chest dogs, 31 doses of the polysaccharide agent SHU-454 were injected into the left ventricular cavity during apical four chamber two-dimensional echocardiography. Data were obtained at different levels of ejection fraction, which were induced by changes in preload, afterload and contractility, and measured by single plane Simpson's rule analysis of digital subtraction left ventriculograms. In a subset of two dogs, eight incremental doses (from 1 to 8 ml) of SHU were injected in the basal state. Contrast echocardiograms were digitized off-line, the mean gray level/pixel of a region of interest inside the left ventricular cavity was measured, and the average value for three systolic frames of each beat was used to obtain time-intensity curves. A good correlation was observed between the peak of the time-intensity curve and the quantity of contrast injected (correlation coefficient r = 0.91 by a logarithmic fit). The echo intensities observed in each animal were subsequently transformed in quantity of contrast according to these functions and their natural logarithm was calculated both with and without background subtraction. All curves relating time and the natural logarithm of the corrected intensity exhibited a descending rectilinear portion (washout) in which the correlation was very good (r = 0.97 +/ 0.02 = mean +/- SD) and which was not significantly affected by background subtraction. The validity of this fit was also unaffected by heart rate (55 to 158 beats/min) and angiographic ejection fraction (22 to 74%), and only minimally influenced by duration of contrast washout (3.3 to 14.6 seconds). Ejection fraction was calculated by an algorithm derived from indicator-dilution theory: ejection fraction = [1 - e(-bd)] X 100, where b = slope of the curve and d = cardiac cycle duration. Linear regression analysis between values of ejection fraction derived by angiography and contrast echo yielded r = 0.73. A second index, based on b and d, was derived by multiple regression analysis. Linear regression analysis of this index and angiographic ejection fraction yielded a correlation of r = 0.87.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3298359 TI - Comparison of single plane videodensitometry-based right ventricular ejection fraction in right and left anterior oblique views to biplane geometry-based right ventricular ejection fraction. AB - To evaluate the reliability of the videodensitometric assessment of right ventricular ejection fraction, 38 patients were studied during diagnostic cardiac catheterization. Digital subtraction images of the right ventricle were obtained in both the right anterior oblique and the left anterior oblique views, using direct intraventricular injection of dilute contrast medium. From the end diastolic and end-systolic images obtained in each view, analysis of the relative brightness values generated a videodensitometry-based right ventricular ejection fraction for both the right and the left anterior oblique views. These values were compared with those generated by applying the geometry-based Simpson's rule to the orthogonal images. Right ventricular ejection fraction ranged from 22 to 88%. Videodensitometric ejection fraction in the right anterior oblique view correlated well with that in the left anterior oblique view (r = 0.88) and each correlated well with geometry-based ejection fraction (r = 0.91 and 0.82, respectively). In a subset of 18 patients without significant cardiac disease, mean videodensitometric right ventricular ejection fraction was 68% (versus 61% in the abnormal subset), and it correlated closely with left ventricular ejection fraction (r = 0.82). Videodensitometric analysis of digital subtraction images provides a reliable method for calculating right ventricular ejection fraction that is independent of geometry and reliably separates normal from abnormal values. Application of videodensitometric techniques should simplify analysis of the response of the right ventricle to different interventions in patients with cardiac disease. PMID- 3298361 TI - Clinical investigation of implantable antitachycardia devices: report of the policy conference of the North American Society of Pacing and Electrophysiology. PMID- 3298360 TI - Anisoylated plasminogen streptokinase activator complex in acute myocardial infarction: a placebo-controlled arteriographic coronary recanalization study. AB - Anisoylated plasminogen streptokinase activator complex (APSAC) is a new thrombolytic agent that is of interest because of its ease of administration as an intravenous bolus injection. This report describes the first double-blind, placebo-controlled evaluation of intravenous APSAC for coronary recanalization in acute myocardial infarction. Unequivocal documentation of recanalization was provided by coronary arteriography before and after the drug intervention. Forty patients with acute myocardial infarction underwent coronary arteriography 3.1 +/ 1.2 hours after the onset of symptoms. This demonstrated occlusion of the infarct-related coronary artery in 29 patients who were then randomized to treatment with intravenous APSAC, 30 mg (n = 16), and placebo (n = 13) 3.3 +/- 1.3 hours after the onset of symptoms. Repeat arteriography 90 minutes later demonstrated recanalization of the infarct-related coronary artery in nine patients who had received APSAC compared with only one patient who had received placebo (56 versus 8%, p less than 0.05). The 95% confidence limits for this 48% difference between the groups are 20 to 76%. Arteriography at 3 days showed persistent patency of all recanalized coronary arteries except one (APSAC group) and also showed late recanalization in another four patients, three of whom had received APSAC. In the patients who had a patent infarct-related coronary artery at the initial arteriographic study, patency was maintained throughout the study period regardless of whether the patient was randomized to APSAC (n = 4) or placebo (n = 7). Complications related to APSAC therapy were excessive bruising at the catheterization site in seven patients and minor sensitivity reactions in three.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298362 TI - Cardiac dynamics during supine exercise in cyclosporine-treated orthotopic heart transplant recipients: assessment by radionuclide angiography. AB - The mechanisms by which the denervated heart responds to supine exercise were assessed by equilibrium gated radionuclide angiography in 18 cardiac transplant recipients 1 to 25 months (mean 11) after surgery. Results were compared with those in 15 normal subjects. Exercise duration among transplant recipients did not differ significantly from that in normal subjects. The heart rate at rest in transplant patients was 30% higher than in normal volunteers. Heart rate increased only 3% between rest and the first stage of exercise in transplant recipients compared with a 37% increase in the normal group (p less than 0.001). Cardiac output at rest was similar in both groups although the rate of rise of cardiac output and peak cardiac output were significantly lower among the transplant recipients. In early exercise, the means by which cardiac output increased in the transplant patients differed significantly from normal. In the transplant recipients, the left ventricular end-diastolic volume index increased 14% compared with a decrease of 2% in normal subjects (p less than 0.001) during the first stage of exercise. At the same time, the end-systolic volume index increased 6% in the transplant group but decreased 11% in normal subjects (p less than 0.001). These changes resulted in an overall increase in stroke volume by 20% in the transplant group compared with only a slight increase (+3%) in normal subjects (p less than 0.001) during the first stage of exercise. Among transplant recipients, the stroke volume index plateaued after the first stage of exercise, which, in combination with the blunted chronotropic response, resulted in a peak cardiac index 25% lower than that in normal subjects (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298363 TI - Prognosis of ventricular arrhythmias in relation to sudden cardiac death: therapeutic implications. AB - The hypothesis that ventricular arrhythmias represent an independent predictor of sudden cardiac death was examined by analyzing the published data. The frequency and complexity of ventricular arrhythmias increase progressively both with age and severity of heart disease, but no age- or disease-related norms have been established for clinical guidance. Simple and complex arrhythmias, including short runs of ventricular tachycardia, do not increase risk of sudden cardiac death in subjects without heart disease or with heart disease and normal myocardial function. Progression of nonsustained into sustained ventricular tachycardia in such individuals is rare. Simple and complex ventricular arrhythmias are not strong independent predictors of sudden death in survivors of myocardial infarction. In these, the overall incidence of sudden cardiac death averages 3.5 to 5% during the first year, but is about 15 to 20% per year in patients with severely impaired ventricular function. The results of this survey suggest that in patients with well preserved ventricular function, prophylactic use of antiarrhythmic drugs is not indicated, and that treatment of asymptomatic or mildly symptomatic ventricular arrhythmias is not likely to reduce the incidence of sudden cardiac death. PMID- 3298364 TI - Computer-aided electrocardiography. AB - The three principal forms of medical electrocardiography are the standard 12 lead electrocardiogram (ECG), the exercise ECG and the long-term ambulatory ECG. The volume of use of the 12 lead ECG is 10 to 20 times greater than that of the exercise test or the ambulatory test, and it has received correspondingly more developmental and marketing attention. A great increase in the rate of adoption of computerized electrocardiography was brought about when large scale integration of computer hardware made it possible to place the entire computational package within a standard-sized ECG cart. Exercise ECG testing involves processing a data sample minutes in duration. Only a very few diagnostic possibilities are examined; emphasis is on measurements of the ST segment and on non-ECG observations. Ambulatory electrocardiography currently involves only one or two ECG leads and these are tested for only a few diagnostic possibilities; however, duration of the data sample is relatively long, usually 24 hours. Computer processing involves examination of about 100,000 cardiac cycles for RR interval, QRS shape and ST segment deviation. PMID- 3298365 TI - Prevention of cardiovascular disease in the elderly. PMID- 3298366 TI - Medical therapy in the elderly. AB - Recommendations concerning nutrition and physical activity are an important part of health care in the elderly. There is increasing evidence that diet and exercise influence the development and progression of cardiovascular disease in the elderly as well as the young. Decreases in coronary risk factors can be achieved in the elderly by attention to proper diet and exercise. PMID- 3298367 TI - Cardiovascular disease in the elderly. Behavioral, cognitive and emotional considerations. PMID- 3298368 TI - Human aging: changes in structure and function. PMID- 3298369 TI - Cardiovascular disease in the elderly. Clinical assessment. AB - The elderly patient with suspected cardiovascular disease poses a diagnostic challenge to the clinician. In many elderly patients the frequent unreliability of the history and the presence of multiple concurrent diseases and medications complicate accurate assessment of the patient's cardiac problem. Clinical laboratory and noninvasive cardiac techniques are now available that enhance the accuracy of cardiac diagnosis and aid in the evaluation of left ventricular function. PMID- 3298370 TI - Cardiovascular disease in the elderly. Coronary heart disease. PMID- 3298371 TI - Cardiovascular disease in the elderly. Hypertensive cardiovascular disease. AB - Hypertension is a common problem with advancing age, approaching or exceeding a 50% prevalence in the aging population. When blood pressure consistently exceeds 140/90 mm Hg, it should be treated. Patients with borderline isolated systolic hypertension should have their blood pressure measured at 6 month intervals. Risk of isolated systolic hypertension is sufficient to justify cautiously administering drug therapy if nonpharmacologic therapy fails to bring the systolic pressure less than 160 mm Hg, even though controlled studies have not been completed to prove efficacy. Both nonpharmacologic and pharmacologic therapy are recommended for those with sustained pressure elevation. Adverse effects of antihypertensive drugs may be minimized by starting with lower doses and by checking blood pressure in the upright position. PMID- 3298372 TI - Cardiovascular disease in the elderly. Valvular and congenital heart disease. PMID- 3298373 TI - Cardiovascular disease in the elderly. Pulmonary heart disease. PMID- 3298374 TI - Cardiovascular disease in the elderly. Arrhythmias. PMID- 3298375 TI - Cardiovascular disease in the elderly. Heart failure. PMID- 3298376 TI - Cardiomyopathies in the elderly. AB - Cardiomyopathies in the elderly have certain characteristic features. The dilated form appears to be less common than in younger patients. Hypertrophic cardiomyopathy is more often associated with severe and concentric hypertrophy. The prognosis of hypertrophic cardiomyopathy seems to be better in the elderly, because they appear to have a lower incidence of sudden death. Restrictive cardiomyopathies are not common in the elderly, and senile amyloid heart disease rarely, if ever, results in congestive heart failure. A syndrome of clinical heart failure with reduced diastolic compliance and preserved systolic function is more common in elderly patients. PMID- 3298377 TI - Sex differences in nitrogen balance following marrow grafting for leukemia. AB - A sex difference in nitrogen balance was investigated in 40 adults, 21 men and 19 women, undergoing chemoradiotherapy and marrow transplantation for leukemia and receiving total parenteral nutrition. Twenty-four hour collections of urine and mixed urine-stool were analyzed for total nitrogen daily through day 14 posttransplant. Nitrogen balance, corrected for changes in blood urea nitrogen, decreased significantly over time (p less than 0.005) in both men and women, but men experienced a greater negative nitrogen balance during the time period (p less than 0.001). Mean daily nitrogen balance in men was -6.0 g for week 1 and 9.2 g for week 2, corresponding to -3.3 g and -5.6 g in women for week 1 (p less than 0.005) and 2 (p less than 0.01), respectively. The differences remained after controlling for stress level and adjusting for total calorie intakes. There were no differences in age, disease status, or nitrogen intakes per kg ideal body weight, and no effects on nitrogen balance by arm muscle area at admission, cyclosporine use, or the branched-chain amino acid content of the parenteral solution. The average rise in 3-methylhistidine excretion was 23% in men and 11% in women. These results suggest higher per kg nutrient needs in males during stress and may indicate differing metabolic responses to stress. The possibility of gender differences should be considered in research evaluating nitrogen metabolism during severe stress. PMID- 3298378 TI - Dietary sodium and potassium in the genesis, therapy, and prevention of hypertension. AB - In this review, we first summarized the evidence from animals and man for and against a role for dietary sodium in the genesis and treatment of hypertension. The evidence for a role for dietary sodium in the genesis of hypertension is strongest in those subjects with impaired ability to excrete sodium due to organic renal disease or mineralocorticoid excess. Here restriction of dietary sodium promptly lowers arterial pressure. Its role in the genesis of essential hypertension is still controversial. Nevertheless, it appears that some patients with mild to moderate essential hypertension respond to moderate sodium restriction with a modest fall in blood pressure. This restriction also seems to reduce the amount of antihypertensive medication needed to keep blood pressure under control. We next considered the mechanism of the pressure response to dietary sodium chloride, concentrating upon the increase in extracellular fluid volume, potassium depletion, and increased plasma levels of prohypertensive sodium pump inhibitor and antihypertensive atrial natriuretic factor. We next summarized the evidence for a primary role for dietary potassium in the genesis of hypertension and pointed out that certain subsets of subjects with a high incidence of hypertension also have a lower dietary potassium intake. Some investigators find that dietary potassium supplementation lowers blood pressure in established hypertension. This may result from natriuresis and from vasodilation subsequent to stimulation of Na+, K+-ATPase in vascular smooth muscle and adrenergic nerve terminals. We then considered practical aspects of dietary sodium restriction and dietary potassium supplementation in the therapy for established hypertension. The review concludes with comments on their possible roles in the prevention of hypertension. PMID- 3298379 TI - Pharmacodynamic evaluation of azelastine in subjects with asthma. AB - A broad antiallergic compound called azelastine was studied pharmacodynamically in 34 subjects to correlate bronchodilator effect with blood levels of azelastine and desmethyl azelastine, its major metabolic product in man. Despite azelastine and desmethyl azelastine blood levels that were proportionate to the dosage range, the bronchodilator effect as measured by FEV1 and forced expiratory flow rate between 25% and 75% of FVC was proportionately greater with 4 mg of azelastine during the 8-hour study period than the anticipated bronchodilator response with the 8 and 16 mg doses. Azelastine, already proven effective in allergic rhinitis, has a bronchodilator effect at doses that do not produce intolerable side effects. PMID- 3298380 TI - Ontogeny of functional sympathetic innervation to the heart and adrenal medulla in the preweanling rat. AB - The development of functional sympathetic innervation to the heart and adrenal medulla was examined in Long-Evans and Sprague-Dawley rats during the preweanling period. Insulin-induced hypoglycemia was used to produce a centrally mediated activation of the sympathetic nervous system and the induction of ornithine decarboxylase activity in the heart and the depletion of adrenal epinephrine were used as indices of sympathetically mediated responses in these target organs. First, dose by time response curves were performed in 11-13 day old Sprague Dawley pups to establish an insulin dose which would simultaneously produce stimulation of cardiac ornithine decarboxylase activity and depletion of adrenal medullary epinephrine at an appropriate time post-injection. This dose of insulin was then administered to pups of different postnatal ages to determine the onset of functional sympathetic innervation to these target organs. Significant increases in heart ornithine decarboxylase activity were seen by two postnatal days of age in both rat strains examined. In contrast, adrenal epinephrine depletions were not found until 8-12 postnatal days of age. These results indicate that functional sympathetic neurotransmission to the heart is present in the first few days after birth, and this precedes the onset of sympathetic control of adrenal epinephrine release, which matures near the end of the first postnatal week in laboratory rats. PMID- 3298381 TI - Characteristics of gastric and pancreatic responses to vagal stimulation with varied frequencies: evidence for different fiber calibers? AB - In order to explore the possibility that different-sized vagal motor fibers innervate different abdominal targets as well as to identify efficient stimulation parameters for future experimentation, response characteristics to various stimulus frequencies were determined for 6 visceral responses caused by vagal nerve stimulations. Gastric acid secretion, plasma levels of insulin, glucagon and glucose, as well as heart rate and mean arterial blood pressure were monitored in anesthetized rats subjected to 1-16 Hz square wave electrical stimulation of either the left or right cut cervical vagus. The frequency response curves evidenced distinctly different profiles for the gastric, pancreatic, and cardiovascular responses respectively: acid secretion was half maximal at less than 1 Hz, insulin and glucagon responses were half-maximal at approximately 3 Hz, and cardiovascular responses were shifted still more to the right (half maximal frequency approximately 15 Hz). These results suggest but do not prove that the gastric parietal cells may be innervated by small C-fiber caliber axons and the pancreatic islets by axons in the large C-fiber or small B fiber range. Alternatively, these findings could reflect differences in neuro effector couplings of the two organs. Furthermore, the present results provide an experimental technique that makes it feasible to select a frequency that will maximize one of the vagally mediated responses or minimize the activation of a second response. PMID- 3298382 TI - [Unilateral progressive annular opacity of the cornea. Apropos of a case. Clinical, histological and ultrastructural study]. AB - A case of unilateral corneal annular opacification with a slowly progressive thickening of the cornea is reported; clinical, optical and electron microscopic studies have made possible to eliminate oedematous pathological process. The central zone of the cornea was histologically within normal aspect. In the peripheral zone intracellular mucopolysaccharides (MPS) and lipids were found in the stroma. Their presence suggest a collagen degeneration, thus likely revealing a forgotten initial stromal pathology. Its consequence, the unilateral annular thickened opacified cornea, seemed to us confusing enough to be presented and discussed. PMID- 3298383 TI - [Monobloc lamellar autokeratoplasty (MLAK) and corneal cicatrization. Apropos of a comparative trial in a control group and a group treated with a L-cystine and pyridoxine hydrochloride combination]. AB - In pterygium cure, one piece lamellar corneo-conjunctival autokeratoplasty allows to perform a reproducible corneal injury in human clinic, and thus, to study the epithelial healing. The authors describe a comparative test on 2 groups of 18 subjects each, receiving in this blind study, either classical post-operative treatment (witness group), or in addition to this treatment: L-Cystine and Pyridoxine Chlorhydrate. Two tests are analysed: the duration of epithelial healing in one day (negative fluorescein test) and post operative "well being" (estimated on the intensity of photophobia, tears and pain). Statistical analysis (non parameter tests) display a significant difference in favor of the group treated by Cystine B 6. PMID- 3298384 TI - [Orbital cysts caused by conjunctival inclusion occurring after orbito-oculo palpebral surgery]. AB - Acquired conjunctival implantation cysts of the orbit after oculo-orbital and palpebral surgery are benign tumors. The term (terminology) implies "mis placement" of the conjunctival epithelium into the orbit. Till now they have been described after "enucleation surgery". In fact, they can follow "any kind" of oculo-orbital-palpebral surgery, our series shows. We report here seven cases of acquired implantation orbital cysts; we discuss pathogeny, diagnosis, and the different investigations. We insist upon curative and above all preventive treatment. PMID- 3298385 TI - [Ocular amylosis]. PMID- 3298386 TI - Free-radical-mediated postischemic reperfusion injury in the kidney. AB - Acute tubular necrosis is a frequent occurrence following hypovolemic shock and human renal transplantation. Although this postischemic injury was originally thought to result from ischemia alone, it has recently been recognized that significant tissue injury can occur during the period of reperfusion. The demonstration of the oxygen free-radical-mediated postischemic reperfusion injury by Granger, Rutili, and McCord in ischemic cat intestine suggested that this mechanism might also be operative following renal ischemia. In the kidney, postischemic injury results in necrosis of the proximal renal tubule and accumulation of erythrocytes in the outer renal medulla. It has been proposed that the primary event leading to these pathologic changes is a free-radical mediated injury to the endothelial cells in the inner stripe of the outer medulla. Experimental evidence in animals subjected to warm and cold ischemia supports a free-radical-mediated mechanism. The clinical significance of these findings is demonstrated in preclinical animal studies of renal transplantation in which approximately two-thirds of the injury following cold ischemia could be ablated by superoxide dismutase administered just prior to reperfusion or by allopurinol when administered both at the time of preservation and reperfusion or at the time of preservation alone. PMID- 3298387 TI - Oxidant-mediated lung disease in newborn infants. AB - High concentrations of oxygen are administered with increased airway pressure to most preterm neonates with respiratory distress syndrome (RDS). Among 20% to 30% of survivors a form of chronic lung disease, bronchopulmonary dysplasia (BPD), develops. Its pathogenesis may include tissue damage caused by the superoxide anion (O2-) and other free oxygen radicals. Animal experiments and other data suggested a rationale for superoxide dismutase (SOD) administration in an effort to prevent or ameliorate BPD. Our preliminary studies in 19 prematures with RDS demonstrated its safety in human newborns and permitted measurement of its plasma levels. No adverse clinical findings occurred, and laboratory parameters were unchanged. Subcutaneous administration (0.25 mg/kg) of bovine SOD led to detectable levels at 1 1/2 h (mean 0.22 microgram/ml), with a slight rise to a higher peak at 2 1/2-4 h and a plateau over the remainder of the 12-h interval. Following doses 2-5, peak levels of 0.64 microgram/ml occurred at 4-8 h. With this background, a prospective double-blind controlled study of 45 neonates (mean gestational age, 29 weeks; birth weight, 1,100 g) showed a statistically significant reduction in prevalence of clinical and X-ray signs of BPD with fewer days of continuous positive airway pressure required. The safety and pharmacokinetics of bovine SOD were confirmed. PMID- 3298390 TI - [Maurice Lacomme 1987-1986]. PMID- 3298388 TI - Fractional hepatic extraction of insulin in man: is it constant? AB - The present study was designed to compare insulin extraction by the liver following oral glucose administrations of different size, in order to evaluate insulin removal by the liver in relation to the insulin exposure, and to the amount of ingested glucose. Insulin secretion by the pancreas was estimated by the measurement of peripheral C-peptide levels, and insulin extraction by the liver by the analysis of peripheral C-peptide to insulin ratios and relations. Ten healthy subjects (5 males and 5 females), aged 16 to 66 yr, with normal bw, and without family history of diabetes mellitus were investigated by means of the administration, on alternate days, of 50 and 150 g oral glucose loads. After the 150 g oral glucose load plasma glucose levels were significantly higher than after the 50 g oral glucose administration: glucose incremental areas of 1.45 +/- 0.12 vs. 0.55 +/- 0.04 mmol/l X min, respectively (p less than 0.001). Similarly, insulin concentrations were significantly higher following 150 g than after 50 g glucose ingestion: insulin incremental areas of 0.52 +/- 0.09 vs. 0.20 +/- 0.04 nmol/l X min (p less than 0.001). Also C-peptide levels were higher after 150 vs. 50 g oral glucose load: C-peptide incremental areas of 1.85 +/- 0.41 vs. 0.64 +/- 0.13 nmol/l X min (p less than 0.01). C-peptide to insulin molar ratios were similar during the two glucose challenge, and averaged 5.25 +/- 0.42 vs. 5.08 +/- 0.50 after 50 and 150 g oral glucose loads, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298391 TI - [Placental localization and scarred uteri. Apropos of 695 scarred uteri]. AB - The authors studied a series of 649 uteri that had been scarred in order to try and find out whether the fact that the uteri had been operated on had made any difference to the site of the placenta as determined by ultrasound from the 32nd week of amenorrhoea onwards. The long-term effect of having a hysterotomy scar in the uterus on the position of the placenta in a subsequent pregnancy was studied. The results do not agree necessarily with those of other published series. The frequency of low-lying placentae found on ultrasound in the 3rd trimester does not seem to be higher when the uterus has a scar in it. On the other hand, there were more anterior situated placentae and more haemorrhages. Finally, it does seem that the quality of the old scar does affect the position of the placenta. PMID- 3298392 TI - [Feto-placental anasarca secondary to a neuroblastoma. Prenatal diagnosis]. AB - The authors describe a very rare case of feto-placental anasarca of non immunological cause (AFPNI) which was secondary to a fetal neuroblastoma. The diagnosis was suspected before birth thanks to ultrasound. After birth a further ultrasound study as well as an anatomo-pathological study were carried out. This, then, is a case history of a stage "IV-S" neuroblastoma, which is also called Pepper's syndrome. The pathological condition is described. PMID- 3298393 TI - [Treatment with LH-RH in female sterility]. AB - The discovery that LH/RH was secreted in a pulsatile manner has made it possible to use the substance therapeutically in certain endocrine conditions of female sterility. 29 patients had sterility because of ovarian dysfunction. 3 of these were polycystic ovaries, 13 unexplained malfunction of ovulation and 30 hypothalamic in cause. They were treated with LH/RH intravenously. The dose used with each pulse was 6-18 micrograms. The patients were treated for between 18 and 30 days. In the 9 pregnancies that occurred (30%) one was in a patient with polycystic ovaries, 8 (70%) were in patients with hypothalamic ovarian failure. In each case the dose of LH/RH had been administered either at a level of less than 10 micrograms/pulse throughout the follicular phase with an injection of 5000 IU of HCG after ovulation or throughout the whole cycle. 77% of the pregnancies were obtained during the two first cycles of treatment. This work shows that hypothalamic female sterility is the proper indication for treatment using LH/RH. The protocol of dosage should be as economical as possible by administering 5-10 micrograms pulses intravenously up to the time that ovulation has been achieved. This takes note of the difficulties of obtaining supplies of the substance. PMID- 3298389 TI - Opioid peptides and glucose metabolism. PMID- 3298394 TI - Holoprosencephaly and related midline cerebral anomalies: a review. AB - We propose a simple pathogenetic mechanism that reduces a bewildering variety of central nervous system malformations to a manageable group sharing defects of midline prosencephalic growth. It is neither new nor innovative, but attempts to summarize many pathologic entities within a concept that accounts for known embryologic events and the sequence and timing of those events. We propose midline prosencephalic dysgenesis as a category of malformations including aprosencephaly, holoprosencephaly, septo-optic dysplasia, and agenesis of the corpus callosum. PMID- 3298395 TI - Choroid plexus papilloma in a 4-month-old child: a case report. AB - We report a case of choroid plexus papilloma arising from the right lateral ventricle in a 4-month-old infant. Because of intermittent vomiting, abdominal pain, and diarrhea, the child was initially treated with intravenous rehydration, which aggravated the symptoms, and a bulging fontanel developed. Before a planned lumbar puncture, cranial ultrasound was performed, which disclosed a choroid plexus papilloma. The tumor was removed surgically, and the child made an uneventful recovery. We discuss the diagnostic value of cranial ultrasound compared to computed tomographic (CT) scan and angiography. PMID- 3298396 TI - "I an sniling!": Mobius' syndrome inside and out. PMID- 3298397 TI - Optic nerve hypoplasia: a review. AB - Optic nerve hypoplasia is a developmental anomaly of the retina and optic nerves in which there is a reduction in the number of ganglion cells in the retina and of their centripetal fibers projecting through the optic nerve to the lateral geniculate body. The condition may be unilateral or bilateral and is frequently misdiagnosed as optic atrophy. In about 25% of cases, bilateral optic nerve hypoplasia is associated with a variety of cerebral malformations of which the commonest single disturbance is absence of the septum pellucidum (septo-optic dysplasia). Cerebral malformations and their endocrine accompaniments are also seen, though less frequently, in unilateral hypoplasia. The endocrine disturbances that may accompany optic nerve hypoplasia include growth hormone deficiency, adrenal insufficiency, hypothyroidism, and disturbances of antidiuretic hormone production. Precocious puberty and hypogonadism have also been observed. The prognosis of optic nerve hypoplasia depends upon the severity of the changes in the optic nerves and especially the degree of associated cerebral malformation. The finding of optic nerve hypoplasia should lead to thorough ophthalmologic, neurologic, and endocrinologic evaluation of the patient. PMID- 3298398 TI - Anesthesia for pediatric neurological and neuromuscular diseases. AB - Children with neurological and neuromuscular diseases often present anesthetic problems in the perioperative period. The anesthetic technique can play a significant role in altering the state of the brain during neurosurgical procedures through effects on the cerebral circulation and metabolism. Pre existing neuromuscular disease may also have specific anesthetic implications such as cardiorespiratory involvement (eg, myotonia dystrophica), the potential for drug interactions (eg, myasthenia gravis) or abnormal responses to commonly used drugs (eg, malignant hyperthermia). In this review, the perioperative anesthetic considerations in a number of common neurological and neuromuscular conditions in the pediatric patient are discussed. PMID- 3298400 TI - Ultrasound for kids? PMID- 3298399 TI - A trial of selenium and vitamin E in boys with muscular dystrophy. AB - The administration of selenium and vitamin E was tried in a group of 20 boys with muscular dystrophy. Muscular strength was measured at intervals of 6 months. The boys were treated for 1 year (selenium 6 micrograms/kg for 6 months and 20 micrograms/kg for 6 months), followed by 1 year of no treatment. The whole series was completed in 16 boys, nine of whom had classical Duchenne muscular dystrophy and the rest who had more benign variants. No boy showed any side effects. The decrease of muscle strength was slightly more rapid during the second year (no treatment) than during the first year (with treatment) of the trial. The difference was, however, slight and could conceivably be explained by the increase of age. No boy showed any practically usable increase of muscle strength during the year of treatment. The minimal muscle strength required for walking is presented. PMID- 3298401 TI - Pediatric neurosonography. AB - Neurosonography is an excellent modality for imaging a wide array of intracranial pathology in the infant and newborn. Neurosonography is also finding increasing use in other accessible regions of the central nervous system, including the adult brain during craniotomy and the spine during laminectomy. Sonography represents the primary modality for the evaluation of the preterm brain. Because of the high incidence of pathology in gestationally immature neonates, screening sonography is required in every infant. The sonographic features of intracranial hemorrhage include areas of increased echogenicity in the region of the germinal matrix, within the ventricles, or in the surrounding cerebral parenchyma. Careful follow-up of these children for sometimes severe posthemorrhagic hydrocephalus is essential. Premature neonates are also at risk for ischemic disease, particularly periventricular leukomalacia, which is accurately diagnosed sonographically and implies a poor prognosis in almost every infant so affected. Cranial sonography is also an excellent method to evaluate abnormalities that are not associated with gestational immaturity. Cranial sonography offers excellent anatomic imaging of the brain when evaluating for congenital anomalies; because sections may be obtained in a multitude of orientations, sonography is actually more versatile than computed tomographic (CT) scans. Cranial sonography is also of use when evaluating children with inflammatory processes such as ventriculitis; sonography is superior to CT scans in identifying intraventricular septae typical of the process. Intrauterine inflammatory processes, however, are frequently associated with intracranial calcifications, CT scans may be more accurate in these cases. CT scans may also be more efficacious in the diagnosis of subdural, epidural, and subarachnoid hemorrhage. Intracranial neoplasms are rare in the younger population and although they are visible with ultrasound, CT scans with contrast are essential in an effort to obtain added information and because of a greater experience using CT scans. Sonography represents an excellent modality with which to evaluate the infant and neonatal brain. In a number of diseases it may be diagnostic alone. The informed clinician, however, should keep in mind those instances where a complimentary modality such as CT scanning can add additional or even essential information. PMID- 3298402 TI - A randomized, double-blind, crossover study of phenobarbital and mephobarbital. AB - Some pediatric neurologists maintain that mephobarbital (Mebaral) causes fewer behavioral side effects than phenobarbital. Because this hypothesis has not been previously tested, we conducted a prospective, double-blind, randomized, crossover study of these two anticonvulsants. Both drugs were equally effective in reducing the frequency of seizure, although serum phenobarbital levels were significantly higher when the patients were taking phenobarbital compared to mephobarbital. As measured by the Abbott Parent Questionnaire, there was no significant deterioration of behavior with either phenobarbital or mephobarbital, regardless of which drug was administered first. PMID- 3298403 TI - Studies on the growth of the fetal guinea pig. Changes in the plasma concentration of sulphation-promoting activity and of insulin-like growth factors during gestation. AB - Plasma sulphation-promoting activity, insulin-like growth factors (IGF)-I and -II and insulin concentrations have been measured in the developing guinea. Sulphation-promoting activity fell progressively from midgestation to term in a manner that correlated fairly closely with the decline in the fractional rate of body and liver growth. The changes in plasma concentrations of IGF-I, & -II were quite different, both being substantially higher than fetal plasma insulin concentration. IGF-I, like insulin, plasma concentration rose between 35 and 50 days, then declined as term approached. These changes correlated with phases of lipid, DNA and RNA synthesis, but not of glycogen synthesis in the fetal liver. Fetal Plasma IGF-II concentration was comparatively low until about 55 days gestation then rose sharply, at the time that large quantities of glycogen are deposited in the fetal liver and myelation is initiated in the fetal brain, to achieve very high levels by 60-63 days then declining as term approaches. Plasma IGF-I and -II, measured by radioimmunoassay and radioreceptor assay respectively, showed the same cross-reactivity or binding characteristics as peptides in human or rat plasma. On separation by hplc IGF-I consisted of two major fractions and IGF-II of one. This picture was the same if the peptides were from fetal or adult plasma. There was no evidence of a distinctly fetal class of IGF. Plasma IGF-I and -II concentrations did not correlate with changes in fetal size or fractional rate of growth. PMID- 3298404 TI - A controlled trial of acyclovir in stable chronic HBsAg, HBeAg-positive carriers. AB - Histological remission is recognised to follow loss of viral replication in chronic hepatitis B virus infection. The aim of antiviral therapies has been to accelerate seroconversion from HBeAg to anti-HBe, but so far none has been shown to be of significant advantage in adequate, controlled trials and toxicity has been common. A randomised controlled trial of acyclovir, 45 mg/kg/day by continuous intravenous infusion for 28 days versus no therapy has been completed in 30 patients positive for HBsAg and HBeAg for a minimum of 6 months. Patients were stratified for sex, histology and homosexual activity. Twenty-eight days therapy was associated with only a modest reduction in serum markers of viral replication. At 12-months DNAp was lost in 5/15 treated and 2/11 of the untreated group, while of the latter, 2 patients initially negative became positive. Seroconversion from HBeAg to anti-HBe had occurred in 4 of 15 treated and 1 of 15 untreated patients (95% confidence limits 12% and 51%) and was associated with histological improvement. Acyclovir had only a weak effect on viral replication and did not significantly accelerate the rate of seroconversion to anti-HBe. PMID- 3298405 TI - Treatment of chronic HBeAg-positive hepatitis with acyclovir. A controlled trial. AB - In a previous study a partial inhibition of viral replication was observed in HBeAg-positive patients after acyclovir (ACV) treatment. To assess those results and to evaluate different treatment regimens, a randomized controlled trial with ACV given at 45 mg/kg/day by continuous infusion (in 5 patients) or by intermittent 8-hourly infusion (in 6 patients) for 28 days versus placebo has been performed in 20 patients affected by chronic hepatitis positive for both HBsAg and HBeAg for at least 6 months. Patients were stratified for sex, presence of cirrhosis and homosexual activity. Modest inhibition of serum DNA polymerase activity was observed after intermittent ACV treatment but not with the continuous infusion. After a 8-12 months follow-up, 2 of 10 of the ACV-treated patients and 3 of the controls had become HBeAg-negative, with 1 and 2 seroconversions to anti-HBe in the treated and placebo group respectively. No adverse effects were observed in ACV-treated patients after continuous infusion, but 2 of 6 patients who received intermittent therapy had to stop treatment, because of abdominal colics and elevation of the serum creatinine. Our data confirm that ACV partially inhibits viral replication in HBeAg-positive patients but without significantly affecting the rate of seroconversion to anti-HBe. PMID- 3298406 TI - A controlled trial of 6 months thrice weekly lymphoblastoid interferon versus no therapy in chronic hepatitis B virus infection. A preliminary analysis of the first 32 patients. AB - A controlled trial of lymphoblastoid interferon versus no therapy in patients positive for HBsAg, HBeAg and DNA polymerase activity with separate randomisation for sexual preference and histology is underway. Thirty two patients have been followed for a minimum period of 6 months of whom 15 have been randomised to receive interferon thrice weekly for 6 months after a 5-day induction phase. Five treated patients developed an hepatitis-like illness during the 3rd month of therapy concurrent with an abrupt and complete loss of DNA polymerase activity from serum. In 3 this was permanent and anti-HBe subsequently developed; 2 of these have also lost HBsAg. In the other 2 patients inhibition of viral replication was transient. In 5 further treated patients DNA polymerase activity was completely inhibited throughout treatment only to return as soon as interferon was withdrawn. In this group serum aminotransferase became normal during treatment. In the remaining 5 treated patients, inhibition of DNA polymerase activity was never complete and serum aminotransferases were unaffected. All the control patients remain seropositive for HBsAg, HBeAg and DNA polymerase activity. The low seroconversion rate in treated patients and the absence of seroconversion in the control group are probably a reflection of the exclusion of patients with marked elevation of serum aminotransferases. The occurrence of an hepatitis-like illness in the 3rd month of therapy in a third of the patients and the loss of HBsAg in 2 of 3 who eventually seroconverted are likely to be a consequence of therapy rather than spontaneous events.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298407 TI - Lymphoblastoid and recombinant alpha-A interferon therapy of chronic hepatitis B virus infection. The Royal Free Hospital experience. AB - Lymphoblastoid interferon (Wellferon), a combination of at least 8 alpha interferons, has been shown to be effective therapy in male chronic carriers of HBV infection, resulting in the loss of HBeAg and HBV-DNA in 50% of those treated. However, 0/8 women (5 Chinese) treated in this trial responded to treatment. Patients with higher ASTs, CAH on biopsy and a history of acute hepatitis are more likely to respond to treatment. Recombinant alpha-A interferon has not been as successful in our particular group of patients. However, this may be explained by the observation that most of these patients are asymptomatic, homosexuals and have lower transaminases, less histological inflammation and a higher percentage of HTLV-III antibody positivity than the Wellferon group. In the HTLV-III-negative group of HBV carriers, the response to recombinant alpha-A interferon is similar to that achieved with lymphoblastoid interferon. PMID- 3298408 TI - Recombinant leucocyte interferon treatment of chronic hepatitis B. An analysis of two therapeutic trials. AB - We have investigated the efficacy of recombinant alpha-interferon treatment of chronic hepatitis B virus (HBV) infection in two therapeutic trials. Forty-four patients positive for HBsAg, HBeAg, DNA polymerase and HBV-DNA were studied. Fourteen carriers were treated in the first trial with doses ranging from 18 to 50 million units (mu)/m2 3 times per week. Six of 14 treated carriers (43%) have a sustained loss of HBeAg, HBV-DNA and DNA polymerase. Four lost HBsAg (29%). Two of 11 (18%) untreated carriers lost HBeAg, but none lost HBsAg (P = 0.05). Nineteen patients were entered in a second trial to assess dose response. Fourteen were treated with doses ranging from 2.5 to 10 mu/m2. Five patients were untreated. Two treated patients seroconverted to anti-HBe, and a third cleared HBsAg and seroconverted to anti-HBs. None of the controls was anti-HBe-positive. Thus 9/28 (32%) carriers have lost replicating HBV versus 2/16 (13%) of untreated patients. Elevated pretreatment serum ALT concentrations and severe chronic active hepatitis were associated with inhibition of viral replication in treated patients suggesting that seroconversion may require an appropriate host response. The efficacy of recombinant interferon is restricted, but it may be of benefit in a proportion of carriers. PMID- 3298409 TI - Randomised controlled trial of lymphoblastoid interferon for chronic active hepatitis B. AB - Thirty male patients (28 homosexual or bisexual) with biopsy proven chronic active hepatitis B were randomised to receive lymphoblastoid interferon (Wellferon) or no treatment. All patients were HBeAg-positive and had continuing viral replication. Interferon was given as a single daily i.m. injection for 28 days at a starting dose of 2.5 megaunits/m2 increasing to a maximum of 7.5 megaunits/m2/day. Transient side-effects occurred in all patients. Hepatitis B viral replication was suppressed during interferon treatment in all patients but the effect was limited to the period of therapy. After 1 year there was no appreciable difference in viral markers between the two groups of patients and this treatment schedule appears less effective than the thrice weekly, 3-month regimes reported from other centres. PMID- 3298410 TI - Treatment of chronic delta hepatitis with alpha-2 recombinant interferon. AB - The Hepatitis Delta Virus (HDV), a defective ribonucleic acid virus dependent on the Hepatitis B Virus (HBV) is a cause of severe liver disease that often leads to cirrhosis and death. Since the HDV finds in the HBV infection a biological niche in which to thrive indefinitely, the major victims of its infection are the carriers of HBsAg. Spontaneous resolution of chronic HDV hepatitis has been observed rarely and therapeutic attempts with steroids or azathioprine and levamisole have been discouraging. With the advent of recombinant DNA technologies several human alpha-interferons (IFNs) have been synthesized by genetic engineering and the availability of large amounts of the drug has dramatically altered the therapeutic prospects of viral hepatitis. In view of the wide range of biological activities of IFN, including inhibition of viral nucleic acid replication, we have tested the tolerance and the efficacy of this drug in chronic HDV hepatitis. The preliminary results of this study are reported. PMID- 3298411 TI - A randomised controlled trial with human lymphoblastoid interferon vs no treatment in chronic hepatitis B virus infection. Preliminary results. PMID- 3298412 TI - Effect of 28 consecutive days lymphoblastoid interferon (alpha-IFN) administration on hepatitis B virus related chronic liver disease. AB - Eight HBsAg, HBeAg, DNA-p, HBV-DNA-positive patients with biopsy-proven chronic hepatitis were treated with human lymphoblastoid interferon (Wellferon) given for 28 consecutive days at a dosage ranging from 2.5 to 7.5 MU/m2 i.m.; 10 patients were used as controls. Our results suggest that certain chronic carriers may respond to the treatment with this agent. In fact, the treated patients showed a permanent inhibition of HBV replication sooner and in higher percentage with respect to untreated patients (37.5% vs 20%). IFN administration does not induce any important changes in the immunoregulatory wetwork, but is able to increase significantly the cytolytic activity of NK cells in the patients who respond to the therapy with a permanent inhibition of HBV replication. PMID- 3298413 TI - Superimposed hepatitis and the effect on viral replication in chronic hepatitis B. PMID- 3298414 TI - Spontaneous loss of HBeAg and the prevalence of HTLV-III/LAV infection in a cohort of homosexual hepatitis B virus carriers and the implications for antiviral therapy. AB - The future design of controlled trials of antiviral therapy which might include homosexual hepatitis B virus (HBV) carriers requires base-line data on the spontaneous rate of loss of HBeAg and the prevalence of human T-lymphotropic virus III (HTLV-III/LAV) infection. Fifty-one untreated HBsAg and HBeAg-positive homosexual HBV carriers were followed for a median HBeAg-positive time of 23.5 months (range 6-85.5). Ten lost HBeAg, giving an annual rate of spontaneous loss of HBeAg of 10%. This rate is considerably higher than the apparent rate in a previous report and has considerable implications for the interpretation of previous, and the design of future, controlled trials in this population. A rapid rise in the prevalence of anti-HTLV-III/LAV amongst HBV carriers was demonstrated from 1981 such that by 1984 over 60% of HBV carriers were anti-HTLV-III-positive. HBV-DNA polymerase levels were not significantly different in asymptomatic anti HTLV-III/LAV-positive compared to anti-HTLV-III/LAV-negative HBV carriers. Nevertheless, since chronic HTLV-III/LAV infection in its later stages may potentiate HBV replication, it is a factor that will need to be considered together with many others in any trial stratification procedure. PMID- 3298415 TI - Effects of captopril on renal function in patients with cirrhosis and ascites. AB - Blockade of angiotensin-converting enzyme has been variously reported to increase or to decrease sodium excretion in patients with cirrhosis and ascites. We administered captopril (50-150 mg) to 11 patients with cirrhosis and ascites to determine the effects on blood pressure, renal blood flow and sodium excretion. Plasma renin activity increased and mean blood pressure fell (by 14 mm Hg). Para aminohippurate clearances increased from 321 +/- 53 to 559 +/- 83 ml/min (P less than 0.005), but inulin clearances were minimally altered (73 +/- 8 to 76 +/- 7 ml/min), suggesting preferential dilation of glomerular efferent arterioles. Despite unchanged glomerular delivery of sodium, urinary sodium excretion fell in all subjects (from 2.70 +/- 1.00 to 0.48 +/- 0.21 mEq/h), urinary volume was reduced (377 +/- 55 to 182 +/- 42 ml/h, P less than 0.005), and the natriuretic effect of furosemide was blunted. The antinatriuretic effect of captopril may be mediated by reduced angiotensin II-mediated sodium excretion, by decreased prostaglandin production, and/or by indirect effects of reduced blood pressure. Captopril impairs rather than promotes sodium excretion. PMID- 3298416 TI - Effect of human immunodeficiency virus (HIV) infection on chronic hepatitis B hepatic viral antigen display. AB - Immunofluorescent and immunoperoxidase monoclonal antibody-based techniques were used to demonstrate hepatitis B e antigen (HBeAg) and hepatitis B c antigen (HBcAg) display in the liver biopsy specimens of 45 chronic hepatitis B virus (HBV) carriers. Anti-human immunodeficiency virus (anti-HIV)-positive HBV carriers had many more HBe- and HBc-positive hepatocyte nuclei than anti-HIV negative carriers (P less than 0.0003 and less than 0.02, respectively), and HBV DNA levels were slightly, but not significantly, increased in the positive subjects. The number of HBe- and HBc-positive nuclei were positively correlated with serum HBV-DNA levels (P less than 0.05 comparing high serum HBV-DNA levels of greater than 2880 pg/ml and levels of 1-480 pg/ml), and were negatively correlated with disease activity (P less than 0.05 comparing those with severe chronic active hepatitis (CAH) and those with mild CAH and chronic persistent hepatitis (CPH]. These results indicate that male homosexual HBV carriers, positive for anti-HIV, may be immunosuppressed before there are clinical signs of immunodeficiency, and this allows an increased level of replication of at least one other virus (HBV). PMID- 3298417 TI - Hepatic clearance and liver blood flow. PMID- 3298418 TI - Lack of sleep-inducing properties of propranolol (80 mg) in chronic insomniacs previously treated by common hypnotic medications. AB - In a double-blind, placebo-controlled crossover trial, propranolol 80 mg did not show any hypnotic properties and even increased the insomnia in a sample of 37 patients previously treated chronically with hypnotic medication (mostly benzodiazepines). This worsening of the insomnia is consistent with the observations of sleep disturbance at the beginning of treatment with beta blocking drugs. This lack of efficacy suggests that the anti-stress or anxiolytic properties of propranolol do not apply to the rebound insomnia seen when stopping treatment with hypnotic drugs. PMID- 3298419 TI - The effects of a 50% reduction of cis(z)-flupenthixol decanoate in chronic schizophrenic patients maintained on a high dose regime. AB - Eighteen chronic schizophrenic patients who had shown improvement from increased maintenance dosages of cis(z)-flupenthixol decanoate were entered into a double blind study in which half of the patients were randomly allocated to be maintained on 50% of their pre-trial dosage. During the 44 week study the reduced dosage group showed increased morbidity and one-third of these patients had a schizophrenic relapse. The greatest deterioration occurred in patients reduced from above to below 200 mg cis(z)-flupenthixol decanoate biweekly. A review of all the patients entered into the study showed a relationship between deterioration of schizophrenic and depressive features and cis(z)-flupenthixol plasma levels which reflected the administered dosage. Prolactin levels in general did not reflect control of schizophrenic symptoms. Side-effects were few, and there was no emergence of tardive dyskinesia. A multicentre trial is needed for further evaluation. PMID- 3298420 TI - A clinical study of the selective MAO-A-inhibitor moclobemide (Ro 11-1163): a comparison of 2 different dosages with particular reference to platelet MAO activity and urinary MHPG-excretion. AB - A new selective MAO-A-inhibitor (noclobemide) was used in a double-blind comparative study of 23 patients with severe unipolar or bipolar depressive disorder. Two different doses of medication were given for 4 weeks. Effectiveness was measured by improvements in the Hamilton Rating Scale for Depression, a self rating scale and clinical global impression. Platelet MAO-activity and urinary MHPG-excretion was also determined. Moclobemide proved to be a well-tolerated and effective antidepressant, with both groups showing improvement. Platelet MAO activity was not markedly influenced by moclobemide, possibly because it selectively inhibits MAO-A. Urinary MHPG did not change significantly with treatment. PMID- 3298421 TI - The influence of S-adenosylmethionine (SAM) on prolactin in depressed patients. AB - Twenty subjects entered a double-blind placebo-controlled trial of SAM in depression. Prolactin concentrations were measured before and after 14 days' treatment. There was a highly significant fall in prolactin concentrations in the SAM-treated group. PMID- 3298422 TI - Microvillus-specific Mr 75,000 plasma membrane protein of human choriocarcinoma cells. AB - We have previously purified from cultured JEG-3 choriocarcinoma cells an Mr 75,000 protein, originally detected using antibodies to a retrovirus-related synthetic peptide. Using polyclonal antibodies, we have now localized this protein immunocytochemically in JEG-3 cells at both light and electron microscopic levels. In immunofluorescence microscopy of saponin-permeabilized cells, the antigen appeared as dots and short strands at the apical cell surface. In pre-embedding immunoperoxidase electron microscopy, the Mr 75,000 protein was specifically localized to microvilli on the apical cell surface. Immunoferritin electron microscopy was used to assess more quantitatively the antigen distribution in the plane of the plasma membrane, and to define the position of the antigenic site(s) with respect to the membrane. The immunoferritin results confirmed the microvillus specificity of the Mr 75,000 protein and showed that the antigenic portion of the protein is within a few nanometers from, and on the cytoplasmic side of, the lipid bilayer. In detergent extraction experiments, the Mr 75,000 antigen was highly enriched in the soluble fractions. These results demonstrate that the Mr 75,000 protein is a membrane protein highly specific for microvilli. PMID- 3298424 TI - Immunoreactive GABA transaminase within the pancreatic islet is localized in mitochondria of the B-cell. AB - Subcellular localization of gamma aminobutyrate-alpha-ketoglutarate transaminase (GABA-T) in the pancreatic islets of Langerhans was determined by use of an electron microscopic, immunogold post-embedding protocol. The objective of this study was to define the islet cell distribution and subcellular localization of GABA-T. Within the islet, GABA-T was found only in the B-cells and was localized in mitochondria; 78 mitochondria contained 336 gold particles, whereas 245 secretory granules contained only 18 gold particles. Although studies utilizing either the isolated perfused pancreas or cultured islets have shown that exogenous GABA modulates D-cell secretion, in this study immunoreactive GABA-T, the catabolic enzyme for GABA, was not detectable in A- and D-cells of the islet. Control studies substituting normal rabbit serum for the GABA-T antiserum resulted in absence of labeling. These results indicate that the high concentration of GABA present in islet B-cells is catabolized by GABA-T in the mitochondrial compartment, consistent with the possibility that GABA functions as a mediator of B-cell activity. PMID- 3298423 TI - Immunolocalization of Gla proteins (osteocalcin) in rat tooth germs: comparison between indirect immunofluorescence, peroxidase-antiperoxidase, avidin-biotin peroxidase complex, and avidin-biotin-gold complex with silver enhancement. AB - Odontoblasts and osteoblasts synthesize gamma-carboxyglutamatic acid (Gla) containing proteins which are partially deposited in the mineralizing tissues and partially released into the plasma. Using four immunostaining techniques, we have evaluated the question of whether dentin Gla proteins (DGP) are transported to the mineralization front through the odontoblast processes. Undecalcified sections of rat incisors and molar tooth germs were immunostained with affinity purified antibodies to DGP using the following methods: indirect immunofluorescence; peroxidase-antiperoxidase (PAP); avidin-biotin-peroxidase complex (ABC-peroxidase); and avidin-biotin-gold complex with silver enhancement (ABC-GSS). The results obtained with these four procedures were compared with respect to the developmental appearance of DGP, staining intensity and presence in odontoblastic processes, predentin, dentin, and blood vessels. Qualitatively, similar results were obtained with the four, with respect to the distribution and developmental appearance of DGP, with two exceptions: indirect immunofluorescence never stained DGP within blood vessels, whereas the other methods occasionally did; and because of its sensitivity, only the ABC-GSS method revealed immunostaining for DGP in odontoblastic processes. All methods revealed weak immunostaining in predentin which was considerably enhanced with hyaluronidase treatment; however, hyaluronidase only moderately increased predentin immunostaining with ABC-GSS. Of these four procedures, ABC-GSS is the most sensitive; however, ABC-GSS appears to detect predominantly antigens at the surface of tissue sections. We conclude that DGP is present in odontoblastic processes but in low amounts; the weak staining was due either to rapid transport of DGP through the process or to the fact that this mode of transport is limited. PMID- 3298425 TI - Human neutrophilic and eosinophilic granulocytes display different levels of c fos proto-oncogene expression: an in situ hybridization study. AB - The cellular homologue of the retroviral oncogene v-fos has been shown to be involved in cell differentiation of hematopoietic cells. By use of the human promyelocyte cell line HL-60, several in vitro differentiation studies suggested a selective activation of c-fos during monocytic differentiation of myeloid precursor cells. In contrast to these observations, we found high levels of c-fos mRNA in purified normal human granulocytes, whereas c-fos was only faintly expressed in blood monocytes. In situ hybridization revealed that the high level of c-fos expression is restricted to neutrophilic granulocytes, whereas c-fos transcription is not detectable in eosinophilic granulocytes. These results indicate that in vitro differentiation systems can be misleading and may not reflect the in vivo situation. The high level of c-fos expression in neutrophilic granulocytes may be caused by superinduction due to the reduced capacity for protein synthesis in these cells. PMID- 3298426 TI - Distribution of vitamin B12 R binder in normal human tissues: an immunohistochemical study. AB - We studied the distribution of vitamin B12 R binder in various normal human tissues by use of an immunoperoxidase technique. Positive staining for R binder was observed in almost all glandular epithelia of digestive system, bronchial glands, renal proximal tubules, prostate, uterus, Fallopian tube, mammary gland, and sweat glands. The distribution of R binder was similar to that of lactoferrin and secretory component. These findings support the hypothesis that R binder plays a role in the local defense mechanism. PMID- 3298427 TI - Identification of human anti-DNA, anti-RNP, anti-SM, and anti-SS-A serum antibodies bearing the cross-reactive 16/6 idiotype. AB - The human idiotype 16/6, characteristic of lupus-derived anti-DNA autoantibodies, was detected in sera of Japanese patients with autoimmune diseases. The 16/6 positive sera were from patients with active SLE and, in one case, a scleroderma polymyositis overlap syndrome; all contained anti-ssDNA antibody. Affinity chromatography was used to isolate 16/6-bearing Ig from sera of seven patients having anti-DNA and other autoantibodies. In a preliminary step, rheumatoid factors and nonspecific binding were removed by four passes of the serum through a column of immobilized normal rabbit gamma-globulin. The absorbed sera were then applied to a column of immobilized specific rabbit anti-16/6 globulin. This combined procedure depleted anti-ssDNA activity selectively. From 44 to 60% of total Ig but only 6 to 25% of anti-ssDNA activity was recovered in the material that passed through both columns. Approximately 40% of the anti-RNP/Sm and anti SS-A/SS-B activities were recovered, reflecting a lesser degree of selective depletion of these antibodies. The specific eluate from the anti-idiotype column contained more IgG than IgM; anti-DNA activity; anti-RNP, anti-Sm, or anti-SS-A activity. Soluble DNA inhibited the binding of one eluate to RNP/Sm but not of another eluate to SS-A/SS-B. The results confirm that the genes encoding the 16/6 idiotype are widely represented in ethnically different human populations, and indicate that 16/6-bearing Ig may bind to other autoantigens as well as to DNA. PMID- 3298428 TI - Distribution and specificity of nucleotide-reactive autoantibodies in human SLE. AB - An enzyme-linked immunosorbent assay (ELISA) was utilized to characterize nucleotide-reactive antibodies present in the sera of 67 human subjects: 27 active SLE, 20 inactive SLE, and 20 asymptomatic controls. This assay consisted of measuring the quantity of antibodies retained by a panel of immobilized 5' nucleotide-BSA conjugates (AMP-, GMP-, CMP-, UMP-, and TMP-BSA) together with ssDNA and dsDNA antigens. Although the relative distribution of antibodies binding to nucleotide-BSA antigens (i.e., anti-GMP greater than anti-AMP greater than or equal to anti-TMP greater than anti-UMP greater than or equal to anti-CMP antibodies) was independent of clinical status, the sera of active SLE patients possessed three- and five-fold higher concentrations of these antibodies relative to those present in inactive SLE and control subjects, respectively. Affinity purification of the most dominant of these antibody populations with DNA- and GMP agarose adsorbents suggested that the majority of anti-GMP antibodies were monospecific with respect to the guanine base moiety. For example, antibodies retained by GMP-agarose reacted with GMP-BSA and ssDNA but not with other nucleotide-BSA or dsDNA antigens. However, ELISA competition-inhibition studies with affinity-purified anti-GMP antibodies indicated that although the guanine base represents an important determinant, guanine-enriched oligo- and polynucleotides were preferred substrates (i.e., guanine-dependent, oligonucleotide specificity). This was exemplified by the finding that a 500- and 50-fold molar excess of dGMP and d(G)4 were required to achieve the same degree of inhibition as that observed with d(G)8. Finally, and as evaluated by indirect immunofluorescence with fixed HEp-2 cells, affinity-purified anti-GMP antibodies reacted with antigens restricted to nucleolar organelles. PMID- 3298429 TI - Enhanced killing of Candida albicans by murine macrophages treated with macrophage colony-stimulating factor: evidence for augmented expression of mannose receptors. AB - The effect of macrophage colony-stimulating factor (CSF-1) on killing of Candida albicans by murine peritoneal macrophages was determined. The killing capacity of resident peritoneal macrophages was unaffected by CSF-1. However, proteose peptone-elicited peritoneal exudate macrophages that had been pretreated with CSF 1 (greater than or equal to 1000 U/ml) for 24 or 48 hr exhibited a significantly enhanced capacity to kill C. albicans. CSF-enhanced killing appeared to be independent of endogenously produced interferon-alpha/beta (IFN) in that enhancement by these two agents differed with regard to onset of the effect, target cell responsiveness, and duration of augmented killing. In addition, a highly specific anti-IFN antiserum that totally neutralized IFN augmentation of candidacidal activity had no effect on CSF-induced enhancement. Evidence was obtained indicating that CSF, unlike IFN, augmented mannose-inhibitable binding and ingestion of C. albicans, suggesting that augmented expression of mannose receptors by CSF-treated macrophages was at least partially responsible for the enhanced killing. PMID- 3298430 TI - Interleukin 1 stimulates human endothelial cells to produce granulocyte macrophage colony-stimulating factor and granulocyte colony-stimulating factor. AB - Endothelial cells are a potent source of hematopoietic growth factors when stimulated by soluble products of monocytes. Interleukin 1 (IL 1) is released by activated monocytes and is a mediator of the inflammatory response. We determined whether purified recombinant human IL 1 could stimulate cultured human umbilical vein endothelial cells to release hematopoietic growth factors. As little as 1 U/ml of IL 1 stimulated growth factor production by the endothelial cells, and increasing amounts of IL 1 enhanced growth factor production in a dose-dependent manner. Growth factor production increased within 2 to 4 hr and remained elevated for more than 48 hr. To investigate the molecular basis for these findings, oligonucleotide probes for granulocyte-macrophage colony-stimulating factor (GM CSF), granulocyte colony-stimulating factor (G-CSF), macrophage colony stimulating factor (M-CSF), and multi-CSF were hybridized to poly(A)-containing RNA prepared from unstimulated and IL 1-stimulated endothelial cells. Significant levels of GM-CSF and G-CSF, but not M-CSF or multi-CSF, mRNA were detected in the IL 1-stimulated endothelial cells. Biological assays performed on the IL 1 stimulated endothelial cell-conditioned medium confirmed the presence of both GM- and G-CSF. These results demonstrate that human recombinant IL 1 can stimulate endothelial cells to release GM-CSF and G-CSF, and provide a mechanism by which IL 1 could modulate both granulocyte production and function during the course of an inflammatory response. PMID- 3298431 TI - Immunoprotective murine monoclonal antibodies specific for the outer-core polysaccharide and for the O-antigen of Escherichia coli 0111:B4 lipopolysaccharide (LPS). AB - The antigen specificity of two immunoprotective monoclonal antibodies derived from mice immunized with Escherichia coli 0111:B4 bacteria and boosted with purified lipopolysaccharide (LPS) were investigated. One of the antibodies, B7, was shown by sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunostaining to bind to the O-antigen containing LPS species, whereas the other antibody, 5B10, reacted with both O-antigen containing homologs and the O-antigen deficient LPS. 5B10 did not bind to LPS from E. coli J5, an Rc mutant of E. coli 0111:B4 that lacks both the O-antigen and outer core sugars. 5B10 did not cross react with LPS from several other E. coli strains. Thus 5B10 appeared to recognize a type-specific epitope in the outer core of LPS exclusive of Rc determinants. The monoclonal antibody specific for the polymeric O-antigen is of the IgG3 subclass, and the monoclonal antibody 5B10 specific for the outer core of LPS is an IgG2a. Although B7 and 5B10 were equally able to protect mice from a lethal challenge of E. coli 0111:B4 organisms, the outer core-specific IgG2a antibody was much more efficient at mediating the binding of human complement C3 than the O-antigen-specific IgG3 monoclonal antibody. PMID- 3298432 TI - Receptor-like role of HLA-class I antigens: regulation of T cell activation. AB - Class I major histocompatibility antigens are known to restrict the cytotoxic activity of T lymphocytes. However, experiments using monoclonal antibodies against class I antigens showed that these antigens also play some role in the regulation of T cell activation. Three monoclonal antibodies, namely W6/32 (anti class I HLA-A, B, C, antigens), 4E (anti-class I HLA-B antigens), and BBM.1 (anti beta 2-microglobulin) significantly suppressed the phytohemagglutinin-induced T cell proliferation. The inhibitory effect of anti-class I antibody was found to depend on the presence of monocyte/macrophage-type adherent cells. In the presence of antibody, adherent cells released a factor that suppressed T cell proliferation. These results suggest that HLA class I antigens on Mo1+ monocyte/macrophage cells function like ligand-receptor molecules, and regulate the secretion of suppressor factor(s). PMID- 3298433 TI - Neutrophil chemotactic factor produced by lipopolysaccharide (LPS)-stimulated human blood mononuclear leukocytes: partial characterization and separation from interleukin 1 (IL 1). AB - LPS stimulated human blood mononuclear leukocytes to produce a chemotactic factor for human neutrophils. The effect of LPS was dose-dependent; 10 micrograms/ml was optimal for production of chemotactic factor. Chemotactic activity was detected 3 hr after LPS stimulation, and reached its peak at 12 hr. No activity was detected in culture supernatants of unstimulated cells, provided LPS-free media were selected. Isoelectric point of the factor, determined by chromatofocusing, was approximately 8 to 8.5. Molecular weight was approximately 10 kilodaltons by Sephacryl S-200 gel filtration or by HPLC gel filtration on TSK-2000 and -3000 columns in succession. The gel filtration fractions were also assayed for IL 1 activity. The elution position of IL 1 activity corresponded to a m.w. of 18. There was no chemotactic activity in the IL 1 activity peak. Furthermore, highly purified natural Il 1 alpha and -beta and recombinant Il 1 alpha and -beta did not exhibit chemotactic activity for neutrophils in our assay. Among mononuclear leukocytes, the monocyte was the principal producer of neutrophil chemotactic factor. These results suggest that a chemotactic factor for neutrophils, different from IL 1, is produced by LPS-stimulated blood monocytes. PMID- 3298435 TI - A competitive inhibition test of enzyme immunoassay for the anti-nRNP antibody. AB - A competitive inhibition test for anti-nRNP antibody was developed, using horseradish-peroxidase-labelled anti-nRNP IgG derived from the serum of a patient with mixed connective tissue disease. In this test, the anti-nRNP antibody was clearly distinguished from the anti-Sm antibody in the patients' sera, and the sensitivity of the assay for anti-nRNP antibody was close to 50 ng/ml. PMID- 3298434 TI - Biosynthesis and glycosylation of p150,95 and related leukocyte adhesion proteins. AB - The p150,95 cell surface protein is a member of a family of heterodimeric leukocyte adhesion proteins that have homologous alpha subunits, each noncovalently associated with a common beta subunit. In this report we have metabolically labeled the U937 cell line at various timepoints during its phorbol myristic acetate-induced maturation to examine the kinetics of synthesis of these proteins during monocytic differentiation, and their maturation and glycosylation. The p150,95 alpha subunit was immunoprecipitated with p150,95 specific monoclonal antibody (MAb), or an antiserum to the denatured, purified alpha X subunit. The glycosylation and polypeptide chain length of the p150,95, Mac-1, and lymphocyte function associated antigen (LFA-1) alpha and beta subunits were compared by immunoprecipitation with subunit specific MAb and antisera, and by digestion with Endo H and N-glycanase. The p150,95 alpha subunit is synthesized as a precursor of 146,000 Mr, has five to six N-linked oligosaccharides, and has a polypeptide chain backbone of 132,000 Mr. Over 50% of the carbohydrate on the mature alpha subunit of 150,000 Mr was sensitive to Endo H digestion. The p150,95 alpha and beta precursors can associate before maturation into the mature form. Conversion to the mature form was accompanied by loss of reactivity with the antiserum to the denatured alpha X subunit, suggesting a change in conformation. Mac-1 and LFA-1 alpha subunits have precursors of 160,000 Mr and 165,000 Mr, respectively, and contain N-linked carbohydrates. The polypeptide chain length for the Mac-1 alpha subunit is 137,000 Mr, and for LFA-1 is 149,000 Mr. Only 14% of the oligosaccharide on the mature LFA-1 alpha subunit was sensitive to Endo H, suggesting that unlike p150,95, most is converted to the complex type. The differences noted in the Mr of the three homologous alpha subunits are therefore due to differences in both polypeptide chain length and carbohydrate processing during biosynthesis. PMID- 3298436 TI - Method of analysis of non-competitive enzyme immunoassays for antibody quantification. AB - A computerized analysis of a quantitative enzyme-linked immunoadsorbent assay (EIA) using a non-specific immunoglobulin (IgG) of known concentration as the standard has been developed for measuring specific antibody levels in serum without the need for affinity purification of the positive control antibody. The computer program utilized logit-log linear regression analysis of sigmoid serial dilution curves plus a weighted least-squares best curve fit analysis and an iterative manipulation to eliminate errant data points. The EIA was performed using serial dilutions of standard and unknown antibodies, and a double sandwich technique. A comparison of antibody levels determined by EIA using non-specific IgG as a standard relative to antibody levels determined using affinity-purified specific antibody as a standard were 1.04, 0.53, 0.48, and 0.97 for four different polyclonal antibody systems. Five monoclonal antibodies to carcinoembryonic antigen gave ratios as described above of 1.07, 1.59, 1.73, 2.32, and 2.42. The corresponding antibody affinity constants (1/mol) were 1.0 X 10(8), 3.8 X 10(8), 5.5 X 10(9), 1.8 X 10(10), and 2.6 X 10(10) respectively. This method permits accurate quantification of serum antibody levels when affinity-purified antibodies are not readily available and avoids errors due to loss of antibody activity during affinity purification. PMID- 3298437 TI - Functional neutrophils from long-term murine bone marrow cell cultures. AB - Murine bone marrow cell cultures that had been established for up to 26 weeks were harvested each week and found to provide functional neutrophils. Leukocytes harvested from the cultures were enriched for neutrophils using discontinuous Percoll density gradients. These cells mounted a chemiluminescence response to Proteus mirabilis in the presence of normal mouse serum (NMS). They killed several NMS-opsonised bacterial species, an activity that was blocked by a monoclonal antibody to the C3 receptor of mouse neutrophils. Cultured bone marrow neutrophils expressed both Fc and C3 receptors. C3 receptor expression could be augmented by exposure to the chemotactic peptide f-Met-Leu-Phe. We conclude that murine bone marrow cell cultures provide a useful source of functional neutrophils, and that their productivity can be sustained in long-term culture. As their receptor expression can be augmented from the resting state by exogenous stimuli, they represent a useful cell source in studies of neutrophil activation. PMID- 3298438 TI - Re.: Colour stability of new anti-HIV immunogold blotting versus conventional immunoblotting techniques. PMID- 3298439 TI - Immunoblot analysis: a new method for fingerprinting hospital pathogens. AB - Immunoblotting has recently become popular as a way of fingerprinting those hospital pathogens where other more conventional typing systems are deficient. Extracts of microorganisms are prepared by chemical or enzymic means, run on a standard SDS-PAGE gel and transferred onto nitrocellulose membrane. They are then probed either by a hyperimmune antiserum raised in a rabbit or by serum from a patient who has been previously infected by the organism. The pattern of antigenic bands which stain forms the basis of the method. This article discusses the limitations of the system, makes recommendations for further systems and outlines a typical fingerprinting protocol. PMID- 3298440 TI - Antigen leakage from immunosorbents. Implications for the detection of site directed auto-anti-idiotypic antibodies. AB - The detection of site-directed anti-idiotypic antibodies is usually based on their ability to inhibit the binding of antigen to idiotype, in either solid- or fluid-phase radioimmunoassays. Passage of serum over antigen-coupled immunosorbents for the purpose of removing the idiotypes from complexes with putative anti-idiotypic antibodies resulted in the release of significant amounts of antigen into the effluents. Normal sera or even isotonic buffers were similarly contaminated with antigen. The amount of antigen released ranged between 200-400 ng/ml, well in excess of the minimal amount required in the inhibition assay. Antigen was detected in effluents passed over a number of antigen coupled-matrices and even in affinity-purified antibody preparations obtained by elution from immunosorbents coupled with dinitrophenyl (DNP)-protein conjugates. Attempts to stabilize the antigen-coupled matrices with glutaraldehyde resulted in a perceptible but insufficient decrease in the amount of antigen released. In the case of anti-hapten antibodies, antigen interference was circumvented by utilizing monovalent haptens such as DNP-lysine coupled to the immunosorbent either directly or through a spacer arm. In the case of protein antigens, the leakage was almost completely prevented by preparing glutaraldehyde polymerized immunosorbents directly from solution. PMID- 3298441 TI - Human monoclonal antibody production. Current status and future prospects. PMID- 3298442 TI - A simple method to eliminate the antigenicity of surface class I MHC molecules from the membrane of viable cells by acid treatment at pH 3. AB - We describe here a simple, reproducible method which specifically eliminates the antigenicity of surface class I major histocompatibility complex (MHC) molecules by acid treatment at pH 3 from the membrane of viable cells. When fresh mononuclear cells (MNC) or established cultured cell lines were treated at 4 degrees C for 2 min with citric acid buffer at pH 3 containing 1% bovine serum albumin, the antigenicity of class I MHC molecules, but not those of class II MHC and the other non-MHC antigens, was eliminated from the surface membrane without significant cell death. This method was effective for both human and murine cells with various origins. Monoclonal and polyclonal antibodies were used to identify the expression of surface antigens in conjunction with immunofluorescence tests. The eliminated antigenicity of human class I MHC antigens (i.e., HLA-A,B,C) on MNC regenerated when cells were incubated in the medium at 37 degrees C for 10 h. The pretreatment of cells with emetine (10(-4) M), a protein synthesis inhibitor, was found to be effective in inhibiting this regeneration. The acid treatment method might be useful for future studies on the functional characterization of surface class I MHC antigens. PMID- 3298443 TI - Evaluation of the apical seal produced by the McSpadden compaction, lateral condensation method and a chloroform softened primary cone. PMID- 3298444 TI - Natural killer cells express the CD16 antigen. PMID- 3298445 TI - IgA immune complexes in patients with dermatitis herpetiformis occur in the absence of IgA rheumatoid factor. AB - Thirty to forty percent of patients with dermatitis herpetiformis (DH) have IgA containing circulating immune complexes (IgA-CIC); however, the antigenic composition of these complexes as well as the role they play in the pathogenesis of DH are unknown. The failure to detect wheat protein in these IgA-CIC, despite the association of DH with gluten-sensitive enteropathy, suggests that the IgA CIC in DH may be similar to those seen in the IgA nephropathies and represent IgA rheumatoid factor (RF)-IgG complexes. We have examined the sera of 32 patients with DH, 16 non-DH patients positive for RF by latex fixation, and 15 normal subjects for IgA and IgM RF using enzyme-linked immunosorbent assays (ELISAs) and for IgA-CIC using an anti-C3 ELISA. Thirteen of 16 (81%) latex fixation test positive patients had IgA RF by ELISA and 15/16 (94%) had IgM RF by ELISA. The total amount of RF detected by the ELISA (IgA + IgM RF) correlated with the latex fixation titer (r = 0.678, p = 0.004) in these latex fixation-positive patients. Six of the 16 (38%) latex fixation-positive patients also were found to have IgA CIC. Solid phase absorption using goat antihuman C3 decreased the levels of immune complexes but not the level of IgA RF, suggesting the IgA-CIC detected do not represent uncomplexed IgA RF. In contrast, although 12 of 31 (39%) patients with DH had IgA-CIC ranging in amount from 0.331-26.0 micrograms IgA/ml (nl less than 0.150 microgram IgA/ml), only 1 of 32 (3%) DH patients had detectable levels of IgA RF (7.0 micrograms IgA/ml, nl less than 2.0 micrograms IgA/ml). Low levels of IgM RF were found in 8/32 (25%) of patients with DH (1.1-1.6 micrograms IgM/ml, nl less than 1.0 microgram IgM/ml). These data document that IgA RF is not present in the sera of patients with DH independent of the presence or absence of IgA-CIC and that it is unlikely that the IgA-CIC present are IgA RF complexed with autologous IgG. PMID- 3298446 TI - Immunophenotyping of the cutaneous infiltrate and of the mononuclear cells in the peripheral blood in patients with atopic dermatitis. AB - Fourteen adult patients with chronic atopic dermatitis and active skin lesions had a skin biopsy and venous blood sample taken on the same day. Absolute numbers of circulating lymphocytes were normal in all patients. Fluorescence-activated cell sorter (FACS) analysis revealed normal numbers of total T lymphocytes and T helper and T-suppressor subsets (helper:suppressor ratio, 2:1) in the atopic patients' peripheral blood, but an increase in circulating B lymphocytes and in HLA-D-related antigen-bearing cells. The skin biopsy showed a dermal infiltrate of predominantly T-helper lymphocytes (helper:suppressor ratio, 7:1). These cells showed strong HLA-DR plasma membrane staining. There was no HLA-DR staining in the membranes of epidermal keratinocytes. Using a monoclonal antihuman IgE, positive staining was observed in the dermis, though none was identified in the epidermis. The dermal anti-IgE staining was concentrated around clusters of T lymphocytes. PMID- 3298447 TI - Identification of new components of the cornified envelope of human and bovine epidermis. AB - Antibodies raised in rabbits to purified cornified envelopes (CEs) of cultured human keratinocytes reacted in a peripheral fashion with the granular and spinous layers of human, cow, rat, and mouse epidermis. This reaction could not be abolished by absorption of the antibody with purified human involucrin to which the antibody reacted by immunoblot, thus indicating the presence of an additional antigenic determinant(s). Antibodies raised to CEs of human epidermis stained the cytoplasm of epidermal cells and gave a strong reaction to cytokeratins and a weak one to involucrin, indicating that in tissue the keratins are also cross linked. The antibody prepared to bovine CEs reacted with keratins, but when absorbed with prekeratin it gave a peripheral staining pattern with epidermis and reacted strongly with a 126 kD component of the neutral buffer extract of cow snout epidermis and weakly with 205 kD and 85 kD ones. This antibody reacted with human involucrin by immunoblot while an antibody to involucrin stained 143 kD, 119 kD, 113 kD, and 107 kD polypeptides in the bovine extract. These latter 3 bands were shown to be substrates of transglutaminase. Further, a monoclonal antibody to bovine CEs reacted with the 119 kD and 113 kD bands and gave a peripheral staining pattern in the epidermis. Proof that the 126 kD protein was a precursor of the envelope was obtained by preparing an antibody to it and demonstrating peripheral staining of epidermal cells. These results point out the value of preparing antibodies to CE as an additional approach to studying the composition of CEs and demonstrate previously undescribed components in human and bovine tissue. PMID- 3298448 TI - Interactions between fibroblasts and a reconstituted basement membrane matrix. AB - A gel-like reconstituted basement membrane matrix containing type IV collagen, laminin, entactin, nidogen, and heparan sulfate proteoglycan was used to examine the interactions between normal calf skin fibroblasts and basement membranes. Within 6 h after seeding, fibroblasts initiated a migration that resulted in the formation of a cellular network after 1 day of culture on top of the gel. Electron microscopy revealed that fibroblasts were able to remodel the basement membrane matrix by penetrating into the gel (from day 3), depositing fibronectin and collagen fibers, and retracting this extracellular matrix. Fibroblasts cultured on the Engelbreth-Holm-Swarm reconstituted basement membrane matrix displayed ultrastructural features characterized by a poor synthetic apparatus (rough endoplasmic reticulum and Golgi vesicles), a large cytoskeleton, and intracytoplasmic vesicles containing laminin. Thus the reconstituted basement membrane matrix is remodeled by skin fibroblasts, and reciprocally their ultrastructural morphologic features are affected by this matrix. PMID- 3298449 TI - The carboxylpropeptide of type I procollagen in skin fibrillogenesis. AB - Previous studies suggested that the aminopropeptide of type I procollagen may initiate fibril formation. The purpose of this investigation was to study the location of the carboxylpropeptide of type I procollagen during collagen fibrillogenesis. Chick embryonic and posthatching skin specimens were studied by immunofluorescence and immunoelectron microscopy and by immunoblotting with antibodies against the amino and carboxylpropeptide of type I procollagen. The carboxylpropeptide was demonstrated at the surface of collagen fibrils, 20-40 nm in diameter (10-day embryos) and in fibrils, 40-65 nm (21-day embryos). In addition, the carboxylpropeptide was found at the cell surface and free in the ground substance. The aminopropeptide was only seen in fibrils, 20-30 nm in diameter, as previously reported. Ratios of pN-collagen/pC-collagen increased from 16 days embryonic to 3 and 9 days postembryonic skins. This study suggests that both pN-collagen (aminopropeptide plus collagen) and pC-collagen (carboxylpropeptide plus collagen) participate in fibrillogenesis. PMID- 3298450 TI - Contribution of neutrophils and cell-mediated immunity to control of Nocardia asteroides in murine lungs. AB - To distinguish between the contributions of neutrophils and cell-mediated immunity to defense against Nocardia asteroides in the lung, we induced pneumonia in BALB/c mice by intranasal inoculation. We studied the course of pneumonia by histology, bronchoalveolar lavage, and quantification of colony-forming units in lungs. Mice with intact host defenses had an initial inflammatory response, consisting mostly of neutrophils, followed by a mononuclear cell infiltrate. Nocardiae were eradicated during the seven days after inoculation. Mice in which the early, predominantly neutrophil inflammatory response was prevented with mechlorethamine or antiserum to neutrophils had little inflammation, and nocardiae grew extensively. Mice in which cell-mediated immunity was impaired with cyclosporin A or cortisone acetate developed abscesses; neutrophils were abundant, but nocardiae proliferated. The occurrence of these three separate and distinct patterns suggested that both neutrophils and cell-mediated immunity are necessary for optimal control of N. asteroides infection. PMID- 3298451 TI - A DNA probe to identify enterohemorrhagic Escherichia coli of O157:H7 and other serotypes that cause hemorrhagic colitis and hemolytic uremic syndrome. AB - Enterohemorrhagic Escherichia coli (EHEC) cause hemorrhagic colitis and hemolytic uremic syndrome (HUS), make potent cytotoxins (Verotoxins [VT] or Shiga-like toxins), and possess a plasmid (approximately 60 megadaltons) that encodes a new fimbrial antigen and promotes attachment to epithelial cells. We evaluated the use of a DNA probe, prepared from a 3.4-kilobase segment of the EHEC plasmid, to detect EHEC. The probe hybridized with 106 (99%) of 107 O157:H7 and 34 (77%) of 44 O26:H11, VT-positive strains from patients with colitis, HUS, and diarrheal disease and hybridized with 21 (81%) of 26 VT-positive E. coli of serotypes other than O157:H7 or O26:H11 from patients with hemorrhagic colitis and HUS. We examined 601 other strains, including 18 serotype O26 isolates of H types other than H11, 306 enteropathogenic E. coli, 60 enteroinvasive E. coli, 119 enterotoxigenic E. coli, and 20 isolates from the urinary tract and 77 isolates from the normal intestinal flora; only one (O127:H-) was positive (specificity, 99.8%). Serotype O26:H11, previously considered a classic enteropathogenic E. coli serotype, is now shown to be EHEC. PMID- 3298452 TI - Cross-reactivity in serological tests for Lyme disease and other spirochetal infections. AB - Serum specimens from 163 persons with Lyme disease, tick-borne or louse-borne relapsing fever, yaws, syphilis, leptospirosis, or Rocky Mountain spotted fever were analyzed to assess the specificity of indirect fluorescent antibody (IFA) tests, an enzyme-linked immunosorbent assay (ELISA), and microscopic agglutination (MA) procedures. Strong cross-reactivity occurred when sera from individuals with Lyme disease, tick-borne relapsing fever, and louse-borne relapsing fever were tested against heterologous Borrelia antigens. Antibodies to Borrelia burgdorferi bound to Treponema pallidum in immunofluorescence tests for syphilis. Sera from subjects with syphilis cross-reacted in IFA tests and the ELISA for Lyme disease. Immunoglobulin antibodies to Borrelia or Treponema spirochetes, however, did not react with serovars of Leptospira interrogans in MA or IFA tests, and the prevalence of false-positive results in the reciprocal analyses was negligible. PMID- 3298453 TI - Mitochondrial DNA polymorphism in Candida albicans. PMID- 3298454 TI - Activity of minocycline in Mycobacterium leprae-infected mice. PMID- 3298455 TI - Serogroup distribution of Cryptococcus neoformans in patients with AIDS. PMID- 3298456 TI - Transient fungemia in acute pulmonary histoplasmosis: detection by new blood culturing techniques. AB - Transient fungemia has been thought to occur with acute pulmonary histoplasmosis in humans, but this has never been confirmed. We report two cases of acute pulmonary histoplasmosis in which transient fungemia was detected by the lysis centrifugation blood-culturing technique. Both patients had self-limited acute pulmonary histoplasmosis, and neither was treated with antifungal therapy. Follow up evaluation at three years and at 17 months disclosed no evidence of active pulmonary or disseminated disease. Transient Histoplasma capsulatum var. capsulatum fungemia may occur with acute pulmonary histoplasmosis. Fungemia may be prevented or arrested by an intact immune system or by other factors not yet known. PMID- 3298457 TI - Hybridoma antibodies to the lipid-binding site(s) in the amino-terminal region of fibronectin inhibits binding of streptococcal lipoteichoic acid. AB - In this report, we present evidence to suggest that streptococci and lipoteichoic acid (LTA) interact with a fatty acid binding site located near the NH2-terminus of fibronectin. The evidence is based on the following observations. Antibodies directed against a synthetic peptide (residues 1-30 of the amino-terminus of fibronectin) reacted with the two thermolysin-generated peptides (24 and 28 kilodaltons [kDa]) that were adsorbed by and eluted from streptococci. The adsorption of the 24- and 28-kDa peptides to streptococci was inhibited by LTA. The two monoclonal antibodies that inhibited the binding of LTA to fibronectin reacted only with the 24- and 28-kDa fragments of fibronectin. Conversely, LTA, as well as lauric acid and oleic acid, blocked the binding of the same monoclonal antibodies to fibronectin. LTA had no effect on the binding of hybridoma antibodies directed against the collagen or cell-binding domain. PMID- 3298458 TI - A monoclonal antibody-based enzyme immunoassay for detecting parasite antigenemia in bancroftian filariasis. AB - We evaluated a monoclonal antibody-based enzyme immunoassay for detecting soluble parasite antigen in sera collected in an area in South India endemic for Wuchereria bancrofti. Filarial antigen was detected in sera from 56 of 57 microfilaremic patients, 9 of 64 aminofilaremic patients with clinical filariasis, and 11 of 70 endemic controls. Antigen was not detected in sera from patients from nonendemic areas who had a variety of other filarial and nonfilarial helminth infections. Parasite antigen titers were significantly correlated with microfilarial counts in night blood smears (r = .64, P less than .01). Negative antigen tests in patients with clinical filariasis may be explained in part by antibody-mediated clearance of circulating antigen. Antibodies to circulating W. bancrofti antigen were detected in 41 of 55 antigen negative sera from patients with clinical filariasis. Despite this limitation, detecting parasite antigen by enzyme immunoassay provides significant advantages over previously available methods for diagnosing active W. bancrofti infection. PMID- 3298459 TI - Antibody response in Yersinia pseudotuberculosis III infection: analysis of an outbreak. PMID- 3298460 TI - Comparison of CFA/I:ST plasmids of enterotoxigenic Escherichia coli. PMID- 3298462 TI - Isolation of viruses from nasopharyngeal secretions: comparison of aspiration and swabbing as means of sample collection. PMID- 3298461 TI - Listeria monocytogenes arthritis in a renal transplant recipient. PMID- 3298463 TI - In vitro predictive testing: the sulfonamide era. AB - Since initial reports of use of a human tumor cloning system to predict response or lack of response of a patient's tumor to chemotherapy, there have been approximately 2,166 clinical correlations attempted. Overall, the percent true positives has been 69% while the percent true negatives has been 92%. Despite the high reliability of this system to predict patient response or lack of response, the cloning assay has not been put into general clinical use. Reasons for this include the past inability to grow a majority of the patients' malignancies and lack of controlled trials demonstrating an advantage of a cloning assay choice over a clinician's choice. Both of these problems are being addressed with greatly improved abilities to grow patient malignancies (70%-80% of patients' tumors can now be grown in vitro) and the reporting of results of prospectively controlled randomized trials. It is likely that the most significant limitation for the human tumor cloning assay will be the lack of agents with in vitro activity. It is proposed that we are in the "sulfonamide era" of in vitro drug sensitivity testing of human tumors. It is unlikely any predictive assay will be of major utility until a more active spectrum of agents becomes available for in vitro testing and in vivo treatment. PMID- 3298464 TI - [Experimental study of the effects of ventricular fibrillation at 20 degrees C on myocardial preservation]. PMID- 3298465 TI - [Report of a successful repair, in a 3-year-old girl, of innominate artery stenosis associated with aortic coarctation, using cardiopulmonary bypass]. PMID- 3298466 TI - The molecular forms of interleukin-1. PMID- 3298468 TI - [Staining of leiomyoma tissue and myoma-derived cultured cells by the enzyme labelled antibody method--using desmin, vimentin and fibronectin]. AB - To elucidate the pathogenesis of leiomyoma, myoma tissues and myoma-derived cultured cells were stained with desmin, vimentin and fibronectin by the enzyme labelled antibody method. Desmin staining was positive in both the myoma tissues and the cultured cells. Vimentin staining was positive in endothelial cells in the blood vessels of the myoma and in the cultured cells. Fibronectin staining was positive in both the myoma and cultured cells. These findings demonstrate that the leiomyoma was derived from myogenic cells. It was suggested that the myoma-derived cultured cells were myofibroblasts with myoblasts and fibroblasts, and had the ability to differentiate. It appears that the original cells of the myoma differentiate to myofibroblasts, which then differentiate into myoblasts and fibroblasts. PMID- 3298467 TI - Distinguishable pathways of viral antigen presentation to T lymphocytes. PMID- 3298470 TI - [Transient hyperprolactinemia during ovulation induction with gonadotropin releasing hormone (GnRH) pulsatile administration]. AB - Seven clomiphene-resistant normoprolactinemic anovulatory patients were treated with GnRH pulsatile administration (total 15 treatment cycles). Several problems with GnRH pulse therapy were raised through 6 unsuccessful cases. In 5 cases (10/15 treatment cycles), transient hyperprolactinemia (50-100 ng/ml) appeared immediately after the initiation of the treatment and persisted for 6-10 days. Follicle maturation and ovulation was not induced in these cases. Frequent blood sampling failed to demonstrate GnRH-induced LH secretion in 3 cases. Synchronous secretion of PRL with LH was observed when serum PRL levels were low, but not in situations with elevated serum PRL levels. The lack of GnRH-induced LH secretion indicates the down-regulation of the pituitary with increased frequency of GnRH pulses due to intrinsic and exogenous GnRH. The synchrony of LH and PRL suggests the contribution of GnRH-mediated PRL releasing factor (PRF) through a paracrine system between gonadotrophs and lactotrophs. Transient hyperprolactinemia observed in the current study might be attributable to a relative increase in GnRH to a GnRH-associated peptide (GAP), a constituent of GnRH prohormone and possessing an intrinsic effect of PRL suppression, by exogenously administered GnRH, causing overwhelming superiority of GnRH-mediated PRF. Transient hyperprolactinemia and regulation of the pituitary may hamper ovulation induction with GnRH pulse therapy when applied to cases with intact hypothalamic-pituitary axis. PMID- 3298469 TI - [Results of fetoscopic examinations at our hospital]. AB - From 1983 to 1985, antenatal diagnosis by fetoscopy under ultrasound guidance has been performed at our institute for 17 pregnant women between 15 and 34 weeks of gestation. Indications for fetoscopy were visualization of the fetus, placenta, and amniotic membrane for morphological anomaly and fetal blood sampling for coagulation disorder. The diagnosis, made by visual observation of the fetus, blood coagulation tests, and karyotyping revealed 12 normal fetuses and 5 abnormal fetuses (one having chromosome abnormality, one amniotic band syndrome, one cephalothracopagus, one Beckwith-Wiedemann syndrome, and one sacral tumor). Courses of pregnancy following fetoscopy resulted in four normal full-term deliveries, six premature deliveries due to four hydramnions and two spontaneous ruptures of the membrane more than 14 weeks after fetoscopy. Three other pregnancies were interrupted due to intrauterine fetal death 11 weeks after fetoscopy in one case and to therapeutic abortion for maternal complications such as toxemia of pregnancy in two cases. The outcome of one case was unknown because the mother had moved away. The other pregnancy is still under observation at the third trimester. Although no complications in the fetuses were seen following fetoscopy, complications in the mothers included two cases of genital bleeding, one case of amniotic fluid leakage, and one cases of abruption of the fetal membrane. Symptoms in all four cases disappeared during several days of bed rest. These results demonstrate the importance of fetoscopy in prenatal diagnosis. PMID- 3298471 TI - [The effect of bismuth subnitrate on cisplatin toxicity]. AB - Bismuth subnitrate (BSN), a bismuth compound medically used for antidiarrheics, was orally administered to see whether it can reduce CDDP nephrotoxicity or not. Thirteen patients aged 19 approximately 60 with ovarian cancer entered this BSN CDDP trial. A total of thirty three courses of BSN-CDDP treatment was undergone. BSN was administered orally at a dose of 50 mg/kg for five days before CDDP therapy. CDDP was infused for two hours. No vigorous hydration or diuresis was performed. Only 2,000 ml of saline with 20 mEq per liter of KCl was given for post-hydration. The median dose of CDDP was 100 mg/m2. The renal toxicity of BSN CDDP treatment was minimum. 82% of the courses at the sixth day after the treatment had creatinine clearance levels which were more than 80% of those before the treatment. But twenty-four hour NAG and beta 2-microglobulin excretion were significantly increased. Bone marrow suppression and gastrointestinal disturbance were commonly observed. The results of our study indicate that BSN pretreatment reduces the renal toxicity of CDDP to some extent. PMID- 3298473 TI - Defective monocyte chemotaxis in active lepromatous leprosy. AB - This study of monocyte chemotaxis in leprosy patients showed a significant inverse correlation (p less than 0.05) of chemotaxis and the bacterial index (BI) (N = 22). In addition, there was a significant inverse correlation (p less than 0.05) between chemotaxis and the serum levels of anti-phenolic glycolipid-I IgM antibodies (N = 20). Patients taking thalidomide who had a BI greater than or equal to 1 had a significantly greater (p less than 0.001) chemotaxis response than that of patients with the same BI who were not taking thalidomide. No significant decrease in chemotaxis of monocytes from healthy donors was observed when the cells were pre-incubated with serum from 18 leprosy patients. We conclude that monocytes from patients with active lepromatous leprosy not receiving thalidomide have an intrinsic abnormality when assessed by chemotaxis. PMID- 3298472 TI - Assessment of the immune deficit in leprosy patients and the effect of recombinant IL-2 in vitro. AB - Although the mechanism of immunologic unresponsiveness in lepromatous leprosy remains unknown, it has been shown that interleukin-2 (IL-2) production is defective in these patients. Peripheral blood mononuclear cells (PBMC) were isolated from treated (less than 16 months) and untreated leprosy patients as well as household contacts; age, sex, ethnically matched control subjects; and laboratory staff. PBMC were cultured for 6 days with sonicated Mycobacterium leprae (1-10 micrograms/ml), Dharmendra lepromin (1:10), or phenolic glycolipid-I (PGL-I) (0.05-5.0 micrograms/ml) in medium supplemented with various concentrations of recombinant IL-2 (rIL-2) or cultured for 3 days with one of the three mycobacterial antigens in the presence of concanavalin A (ConA). TT/BT patients and household control subjects had a robust response to M. leprae and lepromin, but were unresponsive to PGL-I delivered in liposomes. PBMC from LL patients did not respond to any of the three antigen preparations. rIL-2 induced proliferation of PBMC both in leprosy patients and control subjects regardless of the presence or absence of the three leprosy antigen preparations. This antigen nonspecific augmentation of proliferation by the wide range of doses of rIL-2 employed makes difficult the interpretation of the enhanced thymidine incorporation noted when rIL-2 is added in the presence of antigen to cultures of lymphocytes from LL patients. Our studies are at variance with reports that leprosy antigens, specifically PGL-I, induce immunological suppression, in that mycobacterial antigens did not cause significant suppression of the ConA-induced proliferations of PBMC from patients. PMID- 3298474 TI - Sensitivity and specificity of the FLA-ABS test for leprosy in Mexican populations. AB - The epidemiological surveillance for leprosy must include several clinical and laboratory procedures. The FLA-ABS test of Abe could be a useful tool for this purpose because it allows the demonstration of an effective contact with Mycobacterium leprae. In order to establish the specificity, sensitivity, and predictability of the FLA-ABS test under Mexican conditions, we studied sera collected from six groups of individuals: 60 healthy donors from a nonendemic area, 57 cases hospitalized for conditions other than infectious diseases from a general hospital in a nonendemic area, 72 patients with active pulmonary tuberculosis, 26 healthy individuals from an endemic area, 100 patients with polar lepromatous leprosy (LLp), and 123 household contacts of patients with LLp. The FLA-ABS test was negative with sera from the first four groups. Strong positive reactions were found in all LLp patients except one; the false-negative results could be attributed to successful treatment and a long-standing cure in this patient. Analysis of these results shows 100% specificity, 99% sensitivity, and predictability values of the test of 100% for positive results and 99% for negative ones. In addition, none of the 20 randomly selected sera from LLp patients were positive with crossreacting mycobacteria. Because 87.8% of the household contacts were positive in the absence of clinical manifestations of leprosy, it is possible to conclude that a positive result by itself is not enough to establish an early diagnosis of the disease, especially among inhabitants of endemic areas.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298475 TI - Immunization of mice with Mycobacterium leprae/Mycobacterium bovis BCG admixtures: modulation of the acquired response to BCG. AB - The generation of acquired immunity to BCG in mice was compared to that in animals receiving an admixture of BCG and killed Mycobacterium leprae. No significant qualitative differences were observed between the two groups in terms of their generation of delayed sensitivity, of protective T cells, and of immunological memory. In addition, the admixture was as effective as BCG in conferring protective immunity against certain nontuberculous mycobacteria, and in one case, that of M. avium 706, significantly augmented protection. PMID- 3298476 TI - Ability of the phenolic glycolipid-I antigen of M. leprae to elicit a positive Mitsuda response in the armadillo (Dasypus novemcinctus). AB - Three lepromin-positive armadillos and three lepromin-negative armadillos were tested intradermally with 100 micrograms of phenolic glycolipid-I (PGL-I) in 0.1 ml of normal saline. Positive delayed-hypersensitivity granulomas at 21 days in the lepromin-positive animals and negative responses in the lepromin-negative animals were obtained. These observations suggest that purified PGL-I is capable of eliciting cell-mediated immune or delayed-hypersensitivity responses in animals sensitized to Mycobacterium leprae. PMID- 3298477 TI - Influence of route of inoculation on anti-Mycobacterium lepraemurium antibody isotypes in murine leprosy. AB - Mice of the C57BL/6 strain were injected either subcutaneously (s.c.) in the foot pad or intravenously (i.v.) with 10(5) or 10(8) Mycobacterium lepraemurium (MLM). Anti-MLM sonicate total immunoglobulin (Ig), IgM, and IgG antibody production was followed during the course of the infection. The kinetics of appearance and the magnitude of anti-MLM antibodies were found to be related to the size and route of inoculation. The i.v. route induced earlier and higher amounts of anti-MLM antibodies than did the s.c. route. In i.v.-infected mice, a relatively predominant IgM response to MLM was observed, while a relatively higher IgG response was seen in s.c.-infected mice. IgM antibody level was found to increase sharply with the bacterial load as assessed in the spleens of mice with i.v. disseminated infection; whereas a slow progression of both IgM and IgG levels was noted with time in s.c.-infected mice. PMID- 3298478 TI - Activity of selected beta-lactam antibiotics against Mycobacterium leprae. AB - Twelve beta-lactam antibiotics were tested for activity against Mycobacterium leprae growing in the foot pads of mice. Two cephalosporins (7 aminocephalosporanic acid and cefuroxime) and one cephamycin (cefoxitin) showed significant activity against M. leprae, and one penicillin (mezlocillin) exerted possible growth-promoting activity. These results suggest that particular molecular structures may be required for activity against M. leprae. PMID- 3298479 TI - S-100 protein and immunoperoxidase technique as an aid in the histopathologic diagnosis of leprosy. AB - The histopathologic diagnosis of leprosy in the tuberculoid type (TL) and in the indeterminate group (IL) may be difficult and frequently unfeasible. The detection of the impairment of cutaneous nerve branches by the inflammatory reaction may permit the diagnosis of TL over other skin granulomas. In an attempt to overcome these diagnostic difficulties in the lesions with no bacilli and without obvious damage to nerve branches, we utilized the immunoperoxidase technique with S-100 protein as the nerve marker. Two groups were selected: Patients (group 1) with TL confirmed by the presence of bacilli, and patients (group 2) with a clinical diagnosis of TL not confirmed by histopathology. The slides treated by S-100 in group 2 showed that 8 cases (9 total) were confirmed to have TL on the basis of the nerve alteration observed by the immunoperoxidase technique. These data obtained in the present studies show that use of the immunoperoxidase technique for the detection of S-100 protein to visualize peripheral nerves represents an efficient auxiliary aid in the diagnosis of leprosy. PMID- 3298480 TI - Plague and leprosy in the Middle Ages: a paradoxical cross-immunity? PMID- 3298481 TI - Effect of interleukin-1 (IL-1) and IL-2 on lymphocytes from patients with leprosy. PMID- 3298482 TI - An unusual case of untreated lepromatous leprosy with rare bacilli: an immunologic follow-up. PMID- 3298483 TI - Effect of preformed immune complexes on the course of Mycobacterium leprae infection in normal mice. PMID- 3298484 TI - Mycobacterium leprae, probably a microbe-dependent microorganism. PMID- 3298486 TI - In vitro fertilization and embryo transfer in domestic animals: applications in animals and implications for humans. AB - Extensive research has been conducted in domestic animals, particularly in cattle, in the reproductive technologies of sperm handling, capacitation, and acrosome reaction, superovulation, and embryo handling, sexing, bisection, cryopreservation, and transfer. Because of the economic importance of cattle these technologies have been tested and improved under clinical conditions. The results of employing these procedures are available on tens of thousands of pregnancies and offspring. This information has implications in applying some of the same technologies in human reproduction. The large number of normal progeny produced in cattle after a long prenatal development period, similar to humans, provides some assurance that these technologies, carefully applied, are safe. The basis for these conclusions is documented in the publications cited in this review. PMID- 3298485 TI - Nature of bone morphogenetic protein (BMP) from decalcified rabbit bone matrix. AB - Rabbit bone morphogenetic protein (BMP) from demineralized and defatted rabbit bone matrix was partially purified. BMP activity was examined by the implantation of fractionated materials into the thigh muscle pouch of the mouse. Rabbit BMP was solubilized by both 4M guanidine hydrochloride (GuHCl) and 6M urea solutions. Crude BMP had isoelectric point precipitation at pH 3 in 6M urea and showed bone morphogenesis. Fractions eluted with 0 and 0.2 N NaCl in DEAE CL-6B ion exchange chromatography showed bone morphogenesis in each individual pH of pH 4 to pH 7 but the fraction eluted with 1.0 N NaCl did not show any activity. Sephadex G-75 filtration separated the crude material into three peaks and the peak of about 23,000 showed bone morphogenesis. In sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis and isoelectric focusing, rabbit BMP was thought to be an acidic protein having a molecular weight of 24,000 with an isoelectric point around 4.85. PMID- 3298488 TI - The technique of intestinal strictureplasty. PMID- 3298489 TI - Endorectal ultrasound: instrumentation and clinical aspects. AB - During the period 1983 to April 1986, 129 patients with rectal cancer were treated. In 76 of these depth of penetration of the rectal wall by tumour was assessed by ultrasound. T stage determined by ultrasound (uT) corresponded with the pathological stages (pT) in 67 patients. In the remaining 9 cases, ultrasound overstaged the tumour and in only one patient was the growth understaged. Lymph nodes could be visualised in 12 out of 27 patients in whom nodes were looked for but only six cases were found to be positive on histological examination. Of 22 recurrences detected or proven by ultrasound there was a group of 6 patients who had no other sign of recurrence. PMID- 3298487 TI - Functional diarrhoea. AB - Functional diarrhoea remains an elusive and a difficult condition to diagnose and treat; however, with careful history-taking a logical approach to management can be made. Each patient must be considered individually and sub-classification should be attempted. It is very important to rule out organic disease. Unfortunately treatment remains empirical in the majority of cases, but more is now known about functional disorders and there is hope for the future. PMID- 3298490 TI - Transrectal ultrasonography: three years' experience. AB - Since 1983 we have used radial and linear ultrasound probes in the laboratory and clinical examination of the rectum. Normal endosonographic appearances have been characterised by examining polyethylene membranes and resection specimens. Twenty normal subjects and 11 patients with rectal cancer have been examined, and of these 9 were correctly staged. PMID- 3298491 TI - Endorectal sonography: laboratory and clinical experience in Bristol. AB - The normal echographic pattern produced by the colon and rectum has been investigated in vitro. Five basic ultrasonic layers or interfaces have clearly been identified; a first echogenic layer produced by the mucosa, then an echopoor layer representing the mucosa and muscularis mucosae, an echogenic layer which was submucosa, echopoor layer which was muscularis propria and an echogenic layer which was either pararectal fat or serosa. The effectiveness of endoluminal ultrasound (ELU) in the pre-operative staging of rectal cancer has been assessed in a group of 67 patients who were also, where possible, graded by digital examination and in some cases computer aided tomography (CT) (33 patients). Digital examination had an overall accuracy of 50% and could predict invasion beyond or confinement to the rectal with an accuracy of 64%. ELU is a highly accurate method for staging local invasion and when compared to post-operative histopathology had an overall correlation coefficient of 0.88 (p less than 0.001) (Rank Spearman). Our overall accuracy was 91% and it could predict invasion beyond the muscularis propria with a sensitivity of 96%, specificity of 94% and positive predictive value of 98%. In the cohort studied by both radiological techniques ELU was more accurate than CT where overall accuracy was 79%, sensitivity was 84%, specificity was 63% and the positive predictive value was 88%. PMID- 3298492 TI - Computed tomography versus endosonography in the staging of rectal carcinoma: a comparative study. AB - In 29 patients the accuracy of computed tomography (CT) and endosonography were compared for preoperative staging of rectal cancer. CT and endosonography were both reasonably accurate, CT overstaged 6 and understaged one lesion. Endosonography overstaged only 2 cancers. The accuracy of lymph node staging is still not resolved. PMID- 3298493 TI - A comparison of computed tomography and endorectal ultrasound in staging rectal cancer. AB - Endorectal ultrasound was used prospectively to stage 85 patients with rectal cancer. All patients had surgical exploration and histological analysis. Demonstration of tumour, extension into perirectal fat and lymph node involvement were evaluated. Eighty-one tumours were successfully imaged by endorectal ultrasound. The results suggest that: endorectal ultrasound is more accurate than CT in detecting the site of tumour; endorectal ultrasound is more accurate than CT in detecting perirectal fat infiltration; endorectal ultrasound is slightly more accurate than CT in detecting level II lymph node involvement. PMID- 3298494 TI - Commentary: does rectal endosonography influence rectal cancer treatment? PMID- 3298496 TI - The intracolonic bypass procedure. PMID- 3298495 TI - Mucin histochemistry in colorectal disease: principles and potential clinical applications. PMID- 3298498 TI - [An experimental study on retentive capacities of clasps affected by vertical distance in an undercut]. PMID- 3298499 TI - [5-year evaluation of a spiral implant]. PMID- 3298497 TI - [A comparative scanning electron microscopy study of the efficacy of several cleansing methods for cleaning dentures]. PMID- 3298500 TI - [Photoelastic stress patterns produced by abutment retainer designs for tooth supported dentures]. PMID- 3298502 TI - [The fit of labial cervical margins of various collarless metal ceramic restorations]. PMID- 3298501 TI - [An experimental study of the interface between plated cemented pins and amalgams]. PMID- 3298503 TI - [Cephalometrically adjustable occlusal plane for complete denture construction]. PMID- 3298505 TI - [Case studies of alveoloplasty in patients in need of complete dentures]. PMID- 3298504 TI - [The prevalence and intra-oral distribution of Candida albicans]. PMID- 3298507 TI - Effects of lithium on the endocrine system: a review. AB - Lithium has been established as a useful drug for the treatment of mood and behavior disorders. In addition to its therapeutic role in psychiatric disease it is important to recognize that it has diverse effects on endocrine function. These include the development of hypothyroidism and goiter in up to 10% of patients. Hyperthyroidism is a rare but reported side effect. Other abnormalities include hypercalcemia, diabetes insipidus, and altered carbohydrate metabolism. Depending on the clinical situation it is usually not necessary to discontinue lithium treatment, but appropriate intervention to correct the resulting endocrine abnormality may be indicated. This review emphasizes that psychiatrists and clinicians caring for patients given lithium need to be aware of the possible endocrine effects of this drug. PMID- 3298506 TI - Free radicals and myocardial ischemia and reperfusion injury. AB - There is a growing body of evidence for the role of free radicals in mediating myocardial tissue injury during myocardial ischemia and in particular during the phase of myocardial reoxygenation. Associated with myocardial ischemia and reperfusion is the generation of oxygen-derived free radicals from a variety of sources that include the mitochondrial electron transport chain; the biosynthesis of prostaglandins; the enzyme xanthine oxidase; and circulating elements in the blood, with the polymorphonuclear neutrophil assuming a primary focus of attention. Experimental studies have shown that free radical scavengers (e.g., N [2-mercaptopropionyl]glycine) and enzymes that scavenge or degrade reactive species of oxygen (superoxide dismutase or catalase) can reduce the mass of myocardial tissue that undergoes irreversible injury. Additionally allopurinol, which inhibits the enzyme xanthine oxidase, reduces ultimate infarct size, putatively by reducing the xanthine oxidase generation of superoxide anion. Neutrophils that enter the ischemically injured myocardium under the influence of chemotactic attraction and activation of the complement system generate and release highly reactive and cytotoxic oxygen derivatives that are destructive to the vascular endothelium and to the cardiac myocytes. Studies have documented that neutrophil depletion or suppression of neutrophil function (ibuprofen, nafazatrom, BW 755C, or more recently with prostacyclin or iloprost) results in a significant salvage of myocardial tissue that is subjected to a period of regional ischemia followed by reperfusion. Our current understanding of the events associated with myocardial ischemia suggests that within the ischemic myocardial region or area at risk, there is a population of cells that are reversibly injured and that reperfusion within a specified period (less than 3 hours) of time is capable of restoring the majority of the jeopardized cells to a normal status, but that the act of reperfusion itself will lead to the sudden demise of a fraction of the cells because of the cytotoxic effects of reactive species of oxygen derived from one or more of the sources indicated above. The efforts to minimize the amount of tissue that undergoes cell death as a result of myocardial ischemia demand that early reperfusion be established. However, the reintroduction of molecular oxygen and the circulating elements of the blood will be associated with an "explosive" and self-limited destruction of some of the myocardial cells in the area at risk.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3298509 TI - Rediscovering the importance of nasal breathing in sleep or, shut your mouth and save your sleep. AB - Recent research, stimulated by the growing awareness of the sleep apnea syndrome, has shown that nasal breathing plays a major role in the regulation of respiration in sleep. These observations are not new; they confirm century-old clinical findings on the importance of nasal breathing in sleep. The earliest account of the deleterious effects of mouth breathing in sleep was made by Lemnious Levinus towards the end of the sixteenth century. Two hundred years later, Catlin dedicated an entire book to the superiority of nasal breathing over mouth breathing in sleep; and in the late 1800's, Cline, Wells, Griffin and others showed that obstructed nasal breathing causes sleep disorders. PMID- 3298510 TI - Eikenella corrodens: a recently recognized pathogen in head and neck infections. PMID- 3298508 TI - Role of alpha-adrenergic hormones in potassium homeostasis in the rat. AB - To determine whether alpha-adrenergic stimulation impairs extrarenal potassium disposal in the rat, we studied the effect of an alpha-agonist and antagonist on the rise in plasma potassium concentration produced by a potassium infusion of 3 mEq KCl/kg over a 90-minute period to nephrectomized rats. Compared with KCl alone, the alpha-agonist phenylephrine caused more than a 25% increment in the peak plasma potassium, and reduced the volume of distribution of the potassium load. Addition of the alpha-blocker, phentolamine, to phenylephrine completely abolished the increment in potassium caused by KCl infusion. There were no differences in plasma bicarbonate, arterial pH, or plasma glucose levels among the groups. When an identical protocol was performed in nephrectomized rats also prepared by adrenalectomy, induction of diabetes, and chemical sympathectomy, the rise in plasma potassium level after KCl infusion was again augmented by phenylephrine. Addition of phentolamine also markedly blunted the increment in potassium in this group. These results show that alpha-adrenergics impair extrarenal potassium disposal in the rat. The effect does not depend on endogenous insulin or other potassium-regulatory factors. alpha-Adrenergics appear to play an important role in extrarenal potassium homeostasis. PMID- 3298511 TI - Rodin, Patton, Edison, Wilson, Einstein: were they really learning disabled? PMID- 3298512 TI - In vitro cultured human monocytes release fibroblast proliferation factor(s) different from interleukin 1. AB - Human monocytes cultured in vitro released factors with growth stimulatory effect upon human dermal fibroblasts. Monocytes in RPMI 1640 released a growth enhancing activity in nearly constant amounts during in vitro differentiation to macrophage like cells. The growth stimulatory effect mediated by supernatants was reduced when lipopolysaccharide (LPS) or opsonized zymosan particles (OpZ) were added to monocytes during the first 5 days of in vitro culture, thereafter reaching similar levels. The release of interleukin 1 (IL-1) from monocytes was restricted to the first 2 days of culture. IL-1 production by unstimulated monocytes was negligible, while LPS induced a high release of IL-1 from monocytes. A rabbit antibody against human IL-1 abolished the IL-1 activity of the monocyte supernatants as assessed in a mouse thymocyte proliferation assay, but caused only a small reduction of the fibroblast proliferation activity. Thus, the fibroblast growth stimulatory activity mediated by monocytes was caused by factor(s) in addition to IL-1. PMID- 3298513 TI - Cells of the human myelomonocytic line RC-2A synthesize tissue factor-like procoagulant and urokinase-type plasminogen activator. AB - Cells of the myelomonocytic leukemia cell line RC-2A were studied for their ability to synthesize clotting-promoting and fibrinolytic factors. The cells were observed to generate procoagulant activity (PCA) in readily measurable quantities. Incubation of RC-2A cells with phorbol myristate acetate (PMA; 3 ng/ml) or phytohemagglutinin (PHA, 10 micrograms/ml) for 18 h resulted in a 4-5 fold increase in PCA relative to unstimulated control. The PCA of RC-2A cells was tissue factor-like in that it was dependent on factor VII but not on factors VIII or IX. RC-2A cells also produced plasminogen activator (PA). Secreted PA was approximately 70% of the PA of an identical number of human monocyte-derived macrophages; fresh isolated monocytes synthesized virtually no PA. Compared to macrophages, RC-2A cells secreted less or no PA-inhibitors. Lysates of RC-2A cells contained over three times more PA than lysed macrophages. Stimulation of the cells with lectins (PHA, concanavalin A) or PMA was followed by a modest (2-3 fold) increase in PA. Enzyme immunoassay with antibodies to urokinase (u-PA) or tissue-type PA (t-PA) identified the RC-2A plasminogen activator as being of urokinase type. PMID- 3298514 TI - Alveolar macrophage/peripheral blood monocyte-derived factors modulate proliferation of primary lines of human lung fibroblasts. AB - Pulmonary fibrosis is characterized by an alteration in lung collagen synthesis and deposition, as well as by increased fibroblast proliferation. It is also characterized by an intermittent influx of immune and inflammatory cells in the lung. To investigate the nature of the target cell in this disorder, we established a series of primary lines of human adult lung fibroblasts and studied the effect of mediators released from activated normal human alveolar macrophages (AM) and peripheral blood monocytes (PBM) on the proliferation of both normal lung fibroblasts and fibroblasts established from lung tissue of patients with active fibrosis. Our data show that monocyte supernatants containing a 15-18 kD monokine from either AM or PBM inhibits growth of logarithmic phase proliferating lung fibroblasts in a dose-dependent manner. This effect can be entirely abrogated by treating the fibroblasts with indomethacin and is reconstituted by adding exogenous PGE2. A study of the kinetics of this interaction shows that exposure to monocyte supernatant for 30 min to 1 hr is sufficient to cause significant inhibition of fibroblast proliferation and that this effect can be halted, but not reversed, at any stage by incubation with indomethacin. We also show that fibroblasts derived from patients with pulmonary fibrosis are affected more quickly by exposure to the mediators, although the final extent of inhibition seen at each concentration of mediators is similar in normal and "fibrotic" fibroblasts. These studies indicate that activated AM or PBM release cytokines (including IL-1) which inhibit the growth of proliferating normal and fibrotic fibroblasts through activation of the intrinsic arachidonic acid pathway of this cell and also that this effect requires a continuous activation of this pathway to be fully expressed. PMID- 3298516 TI - John Brown talks of breast cancer. PMID- 3298515 TI - On the assessment of the efficacy of pentoxifylline (Trental). AB - The efficacy of Trental (pentoxifylline) in the treatment of intermittent claudication was evaluated in 14 double-blind randomized studies, involving 475 patients with chronic occlusive vascular disease. In twelve studies which were performed in the USA, different countries of Europe and Australia, a placebo was used as control. Low doses of adenosine or nylidrine respectively, were given to the control groups in the other two studies. A total of 238 patients were allotted to Trental and 237 to the control groups. In most studies, the recommended dosage of Trental was 3 X 400 mg pentoxifylline in sustained release tablets. Twelve of the 14 trials had a duration between 8 and 24 weeks. The efficacy of Trental was established in a reproducible manner through the trial series under different trial designs following the requirements and guidelines from local authorities and medical societies. The number of patients with an improvement in walking distance of more than 100% was four times higher in the Trental group compared with the control group. The superiority of the Trental treatment over the control's persisted also when taking into account risk factors such as diabetes, hypertension, smoking habits and duration of the disease. PMID- 3298517 TI - The surgical management of breast cancer. PMID- 3298518 TI - Breast reconstruction following mastectomy. PMID- 3298520 TI - Clinical trial of mustong on secondary sexual impotence in male married diabetics. PMID- 3298519 TI - Garlic and diabetes mellitus phase II clinical trial. PMID- 3298521 TI - Impaired glucose tolerance in Thai adults: status of glucose tolerance after 2 year follow up. PMID- 3298522 TI - Trichomonas vaginalis phenotypic variation occurs only among trichomonads infected with the double-stranded RNA virus. AB - Trichomonas vaginalis isolates were examined for the presence of viral double stranded RNA (dsRNA) and the property of phenotypic variation. Only the heterogeneous isolates composed of mAb-reactive and -nonreactive organisms, as determined by indirect immunofluorescence and flow cytofluorometry, and capable of phenotypic variation possessed the dsRNA. Both the positive and negative phenotype subpopulations separated from the heterogeneous parent contained equal amounts of the dsRNA. Loss of the dsRNA upon prolonged in vitro cultivation always correlated with the lack of expression of the major immunogen. The data indicate a relationship between the presence of the dsRNA and the ability of the pathogenic human trichomonads to express immunogens on their surfaces and to undergo phenotypic variation. PMID- 3298523 TI - Difference in the structural features of streptococcal M proteins from nephritogenic and rheumatogenic serotypes. AB - The association of only certain M protein serotypes of group A streptococci with acute glomerulonephritis is very well recognized. Structural information on the M protein, a dimeric alpha-helical coiled-coil molecule, has come so far from three rheumatogenic serotypes, 5, 6, and 24. However, M proteins from the nephritogenic serotypes have not been well characterized. In the present study, we have isolated a biologically active 20,000 Mr pepsin fragment of type 49 M protein (PepM49), a nephritogenic serotype, and purified it to homogeneity using DEAE Sephadex and gel filtration. The amino acid composition of PepM49 is similar to those of the rheumatogenic M protein serotypes PepM5, PepM6, and PepM24. However, the sequence of the NH2-terminal 60 residues of PepM49 shows little homology to any of these M protein serotypes, although the latter have significant homology among themselves. Nevertheless, PepM49 exhibits a strong heptad periodicity in its nonpolar residues, suggesting its overall conformational similarity with the other M molecules. During the course of the present studies, Moravek et al. (17) reported the NH2-terminal sequence of another M protein serotype, PepM1, which also does not exhibit much homology with the PepM5, PepM6, and PepM24 proteins. Our analysis of this sequence revealed that the PepM1 protein also exhibits a heptad periodicity of the nonpolar amino acids. A closer examination has revealed that the pattern of heptad periodicity in PepM49 and PepM1 proteins is more regular and more similar to each other than has been previously seen for the PepM5, PepM6, and PepM24 proteins. PepM1 is also a nephritogenic serotype. Taken together, these findings indicate an underlying conservation of the tertiary structure of the various M protein serotypes, despite the complexity in their antigenic variation and suggest that the nephritogenic M protein serotypes M1 and M49 may be further apart evolutionarily from the rheumatogenic serotypes 5, 6, and 24. The distinct differences in the structural features of the PepM1 and PepM49 proteins relative to the PepM5, PepM6, and PepM24 proteins are also suggestive of a correlation with the earlier broader classification of the group A streptococci into rheumatogenic and nephritogenic serotypes. PMID- 3298524 TI - Protection of bone marrow transplant recipients from lethal doses of methotrexate by the generation of methotrexate-resistant bone marrow. AB - To develop a highly efficient means for generating methotrexate resistant (MTXr) hematopoietic cells in vivo, a recombinant retroviral genome was constructed that encodes a MTXr dihydrofolate reductase (DHFRr). Cell lines producing high titers of virus capable of transmitting the DHFR gene were generated and used to infect mammalian cells in vitro. Analysis of infected fibroblasts indicated that the DHFRr gene was transmitted intact and conferred a high level of MTXr upon cells. Based on these findings, DHFRr-containing virus was used to infect murine bone marrow cells in vitro. Following infection, the transduced cells were introduced into lethally irradiated recipients via bone marrow transplantation techniques. The presence of the proviral sequences in cells of the spleen and bone marrow of engrafted recipients was associated with significantly increased survival of mice treated with otherwise lethal doses of MTX. PMID- 3298525 TI - Expression of human adenosine deaminase in nonhuman primates after retrovirus mediated gene transfer. AB - Primate bone marrow cells were infected with a retroviral vector carrying the genes for human adenosine deaminase (h-ADA) and bacterial neomycin resistance (neor). The infected cells were infused back into the lethally irradiated donor animals. Several monkeys fully reconstituted and were shown to express the h-ADA and neor genes at low levels in their recirculating hematopoietic cells for short periods of time. PMID- 3298526 TI - Possible pitfalls in the identification of glycophorin-binding proteins of Plasmodium falciparum. AB - Plasmodium falciparum proteins that bind to the putative erythrocyte receptor (glycophorin) have been identified in several laboratories by their ability to bind to glycophorin immobilized on aminoethyl-BioGel (AE-BioGel). We here report that several parasite proteins bind to AE-BioGel in the absence of coupled glycophorin. Binding is apparently due to the strong ion-exchange properties of the matrix, and is sensitive to ionic conditions such as the degree of equilibration of the matrix and the pH. The parasite proteins that bind to the blank column under appropriate conditions include proteins with the serological activities of S-antigen and Ag 23, which also bind to glycophorin-coupled AE BioGel. In the light of these results, the glycophorin-binding specificity of these and other proteins reported to bind to glycophorin-coupled AE-BioGel will have to be reevaluated, preferably using a different support matrix. PMID- 3298527 TI - Osteoporosis prevention: strategies applicable for general population groups. AB - Osteoporosis is a common condition of the elderly population that entails considerable morbidity and mortality. Although prevention recommendations often focus on perimenopausal women, the condition begins well before the age of menopause and also affects men. Prevention techniques include hormonal replacement therapy, optimization of calcium intake and absorption, weight bearing exercise, cessation of tobacco and alcohol abuse, fall prevention, and management of predisposing medical conditions. All of these techniques are analyzed by commonly accepted criteria. Recommendations for osteoporosis prevention that are applicable to general population groups are presented. PMID- 3298528 TI - Prevalence and recognition of depression among primary care outpatients. AB - Studies indicate that more individuals suffering from depressive symptoms will present to the primary care outpatient clinic than to any other medical care setting. Unfortunately, most of these patients complain of somatic problems, not mood disturbances. Consequently, less than one half of all depressed patients in the primary care clinic are initially identified and treated for their depression. As depression causes considerable morbidity and some mortality and is treatable, methods of improving recognition should be sought. Some of these include maintaining a high index of suspicion, conducting a brief but thorough screening interview for depression, and using a depression rating scale. Benefits derived from early recognition include saving time, effort, and money spent on unnecessary tests and inappropriate treatment, and avoiding substantial suffering. The threshold for many somatic complaints can be substantially raised with resolution of depression. PMID- 3298529 TI - Metabolism and energetics of avian embryos. AB - Energy within an avian egg is used primarily to support the metabolic costs of growth and maintenance, deposited in embryonic tissues, or retained in residual yolk. In altricial species, embryonic growth rate and metabolic rate increase continuously during incubation, whereas in precocial species, embryonic growth rate declines shortly before hatching so that metabolic rate usually reaches a plateau before hatching. These differences mean that when altricial and precocial birds are compared using egg mass as a scaling variable, altricial species have lower costs of development, smaller hatchlings, and shorter incubation periods. Their eggs also have lower energy densities, however, and when egg energy content is used as the scaling variable altricial and precocial species cannot be distinguished except by egg size and energy density. This suggests that before hatching all avian embryos expand about the same percentage of the energy stored in their eggs. Altricial and precocial species do not appear to differ in energy cost per gram of yolk-free, dry hatchling produced (15.4 kJ/gm). The major difference between altriciality and precocity lies in the timing of hatching during the developmental process (earlier for altricial species than for precocial species) and in the amount of energy the parent originally deposits in the egg. We suggest that the first step in the evolution of altricial bird species from precocial ancestors was hatching early. This shortened the incubation period and reduced the amount of energy needed prior to hatching. Consequently, the female could reduce her energy investment per egg by decreasing size and increasing water content of the egg. PMID- 3298530 TI - Pores and gas exchange of avian eggs: a review. AB - Pores of the avian eggshell provide the only communicating channels for the exchange of molecules between the developing embryo and the external environment. These trumpet-shaped ducts are microscopic. Their number and effective pore radius increase with egg mass from ca. 300 and 3 microns in 1 gm eggs to about 30,000 and 13 microns, respectively, in 500 gm eggs (Ar and Rahn, Respir. Physiol. 61:1-20, 1985). The total volume of all the gases that diffuse through these pores is large. For example, up to the time when internal pipping takes place, when pulmonary ventilation is initiated, about 20 liters (O2 + CO2 + water vapor) have passed through 10,000 pores of an 80 gm egg. The rules governing this exchange of gases are best described by Fick's first law rather than by Stefan's law, which describes the transfer of gases across stomata of plants. Data are presented for those species for which the water vapor conductance, the oxygen flux at the preinternal pipping stage, the rate of incubation water loss, and the number of pores in the egg have been established. These conductances and flux rates are directly proportional to the number of pores. These relationships suggest that, in spite of differences in egg mass and incubation time, in most birds the average conductance of individual pores is similar, namely, 1.5 microgram (d X torr)-1 and that the average O2 and water vapor flux per pore are 60 and 54 microliters X d-1, respectively. These values are similar to the estimates previously presented (Ar and Rahn, '85). PMID- 3298532 TI - Maturation of the hypothalamo-adenohypophyseal-gonadal (HAG) axes in the chick embryo. AB - In the chick embryo the components of the hypothalamo-adenohypophyseal-gonadal (HAG) axes initially function independently. On day 13 of development in the male embryo, luteinizing hormone (LH) from the adenohypophysis initiates regulation of testosterone (T) synthesis and secretion by the testes, and as a consequence plasma T levels reach a maximum value on day 13.5. The establishment of this feed forward phase of the pituitary-testicular axis involves an increase in the numerical density (NV) of testicular LH receptor-positive interstitial cells (IC) as a result of elevated plasma LH levels ("up regulation"). The elevated plasma T levels on day 13.5 cause plasma LH concentrations to decrease immediately after day 13.5, initiating the feedback phase of the endocrine axis. The NV of testicular LH receptor-positive IC also decreases at the same time, continuing to decline for the remainder of the embryonic period as LH receptor complexes are internalized and plasma T levels decrease. The decrease in the NV of testicular LH receptor-positive IC and the internalization of the LH receptor complexes reflect a "desensitization" of the IC, in which there is a decrease in the ability of LH to stimulate T synthesis and secretion by the IC ("down regulation"). In the male chick embryo the hypothalamus begins to regulate the adenohypophyseal-testicular unit during the last third of embryonic development. There appears to be a series of similar, albeit not as well verified, events that occur in the female embryo with respect to the development of the adenohypophyseal-ovarian axis. PMID- 3298531 TI - Endocrinology of the avian embryo: an overview. AB - The full endocrine system is developed during the embryonic stages of the domestic fowl and probably in all avian species. This involves the genesis and differentiation of endocrine cells and progressive acquisition of interactions between endocrine tissues leading to integrated series of control systems. The embryonic endocrine organs produce hormones with a variety of physiological roles (including homeostatic, homeorhetic, and anticipatory). The present chapter provides an overview of the recent advances in the endocrinology of the avian embryo. Particular attention is focused on the general phenomenon of endocrine development and on the ontogeny of the hypothalamo-pituitary (growth hormone) somatomedin-growth axis, the hypothalamo-pituitary-thyroid axis, and the hormones of calcium homeostasis. PMID- 3298533 TI - Ontogenesis of thyroid function and regulation in the developing chick embryo. AB - B.H. Willier (Analysis of Development, W.B. Saunders, Philadelphia, 1955, pp. 574 619) hypothesized that the early differentiation and initial function of the glandular components of vertebrate endocrine axes are autonomous and that functional interdigitation of these glands occurs later in developmental time. The present review summarizes findings that indicate that the hypothalamus, pituitary, and thyroid glands of the developing chick embryo synthesize their appropriate hormones early in development, i.e., before day 5.5 of incubation. Observations also indicate that it is not until the days 10.5-11.5 embryonic period that the feed-forward and feed-backward components of the adenohypophyseal thyroid or the hypothalamo-adenohypophyseal-thyroid axis mature. Evidence is also presented for a midgestational beginning of hypothalamic regulation of adenohypophyseal-thyroid unit function. PMID- 3298534 TI - Comparative thyroid development in precocial Japanese quail and altricial ring doves. AB - The patterns of thyroid development in precocial Japanese quail and altricial Ring doves are described and compared. Thyroid development can be divided into two phases: The first is characterized by increasing functional capacity of the thyroid gland but low circulating concentrations of thyroid hormones; during the second phase there are further increases in thyroid gland activity as well as a shift toward much higher levels of thyroid activity in the periphery. In Japanese quail, the first phase occurs during the latter half of embryonic life, and there is an abrupt transition to the second phase beginning with a perinatal hormone peak. In Ring doves the first phase continues into the first few days of the posthatching period, and the transition to the second phase of higher serum hormones is gradual and lasts until about 6-8 days of age. In addition to the release of hormones from the thyroid gland, serum binding proteins and peripheral tissue 5'-monodeiodinase (which converts thyroxine to triiodothyronine, the metabolically active hormone) play roles in controlling the balance of thyroid hormone availability to the tissues. The potential roles of peripheral deiodinases in hormone dynamics are discussed in relation to tissue and organ growth and maturation during the first phase and in relation to whole organism metabolism with continued growth during the second phase. PMID- 3298535 TI - Insulin-related receptors in the early chick embryo: from tissue patterns to possible function. AB - Insulin and two closely related peptides, insulinlike growth factors I and II (IGF-I and IGF-II), as well as their respective receptors, overlap in structure, specificity, and function. Very little is known about the role of these peptides and their receptors in embryogenesis. We have found that chick embryo tissues express both insulin and IGF receptors at very early stages of organogenesis. Each type of receptor is regulated throughout embryogenesis in a manner that is tissue-specific. Substances with insulin immunoactivity and bioactivity are detected in chick embryos at prepancreatic stages (days 2 and 3). Embryos that grow in the presence of antiinsulin antibodies (which are known to neutralize the bioactivity of insulin but not that of the IGFs found in adult vertebrates) demonstrate retarded growth and impaired differentiation. These data support the hypothesis that insulin or insulin-related peptides are essential elements for normal development in the chick embryo. PMID- 3298536 TI - Trace element metabolism in the developing avian embryo: a review. AB - Trace element metabolism in the developing avian embryo involves a variety of interrelated processes beginning with metal deposition in the nascent egg. Vitellogenin, the yolk precursor protein, plays a fundamental role in the transport of trace elements from hepatic stores in the hen to the developing oocyte, where it facilitates the uptake and storage of metals in the egg yolk. Egg white proteins such as ovalbumin and conalbumin (ovotransferrin) may function in an analogous manner by effecting the transfer of trace elements from the oviduct to the egg. The uptake and metabolism of trace elements by the developing embryo are mediated by the extraembryonic membranes, predominantly the yolk sac, which are in direct contact with the egg contents. Specific metal-binding proteins play important roles in the interorgan transport, cellular uptake, and intracellular partitioning of trace elements in the developing embryo. Models are proposed to explain the deposition of trace elements in the newly formed egg and the uptake and transfer of trace elements from the egg yolk and white to the tissues of the developing embryo and its associated membranes. PMID- 3298537 TI - Vitamin-binding proteins in the nutrition of the avian embryo. AB - Nutrients required for the growth and development of an avian embryo must be present when the egg is laid. Many, if not most, of the nutrients in eggs are transferred from the blood plasma of the hen into the yolk of the oocyte as specific nutrient-protein complexes. Egg yolk contains vitamin-binding proteins for thiamin, riboflavin, biotin, cobalamin, retinol, and cholecalciferol. The biochemical details of how these plasma vitamin-protein complexes are recognized by and deposited in the oocyte and subsequently dissociated for use by the embryo are not known. Niacin and ascorbic acid are synthesized by the embryo from other compounds deposited in the egg. Pantothenic acid, which is abundant in the egg, is not bound tightly to a specific protein. Binding proteins for thiamin, riboflavin, biotin, and cobalamin are also present in egg white. Because they are usually not saturated with respect to their ligand, these binding proteins are able to scavenge nutrients and thereby are thought to protect the embryo from infection by microbes that require the ligands. In the albumen of a few species, nutritionally significant amounts of bound riboflavin or biotin are present, suggesting both nutritional and antimicrobial functions for their binding proteins. It is postulated that differences in the amounts of various nutrient binding proteins correspond to differences in the nutrient contents among the eggs of various species and reflect differences in the nutrient needs of the contained embryos. Mutations that inactivate nutrient-binding proteins arrest development before hatching and are dependent solely on the maternal genotype. PMID- 3298538 TI - Lipid metabolism in the chick embryo: some recent ideas. AB - The transfer of lipid that occurs from yolk to embryo during the last week of development of the chick is associated with some notable changes in tissue lipid and fatty acid compositions. Recent investigations into the concentration changes of some of the major lipid classes and their fatty acid compositions within the yolk complex and embryo have enabled metabolic interpretation to be placed on several of these observations. As well as its central role in yolk lipid assimilation, the involvement of the yolk sac membrane in some specific yolk lipid changes before uptake by the embryo has been identified. Distinctive changes in the normal pattern of yolk lipid mobilization and utilization have been observed in eggs exhibiting low hatchability and in relation to the survival of chicks from very young parent stock. PMID- 3298540 TI - The 1987 Florida legislative agenda: a physician's perspective. PMID- 3298539 TI - Endocytosis in the embryonic chick chorionic epithelium. AB - The chorionic epithelium of the developing chick embryo consists of two major cell types, villus cavity (VC) and sinus-covering (SC) cells. Ultrastructurally, VC cells contain apical microvilli with numerous underlying vesicles, whereas SC cells possess thin cytoplasmic processes (containing occasional vesicles) overlying adjacent blood sinuses. This study was performed to determine whether vesicles observed in VC and SC cells are endocytic in nature and whether endocytosis is limited to either VC or SC cells. Exposure of air space chorionic epithelium in ovo to microperoxidase (MRP-11) resulted in endocytic uptake of marker by the thin cytoplasmic processes of 70% of SC cells. Vesicles containing MRP-11 reaction product were also observed in approximately 20% of VC cells. Exposure of the chorionic epithelium of shell-less cultured embryos to horseradish peroxidase (HRP) resulted in endocytic uptake of HRP in approximately 80% of SC cells and in 33% of VC cells. Thus, VC and SC cells demonstrate endocytic activity both in ovo and in shell-less culture. In ovo, endocytosis may be involved in the recovery of water and/or ions from the eggshell or shell membranes. PMID- 3298541 TI - Sonographic evolution of multicystic encephalomalacia in an asphyxiated newborn. PMID- 3298542 TI - Inhibitory effect of a protease inhibitor, leupeptin, on the development of influenza pneumonia, mediated by concomitant bacteria. AB - The protease inhibitor leupeptin prevented multiple step replication of an influenza virus (A/swine/1976/31, H1N1) mediated by staphylococcal proteases. It also suppressed virus replication and development of fatal pneumonia in mice co infected with the virus and Staphylococcus aureus. PMID- 3298543 TI - Extension and retraction of axonal projections by some developing neurons in the leech depends upon the existence of neighboring homologues. II. The AP and AE neurons. AB - To assess the generality of our previous finding (Gao and Macagno, 1987) that segmental homologues play a role in the establishment of the pattern of axonal projections of the heart accessory HA neurons, we have extended our studies to two other identified leech neurons: the anterior pagoda (AP) neurons and the annulus erector (AE) motor neurons. Bilateral pairs of AP neurons are found in the first through the twentieth segmental ganglia (SG1 through SG20) of the leech ventral nerve cord. All AP neurons initially extend axonal projections to the contralateral periphery as well as longitudinal projections along the contralateral interganglionic connective nerves toward anterior and posterior neighboring ganglia. Although the peripheral projections are maintained by all AP neurons throughout the life of the animal, the longitudinal projections disappear in all but two segments: the AP neurons in SG1 maintain their anterior projections and extend them into the head ganglion, and those in SG20 maintain their posterior projections and extend them into SG21 and the tail ganglion. When single AP neurons are deleted anywhere along the nerve cord before processes begin to atrophy, however, the longitudinal projections are retained by their ipsilateral homologues in adjacent ganglia. The rescued processes appear to take over the projections of the deleted neurons. In cases where two or more AP neurons on the same side of the nerve cord are deleted from adjacent ganglia, a contralateral homologue sometimes extends projections to the periphery ipsilaterally or on both sides. We obtained similar results when we deleted single AE neurons from midbody ganglia. Thus, our experiments with three different identified neurons consistently show that the initial pattern of projections is the same in all ganglia, but that the existence of homologues in adjacent ganglia leads to the pruning of some of the initial projections. A consequence of this homologue-dependent process retraction is that neurons normally lacking neighboring homologues will have patterns of projections different from those neurons that do have such neighbors. Process loss by the HA, AP, and AE neurons may be the result either of competition for targets, inputs, or growth factors or of direct interactions among homologous cells. PMID- 3298544 TI - A spectroscopic investigation of cobalt(II) substituted alkaline phosphatase. AB - The electronic and 1H NMR spectra are reported for the cobalt(II) alkaline phosphatase (EC 3.1.3.1.) system at pH around 6 in the range 0-2 mol of cobalt per mol protein. It is shown that under the present experimental conditions cobalt(II) selectively populates the A sites. Three isotropically shifted NH signals have been detected in the A site that indicate the presence of three histidines in the coordination sphere of cobalt(II). The electronic spectra and the nuclear relaxation properties are consistent with pentacoordination of cobalt(II) in the A site. The finding of reproducible preparation routes for the derivatives, and of appropriate experimental conditions for the observation of their 1H NMR spectra, open new possibilities for the spectroscopic investigation of alkaline phosphatase. PMID- 3298545 TI - Calmodulin-dependent phosphatases of PC12, GH3, and C6 cells: physical, kinetic, and immunochemical properties. AB - Calmodulin-dependent phosphoprotein phosphatase (CaMDP) activity has been found in each of three cultured cell lines: rat pheochromocytoma (PC12), glioma (C6), and pituitary adenoma (GH3) cells. These CaMDP activities bind to immobilized calmodulin in the presence of Ca2+ and are eluted by EGTA. Sucrose density centrifugation revealed that the phosphatase activities exhibited sedimentation coefficients of 4.37, 4.23, and 4.59 for proteins derived from C6, GH3, and PC12 cells, respectively. The Stokes radii measured for the PC12 and C6 activities were 41.8 and 40.0 A, respectively. The estimated molecular weights calculated for the enzymes from these data are 79,100 and 72,200. The phosphatase activities required the presence of divalent cations such as Ca2+ or Mn2+ for expression of activity, which was optimal only in the presence of calmodulin. The apparent Km for phosphorylated myelin basic protein substrate was 8 microM. Affinity-purified antibodies to the B subunit of bovine brain CaMDP were found by immunoblot (Western blot) to cross-react with a single protein among proteins extracted from PC12, C6, and GH3 cells that had been resolved by two-dimensional electrophoresis. In each case, the cross-reacting protein exhibited an Mr of 16,000 and an isoelectric point of 4.7, values virtually identical to those reported previously for the B subunit of bovine brain CaMDP (sometimes called calcineurin). This cross-reacting protein was found among cellular proteins eluted from immobilized calmodulin by EGTA. Immunocytochemical localization of the cross-reacting protein in undifferentiated PC12 cells or in cells differentiated in response to nerve growth factor revealed its presence diffusely throughout the cytoplasm. These experiments support the contention that each of these cell lines contains a calmodulin-regulated phosphatase homologous physically and kinetically, and immunologically related to bovine brain CaMDP. PMID- 3298546 TI - Developmental and functional studies of parvalbumin and calbindin D28K in hypothalamic neurons grown in serum-free medium. AB - The Ca2+-binding proteins parvalbumin (Mr = 12K) and calbindin D28K [previously designated vitamin D-dependent Ca2+-binding protein (Mr = 28K)] are neuronal markers, but their functional roles in mammalian brain are unknown. The expression of these two proteins was studied by immunocytochemical methods in serum-free cultures of hypothalamic cells from 16-day-old fetal mice. Parvalbumin is first detected in all immature neurons, but during differentiation, the number of parvalbumin-immunoreactive neurons greatly declines to a level reminiscent of that observed in vivo, where only a subpopulation of neurons stains for parvalbumin. In contrast, calbindin D28K was expressed throughout the period investigated only in a distinct subpopulation of neurons. Depolarization of fully differentiated hypothalamic neurons in culture resulted in a dramatic decrease of parvalbumin immunoreactivity but not of calbindin D28K immunoreactivity. The parvalbumin staining was restored on repolarization. Because the anti-parvalbumin serum seems to recognize only the metal-bound form of parvalbumin, the loss of immunoreactivity may signal a release of Ca2+ from intracellular parvalbumin during depolarization of the cells. We suggest that parvalbumin might be involved in Ca2+-dependent processes associated with neurotransmitter release. PMID- 3298547 TI - Neurotensin-metabolizing peptidases in rat fundus plasma membranes. AB - The mechanisms by which neurotensin (NT) was inactivated by rat fundus plasma membranes were characterized. Primary inactivating cleavages occurred at the Arg8 Arg9, Pro10-Tyr11, and Ile12-Leu13 peptidyl bonds. Hydrolysis at the Arg8-Arg9 bond was fully abolished by the use of N-[1(R,S)-carboxy-2-phenylethyl]-alanyl alanyl-phenylalanine-p- aminobenzoate, a result indicating the involvement at this site of a recently purified soluble metallopeptidase. Hydrolysis of the Pro10-Tyr11 bond was totally resistant to N-benzyloxycarbonyl-prolyl-prolinal and thiorphan, an observation suggesting that the peptidase responsible for this cleavage was different from proline endopeptidase and endopeptidase 24.11 and might correspond to a NT-degrading neutral metallopeptidase recently isolated from rat brain synaptic membranes. The enzyme acting at the Ile12-Leu13 bond has not yet been identified. Secondary cleavages occurring on NT degradation products were mainly generated by bestatin-sensitive aminopeptidases and post-proline dipeptidyl aminopeptidase. The content in NT-metabolizing peptidases present in rat fundus plasma membranes is compared with that previously established for purified rat brain synaptic membranes. PMID- 3298548 TI - Two-site immunoassay for acetylcholinesterase in brain, nerve, and muscle. AB - Two-site methods were developed for immunoassay of acetylcholinesterase (AChE; EC 3.1.1.7) in crude extracts of rat and human tissues. A radiometric assay for human AChE utilized a specific monoclonal AChE antibody adsorbed to polystyrene microtiter wells at alkaline pH. AChE bound strongly to this antibody after 24 h at 4 degrees C. Bound enzyme was detected with an 125I-labeled antibody against a different AChE epitope. The assay signal was quasi-linearly related to AChE concentration in purified and crude samples, with a detection threshold near 100 pg. Tetrameric and dimeric AChE behaved equivalently in the assay. Two-site methods with a different pair of species-selective antibodies worked equally well for immunoassay of rat AChE. Assays of the rat enzyme showed that immunoreactivity was lost as rapidly as enzyme activity during heating to 54 degrees C. On the other hand, immunoreactivity was preserved despite loss of enzyme activity after exposure to anticholinesterases or trypsin. A biotinylated second antibody detected by alkaline-phosphatase-conjugated avidin was used to develop an AChE enzyme-linked immunosorbent assay (ELISA) with a sensitivity similar to that of the radiometric assay. Either the ELISA or the radiometric immunoassay may be useful whenever proteolysis or other mechanisms are suspected of dissociating enzyme activity and immunoreactivity. In denervated muscle and ligated peripheral nerve, application of the two-site method showed closely parallel variations in immunoreactivity and enzyme activity. PMID- 3298549 TI - Amino acid sequences of neuropeptides in the sinus gland of the land crab Cardisoma carnifex: a novel neuropeptide proteolysis site. AB - The sinus gland is a major neurosecretory structure in Crustacea. Five peptides, labeled C, D, E, F, and I, isolated from the sinus gland of the land crab have been hypothesized to arise from the incomplete proteolysis at two internal sites on a single biosynthetic intermediate peptide "H", based on amino acid composition additivities and pulse-chase radiolabeling studies. The presence of only a single major precursor for the sinus gland peptides implies that peptide H may be synthesized on a common precursor with crustacean hyperglycemic hormone forms, "J" and "L," and a peptide, "K," similar to peptides with molt inhibiting activity. Here I report amino acid sequences of these peptides. The amino terminal sequence of the parent peptide, H, (and the homologous fragments) proved refractory to Edman degradation. Data from amino acid analysis and carboxypeptidase digestion of the naturally occurring fragments and of fragments produced by endopeptidase digestion were used together with Edman degradation to obtain the sequences. Amino acid analysis of fragments of the naturally occurring "overlap" peptides (those produced by internal cleavage at one site on H) was used to obtain the sequences across the cleavage sites. The amino acid sequence of the land crab peptide H is Arg-Ser-Ala-Asp-Gly-Phe-Gly-Arg-Met-Glu-Ser-Leu-Leu Thr-Ser-Leu-Arg-Gly- Ser-Ala-Glu- Ser-Pro-Ala-Ala-Leu-Gly-Glu-Ala-Ser-Ala-Ala-His Pro-Leu-Glu. In vivo cleavage at one site involves excision of arginine from the sequence Leu-Arg-Gly, whereas cleavage at the other site involves excision of serine from the sequence Glu-Ser-Leu. Proteolysis at the latter sequence has not been previously reported in intact secretory granules. The aspartate at position 4 is possibly covalently modified. PMID- 3298550 TI - John Uri Lloyd, 1849-1936. PMID- 3298551 TI - Plants as sources of antimalarial drugs, Part 4: Activity of Brucea javanica fruits against chloroquine-resistant Plasmodium falciparum in vitro and against Plasmodium berghei in vivo. AB - Extracts of Brucea javanica fruit have been prepared and monitored for their in vitro and in vivo antiplasmodial activities. The antimalarial activity of the fruit was found to be attributable to its quassinoid constituents. Nine of the quassinoids possessed in vitro IC50 values between 0.046-0.0008 microgram/ml against the chloroquine resistant Plasmodium falciparum strain (Kl) tested. The two quassinoid glycosides tested were considerably less active in vitro than the aglycones. Four quassinoids were found to possess activity in vivo against Plasmodium berghei infections in mice after oral dosing. All five quassinoids tested in vivo showed some toxicity. PMID- 3298552 TI - Monoclonal antibodies: does sufficient selectivity to cancer cells exist for therapeutic application? PMID- 3298553 TI - Problems associated with radioimmunodetection and possibilities for future solutions. AB - It is the opinion of the authors that the molecule of the future for radioimmunodetection (and hopefully radioimmunotherapy and delivery of drugs) will have the following characteristics: It will be an altered fragment, rather than an intact molecule or fragment. It will be small, perhaps 60,000 molecular weight, yet remain in the vascular compartment for a comparatively long period of time, then be eliminated via the kidney. It will be of human origin or a murine molecule altered to mask its immunogenic properties. It will be 111In- or 99mTc labeled or bifunctionally chelated to another metal ion. It will target a cell surface antigen, but one that does not circulate. It will be used in combination with derivatives of other MoAbs that target other antigens on the cell. It would be a hapten-type device that follows the administration of a "bifunctional MoAb." Whatever the final molecule, it will be administered to a patient who has been "prepped" with an antigen-enhancing substance or one that "unmasks" a gene and allows a repressed marker to be expressed by the tumor cell to which the MoAb was developed. It may be a MoAb that attaches to a white cell, which then chemotactically seeks the tumor that has been previously induced to produce a substance that the white cell recognizes. PMID- 3298554 TI - Tumoricidal effector mechanisms of murine BCG-activated macrophages. I. Parameters of production and initial characterization of a cytolytic factor serologically related to necrosin. AB - Previous studies have shown that peritoneal macrophages from mice chronically infected with Bacillus Calmette-Guerin (BCG) become highly cytotoxic for tumor targets upon further in vitro triggering with a variety of agents. In the current studies, achievement of this activated state was characterized by the production and release of a cytotoxin, herein termed cytolytic factor (CF), which appeared in the fluid phase. Production/release of CF by the macrophage required transcription, translation, glycosylation, and an intact secretory apparatus, as evident from inhibition by treatment with actinomycin-D, cycloheximide, tunicamycin, and monensin, respectively, prior to and during triggering with lipopolysaccharide (LPS). CF obtained by culture of BCG-activated macrophages appeared rapidly in the supernatant after triggering. Using the actinomycin-D treated L-929 or EMT-6 targets in a microassay, CF secreted by macrophages cultured in low molecular weight serum components was detected as an approximately 150-kD component on Sephacryl S-200. CF demonstrated a spectrum of cytotoxic activity against a number of tumor and normal targets in vitro. Its lytic activity appeared equally effective whether the targets were cultured in medium containing fetal calf serum (FCS) or in Neuman-Tytell medium without serum during the assay. CF was moderately sensitive to treatment with TLCK and TAME; however, its activity in serum and apparent molecular weight distinguish it from a moiety obtained from BCG-activated murine macrophages and previously described. A rabbit heteroantiserum raised against highly purified necrosin, a product of the murine macrophage cell line J774.1, was extremely effective in neutralizing the biological activity of CF. PMID- 3298555 TI - Four permanent cell lines established from human malignant gliomas: three exhibiting striated muscle differentiation. AB - Twenty-two human gliomas were set up in tissue culture and inoculated into nude mice. Permanent cell lines were established from four of these and their growth characteristics, and morphological features defined and cytogenetic features described. All four failed to sustain evidence of glial differentiation while three of the four cell lines exhibited the characteristics of striated muscle, and were tumorigenic in nude mice. Nine gliomas showed some initial growth in nude mice but only two were successfully subpassaged. PMID- 3298557 TI - Facilitating smoking cessation. PMID- 3298556 TI - The distribution of serum albumin in rat peripheral nerve. AB - To clarify the nature of the blood-nerve barrier (BNB) in excluding serum proteins from peripheral nerve endoneurium, we studied the ultrastructural distribution of albumin in peripheral nerve using light and electron microscopic immunocytochemistry. We found that serum albumin is commonly found within the endoneurium, but that it is not normally found intraaxonally. After subperineurial injection of labeled albumin, the albumin redistributed within intrafascicular clefts towards the perivascular spaces and the perineurium. These results suggest that, contrary to previous evidence, axons are exposed to serum proteins in normal nerves, and implies that they may be subject to interaction with abnormal proteins or altered serum proteins without any disruption of the BNB. PMID- 3298558 TI - Therapy of chronic myelogenous leukemia with allogeneic bone marrow transplantation. AB - From December 1982 to January 1986, 57 patients received allogeneic bone marrow transplantation as therapy for Philadelphia chromosome (Ph') positive chronic myelogenous leukemia (CML). All patients were prepared for transplantation with cyclophosphamide 60 mg/kg (day -6, -5) and fractionated total body irradiation, 165 cGy twice daily (day -4, -3, -2, -1) and received major histocompatibility (MHC) matched donor marrow (day 0). All patients received graft-v-host disease (GVHD) prophylaxis with methotrexate, prednisone, and either antithymocyte globulin (ATG) (55 patients) or OKT3 infusion (two patients). The projected survival of 29 chronic phase patients is 64% (95% confidence interval [Cl] 42% to 86%); and of 28 accelerated phase patients, 30% (95% Cl, 12% to 48%) at 30 months (P = .005). Multivariate regression analysis of pretransplant patient characteristics demonstrated that the presence of chronic phase and age less than 30 years were the only prognostic features studied that independently predicted survival. No evidence of persistent or recurrent disease has occurred in chronic phase patients; however, reappearance of the Ph' was observed in seven accelerated-phase patients, and hematologic relapse occurred in three of these seven patients. The incidence of grade II to IV acute GVHD is 63% (95% Cl, 50% to 76%) at 100 days, and that of extensive chronic GVHD is 53% (95% Cl, 33% to 74%) at 30 months. The median Karnofsky activity assessment of survivors is 100% (range, 60% to 100%), and all activity assessments less than 100% can be attributed to complications of GVHD. Bone marrow transplantation therapy for CML after preparation with cyclophosphamide and fractionated total body irradiation results in a high proportion of disease-free survival in chronic-phase patients. Survival in accelerated phase is significantly worse and is associated with relapse. GVHD has emerged as a significant cause of morbidity and mortality in this study. PMID- 3298559 TI - Mitoxantrone versus doxorubicin in combination chemotherapy for advanced carcinoma of the breast. AB - One hundred fifteen patients with metastatic carcinoma of the breast were treated in a randomized trial of mitoxantrone (Novantrone, Lederle Laboratories, Pearl River, NY) combined with vincristine and prednisolone (VMP) or doxorubicin (Adriamycin, Adria Laboratories, Columbus, OH) combined with vincristine and prednisolone (VAP). In 100 evaluable patients, the objective response rates were 35% for VMP and 61% for VAP, the complete response rates being 6% and 13%, respectively. In responding patients, median time to progression was 6.2 months for VMP and 7.9 months for VAP. The median survival whether measured from primary diagnosis, first metastasis, or from the start of chemotherapy was similar for both regimens. Toxicity, particularly alopecia, was appreciably lower in the VMP treated patients, but subclinical cardiotoxicity was seen within the scheduled dosage for both combinations. We conclude that VAP is clearly more active, but clinically more toxic than VMP. There is no survival advantage conferred by the more toxic combination. Cardiac toxicity is a potential hazard with either drug combination. PMID- 3298560 TI - Etiology and treatment of chemotherapeutic agent extravasation injuries: a review. AB - While extravasation from intravenous (IV) lines is common and usually benign, leakage of certain drugs can cause severe skin ulceration. These ulcerogenic drugs can be conveniently divided into two categories, depending on whether they bind to DNA. Chemotherapeutic agents such as doxorubicin, which bind to DNA, are especially prone to cause severe extravasation skin ulcers. These ulcers are often chronic and progressive. Neither clinical nor experimental studies have shown an antidote to doxorubicin extravasation, which is best prevented by careful technique. If extravasation is suspected, the infusion should be immediately stopped. In the event of extravasation, elevation and ice are the currently recommended treatment. While small ulcerations may on occasion heal, large ulcerations require surgical excision for relief of pain and salvage of underlying tissues. PMID- 3298561 TI - The impact of the NINCDS on the neurosciences: an essay written for the centennial of the NIH. AB - This essay, written as a contribution to the June 1987 participation by the NINCDS in the celebration of the centennial of the NIH (dated from the founding of the Hygienic Laboratory at Staten Island in 1887), discusses the impact of the NINDB/NINCDS on the neurosciences. Contrasts are drawn with the status of basic and clinical neurosciences in the late 19th century and prior to 1950, when the NINDB was established. This impact has involved its role as advocate and focal point for the support of research and research training in the neurosciences; the training of research and academic personnel and the funding of research projects, both significant factors in the postwar proliferation of methods and technologies; and the catalyzing of the steady progress in scientific knowledge, as reflected in examples from various facets of the programs of the neurological institute, in a continuum from the very basic and fundamental to the very clinical and pathological neurosciences. PMID- 3298562 TI - Immunological identification of a nicotinic acetylcholine receptor on bovine chromaffin cells. AB - Two probes previously shown to distinguish the nicotinic ACh receptor of chick ciliary ganglion neurons also recognize a component on the surface of bovine chromaffin cells in culture that displays the properties expected for the chromaffin nicotinic ACh receptor. The first probe is a monoclonal antibody, mAb 35, raised against ACh receptor from Electrophorus electric organ, and the second is an alpha-neurotoxin, Bgt 3.1, purified from B. multicinctus venom. mAb 35 binds specifically to a single class of high-affinity sites on the chromaffin cells in culture. Scatchard analysis indicates a KD of 2.1 +/- 0.2 nM for the binding and a Bmax of 1.6 +/- 0.1 X 10(4) mAb 35 sites per cell. The number of sites on the cells can be reduced through modulation by exposure of the cells to Bgt 3.1. The modulation can be blocked by the cholinergic ligands d-tubocurarine and carbamylcholine. Long-term exposure to the agonist carbamylcholine alone also reduces the number of mAb 35 binding sites. Bgt 3.1 inhibits nicotine-induced catecholamine release from the cells to the same extent and with the same concentration dependence that it modulates the number of mAb 35 sites on the cells. In addition, mAb 35 treatment of the cells causes a specific and almost complete blockade of nicotine-induced catecholamine release, apparently through a modulation of the receptor. These results indicate that the bovine chromaffin component recognized by mAb 35 and Bgt 3.1 is likely to be the nicotinic ACh receptor on the cells and that it has many similarities to ACh receptors on chick autonomic neurons. PMID- 3298563 TI - The molecular genetics of nervous system tumors. AB - Major insights have resulted in the last few years from the application of the techniques of molecular genetics to problems of development, differentiation, growth control, and neoplasia. It is now recognized that these problems are often actually different facets of the central question: how are genes regulated under various circumstances? These problems are of particular interest to neurosurgeons insofar as they relate to the mechanisms of development and differentiation of the nervous system and its tumors. This review attempts to provide an introduction to the salient issues and to the current state of knowledge in these various fields in order to promote an understanding of nervous system neoplasia and of areas that bear potential importance for research and therapy. PMID- 3298564 TI - Jakob-Creutzfeldt disease associated with cadaveric dura. PMID- 3298565 TI - Mapping human somatosensory cortex with positron emission tomography. AB - Positron emission tomography measurements of regional cerebral blood flow were used to detect focal neuronal activation in the first somatosensory cortex (SI) of humans induced by cutaneous vibratory stimulation. Intravenously administered water labeled with oxygen-15 (H2(15)O) was used as a blood flow tracer to obtain five stimulated-state and two resting-state blood flow images in each of eight normal volunteers. Three cutaneous surfaces were tested: lips, fingers, and toes. Intense, highly focal SI responses were seen during all 39 stimulated-state trials. The SI responses from the three stimulation sites were anatomically distinct and formed a medial-to-lateral homonculus in every subject. Response magnitudes (increase in local blood flow) and response locales (expressed as proportionately measured bicommissural stereotaxic coordinates) were highly consistent among subjects and on repeated trials for each subject. These findings suggest that eliciting cerebral blood flow responses by cutaneous vibration provides a safe, rapid, and reproducible tool for locating and assessing the functional status of somatosensory cortex, and offers potential clinical and research utility. This study has established normative values for future applications of this experimental paradigm. PMID- 3298567 TI - Cortical localization and monitoring during cerebral operations. AB - Cortical sensory potentials have been evoked under general anesthesia by median nerve stimulation and direct cortical stimulation of the motor cortex in 35 consecutive patients with mass lesions in the middle half of the cerebral hemispheres. The evoked potentials produce movement that is useful in localizing the pre- and postcentral gyri. Ultrasound has also been used to aid in the selection of access routes to subcortical lesions while sparing the cerebral cortex bordering the rolandic fissure. In five of these 35 patients, the sensory evoked response was also monitored throughout selected portions of their operative procedures. Representative cases have been presented to illustrate how observations made with these methods have been used to facilitate the patient's intraoperative management in an effort to limit postoperative morbidity. PMID- 3298566 TI - Regulation of rCBF by intracortical vasoactive intestinal polypeptide-containing neurons. Immunohistochemical and hydrogen clearance study in rats. AB - The role of intracortical vasoactive intestinal polypeptide (VIP)-containing neurons in the regulation of cortical blood flow was investigated in rats by immunohistochemical and hydrogen clearance methods. Immunohistochemical studies revealed an intimate association between intracortical VIP-containing neurons and small blood vessels. Intracortical injection of a VIP solution (10(-5) M) produced significantly higher blood flow in the treated cortex (mean +/- standard error of the mean: 46.2 +/- 4.0 ml/100 gm/min) than in the untreated cortex (36.9 +/- 2.4 ml/100 gm/min). These data suggest that intracortical VIP-containing neurons produce dilatation of intracortical blood vessels. PMID- 3298568 TI - CT-stereotaxic drainage of colloid cysts in the foramen of Monro and the third ventricle. AB - Colloid cysts in the foramen of Monro and third ventricle account for 0.5% to 1% of all intracranial space-occupying lesions. The introduction of computerized tomography (CT) and magnetic resonance imaging has represented a major advance in the early detection of these cysts. The risks associated with the management of benign space-occupying lesions by open surgical procedures have made it necessary to search for safer techniques. The CT-stereotaxic method provides a simple, precise, and safe method of puncturing deep-seated space-occupying cysts. Between January, 1979, and December, 1984, 12 patients with colloid cysts in the foramen of Monro and third ventricle were operated on by this method. The operations were successful, and there were no intraoperative or postoperative complications. The advantages of the CT-stereotaxic method are discussed and the results are presented. PMID- 3298569 TI - Estrogen receptor immunoreactivity in meningiomas. Comparison with the binding activity of estrogen, progesterone, and androgen receptors. AB - Estrogen receptor (ER) analysis was performed in 70 meningioma samples by means of two assays: an enzyme immunoassay that used monoclonal antibodies against human ER protein (estrophilin), and a sensitive radioligand binding assay that used iodine-125-labeled estradiol as the radioligand. Low levels of ER immunoreactivity were found in tumors from 51% of patients, whereas ER binding activity was demonstrated in 40% of the meningiomas examined. In eight (11%) of the tissue samples, multiple binding sites for estradiol were observed. The immunoreactive binding sites corresponded to those of the classic high-affinity ER. In ligand binding studies, however, measurement of classic ER was considerably influenced by a second low-affinity high-capacity estrogen binding component, even at low ligand concentrations. Binding activity of the progesterone receptor (PR) and androgen receptor (AR) was determined concurrently using 17 alpha-methyl-3H-promegestone (3H-R 5020) and 17 alpha-methyl-3H trienolone (3H-R 1881), a synthetic gestagen and androgen, respectively. High concentrations of PR were detected in 53 (76%) of the tumors, whereas a moderate number of AR binding sites were demonstrated in 33 (47%) of the tumors. A positive correlation between ER immunoreactivity and AR binding activity is suggestive of estrogen regulation of AR via the ER system. The presence of gonadal steroid receptors in a large proportion of meningiomas and the tendency toward a dependence of receptor concentrations on the histological subtype of the meningioma could have implications for tumor therapy. PMID- 3298570 TI - Maleah Grover-McKay selected by E&R Foundation for 7th Tetalman Memorial Award. PMID- 3298571 TI - Renal arteriovenous transit times of technetium-radiolabeled chelates. AB - A noninvasive method was developed for quantitating the distribution of renal arteriovenous transit times of technetium-99m (99mTc) radiopharmaceuticals. Using this method, the characteristic transit times and amplitudes of the first two components of [99mTC] DTPA or MDP transit through the renal vasculature were calculated. The first component amplitude (A1) was evaluated for its ability to discriminate between 20 hypertensive patients with renovascular disease and 21 normotensive subjects. A1 was compared with three other quantitative indices: the ascending slope of the initial renal time-activity curve, the kidney-to-aorta slope ratio (K/A), and renal size. A1 nearly perfectly separated the hypertensive patients from the normotensive subjects; the ability of A1 to discriminate between these two groups is clearly superior to renal size, the initial renal slope, and K/A. We conclude that measurements of the intrarenal distribution of blood flow have distinct advantages over indices of renal blood flow that have been derived from scintillation camera measurements of 99mTc radiopharmaceuticals. PMID- 3298572 TI - Skeletal muscle blood flow in vivo: detection with rubidium-82 and effects of glucose, insulin, and exercise. AB - In order to assess the effects of glucose, insulin, and exercise on skeletal muscle blood flow in vivo, we measured positron emission from the thigh muscle of anesthetized rabbits after simultaneous aortic bolus injection of 82Rb and radiolabeled microspheres (15 micron diameter). Estimates of flow with 82Rb were based on first-pass regional extraction of 82Rb by skeletal muscle. Flow estimates were made serially as a function of variations in plasma glucose and insulin and changing the muscle contractile state by electrical stimulation. Flow ranged from 3.1 ml/min/100 g at rest to 71 ml/min/100 g during stimulation. There was good agreement between the two methods of flow measurement over the entire range of flows (r = 0.96 at a slope of 0.90). Flow measured by either method did not vary significantly from baseline over a range of plasma glucose from 5 to 30 mM and plasma insulin from 0 to 20 microU/ml. When flow was increased up to 20 fold by electrical stimulation there was a decrease in extraction of 82Rb proportional to the increase in flow. However, at pharmacologic levels of insulin (greater than 150 microU/ml) flow was increased twofold as measured by radiolabeled microspheres, but not as measured by rubidium. There was no apparent decrease in extraction of 82Rb with high insulin. The discrepancy between the microsphere measured flow and rubidium measured flow with high plasma insulin levels can be explained by the assumption that the expected decrease in the extraction fraction was counteracted by an increase in Na+/K+-ATPase activity. It is concluded that the first-pass flow model gives valid estimates of skeletal muscle blood flow in vivo with 82Rb, provided that plasma insulin levels are normal. PMID- 3298573 TI - Captopril renography in two kidney and one kidney Goldblatt hypertension in dogs. AB - In order to improve on the technique of noninvasive detection of renal artery stenosis, we studied the effects of angiotensin converting enzyme inhibition with captopril on individual kidney hemodynamics and function as assessed by technetium-99m diethylenetriaminepentaacetic acid [( 99mTc]DTPA) renal flow studies and iodine-131 orthoiodohippurate [( 131I]hippuran) renography in experimental Goldblatt's hypertension. In two-kidney, one-clip (renin-dependent) hypertension, captopril (1.5 mg/kg bolus with 1.5 mg/min infusion) reduced mean arterial pressure (MAP) and ipsilateral glomerular filtration rate (GFR) without changes in the contralateral kidney. Captopril infusion resulted in alterations in both the [99mTc]DTPA and [131I]hippuran studies, which were most evident in the 15-min [99mTc]DTPA renal flow studies. In one-kidney, one-clip (volume dependent) hypertension, captopril reduced MAP but did not alter GFR, renal plasma flow, or the radionuclide studies. These studies suggest that the [99mTc]DTPA renal flow study coupled with captopril challenge may unmask intrarenal angiotensin II-dependent functional and hemodynamic changes of the stenotic kidney, and offers promise in the detection of renin-dependent hypertension. PMID- 3298574 TI - Dissolution rate and transit times of technetium-99m DTPA-labeled tablets. AB - In this study we demonstrate that the dissolution rate and gastroduodeno-cecal transit time of radiolabeled tablets of theophylline can be determined in vivo using technetium-99m (99mTc). Six healthy male volunteers ingested a tablet containing 300 mg of theophylline mixed with 3.7 MBq of [99mTc]DTPA. Anterior and posterior scintigraphic views of the abdomen were collected serially over 8 hr, after which a 200-ml solution containing 37 MBq of [99mTc] pertechnetate was ingested in order to visualize the contours of the stomach. The in vivo activity contained in the tablet was calculated from the scintigraphic views after correction of background activity, radioactive decay, and depth attenuation. The dissolution rate of [99mTc] DTPA was also measured in vitro and compared with the dissolution rate of theophylline. The results showed close dissolution rates between [99mTc]DTPA and theophylline in vivo (T1/2 184 min and 176 min, respectively), and a faster early dissolution rate of [99mTc]DTPA in vitro (T1/2 92 min versus 156 min for theophylline). The mean gastroduodenal and duodenocecal times were 72 +/- 25 min (m +/- s.d.) and 245 +/- 15 min, respectively. Scintigraphic imaging of labeled formulations with 99mTc present useful applications in pharmaceutics and pharmacology. PMID- 3298577 TI - Curriculum development in nursing education, 1890-1952. PMID- 3298575 TI - Letters to Miss Sanborn: St. Vincent's Hospital Nurses' accounts of World War I. PMID- 3298578 TI - A nurse on the best-seller list: Mary Roberts Rinehart (12 August 1876-22 September 1958). PMID- 3298579 TI - Pharmacologic role of cysteine in ameliorating or exacerbating mineral toxicities. AB - Cysteine, via chelation reactions, ameliorates biochemical lesions caused by excessive ingestion of several trace elements. Because oral cysteine per se is considerably more protective than the in vivo metabolic cysteine precursors, methionine or cystine, chelation of cysteine with trace elements likely occurs primarily in the gut, thereby decreasing absorption of both cysteine and the trace element in question. Hence, using copper as an example, orally administered cysteine markedly improves growth and reduces liver copper deposition in chicks or rats fed a high level of inorganic copper. Likewise, excessive copper ingestion impairs sulfur amino acid (SAA) utilization and increases the dietary requirement for SAA. Cobalt and selenium toxicities are also ameliorated by oral cysteine ingestion, with the responses being even more striking than those occurring with copper toxicity. While inorganic arsenic poisonings are generally ameliorated by administering cysteine or a cysteine derivative (e.g., dimercaptopropanol), organic pentavalent arsenic toxicity is exacerbated by cysteine administration. Cysteine in this instance acts as a reducing agent, facilitating conversion of organic pentavalent arsenicals such as roxarsone and arsanilic acid to the more toxic trivalent state. PMID- 3298581 TI - Oxygen consumption and metabolite flux of bovine portal-drained viscera and liver. AB - Oxygen (O2) uptake and net metabolite flux by portal-drained viscera (PDV) and hepatic (HEP) tissues have been quantitated in vivo by measuring blood flow and arteriovenous concentration differences in cattle with chronic indwelling catheters in appropriate blood vessels. Results from use of this technique show that PDV of cattle account for 8-10% of body tissue, but 18-25% of whole animal O2 consumption. Similarly, HEP tissues account for 1-2% of body tissues, but more of whole animal O2 consumption than PDV. Glucose, volatile fatty acids (VFA), glutamate and glutamine are used as substrates by PDV; ketones, alanine and glycine are major products of PDV metabolism that are transported to HEP tissues along with absorbed VFA, ammonia, amino acids and other products of digestion. Most amino acids, L-lactate, propionate and butyrate and ammonia in blood from PDV are removed by HEP tissues, which in turn release glucose, glutamate, branched-chain amino acids, ketones, acetate and urea to peripheral blood. Net HEP flux of glucose measured by this technique is compatible with glucose requirements for lactation and other metabolism; similarly, HEP uptake of ammonia and alpha-amino N can account for 95% of HEP release of urea N. The technique is a powerful tool for quantitation of intermediary metabolism. PMID- 3298580 TI - Menaquinone production and utilization in germ-free rats after inoculation with specific organisms. AB - Although menaquinones are biologically active forms of vitamin K, factors that influence their production by bacteria or their absorption from the gut are not well understood. Germ-free rats were inoculated with four different strains of organisms and fecal and tissue menaquinone concentrations were determined. No menaquinones were detected in the tissues or feces of rats colonized with Bifidobacterium longum or Clostridium ramosum, two organisms that have not been reported to produce menaquinones when grown in pure cultures. Rats colonized with Bacteroides vulgatus had high levels of fecal MK-10 with significant amounts of MK-9 and MK-11, whereas rats colonized with Escherichia coli had high levels of fecal MK-8 and small amounts of MK-7. The same menaquinones are produced in pure cultures of these organisms. The predominant fecal menaquinones were also detected in liver and were present in higher concentrations in the liver of those rats not maintained in coprophagy-preventing cages. PMID- 3298582 TI - Hepatic ketogenesis and peripheral ketone body utilization in the ruminant. AB - Hepatic and alimentary ketogenesis occur at similar rates in fed, nonpregnant, nonlactating goats, sheep and dairy cows. Alimentary ketogenesis begins to diminish within 24 h after fasting but compensatory increases in hepatic ketogenesis maintain total splanchnic release and, therefore, no change in circulating concentrations of ketone bodies is observed. By the third day of fast the gut is utilizing acetoacetate and beta-hydroxybutyrate and alimentary ketogenesis has ceased. Hepatic ketogenesis of both ketone bodies accelerates rapidly due to portal-drained visceral and hindquarter lipolysis and subsequent hepatic fatty acid uptake and total circulating concentrations are doubled. During pregnancy and lactation in sheep and cows alimentary ketogenesis is maintained as long as digestible organic matter intake is constant. Hepatic and total splanchnic release of beta-hydroxybutyrate increases in late gestation and early lactation. Again, this is due to increased portal-drained visceral and hindquarter free fatty acid release and hepatic free fatty acid uptake. Hindquarter uptake of both ketones during late gestation is similar to the ratio observed in nonpregnant fed sheep but the percentage of utilization decreases, perhaps reflecting partitioning to uteroplacental tissues. Hindquarter uptake of both ketone bodies in sheep increases in early lactation due to increased circulating concentrations because extraction ratios are similar to those of fed animals. Ketosis during pregnancy in sheep and lactation in cows may be prevented by beta-hydroxybutyrate stimulation of pancreatic insulin production. However, an insulin-independent intrahepatic mechanism apparently occurs in sheep.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298583 TI - Statistical properties of radio-frequency and envelope-detected signals with applications to medical ultrasound. AB - Both radio-frequency (rf) and envelope-detected signal analyses have lead to successful tissue discrimination in medical ultrasound. The extrapolation from tissue discrimination to a description of the tissue structure requires an analysis of the statistics of complex signals. To that end, first- and second order statistics of complex random signals are reviewed, and an example is taken from rf signal analysis of the backscattered echoes from diffuse scatterers. In this case the scattering form factor of small scatterers can be easily separated from long-range structure and corrected for the transducer characteristics, thereby yielding an instrument-independent tissue signature. The statistics of the more economical envelope- and square-law-detected signals are derived next and found to be almost identical when normalized autocorrelation functions are used. Of the two nonlinear methods of detection, the square-law or intensity scheme gives rise to statistics that are more transparent to physical insight. Moreover, an analysis of the intensity-correlation structure indicates that the contributions to the total echo signal from the diffuse scatter and from the steady and variable components of coherent scatter can still be separated and used for tissue characterization. However, this analysis is not system independent. Finally, the statistical methods of this paper may be applied directly to envelope signals in nuclear-magnetic-resonance imaging because of the approximate equivalence of second-order statistics for magnitude and intensity. PMID- 3298584 TI - Nerve sharing by an interpositional sural nerve graft between the great auricular and inferior alveolar nerve to restore lower lip sensation. AB - A case of bilateral nerve sharing via an autogenous sural nerve graft interposed between the ipsilateral great auricular nerve and the inferior alveolar nerve was used to restore sensation to the lower lip. To our knowledge this is the first report of successful nerve sharing between a sensory branch of the cervical plexus and the inferior alveolar nerve. PMID- 3298585 TI - Circumferential cross-sectional specimen preparation for surgical margin evaluation. PMID- 3298586 TI - Denture stomatitis: a review. AB - Denture stomatitis has been reported in 11-67% of complete denture wearers. It is more common on the palatal mucosa and in female patients. In Newton's type I denture stomatitis, where the inflammation remains focal, trauma seems to be responsible. In Newton's types II and III denture stomatitis, where the denture bearing mucosa is diffusely involved, most workers assert that the aetiology is multi-factorial. Evidence is presented incriminating Candida albicans colonization of the fitting surface of the prosthesis in many cases of denture stomatitis promoted by continuous denture wearing. Allergic and primary irritant reactions to the denture base material, systemic predisposing factors including dietary deficiency and haematological disorders, also play a part. In most cases of denture stomatitis, elimination of denture faults, control of denture plaque and discontinuous denture wearing are sufficient treatment. The routine use of antiseptic or antimycotic drugs seems unnecessary. PMID- 3298587 TI - Cantilever bridges or removable partial dentures in geriatric patients: a two year study. AB - The purpose of this study was to compare prosthetic, functional and occlusal conditions in twenty-seven patients treated with distally extending cantilever bridges and twenty-six patients treated with removable partial dentures (RPD) in the mandible. All patients had a complete upper denture. Mean age of the patients in both groups was about 69 years. The patients were under a supervised oral hygiene care throughout the 2-year study period. There were 6.9 +/- 1.7 mandibular teeth left in the bridge group and 7.5 +/- 1.7 in the RPD group and the mean number of posterior teeth (natural teeth/denture teeth/pontics) in occlusion was 4.1 +/- 1.1 and 7.3 +/- 1.4, respectively. During the study period signs and symptoms of mandibular dysfunction became significantly aggravated in the RPD group, P less than 0.05. A balanced occlusion in the muscular contact position was observed in 90% of the patients in the bridge group and in 76% of the RPD wearers. During the study period the need for dental or prosthetic treatment was negligible in the patients treated with bridges. In the RPD group, twenty-two teeth were restored with fillings due to caries and in eight patients major adjustments of the sublingual bar were necessary due to irritation of the oral mucosa. This study has shown that treatment with distally extending cantilever bridges in the mandible is a favourable alternative to treatment with removable partial dentures in elderly patients with a reduced dentition. PMID- 3298589 TI - Effect of clasp design on gingival health. AB - A comparison has been made of the effects on the gingivae of occlusally and gingivally approaching clasps. The effect on the gingivae has been assessed by measuring plaque accumulation, crevicular temperature and microbial distribution in patients and students wearing appliances. Habitual and nil oral hygiene regimes have been used to demonstrate changes. It was concluded that the gingivally approaching clasp is potentially damaging. PMID- 3298588 TI - Experiences with resin-bonded bridges and splints--a retrospective study. AB - In a joint evaluation of 496 resin-bonded bridges and splints anchored by various retention principles and composites, the initial experiences of seventeen clinicians were compiled. The main indications for treatment were congenital anodontia and loss of teeth due to caries and trauma. After 3 months, 95% of the bridges were still in place without need of reattachment procedure. After 6 months the figure was 91%, after 1 year 81.5% and after 1 1/2 years 73%. Seventy five per cent of the loosened bridges were attached successfully a second time. The success rate for splints was significantly lower. PMID- 3298590 TI - The influence of enamel prism orientation on leakage of resin-bonded restorations. AB - A new method is described for the quantification of leakage between etched enamel and restorative resin. A significant correlation was demonstrated between the plane of enamel section prior to etching and subsequent leakage. It is suggested that these findings will be of value in the design of cavities for use with the acid-etch technique; when possible, enamel should be prepared to expose prisms transversely prior to etching and bonding. PMID- 3298591 TI - Molecular and clinical advances in congenital adrenal hyperplasia. PMID- 3298592 TI - Tracheal and bronchial injury in high-frequency oscillatory ventilation compared with conventional positive pressure ventilation. AB - We compared airway histopathologic findings in premature baboons given standard positive pressure ventilation with those seen after high-frequency oscillatory ventilation. Six animals received standard frequency conventional ventilation for a mean of 9.2 days; seven received high-frequency oscillatory ventilation at 10 Hz using a piston oscillator for a mean of 10.2 days; five baboons served as controls, and were killed immediately after birth. A semiquantitative histopathologic scoring system was used to grade tissue changes in the trachea, carina, and both mainstem bronchi. Compared with the nonventilated control animals, injury was produced with both forms of mechanical ventilation (P less than 0.01 for both instruments); however, the degree of damage was mild, with no significant difference in the extent of injury between the two treatment groups. High-frequency oscillatory ventilation appears to result in no greater degree of airway damage than conventional positive pressure ventilation. PMID- 3298593 TI - Performance of an enzyme immunoassay test and anaerobic culture for detection of group A streptococci in a pediatric practice versus a hospital laboratory. AB - The ability of pediatricians and hospital laboratory personnel to detect group A streptococci in patients with suspected streptococcal pharyngitis was evaluated using the TestPack Strep A and anaerobic culture. Duplicate throat specimens (for similar processing by both the pediatricians and laboratory technologists) were simultaneously collected on rayon-tipped swabs from patients with symptoms of pharyngitis. Each swab was first inoculated to a 5% sheep blood agar plate, then tested for group A streptococcus antigen using the TestPack Strep A according to the manufacturer's instructions. Cultures were incubated anaerobically at 35 degrees C for 2 nights unless positive after 1 night. Group A streptococci were identified using specific antisera. Pediatric office or laboratory cultures from 112 (31.3%) of the 358 patients contained group A streptococci. Of the patients with positive cultures, 96 (85.7%) and 107 (95.5%) were detected by the pediatricians and laboratory, respectively. Respective findings with the TestPack Strep A by the pediatricians and laboratory were sensitivity 68.8% and 74.8%, specificity 94.3% and 95.6%, predictive value of a positive result 81.5% and 87.9%, and predictive value of a negative result 89.2% and 89.9%. Anaerobic culture was significantly more sensitive than the TestPack Strep A for detection of group A streptococci by both the pediatricians (P less than 0.005) and laboratory personnel (P less than 0.05). PMID- 3298594 TI - Prospective controlled study of home and hospital therapy of cystic fibrosis pulmonary disease. AB - A controlled prospective study was undertaken to compare the efficacy and benefits of home and hospital treatment for patients with exacerbations of pulmonary disease caused by cystic fibrosis. A total of 41 home and 41 hospital treatments were analyzed. Home and hospital patients were matched according to sex, age, pulmonary function tests, and arterial blood gas values. Both home and hospital treatments resulted in statistically significant improvement in pulmonary function. A comparison of these values did not show any statistically significant difference between groups at admission or discharge. Furthermore, the mean number of treatment days for both groups, individually determined by the primary physician, was equivalent (home 17.7 +/- 1.1 days, hospital 18.1 +/- 4.1). The mean charge for a home treatment was approximately $10,000, and for a hospital treatment $18,000. Sixty-five percent of home care patients and 68% of hospital patients required retreatment for pulmonary exacerbations within the study period; the interval between pulmonary exacerbations for the two groups was not significantly different. In addition, 85% of patients receiving treatment at home were able to maintain at least some of their school or work activities. These data indicate that home therapy for cystic fibrosis patients with pulmonary exacerbations is less costly and is as effective as in-hospital therapy. PMID- 3298595 TI - Bone marrow transplantation in DiGeorge syndrome. AB - A Hispanic infant girl with DiGeorge syndrome underwent successful bone marrow transplantation (BMT) at age 28 1/2 weeks. She had typical facies, a cardiac defect, hypoparathyroidism, severe T and B cell immunodeficiency, and low levels of facteur thymique serique (FTS). In vitro incubation of the peripheral blood lymphocytes with thymosin alpha 1 showed no increase in the number of T cells on two occasions. A fetal thymus for transplantation was not available, and further review of past experience with thymic cells or factors revealed inconsistent and incomplete responses. Because of the patient's worsening clinical and immunologic status, BMT was performed, with her histocompatible brother as donor. The patient has had a good clinical and immunologic response to BMT, with evidence of T cell engraftment, improved B cell function, and increased levels of serum FTS. This experience indicates that minimal thymic influence is necessary for successful BMT and that patients with DiGeorge syndrome with significant T cell deficiency may benefit from this treatment. PMID- 3298596 TI - OKT3 monoclonal antibody in pediatric kidney transplant recipients with recurrent and resistant allograft rejection. AB - Twelve pediatric patients, aged 28 months to 17 years, received OKT3 to reverse renal allograft rejection. In 11 patients, the rejection crisis was resistant to conventional antirejection therapy with high doses of prednisone or polyclonal antithymocyte globulin. Reversal of rejection was successful in 10 patients who completed a treatment course. Because of recurring resistant rejection, five patients received a second course of OKT3, which was successful in reversing the rejection crisis in two. Among these patients, the persistence or the appearance of high levels of circulating T3 lymphocytes after initiating the second treatment course correlated with treatment failure. The immediate side effects associated with OKT3 therapy were transient and medically manageable. We conclude that this monoclonal antibody preparation is a safe and effective treatment for pediatric renal allograft in recipients experiencing rejection crisis resistant to conventional therapy. However, the potential impact of this immunosuppressive medication on long-term renal allograft survival in this patient population remains to be determined. PMID- 3298597 TI - Absence of plasma prostacyclin stimulating activity deficiency in hemolytic uremic syndrome. AB - We compared the effect of plasma from 19 children with hemolytic uremic syndrome (HUS) on prostacyclin (PGI2) production by fresh rat aortic rings to the effect of plasma from 17 age- and sex-matched normal children, taking into account the PGI2 baseline aortic production (PGI2 release in presence of buffer, 21 determinations). After 10, 20, 30, 40, and 60 minutes incubation of rat aortic tissue with either plasma or buffer, the presence of PGI2 was studied by measuring by radioimmunoassay (RIA) the concentration of 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha). 6-keto-PGF1 alpha production increased with time in the two groups of plasma samples and in the presence of buffer, but 6-keto-PGF1 alpha production (ng/mg dried tissue) after 30 minutes incubation and mean 6-keto PGF1 alpha production (slope of regression line, ng/mg/min) were significantly (P less than 0.01) lower in the presence of normal plasma compared with buffer, and significantly (P less than 0.01) higher in the presence of HUS plasma compared with normal plasma. There was no significant difference between buffer and HUS plasma. We conclude that, under our experimental conditions, normal plasma had an inhibitory activity on 6-keto-PGF1 alpha production by rat aorta. This inhibitory activity was absent in HUS plasma. PMID- 3298598 TI - More on rapid strep test kits: when is negative truly negative? PMID- 3298599 TI - The role of Schistosoma mansoni males in feeding and development of female worms. AB - Female Schistosoma mansoni from unisexual infections have scant pharyngeal musculature, thin intestinal cecal walls, pale and scanty intestinal contents, and lack acidic thiol proteinase digestive enzyme as determined by indirect immunofluorescence using a monoclonal antibody. Their intake of host erythrocytes, measured by 51Cr labeling, is about one-fourth that of paired adult females, and they appear to be starved. In contrast, paired adult females have heavier pharyngeal musculature and intestinal cecal walls and abundant digestive enzyme in the anterior third of their intestinal tract. Females in worm pairs surgically transplanted into uninfected mice continued to feed, but separated females were carried into the liver and deteriorated. Adult female S. mansoni, newly separated from their male partners and incubated in vitro with labeled erythrocytes, ingested marginally fewer cells than did still-paired females, indicating their ability to continue feeding almost normally at least for a period after separation. Paired and ex-paired adult females declined similarly in feeding rate with increased time in vitro. In Schistosomatium douthitti, females grow and mature without males, the pharyngeal musculature and cecal walls are well developed, the gut is full of ingested blood, and the acidic thiol proteinase is present in both unisexual and paired female worms. There are different stimulatory pathways for growth and for reproductive maturation in S. mansoni, although both processes require physical contact with the male. We believe that the growth-stimulating function results from the muscular action of the clasping male, which helps the immature female to pump blood into her intestine, thereby overcoming a state of relative starvation. PMID- 3298600 TI - Cytoplasmic polyhedrosis viruses in Phlebotomus papatasi inhibit development of Leishmania major. AB - Cytoplasmic polyhedrosis viruses (CPV's) were observed in wild-caught and laboratory-reared Phlebotomus papatasi. Chronic CPV pathology of the midgut, characterized by structural aberrations in the epithelium and the peritrophic membrane, interfered with blood digestion and rendered the sand flies refractory to Leishmania major infections. Rates of natural and artificial L. major infections were inversely correlated to the incidence of CPV infections. The interaction between viruses and protozoan parasites in an insect host is of basic biological interest and in this case may be of significance in the epidemiology of cutaneous leishmaniasis. PMID- 3298602 TI - Production of monoclonal antibodies specific for Eimeria tenella microgametocytes. AB - A panel of 4 monoclonal antibodies specific for Eimeria tenella, the causative agent of cecal coccidiosis of birds in the genus Gallus, was produced by standard techniques. The indirect fluorescent antibody (IFA) test demonstrated specificity of these 4 antibodies for the microgametocytes. Hybridoma TIA3B9 secreted a monoclonal antibody of subisotype IgG2b that was used throughout the course of this study. Immunologic potency of this antibody was demonstrated by in vitro experiments that revealed a greater than 50% reduction in oocyst production, indicating an apparent inhibition of fertilization. PMID- 3298601 TI - Analysis of Toxocara canis larval excretory-secretory antigens: physicochemical characterization and antibody recognition. AB - Toxocara canis larval excretory-secretory antigens (TEX) were resolved by gradient pore polyacrylamide gel electrophoresis and analyzed using silver, periodic acid-Schiff, and immunoperoxidase stains. At least 15 bands between 29 and 94 kilodaltons (kDa) were detected by silver stain, all of which were recognized by antibodies in serum of a patient with visceral larva migrans. Immunoperoxidase stain detected an additional band at 92 kDa and 4-6 others above 200 kDa. Periodic acid-Schiff stain also detected the high molecular weight components, but did not detect constituents of approximately 53 and 57 kDa. Immunoperoxidase stain using antibody from the vitreous fluid of an ocular larva migrans patient detected 2 TEX components, approximately 76 and 80 kDa. Antigens were compared with respect to batch of larvae and age of larvae in culture. Qualitative differences that correlated with batch were found in the number of constituents above 200 kDa, and in 1 component of 78 kDa. Qualitative differences were noted in many minor components, some of which appeared to correlate with age of larvae in culture. Major TEX constituents were recognized consistently by antibody, regardless of batch or age of larvae. Total protein production per larva was approximately 8 ng/day, and was consistent over time. There was no evidence of neutral proteases in TEX. PMID- 3298603 TI - Helminth remains from prehistoric Indian coprolites on the Colorado Plateau. AB - Examination of coprolites excavated from archaeological sites in the Americas demonstrates excellent preservation of helminth eggs and, in some cases, larvae. To gain an understanding of helminth parasitism in prehistory on the Colorado Plateau of Arizona, New Mexico, and Utah, 319 coprolites from 5 archaeological sites were analyzed. Helminth eggs and larvae were recovered after the coprolites were rehydrated, screened, and sedimented. At a sixth site, soils excavated from 5 rooms used as latrine areas were processed with palynological techniques. The results indicate that all but 1 of the prehistoric populations examined were infected with intestinal worms. The helminths implicated are Enterobius vermicularis, Trichuris trichiura, cf. Ascaris lumbricoides, cf. Trichostrongylus sp., cf. Strongyloides sp., taeniid cestodes, and hymenolepidid cestodes. The study suggests that prehistoric hunter-gatherer peoples carried fewer helminth parasites than agriculturalists. At 1 site, it appears that increased helminth parasitism preceded abandonment of the village. PMID- 3298604 TI - Evidence for transfer of a glycoprotein from male to female Schistosoma mansoni during pairing. PMID- 3298605 TI - Studies on the thermal destruction of Escherichia coli endotoxin. PMID- 3298606 TI - The effects of soluble Saccharomyces cerevisiae mannan on the phagocytosis of Candida albicans by mouse peritoneal macrophages in vitro. AB - Saccharomyces cerevisiae mannan inhibited the phagocytic activity and phagocytic capacity of mouse peritoneal macrophages elicited by Concanavalin A (Con A) for Candida albicans yeast cells that were either unopsonized or opsonized with C3. The mannan had no effect on the phagocytosis of C. albicans opsonized with normal human serum or immunoglobulins. Phagolysosome fusion in macrophages was unimpaired by the presence of S. cerevisiae mannan, which supports previous observations that mannan does not interfere with neutrophil degranulation. PMID- 3298607 TI - Thermometric consideration for RF and microwave research in food engineering. AB - A review of thermometric methods for the processing of food materials at RF and microwave frequencies is presented. Some areas of needed food engineering research are discussed, as well as factors of importance in the selection of temperature monitoring systems. PMID- 3298608 TI - Extracellular matrices and polypeptide growth factors as mediators of functions of cells of the periodontium. A review. AB - This is a review of the interactions between cells and their extracellular matrices and polypeptide growth factors. The review not only attempts to provide a basic understanding of the functions of extracellular matrices and polypeptide growth factors but, in addition, suggests the role these biological molecules may play in periodontal regeneration. It is conceivable that future periodontal therapy will include the treatment of a scaled root with biological response modifiers to predictably attain a true new connective tissue attachment. PMID- 3298609 TI - The concentration of lipopolysaccharide on individual root surfaces at varying times following in vivo root planing. AB - Material with endotoxin activity has been detected in extracts prepared from pooled, periodontally involved teeth, and it has been shown that root planing in vivo reduces the level of such material. However, questions concerning the concentration of endotoxin on the diseased surfaces of individual teeth and questions concerning how rapidly individual root planed tooth surfaces retoxify in vivo have not been addressed previously. Citric acid extracts were prepared from individual, periodontally diseased teeth that had been extracted either from the oral cavity without prior root planing or at varying times up to 12 weeks following root planing. Using a chromogenic Limulus Amebocyte Lysate (LAL) assay, we were able to quantitate the amount of endotoxin associated with diseased root surfaces of individual teeth. We concluded that the extracted material contained endotoxin since it activated LAL and since the LAL-activation was heat-stable, acid-stable and neutralizeable by polymyxin B. The levels of endotoxin found on the root surfaces of these individual, periodontally involved teeth at varying times following in vivo root planing support the following conclusions: the concentration of endotoxin present on diseased root surfaces is markedly reduced, but not eliminated, by in vivo root planing, significant retoxification of root planed surfaces occurs within a relatively short time period after root planing and biological responses to such toxification conceivably may lead to subsequent phases having reduced levels of endotoxin. PMID- 3298610 TI - Periodontal manifestations of the heritable Mac-1, LFA-1, deficiency syndrome. Clinical, histopathologic and molecular characteristics. AB - The clinical, histopathologic and functional consequences of the genetic deficiency of leukocyte Mac-1, LFA-1 and p150,95 were assessed among three affected patients, heterozygotes and unaffected individuals among two generations of a single kindred. Longitudinal assessments of this family afforded the unique opportunity to characterize the natural history of severe periodontal manifestations associated with this disorder. Features uniformly observed among each patient included recurrent, necrotic soft tissue infections, impaired pus formation, delayed wound healing, constant granulocytosis, severe abnormalities of adhesion-dependent granulocyte functions and a profound deficiency (3%-6% of normal) of Mac-1 glycoproteins on granulocyte surfaces. Characteristic features of generalized prepubertal periodontitis including rapidly progressive alveolar bone loss affecting the primary and permanent dentitions (leading to premature tooth loss), recession, clefting and migration in association with intense gingival inflammation were uniformly observed. Biopsies of inflamed periodontal tissues in these individuals demonstrated dense infiltrates of mononuclear leukocytes but a striking absence of extravascular neutrophil granulocytes. Heterozygous family members demonstrated approximately half normal Mac-1 protein expression but no susceptibility to systemic infections and normal, adhesion dependent leukocyte functions. Prepubescent heterozygotes demonstrated no periodontal manifestations but a 31-year-old heterozygous female exhibited clinical and radiographic features typical of postjuvenile periodontitis. The profound periodontal manifestations recognized in this clinical-pathologic model emphasize the physiologic importance of leukocyte adhesion reactions in defense of the periodontium and further suggest a possible pathologic role for Mac-1 proteins in other forms of early-onset periodontitis. PMID- 3298611 TI - Relations between Hand Test variables and the psychological characteristics and behaviors of battered women. AB - Battered and nonbattered women were administered the Hand Test to determine which psychological test variables could distinguish between these groups. Compared to the nonbattered group, the battered group produced substantially more fear responses. We also found significant positive relationships between the amount of fear responses produced and frequency of abuse, number of previous visits to a battered women's shelter, and medical treatment sought following an abusive incident. We discuss these results in the context of previous findings and their implications for the personality of battered women. We speculate that lowered environmental interest might be a personality factor that prolonged the abuse and that fear is a basic reaction to anticipated bodily harm. PMID- 3298612 TI - Production of metalloproteinase in gastric tissue with acetic acid-induced ulcer or taurocholic acid-induced gastritis. AB - A metalloproteinase was extracted from a medium of cultured gastric tissues following acetic acid-induced ulcer or taurocholic acid-induced gastritis, and the enzyme was partially purified by Sephadex G-200 column chromatography. This proteinase was released in active and latent forms with apparent molecular weights of 170,000 and 210,000, respectively. Its activity was abolished by treatment with ethylenediaminetetraacetic acid or 1,10-phenanthroline, but not with phenylmethylsulfonyl fluoride or soybean trypsin inhibitor. This enzyme degraded type I gelatin and type IV collagen but did not attack type I collagen. In contrast, very little of this enzyme was released from gastric tissue following erosion caused by water-immersion stress or from normal gastric tissue. These results suggest that this metalloproteinase plays an important role in gastric lesions by breaking down the basement membrane. PMID- 3298613 TI - [Fluorescent enzyme immunoassay for 17 alpha-hydroxyprogesterone]. PMID- 3298614 TI - [Research on new beta-lactam antibiotics; penem and carbapenem]. PMID- 3298616 TI - RNA polymerase binding sites on a plasmid R6K derivative with increased copy number. AB - The specific binding of Escherichia coli RNA polymerase molecules to the DNA of plasmid pNH602, a deletion derivative of R6K having an increased copy number, was detected by electron microscopy. Seven strong RNApol binding sites were found on pNH602 DNA linearized with BamHI or EcoRI restriction endonuclease. All of these specific sites occur in genetically defined regions of the pNH602 molecule. Two of them correspond with the recently reported transcription initiation sites within a region essential for plasmid R6K replication. PMID- 3298615 TI - Transactivation of several genes of two native Serratia prophages after superinfection by phage kappa. AB - Serratia marcescens HY bacteria must be lysogenic with either prophage y or psi to make it possible for phage kappa to form plaques unless they carry a so-called ink mutation. Genes in y and psi termed any and anp were identified that after infection of ink+ cells are necessary for an effective propagation of these phages as well as of coinfecting kappa phage. When kappa infects y and/or psi lysogenic cells it transactivates the respective prophage genes by means of two early genes termed tay and tap. It appears that on infection of nonlysogenic ink+ cells kappa damps its own development, provided the regulatory region of the responsible gene is undermethylated. After kappa infection duly to achieve the special methylation of this region seems to be the function of any and anp. There are some more genes in y and psi prophage under the control of tay and tap, concerning in both cases a Dam methylation (recognition sequence GATC) of kappa DNA, a recombination proneness under restricting conditions of kappa DNA not modified by the modification enzyme of HY, and the kappa plaque size. By hybridization studies a region of homology common to y and psi was demonstrated which from its size might comprise all the transactivated genes. The view is supported by genetic data indicating an affinity among the any and anp genes. Investigation of various any mutants were indicative of DNA inversions in this region of the y genome. Surprisingly some of the any mutants had become sensitive in their plaque forming ability to an inhibitory activity exerted by prophage psi. Mutants of psi unable to interfere but still able to lysogenize were isolated. A model is presented accounting for the formation of pleiotropic and nonpleiotropic mutations with Any phenotype and their reversion types. Possible functions of the y genes and their counterparts in psi are discussed. PMID- 3298618 TI - Models for the pharmacokinetics and pharmacodynamics of insulin in alloxan induced diabetic dogs. AB - A combined pharmacokinetic/pharmacodynamic model was proposed to describe the pharmacokinetics of intravenously administered regular insulin (0.55 units/kg) in alloxan-induced diabetic dogs. Serum insulin concentrations were described by either a one- or two-compartment open model, in which a hypothetical effect compartment was linked to the central pharmacokinetic compartment, or in which the effect compartment was linked to the peripheral compartment. Response, as measured by percent change in glucose concentration from adjusted basal plasma concentrations, was modeled using the sigmoidal Emax effect model, a linear effects model, a log-linear effects model, and a gamma-linear effects model, using the insulin pharmacokinetic parameters to describe the amount in the hypothetical effect compartment. The results indicated that insulin pharmacokinetics are usually described by a two-compartment open model. Response to insulin was predicted more accurately in half of the dogs using the gamma linear effects model in which the effect compartment was linked to the central compartment. In the other half of the dogs the best model was the sigmoidal Emax model in which the effect compartment was linked to the central pharmacokinetic compartment. The parameters in the latter model were correlated with each other and the confidence limits of the parameter estimates were larger than the parameters of the gamma-linear effects model. These models should be further investigated, but may offer an alternative method for distinguishing rapid insulin metabolism from insulin resistance. PMID- 3298617 TI - Comparison of the effect of cadmium on lymphocytes of young and adult mice. AB - The influence of cadmium on in vitro primary plaque-forming cells (pfc) response of young (3 weeks old) and adult (5 mon old) mice to sheep red blood cells (SRBC) was investigated. Spleen cells of young and adult mice were cultured with various concentrations of cadmium chloride. Cadmium of 4 microM stimulated primary pfc response in cells of both groups, but 40 microM Significantly suppressed those of spleen cells from both groups. In the pre-treatment with 4 microM cadmium for 24 hr, spleen cells from young mice was also stimulated but hose from adult mice remained normal. As to cell viability of T and B cells from both groups after incubation with 4 microM cadmium for 24 hr, T cells from both groups and B cells from young mice were reduced by cadmium exposure. These results showed that young mice were more sensitive to the effect of cadmium on the antibody response than adult mice. PMID- 3298620 TI - Effects of low-dose cyclosporine prophylaxis in nonobese diabetic mice. AB - Among female nonobese diabetic mice, ketotic insulin-dependent diabetes mellitus (IDDM) develops spontaneously in 80% between 12 and 26 weeks of age. This condition resembles human type I diabetes. IDDM developed in 0 of 11 (0%) mice prophylactically treated with 10 mg of cyclosporine A (CyA) per kg s.c. every 4th day from 8 to 26 weeks of age; 8 of 10 (80%) of sex- and age-matched controls developed IDDM; 2 of 8 (25%) followed up to 5 months beyond the time of drug administration developed IDDM. The distribution of specific radioactivity ([3H]CyA) was used to calculate the concentrations of CyA in serum, blood cells and various organs. Serum values of CyA produced by radioimmunoassay were higher than those estimated by the [3H]CyA method. Pancreata of CyA-treated mice were histologically normal. Pancreata of control mice showed lymphocytic infiltration of the islets of Langerhans. Neither hepatotoxicity nor nephrotoxicity assessed by biochemical and histological data was detectable in CyA-treated mice. The insulin secretory capacity of trypan blue viable functional pancreatic islets isolated post-treatment; was significantly lower in controls than in CyA-treated mice; islet content of insulin was not statistically different between controls and CyA-treated mice. We conclude that low nontoxic doses of CyA abrogate completely the development of diabetes in the female nonobese diabetic mouse and abolish lymphocytic infiltration of the islets of Langerhans against which there is autoimmunity. The effect of CyA persists well past the duration of therapy. PMID- 3298619 TI - Facilitated transdermal transport of insulin. PMID- 3298621 TI - Comparison of the effects of a thromboxane synthase inhibitor or prostacyclin in combination with a phosphodiesterase inhibitor for prevention of experimental thrombosis and sudden death in rabbits. AB - This study was designed to determine the in vivo effects of a phosphodiesterase inhibitor (HL 725) in combination with a thromboxane synthase inhibitor (CGS 13080) or prostacyclin (PGI2) as inhibitors of thrombin-induced changes in platelet function and prevention of sudden death. In anesthetized rabbits, the i.v. administration of thrombin reduced the circulating number of platelets from 256,000 +/- 32,000/microliter to 8 +/- 2% of the initial value, and produced a right ventricular thrombus of 285 +/- 52 mg. All animals died within 5 min. PGI2 (0.3 microgram/kg/min) or HL 725 (2 micrograms/kg/min) did not prevent the thrombin-induced fall in the number of circulating platelets, the formation of a right ventricular thrombus or death. Administration of 2 mg/kg of CGS 13080 reduced significantly the mass of the right ventricular thrombus, but did not prevent completely the reduction in the circulating platelet count or death. After the administration of the combination of CGS 13080 with HL 725, the thrombocytopenia was transient, the right ventricular thrombus was reduced (P less than .05), and survival increased to 75% (P less than .05). The combination of PGI2 with HL 725 was similar in benefit to the combination of CGS 13080 and HL 725. Survival for the group of the combination of CGS 13080 with 725 was significantly greater than survival in the CGS 13080 or HL 725 groups, indicating a synergistic effect for the combination. The decrease in blood pressure response to HL 725 was greater with PGI2, but not with CGS 13080.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298623 TI - LP/VNs--the modern-day Nightingales. Vocal, vigilant, valuable. PMID- 3298622 TI - Inhibition of intestinal disaccharidases and suppression of blood glucose by a new alpha-glucohydrolase inhibitor--MDL 25,637. AB - MDL 25,637 is a novel compound designed as a transition-state inhibitor of alpha glucohydrolases. This compound inhibits rat intestinal sucrase, maltase, isomaltase, glucoamylase and trehalase activities at micromolar concentrations. It is a much weaker inhibitor of alpha-amylase and lactase. Inhibition of sucrase was competitive with sucrose. In mice, MDL 25,637 inhibited the rise in serum glucose after a sucrose or starch load but not after a glucose load. MDL 25,637 also reduced the glycemic response to sucrose in rats. The drug was most effective when administered 0 to 30 min before the sucrose load and was as effective in streptozotocin-treated rats as in normals. The inhibition by MDL 25,637 of intestinal glucohydrolases is an effective means of reducing the hyperglycemic response to an oral sucrose or starch load and, as such, warrants further investigation as a potential drug for the treatment of diabetes mellitus. PMID- 3298624 TI - Bond strength of composite to metal mediated by metal adhesive promoters. AB - The effectiveness of three metal primers in promoting the adhesive bond of composites to alloy systems commonly used in making ceramometal restorations was investigated. The results of this study indicated that the bond strengths attained with these tested metal primers are in general not high. Further research is needed for the development of a metal primer with an improved adhesive strength. Until then, dentists should continue to use the current methods of undercutting and roughening the metal surface in order to achieve additional retention. PMID- 3298625 TI - Dimensional stability of silver amalgam and composite used as core materials. PMID- 3298626 TI - Bacterial penetration around amalgam restorations. PMID- 3298627 TI - Denture plaque and palatal mucosa in denture stomatitis: scanning electron microscopic and microbiologic study. AB - Denture plaque is an etiologic factor in denture stomatitis. In this study, denture and mucosa samples from nine patients were examined in the SEM and processed for microbiologic cultures. Denture plaque in patients with denture stomatitis showed a considerable thickness containing cocci, filaments, rods, yeasts, and desquamated epithelial cells. Some microorganisms were revealed in the connective tissue in one patient and phagocytizing polymorphonuclear leukocytes were found in the palatal mucosa of the patients with denture stomatitis. PMID- 3298628 TI - Candidal antibodies in patients undergoing treatment for denture stomatitis. PMID- 3298629 TI - A study of bubbles in a rubber elastomer manipulated under clinical conditions. AB - One hundred addition reaction silicone impressions were made by students and faculty members using two types of syringes with two syringe tip sizes. A count of the bubbles in the impressions revealed a total of 439 with only one impression completely free of bubbles in either the posterior or anterior test regions. Faculty members, presumably more experienced, confirmed the last out fewer bubbles hypothesis developed in a previous laboratory investigation, but some students did not. A pneumatically activated syringe produced no fewer bubbles than did the conventional hand-powered syringe but most of the students and faculty members thought it was advantageous. Half believed that more practice with it would be beneficial. We recommend that practicing dentists try to minimize bubbles by extruding the first part of the syringe contents onto the mixing pad or in a distant intraoral location before injecting around the critical tooth preparations. PMID- 3298630 TI - Bone-metal interface in osseointegration. PMID- 3298631 TI - The relationship of drug use to denture function and saliva flow rate in a geriatric population. AB - This study investigated an "old elderly" population and the relationships between the use of hyposalivatory drugs and denture function, including saliva flow rates and denture-supporting structures and health. There was a high prevalence of drug use and medical problems. Hyposalivatory drugs were prescribed for more than half of the subjects. There was a significant relationship between increased hyposalivatory drug use and reduced saliva flow rates. Reduced values for denture supporting structures were found to be related to increased medical problems and hyposalivatory drug use. Reduced values for denture-supporting tissue health were found to be related to masticatory performance and retention and stability. Bite force showed a strong positive relationship with masticatory performance. Some of the subjective evaluations by the subjects showed statistically significant relationship with their respective objective measures: perceptions of dry mouth were related to saliva flow rates, perceptions of denture rocking or looseness were related to retention and stability ratings, and reports of pain on chewing were related to masticatory performance. It may be concluded that the use of drugs with hyposalivatory side effects may have a deleterious influence on the denture-bearing tissue. Direct influence on denture function, however, was not found. These findings provide valuable insights into the effects of drug usage in old age and their impact on oral health and denture function. Diagnostic and treatment capabilities are thus enhanced in that physicians, pharmacists, and other health-related professionals can be alerted to the problems accompanying hyposalivatory drug use. This may permit alternatives in medication when possible, and dentists may more effectively plan and conduct prosthodontic care for these individuals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298632 TI - Microwave polymerization of acrylic resins used in dental prostheses. PMID- 3298633 TI - A reline procedure for prostheses supported by ramus frame and mandibular staple implants. PMID- 3298634 TI - D-aspartic acid in aged mouse skin and lens. PMID- 3298635 TI - [Evaluation of peri-intraventricular hemorrhages in newborn infants taking into account laterality and parenchymal location. Application to 323 consecutive cases]. AB - An abbreviated scoring system for PIVH was derived from Papile's one: completed by a 0 for normal pattern, abcd divisions of each cerebral hemisphere for localization of parenchymal haemorrhages, and scoring of each side separately. The scoring system was applied to a consecutive series of 323 PIVH (1981-1984). Unilateral haemorrhages (123) accounted for 38% of all PIVH; they were almost exclusively grade I and II, and more frequently left-sided: 90 left and 33 right H. Of 200 bilateral haemorrhages, 127 were of equal severity on both sides, but left H. were more severe than right ones in 46/73 asymmetrical bilateral H. The survival rate was 91% in overall grade I H., 84% in overall grade II H., with little difference between uni- and bilateral H., 43% in overall grade III H. (34% in bilateral grade III), 28% in overall grade IV H. (1/11 in bilateral grade IV H). The extent of parenchymal H. only bore a partial relationship to the severity of the associated SEH-IVH, only half of the parenchymal haemorrhages being associated with grade III IVH on the same side, and only half of the unilateral PH being associated with a more severe SEH-IVH on the same side. The various former scoring systems have been reviewed. The interest of assessing both cerebral hemispheres separately and of evaluating the extent and location of PH is stressed. PMID- 3298636 TI - [Pseudo-ureteroceles resulting from the impression of a loop of a megaureter with an ectopic subvesical orifice]. AB - The authors report 3 rare cases of pseudo-ureteroceles corresponding to a vesical imprint of an ectopic extra-vesical megaureter. When an ectopic extra-vesical ureter follows a sharp juxta-vesical buckle, it can give a deep imprint on the bladder and look similar to an ureterocele. I.V.P. and U.S. can be as misleading since the appearance of this type of megaureter and ureterocele can be similar, and differential diagnosis can be difficult. Such situations are rare. In a ten years of pediatric urologic practice, the authors who have investigated 51 ureteroceles and 26 extravesical ectopic ureters, have only observed 3 children with this lesion. These 3 cases corresponded to two simple ureters, in a 3 year old boy and in a 2.5 year old girl, and one upper ureter of a complete duplex system in a neonate baby girl with antenatal discovery. The clinical, radiological, sonographical and endoscopic clues to the diagnosis are discussed and illustrated. PMID- 3298637 TI - [Diffuse cystic peritoneal lymphangiomatosis. Long-term clinical, ultrasonic and x-ray computed tomographic study. Apropos of a case]. AB - An adult male with episodic manifestations of abdominal lymphangiomatosis has been followed up over a 5 year period. This prolonged surveillance of clinical features combined with ultrasound and CT scan imaging has no doubt contributed to improved knowledge of diagnostic and physiopathologic factors of these rare lesions. The particular behavior of the case reported evokes discussion on the conventional surgical treatment of lymphangioma. PMID- 3298638 TI - [The silent kidney. Evolving ultrasonic picture of emphysematous pyelonephritis: the vanishing kidney. Apropos of a case]. AB - The authors report the progressive disappearing of the sonographical image of a previously visualized kidney in a case of emphysematous pyelonephritis. They have called the sonographic vanishing kidney "the sign of the Deaf Kidney". The non visualisation of a kidney with advanced emphysematous pyelonephritis is due to the infiltration of the perirenal environment by a gas envelope and the filling of the excretory cavities by gas. The perirenal gas-bag forms a shield against ultrasonic waves. The sonographer must be aware of the eventuality of not being able to individualize a renal structure when wrapped in gas. He must then ask for a zonography of the renal area in order to confirm the gas-containing collection in the kidney. PMID- 3298639 TI - Vascularized bone transfer for limb salvage and reconstruction after resection of aggressive bone lesions. AB - At our institution from 1980 to 1985, 30 patients underwent resection of malignant or locally aggressive bone tumors, with limb salvage and reconstruction by free vascularized bone grafts. Of the 26 patients followed up for at least four months (average, 21 months), four had complications. In these four, there were three nonunions, two infections, and one stress fracture. The average duration of immobilization was 7.6 months in the lower extremity, five months in the pelvis, and 3.8 months in the upper extremity. The average time to union was 6.3 months in the lower extremity, five months in the pelvis, and five months in the upper extremity. Although the technique of oncologic reconstruction must be individualized, our experience indicates that vascularized bone grafts offer significant advantages over conventional methods in selected patients. PMID- 3298640 TI - Prolonging survival in vascularized bone allograft transplantation: developing specific immune unresponsiveness. AB - Vascularized bone allografts (VBAs) could be useful adjuncts to the clinical reconstructive surgeon's arsenal. These grafts are known experimentally to be subject to host rejection. One way to control the rejection problem would be to develop specific immune unresponsiveness via host conditioning. Using a proven reliable model in inbred rats for studying heterotopic VBA transplantation, recipient animals were conditioned preoperatively with third-party unrelated blood, donor-specific blood (DSB) alone and with cyclosporine, and ultraviolet irradiated donor-specific blood. The combination of DSB plus cyclosporine delayed rejection of grafts across a strong histocompatibility barrier for three to four weeks. However, rejection was delayed across a weak histocompatibility barrier for five to six weeks using this same host pretreatment. The implications are that specific immunosuppression, although possible, is difficult to achieve in VBA transplantation, and that such techniques will rely on tissue-matching to minimize the genetic disparity between graft and host. PMID- 3298642 TI - An avidin-biotin micro-enzymeimmunoassay for monkey chorionic gonadotrophin. AB - The avidin-biotin micro-enzymeimmunoassay used antiserum to the beta-subunit of sheep LH, biotinylated hCG as tracer and pooled serum from pregnant monkeys as a reference preparation of monkey CG. The assay was validated for specificity, by checking serum samples known to contain high quantities of LH, and false positive results were eliminated to a great extent by prior heating of serum samples at 60 degrees C for 30 min. In 45 bonnet monkeys the test gave 10 true positives, 34 true negatives and 1 false positive, i.e. an accuracy of 97%. The serum profiles of CG, measured by the EIA, in bonnet, cynomolgus and rhesus monkeys during early pregnancy were very similar to those reported for bonnet and rhesus monkeys when a liquid-phase radioimmunoassay was used. PMID- 3298643 TI - Effect of nutrition, temperature and photoperiod on the rate of sexual maturation of the field vole (Microtus agrestis). AB - Weanling male and female field voles were placed in long or short photoperiods, kept at 18 degrees C or 4 degrees C, and fed (ad libitum) diets containing 24%, 16%, 8% and 4% protein, for 6 weeks. Animals in the long photoperiod were more sexually mature than were animals in the short photoperiod. Temperatures had no effect on females, but did affect males: those kept at 4 degrees C had heavier testes and wider seminiferous tubules than those kept at 18 degrees C. There was little difference between the animals on 24%, 16% and 8% protein diets. Animals on 4% protein diets had retarded growth rates and were significantly less sexually mature than those on the other 3 diets, males having smaller testes and seminal vesicles and narrower seminiferous tubules and females having smaller ovaries and uteri. PMID- 3298641 TI - Some effects of epidermal growth factor on reproductive function in Merino sheep. AB - During the i.v. infusion of a depilatory dose (100 micrograms/kg bodyweight) of mouse epidermal growth factor (EGF) into ovariectomized Merino ewes the frequency of pulsatile LH release was significantly reduced. However, the amplitude of pulses of LH secretion, either those naturally occurring or those induced by LHRH injection, was unchanged or only slightly reduced. Similar infusions of mouse EGF were made in progestagen-treated anoestrous Merino ewes in which LH secretion was maintained by injections of LHRH. These ewes did not experience oestrus or ovulate in response to PMSG injected 1 day after mouse EGF treatment (2 days before progestagen withdrawal); both responses occurred in controls. The EGF treated ewes experienced oestrus and ovulated following progestagen-PMSG treatment 6 weeks later. These results suggest that mouse EGF inhibits the hypothalamic pulse generator responsible for LH release in the ewe but has little if any effect on pituitary sensitivity to LHRH; and mouse EGF apparently has a direct effect on the ovaries, temporarily impairing their ability to ovulate in response to exogenous gonadotrophin. PMID- 3298644 TI - Effect of betamethasone treatment on luteal lifespan and the LH response to GnRH in dairy cows. AB - Betamethasone (a synthetic glucocorticoid, 15 mg) was administered i.m. twice daily for 10 days to 4 regularly cycling dairy cows, beginning on Day 10 of the oestrous cycle. Luteal function, monitored by plasma progesterone, was extended by 7, 9, 19 and 20 days, respectively. Luteal function in the next cycle was normal. Endogenous cortisol values were suppressed for 14, 13, 34 and 27 days, respectively. Pituitary responsiveness to 20 micrograms GnRH was assessed by LH measurement on Days -1, +3 and +7 relative to the start of betamethasone treatment. There was a progressive decrease in peak LH concentrations after each GnRH challenge compared to control cows. Hourly measurements of PGF-2 alpha metabolite during the expected period of luteolysis failed to reveal normal increases. It is suggested that betamethasone caused prolonged luteal function, either by directly inhibiting PGF-2 alpha release, or by suppressing pituitary stimulation of follicular growth and hence lowering oestradiol concentrations, since it is known that PGF-2 alpha and oestradiol act synergistically to cause luteolysis. PMID- 3298645 TI - Utility of a screening examination of the fetal cardiac position and four chambers during obstetric sonography. AB - The findings were reviewed for approximately 6,700 high- and low-risk obstetric sonograms that included screening imaging of the fetal cardiac position and four chambers as part of a brief fetal anatomy survey. This screening examination identified 12 major cardiac malformations, 3 unusual cardiomegalies and 12 abnormal positions caused by noncardiac abnormalities. Most of these abnormalities probably would not have been identified without the screening examination. Also, the finding of an abnormal fetal cardiac position was often the main indication of a noncardiac abnormality, such as a diaphragmatic hernia. Screening imaging of the fetal cardiac position and four chambers appears to be a productive addition to the fetal anatomy survey for our particular mix of high- and low-risk patients. PMID- 3298646 TI - Unusual features of parovarian cysts. A report of two cases. AB - In two cases, parovarian cysts were well characterized by ultrasonography and presented with unusual clinical features. In one case the cysts were present bilaterally and associated with an arcuate uterus. In the other, histology of the cyst revealed a papillary serous cystadenoma. The lesion was also associated with an arcuate uterus. PMID- 3298647 TI - Transient fetal ascites and hydrops with a favorable outcome. A report of two cases. AB - Ultrasonically documented severe fetal ascites and hydrops resulted in complete, spontaneous antenatal resolution in two cases. Both of the deliveries were uncomplicated, and the outcome of the newborns was good. PMID- 3298648 TI - Correlation study between prolactin and androgens in male patients with systemic lupus erythematosus. AB - The hypothalamic-pituitary-gonadal axis was studied in 8 male patients with systemic lupus erythematosus (SLE), both before and after intravenous administration of luteinizing hormone-releasing hormone (LH-RH). We provide evidence herein that resting serum levels of estrone are increased and that resting serum testosterone (T) and dihydrotestosterone (DHT) levels are decreased in male patients with SLE. The decreased serum T levels were observed even after the IV administration of 25 micrograms of LH-RH. The high basal serum prolactin (PRL) levels observed in these patients with SLE is a novel finding not previously reported that could explain why serum T and DHT levels are low in this syndrome. We observed a decrease in the pituitary response to LH-RH stimulation; this low response could also be a hormonal manifestation of hyperprolactinemia. Furthermore, it has been suggested that PRL plays a role in immunocompetence, and therefore it could have influence either directly or indirectly in the altered immunoregulation observed in SLE. PMID- 3298649 TI - Acute effects of nifedipine on digital blood flow in human subjects with Raynaud's phenomenon: a double blind placebo controlled trial. AB - In order to determine the acute effect of nifedipine, a calcium channel blocker, on digital hemodynamics in patients with Raynaud's phenomenon, we studied 21 patients in a double blinded, placebo controlled trial. Digital blood flow at room temperature was measured by venous occlusion plethysmography as perfusion pressures were lowered by elevating the hand above the level of the heart. After placebo, there was a small reduction in digital blood flow without any alteration in the perfusion pressure. After nifedipine, there was a significant reduction in both perfusion pressure and digital blood flow at each level of hand elevation. When analyzed as pressure-flow relationships, there was no significant change after nifedipine, indicating that the fall in blood flow could be accounted for by the reduction in perfusion pressure. Four of the placebo group developed Raynaud's phenomenon after the baseline study, whereas none developed Raynaud's phenomenon after nifedipine. Our results suggest that although nifedipine may reduce vascular reactivity, caution is warranted in use of this drug in patients with threatened digital ischemia because of the possibility that digital blood flow may be reduced. PMID- 3298651 TI - HLA-B27, ankylosing spondylitis and Klebsiella pneumoniae: toward a molecular approach. PMID- 3298650 TI - Glycosaminoglycan composition of tight skin and control mouse skins. AB - Tight skin (TSK) mouse skin has previously been shown to contain increased amounts of collagen and glycosaminoglycans (GAG). We now report on the GAG composition of TSK mouse skin. Using an electrophoretic and an enzymatic HPLC method, skin from 99 TSK and control mice (newborn, 1 month-old, and 6 months old) were analyzed for GAG composition. There was no significant difference between TSK and control GAG. PMID- 3298652 TI - Novel renin inhibitors containing analogues of statine retro-inverted at the C termini: specificity at the P2 histidine site. AB - Substituted 1,3- and 1,4-diamines were prepared from epoxides derived from Boc leucine or Boc-cyclohexylalanine. These diamines were incorporated into renin inhibitors (IC50 = 4-1500 nM) replacing the Leu-Val scissile bond in small peptide analogues of angiotensinogen. Replacement of the P2 histidine imidazole with other heterocycles maintained or enhanced binding while changing the overall basicity of the inhibitor. Finally, substitution of O-methyltyrosine for the P3 phenylalanine suppressed chymotrypsin cleavage of the P3-P2 bond. PMID- 3298653 TI - Effects of a stress management course on grades and health of first-year medical students. PMID- 3298654 TI - Antigen-specific messenger RNA for immunological research: purification and characterization of RNA from intestinal epithelial cells using specific antibody. AB - A murine organ-specific antigen system (ECAC B1,B2) has been described that is reactive with sera and lymphocytes from patients with chronic inflammatory bowel disease. However, the amino acid sequence of macromolecules comprising ECAC is unknown, making difficult synthesis of a genetic (DNA) probe for molecular biologic studies. As an alternative to obtain a specific cDNA clone, we developed a methodology to immuno-purify and characterize ECAC-specific messenger RNA from murine and human gut mucosal epithelium. Advantages of this new approach include that it is rapid, non-radioactive, applicable to heterologous or monoclonal immunoglobulin, and of low cost. 100 X 10(6) intestinal epithelial cells were lysed with 0.35% V/V NP-40, and the supernatant layered on a 65% W/V sucrose solution for isolation of polyribosomes by ultracentrifugation. ECAC B1/B2 specific mRNA was isolated from this polyribosome fraction using protein A column purified specific immunoglobulin from heterologous hyperimmune serum or from monoclonal ascites, followed by adsorption of antibody-bound polyribosomes on a solid phase composed of Sepharose-protein A. After messenger RNA elution, the poly-adenine-containing fraction was further purified by oligo-dT chromatography and characterized. The yield of highly purified messenger RNA (A260/A280 greater than or equal to 2) was 10-20 micrograms/10(8) epithelial cells, and formaldehyde agarose gel electrophoresis demonstrated a limited number of RNA bands had been isolated (150-1400 base-pairs in size). The function of murine and human (normal and disease-involved) messenger RNA isolates was determined in a cell-free in vitro translation system, demonstrating synthesis of single components of ECAC identified by immunoblotting, enzyme-linked immuno-sorbent assay, and analytical polyacrylamide gel electrophoresis of lysate fractions after immuno-affinity chromatography. We conclude that heterologous or monoclonal antibody can be used to isolate antigen-specific messenger RNA from a species other than that from which the antigen was originally isolated, that the functional status for translation of newly purified mRNA can be easily determined by one of several non radioactive means, and that the technique can be applied even to cells with a high enzymatic degradative capacity, such as those in gut epithelium. PMID- 3298655 TI - Lymphocyte activation in vivo in the intestinal mucosa of patients with Crohn's disease. AB - We analyzed lymphocyte activation state in vivo in lamina propria by applying a panel of monoclonal antibodies for cellular activation markers and by identifying different subsets of 3H-thymidine incorporating lymphoblasts by combining autoradiography with immunoperoxidase staining. In focal lymphoblastoid infiltrates 75 +/- 8% of all inflammatory cells displayed Ia, but lymphoid cells expressing 4F2 (40 +/- 6%) and T9 (14 +/- 3%) activation markers were less frequent. The expression of receptors for interleukin-2 (Tac) was particularly low (4 +/- 1%). There were very few 3H-thymidine incorporating cells (labeling index approx. 1%) and most of them belonged to the T cell series. T4+ blasts outnumbered T8+ blasts, and in this numerically minor subpopulation the activated T4/T8 ratio was 2.9 +/- 0.7. Our results suggest that, although a big part of the local inflammatory lymphocytes in Crohn's disease may be activated according to the expression of Ia and 4F2 activation markers, only a fraction of them possess interleukin-2 receptor and have been pushed to the S-phase of the cell cycle. PMID- 3298656 TI - C4 nephritic factor in a patient with chronic glomerulonephritis. AB - C4 nephritic factor (C4NeF) was found in the serum of a patient with chronic glomerulonephritis, whose C3 level was quite low (less than 1% of normal). C4NeF prevented the intrinsic decay of C4b2a enzyme and prolonged the half life of the C4b2a from several minutes to more than 1 h in the solid and fluid phase. The C4NeF activity was associated with a protein fraction immunochemically identified as the IgG3 subclass and it bound specifically to the EAC142 cells. In addition, the patient's serum contained C3-cleaving activity, probably C4b2a, C4NeF complex, which may have lowered the level of C3 in the patient's serum. Spontaneously, the titer of C4NeF decreased, while the level of C3 increased. PMID- 3298657 TI - Microcomputer-aided reconstruction: a system designed for the study of 3-D microstructure in histology and histopathology. AB - We have designed a microcomputer system to reproduce 3-D tissue structures graphically from serial microscopic sections. The system, based on a Hewlett Packard model 310 desktop computer, comprises a floppy disc drive, a hard-disc that extends the available user memory by adding 40 Mbytes, a colour memory mapped graphics display, a graphics tablet and a graphics printer. A set of serial 2-D images, manually extracted from serial sections using a microprojector, are digitized on the tablet by tracing the contours of the structure of interest; up to ten different structures can be inputted and reproduced using a 'hidden line' effect. The software, written mainly in HP-BASIC 4.0, produces 3-D pictures of a tissue structure either as a 'stack of slices' with or without being 'tiled' with triangular patches, or in 'wire framing'. Any angle of rotation around the x, y and z axes is assigned for the image to be reconstructed, allowing the operator to obtain the best perspective. The system also discloses the internal connectivity of an object by reducing the structure to a network diagram; this is especially useful in analysing the topological properties of tissue structure. It is shown how, in some examples, the system contributes to a better understanding of tissue microstructures and their morbid changes and how, as an effective tool in morphology, it will aid future studies of histology and histopathology. PMID- 3298658 TI - Promoter properties and negative regulation of the uvrA gene by the LexA repressor and its amino-terminal DNA binding domain. AB - A comparative study of the interaction of the LexA repressor of Escherichia coli and of its amino-terminal DNA binding domain to the uvrA operator has been undertaken. Most of the binding constants are determined from competition experiments with RNA polymerase by measuring the time-course of the abortive initiation transcriptional activity. The presence of repressor increases the lag time, tau, without affecting the final maximum activity. The inhibition of transcription by LexA, at least in the case of the uvrA gene, is thus a transient, time-dependent phenomenon, because once the RNA polymerase is engaged in a stable "open" complex, it is quasi-irreversibly trapped in this state. A study of the binding constants as a function of ionic strength suggests the formation of 5.5(+/- 1) salt bridges between the uvrA operator and a LexA dimer. Surprisingly, the binding affinity of the amino-terminal domain was only about one order of magnitude smaller than that of the entire LexA repressor. The determination of the binding constant of the RNA polymerase to the "closed" uvrA promoter (KB approximately 1 X 10(7) to 2 X 10(7) M-1) allowed us to determine theoretical repression curves for the two repressor species. These calculations show that the binding constant found for LexA is sufficiently high to account for substantial or complete repression, and that of the amino-terminal domain is sufficiently low to account for partial or nearly full induction. Under solvent conditions used by others for the determination of binding constants to other SOS operators by DNAase I footprinting, the uvrA operator turns out to be a rather weak one (K approximately 3 X 10(7) M-1), being comparable with that of the uvrB gene. The uvrA promoter is "association-limited" with a KB X k2 product fitting very nicely the homology score for the promoter of 55. PMID- 3298659 TI - The efficiency of folding of some proteins is increased by controlled rates of translation in vivo. A hypothesis. AB - We propose that the way in which some proteins fold is affected by the rates at which regions of their polypeptide chains are translated in vivo. Furthermore, we suggest that their gene sequences have evolved to control the rate of translational elongation such that the synthesis of defined portions of their polypeptide chains is separated temporally. We stress that many proteins are capable of folding efficiently into their native conformations without the help of differential translation rates. For these proteins the amino acid sequence does indeed contain all the information needed for the polypeptide chain to fold correctly (even in vitro, after denaturation). However, other proteins clearly do not fold efficiently into their native conformation in vitro. We argue that the efficiency of folding of these problematic proteins in vivo may be improved by controlled synthesis of the nascent polypeptide. PMID- 3298660 TI - Crystals of seryl-tRNA synthetase from Escherichia coli. Preliminary crystallographic data. AB - Crystals of seryl-tRNA synthetase from Escherichia coli can be grown from ammonium sulphate/octyl glucoside solutions in two days. The crystals appear to be very suitable for X-ray analysis, diffracting to at least 2.8 A resolution and being resistant to radiation damage. The crystals are monoclinic (space group C2) with cell parameters a = 148.2 A, b = 90.6 A, c = 69.5 A and beta = 119.0 degrees. Depending on whether the asymmetric unit is the enzyme monomer (Mr 48,414) or dimer the Vm value would be either 4.12 or 2.10 A3/dalton. Although the former would indicate a rather high solvent content, other proteins crystallized in the presence of octyl glucoside have Vm values similar to this. PMID- 3298661 TI - Coenzyme A degradation in the heart: effects of diabetes and insulin. AB - Coenzyme A (CoA) degradation was studied in isolated working hearts from acutely diabetic rats (48 h). Hearts from diabetic rats had elevated levels of total CoA (752 +/- 15 nmol/g dry) compared to control (537 +/- 14 nmol/g dry). When hearts from diabetic animals were perfused for 5 mins with perfusate containing pyruvate, (5 mM) and glucose (11 mM) CoA levels remained unchanged. Addition of palmitate, (1.2 mM) and glucose (11 mM) to the perfusate, however, resulted in a rapid drop in CoA levels to 672 +/- 19 nmol/g dry. Palmitate had no effect on CoA levels in control hearts which did not have elevated levels of CoA. Addition of insulin to the buffer containing glucose and palmitate prevented the decrease in CoA levels in diabetic hearts. The level of long chain acyl CoA in diabetic hearts perfused with pyruvate was 105 +/- 11 nmol/g dry, and did not change when insulin was present in the perfusate. In the presence of palmitate, levels of long chain acyl CoA increased from 76 +/- 16 to 149 +/- 13 nmol/g dry, and, in this case, addition of insulin caused a further increase to 192 +/- 18 nmol/g dry. Thus, the lower rate of CoA degradation in the presence of insulin was associated with a rise in long chain acyl CoA levels. In a separate series of experiments, CoA levels were increased in control hearts in vitro (from 537 +/- 14 to 842 +/- 19 nmol/g dry). Subsequent perfusion of these hearts that contained elevated CoA with palmitate also resulted in a rapid drop of CoA to 655 +/- 17 nmol/g dry.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298662 TI - Influence of the mesenchymal microenvironment on myocardial and endocardial cell behaviour in experimental interaction with chick limb mesenchyme. AB - In an attempt to clarify the possible influence of the mesenchymal microenvironment in the differentiation of myocardial and endocardial cells, an "in vivo" transplantation experiment was performed in which the ventricular region of the heart (chick or quail) was placed in close association to the mesenchyme of the anterior chick limb to create an experimental interaction between myocardium and foreign mesenchyme. The results showed that after 48 h of tissue interactions the ventricular myocardium is incorporated into the mesenchyme of the anterior chick limb, changing its organization and cytological appearance. The myocytes tend to dissociate, exhibiting a less organized myofibrillar pattern. In addition, abundant extracellular matrix components made up of granular and fibrillar material were observed associated with the myocardial and the mesenchymal cell membranes as well as distributed in their surrounding microenvironment. The endocardium became discontinuous, due to detachment of the cells and emitted multiple pseudopodia and filopodia. These observations indicate that the mesenchyme from the anterior chick limb modifies the cellular behaviour and organization of the neighbouring myocardium and endocardium with which it interacts. We suggest that this might occur through participation of extracellular matrix components such as glycosaminoglycans, fibronectin and collagen which are known to act as macromolecular mediators in cell to cell interactions, cell migration and differentiation. PMID- 3298663 TI - The survival of adult mouse sensory neurons in vitro is enhanced by natural and synthetic substrata, particularly fibronectin. AB - Primary cultures derived from adult mouse dorsal root ganglia have been maintained in the presence or absence of 5 X 10(-6)M cytosine arabinoside for periods of up to 4 weeks. In cultures in which cytosine arabinoside is present, the non-neuronal cell population is effectively reduced. When uncoated plastic substrata are used there is also a concurrent decrease in the number of neurons if the medium is supplemented with cytosine arabinoside. The effects on neuron survival of substrata coated with fibronectin, polyornithine, polylysine, and exudates prepared from mouse liver cells were studied. It was shown that neuronal densities similar to those with uninhibited media may be retained in the presence of cytosine arabinoside if fibronectin-coated substrata are prepared. With the other coating agents neuronal survival was also enhanced but to a lesser extent. The study offers a means therefore of producing purer cultures of dorsal root ganglia neurons than has previously been possible from adult mammalian sources. PMID- 3298664 TI - Pedestrian tibial injuries. AB - From August 1980 through May 1984, 102 adult pedestrian patients with 130 tibial fractures were admitted to the Shock Trauma Center of the Maryland Institute for Emergency Medical Services Systems. We reviewed their records for admission status, procedures performed, and results: 32 patients who died, underwent primary amputation, or were lost to followup were excluded, leaving 70 patients with 86 tibial fractures as the base study group. We grouped the data by year of admission and analyzed it in terms of the effects of changes in the treatment protocol on results, specifically the time to union. For the first year, the existing treatment protocol included: antibiotics, debridement and irrigation with a bulb syringe, stabilization according to wound size and surgeon preference, split-thickness skin graft, and bone grafting in response to delayed or nonunion. The average time to union for Grade III fractures was 58.39 weeks; average time overall was 53.95 weeks. In the fourth year, the altered treatment protocol included: antibiotics, debridement and jet lavage, scheduled rebridement, external fixation for open fractures, judicious use of open reduction/internal fixation for closed fractures, early free flap soft-tissue coverage, and early bone grafting by history and fracture pattern. The average time to union for Grade III fractures was 37.65 weeks; average time overall was 34.46 weeks. From the first to the fourth year, time to union for Grade III fractures decreased by 64.5% and time to union overall decreased by 63.9%. We feel the decrease is a direct result of early bone grafting, the fixator construct used, and judicious use of open reduction/internal fixation. PMID- 3298665 TI - Blunt trauma to the abdominal aorta. AB - This review of blunt trauma to the abdominal aorta is based on one case summary and 32 cases from the literature. Motor vehicle accidents caused about half of the reported cases. In 69% of the cases the diagnosis was made in the immediate or early period. Associated injuries were present in 71% of the cases. Most injuries occurred at the inferior mesenteric artery (33%) or the renal arteries (24%). Overall mortality was 27%. Lower extremity ischemia evident on physical examination may suggest the diagnosis. When blunt abdominal aortic injury is suspected without distal ischemia, aortography may be used to define or exclude the injury and further therapy. Only minimal intimal disruptions should be managed nonoperatively. PMID- 3298666 TI - Scar carcinoma arising acutely in a skin graft donor site. AB - Scar carcinoma is an uncommon but not rare lesion. Although generally appearing after a long latent period, an acute form exits. In this case an acute squamous cell carcinoma appeared in a skin graft donor site at about 6 weeks, and was removed at 12 weeks. PMID- 3298668 TI - An experimental study of auxiliary partial liver allotransplantation in dogs. PMID- 3298667 TI - Cytoskeletal organization of peripheral blood normal and leukemic lymphocytes and lymphoblasts. AB - Content of actin and vimentin and organization of actin were studied in peripheral blood lymphocytes from healthy donors, circulating lymphocytes from patients with chronic lymphocytic leukemia (CLL) and lymphoblasts from children with common acute lymphoblastic leukemia (c-ALL). Actin and vimentin were quantified as percentage of total proteins by densitometric scanning of SDS polyacrylamide gels loaded with Triton-X-100 cell lysates. In addition, the amounts of F- and G-actin were evaluated by ultracentrifugation of total lysates prior to electrophoresis. Compared to peripheral blood lymphocytes from healthy donors, CLL lymphocytes, but not blasts expressing c-ALL antigen, show a decrease in total actin and vimentin contents. Analysis of SDS gels after ultracentrifugation shows that F-actin is diminished of about 50% in both CLL and ALL cells compared to peripheral lymphocytes from healthy donors. The changes in actin and vimentin content and of actin organization may account for some of the functional abnormalities observed in leukemic cell populations. PMID- 3298669 TI - Experimental and clinical pancreas transplantation. PMID- 3298670 TI - A scanning electron microscopic study on the parasite eggs in an ancient corpse from a tomb of Chu Dynasty, the Warring State, in Jiangling County, Hubei Province. PMID- 3298671 TI - The biochemical pathogenesis of chronic obstructive pulmonary diseases: protease antiprotease imbalance in emphysema and diseases of the airways. AB - Emphysema is believed to result from destruction of elastic fibers due to an imbalance between proteases and their inhibitors in the lung. The imbalance can arise from a primary failure of secretion of the inhibitors, as occurs in hereditary alpha-1-protease inhibitor deficiency, or as the result of complex interactions of environmental agents with the lung. Environmental agents may produce their effects by stimulating degradation of elastic fibers by neutrophils and macrophages, damaging protease inhibitors by oxidative or proteolytic mechanisms or by impairing the biosynthetic repair of damage to the connective tissue. Protease excess has also been consistently observed in purulent sputum. Since experimentally administered proteases stimulate secretion of mucus and damage mucociliary clearance, protease-antiprotease imbalance might be involved in the pathogenesis of bronchitis and bronchiectasis as well as emphysema. Because the protease inhibitors of bronchial mucus are distinct from those of the acinar units, and no hereditary deficiencies are known, there is no direct proof of this hypothesis in man. PMID- 3298672 TI - Medical imaging in asthma. AB - Asthma is a common disease characterized by hyperreactivity of airways to a variety of stimuli. Efficacy studies have shown that while in adults there is no positive predictive value between radiographic abnormalities and certain clinical parameters, in children there may be some correlation with age and the presence of rales. In the Yale-New Haven Emergency Service it is suggested that certain clinical criteria be used to determine which patients receive chest radiographs. A retrospective review of 563 adult asthmatics who presented to the Yale Emergency Room revealed that one third of the patients were radiographed; 50% of these were over 50 years of age, and the overall incidence of radiographic abnormalities that would change patient management was only 3%. Radiographic findings have been categorized into two groups, uncomplicated and complicated asthma, depending on whether bronchodilators will effect a response. PMID- 3298673 TI - Imaging of ventilation in chronic obstructive pulmonary disease. AB - Patterns of radioaerosol deposition in patients with COPD may be interpreted on the basis of derangements in convective ventilation. Thus, in patients with asthma, central deposition is consistently associated with increased airway resistance, in the absence of acute attack, indicating that in this condition major airways are usually the site of bronchial constriction. In patients with chronic bronchitis, inhomogeneous and spotty deposition patterns are strongly associated with indexes of uneven and wasted ventilation and may be explained on the basis of destruction or obstruction of peripheral airways. Spotty deposition is ascribed to very uneven convective ventilation reduced to a limited number of air streams, as opposed to the normal situation of a very high number of air streams giving rise to the uniform pattern of radioaerosol deposition. Patients with emphysema show less distinctive patterns of deposition and may resemble those of the patients with asthma and chronic bronchitis. Nevertheless, the deposition features are very useful to better characterize the patient even in the emphysematous group. From the practical point of view, the features of aerosol deposition provide useful information for evaluation and treatment of the patient with COPD. They may also prove useful to better define and characterize the different disease entities grouped as COPD. PMID- 3298674 TI - 99mTc-DTPA aerosol deposition and clearance in COPD, interstitial disease, and smokers. AB - The application of 99mTc-DTPA radioaerosols to a variety of clinical disorders is described. With the development of simple equipment that can deliver very small droplets, this approach has become increasingly popular for measurements of the distribution of ventilation in patients with obstructive lung disease and suspected pulmonary embolism. In addition, by determining the rate at which the radionuclide is cleared from the lung, information has been obtained concerning the permeability of the pulmonary epithelium to extracellular indicators. Accelerated clearance rates have been found in patients with a variety of chronic interstitial lung diseases indicating that epithelial permeability is increased. Accelerated clearance rates have also been found with acute inflammation of the lung such as the adult respiratory distress syndrome and pneumocystis pneumonia. Furthermore, rapidly reversible increases in 99mTc-DTPA clearance occur in smokers and may be related to the inflammatory changes that contribute to the development of emphysema. PMID- 3298675 TI - Imaging techniques for assessing cardiovascular performance in chronic obstructive pulmonary disease. AB - A variety of imaging techniques are now available for evaluating cardiovascular function. Plain chest radiographs, radionuclide angiocardiography, 201Tl myocardial imaging, and M-mode and two-dimensional echocardiography have been used to detect pulmonary hypertension, right ventricular enlargement, and occult ventricular performance disturbances in patients with chronic obstructive pulmonary disease (COPD). Furthermore, radionuclide angiocardiography and echocardiography combined with hemodynamic measurements have been used to assess short- and long-term cardiovascular effects of such therapeutic agents as theophylline, beta-adrenergics, vasodilators, digitalis, and oxygen. This review evaluates these imaging techniques and their application to COPD patients. PMID- 3298677 TI - The diagnosis, pathogenesis, and treatment of adult respiratory distress syndrome. AB - ARDS is well recognized as a major medical emergency resulting in respiratory failure and refractory hypoxemia. The risk factors and attack rate of ARDS have been identified and principles of management established. The pathogenesis involves the release of toxic cell products that damage the air-blood interface, resulting in pulmonary edema, loss of functioning lung units, and reduced compliance. Today, management is supportive and results in the salvage of approximately 40% of patients suffering ARDS from all causes. Certain roentgenographic features can be identified in both acute and late phases of ARDS. The prognosis of survivors is favorable in the long term. PMID- 3298676 TI - Radiology of the airways with emphasis on the small airways. AB - The anatomy and pathophysiology of obstructive airways diseases are reviewed, with emphasis on the pivotal functional roles of the respiratory and terminal bronchioles. The array of radiologic findings associated with abnormal airways, large or small, is correlated with gross pathologic changes, using surgical and autopsy cases. Examples of inflammatory changes of smaller airways are also drawn from pathologically unproven clinical material. Peripheral linear and nodular densities, which can be distinguished from vascular shadows or septal lines, are seen in association with small bronchial and bronchiolar inflammation. In many cases it is possible to distinguish airways disease patterns from those of "alveolar" or "interstitial" disease. PMID- 3298678 TI - Adult respiratory distress syndrome profiles by computed tomography. AB - Ten patients with full-blown ARDS, on mechanical ventilation with PEEP underwent lung CT. Seven normal subjects were also studied. Three tomographic levels (apex, hilum, and base) were selected. The most consistent morphologic finding in ARDS was the presence of densities in the dependent regions of the lung. Assuming that the three levels were a representative sample of the whole lung, the lung weight was computed from the mean CT number and lung gas volume. Analysis of the CT number frequency distribution revealed three definite patterns of distribution: type 1, bimodal, with one mode in the normal CT number range; type 2, unimodal narrow distribution, with the mode in the CT range of water; and type 3, unimodal broad distribution in the abnormal CT number range. PMID- 3298679 TI - Pulmonary vascular obstruction in the adult respiratory distress syndrome. AB - Pulmonary vascular obstruction is most likely to occur in patients with the severest form of ARDS. Obstruction has been ascribed to fibrin thrombosis and to activation of the blood coagulation system, both well-documented in ARDS. The obstruction has been postulated to occur in two stages during post-traumatic ARDS: an initial transient pulmonary vasoconstriction, attributable to platelet and leukocyte aggregation and the release of vasoactive substances; and, two to five days post injury, a more malignant "delayed microembolism" stage, attributable to the development of protein-rich edema and fibrin deposition in the lungs. Bedside balloon occlusion pulmonary angiography, in a single exposure, allows identification of intraluminal filling defects and occlusions of arteries greater than or equal to 1.0 mm in diameter, irregularity and decreased filling of side branch arteries 0.5 to 1.0 mm in diameter, and decreased filling of the pulmonary microvascular background. Plain radiography findings correlate poorly with angiography results, but the mortality rate of patients who exhibit angiographic evidence of obstruction is twice as high as it is in patients with normal angiography. PMID- 3298680 TI - Determination of lung water content and distribution by nuclear magnetic resonance imaging. AB - NMR imaging techniques are applicable to the assessment of lung water content and distribution because the NMR signal is, under certain conditions, proportional to tissue proton density. NMR imaging is noninvasive, easily repeatable, free from ionizing radiation, and particularly suitable for the assessment of spatial lung water distribution. Lung water content and distribution have been estimated in excised animal lungs and in intact dead or living animals, under normal conditions and in various types of experimental pulmonary edema. Excised human lungs and human subjects have also been studied. Published data indicate that measurements of lung water content by NMR imaging techniques are feasible. These techniques estimate lung water spatial distribution with satisfactory accuracy and excellent resolving power. The application of NMR imaging techniques poses several problems and limitations, but available data suggest that most of the problems can be solved. NMR imaging has the potential to become a powerful tool for lung water research. Prospects of clinical application are also encouraging; numerous applications can be foreseen, although lack of mobility of NMR imaging systems may be a significant limitation in critical care medicine. PMID- 3298681 TI - Central intravascular pressure measurements: when should we believe them? AB - With the widespread use of invasive hemodynamic monitoring of the pulmonary circulation to aid in diagnosis and therapy of cardiac and respiratory failure, shock, and pulmonary hypertension, diagnostic radiologists have become accustomed to interpreting chest radiographs in the context of measured intrathoracic intravascular pressures. Unfortunately, errors in measurement and interpretation of these pressures are common. Perhaps the most difficult aspect of invasive hemodynamic monitoring is the interpretation of measured pressures in the context of a variety of clinical circumstances and disease states, some of which may dramatically alter the usual relationship between the pulmonary artery wedge pressure and left ventricular preload. Without detailed information about the techniques used to obtain these measurements and the clinical status of the patient at the time that they are made, the measurements should not be used as a standard against which clinical and radiographic findings are judged. PMID- 3298682 TI - Computed tomographic--guided stereotaxic biopsy of thoracic lesions. AB - A stereotaxic guidance system has been used in conjunction with a conventional CT unit to biopsy 26 consecutive thoracic lesions. Accurate needle placement with a single manipulation occurred in 24 instances and two lesions required second passes. The technique provided adequate pathologic material with an acceptable complication rate. System advantages include the ability to approach lesions along oblique paths, controlled approach in difficult locations (mediastinal, peripheral, subscapular), capacity to biopsy small nonfluoroscopically visualized lesions, and increased speed over manual techniques. PMID- 3298684 TI - Pneumothorax: evaluation by ultrasound--preliminary results. AB - The ultrasonographic appearance of the pleura was investigated in 20 healthy subjects and eight patients with radiologically established pneumothorax. The respiratory excursions of the visceral pleura could be demonstrated ultrasonographically in all 20 healthy patients. In addition, comet tail artifacts were regularly evoked at the boundary between the pleura and the ventilated pulmonary parenchyma. In all eight patients with pneumothorax, the pleural collection of air could be demonstrated ultrasonographically by the absence of pleural movements and comet tail artifacts. In emergency situations in which radiographs are not available or are not available quickly enough, ultrasonography can make a decisive contribution to diagnosis of pneumothorax. PMID- 3298683 TI - Catamenial pneumothorax: case report and literature review. AB - Since the initial case report in 1958, 69 cases of catamenial pneumothorax have appeared in English-language literature. Despite the extensive case material, the pathogenesis has not been fully elucidated. Herein an additional case is reported utilizing computed tomography (CT) to search for intrathoracic endometrial implants. The four major pathogenetic theories include passage of air from the genital tract via diaphragmatic defects, spontaneous rupture of subpleural blebs, intrathoracic endometriosis, and prostaglandin-induced bronchiolar constriction resulting in alveolar rupture. Evidence for and against each theory is presented. PMID- 3298687 TI - The impact of antisperm antibodies on human infertility. PMID- 3298685 TI - The viral protein sigma 3 participates in translation of late viral mRNA in reovirus-infected L cells. AB - Reovirus late (uncapped) mRNA was previously shown to be efficiently translated in vitro extracts prepared from infected cells but not from uninfected cells. We demonstrated that different fractions from infected cells can stimulate translation of late viral mRNA when added to uninfected extracts. The activity of the different fractions correlated with their relative content of the sigma 3 capsid protein; the fraction prepared by high-salt wash of the ribosomes had the highest specific activity. The activity present in this fraction was abolished by preincubation with an anti-sigma 3 serum. Purified sigma 3 protein also stimulated the translation of late viral mRNA, confirming that it was the factor involved. Altogether, these results suggest that this protein plays the role of a late-viral-mRNA-specific initiation factor. The absence of an inhibitory effect of sigma 3 on the translation of other mRNAs indicates that this protein is not directly involved in the inhibition of host and early viral mRNA translation that occurs in infected cells but that a second mechanism is probably operative. PMID- 3298686 TI - Cloning, purification, and biochemical characterization of the pneumococcal bacteriophage Cp-1 lysin. AB - Cp-1, a small virulent bacteriophage infecting Streptococcus pneumoniae, encodes its own lytic enzyme (CPL). A fragment of Cp-1 DNA containing the gene cpl coding for CPL was cloned and expressed in high amounts in Escherichia coli. CPL was purified to electrophoretic homogeneity by using affinity chromatography on choline-Sepharose (T. Briese and R. Hakenbeck, Eur. J. Biochem. 146:417-427, 1985), and the enzyme showing a Mr of 39,000 was characterized as a muramidase. This muramidase required for in vivo and in vitro activity the presence of choline in the teichoic acids of the pneumococcal cell walls. Free choline or lipoteichoic acid noncompetitively inhibited the activity of CPL. PMID- 3298688 TI - En bloc kidney and bladder transplantation from an anencephalic donor into an adult recipient. AB - The visceral block, composed of both kidneys and their vascular pedicles, inferior vena cava, ureters and bladder, was removed from a 3-day-old male anencephalic donor and transplanted into a 32-year-old adult in chronic renal failure. The urinary tract was reconstructed by vesicovesicostomy for technical ease, and prevention of reflux and ureteral stenosis. Maximum urine output was 150 ml. per day and the kidney grafts were lost owing to rejection 5 months after transplantation. PMID- 3298689 TI - The treatment of ureteral obstruction in Gardner's syndrome: renal autotransplantation. AB - We report a case of successful renal autotransplantation for the treatment of ureteral obstruction owing to retroperitoneal desmoid tumors in Gardner's syndrome. Our patient has survived 2 years postoperatively and represents to our knowledge the only long-term success recorded. PMID- 3298690 TI - Ultrasound in patients with blunt renal trauma managed by surgery. AB - We investigated 24 patients with blunt renal trauma by excretory urography plus nephrotomography and ultrasound. The results of these investigations were correlated with the operative findings. The ultrasound diagnosis was correct in 16 of 18 patients with parenchymal injuries. Injuries to the renal pelvis, ureter and renal pedicle were suspected only in connection with excretory urography. Ultrasound provides an excellent inexpensive noninvasive diagnostic tool for the initial diagnostic study of patients with blunt renal trauma. PMID- 3298691 TI - Intravenous digital subtraction angiography in the evaluation of potential renal donors. AB - Of 65 surgically removed donor kidneys intravenous digital subtraction angiography demonstrated accurately the number of renal arteries in 58 (89 per cent). All accessory vessels missed at digital subtraction angiography were small and their presence did not interfere with successful transplantation in those donated. Of 50 surgically removed donor kidneys examined with conventional aortography only before the routine use of intravenous digital subtraction angiography the number of renal arteries was demonstrated accurately in 46 (92 per cent). Intravenous digital subtraction angiography offers advantages over conventional aortography, including most importantly the routine performance on an outpatient basis, and decreased film cost and examination time. Although the accuracy of conventional aortography (92 per cent) in detecting the number of renal arteries is slightly greater than that for intravenous digital subtraction angiography (89 per cent), the advantages of the digital examination justify its use as the initial examination for the potential renal donor. Conventional aortography can be reserved for use in patients with equivocal or technically inadequate digital examinations. PMID- 3298692 TI - The beneficial effects of thoracic duct drainage in HLA-1 haplotype identical kidney transplantation. AB - The beneficial effects of pre-treatment thoracic duct drainage on graft survival in living related kidney transplantation are presented. Since July 1980 lymphocyte depletion through thoracic duct drainage has been used as pre treatment therapy in 39 HLA-1 haplotype identical living related kidney transplant patients. Thoracic duct drainage was maintained for 29 to 49 days (mean 36 days) before transplantation and 52 to 215 times 10(9) cells (mean 130 times 10(9) cells) were removed. Postoperative immunosuppression consisted of azathioprine and steroids. Actuarial graft survival was 100 per cent at 3 months, 97 per cent at 6 months through 2 years, 92 per cent at 3 years and 57 per cent at 4 years after transplantation. Patient survival was 100 per cent at 3 months, 97 per cent at 6 months through 3 years and 86 per cent at 4 years. Pre-treatment thoracic duct drainage maintained for more than 28 days could have a significant role on the improvement of the graft survival in HLA-1 haplotype identical kidney transplantation. PMID- 3298693 TI - Antimicrobial agents in transurethral prostatic resection. PMID- 3298694 TI - Single course versus maintenance bacillus Calmette-Guerin therapy for superficial bladder tumors: a prospective, randomized trial. AB - A total of 42 patients with recurrent superficial bladder tumors or carcinoma in situ entered a prospective, randomized trial to compare the efficacy of bacillus Calmette-Guerin therapy with and without quarterly maintenance instillations of bacillus Calmette-Guerin. Maintenance therapy did not reduce further bladder tumor recurrence rates or the interval to recurrence in patients who responded to the initial course of therapy. However, prolongation of toxicity was observed with maintenance bacillus Calmette-Guerin therapy. PMID- 3298695 TI - Urethral obstruction owing to retroperitoneal cystic lymphangioma. AB - We report a case of cystic lymphangioma arising from retroperitoneal tissues of the pelvis, which caused urethral obstruction and eventual urinary retention. Sonography and computerized tomography demonstrated a retroperitoneal cystic mass in the pelvis. A preoperative diagnosis of retroperitoneal cystic lymphangioma was suggested by typical computerized and sonographic features. PMID- 3298696 TI - Hemophilia and extracorporeal shock wave lithotripsy: a case report. AB - We report renal calculi fragmentation in a hemophiliac patient through the use of extracorporeal shock wave lithotripsy. The Dornier Human Model III lithotriptor was used with the patient under general anesthesia and high frequency intermittent positive pressure ventilation was delivered via a Siemen-Elema 900-D Ventilator. The pathological features and clinical course are discussed. PMID- 3298697 TI - Renal abscess owing to salmonella septicemia: percutaneous drainage. AB - Renal salmonella abscess is an unusual entity. We report a case in which percutaneous pigtail catheter drainage was performed with computerized tomography guidance. PMID- 3298698 TI - Reduction of bacterial adherence to catheter surface with heparin. AB - Despite many advances in catheter design and use, the most common cause of hospital-acquired infections is catheterization of the urinary tract. In the present investigation the adherence of bacteria to catheters coated with heparin was studied. Since heparin itself does not coat the plastic catheter surface, a complex of heparin with tridodecylmethylammonium chloride (TDMAC) was used which results in hydrophobic association of hydrocarbon chains of the TDMAC with the catheter leaving the quaternary ammonium moiety of TDMAC exposed to the surface forming ionic bonds with the highly anionic sulfate groups of heparin. Coating latex catheter material with TDMAC without heparin resulted in 3.6-fold higher adherence whereas coating with the TDMAC-heparin complex reduced adherence to less than 10% of control untreated latex. TDMAC-heparin also significantly reduced bacterial adherence to teflon coated latex (Bardex) and vinyl catheter material. Less than 30% of the original heparin was removed after wash periods of up to one week. These results indicate that TDMAC-heparin coating of urethral catheters reduces bacterial adherence and thereby may delay the acquisition of catheter associated urinary tract infection. PMID- 3298699 TI - The role of intravenous digital subtraction angiography as an adjunct to computed tomography in the preoperative assessment of patients with abdominal aortic aneurysm. AB - The purpose of this article is to determine the role of intravenous digital subtraction angiography (IV-DSA) as an adjunct to computed tomography (CT) in the preoperative evaluation of patients with abdominal aortic aneurysm. Sixty-six patients underwent IV-DSA as well as CT during a 2-year period. Sixty-four of the 66 patients underwent abdominal aortic aneurysm repair. The results of the 66 patients were analyzed to assess what additional information was obtained by IV DSA concerning aneurysm size, vascular anomalies, visceral arterial anatomy, associated aneurysmal disease, and iliofemoral and distal occlusive disease. On the basis of this study, it is suggested that IV-DSA has a limited role in the preoperative evaluation of patients with abdominal aortic aneurysm. PMID- 3298700 TI - Mycotic carotid aneurysm. AB - Mycotic aneurysms of the extracranial internal carotid artery are rare; they usually appear as an enlarging pulsatile neck mass with associated pain, tenderness, and fever. This case report illustrates the need for prompt diagnosis and urgent surgical intervention. The most common organisms found with these aneurysms have been Staphylococcus aureus and Streptococcus pyogenes. We report a case of a mycotic internal carotid artery aneurysm resulting from Salmonella enteritidis. A 20-year review of both the foreign and English language literature revealed only one other case of a mycotic carotid aneurysm resulting from Salmonella infection. The cornerstone of therapy in the past had been proximal ligation. More recently, primary reconstructive procedures with either an end-to end anastomosis or an interposition vein graft have been described. The present case was managed with an end-to-end technique with the use of a Pruitt-Inahara shunt. PMID- 3298701 TI - Ramuald Weglowski: neglected pioneer in vascular surgery. PMID- 3298702 TI - Salvaging a loose continuous suture line. PMID- 3298703 TI - Developments like major resection bone allografts foster progress in tissue banking technology. PMID- 3298704 TI - Leads from the MMWR. HIV human immunodeficiency virus infection transmitted from an organ donor screened for HIV antibody--North Carolina. PMID- 3298705 TI - Leads from the MMWR. Update: Creutzfeldt-Jakob disease in a patient receiving a cadaveric dura mater graft. PMID- 3298706 TI - Outpatient antibiotic therapy for osteomyelitis. PMID- 3298707 TI - Rubens Peale and his spectacles. PMID- 3298708 TI - Comparative study of maltitol and sucrose by means of continuous indirect calorimetry. AB - The metabolism of the hydrogenated disaccharide maltitol was compared to that of sucrose in a group of eight normal subjects. On two separate days, with an interval of at least one week each subject ingested a load of 30 g of either substance. The evolution of the levels of plasma glucose, insulin, and free fatty acids was followed during the 6 hr following the oral load. Carbohydrate and lipid oxidation rates were assessed simultaneously by continuous indirect calorimetry during the 6 hr following the oral load. Plasma glucose and insulin peaks occurred 30 min after ingestion of the load for both sugars. The peak of the delta glucose concentration was significantly smaller after maltitol than after sucrose (21 +/- 4 vs 38 +/- 4 mg/100 ml, p less than 0.02), as was the peak of the delta insulin concentration (9.3 +/- 2.7 microU/ml after maltitol vs 25.5 +/- 5.0 microU/ml after sucrose, p less than 0.001). The peak of the stimulation of glucose oxidation occurred 60 min after the load of sucrose and 90 min after the load of maltitol. The delta glucose oxidation was significantly lower with maltitol than with sucrose during the first 90 min after the ingestion of the load. It was slightly higher (although not significantly) with maltitol than with sucrose starting from the 210th min. Maltitol resulted in a cumulated suprabasal glucose oxidation which amounted to 40% that obtained with sucrose after 180 min. PMID- 3298709 TI - The first heart sound in normal and pathological conditions. AB - Considerations of the physical basis of cardiac contraction and sound generation explain the mechanism of the first sound. Older theories examining this sound as the result of valve closure or stiffening are refuted. It has been demonstrated that the normal first sound originates in the left ventricle alone and that accelerations and decelerations, "timed" by mitral and aortic valves events, are its cause. Three components have been recognized in the first sound: a occurs when the left ventricular wall and septum have reached a certain tension; b when the aortic valve opens; c when the peak of the aortic pulse has been reached. The ventricular septum is an integral and essential part of the left ventricle. In left bundle branch block, abnormal activation of the septum transforms this into a passive structure resulting in a slower rise of left ventricular pressure and a longer isovolumic period. This causes a small and delayed first sound, whose components, however, are still separated by normal intervals. In right bundle branch block, the first sound has a normal amplitude and its components are separated by normal intervals. If there is a larger late component, it is a c component, similar to that of normal elderly subjects. A larger c component may also be found in atrial septal defect. The cannon sound of AV block is caused by more rapid deceleration due to higher atrial pressure at the onset of ventricular contraction resulting in intense vibrations. The first sound of arrhythmias varies in the different conditions and even in different subjects, due to the effect of several variable factors. Elevated left atrial pressure, stiffening of the mitral valve in mitral stenosis, causes a slow onset and a more rapid rise of LV pressure. This results in a delayed, but larger, first sound. The action of catecholamines on the myocardium dramatically increases the first sound. The latter can be considered as an index of contractility and may be of great interest during stress tests. PMID- 3298710 TI - High renin hypertension in the elderly. AB - This paper describes clinical features of high renin hypertension in the elderly. Peripheral plasma renin activity ranged from 0 to 20.1 ng/ml/hr in 59 hypertensive in-patients aged 70 to 86. The patients were divided into 2 groups: 9 cases with plasma renin activity greater than or equal to 3.0 ng/ml/hr (high renin group) and the remaining 50 with plasma renin activity less than 3.0 ng/ml/hr (control group). The development of hypertension differed between the 2 groups. Six of the high renin group (66.7%) had a history of acceleration of previously mild hypertension, while only 3 of the control group (6.0%) had this history (p less than 0.01). The frequencies of high diastolic blood pressure (greater than or equal to 120 mmHg), massive proteinuria (at least 3.0 g/day), hypokalemia (serum potassium less than or equal to 3.0 mEq/L) and high serum cholesterol (greater than or equal to 250 mg/100 ml) were significantly greater in the high renin group than in the control group (p less than 0.01, respectively). Renovascular hypertension was suspected in 6 patients from the high renin group (66.7%), as compared with 1 of the control group (2.0%) (p less than 0.001). There was massive proteinuria in 3 of 6 patients with renovascular hypertension in the high renin group and 2 showed nephrotic syndrome. Thus, two thirds of the elderly patients with high renin hypertension had probable renovascular hypertension with a history of rapid progression of hypertension. PMID- 3298712 TI - [History of radiotherapy]. PMID- 3298711 TI - Angiotensin II-induced drinking in water-deprived and nephrectomized dogs. AB - We evaluated the dipsogenic effects of angiotensin II (Ang II) in relation to the steady-state level of the endogenous renin-angiotensin system (RAS) by measuring water intake in 22 trained dogs during three 20 min intravenous (i.v.) infusions of [Ile5] Ang II (10, 15 and 50 ng/kg/min). Measurements obtained in normally hydrated (NHyd) dogs were compared with those obtained in dogs pretreated as follows: 24 hr water deprivation (WD); WD combined with chronic blockade of the RAS (300 mg/day X 3 days of SQ 14225) (WD + SQ); and 48 hr after bilateral nephrectomy (BNX). Both WD and WD + SQ were given water before Ang II infusion. Plasma renin activity (PRA) and serum and CSF electrolytes (cisterna magna catheter) were measured. All treatments caused a significant (p less than 0.05) increase in CSF sodium (Na+) that was not paralleled by hypernatremia in BNX dogs (142 +/- 1 vs 144 +/- 1 mEq/L in NHyd). WD and WD + SQ caused a 2- and 12-fold increase in PRA, respectively; PRA was not detectable in BNX. Suppression of blood Ang II by WD + SQ produced a reduced latency and significant enhancement of the thirst behavior elicited by Ang II at all doses; however, i.v. Ang II did not elicit drinking in the WD state. Furthermore, in BNX, the same phenomenon as in WD + SQ was observed. These data are compatible with the concept that endogenous levels of Ang II play a key role in regulating drinking behavior. However, these findings do not negate the possibility that Ang II acts synergistically with CSF Na+, but not plasma Na+, to modulate drinking behavior. PMID- 3298713 TI - [Evaluation of therapeutic results and the concept of clinical trial]. PMID- 3298714 TI - [Cancer in adult twins]. AB - Previous reports on twin cancer have been reviewed. Especially, cancer in later adulthood has been focused. There have been done several large scale twin studies on cancer in Europe and the U.S.A., but not in Japan. Although, it is not easy to establish twin registry in Japan, the importance of twin study in epidemiology and preventive medicine has been emphasized. Methodology of twin research in epidemiology has been described. Epidemiological research methods in Japan have been described through the authors' past experience. PMID- 3298715 TI - [Genetic epidemiology of the familial aggregation of human leukemia]. AB - During the past decade enormous progress has been achieved in the investigation of cytogenetics and moleculargenetics of leukemia and lymphoma, although there have been few systemic studies which clarify genetic etiology leukemia. At this standpoint it is important to review the recent literature which concerns etiology of leukemia. Recently it has been proved that of the incidence of childhood acute lymphocytic leukemia is same in all over the world by Greaves and his collegue. So the major cause of childhood leukemia can be explained to be spontaneous mutation. Nevertheless genetic factors are thought to be a part of another cause of leukemia as well as certain environmental factors. Heterogeneity of genetic mechanism in familial aggregation in each case probably makes difficult to analyse the cause of hereditary mechanism in leukemia. PMID- 3298716 TI - [Refractory respiratory tract infections. 1. The defense mechanism of the pulmonary alveolar airway. a. The physical defense mechanism of the mucociliary system]. PMID- 3298717 TI - [Refractory respiratory tract infections. 2. Disorders of the defense mechanism and infection. a. Basic respiratory diseases]. PMID- 3298718 TI - [Refractory respiratory tract infections. 2. Disorders of the defense mechanism and infection. b. Immune deficiency]. PMID- 3298719 TI - [Refractory respiratory tract infections. 2. Disorders of the defense mechanism and infection. c. Brain diseases]. PMID- 3298720 TI - [Refractory respiratory tract infections. 2. Disorders of the defense mechanism and infection. d. Diabetes mellitus]. PMID- 3298721 TI - [Refractory respiratory tract infections. 2. Disorders of the defense mechanism and infection. e. The aged]. PMID- 3298722 TI - [Refractory respiratory tract infections. 3. Changes in pathogens and chemotherapy. a. Community-acquired pneumonia]. PMID- 3298723 TI - [Refractory respiratory tract infections. 3. Changes in pathogens and chemotherapy. b. Hospital-acquired pneumonia]. PMID- 3298725 TI - [Refractory respiratory tract infections. 3. Changes in pathogens and chemotherapy. d. Chronic lower respiratory tract infections]. PMID- 3298724 TI - [Refractory respiratory tract infections. 3. Changes in pathogens and chemotherapy. c. Lung abscess]. PMID- 3298727 TI - [Refractory respiratory tract infections. 4. Selection of chemotherapeutic agents and their administration. b. Gram-positive bacterial infections]. PMID- 3298726 TI - [Refractory respiratory tract infections. 4. Selection of chemotherapeutic agents and their administration. a. Gram-negative bacterial infections]. PMID- 3298728 TI - [Refractory respiratory tract infections. 4. Selection of chemotherapeutic agents and their administration. c. Pseudomonas infections]. PMID- 3298729 TI - [Refractory respiratory tract infections. 4. Selection of chemotherapeutic agents and their administration. d. Anaerobic bacterial infections]. PMID- 3298730 TI - [Refractory respiratory tract infections. 4. Selection of chemotherapeutic agents and their administration. e. Multi-bacterial infections]. PMID- 3298731 TI - [Refractory respiratory tract infections. 5. Persistence of chronic airway infections. b. Permeability of antibiotics in the airway and chemotherapy]. PMID- 3298732 TI - [Refractory respiratory tract infections. 6. New problems in refractory respiratory tract infections. a. Changes in pathogens and chemotherapy after development of the third generation of cephalosporins]. PMID- 3298733 TI - [Refractory respiratory tract infections. 6. New problems in refractory respiratory tract infections. b. Induction of H. influenzae L type and repetitious infections]. PMID- 3298734 TI - [Refractory respiratory tract infections. 6. New problems in refractory respiratory tract infections. c. Chemotherapy of methicillin-resistant Staphylococci infection]. PMID- 3298735 TI - [Refractory respiratory tract infections. 7. Trends in the development of new chemotherapeutic agents for respiratory tract infections. a. Antibiotics]. PMID- 3298737 TI - [Refractory respiratory tract infections. 8. Clinical efficacy and application of combined therapy with antibiotics. b. Steroid therapy]. PMID- 3298736 TI - [Refractory respiratory tract infections. 7. Trends in the development of new chemotherapeutic agents for respiratory tract infections. b. Synthetic antibacterial agents]. PMID- 3298738 TI - [Refractory respiratory tract infections. 9. Chemotherapy of recent respiratory tract infections. b. Legionnaire's disease]. PMID- 3298739 TI - [Refractory respiratory tract infections. 9. Chemotherapy of recent respiratory tract infections. c. Atypical Mycobacterium infections]. PMID- 3298741 TI - [Refractory respiratory tract infections. 9. Chemotherapy of recent respiratory tract infections. e. Pneumocystis carinii infection]. PMID- 3298740 TI - [Refractory respiratory tract infections. 9. Chemotherapy of recent respiratory tract infections. d. Mycoses]. PMID- 3298742 TI - [Gene structure of the AIDS virus]. PMID- 3298743 TI - [Kaposi's sarcoma--pathology, classification and etiology]. PMID- 3298744 TI - [Basic principles and clinical evaluation of digital radiography]. PMID- 3298745 TI - [Pathological study of the etiology of coronary thrombosis]. PMID- 3298746 TI - Chromosome aberrations in leukocytes of filaria-infected indigenous inhabitants in the Philippines. AB - In the course of genetic population surveys of a tribal group of the Philippine Negritos living on Mindanao island, microfilariae (Wuchereria bancrofti) were incidentally found on the microscopic slides for a cytogenetic investigation. Structural chromosome aberrations in the cultured leukocytes from 19 filaria infected and 22 uninfected subjects were studied. The frequencies of chromosome type aberrations such as dicentrics and chromosome breaks in the infected subjects were significantly higher than those in the uninfected subjects (P less than 0.05). The frequencies of chromatid type aberrations, however, were not significantly different between the filaria-infected subjects and the uninfected subjects. PMID- 3298747 TI - Action of the bacterial neutral protease, dispase, on cultured cells and its application to fluid suspension culture with a review on biomedical application of this protease. AB - The bacterial neutral protease from Bacillus polymyxa, dispase, has been characterized using 21 mammalian cell lines in its cell-dispersing capability, cytotoxicity, and effects on cell growth. The previous observation that fibroblast-like cells are detached by this protease from culture substrate, as well as dissociated into a monodisperse cell suspension, while that epithelial like cells are detached but not completely dissociated, was generally confirmed, although exceptions to these general rules were noted. Efforts were made here by the use of dispase to develop techniques for suspension culture and single cell plating: Successful conditions of suspension culture for 6 lines, and single cell plating for 3 lines were respectively described. Key factors in these techniques were choice of a low concentration of dispase in growth media to avoid its cytotoxic effect, and choice of appropriate serum concentration in the medium to allow this protease to remain active. Recent literatures on the application of dispase in biomedical science were reviewed. PMID- 3298748 TI - Genetic recombination between closely linked markers of bacteriophage T4. II. A mutation which reduces the formation of heteroduplex heterozygotes. AB - A T4 phage mutant MCO4 was isolated as a mutant that reduced the frequencies of recombinants between multiple closely-linked markers but not those between two markers. MCO4 mutation was a non-lethal, recessive mutation and was located nearby gene 24 and gene 25. MCO4 mutation reduced the frequency of heteroduplex heterozygotes but not the frequency of terminally redundant heterozygotes. Therefore, MCO4 mutation appears to block the formation and/or the extension of heteroduplex regions or to shorten their life-time. PMID- 3298749 TI - [The studies of tumor makers and the distribution of carbohydrate antigens in the pancreatic carcinoma tissues]. PMID- 3298750 TI - [Significance of saline injection method on ultrasonography of gastrointestinal tract series]. PMID- 3298751 TI - [A new pancreatic ductal cell antigen prepared by a monoclonal antibody]. PMID- 3298752 TI - [Antihypertensive treatment with captopril or carteolol in elderly patients]. PMID- 3298753 TI - [On midwifery education system by CAI (computer-assisted instruction) at our school]. PMID- 3298754 TI - [Transition in midwifery practice. 22. Toward the end of American occupation]. PMID- 3298755 TI - [Lessons on past activities and progress in midwifery (1): Interviews with midwives who were active in the Taisho era and the first half of the Showa period]. PMID- 3298756 TI - [Analysis of FDP subfragments--application of the western blot]. PMID- 3298757 TI - [A list of 99 books recommended for reading by new nurses. My interactions with literature]. PMID- 3298759 TI - [A list of 99 books recommended for reading by new nurses. On "Death of a Child" through "Shoko wa tori ni natta"]. PMID- 3298758 TI - [A list of 99 books recommended for reading by new nurses. Recommendation of special books to new nursing school graduates]. PMID- 3298760 TI - [A list of 99 books recommended for reading by new nurses. A pleasure in reading: a theory on reading by an experienced nurse]. PMID- 3298761 TI - [A list of 99 books recommended for reading by new nurses. A new definition of nursing given by various books]. PMID- 3298762 TI - [Post-war drafting of nurses by the government: drafting of Japan Red Cross nurses during Korean War]. PMID- 3298763 TI - [Florence Nightingale and I]. PMID- 3298764 TI - [In search of nursing roots in public health nursing practiced at land reclamation projects in Hokkaido. 14]. PMID- 3298765 TI - [Serum drug levels and drug efficacy--antibiotics]. PMID- 3298766 TI - [Ultrasonographic assessment of residual urine in patients with neurogenic bladder dysfunction]. PMID- 3298767 TI - [Renal cell carcinoma of the solitary kidney treated by ex vivo partial nephrectomy with autotransplantation: a case report]. PMID- 3298768 TI - [Incidental prostatic carcinoma diagnosed by the step-section technic for the surgical specimen: histopathological analysis]. PMID- 3298769 TI - [Free full-thickness skin graft for one-stage hypospadias repair]. PMID- 3298770 TI - Diagnostic ultrasound imaging of vegetative valvular endocarditis in cattle. PMID- 3298771 TI - Loving the unlovable. PMID- 3298772 TI - Amanita poisoning treated with endoscopic biliary diversion. PMID- 3298773 TI - Emergency nursing care of the cardiac transplant patient. PMID- 3298775 TI - Dilatation and suction curettage in the emergency department: policies and procedures development. PMID- 3298774 TI - Dilatation and evacuation performed in the emergency department for miscarriage. PMID- 3298776 TI - Vascular access devices: uses and aftercare. PMID- 3298777 TI - Assessment of orthostatic hypotension. PMID- 3298778 TI - A graphic solution to the calculation of dopamine and other vasoactive drug dosages. PMID- 3298779 TI - Law and the emergency nurse. Complications of ED treatment: who is liable? PMID- 3298780 TI - Standardized care plans. Epiglottitis. PMID- 3298781 TI - Triage decisions. An adult diabetic man with a depressed sensorium. PMID- 3298783 TI - Emergency nursing in an American Indian health center. PMID- 3298782 TI - Impressions: Mabel. PMID- 3298785 TI - Existence of N-nitroso-N-propylurea target cells in the thymus of F344 rats in thymic lymphomagenesis. AB - There are two hypotheses for location of first transformation of cells of T-cell lineage into preneoplastic cells from studies of leukemogenesis in mice; one is the bone marrow and another is the thymus. N-Nitroso-N-propylurea [(NPU) CAS: 816 57-9] induces high incidence of thymic lymphoma in F344 rats. In the present experiments, the location of NPU-target cells was examined in F344 rats. In the first experiment, bone marrow cells from NPU-treated male rats were inoculated into sublethally irradiated female rats. However, neither thymic nor other types of leukemias were induced in these rats. In the following experiment, thymectomized male rats received grafts sc with normal thymuses of age-matched female F344 rats. Continuous administration of NPU to the rats successfully induced 9 thymic lymphomas in the grafted thymuses. In 8 thymic lymphomas analyzed, 6 consisted of donor cells and the other 2 consisted of recipient cells. The present results from these 2 experiments strongly suggested that NPU induced rat thymic lymphomas originate from intrathymic cells but not from bone marrow cells. In other words, target cells of leukemogenic activity of the chemical carcinogen NPU probably exist in the thymus of F344 rats. PMID- 3298784 TI - Expression of tumor-associated antigen (DF3) in atypical hyperplasias and in situ carcinomas of the human breast. AB - The monoclonal antibody (MoAb) DF3 prepared against a membrane-enriched fraction of human breast carcinoma has previously shown a differential reactivity to cytoplasmic antigen in carcinomas versus antigen concentrated on apical borders in benign lesions of the breast. In the present report the cytoplasmic reactivity of MoAb DF3 within a spectrum of benign and malignant breast lesions was studied to define whether the DF3 antigen is expressed in the cytoplasm of potentially premalignant lesions, i.e., atypical hyperplasias, or early malignant lesions, i.e., in situ carcinomas. Biopsy specimens of breast lesions from 108 women, including 28 patients with invasive carcinoma, 12 with in situ carcinoma, 17 with atypical hyperplasia, 25 with proliferative lesions without atypia, and 26 with nonproliferative lesions, were examined for DF3 antigen expression with the use of an indirect immunohistochemical method. Atypical hyperplasias were less reactive with MoAb DF3 than invasive carcinomas (P = .05 by Wilcoxon rank sum test). No significant statistical differences were observed, however, between invasive carcinomas and in situ carcinomas or between in situ carcinomas and atypical hyperplasias on the basis of cytoplasmic DF3 reactivity. Invasive carcinomas, in situ carcinomas, and atypical hyperplasias, however, demonstrated significantly higher reactivity with MoAb DF3 in the cytoplasm than proliferative lesions without atypia and nonproliferative lesions (P less than .01). These studies demonstrate that atypical hyperplasias express elevated levels of a given tumor-associated antigen and thus provide further immunologic evidence that these lesions are premalignant. PMID- 3298786 TI - Quantitation of Harvey ras p21 enhanced expression in human breast and colon carcinomas. AB - Molecular studies have demonstrated increased expression of the Harvey (Ha) ras oncogene in human breast and colon carcinomas. With the use of a direct-binding liquid competition radioimmunoassay (RIA), capable of providing truly quantitative analysis of the 21,000-dalton (p21) ras oncogene and protooncogene products, absolute levels of Ha-ras p21 have been determined in human breast and colon carcinomas, benign lesions, and/or their respective normal tissues. Enhanced Ha-ras expression was documented in 66% of breast and 100% of colon carcinomas as compared with their normal counterparts, with levels in breast carcinomas ranging from 10.1 to 50.4 pg ras p21/micrograms protein and those in colon carcinomas ranging from 18.4 to 51.7 pg ras p21/micrograms protein. Some dysplastic lesions of the breast and colon also contained elevated Ha-ras p21. Relative levels of Ha-ras p21 expression, detected by competition RIA, correlated with percent Ha-ras p21-positive cells as determined by immunohistochemical assays. By use of liquid competition RIA and immunohistochemical assays, it has been shown that levels of ras p21 expression did not always correlate between primary and metastatic colon lesions of the same patient. The use of the quantitative RIA and semiquantitative immunohistochemical assays, in concert with cDNA probes for identification of specific ras point-mutated oncogenes or protooncogenes, may now provide the means for definitive quantitative analyses of ras p21 in human carcinomas and benign lesions. PMID- 3298787 TI - Anatomy of an epidemic. PMID- 3298788 TI - [Living history of Finnish midwifery--focus on Maire Warri. Interview by Maija Kennovaara]. PMID- 3298789 TI - [History of the maternity hospital of the Turku municipal hospital]. PMID- 3298790 TI - The remarkable Miss Nightingale. PMID- 3298791 TI - Discussion/life of Florence Nightingale. PMID- 3298792 TI - [Leon Tochowicz--a physician, scientist and teacher. Reminiscences on the 20th anniversary of his death--July 29, 1955]. PMID- 3298793 TI - [Automation of the sinoatrial node and sinoatrial conduction and the autonomic nervous system]. PMID- 3298794 TI - [Prolactin and the cardiovascular system]. PMID- 3298795 TI - Renal magnesium wasting in two families with autosomal dominant inheritance. AB - Hypomagnesemia due to isolated renal magnesium loss was demonstrated in two unrelated families with autosomal dominant mode of inheritance. Magnesium infusions performed in two patients showed not only a reduced renal magnesium threshold but also a lowered renal tubular maximum for magnesium. All members of both families who presented with hypomagnesemia had also a lowered excretion of calcium in the urine, presumably as a consequence of increased reabsorption in Henle's loop. PMID- 3298796 TI - Mechanisms of glucocorticoid-induced hypertension. PMID- 3298797 TI - Effect of angiotensin II on glomerular hemodynamics and ultrafiltration coefficient. PMID- 3298798 TI - Intrarenal effects of angiotensin II in renal artery stenosis. PMID- 3298799 TI - Morphological aspects of renin synthesis, processing, storage, and secretion. PMID- 3298800 TI - Experimental models of heart failure: implications for renin and the kidney. PMID- 3298801 TI - Heterogeneity of nephron anatomy. PMID- 3298803 TI - A periarterial pathway for intrarenal distribution of renin. PMID- 3298802 TI - Intrarenal and intracellular distribution of renin and angiotensin. PMID- 3298804 TI - The renin-angiotensin system and nephron function heterogeneity. PMID- 3298805 TI - The effects of angiotensin II on isolated glomeruli and cultured glomerular cells. PMID- 3298806 TI - The tubular effects of angiotensin II. PMID- 3298807 TI - Control of renal renin release. PMID- 3298808 TI - Prostaglandins modulate the glomerular actions of angiotensin II. PMID- 3298809 TI - [Surgical treatment of splenic injuries]. PMID- 3298810 TI - [Current aspects of the diagnosis and treatment of closed liver injury and its complications]. PMID- 3298811 TI - [Acute emphysematous cholecystitis]. PMID- 3298813 TI - [Comparative evaluation of current methods of diagnosing echinococcosis]. PMID- 3298812 TI - [Hermetic closure of the cecal cupula after appendectomy]. PMID- 3298814 TI - [Discussion on the blind suture of the wound in the treatment of various forms of paronychia]. PMID- 3298815 TI - [A method of applying sutures during operations on organs of the gastrointestinal tract]. PMID- 3298817 TI - [Treatment and surgical rehabilitation of patients with acute suppurative mastitis (review of the literature)]. PMID- 3298816 TI - [Carotid chemodectoma (review of the literature)]. PMID- 3298818 TI - [A continuous interrupted suture]. PMID- 3298819 TI - [Prevention of wound infection in the surgical treatment of postoperative hernia]. PMID- 3298820 TI - [Choice of the method and extent of surgery in complicated cancer of the colon (review of the literature)]. PMID- 3298821 TI - [Improvements in the organization of surgical services during World War II (on the 42d anniversary of victory over fascist Germany)]. PMID- 3298822 TI - [Gastric resection in "difficult" duodenal ulcers]. PMID- 3298823 TI - [Experimental allotransplantation of the pancreas]. PMID- 3298824 TI - [Resection of the liver]. PMID- 3298825 TI - [Ultrasonic diagnosis of kidney disease in urologic practice]. PMID- 3298826 TI - [A case of lymphocele in a patient with a transplanted kidney]. PMID- 3298827 TI - [The placement of sutures in ureteral calculi using visual control (ureteroscopy)]. PMID- 3298828 TI - Significance of non-pneumophila Legionella species in adult community-acquired and nosocomial pneumonias. AB - The number of different Legionella species is increasing at an impressive rate. In two prospective studies, one involving 110 intensive-care unit (ICU) patients with mainly nosocomial pneumonias and the other 105 patients with community acquired pneumonias, we investigated the incidence and significance of Legionella pneumophila and non-pneumophila pneumonias on the basis of 17 different main serogroups. In the first study, 14 ICU patients had 15 (13.6%) Legionella pneumonias, which, in 5 cases (33%), were of non-pneumophila etiology. In the second study, 9 patients with community-acquired pneumonias had 10 (9.5%) Legionella pneumonias. Leading this study were 6 L. gormanii infections, followed by 2 L. dumoffii and only 1 L. pneumophila and 1 L. longbeachae pneumonia. Of the total, 22 of 23 patients with Legionnaires' disease suffered from severe basic diseases and complications (acute renal failure, respiratory insufficiency, etc.) predominant among the nosocomial pneumonias. The mortality rate was significant in these patients at 33% (5 patients) in the ICU group and 10% (1 patient) in the group with community-acquired pneumonias. We conclude that non-pneumophila Legionella species should receive more diagnostic and therapeutic consideration in patients with nosocomial or community-acquired pneumonias. PMID- 3298830 TI - Assessment of cutaneous fat and body fat by ultrasound. AB - A new rapid and simple method is introduced to measure subcutaneous fat and evaluate total body fat. It is based on real-time ultrasound and requires equipment that is used in routine examination of subcutaneous structures, e.g., thyroid gland. Results from seven regions of skin in 100 subjects correlated well with total body weight, Broca's index, and deviation from average weight 0.02 greater than P greater than 0.001). Comparisons were also made with measurements of subcutaneous fat from skinfolds. There was an excellent correlation of values (P less than 0.001 in all experiments), although ultrasound results tended to be slightly higher. For calculation of total body fat, ultrasound values were converted by regression equations to "calculated skinfold thickness"; when applying established mathematical models for calculating body fat from skinfold thickness results were equal in both methods (P greater than 0.1). PMID- 3298829 TI - [Prospective comparison of the diagnostic value of cytology and immunocytology in pleural effusion studied by thoracoscopy and biopsy]. AB - Two issues have been elaborated: the value of immunocytochemistry in the diagnosis of pleural effusions, and the reactivity of the investigated antibodies with different classes of cells in pleural effusions. Effusions of unknown origin from 38 patients were investigated using thoracoscopy, pleural biopsies, conventional cytology, and immunocytochemistry. The following antibodies were used: those monoclonal against various leukocyte antigens, macrophage antigens, epithelial membrane antigen (EMA), various cytoskeleton antigens, and melanoma antigens; those polyclonal against CEA and ferritin. All of the techniques used showed 18 patients (48%) as having a tumor-cell negative effusion. A pleural tumor with a malignant effusion showed in 13 patients (34%); in 12 of these immunocytochemistry also revealed tumor cells. Seven patients (18%) had a tumor of the pleura with a tumor-cell negative effusion; in 2 of these immunocytochemistry revealed a tumor-cell positive effusion. There was no difference with regard to the number of NK cells in patients with inflammation of the pleura and negative cytology and patients with tumor of the pleura and malignant effusion (3% vs 4.5%). Tumor cells were mainly stained by EMA, cytokeratin, and CEA. CEA was the only antibody to be tumor-cell specific, while EMA and cytokeratin were expressed by mesothelial cells also. The antibody against ferritin was a significant marker for mesothelial cells. PMID- 3298832 TI - [Use of echo- and thermography in various diseases of the breast]. PMID- 3298831 TI - Primary aldosteronism by carcinoma of the adrenal cortex. AB - A 58-year-old white woman with hypertension and severe hypokalemia was found to have a carcinoma of the left adrenal gland. Plasma renin activity was constantly under the normal limit, while plasma aldosterone levels were pathologically elevated. Plasma cortisol (8:00 a.m.) and excretion rates of urinary free cortisol were within the normal range. After an adrenalectomy, relapsing excessive aldosterone secretion was successfully treated with opDDD (Lysodrene). Ten months after the diagnosis was established, the patient died from a bleeding liver metastasis. PMID- 3298833 TI - [Early diagnosis of carbohydrate metabolism disorders in patients with essential hypertension]. PMID- 3298834 TI - [Diffuse eosinophilic fasciitis]. PMID- 3298835 TI - [Pathogenesis and diagnosis of muscle lesions in rheumatoid arthritis]. PMID- 3298836 TI - [Role of neuropeptides in regulating the function of the digestive system]. PMID- 3298837 TI - [Atypical forms and outcomes of hepatitis A]. PMID- 3298838 TI - [Effect of lasolvan on the rheologic properties of sputum]. PMID- 3298839 TI - [Ultrasonic diagnosis of calcified gallbladder]. PMID- 3298840 TI - [N.I. Pirogov in Heidelberg]. PMID- 3298841 TI - [Experience with using sinepress in hypertension]. PMID- 3298842 TI - [Computerized tomography and ultrasonic study in various kidney diseases]. PMID- 3298843 TI - [Ultrasonic diagnosis of complicated cholecystitis]. PMID- 3298844 TI - [Men in nursing. "I will not even mention men ..."]. PMID- 3298845 TI - [Intensive care of severely burned patients]. PMID- 3298846 TI - Utero-ovarian infection in aged B6C3F1 mice. AB - An unusually high number of ovarian masses and cysts with purulent material were observed in the B6C3F1 mice on 2 year chemical carcinogenicity studies sponsored by the National Cancer Institute-National Toxicology Program. To determine possible etiology, some of these lesions were cultured for bacteria and a majority yielded Klebsiella sp. Necropsy records of 14,029 female mice in 91 chronic studies necropsied from 1979 to 1983 at six toxicology testing laboratories were reviewed to determine the incidence of lesions and distribution of this disease. Animals for these studies were obtained from barrier production colonies of six suppliers. The incidence of this lesion was low in animals less than 14 months of age, increased with age and reached a peak in 24-26 month old mice. Most animals having this lesion either died or were sacrificed in moribund condition, indicating that this is a life shortening disease of aged B6C3F1 mice. The incidence of lesions ranged from less than 1% to 70% in different chronic studies. There was a marked difference in the incidence in mice from different suppliers and the incidence rate was 2.6 to 15% depending on the source of the animals. The incidence of this lesion in some testing laboratories was several fold higher than in others and ranged from 0.9 to 20%. The proportion of mice with this lesion was low in some laboratories irrespective of the source of the animals, whereas in other laboratories the incidence was several-fold higher with animals from some, but not all suppliers, indicating testing laboratory-supplier interaction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298847 TI - Defining and interpreting diseases through morphometry. PMID- 3298848 TI - Role of immunological factors in male infertility. Immunohistochemical and serological evidence. AB - Immunological deposits in the testis and circulating antibodies to spermatozoa are presented as a possible explanation for infertility in man. Testicular biopsy specimens from infertile patients (N = 52) as well as from fertile controls (N = 6) were analyzed immunohistochemically by using semithin sections. Immunoglobulin deposits were found in the testes of 21 patients. Antibody deposits were observed on the seminiferous tubule wall, on germ cells or in the interstitium. In two cases, the C3 complement component was detected on the tubular wall and in one case on atypical spermatogonia. Deposits of immunoglobulin class G were found most frequently, and were often attached to the seminiferous tubule wall. In addition, the occurrence of circulating antisperm antibodies in the sera of these patients was examined by a recently developed method, the immunobeads binding test. A significant number of patients with normal spermatogenesis had antibodies that exhibited a strong binding reaction to spermatozoa as observed by the immunobeads binding test. It is suggested that at least two different immunological mechanisms may be involved in pathological infertility: an immunoglobulin deposit, induced locally in the testis, in a manner specifically against the germ cells and the seminiferous tubular basement membrane, or in a manner nonspecifically against seminiferous tubular wall, and asystemically induced immunoglobulin production which is directed against spermatozoal antigens. PMID- 3298849 TI - Lectin cytochemistry and histochemistry. PMID- 3298850 TI - Amyloid fibril protein AA. Characterization of uncommon subspecies from a patient with rheumatoid arthritis. AB - Protein AA, the main fibril protein in secondary systemic amyloidosis, is a mixture of protein fragments (subspecies) of different length, probably arising by enzymatic cleavage of a serum precursor, SAA. We have purified amyloid fibril protein AA from a patient with rheumatoid arthritis and secondary amyloidosis with an unusual amyloid distribution in organs. This protein AA contained two major subspecies of which one consisted of 50 amino acid residues shown by complete amino acid sequence analysis. The other major AA subspecies, characterized by N- and C-terminal sequence analysis and amino acid determination of proteolytic peptides, contained 45 amino acid residues. The pI of these AA variants differed considerably, 8.1 to 5.5, respectively. Several minor protein AA subspecies were also identified, among them one with a blocked N-terminal. The findings indicate that AA proteins of different length are connected to varying AA amyloid syndromes. PMID- 3298851 TI - A molecular-pathologic approach to murine senile amyloidosis. Serum precursor apolipoprotein A-II variant (Pro5----Gln) presents only in the senile amyloidosis prone SAM-P/1 and SAM-P/2 mice. AB - Murine apolipoprotein (apo) A-II is a serum precursor of murine senile amyloid protein. We determined the primary structures of apo A-II in accelerated senescence-prone mice (SAM-P) characterized by a high frequency of age-associated systemic amyloidosis and accelerated senescence-resistance mice (SAM-R) in which senile amyloidosis occurred with a low incidence. Apo-A-II variant (Pro5----Gln) was found to be present only in the serum of SAM-P and not in that of SAM-R or other random bred slc:ICR mice. The apo A-II variant in the serum of SAM-P is identical to the murine senile amyloid fibril protein (ASSAM) derived from amyloid-deposited tissues of SAM-P. These findings proved that apo A-II deposits in tissues without degradation and this mutation (Pro5----Gln) probably have significant effects on the structure and function of apo A-II and would play a critical role in murine senile amyloidogenesis. PMID- 3298852 TI - Isolation of rat aortic endothelial cells by primary explant techniques and their phenotypic modulation by defined substrata. AB - An efficient and reliable procedure for the isolation and culture of endothelium from large vessels of small animals (e.g., rat) is described, which takes advantage of endothelial cell-extracellular matrix interactions to promote the outgrowth of cells from tissue explants. The procedure may also permit the isolation by nonenzymatic means, of endothelial cells from other vessels and tissues. Rings and opened segments of aortic tissue were placed on a variety of substrates including: untreated tissue culture plastic; films of fibronectin, laminin, type I collagen, and gelatin; gels of type I collagen (Vitrogen, Collagen Corporation, Palo Alto, California), of basement membrane components derived from the EHS sarcoma (Matrigel, Collaborative Research Inc., Lexington, Massachusetts), and of agar and agarose. The medium used was OPTI-MEM or RPMI 1640 (Gibco Laboratories, Grand Island, New York) with 3% or 20% fetal calf serum, and 50 micrograms/ml endothelial cell growth supplement. Only explants on Vitrogen and on Matrigel produced a significant and consistent outgrowth of cells and this occurred shortly after the initiation of explants. Virtually no outgrowth occurred from explants on the other substrata, even after 10 days in culture. On Vitrogen gels, the cells emerged from the explants as single stellate and bipolar cells, whereas those on Matrigel grew as chains and sheets from the edges of the explant. Cells were passaged from both types of gels onto plastic or glass surfaces. The passaged cells isolated from both gel matrices exhibited specific endothelial cell characteristics including a "cobbled" morphology at confluence, positive staining for von Willebrand factor, and uptake of Di-I-Ac low density lipoprotein. Because rat and other small animal aortic endothelial cells are resistant to isolation by enzymatic treatment, this technique provides a simple means to obtain large numbers of this cell type. Further, the method permits study of endothelial cell functions in vitro, and the roles which the extracellular matrix may play in these processes. PMID- 3298853 TI - Yellow fever at Mt. Pleasant, Charleston Harbor, S. C. in 1857, with a review of its consequences. PMID- 3298854 TI - Midnight macabre. PMID- 3298855 TI - Routine detection of benzoylecgonine in urine at a sensitivity of 35 ng/mL by a combination of EMIT and gas chromatography/mass spectrometry. AB - The limit of detection of a published gas chromatographic/mass spectrometric (GC/MS) procedure for the detection of benzoylecgonine in urine was extended to 35 ng/mL. The GC/MS procedure then was used not only to confirm EMIT positives, but also to detect the presence of benzoylecgonine in urines that gave EMIT readouts below the low calibrator value, but higher than halfway between the negative and low calibrator values. Of 16 such patient urines, 12 were positive by the GC/MS procedure. PMID- 3298856 TI - Comparison of lidocaine by fluorescence polarization immunoassay, enzyme immunoassay, and high resolution gas chromatography. AB - Lidocaine levels in plasma for therapeutic monitoring purposes were compared by using fluorescence polarization immunoassay (Abbott TDx), enzyme immunoassay (EMIT-Cad), and a high-resolution gas chromatography (HRGC). The two immunoassay methods on 29 clinical samples gave excellent correlation (r = 0.998 and 0.999 for TDx and EMIT, respectively), when compared to the HRGC method. PMID- 3298857 TI - Computers in paediatrics: (19). Computer assisted calculation of anthropometric indices for the assessment of childhood obesity. PMID- 3298858 TI - Home glucose monitoring with microcomputer. PMID- 3298859 TI - Ultrasonic measurement of upper-arm skeletal muscle thickness. PMID- 3298860 TI - Seeding and perineal implantation of prostatic cancer in the track of the biopsy needle: three case reports and a review of the literature. AB - Several months (an average of 12.86 months) after perineal needling of the cancerous prostate for the purpose of obtaining tissue for biopsy, a tumor nodule becomes clinically evident in the subcutaneous tissue of the perineum, at the site of the needling in 0.34% of the cases. This nodule presents the same histological picture as the biopsy of the prostatic tumor. This is a review of 15 such cases (12 collected from the literature and an additional three unpublished cases, two of which are personal observations). At the time of needling, no metastases could be clinically detected in any of the patients; the serum acid phosphatase was normal in 73% of them. The average age of the patients was 65.66 years. The perineal nodule was tender in 40% of the cases; its average size was 2.5 cm. Excision of the nodule was the most frequently employed form of management. At the time of reporting, 60% of the patients were living and well, for an average of 18.56 months after excision. In order to prevent perineal implantation, especially in patients who are at risk, it is suggested that a fine needle be employed to obtain prostatic tissue for biopsy, and that every possible therapeutic effort be made. PMID- 3298862 TI - On the involvement of the cerebral cortex in descending modulation of pain and analgesia. PMID- 3298861 TI - Diabetes in pancreatectomized baboons: a model for pancreatic transplantation studies. AB - This study was designed to assess plasma glucose levels (PLG) and insulin release in totally pancreatectomized baboons when challenged with intravenous glucose administration (IVGTT). Ten animals (Papio ursinus) were used and duodenectomy was intentionally avoided. The PLG at death was 18.0 +/- mmol/L, and the mean K value within 3 days after pancreatectomy was 0.4% +/- 0.2%, indicating a significant impairment of glucose disappearance from the blood when compared to the control animals (P less than 0.01). Plasma insulin levels before and after stimulation with glucose were below the lowest level of insulin assay sensitivity. We conclude that in the primate, as in the dog, surgical pancreatectomy produced a reliable diabetic model, which is uniformly lethal if left untreated. PMID- 3298863 TI - The king of medicine Sun Simiao. PMID- 3298864 TI - A medical classic compiled by a high-ranking official. PMID- 3298865 TI - Enumeration of terminal deoxynucleotidyl transferase positive cells in leukemia/lymphoma by flow cytometry. AB - The method to fix single cells in suspension and its application for the detection of TdT-positive cells by flow cytometry are described. In comparison to formalin-methanol fixation, formalin-acetone fixation resulted more formation of aggregated cells which caused non-specific staining. In our assay system 80% cells in human thymus were TdT-positive. Levels of TdT in normal human peripheral blood was 0.5 +/- 0.6% (means +/- 1 S.D., n = 50). A total of 104 patients with leukemia/lymphoma was examined for TdT. TdT-positive cells were detected in ALL (87.5% cases), AML (57.1% cases), CML-BC (58.3% cases) and ML (17.6% cases). Mean channel of fluorescence intensity of the TdT-staining in AML was significantly reduced in comparison with that in ALL. When antigen density of TdT was very low, fluorescence microscopy gave false negative results and flow cytometry could detect this dim fluorescence. PMID- 3298866 TI - Deoxyglucose mapping in the cat visual cortex following carotid artery injection and cortical flat-mounting. AB - Two techniques are described for improving the efficiency of the deoxyglucose metabolic mapping procedure for studies on the cat visual cortex. The first technique involves the bilateral cannulation of the lingual arteries and the symmetrical injection of 2-deoxy-D-[U-14C]glucose in amounts significantly smaller than required with systemic intravenous administration. The second technique is carried out at the end of the stimulation period and involves unfolding the grey matter of the occipital region of the unfixed cortex by blunt dissection (defibrillation) and cutting of the white matter to make a cortical flat-mount: this permits the preparation of large sections parallel to the cortical laminae and thus the interpretation of deoxyglucose uptake patterns in any one lamina over a large area of the visual cortex. The experiments are relatively cheap and the time required to flat-mount the cortices does not seem to produce any significant decrease in spatial resolution of the autoradiograms. In appropriate experiments (published elsewhere) the techniques allow a comparative analysis of the deoxyglucose patterns between hemispheres receiving different visual stimulation. PMID- 3298867 TI - Sir Henry Burdett and the RNPFN. PMID- 3298868 TI - Pulmonary circulation, extravascular water, and solute flux as determined by positron emission tomography. AB - Pulmonary edema is the result of an increased transpulmonary flux of water and solute and a concomitant insufficiency of lung lymphatic drainage. Although this pathogenetic concept seems well-established, the microcirculatory details of pulmonary edema formation and its ultimate resolution are still poorly understood. For example, how do regional changes in pulmonary blood flow affect the resolution of pulmonary edema, and in turn, how do they affect pulmonary gas exchange? When does vascular permeability return to normal after acute lung injury? Is the severity of the permeability defect related to prognosis, and can therapy hasten either the resolution of altered permeability or the accumulation of extravascular lung water? These and similar questions are approachable with positron emission tomography (PET) and are outlined in this brief review. PMID- 3298869 TI - Norwegian zoologist adds to the understanding of life cycles of marine life. PMID- 3298870 TI - Tremor of parkinsonism and stereotactic thalamotomy. PMID- 3298871 TI - [Medicare]. PMID- 3298872 TI - [Alcohol and the heart]. PMID- 3298873 TI - [Reactive arthritis caused by Yersinia enterocolitica]. PMID- 3298874 TI - [Comparison of metabolic control between the continuous subcutaneous insulin infusion pump and augmented conventional treatment. Effects after 12 months]. PMID- 3298875 TI - [Thrombotic thrombocytopenic purpura]. PMID- 3298876 TI - [Diagnostic and therapeutic perspectives of proinsulin]. PMID- 3298877 TI - [A simple rapid cheap method for obtaining quality slides]. PMID- 3298879 TI - [The ideal antihypertensive drug]. PMID- 3298878 TI - [Values of osteocalcin in diabetes mellitus and their variations according to treatment]. PMID- 3298881 TI - [Crosti's reticulosis. Review of 15 cases]. AB - Fifteen patients with clinical and histological features of Crosti's reticulosis are reviewed. Twelve patients had lesions on the upper back and these were the only ones in eight of them. The other ones had extradorsal lesions. The histological picture was always compatible with Crosti's reticulosis. All the patients were treated by superficial roentgen therapy (1,200-1,500 rads) with total regression of the lesions. Four patients were lost for follow up. One progressed to lymphocytic lymphoma and another to Hodgkin's disease. It is possible that Crosti's reticulosis is not an autonomous entity, but a localized stage of more than one lympho-histiocytic neoplasia. PMID- 3298880 TI - [Achromatizing contact dermatitis caused by rubber sandals]. AB - Depigmentation due to contact dermatitis, presents itself in most of the cases as a professional disease, and in only few reports it is shown to be caused by the use of personal items. From June 1982 to March 1983, six patients were observed with a symmetrically distributed contact dermatitis, located on the upper side of the feet, showing the marks of rubber sandal straps, know as "Hawaiian sandals". All patients were exposed to standard patch tests, containing 31 elements among which, there are seven substances that are related to the rubber manufacturing process, such as: potassium dichromate, mercaptobenzothiazole, diphenylguanidine, thiuram-rubber-mixture, colophony, p-phenylenediamine, hydroquinone. The interpretation of the patch tests was done after 48 an 72 hours, following the criteria that were established by the International Contact Dermatitis Research Group (ICORG). Five patients showed sensitiveness to at least, two of the suspected substances. Mercaptobenzothiazole and/or thiuram rubber mixture were the substances most frequently related to these cases of depigmentation. Two patients who had a positive patch test for the thiuram-mix, developed a depigmentation area on the site of the test after two weeks. Depigmentation produced by the thiuram-mix had not been related formerly and though our study it became evident that this substance can lead to it. PMID- 3298883 TI - [Epidermodysplasia verruciformis and achondroplasia]. AB - We are presenting a new case of EV which has association with three diseases: Epilepsy, achondroplasia and endocrine disturbances. We are considering that it is very much interesting the association existing between the previously mentioned diseases (all conditioned by genetic factors) and EV which is characterized by a generalized viral infection also conditioned by genetic factors. PMID- 3298882 TI - [Pilomatrixoma. Pseudoampullar form and other clinical varieties]. AB - Pilomatrixoma presents clinical variants, ulcerated and tumorous, angioid and one very special type characterized because the skin covering the tumor is very thin (anetodermic), pink and folded, simulating an involuting blister. The authors that observed six cases of this variant, considered that for this reason they can name it the "pseudoblistering form of pilomatrixoma". The histopathology that appears in this pseudoblistering variant is characteristic because the collagen existing between the tumor and the epidermis is atrophied and its fibers are separated by the intense edema. PMID- 3298884 TI - [Isolated macronodular sarcoidosis]. AB - A particular case of macronodular isolated sarcoidosis with neurological and ocular involvement is presented, associated with pseudo-balding. A revision of the most important aspects of the diagnostic of this multifaceted disease is realized. The benefits of a surgical treatment for the cases of isolated nodes are pointed out. PMID- 3298885 TI - [PUVA therapy: long-term degenerative effects. I. Histological changes observed after PUVA therapy]. AB - The authors studied PUVA induced histological alterations in a group of 7 patients compared with 6 control subjects of same age. The epidermal alterations were unprominent: a few necrotic keratinocytes and hyperpigmentation of basal layer melanocytes with a lentiginous pattern. Basement PAS positive membrane was in some cases desestructured, but this was reversible. In the papillary dermis there was homogenization and partial or total destruction of orceinophilic vertical fibers, these phenomena were also reversible. PUVA therapy induced aging of the skin which is dose related and depends also of the patients age. No phenomena of precancerous dysplasia were observed. PMID- 3298886 TI - [Diffuse cutaneous mastocytosis. Apropos of 2 familial cases]. AB - The observation of two cases of diffuse cutaneous mastocytosis (DCM) with familiar characteristics in a man and his daughter, with only diffuse infiltration of the skin in the former and the girl also with blister and gastrointestinal participation, was the reason to do histological and ultrastructural studies. The authors observed a good therapeutic response to ketotifen and cyproheptadine, although the dose was higher than the usual one. PMID- 3298887 TI - [Pre-remission syndrome in flat warts. Report of 2 cases]. AB - Two cases of flat warts spontaneous regression syndrome are reported, with description of the histopathologic features. Immunologic mechanism which intervene in the processus are reviewed. PMID- 3298889 TI - [Erythema dyschromicum perstans versus lichen planus]. AB - Erythema dyschromicum perstans and lichen planus have been regarded as related. We describe the case of a 41 year old man presenting a relapsing dermatitis consisting of erythematous patches leaving behind ashy-gray macules. The lesions of lichen planus were atypical and the ashy dermatosis was transient. The possibility that some cases of lichen planus lead to an erythema dyschromicum perstans is discussed. PMID- 3298888 TI - [Histologic chronology of eosinophilic migratory nodular panniculitis (gnathostomiasis)]. AB - Twenty five patients with nodular migratory eosinophilic panniculitis (gnathostomiasis) were studied, several samples of skin were taken in different periods of evolution; and histologic criteria are established for the first time in literature. The histological picture was different and changed according to the day the biopsy was taken. Three parasites were recovered from the skin material showing all the features of generic gnathostoma. PMID- 3298890 TI - [Axillary carcinoid papillomatosis in a linear verrucous nevus]. AB - This report refers to the manifestation of an infrequent skin blastoma, with: Carcinoid papillomatosis developing on a zona-like verrucous nevus. An endeavor is made to determine the nosologic, etiologic, evolutionary and therapeutic aspects of both conditions. PMID- 3298891 TI - On the psychology of aging. PMID- 3298892 TI - Pharmacokinetic changes in the elderly. AB - Drug response in the elderly may qualitatively and quantitatively be different than that seen in young adults receiving an identical dosage regimen. Physiologic changes as function of age may have an important impact on the way the aged body handles the drug. This review addresses the pharmacokinetic processes of drug release from dosage form (liberation), the systemic uptake of drugs (absorption), biotransformation (metabolism), the loss of drug from the body (elimination) and clinical effect (response). Guidelines are given to be considered by the clinician in drug therapy in the aged. PMID- 3298894 TI - Serum bactericidal testing with quality control organisms. AB - Measurements of serum bacteriostatic and bactericidal titers were compared using common quality control organisms. Oxacillin or vancomycin was added to normal sera for duplicate testing against Staphylococcus aureus ATCC 25923 while gentamicin or ampicillin was added for duplicate testing against Escherichia coli ATCC 25922. Recommendations of acceptable ranges are presented in the text. Establishment of acceptable ranges for serum bactericidal assay results could improve accuracy, allow comparisons of data from different studies and help reduce intralaboratory variations. PMID- 3298893 TI - Wit and wisdom in old age--the later work of Wilhelm Busch. PMID- 3298895 TI - [Exercise-induced asthma--a review]. PMID- 3298896 TI - [Arbovirus diseases--a review]. PMID- 3298898 TI - [Temporary wound closure in burns]. PMID- 3298897 TI - [The man behind the syndrome: Daniel Carrion. He died when he experimented on himself with the Peruvian national disease]. PMID- 3298899 TI - [Initial clinical experience using Dermodress, a new temporary biological skin substitute]. AB - A chemically treated bovine skin, Dermodress, is presented as a long-term skin substitute. Dermodress was applied over denuded surfaces of debrided deep burns and was kept in place up to 56 days. At this time it was totally replaced by autograft, so we have no idea yet of how much longer it could have remained. It adheres to all contours of the debrided area, has hemostatic effect, and does not present any sign of infection or rejection. Dermodress can be removed in stages according to the availability of autografts, which may be applied immediately, since the exposed areas are clean and suitable for immediate grafting. Our clinical experience shows that Dermodress has most of the required properties of a long-term temporary skin substitute. PMID- 3298901 TI - Anterior extraoral approach to the atlas and axis. AB - A transcervical extraoral approach was utilized to achieve exposure to the upper cervical spine in five patients, four of whom required bone graft placement. Excellent exposure was achieved in all patients, and the postoperative course was uncomplicated. The anterior extraoral approach is a reliable technique in treatment of pathology of the atlas and axis. PMID- 3298900 TI - Surgical approaches to the left hepatic duct. PMID- 3298902 TI - Specific lymphokine responses in cervical nodes of patients with laryngeal cancer. AB - The role of lymphokines in modulating the immune response in patients suffering from neoplastic disease is still controversial. Recent studies indicate that in patients with head and neck cancer, a decrease in LIF (leukocyte migration inhibiting factor) production is usually present in advanced disease. In this study, the authors investigate: the LIF production in lymphocytes derived from the peripheral blood and cervical nodes of patients with laryngeal carcinoma by using an autologous pattern (i.e., for each patient, the specific LIF production was challenged by means of an autologous cell extract derived from his own tumor); the influence of histologically confirmed cervical node metastases on LIF production. Our results indicate that: There is a significant decrease in LIF production in patients with histologically proven cervical node metastases as compared to patients with no metastatic foci. The decrease of LIF production is related to the presence of mononuclear adherent cells. When the latter are removed, there is a significant reversal of specific LIF suppression. The possible meaning of the data is discussed. PMID- 3298903 TI - Affinity of Mycobacterium leprae with Lewis rat Schwannoma cell line (Lewis TC 98). PMID- 3298904 TI - An unusual bullous reaction in borderline leprosy. PMID- 3298905 TI - Characteristics of patients in the THELEP trials of chemotherapy of leprosy at Bamako and Chingleput. Subcommittee on Clinical Trials of the Chemotherapy of Leprosy (THELEP) Scientific Working Group of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases. PMID- 3298906 TI - An enzyme immunoassay for rat growth hormone: applications to the study of growth hormone variants. AB - A sensitive and specific competitive enzyme immunoassay (EIA) for rat growth hormone was developed using reagents from the National Institutes of Arthritis, Diabetes, Digestive Diseases and Kidney, Bethesda, Md. In this assay soluble growth hormone and growth hormone adsorbed to a solid-phase support compete for monkey anti-growth hormone antibody binding sites. The immobilized antibody growth hormone complex is detected and quantified using goat anti-monkey immunoglobin G covalently conjugated to horse radish peroxidase. Therefore a high concentration of soluble growth hormone in the sample will result in low absorbance detection from the colored products of the enzyme reaction. Assay parameters were optimized by investigating the concentration of reagents and the reaction kinetics in each of the assay steps. The assay can be performed in 27 hours. A sensitivity range of 0.19 ng to 25 ng in the region of 10 to 90% binding was obtained. Near 50% binding (3 ng) the intraassay coefficient of variation (CV) was 5.54% and the interassay CV was 5.33%. The correlation coefficient (r2) between radioimmunoassay and EIA was 0.956 and followed the curve Y = 0.78X + 1.9. Selected applications were described as follows. Alkaline extracts of pituitary tissue increase 2 fold in GH content after mercaptoethanol treatment. Alkaline extracts of pituitary tissue chromatographed on HPLC molecular sieving columns showed selective enhancement of rat growth hormone content based upon molecular weight. Fractions representing a molecular weight greater than 200 kD were enhanced 6 fold. Fractions whose molecular weight range was 22 kD to 50 kD were enhanced 2 fold. This assay provides a reliable alternative to RIA and offers the major advantage of eliminating radioactive reagents and counting equipment. PMID- 3298907 TI - Radiation induced gram negative bacteremia and endotoxemia in rabbits: modification by anti-lipopolysaccharide hyperimmune equine plasma. AB - Lethal whole body irradiation damages the gut mucosa and leads to leakage of endotoxin or lipopolysaccharides (LPS) into the systemic circulation. Sixteen rabbits, irradiated with 900 rads 60Co, were randomly divided on day 4 into 2 groups, one of which received an intraperitoneal injection of normal saline (control) and the other (experimental) an equal volume of anti-LPS hyperimmune plasma. The time course of endotoxemia and bacteremia were determined for the duration of the experiment. While rabbits in both groups died within 13 days after irradiation, rabbits given saline died on average 2 days earlier, than rabbits given anti-LPS plasma. Plasma LPS concentrations rose to a small peak on day 2 prior to treatment. Thereafter plasma LPS in rabbits given saline increased forty fold by day 9. In contrast, in rabbits given anti-LPS plasma, LPS concentrations in the plasma remained within pretreatment limits (p 0.01). By day 12 after irradiation, plasma anti-LPS IgG had declined to 5.8% of pretreatment levels in rabbits given saline as compared to 46% in rabbits given anti-LPS plasma (p 0.005). Whilst both groups developed gram-positive bacteremia, rabbits given saline in addition also developed gram-negative bacteremia. No rabbits treated with Anti-LPS showed gram-negative bacteremia. Treatment with Anti-LPS plasma thus significantly protects radiated rabbits from the incidence of gram negative bacteremia, development of high plasma LPS levels and hence endotoxemia, and prolongs survival to a certain extent. PMID- 3298908 TI - Studies on in vitro antipyrine metabolism by 13C,15N double labeled method. AB - The capacities of forms of cytochrome P-450 to oxidize antipyrine were compared. An isotope dilution gas chromatography/mass spectrometry/selected ion monitoring assay was developed to quantify the three main metabolites, norantipyrine, 3 hydroxymethylantipyrine and 4-hydroxyantipyrine. 13C,15N-Double labeled antipyrine was used as a substrate and the metabolites were analyzed as their trimethylsilyl derivatives. Among forms of cytochrome P-450 examined, a male specific form of P-450, namely P-450-male, showed higher activity to form all the three metabolites. The other forms were responsible only for the formation of norantipyrine and 4-hydroxyantipyrine. The activities of liver microsomes from untreated male and female rats and rats treated with phenobarbital, 3 methylcholanthrene or polychlorinated biphenyl were expressed dependent on the activities of forms of cytochrome P-450 examined. PMID- 3298910 TI - Occurrence of anti-gizzard P34K antibody cross-reactive components in bovine smooth muscles and non-smooth muscle tissues. AB - In our previous paper (Biochem. Biophys. Res. Commun. 141, 20-26 (1986) we reported the isolation of a 34000-dalton protein (p34K) which binds to calmodulin and F-actin from chicken gizzard smooth muscle. We examined the distribution of the immunoreactive component of gizzard p34K in bovine tissues by immunoblot analysis using a rabbit polyclonal antibody raised against gizzard p34K. The immunoreactive components with molecular weights of 33000-35000 were detected in all smooth muscles from aorta, esophagus, stomach, trachea and uterus. In non smooth muscle tissues, a 36000-dalton cross-reactive protein was present in adrenal medulla and cortex. The immunoreactive form of gizzard p34K occurred in large amounts in smooth muscles from various bovine tissues. PMID- 3298909 TI - Analgesic effect of actinonin, a new potent inhibitor of multiple enkephalin degrading enzymes. AB - Actinonin, previously isolated as an antibiotic and shown to be an inhibitor of aminopeptidase M (EC 3.4.11.2), has now been shown to inhibit three enkephalin degrading enzymes from guinea-pig striatum. The values of IC50 were 0.39 microM for striatal membrane aminopeptidase ("enkephalin-aminopeptidase") and 5.6 microM striatal membrane neutral endopeptidase ("enkephalinase A"). Furthermore, soluble dipeptidylaminopeptidase in a rat whole brain homogenate was also inhibited by actinonin with the IC50 value of 1.1 microM. Actinonin administered intracisternally (i.cist., 50 micrograms) or intraperitoneally (i.p., 100 mg/kg), potentiated the analgesic action of met-enkephalin (50 micrograms i.cist.). analgesia by a tail-flick test. The potentiating activity of actinonin i.p. to met-enkephalin analgesia was almost the same potency as that of thiorphan, whereas the inhibitory activity of actinonin against enkephalinase A was 1/1000 that of thiorphan. Actinonin alone, administered either i.cist. or i.p., showed an analgesic action as estimated by the tail-flick test. PMID- 3298911 TI - Origin of the stimulation of food intake by oral administration of enkephalinase inhibitors in sheep. AB - The influence of two enkephalinase inhibitors (thiorphan and acetorphan) orally, parenterally and centrally administered on food intake was tested in hay-fed ewes. When orally administered at a dose of 1 mg/kg, acetorphan, but not thiorphan, produced a biphasic increase in food intake corresponding to a 17.0% increase of daily food intake. Similarly thiorphan (0.1 mg X kg-1) IV administered increased by 19.3% the daily food intake; in contrast acetorphan IV administered produced a early (0-2 h) decrease followed by a late increase in hay consumption without significant (P greater than 0.05) change in the daily food intake. When ICV administered (10 micrograms X kg-1) thiorphan but not acetorphan at the same dose depressed the early (0-2 h) and daily food intake by 43.2% and 25.4% respectively. Pretreatment with naltrexone (0.1 mg X kg-1 IV) blocked the increased food intake induced by oral acetorphan or IV acetorphan and thiorphan but did not affect the anorectic effects of ICV thiorphan. We conclude that enkephalinase inhibitors like thiorphan and acetorphan increase daily food intake in sheep probably by increasing enkephalin levels in peripheral tissues. PMID- 3298912 TI - DSLET (D-ser2-leu5-enkephalin-Thr6) produces analgesia on the hot plate by mechanisms largely different from DAGO and morphine-like opioids. AB - Fifteen generations of selective breeding were used to produce lines (strains) of mice which differ markedly from one another in levorphanol-induced antinociception on the hot plate assay. These are the high antinociceptive response (HAR) and low antinociceptive response (LAR) selection lines, which now differ by over 5-fold in the i.p. dose of levorphanol doubling control (no drug or saline) latency scores. We sought to determine if these large genetically mediated differences in antinociceptive sensitivity bred into these selection lines with i.p. levorphanol would generalize equally to a series of enkephalin analogues known to differ in their selectivity for mu and delta opioid receptors. DAGO (D-ala2, MePhe4, Gly-ol5 enkephalin), a highly mu selective agent, produced a 67-fold difference between HAR and LAR mice in the slopes of the dose-response curves on the hot plate assay, while DSLET (D-ser2, leu enkephalin Thr6), a delta selective agent, only produced a 5.4-fold difference via the i.c.v. route. DADLE (D-ala, D-ser enkephalin) a slightly delta preferring ligand, was found to be intermediate (17.4-fold difference). These findings demonstrate that selective breeding has been quite successful in altering those genes which control analgesia due to mu selective agents, while relatively little change has occurred in those genes which control analgesia due to delta agonists. Thus, analgesia mediated by the former has been genetically dissociated from analgesia mediated by the latter, implying that DAGO has mechanisms of action largely dependent of DSLET on the hot plate assay. These findings are consistent with the contention that the mu receptor mediates analgesia produced by DAGO, while a different receptor (presumably delta) mediates much of the analgesic effects of DSLET. PMID- 3298913 TI - Neuropeptides: conductors of the immune orchestra. AB - There is increasing evidence for a bidirectional communications system between the immune system and the brain. Many of the substances involved in this communication appear to be neuropeptides. These findings have given biochemical validity to the clinical and epidemiological studies that have suggested that psychosocial factors can modulate the response to infections and neoplasms. PMID- 3298914 TI - Lateral hypothalamic lesions and activity of the sympathetic nervous system. AB - The firing rate of efferent sympathetic nerves to brown adipose tissue was measured on 18 h or 18 d following lateral hypothalamic lesions (LH). Eighteen hours following acute lateral hypothalamic lesions, sympathetic firing rate was significantly increased. Following chronic LH lesions there was a decrease in food intake and a fall in body weight which had stabilized by four days. Eleven days after surgery a group of control animals were food restricted and subsequently pair fed twice daily to maintain a body weight comparable to that of the LH lesioned animals. Food intake was lower in the pair-gained animals on all but one day of the experiment. When studied 18 days following LH lesions, sympathetic firing rates were significantly higher than in either the ad lib or pair-fed controls. Sympathetic firing rate in pair fed rats, on the other hand, was significantly lower than in the sham lesioned rats. These data are consistent with the hypothesis that the LH lesion removes an inhibitory control over sympathetic firing rate both acutely and in chronically lesioned animals and that this increased sympathetic firing rate may play an important role in the maintenance of a lower body weight. PMID- 3298915 TI - Alexander Borodin: medical educator, chemist, composer. PMID- 3298916 TI - [Thermography and radionuclide scintigraphy in reconstructive plastic operations following radical mastectomy]. AB - Thermography is quite an informative and reliable method of examination of patients after reconstructive-plastic breast operations. It makes it possible to assess, with a sufficient degree of assurance, the blood circulation in a skin muscular graft of the broadest muscle of the back, to diagnose capsule constrictive fibrosis, to detect foci of hyperthermia at the edge of endoprosthesis in the presence of bulky formations hidden by an implant, and can be recommended for the screening of such patients. In some cases scintigraphy makes it possible to differentiate between tumor and non-tumor origin of foci of lesions detected in endoprosthesis. PMID- 3298917 TI - [Age-related radiosensitivity of the crystalline lens in chronic experimental internal irradiation with 137Cs at low doses]. AB - Internal whole-body irradiation of mice for 1 year with incorporated 137Cs at a dose of 0.5 eV was shown to make a significant cataractogenic effect on the lens. By annual rate this dose exceeded the existing maximum permissible dose only three times and was less than 10% of a cumulative dose for professionals having to do with ionizing radiation which they can accumulate at the maximum permissible dose level in annual irradiation for 50 years. The time of recorded lenticular opacity reduced and a degree of observed changes increased in the study groups as compared to the unirradiated control group indicating the involvement of a radiation factor in their development. More pronounced sensitivity of the mouse lens to chronic radiation exposure in the second half of the life than in the first half was noted. PMID- 3298919 TI - [Interventional radionuclide diagnosis]. PMID- 3298918 TI - [Pharmacological protection of animals during total irradiation]. PMID- 3298920 TI - Aspirin and Reye's syndrome. A reappraisal. PMID- 3298921 TI - Aetiology and treatment of neuroleptic malignant syndrome. AB - The clinical triad of fever, movement disorder, and altered mentation known as NMS represents an infrequent yet highly lethal side effect of neuroleptic therapy. Although awareness and recognition are on the rise, underdiagnosis of the disorder may represent a neglected clinical problem of major proportions considering the number of patients treated with neuroleptics. The recognition of problems such as NMS and tardive dyskinesia point out the need for investigation of low-dose efficacy and neuroleptic serum levels. The idea that neuroleptics are free of severe side effects has created a clinical fallacy that high doses of high potency neuroleptics should be administered to acutely psychotic patients and that low doses of neuroleptics may be used for various diagnostic entities. The emphasis on NMS and its 20% mortality rate should point out that neuroleptics should only be used when clinically indicated to treat psychosis and should be given in the lowest possible dose that achieves antipsychotic effects. Although treatment strategies are still being formulated, aggressive medical care and specific drug therapies exist to reverse the symptoms of this syndrome. With proper education, psychiatrists and other specialists can recognize and treat NMS effectively and thus prevent its malignant outcome. PMID- 3298922 TI - Adverse reactions with oral and parenteral gold preparations. AB - Auranofin (triethylphosphine gold), an oral gold preparation, has recently been made available, and along with injectable gold preparations, is of therapeutic value for rheumatoid arthritis. Serious gold toxicity is uncommon, and drug related deaths rare. Many potential adverse reactions are similar, including dermatitis, stomatitis, thrombocytopenia, leucopenia, and proteinuria, generally with increased incidence in the injectable gold-treated patients. Oral gold is associated with benign lower gastrointestinal side effects, including diarrhoea, loose stools and abdominal cramps that are often dose-related and resolve spontaneously. The incidence of severe reactions such as thrombocytopenia, aplastic anaemia and exfoliative dermatitis is lower with oral gold than injectable preparations, and contributes to a superior risk-benefit ratio. The treatment of gold toxicity depends on the type and extent of organ involvement. PMID- 3298923 TI - Adverse cardiovascular effects of sulphonylurea drugs. Clinical significance. AB - Sulphonylureas are widely used in the treatment of diabetes mellitus. Since the publication of the University Groups Diabetes Program (UGDP) results the discussion on their possible cardiovascular side effects has been lively and sometimes even passionate. The initial UGDP findings about the adverse effects of tolbutamide on the cardiovascular system have been criticised, particularly for shortcomings in the study design. The results of other epidemiological studies of the sulphonylurea effects on cardiovascular morbidity and mortality published this far have been contradictory. This is understandable because the factors involved are very complex. Most of these studies have used tolbutamide only, and the findings cannot necessarily be directly extrapolated to other sulphonylureas. Only properly performed prospective studies may provide further information on this issue. High concentrations of several sulphonylureas may have inotropic effects on heart muscle in in vitro animal models, but human studies performed in vivo do not support the view of clinically significant inotropy for sulphonylureas. High concentrations of tolbutamide or glibenclamide (glyburide) may affect the myocardial metabolism in isolated organs, but the possible clinical significance of these findings remains unknown. Some epidemiological and experimental studies have associated oral antidiabetic treatment with the occurrence of cardiac arrhythmias or increased digitalis toxicity. Only a few results are available, and there may be differences between the sulphonylureas in this respect. Antiaggregatory properties have been postulated for some sulphonylureas. Gliclazide, in particular, has been studied, but some other compounds of this class have also been effective in short term studies. If confirmed, these effects on haemostasis would be noteworthy. The sulphonylurea effects on serum lipids, especially on HDL-cholesterol, have been discussed widely during the last few years. Decreases in HDL-cholesterol concentrations were suggested to be associated with sulphonylurea therapy. However, these findings were not confirmed in recent cross-sectional and longitudinal studies performed with different sulphonylureas. Chlorpropamide, and to a lesser extent tolbutamide, may cause dilutional hyponatraemia and aggravate existing heart failure. Glibenclamide may increase the clearance of water in the kidney. PMID- 3298924 TI - Chronic low-level lead exposure. Its role in the pathogenesis of hypertension. AB - Lead is a common element in the earth's crust, serving useful purposes in industry, but serving no purpose in the human body. Increase in blood pressure is an important public health problem with numerous factors contributing to many facets of the disease. The relationship of lead exposure and increased blood pressure has long been considered, but only recently critically investigated. Reports of subtle changes in calcium metabolism and renal function, as well as in vitro studies examining end-arteriolar smooth muscle contractility, link lead exposure and increased blood pressure. This paper critically examines the evidence associating chronic low-level lead exposure and increased blood pressure. The review focuses on epidemiological, clinical, and toxicological data. The epidemiological evidence is consistent with low-level exposure to lead causing an elevation in blood pressure. The strength of that association, and the dose-response characteristics, are less certain. Individual resistance and susceptibility could affect the degree of blood pressure elevation. The results of animal and in vitro studies are consistent with the epidemiological evidence, and suggest biologically plausible mechanisms for the association. The most probable mechanisms are intracellular perturbations in calcium metabolism mediated by direct lead effects at the end-arteriole, and indirect effects via renal dysfunction. Better indices of lead exposure and lead activity are needed to quantify these effects in humans. New and safer methods of chelating lead suggest interesting approaches for studying the relationship between lead and hypertension. This link could have significant implications in determining what constitutes a 'safe' level of environmental lead exposure, and whether a proportion of essential hypertension could be 'cured' by chelation therapy. PMID- 3298925 TI - [History of the education of nurses in Russia]. PMID- 3298927 TI - [Ultrasonic diagnosis in pediatric gastroenterology]. PMID- 3298926 TI - [They fought in the name of life]. PMID- 3298928 TI - Heart disease in marathon runners: a review. AB - Thirty-six cases of heart attack or sudden death in marathon runners have been reported in the world literature to date. The mean age of the runners was 43.8 yr (range = 18 to 70), the mean years' running was 6.8 yr (range = 0.5 to 29), and the mean best standard 42.2 km marathon time was 3 h 28 min (range = 2 h 33 min to 4 h 28 min). Coronary artery disease was diagnosed either clinically, angiographically, or at autopsy in 27 runners (75%), two of whom also had histological evidence of hypertrophic cardiomyopathy. Seventy-one percent of the runners with coronary artery disease had premonitory symptoms, and most ignored such symptoms and continued to train or race. Fifty percent of all cardiac events occurred either during or within 24 h of competitive running events or long training runs. The marathon running population does not constitute solely persons with excellent cardiovascular health. Marathon runners, especially those with a family history of heart disease and other coronary risk factors, should not consider themselves immune to either sudden death or to coronary heart disease and should seek medical advice immediately if they develop any symptoms suggestive of ischemic heart disease. Physicians should not assume that "physically fit" marathon runners cannot have serious, life-threatening cardiac disease. PMID- 3298929 TI - Metabolic and hormonal responses to lipid and carbohydrate diets during exercise in man. AB - Nine healthy subjects were studied to determine their performance and the metabolic and hormonal responses to prolonged exercise after ingestion of a carbohydrate or a lipid diet. Subjects exercised on a bicycle ergometer (60% VO2max) until exhaustion four times at weekly intervals. The exercise test was performed 1 h after ingestion of three different isocaloric meals (400 Kcal) containing either glucose, medium-chain triglycerides (MCTs) or long-chain triglycerides (LCTs). The fourth test was performed after a night fast. The metabolism of these nutriments was followed using [U-13C]glucose, [1 13C]octanoate, and [1-13C]palmitate added as tracers. The average work time was comparable whatever nutriment used (116 +/- 11 min). Oxidation of the ingested nutriment over this period was 80% for glucose, 45% for MCTs, and 9% for LCTs. Glucose ingestion produced an early insulin peak associated at the end of the exercise with a lower glycemia compared to the fat diets. After MCT ingestion, an increase in ketone bodies was observed. Catecholamine response to physical exercise was decreased by all the meals when compared to fasting. Thus, we conclude that a different lipid meal, MCTs, or LCTs, compared to glucose feeding, do not modify exhaustion time in spite of differences in hormonal and metabolic responses. PMID- 3298930 TI - The morbid anatomy of the human genome: a review of gene mapping in clinical medicine (3). PMID- 3298931 TI - Cerebral infarction: shortcomings of angiography in the evaluation of intracranial cerebrovascular disease in 25 cases. AB - We studied the utility and limitations of conventional cerebral angiography in 25 patients with cerebral infarction unassociated with extracranial cerebrovascular disease during a 7-year period. In only one-third of cases was the angiogram diagnostic, and in a single case it altered the pre-angiogram diagnosis by revealing a previously unsuspected embolus. Among the cases clinically diagnosed as cerebral emboli, the 2 confirmatory angiograms were performed early (within 48 hours), and demonstrated medium-large or large vessel filling defects. Two-thirds of the negative angiograms in the embolic clinical category were delayed, but there was no statistically relevant predilection for specific vessel size involvement. The category, primary cerebral vasculopathy, comprised the largest group, 10 in all, and one-half had angiographic confirmation despite time delays. Angiographic recognition was dependent on a characteristic picture of vascular involvement, and not on timing or vessel size predilection. Mitral valve prolapse figured prominently in the clinical cases of vasculopathy of uncertain etiology, which contained a total of 4 cases. The 3 cases with nondiagnostic angiograms were all delayed and demonstrated nonspecific radiographic changes. Clinically, these cases demonstrated signs or symptoms of autoimmune dysfunction, raising the specter of primary cerebral vasculopathy as a cause of cerebral infarction, in contrast to recurrent cerebral emboli. PMID- 3298932 TI - Persistent hyperlipidemia in renal transplant patients. AB - The exact nature and significance of posttransplant hyperlipidemia is controversial. In the present study, serum lipids were examined in 201 clinically stable renal transplant recipients before, 1 year after, and at the time of the last follow-up, 5.0 +/- 0.1 yr after transplantation. Hypertriglyceridemia, present in 36% of patients treated with dialysis before transplantation, occurred in 23% 1 year after successful transplantation. At last follow-up, 29% had elevated triglyceride levels. Hypercholesterolemia, present in only 8% of patients before transplantation, was found in 27% 1 year after receiving a renal allograft. At the time of last follow-up, 30% had elevated cholesterol levels. HDL cholesterol levels were normal 1 year after transplantation, and increased significantly during the posttransplant follow-up period. Multivariate stepwise linear regression analysis was used to determine factors independently associated with serum lipid levels. Age, body weight, pretransplant serum lipids, and variables linked to allograft function (urine protein excretion, serum creatinine, and the use of loop diuretics) were independently associated with posttransplant cholesterol and triglycerides. Diabetes, the use of alternate day steroids, beta-adrenergic-blocking antihypertensive medications, and thiazide diuretics were not linked to hyperlipidemia. In addition, changes in variables associated with renal function helped to explain why different factors were associated with lipid levels at 1 year than at the time of last follow-up. Thus, the results of this study suggest that hyperlipidemia is a frequent and persistent complication in clinically stable renal transplant recipients. Multiple factors, including several associated with declining allograft function, appear to be involved in the pathogenesis of posttransplant hyperlipidemia. PMID- 3298933 TI - A.C.: portrait of a president (A.C. Edwards). PMID- 3298934 TI - Fasting and diabetes mellitus elicit opposite effects on agonist-stimulated prostacyclin synthesis by the rat aorta. AB - The effects of prolonged fasting and experimental nonketonuric diabetes on rat aortic prostacyclin (PGl2) synthesis were compared. Whereas fasting (for 48 hours or longer) resulted in a marked increase in trauma-, adrenaline-, and U46619 stimulated aortic PGI2 synthesis, prolonged experimental (streptozotocin-induced) nonketonuric diabetes caused a marked decrease in aortic PGI2 synthesis stimulated by the above agonists. Arachidonic acid (AA)-stimulated aortic PGI2 synthesis in fasted and diabetic rats, however, was not different from that in controls. The reduction in adrenaline- and U46619-stimulated, but not AA-induced, PGI2 synthesis in the diabetic rat suggests that the diminished production of PGI2 in diabetes may be due to diminished phospholipase A2 (or of the phospholipase C-diglyceride lipase system) activity, diminished AA stores, or both. The opposite effects of prolonged fasting and diabetes on aortic PGI2 synthesis suggest that caution should be exercised when comparing the metabolic consequences of starvation with those of diabetes. PMID- 3298935 TI - Regulation of lysosomal proteolysis in burn injury. AB - The regulation of the lysosomal pathway by burn injury was investigated using a local burn model in which one hindlimb of a rat is scaled at 85 degrees C for 3.6 s. By two days postinjury the rate of net protein breakdown in the incubated soleus muscle from the burned leg is doubled. The activity of cathepsin D increases 40% to 50% and that of cathepsins B and L increase 80% to 100%. The activity of a lysosomal nonprotease activity, N-acetylglucosaminidase, is not significantly increased. The latency of lysosomal enzymes (an estimate of cellular autophagy) did not change at any time postburn. Inhibitors of autophagy (ie, leucine and 3-methyladenine) inhibited net protein breakdown and increased latency to a similar extent in muscles from control and burned legs. Thus, there is no evidence that a change in cellular autophagy is responsible for the increased proteolysis seen in intact muscle. However, burn-induced changes in alternative routes of protein sequestration cannot be excluded. Burn did not increase either receptor-mediated or fluid phase endocytosis by incubated soleus muscle. Burn injury also did not reduce the inhibitory action of cytoplasmic inhibitors of cathepsins B and L in skeletal muscle. However, burn injury markedly stimulated the synthesis of glycoproteins in the microsomal fraction without affecting overall protein synthesis. This increase in synthesis preceded the rise in lysosomal protease activity. These results support the possibility that induction of lysosomal protease synthesis may underlie burn-induced increases in muscle proteolysis. PMID- 3298936 TI - Effect of porcine gastric inhibitory polypeptide on beta-cell function in type I and type II diabetes mellitus. AB - The effect of highly purified natural porcine GIP on C-peptide release was examined in six type I (insulin-dependent) diabetics (IDD) with residual beta cell function, six type II non-insulin-dependent) diabetics (NIDD), and six normal subjects. All subjects were normal weight. From -120 minutes to 180 minutes glucose or insulin was infused IV to achieve a constant plasma glucose level of 8 mmol/L. On two separate days GIP (2 pmol/kg/min) or isotonic NaCl at random were infused from 0 to 30 minutes. After 10 minutes of GIP infusion plasma IR-GIP concentrations were in the physiologic postprandial range. At 30 minutes a further increase in IR-GIP to supraphysiologic levels occurred. In all subjects plasma, C-peptide increased more after 10 minutes of GIP infusion (IDD, 0.48 +/- 0.05; NIDD, 0.79 +/- 0.11; normal subjects, 2.27 +/- 0.29 nmol/L) than on the corresponding day with NaCl infusion (IDD, 0.35 +/- 0.03; NIDD, 0.62 +/- 0.08; normal subjects, 1.22 +/- 0.13 nmol/L, P less than .05 for all). The responses of the diabetics were significantly lower than that of the normal subjects (P less than .001 for both groups). No further increase in C-peptide occurred during the remaining 20 minutes of the GIP infusion in the diabetic subjects (IDD, 0.49 +/- 0.05; NIDD, 0.83 +/- 0.10 nmol/L). In the presence of a plasma glucose concentration of 8 mmol/L, physiologic concentrations of porcine GIP caused an immediate but impaired beta-cell response in IDD and NIDD patients. PMID- 3298937 TI - Relationships between plasma-free fatty acid concentration, endogenous glucose production, and fasting hyperglycemia in normal and non-insulin-dependent diabetic individuals. AB - Measurements of fasting and postprandial plasma glucose, insulin, and free fatty acid (FFA) concentrations were made in 32 individuals--16 with normal glucose tolerance and 16 with non-insulin dependent diabetes mellitus (NIDDM)--further subdivided into two equal groups on the basis of body weight. In addition, endogenous glucose production was estimated in 32 subjects. Both fasting plasma glucose (251 +/- 14 v 86 +/- 1 mg/dL) and FFA (672 +/- 35 v 434 +/- 45 microEq/L) concentrations were significantly higher in patients with NIDDM (P less than .001), and the differences between normal and diabetic existed in both weight groups. Rates of endogenous glucose production were also significantly elevated (P less than .001) in diabetic (120 +/- 6 mg/m2 X min) as compared to normal subjects (73 +/- 6 mg/m2 X min), and these differences were also independent of degree of obesity. However, there were no significant differences between normal subjects and patients with NIDDM in either fasting or postprandial insulin concentrations. The similarity in insulin values for normal and diabetic subjects was true of both obesity groups, although insulin concentrations were somewhat higher in normal obese individuals as compared to their normal nonobese counterparts. Significant relationships were seen between values for fasting plasma glucose and endogenous glucose production (r = .89), fasting plasma glucose and fasting FFA (r = .64), and FFA levels and endogenous glucose production (r = .58) when all nonobese subjects were considered together. Essentially identical relationships, both qualitatively and quantitatively, were seen within the obese group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298938 TI - Exercise termination effects on food intake, plasma insulin, and adipose lipoprotein lipase activity in the Osborne-Mendel rat. AB - Thirteen-week-old male, Osborne-Mendel rats were exercised for 6 weeks on a motorized treadmill. Exercise depressed weight gain and cumulative light cycle food intake while cumulative dark cycle and 24-hour total food intake were unaffected. Rats in sedentary and exercise groups were killed 24 hours after the last bout of exercise to assess the effects of chronic exercise and at 48, 60, 72, and 84 hours to determine the effects of exercise termination. Compared to sedentary controls, exercise decreased plasma insulin, epididymal and retroperitoneal depot weight and cell size, and retroperitoneal lipoprotein lipase (LPL) activity. Forty-eight hours after exercise, plasma insulin concentration increased to sedentary levels. By 60 hours, dark cycle food intake was increased above and adipose LPL activity was comparable to sedentary levels. At 84 hours postexercise termination, dark cycle food intake, plasma triglyceride, and epididymal LPL activity per depot and per cell were significantly greater than sedentary values. Exercise termination resulted in a preparatory response for rapid lipid deposition probably arising from increased food intake, plasma insulin, and enhanced LPL activity within 84 hours following termination of exercise. PMID- 3298939 TI - Cephalic phase metabolic responses in normal weight adults. AB - The presence and physiologic importance of cephalic phase insulin release in humans remains controversial. The aim of these studies was to determine whether cephalic phase insulin release could be demonstrated in normal weight subjects and whether it would be associated with changes in blood glucose, free fatty acid, and pancreatic polypeptide levels. The studies were followed by a hyperglycemic clamp to determine whether cephalic responses would alter overall glucose disposal or glucose-stimulated insulin secretion. In all, 17 subjects were studied on two occasions with and without (control study) presentation of food stimuli. Tease-feeding alone (n = 6), or the administration of a sweet taste alone (aspartame, n = 5) failed to stimulate cephalic responses. However, the presentation of the combined stimuli (tease meals plus sweet taste, n = 7) resulted in a significant fall (P less than .005) in blood glucose levels and a variable rise in serum insulin (% insulin rise 38 +/- 15%, P less than .05) and C peptide levels (7 +/- 6%, NS) within five minutes of the food presentation when compared with control studies, with no change seen in free fatty acid or pancreatic polypeptide levels. The blood glucose fall correlated strongly (r = .90, P less than .01) with a score of the subjective response to the food and taste.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298942 TI - Immobilization of cells in carrageenan. PMID- 3298940 TI - Mitigation of alimentary lipemia by postprandial exercise--phenomena and mechanisms. AB - The effects of a single bout of exercise at 40% of maximum aerobic capacity with regard to alimentary lipemia and postprandial lipoproteins was studied in a cross over design in 12 young healthy male volunteers. In addition to lipids and lipoproteins, lipoprotein lipase, free glycerol, free fatty acids, plasma insulin, and C-peptide concentrations were quantitated. Postprandial exercise reduced alimentary lipemia by 34% while lipoprotein lipase activity rose by 42%. The postprandial fall of high-density lipoprotein (HDL)3 was abolished and the rise of HDL2 accentuated. Free glycerol and free fatty acid concentrations were higher following the meal plus exercise regimen compared to the meal alone. It is concluded that at least part of the chronic effect of exercise may come from additive effects such as observed from individual bouts of muscular activity. PMID- 3298943 TI - Immobilization of living microbial cells in polyacrylamide gel. PMID- 3298941 TI - Metabolic effects induced by long-term feeding of medium-chain triglycerides in the rat. AB - Energy intake, weight gain, carcass composition, plasma hormones and fuels, hepatic metabolites and the activities of phosphoenolpyruvate carboxykinase (PEPCK), malic enzyme, and glucose 6-phosphate dehydrogenase (G6P-DH) were examined in adult rats during a 44-day period of low fat, high carbohydrate (LF) feeding or of consumption of one or two high (70% metabolizable energy) fat diets composed of 63% (metabolizable energy) long-chain (LCT) or medium-chain (MCT) triglycerides. Energy intake was similar in the LCT and MCT groups but was less than that of LF group. The weight gain of rats fed MCT diet was 30% less than that of rats fed LF or LCT diets. Energy retention was less when the diet provided MCT than LCT or LF, and that resulted in a 60% decrease in the daily lipids deposition. Plasma glucose, free fatty acids, glycerol, and insulin/glucagon ratio were similar in the three groups. Blood ketone body (KB) concentrations in rats fed the high fat diets were extremely elevated, particularly in the MCT group, but declined throughout the experiment and by the 44th day hyperketonemia decreased by 50% but remained higher than in the LF diet. The blood beta-hydroxybutyrate/acetoacetate (B/A) ratio remained slightly elevated in rats fed the high fat diets. Similar changes were observed in liver KB concentration and in the B/A ratio. Liver lactate/pyruvate ratio elevated in the LCT and MCT groups at the initiation of the diets decreased by 50% at the end of the experiment. The consumption of high fat diets led to a 1.5-fold increase in liver PEPCK activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3298944 TI - Gel entrapment of whole cells in cross-linked prepolymerized polyacrylamide hydrazide gels. PMID- 3298945 TI - Immobilization of microbial cells in an epoxy carrier system. PMID- 3298947 TI - Immobilization of enzymes and microbial cells in gelatin. PMID- 3298948 TI - Immobilization of microbial cells on transition metal-activated supports. PMID- 3298946 TI - Entrapment of microbial cells in chitosan. PMID- 3298949 TI - Use of immobilized proteinases and peptidases to study structural changes in proteins. PMID- 3298950 TI - Detection of polysialosyl-containing glycoproteins in brain using prokaryotic derived probes. PMID- 3298952 TI - Reductive cleavage of permethylated polysaccharides. PMID- 3298951 TI - Overlay and solid-phase analysis of glycolipid receptors for bacteria and viruses. PMID- 3298953 TI - Glycolipids. PMID- 3298954 TI - Acetyl-CoA: alpha-glucosaminide N-acetyltransferase from rat liver. PMID- 3298955 TI - Sialic acids: metabolism of O-acetyl groups. PMID- 3298956 TI - CMP-NeuNAc:poly-alpha-2,8-sialosyl sialyltransferase in neural cell membranes. PMID- 3298957 TI - Transport of sugar nucleotides into the lumen of vesicles derived from rat liver rough endoplasmic reticulum and Golgi apparatus. PMID- 3298958 TI - Polysialic acid depolymerase. PMID- 3298959 TI - Keyhole limpet oligosaccharyl sulfatase. PMID- 3298960 TI - Measurement of inositol phospholipid metabolism in PC12 pheochromocytoma cells. PMID- 3298961 TI - Measurement of inositol phospholipid turnover in platelets. PMID- 3298962 TI - Glycogen phosphorylase: a noninvasive indicator of cytoplasmic calcium. PMID- 3298963 TI - Measurement of phorbol ester receptors in intact cells and subcellular fractions. PMID- 3298965 TI - Measurement of calcium release from sarcoplasmic reticulum of skeletal muscle: effect of calcium and inositol 1,4,5-trisphosphate. PMID- 3298966 TI - Assays and substrate preparation for the enzymatic hydrolysis of diacylglycerols and phorbol diesters. PMID- 3298964 TI - Mixed micellar assay for phorbol ester binding. PMID- 3298967 TI - Measurement of prostaglandin production by isolated tissues and cells in culture. PMID- 3298969 TI - Protein kinase C-mediated phosphorylation in intact cells. PMID- 3298968 TI - Hormone- and tumor promoter-induced activation or membrane association of protein kinase C in intact cells. PMID- 3298970 TI - Protein kinase C purification by high-performance liquid chromatography: an improved method. PMID- 3298971 TI - Tumoricidal effects of liposomes containing phosphatidylinositol or phosphatidylcholine. PMID- 3298972 TI - 4-Hydroxyphenylpyruvate dioxygenase from pig liver. PMID- 3298973 TI - Indoleamine 2,3-dioxygenase. PMID- 3298974 TI - Tryptophan C-methyltransferase of Streptomyces flocculus. PMID- 3298975 TI - Transamination of aromatic amino acids in Escherichia coli. PMID- 3298976 TI - Phenylalanine 4-monooxygenase from human liver. PMID- 3298977 TI - Synthesis of tryptophan from chorismate: comparative aspects. PMID- 3298978 TI - Shikimate dehydrogenase from Escherichia coli. PMID- 3298979 TI - 3-Phosphoshikimate 1-carboxyvinyltransferase from Escherichia coli. PMID- 3298980 TI - Anthranilate synthase-anthranilate phosphoribosyltransferase complex and subunits of Salmonella typhimurium. PMID- 3298981 TI - Phosphoribosylanthranilate isomerase-indoleglycerol-phosphate synthase from Escherichia coli. PMID- 3298982 TI - Tryptophan synthase from Escherichia coli and Salmonella typhimurium. PMID- 3298983 TI - Tryptophanase from Escherichia coli B/1t7-A. PMID- 3298984 TI - Chorismate mutase-prephenate dehydrogenase from Escherichia coli. PMID- 3298985 TI - Prephenate aminotransferase. PMID- 3298986 TI - Arylalkylamine N-acetyltransferase from mammalian pineal gland. PMID- 3298987 TI - Hydroxyindole O-methyltransferase. PMID- 3298988 TI - Norepinephrine N-methyltransferase from rabbit adrenal glands. PMID- 3298989 TI - Specific methods for electron immunohistochemistry. PMID- 3298991 TI - Introduction of exogenous molecules into the cytoplasm of Dictyostelium discoideum amoebae by controlled sonication. PMID- 3298990 TI - Electrophoretic isolation and peptide mapping of collagen types from microsamples of tissue. PMID- 3298992 TI - Preparation of deuterated actin from Dictyostelium discoideum. PMID- 3298993 TI - Biochemical and genetic approaches to microtubule function in Dictyostelium discoideum. AB - Methods have been developed for analyzing tubulin and microtubules from the cellular slime mold D. discoideum. alpha- and beta-tubulin have been identified on high-resolution 2D gels, and microtubules have been isolated in cytoskeleton preparations from amoebae (White et al., 1983). These studies have revealed properties unique to Dictyostelium tubulin. Amoebal microtubules can be visualized by indirect immunofluorescence, which has aided in the identification of inhibitors which specifically depolymerize microtubules and block amoebae in mitosis. The mitotic inhibitors CIPC, NOC, and TBZ have been used to select resistant mutants which are currently the subjects of biochemical, morphological, and genetic analysis (Katz et al., 1982; White, 1983). One mitotic inhibitor resistant mutant, CIPC 6, was found to be temperature-sensitive for growth at 27 degrees C as well as CIPC-resistant. At the restrictive temperature amoebae from this mutant are deficient in the passage through mitosis. After incubation for 12 hours at the restrictive temperature, 20% of the CIPC 6 amoebae displayed condensed chromosomes, compared to 2% at the permissive temperature, as determined by Giemsa staining. Examination of the microtubules of this mutant by indirect immunofluorescence showed abnormal spindle microtubule formation at the restrictive temperature, which is the likely cause of the mitotic arrest (White, 1983). Cytoplasmic microtubules were also disrupted in nonmitotic amoebae of CIPC 6 at 27 degrees C. This temperature-sensitive loss of microtubule function suggested the possibility that tubulin from CIPC 6 might be altered. When tubulin from CIPC 6 was examined on 2D gels, no reproducible electrophoretic change was observed from that of the wild type. Through further characterization of mitotic inhibitor-resistant mutants like CIPC 6, more mitotic or microtubule mutants will be identified. Among these mutants, some should contain electrophoretically altered tubulin, microtubule-associated proteins, or components of the amoebal cytoskeleton. Possessing Dictyostelium mutants with known biochemical alterations in cytoskeletal proteins should reveal significant information regarding the function of these proteins in eukaryotic growth and development. PMID- 3298994 TI - Probing the mechanisms of mitosis with Dictyostelium discoideum. PMID- 3298995 TI - Agar-overlay immunofluorescence: high-resolution studies of cytoskeletal components and their changes during chemotaxis. AB - Cells that are flattened by overlaying with a thin sheet of agarose can be instantaneously fixed with freezing absolute methanol containing 1% formalin. This procedure results in good preservation of the cytoskeleton. Use of this technique ("agar-overlay immunofluorescence") clarified that (1) Dictyostelium myosin exists in situ as thick filaments (Yumura and Fukui, 1985), (2) the thick filaments are arranged in a meshwork at the posterior cortex of a polarized cell performing directed locomotion, at the constricting portion of a dividing cell forming a contractile ring, and at the outermost lateral periphery of a cell engaging in spiral aggregation (Fig. 1f; Yumura et al., 1984; Yumura and Fukui, 1985), and (3) the distribution of thick filaments changes dramatically in response to the chemoattractant cAMP in 1 minute (Fig. 3; Yumura and Fukui, 1985). This technique can provide valuable information on the dynamic features as well as the detailed organization of cytoskeletal elements which, otherwise, cannot be visualized with sufficient resolution. PMID- 3298996 TI - A strategy to study development and pattern formation: use of antibodies against products of cloned genes. PMID- 3298997 TI - Cultivation and synchronous morphogenesis of Dictyostelium under controlled experimental conditions. PMID- 3298999 TI - Characterization of two genes, ARGRI and ARGRIII required for specific regulation of arginine metabolism in yeast. AB - Three unlinked genes ARGRI, ARGRII and ARGIII are necessary to control the synthesis of the arginine anabolic and catabolic genes. The three genes have been cloned and sequenced and we report here the results for the ARGRI and ARGRIII genes. They encode proteins of 177 and 355 amino acids, respectively. The ARGRIII protein has a very acidic carboxy-terminus (17 aspartate residues). From a comparison of the sequences, the ARGRI and ARGRIII gene products do not show the common characteristics of other DNA binding proteins (nuclear localization and putative DNA binding site) in contrast to the ARGRII regulatory protein. The transcription of both genes is not affected by the presence of arginine in the growth medium. PMID- 3298998 TI - Promoter switching during development and the termination site of the sigma 43 operon of Bacillus subtilis. AB - Sequencing data indicated that the RNA polymerase sigma 43 operon of Bacillus subtilis consisted of three genes, P23 (function unknown), dnaE (DNA primase), and rpoD (sigma 43) (Wang and Doi 1986a). S1 nuclease mapping experiments with RNA from various stages of growth demonstrated the presence of two overlapping sigma 43 promoters that controlled the expression of the operon during growth and a sigma 37 promoter that regulated the expression of the operon during the sporulation phase. This promoter switching mechanism ensured that this important operon would be expressed during different nutritional states of the cell and also illustrated a function for the minor RNA polymerase sigma 37 holoenzyme in the expression of genes which are normally expressed during the logarithmic phase of growth. The location of the transcription termination signal confirmed that the sigma 43 operon consists of three genes. PMID- 3299000 TI - Characterisation of an autonomously replicating sequence from the fission yeast Schizosaccharomyces pombe. AB - A DNA sequence has been isolated from Schizosaccharomyces pombe which promotes high frequency transformation of plasmids in the same organism. It is closely linked to the DNA ligase gene CDC17 and has therefore been named ARS17 although in structure it differs substantially from ARS elements in Saccharomyces cerevisiae. ARS17 spans some 1.8 kb of DNA and deletion of any part of this region affects activity. Moreover, there does not appear to be any short sequence which is, by itself, sufficient for high frequency transformation. ARS17 lies between and partly overlaps two divergently transcribed genes and it is extremely AT rich. It lacks the consensus sequence found in S. cerevisiae ARSs and it has no ARS activity in S. cerevisiae. PMID- 3299001 TI - Molecular genetics of met 17 and met 25 mutants of Saccharomyces cerevisiae: intragenic complementation between mutations of a single structural gene. AB - We cloned the MET 17 gene of Saccharomyces cerevisiae by functional complementation after transformation of a yeast met 17 mutant. Restriction mapping and nucleotide sequencing of the MET 17 clones revealed that these were from the same genomic region as clones isolated previously and shown to contain the MET 25 gene encoding the enzyme O-acetylhomoserine, O-acetylserine sulphydrylase (OAH-OAS sulphydrylase). Transformation studies with MET 25 clones showed that the MET 17 and MET 25 functions were both endoced in a single transcription unit. We conclude that met 17 and met 25 are both mutations in the structural gene for the OAH-OAS sulphydrylase subunit and that each affects a different functional domain of the enzyme allowing subunit complementation in the met 17 X met 25 diploid. Enzyme assays indicated that the diploid, although not requiring methionine, had a low OAH-OAS sulphydrylase activity (10% of wild type). This is consistent with MET 17 and MET 25 being the same gene. We found that both met 17 and met 25 mutants were devoid of 3' phospho-adenosine 5' phospho-sulphite (PAPS) reductase activity and that this activity was fully restored in the met 17 X met 25 diploid. The possible interactions between OAH OAS sulphydrylase and PAPS reductase are discussed. PMID- 3299002 TI - The use of operon fusions in studies of the heat-shock response: effects of altered sigma 32 on heat-shock promoter function in Escherichia coli. AB - Derivatives of lambda pF13 phage in which lacZ expression (beta-galactosidase synthesis) is directed by transcription initiated at a heat-shock promoter (PrpoDhs or PgroE) were constructed and used for analysis of the heat-shock response in Escherichia coli. A wild-type strain (MC4100) lysogenic for either of these phages exhibited typical transient induction of beta-galactosidase synthesis upon a temperature shift from 30 degrees to 42 degrees C or after addition of ethanol to the medium (4% to 5%) at 30 degrees C. In contrast, most amber rpoH (htpR) mutants tested (in a Su- background) failed to respond to a temperature shift, though some mutants affected in the carboxy-terminal region exhibited a partial response. All rpoH mutants tested showed a weak but significant response to ethanol. F' plasmids carrying each of six known nonsense suppressors were then introduced into each of four rpoH amber mutants lysogenic for lambda pF13-(Phs-lacZ), creating a set of F' strains that produce sigma 32 protein with a specific amino acid substitution at a known site. Some of these strains showed an essentially normal heat-shock response while others showed little response with either or both of the promoters. In some instances, the response was significantly delayed. These results point to the usefulness of the lambda pF13-derivative phages for quantitative and systematic analysis of heat shock response in E. coli. PMID- 3299004 TI - Effects of long-term Org OD 14 administration on blood coagulation in climacteric women. AB - 98 post-menopausal women were randomly allocated to either Org OD 14 [(7 alpha, 17 alpha)-17-hydroxy-7-methyl-19-norpregn-5(10)-en-20-yn-3-one] 2.5 mg/day or placebo. Treatment was continued for up to 6 yr. Any thromboembolic episode that occurred was recorded. Prothrombin time (PT), partial thromboplastin time (PTT), factor VII level and factor X level were measured prior to treatment and at yearly intervals. Antithrombin III level was measured in the last two yr of the study. There was one cerebrovascular accident after 3 months of placebo therapy but no other thromboembolic episodes. No significant difference was found between the effects of Org OD 14 and placebo with regard to any clotting factors at any time interval, although factor VII and factor X levels were consistently lower in the OD 14 group than in the placebo group. Antithrombin III levels measured after 5 and 6 yr were significantly higher (P less than 0.01) in the OD 14 group, suggesting a reduced risk of thrombosis in the treatment group. PMID- 3299003 TI - Catalase has only a minor role in protection against near-ultraviolet radiation damage in bacteria. AB - In bacterial cells near-ultraviolet radiation (NUV) generates H2O2 which can be decomposed by endogenous catalase to H2O and O2. To assess the roles of H2O2 and catalase in NUV lethality, we manipulated the amount of intracellular catalase (a) by the use of mutant and plasmid strains with altered endogenous catalase, (b) physiologically, by the addition of glucose, and (c) by induction of catalase synthesis with oxidizing agents. Not only was there no direct correlation between NUV-resistance and catalase activity, but in some cases the correlation was inverse. Also, while there was correlation between NUV and H2O2 sensitivity for most strains tested, there were a number of exceptions which indicates that the modes of killing were different for the two agents. PMID- 3299006 TI - Study of an artificial endoassociation between Saccharomyces cerevisiae and Escherichia coli. AB - The establishment of an artificial endoassociation between Escherichia coli (JC 5466, trp, his, recA 56, lac delta X 74, SpcR, harbouring the plasmid pRD1 which confers on it the capacity to produce penicillinase), and Saccharomyces cerevisiae (3.2, a, ade, ura, lys) was carried out in order to study its behaviour and stability. The pattern of protoplast reversion to whole cells, the penicillinase production capacity, the stability without selective pressure and the bacterial localization in the yeast cells, is described and discussed. PMID- 3299005 TI - Effects of lemongrass oil on the morphological characteristics and peptidoglycan synthesis of Escherichia coli cells. AB - The antibacterial effect of lemongrass oil, obtained from the aerial part of Cymbopogon citratus, on cells of Escherichia coli was investigated by electron microscopy and by measuring cell wall formation. Two strains of E. coli K-12 were used, one of which required diaminopimelic acid in the growth medium for its murein formation. Lemongrass oil was found to elicit morphological changes like filamentation, inhibition of septum formation, spheroplast formation, production of 'blisters', 'bulges' or mesosomes, as well as lysis and development of abnormally shaped cells. The incorporation of radioactively labelled diaminopimelic acid into the cell wall murein of strain W7, was inhibited by lemongrass oil in a dose dependent way. The sequence of changes induced by lemongrass oil on bacterial cell morphology and also its interference with murein synthesis in E. coli cells were interpreted to involve the penicillin binding proteins PBP 2 and PBP 3. PMID- 3299007 TI - Innovative implementation in public health nursing. The W. K. Kellogg Foundation and The Michigan Community Health Project, 1930-1942. PMID- 3299008 TI - Rapid and sensitive detection of dengue viral antigen using immunogold in light microscopy and solid phase gold immunoassay (SPGIA). PMID- 3299009 TI - Obstetrics during the Early Roman Empire. PMID- 3299010 TI - Breast feeding in Tudor & Stuart England. PMID- 3299011 TI - The story of the first nursing journal--Nursing Notes. PMID- 3299012 TI - Woman & the Midwives Chronicle. PMID- 3299013 TI - 100 years ago--June 1887. PMID- 3299014 TI - Yesterday's district midwife. PMID- 3299015 TI - A three-year study of impetigo in Sydney. AB - Two hundred and forty-three cases of impetigo, which were seen in children in Sydney in the three-year period from July, 1983 to June, 1986, were studied. The great majority of cases was seen in summer and autumn, and over half the cases occurred in the preschool age group. Staphylococcus aureus was grown from 86% of the cases; in 69% of cases it was the only organism to be found, indicating the predominant importance of this organism in impetigo in Sydney in the 1980s. Antibiotic-sensitivity testing of the staphylococci that were cultured demonstrated that fewer than 2% of strains were sensitive to penicillin and fewer than 50% of strains were sensitive to erythromycin. Our experience suggests that flucloxacillin is the antibiotic agent of choice in the treatment of impetigo in children in Sydney. PMID- 3299016 TI - Effects of MK-733 on plasma lipid and lipoprotein levels in subjects with hypercholesterolaemia. AB - MK-733, which is a competitive inhibitor of the rate-limiting step in cholesterol biosynthesis, or a matching placebo was administered to 30 subjects with primary hypercholesterolaemia (who were already receiving dietary treatment) over a period of four weeks in a double-blind trial. Twenty-one subjects manifested heterozygous familial hypercholesterolaemia and nine subjects had polygenic hypercholesterolaemia. Five subjects received placebo, 15 subjects a low dose of MK-733 (2.5-10 mg/day) and 10 subjects received a high dose of MK-733 (20-80 mg/day). Plasma cholesterol levels in subjects who were receiving MK-733 declined significantly and in a dose-dependent fashion (31% reduction in plasma cholesterol levels with a high dose, 19% reduction with a low dose). Eight of 10 subjects who were receiving a high dose of MK-733 achieved better than a 30% reduction in plasma cholesterol levels after four weeks of treatment. The response was independent of the presence or absence of familial hypercholesterolaemia. High-density lipoprotein cholesterol levels did not change significantly, but there was a suggestive, dose-dependent reduction in plasma triglyceride levels after four weeks of treatment. MK-733 was well-tolerated, appeared to be safe, and may ultimately become an important drug in the management of more severe grades of hypercholesterolaemia. PMID- 3299017 TI - The antiphosphorylcholine plaque-forming cell responses induced by the nematode Trichinella in BWF1 mice. AB - We have tested the ability of the nematode Trichinella to infect young and old (NZB x NZW) F1 (BWF1) mice. We report the capacity of these mice to respond to the parasite antigens containing the epitope phosphorylcholine. The values obtained in adult worm intestinal retention rates and in the number of encysted larvae on the 35th day postinfection showed that the old BWF1 mice are more susceptible than young BWF1 and control (BALB/c x CBA/j)F1 (BCF1) mice to Trichinella infection. However, unlike the BCF1 mice, young BWF1 mice were unable to produce a good anti-phosphorylcholine plaque-forming cell response after the killing of Trichinella larvae by the anthelminthic mebendazole. Old BWF1 mice presented a discrete response which is discussed. Finally, our results seem to indicate that the lack of anti-phosphorylcholine response in young BWF1 mice after mebendazole treatment may be related to the high susceptibility of these mice to the suppressive properties of encysted Trichinella larvae against their own antigens. PMID- 3299018 TI - Properties of L-streptococci in comparison with those of A-streptococci. AB - Despite some similarities, L-streptococci could be clearly differentiated from A streptococci. Formamide, autoclaved and nitrous acid extracts of all L streptococcal cultures studied reacted only with their specific antisera and did not cross-react with any other group specific streptococcal antigens. All 33 L streptococcal cultures, in contrast to A-streptococci, produced beta-D glucuronidase and beta-D-galactosidase, hydrolyzed Na-hippurate, grew on 10% and 40% bile blood agar and were agglutinated by the lectin of Arachis hypogaea. Some differences between A- and L-streptococci were also observed in their sensitivity patterns to bacitracin and sulfamethoxazole-trimethoprim. PMID- 3299019 TI - [Dynamics of indices of the indirect hemagglutination test and immunoenzyme analysis with echinococcal antigens among boarding school students in the tundra and taiga zones of Yakutia]. PMID- 3299020 TI - [Alveolar forms of the unicameral echinococcus--Echinococcus granulosus (Batsch, 1786)]. PMID- 3299021 TI - [Various physico-chemical factors affecting the in vitro cultivation of the erythrocyte stages of the agent of tropical malaria]. PMID- 3299022 TI - [Control of echinococcosis in foreign countries (review of the literature)]. PMID- 3299023 TI - [Cystic adenomatoid malformation of the lung. Attempt at a classification of this diseases according to clinical symptoms]. PMID- 3299024 TI - [Treatment of anal fissures by oral administration of 5-amino-salicylic acid]. PMID- 3299025 TI - [Kidney involvement in malignant lymphomas. A clinicoradiologic study of 31 patients]. PMID- 3299026 TI - [Clinicopathologic conference. Heerfordt syndrome in sarcoidosis with simultaneous detection of Mycobacterium tuberculosis by bacterial culture]. PMID- 3299027 TI - Viral interference-dominance of mutant viruses over wild-type virus in mixed infections. PMID- 3299031 TI - Consensus development in biomedicine: the liver transplant controversy. AB - Controversies in biomedical science are seen by some as essential to progress; most policy makers, however, find them politically disruptive. The consensus development (CD) program was initiated by the National Institutes of Health to adjudicate between these views. By focusing on the liver transplantation conference, the CD program is characterized as a mechanism of social control to contain rather than to resolve controversy. This public performance has the trappings of democratic theater, but also the unmistakable mark of backstage politics. PMID- 3299032 TI - Nursing home reimbursement: implications for cost containment, access, and quality. AB - The individual states have many options in designing Medicaid reimbursement systems for nursing homes. Each option has a differential effect on incentives- and outcomes--for containing costs, providing quality care, and maintaining access to care. The mix and consequences of specific choices are analyzed in a framework that disaggregates costs into three components. Tradeoffs among competing elements will be inevitable, but reimbursement policy can maximize both efficiency and equity. PMID- 3299033 TI - The privatization of health care and physicians' perceptions of access to hospital services. AB - Health care in the United States is increasingly delivered by for-profit providers, by multi-facility corporations, and under conditions of price-based competition. The joint influence of these three trends is examined through data drawn from a 1984 survey of physicians conducted by the American Medical Association. For-profit ownership and price competition are reported to restrict admission for the poor and uninsured; the effects of system affiliation are shown to be more complex. Policy responses to future restrictions on access are discussed. PMID- 3299029 TI - Shiga and Shiga-like toxins. PMID- 3299034 TI - [Ultrasonic evaluation of gallbladder pathology in thalassemia major]. PMID- 3299030 TI - Genetics of Vibrio cholerae and its bacteriophages. PMID- 3299028 TI - Tetrathionate reduction and production of hydrogen sulfide from thiosulfate. PMID- 3299035 TI - [Effect of flurbiprofen combined with an antibiotic in inflammatory bronchopneumopathy in pediatrics]. PMID- 3299036 TI - Clinical and laboratory features of cryptococcosis. A five-year experience. PMID- 3299037 TI - An odyssey to the appendix. A centennial. PMID- 3299038 TI - [Clinical trial of a new non-steroidal analgesic (diflunisal) in oral surgery]. PMID- 3299040 TI - Integrating computers into the curriculum. (2): Transforming a concept into a working tool. PMID- 3299039 TI - [Dental secrets in an 18th-century work]. PMID- 3299041 TI - [Respiratory function and pulmonary thromboxane release after total thoracic esophagectomy]. AB - In experimental studies using mongrel dogs, 60 minutes after total thoracic esophagectomy the dog lung transiently released into the systemic circulation up to about 6000 micrograms/ml of thromboxane A2(TXA2) measured by radioimmunoassay as its metabolite thromboxane B2(TXB2). To determine whether lung TX release had effects on pulmonary function, we measured the changes in extravascular lung water (EVLW), lung resistance (RL) before, 10, 30, and 60 minutes after total thoracic esophagectomy in 14 anesthetized dogs. In seven untreated dogs, EVLW and RL increased and CL decreased approximately twofold at 60 minutes after the surgery, which corresponded well with a large transpulmonary plasma concentration gradient of TXB2. In remaining 7 dogs pretreated with intravenous OKY-046 which was TXA2 synthetase inhibitor, increase in EVLW and RL and decrease in CL were minimal and plasma concentration of TXB2 remained low value of a preoperative level. In clinical studies, 20 patients with esophageal carcinoma were evaluated. All of these patients underwent total thoracic esophagectomy with extended lymph node dissection of a similar extent. In 5 control patients, significant increase in EVLW and pulmonary vascular resistance were noted at 60 minutes after surgery. On the other hand, while the patients who had intravenous OKY-046 administration during operation at a dose of 1 microgram/kg/min or 5 micrograms/kg/min showed significant decrease in EVLW and pulmonary vascular resistance at 60 minutes after surgery. Based on these results, it is concluded that TXA2 appears to be one of the most important factors to cause the postoperative pulmonary complication after total thoracic esophagectomy for esophageal cancer. PMID- 3299042 TI - [Experimental study on the development of endotoxemia in peritonitis with special reference to route of absorption of endotoxin]. AB - As endotoxemia develops and presents marked symptoms in severe peritonitis, the absorption route of endotoxin from the peritoneal cavity was studied in this study. Twenty-four adult mongrel dogs were divided into 4 groups as follows. Group 1: Physiological saline solution was injected intraperitoneally with thoracic duct (TD) lymph drainage. Group 2: Peritonitis was induced without lymph drainage. Group 3: Peritonitis was induced with TD lymph drainage. Group 4: Peritonitis was induced with right lymph duct (RLD) and TD lymph drainage. Peritonitis was induced by intraperitoneal injection of endotoxin (Difco 055 B5 LPS) at 0.5 mg/kg. In Group 4, the endotoxin level in lymph from RLD reached a maximum value of 4.19 X 10(7) +/- 2.32 X 10(7) pg/ml (mean +/- S.E.), while that from TD was only 7203 +/- 5022 pg/ml. The endotoxin level in the portal venous blood three hours after administration was almost within normal limits throughout the experiment. In conclusion the route of endotoxin absorption in peritonitis is considered to be via the lymphatic system and in particular RLD is assumed to play an important role. PMID- 3299043 TI - [Problems of the gastric stump]. PMID- 3299044 TI - [Kinetics of inhibition by 8-oxy-ATP of the dinucleotide pppApU synthesis catalyzed by Escherichia coli RNA-polymerase on the promoter A1 of phage T7 delta D111 DNA during coupled synthesis of di- and trinucleotides and a limited set of substrates]. AB - A kinetic analysis of inhibition of synthesis of dinucleotide pppApU catalyzed by Escherichia coli RNA-polymerase on A1 promoter of the DNA from T7 delta DIII phage mutant by 8-oxy-ATP under the conditions of the coupled synthesis of pppApU and pppApUpC and in the presence of an incomplete set of substrates, namely ATP, UTP, CTP, has been performed. It was found that 8-oxy-ATP is an unproductive analog of both ATP and CTP. A comparative analysis of the dissociation constants shows that 8-oxy-ATP binds at ATP center 3.3. times and at CTP center 540 times weaker than natural substrates. At the UTP center 8-oxy-ATP does not bind at all. PMID- 3299045 TI - [Comparison of the conformation of RNA from phage MS2 and 16S rRNA. Interaction with dyes specific for the secondary structure of native RNA and RNA subjected to hydrolysis by nuclease S1]. AB - The interaction of ethidium bromide (EtBr) with double-stranded (ds), and acridine orange (AO) with single-stranded (ss) fragments of 16S rRNA Escherichia coli in a wide range of ionic strength, at various pH, Zn2+ ion concentrations and partial hydrolysis by nuclease S1 was investigated. It was shown that about 90% of the RNA molecule is accessible to both dyes, when the ionic strength is near of 0.01 (pH 7). Approximately half of the RNA becomes inaccessible to dyes, when the ionic strength was increased up to 0.08-0.24 (pH 4.7-7), independent on the presence of Zn2+ ions (10(-3) M). About a half of the ds-, and a quarter of the ss-segments of the RNA, deduced from the secondary structure model were protected from the interaction with EtBr and AO. The hydrolysis of about a half of ss-segments upon addition of the Zn2+ (10(-3) M) ions did not affect the RNA tertiary structure. The experimental data obtained confirm the idea of the existence of some "nucleus" (or "nuclei") within the 16S rRNA molecule. The "nucleus" seems to be inaccessible to the dyes and is very stable to heat denaturation. It was supposed that this structure is organized by means of interaction of some of the parallelly oriented ds-segments, as it was suggested earlier for the phage MS2 RNA structure. PMID- 3299046 TI - Phosphorylation of the Saccharomyces cerevisiae equivalent of ribosomal protein S6 has no detectable effect on growth. AB - The phosphorylation of mammalian ribosomal protein S6 is affected by a variety of agents, including growth factors and tumor promoters, as well as by expressed oncogenes. Its potential role in the regulation of protein synthesis has been the object of much study. We have developed strains of Saccharomyces cerevisiae in which the phosphorylatable serines of the equivalent ribosomal protein (S10) were converted to alanines by site-directed mutagenesis. The S10 of such cells is not phosphorylated. Comparison of these cells with the parental cells, whose genomes differ by only six nucleotides, revealed no differences in the lag phase or logarithmic phase of a growth cycle, in growth on different carbon sources, in sporulation, or in sensitivity to heat shock. We conclude that in S. cerevisiae the phosphorylation of ribosomal protein S10 may play no role in regulating the synthesis of proteins. This conclusion leads one to ask whether certain protein phosphorylations are simply the adventitious, if easily observable, result of the imperfect specificity of one or another protein kinase. PMID- 3299048 TI - Synthesis and localization of pathogenesis-related proteins in tobacco. AB - The PR1 family of pathogenesis-related proteins from tobacco (Nicotiana tabacum L.) leaves is induced by a variety of pathogenic and chemical agents and is associated with resistance to tobacco mosaic virus. The majority of the PR1 proteins did not copurify with mesophyll protoplasts (the major cell type of the leaf) isolated from tobacco mosaic virus-infected N. tabacum cv. Xanthi-nc leaves. However, these isolated protoplasts were capable of synthesizing and selectively secreting the PR1 proteins. Using monoclonal antibodies for immunofluorescence microscopy, we localized these proteins to the extracellular spaces predominantly in regions adjacent to viral lesions as well as in xylem elements of infected leaves. PMID- 3299047 TI - Developmental regulation of SPO13, a gene required for separation of homologous chromosomes at meiosis I. AB - Previous studies have demonstrated that the SPO13 gene is required for chromosome separation during meiosis I in Saccharomyces cerevisiae. In the presence of the spo13-1 nonsense mutation, MATa/MAT alpha diploid cells complete a number of events typical of meiosis I including premeiotic DNA synthesis, genetic recombination, and spindle formation. Disjunction of homologous chromosomes, however, fails to occur. Instead, cells proceed through a single meiosis II-like division and form two diploid spores. In this paper, we report the cloning of this essential meiotic gene and an analysis of its transcription during vegetative growth and sporulation. Disruptions of SPO13 in haploid and diploid cells show that it is dispensible for mitotic cell division. Diploids homozygous for the disruptions behave similarly to spo13-1 mutants; they sporulate at wild type levels and produce two-spored asci. The DNA region complementing spo13-1 encodes two overlapping transcripts, which have the same 3' end but different 5' ends. The major transcript is 400 bases shorter than the larger, less abundant one. The shorter RNA is sufficient to complement the spo13-1 mutation. While both transcripts are undetectable or just barely detectable in vegetative cultures, they each undergo a greater than 70-fold induction early during sporulation, reaching a maximum level about the time of the first meiotic division. In synchronously sporulating populations, the transcripts nearly disappear before the completion of ascus formation. Nonsporulating cells homozygous for the mating type locus show a small increase in abundance (less than 5% of the increase in sporulating cells) of both transcripts in sporulation medium. These results indicate that expression of the SPO13 gene is developmentally regulated and starvation alone, independent of the genotype at MAT, can trigger initial induction. PMID- 3299049 TI - Expression and characterization of transforming growth factor alpha precursor protein in transfected mammalian cells. AB - Analysis of a cDNA clone derived from retrovirus-transformed rat fibroblasts has recently suggested that the mature 50-amino-acid form of transforming growth factor alpha (TGF alpha) is derived from a 159-amino-acid transmembrane precursor by proteolytic cleavage. To understand the processing of the TGF alpha precursor molecule in more detail, we have expressed this protein in baby hamster kidney (BHK) fibroblasts under control of the metal-ion-inducible metallothionein promoter and characterized the expressed precursor with site-specific antipeptide antibodies. One of the BHK transfectants, termed 5:2, expressed the TGF alpha mRNA in a cadmium- and zinc-inducible manner. The TGF alpha precursor protein was detected by immunoprecipitation analysis of radiolabeled cell cultures. In the induced 5:2 cells, a polypeptide of Mr 13,000 to 17,000 was readily identified by peptide antisera made to three different regions of the TGF alpha precursor protein. No such protein species were observed in BHK cells treated with cadmium and zinc or in uninduced 5:2 cells. However, two cell lines known to produce TGF alpha naturally, Leydig testicular tumor cells and Snyder-Theilan feline sarcoma virus-transformed Fisher rat embryo fibroblasts, possessed detectable levels of immunologically related Mr 13,000 to 17,000 proteins. Cell fractionation studies indicate that the Mr 13,000 to 17,000 species expressed in induced 5:2 cells is membrane associated, consistent with predictions based on the cDNA sequence of the TGF alpha precursor. Media conditioned by induced 5:2 cells contained epidermal growth factor receptor-competing activity, which, upon size fractionation, was similar in size to the mature processed form of TGF alpha. These data show that these nontransformed BHK cells possess the ability to process the TGF alpha precursor molecule into its native form. PMID- 3299050 TI - Eucaryotic RNA polymerase conditional mutant that rapidly ceases mRNA synthesis. AB - We have isolated a yeast conditional mutant which rapidly ceases synthesis of mRNA when subjected to the nonpermissive temperature. This mutant (rpb1-1) was constructed by replacing the wild-type chromosomal copy of the gene encoding the largest subunit of RNA polymerase II with one mutagenized in vitro. The rapid cessation of mRNA synthesis in vivo and the lack of RNA polymerase II activity in crude extracts indicate that the mutant possesses a functionally defective, rather than an assembly-defective, RNA polymerase II. The shutdown in mRNA synthesis in the rpb1-1 mutant has pleiotropic effects on the synthesis of other RNAs and on the heat shock response. This mutant provides direct evidence that the RPB1 protein has a functional role in mRNA synthesis. PMID- 3299051 TI - c-mos proto-oncogene RNA transcripts in mouse tissues: structural features, developmental regulation, and localization in specific cell types. AB - c-mos RNA transcripts have been previously detected in mouse gonadal tissue and in late-term embryos. Here, we show that they are also present at low levels in placenta and in adult mouse brain, kidney, mammary gland, and epididymis. Marked differences are observed in the size of the mos RNA transcripts detected in different tissues. All transcripts appear to end at the same 3' position, and the tissue-specific size variations appear to be due to the use of different promoters. For example, the testicular and ovarian RNA transcripts initiate approximately 280 and approximately 70 base pairs, respectively, upstream from the first initiation codon, but both end at a common site downstream from the mos open reading frame. The expression of mos is developmentally regulated in gonadal tissue. Thus, the level of mos transcripts in testes is low for the first 3 weeks after birth, increases at least 10-fold around day 25, and reaches adult levels by day 30. In contrast, ovaries from preweaning mice contain a higher level of mos mRNA compared to ovaries from adult mice. In cell fractionation experiments we show that mos transcripts are present in haploid germ cells. We find that these transcripts are associated with monosomes and polysomes. The peculiar pattern of mos expression in mouse gonadal tissue suggests a role for the c-mos proto-oncogene in germ cell differentiation. PMID- 3299052 TI - Neoplastic transformation by the human gene N-myc. AB - Amplification and abundant expression of a gene known as N-myc are found frequently in advanced stages of human neuroblastoma and may play a role in the genesis of several malignant human tumors. Previous studies have shown that N-myc can cooperate with a mutant allele of the proto-oncogene c-Ha-ras to transform embryonic rat cells in culture. Here we show that N-myc can also act alone to elicit neoplastic growth of an established line of rat fibroblasts (Rat-1). We used recombinant DNA vectors to express either N-myc or its kindred gene c-myc in transfected cells. Both genes caused morphological transformation, anchorage independent growth, and tumorigenicity. We noticed two variables that appeared to influence the ability to isolate cells transformed by N-myc and c-myc: the abundance in which the genes were expressed and biological selection to eliminate untransformed cells from the cultures. Our findings sustain the belief that N-myc is an authentic proto-oncogene, lend further credibility to the role of N-myc in the genesis of human tumors, and establish a convenient assay that can be used to explore further the properties of both N-myc and c-myc. PMID- 3299055 TI - Evidence that the phl gene encodes a 160,000-dalton phosphoprotein with associated kinase activity. AB - In chronic myelocytic leukemia, the human c-abl oncogene is translocated from chromosome 9 to a region on chromosome 22 designated as the breakpoint cluster region (bcr) (A. de Klein, A. Guerts van Kessel, G. Grosveld, C. R. Bartram, A. Hagemeyer, D. Bootsma, N. K. Spurr, N. Heisterkamp, J. Groffen, and J. R. Stephenson, Nature (London) 300:765-767, 1982; J. Groffen, J. R. Stephenson, N. Heisterkamp, A. de Klein, C. R. Bartram, and G. Grosveld, Cell 36:93-99.) Abnormal c-abl homologous mRNA and protein have been detected in the leukemic cells of patients with chronic myelocytic leukemia (E. Canaani, D. Stein-Saltz, E. Aghai, R. P. Gale, A. Berrebi, and E. Januszewicz, Lancet 1:593-595, 1984; S. J. Collins and M. T. Groudine, Proc. Natl. Acad. Sci. USA 80:4813-4817, 1983; R. P. Gale and E. Canaani, Proc. Natl. Acad. Sci. USA 81:5648-5652, 1984; J. B. Konopka, S. M. Watanabe, J. W. Singer, S. J. Collins, and O. N. Witte, Proc. Natl. Acad. Sci. USA 82:1810-1814, 1985). The abnormal mRNA represents a chimeric transcript consisting of 5' bcr and 3' c-abl sequences (G. Grosveld, J. Verwoerd, T. van Agthoven, A. de Klein, K. L. Ramachandran, N. Heisterkamp, K. Stam, and J. Groffen, Mol. Cell. Biol. 6:607-616, 1986; E. Shtivelman, B. Lifshitz, R. B. Gale, and E. Canaani, Nature (London) 315:550-554, 1985; K. Stam, N. Heisterkamp, G. Grosveld, A. de Klein, R. S. Verma, M. Coleman, H. Dosik, and J. Groffen, N. Engl. J. Med. 313:1429-1433, 1985). In the present study, we demonstrated that the abnormal c-abl protein is a fusion protein. In addition, the normal gene encompassing bcr sequences was shown to encode a 160,000-dalton phosphoprotein with an associated serine or threonine kinase activity. We propose that this gene be designated phl, reserving the term bcr for the region within the phl gene encompassing the Ph' translocation breakpoints. PMID- 3299053 TI - Definition of regions in human c-myc that are involved in transformation and nuclear localization. AB - To study the relationship between the primary structure of the c-myc protein and some of its functional properties, we made in-frame insertion and deletion mutants of the normal human c-myc coding domain that was expressed from a retroviral promoter-enhancer. We assessed the effects of these mutations on the ability of c-myc protein to cotransform normal rat embryo cells with a mutant ras gene, induce foci in a Rat-1-derived cell line (Rat-1a), and localize in nuclei. Using the cotransformation assay, we found two regions of the protein (amino acids 105 to 143 and 321 to 439) where integrity was critical: one region (amino acids 1 to 104) that tolerated insertion and small deletion mutations, but not large deletions, and another region (amino acids 144) to 320) that was largely dispensable. Comparison with regions that were important for transformation of Rat-1a cells revealed that some are essential for both activities, but others are important for only one or the other, suggesting that the two assays require different properties of the c-myc protein. Deletion of each of three regions of the c-myc protein (amino acids 106 to 143, 320 to 368, and 370 to 412) resulted in partial cytoplasmic localization, as determined by immunofluorescence or immunoprecipitation following subcellular fractionation. Some abnormally located proteins retained transforming activity; most proteins lacking transforming activity appeared to be normally located. PMID- 3299054 TI - Molecular cloning and characterization of an activated human c-raf-1 gene. AB - Results of previous studies have shown that a raf-related transforming DNA sequence is present in NIH 3T3 transformants that are derived from GL-5-JCK human glioblastoma DNA transfection. The transforming DNA was molecularly cloned by using cosmid vector pJB8 to determine its structure and origin. Analyses of selected clones revealed that the transforming DNA consisted of three portions of human DNA sequences, with the 3' half of the c-raf-1 gene as its middle portion. This raf region was about 20 kilobases long and contained exons 8 to 17 and the poly(A) addition site. RNA blot analysis showed that the raf-related transforming DNA was transcribed into 5.3-, 4.8-, and 2.5-kilobase mRNAs; the 2.5-kilobase transcript was thought to be the major transcript. Immunoprecipitation analyses revealed that a 44-kilodalton raf-related protein was specifically expressed in the NIH 3T3 transformants. The raf-related transforming DNA was considered to be activated when its amino-terminal sequence was truncated and the DNA was coupled with a foreign promoter sequence. On hybridization analysis of the original GL-5 JCK glioblastoma DNA, no rearrangement of c-raf-1 was detectable in the tumor DNA. The rearrangement of c-raf-1 may have occurred during transfection or may have been present in a small population of the original tumor cells as a result of tumor progression. PMID- 3299057 TI - DNA sequence encoding the amino-terminal region of the human c-src protein: implications of sequence divergence among src-type kinase oncogenes. AB - We sequenced the 5'-coding region of the human c-src gene, exons 2 through 5, corresponding to one-third of the human c-src protein consisting of 536 amino acids. Sequence analysis of the src type of protein kinases revealed that the amino-terminal region encoded by exon 2 contains sequences specific for the src proteins and raised the possibility that this region is involved in the recognition of a src-specific substrate(s) or receptor(s). PMID- 3299056 TI - Autonomous expression of c-myc in BC3H1 cells partially inhibits but does not prevent myogenic differentiation. AB - Myogenic differentiation is obligatorily coupled to withdrawal of myoblasts from the cell cycle and is inhibited by specific polypeptide growth factors. To investigate the potential involvement of c-myc in the control of myogenesis, the BC3H1 muscle cell line was stably transfected with a simian virus 40 promoter:c myc chimeric gene. In quiescent cells in 0.5% serum, the exogenous c-myc gene was expressed at a level more than threefold greater than the level of endogenous c myc in undifferentiated, proliferating cells of the parental line in 20% serum. The transfected myc gene partially inhibited the expression of both muscle creatine kinase and the nicotinic acetylcholine receptor, but was not sufficient to prevent the induction of these muscle differentiation products upon mitogen withdrawal. PMID- 3299058 TI - Induction of proliferation of neuroretina cells by long terminal repeat activation of the carboxy-terminal part of c-mil. AB - Expression of the P100gag-mil protein of avian retrovirus MH2 in cultured chicken embryo neuroretina cells was previously shown to result in the proliferation of normally quiescent cell populations. We show here that long terminal repeat activation of the carboxy terminus of the c-mil gene is sufficient to induce neuroretina cell proliferation. PMID- 3299059 TI - Amplification of the neu (c-erbB-2) oncogene in human mammmary tumors is relatively frequent and is often accompanied by amplification of the linked c erbA oncogene. AB - We investigated alterations in the structure and expression of oncogenes in mammary tumors and mammary tumor-derived cell lines. In 16 of 95 samples, we detected amplification of the human neu oncogene, also known as c-erB-2, accompanied by overexpression in the tumors from which intact RNA could be isolated. In 10 of these DNAs, the linked oncogene c-erbA was also amplified, whereas another gene on human chromosome 17, p53, was present in normal copy numbers. Overexpression of c-erbA could not be detected in the tumors analyzed. The relatively high frequency of neu amplification points to a functional role in human breast cancer. Coamplification of the c-erbA oncogene could contribute to this disease as well but is most likely fortuitous. PMID- 3299062 TI - Generalized anxiety disorders. PMID- 3299060 TI - Guanine nucleotide activation of, and competition between, RAS proteins from Saccharomyces cerevisiae. AB - In the yeast Saccharomyces cerevisiae, yeast RAS proteins are potent activators of adenylate cyclase. In the present work we measured the activity of adenylate cyclase in membranes from Saccharomyces cerevisiae which overexpress this enzyme. The response of the enzyme to added RAS2 proteins bound with various guanine nucleotides and their analogs suggests that RAS2 proteins are active in their GTP bound form and are virtually inactive in their GDP-bound form. Also, active RAS2 protein is not inhibited by inactive RAS2, suggesting that the inactive form does not compete with the active form in binding to its effector. PMID- 3299064 TI - Hypoxic pulmonary vasoconstriction and anesthetic drugs. PMID- 3299063 TI - [Collection and preservation of breast milk]. AB - Milk of the own mother is the best food for young babies. Donated breast milk can be fed in untreated raw condition or after preservation. A microbiological examination is a prerequisite for this. Total bacterial colony counts up to 10 Mpt/l can be considered normal. But premature infants should only be given a highest quality milk with a total bacterial count below 1 Mpt/l. Only coutions milk banking procedures should be used. Deep freezing and lyophilization are the most suitable procedures. PMID- 3299061 TI - Isolation and characterization of temperature-sensitive RNA polymerase II mutants of Saccharomyces cerevisiae. AB - Three independent, recessive, temperature-sensitive (Ts-) conditional lethal mutations in the largest subunit of Saccharomyces cerevisiae RNA polymerase II (RNAP II) have been isolated after replacement of a portion of the wild-type gene (RPO21) by a mutagenized fragment of the cloned gene. Measurements of cell growth, viability, and total RNA and protein synthesis showed that rpo21-1, rpo21 2, and rpo21-3 mutations caused a slow shutoff of RNAP II activity in cells shifted to the nonpermissive temperature (39 degrees C). Each mutant displayed a distinct phenotype, and one of the mutant enzymes (rpo21-1) was completely deficient in RNAP II activity in vitro. RNAP I and RNAP III in vitro activities were not affected. These results were consistent with the notion that the genetic lesions affect RNAP II assembly or holoenzyme stability. DNA sequencing revealed that in each case the mutations involved nonconservative amino acid substitutions, resulting in charge changes. The lesions harbored by all three rpo21 Ts- alleles lie in DNA sequence domains that are highly conserved among genes that encode the largest subunits of RNAP from a variety of eucaryotes; one mutation lies in a possible Zn2+ binding domain. PMID- 3299066 TI - [Alcoholism and heredity: biological basis of the predisposition to alcoholism]. AB - Authors critically review current data about biochemical-physiological factors mediating genetic predisposition to alcoholism. Results of genetic investigation of the ethanol and acetaldehyde metabolism and the facts about enzyme polymorphism of systems of the ethanol biotransformation and genetic polymorphism of particular enzymes are summarized. Data about possible determinants of nervous system sensitivity to ethanol action are considered. The investigation of genetic basis of phenomena imminent to alcoholism by use of laboratory animals is discussed. PMID- 3299067 TI - [The nature of DNA damage and its repair after treatment of bacteria with dioxidine]. AB - The nature of the lethal effect of antimicrobial drug dioxidin was studied. The treatment of bacterial cells by dioxidin results in an instant repression of DNA synthesis and formation of single strand gaps in DNA molecule. The repair of single strand gaps in polA+ cells involves the DNA polymerase I. The deficit of this enzyme leads to the increased degradation of DNA. The products of the recA, polA1, lexA, recB are relevant for bacterial resistance to dioxidin while the products of uvrA, uvrE and recF genes are not. On the basis of the obtained data dioxidin may be defined as a "gamma-type" agent due to the nature of dioxidin induced lesions in DNA and their repair. PMID- 3299068 TI - Alexander Hollaender 1898-1986. PMID- 3299065 TI - Nitroprusside versus a nitroprusside-trimethaphan mixture: a comparison of dosage requirements and hemodynamic effects during induced hypotension for neurosurgery. PMID- 3299069 TI - Enhanced mutagenicity of 2-nitropropane nitronate with respect to 2-nitropropane- possible involvement of free radical species. AB - The mutagenicities of the neutral and the anionic (nitronate) forms of 2 nitropropane (2-NP) were compared in S. typhimurium strains TA98, TA100 and TA102. The latter is a special strain sensitive to compounds producing oxidative damage to DNA at thymine-adenine base pair loci. Neutral 2-NP was not mutagenic in TA98, and produced significant mutagenic response in TA100 and TA102 only at levels of 55 mumoles/plate. In contrast, 2-NP nitronate was significantly mutagenic in TA98 at 14 mumoles/plate and, in strains TA100 and TA102, at approximately 4 mumoles/plate. Inclusion of S9 slightly increased the mutagenicity of 2-NP nitronate in TA102, but decreased it in TA100. The mutagenic response in TA102, but not in TA100, was inhibited by DMSO, a scavenger of hydroxyl radicals, in a dose-dependent manner. When 2-NP nitronate was incubated with thymidine and horseradish peroxidase-H2O2, the formation of 2-NP dimer (2,3 dimethyl-2,3-dinitrobutane), a condensation product of 2-NP free radicals, was observed. This was accompanied by 2-NP nitronate-dependent oxidation of thymidine to thymidine glycol, thymine glycol, 5-hydroxymethyldeoxyuridine and thymine, indicating that hydroxyl radicals and/or other reactive oxygen species capable of causing thymidine damage are also formed in this reaction. As a working hypothesis, we suggest that the genotoxicity of 2-NP nitronate may be due to the generation of DNA-damaging reactive forms of oxygen or 2-NP free radicals. PMID- 3299070 TI - Detection of Trp-P-1 and Trp-P-2, carcinogenic tryptophan pyrolysis products, in dialysis fluid of patients with uremia. AB - In order to estimate the exposure levels of mutagenic and carcinogenic heterocyclic amines in humans, we developed a high-performance liquid chromatography method to detect 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp P-1) and 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2) in dialysis fluid of patients with uremia. Using this methods, dialysis fluid of 12 patients who had received hemodialysis treatment or continuous ambulatory peritoneal dialysis was examined. Trp-P-1 was detected in dialysate of all uremic patients (727 +/- 282 pmoles, n = 12). In patients who had been treated with continuous ambulatory peritoneal dialysis, the average amount of Trp-P-1 found in whole dialysate (6 l) per day was 710 +/- 203 pmoles (mean +/- S.D., n = 8). Moreover, Trp-P-2 could be detected in 5 out of 12 patients (206 +/- 85 pmoles, n = 5). These results indicate that patients with uremia are actually exposed to carcinogenic tryptophan pyrolysis products. The average exposure level of Trp-P-1 in uremic patients apparently exceeded 710 pmoles (150 ng) per day. PMID- 3299071 TI - Formation of mutagens, 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and 2-amino-3,4,8-trimethylimidazo[4,5-f]quinoxaline (4,8-DiMeIQx), in heated fish meats. AB - Fish meats were heated under conditions close to those used for cooking and processing. The mutagenic activity of the heated fish meats was estimated toward Salmonella typhimurium TA98 with metabolic activation after extraction with boiling water and adsorption to blue cotton. The numbers of His+ revertant colonies/5 g of the meat heat-dried without charring at 220 degrees C for 15 min were about 3000 for bonito, about 1000 for tunny, less than 500 for mackerel, salmon, swordfish, sardine, horse mackerel and cod, and 0 for cuttlefish. The mutagens in the heat-dried bonito meat were purified by thin-layer chromatography (TLC) and high-performance liquid chromatography (HPLC). They were identified as 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and 2-amino-3,4,8 trimethylimidazo[4,5-f]quinoxaline (4,8-DiMeIQx) by comparison with the authentic specimen with respect to Rf values in TLC, retention times in HPLC, ultraviolet absorption spectra and mass spectra. The contents of MeIQx and 4,8-DiMeIQx in the bonito meat were estimated to be 5.2 and 5.4 ng/g, respectively. The major mutagens produced in the bonito, tunny and mackerel meats heated without charring at 100 degrees C for 48 h and at 220 degrees C for 15 min were found to be MeIQx and 4,8-DiMeIQx. It is interesting to note that the bonito and sardine meats grilled with charring for 15 min contained MeIQx and 4,8-DiMeIQx but higher mutagenicity was observed in the fraction that may contain 2-amino-3 methylimidazo[4,5-f] quinoline (IQ), 2-amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ) and/or 2-aminodipyrido[1,2-a: 3',2'-d]imidazole (Glu-P-2). PMID- 3299072 TI - Kinetics of recB-dependent repair: relationship to post-UV inactivation of the prophage. AB - By making use of the temperature-sensitive mutant recB270, we showed that the RecBCD enzyme is needed for repair between 1 and 4 h after UV exposure. recB dependent prophage inactivation (Petranovic et al. (1984), Mol. Gen. Genet., 196, 167-169) takes place in all dying cells during the same period of time. The kinetics of decrease in the yield of recombinants in phage-propage crosses resemble those of prophage inactivation in UV-irradiated bacteria. This indicates that recombination processes (including site-specific recombination required for prophage excision) are blocked in cells destined to die. On the basis of our results, we suggest that a large fraction of damaged cells is rescued by the RecA RecBCD recombination pathway. If repair is unsuccessful, RecA-RecBCD recombination intermediates persist in the irradiated cells leading to prophage inactivation. PMID- 3299073 TI - The development of ideas about the effect of DNA repair on the induction of gene mutations and chromosomal aberrations by radiation and by chemicals. AB - An historical overview is given of the development of ideas about chromosomal and DNA repair as they relate to the induction of mutations, chromosomal aberrations, and sister-chromatid exchanges by radiations and chemicals. The genetic and molecular bases of the various repair pathways are reviewed whenever possible. Work on both prokaryotes and eukaryotes is included. Mention is made, when deemed appropriate, of major developments in other areas that served as essential background for the repair work, but no attempt is made to cover these background developments in any detail. Near the end, a brief review is given of factors affecting polymerase fidelity. The history is subdivided into approximately 10 year intervals. For the most part, references are to reviews and symposia in which the ideas of the time were brought together. The implications of these findings for some practical problems in genetic toxicology and for our understanding of the maintenance of the genome are discussed at the end. PMID- 3299074 TI - Reduced oxygen species, mutation, induction and cancer initiation. PMID- 3299075 TI - Structure-activity relationships for unsaturated dialdehydes. 1. The mutagenic activity of 18 compounds in the Salmonella/microsome assay. AB - A considerable number of terpenes that contain an "unsaturated dialdehyde" functionality, and possess various biological activities, such as antimicrobial activity, pungency, antifeedant activity, and/or mutagenicity, have been isolated from natural sources. However, large qualitative and quantitative activity differences have been observed for the natural unsaturated dialdehydes, and small structural changes (e.g., stereoisomerization) seem to dramatically affect the biological activity. As part of a general attempt to study structure-activity relationships for unsaturated dialdehydes, the activity of compounds 1-18 (Table 1) in the Salmonella/microsome assay (strains TA98, TA2637 and TA100) has been investigated. 10 of the compounds were found to possess direct-acting mutagenic activity, although the mutagenic potencies vary considerably in this group (from 430 to 0.32 revertants per nmole in the Salmonella strain TA2637). Some structural features that appear to moderate the activity are discussed. The necessity of an intact unsaturated dialdehyde functionality for the mutagenic activity of isovelleral (1) (see Scheme 1 for names, numbers, and chemical structures) in the Salmonella/microsome assay was demonstrated by chemical conversions: modification of either aldehyde group or reduction of the double bond led to loss of activity. PMID- 3299076 TI - Comparison between aqueous-phase and gas-phase exposure protocols for determining the mutagenic potential of nitrogen dioxide and the gas fraction of welding fumes. AB - Nitrogen dioxide and the gas fraction of welding fumes, a complex gas mixture which contains high concentrations of nitrogen dioxide, were tested for mutagenicity in Salmonella typhimurium tester strains, TA1535 and TA1538. A comparison between 2 exposure protocols, aqueous phase and gas phase, was made to evaluate the sensitivity of each in measuring the mutagenic potential of the gases. In the aqueous-phase exposure, a suspension of cells in an isotonic salt solution was exposed by bubbling the gas through the culture. In the gas-phase exposure, the plated cells were exposed to the gas in a chamber. For both gases tested, the gas-phase exposure resulted in a higher reversion frequency than the aqueous-phase exposure. Furthermore, we found that nitrogen dioxide accounted for only a fraction of the mutagenicity observed for the gas fraction of welding fumes. PMID- 3299077 TI - Genetic activity of trimethoprim in the Salmonella/microsomal screening system. AB - Trimethoprim, a widely used antibacterial drug was tested for its mutagenic potential in the Ames Salmonella/microsomal test system. The results indicated that, when used in the recommended dose range, the drug produced a several-fold increase in the reversion mutations on his(-)----his+ marker in some of the tester strains, compared with the spontaneous reversions. Dose-dependent curves were also obtained for reversion mutations caused by the drug. Ethyl methanesulfonate and benzo[alpha]pyrene were used a control mutagens. PMID- 3299078 TI - Effect of histamine H2-receptor antagonist therapy on the mutagenic activity of gastric juice. AB - There is concern at present that treatment with histamine H2-receptor antagonists might promote the development of gastric cancer by producing conditions which favour intragastric formation of N-nitroso compounds. If H2-receptor antagonist therapy causes increased intragastric levels of N-nitroso compounds, an issue not yet resolved by analytical studies, corresponding changes in the mutagenic activity of gastric juice might be anticipated. In this study mutagenic activity and pH were measured in fasting gastric aspirate from 18 peptic ulcer patients before and during the final week of therapy with ranitidine (n = 10) or cimetidine (n = 8). Mutagenic activity was assessed using Salmonella typhimurium TA98 and TA100 in a modified pre-incubation "fluctuation" test. No significant change in mutagenic activity was detected after therapy. Of 15 patients found to have significant mutagenic activity in their fasting gastric juice before treatment, 14 remained mutagenic following treatment. Mutation frequencies (sum of positive wells in duplicate 96-well microtitre plates, mean +/- SD) for TA98 and TA100 were respectively, 20 +/- 34 and 100 +/- 64 before compared with 10 +/- 6 and 102 +/- 65 after therapy (p greater than 0.05). Changes in mutagenic activity were similar in both treatment groups and unrelated to duration of therapy, changes in gastric pH or ulcer healing. In vitro, neither cimetidine in aqueous solution, nor gastric juice preincubated with cimetidine showed significant mutagenic activity. These results provide no evidence that increased intragastric levels of genotoxic chemicals, such as N-nitroso compounds, occur during H2-receptor antagonist therapy. PMID- 3299079 TI - The proper evaluation of bile acid mutagenicity by a fluctuation test. PMID- 3299080 TI - Lack of mutagenic activity of bile acids in bacterial fluctuation tests. PMID- 3299081 TI - Mutagenic reactivities of 3,4-dinitrobiphenyl derivatives. AB - 3,4-Dinitrobiphenyl derivatives were mutagenic in Salmonella typhimurium TA98, TA98/1,8-DNP6 and in TA98NR. We describe here the specific reactivity of 3,4 dinitrobiphenyl derivatives with diluted sodium hydroxide solution and the determination of the amounts of released nitrous ion. 3,4-Dinitrobiphenyl derivatives begin to release nitrous ions when treated with NaOH solution at a concentration of 10(-3) N. The behavior of 4NQO and o-dinitrobenzene was the same as that of 3,4-dinitrobiphenyl derivatives. The residues of 3,4-dinitrobiphenyl derivatives, after releasing nitrous ions, were estimated to be hydroxy nitrobiphenyls, as by GC/MS, we found the formation of o-nitrophenol in the reaction mixture of o-dinitrobenzene with aqueous NaOH solution. 3,4,4' Trinitrobiphenyl, 3,4,3',4'-tetranitrobiphenyl and 4NQO had reduced mutagenic potency in Salmonella typhimurium TA98 following treatment with diluted NaOH. In order to elucidate the ultimate forms of 3,4-dinitrobiphenyl derivatives, we investigated the reaction of o-dinitrobenzene as a basic model substance of 3,4 dinitrobiphenyl, with nucleic bases in the presence of NaOH in nonaqueous solvent. o-Nitrophenyl guanine and adenine adducts were obtained. PMID- 3299082 TI - Mutagenicity studies of alpha, alpha'-dihalomethylbenzenes, alpha-methylbenzyl halides, and 1-chloromethylpyrene in the Ames assay. PMID- 3299083 TI - Localization, biosynthesis, processing and isolation of a major 126 kDa antigen of the parasitophorous vacuole of Plasmodium falciparum. AB - Monoclonal antibodies prepared against a 50 kDa antigen found in Plasmodium falciparum culture supernatants identify a 126 kDa polypeptide which can be localized by immunofluorescence and immunoelectronmicroscopy at the periphery of the schizonts. This polypeptide is released from the infected erythrocytes by mild saponin lysis and is probably a component of the parasitophorous vacuole. Pulse chase kinetic analysis demonstrated its disappearance from the parasitized red blood cell from 6 to 10 h after being synthesized and the concomitant appearance of the 50 kDa molecule in the culture supernatant. Purification of metabolically labeled, schizont infected cells demonstrated that spontaneous release of merozoites is needed for the processing of the 126 to the 50 kDa whereas reinvasion is not. Polyclonal antibodies were raised in rabbit against affinity purified 126 kDa protein. These antibodies, together with another 126 kDa specific monoclonal antibody have enabled us to characterize two other cleavage products of the 126 kDa antigen in culture supernatants, namely 47 and 18 kDa polypeptides. We believe that the processing of the 126 kDa protein into low molecular weight fragments reflects a proteolytic event which may participate in merozoite release. PMID- 3299084 TI - Immunochemical characterization of the pyruvate dehydrogenase complex in adult Ascaris suum and its developing larvae. AB - Polyclonal antibody was prepared against the pyruvate dehydrogenase complex purified from adult Ascaris suum body wall muscle. The antibody reacted with the E2, X, alpha E1 and beta E1 subunits of the complex in immunoblots of mitochondrial supernatant fractions and homogenates of adult muscle. In addition, the same subunits were observed in immunoblots of homogenates of L3 and L4 ascarid larvae, suggesting that a similar enzyme complex was present in all developmental stages despite their marked differences in energy metabolism. The phosphorylated and dephosphorylated alpha E1 peptides migrated differently during sodium dodecylsulfate polyacrylamide gel electrophoresis and both forms of the enzyme were recognized by the antibody. These results and those obtained with ELISA suggest that both phosphorylated and dephosphorylated forms of the alpha E1 subunit react equally well with the antibody. In immunoblots of adult body wall muscle, the phosphorylated alpha E1 peptide predominated, while immunoblots of L3 larvae contained predominantly the dephosphorylated form. These results reflect the in vivo activity state of the pyruvate dehydrogenase complex in these two stages and suggest that this technique may be useful for determining the activity state of enzyme complex directly from immunoblots of homogenates A. suum and other helminths. PMID- 3299086 TI - Clinical and bacteriologic observations of a toxic shock-like syndrome due to Streptococcus pyogenes. PMID- 3299085 TI - Short-term metabolic effects of recombinant human insulin-like growth factor I in healthy adults. AB - Insulin-like growth factor I (IGF I) is structurally similar to insulin and shares many of its biologic properties. We compared the short-term metabolic effects of recombinant IGF I (100 micrograms [13.3 nmol] per kilogram of body weight) and insulin (0.15 IU [1 nmol] per kilogram) in eight healthy volunteers (four men and four women). The hypoglycemic responses to both hormones were nearly identical in the doses used. The lowest blood glucose levels were reached after 30 minutes: 1.98 +/- 0.44 mmol per liter after IGF I and 1.78 +/- 0.29 after insulin. On a molar basis, IGF I was only 6 percent as potent as insulin in the production of hypoglycemia. Insulin also inhibited lipolysis more effectively than IGF I. Levels of epinephrine, norepinephrine, growth hormone, glucagon, and cortisol responded similarly to both agents. The hypoglycemia produced by IGF I is probably due to the supraphysiologic concentrations of the free peptide that result from its rapid intravenous injection. Fifteen minutes after injection, the serum level of IGF I increased from 144 +/- 38 ng per milliliter at base line to 424 +/- 56, of which 80 percent was free in the plasma (not bound to IGF carrier proteins). The determination of whether any of the short-term metabolic effects of IGF I have any clinical application will require further investigation. PMID- 3299087 TI - Antibodies against the acetylcholine receptor in hematologic disorders: implications for the development of myasthenia gravis after bone marrow grafting. PMID- 3299088 TI - Financing the struggle against AIDS. PMID- 3299089 TI - The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. AB - We conducted a double-blind, placebo-controlled trial of the efficacy of oral azidothymidine (AZT) in 282 patients with the acquired immunodeficiency syndrome (AIDS) manifested by Pneumocystis carinii pneumonia alone, or with advanced AIDS related complex. The subjects were stratified according to numbers of T cells with CD4 surface markers and were randomly assigned to receive either 250 mg of AZT or placebo by mouth every four hours for a total of 24 weeks. One hundred forty-five subjects received AZT, and 137 received placebo. When the study was terminated, 27 subjects had completed 24 weeks of the study, 152 had completed 16 weeks, and the remainder had completed at least 8 weeks. Nineteen placebo recipients and 1 AZT recipient died during the study (P less than 0.001). Opportunistic infections developed in 45 subjects receiving placebo, as compared with 24 receiving AZT. The base-line Karnofsky performance score and weight increased significantly among AZT recipients (P less than 0.001). A statistically significant increase in the number of CD4 cells was noted in subjects receiving AZT (P less than 0.001). After 12 weeks, the number of CD4 cells declined to pretreatment values among AZT recipients with AIDS but not amonG AZT recipients with AIDS-related complex. Skin-test anergy was partially reversed in 29 percent of subjects receiving AZT, as compared with 9 percent of those receiving placebo (P less than 0.001). These data demonstrate that AZT administration can decrease mortality and the frequency of opportunistic infections in a selected group of subjects with AIDS or AIDS-related complex, at least over the 8 to 24 weeks of observation in this study. PMID- 3299090 TI - The toxicity of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. AB - We conducted a double-blind, placebo-controlled trial of oral azidothymidine (AZT) in 282 patients with the acquired immunodeficiency syndrome (AIDS) or AIDS related complex. Although significant clinical benefit was documented (N Engl J Med 1987; 317:185-91), serious adverse reactions, particularly bone marrow suppression, were observed. Nausea, myalgia, insomnia, and severe headaches were reported more frequently by recipients of AZT; macrocytosis developed within weeks in most of the AZT group. Anemia with hemoglobin levels below 7.5 g per deciliter developed in 24 percent of AZT recipients and 4 percent of placebo recipients (P less than 0.001). Twenty-one percent of AZT recipients and 4 percent of placebo recipients required multiple red-cell transfusions (P less than 0.001). Neutropenia (less than 500 cells per cubic millimeter) occurred in 16 percent of AZT recipients, as compared with 2 percent of placebo recipients (P less than 0.001). Subjects who entered the study with low CD4 lymphocyte counts, low serum vitamin B12 levels, anemia, or low neutrophil counts were more likely to have hematologic toxic effects. Concurrent use of acetaminophen was also associated with a higher frequency of hematologic toxicity. Although a subset of patients tolerated AZT for an extended period with few toxic effects, the drug should be administered with caution because of its toxicity and the limited experience with it to date. PMID- 3299091 TI - Current concepts: immunology. Idiotypes and idiotypic networks. PMID- 3299092 TI - Pathogenesis of infection with human immunodeficiency virus. PMID- 3299093 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 31-1987. A 50-year-old woman with a central nervous system disorder and renal failure two months after a renal transplant. PMID- 3299094 TI - Temporary use of the artificial heart before transplantation. PMID- 3299096 TI - Insulin resistance in essential hypertension. AB - High blood pressure is prevalent in obesity and in diabetes, both conditions with insulin resistance. To test whether hypertension is associated with insulin resistance independently of obesity and glucose intolerance, we measured insulin sensitivity (using the euglycemic insulin-clamp technique), glucose turnover (using [3H]glucose isotope dilution), and whole-body glucose oxidation (using indirect calorimetry) in 13 young subjects (38 +/- 2 years [+/- SEM]) with untreated essential hypertension (165 +/- 6/112 +/- 3 mm Hg), normal body weight, and normal glucose tolerance. In the postabsorptive state, all measures of glucose metabolism were normal. During steady-state euglycemic hyperinsulinemia (about 60 microU per milliliter), hepatic glucose production and lipolysis were effectively suppressed, and glucose oxidation and potassium disposal were normally stimulated. However, total insulin-induced glucose uptake was markedly impaired (3.80 +/- 0.32 vs. 6.31 +/- 0.42 mg per minute per kilogram of body weight in 11 age- and weight-matched controls, P less than 0.001). Thus, reduced nonoxidative glucose disposal (glycogen synthesis and glycolysis) accounted for virtually all the defect in overall glucose uptake (1.19 +/- 0.24 vs. 3.34 +/- 0.44 mg per minute per kilogram, P less than 0.001). Total glucose uptake was inversely related to systolic or mean blood pressure (r = 0.76 for both, P less than 0.001). These results provide preliminary evidence that essential hypertension is an insulin-resistant state. We conclude that this insulin resistance involves glucose but not lipid or potassium metabolism, is located in peripheral tissues but not the liver, is limited to nonoxidative pathways of intracellular glucose disposal, and is directly correlated with the severity of hypertension. PMID- 3299095 TI - Treatment of cryptococcal meningitis with combination amphotericin B and flucytosine for four as compared with six weeks. AB - One hundred ninety-four patients with cryptococcal meningitis were enrolled in a multicenter, prospective, randomized clinical trial to compare the efficacy and toxicity of four as compared with six weeks of combination amphotericin B and flucytosine therapy. Among 91 patients who met preestablished criteria for randomization, cure or improvement was noted in 75 percent of those treated for four weeks and in 85 percent of those treated for six weeks. The estimated relapse rate for the four-week regimen was higher--27 as compared with 16 percent -whereas the incidence of toxic effects for the two regimens was similar--44 as compared with 43 percent. Among 23 transplant recipients, 4 of 5 treated for four weeks relapsed, leading to the decision to treat the rest of the group for six weeks. Only 3 of the 18 treated for six weeks relapsed. In a third group of 80 patients, the protocol was not followed during the initial four weeks, and these patients were not randomized. Thirty-eight died or relapsed. Multifactorial analysis of pretreatment factors for all 194 patients identified three significant predictors (P less than 0.05) of a favorable response: headache as a symptom, normal mental status, and a cerebrospinal fluid white-cell count above 20 per cubic millimeter. These and other findings in this study are consistent with the view that the four-week regimen should be reserved for patients who have meningitis without neurologic complications, underlying disease, or immunosuppressive therapy; a pretreatment cerebrospinal fluid white-cell count above 20 per cubic millimeter and a serum cryptococcal antigen titer below 1:32; and at four weeks of therapy, a negative cerebrospinal fluid India ink preparation and serum and cerebrospinal fluid cryptococcal-antigen titers below 1:8. Patients who do not meet these criteria should receive at least six weeks of therapy. PMID- 3299097 TI - The Federal regulation of medical devices. PMID- 3299098 TI - Insulin and hypertension: lessons from obesity. PMID- 3299101 TI - The relationship between insulin sensitivity and weight reduction in simple obese and obese diabetic patients. PMID- 3299099 TI - Influence of mucosal cell origin on the in vitro adherence of Candida albicans: are mucosal cells from different sources equivalent? AB - The influence of collecting mucosal cells from various anatomical sites, and varying the date of collection and cell donor on adhesion of Candida albicans to human epithelial cells was examined by using an in vitro adherence assay. Examination of buccal mucosal cells from twenty-four donors showed statistically significant differences in the number of attached yeasts between individuals. Sex did not exert a significant influence on adhesion. Examination of buccal mucosal cells from ten donors collected on five different dates revealed that yeast attachment to mucosal epithelial cells varied significantly within subjects across time. Epithelial cells from some donors manifested greater date-to-date variations in yeast adhesion than others. Adherence of Candida to mucosal cells from three anatomical sites (mouth, vagina and urinary tract) collected from ten different donors was also tested. Yeast adherence to buccal cells was highest, lowest using urinary tract cells, while vaginal epithelium was intermediate. Adherence to mucosal cells from three sites was significantly different both within and between individuals although some subjects manifested larger variations than others. These data suggest that the in vitro adherence of Candida albicans is influenced by mucosal cell donor, date of collection and body site of origin. Mucosal cells from different sources do not appear to be equivalent in receptiveness to C. albicans and this might explain some of the discrepancies observed when adhesion studies performed by different investigators are compared. The existing need for a more uniform methodology with which to pursue studies on fungal attachment to mucosal surfaces is emphasized. PMID- 3299102 TI - Where next? The Second Daisy Memorial Lecture. PMID- 3299100 TI - Circulating IgG antibodies against fungal and actinomycete antigens in the sera of farmer's lung patients from different countries. AB - Sixty-nine farmer's lung patients and 28 normal controls from four countries (Finland, Switzerland, Canada and the United States) were investigated for antibody levels against 13 antigens commonly used for the screening panel for hypersensitivity pneumonitis. Of these antigens, eight were from the Medical College of Wisconsin (United States) and five were from the University of Kuopio (Finland). IgG antibodies against these antigens were studied in 97 sera using a sensitive biotin-avidin-linked enzyme immunoassay. The results indicate that the mean antibody titer against Micropolyspora faeni was highest in the United States (U.S.) followed by Finland. Both Finnish and U.S. antigens reacted almost identically against various groups of patients, although the degree of reactivity varied considerably. Higher antibody levels against Thermoactinomyces vulgaris were detected in Finnish patients than patients from other countries while patients from all four countries showed elevated levels of antibodies against T. candidus. This study demonstrates that antigens from identical species, irrespective of geographic origin, reacted similarly. However, variability between antigens of the same species was still considerably significant. Since the microbiological flora of moldy hay varies widely in different regions, the microbial species associated with the disease at a given geographical area has to be determined before selecting antigens for serological studies. The antigens currently used in various laboratories are crude preparations and need to be purified and standardized for dependable results. Until such antigens are available, all antigenic preparations used in the immunological evaluation of patients should be immunochemically characterized for their reproducibility and reliability although the ultimate goal should be to obtain standardized pure antigens for dependable immunodiagnosis of farmer's lung. PMID- 3299103 TI - Microwave absorption in aqueous solutions of DNA. AB - In a recent Nature leading article the possibility of the occurrence of resonance absorption at microwave frequencies in DNA was discussed in terms of the latest available theoretical and experimental evidence, and its implications were assessed. Because of the far-reaching nature of these implications it is important that the existence or otherwise of such absorption be firmly established. Here we report on a concerted effort in two independent laboratories which has involved the measurement of the dielectric properties of aqueous solutions of circular DNA molecules in the frequency range 1-10 GHz. No resonance absorption or any form of enhanced absorption was demonstrated. PMID- 3299104 TI - Evidence for the involvement of ATP in co-translational protein translocation. AB - Identification of the source of energy for protein translocation across biological membranes is important in understanding the mechanism of this process. In eukaryotic cells, the tight coupling between translation and translocation and firm attachment of the secreting ribosomes to membranes, as well as theoretical calculations, have led to the suggestion that energy derived from protein synthesis is sufficient for protein translocation. On the other hand, in bacterial systems neither the attachment of ribosomes to membrane (other than nascent chains) nor tight coupling of translocation to translocation has been observed. Moreover, certain proteins can be translocated across membranes either at the time of, or after, translation. The separation of protein translocation from translation has made possible the demonstration that ATP hydrolysis is essential for post-translational protein translocation across bacterial membranes and, more recently, also across canine and yeast endoplasmic reticulum membranes. Here we report that certain ATP analogues inhibit co-translational protein translocation at concentrations that do not interfere with protein synthesis, suggesting that ATP is also required for co-translational protein translocation. PMID- 3299105 TI - Malaria vaccines. Are they approaching reality? PMID- 3299106 TI - Genetic evidence that zinc is an essential co-factor in the DNA binding domain of GAL4 protein. AB - The 'cysteine-zinc DNA binding finger' is a recently identified sequence motif that is present in a wide variety of transcriptional regulatory proteins and is thought to be directly involved in DNA binding. It has been proposed that an essential component of this structure is a zinc ion bound between two pairs of cysteine residues. The GAL4-encoded protein of Saccharomyces cerevisiae, which binds to DNA and activates the transcription of several genes, contains this sequence motif. Here I describe a gal4 mutant with an alteration in the cysteine zinc DNA binding finger whose defect is corrected in vivo by high concentrations of ZnCl2. The DNA binding activity of the altered protein from this mutant is restored by ZnCl2 in vitro. This is evidence that the GAL4 protein indeed contains zinc ions essential for its DNA binding activity. PMID- 3299107 TI - A distant enhancer element is required for polymerase III transcription of a U6 RNA gene. AB - U RNAs are highly abundant small nuclear RNAs involved in the processing of messenger RNA. Most U RNA genes are thought to be transcribed by RNA polymerase II (pol II). However, evidence has recently been presented that U6 RNA genes are transcribed by RNA polymerase III (pol III). In the light of these results it was surprising to find that the 5' flanking region of a mouse U6 RNA gene includes a perfect copy of the octamer sequence motif, ATTTGCAT, found in many RNA polymerase II transcription enhancer elements. In the present study we show that deletion of mouse U6 gene sequences upstream of nucleotide position -217, including the octanucleotide motif, reduces U6 transcription by 90% when assayed in Xenopus laevis oocytes, suggesting the presence of a distant control element. DNase I footprinting of the 5' flanking region of the U6 gene shows protection of the octanucleotide sequence. Moreover, the 5' flanking sequence from -217 to -315 can replace the enhancer of a human U2 RNA gene. We therefore conclude that although U6 RNA genes appear to be transcribed by pol III, they are preceeded by an enhancer-like element which can functionally substitute for the enhancer of a pol II-transcribed U RNA gene. PMID- 3299108 TI - The role of heteroduplex correction in gene conversion in Saccharomyces cerevisiae. AB - Two different models have been proposed to explain the relative frequencies of the non-mendelian allelic segregations which are detected by tetrad analysis after meiosis in fungi. The first model maintains that 6:2 type tetrads result from correction of heteroduplexes containing mismatched sites and 5:3 type tetrads result from failure to correct mismatched sites. The second model suggests that 6:2 segregations result from the filling-in of double-strand gaps using information obtained from both strands of a homologous duplex. In this model 5:3 type tetrads result if the allele is included in the heteroduplex regions flanking the gap and the resulting mismatched nucleotides are not corrected. We have studied the correction of heteroduplex plasmid DNA in pms1 mutant strains of Saccharomyces cerevisiae, which are known to exhibit higher frequencies of 5:3 type tetrads and lower frequencies of 6:2 tetrads than wild type strains. Our results suggest that the pms1 mutation causes a defect in mismatch correction, supporting the hypothesis that meiotic gene conversion in wild-type yeast cells often results from the correction of heteroduplex DNA. PMID- 3299109 TI - [Euthanasia; comparison of the current discussions in the Netherlands with discussions in Germany before 1933]. PMID- 3299110 TI - [Immunosuppressive treatment in multiple sclerosis]. PMID- 3299111 TI - Obstetrical ultrasound: the role of ultrasound in the term and post-term pregnancy. PMID- 3299112 TI - Hypoproteinaemia, a menace to the blood volume? PMID- 3299113 TI - Cerebral ischaemia and stroke as side effects of antihypertensive treatment; special danger in the elderly. A review of the cases reported in the literature. PMID- 3299114 TI - Water quality--a neglected problem in hemodialysis. PMID- 3299115 TI - beta 2-Microglobulin-derived amyloid deposition in acquired cystic disease of the kidney with renal cell carcinoma. PMID- 3299116 TI - Effect of calcitriol in the control of plasma calcium after parathyroidectomy. A placebo-controlled, double-blind study in chronic hemodialysis patients. AB - Severe, prolonged hypocalcemia in observed in some, but not all, hemodialysis patients after parathyroidectomy performed because of uncontrolled hyperparathyroidism. The aim of the present study was to investigate whether calcitriol and calcium supplementation in the immediate period after parathyroidectomy (days 1-14) was of more help in the control of plasma calcium than calcium supplementation alone. Fourteen hemodialysis patients were enrolled in a prospective, randomized, double-blind and placebo-controlled study. From the day after parathyroidectomy, 7 patients received calcitriol and the remaining 7 a placebo using incremental doses adjusted to the degree of hypocalcemia (up to 4 micrograms/day for calcitriol). Plasma calcium, phosphorus, alkaline phosphatase and immunoreactive parathyroid hormone levels before parathyroidectomy were comparable in both patients groups, as was the lowest plasma calcium achieved after parathyroidectomy. The decrease in plasma calcium after parathyroidectomy was related to plasma alkaline phosphatase and to the number of osteoclasts and osteoblasts on bone biopsy surface before parathyroidectomy. The mean decrement of plasma calcium (days 3-9) as compared to that before parathyroidectomy was less pronounced in calcitriol-treated than in placebo-treated patients (0.25 +/- 0.06 versus 0.45 +/- 0.05 mM, mean +/- SEM, p less than 0.025). Treatment with placebo was interrupted before day 14 because of persistent severe hypocalcemia in 4 of 7 patients, whereas calcitriol treatment was continued in all 7 patients up to 14 days. Patients on calcitriol treatment required less mean calcium supplements (days 1-9) than patients receiving placebo (37.4 +/- 3.2 versus 49.4 +/- 3.7 g, p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299117 TI - Allograft antiglomerular basement membrane glomerulonephritis in a patient with Alport's syndrome. AB - A patient with Alport's syndrome and chronic renal failure received a cadaver kidney graft. Six months after the transplantation he developed 'de novo' crescentic glomerulonephritis mediated by antiglomerular basement membrane antibodies. This rare complication may be attributed to sensitization against usual antigenic determinants of the graft glomerular basement membrane. PMID- 3299119 TI - Dialysis-associated amyloidosis in a patient on long-term post-dilutional hemofiltration. PMID- 3299118 TI - Carbamylation of insulin and its biological activity. AB - A nonspecific binding reaction between cyanic acid formed from urea and protein or peptide is called carbamylation. In the present study, insulin, a peptide hormone, was subjected to carbamylation and the activity of carbamylated insulin was determined. Both immunological and biological activities of insulin changed on carbamylation. The decrease in biological activity in respect to glucose oxidation of fat cells or receptor-binding capacity of rat hepatocytes was greater than that in immunological activity. PMID- 3299120 TI - Antiproteinuric effect of captopril in primary glomerular disease. PMID- 3299121 TI - The islets of Langerhans in uremic patients receiving chronic hemodialysis. AB - Ten autopsied cases of uremia (none with diabetes mellitus) who had been treated with hemodialysis were studied histopathologically. Hyaline replacement of islets of Langerhans was found in 6 out of 10 cases, while such a change was observed in only 1 of 15 control non hemodialzyed controls. These 6 cases had received hemodialysis therapy for a duration of more than 2 years and 10 months. The hyaline material in the islets of Langerhans was confirmed as the presence of amyloid by electron microscopy. Clinically, urinary glucose was present in 1 out of 3 patients and the blood glucose level was moderately elevated in 2 other cases. Therefore, it should be emphasized that care should be taken about glucose tolerance in uremic patients receiving chronic hemodialysis. PMID- 3299122 TI - Circulating hyaluronate. A potential marker of altered metabolism of the connective tissue in uremia. AB - Hyaluronate, a glycosaminoglycan of connective tissue matrix, was measured in serum by radioassay in patients with renal insufficiency (n = 22) and with end stage renal failure (n = 40). The serum hyaluronate levels were significantly increased in both groups compared with the levels measured in age- and sex matched healthy controls. Significant correlations were found between serum hyaluronate and degree of impaired renal function. None of the patients had laboratory signs indicating affection of the liver, the major elimination route for circulating hyaluronate. No significant alteration of hyaluronate levels was seen during hemodialysis. Renal transplants, previously on dialysis treatment, had normal serum hyaluronate values. Data obtained indicate either an essential role of the kidneys for the elimination of circulating hyaluronate or an increased outflow of hyaluronate to the circulation in uremia or a combination of these two possibilities. The altered metabolism of hyaluronate in uremia was not only related to the azothemic state but also to the age of the patients. The mechanism may be qualitively similar to that underlying the age-dependent increase of serum hyaluronate seen in health. The hypothesis that elevated serum hyaluronate in uremia may reflect an accelerated ageing of the connective tissue is highly speculative, but has some support by the finding that cardiovascular and other clinical symptoms were linked to particularly high serum levels of hyaluronate. PMID- 3299123 TI - Idiopathic membranous nephropathy in two brothers. AB - Idiopathic membranous nephropathy has been reported rarely to develop in genetic association with certain HLA antigens. This paper describes two male siblings presenting with nephrotic syndrome with histologically proven membranous nephropathy. The younger brother maintained a normal renal function with slight proteinuria during the 3 years of follow-up, but the older one experienced a rapid decline in renal function and had to be put on maintenance hemodialysis. No clinical evidence of contributory underlying disease such as malignancy or systemic lupus erythematosus could be found. HLA typing was carried out in the two patients and in members of their family. Several HLA antigens were found to be shared by the two patients. However, the HLA antigens which have been reported to be associated with idiopathic membranous nephropathy were not found in either of them. PMID- 3299124 TI - Immunoelectron microscopic study of glomerular lesions using a postembedding method with a protein A-gold complex. AB - Renal biopsy tissue from 33 children with various glomerular diseases has been investigated by electron microscopy using a postembedding immunostaining technique with a protein A-gold complex in order to establish more precise correlations between immunopathologic and morphologic findings in glomeruli. This technique could detect immunoglobulins (IgG, IgA, and IgM), complement factor (C3c), and fibrinogen-related antigen. The immunoreactivity of these antigens was essentially confined to the mesangial, paramesangial, subendothelial, and subepithelial 'electron-dense deposits' in the glomeruli. Except for IgM and C3c in the case of glomerular sclerosis, the distribution of the mentioned factors was even in the electron-dense deposits, as could be shown by 'double immunolabeling'. From the above-mentioned findings one can conclude that several of the localized factors are associated with the formation of electron-dense deposits, the ultrastructural hallmarks of glomerular disease. PMID- 3299125 TI - [Neurosurgical treatment of trigeminal neuralgia. Direct approach of percutaneous method?]. AB - During the fifteen past years, the treatment of trigeminal neuralgia resistant to medical therapy has benefited from several neurosurgical techniques, either with percutaneous methods (RF-thermorhizotomy, cisternal injection of glycerol, balloon compression of the gasserian ganglion) or direct approach (microsurgical selective section of pars major, microvascular decompression). The respective advantages and disadvantages of these techniques are presented, both from the authors' experience (609 thermocoagulations, 150 direct approaches in the cerebello-pontine angle) and a review of some important series of the literature. PMID- 3299126 TI - In memoriam. Dr. Arthur Cherkin. PMID- 3299127 TI - Quest for a reliable, valid, and sensitive in situ hybridization procedure to detect viral nucleic acids in the central nervous system. AB - In situ hybridization (ISH) to detect and to quantitate viral nucleic acid sequences in cryopreserved central nervous system (CNS) tissue is a reliable, valid and sensitive molecular technique. On the other hand, utilization of formaldehyde fixed paraffin embedded (FFPE) tissue to improve cytomorphology requires fundamental changes in the procedure since it is necessary to cleave the elaborate protein network cross-linked by formaldehyde using elevated concentrations of proteinases in order to permit diffusion of complementary DNA probes to the targets (genomic viral nucleic acid sequences and/or viral mRNA). Adversely, this procedure hydrolyzed the proteinaceous glues generally used to fix tissue to glass slides resulting in loss of tissue sections during the ISH protocol. This report describes the application of a novel procedure utilizing a silano-organic compound to covalently bond to glass slides FFPE sections as well as cryopreserved tissue sections and cultured cells with and without virus infections. This covalent bonding procedure has permitted optimization of the ISH procedure for virus detection and quantification, especially for exploratory studies of specificity and wash stringency in relation to the Tm of the hybridized product. Progressive multifocal leucoencephalopathy (PML) caused by an opportunistic papovavirus (JC) was chosen because of the ready availability of tissue, stability of papovavirus nucleic acids, and specificity of 3H- and 35S radiolabeled JC cloned DNA probes. Further, this laboratory is utilizing the optimized sensitive procedure to search for several virus etiologies in human diseases such as multiple sclerosis, temporal lobe epilepsy, Alzheimer's disease, schizophrenia, and Parkinson's disease, as well as normal aging.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299128 TI - [Surgical treatment of occlusion of the middle cerebral artery]. PMID- 3299129 TI - Effect of synthetic neuromedin-N, a novel neurotensin-like peptide, on exocrine pancreatic secretion and splanchnic blood flow in dogs. AB - Neuromedin-N, a novel neurotensin-like peptide, has recently been identified from porcine spinal cord by using a bioassay for a stimulatory effect on guinea pig ileum. The amino acid sequence of the peptide has been determined to be Lys-Ile Pro-Tyr-Ile-Leu, which is quite homologous to the COOH-terminal sequence of neurotensin. In this study, the effect of neuromedin-N on pancreas and splanchnic blood flow was investigated in eight dogs. Intravenous injections of graded doses of synthetic neuromedin-N caused a dose-dependent decrease of systemic arterial pressure and a dose-dependent increase in both portal and superior mesenteric arterial blood flow, which were measured with transit time ultrasonic flow meter. Volume and protein output of the pancreatic juice were also increased significantly by Neuromedin-N. Pancreatic capillary blood flow measured with laser Doppler flowmetry was increased in a dose-related manner. The present study first demonstrated that neuromedin-N retains a potent stimulatory effect on the pancreas and splanchnic circulation, indicating that this peptide is one of the biological active forms of neurotensin-like peptide in mammals. This study also leads to the suggestion that this peptide possesses physiological significance as a novel neuropeptide. PMID- 3299130 TI - Prevention of deep venous thrombosis in patients with acute spinal cord injuries: use of rotating treatment tables. AB - A randomized clinical trial of 15 patients with acute spinal cord injuries was performed to test the hypothesis that rotating treatment tables prevent deep venous thrombosis in this population. Four of 5 control (nonrotated) patients developed distal and proximal thrombi, assessed by 125I fibrinogen leg scans and impedance plethysmography. In comparison, only 1 of 10 treated (rotated) patients developed both distal and proximal thrombosis (P = 0.007). These results suggest but do not prove that rotating treatment tables prevent the development of proximal deep venous thrombosis in spinal cord-injured patients. Larger clinical trials are needed to confirm this heretofore undocumented benefit of rotating treatment tables. PMID- 3299131 TI - Extradural lymphoma presenting as an acute surgical emergency. AB - Extradural lymphoma can present as an acute neurosurgical emergency. The clinical presentation and radiological appearance may suggest epidural hematoma or meningioma. Lymphoma should be considered as a rare but possible diagnosis before operation. High resolution computed tomography using direct coronal imaging with and without contrast enhancement may aid in suggesting the correct preoperative diagnosis. PMID- 3299132 TI - Charles Albert Elsberg, M.D. (1871-1948): father of spinal cord surgery. PMID- 3299133 TI - Physiology of higher nervous activity: prospects of its development. PMID- 3299134 TI - Anatomical distribution and ultrastructural organization of the GABAergic system in the rat spinal cord. An immunocytochemical study using anti-GABA antibodies. AB - gamma-Aminobutyric acid (GABA)-containing elements have been studied by light and electron microscopy in the rat spinal cord, using immunocytochemistry with anti GABA antibodies. Light microscopy showed immunoreactive somata localized principally in laminae I-III, and occasionally in the deeper laminae of the dorsal horn and in the ventral horn. Small somata were also observed around the central canal. Punctate GABA-immunoreactive profiles were particularly concentrated in laminae I-III, and moderately abundant in the deeper laminae and in the ventral horn where they were observed surrounding the unlabelled motoneurons. At the ultrastructural level, the punctate profiles corresponded to GABA-containing axonal varicosities or small dendrites. GABA-immunoreactive varicosities were presynaptic to labelled or unlabelled dendrites and cell bodies. Some unlabelled terminals presynaptic to unlabelled dendrites received symmetrical synaptic contacts from GABA-immunoreactive terminals. These results confirm data obtained with L-glutamate decarboxylase immunocytochemistry, and support the role of GABA in pre- and postsynaptic inhibition in the spinal cord, respectively via axoaxonal and axosomatic or axodendritic synapses. PMID- 3299135 TI - The neuronal growth cone: a review of its locomotory, navigational and target recognition capabilities. PMID- 3299136 TI - Immunohistochemical localization of cytochrome P-450 in rat brain. AB - The presence of cytochrome P-450 in rat brain was studied by immunohistochemistry, using antibodies to cytochrome P-450 purified from livers of phenobarbital- or 3-methylcholanthrene-treated rats. Immunoreactive nerves were observed only in brain sections incubated with immunoglobulin-G to 3 methylcholanthrene-induced cytochrome P-450. This immunoreactivity was abolished by preabsorption of the antibody with highly purified rat liver cytochrome P 450c, the major cytochrome P-450 isozyme induced by 3-methylcholanthrene, but was not affected by other cytochrome P-450 isozymes induced by phenobarbital, isosafrole or pregnenolone-16 alpha-carbonitrile. The most abundant concentration of nerve fibers with cytochrome P-450 immunoreactivity was observed in the globus pallidus. Immunoreactive fibers were also observed in the caudate putamen, amygdala, septum, ventromedial nucleus of the hypothalamus, medial forebrain bundle, ansa lenticularis, and ventromedial portion of the internal capsule and crus cerebri. Cell bodies with cytochrome P-450 immunoreactivity were observed in the caudate putamen and in the perifornical area of the hypothalamus. The cytochrome P-450 immunoreactive fibers in the globus pallidus and caudate putamen do not appear to emanate from cell bodies in the substantia nigra, since there was no reduction in the density of these fibers after unilateral stereotaxic electrolytic destruction of the substantia nigra (zona compacta and reticulata). Our data suggest that these striatal nerve processes are derived from cell bodies within the caudate putamen itself. The present results indicate that rat brain contains a form of cytochrome P-450 with antigenic relatedness to the hepatic 3 methylcholanthrene-inducible cytochrome P-450c.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299137 TI - Evidence for the coexistence and co-release of [Met]enkephalin and noradrenaline from sympathetic nerves of the bovine vas deferens. AB - The localization and neurosecretion of methionine-enkephalin was studied in sympathetic nerves of the bovine vas deferens. Immunostaining showed methionine enkephalin-like immunoreactivity in a network of varicose nerve fibres in the smooth muscle layers of the vas deferens. When vas deferens homogenates were subjected to differential and sucrose density gradient centrifugation, methionine enkephalin was found to parallel the distribution of noradrenaline in the more dense region of the gradient, where "heavy" or large dense-cored vesicles are present. Electron microscopic immunochemistry confirmed this finding and showed methionine-enkephalin-like immunoreactivity in large dense-cored vesicles. The release of methionine-enkephalin upon electrical stimulation was studied in superfusion experiments. The methionine-enkephalin secretion was shown to be Ca2+ dependent and was inhibited by adding the adrenergic neuron blocking drug guanethidine to the superfusion medium. We conclude that in the bovine vas deferens methionine-enkephalin is only present in large dense-cored vesicles of adrenergic neurons and that the peptide is released from these vesicles together with noradrenaline by a Ca2+-dependent mechanism. PMID- 3299138 TI - Distribution of cholinergic neurons and fibers in the hypothalamus of the rat using choline acetyltransferase as a marker. AB - The distribution of choline-acetyltransferase-like immunoreactive structures in the rat hypothalamus and preoptic area was examined by using avidin-biotin immunocytochemistry. We found that the hypothalamus is richly innervated by the cholinergic neuron system. Sites containing cholinergic neurons of varying density were: medial and lateral preoptic areas, septohypothalamic nucleus, median preoptic area, lateral hypothalamus including the perifornical area, anterior hypothalamic nucleus, arcuate nucleus, dorsomedial hypothalamic nucleus, posterior hypothalamic nucleus, dorsal and ventral premammillary nuclei, neuropil mediodorsal to the anterior hypothalamic nucleus, neuropil ventral to the anterior hypothalamic nucleus and ventromedial hypothalamic nucleus, neuropil between lateral hypothalamus and ventromedial hypothalamus, and neuropil between dorsal premammillary nucleus and posterior hypothalamic nucleus. There were also many varicose and non-varicose fibers in the preoptic area and hypothalamus. Two kinds of varicose fibers, one with strong immunoreactivity and the other with weak immunoreactivity, were seen. Non-varicose fibers were also detected in the optic chiasma and habenulo-interpeduncular tract. These fibers were passing fibers. PMID- 3299139 TI - Local circuit neurons in the rat ventrobasal thalamus--a GABA immunocytochemical study. AB - The ventrobasal thalamus of seven rats was processed for immunocytochemistry using antisera to glutamate decarboxylase or gamma-aminobutyrate (GABA). Glutamate decarboxylase-stained sections showed a network of stained fibers and terminals but no stained cell bodies. GABA-stained sections had fewer stained fibers and terminals but did show a few stained cell bodies. Cell bodies were especially apparent when carbazole was used for a chromogen for the peroxidase antiperoxidase visualization. The GABA-stained cells were found to be distributed throughout the ventrobasal complex, to have smaller soma cross-sectional areas than most other cells (81 +/- 34 microns vs 105 +/- 36 microns for all cells) and to make up 0.4 +/- 0.3% of the neuronal population of the ventrobasal complex. Injections of horseradish peroxidase into the somatosensory cortex (SI) retrogradely filled many neurons in the ventrobasal thalamus, but none of these labeled neurons were double labeled with GABA. These results indicate that the GABA-labeled cells probably represent a small population of local circuit neurons in the rat ventrobasal thalamus. PMID- 3299140 TI - gamma-Aminobutyric acid and 5-hydroxytryptamine interrelationship in the rat nucleus raphe dorsalis: combination of radioautographic and immunocytochemical techniques at light and electron microscopy levels. AB - Serotonin and gamma-aminobutyric acid (GABA) neurons in the nucleus raphe dorsalis were identified by immunocytochemistry using antibodies to 5 hydroxytryptamine or GABA. The pattern of the 5-hydroxytryptamine and GABA immunostaining presented similar features: 5-hydroxytryptamine or GABA immunoreactive somata were fusiform or ovoid (15-20 micron) and positive dendritic profiles were found either without any connection with other nerve elements or in contact with one or several terminals. In addition, some 5 hydroxytryptamine nerve endings were apposed to 5-hydroxytryptamine immunoreactive cell bodies or dendrites; also some GABA-immunopositive terminals were in contact with GABA-immunopositive nerve cell bodies. On the other hand, GABA and 5-hydroxytryptamine patterns may be differentiated in several respects: the 5-hydroxytryptamine-reactive nerve cell bodies were more numerous than the GABA ones. Some small, round (8-10 micron) nerve cell bodies were reactive with GABA antiserum, but no neurons of this type were reactive with a 5 hydroxytryptamine antiserum; finally, GABA nerve terminals were more numerous than 5-hydroxytryptamine ones. In order to understand the relationship between GABA and 5-hydroxytryptamine neurons, radioautographic and immunocytochemical procedures were combined: 5-hydroxytryptamine and GABA immunocytochemistry was combined with radioautography of [3H]GABA and [3H]5-hydroxytryptamine uptake, respectively. Some nerve cell bodies, dendrites or terminals, which were 5 hydroxytryptamine-immunopositive, were also capable of accumulating [3H]GABA and, conversely, some GABA-immunopositive elements were capable of accumulating [3H]5 hydroxytryptamine. Moreover, several nerve elements were reactive with both glutamate decarboxylase and 5-hydroxytryptamine antisera. These data confirm in electron microscopy previous studies suggesting the coexistence of both GABA and 5-hydroxytryptamine in the same neurons. The presence of uptake mechanisms for GABA and 5-hydroxytryptamine may indicate the action of both neurotransmitters in the same neuron. On the other hand, the [3H]GABA-labelled nerve endings in contact with 5-hydroxytryptamine-positive dendrites or nerve cell bodies indicate the possibility of a GABAergic control of the activity of some 5 hydroxytryptamine neurons; this corroborates biochemical and electrophysiological studies whereby a trans-synaptic control of the 5-hydroxytryptamine neurons by GABA may be envisaged. PMID- 3299141 TI - Localization of L-glutamate decarboxylase and GABA transaminase immunoreactivity in the sympathetic ganglia of the rat. AB - The location of L-glutamate decarboxylase and gamma-aminobutyrate (GABA) transaminase immunoreactivity in the superior cervical ganglion and in the coeliac-superior mesenteric ganglion complex of the rat was studied by an indirect immunofluorescence method and by immunoelectron microscopy, with specific antisera raised in rabbits against the corresponding enzymes. In light microscopy, several glutamate decarboxylase- or GABA-transaminase-immunoreactive principal nerve cells were detected in the superior cervical ganglion and coeliac superior mesenteric ganglion complex. In addition, numerous small cells in both the superior cervical ganglion and coeliac-superior mesenteric ganglion complex showed intense immunoreactivity to glutamate decarboxylase or GABA-transaminase. The small cells were 10-20 micron in diameter and resembled in size and morphology the small intensely fluorescent cells. In consecutive sections, the small glutamate decarboxylase-immunoreactive cell clusters also showed immunoreactivity to tyrosine hydroxylase, suggesting that these cells contain the enzymes for both GABA and catecholamine synthesis. In the superior cervical ganglion and in the coeliac-superior mesenteric ganglion complex, GABA transaminase immunoreactivity was also localized in fibre-like processes around and between the principal nerve cells, in nerve trunks traversing the ganglia, and around or in close contact with ganglionic blood vessels. Furthermore, GABA transaminase immunoreactivity was observed in fibre-like structures close to the capsule of the ganglia. Division of the preganglionic nerve trunk of the superior cervical ganglion caused no detectable change in GABA-transaminase immunoreactivity in the ganglion. In immunoelectron microscopy of the superior cervical ganglion, GABA-transaminase immunoreactivity was localized in nerve fibres in association with neurotubules. A large number of GABA-transaminase labelled principal nerve cells were detected, containing immunoreactivity evenly distributed in their cytoplasm. GABA-transaminase immunoreactivity was also observed in satellite cells and their processes in the superior cervical ganglion. The present immunocytochemical results provide evidence that the rat sympathetic ganglia contain an intrinsic neuronal system showing histochemical markers for GABA synthesis and inactivation, but its functional role in the modulation of ganglionic neurotransmission remains to be established. PMID- 3299142 TI - [Met5]enkephalin-Arg6-Phe7- and [Met5]enkephalin-Arg6-Gly7-Leu8-immunoreactive nerve fibres and neurons in the superior cervical ganglion of the rat. AB - [Met5]enkephalin-Arg6-Phe7-(MEAP-) and [Met5]enkephalin-Arg6-Gly7-Leu8-(MEAGL-) immunoreactivity was studied by indirect immunohistochemistry in the superior cervical ganglion of the rat with specific antisera produced in rabbits against the corresponding synthetic opioid peptides. Several MEAP- and a few MEAGL immunoreactive principal nerve cells were observed in the ganglion, while the small intensely fluorescent cells appeared as non-reactive. The superior cervical ganglion also contained dense networks of MEAP- and MEAGL-immunoreactive nerve fibres, which often formed basket-like structures around the principal nerve cells and small intensely fluorescent cells. After ligation of the preganglionic nerve trunk with simultaneous transection of the main postganglionic trunks, a distinct accumulation of both MEAP- and MEAGL-immunoreactivity was observed on both sides of the ligature. Ligation of the preganglionic nerve trunk caused a marked decrease in the number of both MEAP- and MEAGL-immunoreactive nerve fibres in the ganglion. Ligation of the main postganglionic nerve trunks with simultaneous preganglionic nerve division resulted in accumulation of MEAP- and MEAGL-immunoreactive material on the ganglionic side of the ligature in both the external and internal carotid nerve. After division of both the pre- and postganglionic nerve trunks, some immunoreactive nerve fibres and principal nerve cells were still observed in the ganglion. A few immunoreactive neurons and nerve fibres were also observed in the ganglion stellatum. A large number of MEAP- and MEAGL-immunoreactive nerve fibres was detected in the spinal cord at the levels C6-Th6. A few neurons in the intermediolateral cell column of the spinal cord at levels C8-Th1 showed MEAP- but not MEAGL-immunoreactivity. The cultured superior cervical ganglion contained a few MEAP-immunoreactive neurons, and the fibre outgrowth showed immunoreactivity both to MEAP and MEAGL. In electron microscopy, MEAGL-immunoreactivity in the superior cervical ganglion was localized in nerve fibres containing neurotubules and in principal nerve cells. The present results demonstrate that the rat superior cervical ganglion contains both extrinsic and intrinsic MEAP- and MEAGL-immunoreactive nerve fibres. Most of these fibres are of preganglionic origin. Both the principal nerve and small intensely fluorescent cells are often surrounded by MEAP- or MEAGL-immunoreactive nerve fibres and may receive innervation by these fibres. Several ganglionic neurons projecting to the sympathetic target tissues show MEAP- and/or MEAGL-immunoreactivity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299143 TI - Maladie de Parkinson unilateral: symptomatique d'une tumeur de pedoncule cerebral. PMID- 3299145 TI - [Retroperitoneal cysts. Description of a case of voluminous chylous retroperitoneal cyst]. PMID- 3299144 TI - Computer-assisted stereotaxic biopsy for the diagnosis of primary central nervous system lymphoma. AB - Primary CNS lymphoma was diagnosed in 13 patients after stereotaxic biopsy of indeterminate intracerebral mass lesions. Two patients also had laser extirpation of CT-visible tumor. The group consisted of 10 men and 3 women, aged 17 to 81 (mean, 55 years; median, 60 years). The lesions on CT were characteristically hyperdense, homogeneously contrast-enhancing, and associated with mild to moderate mass effect. Five patients had more than one lesion visible on CT. Complete staging procedures for occult systemic lymphoma were negative in all 13 patients. The majority (eight) of the tumors were of the diffuse, large-cell type. Five biopsy specimens underwent special immunostaining as a supplemental diagnostic effort. Two patients with small lymphocytic tumors demonstrated features consistent with T cell phenotype. Two patients with diffuse, large-cell tumors were confirmed as B cell phenotype by monotypic immunoglobulin light chain content. Primary CNS lymphomas represent a treatable group of primary brain tumors. Because of their tendency to develop in deep cerebral regions, they are often inaccessible to conventional neurosurgical techniques. We propose that stereotaxic neurosurgery can provide safe and accurate diagnosis, which is a prelude to planning comprehensive management. PMID- 3299146 TI - [Primary malignant lymphoma of the breast. Apropos of 2 cases]. PMID- 3299147 TI - [Effects of cyclosporin on blood gastrin after kidney transplant]. AB - Fifteen patients who underwent kidney transplant were studied in order to evaluate the effects of CyA on the gastrointestinal hormonal pattern. Eight patients followed traditional therapy while seven were treated with CyA. The basal gastrinemia values were high only in those patients treated with CyA. This might be due to: an increase in hormone secretion and/or release; a decreased hormone elimination probably due to nephro-hepatic toxicity of CyA; an increase in prostaglandins, caused by CyA, which inhibit secretion of gastri acids. PMID- 3299148 TI - [Changes in the phagocytic activity of human polymorphonuclear neutrophils induced in vitro by cefotiam vs 6 other antibiotics]. AB - The variation of granulocyte phagocytosis after antibiotic treatment has been studied. The conclusion is drawn that cephalosporins, piperacillin and aztreonam cause an increase of phagocytosis, while rifampicin and gentamicin induce a decrease of this activity. PMID- 3299149 TI - [Role of blood platelet aggregation in menstrual migraine]. PMID- 3299150 TI - [Migraine and arterial pressure gradients]. PMID- 3299151 TI - [A case of cystic duplication of the intestine. Prenatal diagnosis and treatment]. PMID- 3299152 TI - [Carcinoma of the breast in the pre- and post-menopausal period]. PMID- 3299153 TI - [Ultrasonographic monitoring of stimulated ovarian cycles in patients undergoing in vitro fertilization by embryo transfer]. PMID- 3299154 TI - [Adenocarcinomas of the uterus: infiltration and metastasis]. PMID- 3299155 TI - [Psychological impact of echographic examinations on the pregnant woman]. PMID- 3299157 TI - Baccalaureate and Master's Degree programs in nursing accredited by the NLN 1987 88. PMID- 3299156 TI - Immunohistochemical demonstration of glutamate dehydrogenase in astrocytes. AB - A rabbit antiserum was raised against glutamate dehydrogenase (GDH) and applied immunohistochemically to rat brain. GDH-immunoreactive grains were observed mainly in small cells throughout the brain. In most of these cells, coexistence of GDH and glial fibrillary acidic protein was shown by an immunofluorescence method. The results suggest that GDH is primarily an astrocytic enzyme. Possible roles of astrocytic GDH in glutamate and ammonia metabolism are discussed. PMID- 3299158 TI - Ultrasonic imaging in high-risk newborns. PMID- 3299159 TI - Imaging: urinary tract infections. PMID- 3299160 TI - An unfinished scientific revolution: Medieval anatomical studies. PMID- 3299161 TI - Advances in cancer: hormone receptors and their role in the clinical management of cancer. PMID- 3299162 TI - Nutrition classics. Public Health Reports, Vol. 37, March 3, 1922: Amino-acid deficiency probably the primary etiological factor in pellagra. By Joseph Goldberger, and W. F. Tanner. PMID- 3299163 TI - Absorption of soy protein and minerals in ileostomy patients. PMID- 3299165 TI - Snacks and caries. PMID- 3299164 TI - Interaction of iron, copper, and zinc. PMID- 3299166 TI - Relationship between absorption of cholesterol and serum plant sterols. PMID- 3299167 TI - Nutrition classics. The Journal of Biological Chemistry, Vol. LXXVII, 1928: Iron in nutrition. VII. Copper as a supplement to iron for hemoglobin building in the rat. By E.B. Hart, H. Steenbock, J. Waddell, and C.A. Elvehjem. PMID- 3299168 TI - Mechanism of stimulation of the 25-hydroxyvitamin D3 hydroxylase by parathyroid hormone. PMID- 3299169 TI - Mammalian folylpoly-gamma-glutamate synthetase. PMID- 3299170 TI - Vitamin K-dependent carboxylase in skin. PMID- 3299171 TI - Computer software guide. PMID- 3299172 TI - Primary ovarian sarcomas: report of 46 cases and review of the literature. PMID- 3299173 TI - Oocyte donation and in vitro fertilization for hypergonadotropic hypogonadism: clinical state of the art. PMID- 3299174 TI - Predictability of complications associated with prolongation of pregnancy. AB - The frequency of complications and fetal macrosomia occurring in 243 patients with excellent dates indicating that their pregnancy was prolonged beyond 40 weeks (280 days) was analyzed and compared with that from a control group of 250 normal patients whose pregnancy ended spontaneously between 38 and 40 weeks of gestation. Complications (intrapartum fetal distress, traumatic deliveries, meconium aspiration, postmaturity syndrome) were significantly more frequent in patients in the study group (25.1%) than in the controls (5.6%). Similarly, fetal macrosomia occurred significantly more often in the study patients (29.6%) than in the controls (10.4%). To study the efficacy of antepartum surveillance in predicting these abnormal events, the postterm patients were randomized between two plans of management: 126 were followed with weekly nonstress testing (NST), and 117 with NST plus weekly ultrasound evaluation of fetal size, amniotic fluid volume, and placental grade. Contraction stress testing (CST) was used if the NST was nonreactive. Electronic monitoring had positive and negative predictive values of 42.8 and 87.7%, respectively, whereas ultrasound-plus-electronic monitoring had values of 50 and 65.3%, respectively. These results indicate that the increased incidence of complications in pregnancy prolonged beyond 40 weeks cannot be adequately predicted with antepartum electronic monitoring and ultrasound evaluation of fetal size, placental grade, and amniotic fluid volume. PMID- 3299175 TI - Effect of bacterial growth on the bursting pressure of fetal membranes in vitro. AB - By mounting a layer of chorioamniotic membrane on a specially designed reaction vessel, we studied the effect of Escherichia coli and/or group B streptococcus growing on the decidual surface of the membranes in tissue culture or bacteriologic medium. The organisms grew equally well in either medium. When growing in tissue culture medium, either organism significantly weakened the membranes as compared with controls (membranes incubated in the absence of either organism). Membranes derived from pregnancies delivered vaginally or abdominally responded similarly. When organisms were grown in bacteriologic medium, bursting pressures did not decrease. Addition of bacteriologic medium (20-60%) to tissue culture medium did not affect bacterial growth, but inhibited significantly the lowering of bursting pressures. Bacteriologic medium also inhibited the peroxidase-H2O2-halide system in vitro. Heat-killed bacteria and/or supernatants of culture medium previously inoculated with bacteria were not effective in weakening membranes. The results suggest that live bacteria in conjunction with active membrane metabolism lead to a weakening and eventual rupture of the membranes. PMID- 3299176 TI - A rapid screening test for the diagnosis of endocervical group B streptococci in pregnancy: microbiologic results and clinical outcome. AB - Four hundred thirty-one parturient women were tested for cervical infection with group B streptococcus using standard bacterial culture and a commercially available latex particle agglutination test. The total time required to perform each latex test was 30 minutes or less. The prevalence of endocervical group B streptococcus by culture was 4.4%, half of whom developed clinically significant group B streptococcus infection; all such cases were identified correctly by the latex test. The predictive value of a negative latex test for a negative group B streptococcus culture was 98%. This method seems promising as a rapid intrapartum diagnostic test for ruling out group B streptococcus infection and thus avoiding unnecessary antibiotic treatment. PMID- 3299178 TI - Treatment of premenstrual syndrome with alprazolam: results of a double-blind, placebo-controlled, randomized crossover clinical trial. AB - A double-blind, placebo-controlled, randomized multiple crossover study was designed to determine the effectiveness of alprazolam in the treatment of premenstrual syndrome. Patients maintained daily diaries of 22 premenstrual symptoms for one pretreatment control cycle and four treatment cycles. Alprazolam 0.25 mg or placebo was administered three times daily from cycle day 20 until the second day of menstruation, at which time the dosage was tapered by one tablet per day to minimize withdrawal effects. The results of the clinical trial indicate that alprazolam is significantly more effective than placebo in relieving the severity of premenstrual nervous tension, mood swings, irritability, anxiety, depression, fatigue, forgetfulness, crying, cravings for sweets, abdominal bloating, abdominal cramps, and headache. The low incidence of side effects makes alprazolam an acceptable treatment for premenstrual syndrome for those women unresponsive to other therapies. PMID- 3299177 TI - Premenstrual syndrome: beneficial effects of periodic, low-dose danazol. AB - Danazol (200 mg/day) or placebo was administered to patients with premenstrual syndrome from the onset of symptoms until the onset of menses, for two cycles each, in a prospective, double-blind, crossover design. Eleven of 14 patients improved on danazol. The symptom scores with danazol were significantly lower than those with placebo (P less than .035). No side effects were reported from the medication. We conclude that danazol, given periodically and in a relatively low dose, appears to have a beneficial effect in the treatment of premenstrual syndrome. PMID- 3299179 TI - A comparison of nonculture-dependent methods for detection of Chlamydia trachomatis infections in pregnant women. AB - Two nonculture-dependent methods for the detection of Chlamydia trachomatis in endocervical samples from obstetric patients were compared with routine isolation in McCoy cell cultures. When compared with culture, the sensitivities and specificities of the methods were: direct fluorescent antibody staining (MicroTrak [Syva Co.]) 98.1 and 95.4%, and enzyme immunoassay (Chlamydiazyme [Abbott Laboratories]) 96.3 and 92.9%, respectively. In 89% of apparent false positive direct fluorescent antibody cases and 64% of enzyme immunoassay cases, an additional positive nonculture result was considered to indicate infection missed by culture. Considering these data, revised sensitivities were 84.4% for culture, 95.2% for direct fluorescent antibody, and 95.3% for enzyme immunoassay. Revised specificities were 99.5% for direct fluorescent antibody and 97.3% for enzyme immunoassay. Both nonculture tests appear acceptable for screening high risk obstetric patients, and may be more sensitive than routine cell culture. PMID- 3299180 TI - Anal sphincter function after delivery rupture. AB - Questionnaires were sent to 63 women with anal sphincter rupture that occurred during vaginal delivery two to seven years earlier. Half of them had significant trouble, such as incontinence for gas, dyspareunia, and pain. We performed anal pressure profilometry in 14 of these women and in ten controls for comparison, and found a significant reduced strength in the external anal sphincters of the studied group. When anal sphincter rupture extended through the rectal mucosa, the internal sphincter strength was also reduced. The persisting signs and symptoms of anal dysfunction indicate that women with anal sphincter rupture need more attention and follow-up. PMID- 3299182 TI - The effects of vitamin B6 supplementation on premenstrual symptoms. AB - A double-blind controlled study of the effects of vitamin B6 supplementation on premenstrual symptoms was conducted. Fifty-five women who reported moderate to severe premenstrual mood changes participated in the study. Symptoms were monitored prospectively through daily home record-keeping over a one-month baseline period followed by two months of treatment. Subjects were randomly assigned to receive daily supplements of 150 mg of vitamin B6 or placebo over the entire two-month treatment period. Analysis of covariance suggested that even though vitamin B6 may improve premenstrual symptoms related to autonomic reactions (eg, dizziness and vomiting) and behavioral changes (eg, poor performance and decreased social activities), a significant amount of physical and affective symptomatology remained during the premenstrual phase. In light of recently reported, potentially toxic effects of low doses of vitamin B6, our results call for caution in using this therapy for premenstrual symptoms. PMID- 3299181 TI - Methods of vaginal cuff closure and preservation of vaginal depth during transvaginal hysterectomy. AB - One hundred and twelve vaginal hysterectomies were performed over a 2.8-year period. Five different techniques of cuff closure were performed, and evaluated for their preservation of vaginal depth. We have concluded that all five methods are acceptable ways to close the vaginal cuff at the time of transvaginal hysterectomy as long as there is proper vault support. Each surgical closure is pictorially illustrated. Morbidity was minimal, and vaginal depth was retained. PMID- 3299183 TI - Relationship between fetal growth and maternal fructosamine in diabetic pregnancy. AB - We studied 30 diabetic pregnant women to compare serum fructosamine concentrations at different stages of gestation with fetal growth (as determined by ultrasonography) and with birth weight. Serum fructosamine levels in mothers of macrosomic infants were significantly higher (P less than .05) during the first trimester of pregnancy as compared with mothers of normal birth weight infants. Moreover, first-trimester fructosamine concentrations correlated significantly with birth weight (r = 0.68, P less than .001) and with ultrasound measurements of fetal abdominal circumference and femur length. The fetus destined to be macrosomic had an enlarged abdomen in the second trimester, often before 20 weeks' gestation. We conclude that maternal diabetic control during early gestation has an important influence on fetal growth and contributes to the development of fetal macrosomia. PMID- 3299184 TI - Ultrasound screening for spina bifida: cranial and cerebellar signs in a high risk population. AB - Cranial and cerebellar ultrasound markers of open spina bifida were evaluated in a prospective screening study of 436 pregnancies at high risk for this fetal abnormality. Twenty-six fetuses with open spina bifida were diagnosed. Values below the fifth percentile for gestation were found for biparietal diameter (BPD) in 17 fetuses (62%) and for head circumference in nine (35%). The anterior horn of the lateral cerebral ventricle/hemisphere ratio was above the 95th percentile in 11 (42%), and there was ventriculomegaly of the posterior horn of the lateral ventricle in 14 (54%). Scalloping of the frontal bones, referred to as the "lemon sign," was present in all 26 cases and also in five (1%) of the structurally normal fetuses. A cerebellar abnormality was found in 25 cases (96%). In nine fetuses (35%), the cerebellum was absent, and in 16 cases (62%), the cerebellar hemispheres curved anteriorly, producing the "banana sign." The predictive ability of each ultrasound marker to detect open spina bifida was evaluated by measuring the sensitivity, specificity, and predictive value of a positive and negative test. These findings demonstrated that certain cranial and cerebellar markers, in particular the lemon sign and the banana sign or absent cerebellum, are consistent features of open spina bifida and are likely to improve the diagnostic accuracy of ultrasonography in the evaluation of pregnancies at high risk for this fetal abnormality. PMID- 3299185 TI - Detection of fetal movement using Doppler ultrasound. AB - Using conventional cardiotocographic equipment with the ultrasound transducer placed to detect the fetal heart, we obtained unprocessed Doppler signals in the frequency range 13-70 Hz and used them to detect movements of the fetal trunk. In an assessment of maternal perception of fetal activity, we found that Doppler signals were associated with 739 of 780 appreciated movements (95%); however, 36% of all the Doppler signals were unaccounted for. A separate comparison of the Doppler signals against real-time ultrasound observations of fetal activity showed that 913 of 970 visualized trunk movements (94%) were associated with Doppler signals. Other Doppler signals were found to be due principally to fetal breathing and fetal hiccups. Appropriate processing of the Doppler signals obtained during antenatal cardiotocography may allow an objective assessment of fetal activity to be added to the fetal heart rate recording. PMID- 3299186 TI - Normal fetal heart axis and position. AB - Cardiac position and axis were evaluated by ultrasound in 183 normal fetuses; both position and axis were found to be constant throughout gestational life. In the four-chamber view of the fetal heart, the normal axis lies at a 45 degree angle (range 22-75 degrees) to the left of an anteroposterior line drawn from the spine to the anterior chest wall. The normal position of the posterior portion of the heart can also be defined. The axis or position of the heart deviated from the established normal range in 15 cases, the outcome of which is discussed. Abnormal axis was associated with 50% mortality; abnormal position with 81% mortality. Deviation from the normal position of the fetal heart should initiate a search for an intrathoracic mass, whereas an abnormal axis is an indication for fetal echocardiography. Axis and position of the fetal heart are easily evaluated during a standard obstetric scan. PMID- 3299187 TI - Current therapy for dysgerminoma of the ovary. AB - It is important that therapy of ovarian dysgerminoma be optimized because of the young age of women affected and the threat that therapy may pose to fertility. Our understanding of dysgerminoma has improved, so that treatment schemes with better therapeutic ratio may now be used. Approximately 65% of patients present with stage IA disease. For those wishing to preserve fertility, conservative surgery with close clinical, radiologic, and serologic follow-up is the treatment of choice, with chemotherapy for relapse. Cure rates should approach 100%, and fertility is usually preserved. Intra-abdominal relapse in those not wishing to preserve fertility should be treated with modest-dose pelvic and abdominal irradiation. For those patients with disease presenting in stages IB, II, and III who wish to maintain fertility, unilateral oophorectomy followed by combination chemotherapy may be curative and spare ovarian function. Otherwise, complete surgery, followed by abdominopelvic radiation therapy, is recommended. This treatment produces less morbidity than chemotherapy and will cure approximately two-thirds of patients. Chemotherapy should be used for salvage of subsequent relapse. Both radiation and chemotherapy are highly effective treatment modalities for dysgerminoma. This information, coupled with better understanding of the patterns of disease spread and improved ability to identify nondysgerminomatous elements using serum tumor markers, means that a more conservative approach can be taken to management without compromising the chance of cure. Cure rates for dysgerminoma should now approach the role of 97% achieved in the comparable tumor, testicular seminoma. PMID- 3299188 TI - [Kulzer Silicoater methods]. PMID- 3299189 TI - [Comparative study of the immunomorphologic response to corneal auto- and allografts]. PMID- 3299190 TI - Study of human post-implantation conceptuses, normal and abnormal. PMID- 3299191 TI - Fine structural changes in the three-dimensional structure of the rat juxtaglomerular apparatus in response to water deprivation. PMID- 3299193 TI - A new suturing method for the treatment of giant retinal tear. AB - We report a new method for suturing the retina to the ocular wall when this is required for treatment of retinal detachment due to giant retinal tear. After closed vitrectomy, one of two ski-shaped needles (2.8 mm long and 0.4 mm thick) with an 8-0 nylon thread is introduced from a 1.4 mm scleral incision in the pars plana, advanced under direct observation through the retinal flap, and led extraocularly to an appropriate site in the opposite ocular wall. The second needle is advanced similarly through the same scleral incision and exited from the opposite ocular wall. The thread is then tied extraocularly on the sclera. The retinas of two patients were successfully reattached using this procedure in combination with encircling and the use of SF6 gas and air. PMID- 3299192 TI - Pseudophakic keratoplasty: posterior chamber lens implantation in the presence of ruptured capsule. AB - A technique is described for implantation of a posterior chamber intraocular lens during keratoplasty for bullous keratopathy when a large capsulotomy and vitreous prolapse are present. Seven cases of pseudophakic or aphakic bullous keratopathy with anterior chamber, iris-fixated, or no intraocular lens in place are reported. A completely intact posterior capsule is not necessary to support safely a sulcus-fixated posterior chamber lens. Anterior segment reconstruction, careful removal of existing intraocular lenses (except a posterior chamber lens), vitrectomy through the ruptured posterior capsule, and assessment of the remaining posterior capsule rim are important surgical objectives. PMID- 3299194 TI - Cataract blindness in Africa. AB - Of the estimated 17 million blind from cataract in the world, two to three million live in Africa, where manpower and material resources are inadequate to meet the increasing backlog of treatable blindness. The training of primary health care workers to screen rural Africans for cataract, and of eye auxiliaries and general doctors to select patients and perform surgery, is essential. Motivation for surgery will increase if eye services are made more accessible and reliable. This requires more motivated trained staff and appropriately equipped static eye facilities. PMID- 3299195 TI - An easy method to monitor the calibration of ultrasound instruments. PMID- 3299196 TI - A simple method for controlled freezing of human donor corneae. AB - A simple method for freezing cultured human donor material with dimethyl sulfoxide (DMSO) was developed empirically in a commercially available microcomputer-controlled apparatus allowing reproducible freezing curves to be made. The optimum cooling rate was found to be 1.0 degrees C/min down to -40 degrees C and then 5.0 degrees C/min to -80 degrees C. Total cell loss rates were 36.9 +/- (SD) 19.8% of postmortem endothelial cell counts. An improved method for evaluating endothelial viability was applied, which enabled us to observe definite cell survival after a postculture period. PMID- 3299197 TI - Superoxide dismutase molecules in human cataractous lenses. AB - Specific activity of superoxide dismutase (SOD) in cataractous lenses was examined. Immunoprecipitation with monospecific antibodies showed an accumulation of catalytically inactive, but antigenically reactive enzyme molecules in lenses with various types of cataracts. The inactive enzyme molecules can be demonstrated in all kinds of cataracts, including dense, mature cataracts with very low or nondetectable enzyme activity. In cataracts from diabetic patients, the mean enzyme activity was higher than in nondiabetic patients. This was especially marked in nuclear cataracts, in which the specific activity of SOD was higher than in similar cataracts from nondiabetics. PMID- 3299198 TI - Expression of the antigens recognized by monoclonal antibodies to human amnion (GB4, GB9, GB11) on the rabbit eye during embryonic development. AB - Three monoclonal antibodies to human amnion (GB4, GB9 and GB11) which recognized well-defined structures of the adult rabbit eye were used to study the embryonic eye development. The reactivity of GB4 could be identified on the migrating neural crest cells under the corneal epithelium at 2 weeks of gestation. At 3 weeks of gestation, the conjunctival epithelium, corneal epithelium and corneal endothelium reacted with GB4. In the newborn rabbit, the corneal epithelium was reactive with GB9 instead of GB4; corneal endothelium was positive with GB4 at this stage, but gradually became negative in the adult rabbit; the subcapsular epithelium of the lens was recognized by GB4 when it changed from pseudostratified to simple cuboidal epithelium. During early embryonic life, GB11 was positive on the external retinal layer of the optic cup and lens vesicle. In the adult, GB11 reacted only with the pigmented epithelium of the ciliary processes. The results of this study demonstrated that the expression of antigens recognized by GB4, GB9 and GB11 could be mapped according to the epithelial differentiation of the rabbit eye during embryogenesis. PMID- 3299199 TI - Effects of diabetes and insulin treatment on sorbitol and water of rat lenses. AB - Since increased lens sorbitol and osmotic swelling are central causative features of cataract in diabetic rats, the effects of insulin treatment on lens sorbitol, water, sodium, and potassium were studied. The sorbitol concentration in early stage diabetic lenses was greater than in normal ones by 83 mmol/kg water, and the lens water was greater by 1.3%. Sodium was greater by 9 mmol/kg water; potassium was less by the same amount so that the sum of sodium and potassium was not different. In insulin-treated diabetic lenses, the sorbitol was less than in untreated diabetic lenses by 39 mmol/kg water, and the lens water was not different. Insulin restored the potassium, but not the sodium, to normal concentration so that the sum of sodium and potassium was greater by 16 mmol/kg water. The differences in lens water were less than would be expected on the basis of osmosis due to differences in sorbitol and suggested that the lenses were able to maintain their water content within a narrow range by losing or gaining solutes to offset the differences in sorbitol. PMID- 3299200 TI - Effects of L-timolol, D-timolol, haloperidol and domperidone on rabbit retinal blood flow measured with laser Doppler method. AB - L-Timolol (0.4 mg/kg) reduced significantly retinal blood flow (17%), systemic blood pressure (18-20%) and heart rate (28%) in the rabbit. D-Timolol (4.0 mg/kg) increased retinal blood flow slightly (9%) and did not significantly affect systemic blood pressure or heart rate. Since D-timolol is effective in reducing intraocular pressure, these results indicate that D-timolol is superior to L timolol for glaucoma treatment. Haloperidol and domperidone are dopamine antagonists, but, while haloperidol (0.1 mg/kg) suppressed retinal blood flow (16%), domperidone (0.2 mg/kg) increased it (12%). Neither of them affected blood pressure or heart rate significantly. While either of these given topically decreases intraocular pressure significantly, domperidone's ability to increase retinal blood flow makes it more useful than either haloperidol or L-timolol for treating glaucoma. PMID- 3299201 TI - Intraocular lens removal during penetrating keratoplasty for pseudophakic bullous keratopathy. AB - Pseudophakic bullous keratopathy is now the most common reason for penetrating keratoplasty. In previous reports, the type of intraocular lens (IOL) most frequently encountered in these eyes was the iris plane IOL. The authors reviewed 27 cases of IOL removal during penetrating keratoplasty. Lenses were removed if they were dislocated or associated with iritis, recurrent hyphema, glaucoma, or persistent cystoid macular edema. The IOL encountered most often was the anterior chamber lens (in 22 eyes); closed thin loop, semiflexible or flexible anterior chamber lenses accounted for 19 of these. Iris plane lenses were removed from five eyes. No posterior chamber lenses were removed. Clear grafts were obtained in 24 of 27 cases (89%); visual acuity improved or remained the same in 24 cases, to 20/60 in 11 cases. The most common causes of poor postoperative vision were retinal disease (6/27 cases) and glaucoma (6/27 cases). The association between anterior chamber lenses and pseudophakic bullous keratopathy is probably the result of both the increase in use of these lenses and the documented propensity of the closed loop semiflexible anterior chamber lenses to cause complications. PMID- 3299202 TI - Evaluation of diagnostic tools for adult chlamydial keratoconjunctivitis. AB - Conjunctival smears and serum specimens of 150 patients with presumed chlamydial keratoconjunctivitis were evaluated over a period of 16 months and compared to age- and sex-matched healthy controls. Sensitivity, specificity, and predictive values of fluorescent monoclonal antibody (FMAb) direct tests, IgG single antigen tests for the detection of serum antibody (IgG-IFT), and IgA and IgG immunoperoxidase tests (IgA-IPAs and IgG-IPAs) for serum antibody were compared to McCoy cell culture techniques in a nonoptimized clinical setting. Thus, FMAb sensitivity was 100%, specificity was 52%, and predictive value was 30%. IgG-IFT sensitivity was 94%, specificity was 67%, and predictive value was 37%. IgA-IPA sensitivity was 100%, specificity was 70%, and predictive value was 40%. The IgG IPA was sensitive but nonspecific. With respect to the current epidemiologic situation in our area, FMAb and IgA-IPA in addition to McCoy cell culture techniques may represent valuable diagnostic tools for the detection of chlamydial disease. PMID- 3299203 TI - Clear lens extraction for axial myopia. An appraisal. AB - Optional surgery requires a higher degree of safety than that performed for medical necessity. This ethical principle is particularly applicable to axial myopes, who have higher-than-normal rates of operative and postoperative complications if they undergo lens extraction. Moreover, several noninvasive, extraocular, and reversible techniques now exist for the correction of myopia. Currently, it would appear that the possible optical benefits of clear lens extraction in axial myopia are usually outweighed by the severity of the risks and by the availability of safer alternatives. PMID- 3299205 TI - Subject: molecular adhesion to dentin & enamel. PMID- 3299204 TI - Attachments for removable partial overdentures. PMID- 3299206 TI - The physiology and immunology of the pharyngeal lymphoid tissue. AB - The immunologic structure and function of the parapharyngeal lymphoid tissue are presented. The antigen-processing activities of the tonsils are compared to those of the adenoids and other mucosal-associated lymphoid tissues. Both immunoglobin synthesis and secretion as well as T-lymphocyte activities are described. PMID- 3299207 TI - Upper airway obstruction and the pharyngeal lymphoid tissue. AB - Enlarged tonsils and adenoids can cause chronic upper airway obstruction that may result in a spectrum of clinical findings ranging from sleep apnea to cor pulmonale and right heart failure. The clinical findings associated with this entity are reversible if the condition is identified early and removal of the obstructing tissue is performed before life-threatening changes occur. PMID- 3299208 TI - Dental development and the pharyngeal lymphoid tissue. AB - Because the teeth are housed and develop within the jaws, skeletal development of the maxilla and mandible is a primary factor in the consideration of any problems pertaining to the developing dentition. Growth of the posterior nasal choanae, the maxilla, and the nasopharynx should be evaluated as a unit in assessing the favorable or unfavorable character of the nasopharyngeal region. Both large and small adenoidal tissues should be examined in light of the morphologic character of the nasopharynx (be it small, large, narrow, or wide) and related to the developing maxilla. Variables in size and location of the maxilla and the pharynx will play an important role in the impact that lymphoid tissue will have on the patency of the nasopharyngeal isthmus. Synchronized growth between the normally developing adenoids and the migration of the maxilla away from the cranial base will produce a balanced environment that precludes nasal obstruction by the presence of adenoids. With time, the changes in spatial relationships between the posterior border of the maxilla and the posterior pharyngeal wall plus atrophy of the adenoidal tissue will generally minimize or eliminate the problems of nasal obstruction and mouth breathing. Growth data may be used to evaluate the status, assess progress, measure comparability, determine inheritance patterns, and confer individuality. Unit-trait inheritance of the teeth, alveolar processes, maxilla, mandible, soft-tissue profile, tongue, pharynx, and lymphoid tissues may well produce more definitive answers to the question of the developing dentition and the pharyngeal lymphoid tissue. Finally, at present, no clinician can categorically state that enlarged tonsils or adenoids per se are responsible for abnormal dentition in the absence of other factors. PMID- 3299209 TI - The clinical microbiology of Waldeyer's ring. AB - The role of microorganisms in infections of Waldeyer's ring is reviewed. The agents involved are aerobic and anaerobic bacteria, viruses, chlamydia, fungi, parasites, and rickettsia. The therapeutic implications of the presence of beta lactamase-producing bacteria are discussed. PMID- 3299210 TI - Ear disease in patients with inflammations of Waldeyer's ring. AB - The etiologies of otitis media with effusion are certainly multiple but remain incompletely understood. The treatment of otitis media with effusion varies considerably. A discussion of known facts as well as debated issues underlying these differences is presented. PMID- 3299212 TI - Pediatric considerations of infections and inflammations of Waldeyer's ring. AB - Acute suppurative streptococcal pharyngitis remains a significant pediatric problem, accounting for much time lost from both school and play. Antibiotic therapy will usually treat the acute symptoms; tonsillectomy is often needed when the inflammation becomes chronic and recurrent. PMID- 3299211 TI - Allergy and the pharyngeal lymphoid tissues. AB - Allergic reactions involving the pharyngeal lymphoid tissues are thought to play a role in several clinical disorders seen commonly in ear, nose, and throat surgical practices. The pathogenesis of the allergic reaction is discussed in relationship to disorders involving the tonsillar tissues, the upper airways and nasopharynx, and the ear. PMID- 3299213 TI - Evaluation of coagulation disorders in patients with diseases of Waldeyer's ring. AB - The presence of pre-existing hemostatic disorders in a surgical patient may pose difficulties in the care of patients during and after surgery. To reduce the risk of excessive hemorrhage, this article has stressed the value of a thorough medical history, physical examination, and appropriate laboratory assays before surgery. When these measures reveal no evidence of a coagulation disorder, the surgeon can have confidence that the patient's hemostatic system has the appropriate resources to prevent excessive bleeding during surgery. However, if the coagulation screening procedure suggests that an abnormality exists, specific diagnostic assays must be performed before any necessary surgery to determine the exact nature of the coagulopathy. When this information is present, specific forms of blood component therapy can be given to minimize the risk of excessive hemorrhage during the operative period. PMID- 3299214 TI - Anesthesia for tonsillectomy and adenoidectomy. AB - Despite advances in the anesthetic pharmacopeia and improved noninvasive monitoring techniques, subjective bias and individual clinical experience remain major determinants of individual practice. Medicolegal pressures have increased in recent years, as has the concept of shared responsibility for surgical and anesthetic complications. New standards of anesthesia monitoring and practice are evolving in response to the need for perioperative risk management and cost effective surgical care. Continued vigilance and close communication between the otolaryngologist and anesthesiologist remain key elements for safe anesthetic practice. PMID- 3299215 TI - A traditional approach to surgery of the tonsils and adenoids. AB - Current indications and contraindications for tonsil and adenoid surgery are discussed and the surgical techniques used are reviewed. A philosophy for managing patients is presented. PMID- 3299216 TI - Complications of tonsillectomy and adenoidectomy. AB - This article deals with fatality rate, causes of death, bleeding, and appropriate measures to prevent or treat such complications. Immunologic disturbances, consequences of tissue trauma, and recurrences after surgery are discussed. PMID- 3299217 TI - Hodgkin's disease and tonsillectomy. AB - We have reviewed the evidence associating tonsillectomy and Hodgkin's disease. Hodgkin's disease and tonsillectomy may share certain epidemiologic features, such as higher socioeconomic status. Does tonsillectomy lead to Hodgkin's disease? There is no evidence for this, nor is there any plausible reason to suspect it on the basis of the experimental evidence to date. PMID- 3299219 TI - CAI has greatest potential for clinical simulations. PMID- 3299218 TI - The history of tonsil and adenoid surgery. AB - At present, there remains the controversial issue as to who should or should not have his tonsils removed. But whether or not a particular patient needs them removed, the historical development of tonsillectomy has rendered tonsillectomy a very precise operation. It is by no means a minor procedure and requires great skill and concentration to meet the altering circumstances that may occur during this procedure. PMID- 3299220 TI - Researcher makes recommendations for use of computer-aided instruction. PMID- 3299221 TI - Computers have much to offer educator, administrator, staff nurse. PMID- 3299222 TI - Historical review of paraplegia before 1918. PMID- 3299223 TI - The development and care of spinal cord paralysis (1918 to 1986) PMID- 3299224 TI - Plasmodium falciparum-inhibitory monoclonal antibodies produced by human hybridomas. AB - Stable human hybridomas were generated that produced inhibitory anti-Plasmodium falciparum monoclonal antibodies. Peripheral blood lymphocytes, obtained from adults in Liberia, a malaria endemic area, were immortalized with Epstein-Barr virus and then fused with KR4, a human, lymphoblastoid cell line. Stable hybridomas that produced anti-P. falciparum monoclonal antibody were identified by an ELISA assay that used the trophozoite and schizont antigens of both the Honduras I and FCR3 parasite strains. Monoclonal antibodies produced by selected hybridomas derived from lymphocytes of two individuals were subsequently studied. The anti-parasite antibodies were produced at 1-3 micrograms/ml in culture supernatants. All of the monoclonal antibodies bound specifically to trophozoites and schizonts of both strains of parasite in an indirect immunofluorescence assay and inhibited production of ring stage parasites by more than 90% when added to trophozoite or schizont containing erythrocytes in culture. Western immunoblot analysis of antigens obtained from trophozoites and schizonts (parasite age span of 36 to 48 h) was performed using either affinity purified or ammonium sulfate concentrated monoclonal antibody. Antibody from three hybridomas which bound primarily to antigens of the Honduras 1 strain had Mr of approximately 140,000, 130,000 and 123,000. PMID- 3299226 TI - Isolation and characterization of salivary antigens from the female tick, Dermacentor andersoni. AB - The salivary glands of ixodid ticks are complex organs which are known to contain the antigens responsible for tick resistance in animals. We have identified a large number of proteins from salivary gland extracts (SGE), at least some of which are immunologically recognized by tick resistant animals and which are therefore presumed to be secreted salivary components. During the 6 to 10 day feeding process, a number of these antigens alter in concentration according to individual kinetics, and some of these changes correlate with the kinetics of skin test reactivity of SGE obtained at different times throughout the feeding period. By use of immunoaffinity chromatography we have isolated large quantities of many of the salivary antigens (SGA) contained in SGE, and found that they contain several esterase activities. SGA stimulates both immediate and delayed skin reactions in tick resistant guinea-pigs, and these reactions are about 200 fold more intense, per unit protein, than those elicited by SGE. The skin reactions to SGA are basophil-mediated and have many features in common with the cutaneous basophil hypersensitivity reactions of tick resistant animals. The demonstrated antigenic complexity of the glands may have profound implications for attempts to develop anti-tick vaccines, as it may eventually be found that candidate vaccines will have to incorporate more than one tick antigen in order to be effective. PMID- 3299225 TI - Target antigens of malaria transmission blocking immunity exist as a stable membrane bound complex. AB - Monoclonal antibodies (MoAbs) blocking transmission of malaria by blocking fertilization of female gametes by male gametes in the mosquito midgut immunoprecipitate three polypeptides (apparent non-reduced mol. wt of 230,000, 48,000, 45,000) from the surface of gametes and zygotes of Plasmodium gallinaceum and P. falciparum. Earlier studies have shown that the epitopes with which the MoAbs react are present only on the mol. wt 230,000 polypeptide in P. gallinaceum and the 48,000/45,000 mol. wt antigens in P. falciparum (Kumar 1985, Vermeulen et al. 1985). In gel permeation chromatography all three polypeptides were found to be co-eluted. Cross-linking reagents were used to cross-link proteins on the intact cells and in the soluble extracts. The cross-linked product immunoprecipitated by the MoAbs showed an approximate mol. wt of 290,000 to 300,000, suggesting a stoichiometry of 1:1 between the high and low mol. wt polypeptides. Evidence was also obtained for the existence of a subpopulation of the 48,000/45,000 mol. wt polypeptides which is not complexed with the 230,000 mol. wt polypeptide. These data indicate that the 230,000 polypeptide is physically associated with the 48,000 and 45,000 polypeptides; the high and low molecular weight polypeptides appear to exist in a stable membrane bound complex. PMID- 3299227 TI - Trypanolytic activity and antibodies to metacyclic trypomastigotes of Trypanosoma cruzi in non-Chagasic human sera. AB - Metacyclic trypomastigotes of Trypanosoma cruzi, derived either from triatomid vectors or axenic cultures, were found to be extensively lysed by sera of some non-Chagasic healthy individuals through activation of the alternative complement pathway. Antibodies to T. cruzi metacyclics were detected by direct agglutination test in normal human sera (NHS) containing trypanolytic activity. Absorption of lytic NHS with metacyclic trypomastigotes, but not with non pathogenic Herpetomonas samuelpessoai promastigotes, abolished the trypanolytic effect. Natural antibodies to trypomastigotes were not found in NHS devoid of trypanolytic activity. Precipitation of 131I-labelled metacyclic surface proteins with lytic NHS revealed as the major band a polypeptide with an apparent molecular weight of 75,000. PMID- 3299228 TI - Publications of W. Horsley Gantt. PMID- 3299229 TI - Vascular compromise in chronic volvulus with midgut malrotation. AB - Three cases of chronic volvulus of the small bowel in midgut malrotation are presented, all of whom manifested similar angiographic findings: proximal occlusion of the superior mesenteric artery and vein and development of collateral vessels. These findings may indicate the pathophysiology of chronic volvulus in midgut malrotation; the volvulus is progressive and eventually results in the twisting of the mesenteric root itself, but because of its chronic nature collateral circulation develops, eliminating bowel necrosis. Computed tomography (CT), performed in two cases, revealed dilated, tortuous vessels in the mesentery in addition to the known CT finding of a whirl-like pattern of the volvulated small bowel loops. Sonography, performed in one case, showed an unique feature of whirling sonolucent layers probably representing the volvulated small bowel loops intermixed with dilated mesenteric collateral vessels. We would like to emphasize the usefulness of CT and sonography in the early diagnosis of those cases with vague and nonspecific clinical manifestations. PMID- 3299230 TI - Kidney dimensions in ultrasound compared to somatometric parameters in normal children. AB - In 196 children aged between 4 weeks and 16 2/12 years a sonographic investigation of kidneys was performed and put into relation to somatometric data including bodyweight (BW) bodylength (BL), length of the trunk and the upper and the lower limb, breadth of thorax and pelvic, head circumference, maximum cranial length and maximum cranial breadth. None of the children had signs of renal disorder. Morphometric data, as kidney length, width, depth, parenchymal areas in longitudinal and transverse sections and the prolate ellipsoid volume (PEV) were documented. The children were divided into five groups (group 1: 2-6 months, group 2: 6-31 months, group 3: 31-99 months, group 4: 99-131 months, group 5: 131 194 months). Mean values of all parameters were calculated. For each group a multiple regression analysis was performed and a regression equation of kidney length, parenchymal areas and volume was established. This method allows an individual determination of renal size and parenchymal mass. PMID- 3299232 TI - [Extrarenal kidney failure and cerebrospinal meningitis caused by Candida albicans infection]. PMID- 3299233 TI - Adoption of children from countries with endemic hepatitis B: transmission risks and medical issues. PMID- 3299235 TI - School performance and theophylline. PMID- 3299234 TI - Treatment of Salmonella meningitis and brain abscess with the new cephalosporins: two case reports and a review of the literature. PMID- 3299231 TI - Ventilatory management of infant baboons with hyaline membrane disease: the use of high frequency ventilation. AB - We tested the hypothesis that high frequency oscillatory ventilation (HFOV) would result in decreased pulmonary barotrauma in infants with hyaline membrane disease by comparing HFOV at 10 Hz to conventional positive pressure ventilation with continual distending airway pressure (PPV/PEEP) in premature baboons with hyaline membrane disease. Nineteen baboon fetuses were randomized to one of two treatment groups, delivered at 140 +/- 2 days, and, after stabilization and instrumentation of PPV/PEEP, placed in their respective ventilator group. Animals on conventional ventilation were managed by adjustment of tidal volume and frequency (to 1 Hz) to keep PaCO2 below 55 and by adjustment of the mean airway pressure. One of the "HFOV" group died of cardiovascular complications before going on HFOV and was eliminated from data analysis. The remaining HFOV baboons survived the 11-day experimental period without evidence of airleak. Six of the 11 prematures treated with PPV/PEEP developed pulmonary interstitial emphysema and/or pneumothorax and five of the animals died within 48 h. The intergroup differences in airleak were significant (p less than 0.05). Mean airway pressure (measured at the proximal airway) was higher initially with HFOV but then was lowered more rapidly than in the PPV/PEEP animals. The arterial to alveolar oxygen ratio rose and the FIO2 could be lowered more rapidly with HFOV than with conventional ventilation. These differences reached significance by 20 h. After 60 h there were no significant differences between HFOV and the PPV/PEEP survivors. HFOV resulted in more uniform saccular expansion, higher arterial to alveolar oxygen ratio, less oxygen exposure, and decreased acute barotrauma when compared to PPV/PEEP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299237 TI - [Diabetes mellitus as a manifest form of polyglandular failure in children]. PMID- 3299238 TI - [Seasonal rhythms of the functional activity of the hypophysis and insular apparatus in healthy children 8 to 15 years old]. PMID- 3299239 TI - [Glucose metabolism in the fetus and newborn infant]. PMID- 3299240 TI - [Botulism in nursing infants]. PMID- 3299236 TI - Escherichia coli O157:H7 as the predominant pathogen associated with the hemolytic uremic syndrome: a prospective study in the Pacific Northwest. AB - During a 12-month period, 14 patients with the hemolytic uremic syndrome were identified in a prospective study of enteric pathogens associated with this disorder. Of the 12 patients with a diarrheal illness preceding the onset of hemolytic uremic syndrome, fecal Escherichia coli O157:H7 was detected in seven (58%), all of whom had bloody diarrhea. Half of the siblings of these patients had concurrent nonbloody diarrhea. No source for infection with this organism was identified. Enteric infection with E coli O157:H7 occurs in the majority of cases of hemolytic uremic syndrome following diarrheal illness in the Pacific Northwest and may represent a previously overlooked cause of hemolytic uremic syndrome in other locales. Evaluation of all cases of hemolytic uremic syndrome for enteric pathogens should routinely include cultures for E coli O157:H7 until results of additional studies clarify the distribution of agents associated with hemolytic uremic syndrome in different geographic regions. These findings may provide new opportunities for the design of therapeutic and preventive strategies in this disorder. PMID- 3299241 TI - [Diagnostic importance of determining high-density lipoprotein cholesterol in the clinic]. PMID- 3299242 TI - [Problems of perinatal endocrinology]. PMID- 3299243 TI - [Results of echographic study of the liver in diabetes mellitus in children]. PMID- 3299244 TI - [The proportion of Escherichia infections caused by enteropathogenic Escherichia and their clinical characteristics in children]. PMID- 3299245 TI - [Sphincter function of the digestive system in children with gastroenterologic pathology]. PMID- 3299247 TI - Founders of pediatric pathology: Agnes Rose Macgregor, MD, FRCPE, FRCOG. PMID- 3299246 TI - Serum beta 2-microglobulin (beta 2m) and anti-beta 2m antibody in chronic hepatitis. AB - Serum beta 2-microglobulin (beta 2m) concentration is increased in pathological processes associated with lymphocyte activation. beta 2m and anti-beta 2m autoantibody (anti-beta 2m) determinations were made in the sera of 41 patients with chronic hepatitis and cirrhosis, respectively, in 19 with systemic lupus erythematosus (SLE) as well as in 27 healthy controls. A pathologically high beta 2m value was found in one-third of inactive persistent hepatitis, and in more than two-thirds of active hepatitis and postnecrotic cirrhosis cases. In SLE it occurred in 16 out of 19 cases. The beta 2m level was elevated mainly in HBV negative and circulating immune complex-positive hepatic patients. Anti-beta 2m antibody occurred in one-third of chronic hepatitis, but only in one out of 13 cases in cirrhosis and in 12 out of nineteen patients with SLE. The results suggest that beta 2m and anti-beta 2m as in SLE may be further laboratory indicators of immunological activity in inflammatory hepatic disease. PMID- 3299248 TI - Gastroesophageal reflux and esophagitis in infants and children. PMID- 3299250 TI - Indian childhood cirrhosis. PMID- 3299249 TI - Normal anatomy of the myenteric plexus of infants and children. Demonstration by flat-mount (circuit diagram) preparations. PMID- 3299251 TI - Idiopathic pulmonary hemosiderosis and related disorders in infancy and childhood. PMID- 3299253 TI - Master's education in nursing: route to opportunities in contemporary nursing 1986-87. PMID- 3299252 TI - A historical perspective: the Netherlands and the United States. PMID- 3299254 TI - Education for nursing: the diploma way 1986-87. Information about NLN-accredited diploma programs in nursing. PMID- 3299255 TI - Nursing data review: 1986. PMID- 3299256 TI - Practical nursing career 1986-87. PMID- 3299257 TI - Guidelines for basic computer education in nursing. PMID- 3299259 TI - Solid-phase assembly of cow colostrum trypsin inhibitor gene. AB - A gene for cow colostrum trypsin inhibitor (CTI) was constructed from synthetic oligonucleotides using a novel method of solid-phase gene assembly. In the first step an anchor oligonucleotide was covalently bound to the CNBr-activated Sephacryl S-500 support. Next, triads or tetrads of separately annealed oligonucleotides were stepwise hybridized to the immobilized complementary sequence, with washing after each step. In the last step a linearized vector molecule was ligated to the assembled gene. The whole construct was released from the solid support with a restriction enzyme, circularized, and used for transformation, with a high yield of recombinant clones being obtained. The method represents a generally applicable approach to rapid and efficient assembly of extended DNA duplexes. PMID- 3299258 TI - Novel non-isotopic in situ hybridization technique detects small (1 Kb) unique sequences in routinely G-banded human chromosomes: fine mapping of N-myc and beta NGF genes. AB - A novel in situ hybridization technique is described. This non-radioactive technique combines, for the first time, the high spacial resolution and rapid signal development of the non-isotopic approach with the previously unrivalled sensitivity of autoradiography. The procedure, which employs biotin labelled DNA probes and a streptavidin-alkaline phosphatase based detection system, is compatible with pre G-banding and can be performed on archival material. Unique sequences as small as 1 Kb are detectable. Using this technique, we have mapped the N-myc oncogene and the gene for beta-Nerve Growth Factor to 2p24 and 1p13 respectively. PMID- 3299261 TI - A common structural feature in promoter sequences of E. coli. AB - We have searched promoter regions of E. coli, structural genes of the same organism, and computer-generated random sequence DNA for the occurrence of common structural features. This is done by converting the base sequence to a series of numbers representing the sequence of helix twist angles and examining these numerical sequences statistically. Common structural features are shared by the promoter regions with a much higher frequency than are found in structural genes or in random sequences. These structures appear to be scattered randomly throughout the promoters, both in terms of the number of such structures per promoter and in terms of location within each promoter. One particular structure consisting of five successive helix twist angles is reported, along with a list of 60 different hexanucleotide sequences that share this structure. The locations of these structural elements in 61 E. coli promoters are also tabulated. PMID- 3299260 TI - The repair of psoralen monoadducts by the Escherichia coli UvrABC endonuclease. AB - We have examined the interactions of UvrABC endonuclease with DNA containing the monoadducts of 8-methoxypsoralen (8-MOP) and 4,5',8-trimethylpsoralen (TMP). The UvrA and UvrB proteins were found to form a stable complex on DNA that contains the psoralen monoadducts. Subsequent binding of UvrC protein to this complex activates the UvrABC endonuclease activity. As in the case of incision at pyrimidine dimers, a stable protein-DNA complex was observed after the incision events. For both 8-MOP and TMP, the UvrABC endonuclease incised the monoadduct containing strand of DNA on the two sides of the monoadduct with 12 bases included between the two cuts. One incision was at the 8th phosphodiester bond on the 5' side of the modified base. The other incision was at the 5th phosphodiester bond 3' to the modified base. The UvrABC endonuclease incision data revealed that the reactivity of psoralens is 5'TpA greater than 5'ApT greater than 5'TpG. PMID- 3299262 TI - Complete nucleotide sequence of the Escherichia coli gene encoding malate dehydrogenase. PMID- 3299263 TI - The yeast DNA polymerase I transcript is regulated in both the mitotic cell cycle and in meiosis and is also induced after DNA damage. AB - Using mitotic cultures synchronised by a feed-starve protocol or by elutriation, we have shown that the yeast DNA polymerase I gene is periodically expressed with its transcript increasing at least 100-fold in late G1 with a peak around the G1/S phase boundary. This is precisely the same interval of the cell cycle in which three other yeast DNA synthesis genes, CDC8, CDC9 and CDC21, have been found to be periodically expressed (White et al 1987. Expl. Cell. Res., in press). The polymerase I transcript is also regulated in meiosis, showing an overall fluctuation in level of some 20-fold, with a peak at about mid-S phase. In addition, following irradiation with 50J/m2 ultraviolet light, there was a 20 fold increase in the transcript, starting after 30 minutes and reaching a peak two hours later. These results indicate that DNA polymerase I is subject to a complex control and imply that it has a role in both DNA synthesis and DNA repair. PMID- 3299264 TI - Analysis of the terminator region after the deoCABD operon of Escherichia coli K 12 using a new class of single copy number operon-fusion vectors. AB - We describe the construction of low copy number operon-fusion vectors, and use one of these vectors for the cloning and transcriptional analysis of the terminator region after the deo operon of Escherichia coli K-12. The new vectors are miniderivatives of plasmid R1 containing the parB stability locus of this plasmid and the lac genes as a selectable marker. Since the copy number of the vectors is only one per genome-equivalent at temperatures below 37 degrees C this system is ideally suited for isolation and characterization of transcriptional and translational signals from E. coli. Our results show that a very strong terminator (deot), which resembles Rho-independent terminators, is located 60 bp downstream from the fourth structural gene of the deo operon. This confirms that deoD is the last gene in the operon. In addition, we have identified a new promoter just after the deot terminator and a short DNA sequence that is able to reduce lacZ expression by 85% when inserted between the deoP2 promoter and the lac genes. PMID- 3299265 TI - Specific and cooperative binding of E. coli single-stranded DNA binding protein to mRNA. AB - Fluorometric titration of E. coli single-stranded DNA binding protein with various RNAs showed that the protein specifically and cooperatively binds to its own mRNA. The binding inhibited in vitro expression of ssb and bla but not nusA. This inhibition takes place at a physiological concentration of SSB. The function of the protein in gene regulation is discussed. PMID- 3299266 TI - Structure of yeast regulatory gene LEU3 and evidence that LEU3 itself is under general amino acid control. AB - Determination of the nucleotide sequence of a DNA region from Saccharomyces cerevisiae previously shown to contain the LEU3 gene revealed one long open reading frame (ORF) whose 887 codons predict the existence of a protein with a molecular mass of 100,162 daltons. The codon bias index of 0.02 suggests that LEU3 encodes a low-abundance protein. The predicted amino acid sequence contains a stretch of 31 residues near the N-terminus that is rich in cysteines and basic amino acids and shows strong homology to similar regions in five other regulatory proteins of lower eukaryotes. Additional regions with a predominance of basic amino acids are present adjacent to the cysteine-rich region. A stretch of 20 residues, 19 of which are glu or asp, is found in the carboxy terminal quarter of the protein. The 5' flanking region of LEU3 contains a TATA box 111 bp upstream from the beginning of the long ORF and two transcription initiation elements (5'TCAA3') 58 and 48 bp upstream from the ORF. The 3' flanking region shows a tripartite potential termination-polyadenylation signal. The predicted 5' and 3' ends of the transcript are in very good agreement with the previously determined size of the LEU3 message. Analysis of a LEU3'-'lacZ translational fusion suggests that the LEU3 gene, whose product is involved in the specific regulation of the leucine and possibly the isoleucine-valine pathways, is itself under general amino acid control. Consistent with this observation is the finding that the 5' flanking region of LEU3 contains two perfect copies of the general control target sequence 5'TGACTC3'. PMID- 3299267 TI - Enzyme-linked synthetic oligonucleotide probes: non-radioactive detection of enterotoxigenic Escherichia coli in faecal specimens. AB - Synthetic oligonucleotides, complementary to unique sequences in the heat stable enterotoxin gene of Escherichia coli specific for humans, were prepared with a 30 atom spacer arm and a 3' terminal sulfhydryl group which was coupled to bromoacetyl-derivatized alkaline phosphatase. The resulting direct enzyme-linked oligonucleotide probes, containing one enzyme molecule per oligonucleotide, successfully diagnosed enterotoxigenic Escherichia coli in clinical specimens by using a modified colony hybridization method and a colorimetric assay. The procedure is rapid, simple and reliable with a sensitivity equivalent to that using 5'-terminally labelled [32p]-oligonucleotide probes. The results indicate that the enzyme-labelled oligonucleotide probes should be applicable to the routine diagnosis of enterotoxigenic Escherichia coli and possess the potential for the detection of other microbial pathogens. PMID- 3299268 TI - Synthesis and reactivity of intermediates formed in the T4 RNA ligase reaction. AB - The intermediate adenylated donor derivatives A(5')pp(5')dTp and A(5')pp(5')GpGpGp have been prepared from suitable phosphorylating reagents activated by 1-hydroxybenzotriazole. Phosphodiester bond formation between donor and acceptor oligonucleotides as catalyzed by T4 RNA ligase is shown to be more efficient when the adenylated form of the donor molecule is used. PMID- 3299270 TI - Analysis of trp repressor-operator interaction by filter binding. AB - A filter binding assay was developed that allows measurement of specific binding of trp repressor to operator DNA. The most important feature of this procedure is the concentration and type of salt present in the binding buffer. Using this assay the dissociation constant of the repressor-operator complex was determined to be 2.6 X 10(-9) M, and 1.34 repressor dimers were found to be bound to each operator-containing DNA molecule. These values agree with those obtained by more complex methods. The dissociation constant of the repressor for the corepressor L tryptophan in the presence of operator DNA was shown to be 2.5 X 10(-5) M. A synthetic 48 bp operator fragment was used to determine the repressor-operator dissociation constant in the presence of tryptophan or tryptophan analogs which have higher or lower affinities for aporepressor. The rate of dissociation of repressor from operator DNA also was determined. Our findings indicate that dissociation is influenced by the concentration of tryptophan or tryptophan analogs and suggest that release of the corepressor may be the first step in dissociation of the repressor-operator complex. PMID- 3299269 TI - High frequencies of short frameshifts in poly-CA/TG tandem repeats borne by bacteriophage M13 in Escherichia coli K-12. AB - Slipped-strand mispairing (SSM) may play an major role in repetitive DNA sequence evolution by generating large numbers of short frameshift mutations within simple tandem repeats. Here we examine the frequency and size spectrum of frameshifts generated within poly-CA/TG sequences inserted into bacteriophage M13 in Escherichia coli hosts. The frequency of detectable frameshifts within a 40 bp tract of poly-CA/TG is greater than one percent and increases more than linearly with length, being lower by a factor of four in a 22 bp target sequence. The frequency increases more than 13-fold in mutL and mutS host cells, suggesting that a high proportion of frameshift events are normally repaired by methyl directed mismatch repair. Of the 87 sequenced frameshifts in this study, 96% result from deletion or insertion of only or two 2 bp repeat units. The most frequent events are 2 bp deletions, 2 bp insertions, and 4 bp deletions, the relative frequencies of these events being about 18:6:1. PMID- 3299271 TI - Construction of bacteriophage T7 late promoters with point mutations and characterization by in vitro transcription properties. AB - This paper describes the construction of 18 cloned bacteriophage T7 late promoters with single point mutations. In vitro transcription experiments were used to characterize the properties of these promoters. Since the mutated promoters are cloned into identical backgrounds, differences seen in the transcription assays are directly attributable to the point mutations. All of the mutated promoters are less active than wildtype, but they can be divided into two types. Type A mutations map from -4 to +1 and reduce promoter activity when the template is linearized or when 60mM NaCl is added to the reaction buffer. Type B mutations map from -9 to -7 and reduce promoter activity under all conditions tested. At several sites all three possible point mutations are available. At these sites we observed hierarchies of base pair preference, as determined by promoter activity, that may indicate that T7 RNA polymerase interacts with groups in the major groove. PMID- 3299272 TI - Nucleotide sequence of the bacteriophage T5 DNA fragment containing a distal part of tRNA gene region. PMID- 3299273 TI - Sequence of an isoleucine tRNA from Mycoplasma mycoides sp. Capri. PMID- 3299274 TI - [Bone marrow transplantation after preoperative chemotherapy and total body irradiation. I. Clinico-radiobiological principles]. PMID- 3299275 TI - [Bone marrow transplantation after preoperative chemotherapy and total body irradiation. II. Technic and dosimetry of total body irradiation]. PMID- 3299276 TI - [Bone marrow transplantation after preoperative chemotherapy and total body irradiation. III. Case report]. PMID- 3299277 TI - Community practice: nursing influence on policy formulation. PMID- 3299278 TI - The Braden Scale for Predicting Pressure Sore Risk. AB - The Braden Scale for Predicting Pressure Sore Risk was developed to foster early identification of patients at risk for forming pressure sores. The scale is composed of six subscales that reflect sensory perception, skin moisture, activity, mobility, friction and shear, and nutritional status. Content and construct validity were established by expert opinion and empirical testing. Three studies of reliability are reported here, using raters who varied in level of educational preparation and geographic region. Two prospective studies of predictive validity were completed to determine the scale's sensitivity and specificity. Reliability ranged from r = .83 to r = .94 for nurses' aides and licensed practical nurses; when used by registered nurses, the reliability increased to r = .99. Predictive validity was calculated for each cut-off point of the scale. Using a cut-off point of 16, sensitivity was 100% in both studies. Specificity ranged from 64% to 90%. This instrument has highly satisfactory reliability when used by RNs, and greater sensitivity and specificity than instruments previously reported. PMID- 3299279 TI - Reliability and validity of mental status questionnaires in elderly hospitalized patients. AB - Reliability and validity of three mental status questionnaires--the Short Portable Mental Status Questionnaire, Mini-Mental State Examination, and Cognitive Capacity Screening Examination (CCSE)--were assessed using 66 elderly (age greater than or equal to 65 years) hospitalized medical-surgical patients. Internal consistency as well as content, criterion-related, and construct validities were examined. The CCSE was found to be the most valid and reliable measure of mental status in this patient population. Implications of the findings regarding selection of mental status questionnaires for differing purposes are discussed. PMID- 3299281 TI - Oral hygiene. Denture care. PMID- 3299280 TI - Oral hygiene. The mouth trap. PMID- 3299282 TI - The journal of infection control nursing. On the right track. PMID- 3299283 TI - Caloric intake, body weight, and cancer: a review. AB - The literature is reviewed for evidence concerning the relation between caloric intake, body weight, and cancer. Convincing experimental data regarding caloric intake and benign and malignant tumor incidence have been available since the 1940s and demonstrate that caloric restriction significantly reduces tumor incidence for a variety of tumor types in several animal models. Some epidemiological investigations provide evidence for a positive calorie-cancer association in humans, although it is difficult (in these studies) to separate the effects of calories per se from those of dietary fat. A larger number of investigations have evaluated body weight alone, and high relative body weight or high caloric intake has been associated with increased risk of cancer of the breast, colon, rectum, prostate, endometrium, kidney, cervix, ovary, thyroid, and gallbladder. In contrast, lung, bladder, and stomach cancers appear to be inversely associated with body weight, and some prospective studies of men demonstrate greater total cancer mortality among lean individuals. However, in their analyses, few of these latter investigations considered the effects of cigarette smoking, antecedent illness, or competing causes of death. While the relations between caloric intake, other dietary macronutrients (e.g., fat), and body weight are complex and require further investigation, a complete review of the data suggests that reducing caloric intake and relative body weight may lead to a considerable decrease in cancer risk in humans. PMID- 3299284 TI - Autologous bone marrow transplantation. PMID- 3299285 TI - [Validity of antigliadin antibodies in the diagnosis of celiac disease]. AB - Antibodies to gliadin, detected by immunofluorescence (IFL-AGA) and ELISA (ELISA AGA), have been found in 68 of 71 (96%) sera from children with active celiac disease. AGA of IgA class were confined to celiac disease on normal diet and after gluten challenge, as all the antibodies, found in children on gluten free diet (40%) and in control gastroenterological diseases (20%), were of IgG class. Sera from 175 first-degree relatives of our celiacs were also screened for AGA. IFL-AGA were positive in 13 (7%) and ELISA-AGA in 27 cases (15%). Antibodies were of IgA class in 13 relatives (7%). A celiac's asymptomatic sister, selected for jejunal biopsy only on the basis of IgA AGA positivity, showed subtotal villous atrophy. Although AGA cannot replace jejunal biopsy in the diagnosis of celiac disease, they can be regarded as useful tools in the screening of gluten sensitive enteropathy. Moreover, as a positive IgA AGA test is closely related to the active phases of celiac disease, their research can be useful both to evaluate the effect of gluten free diet and to establish when a new biopsy is appropriate after gluten challenge. PMID- 3299286 TI - [Surgery of malformations of extrahepatic bile ducts in childhood]. AB - The actual hypothesis on the etiology and pathogenesis of neonatal hepatitis, intrahepatic and extrahepatic biliary atresia and choledocal cyst is that these disorders can be different results or permissible outcomes of a single basic process: infantile obstructive cholangiopathy. This hypothesis can explain the failure of many infants with operable extrahepatic biliary atresia to do well following surgically successful anastomosis. Very possibly no surgical mode of therapy will cure a significant fraction of infants with biliary atresia (correctable and non-correctable types) because the basic disease process actually produces portal fibrosis and destroys intrahepatic bile ducts as well. However, since the obliterative process can resolve, even if not usually completely, surgical procedures of conventional or of hepatic-portoenterostomy type should be considered for all infants who are found to have biliary atresia. Probably biliary atresia is more in need of preventive or prophylactic measures than of new surgical procedures. PMID- 3299287 TI - [Tendency to low T3 syndrome in type 1 juvenile diabetes. Comparison of treatment with human and porcine insulin]. AB - We investigated the serum thyroid hormones an the degree of diabetic control in 30 children and adolescents suffering from type 1 insulin-dependent diabetes, first while they were being treated with porcine insulin (group A) and then while 23 of them, random selected, were being treated with human insulin (group C). The purpose of our study was to evaluate if the change to human insulin would result in better metabolic control and disappearance of the tendency to the low T3 syndrome that was evidenced in group A. If we compare group A with group C, it can be seen that the degree of diabetic control is higher in group C (decrease in HbA1C), but that the tendency to the low T3 syndrome has not disappeared. Then we selected inside the groups A and C the patients in good metabolic control, and called them respectively group B and group D. If we compare group B with group D it can be seen that there is not any significant difference at all between them and that both groups show a tendency to the low T3 syndrome if compared with the control group (group K). In conclusion, we may state that substituting porcine with human insulin has not brought about any significant metabolic improvement in our patients, as can be seen from the persistent tendency to the low T3 syndrome. PMID- 3299289 TI - [Natural history of fetal uropathies. Experience in 40 cases]. AB - Appropriate management of fetal uropathies depends on accuracy in assessing the severity of urinary tract obstruction and renal damage, and in predicting the potential for recovery after surgical correction. A review of 40 fetuses aged between 20 an 39 weeks referred to us for prenatal counseling for a suspected anomaly of the urinary tract, has been made. Reliability of our diagnostic resources has been retrospectively evaluated on the basis of clinical, ultrasonographic and radiological postnatal data. Conservative approach has been adopted in all our cases. None intrauterine surgery was attempted; pre term delivery was advised only in two cases. Our results confirm poor prognosis of fetuses with marked decrease of amniotic fluid within the 24th week of gestational age. After this date the amount of amniotic fluid alone may not be a completely reliable prognostic factor. Ultrasonographic aspect of fetal kidneys and, in some occasions, chemical analysis of fetal urines may accomplish our prenatal study and help to predict the degree of neonatal renal function and potential of survival. PMID- 3299288 TI - [Significance of the evaluation of C-peptide in children with type 1 diabetes mellitus]. AB - In type I diabetes mellitus (DM) the presence of C peptide (Cp), whose determination is unaffected by exogenous insulin, is considered expression of a residual beta-cell activity, which allows a better metabolic control. In 35 children affected by type I DM the fasting Cp was measured: in 18 cases (1st group) a value greater than or equal to 1 ng/ml was observed, while in the remaining 17 (2nd group) the Cp value was less than 1 ng/ml. A statistical comparison between the two groups demonstrated that in the first one a better metabolic control was achieved with a daily lower insulin dosage. Moreover in the 1st group the onset of the disease was more recent, while there was no difference between the two groups with regard to the age at diagnosis. The Cp evaluation and follow-up is useful in the assessment of the individual case; furthermore, on the basis of these studies, an immunosuppressive treatment may be considered during the early phase of the disease, when a residual beta-cell activity is demonstrated. PMID- 3299290 TI - [Juvenile hyaline fibromatosis. Description of a case and review of the literature]. AB - The authors report a typical case of JHF. The complete review of the literature shows that no more than 20 cases have been so far described. The clinical, pathological and electron microscopic features are stressed and the main clinical and pathological differential diagnoses are considered. The disease, formerly thought to be due to an abnormal composition of collagen fibers, seems to be nowadays, thanks to Japanese authors, related to an error in glycosaminoglycans metabolism. PMID- 3299291 TI - [Ureteral duplication and anomalous symptomatology. Presentation of a case]. AB - The authors report a case of unilateral ureteral duplication with extravesical ureteral orifice evaluated with sonography and confirmed by surgery. The peculiarity of the case is founded on the anomalous clinical findings with poorly significant uroculture and the apparent discrepancy between sonographic and urographic finding. The important rule of sonographic evaluation in early diagnosis of kidney malformations is confirmed. PMID- 3299292 TI - [Vertebrobasilar insufficiency of prenatal origin: a case report]. AB - The case of a newborn presenting from birth with arthrogryposis multiplex congenita resting mainly on the legs, severe hypotonia, consciousness anomalies, clonic fits, recurrent apnea and bradycardia, absent sucking and swallowing is described. At the age 4 months a further episode of apnea and bradycardia was followed by death. The neuropathologic analysis disclosed a number of bilateral, cystic and symmetric infarcts in the thalamus and hypothalamus, spreading caudally to the tegmentum of the mesencephalon and the pons. Such distribution of lesions does suggest a vascular topography, i.e. in the territories supplied by branches of the vertebro-basilar arteries. There was light clinical and neuropathological evidence of prenatal occurrence of the vascular injuries, possibly at the end of the 7th month by a defective arterial perfusion of the fetus due to protracted menaces of premature birth. We would outline the existence and frequency of the thalamic and dorsal brain stem necrotic involvement by acute anoxia-ischemia occurring in the third trimester of gestation or at birth, and the relative peculiarity of their clinical picture. PMID- 3299294 TI - Indications for immunotherapy. AB - Underlying immunodeficiency should be suspected in every patient, irrespective of age, who has recurrent, persistent, severe, or unusual infections. Defects in immunity can be classified into primary or secondary disorders involving specific or nonspecific immune mechanisms. Several forms of primary and secondary immunodeficiency exist for which various immunotherapeutic modalities are available. Significant among these are immunoglobulins commercially available for intravenous infusion. Other therapies include transplantation of tissue such as bone marrow, fetal liver, and fetal thymus. Enzyme replacement therapy is being developed, as is the use of products unique to immunocompetent cells, such as thymus extract, thymosin, interleukins, and transfer factor. Forms of nonspecific immune modulators and stimulators are other possibilities, especially in the context of the immunotherapy of tumors. PMID- 3299293 TI - [Retinopathy of prematurity. Notes on pathogenesis and therapy]. AB - The retinopathy of prematurity reveals a pathology that involves a very important organ for the relation-life of a newborn. It was first identified and described by Terry in 1942. The incidence of retinopathy decreased dramatically after the discovery of the damages of oxygen an a sensitive immature retina and the oxygen monitoring therapy. Since the mid 1960's, the incidence of ROP is risen again, probably, in relation either to the more precise and developed techniques of examining, or to the increased rate of survival of a newborns with a very low birth weight, who are the most high-risk infants. This work considers the participations of several authors about the pathogenesis and the therapy of the retinopathy of prematurity. After a review of some historically important works, the author describes the pathogenesis of the illness and inspects the therapeutic methods that are now possible in relation to the changes and the stages of ROP (Vit. E, photocoagulation, cryotherapy, scleral buckling and vitrectomy). The conclusions of this study emphasize the essential role of the prevention and the early diagnosis of retinopathy and wish the diffusion and the standardizing of this methodologic approach. PMID- 3299295 TI - Recent advances in solid organ transplantation. AB - Advances in organ transplantation have come rapidly and consistently in recent years as the result of improved surgical techniques and immunosuppressive drug therapies. Experience gained in renal transplantation over the past 30 years has made this a standard therapeutic approach for treating chronic renal failure. This knowledge has been successfully applied to the transplantation of other organs to produce steadily increasing survival rates and improved quality of life. This article reviews the advances that have been made in solid organ transplantation and immunosuppressive drug therapy. PMID- 3299296 TI - Bone marrow transplantation. AB - Since the 1970s major progress in bone marrow transplantation has resulted in long-term survival and even cure for many patients with serious hematologic disease. Many patients undergoing the procedure, however, experience serious complications, including graft rejection, graft-versus-host disease, and infection. Preventing or treating these complications with drugs or other forms of immunotherapy is effective in many, but not all, patients. PMID- 3299297 TI - Intravenous immune globulin: dosage and administration. AB - Intravenous immune globulin (IV-IgG) is approved for use in substitution therapy of immunodeficiency syndromes and treatment of idiopathic thrombocytopenic purpura (ITP). The initial dose for substitution therapy is 0.2 g/kg body weight repeated monthly. If necessary, the dose may be increased to 0.3 g/kg and the frequency to every 2-3 weeks. The approved dosage for ITP is 0.4 g/kg daily for 2 to 5 consecutive days. Repeat doses of 0.4 g/kg have been used as maintenance therapy. The initial infusions of IgG to immunodeficient patients who have not been treated during the previous 8 weeks or never treated at all should proceed with caution. These patients are at risk of potentially serious complement mediated adverse reactions. Adverse reactions due to IgG administration are less frequent and less severe for patients with ITP. Currently available preparations are contraindicated in patients with a selective IgA deficiency and detectable IgA antibodies. PMID- 3299298 TI - Immunology for the clinical pharmacist. AB - Major advances in the field of immunology within the past decade have led to greater understanding of the immune network. The immune system is finely balanced, with cells communicating both by direct contact and through soluble mediators. Drugs may exert their effects at different sites within the immune network. To understand fully how these drugs act and how side effects may occur, clinicians must comprehend the basic workings of the immune system. PMID- 3299300 TI - Methodology and safety considerations in the production of an intravenous immunoglobulin preparation. AB - Intravenous immunoglobulins are biologic substances and differ in many respects from chemical pharmaceuticals. To produce a safe and efficacious preparation, special points must be considered. Careful screening procedures and excluding high-risk donor populations reduce the risk of transmitting viral disease from the starting material. With plasma fractionation the immunoglobulins are purified, and safety is further improved by eliminating potentially remaining viruses. Cold ethanol-fractionation methods have proved to be safe and economical. Anticomplementary aggregates, responsible for anaphylactoid reactions in agammaglobulinemic patients, are removed to achieve intravenous tolerance. Enzymatic digestion or chemical modifications impair the efficacy of the preparation. Ion-exchange adsorption removes immunoglobulin subpopulations. Mild acid treatment at pH 4 yields a safe product with intact potency. Optimal stability is ensured by freeze-drying. A fine net of quality controls virtually guarantees a safe preparation. PMID- 3299301 TI - Immunotherapy of idiopathic thrombocytopenic purpura and autoimmune neutropenia. AB - Idiopathic thrombocytopenic purpura (ITP) is a disorder characterized by a low platelet count and purpura. Identification of an antiplatelet antibody suggests that this is an autoimmune disease. Corticosteroids and splenectomy have been the major therapies for many years. High-dose intravenous immune globulin (IV-IgG) has been very successful in the management of ITP and has recently received FDA approval for this condition. It was also successful when administered to a few patients with autoimmune neutropenia. The exact mechanism of action of IV-IgG in autoimmune disorders is poorly understood. Currently, high-dose IV-IgG has a definite place in the management of ITP. Its role in therapy includes emergency treatment, preoperative preparation, the postponement of splenectomy in young children, and treatment of ITP during pregnancy. PMID- 3299299 TI - Antibody immunotherapy of gram-negative bacterial sepsis. AB - Gram-negative bacterial sepsis continues to represent a significant cause of morbidity and mortality in hospitalized patients. Currently available medical therapy (antimicrobial agents, hemodynamic monitoring, aggressive fluid resuscitation, and nutritional support) for this disease process has reduced but not eliminated the severe consequences that may ensue. Recent investigations have demonstrated the ability of antibody directed against gram-negative bacterial lipopolysaccharide (LPS or endotoxin) to afford protection during experimental gram-negative bacillary sepsis. The core LPS-lipid A portion of endotoxin represents a determinant shared by many common gram-negative microorganisms that is luxuriantly expressed on the cell surface of rough mutants of Escherichia coli and Salmonella minnesota. These organisms or the outer membrane LPS isolated from them thus represent suitable immunogens for the development of cross-protective antibody preparations. Large quantities of highly cross-reactive antibody may potentially be obtained from several sources: murine or human monoclonal antibodies, immunization of large animals or humans with subsequent plasmapharesis and antibody isolation, affinity purification of large amounts of normal antibody, and pooling of prescreened lots of normal animal or human antibody that react to a particular bacterial antigen. PMID- 3299302 TI - HLA: its role in pathogenesis of disease. AB - The complexity of the HLA system, the major histocompatibility complex in man, is reviewed with regard both to the isotypic complexity (the number of loci) as well as the polymorphism of the individual loci. Different methods used to define polymorphism, including serological analysis and T lymphocyte response analysis, are considered. The possible role of HLA antigens in association with a variety of diseases is discussed. PMID- 3299303 TI - Review of intermittent dobutamine infusions for congestive cardiomyopathy. AB - Dobutamine is a potent inotropic agent traditionally used for treatment of acute cardiac decompensation of congestive heart failure (CHF). It acts primarily by increasing myocardial contractility and cardiac output. It has a rapid onset of action, a half-life of 2 minutes, and a duration of action of 10 minutes. Recently, the therapeutic effect of dobutamine was noted to be prolonged beyond the discontinuation of an infusion, persisting for 4-10 weeks after infusion of 48-72 hours. Because of this prolonged effect, dobutamine infusions were evaluated in outpatients with intractable CHF and were effective in improving their functional status. No effect on survival rates may be expected, but this form of therapy may improve the patient's lifestyle. Although several factors may limit the application of dobutamine infusion to outpatients, it offers an effective alternative to traditional therapy for select patients. PMID- 3299304 TI - [Role of aminoglutethimide in the treatment of adrenal hyperfunction]. PMID- 3299306 TI - [Etiopathological factors in insulin-dependent diabetes mellitus (type 1)]. PMID- 3299305 TI - [Value of ultrasonic examination of the abdominal cavity in treatment monitoring in malignant lymphoma]. PMID- 3299307 TI - History of the general hospital psychiatric inpatient unit. 1947 to 1986. AB - Thirty-five years ago, the Mount Sinai unit was considered the state of the art for inpatient psychiatry. Now, short-term hospitalization, active management techniques, and quick dispositions are the practice. At the rate at which neurophysiology and psychiatry are expanding, I have to anticipate that inpatient psychiatric care will again change radically, and long before another 35 years. I doubt that the psychiatric unit of today that I have described will still be recognizable in 10 years. PMID- 3299308 TI - [Mechanism of action and use of antagonists of serotonin receptors S2, especially ketanserin, in the treatment of various diseases of the cardiovascular system]. PMID- 3299309 TI - [Ultrasonographic control of the positioning of the catheter and intracardiac electrode]. PMID- 3299310 TI - [Comparison of the effectiveness of various models of therapeutic management in acute Amanita poisoning]. PMID- 3299311 TI - [Allergy to Hymenoptera venoms in the light of the literature and personal studies]. PMID- 3299312 TI - [Selected clinical problems in occupational asthma]. PMID- 3299313 TI - [IgE-dependent responses of the immune system]. PMID- 3299314 TI - [Results of using the preparation Voltaren SR 100 in the treatment of rheumatoid arthritis]. PMID- 3299315 TI - [Reactive (post-infection) arthritis]. PMID- 3299316 TI - [Rehabilitation of patients after surgical treatment of backache syndromes]. PMID- 3299317 TI - [Replacement biofeedback in the rehabilitation of children and adolescents with lateral spinal curvature]. PMID- 3299318 TI - [Late bronchial spasm after physical exertion and after hyperventilation of cold air and the activity of the neutrophil chemotactic factor in the serum of patients with bronchial asthma]. PMID- 3299319 TI - [Pulmonary embolism caused by factors other than blood clot]. PMID- 3299320 TI - [Treatment of decompression sickness and air embolism]. PMID- 3299321 TI - [Value of ultrasonography in comparison with other diagnostic methods and intraoperative exploration in cholelithiasis]. PMID- 3299322 TI - [Results of the treatment of chronic active hepatitis with thymus extract (TFX Polfa). (Evaluation of the preliminary stage of clinical studies)]. PMID- 3299323 TI - [Fine-needle biopsy guided by an ultrasonic device USG-40]. PMID- 3299324 TI - [Advances in the laboratory diagnosis of thyroid diseases]. PMID- 3299325 TI - [Fever in children]. PMID- 3299326 TI - Classification of myositis. Correlations between morphological and clinical classifications of inflammatory muscle disease. AB - Insufficient clinical data given to pathologists often hamper the differentiation of inflammatory muscle diseases. Thus we proved the value of a classification based only upon morphological criteria. Among 160 biopsies with myositic pattern (4.9% of a series of 3264 muscle biopsies) we could distinguish the following groups: Interstitial inflammation with only few fibre necroses (17.6%), predominance of fibre necroses with few inflammatory infiltrates (38.1%), small vessel vasculitis (20.0%), arteritis (13.1%), granulomatous myositis (8.8%) and polymorphonuclear leukocytic infiltrates (2.6%). This classification is compared with the used clinical diagnoses. Some special morphological aspects (histometric and immunocytologic examinations, tissue calcification, inclusion bodies, neurogenic atrophies) are analysed and so are some clinical peculiarities (e.g. malignoma-association, differentiation of mixed connective tissue syndrome, drug induced reactions). The diagnostic value of purely morphologic criteria is restricted. For better diagnostic work a great number of clinical informations is required. Nevertheless, certain morphological patterns give important directions, e.g. to occult malignoma. PMID- 3299327 TI - Systemic angioendotheliomatosis of the lung. AB - Systemic angioendotheliomatosis is a very rare malignant disease characterized by intravascular neoplastic proliferation of reticuloendothelial cells. According to the clinical features three different types of prognostic value can be distinguished: Exclusive skin involvement; Progressive skin lesions disseminating to internal organs; Aggressive and lethal type affecting primarily internal organs. Until now about 60 cases of systemic angioendotheliomatosis have been reported in the literature. Here we describe the first well-documented case with almost isolated lung involvement. The presentation of morphologic and clinical signs and differential-diagnostic considerations are followed by a critical review of the literature. PMID- 3299329 TI - Herpes simplex virus: fetal and decidual infection. AB - We report 2 cases of probable in-utero transmission of herpes simplex virus. Herpes viral antigen was localized in these cases to the decidualized endometrium, using an immunoperoxidase staining technique. Routine histology did not show herpes inclusions in the decidual or glandular cells. This finding suggests that herpes virus may infect endometrial cells during pregnancy. PMID- 3299328 TI - Hemangioma of the umbilical cord. AB - Tumors of the umbilical cord are extremely rare. Only two types are recognized: hemangioma and teratoma. A case of hemangioma of the cord prompted a review of the world literature that uncovered 17 other cases, bringing the total number of known cases up to 18. Our case is the first to be diagnosed by ultrasonography and was associated with polyhydramnios. PMID- 3299330 TI - History of diapering in Japan. AB - A review of the history of diaper use in various countries reveals a number of difficulties that have been confronted. These difficulties seem to be associated with both climatic and traditional factors in each country. In Japan, for example, because of the hot and humid summers, there was a need to make diapers both leak- and 'stuffiness'-proof. At first the use of natural fiber diaper covers met this need, but the recent development of disposable diapers seems to even better solve these problems. Yet disposable diapers still make up only 25% of the diaper market in Japan. This is because the Japanese view of baby care and the country's economy have worked against acceptance of disposable diapers, despite their merits. The slower trend toward disposable diaper use in Japan is in contrast to their rapid acceptance in Western Europe and the United States. Western acceptance probably stems from the perception that disposable diapers are a convenient and practical alternative to cotton diapers. Japan is moving in the direction of greater acceptance, but will do so according to Japanese customs and thought. PMID- 3299331 TI - Clinical correlates with diaper dermatitis. AB - Three types of clinical studies were carried out to better understand diaper dermatitis in a general infant population. In 'snapshot' clinical studies, skin condition under the diaper was evaluated at a given point in time across a large base of infants. Correlations were sought between diaper dermatitis incidence and severity and a number of factors, including sex, diet, maturity, type of diaper, history of allergy, contact with fecal matter, presence of Candida albicans, and diaper change frequency. Severe diaper rash correlated strongly with the presence of C. albicans, and the frequency of rash correlated with duration of contact with feces and inversely with diaper change frequency. Diaper rash peaked at ages 9-12 months and was lower for breast-fed than for formula-fed infants. Exclusive use of disposable diapers correlated with lower rash levels than when some or all cloth diapers were used. In a longitudinal study, infants were observed daily for 50 days in order to determine the frequency and duration of rash episodes. In this study, the tendency for some infants to be rash-prone was clearly indicated. In a third type of study, over 10,000 infant visits to physicians' offices were used to record skin condition. Results showed a three-to fourfold increase in diaper rash if the child had diarrhea during the previous 48 h. PMID- 3299333 TI - [Reflections and reminiscences on Prof. Hugon Kowarzyk]. PMID- 3299332 TI - [Prof. Hugon Kowarzyk]. PMID- 3299335 TI - [The pharmacology of pain]. PMID- 3299336 TI - [Methods of evaluating analgesia in humans]. PMID- 3299337 TI - [The concept of pain in psychology and medicine]. PMID- 3299334 TI - [On the 80th anniversary of the classical theory of blood coagulation]. PMID- 3299338 TI - [Pain and consciousness]. PMID- 3299339 TI - [Clinical symptoms and mechanisms of drug-induced allergic reactions]. PMID- 3299341 TI - [Mechanisms of viral leukemogenesis. I. Studies on animal retroviruses]. PMID- 3299342 TI - [Significance of a glycoprotein opsonin--fibronectin, in the diagnosis and therapy of patients with severe burns]. PMID- 3299343 TI - [Diagnosis, prevention and treatment of drug allergy]. PMID- 3299345 TI - Orthopedic surgery 1947-1987. A PGM retrospective. PMID- 3299340 TI - [Allergy to insect venoms]. PMID- 3299344 TI - [Proteolytic enzymes of the reproductive organs]. PMID- 3299346 TI - Adoptive immunotherapy of cancer with activated lymphocytes and interleukin-2. PMID- 3299347 TI - Comparison of natural killer and natural cytotoxic cells: characteristics, regulation, and mechanism of action. AB - NK cells are distinct cell populations that can be defined by a series of functional and surface characteristics. The existence of the discrete morphological counterpart for the NK cell, the LGL, has made it particularly convenient for categorizing these effector cells and distinguishing them from a variety of other effector cells. In addition, similar to T cells, considerable diversity exists among the NK cells. The diversity is seen not only in the expression of different surface markers but also within the specificity of target recognition as well as the secretory ability of LGL. It remains possible that much or even all of the heterogeneity that is seen in the phenotype and the function of LGL is due to differences and phases of activation and/or differentiation of these cells. Such differentiation-dependent, non-clonal, heterogeneity appears to account for the heterogeneity seen in subsets of monocytes and macrophages which can be detected in the expression of Ia antigen and Fc gamma receptors on activated macrophages. NK activity is highly regulated by IFNs (alpha, beta) and IL-2. Since NK cells also produce these factors, an autocrine regulation of these cells or their activity may occur. In addition, the mechanism of NK lysis is not yet clearly defined, but seems to involve cytotoxic molecules present in cytoplasmic granules that are released in various forms after effector-target cell contact. In contrast, NC activity against the WEHI-164 target cells appears to be a cytokine-mediated phenomenon, apparently mediated by the release of TNF during the course of the cytotoxicity assay. The mediation of NC activity by the release of TNF may account for the usual requirement for prolonged incubation periods to demonstrate this activity, in contrast to the rapid kinetics of NK activity. The association of TNF with NC activity also provides new clues about the nature of the NC cell, since TNF has been found to be produced predominantly by macrophages but can also be released by lymphocytes. PMID- 3299348 TI - Recent advances in the study of the molecular structure of the complement proteins. PMID- 3299350 TI - Diagnostic flow cytometry in hematology: the leukemias. PMID- 3299349 TI - Mo1 surface glycoprotein: structure, function and clinical importance. PMID- 3299351 TI - [Importance of phonetics in dental prosthetics]. PMID- 3299352 TI - [A simplified methacholine test in the detection of bronchial hyperreactivity]. PMID- 3299353 TI - ["Berry sorter's lung" or wine grower's lung--an exogenous allergic alveolitis caused by Botrytis cinerea spores]. PMID- 3299354 TI - [Polysomnographic measurements in early and late administration (18.00 vs. 22.00 hours) of retarded theophylline in bronchial asthma]. PMID- 3299355 TI - [Immunoenzyme detection of autoantibodies to the surface of pancreatic islet cells in diabetes mellitus and in increased risk of its development]. AB - The authors described the use of an enzyme-linked immunosorbent assay to determine islet cell surface antibodies (ICSA) in persons at high risk of developing insulin dependent diabetes (IDD) and different types of manifest disease. Among I degree healthy relatives of probands with IDD antibodies were detected in 16%. In disorder of the oral GTT (a small group) ICSA were found in 57% of examinees. In the group of IDD patients which was heterogeneous in duration of disease and age at its onset, the frequency of ICSA was 38%. The least frequency (10%) of antibodies was observed in patients with non-insulin dependent (NIDD) compensated by a diet and oral hypoglycaemic drugs. Among non compensated NIDD patients 62% were ICSA-positive. Thus, ICSA determined by the enzyme-linked immunosorbent assay, could be employed as a marker of autoimmune damage of the insular apparatus for prognosis of the development of "primary" and "secondary" insulin dependence. PMID- 3299357 TI - [Effect of taurine on the functional status of the insular apparatus and adrenal cortex of the rat with experimental diabetes]. AB - The effect of taurine on the regulation of function of the insular apparatus and adrenal cortex of rats with experimental alloxan diabetes was studied. The assessment of the state of the endocrine glands was based on the determination of the content of immunoreactive insulin, total, free and protein-bound 11 oxycorticosteroids (11-OCS) in the blood of rats and a study of the secretory ability of the adrenals and pancreatic fragments in vitro. A single administration of taurine (300 mg/kg per os) to the rats with experimental alloxan diabetes was accompanied by the reduction of the content of immunoreactive insulin, total and free 11-OCS in the blood, a secretory ability of the adrenal cortex and insulin excretory function of the pancreas. The ability of the pancreatic islet tissue to produce insulin in vitro in response to the natural stimulator glucose was disturbed in the rats with experimental diabetes. Taurine (12 mumol/ml) added to the incubation medium containing isolated adrenals and fragments of the pancreas from the diabetic animals, caused a decrease in a high secretory ability of the cortical substance of the adrenal glands and a partial reduction of the insulin secretory ability of the pancreatic tissue. PMID- 3299356 TI - [Current trends in the treatment of non-insulin-dependent diabetes mellitus]. PMID- 3299358 TI - [Age and features of insulin reception by the plasma membranes of liver cells]. AB - The specific binding of 125I-insulin by liver cell plasmatic membranes of rats aged 5-6 mos. and 24-26 mos. was studied. A decrease in hormone binding with the receptors of old animals as compared to young ones in the presence of similar concentration of immunoreactive insulin in the blood was established. A graphical analysis of the data after Scatchard showed that an age-related decrease in 125I insulin binding with rat liver cell plasmatic membranes resulted from the loss of binding sites in old rats as compared to young animals. The affinity of insulin receptors to the hormone did not change with age. PMID- 3299359 TI - [Ultrastructural features of pancreatic islet cells during prolonged glucose administration]. AB - The time course of ultrastructural changes in pancreatic islet cells was studied in experiments on albino male rats in prolonged administration of glucose at a dose of 15 g per 1 kg of body mass 3 times daily. Changes in the ultrastructures of beta-cells revealed in the first 10 days, indicated their functional tension. Later on (in 15-30 days) an increase in the level of blood serum immunoreactive insulin manifested itself in hypertrophy and hyperplasia of the intracellular structures of beta-insulocytes. An increase in the synthesis and excretion of insulin by beta-cells promoted the utilization of administered glucose manifesting itself in hypoglycemia on an empty stomach and a more intensive increment of the body mass of experimental animals. A relative volume of pancreatic islets over a studied period did not significantly change as compared with the control one. PMID- 3299360 TI - [Diabetes mellitus and pregnancy]. PMID- 3299362 TI - [Surgical occlusion of the bronchi of the upper lobes by transsternal approach in patients with destructive tuberculosis]. PMID- 3299361 TI - [Structuro-energy factors in steroid-receptor interaction]. PMID- 3299363 TI - [Pathogenesis of a combined lesion of the kidney caused by tuberculosis and chronic pyelonephritis]. PMID- 3299364 TI - [Use of lasers in the diagnosis and treatment of diseases of the respiratory organs]. PMID- 3299365 TI - Nucleotide sequence of the Shiga-like toxin genes of Escherichia coli. AB - We have determined the nucleotide sequence of the sltA and sltB genes that encode the Shiga-like toxin (SLT) produced by Escherichia coli phage H19B. The amino acid composition of the A and B subunits of SLT is very similar to that previously established for Shiga toxin from Shigella dysenteriae 1, and the deduced amino acid sequence of the B subunit of SLT is identical with that reported for the B subunit of Shiga toxin. The genes for the A and B subunits of SLT apparently constitute an operon, with only 12 nucleotides separating the coding regions. There is a 21-base-pair region of dyad symmetry overlapping the proposed promoter of the slt operon that may be involved in regulation of SLT production by iron. The peptide sequence of the A subunit of SLT is homologous to the A subunit of the plant toxin ricin, providing evidence for the hypothesis that certain prokaryotic toxins may be evolutionarily related to eukaryotic enzymes. PMID- 3299366 TI - Increased biological activity of deglycosylated recombinant human granulocyte/macrophage colony-stimulating factor produced by yeast or animal cells. AB - Human granulocyte/macrophage colony-stimulating factor (hGM-CSF) produced by several recombinant sources including Escherichia coli, yeast, and animal cells was studied. Recombinant animal cells produced hGM-CSF in low quantities and in multiple forms of varying size. Mammalian hGM-CSF was purified 200,000-fold using immunoaffinity and lectin chromatography. Partially purified proteins produced in yeast and mammalian cells were assayed for the effects of deglycosylation. Following enzymatic deglycosylation, immunoreactivity was measured by radioimmunoassay and biological activity was measured in vitro on responsive human primary cells. Removal of N-linked oligosaccharides from both proteins increased their immunoreactivities by 4- to 8-fold. Removal of these oligosaccharides also increased their specific biological activities about 20 fold, to reach approximately the specific activity of recombinant hGM-CSF from E. coli. The E. coli produced-protein--lacking any carbohydrate--had by far the highest specific activity observed for the recombinant hGM-CSFs. PMID- 3299367 TI - Dependence of conformational stability on hydrophobicity of the amino acid residue in a series of variant proteins substituted at a unique position of tryptophan synthase alpha subunit. AB - To elucidate the role of individual amino acid residues in stabilizing the conformation of a protein, we have constructed a series of variant alpha subunits of tryptophan synthase from Escherichia coli substituted by each of 20 amino acids at position 49, which is buried in the interior of the protein. The stabilities were quantitatively examined except for the mutant protein substituted by arginine, which was not obtained in enough quantity. The Gibbs energy of unfolding in water and the activation Gibbs energy of unfolding in 3 M guanidine hydrochloride for each protein were compared at pH 7.0 and pH 9.0. The Gibbs energy of unfolding in water at pH 7.0 varied from 0.72 to 1.92 times that of the wild-type protein by the substitutions, but the activation Gibbs energy of unfolding in 3 M guanidine hydrochloride varied only from 0.95 to 1.03 times that of the wild-type protein. Moreover, the stability of the protein substituted at this position, which is buried in the interior of the molecule, tended to increase linearly with increasing hydrophobicity of the substituted residue, unless the volume of the substituted residue was over a certain limit. PMID- 3299369 TI - Theoretically determined three-dimensional structure for the repeating tetrapeptide unit of the circumsporozoite coat protein of the malaria parasite Plasmodium falciparum. AB - A model for the three-dimensional structure of the repeating Asn-Pro-Asn-Ala tetrapeptide of the immunodominant circumsporozoite protein of Plasmodium falciparum has been developed. A trial structure in the form of a type I beta turn with asparagine side chains hydrogen-bonded to the backbone peptide linkages was used as a starting point. A repeating oligomer of this trial structure was modeled using energy minimization and molecular dynamics computer simulations in conjunction with image boundary conditions. The most stable structure generated is a right-handed 12(38) helix, which is unlike any previously identified protein secondary structure. The helix has 12 residues per turn, corresponding to an angle of twist of 120 degrees per tetrapeptide unit, and a pitch of 4.95 A, corresponding to a rise of 1.65 A per tetrapeptide unit. It is highly stabilized by extensive hydrogen bonding, with each tetrapeptide unit acting as an acceptor for five hydrogen bonds and as a donor for five hydrogen bonds to residues in adjacent turns as well as having four weak internal hydrogen bonds. A number of nearly isoenergetic variations on the most stable structure that still retained the basic 12(38) helical motif were also discovered. The implications of these structures for vaccine development are discussed. PMID- 3299368 TI - Organization and nucleotide sequence determination of a gene cluster involved in 3-chlorocatechol degradation. AB - Three critical enzymes catechol oxygenase II (chlorocatechol dioxygenase), muconate cycloisomerase II, and dienelactone hydrolase, are involved in the degradation of chlorocatechols, which are obligatory intermediates in the catabolism of chlorinated aromatic compounds. The organization and complete nucleotide sequence of the genes for these enzymes have been determined on a 4.2 kilobase-pair (kbp) Bgl II fragment cloned from the plasmid pAC27, based on the agreement of open reading frame lengths with apparent mobilities of polypeptides expressed in Escherichia coli maxicells, predicted N-terminal amino acid sequences with those of the purified proteins, and predicted total amino acid compositions with those of the purified proteins. The 4.2-kbp fragment contains the three genes and ribosome binding sites for those genes but no promoter. When placed downstream of the tac promoter in the broad-host-range plasmid pMMB22, this fragment directs the synthesis of all three enzymes in both E. coli and Pseudomonas putida only on induction with isopropyl beta-D-thiogalactopyranoside, suggesting that the gene cluster is regulated as a single unit under the control of a single promoter. Endogenous transcription initiation of the gene cluster on pAC27, however, occurs from a site present within a 386-bp Bgl II fragment upstream of the 4.2-kbp fragment, and sequences 5' to that site are similar to the sequences of other positively controlled Pseudomonas promoters occurring on the TOL and NAH plasmids. PMID- 3299371 TI - Activity of a recombinant fusion protein between transforming growth factor type alpha and Pseudomonas toxin. AB - The transforming growth factor type alpha gene has been fused to a modified Pseudomonas toxin gene from which the cell-recognition domain has been deleted. The chimeric gene has been expressed in Escherichia coli, and the chimeric protein, PE40-TGF-alpha, has been highly purified. PE40-TGF-alpha kills cells expressing epidermal growth factor receptors and has little activity against cells with few receptors. This chimeric protein might be useful in treating cancers that contain high numbers of epidermal growth factor receptors. PMID- 3299370 TI - Tumor cell heterogeneity: divided-colony assay for measuring drug response. AB - In vitro tests for predicting the response of tumors to chemotherapeutic agents might be improved if they were modified to take into account tumor-cell heterogeneity. We have studied the heterogeneity of cellular growth rate and drug response in mouse fibroblast NIH 3T3 cells and in NIH 3T3 cells transformed with the human HRAS gene (homologue of the Harvey sarcoma virus oncogene v-Ha-ras) from the EJ human bladder carcinoma cell line. Growth-rate heterogeneity was detected as a broad distribution of numbers of cells per colony. In spite of this heterogeneity, secondary colonies have numbers of cells per colony that resemble that of the primary colony from which they were derived. The variance between unrelated secondary colonies is increased by HRASEJ. Colony-size measurements are reliable because primary colonies divided in half formed two groups of secondary colonies (on two separate plates) that had indistinguishable mean colony sizes. Based on these observations, a divided-colony procedure was devised to detect the drug response of heterogeneous cell populations. Primary colonies are divided into two groups of cells, one of which is treated with a drug and the other is left untreated as a control. The size distribution of treated secondary colonies is then compared to that of the untreated control and to that of the primary colony from which it was derived. The divided-colony procedure is proposed as a modification of the human-tumor-cloning system to increase the sensitivity and reliability of in vitro procedures used to determine the drug response of heterogeneous tumor-cell populations. PMID- 3299372 TI - Distinct cellular and regional localization of immunoreactive protein kinase C in rat brain. AB - Monoclonal antibodies raised against highly purified protein kinase C were used to localize protein kinase C in the rat brain. Using various monoclonal antibodies, at least three distinct antibody-staining patterns were found. One monoclonal antibody exclusively labeled astroglial elements, including astrocytes, tanycytes, and cerebellar radial glia. Another monoclonal antibody exclusively labeled neural cells, including cortical and hippocampal pyramidal dendrites and Purkinje cells of the cerebellum. A third monoclonal antibody (which inhibited protein kinase C activity) intensely stained more limited brain regions, particularly thalamic neurons, and also stained astroglial structures in brain, spinal cord, and cerebellum. The possibility that the three staining patterns reflect the differential regional and cellular localization of related, but distinct, enzymes of protein kinase C is discussed. PMID- 3299373 TI - Sequence homologies between proteins of bacterial phosphoenolpyruvate-dependent sugar phosphotransferase systems: identification of possible phosphate-carrying histidine residues. AB - The DNA sequences for some of the genes involved in the phosphoenolpyruvate dependent phosphotransferase system (PTS) of Escherichia coli and Salmonella typhimurium have been reported. Comparison of the deduced amino acid sequences of enzyme IIBgi, enzyme IIMtl, and enzyme IIGlc/enzyme IIIGlc, which catalyze the uptake and concomitant phosphorylation of beta-glucosides, mannitol, and glucose, respectively, reveals considerable sequence homology. In particular, the carboxyl terminal region of enzyme IIBgl is so homologous to the whole of enzyme IIIGlc as to suggest a common function. We postulate that His-547 of enzyme IIBgl receives a phosphate group directly from the cytoplasmic protein HPr and transfers this phosphate to His-306 located in the amino-terminal half of enzyme IIBgl. This latter histidine is conserved in enzyme IIBgl and enzyme IIGlc and, in both proteins, occurs in a region that shows homology with the His-15 region of HPr, which is known to act as the phosphate carrier. An equivalent histidine residue, His-195, is also present in enzyme IIMtl, although here the flanking sequence is different. None of these specified histidine residues is likely to be buried within the membrane. PMID- 3299374 TI - A serine protease activity in C3H/10T1/2 cells that is inhibited by anticarcinogenic protease inhibitors. AB - Several different protease inhibitors have the ability to suppress transformation in vitro and carcinogenesis in vivo. The mechanism(s) by which protease inhibitors suppress carcinogenesis, however, is not fully understood. Presumably, these agents inhibit one or more intracellular proteases whose functions are essential for the induction and/or expression of the transformed phenotype. We have isolated an endopeptidase activity capable of hydrolyzing the substrate Boc Val-Pro-Arg-MCA (Boc = butoxycarbonyl; MCA = 7-amino-4-methylcoumarin) from C3H/10T1/2 mouse embryo fibroblast cells. This intracellular protease was inhibited by the soybean-derived Bowman-Birk inhibitor (BBI), chymostatin, and L 1-tosylamido-2-phenylethyl chloromethyl ketone, all of which have anticarcinogenic activity, but was unaffected by soybean trypsin inhibitor, which lacks anticarcinogenic activity. Other protease inhibitors affected the proteolytic activity to an extent that correlates with their relative ability to suppress transformation in vitro. The enzyme has a mass of about 70 kDa, contains a single subunit, and exhibits maximal activity at pH 7.0. Diisopropyl fluorophosphate covalently binds to this enzyme and blocks its activity, indicating that the enzyme is a serine protease. We have previously demonstrated that several protease inhibitors are effective suppressors of radiation-induced transformation of C3H/10T1/2 cells. Since these agents reduce the Boc-Val-Pro-Arg MCA-hydrolyzing activity to an extent that correlates with their ability to inhibit malignant transformation in vitro, this endopeptidase activity may be a cellular target of the anticarcinogenic protease inhibitors. PMID- 3299375 TI - Amino acid sequence of the beta subunit of bovine lung casein kinase II. AB - The amino acid sequence of the 209-residue beta subunit of bovine lung casein kinase II has been determined. Excluding the amino-terminal blocking group, which was not identified, the molecular weight of the polypeptide chain is 24,239. A marked polarity of the beta subunit is indicated by clusters of negative charges in the amino-terminal region and of positive charges in the carboxyl-terminal region. Whereas the beta subunit shows no homology with any known protein, a segment of the sequence of the larger and microheterogeneous alpha subunit exhibits homology with the catalytic domains of other protein kinases, particularly with the yeast cell-division-control protein CDC28. PMID- 3299376 TI - Heterologous transmembrane signaling by a human insulin receptor-v-ros hybrid in Chinese hamster ovary cells. AB - A hybrid receptor molecule composed of the extracellular ligand-binding domain of the human insulin receptor and the transmembrane and cytoplasmic (protein tyrosine kinase) domains of the chicken sarcoma virus UR2 transforming protein p68gag-ros has been constructed and expressed in Chinese hamster ovary (CHO) cells. The hybrid is processed normally into alpha and hybrid beta subunits, is expressed on the cell surface at high levels, and binds insulin with near-wild type affinity. Furthermore, insulin stimulates the phosphorylation on tyrosine residues of the hybrid beta subunit in vivo and the phosphorylation of an exogenous substrate [poly(Glu,Tyr)] in vitro. Thus the hybrid is capable of heterologous transmembrane signaling. However, the hybrid mediates neither the insulin-activated uptake of 2-deoxyglucose nor the incorporation of [3H]thymidine into DNA, suggesting that the physiological response(s) mediated by ligand activated protein-tyrosine kinases may utilize distinct intracellular mechanisms for postreceptor signaling. PMID- 3299377 TI - Primary structure of human corticosteroid binding globulin, deduced from hepatic and pulmonary cDNAs, exhibits homology with serine protease inhibitors. AB - We have isolated and sequenced cDNAs for corticosteroid binding globulin (CBG) prepared from human liver and lung mRNAs. Our results indicate that CBG mRNA is relatively abundant in the liver but is also present in the lung, testis, and kidney. The liver CBG cDNA contains an open reading frame for a 405-amino acid (Mr 45,149) polypeptide. This includes a predominantly hydrophobic, leader sequence of 22 residues that precedes the known NH2-terminal sequence of human CBG. We, therefore, predict that the mature protein is composed of 383 amino acids and is a polypeptide of Mr 42,646. A second, in-frame, 72-base-pair cistron of unknown significance exists between the TAA termination codon for CBG and a possible polyadenylylation signal (AATAAA) located 16 nucleotides before the polyadenylylation site. The deduced amino acid sequence of mature CBG contains two cysteine residues and consensus sequences for the attachment of six possible N-linked oligosaccharide chains. The sequences of the human lung and liver CBG cDNAs differ by only one nucleotide within the proposed leader sequence, and we attribute this to a point mutation. No sequence homology was found between CBG and other steroid binding proteins, but there is a remarkable similarity between the amino acid sequences of CBG and of alpha 1-antitrypsin, and this extends to other members of the serpin (serine protease inhibitor) superfamily. PMID- 3299378 TI - Recruitment of substrate-specificity properties from one enzyme into a related one by protein engineering. AB - The Bacillus licheniformis and Bacillus amyloliquefaciens subtilisins differ by 31% in protein sequence and by factors of greater than 60 in catalytic efficiency, kcat/Km, toward various substrates. Despite large differences in sequence and substrate specificity for these serine proteases, only two amino acid substitutions (residues 156 and 217) occur within 4 A (contact distance) of modeled substrates, and a third substitution (residue 169) is within 7 A. The three B. licheniformis substitutions (Ser-156/Ala-169/Leu-217) were introduced into the wild-type B. amyloliquefaciens subtilisin (Glu-156/Gly-169/Tyr-217) by site-directed mutagenesis. The substrate specificity of the triple mutant approaches that of B. licheniformis enzyme when assayed with seven different substrates that vary in charge, size, and hydrophobicity. Thus, specificity properties of distantly related and functionally divergent enzymes can be exchanged by limited amino acid replacements, in this case representing less than 4% of the sequence differences. PMID- 3299379 TI - Amino-terminal extension generated from an upstream AUG codon is not required for mitochondrial import of yeast N2,N2-dimethylguanosine-specific tRNA methyltransferase. AB - The TRM1 gene of Saccharomyces cerevisiae is necessary for the N2,N2 dimethylguanosine modification of both mitochondrial and cytoplasmic tRNAs. The DNA sequence of the TRM1 locus and the 5' ends of mRNAs expressed from this gene have been determined. The majority of the 5' ends map within a large open reading frame between two in-frame ATGs at positions +1 and +49. A small fraction of the 5' ends are located upstream of the first ATG. Both AUGs of the TRM1 mRNAs are used to initiate translation, and two forms of N2,N2-dimethylguanosine-specific tRNA methyltransferase, which differ by an amino-terminal extension of 16 amino acids, are made. Mitochondrial tRNAs are modified when the initiation of translation is limited to one or the other of the AUGs, suggesting that the amino terminal extension is not necessary for import of the protein into mitochondria. Mitochondrial targeting information must, therefore, be located in a region of N2,N2-dimethylguanosine-specific tRNA methyltransferase that is found in both forms of the enzyme. PMID- 3299380 TI - Eukaryotic Mr 83,000 heat shock protein has a homologue in Escherichia coli. AB - We have isolated a gene from Escherichia coli homologous to the gene encoding the Mr 83,000 Drosophila heat shock protein (hsp83). In E. coli the protein homologous to hsp83 is a heat shock protein called C62.5. The predicted amino acid sequence of C62.5 is 41% and 42% identical to the Drosophila and human hsp83 proteins, respectively. Selected regions of the protein have conservation as high as 90%. The gene encoding C62.5 (named htpG) is located between the dnaZ and adk genes at 11.1 minutes on the E. coli chromosome. The htpG gene appears to be a newly identified locus. The isolation of an E. coli homologue of hsp83 illustrates the remarkable conservation of heat shock proteins in evolution and will facilitate genetic and biochemical experiments aimed at determining the function of hsp83. PMID- 3299381 TI - Trigger factor: a soluble protein that folds pro-OmpA into a membrane-assembly competent form. AB - Pro-OmpA that is synthesized in vitro can assemble into bacterial inner membrane vesicles in the presence of ATP and NADH. We have purified pro-OmpA to determine which additional soluble proteins are necessary for its membrane assembly. [35S]Pro-OmpA was bound to Sepharose-linked antibody to OmpA, then eluted with 8 M urea and chromatographed on an anion-exchange resin in 8 M urea. This pro-OmpA is purified 2000-fold and is radiochemically pure. After dialysis, it is soluble but incompetent for membrane assembly. Addition of an Escherichia coli cytoplasmic fraction (S100) to the assembly reaction does not allow translocation. However, when S100 is added to pro-OmpA prior to dialysis, full assembly competence is restored, suggesting that a soluble factor, termed "trigger factor," triggers the folding of pro-OmpA into an assembly-competent form as the urea is removed. We noted that, prior to the last purification step, the immunoaffinity-purified pro-OmpA was partially competent for membrane assembly without addition of trigger factor. To test whether trigger factor had bound to the antibody column by means of its association with pro-OmpA, the crude pro-OmpA was acid-denatured prior to immunoadsorption. In this experiment, the trigger factor did not bind to the anti-OmpA column, and S100 was required for renaturation of this [35S]pro-OmpA. As suggested by this experiment, the crude [35S]pro-OmpA was in a complex with other proteins. Sedimentation velocity studies showed that the trigger factor has an apparent molecular weight of approximately 60,000. We propose that it is required for translocation-competent folding of pro-OmpA and other precursor proteins. PMID- 3299382 TI - High-level expression of human insulin receptor cDNA in mouse NIH 3T3 cells. AB - In order to develop a simple, efficient system for the high-level expression of human insulin receptors in eukaryotic cells, a full-length human kidney insulin receptor cDNA was inserted into a bovine papilloma virus vector under the control of the mouse metallothionein promoter. After transfection of mouse NIH 3T3 cells with this construct, seven cell lines expressing insulin receptors were isolated; two cell lines had more than 10(6) receptors per cell. The cell line with the highest insulin binding (NIH 3T3 HIR3.5) had 6 X 10(6) receptors with a Kd of 10( 9) M. This level was not dependent on exposure to metals but could be increased further to 2 X 10(7) receptors per cell by addition of sodium butyrate to the culture medium. The alpha and beta subunits had apparent molecular weights of 147,000 and 105,000, respectively (compared to 135,000 and 95,000 in IM-9 human lymphocytes), values identical to those of the alpha and beta subunits of the insulin receptors of nontransformed NIH 3T3 cells. This size difference was due to altered carbohydrate composition, as N-glycanase digestion reduced the apparent receptor subunit size of the transfected cells and IM-9 lymphocytes to identical values. The alteration in N-linked oligosaccharide composition could not be ascribed to differences in the kinetics of posttranslational processing of the insulin receptors, which was comparable to that of other cells studied. The basal rate of glycogen synthesis in the cells overexpressing insulin receptors was increased 4- to 5-fold compared with controls. Low levels of added insulin (0.1 nM) caused a 50% increase in the rate of glycogen synthesis. PMID- 3299383 TI - Microtubule polarity reversal accompanies regrowth of amputated neurites. AB - Intact chicken sensory neurites have the same microtubule polarity reported for nongrowing axons in intact organisms. The assembly-favored or + ends of the microtubules are found at the distal terminal (growth cone) of the neuron. After amputation of chicken sensory neurites, the fragment removed from the cell body collapsed to a bead of axoplasm from which neurites rapidly regrew. In nine such regrown neurites analyzed for microtubule polarity, the + ends of microtubules faced the newly formed growth cones, i.e.,--ends of microtubules were now at the original distal terminal of the neuron. These results indicate that microtubules reorganized concomitant with neurite regrowth to form a uniformly polar microtubule array but with reversed polarity. This suggests that mechanisms within the neurite, independent of the cell body, are sufficient for organization of microtubule assembly during axonal elongation. Our data also indicate that microtubule + ends were correlated with growth cone formation in the following three experimental classes of neurites: normal, regrown, and amputated but extended. We speculate that + ends of microtubules are a requirement for growth cone formation and advance. PMID- 3299385 TI - Professor Franz Halberg. PMID- 3299386 TI - Correlation of rhythmic variations in subcellular structures of rat hepatocytes, pancreatic acinar cells, and islet B cells. AB - Correlation of variations in subcellular structures of hepatocytes, pancreatic acinar cells, and islet B cells was examined morphometrically at six time points during 24 hr, using 24 Wistar male rats housed under standardized conditions (LD 12:12; light from 0600 to 1800). The morphometric features examined were subject to strong variations during the 24-hr period. The volume and surface densities of rough endoplasmic reticulum in hepatocytes and acinar cells were highest at 0400, when those of secretory granules in B cells were lowest. At 0400, the surface density of the plasma membranes of B cells facing the intercellular spaces exhibited its highest value. The volume density of glycogen granules in hepatocytes was highest 4 hr after the secretory granules of B cells showed the lowest value. The volume density of glycogen granules in hepatocytes decreased during the light cycle, being lowest at 2000, while that of secretory granules in acinar cells increased during the light cycle, being highest at 1600. At 1600 and 2000, the volume and surface densities of secretory granules were high in B cells. These results suggest that insulin secreted from B cells stimulates protein synthesis in hepatocytes and pancreatic acinar cells, but not directly the synthesis of glycogen granules and secretion of zymogen granules. PMID- 3299384 TI - Magainins, a class of antimicrobial peptides from Xenopus skin: isolation, characterization of two active forms, and partial cDNA sequence of a precursor. AB - A family of peptides with broad-spectrum antimicrobial activity has been isolated from the skin of the African clawed frog Xenopus laevis. It consists of two closely related peptides that are each 23 amino acids and differ by two substitutions. These peptides are water soluble, nonhemolytic at their effective antimicrobial concentrations, and potentially amphiphilic. At low concentrations they inhibit growth of numerous species of bacteria and fungi and induce osmotic lysis of protozoa. The sequence of a partial cDNA of the precursor reveals that both peptides derive from a common larger protein. These peptides appear to represent a previously unrecognized class of vertebrate antimicrobial activities. PMID- 3299388 TI - Circadian changes in human natural killer-cell activity. AB - The circadian changes in natural killer (NK) activity of peripheral blood mononuclear cells (PDM) were studied in five clinically healthy, diurnally active, nocturnally resting women. Data on spontaneous NK-cell activity were complemented by data on the chronosusceptibility to in vitro inhibition by 1 X 10(-6) M cortisol and by the rhythmometric evaluation of rectal temperature and plasma cortisol as potential circadian markers. In April-July, 1985, blood was drawn at 4-hr intervals for 24 hr starting at 0800 hr. Cells were immediately separated and assayed for NK activity using K 562 cultured cells as a target and a 4-hr 51Cr-release assay. Circadian variations of the spontaneous NK activity were apparent; the maximum of the activity occurred in the morning or in the early afternoon. In individual subjects, peak-to-through differences were 50% or more of the 24-hr mean. Chronosusceptibility to cortisol (20 hr incubation prior to the cytotoxic assay) was ecphasic with respect to the spontaneous NK-cell activity, with a maximum in the evening or night. Data obtained by immunofluorescence using specific anti-NK cell monoclonal antibodies confirm the occurrence of a higher number of phenotypically identifiable NK effectors in the morning vs. other circadian stages. Our data confirm previous findings and extend their scope to immunopharmacology emphasizing the need for time-qualified investigations on immune coordination in vivo. PMID- 3299387 TI - Circadian variations in eleven radioimmunoassay variables in the serum of clinically healthy men. AB - Radioimmunoassay studies were conducted on 13 clinically healthy male subjects. Ten ranged in age between 23 and 44 years, two were age 51, and one was age 58. Blood samples were collected at 3-hr intervals over a period of 27 hr. Each serum sample was analyzed for the following hormones: insulin, gastrin, melatonin, prolactin, triiodothyronine (uptake), thyroid-stimulating hormone, triiodothyronine, thyroxine, luteinizing hormone, growth hormone, and follicle stimulating hormone. Group data for each hormone were fitted to a 24-hr cosine curve. A statistically significant fit to this curve was evident in the six italicized variables. Those that did not yield a statistically significant fit frequently revealed a statistically significant variation along the 27-hr span. Chronogram and cosinor plots are presented. PMID- 3299389 TI - Treatment of systemic and organ-specific autoimmune disease in mice by allogeneic bone marrow transplantation. AB - Autoimmune diseases have been clinically divided into those which are systemic and organ-specific. (NZB X NZW) F1, MRL/1, and BXSB mice have been utilized as models for systemic autoimmune diseases. When these mice which had already developed autoimmune diseases were irradiated and reconstituted with T cell depleted allogeneic bone marrow cells, the recipient survived for more than 5 months without showing graft-versus-host reaction. Immunohistopathological studies revealed that deposits of immunoglobulin and complement into the glomeruli were markedly reduced. In addition, levels of circulating immune complexes and auto-antibodies such as anti-dsDNA and anti-Sm antibodies decreased. Three months after bone marrow transplantation, T cell dysfunction was restored, and hyperfunction of B cells and macrophages were normalized. These data prompted us to examine whether or not organ-specific autoimmune diseases can be treated by allogeneic bone marrow transplantation. NOD mice which develop insulitis and overt diabetes were used for this experiment. The mice showed marked infiltration of T cells into the pancreatic islets which resulted in selectively destroying beta cells. Most of the T cells are Lyt-1+, and some are Lyt-2,3+. When NOD mice (6 months old) were irradiated and reconstituted with bone marrow cells of young BALB/c nu/nu mice (less than 2 months), the NOD mice exhibited neither insulitis nor overt diabetes. Deposits of immunoglobulin in the mesangial area of the glomeruli disappeared 3 months after bone marrow transplantation. Assays for immunological functions revealed that NOD mice showed hyperfunction of T cells, B cells, and macrophages. In NOD mice reconstituted with BALB/c nu/nu bone marrow cells, these functions were normalized. Newly developed T cells are found to be tolerant of both bone marrow donor-type and host-type major histocompatibility complex determinants. These results suggest that bone marrow transplantation is a strategy to be considered as an approach to the treatment for both systemic and organ-specific autoimmune diseases in humans. PMID- 3299390 TI - Some aspects of the preclinical safety of drugs produced by recombinant DNA technology: Japanese government regulatory position. PMID- 3299391 TI - Detection of a macrophage population in the thyroids of obese strain chickens using monoclonal antibodies. PMID- 3299392 TI - Characterization of chicken thymic and bursal stromal cells. PMID- 3299393 TI - A clinical trial of hydrocortisone/potassium hydroxyquinoline sulphate ('Quinocort') in the treatment of infected eczema and impetigo in general practice. AB - A double-blind, multi-centre study was carried out in general practice in 76 patients with infected eczema and 43 with impetigo to assess the effectiveness and acceptability of treatment with 1% hydrocortisone plus 0.5% potassium hydroxyquinoline sulphate cream compared with that of 1% hydrocortisone plus 2% miconazole nitrate cream. Patients were allocated at random to receive treatment with one or other preparation, applied twice daily, over a period of 2 weeks. Assessments were made of total symptom severity scores on entry and at the end of each week, as also were bacteriological investigations. The results showed that both combinations produced marked clinical and bacteriological improvement or cure in approximately 90% of patients with infected eczema and the success rate was similar with each preparation. In the case of patients with impetigo, hydrocortisone/potassium hydroxyquinoline sulphate proved significantly more effective than the other combination, the success rates being 92% and 74%, respectively. Patient assessment of the two topical preparations in terms of greasiness, odour and staining showed that, whilst both were considered acceptable by most, there was a trend in favour of the hydrocortisone/potassium hydroxyquinoline sulphate cream. No systemic or local side-effects were reported. PMID- 3299395 TI - The combination of verapamil and captopril in the treatment of essential hypertension. AB - A single-blind trial was carried out in 18 patients with moderately severe hypertension to investigate the efficacy of the angiotensin-converting enzyme inhibitor captopril in combination with the calcium antagonist verapamil after treatment with captopril alone had failed to achieve satisfactory control. For the first 2 weeks of the study, patients received 50 mg captopril twice daily, then 50 mg captopril plus 160 mg verapamil twice daily for 4 weeks, followed by 160 mg verapamil twice daily for a further 4 weeks. The double-dummy technique was used with placebo tablets given during the first and last treatment periods. Blood pressure and heart rate measurements in the supine and standing position were made at 2-week intervals throughout the study. Analysis of the results from the 13 patients who completed the trial protocol showed that the two drugs in combination produced significant reductions (p less than 0.01) in both supine and standing blood pressures compared with captopril alone, but a significant reduction (p less than 0.02) only in diastolic blood pressure compared with verapamil alone. Heart rate was not changed significantly throughout the study. Only 1 patient was withdrawn because of side-effects, although on questioning constipation, in particular, proved to be a problem in many. PMID- 3299396 TI - Effects of the dopamine D-1 antagonist SCH 23390 and the D-2 antagonist sulpiride on saline acceptance-rejection in water-deprived rats. AB - Separate groups of water-deprived rats were familiarized with drinking water or one of a range of NaCl solutions (0.45-2.7%) in a 30 min test. The substituted benzamide, sulpiride, a selective dopamine D-2 receptor antagonist, significantly increased the consumption of water and hypotonic saline at 30 mg/kg. In contrast, the selective dopamine D-1 receptor antagonist, SCH 23390 (0.01-0.1 mg/kg SC) significantly reduced the intake of water and of saline at different concentrations in a dose-dependent manner. Consumption of water and 0.45% saline were most sensitive to the antidipsogenic effect of SCH 23390. These results suggest that previously-reported antidipsogenic effects of neuroleptics may depend, to at least some degree, on dopamine D-1 receptor blockade. The increase in drinking produced by sulpiride indicates that dopamine may act at D-2 receptors to inhibit the consumption of water and hypotonic saline, but not of stronger salt solutions. PMID- 3299397 TI - SCH 23390 and its S-enantiomer stereoselectively prevent EEG and behavioral activation induced by dopamine agonists in the rabbit. AB - The selective D-1 dopamine antagonist SCH 23390 (R-enantiomer) and its unselective S-enantiomer (SCH 23388) were compared for their ability to prevent EEG and behavioral activation induced by the dopamine receptor agonists SKF 38393, apomorphine and LY 171555 in the rabbit. SCH 23390, at very low doses (0.003 mg/kg IV), inhibited EEG responses elicited by SKF 38393 and apomorphine, while the S-enantiomer displayed similar effects at doses at least 300-fold higher (1-3 mg/kg IV). Both isomers were approximately equipotent in preventing behavioral excitation caused by the D-2 agonist LY 171555. The dose of SCH 23390 interacting with LY 171555 was at least 100-fold higher than that effective for D 1 mediated responses. Conversely, the doses of S-enantiomer which prevented the stimulating effects induced by the different dopamine agonists were similar. The data demonstrate the stereoselectivity of the R-isomer SCH 23390 for blockade of D-1 receptors in vivo and provide evidence for the sensitivity of the EEG models in studying D-1 mediated responses. PMID- 3299394 TI - Ferritin versus ferrous sulphate preparations: a controlled study in sideropaenic patients. AB - A double-blind study was carried out in 54 patients requiring iron therapy to compare the effects of orally administered bivalent and trivalent iron over a period of 12 weeks. Patients were allocated at random to receive ferrous sulphate (100 mg/day), ferritin (80 mg/day as Fe3+) or a combination of ferritin (80 mg Fe3+/day), folinic acid and vitamin B12 coenzyme. Haematological measurements made before and during treatment showed that, whilst there were significant improvements in all of the parameters studied with both the bivalent and trivalent forms of iron, the results were more progressive and consistent with the two ferritin preparations, indicating that ferritin is clinically effective as a physiological iron donor in sideropaenic conditions. PMID- 3299398 TI - Effects of polysorbate 20 on bacterial growth. PMID- 3299399 TI - [The history of pharmaceutical science. 25. The development of pharmacy at the University of Greifswald between 1903 and 1968. 5. Pharmacy research profile in Greifswald]. PMID- 3299400 TI - Photoaffinity labeling of calmodulin-dependent systems. PMID- 3299401 TI - The metabolism of triazene antitumor drugs. PMID- 3299402 TI - Disease discovery as process: the example of Addison's disease. PMID- 3299404 TI - The doctor as hero in nineteenth-century British fiction. PMID- 3299403 TI - A history of hand washing: seven hundred years at a snail's pace. PMID- 3299405 TI - Carlos Finlay and the Nobel Prize in Physiology or Medicine. PMID- 3299406 TI - Open clinical trial of carbamazepine in chronic schizophrenic inpatients. AB - 14 male chronic schizophrenic patients were treated over 3 months with carbamazepine, mostly as an adjunct to neuroleptics. Psychopathological status was assessed using the Brief Psychiatric Rating Scale. A significant improvement was found in the following categories: excitement (p less than 0.01) and tension (p less than 0.05). But no beneficial effect on the schizophrenic defect could be detected. PMID- 3299407 TI - Comparison of UV action spectra for lethality and mutation in Salmonella typhimurium using a broad band source and monochromatic radiations. PMID- 3299408 TI - Sunburn cell: factors involved in its formation. PMID- 3299409 TI - Theoretical studies of gas mixing and ventilation distribution in the lung. PMID- 3299410 TI - Neural control of pursuit eye movements. PMID- 3299411 TI - Functions of trace elements in brain metabolism. PMID- 3299412 TI - Extrinsic nervous control of motility of small and large intestines and related sphincters. PMID- 3299413 TI - Time course of insulin, corticosterone and metabolic changes caused by lesion of the ventromedial hypothalamus in the rat. AB - The time course of changes in glycemia, insulinemia, corticosteronemia, liver glycogen, food intake, body and stomach's fresh weight were studied in rats subjected to electrolytic bilateral destruction of the ventromedial hypothalamus (VMH) and in a sham-operated (SO) group. Some of these parameters were determined during the first four hours after lesioning and all were measured also up to two weeks. Glycemia increased steadily, attaining 37.1% 120 min post-lesioning, and a parallel decrease (51.3%) in hepatic glycogen was observed. Twenty minutes after VMH destruction the insulin levels were 215.8% higher than in the SO group, a difference that was reversed 220 min later. At the first day post-lesioning the insulin levels increased 348%. It is suggested that the release was stimulated by the early reflex insulin secretion elicited by food ingestion. During the first hours after VMH lesioning corticosteronemia was elevated to 253.9% of the corresponding parameter in the SO group. When the effects of the lesion were followed up during fifteen days it was found that glycemia and hepatic glycogen returned to normal levels but insulinemia went up again. Plasma insulin increased 325.9% by the end of the observation period while corticosteronemia was 404.5% higher as compared with the SO animals. Food intake increased 63.5% on the day after lesioning and continued to rise, attaining 106% by the fifteenth day, which paralleled the weight gain (31%). A close topographic correlation was found in this study between the precise lesioning of the ventromedial nuclei of the hypothalamus and the changes herein described. PMID- 3299414 TI - Medicines from plants with special reference to herbal products in Great Britain. PMID- 3299415 TI - Surgical scar camouflage in donor site for composite earlobe graft. AB - The purpose of this paper is to report a modification of the commonly used incisions for obtaining a composite earlobe graft. A procedure is described to reconstruct a skin fold between the earlobe and the cheek after excision of the graft. The presence of a definitive skin fold, the avoidance of scar and notching in the lobule border, and the maintenance of a normal lobule contour under a reconstructed earlobe after the excision of a composite graft do much to enhance its appearance. Two demonstrative patients are illustrated. PMID- 3299416 TI - Use of the cylinder osteotome for cancellous bone grafting. AB - An instrument is described for removing iliac crest cancellous bone grafts under local anesthesia. The device has widespread applications for plastic and orthopedic surgery. The convenience of obtaining bone grafts with this device broadens the use of bone-grafting techniques in patients in whom the need for bone graft is unexpected. PMID- 3299417 TI - The facial lesion of George Washington. PMID- 3299418 TI - Sliding genioplasty as a local anesthetic outpatient procedure: a prospective two center trial. AB - A two-center (U.C.L.A. and Georgetown) prospective trial was planned to examine sliding genioplasty as an outpatient local anesthetic procedure. Thirty-nine patients, 14 male and 25 female, underwent the procedure. Average operating time was 43 minutes (range 15 to 70 minutes). Perioperative pain was remarkably mild, and patient satisfaction was extremely high, even among patients unhappy from previous chin implants. The overall complication rate was 20 percent, including two wound infections and one mental nerve injury. Both wound infections resolved uneventfully without detracting from the final result. Neither bleeding nor airway problems were encountered. An osseus genioplasty is a useful technique for correction of the hypoplastic chin. This technique may be performed as an outpatient procedure under local anesthesia with minimum pain and excellent patient acceptance. In light of the low risk and favorable results from this procedure, we recommend this technique as a practical alternative to alloplastic chin augmentation in selected patients. PMID- 3299419 TI - The role of cyclosporin in prolonging survival in vascularized bone allografts. AB - It is known that experimental vascularized bone allografts are subject to host rejection. To be useful clinically, this rejection response would need to be controlled. Cyclosporin is a potent immunosuppressant whose precise role in vascularized bone allograft transplantation has not been established. Using a proven reliable vascularized knee allograft model in inbred rats, cyclosporin was used postoperatively both continuously and short term (14 days after transplant) at 10 mg/kg per day as recipient treatment. Across a strong histocompatibility barrier, continuous cyclosporin was required for long-term graft survival. Short term therapy delayed rejection for 4 to 6 weeks. However, across a weak histocompatibility barrier, short-term therapy was as effective as continuous therapy in achieving long-term graft survival. The implication is that a limited course of cyclosporin may be clinically successful in sustaining vascularized bone allograft survival, provided the genetic disparity between graft and host has been minimized by genetic matching techniques. PMID- 3299421 TI - Cancer care in the 1980s. AB - Even when all available preventive strategies are strongly encouraged, the diagnosis of cancer will often be encountered in the primary care setting. Patients will look to their personal physician for advice in dealing with their illness and commonly ask, "What would you do?" Knowing the patient well, whether he or she desires to fight for every possible day of life or apparently welcomes an earlier death with freedom from life prolongation therapies, is the basis for helping the patient to choose alternatives. Informed decisions by the physician are facilitated by appropriate classification and staging of the tumor. Entrusted to the primary physician are numerous responsibilities that include team management, aiding the patient and family to cope with the illness, and maintaining a quality life with the best possible functional status. Both patient and physician must fully understand and share what is known about the cancer in order to individualize treatment with the proper level of care. Modern cancer care is highly sophisticated and changeable; to do it well requires a special interest and attention from the physician. PMID- 3299420 TI - Statistical analysis and study design in plastic and reconstructive surgical research. AB - Appropriate study design and proper statistical analysis are necessary ingredients for improving the quality and reliability of the information in journal articles. General surgery and plastic surgery articles were compared for principal author's academic degree, a Ph.D.'s presence as a coauthor, the study type, the presence of statistical analysis, the analysis' appropriateness, and the types of errors in study design or statistical analysis. Ph. D. authorship was associated with increased percentage of articles using statistical analysis. When compared with general surgery articles, plastic surgery articles performed four times fewer statistical analyses. However, when statistical analyses were performed, there were few differences between these two specialties. Although there were no differences in the types of statistical analysis errors, there were differences in the types of study design errors. The causes of these discrepancies may lie in the nature of plastic surgery; they may be reduced by adherence to Feinstein's principles of study design and result interpretation. PMID- 3299422 TI - Screening and diagnosis of cancer in office practice. AB - Nearly all cancers, with the exception of lung cancer, are amenable to screening in the primary care office. For many of these tumors, appropriate screening holds greater promise than improved cures for decreasing mortality rates. Screening of asymptomatic patients can be associated with significant costs, both financial and emotional. Excessively rigorous screening efforts can alienate patients from the concept of early diagnosis and may even cause them to avoid seeking other needed medical care. Failure to screen adequately may result in unnecessary loss of life from potentially curable tumors. Because of the complexities involved in carrying out adequate randomized controlled trials of various cancer-screening methods, recommendations must necessarily be based on incomplete information. Although there is room for disagreement among authors and organizations formulating screening plans, the recommendations of the ACS were selected and reproduced in this article. A review of other recommendations is available. PMID- 3299423 TI - The psychosocial aspects of malignancy. AB - This article has described many of the psychosocial issues associated with malignancy. Issues related to delivering the diagnosis of cancer, such as telling the truth, including the family, and initiating a "shared meaning" process, were considered. Patient reactions related to cancer such as grief, depression, and needs for control were described. Family reactions to the cancer patient, including anticipatory grief and weariness, were noted. The need for psychosocial support for the family of the cancer patient was discussed. Finally, the need for caregivers to pay attention to their own emotional needs was described. PMID- 3299424 TI - Special problems of cancer care for the elderly. AB - This article focuses on the more common cancers; it does not attempt to cover the whole gamut of cancer in the elderly. Lung, pancreas, rectal, and stomach cancers are picked up sooner in the elderly than in the younger population, but bladder, breast, cervical, ovarian, thyroid, and uterine cancer, and malignant melanoma are diagnosed at a more advanced stage in the elderly, possibly because of inadequate routine screening of the elderly on the part of the physician. PMID- 3299425 TI - Commonly used chemotherapeutic agents. AB - The primary care physician is often responsible for the management of cancer patients who may be receiving complex chemotherapeutic regimens. The World Health Organization has recommended standard approaches to recording baseline data and reporting treatment results (see Table 4, pp 252-253). These standards are intended for international use to compare results from various centers or investigators. Most antineoplastic agents have a number of serious toxicities or adverse effects associated with their use. By recognizing and quickly diagnosing drug-induced adverse effects of antineoplastic agents, morbidity or early mortality may be avoided. PMID- 3299427 TI - Rehabilitation of the cancer patient. AB - Today, patients who have a diagnosis of cancer often face the same concerns as persons who have other types of chronic illnesses. The effects of the disease, the treatment, or both, may leave patients with residual impairments that necessitate sometimes prolonged periods of rehabilitation. Rehabilitation may be preventive, restorative, supportive, or palliative, depending on the type and stage of the disease and characteristics of the patient. Rehabilitation is most effectively planned and carried out by a team composed of various disciplines, as appropriate, but always with the patient and family as the central members of the team. Patients need to be well-informed about the illness and treatment from an early stage and assisted in learning methods to deal with problems they may face in areas such as coping, independent functioning, sexual functioning, employment, and financial pressures. The physician can provide the most effective care to the patient by being familiar with and involving the wide range of rehabilitation services, community support programs, and necessary resources. Through these services, patients can be helped to lead productive and satisfying lives. PMID- 3299426 TI - Symptom control in terminal illness. AB - Toward the goal of comfort and quality of life, symptom management is utmost in importance and requires constant reassessment of the patient. Before launching a medication program, each set of symptoms should be assessed by history, physical examination, and laboratory tests. When symptoms can be understood in the context of the disease without correctable, specific causes, the physician can carefully prescribe treatments to alleviate the misery and suffering. The most common symptoms in terminally ill cancer patients are anxiety and depression (80 to 90 per cent); pain (66 per cent); nausea, vomiting, and constipation (50 per cent); and respiratory symptoms (30 to 40 per cent). Medical attention to these discomforts will help the patient and family to cope better with the dying process. PMID- 3299428 TI - Follow-up of the cancer patient: surveillance for metastases. AB - Cancer surveillance is an important part of the follow-up of the cancer patient. Guidelines are given for the follow-up of the eight most common cancers. Psychological support is an ongoing need that the primary physician should supply. PMID- 3299429 TI - Managing grief and bereavement. AB - This article reviews recent literature on bereavement concerning the typical features of both normal and pathological grief. It discusses the distinctive aspects of grief in children and concludes with suggestions for physicians seeking to assist bereaved families. PMID- 3299430 TI - [Principles of computer-assisted classification in psychiatry]. AB - The use of computer based diagnostic decision and artificial intelligence are discussed in relation to the problems of validity and reliability of psychiatric diagnoses. The authors suggest a definition of a computer aided classificator as an existent decision system for an automatically analysis of findings. PMID- 3299431 TI - [Experiences with the Rene Bloch "multidimensional art test"]. AB - The Multidimensional Drawing Test of Rene B l o c h is a little-known projective test method in psychological diagnosis. In a series of 30 pictures, free associations are recorded graphically, with a time limit of 60 seconds per picture. The test material consists of a DIN A 6 jotting pad and seven felt pens, red, orange, yellow, blue, brown, green, and black. The test results can be equated with statistically determined combined variables, and thus enable differential diagnosis distinction between acute and chronic schizophrenia, hebephrenia, "schizoaffective psychoses", and more especially, endogenous and other forms of depression. The test can also be used in psychotherapy. PMID- 3299432 TI - Mianserin in the treatment of depressive symptoms in alcoholics. A double-blind placebo controlled study using a computer delivered self-rating scale. PMID- 3299434 TI - [Malignant neuroleptic syndrome]. PMID- 3299435 TI - [A review of the more important evaluation scales in geriatrics]. PMID- 3299433 TI - [Catecholamines in selected mental disorders in children]. PMID- 3299436 TI - [Classical texts--newly read. Wilhelm Griesinger: "Pathology and therapy of psychiatric diseases"--a pioneer in humane psychiatry]. PMID- 3299437 TI - Baseline characteristics of 10-day placebo washout responders in antidepressant trials. AB - In antidepressant drug trials, the randomized treatment phase is usually preceded by a single-blind placebo period or "washout." Ninety-four depressed patients who improved during this 10-day placebo period constitute our study focus. Analysis of baseline and postplacebo measures showed that the 10-day placebo responders in our sample were convincingly depressed at baseline and improved significantly after placebo washout. This group of patients differed from 6-week placebo responders in our randomized trials in being more mildly ill, being more chronic, containing fewer cases of primary depression, and having fewer illness precipitants. They differed from placebo nonresponders largely in manifesting milder illness symptoms across the range of psychopathology. The proportion of placebo washout responders declined in the winter months. PMID- 3299438 TI - The explicitly stated rationale for the involuntary commitment of the mentally ill given by the nineteenth-century German-speaking psychiatrists. AB - The contemporary practice of involuntary commitment to psychiatric institutions of individuals diagnosed as mentally ill is based upon practices established by psychiatrists in the nineteenth century. The justifications given by nineteenth century German-speaking psychiatrists for involuntary commitment are considered. An examination of sixty-seven texts by German-speaking psychiatrists reveals that involuntary commitment was justified more often as benefiting the mentally ill individual than as benefiting society. Justification for involuntary commitment was made somewhat more frequently during the second part of the nineteenth century than during the first part. PMID- 3299439 TI - The timing, specificity and clinical prediction of tricyclic drug effects in depression. AB - This research was aimed at studying the rate of action of tricyclic drugs in depressive disorders, specifying the behavioural effects associated with recovery, and predicting clinical response. The research design involved comparison of a recovered group with a group treated for the equivalent four weeks, who showed minimal to no response. The findings indicated significant differences in baseline characteristics between responders and non-responders. Further, the drugs were found to act early in the responders, within the first week of treatment. Specific changes at one week which distinguished responder and non-responder groups occurred in the disturbed affects, and in cognitive functioning. Improvements also occurred in somatic symptoms, but these latter changes were general and not associated with later recovery. At 2 1/2 weeks, all facets of the depressed condition showed positive change in the responders. Implications of the results for assessing rate of tricyclic drug actions, their effects on the interaction of affect and neurochemistry, and the practical application of the results for the clinical situation, are discussed. PMID- 3299440 TI - Cholinergic effects on constructional abilities and on mnemonic processes: a case report. AB - The effects of physostigmine on test performance of a patient with multiple cognitive deficits were observed in a double-blind, placebo-controlled study. Scores on tests of learning and memory and tests of visuo-spatial and constructional ability were both improved by physostigmine, while lecithin improved scores only on the former tests. PMID- 3299441 TI - The effects of stress and caffeine on hypertensives. AB - Eighteen male hypertensives on diuretic medication between the ages of 37 and 60 were studied in a double-blind, randomized, crossover design under three conditions: 200 mg of caffeine and mental arithmetic; placebo and mental arithmetic; and 200 mg of caffeine alone. Systolic and diastolic blood pressure, heart rate, and skin conductance were recorded. During rest, caffeine compared to placebo increased blood pressure by 8/6 mm Hg, but had no effect on heart rate or skin conductance. During mental arithmetic, the combined effect of mental stress and caffeine led to a further increase of 17/7 mm Hg, reaching a pressure level of 163/100 mm Hg. Heart rate and skin conductance were increased above their prior caffeine levels. There were no significant differences between the blood pressure response to mental arithmetic with caffeine and that response to mental arithmetic with a placebo, which may have been due to the fact that the hypertensives were already responding at ceiling level during the mental stressor. PMID- 3299442 TI - Relaxation training for essential hypertension at the worksite: I. The untreated mild hypertensive. AB - This industry-based randomized study compared the effects of behavioral treatment (BT) and blood pressure monitoring (BPM) on blood pressure (BP) change in 158 unmedicated persons with mild hypertension (diastolic blood pressure 90 to 104 mm Hg). Participants recruited by a three-stage screening were randomly assigned to BT or BPM groups and stratified by entry diastolic blood pressure (DBP), age, and sex. BT participants received relaxation training, with or without the addition of biofeedback, cognitive restructuring, and health behavior change components. During the study, all participants were followed by their usual care physicians and received medical advice. At 18 weeks into the study, after the BT groups completed training, both the BT and BPM groups showed significant reductions in systolic blood pressure (SBP) and DBP assessed in the company medical clinic (7.4 and 9.0 mm Hg SBP and 4.5 and 5.9 mm Hg DBP, respectively). These reductions were maintained throughout the 36-week follow-up period. Reductions in BP assessed at the participants' worksite were similar for BT and BPM participants throughout most of the trial, indicating little advantage to the inclusion of behavioral interventions over monitoring alone. Differences in BP changes observed among participants receiving various combinations of behavioral treatment components indicated that the cognitive restructuring component reduced SBP in the worksite by an additional 5.4 mm Hg (p less than 0.05). Possible explanations for the BP changes observed in the BPM group and implications of the results for the treatment of unmedicated mild hypertensives are discussed. PMID- 3299443 TI - Relaxation training for essential hypertension at the worksite: II. The poorly controlled hypertensive. AB - This article reports the findings of a study designed to evaluate the long-term effectiveness of an industry-based relaxation training program in the treatment of hypertensives whose blood pressures were not well controlled by antihypertensive medication. Following a three-stage screening process, 137 participants were randomly allocated to either relaxation training (RT) or to blood pressure monitoring (BPM) at two worksites. Participants continued to receive medical care from their primary physicians during the course of the study. The advantage for participants receiving RT, in terms of mean blood pressure changes, was modest and of short duration. However, a larger proportion of participants in the RT group came into good control (blood pressures below 90 mm Hg) than in the BPM group following treatment (69.4% vs 41.5%, p less than 0.001). This advantage continued to 24 months' follow-up (63.9% vs 47.7%, p less than 0.05). At 30 months' follow-up there was no significant difference between the groups (75.0% vs 70.8%). Within-group analyses revealed that the BPM group also achieved significant blood pressure lowering which was maintained during the study. The largest initial difference between the two groups was for individuals whose entry diastolic blood pressures were most out of control despite several years of pharmacologic treatment. No difference was found between the two groups in the prescription of antihypertensive medication. PMID- 3299444 TI - Validity assessment of SAFTEE: a preliminary report. PMID- 3299445 TI - A controlled trial of phenelzine in bulimia. PMID- 3299446 TI - Intra-interrater reliability of SAFTEE using videotape interviews and clinical trial data. PMID- 3299447 TI - Interrater agreement and reliability measures of SAFTEE: general inquiry vs. systematic inquiry. PMID- 3299448 TI - Psychotherapy research. Clinical trials versus clinical reality. AB - The benefits of psychotherapy have been established in a number of controlled studies, yet the application of these research findings in clinical practice seems to be limited. The converging developments of psychopharmacology, behavior modification and dynamic psychotherapy are briefly reviewed, and the needs for methodological and clinical integration are underscored. PMID- 3299449 TI - Thermal noise and biological information. AB - Thermal noise limits the efficiency of all information-handling systems. This principle, which is a routine consideration in electronics, is just as fundamental to the handling of highly specific information by living organisms. The rapid basal turnover rates of cells and intracellular proteins and the high energy consumption of regulatory organs, previously unaccounted for, can be explained to a large extent by the need to compensate for the steady loss of essential information due to thermal noise. PMID- 3299450 TI - Involuntary sterilization in the United States: a surgical solution. AB - Although the eugenics movement in the United States flourished during the first quarter of the 20th Century, its roots lie in concerns over the cost of caring for "defective" persons, concerns that first became manifest in the 19th Century. The history of state-supported programs of involuntary sterilization indicates that this "surgical solution" persisted until the 1950s. A review of the archives of prominent eugenicists, the records of eugenic organizations, important legal cases, and state reports indicates that public support for the involuntary sterilization of insane and retarded persons was broad and sustained. During the early 1930s there was a dramatic increase in the number of sterilizations performed upon mildly retarded young women. This change in policy was a product of the Depression. Institutional officials were concerned that such women might bear children for whom they could not provide adequate parental care, and thus would put more demands on strained social services. There is little evidence to suggest that the excesses of the Nazi sterilization program (initiated in 1934) altered American programs. Data are presented here to show that a number of state supported eugenic sterilization programs were quite active long after scientists had refuted the eugenic thesis. PMID- 3299451 TI - Modified enameloplasty-fissure sealant technique using an acid-etch resin method. PMID- 3299452 TI - Color, light, and the perception of form. PMID- 3299453 TI - A simplified approach to DEB impression making. PMID- 3299455 TI - Stress and retention properties of a new threaded endodontic post. PMID- 3299454 TI - Assessment of microleakage of 12 restorative systems. PMID- 3299456 TI - [Improvement in the function of immediate complete denture]. PMID- 3299457 TI - [Practical use of individual anterior tooth reconstruction concepts: handling the contour curve former (CCF) (II)]. PMID- 3299458 TI - [Metal incompatibility]. PMID- 3299459 TI - [Indications for reciprocal transverse tooth curve in problem complete denture care--masticatory physiologic studies with denture stress (I)]. PMID- 3299460 TI - [Dalbo-Rotex anchor for anchoring partial and complete dentures. How will the root base be sealed for optimal caries prevention after cementation of the root screw?]. PMID- 3299461 TI - [Hygienic care of dental hand- and angle-pieces as well as turbines during the use of steam disinfection]. PMID- 3299462 TI - [Impressions and models]. PMID- 3299463 TI - [Principles of prosthetics: prosthetic aids (IV)]. PMID- 3299464 TI - [Combination milling and attachment methods in 1-piece castings]. PMID- 3299465 TI - [Combination VMK and jacket crowns: 20 points for the patient (II)]. PMID- 3299466 TI - [The Kuwata ceramic veneer in the posterior region (I)]. PMID- 3299467 TI - [Marginal fit in Ceraplatin crowns (I)]. PMID- 3299468 TI - [Pre-firing technic in metal-ceramic prosthetics--placement of porcelain materials onto the metal frameworks of bridge pontics]. PMID- 3299469 TI - [Co-Cr-Mo-Ti-alloys in casting technic: primary and secondary Konus crowns]. PMID- 3299470 TI - [Function and esthetics--dental technical-physiological occlusal concept (I)]. PMID- 3299471 TI - [The Kuwata ceramic veneers for posterior teeth (II)]. PMID- 3299472 TI - [Marginal seal in ceramic-platinum crown systems (II)]. PMID- 3299473 TI - The RBE of neutrons for induced mitotic gene conversion in "error-prone repair" defective yeast. AB - Mitotic gene conversion was induced in the diploid yeast strain D7.rad6 which lacks "error-prone repair" and thus does not mutate. Neutrons (14.5 MeV), 60Co gamma rays, and 150 kVp X rays delivered under oxic or anoxic conditions were compared for their ability to induce gene conversion. Doses were chosen to minimize cell killing. A lack of induced mutation in this strain at the ilv1-92 allele was confirmed. Gene conversion of the trp5-27/trp5-12 alleles was induced with a linear dose response, and the yield of convertants per gray was significantly enhanced over yields reported previously for a wild-type stain. The relative biological effectiveness (RBE) of neutrons relative to low-LET radiations was found to be about 2.2 for either oxic or anoxic radiation in contrast to wild-type where the oxic RBE was 1.7 and the anoxic RBE 2.7. Absence of the rad6 function was therefore associated with an altered RBE for the conversional end point. The oxygen enhancement ratio (OER) for gene conversion was found to be about 1.7 for all radiations in contrast to the wild type where the OER for neutrons was 1.7, but for low-LET radiations it was 2.7. As repair of ionizing damage in the rad6 strain did not lead to mutation, owing to the loss of "error-prone repair," the changes in yield, RBE, and OER were consistent with the hypothesis that some of the lesions processed by wild type to generate mutations could, in the rad6 strain, lead instead to gene conversion. PMID- 3299474 TI - Computed tomography scanning in the evaluation of ocular motility disorders. AB - Ocular muscle disturbances (strabismus) are common disorders affecting two to four per cent of the population. Until recently, CT and MRI have not been used extensively in the diagnosis of congenital and acquired conditions causing strabismus. In this article the value of these scanning techniques in terms of more appropriate therapeutic intervention and further insight into the pathophysiology of these conditions is detailed. PMID- 3299475 TI - Lacrimal gland and fossa lesions: role of computed tomography. AB - The lacrimal gland region can be involved in a wide spectrum of orbital pathology, including tumors and inflammatory and lymphoid lesions. This article focuses special attention on benign mixed tumors because of the excellent prognosis for the patient when it is completely excised at first surgery. The appearance of these lesions on CT is detailed in the illustrations of this article, and the findings of experts in the field are presented as well. PMID- 3299476 TI - Dacryocystography: the technique and its role in the practice of ophthalmology. AB - Modern lacrimal tract imaging has most recently been enhanced by computerized digital subtraction techniques. Current standard dacryocystography technique includes the injection of a water-soluble agent and the use of topical anesthesia. In this article the dacryocystogram of the normal lacrimal system and those with various types of obstruction are presented. PMID- 3299477 TI - Computed tomography and magnetic resonance imaging of the orbital apex. AB - This article describes the CT and MR appearance of the orbital apex and masses in this region. The sectional anatomy by axial, coronal, and sagittal planes as well as the thin-layer technique used to accomplish this is detailed first. Then the application of these techniques to the presence of tumors is illustrated and discussed. PMID- 3299478 TI - MRI and CT of sellar and parasellar disorders. AB - Discussion of the anatomy of the parasellar region focuses on the optic chiasm and its relationship to surrounding structures. CT and MRI are valuable tools in the imaging of these regions. This article provides a brief review of the technique of CT and MRI with visualized anatomic structures of these areas. A closer look at how CT and MRI are used to delineate the different pathologic processes of the sellar and parasellar regions then follows. PMID- 3299479 TI - The role of the neuroradiologist in vascular disorders involving the orbit. AB - CT and MRI have become imaging techniques of great value in the diagnosis of vascular orbital lesions. Intraorbital vascular lesions, vascular tumors, intracranial aneurysms, carotid cavernous fistulas, and Tolosa-Hunt syndrome are discussed in detail. They illustrate how the accuracy of CT and MRI in evaluating orbital and intracranial masses has focused the role of angiography in exophthalmos and ophthalmoplegia on detection and assessment of those vascular lesions that may require surgical intervention. PMID- 3299480 TI - The role of medical imaging in the practice of neuro-ophthalmology. AB - The neuro-ophthalmologist is concerned with the myriad afflictions that can cause transient or permanent visual loss, derangement of ocular motor function, pupillary dysfunction, abnormality of lid position or function, and headache or facial pain syndrome. Once preliminary clinical evaluation has implicated dysfunction of a certain anatomic locale, the practitioner must precisely confirm or eliminate possible etiologies. This article examines pathology in six areas: orbital contents and optic nerve; cavernous sinus; chiasm; posterior visual pathway and cerebral cortex; brain stem and posterior fossa; and spinal cord. Through discussion of lesions in these areas the value of CT versus MR in making an accurate diagnosis is elucidated. PMID- 3299481 TI - [MR tomography of the breast. Supplemental information in select cases]. AB - Magnetic resonance tomography (MRT), as the newest imaging procedure in breast diagnosis, has to be compared with the combined use of conventional imaging methods. Many advantages of MRT, which have been emphasized in comparison with mammography, are not superior to the complementary use of mammography and sonography. Additional diagnostic information through MRT is yielded only in the following cases: differentiation between fibrous fibroadenoma of the elderly woman and circumscribed carcinoma with similar mammographic and sonographic appearances; distinction of stellated fibrous scar tissue from the scirrhotic configuration of the more vascular tumour fibrosis around a carcinoma by using contrast medium MRT; differentiation of periductal fibrosis from inflammatory or carcinomatous ductal and periductal infiltration; better delineation of fat or silicon implants. Finally, a significant advantage of mammography over all other imaging methods should be pointed out: the detailed visualization of microcalcifications for the early diagnosis of breast carcinoma. PMID- 3299482 TI - Pulmonary embolism: diagnosis with multiple imaging modalities. PMID- 3299483 TI - Mesenteric and omental cysts: histologic classification with imaging correlation. AB - Forty-one cases of mesenteric and omental cysts are reported. Histologically, several specific types could be distinguished: lymphangioma, 19 cases; nonpancreatic pseudocyst, 11 cases; enteric duplication cyst, six cases; mesothelial cyst, three cases; and enteric cyst, two cases. A lymphangioma is usually a multiloculated cyst located in the mesentery that shows no discernible wall on computed tomography (CT) and may have characteristics of fat on CT and magnetic resonance imaging. Abnormalities in the small bowel mucosa were frequently noted on barium studies. A nonpancreatic pseudocyst is usually a unilocular or multilocular cyst located in either the mesentery or the omentum, with abundant debris sonographically and an enhancing wall on CT. An enteric duplication cyst is a unilocular cyst with an enhancing wall on CT. Mesothelial and enteric cysts are anechoic, thin-walled cysts. Emphasis is placed on the importance of identifying lymphangioma, which is more difficult to manage than the other forms of mesenteric and omental cysts. PMID- 3299484 TI - Radiation appendicitis: demonstration with graded compression US. AB - In a patient who had received presurgical radiation therapy for extensive rectal carcinoma, ultrasonography with graded compression disclosed an inflamed appendix. The patient had no clinical signs of acute appendicitis. At laparotomy for resection of the rectal carcinoma, the appendix appeared grossly abnormal and was removed. Pathologic examination showed severe radiation enteritis of the appendix. The sonographic appearance of radiation appendicitis closely resembled that of acute appendicitis. PMID- 3299485 TI - Sonographic parallel channel sign: a reappraisal. AB - Tubular structures proximal to the right and left hepatic ducts, when seen with ultrasonography, are generally considered to be abnormally dilated ducts. However, newer, electronically focused transducers reveal peripheral tubular structures paralleling portal venous branches. The diameters of all visible tubular structures that would have been thought to be bile ducts were measured in 50 persons with no evidence of hepatobiliary disease. "Ducts" were seen with the following frequencies: right hepatic, 100%; right anterior, 100%; right posterior, 88%; left hepatic, 98%; left medial, 62%; left lateral, 96%; left lateral superior, 54%; and left lateral inferior, 54%. All ducts proximal to the right and left hepatic ducts were 2 mm or less in diameter. Those proximal to the common hepatic ducts averaged approximately 20% of the diameters of their accompanying portal veins. Except for 4% of the left lateral inferior ducts, no ducts proximal to the common hepatic ducts were more than 40% the diameter of their respective portal vein branches. Mere observation of parallel channels proximal to the right and left hepatic ducts is therefore not evidence of biliary dilatation. PMID- 3299486 TI - Placental abruption and placental hemorrhage: correlation of sonographic findings with fetal outcome. AB - Sixty-nine cases of placental abruption and placental hemorrhage detected with ultrasonography (US) were reviewed retrospectively to determine whether US findings correlate with fetal outcome. Four patients were lost to follow-up, and in the remaining 65 patients fetal outcome included demise in 12 cases (18%), termination of pregnancy in six (9%), premature delivery of a living infant in 15 (23%), term delivery of an infant who was small for gestational age in four (6%), and normal term delivery in 28 (43%). Fetal mortality correlated best with the estimated percentage of placental detachment, but was also significantly (P less than .01) associated with the location (retroplacental) and size (greater than 60 ml) of hemorrhage. Premature labor was associated (P less than .001) only with gestational age at the time of clinical presentation. No sonographic finding was identified as a risk factor for small-for-gestational-age infants. Sonographic findings of placental abruption correlate with fetal outcome, and this information may be useful for guiding obstetric management. PMID- 3299487 TI - Testicular tumors: prospective analysis of real-time US patterns and abdominal staging. AB - Echomorphologic features of 57 testicular lesions (48 neoplasms, nine benign lesions) were analyzed prospectively by means of high-resolution real-time ultrasonography (US). There was a broad spectrum of texture patterns for testicular malignancies, 92% of which exhibited a predominantly decreased echogenicity compared with that of normal tissue. US findings alone could not be used to make a specific prediction of malignant disease or to classify a neoplasm histologically. However, different kinds of tumors exhibited characteristic echomorphologic features that corresponded to their gross morphologic appearance; a knowledge of these echomorphologic features is extremely useful for the US differentiation of tumors from nonneoplastic scrotal pathologic conditions. All neoplasms in this series displayed distinct abnormalities in parenchymal texture, and all were detected with US. The sensitivity and predictive value of a normal sonogram were as high as 100%. With regard to the detection of retroperitoneal lymph node metastases from testicular tumors, abdominal US had an overall accuracy rate of 96% and was of superior diagnostic value compared with bipedal lymphangiography. PMID- 3299488 TI - Leiomyomas in pregnancy: sonographic study. AB - With ultrasound monitoring, analysis of the behavior of uterine leiomyomas (fibroids) and their impact on the course of pregnancy was undertaken in a group of 113 patients. Fibroid size changes were analyzed on the basis of trimesters. In the second trimester, smaller fibroids increased in size, whereas larger fibroids decreased in size. In the third trimester, a decrease in size was documented regardless of initial size. The most common patterns of echotexture were hypoechoic, heterogeneous, and echogenic rim. The development of a heterogeneous pattern or anechoic/cystic spaces on a follow-up study was accompanied in seven of ten patients by severe abdominal pain, compared with 12 cases of abdominal pain in 103 patients without such echotexture changes. Although the number of patients was small, the development of these patterns apparently indicates significant degeneration of the fibroid. Fibroids located in the lower uterine segment were accompanied by a higher frequency of cesarean section and retained placenta. Fibroids located in the uterine corpus were more frequently associated with early abortions. Multiple fibroids were accompanied by a higher frequency of malpresentation and premature contractions compared with cases with one or two fibroids. PMID- 3299489 TI - Randomized trials in coronary artery bypass surgery. PMID- 3299490 TI - Myocardial consequences of reperfusion. PMID- 3299491 TI - Syndromes of cardiac cachexia and the cachectic heart: current perspective. PMID- 3299492 TI - Platelet activation by plasma lipoproteins. AB - Enhanced platelet activity in patients with hypercholesterolemia and moderate hypertriglyceridemia can be attributed to increased LDL and VLDL and/or decreased HDL concentrations. In marked hypertriglyceridemia, where there is an accumulation of chylomicrons, platelet function is reduced. Treatment, whether by diet, medication, or plasmapheresis, that will result in a change in lipoprotein pattern is accompanied by a parallel change in platelet responsiveness. Incubation of lipoproteins with isolated platelets results in enhancement of platelet activation by LDL and VLDL and suppression of activity by HDL and chylomicrons. These findings have in vivo confirmation. They are even more pronounced and sometimes altered when the lipoproteins are derived from hyperlipidemic subjects. The effects of the lipoproteins on platelet activity appear to be dependent on lipoprotein composition and on factors such as cholesterol:protein ratio, apo C-III0:apo C-III2 ratio, apo B concentration, and triglyceride:protein ratio. The lipoproteins interact with platelets at specific receptor sites. Rapid change in platelet composition, particularly with regard to cholesterol, phospholipid, and fatty acid content, might ensue, with consequent alterations in membrane fluidity and enzyme activities and either suppression or activation of platelet function. This review has indicated that lipoproteins have a clear influence on platelet function. This interaction could be well of paramount importance in determining atherogenic risk. PMID- 3299493 TI - Why are so many biological systems periodic? AB - The ubiquity of oscillations in biological systems is well established. Oscillations are observed in all types of organisms from the simplest to the most complex. Periods can range from fractions of a second to months or years. From time to time, it has been suggested that many biological oscillations are the result of the breakdown of effective self-regulation. The opposite view is defended here. It is argued that most periodic behavior is not pathological but rather constitutes the normal operation for these systems. They are present because they confer positive functional advantages for the organism. The advantages fall into five general categories: temporal organization, spatial organization, prediction of repetitive events, efficiency and precision of control. PMID- 3299494 TI - Membrane and synaptic properties of identified neurons in the olfactory bulb. PMID- 3299495 TI - The effect of trihexphenidyl (Artane) on memory in schizophrenic patients. AB - The anticholinergic effect of trihexphenidyl on memory function of 20 schizophrenic patients has been investigated in a double blind crossover design. Impairment of immediate memory and short term memory was evident after trihexphenidyl treatment in comparison with placebo. Sensory short term memory tested by visual tasks and remote memory showed no significant statistical differences. Our data suggested that trihexphenidyl due to its anticholinergic effect might impair memory function. PMID- 3299496 TI - Efficacy of oral hydergine (ergoloid mesylates) in alcohol related encephalopathy. AB - A pilot-study to explore the efficacy of oral hydergine in seven cases of alcohol related encephalopathy was undertaken. It showed significant improvement in symptoms of depression, plus some improvement in sleep disturbance and agitation, as measured by the Geriatric Profile (GP). PMID- 3299497 TI - Stereotyped behaviour, hyperaggressiveness and "tyrannic" hierarchy induced in bank voles (Clethrionomys glareolus) by a restricted cage milieu. AB - This investigation was originally conceived as a further development of studies made with the "amphetamine model" of psychosis. Since amphetamine itself seemed to be the most important flaw in this model, it was judged promising to study abnormal behaviour in animals elicited without the use of drugs. Bank voles were placed in two different cage milieux, a restricted milieu approaching usual laboratory conditions for experimental animals, and an enriched milieu offering opportunities for satisfaction of natural behavioural (ethological) needs. During an experimental period of 6 months normal behaviours (known from the ethogram of the bank vole) and abnormal behaviours were recorded in eight 5-min observation periods of each cage. Social structure (hierarchy) was studied by the intruder method and social function (peaceful or tyrannic hierarchy) by inspection of the subordinate voles for wounds. Stereotypies, hyperaggressive behaviour and tyrannic hierarchy, replacing normal behaviour and social structure, were seen frequently in the restricted milieu, but only occasionally in the enriched milieu (differences highly significant). It is concluded that these findings indicate possibilities for further development of the basic studies of abnormal behaviour made by means of the "amphetamine model" of psychosis. Opportunities exist for investigation of the interaction of milieu factors with genetic, pharmacological and other factors relevant to the development, prevention and treatment of abnormal behaviour and mental disease. PMID- 3299498 TI - Cardioprotective effect of prostacyclin and 7-oxo-PGI2 in rats against chronic isoproterenol damage. AB - Isoproterenol (ISO) was injected in 5 mg/kg i.p. doses to rats, daily for two weeks. We evaluated the developed myocardial hypoxia and necrosis quantitatively by histological methods. To follow the time course of cardioprotection prostacyclin or 7-oxo-PGI2 were injected daily, i.p. 5, 30 min and 1, 2, 3, 4 hours before or after the ISO to groups of ten rats, respectively. Cardioprotection was defined as the reduction of necrotized areas and was expressed as percentage change compared to the control (saline treated) group. 1 microgram/kg PGI2 and 50 micrograms/kg 7-oxo-PGI2+ showed nearly equipotent cardioprotection (37.3-7.9% and 38.3-6.8%, respectively). The peak effect of both compounds appeared when injected prior to ISO in the 120. min but the action of 7 oxo-PGI2 was more prolonged. The different doses of prostacyclin analogs given after the ISO injection were ineffective with the exception of 50 micrograms/kg 7 oxo-PGI2 (29.75 +/- 5.2%). PMID- 3299499 TI - Gastric leiomyoblastoma: report of a case. AB - The case of a 38-year-old man with an exogastric leiomyoblastoma is reported. CT and ultrasound examinations revealed a large mass in the left hypochondrium that had both solid and cystic components. These findings mimicked those of cystadenoma of the pancreas. Because of intraperitoneal hemorrhage in the preoperative course, emergency laparotomy was performed. A large tumor was found to arise from the greater curvature of the stomach. The diagnosis was confirmed histologically. PMID- 3299500 TI - Sonographic diagnosis of primary muscular echinococcosis. PMID- 3299501 TI - Clinical staging of rectal cancer: a study on 126 patients. PMID- 3299502 TI - Intra-arterial digital angiography of the liver: comparison with conventional angiography. PMID- 3299503 TI - Ultrasonography in the evaluation of pleural pathology. PMID- 3299504 TI - Applications and limitations of ultrasonography in gastric pathology. PMID- 3299505 TI - Sonographic patterns in diffuse splenic lesions. PMID- 3299506 TI - Ultrasound in Crohn's disease--a comparison with small bowel enema. PMID- 3299507 TI - Effects of proglumide on pancreatic endocrine and exocrine function in healthy humans. AB - A comparative study was done on the pancreatic endocrine (insulin (IRI), human pancreatic polypeptide (hPP] and exocrine secretion (fluid volume, amylase output, bicarbonate output), before and after administration of proglumide. At the time of the test meal loading, plasma hPP and cholecystokinin (CCK) were also measured. During continuous i.v. administration of proglumide 750 mg and 1650 mg/h 30 min before CCK-8 (20 ng/kg) stimulation, no significant difference in the rise of plasma hPP level was observed, as compared with a single stimulus of CCK 8, nor were there any significant differences in the exocrine secretion. The values of hPP and CCK-8 under a load of test meal significantly elevated after a food load. Although hPP showed a significant inhibition with the administration of proglumide 1650 mg/h, plasma CCK-8 and blood sugar levels were not significantly different from control groups. Therefore, while proglumide has a very weak effect on the action of pancreatic endocrine function, it does have an inhibitory effect on pancreatic function, during physiological stimulation. PMID- 3299508 TI - [Recent trend of medical imaging technology--emphasis on radionuclide imaging]. PMID- 3299509 TI - [Handling manual for brachytherapy sources. II. Equipments and their safety use in brachytherapy]. PMID- 3299510 TI - [Echography in hip dysplasia in neonates and infants. Echographic anatomy, technic and case material]. AB - The value of hip joint sonography in newborns and unweaned infants is the latest development in the diagnosis of hip dysplasia. Knowledge of the sonographic anatomy makes accurate examination and staging according to Graf's tables possible. Since sonography is non-invasive it can be used for screening and check up, thus reducing the use of radiography. A personal series of 250 patients is presented. PMID- 3299511 TI - [The urethral canal in the prostatectomy patient. Echographic aspects]. AB - An evaluation of the urethra has been made in patients who underwent open surgery or endoscopic resection of the prostate, by means of transrectal echography (EG). The technique used is described; studies have been performed both in basal conditions and in various functional phases, including micturation. Echographic findings are compared to those achieved with micturating cystourethrography (MCU). In case of total prostatectomy EG and MCU findings are similar, showing the surgical bladder neck and the urethral aspect even during micturation. EG shows furthermore possible liquid fluid collections. In partial prostatectomies EG and CUM findings differ, showing the first, besides the site of the surgical intervention, the possible presence of calculi, while CUM findings do not differ from those visible in total prostatectomies. Conclusions are that for the whole study of the urethra CUM is necessary, while for the study of the prostatic region EG gives more information. Therefore EG is proposed as method complementary to CUM in the evaluation of the proximal urethra. PMID- 3299512 TI - [Internal echography. Problems inherent in iconographic documentation and reporting. A proposal for codification]. AB - Problems concerning iconographic documentation and reporting in abdominal ultrasound are discussed. The authors propose schemes for a minimal iconographic documentation of the various organs and systems in case of negative examinations or to be associated with the documentation of the lesion in pathologic cases. Afterwards more complex questions in reporting are discussed, concerning dimensions of organs, echostructure and terminology in use with the proposal of a standard pattern. The authors point out how codification and standardization both of images and report are by now necessary in echography, in order to make examinations more comparable and capable of being evaluated. PMID- 3299513 TI - [Cyclophosphamide and total lymph node irradiation as conditioning for bone marrow transplant in severe aplastic anemia]. AB - Personal experience is outlined with a preparative regimen consisting of total nodal irradiation (TNI) and cyclophosphamide in patients with severe aplastic anemia undergoing bone marrow transplantation (BMT). Nine patients (median age 23) previously having blood transfusions received BMT at the BMT Center in Pesaro. All patients were prepared for transplantation with cyclophosphamide 50 mg/kg/day (day -6, -5, -4, -3), and 7.5 Gy total nodal irradiation day -1, with a dose rate of 26 cGy/m. Six out of eight evaluable transplanted patients are still surviving 3 to 23 months with a median follow-up of 16.5 months. This preoperative regimen is extremely effective in decreasing rejection following transplantation for severe aplastic anemia. Future investigation must be aimed at the elimination of graft-versus-host-disease and control of fatal infections. PMID- 3299514 TI - [A case of antideclive dissection of popliteal cysts]. PMID- 3299515 TI - [Unusual echographic finding of renal lymphoma. Description of 2 cases]. PMID- 3299516 TI - [Etiopathogenesis of diabetes mellitus]. PMID- 3299517 TI - [Physiopathology of diabetes]. PMID- 3299518 TI - [Oral hypoglycemic agents]. PMID- 3299519 TI - [Insulin]. PMID- 3299520 TI - [Strategy in the treatment of diabetes]. PMID- 3299521 TI - [Treatment of chronic renal insufficiency in the diabetic patient]. PMID- 3299522 TI - Adhesive bonding treatments for aesthetic restorative dentistry. PMID- 3299523 TI - [Treatment of a lateral root perforation]. PMID- 3299524 TI - [Apical seal: reality or fiction? In vitro study using bacterial colonization]. PMID- 3299525 TI - [Endodontic bacteriology]. PMID- 3299526 TI - [The significance of a double embedding technic in the quantification of the gap in the dentin pericanal/filling material. Use of a modified ZOE paste. An SEM study]. PMID- 3299527 TI - [Rational use of prefabricated parts in the construction of the removable partial denture framework. 1]. PMID- 3299528 TI - [Rational use of prefabricated parts in the construction of the removable partial denture frameworks. 2]. PMID- 3299529 TI - [Rational use of prefabricated parts in the construction of the removable partial denture frameworks. 3]. PMID- 3299530 TI - [The nursing school of the Federal University of Bahia--40-year history]. PMID- 3299531 TI - EDB: a case study in communicating risk. AB - This is a report on the Environmental Protection Agency's (EPA's) efforts to communicate with the public about the risks of ethylene dibromide (EDB), what the agency said it was doing about these risks and what information the public actually received through television and newspapers. Although special in many ways, the EDB case illustrates the problems that regulatory agencies have when they must take regulatory action and assure the public that the risks in question are being dealt with adequately. It also illustrates issues that the press faces. Above all, it illustrates the barriers to communication presented by the different perspectives of regulatory agencies and individuals and the types of information they each are most interested in. PMID- 3299532 TI - [Tumors of the sacrum. Radiotherapy and chemotherapy aspects]. PMID- 3299533 TI - [Diaphyseal resection and reconstruction in cases of tumors involving the long bones of the extremities. Apropos of 23 cases]. AB - An analysis has been made of the records of 23 cases of resection-reconstruction of the shafts of long bones for a variety of tumours of bone. Four were in the humerus, four in the forearm bones, five in the femur and ten in the tibia. The reconstructed bone was stabilised by an intramedullary nail in thirteen cases and by a plate or blade-plate in five cases. In five cases, the grafts were simply held by screws. The bone was reconstructed by an autograft in thirteen cases and by allograft in ten cases, four of which were combined with an autograft. Resections in the upper limb gave rise to few complications. Conversely, reconstructions in the lower limbs, particularly of the tibia, were associated with a significant number of complications because of infection and delayed union. The best fixation, when it was technically possible, was an intramedullary nail surrounded by autografts. Allografts, and the vascularised fibular graft, were very liable to secondary fatigue fracture. A combination of autograft and allograft needs to be considered if a sufficient quantity of autograft is not available. PMID- 3299534 TI - [Results of surgical treatment of spondylolisthesis using posterolateral intertransverse grafts. Apropos of 39 cases]. AB - Thirty-nine postero-lateral intertransverse spine fusions performed for isthmic spondylolisthesis of L5 in 38 patients and L4 in one patient were reviewed clinically and radiologically at a mean of 7.5 years following operation. In thirty-three patients, fusion was combined with excision of the mobile posterior vertebral arch. In thirty-seven patients, the graft was applied in situ and in two patients after pre-operative reduction with halo-femoral traction. There were 87 per cent of excellent and good clinical results and a fusion rate of 94.6 per cent. This simple and reliable technique gives results comparable with other more complex methods of spine fusion. It is, however, unsatisfactory in cases with a displacement greater than 60 per cent, requiring pre-operative reduction, Removal of the mobile posterior arch (Gill) did not significantly improve the results. PMID- 3299535 TI - [Malignant bone tumors and giant cell tumors of the sacrum in adults]. PMID- 3299536 TI - [Change in circadian secretion of cortisol in some diabetic patients: clinical and therapeutic implications]. PMID- 3299537 TI - [High-dose cyclophosphamide and whole-body radiotherapy followed by bone marrow transplant in patients with leukemia]. PMID- 3299538 TI - [Treatment with antibiotic therapy and percutaneous drainage under echographic control of a multiple hepatic abscess]. PMID- 3299539 TI - [Bilateral pyosalpinx and osteomyelitis of the femur associated with reactive arthritis in salmonellosis]. PMID- 3299540 TI - [Detection of resistance to DDT in larvae of Culex (C.) quinquefasciatus Say, 1823 (Diptera: Culicidae) bred in the laboratory]. PMID- 3299541 TI - [Epidemiologic aspects of fascioliasis hepatica]. PMID- 3299542 TI - [Dipetalonema reconditum (Grassi, 1890) (Nematoda: Filaroidea). First report in the Isla de la Juventud]. PMID- 3299543 TI - [The Hughes complex. Ecological aspects]. PMID- 3299544 TI - [Influence of various abiotic factors on fluctuations of the larval population of Culex quinquefasciatus, Say 1823 (Diptera: Culicidae)]. PMID- 3299545 TI - [Simultaneous comparison of acridine orange and Giemsa stains in the diagnosis of malaria]. PMID- 3299546 TI - [Testing of the footpad technic for the cultivation of Mycobacterium leprae in different lines of mice populations in Cuba]. PMID- 3299547 TI - [Urticaria and Fasciola hepatica]. PMID- 3299548 TI - [Isolation of anaerobic bacteria in samples from human clinical cases]. PMID- 3299549 TI - [Successful treatment of a case of histoplasmosis africana with miconazole (daktarin)]. PMID- 3299550 TI - [Infestation capacity of Romanomermis culicivorax (Ross and Smith, 1976) (Rhabditida: Mermithidae) in larvae of Aedes (S) aegypti (Linnaeus), 1972 (Diptera: Culicidae) under laboratory conditions]. PMID- 3299551 TI - [Arboreal mollusks and mollusks associated with vegetation in Cuba]. PMID- 3299552 TI - [Scorpion stings]. PMID- 3299553 TI - [Pica associated with ascariasis. Presentation of a case]. PMID- 3299554 TI - [Chromobacterium violaceum infection. Presentation of a case with fatal outcome]. PMID- 3299555 TI - [Technic for the collection of larvae of Angiostrongylus cantonensis from Mollusca]. PMID- 3299556 TI - [Technic of segmental autotransplant of the pancreas in the dog by microanastomosis of the main pancreatic vessels]. PMID- 3299557 TI - [Effects of zinc sulfate on in vivo gastric secretion]. PMID- 3299558 TI - [Diagnostic aspiration puncture with fine needle guided by ultrasonics]. PMID- 3299559 TI - [Esthetic restoration of the posterior teeth. Analysis of the current situation]. PMID- 3299560 TI - [Dentistry in antiquity. Egypt, Hippocrates, Galen and Celsus]. PMID- 3299561 TI - [A sesquicentenial: Greene Vardiman Black]. PMID- 3299562 TI - [French Language Society of Pneumology. List of members (1987)]. PMID- 3299563 TI - [Diagnostic procedure, from art to science: what role has the computer?]. PMID- 3299564 TI - Renin status of the afferent arteriole and ultrastructure of the juxtaglomerular apparatus in 'superficial' juxtamedullary nephrons from rats. AB - The present light (LM) and transmission electron microscopic (TEM) studies were carried out to further document the anatomy of the 'superficial' juxtamedullary nephrons (SJMNs) located on the inside cortical surface of the rat kidney. TEM revealed that SJMNs possess all vascular and tubular cell types constituting the juxtaglomerular apparatus (JGA) in typical cortical and juxtamedullary nephrons (JMNs). Proximal to the glomeruli, epithelioid cells filled with secretory granules predominated in the media of afferent arterioles. The presence of renin in the granules was immunocytochemically demonstrated by the protein A-gold method. Further upstream from the glomeruli, epithelioid cells alternated with plain smooth muscle cells. The use of renin and angiotensin II antisera revealed similar arteriolar distributions of renin and angiotensin II positive cells in SJMNs as well as in typical JMNs. Numerous nerve terminals were found along afferent and efferent arterioles, suggesting a dense innervation of these vessels. The distribution of renin-containing (i.e., epithelioid) cells in the preglomerular arterioles was assessed in various nephron populations by LM using the PAP method and renin antiserum. In SJMNs, most renin-positive cells were found in the vicinity of the JGA along a mean arteriolar length of 35 +/- 3 micron (range 7-107 micron). In JMNs, renin-positive cells had a similar distribution along a mean arteriolar length of 35 +/- 1 micron. Scattered renin positive cells were observed up to a maximal arteriolar length of 173 and 238 micron in SJMNs and JMNs, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299565 TI - Ambroxol and simple chronic bronchitis. Effects on subjective symptoms and ventilatory function. AB - In a double-blind, randomized, controlled trial using parallel groups, we evaluated the effects of two dose levels of ambroxol (60 and 120 mg daily) versus placebo by means of pulmonary function tests, patients' diary cards, interviews on current airway symptoms and subjective drug effects in 92 subjects with simple hypersecretory chronic bronchitis. The treatment period was 2 weeks. Subjects in the 120-mg group compared to the placebo group reported improvement in respiratory symptoms (p less than 0.05), particularly in phlegm loosening (p less than 0.05) and tended to prefer the treatment period when compared to placebo (p = 0.056). Lung function values and diary cards did not indicate significant changes. PMID- 3299566 TI - Clinical efficacy of ambroxol in the treatment of bronchial stasis. Clinical trial in 120 patients at two different doses. AB - Mucosolvan is a 'mucus-modifier' whose active compound is ambroxol. The aim of our research was to determine its clinical efficacy in the treatment of bronchial stasis by carrying out two successive double-blind studies in two parallel groups of patients and comparing ambroxol with placebo in a treatment lasting 10 days. The first trial involving 60 patients daily treated with 120 mg of ambroxol showed significant differences (p less than 0.05) in sputum volume, sputum viscosity, difficulty of expectoration, and severity of cough when compared with the placebo group. The two groups of patients were initially well matched and the drug was well tolerated. In a second trial involving 60 new patients daily treated with 30 mg of ambroxol, the drug showed no clear clinical effects. We conclude that ambroxol is an effective 'mucus modifier' and is well tolerated at a dose of 120 mg/day. PMID- 3299567 TI - Ambroxol for the prevention of chronic bronchitis exacerbations: long-term multicenter trial. Protective effect of ambroxol against winter semester exacerbations: a double-blind study versus placebo. AB - In a 6-month, double-blind multicenter trial conducted over the winter, the effects of daily administration of ambroxol retard (75 mg) were compared with those of placebo in preventing exacerbations and improving symptoms and clinical signs in chronic bronchitis patients. The trial was completed by 110 patients in the ambroxol group and by 104 in the placebo group. Initially, there were no significant differences between the groups. By the end of the 2nd month of treatment, 67.2% of the ambroxol group had had no exacerbations compared to 50.4% in the placebo group. At the end of the 6-month trial, 45.5% of the treatment group had had no exacerbations, compared to only 14.4% of the control group. These differences were statistically significant. Patients in the treatment group lost significantly fewer days through illness (442) and had fewer days when they needed antibiotic therapy (371) compared to the placebo group patients (837 and 781). Ambroxol also produced statistically significant symptomatic improvement, measured as difficulty in expectoration, coughing, presence of dyspnea and the auscultatory signs as compared to controls. Since ambroxol was well tolerated and compliance was good, it appears like a drug of choice for pharmacological prophylaxis of chronic bronchitis. PMID- 3299568 TI - Ambroxol in the treatment of idiopathic respiratory distress syndrome. An interim report on a controlled double-blind multicenter study versus placebo. AB - In a double-blind multicenter study versus placebo, the therapeutic effects of ambroxol (10 mg/kg, i.v. twice daily for 7 days) were studied in an appropriately selected population with severe respiratory failure. Treatment was given to 28 neonates with birth weight less than or equal to 2,000 g, appropriate for gestational age with idiopathic respiratory distress of such severity as to require assisted ventilation (IMV or IPPV) within 12 h of birth. The preliminary results showed that ambroxol treatment, and not placebo, increased survival, reduced the time during which mechanical ventilation was required and improved the FiO2/PaO2 ratio and the biochemical indices of pulmonary maturity. This latter improvement suggests that the amelioration of the IRDS clinical picture and the reduction of ventilatory requirement might be due to an increase in pulmonary surfactant. No side effects attributable to ambroxol therapy were observed in the treated infants. PMID- 3299569 TI - A new temporary keratoprosthesis for pars plana vitrectomy. AB - Using a new temporary keratoprosthesis in an eye with an opaque cornea and a proliferative vitreoretinopathy, a pars plana vitrectomy combined with a silicone oil injection was successfully performed. The new keratoprosthesis is made of silicone rubber and is fixed to the threphined corneal bed with four 10-0 nylon sutures. It permits an excellent view of the intraocular structures and allows vitreoretinal surgery even in the region of the pars plana and vitreous base. It is replaced by a corneal graft at the end of the vitrectomy. PMID- 3299570 TI - Influence of lung stiffness on rapidly adapting receptors in rabbits and cats. AB - We examined the response of rapidly adapting receptors (RARs) to changes in dynamic lung compliance (CDYN), recording vagal impulses in open-chest rabbits and cats with lungs ventilated at constant f and VT, and a positive end expiratory pressure (PEEP) of 3-4 cm H2O. After hyperinflation to produce maximal CDYN, most RARs fired irregularly and sparsely (less than 1 impulse X sec-1). Reducing CDYN in steps by briefly removing PEEP progressively stimulated RARs during inflation, activity increasing sevenfold when CDYN was reduced by 40% (P less than 0.0001). Reducing CDYN also increased RAR responses to static lung inflation. RAR stimulation by decreasing CDYN was virtually unaltered by atropine and hence was largely independent of reflex changes in bronchomotor tone. RARs were also stimulated by increasing VT at constant f, but, expressed as a function of airway pressure, the afferent response was less than that to increased lung stiffness (1/CDYN); expressed as a function of 1/CDYN, however, the responses were similar. We conclude that RARs signal increases in the force required to expand the lung, and speculate that their excitatory influence helps to maintain VT as the lungs become stiffer. PMID- 3299571 TI - Anorexia nervosa: historical background and biopsychosocial determinants. PMID- 3299572 TI - Understanding and recognizing the effects of Chlamydia trachomatis infections. PMID- 3299573 TI - Adolescent pregnancy: selected topics. PMID- 3299574 TI - [Skin autografts obtained for in vitro culture of epidermal cells]. PMID- 3299575 TI - Behavior of the vitamin D endocrine system in the development of renal osteodystrophy. PMID- 3299576 TI - The physiology of the vitamin D endocrine system. AB - It is clear that the vitamin D endocrine system plays a central role in the maintenance of calcium and phosphate homeostasis. It may be involved in the cellular differentiation and growth of various cells. Investigation of these properties in the future is likely to yield interesting information concerning the biology of this sterol hormone. PMID- 3299577 TI - Renal osteodystrophy. PMID- 3299578 TI - Aluminum: culprit or accessory in the genesis of renal osteodystrophy. PMID- 3299579 TI - The role of metabolic activation and pharmacokinetics in clinical pharmacology. PMID- 3299580 TI - Diuretics: mechanism of action and therapy. PMID- 3299581 TI - Current therapy of urinary tract infections and pyelonephritis. PMID- 3299582 TI - Transport and renal effects of general anesthetics. PMID- 3299583 TI - The use of drugs in renal failure. AB - We have tried to emphasize specific variables that impact upon the use of drugs in the patient with renal disease. These variables are complex, often interrelated, and if neglected by the physician will surely lead to unwarranted drug reactions and serious harm to the patient. We have purposely limited the tables of "Selected Pharmacologic Agents" to a few prototypic drugs from each class, emphasizing the newer agents recently introduced in clinical medicine. We strongly recommend that as new drugs are used, the original literature be consulted for verification. PMID- 3299584 TI - Immunosuppressive strategy for transplantation: historical perspective and developing concepts. PMID- 3299585 TI - Cytodiagnostic urinalysis for the nephrology practice. PMID- 3299586 TI - Proteinuria and enzymuria. PMID- 3299587 TI - The metabolism of aluminum and aluminum-related encephalopathy. AB - The dialysis encephalopathy syndrome is at once the most widely recognized and most severe manifestation of aluminum toxicity. Evidence linking this syndrome and aluminum intoxication is virtually incontrovertible. The syndrome is characterized by speech and motor difficulties, dementia, and seizures. Less widely recognized symptoms include subtle changes in cognition and personality and directional disorientation. Since the widespread use of water treatment, aluminum exposure in the dialysis population has been primarily via intravenous (IV) medications and oral aluminum-containing, phosphate-binding antacid gels. In addition to the encephalopathy syndrome, aluminum has been linked to toxicity in bone, parathyroid gland, RBC, and kidney. These organ toxicities seem to be the result of specific protein enzyme inhibition. Currently identified factors that affect aluminum accumulation and modulate aluminum balance include uremia, renal function, parathyroid hormone withdrawal and suppression, 1,25 dihydroxycholecalciferol, and serum aluminum binding. Impaired renal function is not a prerequisite for increased tissue aluminum burdens. It is likely that aluminum-related disease will be increasingly observed in populations other than those with chronic renal failure. PMID- 3299588 TI - Diagnosis of aluminum-related bone disease and treatment of aluminum toxicity with deferoxamine. AB - Bone disease related to aluminum toxicity (aluminum-related bone disease) presents with variable clinical and biochemical findings in patients with renal failure. Bone pain and muscle weakness are common, although afflicted patients can be asymptomatic. Bone pain can be generalized or localized to the hips, back, feet, or ankles; proximal muscle weakness is common. Most cases in the United States arise from the ingestion of aluminum-containing gels by patients on long term dialysis treatment. Patients at increased risk for developing aluminum related bone disease include those with earlier parathyroidectomy, failed renal transplant, previous bilateral nephrectomy, and diabetes mellitus. Biochemical features that are common with aluminum-related bone disease include plasma aluminum levels greater than 100 to 150 micrograms/L, serum parathyroid hormone (PTH) levels equal to or lower than those in dialysis patients without bone disease, and normal or slightly elevated serum calcium levels. Plasma alkaline phosphatase levels are often elevated. In our experience, microcytic anemia has been uncommon. An increase in plasma aluminum levels greater than 200 micrograms/L 24 to 48 hours after the infusion of the chelating agent deferoxamine (DFO) correlates with an increased bone aluminum content, and an increment greater than 400 micrograms/L suggests marked aluminum accumulation. Radiographs are usually nonspecific. When results from indirect diagnostic procedures are equivocal, a bone biopsy is necessary. After a diagnosis of aluminum-related bone disease is established, therapy with DFO may be useful. DFO increases both the total plasma aluminum level and its ultrafilterable fraction. After an infusion of DFO, the removal of aluminum increases from 50 to 300 micrograms to 4 to 8 mg per dialysis session. Aluminum removal is similar during continuous ambulatory peritoneal dialysis after either intravenous (IV) or intraperitoneal (IP) administration of DFO. Usually, 2 to 4 g of DFO is administered once weekly, but the optimal dose and duration of therapy have not been determined. Symptoms usually improve after 4 to 12 weeks, and bone biopsies show improvement after treatment for 6 to 12 months. Further experience with DFO is needed, both to identify the optimal dosage and to clarify the risks of long term therapy in patients with renal failure. PMID- 3299589 TI - Management of iron overload in dialysis patients. AB - Acquired hemosiderosis resulting from massive iron deposits in various organs, including heart, liver, and pancreas, may lead to architectural and functional disturbances of these organs. Even though iron overload can occur in nonuremic as well as in uremic individuals, the dialysis patient is at particular risk for developing hemosiderosis. Many dialysis patients receive exogenous iron from either oral iron therapy or blood transfusions. In addition, these patients seem to be at high risk for retaining iron. A diagnosis of excess iron deposition should be considered if the patient has unexplained cardiomyopathy, hepatic cirrhosis, proximal myopathy, diabetes mellitus, arthropathy, or immune dysfunction such as listeriosis. Several techniques are available for determining iron overload. Diagnostic tests include measuring serum ferritin levels, staining bone marrow preparations for excess iron, measuring tissue hemosiderin concentrations, magnetic resonance imaging, and the deferoxamine (DFO; Desferal) "challenge test." The simplest treatment for iron overload in nonuremic patients is removal of iron by venesection. However, in patients in whom venesection is not feasible, the chelating agent DFO can effectively remove excess iron. In the dialysis patient, DFO therapy can be combined with either dialysis or hemoperfusion to remove the iron-DFO complex that would otherwise be removed by the kidney. DFO therapy in the nondialyzed individual has proven to be successful, but before treatment, the benefits of the treatment must be weighed against possible adverse side effects such as cataracts, changes in color vision, and anaphylaxis. In the dialysis patient, indications for iron removal are less clearly defined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299590 TI - Iliac crest bone biopsy for diagnosis of aluminum toxicity and a guide to the use of deferoxamine. AB - Diagnosis of aluminum-related bone disease in patients with renal failure often requires a bone biopsy. Percutaneous biopsy of the iliac crest has been safely carried out as an outpatient procedure in over 300 patients. No instances of significant bleeding or infection have occurred. The procedure was well accepted in 85% to 90% of patients recently surveyed. Before biopsy, each patient received two short courses of oral tetracycline, separated by a ten- to 14-day interval. Double tetracycline labeling permits the evaluation of dynamic characteristics of bone for the diagnosis of aplastic disease due to aluminum toxicity. When a diagnosis of aluminum toxicity is established, treatment with the chelating agent deferoxamine (DFO) administered during dialysis is effective for aluminum removal. Initially, a standardized infusion of DFO, 40 mg/kg, is administered over two hours immediately following dialysis treatment. The increase in plasma aluminum 24 to 48 hours following such an infusion provides an index of tissue aluminum stores and provides a guide to the appropriate therapeutic dose of DFO. DFO (2 to 4 g) is administered once weekly during the last two hours of dialysis; in rare cases higher dosages have been used. Reported side effects of DFO therapy include hypotension, hypoferremia, and allergic reactions; other investigators have reported ocular abnormalities and unusual infections. Patients are reevaluated after 6 to 12 months of therapy with a DFO infusion test and/or bone biopsy. However, the duration of therapy needed for the successful treatment of aluminum-related bone disease is uncertain. PMID- 3299591 TI - Aluminum and renal osteodystrophy. AB - Bone disease is recognized as a major problem in dialysis patients. initially, hyperparathyroidism was thought to be the major cause of bone disease in these patients. However, an aluminum-related bone disease has been identified in dialysis patients receiving exogenous aluminum. Patients with hyperparathyroidism and aluminum toxicity present with similar clinical and laboratory features; therefore, diagnosis of these two bone abnormalities is often difficult. Understanding normal bone development helps to elucidate the distinctions between aluminum and renal osteodystrophy. Patients with either bone syndrome may present with hypercalcemia, elevations in parathyroid hormone levels, bone pain, fractures, and radiographic evidence of subperiosteal resorption. The subtleties of these syndromes must be understood to avoid misdiagnosis. A diagnosis of hyperparathyroidism may lead to a parathyroidectomy, exacerbating the development of aluminum toxicity. Hyperparathyroidism is associated with increased surface osteoid, a high bone formation rate, increased numbers of bone cells, abnormal "twoven" osteoid, and low serum aluminum levels. Aluminum toxicity is associated with a low rate of bone turnover, paucity of bone cells, maintenance of a "laminar" osteoid, and significant aluminum bone deposition. Serum aluminum level measurements are key to the diagnosis of aluminum toxicity. For patients displaying intermediate aluminum values, the deferoxamine (DFO) challenge test is necessary for diagnosis. If noninvasive methods fail to determine a definitive diagnosis, a bone biopsy is required. PMID- 3299592 TI - [Single dose of nitrofurantoin in the treatment of acute uncomplicated urinary tract infection]. PMID- 3299593 TI - [Effect of prolonged administration of ketotifen on bronchial reactivity and the medication of asthma patients]. PMID- 3299594 TI - [Infection in the 20th century]. PMID- 3299595 TI - [Short-term chemotherapy of tuberculosis with 5-month regimens with and without pyrazinamide in the 2d phase (TA-82)]. PMID- 3299596 TI - [Insulin and atherosclerosis]. PMID- 3299597 TI - [Forensic pharmacognosy: drugs from plants--myth and reality (II)]. PMID- 3299598 TI - [Epidemiologic retrospective in the Duchy of Bucovina. New data on the epidemiologic situation in Bucovina at the start of the 19th century]. PMID- 3299599 TI - Different binding forms of cadmium--implications for distribution and toxicity. AB - Our present understanding of mechanisms for induction of renal tubular damage by cadmium is summarized in Fig 1: Cadmium is taken up from various exposure routes into plasma where it is initially bound to albumin. Such cadmium is mainly taken up by the liver where it induces the synthesis of metallothionein, which is mainly kept intracellularly, but a small proportion escapes into blood plasma. Cadmium bound to metallothionein in plasma is quickly transported to the kidney tubule by glomerular filtration and subsequent uptake by pinocytosis into renal lysosomes. Uptake of cadmium bound to low mol. wt protein from hemolyzed blood cells may also contribute to cadmium accumulation in the renal tubule. Cadmium is released from metallothionein in the renal lysosomes, where proteins are catabolized. Non-metallothionein bound cadmium may then interact with sensitive sites in the renal cell and cause renal tubular damage. There is an internal synthesis of metallothionein in the renal cells and a balance is thus formed between metallothionein bound cadmium and non-metallothionein bound cadmium. Only in such situations when non-metallothionein bound cadmium reaches a sufficient concentration does the renal damage appear. This scheme has been based mainly on observations in animals and cellular systems. It is probable that similar conditions occur in humans; however, the amount of human evidence available to quantify the different pathways is limited. Nevertheless, based on several assumptions, a quantitative model has been designed for humans concerning relationships between exposure and development of renal damage. Available data have been summarized in two chapters of a recent publication (Nordberg et al 1985, Kjellstrom and Nordberg 1985). Much more data on humans would be desirable to make this kind of extrapolation with confidence. PMID- 3299600 TI - Health assessment of chromium. PMID- 3299601 TI - Relationships of toxicological effects to chemical forms of inorganic compounds. PMID- 3299602 TI - Pathology of gold nephropathy: a review. PMID- 3299603 TI - Effects of selenium antagonists on cancer susceptibility: new aspects of chronic heavy metal toxicity. AB - Uptake, transport, metabolism and physiological activity of selenium are influenced by interactions with a variety of heavy metals. With elements exhibiting especially high affinities for selenium, significant interactions may occur at concentrations close to the no-effect threshold levels. At low dietary Se intakes, this may produce states of latent Se deficiency as well as increased susceptibility to cancer development. In experiments with MMTV-infected female mice, exposures to low levels of the Se-antagonistic elements As, Pb and Cd in the drinking water abolish the cancer-protecting effects of Se. At higher exposure levels, these elements may act as inhibitors or promotors of malignant transformation and tumor growth. These findings are of potential importance to human health as the contaminant levels of Se-antagonistic elements in foods and in the environment result in exposures which often significantly exceed the dietary Se intakes. PMID- 3299604 TI - Cisplatin nephrotoxicity. PMID- 3299605 TI - Biological monitoring of metals with special references to the early stages of the life cycle. AB - In summary, the biological monitoring of toxic metals in the early stages of the life cycle has not yet received the attention it deserves. Most metals have simply not been studied at all. Some successful applications with mercury, lead, and cadmium have been reviewed here. But even for these widely studied metals, there is a great need to study physiological models for metal disposition in developing animals. PMID- 3299606 TI - Metals as nutritional factors. PMID- 3299607 TI - [Role of almitrine in the treatment of chronic obstructive bronchopneumopathy]. PMID- 3299608 TI - [Heart transplant. Indications and results]. PMID- 3299609 TI - [The role of immunology in heart transplants]. PMID- 3299610 TI - [The cardiologic follow-up of the transplant patient]. PMID- 3299611 TI - Growth hormone and athletes. AB - Growth hormone is a powerful anabolic hormone that affects all body systems and plays an important role in muscle growth. It is released from the anterior pituitary in response to a variety of stimuli including exercise, sleep, stress, and the administration of a variety of drugs and amino acids. Serum levels are variable and are dependent on such factors as age, sex, body composition and level of fitness. Animal experiments have shown that growth hormone can partially reverse surgically induced muscle atrophy and weakness. Growth hormone administration to normal animals leads to muscle hypertrophy, but this muscular growth is not accompanied by increased strength. Growth hormone excess leads to acromegaly, a disease with significant morbidity, including a myopathy in which muscles appear larger but are functionally weaker. Although there is no scientific evidence documenting an improvement in athletic performance following growth hormone supplementation, it is reported that this practice is becoming more widespread among athletes wishing to avoid detection with current doping control measures. There are anecdotal reports that athletes are injecting cadaveric or biosynthetic forms of growth hormone, both of which are associated with potentially serious complications. In addition, some athletes are ingesting drugs and amino acids in the belief that their endogenous growth hormone secretion will be increased. There have been no scientific studies on the effects of growth hormone supplementation, and the anecdotal reports have been equivocal, with some individuals reporting spectacular results while others report no change. Despite the lack of valid evidence for its efficacy and its potentially serious side effects, it has been predicted that growth hormone use may increase. Growth hormone use and abuse has the potential to dramatically change the future conduct of athletics and may prove to be a threat to the concept of fair competition. PMID- 3299612 TI - Exercise response and rehabilitation in cystic fibrosis. AB - Exercise testing can be performed safely in cystic fibrosis patients, and provides a simple and reproducible index of overall health in the disease. A wide variability in exercise capacity of cystic fibrosis patients is found, but, in general, exercise is limited by the degree of lung disease and, to a lesser extent, by compromised nutritional status. Based on the results of exercise tests, patients can then be supplied with individualised exercise prescriptions. Exercise training can be expected to improve the exercise capacity of the majority of cystic fibrosis patients, but pulmonary function generally remains unchanged. Whether exercise rehabilitation will improve the long term prognosis for patients with cystic fibrosis is currently not known. PMID- 3299613 TI - Strength and endurance training. Are they mutually exclusive? PMID- 3299614 TI - The effects of exercise on the development and function of the coronary collateral circulation. PMID- 3299616 TI - [Diagnostic and microbiological aspects of skeletal infections]. PMID- 3299617 TI - [Bronchial asthma in children]. PMID- 3299618 TI - [Treatment of progressive and severe forms of multiple sclerosis using a combination of antilymphocyte serum, azathioprine and prednisone. Clinical and biological results. Comparison with a control group treated with azathioprine and prednisone only. 4-year follow-up]. AB - 45 patients were treated by combined application of antilymphocyte serum, azathioprine and prednisone: a control group of such 22 patients was besides treated by azathioprine and prednisone only. The treatment by antilymphocyte serum included a four weeks initial treatment, and one year continuous treatment one infusion per week. Azathioprine and prednisone were given every day during the same time. Azathioprine only was given during the three following year. The two groups were followed up during four years. This treatment was well accepted by patients under strict technical survey conditions. Serum sickness was noted in 11 p. cent of the cases. The equine antiglobulin antibody titre, increased during the initial treatment, was connected with serum sickness or, when the treatment was continued, with the inefficacy of the treatment. Rosettes titre decreased in ten cases, no clinical correlation was possible. The complement, immune complexes, were normal before treatment with most of the observed patients. The delayed hypersensitivity skin tests were negative after a month in 80 p. cent of the cases. The cerebrospinal fluid analysis, for the elements as well as for the rate of proteins and gammaglobulins, showed no significant variations before and after the treatment. The comparison with the control group showed a significant statistical difference as too the number of aggravated and improved patients after the first year. When grouping together stable and improved patients, the difference was statistically significant after the third year. The difference was not significant in years "two" or four. No difference in the frequency of the relapses could be noted, in the first year or the following three years. In spite of inconsistent results comparison showed favorable data after three years. The good results seemed due to the additional use of antilymphocyte serum. Such a treatment associating antilymphocyte serum to azathioprine and prednisone is beneficial in evolutive, remittent and recent multiple sclerosis. Through the length of the treatment remains difficult to determine, we conclude that it is really beneficial for such patients. PMID- 3299619 TI - [Clinical reflection of the immunologic heterogeneity of rheumatoid arthritis]. PMID- 3299615 TI - Mobilisation of structural proteins during exercise. AB - In general, the mobilisation of structural proteins is necessary for enzyme synthesis and for renewing cellular structures with amino acids and precursors of nucleotic acids. However, during exercise the adaptive synthesis of proteins occurs only in the liver to some extent. In muscle tissue most protein synthesis is suppressed, although the synthesis of certain proteins in muscle remains unchanged or even increases. The general suppression of protein synthesis in muscle leaves much of the free amino acid pool unused. The breakdown of tissue proteins may also increase in various tissues, but there is no convincing evidence for proteolysis of contractile proteins in active muscle. As a result of these processes, an increased pool of available free amino acids is created. The main use of free amino acids is connected with the energy requirement of muscular activity, through the oxidation of branched-chain amino acids and the use of alanine in gluconeogenesis. In active muscles the output of alanine is increased. It is based on usage of pyruvate, which is produced in increased amounts due to intensified glycogenolysis and glycolysis, and of amino groups, which are liberated in oxidation of branched-chain amino acids. In the liver, alanine is consumed. The carbon skeleton of alanine is required for gluconeogenesis and the liberated amino groups are used in ureagenesis. The branched-chain amino acids are transported from the liver to active muscle for their oxidation. The increases in the free amino acid pool, in the rate of the glucose-alanine cycle, and in the use of amino acids in the liver are stimulated by an increased level of glucocorticoids and a decreased level of insulin during exercise. During recovery after exercise the use of amino acids for adaptive protein synthesis is intensified. This coincides with a persistently high rate of protein breakdown, constituting an increased rate of protein turnover. During recovery, the production of 3-methylhistidine by previously active muscles increases. It results in an increase in urinary output of 3-methylhistidine after exercise. Immediately after exercise the level of free 3-methylhistidine is elevated in the intestine for only a short time and the fact that it does not contribute significantly to the delayed increase in the excretion of 3-methylhistidine excretion after exercise must be considered as a sign of increased turnover of contractile proteins, helping to restore a good contractile function.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3299620 TI - [Status of the liver of rheumatoid arthritis patients after treatment with open radionuclides]. PMID- 3299621 TI - [Effect of hemoperfusion therapy on the system of soluble leukocyte antigens in systemic rheumatic and similar diseases]. PMID- 3299622 TI - [Methods of ultrasonic examination in diffuse connective tissue disease in children]. PMID- 3299623 TI - [Evolution of reconstructive valve surgery in rheumatic heart defects]. PMID- 3299624 TI - [Diagnostic significance of parameters of respiratory mechanics in systemic scleroderma and pneumosclerosis caused by chronic nonspecific lung diseases]. PMID- 3299625 TI - [Ultrastructural studies of joint effusion sediment in rheumatoid arthritis, Reiter's disease and ankylosing spondyloarthritis]. PMID- 3299626 TI - [Clinical manifestations of skeletal muscle involvement in rheumatoid arthritis]. PMID- 3299627 TI - [Participation of immunologic mechanisms in the pathogenesis of gout]. PMID- 3299628 TI - [Quantitative and functional characteristics of cells of the mononuclear phagocyte system of rheumatoid arthritis patients]. PMID- 3299629 TI - [Rheumatoid arthritis and secondary amyloidosis]. PMID- 3299630 TI - [Association of juvenile rheumatoid arthritis with hepatitis B]. PMID- 3299631 TI - [Primary lesion of the heart in systemic scleroderma]. PMID- 3299632 TI - [Double-blind evaluation of the therapeutic efficacy of D-penicillamine and hydroxychloroquine in juvenile rheumatoid arthritis]. PMID- 3299633 TI - Delusions of parasitosis: a review. AB - Patients who are erroneously convinced that they harbor dermatologic parasites present a diagnostic and therapeutic challenge to the practitioner. Delusions of parasitosis can exist as an isolated psychosis or as part of a much more complicated medical and/or psychiatric illness. To diagnose these patients, physicians must be familiar with the patterns of presentation usually seen in patients with delusions of parasitosis and must be confident that other psychiatric and/or medical conditions that could be causing the symptoms- including true parasitosis--have been ruled out. Clinical signs, such as the presence of cutaneous lesions on exposed and accessible parts of the body (wounds self-inflicted in efforts to extricate parasites with needles, knives, or fingernails), and behavioral signs, such as the collection of bottles and jars purported to contain samples of the parasites, are characteristic. These patients can be rigid, antagonistic, distant, and demanding; they may write long letters to physicians describing their parasites in detail, enclosing drawings or samples. Psychotherapy, with or without confrontational denial, has a reported efficacy of approximately 10%; placebo therapy is usually not recommended. The recent application of a new neuroleptic agent, pimozide, to the treatment of this disorder is controversial and a new neuroleptic agent, pimozide, to the treatment of this disorder is controversial and needs further study. Guidelines for an appropriate approach to patients with delusions of parasitosis include the necessity of identifying medical or psychiatric disease, if present, and of listening carefully to the patient's history.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299634 TI - Use of antimicrobial agents in animal feeds: implications for human health. AB - The inclusion of subtherapeutic doses of antimicrobial agents in animal feed is credited for having contributed to lower costs of meat, milk, and eggs. The practice often is associated with the acquisition of resistant enteric flora by the involved animals, a phenomenon that in turn may contribute to the human reservoir of coliforms and salmonellae resistant to antimicrobial agents. Farm workers may transiently acquire resistant intestinal flora and on rare occasions develop salmonellosis. Although irrefutable evidence of the growth-promoting properties of antibiotics in animal feed was provided 30-40 years ago, additional studies--with a focus on mechanisms of the effect--are presently needed. It may be possible to identify factors effective in promoting growth without deleterious effects on the intestinal flora. A national program of surveillance of antimicrobial administration (in both subtherapeutic and therapeutic doses) to food-producing animals should be established. Molecular epidemiologic research efforts must be undertaken to determine whether genetic information of animal origin contributes significantly to the human environmental pool of antimicrobial resistance. In the meantime, it does not appear that the banning of drugs as feed additives, with concomitant unrestricted use of these agents for the treatment of both animals and people, would favorably influence the problems of antimicrobial resistance and salmonellosis in human populations. PMID- 3299635 TI - Bacterial colonization and infection resulting from multiplication of a single organism. AB - There are at least two possible explanations for the observation that inoculation with a single microorganism is generally insufficient to cause infection while inoculation with many organisms may regularly result in infection in a susceptible host. Microorganisms may act cooperatively, with the occurrence of infection resulting from their joint action. Alternatively, each organism of the infecting inoculum may independently possess the potential to cause infection, and, with an inoculum size approximating the 50% infectious dose, infection may result from the survival and multiplication of a single organism. Several lines of experimental data involving several bacterial species strongly support the independent-action, or "single-organism," hypothesis of the pathogenesis of colonization and infection. Available data also support the independent-action hypothesis in the pathogenesis of experimental viral infections. This hypothesis provides an explanation for the occurrence of sporadic episodes of infection. PMID- 3299636 TI - Is there a risk to contacts of patients with rabies? AB - The number of persons in the United States potentially in contact with rabid humans has increased in recent years because of labor-intensive medical care, longer survival times, and care in two or more hospitals. Many of these persons request rabies prophylaxis, and their physicians prescribe it because of their insecurity, a situation that is expensive and often unnecessary. Records of the Centers for Disease Control and the literature were reviewed to examine the current practice of prophylaxis of contacts and the actual need for it. Rabies virus is present in a variety of human fluids and tissues during the first five weeks of illness, but there are only four well-documented reports of human-to human transmission--all in corneal transplant recipients. Prophylaxis of contacts of 14 rabid patients was predominantly for saliva exposure to open wounds or mucous membranes and was given most often to medical personnel having the greatest contact with the patient. Although it has never been documented, human to-human transmission of rabies following saliva exposure remains a theoretical possibility. Virus shedding by rabid patients should be studied thoroughly in the future. Recommendations for managing contacts of rabid patients are presented. PMID- 3299637 TI - Environmental nonhuman sources of leprosy. AB - Leprosy has been considered to occur only after exposure to a human case. However, evidence has been accumulating that this conventional view is wrong and that an environmental nonhuman source is critical to some human infections with Mycobacterium leprae. Observations, some of which date back to the nineteenth century, support soil, vegetation, water, arthropods, and armadillos (Dasypus novemcinctus) as environmental sources of leprosy. Disparate clinical, epidemiologic, and microbiologic evidence has been critically reviewed in light of the fact that 50%-70% of sporadic cases of leprosy in well-studied populations occur in persons who have had no known contact with human leprosy. Historical data and current information alike substantiate the concept of nonhuman sources of the disease; recent observations with monoclonal antibody have shown that phenolic glycolipid-I antigen, which is unique to the M. leprae cell wall, is present in soil. In the absence of a technique for in vitro cultivation, indirect methods and the body of observations reviewed here persuasively favor but do not prove the existence of environmental nonhuman sources of M. leprae. PMID- 3299638 TI - Leprosy: cause, transmission, and a new theory of pathogenesis. AB - Leprosy is generally accepted as being caused by Mycobacterium leprae, an acid fast organism often present in great numbers in certain forms of leprosy. However, it has not been possible to confirm with scientifically acceptable evidence that this entity is the cause of leprosy; laboratory cultivation, an essential factor in the proof, has not been accomplished with the acid-fast bodies seen in leprotic tissue. The mechanisms of transmission of the disease also remain conjectural; prolonged, close contact and transmission by nasal droplet have both been proposed, and, while the latter fits the pattern of disease, both remain unproved. It is proposed that the causative agent of leprosy is not a difficult-to-transmit agent but, rather, an organism that has evolved a highly efficient state of parasitism in stable types of populations and that everyone in the population harbors the leprosy parasite at some time. The majority of the population incubate subclinical infections at various levels; clinical leprosy arises from within the pool of subclinical infection in the endemic population rather than by transmission from an index case. A theory of complete infection of endemic populations is consistent with the rate of development and distribution of positive lepromin reactions among healthy persons in endemic regions and provides an explanation for the difficulty in controlling leprosy in endemic populations by isolation of patients or by therapy for clinical cases. PMID- 3299639 TI - Current concepts in the management of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. AB - During the past five years, continuous ambulatory peritoneal dialysis (CAPD) has become recognized as a major form of therapy for end-stage renal disease. Despite continued advances, peritonitis remains a major limiting factor in the widespread application of CAPD. The pathogenesis of CAPD peritonitis is strikingly different from that of surgical peritonitis. Not only are the sources of infection and the microbiologic findings dissimilar, but the severity of infection is markedly different. Moreover, in CAPD peritonitis, both biofilms (extracellular slime substances) associated with microbial growth on the implanted silicone catheter and compromised local defenses (depletion of opsonins and intracellular survival of certain microorganisms) are of pathogenic importance. Once the diagnosis of peritonitis is suspected, therapy should be instituted immediately. However, the optimal antibiotic regimen and the best route, dose, and duration of antibiotic administration remain unknown because of a paucity of randomized, controlled studies. New approaches to the prevention and treatment of CAPD peritonitis are being evaluated; if this infection can be successfully managed, CAPD promises to become increasingly popular for the treatment of chronic renal failure. PMID- 3299640 TI - The prevention of infection in total joint replacement surgery. AB - A fundamental prerequisite for the prevention of sepsis is adherence to well known and accepted listerian principles of asepsis. This article reviews the roles of the high-risk patient, nutritional status, high-risk surgery, environmental factors, airborne contamination, preventive antibiotics, and antibiotic-acrylic composites in surgical sepsis. PMID- 3299641 TI - A unique tribute to Theobald Smith, 1915. AB - From 1895 to 1915 Theobald Smith served as Professor of Comparative Pathology in the Harvard Medical School in Boston and concurrently as Director of the Massachusetts State Antitoxin and Vaccine Laboratory. On the verge of his departure for a new post at the Rockefeller Institute in Princeton, New Jersey, Smith's colleagues sponsored an elaborate dinner in his honor. Marshall Fabyan, who was the moving spirit behind the affair, also designed an eight-inch by ten inch souvenir card on which twenty-six sketches depicted Smith's signal researches. This previously unpublished card is reproduced in the present paper, and a digest of the work represented by each sketch is provided. Collectively these summaries are evidence of the remarkable range of Smith's accomplishments, and they serve as a remainder of why Smith is universally regarded as the premier American microbiologist of his day. PMID- 3299642 TI - Biographical memoir of Theobald Smith, 1859-1934. PMID- 3299643 TI - Microbial synergy. PMID- 3299644 TI - Nocardia asteroides meningitis. PMID- 3299645 TI - Estimating worldwide current antibiotic usage: report of Task Force 1. AB - Estimates of antibiotic availability from a number of countries throughout the world were developed as an indicator of potential patterns of human antibiotic use. Data were organized by major classes of antibiotics and by some individual products and converted to units of weight and defined daily dosages per 1,000 population per day. Estimates were based either on sales or on production and trade data, including global production of penicillins, cephalosporins, tetracyclines, and erythromycins. The data obtained showed that antibiotic availability can vary widely among countries as well as from year to year in the same country. PMID- 3299646 TI - Resistance of bacteria to antibacterial agents: report of Task Force 2. AB - The use of a growing number of antibacterial agents over the past half century has elicited a widespread deployment of genes for resistance to these agents in populations of bacteria throughout the world. Task Force 2 of the NIH Study on Antibiotic Use and Antibiotic Resistance Worldwide found that data on prevalence of resistance was fragmentary and underanalyzed but indicative of several trends. Resistance to older antibacterial agents appears to have stabilized overall, but shifts of resistance genes into new strains and species have continued to cause new clinical problems. Resistance to newer antibacterial agents has increased. Resistance is more prevalent in developing countries. Systematic surveillance of resistance integrated with understanding of its molecular basis is needed for control of resistance. PMID- 3299647 TI - Social, behavioral, and practical factors affecting antibiotic use worldwide: report of Task Force 4. AB - In addressing its charge from the General Chairperson of this study, Task Force 4 decided to direct special attention to antibiotic use in developing nations because of the critical importance of the disease burden of bacterial infections in these regions of the world. The task force recognized the impact of respiratory and diarrheal diseases on morbidity and mortality among young children in developing nations. Another major concern was the potential for global spread of resistant strains. Emergence and spread of antibiotic-resistant bacteria is augmented in settings in which treatment may be inadequate because of socioeconomic constraints and where there is crowding and poor sanitation. Much of the information concerning the factors that govern antibiotic use in these countries is anecdotal. No two countries are identical in their use of antimicrobial agents, and patterns of use may differ greatly in regions within the same country. Efforts to improve the usage of antibiotics in developing countries must take into consideration the perception of health and disease of the populations, the availability of antibiotics, and the characteristics of the established systems of medical care. PMID- 3299648 TI - Information and education as determinants of antibiotic use: report of Task Force 5. AB - The "epidemiology of knowledge" underlying clinical decision making related to antibiotic therapy is one of the most important determinants of how such therapy is used, misused, or not used. A growing literature describes how prescribers and patients acquire the information that influences them in their utilization of these agents. The quality and content of this information ultimately determine whether a given microorganism will ever meet a particular drug. Most evidence indicates that there is considerable room for improvement in such decision making. Research data, including those from randomized controlled trials, have been used to compare the efficacy of several methods of improving the flow of information about proper antibiotic use. While traditional passive forms of education are not powerful means of changing prescribing behavior, innovative approaches, including person-to-person tutorials, can improve the quality of antibiotic prescribing. Benefit-cost analysis documents that these programs can save more than they cost. Additional research on these questions will be a powerful way of maximizing both effectiveness and efficiency in the treatment of infectious diseases. PMID- 3299649 TI - Economic evaluations of antibiotic use and resistance--a perspective: report of Task Force 6. AB - The economic consequences of antibiotic prophylaxis and therapy for bacterial infections in humans are profound. The reduction in real-dollar terms in the amount of illness and disability resulting from the use of developed and marketed antibiotics far outweighs costs of adverse effects, including resistance. Although bacterial infections continue to cause substantial mortality and morbidity worldwide, standard criteria for assessing the relation of infection to death or the contribution of resistance to mortality and morbidity do not exist. While local outbreaks of resistance may have serious consequences, bacterial susceptibility to antimicrobial therapy has remained virtually unchanged nationally where studied. Nevertheless, discriminating use of antimicrobial agents is held widely to be the keystone for minimizing resistance. It is not clear whether risk of selecting resistance is lowered by current community or clinical practices. Some analysts concentrate on the "problem" and "cost" of resistance and forget the benefits of the use of antibiotics. Development of resistance is a natural consequence of antibiotic use, but further quantification of this relation is required. Reports that resistance is increasing worldwide have presented a scientific challenge and economic opportunity to the pharmaceutical industry for the development of new antimicrobial agents. However, if a reasonable rate of return cannot be foreseen, capital for research and development is likely to be invested in areas that appear more financially attractive. PMID- 3299650 TI - [Treatment of advanced cancer of the ovary using intensive chemotherapy with autograft of bone marrow. From a case, discussion and review of the literature]. AB - A case of treatment of an advanced ovarian adenocarcinoma (Stage IIIc of the FIGO) is reported. The patient underwent a maximal tumor reduction followed with polychemotherapy. After this treatment, a "second look" laparotomy shows an incomplete remission. An intensive chemotherapy with abdomini-pelvic radiotherapy and protection of medullary toxicity by a bone marrow autograft is performed, with a satisfactory result, without relapse, 16 months after this treatment (or 25 months after the first laparotomy). A review of the literature concerning the treatment to be undertaken following the "second look" operation, is briefly exposed. Reasons which led the authors to perform an autograft and mostly the conditions under which this treatment may be offered, are then presented. PMID- 3299651 TI - [The emblem of the Institute of Orthopedics and Traumatology]. PMID- 3299652 TI - [Tissue reaction to implant material: experimental study]. PMID- 3299653 TI - [Ultrasound in the early diagnosis of congenital hip dislocation]. PMID- 3299655 TI - Revolutionary two-pour technique for fabricating a diagnostic set-up. PMID- 3299654 TI - [Blood transfusion by computer assisted instruction]. PMID- 3299656 TI - Leon Croizat on Charles Darwin (documents). PMID- 3299657 TI - Monoclonal antibody identification of Leishmania tropica from Sudanese mucosal leishmaniasis. AB - Monoclonal antibodies have been raised against a stock of Leishmania parasites which were isolated from a patient with mucocutaneous leishmaniasis in the Sudan. This stock did not react with monoclonal antibodies to L. donovani, and monoclonal antibodies raised to this stock were not reactive with stocks of L. donovani. They did react with stocks of L. tropica. The antibodies recognized antigens of high and of low molecular weights which were detectable in immunofluorescence on cultured promastigotes and on amastigotes cultured in macrophages. The taxonomy of the species responsible for the different clinical manifestations of infection with Leishmania is not yet clear; there has been for example discussion as to whether the different forms of the disease in the Sudan are caused by one or more species of parasite. Studies with highly specific monoclonal antibodies can help to clarify this picture. PMID- 3299658 TI - A new method for fixation and preservation of trypanosomal antigens for use in the indirect immunofluorescence antibody test for diagnosis of bovine trypanosomiasis. AB - A new method for fixation of trypanosomes for use in the indirect immunofluorescent antibody test (IFAT) is described. The method involves fixation of live trypanosomes, in suspension, using a mixture of 80% cold acetone and 0.25% formalin in saline. The fixed trypanosomes were stored in suspension at -60 degrees C, 4 degrees C or at room temperature for at least one year without loss of antigenicity. Using trypanosomes prepared this way as antigens in IFAT, species-specific antibodies were detected within 2 weeks of infection in sera of cattle infected with T. brucei or T. vivax. Thereafter, antibodies recognizing antigens common to the two species as well as T. congolense were detected. The antibody levels to common antigens of the three species declined 2-3 months post infection, leaving only the species-specific antibodies. The sera obtained from T. congolense infected animals, did not react with T. vivax or T. brucei antigens. The non-specific fluorescence commonly associated with this assay was eliminated by prior absorption of the test sera with normal bovine lymphocyte lysate. This treatment of serum did not affect the specific antibodies to trypanosomal antigens. Analysis of bovine sera prepared from cattle in Kisiwani and Muhaka, along the Kenya coast, using the fixed trypanosomes revealed that some animals had antibodies to one trypanosome species only while others had antibodies to 2 or all 3 trypanosome species. PMID- 3299659 TI - Mode of action of intercalating drug, cis-Pt(II)(DDH)Cl2, cis-Pt(II)(DDH) (metafluorobenzoic)2, and cis-Pt(II)(DDH)(mucubromic)2, on Trypanosoma cruzi. AB - The trypanocidal activity of three new compounds derived of the antineoplastic drug cis-diamminodichloroplatinum(II) (DDP) has been studied over epimastigote forms of Trypanosoma cruzi. The electron microscopy indicated that, in the treated animals, the nuclear chromatin is distributed in the nucleus in a lax form and that the number of lipidic vacuoles increases largely. This action is more significant when cis-Pt(II)1,2-diaminocyclohexane is used. In addition this compound causes a destabilization of the DNA double helix with a decrease of melting temperature. The three compounds inhibit the incorporation of leucine, uridine and thymidine, although the thymidine uptake is the most significantly affected. PMID- 3299660 TI - Seven patients with relapses of Plasmodium vivax or P. ovale despite primaquine treatment. AB - Seven relapses of Plasmodium vivax or Plasmodium ovale despite standard treatment with primaquine (3.0 mg Kg-1) daily for fourteen days are presented. The majority of patients came from areas outside the countries where resistance to primaquine is well known. The various possibilities of reasons for relapses are discussed. PMID- 3299661 TI - Localization of H blood group antigen in ectoblastic derivatives of murine teratocarcinoma. AB - Ectoblastic derivatives (ectodermal and neuroectodermal components) constitute more than 90% of all structures in the murine teratocarcinoma derived from the PCC4-aza-1 line. This tumor was labeled immunocytochemically with fluoresceinated antibodies to A, B and H blood groups. A and B antigens were always noted to be absent from all structures of the three germ layers. With anti-H, however, embryonic and fetal endodermal components, e.g. alimentary or respiratory duct like structures, gave positive staining. Mesodermal components, i.e. bone and cartilage structures, fibroblasts and myocytes of mature or embryonal type, were negative. Immature and mature ectodermal components, viz. epidermoid cysts or islets, were always positive. Neuroectodermal components, neuroblastic cysts and differentiated neuronal, glial and ependymal elements were always negative. Ectoblastic and/or neuroectoblastic individual cells or cell clusters, observed in the vicinity of positive differentiating ectodermal and neuroectodermal structures, were positive. Similar cells or clusters were negative when located close to negative neuroectodermal components. The undifferentiated, embryonal carcinoma cells and structures were always negative. These observations are compared to the staining patterns of H antigen in murine embryos and adult mice and in human teratocarcinomas. It is suggested that poorly differentiated, morphologically similar ectoblastic and/or neuroectoblastic structures are positive, if they concern ectodermal components, and negative, if they belong to neuroectodermal components, with the exception of some primary sensory cells that are positive. These last cells are also positive in normal fetal and adult tissues. PMID- 3299662 TI - When the patient is also a diabetic. PMID- 3299663 TI - Certification: is the payoff worth the price? PMID- 3299664 TI - Toward the year 2000. PMID- 3299665 TI - Helen Randal: a woman for all times. PMID- 3299666 TI - [Ultrasonic detection of gallstone ileus]. AB - A woman of 60 years of age with acute abdominal pain, vomiting, constipation and radiological signs of small bowel obstruction was subjected to sonographic examination. Careful examination of the entire abdomen demonstrated a hyperechoic object within the distended terminal ileum with an intensive acoustic shadow. The gallbladder was not visible. This strongly suggested gallstone ileus, especially since the patient had a history of gallbladder disease. She was treated immediately by enterotomy and extraction of a noncalcified obstructing stone. The value of ultrasound in detecting gallstones causing small bowel obstruction is discussed. PMID- 3299667 TI - Sonographic measurement of renal transplant area compared with scintigraphy. AB - A change in transplant size, which can easily be measured by ultrasound, is one indicator of acute or chronic rejection. We report here on 49 areal measurements of transplant size from a coronal section and compare the results with isotopically measured areas. The areas measured in the isotope examinations correlated well with those measured sonographically (r = 0.82) in the case of the 33 transplants with a normal perfusion index but poorly (r = 0.45) in those with an abnormal perfusion index. The sonographically measured transplant area was about 85 cm2 in cases of acute rejection, 54 cm2 in cases of chronic rejection and 62 cm2 in cases with normal or slightly impaired transplant function (creatinine level below 200 mumol). Sonography is more suitable than isotope examination for monitoring transplant size in cases with poor perfusion. PMID- 3299668 TI - [Imaging of iatrogenic aneurysms and AV fistulas of the lower extremity with IV DSA and sonography]. AB - Using IV-DSA and ultrasound (real-time), we demonstrated 13 false aneurysms, 2 isolated AV fistulas, 7 aneurysms of profunda patches and 8 aneurysms of bypass grafts. Aneurysms and AV fistulas developed in all 30 patients after different diagnostic and therapeutic procedures. Ultrasound showed partial thromboses of the aneurysms, perivascular changes and compression of the femoral vein, that could not be demonstrated by IV-DSA. On the other hand IV-DSA allowed the recognition of important findings not shown sonographically, such as AV fistulas and stenoses of the proximal and distal arteries. These findings were relevant for further surgical approach. It is therefore concluded that in patients with suspected aneurysm of the femoral or popliteal artery, IV-DSA and ultrasound should be used in conjunction rather than as alternative methods. PMID- 3299669 TI - [Results and experiences with digital subtraction angiography (DSA) in traumatic vascular lesions of the thoracic aorta and the supra-aortic branches]. AB - Numerous positive reports on the results obtained with digital subtraction angiography (DSA) in x-ray diagnostics in the visualisation of peripheral vascular areas, have been published ever since that method was introduced. From a surgical point of view it has therefore been suggested to extend the indication for vascular visualisation on account of the low invasiveness of venous DSA (vDSA). Only few reports have been published on the suitability of vDSA in traumatic vascular lesions. Whereas Starck and Rauber recommend vDS as a feasible method for the visualisation of traumatic vascular lesions, Galanski and Fiedler continue to postulate the need for arterial DSA (aDSA) in the clarification of degenerative diseases of the supraaortal branches. Conventional angiography has lost some of its importance in traumatic vascular lesions, as Traupe has stated. Our first experiences with vDSA in traumatic vascular lesions have been partly unsatisfactory. This, and the resulting consequences, are described in the present article. PMID- 3299670 TI - [Foreign body injuries in nuclear magnetic resonance tomography]. AB - The hazard involved in MR tomography if there are foreign parts in the body made of metal, is assessed. There are certain hazard-influencing factors. As far as the foreign body is concerned, these are: ability to become magnetized, size, length, elasticity, sharp edges or ends, and sharp surfaces. In the human body itself, risk factors are determined by the position of the foreign body in or near sensitive organs such as cerebrum, nerves, vessels, lungs, eyes, ears and the heart; other factors are the fixation to bones or lack of fixation in hollow organs. One should assume when assessing the risk that the foreign body consists of iron that is capable of complete magnetisation. In that case the attacking forces will not exceed the 25 to 36 fold value of the foreign body's own weight. It is thus possible to predict with some measure of probability whether the position of the foreign body will shift during MR examination and whether the examination can result in injury. PMID- 3299671 TI - [New laboratory technics for assisting in the diagnosis and treatment of bacterial and viral diseases]. PMID- 3299672 TI - [Occupational risk of cancers incurred by physicians and research workers]. PMID- 3299673 TI - [Therapeutic use of vitamin D metabolites. II. Principal indications]. PMID- 3299674 TI - Lysosomal enzyme pattern in lung lymph and blood during E. coli sepsis in sheep. AB - Systemic release of lysosomal enzymes and local release in the pulmonary microcirculation from sequestrated and activated leucocytes could be an important factor in the development of the lung microvascular injury seen after septicaemia. The maximal activities of 11 lysosomal acid hydrolases (acid phosphatase, alpha- and beta-glucosidase, alpha- and beta-galactosidase, alpha mannosidase, beta-acetylglucosaminidase, beta-glucuronidase, arylamidase and cathepsins B and C) were measured in serum and lung lymph from seven sheep before and after infusion of live E. coli bacteria. In the early phase of septicaemia (the first hour) the activities of eight enzymes were increased in serum and/or lung lymph (1.1 to 2X pre-infusion values). In the late phase, 3-4 h after sepsis, there were significantly elevated serum activities of beta-glucosidase (5.4X), alpha- and beta-galactosidases (2.7X, 1.5X), beta-acetylglucosaminidase (2.0X) arylamidase (1.2X) and cathespin B (1.7X). In lymph acid phosphatase (1.7X), alpha- and beta-glucosidases (1.6X, 6.4X), alpha- and beta-galactosidases (2.1X, 1.7X). Beta-acetylglucosaminidase (2.6X), and beta-glucuronidase (4.0X pre infusion) were elevated. The findings of a heterogenicity of changes in serum and lymph activities, as well as the large molecular sizes of some of the enzymes with changed activities indicated to us that permeability changes were not major causes of increased lymph enzyme activities. The results could indicate a local release of enzymes either from sequestrated leucocytes or lung tissue due to local reactions in the lung or lung microvessels. The heterogenous changes in activities for the various lysosomal enzymes as found in the present study indicated that measurement of only one enzyme could be misleading.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299675 TI - Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. AB - A review of histologic classification systems for grading of malignancy in squamous cell carcinomas of the head and neck region is presented. Reasons behind the varying results obtained in studies using histomorphologic grading schemes are presented and potential errors involved in this type of clinical research are discussed. Requirements for the study of correlations between malignancy grade scoring, and recurrence and survival rates are presented. These include factors as patient selection, clinical staging, and follow-up principles. Special attention must be given to treatment modalities, establishment of negative surgical margins and occurrence of regional lymph node and/or distant metastases. PMID- 3299676 TI - Crohn's disease and ulcerative colitis. A review of dietary studies with emphasis on methodologic aspects. PMID- 3299677 TI - Maintenance treatment with cimetidine in peptic ulcer disease for up to 4 years. AB - A multinational maintenance trial was conducted in 1842 peptic ulcer patients to investigate the efficacy and safety of continuous cimetidine maintenance therapy for up to 4 years. Patients with healed ulcers entered maintenance treatment with a 400-mg bedtime dose of cimetidine. Symptomatic ulcer relapse occurred in 17.2% of patients during the 1st year of treatment, in 9.6% during the 2nd year, and in 8.8% during the 3rd year. In addition to life-table analysis, the monthly prevalence of active ulceration over the 3-year period was examined. The average monthly prevalence rates were 2.1%, 1.8%, and 1.5% for the three successive yearly periods of continued cimetidine treatment. The adverse reactions observed in this study were not different from those previously reported with cimetidine. Moreover, there was a progressive decrease in the incidence of adverse events over the 4 years, thus establishing the long-term safety of continuous cimetidine treatment. It is concluded from this study that cimetidine maintenance treatment not only continues to be effective and safe beyond 1 year but also may reduce the risk of relapse over time. PMID- 3299678 TI - Effect of combined blockade of beta-adrenoceptors and acetylcholinesterase in the treatment of postoperative ileus after cholecystectomy. AB - The effect of treatment with a non-selective beta-adrenoceptor blocker (propranolol) and an acetylcholinesterase blocker (neostigmine) on the duration of postoperative ileus after cholecystectomy was investigated in a double-blind, randomized study comprising 51 patients. Propranolol (P), 10 mg intravenously twice daily was, together with neostigmine (N), 0.5 mg subcutaneously twice daily, administered to 16 patients. Eighteen patients were treated with neostigmine, 0.5 mg subcutaneously twice daily only, and 17 patients were placebo treated controls (C). The medical treatment started in the evening of the day of operation. The time to first passage of stool after operation was determined and used as a measure of duration of the postoperative ileus. The mean time was 68 +/ 6 h in the P + N-treated group, 82 +/- 6 h in the N group, and 90 +/- 7 h in the C group. The difference between the P + N group and controls was significant (p less than 0.01). P + N was effective in patients older than 60 years (p less than 0.01), whereas no effect was seen in patients younger than 60 years. In conclusion, treatment with a combination of propranolol and neostigmine shortened the duration of postoperative paralytic ileus after cholecystectomy. This effect was not seen after treatment with neostigmine only. The effect of P + N was most marked in patients older than 60 years. PMID- 3299679 TI - Chronic portal venous hypertension. The effect on liver blood flow and liver function and the development of esophageal varices. AB - Portal venous hypertension was induced in Gottingen minipigs by banding the portal vein. The pigs were checked repeatedly during the following 24 weeks. Portal pressure increased immediately on banding, from 8.4 +/- 0.7 mm Hg to 19.4 +/- 0.7 mm Hg, and remained constant throughout the observation period. Within 5 weeks all pigs developed esophageal varices, as demonstrated by portal angiography and endoscopy. The experimentally induced portal hypertension was accompanied by a 65% decrease in hepatic blood flow, most probably caused by almost complete shunting of portal venous blood. The hepatic arterial flow appeared to be within normal limits and sufficient to cover the oxygen demand of the liver; to judge from the splanchnic elimination rate of galactose, the hemodynamic changes did not affect the functional capacity of the liver. PMID- 3299680 TI - Immunological properties of antigen 60 of BCG. Induction of humoral and cellular immune reactions. AB - Antigen 60 (A60), a member of the thermostable macromolecular antigen family (TMA) and main component of old tuberculin and purified protein derivative (PPD), has been purified from the cytoplasm of Mycobacterium bovis BCG; its structure and metabolism have already been described. In the present paper, the action of A60 on humoral immunity has been analysed by an ELISA type immunoassay, and that on cellular immunity by the mouse footpad swelling test. Injection of very low A60 doses into unprimed mice produced an undetectable level of anti-A60 antibodies; the effect of a booster inoculation was not appreciable in the absence of incomplete Freund's adjuvant, but was evident when the latter was added. Higher doses of the antigen produced an appreciable primary response, and a sharp and long-lasting secondary response, which had a 10-fold higher intensity in the presence of incomplete adjuvant. No detectable delayed hypersensitivity reactions were observed in unprimed mice after footpad injection of A60, whereas clear responses were elicited in primed mice. This effect was more pronounced when the footpad was injected after a secondary response than after a primary response, and it was invariably magnified by incomplete adjuvant. It is concluded that A60 is a powerful immunogen, which is able to induce primary and secondary responses and delayed hypersensitivity reactions, effects that are adjuvant modulated and develop concurrently. PMID- 3299681 TI - Quality of life in patients receiving auranofin therapy: confirmation of efficacy using nontraditional health status measures. AB - Traditionally, assessment of therapeutic efficacy in patients with rheumatoid arthritis (RA) has been based on objective measurement of disease parameters, such as the number of tender and swollen joints, 10-cm analogue pain scale, or grip strength. More recently, however, it has been realized that these parameters may not provide a true reflection of the impact of disease or therapy on the patient's overall emotional state and ability to function--the "quality of life." Nontraditional measurements of health status have been used by several researchers in order to provide comprehensive data about the benefits of drug therapy. Most recently the Auranofin Cooperating Group conducted a prospective, 6 month, randomized, double-blind, multicenter study that compared auranofin (AF) oral gold with placebo in the treatment of RA. The study was unique in that it assessed the efficacy of AF using a battery of nontraditional health status measures ("quality-of-life" measures) in addition to the traditional parameters used to chart rheumatic disease activity. Composite scores were calculated for 4 distinct dimensions of RA: physical, functional, pain, and global. Pairwise correlations between composite scores ranged from 0.45 to 0.67, indicating that the scores represented different dimensions of the impact of RA. Results indicated that AF effectively improves several dimensions of RA. In addition, it was apparent that several health status measures are sensitive to changes in clinical status. These measures may be useful in future clinical trials of RA, perhaps indicating when DMARD therapy should be initiated. They should also prove useful in drug trials for other diseases. PMID- 3299682 TI - Efficacy of auranofin as demonstrated by improvement in clinical parameters and decrease in anti-inflammatory usage: a long-term, multicenter study. AB - An open, noncomparative study at 8 rheumatology centers in Brazil assessed the efficacy and safety of auranofin (AF) when given for up to 24 months. The study enrolled 80 patients with classic or definite rheumatoid arthritis (RA); disease was severe in 20 (25%), moderate in 55 (69%), and mild in 5 (6%). Patients received auranofin, 3 mg twice daily, and varying doses of anti-inflammatory drugs (aspirin, nonsteroidal anti-inflammatory drugs, and corticosteroids). Sixty patients (75%) completed the full 24 months of therapy. No patients were withdrawn from therapy because of insufficient therapeutic effect. There was statistically significant improvement (p less than 0.001) in 9 clinical parameters of disease activity, evident as early as 3 months after beginning AF therapy, increasing steadily over 12 months, and remaining at improved levels for another 12 months. Improvements in some parameters were particularly striking. By 24 months, assessment of well-being had increased by 150%, intensity of pain had decreased by 66%, and duration of morning stiffness had decreased by 78%. The average daily dose of anti-inflammatory drugs also decreased over time. The safety profile of AF was similar to that found in comparable trials. Ten patients (12.5%) were withdrawn because of adverse events: 6 for diarrhea (7.5%), 2 for proteinuria (2.5%), and 1 each for pruritus and anemia (1.25%). Adverse events occurred in 24 of 80 patients; some reported more than one adverse event. The most common adverse events were loose stools (20 patients) or diarrhea (11 patients).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299683 TI - Postmarketing experience with auranofin in the Federal Republic of Germany. AB - Data about adverse events can be particularly useful when assessing newly marketed drugs. However, spontaneous reporting of adverse events does not generally provide sufficient or highly accurate data on incidence and prevalence. In order to provide the most complete and accurate data, a postmarketing surveillance program (PMSP) for auranofin (AF) oral gold therapy for rheumatoid arthritis (RA) was conducted in the Federal Republic of Germany (FRG) from December 1982 through December 1985. The objectives of the program were to observe a large population treated with AF for more than a year; to compare the safety profile of AF with experience from clinical trials; and to register rare or previously unknown adverse events. The program included 2,777 patients with RA from 928 test centers. Disease duration was less than 2 years in 29%. 2-5 in 23.2%, 5-10 in 32.5%, and more than 10 in 13.3% (no data for 2%); disease was mild or moderate in 67.4% and severe in 29.9% (no data for 2.7%). Auranofin was given 6 mg/day as either two 3-mg tablets at breakfast or 1 tablet at breakfast and 1 at the evening meal. Laboratory studies and efficacy, as indicated by increase in grip strength and decrease in number of tender and swollen joints, were monitored regularly. A total of 1,595 patients completed 1 year of treatment with AF. Withdrawals included 12.9% for adverse events, 4.2% for insufficient therapeutic effect, and 33.1% for a variety of administrative or technical reasons. The most common adverse event was alteration in stool pattern, which occurred in 22.5% of patients, compared with 46.6% in worldwide AF clinical trials. Other gastrointestinal symptoms occurred in 17.4%, compared with 22.4% worldwide. The occurrence of most adverse events in the PMSP was much less than in worldwide studies, for example: skin rash 7.3% vs. 24.2% worldwide, pruritus 4.2% vs. 16.6%, proteinuria 1.0% vs. 5.0%, and leukopenia 0.7% vs. 1.9%. These discrepancies may be explained by the method of monitoring employed in the postmarketing study, which favored the reporting of only clinically relevant adverse events. The pattern of occurrence of adverse events was similar to that seen during other AF trials, indicating that any intolerance to AF occurs primarily within the first 6 months of treatment. However, hematologic or nephrologic adverse events appear to be independent of time on therapy, with a constant monthly prevalence of about 0.1-0.2%.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3299684 TI - Comparison of synovectomy and no synovectomy in patients with juvenile rheumatoid arthritis. A 24-month controlled study. AB - Thirty patients with pauciarticular or polyarticular juvenile rheumatoid arthritis entered a randomized, 24-month, parallel trial of synovectomy (n = 15) versus no synovectomy (n = 15). The joints studied were 18 wrists, 8 ankles and 4 knees. The synovectomies were performed as radically as possible. Joint motion was slightly decreased in the operated joints, especially for passive movements during the first 6 months following surgery. Swelling and disease activity of the joints studied as well as subjective evaluation of joint pain improved in the synovectomy group compared with the non-synovectomy group. This improvement seemed to continue for at least 2 years. PMID- 3299685 TI - Pharmacokinetics of organic solvent vapors in relation to their toxicity. AB - The volatility and lipophilicity by which organic solvents are distinct from other chemicals constitute a characteristic pharmacokinetic feature. They enter a living body by inhalation, preferentially distribute in the adipose tissue, and are eliminated by both expiration and metabolic degradation. This review article is centered on experimental studies conducted by the authors and their co workers, and it deals with pharmacokinetic principles, partition coefficients in relation to toxicity, significance of metabolism in the development of organic solvent toxicity, and environmental factors that alter the metabolism and toxicity of solvents. PMID- 3299686 TI - [Computed tomography evaluation of kidney diseases]. AB - The primary role of renal computed tomography (CT) is to determine the extent of a complicated cystic or solid mass lesion. CT is indicated if the nature of a mass detected on urography cannot be determined by sonography and if sonography fails to define the perirenal or pararenal extension of a lesion. When urographic findings suggest a pathologic entity other than a simple cyst (calcifications or fat in a mass lesion, destruction of the collecting system), CT may be performed subsequent to urography. PMID- 3299687 TI - [Advances in the central mechanisms of vision]. PMID- 3299688 TI - [The nutritional function of taurine]. PMID- 3299689 TI - [Cardiolipin and the mitochondrial inner membrane]. PMID- 3299690 TI - [Eukaryotic active genes]. PMID- 3299691 TI - [Peptides and the blood-brain barrier]. PMID- 3299692 TI - [Role of vasopressin in the regulation of blood pressure]. PMID- 3299693 TI - [Endogenous clonidine-like substances]. PMID- 3299694 TI - [Sialic acids and the cellular function of the hematopoietic system]. PMID- 3299695 TI - The protein subunits of the double-stranded RNA dependent RNA polymerase and methyltransferase of the cytoplasmic polyhedrosis virus of silkworm, Bombyx mori. AB - The particles of CPV of silkworm contain double-stranded RNA polymerase and methyltransferase. It was reported in a previous paper that the genome-enzyme complex could be isolated. The genome-enzyme complex shows high enzyme activity of RNA polymerase and methyltransferase in spite of the fact that it consists of only 5 percent of the protein. In order to clarify the protein subunits of the RNA polymerase and methyltransferase, two methods were adopted. The SDS polyacrylamide gel electrophoretogram showed that the 125I-labeled genome-enzyme complex of CPV contained three protein components in molecular weight of 33 K, 67 K and 142 K daltons respectively and each protein component of them consisted of more than two protein subunits with different isoelectric points in 2-dimensional electrophoretogram. The antibody to the five protein components (P1, P2, P3, P4, P5) was prepared and used to inhibit the enzyme activities of RNA polymerase and methyltransferase. It showed that the RNA polymerase was inhibited by the antibody to proteins P1, P2 and P4, whereas the methyltransferase was mainly inhibited by the antibody to protein P1. PMID- 3299696 TI - The hyperglycaemic, hyperosmolar non-ketotic syndrome: some aspects of management. AB - Hyperosmolar non-ketotic coma is a relatively uncommon but important medical emergency. It is associated with a high mortality, which has changed little over the past twenty years. Approximately half of all patients give no prior history of diabetes and since patients often present with neurological abnormalities, resembling a cerebrovascular accident, the diagnosis can sometimes be delayed or missed. Therefore every patient presenting to hospital with a state of clouded consciousness or objective signs of neurological abnormality, should have a blood glucose estimation performed at an early stage. It has been suggested that a regimen of less aggressive early fluid replacement, with more attention being directed to the associated or underlying problems, may be beneficial to the patient. Claims that the continuing high mortality in non-ketotic coma can be improved by such measures await confirmation. PMID- 3299697 TI - The neurological assault on the great toe (1893-1911). AB - The late 19th/early 20th century heralded a period in neurology when there was claim and counter claim about the founders of new reflex movements of the great toe. The cutaneous plantar reflex is undoubtedly one of the most important signs in clinical neurology, and there have been several methods described of eliciting this sign, each with its own eponymous name. This article reviews the background to these claims and the contribution of the various authors, to the discovery, clinical relevance and ease of eliciting reflex movements of the great toe. PMID- 3299698 TI - Mark Jameson's physic plants, a sixteenth century garden for gynaecology in Glasgow? AB - Deputy Rector of the University of Glasgow and a vicar choral of Glasgow Cathedral, the physician Mark Jameson made many annotations in his copy of the 1549 edition of Fuchs' herbal. On the back flyleaf are the names of 26 plants, 22 of which were "To be sett & sawin in ye garding". Many of the 26 plants have gynaecological properties; some are even abortifacient, especially the highly dangerous savin, Juniperus sabina. PMID- 3299699 TI - Cytokines alter AIDS virus production. PMID- 3299700 TI - Genetic analysis of the human malaria parasite Plasmodium falciparum. AB - Malaria parasites are haploid for most of their life cycle, with zygote formation and meiosis occurring during the mosquito phase of development. The parasites can be analyzed genetically by transmitting mixtures of cloned parasites through mosquitoes to permit cross-fertilization of gametes to occur. A cross was made between two clones of Plasmodium falciparum differing in enzymes, drug sensitivity, antigens, and chromosome patterns. Parasites showing recombination between the parent clone markers were detected at a high frequency. Novel forms of certain chromosomes, detected by pulsed-field gradient gel electrophoresis, were produced readily, showing that extensive rearrangements occur in the parasite genome after cross-fertilization. Since patients are frequently infected with mixtures of genetically distinct parasites, mosquito transmission is likely to provide the principal mechanisms for generating parasites with novel genotypes. PMID- 3299701 TI - Localization of amyloid beta protein messenger RNA in brains from patients with Alzheimer's disease. AB - The distribution of cells containing messenger RNA that encodes amyloid beta protein was determined in hippocampi and in various cortical regions from cynomolgus monkeys, normal humans, and patients with Alzheimer's disease by in situ hybridization. Both 35S-labeled RNA antisense and sense probes to amyloid beta protein messenger RNA were used to ensure specific hybridization. Messenger RNA for amyloid beta protein was expressed in a subset of neurons in the prefrontal cortex from monkeys, normal humans, and patients with Alzheimer's disease. This messenger RNA was also present in the neurons of all the hippocampal fields from monkeys, normal humans and, although to a lesser extent in cornu ammonis 1, patients with Alzheimer's disease. The distribution of amyloid beta protein messenger RNA was similar to that of the neurofibrillary tangles of Alzheimer's disease in some regions, but the messenger RNA was also expressed in other neurons that are not usually involved in the pathology of Alzheimer's disease. PMID- 3299702 TI - Human aging: usual and successful. AB - Research in aging has emphasized average age-related losses and neglected the substantial heterogeneity of older persons. The effects of the aging process itself have been exaggerated, and the modifying effects of diet, exercise, personal habits, and psychosocial factors underestimated. Within the category of normal aging, a distinction can be made between usual aging, in which extrinsic factors heighten the effects of aging alone, and successful aging, in which extrinsic factors play a neutral or positive role. Research on the risks associated with usual aging and strategies to modify them should help elucidate how a transition from usual to successful aging can be facilitated. PMID- 3299703 TI - Localization, secretion, and action of inhibin in human placenta. AB - Inhibin is a gonadal glycoprotein hormone that regulates the production of follicle-stimulating hormone (FSH) by the anterior pituitary gland and exhibits intragonadal actions as well. The present study shows that inhibin-like immunoreactivity (inhibin-LI) is present in cells of the cytotrophoblast layer of human placenta at term and in primary cultures of human trophoblasts. Human chorionic gonadotropin (hCG) stimulated secretion of inhibin-LI from these cultured placental cells. This effect was mimicked by 8-bromo-cyclic adenosine monophosphate (8-bromo-cAMP), forskolin, and cholera toxin, suggesting that the mechanism of hCG induction of placental inhibin-LI secretion is cAMP-dependent. Incubation with an antiserum that binds the alpha-subunit of human inhibin increased the secretion of hCG and gonadotropin-releasing hormone-like immunoreactivity (GnRH-LI) from trophoblast cells in culture, suggesting a local tonic inhibitory action of endogenous inhibin on hCG and GnRH-LI release. The action of inhibin on hCG secretion may partially require the presence of placental GnRH, as suggested by evidence that a synthetic GnRH antagonist partially reverses the hCG increase induced by inhibin immunoneutralization. Results suggest paracrine roles for both inhibin and GnRH in the regulation of placental hCG production. PMID- 3299704 TI - Engineering enzyme specificity by "substrate-assisted catalysis". AB - A novel approach to engineering enzyme specificity is presented in which a catalytic group from an enzyme is first removed by site-directed mutagenesis causing inactivation. Activity is then partially restored by substrates containing the missing catalytic functional group. Replacement of the catalytic His with Ala in the Bacillus amyloliquefaciens subtilisin gene (the mutant is designated His64Ala) by site-directed mutagenesis reduces the catalytic efficiency (kcat/Km) by a factor of a million when assayed with N-succinyl-L-Phe L-Ala-L-Ala-L-Phe-p-nitroanilide (sFAAF-pNA). Model building studies showed that a His side chain at the P2 position of a substrate bound at the active site of subtilisin could be virtually superimposed on the catalytic His side chain of this serine protease. Accordingly, the His64Ala mutant hydrolyzes a His P2 substrate (sFAHF-pNA) up to 400 times faster than a homologous Ala P2 or Gln P2 substrate (sFAAF-pNA or sFAQF-pNA) at pH 8.0. In contrast, the wild-type enzyme hydrolyzes these three substrates with similar catalytic efficiencies. Additional data from substrate-dependent pH profiles and hydrolysis of large polypeptides indicate that the His64Ala mutant enzyme can recover partially the function of the lost catalytic histidine from a His P2 side chain on the substrate. Such "substrate-assisted catalysis" provides a new basis for engineering enzymes with very narrow and potentially useful substrate specificities. These studies also suggest a possible functional intermediate in the evolution of the catalytic triad of serine proteases. PMID- 3299705 TI - Adipsin: a circulating serine protease homolog secreted by adipose tissue and sciatic nerve. AB - Adipsin is a serine protease homolog whose primary structure was predicted from the nucleotide sequence of a differentiation-dependent adipocyte messenger RNA. Immunoblots probed with antisera to synthetic peptides identify two forms of adipsin that are synthesized and secreted by 3T3 adipocytes. These proteins of 44 and 37 kilodaltons are converted to 25.5 kilodaltons by enzymatic deglycosylation. Although adipsin is principally synthesized in adipose tissue, it is also produced by sciatic nerve and is found in the bloodstream. Because of the apparent restriction of adipsin synthesis to tissues highly active in lipid metabolism, its presence in serum, and its modulation in altered metabolic states, this molecule may play a previously unrecognized role in systemic lipid metabolism or energy balance. PMID- 3299706 TI - Severely impaired adipsin expression in genetic and acquired obesity. AB - Adipsin, a serine protease homolog, is synthesized and secreted by adipose cells and is found in the bloodstream. The expression of adipsin messenger RNA (mRNA) and protein was analyzed in rodents during metabolic perturbations and in several experimental models of obesity. Adipsin mRNA abundance is increased in adipose tissue during fasting in normal rats and in diabetes due to streptozotocin induced insulin deficiency. Adipsin mRNA abundance decreased during the continuous infusion of glucose, which induces a hyperglycemic, hyperinsulinemic state that is accompanied by an increased adipose mass; it is suppressed (greater than 100-fold) in two strains of genetically obese mice (db/db and ob/ob), compared to their congenic counterparts, and is also reduced when obesity is induced chemically by injection of monosodium glutamate into newborn mice. Circulating adipsin protein is decreased in these animal models of obesity, as determined by immunoblotting with antisera to adipsin. Little change in adipsin expression is observed in a model of obesity obtained by pure overfeeding of normal rats (cafeteria model). These data suggest a possible role for adipsin in the above-mentioned disordered metabolic states, and raise the possibility that adipsin expression may be used to distinguish obesities that arise from certain genetic or metabolic defects from those that result from pure overfeeding. PMID- 3299707 TI - Stanford psychiatrist resigns under a cloud. PMID- 3299708 TI - erg, a human ets-related gene on chromosome 21: alternative splicing, polyadenylation, and translation. AB - The avian acute leukemia virus E26 induces a mixed erythroid-myeloid leukemia in chickens and carries two distinct oncogenes, v-myb and v-ets. Recently, a novel gene named erg, closely related to the v-ets oncogene, was identified in human COLO 320 cells and the nucleotide sequence of its approximately 5.0-kilobase transcript, erg 1 was determined. In the present study, the nucleotide sequence of the alternatively spliced transcript, erg 2, was found to differ from erg 1 by a splicing event that causes a coding frameshift near the amino terminus, resulting in an additional 99-amino acid insertion at the amino-terminus. Expression of complementary DNAs for the two transcripts in vitro resulted in synthesis of polypeptides of approximately 41 and 52 kilodaltons, suggesting the use of alternative translation initiation codons in the case of erg proteins. The erg gene was localized by somatic cell genetic analysis to human chromosome 21. It is proposed that alternative sites of splicing and polyadenylation, together with alternative sites of translation initiation, allow the synthesis of two related polypeptides from a single erg gene transcriptional unit. PMID- 3299709 TI - Naturally acquired antibodies to sporozoites do not prevent malaria: vaccine development implications. AB - The first human vaccines against the malaria parasite have been designed to elicit antibodies to the circumsporozoite protein of Plasmodium falciparum. However, it is not known whether any level of naturally acquired antibodies to the circumsporozoite protein can predict resistance to Plasmodium falciparum malaria. In this study, 83 adults in a malaria-endemic region of Kenya were tested for circumsporozoite antibodies and then treated for malaria. They were monitored for the development of new malaria infections for 98 days. Antibody levels, as determined by four assays in vitro, were indistinguishable between the 60 individuals who did and the 23 who did not develop parasitemia during follow up, and there was no apparent relation between day of onset of parasitemia and level of antibodies to circumsporozoite protein. Unless immunization with sporozoite vaccines induces antibodies that are quantitatively or qualitatively superior to the circumsporozoite antibodies in these adults, it is unlikely that such antibodies will prevent infection in areas with as intense malaria transmission as western Kenya. PMID- 3299710 TI - Rheumatic disease syndromes associated with antibodies to the Ro (SS-A) ribonuclear protein. PMID- 3299711 TI - DNA antibody idiotypes: a review of their genetic, clinical, and immunopathologic features. AB - The initial studies of anti-DNA antibody idiotypes we performed, along with those of our colleagues and other groups, focused on the narrow question of their relevance to lupus autoantibodies. The subsequent studies in this report have forced us to examine a much broader range of issues. It is evident that despite the great advances in understanding the structure and function of antibodies, lymphocytes, and receptors, our knowledge of many fundamental elements in autoimmune disease is woefully incomplete. We are still unsure whether the germ line gene sequences controlling antibody production have evolved solely in response to exposure to new foreign antigens. Alternatively, these antibodies (and the idiotypes they bear) may have developed largely in response to changes in the internal environment. Superficially, it can be argued that "self reactivity" associated with the clinical expression of a disease results from a combination of immunologic, genetic, hormonal, and environmental elements. For example, the expression of the 16/6 Id in an appropriate setting may have pathogenetic consequences for some individuals. However, our knowledge of the precise sequence of events that result in devastating disease for some but minimal disease for others is just one of the remaining mysteries. PMID- 3299712 TI - Are rehabilitation programs for rheumatoid arthritis patients effective? PMID- 3299713 TI - Antiinflammatory drugs and gastric mucosal damage. PMID- 3299714 TI - Effect of chrysotherapy on the lower gastrointestinal tract: a review. PMID- 3299715 TI - Myopathy in sarcoidosis: clinical and pathologic study of four cases and review of the literature. AB - The clinical course and muscle biopsy findings of four adults with sarcoidosis who developed a myopathy are described. Three patients had evidence of an inflammatory myopathy and elevated CPK. Two patients had no detectable granulomas at muscle biopsy and may represent a separate autoimmune disorder (polymyositis) concurrent with sarcoidosis. Asymptomatic muscle disease in sarcoidosis probably occurs with a much greater frequency than symptomatic disease. Isolated sarcoid myopathy without prior or concurrent organ involvement has been described, but comprehensive autopsy studies to confirm this are lacking. The origin of symptoms associated with granulomas is obscure and may be mediated through the effects of lymphokines and monokines. Corticosteroids seem to play a useful role in therapy, but treatment over a prolonged period may be necessary. The use of cytotoxic agents is largely untested. PMID- 3299716 TI - [Value, technic and clinical use of meniscus sonography]. PMID- 3299717 TI - Non-Hodgkin's lymphomas and other malignancies in the acquired immune deficiency syndrome. AB - Approximately 95% of neoplasms in acquired immune deficiency syndrome (AIDS) patients are either Kaposi's sarcoma or non-Hodgkin's malignant lymphoma. Kaposi's sarcoma is by far the most prevalent malignancy found, although a marked increase in the incidence of predominantly high-grade B cell malignant lymphomas has also been reported. There is evidence suggesting a correlation between Epstein-Barr virus (EBV) and the high incidence of lymphomas, and the most plausible explanation for this is the ability for EBV to cause ongoing B cell proliferation. Other agents have also been studied as potential cofactors in the induction of B cell lymphomas or Kaposi's sarcoma in AIDS patients, including cytomegalovirus and nitrites. Their precise roles remain speculative, however, and further study is needed. At this time there is no evidence of a cause-and effect relationship between human immunodeficiency virus (HIV)-infected patients and Hodgkin's disease, nor is there epidemiologic data to suggest that Hodgkin's disease is related to AIDS. Other neoplasms that have been described in HIV infected individuals include cloacogenic anorectal carcinoma and squamous-cell carcinoma of the head, neck, and oral cavity, but there is currently no epidemiologic evidence to prove that these cancers are part of the spectrum of AIDS. Although complete remission may be achieved using standard chemotherapeutic regimens, these remissions are not durable in the majority of patients. PMID- 3299718 TI - Pathophysiology and epidemiology of epidemic Kaposi's sarcoma. AB - The epidemic form of Kaposi's sarcoma (KS) that occurs in patients with the acquired immune deficiency syndrome (AIDS) produces lesions that, histopathologically, are indistinguishable from those of classical KS or of the endemic form of the disease seen in children and adults in certain areas of Africa. There are, however, important differences in the pathogenesis of the disease in the different groups affected by the neoplasm. Compared with classical KS in people of eastern European and Mediterranean descent, which commonly takes a protracted, indolent course, the epidemic Kaposi's sarcoma (EKS) is far more aggressive. However, the KS seen in adults in endemic areas of Africa may also become florid and rapidly progressive after years of quiescence. Some degree of immune dysfunction is thought to be a factor in all forms of KS, with immune depression being the hallmark of EKS and the setting in which it occurs. Cytomegalovirus (CMV) is thought to be at least a cofactor in the disease, but it has also been suggested that the etiologic agent of AIDS, human immunodeficiency virus (HIV), may also play a role in EKS. PMID- 3299719 TI - Prostacyclin in thrombotic microangiopathy. PMID- 3299720 TI - Thrombotic microangiopathy in pregnancy and the postpartum period. PMID- 3299721 TI - Clinicopathologic features of thrombotic thrombocytopenic purpura. PMID- 3299722 TI - Pathogenesis of thrombotic thrombocytopenic purpura. PMID- 3299723 TI - [Changes in the adaptive cytoprotection and its relation to endogenous prostaglandins in rats with gastric mucosal atrophy]. PMID- 3299724 TI - Primary dapsone resistance in multibacillary leprosy among Nepalese children. PMID- 3299726 TI - [Which interviewers are best--computers or doctors?]. PMID- 3299725 TI - Single dose half body irradiation for pain relief in metastatic carcinoma. PMID- 3299727 TI - [Technologic innovations and the development of the nursing profession]. PMID- 3299728 TI - Shellfish and fish poisoning related to the toxic dinoflagellates. AB - At least four different species of the toxic dinoflagellates cause shellfish and fish poisoning in the United States: Ptychodiscus brevis, neurotoxic shellfish poisoning; Protogonyaulax catenella and P tamarensis, paralytic shellfish poisoning; and Gambierdiscus toxicus, ciguatera fish poisoning. These three disorders have similar clinical manifestations, primarily neurologic and alimentary. A complete history is essential; confirmation, while dependent on specific laboratory analysis, is usually based on a history of ingestion of fish or shellfish previously associated with these types of poisonings. The principal toxins affect sodium channels; Ptychodiscus brevis toxins and ciguatoxin by stimulating these channels and saxitoxin by blocking them. Since no antidote is known, treatment is symptomatic. Public health measures and public education are necessary to prevent this form of poisoning. PMID- 3299729 TI - Fine needle aspiration biopsy in the diagnosis of hepatic malignancy. PMID- 3299730 TI - Clonorchiasis: an update. AB - The ability of Clonorchis sinensis to cause severe hepatobiliary disease is illustrated by the case we have reported, in which biliary obstruction and hepatic fibrosis resulted from the pathologic process associated with chronic clonorchiasis. Immunodiagnostic tests are currently limited, and diagnosis, as illustrated by our case, relies on identification of the fluke, usually as the adult or egg stage in clinical specimens. Praziquantel has revolutionized therapy of this disease, but surgical drainage may be necessary to relieve biliary obstruction. Physicians caring for emigrants or travelers from the Clonorchis endemic belt need to be aware of the manifestations of clonorchiasis to enhance diagnosis and therapy. PMID- 3299731 TI - Branhamella catarrhalis conjunctivitis. AB - Eleven cases of Branhamella catarrhalis conjunctivitis have been reported. In four recent studies that examine the microbial etiology of ophthalmia neonatorum, B catarrhalis was identified only twice in 1,299 cases. However, diagnosis by Gram stain in some and previous antibiotic therapy in others may have resulted in underdiagnosis of B catarrhalis and inaccurate diagnosis as gonococcal ophthalmia. PMID- 3299732 TI - [Role of the Dnepropetrovsk Medical Institute in the development of higher medical education in the Ukraine]. PMID- 3299733 TI - [E. F. Zveriaka--inspector of the Bessarabian Medical Authority]. PMID- 3299734 TI - [Immunologic aspects of peptic ulcer]. PMID- 3299735 TI - [Medico-social aspects of post-injection suppurative complications]. PMID- 3299736 TI - [Diagnostic value of electropunctometry in reflexotherapy]. PMID- 3299737 TI - [Gastric resection using mechanical compression sutures]. PMID- 3299738 TI - [Analysis of the causes of unsuccessful outcome of human cadaver kidney allografts]. PMID- 3299739 TI - [Growth and development of a population of the causative agent during an infection]. PMID- 3299740 TI - [Computed tomography following subtotal resection of the cervical vertebral bodies]. PMID- 3299741 TI - [Suppurative septic infection]. PMID- 3299742 TI - [Alcoholic lesions of the myocardium]. PMID- 3299743 TI - [Social psychological prerequisites for the deontological education of students in medical colleges]. PMID- 3299744 TI - [Function of the laboratory in the control of nosocomial infections]. PMID- 3299745 TI - [Report on Mexico 1982-1986. The National Health System of Mexico: origins, definitions and achievements]. PMID- 3299746 TI - Correction of deletions in mammalian cells by gene conversion. AB - We have constructed substrates to study the conversion of deletions in mammalian cells both extrachromosomally and after the stable integration of the substrates into the chromosome. These substrates were designed to study gene conversion without the complication of reciprocal recombination events. The substrates contain insertion or deletion mutations of the neomycin resistance gene (neo) and an internal, homologous fragment of the neo gene (neo-526), such that gene conversion from neo-526 to the mutated neo gene restores a functional neo gene. We have shown that extrachromosomally insertions of 10 bp or deletions of 22 or 167 bp are converted to wild-type at similar frequencies (1-6 X 10(-4)). Chromosomal gene conversion occurred at frequencies of about 10(-6)-10(-7) per cell generation. As expected from the experimental design, all recombination events analyzed in mammalian cells using these substrates appear to be due to gene conversion. PMID- 3299747 TI - Gene for M1 subunit of ribonucleotide reductase is amplified in hydroxyurea resistant hamster cells. AB - The hydroxyurea-resistant Chinese hamster cell line 600H has been shown to have greatly elevated quantities of ribonucleotide reductase. This increase in enzyme activity is due to an increased level of both the M1 and M2 subunit activities. The M1 subunit has been purified from the 600H cell line and shown to consist of a series of six protein spots with apparent molecular weights of 88,000 daltons, but with varying isoelectric points in the range of pH 6.5-7.0. Western blot analyses with antisera against the M1 and M2 proteins indicated that both subunit proteins are present in elevated quantities in the 600H cell line when compared to the wild-type V79 cell line. Southern blot analyses with genomic DNA from the series of stepwise-selected hydroxyurea-resistant cell lines leading to 600H showed that, in latter steps of selection, genomic sequences homologous to a mouse M1 cDNA have undergone a fivefold amplification. This was accompanied by a four- to eightfold increase in the single M1 homologous mRNA. PMID- 3299748 TI - A-raf oncogene localizes on mouse X chromosome to region some 10-17 centimorgans proximal to hypoxanthine phosphoribosyltransferase gene. AB - The localization of the A-raf cellular oncogene on the mouse X chromosome has been determined using Xbal-restricted DNAs prepared from progeny of an interspecies backcross between the B6.CBA.R1 and the Spe/Pas mouse strains. This localization to the proximal part of the mouse X chromosome has been confirmed by the use of somatic cell hybrids, carrying partially deleted X chromosomes and suggests that the A-raf oncogene localizes to a region lying some 10-17 centimorgans proximal to the hypoxanthine phosphoribosyltransferase (Hprt) gene between the locus DXPas4 and the locus DXPas7 defined by the cross-reacting human X chromosome-specific probe DXS32 (M2C). This localization on the mouse X chromosome is compatible with the presence of the A-raf oncogene on the short arm of the human X chromosome between the centromere and Xp21. PMID- 3299749 TI - General protocol for microcell-mediated chromosome transfer. AB - We have developed a general technique for making micronucleated cells to use in microcell-mediated chromosome transfer. Growing cells are blocked in mitosis with colcemid, placed in a hypotonic solution for 10 min, and returned to culture medium for 24 h. This treatment promotes the formation of micronuclei within lymphoblast or fibroblast cells. The microcells are generated by cytochalasin B treatment on a Percoll density gradient centrifuged at 43,500g. The resulting mixture of microcells, whole cells, and karyoplasts is filtered through 3-micron pores to obtain a pure microcell preparation. The microcells are fused to recipient whole cells using phytohemagglutinin-P and polyethylene glycol. Advantages of this technique are: donor cells need not be attached to a substrate; and cell lines which form micronuclei in low frequency can still be used efficiently as microcell donors. PMID- 3299750 TI - [Load testing of bonded bridges]. PMID- 3299751 TI - [Development of international cooperation at the Traumatology Research Institute in Brno (1954-1985)]. PMID- 3299752 TI - [The L. Bohler system of conservative functional therapy of fractures]. PMID- 3299753 TI - [Clinical evaluation of proglumetacin malate in rheumatoid arthritis--a multi institutional cooperative study]. PMID- 3299754 TI - [The causes of urothelial cancer]. PMID- 3299755 TI - Penile ultrasonography in impotence. PMID- 3299756 TI - Comparative in vitro activity of ceftriaxone. PMID- 3299757 TI - A comparative trial of ceftriaxone and a penicillin/chloramphenicol combination in gynaecological infections complicated by peritonitis. PMID- 3299758 TI - A bolus/basal multiple injection regimen in type I diabetes. A multicentre trial using a new 'fountain-pen' device for short-acting human insulin as well as long acting human insulin. AB - A trial was undertaken to ascertain the effect and acceptability of a multiple insulin injection regimen (MII) in patients with insulin-dependent diabetes mellitus using short-acting monocomponent human soluble insulin (Actrapid HM; Novo) for pre-meal bolus injections with the NovoPen injection device (Novo) and long-acting human insulin (Ultratard HM; Novo) at bedtime. Fifty-four patients, all previously on twice-daily short/intermediate-acting human insulin (Monotard HM; Novo) and Actrapid HM, were randomly selected. There was a significant overall improvement in diabetic control over the 12 weeks of the trial, the glycosylated haemoglobin (Hb A1) dropping from a mean of 9.8 +/- 2.2% to 8.6 +/- 1.7% (P less than 0.05). MII, using the NovoPen, was found to be more convenient than conventional insulin administration by 92% of the subjects. It is concluded that the NovoPen is a useful and convenient means of administering pre-meal boluses in an MII regimen, with a very high rate of acceptance by patients of all ages. PMID- 3299759 TI - Renal retransplantation. The Johannesburg Hospital experience. AB - Between 1968 and 1985 108 renal retransplants were performed at Johannesburg Hospital; 102 patients received a second, 5 patients a third, and 1 patient a fourth kidney. The actuarial graft survival at 1 and 5 years is 52.8% and 40.5%. All retransplanted kidneys were obtained from cadaver donors. Factors that influence second graft survival are the period of survival of the previous graft, the use of cyclosporin A, the level of pre-sensitisation determined by preformed antibodies, the original disease (in particular diabetes and analgesic nephropathy) and the patient's sex. The results of retransplantation are not significantly different from those found in patients with first allografts; hence retransplantation is justified in those individuals whose previous donor kidney has ceased to function. PMID- 3299760 TI - The role of mammography in the detection of breast cancer. AB - Attempts to reach a tissue diagnosis of breast masses by the use of X-rays (mammography) proved unsuccessful and, as a consequence, the popularity of the method waned. A more natural and less radical surgical approach to the treatment of breast cancer, coupled with statistical evidence that more favourable results were obtained in early cases (stage I and II) resulted in mammography, which is one of the known methods of detecting early lesions, regaining some of its lost status. Screening programmes of asymptomatic well women by mammography in an attempt to detect early breast lesions has been instituted in many countries and the early results (5 years) have been promising. Newer techniques, including the use of special film screen combinations, microfocus tubes with enlargement techniques and grid carbonfilter cassettes, have all contributed to the improvement in diagnostic accuracy. These advances and the place of mass screening programmes in attempts to control this disease are discussed. PMID- 3299761 TI - Sensitivity of endoscopic detection of malignancy in resectable gastric carcinoma. AB - In 50 consecutive cases of resected gastric carcinoma the absolute sensitivity in making an unequivocal pre-operative diagnosis was 54% for endoscopic inspection, 76% for biopsy and 48% for cytology. Inspection and biopsy in combination yielded 90% and adding cytology achieved 92% absolute sensitivity. The relative sensitivity (which included equivocal reports) was far higher for each individual test, and 100% for the combination of all three, but did not reflect the clinical value of these investigations as clinicians did not react appropriately to equivocal reports. Thus for the endoscopic detection of gastric carcinoma in routine clinical practice, inspection was insensitive, biopsy mandatory, cytology of little additional value and endoscopic followup of apparently benign lesions appeared important. PMID- 3299762 TI - Mucus and mucins. AB - Mucus is a secretion which contains a number of components of which mucins (glycoproteins of varying structure) are the entities mainly responsible for the physical properties of a visco-elastic gel. Technical problems which have previously hindered the elucidation of the chemical structure of these molecules have recently been overcome sufficiently to permit the development of structural models which explain both the common and variable features of mucus, healthy or pathological, in different sites of the body. PMID- 3299763 TI - Comparative bio-availability of theophylline whole and halved sustained-release tablets. AB - In a randomised, multiple-dose, cross-over study in 14 healthy volunteers, plasma theophylline concentrations were compared during a 12-hour dosing interval after repeated administration of theophylline (Euphyllin Retard; Byk Gulden) as whole and halved tablets. Bio-availability of theophylline from the halved tablets relative to the whole tablets was: 116% (100%, 134%) for the extent of absorption as judged by the area under the concentration time curve (AUC) and 115% (99%, 135%) for the rate of absorption as judged by maximum concentration (Cmax). The confidence levels for the 80-120% bio-equivalence range were 72% (AUC) and 76% (Cmax), those for the 80 and 125% range were 91% (AUC) and 91% (Cmax). The plateau times T75% Cmax, which characterise the sustained-released properties, were 8.5 +/- 2.9 hours (halved) and 8.3 +/- 2.5 hours (whole) during the 12-hour dosing interval. It is concluded that no clinically relevant deviations in steady state plasma theophylline concentration and sustained-release properties are likely to result from breaking (halving) the film-coated tablets. PMID- 3299764 TI - Suppression of pancreatic beta cell function by cyclosporin. PMID- 3299765 TI - Health issues in the microelectronics industry. AB - Since 1948, when microelectronics entered the American industrial scene, the rapid growth and advancing technology of the industry has caused production facilities to be spread throughout most industrialized areas in the United States. It is now speculated that microelectronics production will be the fourth largest industry in the United States by the end of the century. This article addresses the questions raised about the safety of this industry both for its workers and for the communities in which production facilities are located. PMID- 3299766 TI - The microelectronics industry. PMID- 3299767 TI - Toxic gases used in the microelectronics industry. AB - Toxic gases are among the most dangerous materials used in manufacturing semiconductors and related devices. The storage, handling, and disposal of these gases pose a major hazard to workers and to communities located near high technology companies. It must be anticipated that accidents, acts of terrorism, and natural calamities will result in exposure. Flammability, corrosiveness, and concentration must be considered, as well as the immediate danger to life and known human health effects of the gases used. PMID- 3299768 TI - Carcinogens and cancer risks in the microelectronics industry. AB - Additional epidemiologic studies and a systematic program of carcinogenicity testing of materials are necessary to demonstrate that the electronics industry is free of cancer risks. Screening of new and existing materials for mutagenic activity is needed before these materials are introduced into the workplace. Materials found to possess mutagenic activity should be more extensively tested in animals so that their carcinogenic potential can be defined. Those found to be carcinogenic in animals should be regarded as though they are carcinogenic to humans. PMID- 3299769 TI - The chemical nature of the microelectronics industry. AB - Many of the processes used in semiconductor fabrication involve chemical reactions. These reactions range from fundamental procedures such as electroplating and cleaning to plasma reactions and ion implantation. This article analyzes the various steps of the semiconductor fabrication process in light of their chemical nature. PMID- 3299770 TI - Reproductive hazards in the microelectronics industry. AB - There has been increased awareness of the potential for occupational and environmental exposures to hazardous substances to adversely affect reproductive outcome in men and women. The purpose of this article is to familiarize the clinician with some of the normal physiologic changes of pregnancy and how those may interact with working conditions in the electronics industry. It also reviews some of the data regarding potential reproductive hazards of substances and physical agents used in this industry. PMID- 3299771 TI - Radiofrequency and microwave radiation in the microelectronics industry. AB - The microscopic precision required to produce minute integrated circuits is dependent on several processes utilizing radiofrequency and microwave radiation. This article provides a review of radiofrequency and microwave exposures in microelectronics and of the physical and biologic properties of these types of radiation; summarizes the existing, relevant medical literature; and provides the clinician with guidelines for diagnosis and treatment of excessive exposures to microwave and radiofrequency radiation. PMID- 3299772 TI - Dermatitis in the microelectronics industry. AB - Many of the chemicals used in the semiconductor industry are strong skin irritants, and several are capable of readily inducing contact allergic sensitization. In plants in which state-of-the-art equipment is used, the hazards to production workers are minimal today, but those workers who clean, repair, and maintain equipment remain at special risk. The major potential cutaneous hazards of each step in the production of microchips are the subject of this article. PMID- 3299773 TI - Repetitive motion musculoskeletal problems in the microelectronics industry. AB - Occupational rheumatologic problems due to rapid repetitive motion are increasing in frequency in the electronics industry and are more commonly responsible for awards of Workers' Compensation benefits. If not handled correctly, these problems can result in significant pain and disability for employees and heavy medical and disability costs for employers. Corporate health and safety personnel can play a major role in reducing this human and fiscal cost by the following measures: Careful evaluation of patterns of injury and illness among employees will identify production areas with a high rate of problems. An intervention system designed to provide rapid early identification of employees with early symptoms of carpal tunnel syndrome, tendinitis, and muscle pain-spasm syndrome. Early treatment will produce much better medical results and will significantly reduce temporary disability and medical costs. Corporate ergonomic expertise or outside consultant evaluation of "hot spot" areas where significant numbers of cases are identified is critical to the prevention of future injury among employees. Some large electronics firms have ergonomic experts on staff in at least one plant facility. Arranging expert consultation can be expensive, with consulting fees of up to +1000 per day, plus expenses. However, this must be balanced against the medical disability costs of even one case of carpal tunnel syndrome, for example (up to +30,000 per case), and the required transfer of an experienced employee who develops a problem to another work area. Finally, these problems often do not occur in isolation. An employee with carpal tunnel syndrome very often has concomitant tendinitis and/or muscle pain-spasm syndrome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3299774 TI - Environmental health aspects of the microelectronics industry. AB - This article reviews examples of contamination to the surface or groundwater, the ambient air, and soil resulting from the microelectronics industry. The potential effects on human health arising from such environmental contamination are discussed, as well as aspects of their diagnosis, treatment, and related public health implications. Given the high costs of pollution control, the emphasis must be on prevention, which can be facilitated by a high level of suspicion and by the design of safety and pollution control into manufacturing processes. PMID- 3299775 TI - Dopant materials used in the microelectronics industry. AB - Advances in microelectronics have transformed the occupational environment of the electronics industry. Large quantities of potentially hazardous materials are now in routine use as integrated circuit manufacturing becomes more complex and specialized. While the acute hazards associated with these dopant materials are clear, the subacute and chronic effects are less evident. Many of these elements are trace elements in humans and may play roles in health and disease in minute concentrations. Early detection and prevention of adverse health effects requires both astute medical surveillance, industrial hygiene, and safety engineering efforts to eliminate the sources of exposure to workers. PMID- 3299776 TI - Gallium arsenide. AB - The demand for high-speed devices for a variety of communications and military purposes has resulted in a growing interest in alternatives to silicon, with particular attention to compounds of groups 3 to 5 on the periodic table. Gallium arsenide has proved to be an ideal substrate material for some uses but is associated with unique health hazards. PMID- 3299777 TI - Photoactive chemicals used in photoresist systems. AB - Among the most significant advances in the manufacture of microelectronic devices have been chemical changes in photoresist materials and processes. These materials should be handled with great care in the workplace. Careful medical surveillance of employees who regularly handle photoresist materials is appropriate in view of the very limited biologic information available. PMID- 3299778 TI - Health hazards of solvents. AB - Organic solvents comprise a majority of the chemicals used by the microelectronics industry. Much of the production of semiconductors, in particular, takes place in cleanrooms, where high-efficiency particulate absolute filtration units remove dust. Workers wear protective caps, gowns, masks, and booties to prevent dust contamination of the chips. The appearance of cleanliness obscures the fact that workers are exposed to a multitude of chemical and physical hazards. Recirculated air protects the chips from contamination but also exposes workers to recirculated solvent and other chemical fumes and vapors. PMID- 3299779 TI - Hydrofluoric acid burns. AB - Chemical burns sustained in the microelectronics industry consist mostly of injuries to the skin of the hand and face. The injuries are caused by splashes, holes in gloves, or accidental use of a chemical improperly. The chemical burns of the face primarily involve splashes. Employee education and the ability to intervene swiftly are the foundations of prevention of serious injury. Every facility using hydrogen fluoride should be certain that they have current treatment protocols reviewed by someone with expertise in this area. Furthermore, companies should not assume that all local physicians are knowledgeable about hydrogen fluoride and should educate them as well. PMID- 3299780 TI - Reproductive problems in the workplace. PMID- 3299781 TI - Effects of occupational exposures on the fertility of couples. AB - The biology of couple fertility is discussed, studies of the relationship of couple fertility to occupational exposures are reviewed, and three methods of measuring couple fertility--their advantages and disadvantages--are described. PMID- 3299782 TI - Male reproductive hazards. AB - Studies of adverse reproductive effects on male workers have only become prominent in the last 10 years and have used a variety of approaches to evaluate male reproductive function. This article focuses on studies that utilize semen analysis. PMID- 3299783 TI - Maternal occupation: effects on spontaneous abortions and malformations. AB - The epidemiology of spontaneous abortion is described and the literature relating selected occupations to spontaneous abortion and to malformations is reviewed. A study on the effects of anesthetic gases on pregnancy outcome is presented to demonstrate approaches to research. PMID- 3299784 TI - Working during pregnancy: physical and psychosocial strain. AB - The article concerns more general aspects of stress during pregnancy in connection with employment. Various existing studies are reviewed, mainly related to pre-term delivery and birth weight. PMID- 3299785 TI - Breastfeeding in the workplace. AB - There is potential for damage to lactation or to the nursling from a variety of agents that might be encountered in the workplace. PMID- 3299786 TI - Childhood cancer. AB - The literature generally supports the evolving recognition that childhood cancers are influenced by the environment. This article discusses specific childhood cancers in regard to paternal and maternal occupation. PMID- 3299787 TI - Environmental and direct measures of exposure. AB - The need for epidemiologic reproductive studies of workers exposed to antineoplastic agents has been underscored by a proliferation of literature expressing concern about the potential for biologic hazard, animal and patient studies demonstrating reproductive effects of these drugs, and by the two recent case-control studies reporting findings of reproductive hazard, specifically spontaneous abortion and congenital malformations. The numbers of workers with past exposure must be approaching 100,000, based on the number of exposed workers per hospital in a study at one point in time by Stellman et al. Many of those handling these drugs in the past probably experienced substantial exposure because protection was unavailable and handling practices were careless since the hazard was not recognized until 1979. Because of the recent and continuing publicity given in the professional literature to antineoplastic drugs as potential hazards to the health and reproductive function of pharmacists and nurses, it is hoped that exposure to these agents will decrease in sizable portions of the occupational groups who have current and past exposure to these drugs, although many workers have reported to the author that they used protection for a short time after hearing a report of possible effects, then returned to their previous unprotected handling practices. Since substantial numbers of persons were heavily exposed in the past, questions about the long term effects of such exposures remain an issue and need to be studied. Effects on menstrual function, for example, could have ongoing reproductive implications. Answers about reproductive hazard and utility of various protective measures are needed to guide policy decisions about how to best protect workers. Conflict has arisen between nurses and administrators regarding institutional policies that prohibit pregnant nurses from handling antineoplastic drugs or caring for patients on drug protocols. If pregnant nurses are to be permitted to handle these drugs, then it is essential to provide evidence that the use of protective clothing and equipment gives adequate protection. The development of biologic markers of cumulative exposure is thus a desirable, although hard to realize, ideal.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3299788 TI - Linking data to study reproductive effects of occupational exposures. AB - This article describes existing data systems or registries on reproductive outcomes or occupational exposures--birth registries, vital record systems, birth defect registries, hospital discharge registries, etc.--and describes approaches to linking the data. PMID- 3299789 TI - Study designs appropriate for the workplace. AB - Carlo and Hearn have called for "refinement of old [epidemiologic] methods and an ongoing evaluation of where methods fit in the overall scheme as we address the multiple complexities of reproductive hazard assessment." This review is an attempt to bring together the current state-of-the-art methods for problem definition and hypothesis testing available to the occupational epidemiologist. For problem definition, meta analysis can be utilized to narrow the field of potential causal hypotheses. Passive active surveillance may further refine issues for analytic research. Within analytic epidemiology, several methods may be appropriate for the workplace setting. Those discussed here may be used to estimate the risk ratio in either a fixed or dynamic population. PMID- 3299790 TI - Reproduction and the workplace: an industry perspective. AB - The main issue confronting industry in addressing reproductive health and the workplace is how to obtain needed data. The advantages and limitations of four methods of data collection--literature reviews, toxicology, epidemiology, and medical surveillance--are described, and recommendations made for improving reproductive health monitoring by industry. PMID- 3299791 TI - The worker's perspective. AB - The author recommends involvement of workers in every phase of epidemiologic research or clinical surveillance programs, from hypothesis generation and study design through interpretation of results and discussion of recommendations for notification, counseling, and intervention. Clinicians must be aware of the potential work-relatedness of illness and routinely obtain an occupational history. PMID- 3299792 TI - Reproduction, women, and the workplace: legal issues. AB - Legal conflict has marked the effort to protect workers against reproductive injury, and legal activity in the management of occupational risks reflects a much broader range of important social issues, such as sexual discrimination in the workplace. This article describes the evolving law related to reproductive hazards that concern men, women and children. PMID- 3299793 TI - Ethical aspects of reproductive health in the workplace. AB - Reproductive health in the workplace presents in microcosm all of the ethical dilemmas raised by occupational medicine and medicine generally, including confidentiality, workers' right to know, individual autonomy, paternalism, informed consent, cost-benefit analysis, and a host of other issues. PMID- 3299795 TI - The troubled employee. PMID- 3299794 TI - Work and reproduction: sociologic context. AB - For nearly all women in the U.S., combining reproduction with employment is a complex juggling act. Reproduction as a social process is defined, followed by a review of the status of women at work, ways in which work influences the experience of reproduction, and various maternity provisions in the workplace. PMID- 3299796 TI - The troubled employee. Role of the medical department. AB - Occupational medical departments are frequently called upon to deal with the troubled employee. Successful rehabilitation is significantly improved by early identification before significant work-related problems exist. Self-referral or diagnosis by the medical department staff are therefore the preferred means of detection. In that the medical conditions identified tend to be chronic, on-going follow-up of the troubled employee by the medical department is often indicated. In cases in which business-related issues have been identified, the occupational physician is often in a unique position to interact with both the treating physician and management to attempt rehabilitation and, where possible, selective job placement. Ethical dilemmas in handling information can be formidable, particularly when the interests of the troubled employee, management, and fellow workers diverge. PMID- 3299797 TI - The troubled employee. The psychiatric patient at work. AB - Despite the prevalence of psychiatric illness in society there has been only limited research on vocational rehabilitation of the psychiatric patient. The work that has been done, however, suggests that the prevailing pessimistic attitude is unjustified. A committed occupational medical department working closely with the patient-employee, management, and the community treatment resource can frequently assist the employee in a satisfactory return to gainful employment. PMID- 3299798 TI - The troubled employee. Dangerous and violent behavior. AB - The events precipitating violent behavior, demographic characteristics of violent people, sources of stress, cognitive and affective factors, historical and current contexts of violence, the means of violence and the victims are all addressed. PMID- 3299799 TI - The troubled employee. Ages, stages, and vulnerability to stressors. AB - In the form of three detailed case studies, the author explains the timing and nature of emotional crises in employees. Context, vulnerability and specific stressors are discussed as components of work stress. PMID- 3299800 TI - The troubled employee. Chronic physical disease. AB - The author covers chronic non-occupational illness as it affects employee performance and outlines the responsibilities of a company in managing such problems. PMID- 3299801 TI - The troubled employee. Absenteeism. AB - Absenteeism is a very costly problem in business and industry. The author discusses the dimensions of the problem, its causes and complexity, and practical steps that occupational health professionals can take to assist management in improving the problem. PMID- 3299802 TI - The troubled employee. Mentally retarded and learning disabled employees. AB - Employees who are mentally retarded or learning-disabled are not troubled when there is a good job match and appropriate management. The article covers the nature of these disorders and various issues that concern business and industry in arranging appropriate employment for such individuals. PMID- 3299803 TI - The troubled employee. Alcoholism. AB - The magnitude of the problem and the role of the Occupational Medical Department in dealing with it are covered. Criteria for diagnosis, both major and minor are detailed, as well as various approaches to early identification and treatment. PMID- 3299804 TI - The troubled employee. Drug abuse in the workplace. AB - The ramifications of the "drug generation" entering the workforce are spelled out, including the implications for the occupational health professional. The importance of in-company education and policy formation is emphasized, along with the processes of evaluation and referral. PMID- 3299805 TI - The troubled employee. Employee assistance programs. AB - Cost/benefit aspects of EAPs are elucidated as well as program development and evaluation. Various EAP models are described and future directions of EAPs are postulated. PMID- 3299806 TI - The troubled employee. Role of the occupational health nurse in working with troubled employees. AB - Nurses are the largest group of health care providers in industry. The role of the occupational health nurse in dealing with troubled employees is discussed and the nursing skills required are explained. PMID- 3299807 TI - The troubled employee. Legal and ethical considerations in managing the troubled employee. AB - Programs installed to deal with troubled employees are not simple to design because of many legal and ethical issues. The best interest of the employer can be in conflict with individual freedoms and result in a dilemma. The author addresses ethical, constitutional, and other legal considerations that bear. PMID- 3299808 TI - Social work groups in health care settings: four emerging approaches. AB - The impact of medical technology, with its organizational consequences for patients and health providers, serves as a basis for the differential use of four models of group work practice identified from a review of articles in professional journals. Models emphasize patient compliance and marketing of services, reciprocal patient-system relations, social care and self-help. Examples and practice issues for each approach are specified. PMID- 3299809 TI - Group meetings for parents and spouses of bone marrow transplant patients. AB - To reduce the stress and social isolation of being the parent or spouse of a patient hospitalized for bone marrow transplantation (BMT), a support group for family members was established. Sharing the common experience of the BMT procedure was valuable to family members despite differences in patient's age or disease, relationship to the patient, or socio-economic status. Recommendations are made to include similar groups in planning to meet the psychosocial needs of family members at other centers where patients are treated with high-risk, high intensity procedures. PMID- 3299810 TI - Business planning for ambulatory surgical services. AB - Successful responses to the rapid expansion of ambulatory surgical services in the United States require careful planning on the part of current and potential providers. The recommended approach to business' planning includes development of a detailed business concept, assessment of market and competitive characteristics, and analysis of current and projected financial performance. PMID- 3299811 TI - Major ambulatory surgery of the general surgical patient. Management of anorectal conditions, peripheral vascular problems, and gastrointestinal endoscopy. AB - The growing experience with controlling postoperative pain and with using Foley catheters postoperatively has made surgeons less hesitant to perform some anorectal procedures in an ambulatory setting. Procedures for the treatment of varicose veins of lesser severity can often be done in an ambulatory surgical center. Because of the risk for respiratory complications and perforations, some endoscopic procedures are appropriate for the major ambulatory surgical unit. PMID- 3299812 TI - Historical review of Raynaud's phenomenon nomenclature and pathophysiology. PMID- 3299813 TI - Raynaud's phenomenon and systemic diseases. PMID- 3299814 TI - The diagnostic role of nailfold microscopy. PMID- 3299815 TI - Drug treatment in Raynaud's phenomenon. PMID- 3299816 TI - The role of the sympathetic nervous system in the pathophysiology and therapy of Raynaud's phenomenon. PMID- 3299817 TI - Does serotonin receptor blockade have a therapeutic effect in Raynaud's phenomenon? PMID- 3299818 TI - Treatment of Raynaud's phenomenon with nifedipine short-term and long-term effects. PMID- 3299819 TI - A double-blind controlled trial of low dose acetylsalicylic acid and dipyridamole in the treatment of Raynaud's phenomenon. PMID- 3299820 TI - The theorem of Bayes as a clinical research tool. AB - The theorem of Bayes is a powerful research tool that has a multitude of clinical applications. Its use has been somewhat restricted because of the intrinsic complexity of Bayesian theory and the need for computer support. We explain herein the Theorem of Bayes in practical terms that specifically apply to clinical research. PMID- 3299821 TI - Gastric devascularization. AB - Gastric devascularization has been reported to effectively control massive hemorrhage from stress related gastric mucosal injury with acceptable mortality and morbidity rates. Since this type of injury formation is partially based upon decreased gastric mucosal blood flow, the success of devascularization seems paradoxical. Thus, gastric devascularization was performed upon miniature swine and the gastric mucosal blood flow was serially measured in order to attempt to explain its efficacy. Total gastric mucosal blood flow decreased immediately, a maximum 36 per cent at 60 minutes. At three hours, gastric mucosal blood flow, although still significantly lowered (11 per cent), had begun a recovery that was total at one week. These results suggest that the efficacy of devascularization lies in its ability to modulate decreased gastric mucosal blood flow and, thereby, stop hemorrhage from established lesions. The rapid rebound of gastric mucosal blood flow to near normal levels prevents extension of the erosive process. These factors form the physiologic basis for the efficacy of gastric devascularization. PMID- 3299822 TI - Etiologic and epidemiologic factors of carcinoma of the esophagus. AB - Carcinoma of the esophagus is one of the most interesting tumors due to the great diversity with regard to its regional incidence worldwide. The areas of especially high incidence include the Caspian provinces of Iran and certain regions of the People's Republic of China, South America and Africa. The precise cause of these major regional differences with regard to the incidence of carcinoma of the esophagus are still not fully clarified. The results of the present study explain conceptions with regard to the etiopathogenesis and shows that the factors with a promotive role in various individual regions differ, in some instances, considerably from one another. PMID- 3299823 TI - Transcerebellar biopsy in the posterior fossa: 12 years experience. AB - Utilizing the Leksell stereotactic system, the transcerebellar approach was used for posterior fossa biopsies. During a period of 12 years, a total of 29 patients were operated on by this technique, among them 12 children. In the adult, the procedure was carried out with the patient awake and sitting upright; the pediatric patients required general anesthesia and the head was supported either manually or by a clamp. Representative specimens were obtained in all cases but one, showing a wide diagnostic spectrum. As a rule, the procedures were performed smoothly, with no serious side effects. Stereotactic biopsies in the posterior fossa, hitherto seldom performed, open new diagnostic perspectives, one of which is for use in obscure brain stem lesions. The transcerebellar approach has been proven to be easy, direct, and safe provided an appropriate technique is used, such as that described in the present paper. PMID- 3299824 TI - Is a case report an anecdote? In defense of personal observations in medicine. PMID- 3299825 TI - Nocardial brain abscess: diagnostic and therapeutic use of stereotactic aspiration. AB - Three cases of nocardial brain abscess are presented. All three patients were receiving immunosuppressive therapy at the time of diagnosis. Two patients had cardiac transplantation and the third had periarteritis nodosa. The patients presented with generalized seizures or focal weakness. Accurate localization of the intracerebral mass lesion was obtained from computed tomography (CT) scans, but CT-guided stereotactic aspiration was required for diagnosis and treatment in every case. After Nocardia asteroides was seen on Gram's stain and subsequently identified by culture, appropriate antibiotic therapy was initiated. Both heart transplant patients survived in good neurological condition. We believe that stereotactic aspiration followed by prolonged antibiotic therapy may significantly improve the outcome of patients with nocardial brain abscess. PMID- 3299826 TI - Choroidal epithelial cyst of the cerebral hemisphere. An immunohistochemical study. AB - A case of choroidal epithelial cyst in the left cerebral hemisphere of a 4-month old infant is described. The cyst wall was composed of a single epithelial layer with a basement membrane and fibrous connective tissue. An immunohistochemical study revealed the presence of prealbumin in the cytoplasm of these cuboidal epithelial cells. This fact strongly suggested that the cuboidal epithelium lining the cyst wall originated from choroidal epithelial cells. The diagnostic usefulness of the immunohistochemical study in choroidal epithelial cysts is discussed. PMID- 3299827 TI - Pathophysiology of age-related macular degeneration. AB - The clinical and histopathological features of age-related macular degeneration (AMD) include a relationship with age, and the presence of pigmentary disturbances, drusen, thickening of Bruch's membrane, and basal laminar deposits. AMD is an advanced stage of a deteriorative process that takes place in all eyes. The primary lesion in AMD appears to reside in the retinal pigment epithelium (RPE), possibly resulting from its high rate of molecular degradation. Beginning early in life, and continuing throughout the life span, cells of the RPE gradually accumulate sacs of molecular debris. These residual bodies (lipofuscin) are remnants of the incomplete degradation of abnormal molecules which have been damaged within the RPE cells or derived from phagocytized rod and cone membranes. Progressive engorgement of RPE cells with these functionless residues is associated with the extrusion of aberrant materials which accumulate in Bruch's membrane and aggregate in the form of drusen and basal laminar deposits. These excretions contribute to the further deterioration of the RPE. Loss of vision results from death of visual cells due to degeneration of RPE cells, or the effects of leakage from neovascular membranes that invade the region of abnormal extracellular deposits. PMID- 3299828 TI - [My best memory. We had time and we had plenty]. PMID- 3299829 TI - [Now to Norway: Virginia Henderson--nursing's grand old lady]. PMID- 3299830 TI - [My best memory. To study the curriculum was purely holidays]. PMID- 3299832 TI - [My best memory. An industrious life in happiness. Interview by Marianne Monsen]. PMID- 3299831 TI - [Florence Nightingale--angel or determined old maid]. PMID- 3299833 TI - [Historical perspective: Borghild Egilsrud--mother of the pension system]. PMID- 3299834 TI - [Children's health. Most children relate health to what we eat]. PMID- 3299835 TI - [Children's health. Spare mothers and upper-class children--a picture from the past]. PMID- 3299836 TI - [Children's health. 5.400 years with children's institutions: purpose rarely achieved]. PMID- 3299837 TI - [Children's health. 6. Corporal punishment legislation and the campaign to have the law removed]. PMID- 3299838 TI - [Children's health. 7. Pregnancy and childbirth--myths and reality]. PMID- 3299839 TI - [Health visiting. The "itinerant women's network" and professional development]. PMID- 3299840 TI - [Health visiting. When women obtained right to vote we got health visitors]. PMID- 3299841 TI - [Health visiting. Doctors took out a patent on guidance of infants--mothers]. PMID- 3299842 TI - [Health visiting is not only something one can use in America]. PMID- 3299843 TI - [Children's health. 9. Children's conditions are the most important in life, believes Peter Sabroe]. PMID- 3299844 TI - [Children's health. 11. Children and their parents: 300 years development history]. PMID- 3299845 TI - [Children's health. 13. Developments in the care of hospitalized children]. PMID- 3299846 TI - [Children's health. 14. Incubators are best for a safe survival but are no perfect solution]. PMID- 3299847 TI - [Cerestore, Dicor and Ceplatec--alternative materials and technics for porcelain crowns]. PMID- 3299848 TI - [A unique method for fabrication of a crown restoration using titanium]. PMID- 3299849 TI - [Ultrasonic aerosols in the complex treatment of nonspecific inflammatory diseases of the respiratory system]. PMID- 3299850 TI - [Use of calcium antagonists in the clinical treatment of internal diseases]. PMID- 3299851 TI - [Diagnosis of pulmonary hypertension using Doppler-echocardiography]. PMID- 3299852 TI - [Polymorphonuclear leukocytes: their role in the development of acute and chronic nonspecific inflammation in the lungs]. PMID- 3299853 TI - [Use of tests characterizing the locomotor activity of phagocytic cells in the differential diagnosis of forms of bronchial asthma]. PMID- 3299854 TI - [Allergic bronchopulmonary aspergillosis]. AB - The article concerns one of the present-day problems in the teaching of the allergic diseases of the lungs, namely allergic bronchopulmonary aspergillosis. Discusses the disease diagnosis and clinical course, diagnostic approaches, efficient drug therapy, and prognostic aspects. Based on an analysis of the authors' own data, the problem of the possibility of the systemic pathoimmune manifestations associated with skin, eye and kidney injuries that occur during allergic bronchopulmonary aspergillosis is discussed. PMID- 3299855 TI - Identification of platelet antigens by monoclonal antibodies using crossed immunoelectrophoresis with immunoblotting of the monoclonal antibody. AB - A method is described for the identification of antigens by monoclonal antibodies. This is applicable whenever precipitating antibodies to the same antigens from a different species are available. The method is based upon: Separation and immunoprecipitation of cellular proteins with a polyspecific antiserum in crossed immunoelectrophoresis in the presence of the non-denaturing detergent Triton X-100 and the monoclonal antibody. Coprecipitation of the monoclonal antibody with its antigen. Subsequent passive transfer of the monoclonal antibody in the antibody-antigen complex onto a nitrocellulose membrane. Visualization of the blotted antibody using an enzyme-linked secondary antibody and a chromogenic substrate. Identification of the corresponding antigen by comparisons to the immunoprecipitate pattern of the original immunoplate. To test this method we have analyzed the detection of the antigens recognized by six previously described monoclonal antibodies against platelet membrane proteins and von Willebrand factor. Specific immunoblots were obtained in each case using small amounts of monoclonal antibodies. Thus, the technique provides an alternative when epitopes are denatured by SDS, and avoids the use of radioactively labelled monoclonal antibodies. PMID- 3299856 TI - [Endoscopic hemostasis in the upper gastrointestinal tract]. PMID- 3299857 TI - [Anastomoses in the upper gastrointestinal tract by means of suture staplers]. PMID- 3299858 TI - [Triphasic versus monophasic p-pill. A comparative multicenter study]. PMID- 3299859 TI - [Sodium restriction in hypertension. Sympathetic tonus, renin and vasopressin]. PMID- 3299860 TI - [Ductus arteriosus. Physiopathological and clinical aspects]. PMID- 3299861 TI - [Proximal gastric vagotomy and ulcer excision for stomach ulcer]. PMID- 3299862 TI - Martin M. Cummings. Interview by Ole K. Harlem. PMID- 3299863 TI - [Acculevel. A rapid and precise method for theophylline determination]. PMID- 3299864 TI - [Transrectal ultrasonography in rectal cancer. Still no revolution for the clinician?]. PMID- 3299865 TI - [Double-contrast examination of the large intestine. Mixobar and Polibar AC 20 (EZEM)]. PMID- 3299866 TI - [Doppler examination of the precerebral arteries]. PMID- 3299867 TI - [From the sanitary service of the Royal Norwegian Naval forces in Great Britain during the war 1940-1945. Revolutionary progress in the treatment of syphilis and gonorrhea]. PMID- 3299868 TI - [The medical leech--Hirudo medicinalis. Natural occurrence, medical use and complications]. PMID- 3299869 TI - [Klebsiella pneumoniae mastitis as a dairying problem]. AB - Quarter samples were taken from lactating and dry cows of a dairy herd in the Netherlands. Klebsiella pneumoniae was isolated from milk and dry udder secretum of cattle, and from the bedding of the cubicles. The animals concerned did not show any clinical symptoms. For some years Klebsiella mastitis caused severe problems on this farm. A strict hygienic program resulted in complete control of the disease. Diagnostics, therapy and prevention of Klebsiella mastitis are discussed. PMID- 3299870 TI - Screening a hybridoma producing a specific monoclonal antibody to HLA-A24+Bw4 antigen by cytotoxicity inhibition assay. AB - A hybridoma secreting a monoclonal antibody (Tsa-1, IgG3) reacting specifically to HLA-A24+Bw4 was screened by cytotoxicity inhibition assay and micrototoxicity test. The R value of the antibody was 0.843. PMID- 3299871 TI - Expression of class I-MHC antigens by cultured human epidermis and epidermal allografts. AB - In vitro grown class II-MHC antigen free epidermal sheets were used as epidermal allografts (EAG) across a major histocompatibility barrier in 20 non immunosuppressed recipients suffering from leg ulcers. Class I antigens were expressed on cell membranes of basal cell layer only on the epidermal sheets. After grafting, patchy areas of membrane fluorescence were observed among cells from the suprabasal layers on the epidermis from skin biopsies taken between days 5 and 28. All cells of the basal and the suprabasal layers expressed class I antigens on biopsies taken after day 28, as on normal human epidermis. This work demonstrates that class I antigens are expressed by epidermal cells in cultures used for grafting. The absence of rejection cannot be explained by the absence of class I-MHC antigens in EAG. PMID- 3299872 TI - Test of prolongation of skin graft survival by blood injections provides evidence for presence of a new histocompatibility locus in the B-G region of chicken MHC. AB - When used for pretransplantation treatment, blood of congenic chicken lines CB and CB.R1, incompatible only in the B-G region of the major histocompatibility complex (MHC), differed in their ability to induce prolonged survival of skin grafts transferred from either of these lines onto recipients of a third congenic line, CC. Moreover, skin grafts from CB and CB.R1 donors displayed a difference in survival time, irrespective of blood pretreatment. Graft survival time after pretreatment of recipients with CB blood could be prolonged by prior induction of neonatal tolerance to the B-G product; this could be done with injections of whole blood or of separated erythrocytes or leucocytes of line CC.R1 chickens (incompatible with CC recipients in the B-G region). The results indicate that a new histocompatibility locus is present in the B-G region of the chicken MHC. PMID- 3299873 TI - Comparison of serum concentrations of the acetylcholinesterase oxime reactivators HI-6, obidoxime, and PAM to efficacy against sarin (isopropyl methylphosphonofluoridate) poisoning in rats. AB - A comparison of serum concentrations of the oximes HI-6 [1-(((4-aminocarbonyl) pyridino)methoxy)methyl)-2(hydroxy imino)methyl- pyridinium dichloride], PAM [2 [hydroxyimino)methyl-1-methylpyridinium chloride], and obidoxime [1,1' (oxybis(methylene]bis(4-((hydroxyimino) methyl)-pyridinium dichloride] to the efficacy against sarin (350 micrograms/kg; sc) lethality was evaluated in rats. The oximes were administered prophylactically by means of Alzet osmotic minipumps. Atropine (17.4 mg/kg; im) was administered immediately following sarin (350 micrograms/kg; sc) administration. At serum concentrations of 3.6, 3.6, and 3.3 micrograms/ml for HI-6, obidoxime, and PAM, respectively, the 24-hr mortality following sarin poisoning was 0, 90, and 20%. The serum oxime concentrations (ED50 values) for HI-6, obidoxime, and PAM against a 3 LD50 dose of sarin were 0.72, 9.05, and 2.56 micrograms/ml, respectively. HI-6 was determined to be the most efficacious oxime when combined with atropine against sarin poisoning followed in order by PAM and obidoxime. PMID- 3299874 TI - Experimental sensitization to subtilisin. II. Production of specific antibodies following inhalation exposure of guinea pigs. AB - We have previously reported the development of pulmonary sensitivity in guinea pigs exposed for 5 consecutive days to bacterial subtilisin in concentrations ranging from 1.9 to 15.0 mg proteolytic enzyme/m3. Animals exposed to lesser concentrations of 0.0083 and 0.041 mg/m3 failed to demonstrate this sensitivity. In the same study, animals exposed for 11 weeks to a subtilisin concentration of 0.00068 mg/m3 followed by 6 weeks to 0.0051 mg/m3 failed to demonstrate pulmonary sensitivity. We report here the antibody response in these animals. Both an enzyme-linked immunosorbent assay and a latex agglutination assay were developed for antibody detection. A concentration-related antibody response was detected in animals which had received acute subtilisin exposures of 0.0083 to 1.9 mg/m3. Antibody titers were not increased further upon exposure to higher subtilisin concentrations. A single 3-hr exposure to 1.9 mg/m3 resulted in the same antibody response as that produced following 5 days of exposure to the same concentration. The cumulative 17-week exposure of 1.12 mg/m3 X hr subtilisin resulted in 36% (9 of 25) of the animals producing significant levels of IgG or IgM antibodies. None of these animals demonstrated pulmonary sensitivity. These results indicate that the circulating antibody titer reflected antigen exposure levels and occurred at exposures below those necessary for production of pulmonary sensitivity. PMID- 3299875 TI - Cytotoxicity and induction of repairable DNA damage by photoactivated 5 nitrofurfural. AB - 5-Nitrofurfural (NFA) an important photodecomposition product and metabolite of medicinal nitrofurans is phototoxic in bacterial test systems. Its major photodecomposition product 5-hydroxymethylene-2(5H)-furanone (HMF) appears to be responsible for this. Furthermore HMF and photoactivated nitrofurfural can induce repairable DNA damage in Escherichia coli bacteria. These effects may be important with respect to skin and allergic reactions and carcinogenicity appearing in nitrofuran therapy. PMID- 3299876 TI - The effect of lead on cholinergic contractile function in the rat forestomach. AB - Previous studies have demonstrated that subchronic exposure to lead in rats slows gastric emptying. Therefore, the isometric contractile response of the forestomach from lead-treated rats was examined in vitro. Male Wistar rats were fed 4% lead acetate in their diet (NIH-07); controls were pair-fed. After 7 weeks, blood lead levels reached 180-389 micrograms/dl. The forestomach was dissected and suspended in buffer which for lead-treated rats contained 1.2 X 10( 5) M lead acetate. Subchronic lead exposure had no effect on the maximum tonic contraction induced by KCl, methacholine or serotonin. However, lead-treated tissue showed enhanced sensitivity to methacholine with a reduction in EC50 to 59.7% of control. This effect was not observed in control tissue exposed to lead (1.2 X 10(-5) M) only in vitro. Higher in vitro concentrations of lead (16 X 10( 5) M) produced an increase in methacholine EC50. Physostigmine-induced increase in tension was also significantly greater in tissue from lead-treated rats. Electric field stimulation, which produced a contraction attributable to postganglionic acetylcholine release, was unaltered in lead-treated tissue. These results indicate that lead intoxication did not impair the contractile apparatus of the forestomach smooth muscle. The lack of net effect on activation of intramural cholinergic neurons, despite the enhanced sensitivity to a cholinergic agonist, may indicate reduction in acetylcholine release in lead-treated tissue. PMID- 3299877 TI - A highly sensitive bacterial assay for toxins based on swarming inhibition, and comparison with the cup plate assay based on growth inhibition. AB - The motility inhibition of the swarming bacteria Proteus mirabilis and Azospirillum brasilense was found to be an appropriate parameter to indicate toxic effects caused by some mycotoxins, lactones and anhydrides of dicarboxylic acids. If these substances are in contact with the motile bacteria the following phenomena can be observed: at a certain toxin concentration the swarming of the bacteria is inhibited. If the concentration is increased the swarming ceases, and at still higher concentrations the bacteria are inactivated. In some instances swarming is stimulated at very low toxin doses. The sensitivity of this assay is comparable to the cup plate assay based on growth inhibition with Bacillus thuringiensis [Lenz, P. et al., Toxicology, 40 (1986) 199, Boutibonnes et al., Pharmacology, 11 (1983) 430] and in some cases it is even higher. PMID- 3299878 TI - Generation of free radical and hydrogen peroxide from 2-hydroxyemodin, a direct acting mutagen, and DNA strand breaks by active oxygen. AB - Among several hydroxylated metabolites of emodin, a fungal anthraquinone and constituent of rhubarb, 2-hydroxyemodin was a direct-acting mutagen showing a large electron-spin resonance (ESR) signal in the presence of DNA, especially at alkaline pH. Coupled with generation of free radical, hydrogen peroxide but not superoxide was formed. The active oxygen produced from 2-hydroxyemodin induced strand breaks in phi X 174 replicative form I DNA (supercoiled covalently closed circular duplex DNA). These results suggest a possible role of active oxygen in the process of mutagenesis. PMID- 3299879 TI - Use of tetramethylrhodamine-phallacidin in the morphological study of striated skeletal muscle. PMID- 3299880 TI - Unfixed material embedded in a methacrylate resin (Technovit 7100) for immunofluorescent staining. AB - Wheat grains were embedded with or without fixation in Technovit 7100 or in paraffin. This enabled us to produce 4 microns sections for immunofluorescent staining to see whether serum of patients with baker's asthma contained IgG antibodies against wheat grains. Embedding without fixation in Technovit 7100 appeared to be suitable for immunofluorescent staining and gave superior results to protocols requiring fixation. PMID- 3299881 TI - Some new methods for affixing sections to glass slides. II. Organic-solvent based adhesives. AB - Adhesion of various organic-solvent based adhesives to glass slides could be greatly improved by first priming the slide with a copolymer of allyl methacrylate and methacryloxypropyltrimethoxysilane. The use of different solvents and types of adhesives with these slides is discussed. Cellulose nitrate in different esters of acetic acid proved to be an effective adhesive for varied sections at room temperature and in the cryostat. Carbowax sections as a special case preferably were affixed with polyisobutylene in petroleum ether. Most of the attachments formed resisted even boiling water. PMID- 3299882 TI - Extracranial carotid arterial disease in patients with familial hypercholesterolemia and coronary artery disease treated with colestipol and nicotinic acid. AB - Carotid bifurcation atherosclerosis was demonstrated in 34 of 108 patients with familial hypercholesterolemia and coronary artery disease by B-scan, continuous wave Doppler sonography, and intravenous digital subtraction angiography. An intensive combined therapy of diet, colestipol, and nicotinic acid was mounted to control the hypercholesterolemia of these patients. Their serial sonographies and digital subtraction angiography were evaluated independently by technical specialists who served as coinvestigators. The data obtained suggest that extracranial arterial disease can develop concurrently with coronary artery disease in a significant proportion of patients with familial hypercholesterolemia, and amaurosis fugax, transient ischemic attack, cerebral infarction, and myocardial infarction did not recur during 58-72 months of control of familial hypercholesterolemia in this series of patients. PMID- 3299883 TI - Visually evoked dynamic blood flow response of the human cerebral circulation. AB - The dynamics of the metabolic mechanism that regulates cerebral blood flow was studied in 10 normal human subjects using a noninvasive transcranial ultrasonic Doppler method. Flow volume in the posterior cerebral artery, supplying the visual cortex, increased 20.2% in response to light stimulation of the retina, while flow velocity in the same artery increased 16.4%. The regulation of blood flow was very rapid; only 2.3 seconds elapsed from application of the light stimulus to 50% of full response. Full regulation (90% of full response) took 4.6 seconds. The blood flow response adapted slightly after about 10 seconds. Flow velocity in the middle cerebral artery increased significantly, by 3.3%, while flow in the superior cerebellar artery showed no significant change in response to this stimulus. These findings suggest the mechanism of very fast metabolic regulation of cerebral blood flow in humans. PMID- 3299884 TI - Transcranial Doppler in cerebrovascular disease. PMID- 3299885 TI - The clinical significance of gastrointestinal helminths--a review. AB - Gastrointestinal helminths (nematodes, trematodes and cestodes) constitute some of the most common and important infective agents of mankind and are responsible for much morbidity and some mortality. Whereas many symptoms and signs are confined to the intestine and less often the associated digestive organs, systemic manifestations are also numerous; this applies especially to indigenous populations of developing 'Third World' countries. Using a clinical classification these organisms can be broadly separated into those involving the small-intestine and those which have a colo-rectal distribution; of the former, a minority has been causally related to intestinal malabsorption. Clearly, however, not all gastrointestinal helminths are associated with disease and it is important to be able to separate these two groups; when present at high concentration and especially in infants and children some of the least pathogenic are not, however, entirely asymptomatic. Maintenance of a high 'index of suspicion' is necessary and this applied especially to 'western' populations in whom rapid and extensive travel to areas of the world with substandard sanitation and contaminated food and water supplies is now common; first evidence of infection in them may result from serious clinical complications. Recent advances have focussed on treatment, and especially the introduction of the benzimidazole compounds (especially albendazole) for nematode, and praziquantel for cestode, infections. Treatment of strongyloidiasis remains, however, unsatisfactory. Mass elimination of gastrointestinal helminths in developing 'Third World' countries remains a major challenge. PMID- 3299886 TI - The population dynamics and epidemiology of intestinal nematode infections. AB - The paper reviews recent studies on the population biology, transmission dynamics and epidemiology of intestinal nematode infections. Particular attention is given to patterns of change in average intensity of infection with age, the possible role of acquired immunity assessed via reinfection studies after chemotherapy, evidence of predisposition to heavy (or light) infection by single and multiple species of parasites and control by mass, selective and targetted chemotherapy. PMID- 3299887 TI - Nutritional aspects of infection. AB - Current knowledge is examined about the means whereby ascariasis, hookworm disease, strongyloidiasis and trichuriasis may contribute to the aetiology of human malnutrition. Results from experiments with related parasites in the laboratory have demonstrated the role of gastrointestinal helminthiases in animal malnutrition. Some evidence shows that in children, infection with the intestinal stages of Ascaris lumbricoides is associated with reduced growth rate, disturbed nitrogen balance, malabsorption of vitamin A, abnormal fat digestion, lactose maldigestion and an increased intestinal transit time. The main impact of hookworm infection is its relationship with iron-deficiency anaemia which may have effects at the community level as regards work and productivity in adults and learning and school performance in children. More research is needed to extend knowledge of the nutritional impact of ascariasis and hookworm disease in order to establish their public health significance. Research is needed also to identify the range of nutritional effects on man that occur as a result of trichuriasis and strongyloidiasis. The significance of less prevalent and more localized gastrointestinal helminthiases should not be ignored. PMID- 3299888 TI - Epidemiological aspects of Trichuris and trichuriasis in Caribbean communities. AB - The review argues for a reappraisal of the health significance of the human whipworm, Trichuris trichiura. Infections with this geohelminth are at least as prevalent as Ascaris lumbricoides in many localities, and are associated with significant morbidity. Infection may result in severe trichuriasis syndrome or, more frequently, in a chronic colitis associated with growth stunting. Under reporting of the chronic manifestations of disease has resulted in a gross under estimation of the health impact of trichuriasis. Furthermore, estimation of the population dynamical parameters of T. trichiura transmission suggests that whipworm infections are intrinsically more resistant to control than those of other common geohelminths. A major determinant of the transmission dynamics and morbidity characteristics of this helminthiasis is the aggregation of worm burdens in certain predisposed individuals and age groups. It is suggested that improved understanding of the factors generating this distribution of infection intensity is a pre-requisite for effective control of both infection and morbidity. PMID- 3299889 TI - Antigens of gastrointestinal nematodes. AB - Nematodes occupying the gastrointestinal (GI) tract of man shed an as yet undefined array of chemicals into their environment. To combat effectively the potentially debilitating disease caused by infection with these organisms we must (a) define the parasite products chemically, (b) determine their ability to induce protective immunity (or to counter a protective immune response), and (c) establish their potential for the diagnosis of infection. Whilst it has become clear that "antigens" can be derived from within the parasite and from the turnover of external cuticular components (the term "ES" must include both), further work is necessary to establish the significance of these molecules to the survival of the parasite. In this context, a number of questions will be answered in the near future. For example, how important is the hookworm protease to parasite nutrition? Can vaccination using the genetically engineered and purified enzyme generate protective immunity? Will the stichocyte secretions of Trichuris trichiura prove to be as immunogenic as those of Trichinella spiralis? (Surprisingly, little has been published with regard to the presence of enzymes in stichocyte secretions.) Are GI nematodes on the way out? PMID- 3299890 TI - Immunity in intestinal helminth infections: present concepts, future directions. AB - Although intestinal helminth and protozoan infections are prevalent throughout the world, their impact is poorly known. Nevertheless, the morbidity and mortality that occur have stimulated research into host resistance and pathogenesis. Unfortunately, despite an increasing knowledge base, the actual effector molecules which lead to parasite loss are unknown. IgA antibody, intraepithelial leukocytes and mucosal mast cells are thought to be involved. The role of these and other responses in making the intestinal microenvironment hostile to the parasite through effects of neurotransmission, epithelial cell differentiation and function, smooth muscle activities, and local inflammatory responses must be studied. Future research will include: further definition of the cellular and molecular immunologic repertoire of the intestine, identification of local effector molecules and investigation of interactions between antigen-specific immune responses and intestinal physiology. Studies of human infections will be more restricted but must include: assessment of parasite specific local immunologic responses, inflammatory events in the intestine, and development of relatively non-invasive techniques to study gastrointestinal physiology during parasitic infection. Perhaps most importantly, research facilities must be established in developing countries to investigate intestinal immunological, inflammatory and physiological responses during infection. Through such investigations, risk factors for susceptibility and disease severity may be identified and therapeutic or prophylactic strategies developed. PMID- 3299891 TI - Synergy of four macrolide antibiotics with chloroquine against chloroquine resistant Plasmodium falciparum in vitro. AB - The antimalarial activity of four macrolide antibiotics was investigated against the multidrug resistant K1 strain of Plasmodium falciparum in vitro. ID50 (50% inhibitory concentration) values for erythromycin, spiramycin, tylosin tartrate and oleandomycin phosphate in 48-hour assays were 1.6 X 10(-4)M, 2.5 X 10(-5)M, 1.2 X 10(-5)M and 9 X 10(-6)M respectively, and in 96 hour assays were 10(-5)M, 2.6 X 10(-6)M, 2.6 X 10(-6) and 3 X 10(-6)M, respectively. Comparable values were obtained in assays in which drug effect was quantified from either parasite counts or 14C isoleucine incorporation. Each of the four macrolides displayed synergy with chloroquine at the IC90 (90% inhibitory concentration) level, but at the IC50 level synergy was either less pronounced or absent. For each combination this difference in the degree of synergy was significant at the 95% level of confidence. In replicate assays in which 3H hypoxanthine was the marker of drug effect, synergy between chloroquine and either erythromycin or spiramycin could not be detected. PMID- 3299892 TI - In vitro susceptibility of Plasmodium falciparum to amodiaquine, mefloquine, quinine and chloroquine in Liberia, West Africa. AB - The in vitro susceptibility of seven Plasmodium falciparum isolates to four schizonticidal drugs was studied in Yekepa area, northern Liberia, by the Rieckmann 24-hour micro method. The seven patients were successfully treated with the standard chloroquine regimen. The results of the individual in vitro tests all indicated full susceptibility to the four drugs. By probit analysis, the drug concentrations achieving 50% (EC 50) and 99% (EC 99) inhibition, respectively, were 0.2 and 0.7 microM chloroquine, 0.04 and 0.2 microM amodiaquine, 0.01 and 0.07 microM mefloquine and 1.4 and 3.0 microM quinine. PMID- 3299893 TI - Whole blood concentrations of chloroquine and desethylchloroquine during and after treatment of adult patients infected with Plasmodium vivax, P. ovale or P. malariae. AB - Whole blood concentrations of chloroquine and desethychloroquine were determined during and after chloroquine treatment of 15 adult patients infected with P. vivax, P. ovale or P. malariae. The median of chloroquine concentrations remained practically unchanged in samples drawn three hours after initiation of treatment and in samples drawn immediately before the next dose of chloroquine. Concentrations of chloroquine remained above 1.0 mumol/litre for at least four days. The calculated sum of chloroquine and desethylchloroquine concentrations was above 1.0 mumol/litre for at least seven days. These concentrations are regarded as sufficient for treatment of P. vivax, P. ovale and P. malariae infections. PMID- 3299894 TI - Efficiency of papain-treated microfilariae of Wuchereria bancrofti (var. pacifica) as antigen for serodiagnosis of bancroftian filariasis in French Polynesia. AB - Papain-treated microfilariae of Wuchereria bancrofti have been used as antigen for indirect fluorescent assay: 0% of non-endemic sera, 8% of healthy exposed Polynesians, 48% of clinical patients and 96% of microfilaraemic subjects were positive by this test. The geometric mean titres were 22, 41, 147 and 605 respectively. Untreated microfilariae were unsuitable for diagnostic purposes. Dirofilaria immitis adult sections showed low reactivity, giving poor discrimination between non-endemic and microfilaraemic sera. The geometric mean titres were 6 and 61 respectively. PMID- 3299895 TI - Similarity in variable antigen type composition of Trypanosoma brucei rhodesiense populations in different sites within the mouse host. AB - Trypanosoma brucei rhodesiense subpopulations in different sites within the body of infected mice were isolated and enumerated on day 6 of cyclically transmitted infections. Most trypanosomes were in the blood vasculature and spleen but approximately 6% occurred in lymph nodes and about 9% were extravascular. Most of the extravascular trypanosomes were in the peritoneal and pleural cavities; significant numbers also occurred in the brain and kidneys. Six major variable antigen types (VATs) were detected by immunofluorescence using specific antisera and monoclonal antibodies. The prevalence of each VAT was essentially the same in subpopulations in the blood, mesenteric and inguinal lymph nodes, brain, kidneys and peritoneal and pleural cavities. This similarity of VAT composition in different subpopulations is probably caused by high rates of dynamic interchange of trypanosomes between sites. Extravascular trypanosomes, therefore, form a significant proportion of the total population in acute infections of mice but they do not appear to play any special role in the population biology of antigenic variation at this stage of infection. PMID- 3299896 TI - Failure of malaria chemoprophylaxis with a proguanil-chloroquine combination in Papua New Guinea. AB - Proguanil 200 mg daily and chloroquine base 300 mg weekly were used as prophylaxis for 120 British Army soldiers from Hong Kong on a seven-week jungle exercise in the highly malarious Sepik district of Papua New Guinea. Compliance was rigidly enforced. Four men developed falciparum malaria whilst in Papua New Guinea and one within a few days of returning to Hong Kong. After stopping chloroquine four weeks after returning to Hong Kong 11 cases of mixed vivax and falciparum malaria and three cases of falciparum alone occurred within a 16-week period. This proguanil-chloroquine combination allows an unacceptably high level of breakthrough malaria and cannot be recommended for visitors to the highly malarious areas of Papua New Guinea. PMID- 3299897 TI - Community laboratory work and hand held microscopes. PMID- 3299898 TI - Low parasite specific T cell response in clinically immune individuals with low grade Plasmodium falciparum parasitaemia. PMID- 3299899 TI - Further trials of a vaccine against American cutaneous leishmaniasis. PMID- 3299900 TI - Long term culture of Plasmodium falciparum in human erythrocytes with reduced K+ content. PMID- 3299901 TI - Clinical trial of benznidazole and an immunopotentiator against Chagas disease in Chile. PMID- 3299902 TI - Epidemiology of imported malaria in a hospital in Milan, Italy. AB - The main epidemiological features of 47 cases of malaria imported into Italy and diagnosed in Milan during the period 1980-84 are reported. Plasmodium falciparum was the most frequently found species and caused two deaths. In P. falciparum infections, the importance for epidemiological and therapeutic purposes of the evaluation of chloroquine sensitivity, not only with in vivo tests but also with in vitro techniques, is stressed. PMID- 3299903 TI - Race-linked differences in serum concentrations of dapsone, monoacetyldapsone and pyrimethamine during malaria prophylaxis. AB - Serum concentrations of dapsone (DDS), monoacetyldapsone (MADDS), the principal acetylated metabolite of DDS, and pyrimethamine (PYR) were measured in 55 Caucasian adults (31 males, 24 females) and 159 Papua New Guinean adults (140 males, 19 females) following the oral administration of Folaprim (100mg DDS; 12.5mg PYR). Blood samples were collected at mean sampling times of eight hours after medication and 18 hours before the next weekly dose for malaria prophylaxis. Clearance of DDS and MADDS from serum were significantly faster (p less than 0.001) in Caucasians than in Papua New Guineans. Significantly lower (p less than greater 0.001) serum concentrations of PYR were found in Papua New Guineans than in Caucasians at both sampling times, an observation which may reflect differences in the bioavailability of PYR between the two racial groups. The theoretical implications of these results are that Caucasians may be more susceptible to PYR-resistant Plasmodium falciparum malaria than Papua New Guineans whilst Papua New Guineans may be more susceptible to P. vivax; malaria than Caucasians. PMID- 3299904 TI - High level of chloroquine resistance in seven Plasmodium falciparum malaria cases from the Congo and Gabon. PMID- 3299905 TI - A double-blind comparison of the efficacy and safety of ivermectin and diethylcarbamazine in a placebo controlled study of Senegalese patients with onchocerciasis. AB - Ivermectin (MK-933) has been compared with diethylcarbamazine (DEC) and placebo in a double-blind study in 30 adult male Senegalese patients with Onchocerca volvulus infection. 10 patients were randomly assigned to each treatment group. Ivermectin was administered as a single oral dose of 12 mg and DEC as 50 mg daily for two days and 100 mg twice daily for the following six days, total 1.3 g in eight days. Skin O. volvulus microfilaria densities remained near pre-study values in the placebo patients, but decreased rapidly with both active drugs to mean values about 2% of pretreatment (Day 8) and then increased slowly, reaching in 12 months about 4% of pre-treatment (ivermectin) and 18% (DEC). This difference is statistically significant. Clinical adverse reactions were recorded in four ivermectin, ten DEC and three placebo patients. One ivermectin and six DEC patients received steroid treatment for relief of these reactions. Serious adverse ocular changes were not seen in any patients, possibly because of the steroid therapy in the DEC patients. Adult O. volvulus from onchocercal nodules one and six months after treatment showed no effect of either drug on viability. Intra-uterine developing forms of the microfilariae appeared normal in all three treatment groups at the one month examination but deformed and degenerated forms were evident at six months in the ivermectin group but not in the DEC and placebo patients. Ivermectin as a single oral dose appears to be a safer and more effective microfilaricidal drug in human onchocerciasis than DEC in the standard multi-dose regimen. PMID- 3299906 TI - Elution characteristics of bloodstream forms of three strains of Trypanosoma cruzi during isolation on DEAE-cellulose. PMID- 3299907 TI - Severe chloroquine-resistant falciparum malaria in Gabon with decreased sensitivity to quinine. PMID- 3299908 TI - The acquired immunodeficiency syndrome and transplantation. PMID- 3299909 TI - Prolonged survival of cultured keratinocyte allografts in the nonimmunosuppressed mouse. AB - The effect of in vitro culture on the survival of allografts of epidermal keratinocytes has been examined using a mouse model. Female BALB/c tail epidermal cells were cultured from single cell suspensions to form confluent sheets that were grafted onto male CBA recipients using a transplantation technique that ensured separation of donor graft from host skin. Animals were killed at defined intervals, and the status of the grafts determined histologically. Full thickness skin allografts rejected at 13-15 days. Allografts of epidermis (obtained by enzymatic cleavage at the dermoepidermal junction) rejected at 19-20 days. Cultured keratinocyte allografts were not rejected at least within 70 days and had a histological appearance identical to syngeneic controls. The expression of MHC class I and class II determinants and the leukocyte common (Ly5) surface marker on the donor cells before and after culture were examined using indirect immunofluorescence and monoclonal antibodies. These and other cytochemical studies showed that freshly dissociated tail epidermal cells contained 0.3% of cells that expressed membrane-bound ATP-ase activity, Ia antigens, and the Ly5 surface antigen. These are the Langerhans' cells of the epidermis. In culture, these cells decrease so that by day 8 of culture, no such cells can be detected. At confluence, there are no Ia positive cells, but all cells express MHC class I antigens and stain with an antikeratin antibody. The loss of Ia expression on culture correlates with a decreased stimulation of the class II H-2d-restricted T cell clone D7.1 by cultured keratinocytes compared with freshly dispersed epidermal cells. Furthermore, cultured keratinocytes fail to prime allogeneic mice as determined by the survival of whole thickness skin grafts, whereas freshly dispersed cells induce an accelerated rejection. The results suggest that the survival of cultured keratinocyte allografts is due to the elimination of cells expressing Ia antigens and supports the passenger leukocyte theory of graft rejection. PMID- 3299910 TI - Release of platelet-activating factor from rabbit heart perfused in vitro by sera with transplantation alloantibodies. AB - During "hyperacute rejection" of rabbit heart perfused with transplantation alloantibodies, platelet activating factor (PAF) was released into the coronary effluent, which appeared to have physicochemical and functional properties similar to the 1-octadecyl-2-acetyl-sn-glyceryl-3-phosphorylcholine (synthetic PAF) and to PAF obtained from IgE-sensitized rabbit basophils. The release of PAF was associated with an early tachycardia, followed by increasing bradycardia and conduction arrhythmias, as well as decrease of coronary flow and of amplitude of electrogram. The heart stopped beating within 30 min. The release of PAF as well as the "rejection" required the presence of fresh rabbit serum as a source of complement. The PAF receptor antagonist SRI 63-072 in a dose of 0.6 mg, reversed by 70% the reduction of coronary flow within 2-4 min after its addition to the perfusate; ED50 was 0.4 mg. Bradycardia and arrhythmia were reduced; however, the normal electrical activity was only occasionally restored. The cessation of heart action was delayed up to 50 min after the beginning of perfusion with transplantation alloantibodies and complement, but it was not prevented. These results suggest that PAF is released during "rejection" of the heart perfused in vitro with serum containing transplantation alloantibodies in the absence of inflammatory cells and that this mediator is at least in part responsible for the deterioration of cardiac function. PMID- 3299911 TI - Interference by cyclosporine with the endocrine function of the canine pancreas. AB - This study addresses itself to the eventual interference of cyclosporine (CsA) with the function of pancreatic beta cells in vivo. We have used dogs that had at least six weeks previously been subjected to segmental pancreatic autotransplantation. This model has been well established to be associated with stable normoglycemia but with incomplete endocrine reserve capacity, which renders it suitable for detecting eventual toxic drug effects. CsA was administered for 6 weeks in an oral dose of either 30 mg/kg/day (first series of 4 dogs) or 40 mg/kg/day (second series of 7 dogs). CsA trough levels in blood were determined at least weekly, and the mean of the levels in each dog ranged from 218 to 1274 ng/ml, with one exception (2191 ng/ml). The endocrine function was tested not only before and after 6 weeks of CsA administration, but also at 4 weeks after cessation of CsA administration. The postprandial insulin output was reversibly reduced in the first series (P less than 0.05) and the i.v. glucose stimulated insulin output was reversibly reduced in the second series (P less than 0.001). Other parameters, like postprandial peak and mean blood glucose levels and K-values, showed reversible changes that, although not always statistically significant, were compatible with a reversible suppressive effect by CsA in all instances. Finally, we found that the severity of suppression as expressed in individual reduction of i.v. glucose-stimulated insulin output correlated with the individual mean CsA trough level (r = 0.71, P less than 0.015). It is concluded that CsA exerts a detrimental effect on the function of canine beta cells in vivo, which effect is reversible and dependent upon the CsA blood level. PMID- 3299912 TI - Bulk purification of a naturally occurring soluble form of RT1-A class I major histocompatibility complex antigens from DA rat liver, and studies of specific immunosuppression. AB - We describe the bulk purification of a water-soluble form of RT1-A class I MHC antigens from aqueous extracts of DA liver. Using a combination of monoclonal antibody affinity, lentil lectin affinity, and gel permeation chromatography, we were able to obtain large quantities of pure water-soluble RT1-A antigens. Typically, from 40 DA livers, 0.5 mg of pure antigen with antigen activity equivalent to 7 X 10(9) nucleated DA spleen cells was obtained. The water-soluble RT1-A molecule had a discrete heavy chain of 40 kD, linked noncovalently to beta 2 microglobulin. The heavy chain of the water-soluble RT1-A molecule was 5 kD smaller than the membrane-bound form of RT1-A from DA liver membranes. The smaller molecule probably represents a secreted form of RT1-A class I molecules that lack the transmembrane domain (exon 5). Large quantities of this water soluble RT1-A class I antigen from the DA strain, given intravenously to PVG recipients of DA cardiac allografts by a variety of protocols, did not have any effect on graft survival. The fairly ready availability of milligram quantities of pure class I transplantation antigens should be of considerable value for studies in transplantation. PMID- 3299913 TI - Nontyphoid Salmonella infections after renal transplantation. PMID- 3299914 TI - Arteriovenous fistula involving a transplant kidney. PMID- 3299915 TI - Thrombocytopenia and autoimmune hemolytic anemia following renal transplantation. PMID- 3299916 TI - Donor-specific transfusions in renal transplantation in children. Effect of azathioprine plus transfusions. PMID- 3299917 TI - A blue kidney in a living donor. PMID- 3299918 TI - Human immunodeficiency virus transmission by organ donation. Outcome in cornea and kidney recipients. AB - The human immunodeficiency virus (HIV) is reportedly transmitted by sexual contact, sharing of infected needles among intravenous drug abusers, blood and blood products, artificial insemination, and kidney transplantation. This study reports on cornea and kidney recipients of two HIV-infected donors. HIV was transmitted to two kidney recipients who developed symptoms of acute HIV infection (i.e., fever, leukopenia, mild thrombopenia, splenomegaly) starting 12 days after transplantation. These signs of acute infection ended with seroconversion of HIV antibodies on approximately the 56th day after transplantation. The three cornea recipients showed no signs of acute infection and no HIV antibodies were detected up to three years after transplantation. The nontransmission observed in our cases, however, may not be representative of cornea transplantations in general. HIV is neurotropic in the later stages of the disease, and transmission of other neurotropic viruses like rabies and Creutzfeldt-Jakob disease by cornea transplantation has been reported. All tissue and organ donors should be tested for anti-HIV prior to donation. PMID- 3299919 TI - Blocking antibodies and T cell subsets in long-term survivors of renal allografts. AB - Fc-receptor blocking antibodies as well as T cell subsets were studied in a group of 12 long-term survivors of renal allografts. The absolute number of T suppressor cells was similar to that found in a control group, but there was a significant decrease in the total number of T helper lymphocytes and a decreased helper/suppressor ratio. Sera from all patients tested showed inhibitory activity in the erythrocyte antibody model against leukemic B lymphocytes, demonstrating the presence of Fc-receptor blocking antibodies. Also inhibited was the ability of normal human lymphocytes to form E rosettes and to induce a local xenogeneic graft-versus-host reaction. These findings indicate that the Fc blocking antibodies are beneficial to the patient, possibly by abrogating the cellular and humoral immune mechanism that is detrimental to the kidney allograft. PMID- 3299920 TI - Phenotypic composition and in vitro functional capacities of unmodified fresh cells infiltrating acutely rejected human kidney allografts. AB - Cell surface markers of isolated graft-infiltrating cells (GIC) were studied, and functional in vitro assays performed in 8 cases of acute irreversible rejection of human renal allografts. The GIC were mostly activated T cells (OKT11+, OKT3+, Ia+), with predominance of the cytotoxic/suppressor T cell phenotype (OKT8+). A small proportion of B cells and monocytes/macrophages were also present among these GIC. The GIC were able to proliferate with lectin of allogeneic stimulation and were strongly cytotoxic toward specific donor target cells. Within the T cell subset, OKT8+ cells displayed most of the specific cytotoxicity. Despite allograft morphology typical of cellular rejection, anti-HLA complement-dependent antibodies and antibody-dependent cell cytotoxicity were found in the eluted material from rejecting kidneys. The results of our phenotypic and functional testing of unmodified GIC (no enzyme treatment, no additional culture with or without interleukin 2), show that T cells, especially OKT8+ cells, are of paramount importance in the mechanism of this type of acute irreversible rejection of human renal allografts (i.e., to the point of allograft rupture), but other potential effector mechanisms are also present in situ. PMID- 3299921 TI - Posttransplant antidonor lymphocytotoxic antibody production in relation to graft outcome. AB - Serial serum samples from 266 recipients of primary renal allografts were monitored posttransplant for the presence of panel reactive lymphocytotoxic antibodies (PRA). The minimum posttransplant follow-up period was 18 months. Patients were classified according to whether or not they produced PRA before and/or after transplantation. The groups were as follows: PRA negative before and after transplant, -/-, 171; PRA positive before and negative after transplant, +/ , 5; PRA positive before and positive after transplant, +/+, 27; PRA negative before and positive after transplant, -/+, 63. Actuarial graft survival at 1 year for each group was 81.3%, 100%, 70.4%, 47.6%, respectively. Fifty-five of the 63 /+ recipients were retrospectively crossmatched with posttransplant sera against stored donor lymphocytes. Of these, 50 (91%) were posttransplant cross match positive, and 37 (67%) have lost their grafts. In 23 of the 26 cases where an anti-HLA specificity was defined, the antibody was directed against antigens present in the donor but not in the recipient. These results clearly indicate that the production of PRA in recipients of renal transplants is associated with antidonor reactivity and poor graft outcome. The fact that these PRA were often directed against donor HLA antigens emphasizes one of the hazards of mismatching for HLA at transplantation. PMID- 3299922 TI - Antiidiotypic antibodies to human major histocompatibility complex class I and II antibodies in hepatic transplantation and their role in allograft survival. AB - In order to evaluate the role of antiidiotypic antibodies to anti-MHC in human liver transplant recipients, serial serum samples obtained from 10 liver recipients both pre- and posttransplantation were analyzed for the development of HLA alloantisera inhibitory activity by a microcytotoxicity inhibition assay. Seven of the 10 recipients developed strong anti-anti-HLA activity during the immediate posttransplant period, which was able to block killing of a specific alloantiserum to class I MHC antigens (44-100%). Recipients' sera were also able to block class II alloantisera (HLA-DR8) cytotoxicity of B-lymphocytes. The inhibitory activity developed 10-15 days posttransplantation, was cyclical, and was present in the immunoglobulin fraction of the serum. One patient developed specific antibodies to anti-HLA-B7 and had no inhibition for alloantisera to HLA B8,B17,B49 and B13. Another developed antibodies capable of blocking anti-HLA B44 (mismatched donor antigen) and also cytotoxicity of HLA-B17,B49 (crossreactive group), but showed no significant inhibition of HLA-B13,B8 and B7. One recipient, transplanted across strong (1:500 titer) antilymphocyte crossmatch, rejected the graft within 1 month and failed to develop any inhibitory antibodies to anti-HLA. Two other patients who lost their grafts within 2 months posttransplantation developed only minimal (11% and 16%) and transient inhibition. Immunoprecipitation of surface-labeled, mixed lymphocyte culture stimulated lymphocytes, with sera containing inhibitory antibodies, identified membrane components of approximate molecular weights of 54,43 and 17,000, suggesting T cell clonotypic structures. Thus, these studies provide support for the development of antiidiotypic antibodies to anti-MHC in human liver transplant recipients, which may play a regulatory role in the tolerance of allograft. PMID- 3299923 TI - Graft-versus-host disease prevention in allogeneic bone marrow transplantation from histocompatible siblings. A pilot study using immunotoxins for T cell depletion of donor bone marrow. AB - Seventeen patients, ages 7-53 years were transplanted with histocompatible bone marrow that had been depleted of T lymphocytes by ex vivo immunotoxin (IT) treatment. Twelve patients had high-risk acute leukemias, and five had chronic myelogenous leukemia. No other graft-vs.-host disease (GVHD) prophylaxis was used. A mixture of three anti-T-cell monoclonal antibodies conjugated to ricin were used in this study: TA-1, UCHT-1 (anti-CD3), and T101 (anti-CD5). The mean number of bone marrow cells infused was 1.5 X 10(8) mononuclear cells/kg recipient weight. Thirteen of the 17 patients demonstrated complete and sustained engraftment. Four patients experienced autologous marrow recovery and/or graft rejection. Compared with an historical group of leukemic patients who received GVHD prophylaxis with methotrexate alone or combinations of methotrexate, and prednisone plus antithymocyte globulin, (ATG) or OKT3, the IT patients with stable engraftment demonstrated shorter time to recovery of leukocytes greater than or equal to 1000mm3 for three consecutive days (median, 20 days vs. 26 days, P = .03). The recovery of total lymphocytes, B and T cell subsets, and T cell function by day 28 was highly variable, but similar, for patients in both the IT treated group and historical controls. Four patients (ages 13, 18, 21, and 38) developed grade II skin GVHD, but none had severe GVHD. Eight of the 13 patients with durable engraftment have had posttransplant leukemic relapse. Currently only four patients remain alive; two have not relapsed posttransplant, while the other two achieved remission following posttransplant relapse. We conclude that severe GVHD was not observed in this small series with ex vivo T cell depletion for GVHD prophylaxis, and that favorable recovery of hematologic and lymphocytic function was demonstrated for cases where primary engraftment was sustained. A larger randomized controlled study will be needed to establish whether T cell depletion of donor bone marrow with IT can significantly reduce GVHD, and/or improve disease-free survival. PMID- 3299924 TI - Effect of posttransplantation administration of peripheral blood lymphocytes in skin-grafted mice treated with antilymphocyte serum or antilymphocyte serum plus bone marrow. AB - Posttransplantation administration of donor-specific bone marrow cells to ALS treated allograft recipients produces graft survival that is greater than that produced by ALS treatment alone. We have now studied the effect of peripheral blood lymphocytes (PBLs) in a mouse skin allograft model using this protocol (C3H skin grafted to B6AF1 mice, day 0; i.p. ALS on days -1 and +2; i.v. bone marrow days +6 or +7). When PBLs are injected in place of bone marrow cells, graft survival is extended beyond that noted for control mice given ALS only. The timing and specificity of this phenomenon suggest that it resembles the effect produced by posttransplant bone marrow administration and not that associated with pretransplant blood transfusion. The PBLs active in graft prolongation are Thy-1-negative and display a density in Percoll gradients similar to that of the active marrow cells. In contrast, when PBLs are injected in combination with bone marrow cells, the length of graft survival is shortened in comparison with that produced by bone marrow alone. The cells associated with this partial abrogation of the effectiveness of bone marrow appear to be mature T cells; this abrogation cannot be produced by PBLs treated with anti-Thy-1 plus complement or by thymocytes, but it is a property of lymph node cells enriched for T cells by nylon-wool fractionation. This study suggests that clinical application of this posttransplantation induction of specific allograft unresponsiveness can be facilitated by the use of peripheral blood lymphocytes rather than marrow, sparing a living organ donor from having to undergo bone marrow harvest. Additionally, the data indicate that contamination of marrow with blood lymphocytes should be minimized. However, the density gradient fractionation method that we have found to be effective in preparing the graft prolonging bone marrow cells simultaneously removes the PBLs deleterious to graft survival. PMID- 3299925 TI - Long-term survival of skin allografts in rats treated with topical cyclosporine. AB - The use of topical cyclosporine (CsA) was studied in skin allografts from Buffalo to Lewis rats. CsA prepared in olive oil and dimethyl sulfoxide was administered in various dosages topically on allografts. Untreated allografts were rejected in 7.4 +/- 1.1 days but survived for 18.6 +/- 0.9, 29.3 +/- 1.8, or 40.6 +/- 2.2 days after 10, 20, or 28 days of topical CsA treatment (10 mg/rat/day), respectively. Long-term graft survival (greater than 100 days) was seen with continuous CsA treatment at 10 mg/rat/day, 10 mg/rat/2 days, and 5 mg/rat/day, as compared with rejection in 13.1 +/- 2.3 and 8.9 +/- 0.9 days with CsA 10 mg/rat/3 days and 5 mg/rat/2 days, respectively. The therapeutic blood level of CsA ranged from 250 to 500 ng/ml. Most grafts were rejected when CsA blood levels fell below 200 ng/ml. Direct administration of topical CsA onto the allografts resulted in longer survival compared with those applied on the normal recipient skin 6 cm distal to the allografts, with both high and low doses. Locally high concentrations of CsA in allografts may play an important role in prolongation of graft survival. Minimal cell infiltration and loss of hair follicles were the main histological features in long-surviving allografts (greater than 120 days). PMID- 3299926 TI - Characterization of xenogeneic mouse-to-rat bone marrow chimeras. I. Examination of hematologic and immunologic function. AB - Eighteen xenogeneic chimeric rats (survival: greater than 100 days) were established by transplanting bone marrow cells from femurs of 10 gnotobiotic CFW mice into each germfree Sprague-Dawley or Wistar rat. The erythrocytes circulating in the rats were of mouse origin as determined by hemagglutination. Hemoglobin electrophoresis, radial immunodiffusion for IgG, and assay of granulocytic neutrophils for leukocyte alkaline phosphatase verified that true chimerism was achieved. The extent of hematological and immunological reconstitution varied. In general, hematocrit levels were low to normal, white blood cell counts and differentials were within normal limits, and serum protein levels were normal. Levels of circulating IgG of each species were comparable to those of germfree rat and mouse controls. Natural killer (NK) activity was depressed, a phenomenon that may be attributable to the radiation treatment of recipients, or to failure to transfer NK cells or precursors. Mitogenic stimulation reactions were varied, but most chimeric rats demonstrated moderately depressed responses. Reactions as a whole suggested that gnotobiotic rats with xenogeneic bone marrow are incompletely reconstituted, both hematologically and immunologically. No acute graft-versus-host reaction was seen. PMID- 3299927 TI - A comparison of cyclosporine A and Nva2-cyclosporine (cyclosporine G) in a rat renal allograft model. AB - We compared CsG and CsA in the DA-to-Lewis rat renal allograft model. At equivalent oral doses, plasma radioimmunoassay (RIA) CsG levels were higher than CsA (P less than 0.02). Neither drug prevented rejection at doses of 5 mg/kg/day. CsG-treated rats had a higher rejection rate at doses of 7.5 mg/kg/day (P less than 0.05). Both drugs were equally effective in preventing rejection at doses of 10 mg/kg/day. Neither drug was nephrotoxic at the doses used in this study. CsG is a potent immunosuppressant, and thus a potential clinical successor to CsA. Since CsG and CsA provide equivalent immunosuppression at therapeutic doses, CsG's clinical significance will ultimately depend on its nephrotoxicity in man. PMID- 3299928 TI - Immunological competence and host-specific tolerance of antibody-facilitated bone marrow chimeras. AB - We have generated murine antibody-facilitated (AF) bone marrow chimeras in the genetic combination P1----(P1 X P2)F1 by the simultaneous injection of P1 bone marrow cells and anti-P2 MHC monoclonal antibody into normal (unirradiated) adult (P1 X P2)F1 recipients. These mice have normal life spans and appear to be healthy, with no overt signs of graft-versus-host disease. We have undertaken an extensive survey of the ability of stable, long-term AF chimeras to generate immune responses in vitro and in vivo. Both T and B lymphocyte functions have been analyzed in proliferative and effector cell assays. The AF chimeras respond normally to mitogenic as well as antigenic stimuli, and exhibit normal capacities for cellular collaboration in the generation of immune responses. However, splenic lymphocytes from AF chimeras are substantially and specifically hyporesponsive or nonresponsive to host, P2-encoded, alloantigens in in vitro assays of cell-mediated immunity. This host-specific tolerance is exhibited by the cytotoxic T lymphocyte lineage; T helper cells necessary for the generation of a cytotoxic response may also have decreased reactivity to host determinants. We conclude that our protocol for the production of AF chimeras does not compromise the immune system of chimeric animals but does allow the maintenance of host-specific tolerance, after stable equilibrium has been attained. PMID- 3299929 TI - Idiopathic ulcerative colitis--clinical problems, controversies and what's new. PMID- 3299930 TI - Proximal gastric vagotomy: sixteen years on. PMID- 3299931 TI - Sonographic evaluation of jaundice in Benin-City, Nigeria. A preliminary report. AB - We performed sonographic evaluations on 14 jaundiced patients over a six months period. Medical jaundice was correctly diagnosed in three, as confirmed by the subsequent clinical course. Sonographic features of surgical jaundice were identified in the remaining 11 cases, five of which were confirmed through either percutaneous transhepatic cholangiography, surgery and pathology or both. Sonography is efficacious in the work-up of jaundice; since the technique is affordable and versatile, it is particularly relevant in developing economies where available resources are limited. PMID- 3299932 TI - Recurrent meningitis of 5 years duration due to Cryptococcus neoformans. AB - A patient with recurrent meningitis over five and a half years due to Cryptococcus neoformans is reported. The relapsing course and the unusual diagnostic features are emphasized. PMID- 3299933 TI - A case of falciparum malaria acquired in Italy. AB - The first case of Plasmodium falciparum malaria acquired in Italy after the eradication of the disease is reported. The P. falciparum strain was sensitive to chloroquine in vitro and in vivo. It seems most likely that an infective mosquito of tropical origin was responsible for transmission. PMID- 3299934 TI - Multiple enteric pathogens in a patient with diarrhoea. AB - A woman who recently arrived in Canada from India developed a febrile, diarrhoeal illness. Stool culture revealed the presence of Salmonella typhi, Campylobacter fetus subspecies jejuni and Shigella flexneri. Concurrent infection with these three pathogens does not appear to have been previously reported. The possibility of multiple pathogens should be considered in travellers who fail to respond to treatment of a single organism. PMID- 3299935 TI - [Changes in the surface and cytoskeletal apparatus of the endotheliocytes of the rat aorta during division (based on scanning electron microscopic data)]. AB - Endothelium of the abdominal aorta of 32 KWR-line rats was exposed to freeze injury. En face preparations were made to look for endothelial cells (EC) on different stages of mitosis. Specimens were dried by critical point technique, and the grid was placed on their surface. Then specimens were investigated in succession with light and scanning electron microscopes. The cytoskeleton of EC was investigated on detergent-extracting preparations. It is shown that the end of phase S of the cell cycle and the beginning of prophase are characterized with the lifting of the nuclear-containing zone. Fine microvilli appear on the EC surface during prophase. The cytoskeleton becomes more structured and polarized. During metaphase, EC becomes spherical, its microvilli are shortened. Fine cytoplasmic shoots are seen to extend from the cell poles to the substratum. The density of the fibrillar structures swiftly rise. During anaphase the EC surface is covered with blebs. During late telophase the surface of dividing EC becomes flatter. Their nuclei are connected with rare bundles of fibrillar structures. Mechanisms of EC surface changes during mitosis and the role of cytoskeletal elements are discussed. PMID- 3299936 TI - Reverse phase passive haemagglutination test for the detection of rinderpest antigen. AB - Reverse phase passive haemagglutination [RPHA] test was applied for the detection of rinderpest antigen in various organs of rinderpest infected cattle. The results of RPHA were compared with counter immunoelectrophoresis [CIE] and single radial haemolysis [SRH] test. RPHA was as sensitive as CIE and SRH in detecting rinderpest antigen. PMID- 3299937 TI - [Florence Nightingale and nursing]. PMID- 3299938 TI - [Protein immunoblot and immunodot in biochemical studies]. AB - General notions on the protein immunoblot and immunodot are reported. Possibilities of their wide application in biochemical studies are discussed. The employed materials, the most important operations when performing different variants and modifications of these methods as well as resolution and advisability of their application are comprehensively analyzed. PMID- 3299939 TI - [Characteristics of mRNA and cDNA of fructose-1,6-diphosphate aldolase]. AB - Problems concerning synthesis of fructose-1,6-diphosphataldolase A (EC 4.1.2.13) in vitro, and localization in a cell and sizes of mRNA of this enzyme are considered in the review. The following items are described: methods for production and properties of individual mRNA and cDNA of the aldolase isoenzymes; making of the amino acid sequence of the aldolase isoenzyme forms according to the nucleotide sequence of mRNA and cDNA and peculiarities of isoform structure in different tissues of animals; structure of mRNA and cDNA of FDP-aldolase in the norm and under pathology and mechanisms of the appearance of nonspecific enzyme isoforms. Regulation of protein biosynthesis under pathology is considered as exemplified by mRNA and cDNA of FDP-aldolase. PMID- 3299940 TI - [Angina pectoris and the pharmacology of coronary circulation]. PMID- 3299941 TI - [Has cimetidine lived up to expectations in the treatment of ventricular ulcer?]. PMID- 3299942 TI - [Ultratard human insulin]. PMID- 3299943 TI - [Diet and diabetes mellitus. A review]. PMID- 3299944 TI - [The value of clinical examination, microscopy and culture for Candida and Trichomonas vaginalis vaginitis]. PMID- 3299945 TI - [Diet and cancer. A review]. PMID- 3299946 TI - [Occupational diseases in musicians]. PMID- 3299947 TI - [Consciousness during anesthesia]. PMID- 3299948 TI - [A comparative study of intensive conventional insulin treatment and a multiple insulin-injection regimen with NovoPen]. PMID- 3299949 TI - [Benign non-parasitic splenic cysts]. PMID- 3299950 TI - [Domperidone in the treatment of irritable colon. A placebo-controlled double blind study]. PMID- 3299951 TI - [Treatment of non-acute gynecological patients in a 1-day section. A trial arrangement in the Department of Gynecology and Obstetrics, Hillerod Central Hospital]. PMID- 3299952 TI - [Maxillary surgery in cleft palate reconstruction. Surgical reconstruction of teeth, mouth and jaws in cleft lip and cleft palate]. PMID- 3299953 TI - [Standardized provocation for determination on non-specific bronchial reactivity]. PMID- 3299954 TI - [Sleep apnea]. PMID- 3299955 TI - [The effects of neuroleptics on tardive dyskinesias. A video-controlled, randomized study of chlorprothixene, perphenazine, haloperidol and haloperidol + biperiden]. PMID- 3299956 TI - [N-3 poly-unsaturated fatty acids and their possible role in the prevention of disease. A review with special attention to ischemic heart disease]. PMID- 3299957 TI - [Postoperative control of pain by intrathecal morphine]. PMID- 3299958 TI - [Lectins. Biological, research and clinical aspects]. PMID- 3299959 TI - [Naloxone and acute severe alcoholic intoxication]. PMID- 3299960 TI - Dependence of ultrasonic velocity in rabbit liver on water content and structure of the tissue. AB - This paper investigates the dependence of ultrasonic velocity in rabbit liver on the water content and tissue structure. The results obtained indicate that the composition and water content of the liver tissue but not its structure determine the value of velocity. PMID- 3299961 TI - [Sonography as a screening method in suspected rupture of the rotator cuff]. AB - We have found ultrasonography of the shoulder in differentiating between normal rotator cuff and rotator cuff lesion according to trauma a very helpful method. In comparison to arthrography it is a quick and painless method without any risk. Whereas other authors report a sensitivity of 100% and a specificity of 94% in shoulder disease we recommend ultrasonography in acute shoulder trauma as a screening method. Pathological findings in ultrasonography will make the decision for arthrography easy. The major diagnostic pitfall is the calcified tendon of the rotator cuff. PMID- 3299962 TI - Shrinking and disappearing renal cysts. AB - This paper presents 4 patients with what were thought to be hemorrhagic renal cysts that disappeared on follow-up, and an additional patient with a large superficial simple cyst that became smaller on follow-up examination. In 1 patient only was this appearance associated with renal scarring. One patient had uremic-acquired cystic disease of the kidney. The reasons for the disappearance or shrinkage are unclear, but might include bleeding into the cyst or rupture of the cyst into the perirenal space or the collecting system. PMID- 3299963 TI - Cystic renal melanoma: CT/ultrasound correlation. AB - A new computed tomographic and sonographic appearance of renal metastatic melanoma is described. Bilateral cystic masses with thick walls, many with mural nodules, were noted. Sonography also demonstrated complex echopenic masses with irregularly thickened walls and mural nodules. PMID- 3299964 TI - Polar infarct in a transplanted kidney: cause of a pseudomass. AB - Ultrasonography has become fairly standard for assessing common complications of renal transplantation such as hydronephrosis, urinomas, and lymphoceles. Infarctions are a less common complication that may occur in the setting of transplant rejection. We report a case in which an apparent solid mass on sonography proved to represent normal residual renal parenchyma in a kidney with a small shrunken lower pole due to infarction. PMID- 3299965 TI - Diagnosis of cystitis glandularis. AB - Bladder tumor mass may represent a benign lesion and the diagnosis of cystitis glandularis should be considered and cystoscopically evaluated. PMID- 3299966 TI - Optimal precision in ultrasound attenuation estimation and application to the detection of Duchenne muscular dystrophy carriers. AB - This paper deals with the measurement of the attenuation of ultrasound in muscle and its application to the detection of Duchenne Muscular Dystrophy (DMD) carriers. The precision obtained when measuring the attenuation is an important parameter to be considered. A statistical approach is taken on simulated data and compared to in vivo results. The results allow discussion for the minimum tissue volume needed for the estimation. Variations in muscle attenuation between normals were obtained from studies on 27 volunteers. These attenuation values were compared to those obtained from 19 carriers of DMD. Attenuation appears to be a potential clinical indicator of DMD carriers. PMID- 3299967 TI - Correlations of sound speed with tissue constituents in normal and diffuse liver disease. AB - The speed of sound in normal and diffusely-diseased liver specimens was measured. There were four experimental groups, consisting of normal (n = 21), fatty (n = 7), fibrotic (n = 7) and mixed fatty and fibrotic (n = 9). These classifications were based on histological grading. We found that the results corroborate and extend most of the results of Bamber and coworkers. Specifically, no significant correlation was found between speed of sound and fibrosis score; a moderate correlation was found between speed of sound and tissue water content; and a relatively good correlation (r = -0.670, p less than 0.1%) was found between the speed of sound and the histological fat score, which increased to r = -0.819 (p less than 0.1%) when a correction for variations in water content was used. PMID- 3299968 TI - [Significance of sonographic diagnosis of fetal abnormalities of the urinary tract]. AB - Out of 5,209 fetuses, routinely screened at our prenatal clinic 56 fetuses with malformations of the urinary tract were diagnosed. In 37 cases dilatation of the urinary tract was found. Five fetuses presented with unilateral multicystic kidneys whereas 3 fetuses suffered from bilateral polycystic kidney disease and 11 were found to have bilateral non-functioning kidneys. Prenatal diagnosis of dilatation of fetal urinary tract and of unilateral multicystic kidneys allows referral of these newborns for further urological evaluation before symptoms are present. Refinement in prenatal diagnosis of bilateral polycystic kidney disease and bilateral non-functioning kidneys helps evaluating fetal viability. PMID- 3299969 TI - [Dilatation of the upper urinary tract in pregnancy--incidence, severity and follow-up. A sonographic study]. AB - Incidence, onset and degree of the dilatation of upper urinary tract as well as the course throughout pregnancy was sonographically assessed in 310 pregnant women without symptoms from the urinary tract. 30 patients were regularly observed from the 16th week of gestation until delivery and within one week post partum. A grading system based on maximum calyceal diameter was used. 25% showed dilated calyces, primiparae more often than multiparae. The right kidney was dilated in 56, the left in 3 and both kidneys in 20 women. No decrease in parenchymal diameter was found during longer lasting dilatation of the pelvicalyceal system. Within one week after delivery the dilatation disappeared in nearly all cases. A gradual linear increase in incidence and severity of dilatation throughout pregnancy was found. PMID- 3299970 TI - [Value of percutaneous diagnosis and therapeutic procedures in obstructive uropathy following kidney transplantation]. AB - Postrenal obstruction is a severe complication after renal transplant. To evaluate side effects and effectiveness we analyzed 71 ategrade pyeloureterographies (AP) and 30 percutaneous and open nephropyelostomies. AP shows a sensitivity of 93% and proved thereby its superiority to alternative diagnostic procedures. Also percutaneous pyelostomy proved its reliability in therapy of obstructive disease. Comparing side effects to those in normal kidneys we found a higher incidence of bleeding (17%). There was no severe complication with loss of graft. In 6 cases of obstructive disease we could prevent an operation by temporary percutaneous nephrostomy. Long term nephrostomy allows to evaluate the function of the kidney accurately which may not be possible until after 1-2 months. PMID- 3299971 TI - Oncogenes: their role in neoplasia. PMID- 3299972 TI - Management of obstruction and resultant complications in transplant kidney by endoscopic and percutaneous techniques. AB - Management of obstructive complications in a renal transplant patient are most efficiently performed using endoscopic and percutaneous techniques where possible. A case of such obstruction managed by placement of an internal stent is described. An unusual complication involving the fracture of the stent was also managed percutaneously. PMID- 3299973 TI - Phantom kidney--a pitfall in radionuclide study of urinary tract. AB - A survey was done on 39 nephrectomized patients who underwent our routine radionuclide kidney study including blood flow imaging at various periods postoperation. Perfusion of varying degree was demonstrated in the area of the nephrectomized kidney in 17 patients showing equal or less activity than the actual kidney. This so-called phantom kidney was reproducible in the same patient and was found four weeks to ten years after nephrectomy. Thirteen phantom kidneys were found on the left side and four on the right. Seven were after simple nephrectomy, four after radical nephrectomy, and six after nephroureterectomy. Besides being a source of error in interpretation in kidney imaging, the appearance of this residual postnephrectomy blood flow is difficult to explain, particularly in the cases of radical nephrectomy. PMID- 3299974 TI - One hundred years of clinical science: a view from the United Kingdom. PMID- 3299975 TI - Atherosclerosis and its complications: contributions from the Association of American Physicians, 1886-1986. PMID- 3299976 TI - Acceptance of the George M. Kober Medal. PMID- 3299977 TI - One hundred years of clinical science--an overview of contributions through the Association of American Physicians. PMID- 3299978 TI - Cortisone and the adrenal cortex. PMID- 3299979 TI - Insulin and diabetes. PMID- 3299980 TI - Presentation of the George M. Kober Medal to Lloyd H. Smith, Jr. PMID- 3299982 TI - Association of American Physicians. List of members. PMID- 3299981 TI - Presidential address. PMID- 3299983 TI - Glucocorticoid and thyroid hormone regulation of angiotensinogen gene expression in a pancreatic islet cell line. AB - The renin-angiotensin system is an important regulator of blood pressure and volume homeostasis in mammals. Angiotensinogen, a precursor of the octapeptide angiotensin II and an effector of the renin-angiotensin system, is synthesized in numerous rat tissues. Angiotensinogen is expressed in an islet cell line (RIN 1056A) derived from a rat pancreatic tumor. Angiotensinogen mRNA detected by Northern analysis is abundant in the cell line and is approximately 200 bases longer than the mRNA isolated from rat liver, due to both a longer poly(A) tract and the use of a second polyadenylation site. Dexamethasone is a potent inducer of angiotensinogen mRNA, producing a progressive accumulation from 3 to 96 hr in culture (9-fold above control levels). The dexamethasone effect is competitively inhibited by the glucocorticoid antagonist RU486, and transcription rate assays using isolated nuclei indicate that the effect is primarily at the transcriptional level. PMID- 3299984 TI - Mutant insulin syndrome: identification of two families with [LeuA3]insulin and determination of its biological activity. PMID- 3299985 TI - Effects of dietary calcium on sodium volume vs. renin-dependent forms of experimental hypertension. PMID- 3299986 TI - Parasitized erythrocyte antigens and thrombospondin adhesion in the immunology and pathogenesis of falciparum malaria. AB - Falciparum-parasitized erythrocytes develop new antigens on the erythrocyte surface. Both antimalarial antibody and thrombospondin bind to surface antigens or ligands on the surface of the infected red cell. Diverse antigens may be involved in parasite evasion of host immunity, but conserved molecules may be required for pathogenesis. There is a high degree of antigenic diversity at the infected erythrocyte surface among isolates. This diversity may underlie the potential of falciparum malaria to repeatedly reinfect the same person. There is also evidence for an antigenically conserved, possibly functionally conserved, determinant on the infected red cell surface. Antibody to a conserved determinant on the infected red cell surface may be associated with immunity to falciparum malaria. A conserved membrane surface determinant may be involved in parasitized erythrocyte sequestration. Thrombospondin binding in vitro is specific to mature trophozoites and schizonts, the same stages which sequester in vivo. Specific adhesion to thrombospondin is common among laboratory strains of falciparum parasitized erythrocytes bearing knobs and among all isolates of falciparum tested. The numbers of parasitized erythrocytes bound to thrombospondin in vitro increases with parasitemia. Specific binding of parasitized erythrocytes to an endothelial receptor and to thrombospondin, which itself interacts with clotting factors, may play a role in sequestration and vascular obstruction. PMID- 3299987 TI - Actions of estradiol on the pulsatile secretion of bioactive luteinizing hormone in man. AB - We evaluated the impact of estradiol on bioactive LH release in normal men by steady-state intravenous infusions of estradiol and oral administration of the antiestrogen tamoxifen HCl. The secretion of biologically active LH was monitored by the rat interstitial cell testosterone bioassay. Estradiol infusions decreased mean plasma bioactive LH concentrations and diminished the bio/immuno LH ratio. Conversely, the antiestrogen tamoxifen increased bioactive LH pulse frequency, bioactive LH pulse amplitude, and the plasma bio/immuno LH ratio. Exogenous injections of GnRH at 2-hr intervals also increased the bio/immuno LH ratio basally. However, tamoxifen attenuated the ability of exogenous GnRH to increase the bio/immuno LH ratio further, indicating attainment of maximal enrichment in LH bioactivity. These complementary observations on the impact of infused estradiol and exogenous antiestrogen indicate that estradiol modulates the pulsatile secretion of LH molecules enriched in biological activity in man. PMID- 3299988 TI - Retroviral-mediated gene transfer into hematopoietic cells. PMID- 3299989 TI - [Evaluation of different methods for preventing ciliochoroidal detachments after trabeculectomy]. PMID- 3299990 TI - [Role of different methods of forming a conjunctival flap in the effectiveness of antiglaucoma operations]. PMID- 3299991 TI - [Combined use of computed tomography and ultrasonic scanning in the diagnosis of posttraumatic intraocular pathology with the presence of an intraocular foreign body]. PMID- 3299992 TI - [Dopplerography in anterior ischemic ophthalmic neuropathy]. PMID- 3299993 TI - [Acoustic B-scanning of the eye using the grey scale]. PMID- 3299994 TI - [Experimental morphological research on the surgical correction of posttraumatic cicatricial deformities of the anterior eye segment]. PMID- 3299996 TI - [Analytical methods in the early diagnosis of glaucoma using computer technology]. PMID- 3299995 TI - [Myorelaxants in ophthalmology]. PMID- 3299997 TI - [Founder of Russian histology and pathological anatomy of the organ of vision (on the 150th anniversary of the birth of Prof. A. V. Ivanov)]. PMID- 3299998 TI - Fetal loss in the dog and cat. AB - Occurrence and type (resorption, abortion, stillbirth, mummification) of pregnancy loss in the dog and cat depend on the cause of the loss and the stage of gestation at which it occurs. General categories of known causes of embryonic or fetal death in the dog and cat include chromosome and developmental abnormalities of the fetus, infectious agents, maternal endocrine abnormalities, trauma, exogenous drugs, uterine torsion, and dystocia. Diagnosis of fetal loss and of cause of fetal loss relies on the history, physical examination, abdominal radiography and ultrasonography, serology, hormone assay, and on culture, pathology, and karyotype of fetal/placental tissue. Aggressive diagnostics at the time of fetal loss are essential to preventive strategies at subsequent pregnancies. PMID- 3299999 TI - The effect of maternal illness on perinatal health. AB - Only healthy animals should be included in a breeding program. The potential effects of maternal illness and therapeutic agents on the fetus or neonate are often ignored until veterinary assistance becomes an absolute necessity. We must be mindful of these effects in order to minimize maternal and neonatal morbidity and mortality. PMID- 3300000 TI - Congenital and acquired neuromuscular disease of young dogs and cats. AB - Neuromuscular disorders in small animals include a diverse group of congenital and acquired diseases. The prognosis will vary according to the disorder and the portion of the motor unit affected. A number of diseases might be satisfactorily treated (for example, myasthenia gravis, congenital myotonia), whereas others may be self-limiting (for example, hereditary myopathy of Labrador Retrievers). Accurate diagnosis is necessary for establishing a prognosis and treatment plan suitable to the patient and client. Specific diagnosis in the absence of specialized tests is difficult, although not always impossible (for example, congenital myotonia in the Chow Chow). A knowledge of the neuromuscular diseases that might affect small animals, a detailed history, and a thorough physical examination will help in the presumptive diagnosis. Specialized laboratory examinations may need to be applied (for example, antiacetylcholine receptor antibody titer for acquired myasthenia gravis). Referral may be necessary for more detailed diagnostic workup (for example, electromyographic examination, nerve or muscle biopsy examination). In the case of inherited neuromuscular disorders, a knowledge of inheritance patterns will allow genetic counseling to avoid future problem breedings. PMID- 3300001 TI - Esophageal, gastric, and intestinal disorders of young dogs and cats. AB - Digestive tract disorders are common diagnostic and therapeutic problems among young dogs and cats. Prompt and effective symptomatic therapy is necessary in all cases, and is sufficient in many. Parasitic and protozoal problems require attention to kennel management as well as to individual treatment. Chronic and congenital disorders are often extremely challenging diagnostic dilemmas. PMID- 3300002 TI - Urologic disorders of immature cats. AB - Numerous inherited and congenital disorders may affect the urinary system of cats. Those associated with clinical signs include renal dysplasia, renal hypoplasia, polycystic kidneys, ectopic ureters, urachal anomalies, and fistulas between the lower urinary tract and other structures. Acquired disorders of the urinary system of immature cats have been uncommonly recognized. Further studies are warranted to better define their prevalence in immature cats. PMID- 3300003 TI - Immunohistochemical demonstration of desmin in canine smooth muscle tumors. AB - Sections of formalin-fixed, paraffin-embedded canine leiomyomas, leiomyosarcomas, or fibrosarcomas were examined by immunohistochemical methods for the presence of desmin. Twenty-two leiomyomas and leiomyosarcomas were stained using the avidin biotin complex technique, and 14 samples demonstrated positive staining for desmin. The eight negative results obtained may reflect differences in fixation or the affinity of the primary antibody for the tissues examined. Desmin was specific for myogenic tissues. Five canine fibrosarcomas examined immunohistochemically were all negative for desmin staining. The results indicate that desmin is a useful marker for immunohistochemical identification of canine leiomyomas and leiomyosarcomas. PMID- 3300004 TI - Spontaneous nonneoplastic gastric lesions in female Han:NMRI mice, and influence of food restriction throughout life. AB - A life span study of 900 female virgin Han:NMRI mice (300 outbred controls, 300 of a fat subline, and 300 of a lean subline) was done to determine the occurrence of spontaneous disease with ad libitum or restricted feeding. Major nonneoplastic lesions in the glandular stomach were erosions, ulcers and adenomatous hyperplasia of the fundus. Ulcers, ranging in incidence with ad libitum feeding from 5 to 9% and with food restriction from 13 to 34%, either occurred secondary to other diseases or were due to stress associated with food restriction, causing death mainly in the lean subline. Adenomatous hyperplasia was most common in the control group (41%); the frequency increased with age and was significantly reduced by food restriction. The etiology of adenomatous gastric hyperplasia is yet unknown. However, a lack of antiparietal cell antibodies, as determined by an immunofluorescent technique, indicates that an autoimmune disorder is not involved and an increase in antral gastrin cells, as determined by avidin-biotin peroxidase immunocytochemistry, suggests a hormonal involvement in pathogenesis. PMID- 3300005 TI - Ovarian choriocarcinoma in the mouse. AB - Choriocarcinoma is one of the rarest ovarian tumors in any animal species. This paper describes the gross and microscopic appearance of seven such neoplasms in B6C3F1 mice. Mean age at death was 47 weeks. Tumors were described at necropsy as dark or hemorrhagic cystic lesions. On microscopic examination tumors were composed of hematocysts, intercellular hemorrhage, and cytotrophoblasts, syncytiotrophoblasts, and/or trophoblastic giant cells. Cytotrophoblasts, syncytiotrophoblasts, and occasional giant cells were present in three cases while the other four tumors contained only trophoblastic giant cells. PMID- 3300006 TI - Experimental Haemophilus somnus pneumonia in calves and immunoperoxidase localization of bacteria. AB - Pneumonia was produced in nine, conventionally reared calves by intrabronchial inoculation with Haemophilus somnus. Volumes of pneumonic lung were determined stereologically, following serial slicing of lungs fixed by vascular perfusion. Twenty-four hours after inoculation, consistent findings were: neutrophilic to fibrinoid vasculitis, degeneration of alveolar macrophages, necrotizing bronchiolitis, suppurative bronchopneumonia, lobular necrosis, and dilation and thrombosis of lymphatics. Bacteria were identified histologically by an immunoperoxidase technic and were either free in alveoli or associated with degenerative alveolar macrophages. The latter suggests that macrophage degeneration may be a result of bacteria/macrophage interaction. Immune complex deposition is unlikely to be the principal mechanism for the vasculitis because bacterial antigen was not generally found in necrotic vessel walls, and two colostrum-deprived, H. somnus antibody-negative calves also had neutrophilic vasculitis 12 to 24 hours after inoculation with the lowest dose of H. somnus used in the above experiment. PMID- 3300007 TI - Mediastinal ganglioneuroma in a puppy. PMID- 3300008 TI - Pathogenesis and transmission of AIDS. AB - AIDS is a slow virus disease caused by a lentivirus. The silent incubation period following infection usually lasts many years, during which the infected person is potentially infectious to others. Pathological changes accumulate imperceptibly. When major symptomatic disease develops it is eventually fatal. The epidemic spread of the virus is new in Africa, as well as in North America and Europe. Twenty-five per cent of people infected with the virus die within seven years of infection. The ultimate mortality 20 years after infection cannot yet be known, but it may turn out to be close to 100 per cent. It is already apparent that AIDS is the most lethal epidemic viral disease of humans known to medical science. Flaws in the generally accepted hypothesis that AIDS is a sexually transmitted infection are exposed. It has been, characteristically, a blood-borne infection in the early years of the epidemic. However, the AIDS virus is exceptionally unstable genetically and it is probable that means of transmission more efficient than through blood have already developed. PMID- 3300009 TI - Echographic diagnosis of twin pregnancy in thoroughbreds. PMID- 3300010 TI - A reassessment of the dual vaccine against rinderpest and contagious bovine pleuropneumonia. AB - In the light of the recent outbreaks of rinderpest in Africa a further assessment of the efficacy of the simultaneous inoculation of rinderpest virus vaccine and contagious bovine pleuropneumonia vaccine was undertaken. Groups of cattle were inoculated with a dual preparation of rinderpest vaccine virus and Mycoplasma mycoides subspecies mycoides or M mycoides alone. These groups were then challenged with M mycoides, first unsuccessfully by an in-contact challenge method and then by subcutaneous challenge. All animals were examined clinically after challenge for evidence of contagious bovine pleuropneumonia and serologically for rinderpest virus and M mycoides mycoides antibodies. There was no evidence that the serological response to the dual vaccine was in any way less than that to either agent given alone and no clinical disease was detected in these animals after in-contact challenge. However, after subcutaneous challenge, the dual vaccinated groups reacted similarly to an unvaccinated control group and unlike the group vaccinated only with M mycoides. This would indicate that the rinderpest virus component of the dual vaccine interfered with the ability of the M mycoides component to induce a fully effective immune response. In the pan African rinderpest campaign the use of the dual vaccine in areas where contagious bovine pleuropneumonia occurs should be carefully considered; in areas where the disease does not occur it is contraindicated. PMID- 3300011 TI - Haematogenous osteomyelitis in cattle. AB - The examination of 70 cattle with haematogenous osteomyelitis resulted in the classification of the bone lesions into two main groups: the physeal type, in which an infection, usually of metaphyseal bone, originated at or near the growth plate, usually in the distal metacarpus, metatarsus, radius or tibia, and the epiphyseal type, in which an infection originated near the junction of the subchondral bone and the immature epiphyseal joint cartilage, most often in the distal femoral condyle epiphysis, the patella and the distal radius. Combinations of physeal and epiphyseal defects and even diaphyseal involvement were occasionally seen. Epiphyseal osteomyelitis was mostly caused by salmonella infection, physeal by Corynebacterium pyogenes, salmonella and other bacteria. The salmonella affected animals were with one exception less than 12 weeks old and the majority had had some previous illness or came from a problem herd. The C pyogenes affected calves were in almost all cases more than six months old. The prognosis of the metaphyseal infection was in general satisfactory, and surgical intervention (osteotomy or sequestrectomy) was often required. The prognosis of the epiphyseal type was grave but two of the three animals in which physeal and epiphyseal defects were accompanied by diaphyseal lesions recovered. PMID- 3300012 TI - Virulence factors in Escherichia coli isolated from piglets with neonatal and post-weaning diarrhea in Japan. AB - A total of 567 strains of Escherichia coli were isolated from piglets with neonatal diarrhea (ND) or post-weaning diarrhea (PWD) in Japan. They were investigated for enterotoxigenicity and possession of adhesins and O antigens. There were clear differences between the strains of ND origin and those of PWD origin in the occurrence of enterotoxigenic E. coli (ETEC) strains, type of enterotoxin and frequency of adhesins: ETEC was found in 77 (25.7%) of 300 strains of ND origin and in 137 (51.3%) of 267 strains of PWD origin. ETEC strains producing heat-labile enterotoxin (LT) or heat-stable enterotoxin (STa), alone or in combination were evenly distributed among the strains of PWD origin. In contrast most of the ETEC strains of ND origin produced LT alone. Adhesins appeared in 42 (54.5%) of 77 ETEC strains of ND origin and in 36 (26.3%) of 137 ETEC strains of PWD origin. Adhesins were less common in ETEC strains of PWD origin than in those of ND origin. Some K99-positive ETEC strains of PWD origin produced both LT and STa. There was a similarity in the distribution of O antigens, particularly O149 and O157, between the strains of ND origin and those of PWD origin. PMID- 3300013 TI - Isolation of Legionella pneumophila from calves and the prevalence of antibodies in cattle, sheep, horses, antelopes, buffaloes and rabbits. AB - The lungs of 139 calves presented for autopsy and 29 healthy slaughtered calves were examined for Legionella by culture and by direct immunofluorescence (DIF) with fluorescein-conjugated antisera. About 17% of the cadaver lungs and 4% of lungs from slaughtered animals were positive by DIF. Legionella organisms were only isolated from the lungs of two cadavers (L. pneumophila, serogroup 1). In a prevalence study of antibodies to Legionella in domestic and wild animals of various species, titers of greater than or equal to 64 were demonstrated by indirect immunofluorescence in sera of 10% of dairy cattle, 5% of beef cattle, 4% of sheep, 22% of antelopes, 35% of horses, 36% of buffaloes and 0% of laboratory rabbits. The isolation of Legionella from lung tissue is evidence for a possible etiologic role of Legionella spp. in natural pathology of animals. PMID- 3300014 TI - Proteolytic activity of the cowpea mosaic virus encoded 24K protein synthesized in Escherichia coli. AB - The function of the 24-kilodalton (24K) protein encoded by cowpea mosaic virus (CPMV) has been studied by constructing a bacterial expression plasmid that contained a cloned chimeric segment consisting of partial DNA copies of CPMV M RNA (including sequences coding for both capsid proteins) and B-RNA (including sequences coding for the 24K protein). Viral sequences were transcribed from the phage T7 promoter phi 10 of plasmid pT7-6 using T7-RNA polymerase expressed from plasmid pGP1-2 present in the same cells. Upon inducing the synthesis of T7-RNA polymerase several new polypeptides that contained CPMV-specific sequences were expressed, as demonstrated by immunoprecipitation and immunoblotting. Furthermore a proteolytic activity was detected in induced cells which cleaved the viral protein sequences specifically at two glutamine-glycine sites. One of the cleavage products represented capsid protein VP23. The proteolytic activity was absent when an 87-bp deletion was introduced in the coding region for the 24K protein, indicating that this protein represented the protease involved in the proteolytic processing at those specific sites. PMID- 3300015 TI - [Microclimate problems in airplanes (review of the literature)]. PMID- 3300016 TI - [The newspaper "Pravda" on the revolutionary speeches of students at the Military Medical Academy]. PMID- 3300017 TI - [The Sevastopol' letters of N. I. Pirogov]. PMID- 3300018 TI - [The Central Hospital of the Yugoslav National Liberation Army and Yugoslav Resistance Movement in Jasikovac]. PMID- 3300019 TI - [Blood insulin and characteristics of nitrogen metabolism in organs during myocardial necrosis developing after emotional stress]. AB - Simulation of myocardium necrosis developed after emotional stress led to hyperinsulinemia and hyperglycemia simultaneously with a decrease in arterial venous difference of oxygen. In control, stress-treated animals, hypoinsulinemia and hyperglycemia were detected. Dissimilar alterations in nitrogen metabolism were observed in heart and brain tissues of the animals with myocardium necrosis under conditions of anomalous insulin secretion and glucose consumption. During the first steps of myocardium necrosis after emotional stress increase in content of nucleic acids, ammonium, urea as well as activation of leucine aminopeptidase were found in heart of the animals. At the same time, a number of compensatory reactions, involved in nitrogen metabolism, were not found in brain of the animals with myocardium necrosis; distinct activation of leucine aminopeptidase was detected in the tissue. PMID- 3300020 TI - [Biologically active metabolites of membrane glycerophospholipids in normal conditions and in pathologic states]. AB - The data on biological role of numerous phospholipid metabolites, main part of which is localized in cell membranes, are reviewed. Many of these metabolites are related to slowly reacting substances of anaphylaxis and participate in allergic and inflammatory reactions. Conditions of biosynthesis of phospholipid active metabolites are characterized in the reactions of lipid peroxidation, N acetylation, formation of Shiff bases, enaminales via transacetylation, by the action of phospholipases, lipooxygenase, cyclooxygenase, by formation of plasmalogens, phosphomonolipids, phospholipid diols. Role of individual phospholipid metabolites in normal and pathological states is discussed. PMID- 3300021 TI - [The role of prostaglandins in the activation of sugar transport into the rat diaphragm]. AB - Kinetic parameters of D-xylose (nonmetabolized analogue of glucose) transport were studied in isolated rat diaphragm in presence of insulin and prostaglandins E2 and F2 alpha. Prostaglandins E2 and F2 alpha simultaneously with insulin were found to increase the rate of D-xylose transport by 49 +/- 3% and 19 +/- 2%, respectively, which occurred due to increase in Vmax, while Km value of the carrier-sugar complex was unaltered. PMID- 3300023 TI - Which are the appropriate modifications of existing regulations designed to prevent the transmission of malaria by blood transfusion, in view of the increasing frequency of travel to endemic areas? PMID- 3300022 TI - WES, a 'new' infrequent blood group antigen in Finns. AB - A previously unrecognized infrequent blood group antigen WES occurs with a frequency of 0.56% in the Finnish population, but has an ethnically restricted distribution. Apart from Finns it was found only in 2 donors, most likely of African origin, among 4,655 people tested who represented many different ethnic groups. WES is shown to be a dominant autosomally inherited character different from previously published infrequent antigens. The data allow exclusion from almost all established blood group systems. The WES antigen is destroyed by enzymes alpha-chymotrypsin and pronase. It is also present in plasma of WES+ individuals. Evidence suggests that the soluble form of the antigen is a high molecular weight protein constituent of plasma. Unlike many other antigens present on red cells as well as in plasma, the WES antigen is well developed on red cells of neonates and can also be found in cord serum. PMID- 3300024 TI - Fundamental discoveries in immunohematology and immunogenetics by Ludwik Hirszfeld. PMID- 3300025 TI - The "Bombay" (Oh) blood group. PMID- 3300026 TI - Alloimmunization to red cell antigens in thalassemia: comparative study of usual versus better-match transfusion programmes. AB - Transfusion records and serological data concerning 120 regularly transfused thalassemic children were followed up, beginning with their first transfusion, for a 5-year period. All patients had been phenotyped for 18 red cell antigens before their first transfusion. The usual-match (UM) group consisted of 64 children who received blood compatible with their ABO and Rho (D) antigens. The better-match (BM) group comprised 56 children who received blood compatible with ABO, CcDEe and K antigens. It was found that a statistically significant difference does not exist in the overall frequency of alloimmunization between the UM (23.43%) and BM group (14.28%) and also between the children that started transfusion therapy before they were 12 months old regarding UM (9%) and BM policies (5.2%). However, a large numerical difference, which might become statistically significant with a larger number of patients was observed in the group of children who were started on transfusions after they were 12 months old, between the UM (38.7%) and BM (18.9%) policy. Finally, a statistically significant difference (less than 0.005) was found only between the children that started transfusions early (7.69%) and those that started them later in life (27.9%), irrespective of the transfusion policy observed. We report, in this study, the mean transfusion numbers of immunized and nonimmunized patients and the frequency, specificity and clinical significance of the identified antibodies are analyzed. Our conclusion is that a BM policy in transfusion programmes, including at least the Rhesus and Kell antigens, is recommended for all thalassemic children that start transfusion therapy after they are 12 months of age; if they start earlier, observation of the BM policy is not necessary. PMID- 3300027 TI - Human immunodeficiency virus antibody screening in blood donors from India, Nigeria and Thailand. AB - Screening for human immunodeficiency virus (HIV) (LAV/HTLV-III) antibodies in 3 blood donor populations from India (n = 1,000), Nigeria (n = 500) and Thailand (n = 650; sampling in 1982) with a sensitive enzyme immunoassay (EIA; Abbott) yielded seropositivity rates of 0.5, 2.2 and 1.7%, respectively. Two EIAs with control antigens prepared from uninfected cell cultures ('ELAVIA', VIRGO'), a recombinant Escherichia coli DNA EIA ('ENV/CORE'), Western blot, an immunofluorescence assay and a radio-immunoprecipitation assay confirmed none of the EIA-reactive specimens as truly positive. The lack of specificity of the screening test was also attributable to monochromatic evaluation of the test trays at 492 nm only, and to reactivities against determinants of H9 cells used to grow HIV (HLA antibodies). PMID- 3300028 TI - Monoclonal anti-K14 and anti-K2. AB - Mouse hybridoma clones have produced monoclonal antibodies directed against the K:14 and K:2 high-incidence antigens of the Kell blood group system. Two examples of anti-K14 were isolated, each arising from a separate fusion procedure. All three monoclonal antibodies are of the immunoglobulin class IgG1. Serological activity is consistent with that seen with human antibodies to high-incidence Kell system antigens, and their epitopes are destroyed, as usual, by 2 aminoethylisothiuronium bromide treatment. Specificity was further confirmed by adsorption and elution studies. Tests against nonhuman primate red cells demonstrated the expression of K:14 only by the great apes, whereas K:2 was present on all red cells tested. These findings emphasize the usefulness of monoclonal antibodies to elucidate the evolutionary patterns of blood group variants. PMID- 3300029 TI - [Natural cytotoxic lymphocytes (natural killers) and their role in resistance to viral infections]. PMID- 3300030 TI - [Detection and identification of host cell antigens in the composition of influenza B virus]. AB - Two heterogeneous antigens, Forssman antigen and an antigen similar to human group A antigen, were detected by enzyme-immunoassay in cells of normal chick embryo CAMN and MDCK culture (dog kidney). Both these antigens were associated with purified influenza B virus preparations reproduced in these cultures since the variants under study actively reacted with antibodies both to Forssman antigen and to human A antigen. Serological differences between the variants grown in different cell systems were due to the presence in their composition of the species-specific cell component typical either of chick embryo tissues or MDCK cultures, since the viruses of chicken origin contained the specific cell antigen CAMN, whereas the same viruses grown in MDCK did not contain it but had the specific activity for dog kidney cells. The virus-specific activity of the variants under study showed no significant differences in relation to host cells. PMID- 3300031 TI - [Use of immunoenzyme analysis employing a staphylococcal protein A conjugate with peroxidase in the serodiagnosis of influenza]. AB - A test-system was developed on the basis of solid-phase enzyme-immunoassay using protein A/peroxidase conjugate for the determination of antibody levels to influenza virus in sera of humans who had experienced a natural infection or received a live influenza vaccine. The accurate observation of the test conditions was demonstrated to give the results well correlating with those of the HI test. The use of isolated hemagglutinin as the antigen considerably increased the specificity of the enzyme-immunoassay and in a number of cases detected a 4-fold or higher rise of antibody titres to hemagglutinin in paired sera of the vaccinees where the HI test showed no rise in antibody titres. PMID- 3300033 TI - [Circulating immune complexes--their properties, methods of determination and importance for the diagnosis and therapy of diseases]. PMID- 3300032 TI - [Results of coded trials of the activity of the trivalent subunit influenza vaccine Grippovak in Moscow kindergartens in December 1983 through the 1st quarter of 1984]. AB - During the autumn-winter epidemic of influenza-like diseases in December, 1983- first quarter, 1984, in Moscow commissioned coded observations on the effectiveness of prophylactic vaccination against influenza of 3-7-year-old children with a preparation "Grippovak SE-AZh" were carried out in day-care centers. In the previous large-scale trials, 1981-1984, the "Grippovak" had been evaluated positively as a completely harmless, serologically and immunologically active preparation reducing 3-3.5-fold the number of laboratory-verified cases of viral type A and B influenza in the vaccinees. In 1986, however, the "Journal of Microbiology, Epidemiology, Immunology" (JMEI, 2: 49-54) published a paper whose authors, on behalf of the Commission which had checked the preparation in the day care centers (Z.A. Bashliaeva, A.A. Sumarokov, et al.), came to a conclusion that "Grippovak" was ineffective in children. Other members of the above Commission disagreeing with this conclusion made a repeat analysis of the decoded materials of the observations in the day-care centers using computer methods and demonstrated that because of significant prevalence of non-influenza ARD cases and recurrent (up to 44%) ARD cases in children in the 4 months of observation, it was impossible to judge the effectiveness of the vaccine by comparison of the total incidence of influenza and ARD from the clinical data alone in the vaccinees and controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300034 TI - [Glycosylated proteins]. PMID- 3300035 TI - [Coronary spasm in the etiopathogenesis of ischemic heart disease]. PMID- 3300036 TI - [Zinc-containing protoporphyrin and hemoglobin]. PMID- 3300037 TI - [Functional criteria for the differentiation of leukemic cells. II. The fungicidal activity of the blast cells from patients with acute monoblastic leukemia]. AB - The studies in the present work are a continuation of the previous studies of the author's on the functional activity of leukosis cells and discuss their fungicidal activity versus Candida albicans. Blast cells from 22 patients with various clinical-morphological forms of acute leukosis were studied. It has been concluded from the results obtained that leukosis cells of monoblast type in acute myelomonoblast (M4) and monoblast (M5) leukosis are able to lyse Candida albicans, the value of their fungicidal activity being lower than that of mature monocytes from peripheral blood of healthy subjects. The fungicidal activity is observed in leukosis cells from patients with promyelocyte (M3) leukosis. The authors propose the fungicidal activity of leukosis cells to be used as an additional, functional criterium in the differentiation of their type. PMID- 3300038 TI - Prevalence of asymptomatic bacteriuria in a West Virginia Health Department Clinic. PMID- 3300039 TI - Historiography in nursing research. PMID- 3300040 TI - [Maximilian Stoll (1742-1787) on the 200th anniversary of his death 23 May 1987]. PMID- 3300041 TI - [Orthotopic heart transplantation--experiences at the University Surgical Clinic II in Vienna (status: June 1986)]. AB - Since 1984 27 heart transplantations (HTX) were carried out in 25 patients at the 2nd Department of Surgery, University of Vienna. The classic orthotopic technique of Lower and Shumway was used in all cases. Routine immunosuppression consisted of azathioprine and cyclosporin-A. In order to treat the main complications successfully, i.e. rejection and infections, we were compelled to establish an extensive follow up regimen. The early recognition of acute rejection was based on the findings obtained by cutaneous as well as epicardial ECG leads, in conjunction with cytoimmunological monitoring on the basis of RIA measurements of the serum levels of Neopterin and gamma-Interferon. Furthermore, we recorded some parameters of ventricular performance, such as the isovolumetric relaxation time and the radiologically measured heart volume. An endomyocardial biopsy was carried out to secure the diagnosis. Pulsed doses of methylprednisolone were used for the treatment of rejection, facultatively combined with ATG in the absence of improvements. Infections were pinpointed by comprehensive serum tests and various blood, sputum and urine cultures. The management consisted of treatment with the requisite antibiotics. Of 25 primarily transplanted patients 15 patients are still alive. 5 persons, amongst them 2 children, have survived already for more than 1 year. 6 patients died at an early stage. In 3 cases the cause of death was intractable infection. In 1 case multi-organ failure occurred and 1 patient died due to acute organ failure. 4 patients died at a late stage and acute severe rejection was responsible in all these cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300042 TI - [Basic-bolus therapy of diabetic children and adolescents using Novo Pens]. AB - A multiple injection regimen using a pen-injector (Novo Pen) was applied to 34 diabetic adolescents (age: 15.4 +/- 2.4 years). During the observation-period of 6 months HbA1c fell significantly from 8.98 +/- 0.31 to 7.82 +/- 0.25 rel%. At the end of the study all patients wanted to continue this regimen considering the advantage of improved life quality compensating for the inconvenience of multiple injections. PMID- 3300043 TI - [Diagnosis and treatment of an occult intrauterine device]. AB - Between February 1978 and December 1985 53 women with lost intrauterine devices (IUD) were treated. To exclude unrecognized expulsion and to locate the device sonography was primarily employed. In 90.6% of cases a correct diagnosis was established. Only in 9.4% of cases a plain X-ray of the abdomen was necessary because sonography was not diagnostic. In 47 patients (88.7%) the IUD could be located by hysteroscopy and was removed. Using biopsy forceps or curette. Of the remaining 6 cases there were 4 with perforation and intraabdominal dislocation, 1 spontaneous expulsion in the interval between diagnosis and admission to the hospital and 1 case of endometrial incrustation which escaped hysteroscopic diagnosis. PMID- 3300044 TI - [Ultrasound-guided cyst puncture of the human breast]. AB - For mammadiagnosis sonography should be used only carefully directed as a supplement investigation. Excellent results in diagnosis, treatment and follow up examinations are obtainable, if sonography is employed together with mammography and puncture-cytology as triple-diagnosis. With the help of sonography localisation and puncture of not palpable cysts is possible. Together with pneumocystography the diagnosis is reliable, biopsies can be reduced. Follow up examinations must be done periodical. The employment of sonography reduces the numbers of radiographs. In a scheme our procedure is clearly arranged. PMID- 3300045 TI - [Trimethoprim as a monosubstance and cotrimoxazole in infections of the efferent urinary tract]. AB - In a randomized single blind study the efficiency of Trimethoprim as a monosubstance used in the therapy of urinary tract infections was compared to that of Cotrimoxazole. There was a total of 40 patients available 20 of whom were given 2 X 200 mg Trimethoprim throughout 10 days whereas the other 20 patients were given 2 X 160 mg Trimethoprim + 800 mg Sulphamethoxazole in the same period. All patients were hospitalized during treatment. The urine was bacteriologically checked at the beginning of the treatment and after 7, 14 and 28 days respectively. The therapy was equally successful in both groups, both from the clinical and the bacteriological point of view (Trimethoprim 17, Cotrimoxazole 18); a statistically significant difference was not to be proved. In the Trimethoprim group there was one relapse, in the Cotrimoxazole group there were two. Undesirable side effects occurred in both groups with a larger number of them occurring in the Cotrimoxazole group. Cotrimoxazole and Trimethoprim proved equally efficient from a clinical point of view. The proportion of side effects is more favourable for Trimethoprim alone; the cost of therapy is almost 50% lower than that of Cotrimoxazole. PMID- 3300046 TI - [A hierarchy of findings within the scope of cerebrovascular diagnosis today]. AB - Table 5 gives an overview as to the timing and indication for diagnostic methods and procedures in cerebro-vascular diseases. Anamnesis and clinical aspects have still leading position. After that, computer-tomography stands first in the diagnostic line, followed by angiography, indicated in the acute phase only in progressive stroke. More often it is used during rehabilitation period for indication towards extra-intracranial anastomosis. Sonography gives informations specially in the extracranial stenoses by duplex sonography. The EEG is still necessary in the early stage and for follow-ups. Cerebro spinal fluid analysis, intern medicine (mainly cardiology) examinations, give extra information and should not be skipped. Psychological exams and intracranial bloodflow-studies are used during rehabilitation. Digital angiography, with the possibility of postprocessing, is in comparison to conventional angiography, less invasive. Nuclear-magnetic-resonance with its fast development is taking now place in the clinical field. Cerebro-vascular patients should be treated in specialized centers where beside the equipment, an experienced team is available, which has required its knowledge on a high number of cases and where the cooperation between the different fields of conservative (intern and neurology) radiology and surgery is guaranteed. This paper however has tried to show the up-to-date guidelines to the other medical specialties that handle cerebrovascular patients. PMID- 3300047 TI - Bleeding gastroduodenal ulcers: choice of operations. PMID- 3300048 TI - Obesity: a disorder of the sympathetic nervous system. PMID- 3300049 TI - Structure and metabolism of glycoproteins: nutritional regulation. PMID- 3300050 TI - Lipid peroxides and nutrition. PMID- 3300051 TI - Human riboflavin requirements, and metabolic consequences of deficiency in man and animals. PMID- 3300052 TI - Obesity and fat distribution in relation to health--current insights and recommendations. PMID- 3300053 TI - Clinical aspects of osteoporosis. PMID- 3300054 TI - A study of glomerular minimal lesion and minimal mesangial proliferation with or without nephrotic syndrome; pathologic, immunopathologic and clinical correlations. PMID- 3300055 TI - Relapsing malaria infection acquired in Kenya. AB - An American physician-traveler to East Africa presented with manifestations of cerebral malaria and was treated with intravenous quinidine for chloroquine resistant falciparum malaria. He later relapsed with Plasmodium ovale infection, despite previous primaquine therapy. Treatment of chloroquine-resistant malaria is discussed. The difficulty in diagnosing P. ovale infections and the predominance of this malaria species over P. vivax in East Africa are reviewed. PMID- 3300056 TI - [Legionellosis in a sample of pneumonia patients at a lung clinic]. AB - The Legionellaceae as agents causing pneumonias are widespread distributed and lead to partially very serious diseases, particularly in predisposed persons with impaired resistance. Two of 12 cases observed are reported casuistically. Erythromycin as the drug of choice should be given already at suspicion. Since Legionellosis cannot be differentiated from pneumonias of other etiology on the basis of clinical findings alone, the authors refer to the importance of the relevant microbiologic methods. PMID- 3300057 TI - Blood glucose and plasma insulin responses to fat free milk and low-lactose fat free milk in healthy human volunteers. AB - The blood glucose and plasma insulin responses to test milk samples were studied in healthy normal volunteers. After an overnight fast the subjects were given 500 ml of either regular fat free milk (approximately 25 g lactose) or 500 ml of a new low-lactose fat free milk (3.75 g lactose and 4.25 g fructose). Blood glucose levels were not significantly altered after either milk sample, but plasma insulin responses were significantly elevated after milk consumption. The response was slightly but not significantly higher after regular fat-free milk than after the low-lactose fat free milk. The results suggest that fat free milk does not exert a fast effect on blood glucose concentration and therefore fat free milk and especially low-lactose fat free milk may prove to be suitable for diabetic diets. PMID- 3300058 TI - [The historical beginnings of scientific prevention in childhood and adolescence]. PMID- 3300059 TI - [Status and prognosis of chemoprevention of malaria]. PMID- 3300060 TI - [Detection of Chlamydia trachomatis in cell culture]. PMID- 3300061 TI - [Education and continuing education in psychiatry in the 19th century]. PMID- 3300062 TI - [Hypoxia, acidosis and nephrology]. AB - In a survey the correlations between hypoxia, acidosis and nephrology are presented. In chronic oxygen deficiency the individual aspects concern the uncertainties of erythropoietin and the carotid-sinusoidal natriuresis stimulated by chemoreceptors. The effects of acute ischaemic hypoxic reactions are described with regard to the acute renal failure. The regulatory renal function of acidification and its disturbance in chronic renal insufficiency as well as the renotubular acidosis are discussed. Finally the authors enter the influence on the renal function during positive pressure respiration (e.g. for the purpose of the normalisation of the pulmonary gas exchange in acute respiratory insufficiency) as well as on reactions of the haemodialysis (bicarbonate and acetate dialysis) to the blood gas and acid-base metabolism, taking into consideration the pulmonary function. PMID- 3300063 TI - [Presentation of an insulin-treated patient group within the scope of a 5-year study of the Diabetes Intervention Study (DIS)]. AB - The diabetes intervention study (DIS) is an intervention and examination programme which in dietetically conducible diabetics who freshly became manifest shall decrease the incidence of cardiovascular diseases and analyse the influence of various steps of intervention on the course of diabetes. In the course of 5 years 54 out of 988 patients were insulinized by reason of deteriorations of metabolism. There were no significant differences between the intervention and control group concerning age, sex, index of ideal weight, fasting blood glucose, quantity of injected insulin and duration of the insulin treatment. By means of a C-peptide short-time test following glucagon stimulation an attempt of differentiation into type 1 and type 2 diabetics, was performed and compared with the results in literature. PMID- 3300064 TI - [Effect of uterotonic agents on the pathophysiology of endotoxin-induced shock]. AB - Different uterus contracting compounds (methylergonovine, oxytocin and prostaglandin F2 alpha) were evaluated with respect to their effect on the pathophysiology of endotoxin-induced shock. We used the model developed by Beller and Theiss of a continuous endotoxin-infusion in female Sprague-Dawley rats. In each group fibrinogen, plasma hemoglobin, hematocrit and thrombocytes were measured. The body weight of the rats was determined before and after the infusions. After the end of the experiment the intravasal fibrin deposits in the kidneys were evaluated quantitatively. Methylergonovine showed a slight protective effect regarding the clotting system and the shock events. This effect was more pronounced with oxytocin. In contrast prostaglandin F2 alpha enhanced the shock events. Based on our results we feel that the use of prostaglandin F2 alpha under septic conditions can be associated with significant risks. PMID- 3300065 TI - [Exogenously induced diseases of the mouth mucosa]. AB - Exogenously induced diseases of the oral mucous membrane and the lips caused by chemical, actinic, or mechanical irritations, by drugs, by infections, as well as by dental materials are usually characterized by definite morphology. We report on these diseases, their assignment to various groups of releasing agents, and their course. In particular, we present current developments of dental materials and their relationship to alterations in the oral mucous membrane. PMID- 3300066 TI - [Surgical treatment possibilities in aseptic and septic loosening of endoprostheses of the hip]. AB - There is a permanent increase of replacement of endoprosthesis of the hip. The improvement of operation procedure and the application of spongious bone make it possible to reconstruct extreme defects of bone tissue of acetabulum and femur. The bacterial infection of the supporting tissue is the most serious complication in endoprosthesis. Even in early diagnosis and consequent therapy the infection often is not curable until endoprosthesis is removed. The resulting condition, which is similar to that seen after Girdlestone's operation, will mostly ensure an improved functional capacity of the hip joint. PMID- 3300067 TI - [Activation of proteases in plasmas from various species]. PMID- 3300068 TI - [Determination of estriol in the serum of pregnant patients with a homogeneous enzyme immunoassay]. PMID- 3300069 TI - [Detection of anti-HBs with the sandwich enzyme immunoassay]. PMID- 3300070 TI - [Use of dried blood in the detection of primary Toxoplasma infection in pregnant patients]. PMID- 3300071 TI - [Functional organization of the auditory system of tailless amphibia]. PMID- 3300072 TI - [Functional brain mapping]. PMID- 3300073 TI - [In memory of Academician Vladimir Nikolaevich Chernigovskii]. PMID- 3300074 TI - [Characteristics of recapitulation and the functional evolution of the brain]. PMID- 3300075 TI - [Histophysiology of the microcirculatory system]. PMID- 3300076 TI - [Elementary neurophysiological mechanisms of learning]. PMID- 3300077 TI - [Muscle efficiency and energy expenditure in muscle]. PMID- 3300078 TI - Absorption of Mycobacterium bovis BCG administered by the oral route. AB - The action of gastric and duodenal juices on BCG as well as on its absorption and its distribution in the organs after intragastric administration in mice were studied. A significant decrease in BCG oxygen uptake and a moderate loss of viability were found after 2 h treatment with gastric juice. Using duodenal juice, a marked decrease of respiration and a notable fall in viability were observed. Labelling of BCG with carbon-14 was accomplished using [14C]glycerol as a precursor of mycobacterial lipids. Similar levels of radioactivity were recovered in organs of mice 24 h after intragastric administration of 14C-BCG, sonicated 14C-BCG and [14C]glycerol. The level of 14C-BCG remained stable from 6 to 24 days, while sonicated 14C-BCG and [14C]glycerol defined a biological decay process. Studies of biological decay from the small intestine and liver indicated that the absorptive process started rapidly and reached its highest level at 24 h, declining thereafter according to the complexity of the material given to mice. However, living bacilli were not cultured from organs of mice given single doses of unlabelled BCG. Therefore, judging from the above data it may be concluded that the majority of BCG bacilli absorbed intact were not alive. PMID- 3300079 TI - Antigenicity and immunogenicity of domains of the human immunodeficiency virus (HIV) envelope polypeptide expressed in the yeast Saccharomyces cerevisiae. AB - Expression vectors were constructed for the production of various domains of the envelope gene product of the SF-2 isolate of human immunodeficiency virus (HIV) in the yeast Saccharomyces cerevisiae. Serum specimens from HIV seropositive blood donors reacted in immunoblot assays with recombinant polypeptides from both the gp120 and gp41 coding regions of env. Polypeptides from both domains were purified and injected into experimental animals. Antibodies raised in rabbits to env-2, a recombinant polypeptide representing the majority of the protein moiety of gp120, reacted with fully glycosylated native gp120 of HIV-SF2 virions. In addition, these env-2 antisera showed reactivity with viral gp120 of divergent HIV isolates. A 121 amino acid polypeptide (env-5), representing the region of gp41 stretching between the two hydrophobic domains of the protein, elicited antibodies in rabbits that reacted with glycosylated, native gp41. Thus, selected domains of the HIV env gene expressed in genetically engineered yeast, are recognized by sera from HIV infected humans, elicit antibodies that react with native HIV glycoproteins and provide a source of envelope antigens for evaluation as potential subunit vaccines for HIV. PMID- 3300080 TI - Sanguinarine as an antiplaque agent: a review of current literature. PMID- 3300081 TI - Gustavus Richard Brown Horner, a commodore and his chronicle. PMID- 3300082 TI - Eikenella corrodens cervical osteomyelitis: case report. PMID- 3300083 TI - Chickens unlocked lymphocyte mystery. PMID- 3300084 TI - [Effect of hydrostatic stress on water-electrolyte balance in patients with chronic venous insufficiency]. PMID- 3300085 TI - Influence of calcium dobesilate (Doxium) on blood viscosity and coagulation parameters in diabetic retinopathy. PMID- 3300087 TI - [Current possibilities for ultrasound examination in prenatal diagnosis]. PMID- 3300086 TI - [The past and present of radical surgery in gynecological oncology]. PMID- 3300088 TI - [Study of T lymphocyte subpopulations in patients with lupus erythematosus using monoclonal antibodies during immunocorrective therapy]. PMID- 3300089 TI - [Treatment of patients with atopic dermatitis using hemodes]. PMID- 3300090 TI - [Total immunoglobulin E level in dermatoses studied by immunoenzyme analysis]. PMID- 3300091 TI - [New approach to the pathogenetic therapy of psoriasis]. PMID- 3300092 TI - [New data on the effect of chemical and biological agents on Treponema pallidum in vitro]. PMID- 3300093 TI - [Comparative study of the passive hemagglutination test with diagnostic agents prepared from pathogenic and cultured Treponema pallidum from different forms of syphilis]. PMID- 3300094 TI - [Characteristics of the course of urogenital infections in persons suffering from alcoholism and social drunkenness]. PMID- 3300095 TI - [Psychology and dentistry]. PMID- 3300096 TI - [Plea for Konus crowns. Progress report of 10 years' clinical and technical testing]. PMID- 3300097 TI - [Cellular immunity in prostatic cancer modified by Cytonal, Estrazyt and Turisteron]. AB - The influence on the specific cell-mediated immunity (CMI) of the carcinoma of the prostate gland by the contra-sexual hormone therapy with Cytonal, Estrazyt and Turisteron is controlled. For this purpose the macrophage-electrophoresis mobility test on the basis of allogenic tumour-associated antigen of the carcinoma of the prostate gland is used. As a result the use of Cytonal at least in the dosage hitherto used is no longer worth being advocated. Turisteron and Estrazyt, respectively, taking into consideration their pharmacokinetics and indication, prove to be immunologically optimal and without hesitation, respectively. Turisteron is the basic therapeutic in the androgen-dependent carcinoma of the prostate gland. Estrazyt should be reserved to primarily and secondarily hormone-refractory tumours. For the application of Estrazyt an additive immune stimulation seems to be worth taking into consideration. PMID- 3300099 TI - [It was written in 1807: implantation at that time]. PMID- 3300098 TI - [Initial results of a phase IV multicenter clinical trial of Turisteron in the treatment of prostate cancer]. AB - Turisteron proves to be a highly effective, poor in side effects, orally applicable estrogen preparation for the hormone therapy of the carcinoma of the prostate under the conditions of the routine practice. The cumulative 5-year survival rates of 197 patients observed of all categories of tumours (T1-4NxM0-1) were 66 +/- 10% and were depending upon the local growth of the tumour and upon the degree of metastasation between 81 +/- 18% and 47 +/- 42%. A discontinuation of the therapy due to strong side effects was necessary only in 4 cases (2.07%). PMID- 3300100 TI - [Good patient relations advance the acceptance of dentures]. PMID- 3300101 TI - [Tissue reactions to implant materials]. PMID- 3300102 TI - [TPS indications]. PMID- 3300103 TI - [Intra-arterial chemotherapy in advanced ovarian cancer. 2. Technic, results, complications]. AB - Between 1978 and 1984 43 patients with advanced ovarian carcinomas got intra arterially MTX and 5-FU after being operated, later they received systemically a CMFV chemotherapy (therapy arm A). 42 patients were treated systemically only with a CMFV combination. The results and complications of both types of treatment were evaluated according to theoretical and technical basis of the intraarterial infusion. The intra-arterial chemotherapy led to a significant better rate of remission (74 per cent in therapy arm A compared with 62 per cent in therapy arm B) because of a rapid induction of remission. The cumulative survival time was significantly extended to 27 months compared with 16 months after systemic therapy only. PMID- 3300104 TI - Bacterial lectins: mediators of adhesion. PMID- 3300105 TI - Haemagglutinins and adherence properties to HeLa and intestine 407 cells of Klebsiella pneumoniae and Klebsiella oxytoca isolates. AB - The occurrence of haemagglutination (HA) and adherence properties were examined in 50 strains of K. pneumoniae and 17 K. oxytoca strains isolated from humans. All isolates except three exhibited HA activity. Mannose-sensitive haemagglutinins (MSHA) were expressed by the majority of K. pneumoniae strains, but only by one K. oxytoca isolate. Mannose-resistant haemagglutination (MRHA) to human or guinea pig erythrocytes could not be detected; haemagglutinins of the MR/K type were found in both species with similar frequencies. Adhesive properties could be demonstrated in K. pneumoniae as often as in K. oxytoca: About half of the strains adhered to two human cell lines: HeLa and Intestine 407. The incidence of HA activity was similar in adhering and nonadhering strains. A correlation between MSHA, MR/K-HA and adherence to tissue-cultured cells could not be detected. PMID- 3300106 TI - Experimental studies on circulating antigen of Toxoplasma gondii in intermediate hosts: criteria for detection and structural properties. AB - The present study was performed to demonstrate circulating antigen (cag) of Toxoplasma gondii in the sera of orally and intraperitoneally infected rabbits and swine, to determine the time of their appearance after infection, and to characterize the antigenic components of the cag by means of affinity chromatography, SDS-polyacrylamide gel electrophoresis (SDS-PAGE) and electrophoretic blot onto nitrocellulose sheets. Cag, as detected by an indirect ELISA, was found in the sera of both rabbits and swine from week 5 to week 8 after infection. Electrophoretic separation of cag extracted from swine and human sera showed 5 and 8 distinct protein bands, respectively, the molecular weight of which ranged between 25 and 100 kD. After Western blot, 2 of the 5 protein bands of swine-cag (27 and 57 kD) and 3 of the 8 protein bands of human cag (27, 32, and 57 kD) reacted with the anti-Toxoplasma antibody used in the ELISA. On the basis of the data presented, the influence of the dose and mode of infection as well as that of the preparation method of antisera on cag detection is discussed. PMID- 3300107 TI - [Humoral immune response to staphylococcal antigens in the clinic and in an experiment]. PMID- 3300108 TI - [Significance of rec A-gene activity in altering the ultrastructure of Escherichia coli]. AB - The pathogenic E. coli strain, serovar 0124 studied in this investigation and its mutants rec A 56 and rec A 441 differ in their ultrastructural organization. In strains having defects in gene rec A, the appearance of intracytoplasmic membranous structures and a great number of extracellular membranous vesicles, as well as the formation of the filamentous forms of cells in the colonies, can be observed. These data indicate that the product of gene rec A plays an active role in the metabolism of bacterial membranes. PMID- 3300109 TI - [Plasmid characteristics of Salmonella strains of various origins]. AB - Salmonella antibiotic-resistant strains, isolated from patients with hospital infections and from various environmental objects, showed lower virulence than antibiotic-sensitive strains in experiments on mice infected by intraperitoneal and enteral routes. Salmonella strains, sensitive to antimicrobial preparations, contained 1-2 plasmids, while those with multiple drug resistance contained 3-10 plasmids varying in their molecular weight. All these strains, with the exception of one laboratory strain, carried a plasmid with a molecular weight of about 60 Md. A decrease in the virulence of Salmonella strains, carrying R-plasmid, with respect to mice, their natural host, in experimental infection by the above mentioned routes was probably unrelated to the loss of this plasmid. 80% of Salmonella strains with multiple resistance to antibiotics yielded positive results in the keratoconjunctival and conjunctival tests as compared with 42% of sensitive strains. These data suggest that Salmonella strains, carrying R plasmid, retained pronounced capacity for local colonization. PMID- 3300110 TI - [Allergenic activity of mites of the genus Dermatophagoides]. AB - The allergenic activities of the laboratory batches of D. farinae allergens have been studied by the methods of indirect mast-cell degranulation, neuroglial cytocrit, electrophoretic mobility changes. D. farinae allergens have been shown to possess specific activity. The method of changes in the electrophoretic mobility of sheep red blood cells has demonstrated that D. pteronyssimus and D. farinae allergens possess common allergenic properties. PMID- 3300111 TI - [Effect of polyvinylpyrrolidone on microbial cells]. AB - The oral administration of polyvinylpyrrolidone to rats produces no effect on the intestinal microflora. At the same time, polyvinylpyrrolidone solutions decrease the toxicity of Escherichia coli and Proteus vulgaris, produce a bactericidal and agglutinating effect. PMID- 3300112 TI - [Structural and functional properties and the biological activity of Yersinia pestis capsular antigen, murine toxin and endotoxin]. PMID- 3300113 TI - [Immunobiology of thymus peptides: T-activin]. PMID- 3300114 TI - Cloning of cysB mutant alleles of S. typhimurium. AB - Two cysB mutant alleles of S. typhimurium have been cloned onto pBR vectors. The product of the constitutive cysBc 1352 allele present on the plasmid was found to fulfill regulatory functions: as an activator of the cysteine regulon and as an autorepressor. CysB70 auxotrophic mutation impairs both regulatory functions cysB protein. Transfer of the clones cysBc 1352 allele from E. coli to S. typhimurium and from S. typhimurium to E. coli and biochemical analysis of transformants suggest involvement of a restriction-modification system in the constitutive expression of the cysteine regulon. PMID- 3300115 TI - Potassium metabolism and therapy in hypertension. AB - Several studies are available now to highlight the use of K salts in the management of hypertension. Potassium supplements correct diuretic-induced K loss and also lower the blood pressure. However, salt-sensitive hypertension might not respond to K therapy. It acts as a diuretic and reduces plasma volume by inhibiting sodium reabsorption in the renal tubules. It has a vasodilatory effect on the arterioles by directly acting on the smooth muscle cells. Potassium also suppresses plasma renin activity which is not a uniform observation, however; patients who do not respond to K can have a raised plasma renin activity. Potassium might also inhibit neurogenic mechanisms in reducing blood pressure by inhibiting catecholamines. The notion that a low sodium and high K diet can reduce blood pressure without antihypertensive drug therapy is quite interesting because a large number of subjects with subnormal and mild hypertension can benefit from this remedy. However, long term prospective studies would be necessary to generalize the use of K salts in the prevention and treatment of hypertension. PMID- 3300116 TI - Prostacyclin in (extracted) plasma of essential hypertensives. AB - Plasma 6-Keto-Prostaglandin F1 alpha (6-Keto PG F1 alpha; stable hydrolysis product of prostacyclin) levels in 24 patients with essential hypertension and 15 age and sex matched healthy controls were studied. 6-Keto PG F1 alpha levels were measured in extracted plasma by radioimmunoassay using a commercial kit. The 6 Keto PG F1 alpha levels were significantly (P less than 0.001) higher in hypertensive patients as compared to controls. The raised levels of plasma 6-Keto PG F1 alpha in hypertensive patients may be an adaptive response of blood vessels to increased blood pressure. PMID- 3300117 TI - Septic shock in the rat: activation of plasma proteolytic systems and effects of a kallikrein inhibitor/bradykinin antagonist (S-2441). AB - Septic shock was induced in rats by intraperitoneal injection of live Escherichia coli. Plasma prekallikrein, antithrombin III and plasminogen levels were studied with chromogenic peptide substrate assays. Decrease of all the studied plasma components occurred in all rats, but not until late in shock. S-2441, a kallikrein inhibitor/kinin antagonist, slightly delayed the fall in plasma prekallikrein, but no other effects were found. Rat survival was neither enhanced nor prolonged. PMID- 3300118 TI - Volume substitution and treatment with prostaglandin E1 in a porcine model of endotoxaemia-induced pulmonary and cardiovascular failure. AB - The effects of prostaglandin E1 (PGE1) and volume substitution (5% albumin) on pulmonary haemodynamics and oxygen transport were evaluated in a porcine model of pulmonary and cardiovascular failure. Albumin was infused i.v. to maintain baseline mean left atrial pressure throughout the experiments. Ten pigs received endotoxin + albumin and showed ten-fold increase in venous admixture, 90% increased extravascular lung water and 25% fall in cardiac output. Oxygen delivery and base excess decreased significantly and four pigs died. In ten other endotoxin-albumin-treated pigs PGE1 infusion (0.25 micrograms X kg-1 X min-1) was begun after established pulmonary and cardiovascular dysfunction, for closer mimicking of clinical use. The raised pulmonary vascular resistance thereafter normalized and extravascular lung water increased by only 15%, but the increase in venous admixture was not influenced. Cardiac output was maintained at baseline. PGE1 prevented further derangement of oxygen delivery and base excess. All the animals survived. The clinical implications may be that volume infusion, even optimally titrated, is not optimum treatment in endotoxemic pulmonary and cardiovascular failure. PGE1 added to optimum volume treatment may be a useful adjuvant in endotoxaemia. PMID- 3300119 TI - Microsurgical repair of iatrogenic accessory nerve lesions in the posterior triangle of the neck. AB - Of ten patients with iatrogenic lesion of the accessory nerve in the posterior triangle of the neck, nine underwent secondary reconstructive surgery, with direct end-to-end nerve suture or with nerve grafting. In the six patients whose operation was performed within 4 months from the injury recovery was satisfactory, but the three with longer delay did not recover. Reconstructive surgery as soon as possible after the injury is advocated. PMID- 3300120 TI - Stratified duration of prophylactic antimicrobial treatment in emergency abdominal surgery. Metronidazole-fosfomycin vs. metronidazole-gentamicin in 381 patients. AB - Consecutive adult patients requiring emergency abdominal surgery were randomly allocated to preoperative treatment with metronidazole-gentamicin (M-G) or metronidazole-fosfomycin (M-F). Postoperative continuation of antibiotics depended on the estimated risk of septic complications. Peroperatively the cases were stratified as group A, acute inflamed appendicitis, or absence of septic disorder--no postoperative antibiotics, group B, gangrenous appendicitis or cholecystitis or intestinal obstruction without resection, or operations with contamination regarded as minor (gastrotomy or enterotomy)--three further doses of antibiotics, or group C, perforated appendicitis, perforation of the alimentary tract, generalized peritonitis or gross contamination--antibiotics continued for 5 days. Assessment for septic complications was made in 381 patients (191 M-G, 190 M-F). The total incidence was 4.8% (M-G 7.8%, M-F 1.6%, p less than 0.01). The difference was mainly due to higher infection rate in patients stratified to group C and randomized to M-G. Stratification thus permitted restricted duration of antibiotic treatment with a low septic complication rate, significantly less with M-F than with M-G regimen. PMID- 3300121 TI - Peroperative cefuroxime v. long-term ampicillin and metronidazole in high-risk biliary and gastric surgery. A multicentre trial. AB - Randomization to cefuroxime in a two-dose peroperative regimen or to combined peroperative and postoperative (4 days) ampicillin and metronidazole was performed in a series of 418 high-risk patients undergoing biliary or gastric surgery. Postoperative wound infection appeared in 9 of the 210 patients who received ampicillin and metronidazole and in 2 of the 208 given cefuroxime (p less than 0.05). Four intraabdominal abscesses occurred in the former group and one in the latter. Three of these abscesses probably were attributable to complications of surgery as such, leaving one intraabdominal abscess in each group. Peroperative cefuroxime is concluded to be more effective than longer administration of ampicillin/metronidazole as protection against wound infection in high-risk patients undergoing biliary or gastric surgery. PMID- 3300123 TI - [Distal extension denture]. PMID- 3300122 TI - [Antibiotics in periodontal disease]. PMID- 3300124 TI - Value of lymphocyte marker studies in diagnostic cytopathology. AB - The separation of lymphoreticular neoplasms from poorly differentiated epithelial and mesenchymal tumors and reactive processes can be a difficult problem in cytopathology. Immunodiagnostic techniques can be applied to cytologic specimens to detect cellular antigens, which may aid in their proper identification. We have reviewed 67 cytologic specimens in which immunoperoxidase techniques were employed using antibodies to common leukocyte antigen (HLE1), B-cell markers (B1, Leu 12 and kappa and lambda light chains), T-cell markers (Leu 1, OKT11, Leu 12 and kappa and lambda light chains), T-cell markers (Leu 1, OKT11, OKT4 and OKT8) and monocytes (OKM1 and LeuM1). These specimens included 33 body cavity fluids (21 pleural, 8 ascitic and 4 pericardial), 22 cerebrospinal fluids (CSF) and 12 fine needle aspirates (4 brain, 1 adrenal, 2 liver, 1 kidney, 3 retroperitoneal masses and 1 lymph node). The marker studies confirmed the initial cytomorphologic diagnoses in 31 specimens and modified the final diagnoses in 16 specimens. Markers in 20 specimens were noncontributory due to low cellularity or technical difficulties. Two problems may limit the usefulness of these procedures. First, many of the CSF specimens contained too few cells for adequate processing. Second, the mesothelial cells from pleural specimens often stained with HLE1. Our findings indicate that marker studies are of value in the diagnosis of problematic cases presenting as undifferentiated tumors in cytopathology. PMID- 3300125 TI - Flow cytometric DNA analysis of normal, premalignant and malignant human epidermal tissues. PMID- 3300126 TI - Demonstration of glucose inhibition of insulin release in the presence of diazoxide. AB - beta-Cell-rich pancreatic islets from ob/ob mice were taken for measurements of insulin release in response to glucose after culture in RPMI 1640 medium. The stimulatory effect of 20 mmol/l glucose was converted into an inhibition when the medium was supplemented with 400 mumol/l diazoxide. Glucose inhibition of insulin release was observed when the islets had been cultured in the presence of 1 or 20 mmol/l glucose in media either containing or lacking Ca2+. The data provide further evidence for an inhibitory component in the action of glucose on insulin release, suggesting that glucose stimulation of the Ca2+ efflux is essential for the appearance of this inhibition. PMID- 3300127 TI - Immunoreactive epidermal growth factor in mouse digestive organs. Use of a sensitive enzyme immunoassay. AB - A sandwich enzyme immunoassay (ELISA) system for mouse epidermal growth factor (EGF), which has a high sensitivity (500 fg/tube), has been established. It makes it possible to measure minute amounts of immunoreactive EGF in various mouse tissue without pretreatment. The immunoreactive EGF concentrations in digestive tissues of adult mice were much lower than previously reported. A significant sex difference was detected not only in the submandibular gland, but also in the oesophagus and forestomach. Although sialoadenectomy decreased the immunoreactive EGF contents in the alimentary tract to 4.2-23.8% of the pre-operative levels, the duodenal immunoreactive EGF was unaffected. Positive immunostaining was observed in the submandibular and sublingual gland, but not in the other digestive tissues, including the duodenum. These data implied that most of the EGF in the digestive tissues was derived mainly from the saliva and that a small amount of endogenous EGF existed in the duodenum. The physiological role of exogenous salivary EGF in the alimentary tract and the origin of endogenous duodenal EGF are discussed. PMID- 3300128 TI - Near-normoglycemia and late diabetic complications. The Oslo Study. AB - A fast and precise method for routine, large scale measurements of HbA1, with elimination of pre-Alc, was established. Near normal blood glucose levels were obtained during treatment with CSII and MI; significantly better than during conventional treatment with two daily injections of mixed regular/intermediate insulin. On most parameters of glycemic control, CSII was slightly better than MI (n.s.). The frequency of hypoglycemic coma was significantly reduced, but blood glucose values below 2.5 mmol/l were more frequent on CSII, compared to conventional treatment. The frequency on MI was similar to that of conventional treatment. CSII patients have an increased risk of developing ketoacidosis by accidental cessation of insulin infusion, and of developing cutaneous infections at the infusion site. Insulin antibodies increased during one year of CSII and MI, when compared to conventional treatment. Rapid tightening of blood glucose control may lead to transient deterioration of retinopathy, mainly by the occurrence of cotton wool spots. Patients who already have background retinopathy are at higher risk for such changes. A significant increase in the number of microaneurysms and haemorrhages was observed on conventional treatment whilst no significant change was found on CSII and MI. Less progression of retinopathy (elevated by fluorescein angiograms) was observed on CSII and MI (n.s.) when compared to conventional treatment. Thus long term near-normoglycemia may retard the progression of early retinopathy. Urinary albumin excretion was reduced during CSII and MI (n.s.), but no change was observed during conventional treatment. Glomerular hyperfiltration improved during intensified treatment. Motor nerve conduction velocity deteriorated on conventional treatment, but improved during CSII. No change occurred on MI. PMID- 3300129 TI - [Echographic aspects of the pancreas in hemochromatosis]. PMID- 3300130 TI - [Echography-guided puncture of a cystadenocarcinoma of the pancreas]. PMID- 3300132 TI - Blood-brain barrier in Alzheimer dementia and in non-demented elderly. An immunocytochemical study. AB - Peroxidase-antiperoxidase staining of formalin-fixed brain was employed to compare the blood-brain barrier (BBB) function in five patients with Alzheimer's disease/senile dementia of the Alzheimer type (AD/SDAT) and three patients with AD/SDAT combined with multi-infarct dementia (MID/SDAT) with that of six non demented aged controls. The diffusion of serum proteins through the BBB was visualized with antisera to albumin, prealbumin, immunoglobulin, C1q, C3c and to fibrinogen. A similar patterns of diffusion was seen in AD/SDAT and non-demented aged individuals. Neuron and glial cells were stained with different antisera in the vicinity of the diffusion. Senile (neuritic) plaques were occasionally visualized with antisera to IgG, C1q and C3c but not with antisera to albumin, prealbumin and fibrinogen in both demented and non-demented aged individuals. Neurofibrillary tangles were not labelled with any of the antisera studied. These results indicate that the BBB is compromised equally in AD/SDAT and in the non demented elderly. PMID- 3300131 TI - Infectivity of influenza B virus in cultured human muscle. AB - Severe muscle symptoms, particularly in children, are frequently associated with influenza B virus infection. In this study we examined the effects of influenza B virus (Lee Strain) on cultured human muscle by light and electron microscopy (EM), immunofluorescence, hemadsorption and plaque assays. Muscle injury was also evaluated by the appearance of muscle-specific creatine kinase (CK) in the culture medium. By fluorescence immunocytochemistry viral antigen was demonstrated in muscle cell nuclei within 3 h postinoculation (p.i.) and in the cytoplasm at 6 h p.i. Membrane-associated viral antigen was seen at 16 h p.i., at which time budding influenza virus-like particles could be demonstrated by EM, both in myoblasts and multinucleated myotubes. At 16 h all cells were hemadsorption positive. Plaque assays showed peak virus production at 48 h (p.i.), at which time cytopathic effects (cell retraction, pycnosis and cytoplasmic vacuolization) were prominent and some cells detached from the substratum. Leakage of muscle-specific CK isozyme into the culture medium could be demonstrated as early as 6 h p.i. with peak enzyme activity around 40-48 h p.i. Cytopathic changes and virus production were observed both in myoblasts and myotubes indicating that both cell types are susceptible. PMID- 3300133 TI - Prophylactic antibiotics in women with a history of pelvic inflammatory disease undergoing first-trimester abortion. AB - In a double-blind controlled trial the effect of prophylactic metronidazole on postabortal infection in women with a history of pelvic inflammatory disease (PID) was assessed. One hundred and thirty-five women were eligible for randomization, of whom 17 were excluded. The regimen consisted of oral metronidazole 400 mg 1 h before the abortion and again 4 and 8 h after, or else placebo. In the placebo group the rate of postabortal PID was 13.0% (7/54) and in the metronidazole group 10.9% (7/64), a nonsignificant difference (p greater than 0.7). Women in gestational weeks 11-12 had a significantly increased rate of postabortal PID compared with women in weeks 6-10 (p less than 0.005), but this rate was not influenced by the treatment (p greater than 0.2). Women with parity 1 had a significantly increased rate of postabortal PID compared with women with parity 0 (p less than 0.05), but again the treatment did not influence this rate significantly (p greater than 0.2). The number of hospital days for women in the metronidazole group did not differ significantly from that in the placebo group (p less than 0.1). The amount of metronidazole administered for prophylactic and postabortal treatment was significantly greater in the metronidazole group (p less than 0.001). The amounts of other antibiotics prescribed showed non significant differences between the two groups (all p-values greater than 0.3). PMID- 3300134 TI - The concentrations of ceftazidime and thiopental in maternal plasma, placental tissue and amniotic fluid in early pregnancy. AB - Studies on the transfer of drugs from mother to fetus in the first trimester of pregnancy are important because of the possible teratogenic effect on the fetus as well as possible therapeutic effect on both sides of the feto-maternal barrier. The purpose of this study was to measure drug concentrations in maternal plasma, placental tissue and amniotic fluid in a group of first-trimester abortion patients. Ceftazidime and thiopental were chosen as experimental drugs. The analyses were done with high pressure liquid chromatography. The penetration of ceftazidime into placental tissue and amniotic fluid was 20.6 and 2.2% from 1 to 4 h after drug administration. The corresponding values for thiopental were 54.3-71 and 1.5-7.4% from 5 to 15 min after drug administration, indicating a rapid transfer of both drugs across the feto-maternal barrier during this period in pregnancy. PMID- 3300135 TI - Preinduction cervical softening with endocervical PGE2 gel. A multi-center trial. AB - In a prospective, randomized trial, a single dose of PGE2 gel, 0.5 mg (2.5 ml), was given to 416 low Bishop Score patients 12 h prior to indicated oxytocin induction and compared with 404 non-gel controls. Successful initial induction was achieved in 83% of the treated and 58% of the non-treated subjects. In addition the induction-delivery interval was shortened (median times 9.0 h vs. 11.3 h) and fewer cesarean sections were performed (16% vs. 21%) in the PGE2 gel series. The endocervical administration of PGE2 was well tolerated and, provided care is taken to avoid excess extra-amniotic placement, systemic PGE2 effects are minimal. PMID- 3300136 TI - Umbilical cord acid-base state and Apgar score in term breech neonates. AB - Umbilical cord acid-base state and Apgar score were compared in neonates after breech and vertex term birth. The breech group comprised 149 consecutive newborns, 91 born vaginally and 58 by cesarean section. The control group consisted of a random sample of 150 newborns in vertex presentation: 100 born vaginally and 50 by cesarean section. Among vaginally born babies, the 1-min Apgar score was more often depressed in the breech presentation group than in the vertex group; after 5 min the Apgar scores were comparable in both groups. No difference was found in umbilical cord values of pH and base excess between the breech and the vertex groups when comparison was made within each delivery mode. In both groups, umbilical cord values were lower after vaginal than after abdominal delivery. It is concluded that in selected cases, uneventful vaginal breech labor and delivery at term is not associated with an increased risk of asphyxia. PMID- 3300137 TI - Dicephalus tribrachius: prenatal diagnosis and management. AB - A case of conjoined twins diagnosed prenatally by ultrasound is presented. The pathologist's report, the ultrasonographic differential diagnosis, management of delivery and a summary of the literature are included. PMID- 3300138 TI - A comparative study of transcutaneous electrical nerve stimulation (TENS), entonox, pethidine + promazine and lumbar epidural for pain relief in labor. AB - Analgesic effect, labor outcome, safety and consumer satisfaction were compared in 170 primigravid women; 50 using TENS initially for pain relief, 20 using entonox, 50 pethidine + promazine and 50 lumbar epidural. 88% choosing epidural related it fully effective. 90% using entonox, 96% using TENS and 54% given pethidine + promazine found partial relief. 82% of patients given TENS and 80% given pethidine + promazine required additional analgesia. This was also needed by one of the 20 patients choosing entonox. Women using entonox alone had the shortest labors and women using lumbar epidural, the longest. Operative delivery was significantly more common in women receiving lumbar epidural. No significant inter-group differences were noted in cord pH or Apgar scores. Parturients and midwives both gave high consumer satisfaction ratings to all methods--except for pethidine + promazine, whose use must therefore be questioned. The analgesic efficacy of lumbar epidural outweighs any possible side effects. Entonox appears suited to those able to cope with the earlier part of labor, drug-free. Realization of the potential of TENS requires the design of machines specifically to cope with the quality of the pain of labor. PMID- 3300139 TI - Fucithalmic in acute conjunctivitis. Open, randomized comparison of fusidic acid, chloramphenicol and framycetin eye drops. AB - Fucithalmic, which is 1% fusidic acid in a sustained-release eye preparation, was shown to be superior to both chloramphenicol eye drops and framycetin (Soframycin) eye drops in the treatment of bacterial conjunctivitis in Tanzania. The clinical success rate was 77/83 (93%) on fusidic acid compared with 22/46 (48% on chloramphenicol and 26/35 (74%) on framycetin (P less than or equal to 0.02). The better effect of fusidic acid could be ascribed to a much lower rate of in vitro resistance (17%) compared to chloramphenicol (58%) and framycetin (41%). Because of the low resistance rate to fusidic acid among eye pathogens, especially in areas of the world with a high resistance towards other commonly used eye anti-infectives, Fucithalmic given twice daily would seem to be a valuable new eye anti-infective. PMID- 3300140 TI - Diabetic retinopathy after 3 years' treatment with continuous subcutaneous insulin infusion (CSII). AB - Twenty-four insulin-dependent juvenile diabetics with no or minimal background retinopathy were randomly allocated to conventional insulin therapy (CIT) or continuous sc insulin infusion (CSII) administrated by a portable pump. At the present 3 year follow-up, there was one drop-out in the CSII group. Although the metabolic control was significantly better in the CSII patients, both groups improved significantly in metabolic control during the observation period. After 3 years, the HbA lc level was 7.4% +/- 1.2 (+/- SD) in the CSII patients and 8.6% +/- 1.6 in the CIT patients (P less than 0.01). As compared to the status at the beginning of the study, a progression of diabetic retinopathy (criteria: development of more than 2 microaneurysms) was observed in 4 of 11 in the CSII group and in 5 of 12 in the CIT group (P greater than 0.05). None of the patients were seen to develop soft exudates or neovascularisations. This study confirms the impression gained from a previous one-year follow-up of similar progression of retinopathy in patients on CSII and CIT. PMID- 3300141 TI - Nerve regeneration and repair. A review. PMID- 3300142 TI - Functional treatment of Colles fracture. PMID- 3300143 TI - [Status of biomechanical studies of gait]. PMID- 3300144 TI - [Lyophilized banked bone. Technic and results after 3 years of use]. PMID- 3300145 TI - The history of treatment using plaster of Paris. PMID- 3300146 TI - The actual status of acrylic bone cement in total hip replacement. A review. PMID- 3300147 TI - Oral rehydration therapy in neonates and young infants with infectious diarrhoea. AB - The clinical response and changes in water and salt homeostasis during ORT was studied in 15 infants less than 2 months old (range 2-50 days) with acute diarrhoea. Eight patients were neonates and 7 were 1-2 months old. The oral rehydration solution contained 60 mmol sodium per litre. All patients except one were successfully rehydrated. The fluid retention was significantly higher in neonates and young infants than in infants above 3 months of age treated in the same way. One patient in the group of neonates who had a normal sodium level on admission developed hypernatremia with a sodium level of 162 mmol/l 36 hours after the start of ORT. The urinary sodium excretion was lower in the neonates than in the young infants. The results show that neonates and young infants have a lower capacity than older infants to excrete water and salt and therefore run a great risk of developing fluid and salt retention during ORT. The risk is most pronounced in neonates who, due to immaturity of the renal function, are unable to excrete excess fluid and salt. PMID- 3300148 TI - Passage of gliadin into human breast milk. AB - Samples of breast milk were taken from 53 women following the ingestion of 20 g of gluten. The samples were analysed for the presence of gliadin by a double antibody sandwich enzyme immunoassay. Gliadin (5-95 ng/ml) was detected in 54/80 samples collected at various stages of lactation. Maximum levels in milk were found 2-4 hours after ingestion; gliadin could not be detected in serum. The transfer of gliadin from mother to infant might be critical for the development of an appropriate specific immune response to gliadin later in life. PMID- 3300149 TI - Neonatal group B streptococcal septicaemia in a developing country. AB - During a 3-year study at the neonatal intensive care unit, University Hospital of the West Indies, the incidence of group B streptococcal (GBS) septicaemia was 13.6/1,000 admissions and 1.4/1,000 live births. GBS accounted for 35% of blood culture isolates and was the most frequent cause of septicaemia. Underlying disease or other possible predisposing factors were identified in 16 of 25 neonates with GBS septicaemia. Comparison of early onset and late onset disease indicated an increased incidence of prematurity, prolonged rupture of membranes, and respiratory distress in the former and a predominance of meningitis associated cases in the latter. Mortality was 50% for early onset cases, 29% for late onset cases and 36% overall. Antimicrobial therapy and preventive measures which may be appropriate for a developing country are discussed. PMID- 3300150 TI - Present situation worldwide regarding the use and clinical experience of Somatonorm (somatrem). PMID- 3300152 TI - Preliminary results of authentic recombinant somatropin treatment in human growth hormone deficient children. French Collaborative Study. AB - A total of 50 children with hGH deficiency have been enrolled in a multicentre open trial of recombinant somatropin in France. Recombinant somatropin, 0.2 IU/kg s.c., was administered 3 times/week (0.6 IU/kg/week). Results are available after 3 months' treatment for 24 of the patients (11 prepubertal, 13 pubertal). The mean growth rate increased from 3.8 +/- 1.5 cm/year to 9.9 +/- 3.6 cm/year. Only one child developed anti-hGH antibodies with a very low binding capacity of 0.02 mg/litre; adverse events were uncommon and probably unrelated to treatment. PMID- 3300151 TI - Clinical trial with authentic recombinant somatropin in Japan. AB - Recombinant somatropin, produced by recombinant DNA technology, was administered by injection in daily doses of 8 IU to six healthy young volunteers. Daily injection for 4 days did not cause any significant change in the results of physical examination, blood count or urinalysis. Non-esterified fatty acid levels increased significantly from 0.45 +/- 0.16 to 1.08 +/- 0.12 mEq/litre (mean +/- SEM) at 4 hours after the first injection (p less than 0.001). Plasma IGF-1 levels increased from 0.80 +/- 0.14 units/ml to 1.72 +/- 0.50, 3.22 +/- 1.02, 3.17 +/- 1.20 and 3.63 +/- 0.78 units/ml at 24 hours after each daily injection for 4 days (p less than 0.001). Plasma hGH reached peak levels at 3 hours after intramuscular injection of recombinant somatropin, 4 IU, and this peak value was 57.3 +/- 2.8 ng/ml. A total of 21 patients with pituitary dwarfism were also treated with recombinant somatropin for 6 months at a dose of 0.5 IU/kg/week. Their heights increased by 2.2-5.0 cm during the 6 months of treatment, which was calculated to be equivalent to 4.4-10.0 cm/year with a mean growth rate of 7.4 +/ 0.4 cm/year. Anti-hGH antibody with a titre of 10 was observed in two patients at the end of 6 months of treatment. PMID- 3300153 TI - Clinical trial with authentic recombinant somatropin in Sweden and Finland. AB - A total of 47 prepubertal children with hGH deficiency were treated for up to 6 months with recombinant somatropin. All the children markedly increased their growth rate; 21 of them were naive (not previously treated with hGH), and increased their growth rate from 4.2 +/- 0.2 cm/year to 13.9 +/- 0.9 cm/year (calculated from growth data after 6 months' treatment, n = 11). Of the 47 children, 26 had been previously treated for 2 +/- 0.3 years (range 0.3-8.3 years) with pituitary hGH. After a period of 0.9 +/- 0.03 years (range 5-15 months) without any hGH therapy, their growth rate increased from 2.9 cm/year to 11.1 cm/year on recombinant somatropin therapy (calculated from growth data after 6 months' treatment, n = 10). One child reacted with temporary local erythema at the injection site. Anti-hGH antibodies, with a binding capacity of 0.02 mg/litre, were detected in 1 of the 16 children after 6 months of therapy. No adverse effect on her growth rate was seen. No changes in levels of antibodies to Escherichia coli proteins were detected. No other allergic manifestations or systemic side-effects were demonstrable. PMID- 3300154 TI - Immune responses to human growth hormone--cellular and humoral aspects. PMID- 3300155 TI - Production of authentic recombinant somatropin. AB - Further developments in recombinant DNA technology, exploiting a natural mechanism for export using a signal peptide in E. coli, have enabled the production of recombinant somatropin, with full biological activity and extremely high purity. The secretion of the protein into the periplasmic space has simplified purification procedures, providing a unique and simple process and a pure and active product. PMID- 3300156 TI - Current views on the treatment of Turner's syndrome. PMID- 3300158 TI - Is growth hormone deficiency a useful diagnosis? AB - Evidence is presented that there is a continuum in endogenous hGH secretion ranging from those children with poor growth velocities who secrete very little, formerly called hGH deficient, to those with normal growth velocities who secrete a much greater amount. The relationship between growth velocity and hGH secretion in short children is described by an asymptotic regression. Further, the relationship between growth and hGH is modulated by hGH pulse amplitude. The therapeutic implications of this relationship are that any short child given hGH will grow more rapidly, and that those children growing most slowly with the least endogenous hGH secretion will have the greatest increment in height velocity for a standard dose of exogenous hGH. PMID- 3300157 TI - Results from the first 2 years of a clinical trial with recombinant DNA-derived human growth hormone (somatrem) in Turner's syndrome. AB - A total of 70 subjects with Turner's syndrome from 11 centres were enrolled in a study of somatrem. After an initial observation period, they were randomly assigned to one of four groups, receiving no treatment (Group 1, control); oxandrolone, 0.125 mg/kg/day (Group 2); somatrem, 0.125 mg/kg 3 times/week (Group 3); or a combination of somatrem and oxandrolone on the above dose regimens (Group 4). After 12-20 months, Groups 1 (control), 2 (oxandrolone) and 4 (combination) were treated with somatrem, 0.125 mg/kg 3 times/week, and oxandrolone, 0.0625 mg/kg/day; Group 3 remained on somatrem, 0.125 mg/kg 3 times/week. All three treatment groups showed a statistically significant increase during year 1 in growth velocity over both their pretreatment growth rates and the control group growth rate. These increases were slightly less in year 2 for the somatrem and combination therapy groups, but remained significantly higher than the year 1 control group growth rate. Plasma IGF-1 levels were elevated in years 1 and 2 in the somatrem and combination groups. Adverse events were few with the somatrem group, though mild virilization occurred with oxandrolone, alone or in combination. Bone age advancement was observed with all treatments but was greater with combination therapy; it was accompanied by height age advancement. The effect of this therapy on predicted adult height was also evaluated. PMID- 3300160 TI - Primary leiomyosarcoma of bone. A case report and review of the literature. AB - A 62-year-old female with primary leiomyosarcoma of the left femur is reported with a review of 21 cases reported in the literature. The resected specimen showed that the tumor extended from the femoral head to the diaphysis for 13 cm in length. The tumor showed mainly intramedullary proliferation, but extraosseous growth was also noted at the great trochanter. Microscopic examination revealed well differentiated leiomyosarcoma characterized by interlacing bundles of fusiform cells with eosinophilic cytoplasm and rod-shaped hyperchromatic nuclei. PAP stain of actin on the tumor cells was positive. On electron microscopy, microfilament of 6-8 nm in diameter, dense bodies, pinocytotic vesicles, marginal attachment plate, and basal lamina were noted. The patient died with pulmonary metastasis, 1 year and 7 months after the operation. An autopsy showed metastases in the right pelvic cavity and bilateral lungs, and confirmed the primary site to be the left femur. PMID- 3300159 TI - Clinical experience with authentic recombinant somatropin--German Collaborative Study. AB - A multicentre clinical trial with recombinant somatropin was initiated in West Germany in early 1986. Acceptance of patients to the study was determined according to criteria outlined in a detailed study protocol. To the present time, 41 patients with hGH deficiency not previously treated (naive) and 28 patients previously treated with pituitary hGH have been admitted. Recombinant somatropin is given, 12 IU/m2/week s.c., divided into six doses. Height velocities during treatment rose dramatically for naive patients from 3.5 cm/year (n = 40, before treatment), to 15.0 cm/year (n = 19, calculated at 3 months), and 13.3 cm/year (n = 8, calculated at 6 months). For previously treated patients, the increase in height velocity was from 5.8 cm/year (n = 20) to 9.2 cm/year (n = 19, after 3 months) and 8.6 cm/year (n = 9) at 6 months. Tolerance of recombinant somatropin was good, and no anti-hGH antibodies were detected in any of the patients. PMID- 3300161 TI - Myxoid sarcoma arising from the pulmonary trunk. AB - We reported a case of a myxoid sarcoma of the pulmonary trunk in a 40-year-old women. On light and immunohistochemical studies, spindle-shaped tumor cells revealed the nature of smooth muscle origin. PMID- 3300162 TI - Ultrastructural studies of time-course and cellular specificity of interleukin-1 mediated islet cytotoxicity. AB - Previous electron-microscopic studies of isolated islets of Langerhans exposed to the monokine interleukin-1 for 7 days have indicated that interleukin-1 is cytotoxic to all islet cells. To study the time-course and possible cellular specificity of interleukin-1 cytotoxicity to islets exposed to interleukin-1 for short time periods, isolated rat or human islets were incubated with or without 25 U/ml highly purified human interleukin-1 for 24 h. Samples of rat islets were taken after 5 min, 30 min, 1, 2, 4, 6, 8, 10, 12, 16, 20 and 24 h and samples of human islets after 5 min, 30 min and 24 h of incubation and examined by electron microscopy in a blinded fashion. Already after 30 min, accumulation of opaque intracytoplasmic bodies without apparent surrounding membranes, and autophagic vacuoles were seen in about 20% of the beta cells examined in rat islets exposed to interleukin-1. After 16 h of incubation with interleukin-1, more than 80% of rat beta cells showed signs of degeneration. Beta cell specific changes similar to those observed in rat islets exposed to IL-1 for 30 min were seen in human islets exposed to IL-1 for 24 h. The described changes were not observed in alpha cells in interleukin-1-treated rat or human islets, or in alpha and beta cells in control islets. Passing interleukin-1 over columns containing Sepharose-coupled anti-interleukin-1 antibody completely removed the beta cell cytotoxic action on rat islets.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300163 TI - [Quantitative structure-activity relationships of the inhibition of Escherichia coli bacteria (1515) by 5-(substituted-benzyl)-2,4-diaminopyrimidines]. PMID- 3300164 TI - [Recent advances in immunopharmacology]. PMID- 3300165 TI - Metabolic and pancreatic changes caused in male dogs by testosterone chronic administration. AB - The pancreatic cytology and the glycemic, insulinemic and serum free fatty acid responses in dogs during hyperglycemia induced by glucose and over hypoglycemia evoked by insulin have been studied. The dogs were in the alternative following conditions: untreated, under propylenglycol treatment (vehicle controls) and under testosterone propionate plus its vehicle. Testosterone dose: 0.75 mg/kg body wt./day, once daily. Both intramuscular treatments lasted 2 weeks. In the pancreas of the untreated dogs, the islets presented irregular edges with acute prominences, and B-cells could be clearly appreciated, with a high content of dark brown beta-granules of insulin. B-cells presented negative images of nuclei located in the central areas of such cells. In the pancreas of the testosterone treated dogs, the yellowish cytoplasms of the B-cells looked empty, bearing just a few beta-granules (small amount of stored insulin). The B-cells appear to present a great number of vacuoles in testosterone treated dogs. The curve of glycemia in the glucose and insulin tests, the glucose space and the half-life time of insulin in circulation in dogs under testosterone plus vehicle treatment were similar to those observed in dogs treated with propylenglycol pursuant to the same experimental design used in the other two groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300166 TI - Islet cell population changes induced by short term ovariectomy. AB - Changes induced in the endocrine pancreas were studied in rats 14 days after ovariectomy. The study was performed in age matched control (C) and ovariectomized (O) rats. The pancreases were stained using the p-aldehyde-fuchsin and the peroxidase (using antiinsulin serum) methods. Morphometric analysis was done using the Weibel technique. The results obtained show a diminution in the total volume of the endocrine pancreas accompanied by an increment in the individual islet volume following the ovariectomy. The last change would be the consequence of an increment in the number of islet cells (mainly the B cell population), without change in cellular volume, i.e., hyperplasia without hypertrophy. These changes might explain the apparent discrepancy regarding the effect of ovariectomy upon insulin secretion when this process is studied using either the total pancreas preparation or the isolated islet model. PMID- 3300167 TI - Quantitative ultrastructural changes induced by glucose in pancreatic B cells. AB - The acute ultrastructural changes induced by glucose upon the B cells were studied in normal rat pancreas perfused with 3.3 and 16.6 mmol/l glucose. A significant increment in the volume of the RER, microtubule, mitochondria, lysosomes and B granules was induced by 16.6 mmol/l glucose, while no significant changes were detected in the total B cell volume or in the size of the nucleus, cytoplasm and Golgi complex. The number of secretory granules was greatly reduced in B cells obtained from pancreas perfused with 16.6 mmol/l glucose, while its diameter was significantly enhanced. In these cells both, the number of pale granules as well as those attached to the cell membrane, were increased. All these data suggest that the increase in the extracellular glucose concentration produces not only the classical biphasic secretion on insulin, but also induces significant and measurable changes in the volume of several B cell organelles. Such ultrastructural changes correlate well with the well-known effect of glucose upon the metabolism of these cells. PMID- 3300168 TI - Seventy years of the Bainbridge reflex. AB - The discovery of the Bainbridge reflex 70 years ago, of a tachycardic response to a rise in central venous pressure, stimulated a lot of interest in this and other cardiovascular reflexes. The mechanoreceptors that elicit the reflex are located at the junction of the right atrium and caval veins or at the junctions of the pulmonary veins and the left atrium. The Bainbridge reflex is controversial, however, because its existence cannot always be demonstrated. Intravenous infusions, which usually elicit a reflex tachycardia, sometimes cause a bradycardic response. This paper reviews the history of the studies associated with the reflex. Results are reported, which demonstrate that the chronotropic response to i.v. infusions depends upon the resulting change in aortic diameter; bradycardia is evoked by infusions leading to a rise in aortic baroreceptor activity through increases in aortic diameter, volume or pressure; tachycardia follows whenever the infusion fails to trigger the baroreflex. The importance of the Bainbridge reflex as a counterbalance to the baroreceptor reflex is discussed. PMID- 3300169 TI - The effect of secretin on the glucose-induced insulin release from isolated pancreatic islets in mice. AB - A simple and rapid method for isolation of pancreatic islets from mice using Percoll as a separation medium is described. Increasing concentrations of secretin from 10(-11) to 10(-6) M were without effect on the insulin release from the islets at 5 X 5 mM glucose, whereas significant increases were found at 12 mM glucose. Secretin did not elicit additional increases of the insulin release at 5 X 5 and 12 mM glucose with 5 mM theophylline. The mechanism by which secretin acts on the pancreatic islets is discussed. Based upon the above observations it is suggested that secretin apparently represents a modulator of the insulin release from the pancreatic islets. PMID- 3300170 TI - Regenerating skeletal muscle cells express insulin-like growth factor I. AB - The expression of the trophic peptide insulin-like growth factor I (IGF-I; somatomedin C) was investigated in the regenerating soleus muscle of mice after injury by the snake venom taipoxin. No specific IGF-I immunoreactivity was observed in muscle cells during control conditions. Within 2 days after taipoxin injection, IGF-I immunoreactivity could be demonstrated in activated satellite cells. Myoblasts and myotubes expressed high IGF-I immunoreactivity. The IGF-I immunoreactivity was strictly cytoplasmatic and obviously associated with polyribosomes. No vesicular or membraneous IGF-I immunoreactivity could be demonstrated. It is concluded that IGF-I is synthesized in myogenic cells during skeletal muscle regeneration. It is suggested that IGF-I exerts its effects on skeletal muscle mainly by autocrine mechanisms. PMID- 3300171 TI - A double-blind comparison of citalopram (Lu 10-171) and amitriptyline in depressed patients. AB - In a controlled, clinical, multicentre trial comprising a total of 43 patients (17 men and 26 women) citalopram was compared double-blindly with amitriptyline. Nineteen patients of each group were classified as endogeneously depressed, whereas four patients of the citalopram group and one of the amitriptyline group were classified as non-endogenously depressed. The patients were seriously ill with a high frequency of previous depressive episodes and of mental disorders among their closest relatives. Thirteen of the patients in either group had received antidepressants without satisfactory effect before entry into the trial. Each patient was treated for a period of at least 3 weeks with daily citalopram doses of 30-60 mg or daily amitriptyline doses of 75-225 mg. A statistically significant reduction of MADRS scores (total scores as well as each of the 10 individual items) was recorded in both groups. The only difference between the groups was a trend towards a better effect on sleep disturbances in the amitriptyline group. Side-effects were recorded more frequently in the amitriptyline group than in the citalopram group, global assessment of side effects being significantly different in favour of citalopram. It is concluded that citalopram is an effective and safe drug in the treatment of endogenous depression - probably as efficacious as amitriptyline, but with fewer side effects. PMID- 3300172 TI - Obstructive and non-obstructive fetal hydronephrosis: sonographic detection and clinical implications. PMID- 3300173 TI - The enigma of coronary heart disease and its prevention. PMID- 3300174 TI - A controlled study of the influence of continuous subcutaneous insulin infusion treatment on diabetic retinopathy during pregnancy. AB - Forty consecutive pregnant patients with insulin-dependent (Type I) diabetes mellitus were randomized at the end of the first trimester for treatment with conventional insulin therapy (CIT) or continuous subcutaneous insulin infusion therapy (CSII). Nine patients randomized into the CSII group declined the pump treatment. The mean glycosylated haemoglobin (Hb AIc) decreased (p less than 0.001) both in the CIT and the CSII groups with no difference between the groups. Some deterioration in retinopathy was found in 2/18 patients in the CIT group, in 5/13 in the CSII group, and in 3/9 of those who declined the pump treatment. The proportion of patients whose retinopathy progressed did not differ significantly between the groups, and in the majority the deterioration was mild. However, two patients in the CSII group developed acute ischaemic retinopathy, which progressed to proliferative stage in spite of laser treatment. In these two cases the decrease in the Hb AIc level was among the greatest and fastest in the study. These data suggest that a rapid near normalization of glycaemic control by CSII during pregnancy can accelerate the progress of retinopathy in poorly controlled diabetic patients. PMID- 3300175 TI - A crossover comparison of continuous insulin infusion and conventional injection treatment of type I diabetes. AB - We evaluated the feasibility and effectiveness of continuous subcutaneous insulin infusion therapy (CSII) as compared to conventional injection treatment (CIT) in an ordinary diabetic clinic in a one-year randomized crossover study of 65 type I diabetic patients. Home blood glucose levels were lower during CSII (8.6 +/- 0.2 mmol/l, mean +/- SEM) than during CIT (9.1 +/- 0.3 mmol/l, p less than 0.05). During the first six months, HbA1 fell on CSII therapy (from 10.6 +/- 0.4 to 9.7 +/- 0.3%, p less than 0.001), whereas no change occurred during CIT. After the crossover, HbA1 decreased again on CSII (p less than 0.05), but rose in patients shifted from CSII to CIT (p less than 0.05). The fall in glycosylated haemoglobin during CSII correlated with the initial HbA1 level (r = 0.54, p less than 0.001). Ketoacidosis was more common during CSII (16 vs. 2 verified episodes). Hypoglycaemia occurred infrequently, without difference between CSII and CIT. Fifty-six per cent of the patients preferred CSII after the study. In conclusion, while CSII slightly improves the metabolic control, the improvement in the unselected study population is less than previously reported among highly selected patients. PMID- 3300176 TI - Multiple myeloma and polyclonal hypogammaglobulinaemia. PMID- 3300177 TI - Amiodarone for refractory supraventricular tachycardias. AB - Amiodarone was administered to 53 patients with otherwise drug-refractory supraventricular tachycardias. Therapy was effective in 35 patients and partially effective in nine patients for a median duration of 35 months. The median maintenance dose was 200 mg/day in both groups, whereas the median serum amiodarone concentrations were 1.1 mg/l and 0.7 mg/l, respectively. Amiodarone was ineffective in nine patients despite higher dosage (median 400 mg/day) and insignificantly higher serum concentrations (median 2.0 mg/l). Neither the age of the patients, the duration or type of arrhythmia, the cardio-thoracic index, nor the type of underlying heart disease were predictive of the efficacy of amiodarone. Side-effects occurred in 28 patients, leading to withdrawal of therapy in 12 patients. Side-effects were not associated with higher serum amiodarone concentrations. Despite its efficacy, amiodarone should be reserved for otherwise drug-resistant supraventricular tachyarrhythmias. PMID- 3300178 TI - Trimethoprim prophylaxis of acute exacerbations in chronic obstructive pulmonary diseases. AB - A double-blind randomized trial was carried out to study the efficacy and tolerance of trimethoprim with a daily single dose of 300 mg in long-term prophylaxis of acute exacerbations of chronic obstructive pulmonary diseases (COPD). The patients, 13 in the trimethoprim group and 11 in the placebo group, were followed up at fixed intervals and checked for respiratory functions and haematological parameters for six months. The number of exacerbations were significantly lower than during the previous winter in both groups: 0.6 compared to 3.8 in the trimethoprim group, and 0.6 to 3.0 in the placebo group. Tolerance of trimethoprim was good and did not differ from that of placebo. The necessity of double-blind trials in evaluating the prophylactic value of antibiotics in COPD is emphasized, since the exacerbations are also dependent on many unknown factors. There were no statistically significant differences in blood counts of folate levels. PMID- 3300179 TI - Erythropoietin in haemangioblastoma: immunohistochemical and electron microscopy studies. AB - Immunohistochemical studies for erythropoietin were carried out in six capillary haemangioblastomas, three of which were also studied by electron microscopy. The immunohistochemical studies showed that positively stained cells were scattered in the vicinity of capillaries, and that neither endothelial cells nor stromal cells were stained. In their morphology and distribution, the positively stained cells were identical to mast cells as observed by electron microscopy. In one case, erythropoietin was demonstrated in the cyst fluid of the tumour. These findings suggest that mast cells with abundant secreting granules in haemangioblastomas are capable of producing erythropoietin. PMID- 3300180 TI - Photoperiod and testicular function in Phodopus sungorus. PMID- 3300181 TI - Biophysics of the pancreatic beta-cell. PMID- 3300182 TI - Insulin release and K+-induced depolarization in mouse pancreatic beta-cells. PMID- 3300183 TI - Effects of verapamil and nifedipine on glucose-induced electrical activity in pancreatic beta-cells. PMID- 3300184 TI - Contribution of isotope flux studies to understanding the mechanism of the beta cell membrane. PMID- 3300185 TI - The role of anions in the regulation of insulin secretion. PMID- 3300186 TI - Prediction of the glucose-induced changes in membrane ionic permeability and cytosolic Ca2+ by mathematical modeling. PMID- 3300187 TI - Insulin secretion studied in islets permeabilised by high voltage discharge. PMID- 3300188 TI - The role of cytosolic calcium in insulin secretion from a hamster beta cell line. PMID- 3300189 TI - Glucose-evoked changes in [K+] and [Ca2+] in the intercellular spaces of the mouse islet of Langerhans. PMID- 3300190 TI - Relationship between extracellular Na+ and the total ionized Ca2+ content of rat pancreatic islets. PMID- 3300191 TI - Mobilization of different pools of glucose-incorporated calcium in pancreatic beta-cells after muscarinic receptor activation. AB - Muscarinic receptor activation resulted in a biphasic mobilization of Ca2+ from isolated pancreatic islets. Glucose was essential for preparing the beta-cells to respond with the initial stimulatory phase. This effect seems to depend on the ability of the sugar to promote active sequestration of Ca2+ in the endoplasmic reticulum. PMID- 3300192 TI - Effect of the order of application of neural inputs on insulin secretion. PMID- 3300193 TI - Muscarinic receptors and the control of glucose-induced electrical activity in the pancreatic beta-cell. PMID- 3300194 TI - Electrophysiological evidence for histaminergic modulation of pancreatic beta cell function. PMID- 3300195 TI - The insulin secretory granule: features and functions in common with other endocrine granules. PMID- 3300196 TI - Effects of monensin on glucose-induced insulin release and 45Ca2+ outflow. PMID- 3300197 TI - Pulsatile insulin release and electrical activity from single ob/ob mouse islets of Langerhans. PMID- 3300198 TI - Protein carboxyl methylation in rat pancreatic islets: possible role in beta-cell function. PMID- 3300199 TI - Biochemical design features of the pancreatic islet cell glucose-sensory system. PMID- 3300200 TI - Tumor promoters and genotoxic chemicals in short-term testing for carcinogenicity. PMID- 3300201 TI - The endocrine system as the target in experimental toxicology. PMID- 3300202 TI - Predictive value of ocular irritation tests. PMID- 3300203 TI - The significance of preneoplastic liver lesions in experimental animals. PMID- 3300204 TI - Liver tumors in rodents: extrapolation to man. AB - Man is a poor model for the prediction of agents that are hepatocarcinogenic for laboratory rodents. Relatively few agents are known to cause any form of primary liver cancer in man. The most important is hepatitis B virus, for which there is possibly a model in the woodchuck but not one in rats or mice. The only other agents known to cause primary liver cancer in man are certain steroid hormones, vinyl chloride, and thorium dioxide. There are animal models for the first two of these and a reasonable expectation that thorium dioxide would produce liver tumors in animals if the appropriate experiments were done. Aflatoxin, a potent hepatocarcinogen in rats and other species but not mice, is strongly suspected of being an important human hepatocarcinogen in certain geographical areas of the world, but the evidence is circumstantial. There is no more than a weak association between the nutritional type of cirrhosis secondary to excessive intake of alcohol and increased primary liver cancer in man, and no evidence at all that ethanol per se causes liver tumors in mice, rats, hamsters, or mastomys. By contrast, a very large number of chemicals to which people in the West have been exposed for many decades have been found to be hepatocarcinogens in laboratory rodents. In most cases the levels of exposure required to produce liver tumors in rodents far exceed those to which man is normally exposed. The problem is to guess whether low-level exposure to such rodent hepatocarcinogens poses any real liver cancer threat to man?The mortality from primary liver cancer is very low in countries such as England and Wales where there is widespread exposure to low doses of both natural and synthetic agents which, in high dosage, cause liver tumors in rodents. This suggests that, if there is any risk, it can only be very small. Death rate data collected in England and Wales by the Registrar General are consistent with there having been a small increase in the incidence of primary liver cancer in England and Wales during the past 20 years, but the apparent increase might well be a consequence of revisions in the International Classification of Diseases system and not real. During the first half of the present century the age-standardized incidence of primary liver cancer in England and Wales was falling.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3300205 TI - Neurobehavioral toxicology: an overview. PMID- 3300206 TI - Immunotoxicology. PMID- 3300207 TI - Reduced plasma renin activity in elderly subjects in response to vasovagal hypotension and head-up tilt. AB - The sympathoadrenal and renin-angiotensin systems play an important role in the cardiovascular responses induced by head-up tilt. In young people, hypotension and postural changes induced by tilt produce significant increases in plasma renin activity. The response of plasma renin activity to prolonged tilt and subsequent vasovagal hypotension has not been assessed in the elderly. Seventeen elderly subjects (10 with carotid sinus syndrome and seven age-matched controls) were studied during 45 minutes of recumbency and 120 minutes of head-up tilt to 40 degrees. Intra-arterial systolic blood pressure and heart rate were monitored continuously and plasma renin activity was measured at frequent intervals. Ten subjects developed vasovagal syncope during tilt (at 32 +/- 18 min). Systolic blood pressure and heart rate fell by 70 +/- 20 mmHg and 20 +/- 7 beats . min-1 (P less than 0.001 and P less than 0.01, respectively). Plasma renin activity did not change in syncopal subjects and remained unchanged up to 60 min after syncope. In seven subjects who completed 120 min of tilt without symptoms, heart rate rose during tilt but plasma renin activity remained unchanged. Plasma renin activity is not influenced by marked hypotension or prolonged head-up tilt in the elderly. PMID- 3300208 TI - The art of living long by Luigi Cornaro. PMID- 3300209 TI - Mechanism of signal transduction in mast cells and basophils: studies with RBL 2H3 cells. PMID- 3300210 TI - [The localization of retinal S-antigen in the choroid]. PMID- 3300211 TI - [Determination of the retention forces of dental magnets]. PMID- 3300212 TI - [The marginal edge of the crown]. PMID- 3300213 TI - [New cobalt-based alloys and their use in combined fixed and removable partial dentures]. PMID- 3300214 TI - [Construction of the bridge framework]. PMID- 3300215 TI - [Analysis of metals used in the manufacture of cast superstructures]. PMID- 3300216 TI - The development of hippocampal structure and how it is influenced by hypoxia. AB - When analysing the function of a neuronal system, it is important to know how the connections of the various neuronal elements are organized. One way in which the structure of nervous tissue can be studied is to become acquainted with the basic principles of its development. This can be achieved by studying the process of normal development, or else by experimental means aimed at inducing changes which help to uncover the laws of the interrelationships of the various elements forming the neuronal system. We studied pyramidal cell structure in the CA1 region of the rat hippocampus during normal postnatal development and after repeated exposure to altitude hypoxia (8 h a day from birth to 17 days at a simulated altitude of 7000 m). At 18 and 90 days the brains of the experimental and control animals were impregnated by the Golgi-Cox method for light microscopy. The brains of 5-, 10-, 15-, 24-, 48- and 90-day-old animals which had developed normally were treated similarly and subjected to a parallel analysis including quantitative methods of electron microscopy. The various parts of the dendritic system are not formed simultaneously. Up to the 15th day, the basal dendrites and the shaft of the apical dendrite, together with its terminal branches, develop. Between the 15th and the 24th day development continues with the proliferation and ramification of the lateral and preterminal branches of the apical dendrite. The number of dendrites is established the first, followed by growth and branching. Development of the dendritic spines involves a change in their shape as well as an increase in their number. From being short and thick the spines develop into structures with a thin neck and a claviform and sometimes branched head. Development of the receptive component of neuronal structure is accompanied by an increase in the number of afferent fibre terminals. Type I synapses are differentiated earlier and in larger numbers than type II synapses. The pyramidal cells of the hippocampus of rats exposed to hypoxia in early life have fewer basal dendrites and fewer terminal fibres on the apical dendrites at 18 days. Hypoxia also leads to lower dendritic spine density and to changes in the shape of the spines reminiscent of less mature forms.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3300217 TI - Biliary lithotripsy: what will the issues be? PMID- 3300218 TI - The promise of extracorporeal shock-wave lithotripsy for the treatment of gallstones. PMID- 3300219 TI - Imaging of surgically relevant hepatic vascular and segmental anatomy. Part 1. Normal anatomy. PMID- 3300220 TI - Abdominal sonography after hepatic transplantation: results in 36 patients. AB - Hepatic transplantation was performed in 46 patients over a 2-year period at the University of Minnesota. Thirty-six of these patients subsequently underwent 166 sonographic examinations of the upper abdomen. Forty-three examinations were performed within 2 weeks of transplantation, 47 between 2 and 8 weeks after transplantation, and 76 more than 8 weeks after transplantation. The sonograms were reviewed retrospectively and correlated with the available clinical and histopathologic data. Diffuse, nonspecific parenchymal abnormalities were seen in 27 patients. Focal regions of parenchymal abnormality seen in four patients were associated with abscess and infarction. Moderate to severe biliary dilatation was seen in seven patients with biliary obstruction diagnosed by percutaneous or T tube cholangiography. Obstruction was seen most commonly in children who had undergone cholecystojejunostomy biliary reconstruction, and it required radiologic or surgical intervention. Routine sonographic assessment of the upper abdominal vasculature showed thrombosis of the portal vein in two cases, thrombosis of the inferior vena cava in one case, thrombosis of the donor aorta in three cases. Focal intraabdominal fluid collections were identified in 14 patients and represented hematomas in all but one. Free peritoneal fluid was detected in 19 patients. Sonography was used to guide percutaneous aspiration of abdominal fluid and to guide fine-needle puncture for percutaneous transhepatic cholangiography. Upper abdominal sonography provides a noninvasive means of evaluating and confirming a wide spectrum of complications that can follow hepatic transplantation. Because clinical and laboratory findings often are nonspecific in these patients, sonographic detection of focal parenchymal abnormalities, biliary dilatation, and vascular compromise is especially valuable. PMID- 3300221 TI - Duplex Doppler evaluation of puerperal ovarian vein thrombosis. PMID- 3300222 TI - Arctic paleoradiology: portable radiographic examination of two frozen sailors from the Franklin expedition (1845-1848). PMID- 3300223 TI - Hepatic regenerating nodules in hereditary tyrosinemia. AB - Hereditary tyrosinemia is an autosomal recessive, enzymatic disorder that results in micro- and macronodular cirrhosis in early childhood. Hepatocellular carcinoma occurs in approximately one-third of affected children. We evaluated the imaging studies performed in five children with this disorder. Pathologic examination of all five of the livers revealed cirrhosis and multiple regenerating nodules; hepatocellular carcinoma was present in two of the five livers. All five patients had high-attenuation or high- and low-attenuation foci within the liver. These high-attenuation foci were not apparent as focal lesions in three of four hepatic sonograms or in one of two hepatic nuclear scans. Angiography showed tumor vascularity in one patient with a focal hepatocellular carcinoma, but was indeterminate in a second patient with severe cirrhosis and multifocal hepatocellular carcinoma. Children with cirrhosis due to tyrosinemia may develop regenerating nodules that appear as high-attenuation hepatic foci on CT scans. It is difficult to differentiate regenerating nodules from multifocal hepatocellular carcinoma in these patients. PMID- 3300224 TI - Anorectal atresia: prenatal sonographic diagnosis. AB - To determine the prenatal sonographic findings of anorectal atresia (ARA), we retrospectively reviewed 12 proven cases. Sonography showed abnormally dilated bowel segments in five cases (42%), four of which were identified prospectively; at autopsy, two other cases showed mild colon dilatation not evident on sonograms. Bowel dilatation was not associated with the location of atresia or the presence of a fistula, but was possibly related to menstrual age. Eleven fetuses (92%) had significant other anomalies primarily related to the VACTERL syndrome (vertebral defects, anal atresia, tracheoesophageal fistula with esophageal atresia, radial and renal dysplasia, and limb malformations) and/or the caudal regression syndrome; of these, sonography identified one or more concurrent anomalies in seven cases. In two cases, bowel dilatation was the primary sonographic finding. Death in nine cases resulted from termination of pregnancy (four cases) or perinatal demise (five cases); three patients are still alive. We conclude that some cases of ARA can be suspected on prenatal sonograms by demonstration of dilated colon, and that the sensitivity of this finding may be related to menstrual age at the time of the examination. Distinguishing ARA from other causes of fetal-bowel dilatation is important because of the frequency of concurrent anomalies associated with ARA. PMID- 3300225 TI - Gallbladder contraction in biliary atresia. PMID- 3300226 TI - Multicystic dysplasia and crossed renal ectopia. AB - Multicystic renal dysplasia in a crossed fused or nonfused ectopic kidney is a rare occurrence that produces unusual imaging findings. In four such cases in neonates, three presented with a palpable abdominal mass and one was discovered in utero with maternal sonography. In three cases, sonography showed a multicystic mass, contiguous with the lower pole of the orthotopic kidney. In the fourth infant, a crossed, tiny dysplastic kidney was not visualized, but its markedly dilated ectopic ureter was seen traversing the spine on CT. Ureteropelvic junction obstruction was present in the three fused orthotopic kidneys. The characteristic imaging findings of multicystic dysplasia and crossed renal ectopia include a multicystic mass of variable size that is contiguous with the lower pole of a hydronephrotic, malrotated kidney; ureteral displacement and/or dilatation; and contralateral absence of the kidney and its renal artery. PMID- 3300227 TI - Computerized reference management--filing the literature. PMID- 3300228 TI - A reverse enzyme immunoassay for detection of Vespula spp. sensitivity. AB - The Reverse Enzyme Immunoassay (REIA) method for the detection of specific IgE recently described by us has been applied to the diagnosis of Vespula spp. sensitivity. To do so, 0.5 mg of Vespula venom of commercial origin was conjugated with peroxidase according to a previously described technique. The results obtained from the study of 50 nonallergic patients have demonstrated the specificity of the method in as much as no positive value was found. In addition, only one low positive value was obtained from a group of 47 atopic patients showing no evidence of sensitivity to insect stings. On the contrary, very high ELISA values from a group of 23 patients with suspected sensitivity to insect venom were obtained. With these results, we conclude that this method can constitute an aid in the diagnosis of these patients, besides being a low-cost method free from the interference of blocking antibodies. It is our opinion however, that this method is not as reliable as the RAST. PMID- 3300229 TI - Hereditary angioedema: preliminary report on skin biopsy finding of fibrin and/or C4 through immunofluorescence. AB - Hereditary angioedema is considered an inherited disorder of the complement system, manifested by repeated crises of angioedema involving the skin, the gastrointestinal and respiratory tracts. Biopsies of normal skin obtained from 5 patients, diagnosed with hereditary angioedema, were found to be positive for fibrin and in one case also positive for C4. The sections stained with anti fibrin serum showed fibrin deposits around isolated epidermal cells, while C4 staining revealed a homogeneous pattern along the epidermis. Fluorescence patterns and laboratory findings before and after treatment with danazol and/or anti-fibrinolytic treatment are reported. PMID- 3300230 TI - Sotalol: a beta blocker with unique antiarrhythmic properties. PMID- 3300231 TI - The paradox of pulsus paradoxus. PMID- 3300232 TI - Metabolic support during coronary reperfusion. AB - The limitation of infarct size by thrombolysis could potentially be improved by an early metabolic intervention. We therefore evaluated the effects of a 48-hour infusion of glucose-insulin-potassium (GIK) in patients with anterior infarctions. Seventeen patients were randomized to receive intravenous GIK (n = 10) or placebo (n = 7). All patients additionally received streptokinase. Changes in left ventricular function were assessed by comparing the global ejection fractions and the regional infarct area ejection fractions of the first ventriculogram with the 10-day second ventriculogram. There was a significantly greater improvement in the global ejection fraction of patients receiving GIK (increases 0.07 +/- 0.04) than in those randomized to placebo (decreases 0.08 +/- 0.04) (p less than 0.02). There was also a much greater improvement in the area ejection fractions of the group receiving GIK vs the group receiving placebo in the anterolateral (increases 0.24 +/- 0.07 vs decreases 0.02 +/- 0.04 [p less than 0.02]) and diaphragmatic (increases 0.08 +/- 0.08 vs decreases 0.17 +/- 0.05 [p less than 0.005]) segments. Thus in patients with anterior infarctions receiving streptokinase, GIK improves ventricular function and reduces the size of the segmental wall motion abnormality. PMID- 3300233 TI - New perspectives on cardiovascular risk factors. AB - Atherogenic traits, living habits, signs of preclinical disease, and susceptibility all contribute to cardiovascular disease. High low-density lipoprotein is positively related to coronary heart disease, and high high density lipoprotein is inversely related. Systolic or diastolic hypertension at any age in either sex contributes powerfully. The impact of diabetes is greater for women and varies with the number of accompanying risk factors. High-normal fibrinogen values further escalate risk of these atherogenic factors. An atherogenic life-style is typified by a diet excessive in fat, calories, and salt; sedentary habits; unrestrained weight gain; and cigarette smoking. Moderate alcohol use may be beneficial. Use of oral contraceptives beyond age 35 years and in conjunction with cigarette smoking predisposes one to thromboembolism. Type A behavior carries an increased risk, and men married to more highly educated women and to women in white-collar jobs are more vulnerable. Signs of preclinical ischemia include silent myocardial infarction, left ventricular hypertrophy on ECG, blocked intraventricular conduction, and repolarization abnormalities. Measures of innate susceptibility include a family history of early cardiovascular disease. Quantitative combination of risk factors provides optimal prediction, including persons with multiple marginal abnormalities. Preventive management should also be multifactorial and requires a commitment to behavior modification and alteration in life-style. PMID- 3300234 TI - Impact of antihypertensive drugs on the cardiovascular patient. AB - The impact of antihypertensive drugs has been considerable over the last few decades. Hypertension-associated mortality and morbidity have decreased significantly following the introduction of potent and useful antihypertensive drugs. Against this background, it is disturbing that three recent large-scale studies have shown that morbidity and mortality in treated hypertensive patients are markedly higher than in comparable normotensive subjects. It is conceivable that these findings can be explained to some extent by the fact that the elevated arterial pressure quite frequently is not lowered to strictly normotensive levels. Another aspect of the impact of antihypertensive drugs is that they frequently affect the mood and well-being of the patient. In the early days of antihypertensive therapy, the interference of drugs with the quality of life was considerable. With the drugs available today, negative effects on well-being are much rarer, although still extant. Thus, there is still room for improvement of antihypertensive drugs both in this respect and, more importantly, in achieving a further lowering of hypertension-induced cardiovascular morbidity and mortality. PMID- 3300235 TI - Drug therapy and quality of life in angina pectoris. AB - Quality of life is impaired in patients with angina pectoris because of their symptoms, impaired activity, and anxiety. These various factors reduce enjoyment of life, but their components and interrelationships are difficult to measure in the individual. There is no consensus on the best methods of measurement of quality of life; many general instruments have been proposed but none that specifically concern angina pectoris. Despite the absence of such quantitative information, there is no doubt that antianginal drugs benefit the majority of patients and, despite their side effects, advantageously change the relationship between the factors that add up to "quality of life." How the relief of symptoms, both organic and psychologic, interact and how far they are offset by the negative aspects of treatment in the patient with angina pectoris remain to be defined. Past and present trials give encouragement that instruments will be developed that are relevant, valid, reproducible, and sufficiently sensitive to convincingly measure the different impacts on quality of life of the patient with angina pectoris. PMID- 3300236 TI - Diagnosis of cerebral arteriovenous malformation by contrast two-dimensional and Doppler ultrasonography of the head after saline injection in the umbilical arterial line. PMID- 3300237 TI - Usefulness of nicardipine for angina pectoris. AB - Nicardipine treatment has been evaluated in patients with chronic stable effort angina or with angina at rest due to coronary spasm. Acute studies in patients with effort angina suggest a very favorable hemodynamic profile characterized by coronary vasodilatation and reduction in determinants of myocardial oxygen demand. Both open and controlled trials in patients with effort angina show that long-term oral administration increases exercise time and time to onset of 1 mm ST-segment depression and decreases angina frequency. With treatment for up to 6 months, antiischemic effects were maintained without serious adverse reactions. Other studies indicate that nicardipine is generally comparable to propranolol and nifedipine in prolonging exercise time and time to onset of ST-segment depression. Nicardipine, however, does not depress heart rate at rest, and maximal exercise workload is higher with nicardipine than with either placebo or propranolol. In a controlled study of patients with angina at rest due to coronary spasm, nicardipine decreased angina frequency and nitroglycerin consumption by approximately 80%. Episodes of symptomatic and asymptomatic ST segment shift, as recorded by ambulatory electrocardiographic monitoring, showed a trend to decrease in number. Nicardipine appeared similarly effective in patients with coronary spasm superimposed on significant coronary disease and with spasm in the absence of significant coronary disease. Nicardipine appears to be safe and effective in the management of patients with angina pectoris. PMID- 3300238 TI - Nicardipine for systemic hypertension: effects on blood pressure and target organ function. AB - Nicardipine has been shown to lower blood pressure in patients with uncomplicated hypertension as well as in patients with concomitant renal impairment, coronary artery disease or congestive heart failure. The decrease in blood pressure induced by nicardipine is related to a concurrent decrease in total peripheral vascular resistance. The antihypertensive actions of nicardipine are maintained during long-term administration without the development of tachyphylaxis. In patients receiving diuretics or beta blockers, the addition of nicardipine has been shown to produce an additional decrease in blood pressure. The combined use of nicardipine and beta blockers may be beneficial in the treatment of hypertension: the increase in peripheral vascular resistance during beta blockade may be prevented by nicardipine-induced vasodilation; conversely, beta blockers may prevent reflex tachycardia and other consequences of peripheral vasodilatation. Although nicardipine may increase the heart rate acutely, tachycardia does not occur during long-term therapy. Preliminary data suggest that nicardipine exerts potent antihypertensive effects in patients with renal insufficiency without altering renal parameters. In patients with normal renal function, nicardipine has been shown to cause acute natriuresis and an increase in renal blood flow and glomerular filtration rate. Nicardipine also has a favorable effect on peripheral and cerebral blood flow. Like other dihydropyridines, nicardipine appears to have an antiatherogenetic effect in the experimental model. Short-term therapy with nicardipine does not affect serum lipid levels. Results from several studies suggest that nicardipine is an effective antihypertensive agent that can be used as monotherapy or in combination with other drugs such as beta blockers or diuretics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300239 TI - An overview of the safety and efficacy of nicardipine in clinical trials. AB - Nicardipine is currently being evaluated in clinical trials as a treatment for angina and hypertension. Over 2,000 patients have received nicardipine, most at dosages of 20 to 40 mg 3 times daily. In 12 double-blind, parallel-group studies (4 of them placebo-controlled) the efficacy of nicardipine was evaluated in mild to moderate hypertension; supine systolic blood pressure was lowered by 10 to 15 mm Hg and supine diastolic blood pressure by 10 mm Hg. A clear dose response is present at dosages from 10 to 40 mg 3 times daily. Patients with angina were treated in 9 double-blind, crossover design studies: 4 of these were placebo controlled; 3 were comparison studies with beta blockers; 2 were comparisons with nifedipine. Treadmill exercise tests were the major measure of efficacy. Results of these studies showed consistent, statistically significant improvement in exercise tolerance and time to onset of angina, and clinical improvement in patients with chronic stable angina. The effective dosages of nicardipine were 30 or 40 mg 3 times daily. A placebo-controlled study demonstrated remarkable efficacy in patients with vasospastic angina. No deaths or serious adverse reactions were attributed to nicardipine during clinical trials. The most common side effects reported were flushing, palpitations, headache and pedal edema. These appeared to be due to the drug's pharmacologic property of vasodilatation. PMID- 3300240 TI - Hemodynamics of nicardipine in coronary artery disease. AB - Calcium antagonists influence cardiovascular hemodynamics by 3 actions: peripheral arterial dilatation, coronary arterial dilatation and negative inotropic effect. The net hemodynamic effects vary depending on the relative strength of each action. Intravenous administration of the new compound nicardipine, a dihydropyridine derivative with calcium antagonist activity that is chemically related to nifedipine, induced a marked reduction of systemic vascular resistance in patients with and without beta blockade. This was accompanied by an increase in cardiac output and left ventricular ejection fraction. In addition, end-diastolic pressure, peak (+) dP/dt and dP/dt measured at a developed pressure of 40 mm Hg and normalized for this pressure remained unchanged. The time constant of isovolumetric pressure drop during the first 40 ms also decreased. Intravenous administration of nicardipine prevented a marked increase in end-diastolic pressure during exercise, and augmented left ventricular ejection fraction in chronic heart failure. At doses producing similar increases in coronary sinus blood flow, intracoronary administration of nicardipine, unlike nifedipine, has little effect on left ventricular contractility and end-diastolic pressure. Nicardipine is a powerful systemic vasodilator with minimal effects on myocardial inotropic state, even in patients with compromised left ventricular function and patients receiving beta blocker therapy. PMID- 3300241 TI - Comparison of nitrendipine and hydrochlorothiazide for systemic hypertension. AB - Left ventricular (LV) hypertrophy with associated LV systolic and diastolic dysfunction is frequently found in patients with systemic hypertension, and is multifactorial in origin. Although a reduction in blood pressure (BP) often results in regression of hypertrophy, the pharmacologic profiles of the antihypertensive agents used may determine the probability of such regression despite similar levels of BP reduction. Thiazide diuretic drugs may actually result in increased LV hypertrophy; calcium channel antagonists may cause regression or no change. The effects of treatment with nitrendipine (20 mg/day) or hydrochlorothiazide (50 mg/day) were compared in an 8-week, double-blind study of 18 hypertensive subjects aged 50 years or older. BP was significantly reduced (p less than 0.05) by both nitrendipine (from 161 +/- 29/102 +/- 4 to 145 +/- 24/92 +/- 7 mm Hg; mean +/- standard deviation) and hydrochlorothiazide (from 162 +/- 15/105 +/- 6 to 143 +/- 20/95 +/- 7 mm Hg). Plasma norepinephrine increased in the nitrendipine group, from 202 +/- 110 to 332 +/- 220 pg/ml at 8 weeks of therapy and in the hydrochlorothiazide group, from 147 +/- 130 to 313 +/- 277. Plasma renin activity changed from 3.2 +/- 2.4 to 3.5 +/- 2.1 during nitrendipine treatment, but from 2.1 +/- 2.1 to 10.5 +/- 10.8 ng angiotensin l/ml/90 min (p less than 0.05) during treatment with hydrochlorothiazide. Left ventricular mass index did not change significantly with either therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300242 TI - Enhanced metabolic vasodilation secondary to diuretic therapy in decompensated congestive heart failure secondary to coronary artery disease. AB - Since sodium and water retention have been implicated as major factors limiting maximal metabolic vasodilation in congestive heart failure (CHF), the effect of rigorous diuresis on maximal vasodilatory capacity was studied systematically in 9 subjects hospitalized with decompensated CHF. Peak reactive hyperemic blood flow, measured by strain-gauge plethysmography, was used as an index of maximal vasodilatory capacity. After 24 hours of diuresis and a 2.2-kg weight loss, maximal flow increased from 19.9 to 26.1 ml/min X 100 ml (p less than 0.05). Despite a further 1.4-kg weight loss between 24 and 48 hours, maximal blood flow increased no more (26.1 to 25.8 ml/min X 100 ml). Since blood pressure did not change significantly, minimal forearm resistance and maximal conductance showed similar improvements. It is unlikely that vasoconstrictor hormone changes could account for this effect since a marked decrease in plasma norepinephrine occurred in only 2 of 8 subjects and plasma renin activity decreased in only 1 subject. As a group there was no significant change in norepinephrine level, which remained substantially above normal (1,525 to 1,148 pg/ml), or in plasma renin activity (12.3 to 18.9 ng/ml/hour). Because the improvement in vasodilator capacity reached a plateau by 24 hours despite continued diuresis, and because peak reactive hyperemic blood flow was still 32% below normal, it is suggested that a second mechanism besides sodium and water retention is responsible for a significant portion of the impaired peripheral vasodilation in CHF. PMID- 3300243 TI - Mitral regurgitation after cardiac transplantation. AB - The contribution of the left atrium to mitral valve competence was assessed using the model of altered atrial size and geometry created by atrial anastomosis during cardiac transplantation. Sixteen patients underwent Doppler and 2 dimensional echocardiography after orthotopic transplantation. Mitral regurgitation was present in 14 of 16 patients. Left atrial geometry was uniformly abnormal, in a "snowman" configuration. Compared with 16 normal control subjects, the transplanted left atria were dilated (23 +/- 6 vs 13 +/- 3 cm2 during ventricular systole, p less than 0.001). Mitral valve anular diameter indexes, anular systolic reduction and ventricular function were normal in both groups. Ventricular volumes were small in the transplanted heart relative to donor body size (15 +/- 5 vs 20 +/- 8 cm3/m2 in systole, p less than 0.05). The ratio between ventricular length and anular diameter was smaller in the transplant patients (0.87 +/- 0.1 vs 1.0 +/- 0.2, p less than 0.05). In the presence of abnormal left atria, mitral regurgitation may occur without other structural abnormalities of the mitral apparatus. This study suggests that the left atrium plays an important role in mitral valve competence for primary cardiac disease associated with left atrial enlargement, even in the absence of intrinsic mitral valve disease or left ventricular dysfunction. PMID- 3300244 TI - Diagnostic applicability of magnetic resonance imaging in assessing human cardiac allograft rejection. AB - To assess the diagnostic applicability of magnetic resonance imaging (MRI) for diagnosis of cardiac allograft rejection, 25 patients who recently underwent cardiac transplantation were studied on a 0.15-tesla resistive system within 24 hours of endomyocardial biopsy. Ten normal volunteers and 4 patients who had recent (within 2 weeks) nontransplant cardiac surgery were also studied. In the 19 transplant patients imaged within 24 days of graft implantation, only 1 had evidence of graft rejection on biopsy. However, all nonrejecting grafts had increased T1 and T2 values, 501 +/- 22 and 61 +/- 6 ms, respectively (mean +/- standard deviation) and the only rejecting graft had values of 496 and 60 ms, respectively. In the normal volunteers mean T1 was 352 +/- 18 ms and T2 was 35 +/ 6 ms. There was no significant difference in T1 and T2 values between patients who underwent nontransplant surgery and control subjects. In patients with nonrejecting transplants who were imaged more than 25 days after surgery, the T1 and T2 values had normalized to 359 +/- 17 ms and 36 +/- 7 ms, respectively (n = 28 images in 20 patients). However, in those grafts with rejection, T1 and T2 were both elevated to 502 +/- 21 ms and 62 +/- 6 ms, respectively (n = 15 in 13 patients); wall thickness was also increased. Fourteen of 15 late rejection events (more than 25 days after surgery) were correctly identified on the basis of increases in T1 and T2 to more than 2 standard deviations above normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300245 TI - Goffredo Gensini, MD (1928-1986). PMID- 3300246 TI - Sir William Osler's angina pectoris and other disorders. PMID- 3300247 TI - Heart rate variability and sudden death secondary to coronary artery disease during ambulatory electrocardiographic monitoring. AB - Data are analyzed from 5 patients who died suddenly during ambulatory electrocardiographic monitoring. Three of the patients were also assessed in terms of 2 recently developed indexes of heart rate (HR) variability. One of these, the standard deviation of RR intervals during successive 5-minute segments averaged over 24 hours, has been reported to be a putative index of vagal tone. Comparisons were made with HR variability findings in 20 normal volunteers. Sudden death was due to ventricular tachycardia degenerating into ventricular fibrillation in all cases. Both early (3 patients) and late cycle (2 patients) ventricular premature complexes initiated the terminal dysrhythmia. An increased density of ventricular ectopic activity was noted in the hour before onset of ventricular fibrillation. HR variability as measured by the standard deviation was significantly (p less than 0.01) lower in the patients who died suddenly (30 +/- 10 ms) than in the normal subjects (76 +/- 14 ms). These findings support suggestions that HR variability analysis may be useful in identifying patients at a higher risk of sudden death. PMID- 3300248 TI - Antihypertensive effect of sustained-release isosorbide dinitrate for isolated systolic systemic hypertension in the elderly. AB - A double-blind, randomized trial was performed in 40 patients, mean age (+/- standard deviation) 80 +/- 4 years, with isolated systolic systemic hypertension to evaluate the antihypertensive effect of oral sustained-release isosorbide dinitrate (ISDN), 20 to 40 mg twice daily, vs placebo. After 12 weeks of treatment, supine systolic blood pressure (BP) decreased from 192 +/- 10 to 162 +/- 12 mm Hg with ISDN (p less than 0.001) and from 189 +/- 10 to 175 +/- 15 mm Hg with placebo (p less than 0.001). On the basis of variance analysis, the decrease in systolic BP was significantly lower with ISDN (27 mm Hg) than with placebo (13 mm Hg). Similar results were observed for supine and erect systolic BP measured at 8 AM and 4 PM, 8 and 12 hours after drug intake. No significant differences in diastolic BP, heart rate or side effects occurred. After the ISDN tapering off-period (2 weeks), systolic BP increased significantly but did not change with placebo. The study provided evidence that in elderly patients with systolic hypertension, sustained-release ISDN induced a selective and sustained decrease in systolic BP, antihypertensive effect was observed 8 and 12 hours after drug administration, and no tolerance phenomenon was noted. PMID- 3300249 TI - Special issue dedicated to the memory of William A. Wimsatt. PMID- 3300250 TI - Effectiveness and nutritional consequences of amino acid-based vs glucose-based dialysis solutions in infants and children receiving CAPD. AB - Excessive glucose absorption and dialysate amino acid and protein losses contribute to malnutrition in children on glucose-based continuous ambulatory peritoneal dialysis (CAPD). We used 2.5 and 4.25% glucose and 1.1 and 2.0% amino acid dialysates to assess short-term effectiveness and nutritional consequences of amino acid-based dialysis solutions. Plasma and effluent urea and creatinine concentrations were similar with amino acid and glucose dialysis although 16% less fluid was removed with amino acid dialysates. Absorption of 77.3 +/- 5.3% of dialysate amino acids exceeded losses of amino acids and protein in glucose effluent. With amino acid dialysates, fasting plasma glucose concentrations were maintained while plasma amino acid levels rose, peaked at 1 h, and, excepting methionine, isoleucine, and phenylalanine with the 2.0% solution, returned to initial levels after 5 h. Compared with glucose, amino acid dialysates provide reduced but satisfactory fluid and waste removal, maintain normoglycemia, and more than compensate for effluent losses of amino acids and protein. PMID- 3300251 TI - Sex-specific differences in plasma branched-chain keto acid levels in obesity. AB - Obesity was associated with a significant increase in postabsorptive plasma concentrations of the branched-chain keto acids in men but not in women matched for body-mass index and age. Plasma glucose and serum insulin were significantly higher in obese subjects than in nonobese control subjects. Obese women had more adipose tissue than did obese men from the sum of triceps and subscapular skinfold thickness. It is suggested that augmentation in plasma branched-chain keto acids in obesity may reflect insulin resistance and that the apparent differences observed between obese women and men may be due to differences in body composition. PMID- 3300252 TI - Low-glycemic index diet in hyperlipidemia: use of traditional starchy foods. AB - To define those patients most likely to benefit from the hypolipidemic effect of low-glycemic-index (GI) traditional starchy foods, 30 hyperlipidemic patients were studied for 3 mo. During the middle month, low-GI foods were substituted for those with a higher GI with minimal change in dietary macronutrient and fiber content. Only in the group (24 patients) with raised triglyceride levels (types IIb, III, and IV) were significant lipid reductions seen: total cholesterol 8.8 +/- 1.5% (p less than 0.001), LDL cholesterol 9.1 +/- 2.4% (p less than 0.001), and serum triglyceride 19.3 +/- 3.2% (p less than 0.001) with no change in HDL cholesterol. The percentage reduction in serum triglyceride related to the initial triglyceride levels (r = 0.56, p less than 0.01). The small weight loss (0.4 kg) on the low-GI diet did not relate to the lipid changes. Low-GI diets may be of use in the management of lipid abnormalities associated with hypertriglyceridemia. PMID- 3300253 TI - A festschrift for Lloyd Jackson Filer, Jr. Papers presented at a symposium honoring LJ Filer, Jr. October 6, 1986, Iowa City, IA. PMID- 3300254 TI - Biographical sketch of Lloyd Jackson Filer Jr, MD, PhD. PMID- 3300255 TI - History of infant feeding practices. AB - Human milk was the one successful infant food until the advent of scientific pediatrics, the invention of electric refrigeration, and the development of formulas containing the major nutrients in concentrations similar to human milk. Infants apparently thrive on artificial formulas but the current formulas represent only a stage in the journey to optimal nutrition for infants. Better analyses of the composition of human milk are likely to lead to an improved understanding of the infant's nutritional requirements and thus to better feeding practices. PMID- 3300256 TI - Reflections on infant feeding in the 1970s and 1980s. AB - In 1985 35% of US infants were breast-fed until at least age 4 mo whereas in 1971 the corresponding figure was only 10%. Breast-feeding is less common among lower income than among higher income groups. In 1985 10% of infants aged 6 mo were fed fresh fluid cow milk--down from 70% in 1971. Most formula-fed infants receive iron-fortified formulas (12 mg Fe/L). Beikost is now commonly fed to infants less than age 2 mo. The Infant Formula Act of 1980 resulted in promulgation of new quality control and labelling requirements for infant formulas. Over the past 15 y, salt and sugar concentrations of commercially prepared beikost items have been decreased, and certain modified food starches are no longer used. There is considerable doubt about the bioavailability of the electrolytic iron powder used to fortify most of the dry infant cereals. PMID- 3300257 TI - History of vitamin E in infant nutrition. AB - Vitamin E was discovered by Evans and Bishop in 1922. Work in the 1930s revealed the chemical structure and the biological function of alpha-tocopherol. In the 1940s Filer and others demonstrated that vitamin E protects tissue unsaturated fatty acids against oxidation. The 1940s and the 1950s marked the beginning of interest in the role of vitamin E in infant nutrition. During this period, investigators examined the intestinal absorption of vitamin E in infants and its use for the prevention of hemolysis, retrolental fibroplasia, intracranial hemorrhage, and pulmonary oxygen toxicity. These studies were the forerunners of more recent studies examining possible benefits of vitamin E therapy in premature infants. Recent studies confirmed earlier reports indicating that enteral administration of vitamin E is the safest and most effective route in infants. Although preventing vitamin E deficiency is clearly necessary, neither earlier nor more recent work has shown any benefit from high-dose vitamin E therapy (greater than 20 IU X kg-1 X d-1) for premature infants. PMID- 3300258 TI - Current perspectives on vitamin E in infant nutrition. AB - The human infant is born with low body stores of vitamin E. Thus, the infant requires an adequate intake of vitamin E soon after birth. If adequate sources of tocopherol are not provided, a clearly defined deficiency state characterized by hemolytic anemia and, after a period of years, spinocerebellar degeneration results. However, the benefit of pharmacologic doses of vitamin E given as prophylaxis against diseases believed to be related to oxygen toxicity (bronchopulmonary dysplasia, retinopathy of prematurity, and periventricular intraventricular hemorrhage) is not clear. Possible benefits must be balanced against the potential for serious toxicity. Few data are available on the pharmacokinetics of tocopherols in infants, particularly with respect to esterified forms of tocopherol, and little is known about the toxicity associated with parenteral administration of the vitamin. PMID- 3300259 TI - Continuing physician education: the Ross Conference approach. AB - The Ross Conferences on pediatric research are a series designed to assist in the correlation of findings from recent research on subjects pertaining to pediatrics with clinical practice and to stimulate further research by the exchange of information. Reports of the proceedings are published and distributed worldwide to pediatricians and other physicians in order to disseminate information at the leading edge of pediatric medicine. PMID- 3300260 TI - Continuing physician education: the Health Learning Systems approach. AB - In the past 10 years, Jack Filer has served as executive editor for a series of five separate national education programs on infant nutrition. Four of these have been directed towards physicians and the last been developed for mothers. He was assisted by a group of associate editors with expertise in various areas, as needed, depending on the material to be developed. The educational programs have included closed-circuit live telecasts, films and slides for use in a visiting faculty program, monographs and newsletters, and videotapes for maternal instruction. The nutritional guidelines for infant feeding emphasized throughout the recommendations of the Committee on Nutrition of the American Academy of Pediatrics to promote breast-feeding with commercial infant formula as an alternative if breast-feeding is not elected or stopped early. Delayed introduction of solid food and cow milk was also recommended. PMID- 3300261 TI - Food additives--an unending controversy. AB - The use of food additives originated in ancient times but did not engender controversy until the early 1800s, when intentional food adulteration became appallingly common in some countries. Problems with intentional food adulteration continued until about 1920, when regulatory pressures and effective methods of food analysis reduced the frequency and seriousness of food adulteration to acceptable levels in the United States. Since 1920 the use of legally sanctioned food additives has become common. However, for the last several decades the regulation of food additives has been a matter of controversy. Explanations for this controversy, which is likely to continue, are not difficult to identify and are discussed in the text. PMID- 3300262 TI - The aspartame story: a model for the clinical testing of a food additive. AB - Toxicology is based on the premise that all compounds are toxic at some dose. Thus, it is not surprising that very large doses of aspartame (or its components- aspartate, phenylalanine, and methanol) produce deleterious effects in sensitive animal species. The critical question is whether aspartame ingestion is potentially harmful to humans at normal use and potential abuse levels. This paper reviews clinical studies testing the effects of various doses of aspartame upon blood levels of aspartate, phenylalanine, and methanol. These studies demonstrate that blood levels of these compounds are well below levels associated with adverse effects in sensitive animal species. PMID- 3300263 TI - Immunohistology of persistent generalized lymphadenopathy. Evidence for progressive lymph node abnormalities in some patients. AB - Immunohistologic analysis of cellular changes in serial lymph node biopsies of eight patients with persistent generalized lymphadenopathy (PGL) syndrome was performed and correlated with clinical and laboratory findings to better determine the natural history of human immunodeficiency virus (HIV) infection. The authors observed decreased follicle size and area in the second biopsies of six of the eight patients, associated in some with increased numbers of B-cells in medullary regions (four of eight) and more involuted follicles (four of eight). Five cases showed progressively increased paracortical areas in the second biopsies, with increased numbers of T-cytotoxic/suppressor cells and decreased T-helper cells. Seven of the patients also had a progressive loss of T helper cells in the peripheral blood. These findings provide tissue and peripheral blood evidence for progressive immunologic deterioration in some patients with PGL. PMID- 3300264 TI - Cutaneous complications in renal transplant recipients. AB - Systematic review of the histologic characteristics of skin lesions biopsied and/or resected in a group of 580 renal transplant recipients collected over a 16 year period showed a total of 170 specimens from 120 patients. In this group there were 41 benign tumors, 22 infections, 35 inflammatory dermatoses, and 13 miscellaneous lesions. Fifty-nine lesions were malignant, and half of these were squamous cell carcinomas (SCCs). None were lethal or metastasized, although deeply invasive local recurrences and multiple lesions were common. Comparison with SCCs from a control group showed no clearcut differences with respect to level of invasion, grade, pattern, or presence of actinic change. Most of these lesions were found in sun-exposed areas, were associated with actinic changes, and with actinic keratoses. Problems in differentiating SCC from keratoacanthoma and the clinical implications of these difficulties are discussed in conjunction with a review of the literature. PMID- 3300265 TI - Immunoalkaline phosphatase labeling of terminal transferase in hematologic samples. AB - Early studies of terminal transferase (TdT) expression in acute leukemia indicated that this enzyme is only found in acute leukemia of lymphoblastic type (ALL). More recently, however, several reports have suggested that TdT-positive blast cells may be found in a substantial number of cases of acute myeloid leukemia (AML). In this study, a sensitive immunoalkaline phosphatase procedure (the APAAP technic) has been used to stain normal and neoplastic blood and bone marrow samples for TdT with the use of both polyclonal and monoclonal anti-TdT antibodies. As expected, most cases of ALL studied (63 of 65) were TdT-positive. In addition, however, blast cells in 22 out of 59 (37%) cases of AML were stained by anti-TdT antibodies. Both nuclear and cytoplasmic localization were seen in each type of acute leukemia. These findings, together with previous immunocytochemical and biochemical studies, suggest that a substantial number of cases of AML express TdT (usually in a minority of blast cells) and that the frequency with which these cases are detected is directly related to the sensitivity of the staining technic used. PMID- 3300266 TI - Overlapping IgA and membranous nephropathy. AB - Four patients with overlapping IgA nephropathy and membranous nephropathy recently have been reported from two different medical centers in Japan. The authors describe two patients from the United States with the concurrence of IgA and membranous nephropathy and a third patient who may have the same overlapping glomerular lesions. All three patients had hematuria and nephrotic range proteinuria. Renal biopsy specimens from two of the patients revealed focal proliferative glomerular lesions, large mesangial and numerous subepithelial electron-dense deposits, exclusively mesangial intense immunostaining for IgA, and extensive granular capillary wall immunostaining for IgG. The third patient is a sibling of one of the other patients and was shown to have focal proliferative glomerular lesions, mesangial immunostaining for IgA, and numerous subepithelial electron-dense deposits. Pathogenic possibilities are discussed. PMID- 3300267 TI - The histopathology of rectosigmoid biopsies from adults with bloody diarrhea due to verotoxin-producing Escherichia coli. AB - The histopathology of rectosigmoid biopsies from 20 patients with bloody diarrhea resulting from verotoxin-producing Escherichia coli infection is reported. The biopsies displayed a range of appearances, from normal to mild, nonspecific inflammation to acute infectious-type colitis. Surface-adherent or invasive bacteria were not identified. The morphologic features of infectious colitis and the absence of bacteria suggest that verotoxin may be responsible for the pathologic changes. PMID- 3300268 TI - Reactivity of neoplastic cells of hairy cell leukemia with antisera to S-100 protein. AB - Rabbit antibodies to bovine S-100 protein were tested by immunoperoxidase technics against fresh hairy cell leukemia (HCL) cells obtained from nine patients (peripheral blood in six and spleen in three), as well as lymphoblastoid cell lines derived from three patients with HCL. Peripheral mononuclear cells from three normal persons and two patients with chronic lymphocytic leukemia (CLL) and cells from two melanoma lines were used as controls. The melanoma cell lines, cell lines derived from patients with HCL, and fresh HCL cells displayed cytoplasmic and nuclear positivity after exposure to anti-S-100 protein sera. By contrast, normal peripheral blood lymphocytes and CLL cells were negative for S 100 protein. Additional studies were performed by immunoperoxidase technics on representative sections of formalin-fixed splenic tissues from eight patients who had splenectomies. The cause of splenectomy was HCL in three, traumatic rupture in one, CLL in one, Hodgkin's disease in one, and hypersplenism in two patients. Sections from all three HCL patients showed moderate to marked positivity with antisera to S-100 protein. These results strongly suggest the presence of S-100 protein in HCL cells. PMID- 3300269 TI - Antinuclear antibodies and survival in cardiac transplant patients. AB - Serum from 48 patients with cardiac transplants was tested for the presence of antinuclear antibodies (ANA). Thirty-two of the sera were negative for ANA (ANA ), and 16 were positive for ANA (ANA+). Six of the ANA+ sera had a diffuse pattern, six had a peripheral pattern, three had a combined diffuse and rim pattern, and one had a diffuse and nucleolar pattern. Seven of the ANA+ sera were positive at a 1:40 titer, one at a 1:80 titer, four at a 1:160 titer, two at a 1:320 titer, and two at a 1:640 titer. Thirteen of the 32 ANA- patients have died, at intervals of one month to four years after transplantation. Fourteen of the 16 ANA+ patients have died, at intervals ranging from less than one day to four years after transplantation. The mean time period from transplantation to death was 13 +/- 15 months for the ANA+ patients: these were not statistically significantly different. However, the mean interval from transplantation to death of the ANA+ patients with an ANA titer greater than 1:40 was 0.8 +/- 0.8 months, which was significantly different from the mean survival period of the ANA+ group as a whole (P less than or equal to 0.05) and the mean survival of the ANA- group (P less than or equal to 0.005). Although the mechanism is not clear, there appears to be an association between higher titer serum ANA positivity and increased mortality in patients with cardiac transplants with significantly decreased duration of survival after transplantation. PMID- 3300271 TI - Re: Informed consent. PMID- 3300270 TI - Demineralization and remineralization around orthodontic appliances: an in vivo study. AB - The presence of clinically detectable areas of decalcification (observable as whitened areas) following the removal of orthodontic appliances is well recognized. The aim of the present study was to determine quantitatively the amount of demineralization and the ability of commercially available products to inhibit or reverse orthodontically related demineralization. Twenty orthodontic patients scheduled to have premolars extracted were randomly divided into four groups--one control and three test groups. The extracted premolars (numbering 58) were bracketed using an acid-etch composite system; each patient was given precise oral hygiene instructions and supplied with a sodium fluoride (1,100 ppm fluoride) dentifrice and an orthodontic toothbrush. The control group brushed only with the supplied dentifrice. In addition to brushing with the dentifrice, those in test group I rinsed once each night with a sodium fluoride (0.05%) mouthrinse; group II received a weekly topical APF treatment (1.2% fluoride); and Group III received a weekly topical APF treatment and rinsed once each night with the sodium fluoride mouthrinse. All premolars were extracted after 1 calendar month. Mineral profiles were determined on cross-sectioned teeth 50 to 75 micron occlusal and cervical to the brackets, directly underneath the brackets, and 500 micron away from the brackets. The control teeth (dentifrice only) demonstrated up to 15% demineralization to a depth of 50 micron. All of the test teeth produced rehardening and/or inhibition of demineralization (P less than 0.01). Those in test group III showed a particularly hard outer layer. The study demonstrated that measurable demineralization occurred around orthodontic appliances after only 1 month and this demineralization can be completely inhibited and/or reversed by the use of commercially available fluoride products. PMID- 3300272 TI - The trial of Spencer Cowper. Expert witnesses to the rescue. PMID- 3300273 TI - A review of liver transplantation for gastroenterologists. AB - The 1980s will be remembered as the era of transplantation. During this period both liver and heart transplantation have their places as established therapeutic procedures for selected patients with end stage organ failure. As increasing numbers of patients are transplanted, others practicing physicians, especially gastroenterologists and cardiologists, will need to become familiar with all aspects in the care of patients that they have referred for transplantation. Only through close cooperation between transplant surgeons and this new breed of "transplant internists" will all suitable patients be referred for these life saving procedures and receive appropriate follow-up care. PMID- 3300274 TI - No effect of long-term oral testosterone treatment on liver morphology in men with alcoholic cirrhosis. AB - The effect of oral testosterone treatment (200 mg tid) on liver morphology was examined in a double-blind, placebo controlled study including men with alcoholic cirrhosis (n = 126). Liver biopsies obtained before randomization showed micronodular cirrhosis in 119 patients (94%), alcoholic hepatitis in 64 (51%), and fatty liver in 104 (83%). These and other morphological findings did not differ significantly in the patients randomized to testosterone (n = 76) and to placebo (n = 50) (skewed randomization 3:2). Follow-up liver specimens (biopsies or autopsies) obtained after a median treatment duration of 30 months demonstrated a significant (p less than 0.01) increase in the prevalence of macronodular cirrhosis (from 6 to 51%) and a significant (p less than 0.01) decrease in the prevalence of alcoholic hepatitis (to 21%) and of fatty liver (to 52%). Testosterone treatment did not significantly influence the prevalence of these changes. Further, testosterone treatment had no significant effect on the prevalence of other morphological changes, including vascular and malignant changes. However, in the testosterone-treated group one patient developed diffuse sinusoidal dilation and one patient showed Budd-Chiari's syndrome. The degree of fatty liver and of alcoholic hepatitis in follow-up liver specimens were significantly (p less than 0.002) higher among patients who consumed ethanol during follow-up than in patients who abstained (76 versus 22% and 30 versus 6%). In conclusion, this study does not establish any indication or any contraindication in terms of hepatic histopathology with the possible exception of hepatic venous thrombosis for the use of oral testosterone treatment in men with alcoholic cirrhosis. PMID- 3300275 TI - Cholecystokinin receptor antagonists: a review. PMID- 3300276 TI - The effects of liver directed radiotherapy and chemotherapy on liver function tests and hematological parameters in patients with surgically resected colon cancer: findings from the Gastrointestinal Tumor Study Group. AB - The effects on liver function tests of liver-directed radiation (RT) and systemic chemotherapy (CT) were examined at 6 months after initiation of treatment on two Gastrointestinal Tumor Study Group protocols. Data from patients on protocol GI 6175 (adjuvant CT or no adjuvant therapy) were used to evaluate the effect of CT alone, and data from patients on protocol GI 6179 (adjuvant CT plus liver directed RT or no adjuvant therapy) were used to evaluate the combined effects of CT and RT. Finally, data from patients on GI 6179 who received less than protocol specified RT doses were used to determine whether minor differences in dose are detectable via liver function tests. In 40 patients receiving CT, the serum level of alkaline phosphatase was not significantly increased (p = 0.14) compared to that of control patients whereas the level of serum glutamate oxoloacetate transaminase was significantly elevated (p = 0.03). In 31 patients receiving both CT and RT, both alkaline phosphatase and SGOT were significantly elevated (both p = 0.03). In addition, in 19 patients who received less than full RT doses, the changes in dose were not detectable from those patients who received full dose (all p greater than 0.10). In summary, CT alone may elevate hepatocellular enzymes, whereas a combination of CT and liver-directed RT is associated with a significant increase in both SGOT and alkaline phosphatase. Small alterations in the dose of volume of RT are not detectable by liver function test variations. PMID- 3300277 TI - Echo-guided fine-needle biopsy of pancreatic masses. AB - Aim of this study was the evaluation of percutaneous echo-guided fine-needle biopsy in the diagnosis of focal lesions of the pancreas. In patients with masses of the pancreas 43 echo-guided fine-needle punctures have been performed. In 27 of the 30 cases of cancer, echo-guided puncture allowed aspiration of cells revealing malignancy. In the remaining three cases the histology was normal. Malignancy was not detected in the aspirate of any of the 13 cases of benign solid masses. In one of these patients we failed to obtain sufficient material for the purpose of diagnosis. The sensitivity of the method was 90%, the specificity 100%, and the diagnostic accuracy 92.8%. Positive and negative predictive values were 100 and 75%, respectively. No complications worthy of note occurred. PMID- 3300278 TI - A study of the correlation between endoscopic and histological diagnoses in gastroduodenitis. AB - Serial histological specimens from 14 patients with the endoscopic diagnosis of erosive gastritis and/or duodenitis were examined for correlation between endoscopic and histological findings. All patients were symptomatic outpatients without history of alcoholism or usage of aspirin or nonsteroidal antiinflammatory drugs. After the initial diagnosis, the patients underwent follow-up endoscopy until healing of erosions at 1, 4, and 8 wk. Pairs of biopsies from the gastric fundus, body, and antrum, and the duodenum were obtained at each endoscopy. Agreement between histological and endoscopic findings occurred in only 56% of the 161 sites studied. The best correlation occurred in the duodenum when there was endoscopic disease (89%) and was worst in the stomach at all sites regardless of endoscopic findings (46%). A normal histology in the face of abnormal endoscopic changes was seen in only 16% of all biopsies. Histological inflammation occurred in 27% of all biopsies with a normal endoscopic appearance and in 55% of the normal endoscopic areas in the stomach. Histological appearances at each biopsy site remained constant in individual patients throughout the study. The specific histological findings, such as activity and severity, did not correlate with the endoscopic severity of inflammation or with any specific endoscopic appearances, such as erosions, petechiae, or nodules. In conclusion, the histological and endoscopic findings in the stomach from patients with symptomatic erosive gastroduodenitis correlate poorly while good correlation occurs in the duodenum. PMID- 3300279 TI - Misinterpretation and misuse of the kappa statistic. PMID- 3300280 TI - Epidemiology of rabies virus variants. Differentiation using monoclonal antibodies and discriminant analysis. AB - Rabies virus was isolated by cell culture from the brains of 104 confirmed rabies cases diagnosed by the fluorescent-antibody staining technique in the United States during 1974-1984. Eighty-seven isolates were obtained from wild-life species, 10 from humans, and seven from domestic animals. These isolates were tested in virus neutralization and immunofluorescence assays using a panel of 34 monoclonal antibodies specific for rabies virus nucleocapsid protein, 44 monoclonal antibodies specific for rabies virus glycoprotein, and two monoclonal antibodies specific for rabies virus nucleocapsid-associated phosphoprotein. Using discriminant analysis, a distinctly different reactivity pattern was revealed between virus isolates from terrestrial (raccoon, skunk) and nonterrestrial (bat) reservoir hosts. The usefulness of this approach for studying the epidemiology of rabies and for predicting the source of infection when this information is unknown is discussed. PMID- 3300281 TI - The Multicenter AIDS Cohort Study: rationale, organization, and selected characteristics of the participants. AB - The Multicenter AIDS Cohort Study was designed to elucidate the natural history of the infection causing acquired immunodeficiency syndrome (AIDS), identify risk factors for occurrence and clinical expression of the infection, and establish a repository of biologic specimens for future study. A variety of recruitment techniques, including special assurance of confidentiality, were used to enroll participants. Nearly 5,000 homosexual men volunteered for semiannual interview, physical examination, and laboratory testing in four metropolitan areas. A significant majority of these men in each center (69-83%) reported having 50 or more lifetime sexual partners, and over 80% had engaged in receptive anal intercourse with at least some of their partners in the previous two years. By the time of the participants' initial evaluation (April 1984-April 1985), infection with the human immunodeficiency virus (HIV) had occurred in higher proportions of men in Los Angeles (51%) and Chicago (43%) than in Baltimore/Washington, DC (31%) and Pittsburgh (21%), presumably as a result of the higher number of partners and proportion with whom these men had engaged in high-risk practices (e.g., receptive anal intercourse). Follow-up evaluations are underway in this comprehensive longitudinal investigation of HIV infection. PMID- 3300282 TI - Myeloid lineage specificity and high sensitivity of monoclonal antibody GM 58/8 proves its usefulness as a diagnostic reagent in acute leukemia. AB - Monoclonal antibody (MoAb) GM 58/8 was earlier reported to be directed against an antigen expressed by myeloid progenitors (CFU-GM), myeloid precursors, granulocytes, and monocytes. Immunophenotyping of 216 cases of acute leukemia [acute myeloblastic leukemia (AML) = 147 and acute lymphoblastic leukemia (ALL) = 69] and 18 cases of chronic granulocytic leukemia in blast crisis (CGLBC) with this antibody showed that GM 58/8 reacted with 92% of AML cases (M1-M5) and 100% of myeloblastic crisis in CGL cases. All cases of ALL, lymphoblastic crisis in CGL, erythroleukemia, and erythroblastic crisis in CGL were unreactive with GM 58/8. The antibody revealed the myeloid phenotype in an additional 15 cases of otherwise unclassifiable acute leukemia and six cases of CGLBC. Eleven cases of acute "mixed lineage" leukemia were also diagnosed with the help of GM 58/8. The high specificity (100%) and sensitivity (92%) of MoAb GM 58/8 for myeloblastic leukemia is unmatched by almost all previously described myeloid MoAb and proves its usefulness as a single diagnostic reagent for AML and myeloblastic crisis in CGL. PMID- 3300283 TI - No evidence for bradykinin hydrolysis in human erythrocyte suspensions: 1H NMR studies. AB - In view of their permeability to small peptides, it has been postulated that human erythrocytes may play a role in terminating the action of some circulating peptide hormones. Work using classical paper chromatographic techniques for detecting free amino acids indicated that the octapeptide, des-(Arg9)-bradykinin, enters these cells and its amino-terminal arginine residue is released by cytosolic aminopeptidase-P. We have used 1H NMR to monitor directly the release of arginine from bradykinin. The hydrolytic reaction rate in hemolysates, with an initial peptide concentration of 13.0 mmol l-1 was 6.5 mmol (1 packed red cell)-1 h-1. But no reaction was evident after a 4.5-h incubation with intact cells, thus contradicting the earlier suggestion that erythrocytes are involved in the primary inactivation of this hormone. This is consistent with our previous findings that the pentapeptide leu-enkephalin fails to enter human erythrocytes but that its lower-order degradation products may do so. PMID- 3300284 TI - Nonleukemic granulocytic sarcoma of the heart: a report of a fatal case. AB - We report the clinical and pathological features of a cardiac fatality caused by granulocytic sarcoma in a young adult man with no evidence of leukemia involving bone marrow or peripheral blood. At autopsy, walls of the four cardiac chambers were massively infiltrated by tumor, resulting in a cardiac weight of almost three times normal. Routine cytochemical stains plus immunoperoxidase staining for OKM1 confirmed the diagnosis. Although subclinical cardiac infiltrates are commonly detected at autopsy in patients with acute nonlymphoblastic leukemia (ANLL), massive cardiac granulocytic sarcoma in the absence of bone marrow disease has not been previously described. Cytochemical and immunological methods of diagnosing granulocytic sarcoma in fixed tissues are reviewed. PMID- 3300285 TI - Uremic pleuritis. AB - Pleural abnormalities of uremia have been recognized for many years but have been given little attention despite their high incidence. Mechanisms underlying pleural effusion relate to filtration forces across subpleural capillaries and lymphatic absorption, either of which can be abnormal in patients with renal failure. Uremic patients have increased susceptibility to many causes of pleural exudate. In addition, a specific uremic pleuritis has been characterized as necrotizing fibrinous sterile exudate that is often hemorrhagic. Spontaneous remission, often with recurrences, or constrictive pleural thickening requiring surgical decortication may occur. Neither the pathogenesis nor the appropriate treatment of uremic pleuritis has been established definitively. PMID- 3300286 TI - Acquired renal cystic disease: two cases of associated adenocarcinoma and a renal ultrasound survey of a peritoneal dialysis population. AB - Long-term dialysis patients frequently develop acquired renal cystic disease (ARCD). The discovery of ARCD and renal cell carcinoma in one of our hemodialysis patients led us to review the literature. ARCD has been described mainly in the maintenance hemodialysis (MH) population. Therefore, we investigated 20 peritoneal dialysis (PD) patients for ARCD using ultrasonography. Seven patients (35%) had detectable cysts and two patients (10%) had multiple bilateral cysts. One patient had a large asymptomatic complex cyst that proved to be an adenocarcinoma. Our study suggests that ARCD is relatively common in the PD population, and we speculate that it may be related more to length of time in end stage renal disease (ESRD) than to the mode of dialysis. The potential for malignant change appears to justify a routine screening examination with ultrasonography and/or computerized tomography (CT) to detect this recently described and probably underrecognized entity. PMID- 3300287 TI - Plasma exchange in patients with rapidly progressive idiopathic IgA nephropathy: a report of two cases and review of literature. AB - Primary IgA nephropathy is generally considered an indolent disease, but progression to chronic renal failure is not uncommon, and a rapidly progressive course is observed in some cases, especially when extensive fibrocellular crescents are present. The therapeutic benefit of immunosuppression and plasma exchange remains controversial. We described two patients with primary IgA nephropathy and rapidly progressive renal failure. Both patients showed extensive glomerulosclerosis and crescent formation in their renal biopsies. Corticosteroid and immunosuppressive therapy failed to control the progression of the disease, and plasma exchanges were performed. In both cases, the serum creatinine and creatinine clearance initially improved with plasma exchange and the rapid progression of renal failure was apparently halted. In one patient, the serum creatinine rose when treatment was discontinued and fell again when plasma exchange was recommenced. Nevertheless, the long-term benefit of plasma exchange in crescentic IgA nephropathy was unsatisfactory as the renal function continued to deteriorate in the following 12 months despite an initial stabilization. PMID- 3300288 TI - The cell biology of Heymann nephritis: a model of human membranous glomerulonephritis. PMID- 3300289 TI - Ascites associated with end-stage renal disease. AB - Patient characteristics, clinical outcomes, and proposed pathophysiologic mechanisms are reviewed in 138 patients reported in the literature to have had ascites associated with end-stage renal disease. Contributing mechanisms may include fluid overload, peritoneal membrane changes (not necessarily related to peritoneal dialysis), hypoproteinemia, and lymphatic drainage disturbances. In 15% of cases, extensive evaluations may reveal an underlying disease. The most effective therapy may be kidney transplantation. PMID- 3300290 TI - Renal hemodynamics in hypertension. AB - The relationships between systemic arterial pressures, renal blood flow, filtration, and sodium homeostasis are complex. Considerable evidence has accrued indicating that changes in renal sodium handling as a function of perfusion pressure participate in the pathogenesis of hypertension. Central to this viewpoint is the normalization of BP after transplantation of a normal kidney to a hypertensive host, both in animals and humans. Renal blood flow varies inversely with the severity and duration of hypertension. Studies of regional hemodynamics underscore the importance of independent regulation of different vascular beds. Some observations suggest that abnormal renal vascular reactivity may be among the earliest changes in essential hypertension. The degree to which these represent structural changes as opposed to functional responses to endocrine or neurogenic stimuli may vary under different circumstances and merits further study. Although antihypertensive therapy generally has been well tolerated by the kidney, deterioration of renal function has been encountered during pharmacological BP reduction. In the presence of preglomerular arterial disease, blood flow and filtration may become sensitive to hemodynamic fluctuations, which leads to the designation of "critical perfusion pressure." Awareness of the mechanisms by which changes in systemic hemodynamics impinge upon renal function may lead to more rational use of specific antihypertensive agents. PMID- 3300291 TI - Utility of behavioral science techniques in assessing adverse effects of antihypertensive agents. AB - Noncompliance of hypertensive patients to their treatment program is a common problem. The basis of this noncompliance is multifactorial, but a large component is related to the adverse symptoms produced by the commonly prescribed antihypertensive agents. There is increasing evidence that one can use social and behavioral science techniques to quantitate the effect of antihypertensive agents on a patient's quality of life. Thus, in addition to efficacy, serious side effects, and cost, the physician also now will be able to add impact on quality of life as a fourth dimension in determining which antihypertensive program is the most appropriate. PMID- 3300292 TI - A comparison of betaxolol and nadolol on renal function in essential hypertension. AB - Betaxolol, a beta 1-selective adrenergic antagonist, and nadolol, a nonselective beta-adrenergic antagonist are both potent long-acting antihypertensive drugs. The effects of betaxolol on renal function have not been reported. The effects of nadolol on renal function are controversial. The current randomized double-blind study was designed to compare the effects of betaxolol and nadolol on glomerular filtration rate, assessed by creatinine and inulin clearances, and renal hemodynamics, assessed by p-aminohippurate clearance. Following a 4-week placebo run-in period, 15 patients with essential hypertension were randomized to a mean dose of 22 mg betaxolol for 12 weeks, and 12 patients with essential hypertension were randomized to a mean dose of 103 mg nadolol for 12 weeks. Results indicate that neither drug produced a clinically relevant effect on renal function. These findings are consistent with previously reported observations with other beta adrenergic blocking drugs. We conclude that neither of the beta-adrenergic antagonists, betaxolol or nadolol, convey a specific renal pharmacologic advantage; both are equally efficacious and safe in the treatment of mild-to moderate essential hypertension. PMID- 3300294 TI - The effect of ethanol on serum cyclosporine A levels in renal transplant recipients. AB - Following an alcohol binge, cyclosporine A (CyA) levels rose by 100% in a 51-year old transplant recipient treated with CyA. As CyA and ethanol are both metabolized by the cytochrome P-450 enzyme system, ethanol could theoretically interfere with CyA metabolism. Therefore, eight male renal transplant recipients were assessed in a crossover study to determine the effects of acute ethanol ingestion on CyA serum concentrations. CyA serum concentrations did not rise following 50 mL of 100% alcohol. We conclude that heavy alcohol intake may increase CyA levels but that acute moderate intake does not. PMID- 3300293 TI - The plasma creatinine concentration is not an accurate reflection of the glomerular filtration rate in stable renal transplant patients receiving cyclosporine. AB - We studied 31 stable renal cadaver kidney transplant patients receiving cyclosporine (CyA) and prednisone for immunosuppression to determine what reduction in true glomerular filtration rate (GFR) was reflected by their mild elevation in plasma creatinine concentration (1.8 +/- 0.11 mg/dL). We measured both the creatinine clearance (60 +/- 4.32 mL/min/1.73 m2) and the true GFR using Technetium 99m-DTPA (44 +/- 2.72 mL/min/1.73 m2). The creatinine clearance overestimated true GRF by a mean of 38%, indicating that this percentage of creatinine reached the urine by tubular secretion rather than glomerular filtration. A similar degree of overestimation was found in a separate group of 14 patients receiving imuran for immunosuppression. In 23 patients receiving CyA in whom the serum creatinine concentration was less than 2.0 mg/dL, the mean DTPA clearance was 49.5 +/- 2.83 mL/min/1.73 m2. In stable renal transplant patients receiving CyA, a serum creatinine concentration at, or close to, the upper limit of the normal range may reflect markedly impaired renal function. PMID- 3300295 TI - Occurrence of multiple myeloma three years after successful renal transplantation. AB - A living-related renal transplant recipient developed premature progressive allograft dysfunction 3 years after transplantation. Histopathologic examination of a transplant biopsy specimen demonstrated kappa light chain nephropathy, whereupon the diagnosis of multiple myeloma was subsequently confirmed. A variety of tumors have been reported to develop in the successful renal allograft recipient, although multiple myeloma is decidedly uncommon. This may be due to the relatively young age of transplant recipients. Histopathologic examination of renal tissue in the evaluation of premature or unexpected renal failure in the transplant recipient is underscored. PMID- 3300296 TI - Renal infections in autosomal dominant polycystic kidney disease. AB - Renal infection is a common occurrence in autosomal dominant polycystic kidney disease (ADPKD) and often leads to serious complications, including perinephric abscess, septicemia, and death. Important predisposing factors include age, female sex, and recent instrumentation of the urinary tract. Renal infections in ADPKD are most commonly caused by gram-negative enteric organisms. Diagnosis of these infections may be difficult since some patients do not have bacteriuria. Eradication of cyst infections with conventional antibiotic therapy can be difficult despite in vitro sensitivity of responsible organisms to the agents administered. We review recent studies of the anatomic and functional characteristics of renal cysts and discuss their possible relevance to the treatment of renal cyst infections. Finally, we set forth guidelines for the use of diagnostic studies, antimicrobial therapy, and surgical intervention for polycystic kidney infections. PMID- 3300297 TI - Influence of cyclosporine on posttransplant blood pressure response. AB - The suggestion that hypertension is more prevalent in renal allograft recipients receiving cyclosporine (CyA), particularly those displaying nephrotoxicity, was tested by reviewing 200 patients' courses, including 92 cadaver (CAD) and 58 living-related (LRD) transplants using CyA and prednisone immunosuppression, and 19 CAD and 31 LRD transplants using azathioprine (Aza) and prednisone, all of whom had at least 1 year posttransplant complete outpatient follow-up. Both groups had a mean age of 33 years with a similar distribution of renal failure etiologies. Renal function was significantly impaired in the CyA group at all intervals (P less than .001, t test). The prevalence of hypertension was higher in the CyA group at all intervals, becoming significant at 12 (P less than .01) and 24 (P less than .05) months following transplantation (chi 2). While there was only a significant difference in mean diastolic BP at 12 months (P less than .05, t test), the mean number of antihypertensive and/or diuretic medications was significantly greater in the CyA group at 1 and 6 months (P less than .001) and at 12 months (P less than .01). By 24 months, the mean number of all antihypertensive and/or diuretic medications was no longer significantly different. However, the antihypertensive and diuretic requirements of the CyA group diminished with time, suggesting that the hypertension is not progressive if the CyA serum trough levels are maintained in the nontoxic range (less than 200 ng/mL). PMID- 3300298 TI - Effects of dibromochloropropane and ethylene dibromide on biochemical events and ultramorphology of ejaculated ram spermatozoa in vitro. AB - The effects of dibromochloropropane (DBCP) and ethylene dibromide (EDB) on the function and ultrastructure of freshly ejaculated washed ram spermatozoa were assessed. These two compounds inhibited the collective motility of the sperm in a dose-dependent fashion when the sperm cells generated their energy either by mitochondrial respiration (2-deoxyglucose-treated sperm cells) or by the intact energy production system. DBCP and EDB inhibited the oxygen uptake by the sperm in a dose-dependent manner. No change in lactic acid accumulation and glucose utilization by the sperm cells was noted following DBCP and EDB addition. No change in the collective motility of the sperm was noted when DBCP or EDB were added to spermatozoa treated with the electron transfer inhibitor, antimycin A. Electron microscopy studies of sperm cells treated with DBCP revealed lesions in the plasma membrane adjacent to the acrosome and in the acrosomal membrane forming vesiculations. The inner membrane and the matrix space of the mitochondria were condensed following DBCP treatment, leaving a large mitochondrial peripheral space, compared with the control. EDB, at the concentration studied, caused no change in the ultramorphological structure of the sperm. DBCP was more potent, at least 4-fold, compared with EDB. An in vitro direct effect of DBCP and EDB on ram spermatozoa was established. It is suggested that quantitative measurements of sperm collective motility derived by different metabolic pathways can be used as an in vitro toxicological model for evaluation of toxicological and environmental factors affecting biological systems. PMID- 3300299 TI - Medicare subsidy of hospital pharmacy residencies. PMID- 3300300 TI - Hospital diversification: evaluating alternatives. AB - The appropriateness of diversification as a growth strategy for hospitals is discussed, and planning for diversification is described. Because new forms of health-care delivery are now in direct competition with hospitals, many hospitals are confronting environmental pressures and preparing for future survival through diversification. To explore the potential risks and benefits of diversification, the hospital must identify opportunities for new business ventures. Diversification can be "related," through an expansion of the primary product line (health care), or "unrelated," into areas not directly associated with health care. The hospital must establish specific criteria for evaluating each diversification alternative, and the two or three most attractive options should be analyzed further through a financial feasibility study. The hospital should also seek legal advice to determine the implications of diversification for maintenance of tax status, antitrust limitations, and applicability of certificate of need. Although diversification may not be appropriate for every institution, hospitals should consider it as a strategy for increasing their revenue base, confronting environmental pressures, and securing future survival. PMID- 3300301 TI - Hospital diversification: corporate restructuring as a survival strategy. AB - Corporate restructuring of hospitals as a strategy for survival and continued success is described. Health-care providers' traditional orientation has been toward service and mission; now, profits and new markets in health care must be considered also. To remain competitive, hospitals must be prepared to act rapidly on opportunities. Corporate reorganization, the creation of new corporate entities that perform diversified medical and nonmedical functions, may provide the flexibility needed for quick action. Legal and accounting costs will be incurred by corporate reorganization. Tax issues, staff morale, community support, and effect on hospital managers and board members should be considered. Hospitals can cut costs through vertical integration of existing services; in this system-building strategy, new services can be added to broaden the patient base. Corporate reorganization is more important for diversification--the extension of a hospital's medical and health businesses--than for system building. Guidelines for diversification are offered. Corporate reorganization is a technique that should be considered in an institution's planning process. PMID- 3300302 TI - New Medicare Conditions of Participation for Hospitals. AB - The new Medicare Conditions of Participation for Hospitals are reviewed, and their effect on hospital pharmacy is discussed. In general, the revised Conditions, which are federal regulations establishing requirements that hospitals must meet to participate in Medicare programs, focus on outcomes and services rather than on procedures and departments. A new standard requiring discharge planning as part of an institution's quality-assurance program implicitly invites pharmacy participation by not limiting responsibility for such a program to the medical staff. The medical staff is accountable to the governing body, rather than co-equal with it, as was the case previously. Hospitals now have greater flexibility in granting staff privileges to nonphysician practitioners; pharmacists could be designated as a category of medical-staff membership. The opportunity exists for initiation and expansion of pharmacy-based medication-administration programs, since the Conditions do not limit such services to nursing or medical personnel. Pharmacists are permitted to receive oral orders for prescriptions. The importance of pharmaceutical services is recognized in the new standards by requirements for drug-therapy monitoring and information and drug-product control. Further, the regulations mandate establishment of a formulary system. The pharmacy-related changes in the Conditions recognize several key professional practice concepts, thus easing implementation of new strategic directions for hospitals and hospital pharmacy. PMID- 3300303 TI - Role of bone and kidney in tumor-induced hypercalcemia and its treatment with bisphosphonate and sodium chloride. AB - The efficacy of intravenous aminohydroxypropylidene bisphosphonate as treatment for the hypercalcemia of malignancy was examined in a phase II multicenter study in 132 patients with a large variety of primary tumors. This provided an opportunity for an analysis of the separate influences of bone resorption and renal calcium handling on the genesis and maintenance of hypercalcemia. The results demonstrated that increased bone resorption is the major contributory factor and that inhibition with bisphosphonate normalizes the serum calcium concentration within five days in more than 90 percent of patients. Hypercalcemia is sustained by an inability of the kidney to deal efficiently with a chronically increased calcium load. This is influenced by the requirements of volume regulation in the presence of a sodium diuretic effect of hypercalcemia and is very sensitive to induced variations of sodium load. In addition, in a minority of patients, direct renal actions of tumor-derived humoral factors adversely reduce the ability to excrete calcium. For optimal treatment of tumor-induced hypercalcemia, bisphosphonate treatment should be combined with intravenous administration of saline solution. PMID- 3300304 TI - The death of Samuel Johnson, L.L.D. A clinicopathologic conference. PMID- 3300305 TI - Vasopressin as vasopressor. PMID- 3300306 TI - Sweet's syndrome and malignancy. AB - Acute febrile neutrophilic dermatosis (Sweet's syndrome) is characterized by pyrexia, neutrophilia, and the abrupt appearance of erythematous, painful, cutaneous plaques, primarily on the upper extremities, head, and neck. Histologically, the salient feature is a dense dermal infiltrate of neutrophils. Approximately 10 to 15 percent of published cases of Sweet's syndrome occurred in patients with cancer. This report reviews the 39 patients with malignancy associated Sweet's syndrome described in the world literature and compares Sweet's syndrome in cancer patients with the idiopathic form of the disease. The most common associated malignancy was acute myelogenous leukemia. However, other myeloproliferative disorders, lymphoproliferative disorders, myelodysplastic syndrome, and carcinomas have been observed. Importantly, the diagnosis of Sweet's syndrome was often the presenting sign of a new or recurrent tumor. The presence of anemia, abnormal platelet counts, immature cells in the differential, and/or severe vesiculobullous or ulcerative cutaneous lesions is infrequent in idiopathic Sweet's syndrome and should alert physicians to the possibility of a more serious underlying disease. Extracutaneous manifestations may occur and most often involve the musculoskeletal system. Response to systemic steroids is dramatic in virtually all patients, regardless of the presence of malignancy. PMID- 3300307 TI - Massive insulin resistance apparently due to rapid clearance of circulating insulin. AB - A 23-year-old insulin-dependent diabetic woman demonstrated increasing resistance to insulin administered by all routes, eventually requiring up to 20,000 units per day intravenously. Therapeutic trials of human and chemically modified insulin and of aprotinin were unsuccessful. Inappropriately low plasma free insulin levels (less than 60 mU/liter) during administration of extremely high insulin dosages (300 to 10,000 units per day) suggested that resistance was caused by rapid clearance of circulating insulin. There were several short periods of normal insulin sensitivity with hyperinsulinemia (more than 300 mU/liter) persisting long after intravenous insulin withdrawal, suggesting reentry to the circulation of intact, previously sequestered insulin. For four years, she has been treated with ambulatory continuous intravenous insulin infusion, which has been complicated by septicemia and central venous thrombosis. Her condition remains poorly controlled with documented intravenous insulin requirements of 2 to 20 units/hour. PMID- 3300308 TI - Review of the bioavailability and pharmacokinetics of oral norfloxacin. AB - The pharmacokinetic profile of norfloxacin, an oral fluoroquinolone, is more complex than that of many antibacterial agents. Following administration of a 400 mg dose, peak serum concentrations of 1.5 to 2.0 micrograms/ml are achieved within one to two hours. The drug is widely distributed throughout the body, achieves high ratios of tissue to serum concentrations in both renal and prostatic tissue, and undergoes metabolic conversion. Six metabolites of norfloxacin have been identified. Approximately 30 percent of an administered dose is excreted as unchanged drug by glomerular filtration and tubular secretion. Following a single dose of norfloxacin, therapeutic levels of drug in the urine are achieved rapidly and maintained for at least 12 to 24 hours. Norfloxacin has a terminal elimination half-life of approximately three hours, although the presence of a reduced glomerular filtration rate increases the elimination half-life. Dosage modification is, therefore, necessary when the glomerular filtration rate falls below 20 ml/minute. PMID- 3300309 TI - Norfloxacin: its potential in clinical practice. AB - The in vitro spectrum and potency of norfloxacin against both aerobic gram negative and gram-positive bacteria, its limited activity against anaerobes, and the apparent difficulty organisms have in acquiring resistance to it, have provided a rationale for the clinical development of this oral fluoroquinolone antimicrobial agent. The clinical experience with norfloxacin as treatment for a variety of urinary tract infection syndromes, uncomplicated gonococcal infection, and diarrheal disease, and as prophylaxis of infection in neutropenic patients with cancer, is reviewed. Norfloxacin appears at least equivalent to standard regimens for the treatment of acute urinary tract infections; however, long-term studies are needed to define its role in the treatment of recurrent urinary infections. Initial studies of norfloxacin treatment of uncomplicated gonococcal infection and bacterial gastroenteritis are also promising, and in neutropenic patients, continuous norfloxacin prophylaxis has been shown to reduce the incidence of gram-negative infections. Further prospective evaluation is required to confirm these findings. PMID- 3300310 TI - Norfloxacin in the treatment of uncomplicated gonococcal infections. AB - Norfloxacin, an oral fluoroquinolone antibacterial, is active in vitro against a variety of gram-positive and gram-negative pathogens, including both penicillinase-producing and non-penicillinase-producing strains of Neisseria gonorrhoeae. An earlier study demonstrated that a two-dose regimen of norfloxacin was as effective as standard therapy with spectinomycin for treating gonococcal urethritis, including infections caused by penicillinase-producing organisms. In this randomized study of treatment for uncomplicated gonococcal infection in men and women, three oral treatment regimens were compared: patients received either two doses of norfloxacin (600 mg twice daily), a single dose of norfloxacin (800 mg), or a single-dose ampicillin (3.5 g)/probenecid (1.0 g) regimen (as recommended by the Centers for Disease Control). All three treatment regimens achieved similar cure rates. Although the number of patients treated was too small to yield statistically significant conclusions, it appears that norfloxacin may be slightly better treatment for rectal and pharyngeal gonococcal infections than ampicillin and probenecid. Additionally, norfloxacin was well tolerated in this study. Thus, based on a review of these data, norfloxacin appears to be an alternative, single-dose, oral treatment regimen for uncomplicated gonococcal infection. PMID- 3300311 TI - Multiclinic study of norfloxacin for treatment of urinary tract infections. AB - A multicenter open study of 477 patients with urinary tract infections was undertaken. The patients were treated with 400 mg of norfloxacin twice daily for seven to 30 days. Four hundred eight (98 percent) of 417 gram-negative organisms and 58 (94 percent) of 62 gram-positive organisms were susceptible to norfloxacin. The infecting organisms were eradicated in 276 of 307 evaluable patients (90 percent). Of the 31 bacteriologic failures, two organisms were initially resistant to norfloxacin and four organisms acquired resistance to norfloxacin and persisted despite treatment. Twenty-eight patients (10 percent) had recurrent infections; 24 of the 25 organisms involved in these infections were susceptible to norfloxacin. Seventeen patients (3.5 percent) experienced clinical adverse effects that were probably or definitely related to the drug. One adverse reaction was serious. Although norfloxacin was discontinued in two patients because of clinical side effects, none of the patients experienced laboratory adverse effects that were either serious or drug related. PMID- 3300312 TI - Oral norfloxacin versus parenteral treatment of nosocomial urinary tract infection. AB - In a multiclinic, randomized trial, oral norfloxacin, a fluoroquinolone antibacterial, was compared with several standard parenteral regimens for the treatment of nonbacteremic, hospital-acquired urinary tract infections. Parenteral antibiotic agents included aminoglycosides alone; aminoglycosides in combination with either broad-spectrum penicillins or first-generation cephalosporins; or cefotaxime alone. Ninety-two percent of bacterial isolates were multiresistant gram-negative rods including Pseudomonas aeruginosa (31 percent), Escherichia coli (17 percent), Klebsiella/Enterobacter species (14 percent), and Serratia species (11 percent). In the first evaluable 94 patients, norfloxacin was comparable to the parenteral agents in eliminating infecting bacteria from the urine. Similarly, combined bacterial eradication and clinical cure or improvement occurred in 96 percent (76 percent with cures, 20 percent with improvement) of those treated with norfloxacin and 88 percent (67 percent with cures, 21 percent with improvement) of those treated with parenteral agents. A negative outcome (i.e., failure, superinfection, or reinfection) occurred in two (4 percent) norfloxacin-treated patients versus six (12 percent) parenterally treated patients. Adverse effects were few, infrequently drug related, and rarely serious (one with norfloxacin versus two with parenteral agents). Additionally, drug, preparation, and administration costs were substantially less with oral norfloxacin compared with the parenteral agents. The data suggest, therefore, that oral norfloxacin can be substituted for commonly used parenteral antibiotic regimens, without any compromise in efficacy, in the treatment of nonbacteremic patients with multiresistant, nosocomial urinary tract infections. PMID- 3300313 TI - Norfloxacin in the treatment of complicated and uncomplicated urinary tract infections. A comparative multicenter trial. AB - In a multicenter, prospective treatment study, 59 patients with complicated or uncomplicated urinary tract infections (UTIs) were treated with norfloxacin (400 mg orally twice daily) and compared with 45 patients treated with trimethoprim/sulfamethoxazole. Norfloxacin was relatively safe and highly effective in treating both uncomplicated UTIs (86 percent cure rate) and complicated UTIs (75 percent cure rate). Failure of trimethoprim/sulfamethoxazole therapy was associated with initial bacterial resistance, e.g., from Pseudomonas aeruginosa and Serratia marcescens; such multiresistant bacteria were successfully treated with norfloxacin. Thus, norfloxacin appears to extend the range of oral agents available to treat UTIs. PMID- 3300314 TI - Norfloxacin in the treatment of urinary tract infections in men with and without identifiable urologic complications. AB - A retrospective analysis of data from the treatment of 95 men with nonbacteremic urinary tract infections (UTIs) (clean-catch urinary bacterial count greater than or equal to 10(5) colony-forming units/ml) who received norfloxacin (400 mg orally twice daily) was performed. Treatment duration ranged from a required minimum of seven days to a maximum of 30 days. If an underlying anatomic or functional condition existed that might decrease the likelihood of a favorable medical response and/or require prolonged treatment, the patient's UTI was considered "complicated." In addition to eight patients with polymicrobic UTIs (usually involving enterococci or Pseudomonas aeruginosa), 48 men (i.e., 51 percent of the total population) had an identifiable complication. Complications included benign prostatic hypertrophy in 13 patients; prostatic cancer in four; urethral stricture in four; quadriplegia/paraplegia with indwelling urinary catheter in four; prostatism in three; and other conditions commonly recognized as altering the response to antibiotic treatment. Among the 95 patients treated, 76 (80 percent) were considered to have had a cure and five (5 percent) showed improvement. Fourteen patients (15 percent) failed to show a response to treatment. Of the 48 patients with UTI and defined complications, 36 (75 percent) had a cure, three (6 percent) showed improvement, and therapy failed in nine (19 percent). Ninety-seven percent (105 of 108) of the pretreatment bacterial isolates were susceptible to norfloxacin. In addition to the three resistant organisms that were present prior to therapy, three organisms (two P. aeruginosa and one Enterobacter) persisted and acquired resistance during therapy. Five adverse clinical experiences and six adverse laboratory experiences were noted. Only one of the former (mild heartburn) was thought to be drug related, and no adverse experience was considered serious or required discontinuation of treatment. Gastrointestinal tolerability of oral norfloxacin was good. PMID- 3300315 TI - Treatment of urinary tract infection with norfloxacin. Analysis of cost. AB - Twenty-five patients with urinary tract infection were treated with norfloxacin, a fluoroquinolone antibacterial with a wide spectrum of activity for an oral agent. Of 22 patients who were evaluable, 20 had complicated urinary tract infection; infection was cured in 19 patients at one week after treatment. Optimal alternative treatments were also selected in norfloxacin's stead, based on each patient's characteristics and the results of susceptibility testing for each isolated pathogen. Direct costs for alternative treatment ranged from $7 to $970. The results indicated that for those patients with suspected or proven urinary tract infection caused by multiresistant bacteria, therapy with norfloxacin may represent a cost-effective choice. PMID- 3300316 TI - Use of norfloxacin in the treatment of acute diarrheal disease. AB - In studies conducted in seven countries, 392 persons with acute diarrhea were enrolled and randomly assigned to one of three regimens. In order to compare the effectiveness of various therapies for acute gastroenteritis, patients were treated for five days with either norfloxacin, 400 mg twice daily, norfloxacin, 400 mg three times a day, or trimethoprim/sulfamethoxazole, (160 mg/800 mg) twice daily. Clinical cure occurred in 89 percent (lower dose) and 91 percent (higher dose) of those treated with norfloxacin, compared with 78 percent of those receiving trimethoprim/sulfamethoxazole; cure rates in each treatment group were greater when the patient's stool contained fecal leukocytes. In 105 of 106 (99 percent) patients treated with either dose of norfloxacin and in 49 of 52 (94 percent) trimethoprim/sulfamethoxazole-treated subjects, the bacterial enteropathogen identified in the pretreatment stool was eradicated on the posttreatment specimen. Two percent (two patients) of those receiving the lower dose of norfloxacin, 3 percent (two patients) of those receiving trimethoprim/sulfamethoxazole, and 4 percent (three patients) of those receiving the higher dose of norfloxacin experienced minor and transient adverse hematologic or blood chemistry reactions. In addition, mild cutaneous reactions that were attributed to the study medications developed in two patients receiving the higher dose of norfloxacin and in three patients who received trimethoprim/sulfamethoxazole. These studies indicate that norfloxacin is safe and effective therapy for bacterial diarrhea. PMID- 3300317 TI - Effect of inoculum size on in vitro activity of norfloxacin against fecal anaerobic bacteria. Rationale for selective decontamination of the digestive tract. AB - Previous studies have shown that anaerobic bacteria are susceptible to norfloxacin at the levels attained in the feces. Conversely, studies in laboratory animals and neutropenic humans using norfloxacin for selective decontamination of the digestive tract have shown that norfloxacin markedly reduces the aerobic enteric flora without reducing fecal anaerobic flora. In an effort to resolve this paradox, the effect of a 10(9) colony-forming units (cfu)/ml inoculum, which is more reflective of actual fecal counts than the standard 10(5) cfu/ml inoculum, on the activity of norfloxacin against two fecal Escherichia coli isolates and 16 fecal anaerobic isolates was studied. The results showed a marked inoculum effect at 10(9) cfu/ml for most anaerobic isolates but not for the E. coli strains tested. At 256 micrograms/ml, all E. coli were killed while the anaerobic bacteria maintained colony counts greater than or equal to 10(9) cfu/ml. Hence, the lack of anaerobic activity (minimal inhibitory concentration greater than or equal to 512 micrograms/ml) at higher fecal inocula might explain the utility of norfloxacin in selective decontamination of the bowel. PMID- 3300318 TI - Dementia. PMID- 3300319 TI - Beyond the wedge: clinical physiology and the Swan-Ganz catheter. AB - The Swan-Ganz catheter was introduced into general clinical medicine in 1970 and quickly gained widespread use in the management of critically ill patients. The device offers highly sophisticated physiologic information; however, in many instances, only the wedge pressure and the cardiac output are utilized when managing acutely ill patients. The purpose of this review is to illustrate and explain the array of physiologic data available from the Swan-Ganz catheter in most circumstances. A basic understanding of the information that can be obtained with the Swan-Ganz catheter is quite useful in the diagnosis and management of a variety of cardiovascular disorders. In addition, the Swan-Ganz catheter can be a helpful tool for teaching cardiovascular pathophysiology. PMID- 3300320 TI - Diffuse fasciitis after bone marrow transplantation. AB - This report describes a patient in whom the clinical, laboratory, and histologic features of diffuse fasciitis with eosinophilia developed several months after allogeneic bone marrow transplantation for acute lymphoblastic leukemia. Numerous reports detail the association between diffuse fasciitis and hematologic diseases; a patient in whom diffuse fasciitis developed in the setting of chronic graft-versus-host disease following bone marrow transplantation for acute leukemia is discussed. Treatment of the chronic graft-versus-host disease improved the symptoms of the diffuse fasciitis. PMID- 3300321 TI - Spectrum of gas within the kidney. Emphysematous pyelonephritis and emphysematous pyelitis. AB - Renal emphysema is an important clinical entity that is not addressed frequently in the medical literature. The affected patients may have gas within the renal parenchyma, emphysematous pyelonephritis, or confined to the collecting system, emphysematous pyelitis. Two patients that illustrate the spectrum of this entity are described. The literature has been reviewed to determine the clinical features of each disorder and to provide a schema for diagnosis and management. Emphysematous pyelonephritis is seen primarily in diabetic patients, whereas emphysematous pyelitis is recognized most often in association with urinary tract obstruction. The diagnosis is made radiographically by demonstrating renal gas on plain abdominal roentgenography or intravenous pyelography. Location and extent of renal gas are best evaluated by computed tomographic scanning. Intraparenchymal gas usually requires nephrectomy, whereas successful therapy of gas limited to the collecting system involves medical management, with a drainage procedure when obstruction coexists. PMID- 3300322 TI - Wegener's granulomatosis involving the breast. Report of three cases and review of the literature. AB - Three cases of necrotizing granulomatous vasculitis of the Wegener's type involving the breast are described. In each, the presumed diagnosis was localized or metastatic carcinoma. The breast lesion and other manifestations of Wegener's granulomatosis developed concomitantly in one patient, and the breast lesion appeared several months before classic pulmonary symptoms in another. In the third patient, not only were her upper and lower airway symptoms explained only in retrospect, but even the significance of the breast biopsy findings was clarified only after other aspects of Wegener's granulomatosis developed. All patients ultimately demonstrated a good response to corticosteroids and cyclophosphamide therapy. Wegener's granulomatosis is a rare lesion affecting the breast but should nonetheless be considered in the evaluation of any breast mass. PMID- 3300323 TI - Seizures and death in a young woman. PMID- 3300324 TI - Lipodystrophy from recombinant DNA human insulin. PMID- 3300325 TI - Prospective randomized comparison of therapy and no therapy for asymptomatic bacteriuria in institutionalized elderly women. AB - Fifty elderly (mean age, 83.4 +/- 8.8 years) institutionalized women with asymptomatic bacteriuria were randomly assigned either to receive therapy for treatment of all episodes of bacteriuria identified on monthly culture or to receive no therapy unless symptoms developed. Subjects were followed for one year. The therapy group had a mean monthly prevalence of bacteriuria 31 +/- 15 percent lower than those in the no-therapy group, but periods free of bacteriuria lasting six months or longer were documented for only five (24 percent) subjects. For residents receiving no therapy, 71 percent showed persistent infection with the same organism(s). Antimicrobial therapy was associated with an increased incidence of reinfection (1.67 versus 0.87 per patient-year) and adverse antimicrobial drug effects (0.51 versus 0.046 per patient-year) as well as isolation of increasingly resistant organisms in recurrent infection when compared with no therapy. No differences in genitourinary morbidity or mortality were observed between the groups. Thus, despite a lowered prevalence of bacteriuria, no short-term benefits were identified and some harmful effects were observed with treatment of asymptomatic bacteriuria. These data support current recommendations of no therapy for asymptomatic bacteriuria in this population. PMID- 3300327 TI - Longitudinal changes in lung function and respiratory symptoms in progressive systemic sclerosis. Prospective study. AB - Most patients with progressive systemic sclerosis (PSS) exhibit lung involvement. However, the natural history of lung disease in PSS remains poorly defined. To evaluate lung function over time in PSS, a battery of lung function tests were prospectively performed serially between 1973 and 1982 in 61 patients with PSS. Functional indexes of restriction (vital capacity and total lung capacity) and diffusion impairment (diffusing capacity) showed greater-than-expected annual rates of change. Male subjects showed a trend toward faster declines in forced vital capacity, forced expired volume in one second, total lung capacity, and functional residual capacity and a more rapid increase in static recoil pressure at 90 percent of total lung capacity than did female subjects. Nonsmokers had greater rates of decline in total lung capacity and static lung compliance (but not in forced vital capacity or diffusing capacity) and a greater rate of increase in static recoil pressure than did current and former smokers. Level of lung function at initial study visit, age, race, and chlorambucil therapy had no significant effect on the annual rates of change in lung function, whereas longer duration of disease prior to study entry was associated with a slower annual decrease in lung volumes. Between the first and last visits (mean interval 3.1 years, maximum nine years), the frequency of abnormality in pulmonary function test results showed significant change only in the diffusing capacity (60 percent increasing to 82 percent) and static lung compliance (40 percent increasing to 54 percent), whereas the frequency of respiratory symptoms showed little change. These findings indicate an overall indolent progression of PSS-related lung disease, with substantial individual variability. PMID- 3300326 TI - Suppression of plasma renin activity by cyclosporine. AB - Cyclosporine treatment is associated with hypertension and suppression of plasma renin activity, the causes of which are unclear. To determine whether suppressed plasma renin activity is due to extracellular fluid volume expansion, 10 cyclosporine-treated renal transplant recipients were compared with 10 azathioprine-treated renal transplant recipients and seven patients with renal insufficiency. Glomerular filtration rate and effective renal plasma flow were significantly lower in cyclosporine-treated patients than in azathioprine-treated patients. Upright plasma renin activity was suppressed in cyclosporine-treated patients (cyclosporine 2.9 +/- 0.9, azathioprine 4.7 +/- 0.9, renal insufficiency 5.2 +/- 1.9 ng/ml/hour) but could be stimulated by a four-day period of dietary sodium restriction and diuretic administration (cyclosporine 15.8 +/- 4.4 ng/ml/hour). Extracellular fluid volume tended to be higher in cyclosporine treated patients (cyclosporine 30.7 +/- 2.3, azathioprine 26.7 +/- 2.5, renal insufficiency 25.5 +/- 1.4 percent lean body mass), although the difference between cyclosporine-treated and azathioprine-treated patients did not attain statistical significance. There were no differences in the urinary excretion of prostaglandin E2 or 6-keto prostaglandin F1 alpha between the two groups of renal transplant recipients. It is concluded that suppression of plasma renin activity by cyclosporine is physiologic and may reflect expansion of extracellular fluid volume, which can be reversed by sodium depletion. PMID- 3300328 TI - Detection of multiple PRL- and GH-like proteins in human pituitary by Western blot analysis. AB - Surgically removed normal and tumorous pituitary tissues from a prolactinoma patient were analyzed by Western blot techniques for PRL and GH variants. Criteria for identification were the Rf of the bands within the gel, immunologic crossreactivity to specific antisera, and structural verification by tyrosine peptide-mapping of individual bands from the gel. The authors found the tumor tissue to be characterized by the presence of a PRL band greater in concentration than in the normal tissue and the virtual absence of a GH band. Immunoblotting of the electrophoretically resolved proteins form both types of tissues revealed several new bands crossreactive with human PRL and GH antibodies. Some of the new bands were of Mr greater than the monomeric PRL and GH and others were of lower Mr. Relative of two of the low mobility Mr PRL-immunoreactive bands designated as 16K and 8K corresponded to the Rf of the two fragments of cleaved PRL, which suggested that cleaved PRL occurred naturally in the human pituitary gland. The most conspicuous of the new PRL-immunoreactive bands, a 25,000 Mr protein migrating slightly behind PRL, displayed strong crossreactivity to hPRL antibodies and was present in greater concentration in the prolactinoma tissue than in the normal tissue. These properties suggested that it was related to hPRL and perhaps represented its glycosylated variant. However, its tyrosine peptide map did not resemble that of hPRL. Thus, it is not clear whether it represented G hPRL or a new pituitary protein that cross-reacts with hPRL antibodies. In addition, two other bands of low Mr, designated as unknown 1 and unknown 2, reacted with hPRL antibodies. Immunostaining with hGH antibodies revealed the 20K hGH variant, the F1 fragment of cleaved hGH, and a pair of new bands immediately behind GH that could represent glycosylated hGH--possibly a product of Seeburg's variant hGH gene. Both PRL and GH antibodies elicited numerous bands of high Mr by the technique employed, far more than ever observed by Sephadex chromatography. The nature of the high Mr bands remains unknown. Further characterization of these new PRL- and GH-immunoreactive proteins might help in the understanding of the multiple physiologic functions of PRL and GH in man. PMID- 3300329 TI - Adjuvant chemotherapy of solid tumors. AB - Adjuvant chemotherapy for microscopic disease following eradication of clinically detectable lesions by primary surgery and/or radiotherapy is of documented benefit for some oncology patients. However, for many primary cancers efficacy is limited to specific subgroups of patients or has demonstrated no advantage over primary therapy alone. The rationale for adjuvant chemotherapy and results of selected trials are reviewed. In patients for whom adjuvant therapy is of demonstrated benefit, further trials aimed at delineation of patient selection factors, optimal chemotherapy regimens and schedules, and duration of therapy are needed; progress in adjuvant treatment of other subgroups may require development of more effective antineoplastic drugs, in addition to exploration of these factors. PMID- 3300330 TI - The Neu-Laxova syndrome in female sibs: clinical and pathological features with prenatal diagnosis in the second sib. AB - We report on affected sisters with the Neu-Laxova syndrome. Prenatal diagnosis of the condition was achieved by serial ultrasound examinations which demonstrated abnormal fetal growth in the second affected fetus before 24 weeks gestation. PMID- 3300331 TI - Microcephaly, micrognathia, and bird-headed dwarfism: prenatal diagnosis of a Seckel-like syndrome. AB - Microcephaly, intrauterine growth retardation, a hellenic nose, and severe micrognathia were diagnosed as a form of bird-headed dwarfism (Seckel-like) syndrome in a female infant. In the subsequent pregnancy, monitored by serial ultrasound examinations, severe growth retardation was established at 17 and 20 weeks of pregnancy. The head circumference was disproportionately small in relation to the abdominal circumference and enabled the diagnosis of microcephaly. There was also extreme micrognathia. The pregnancy was terminated, and the diagnosis of a Seckel-like syndrome of bird-headed dwarfism was confirmed at autopsy of the male fetus. This variant of bird-headed dwarfism has probably autosomal recessive inheritance. Ultrasonic assessment of the facial area together with the measurements of fetal head and abdominal circumference are essential in the early prenatal diagnosis of this syndrome in pregnancies of reliably established duration. PMID- 3300332 TI - Partial duplication 8q12----q21.2 in two sibs with maternally derived insertional and reciprocal translocations: case reports and review of partial duplications of chromosome 8. AB - We report on two sibs with duplication of the segment 8q12----8q21.2 resulting from malsegregation of a maternal insertional translocation: [inv ins (5;8)(p13;q12q21.2)]. The mother also carries a reciprocal translocation [t(1;6)(q31;q5)], which was transmitted in the balanced state to the propositi and to a phenotypically normal son and daughter. The literature on two translocations occurring in one individual and on insertional rearrangements is reviewed in terms of reproductive risks to balanced carriers. The two affected infants have a previously undescribed partial duplication of an interstitial segment of 8q and a pattern of abnormalities distinct from those seen in other partial duplications of 8. These infants are reviewed with 78 other cases of partial duplications of chromosome 8 with regard to phenotype-karyotype correlations. PMID- 3300333 TI - Prenatal ultrasound diagnosis of diastrophic dysplasia at 16 weeks. AB - We report on the prenatal ultrasound diagnosis of diastrophic dysplasia at 16 wk of gestation. The ultrasound examination showed abnormally short limbs and lateral projection on the thumbs. Radiological and histological studies confirmed the presence of diastrophic dysplasia in the aborted fetus. PMID- 3300334 TI - Genetic aspects of early childhood scoliosis. AB - Eighty-seven families with early onset scoliosis were evaluated. These were divided into 3 groups: resolving infantile idiopathic scoliosis (15 families), progressive infantile idiopathic scoliosis (21 families), and congenital scoliosis due to vertebral malformations (51 families). The children with congenital scoliosis were subdivided into those who had closed neural arch defects (19 families) and those who did not (32 families). Resolving infantile idiopathic scoliosis was usually associated with plagiocephaly, and both deformations tended to show spontaneous recovery. These children were otherwise normal. Seven (33%) of the children with progressive infantile idiopathic scoliosis were mentally retarded, but only 2 had a congenital malformation. In contrast, 18 (33%) of the children with congenital scoliosis had other malformations, but only 2 were mentally retarded. The recurrence risk for scoliosis was low in each group studied. However, there was an increased risk (4% for sibs) of neural tube defects in the families with congenital scoliosis (with or without neural arch defects). This sib risk was apparent for probands with only a single hemivertebrum in addition to probands with more extensive vertebral defects and would support an etiological relationship between neural tube defects and other vertebral malformations. PMID- 3300335 TI - Herrmann-Opitz syndrome: report of an affected fetus. AB - In 1969, Herrmann and Opitz described a syndrome of acrocephaly, oligosyndactyly, hypertelorism, and mental retardation. We report on a second case, a fetus with cleft palate, urethral astresia, oligohydramnios, and intrauterine death. PMID- 3300336 TI - Evidence for reduced catabolism by the antiglucocorticoid RU 38486 in acutely uremic rats. AB - Previous studies suggested that increased blood levels of, or increased tissue sensitivity to, glucocorticoids may contribute to catabolism in acute uremia. To examine this possibility we determined urea nitrogen (urea-N) appearance, plasma levels of Nt-methylhistidine and the activity of the alkaline myofibrillar proteinase in acutely uremic rats with and without treatment with RU 38486, a selective antiglucocorticoid. Forty-eight hours after bilateral nephrectomy, the rats had markedly elevated serum levels of urea-N, creatinine, potassium and phosphorus. In uremic rats receiving RU 38486, comparable levels of serum creatinine were found, but the serum levels of urea-N (221 +/- 4 vs. 259 +/- 5 mg/dl) and phosphorus (6.5 +/- 0.3 vs. 8.5 +/- 0.4 mmol/l) were significantly decreased as compared to uremic animals without RU 38486. In comparison to sham operated rats, urea-N appearance (net urea production) was increased by 56% 48 h after bilateral nephrectomy. This increment was almost completely reversed in uremic animals receiving the antiglucocorticoid. In untreated uremic rats, plasma levels of Nt-methylhistidine were 10.3 +/- 0.9 microgram/dl, whereas the administration of RU 38486 caused a significant decline in the levels of this amino acid (7.6 +/- 0.5 microgram/dl). This reduction in Nt-methylhistidine was associated with a concomitant decrease of myofibrillar proteinase activity in muscle tissue homogenates. Compared to sham-operated animals, this proteinase activity was increased by 30% in uremic rats, but was normal in those given RU 38486. Taken together, these data support the view that in acute uremia accelerated ureagenesis occurs, while enhanced muscle protein breakdown, owing to an increment in myofibrillar proteinase activity, provides the necessary amino acid precursors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300337 TI - Nephrologic beginnings: the kidney in the age of Ibn Sina (980-1037 AD). PMID- 3300338 TI - Recurrent membranoproliferative glomerulonephritis type 1 in successive renal transplants. AB - We report a man who developed renal failure due to membranoproliferative glomerulonephritis (MPGN) type 1 which recurred in two cadaveric kidney transplants. This is the third such case in the literature. Nephrotic syndrome developed within 1 month following transplantation and histologic evidence of disease recurrence was documented in both kidneys 2 months after transplantation. Both grafts failed within 18 months. Factors which determine disease recurrence remain obscure. PMID- 3300339 TI - Preventing home care denials. PMID- 3300340 TI - A modern parable. PMID- 3300341 TI - Genetic implications of idiopathic hydramnios. AB - The antenatal diagnosis of hydramnios requires a careful search for associated underlying maternal or fetal conditions. Even in pregnancies associated with idiopathic hydramnios in which no underlying condition can be identified, a high perinatal mortality rate exists. Although trisomy 18 has been seen in pregnancies with hydramnios and growth retardation, the association with specific chromosomal disorders and idiopathic hydramnios has not been well defined. A review of pregnancies complicated by hydramnios was undertaken; 99 cases with complete pregnancy and delivery information were identified. Fifty-nine pregnancies were complicated by idiopathic hydramnios, and except for the hydramnios, sonographic evaluation was normal. Delivery information revealed one infant with trisomy 18 and eight infants with structural anomalies not appreciated antenatally. Of the undiagnosed malformations, 25% are frequently associated with trisomy 21. We recommend fetal chromosomal analysis as an adjunct to the evaluation of pregnancies complicated by idiopathic hydramnios. PMID- 3300342 TI - Fetal pulmonary hypoplasia with hydrothorax. AB - Described is a case of fetal congenital malformation with hydrothorax, for which left pulmonary hypoplasia was initially presumed by ultrasonography and for which hypoplasia was diagnosed postnatally only in the left lower pulmonary lobe by a pulmonary technetium Tc-99m scintigram. The pathogenesis of this disease is discussed. PMID- 3300343 TI - Reduction of group B streptococcal maternal and neonatal infections in preterm pregnancies with premature rupture of membranes through a rapid identification test. AB - To establish the effect of rapid detection and chemoprophylaxis of group B streptococcal genital colonization in preterm gestations with premature rupture of membranes, 260 singleton pregnancies were cultured. Through the use of a rapid test based on coagulation methods, group B streptococcus was identified in 84 (32%) patients, of which 18 (7%) had heavily colonized infections. The treatment of 36 patients resulted in no cases of chorioamnionitis or neonatal sepsis compared with 11 (23%) cases of chorioamnionitis and 13 (27%) of neonatal sepsis among 48 untreated patients (p less than 0.01). Although the risk of infection was significantly higher in patients with heavily colonized infections, characterized by less than 5 hours' growth for detection, even light colonization, requiring 20 hours for detection, resulted in a 14% rate of maternal and 16% rate of neonatal infection, respectively. PMID- 3300344 TI - Transabdominal chorionic villus sampling: a freehand ultrasound-guided technique. AB - A simple transabdominal chorionic villus sampling method, carried out with a 20 gauge spinal needle under ultrasound guidance, was evaluated in 100 cases selected for genetic evaluation in the first trimester. Its use was limited to the management of anatomic and clinical conditions that contraindicated transcervical aspiration. The high efficacy of the method was demonstrated by an ability to obtain enough villus tissue for karyotyping in all but one case. In 94% of the cases, only one pass of the needle was required. Although the only complication observed was light bleeding in four cases, the safety of the method needs more extensive evaluation. PMID- 3300345 TI - The immediate effects of chorionic villus sampling on fetal movements. AB - The immediate effects of chorionic villus sampling on the fetus was studied by real-time ultrasound observation of fetal movements. Thirty-minute recordings, directly before and after chorionic villus sampling, were made in 10 women. No changes were observed in the incidence or distribution of the four movement patterns studied. This held true even in the two cases that ended in a spontaneous abortion. It is concluded that chorionic villus sampling does not stimulate movements or alter the intrauterine situation in such a way that fetal movements decrease. PMID- 3300346 TI - Influence of the menstrual cycle on glucose tolerance and insulin secretion. AB - To evaluate the impact of the menstrual cycle on glucose tolerance and insulin secretion, in the present study we have measured the plasma concentrations of glucose, insulin, and C-peptide during a 2-hour oral glucose tolerance test in 110 healthy, nonobese, regularly menstruating women. Fifty-five women were in the follicular phase, and 55 were in the luteal phase of the cycle. The two groups were well matched for age and body weight. Plasma concentrations of glucose, insulin, and C-peptide either in the fasting state or after the oral glucose load did not differ in the two groups. These results suggest that in nondiabetic women the menstrual cycle has no major effect on glucose tolerance and insulin secretion and that the phase of the menstrual cycle should not be considered in programming and interpreting an oral glucose tolerance test. PMID- 3300347 TI - Prescription drug use before and during pregnancy in a Medicaid population. AB - This study describes prescription drug use before and during pregnancy and is based on data obtained from the paid Medicaid claims of 18,886 Michigan women aged 15 to 44 years who were delivered of a live infant. Rates of exposure to drugs within 15 therapeutic categories are presented for each of five 90-day periods preceding delivery. Overall dispensed drug use (excluding vitamins) decreased during pregnancy; however, there was still substantial exposure to drugs including drugs that are contraindicated during pregnancy. During the gestational period, study mothers received an average of 3.1 prescriptions for nonvitamin drugs. Black mothers received more exposure to drugs other than vitamins than did white mothers. Black mothers had higher rates of exposure to analgesics, ampicillin, codeine, and vaginal preparations. Similarities between black and white mothers in the use of vitamins with and without other drugs suggest there is no racial difference in attaining prenatal care within the Medicaid system, but that black mothers may have more medical problems that warrant the use of other medications in addition to vitamins during pregnancy. PMID- 3300348 TI - Influence of umbilical vein administration of oxytocin on the third stage of labor: a randomized, double-blind, placebo-controlled study. AB - A randomized, double-blind, placebo-controlled study evaluated the influence of umbilical vein administration of oxytocin on the third stage of labor. Five minutes after delivery, 37 women received 10 units of oxytocin diluted in physiologic saline solution to a total volume of 20 ml; 41 women received 20 ml of saline solution alone. There was no significant difference between groups in mean (+/- SD) injection-placental expulsion interval (9 +/- 7 versus 10 +/- 8 minutes). PMID- 3300349 TI - Echographic [corrected] and anatomic studies of the maternotrophoblastic border during the first trimester of pregnancy. AB - The initiation of uteroplacental circulation was investigated in early pregnancy with the following material: contact ultrasonography, 250 cases; direct-vision chorionic biopsy, 10 cases; products from voluntary interruption of pregnancy, 60 cases; and hysterectomy with the pregnancy in situ, three cases. Using all of these techniques, we were unable to demonstrate a true intervillous blood flow during the first 12 weeks. We suggest that during this period the intervillous space is bathed by an acellular fluid that could be plasma filtered by the trophoblastic shell and its endovascular cone. If this is the case, the physiology of early pregnancy must be reconsidered. PMID- 3300350 TI - Percutaneous ultrasound-guided fetal blood sampling in the management of nonimmune hydrops fetalis. AB - Nonimmune hydrops fetalis can be caused by fetal chromosomal, hematologic, cardiac, or infectious conditions. A fetal blood sample obtained from percutaneous ultrasound-guided fetal blood sampling can offer vital information about the underlying cause of nonimmune hydrops fetalis, and perinatal management can be planned accordingly. Ten cases of nonimmune hydrops fetalis were investigated with percutaneous ultrasound-guided fetal blood sampling and subsequent fetal blood analysis. Nine were proved to be Bart's hemoglobin hydrops fetalis, with 78.2% to 99% of Bart's hemoglobin in the fetal blood. Terminations of pregnancy were undertaken immediately, resulting in a lowered maternal morbidity rate. Free cord loops or an intra-abdominal portion of the dilated umbilical vein can be used for percutaneous fetal blood sampling in nonimmune hydrops fetalis when the placental cord insertion is difficult to visualize. Percutaneous ultrasound-guided fetal blood sampling and subsequent fetal blood analysis will eventually play a key role in the management of the puzzling nonimmune hydrops fetalis if the safety of ultrasound-guided fetal blood sampling can be verified by further clinical studies. PMID- 3300351 TI - Localization of extracellular proteins of the human trabecular meshwork by indirect immunofluorescence. AB - We used monospecific antibodies on semithin frozen sections to identify and localize the major tissue constituents of the nonglaucomatous human trabecular meshwork. The trabecular beams (sheets and cords) consist of a basement membrane (subendothelial extracellular matrix) surrounding an interstitial central core of connective tissue (substantia propria). The basement membrane contains collagen types III, IV, and V, the glycoproteins laminin and fibronectin, and the basement membrane-associated heparan sulfate proteoglycan. The trabecular basement membrane is unlike most subendothelial basement membranes because it contains collagen type III and a relatively disorganized structure. The central core contains collagen types I and III, and elastin. The closely linked juxtacanalicular meshwork contains collagen type III, but no collagen type I or elastin. The connective tissue composition of the trabecular meshwork appears similar to other highly compliant and resilient tissues, such as lung, blood vessels, and conjunctiva. PMID- 3300352 TI - Traumatic wound dehiscence after penetrating keratoplasty. AB - Between 1980 and 1986, 14 of our patients had traumatic globe ruptures three days to 13 years after penetrating keratoplasty. There were eight men and six women, ranging in age from 29 to 82 years (average, 62 years). All ruptures occurred at the corneal donor-host interface. Eleven wound separations occurred with corneal sutures in place. Three of five patients who wore protective eyewear at the time of injury had final visual acuity of 20/200 or less. Final visual acuity was better than 20/200 in only seven patients. The force of the blunt trauma was the most significant factor in visual outcome. Ultimate causes of visual failure included posterior segment damage and intractable glaucoma. PMID- 3300353 TI - Candida albicans endophthalmitis after penetrating keratoplasty. AB - We examined two patients who received contaminated corneas from the same organ donor during penetrating keratoplasty. Both developed Candida albicans endophthalmitis, which responded to surgical and antifungal therapy. On follow-up examination one patient had a visual acuity of hand motions, a pupillary membrane, and a macular scar. The other had a visual acuity of 20/100 and a clear graft. PMID- 3300354 TI - Oculocardiac reflex during manipulation of adjustable sutures after strabismus surgery. AB - We studied 44 patients who underwent strabismus surgery with the use of adjustable sutures to determine the occurrence of the oculocardiac reflex during the postoperative adjustment process. We defined the reflex as at least a 10% decrease in the baseline heart rate. Only two patients (4.5%) displayed an oculocardiac reflex during the adjustment. We did not identify any preadjustment factors that would increase the susceptibility to develop the reflex. PMID- 3300355 TI - Corneal ulcer caused by Shigella flexneri in an infant. PMID- 3300356 TI - A new look at lymphoma immunohistology. PMID- 3300357 TI - Thymic and lymphoid changes and serum immunoglobulin abnormalities in mice receiving cyclosporine. AB - The authors recently demonstrated that cyclosporine (CsA) enhanced the development of murine thymic lymphomas by its tumor promoter-like action. To clarify the underlying mechanism, they investigated the morphologic alterations in the thymus and other lymphoid tissues and the serum immunoglobulin abnormalities in mice receiving CsA. Feeding male Swiss Webster mice with diets containing 0.015% and 0.027% CsA for 1, 2, 4, and 8 weeks led to a marked reduction of the thymic medulla. Thymocytes remaining after CsA treatment were completely destroyed by a single injection of cortisone acetate (8 mg/mice), and cortisone-resistant cells were markedly decreased. Immunoperoxidase staining using anti-keratin antibodies showed a decrease in the number of keratin-positive cells, presumably epithelial cells, in the thymus of CsA-treated mice. These changes were completely reversible within 4 weeks after withdrawing CsA from the diet. The lymph nodes and the gut-associated lymphoid tissues of CsA-treated mice showed blurring of the germinal centers, diminished Thy-1-positive lymphocytes, and proliferation of lymphocytes carrying IgG, IgM, and IgA on their surface. Similar changes were observed in the spleens of CsA-treated mice. There was a slight increase in serum IgG, a twofold increase in serum IgM, and a six- to tenfold increase in serum IgA. The results suggest that CsA interferes with the functions of both T and B lymphocytes in vivo and that disturbance of T-cell maturation in the thymus may be the mechanism by which CsA promotes the induction of thymic lymphomas in mice. PMID- 3300358 TI - Endogenous peroxidase activity as a marker of macrophage renewal during BCG induced inflammation in the rat lung. AB - To determine whether the cytochemical localization of peroxidase activity could be used as a marker of monocyte influx into the lung during an inflammatory response, the authors studied the peroxidase phenotypes of lavaged alveolar macrophages from rats with bacille Calmette-Guerin (BCG)-induced pulmonary inflammation. Rats were immunized subcutaneously and 2 weeks later intravenously with BCG. During the early phase of pulmonary inflammation, an increase was observed in the numbers of alveolar macrophages with no peroxidase activity in the endoplasmic reticulum. These cells appeared to reflect monocyte influx into the injured lung. The later stages of inflammation were characterized by increased numbers of alveolar macrophages with peroxidase-positive endoplasmic reticulum, probably due to activation of enzymatic activity in situ. During the early phase, peroxidase activity was also observed within macrophage cytoplasmic inclusions, probably representing both primary monocyte lysosomes and internalized myeloperoxidase from inflammatory neutrophils. Serial observations indicated that the peroxidase-positive cytoplasmic inclusions became negative with time. It is concluded that inflammation-induced modulation of peroxidase activity in the endoplasmic reticulum and in cytoplasmic inclusions makes the alveolar macrophage peroxidase phenotype no more than a rough marker of monocyte influx into the inflamed lung. PMID- 3300359 TI - Complement complex C5b-8 induces PGI2 formation in cultured endothelial cells. AB - The effects of the terminal complement sequence on prostacyclin (PGI2) generation in antibody-sensitized pulmonary arterial endothelial cells were examined. Whereas C5b-7 complement complexes induced no PGI2 formation, addition of purified complement component C8 resulted in a time- and dose-dependent burst of PGI2 release in the absence of overt cell damage. Formation of the complete terminal complement complex C5b-9 enhanced PGI2 release but was accompanied by cytolysis. Extracellular Ca2+ was required for C5b-8-dependent PGI2 formation. Three different blockers of physiological calcium channels failed to suppress the observed stimulatory effect. In contrast, W7 [N-(6-amino-hexyl)-5-chloro-1 naphthalene sulfonamide] and trifluoperazine, inhibitors of calmodulin activity, all reduced the C5b-8-dependent PGI2 generation. None of the inhibitors used impaired Ca2+ flux into the cells. One minute after addition of C8 to endothelial cells carrying C5b-7 complexes, a six- to seven-fold enhanced passive influx of 45Ca2+ into the cells was noted. An enhanced passive influx was also observed for 51Cr O4(2-), [3H] aminobutyric acid, and [3H]sucrose, but not for [3H]inulin and [3H]dextran. These data together suggest that complement C5b-8 complexes may serve as Ca2+ bypass gates in endothelial cells, the ensuing influx of Ca2+ leading to subsequent activation of the arachidonic acid pathway. PMID- 3300360 TI - Rescue of a wild-type MDCK cell by a ouabain-resistant mutant. AB - When wild-type MDCK cells (W-MDCK) were cocultured in mixed monolayers with a ouabain-resistant mutant (R-MDCK), the wild-type cells were protected from the effect of ouabain up to concentrations as high as 100 microM. Rescue depended on the dose of ouabain and on the proportion of each cell type in the coculture. The survival of R-MDCK cells at 1 microM ouabain was not endangered by varying from 1:9 to 9:1 the proportion of W-MDCK cells to be rescued. Ouabain binding revealed two kinds of binding sites in R-MDCK cells, one with high and the other with low affinity. Only the high affinity site was present in W-MDCK cells. Electron probe analysis of individual cells revealed that rescued cells kept a high K and a low Na intracellular contents, similar to control cells. Histograms of intracellular K/Na in cocultured cells treated with ouabain were unimodal. Using microinjection of Lucifer yellow or electrophysiological techniques we estimated that at most 13% of the R-MDCK and W-MDCK cells may be connected at a given time through cell to-cell junctions. Therefore permanent cell-to-cell communication did not seem to play a central role in the rescue. W-MDCK cells cocultured with R-MDCK cells and subsequently separated, were not rescued. Thus rescue did not seem to depend on the transfer from R-MDCK to W-MDCK cells of either ouabain-resistant Na-K pumps or of information to synthesize them. It is speculated that intercellular communications were sporadic events, so that all cells may become intermittently connected and rescued. PMID- 3300361 TI - Heterogeneity of expression of apical membrane determinants in A6 epithelial cells. AB - Expression of apical membrane antigens by A6 cells is heterogeneous. The A6 cell line is a model system for sodium transport and hormone action in "tight" epithelia. To create probes for the study of sodium transport and aldosterone action, we generated monoclonal antibodies (MoAbs) by immunization of BALB/c mice with intact A6 cells. MoAbs binding to apical membrane determinants were selected by an enzyme-linked immunoadsorbance assay (ELISA) against the apical surface of confluent A6 monolayers. Examination of ELISA-positive MoAbs by indirect immunofluorescence on confluent cells grown on glass cover slips revealed heterogeneity of apical expression: individual cells comprising the monolayer were fluorescently labeled to variable degrees and some cells were unlabeled. Expression of one antigen, recognized by MoAb I4C1, was heterogeneous in cells at low density as well as for confluent cells. Another antibody, 2B8, exhibited heterogeneity of labeling in confluent A6 monolayers, but no labeling of any cells at low density. This heterogeneity of antigen expression suggested that A6 cells are not a single cell type. However, cloned A6 cells established by limiting dilution were also labeled heterogeneously by both antibodies. Thus the heterogeneity observed is not due to genetic inhomogeneity between cells. Expression of the antigens on apical membranes of cells grown on Millipore filters was heterogeneous for the antigen recognized by 2B8, but essentially homogeneous for that recognized by I4C1, suggesting that the degree of differentiation of the cells plays a role in the heterogeneous expression of apical antigens. This heterogeneity of expression of apical antigens adds new complexity to the study of A6 cells and the differentiation of epithelial cells in culture. PMID- 3300362 TI - Kinetics of glucose transport in rat muscle: effects of insulin and contractions. AB - The effects of insulin and prior muscle contractions, respectively, on 3-O methylglucose (3-O-MG) transport in skeletal muscle were studied in the perfused rat hindquarter. Initial rates of entry of 3-O-MG in red gastrocnemius, soleus, and white gastrocnemius muscles as a function of perfusate 3-O-MG concentration exhibited Michaelis-Menten kinetics. Uptake by simple diffusion could not be detected. The maximum 3-O-MG transport velocity (Vmax) was increased more by maximum isometric contractions (10- to 40-fold, depending on fiber type) than by insulin (20,000 microU/ml; 3- to 20-fold) in both red and white muscles. The effects of both contractions and insulin were greater in red than in white muscles. In red but not in white muscles, maximum increases in Vmax elicited by contractions and by insulin were additive. Both insulin and contractions decreased the half-saturating substrate concentration for glucose transport (apparent Km) in all three muscles, in fast-twitch fibers from 70 to approximately 7 mM and in slow-twitch fibers from 12 to 7 mM. After contractions, reversal of contraction-induced glucose transport was monoexponential in red fibers, with a half-time of 7 and 15 min in slow- and fast-twitch fibers, respectively. In white muscle, Vmax continued to increase after contractions, reached a plateau after 10 min, and had only decreased 45% after 70 min. In contrast to the prevailing opinion, in all fiber types, reversal of contraction induced glucose transport took place in the absence of muscle glycogen repletion. PMID- 3300363 TI - Stimulation of proteoglycans by IGF I and II in microvessel and large vessel endothelial cells. AB - Endothelial cells were cultured from bovine capillaries and pulmonary arteries, and the effect of insulinlike growth factor (IGF) I and II (multiplication stimulating activity) and insulin on the synthesis of proteoglycans was determined. IGF I and II stimulated 35SO4 incorporation into proteoglycans in a dose-dependent manner in both microvessel and pulmonary artery endothelial cells with maximum threefold increases. In pulmonary artery cells, the IGFs caused a general stimulation of all classes of glycosaminoglycan-containing proteoglycans. In microvessel endothelial cells, the IGFs appeared to preferentially increase heparan sulfate-containing proteoglycans. Insulin, at concentrations up to 10(-6) M, had no effect on the synthesis of proteoglycans in either microvessel or pulmonary arterial endothelial cells. Thus, the IGFs stimulate the synthesis of proteoglycans in both microvessel and large vessel endothelial cells, a property that is not mimicked by insulin. Because vascular endothelial cells are bathed by IGFs in vivo, such IGF-mediated functions are likely to be significant in both the normal physiology of vascular endothelium and in disease states such as diabetes mellitus. PMID- 3300364 TI - Increased uptake and phosphorylation of 2-deoxyglucose by skeletal muscles in endotoxin-treated rats. AB - Glucose metabolism of respiratory and nonrespiratory muscles of different fiber composition was investigated in conscious rats. The accumulation of phosphorylated 2-deoxyglucose (2DGP) was increased in skeletal muscles by 56-102% and in diaphragm by 236% at 3 h after treatment with 100 micrograms/100 g endotoxin. The increase was still marked at 24 h, whereas it diminished at 48 h in the diaphragm, abdominal muscle, and white portion of the quadriceps. In the red portion of this muscle 2DGP accumulation was less than that in time-matched controls at 24 and 48 h. Whole gastrocnemius (mixed-fiber types) showed no changes after 24 h. The high 2DGP accumulation in brain remained stable. The retention of 2DGP in tissues, studied by sequential double labeling, did not change 3 h after endotoxin. The lumped constant was similar in the isolated epitrochlear muscles of endotoxemic and control rats. Whole-body glucose utilization (Rd) was increased by 68% 3 h after endotoxin, but it was normal at 24 and 48 h. The increase of glucose utilization by the entire skeletal muscle mass was responsible for approximately 25% of the increase in Rd; therefore it appears that other tissues also contributed significantly to the endotoxin induced alterations in carbohydrate metabolism. PMID- 3300365 TI - Decreased myofibrillar proteolysis after refeeding requires dietary protein or amino acids. AB - Previous studies have demonstrated that brief fasting augments and refeeding a complete diet diminishes the breakdown of myofibrillar proteins in rat skeletal muscle. The purpose of the present study was to determine which dietary component(s) was responsible for this effect and to determine the role of insulin and amino acids. Myofibrillar proteolysis was evaluated by measuring the release of 3-methylhistidine by perfused rat muscle of 1-day fasted rats and 1-day fasted rats refed for 4-24 h with a complete, protein-free, or lipid meal. For comparison, tyrosine release by perfused muscle was measured in the absence and presence of cycloheximide to evaluate net and total proteolysis, respectively. Refeeding of either diet increased plasma insulin. Despite this, myofibrillar proteolysis decreased only when protein or amino acids was included in the test meal. On the other hand, the complete or protein-free meal decreased tyrosine release in the absence but not in the presence of cycloheximide, suggesting that either diet enhanced muscle protein synthesis. Most amino acids in plasma and muscle decreased after refeeding the protein-free meal, whereas after the complete meal some amino acids in plasma and muscle increased, whereas other decreased or changed little. These results indicate that decreased myofibrillar proteolysis in muscle after refeeding of food-deprived rats requires dietary protein or amino acids. They also suggest that hormonal and/or nutritional factors other than insulin and amino acids may orchestrate this response. However, a role of amino acids cannot yet be excluded, because it is conceivable that changes in specific amino acids in plasma instead of muscle may signal diminished proteolysis. PMID- 3300366 TI - 1,25-Dihydroxyvitamin D3 target cells in immature pancreatic islets. AB - Target cells of 1,25-dihydroxyvitamin D3 were identified by autoradiography in islets from rats of different ages. Nuclei of pancreatic islet cells selectively concentrated 1,25-[3H]dihydroxyvitamin D3 but not 25-[3H]hydroxyvitamin D3 or 24,25-[3H]dihydroxyvitamin D3. Developmental studies of pancreatic islets indicated that target cells, as revealed by significant nuclear concentration of 1,25-[3H]dihydroxyvitamin D3, are present in islet cells of fetal rats. The percentage of islet cells that concentrated 1,25-[3H]dihydroxyvitamin D3 increased from 10 to 15% in the fetus to 60% at 1 day of age. Immunocytochemical staining indicated that insulin-containing cells but not glucagon or somatostatin cells concentrated 1,25-[3H]dihydroxyvitamin D3. Peak uptake of 1,25 [3H]dihydroxyvitamin D3 was calculated to be 400 pmol/mg DNA, with no significant difference in nuclear accumulation between islet cells from neonatal and adult rats or between islets in vivo and isolated islets in vitro. The results of these studies indicate that 1,25-[3H]dihydroxyvitamin D3 target cells are present in islets before pancreatic beta-cells are morphologically or functionally mature; islet beta-cells concentrate 1,25-dihydroxyvitamin D3, but not 25-hydroxyvitamin D3 or 24,25-dihydroxyvitamin D3. We conclude that only the 1,25-dihydroxyvitamin D3 metabolite of vitamin D is accumulated by nuclei of developing and mature beta cells and suggest that 1,25-dihydroxyvitamin D3 plays a role in the maturation of islet beta-cells. PMID- 3300368 TI - Angiotensin receptor subtypes of the kidney cortex. AB - Angiotensin II (ANG II) binds with high affinity to specific renal receptors and exerts major influences on hemodynamics and tubular transport. Glomerular and tubular epithelial receptors are well characterized in contrast to pre- and postglomerular and medullary vasculature. Therefore, the scope of this review is limited to an indepth comparison of ANG II receptor kinetics, analogue specificity, and mechanisms of receptor regulation and signal transduction in glomeruli and epithelial cells. Despite the fact that these receptors are in close proximity anatomically, there is evidence from a number of laboratories that permits classification into two distinct receptor subtypes. The receptor of the glomerular mesangium, classified herein as "type A," is characterized by high affinity for ANG II and the heptapeptide, des-Asp1-Ang II (ANG III), "downregulation" with high ambient concentrations of ANG II and signal transduction mediated by phospholipase C-induced Ca2+ transients. The tubular epithelial ANG II receptor, "type B," is of lower affinity for ANG II and ANG III, "upregulated" by high levels of ANG II and mediates inhibition of adenylate cyclase following coupling to an inhibitory GTP binding protein. Both receptors possess secondary mechanisms of signal transduction that may also participate in regulation of cellular function(s). These findings support the hypothesis that at least two distinct classes of ANG II receptors are present in the kidney cortex. PMID- 3300367 TI - Degradation of endogenous heptadecapeptide gastrin by endopeptidase 24.11 in the pig. AB - Hydrolysis of heptadecapeptide gastrin (G-17) by endopeptidase 24.11 (EC 3.4.24.11) was studied in vivo and in vitro in the pig. Ion exchange chromatography and radioimmunoassay with three region-specific antisera were used to identify the products of porcine G-17 degradation. Incubation of antral extracts with pure endopeptidase 24.11 resulted in a substantial loss of intact G 17: 80% C-terminal immunoreactivity was lost in 60 min. This hydrolysis was completely inhibited by phosphoramidon, which is a specific inhibitor of endopeptidase 24.11. In antral extracts G-17 accounted for greater than 95% of total C-terminal immunoreactivity, compared with less than 60% C-terminal immunoreactivity in the gastric venous outflow; shorter C-terminal forms comprised the major part of the remaining immunoreactivity. After infusion of phosphoramidon, the concentration of intact G-17 was increased, and there was a corresponding reduction in the concentration of other C-terminal immunoreactive fragments. We conclude that endopeptidase 24.11 degrades G-17 in vitro and in vivo and may be responsible for the generation of C-terminal fragments from G-17 after secretion from the porcine antral mucosa. PMID- 3300369 TI - Insulin-stimulated protein metabolism in chronic azotemia and exercise. AB - To determine whether training reduces the acute catabolic stress of an exercise bout, control and azotemic rats, either exercise trained or untrained, were subjected to a bout of exercise or allowed to rest. Protein turnover was measured immediately following exercise in isolated muscles. Azotemia (no exercise) increased protein degradation; acute exercise (no azotemia) decreased protein synthesis. Protein catabolism was greatest in acutely exercised azotemic rats. Training reduced azotemia-induced and acute exercise-stimulated increase in protein degradation. To determine whether this improvement in protein metabolism by training was due to increased insulin sensitivity, the dose-response to insulin was determined. Resistance of protein synthesis or degradation to insulin was not observed in azotemic rats. Either acute exercise or training increased sensitivities of protein degradation and synthesis to insulin; training also increased responsiveness of protein degradation to insulin. Thus exercise training reduced the elevated muscle protein catabolism due to azotemia and/or acute exercise and enhanced the action of insulin on muscle. PMID- 3300370 TI - Glomerular dynamics in the hypothyroid rat and the role of the renin-angiotensin system. AB - Munich-Wistar rats underwent thyroidectomy (TX) with reimplantation of the parathyroid glands. Systemic hemodynamic and micropuncture studies were performed at 1 and 3 wk post-TX, and the results were compared with levothyroxine replaced controls (TXT4). Cardiac output (CO) in TX rats fell progressively and was 40% of that in TXT4 at 3 wk. Renal blood flow declined in parallel with CO. Systemic blood pressure did not fall in TX rats because of a 50% increase in systemic vascular resistance by 3 wk post-TX. Glomerular dynamics were not significantly different between TX and TXT4 rats at 1 wk; however, by 3 wk single-nephron glomerular filtration rate (SNGFR) had fallen to 16.5 +/- 1.1 vs. 34.1 +/- 3.4 nl/min in TXT4 controls (P less than 0.001). In 3-wk TX rats, glomerular plasma flow (QA) was 50.9 +/- 3.7 vs. 108.0 +/- 8.7 nl/min in TXT4 rats (P less than 0.001), net hydraulic ultrafiltration pressure (delta P) was 33 +/- 2 vs. 37 +/- 1 mmHg in TXT4 rats (P less than 0.01), and the ultrafiltration coefficient (Kf) was 0.025 +/- 0.003 vs. 0.084 +/- 0.008 nl X s-1 X mmHg-1 in TXT4 controls (P less than 0.001). Although the changes in systemic and glomerular hemodynamics were progressive over 3 wk, proximal tubular reabsorption fell maximally within 1 wk. Similar patterns of alterations in glomerular dynamics are known physiological consequences of angiotensin II (ANG II).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300371 TI - Development of postglucoprivic insulin-induced suckling and feeding in rats. AB - Increased food or milk intake in response to insulin-induced hypoglycemia cannot be demonstrated in the rat until pups reach weaning age. However, when food and suckling are withheld from insulin-treated 5- to 25-day-old rats until their altered blood glucose levels return to normal, their rate of milk intake via suckling from their anesthetized dam is increased over saline-treated control pups. This postglucoprivic action of insulin could not be demonstrated in rats consuming wet mash until pups reached 25-30 days of age. Nonnutritive oral stimulation from dry suckling during the glucoprivic episode is sufficient to disrupt postglucoprivic suckling in 20-day-old rats. In contrast consuming a small quantity of wet mash became an effective inhibitor of postglucoprivic suckling only when pups reached 25 days of age. These data demonstrate the existence of an insulin-sensitive neural system for suckling and feeding in infant rats and point to the involvement of multiple and changing oral factors during development in insulin-induced postglucoprivic feeding. PMID- 3300372 TI - Role of brain serotonergic pathways and hypothalamus in regulation of renin secretion. AB - To investigate the role of brain serotonergic neurons in the regulation of renin secretion, we measured changes in plasma renin activity (PRA), and, in some instances, plasma renin concentration (PRC), plasma angiotensinogen, and plasma adrenocorticotropic hormone (ACTH) in rats with lesions of the dorsal raphe nucleus and lesions of the paraventricular nuclei, dorsomedial nuclei, and ventromedial nuclei of the hypothalamus. We also investigated the effects of p chloroamphetamine (PCA), immobilization, head-up tilt, and a low-sodium diet in the rats with dorsal raphe, paraventricular, and dorsomedial lesions. Lesions of the dorsal raphe nucleus abolished the increase in PRA produced by PCA but had no effect on the increase produced by immobilization, head-up tilt, and a low-sodium diet. Paraventricular lesions, which abolish the increase in plasma ACTH produced by PCA, immobilization, and head-up tilt, decreased plasma angiotensinogen. The paraventricular lesions abolished the PRA and the PRC responses to PCA and the PRA but not PRC response to immobilization, head-up tilt, and a low-sodium diet. The ventromedial lesions abolished the PRA and PRC responses to PCA and did not reduce plasma angiotensinogen. The data suggest that paraventricular lesions depress angiotensinogen production by the liver and that the paraventricular and ventromedial nuclei are part of the pathway by which serotonergic discharges increase renin secretion. They also suggest that the serotonergic pathway does mediate the increases in renin secretion produced by immobilization, head-up tilt, and a low-sodium diet. PMID- 3300374 TI - A naturalistic study of imipramine in panic disorder and agoraphobia. AB - This naturalistic study examined the treatment response to imipramine of 60 patients who had panic disorder or agoraphobia with panic attacks. Only half of the patients could tolerate the drug, but of those who did, 88% obtained a markedly beneficial clinical effect. An amphetamine-like side effect accounted for most of the dropouts. More than one-half of the responders achieved clinical remission at doses (less than or equal to 100 mg/day) and plasma levels (less than or equal to 150 ng/ml) considered to be subtherapeutic for depression. There appears to be neither a clear threshold for response nor a therapeutic dose range for imipramine in the treatment of panic. Doses should be adjusted individually and increased conservatively. PMID- 3300373 TI - 3-O-methylglucose transport in soleus muscle of bacteremic rats. AB - Basal and insulin-stimulated soleus muscle 3-O-[14C]methylglucose ([14C]-3-O-MG) transport was studied in vitro and in vivo during bacteremia in rats. Fasted rats were injected with Escherichia coli to produce bacteremia (B), and controls (C) received saline. In vitro studies using soleus muscles were carried out 8 or 12 h after bacterial injection, and transport was measured using the rate coefficient (lambda = min-1). Although insulin-stimulated (10 mU/ml) [14C]-3-O-MG transport was decreased in 12-h bacteremic rat muscles (lambda B = 0.041 +/- 0.003; lambda C = 0.055 +/- 0.002), the basal [14C]-3-O-MG transport rate coefficient was elevated (lambda B = 0.027 +/- 0.004; lambda C = 0.019 +/- 0.001). For in vivo studies, [14C]-3-O-MG with or without insulin was injected into rats 10-40 min prior to removing soleus muscles at 12 h postbacterial or postsaline injection. Transport was measured as the ratio of [14C]-3-O-MGintracell/[14C]-3-O MGextracell. Basal ratios were not different and muscles from both control and bacteremic rats responded comparably to insulin with increased [14C]-3-O-MG transport during the initial 30 min. At 35-40 min postinsulin injection there was a further stimulation of [14C]-3-O-MG transport in control but not in 12-h bacteremic rat muscles. The changes in [14C]-3-O-MG transport observed in vitro and in vivo after 12 h of bacteremia may be due to circulating mediators and/or changes in membrane function. PMID- 3300375 TI - Effect of bromocriptine on affect and libido in hyperprolactinemia. AB - Six women with primary hyperprolactinemia (mean prolactin level, 50 ng/ml) were matched with six normal women on eight factors influencing life style. Observers blind to endocrine status followed the subjects weekly for 10 weeks. Patients took bromocriptine, 2.5 mg twice daily, or placebo in a randomized double-blind sequence with crossover at 5 weeks. The mean Hamilton score for the patients was compatible with mild depression and higher than that for normal subjects during placebo but not during bromocriptine treatment. Libido was similar in both groups during placebo and bromocriptine. The mean number of orgasms reported per day was lower in patients than in normal subjects during both treatment conditions, although one patient reported orgasms during drug treatment only. Hyperprolactinemia in women may be associated with mild depression and a decrease in orgasmic frequency. PMID- 3300376 TI - An open trial of L-tyrosine in the treatment of attention deficit disorder, residual type. AB - To elucidate the role of catecholamines in attention deficit disorder, the authors conducted an open 8-week trial of L-tyrosine in 12 adults with attention deficit disorder, residual type. Eight showed marked to moderate clinical response in 2 weeks; at 6 weeks these eight developed tolerance, suggesting that L-tyrosine is not useful in attention deficit disorder, residual type. PMID- 3300377 TI - New female perceptions of parental power. AB - In a study of family roles, 85 adolescent sons and daughters from 27 families initially attributed "power" roles to fathers and "support" roles to mothers. Three years later, daughters perceived power and support roles as shared, while sons still perceived the earlier dichotomy. PMID- 3300378 TI - Weir Mitchell and lithium bromide. PMID- 3300379 TI - Robert O. Pasnau, M.D., one hundred fifteenth president, 1986-1987. American Psychiatric Association. PMID- 3300380 TI - The theory and practice of movie psychiatry. AB - The depiction of psychiatry in the movies has been a source of concern over the years to many in the profession who feel that a false picture of psychiatrists' work has been presented to the public. In fact, psychiatry in the movies has developed its own characteristics, which only occasionally intersect with those of the real-life profession. This paper outlines the methods and theories of the invented profession of movie psychiatry. PMID- 3300381 TI - Constructivist view of meditation. AB - Meditation experiences are viewed from a constructivist perspective. Concentrative and mindfulness approaches are compared. It is concluded that, although these meditative techniques differ (and often are used in conjunction), they both yield insight into how the mind processes experience at both the preverbal and verbal levels. PMID- 3300382 TI - Control of a non-foodborne outbreak of salmonellosis: day care in isolation. AB - We report an outbreak of Salmonella typhimurium in the infant room of a day care center. Time between onset dates, clustering of cases in the room, lack of a common food exposure, lack of illness among other children and staff, and lack of community-wide infection suggested person-to-person or continuing-common-source transmission. Successful preventive measures included instruction of personnel in proper handwashing and diaper-changing procedures and cohorting of infected and non-infected children. This is the second description of a non-foodborne outbreak of salmonellosis in a day care center, and the first involving S. typhimurium. PMID- 3300383 TI - Cesarean section prophylaxis: comparison of two doses with three doses of mezlocillin. AB - A prospective randomized double-blind comparison of two doses, with three doses of mezlocillin for nonelective cesarean section prophylaxis was performed. One hundred seven (107) patients were evaluated. Mezlocillin (4 g) was given post cord clamping and then at 4-h intervals for a total of two doses or three doses. The incidence of febrile morbidity was lower in the three-dose group (2 of 46, 4%) than the two-dose group (14 of 61, 23%) (P less than 0.02). However, the incidence of infectious morbidity was not different between the three-dose group (3 of 46, 7%) and the two-dose group (10 of 61, 16%), and the incidence of endomyometritis was similar in the two groups (6.5% vs 9.8%). Among failures of prophylaxis there were no differences compared to successes in the number of potential commensals or potential pathogens cultured from amniotic fluid. However, the proportion of failures among patients with both commensals and potential pathogens isolated (10/58) was significantly greater than among patients with none or only commensals isolated (1/37) (P less than 0.03). We found mezlocillin to be an effective agent for perioperative cesarean section prophylaxis with two doses as effective as three doses. The presence of clinically important organisms in the amniotic fluid at the time of operation typified patients with postoperative infectious complications despite perioperative prophylaxis. PMID- 3300384 TI - A classification of cardiac allograft rejection. A modification of the classification by Billingham. AB - We herein propose a classification of rejection in cardiac allografts based on the original Stanford work. Our modified classification, as a work hypothesis, defines the following grades: mild acute rejection (A-1), corresponding to Billingham's "mild rejection"; mild acute rejection with probable conversion to moderate rejection (A-2); moderate acute rejection (A-3), comparable to Billingham's "moderate rejection"; and severe acute rejection (A-4), morphologically identical with the respective grade in the Billingham classification. The resolution of rejection has been classified into two grades- early (A-5a) and late (A-5b) resolution--according to the development of granulation tissues. We also grade the degree of vasculopathy (B-1, B-2) and chronic rejection (C), which is characterized by aggressive fibrosis and persistent vasculopathy. Mild rejection with possible conversion to moderate rejection is defined by an increasing quantity of retrogressive changes in myocytes. Changes not related to transplantation are characterized in our classification by descriptive diagnosis. The proposed classification was validated by 1 year of clinical experience and by the evaluation of possible prognostic aspects of the classification. PMID- 3300385 TI - Use of Ulex europaeus agglutinin I in the identification of lymphatic and blood vessel invasion in previously stained microscopic slides. AB - Lymphatic and blood vessel invasion is one of the most important diagnostic and prognostic parameters used by pathologists in the evaluation of neoplastic conditions. Although a variety of tissue artifacts can make the recognition of vascular, capillary, and lymphatic permeation by tumor cells extremely difficult, recent immunohistochemical studies have employed a variety of tissue markers that appear to have great value in establishing the diagnosis of lymphovascular involvement. In the present study, we applied an immunoperoxidase staining technique to previously stained microscopic tissue sections using Ulex europaeus agglutinin I lectin, an endothelial marker that can be used in paraffin-embedded tissues. Our results indicate that this technique can be successfully applied on microscopic slides previously stained with a variety of histochemical stains. It can also be used in those cases in which paraffin blocks are not available or the area in question is absent from the recut tissue sections. PMID- 3300386 TI - Chromogranin A and B and secretogranin II in medullary carcinomas of the thyroid. AB - We have studied the presence of chromogranins A and B and secretogranin II in medullary carcinomas of the thyroid using the methods of immunoblotting and immunohistochemistry. All three antigens were identified by immunoblotting. Chromogranin A and secretogranin II behaved identically to the adrenal antigens in electrophoresis, whereas the molecular size of chromogranin B in the thyroid tissue appeared slightly smaller, possibly due to a higher degree of proteolytic processing. In immunohistochemistry, positive staining was obtained with all three antigens throughout the tumor tissue. All three antigens, as well as the hormone calcitonin, were apparently present in the same cells. Our study suggests that in addition to chromogranin A, the other two antigens (chromogranin B and secretogranin II) may also be useful markers for tumors arising from endocrine tissues. PMID- 3300387 TI - Epithelioid leiomyosarcoma of the stomach. A case study of the intermediate filaments. AB - The intermediate filament typing of skeletal and smooth muscle tumors has shown that these neoplasms are characterized by the combined expression of desmin and vimentin intermediate filaments. A case of epithelioid leiomyosarcoma of the stomach was studied by conventional light microscopy and by indirect immunofluorescence using tissue-specific antibodies against intermediate filaments. The tumor cells labeled strongly with vimentin antibodies and were negative for desmin and prekeratin. This peculiar staining pattern may be the result of poor differentiation of the tumor cells with resultant loss of expression of desmin, or may be due to origin from a distinctive smooth muscle cell characterized by the exclusive expression of vimentin intermediate filaments. PMID- 3300388 TI - Pathologic changes associated with fatal Plasmodium falciparum infection in the Bolivian squirrel monkey (Saimiri sciureus boliviensis). AB - Fatal cases of experimental Plasmodium falciparum (Indochina I) in Bolivian squirrel monkeys (Saimiri sciureus boliviensis) were examined by histologic and ultrastructural methods. Gross lesions were characterized by hepatosplenomegaly and interstitial pulmonary changes. Histologically, there was marked diffuse reticuloendothelial hyperplasia, pulmonary alveolar septal thickening, mesangioproliferative glomerulonephropathy, sequestration of parasitized erythrocytes in deep vascular beds, degenerative parenchymal changes in the liver and myocardium, and in one case retinal and cerebral hemorrhage. These data indicate that the Bolivian squirrel monkey is a good model for studying pathologic changes associated with human falciparum malaria. PMID- 3300389 TI - The disappearance of bancroftian filariasis from Charleston, South Carolina. AB - I suggest the hypothesis that bancroftian filariasis, endemic since the early days of slavery in Charleston, South Carolina, disappeared around 1930 by virtue of the long-term effects of a municipal sewerage-water system begun in the 1890s or thereabouts. These public works, originally intended to abate typhoid and related diseases, helped to eliminate filariasis by reducing the availability of polluted domestic waters which are the preferred breeding sites for the urban vector, Culex quinquefasciatus (= fatigans). Cause and effect having been separated by some three decades, the epidemiologic connections between these events in Charleston seem not to have been appreciated hitherto. PMID- 3300390 TI - Sensitivity of various serologic tests for RMSF. PMID- 3300391 TI - Antibodies to the PF155 antigen of Plasmodium falciparum: measurement by cell ELISA and correlation with expected immune protection. AB - Plasmodium falciparum polypeptide Pf155 is one of the main candidates for a vaccine against asexual blood stages of P. falciparum. Antibodies against Pf155 can be detected by a cell-ELISA technique with glutaraldehyde-fixed and air dried P. falciparum-infected erythrocytes as antigen. Using this assay, we measured the level of antibodies in sera from 230 subjects with various degrees of past exposure to P. falciparum. Significant levels of antibodies (OD492 greater than 0.5) were detected in 41/50 sera from Central African adults and in 34/50 sera from West African adults. All sera from 50 European adults suffering primary malarial attack and 28/30 sera from West African children (10 to 12 years old) were negative. Intermediate results were obtained with 50 sera from West African adults living in France for greater than or equal to 2 years (12 positive). Mean OD values of the sera of these five groups of subjects varied in the same direction as the positivity rates. These preliminary results suggest that the level of anti-Pf155 antibodies as detected by cell-ELISA might provide an assessment of protective immunity against P. falciparum which could complement clinical or epidemiological criteria. PMID- 3300392 TI - Assessment of a synthetic DNA probe for Plasmodium falciparum in African blood specimens. AB - Synthetic DNA oligomers homologous to 21-base long repetitive sequences of Plasmodium falciparum DNA were labeled with 32P using T4 kinase, and were hybridized with purified DNA and with processed blood samples from Africa. The sequence PFR1, its antiparallel oligomer PFR1R, and PFR1 covalently attached to biotin hybridized similarly to P. falciparum DNA. One-microliter aliquots of blood from Zaire spotted on prewet nylon filters and hybridized with PFR1 gave detectable autoradiogram signals from samples with parasitemias as low as 1,000 parasites/mm3. Blood lysis and protein digestion followed by alkylation allowed dot-blot processing of larger aliquots of blood. After hybridization with PFR 1 and autoradiography, 26 samples were scored positive visually, compared with 34 scored positive by microscopy. The effective sensitivity for processed 10 microliter samples was about 500 parasites/mm3. Signals from hybridized probes were quantitated by liquid scintillation counting and densitometry, and were proportional to the amounts of purified P. falciparum DNA applied to the filter. Autoradiogram signals also were roughly proportional (correlation coefficient, r = 0.77) to the number of parasites/mm3 of blood from field samples as determined by microscopic examination. PMID- 3300393 TI - Optimal concentration of p-aminobenzoic acid and folic acid in the in vitro assay of antifolates against Plasmodium falciparum. AB - In vitro tests for Plasmodium falciparum sensitivity to pyrimethamine, sulfadoxine, and both drugs in combination were performed in four kinds of culture medium, each differing in p-amino benzoic acid (PABA) and folic acid concentrations. Results of the tests using pyrimethamine-sensitive and pyrimethamine-resistant isolates indicated that drug activity was reduced proportionally to the concentrations of these two growth factors in the medium. The optimal concentrations of PABA and folic acid for parasite growth and drug susceptibility, as evaluated by microscopic examination and by the extent of incorporation of radioactive 14C-pyrimethamine and 14C-sulfadoxine, were 10 ng/ml and 2 ng/ml, respectively. Depletion of PABA and folic acid from the medium had no effect on drug-resistant parasites but multiplication of drug-sensitive isolates was markedly reduced. Medium containing 0.5 ng/ml PABA and 10 ng/ml folic acid was the best for parasite growth regardless of the degree of drug sensitivity. Results obtained by using this medium agreed most closely with results from in vivo observations. PMID- 3300394 TI - Potentially curable masses in the pancreas. AB - Twenty patients with intraabdominal non-Hodgkin's lymphoma localized to the peripancreatic area were reviewed. Appropriate diagnosis and staging required exploratory laparotomy and biopsy. With appropriate chemotherapy and radiotherapy, 40 percent of these patients were alive 3 years after diagnosis without evidence of disease. It is for this reason that we have adopted an aggressive approach in obtaining histologic diagnoses for all pancreatic masses. PMID- 3300395 TI - Fulminant hepatic failure: the role of liver transplantation as primary therapy. AB - Fulminant hepatic failure is a clinical syndrome with a high mortality rate when traditional supportive therapy is used as treatment. Orthotopic liver transplantation has been proposed as a therapeutic option. Clinical and logistic difficulties include the rapid deterioration of the patients, unpredictable recovery, and the immediate need for a donor organs. Including this series, a total of 41 patients with fulminant hepatic failure have been transplanted, with a survival rate of 61 percent. We have reported eight liver transplantations carried out in six patients. Four of the patients survived (66 percent). Death was due to irreversible neurologic dysfunction in one patient and fungal sepsis in one patient. These results indicate that orthotopic liver transplantation is a practical therapeutic option for fulminant hepatic failure which should be considered early, before neurologic deterioration becomes irreversible. PMID- 3300396 TI - Surgical correction of late sequelae from facial bone fractures. AB - This study has described the UCLA experience over a 5 year period in the treatment of secondary traumatic deformities utilizing the craniofacial techniques originally proposed by Tessier. Because of scarring, absent parts, and the malposition of segments, correction of long-standing traumatic deformities remains difficult and treatment results remain less than ideal. Primary correction utilizing the principles we have described herein still provides the best functional and aesthetic results. Facial fractures can no longer be considered as an independent and unrelated entity when dealing with the traumatized patient. If primary reconstruction continues to be compromised, correction of residual disfigurement will result in unnecessary patient morbidity and disturbances of facial form and function. PMID- 3300397 TI - In situ saphenous vein bypass: 1962 to 1987. AB - The historical development of in situ saphenous vein bypass has been traced over the past quarter century. The principal advantage of the in situ vein graft over the conventional reversed vein graft is the increase in flow that occurs in a tapered channel. Both the advantages of this hemodynamic observation in the in situ graft and its disadvantages in the reversed graft are accentuated in longer bypasses as the discrepancy in proximal and distal vein diameter increases. Furthermore, there is new evidence that unusual shear and stress tend to occur at sites of severe vein-artery discrepancy, such as seen in reversed vein grafts but less so in the in situ graft. Experience with the in situ graft has shown that another important advantage is that there is less chance of trauma to the vein from overdistention and rotation, which is inherent in the operation since the vein is not removed from its bed. On the other hand, the overly traumatic disruption of venous valves required in the in situ operation can cause subendothelial damage with resultant fibrosis of the vein. Although it has been demonstrated that equally good results with reversed as with in situ grafts can be obtained by careful attention to detail, this is true only for grafts carried to the popliteal level. The advantages of increased flow and less shear damage because of tapering, physiologic distention under arterial pressure, and finally, decreased handling and manipulation of the vein have become increasingly important as bypass is carried distal to the knee. I believe that the evidence to date indicates that the in situ operation has strong superiority over the conventional reversed graft for reconstructive operations on the lower extremity extending below the knee. PMID- 3300398 TI - Changing clinical spectrum of splenic abscess. A multicenter study and review of the literature. AB - The changing demographics of splenic abscess in regard to predisposition, clinical setting, diagnosis, bacteriologic findings, and treatment have been presented based on 19 patients from five institutions and 170 patients reported in the literature since 1978. These data, in turn, have been compared with a previously published retrospective review of the world literature from 1900 to 1977. It has become clear that since 1978, splenic abscess is diagnosed earlier in its presentation due to the widespread use of improved imaging techniques, immunocompromised patients comprise a much larger proportion of patients (24 percent) than previously due to increasing use of steroids and chemotherapeutic agents, and the diagnosis of fungal splenic abscess, almost unheard of before 1978, has increased to 26 percent of patients. The diagnostic sensitivity of computerized tomography (96 percent) has clearly been shown to be superior to ultrasonography, and gallium, indium, and technetium-99m liver and spleen scanning. The diagnosis of splenic abscess, however, is still often not considered due to its rarity and the presence of predisposing conditions which obscure its clinical presentation. Untreated splenic abscess is still fatal, and although splenectomy is the mainstay of treatment, it appears that antifungal treatment without splenectomy can be recommended for patients with disseminated fungal disease as long as bacterial abscess has been ruled out by invasive culture techniques. Scattered reports of percutaneous drainage exist and are increasing in the literature, although the results are as yet inconclusive. Eventual recovery depends on early diagnosis and successful treatment of the underlying condition. PMID- 3300399 TI - [Current aspects of the prenatal diagnosis of hereditary pathology]. PMID- 3300400 TI - [Rational methods of dissecting and suturing the perineum in labor]. PMID- 3300401 TI - [Zinc deficiency in the mother, fetus and progeny in alcohol abuse]. PMID- 3300402 TI - [Bloodless method of treating recurrent uterine inversion in the puerperal period]. PMID- 3300403 TI - [60th anniversary of the Irkutsk Province Society of Obstetricians and Gynecologists]. PMID- 3300405 TI - The Child Neurological Society in Taiwan: its history and present status. PMID- 3300404 TI - [The discovery and tragedy of Ignaz Semmelweis (on the 140th anniversary of his discovery)]. PMID- 3300406 TI - [Endobronchial administration of adrenaline in preclinical cardiopulmonary resuscitation]. AB - The present clinical study was designed to investigate the effectiveness of epinephrine when administered endobronchially (e. b.) in patients undergoing out of-hospital cardiopulmonary resucitation (CPR). Plasma catecholamine measurements during and following CPR in 30 patients revealed plasma levels of epinephrine and norepinephrine with tremendous variations and elevated, sometimes, for nearly 1,000 fold when compared to normal resting levels. In patients with ventricular fibrillation (VF) native epinephrine concentrations (23.5 +/- 20.4 ng/ml) were significantly different from asystolic victims (2.1 +/- 1.2 ng/ml). This finding once more supports the importance of early defibrillation as main therapeutical step in VF. When epinephrine (2-3 mg) was instilled endobronchially shortly after endotracheal intubation therapeutic concentrations of more than 10 ng/ml of epinephrine were measured when the first venous access was achieved. In 7 patients with successful CPR e. b. epinephrine was the only pharmacological therapy provided to support the cardiovascular system. Under these circumstances plasma epinephrine levels remained within the therapeutic range of 10-20 ng/ml for about 30 minutes. By these clinical findings it becomes clear that e. b. epinephrine (2-3 mg in 5-10 ml of NaCl 0.9%) instilled deeply by a catheter following intubation is the pharmacological therapy of choice in asystolic patients. PMID- 3300407 TI - [In memory of His Most Excellent, the Honorable Jorge Tamarit Torres]. PMID- 3300408 TI - [Nalbuphine following fentanyl. Postoperative analgesia]. AB - It has been suggested in various studies that the opiate agonist/antagonist nalbuphine (Nubain) provides for effective reversal of the respiratory depression after fentanyl while maintaining postoperative analgesia. We tested this hypothesis in a relatively large number of patients. The study consisted of two parts: one randomized open, the other randomized double-blind, each with 150 ASA I or II patients aged 18 to 65 years. After premedication with atropine 0.5 mg and flunitrazepam 0.5 mg, anaesthesia was induced with flunitrazepam 0.5 mg, fentanyl 0.1 mg, and etomidate 10 mg and maintained with N2O/O2, 2/1, and additional increments of 0.1 mg fentanyl as required. Relaxation for intubation and surgery was obtained with vecuronium, atracurium, or pancuronium depending on the expected duration of anesthesia. After the operation the patients were extubated and the residual effects of fentanyl antagonized with naloxone 0.05 mg or nalbuphine 10 mg or 20 mg i.v. (randomized open or double-blind). The patient data and fentanyl dosages are given in Table 1. Postoperative pain was assessed by the time interval between administration of the opiate antagonist and the requirement for the first analgesic medication. Figures 1a and b and Table 2 indicate that after nalbuphine 20 mg the first analgesic was required significantly later than after naloxone 0.05 mg (median 115 or 123 min after nalbuphine 20 mg vs 56 or 52 min after naloxone 0.05 mg; P less than 0.02). There was no significant difference between nalbuphine 10 mg and naloxone 0.05 mg. The open and double-blind studies gave virtually identical results. Sixty minutes after administration of 20 mg nalbuphine, vigilance was significantly reduced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300410 TI - Surgical and anaesthetic considerations in transurethral resection of the prostate. PMID- 3300409 TI - Oral premedication in children. AB - Preoperative and postoperative sedation, postoperative analgesia and vomiting were assessed following four different oral premedications in 143 children aged 1 10 years, weighing 10-30 kg, and undergoing elective adenotonsillectomy or inguinal surgery. Diazepam, diazepam combined with droperidol, trimeprazine and trimeprazine combined with droperidol were compared in a double-blind trial in conjunction with a standardised inhalational anaesthetic technique employing an intraoperative narcotic. Trimeprazine produced significantly more preoperative sedation (P less than 0.001) and was associated with enhanced postoperative analgesia (P less than 0.01). The incidence of postoperative vomiting was significantly less in the group receiving trimeprazine (P less than 0.001). The addition of droperidol to diazepam and trimeprazine only marginally improved the performance of those drugs but significantly prolonged postoperative recovery times. This was more marked when droperidol was combined with trimeprazine. PMID- 3300411 TI - Detection of the cofactor pyrroloquinoline quinone. AB - In order to demonstrate the presence or absence of a pyrroloquinoline quinone (PQQ) synthesizing capacity in microorganisms, we have found that media and equipment must be treated to remove contaminating PQQ. Procedures are described which appear to be effective for that purpose. These have been used with Acinetobacter calcoaceticus PQQ- strains to develop a sensitive and reliable assay for PQQ. They also have been used to show that under our conditions of growth Escherichia coli does not synthesize PQQ. Fluorescence spectroscopy is not selective enough to detect PQQ in a protein hydrolysate due to background fluorescence in the same spectral regions as PQQ. In addition, PQQ reacts with amino acids to give products that cannot be detected by either fluorescence spectroscopy or biological assay. In this regard, claims that several materials originating from plants or animals contain PQQ should be reexamined. Moreover, PQQ cannot be detected with these methods in hydrolysates of enzymes containing covalently bound PQQ. PMID- 3300412 TI - Phase change enzyme immunoassay. AB - A novel enzyme-linked immunoassay employing a partitioning chromophore was developed. The assay system consisted of an aqueous phase and an immiscible organic solvent. Antigen-antibody interaction was indicated by transfer of a chromogenic indicator from the aqueous phase to an organic layer. The indicator employed was a water-soluble phosphate ester of phenylazophenol. Hydrolysis of the ester by acid or alkaline phosphatase produced a water-insoluble phenol that partitioned into toluene. The enzyme employed in this assay format can be covalently linked to antibody or a specific antibody for the phosphatase can be used. Phase change immunoassays were developed for the measurement of alkaline phosphatase, human IgG in whole blood, and the human tumor marker prostatic acid phosphatase. Solid supports of small polystyrene latex particles and Sephadex were employed. PMID- 3300413 TI - N-anthraniloylation converts peptide p-nitroanilides into fluorogenic substrates of proteases without loss of their chromogenic properties. AB - By simple substitution of an N-acyl group for the anthraniloyl(o-aminobenzoyl) group, chromogenic p-nitroanilide substrates are converted into highly sensitive fluorogenic substrates of proteases. The fluorescence of the anthraniloyl group is completely quenched by the p-nitroanilide moiety in the intact substrates and is released during their enzymatic hydrolysis. The approach is exemplified by the synthesis of anthraniloyl-Phe p-nitroanilide, anthraniloyl-Lys p-nitroanilide, and anthraniloyl-Gly-Gly-Phe p-nitroanilide as substrates for chymotrypsin, trypsin, and alkaline mesentericopeptidase, respectively. The kinetic parameters of these substrates are slightly better than those of similar derivatives bearing other acyl groups, suggesting that the enhanced sensitivity is completely due to the method of measurement. Since the conversion does not affect the chromogenic properties of the substrates, the same compounds can be used as usual p nitroanilide substrates as well. PMID- 3300414 TI - Heparin-agarose chromatography for the purification of tetrahydrofolate utilizing enzymes: C1-tetrahydrofolate synthase and 10-formyltetrahydrofolate synthetase. AB - Rapid and convenient purification procedures based upon heparin-agarose chromatography for C1-tetrahydrofolate synthase from Saccharomyces cerevisiae and 10-formyltetrahydrofolate synthetase from Clostridium acidi-urici have been developed. The purification of the yeast enzyme involves three chromatographic steps that can be done rapidly, with no intervening dialyses, and results in high yield. The first step alone, heparin-agarose chromatography, is sufficient to purify the enzyme from yeast bearing a cloned copy of the ADE3 gene that overexpresses the protein. The other steps in the purification from wild-type yeast are matrex gel red A and phenyl-Sepharose chromatography. The purification of the clostridial enzyme involves protamine sulfate fractionation and heparin agarose chromatography. Heparin-agarose also binds two other enzymes that use tetrahydrofolate, 5,10-methenyltetrahydrofolate cyclohydrolase and 5,10 methylenetetrahydrofolate dehydrogenase. Thus, heparin-agarose should prove useful in purification of a variety of enzymes that utilize tetrahydrofolate or its derivatives as a cofactor. PMID- 3300415 TI - Quantitative measurement of 5-, 12-, and 15-hydroxyeicosatetraenoic acid together with 12-hydroxyheptadecatrienoic acid by stable isotope dilution gas chromatography-negative ion chemical ionization-mass spectrometry. AB - A stable isotope dilution gas chromatography-negative ion chemical ionization mass spectrometry assay for simultaneous quantitative measurement of 5 hydroxyeicosatetraenoic acid (HETE), 12-HETE, 15-HETE, and 12 hydroxyheptadecatrienoic acid in one single GC/MS run was established. 18O2 Labeled analogs as internal standards, prepared according to conventional procedures, were found to be useful for this application. A sample processing and derivatization sequence providing highly purified compounds with a recovery of 42.7% was elaborated. The detection limit was in the femtomole range. PMID- 3300416 TI - An immunological assay for chloramphenicol acetyltransferase. AB - We report the production and utility of rabbit polyclonal antisera to the bacterial protein chloramphenicol acetyltransferase (CAT). The anti-CAT antibodies specifically react with CAT protein produced in bacterial or avian cells. Results reported here demonstrate that detection of CAT by immuno-dot blot techniques is at least as sensitive as the currently used in vitro enzymatic assay. The availability of antibodies to CAT offers a number of potential advantages to investigators who now use the CAT gene to study factors influencing gene regulation. PMID- 3300417 TI - Primer extension analysis of tRNA gene transcripts synthesized in vitro and in vivo. AB - The primer elongation method has been adapted to analyze tRNA gene transcripts. The primer used to direct cDNA synthesis from a corresponding tRNA template, in the presence of AMV reverse transcriptase, was a restriction fragment, or a synthetic oligonucleotide, containing exclusively coding nucleotides of a tRNA gene. This method not only allows one to identify the exact 5'-end of mature tRNA, but also 5'-ends of primary transcripts are readily determined. Further, analysis of tRNAs synthesized in vitro, as well as tRNAs produced in vivo in homologous and heterologous organisms can be studied. Purification of the tRNAs questioned, from bulk tRNA, is not necessary. PMID- 3300418 TI - Direct determination of the specific activity of RNA uniformly labeled with 32P. AB - A simple method for the direct determination of the specific activity of RNA uniformly labeled with 32P is described. The procedure is based on the premise that upon disintegration of 32P to 32S, the phosphodiester bond is broken. Analysis of the rate of decay of the full-length molecule by gel electrophoresis and autoradiography can accurately determine the "intramolecular specific activity" of the RNA. An equation that predicts the relative intensity of the intact RNA molecules remaining as a function of time is presented. These predictions are confirmed using in vitro-synthesized RNA labeled at a known specific activity. This procedure has been used to determine the intramolecular specific activity of RNA labeled in vivo in yeast. It can also be employed to choose the best conditions for experiments utilizing uniformly labeled RNA or single-stranded DNA and requiring the detection of intact molecules. PMID- 3300419 TI - Chemical marker for the differentiation of group A and group B streptococci by pyrolysis-gas chromatography-mass spectrometry. PMID- 3300420 TI - [In memoriam Professor Seiho Nishi]. PMID- 3300421 TI - [Functional morphology of the maxillo-mandibular apparatus in the mini-Lewe minipig. 1. Miniature swine in oro-anatomically-oriented research]. AB - This bulletin marks the beginning of a cycle dealing with the structure, function, innervation and quantitative analysis of jaw muscles as well as postnatal cranial growth and dentition in the miniature pig MINI-LEWE. The aims, the importance of the miniature pig MINI-LEWE for medical research, the material and the methods are explained. PMID- 3300422 TI - Light and electron microscopic immunohistochemical studies of serotonin nerve fibers in the substantia nigra of the rat, cat and monkey. AB - The distribution of serotonin-containing nerve fibers in the substantia nigra of the rat, cat and monkey was studied with a highly sensitive peroxidase antiperoxidase immunohistochemical method. Serotonin fibers in the substantia nigra of all species consisted of fine varicose fibers and formed a fine network. In the zona compacta of all species, serotonin fibers were sparsely distributed. In the zona reticularis of the rat and cat, these fibers were densely distributed and their distributional pattern was almost uniform, while in the monkey such fibers were unevenly distributed and high and low dense areas were intermingled. In the pars lateralis of all species, serotonin fibers were diffusely distributed, and the distributional density was much higher in the cat and monkey than in the rat. Immunoelectron-microscopic studies further revealed that a majority of the labeled varicosities in the rat substantia nigra were in close apposition to peridendritic axon terminals and were also free in the neuropil; occasionally they exhibited symmetrical synapses of "en passant" type with non immunoreactive dendrites or somata. Our results support a functional significance of serotonergic regulation of the substantia nigra in mammals. PMID- 3300424 TI - Epidural ketamine for postoperative pain relief after gynecologic operations: a double-blind study and comparison with epidural morphine. AB - This double-blind study evaluates whether ketamine given epidurally is effective for postoperative pain relief, and compares the effects of epidural ketamine with those of epidural morphine. Sixty-eight patients undergoing abdominal gynecologic surgery were randomly assigned into six groups (control; ketamine 4, 6, and 8 mg in saline; 6 mg in 10% glucose; morphine 3 mg). All patients were anesthetized with thiopental, nitrous oxide, and enflurane, and drugs were administered epidurally at the end of the operation. The duration of analgesia in the ketamine groups did not differ from that in control patients and the difference in diluent had no observable effects. Significantly, none of the patients in the morphine group needed additional analgesics within 24 hr, whereas 85% in the other five groups did. We conclude that ketamine administered epidurally is inadequate for postoperative pain relief after gynecologic operations. PMID- 3300423 TI - Postoperative analgesia induced by subarachnoid lidocaine plus calcitonin. AB - A randomized double-blind study tested the analgesic effects of subarachnoid administration of salmon calcitonin (sCT) in acute postoperative pain. Sixty patients were grouped according to type of surgery (intraabdominal, extraabdominal, and lower extremities), subdivided into those given subarachnoid lidocaine 1 mg/kg plus sCT (100 IU) or lidocaine plus saline. Pain was evaluated by a descriptive scale 3, 6, 12, 24, 48, and 72 hr after surgery, as well as by the frequency of the patients' requests for postoperative analgesics. In all instances, the sCT-treated patients had significantly less postoperative pain. Similarly, the requests for analgesics was significantly lower or absent in the sCT-treated group. Minor side effects such as nausea and vomiting, abdominal pain, and "nervousness" were observed in a small number of sCT-treated patients. In our series of 30 patients, subarachnoid administration of sCT was an effective analgesic with minimal side effects. Its safety remains to be proved by further studies. PMID- 3300425 TI - Clinical pharmacokinetics of carbonated local anesthetics. I: Subclavian perivascular brachial block model. AB - Fifty healthy adult patients undergoing upper extremity surgery under brachial plexus anesthesia provided by the subclavian perivascular technique were divided into two groups, so that anesthesia provided by 1% lidocaine hydrochloride in one group could be compared with that provided by 1.1% lidocaine carbonate in the other group. Epinephrine, 1:200,000, was added to both solutions just before injection. Carbonated lidocaine reduced the latency of anesthesia by 45% as compared with the hydrochloride salt and produced complete motor block in almost twice as many patients (54 vs 31%). The duration of anesthesia provided by the two agents was virtually identical, as was duration of motor blockade. PMID- 3300426 TI - Nitrous oxide does not increase the incidence of nausea and vomiting after isoflurane anesthesia. AB - A total of 110 patients undergoing elective abdominal hysterectomy were anesthetized in random order with either isoflurane in nitrous oxide and oxygen or isoflurane in air and oxygen. Fentanyl was used as an adjunct to isoflurane in all patients, 0.05 mg every 45 min. No difference was found between the two anesthetic techniques in the incidence of nausea, vomiting, or both during the first 24 hr after operation. The overall incidence was 62 and 67% for air-O2 and N2O-O2 groups, respectively. Patients who had had nausea or vomiting after previous anesthetics had nausea or vomiting significantly more frequently than patients who did not. It is concluded that nitrous oxide does not contribute to the occurrence of nausea or vomiting after isoflurane anesthesia for gynecologic laparotomies. PMID- 3300427 TI - Comparison of halothane and isoflurane for rapid anesthetic induction. AB - To study the hypothesis that isoflurane will induce anesthesia faster than halothane when given by a single vital capacity breath technique, we studied 20 ASA I and II adults who breathed approximately 4.5 MAC equivalents of either vapor. The patients, randomly assigned to receive either agent, were fully preoxygenated and monitored for cardiovascular, respiratory, and EEG parameters. All subjects were premedicated with 5 micrograms/kg fentanyl IV 5 min before induction. Time to loss of consciousness was significantly longer with halothane than with isoflurane (86 +/- 4 vs 38 +/- 2 sec, respectively) although there were no clinically remarkable differences in cardiovascular or respiratory variables. Patients given halothane had a greater excitatory phase on EEG, whereas those given isoflurane had low frequency predominance. Overall rapid inhalation induction was well-received by all patients and was significantly faster with isoflurane. PMID- 3300428 TI - Influence of balloon inflation and deflation on location of pulmonary artery catheter tip. PMID- 3300430 TI - Sequential one-lung ventilation for bilateral bullectomy. PMID- 3300429 TI - The effect of nitroprusside on pulmonary edema, oxygen exchange, and blood flow in hydrochloric acid aspiration. AB - In canine pulmonary capillary leak induced by intravenous oleic acid, reducing pulmonary wedge pressure (Ppw) reduces pulmonary edema, venous admixture (Qva/Qt), and cardiac output (Qt). The authors tested the possibility that in another canine model of pulmonary capillary leak, that induced by endobronchial instillation of hydrochloric acid, nitroprusside would reduce Ppw and edema without reducing Qt or oxygen delivery (QO2). In 18 dogs, the authors measured extravascular lung water (EVLW) by thermal-dye dilution and the hemodynamic and gas exchange variables before and at intervals (1, 1.5, 3, and 5 h) after .1 N HCl bronchial infusion. By 1 h, HCl increased EVLW from 175 to 250 ml and Qva/Qt from 11 to 21%. Immediately after the 1-h measurements, the dogs were divided into three equal groups: six controls (C) were maintained with a Ppw of 12 mmHg, while plasmapheresis (P) or nitroprusside (NP) reduced Ppw to 5 mmHg for the next 4 h. EVLW continued to increase to 548 ml in C, but did not increase further in P and NP. Weights of lungs excised at 5 h confirmed that P and NP reduced edema by 50% in 4 h. In C, Qva/Qt increased, but there was no reduction in Qt or QO2. In contrast, plasmapheresis reduced Qva/Qt, Qt, and QO2. With nitroprusside, Qt and QO2 were maintained despite reduced Ppw at 1.5 and 3 h, and Qva/Qt did not decrease as in Group P. We conclude that plasmapheresis-induced reduction in Ppw reduces the pulmonary capillary leak and venous admixture following acid aspiration, but this has the potentially adverse effect of reducing cardiac output and oxygen delivery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300431 TI - Atypical serum cholinesterase eliminated by orthotopic liver transplantation. PMID- 3300432 TI - [Mechanism of disorders in intracranial volume correlations in severe craniocerebral injury]. PMID- 3300433 TI - [Middle molecules and the problem of endogenous intoxication in critical states of various etiologies]. PMID- 3300434 TI - [Parasites in East Germany. 8. Helminths of Ondatra zibethica]. AB - In 1984/85 80 muskrats have been investigated by helminthological autopsy. Helminth infection was established in 72 animals. Altogether 4 trematodes, 7 cestodes and 2 nematodes were found. 2 cestodes were detected for the first time in the muskrat. Relations between parasite fauna and biotope are recognizable. PMID- 3300435 TI - [Diagnosis of drug-resistant strains of Plasmodium falciparum]. AB - Expanding drug-resistance of P. falciparum strains is one of the main problems of the control and treatment of malignant tropical malaria. The World Health Organisation recommends the in vivo test as well as macro and micro in vitro tests for the epidemiological and clinical diagnosis. The authors describe the methodology of these tests, which helped them to identify the first chloroquine resistant P. falciparum strains from Mocambique and Angola as well as one fansidar-resistant strain from Angola. PMID- 3300436 TI - Outpatient management of asthma with regular nebulized beta agonists: comparison of bitolterol mesylate and isoproterenol. AB - Nebulized bitolterol solution and isoproterenol solution were compared when used on a regular basis, 2.5 mg three times a day for 1 month by patients with chronic asthma. In this multicenter, double-blind trial; 130 nonsteroid-dependent patients were randomized to receive one of the two treatments concomitantly with their regular asthma medications. On study days, at the beginning of the study and after 2 and 4 weeks, treatments were given in the office or laboratory and patients were monitored with pulmonary function tests for eight hours. Both medications induced rapid bronchodilation that had a longer duration after bitolterol. The incidence of tremor was similar with the two medications. Tachycardia and palpitations were more frequent following isoproterenol. Bitolterol has a much longer duration of action and should be considered as a suitable bronchodilator for regular nebulizer treatment of chronic asthma. PMID- 3300438 TI - The struggle for breast feeding: a historical note. PMID- 3300437 TI - Delayed-type allergy against various insulin preparations including human semisynthetic insulin. AB - The authors present a patient with delayed-type allergy against insulin preparations of different species including highly purified monocomponent insulin and human semisynthetic insulin. Positive results for cutaneous delayed-type hypersensitivity and for lymphocyte blastogenesis suggested a type IV immunopathogenic reaction. Intradermal tests performed with various components of insulin preparations revealed delayed-type allergy to insulins of different species (bovine, porcine and human) but not to any of the other components. PMID- 3300439 TI - Effects of Bordetella avium infection on the pulmonary clearance of Escherichia coli in turkeys. AB - Thirty-six 1-day-old turkeys were inoculated intranasally with Bordetella avium (BA) strain 838. Noninoculated hatchmates (n = 36) were housed separately. At 2 and 4 weeks of age, 15 inoculated (BA+) and 15 noninoculated (BA-) turkeys were exposed to an aerosol of virulent Escherichia coli. The remaining six BA+ turkeys and six BA- turkeys were used as controls (ie, not exposed to E coli). Turkeys were necropsied on postaerosolization days 0 (immediately after aerosolization), 1, 3, 5, and 7. Lung and tracheal specimens were collected from each turkey for bacterial quantitation and histologic examination. A 1-ml blood sample was collected for detection of bacteremia. Numbers of E coli in lung specimens from 2 and 4-week-old turkeys were not significantly different between BA+ and BA- groups (pooled data over time); however, numbers of E coli isolated from tracheal specimens were significantly greater in BA+ turkeys than those in BA- turkeys. Although the incidence of pulmonary abcesses and E coli bacteremia was greater in 2-week-old turkeys than in 4-week-old turkeys, the incidence was not different between BA+ and BA- turkeys. At both ages, air sacculitis developed more often and was more severe in BA+ turkeys than in BA- turkeys. Hyperplastic bronchus associated lymphoid tissue was found more often in BA+ turkeys than in BA- turkeys and appeared to be the first site of heterophil infiltration after E coli aerosolization. PMID- 3300440 TI - Effect of heparin on increased pulmonary microvascular permeability after bone marrow embolism in awake sheep. AB - We examined the alterations in pulmonary transvascular fluid and protein exchange after intravenous infusion of fat emboli, i.e., bone marrow suspension (BMS) in awake sheep prepared with chronic lung lymph fistulas and compared these changes with those observed in sheep pretreated with heparin. The BMS injection (0.2 ml/kg) over 15 min caused rapid, but transient, increases (p less than 0.05) in mean pulmonary artery pressure and pulmonary vascular resistance. These increases were accompanied by significant increases in the lymph concentrations of thromboxane B2 and 6-keto-PGF1 alpha. Pulmonary lymph flow increased by 3.9-fold (+/- 0.8) over baseline by 120 min after BMS with no change in the lymph-to plasma protein concentration ratio (L/P ratio). Heparin pretreatment (700 U/kg) enhanced the BMS-induced increases in pulmonary artery pressure and pulmonary vascular resistance. Thromboxane B2 concentrations in the lymph increased, whereas there was no change in the concentration of 6-keto-PGF1 alpha. Lung lymph flow increased 4-fold (+/- 1.0) over baseline by 120 min after BMS without a change in L/P ratio. Changes in lung vascular permeability were evaluated by elevating pulmonary microvascular pressure (left atrial balloon catheter inflation) at 120 min after BMS. Lung lymph flow increased 7-fold (+/- 1.1) from baseline, whereas the L/P ratio decreased to a mean value of 0.48 +/- 0.03. The protein reflection coefficient (sigma = 1 - L/P ratio) decreased from a control mean of 0.69 +/- 0.02 to 0.52 +/- 0.03 after the BMS challenge.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300441 TI - Treatment of alveolar hypoventilation in a six-year-old girl with intermittent positive pressure ventilation through a nose mask. AB - Persons with alveolar hypoventilation have abnormal daytime arterial blood gases and abnormal responses to hypercapnia and hypoxia in the absence of any identifiable lung or neuromuscular disease. The underlying defect in the control of breathing has not, however, been confirmed. We studied a 6-yr-old girl who was admitted in respiratory failure after a long history of disturbed breathing awake and asleep, which had been diagnosed as primary alveolar hypoventilation, (PaCO2 = 120). After several days of endotracheal intubation and assisted ventilation, her condition improved and she was extubated. At this time her ventilatory response to hypoxia was absent (VE/SaO2:0.1 l/min/% at a CO2 of 45) and there was a right-shifted response to hypercapnia (VE/PaCO2:2.6 l/min/mmHg). As obstructive sleep apnea was suspected, nocturnal nasal continuous positive airway pressure (CPAP) was tried; however, it was not effective in maintaining arterial oxyhemoglobin saturation. Definite central apneas were observed during sleep both with and without nasal CPAP, and there was an absence of snoring. Her condition deteriorated, and there was a progressive increase in her awake arterial CO2 levels for a period of 4 wk. The IPPV with 5 cm H2O of PEEP was administered through a nose mask during sleep and this maintained both oxygen saturation and transcutaneous CO2 levels within the normal range. After 10 days of nocturnal assisted ventilation, the hypercapnic response returned to the normal position (VE/CO2:2.1 l/min/mmHg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300443 TI - Possible role for membrane Lipids in the function of the normal and ab normal pulmonary circulation. AB - We have proposed that the necessity of transporting large quantities of a relatively insoluble molecule, 02, from alveolar air to blood may have led to the evolution of an extremely thin but extensive membrane. The very structure of the membrane has required specialized machinery to maintain low vascular pressures within it, to divert blood flow to the better oxygenated areas, and to defend the membrane from external or internal attack. The purpose of this paper is to consider whether membrane lipids (platelet-activating factor and the metabolities of arachidonic acid) constitute some of this specialized machinery, and, if so, how this machinery might work. PMID- 3300442 TI - Neutrophil-mediated pulmonary vascular injury. Synergistic effect of trace amounts of lipopolysaccharide and neutrophil stimuli on vascular permeability and neutrophil sequestration in the lung. AB - The pathogenesis of acute lung injury in humans is obscure, but lipopolysaccharide (LPS), complement activation, and neutrophils have been implicated. We investigated in rabbits the interaction of small amounts of intravascularly administered LPS (100 ng) with neutrophil chemotactic factors, the synthetic chemotactic peptide formyl-norleucyl-leucyl-phenylalanine (FNLP), and the biologically relevant chemotactic fragments of C5 (C5f). These neutrophil stimuli produce neutropenia when injected intravascularly in rabbits, reflecting neutrophil adherence to vascular endothelium. When LPS was injected with FNLP, the duration of neutropenia was enhanced. Studies with radiolabeled neutrophils infused in vivo demonstrated prolonged neutrophil sequestration within the lung in rabbits that were given FNLP plus LPS, an effect that was visible for 4 h after injection. Morphometric analysis of tissue sections 4 h after infusion confirmed the presence of greater numbers of neutrophils in the lungs of animals receiving LPS and FNLP. When a combination of LPS and chemotactic factors was infused at both zero and 6 h, we found a marked enhancement of lung vascular permeability at 24 h (as assessed by radiolabeled albumin accumulation), an effect not seen with either LPS or chemotactic factor alone. Ultrastructural studies revealed neutrophil sequestration and alteration in endothelial cells in the animals that received the combination of LPS and chemotactic factors. Neutrophil depletion with nitrogen mustard completely abolished the increased vascular permeability seen in animals that received LPS and chemotactic factors. This study suggests that small amounts of intravascularly administered LPS enhance the sequestration of neutrophils within the lung and increase lung vascular permeability and endothelial injury caused by neutrophils stimulated by intravascularly administered chemotactic factors. This mechanism may be relevant to the production of acute lung injury in human beings. PMID- 3300444 TI - Production of platelet-activating factor, a biologically active lipid, by vascular endothelial cells. PMID- 3300445 TI - Measurement of platelet-activating factor by physicochemical technique s. AB - The measurement of PAF by physiochemical methods perhaps in the future will become the normal mode for the measurement of this molecule. This is due in part to the limitations in the bioassay and radiometric assays but also to the fact that the development of facile techniques that are acceptable to the community both in terms of operation, sensitivity, and accuracy are attainable. It is with these latter forms of measurement that significant advances can be made in the understanding of the biosynthesis and metabolism of PAF after specific stimuli of either isolated cells, organs, or the intact organism. Recent studies using mass spectrometry have suggested that 95% of PAF administered via the airway was retained within the lung primarily in only 2 cell types: the alveolar type II cell and the nonciliated bronchiolar epithelial cell (Clara cell). Further characterization of the metabolites in these lungs suggested a biochemical interconnection between PAF and arachidonate metabolism. PMID- 3300446 TI - Role of membrane lipids in the control of normal vascular tone. PMID- 3300447 TI - Leukotrienes and the immature pulmonary circulation. PMID- 3300448 TI - Postnatal regulation of the pulmonary circulation: a role for lipid mediators? AB - The action and interaction of many products of arachidonic acid metabolism can affect the pulmonary circulation in the perinatal period. The rapid increase in pulmonary blood flow with the onset of ventilation likely is brought about to a large degree by the production locally of prostaglandin I2 (PGI2). This can be stimulated by purely mechanical factors, by the normally increasing concentrations of angiotension II, by the 02-mediated release of bradykinin, or perhaps by other phenomena. Prostaglandin D2 release from mast cells also may play some role. The opposing pulmonary vascular effect, i.e., pulmonary vasoconstriction, of leukotrienes is likely to play a role in regulating fetal pulmonary blood flow. Inhibition of the production or action of these substances will allow for vasodilatation, and it is probable that perinatal pulmonary vascular tone reflects a balance between local prostaglandin and leukotriene production. PMID- 3300449 TI - The effects of aminophylline on sleep and sleep-disordered breathing in patients with obstructive sleep apnea syndrome. AB - The methylxanthine derivatives are known to have respiratory stimulant properties. To determine whether these drugs would improve obstructive sleep apnea, 10 male patients with obstructive sleep apnea (OSA) (Apnea Index greater than 15/h) were given infusions of aminophylline and a saline placebo on 2 separate nights a week apart, using a randomized crossover design. There was a significant decrease during aminophylline infusion in the frequency of those apneas, which contained periods of complete respiratory inactivity (central and mixed apneas; placebo, 4.3 +/- 1.8/h; aminophylline, 0.7 +/- 0.5/h; p less than 0.05). There was no change in either the frequency (placebo, 31.8 +/- 5.9/h; aminophylline, 28.7 +/- 8.7/h; NS) or duration of obstructive apneas. Mean and minimal arterial oxygen saturation values were also unchanged. Sleep architecture was markedly disturbed by aminophylline. There was a reduction in sleep efficiency (placebo, 84.8 +/- 2.0%; aminophylline, 60.2 +/- 5.0%; p less than 0.005), an increase in sleep fragmentation (sleep stage shifts/h: placebo, 11.6 +/- 1.3: aminophylline, 21.0 +/- 2.9; p less than 0.05) and less Stage 2 and more Stage 1 non-REM sleep. We conclude that aminophylline reduces central apnea and the central component of mixed apneas but has no effect on obstructive apnea. Theophylline is therefore unlikely to be therapeutically useful in patients with OSA, and because it leads to marked sleep disruption, its long-term use could conceivably increase the propensity to upper airway occlusion during sleep. PMID- 3300450 TI - B-mode ultrasonic imaging in the preoperative evaluation of saphenous vein. AB - This prospective study was undertaken to determine if B-mode ultrasonic imaging of the greater saphenous vein can provide reliable information about anatomy, sites of valves, and location of major tributaries or duplicate systems. Preoperative ultrasonic imaging was performed on 15 consecutive patients prior to in situ saphenous bypass. The findings of the ultrasonic evaluations were compared with the intraoperative findings. Preoperative assessment of the greater saphenous vein was performed with a high resolution real-time B-mode ultrasonic imager. The procedure was performed with the patient seated with the leg extended. The saphenous vein was imaged starting at the ankle. A waterproof pen was used to mark the vein. The locations of valves and tributary vessels were marked and the diameter of the saphenous vein was recorded. These results were compared with operative findings. In all 15 patients, the saphenous vein was imaged. There was 100 per cent accuracy in the detection and location of valve sites. In one patient, the proximal portion of the vein was thrombosed and this was detected by the B-mode scan. There was exact correlation in 14 of 15 limbs (93%). The one error was due to the examiners' failure to identify a triple venous system; only a double venous system was identified by scan in this patient. The actual venous diameter was consistently within 0.5 mm of that measured by the ultrasound imager. In all patients, the ultrasound image demonstrated the correct anatomic location and size of the vein. In conclusion, B mode ultrasonic imaging provides an accurate description of the anatomy of the saphenous vein, without the morbidity associated with contrast venography. PMID- 3300451 TI - Potent immunosuppression overcomes immunologic high-risk factors in recipients of cadaveric renal allografts. AB - With the introduction of more potent immunosuppressive regimens, increasing numbers of kidney transplant recipients traditionally viewed as being at high immunologic risk for rejection and graft loss have been accepted. These include recipients of multiple grafts, sensitized patients as measured by high panel reactive antibody (PRA), and patients with current warm B or historical positive crossmatches. Since November 1983, all recipients of cadaver kidneys have been treated with cyclosporine and prednisone. In addition, most also received a short posttransplant course of antilymphocyte globulin and long-term azathioprine. With these regimens, retransplantation, sensitization, current B-cell crossmatch and historical B- and/or T-cell crossmatch do not affect graft survival. PMID- 3300452 TI - Serratial bacteremia in the surgical patient. AB - A 42-month review has identified 32 surgical patients that had 45 episodes of Serratia marcescens bacteremia. Patients were identified in many surgical specialties. The primary focuses of infection were the urinary tract, intravascular devices, sputum, and soft tissue. In five patients, no focus was identifiable. Nine patients had polymicrobial sepsis with other bacteria or Candida. Of 41 isolates studied, five were resistant to all antibiotics that were commercially available. Only 76 per cent were sensitive to amikacin, 63 per cent to gentamicin, and 46 per cent to tobramycin. Statistically fewer patients died when an aminoglycoside and an expanded-spectrum penicillin were used in combination. The 44 per cent mortality rate of this group of patients indicates that environmental control, behavioral modification of health care professionals, and a more rationale use of broad-spectrum antibiotics are necessary to prevent this morbid complication. PMID- 3300453 TI - Trypsin and chymotrypsin inhibitor of Vigna unguiculata seeds--involvement of tyrosyls in its interaction with proteases. AB - When trypsin and chymotrypsin inhibitor of Vigna unguiculata seeds (black-eyed pea trypsin and chymotrypsin inhibitor, BTCI) combines with beta-trysin, 4.0, 4.5, 5.0, 5.8, and 6.6 tyrosyl residues are shielded from reaction with N acetylimidazole, at reagent/protein molar ratios of 60, 120, 200, 350 and 500, respectively. This may result from the presence of tyrosyl residues in the zone of contact between enzyme and inhibitor. In the interaction of BTCI and alpha chymotrypsin, only 0.6 tyrosyl residues are shielded from the reaction with N acetylimidazole, at a 500-fold reagent molar excess. PMID- 3300454 TI - [What is researched in Spain on childhood accidents and poisonings? A descriptive study of the last 11 years]. AB - Situation of research done in childhood accidents an accidental poisoning in Spain must be known to plan future studies. Authors studied 131 publications obtained from IME (Indice Medico Espanol) data bank (1974-1984). Only 62 of them were epidemiological studies or reviews. Most of them were based on hospital data. Authors were mainly pediatricians who lived in big cities and had articles published in pediatric journals. They conclude that there are few studies on epidemiology of accidents in general populations and on how to prevent them. PMID- 3300455 TI - [Echography of the hip in children. Diagnostic importance]. AB - This paper reports a technique of study of infant hip with ultrasound. Author report observations with 160 sonograms in 40 children. Luxation and subluxation of the hip can be visualised. Hip sonography technique is easy and without exposure to radiation. PMID- 3300456 TI - [Solitary ulcer of the rectum. Apropos of a case in childhood and review of bibliography]. AB - A case of a chronically constipated 10 year-old-girl, who had severe rectal bleeding associated with her monthly bowel movement is presented. Barium enema revealed an irregular and rigid area in rectal and sigmoid wall. Endoscopy showed an irregular erosion of 4 by 2 cm, from which biopsies were taken. These were reported as compatible with solitary ulcer of rectum. Patient was treated with dietetic management and clinically and psychiatrically controlled. Two years after initial admission she had no clinical or endoscopic evidence of disease. PMID- 3300457 TI - Diltiazem and propranolol in mild to moderate essential hypertension as monotherapy or with hydrochlorothiazide. AB - We compared the safety and efficacy of diltiazem and propranolol, and examined demographic factors influencing responses to these agents. One hundred ninety-six patients with supine diastolic blood pressures of 95 to 114 mm Hg were treated with propranolol (80 to 240 mg twice a day) or a sustained-release preparation of diltiazem (60 to 180 mg twice a day) in a double-blind, randomized, parallel group protocol for 6 months. Hydrochlorothiazide was added for patients not achieving the treatment goal. Both agents produced nearly identical and highly significant (p less than 0.001) reductions in supine blood pressure. There were no significant differences at the end of the optional combination therapy phase, although additional reduction with hydrochlorothiazide was slightly greater in the propranolol group. Blood pressure responses in relation to age, gender, race, and smoking history showed that diltiazem produced greater changes in older subjects and women, whereas propranolol was less effective in blacks. However, these differences were not critical. PMID- 3300458 TI - Should tests for Chlamydia trachomatis cervical infection be done during routine gynecologic visits? An analysis of the costs of alternative strategies. AB - We used decision analysis to estimate the clinical and economic implications of testing for cervical infection caused by Chlamydia trachomatis in women during routine gynecologic visits. We compared a strategy of no routine testing with a strategy involving the use of routine cultures or the use of less expensive rapid tests for chlamydial infection (the direct fluorescent assay or the enzyme immunoassay). We used different assumptions for the costs and operating characteristics of the diagnostic tests, complications of undetected infection, and the cost of false-positive test results. We found that using one of the rapid tests would reduce overall costs if the prevalence of infection was 7% or greater. The use of routine cultures would reduce costs if the frequency of infection was 14% or greater. We conclude that testing for cervical infection with C. trachomatis in women seeking routine gynecologic care may reduce overall costs. The choice of diagnostic test should depend on the expected prevalence of infection, local cost considerations, and laboratory expertise in the execution of these tests. PMID- 3300459 TI - Immediate hypersensitivity reactions to beta-lactam antibiotics. AB - Allergic reactions to the beta-lactam antibiotics (penicillins, cephalosporins, carbapenems, and monobactams) are a major factor limiting their use. Immediate hypersensitivity reactions to penicillins depend on the presence of preformed allergic (IgE) antibodies to several penicillin determinants. These materials can be used in in-vivo skin testing to exclude those patients at risk for immediate or accelerated allergic reactions. The cephalosporins have not had their relevant determinants defined as related to allergic reactions. The results of in-vivo challenges of patients with IgE to penicillin suggest the incidence of reactivity of cephalosporins in patients allergic to penicillin is less than generally appreciated. The monocyclic beta-lactam antibiotic, aztreonam (a monobactam), failed to show cross-reactivity with penicillin antibodies, because immune reactivity toward the monobactam was directed against side chain rather than nuclear determinants. On the other hand, the new bicyclic carbapenem beta-lactam drugs, represented by imipenem, showed extensive in-vivo cross-reactivity with penicillins. PMID- 3300460 TI - Meta-analysis in clinical research. AB - Meta-analysis is the process of combining study results that can be used to draw conclusions about therapeutic effectiveness or to plan new studies. We review important design and statistical issues of this process. The design issues include protocol development, objectives, literature search, publication bias, measures of study outcomes, and quality of the data. The statistical issues include consistency (homogeneity) of study outcomes, and techniques for pooling results from several studies. Guidelines are provided to assess the quality of meta-analyses based on our discussion of the design and statistical issues. Limitations and areas for further development of this approach are discussed; researchers should come to a general agreement on how to conduct meta-analysis. As an explicit strategy for summarizing results, meta-analysis may help clinicians and researchers better understand the findings of clinical studies. PMID- 3300462 TI - [Medico-Psychological Society. List of members]. PMID- 3300461 TI - Immunology of human immunodeficiency virus infection and the acquired immunodeficiency syndrome. An update. AB - Recent advances in the understanding of the pathogenesis of infection with human immunodeficiency virus (HIV) stems from the demonstration that the membrane glycoprotein, CD4, is the cellular receptor for HIV. This glycoprotein is found mainly on the surface of a major subpopulation of T lymphocytes and also on macrophages, natural killer cells, some B lymphocytes, and neuronal cells. Cells infected with HIV may be destroyed or have their normal function impaired. Host immune responses to HIV are poor and are not sustained. Neutralizing antibody often is not produced, or HIV may escape from normal immunosuppressive mechanisms through the process of rapid antigenic variation. Factors and markers that may be important in the outcome or that may predict progression of HIV infection are genetic (Gc type), environmental (nutritional status or intercurrent sexually transmitted diseases sustained by the host), and immunologic (rate of decline in number and impairment of function of CD4 lymphocytes and of decline in antibody titers to HIV core protein, p24). A recombinant vaccine will probably be developed for testing in future clinical trials. PMID- 3300463 TI - [Leopold Szondi, his destiny, his work]. PMID- 3300464 TI - [The death of Levy-Valensi (28 February 1879-23 November 1943)]. PMID- 3300465 TI - Hypermetabolic state, hepatocyte expansion, and liver blood flow: an interaction triad in alcoholic liver injury. PMID- 3300466 TI - Inositol trisphosphate as a second messenger in signal transduction. PMID- 3300467 TI - Transplantation of human embryonic oligodendrocytes into shiverer brain. PMID- 3300468 TI - Enkephalins and immunity. I: In vivo suppression and potentiation of humoral immune response. AB - BALB/c mice and Wistar rats immunized with sheep red blood cells and ovalbumin were treated intraperitoneally with different doses of methionine-enkephalin, leucine-enkephalin, and naloxone. Large doses of enkephalins (10-5 mg/kg b.w.) induced a significant decrease in hemolysin-forming cell response and production of hemagglutinating antibody. Immunosuppression induced by enkephalin was dose dependent. In rats met-enkephalin was a more potent immunosuppressor than leu enkephalin. Rats injected with 2.5 mg/kg b.w. of enkephalins into the lateral ventricle of the brain showed more pronounced immune suppression than did animals treated intraperitoneally with 5 mg/kg b.w. of enkephalins. These neuropeptides, and met-enkephalin in particular, exhibited a protective action against anaphylactic shock in rats sensitized to ovalbumin. In those animals, passive cutaneous anaphylaxis and elaboration of precipitating anti-ovalbumin antibody were considerably reduced. On the other hand, small doses of enkephalins stimulated humoral immune responses in the rat. Thus, it appears that enkephalins both suppress and potentiate immune responsiveness, depending on the dose used. As for naloxone, a large dose of this blocker of opioid receptors enhanced humoral immune reactions in the rat. PMID- 3300469 TI - The neuropharmacology of immune complex activity in the rat hypothalamus. PMID- 3300470 TI - Neuroendocrine and bone marrow factors for control of marrow transplantation and tissue regeneration. PMID- 3300471 TI - Brown adipose tissue. Its in vivo immunology and involvement in neuroimmunomodulation. AB - The material presented here summarizes the bulk of the presently available immunologic data bearing upon the in vivo relationship between brown adipose tissue and the immune system. The experiments were carried out in rats adipectomized (by surgical excision of the interscapular brown adipose tissue at birth), thymectomized (by neonatal removal of the thymus), adipectomized and thymectomized, and corresponding sham-operated controls. The following immune phenomena were studied: antibody production to soluble and corpuscular antigens; Arthus and delayed hypersensitivity skin reactions to bovine serum albumin; rejection of allogeneic skin and thyroid grafts; lymph node enlargement in a host versus-graft reaction; experimental allergic encephalomyelitis and thyroiditis; immune response in normal animals treated with extracts from brown adipose tissue; allergic encephalomyelitis in thymoadipectomized animals; plaque-forming cell response and hemagglutinating antibody titers in animals injected with met enkephalin and leu-enkephalin; and survival rate of adipectomized mice inoculated with Sarcoma-I cells. The results indicated that the cell-mediated immune reactions were potentiated in adipectomized rats. Antibody production was not significantly changed by neonatal adipectomy. Adipectomized mice, inoculated with Sa-I tumor cells, survived longer than controls, thus indicating that adipectomy made possible the recognition of discrete histocompatible differences between Sa I cells and A/JAX mice. Adipectomy increased the ability of rats to develop autoimmune diseases. Saline extracts from brown adipose tissue of newborn rats suppressed hypersensitivity skin reactions in normal adult rats. Thymoadipectomized rats showed an almost normal ability to develop allergic encephalomyelitis, a finding that suggested that the potentiating influence of adipectomy on encephalomyelitis was neutralized by thymectomy. It appears that brown adipose tissue functions as a natural antagonist of the thymus. Enkephalins were found to be more effective immunosuppressors in adipectomized than in normal animals. The last finding establishes a functional link between brown adipose tissue and neuropeptides. It seems that the potentiation of immune response in adipectomized animals is effected by altered release of yet unidentified mediators and modulators. The evidence indicates that brown adipose tissue, in which neurohumoral activity occurs, may be an important component of an integrated immunoneuroendocrine system. PMID- 3300472 TI - Neuroendocrine modulation of the thymus-dependent immune system. Agonists and mechanisms. PMID- 3300473 TI - The influence of emotional state on the mobilization of marginal pool leukocytes after insulin-induced hypoglycemia. A possible role for eicosanoids as major mediators of psychosomatic processes. PMID- 3300474 TI - Conditioned suppression of plaque-forming cell responses with cyclophosphamide. The role of taste aversion. PMID- 3300475 TI - Relaxation, imagery, and neuroimmunomodulation. AB - Thirty undergraduates screened for high absorption ability were randomly assigned to three conditions. The first condition consisted of relaxation alone (progressive muscle relaxation and focused breathing). The second one combined this same relaxation training with mental imagery of the immune system. The third condition served as an alertness or mild arousal control; in a vigilance task subjects discriminated between tones presented in variable inter-trial intervals. Subjects reported trial levels of tension and daily stress. Before and after the protocols, which lasted about 1 hour, salivary immunoglobulin A (SIgA), cortisol and catecholamines (saliva and plasma), mood states, and power motivation were assessed. Afterwards, subjects doing relaxation alone and with imagery had a higher level of SIgA than did the vigilance task control group, with a large effect size. When the influence of plasma cortisol was controlled, this immune effect size increased by half, mainly by doubling the SIgA level after relaxation alone. SIgA was significantly and negatively correlated with saliva norepinephrine. The saliva and plasma levels for the neuroendocrine variables appear to be independent. Yet some saliva measures (e.g., epinephrine) did correspond highly with other plasma measures (e.g., norepinephrine). PMID- 3300477 TI - Alterations in nutrient intake and utilization caused by disease. PMID- 3300476 TI - The difference in the storage capacities for carbohydrate and for fat, and its implications in the regulation of body weight. AB - The two-compartment model presented here suggests that weight maintenance can be achieved by a regulation of food intake geared primarily toward the maintenance of stable glycogen levels, rather than toward the preservation of the overall energy balance. This concept is reminiscent of the glucostatic theory of food intake regulation proposed by Mayer. It is viewed here as being linked to changes in the body's carbohydrate stores, which represent an integration of carbohydrate and lipid fluxes, rather than to changes in blood glucose levels, whose substantial variations during the day are dependent on various circumstantial events. The model illustrates that the fat to carbohydrate ratio of the diet may have considerable potential influence on steady state body composition, even though carbohydrates and fats are both able to meet the body's energy substrate requirements. It appears that failure of appropriately reducing the range within which glycogen levels are maintained when the diet's fat content rises will require an expansion of the adipose tissue mass to raise FFA levels and fat oxidation to a rate commensurate with the proportion of fat in the diet. Maintenance of glycogen reserves below their level of saturation is made less likely by the high palatability and ubiquitous availability of foods in affluent societies. Thus, one can understand the high incidence of obesity among populations consuming mixed diets with a relatively high fat content, without having to attribute this to some defect(s) in the mechanism(s) controlling food intake. PMID- 3300478 TI - The effect of gut peptides on hunger, satiety, and food intake in humans. AB - A number of peptides synthesized and secreted by gastrointestinal cells have been shown to possess significant effects on food intake and on perceptions of hunger and satiety in humans. In this paper, we review the available literature on these effects and emphasize the current obstacles for the therapeutic application of peptides to the problem of obesity. PMID- 3300479 TI - Overweight is risking fate. Definition, classification, prevalence, and risks. AB - In this paper I have defined obesity and indicated its prevalence, as well as its risks. Body fat and its relation to other body components can be quantitated in many ways. From a practical point of view, the use of body mass or Quetelet index, defined as the ratio of weight (kg) divided by the square of the height (m2) is the most useful. Overweight is defined as a BMI of 25 to 30 kg/m2 and obesity as a BMI above 30 kg/m2. The WHR can provide additional information about the risk of obesity. Using BMI, the prevalence of overweight in the English speaking countries of Australia, Great Britain, and the United States is almost identical at 24% of women and 31 to 34% of men. In the obese category, there are more Americans (12%) than in the other two countries (6-8%). There is a U-shaped relationship between weight and risk of death. When body weight is increased 20% above average, the extra mortality rises to 20% for men and 10% for women. This extra mortality is associated with an increased death rate from heart disease, hypertension, diabetes mellitus, digestive diseases, and cancer. In addition to an increased risk of death, overweight individuals demand more from their heart, lungs, and musculoskeletal and digestive systems. PMID- 3300480 TI - Nutritional manipulations for altering food intake. Towards a causal model of experimental obesity. PMID- 3300481 TI - Regulation of food intake during pregnancy and lactation. PMID- 3300482 TI - Disorders of food intake. Excessive carbohydrate snack intake among a class of obese people. PMID- 3300483 TI - Disturbances of appetite and weight regulation in seasonal affective disorder. PMID- 3300485 TI - Dietary treatments of obesity. AB - Dietary treatment of obesity is based on one or another of two premises: that the obese eat too much or that they eat the wrong things. The first is a tautology lacking explanatory power. The second is a meaningful and promising hypothesis but has yet to be effectively applied. At present, virtually all outpatient treatments of obesity, including behavior modification, are based on the first premise and consist of strategies for reducing the subject's caloric intake. Most such interventions produce short-term weight loss. Regain after the end of treatment remains the usual outcome. A survey of studies published in the period 1977-1986 and reporting on dietary or behavioral treatment of obesity reveals that the maximum percentage of body weight lost is, on average, 8.5 percent--no different from the value, 8.9%, in similar studies from 1966-1976, as reviewed by Wing and Jeffery. The principal determinant of success in such programs appears to be the intake weight of the subjects: the higher the intake weight, the more successful the intervention will appear to be. The goals and research methods of studies on dietary treatments for obesity are overdue for ethical as well as scientific reevaluation. The same may be said for the numerous programs providing such treatment outside the context of research. PMID- 3300484 TI - Alcoholism: is it a model for the study of disorders of mood and consummatory behavior? AB - Depression, eating disorders, and carbohydrate craving are frequently seen in alcoholics or recovering alcoholics. Accordingly, these disorders may share some mediating pathways. It is now well-established that there is a genetic predisposition to alcoholism. Through genetic means, our laboratory has developed an animal model of alcoholism. Free-fed Wistar rats were selectively bred for the traits of alcohol-preference (the P line) and non-preference (the NP line). After more than 20 generations of selection, the lines show a stable difference of more than six-fold in voluntary ethanol consumption. We have now shown that the P line satisfies all the perceived requirements of an animal model of alcoholism. One major discovered difference between the P and the NP line is the lowered content of serotonin in certain brain regions of the P rats. Interestingly, fluoxetine curbs the alcohol-seeking behavior of the P rats; variation in the carbohydrate content of the diet, however, does not modify voluntary ethanol intake. The P rats are similar in body weight to the NP rats, but are more active in a novel environment than the NP rats. PMID- 3300486 TI - New developments in pharmacological treatments for obesity. PMID- 3300487 TI - Pharmacological treatments that affect CNS activity: serotonin. PMID- 3300489 TI - Mechanical treatment for obesity. PMID- 3300488 TI - An anthropological perspective on obesity. AB - An anthropological perspective on obesity considers both its evolutionary background and cross-cultural variation. It must explain three basic facts about obesity: gender dimorphism (women greater than men), an increase with modernization, and a positive association with socioeconomic status. Preindustrial diets varied in quality but shared a tendency to periodic shortages. Such shortages, particularly disadvantageous to women in their reproductive years, favored individuals who, for biological and cultural reasons, stored fat. Not surprisingly, the majority of the world's cultures had or have ideals of feminine beauty that include plumpness. This is consistent with the hypothesis that fat stores functioned as a cushion against food shortages during pregnancy and lactation. As obesity has increased, the traditional gap between males and females in its prevalence has narrowed. Under Western conditions of abundance, our biological tendency to regulate body weight at levels above our ideal cannot be easily controlled even with a complete reversal of the widespread cultural ideal of plumpness. PMID- 3300490 TI - A new approach to the treatment of obesity. A discussion. PMID- 3300491 TI - Characteristics of obesity: an overview. AB - Obesity is considered to be a major nutritional disorder in the U.S. and in many parts of the industrialized world. The physiology of the obese and their propensity for chronic disease has been of growing interest over the past few years, and an extensive literature has begun to accumulate. Obesity is a heterogeneous disorder. When viewed in the broadest sense, it has been considered a disorder of energy balance. The development of obesity in humans is of complex etiology, involving genetic and environmental components that affect regulatory and metabolic events. The prevalence of overweight and obesity in a population depends on the particular reference or standard of desirable weight selected for use. A trend toward increasing height and weight has been evident among adults for several centuries, and among children as early as the 7th year of life in developed countries. Overweight persons are at increased risk for coronary artery disease, high blood pressure, diabetes mellitus, and cancer. The degree of overweight that carries additional risk without affecting mortality needs to be defined. Overweight most likely contributes in varying degrees to morbidity in different societies, because the risk for most common chronic diseases is multifactorial. In defining overweight and obesity, morbidity, in addition to mortality, ought to be taken into consideration. The multidisciplinary approach to the study of obesity--borrowing concepts and techniques from endocrinology, neurobiology, genetics, and nutrition--should yield new insights into how environmental factors such as diet and physical expenditure interact to influence energy metabolism and body composition. PMID- 3300492 TI - Childhood obesity. PMID- 3300493 TI - Psychopathology and obesity. AB - Obesity has historically been linked to emotional factors by clinicians and the lay public alike. Early psychiatric studies reinforced the popular perception that psychopathology is common among the overweight and plays an important role in the development of obesity. This notion has been challenged by recent investigations which suggest that psychological disturbances are more likely to be the consequences than the causes of obesity. Emotional difficulties faced by the obese may be largely attributable to an entrenched cultural contempt for the obese and a pervasive preoccupation with thinness. PMID- 3300494 TI - Fat cell distribution and metabolism. PMID- 3300495 TI - Energy utilization in human obesity. PMID- 3300496 TI - Insulin resistance and amino acid metabolism in obesity. PMID- 3300497 TI - Exercise effects on calorie intake. AB - The promotion of exercise for the treatment of obesity has been based on the double premise that exercise generates special metabolic signals and that these reduce food intake. The decrease in intake coupled with the increase in expenditure leads to weight loss. Strong support for this premise comes primarily from animal studies, not from studies in humans. This arises in part because the premise is so difficult to prove in people. It ought to be a simple matter to exercise sedentary people and watch them eat less. In fact, the methodologic problems associated with measuring energy expenditure, voluntary changes in energy intake, and small shifts in body composition are great. As a result, there is a paucity of information in this area. PMID- 3300498 TI - Immobilized inhibitors as ligands for the development of a reversible bienzymatic system in immuno enzymatic techniques. PMID- 3300499 TI - An enzyme-based DNA probe system. PMID- 3300500 TI - Immobilized bacteria and plasmid stability. PMID- 3300501 TI - Rapid detection of E. coli immobilized in gel microdroplets. PMID- 3300502 TI - Chemical modification and immobilization of L-aspartase. PMID- 3300503 TI - Penicillin amidase from E. coli. Enzyme heterogeneity and stability. PMID- 3300504 TI - [Results of a multicenter study of an amoxicillin-clavulanic acid combination in sinusitis in children and adults]. AB - Efficacy and safety of Augmentin were evaluated in 79 patients, 64 adults and 15 children, treated for sinusitis during a multicentric hospital trial. Pre treatment meatal pus samples were examined for bacteriology: 37 of 39 strains (95%) isolated from adults were sensitive to Augmentin, and two beta-lactamase producing Haemophilus strains sensitive to Augmentin were isolated from the children. Adult dosage was usually 2 g per day as two divided doses over 8 to 10 days. Recovery was obtained at end of treatment in 92% of cases, side effects being reported in 56 patients, including 8 with benign digestive disorders. Usual dosage in children was 25 to 50 mg/kg/d over 8 to 10 days and treatment was effective in 13 cases. One child developed a skin rash, and there was no report of digestive disturbance. PMID- 3300505 TI - Human endolymphatic sac: morphologic evidence of immunologic function. AB - The ultrastructure of ten normal human endolymphatic sacs (ES), fixed immediately after death and obtained at autopsy, was observed by transmission electron microscopy. The roles of the epithelium, subepithelial space, vasculature, and ES leukocytes were morphologically studied to evaluate possible immunologic functions of the human ES. In addition, five intraosseous ES biopsies from patients undergoing translabyrinthine acoustic neuroma resection were studied using the immunoperoxidase technique to identify specific leukocyte subpopulations. Evidence of phagocytic activity included the presence of phagocytic epithelial cells, monocytes, macrophages, and polymorphonuclear leukocytes. Immune surveillance was suggested by intraepithelial and subepithelial T-lymphocytes, numerous fenestrated blood vessels, and the presence of a homogeneously staining substance within the lumina of ES epithelial tubules. No B-lymphocytes were found. The findings support the existence of a local immune system of the normal human inner ear. PMID- 3300506 TI - Carcinoid (neuroendocrine carcinoma) of the larynx. AB - Carcinoid of the larynx is a rare aggressive malignancy with few long-term survivors. Three cases of laryngeal carcinoid treated at the University of Michigan and 23 cases reported previously are reviewed. The clinical behavior, patterns of metastasis, and response to therapy were analyzed to determine optimal therapeutic evaluation and treatment strategies. Patient survival did not correlate with clinically evident regional adenopathy, length of symptoms, extent of laryngeal surgery, or retrospective staging according to American Joint Committee guidelines on cancer of the larynx (AJC-1980). Distant metastatic spread occurred frequently and was the most common cause of death. Surgical therapy is currently the only effective treatment for primary or recurrent disease. Future treatment regimens must address distant spread of tumor. PMID- 3300508 TI - [Immunoelectron microscopy. Diagnostic value in dermatology]. PMID- 3300507 TI - [Photocarcinogenesis]. PMID- 3300509 TI - [Renal failure caused by rhabdomyolysis secondary to dog bites and scratches in an infant victim of negligence]. PMID- 3300510 TI - The growth of vascularized onlay bone transfers. AB - The growth of vascularized onlay bone (autogenous) transfers on the skulls of 27 newborn New Zealand white rabbits was studied. Freeze-dried bone weight in control newborns and control adults (group 1) was compared with that in experimental adult animals (group 2). In the experimental group, the bone was transferred on the auricularis anterior muscle and neurovascular pedicle. The flap was deliberately maintained without osseous contact or functional-myogenic stress. The myoosseous bone transfers (group 2) exhibited statistically significant osseous enlargement when compared with the control newborns (p = 0.006); however, the weights were significantly less than those of the adult matched controls (group 1, p less than 0.001). Representative histological sections were also studied. Skeletal unit growth of a portion of the New Zealand white rabbit's skull was achieved despite marked alteration in the "functional matrix." The study demonstrated that vascular supply is the other independent factor affecting bone growth. Generally neglected as a variable in the literature of the subject, vascular supply should be considered within the functional matrix concept of craniofacial growth. PMID- 3300511 TI - Bolster dressing to support a full-thickness skin graft. AB - The patient with a through-and-through defect of the nose suffers from a loss of skin, subcutaneous tissue, cartilage, and nasal lining. Repair of this defect is generally directed toward restoring the components of skin and lining. The forehead flap is a useful substitute for nasal skin. A full-thickness skin graft may be used to substitute for absent nasal mucosa and serve as a lining for the forehead flap, covering its deep surface and retarding wound contracture. In the case presented, firm contact was maintained between the forehead flap and its full-thickness graft lining using a bolster dressing of simple design. We believe this dressing discourages seroma and hematoma formation while maintaining contact between the graft and the vascularized flap bed. PMID- 3300512 TI - The use of sterile adhesive tape in the closure of arthroscopic puncture wounds: a comparison with a single layer nylon closure. AB - A prospective trial was undertaken comparing the wound healing and infection rates in arthroscopic arthrotomy wounds closed by sterile adhesive tapes on interrupted Nylon skin sutures. Two hundred and thirty consecutive arthroscopic procedures had arthrotomy wounds closed by a single layer skin closure of either interrupted Nylon (n = 62) or sterile adhesive tapes (n = 168). All wounds healed by primary intention. Only one wound developed a superficial infection around a Nylon suture and no patient developed a synovial herniation. It is concluded that closure of arthroscopic puncture wounds with sterile adhesive tape is effective and convenient for wound management. PMID- 3300513 TI - Strategies to modify the test-requesting patterns of clinicians. AB - Studies of the effectiveness of various strategies for influencing clinicians' test-requesting behaviour are reviewed. Numerical rationing, although crude, effectively reduces unnecessary repeat testing without detriment to patient outcome. Educational programmes involving peer review show pronounced but short lived effects. Simple feedback of information about numbers of tests requested and their costs is surprisingly ineffectual. Direct financial incentives, in a private health care system, also failed. Clinical budgeting, of benefit in experimental trials, has yet to be widely tested, and the savings on reducing laboratory requesting may not be large enough to be attractive to clinicians. Agreed requesting policies in various specialties and clinical circumstances, endorsed by senior clinicians and prestigious professional bodies, seems a promising approach to more appropriate test requesting; further objective studies of their long-term effects are needed. Redesign of request forms into a problem orientated format may be the simplest and most effective contribution by the laboratory; this strategy deserves further critical appraisal. PMID- 3300514 TI - Total IgE and allergen-specific IgE assays: guidelines for the provision of a laboratory service. AB - The Analytical Methods Working Party of the Association of Clinical Biochemists (ACB) established this Task Force to consider the measurement of total serum IgE and specific IgE. The aims were to give general guidance on available methods of assay; to survey commercial kits and 'in-house' methods; to investigate performance based on external Quality Assessment and independent evaluation, and to advise on criteria laboratories should consider before setting up IgE and specific IgE assays. PMID- 3300515 TI - Expression of human IgG subclasses. AB - Human immunoglobulin G (IgG) can be divided into four subclasses that are selectively expressed. For instance, carbohydrate antigens preferentially elicit IgG2 antibodies, whereas protein antigens usually elicit IgG1 and IgG3. Elucidating the biological basis of the selective expression of these IgG subclasses is important to our understanding immunodeficiencies and B lymphocyte development. To investigate clinical importance of IgG subclass deficiencies, a sensitive and specific assay has been developed for IgG subclasses using particle concentration fluorescence immunoassay. Preliminary clinical studies have already shown that infection-prone individuals often have selective IgG2 subclass deficiency. Normal levels of IgG2, however, do not rule out an immunodeficiency in the infection-prone individuals because some individuals have normal levels of IgG subclasses and are poorly responsive to antigens of bacteria. Based on animal studies, two contrasting models of B cell development have been advanced. One model of B cell development proposes a single lineage and proposes that a B cell can successively switch and produce any IgG subclass. The other model proposes multiple lineages and proposes that a B cell can express only some IgG subclasses. It has been found by us that anti-PC antibodies are mostly IgG2 with some IgG1, and that the V region of IgG1 anti-PC antibody is different from that of IgG2 antibody. Our finding, therefore, suggests that B cells producing anti-PC antibodies are progeny of not one ancestral B cell that has successively switched, but two independent ancestral B cells. Cellular studies using polyclonal activators also suggest that regulatory mechanisms for IgG1 and IgG3 are different from those of IgG2 and IgG4. Taken together, we favor the multi lineage model better than the single lineage model of human B cell development. PMID- 3300516 TI - Heights and economic history: the Swedish case. AB - Measurements of Swedish soldiers were recorded in muster rolls as early as the 1760s. Results of a sample of these measurements over the period up to 1880 are used as an index of living standards in comparison with perceptions formed from other sources. The most striking contrast concerns the period of the mid nineteenth century. Among economic historians, those who hold the optimistic view that living standards continuously improved during the mid-1800s predominated, but our results combined with other evidence point, on the contrary, to a mild subsistence crisis in western Sweden at that period. PMID- 3300518 TI - Clonidine and Gilles de la Tourette's syndrome: double-blind study using objective rating methods. AB - Clonidine has been suggested to be effective in Gilles de la Tourette's syndrome (GTS), but no double-blind study has ever evaluated its effects using objective measures. Thirty patients with GTS completed a 6-month placebo-controlled crossover study of the effectiveness of clonidine. Videotapes were obtained at each 3-week visit and were evaluated randomly at the end of the study for distribution, frequency, and severity of motor and vocal tics. Quantifiable psychometric examinations were performed as well. The use of clonidine did not significantly (p less than 0.05) reduce motor tics, vocalizations, or behavior. The effect of a low dose (0.0075 mg/kg/day) was no different from that of a high dose (0.015 mg/kg/day); children's responses were no different from adults'; and those also receiving neuroleptic agents showed the same lack of efficacy as seen in patients on no other medication. Dosing schedule did not affect the objective ratings; scores from clonidine given twice a day were equivalent to those for three times a day. PMID- 3300517 TI - Growth depression and recovery: the remarkable case of American slaves. AB - Legislation designed to prevent slave smuggling after 1807 created an extra ordinary set of documents identifying slaves transported in the coastwise trade by name, age, sex height and colour. Slaves fell below the first or second centile of modern height standards as children but recovered during and after adolescence to exceed the 25th centile as adults. This profile differs remarkably from other populations. Poor pre-natal care, early weaning, food supplements that were nutritionally poor and often contaminated, and a heavy disease load thwarted growth during childhood, but the diet improved substantially when young adolescents entered the labour force. The results show that humans have remarkable capacity for catch-up growth. PMID- 3300519 TI - Disorders of the autonomic nervous system: Part 2. Investigation and treatment. AB - Autonomic function may be adequately tested with noninvasive tests of sympathetic and parasympathetic pathways, including: the response of blood pressure to change in posture and isometric contraction, heart rate response to standing, variation in heart rate with respiration, Valsalva ratio, sweat tests, and plasma noradrenaline measurements. Abnormal results in two or more of these tests indicate autonomic dysfunction. Intraarterial catheterization and tests of vasomotor function are usually required only in doubtful cases or for research purposes. Treatment of autonomic dysfunction is focused primarily on bladder control and control of orthostatic hypotension. Orthostatic hypotension is best treated with physical measures, pharmacologically with 9-alpha fluorohydrocortisone and dihydroergotamine mesylate. A number of other agents may be tried but results have been less effective. PMID- 3300520 TI - Immunoblotting of Creutzfeldt-Jakob disease prion proteins: host species-specific epitopes. AB - Creutzfeldt-Jakob disease (CJD) is a rare dementia that is generally found in older people and is caused by unusual infectious pathogens or prions. Using rabbit antisera raised against hamster scrapie prion proteins (HaPrPSc), we identified by immunoblotting human CJD prion proteins (HuPrPCJD) in the brains of 14 patients dying of CJD. Extracts from 6 of the patients were transmitted to mice after prolonged incubation. The rabbit antisera raised against HaPrPSc also reacted with the mouse CJD prion proteins (MoPrPCJD) found in the brains of these experimentally infected mice. When mice were immunized with HuPrPCJD, they produced antibodies that reacted with HuPrPCJD but not with MoPrPCJD. Mice immunized with MoPrPCJD produced antibodies to neither murine nor human prion proteins. Our results provide evidence for host species-specific epitopes on prion proteins. The existence of such epitopes is consistent with the apparent lack of an immune response during prion infections and the finding that prion protein molecules are encoded by host genes. PMID- 3300522 TI - [Sensitivity of dimorphic Candida albicans cells to polyene antibiotics and their combinations with other biologically active substances]. AB - It was shown that polyenic antibiotics and their combinations with some other antifungal and antibacterial agents prevented transformation of the C. albicans yeast phase into the tissue one. Moreover, the fungus tissue form proved to be more sensitive than the yeast form to the drugs and especially to their combinations. The in vitro findings were confirmed by the in vivo studies. Combinations of amphotericin B with methacycline, rifampicin, 5-fluorocytosine or polymyxin B were more efficient than the polyene alone. Summation of the drug antifungal effects provided a 4-fold decrease in the polyene quantity required for administration to experimental animals. PMID- 3300521 TI - [Current problems in the theory of regulation of enzymes and enzyme systems]. AB - The kinetic fundamentals of enzyme and enzymatic system regulation are discussed. The use of modern computers for analysis and modeling of the process is a qualitatively new approach to studies in this field at the present stage. Basic biokinetic equations, regularities and kinetic specific features of the processes in multienzymatic systems are considered. The kinetic behaviour of a multienzymatic system for prostacyclin and thromboxane synthesis is analyzed by way of example. The capacity of the system for maintaining constant concentrations of these physiologically active substances is shown to be its most valuable characteristic. The problems and prospects of developing a quantitative theory of enzyme and enzymatic system regulation are scrutinized. PMID- 3300523 TI - [The type of interaction of polyene antibiotics with antifungal and antibacterial agents]. AB - The combined effect of various polyenic antibiotics and other antifungal and antibacterial drugs on Candida was studied. The efficacy of the combinations was estimated with the method of square titration followed by quantitative plating out of the samples. By the interaction type the combinations were divided into 3 groups. The character of the drug interaction in these groups might be considered as indifferent, additive or synergistic. No antagonistic effect was observed in any of the combinations. The findings may be useful in more successful treatment of candidiasis when monotherapy is not sufficiently efficient, as well as in optimization of schemes for treating mixed infections. PMID- 3300525 TI - [Structural-functional role of the fatty acid component of bacterial lipids and related aspects of bacterial sensitivity and resistance to antibiotics]. PMID- 3300524 TI - [Effect of antibiotics on Candida adhesion to epitheliocytes]. AB - Tetracycline hydrochloride, a broad spectrum antibiotic was studied with respect to its effect on Candida adhesion to epitheliocytes of the oral mucosa. The experiments on mice showed that administration of 0.1 per cent solution of the antibiotic to the animals for 4 days resulted in increasing the adhesive number (AN) and adhesion index (AI) up to 175 and 250 per cent respectively as compared to the control. After 3 weeks of the antibiotic use the AN and AI amounted to 220 and 350 per cent respectively as compared to the control. PMID- 3300526 TI - [Antibiotics as a component of prolonged-action preparations and materials for surgical use]. PMID- 3300527 TI - Role of aminoglycoside antibiotics in the treatment of intra-abdominal infection. PMID- 3300528 TI - In vitro activity and beta-lactamase stability of a new monobactam, B0-1165. AB - B0-1165 is a 1-carboxy-1-cyclopropoxyamino,4-fluoromethyl monobactam. It inhibited the majority of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Citrobacter diversus, Aeromonas hydrophila, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, Yersinia enterocolitica, Haemophilus influenzae, Neisseria gonorrhoeae, and Salmonella and Shigella species at less than or equal to 0.125 microgram/ml. Overall, its in vitro activity was similar to that of aztreonam, cefotaxime, and ceftazidime, with minor differences in the MICs for individual isolates. Enterobacter species and Citrobacter freundii which were derepressed for beta-lactamase production and had higher MICs of aztreonam and ceftazidime had MICs that ranged from 4 to 32 micrograms/ml. B0-1165 had activity against Pseudomonas aeruginosa similar to that of aztreonam but lower than that of ceftazidime and carumonam. Pseudomonas maltophilia and other Pseudomonas species were resistant or had MICs of 32 micrograms/ml, as did Acinetobacter species. B0-1165 did not inhibit streptococcal, staphylococcal, or anaerobic species, such as Clostridium and Bacteroides species. B0-1165 was not hydrolyzed to any appreciable extent by common plasmid- and chromosomally Richmond-Sykes type 1a-, 1c-, and 1d-mediated beta-lactamases. It inhibited the Enterobacter cloacae P99 and inducible Pseudomonas aeruginosa beta-lactamases. B0-1165 was a poor inducer of beta lactamase, but exposing E. cloacae and C. freundii to B0-1165 selected for resistant isolates. Overall, B0-1165 had in vitro properties similar to those of other monobactams currently available or under investigation. PMID- 3300529 TI - Killing of Saccharomyces cerevisiae by the lysosomotropic detergent N dodecylimidazole. AB - The lysosomotropic detergent N-dodecylimidazole (C12-Im) has previously been found to kill mammalian cells by concentrating in lysosomes, followed by lysosomal disruption and release of cytotoxic enzymes into the cytoplasm. The action of C12-Im on Saccharomyces cerevisiae is described in this report. C12-Im prevented growth of colonies when present in 1% yeast extract-2% Bacto-Peptone-2% glucose plates at concentrations of 5 micrograms/ml or above, or when present in a soft agar overlay at 20 micrograms/ml. Treatment of cells suspended in glucose containing buffer (pH 8.0, 37 degrees C) with C12-Im (6 micrograms/ml) caused greater than 95% cell death within 6 min. Dependence of killing on C12-Im concentration was sigmoidal, suggesting a cooperative mode of action. Killing was pH dependent, being much more effective at pH 8.0 than at pH 5.0. Ammonium sulfate and imidazole protected against killing if added before, but not after, the addition of C12-Im. Sensitivity to C12-Im was strongly growth dependent: the cells were most sensitive at early to mid-logarithmic phase of growth and became progressively less sensitive during progression through late logarithmic and stationary phase. Vacuolar disruption by C12-Im was demonstrated by using cells loaded with lucifer yellow CH or fluoresceinated dextran in their vacuoles; vacuoles of logarithmically growing cells were more sensitive than those of stationary-phase cells. These results suggest that vacuolar disruption by C12-Im may underlie its cytotoxic effects. PMID- 3300530 TI - Comparative efficacy of cefotiam, cefmenoxime, and ceftriaxone in experimental endocarditis and correlation with pharmacokinetics and in vitro efficacy. AB - To determine the influence of in vitro activity, pharmacokinetic properties, and therapeutic regimen on the antibacterial effect in vivo, we compared three cephalosporins, cefotiam, cefmenoxime, and ceftriaxone, in a rabbit model of experimental Escherichia coli endocarditis after 4 days of treatment. The MBCs of cefotiam, cefmenoxime, and ceftriaxone for the E. coli strain were 0.5, 0.125, and 0.06 microgram/ml, respectively. Killing curves at 10 times the MBC were similar for the three cephalosporins. In serum, the elimination half-life of ceftriaxone was twice as much as the elimination half-life of cefotiam or cefmenoxime (2.8 +/- 0.45 versus 1.4 +/- 0.25 or 1.3 +/- 0.4 h, respectively). Ceftriaxone was much more effective than cefotiam. The bacterial titer in the vegetations (log10 CFU per gram of vegetation) was 7.56 +/- 1 with cefotiam and 2.41 +/- 2.6 with ceftriaxone, as their concentrations were 18 and 466 times higher, respectively, than their MBCs. Although ceftriaxone and cefmenoxime exhibited a similar rate of killing and percentage of protein binding, ceftriaxone was more effective than cefmenoxime at the same regimen of 15 mg/kg twice a day (3.08 +/- 1.1 versus 4.82 +/- 3.2 log10 CFU/g of vegetation). When antibiotic was given as a single daily injection of 30 mg/kg, the antibacterial effect persisted for ceftriaxone, but not for cefmenoxime. The longer elimination half-life and the higher local concentration/MBC ratio of ceftriaxone explained these results. The bacterial titer measured 24 h after the fourth injection of 30 mg of ceftriaxone per kg confirmed that this regimen prevented regrowth of bacteria. These results suggest that the local antibiotic level/MBC ratio roughly correlated with the antibacterial effect and could represent an adequate basis to explain the differences observed between the drugs in vivo. They also demonstrate that, provided that the dose is sufficient, a long-acting broad-spectrum cephalosporin may be effective in severe gram-negative infections, even when given at relatively long dosing intervals, in contrast with a rapidly cleared drug with the same intrinsic activity. PMID- 3300531 TI - Inhibition of R-plasmid transfer in Escherichia coli by 4-quinolones. AB - Inhibition of transfer of four conjugative R plasmids by ciprofloxacin, enoxacin, norfloxacin, ofloxacin, and pipemidic acid was investigated in an Escherichia coli mating system. The absolute concentrations needed for inhibition of conjugation varied from 0.12 microgram/ml for ciprofloxacin to 16 micrograms/ml for pipemidic acid, but the relationship to the MICs for the parent strains was identical for all substrates. Concentrations for a 90% reduction of transconjugants were in the range of one to six times the MIC for the parent strains, which also had lethal effects on donors and recipients. A similar effect on conjugation was found with chloramphenicol. These observations question the specificity of transfer inhibition by quinolones and cast doubt on the clinical importance of such an effect. PMID- 3300533 TI - Antibiotic residues and drug resistance in human intestinal flora. AB - The effect of residual levels of ampicillin on the drug resistance of fecal flora was studied in human volunteers given 1.5 mg of ampicillin orally per day for 21 days. This treatment failed to have any significant reproducible effect on the number of resistant Escherichia coli in their feces. The effect of continuous administration of small doses of ampicillin, chlortetracycline, or streptomycin in the drinking water was studied in gnotobiotic mice inoculated with a human fecal flora. In this animal model, which is free of many interfering factors, an increase in the fecal concentration of resistant E. coli was observed when the mice were given 0.5 microgram of ampicillin or chlortetracycline per ml of water. This model is therefore a sensitive system for testing the effect of antimicrobial drugs on the resistance characteristics of the intestinal flora. PMID- 3300532 TI - Selective gut decontamination with nalidixic acid or trimethoprim sulfamethoxazole for infection prophylaxis in neutropenic cancer patients: relationship of efficacy to antimicrobial spectrum and timing of administration. AB - Eighty-four cancer patients at risk of infection because of neutropenia were randomized to receive nalidixic acid as an alternative to trimethoprim sulfamethoxazole (TMP-SMX) for infection prophylaxis. Infections were documented significantly earlier and more often among patients who entered the trial with neutrophil counts of less than 0.1 X 10(9)/liter. TMP-SMX recipients experienced fewer microbiologically documented infections and bacteremias and were free of infection for a higher proportion of days with severe neutropenia (less than 0.1 X 10(9)/liter) than nalidixic acid recipients. Gram-negative bacillary and Staphylococcus aureus infections accounted for the major differences. Although the majority of aerobic gram-negative bacilli were eliminated from the feces after 1 week of prophylaxis with either agent, TMP-SMX was proved superior to nalidixic acid in this regard and was associated with acquired drug resistance by gram-negative bacilli less frequently. Both agents selected for colonization and subsequent infection by gram-positive cocci. Our data suggest that prophylaxis is most likely to be effective if administered to patients for at least 1 week before they become severely neutropenic. Nalidixic acid used as a single agent in doses of 4 g daily, however, cannot be recommended as an alternative to TMP-SMX for infection prophylaxis in neutropenic cancer patients. PMID- 3300534 TI - Broth dilution testing of Candida albicans susceptibility to ketoconazole. AB - We performed a detailed investigation of the kinetics of ketoconazole activity in the setting of broth dilution testing of Candida albicans susceptibility. Turbidimetric readings reflected parallel quantitative colony counts. The method of endpoint determination markedly affected the results. Determinations of 50% inhibitory concentrations clearly separated the ketoconazole-resistant strains from the susceptible strains. PMID- 3300535 TI - Liposomes as carriers of antimicrobial agents. PMID- 3300537 TI - Ciprofloxacin pharmacokinetics in patients with normal and impaired renal function. AB - The pharmacokinetics of ciprofloxacin following single oral doses of 500 and 750 mg in 32 patients with various degrees of renal function impairment were investigated in an open, randomized crossover fashion. Ciprofloxacin was administered after overnight fasting; the washout time between the two doses was 1 week. Serum and urine samples were collected serially between 0 and 24 h and subjected to bioassay and high-performance liquid chromatography. Pharmacokinetic parameters were analyzed, assuming an open two-compartment model with first-order input and elimination. A distinct difference was observed in pharmacokinetic parameters between patients with impaired renal function (creatinine clearance, less than 50 ml/min per 1.73 m2) and those with normal renal function (creatinine clearance, greater than or equal to 50 ml/min per 1.73 m2). For the former group, the area under the curve of serum concentration versus time was doubled, the renal clearance of ciprofloxacin was cut to one-fourth, the total and nonrenal ciprofloxacin clearance was reduced by 50%, and the elimination half-life was prolonged by a factor of approximately 1.7. The correlation between renal drug clearance and creatinine clearance was highly significant (r = 0.890; P less than 0.001). On the basis of these findings, it appears that a 50% dose reduction of ciprofloxacin in patients with impaired renal function (creatinine clearance, less than 50 ml/min per 1.73 m2) may be indicated to achieve concentrations in serum similar to those observed in normal individuals. As the concentration of ciprofloxacin in urine after 24 h remained above the MIC for most urinary pathogens, this drug appears to be of potential benefit for the treatment of urinary tract infections in patients with impaired renal function. PMID- 3300536 TI - Enhanced immune responses in mice treated with penicillin-tetracycline or trimethoprim-sulfamethoxazole when colonized intragastrically with Candida albicans. AB - Immune consequences of gastrointestinal colonization of CD-1 and CBA/J mice with Candida albicans in the presence or absence of continuous antibiotic treatment with penicillin-tetracycline or trimethoprimsulfamethoxazole were investigated. Intubation with C. albicans in the absence of antibiotics resulted in the induction of low but detectable delayed-type hypersensitivity (DTH), demonstrable by footpad testing with a C. albicans wall glycoprotein (GP), and in the stimulation of a moderate level of protective immunity, demonstrable by intravenous (i.v.) challenge. DTH to a membrane extract, BEX, could not be detected in such animals. However, animals colonized in the presence of antibiotics and then inoculated cutaneously prior to being tested for DTH or protective immunity developed significantly enhanced levels of DTH to GP and BEX and were protected to an even greater extent than animals colonized in the absence of antibiotics who were not inoculated cutaneously. The priming effect of colonization, particularly with respect to the antigen GP, was also obvious from an enzyme-linked immunosorbent assay for GP-specific antibody with sera of mice surviving the i.v. challenge, in that GP-specific antibody was present in the highest titers in colonized animals that had been inoculated cutaneously prior to i.v. challenge. While the antibiotics promoted higher levels of colonization, as evidenced by stomach and fecal cultures of intubated mice, antibiotic administration was not necessary for the induction of C. albicans-specific responses. Moreover, contrary to reports in the literature, antibiotic administration had no adverse effect on the immune responses measured. Females were innately more resistant than males to i.v. challenge with C. albicans, but each sex was capable of developing protective immunity of equal intensity in response to colonization or immunization by cutaneous challenge. PMID- 3300538 TI - Sub-MICs of cefuroxime and ciprofloxacin influence interaction of complement and immunoglobulins with Klebsiella pneumoniae. AB - Growth of encapsulated (K+) and nonencapsulated (K-) Klebsiella pneumoniae strains in media containing sub-MICs of either cefuroxime or ciprofloxacin resulted in cell elongation but had little effect on the outer membrane protein or lipopolysaccharide profiles. Exposure to serum complement increased the surface hydrophobicity of a K- strain but failed to interact or to increase the surface hydrophobicity of the K+ strains. However, after growth of the K+ strains in sub-MICs of the antibiotics, complement increased their surface hydrophobicity and complement C3 was detected bound to their surface. Antisera raised against a K-O- strain agglutinated the K+ strains grown in the presence but not in the absence of cefuroxime or ciprofloxacin. These findings suggest that the filamentous morphology induced by these antibiotics influences the distribution or amount of capsular polysaccharide such that cell envelope components previously masked by the capsule become accessible to complement and immunoglobulins. PMID- 3300539 TI - Rapid in vitro metabolic screen for antileprosy compounds. AB - Measurement of intracellular ATP of Mycobacterium leprae after direct in vitro exposure to antimicrobial agents was evaluated as a rapid means of identifying potentially useful therapeutic agents. Nude mouse-derived M. leprae was incubated in an axenic modified Dubos medium in the presence or absence of antimicrobial agents for up to 3 weeks. ATP was then assayed by using the firefly bioluminescence technique. Rifampin, clofazimine, and ethionamide each effected a significantly accelerated rate of ATP decay compared with controls. Dapsone appeared inactive, possibly reflecting a general insensitivity of this system to compounds acting at certain loci. The system appeared suitable for assessing comparative activity of new structural analogs of clofazimine. Other active compounds included erythromycin, minocycline, chloramphenicol, gramicidin, and, to a lesser extent, cycloserine, cephalothin, ciprofloxacin, tetracycline, and gramicidin S. The penicillins, bacitracin, isoniazid, nalidixic acid, trimethoprim, polymyxin B, and griseofulvin were all inactive. The system appears sensitive to agents with various modes of action and may prove useful as a primary screen for antileprosy drugs. PMID- 3300540 TI - Persistence of an antibiotic resistance plasmid in intestinal Escherichia coli of chickens in the absence of selective pressure. AB - We studied eight strains of Escherichia coli resistant to high levels of trimethoprim that were isolated over a 6-week period in a commercial breeding flock of broilers. The strains originated from fecal samples and from a carcass immediately after slaughter. Seven of eight strains belonged to the same infrequent biotype. They were also resistant to ampicillin and streptomycin, and some were resistant to tetracycline and potassium tellurite. All the strains transferred trimethoprim and ampicillin resistance to E. coli. Analysis of the donors and of the transconjugants by agarose gel electrophoresis after digestion by restriction endonucleases and by nucleic acid hybridization indicated that resistance to trimethoprim (dfrI) and to ampicillin (bla TEM-1) was mediated by a 65-kilobase plasmid, pIP1531. Persistence of resistance to trimethoprim and ampicillin in this flock was therefore due to two cumulative factors, both occurring in the absence of selective pressure, namely the dissemination of a particular plasmid between strains and the ability of an atypical E. coli strain to stably colonize many animals. PMID- 3300541 TI - Quantitative neutralization assay of fungicidal activity of disinfectants. AB - A quantitative assay using a neutralization medium was developed to evaluate fungicidal activity of disinfectants. Concentrated Dey-Engley neutralizing broth was used in this study and was demonstrated to inactivate various chemical agents within 5 min when disinfectant concentrations were reduced to specific levels. Addition of this Dey-Engley broth to test tubes containing fungal cells and disinfectants permitted control of the various interactions times. Subsequent concentration of the disinfectant-treated cells to a 1-ml final volume also permitted examination of a larger population for the presence of resistant cells. After timed exposures of 15, 30, and 60 min, only three of seven disinfectant solutions were found to be lethal for quantitative populations of 11 fungi tested. The recommended use dilution formulations of a quaternary ammonium product and an iodophor product were the least effective agents. Various fungi, including Trichophyton mentagrophytes, Epidermophyton floccosum, and Aspergillus niger, survived 30- to 60-min interactions with these disinfectant solutions. The most resistant organism encountered was Aspergillus fumigatus, which survived 60 and even 90 min of exposure to most disinfectants. Only use dilutions of a chlorine dioxide formulation, a glutaraldehyde formulation, and an ethyl alcohol product were effective against this species and all of the other fungi after a 15 min interaction. PMID- 3300542 TI - Penetration of ceftazidime into heart valves and subcutaneous and muscle tissue of patients undergoing open-heart surgery. AB - Patients undergoing open-heart surgery were given an intravenous bolus injection of 2 g of ceftazidime as a single dose over a period of 5 min. Within 12 h, ceftazidime concentrations in serum declined from 55.8 to 3.9 mg/liter. Subcutaneous tissue concentrations of the drug decreased from 21.0 to 2.7 micrograms/g, and muscle concentrations decreased from 34.5 to 2.5 micrograms/g. Ceftazidime concentrations in cardiac valvular tissue were even higher than those in muscle or fat, declining from 37.4 to 6.3 micrograms/g within 10 h. PMID- 3300543 TI - Activity of phenothiazines against medically important yeasts. AB - Two phenothiazine compounds, trifluoperazine and chlorpromazine, inhibited growth in vitro of the five most common pathogenic yeasts, with MICs ranging from 10 to 40 micrograms/ml. Daily intraperitoneal injections of trifluoperazine (4 to 7 mg/kg of body weight) increased the survival of mice experimentally infected with Candida albicans or Cryptococcus neoformans. The potential use of these drugs against fungal meningitis is discussed. PMID- 3300544 TI - Enzymes and cells in organic solvents and supercritical fluids. Patents and literature. PMID- 3300545 TI - Inhibition of type A and type B (proteolytic) Clostridium botulinum by sorbic acid. AB - The effect of sorbic acid in the pH range 4.9 to 7.0 on the probability P of growth of a single vegetative bacterium of proteolytic strains of Clostridium botulinum has been determined by comparison of the most probable number count of the bacteria in media at pH 4.9 to 7.0 containing a series of concentrations of potassium sorbate and in a nutrient medium at pH 6.8 to 7.0. The media were maintained under strictly anaerobic conditions at a redox potential equivalent to lower than -350 mV at pH 7. In medium adjusted to the required pH with HCl, P for strain ZK3 (type A) at pH 5.1 or 5.5 after 2 days at 30 degrees C was similar to that at pH 6.8 to 7.0 but was slightly lower at pH 4.9. Potassium sorbate inhibited growth, the inhibition being a function of the concentration of undissociated sorbic acid. A calculated undissociated sorbic acid concentration of 156 mg/liter delayed growth of strain ZK3 (type A) but did not result in a significant decrease in P after an incubation time of 14 days. Higher concentrations of undissociated sorbic acid caused longer delays before maximum most probable number counts developed, and a calculated undissociated sorbic acid concentration of 282 mg/liter decreased log P for strain ZK3 after an incubation time of 14 days by a factor of 5.5 to 7.5. Four additional type A strains and five type B strains were inhibited to an extent comparable to inhibition of strain ZK3.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300546 TI - Maintenance and stability of introduced genotypes in groundwater aquifer material. AB - Three indigenous groundwater bacterial strains and Pseudomonas putida harboring plasmids TOL (pWWO) and RK2 were introduced into experimentally contaminated groundwater aquifer microcosms. Maintenance of the introduced genotypes was measured over time by colony hybridization with gene probes of various specificity. On the basis of the results of colony hybridization quantitation of the introduced organisms and genes, all introduced genotypes were stably maintained at approximately 10(5) positive hybrid colonies g-1 of aquifer microcosm material throughout an 8-week incubation period. Concomitant removal of the environmental contaminants, viz., toluene, chlorobenzene, and styrene, in both natural (uninoculated) and inoculated aquifer microcosms was also demonstrated. The results indicate that introduced catabolic plasmids, as well as indigenous organisms, can be stably maintained in groundwater aquifer material without specific selective pressure for the introduced genotypes. These results have positive implications for in situ treatment and biodegradation in contaminated aerobic groundwater aquifers. PMID- 3300547 TI - Improved membrane filtration media for enumeration of total coliforms and Escherichia coli from sewage and surface waters. AB - Two media were developed that allowed both a total coliform count and an Escherichia coli count to be determined on the same medium after 24 h of incubation at 35 degrees C. The new media were tested along with two standard media on 10 surface water and 7 sewage samples. The experimental media yielded equivalent or higher counts relative to the standard media and recovered more specifically the desired indicator groups as determined by colony identification. PMID- 3300548 TI - Cytolytic activity and immunological similarity of the Bacillus thuringiensis subsp. israelensis and Bacillus thuringiensis subsp. morrisoni isolate PG-14 toxins. AB - The parasporal bodies of the mosquitocidal isolates of Bacillus thuringiensis subsp. israelensis and B. thuringiensis subsp. morrisoni isolate PG-14 were compared with regard to their hemolytic and cytolytic activities and the immunological relatedness of the 28- and 65-kilodalton (kDa) proteins that occur in both subspecies. The alkali-solubilized parasporal bodies of B. thuringiensis subsp. israelensis caused 50% lysis of human erythrocytes at 1.14 micrograms/ml, whereas those of B. thuringiensis subsp. morrisoni caused similar lysis at 1.84 micrograms/ml. Preincubation of solubilized parasporal bodies with dioleolyl phosphatidylcholine significantly inhibited the hemolytic activity of both supspecies. In cytolytic assays against Aedes albopictus cells, the toxin concentrations causing 50% lysis for B. thuringiensis subsp. israelensis and B. thuringiensis subsp. morrisoni were 1.87 and 11.98 micrograms/ml, respectively. Polyclonal antibodies raised separately against the 25-kDa protein (a tryptic digest of the 28-kDa protein) or the 65-kDa protein of B. thuringiensis subsp. israelensis cross-reacted, respectively, with the 28- and the 65-kDa proteins of B. thuringiensis subsp. morrisoni. However, neither of these antibodies cross reacted with the 135-kDa protein of either subspecies. These results indicate that the mosquitocidal and hemolytic properties of B. thuringiensis subsp. israelensis and B. thuringiensis subsp. morrisoni isolate PG-14 are probably due to the biologically related proteins that are present in the parasporal bodies of both subspecies. The lower hemolytic activity of the B. thuringiensis subsp. morrisoni may be due to the presence of lower levels of the 28-kDa protein in that subspecies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300549 TI - Quin's oval and other microbiota in the rumens of molasses-fed sheep. AB - Two rumen-cannulated wether sheep were fed a diet containing 1 kg of a liquid molasses mixture, 80 g of soybean oil meal, and 100 g of chopped wheat straw once a day. In 6 weeks and thereafter, the microbiota adapted such that Quin's oval, a very large bacterium, was present in huge numbers (11.3 X 10(10) and 1.3 X 10(10) ml-1 after 73 days). Direct microscopic counts were also done on small bacteria, moderate-sized Selenomonas spp., and small Entodinium spp., which were the only protozoa seen. After the necessary dilution of rumen contents to make the microbial cells visible, Quin's ovals were seen to be much smaller in sheep 1 than in sheep 2. Most-probable-number estimates indicated that Methanobrevibacter spp. were present at 10(7) ml-1, Methanosarcina spp. were present at 10(3) ml-1, and Eubacterium limosum-like bacteria were present at 10(5) to 10(6) ml-1. In the adapted sheep, the dry portion of the diet was rapidly consumed, but the molasses mixture was consumed over a 9- to 10-h period. Volatile fatty acids in the rumen were present in very low amounts just prior to feeding and were much higher during the consumption of the diet, with about a 1:1 molar ratio of propionate to acetate between 1 and 9 h after feeding. Data were obtained on hourly feed consumption, levels of volatile fatty acids, and pH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300551 TI - Effect of NaCl, pH, temperature, and atmosphere on growth of Salmonella typhimurium in glucose-mineral salts medium. AB - The interactions of pH (5.0, 6.0, and 7.0), temperature (19, 28, and 37 degrees C), and atmosphere (aerobic versus anaerobic) with NaCl (0, 1, 2, 3, 4, and 5%) on the growth of Salmonella typhimurium ATCC 14028 in defined glucose-mineral salts culture medium were evaluated. Response surface methodology was used to develop equations describing the response of S. typhimurium to environmental changes. The response to an increasing concentration of NaCl at any temperature tested was nonlinear. The maximum growth was predicted to occur at an NaCl concentration of 0.5%, a temperature of 19 degrees C, and an initial pH of 7.0 under aerobic growth conditions. The relative amounts of aerobic growth at 19 degrees C, pH 7.0, and NaCl concentrations of 0, 0.5, 1, 2, 3, 4, and 5% were predicted to be 99.2, 100.0, 98.8, 90.2, 73.5, 48.6, and 15.6%, respectively. Anaerobic growth conditions repressed the amount of growth relative to that under aerobic conditions, and the effects of NaCl and pH were additive at low salt concentrations; however, at higher salt levels anaerobiosis provided protection against the effects of NaCl. PMID- 3300550 TI - Ethanol production during batch fermentation with Saccharomyces cerevisiae: changes in glycolytic enzymes and internal pH. AB - During batch fermentation, the rate of ethanol production per milligram of cell protein is maximal for a brief period early in this process and declines progressively as ethanol accumulates in the surrounding broth. Our studies demonstrate that the removal of this accumulated ethanol does not immediately restore fermentative activity, and they provide evidence that the decline in metabolic rate is due to physiological changes (including possible ethanol damage) rather than to the presence of ethanol. Several potential causes for the decline in fermentative activity have been investigated. Viability remained at or above 90%, internal pH remained near neutrality, and the specific activities of the glycolytic and alcohologenic enzymes (measured in vitro) remained high throughout batch fermentation. None of these factors appears to be causally related to the fall in fermentative activity during batch fermentation. PMID- 3300552 TI - Biosynthesis of o-succinylbenzoic acid. I: Cell free synthesis of o succinylbenzoic acid from isochorismic acid in enzyme preparations from vitamin K producing bacteria. AB - Escherichia coli K12 and a mutant of E. coli (viz., AN 154) as well as Aerobacter aerogenes 62-1 (i.e., Klebsiella pneumoniae) were used as sources of the enzyme catalyzing the formation of o-succinylbenzoic acid (OSB) from isochorismic acid and alpha-ketoglutaric acid in the presence of thiamine pyrophosphate. The product of the reaction (OSB) was identified by HPLC before and after derivatization to the methylester, dilactone, and coenzyme A ester. OSB synthase and alpha-ketoglutarate dehydrogenase are similar in that both decarboxylate alpha-ketoglutarate in the presence of thiamine pyrophosphate but the enzyme systems can be separated easily by several methods. Reexamination of mutants E. coli AN 154 and AN 191 showed that these mutants are leaky, rather than blocked, between chorismic acid and isochorismic acid. This finding, together with the observation that isochorismic acid rather than chorismic acid is the substrate of OSB synthase, invalidates previous assumptions on the reaction initiating vitamin K2 biosynthesis. PMID- 3300553 TI - Biosynthesis of o-succinylbenzoic acid. II: Properties of o-succinylbenzoic acid synthase, an enzyme involved in vitamin K2 biosynthesis. AB - The enzyme system (OSB2 synthase) catalyzing the synthesis of o-succinylbenzoic acid from isochorismic acid and alpha-ketoglutaric acid in the presence of thiamine pyrophosphate was isolated from Escherichia coli AN 154 and characterized. The purification factor of the enzyme did not increase during column chromatography on Sephadex G-200 or chromatofocusing, suggesting that the OSB synthase is labile. Chromatography on DEAE-Sephadex A-50 or A-25 showed that an enzyme activity separated from fractions containing OSB synthase that decarboxylates alpha-ketoglutarate. This activity is provisionally referred to as the decarboxylating "subunit" or decarboxylating activity of OSB synthase. Both the "subunit" and the holoenzyme were characterized with respect to pH optimum, temperature optimum, and KM values. The OSB synthase loses all activity during treatment with EDTA and activity is most efficiently restored with Mn2+. The activity of the decarboxylating subunit did not depend on Mn2+. When the decarboxylating fraction was incubated with alpha-ketoglutarate and thiamine pyrophosphate, succinic semialdehyde could be isolated as its hydrazone. After treatment of the incubation mixture with phosphorylase a compound was isolated which is most likely the thiamine adduct of succinic semialdehyde. PMID- 3300554 TI - Radiation inactivation of hepatic sulfite oxidase. AB - Sulfite oxidase (EC 1.8.3.1), purified from chicken liver, is comprised of two identical subunits of 55 kDa, each of which contains a molybdenum and heme prosthetic group. The functional size of sulfite oxidase was determined by radiation inactivation analysis using both full, sulfite:cytochrome c reductase, and partial, sulfite:ferricyanide reductase, catalytic activities. Inactivation of full enzyme activity indicated a target size of 42 kDa while the partial activity indicated a target size of 25 kDa. These results confirm the earlier findings of two equivalent subunits and suggest the presence of a functional domain within the subunit structure that contains the molybdenum center and exhibits a smaller molecular mass than that of the enzyme subunit. PMID- 3300555 TI - Synthesis, cloning, and expression in Escherichia coli of a spinach acyl carrier protein-I gene. AB - A synthetic gene of 268 bp encoding the 82 amino acid spinach acyl carrier protein (ACP)-I was constructed based on the known amino acid sequence. Two gene fragments, one encoding the amino-terminal portion and the other the carboxy terminal portion of the protein, were assembled from synthetic oligonucleotides and inserted into the phage M13mp19. These partial gene constructions were joined and inserted into the plasmid pTZ19R. DNA sequencing confirmed the accuracy of the constructions. The synthetic gene was then subcloned into the Escherichia coli expression vector pKK233-2, under the control of the trc promoter. Western blot analysis and radioimmunoassay indicated that E. coli cells carrying this plasmid produced up to 6 mg/liter of a protein which was immunologically cross reactive and similar in electrophoretic mobility to authentic spinach acyl carrier protein. The bacterial cells were able to attach the phosphopantetheine prosthetic group to the synthetic plant gene product allowing it to be acylated in vitro by acyl-ACP synthetase. PMID- 3300556 TI - [Activated c-raf-1 gene from human stomach cancer]. AB - We previously isolated a novel human transforming sequence from a primary stomach cancer and identified the gene as an activated version of the c-raf-1 gene which is the human homologue of v-raf, a viral oncogene encoding a serine/threonine specific protein kinase. Of 57 kbp of the human sequence isolated, a region of 40 kbp was found to be the minimum functional unit for the transforming activity, because a cosmid clone harboring this region was capable of inducing foci upon transfection. The size of the transcript of the transforming c-raf-1 gene was estimated to be about 2.8kb. Analyses of cDNA clones of this gene revealed that the gene was generated by substitution of the 5'-sequence (exons 1-5) of the normal c-raf-1 gene with an unrelated human sequence. We identified a region in the genomic clone where the rearrangement had occurred. The rearranged EcoRI fragment was detected in all the primary transformants obtained from two independent transfections, suggesting that the recombination had occurred in the primary cancer. The substituted cDNA sequence is composed of an open reading frame, which joins to exon 6 of the c-raf-1 gene in an in-phase manner. The substituted open reading frame encodes an extremely hydrophobic polypeptide. Thus, the putative product of the transforming gene seems to have a hydrophobic stretch ahead of the ser/thr-protein kinase domain of the c-raf-1 gene product. These results suggest that the truncation or replacement of the amino-terminal domain of the c-raf-1 protein leads to constitutive activation of the protein kinase residing in the downstream domain. PMID- 3300557 TI - [Serological and immunomolecular markers for the diagnosis of hematopoietic tumors]. AB - The analysis of cell surface markers with monoclonal antibodies has recently been developed and has been proved to be valuable in the diagnosis and classification of hematopoietic tumors. Occasionally, however, such serological studies have been shown to be inconclusive in identifying cell lineage and or clonal proliferation. In order to overcome these problems, two new approaches were introduced in our laboratory. First, T cell receptor and immunoglobulin gene rearrangement analysis as a means of immunomolecular marking was carried out. Second, a double immunoenzymatic staining technique for determining the surface phenotypes of proliferating lymphocytes using a monoclonal antibody against DNA polymerase alpha together with those detecting lymphocyte membrane antigens was developed. The results revealed by these techniques strongly suggested that some CD2-, CD5+, CD7+ ALL cases are of T cell origin and that AILD may be a neoplastic disease derived from either of the subsets of peripheral T cells. PMID- 3300558 TI - [An attempt at using monoclonal antibodies to oncogene products]. AB - Four mouse hybridoma cell lines rp12, rp28, rp35 and rp38 producing monoclonal antibodies (MoAbs) reactive with ras oncogene product p21 were established with the use of recombinant proteins as immunogens. Using immunofluorescence, avidin biotin complex or peroxidase-antiperoxidase methods, the reactivity of rp12, rp28 and rp35 MoAbs was examined in fresh and paraformaldehyde- or formalin fixed tissues of malignant and benign lesions of the skin, lung, stomach, uterus and ovary. These MoAbs strongly reacted with most malignant melanomas, lung cancers, stomach cancers, colon cancers and adenomatous polyps, uterus cancers, and ovary cancers, while they weakly reacted with inflammatory lung tissues, stomach polyps and metaplastic tissues and cervical dysplastic lesions, and did not react with pigmented nevi. The cancers and colon adenomatous polyps showed a high positive cell ratio, with not only cytoplasmic but also membranous localization of the staining, while other tissues had a low positive cell ratio and cytoplasmic staining localization. The MoAbs rp12, rp28 and rp35 could therefore be helpful for differential diagnosis between cancers and benign lesions. PMID- 3300559 TI - [Oncogene products as tumor markers]. AB - Monoclonal antibodies reactive with ras gene products were produced. Specificity of the antibodies obtained was determined by ELISA and immunoblotting assays. Using one of those anti-ras p21 monoclonal antibodies, RASK-3 the expression of p21 in human stomach cancer and thyroid cancer was studied by means of immuno histochemistry. ras p21 was more dominantly expressed in cancer cells than in normal epithelial cells. PMID- 3300560 TI - [Cancer epidemiology in Japan]. AB - Cancer became the leading cause of death in Japan in 1981. In 1985, the cancer death rate was 156.1 per 100,000 population, and cancer deaths accounted for 25.0% of all deaths. The number of cancer deaths and the crude cancer death rate are still increasing in Japan, but the age-adjusted death rate from cancer has been stable in males and has been declining in females in recent years. Thus, the main reason behind the increase of cancer deaths in Japan is an increase in the aged population. In Japan, stomach cancer is the most common cancer in both males and females, but the stomach cancer death rate as well as the incidence rate have been declining in recent years. The death rates and incidence rates of cancers of the cervix, liver (female only), and esophagus (female only) have also been declining in recent years. The death rates and incidence rates for other cancers have been increasing in recent years. Among all increasing cancers, cancers of the lung, biliary tract, pancreas, ovary and prostate have shown a remarkable tendency to increase. Thus, the cancer pattern in Japan seems to be approaching, in general, that of Western countries. Although the reasons for these changes in the death rate and incidence rate of cancer by site are not clear, it is considered likely that changes in dietary habits, cigarette consumption, age of marriage, number of births and progress in cancer screening, diagnosis and treatment have contributed to those changes. Major risk factors for cancer were reviewed. Smoking and diet were considered the most important risk factors. The importance of primary prevention of cancer by life style modification was emphasized. PMID- 3300561 TI - [Antiemetic effects of combinations of metoclopramide, droperidol and dexamethasone for the prevention of cisplatin-induced gastro-intestinal toxicity: a randomized crossover trial]. AB - Thirty-two patients with primary lung cancer receiving combination chemotherapy including cisplatin at a dosage of 80-120 mg/m2 were entered into an antiemetic randomized crossover trial. Patients received metoclopramide (2 mg/kg i.v. every 2 h X 5), droperidol (0.5 mg/kg i.v.) and dexamethasone (30 mg i.v.) on day 1, and metoclopramide (1mg/kg i.v. every 8 h X 3) (Regimen A) or metoclopramide and droperidol (2.5 mg i.v. every 8 h X 3) (Regimen B) on days 2 to 5. No vomiting occurred within the first 24 hours after cisplatin administration in 75% of patients. Regimen B was found to be more effective than regimen A with respect to the mean duration of vomiting (p less than 0.1), the mean duration of nausea (p less than 0.05), the mean duration of anorexia (p less than 0.05), and the mean score of the patients' opinions (p less than 0.1). When the patients were asked for their opinion of the two regimens, 39% preferred regimen B (p less than 0.05). There were no major side effects with either regimen. PMID- 3300562 TI - [Role of natural killer cells in the antimetastatic effect of defibrinogenation with batroxobin]. AB - The antimetastatic effects of defibrinogenation with batroxobin were investigated in normal mice and in mice with depressed or activated natural killer (NK) cell activity. Batroxobin inhibited the formation of lung metastases after intravenous inoculation of the F10 subline of B16 melanoma. Inhibition of NK activity by treatment of mice with anti-asialo GM1 antibody abrogated the antimetastatic effects of Batroxobin. Conversely, augmentation of NK cell activity by poly I:C plus treatment with batroxobin produced additive antimetastatic effects. Studies on the mechanism of interaction between Batroxobin and NK cells revealed that Batroxobin treatment did not affect splenic NK activity in vitro. From these data, it was found that the antimetastatic effects of batroxobin are dependent on the level of NK activity in the host. PMID- 3300564 TI - Glycosaminoglycans in histologic sections. PMID- 3300563 TI - [Clinical trials of combination chemotherapy using cis-platinum with aclarubicin in intracranial rhabdomyosarcoma]. AB - Combination chemotherapy of Cis-platinum with Aclarubicin was performed in patients with intracranial alveolar rhabdomyosarcoma. These patients were treated with Cis-platinum (20 mg/day) and Aclarubicin (20 mg/day) for 5 days. After two trials with about a four-week interval, complete tumor regression on CT scan was observed. Mild gastrointestinal toxicity was observed in these patients but the symptoms were transient and soon disappeared. No other side effects appeared, on or after treatment. This result demonstrated that combination chemotherapy of Cis platinum and Aclarubicin is an effective regimen for remission induction chemotherapy in patients with intracranial sarcoma. PMID- 3300565 TI - PUVA, etretinate, and PUVA-etretinate therapy for pustulosis palmoplantaris. A placebo-controlled comparative trial. AB - Thirty patients with severe pustulosis palmoplantaris completed a placebo controlled comparative trial. Patients were randomly allocated to placebo or etretinate therapy; after two weeks, psoralen plus long-wave ultraviolet light (PUVA) treatment was instituted on one hand or foot, while the other hand or foot served as an untreated control. Fourteen of 18 hands or feet cleared with the combined treatment, compared with three of 18 with etretinate treatment and three of 12 with PUVA treatment. Follow-up showed a high relapse rate. Treatment of severe pustulosis palmoplantaris must be individualized to minimize short- and long-term side effects. PMID- 3300566 TI - Effects of relaxation therapy and hypnotizability in chronic urticaria. AB - The therapeutic results of hypnosis with relaxation therapy were evaluated in 15 patients with chronic urticaria of 7.8 years' average duration. Compared with baseline and control session values, the hypnosis session provided relief of pruritus as measured by three self-report parameters. There was no change in the number of hives. All subjects were given a standard test for hypnotizability. Assuming that the results were not biased by their preceding relaxation sessions, we determined that six subjects were hypnotizable and nine were nonhypnotizable. Subjects in both groups improved symptomatically, but hypnotizable subjects had fewer hives and became more symptomatic during the control (testing and history taking) session. Hypnotizable subjects also more frequently related stress as a causative factor. At a follow-up examination five to 14 months after the completion of the experimental sessions, six patients were free of hives and an additional seven reported improvement. PMID- 3300567 TI - Ischemic forms of acute venous thrombosis. AB - Venous thrombosis in an extremity, when extensive, can cause reversible tissue ischemia or frank gangrene even without arterial or capillary occlusion. Patients gradually or abruptly develop severe pain, extensive edema, and cyanosis of the extremity, nearly always in the legs. Gangrene can occur unless the venous obstruction is relieved. Such ischemic venous thrombosis can complicate surgery, trauma, childbirth, or prolonged immobility, but malignant neoplasms, either obvious or occult, are a major predisposing factor. The optimal therapy is anticoagulation and thrombectomy. Patients with venous gangrene may require amputation if extensive, deep-tissue destruction occurs. The mortality rate for ischemic venous thrombosis is about 40%, the cause of death usually being the underlying disease or pulmonary emboli. PMID- 3300568 TI - Bullous eruption in a patient with lupus erythematosus. PMID- 3300569 TI - Hydrolysed wheat based oral rehydration solution for acute diarrhoea. AB - A randomised three cell study was carried out in 78 children with acute diarrhoea to evaluate the relative efficacy of oral rehydration solution (ORS) made from partially hydrolysed wheat grain, cooked rice powder, or glucose. Twenty six patients with comparable age, body weight, duration of diarrhoea, and degree of dehydration were studied in each of the three groups. Initial rehydration was carried out by using intravenous Dhaka solution within one to two hours followed by administration of oral rehydration solution. The mean ORS intake during the first and second 24 hours of treatment in patients with cholera receiving wheat ORS and rice-ORS was significantly less compared with those receiving glucose ORS. The stool output during the same period in patients receiving wheat-ORS and rice-ORS was significantly less compared with those receiving glucose-ORS. Similar trends in both ORS intake and stool output were observed during the next 24 hours. PMID- 3300570 TI - Cisapride for gastro-oesophageal reflux and peptic oesophagitis. AB - Twenty children (age range 75 days-47 months) with reflux oesophagitis entered a random double blind trial in which they received either Cisapride (Janssen Pharmaceutical Ltd), a new prokinetic agent, or an identical placebo syrup. Diagnosis of gastro-oesophageal reflux was made by measurement of intraluminal oesophageal pH combined with manometry. Oesophagitis was assessed in all patients by histological examination of mucosal specimens taken during oesophagogastroduodenoscopy. Manometry, pH test, and endoscopy with biopsy examination were repeated at the end of the treatment period. Seventeen patients completed the trial, eight of whom were taking the drug and nine the placebo. Mean total clinical score and post-prandial reflux time (% of reflux) significantly improved in patients in the group given Cisapride but not in the group given placebo. Furthermore, there was a significant improvement of the histological oesophagitis score only in the children in the group given Cisapride, whereas placebo was ineffective. It is concluded that Cisapride is a useful agent both for the relief of symptoms of gastro-oesophageal reflux and for the healing of peptic oesophagitis in infancy. PMID- 3300572 TI - Persistence of DDT and metabolites in wildlife from Washington State orchards. PMID- 3300571 TI - Aldicarb immunomodulation in mice: an inverse dose-response to parts per billion levels in drinking water. PMID- 3300573 TI - Toxic effects of herbal teas. AB - At least 26 herbal teas contain toxic ingredients, many of which have caused serious gastrointestinal, hematologic, cardiac, and nervous system disease. The severity of illness following herbal tea use has ranged from contact dermatitis to fulminant hepatic failure and death. Most of these teas are available in health food stores and there is no requirement that their toxic potential be labeled for consumer protection. Patients on anticoagulant drugs should avoid herbal teas containing coumarin. PMID- 3300574 TI - Vaginosonographical determination of the true conjugate and the transverse diameter of the pelvic inlet. AB - In suspected cases of cephalopelvic disproportion pelvic measurement and the estimation of the fetal weight can be essential for the management of labor. We measured the true conjugata and the widest transverse diameter of the pelvic inlet with a new vaginal scanner. The biparietal diameter (BPD) was measured with a real-time sector scanner. The results of vaginosonographical measurement were compared and showed good correlation with both conventional radiological measurement and measurements obtained by a compound scanner. Vaginosonographical measurement which causes no pain, is quick and also allows measurement of the transverse diameter of the pelvis, might become a routine method in all suspected cases of cephalopelvic disproportion. PMID- 3300575 TI - The out-of-body experience and other states of consciousness. PMID- 3300576 TI - Pregnancy in dialysis and transplant patients. 2. PMID- 3300577 TI - Outcome criteria and nursing diagnosis in ESRD patient care planning. Section III: Renal transplantation. PMID- 3300579 TI - Diagnosis of varicocele and postoperative evaluation using inguinal ultrasonography. AB - Ultrasonographic real-time imaging and measurements of spermatic veins in the inguinal canal were evaluated in two groups of patients: 20 young men with varicocele and 18 controls. Examinations were performed with the patient in an upright relaxed position, and performing the Valsalva maneuver. The increase in diameter of the main vein during Valsalva maneuver was considered to quantitatively represent venous reflux. The data obtained were correlated with pre- and postoperative clinical findings. This method of evaluation proved to be a useful noninvasive diagnostic modality for detecting varicocele and for assessing treatment results. On the basis of venous diameters and reflux values, a classification of varicocele is proposed. Such an objective method of grading would eliminate the subjective impression and interpretation factors of the examiner. PMID- 3300578 TI - Comparison of intraoperative ultrasonography and cholangiography in detection of small common bile duct stones. AB - High-resolution intraoperative ultrasonography was compared with conventional radiographic imaging in the detection of small common bile duct (CBD) stones (less than 5 mm in diameter). Sixteen mongrel dogs had laparotomy and ligation of distal CBD; 1 week to 10 days later, 0-3 gallstones of varying sizes (2-5 mm) were introduced into the dilated CBD (6-16 mm). High-resolution intraoperative ultrasonography of the CBD and a conventional intraoperative cholangiogram were performed to detect the presence and number of stones. The results of these two tests were evaluated independently by two ultrasonographers and two surgeons. There were 21 true-positive and five false-negative readings by sonogram compared with 17 and 9, respectively, by cholangiogram. Sensitivity of the sonogram was 81% and 65.4% by cholangiogram. Score of accuracy was 1.06 and 1.62 by cholangiogram and 0.81 and 0.87 by ultrasound (p less than 0.05). Intraoperative ultrasonography was found to be more sensitive in detecting small CBD stones when compared with intraoperative cholangiogram. PMID- 3300581 TI - An analysis of survival and treatment failure following abdominoperineal and sphincter-saving resection in Duke's B and C rectal carcinoma. A report of the NSABP clinical trials. PMID- 3300580 TI - The comparative influence of prophylactic antibiotics on the prothrombin response to warfarin in the postoperative prosthetic cardiac valve patient. Cefamandole, cefazolin, vancomycin. AB - A prospective randomized trial was conducted comparing the effect of three antibiotics: cefamandole (CM), cefazolin (CZ), and vancomycin (V), used as prophylaxis for prosthetic valve surgery, on the prothrombin (PT) response to warfarin (W) on the third day of anticoagulant therapy. Twenty patients, with normal preoperative PTs, were randomized to each antibiotic. Their PTs were not significantly different at 2 hours after operation and the morning before W was begun. The three groups received similar W doses for 2 days, and the PT, as percentage of activity, on the morning of the third day demonstrated that V (51 +/- 18%) was significantly greater (p less than 0.005) than CM (29 +/- 14%) or CZ (38 +/- 18%). CM had a significantly greater percentage of change in PT (64 +/- 14%, p less than 0.0001) from the first to third day than either CZ (51.1 +/- 18%) or V (44.6 +/- 19%). CM also had a greater number of patients (6) with PTs greater than or equal to 30 seconds on day 3 than either CZ (1) or V (1). The antibiotic influence on the PT response to W in this study is ranked as CM greater than CZ greater than V. PMID- 3300582 TI - Mechanical assistance for cardiogenic shock following cardiac surgery, myocardial infarction, and cardiac transplantation. AB - From January, 1982, to October, 1986, 33 patients were treated with either the Pierce-Donachy prosthetic ventricle or the Bio-Medicus ventricular assist device for cardiogenic shock following a cardiac operation, myocardial infarction, or cardiac transplantation. Twenty-five patients required the assistance for postcardiotomy shock and 8, for a variety of conditions including myocardial infarction shock and myocarditis, and as a bridge to cardiac transplantation. Complications were frequent and usually secondary to prolonged cardiopulmonary bypass. Results were poorest in the group with postcardiotomy shock. Earlier application of an assist device could lead to more frequent survival and avoidance of the detrimental effects of prolonged extracorporeal circulation. PMID- 3300584 TI - Willis J. Potts: his contributions to cardiovascular surgery. PMID- 3300583 TI - Blood conservation with membrane oxygenators and dipyridamole. AB - Cardiopulmonary bypass induces platelet activation and dysfunction, which result in platelet deposition and depletion. Reduced platelet numbers and abnormal platelet function may contribute to postoperative bleeding. A membrane oxygenator may preserve platelets and reduce bleeding more than a bubble oxygenator, and the antiplatelet agent dipyridamole may protect platelets intraoperatively and reduce bleeding postoperatively. A prospective randomized trial was performed in 44 patients undergoing elective coronary artery bypass grafting to assess the effects of the membrane oxygenator and dipyridamole on platelet counts, platelet activation products, and postoperative bleeding. Patients who were randomized to receive a bubble oxygenator and no dipyridamole had the lowest postoperative platelet counts, the greatest blood loss, and the most blood products transfused. Platelet counts were highest and blood loss was least in patients randomized to receive a membrane oxygenator and dipyridamole (p less than .05). A bubble oxygenator with dipyridamole and a membrane oxygenator without dipyridamole resulted in intermediate postoperative platelet counts and blood loss. Arterial thromboxane B2 and platelet factor 4 concentrations were elevated on cardiopulmonary bypass in all groups. Both the membrane oxygenator and dipyridamole were independently effective (by multivariate analysis) in preserving platelets. Optimal blood conservation was achieved with a membrane oxygenator and dipyridamole. PMID- 3300585 TI - Spontaneous coronary artery dissection. AB - Spontaneous coronary artery dissection is a rare event that occurs most commonly in young, otherwise healthy women. Approximately 85 cases have been reported in the world literature. Dissection of the left main coronary artery is even less common; only 18 cases have been reported. This review discusses the incidence, presentation, pathogenesis, and management of spontaneous coronary artery dissection. The case of another patient with left main coronary artery dissection is described; to our knowledge, it is the first to be successfully treated by internal mammary artery bypass grafting. PMID- 3300586 TI - Nephrotoxicity of common drugs used in clinical practice. AB - Drug-induced nephrotoxicity is an increasingly recognized complication of a wide variety of therapeutic agents. The nephrotoxicity of three of the most commonly used drug groups are reviewed in this article. They include antibiotics, radiocontrast agents, and nonsteroidal anti-inflammatory drugs. Since the clinical spectrum of drug-induced nephrotoxicity is broad, it is imperative that the clinician recognize these nephrotoxic syndromes while they are reversible with discontinuation of the offending drug. PMID- 3300587 TI - Clonidine vs chlordiazepoxide in the management of acute alcohol withdrawal syndrome. AB - To our knowledge, this is the first reported comparison of clonidine with benzodiazepine in the management of acute alcohol withdrawal syndrome. In a double-blind trial, 61 men experiencing acute alcohol withdrawal were randomly assigned to receive clonidine or chlordiazepoxide over a 60-hour treatment period. Clonidine was more effective than chlordiazepoxide at reducing alcohol withdrawal scale scores, systolic blood pressures, and heart rates over the entire study period. Clonidine was as good as chlordiazepoxide at improving Cognitive Capacity Screening Exam, Hamilton Anxiety Rating Scale, and Self-Rating Scale scores. Adverse drug reactions reported by each group were similar, though less nausea and vomiting were observed in the clonidine group. Clonidine may represent a new alternative agent for the management of acute alcohol withdrawal syndrome. PMID- 3300588 TI - Serum transaminase levels and cholescintigraphic abnormalities in acute biliary tract obstruction. AB - Twenty-five patients presenting to the hospital with symptoms suggestive of acute biliary tract disease were noted to have a characteristic pattern of transaminase and cholescintigraphic abnormalities. There was marked variability in the initial serum transaminase levels; however, 16 patients had aspartate aminotransferase levels greater than 300 IU, and 19 patients had alanine aminotransferase values greater than 300 IU. Regardless of the initial values, there was a 76% (aspartate aminotransferase) and 58% (alanine aminotransferase) reduction in transaminase levels within 72 hours, prior to therapeutic relief of bile duct obstruction. In ten patients with common bile duct obstruction, cholescintigraphy revealed no excretion of technetium Tc-99m-labeled iminodiacetic acid, for up to two hours after injection, into the extrahepatic biliary tract or small bowel. Common bile duct stones were present in 16 patients, five patients had acute pancreatitis, and four patients were thought to have spontaneously passed common duct stones. We believe that high transaminase levels may be found in patients with obstructive biliary tract disease, sequential measurements of transaminase levels may provide an important diagnostic clue for biliary tract disease, and nonexcretion of radionuclide on cholescintigraphy may be a feature of acute bile duct obstruction. PMID- 3300589 TI - Xerostomia. A neglected symptom. AB - Xerostomia, the subjective feeling of dry mouth caused by a severe reduction in the flow of saliva, is a common problem that is particularly prevalent among the aged. It has become increasingly evident that dry mouth is associated with a number of serious systemic conditions and diseases. Among these are the intake of commonly prescribed medications, autoimmune diseases, and irradiation to the head and neck. The diminution in the flow of saliva may profoundly affect oral health, disturb digestion and speech, and seriously impair the patient's quality of life. Food avoidance, nonabsorption of sublingually placed drugs, and noncompliance with medication may also result. Sialometry can be used to confirm the presence of dry mouth. Treatment is aimed at increasing the flow of saliva, when possible, or providing oral moisture by other means. PMID- 3300590 TI - [Creutzfeldt-Jakob disease in Tenerife]. PMID- 3300591 TI - [Orienting studies on the ovulation-inducing effect of the gonadotrophin releasing analog D-Phe6-LH-RH in rabbits]. PMID- 3300592 TI - Molecular biology and the pathologist. General principles and applications. AB - This review article contains two parts. In the first part, molecular biological principles and techniques are discussed. These include nucleic acid isolation, restriction endonucleases, various types of hybridization methods, and restriction fragment-length polymorphisms. The second section focuses on the application of these techniques to genetic analyses, microbiological diagnosis, cell differentiation, and tumor biology. It is our hope to provide the reader with a broad understanding of the tools and an appreciation of their applications. PMID- 3300593 TI - New techniques in gene product analysis. AB - Many of the new technologies that have developed as a result of advances in cellular and molecular biology, genetics, and immunology have had a major impact in clinical medicine and will continue to provide important diagnostic and investigative tools in the future. The ability to localize a wide variety of gene products in tissues has been accomplished largely through the use of immunohistochemistry. Characterization of gene expression at the levels of specific messenger RNAs and genomic DNAs is now possible through the use of both blot and in situ hybridization techniques. These molecular biological technologies provide important new approaches for understanding the pathobiology of disease and for providing more objective and rational diagnostic and prognostic criteria in biopsy specimens. The pathologist is in a unique position to coordinate, implement, and lead efforts utilizing these new methods for the study of human disease. In addition, the pathologist must assume a leadership role in the assessment of the efficacies of the new technologies in resolving specific clinical problems and in providing novel approaches for clinical and basic research. PMID- 3300595 TI - Triceps spasticity in traumatic hemiplegia: diagnosis and treatment. AB - Three patients with adult-acquired hemiplegia are described with the unusual dynamic deformity of spasticity of the triceps muscle. This deformity produces motor imbalance with the triceps overpowering the elbow flexors, thus impeding volitional elbow flexion. The nature of the deformity was defined by electromyography of the muscle groups about the elbow, which demonstrated out-of phase inhibitory electrical activity of the triceps muscle. Treatment consisted of V-Y lengthening of the triceps muscle to achieve agonist-antagonist motor balance. The operation improved hand placement for all three patients. PMID- 3300596 TI - Recent data concerning bacteriocin-bacteriophage interrelationship. PMID- 3300594 TI - Effects of acetylsalicylic acid on intramuscular bone matrix implants and composite grafts in rats. AB - Antigen-extracted, autolyzed, demineralized bone matrix and bone matrix combined with isogeneic bone marrow (i.e., a composite graft) were placed in the musculature of young male rats. The influence of acetylsalicylic acid (ASA) on the osteogenic potential of these bone-inducing materials was studied during an 18-day period. ASA (150 mg/kg/12 h) was used to obtain anti-inflammatory serum levels comparable with those in humans. Resorption of the implanted matrix and new formation of bone were quantified using collagen- and mineral-tracing radioisotopes and collagen and calcium analyses. The matrix implants showed a slow tissue turnover and produced only small amounts of new bone, with no significant differences between ASA-treated and control rats. However, during the last 24 h of the study the ASA-treated implants had a significantly hampered rate of new bone formation. The tissue turnover and new bone yield, as well as the rate of new bone formation, increased in the control composite grafts but not in the ASA-treated composite grafts. Thus, the results indicate an inhibitory effect of ASA on the bone-forming capacity of bone marrow. PMID- 3300597 TI - Experimental study on "the postvaccinal negative phase" in the Salmonella typhimurium infection of the mouse. PMID- 3300599 TI - Surveillance of the infections and carriers with group B streptococci in the period 1982-1986. PMID- 3300598 TI - Live dysentery vaccine "Vadizen" (T32-Istrati) immunogenicity against Shigella like challenge in animals. PMID- 3300600 TI - Ultrastructural study on the bacterial symbiont in Giardia lamblia. PMID- 3300601 TI - Factors related to sexual functioning in male patients undergoing hemodialysis and with kidney transplants. AB - The sexual functioning of 13 male patients undergoing renal dialysis and 13 male patients who had received kidney transplants was compared. Standardized interviews were used to assess the frequency of intercourse before illness, during dialysis, and after transplantation and to assess sexual difficulties experienced during these periods. In addition, plethysmographic recordings of erection levels were obtained for three dialysis and three transplant patients at eight separate time periods corresponding to particular points in the dialysis cycle. Assessments of depression and anxiety (IDA scale) and renal functioning (Marital Patterns Test) were also carried out. Dialysis patients were less able to gain and maintain erections than transplant patients and intercourse was less frequent for couples where the husband was on dialysis. Dialysis patients were more depressed than transplant patients, although transplant patients showed greater levels of anxiety. More marital difficulties were experienced by patients on dialysis than patients who had received transplants. The implications of these findings for the treatment of sexual problems in these patients are discussed. PMID- 3300602 TI - Psychological findings in early treated cases of female pseudohermaphroditism caused by virilizing congenital adrenal hyperplasia. AB - Nine female adolescents with female pseudohermaphroditism resulting from virilizing congenital adrenocortical hyperplasia (CAH) were studied in terms of gender identity, sex-role behavior, psychological adjustment, and psychosexual development. A group of adolescents with chronic illness was used as a control. The Draw-A-Person, the Bem Sex-Role Inventory, Rorschach, TAT, and a questionnaire reviewing peer and romantic activities were administered to both groups. The two groups were comparable on measures of general personality adjustment, with the CAH girls showing a trend toward greater bodily concerns. Sex-role identity for both groups was near the adolescent girl norms for both Femininity and Masculinity, with virilized CAH girls showing slightly higher Androgyny scores. Significant differences were found on gender identity as measured by greater differentiation of the drawn male figure as well as a trend toward drawing the male figure first. The CAH females also showed consistent patterns of psychosocial delay in dating and sexual relations as compared to the control group. Gender identity in this group appears to be mediated by body image. The resulting ambivalence may be evidence of feelings of incompetence, leading to resistance to social interactions and goals involving intimacy and nurturance. PMID- 3300605 TI - [Origin of mast cells and cell differentiation]. PMID- 3300603 TI - Study of canine parvovirus polypeptides by immunoblot analysis. AB - The immunoblot analysis of canine parvovirus (CPV) polypeptides with 47 rat monoclonal antibodies (RH) has revealed four different types of reaction. Many of these antibodies do not recognize the electroblotted proteins. However, among these monoclonals that do react, 12 recognize all three viral polypeptides (VP67, VP70 and VP85), 3 recognize preferentially the VP85 and one is exclusively directed against VP70. Thus, three antigenic regions are proposed which correspond to domains of the CPV polypeptides. In addition, these results together with evidence for the biological activities of the monoclonals suggest that the C and N terminals of VP85 are exposed at the surface of the viral particle. PMID- 3300604 TI - [Time course of airway hyperresponsiveness and polymorphonuclear leukocyte counts in bronchoalveolar lavage fluid following endotoxin inhalation]. PMID- 3300606 TI - [Fall of the respiratory resistance curve in the inhalation test with methacholine using the Astograph in spite of bronchial constriction]. PMID- 3300607 TI - [Immunological studies on insulin-dependent diabetes mellitus (IDDM). I. Natural killer (NK) cell activity]. PMID- 3300608 TI - [The fate of the blastocele and homology of early stages of vertebrate embryos]. AB - A disputable problem is discussed, which cavity in the Amniota embryo corresponds to blastocoele. General morphophysiological characteristics of the embryos at the blastula stage are presented. Basing on comparative survey of the data on origin, functions and fate of the blastocoele in development of vertebrate embryos, the notion is substantiated that the subembryonal cavity corresponds to blastocoele in Amniota. A critical analysis is given to another interpretation, according to which blastocoele in Amniota is a cleft between epi- and hypoblast. Ideas on homology criteria are explained, with a reference to initial stages of the embryonal development. Since prospective importance of blastocoele in low Chordata (convertion into gastrocoele) is different, a conclusion is made about incomplete homology of blastocoele in the animals mentioned. A hypothesis is put forward on pathways of changes of prospective importance of blastocoele in the vertebrate phylogenesis, in connection with their transition to meroblastic development. The problem on changes in assimilation of yolk by the vertebrate embryo at transition from holoblastic to meroblastic development is discussed from comparative point of view, as well as on nature of yolk entoderm in Amniota and Anamnia. PMID- 3300610 TI - [Numerical projection effect and measurement of the number of sections in histological slices]. PMID- 3300609 TI - [Ultrastructure of cells from the liver-endocrine pancreas system in hibernating animals]. AB - In hibernated ground squirrel (Citellus erythrogenys) during various periods of hibernation morphological changes in organs participating in insurance of energoplastic homeostasis (liver, endocrine part of the pancreas) have been followed. At the beginning of hibernation certain signs of functional strain in the liver are observed-shortening and swelling of the endoplasmic reticulum (ER) canaliculi, decreases of glycogen resources and activation of the lysosomal apparatus, as well as certain features demonstrating its decreased activity- shortening cisterns in the Golgi complex, poorly manifested granular ER, tightening of mitochondrial matrix. At a deep hibernation, the signs of strain disappear, ultrastructure of hepatocytes corresponds to a new lower level of functioning in comparison to that in the active state and at the beginning of hibernation. During these periods the structure of endocrine cells in the pancreas demonstrates certain changes in the character of functioning of the cells. Ultrastructural transformations in the liver and endocrine part of the pancreas in the ground squirrel are mutually correlated. PMID- 3300611 TI - [Role of opportunistic fungi in human pathological anatomy]. AB - The role of opportunistic fungi (OF) in modern human pathology is discussed in connection with the increased incidence of mycotic infections caused by these organisms. Due to a complex of biological properties, OF are able to survive both in the environment and in human body, exhibiting their pathogenic potential when the body defenses are compromised. The highest frequency of infections caused by OF is encountered in the presence of risk factors (immunodeficiencies, endocrinopathies, oncological and hematological diseases, organ transplantation, antibiotic and corticosteroid therapy, infancy and pregnancy). The spectrum of lesions caused by OF encompasses practically all organs and systems. Being a secondary process, mycotic infection may either have no influence on the primary process, or aggravate it. In most severe cases it may overbalance the importance of the underlying disease. Cytohistological methods play a special role in the diagnosis of mycotic infections, as they are able to reveal the invasive process, evaluate its extent and the characteristics of host defense responses. PMID- 3300612 TI - [Neurospecific proteins: potentials and prospects for their use in morphological research on tumors]. AB - Data on the application of neurospecific proteins S-100, GFAP, D2 glycoprotein and neuron-specific enolase (NSE) in the differential tumor diagnosis are reviewed. S-100 protein and GFAP are found in well differentiated astroglial tumors. S-100 protein can be used as melanoma and Schwannoma specific marker. In malignant CNS tumors there is a decrease of S-100 protein content up to its complete disappearance, while the content of GFAP is variable. D2 glycoprotein is detected in gliomas and medulloblastomas, being absent in other brain tumors. NSE is invariably present in apudomas and was also found in the majority of investigated astrocytomas, ependymomas, glioblastomas and in some medulloblastomas. PMID- 3300613 TI - [Behavior of the indirect immunofluorescence reaction and of cerebrospinal fluid parameters in neurocysticercosis]. AB - Cerebrospinal fluid from 53 patients with clinical evidence of neurocysticercosis and 11 who suffered from several diseases were studied to evaluate the behaviour of indirect immunofluorescence test and some parameters of routine analysis. In neurocysticercosis there were pleocytosis in 88.7% of cases, eosinophilorrachia in 60.3%, hyperproteinorrachia in 71.7% and hypoglucorrachia in 13.2%. The indirect immunofluorescence test was positive in 79.2% of cases but false positive results were found when the samples showed xanthochromia or erythrocyte contamination. The authors discuss their results in comparison with those in literature and conclude that the immunofluorescent test is sensitive and useful in diagnosis of neurocysticercosis, except when the interferents previously mentioned are present. PMID- 3300614 TI - [Creutzfeldt-Jakob disease: report of a case]. AB - A case of Creutzfeldt-Jakob disease (CJD) in a 76 year-old man is presented. The clinical picture included a rapid progressive dementia associated with ataxia, global aphasia, myoclonus and pyramidal signs; death occurred after about 4 months. There was an antecedent of chemical trauma caused by plant liquid on right eye 12 to 18 months before. The electroencephalogram showed diffuse slow activity and the neuropathological findings were typical. The detection of a protein called "prion" or PrP27-30 in the scrapie and the finding that some proteins isolated from brain of patients with CJD have reacted with antibodies raised against it have improved the knowledge about the infectious agent. The recent reports of young patients with CJD after human growth hormone therapy prepared from pools of pituitary glands obtained at autopsy are alarming and probably new cases will be described. PMID- 3300615 TI - Topical vs systemic gentamicin penetration into the human cornea and aqueous humor. AB - Twenty-two patients undergoing penetrating keratoplasty received either topical fortified gentamicin (13.6 mg/mL) or a loading dose of intramuscular gentamicin before surgery. Cornea and aqueous humor samples were obtained and assayed by radioimmunoassay for gentamicin. In the topical group, the average gentamicin levels in the cornea and aqueous were 16.2 micrograms/g and 0.3 microgram/mL, respectively. Parenteral drug levels were less variable and averaged 6.1 micrograms/g in the cornea and 0.4 microgram/mL in the aqueous. Although this study demonstrates that parenteral therapy can be used to deliver adequate drug levels to the cornea, it requires far more antibiotic and subjects the patient to potentially toxic systemic side effects. Therefore, topical administration is the preferred route of delivery of antibiotic to the cornea. PMID- 3300616 TI - Refractive keratoplasty for disabling astigmatism after penetrating keratoplasty. AB - Postoperative astigmatism is one of the major limitations of penetrating keratoplasty. In an attempt to reduce postkeratoplasty astigmatism, we combined corneal-relaxing incisions with orthogonal compression sutures, guided by the intraoperative use of a ring keratometer. Eleven consecutive patients from a mixed referral population with functionally disabling astigmatism were studied. The average preoperative keratometric cylinder of 11.68 diopters was reduced by 7.95 (+/- 3.03 SD) diopters. Each patient's net keratometric cylinder was reduced. We believe that this technique is safer and more predictable than previously published techniques. PMID- 3300617 TI - Correlates of high density lipoprotein cholesterol and apolipoprotein A-I levels in children. The Bogalusa Heart Study. AB - Levels of high density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apo A-I) may provide independent information concerning cardiovascular disease risk. Therefore, possible correlates of HDL-C and apo A-I levels were studied in 2827 5- to 17-year-olds from a biracial community, and the possible differences in these relationships were assessed. The characteristics examined included sexual maturation, plasma levels of glucose and insulin, obesity, reported oral contraceptive use, alcohol consumption, and cigarette smoking. In addition, levels of endogenous sex hormones (testosterone, estrogen, and progesterone) were measured in 515 adolescent males. HDL-C and apo A-I levels showed different (p less than 0.001) relationships with both obesity and oral contraceptive use. Increases in subscapular skinfold thickness corresponded more closely to decreases in HDL-C, rather than apo A-I, levels; the relationship with HDL-C was probably mediated by triglyceride levels. In contrast, oral contraceptive use was associated with increases in mean levels of apo A-I (8 mg/dl, whites; 16 mg/dl, blacks), but with only very small changes in HDL-C. (High-estrogen oral contraceptives were related most closely to increases in levels of both HDL-C and apo A-I). Levels of both HDL-C and apo A-I were similarly related to sexual maturation and levels of testosterone (negatively in boys), cigarette smoking (negatively), and alcohol intake (positively). Since levels of apo A-I independently of HDL-C may indicate an increased risk of cardiovascular disease, characteristics related to apo A-I levels should be further examined. PMID- 3300618 TI - Production of plasminogen activators and inhibitor by serially propagated endothelial cells from adult human blood vessels. AB - Endothelial cells were isolated from arteries and veins obtained from elderly people at autopsy and propagated for 37 to 69 population doublings. The cells secreted tissue-type plasminogen activator (t-PA) and PA inhibitor-1, and, after subculturing, urokinase-type PA (u-PA) antigen. The following differences between endothelial cells from adult arteries and veins were observed: 1) The cells had the potential to be propagated as a healthy monolayer. The diameter of aortic endothelial cells increased after 8 to 19 population doublings, while a homogeneous population of small diameter vena cava cells was retained for 35 population doublings. 2) The amount of secreted t-PA varied. Vena cava cells produced four times more t-PA than aorta cells, and 20-fold more than umbilical artery or vein endothelial cells. The t-PA mRNA content of vena cava cells did not exceed that of aorta cells, but was fourfold greater than that of umbilical cord endothelial cells. 3) The release of u-PA antigen varied. No u-PA antigen was detectable in conditioned medium of primary cultures of human aorta and vena cava endothelial cells or of early passage vena cava cells. After prolonged subculturing, vena cava cells started to secrete u-PA. Endothelial cells from aorta and other adult arteries, however, started secreting u-PA after one to four passages, parallel to the occurrence of enlarged endothelial cells. u-PA was present as a u-PA/inhibitor complex and as a single-chain u-PA. These differences may be developmentally related to their artery or vein origin or may reflect differences acquired during the "life history" of these blood vessels in vivo. Our data suggest that the release of u-PA antigen by human macrovascular endothelial cells can be used as an indicator of cell senescence. PMID- 3300619 TI - Sex preselection--a review. PMID- 3300620 TI - Medical aspects of liver transplantation. PMID- 3300621 TI - Surgery for craniofacial deformities: recent advances in a challenging field. PMID- 3300622 TI - Bone grafting in cleft deformity: a craniofacial approach. PMID- 3300623 TI - Surgical treatment of the jaw deformities in hemifacial microsomia. AB - The surgical treatment of the mandibular and maxillary deformities in patients with hemifacial microsomia requires some form of mandibular lengthening. This is usually either via ramus interpositional bone grafting or end-on bone grafting. In a few cases, ramus lengthening may be completed by a sagittal split. Once the mandible has been reconstructed, the maxillary surgery can be completed. In previous forms of treatment, mandibular bone grafting was completed without regard to function and neuromuscular adaptation and a significant percentage of such procedures completed failed. Egil Harvold and his colleagues developed a method by which changes in form and function are co-ordinated by using a functional appliance resulting in neuromuscular adaptation. After the bone grafting is completed, as the second of six phases of treatment, a specially designed registration bite-block further facilitates neuromuscular adaptation by controlling mandibular movements (function), but in addition it protects the bone graft from excessive forces thereby aiding in osteogenesis (third phase). The theoretical basis, classification of deformities, and phases of treatment developed are presented and the surgery is described in detail. The results of a consecutive group of patients treated by these methods is then presented. While this form of treatment is not the only one possible, it is the only one that has been tested in the laboratory, proven in patient care, and stood the test of time. PMID- 3300624 TI - Breast pain: classification, aetiology and management. PMID- 3300625 TI - Monoclonal antibodies in surgery. PMID- 3300626 TI - Infectious bovine keratoconjunctivitis: seasonal variation in cultural, biochemical and immunoreactive properties of Moraxella bovis isolated from the eyes of cattle. AB - The eyes of 20 young cattle were examined over an 18 month period in which 12 members of the group contracted infectious bovine keratoconjunctivitis (IBK). On each of 23 occasions cultural, biochemical and immunoreactive properties of up to 6 isolates of Moraxella bovis derived from each eye were determined. Relationships between the clinical response of eyes, phenotypic properties of M. bovis and annual variations in the level of solar ultraviolet radiation of 280 to 320 nm wavelength were examined. M. bovis was isolated from all IBK-affected and some unaffected eyes less than one month after the maximum annual level of the mean weekly UV radiation (2,840 mWh.m-2 X nm-1) was recorded. A high proportion of M. bovis from IBK lesions were simultaneously active in haemolysis, agar corrosion, gelatin liquefaction and litmus milk peptonisation. Some of these characteristics showed marked dissociation despite consistent reactivity in the fluorescent antibody test, which had a sensitivity and specificity of 95%. Fall in the mean weekly level of UV radiation below 1,438 mWh X m-2 X nm-1 in autumn was accompanied by healing of ulcers, persistent scar formation and a decline in the number of M. bovis isolated from affected eyes. A slower decline in the number of M. bovis isolated from apparently healthy eyes occurred in the winter and occasional fresh IBK lesions occurred.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300628 TI - Influence of protein source and level on the utilization of proximate nutrients by the African giant rat (Cricetomys gambianus Waterhouse). AB - 16 African giant rats received in four groups over a period of 28 days a diet with a crude protein content of 20% based on groundnut cake (diet 1), palmkernel cake (diet 2), and a diet with a crude protein content of 17% based on palmkernel cake (diet 3), or 24% crude protein based on groundnut cake (diet 4). The best results were obtained by diet 2 with 12.3 g liveweight gain per day and 2.1 g feed/g liveweight gain. Diets 2 and 3 had a significantly higher liveweight gain per gram protein utilized. Diet 1 caused a significantly lower digestibility of the dry matter, the crude protein, the crude fibre, and the nitrogen-free extractive. Diet 2 yielded the most favourable protein source in economic terms. PMID- 3300627 TI - Effects of constant magnetic fields on the B-cells and insulin target cells in the rat. AB - Young male rats were exposed to constant uniform magnetic fields of 400 and 800 millitesia (mT). No changes were observed in the body and in the pancreas weight, in the pancreatic insulin content and in the in vitro insulin release of Langerhans islets, in glucose and insulin plasma levels. The magnetic fields abolished the insulin effect on glucose uptake of diaphragms, but not on 1-14C glucose oxidation. In adipocytes 400 mT increased insulin-stimulated 1-14C glucose oxidation, when expressed as percentage of mean basal oxidation, and 800 mT diminished it. PMID- 3300629 TI - Nutrients, platelet functions and coronary heart disease. PMID- 3300630 TI - Body content and distribution of water in healthy individuals. PMID- 3300631 TI - Thirst mechanism and its inhibition. PMID- 3300632 TI - [Insufficient consumption of water: effect on renal function]. PMID- 3300633 TI - Influence of (n-3) fatty acids on platelets and endothelial cells. PMID- 3300634 TI - Fish consumption and prevention of coronary heart disease. PMID- 3300635 TI - Platelet fatty acid metabolisms and their functions. PMID- 3300636 TI - Food fortification: the need for scientific contribution. PMID- 3300637 TI - Evolutionary relationships between laboratory mice and subspecies of Mus musculus based on the genetic study of pancreatic proteinase loci, Prt-1, Prt-2, Prt-3, and Prt-6. AB - Various patterns of mouse pancreatic proteinase activity bands were observed on agarose gel electrophoresis. Prt-1a and Prt-1b genes control the positive (PRT 1A) and negative (PRT-1B) expression of tryptic band V, respectively; Prt-2a and Prt-2b correspond to chymotryptic bands II (PRT-2A) and III (PRT-2B); Prt-3a and Prt-3b control the low (PRT-3A) and high (PRT-3B) tryptic activities of band IV; the Prt-1 and Prt-3 loci are closely linked on the same chromosome; Prt-6a and Prt-6b correspond to tryptic bands I (PRT-6A) and I' (PRT-6B). Twenty-four laboratory strains from the United States showed the phenotype PRT-1A, PRT-3A, and PRT-2A. Of laboratory strains established in Europe, 6 showed PRT-1A, PRT-3A, and PRT-2A, and 10 had PRT-1B, PRT-3A, and PRT-2A bands. Most wild mice around the world and their descendants showed the phenotype PRT-1B, PRT-3B, and PRT-2A. Only the phenotype of M. m. brevirostris was PRT-1A, PRT-3A, and PRT-2A, which was the same as most laboratory inbred strains. PRT-2B was observed mainly in Japanese (M.m. molossinus) and Korean (M.m. yamashinai) wild mice. PRT-6B was detected only in Mus spicilegus and Mus caroli, but all other mice including wild populations and laboratory strains showed PRT-6A. New biochemical phenotypes such as PRT-2C and PRT-3C were also found in this study. PMID- 3300638 TI - Effects of lactation and removal of pups on the rate of triacyglycerol/fatty acid substrate cycling in white adipose tissue of the rat. AB - The rate of the triacylglycerol/fatty acid substrate cycle was measured in vivo in adipose tissue of virgin and lactating rats with pups removed. The rate decreased by 70% in adipose tissue of lactating rats and increased 9-fold on removal of the pups. Similar differences in cycling rate were seen in adipose tissue incubated in vitro in the presence of isoprenaline. PMID- 3300639 TI - Effects of streptozotocin-diabetes and insulin administration in vivo or in vitro on the activities of five enzymes in the adipose-tissue triacylglycerol-synthesis pathway. AB - At 2 days after administration of streptozotocin (100 mg/kg), activities in rat epididymal fat-pads of the following enzymes were significantly decreased: fatty acyl-CoA synthetase (FAS), mitochondrial and microsomal forms of glycerolphosphate acyltransferase (GPAT), monoacylglycerolphosphate acyltransferase (MGPAT) and Mg2+-dependent phosphatidate phosphohydrolase (PPH). There were no significant changes in diacylglycerol acyltransferase or Mg2+ independent PPH. Insulin administration to diabetic rats over 2 days restored activities of FAS, both forms of GPAT, MGPAT and Mg2+-dependent PPH. Significant restoration of all five activities was also seen 2 h after a single administration of insulin, but was not observed 45 min after insulin treatment. Insulin significantly increased all five enzyme activities when adipocytes from diabetic rats were incubated for 2 h with a mixture of glucose, lactate, pyruvate and amino acids. PMID- 3300641 TI - Genetics of calcium-binding proteins in yeasts. PMID- 3300640 TI - Tissue-specific changes in the ability of insulin and noradrenaline to activate pyruvate dehydrogenase in vivo during lactation in the rat. AB - Changes are described in the total pyruvate dehydrogenase (PDH) activity, the proportion of PDH in the active state and its control by insulin and noradrenaline in vivo, in white adipose tissue, liver, skeletal muscle and mammary gland with pregnancy, lactation and on weaning. Lactation resulted in a decrease in total PDH in white adipose tissue and an increase in the mammary gland, whereas the proportion in the active state decreased in muscle and increased in the mammary gland. The ability of insulin to activate PDH of white adipose tissue was lost during lactation, whereas it was retained by the other tissues. The ability of noradrenaline to activate PDH was decreased in white adipose tissue but increased in liver during lactation. These various adaptations should limit the use of glucose and lactate carbon by adipose tissue and skeletal muscle during lactation and thereby facilitate their preferential utilization by the mammary gland. PMID- 3300642 TI - Production of an hEGF-like immunoreactive factor by human gastric cancer cells depends on differentiational state of the cells. AB - We have extended our recent observation that human gastric cancer cells (MKN-45) synthesize and secrete an hEGF-like immunoreactive factor (designated as EGF-LI) by characterization of EGF-LI produced by five human gastric cancer cell lines in culture. Two cell lines (MKN-45 and KATO-III) derived from poorly differentiated adenocarcinoma synthesized and secreted a much larger amount of EGF-LI than three cell lines (MKN-1, MKN-28, and MKN-74) derived from well-differentiated adenocarcinoma. Treatment of MKN-45 cells by retinoic acid reduced significantly synthesis and secretion of EGF-LI, suggesting that production of EGF-LI is dependent on differentiational state of gastric cancer cells. PMID- 3300643 TI - Cross-reaction of a plant protein kinase with antiserum raised against a sequence from bovine brain protein kinase C regulatory sub-unit. AB - The partly purified calcium-dependent, phospholipid-activated protein kinase from A. tricolor seedlings contains three major protein species (Mr = 84,500, 65,000 and 40,000) which cross-react with antiserum raised against the regulatory domain of bovine brain protein kinase C. Two of these species (Mr = 84,500 and 40,000) were phosphorylated when the preparation was incubated with [gamma-32P] ATP. It is suggested that the three cross-reacting proteins correspond to native enzyme, partly proteolysed enzyme and regulatory sub-unit respectively. PMID- 3300644 TI - Purification and partial characterization of dimeric dihydrodiol dehydrogenase from monkey kidney. AB - Dihydrodiol dehydrogenase activity was detected in the cytosol of several monkey tissues, among which kidney exhibited the highest activity and contained a high molecular weight (Mr approximately 65,000) enzyme species. The enzyme species was purified to apparent homogeneity and showed a subunit molecular weight of 39,000. The enzyme oxidized benzene dihydrodiol (Km = 0.9 mM) at a pH optimum of 9.8, and highly reduced vicinal diketones such as camphorquinone (Km = 0.1 mM) and diacetyl (Km = 0.8 mM) around pH 7.5, but alicyclic alcohols, hydroxysteroids and ketosteroids were inactive substrates for this enzyme. Quercitrin, SH-reagents, stilbestrol were inhibitory to the enzyme activity, but other synthetic estrogens, anti-inflammatory agents and 3-ketosteroids were not. PMID- 3300645 TI - Reversion of hydroxyurea resistance, decline in ribonucleotide reductase activity, and loss of M2 gene amplification. AB - A key rate-limiting reaction in the synthesis of DNA is catalyzed by ribonucleotide reductase, the enzyme which reduces ribonucleotides to provide the deoxyribonucleotide precursors of DNA. The antitumor agent, hydroxyurea, is a specific inhibitor of this enzyme and has been used in the selection of drug resistant mammalian cell lines altered in ribonucleotide reductase activity. An unstable hydroxyurea resistant population of mammalian cells with elevated ribonucleotide reductase activity has been used to isolate three stable subclones with varying sensitivities to hydroxyurea cytotoxicity and levels of ribonucleotide reductase activities. These subclones have been analyzed at the molecular level with cDNA probes encoding the two nonidentical subunits of ribonucleotide reductase (M1 and M2). Although no significant differences in M1 mRNA levels or gene copy numbers were detected between the three cell lines, a strong correlation between cellular resistance, enzyme activity, M2 mRNA and M2 gene copies was observed. This is the first demonstration that reversion of hydroxyurea resistance is directly linked to a decrease in M2 mRNA levels and M2 gene copy number, and strongly supports the concept that M2 gene amplification is an important mechanism for achieving resistance to this antitumor agent through elevations in ribonucleotide reductase. PMID- 3300646 TI - Mechanistic consequences of charge transfer systems in serine proteases and angiotensin: semiempirical computations. AB - Structures and relative energies for the triads of interacting groups in the serine charge relay system of serine proteases and the proposed tyrosine charge relay system of angiotensin II, respectively, were computed according to the standard MNDOC procedure. The most stable configuration obtained for both systems was one in which the histidine residue was negatively charged. These findings indicate that the histidine ring and not the serine hydroxyl group at the active site of serine proteases would be the nucleophilic center which is acylated by substrate. Similarly, the extreme nucleophilicity of the imidazole anion produced by the proposed triad of interacting groups in angiotensin could provoke the formation of a transient covalent bond (acyl intermediate) between receptor and peptide in the receptor activation mechanism. PMID- 3300647 TI - Insulin-dependent alterations of phorbol ester binding to adipocyte subcellular constituents. Evidence for the involvement of protein kinase C in insulin action. AB - The binding of tritiated phorbol-12,13-dibutyrate (3H-PBu2) was employed to estimate the mass of protein kinase C associated with plasma membranes and cytosol isolated from untreated and insulin-treated adipocytes. Binding of 3H PBu2 to both plasma membranes and cytosol was rapid, achieving a steady state within minutes. Treatment of cells with physiological concentration of insulin (0.67 nM) caused a 42% increase (from 0.92 +/- 0.08 to 1.30 +/- 0.12 pmol 3H PBu2/mg protein, p less than 0.0001) and a 27% decrease (from 0.41 +/- 0.07 to 0.30 +/- 0.05 pmol 3H-PBu2/mg protein, p less than 0.020) in phorbol ester bound to cytosol and plasma membranes, respectively. The half-maximal concentrations of unlabelled PBu2 needed to displace 3H-PBu2 bound to cytosol from control and insulin-treated cells were 54 and 13 pM, respectively. These data indicate that insulin modifies protein kinase C in adipocytes. PMID- 3300648 TI - Is EGF a physiological inhibitor of mouse mammary casein synthesis? Unphysiological responses to pharmacological levels of hormones. AB - It has been observed that EGF inhibits the induction of casein synthesis by mouse mammary tissue in vitro in addition to acting as a promoter of mammary epithelial proliferation. However, since the circulating level of EGF increases during lactation, and since functional EGF receptors are retained by the lactating cells, it seemed unlikely that EGF is an inhibitor of mammary differentiation in vivo. The current studies demonstrate, in fact, that EGF inhibits the induction of casein synthesis in vitro only when insulin is present in the culture medium at unphysiologically high concentrations. Other artifactual responses to high levels of hormones are described. PMID- 3300649 TI - Characterization of protein kinase C from normal and transformed cultured murine fibroblasts. AB - Protein kinase C of normal and ras-transformed NIH 3T3 cells was purified by chromatography on TSK DEAE-5PW, threonine-Sepharose, and TSK phenyl-5PW columns. Comparison of the fibroblast enzyme with several types of rat brain protein kinase C by chromatography on a hydroxyapatite column and by immunoblotting, indicates that both normal and transformed fibroblasts possess only one of the four subspecies of protein kinase C which have been identified in brain tissues. This subspecies presumably has the structure encoded by alpha-sequence or a closely related sequence. No significant difference was seen between those enzymes purified from normal and transformed fibroblasts. PMID- 3300650 TI - High-pressure infrared spectroscopic study of human proinsulin gene expression in live Escherichia coli cells. AB - Infrared spectra of E. coli strain JM103 and transformants which overproduced recombinant proinsulin have been measured as a function of pressure up to 38 kbar. It is the first time that high-pressure infrared spectra of live bacteria have been successfully measured. In ambient conditions, spectra of the host strain JM103 and the transformants are generally identical. However, under pressure, distinct shifting pattern can be observed in specific spectral parameters of transformants, presumably due to accumulation of proinsulin in form of cytoplasmic inclusion bodies. In particular, the pressure-induced frequency shift of the amide III band (1235 cm-1) in the proinsulin-producing transformants is much smaller than in the host JM103. This pressure effect can potentially be an efficient approach to monitor maximum gene expression in microorganisms. Contrary to predictions based on model system, the pressure-induced denaturation and the sharp transition from disordered liquid crystalline state to the ordered gel state commonly observed in the aqueous solution of protein and aqueous bilayer dispersion of lipids, respectively, do not occur in the bacterial proteins and cell membrane of E. coli. PMID- 3300651 TI - Microbore HPLC/mass spectrometry for the analysis of peptide mixtures using a continuous flow interface. AB - Microbore HPLC techniques have been combined with fast atom bombardment mass spectrometry to provide HPLC/MS capabilities for the analysis of mixtures of peptides and small proteins. The interface between the liquid chromatograph and mass spectrometer is a continuous flow direct insertion probe which contains a fused silica capillary that delivers the eluting solvent to the FAB source of the mass spectrometer at a rate of 5-10 microL/min. Data are presented for the analysis of several mixtures of peptides ranging in molecular weights from about 900 to 6000 daltons. In addition, the analysis of 100 pmol of a tryptic digest of whale myoglobin is shown where 16 of the possible 19 peptides were identified in the mass range m/z 2200-250. The advantages of this approach to HPLC/MS are a relatively high sensitivity because of the low flow rates and low background, and the ability to detect high molecular weight compounds. PMID- 3300652 TI - Ethanol as a neurotoxin. PMID- 3300653 TI - Insulin stimulation of adipocyte membrane glucose transport. A graded biologic response insensitive to bilayer lipid disordering. AB - Aspects of the mechanism by which insulin stimulates the membrane glucose transport system were examined by assessing the influence of the bilayer lipid structure on transport stimulation characteristics, and considering the form of the insulin dose-response curve. We tested the effects of membrane lipid perturbation on the insulin stimulation process. Benzyl alcohol, at concentrations (25 mM) that grossly fluidize lipids forming the adipocyte membrane bilayer matrix, caused 50% inhibition of intrinsic transporter activity. However, this membrane perturbation had no significant effect on either the insulin dose-response curve (conducted at 37 degrees) or the time-course of the insulin stimulation of hexose transport (conducted at 32 degrees). These data are difficult to rationalize in terms of a model in which transport stimulation involves interaction of transporters and hormone-bound receptors that is limited by lateral diffusion of these proteins in the fluid lipid bilayer. Curve-fitting experimental insulin dose-response data for stimulation of 2-deoxy-D-glucose and D-glucose uptake provided an estimate of an insulin "association constant" for transport regulation that may be compared with recent insulin receptor binding data. Similar magnitude constants were obtained whether estimated directly from plots of transport velocity versus arithmetic hormone dose, or by extrapolation from linear segments of sigmoidal velocity versus log dose plots, or from inverse (Lineweaver-Burk-type) plots of the insulin dose-response data. Insulin apparently regulates transport by associating with a binding site, having an apparent dissociation constant which is determinable through kinetic measurements of hexose uptake (KDapp approx. 17-40 pM). This is in good agreement with the dissociation constant, KD, determined from Scatchard plots of recent binding data to adipocytes, for a class of receptors representing the "high affinity" binding sites for insulin. Insulin dose-response curve simulations also indicated that the stimulation process may be classified in pharmacologic terms as a typical graded biologic response and may involve insulin association with a site that regulates transport rates in a manner kinetically analogous to allosteric modulation of a V-series enzyme by a noncompetitive ligand. From the results we suggest that a relatively close association occurs between transport and receptor proteins in the membrane, where the relative activation of transport depends on the fractional occupancy of functional high affinity receptors by insulin, and the insulin stimulation of transport involves regions of the membrane that are not influenced significantly by PMID- 3300654 TI - Castanospermine: an apparent tight-binding inhibitor of hepatic lysosomal alpha glucosidase. AB - Castanospermine is a potent inhibitor of rat hepatic lysosomal alpha-glucosidase in vitro. The alkaloid showed time-dependent inhibition with an IC50 of 5 X 10( 6) M without preincubation and 1 X 10(-7) M with 1 hr of preincubation. Inhibition appeared competitive without preincubation but noncompetitive after preincubation. The time-dependent inactivation of the enzyme followed pseudo first-order kinetics with an inactivation constant of 1.2 X 10(3) M-1 sec-1. The apparent irreversibility of enzyme inhibition by castanospermine is postulated to be by tight-binding inhibition. PMID- 3300655 TI - Phospholipase A2: function and pharmacological regulation. PMID- 3300656 TI - S-adenosylhomocysteine hydrolase inhibitors as broad-spectrum antiviral agents. PMID- 3300657 TI - Diclofenac binding to human polymorphonuclear neutrophils: effect on respiratory burst and N-formylated peptide binding. AB - The respiratory burst of human polymorphonuclear neutrophils (PMN) induced by particle or soluble stimuli was measured in the presence of the nonsteroidal anti inflammatory drug, diclofenac sodium (Voltaren). Diclofenac (25-100 micrograms/ml) inhibited the oxygen consumption of PMN stimulated by 5 X 10(-7) M of N-formyl-methionyl-leucyl-phenylalanine (FMLP). The inhibition was linearly correlated to diclofenac concentration. By contrast, diclofenac did not affect the rate of heat-killed Klebsiella pneumoniae ingestion of PMN, or the PMN O2 uptake induced by (0.67 microgram/ml) serum-opsonized zymosan or (1 microgram/ml) phorbol myristate acetate (PMA). The PMN production of superoxide anion induced by various FMLP concentrations (10(-7), 10(-6) and 10(-5) M) was also decreased by diclofenac. However, this inhibition declined when the formylated peptide concentration was raised suggesting that diclofenac could alter FMLP binding to the PMN membrane. Binding experiments of tritiated FMLP to intact PMN performed at 22 degrees and 4 degrees showed high- and low-affinity FMLP sites with dissociation constant (Kd) values of approximately 2 X 10(-8) M and 10(-5) M respectively. Diclofenac did not significantly alter the low-affinity component but induced modifications of the high-affinity component which were different at 22 degrees and 4 degrees. At 22 degrees only the dissociation constant value was enhanced by diclofenac (competitive inhibition) whereas at 4 degrees both binding parameters (i.e. dissociation constant and number of available binding sites) were modified (mixed inhibition). Diclofenac was also shown to bind to PMN with a low affinity. This binding was not diminished at 4 degrees by various concentrations of FMLP which even increased the number of diclofenac binding sites on PMN at 22 degrees. These data suggest that diclofenac binding to PMN may decrease FMLP-induced PMN respiratory burst by interfering with the peptide recognition by specific FMLP receptors. PMID- 3300658 TI - [The synthesis of specific enzyme inhibitors]. AB - The review deals with directed synthesis of specific enzyme inhibitors. They are classified within the framework of the mechanistic approach, namely, stable analogues of substrates, which form enzyme complexes mimicking the Michaelis complex or those which influence the chemical stages of enzyme catalysis; conformational inhibitors; substrate analogues participating in enzyme reactions and producing modified products; suicide inhibitors; stage inhibitors (inhibitors influencing certain stages of enzyme reaction); transition state analogues; multisubstrate analogues and collected substrates. Types of chemical modification used in synthesis of the specific inhibitors are discussed. Some possibilities of the quantity structure-activity relationship methods, computer modelling and molecular graphics in designing the optimal structure of inhibitors are mentioned. PMID- 3300660 TI - Rheumatoid nodules of the spine: case report and review of the literature. AB - We present the case of a patient who had rheumatoid nodules of the vertebrae, which had resulted in bony destruction of the spine at 3 levels. Although there have been only 3 previous reports of such findings with confirmation by histologic analysis, we believe the condition is more common than has been thought. From a review of the literature, we found that similar clinical and radiographic features, as well as descriptions of rheumatoid granulation tissue invading the disc spaces, have been described in several subjects. PMID- 3300659 TI - [Highly selective affinity labeling of a promoter in a complex with E. coli RNA polymerase by alkylating derivatives of initiating substrates]. AB - The complex [promoter A2 X E. coli RNA polymerase] was treated with phosphoamides, derivatives of 4-[N-methyl, N-(2-chloroethyl)]-aminobenzylamine and guanosine-5'-mono-, di-, and triphosphates with the alkylating group attached to the terminal phosphates. After this, [alpha-32P]CTP was added. Residues of the affinity reagents bound covalently at the first stage were elongated by radioactive -pC residues due to the catalytic action of the active centre of RNA polymerase. Affinity labelled were beta-and sigma-subunits of the enzyme, and the promoter. The affinity label was localized on -pGpC residues. A guanine residue was alkylated in the promoter as suggested by radioactivity elimination kinetics. As the data obtained and the previously known length of the reagent (maximum distance between the alpha-phosphorus atom of the reagent and the point of alkylation is less than 0.6 nm) indicate, there is a direct rather than protein mediated contact between the template and the substrate within the complex [promoter X RNA polymerase]. PMID- 3300661 TI - Response to the editorial by Terasaki and Yu on the ankylosing spondylitis/Klebsiella/HLA-B27 problem. PMID- 3300662 TI - Calcium antagonists and blood glucose in normal rabbits. AB - The effects of the calcium antagonists verapamil and nifedipine on blood glucose levels, glucose tolerance, insulin secretion during glucose tolerance and hypoglycaemic effect of tolbutamide were studied in normal nondiabetic rabbits. Daily dosage of 40 mg/kg verapamil and 5 mg/kg nifedipine given orally up to 7 days did not affect blood glucose level, glucose tolerance, insulin secretion during glucose tolerance and hypoglycaemic activity of tolbutamide 250 mg/kg p.o. PMID- 3300663 TI - Nitrendipine-stimulated release of prostacyclin-like substance in normal and atherosclerotic animals. AB - Nitrendipine (Bayotensin) is a dihydropyridine derivative that appears to preferentially dilate peripheral vessels by a cellular mechanism similar to those found with other calcium blocking agents. In this study nitrendipine when infused (0.2-0.3 mg/kg i.v.) into anaesthetized cats caused a release of a substance disaggregating platelet clumps which had adhered to blood superfused collagen strip. The appearance of this unstable disaggregating substance was prevented by the pretreatment of cats with acetylsalicylic acid (50 mg/kg i.v.). In atherosclerotic rabbits nitrendipine stimulated release of prostacyclin-like substance without effect on proaggregatory concentrations of arachidonic acid and adenosine diphosphate. In rats nitrendipine inhibited the development of atherosclerotic changes in the aorta evoked by the atherogenic diet with ergocalciferol (vitamin D2). It is suggested that nitrendipine may promote formation of prostacyclin in arteries and inhibit the development of atherosclerosis. PMID- 3300664 TI - Thymostimulin in the treatment of hepatitis B surface antigen-positive chronic active hepatitis. Controlled clinical trial--two years follow-up. AB - In this paper results obtained with thymostimulin (TP-1 Serono) in patients with hepatitis B surface antigen (HBsAg)-positive chronic active hepatitis after 2 years follow-up are reported. The favourable trend observed in a previous trial was confirmed after a longer observation period, most patients showing a significant amelioration of clinical, biochemical and histological parameters, with respect to control group. Hepatitis B virus (HBV) serology, too, showed a significantly higher rate of seroconversion and antigen disappearance in treated patients. Finally, hospitalization period of the latter was significantly lower. These results, though obtained in a small population of patients, seem to indicate a role for thymic hormone therapy in the management of chronic active hepatitis. PMID- 3300665 TI - Research dollars for speech-language-hearing. PMID- 3300666 TI - Curriculum approaches to multicultural professional education in communicative disorders. PMID- 3300667 TI - High density lipoprotein subfractions during continuous insulin infusion therapy. AB - This study compared the effects of continuous subcutaneous insulin infusion (CSII) and conventional insulin therapy (CIT) on serum lipid and lipoprotein levels in type I diabetic patients during 1 year cross-over study (6 months on CSII and 6 months on CIT). The study group consisted of 28 normolipidemic and nonobese diabetic patients (14 males and 14 females) aged 31 +/- 2 yr. The glycemic control was moderate (HbA1 10.2 +/- 0.3%) before starting the study. During the first 6 months, the HbA1 level fell significantly in the CSII group (from 10.4 +/- 0.5% to 9.8 +/- 0.4%, P less than 0.05), but remained unchanged in patients on CIT. During the second 6 months after cross-over no significant alterations in HbA1 levels were observed in either group. HDL-cholesterol (HDL chol) rose by 38% during the first 6 months in the patients using CSII (P less than 0.001) and by 18% in the CIT group (P less than 0.005). The rise in HDL-chol was accounted for by an increase in both HDL2-chol and HDL3-chol subfractions. Following the shift from CIT to CSII, HDL2-chol rose further (P less than 0.05), whereas HDL3-chol remained unchanged. When CSII was changed to CIT, the HDL3-chol level decreased (P less than 0.02), but HDL2-chol remained constant. There was no correlation between HDL-cholesterol and HbA1 levels or between the changes in either variable. HDL2-chol was 35% higher in females when compared to males at entry, and it rose in both sexes during CSII. HDL3-chol elevated during CSII only in females. CSII or CIT treatments did not cause significant changes in cholesterol or triglyceride levels of VLDL or LDL lipids during the study. Thus, even a mild improvement in glycemic control during CSII is associated with a rise in HDL-chol, particularly the HDL2 subfraction. PMID- 3300668 TI - A familial basis for the heterogeneity in coronary atherosclerotic disease. AB - Miniature swine fed a high-cholesterol, high-fat diet demonstrated heterogeneity in the extent of coronary artery disease. Plasma cholesterol or lipoprotein concentrations as well as other known risk factors accounted for little of this heterogeneity. However, the majority of the variability could be accounted for by the familial predisposition to develop cardiovascular disease in the individual animal kindreds. This study strongly suggests that the enhanced rate of development of coronary atherosclerotic disease during hypercholesterolemia is more critically modulated by previously unrecognized genetic actors than by absolute plasma cholesterol concentrations. PMID- 3300669 TI - Effect of repeated endotoxin treatment and hypercholesterolemia on preatherosclerotic lesions in weaned pigs. Part 1. Scanning and transmission electron microscopic study. AB - Endothelial cell damage is considered to be the primary event in atherogenesis. In this study we compared the effects of mild hypercholesterolemia and repeated E. coli endotoxin infusions on the endothelial cells of the coronary arteries of the pig. We divided 24 pigs into 4 groups: I: controls on normal diet; II: normal diet and endotoxin treatment; III: fat-supplemented diet; IV: fat-supplemented diet and endotoxin treatment. The animals on a fat-supplemented diet showed the most frequent and most severe endothelial cell damage. The damage was less when this diet was combined with endotoxin treatment. Endotoxin reduced the serum total cholesterol level (P less than 0.01). The cholesterol level correlated very significantly (P less than 0.001) with endothelial damage of the coronary arteries. Mild hypercholesterolemia (s-cholesterol 5.68 mmol/l, controls 2.28 mmol/l) was thus associated with toxic effects in the endothelial cells. The E. coli endotoxin infusions did not have any cumulative effect on the lesions. PMID- 3300670 TI - The use of clinical, biochemical, and ultrasound parameters for the diagnosis of intrauterine growth retardation. AB - Fifty-four pregnant patients referred for nonstress testing with findings suggestive of intrauterine growth retardation (IUGR) were followed with serial biochemical determinations and ultrasound evaluations. Confirmation of IUGR was made in 18 of the neonates based on body weights below the 10th percentile. Stepwise discriminate function analysis was used to determine the factors most predictive of IUGR among several clinical, biochemical, and ultrasound parameters as well as their combinations. Only the determinations closest to the time of delivery were used in analysis. The presence of abnormal fetal ultrasound measurements had the highest predictive value. Prepregnancy weight improved the prediction slightly with a proportion of correct predictions increasing from 70 to 74%. Only the extremes of prepregnancy weight altered the prediction made on the basis of ultrasound. In contrast, no significant predictive value was demonstrated for weight gain, heavy cigarette smoking, hypertension, serum estriol, human placental lactogen, alpha-fetoprotein, or a decrease in amniotic fluid volume, either singly or in combination with other variables. PMID- 3300671 TI - Neonatal hypoglycemia associated with umbilical artery catheter positioned at the eighth to ninth thoracic vertebrae. AB - Previous reports of neonatal hypoglycemia have been associated with malpositioned umbilical cord artery catheters. Neonatal hypoglycemia in association with normally positioned umbilical artery catheter and responsive to catheter repositioning is reported for the first time. PMID- 3300672 TI - A randomized trial of induction at 42 weeks gestation versus expectant management for postdates pregnancies. AB - A randomized prospective clinical trial of induction of labor at 42 completed weeks gestation versus expectant management in postdates pregnancies was performed. The primary screening test was the 24-hr urinary estriol creatinine ratio. The cesarean section rate was high in both groups and did not differ statistically. Intervention by delivery at 42 weeks decreased the development of small for gestational age infants, but costs slightly more. Twenty-four-hour urinary estriol creatinine ratio determinations predicted fetal distress in labor, but could not predict postmaturity syndrome or infants who were small for gestational age. As expectant management did not differ from induction of labor at 42 weeks from the standpoint of maternal outcome, and as the cost difference was small, induction of labor at 42 weeks may be the preferred management as it improves infant outcome. PMID- 3300673 TI - Fetal giant hemangiolymphangioma: report of a case. AB - A hemangiolymphangioma is a malformation of both lymphatic and blood vessels. A case of giant hemangiolymphangioma with extensive fetal involvement is presented and considerations in the antenatal diagnosis of this anomaly are discussed. PMID- 3300674 TI - The evolution of neonatal herpes encephalitis as demonstrated by cranial ultrasound with CT correlation. AB - Three neonates with herpes encephalitis had serial cranial ultrasound and CT studies performed during their hospitalization. Initially, subtle changes of diffuse brain edema were present but with no ventricular compression. A second phase revealed progressive brain edema with ventricular compression. A third phase with enlarging ventricles indicates developing encephalomalacia. Occasionally cyst formation may be noted within the cerebral white matter, a phenomenon initially more readily evident by ultrasound. PMID- 3300676 TI - Biparietal diameter growth in uncomplicated twin gestation. AB - Ninety-six fetuses of uncomplicated concordant twin pregnancies were monitored by ultrasonic cephalometry from 13 to 38 weeks gestation. The biparietal diameter (BPD) growth of 96 twin fetuses was then compared to a sample of 299 uncomplicated, appropriate-for-gestational-age singleton pregnancies. Regression analysis applied to these measurements of BPD on twin and singleton pregnancies showed no significant difference in biparietal diameter between uncomplicated singleton and twin pregnancies. It is concluded that charts derived from singleton pregnancies may be reliably used for estimation of gestational age of twins. PMID- 3300675 TI - Intracranial hemorrhage in low-birth-weight twins during neonatal period. AB - Since twins have a higher incidence of premature birth, fetal distress, asphyxia and other pre- and intrapartum high-risk factors, it is reasonable to expect that they may be vulnerable to intracranial hemorrhage. Forty-seven pairs of low-birth weight twins were studied during the newborn period by serial cranial ultrasound. The comparisons of groups, based on birth order, relative size of the neonates, and the mode of delivery, showed no significant differences in the incidence of intracranial hemorrhage between first and second twins, smaller and larger twins, or vaginal and cesarean delivery. However, the comparison based on the presentation of the infant revealed a significantly higher number of intracranial hemorrhages within the first week of life in the breech group than in the cephalic presentation group. The adverse effect of breech presentation on intracranial hemorrhage did not appear to be mediated by the well recognized risk factors such as lower gestational age, lower Apgar scores, and higher incidence of respiratory distress syndrome and assisted ventilation. Since most of the twins with ICH had breech presentation and were delivered by cesarean section, this mode of delivery does not seem to protect the twins with breech presentation from intracranial hemorrhage. PMID- 3300677 TI - Reversing severe hypoglycemia during pregnancy with glucagon therapy. AB - Glucagon therapy has been used to reverse severe hypoglycemia-induced unconsciousness, but no known study exists which reports its use during pregnancy. Pregnant diabetic women were eligible if they had either a prior hypoglycemic episode requiring intravenous glucose administration or had repeated capillary blood glucose determinations less than 40 mg/dl without any warning adrenergic symptoms. Of 51 insulin-dependent diabetic women, 16 were candidates for glucagon use during a recent 3 1/2-year period. Seven of these 16 persons required an injection on 12 occasions, and an immediate reversal of unconsciousness was encountered in 11 circumstances. No apparent short- or long term maternal adverse effects were present. We conclude that glucagon therapy is needed infrequently for diabetic women during pregnancy but is helpful in reversing acute episodes of severe hypoglycemia. PMID- 3300678 TI - Third-trimester biparietal diameter as a predictor of fetal lung maturity. AB - The major fetal risk associated with elective delivery is unexpected fetal lung immaturity and the development of hyaline membrane disease soon after birth. Prior to elective vaginal or abdominal delivery it has become standard obstetric practice to predict fetal lung maturity by the analysis of amniotic fluid obtained by amniocentesis or vaginal pool sample following preterm rupture of membranes. A correlation between third-trimester fetal biparietal diameter and the lecithin/sphingomyelin (L/S) ratio has been established by several investigators. In order to determine if a threshold BPD could be consistently correlated with fetal lung maturity, we retrospectively examined the hospital and laboratory records of a group of 115 nondiabetic parturients in whom BPD measurements and amniotic fluid analysis for L/S ratio had been performed for various clinical indications. A threshold BPD of greater than or equal to 9.2 cm in all parturients who underwent elective repeat cesarean delivery was associated with no hyaline membrane disease (HMD). Two of the three neonates who developed HMD had mature L/S ratios but were products of pregnancies complicated by third trimester hemorrhage. A review of our present data suggests that about one-third of clinically-indicated amniocenteses in the absence of maternal diabetes or third-trimester hemorrhage could potentially be avoided without adverse neonatal impact. Possible therapeutic application of this finding requires further prospective study. PMID- 3300679 TI - Tetanus in Greenlandic soil. PMID- 3300680 TI - Cancer incidence in Greenland. PMID- 3300681 TI - Arthroscopic Bankart suture repair: technique and early results. AB - Twenty-five recurrent traumatic unidirectional anterior shoulder dislocators were stabilized arthroscopically with a transglenoid absorbable suturing technique. A Bankart lesion was documented and repaired in all cases. Postoperative follow-up averaged 17 months (range 1 year to 30 months). All results were rated excellent. All patients achieved full, painless range of motion (ROM), and no instances of postoperative instability occurred. There were no complications. The details of the operative technique are described. PMID- 3300682 TI - The early days of arthroscopy in the United States. PMID- 3300683 TI - Morphometry and immunocytochemistry. AB - The use of morphometry (and stereology), especially in conjunction with immunocytochemistry, in surgical and experimental pathology is reviewed. The combined use of morphometry and immunocytochemistry permits the study of secretory products and the distinction between cells that produce them, e.g., as in the pancreas. Several examples to illustrate the application of immunocytochemical techniques in morphometry are presented. For example, using this approach on the pancreas, it was shown that not only B cells, but also A and D cells, seem to undergo pathologic changes in a prediabetic organism. Since morphologic alterations may be distributional as well as quantitative, a model for the assessment and statistical evaluation of the distribution of objects within an area is discussed. Similar procedures were used to analyze the distribution of cytochrome P-450 molecules along intracellular membranes; however, special labeling techniques were necessary for this quantification in the electron microscope. Immunoenzyme cytochemically stained secretions can also be studied morphometrically, and microdensitometry and microfluorometry can also be used to quantify immunocytochemical reactions, as is shown in the analysis of the intralobular distribution of NADPH-cytochrome P-450 reductase in the rat liver. Finally, the BIVAS semiautomatic system for morphometric measurements, developed at the Department of Pathology of the University of Basel, is briefly described. PMID- 3300684 TI - Fluorescence flow cytometry and immunology applied to cancer. AB - Antibodies against cell-surface determinants present on limited types of normal cells, such as differentiation antigens, offer an approach to detecting and characterizing tumor cells that is well-suited to fluorescence flow cytometry. This paper reviews the technology involved and its application in the study of hematologic malignancies, especially in the detection and characterization of tumor cells in leukemias and lymphomas. PMID- 3300685 TI - Characterization of hematologic malignancies by flow cytometry. AB - The quantitative assessment of cellular DNA and RNA content by flow cytometry to provide useful information for both diagnosis and prognosis of patients with hematologic malignancies is reviewed. While the characterization of cell surface antigens seems to be more germane to questions of the normal cell counterpart (stage) of malignant transformation and the biology of regulation of proliferation and differentiation by cell-cell contact and humoral factors, DNA derived and RNA-derived parameters were surprisingly sensitive in the distinction of major morphologic groups, drug sensitivity and long-term prognosis. Our findings to date in the study of leukemias, lymphomas and myelomas are summarized. PMID- 3300686 TI - Correlation of prognosis to nuclear roundness and to flow cytometric light scatter. AB - The application of quantitative pathology to the study of malignant tumors is discussed, with emphasis on the correlation between nuclear roundness and prognosis in prostatic carcinoma. Stage A2 prostatic carcinoma patients with 4 year follow-ups and surgically treated stage B1 and B2 prostatic carcinoma patients with 15-year follow-ups were characterized by manual digitization of cancerous nuclei. A form factor that assessed nuclear shape produced an accurate separation of those patients who developed metastatic disease from those who did not. The digitized nuclear roundness correlated with the perpendicular light scatter measured by flow cytometry. When combined with forward light scatter, perpendicular light scatter separated four tumor cell lines of different metastatic potential in an animal model of prostatic cancer; a relative grading index based on these findings seemed capable of identifying human patients with more extensive disease in a preliminary study. The observation of freshly aspirated viable prostatic carcinoma cells led us to appreciate membrane ruffling, pseudopodal extension and translational movements that appear to distinguish these cells from their benign counterparts. Time-lapse cinematography, image digitization and Fourier analysis allow for the objective description of cell motion and should provide new and exciting tools for the pathologist. PMID- 3300687 TI - Application of morphometry in tumor pathology. AB - The application of morphometry in tumor pathology is discussed, e.g., its use in studying the biology of tumors, in creating tumor classification(s), in creating methods for the identification of a tumor in the diagnostic context, and in characterizing diagnostic histopathology in absolute terms. In traditional subjective diagnostic histopathology, reproducibility can be defined satisfactorily, but the definition of accuracy is ambiguous; in morphometric histopathology, a satisfactory definition is found for both concepts but it may be difficult to separate them in practice. Morphometric histopathology can study parameters measured from sections or parameters derived from the primary measurements through calculations. In the histopathology of tumors, the following parameters have turned out to be specially valuable: densitometric measurements of nuclei, nuclear area, perimeter and form factors, nucleolar parameters, the number of mitotic cells per area, the cellularity, the volume fraction of the epithelium, and parameters associated with the fraction of tumor tissue in the sample. The standard deviation or other moments of the distribution of these measurements can be more relevant than the mean values of the results. This indicates that more attention should be given to sampling rules, which are important in defining the efficiency of the methods. For rational application of morphometric methods, it is very important to make a distinction between group morphometry and diagnostic morphometry. The latter engenders numerous sources of variation (variation in section thickness, variation in tissue processing, variation in the techniques of measurement, interobserver variation, interlaboratory variation, variation due to subjective interpretation, etc.), which are usually better controlled in group morphometry. The influence on morphometric parameters of variation in section thickness and tissue shrinkage during processing are discussed. PMID- 3300688 TI - The principles and advances of quantitative pathology. AB - This article gives an overview of the quantitative pathologic techniques used today, with special emphasis on interactive morphometry and its application in the clinical setting. At present, stereologic calculations may be necessary, but in a diagnostic setting have only rarely proved to be essential. The reproducibility of the measurements is discussed in relation to the definition of the particles and staining methods. A number of technical factors that cause random errors are mentioned, such as quality of the slides, magnification, definition of the particles to be measured and measuring protocol. Large-scale experiments have revealed that the means of nuclear morphometric and certain stereologic features are reproducible, such as in the volume percentage of epithelium, the surface densities of glands and the mitotic activity index. The diagnostic applications of the standard deviation and shape factors of nuclear quantitative features require additional precautions, however. Having quantified cell and tissue features, multivariate analysis may result in a better discrimination of two or more groups under study. The quantitative pathologic examination of cells and tissues can provide important diagnostic and prognostic information. Quantitation in pathology is especially useful in so-called continuous lesions, in which interobserver and intraobserver disagreement is considerable. An important requirement of diagnostic morphometry is object selection by a skilled pathologist; the use of morphometry as a black box can result in dramatic errors. The criteria used for a morphometric classification rule that can be used for clinical applications are summarized. Quality control of the whole measuring system is essential. Application of these techniques for more than six years in diagnostic pathology has repeatedly corrected previous qualitative diagnoses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300689 TI - Cytophotometric DNA determination correlated to karyotype, particularly in cancer. AB - Variation from the normal in the distribution patterns of the DNA content of interphase tumor cells is considered in relation to the chromosome abnormalities that occur in these cells. The possible diagnostic and prognostic significance of the DNA distributions, particularly the modal values, of human tumors is discussed. Tumors with normal or near-normal modes frequently have a favorable prognosis, but this is not true for all tumor sites or types, including squamous cell carcinomas of the cervix uteri and carcinomas of the large bowel, in which near-triploid tumors may have a relatively favorable prognosis. PMID- 3300690 TI - [AIDS: a high-priority health problem]. PMID- 3300691 TI - [Rapid identification of group B streptococci]. PMID- 3300692 TI - [Diarrhea in the newborn infant]. PMID- 3300693 TI - [Precision attachments]. PMID- 3300694 TI - [Prefabricated posts for overdentures]. PMID- 3300695 TI - Interaction and combination of separate A and B chains of insulin effects of D and L-tryptophan in position A1. AB - The S-thiomethyl derivatives of insulin A chain with A1-Gly replaced by D- or L Trp have been prepared and their respective interaction and combination with the S-thiomethyl B chain studied. The UV difference spectra of the mixed against the separated [Trp1]A chains with the B chain at pH 10.8 are similar to those obtained for the unmodified chains except that the 295-nm-negative peak for ionized Tyr residue appears to be less marked. Fluorescence studies show very little environmental changes at the A1-Trp residues when mixed with the B chain. The intact hormone with A1-Gly replaced by D-Trp is known to be considerably more active than the analog with L-Trp replacement. However, for both derivatives the resynthesis of the whole molecules correctly joined by disulfide bridges starting from the separated reduced chains, gives similar low yields as shown by HPLC analysis and by receptor-binding assay. The replacement of A1-Gly by D-Trp appears to affect the separated A chain more than the intact hormone and replacements at A1 by both D- and L-Trp probably lead to significant conformational changes of the A chain so as to prevent its correct pairing with the B chain. PMID- 3300696 TI - [Pharmacological and immunological approaches to inhibiting the renin-angiotensin system]. PMID- 3300697 TI - [Immunoenzyme determination of fibrin-fibrinogen degradation product levels in acute myocardial infarct patients]. AB - The changes in the blood level of fibrin-fibrinogen degradation products (FDP) have been studied in 62 patients with myocardial infarction. 30 healthy donors served as the control. FDP was determined using solid-phase immunoenzyme assay. Acute and subacute phases of myocardial infarction were characterized by an increase in FDP blood level. However, in severe cases a possible low FDP blood level in conditions of fibrinolysis depression may be associated with an increased risk of severe thromboembolic complications. PMID- 3300698 TI - [Ultramicromethod of erythrocyte immunoadsorption in screening for somatic antigens in acute myocardial infarct]. AB - Test-systems for the identification of somatic myoglobin antigens and fibrin fibrinogen degradation products in the sera of patients with acute myocardial infarction have been developed and tested. A significant correlation between erythrocyte immunoadsorption technique and solid-phase immunoenzyme assay was observed, the former technique being simpler and express. PMID- 3300699 TI - [Opioid peptides as regulators of the immune system]. PMID- 3300700 TI - [Possibilities of using immunoenzyme test systems for determining levels of myoglobin, fibrinogen, fibrin-fibrinogen degradation products and fibronectin in the diagnosis of somatic diseases]. AB - Clinical trials of immunoenzyme test-systems for the quantitative determination of fibronectin, fibrinogen, fibrin/fibrinogen degradation products and myoglobin have been performed on serum and plasma samples obtained from patients and healthy donors. The tests were informative and possessed diagnostic value in the following conditions: fibronectin--in pyogenic septic complications of newborns, burn infections; fibrinogen and fibrin/fibrinogen products--in thrombosis, myocardial infarction and disseminated intravascular coagulation syndrome; myoglobin--in myocardial infarction. PMID- 3300701 TI - [Morphological approach to characterizing the heterogeneity of blood plasma lipoproteins in different types of pathology]. AB - Heterogeneity of lipoprotein particles of the main classes is shown in primary and secondary hyperlipidemias. It displays biochemical, physical and chemical impairments in the system of lipid transport. Aggregation is one of lipoprotein heterogeneity manifestation. Morphological electron microscopic characteristic is one of the main methods in lipoprotein abnormal heterogeneity diagnosis. PMID- 3300702 TI - Is lymphocyte transfer a promising therapeutic approach towards AIDS? PMID- 3300703 TI - [Determination of cell surface antigens on cryostat sections with monoclonal antibodies]. AB - Most monoclonal antibodies recognize antigens which do not survive conventional tissue processing: the use of frozen tissue sections and the immunofluorescence method overcome this obstacle but introduce other problems. Three improvements are reported here: the use of serum-free (substitute) "Ultroser Hy" as a culture medium for hybridomas, in order to diminish background staining and the diffusion artifact; the use of freon for freezing tissue sections, so as to slightly increase cellular morphology and staining; the use of a new immunofluorescent slide-mounting medium to enhance histologic preservation and immunohistologic contrast and to diminish fading of immunofluorescence. PMID- 3300704 TI - Granule exocytosis by cytotoxic T lymphocytes generated in vivo. PMID- 3300705 TI - Evidence for the involvement of a T-cell-associated serine protease (TSP-1) in cell killing. PMID- 3300706 TI - Microvascular anastomoses. An evaluation of laser-assisted technique. AB - The carbon dioxide milliwatt laser was used to perform microvascular anastomoses in 23 rat femoral arteries and 21 femoral veins. This technique was compared with conventionally sutured controls and then evaluated histologically at intervals of three to four days and 1, 2, 3, 4, 6, 8, and 12 weeks postoperatively. Patency rates in both methods, for arteries and veins, were comparable, confirming the feasibility of laser-assisted microvascular anastomoses. Moreover, the major benefit of the laser procedure was to allow for fewer sutures, thereby diminishing a foreign body reaction. PMID- 3300707 TI - A clinical evaluation of gold-plated tubes for middle-ear ventilation. AB - Gold-plated tympanostomy tubes have been recently marketed as possessing qualities making them ideal for middle-ear ventilation. The performance of these tubes was compared with that of similarly designed Teflon tubes in a controlled, prospective study. Twenty-eight children underwent bilateral myringotomy and tube placement. One ear was randomly chosen for intubation with a gold-plated tube, and a Teflon tube was inserted into the other ear. Patients were examined monthly for 12 months and evaluated for otorrhea, tube occlusion, and early tube extrusion. Although the incidence of otorrhea and tube occlusion were higher for the gold-plated tube, these differences were not statistically significant. The gold-plated tube had a significantly higher rate of early extrusion than the Teflon tube. Based on these findings, there appears to be no advantage to using gold-plated tubes for middle-ear ventilation. PMID- 3300708 TI - Partial purification and characterization of a neutral proteinase with collagen telopeptidase activity produced by human gingival fibroblasts. AB - A neutral proteinase was purified 1930-fold from medium conditioned by the culture of human gingival fibroblasts that had been stimulated to secrete enzymes by concanavalin A. This enzyme had an apparent molecular weight of 35,000 (gel chromatography) and apparent isoelectric point of 4.3 (chromatofocusing). It was inhibited by chelating agents, serum, and nonactivated conditioned fibroblast medium, but not by phenylmethylsulphonyl fluoride or N-ethylmaleimide. This proteinase removes the C-telopeptide from the alpha 1 chain of type I collagen, an activity which could be important in the degradation of collagen in the extracellular matrix. It was also found to digest fibronectin but had no effect on proteodermatan sulphate under the conditions used. It appears to be unrelated to previously described fibroblast extracellular proteinases and we, therefore, tentatively propose the name fibroblast metalloproteinase IV. PMID- 3300709 TI - The use of a monoclonal antibody for the rapid purification of kidney neutral endopeptidase ("enkephalinase") solubilized in octyl glucoside. AB - The neutral endopeptidase ("enkephalinase") of the rabbit brush border membrane has been purified to homogeneity by a rapid immunoaffinity method using a monoclonal antibody. In contrast with other methods used so far, a complete extraction of enkephalinase from the brush border membrane can be achieved with octyl glucoside, without loss of activity. The solubilized enzyme can be selectively separated from the other proteins in a single step using an immunoaffinity column consisting of the monoclonal antibody covalently linked to Sepharose CL-4B. It is demonstrated that enkephalinase can then be recovered in an active form by elution at low pH. The purified enzyme obtained by this method is completely inhibited by thiorphan and appears as a single 94,000 dalton protein after polyacrylamide gel electrophoresis under denaturing and reducing conditions. PMID- 3300710 TI - Chemotherapy in advanced breast cancer. PMID- 3300711 TI - Estrogen receptor levels and survival of breast cancer patients. A study on patients participating in randomized trials of adjuvant therapy. AB - A series of 1,022 patients taking part in clinical trials to compare postoperative radiation therapy with postoperative CMF chemotherapy, and postoperative tamoxifen with no adjuvant therapy, had their tumors analyzed for estrogen receptor content. Isoelectric focusing of the receptor in polyacrylamide gel was used for receptor assay and the results were related to tumor DNA content. The estrogen receptor content was significantly correlated to prolonged survival both for premenopausal and postmenopausal women. It was confirmed that postmenopausal women have increased median receptor values, and for this group values of more than approximately 0.3 fmol per microgram DNA were correlated to prolonged survival. For premenopausal women, a lower level of more than 0.1 fmol per microgram of DNA defined patients with prolonged survival. Lymph node involvement and receptor level were independent prognostic indicators. Patients randomized to tamoxifen or CMF tended to live longer as compared with control patients but this was not statistically significant. Moreover, there was no tendency for adjuvant tamoxifen to further increase the survival of patients with receptor-containing tumors as compared with control patients with similar receptor values. PMID- 3300713 TI - Brucellosis and immunity: humoral and cellular components in mice. PMID- 3300712 TI - Brucella lipopolysaccharides and polysaccharides. PMID- 3300714 TI - Brucella infection and immunity in placenta. PMID- 3300715 TI - Human immune response to Brucella infection. PMID- 3300716 TI - Vaccines, vaccination in brucellosis. PMID- 3300717 TI - Control of Brucella melitensis brucellosis in developing countries. PMID- 3300718 TI - Evidence of heterogeneity of lipopolysaccharides among Brucella biovars in relation to A and M specificities. AB - Sixteen smooth Brucella strains were lysed and digested by proteinase K, and the LPS fractions analysed by sodium dodecyl sulphate polyacrylamide gel electrophoresis. Two profiles were distinguished after periodic acid oxidation and silver staining. The first, present in biovars A greater than M, was a close succession of regularly spaced narrow bands; the second, present in biovars M greater than A, showed regularly spaced doublets separated by a barely visible band (B. abortus = A, melitensis = M). PMID- 3300719 TI - Application of immunoenzymatic techniques for epidemiological surveys on brucellosis among human populations. PMID- 3300721 TI - Outer membrane proteins of Brucella. PMID- 3300720 TI - Protective antigens in brucellosis. PMID- 3300722 TI - Properties of the outer membrane of Brucella. PMID- 3300723 TI - Immunocytochemical localization of in vitro binding of human fibrinogen to Candida albicans germ tube and mycelium. AB - In vitro fixation of human fibrinogen to different morphological stages of Candida albicans was examined immunocytochemically. When detected by fibrinogen latex microspheres or gold particles by scanning electron microscopy, fibrinogen binding sites were found on the surface of germ tubes and mycelium, but not on blastospores. With transmission electron microscopy, fibrinogen-binding sites appeared associated with the flocculent surface layer, and increased during growth of germ tubes. Prefixation of C. albicans with formaldehyde decreased binding of fibrinogen, and pretreatment with mercaptoethanol and pronase abolished it. On thin sections of low temperature "Lowicryl K4M" -embedded organisms, gold particles were arranged in the form of clusters which extended from the surface through the cell wall. In contrast, the inner cell wall layers were weakly labelled. Labelling was also detected in the cytoplasm of germ tube, suggesting that fibrinogen receptors were synthesized during germ tube formation. In view of the importance of filamentous forms in host tissue adherence and colonization, the role of fibrinogen as a ligand for binding of C. albicans to epithelial cells was postulated. PMID- 3300724 TI - Atherosclerosis detection by ultrasounds. A comparative histologic study on aortic specimens. AB - The aim of the study was to establish whether ultrasonic tissue characterization may be an useful tool in atherosclerosis detection. Ultrasonic measurements were performed on fresh aortic specimens taken from autopsy. Four hundred aortic regions were studied in vitro and histologically classified in four groups of 100 samples each: normal walls, fibrous, fibro-fatty and calcified plaques. Two different indices were measured, one derived from the Fourier transform of the echo produced by a specular reflector placed behind the specimen under study and named integrated attenuation index (IAI); the other derived from the Fourier transform of the echo reflected from the specimen under study and named integrated backscatter index (IBI). Results obtained from ultrasonic and histologic analyses showed that both attenuation and backscatter indices increase in atherosclerotic specimens where a deposition of biochemical components such as collagen and calcium salts takes place. This is not true for fatty tissue that reduces the echogenicity of the atherosclerotic profile of the arterial wall. PMID- 3300725 TI - Comparative ultrasonic-histologic study in breast lesions detection. AB - The aim of this study is to establish whether a comparative morphologic ultrasonic analysis is able to identify acoustical parameters for mammary lesions characterization. Breast specimens from radical mastectomy have been selected by frozen sections and then analyzed by nonconventional techniques based on ultrasonic attenuation measurements. After histologic examination of the fixed specimens, both ultrasonic and morphologic appearances have been compared. Our results suggest that the slope index is able to differentiate breast lesions on the basis of the amount of cells and collagen fibers they contain. The slope increases with increasing collagen fibers content while necrosis reduces the overall attenuation of the specimen. On the basis of the above results, it appears possible to differentiate both malignant breast tumors characterized by productive fibrosis and breast dysplasia. Malignant breast tumors without productive fibrosis cannot be distinguished from benign tumors. PMID- 3300726 TI - Estrogen receptor content in breast cancer: correlation between biochemical and immunohistochemical methods. AB - Estrogen receptor content of 26 consecutive cases of ductal breast carcinoma was evaluated by using both biochemical and immunohistochemical methods. Agreement was present in 20/26 cases (76.9%). The analysis of discordant cases shows that in 5 cases disagreement is due to sampling error or to prolonged storage before biochemical evaluation. Such cases may reasonably be excluded when correlating results. Linear regression of the remaining 21 cases shows a significant relationship (r = 0.931; p less than 0.001) between biochemical and immunohistochemical values. Results show that immunohistochemical and biochemical assays are largely comparable, and stress the important role of the pathologist in tumor sampling. PMID- 3300727 TI - Radioenzymatic microassay for picogram quantities of serotonin or acetylserotonin in biological fluids and tissues. AB - This paper describes several modifications of the original radioenzymatic assay for serotonin which increase the sensitivity of the assay 20-fold as well as enhance its reliability. Using this method serotonin concentrations can be directly measured in biological examples without precleaning the sample. When compared to currently available methods this assay is specific and sensitive to approximately 1 pg of serotonin and can be used to measure serotonin levels in individual brain nuclei or microliter quantities of biological fluids. This assay can be easily adapted for the direct measurement of N-acetylserotonin. A large number of samples can be assayed in a single working day. PMID- 3300729 TI - Phenylketonuria. PMID- 3300728 TI - The phenomenon of famine. AB - Famines are sustained, extreme shortages of food among discrete populations sufficient to cause high rates of mortality. Signs and symptoms of prolonged food deprivation include loss of fat and subcutaneous tissue, depression, apathy, and weakness, which progress to immobility and death of the individual, often from superimposed respiratory or other infections. The social consequences of famines are disruption from mass migrations of people in search of food, breakdown of social behavior, abandonment of cooperative effort, loss of personal pride and sense of family ties, and finally a struggle for individual survival. Famines have been common ever since the development of agriculture made human settlements possible. Food shortages due to crop failures caused by natural disasters including poor weather, insect plagues, and plant diseases; crop destruction due to warfare; and enforced starvation as a political tool are by no means the only causative factors. Many of the worst famines have been due to poor distribution of existing food supplies, either because of inequities that result in a lack of purchasing power on the part of the poor or because of political interference with normal distribution or relief movements of food. Europe and Asia, which in the past experienced frequent severe famines, sometimes with deaths in the hundreds of thousands or millions, have now largely eliminated famines through social and technological change. However, in Africa, political and social factors have destroyed the capacity of many populations to survive drought-induced variations in local food supplies and prices. Thus, famines are due to varying combinations of inadequacy of food supplies for whatever reason and the inability of populations to acquire food because of poverty, civil disturbances, or political interference. Despite the role of natural causes, the conclusion is inescapable that modern famines, like most of those in history, are man-made. PMID- 3300730 TI - Diseases associated with defects in vitamin B6 metabolism or utilization. AB - It is clear that many diseases are known to involve defects in vitamin B6 metabolism, but that even more await definitive studies. Furthermore, some functions of vitamin B6, such as its role in glucocorticoid action (21), have been discovered so recently that the medical implications have not yet been fully explored. PMID- 3300731 TI - Dietary regulation of gene expression: enzymes involved in carbohydrate and lipid metabolism. AB - The mechanisms of the responses of an enzyme to different hormones and metabolites or several enzymes to a single hormone are surprisingly varied. There is neither an operon for lipogenic enzymes nor a common step at which hormones and metabolites coordinately regulate the expression of lipogenic genes. In bacteria, coordinated expression of several enzymes in a single metabolic pathway often is achieved by organizing the genes into operons. An operon is a group of genes linked together in a linear fashion and producing a polycistronic mRNA. Trans-acting factors regulate the transcription of these genes by interacting with promoter/regulatory sequences in the 5'-flanking region of the most 5'-ward of the genes. In vertebrate animals, however, coordinated control of gene transcription is not achieved by linking the individual genes, but by putting in the 5'-flanking regions of these genes a regulatory sequence that interacts with common trans-acting factors. Genes controlled by different hormones are expected to have regulatory elements for each hormone. The presence of glucocorticoid and cyclic AMP regulatory elements at the 5'-end of the PEPCK gene is consistent with this notion. Transcription is not the only step at which hormones and metabolites control the pathways for gene expression. The levels of the mRNAs for L-PK, ME, S11, and S14 are increased by T3 at post-transcriptional steps. Glucagon also regulates the accumulation of ME mRNA post-transcriptionally. Neither the mechanism nor the sequence organization of regulatory elements is known for post transcriptional control of gene expression. In the case of PEPCK and HMG-CoA reductase, the next steps will be to determine more precisely the sequences in the 5'-region that mediate hormone sensitivity and feedback inhibition, respectively, and whether trans-acting factors are involved. For the other genes discussed, identification of the regulated step must precede identification of sequences that confer hormone or metabolite-sensitive regulation on a specific gene. In general, it is probable that the hybrid gene approach, so successful for PEPCK and HMG-CoA reductase, also will be effective in defining cis-acting hormone- or metabolite-regulatory elements in other genes. These techniques should be applicable to both transcriptional and post-transcriptional mechanisms. Our long-term objective is to understand the molecular basis of each event that intervenes between the binding of hormone or metabolite to its appropriate receptor and altered enzyme level.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3300732 TI - Assessment of energy expenditure and fuel utilization in man. PMID- 3300733 TI - Dietary D-amino acids. PMID- 3300734 TI - A global view of human selenium nutrition. PMID- 3300735 TI - Nutritional requirements of the elderly. PMID- 3300736 TI - Effects of fat-modified diets on cholesterol and lipoprotein metabolism. PMID- 3300737 TI - Inherited defects of vitamin B12 metabolism. PMID- 3300738 TI - The metabolic significance of mammalian fatty-acid-binding proteins: abundant proteins in search of a function. PMID- 3300739 TI - The pig as a model for human nutrition. PMID- 3300740 TI - Water homeostasis. PMID- 3300741 TI - Nutrient effects on DNA and chromatin structure. PMID- 3300742 TI - Nutritional applications of the Health and Nutrition Examination Surveys (HANES). PMID- 3300743 TI - Starvation and semistarvation diets in the management of obesity. PMID- 3300744 TI - Iron overload: causes and consequences. PMID- 3300745 TI - Evolution of recommended dietary allowances--new directions? PMID- 3300746 TI - Intracellular protein catabolism and its control during nutrient deprivation and supply. AB - The continuous turnover of intracellular protein and other macromolecules is a basic cellular process that serves, among other functions, to regulate cytoplasmic content and provide amino acids for ongoing oxidative and biosynthetic reactions during nutrient deprivation. The intensity of breakdown and pattern of regulation, though, vary widely among cells. Rat hepatocytes, for example, exhibit high absolute rates of proteolysis and regulatory effects that diminish during starvation, while corresponding responses in skeletal and cardiac muscle move in the opposite direction. It is also becoming apparent that effects of insulin and other acute regulatory agents on muscle breakdown are limited to nonmyofibrillar components. The latter may be sequestered and degraded within autophagic vacuoles, whereas myofibrillar proteins require an initial attack by calcium-dependent proteases in the cytosol. By contrast, most if not all of the breakdown of resident (long-lived) proteins as well as RNA in the hepatocyte can be explained by lysosomal mechanisms. The uptake of cytoplasmic components by lysosomes can be divided into two major categories, macroautophagy and micro- or basal autophagy. The first is induced by amino acid or insulin/serum deprivation. In the hepatocyte, amino acids alone can regulate this process almost instantaneously over two thirds of the full range of proteolysis, 4.5% to 1.5% per hour. Glucagon, cyclic AMP, and beta-agonists also stimulate macroautophagy in hepatocytes but have opposite effects in skeletal and cardiac myocytes. Basal autophagy differs from the macro type in that the cytoplasmic "bite" is smaller and sequestration is not acutely regulated. It is, however, adaptively decreased during starvation in parallel with absolute rates of basal turnover. Since endoplasmic reticulum comprises an appreciable fraction of the vacuolar content, volume sequestration would be compatible with the known heterogeneity of individual protein turnover if some proteins (or altered proteins) selectively bind to membranes. The amino acid control of macroautophagy in the hepatocyte is accomplished by a small group of direct inhibitors (Leu, Tyr/Phe, Gln, Pro, Met, Trp, and His) and the permissive effect of alanine whereas only leucine is involved in myocytes and adipocytes. Of unusual interest is the fact that the inhibitory amino acid group alone evokes responses in perfused livers that are identical to those of a complete plasma mixture at 0.5 and 4 times normal plasma levels but loses effectiveness almost completely at normal concentrations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3300747 TI - Mechanisms of transport of amino acids across membranes. PMID- 3300748 TI - Nutritional requirements of low and very low birthweight infants. PMID- 3300750 TI - Early days of hemofiltration. PMID- 3300749 TI - Biologic versus bionic heart substitutes. Will xenotransplantation play a role? PMID- 3300751 TI - Cell adhesion to biomaterials. The role of several extracellular matrix components in the attachment of non-transformed fibroblasts and parenchymal cells. AB - This presentation has covered, in part, the subject of fibroblasts or parenchymal cell adhesion to biomaterials and the manipulation of biomaterial surfaces by appropriate biologic coatings from the viewpoint of the biologist. A tissue culture laboratory with good biochemical instrumentation can contribute greatly to the understanding of biomaterial-cell interactions. Such a laboratory cannot only test the toxicity of polymers, but can also proceed with systematic investigations of the role of synthetic and biologic substrates in favoring non transformed cell attachment, improving cell spreading, and prolonging the life in vitro of normal cell constituents from a diversity of human tissues or organs. Yet, there are certain questions about the biomaterial-tissue interactions that will only be answered by in vivo experiments, since in vitro data may or may not predict the in vivo attachment of a particular cell in a highly protein competitive environment. One important, albeit neglected, fact is that the early deposition of a protein/glycoprotein/lipid layer from serum, plasma, or peritoneal fluid will modify any synthetic surface introduced into the body. Baier called this early step "interface conversion," and it is quite clear that the shape, surface contamination, and physiochemical properties of the synthetic substratum triggers many events that take place during this "interface conversion." Many investigators have tried to explain cell behavior in vitro by manipulating polymer surface charges, hydrophilicity/hydrophobicity, physical and chemical anisotropy, and/or substrate contractility. We believe that new biomaterial surface coatings will be available as soon as new methods of extraction from biomatrices or extracellular matrices become more familiar. These new coatings will probably promote attachment in more specific terms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300752 TI - Badges of the dental profession. British Association of Dental Therapists. PMID- 3300753 TI - Pressure changes at the denture base-mucosal surface interface resulting from mandibular vestibuloplasties. PMID- 3300754 TI - A unique tribute to two pioneers (Drs. W. R. Burston and Peter G. Bush). PMID- 3300755 TI - Comparison of midazolam by mouth and diazepam i.v. in outpatient oral surgery. AB - In a randomized double-blind, parallel groups study, 40 patients undergoing surgical removal of impacted 3rd molar teeth received either midazolam 15 mg orally followed at 35 min by i.v. saline, or oral placebo followed at 35 min by i.v. diazepam 10 mg (Diazemuls). Rapid onset of sedation was seen after midazolam, while the pattern and duration of postoperative sedation, as measured by standard psychometric tests, indicated slower recovery after midazolam than after diazepam. Ratings by the surgeon indicated superior anxiolysis following midazolam and significantly more patients expressed a preference for oral midazolam sedation. Significant, comparable anterograde amnesia was seen with both treatments. No significant cardiovascular complications occurred with either treatment. The findings indicate that rapidly acting oral benzodiazepines such as midazolam provide safe, effect alternatives to i.v. diazepam for conscious sedation in outpatients undergoing minor surgical procedures. PMID- 3300756 TI - Haemodynamic effects following surgical release of increased intra-abdominal pressure. AB - The haemodynamic indices of three patients, who developed abdominal tamponade as a result of intra-abdominal bleeding following liver transplantation, were measured on four occasions as the increased intra-abdominal pressure was released. Hypotension followed the release of the tamponade in all patients and was the result of a decrease in systemic vascular resistance. This was treated with vasoconstrictors; the response to various agents was monitored. Treatment of hypotension following release of abdominal tamponade by volume replacement alone may be inappropriate and may lead to over-transfusion; adrenaline may be the treatment of choice. Intensive haemodynamic monitoring is advisable. PMID- 3300757 TI - A double-blind placebo controlled study of male alcoholics given a subcutaneous disulfiram implantation. PMID- 3300758 TI - Some observations on the effects of a calcium channel blocker, nitrendipine, in early human pregnancy. AB - The effects of a dihydropyridine calcium channel antagonist, nitrendipine 20 mg orally, have been investigated in 24 women in the first trimester human pregnancy in a double-blind, placebo controlled study. The effects on systemic arterial pressure, pulse rate (PR), blood loss at termination of pregnancy (TOP), plasma renin, renin substrate and aldosterone concentrations and platelet aggregation to adenosine diphosphate 0.5 microM, adrenaline bitartrate 0.1-1.0 microM, thrombin 0.05 u ml-1 and sodium arachidonate 0.1-0.2 mM were studied. Administration of nitrendipine was associated with a statistically-significant fall in diastolic pressure (BPD) the magnitude of which was directly related to the individual peak concentrations of the drug (P less than 0.02). No significant effects were observed on systolic pressure (BPS);PR rose slightly. Baseline variability of all three parameters fell in the nitrendipine-treated group over the first 2 h but then increased significantly (BPS, P less than 0.05; BPD, P less than 0.025; PR, P less than 0.005). There was a positive association in both placebo and treated groups between the rates of change of BPD and PR (P less than 0.005 for both); nitrendipine exerted a highly significant (P less than 0.001) effect on this association compatible with its effect as a vasodilator. Blood loss consequent on TOP did not differ in the two groups (nitrendipine 104 +/- 16 ml; placebo 114 +/- 20 ml). There were no significant differences in basal or stimulated hormone concentrations in the two groups. The ex vivo platelet aggregatory response in whole blood to 0.1 mM sodium arachidonate was inhibited by nitrendipine (P less than 0.05); responsiveness to the other aggregatory agents studied was not changed. There was a wide individual variation in both time to peak concentration of nitrendipine and the size of the peak, making classical pharmacokinetic analysis impossible. The median time after ingestion to peak concentration was 105 min; the median concentration was 7.8 ng ml-1. These data suggest that, in the context of the severe vasoconstriction and platelet aggregability of pregnancy-induced hypertension, further studies of this drug in pregnancy are warranted. PMID- 3300759 TI - Effect of prostacyclin on the perfusion pressure and on the vasoconstrictor response of angiotensin II in the human isolated foetal placental circulation. AB - The effect of prostacyclin infusion on the perfusion pressure and on the vasoconstrictor response to three doses of angiotensin II was investigated in six full-term human placentas. The placentas were perfused with a modified Krebs Henseleit solution and placenta perfusion pressure was recorded. Prostacyclin 5 X 10(-8) M, infused through the foetal placental circulation, produced a significant decrease in placental vascular resistance. The vasodepressor effect of prostacyclin persisted throughout the perfusion period and promptly disappeared when the infusion was stopped. The pressor response of angiotensin II was significantly reduced by prostacyclin infusion. These data suggest an interaction between the vascular effects of prostacyclin and angiotensin II on the placental circulation that might be important in the control of foetal placental blood flow. PMID- 3300760 TI - Antigenic heterogeneity and individuality in adenocarcinomas of the rectum and their secondaries. AB - The reaction patterns of eight antibodies directed against blood group substances A, B and H, respectively, against Lewis B antigen, difucosylated carbohydrate antigens (DFCA), gastrointestinal cancer antigen CA 19-9 (GICA), carcinoma associated antigen CA-50 and CEA, were studied in 68 rectal carcinomas using the avidin-biotin-peroxidase method. A pronounced intratumoral antigenic heterogeneity was revealed for most antigens. It thus became evident that an interpretation based upon small preoperative biopsies would be inaccurate. The overall proportion of positive carcinoma cells, however, did not vary much between larger samples taken postoperatively from different regions of the tumours. The intertumoral antigenic variability was also considerable: nearly all tumours had an individual immunohistochemical profile according to the proportions of positive cells. Heterogeneous staining patterns were also present within metastases, and lymph node metastases from the primary tumour in some cases differed completely from each other. The staining pattern did not correlate with Dukes' stage, and degree of differentiation; the expression of any individual antigen, or several antigens in combination. PMID- 3300761 TI - A comparison of the incidence of the myelodysplastic syndrome and acute myeloid leukaemia following melphalan and cyclophosphamide treatment for myelomatosis. A report to the Medical Research Council's working party on leukaemia in adults. AB - Twelve of 648 patients in the Medical Research Council's first two trials in myelomatosis have developed myelodysplasia or acute leukaemia. This corresponds to a 5-year actuarial prevalence of 3% and an 8-year prevalence of 10%. Patients were randomised to treatment with either melphalan or cyclophosphamide and the relative capabilities of these two drugs to cause these conditions were examined as a function of duration of treatment. A significant relationship with length of melphalan treatment was found but no relationship was observed for cyclophosphamide treatment. The amount of melphalan treatment given in various intervals before diagnosis of myelodysplasia or leukaemia was studied and it was found that the amount of treatment in the most recent 3-year period was the most important determinant of risk (P = 0.0001). It is estimated that the risk of haemopoietic neoplasia after 10 years of follow-up is about 3% for each year of melphalan treatment and that much of this risk will occur within three years of the last treatment. PMID- 3300763 TI - Sensitive methods for determining subclasses of IgG anti-A and anti-B in sera of blood-group-O women with a blood-group-A or -B child. AB - The determination of the subclasses of IgG antibodies against blood groups A and B is important in order to improve our understanding and predict haemolytic disease of the newborn due to IgG anti-A or -B. We describe two techniques that circumvent the problem of the agglutination of A and B red cells by the corresponding IgG antibodies in saline: an antiglobulin consumption test and a modified solid-phase micro-immunofluorescence test. The results of the two techniques are compared with the results obtained in the indirect antiglobulin test beyond the saline agglutination titre in a microplate technique. The solid phase micro-immunofluorescence test was the most sensitive for the determination of the subclasses of IgG anti-A and -B. Usually sera contained IgG2 anti-A, B in a higher titre than antibodies of other subclasses. PMID- 3300762 TI - Tumour burden in early stage Hodgkin's disease: the single most important prognostic factor for outcome after radiotherapy. AB - One hundred and forty-two patients with Hodgkin's disease PS I or II were treated with total or subtotal nodal irradiation as part of a prospective randomized trial in the Danish National Hodgkin Study during the period 1971-83. They were followed till death or--at the time of this analysis--from 15 to 146 months after initiation of therapy. The initial tumour burden of each patient was assessed, combining tumour size of each involved region and number of regions involved. Tumour burden thus assessed proved to be the single most important prognostic factor with regard to disease free survival. Other known prognostic factors such as number of involved regions, mediastinal size, pathological stage, systemic symptoms, and ESR were related to tumour burden and lost their prognostic significance in a multivariate analysis. The only other factors of independent significance were histologic subtype and, to a lesser extent, sex. Combining tumour burden and histologic subtype made it possible to single out a group of patients with a very poor disease free survival. These patients also had a poorer survival from Hodgkin's disease and thus clearly candidates for additional initial treatment. PMID- 3300764 TI - Indirect bonding using a visible light cured adhesive. AB - A method of indirect bonding using a visible light cured adhesive is described in detail. The advantages include convenience and rapid placing of many brackets to a predetermined position. The ease of removal of the brackets and the material following treatment is also a major benefit of this technique. PMID- 3300765 TI - Orthodontic rather than surgical aspects of traction. PMID- 3300766 TI - Semiquantitative calculations of catalytic free energies in genetically modified enzymes. AB - The catalytic free energy and binding free energies of the native and the Asn-155 ---Thr, Asn-155----Leu, and Asn-155----Ala mutants of subtilisin are calculated by the empirical valence bond method and a free energy perturbation method. Two simple procedures are used; one "mutates" the substrate, and the other "mutates" the enzyme. The calculated changes in free energies (delta delta G not equal to cat and delta delta Gbind) between the mutant and native enzymes are within 1 kcal/mol of the corresponding observed values. This indicates that we are approaching a quantitative structure-function correlation. The calculated changes in catalytic free energies are almost entirely due to the electrostatic interaction between the enzyme-water system and the charges of the reacting system. This supports the idea that the electrostatic free energy associated with the changes of charges of the reacting system is the key factor in enzyme catalysis. PMID- 3300767 TI - Effect of single amino acid replacements on the folding and stability of dihydrofolate reductase from Escherichia coli. AB - The role of the secondary structure in the folding mechanism of dihydrofolate reductase from Escherichia coli was probed by studying the effects of amino acid replacements in two alpha helices and two strands of the central beta sheet on the folding and stability. The effects on stability could be qualitatively understood in terms of the X-ray structure for the wild-type protein by invoking electrostatic, hydrophobic, or hydrogen-bonding interactions. Kinetic studies focused on the two slow reactions that are thought to reflect the unfolding/refolding of two stable native conformers to/from their respective folding intermediates [Touchette, N. A., Perry, K. M., & Matthews, C. R. (1986) Biochemistry 25, 5445-5452]. Replacements at three different positions in helix alpha B selectively alter the relaxation time for unfolding while a single replacement in helix alpha C selectively alters the relaxation time for refolding. This behavior is characteristic of mutations that change the stability of the protein but do not affect the rate-limiting step. In striking contrast, replacements in strands beta F and beta G can affect both unfolding and refolding relaxation times. This behavior shows that these mutations alter the rate limiting step in these native-to-intermediate folding reactions. It is proposed that the intermediates have an incorrectly formed beta sheet whose maturation to the structure found in the native conformation is one of the slow steps in folding. PMID- 3300768 TI - Kinetic analysis of T7 RNA polymerase-promoter interactions with small synthetic promoters. AB - Specific interactions between T7 RNA polymerase and its promoter have been studied by a simple steady-state kinetic assay using synthetic oligonucleotide promoters that produce a short five-base message. A series of promoters with upstream lengths extending to promoter positions -19, -17, -14, and -12 show that promoters extending to -19 and -17 produce very specific transcripts with initiation rate constant Kcat = 50 min-1 and a Michaelis constant Km = 0.02 microM, indicating that the consensus sequence to position -17 is sufficient for maximum promoter usage. Shortening the upstream region of the promoter to -14 substantially increases Km (0.3 microM) but does not significantly reduce the maximum velocity (kcat = 30 min-1). Finally, truncation of the promoter at position -12 results in extremely low levels of specific transcription. The coding and noncoding strands appear to make different contributions to promoter recognition. Although the double-stranded promoter of upstream length -12 is very poor as a transcription template, extension of only the noncoding strand to -17 very significantly improves both Kcat and Km. In contrast, extension of only the coding strand results in no significant improvement. Substitution of an AT base pair at position -10 by CG (as found in T3 RNA polymerase promoters) produces a 10-fold increase in Km, with little effect on Kcat. Comparison of two promoters containing a base pair mismatch at this site (AG or CT) demonstrates that promoter recognition is very sensitive to the nature of the base on the noncoding strand and is only slightly affected by the presence of a mismatch created by a wrong base in the coding strands.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300769 TI - Fourier transform infrared investigation of the Escherichia coli methionine aporepressor. AB - This study represents the first physicochemical analysis of the recently cloned methionine repressor protein (Met aporepressor) from Escherichia coli. Infrared spectrometry was used to investigate the secondary structure and the hydrogen deuterium exchange behavior of the E. coli Met aporepressor. The secondary structure of the native bacterial protein was derived by analysis of the amide I mode. The amide I band contour was found to consist of five major component bands (at 1625, 1639, 1653, 1665, and 1676 cm-1) which reflect the presence of various substructures. The relative areas of these component bands are consistent with a high alpha-helical content of the peptide chain secondary structure in solution (43%) and a small amount of beta-sheet structure (7%). The remaining substructure is assigned to turns (10%) and to unordered (or less ordered) structures (40%). The temperature dependence of the infrared spectra of native Met aporepressor in D2O medium over the temperature interval 20-80 degrees C indicates that there are two discrete thermal events: the first thermal event, centered at 42 degrees C, is associated with the hydrogen-deuterium exchange of the hard-to-exchange alpha helical peptide bonds accompanied by a partial denaturation of the protein, while the second event, centered around 50 degrees C, represents the irreversible thermal denaturation of the protein. PMID- 3300770 TI - A probe for the mutagenic activity of the carcinogen 4-aminobiphenyl: synthesis and characterization of an M13mp10 genome containing the major carcinogen-DNA adduct at a unique site. AB - The duplex genome of Escherichia coli virus M13mp10 was modified at a unique site to contain N-(deoxyguanosin-8-yl)-4-aminobiphenyl (dG8-ABP), the major carcinogen DNA adduct of the human bladder carcinogen 4-aminobiphenyl. A tetradeoxynucleotide containing a single dG8-ABP residue was synthesized by reacting 5'-d(TpGpCpA)-3' with N-acetoxy-N-(trifluoracetyl)-4-aminobiphenyl, followed by high-performance liquid chromatography purification of the principal reaction product 5'-d(TpG8-ABPpCpA)-3' (yield 15-30%). Characterization by fast atom bombardment mass spectrometry confirmed the structure as an intact 4 aminobiphenyl-modified tetranucleotide, while 1H nuclear magnetic resonance spectroscopy established the site of substitution and the existence of ring stacking between the carcinogen residue and DNA bases. Both 5'-d(TpG8-ABPpCpA)-3' and 5'-d(TpGpCpA)-3' were 5'-phosphorylated by use of bacteriophage T4 polynucleotide kinase and were incorporated into a four-base gap uniquely positioned in the center of the recognition site for the restriction endonuclease PstI, in an otherwise duplex genome of M13mp10. In the case of the adducted tetranucleotide, dG8-ABP was located in the minus strand at genome position 6270. Experiments in which the tetranucleotides were 5' end labeled with [32P]phosphate revealed the following: the adducted oligomer, when incubated in a 1000-fold molar excess in the presence of T4 DNA ligase and ATP, was found to be incorporated into the gapped DNA molecules with an efficiency of approximately 30%, as compared to the unadducted d(pTpGpCpA), which was incorporated with 60% ligation efficiency; radioactivity from the 5' end of each tetranucleotide was physically mapped to a restriction fragment that contained the PstI site and represented 0.2% of the genome; the presence of the lesion within the PstI recognition site inhibited the ability of PstI to cleave the genome at this site; in genomes in which ligation occurred, T4 DNA ligase was capable of covalently joining both modified and unmodified tetranucleotides to the gapped structures on both the 5' and the 3' ends with at least 90% efficiency. Evidence also is presented showing that the dG8-ABP-modified tetranucleotide was stable to the conditions of the recombinant DNA techniques used to insert it into the viral genome.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3300771 TI - A general method of analysis of ligand-macromolecule equilibria using a spectroscopic signal from the ligand to monitor binding. Application to Escherichia coli single-strand binding protein-nucleic acid interactions. AB - We describe a general method for the analysis of ligand-macromolecule binding equilibria for cases in which the interaction is monitored by a change in a signal originating from the ligand. This method allows the absolute determination of the average degree of ligand binding per macromolecule without any assumptions concerning the number of modes or states for ligand binding or the relationship between the fractional signal change and the fraction of bound ligand. Although this method is generally applicable to any type of signal, we discuss the details of the method as it applies to the analysis of binding data monitored by a change in fluorescence of a ligand upon binding to a nucleic acid. We apply the analysis to the equilibrium binding of Escherichia coli single-strand binding (SSB) protein to single-stranded nucleic acids, which is monitored by the quenching of the intrinsic tryptophan fluorescence of the SSB protein. With this method, one can quantitatively determine the relationship between the fractional signal change of the ligand and the fraction of bound ligand, LB/LT, and rigorously test whether the signal change is directly proportional to LB/LT. For E. coli SSB protein binding to single-stranded nucleic acids in its (SSB)65 binding mode [Lohman, T. M., & Overman, L. B. (1985) J. Biol. Chem. 260, 3594; Chrysogelos, S., & Griffith, J. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 5803], we show that the fractional quenching of the SSB fluorescence is equal to the fraction of bound SSB. PMID- 3300772 TI - Refolding of denatured thioredoxin observed by size-exclusion chromatography. AB - Molecular sieve chromatography can resolve interactive systems into populations having different effective hydrodynamic volumes. In this report, the advantages of such resolution to protein folding are illustrated by using moderate pressure to decrease analysis time and lowered temperature to slow down the kinetics of conformational change. A 300-mm Bio-Sil TSK-125 size-exclusion column was equilibrated with a series of different concentrations of guanidine hydrochloride at 2 degrees C in 50 mM phosphate buffer, pH 7.0. Samples of native Escherichia coli thioredoxin, denatured thioredoxin, or thioredoxin equilibrated with the column solvent were injected, and the effluent was monitored at 220 nm. Injection of equilibrated protein samples defined three denaturant concentration zones identical with those observed by spectral measurements: the native base-line zone where only compact protein is observed in the effluent profile; the transition zone in which both compact and denatured forms are observed in slow exchange; and the denatured base-line zone in which only denatured protein is observed. Unfolding was observed by injection of native protein into columns having isocratic denaturant concentrations in the transition and denatured base-line zones. Effluent profiles indicated a dynamic conversion of compact to denatured protein with a time constant which appeared to decrease markedly with increasing denaturant concentration. Refolding was observed by injection of denatured protein into columns having isocratic concentrations in the transition and native base-line zones. As the denaturant concentration was decreased, the effluent profiles evidenced a persistent slow conversion of denatured to compact protein which was suddenly accelerated about midway in the native base-line zone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300773 TI - Escherichia coli tryptophan synthase: synthesis of catalytically competent alpha subunit in a cell-free system containing preacylated tRNAs. AB - A cell-free protein biosynthesizing system prepared from Escherichia coli CF300 was found to synthesize E. coli tryptophan synthase alpha subunit in a time dependent manner when programmed with pBN69 plasmid DNA. This plasmid contains the trp promoter from Serratia marcescens adjacent to the coding region of E. coli tryptophan synthase alpha protein [Nichols, B.P., & Yanofsky, C. (1983) Methods Enzymol. 101, 155-164]. The synthesized tryptophan synthase alpha subunit was found to be indistinguishable from authentic alpha subunit protein when analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and to have the same specific activity for catalyzing the conversion of indole----L tryptophan by tryptophan synthase beta 2 subunit, as well as the conversion of indole + glyceraldehyde 3-phosphate to indole-3-glycerol phosphate. In the absence of exogenously added phenylalanine, admixture of E. coli phenylalanyl tRNAPhe to the protein biosynthesizing system stimulated the production of functional alpha protein; the analogous result was obtained when valine was replaced by E. coli valyl-tRNAVal. The ability of a misacylated tRNA to participate in alpha protein synthesis in this system was established by the use of E. coli phenylalanyl-tRNAVal in the absence of added valine. Protein biosynthesis proceeded normally and gave a product having the approximate molecular weight of tryptophan synthase alpha subunit; as expected, this polypeptide lacked catalytic activity. PMID- 3300774 TI - The valyl-tRNA synthetase from Bacillus stearothermophilus has considerable sequence homology with the isoleucyl-tRNA synthetase from Escherichia coli. AB - We report the DNA sequence of the valS gene from Bacillus stearothermophilus and the predicted amino acid sequence of the valyl-tRNA synthetase encoded by the gene. The predicted primary structure is for a protein of 880 amino acids with a molecular mass of 102,036. The molecular mass and amino acid composition of the expressed enzyme are in close agreement with those values deduced from the DNA sequence. Comparison of the predicted protein sequence with known protein sequences revealed a considerable homology with the isoleucyl-tRNA synthetase of Escherichia coli. The two enzymes are identical in some 20-25% of their amino acid residues, and the homology is distributed approximately evenly from N terminus to C-terminus. There are several regions which are highly conservative between the valyl- and isoleucyl-tRNA synthetases. In one of these regions, 15 of 20 amino acids are identical, and in another, 10 of 14 are identical. The valyl tRNA synthetase also contains a region HLGH (His-Leu-Gly-His) near its N-terminus equivalent to the consensus HIGH (His-Ile-Gly-His) sequence known to participate in the binding of ATP in the tyrosyl-tRNA synthetase. This is the first example of extensive homology found between two different aminoacyl-tRNA synthetases. PMID- 3300775 TI - The steroid binding domain of porcine estrogen receptor. AB - For the purpose of characterizing the estrogen binding domain of porcine estrogen receptor (ER), we have made use of affinity labeling of partially purified ER with [3H]tamoxifen aziridine. The labeling is very efficient and selective particularly after partial purification of ER. A 65,000-dalton (65-kDa) band was detected on the fluorogram of a sodium dodecyl sulfate-polyacrylamide gel, together with a 50-kDa band and a few more smaller bands. The 50-kDa protein appears to be a degradation product of the 65-kDa protein in view of the similar peptide map. ER was affinity labeled before or after controlled limited proteolysis with either trypsin, papain, or alpha-chymotrypsin. The labeling patterns of limited digests indicate that a fragment of about 30 kDa is relatively resistant to proteases and has a full and specific binding activity to estrogen, whereas smaller fragments have lost much of the binding activity. This fragment is very hydrophobic and probably corresponds to the carboxy half of ER. PMID- 3300776 TI - Carbamoyl-phosphate synthetase II of the mammalian CAD protein: kinetic mechanism and elucidation of reaction intermediates by positional isotope exchange. AB - The kinetic mechanism of carbamoyl-phosphate synthetase II from Syrian hamster kidney cells has been determined at pH 7.2 and 37 degrees C. Initial velocity, product inhibition, and dead-end inhibition studies of both the biosynthetic and bicarbonate-dependent adenosinetriphosphatase (ATPase) reactions are consistent with a partially random sequential mechanism in which the ordered addition of MgATP, HCO3-, and glutamine is followed by the ordered release of glutamate and Pi. Subsequently, the binding of a second MgATP is followed by the release of MgADP, which precedes the random release of carbamoyl phosphate and a second MgADP. Carbamoyl-phosphate synthetase II catalyzes beta gamma-bridge:beta nonbridge positional oxygen exchange of [gamma-18O]ATP in both the ATPase and biosynthetic reactions. Negligible exchange is observed in the strict absence of HCO3- (and glutamine or NH4+). The ratio of moles of MgATP exchanged to moles of MgATP hydrolyzed (nu ex/nu cat) is 0.62 for the ATPase reaction, and it is 0.39 and 0.16 for the biosynthetic reaction in the presence of high levels of glutamine and NH4+, respectively. The observed positional isotope exchange is suppressed but not eliminated at nearly saturating concentrations of either glutamine or NH4+, suggesting that this residual exchange results from either the facile reversal of an E-MgADP-carboxyphosphate-Gln(NH4+) complex or exchange within an E-MgADP-carbamoyl phosphate-MgADP complex, or both. In the 31P NMR spectra of the exchanged [gamma-18O]ATP, the distribution patterns of 16O in the gamma-phosphorus resonances in all samples reflect an exchange mechanism in which a rotationally unhindered molecule of [18O3, 16O]Pi does not readily participate. These results suggest that the formation of carbamate from MgATP, HCO3-, and glutamine proceeds via a stepwise, not concerted mechanism, involving at least one kinetically competent covalent intermediate, such as carboxyphosphate. PMID- 3300777 TI - Nuclear magnetic resonance analysis and conformational characterization of a cyclic decapeptide antagonist of gonadotropin-releasing hormone. AB - Two-dimensional proton nuclear magnetic resonance spectroscopy at 500 MHz has been carried out on the cyclic decapeptide antagonist of gonadotropin-releasing hormone: cyclo-(delta 3-Pro1-D-pClPhe2-D-Trp3-Ser4-Tyr5-D-Trp6-NMeLeu7-Arg8- Pro9 beta-Ala 10). The antagonist exists in two slowly interconverting conformations. All data are consistent with the conclusion that one form has all-trans peptide bonds and the other has a cis beta-Ala10-delta3-Pro1 bond. With the use of sequential assignment methods, chemical shift assignments were obtained for all backbone and side-chain protons of both conformational isomers except for the serine and tyrosine hydroxyl groups and the C gamma, C delta, and guanidinium group protons of the arginine. Temperature dependence of spectral parameters and magnitudes of observed nuclear Overhauser effects support the interpretation that both conformers of the antagonist consist of two beta-turns (type II', D-Trp6 NMeLeu7; type II, delta 3-Pro1-D-pClPhe2) connected by extended antiparallel beta like strands. PMID- 3300778 TI - Sedimentation characteristics of vesicles associated with insulin-sensitive intracellular glucose transporter from rat adipocytes. AB - The sedimentation characteristics of vesicles associated with the insulin sensitive intracellular glucose transporter from rat adipocytes were studied. The method used was sucrose density gradient centrifugation, which was carried out under non-equilibrium and equilibrium (isopycnic) conditions. The glucose transport activity was determined by the reconstitution method. As reported previously, the sedimentation velocity of the intracellular glucose-transport activity was considerably slower than that of the counterpart in the plasma membrane. It was found, however, that the specific gravity of the slow sedimenting glucose-transport activity was almost identical to that of the activity in the plasma membrane (d = 1.118-1.122). It is concluded that the intracellular glucose transport activity is associated not with low-density microsomal vesicles, but with unidentified slow-sedimenting vesicles that have a specific gravity similar to that of the plasma membrane. PMID- 3300779 TI - Purification and characterization of the 17 K protein, a DNA-binding protein from Escherichia coli. AB - A basic protein of molecular mass 17 kDa (protein 17 K) which binds to relaxed DNA has been isolated and purified to homogeneity from Escherichia coli cells. The protein behaves as a tetramer in solution and there are 4800 monomers per cell in exponentially growing cells. The amino-acid composition and N-terminal sequence were determined. No effect of the protein on in vitro transcription was observed. The protein was shown to be different from the Ssb protein (Sigal, N. et al. (1972) Proc. Natl. Acad. Sci. USA 69, 3537-3541), protein H1 (Cukier-Kahn et al. (1972) Proc. Natl. Acad. Sci. USA 69, 3643-3647) and the HLP-1 protein (Lathe, R. et al. (1980) Proc. Natl. Acad. Sci. USA 77, 3548-3552). PMID- 3300780 TI - Comparison of spectral and structural properties of three homologous dimeric proteins. AB - Spectroscopic and structural properties of three homologous dimeric inhibitors of microbial origin, Streptomyces subtilisin inhibitor, alkaline proteinase inhibitor and plasminostreptin, were discussed by comparing the hydropathy maps, the secondary structure contents obtained from the CD analysis, and the Chou and Fasman prediction. The major process of thermal denaturation of these proteins was the two-step transition. The denaturation temperature dropped in the order Streptomyces subtilisin inhibitor greater than alkaline proteinase inhibitor greater than plasminostreptin. Differences in the denaturation temperature were interpreted in terms of differences in the hydropathy scale of side-chains of the alpha 1-helix of these proteins. The lower CD change upon the complex formation of plasminostreptin with subtilisin BPN' than those with of Streptomyces subtilisin inhibitor and alkaline proteinase inhibitor was explained in terms of the large increase in hydrophilicity of the contact region of plasminostreptin with the enzyme. PMID- 3300781 TI - Substituent effects during the rat liver aldehyde dehydrogenase catalyzed oxidation of aromatic aldehydes. AB - The influence of the steric hindrance of halogen substituents was investigated in vitro by measuring the activity of yeast aldehyde dehydrogenase (aldehyde: NAD(P)+ oxidoreductase, EC 1.2.1.5) and of aldehyde dehydrogenases in subcellular rat liver fractions with a series of ortho- and para-halo-substituted benzaldehydes as substrates. Upon an increase in the size of the halogen substituent (F, Cl, Br), the reactivity of yeast aldehyde dehydrogenase to ortho substituted benzaldehydes decreased drastically. The same phenomenon was observed with the unspecific aldehyde dehydrogenases in three rat liver fractions; cytoplasm, mitochondria and microsomes. The corresponding para-halobenzaldehydes (F, Cl, Br, I) did not reveal large differences in reactivity to the various rat liver aldehyde dehydrogenases. The aldehyde dehydrogenases in the rat liver microsomal fraction exhibited most clearly the regiospecificity. Enzymatic oxidation of 4-bromobenzaldehyde was more than 30-times faster then the ortho isomer. The findings in this investigation confirm the suggestion that the steric hindrance of bulky ortho-substituents of benzaldehydes account for the slowing down of the aldehyde dehydrogenase-catalyzed oxidation of benzaldehydes to corresponding benzoic acids. The enzymatic oxidation of microsomal aldehyde dehydrogenase is strongly influenced by steric effects of benzaldehydes, bearing a halogen in ortho-position. We think that the microsomal aldehyde dehydrogenase might be the principal enzyme responsible for oxidation of halobenzaldehydes in rat liver. PMID- 3300782 TI - Detection of gangliotriaose-series glycosphingolipids in serum of cord blood and patients with neuroblastoma by a sensitive TLC/enzyme-immunostaining method. AB - Concentration of gangliotriaose-series glycosphingolipids, including GA2, GM2, GD2 and GT2, was measured in human sera by a thin-layer chromatography/enzyme immunostaining method. By this method, as little as 5-10 ng/ml of these glycolipids in serum could be determined simultaneously. Although GD2 ganglioside could be consistently detected in normal cord blood (1-2 ng/ml of serum), the ganglioside was never detected in normal adult serum. However, the same ganglioside was found to be present in large quantity in preoperative sera of 6/9 patients with neuroblastomas (25-658 ng/ml of serum). In addition to GD2, gangliosides GM2 and GA2 increased concomitantly than usual. It is concluded that this highly sensitive quantification of the tumor-associated glycolipids circulating in serum of neuroblastoma patients could be useful in their diagnosis. PMID- 3300784 TI - Induction and characterization of the major surfactant apoprotein during rabbit fetal lung development. AB - Antibodies directed against the major apoprotein associated with rabbit lung surfactant were used to characterize the induction and cellular localization of this protein during rabbit fetal lung development. In lung tissues from rabbits of 26 days gestational age and older, discrete epithelial type II cells were stained positively using the peroxidase antiperoxidase technique. The content of the major protein in homogenates of fetal lung tissue was analyzed using an immunoblotting technique. A protein of about 29 kDa, pI less than or equal to 5.6, was first detectable in fetal lung tissue on day 24 of gestation. The 29-36 kDa, mature form of the surfactant apoprotein was first detectable in lung homogenates from 30-day gestational age fetal rabbits. Treatment of homogenates of day 26 and 31 fetal lung tissues with endoglycosidase F, yielded, in both cases, an immunoreactive triplet with more neutral isoelectric points than the proteins in the untreated homogenates. By immunoblot analysis, we found that only the 29-36 kDa, mature form of the surfactant apoprotein was present in lamellar bodies purified from lung tissues of fetuses of 28 and 31 days and from day 2 neonates. These findings are suggestive that only the mature, 29-36 kDa form of the surfactant apoprotein is associated with lamellar bodies during fetal lung type II cell differentiation in vivo. PMID- 3300783 TI - Relation between binding and the action of phospholipases A2 on Escherichia coli exposed to the bactericidal/permeability-increasing protein of neutrophils. AB - Exposure of Escherichia coli to the bactericidal/permeability-increasing protein (BPI) of neutrophils renders the bacterial phospholipids susceptible to hydrolysis by only a few of numerous phospholipases A2 tested. To explore further the determinants of hydrolysis we measured the binding of 125I-labeled phospholipase A2 to E. coli in the presence and absence of BPI. Phospholipases A2 from Aqkistrodon piscivorus piscivorus venom and pig pancreas neither degraded nor bound to BPI-treated E. coli. In contrast, the phospholipases A2 from Aqkistrodon halys blomhoffii and Aqkistrodon halys palas venoms actively hydrolyzed the phospholipids of BPI-treated E. coli: they also bound to E. coli in the presence but not in the absence of BPI. Carbamylation of lysines of the A.h. blomhoffii phospholipase A2 progressively reduced binding in parallel with reduced phospholipid hydrolysis. Both binding and hydrolysis increased with increasing BPI dose. However, maximal binding occurred at 25% of the BPI dose that produced optimal hydrolysis. Thus, binding may be necessary but is not sufficient for maximal BPI-mediated phospholipid hydrolysis. Comparison of the NH2-terminal amino sequences of the active and inactive phospholipase A2 suggests that this portion of the phospholipase A2 molecule plays a role in BPI independent binding and hydrolysis. PMID- 3300787 TI - Behavioral treatment of irritable bowel syndrome: a 1-year follow-up study. AB - Sixteen clients afflicted with irritable bowel syndrome (IBS) were reassessed 1 year following completion of a multicomponent treatment package incorporating progressive muscle relaxation, thermal biofeedback, cognitive therapy, and IBS education. For the 14 patients who kept a 2-week symptom diary, significant reductions in ratings of abdominal pain and tenderness, diarrhea, and flatulence were obtained comparing pretreatment and follow-up symptom-diary ratings. Eleven of 14 clients were improved over pretreatment levels, 57% met the criteria for clinical improvement of at least a 50% reduction in major symptom scores, and all but 1 of 16 rated themselves as subjectively improved. PMID- 3300785 TI - The relationship of phosphorylation of membrane proteins with the osmotic fragility and filterability of Plasmodium berghei-infected mouse erythrocytes. AB - Membrane from Plasmodium berghei-infected mouse erythrocytes showed a pattern of protein phosphorylation which was substantially altered from the normal pattern, with an increase in the phosphorylation of the protein with an apparent molecular weight of 43,000 (M 43), which increased from undetectable in uninfected cells to a maximum in the mature trophozoite stage. Phosphorylation levels of this and other minor bands were strongly correlated with osmotic fragility and filterability. The level of M 43 phosphorylation in membranes from cells which remained intact in a hypotonic medium was 3.82 +/- 0.59-times that of lysed cells, compared with the value of 0.76 +/- 0.07 calculated from distribution alone. Results found when intact erythrocytes were phosphorylated by incubation with [32P]Pi prior to partial lysis were similar to those found when membranes from the lysed and unlysed fractions were subsequently phosphorylated with [gamma 32P]ATP. Infected erythrocytes which could pass repeatedly through 3-micron polycarbonate filters had a much higher phosphorylation level for the M 43 region than whole infected cells with similar parasitemia and stage distribution. The phosphorylation change could play a role in the control of osmotic and mechanical properties of the infected erythrocytes during maturation. PMID- 3300786 TI - The glucose transporter in human fibroblasts is phosphorylated in response to phorbol ester but not in response to growth factors. AB - The possibility that the stimulation of hexose transport in human fibroblasts by phorbol myristate acetate (PMA), insulin, platelet-derived growth factor (PDGF) or epidermal growth factor (EGF) is associated with phosphorylation of the glucose transporter has been investigated. The time and concentration dependencies of the stimulation of transport by these agents under conditions identical to those used for phosphorylation were determined. Each agent, when used at the concentration that resulted in the maximal increase in transport rate, elicited this effect within 30 min of exposure. The extent of stimulation ranged from 15 to 70%. For determination of phosphorylation of the glucose transporter, fibroblasts were incubated for 16 h with [32P]Pi and exposed to the agonist for 30 min; the transporter was then isolated from a detergent lysate of the cells by immunoprecipitation with a monoclonal antibody. Under these conditions, there was no phosphorylation of transporter in basal cells and only PMA caused detectable incorporation of phosphate into the transporter. Thus, it is unlikely that the stimulation of glucose transport by insulin, PDGF and EGF involve transporter phosphorylation. PMID- 3300789 TI - [Physiological functions of bile acids in the body]. AB - A literary review and own data on the various physiological functions of bile acids in organism are given. The modern state of the problem on the bile salt role in lipid assimilation is reflected. The other functions of bile salts in the digestive tract are described. The regulating influence of bile acids on some metabolic processes in organism is shown. The alteration of membrane enzyme activity under the influence of bile acids possessing the detergent properties may play an important role in different pathological conditions. The significance of bile acid metabolism under physiological and pathological conditions is underlined. PMID- 3300788 TI - [Effect of acid metabolites on the osteoinductive activity of the bone matrix]. AB - The osteoinductive activity of bone matrix demineralized in acid metabolites of glycolysis and Krebs cycle have been studied in rats. The highest osteoinductive effect was reached during the demineralization in oxaloacetic acid, the lowest one--in the malic acid. The regulatory role of glycolysis metabolites and Krebs Cycle in posttraumatic osteogenesis is under discussion. PMID- 3300790 TI - [Evaluation of the genotoxic effects of industrial and domestic waste]. AB - Using the Ames test system and tests of cytotoxicity in cultured mouse cells L the mutagenic and cytotoxic activity of the samples of the industrial waste water and washing mill effluents have been investigated. The tests of cytotoxicity make it possible to detect the effects which were not found in the Ames test. PMID- 3300791 TI - Treatment of psychiatric illness by stereotactic cingulotomy. AB - The treatment of 198 psychiatrically disabled patients with stereotactic cingulotomy was evaluated prospectively for a mean follow-up of 8.6 years. Patients with major affective disorders and anxiety disorders fared the best, with a return to normal functioning in the majority. Patients with obsessive compulsive disorders, schizophrenia, and personality disorders improved less predictably, with an uneven improvement in functioning that required active ongoing psychiatric treatment. Low mortality and morbidity, a reduction of violent behavior, a possible reduction of suicidal risk, and a lessening of the intractable suffering of chronic psychiatric illness all indicate that cingulotomy can be an effective, safe treatment for patients with affective disorders that are unresponsive to all other forms of therapy. PMID- 3300792 TI - In memoriam. Lauretta Bender 1899-1987. PMID- 3300793 TI - Comparison of calcium phosphate glass ceramics with apatite ceramics implanted in bone. An interface study--II. AB - In order to study bone tissue interaction on calcium phosphate glass ceramics and on apatite ceramics, cylinders of standard size were implanted in the tibiae of rabbits. The materials were evaluated by radiography, light microscopy and microradiography. Apatite ceramics gave rise to a very close contact with new bone. Glass with an apatite surface evoked bone growth similar to that for apatite ceramics but with a loose contact while glass without an apatite surface gave rise to porous remodelling of new bone without close contact to the implant. PMID- 3300794 TI - Cell selection in development. PMID- 3300795 TI - Control of electron flux through the respiratory chain in mitochondria and cells. PMID- 3300796 TI - A comparison of automatic algorithms for insulin adjustment via a computer model of diabetes mellitus. PMID- 3300797 TI - Production system in biomedical equipment maintenance application. PMID- 3300798 TI - Design simulation of ultrasonic transducer systems. PMID- 3300799 TI - A proposed VLSI implementation of a digital beamformer used in ultrasonic medical imaging. PMID- 3300800 TI - Logarithmic transformations in ANOVA. AB - A method is presented for choosing an additive constant c when transforming data x to y = log(x + c). The method preserves Type I error probability and power in ANOVA under the assumption that the x + c for some c are log-normally distributed. The method has advantages similar to those of rank transformations- namely, it is easy to use and is resistant to extreme observations. Since the special case c----infinity corresponds in ANOVA to y = x, the method is a useful generalization of least squares. PMID- 3300802 TI - Manfred Eigen Festschrift: special issue dedicated to Professor Manfred Eigen on the occasion of his 60th birthday. PMID- 3300801 TI - Quenching of alkaline phosphatase phosphorescence by O2 and NO. Evidence for inflexible regions of protein structure. AB - The rate constant for quenching the phosphorescence of alkaline phosphatase by molecular oxygen was measured as a function of temperature. The results disagree with previous determinations and, contrary to fluorescence quenching, show that diffusion of O2 to this region of the macromolecule is a highly hindered process. When nitric oxide is introduced as a quencher, similarly small rate constants were found. While the activation energy for this process is identical for both quenchers, it is much smaller than for structural fluctuations at the chromophore site as manifested by the intrinsic triplet-state lifetime. These findings are analyzed in terms of a mechanism that takes into account static quenching at large distances and does not require penetration of the quencher all the way to the chromophore. PMID- 3300803 TI - Curriculum vitae of Manfred Eigen. PMID- 3300804 TI - List of publications by Manfred Eigen. PMID- 3300805 TI - Manfred Eigen. Scientist and musician. PMID- 3300806 TI - Complexes of the single-stranded DNA-binding protein from Escherichia coli (Eco SSB) with poly(dT). An investigation of their structure and internal dynamics by means of electron microscopy and NMR. AB - Based on electron microscopy and NMR spectroscopy it is deduced that Eco SSB binds with moderate cooperativity to polynucleotides. Evidence is provided that the protein binds in its tetrameric form to the nucleic acid forming a nucleosome like structure. NMR-spectroscopic analysis of the complexes shows that the carboxy-terminal region of the Eco SSB maintains a high flexibility even when the protein is immobilized in large protein-protein clusters. PMID- 3300807 TI - Computer simulation of T3/T7 phage infection using lag times. AB - A minimal mechanism is proposed which describes the transcriptional and translational processes for four phage proteins (RNA polymerase, DNase, primase and DNA polymerase) involved in T3/T7 DNA replication. Phage DNA replication is also included. It is shown how lag times may be incorporated into a kinetic mechanism. The distinct three-stage transport of phage DNA into the bacterial host (E. coli) is considered. DNA transport is assumed to be rate-determining for the transcription of class I and II proteins. Transcriptional and translational lag times have been calculated on the basis of available gene mapping of T7 phages. The kinetic behavior of T7 and T3 phage infection is practically identical. The hydrolysis of bacterial DNA by phage DNase (endonculease and exonuclease) as well as the subsequent phosphorylation to the deoxymononucleoside triphosphates are assumed to be rate-determining in phage DNA replication. Good agreement with experiment is obtained in our computer simulations. PMID- 3300808 TI - A comparative trial of a MAOI, iproniazide, and a polycyclic agent, mianserine, for the search of the most rapidly and frequently active treatment of depressive syndromes in an oncology service. AB - Many cancer patients of the "Service des Maladies Sanguines et Tumorales" of Hopital Paul-Brousse, Villejuif, are psychologically studied by: the objective and quantified Szondi test, and in the case a depressive syndrome clinical diagnosis is confirmed, this state is quantified by a quintile questionnaire requiring 25 "yes or no" answers (determined by five grades and five stages), in case an inhibition or/and hysteric component is found, the subjects are submitted to the care of a psychoanalyst. A comparative trial of the MAOI, iproniazide, and the tetracyclic analog, mianserine, has been conducted for the search of the most frequently and rapidly active antidepressant agent among them both. The hypothesis that mianserine is less frequently and rapidly active than iproniazide was drawn from our previous experience of 20 years: thus patients presenting a score less than or equal to 12/25 were given mianserine (20 up to 30 mg/day to be possibly increased according to medical decision), while those presenting a score greater than or equal to 13/25 received iproniazide (50 up to 75 mg/day). The patients who failed with mianserine received iproniazide, while those who failed with iproniazide were supposed to receive mianserine. The registered results are the following: a) out of the 25 patients with major depressive syndromes (score greater than or equal to 13) submitted to iproniazide, 16 (61%) were in complete remission (score at 0/25) and five in partial regression (score decreased by more than half); this makes 21 responses in all, i.e. 80%, obtained between the 10th and the 30th days, which is superior to all placebo responses which have varied in the reliable literature from 13 to 70%; b) out of 18 depressive patients submitted to mianserine, only one had benefited of a complete remission and four of a partial regression at the 30th day, which makes 28% responses. Among the side effects of iproniazide, they were two colon meteorism syndromes, easily corrected by prostigmine, five hyposomnia cases corrected by dipotassium chlorazepate, four anejaculation or delay at ejaculation cases which needed eserine when the patients require their disappearance or attenuation. We did not register either hepatic or hyperthermic or hypertensive complications: this is in good agreement with the true incidences, especially that of hypertensive crisis which could be found in serious and scientifically documented articles, to be 0.3 to 0.5% for their appearance, and 1 per 100,000 for their fatal evolution. Among the side effects of mianserine, we have not registered any of the hepatic, renal and cardiac complications mentioned in the literature.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3300810 TI - [Full-share integration of psychopathology in general or internal medicine thanks to the Szondi test. I. An objective language and a quantitative method]. PMID- 3300809 TI - Beta 2-microglobulin in liver cirrhosis: study of a local synthesis in ascitic fluid. AB - Beta 2-microglobulin determinations in ascitic fluid (A) and serum (S) collected on the same day, were performed in 24 patients suffering from alcoholic liver cirrhosis. Ascitic beta 2-m concentration varied from 0.4 to 4.6 mg/l for patients with a normal renal function. Much higher values were found in patients with chronic renal failure. No correlation could be established between ascitic beta 2-m level and the clinical evolution of the cirrhosis. Comparative measurements of beta 2-m S/A ratio and albumin, transferrin, total protein S/A ratios suggests a local synthesis of beta 2-m in ascitic fluid. This is confirmed by an immuno-cytochemical technique which reveals the localisation of beta 2-m in the cytoplasm of peritoneal cells. The presence of beta 2-m in ascitic fluid seems to be related to an ultrafiltration across the peritoneal membrane as well as a local polyclonal activation of the immune system. PMID- 3300811 TI - [Full-share integration of psychopathology in general or internal medicine thanks to the Szondi test. II. Principle and applications of the test]. PMID- 3300812 TI - The effect of insulin on human-mouse hybridoma formation. AB - To evaluate the effect of insulin on the formation of human-mouse hybridoma clones, P3U1 mouse plasmacytoma cells were fused with human lymph-node lymphocytes in the presence of polyethylene glycol. After fusion, cells were grown for 2 weeks in HAT medium supplemented with insulin (H1AT, 10(-1)-10(-5) units/ml) or in HAT medium alone. The addition of 10(-3) units/ml of insulin to HAT medium resulted in an over two fold increase in the number of clones formed and in the average colony size compared to growing the fused cells in HAT medium alone. In view of the recent increasing interest in human-mouse hybridoma fusions it is suggested that selective medium HAT should be supplemented by insulin (H1AT) to enhance the number of colonies formed and provide a more efficient way for stabilizing the newly formed hybrids. PMID- 3300813 TI - Early evolution of microtubules and undulipodia. AB - A critique of both autogeneous and symbiotic hypotheses for the origin of microtubules and cilia and eukaryotic flagella (undulipodia) is presented. It is proposed that spirochetes provided the ancient eukaryotic cell with microtubules twice; cytoplasmic microtubules originated from phagocytosed spirochetes whereas axopodial tubules of undulipodia were transformed from ectosymbiotic spirochetes. A role in transport for microtubules in spirochetes together with a detailed scenario by which free-living spirochetes attached as ectosymbionts and subsequently differentiated into undulipodia is outlined. A mechanism for the continuity of motility in the form of "training" of the novel microtubular axoneme by the ancient spirochete motility apparatus is proposed. Transitional states (missing links) are unlikely to have survived. Constraints regarding the nature of the host cell are discussed. A corresponding flowchart of the early evolution of eukaryotes is presented in which plastids and mitochondria are polyphyletic in their origins. PMID- 3300814 TI - Erythropoietin production by the fetal liver in an adult environment. AB - To gain insight into the mammalian liver to kidney erythropoietin (Ep) switch, we heterotopically transplanted livers from preswitch, switched, and postswitch fetal and newborn lambs into normal adult sheep. Recipients' serum Ep and circulating reticulocyte levels were serially determined until rejection of the graft and compared with identical samples from sham-operated control adult ewes. Transplantation of preswitch and switched fetal livers caused an impressive rise in recipients' serum Ep activity and provoked a corresponding increase in reticulocytosis. In contrast, Ep activity and reticulocyte counts did not change from preoperative levels in adult ewes transplanted with postswitch livers or in the sham-operated controls. The production of Ep by the preswitch fetal liver in the adult environment was not dependent on the presence or absence of host kidneys and was stimulated by anemic hypoxia. These results suggest that the fetal liver is capable of producing relatively large amounts of Ep activity, and the production of Ep can be maintained in the adult environment in the presence of functional adult kidneys. This argues against suppression of liver Ep production by renal Ep, or some other factor in the postnatal environment, and suggests that the liver to kidney switch of Ep production during ontogeny may represent a genetically determined event. PMID- 3300815 TI - Bone marrow transplantation for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. AB - We report the treatment outcome of allogeneic bone marrow transplantation in ten patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. Six patients are alive and well for 6 to 30 months (median 19 months) after transplantation. Four patients died with transplant related complications. In view of the poor prognosis associated with this disease, marrow ablation followed by allogeneic or syngeneic marrow grafting may be the preferred treatment modality if a suitable marrow donor is available. PMID- 3300816 TI - Allogeneic bone marrow transplantation for high risk non-Hodgkin's lymphoma during first complete remission. AB - Allogeneic bone marrow transplantation from histocompatible sibling donors was performed in six patients with extranodal involvement of high grade lymphoma during first complete remission. Five patients had lymphoblastic lymphoma and one had diffuse undifferentiated lymphoma. The cytoreductive/immunosuppressive regimen consisted of total body irradiation and high dose cyclophosphamide. Four patients are alive in complete remission at 8 months, 14 months, 21 months and 47 months post transplantation. One patient who relapsed 7 months after his initial transplantation underwent a second transplantation but another relapse 17 months later led to his death. One patient died of chronic graft-versus-host disease and at autopsy there was no evidence of lymphoma. These data demonstrate that allogeneic bone marrow transplantation can produce durable remissions in patients with high grade lymphoma who present with bone marrow, central nervous system and/or skin involvement. PMID- 3300817 TI - High dose busulfan/etoposide as a preparatory regimen for second bone marrow transplants in hematologic malignancies. AB - Five patients with hematologic malignancies who had relapsed between seven months and eight years after their primary bone marrow transplants were prepared with high dose busulfan/etoposide for second marrow transplantations from the same donors who had provided the marrow for the primary transplants. The preparatory regimen was well tolerated. All patients engrafted and entered complete remission. Two patients are alive and in continued remission two and ten months after second transplant. One patient died with acute respiratory failure after two months and two patients relapsed again eight and 17 months after second marrow transplantation. The combination busulfan/etoposide may prove to be a suitable preparatory regimen for second bone marrow transplant attempts in selected patients. PMID- 3300818 TI - Immunohistochemical evaluation of bone marrow involvement in hairy cell leukemia during interferon therapy. AB - Bone marrow biopsies from 7 patients afflicted with hairy cell leukemia were studied with a panel of monoclonal antibodies at different intervals during alpha recombinant interferon therapy. Monoclonal antibodies Dako-LC and F 8.11.13 were used because they are highly reactive with hairy cells, and 82H3 and LeuM 1 were also utilized to identify respectively the residual hemopoietic and myeloid tissue. All antibodies are reactive on sections of formalin-fixed, paraffin embedded biopsy material. Before therapy a uniform hairy cell infiltrate was present and very little tissue was visible even after immunohistochemical staining. During therapy, identification of hairy cells in routine biopsies was difficult, since they were mixed with normal cells and the bone marrow was generally hypoplastic. Immunohistochemical stains seem to allow better identification of hairy cells and a more precise estimate of the degree of repopulation by normal bone marrow cells. It was evident, especially after immunocytochemical analysis, that interferon drastically reduced the extent of the infiltrate and allowed recovery of normal hemopoiesis, but did not produce complete remissions. PMID- 3300819 TI - Ganglioside GM1a as inhibitor of Plasmodium falciparum growth in vitro. PMID- 3300820 TI - The physician data query (PDQ) cancer information system. AB - PDQ is an online database that provides information about the prognosis and treatment of all major types of cancer. It represents a major effort by the NCI to communicate advances in cancer treatment using computer technology, and serves as a major component of the Institute's program to reduce cancer mortality nationwide. PDQ utilizes a modern large-scale computer to provide processing speed, a general purpose database management system to provide retrieval and display functions, and commercial telecommunication networks to provide online access to up-to-date information on cancer treatment. A series of user-friendly menus allow searching, browsing, and displaying without having to learn a specialized search language. PDQ is accessible through the National Library of Medicine's computer system via a computer terminal or personal computer and is available to the medical community at over 6,000 medical libraries and centers and through individual access codes. PDQ is also available as an online database under a special license agreement with NCI through two medical information systems produced by commercial database vendors: BRS/Saunders' COLLEAGUE Mead Data Central's MEDIS, and Telmed, a Swiss database. PMID- 3300821 TI - R-plasmid transfer in soil. PMID- 3300822 TI - Coliphages and bacteria in groundwater from Tehran, Iran. PMID- 3300823 TI - Respiratory support in patients with heart failure. PMID- 3300824 TI - [Histopathological classification and treatment of odontogenic cysts]. PMID- 3300825 TI - Bacterial resistance: exploring the facts and myths. PMID- 3300826 TI - Virulence versus resistance. PMID- 3300827 TI - Is antimicrobial resistance in hospital microorganisms related to antibiotic use? PMID- 3300828 TI - Chemistry of newer antibiotics directed toward overcoming bacterial resistance. PMID- 3300829 TI - The biochemical basis of antimicrobial and bacterial resistance. PMID- 3300831 TI - Some historical aspects of bacterial resistance. PMID- 3300830 TI - Therapy of patients with resistant bacterial infections. PMID- 3300832 TI - Resistant bacteria and infection control in the nursing home and hospital. PMID- 3300833 TI - pH-dependent stimulation by Ca2+ of prostacyclin synthesis in rat aortic rings: effects of drugs and inorganic ions. AB - Fresh rat aortic rings were incubated in HEPES-buffered salt solutions. Extracellular Ca2+ stimulated the production of prostacyclin (PGI2), as determined by radioimmunoassay of its stable hydrolysis product 6-oxo prostaglandin F1 alpha. This action of Ca2+ was modified by H+ over the pH range 8.0-6.5. Stimulation by calcium ionophore A23187 was not pH-dependent. In parallel incubations of aortic rings with 45Ca2+, followed by washing in the presence of La3+, tissue uptake of 45Ca2+ increased progressively as extracellular pH was increased from 6.5-8.0. Over this range intracellular pH, estimated by the distribution of [14C]-dimethadione, varied from 5.9-7.4. Stimulation by Ca2+ of PGI2 synthesis was concentration-dependent over the range 0.7-20 mM. The maximum effect was an increase of approx. 4 fold. Nifedipine, but not verapamil or diltiazem, inhibited Ca2+-stimulated PGI2 synthesis. A dihydropyridine compound that activates voltage-dependent Ca2+ channels, Bay K 8644, did not increase PGI2 synthesis. 8-(N, N-diethylamino)-octyl-3,4,5 timethoxybenzoate (TMB-8), an antagonist of intracellular Ca2+ mobilisation, inhibited basal and Ca2+-stimulated PGI2 synthesis to a similar extent. A solution containing 40 mM K+ reduced Ca2+-stimulated PGI2 production. Mg2+ stimulated PGI2 synthesis in a pH-dependent manner but was less potent than Ca2+. Other divalent cations (Mn2+, Ba2+ and Sr2+), and La3+ had little or no effect on basal or Ca2+-stimulated PGI2 synthesis. PMID- 3300834 TI - Combined D-penicillamine and chloroquine treatment of rheumatoid arthritis--a comparative study. AB - Seventy-two patients with relatively early but progressive rheumatoid arthritis were treated with chloroquine sulphate, D-penicillamine or a combination of both drugs over 1 year. Chloroquine resulted in significantly fewer side-effects but combined treatment appeared to increase the risks of toxicity. Significant clinical improvements were seen with each regimen and these were indistinguishable between treatments. However, chloroquine had less impact on haemoglobin, ESR, rheumatoid factor levels and C-reactive protein than the other treatments. Furthermore, radiological deterioration was most frequent amongst those given chloroquine alone. Combination treatment with D-penicillamine and chloroquine thus offered no advantages. Chloroquine caused fewer side-effects than both D-penicillamine and combination treatment but appeared to have a less pronounced effect on the disease process as measured by laboratory and radiological indices. PMID- 3300836 TI - The safety of diagnostic ultrasound. Report of a British Institute of Radiology Working Group. PMID- 3300837 TI - Reflux stricture of the oesophagus. AB - Benign oesophageal stricture remains a common problem. Following accurate diagnosis, early treatment allows dilatation in the great majority of patients. Resection can frequently be avoided and in fit patients dilatation should be combined with an anti-reflux operation plus gastroplasty where necessary. Frail elderly patients may be managed by continued dilatation and medical means to reduce and combat the effects of reflux. Resection should now be necessary in only about 5 per cent of patients and colonic interposition offers good long-term results. It must be remembered that adenocarcinoma is a small but real risk in patients with reflux stricture. PMID- 3300835 TI - Cyclosporin A in the treatment of severe Behcet's uveitis. AB - Twelve patients with active Behcet's uveitis with marked deterioration of visual acuity in at least one eye were treated with cyclosporin A (CyA). An initial improvement in the severity of ocular inflammation and systemic features occurred in all cases and persisted until the dose was reduced or the drug withdrawn when a rapid recurrence of symptoms was noted. The visual acuity also initially improved in ten patients and this was maintained in seven cases until the dose of CyA was reduced. At this time, acuity was unchanged in two patients and was worse in three others-two of the latter as a result of vitreous haemorrhage in the absence of active inflammation. Seven of the 12 patients had therapy stopped because of complications; severe malaise and nausea (three cases), decreased renal function (three cases), and blindness (one case). Cyclosporin A is of value in the control of Behcet's uveitis but toxicity limits its use and the benefits only last while the patient is on this therapy. PMID- 3300838 TI - Role of ultrasound in the diagnosis of liver metastases before surgery for large bowel cancer. PMID- 3300839 TI - Asymptomatic carotid murmur: ultrasonic factors influencing outcome. AB - Sixty consecutive patients with an asymptomatic mid-cervical murmur on auscultation were identified amongst 1000 patients who underwent duplex scanning of the extracranial carotid arteries during 1981-83. They were classified according to the scan results into 12 high risk subjects with greater than 75 per cent stenosis of an internal carotid artery, 37 low risk subjects with a less than 75 per cent stenosis and 6 with no detectable stenosis. The mean duration of follow-up was 3 years (minimum 2 years) or until stroke or death. One was lost to follow-up and four were excluded having undergone carotid endarterectomy during the study. Six of twelve subjects with greater than 75 per cent stenosis suffered a stroke (five fatal and one non-fatal). There were no premonitory signs except in one patient with non-focal cerebral ischaemia for 2 months before an hemispheric stroke. There was one fatal stroke in the less than 75 per cent stenosis group and none in the control group. In all, 17 (28 per cent) patients died (myocardial infarction, 8; stroke, 6; malignant disease, 3). These results confirm that asymptomatic carotid murmurs are associated with increased mortality with most having non-severe carotid disease on duplex scanning and few strokes during follow-up. There is an important minority with tight carotid stenosis who carry a worrying risk of stroke if left untreated. PMID- 3300840 TI - A reliable and readily available method of measuring limb blood flow in intermittent claudication. AB - To evaluate isotope limb blood flow measurement in intermittent claudication we have assessed 58 non-diabetic patients comparing our new method with treadmill testing and Doppler assessment. Limb blood flow was applicable to all 58 patients; 25 patients were unable to walk on a treadmill and of the 33 who could 12 failed to walk for one minute, making a standard one minute exercise test inappropriate. In those patients who could perform exercise tests there was a significant correlation between maximum walking distance and limb blood flow (r = 0.35, P = 0.02). Resting, post-exercise and post-hyperaemic ankle-brachial systolic pressure indices bore no relationship to the maximum walking distance. Isotope limb blood flow measurement is reproducible (r = 0.97), can be applied to those patients who cannot walk on a treadmill and provides information about both legs. It correlated significantly with all the other tests and can be recommended for the minimally invasive assessment of intermittent claudication. PMID- 3300841 TI - Controlled trial of long term oral potassium supplements in patients with mild hypertension. AB - A 15 week randomised double blind placebo controlled trial of oral potassium supplements (48 mmol daily) was conducted in 37 patients who had mildly increased blood pressure and a normal dietary intake of sodium. After a two month run in and a one week baseline period the patients were randomly assigned to receive either potassium supplements (n = 18) or placebo (n = 19). By the third week of treatment blood pressure in the actively treated group had decreased significantly compared with that in the placebo group, though the decrease reached its maximum after 15 weeks. Urinary potassium excretion increased significantly in the group who received potassium supplements, but no significant changes were found in plasma sodium and potassium concentrations or in urinary sodium excretion. In a subgroup of 13 patients who underwent a further nine weeks of treatment with oral potassium supplements at half of the previous dose (24 mmol daily) their blood pressure, at the end of this second study period, was still significantly lower compared with their baseline value but not with that of the placebo group. These results show that moderate oral potassium supplements are associated with a long term reduction in blood pressure in patients who have mild hypertension. PMID- 3300842 TI - Effect of chronic hyperprolactinemia on tuberoinfundibular dopaminergic neurons: histofluorescence in aged and in diethylstilbestrol-treated male rats. AB - Catecholamine histofluorescence was used to examine morphology of hypothalamic tuberoinfundibular dopaminergic (TIDA) median eminence-afferent neurons (areas A12 and A14) in male Fischer 344 rats bearing prolactin (PRL)-secreting tumors. These tumors were either spontaneous, discovered in rats aged 20-32 months, or were induced by chronic diethylstilbestrol (DES) treatment in younger animals. In the latter case, histofluorescence was examined in two groups of animals: (1) those which had been treated, beginning at 6 months of age, with 8 weeks of DES, and subsequently had had the treatment discontinued for 10 months, but which continued to exhibit hyperprolactinemia; (2) animals treated continuously with DES, for 50 or 70 days. Histofluorescence was induced using either the Falck Hillarp, aluminum-formaldehyde ('ALFA') or the formaldehyde-glutaraldehyde ('FAGLU') technique and pituitaries were examined for PRL immunoreactivity, as permitted by the fixation method chosen for histofluorescence. For selected animals, pituitaries were enzymatically dissociated, maintained in primary culture, and were assessed for PRL cell quantification, intracellular PRL content, and in vitro release. Among animals treated chronically with DES, histofluorescence was assessed by the Falck-Hillarp technique, and counts of A12 and A14 perikarya were made in each hypothalamus. Median eminence zona externa fluorescence was diminished in aged rats with normal pituitaries, in aged rats bearing spontaneous tumors, and in rats treated continuously with DES, in comparison with fluorescence in younger rats with normal pituitaries or from which DES treatment had been with-drawn. Perikaryal fluorescence showed typical cell morphology and numbers in aged rats, aged rats bearing spontaneous tumors, and in rats from which DES had been withdrawn. In one animal, treated continuously for 70 days with DES, numbers of A12 and A14 perikarya decreased. In aged rats bearing spontaneous tumors, histofluorescence morphology indicated stimulatory effects on TIDA perikarya and terminals, including increased perikaryal and terminal fluorescence intensity. The morphological results support biochemical evidence of PRL stimulation of tuberoinfundibular dopaminergic neurons, and suggest that inhibitory effects of increased PRL secretion on these hypothalamic cells in DES-induced hyperprolactinemia reflect a direct and reversible effect of DES on these neurons. PMID- 3300843 TI - N-acetylaspartylglutamate identified in the rat retinal ganglion cells and their projections in the brain. AB - N-Acetylaspartylglutamate like immunoreactivity (NAAG-L) was identified in retinal ganglion cell bodies and their axons. The presence of the dipeptide in ganglion cell projection areas, the lateral geniculate nucleus (LGN) and superior colliculus (SC), was confirmed following NAAG purification from these tissues by a high-performance liquid chromatographic method. NAAG-L was identified in the optic tract as well as within fibers and puncta in the LGN and SC. The hypothesis that NAAG is present within ganglion cell axons in the brain was tested by unilateral enucleation which resulted in loss of NAAG and NAAG-L within the contralateral LGN and SC. PMID- 3300844 TI - Stimulation of substantia nigra pars reticulata enhances dentate granule cell excitability. AB - We studied the effects of electrical and chemical stimulation of the substantia nigra (SN) on the dentate granule cell (DGC) response to perforant path stimulation. Studies were carried out in both pentobarbital anesthetized and awake freely moving rats. Chemical stimulation was achieved by microinjection of N-methyl-D,L-aspartate (NMDA), an excitatory amino acid. Electrical preconditioning stimulation applied to the area of the SN, but not dorsal to SN, increased the excitability of DGCs. Intracerebral microinjection of NMDA into the contralateral SN pars reticulata (SNR), but not into SN pars compacta or cerebral peduncle, also produced a marked and reversible enhancement of DGC excitability. In both instances, the increased DGC excitability consisted of increased amplitude of the perforant path evoked population spike without change in the slope of the population excitatory postsynaptic potential (pEPSP). We interpret the data to indicate that increasing the output of the SNR increases the excitability of the DGCs, a limbic neuronal population regulating information transfer through hippocampal pathways. Together with our previous finding that decreasing the output of SNR suppressed limbic seizures, these data demonstrate that the SNR exerts a powerful influence on limbic system excitability. Delineating the anatomic pathway mediating this influence could provide valuable insight into the mechanisms underlying basal ganglia-limbic interactions in both physiologic and pathologic conditions. PMID- 3300845 TI - Phenylethanolamine N-methyltransferase-containing neurons in the rostral ventrolateral medulla of the rat. I. Normal ultrastructure. AB - The electron microscopic localization of the adrenaline-synthesizing enzyme, phenylethanolamine N-methyltransferase (PNMT) was examined in the rostral ventrolateral medulla (RVL) of adult rats. The brains were fixed by perfusion with 3.75% acrolein and 2.0% paraformaldehyde in phosphate buffer. Coronal Vibratome sections through the RVL were immunocytochemically labeled using a rabbit polyclonal antiserum to PNMT and the peroxidase-antiperoxidase method. A semi-quantitative ultrastructure analysis revealed that the perikarya constituted 9% of the total immunoreactive profiles observed in the RVL. The labeled somata were large (18-24 microns) and were characterized by an indented nucleus and abundant cytoplasm with numerous mitochondria. An average of 136.8 +/- 11.6 mitochondria were present per 100 microns2 cytoplasm, which is 38% greater than the numbers found for PNMT-immunoreactive neurons in the nucleus of the solitary tract. Moreover, the labeled somata were often found in direct apposition to the basal lamina of small capillaries and neighboring astrocytic processes. The remaining labeled profiles were neuronal processes of which 72% were dendrites. Both the PNMT-labeled somata and dendrites received primarily symmetric contacts from unlabeled axon terminals. Only a few axons and terminals containing immunoreactivity for PNMT were observed. The axons were both unmyelinated and myelinated. The PNMT-immunoreactive terminals were characterized by a mixed population of vesicles and by the formation of synaptic junctions with both unlabeled dendrites and PNMT-labeled perikarya and dendrites. The ultrastructural morphology and proximity to blood vessels and glia suggest a high metabolic activity and possibly a chemosensory function of PNMT neurons in the RVL. The existence of myelinated and unmyelinated axons could imply that PNMT-containing neurons have different conduction velocities in efferent pathways to the spinal cord or other brain regions. Furthermore, the multiple types of synaptic interactions between labeled and unlabeled axons and dendrites support the concept that adrenergic neurons modulate and are modulated by neurons containing the same or other putative transmitters in the RVL. PMID- 3300846 TI - Phenylethanolamine N-methyltransferase-containing neurons in the rostral ventrolateral medulla. II. Synaptic relationships with GABAergic terminals. AB - The ultrastructural morphology of terminals synthesizing gamma-aminobutyric acid (GABA), as indicated by peroxidase immunoreactivity for its synthetic enzyme L glutamate decarboxylase (GAD), was examined in the rostral ventrolateral medulla (RVL) of the adult rat brain. The objective of the study was to determine the types of synaptic associations between the GABAergic terminals and other neurons in the RVL, particularly the C1-adrenergic neurons containing phenylethanolamine N-methyltransferase (PNMT). The brains were fixed by perfusion with 3.75% acrolein and 2.0% paraformaldehyde in phosphate buffer. Coronal Vibratome sections through the RVL were singly labeled with a sheep antiserum to GAD using the peroxidase-antiperoxidase (PAP) method. Additional sections were dually labeled using the PAP technique for the GAD antiserum and immunogold labeling for a rabbit antiserum against PNMT. Ultrastructural analysis revealed that peroxidase labeling for GAD was localized primarily to axons and axon terminals in both single and dual labeled material. The axons were small and unmyelinated. The GAD-labeled terminals were 0.5-2.0 microns in diameter and contained a large population of small clear vesicles usually associated with a few mitochondria. These terminals formed synapses with many dendrites, a few nerve cell bodies and axon terminals. The junctions were all symmetric and the postsynaptic structures failed to exhibit immunoreactivity when processed only for GAD labeling. In sections incubated with both GAD and PNMT antisera, the peroxidase-labeled GABAergic terminals formed symmetric synapses with nerve cell bodies and dendrites showing immunogold labeling for PNMT. In addition, the GAD-labeled terminals were presynaptic to other dendrites which appeared to have equal access to the antisera and gold markers, but failed to exhibit detectable immunoreactivity for PNMT. Both the PNMT-labeled and unlabeled somata and dendrites also received symmetric and asymmetric contacts from terminals containing neither GAD nor PNMT-immunoreactivity. We conclude that GABA is at least one of the inhibitory transmitters regulating adrenergic as well as non adrenergic outflow from the RVL. PMID- 3300847 TI - Reactive glial cells in CNS demyelination contain both GC and GFAP. AB - The glial cell response to anti-galactocerebroside (GC) induced demyelination of the cat optic nerve was studied using electron microscopy and immunocytochemistry. Oligodendrocytes, which are a primary target for anti-GC, were depleted in the early lesions but astrocytes survived and showed reactive changes. Astrocytic processes exhibited dual staining for both GC and glialfibrillary acidic protein, a feature not seen in astrocytes outside the lesion or in normal optic nerve. These reactive astrocytes did not stain for anti myelin basic protein, nor did they contain myelin debris, making it unlikely that the GC immunoreactivity was due to phagocytosis of myelin. Rather, it is postulated that the presence of GC in these cells represents a process of dedifferentiation to a more primitive state in which both astrocytic and oligodendrocytic determinants are synthesised, and that these reactive glial cells may be precursors of a new population of remyelinating oligodendrocytes. PMID- 3300848 TI - Sleep abnormalities with REM disorder in experimental Creutzfeldt-Jakob disease in cats: a new pathological feature. AB - Alterations in sleep organization were studied during the clinical phase of experimental Creutzfeldt-Jakob disease (CJD) in cats. Twenty months after intracerebral inoculation of a CJD agent, cats developed clinical signs including behavioral changes, diminished grooming activity, dysmetria, startle reflex, myoclonus, and unusual sleep abnormalities. Rapid eye movement (REM) sleep displayed a new and irreversible organization, with a continuous and constant pseudoperiodic pattern of rapid eye movements, synchronous with diffuse bursts of cortical abnormalities and with ponto-geniculo-occipital (PGO) wave activity. Computer analysis revealed a constant morphology of cortical bursts and their temporal relationship with ocular episodes. Induction of PGO wave activity with benzoquinolizine derivative Ro 4-1284 demonstrated the PGO-dependent nature of the cortical alterations. Abnormal unresponsive states were observed during REM sleep phases and arousal thresholds were increased in CJD cats during REM sleep. The percentages of wakefulness and slow-wave sleep were reversed in these animals. Preliminary neuropathological observations included discrete to minimal spongiosis of cerebral gray matter and a remarkably focalized intracytoplasmic vacuolation in neurons of the raphe system. Our findings suggest that particular neuronal systems involved in sleep regulation are impaired in CJD cats. PMID- 3300849 TI - GABAergic input to the synaptic terminals of mb1 bipolar cells in the goldfish retina. AB - An EM-autoradiographical/immunocytochemical technique was used to study amacrine cell synapses onto mb1 bipolar cell terminals in goldfish retina. Tissue was double labeled for [3H]GABA uptake and glutamate decarboxylase (GAD) immunolocalization. Nearly 90% of the amacrine cell synaptic processes onto both proximal and distal halves of mb1 terminals were labeled with either [3H]GABA or GAD-immunoreactivity (IR). Proximal half: 73% of the amacrine synapses were labeled with [3H]GABA uptake and 82% with GAD-IR; 88% of [3H]GABA labeled contacts were double labeled. Distal half: 17% of the amacrine synapses were labeled with [3H]GABA uptake and 67% with GAD-IR; 63% of [3H]GABA labeled contacts were double labeled. After consideration of the possible sources of [3H]GABA labeled synapses onto mb1 terminals, we concluded that the synaptic terminals of pyriform Ab amacrine cells double label for [3H]GABA and GAD-IR despite our previous report that Ab cell bodies do not stain for anti-catfish brain GAD antiserum. We suggest that Ab cells contain isoenzymes of GAD which differ in subcellular distribution, thereby accounting for the differential staining of the cell bodies and dendrites obtained with the GAD antiserum we used. PMID- 3300850 TI - The avian somatosensory system: connections of regions of body representation in the forebrain of the pigeon. AB - In order to establish the basic connectivity of physiologically identified somatosensory regions of the thalamus and telencephalon in the pigeon, injections of wheatgerm agglutinin-horseradish peroxidase were made under electrophysiological control and the projections were charted following conventional neurohistochemistry. The physiological recordings generally confirmed the findings of Delius and Bennetto (Brain Research, 37 (1972) 205-221) of somatosensory sites within the dorsal thalamus, anterior hyperstriatum and caudomedial neostriatum, and the anatomical results show that the thalamic cells of origin of the projections to the two telencephalic regions are largely separate: a rostral cell group comprising nucleus dorsalis intermedius ventralis anterior projects to the anterior hyperstriatum accessorium (HA), whilst a caudal cell group comprising caudal regions of nucleus dorsolateralis posterior (DLP) projects to the medial neostriatum intermedium and caudale (NI/NC). Caudal DLP is also the origin of a visual projection to NI/NC, and its terminal field also approximates that of the thalamic auditory nucleus ovoidalis. Since the anterior HA and NI/NC were here shown to be reciprocally connected, there is a possibility of multimodal input to both telencephalic regions. HA was also further defined as the origin of the basal branch of the septomesencephalic tract, and hence potentially provides an outlet for both telencephalic somatosensory regions. The results are discussed within a comparative context. PMID- 3300851 TI - The role of substantia nigra in the development of kindling: pharmacologic and lesion studies. AB - The role of substantia nigra (SN) in the development of kindling was investigated. Microinjection of gamma-vinyl gamma-aminobutyric acid (GVG), a gamma-aminobutyric acid (GABA) transaminase inhibitor, into the SN bilaterally retarded kindling development by 77%. GVG injected dorsal to the SN did not alter the kindling rate. By contrast, lesions of the SN, whether by thermocoagulation or by microinjected neurotoxin, N-methyl-D,L-aspartate, facilitated kindling development by 27-44%. Thermocoagulative lesions dorsal to the SN did not affect the rate of kindling development. Thus these two manipulations, each presumed to suppress the activity of the SN, resulted in opposite effects on kindling development. We interpret the pharmacologic findings to indicate that the intact SN can powerfully facilitate kindling development. However, the SN is not vital for kindling development, since kindling can be established after destruction of a considerable portion of SN. Whether the increased rate of kindling development following SN lesions is due solely to the absence of SN remains unclear. PMID- 3300852 TI - Cortical projection patterns of magnocellular basal nucleus subdivisions as revealed by anterogradely transported Phaseolus vulgaris leucoagglutinin. AB - The present paper deals with a detailed analysis of cortical projections from the magnocellular basal nucleus (MBN) and horizontal limb of the diagonal band of Broca (HDB) in the rat. The MBN and HDB were injected iontophoretically with the anterograde tracer Phaseolus vulgaris leucoagglutinin (PHA-L). After immunocytochemical visualization of labeled efferents, the distribution of projections over the cortical mantle, olfactory regions and amygdala were studied by light microscopy. Based on differences in cortical projection patterns, the MBN was subdivided in anterior, intermediate and posterior portions (MBNa, MBNi and MBNp). All subdivisions maintain neocortical projections and are subject to an anterior to posterior topographic arrangement. In the overall pattern, however, the frontal cortex is the chief target. Furthermore, all MBN parts project to various regions of meso- and allocortex, which are progressively more dense when the tracer injection is more anteriorly placed. The most conspicuous finding, however, was a ventrolateral to dorsomedial cortical projection pattern as the PHA-L injection site moved from posterior to anterior. Thus, the posterior MBN projects predominantly to lateral neo- and mesocortex while the anterior MBN sends more fibers to the medial cortical regions. Furthermore, the MBNa is a source of considerable afferent input to the olfactory nuclei and as such should be regarded as a transition to the HDB. The HDB, apart from projecting densely to olfactory bulb and related nuclei, maintains a substantial output to the medial prefrontal cortical regions and entorhinal cortex, as well. Comparison of young vs aged cases indicate that aging does not appear to have a profound influence on cortical innervation patterns, at least as studied with the PHA-L method. PMID- 3300853 TI - Endogenous benzodiazepine-like molecules in the human, rat and bovine brains studied with a monoclonal antibody to benzodiazepines. AB - The anti-benzodiazepine monoclonal antibody 21-7F9 has been used for the identification and study of endogenous benzodiazepine-like molecules in the human, rat and bovine brains. A sandwich radioimmunoassay has been designed for the quantification of the membrane-bound endogenous benzodiazepine-like molecules. The localization of these molecules is not restricted to the brain tissue. They are also present in kidney, liver and spleen as well as in the neuroblastoma X glioma NG108-15 hybrid cell line. Immunoblots show benzodiazepine like immunoreactivity in the membrane proteins of all of these tissues. The membrane-bound benzodiazepine-like molecules are resistant to limited proteolysis of the membranes. Moreover, this treatment increases the binding of the monoclonal antibody 21-7F9 to the membranes, probably by exposing sites that normally are not accessible to the antibody. Immunocytochemistry experiments show that benzodiazepine-like molecules are also present in samples of human cerebella that have been stored in paraffin since 1940, 15 years before the first chemical synthesis of benzodiazepines. The results indicate that the cerebellar benzodiazepine-like molecules recognized by the antibody are the product of biological (not chemical) synthesis. Benzodiazepine-like immunoreactivity has also been detected in NG108-15 cells that have been cultured for 3 months in serum-free medium. These results suggest that the cells could biosynthesize benzodiazepine-like molecules. PMID- 3300854 TI - Localization of benzodiazepine-like molecules in the rat brain. A light and electron microscopy immunocytochemistry study with an anti-benzodiazepine monoclonal antibody. AB - The anti-benzodiazepine (BZD) monoclonal antibody 21-7F9 was used with light and electron microscopy immunocytochemistry techniques for studying the distribution of BZD-like molecules in the rat brain. With light microscopy, BZD-like immunoreactivity was found throughout the brain, mainly in neurons and occasionally in some glial cells (in periventricular areas, as well as in some perivascular astrocytes). Despite the fact that in the cerebellum the GABAergic neurons exhibit BZD-like immunoreactivity, co-localization of these two molecules is not exact, since there are also BZD-like positive neurons that are non GABAergic (e.g., cerebellar granule cells, some neocortical and hippocampal pyramidal cells). Ultrastructural study of the cerebellar cortex disclosed that all neuronal categories were immunoreactive, as were some astrocytes within the granular layer. The reaction product was concentrated in neuronal perikarya and dendritic processes. Axons and axon terminals remained mostly unlabeled. The absence of immunoprecipitate within cytoplasmic organelles (Golgi apparatus, mitochondria, lumen of endoplasmic reticulum) and its presence at the cytoplasmic face of the cell membranes strongly suggests that endogenous BZD-like molecules are present in both the soluble cytoplasm (hyatoplasm), and also in association with both external and internal cell membranes. The results suggest that the brain BZD-like molecules might be functionally involved in either the modulation of GABA neurotransmission and/or the biotransformation, accumulation and elimination of benzodiazepines and benzodiazepine-like molecules in the brain. PMID- 3300855 TI - Cholinergic innervation of the optic tectum in the frog Rana pipiens. AB - An immunohistochemical method for choline acetyltransferase (ChAT) identifies presumably cholinergic axons in two retino-receptive laminae in the optic tectum of the frog Rana pipiens. Following eye enucleation there is no loss of immunoreactive axons in the optic tectum. Following unilateral ablation of the nucleus isthmi there is a near-total loss of ChAT-positive axons in the superficial cholinergic lamina contralaterally and in the deeper cholinergic lamina ipsilaterally. Thus, the cholinergic innervation of the tectum appears to derive from the nucleus isthmi. However, ChAT-positive staining of the basal optic nucleus does depend upon an intact retinal input and could derive from either retinal axons or some system trophically dependent on them. PMID- 3300856 TI - Localization of a developmentally regulated neuron-specific protein S54 in dendrites as revealed by immunoelectron microscopy. AB - We sought to determine the ultrastructural localization of the developmentally regulated neuron-specific protein S54 in the chicken cerebellar cortex and optic tectum. The brains were fixed by perfusion with paraformaldehyde and glutaraldehyde. Frozen sections were immunocytochemically labeled with a monoclonal antibody to S54 protein. The immunoreactivity for S54 protein was localized in dendrites. No immunoreactivity for S54 protein was detected in axons and their presynaptic terminals. PMID- 3300858 TI - Neuropeptide Y-like immunoreactivity in cat spinal cord with special reference to autonomic areas. AB - The distribution of nerve terminal-like structures (herein called nerve terminals), fibers, and neurons containing neuropeptide Y-like immunoreactivity (NPY-ir) was studied immunohistochemically in cat spinal cord with and without colchicine treatment. Rexed laminae II and III of the dorsal horn contained large amounts of immunoreactive nerve terminals and few fibers at all levels of the cord whereas laminae I and IV-VI contained fewer terminals and numerous fibers. In segments C7-T3, fibers with NPY-ir in the superficial laminae collected into bundles which travelled ventromedially toward the dorsal gray commissure (DGC). In addition, another bundle of fibers was present in segments C8-T2 and T11-S2; these fibers also originated from the upper dorsal laminae and travelled along the dorsomedial border of the gray matter to cross the midline in the DGC. In the intermediate and central gray, most immunoreactivity was found in the autonomic areas: terminals and fibers containing NPY-ir were found in the intermediolateral cell column pars principalis (IMLp) in all segments between C8 and L4 with the densest accumulation in segments T6 and T7. All other autonomic areas contained immunoreactive structures in nearly all thoracolumbar segments except for the IML pars funicularis, which contained small numbers of immunoreactive fibers only between segments T2 and T8, inclusive. In the sacral cord, the autonomic areas in the intermediate and central gray also contained relatively large numbers of immunoreactive terminals and fibers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300857 TI - Immunocytochemical staining of cholinergic amacrine cells in rabbit retina. AB - Cholinergic neurons of rabbit retina were labelled with an antibody against choline acetyltransferase, the synthesizing enzyme for acetylcholine. Two populations of cells are immunoreactive. Type a cell bodies lie in the inner nuclear layer (INL), their dendrites branching narrowly in sublamina a of the inner plexiform layer (IPL), while type b cell bodies lie in the ganglion cell layer (GCL) with dendrites branching in sublamina b of the IPL. The irregular networks of clustered immunoreactive dendrites are similar, but not identical, in the two sublaminae. Type b cells are more numerous than type a cells in central retina. No axons were stained. It appears that the immunoreactive neurons are normally placed and displaced starburst/cholinergic amacrine cells. PMID- 3300859 TI - Transient appearance of calcitonin gene-related peptide-like immunoreactive fibers in the developing cerebellum of the rat. AB - A plexus of calcitonin gene-related peptide (CGRP)-containing fibers were transiently found in the developing cerebellum of the rat by means of the indirect immunofluorescent method. CGRP-like immunoreactive fibers appeared in the cerebellum by embryonic day 22. Immunoreactive fibers rapidly increased and these made a dense plexus in the Purkinje cell layer by postnatal day 2. However, only a few if any immunoreactive fibers were seen in the Purkinje cell layer or molecular layer of adult rats. PMID- 3300860 TI - The morphogenesis of glutamic acid decarboxylase in the neostriatum of the cat: neuronal and ultrastructural localization. AB - Correlative light and electron microscopic immunohistochemical methods were adapted for a descriptive analysis of the normal time course and pattern of expression and intraneuronal localization of the enzyme glutamic acid decarboxylase (GAD) in the neostriatum (Ns) of fetal, postnatal and adult cats. The differentiation of this synthesizing enzyme demonstrated the establishment of gamma-aminobutyric acid (GABA) transmitter identity in these neurons and their connections. The structural modifications of these GABAergic profiles revealed the morphogenesis of important inhibitory synaptic inputs in the Ns. The expression of GAD began during late fetal development and proceeded in a diagonal gradient from the first-formed ventrolateral putamen to the last-formed dorsomedial caudate nucleus. The frequency of GAD-positive elements increased with age particularly during the early postnatal period. After the initial expression of GAD, 3 interrelated processes contributed to its differentiation: (1) enzyme accumulation; (2) enzyme association with membranous organelles and (3) progressive elaboration of neuronal infrastructure. Synaptogenesis was both coincident and subsequent to GAD differentiation. Two principal types of GABAergic structures, cell bodies and axonal 'terminals', were evident from the initiation of GAD expression. The GABAergic cell bodies were polymorphic by and after the day of birth and consisted of ubiquitous medium sized cells (often having somatic and/or dendritic spines) and rare large sized cells (apparently aspiny and confined to a limited region of the Ns). The GABAergic axonal terminals changed from growth cone and prototerminal forms to mature bouton en passage and bouton terminaux forms establishing axosomatic and axodendritic contracts, having symmetric synaptic specializations and providing inputs to both medium- and large-sized GABAergic target neurons. PMID- 3300862 TI - The dorsomedial hypothalamic nucleus revisited: 1986 update. PMID- 3300861 TI - A review of the organization and evolution of motoneurons innervating the axial musculature of vertebrates. AB - In most anamniotes the axial musculature is myomeric and is functionally subdivided into superficial red and deep white muscle. In those anamniotes that have been studied the organization of the motor column is related to this functional subdivision. The motoneurons innervating red and white muscle differ in size, distribution in the motor column, and developmental history. There is no obvious topographic relationship between the location of motoneurons in the motor column and the dorsoventral location of the muscle they innervate in the myomeres; epaxial motoneurons are not segregated from hypaxial ones. Among amniotes, the myomeres divide to form a number of discrete muscles that may be complexly arranged. This breakup of the musculature is correlated with a subdivision of the motor column into discrete motor pools serving the different muscles. Unlike anamniotes, the motor pools are topographically organized. The epaxial pools are segregated from hypaxial ones, and within the epaxial and hypaxial pools the location of motoneurons innervating any particular muscle is related to the location of the muscle's precursor in the embryonic muscle masses. Thus adjacent motor pools innervate muscles arising from adjacent positions in the myotome. These dramatic differences between the motor columns in anamniotes and amniotes imply that the medial motor column has undergone a major restructuring during the evolution of vertebrates. The available evidence--which is tentative because of the few species that have been studied--suggests that a topographically organized motor column was absent in early vertebrates. A motor column/myotome map appears to have arisen just prior to, or in conjunction with the origin of amniotic vertebrates. The details of this map were conserved in different amniotes in spite of major structural and functional changes in the musculature. The map may be important for the proper control of the many muscles arising from the myotomes in amniotes because it facilitates the development and evolution of motor systems in which anatomically and functionally different muscles have spatially separate motor pools in the cord. PMID- 3300863 TI - Water intake induced in rats by serotonin and 5-hydroxytryptophan: different mechanisms? AB - The present studies were designed to investigate further the mechanism by which water intake is induced in rats by peripheral administration of either serotonin (5HT) or its precursor 5-hydroxytryptophan (5HTP). Consistent with previous studies that have implicated mediation by the renal renin-angiotensin system (RAS), we now report that bilateral nephrectomy completely abolishes the drinking response to various doses of 5HT. In contrast, nephrectomy had little effect on the drinking induced by 5HTP. Thus, 5HTP may induce drinking by mechanisms other than its peripheral conversion to 5HT and subsequent activation of the RAS. The drinking responses to both 5HT and 5HTP were blocked by peripheral administration of the 5HT receptor antagonist, metergoline, but the drug was at least ten-fold more potent against 5HTP than 5HT. Intracerebroventricular (ICV) administration of metergoline also prevented the drinking response to peripherally-administered 5HTP. The drinking responses to both 5HT and 5HTP were enhanced by peripheral administration of low doses of an angiotensin I converting enzyme inhibitor, captopril. Collectively, these findings support previous conclusions that 5HT induced intake of water is mediated exclusively by the renal RAS. However, 5HTP induced drinking may additionally involve a renin-independent, serotonin-mediated mechanism, possibly in the brain. PMID- 3300864 TI - Transferrin gene expression in choroid plexus of the adult rat brain. AB - Transferrin immunoreactivity and transferrin messenger RNA (mRNA) were recently found to be present in oligodendrocytes of the adult rat brain by using immunohistochemistry and in situ hybridization procedure. The present study demonstrates, in the same way, that epithelial cells of the choroid plexus also contain transferrin together with transferrin mRNA. Choroid plexus of the lateral and the third ventricle are rich in transferrin mRNA, while choroid plexus of the fourth ventricle contain few if any transferrin mRNA. These results demonstrate that epithelial cells of the choroid plexus as well as oligodendrocytes express the transferrin gene in the adult rat brain. PMID- 3300865 TI - Adenosine deaminase-containing neurons in the olfactory system of the rat during development. AB - The development, distribution and olfactory bulb projections of neurons immunoreactive for the enzyme adenosine deaminase (ADA) were studied in olfactory systems of embryonic, early postnatal and young adult rats. On embryonic day (E) 12, ADA-immunoreactivity first appeared in the placode of the olfactory epithelium. On E15, ADA-immunoreactive olfactory receptor and precursor cells gave rise to immunostained axons projecting to the olfactory bulb. Numerous immunostained glomeruli were observed on postnatal day (P) 1. After P25, immunoreactivity within receptor cells and glomeruli decreased. In prenatal and early postnatal animals, ADA-immunoreactive neurons were observed in the anterior olfactory nucleus (AON), dorsal transition area, ventral taenia tecta, primary olfactory cortex (POC), entorhinal cortex and ventral agranular insular cortex. After P25 to P30, these neurons lost their immunoreactivity, except those in the medial AON where light immunostaining persisted. In contrast, ADA-immunostaining of neurons in the horizontal limb of the diagonal band (HDB) and olfactory tubercle increased throughout development. About 70 to 75% of the ADA immunoreactive neurons in the AON, a small number of those in the POC and about 75% of the ADA-immunoreactive non-cholinergic neurons in the HDB were found to project to the olfactory bulb. The functions of ADA in the olfactory system may be related to the precocious development of, and/or purinergic neurotransmission within, this system. PMID- 3300866 TI - [Scientific and technical development in pathology at the Pathology Institute of Comenius University Medical School and Hospital in Bratislava. III. Immunohistochemistry]. PMID- 3300867 TI - [Eulogy on Maurice Lacomme (1897-1986)]. PMID- 3300868 TI - [Does the search for new drugs still make sense?]. PMID- 3300869 TI - [Radiodiagnosis by magnetic resonance at 1.5 tesla or by more traditional methods? A comparison of costs in the exploration of the central nervous system]. PMID- 3300870 TI - [Paul Ravaut (1872-1934)]. PMID- 3300871 TI - [Isotopic synoviortheses in the current status of our knowledge (apropos of 179 cases)]. PMID- 3300872 TI - [Approach to primo-infection and tuberculosis through selective service centers. Its limitations]. PMID- 3300874 TI - [Value of biological evaluations established by the European Center for Computer Technology and Automation located at the Carbonnieres chateau (Lacenas - 69640 Denice)]. PMID- 3300873 TI - [Report of the National Laboratory of Health (Department of Hydrology and Thermal Studies]. PMID- 3300875 TI - [Research on the Ramses II mummies]. PMID- 3300876 TI - [Clinical neurology and technological progress]. PMID- 3300877 TI - [Exchange and development therapies in pediatric autism--the physiological bases]. PMID- 3300878 TI - [Specialization in surgery of foreign physicians]. PMID- 3300879 TI - [Current clinical profile of Streptococcus B infections in a Parisian neonatal intensive care unit (apropos 41 cases)]. PMID- 3300880 TI - [Bronchial asthma in France: satisfaction and uneasiness]. PMID- 3300881 TI - [Classification and histomorphometry of the human laryngeal nerves]. PMID- 3300883 TI - [Homeopathic preparations and the pharmacopoeia]. PMID- 3300882 TI - [Performance of an angioplasty procedure using a xenon-chlorine eximer laser and fiber optics]. PMID- 3300884 TI - [Reflexions on medical practice in the '80s and certain deviations]. PMID- 3300885 TI - [An inquiry on so-called functional medicine]. PMID- 3300886 TI - [Informatics, its influence in medicine]. PMID- 3300887 TI - [Computer-assisted system for therapeutic decisions in cranial traumatology]. PMID- 3300888 TI - Cultured epithelium as a skin substitute. AB - Twenty-five burn patients with full or partial thickness skin loss received cultured epithelium (CE), allografts or autografts as part of their treatment. Overall, a 30 per cent graft 'take' was achieved irrespective of whether the CE was autograft or allograft, fresh or frozen. In the case of deep dermal burns this figure improved to 50 per cent. The surviving grafts merged with split thickness skin grafts (SSG) and advancing wound edges. When full thickness skin loss was grafted, only a patchy take could be achieved and the surviving islands of CE tended not to spread across the wound. No rejection of CE allograft was recorded either clinically or histologically up to 6 months. The technical problems and clinical implications are discussed. PMID- 3300890 TI - Management of lower limb burns using suspension of the leg by means of ASIF bone screws. An analysis of the results. AB - Skin grafts on the dorsal side of the legs are liable to failure because of mechanical trauma, maceration and subsequent infection. Suspension of the legs in traction is a well-known method to overcome these problems. In 1984 and 1985, in 14 patients who underwent skin grafting on the dorsum of the leg, suspension was attained by means of two ASIF screws drilled in the ventral side of the proximal and distal tibia. The 'take' percentage of the transplantations on the dorsum of the legs was the same as the 'take' percentage of skin grafts on other sites of the body. No serious complications were encountered. PMID- 3300889 TI - A laboratory method to evaluate formulation effects on the in vitro antimicrobial activity of topical creams and ointments. AB - A simple and reproducible method is described to assess the effect of formulation on the bactericidal and fungicidal activity of topical antimicrobial agents. The technique involves direct inoculation of test and control articles followed by aliquot sampling, neutralization of active antimicrobial ingredients and enumeration of viable microorganisms by standard methods. Two silver sulphadiazine cream formulations, differing in their aliphatic alcohol content, were evaluated as manufactured and in diluted forms in this manner using three bacterial and one fungal burn wound isolates. Results were analysed by a multivariate analysis of variance to test formulation effects, concentration effects and their interaction over time. The results demonstrate that the antimicrobial activity of both creams is equivalent. PMID- 3300891 TI - Low antigen density tumor cells: an obstacle to effective autologous bone marrow purging? AB - Autologous bone marrow transplantation is a potentially curative approach to the treatment of various tumors that are refractory to conventional therapies. A major problem associated with the procedure is the possibility of tumor cell contamination in the autologous graft used to reconstitute the patient's immune system after supralethal chemoradiotherapy. A variety of different approaches to eliminating tumor cells from bone marrow have been proposed and tested. These include destruction of tumor cells with antibody and complement, use of antibody conjugated to drugs or toxins, and the physical separation of antibody-coated tumor cells by attachment to magnetic microspheres. Each of these approaches has different limitations and technical problems. One problem common to all, however, is that the tumor cells most likely to avoid removal are those demonstrating a low level of surface antigen. In this paper we have offered a practical approach to amplifying the unique surface antigen expression in order to enable this elusive tumor cell population to be eliminated. The approach proposed is adaptable to all the techniques currently being studied, since it is designed to add additional antigens to tumor cells which can then be used as targets at which to direct the various purging strategies. PMID- 3300893 TI - The patient and profession at risk ... alternative delivery systems. College of Dental Surgeons of British Columbia. PMID- 3300892 TI - Do carcinogen-modified deoxynucleotide precursors contribute to cellular mutagenesis? PMID- 3300894 TI - [The recovery of dental waxes: a difficult and uncertain procedure]. PMID- 3300896 TI - Research developments and the (undergraduate) periodontics curriculum (reactor paper). PMID- 3300897 TI - Implementation of changes in the dental curriculum. PMID- 3300895 TI - Curriculum changes based on research developments. PMID- 3300898 TI - Implementation of curriculum changes. PMID- 3300899 TI - A comparison of bupivacaine to lidocaine with respect to duration in the maxilla and mandible. PMID- 3300900 TI - Acupuncture analgesia for postoperative dental pain. PMID- 3300901 TI - Analysis of compression plating of mandibular fractures. PMID- 3300902 TI - Altered calcium uptake by the sarcoplasmic reticulum following cardiac transplantation in humans. AB - Abnormalities in the diastolic properties of the heart have been described following human cardiac transplantation and may reflect, at least in part, decreased Ca2+ uptake by the sarcoplasmic reticulum. This possibility was evaluated by obtaining serial myocardial biopsies in 13 patients who underwent cardiac transplantation for severe heart failure. Oxalate-supported Ca2+ uptake by the sarcoplasmic reticulum was measured in homogenates of 83 ventricular biopsies from transplanted hearts. Biopsies from seven subjects with normal cardiac function and morphology served as controls. In the transplanted hearts, there was a tendency for Ca2+ uptake rate to decline with time so that 4-5 months postoperatively, it was significantly lower (4.5 +/- 0.5 nmoles Ca2+/mg/min) compared to controls (5.6 +/- 0.5 nmoles Ca2+/mg/min, p less than 0.01). Plasma norepinephrine levels fell from the high preoperative values (689 +/- 50 pg/mL) towards normal (215 +/- 7 pg/mL) within 30 days after transplantation. Subsequently, however, there was a tendency for norepinephrine levels to increase (369 +/- 55 pg/mL at 4 months). In four patients for which serial observations were available, there was an inverse relationship between myocardial Ca2+ uptake and plasma norepinephrine levels. These results indicate the feasibility of obtaining reproducible serial measurements of Ca2+ uptake in human cardiac biopsies. The decline in sarcoplasmic reticulum function following cardiac transplantation may be, in part, the biochemical basis for the reported impairment in diastolic relaxation. PMID- 3300903 TI - Effects of pinacidil on the heart: serial electrocardiographic and echocardiographic observations. AB - In a prospective, double-blind study comparing pinacidil to hydralazine in mild systemic hypertension, 33 patients were followed with serial echocardiograms and electrocardiograms. There were four study groups: pinacidil and hydralazine (long term therapy), and pinacidil and placebo (short-term therapy). There were no significant changes in mean echo LV mass or in LV systolic function in any of the groups. One patient in each group developed LVH de novo despite decreases in blood pressure. Four patients receiving pinacidil therapy (23%) developed new T wave abnormalities and in 1, the initially abnormal T waves returned to normal at follow-up. Seven of 9 T-wave abnormalities were minor (Minnesota Code) and were not associated with any echocardiographic abnormality. One patient in the placebo group also developed new minor T-wave abnormalities. One patient receiving pinacidil therapy who had new major T-wave abnormalities developed cardiac ischemia. There were no other cardiac events. PMID- 3300904 TI - The health care delivery system. Information requirements and computer technology. PMID- 3300905 TI - Cataract surgery in the early years of the Canadian Ophthalmological Society. PMID- 3300906 TI - Renal ammonium production--une vue canadienne. AB - The purpose of this review is to examine the factors regulating ammonium production in the kidney and to place these factors in the perspective of acid base balance. Renal ammonium production and excretion are required to maintain acid-base balance. However, only a portion of renal ammonium production is specifically stimulated by metabolic acidosis. One should examine urinary ammonium excretion at three levels: distribution of ammonium between blood and urine, augmented glutamine metabolism, and an energy constraint due to ATP balance considerations. With respect to the biochemical regulation of acid-base renal ammonium production, an acute stimulation of alpha-ketoglutarate dehydrogenase by a fall in pH seems to be important but this may not be the entire story. In chronic metabolic acidosis augmented glutamine entry into mitochondria (dog) or increased phosphate-dependent glutaminase activity (rat) become critical to support a high flux rate. Metabolic alterations, which diminish the rate of oxidation of alternate fuels, might also be important. The above principles are discussed in the ketoacidosis of fasting, the clinically important situation of high rates of renal ammonium production. PMID- 3300907 TI - Relationship of membrane systems in muscle to isomyosin content. AB - The structures and functions of the various subdivisions of the membrane systems of muscle are reviewed. Morphometric data have been recalculated using functional definitions of the membranes as identified by their proteins. Thus, the junctional coupling between the sarcoplasmic reticulum and T system is separated from the remaining longitudinal sarcoplasmic reticulum that bears the calcium ATPase protein. In addition, the morphometry of the membrane systems is related to the various muscle fiber types as defined histochemically and by protein isoforms. The relation of isomyosin type and membrane quantities are compared for guinea pig, chicken, frog, and lobster skeletal muscles and rat and rabbit cardiac muscles. Fiber plasticity is considered in terms of the mixing and matching of amounts and kinds of membranes and proteins. PMID- 3300908 TI - The role of calcium at the sarcolemma in the control of myocardial contractility. AB - The importance of sarcolemmal-bound calcium (Ca) in the control of contraction in mammalian myocardium is indicated by the following results. The curve that relates [Ca]o (from 50 microM to 10 mM) to force development and that which relates [Ca]o to Ca bound to a highly purified sarcolemmal fraction are superimposable. The ability of a series of cations to uncouple excitation from contraction is the same as their relative ability to displace Ca from the sarcolemma. Dimethonium, which specifically displaces cation from the diffuse double layer of the cellular surface, has little effect on contractile force. This indicates that the Ca actually bound to the sarcolemma is the surface Ca important in contractile control. Polymyxin B, a highly charged cationic amphiphilic peptidolipid, specifically competes for Ca-binding sites on anionic and zwitterionic phospholipid. It is a potent displacer of Ca from myocardial cells and purified sarcolemma and a potent uncoupler. Phospholipase D cleaves the nitrogenous base from sarcolemmal phospholipid with production of anionic phosphatidic acid. Phospholipase D treatment increases Ca bound to cells and purified sarcolemma and increases force development of ventricular tissue from both neonatal rat and adult rabbit. Insertion of charged amphiphiles in the sarcolemma as phospholipid analogues modulate interaction of Ca with the sarcolemma, e.g., anionic dodecylsulfate increases Ca bound to sarcolemmal vesicles by more than 80% and increases force development in rabbit papillary muscle by 100%. The effect of pH variation on Ca binding to phospholipid extracted from sarcolemma indicates that phospholipid accounts for at least 75% of the binding. The current model proposes a two-site control of Ca binding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300909 TI - Studies of the halothane-cooling contractures of skeletal muscle. AB - The characteristics of transient contractures elicited by rapid cooling of frog or mouse muscles perfused in vitro with solutions equilibrated with 0.5-2.0% halothane are reviewed. The data indicate that these halothane-cooling contractures are dose dependent and reproducible, and their amplitude is larger in muscles containing predominantly slow-twitch type fibers, such as the mouse soleus, than in muscles in which fast-twitch fibers predominate, such as the mouse extensor digitorum longus. The halothane-cooling contractures are potentiated in muscles exposed to succinylcholine. The effects of Ca2+-free solutions, of the local anesthetics procaine, procainamide, and lidocaine, and of the muscle relaxant dantrolene on the halothane-cooling contractures are consistent with the proposal that the halothane-cooling contractures result from synergistic effects of halothane and low temperature on Ca sequestration by the sarcoplasmic reticulum. Preliminary results from skinned rabbit muscle fibers support this proposal. The halothane concentrations required for the halothane cooling contractures of isolated frog or mouse muscles are comparable with those observed in serum of patients during general anesthesia. Accordingly, fascicles dissected from muscle biopsies of patients under halothane anesthesia for programmed surgery develop large contractures when rapidly cooled. The amplitude of these halothane-cooling contractures declined with the time of perfusion of the muscle fascicles in vitro with halothane-free physiological solutions. It is suggested that the halothane-cooling contractures could be used as a simple experimental model for the investigation of the effects of halothane on Ca homeostasis and contractility in skeletal muscle and for study of drugs of potential use in the management of the contractures associated with the halothane induced malignant hyperthermia syndrome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300910 TI - Differentiation of mechanisms for mobilization of calcium in smooth muscle. AB - Techniques to dissociate different sites or stores important for Ca2+ entry or release in smooth muscle include washouts of 45Ca in cold La3+ -substituted solutions. Scatchard-coordinate plots of Ca2+ uptake, substitution of Sr2+ for Ca2+, and both desaturation and rate coefficient plots. Rabbit aortic smooth muscle is particularly useful because Ca2+ mobilization components can be clearly separated. Other vascular preparations investigated (e.g., renal vessels, coronary arteries) appear to have similar components, but their relative importance varies. Respiratory smooth muscle also has similar Ca2+ mobilization components, but they are less readily dissociated by techniques employed in vascular smooth muscles. In guinea pig trachea, cold La3+ washouts do not retain cellular Ca2+ as well as in other preparations: use of other experimental approaches including the Ca2+ channel entry stimulator, CGP 28392, can demonstrate different Ca2+ uptake mechanisms for K+ -stimulated and agonist induced Ca2+ uptake. In rabbit aorta, CGP 28392 potentiates tension increases elicited with lower concentrations of added K+ but has no effect on norepinephrine-induced contraction. A general model illustrating different Ca2+ entry mechanisms present in three types of smooth muscle provides examples drawn from a spectrum of possible variations in smooth muscle specificity for Ca2+ mobilization. PMID- 3300911 TI - Mg2+-Ca2+ interaction in contractility of vascular smooth muscle: Mg2+ versus organic calcium channel blockers on myogenic tone and agonist-induced responsiveness of blood vessels. AB - Contractility of all types of invertebrate and vertebrate muscle is dependent upon the actions and interactions of two divalent cations, viz, calcium (Ca2+) and magnesium (Mg2+) ions. The data presented and reviewed herein contrast the actions of several organic Ca2+ channel blockers with the natural, physiologic (inorganic) Ca2+ antagonist, Mg2+, on microvascular and macrovascular smooth muscles. Both direct in vivo studies on microscopic arteriolar and venular smooth muscles and in vitro studies on different types of blood vessels are presented. It is clear from the studies done so far that of all Ca2+ antagonists examined, only Mg2+ has the capability to inhibit myogenic, basal, and hormonal-induced vascular tone in all types of vascular smooth muscle. Data obtained with verapamil, nimopidine, nitrendipine, and nisoldipine on the microvasculature are suggestive of the probability that a heterogeneity of Ca2+ channels, and of Ca2+ binding sites, exists in different microvascular smooth muscles; although some appear to be voltage operated and others, receptor operated, they are probably heterogeneous in composition from one vascular region to another. Mg2+ appears to act on voltage-, receptor-, and leak-operated membrane channels in vascular smooth muscle. The organic Ca2+ channel blockers do not have this uniform capability; they demonstrate a selectivity when compared with Mg2+. Mg2+ appears to be a special kind of Ca2+ channel antagonist in vascular smooth muscle. At vascular membranes it can (i) block Ca2+ entry and exit, (ii) lower peripheral and cerebral vascular resistance, (iii) relieve cerebral, coronary, and peripheral vasospasm, and (iv) lower arterial blood pressure. At micromolar concentrations (i.e., 10-100 microM). Mg2+ can cause significant vasodilatation of intact arterioles and venules in all regional vasculatures so far examined. Although Mg2+ is three to five orders of magnitude less potent than the organic Ca2+ channel blockers, it possesses unique and potentially useful Ca2+ antagonistic properties. PMID- 3300912 TI - Urease testing and yeast taxonomy. AB - When urease production was assayed by the hydrolysis of [14C]urea, all basidiomycetous yeasts tested, including the Cryptococcus vishniacii complex (previously reported urease negative), produced significant amounts of 14CO2. The Schizosaccharomycetaceae were the only urease-positive ascomycetous yeasts tested. Yarrowia lipolytica was urease negative. The stoichiometry of [14C]urea hydrolysis paralleled by Roberts' rapid urea hydrolysis (RUH) test indicated that causes of anomalous results in conventional urease testing include acidification and alkalinization of the test medium by products of endogenous metabolism and autolysis rather than urease activity. Anomalous results also occurred when cells were grown on media containing the chelating agent ethylenediaminetetraacetic acid (EDTA) prior to RUH. The addition of EDTA to a complex natural medium inhibited urease production in all yeasts reportedly growing at 35 degrees C (and all other yeasts tested), except Filobasidiella (Cr.) neoformans var. neoformans (NIH 12). The RUH test could differentiate at the varietal level: Fil. (Cr.) neoformans var. neoformans was about 10 times more resistant to EDTA in media used for the growth of cells prior to RUH testing than was Fil. neoformans var. bacillispora (Cr. neoformans var. gattii) (NIH 191). Urease production by Fil. neoformans var. bacillispora was specifically restored to half maximal activity by the addition of 22 microM Ni+2 (as NiCl2) to a growth medium containing 0.100 mM EDTA. PMID- 3300914 TI - Alterations in lipopolysaccharide produced by chemostat-grown Escherichia coli O157:H7 as a function of growth rate and growth-limiting nutrient. AB - Escherichia coli O157:H7 was grown in chemostats as continuous cultures at different controlled growth rates and under different nutrient limitations to determine the effects on lipopolysaccharide (LPS) structure. LPS from whole cells and extracted using the hot aqueous phenol method was examined by sodium dodecyl sulfate--polyacrylamide gel electrophoresis (SDS-PAGE) and by gel filtration after hydrolysis with acetic acid. At low growth rates under glucose limitation (D = 0.1 h-1, doubling time (td), approx. 416 min; or D = 0.4 h-1, td, approx. 104 min), E. coli O157 produced high molecular weight LPS identical to that previously characterized from cells grown in batch culture. At a high growth rate (D = 0.8 h-1, td, approx. 52 min), the ratio of high molecular weight LPS to low molecular weight LPS produced greatly decreased. A small amount of high molecular weight LPS, containing O-polysaccharide which lacked amino sugars, and which thus was chemically different from that previously characterized, was produced by the cells at high growth rates. The predominant form of LPS from these cells was of slightly higher molecular weight than rough LPS, probably S-R LPS, and it consistently formed aggregates on SDS-PAGE. This form of LPS was also predominant when E. coli O157 was grown under Mg2+ limitation at an intermediate growth rate (D = 0.4 h-1, td, approx. 104 min). PMID- 3300913 TI - Cellular incorporation of poly-beta-hydroxybutyrate into plasma membranes of Escherichia coli and Azotobacter vinelandii alters native membrane structure. AB - Under growth-limiting conditions or conditions which mediate genetic transformation, Escherichia coli and Azotobacter vinelandii incorporate poly-beta hydroxybutyrate into their plasma membranes. Genetic transformation competence of both bacteria increased in proportion to the concentration of membrane poly-beta hydroxybutyrate. The effects of this lipid polymer on membrane structure were investigated by freeze-fracture electron microscopy. Before poly-beta hydroxybutyrate incorporation, freeze-fracture revealed a typical mosaic of particles and pits on both concave and convex surfaces of the plasma membrane. As the cells incorporated the lipid polymer into the membrane, transformability developed and small semiregular plaques which possessed shallow particles were seen. These plaques grew in size and frequency as the membrane poly-beta hydroxybutyrate concentrations and transformability increased. PMID- 3300915 TI - Effect of some soybean and bean phytoalexins and related isoflavonoids on growth of Candida albicans. AB - The influence of a series of related isoflavonoids on growth of the zoopathogenic yeast, Candida albicans, in liquid media was studied. The order of effectiveness was identical with that previously found for a range of phytopathogenic fungi. Minimum inhibitory concentration of phaseollinisoflavan, the most active test compound, was 250 microM for 3 days after inoculation. However, C. albicans resumed growth thereafter. Phaseollinisoflavan, 500 microM, did not inhibit but only delayed growth of the yeast. Tolerance of C. albicans to phaseollin and phaseollinisoflavan was based on nondegradative mechanism(s), while tolerance to glyceollin appeared to be based on detoxification. PMID- 3300916 TI - Care of the ureter in pelvic surgery. AB - Maintaining the integrity of the ureter is crucial in pelvic surgery. The ureter is best safeguarded by routine intraoperative exposure, which will also allow immediate recognition of injury to it. If doubts over possible injury persist, it is best to open the bladder. The flux of urine from the ureteric orifices or the retrograde passage of catheters will then confirm or deny clinical suspicions. If specialist help is unavailable, the pelvic surgeon must be able to perform simple ureteric repairs or temporize in a way that allows the safe delay of definitive surgery. End-to-end ureteric anastomosis and ureteroneocystostomy are straight forward procedures that all pelvic surgeons should be familiar with. If they cannot be performed safely, the situation may be salvaged by draining the proximal ureter through the lateral abdominal wall; later, definitive surgery can be performed. PMID- 3300918 TI - St. Anthony's fire, then and now: a case report and historical review. AB - A rare case of morbid vasospasm, together with striking angiographic findings, is described secondary to the ingestion of methysergide by a 48-year-old woman. A brief review of the literature on similar cases is presented. A discussion of the history of ergot includes its original discovery, the epidemics of gangrene that it has caused through the ages and its past and present role in the management of migraine headache. Despite the advent of calcium channel blockers and beta adrenergic antagonists, ergot preparations continue to play a major role in migraine therapy, so that the danger of St. Anthony's fire persists. PMID- 3300917 TI - Posterior wall disruption of the left ventricle after mitral valve replacement: management of bleeding and cardiac enlargement. AB - Two patients who underwent mitral valve replacement sustained posterior left ventricular disruption postoperatively and survived. Management consisted of repair from outside the heart without removal of the mitral prosthesis. This was achieved with a running Prolene suture in the atrioventricular junction in one patient and pledgeted sutures in the other who had transverse midventricular disruption. Biologic glue was crucial in controlling hemorrhage after the repair in both cases. The patient with transverse midventricular disruption required placement bilaterally of pectoralis muscle flaps to close the sternal wound because of swelling and dilatation of the heart. PMID- 3300919 TI - Serum susceptibility of bovine pasteurellas. AB - In this study, the serum sensitivity of 23 P. haemolytica isolates and 18 P. multocida isolates was determined by incubating dilutions of bacteria with equal volumes of fresh or heat-inactivated bovine serum for one, two, or three hours. Clinical isolates of both Pasteurella species were resistant to serum, whereas isolates from asymptomatic cattle varied in serum susceptibility. The classical pathway of complement appeared to be the principal means of complement mediated killing as detected by incubation in the presence or absence of EGTA-MgCl2. Lyzozyme and iron saturation of serum did not greatly affect serum susceptibility with either of the Pasteurella species. PMID- 3300920 TI - The resemblance of clinical attributes between mastitic cows with no growth on bacterial milk cultures and those with gram-positive bacteria cultured. AB - The clinical attributes of 40 dairy cows which had mastitis but no growth of bacteria from the milk were analyzed and compared to the attributes in 102 cows with only gram-positive and 61 cows with only gram-negative bacteria cultured from the milk. Cows with no bacteria cultured from the milk did not differ significantly from cows with gram-positive bacteria cultured, but 9 of 12 attributes were significantly different between cows with no bacteria cultured and cows with gram-negative bacteria cultured. Discriminant analysis was used to classify cows as members of the gram-positive or gram-negative culture groups. The discriminant equation was then applied to the cows with no bacteria cultured, and 78% of cows with no bacteria cultured were classified as members of the gram positive group. Most mastitis in cows with no bacteria grown from the milk was probably due to gram-positive bacteria. If antibiotic therapy is used in cows with persistent mastitis and a negative culture in the belief that the culture is a false negative, treatment with antibiotics effective only against gram-negative organisms would not be appropriate. PMID- 3300921 TI - Vaccination studies against experimental bovine Pasteurella pneumonia. AB - Vaccination-challenge experiments were conducted in colostrum-deprived calves to evaluate the efficacy of Pasteurella bacterins and vaccines against experimental pneumonic pasteurellosis. Calves were vaccinated with formalin-killed bacterins and live vaccines, then challenge exposed intratracheally with P. haemolytica or P. multocida. Infectious bovine rhinotracheitis virus was inoculated intranasally three to four days prior to P. haemolytica challenge-exposure. All calves were examined for macroscopic and microscopic lesions after being found dead or following euthanasia four to seven days after challenge exposure with the bacterial pathogen. Clinical, hematological, and pathological responses to challenge exposure in aluminum hydroxide absorbed P. haemolytica and P. multocida bacterin-treated calves were consistent with the pneumonic lesions of pulmonary pasteurellosis in the control calves. An oil-adjuvanted P. haemolytica bacterin limited clinical and pathological responses in the affected calves whereas a P. multocida oil-adjuvanted bacterin did not. Both clinical and pathological responses to challenge exposure in calves vaccinated with live Pasteurella vaccines were less severe than those of the control calves. Vaccine effectiveness appeared to be dose dependent. PMID- 3300922 TI - Isolation of Leptospira hardjo from kidneys of Ontario cattle at slaughter. AB - Kidneys from 117 cattle from 110 Ontario farms were examined at slaughter for leptospires. Leptospira hardjo (hardjo-bovis A) was isolated from 11 kidneys and L. kennewicki from one. The isolations were all made (12/89, 13.5%) from beef cattle from feedlots, no isolates being obtained from dairy or beef cattle from extensive farms (0/28). Isolations were only made from cattle with antibody titers (greater than or equal to 20) against the serovars recovered. Isolation was more sensitive than immunofluorescence in identifying leptospira, particularly in animals with low antibody titers against L. hardjo. Leptospira were isolated from two kidneys with multiple gross lesions of focal nephritis, but there was no correlation between the presence of scanty kidney lesions and isolations of leptospira. Leptospira hardjo infection appears to be common in Ontario feedlot cattle. PMID- 3300923 TI - Prevalence and significance of group B Streptococcus in a large obstetric population. AB - Between Jan. 1 and Dec. 31, 1985, vaginal swabs were obtained for culture for group B beta-hemolytic Streptococcus (GBS) from 3078 women admitted for labour and delivery to Regina General Hospital. Seventy-one women had positive results; thus, the colonization rate was only 2.3%. The charts of the 71 women and their 73 babies were analysed. Of the 58 babies from whom swabs were obtained, 20 had GBS at one or more sites; the transmission rate was therefore 34%. Early-onset GBS disease developed in one infant. Two infants died within the first month; however, death was not directly attributable to GBS. Higher rates of preterm delivery and of low birth weight were noted among the babies of the colonized women than among the babies of all women admitted for labour and delivery in 1985. Given the low rate of GBS disease in our centre, we suggest that emphasis be placed on GBS as a possible source of obstetric complications such as preterm labour. PMID- 3300924 TI - A Canadian giant: Dr. Gordon Murray and the artificial kidney. PMID- 3300925 TI - Future directions of bone marrow transplantation. PMID- 3300926 TI - Registry of unrelated bone marrow donors. AB - Reports of successful transplantation of bone marrow obtained from unrelated donors who were histocompatibility leukocyte antigen (HLA) identical prompted the Canadian Red Cross Blood Transfusion Service in Ottawa to assess the possibility of developing a bone marrow donor registry in Canada. We sent a pamphlet that explained the program to 1568 people who had undergone apheresis and asked them to reply, stating their interest. At the same time the pamphlets and a poster were placed in the blood donor clinic. We received 1232 replies (78.6%) from the apheresis donors, 838 (68.0%) of which indicated a willingness to attend information sessions. Of the 7158 people who gave blood during the 3-month study period, 225 (3.1%) were interested. At the time this paper was written 47 information sessions had been held, and 721 people had attended, 624 (86.5%) of whom had signed a consent form. This indicates a clear interest in a bone marrow donation program. We believe that the ethical issues are overcome by requesting the donation before identification of any patient. From our experience a national registry of unrelated donors seems feasible, and steps are being taken to implement such a program. PMID- 3300927 TI - Exposure of involuntary smokers to toxic components of tobacco smoke. PMID- 3300928 TI - Dermatology and mucous membrane disease. A historical perspective. PMID- 3300929 TI - Sexually transmitted diseases of mucous membranes. PMID- 3300931 TI - Reactions of the mucous membrane to contactants. PMID- 3300930 TI - Non-sexually transmitted infectious diseases of the oral, nasal, and vaginal mucosae. PMID- 3300932 TI - Diseases of the mucous membranes in children. PMID- 3300933 TI - Mucous membranes in systemic disease. PMID- 3300934 TI - Microbial colonization of mucous membranes. PMID- 3300935 TI - Mucous membrane manifestations of the acquired immunodeficiency syndrome. PMID- 3300936 TI - Diseases of the lips and oral cavity of domestic animals. AB - Oral and lip lesions in domestic animals, as in man, may be due to a vast number of diseases. While some of these diseases are unique to each species, the majority of them are similar to human afflictions. These represent an untapped resource in comparative medicine, and research in this area can only benefit both man and the domestic animals he is dependent upon. PMID- 3300937 TI - Inflammatory and neoplastic diseases of the conjunctiva. PMID- 3300938 TI - Inflammatory and neoplastic disorders of the nasal mucosa. PMID- 3300939 TI - Inflammatory and neoplastic lesions of the oral cavity. PMID- 3300940 TI - Odontologic and periodontal diseases. PMID- 3300941 TI - Inflammatory and neoplastic diseases of the vulva. PMID- 3300942 TI - Inflammatory and neoplastic lesions of penile gland and periglandular regions. PMID- 3300943 TI - Inflammatory and neoplastic diseases of the anal and perianal regions. PMID- 3300944 TI - Microparticulate drug delivery systems as an adjunct to cancer treatment. AB - In an attempt to improve the therapeutic ratio of cytotoxic drugs, which have steep dose-response curves, microparticulate drug delivery systems (MDDS) have been designed for regional administration. Introduction of antineoplastic drug containing microspheres, of appropriate size, into the arterial system of an organ harboring primary or metastatic tumor, will cause tumor infarction by an embolic effect and provide a slow release source of drug trapped within the tumor microvasculature. This review describes recent innovations in synthesis of MDDS and their potential clinical application. PMID- 3300945 TI - Localized neuroblastoma. Surgical and pathologic staging. AB - Sixty-five children with neuroblastoma without evidence of distant metastases underwent initial tumor resection. Seventeen with no evidence of lymph node involvement in whom tumor resection was complete (Group 1) received no further antitumor therapy. One child died postoperatively; disease recurred in the bone marrow of one child at 52 months, the child subsequently died. Fifteen were alive without disease, giving an 82% actuarial five year survival. Forty-eight children with minimal residual tumor and/or regional lymph node involvement (Group 2) received two 5-day courses of Peptichemio (1.2 mg/kg/d) and the 29 children in this group who were older than 1 year of age at diagnosis were randomized to receive either radiotherapy to the tumor bed in addition or no radiotherapy. In Group 2, ten of the 48 have relapsed: six of 17 with initial lymph node involvement, three of four with tumor rupture at operation, and one of eight with tumor extension to the intervertebral foramen. No relapses were seen in the 19 children with minimal residual tumor confined to the tumor bed. Only one of the 18 Group 2 children who were younger than 1 year of age at diagnosis relapsed. Of the 29 Group 2 children who were older than 1 year of age at diagnosis, five relapses occurred in the 14 who received radiotherapy and four relapses in the 15 who did not receive radiotherapy. All six children with disseminated relapse died. Actuarial 5-year survival in Group 2 is 87%, and actuarial relapse-free survival, 76%. PMID- 3300946 TI - Craniopharyngioma in an elderly patient. AB - Craniopharyngioma, a tumor most commonly diagnosed in the young, may occur at any age. The oldest patient known to have histologic documentation of a craniopharyngioma, an 82.5-year-old woman, presented with visual field changes, panhypopituitarism, and mental status changes. This diagnosis should be considered in such patients, because craniopharyngioma is a potentially curable tumor by either surgery or radiation therapy. PMID- 3300947 TI - Metastasis of invasive carcinoma of the breast to an extradural meningioma of the cranial vault. AB - A case of metastasizing invasive carcinoma of breast to an expanding extradural frontal meningioma is presented. The peculiar tendency of meningioma to be the host tumor for carcinoma is discussed. The literature pertaining to such rare occurrences is reviewed. PMID- 3300948 TI - Dysphagia as the presenting symptom of recurrent breast carcinoma. AB - Esophageal obstruction secondary to recurrent breast carcinoma is not widely recognized. Frequently, the esophageal narrowing is attributed to a benign process, resulting in delays of diagnosis and treatment. Such a case prompted this report and review of the literature. PMID- 3300949 TI - Adenosquamous carcinoma of the colon presenting with hypercalcemia. AB - A rare adenosquamous carcinoma of the colon occurred in a 41-year-old patient. Its presentation with hypercalcemia, in the absence of osseous metastases, has not been described previously. The hypercalcemia in this case was due to the elaboration of a parathyroid hormone-like substance by the tumor. The general characteristics of primary adenosquamous and squamous cell carcinomas of the colon are presented. These tumors present with advanced disease, in younger patients, and follow a highly aggressive course, as compared with adenocarcinomas of the colon. The cause of the malignancies, in the light of current theories regarding their genesis, is discussed. PMID- 3300950 TI - Serum ferritin in patients undergoing bone marrow transplantation. AB - Serum ferritin levels were monitored in nine patients with acute lymphoblastic leukemia (ALL), nine patients with acute nonlymphoblastic leukemia (ANLL), four patients with chronic myelogenous leukemia (CML), three patients with non Hodgkin's lymphoma (NHL), and three patients with severe aplastic anemia (SAA) undergoing bone marrow transplantation (BMT) for hematologic malignancies or aplastic anemia. Serum ferritin analysis was performed before and after BMT at monthly intervals and/or according to the clinical condition of the patient. Serum ferritin increased considerably during the first 3 months following BMT and then decreased in patients with an uncomplicated course. Ferritin levels in the serum of patients who had undergone BMT decreased gradually when complete remission was achieved, but increased with any clinical complication. Thus, elevation of serum ferritin concentration was predictable for clinical complications and for relapse. Patients with acute leukemia with serum ferritin levels above 400 micrograms/l at time of BMT had a risk of relapse within 1 year, triple that patients with lower ferritin levels. All patients who underwent BMT to treat severe aplastic anemia have completely recovered. Accordingly, following an initial increase after BMT, serum ferritin levels returned to normal and remained so in line with the patients' good clinical condition. The findings indicate that serum ferritin yields useful information in the clinical evaluation of patients undergoing BMT. PMID- 3300951 TI - The Memorial Pain Assessment Card. A valid instrument for the evaluation of cancer pain. AB - Effective evaluation and treatment of cancer pain require valid and independent measurement of pain intensity, pain relief, and psychological distress. The Memorial Pain Assessment Card (MPAC) is a simple instrument designed to provide rapid evaluation of these subjective experiences. On the 8.5 by 11 inch card are printed the eight pain intensity descriptors, and three visual analog scales which measure pain intensity, pain relief, and mood. Experienced patients can complete it in less than 20 seconds. The authors administered the MPAC to 50 hospitalized cancer patients within 48 hours of referral to the Pain Service for inadequate pain control, together with standard measures: The McGill Pain Questionnaire, Profile of Mood States, Hamilton Depression Scale, and Zung Anxiety Scale. Correlational and multiple regression analyses revealed that the MPAC can distinguish pain intensity from pain relief and from general psychological distress, and it can provide multidimensional assessment that is practically equivalent to the full assessment battery. We conclude that the MPAC is valid and effective for clinical use, and recommend it for the assessment of individual patients, and as an outcome measure in clinical trials. PMID- 3300952 TI - Successful treatment with chemotherapy and subsequent allogeneic bone marrow transplantation for myeloid blastic crisis of chronic myelogenous leukemia following advanced Hodgkin's disease. AB - A 33-year-old man was treated with intensive chemotherapy for myeloid blastic crisis of chronic myelogenous leukemia (CML), which developed after radiotherapy and chemotherapy for Hodgkin's disease. After achieving a second chronic phase, he underwent allogeneic bone marrow transplantation (BMT). Despite many complications, 1 year after BMT the disease was in complete remission and the patient was in excellent condition. The incidence of CML following treatment for Hodgkin's disease is briefly discussed. This is the first report of prolonged complete remission for blastic crisis of CML, which developed after combined treatment for advanced Hodgkin's disease. PMID- 3300953 TI - Adjuvant postoperative radiotherapy, chemotherapy, and immunotherapy in stage III breast cancer. II. 5-year results and influence of levamisole. AB - One hundred twenty pathologically confirmed operable Stage III breast cancer patients were randomized to receive either postoperative radiotherapy or chemotherapy, or a combination of these, with or without levamisole immunotherapy. Radiotherapy was given to regional lymph nodes and chest wall. Chemotherapy consisted of six cycles of vincristine, doxorubicin, and cyclophosphamide. Radiotherapy provided local and chemotherapy systemic control over the tumor, but the best patient-saving results were achieved with a combination of radiotherapy and chemotherapy. This clinical trial was commenced in 1976, and the first 60 of 120 patients also received oral levamisole, 150 mg/day, on 2 consecutive days weekly as immunotherapy. All patients were followed for at least 5 years. At this stage levamisole seems to increase disease-free and overall survival in all three treatment arms (radiotherapy, chemotherapy, combined treatment). Significance is reached in disease-free survival (P = 0.035) and overall survival, adjusted for all other treatment modalities (P = 0.019). PMID- 3300955 TI - [How does the computer affect the nurse's work]. PMID- 3300954 TI - Immunoreactive vasoactive intestinal polypeptide in acinic cell carcinoma of the parotid gland. AB - Vasoactive intestinal polypeptide (VIP) in the neoplastic cells of acinic cell carcinomas arising in the human parotid gland was found immunohistochemically, whereas other parotid gland tumors, such as pleomorphic adenoma, Warthin's tumor, oxyphilic adenoma, mucoepidermoid carcinoma, adenocarcinoma, and adenoid cystic carcinoma, did not show positive immunoreactivity for VIP. The acinic cell carcinoma stained with Grimelius impregnation and had dense core granules immunoreactive with anti-VIP serum. Moreover, a comparatively high concentration of immunoreactive VIP was detected by radioimmunoassay in an acinic cell carcinoma, whereas VIP concentration of the other tumors was undetectable. PMID- 3300956 TI - A historical outline of the development of cancer cytogenetics. PMID- 3300957 TI - Role of thymidine in biochemical modulation: a review. AB - The role of thymidine in the treatment of cancer has been under clinical investigation for nearly a decade. Clinical trials have demonstrated that it lacks antitumor activity in its own right. In this review, the mechanism of action and rationale for the use of thymidine as a biochemical modulator of standard agents such as 5-fluorouracil, 1-beta-D-arabinofuranosylcytosine, and methotrexate are summarized. With this background, the clinical trials which have been conducted with thymidine, either alone or in combination, are described. We suggest a number of further studies of the role of thymidine in the biochemical modulation of antimetabolites. PMID- 3300958 TI - Cellular pharmacology of 3'-(3-cyano-4-morpholinyl)-3'-deaminoadriamycin and structural analogues in human colon carcinoma HT-29 cells in vitro. AB - The new Adriamycin (ADR) analogue, 3'-(3-cyano-4-morpholinyl)-3' deaminoadriamycin (CMA), is the most potent anthracycline yet developed. The cellular pharmacology of CMA and 3'-(4-morpholinyl)-3'-deaminoadriamycin (MA), and their 5-imino derivatives, ICMA and IMA, were compared with ADR in a human colon carcinoma (HT-29) cell line in vitro. In a soft agar clonogenic assay, the order of antitumor activity was CMA greater than ICMA greater than ADR greater than MA greater than IMA, for both 2- and 24-h drug exposure periods, indicating a requirement for the cyanide group and an intact quinone ring for the potent antitumor effect of CMA. The cellular uptake of CMA was 2-fold less than that of MA, although, consistent with its greater nuclear binding, the degree of efflux of CMA was less than that of MA. The order of cytotoxicity of the analogues correlated approximately with their effects on cellular DNA synthesis, indicating that this feature may contribute to the antitumor effect. Using isolated nuclei, the order of inhibition of DNA transcription by the analogues was CMA greater than MA greater than ADR, which was similar to their nuclear affinities, suggesting that their effects on cellular nucleic acid synthesis were due to a direct interaction of drug with DNA. However, CMA did not appear to differ from the other drugs in its base specificity as all the analogues preferentially inhibited Escherichia coli RNA polymerase activity directed by poly(dAdT).poly(dAdT) compared to poly(dGdC).poly(dGdC). PMID- 3300959 TI - Oncogene-mediated multistep transformation of C3H10T1/2 cells. AB - We have examined the response of the mouse embryonic cell line C3H10T1/2 to transfection with the activated human c-H-ras oncogene and the gag-myc oncogene from avian myelocytomatosis virus 29. C3H10T1/2 cells are not morphologically transformed following transfection with the gag-myc oncogene. A low level of focus formation is observed following transfection of the c-H-ras oncogene. When C3H10T1/2 cells are cotransfected with the ras and myc oncogenes, focus formation is increased by an average of 13 fold. In addition, C3H10T1/2 ras/myc foci have a distinct, transformed morphology which correlates with an increased potential for anchorage-independent growth. Although morphological transformation in this system is largely a function of ras oncogene expression, our studies demonstrate that it is potentiated by the presence of a functional gag-myc protein. Oncogene mediated multistep transformation, which was first described in primary embryo cultures, is not a general property of established cell lines. The C3H10T1/2 cell line is an exception and provides a model system in which partially transformed phenotypes, in a progression toward malignant transformation, can be isolated and studied. PMID- 3300960 TI - Macrophage content of spontaneous metastases at different stages of growth. AB - The macrophage content of spontaneous metastases has been quantified morphometrically for a panel of rodent tumors at different stages of metastatic tumor growth. Using a histochemical technique to selectively stain macrophages, we have evaluated the relative content of macrophages in spontaneous pulmonary metastases from the 13762NF MTLn3 rat mammary adenocarcinoma and the B16-BL6 mouse melanoma, as well as in spontaneous hepatic metastases from the M5076 mouse reticulum cell sarcoma and from autochthonous reticulum cell sarcomas in SJL/J mice. Between 112 and 254 separate, individual metastases were evaluated for each of these tumors. The data show that the relative macrophage content of very small metastases is high. However, as metastases grow the relative macrophage content falls, reaching uniformly low levels by the time the metastases are 0.5 mm in diameter. These data are very similar to our previous observations on experimental metastases where the same pattern of high macrophage content in small metastases was seen. Finding the same pattern in more slowly growing, spontaneous metastases of tumors derived from several different tissues and in two species suggests that the fall in relative macrophage content is not a phenomenon isolated to experimental metastases, a particular site, or a tissue of origin for the tumor. The relative decrease in macrophage content may thus be a general phenomenon with important implications for immunotherapy directed to enhancing the tumoricidal activity of macrophages. PMID- 3300962 TI - Recent hypotheses for the origin of colon cancer. PMID- 3300961 TI - High correlation between molecular alterations of the c-myc oncogene and carcinoma of the uterine cervix. AB - We have examined 35 human tumors of the uterine cervix (carcinoma presenting the highest incidence in Mexico; about 34% of women's malignant tumors) for alterations of the cellular myc (c-myc) protooncogene. Elevated amplification and/or rearrangement of the c-myc oncogene were detected in most (approximately 90%) samples (48% showed amplification and 43% presented both alterations). Most tumors were stage II cervical carcinomas and for some of them we detected up to 60-fold amplification of c-myc. These results suggest an important role for c-myc oncogene in the development of tumors of the uterine cervix. PMID- 3300963 TI - Impact of insulin on doxorubicin-induced rat host toxicity and tumor regression. AB - To test whether the anorexia and host depletion following doxorubicin chemotherapy can be improved by concomitant insulin therapy, 70 F344 rats were divided equally between tumor-bearing (TB) and non-tumor-bearing (NTB) groups and studied for food intake, host weight, and tumor size changes. Sarcoma fragments were implanted s.c. in TB rats and 18 days later all rats received an i.v. dose of doxorubicin (8 mg/kg). The following day TB and NTB rats were randomized to receive neutral protaminehagedorn insulin (2 units/100 g/24 h) or normal saline until food intake returned to normal. Following doxorubicin administration food intake and host weight declined in an identical pattern in both NTB and TB rats treated with saline. However, beginning on day 6 insulin-treated TB and NTB rats ate significantly more than saline-treated controls. Insulin-treated animals returned to normal food intake levels in 50% less time than controls. This improved food intake resulted in an improved host mass beginning also on day 6 for both TB and NTB rats. In addition, it appeared that insulin treatment significantly improved the tumor shrinkage initiated by doxorubicin. Following doxorubicin, insulin-treated TB rats had a greater reduction of tumor size (10.6 +/- 1.2 cm3) compared to saline-treated rats (6.6 +/- 0.8 cm3, P less than 0.01). To further characterize the effect of insulin and/or doxorubicin on tumor growth, the experiment was repeated in the same manner except for two additional TB groups: saline- and insulin-treated tumor bearers with treatment beginning 19 days after tumor implant. Rats treated with doxorubicin had a significant reduction in tumor size compared to rats not treated with doxorubicin (P less than 0.001). Insulin alone did not affect tumor growth, but insulin plus doxorubicin significantly decreased tumor size compared to doxorubicin alone (P less than 0.01). In a second experiment using 80 rats insulin treatment had no apparent effect on reduction of peripheral blood counts including white blood cells, neutrophils, lymphocytes, platelets, and hematocrit induced by doxorubicin in either NTB or TB rats. Insulin given 24 h previously had minimal effect on plasma glucose. The marked improvement in food intake and host weight, as well as additional tumor reduction with exogenous insulin following doxorubicin, suggests that insulin may have a role in reversal of doxorubicin host nutritional toxicity and perhaps improvement of antitumor efficacy. PMID- 3300964 TI - Hyperthermic enhancement of cis-diammine-1,1-cyclobutane dicarboxylate platinum(II) cytotoxicity in human leukemia cells in vitro. AB - Hyperthermic enhancement of cis-diammine-1,1-cyclobutane dicarboxylate platinum(II) (carboplatin) cytotoxicity was studied in vitro in JM, a human acute lymphoblastic leukemia cell line. Corrected for direct heat toxicity, hyperthermia enhanced carboplatin killing at the clinically relevant temperatures of 40.5 degrees and 41.8 degrees C. The thermal enhancement ratios at these temperatures were 1.89 and 3.32, respectively. Cell killing increased exponentially with increasing duration of combined treatment (41.8 degrees C, carboplatin 30 micrograms/ml) for at least 3.5 h. Hyperthermic enhancement was maximal when heat was given during or immediately before carboplatin; enhancement was diminished when heat preceded carboplatin by more than an hour and was not apparent when heat followed drug treatment. As carboplatin is associated with different clinical toxicity than is cis-diamminedichloroplatinum(II), carboplatin may represent an ideal drug in its class of anticancer agents to use in clinical whole body hyperthermia trials. PMID- 3300965 TI - Slow DNA rejoining in ultraviolet-irradiated human diploid fibroblasts treated with the mitogens trypsin and insulin. AB - Normally in mammalian cells the postincision steps of UV-induced excision repair are much more rapid than the recognition of damage and incision. This means that at any one time the level of repair-generated single-stranded DNA breaks is very low. Here we report that detectable levels of DNA breaks accumulate in quiescent human fibroblasts which are UV irradiated a few hours after replating in conditions that stimulate progress through the cell cycle. Most DNA breaks accumulate in cultures trypsinized and seeded in medium supplemented with insulin, and irradiated in early G1. Because trypsin and insulin have no effect on UV-induced incision rates, as measured by DNA break accumulation in the presence of DNA synthesis inhibitors, we argue that our ability to detect incomplete repair-sites is due to a significant reduction in the rate of gap sealing indicative of a shift in the steady state of excision repair. Provision of DNA precursors prevents the enhancing effect of trypsin and insulin on the accumulation of DNA breaks, implying that these agents affect DNA precursor metabolism. Perturbation of the repair process, which leads to the accumulation of 1500-2000 DNA breaks/genome, is also associated with other effects including increased lethality, the appearance of double-strand breaks and the loss of NAD, the last effect presumably arising as a consequence of break-stimulated poly(ADPR) transferase activity. Addition of 3-amino-benzamide, an inhibitor of poly(ADPR) synthesis, completely blocks the decline in NAD levels, but does not change the rate of sealing of the accumulated DNA breaks. These results strongly suggest that ligation is largely, if not entirely, independent of ADP ribosylation in this system. PMID- 3300966 TI - Response to tamoxifen and fluoxymesterone in a group of breast cancer patients with disease recurrence after cessation of adjuvant tamoxifen. AB - The response to tamoxifen or a combination of tamoxifen and fluoxymesterone was assessed in 54 postmenopausal breast cancer patients with recurrent disease. The patients had originally been entered in a randomized trial of 2 years of tamoxifen (40 mg daily), as an adjunct to primary surgery, versus no adjuvant endocrine therapy. The objective response rate (complete + partial) to the mentioned salvage endocrine therapies was significantly lower among patients from the tamoxifen group as compared to the controls (14% vs 54%; P less than 0.01). Their median time to disease progression was also significantly shorter (4 vs 15 months; P less than 0.05). Differences between the groups in regard to prognostic factors could not explain these differences. The lower response rate to these endocrine treatments was possibly one reason for the poorer survival outlook after relapse observed among the patients previously treated with adjuvant tamoxifen. An increased relapse-free survival achieved with adjuvant therapy may thus to some extent be offset by a poorer survival after relapse. PMID- 3300967 TI - Platinum analogs in recurrent and advanced head and neck cancer: a Southwest Oncology Group and Wayne State University Study. AB - Cisplatin combinations are active in patients with epidermoid cancer of the head and neck. Because of the incidence of dose-limiting toxicity and the need for hospitalization for iv hydration and mannitol diuresis, the search for active analog(s) with less of such toxicity has been intensive. In a limited institution study of Wayne State University and the Southwest Oncology Group, a clinical trial of carboplatin (CBDCA) and iproplatin (CHIP) in patients with recurrent head and neck cancer was carried out. Sixty-four patients were entered and 63 were evaluated, 29 receiving CBDCA and 34 receiving CHIP therapy. These patients were stratified according to important prognostic factors. The response rate to CBDCA was 24% (seven responses among 29 patients; three complete responses and four partial responses), and to CHIP was 12% (four responses among 34 patients; one complete response and three partial responses). Both drugs were administered without prior hydration or mannitol diuresis on an outpatient basis. The major side effect was myelosuppression, which was reversible but cumulative and dose limiting. Less severe vomiting occurred as compared to the incidence of this toxicity with cisplatin and no significant renal or hearing loss occurred. It was concluded that further evaluation of these agents with other active drug(s) in patients with head and neck cancer is warranted. PMID- 3300968 TI - Cardiotoxicity of 5-fluorouracil. AB - Three patients developed anterior substernal chest pain in association with ischemic electrocardiographic changes temporally related to continuous infusions of 5-fluorouracil (5-FU). Two patients developed myocardial infarctions and one died. Cardiac toxicity of 5-FU may be more likely when the drug is given by continuous infusion in the presence of preexisting cardiac disease. The pattern of cardiac toxicity suggests cardiac ischemia most likely secondary to coronary artery vasospasm. Patients should not receive 5-FU by infusion if they have significant underlying coronary artery disease or if they develop anterior substernal chest pain while receiving the drug. PMID- 3300969 TI - Phase II study of esorubicin in patients with advanced colorectal carcinoma and no prior chemotherapy: an Illinois Cancer Council Trial. PMID- 3300970 TI - Phase II evaluation of aclarubicin in refractory multiple myeloma: a Southeastern Cancer Study Group Trial. PMID- 3300971 TI - 5-Fluorouracil and cytarabine--ineffective treatment in advanced colorectal carcinoma: a Southeastern Cancer Study Group Trial. PMID- 3300972 TI - Chemical synthesis of the trisaccharide unit of the species-specific phenolic glycolipid from Mycobacterium leprae. AB - O-(3,6-Di-O-methyl-beta-D-glucopyranosyl)-(1----4)-O-(2,3-di-O-methyl- alpha-L rhamnopyranosyl)-(1----2)-3-O-methyl-L-rhamnopyranose, the haptenic trisaccharide of the Mycobacterium leprae-specific phenolic glycolipid I (PGL-I) antigen, and related trisaccharides, were synthesized by allylation of O-2 of benzyl 4-O benzyl-alpha-L-rhamnopyranoside using phase-transfer catalysis, methylation of the product, deallylation, and coupling to O-(2,4-di-O-acetyl-3,6-di-O-methyl beta-D-glucopyranosyl)-(1----4)-2,3- di-O-methyl-L-rhamnopyranosyl bromide or related disaccharides. Anomeric mixtures of the trisaccharide derivatives were separated by preparative t.l.c., deacetylated, and hydrogenolyzed, to give the pure trisaccharides. It had already been demonstrated that only those trisaccharides containing an intact, terminal 3,6-di-O-methyl-beta-D glucopyranosyl unit are effective in inhibiting the specific binding between PGL I and anti-PGL-I immunoglobulin M antibodies in human lepromatous leprosy sera. PMID- 3300973 TI - Structural investigation of the capsular polysaccharide from Escherichia coli O9:K37 (A 84a). AB - The structure of the capsular polysaccharide from E. coli O9:K37 (A 84a) has been studied, using methylation analysis, Smith degradation, and graded acid hydrolysis. The configurations at the anomeric centres were assigned by 1H-n.m.r. spectroscopy of the polysaccharide and its derivatives and oligosaccharide fragments. The polysaccharide has the following trisaccharide repeating-unit which is unique in the E. coli series of capsular polysaccharides in possessing a 1-carboxyethylidene group as the sole acidic function. (Formula: see text) E. coli capsular polysaccharides have been classified into seventy-four serotypes. The structures of about twenty of these polysaccharides have been elucidated, one of which, K29, has been reported to contain a 1-carboxyethylidene group. In continuation of a programme aimed at establishing the structural basis for the serology and immunochemistry of the E. coli capsular antigens, we now report on the structure of the capsular polysaccharide from E. coli O9:K37. PMID- 3300974 TI - An evaluation of the effects of isosorbide 5-mononitrate in patients with angina on effort using dynamic electrocardiography and echocardiography. AB - We studied 14 patients, 9 males and 5 females, with an average age of 53.6 +/- 9.2 years, having been suffering from effort angina for over 6 months, with positive ergometer test for angina and ST-segment depression greater than 1 mm. All the patients performed a washout period of 7 days at the end of which, before and after acute administration (90 min) of isosorbide 5-mononitrate or placebo some echocardiographic parameters were controlled according to a double-blind, randomized, crossover design. Moreover, after 2 months of open treatment with isosorbide 5-mononitrate (20 mg three times daily), echocardiographic parameters were investigated again. Continuous ECG monitoring (24 h) was performed after the washout period and after 2 months of treatment. After acute administration of isosorbide 5-mononitrate, we observed a reduction in pre- and afterload, whereas after 2 months of treatment the reduction in preload seems to play a more important role. Together with other mechanisms these haemodynamic changes are responsible for the substantial diminution of myocardial oxygen consumption, and consequently for the reduction of transient ischaemic episodes, both symptomatic and asymptomatic with heart rate increase. These results suggest that isosorbide 5-mononitrate exhibits a definite nitrate-typical vascular activity that is evident both after single administration and after 2 months of treatment. PMID- 3300975 TI - Dose-effect relationship amongst three different sustained-release forms of isosorbide 5-mononitrate in patients with coronary artery disease. AB - Fifteen patients with coronary artery disease and stable angina pectoris were included in a double-blind, randomized, cross-over study. The patients received 25, 50 and 100 mg isosorbide 5-mononitrate, as well as a placebo, for subsequent 1-week periods. On the 7th day of each treatment period, 8 h after medication application, an exercise test was performed. A highly significant (p less than 0.001) and dose-dependent reduction of the sum of the ST-segment depression was observed at similar workloads: 28.6, 46 and 63.5% decreases occurred at the 25, 50 and 100 mg isosorbide 5-mononitrate doses, respectively. Compared to placebo, the frequency of anginal attacks and the consumption of nitroglycerin likewise decreased highly significantly (p less than 0.001) with all three doses. Isosorbide 5-mononitrate plasma levels (8 h post-application) increased linearly with the dose; amounting to 228 +/- 53, 485 +/- 93 and 991 +/- 177 ng/ml at the 25, 50 and 100 mg doses of the sustained release medication forms, respectively. PMID- 3300976 TI - Development of mononitrates. PMID- 3300977 TI - Influence of isosorbide 5-mononitrate 20 mg, sustained-release 50 mg and sustained-release nifedipine 20 mg on ischaemic ST-segment changes during Holter monitoring. A double-blind cross-over study in patients with spontaneous angina pectoris. AB - Objective evidence of transient ischaemia can be obtained by ST-segment analysis of ambulatory ECG recordings. To compare the anti-ischaemic effects of isosorbide 5-mononitrate (IS 5-MN) and nifedipine in sustained-release formulations, we entered 16 patients with documented spontaneous ischaemic episodes in a double blind cross-over study. The study consisted of four 1-week treatment periods with repeated 24-hour recordings at the end of each period. Nifedipine 3 X 20 mg/day was compared to IS 5-MN 3 X 20 mg/day and IS 5-MN 50 mg once daily for 1 week each. 12 patients completed the study protocol: 1 withdrew because of headache, 1 developed hyperthyroidism and in 2 patients the study was discontinued because the anginal symptoms became unstable. For the entire group both ways of treatment showed beneficial effects with significant reductions of the number of episodes (reduced by 65-68%, p less than 0.01), duration of episodes (reduced by 65-70%, p less than 0.05) and degree of ST deviation (reduced by 39-70%, p less than 0.05). With both IS 5-MN (7 of 12 and 6 of 12 patients) and nifedipine (5 of 12 and 8 of 12) a part of the group of patients became free of ischaemic episodes. In individual patients, however, different patterns of response were observed: 3/12 showed a complete response on both treatments, 1/12 was free on IS 5-MN only and 1/12 on nifedipine only.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300978 TI - Changing ideas in the treatment of heart failure--an overview. AB - Patients with heart failure should stop smoking, maintain an optimal weight and limit their intake of salt. Alcohol abuse should be avoided. The detection and early treatment of hypertension appears to have had a major impact in preventing heart failure. Diuretics revolutionized the treatment of congestive heart failure and their proper and appropriate use can alleviate peripheral and pulmonary oedema. Diuretics should not be overused and care should be taken to avoid hypokalaemia. Controversy surrounds the use of digoxin in patients in sinus rhythm; the drug should be used in patients in atrial fibrillation. The use of an inotropic drug may be harmful in the presence of coronary artery disease. A reduction in the current use of digoxin might be of benefit to many patients with heart failure. When the drug is prescribed it should be used in a therapeutic and not homeopathic dose. Recent interest has been directed toward the use of vasodilators and the angiotensin-converting enzyme inhibitors in patients with heart failure. In my opinion, these drugs should be used after patients have been treated with thiazide and loop diuretics. Vasodilators are particularly beneficial in acute heart failure or in patients with chronic heart failure when the symptoms are related to fluid overload and volume expansion. The cause of symptoms in patients with chronic heart failure optimally treated with diuretics is controversial. Shortness of breath may not be simply related to the left atrial pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3300979 TI - Isosorbide 5-mononitrate pharmacokinetics. AB - Isosorbide 5-mononitrate differs from other clinically used organic nitrate vasodilators because of its almost complete oral absorption, the low intersubject variability in its plasma concentrations and pharmacokinetic parameters, its relatively long half-life and its lack of active metabolites. The drug does not appear to be bound to plasma proteins and it is metabolized primarily by denitration and conjugation. Its clearance is 127 ml/min, volume of distribution 48.5 litres and half-life 4.4 h. Its pharmacokinetics are linear over the dosage range likely to be used clinically. Sustained-release formulations of the drug could prove suitable for once-a-day administration. In disease states (cardiac, renal or hepatic), the plasma concentrations and pharmacokinetics of the drug appear to be similar to those in healthy subjects. PMID- 3300980 TI - Thrombosis in acute myocardial infarction and sudden death. PMID- 3300981 TI - Thrombosis in unstable angina: angiographic aspects. AB - Angiographic studies in patients with unstable angina indicate that intracoronary thrombus is present in a substantial proportion of patients with unstable angina who have early angiography and that these patients often have distinctive coronary lesion morphology that may represent a marker for instability. These studies, in conjunction with recent histopathologic studies demonstrating plaque defects and overlying thrombosis in patients with unstable ischemia and sudden death, suggest a common mechanism for unstable angina and myocardial infarction and strongly support the rationale for antithrombotic therapy with heparin and with aspirin in the management of patients with unstable angina. PMID- 3300982 TI - Thrombosis in acute myocardial infarction and sudden death: angiographic aspects. PMID- 3300983 TI - Clinical trials of antiplatelet drug therapy in acute myocardial infarction, unstable angina, and aortocoronary bypass surgery. PMID- 3300984 TI - Advances in the treatment of coronary heart disease: fish oils, cholestyramine, and mevinolin. PMID- 3300985 TI - Physiology of hemostasis and its relationship to cardiovascular disease. AB - Our original understanding of coagulation was too simple. The waterfall or cascade system made sense but never gave clues either to points for control of the reaction or to areas to inhibit or reverse clotting. We now know critical points for control and reversal of hemostasis. By understanding more modern physiology, one is better able to design rational treatment programs to negate unwanted thrombosis. This chapter gives the reader a physiologic foundation to underscore the subsequent chapters. PMID- 3300986 TI - Thrombosis, platelets, spasm, and acute myocardial ischemia. PMID- 3300987 TI - Current concepts of cellular immunity and their therapeutic implications. PMID- 3300988 TI - Comparison of cefatrizine and erythromycin for pediatric ear, nose, and throat infections. AB - A comparison was made of cefatrizine in dosages of 75 mg/kg/day administered once daily or twice daily and erythromycin in a mean daily dosage of 50 mg/kg given in three divided doses for the treatment of acute infections of the ear, nose, and throat in children. Temperature was recorded twice a day during therapy. At the end of treatment, a clinical evaluation of cure, improvement, or failure was made, based on defervescence and abatement of symptoms. All ten children given cefatrizine once daily were cured (P less than or equal to 0.05), as were eight of ten given cefatrizine twice daily and four of ten given erythromycin. The remaining eight patients were improved. One patient given cefatrizine had diarrhea, which appeared on the fifth day of treatment. No other side effects were observed. Cefatrizine appeared to be similarly effective whether given once a day or twice a day; further trials are warranted to confirm the efficacy of once-daily treatment with this cephalosporin. PMID- 3300989 TI - Effect of nifedipine on glucose tolerance, serum insulin, and serum fructosamine in diabetic and nondiabetic patients. AB - The hypothesis that nifedipine may cause an insidious but reversible change in glucose tolerance, similar to that associated with thiazide therapy, was studied in six nondiabetic and six noninsulin-dependent diabetic patients with hypertension. After medium-term nifedipine therapy (mean duration, 11.5 months) was stopped for one month and then resumed for a month, values for fasting blood glucose, fasting serum insulin, serum fructosamine, glucose tolerance, and insulin release in response to oral glucose were unchanged in both groups. These findings suggest that nifedipine in conventional doses does not have important effects on glucose handling in either diabetic or nondiabetic patients. PMID- 3300990 TI - A clinical and mycological assessment of tioconazole solution in the treatment of superficial dermatomycoses. AB - The efficacy, acceptability, and tolerability of tioconazole solution (1%) in a pump spray were evaluated in an open-label trial in 26 patients with dermatophytosis, superficial candidiasis, and tinea versicolor. Medication was applied twice daily for 30 consecutive days. Eighteen patients had dermatophyte lesions: four patients had tinea pedis interdigitalis (one of these also had tinea cruris), and 14 patients had tinea corporis. Of these, four patients did not respond to treatment and were considered therapeutic failures and ten were carriers and remained so one month after therapy. Five patients were clinically and mycologically cured at the end of therapy and did not relapse one month after therapy. All of the eight remaining patients were clinically and mycologically cured at the end of treatment and one month later: these included seven patients with tinea versicolor and one with anal candidiasis. PMID- 3300991 TI - Distribution patterns of calcitonin gene-related peptide-containing fibers in the wall of the three different arteries: an immunohistochemical study. PMID- 3300992 TI - Role of insulin degradation in deactivation of insulin-mediated sugar uptake in fibroblasts. PMID- 3300993 TI - Immunocytochemical evidence for alpha-melanocyte-stimulating hormone in the hypothalamus of the frog Rana esculenta. AB - The distribution of immunoreactive alpha-melanocyte-stimulating hormone (alpha MSH) within the brain of the frog, Rana esculenta, has been studied on adjacent serial sections using an indirect immunofluorescence technique. Immunoreactive cell bodies are found in the anterior part of the preoptic nucleus and in some ventral subependymal cerebrospinal fluid-contacting elements, and in the nucleus infundibularis ventralis. Numerous alpha-MSH-like immunoreactive fibers are present in the preoptic area, in the pars ventralis of the tuber cinereum, and in the outer layer of the median eminence. This staining pattern is completely eliminated after preabsorbing the antiserum with the corresponding antigen, but blocking tests with alpha-MSH-related peptides do not lead to any change in the immunoreaction. From these results it may be inferred that an alpha-MSH-like system is present in the hypothalamic neurosecretory area of R. esculenta, and is probably related to its hypophysiotropic functions. The results are compared to the distribution of alpha-MSH within the hypothalamus of reptiles and mammals. PMID- 3300994 TI - Myosin content and vasoconstrictive ability of the proximal and distal (renin positive) segments of the preglomerular arteriole. AB - The PAP-technique and antibodies to myosin were used to demonstrate the prerequisites for vasoconstriction in the juxtaglomerular part of the preglomerular arteriole as compared with its proximal segment in rats and mice. In contrast with the myosin-positive/renin-negative proximal part of the afferent arteriole no myosin-like activity could be demonstrated in its distal, renin positive part. In accordance, no thick myofilaments were found in fully differentiated juxtaglomerular epithelioid cells replete with mature secretory granules. Stimulation of the renin-angiotensin system was followed by an increase of the renin-positive/myosin-negative portions of the preglomerular arteriole. Marked interspecies and internephron variations in the length of this vessel segment under control and stimulated conditions were observed. The juxtaglomerular part of the preglomerular arteriole close to the macula densa seems therefore to have only limited capabilities for vasoconstriction. This finding may be of importance regarding the tubulo-glomerular feedback, a mechanism allegedly triggered by the so-called 'macula densa-signal'. It is suggested that this non-contractile segment of the afferent arteriole may represent the renal vascular receptor responsible for the increase of renin secretion during pressure reduction. Unlike the afferent arterioles, most of the efferent arterioles showed the highest level of their weak but distinct myosin like immunoreactivity in the juxtaglomerular region, indicating some efferent juxtaglomerular vasoconstrictive ability. PMID- 3300995 TI - Characterization of rodent pineal astrocytes by immunofluorescence microscopy using a monoclonal antibody (J1-31). AB - In previous studies pineal astrocytes have been characterized immunohistochemically mainly by use of antisera to glial fibrillary acidic protein. Because of the recent demonstration of this protein in non-astrocytic cells the question of its specificity as an astrocytic marker has been raised. A possible alternative tool for characterizing pineal astrocytes is the J1-31 monoclonal antibody, which is directed against a 30,000 dalton astrocytic protein clearly distinguishable from glial fibrillary acidic protein. Immunofluorescence microscopy of this antibody in the pineal gland of rat and guinea-pig revealed a staining pattern similar to that obtained by glial acidic fibrillary protein antisera. In the rat, J1-31-immunoreactive cells and processes were concentrated in the transitional region between the superficial pineal gland and pineal stalk. Fibrillar J1-31-immunoreactive structures were seen in the most proximal part of the guinea-pig pineal gland. The J1-31 monoclonal antibody therefore appears to be a useful tool for the demonstration of pineal astrocytes; it avoids the specificity problems of glial fibrillary acidic protein immunohistochemistry. PMID- 3300996 TI - Microheterogeneity of the collecting duct system in rabbit kidney as revealed by monoclonal antibodies. AB - This report describes the immunolocalization of three monoclonal antibodies along the collecting duct system in rabbit kidney. The antibodies were raised against antigens derived from a membrane fraction of homogenized papillary tissue. Western Blot analysis demonstrated that each of the antibodies recognized a single band of about 190,000 (PCD1), 210,000 (PCD2) and 50,000 (PCD3) daltons. In renal tissue, the antibodies bound specifically to the epithelia of the connecting tubule (CNT), the collecting duct (CD) and the papillary surface epithelium. Differences in the binding patterns of the antisera were limited to the cortex. PCD1 labeled only a few scattered cells in the CNT, and exhibited a heterogeneous binding along the cortical collecting duct (CCD). PCD2 and PCD3 binding patterns were similar. In the CNT, these antibodies bound to the intercalated cells (IC-cells) but not to the CNT-cells proper. In the CCD, both IC-cells and principal cells were labeled. The binding to the medullary collecting duct by all three antisera was identical. The ureter was labeled only by PCD2 and PCD3, and none of the antisera bound to the bladder epithelium. The antibody binding patterns provide information concerning tubular axial heterogeneity and embryogenetic aspects of the CNT and the CCD. These antibodies may be used as differentiation markers in studies of the developing kidney and of renal tissue culture systems. PMID- 3300997 TI - A novel antigen is common to the dome epithelium of gut- and bronchus-associated lymphoid tissues. AB - The dome epithelium (DE) covering bronchus- and gut-associated lymphoid tissues (BALT and GALT) is composed of columnar cells, groups of lymphocytes, M cells, and pre-M cells. Although the cell biology and immunologic processes of this tissue are likely important in the afferent arm of secretory immune responses, virtually nothing is known about biochemical constituents of the DE. Therefore, a monoclonal antibody, 30E5, was used to study the distribution of a novel antigen, common to dome epithelia of GALT and BALT. 30E5 was secreted by a hybridoma, prepared by fusing murine splenocytes, immunized against dome epithelial cells, with P3 X 68/Ag8 myeloma cells. Reactivity of antigens was defined by indirect immunocytochemistry on sections of rabbit tissues or with dissociated epithelial cells. In situ, 30E5-reactive antigen circumscribed each group of dome epithelial lymphocytes, most or all of which were T cells, in rabbit appendix, sacculus rotundus, cecal patch, Peyer's patch, and BALT. In the DE this antigen was associated with the apical surface and the supranuclear or perinuclear regions of epithelial cells, but it was not associated with epithelial cells of villi, epithelium, or with individual lymphocytes. In peripheral lymph nodes, spleen, and in domes and follicles of GALT or BALT, 30E5-reactive antigen was visualized in linear wisps, primarily in regions populated by thymocytes. In other adult tissues, 30E5-reactive antigen was associated with involuntary muscle, myoepithelial cells of lactating mammary gland and with what appeared to be neural dendrites; but it was not found in epithelia other than DE. In neonatal rabbit appendix, this antigen first appeared in the upper dome epithelium two days after birth, a period coinciding with T cell infiltration and M cell maturation. The histologic distribution of 30E5-reactive antigen suggested that it might be a contractile filament, a receptor, or a differentiation antigen. Since 30E5 was associated with DE of both GALT and BALT, results support the concept of a molecule common to all mucosa-associated lymphoid tissues. PMID- 3300998 TI - Development of dome epithelium in gut-associated lymphoid tissues: association of IgA with M cells. AB - The dome epithelium (DE), which covers gut-associated lymphoid tissues (GALT) and provides both a protective barrier over lymphoid follicles and a route for antigen uptake from the gut, develops in rabbit appendix (caecum) during the first week of neonatal life. To determine if secretory immunoglobulins from maternal milk interact with this developing tissue, their interrelationships in neonatal rabbit appendix were examined by use of immunocytochemical techniques. The glycoprotein, secretory component, was not produced by neonatal rabbits less than 15 days old, since neither the membranous nor the free, secreted forms of maternal secretory component were associated with villi or DE of neonates. Immunoglobulin A (IgA), but neither IgG nor IgM, were noted on DE by light microscopy, even though IgG was abundant in the villus lamina propria and vascular spaces. The epithelial IgA was distributed, in a patchy pattern, across the upper dome surface of some two-day-old, and all five-and ten-day old nursing animals, but IgA was not on DE of rabbits prevented from nursing. Immuno-electron microscopy of appendix from nursed rabbits revealed IgA directly over the apical surface of M cells, where it formed a continuous, thick coating without binding to adjacent immature absorptive cells; it was also within apical vacuoles of M cell cytoplasm. The distribution of IgA on the DE of rabbit appendices indicated that in differentiating GALT, maternal IgA reacted preferentially with M cells or pre-M cells, leading to speculation concerning a role for IgA in the development of GALT and in establishment of mucosal immune responses in neonates. PMID- 3300999 TI - Immunocytochemical localization of albumin in ovarian follicles of fertile rats. AB - The purpose of this study was to investigate whether albumin (Alb) can be detected in ovarian rat granulosa cells. Using immunocytochemistry and morphometrics, the percentages of Alb-positive follicles (follicle-index), of Alb positive granulosa cells (granulosa-index), and of strongly reacting follicles (intensity-index) were evaluated in intact and regressing follicles of different diameter groups during different stages of the estrous cycle. In intact follicles, the follicle- and the granulosa-index increased from small-sized to large-sized follicles. Although the follicle-index did not change in any group during the stages of the estrous cycle, the granulosa-index was higher during proestrus than during the other stages. Intact follicles showed a stronger immunoreactivity than regressing follicles throughout the stages of the estrous cycle. Thus, Alb may be a requirement for the control of follicle growth in fertile rats. This Alb function may be attributable to Alb binding to specific cell-membrane components followed by the intracellular uptake of Alb-bound substances. PMID- 3301001 TI - Dihydroergotamine nasal spray during migraine attacks. A double-blind crossover study with placebo. AB - Ergot derivatives have been used in the treatment of migraine for more than 50 years. We have compared the efficacy of dihydroergotamine (DHE) nasal spray with that of placebo in patients with classic or common migraine attacks. The study was performed in accordance with a double-blind, crossover design. In this study a great placebo effect was observed with a dose of 1.36 mg/attack, and the overall efficacy was rated by the patients to be 41% and 52% for placebo and DHE, respectively. PMID- 3301000 TI - Immunocytochemical localization of serotonin in the reptilian lung. AB - The distribution of serotonin-immunoreactive cells in the lung of 4 species of reptiles was investigated. Serotonin-containing cells were found forming groups in the interconnecting septa in all 4 species studied, and also as solitary cells in Testudo graeca and Mauremys caspica. Serotonin-containing cells were also localized in the intramural ganglia of Pseudemys scripta elegans and Testudo graeca. The present study confirms that serotonin is widely distributed in the lung of vertebrates. PMID- 3301002 TI - A yeast operator overlaps an upstream activation site. AB - The product of the BAR1 gene of Saccharomyces cerevisiae is synthesized only in the a cell type and inactivates alpha-factor, the mating pheromone made by alpha cells. The MAT alpha 2 protein represses the transcription of a-cell-specific genes, including BAR1, in alpha and a/alpha diploid cells. Transcription of BAR1 in a cells in stimulated upon exposure to alpha-factor. Deletion analysis of the 5' noncoding region of the BAR1 gene revealed that the major upstream activation site (UAS) overlaps the 31 bp operator sequence required for MAT alpha 2 repression. This result has implications for the negative control of transcription in yeast. The deletion analysis also indicated that the sequence TGAAACA mediates alpha-factor stimulation. PMID- 3301003 TI - A bacterial gene involved in transcription antitermination: regulation at a rho independent terminator in the bgl operon of E. coli. AB - We have investigated the mechanism of regulation of the bgl operon in Escherichia coli K-12. A regulatory region has been located downstream of the bgl promoter, revealing a 130 base leader containing a sequence from +64 to +112 characteristic of a rho-independent terminator. In vitro, over 90% of the transcripts initiated at the bgl promoter terminate within the leader, at the 3' end of the terminator. Transcriptional fusions containing the terminator require the bglC gene in trans for expression; fusions deleted for the sequence show bglC-independent expression. A mutation resulting in partially constitutive expression of the fusion maps within the terminator. We propose that the bglC gene product mediates positive regulation of the bgl operon by functioning as an antiterminator at the rho-independent terminator located within the leader. PMID- 3301004 TI - Yeast KEX1 gene encodes a putative protease with a carboxypeptidase B-like function involved in killer toxin and alpha-factor precursor processing. AB - The yeast KEX1 gene product has homology to yeast carboxypeptidase Y. A mutant replacing serine at the putative active site of the KEX1 protein abolished activity in vivo. A probable site of processing by the KEX1 product is the C terminus of the alpha-subunit of killer toxin, where toxin is followed in the precursor by 2 basic residues. Processing involves endoproteolysis following these basic residues and trimming of their C-terminal by a carboxypeptidase. Consistent with the KEX1 product being this carboxypeptidase is its role in alpha factor pheromone production. In wild-type yeast, KEX1 is not essential for alpha factor production, as the final pheromone repeat needs no C-terminal processing. However, in a mutant in which alpha-factor production requires a carboxypeptidase, pheromone production is KEX1-dependent. PMID- 3301005 TI - The egg cortex: from maturation through fertilization. PMID- 3301006 TI - Expression of fibronectin and laminin in fetal male gonads in vivo and in vitro with and without testicular morphogenesis. AB - Sertoli cell differentiation occurs in vitro, even when testicular morphogenesis is inhibited by addition of serum to the culture medium (Magre, S. and A. Jost: Proc. Natl. Acad. Sci. USA 81, 7831-7834 (1984]. Using indirect immunohistochemical technique, we have studied the expression of fibronectin and laminin in gonads lacking testicular morphogenesis, as compared to in vivo controls and gonads cultured in synthetic medium. In undifferentiated gonads in vivo, fibronectin and laminin are distributed uniformly in the blastema. If testicular differentiation occurs in vivo, laminin is detected only in the basement membranes; when it occurs in vitro, laminin is found both in the basement membranes and among the stromal tissue. In gonads without seminiferous cords (cultured in serum-supplemented medium), fibronectin and laminin are both present, they are uniformly distributed among the gonadal cells. PMID- 3301007 TI - Myosin filaments in cytoskeletons of Dictyostelium amoebae. AB - Cytoskeletons were prepared from vegetative amoebae of Dictyostelium discoideum by extraction with Triton X-100. The cytoskeletons were suspended in buffers known to induce the assembly or disassembly of myosin filaments. The samples were fixed, and thin sections were examined by transmission electron microscopy. In both types of buffers, myosin-containing cytoskeletons exhibited a ring of densely staining proteinaceous material within the cortical filament matrix; this ring was not observed in myosin-free cytoskeletons. When myosin-containing cytoskeletons were placed in buffers that induced myosin polymerization, the ring appeared as an array of rodlike filaments approximately 13 nm wide and up to 0.5 micron in length--dimensions appropriate for myosin thick filaments. If ATP was added to cytoskeletons containing such filaments, the cytoskeletons contracted and the ring of filaments disappeared. ATP-induced contraction of cytoskeletons was also visualized by indirect immunofluorescence by using monoclonal antibodies to Dictyostelium myosin. All data were consistent with the identification of the protein ring seen by electron microscopy as cortical myosin. Its location and organization were appropriate for the production of cortical contraction through a sliding filament mechanism. PMID- 3301008 TI - Cordycepin disrupts the microtubule networks and arrests Nil 8 hamster fibroblasts at the onset of mitosis. AB - The nucleoside analogue 3'-deoxyadenosine (cordycepin) arrests dividing cells at the onset of mitosis in prometaphase. The microtubules in the arrested prometaphase cells depolymerize to two small asters. A minimum of 80 micrograms/ml cordycepin or 20 micrograms/ml cordycepin in combination with 2 micrograms/ml of the deaminase inhibitor erythro-9-(2-hydroxy-3-nonyl) adenosine (EHNA) to inhibit its degradation is required to see these effects. Analysis of cell extracts by high-pressure liquid chromatography indicates that cordycepin enters the cells rapidly and is phosphorylated to 3'-dATP. The intracellular concentration rises almost linearly from 0.7 mM after 15 min to 7 mM by 210 min. Concomitantly the ATP concentration shows a rapid drop from the 4 mM present in controls. However, the direct reduction of ATP levels does not mimic the same rapid effects of cordycepin on the microtubules. In addition, similar effects are not produced by a variety of other adenosine analogues with alterations in the 2' and 3' ribose positions. Although other pharmacological reagents arrest cells at the onset of mitosis, cordycepin is unusual because of the collapse of the microtubule networks to two small asters that radiate from the microtubule organizing center. 3'-dATP can replace the requirement for ATP or GTP in the vitro polymerization of microtubules from microtubule protein: however, at limiting concentrations of nucleotide it requires approximately two times the concentration of 3'-dATP as ATP to support an equivalent level of microtubule polymerization. This suggests that the effects of cordycepin in vivo may be the result of the depletion of cellular ATP pools and the altered ability of 3'dATP to substitute for ATP-dependent reactions. Current experiments are testing this hypothesis. PMID- 3301009 TI - The post-injury responses in trauma and ischemia: secondary injury or protective mechanisms? AB - Transient injuries to the central nervous system, whether due to trauma or ischemia, often produce long lasting metabolic derangements, lipid peroxidation, edema, and falls in blood flow at the lesion site. Because these post-injury responses are believed to be causes of secondary injury, much research effort has been devoted to developing therapies that prevent them. Recent studies suggest that excessive Ca entry into injured cells instigates these post-injury responses. A new theory is proposed to explain these post-injury responses. This theory posits that Ca ions entering dying cells activate phospholipases that break down membranes to release phosphates. The phosphates then bind and precipitate Ca ions, producing the profound and prolonged decreases in extracellular Ca activity that have been observed in traumatized spinal cords and ischemic brains. The phospholipase activity also facilitates release of lipid peroxides which enhance edema and reduce blood flow. Both of these in turn decrease Ca diffusion to the lesion site and slow the recovery of extracellular Ca activity, giving the tissue time to recover and avoiding the consequences of rapid restoration of extracellular Ca activity. The theory suggests that central nervous tissues evolved these Ca-activated responses as a general mechanism to protect neurons against excessive Ca entry. Brain and spinal cord tissues contain very high concentrations of phosphates, many times greater than is necessary to bind all the Ca ions in the tissues. This excessive Ca buffering capacity enables the tissue to sacrifice a small proportion of severely injured cells to reduce Ca entry into less severely injured neurons. This process will also rapidly eliminate moribund cells that may otherwise linger and consume oxygen and metabolic substrates better utilized by the remaining cells. If confirmed, this theory raises serious questions concerning the current experimental therapeutic approaches to CNS trauma and stroke. Therapy should perhaps be designed to optimize rather than to abort the post-injury responses. PMID- 3301010 TI - Total phosphate determination in brain tissues: a method for regional determination of total phosphate in rat brain. AB - A quantitative microassay method is described for brain tissue phosphates. Based on molybdate colorimetric measurements of inorganic phosphate in tissue solutions prepared by acid digestion and high temperature ashing, the method includes the use of calcium to precipitate inorganic phosphate in acid-digested tissues and a correction for contaminants released from porcelain crucibles during the ashing procedure. This method was used to measure the total tissue phosphate concentrations in regional microsamples of rat brain. Averaged values derived from these regional measurements were 100.1 +/- 10.2 mumol/gm wet tissue weight, corresponding closely to whole brain tissue phosphate values reported in the literature. Phosphate concentrations were remarkably uniform in different areas of the cortex and basal ganglia. PMID- 3301011 TI - [Sonographic study of the biliary tract during pregnancy]. PMID- 3301012 TI - [Regulation of the synthesis and secretion of follicle stimulating hormones- foliberin, inhibin, and activin]. PMID- 3301013 TI - [Assessment of insulin resistance in diabetic children]. PMID- 3301014 TI - [Historical aspects of bone dysplasias]. PMID- 3301015 TI - Proven and unproven methods in hospital infection control in intensive care units. AB - Most common nosocomial infections in Intensive Care Units are: respiratory tract infections, urinary tract infections, bacteremias, and wound infections. Proven methods in hospital infection control are: hand washing, discipline of all personnel, appropriate nursing techniques, specially trained hygiene staff, isolation, appropriate number of nursing personnel per patient, appropriate use of antibiotics, few and brief usage of foreign bodies such as intravenous lines. Useless and unproven methods in hospital infection control are: environmental cultures, routine cultures of personnel, routine air sampling, fogging and spraying of disinfectants, UV lights, plastic shoe covers, routine floor disinfection, disinfection or sticky mats, change of humidifiers and tubings every eight hours, and systematic antibiotic prophylaxis against pneumonia. PMID- 3301016 TI - Principles of antimicrobial chemoprophylaxis in surgery. AB - In the last fifteen years great efforts have been made to establish the appropriate use of antimicrobial agents in surgery. The most common error in the use of prophylactic antibiotics is to continue the drugs beyond the time necessary for maximal benefit: the smallest dose of the drug should be given over the shortest period of time which results in a low rate of postoperative septic complications. In the selection of appropriate antimicrobial drugs for prevention or therapy of surgical infections the most important pharmacological and clinical factors affecting the choice are considered. PMID- 3301017 TI - Controversies in antimicrobial prophylaxis. AB - This paper examines four controversies in antimicrobial prophylaxis. Duration of prophylaxis: Antimicrobial agents must be present in the tissues throughout the operation. Usually, a single preoperative or intraoperative dose will suffice; postoperative doses are unnecessary. Third-generation cephalosporins: no clinical evidence supports their use for surgical prophylaxis. Optimal prophylaxis for colorectal surgery: the information is conflicting, but oral agents combined with a parenteral antibiotic may be optimal. Prophylaxis for patients with indwelling prosthetic joints or vascular grafts: prophylaxis is unnecessary for procedures like dental work that cause transient bacteremia, but established infections should receive prompt, vigorous antimicrobial therapy. PMID- 3301018 TI - Preventing infection in open heart surgery. AB - The risks for infection following open heart surgery may be divided into three components: the environment, operating room personnel, and the patient. Critical appraisal of the available literature yields the following conclusions. First, the environment may result in fungal or bacterial contamination of the surgical wound or mucosal surfaces. However, it is infrequently possible to prove that such contamination causes infections. Second, personnel may contaminate the patients, but rarely do so. Third, the patient's endogenous flora is most often the source of infecting bacteria. Proper preoperative preparation and judicious use of prophylactic antibiotics minimize the risk of infection. PMID- 3301019 TI - Efficient synthetic method for ethyl (+)-(2S,3S)-3-[(S)-3-methyl- 1-(3 methylbutylcarbamoyl)butylcarbamoyl]-2-oxiranecarb oxylate (EST), a new inhibitor of cysteine proteinases. PMID- 3301020 TI - Correlation between tumor cell cytotoxicity and serine protease activity of peritoneal macrophages from mice treated with bakers' yeast mannans. PMID- 3301021 TI - Interaction between semi-alkaline proteinase and protease inhibitors of rabbit serum. PMID- 3301022 TI - A stereoselective synthesis of a stable prostacyclin analogue; dl-3-oxa-9(O) methano-delta 6(9 alpha)-prostaglandin I. PMID- 3301023 TI - [Factors relevant to the pharmacodynamics of rhubarb]. PMID- 3301024 TI - A neutron diffraction study of the headgroup conformation of phosphatidylglycerol from Escherichia coli membranes. AB - By using neutron diffraction, the headgroup conformation of purified phosphatidylglycerol from Escherichia coli membranes has been investigated. Measurements at 25 degrees C and 15% relative humidity on oriented multilayers of lipid selectively deuterated at the sn-3-position of the glycerol backbone and of the gamma-position of the glycerol headgroup show that the labels are at a mean distance of 23.0 A and 27.6 A from the centre of the hydrocarbon chain region. This suggests that the negatively charged headgroup is oriented at about 30 degrees to the membrane surface. The orientation of the phosphatidylglycerol headgroup makes the negatively charged phosphate group easily accessible to cations present in the adjacent water layer. PMID- 3301025 TI - [Hyperparathyroidism in patients having undergone a kidney transplant]. AB - The persistence or onset of hyperparathyroidism following kidney transplant is characterized by an incidence ranging from 2.6 to 70% according to the various statistics available. In a total of 462 kidney transplants performed in our department, hyperparathyroidism was detected in 9 patients. Surgery took the form of parathyroidectomy 8/8 plus autograft in 3 cases, parathyroidectomy 3/4 in 2 cases, 7/8 in 2 cases, and 4/8 in 1 case. Serum calcium values returned to normal in all patients after the operation. PMID- 3301026 TI - [Cyclosporin A in immunosuppressive therapy of kidney transplants (clinical results in 55 patients)]. AB - The authors report the results of a clinical study of the use of cyclosporin A plus low-dose steroids in a consecutive series of 55 kidney transplants with follow-up ranging from 6 to 20 months. The clinical results (rejects, immunosuppressant side effects, 12-month survival of transplant and patient) are compared with those of a similar group of patients on "traditional" therapy (azathioprine plus high-dose steroids). The results of the study confirm the efficacy of cyclosporin A in preventing and controlling acute reject crises in the course of allogenic transplant, though many of the problematic issues related its clinico-therapeutic management remain open questions. PMID- 3301027 TI - [Development of suture materials: from the beginning to our day]. AB - The history of suture materials from the beginnings to the II World War is reported. In this period, catgut and silk were the most employed sutures. The appearance and successive development of synthetic materials revolutionized the field of surgical sutures. This evolution is still active, to the search of ideal suture line. PMID- 3301028 TI - [Treatment of acute cholecystitis, yesterday and today: the role of diagnostic research]. AB - To evaluate the influence of both ultrasonography and cholescintiscan on the choice of the treatment and prognosis of acute cholecystitis, the authors reviewed their series of 187 patients observed between 1974 and 1985. On the basis of diagnostic investigations employed, two distinct periods are considered, 1974-79 and 1980-85. In the I period, the exact diagnosis of the disease was obtained in 31 patients (26.3 percent) and the treatment was conservative in 81.3 percent of cases and surgical in 18.7 percent. In the II period, the disease was exactly diagnosed in 95.6 percent and all patients underwent surgery. The overall mortality and complication rate was respectively 5.1 percent and 11.8 percent in the I period and 1.1 percent and 5.8 percent in the II period. Authors conclude that ultrasonography and cholescintiscan, arising rapidly to the exact diagnosis of disease, influenced markedly the choice of surgical treatment, improving the prognosis of these patients. PMID- 3301029 TI - [Blunt injuries of the pancreas in children. Diagnostic and therapeutic approach apropos of 8 cases]. AB - From 1970 to 1985, eight severe blunt pancreatic traumas were admitted. There is significant difference in morbidity between early pancreatectomy with or without splenectomy (a mean hospital stay of 23 days, low loss of weight) and initial simple external pancreatic drainage with delayed partial pancreatectomy or pancreato-cystojejunostomy Roux-en-Y (mean hospital stay of 45 days, 24% loss of weight, one death two years later). Thus it seems essential to diagnose the pancreatic injury and particularly rupture of the pancreatic duct. Aiming to evaluate these lesions, biology, ultrasonography or computerized axial tomography proved insufficient. As a result, in the last two patients, an endoscopic retrograde pancreatography was performed confirming total transection of the pancreatic duct, one case with fistula, the other with a contrast fluid stop. The surgical approach was guided by these X-ray findings and a distal pancreatectomy performed preserving spleen. The authors propose the following protocol: endoscopic pancreatography if an evident improvement in recent pancreatic injury is not obtained in 48 hours, or in the case of former complicated pancreatic trauma; in the event of total rupture of pancreatic duct, operation should be carried out: abdominal exploration guided by the X-rays findings, distal pancreatectomy or, rarely, repair of the pancreatic duct; when no pancreatic duct lesion is found, but ultrasonographic blunt trauma patent, the surgical decision depends on the amount of peripancreatic reaction: medical treatment or external drainage; when lesion of the head of pancreas is detected, conservative treatment is to be preferred to pancreatoduodenectomy. PMID- 3301030 TI - [Effect of cardiac rejection on blood volume]. AB - The variations of blood volume after autotransplantation have been documented recently by our group. Since, in the homotransplanted heart, acute rejection affects cardiac function we felt that the blood volume variations might be different than that of the autotransplants. In thirty-one immunosuppressed dogs with an orthotopic homotransplanted heart, daily assessments of blood volume with iodine 131 tagged albumin was carried out from preoperative period (control) until death from acute rejection. In the immediate postoperative period there was a significant fall of 21% of the blood volume caused by a 20% fall of plasmatic volume and of a 23% fall in erythrocyte volume. From the second to the fifth postoperative day in spite of persistence of a low erythrocyte volume the blood volume progressed to normal due to a compensatory increase of the plasmatic volume. In the terminal phase of rejection there was a 32% increase of the plasmatic volume leading to an 8% increase of the total blood volume. PMID- 3301031 TI - [Hypotheses on the role of the prehistoric Sahara in the spread of parasitic and hematologic diseases]. AB - 15,000 years ago, the Sahara was moist, inhabited by tropical fauna and travelled over by nomadic populations. Later, the dryness incited human migrations to North or West Africa. African bilharziasis (S. mansoni and S. haematobium) could have been carried by nomadic populations infected in the Nile River. Sickle cell disease and alpha-thalassemia are derived from Saudi Arabia (unless in the case of alpha-thalassemia there was an identical mutation in several regions). Echinococcosis was brought with the dromedary in the ptolemaic era whereas ankylostomiasis was brought by the Romans or the Arabs. PMID- 3301032 TI - [Parasite burden and immune response in kala-azar]. AB - The parasite-burden, which is indicative of the macrophage activity, was determined before treatment in 84 kala azar cases (L. infantum) and compared to non specific immune response parameters (serum IgG, and IgM), to the specific antibody levels as detected by immunofluorescence and IgG and IgM-ELISA, as well as to rheumatoid factor titers. In 57 cases presenting with less than 3 months from the first appearance of symptoms and despite some individual variations, high parasite-burden levels were accompanied with high specific and non specific immune response parameters and inversely. The data suggest that, during kala azar, low and high immune responders could be distinguished in the humans in the way it was demonstrated by Biozzi in mice. Data collected from 27 cases with more than 3 months duration showed a poor correlation. However, at highest antibody levels, some decreasing in parasite-burden was noticed. The prognostic value of the parasite-burden determination is emphasized. Genetic studies of populations would improve control measures. PMID- 3301033 TI - [Implantation in the capsular sac. A 4-year evaluation]. PMID- 3301034 TI - [Cuppers' Fadenoperation on the superior rectus muscle with transposition of the superior oblique muscle]. PMID- 3301035 TI - [Microsurgical treatment of narrow lacrimal points]. PMID- 3301036 TI - [Lacrimal hyposecretion and ophthalmologic surveillance of 65 renal transplant patients]. PMID- 3301037 TI - [Clinical results of trials of therapeutic lenses: analysis of a series of 134 eyes]. PMID- 3301038 TI - [Effects of hyperbaric oxygen therapy on the visual evoked potentials of patients with multiple sclerosis]. PMID- 3301039 TI - [Dermo-adipose grafts in the repair of orbital cavities]. PMID- 3301040 TI - Anaesthesia and pre-eclampsia. PMID- 3301042 TI - A phase-III clinical trial of mefloquine in children with chloroquine-resistant falciparum malaria in Thailand. AB - Mefloquine is a highly effective drug for the treatment of falciparum malaria among adults, but studies of its effects on children are lacking. An open, noncomparative trial of mefloquine was therefore carried out among 84 children aged 5-12 years who were patients at the Hospital for Tropical Diseases, Mahidol University, Bangkok, Thailand. The drug was administered as a single dose of 18 29 mg base per kg body weight. Eighty-two of the 84 children completed a 42-day period of post-treatment observation. The drug was well tolerated also by 11 children with glucose-6-phosphate dehydrogenase deficiency, and all the children in the study cleared their parasitaemia initially (average clearance time, 65 hours). Furthermore, the clinical-chemical parameters measured exhibited no drug related changes during the study. The radical cure rate of nearly 98% and high tolerance indicate that mefloquine can be used effectively and safely for the treatment of children aged 5-12 years who are suffering from uncomplicated falciparum malaria. PMID- 3301041 TI - Potential sources of enterotoxigenic Escherichia coli in homes of children with diarrhoea in Thailand. PMID- 3301043 TI - Malignant melanoma of the skin. AB - Ultra-violet radiation (UVR) in sunlight is thought to be the main cause of malignant melanoma in lightly-pigmented populations. Individuals with fair skin, fair hair, blue eyes and/or a tendency to burn rather than tan when exposed to the sun are at particularly high risk of melanoma and should be given special attention in primary prevention programmes. Intermittent exposure to the sun, as in recreational exposure, may be a more potent cause of melanoma than more continuous exposure. Primary prevention offers the best prospects for a substantial reduction in mortality from malignant melanoma. However, there is little evidence available to judge the effectiveness of primary prevention of melanoma through reduction of exposure to the sun. Education for reducing exposure to the sun is common in high-risk populations but has never been evaluated adequately. Mortality from melanoma could also possibly be reduced by earlier diagnosis through education or screening of high-risk groups. Regular screening of patients with the familial dysplastic naevus syndrome should reduce their mortality from melanoma. PMID- 3301044 TI - Mutagenicity studies of different polycyclic aromatic hydrocarbons: the significance of enzymatic factors and molecular structure. AB - Dependence of polycyclic aromatic hydrocarbon (PAH)-induced mutagenicity on the bay region of the molecule and on the activating cytochrome P-450 enzyme was studied. Eleven PAHs with and six without a bay region were activated by postmitochondrial supernatants from control and 3-methylcholanthrene (MC) pretreated C57BL/6 mice and from control, MC- and 2,3,7,8-tetrachlorodibenzo-p dioxin (TCDD)-pretreated DBA/2 mice and from control and MC-pretreated Sprague Dawley and Lewis rats. S-9 fractions from MC- or TCDD-treated animals induced more mutagenicity with PAHs with a bay region compared with S-9 fractions from control animals or MC-treated D2 mice. Mutagenicities of PAHs without a bay region were largely independent of the source of activating enzyme. There were three exceptions, namely benzo[e]pyrene, phenanthrene and perylene (each possessing a bay region), which were not mutagenic. These studies support the notion that the Ah-locus-controlled induction of cytochrome P1-450 activating PAHs into reactive intermediates at the bay region of the hydrocarbon molecule is of prime importance in the mutagenicity of PAHs. Qualitative correspondence to carcinogenicity is also apparent. PMID- 3301045 TI - Biochemical studies on the catalysis of nitrosation by bacteria. AB - Biochemical and microbiological studies were conducted to characterize the mechanism of bacterial formation of N-nitrosomorpholine from morpholine and nitrite at neutral pH. Nitrosating activity was markedly induced when bacteria were cultured anaerobically in minimal culture medium containing nitrate, while the presence of cysteine or tungsten in the medium inhibited induction. Of various metals, coenzymes and inhibitors tested for their effects on in vitro nitrosation of morpholine, potassium cyanide, sodium azide, NAD(P)H and nitrate strongly inhibited nitrosation. Several mutants of Escherichia coli A10 strain were prepared in order to examine whether nitrosation activity is linked to specific loci. Niridazole-resistant mutants, which lack nitroreductase, had as much nitrosating activity as the original E. coli A10, but chlorate-resistant mutants had completely lost this activity. A good correlation was observed between nitrate reductase activity and nitrosating activity in these mutants. These results indicate that bacterial nitrosation is an enzyme-mediated reaction closely associated with molybdenoenzymes such as the nitrate reductase/formate hydrogenlyase system. PMID- 3301046 TI - Effect of magnesium on nickel-induced genotoxicity and cell transformation. AB - Raising the extracellular level of magnesium ions inhibited nickel-induced DNA strand breaks, DNA-protein crosslinks, sister chromatid exchanges, chromosomal aberrations and cell transformation. Carcinogenic nickel ions preferentially damaged centromeres and other heterochromatic regions of Chinese hamster ovary cell chromosomes. Elevation of extracellular magnesium levels prevented the effects of nickel on heterochromatin and inhibited cell transformation, but did not substantially reduce the DNA damage induced by nickel in euchromatic regions. This study suggests that heterochromatic DNA damage may be important to the nickel-induced neoplastic transformation process. PMID- 3301047 TI - Sulfite-dependent mutagenicity of benzo[a]pyrene derivatives. AB - Benzo[a]pyrene (BP) and sulfur dioxide (SO2) are ubiquitous air pollutants and are also components of tobacco smoke. Although SO2 itself is not carcinogenic, concurrent administration with BP results in enhancement of respiratory tract tumorigenesis. In biological systems, SO2 exists as its hydrated form, sulfite (SO3(2-) ). Sulfite readily undergoes autoxidation, generating potent oxidant species. When 7,8-dihydroxy-7,8-dihydrobenzo[a]pyrene (BP-7,8-diol) is included in sulfite autoxidation mixtures it is converted to more polar products, most notably 7,8,9,10-tetrahydroxy-7,8,9,10-tetrahydrobenzo[a]pyrenes (BP tetraols). This implies the intermediacy of 7,8-dihydroxy-9,10-epoxy- 7,8,9,10-tetrahydro benzo[a]pyrenes (BPDE). We report here the sulfite-dependent conversion of BP-7,8 diol to forms highly mutagenic to Salmonella typhimurium strain TA 98. This activation is observed at BP-7,8-diol concentrations of from 2 to 40 microM and at sulfite concentrations of from 0.5 to 10 mM. In the presence of 10 microM BP 7,8-diol, half-maximal activation is observed at 1.6 mM sulfite. Sulfite itself is neither toxic nor mutagenic to the bacteria under these conditions. The time course of the activation of BP-7,8-diol and its sensitivity to inhibition by antioxidants indicate a requirement for sulfite autoxidation. These data further support the sulfite-dependent epoxidation of BP-7,8-diol. Not only does sulfite convert this promutagen to its active mutagenic form, sulfite also enhances the mutagenic activity of BP diolepoxides toward the tester strain. The reversion frequency in response to 0.1-0.5 microM anti-BPDE is increased by up to 33% in the presence of 1 mM sulfite, and by up to 270% with 10 mM sulfite. The mechanism of this enhancement of anti-BPDE activity is not known, but could be related to inhibition of the glutathione-S-transferase system which has been previously reported for sulfite. These results are discussed in regard to the noted cocarcinogenicity of sulfur dioxide for BP. PMID- 3301048 TI - Activation of H-ras oncogene in 3-methylcholanthrene-transformed human cell line. AB - DNA prepared from the 3-methylcholanthrene (3MC)-transformed human 312H cell line induced foci on NIH/3T3 cells, whereas DNAs prepared from 7,12-dimethylbenz[a] anthracene-transformed and the dimethylsulfoxide control 312H cell lines failed to induce foci. The transformed gene from the 3MC-transformed 312H cells was identified as an activated form of the human cellular transforming H-ras oncogene. Analysis of the ras oncogene p21 product in this transformant by immunoprecipitation and gel electrophoresis suggested that this gene was activated by mutation in the 61st codon. These findings demonstrate that activation of a member of the ras gene family can occur in a chemically transformed human cell line. PMID- 3301049 TI - Immunohistochemical localization of albumin and in situ hybridization of albumin mRNA. AB - Hepatocytes actively involved in albumin synthesis were identified by immunohistochemical method. In sections of perioidate-lysine-2 per cent (w/v) paraformaldehyde fixed normal rat liver, albumin was detected in all hepatocytes. At the ultrastructural level, albumin was localized in the rough endoplasmic reticulum and in Golgi complexes located near the nucleus in only a small subpopulation of hepatocytes, while all other hepatocytes contained albumin only in Golgi complexes located near the bile canaliculi. Stimulation of albumin synthesis by puromycin aminonucleoside-induced nephrosis resulted in an altered intracellular distribution of albumin at the light microscopic level. When examined at the ultrastructural level, albumin was localized in the rough endoplasmic reticulum as well as in Golgi complexes located near the nucleus in nearly all these hepatocytes. Hepatocytes with the potential to synthesize albumin were identified by in situ hybridization of albumin mRNA. In sections of 0.1 per cent (v/v) glutaraldehyde perfusion fixed normal rat liver, albumin mRNA was detected in the cytoplasm of only a few hepatocytes scattered throughout the lobule. Following stimulation of albumin synthesis by the induction of nephrosis, albumin mRNA was detected in the cytoplasm of the hepatocytes. The source of albumin in those hepatocytes which lacked albumin mRNA was identified in analbuminemic rats injected with rat albumin. At 6 h post injection, the light microscopic distribution of albumin in the liver of these animals was virtually indistinguishable from that in normal rat liver. At the ultrastructural level, injected albumin was localized in lysosomes and in Golgi complexes located near the bile canaliculi. PMID- 3301050 TI - Changes in central hemodynamics during experimental septic shock in conscious rats. AB - This study describes the hemodynamic, metabolic, and respiratory effects of a 4-h continuous intravenous infusion of live Escherichia coli bacteria (10(9)/h) in conscious, unrestrained rats. The early response to bacterial infusion was moderate hypotension and a marked and sustained increase in heart rate and respiratory rate. During later stages of bacteria infusion a marked decrease in stroke volume and cardiac output was observed, while total peripheral resistance increased. Arterial blood gas measurements showed an early primary respiratory alkalosis, while later stages of bacteria infusion were accompanied by progressive development of metabolic acidosis. This small-sized animal shock model may be useful for further studies, particularly since conscious rats were used to avoid the influence of anesthesia upon the development of septic shock. PMID- 3301051 TI - Systemic and regional hemodynamic changes after intraperitoneal endotoxin in rabbits: development of a new model of the clinical syndrome of hyperdynamic sepsis. AB - Rabbits were injected intraperitoneally with sterile saline or Escherichia coli endotoxin (LPS; 50 or 500 micrograms/kg). Sixteen to 18 h later, the animals were anesthetized with ketamine and instrumented to permit measurement of mean arterial pressure, cardiac output (by thermodilution), and regional blood flow (using radioactive microspheres). The animals were allowed to waken fully in a plastic restraining cage prior to measuring systemic and regional hemodynamics. LPS had similar effects regardless of dose, and results from the two dosage groups have been combined. Compared to controls, administrations of LPS resulted in a 29.3% increase in cardiac output (P = .011) and a 22.8% decrease in systemic vascular resistance (P = .0009). Injection of LPS caused significant changes in blood flow to the heart (55.3% increase), small intestine (128.3% increase), portal vein (54.7% increase), and hepatic artery (65.0% decrease). The percentage of cardiac output perfusing the kidneys and hepatic artery was significantly decreased in the endotoxemic group (P = .037 and P = .002, respectively). Injecting LPS resulted in increased relative flow to the heart (P = .024), small intestine (P = .049), and portal vein (P = .041). We conclude that this model reproduces several of the systemic hemodynamic features of the sepsis syndrome in humans. In this model, the hyperdynamic state is associated with vasodilatation in mesenteric (small intestine and colon) and coronary beds and vasoconstriction in the hepatic artery. PMID- 3301052 TI - Effects of granulocytopenia on the hemodynamic responses of dogs during E. coli bacteremia. AB - In both neutropenic and normal dogs a significant and sustained fall in mean arterial pressure (MAP) occurred within 2 h (P less than .01) of the onset of E. coli bacteremia. The MAP remained depressed (P less than .001) in the neutropenic dogs while it increased to normal by 4 h in the control dogs. The fall in MAP was primarily related to a fall in total peripheral resistance (TPR). Although myocardial performance curves declined in both groups over the 4-h period, cardiac index (CI) and left ventricular stroke work index (LVSWI) were not significantly different from baseline in either group; nor was LV filling as assessed by the pulmonary artery wedge pressure (PAWP). No significant differences between groups were demonstrated between the mean pulmonary vascular resistance (PVR), dead space, shunt, or oncotic pressure for either group. A significant (P less than .01) percent reduction of arterial PO2 (PaO2) occurred in the neutropenic dogs. The pH of both groups fell during the course of the experiment and was significantly lower (P less than .02) in the neutropenic dogs at the termination of the study. A similar percent fall in platelet count, factor VIII, and fibrinogen levels was observed in both groups. Circulating endotoxin levels were paradoxically higher in normal animals and did not correlate with any hemodynamic alteration in either group--except that the earlier, higher endotoxin levels in the normal animals were associated with a more rapid decline in myocardial performance. However, the vasodilation of the neutropenic group was clearly related to the higher level of E. coli circulating since the concentration of E. coli in both groups at 4 h was significantly inversely correlated with the MAP (P less than .001). PMID- 3301054 TI - The electrocardiogram in patients undergoing thrombolysis for myocardial infarction. PMID- 3301053 TI - The hemodynamic effects of sotalol and quinidine: analysis by use of rest and exercise gated radionuclide angiography. AB - This placebo-controlled, double-blind trial compared the hemodynamic effects of sotalol and quinidine with the use of rest and exercise gated radionuclide angiography. Patients had frequent ventricular premature depolarizations (greater than or equal to 30 VPDs/hour) and depressed cardiac function (mean ejection fraction 43 +/- 15%). Resting left ventricular ejection fraction and stroke volume index increased (p less than .002, p less than .001, respectively) during sotalol therapy, associated with a concomitant fall in heart rate (p less than .001). Quinidine also increased mean left ventricular ejection fraction, but less so than did sotalol (p less than .05). Quinidine significantly decreased left ventricular end-diastolic (p less than .05) and end-systolic (p less than .002) volumes, but had no effect on stroke volume index or heart rate. Neither drug affected cardiac index. Quinidine resulted in no symptomatic deterioration in left ventricular function or serious arrhythmia aggravation. In contrast, five patients on sotalol developed either decompensated congestive heart failure (two patients), arrhythmia aggravation (two patients), or hypotension associated with bradyarrhythmia (one patient). These patients had a unique hemodynamic profile that can be used to identify patients likely to have a poor outcome on sotalol. This profile reflected a lack of cardiac reserve, characterized by an inability to increase stroke volume and cardiac output with supine bicycle exercise. PMID- 3301055 TI - Acute myocardial infarction: thrombolysis and infarction. Clinical sequelae: special patient subsets, incomplete occlusion of the infarct-related artery, and coronary collaterals. PMID- 3301056 TI - Risk of death from recurrent ischemic events after intravenous streptokinase in acute myocardial infarction: results from the Intravenous Streptokinase in Myocardial Infarction (ISAM) Study. PMID- 3301057 TI - The GISSI Study: further analysis. Italian Group for the Study of Streptokinase in Myocardial Infarction (Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico, GISSI). PMID- 3301058 TI - Intracoronary thrombolysis in patients with acute myocardial infarction: the Netherlands Randomized Trial and current status. PMID- 3301059 TI - Artificial intelligence in the clinical laboratory. PMID- 3301060 TI - Sequential investigation of aspartate aminotransferase elevation in outpatients. PMID- 3301061 TI - Newer procedures using the fiberoptic bronchoscope in the diagnosis of lung cancer. PMID- 3301062 TI - Amoebae and humidifier fever. AB - One hundred and nineteen sera from workers at four different work sites exposed to different contaminated humidifiers were examined by the immunofluorescent antibody (IFA) technique for antibodies to the amoebae Acanthamoeba polyphaga and Naegleria gruberi. Twenty-five of the sera were from workers with humidifier fever (HF) and six from workers with work related asthma (WRA) shown to be due to the contaminated humidifiers. A positive IFA test was found to correlate precipitin reaction to humidifier antigen, but did not correlate with smoking habit, work related symptoms (detected by standard questionnaire) or with HF or WRA. Amoebae were identified in all humidifiers studied. PMID- 3301063 TI - Plasma sex hormones and ischemic heart disease. AB - The reason why men have a higher incidence of ischemic heart disease than women, and women rarely develop ischemic heart disease before the menopause, is not known. However, elevated plasma estradiol and estrone concentrations have been found in men surviving myocardial infarction. Hence, hyperestrogenemia has been suggested as a coronary risk factor. To assess this theory we review the literature on sex steroid production, the relationship between established coronary risk factors and plasma sex hormones, as well as results from clinical trials in which estrogens have been administered to men and women. Other possible explanations why plasma estradiol levels are elevated in male survivors of myocardial infarction are discussed. Based on earlier and recent evidence, it is hypothesized that the elevated plasma estradiol concentration found in men surviving myocardial infarction is due to either the myocardial infarction itself or established risk factors such as smoking or hypertension. PMID- 3301064 TI - Advances in the application of biochemical tests to diseases of the liver and biliary tract: their role in diagnosis, prognosis, and the elucidation of pathogenetic mechanisms. AB - Despite the biochemical complexity of the liver, few laboratory tests provide discriminatory diagnostic information in patients with hepatobiliary disease. Recent efforts have concentrated upon tests which assess the function of the liver, the severity of the disease state, and underlying pathological processes. Bile Acids: The emergence of facile technology and widespread application has brought the realization that these assays are not as sensitive in detecting liver disease as previously believed, although the cholate/chenate ratio may be useful in distinguishing cholestasis from chronic liver disease. The presence of unusual bile acids in serum or urine may be helpful in some cases. Drug Metabolism: A number of tests provide good evidence about liver function, hepatic blood flow and portal shunting, but the aminopyrine breath tests is the most useful, giving prognostic information in acetaminophen overdose and alcoholic liver disease. The antipyrine half-life identifies surgical cases at risk from poor hepatic function. Proteins and Immunochemical Tests: Interest has developed in plasma proteins such as prealbumin and retinol-binding protein to monitor hepatic protein synthetic function. Secretory IgA is more elevated in biliary tract disease, unlike the native protein which is increased principally in cirrhosis. Type III procollagen can be measured in serum, and correlates with the activity of collagen synthesis and the degree of fibrosis in biopsy samples. Reye's Syndrome: Biochemical tests play an essential role in diagnosis of this recently discovered disease. These will be presented and discussed. PMID- 3301065 TI - The enzymology of intestinal disease. AB - The role of enzyme estimations is reviewed. Serum levels of most enzymes do not alter significantly in intestinal diseases because dying mucosal cells slough off into the lumen. Similarly, biopsy material may provide misleading results because of lack of homogeneity between diseased and normal segments of bowel, whether in inflammatory or neoplastic conditions. Lactase deficiency is the most common intestinal enzyme deficiency. The once popular lactose tolerance test is lately giving way to the breath hydrogen test, which generally reflects unabsorbed carbohydrate reaching the colon. This test and its clinical usefulness are reviewed in some detail, and the use of lactulose as an indicator of intestinal transit is also discussed. PMID- 3301066 TI - Intracellular precursor forms of plasma proteins: their functions and possible occurrence in plasma. AB - An attempt is made to review the steps in the biosynthesis of plasma proteins by the liver and to point out intermediate precursor forms that might escape to the plasma. With the use of immunochemical techniques such as immunofixation electrophoresis it is possible to identify these precursors when they present an unusual bands on protein electrophoresis. The discovery of the role of vitamin K in the formation of the blood-clotting proteins, for example, followed the immunochemical detection of an abnormal form of inactive prothrombin in plasma. The chief types of precursors likely to occur in blood are forms that are incompletely glycosylated, phosphorylated, or sulfated, or which are single peptide chains of multichain proteins. Precursors containing basic propeptides such as proinsulin or proalbumin may also appear. By being alert to the possible appearance of intracellular forms in plasma, the clinical chemist may be able to relate their presence to the nature of the disease process responsible. PMID- 3301068 TI - Precision of glucose measurements in control sera by isotope dilution/mass spectrometry: proposed definitive method compared with a reference method. AB - This improved isotope-dilution gas chromatographic/mass spectrometric (GC/MS) method, in which [13C]glucose is the internal standard, meets the requirements of a Definitive Method. In a first study with five reconstituted lyophilized sera, a nested analysis of variance of GC/MS values indicated considerable among-vial variation. The CV for 32 measurements per serum ranged from 0.5 to 0.9%. However, concentration and uncertainty values (mmol/L per gram of serum) assigned to one serum by the NBS Definitive Method (7.56 +/- 0.28) were practically identical to those obtained with the proposed method (7.57 +/- 0.20). In the second study, we used twice more [13C]glucose diluent to assay four serum pools and two lyophilized sera. The CV ranged from 0.26 to 0.5% for the serum pools and from 0.28 to 0.59% for the lyophilized sera. In comparison, results by the hexokinase/glucose-6-phosphate dehydrogenase reference method agreed within acceptable limits with those by the Definitive Method but tended to be slightly higher (up to 3%) for lyophilized serum samples or slightly lower (up to 2.5%) for serum pools. PMID- 3301067 TI - Specificity of sensitive assays of thyrotropin (TSH) used to screen for thyroid disease in hospitalized patients. AB - Thyrotropin (TSH) concentrations were measured in 1580 hospitalized patients and 109 normal persons. Using the mean +/- 3 SD limits of the log values for the controls (0.35-6.7 milli-int. units/L), the proportion of abnormal TSH results in the hospitalized patients was 17.2%. TSH was undetectable (less than 0.1 milli int. unit/L) in 3.1% of patients, suggesting hyperthyroidism, and high (greater than 20 milli-int. units/L) in 1.6%, suggesting hypothyroidism. On follow-up of 329 patients, 62% with abnormal TSH (less than 0.35 or greater than 6.7 milli int. units/L) and 38% with normal TSH concentrations, only 24% of those with undetectable TSH had thyroid disease: 36% of them were being treated with glucocorticoids and 40% had nonthyroidal illness (NTI). Although half the patients with TSH greater than 20 milli-int. units/L had thyroid disease, 45% of patients had high TSH values associated with NTI. TSH concentrations usually returned towards normal when patients' therapy with glucocorticoids was discontinued or they recovered from NTI. TSH test sensitivity appeared good when the mean +/- 3 SD limits of the reference population were used, i.e., no cases of hyper- or hypothyroidism, as identified by free thyroxin index (FT4I), were missed. However, TSH test specificity was inferior to that of the FT4I test (90.7% vs 92.3%), although specificity could be improved to 97.0% if the wider TSH reference limits of 0.1 to 20 milli-int. units/L were used--limits considered pathological if applied to outpatients. Evidently, different reference intervals for TSH are needed for hospitalized and nonhospitalized patients. We conclude that a "sensitive TSH assay" is not a cost-effective thyroid screening test for hospitalized patients as compared with the FT4I. PMID- 3301069 TI - Isotope dilution/mass spectrometry of serum cholesterol with [3,4 13C]cholesterol: proposed definitive method. AB - We describe a new gas-chromatographic/mass-spectrometric (GC/MS) isotope-dilution method for determination of serum cholesterol. The method has been fully optimized and documented to provide the high accuracy and precision expected for a Definitive Method. In the presence of [3,4-13C]cholesterol, cholesteryl esters in serum are hydrolyzed under optimum conditions and the entire cholesterol pool is extracted and derivatized to silyl ethers. The cholesterol derivatives are resolved from other sterols by gas-liquid chromatography on a fused silica column, and selected ions characteristic of cholesterol and the [3,4 13C]cholesterol are monitored with a GC/MS quandrupole system. We estimated the cholesterol content of samples by bracketing each sample with standards of comparable cholesterol concentration that also contained the [3,4 13C]cholesterol. The procedure was highly reproducible (CV less than 0.5%), better accuracy and precision being obtained with [3,4-13C]cholesterol than with heptadeuterated cholesterol. Mean values per gram of dry serum for one serum pool assayed by this method and that of the National Bureau of Standards differed by 0.5%. We conclude that the method satisfies the criteria for a Definitive Method. PMID- 3301070 TI - EMIT quantitative tricyclic antidepressant assays applied to the Hitachi 705 chemistry analyzer. PMID- 3301071 TI - EMIT quantitative tricyclic antidepressant assays applied to the Encore Chemistry System. PMID- 3301072 TI - Organization and history of the New York Metropolitan Section, AACC: some recollections. PMID- 3301073 TI - False-positive ketostix in a diabetic on antihypertensive therapy. PMID- 3301075 TI - Animal models of inherited hematologic disease. AB - Inherited or acquired hematologic disease is the most prevalent of all human disease when we include the hematologic disorders which are secondary to disease of other systems. It follows that the study of the fundamental mechanisms of the disease processes affecting the hematopoietic system is of prime importance and much remains to be done when one considers that in only 25% of ail hemolytic anemias is the fundamental cause eventually discovered [150]. In the current climate of societal pressures on experimental animal research, animals with spontaneous inherited disease mimicking diseases of the various physiological systems assume proportionately greater importance. These animal models have been extremely valuable in the study of fundamental questions of molecular genetics, metabolic aberrations of the cell and its membrane, synthetic mechanisms of the cell as well as clinical questions of disease manifestations, pathogenetic mechanisms and management. Exploration of differences between normal animal species offer a secondary avenue of investigation into these same fundamental questions. New animal models are being uncovered constantly and this augurs well for the future of biomedical research and the ultimate benefit to humankind and to animals in their own right. PMID- 3301074 TI - Endogenous digoxin-like immunoreactive substances eliminated from serum samples from patients with liver disease by the EMIT column digoxin assay. PMID- 3301077 TI - Immunochemical determination of acetylcholinesterase in amniotic fluid--an evaluation of eleven monoclonal antibodies. AB - Eleven monoclonal antibodies and a polyclonal rabbit antiserum were evaluated with respect to reactivity with acetylcholinesterase (AChE, EC 3.1.1.7) from erythrocytes and brain. Employing our enzyme antigen immunoassay for AChE five selected antibodies were evaluated with regard to their clinical usefulness in the prenatal diagnosis of neural tube defects (NTD). Of these, one antibody preferentially bound the enzyme from human brain, and discerned better than the others pathological samples (anencephaly, spina bifida and encephalocele) from normal ones. With this antibody no false positive values were obtained even if amniotic fluid samples were blood contaminated. PMID- 3301076 TI - Apoenzyme content of serum aminotransferases in patients with a renal allograft treated with cyclosporine A and azathioprine. AB - In 16 patients with a renal allograft the activity concentrations of aspartate aminotransferase and alanine aminotransferase and the percentage stimulation of both enzymes were investigated. After the transplantation the patients received prednisone and cyclosporine A as immunosuppressive therapy, while exactly 3 months after the date of transplantation prednisone and azathioprine were given as immunosuppressives. In the first period, the percentage increase of the activity concentration of aspartate aminotransferase and alanine aminotransferase upon supplementation of pyridoxal-5'-phosphate in vitro were similar to that of healthy individuals. In the second period, however, the percentage increase of the activity concentration of alanine aminotransferase was much higher than that of aspartate aminotransferase. Cyclosporine A given during a period of about 400 days did not influence the percentage increase of both enzymes. It is concluded that the high stimulation of alanine aminotransferase in the second period depends on the presence of azathioprine or its metabolites in serum. PMID- 3301078 TI - Central effect of captopril on baroreflex. AB - To clarify effect of converting enzyme inhibitors (CEI) on heart rate regulation, captopril (2 mg/kg) was injected intravenously (i.v.) with or without pretreatment of atropine and also responses to intracisternal (i.c.) injections were examined. Captopril induced bradycardia with lowering blood pressure, and this bradycardia was abolished by pretreatment of atropine. Reduction of heart rate by i.c. injection of captopril was significantly larger than those of i.v. injection. Furthermore, to determine whether CEI can modify baroreflexes centrally, the aortic depressor nerve (ADN) was stimulated electrically in captopril treated rats. Vasodepressor and sympatho-inhibitory responses induced by ADN stimulation were significantly attenuated by captopril, while the bradycardiac response was not changed. These findings suggest that captopril attenuated centrally vasodepressor and sympatho-inhibitory responses of the baroreflex and activated centrally cardiac vagal efferent activity. PMID- 3301079 TI - Pharmacodynamic and humoral effects of single intravenous doses of captopril in normal subjects. AB - The blood pressure, heart rate and humoral responses to single intravenous doses of the angiotensin converting enzyme inhibitor captopril were evaluated in 5 volunteers on a free salt intake. Each subject was given at one-week intervals a 1, 5 and 25 mg intravenous dose of captopril as well as the vehicle of captopril. The study was conducted in a single-blind fashion and the order of treatment phases was randomized. Captopril was found to inhibit the renin-angiotensin system in a dose-dependent fashion. A fall in circulating angiotensin II was observed with doses of 1 and 5 mg. Plasma angiotensin II was not detectable 15 min after the 25 mg dose. Acute inhibition of angiotensin converting enzyme with intravenous captopril had no effect on blood pressure and heart rate. PMID- 3301080 TI - The hypotensive effect of captopril is not mediated by renal medullary lipids. AB - The role of renomedullary lipids in the hypotensive effect of captopril was studied in spontaneously hypertensive rats, one-kidney, one clip hypertensive rats and two-kidney, one clip hypertensive rats using inhibitors of acetyl glyceryl ether phosphorylcholine and prostaglandins, and chemical medullectomy. Our experiments indicate that it is unlikely that renomedullary lipids contribute to the hypotensive action of captopril. PMID- 3301082 TI - Renal haemodynamics and comparative effects of captopril in patients with benign- or malignant-essential hypertension, or with chronic renal failure. AB - Effects of captopril on arterial pressure (AP) and renal function were investigated in patients with non-malignant "benign" or malignant phase essential hypertension (EH group), or with chronic renal failure (CRF group). After captopril administration, AP and renal vascular resistance (RVR) decreased significantly, and renal blood flow (RBF) and plasma renin activity (PRA) increased in both groups. Glomerular filtration rate (GFR) increased in the EH group, but was unchanged in CRF. Filtration fraction decreased in the malignant hypertension and CRF groups. Significant correlations were found between baseline PRA and baseline RVR, and the captopril-induced decrease in mean AP, decrease in RVR, increase in RBF, and increase in GFR in the EH group, while these associations were not observed in CRF. These results indicate that the high AP, RVR, suppressed RBF and GFR in the EH group were closely related to activity of the renin-angiotensin system, but not so the low RBF and GFR in CRF. Small doses of captopril may improve impaired renal function in EH, and may not cause deterioration in the CRF group. PMID- 3301081 TI - Effect of captopril on angiotensin II release from vascular tissues in rats. AB - Isolated rat hindlegs were perfused with Krebs-Ringer solution and released angiotensin I (ANG I) and ANG II were determined. The release of ANG I and ANG II in nephrectomized rats did not differ from those in control group. Pretreatment with captopril (50 mg/kg/day) for 3 days or addition of captopril (2 X 10(-6) M) to the perfusate induced increase in ANG I release and decrease in ANG II release. These findings suggest that ANG II is locally generated and release from the vascular tissues. Captopril may inhibit the conversion of vascular ANG I into ANG II. PMID- 3301083 TI - Effects of captopril on peripheral hemodynamics in severe congestive heart failure. AB - The effects of captopril on the forearm hemodynamics in patients with severe congestive heart failure were studied, using strain-gauge plethysmography. To determine whether prostaglandins are involved in the captopril actions, indomethacin, an inhibitor of prostaglandin synthesis, was administered. In 8 patients, captopril (25 mg) decreased mean blood pressure (P less than 0.01) and venous pressure (P less than 0.05); forearm blood flow (P less than 0.05) and maximum venous volume (P less than 0.05) were increased; forearm vascular resistance (P less than 0.05) and forearm venous tone (P less than 0.05) were decreased. Venous distensibility was improved with captopril (P less than 0.05). All the hemodynamic changes were attenuated by indomethacin (50 mg). Captopril increased circulating bradykinin (P less than 0.05), prostaglandin E2 (P less than 0.05) and 6-keto-prostaglandin F1 alpha (P less than 0.05). Indomethacin did not affect bradykinin level but blocked the increase in prostaglandins. These data suggest that captopril dilates both arterial and venous vessels not only by blocking the renin-angiotensin system but by increasing local or circulating vasodilator prostaglandins. PMID- 3301084 TI - Relation between urinary kallikrein excretion and blood pressure response to a single oral dose of captopril. AB - Thirty-one essential hypertensives with normal or low PRA were evaluated before and after a single oral dose (50 mg) of captopril. A significant fall both in systolic and diastolic blood pressure (BP) was obtained in the subgroup of patients who were classified as "normal kallikrein hypertensives", while no significant change in BP was observed in "low kallikrein hypertensives". Furthermore the mean percentage fall in mean BP, throughout the 2 hours following captopril administration, was significantly related to the basal value of urinary kallikrein excretion (r = 0.47 p less than 0.05) in the entire group of patients. Our results suggest that a blunted activity of the kallikrein system might be responsible for failure of captopril in lowering BP in patients in whom the renin angiotensin system is not pathogenetically implicated. PMID- 3301085 TI - Effect of propranolol and indomethacin on the depressor action of captopril in patients with essential hypertension. AB - The contribution of the renin-angiotensin system (RA) and of prostaglandins (PG) to the acute depressor effect of captopril (Capt) was studied in 13 hypertensive patients suppressing either RA by propranolol (Prop) or PG by indomethacin (Indo). Four patients showed abolition of the depressor effect of Capt by pretreatment with both Prop and Indo (Group 1). Indo, but not Prop, cancelled the depressor effect in another 4 patients (Group 2). In the remaining 5 patients, either Prop or Indo did not alter the depressor response to Capt (Group 3). Patients in Group 3 were older than patients in Group 1 and 2 and showed lower plasma volume value. Several mechanisms might contribute to the acute depressor effect of Cap, including not only the suppression of RA and the enhancement of PG, but perhaps other undetermined factor(s), especially in older patients. PMID- 3301086 TI - Glucose metabolism during captopril mono- and combination therapy in diabetic hypertensive patients: a multiclinic trial. AB - The effects of captopril monotherapy and combination therapy with thiazide diuretics or with methyldopa on glucose tolerance test (GTT) were investigated in 71 diabetic hypertensives. After the baseline evaluation, captopril (37.5-75 mg/day) was given. GTT and insulin assay were performed again between 10 and 12 weeks after the initiation of captopril therapy. We also studied the effects of chronic captopril therapy (6-12 months) on GTT in patients with essential hypertension. Captopril was well tolerated in all patients and no adverse reactions were observed. Chronic captopril therapy produced a significant (p less than 0.01) fall of blood pressure in all patients. There was no significant deterioration of the insulinogenic index or the time course curves of plasma glucose and insulin after GTT. These results indicate that captopril therapy does not affect glucose metabolism. Thus captopril may have an advantage for clinical use in hypertensive patients with or without impaired glucose metabolism. PMID- 3301087 TI - Inhibition of hydrolytic activities of human dipeptidases toward leukotriene D4 and kyotorphin by captopril. AB - We investigated inhibition by captopril of the hydrolysis of leukotriene D4 (LTD4) and kyotorphin by human dipeptidases (DPases). The rate of LTD4 hydrolysis by kidney DPases F and S, pancreas and liver DPases were 60.6, 23.8, 23.3 and 0.358 units/mg protein, respectively. The inhibition by captopril was competitive for DPase F and liver DPase, and non-competitive for DPase S and pancreas enzyme. Using kyotorphin as a substrate, captopril inhibited four DPases competitively. From these results it is suggested that some side effects of captopril may relate to inhibition of hydrolytic activities of DPases with physiologically active dipeptides in man. PMID- 3301088 TI - Light and electronmicroscopic studies on Polycel ossicular replacement prostheses. AB - Recently, a new form of porous high density polyethylene (Polycel) has been promoted for use in ossicular chain reconstruction. However, we have found no reports of investigation of the fate of this material used for this purpose in either animals or man. This study was undertaken to look at the tissue tolerance and fate of Polycel in the middle ear of gerbils before its extensive use in humans. We present the light and transmission electromicroscopic findings from these prostheses, removed from the middle ear between 1 and 5 months post implantation. The results are similar to those found with Plastipore, showing a strong foreign body reaction and the likelihood of phagocytic consumption. As with the other porous plastics, we have reservations about the use of Polycel for ossicular reconstruction. PMID- 3301090 TI - Extrusion of middle ear implants. PMID- 3301089 TI - Non-Hodgkin's lymphoma of the head and neck: prognostic factors. AB - A series of 127 patients were studied, presenting with non-Hodgkin's lymphoma of the head and neck between 1962 and 1986. Clinical data on the site of tumour, stage, patient's age, sex, condition and outcome were compared with the pathological diagnosis and lymphoma type according to the Kiel classification. Pathological material was received and new preparations made, including immunohistology where appropriate. An exact pathological classification was possible in 102 patients, and most were either centroblastic or centroblastic/centrocytic, with diffuse morphology. Other types of lymphoma were too few in number to enable correlation of histological type with prognosis. The most significant factor was the pathological stage at presentation, and it was important to examine trephine specimens of bone marrow to ensure accurate staging. PMID- 3301091 TI - Glucose intolerance and hepatic, biliary tract and pancreatic dysfunction. PMID- 3301092 TI - Partial duplication 16q: report of two affected siblings resulting from a maternal translocation and literature review. AB - Two siblings with a partial duplication 16q, born to a woman with a balanced translocation (6;16), are described. The first infant died at 8 weeks of age; the second died at 4 months. Fifteen other cases of duplications involving 16q have been reported, all of them derived from a balanced parental translocation. The most frequent physical findings have included dysmorphic facies characterized by high forehead, prominent nose, antimongoloid slant, malformed ears, and micrognathia, as well as flexion contractures of the joints, deformity of the feet, and genital hypoplasia in the male. Anorectal, intestinal and cardiac malformations were less frequent findings. Most of the affected infants died at ages ranging from 8 days to 6 months. The few with longer survival (up to 6 years) had a shorter, more distal segment duplication of chromosome 16. Although intrauterine growth retardation and microcephaly were not always present at birth, most of the infants had postnatal growth failure. The phenotypic and clinical findings of the two infants in this report are compared with those of previously reported cases, from which there appears to be correlation of the length of the 16q duplication with clinical phenotype and survivals. PMID- 3301093 TI - Detection of IgA-class circulating immune complexes (CIC) in sera from patients with IgA nephropathy using a solid-phase anti-C3 Facb enzyme immunoassay (EIA). AB - The detection of circulating immune complexes (CIC) in sera from patients with IgA nephropathy is described. A solid-phase anti-C3 Facb enzyme immunoassay (EIA) was employed for detection of IgA-, IgG- and IgM-CIC in sera. The C1q-binding enzyme assay was also used for the detection of CIC in sera from these patients and healthy adults. Twenty-two patients with IgA nephropathy, 14 patients with other glomerular diseases and 19 healthy adults were examined by anti-C3 Facb EIA. The levels of IgA-CIC in sera from patients with IgA nephropathy were significantly higher than those in sera from patients with other glomerular diseases and healthy adults. CIC measured by the C1q-binding enzyme assay was detected in some patients with IgA nephropathy. The levels of serum IgA in patients with IgA nephropathy were significantly higher than those in patients with other glomerular diseases and healthy adults. However, there was no significant correlation between the levels of IgA-CIC in sera and those of serum IgA in patients with IgA nephropathy. There was also no significant correlation between the levels of IgA-CIC in sera and the degree of histopathological injuries in the patients. It is concluded that the solid-phase anti-C3 Facb EIA is useful for the detection of IgA-CIC in sera from patients with IgA nephropathy. PMID- 3301094 TI - Dissociation between onset of natural killer E-rosette forming cells and of T3 positive cells following HLA-mismatched T cell depleted bone marrow transplantation. AB - We have studied immunological reconstitution following partially HLA-incompatible T cell depleted bone marrow transplantation, compared with reconstitution following HLA identical T cell depleted and HLA identical untreated bone marrow transplantation. We often observed an early emergence of E-rosette forming cells that were T3 negative and displayed strong natural killer activity in the first group of patients. This activity was shown with fresh leucocytes as well as interleukin 2 grown cells. The appearance of T3+ cells was delayed in this situation compared to that observed in HLA identical bone marrow transplantation. The delay in T3+ cell differentiation and in cellular immune function development probably explains why NK rosette forming cells are early detected within 3-4 months following HLA mismatched bone marrow transplantation. This NK subset is likely to be present at an early stage in all types of bone marrow transplantation, but is most commonly observed simultaneously with the T3+ cells in HLA identical untreated bone marrow transplantation. The respective role of T cell depletion and HLA incompatibility in this phenomenon are discussed while patients' conditioning, cyclosporine A and graft-versus-host disease have been shown to be irrelevant for the dissociation between NK E-rosette forming cells and T3+ subset onsets. PMID- 3301095 TI - Heterogeneity of non-lymphoid cells expressing HLA-D region antigens in human fetal gut. AB - Human fetal ileum contains an abundance of cells expressing HLA-D region (HLA-DR) antigens. In this study we characterized the HLA-DR positive cellular infiltrate in fetal ileum using a panel of monoclonal antibodies against cells of the macrophage/monocyte lineage. As well as anti-HLA-DR, the whole infiltrate was recognized by three of the antibodies in the panel studied: RFD1, reported to be an antibody to 'dendritic cells', leu3a which recognizes CD4 (an antigen expressed on helper/inducer T cells and macrophages), and PD7/26 which recognizes the leukocyte common antigen. The macrophage specific antibodies RFD7 and 3.9 stained fewer cells than the anti-HLA-DR. By sequential staining it was clear that most of the RFD7 positive macrophages in the fetal gut lamina propria were not recognized by 3.9 which is a broad specificity antimacrophage antibody in adult tissue. In contrast to this, more of the macrophages within the Peyer's patches of the fetal gut were recognized by 3.9 than by RFD7. In fetal lamina propria not all of the HLA-D region positive cells expressed macrophage markers and some expressed both markers associated with macrophages and 'dendritic' cells. Macrophages with different surface phenotypes were differentially distributed between the lamina propria and the primitive Peyer's patches; RFD7+, 3.9- macrophages were concentrated in the lamina propria whereas RFD7-, 3.9+ macrophages were abundant in Peyer's patches. Within the Peyer's patch lymphoid tissue RFD7+, 3.9- cells were present in the T cell zone whereas RFD7-, 3.9+ cells were concentrated in the dome region as they are in the adult. This suggests that functional heterogeneity of organized macrophage populations may occur in fetal ileum which is free of dietary and bacterial antigens. PMID- 3301096 TI - The sera of patients with Klebsiella infections contain a common anti-DNA idiotype (16/6) Id and anti-polynucleotide activity. AB - In view of recent reports linking Klebsiella pneumoniae with autoimmunity, we have examined the sera of 52 patients with urinary tract infection or septicaemia from this Gram-negative pathogen, for the presence of antibodies to DNA, polynucleotides, cardiolipin and a common anti-DNA idiotype 16/6. Up to 27% of these patients had anti-polynucleotide antibodies detectable, and in 37% the 16/6 idiotype was found. Absorption of the sera of two patients, with no DNA binding, against the Klebsiella polysaccharide K-30 induced a significant fall in both their anti-K30 antibody and 16/6 idiotype levels. Among 52 patients with other Gram negative infections a maximum of 17% and 19% respectively, had anti-DNA antibodies and the 16/6 idiotype present in their serum. In 37 normal controls, the rate of antibody and idiotype detection was 5% or less. The presence of autoantibodies in the serum of patients with Klebsiella infections may be the result of non-specific stimulation due to bacterial polyclonal activation. However, there might also be a specific stimulus triggered by idiotypic cross reaction between autoantibodies and anti-Klebsiella antibodies. PMID- 3301097 TI - Profile of autoantibodies in the serum of patients with tuberculosis, klebsiella and other gram-negative infections. AB - Autoantibody profiles were examined in the sera of untreated patients with tuberculosis, and those with klebsiella septicaemia, and klebsiella and E. coli urinary tract infections. Rheumatoid factors of the IgM, IgA and IgG isotypes, antinuclear antibodies and antibodies to poly(ADP-ribose) were all frequently detected (generally 15-40%). In contrast, antibodies to the extractable nuclear antigens and to the organ specific antigens were unusual (generally less than 10%). In comparison, in a group of lupus patients IgM rheumatoid factor, anti nuclear antibodies, antibodies to poly(ADP-ribose) and antibodies to the extractable nuclear antigens were more frequently found, but IgA and IgG rheumatoid factors and antibodies to the organ-specific antigens were present in much the same frequency. PMID- 3301098 TI - Intrathecal immunoglobulin synthesis in cerebral malaria. AB - Local synthesis of immunoglobulin within the central nervous system has been evaluated in 37 patients with acute cerebral malaria; seven patients were also studied in the convalescent phase. There was evidence in the cerebrospinal fluid (CSF) of 21 patients that intrathecal IgG synthesis occurs in the acute phase. There were raised IgG: albumin ratios in 43% of acute patients. Oligoclonal IgG bands or cathodal IgG was seen in the CSF of 43% of patients tested by polyacrylamide electrophoresis. Only eight out of 37 acute patients (22%) had no evidence of intrathecal IgG synthesis by either method. The serial studies showed that most patients had IgG-CSF abnormalities when tested in convalescence. These studies suggest that an immune stimulus (perhaps malarial antigens or mitogens) may be present in the brain in acute cerebral malaria. PMID- 3301099 TI - Effect of subcutaneous thymopentin treatment in drug addicts with persistent generalized lymphadenopathy. AB - The effect of thymopentin treatment on the immune defects in drug addicts with persistent generalized lymphadenopathy and HTLV-III infection was investigated. Thymopentin was administered subcutaneously at two different dose schedules: 50 mg three times a week for 3 weeks (first cycle) and 50 mg/week for 3 months (second cycle). After the first cycle an increased number of OKT4+ lymphocytes and an improvement of PWM-induced blastogenesis and IgG synthesis in vitro was observed. The second cycle was unable to modify the same immune parameters in vitro. The treatment had no effect on the PHA responsiveness and on PHA-induced interleukin 2 production. The significance and the prognostic value of these findings are discussed in terms of the clinical evolution of the syndrome. PMID- 3301100 TI - Lymphocyte expression of a 90 kD brush border antigen. AB - This study analyses the expression by rat lymphocytes of six renal brush border (BB) antigens defined by a set of monoclonal antibodies and demonstrates that a 90 kD protein (gp 90), synthesized by BB and glomeruli is found on the surface of T and B cells. The other antigens, including the 330 kD protein involved in Heymann's nephritis--a model of epimembranous glomerulonephritis--are not detectable on the surface of lymphocytes. Immunochemical studies indicate that gp 90 and the related protein immunoprecipitated from thymocyte membranes co-migrate in SDS-PAGE. Quantitative binding analysis shows that the number of antigenic sites is in the same order of magnitude on thymocytes, spleen and bone-marrow lymphocytes as well as on two lines of pre-B and pre-T cells, but considerably lower on a highly differentiated helper T cell line. PMID- 3301101 TI - The clinical condition of IgA-deficient patients is related to the proportion of IgD- and IgM-producing cells in their nasal mucosa. AB - Nasal biopsy specimens from 15 adult patients with selective IgA deficiency but normal IgG-subclass levels were examined by immunohistochemistry for the presence of immunocytes producing various Ig isotypes. The mucosal samples were completely IgA-deficient except in two cases where 0.9% and 8.4% IgA cells were found, respectively (normal, 69.8%). Numerous IgG- (mainly IgG1-) producing cells were present in 10 samples; in five of these there were additional IgM- but virtually no IgD-producing cells, whereas in the other five a marked dominance of the IgD over the IgM isotype was seen. The latter category of patients had more upper airways infections (recurrent acute rhinosinusitis, otitis media, and tonsillitis) than the former, who had no recurrent upper respiratory tract infections except one patient with recurrent acute rhinosinusitis. The five remaining samples, which contained very few Ig-producing cells, were derived from patients with even more frequent infections than those showing IgD predominance. Our results indicate that IgM acts as a compensatory secretory Ig in the upper respiratory tract of some IgA-deficient subjects. However, immunoregulatory events favouring local IgD responses apparently do not support mucosal defence satisfactorily, either because local production of IgM is hampered or because IgD (which is not a secretory Ig) blocks complement-dependent reactions mediated by IgG and IgM antibodies within the mucosa. PMID- 3301102 TI - Polyspecific reactivity of a murine monoclonal antibody that binds to nuclear matrix-associated, chromatin-bound autoantigens. AB - To investigate polyspecific autoantibody interactions, we have characterized the binding of a cloned murine monoclonal IgM antibody termed (RTE-23) of strain BALB/c origin. By indirect immunofluorescence this antibody displayed a nuclear speckled and peripheral pattern in interphase cells from human and rodent cell lines. In contrast, in mitotic cells, antibody RTE-23 bound to the periphery of individual chromosomes. Immunoblot analysis of soluble and insoluble nuclear proteins from purified rat fibroblast nuclei showed that antibody RTE-23 bound to molecules of 28, 29, and 33 kDa. Furthermore, antibody RTE-23 demonstrated marked polyspecificity and reacted with cytoskeletal proteins (vimentin, keratin, actin), single-stranded DNA, specific synthetic polynucleotides, and cardiolipin. Antibody RTE-23 also showed a lupus anticoagulant-like activity. Screening of sera of autoimmune disease patients with antinuclear antibodies revealed two patients, both with SLE, whose sera blocked antibody RTE-23 binding to nuclei and recognized nuclear proteins identical to those recognized by antibody RTE-23. These results suggested that antibody RTE-23 displays a pattern of self-antigen binding that is represented as well in SLE patient sera. PMID- 3301103 TI - [The intra-mobile cylinder implant (IMZ) system. Methods--clinical aspects- results]. PMID- 3301104 TI - [Experimental osteopetrosis]. PMID- 3301105 TI - The biology of hair. AB - Hair is a product of small pits in the skin known as hair follicles. The most important feature of hair follicles is that their activity is intermittent; each active phase or anagen is succeeded by a transitional phase (catagen) and a resting phase (telogen), during which the fully formed "club hair" is retained for a period and then shed. The growth of facial, body, axillary, and pubic hair depends on androgens. Facial hair and body hair require high levels of testosterone and its conversion to 5-alpha-dihydrotestosterone. Pubic and axillary hair follicles require much lower levels of hormone, and 5-alpha reduction appears to be unnecessary. Paradoxically, male pattern alopecia and its female equivalent also require androgen for their manifestation. The differing lengths of hair in the various regions of the body result largely from differences in the duration of anagen and only to a small extent from differences in the rates of growth. Some hair loss from the scalp can be characterized in terms of the hair growth cycle, and some involves long-term changes in the follicular architecture. Thus postfebrile and postpartum alopecias are telogen effluvia that involve shedding of club hairs, whereas drug-induced alopecia and alopecia areata involve shearing and loss of growing hairs. Male pattern baldness and female diffuse alopecia involve gradual shortening of the periods of anagen and shrinkage of the hair follicles over a long term. PMID- 3301106 TI - General evaluation of the patient with alopecia. AB - The evaluation of the patient with alopecia is a multistep process that comprises obtaining a good medical history, performing the clinical examination with a special emphasis on the examination of cut and plucked hair, doing a scalp biopsy, and ordering appropriate laboratory studies. Genetic counseling may be given if it is requested. PMID- 3301107 TI - Androgenic alopecia. AB - Androgenic alopecia is a common and perplexing clinical problem in the female patient. In the past medical literature has offered little assistance in understanding or evaluating the balding woman. Recent advances in technology have better enabled the physician to evaluate and treat females with androgenic alopecia. This article presents the current evaluation and possible treatment modalities of androgenic alopecia. PMID- 3301108 TI - Hirsutism. AB - The androgen status of a hirsute woman can be diagnosed today by new techniques for measuring circulating androgens. Unfortunately, a battery of expensive tests is required to make this assessment. Two specific basic screening tests, DHEA-S and total free testosterone determinations, should be done. If the patient is interested in and can afford it, further testing can be done; it includes 17 hydroxyprogesterone, prolactin, compound S (serum 11-deoxycortisol) and cortisol measurements and a dexamethasone suppression test. Elevations of androgens, whereas elevations of testosterone can be due to ovarian or adrenal secretion. Establishing the site of androgen hypersecretion allows one to be more selective regarding the antiandrogen therapy. When excess androgen secretion is primarily adrenal in origin, adrenal suppression is effective with the use of such drugs as dexamethasone. If the excess androgen is primarily of ovarian origin, cyclic estrogens, for example, Demulen or Premarin with Provera, would be helpful. The evaluation of a hirsute patient takes time, interest, and knowledge of specific androgen-dependent cutaneous syndromes involving multiple possible enzymatic defects in the conversion of cholesterol to testosterone or intercellular pathways of androgen metabolism. If the dermatologist is not interested in or lacks the knowledge for such an evaluation, the patient is best referred to an interested endocrinologist. PMID- 3301110 TI - Hair transplantation. A review. AB - Hair transplantation has developed into a refined art in the past 30 years. Refined techniques and instruments, appreciation of properly placed hairlines, better methods of harvesting donor grafts, and better cutting materials in punches have significantly improved results in one of the most frequently performed cosmetic plastic procedures. PMID- 3301109 TI - Hair replacement techniques. An overview. AB - From Orentreich's initial studies of the donor and recipient dominance of disease and of dermatologic conditions and his translation of those observations into punch-graft hair transplantation, a number of innovations in hair replacement have occurred. Many of these have been modifications and improvements of punch graft techniques. Others have had major impacts on the treatment of baldness, such as flaps, scalp reduction, and tissue expansion. It is the combination of techniques, especially tissue expansion and punch-graft transplantation, that seems to hold the greatest promise for surgical treatment of baldness. Whether the hair replacement surgeon performs all of these procedures or not, he or she must be aware of the benefits of all of them and take them into consideration in developing a total plan for the individual patient. The hair transplant surgeon must also be aware that procedures desirable during the earlier stages of baldness may need to be modified with other types of surgery later in life as the alopecia becomes more developed, especially in the face of imprecise genetics in male-pattern baldness. The hair replacement surgeon not only must be aware that such modification may be necessary, but also must be knowledgeable about what those options entail. For example, tissue expansion may be a desirable adjunctive treatment with progression of baldness and would be possible if the parietal area has not been extensively harvested for punch grafts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301111 TI - Scalp reduction in the treatment of androgenic alopecia. AB - Scalp reductions represent an advance in the surgical treatment of male-pattern baldness. The initial enthusiasm that is shared by both the patient and the surgeon should be tempered by the knowledge that there will be some stretch-back and distortion of the bald area and that the scar may present a problem with styling. PMID- 3301112 TI - Alopecia areata. AB - Although a specific etiology remains undetermined, most evidence points to an autoimmune pathogenesis for alopecia areata. Treatments for alopecia areata are likely to remain palliative until its etiology is better understood. Even it prolonged remissions cannot always be achieved with the treatments presently available, preservation of hair regrowth with maintenance therapy is a reasonable goal. When this is not possible, the value of supportive interaction with patient and family should not be minimized, as the psychologic effects of the disease can be great. Support groups such as those sponsored by the Alopecia Areata Foundation cna assist the physician in this endeavor. PMID- 3301113 TI - Hair loss in systemic disease. AB - A careful history and examination of shed hairs will reveal the etiology of most alopecias due to systemic processes. Telogen effluvium is preceded by a severe systemic stress occurring at least two months prior to the loss of normal club hairs. Most other causes of hair loss involve damage to the hair follicle, which leads to the shedding of dystrophic, brittle anagen hairs. A history of drug ingestion or nutritional compromise or concurrent symptoms suggestive of a genetic, endocrinologic, collagen vascular, or infectious etiology will lead to an accurate diagnosis. PMID- 3301114 TI - Drug-related alopecia. AB - Drugs and chemicals are capable of producing a wide spectrum of hair loss, ranging from barely detectable shedding to frank, irreversible baldness. Agents may act directly or indirectly upon the follicle, but in either case, diagnosis of subtle alopecia can be difficult. General aspects of the clinical and research problems have been discussed, and 40 drugs and drug classes that have been linked to hair disturbances have been reviewed. PMID- 3301115 TI - Hair-shaft anomalies. AB - Variations in the structure of the hair shaft are commonly seen under the microscope and are usually of little clinical significance. Defects of the hair shaft become significant when they produce an unsightly cosmetic appearance or when they lead to the diagnosis of an underlying metabolic disorder or genetic syndrome. The article reviews hair-shaft anomalies and presents updated information and relevant clinical guidelines for diagnosing such defects. PMID- 3301117 TI - Scarring alopecia. AB - The scarring alopecias are a diverse group of diseases characterized by the combination of follicular destruction and dermal scarring. In this article we divide scarring alopecias into three broad categories, pediatric diseases, perifollicular lymphocytic diseases, and folliculopustular diseases, and discuss selected entities from each category. PMID- 3301116 TI - Trichotillomania. AB - Trichotillomania is more common than is generally appreciated, especially in children. At the Mayo Clinic, we saw 145 patients in a ten-year period (1968 1977), and we have observed approximately 15 to 20 such patients per year since that time. Trichotillomania can be a mild or major cosmetic impairment and can be a minor neurotic trait or a sign of serious psychiatric disorder. Although the clinical presentation is characteristic, it can be confused with many different types of alopecia but particularly alopecia areata. Punch biopsy of the affected scalp may be very useful in confirming the clinical diagnosis of trichotillomania, particularly if catagen hairs, melanin casts, and signs of follicular tear or avulsion are present. Trichophagy and trichobezoars are rare associated disorders that should be sought. A common sense approach with a kind and honest explanation to the patient or the parents may be sufficient to terminate the hair-pulling. It is the responsibility of the physician to determine whether psychiatric consultation is desirable in the assessment and treatment of associated psychiatric disorders. Patients in whom the trichotillomania is resistant to simple reinforcement and explanation should have psychiatric consultation. Intensive psychotherapy may be worthwhile in selected patients. PMID- 3301118 TI - Minoxidil. AB - Topical minoxidil has shown some promise for the treatment of male-pattern alopecia and alopecia areata. Clinical trials suggest that careful patient selection and appropriate drug formulation are both important factors to maximize efficacy. Side effects attributable to topical minoxidil appear to consist almost entirely of cutaneous reactions in patients who have been studied thus far, i.e., patients without hypertension or cardiovascular disease. The mechanism of minoxidil-induced hair regrowth is not fully understood, but it may involve a synergistic effect of minoxidil on a variety of cell types. PMID- 3301119 TI - Acute renal failure in man: pathogenesis in light of new morphological data. AB - The pathogenesis of acute renal failure (ARF) in such common conditions as acute tubular necrosis, acute interstitial nephritis, and primary graft anuria (ischemic transplant ARF) is poorly understood. Animal models may not exactly mimic the situation in man and thus human morphologic studies are of particular importance. Non-replacement of individual sloughed tubular cells and simplification of the brush border and basolateral infoldings of tubular cells are prominent morphologic changes which correlate with the presence of renal failure. It is possible that the initial injury inhibits cell membrane synthesis, thus interfering with proximal tubular sodium reabsorption with resulting activation of the renin angiotensin system and afferent arteriolar vasoconstriction. Tubular backleak, tubular obstruction by casts and debris, and decreased glomerular ultrafiltration coefficient may also play a role. Although poorly studied until now, the renal failure in primary graft anuria may have a completely different pathogenesis from that in acute tubular necrosis and acute interstitial nephritis. Cyclosporine nephrotoxicity is an important component of primary graft anuria, as seen in many transplant centers in the 1980's. PMID- 3301120 TI - Effectiveness of intravenous streptokinase on infarct size and left ventricular function in acute myocardial infarction. Prospective and randomized study. AB - Within 3 h after the onset of symptoms of myocardial infarction, 64 patients were randomly assigned to receive either a 1-h intravenous infusion of 1,500,000 IU of streptokinase (SK) or a conventional therapy. Infarct size was estimated in CK gram equivalent (CKg) by measurement of CK-MB every 3 hours during a 48-h period. Enzymatic study revealed that myocardial infarction of the SK group was significantly smaller (61.4 +/- 45 vs. 89.4 +/- 56 CKg, p less than .05). Angiograms were performed at early stage and five weeks after myocardial infarction. At first coronary angiogram, the infarct-related vessel was open in 82% in the SK group versus 12% in controls. The SK group had higher global ejection fraction at second angiogram (57 +/- 11% vs. 49 +/- 11%, p less than .02), but differences in regional wall motion were not significant. By analysis according to patency or occlusion of infarct-related vessel, global and regional ejection fractions were significantly better at first and at second angiograms in all patients and in anterior infarctions with a patent infarct-related coronary artery. There was no significant difference for inferior infarction. We conclude that intravenous streptokinase infusion early after the onset of myocardial infarction reduces infarct size and improves left ventricular function, chiefly in anterior infarction. This benefit appears to be closely correlated to patency of infarct-related vessels. PMID- 3301121 TI - Shigella sonnei myocarditis. AB - A 19-year-old male was admitted to our department because of high fever, abdominal pain, and diarrhea. Electrocardiogram (ECG) on admission revealed diffuse ST-T changes which persisted for 5 days. Stool culture grew Shigella sonnei. We conclude that the infection with Shigella sonnei was the cause for these findings which were most probably due to myocarditis. To the best of our knowledge myocarditis as a complication of shigella infestation has never been reported. PMID- 3301122 TI - The scientific contributions of Alexis Carrel. PMID- 3301123 TI - In vitro binding of IgG from patients with primary and secondary Sjogren's syndrome to different components of keratinized stratified squamous epithelia. AB - The ability of serum IgG from patients with Sjogren's syndrome (SS) to bind to keratinized stratified squamous epithelium of human skin or rat oesophagus was examined, using an indirect immunofluorescence technique. No in vitro binding of serum IgG to the cell membranes of normal human epidermis was demonstrated in 7 patients with primary SS and two normal controls. Thus, the intraepidermal in vivo IgG deposits previously found in 5 of the 7 patients could not be imitated in vitro. Examination for in vitro binding to rat oesophageal epithelium of serum IgG from 21 consecutive patients with primary SS, 19 consecutive patients with rheumatoid arthritis and secondary SS and 22 normal controls showed that antikeratin antibodies occur more frequently (p less than 0.001) in the patients with secondary SS compared to patients with primary SS and to normal controls. PMID- 3301124 TI - Pustulotic arthro-osteitis in children and adults. A report of 13 cases. AB - Thirteen cases of pustulotic arthro-osteitis are reported: 3 children and 10 adults. The clinical and radiological aspects of this rare entity are discussed as well as the classification of this disease in the context of seronegative spondyloarthropathies. PMID- 3301125 TI - Immunopathological features of primary Sjogren's syndrome. AB - When the immunopathological features of primary Sjogren's syndrome (SS) are outlined, three questions may be asked. Firstly, how is auto-immunity triggered off? The arguments which suggest that viruses play a role are discussed and the key role of the genetic background is emphasized. Secondly, why does the auto immune vicious circle operate? Lymphocyte proportions, activation markers and functions are analysed in the peripheral blood and in the salivary glands. Thirdly, how do SS lesions occur? Although their physiopathological role is not well defined, a myriad of organ-specific or non organ-specific autoantibodies are observed. In addition to this B-lymphocyte polyclonal activation, apparently there is an early monoclonal proliferation in the course of the disease. PMID- 3301126 TI - The epidemiology of fetal death. PMID- 3301127 TI - Diagnosis of fetal death. PMID- 3301128 TI - Chromosomal causes of fetal death. PMID- 3301129 TI - Nonchromosomal malformations and syndromes associated with stillbirth. PMID- 3301131 TI - Management of fetal demise. PMID- 3301130 TI - Other causes of fetal death. AB - Although perinatal mortality rates have fallen considerably in the past several decades, the fetal component of this statistic has not decreased as rapidly as the neonatal portion. Syphilis, a significant cause of fetal death at the beginning of this century, has been eliminated and other conditions such as erythroblastosis fetalis and diabetes mellitus have been markedly reduced. It is clear, however, that minimum fetal mortality has not been achieved. Potentially salvagable fetuses still die from the effects of maternal hypertension, intrauterine growth retardation, and post-maturity. Widespread application of current knowledge and techniques would save some of these fetuses; others will only be saved with an increased understanding of pathological processes and their treatment. In the meantime, it is imperative that those involved in obstetrical care follow the sound principles of accurate determination of gestation age, identification of patients at risk for fetal death, meticulous care of associated medical conditions, and careful attention to the progress of pregnancy. PMID- 3301132 TI - Pathologic aspects of fetal death. AB - The number of autopsies has declined during the past decade; however, repeated studies by pathologists, clinicians, and others have shown its great value in defining disease, quality control, patient and physician education, and providing material for basic research. In recent years financial concerns have added to the decrease in autopsies. Nonetheless, reported studies find perinatal autopsies clinically useful. The authors have attempted to outline an approach to the fetal and neonatal autopsy that minimizes cost and is complete enough to form a basis for making decisions about future pregnancies. PMID- 3301133 TI - Diagnostic evaluation of the stillborn infant. PMID- 3301134 TI - Emotional aspects of perinatal death. PMID- 3301135 TI - The epidemiology and social impact of premenstrual symptoms. PMID- 3301136 TI - The relationship of menstrually related mood disorders to psychiatric disorders. PMID- 3301137 TI - General evaluation of premenstrual symptoms. PMID- 3301138 TI - Evaluation of psychiatric symptoms in patients presenting with symptoms of premenstrual tension syndrome. AB - The principal psychiatric syndrome seen in patients with premenstrual tension syndrome is depressive disorder. Questions that should be used to evaluate depression are reviewed and the addition of structured questionnaires for the depressive symptoms is not considered useful in this assessment. Other conditions that may or may not be related to the premenstrual period include psychosis (especially depression and mania), alcoholism, anxiety, and bulimia. Brief questioning concerning these conditions can be performed relatively quickly during the clinical evaluation. Second-source information should be obtained when at all possible. If treatable psychiatric illness is identified in those with premenstrual tension, it should be treated as if the psychiatric syndrome alone were present. There is no indication, however, that such treatment will alter the course of the premenstrual condition should it be present as well. PMID- 3301139 TI - Menstrual migraine: differential diagnosis, evaluation, and treatment. PMID- 3301140 TI - Fluid retention: evaluation and use of diuretics. PMID- 3301141 TI - Use of prostaglandin inhibitors in the treatment of PMS. PMID- 3301142 TI - The use of progesterone in the treatment of PMS. PMID- 3301143 TI - Reconstruction of musculoskeletal defects about the knee for tumor. AB - One of the most challenging problems of limb salvage is a large tumor involving the knee joint. Since 1970, 79 patients, ranging in age from 14 to 74 years (mean, 27 years), have had reconstruction of the knee after en bloc resection of a primary bone tumor. Sixty-one patients had lesions involving the distal femur, with a mean resection length of 13.5 cm, and 18 patients had lesions involving the proximal tibia, with a mean resection length of 10.5 cm. Thirty-nine patients had malignant lesions, of which osteosarcomas predominated, and 40 patients had benign tumors, of which giant cell tumors were the most prevalent. Reconstruction was done with a custom total knee arthroplasty in 41 patients, a resection arthrodesis in 27, and an allograft in 11. The functional results were graded according to the rating system devised by the Musculoskeletal Tumor Society. of the patients with resection arthroplasty, 70% had a good or excellent rating, although ten required revision. Of the patients with resection arthrodesis, 74% had a good or excellent rating, as did 55% of the patients with osteochondral allografts. When a limb salvage procedure is done, careful consideration must be given to the type of procedure chosen to reconstruct the knee. This decision is based on a number of factors related to the tumor and the patient. Although these various procedures promise functional restoration, the reconstructive procedure should be individualized and designed to meet the needs of the patient. PMID- 3301144 TI - Ligamentous injuries in dislocations of the elbow joint. AB - The opinions concerning presence of instability and ligamentous injuries following dislocation of the elbow differ. Thirty-one patients with an elbow dislocation without concomitant fracture were examined under anesthesia for stability at an average time of two days after the injury. All elbows were unstable to valgus stress in the extended position compared with the healthy side. Eight elbows were unstable to varus stress. Nine elbows were easily redislocated in semiflexed position under anesthesia. Surgical exposure and ligament suture were performed medially in all cases and laterally in 18 cases. All the ligaments were completely ruptured or avulsed in the epicondyle attachment. In most cases the ligamentous ruptures were combined with rupture or avulsion of the muscular origins at the epicondyles. The degree of muscular damage was correlated with the tendency to redislocate under anesthesia. PMID- 3301145 TI - [A case report of captopril-induced parkinsonism]. PMID- 3301146 TI - Masked obstruction of the renal collecting system. AB - Two cases of apparent unilateral renal obstruction in which lesser contralateral obstructions were not seen are presented. In both cases, relief of the more severe obstruction resulted in an unmasking of the milder contralateral lesion. PMID- 3301147 TI - Technetium-99m DTPA aerosol and gallium scanning in acquired immune deficiency syndrome. AB - In 11 non-smoking AIDS patients suspected of pneumocystis carinii pneumonia (PCP), the results of Tc-99m DTPA aerosol clearances, gallium scans, and arterial blood gases were compared with those of bronchoalveolar lavage (BAL). Nine patients had PCP. All had increased clearances five times higher than the normal (5.6 +/- 2.3% X min-1 vs 1.1 +/- 0.34% X min-1, N = 10, P less than 0.001), suggesting an increased alveolar permeability. Gallium scans were abnormal in six patients but normal or slightly abnormal in the three others. Four of these nine patients had normal chest x-rays. In two of these the gallium scan was abnormal, but in the two others, only the increased Tc-99m DTPA clearances showed evidence of lung disease. Two patients had normal BAL, with normal clearances and gallium scans. Four out of the nine patients with PCP were studied after treatment. Three recovered and had normal clearance and gallium scans. One still had PCP with increased clearance but normal gallium scan. Gallium scanning and Tc-99m DTPA clearance are useful for detecting lung disease in AIDS patients with suspected PCP and for prompting BAL when chest x-rays and PaO2 levels are normal. Due to its high sensitivity, a normal Tc-99m DTPA clearance could avoid BAL. PMID- 3301148 TI - Pharmacokinetic interactions of cimetidine 1987. AB - The number of studies on drug interactions with cimetidine has increased at a rapid rate over the past 5 years, with many of the interactions being solely pharmacokinetic in origin. Very few studies have investigated the clinical relevance of such pharmacokinetic interactions by measuring pharmacodynamic responses or clinical endpoints. Apart from pharmacokinetic studies, invariably conducted in young, healthy subjects, there have been a large number of in vitro and in vivo animal studies, case reports, clinical observations and general reviews on the subject, which is tending to develop an industry of its own accord. Nevertheless, where specific mechanisms have been considered, these have undoubtedly increased our knowledge on the way in which humans eliminate xenobiotics. There is now sufficient information to predict the likelihood of a pharmacokinetic drug-drug interaction with cimetidine and to make specific clinical recommendations. Pharmacokinetic drug interactions with cimetidine occur at the sites of gastrointestinal absorption and elimination including metabolism and excretion. Cimetidine has been found to reduce the plasma concentrations of ketoconazole, indomethacin and chlorpromazine by reducing their absorption. In the case of ketoconazole the interaction was clinically important. Cimetidine does not inhibit conjugation mechanisms including glucuronidation, sulphation and acetylation, or deacetylation or ethanol dehydrogenation. It binds to the haem portion of cytochrome P-450 and is thus an inhibitor of phase I drug metabolism (i.e. hydroxylation, dealkylation). Although generally recognised as a nonspecific inhibitor of this type of metabolism, cimetidine does demonstrate some degree of specificity. To date, theophylline 8-oxidation, tolbutamide hydroxylation, ibuprofen hydroxylation, misonidazole demethylation, carbamazepine epoxidation, mexiletine oxidation and steroid hydroxylation have not been shown to be inhibited by cimetidine in humans but the metabolism of at least 30 other drugs is affected. Recent evidence indicates negligible effects of cimetidine on liver blood flow. Cimetidine reduces the renal clearance of drugs which are organic cations, by competing for active tubular secretion in the proximal tubule of the kidney, reducing the renal clearances of procainamide, ranitidine, triamterene, metformin, flecainide and the active metabolite N acetylprocainamide. This previously unrecognised form of drug interaction with cimetidine may be clinically important for both parent drug, and metabolites which may be active.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3301151 TI - Pharmacokinetics of enteric-coated aspirin and inhibition of platelet thromboxane A2 and vascular prostacyclin generation in humans. AB - We evaluated whether an enteric-coated aspirin formulation showed a "presystemic" component in its antiplatelet effect and if so would spare vascular cyclooxygenase. In six healthy volunteers, 30 to 45 minutes after ingestion of 325 mg enteric-coated aspirin, platelet thromboxane A2 generation was inhibited by about 20% before any drug could be detected in the peripheral venous blood. A further decline in thromboxane A2 generation occurred with appearance of aspirin in blood between 60 and 240 minutes. No presystemic component could be detected after 325 mg aspirin tablets. Ten patients undergoing saphenectomy received 325 mg of either aspirin tablet or enteric-coated aspirin; 12 hours later platelet thromboxane A2 and peripheral vascular prostacyclin generation were significantly reduced by 98% and 58%, respectively. The effects of the two aspirin formulations were not different. Aspirin formulations with "presystemic" component in their antiplatelet effect may not necessarily result in sparing of peripheral vascular cyclooxygenase. PMID- 3301152 TI - Trimethoprim pharmacokinetics in children with renal insufficiency. AB - We studied the pharmacokinetics of trimethoprim in 14 children (two neonates) with renal insufficiency. They were 1 week to 16.4 years old and had glomerular filtration rates (GFR) between 10.8 to 72.3 ml/min/1.73 m2. The half-life (t1/2) of trimethoprim was inversely related to the GFR. The relation followed a power curve (correlation of t1/2 with GFR: r = -0.86; P less than 0.001). The slower elimination rate was mainly the result of lowered renal clearance of trimethoprim. The volume of distribution (Varea) was, in most patients, in the upper normal range for children. In some of the patients, chiefly infants with severe renal insufficiency, the Varea was larger than normal. In some individuals the pharmacokinetics of trimethoprim deviated from that to be expected from the GRF. We recommend reduced daily doses of trimethoprim if the GFR is less than 30 ml/min/1.73 m2. The reduction should be proportional to the reduction in GFR and primarily take the form of a prolonged dose interval. PMID- 3301149 TI - The relationship between the pharmacokinetics and pharmacodynamic effects of oral hypoglycaemic drugs. AB - Oral hypoglycaemic drugs have widely differing pharmacokinetic properties. Possible pharmacodynamic benefits include greater efficacy and fewer adverse effects. In general, it has not been possible to demonstrate unequivocal differences in clinical efficacy between the sulphonylureas during long term use, although there are clear differences in potency. These differences have been emphasised to the extent that the term 'second-generation' has been used for the most potent sulphonylureas, but there is little to suggest that potency is of any therapeutic significance. Trials to study differences in efficacy have rarely been of acceptable design. They have often used fixed doses of drugs, begging the question of whether true potency ratios have been established for chronic treatment. They have rarely involved substantial numbers of patients in double blind crossover studies with a suitable washout period. Trials which show that there is a clear relationship between drug concentrations in blood and drug effects (whether therapeutic effects or adverse effects such as severe hypoglycaemia) are generally lacking. Qualitative and semiquantitative analysis of adverse effects supports the concept that drugs with a long half-life (e.g. chlorpropamide), renally excreted active metabolites (e.g. acetohexamide) or unusual properties (e.g. glibenclamide, which accumulates progressively in islet tissue) are more likely to cause prolonged hypoglycaemia, which may be fatal. The major adverse effect of treatment with biguanides is lactic acidosis, and this probably occurs more commonly in patients treated with phenformin than those treated with metformin because of pharmacogenetic variation in phenformin metabolism. The available evidence therefore favours the use of drugs with a short elimination half-life which are extensively metabolised and which have no active metabolites. PMID- 3301153 TI - Efficacy, safety, hemodynamic effects, and pharmacokinetics of high-dose moricizine during short- and long-term therapy. AB - Moricizine, 15 mg/kg, was given to 10 patients with frequent ventricular ectopic depolarizations, eight of whom had previously been treated unsuccessfully with antiarrhythmic drugs. A single-blind inpatient study was followed by therapy for up to 6 months. Two patients developed aggravation of arrhythmia during inpatient therapy. Of the eight patients who completed the inpatient study, seven achieved greater than or equal to 80% suppression of total ventricular ectopic depolarizations (P less than 0.001). During inpatient therapy the mean of the individual patients' suppression of total ventricular ectopic depolarizations was 87.9%, paired ventricular beats 99.3%, nonsustained ventricular tachycardia 99.6%, and premature atrial contractions 89.0%. Suppression was maintained during long-term therapy. The PR interval increased 27% (P less than 0.001), QRS interval increased 10% (P less than 0.0001), QTc increased 1% (P not significant), and JTc decreased 2% (P not significant). Heart rate, blood pressure, and left ventricular performance at rest and exercise were unchanged by moricizine. Moricizine half-life was 9.2 +/- 3.4 hours. Plasma levels of moricizine decreased after 10 days of therapy, suggesting induction of metabolic enzyme systems. PMID- 3301154 TI - Comparison of intramuscular dezocine with butorphanol and placebo in chronic cancer pain: a method to evaluate analgesia after both single and repeated doses. AB - Sixty hospitalized subjects with chronic moderate to severe pain as a result of advanced cancer were enrolled in a randomized, parallel, double-blind trial comparing single doses and multiple doses of intramuscular dezocine (10 mg) with butorphanol (2 mg) and placebo. During the initial 6-hour efficacy evaluation, analgesia was measured using verbal and visual scriptors and vital signs, and acute toxicity information was recorded. Subjects with initial pain relief entered the 7-day multidose portion of the trial, and efficacy and toxicity data were recorded daily. After the initial dose the peak analgesia of the active agents was similar, but the duration of analgesia was longer with dezocine. After multiple doses, dezocine was superior to butorphanol in terms of length of treatment. Dezocine had less toxicity than had butorphanol after both single and repeated doses, further suggesting that dezocine may be beneficial in managing chronic cancer pain. The described study design is unique in that it compares the analgesic efficacy and toxicity of several analgesics with placebo after both single and multiple doses in the same subject. This method may prove to be an alternative pain model to evaluate chronic cancer pain. PMID- 3301155 TI - Multiple oral doses of nicardipine, a calcium-entry blocker: effects on renal function, plasma renin activity, and aldosterone concentration in mild-to moderate essential hypertension. AB - We studied the effects of nicardipine administered in a 4-week fixed oral maintenance dosage (20 or 40 mg t.i.d.) on renal function, plasma renin activity (PRA), and plasma aldosterone concentration in seven patients with mild-to moderate essential hypertension. Glomerular filtration rate and renal blood flow were measured by means of sodium thiosulfate and para-aminohippurate, respectively. Nicardipine increased renal blood flow by 11.5% +/- 4.3% (mean +/- SE; P less than 0.05) and glomerular filtration rate by 16.3% +/- 6.4% (P less than 0.05) and decreased total renal vascular resistance by 30.0% +/- 2.7% (P less than 0.05), with a significant (P less than 0.05) reduction in systolic and diastolic blood pressure as compared with placebo values. Nicardipine increased PRA significantly (P less than 0.05), whereas plasma aldosterone concentration remained unchanged. Our results indicate that nicardipine given in a multiple oral dosage has some favorable renal effects with a concomitant hypotensive action in patients with mild-to-moderate essential hypertension. Nicardipine appears to blunt the secretion of aldosterone responding to an increased PRA possibly through its calcium-antagonizing action. PMID- 3301156 TI - Histopathology of human expanded tissue. AB - In this article the authors summarize statistical data from 19 patients obtained during quantitative analysis of the thickness of expanded skin and soft tissues utilizing silicone expander procedures. Histopathologic and ultrastructural changes that take place in individual levels of expanded tissues are also illustrated. PMID- 3301157 TI - Detection of islet cell autoantibodies in newly diagnosed diabetic patients using insulin-producing Syrian hamster cells. AB - An insulin-producing cell line, Clone-16, of hamster origin, was characterized for islet hormone production and for reactivity with islet cell surface (ICSA) and islet cell cytoplasmic (ICA) antibodies in sera from children with newly diagnosed insulin-dependent (Type 1) diabetes mellitus (IDDM). The Clone-16 cells have a doubling time of about 50-60 hr. The cells produced 63 +/- 3 ng (mean +/- SD) immunoreactive insulin and 9.4 +/- 0.3 ng immunoreactive glucagon per day per 10(6) cells, while somatostatin (SRIF) and pancreatic polypeptide (PP) were undetectable. The reactivity with autoantibodies in IDDM sera was assessed by indirect immunofluorescence or 125I-protein A binding assay on intact cells to detect islet cell surface antibodies (ICSA) or on frozen sections of cell pellets to detect islet cell cytoplasmic antibodies (ICCA) by indirect immunofluorescence. Although the proportion of the ICSA-positive Clone-16 cells compared favorably with rat islet cells (r = 0.81; p less than 0.01), we found 5/10 IDDM sera to be positive on rat islet cells but 8/10 on the Clone-16 cells. There was also a good correlation in the 125I-protein A binding assay between mouse islet cells and Clone-16 cells (r = 0.91; p less than 0.01). Frozen sections of Clone-16 cells showed a cytoplasmic immunofluorescence in 8/10 of the IDDM sera and this reaction parallelled the results obtained in the standard indirect immunofluorescence assay with a frozen section of human blood group O pancreas. We conclude that the insulin- and glucagon-producing Clone-16 cells are a useful cell line for detecting islet cell autoantibodies. PMID- 3301158 TI - Insulin secretion to glucose infusion in gestational diabetes subjects with differing DNA polymorphisms flanking the insulin gene. AB - Glucose-stimulated insulin secretion was assessed in relation to the DNA polymorphism flanking the insulin gene in 16 women who had had gestational diabetes. When not pregnant they were studied by a Constant Glucose Infusion for 1 hr with Model Assessment (CIGMA). The patients with either heterozygous 1/3 alleles or homozygous 1/1 or 3/3 alleles in the 5' flanking region of the insulin gene had similar plasma insulin and C-peptide concentrations and similar estimates of beta-cell function. This suggests that the large DNA insert (Class 3 allele) near the insulin gene does not directly affect insulin secretion. The association of polymorphisms with Type 2 diabetes may be due to linkage disequilibrium with other disease-related alleles. PMID- 3301150 TI - Protein binding as a primary determinant of the clinical pharmacokinetic properties of non-steroidal anti-inflammatory drugs. AB - The ability of a wide variety of anionic, cationic, and neutral drugs to bind in a reversible manner to plasma proteins has long been recognised. Non-steroidal anti-inflammatory drugs (NSAIDs) are distinguished as a class by the high degree to which they bind to plasma protein. Plasma protein binding properties are primary determinants of the pharmacokinetic properties of the NSAIDs. Theoretical relationships are reviewed in order to define quantitatively the impact of plasma protein binding on clearance, half-life, apparent volume of distribution, and the duration and intensity of pharmacological effect. The quantitative relationships governing competitive displacement binding interactions are also presented. Experimental methods for in vitro and in vivo determination of the degree of plasma protein binding are discussed. The more common in vitro methods are equilibrium dialysis and ultrafiltration. Methods for characterising the degree of plasma protein binding in vivo consist of either measuring the concentration of drug at equilibrium in an implanted semipermeable vessel or measuring the relative drug concentrations in two body spaces with different protein content. Emphasis is given to the comparative advantages and disadvantages of experimental application of the various in vitro and in vivo methods. Plasma protein binding is discussed as a determinant of the trans-synovial transport of NSAIDs. Trans synovial transport of NSAIDs appears to be a diffusional process. Limited data in humans receiving ibuprofen, indomethacin, aspirin, carprofen, alclofenac, or diclofenac suggest that clearance of each of these NSAIDs from the synovium is slower than clearance from plasma. The clinical data relevant to the relationship between plasma NSAID concentration and various measures of anti-inflammatory effect are reviewed. A positive correlation between plasma NSAID concentration and anti-inflammatory effect has been observed in only one study on naproxen and one study on piroxicam. In several other studies, the lack of concentration response correlations is generally attributed to the relatively subjective, quantitatively inexact methods used to assess anti-inflammatory effect and analgesia in arthritic patients, as well as the substantial interpatient variabilities in the fraction of unbound NSAID and the unbound plasma NSAID concentration. In view of the generally poor correlation between concentration and therapeutic response, routine therapeutic monitoring of total plasma NSAID concentration is not recommended as a means of titrating individual dosages to the desired effect in each patient.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3301159 TI - Effects of duration of cold storage and gestational age on the insulin secretory capacity of human fetal pancreatic islets. AB - Studies were performed on human fetal pancreatic tissue to determine viability after long-term cold storage at 0 degrees to 2 degrees C and the effect of gestational age on in vitro insulin secretory capacity. Viability expressed by the insulin secretory capacity was assessed by insulin responses to 2 successive 1 hr static batch incubations. The first incubation (F1) was in low glucose (2mM) medium while the second incubation (F2) included 25 mM glucose and 1 mM 3 isobutyl-1-methylxanthine (IBMX) as potentiator. The fractional stimulatory ratio (FSR defined as F2/F1) and trypan exclusion rates of isolated fetal islets were used as indexes of viability. Cold storage at 0 degrees to 2 degrees C of whole pancreata for period up to 144 hr was not found to alter insulin secretory capacity (FSR-values), but the percentage of dead islets indicated by trypan blue uptake increased. Microscopic examination of dithizone stained pancreatic islets showed intact and well demarcated variable sized islets. Histologically, islets showed well preserved endocrine cells after cold storage for 18 hr followed by culture for 48 hr. Fetal islets isolated from pancreata of 16-18 weeks gestational age were found to have a 2-fold increase in FSR-values when compared to islets isolated from pancreata of 19-24 weeks gestational age. These experiments document the feasibility of obtaining human fetal islet tissue for transplantation at centers widely separated from the site of transplantation. The implication of the enhanced insulin secretory response of islets obtained between 16-18 weeks gestational age remains to be defined. PMID- 3301160 TI - A comparative study of once daily insulin injection regimes in the treatment of elderly diabetics. AB - A randomised crossover trial of Insulatard, Lentard and Mixtard insulins as once daily therapy was undertaken in 10 diabetics who had been on long term insulin and in 7 patients who were poorly controlled on oral hypoglycaemic agents and had not previously received insulin. The glycaemic control of those patients with prior insulin therapy was very similar under these 3 insulin regimes. In patients previously on oral hypoglycaemic agents the mean (+/- SEM) blood glucose (10.0 +/ 0.8 mmol/l), log "M" value (1.78 +/- 0.10) and area under the glucose curve (192 +/- 16 mmol . hr/l) were all lower on Insulatard than when on Lentard (13.0 +/- 0.9, 2.03 +/- 0.08 and 258 +/- 17 respectively; p less than 0.05 in each case). Mixtard values were intermediate (11.2 +/- 1.3, 1.83 +/- 0.19 and 258 +/- 17). Furthermore blood glucose values were within the physiological range of 3-7 mmol/l in 20% of patients on Insulatard, in 16% on Mixtard but in only 2% on Lentard. Significant hypoglycaemia (blood glucose less than 3 mmol/l) in both groups of patients was noted more commonly with Mixtard (7 episodes) than with Lentard (3 episodes) or Insulatard (2 episodes). There was no significant difference in the free insulin levels between these insulin regimes but mean log total insulin levels were higher (p less than 0.005) when the patients were taking Lentard (2.33 +/- 0.13) in comparison with both Insulatard (1.99 +/- 0.14) and Mixtard (1.92 +/- 0.13). The mean insulin binding rose 4.9% during Lentard treatment and fell slightly by 0.6% on Insulatard and 0.9% on Mixtard (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301161 TI - C-peptide and insulin secretion in diabetes mellitus treated with oral hypoglycaemic agents or diet alone. A 3 years epidemiological cohort study on the Island of Falster, Denmark. AB - In a 3 yr epidemiological cohort study of 273 diabetics treated with oral hypoglycaemic agents (OHA) and 60 diet-treated diabetics the predictive value of fasting plasma C-peptide levels was assessed with the attempt to discriminate between insulin dependence and non-insulin dependence. Serum insulin, blood glucose, haemoglobin AI, bicarbonate, urine for ketone bodies, height and weight were measured too. All but 8 OHA-treated patients (97%) had fasting C-peptide greater than 0.40 pmol/ml at both investigations. Six had C-peptide in the interval 0.21-0.40 pmol/ml at both investigations and 2 a C-peptide less than or equal to 0.20 pmol/ml all of which became insulin dependent during the 3 yr period. The highest fasting C-peptide concentrations were found in overweight diabetics with a blood glucose level greater than 8.5 mmol/l. Overweight diabetics had significantly elevated fasting insulin compared to the normal weights but when the IRI concentrations were corrected by the body mass index hyperinsulinaemia was positively correlated with high levels of blood glucose and haemoglobin AI, i.e. poor glycaemic control and not with overweight. The results suggest that determination of fasting plasma C-peptide can be an additional clinical help in discriminating between insulin dependence and non-dependence. PMID- 3301162 TI - The changing face of Clinical Science. In the shadow of Thomas Lewis. PMID- 3301164 TI - Prostacyclin in the circulation of patients with vascular disorders undergoing surgery. PMID- 3301163 TI - Free D-amino acids in human plasma in relation to senescence and renal diseases. AB - Minute but appreciable amounts of D-amino acids were detected in normal human plasma. The content was significantly higher in an elderly population (age 76 +/- 6 years, mean +/- SD, n = 41) than in a younger group (age 42 +/- 4 years, n = 26), i.e. 6.9 +/- 4.8 nmol/ml (mean +/- SD, range 0-18.8 nmol/ml) and 2.5 +/- 1.8 nmol/ml (range 0-6.3 nmol/ml) for the elderly and the younger groups, respectively. Elevation of plasma D-amino acid level was observed in a group of patients with renal disease (3.6-52.6 nmol/ml), in proportion to the serum level of creatinine (n = 50, r = 0.726, P less than 0.001), beta 2-microglobulin (n = 34, r = 0.551, P less than 0.005), and to glomerular filtration rate (n = 39, r = 0.556, P less than 0.001). PMID- 3301165 TI - Energy expenditure in non-insulin dependent diabetic subjects on metformin or sulphonylurea therapy. AB - In the management of the non-insulin dependent diabetic patient, metformin often facilitates weight loss whereas sulphonylurea may predispose to weight gain. To investigate whether this is due to alterations in energy expenditure we have studied energy expenditure in seven non-insulin dependent diabetic subjects while on metformin or sulphonylurea therapy. Three components of energy expenditure were measured by indirect calorimetry, namely resting metabolic rate and the thermic responses to infused noradrenaline and to a mixed constituent meal. There was no significant difference in the resting metabolic rate on metformin (5.29 +/ 0.41 kJ/min; mean +/- SE) compared with sulphonylurea (5.34 +/- 0.34 kJ/min). The resting metabolic rate was also similar to predicted values for non-diabetic subjects (r = 0.96). The thermic response to infused noradrenaline was similar on metformin (23.14 +/- 1.87 kJ) and sulphonylurea (21.40 +/- 2.98 kJ). There was no significant difference in the thermic response to the meal on sulphonylurea (75.8 +/- 7.5 kJ) or on metformin (86.8 +/- 10.8 kJ; 95% confidence limits -17 to +39 kJ). We conclude that in non-insulin dependent diabetic subjects metformin does not enhance energy expenditure overall, compared with sulphonylurea. PMID- 3301166 TI - The effect of indomethacin on the response of protein synthesis to feeding in rats and man. AB - Protein synthesis was measured in muscle of fed and fasted rats. Synthesis rates were 29% higher with feeding. Treatment with indomethacin before feeding completely blocked the stimulation of protein synthesis. Whole-body protein synthesis was measured in six healthy volunteers with [15N]glycine in fasted and fed states. Feeding increased synthesis rates by 50%. An oral dose of indomethacin 2 h before the measurement of protein synthesis had no effect in either the fasted or fed state. PMID- 3301167 TI - Platelet catecholamines and platelet function in normal human subjects. AB - We have used high-performance liquid chromatography with electrochemical detection to measure plasma and platelet catecholamines in 24 normal subjects. In the same subjects platelet function was assessed by measuring platelet aggregation in response to adenosine 5'-pyrophosphate, thrombin, adrenaline and collagen. Platelet sensitivity to prostacyclin was also examined. Platelet noradrenaline showed a positive correlation with extent of aggregation induced by 'low-dose' collagen (1 microgram/ml). No correlation was seen at the higher collagen concentration. Platelet noradrenaline content also correlated with sensitivity of platelets to prostacyclin. High platelet noradrenaline concentrations appeared to result in decreased sensitivity to prostacyclin. No other correlations were observed. These data suggest that platelet noradrenaline rather than plasma levels may be involved in modifying platelet function in vivo. Local release of platelet catecholamines may affect the platelet/vessel wall interaction, the primary physiological step in platelet activation. PMID- 3301168 TI - Insulin sensitivity in patients with arterial insufficiency. Re-evaluation with the multilevel glucose clamp technique. AB - Previous studies have claimed that changes in insulin and glucose metabolism in patients with peripheral arterial insufficiency indicate an increased sensitivity to insulin for glucose uptake. We have re-evaluated this concept in 11 patients with intermittent claudication and 11 matched controls with a multilevel euglycaemic glucose clamp technique. The groups were matched for age, sex and body composition but not completely for smoking habits and physical fitness. Although the control group had a normal physical fitness the patients had 40% lower maximal exercising capacity. The patients' maximal walking capacity was 186 +/- 27 m evaluated on a treadmill. No patient with ischaemic ulcers or rest pain were included. The euglycaemic glucose clamp was performed at five insulin plateau levels (70, 110, 190, 590 and 1440 mU/l) of one h duration each and whole body glucose uptake during the last 20 min was calculated. No differences in maximal glucose uptake (Vmax) or insulin level for half maximal glucose uptake (Km) between the groups were observed. The concentration or the magnitude of the decrease in arterial FFA levels did not differ significantly between the groups at any physiological insulin level. This study can not confirm previously described changes in insulin sensitivity in patients with arterial insufficiency. Although the discrepancy between present and previous results remains unclear it may reflect the combined effects of different methods used, including the selection of reference patients, rather than an increased insulin sensitivity in patients with arterial insufficiency. This study suggests that previous conclusions based on glucose tolerance tests should be interpreted with caution. PMID- 3301169 TI - Basic principles of pharmacokinetics. AB - Pharmacokinetics can be used clinically to empirically describe the serum concentrations of drugs in the body. With a good understanding of the general principles utilized in predicting drug levels, the practitioner can understand the drugs and specific patient populations most likely to benefit from or need careful adjustment in therapeutic drug monitoring. PMID- 3301170 TI - Free drug monitoring. AB - The principles, technique of measurement, and clinical significance of free drugs are reviewed. Albumin, alpha-1-acid glycoprotein, and lipoprotein are the main drug-binding proteins in blood. Variations of the concentrations of these proteins owing to disease would result in changes in the free drug levels. These levels may be determined by equilibrium dialysis, ultrafiltration, and other techniques. PMID- 3301171 TI - Individualization of drug dosage regimens. AB - Individualizing drug dosage regimens is a common application of therapeutic drug monitoring. For drugs with a narrow therapeutic index or variable pharmacokinetic parameters, pharmacokinetic-based dosing can be useful. Pharmacokinetic methods that can aid the clinician in targeting for desired drug serum concentrations have been developed and clinically evaluated. These methods range from single nomograms or pharmacokinetic equations in which no serum concentrations are necessary to more complex techniques requiring serum concentration data and computer support. The most recently developed technique, Bayesian forecasting, may allow for more precise dosage individualization. PMID- 3301172 TI - Polymeric controlled release systems: new methods for drug delivery. AB - Controlled release delivery systems are playing an ever-increasing role in drug therapy. By means of polymeric devices, drugs with a variety of physicochemical properties can be released predictably in therapeutic dosages. PMID- 3301173 TI - Instrumentation and techniques for therapeutic drug monitoring. AB - This article describes and compares the predominant systems for performing therapeutic drug monitoring. Advantages and disadvantages, costs, and future trends are noted. Useful information for the initiation or expansion of this clinical service is provided. PMID- 3301174 TI - Chromatographic techniques for therapeutic drug monitoring. AB - Although GLC is still used with some frequency, HPLC is currently the most widely practiced chromatographic technique for the measurement of therapeutic drugs. Efficiency and selectivity can be manipulated to meet the requirements of clinical samples, especially when drug metabolites are present and their concentrations are of importance. The ability to simultaneously quantitate several drugs has led to the development of many methods for antiepileptic, antiarrhythmic, and antidepressant drugs. Selective detectors offer more sensitive analysis in many separations and are increasingly popular. The development of automated methods for sample preparation suggests that more cost effective strategies for the chromatographic analysis of new drugs will be possible in the near future. PMID- 3301175 TI - Immunoassays in therapeutic drug monitoring. AB - Numerous immunoassay methods are now in routine use for therapeutic drug monitoring of drugs and metabolites. Most methods are homogeneous immunoassays with excellent specificity, accuracy, and precision. In addition, these assays are readily automated, and commercial versions of theses reagents are available with dedicated instrumentation. This report reviews current methods and systems and discusses methodology that has been developed for physician office or other nontraditional settings. PMID- 3301176 TI - Drug screening in hospital clinical laboratories. AB - Although hospital toxicology laboratories are usually established to assist their emergency services in the diagnosis and treatment of patients, they could and should be used by other departments in the hospital, as well as by other facilities in the area. Overall, toxicology services vary widely in both scope and practice. Comprehensive screens are generally processed by larger hospitals or by university-affilitated medical centers. However, smaller facilities may be able to offer comprehensive services by marketing their efforts in the geographic area of the hospital. The ultimate success of the hospital toxicology laboratory will depend on its ability to communicate its services to its users and to offer a wide range of tests in a proficient and cost-effective manner. PMID- 3301177 TI - Drug screening in the workplace. AB - Drug use is pervasive in our society. Because Americans who use and abuse drugs are part of the working population, employers will continue to be affected by employees with substance abuse problems. The social, economic, and legal costs to business have created a new awareness, and companies are recognizing the need to take special measures to control drug and alcohol use. Urine drug screening has been identified as a valuable tool in discovering, documenting, and ultimately controlling drug use in the workplace. This article deals with the complex issues involved in designing and implementing an industrial drug screening program. The various laboratory techniques are identified and discussed, with special emphasis on their advantages and limitations. PMID- 3301178 TI - Methodologies for antidepressant monitoring. AB - Advances in clinical analytic technology have contributed to antidepressant therapy. This article emphasizes recent developments in liquid chromatographic and immunoassays, including the "semiquantitative" and quantitative enzyme multiplied immunoassay technique (EMIT) and fluorescence polarization immunoassay (FPIA). PMID- 3301179 TI - Misuse of therapeutic drug monitoring: an analysis of causes and methods for improvement. AB - The quantification of serum drug levels provides physicians with an indication of attainment of the desired pharmacologic goals. However, based on the preceding evidence, therapeutic drug monitoring (TDM), which is commonly used in conjunction with the prescribing of anticonvulsants, antiarrythmics, cardiac glycosides, antibiotics, antineoplastics, bronchodilators, lithium, antidepressants, neuroleptics, benzodiazepines, and other psychotropic drugs, is not used effectively for therapeutic intervention in the elderly. In addition to determining if a blood level is within the therapeutic range, TDM can also be helpful in identifying the reasons why a patient is not responding to a prescribed drug or is exhibiting toxic signs or symptoms, as well as in elucidating causes of coma, patient noncompliance, poor absorption, and excessively rapid metabolism. Furthermore, drug blood levels can be an asset in the diagnosis and monitoring of treatment programs for alcohol and drug abuse. Despite the existence of computerized programs for drug level determination in clinical laboratories, and the existence of individualized computer programs for optimizing the choice and dosage of drugs for many categories of patients with a multitude of metabolic and pathophysiologic problems, most physicians still rely on tradition, imitation, and information provided by drug advertising and sales representatives to choose therapeutic regimens for patients. To make proper use of TDM, a physician has to have at least a working knowledge of the basic concepts of pharmacokinetics. This advancing medical science also demands a thorough knowledge of the routes of absorption, distribution, metabolism, and excretion of drugs. Results from TDM determinations indicate how effectively the appropriate amount of drug is delivered to the desired location of action from the site of administration. One of the most common reasons for misuse of TDM results is that physicians order specimens for drug monitoring to be drawn at inappropriate times. Accurate TDM requires that (most) specimens be drawn at trough levels, after steady-state levels have been attained. Trough levels occur immediately prior to the administration of the next dose. Such measurements avoid the absorptive peaking levels that occur shortly (usually) after drug administration. Steady-state levels are attained when the amount of drug absorbed and the amount excreted are essentially equal. This usually occurs after the drug has been administered for approximately five half-lives.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3301180 TI - Establishing a therapeutic drug monitoring consultation service. AB - A formal therapeutic drug monitoring consultation service (TDMCS) will enhance the clinical benefits of drug level determinations. It can result in decreased length of stay and improved risk management posture. The successful implementation of a TDMCS requires the coordinated efforts of a multidisciplinary team that may include physicians, pharmacists, nurses, and laboratory personnel. Clinical pathologists and clinical pharmacists are particularly well qualified to direct a TDMCS. Consistent delivery of quality services requires that all procedures related to the consultation process be standardized and documented in a procedures manual. The cost of providing the service may be recovered through both direct and indirect mechanisms. PMID- 3301181 TI - Evaluation and management of primary pulmonary hypertension. PMID- 3301182 TI - Goodpasture's syndrome. PMID- 3301183 TI - Characterization of a monoclonal antibody recognizing small collagenous proteins in fetal bone. AB - A monoclonal antibody (MBP-322) that recognizes two small collagenous, apatite binding (SCAB) proteins associated with the mineral phase of fetal bone, has been prepared. The SCAB proteins, which are quantitatively extracted from bone with EDTA, have been shown by immunotransfer analyses to have MrS of 28K and 25K and both were selectively degraded by bacterial collagenase. Amino acid analysis of the collagenase-digested protein revealed a hypro:pro:gly ratio of approximately 0.5:1:0.7 for both proteins and indicated that one-third of the protein could have a collagen-like sequence. The SCAB proteins, unlike other collagens and collagen fragments tested bound quantitatively to hydroxylapatite in the presence of 4M guanidine hydrochloride and appear to be unique to bone. The antibody, however, was not specific for the SCAB proteins and showed comparable immunoreactivity against denatured alpha 1 chains of types I, II and III collagens and the alpha 2 chains of types I and V collagens but not type IV collagen nor native collagens I-V. The epitope was further localized to the CB6 fragment in the alpha 1(I) chain and the CB5 fragment of alpha 1(III) chain, and was present in both the TCA and TCB fragments of alpha 2(I). Despite the immunological reactivity, the properties of the SCAB proteins were not consistent with their being derived from known collagen types. Immunocytochemical staining of permeabilized bone cells with MPB-322 showed a perinuclear, punctate staining pattern in most cells with some cells showing specific nuclear staining. In non permeabilized cells, the antibody stained various sized spherical particles, many of which were closely associated with the cell surface. Immunoblots of cell proteins revealed a number of immunoreactive proteins sensitive to collagenase digestion including two proteins with MrS similar to the SCAB proteins. The MBP 322 antibody appears useful for identifying sequence homology in various collagens, and for recognizing denatured collagen and specific collagen fragments in tissues, as well as being important for the further characterization of the SCAB proteins. PMID- 3301184 TI - Biosynthetic precursors of cartilage chondroitin sulfate proteoglycan. AB - Early steps in the biosynthesis of chondroitin sulfate proteoglycan (CSPG) and collagenous cartilage matrix molecules were examined by the comparison of products translated in mRNA-directed cell-free reactions and those synthesized by intact cartilage cells. RNA isolated from embryonic chicken sterna was used to direct cell-free translation reactions. Chicken sternal chondrocytes in culture were pulse-labeled with [35S]-methionine. The CSPG core protein was identified by immunoprecipitation. The Mr of the cartilage cell-synthetized core protein was determined to be 370K, approximately 10-15K greater than that of the comparable cell-free translation product. Experimental results strongly support the view that the observed difference in Mr reflects the cotranslational addition of mannose-rich, N-asparagine-linked oligosaccharides to the cell-synthesized core protein: 1) the cell-synthesized product was labeled with [3H]-mannose and precipitated by concanavalin A-sepharose beads; 2) the incorporated [3H]-mannose could be subsequently removed by digestion with endoglycosidase H (Endo H); 3) the Mr of the cell-synthesized core protein was reduced by Endo H digestion to that of the comparable cell-free translation product; 4) the core protein synthesized by tunicamycin-treated chondrocytes (inhibited in their ability to add N-asparagine-linked mannose-rich oligosaccharides to proteins) was comparable in electrophoretic mobility to that of the core protein cell-free translation product; and 5) the core protein translated in microsome-coupled cell-free reactions had an Mr 8-10K greater than that of the core protein translated in the absence of microsomes. For the purpose of examining biosynthetic intermediates, chondrocytes were labeled continuously or pulse-chase labeled for varying times. No biosynthetic CSPG intermediates migrating between the core protein and the CSPG monomer were detected. However, a band of 355Kdal appeared to share certain characteristics with the 307Kdal core protein (including its immunoprecipitability with CSPG antibodies), and a 340Kdal band was noted. Type II procollagen and other collagenase-sensitive products of 205Kdal and 110Kdal were observed among translation and chondrocyte-synthesized products. In chondrocytes, all three products exhibited labeling or chase time-dependent increases in Mr which were accelerated by ascorbate supplements and inhibited by the addition of alpha, alpha'-dipyridyl. These results suggest that the observed time-dependent increases in Mr are a consequence of collagen hydroxylation. The 110Kdal and 205Kdal collagenous proteins may be related to the minor collagens recently described in cartilage. PMID- 3301185 TI - The substitution of nursing home for inpatient psychiatric care. AB - Although the era of deinstitutionalization of the aged from state mental facilities and of the rapid growth of the nursing home industry appears to have ended, the question remains of the extent to which nursing home care is substituted for psychiatric care. To study this question, the numbers per capita of Medicaid program recipients of inpatient psychiatric care for each state in the period 1979-82 was regressed on numbers per capita of Medicaid nursing home recipients, numbers of nursing home beds per capita, and the percentage aged. As expected, psychiatric care is negatively related to bed supply, positively to nursing home recipients and to percentage aged; and the relationship to nursing home recipients is stronger in states with undersupplies of beds. These findings are interpreted to show that nursing home care is substituted for inpatient psychiatric care, depending on bed supply, the generosity of the Medicaid program, and the level of demand for care. PMID- 3301186 TI - Purification and comparative studies of alcohol dehydrogenases. AB - Alcohol dehydrogenases from various animal and plant sources were purified by a common procedure which employed DEAE, Sephadex-G100 and affinity chromatographies. The procedure achieves an 80-130 fold purification for animal enzymes. However, only a 5-15 fold purification for plant enzymes was attained because of the instability of these enzymes. Purified alcohol dehydrogenases from animal and plant sources differ in coenzyme and substrate specificities. The enzymes from mammalian, avian and fish livers display aldehyde oxidizing and esterolytic activities in addition to alcohol oxidizing activity. However, the enzymes from plants and yeast show only the oxidative activity toward alcohols. Chemical modifications have been performed to identify amino acid residues which are essential to the oxidative and esterolytic activities of alcohol dehydrogenases. PMID- 3301187 TI - A therapy planning architecture that combines decision theory and artificial intelligence techniques. AB - Through our experience with the ONCOCIN cancer therapy consultation system, we have identified a set of medical planning problems to which no single existing computer-based reasoning technique readily applies. In response to the need for automated assistance with this class of problems, we have devised a computer program called ONYX that combines decision-theoretic and artificial intelligence approaches to planning. We discuss our rationale for devising a new planning architecture and describe in detail how that architecture is implemented. The program's planning process consists of three steps: (i) the use of rules derived from therapy planning strategies to generate a small set of plausible plans, (ii) the use of knowledge about the structure and behavior of the human body to create simulations that predict possible consequences of each plan for the patient, and (iii) the use of decision theory to rank the plans according to how well the results of each simulation meet the treatment goals. This architecture explicitly manages the uncertainty inherent in many planning tasks, introduces a possible mechanism for the dissemination of decision-theoretic therapy advice, and potentially increases the number of problem solving domains in which expert system techniques can be effectively applied. PMID- 3301188 TI - Intelligent physiologic modeling: an application of knowledge based systems technology to medical education. AB - This article describes the design and implementation of a knowledge-based physiologic modeling system (KPBMS) and a preliminary evaluation of its use as a learning resource within the context of an experimental medical curriculum--the Harvard New Pathway. KBPMS possesses combined numeric and qualitative simulation capabilities and can provide explanations of its knowledge and behavior. It has been implemented on a microcomputer with a user interface incorporating interactive graphics. The preliminary evaluation of KBPMS is based on anecdotal data which suggests that the system might have pedagogic potential. Much work remains to be done in enhancing and further evaluating KBPMS. PMID- 3301189 TI - Computed tomographic analysis of bilateral cingulotomy for intractable mood disturbance and chronic pain. AB - Forty-two patients out of 300 who had undergone bilateral stereotactic cingulotomies were studied by means of computerized tomography (CT). The appearance showed bilateral encephalomalacia, measuring on the average 5 X 7 mm2, located in the cingulate gyrus. These induced lesions had attenuation values similar to cerebrospinal fluid and did not enhance with contrast. CT is a useful technique for initial evaluation, management, and follow up of these patients. PMID- 3301190 TI - Intracranial tuberculosis due to Mycobacterium bovis. AB - A case of intracranial tuberculosis due to Mycobacterium bovis is presented. Computed tomography (CT) identified multiple enhancing lesions which by biopsy proved to be intracranial tuberculomas. The CT appearance, epidemiology and bacteriology as well as pharmacotherapy of this uncommon entity are discussed. PMID- 3301191 TI - Moods, madness, and music. I. Major affective disease and musical creativity. PMID- 3301192 TI - Health effects of video display terminals. AMA Council on Scientific Affairs. PMID- 3301193 TI - The renin system in hypertension. A review. PMID- 3301194 TI - Captopril as a predictor of curable hypertension in renal transplant recipients. PMID- 3301195 TI - In vivo renal viability assessment by 31P magnetic resonance spectroscopy in an exteriorized kidney. Transplant model. PMID- 3301196 TI - Radionuclide differentiation of acute cellular rejection from ciclosporin nephrotoxicity. PMID- 3301197 TI - 123I-hippuran accumulation in renal transplants during azathioprine and low dose ciclosporin therapy. PMID- 3301198 TI - Ischemic injury to renal allografts studied by gamma camera technique using 123I hippuran. PMID- 3301199 TI - Role of radionuclide ventriculography in the management of kidney transplant candidates. PMID- 3301200 TI - Parathyroid imaging: comparison of methods in the evaluation of secondary hyperparathyroidism. PMID- 3301201 TI - Criteria for ureteral obstruction by functional imaging of the upper urinary tract. PMID- 3301202 TI - Radionuclide evaluation pre- and post-extracorporeal shock wave lithotripsy for renal calculi. PMID- 3301203 TI - Effect of volume expansion and urinary obstruction on the renal transit time of 99mTc-DTPA. PMID- 3301204 TI - Experimental studies on the renal transfer function for 131I-hippuran and 99mTc DTPA. PMID- 3301205 TI - Reproducibility of three methods of renal clearance estimation without blood samples by means of 99mTc-DTPA. PMID- 3301206 TI - The significance of captopril renography in renovascular hypertension. PMID- 3301207 TI - Epikeratoplasty for keratoconus. A clinicopathologic case report. AB - A 20-year-old man with bilateral keratoconus underwent an epikeratoplasty in the left eye. The postoperative course was uneventful. Five years postepikeratoplasty he developed progressive myopia in the operated eye. A contact lens would not remain centered and the spectacle correction in a trial frame was not tolerated. A successful penetrating keratoplasty was performed six years after the epikeratoplasty procedure. Light and electron microscopic studies of the corneal button showed hypocellularity and irregular distribution of the keratocytes in the lenticule and the accumulation of a periodic acid-Schiff-positive, electron dense fibrillogranular material at the interface between the lenticule and the recipient Bowman's layer. PMID- 3301208 TI - Epikeratophakia following rotational autokeratoplasty in a child. AB - A 3-year-old child with posttraumatic aphakia and a corneal scar was treated with a rotational penetrating ipsilateral autokeratoplasty followed by epikeratophakia 2 months later. His final best corrected visual acuity was 20/30, with 1.37D of corneal astigmatism. There were no significant operative or postoperative complications. PMID- 3301209 TI - Conjunctival lesions in adults. A clinical and histopathologic review. AB - A total of 2,455 conjunctival lesions in adults (over 15 years old) obtained during a 61-year period were reviewed and histopathologically classified as congenital, acquired epithelial, acquired subepithelial, pigmented, inflammatory/degenerative, and miscellaneous. The most common lesions in decreasing order of frequency were: pterygium, nevus, dysplasia, nonspecific nongranulomatous inflammation, and epithelial inclusion cyst. The most common conjunctival malignancy in adults was squamous cell carcinoma, followed by melanoma, and pagetoid change associated with sebaceous gland carcinoma. Squamous cell carcinomas arise from progressive stages of mild, moderate, and severe dysplasia. These tumors have a low malignant potential but may behave more aggressively in the spindle cell and mucoepidermoid variants. Melanomas arise de novo, from nevi or, most commonly, from acquired melanosis and have an associated 14-32% mortality rate by metastatic spread. Sebaceous carcinomas are often initially clinically misdiagnosed, involve the conjunctiva by pagetoid spread, and can have a low rate of metastasis and death if diagnosed early and excised with frozen-section monitoring of the surgical margins. PMID- 3301210 TI - Problems with measurements caused by high concentrations of serum solids. AB - There have been numerous reports of spectrophotometric and volume problems caused by elevated levels of lipids in blood. The offending lipids, primarily triglycerides, not only cause turbidity leading to optical aberrations when added to analytical reagents, but also result in short-sampling errors leading to the measurement of inaccurate volumes of sample. Numerous methods have been developed to clear the lipemia, including ultracentrifugation organic solvent extraction, chemical precipitation and, most recently, enzymic hydrolysis. Although the latter procedures eliminate the optical problems, they do not deal with the volume dilution error created by the triglycerides. In turn, corrective mathematics have been developed to compensate for the inaccurate pipetting caused by the elevated lipids in a sample; however, these empirical calculations are not truly accurate at high concentrations of total lipids. This monograph will describe the problems caused by the presence of elevated lipids and the means available for treating them. PMID- 3301211 TI - Clinical and laboratory approaches to evaluate diarrheal disorders. AB - Diarrheal disorders are the result of excessive fluid and electrolyte loss through the gastrointestinal tract. Many different underlying mechanisms are known to cause diarrhea. Fordtran suggested that in secretory diarrhea the osmolality of stool water should be accounted for by its electrolyte contents. Therefore, the osmotic gap between the measured osmolality and that estimated from electrolyte contents should be small. In osmotic diarrhea, due to the presence of the osmotic agent, there should be a greater gap between the measured and the estimated osmolalities. Osmotic gaps varying from 100 to 40 mOsm have been used arbitrarily in literatures to define the underlying pathogenesis. Because of the uncertainty, the usefulness of these measurements remains in question. In this article, methods used to measure stool osmolality and electrolyte contents are reviewed. Limitations of these measurements are discussed. Measurements derived from various diarrheal disorders revealed that the basic concepts put forward by Fordtran are corrected. However, we found that the osmotic gaps (measured osmolality - 2 [Na + K] in secretory diarrheal disorders are frequently negative numbers. In osmotic diarrhea, the osmotic gap (greater than 160 mOsm) is substantially greater than the figures used in the literature. In many diarrheal disorders the osmotic gap falls between the two extremes and the pathogenesis is multifactorial in origin. Under these circumstances, stool osmolality and electrolyte measurements provide little insight into the underlying mechanism causing the diarrhea. Furthermore, stool contains many biologically active organisms which can alter the stool osmolality. Unless these effects are appreciated, an inaccurate interpretation of these measurements may result. PMID- 3301212 TI - Nucleic acid probes in clinical microbiology. AB - The infectious disease applications of nucleic acid probe have been described. In addition, the basic procedures of nucleic acid probe technology have been discussed, as have the factors affecting implementation of probe technology in diagnostic laboratories. Despite the questions raised, nucleic acid probes will become part of the diagnostic laboratory in the near future. Commercial interests are developing and marketing new probes, reagents, and kits which will expedite the employment of this technology. High-volume reference laboratories will first use probes as part of a battery of tests which will include ELISA and monoclonal antibody methods. In all probability, probes will replace methods: that have proven to be ineffective, difficult, or costly such as culturing for some enteric pathogens and Legionella, that require long incubation periods, such as mycobacteria, or that have high costs and low yields, such as virology. PMID- 3301213 TI - Salicylate measurement: clinical usefulness and methodology. AB - The salicylates are the most commonly used analgesic, antipyretic, and anti inflammatory drugs. They are available in hundreds of preparations, many of which are over-the-counter medications. The easy access to large quantities of the drug and the widespread perception that the drug is harmless have contributed to salicylate intoxication becoming a serious and common problem, particularly among the pediatric and geriatric populations. Salicylate is still the major drug for the treatment of rheumatic diseases. The use of salicylate in high doses for the management of these patients requires close monitoring of serum salicylate levels because of the large interindividual variation in dose-serum level relationships and the narrowness of the therapeutic range. Thus, both for the management of patients intoxicated with salicylate and patients who are on high-dose salicylate therapy, the measurement of serum salicylate levels is an important clinical laboratory service. Recent research on the inhibitory effect of aspirin on platelet aggregation has led to the prophylactic use of aspirin in low doses as an antithrombotic drug. This new therapeutic use of aspirin can be aided by monitoring low serum levels of salicylate and perhaps aspirin itself. This article reviews the current state of the knowledge of the pharmacokinetics and clinical toxicology of salicylate, the clinical usefulness of salicylate measurement by the clinical laboratory, and recent development in the analytical technology for salicylate analysis. PMID- 3301214 TI - The myoepithelial cell: embryology, function, and proliferative aspects. AB - Myoepithelial cells form an integral part of the secretory and ductular portion of most glands. They share a common origin with lumenal epithelial cells and influence proliferation and differentiation of developing terminal glandular buds by producing a scaffold of basement membrane proteins. Their contractile capacity, controlled by hormonal and neural mechanisms, plays an important role in propulsion of secretions. Furthermore, myoepithelial cells maintain glandular structural integrity and transport metabolites to secretory cells. The advent of modern immunochemistry made identification of specific myoepithelial cell markers possible which facilitated studies on their presence and behavior in disease processes. Although the significance of many myoepithelial alterations is speculative, some have proved valuable in determining the histogenesis of glandular lesions. PMID- 3301215 TI - Computed tomographic evaluation of gallbladder disease. AB - Evaluation of gallbladder diseases by computed tomography (CT) is limited compared with ultrasonographic evaluation. However, CT can bring about excellent information in advanced carcinoma of the gallbladder, severe and complicated cholecystitis, porcelain gallbladder, and indication for dissolution of gallbladder stones. Unique findings are also available in emphysematous cholecystitis, xanthogranulomatous cholecystitis, stones with gas (Mercedez-Benz sign), limy bile, and enhancement in acute cholecystitis. Combined use of CT and ultrasound apparently increase the accuracy of diagnosis in carcinoma and cholecystitis. This article is composed of sections on carcinoma, cholecystitis, stone, bile in the gallbladder, calcification, gas and fat, and miscellaneous topics including polypoid lesions, adenomyomatosis, hydrops, and wall thickening. PMID- 3301216 TI - Optimizing single- and double-contrast colon examinations. AB - Recent technical advances have greatly increased the effectiveness of barium enema examinations for detection of common diseases of the colon. As documented in the literature, the double-contrast enema may equal or exceed colonoscopy in detection of colonic neoplasms and, with proper technique, the single-contrast enema may also closely approach these results. This presentation reviews recent technical improvements in the areas of radiographic-fluoroscopic equipment, fluoroscopic images, film-screen combinations, barium suspensions, examination techniques, filming sequences, and quality controls. These are employed to optimize both the double- and single-contrast barium enemas to where their sensitivities are competitive with endoscopy. PMID- 3301217 TI - Computed tomography finding in Mayer-Rokitansky-Kuster-Hauser syndrome associated with endometriosis: a case report. PMID- 3301218 TI - Urinary diversion. PMID- 3301219 TI - Intraoperative monitoring during carotid endarterectomy. PMID- 3301220 TI - Effects of sulfur and salicylic acid in a shampoo base in the treatment of dandruff: a double-blind study using corneocyte counts and clinical grading. AB - The effectiveness of sulfur 2 percent and salicylic acid 2 percent either alone or in combination in a shampoo base was determined in a double-blind controlled study using two methods of evaluation: clinical assessment of scaling and corneocyte counts (the number of desquamating cells/cm2). Forty-eight subjects (twenty-nine men and nineteen women) with moderate to severe scaling shampooed their hair under supervision twice a week for five weeks, using one of four formulas: sulfur 2 percent plus salicylic acid 2 percent in a shampoo vehicle; sulfur 2 percent in a shampoo vehicle; salicylic acid 2 percent in a shampoo vehicle; or the shampoo vehicle alone. On days 0, 7, 14, 21, 28, and 35 the degree of scaling was assessed, and specimens were taken for corneocyte counts. Significantly greater and earlier reductions in both degree of scaling and corneocyte counts were seen in subjects treated with the formula containing both sulfur 2 percent and salicylic acid 2 percent in the shampoo base than in those who received either active ingredient alone or the shampoo vehicle. PMID- 3301221 TI - Prevention of acute pulmonary edema after bone marrow transplantation. AB - In a retrospective review of 21 bone marrow transplantation procedures (BMT), we identified ten episodes of acute pulmonary edema coinciding with significant weight gain in the second week after BMT. When we prospectively observed nine consecutive BMT recipients, six patients developed acute pulmonary edema associated with significant (p less than 0.05) weight gain and an increase in echocardiographically determined left ventricular end diastolic diameter. These findings led to a prospective prophylactic intervention study of 30 consecutive BMT patients. Prophylactic intervention consisting of reduced fluid volume of parenteral alimentation, and diuretic therapy was instituted at any clinical sign of fluid overload. No episode of pulmonary edema occurred. The dramatic difference--acute pulmonary edema occurred in 16/30 untreated vs 0/30 treated cases--suggests that this post-BMT complication is critically related to fluid balance and can be prevented by careful clinical examination, close monitoring of weight change, avoidance of fluid overload and the appropriate use of diuretic therapy. PMID- 3301222 TI - The kingdom of the near-dead. The shortened unnatural life history of primary pulmonary hypertension. PMID- 3301223 TI - Lung imaging. Past as prologue. PMID- 3301224 TI - Constrictive pericarditis associated with patch electrodes of the automatic implantable cardioverter-defibrillator. AB - A case of constrictive pericarditis intimately involving patch electrodes of the automatic implantable cardioverter-defibrillator is described. Typical clinical and hemodynamic findings for constrictive pericarditis were noted 15 months after lead installation. Additionally, chest x-ray examination revealed a severe crumpling deformity of the patch electrodes. Thoracotomy was performed and revealed marked fibrous reaction surrounding both surfaces of each patch electrode. Histologic examination revealed fibrous tissue with multinucleated giant cells, consistent with a foreign body reaction. The patient had complete resolution of signs and symptoms of constrictive pericarditis after removal of the patch electrodes and pericardial stripping. Constrictive pericarditis from implanted patch electrodes appears to be an uncommon complication of the automatic implantable cardioverter-defibrillator and should be considered in patients with one or more patch electrodes and other signs of constrictive pericarditis. PMID- 3301225 TI - [90th birthday of Prof. Wiktor Dega]. PMID- 3301226 TI - [Scientific works of Wiktor Dega 1925-1985]. PMID- 3301227 TI - [Pancreatogastrostomy in Whipple's operation]. PMID- 3301228 TI - [Urologic manifestations of retroperitoneal fibrosis]. PMID- 3301229 TI - [Therapy with combined antiarrhythmia agents]. PMID- 3301230 TI - [Randomized double-blind study on the dosage of ranitidine (China-made) in the treatment of duodenal ulcer]. PMID- 3301231 TI - Gallbladder volume and emptying in insulin-requiring male diabetics. AB - Gallbladder function was evaluated in 27 healthy male volunteers and 47 male insulin-requiring diabetics from a diabetic clinic. Three groups of patients were studied: 18 patients without neuropathy or retinopathy (A); 17 patients with evidence of peripheral neuropathy (B); and 12 patients with evidence of peripheral and autonomic neuropathy (C). Eleven patients complained of gastrointestinal symptoms (three in group B, eight in group C). Thirty minutes after a standard breakfast, fasting gallbladder volumes and gallbladder emptying rates were measured using a real-time mechanical sector ultrasound scanner. Fasting gallbladder volume in diabetic patients was similar to controls (24.9 +/- 2.7 N; 28.9 +/- 3.9 A; 23.7 +/- 2.2 B; 16.7 +/- 3.4 C ml mean +/- SEM). Postprandial gallbladder emptying was not significantly different in any groups (47.4 +/- 5.1% N; 43.2 +/- 7.7% A; 50.7 +/- 7.7% B; 46.8 +/- 11.1% C). Seven diabetics and two controls had poor gallbladder emptying. One screened patient had cholecystectomy, three patients had stones, and two had sludge with a thickened gallbladder wall for a total of 12.5% gallbladder disease. These data suggest that gallbladder dysfunction in male insulin-requiring diabetics is rare. PMID- 3301233 TI - Urinary excretion of N-acetyl-glucosaminidase and beta-2-microglobulin as early markers of gentamicin nephrotoxicity in neonates. AB - A prospective study in 16 healthy and 16 gentamicin-treated neonates was undertaken to compare the urinary excretion of proximal tubular markers such as beta 2-microglobulin (beta 2-m) and total N-acetyl-beta-D-glucosaminidase (NAG) and its isoenzymatic form NAGB. beta 2-m excretion was not related to postnatal age in control full-term neonates; it was significantly increased in gentamicin treated full-term neonates. The urinary excretion of the lysosomal markers, total NAG and NAGB, rose significantly with postnatal age in control group. fMean values for total NAG and NAGB were significantly higher in the treated group but the isoenzymatic profile (NAGB/total NAG X 100) was not modified by gentamicin treatment. PMID- 3301232 TI - Reduction of endoscopically assessed acute aspirin-induced gastric mucosal injury with cimetidine. AB - We studied the influence of cimetidine on the gastroscopically visible effects of a single 1296-mg dose of aspirin. An initial dose-response study in 48 subjects showed that 200- and 400-mg doses of cimetidine conferred a sufficient reduction in gastric mucosal injury to warrant further study. A second study showed that coadministration of a single 200- or 400-mg cimetidine tablet with the aspirin conferred the same degree of injury reduction as when cimetidine was given before the aspirin. Reduction in mucosal injury by a 200-mg cimetidine tablet, coadministered with four aspirin tablets, was then compared to placebo in a double-blind trial. A reduction of mucosal injury was observed in 14 of 20 (70%) subjects receiving cimetidine and 0 of 10 subjects receiving placebo (P less than 0.001). Two hundred milligrams of cimetidine is therefore a rational dose for further studies of the reduction of chronic aspirin-induced gastric mucosal injury. PMID- 3301234 TI - The fetal heart insulin receptor responds differently to varying plasma insulin concentrations. AB - We investigated in vivo the effect of varying plasma concentrations of insulin on the 28- and 30-day-old fetal rabbit heart insulin receptors using plasma membranes. Alloxan induced maternal diabetes (n = 5) associated with fetal hyperglycemia and mild hyperinsulinemia (59.80 +/- 8.10 microU/ml versus a control of 26.25 +/- 3.70, p less than 0.01) increased the insulin receptor number from a control (30 d) of 168 +/- 1.01 to 320 +/- 34 X 10(10)/mg protein (p less than 0.01). Fetal administration of 1.0 U of insulin (n = 4) resulting in normoglycemia and moderately high plasma insulin concentrations (103.3 +/- 34.63 microU/ml versus a control of 13.72 +/- 1.60, p less than 0.05) did not alter the insulin receptor number (28 d). On the other hand fetal administration of 2.0 U of insulin (n = 4) resulting in hypoglycemia and severely high plasma insulin concentrations (288.3 +/- 51 microU/ml versus a control of 13.72 +/- 1.60, p less than 0.01) decreased the insulin receptor number from a control (28 d) of 200 +/- 23 to 82 +/- 23 X 10(10)/mg protein (p less than 0.01). The receptor affinity remained constant. We conclude that the downregulation (decrease) of the fetal heart insulin receptors in vivo is not a physiologic but a pharmacologic effect of insulin. PMID- 3301235 TI - Clinical pharmacokinetics in pregnancy and perinatology. II. Penicillins. AB - Ampicillin has been most thoroughly studied in regard to placental transfer. Both during the first/second trimester and at term, fetal drug levels rose slowly to reach values similar to those in the maternal circulation 1-3 h after maternal drug administration; thereafter, fetal drug levels exceeded corresponding maternal values. Amniotic fluid levels were low during early gestational periods; during late gestation these levels were significant and even exceeded corresponding maternal values 6-8 h after drug administration. Slow exchange rates and fetal micturation may be responsible for the elevated ampicillin levels during late gestation. Administration via the intramuscular (recommended with 0.5 g every 4-6 h) or intravenous routes, but not by the oral route, resulted in adequate drug levels. Because of increased plasma clearance of ampicillin during pregnancy, a dose increase in pregnant patients may be necessary to obtain adequate drug levels. Amoxillin and azidocillin have been suggested to give effective drug levels even after oral administration, except during labor. The fetal levels of epicillin and benzylpenicillin (Penicillin G) were lower than the corresponding maternal values; amniotic fluid concentrations of these two drugs were elevated during late, but very low during early gestation, similar to the situation with ampicillin. Methicillin and sulbenicillin were effectively transferred across the placenta (similar to ampicillin), while dicloxacillin was not. The low concentrations of dicloxacillin in the fetus and amniotic fluid may be the results of extensive protein binding (greater than 90%) of this drug in maternal blood. Other highly bound penicillins such as cloxacillin and flucloxacillin have not yet been investigated in regard to placental transfer. Excretion of penicillins in human milk was usually very limited. Following therapeutic doses, the mean milk concentrations were 0.1-0.6 microgram/ml for amoxicillin, 0.1-0.2 microgram/ml for epicillin, about 0.5 microgram/ml for sulbactam, 2-2.5 micrograms/ml for ticarcillin, and 0.1-0.4 microgram/ml for aztreonam. PMID- 3301236 TI - Low density lipoprotein metabolism in non-insulin-dependent diabetes mellitus. PMID- 3301237 TI - HDL metabolism in diabetes. AB - Based on the data reviewed, it is necessary to conclude that diabetes is associated with profound changes in HDL metabolism. However, once we go beyond this simple generalization, it is apparent that the relationship between diabetes and HDL metabolism is not a simple one. A good deal of the complication evolves from the fact that IDDM and NIDDM seem to affect HDL metabolism quite differently, with the only apparent similarity the fact that plasma HDL cholesterol concentration can be low in untreated patients with either IDDM or NIDDM. Thus, in patients with IDDM the primary event seems to be related to the insulin-deficient state, which results in a decrease in HDL turnover rate and resultant decline in plasma HDL-cholesterol concentration. In contrast, HDL turnover appears to be accelerated, not reduced in patients with NIDDM, and the low plasma HDL-cholesterol concentration is a consequence of the increased turnover rate. In addition, patients with NIDDM are not absolutely insulin deficient, and available evidence suggests that the higher the plasma insulin level, the lower the plasma HDL-cholesterol concentration in these patients. The differences noted above in the effect of IDDM and NIDDM on HDL metabolism are of great interest, and, unfortunately, not very well understood. There is, however, one additional difference, which may be of paramount clinical importance. For reasons not totally clear, plasma HDL-cholesterol concentrations in patients with IDDM treated with insulin are not lower than normal, and even tend to be higher than these values in a nondiabetic population. Possibly as a result of this phenomenon, there is no evidence that changes in plasma HDL-cholesterol concentration play a role in the development of macrovascular complications in IDDM. Although it is apparent from the considerations discussed in this review that a great deal more needs to be learned about the effect of insulin deficiency on HDL metabolism, changes in HDL metabolism do not appear to be clinically important in patients with IDDM. Unfortunately, this does not appear to be the situation in patients with NIDDM. Plasma HDL-cholesterol concentrations are lower than normal in patients with NIDDM, and this finding seems to be related to increased morbidity and mortality from CAD. Furthermore, there is no form of anti diabetic treatment, irrespective of how effective it has been in achieving glycemic control, that has been shown to substantially increase plasma HDL cholesterol level. Indeed, it has been difficult to demonstrate a consistent effect of any therapeutic approach on plasma HDL-cholesterol concentration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3301238 TI - The BB rat. PMID- 3301240 TI - Molecular biology of the HLA system in insulin-dependent diabetes mellitus. AB - Genetic studies indicate that the IDDM susceptibility genes in the HLA region are closely linked to the DR3 and DR4 specificities; however, these specificities do not define the actual susceptibility genes. Molecular studies confirm this hypothesis by demonstrating restriction fragment length polymorphism between DNA's of identical DR specificities and thereby separating the DR haplotypes into those strongly or weakly associated with IDDM. Further studies at the nucleotide sequence level demonstrate further heterogeneity, with DR4 being associated with at least three different DQ beta genes and five different genes of the DR beta-1 locus. However, the majority of these subtypes are now recognized either serologically or by T-cell responses in mixed lymphocyte cultures. Furthermore, the sequences associated with IDDM are those most commonly found in DR4 individuals, ie, Dw4 and DQw3.2. Clearly, these and other class II genes must be studied for additional DNA polymorphism and their relevance for IDDM. For example, the DX alpha, 2.1-kb Taql polymorphism shows a stronger correlation with IDDM than DR3. However, it is not even known if the DX alpha genes are expressed. In addition, little is known of the DQ beta and DR beta genes associated with different DR3-associated haplotypes. Furthermore, an IDDM susceptibility gene may contain important differences in flanking or intron sequences controlling expression of these genes. The methods of recombinant DNA technology are enabling these unanswered questions to be addressed. PMID- 3301239 TI - HLA and diabetes from a T-cell perspective. PMID- 3301241 TI - Cardiac arrhythmias--update 1987. AB - Arrhythmias may result from abnormalities of impulse initiation (automaticity), conduction (slow conduction, block, reentry), or a combination. The central and peripheral nervous systems have an important influence on the genesis of cardiac arrhythmias. Sympathetic and parasympathetic fibers innervate both atria and ventricle. The study of clinical cardiac arrhythmias includes the use of invasive and noninvasive testing procedures. The ECG, ambulatory monitoring, esophageal recording, exercise testing, and signal averaging techniques are the currently used noninvasive tests. Intracardiac electrophysiologic studies and endocardial catheter mapping are invasive techniques. The treatment of cardiac arrhythmias includes the use of antiarrhythmic drugs, cardiac pacing (antibradycardia, antitachycardia), implantable automatic defibrillator, cardiac fulguration, and antitachycardiac surgery. Clinical cardiac arrhythmias are of two types, the bradyarrhythmias and the tachyarrhythmias. The tachyarrhythmia, in turn, may be supraventricular or ventricular. There are clinical syndromes specifically related to arrhythmias: preexcitation syndromes are associated with supraventricular tachyarrhythmias, long Q-T syndromes with ventricular tachyarrhythmias, and sick sinus syndrome with bradyarrhythmias. The "tachycardia bradycardia syndrome" is a combination of atrial tachyarrhythmias and sinus node dysfunction (some of the patients may also have ventricular tachyarrhythmias). Specific arrhythmias are recognized by their ECG characteristics. These arrhythmias also have specific electrophysiologic features which can be defined during invasive electrophysiologic studies. Cardiac arrhythmias may or may not be accompanied by underlying organic heart disease. Their treatment is related to the specific diagnosis and mechanism of the rhythm disturbance. The presence and extent of underlying organic heart disease is an important factor in the selection of antiarrhythmic therapy (drug, pacemaker, or surgery). PMID- 3301242 TI - [Dominant selection by thymidine of transformed animal bone marrow cells]. PMID- 3301243 TI - Attitudes about alcohol: a general review. AB - This paper reviews 266 articles relating to attitudes towards alcohol use and misuse. It is concluded that adults typically regard themselves as moderate drinkers and disapprove of excessive drinking by others, expressed attitudes vary in accordance with respondent characteristics, drinker characteristics, beverage and amount, setting and time, the term 'alcoholism' has pejorative connotations, but there is no public consensus about etiology or treatment, and alcohol-related attitudes are generally poor predictors of behaviour (but need not be so). It is suggested that a pool of items relating to topic areas of continuing interest be created in order to increase comparability between surveys and further research using more complex attitudinal models be undertaken. PMID- 3301244 TI - Bepridil: a new long-acting calcium channel blocking agent. AB - Bepridil is an investigational calcium channel blocking agent with antianginal activity that has a distinct and complex pharmacologic profile. Bepridil produces significant coronary vasodilation and modest peripheral effects, in addition to negative inotropic and chronotropic effects. Bepridil favorably modifies both myocardial oxygen demand and supply, supporting its use as an antianginal drug. Electrophysiologically, bepridil exhibits classes I, III, and IV antiarrhythmic activity. Five U.S. trials evaluating the short-term antianginal efficacy of bepridil collectively reported that bepridil causes significant improvement in both subjective and objective parameters of efficacy without depressing left ventricular function. In addition, one U.S. trial reported continued antianginal effects of bepridil after long-term use. There are limited data comparing and/or combining bepridil with other antianginal drugs, but the available information is promising. Limited information also exists on the use of bepridil in acute myocardial infarction and arrhythmias. Tolerance to bepridil therapy has been excellent, with the most common adverse effects being diarrhea and dizziness. It is unclear whether bepridil will be used as a first-line agent in the treatment of chronic stable angina pectoris; however, its long half-life, which makes once daily dosing possible, is certainly a significant advantage. PMID- 3301245 TI - Maintenance therapy for prevention of recurrent peptic ulcers. AB - Peptic ulcer disease is a chronic, relapsing disease. Successful healing of duodenal and gastric ulcers with antacids, cimetidine, ranitidine, famotidine, or sucralfate is frequently followed by ulcer recurrence. The need for long-term, low-dose maintenance therapy is based on disease severity, ulcer history, complications, therapeutic intervention, response to treatment, and potential risk factors. Comparison of ulcer maintenance trials requires consideration of important factors such as frequency of endoscopy, duration of follow-up period, and the method used to calculate ulcer recurrence rates. Clinical trials indicate that chronic treatment with low-dose cimetidine, ranitidine, famotidine, and probably sucralfate decreases the frequency of duodenal ulcer recurrence and that ranitidine may be superior to cimetidine. Preliminary studies indicate that higher doses of these same medications may be required to prevent gastric ulcer recurrence. Long-term maintenance therapy with these agents must be continuous in order to prevent relapses, but treatment should be limited to one year because of unknown consequences beyond this period. PMID- 3301246 TI - Calcium antagonists in the management of asthma: breakthrough or ballyhoo? AB - Research demonstrating the importance of intracellular calcium regulation in each of the pathophysiologic events of asthma has lead to speculation that calcium antagonists may be beneficial in the treatment of reactive airways disease. A plethora of data has been generated on the effects of verapamil, diltiazem, nifedipine, and several investigational agents on experimentally induced asthma, indicating that none of these agents significantly affects resting bronchomotor tone, and their efficacy in preventing bronchospasm is a function of the drug, dose, route of administration and method of bronchoprovocation. Most studies have demonstrated calcium antagonists have only modest and highly variable effects on airway smooth muscle contraction. Additional studies are needed to define the effects on the inflammatory component of airways obstruction, steroid requirements in steroid-dependent patients, and on the alteration of the pharmacodynamics of other agents used for the management of chronic asthma. PMID- 3301247 TI - Ciprofloxacin. AB - Ciprofloxacin is a new fluorinated quinolone antibiotic with high activity against a wide spectrum of gram-positive and gram-negative bacteria, including methicillin-resistant Staphylococcus aureus, Enterobacteriaceae, and Pseudomonas aeruginosa. Clinical trials using the oral preparation of ciprofloxacin have demonstrated its effectiveness in a wide variety of infections. In addition, extensive clinical trials with the intravenous preparation are underway. In vitro and in vivo studies with ciprofloxacin have reported the incidence of resistant organisms to be very low. In addition, the incidence of ciprofloxacin-related side effects throughout its clinical trials has been minimal. Most reports of side effects have been related to the gastrointestinal tract, such as nausea or vomiting. The incidence of adverse experiences in worldwide clinical trials has been reported to be approximately 6.4 percent. PMID- 3301248 TI - Calcium modulators: future agents, future uses. AB - The calcium modulators have been a significant therapeutic advancement for the treatment of angina. Structural analogs of verapamil and nifedipine have been synthesized, as have structurally unique compounds. As the role of calcium in body processes is further elucidated, the efficacy of the calcium modulators is being evaluated for numerous disorders. It is anticipated that the newly synthesized compounds will have specificity toward particular body processes, thus providing efficacy with minimal side effects. PMID- 3301249 TI - Fish oil: effectiveness as a dietary supplement in the prevention of heart disease. AB - The low incidence of reported heart attacks and cardiovascular-related deaths in Greenland Eskimos and the Japanese has generated interest in the possible protective effect of their diet, which is made up primarily of fish and related marine foods. This paper reviews the current evidence for reducing the risk of cardiovascular disease with fish-oil supplementation, and discusses related clinical data to support the mechanisms proposed. Included is evidence that fish oil can lower certain serum lipid levels, prolong bleeding time, and reduce systolic blood pressure when consumed in moderately large doses. Information on safety and side effects is also presented, such as a possible increase in serum cholesterol levels and annoying side effects that may severely limit widespread use of this food supplement. Presently it remains unanswered whether fish oil should be recommended as a dietary supplement for the prevention and/or treatment of hypercholesterolemia and associated coronary artery disease. Further research is required to demonstrate a clear reduction in cardiovascular mortality before a uniform recommendation can be made. PMID- 3301250 TI - Therapeutic dosing of pralidoxime chloride. AB - Pralidoxime chloride is a useful agent in the treatment of organophosphate poisoning. Poisindex, a widely used poisoning treatment resource, recommends dosing pralidoxime chloride as an intermittent iv infusion every 8-12 hours, whereas other authors have used continuous iv infusion with good results. Available animal data suggest that a serum concentration of 4 micrograms/ml may be a minimal level to protect against the toxic effects of organophosphates. Pharmacokinetic simulations, based on parameters obtained from healthy nonpoisoned subjects, show that pralidoxime levels fall rapidly to less than 4 micrograms/ml within 1.5-2 hours after a 1-g iv bolus. Continuous iv infusion (0.5 g/h) maintains pralidoxime levels greater than 4 micrograms/ml throughout the length of infusion. We conclude that continuous iv infusion of pralidoxime chloride may be the preferred method of administration in patients with acute organophosphate poisoning. Clinical trials will be necessary to document the effectiveness of this regimen. PMID- 3301251 TI - Hepatotoxicity associated with choline magnesium trisalicylate: case report and review of salicylate-induced hepatotoxicity. AB - A case of a 21-year-old woman who had developed mild hepatotoxicity while receiving choline magnesium trisalicylate therapy is described. She presented with fever and mild hepatic enzyme elevations before salicylate therapy was instituted. Liver function tests (LFT) returned to normal within five days of hospitalization but she continued to develop daily fevers. Blood, urine, and throat cultures were negative. An acute viral illness or reactivation of systemic lupus erythematosus were the suspected diagnoses. Choline magnesium trisalicylate was then administered in an effort to control her fever, and was successful. After three days of salicylate therapy her LFT values began to rise. They continued to rise for five more days before salicylate hepatotoxicity was suspected. Choline magnesium trisalicylate was discontinued after eight days and the patient's LFT quickly returned to normal. The source of fever was never identified, although infection with cytomegalovirus was considered the most likely cause. Salicylate-induced hepatotoxicity is reviewed. PMID- 3301252 TI - [Problems of occupationally induced respiratory allergies as exemplified by bakers' asthma]. AB - In the Federal Republic of Germany (FRG) approximately every fourth case of occupational lung disease, registered with application for compensation at the "Gewerbliche Berufsgenossenschaften", in 1984 was suspected to be caused by allergic airway obstruction. Respiratory allergies may arise if two prerequisites exist firstly exposure to sensitizing agents in the work environment and secondly individual disposition to allergic reactions. The large range of sensitizing agents includes organic and inorganic substances derived from animals, plants, fungi, metals or chemicals. Most of them are responsible for Type-I IgE-mediated allergic reactions. Three different patterns of respiratory responses can be found following simulated occupational exposure: immediate, late (non-immediate), and the dual-type of asthmatic reaction, whereby the non-immediate asthmatic response must be strictly differentiated from the genuine Type-III hypersensitivity. Today, bakers' asthma is the most frequent and most costly occupational allergy in the FRG, contributing more than 50% of all registered and more than 75% of all compensated cases. Therefore, flour allergies can be used as a classic model of an occupational allergic disease in order to discuss epidemiological, social and clinical problems, such as prevalence, socioeconomic impact, as well as prevention, early diagnosis and therapeutic measures. Despite many well-known clinical and epidemiological data, respiratory allergies display a lot of unresolved questions calling for further research. PMID- 3301253 TI - The effect of copper deficiency on the immune response in mice. AB - Weanling female Swiss mice were fed copper-deficient or copper-replete diets for 28 days. Mice fed the copper-deficient diet exhibited typical signs copper deficiency, which included reduced weight gains, anemia, and low liver copper concentrations. The effect of copper deficiency on antibody production, in particular, T-lymphocyte dependent and independent antibody responses, lymphocyte blastogenesis, and sensitivity to endotoxin were evaluated. Antibody production against sheep red blood cells, a T-lymphocyte dependent response, was suppressed in copper-deficient mice (P less than .0001). In contrast, antibody production against dinitrophenyl-ficoll, a T-lymphocyte independent response was not altered by copper deficiency (P = 0.90). Lymphocyte blastogenesis studies demonstrated that copper deficiency did not alter T-lymphocyte blastogenesis induced by concanavalin A (P = 0.27) or B-lymphocyte blastogenesis induced by Escherichia coli lipopolysaccharide (P = 0.40). These results indicate that the immunosuppressive effects are not due to an impairment of lymphocyte blastogenesis, an intermediate step involved in the generation of an immune response, but rather are a manifestation of impaired T-lymphocyte function associated with antibody production. Increased susceptibility to endotoxin, involving nonspecific defense mechanisms, was also observed in copper-deficient mice. Mortality associated with the endotoxin was 68% in the copper-deficient mice as compared to 35% in the copper-replete mice (P = 0.0026). Impaired T lymphocyte dependent antibody production and enhanced susceptibility to endotoxin were observed in copper-deficient mice exhibiting classical manifestations of copper deficiency. PMID- 3301254 TI - [Vasectomy--pros and cons]. PMID- 3301255 TI - [173 cases of insulin-induced hypoglycemia admitted to the hospital]. AB - From 1980 to 1985, 120 insulin-dependent diabetics were admitted to the emergency department of the Cantonal Hospital, Basle, for altogether 173 severe hypoglycemic attacks. Relating these numbers to a total of 700 insulin-dependent diabetics in Basle, this means an hypoglycemia incidence of 4.2 per 100 treatment years. The principal causes were: dietary error or increased physical activity (43.7%); increase in daily insulin dose by the patient or his doctor (14.6%); and other illnesses, mostly involving the gastrointestinal tract (10.9%). Age and duration of insulin treatment were risk factors for the occurrence of hypoglycemic episodes. Thus, comparing patients at the Cantonal Hospital with or without hypoglycemia, there were significantly more hypoglycemic attacks (p less than 0.05) in the group of patients aged over 60 years or who had been treated with insulin for more than ten years. Average daily dose of insulin was about the same in both groups (35.8 U daily with hypoglycemia; 39.6 U without). Regardless of the daily number of injections, hypoglycemia occurred most frequently between 10 and 13 h and before the evening meal between 17 and 19 h. PMID- 3301256 TI - [Cavernous transformation of the portal vein]. PMID- 3301257 TI - [Therapy of short bowel syndrome]. PMID- 3301258 TI - [Methotrexate therapy of chronic polyarthritis]. PMID- 3301259 TI - [Insulin therapy: the basis-bolus principle]. PMID- 3301260 TI - [Treatment of type II diabetes using homologous intermediate-acting insulin combinations. Comparison of the effectiveness of 5 commonly used preparations]. AB - Although intraindividual comparisons of commonly used human standard combination insulins have not been made, pharmacodynamic differences between preparations in the by now no vast insulin market have been highlighted. The action of five bio- or semisynthetic human insulins of all four manufacturers using the same galenic formula and with a fixed normal insulin content of 20-30% was tested at equal dosages in type IIa and type IIb diabetics with differing residual pancreatic secretion. No differences were demonstrated in onset, maximum or duration of action. The blood-sugar lowering effect of the preparations is particularly marked in the late morning hours and may, if not counteracted by adequate carbohydrate intake, lead to hypoglycaemia. Duration of action of the preparations depends on the individual extent of endogenous pancreatic insulin reserves. PMID- 3301261 TI - [Herpes gestationis]. PMID- 3301262 TI - [Jakob-Creutzfeld disease--intra vitam diagnosis?]. AB - The diagnosis of Jakob-Creutzfeld disease was made in two women (aged 59 and 76 years) whose course was marked by rapidly progressing signs of dementia, myoclonus and rhythmic bi- and tri-phasic steep waves in the EEG. The diagnoses were confirmed neuropathologically at autopsy. Since the disease is transmissible, precautions must be taken if the disease is suspected: wearing of disposable gloves, disinfection of instruments by one-hour autoclaving at 121 degrees C, disinfection of potentially contaminated surfaces with 5% sodium hypochlorite, and avoidance of skin cuts or punctures by instruments or syringes. PMID- 3301263 TI - [Gerhardt Katsch. 14 May 1887-7 March 1961]. PMID- 3301264 TI - [Issued dedicated to Dr. Matthaeus Stober on his 60th birthday]. PMID- 3301265 TI - [Prevention and treatment of respiratory diseases in young cattle]. PMID- 3301267 TI - The economics of private veterinary practice in the United Kingdom 1951-1985. PMID- 3301266 TI - [Infertility in bulls]. PMID- 3301268 TI - [Retention of radionuclides in cattle as a consequence of fallout from Chernobyl: retention per unit time and application of a model for the prediction of the course of retention]. PMID- 3301269 TI - Planning and preparing for future veterinary activities within the EEC. PMID- 3301270 TI - [The effect of a single oral dose of iron-dextran for the prevention of anemia in suckling pigs]. PMID- 3301271 TI - [Functional approach to respiratory diseases of double-loined cattle of the white blue Belgian breed]. PMID- 3301272 TI - [Changes of certain parameters of fat metabolism in dairy cows during the peripartum period]. PMID- 3301273 TI - [Electrocardiographic studies in cattle]. PMID- 3301274 TI - [Hoflund syndrome 47 years later]. PMID- 3301275 TI - [The significance of the injection site for the hypercalcemic effect of 1-alpha hydroxyvitamin D3 in dairy cows]. PMID- 3301276 TI - [The occurrence of hoof diseases in slaughtered cattle in southern Chile]. PMID- 3301277 TI - [Prevention of calf diarrhea by the addition of CEFID to milk]. PMID- 3301278 TI - [Fescue toxicosis (fescue grass poisoning)--an important poisoning of cattle in South America]. PMID- 3301279 TI - [Abomasal ulcer in the calf]. PMID- 3301280 TI - [Hematologic and biochemical profile of dairy cows in Slovenia]. PMID- 3301281 TI - [Present trends and future perspectives in veterinary diagnosis]. PMID- 3301282 TI - [The role of objective and subjective elements in clinical diagnosis]. PMID- 3301283 TI - [Experimental treatment of calf diarrhea with the aminoglycoside sisomicin (3'-N desmethyl-3'-N-ethylsisomicin)]. PMID- 3301284 TI - [The function and morphology of the immune system of the intestinal mucosa]. PMID- 3301285 TI - [Steroid hormone profile in the afterbirth expulsion period of cattle]. PMID- 3301286 TI - [June 20, 1887--an important day in the history of veterinary medicine]. PMID- 3301288 TI - [Tonometry in Merle dogs]. PMID- 3301289 TI - [Light microscopy studies of the cornea of Merle dachshunds]. PMID- 3301287 TI - [Osteomyelitis of the metacarpal bone and metatarsal bones II and IV in the horse]. PMID- 3301290 TI - [Influences on the concentration of different substances in sow's urine]. PMID- 3301291 TI - [Relation between age and body weight and location, form and size of the fat fold near the pylorus ("pig's ear") in the greater omentum of cattle]. PMID- 3301292 TI - [Basic principles of the measurement and effect of radioactivity]. PMID- 3301293 TI - [Systematic observations on roots of exposure and radiation burden with regard to animal husbandry]. PMID- 3301294 TI - [The behavior of radionuclides in soil]. PMID- 3301295 TI - [Transfer of radionuclides into crops]. PMID- 3301296 TI - [Determination of the radioactive burden of vegetation and the transfer of radionuclides from plants into meat]. PMID- 3301297 TI - [Transfer of radionuclides from forage plants into milk]. PMID- 3301298 TI - [Estimation of radionuclides on the basis of radioecologic models]. PMID- 3301299 TI - [The Radiation Protection Planning Act: inspection of environmental radioactivity and precautionary steps after a nuclear accident]. PMID- 3301300 TI - Calcium antagonists in cerebral/peripheral vascular disorders. Current status. PMID- 3301301 TI - Bezafibrate. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hyperlipidaemia. AB - Bezafibrate is a lipid-lowering drug, chemically related to clofibrate. At its recommended dosage of 200 mg 3 times daily, or alternatively 400 mg once daily as a sustained-release preparation, it produces substantial reductions in plasma triglyceride and cholesterol concentrations in patients with hypertriglyceridaemia and hypercholesterolaemia, respectively. Preliminary investigations indicate that a single daily dose of 400 mg in a sustained-release preparation is as effective as 200 mg 3 times daily. In patients with any type of hyperlipoproteinaemia bezafibrate also increases the plasma HDL-cholesterol concentration. These effects are equivalent in patients with primary hyperlipoproteinaemia or hyperlipoproteinaemia secondary to diabetes or renal disease, although dosage adjustment is important in the latter group. During long term therapy (2 to 4 years) the influence of bezafibrate on the lipid profile is sustained. The lipid-lowering effects of bezafibrate are at least equivalent to those of clofibrate, fenofibrate, colestipol, probucol or sustained release etofibrate. In addition, the increase in HDL-cholesterol tends to be at least as great as with all alternative treatments studied. Bezafibrate is rapidly eliminated, and thus does not accumulate during prolonged administration in patients with normal renal function. Experimental studies have shown bezafibrate to have a complex range of effects on lipoproteins and on the enzymes and receptors involved in lipid metabolism. However, its exact mechanism of lipid lowering action is unclear. Bezafibrate enhances anticoagulation in hyperlipoproteinaemic patients requiring anticoagulant therapy, and preliminary investigations indicate that it reduces the plasma fibrinogen concentration, especially in patients with hyperfibrinogenaemia. These properties of bezafibrate could contribute to an antiatherogenic effect of the drug, but further investigation is required to establish the drug's potential as chronic therapy in patients with hyperfibrinogenaemic atherosclerosis. Adverse reactions to bezafibrate have largely been restricted to gastrointestinal disturbances, with some cutaneous reactions and central nervous system effects. The incidence of side effects has been no greater than with comparative lipid-lowering drugs. In patients with renal disease, a few cases of marked elevation of serum creatine phosphokinase and myoglobin, and associated muscle cramps, have been reported (diagnosed as rhabdomyolysis). Hepatic enzyme induction by bezafibrate in rats results in hepatomegaly, but there has been no case of significant hepatotoxicity in man.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3301304 TI - [Hyperkalemia and hyperchloremia in metabolic acidosis]. PMID- 3301305 TI - [Clinical applications of autoantibody research]. PMID- 3301303 TI - Management of cardiac arrhythmias during pregnancy. Current concepts. AB - Cardiac arrhythmia is one of the most common reasons for cardiac consultation during pregnancy. Fortunately, malignant arrhythmias during the course of normal gestation are rare, and the relatively common complaint of palpitations is usually due to benign arrhythmias. However, in pregnant patients with organic heart disease, arrhythmias are often triggered by the haemodynamic burden of pregnancy and may be the first manifestation of the disease. In addition, rhythm abnormalities in patients with limited cardiac reserves may have significant haemodynamic consequences and can compromise fetal well-being. Any woman who presents with rhythm disorders during pregnancy should undergo a diagnostic evaluation to rule out an underlying disease, including cardiac, pulmonary, endocrine, or metabolic disease. Additionally, removal of precipitating factors, such as excessive ingestion of caffeine and/or alcohol, cigarette smoking, drug abuse or therapy with arrhythmogenic compounds, is indicated (as these measures are desirable in any pregnant woman). Antiarrhythmic drug therapy is indicated in such patients only in symptomatic or haemodynamically significant arrhythmias. In cases where organic heart disease or any other cause for arrhythmia is identified, the underlying disease should be treated first. Antiarrhythmic drug therapy is indicated when arrhythmias persist or as a prophylactic measure. In principle, the approach to drug therapy in pregnant patients is similar to that in non-pregnant patients. However, special consideration should be given to drug selection in order to avoid adverse effects to the fetus. Those antiarrhythmics that have been shown to be relatively safe during pregnancy include digoxin, quinidine, procainamide, some beta-blocking drugs and lignocaine (lidocaine). In addition to careful drug selection, the smallest effective dose should be used and the indication for antiarrhythmic therapy should be periodically reassessed during the course of pregnancy. PMID- 3301302 TI - The effects of drugs on sperm. AB - Spermatogenesis is a complex process which takes about 70 days in the human. Its endocrine control may be affected by various hormones, antihormones or psychotrophic drugs. Cytotoxic agents, or industrial chemicals such as dibromochloropropane, directly affect the germinal epithelium. Sperm maturation may be impaired by alpha-chlorohydrin, antiandrogens, or sulphasalazine, and sperm motility in the female genital tract can be inhibited by vaginal spermicides such as nonoxynol-9 and by propranolol. Drug treatment of idiopathic oligozoospermia is disappointing, though gonadotrophins or their releasing hormone are useful in treating gonadotrophin deficiency. As far as contraception is concerned, there is still no suitable 'male pill': combinations of hormonal steroids are not sufficiently effective and gossypol appears to be too toxic. PMID- 3301306 TI - [Light-induced retinal injury]. PMID- 3301307 TI - Upper airway problems and pre-orthodontic orthopedics. PMID- 3301308 TI - Rapid maxillary expansion in the treatment of nasal obstruction and respiratory disease. PMID- 3301309 TI - Rapid maxillary expansion and impaired nasal respiration. PMID- 3301310 TI - [Immunoenzyme method for demonstrating hemoglobin O Arab]. PMID- 3301311 TI - [Prostaglandins--regulators of kidney function]. PMID- 3301312 TI - [Transforming and oncogenic properties of the adenovirus genome]. AB - Analysis of data on transforming and oncogenic properties of adenovirus genome has shown that oncogenic properties of the cells transformed by adenoviruses are not determined by the length (to a definite extent) and by the number of copies of integrating parts of the viral DNA molecules. There are numerous sites of virus genome integration into the genome of the cell. The E1 region of the viral genome (0 to 11% of the map unit) consists of two transcription units E1a and E1b and plays the leading role in the tumourigenicity of transformed cells. Proteins coded by E1a are responsible for immortalization and initiation of transformation, those coded by E1b--for complete transformation and tumourigenicity. Proteins coded by the E1a region are the universal activators of transcription. Proteins coded by the E4 region activate expression of the E1b region and increase the virus carcinogenicity. PMID- 3301313 TI - [The use of surface antigens of erythroid cells in the study of hemoblastoses]. AB - Data concerning the nature and expression of erythroid cell surface antigens having protein nature are considered. The diagnostic value of these antigens and corresponding monoclonals in the study of human leukemias is discussed. PMID- 3301314 TI - The Endocrine Society 1987 annual awards. PMID- 3301315 TI - A radioimmunoassay for human pro-luteinizing hormone-releasing factor [pro-LRF(14 69)OH]. AB - A radioimmunoassay (RIA) for human pro-LRF(14-69)OH was developed with an antiserum, generated in a rabbit, to [Tyr67]pro-LRF(47-67)NH2 conjugated to BSA. This antiserum bound 28-32% of [125I]pro-LRF(14-69)OH at a final dilution of 1:2500 and the binding was inhibited by pro-LRF(14-69)OH in a dose-dependent manner. The sensitivity of the RIA was 31.2-62.5 pg and the dose that inhibited 50% of the binding to the tracer was 280-320 pg. Intra- and inter-assay coefficients of variation at 50% inhibition were 8 and 12%, respectively. Neither LRF nor pro-LRF(14-37)OH was recognized by the antiserum. The dilution curve generated with human hypothalamic extract was parallel to that of pro-LRF(14 69)OH. In addition the extract yielded a major immunoreactive peak emerging in elution volumes concordant with [125I]pro-LRF(14-69)OH on Sephadex G-50 chromatography. PMID- 3301316 TI - Effect of growth hormone on carbohydrate and lipid metabolism. PMID- 3301317 TI - The gonadotropic function of insulin. AB - We have reviewed the role of insulin in ovarian physiology. Clinical observations and experimental data strongly support the hypothesis that insulin possesses gonadotropic activity, when acting alone or with FSH or LH. This idea is further supported by the recent discovery of insulin in follicular fluid. The idea that insulin has gonadotropic function can explain a variety of clinical observations, which otherwise are difficult to understand. For example, manifestations of ovarian hypofunction (primary amenorrhea, late menarche, anovulation, low pregnancy rate, and early menopause) in IDDM can be understood if it is accepted that insulin is necessary for the ovary to reach its full steroidogenic potential. The idea that insulin affects ovarian steroidogenesis also helps to understand the observation that hyperandrogenism frequently accompanies each of the various insulin-resistant states, regardless of the latter's etiology (e.g. genetic deficiency in the number of insulin receptors, antiinsulin receptor antibodies, obesity, etc.). The explanation for this association is based on the idea that hyperinsulinemia intensifies ovarian steroidogenesis, which manifests clinically as hyperandrogenism. Continuous stimulation of the ovary by insulin over a long period of time possibly produces morphological ovarian changes, such as hyperthecosis or polycystic changes; these changes commonly are observed among women with insulin resistance. The effects of insulin on ovarian cells are mediated possibly through binding of the peptide to its own receptor or to the IGF-1 receptor (the specificity spillover phenomenon). The latter could be an important mechanism in cases of insulin resistance. Potential mechanisms underlying the gonadotropic activity of insulin include direct effects on steroidogenic enzymes, modulation of FSH or LH receptor number, synergism with FSH or LH, or nonspecific enhancement of cell viability. The gonadotropic function of insulin adds yet another note to what has been termed a symphony of insulin action. Further investigation into this new area may yield greater insights not only into normal ovarian physiology, but also into the pathogeneses of such diverse entities as PCO, obesity, diabetes mellitus, and the syndromes of insulin resistance and acanthosis nigricans. PMID- 3301318 TI - Hypothyroidism in the elderly. PMID- 3301319 TI - The renal functions following a severe hypoxia in conscious rats. AB - The aftereffects of renal function were studied in rats exposed to hypoxia at 35,000 ft simulated altitude for 60 min. It was observed that the renal handling of a large volume of infused saline was retarded 4 hr after hypoxia, but it was nearly recovered by the end of 24 hr after exposure to severe hypoxia. However, the urine output, plasma and urine electrolytes, and renal hemodynamics were not significantly altered in hypoxic rats. A high mortality of rats exposed to such a low oxygen tension is also reported. PMID- 3301320 TI - Psychosocial stress and coping in smokers who relapse or quit. AB - Relapse remains a major problem in successful smoking cessation. This study evaluated selected responses and coping skills in male and female quitters and relapsers in four situational contexts: general social competence, smoking specific "high-risk-for-relapse" situations, social anxiety, and relaxation. Results showed that quitters coped better than relapsers with intrapersonal (e.g., negative mood) smoking-specific situations. Quitters had lower heart rates than relapsers during relaxation and intrapersonal situations and had lower anxiety scores at the end of the procedures. Women showed more stress and less confidence in their ability to cope than did men. Groups did not differ in responses to the general social competence and social anxiety procedures. Results are discussed in the context of the importance of considering individual differences in responses and in coping skills for treatment and relapse prevention for smokers. PMID- 3301321 TI - Metabolic and hormonal responses to neuroleptanalgesia (etorphine and acepromazine) in the horse. AB - Administration of etorphine and acepromazine to horses was associated with an increase in haematocrit, blood glucose, blood lactate and plasma non-esterified fatty acids (NEFA). The rise in plasma NEFA was most striking following injection of the antagonist diprenorphine and could contribute to the production of cardiac arrhythmias. Plasma insulin was depressed at the end of surgery. These changes, plus profuse sweating, are indirect evidence of strong sympathetic stimulation. Plasma cortisol did not alter significantly due to wide individual variation. Venous blood pH fell, reflecting the rise in lactate and venous carbon dioxide tension. PMID- 3301322 TI - Use of GnRH to induce oestrus in seasonally anoestrous mares. PMID- 3301323 TI - Office health hazards: an annotated bibliography. PMID- 3301324 TI - The nerve growth factor: thirty-five years later. PMID- 3301325 TI - The complete sequence of the gene for the knob-associated histidine-rich protein from Plasmodium falciparum. AB - 'Knobs' at the surface of erythrocytes infected with mature stages of Plasmodium falciparum are believed to be important in adherence of these cells to capillary walls. They contain at least one parasite protein, designated the knob-associated histidine-rich protein (KAHRP). We present here the sequences of a cDNA and chromosomal clone that predict the complete sequence of KAHRP. The gene contains a single intervening sequence, located at the 3' boundary of the hydrophobic core of a putative signal sequence. Exon two encodes a short region that is rich in histidine as well as two separate regions of repetitive sequence, the 5' repeats (five copies related to SKKHKDNEDAESVK) and the 3' repeats (seven copies related to SKGATKEAST). These repeat blocks were both shown to bear epitopes recognized by the human immune system during natural infection by expressing them separately in Escherichia coli, and reacting human antibodies affinity-purified on lysates of the resulting clones with the corresponding synthetic oligopeptides. The 3' end of the molecule, presumably the repetitive region, is a site of size variation in KAHRP from different isolates. PMID- 3301326 TI - cDNA sequence encoding a Plasmodium falciparum protein associated with knobs and localization of the protein to electron-dense regions in membranes of infected erythrocytes. AB - Plasmodium falciparum modifies the host erythrocyte's plasma membrane by the formation of electron-dense structures called knobs. We have produced monoclonal antibodies (McAbs) which specifically bind to the knobs in immunoelectron microscopic experiments with thin sections of parasitized erythrocytes. However, the McAbs fail to bind to the surface of live parasitized erythrocytes. Immunoblotting experiments with these McAbs show the antigen is localized to the erythrocyte plasma membrane. The antigen with which the McAbs react varies in mol. wt from 80 to 95 kd in different knob-producing isolates of P. falciparum and is absent in knobless variants. The McAbs react with the expressed product of a P. falciparum cDNA clone, thus demonstrating that the clone encodes part of this knob-associated protein. The sequence of the cDNA fragment partially overlaps a published cDNA sequence reported to encode the amino-terminal portion of the knob protein, and extends the predicted open reading frame by 190 amino acids. The carboxyl-terminal portion of the predicted amino acid sequence contains a highly charged stretch of approximately 100 amino acid residues. We suggest that this unusual, highly charged region participates in intermolecular salt bridging leading to dense packing of these molecules. This would create the electron-dense regions observed by electron microscopy and might also explain the insolubility of the knob-associated protein in the absence of strong ionic detergents or chaotropic agents. PMID- 3301327 TI - Specific binding of TUF factor to upstream activation sites of yeast ribosomal protein genes. AB - Transcription activation of yeast ribosomal protein genes is mediated through homologous, 12-nucleotide-long and, in general, duplicated upstream promoter elements (HOMOL1 and RPG, referred to as UASrpg). As shown previously, a yeast protein factor, TUF, interacts specifically with these conserved boxes in the 5' flanking sequences of the elongation factor genes TEF1 and TEF2 and the ribosomal protein gene RP51A. We have now extended our studies of TUF-UASrpg binding by analysing--using footprinting and gel electrophoretic retardation techniques--the genes encoding the ribosomal proteins L25, rp28 (both copy genes), S24 + L46 and S33. Most, but not all, conserved sequence elements occurring in front of these genes, turned out to represent binding sites for the same factor, TUF. The two functionally important boxes that are found in a tandem arrangement (a characteristic of many rp genes) upstream of the L25 gene are indistinguishable in their factor binding specificity. Large differences were shown to exist in the affinity of the TUF factor for the various individual boxes and in the half-life of the protein-DNA complexes. No binding cooperativity could be demonstrated on adjacent sites on L25 or RP51A promoters. Based on binding data, the UASrpg sequence ACACCCATACAT appears to be the one recognized most efficiently by the TUF factor. Previously, no conserved box was found in front of the gene encoding S33. Nevertheless, complex formation with the protein fraction used was observed in the upstream region of the S33 gene. Competition experiments disclosed the existence of an additional binding component, distinct from TUF. This component may possibly regulate a subset of genes for the translational apparatus. PMID- 3301328 TI - lac repressor forms loops with linear DNA carrying two suitably spaced lac operators. AB - Tetrameric lac repressor may bind to two lac operators on one DNA fragment and induce the intervening DNA to form a loop. Electron microscopy, non-denaturing polyacrylamide gel electrophoresis, and DNase I protection experiments were used to demonstrate such DNA loops, where the distance between the centres of symmetry of the two lac operators varies between 63 and 535 bp. Formation of a DNA loop is favoured by correct phasing of the two lac operators and a low concentration of both components of the reaction. When a large excess of lac repressor over DNA is used, a 'tandem' structure is observed, in which both lac operators are occupied independently by two repressor tetramers. When the concentrations of both lac repressor and lac operator are high, a 'sandwich' structure is observed, in which two DNA molecules are connected by two lac repressor tetramers in trans. PMID- 3301329 TI - Systematic alterations in the anticodon arm make tRNA(Glu)-Suoc a more efficient suppressor. AB - Using site-specific mutagenesis, we constructed five more efficient variants of tRNA(Glu)-Suoc, an extremely inefficient ochre suppressor. Each variant has an extended anticodon, or region of the anticodon arm, which is more similar to that found in normal tRNAs which translate codons Uxx. Suppressor efficiency invariably increases with similarity of the extended anticodon to that of a normal Uxx-translating tRNA. Altered nucleotides in both helix and loop strongly affect efficiency, with no position dependence and no significant interaction between substitutions. The variant with all substitutions is 230-fold more efficient (in one context) than the parental tRNA(Glu)-Suoc. Two other unexpected variants seem to be 'context mutants', having altered response to message context. PMID- 3301331 TI - Crosses of two independently derived transgenic mice demonstrate functional complementation of the genes encoding heavy (HLA-B27) and light (beta 2 microglobulin) chains of HLA class I antigens. AB - In man a number of diseases are associated with certain alleles of MHC antigens. The most pronounced example is ankylosing spondylitis, which is strongly associated with HLA-B27. As a first step towards a model system to study the basis of this association, transgenic mice were generated that showed cell surface expression of the HLA-B27 antigen biochemically indistinguishable from HLA-B27 antigen expressed on human cells. This result was obtained by crossing two independently derived strains of mice, one of which is transgenic for the HLA B27 heavy chain gene, and the other carrying and expressing the human beta 2m gene. Examination of HLA-B27 and human beta 2m mRNA in various tissues shows the two genes to be expressed in a coordinate fashion. The mRNA levels follow those of endogenous H-2 Class I genes. PMID- 3301332 TI - The Kellersberger memorial lecture. PMID- 3301330 TI - An angiogenic growth factor is expressed in human glioma cells. AB - Progression to increased malignancy frequently occurs in human brain tumors of glial origin and usually involves neovascularization--a massive proliferation of endothelial cells into the tumor tissue. We have shown previously that subversion of a normal growth factor-related pathway is frequently associated with human gliomas. Here we show that human glioma cell lines express the gene encoding the angiogenic peptide endothelial cell growth factor (ECGF) or acidic fibroblast growth factor (a-FGF) and that an ECGF-like polypeptide is produced by these cells. The glioma-derived growth factor was partially purified from cell extracts by heparin-Sepharose affinity chromatography where it eluted at 1.5 M sodium chloride. On reversed-phase h.p.l.c., growth factor activity for endothelial cells was eluted at the same concentration of acetonitrile as found for bovine brain-ECGF, also a potent mitogen for endothelial cells. Moreover, human glioma cells possess specific cell surface receptors for ECGF and are mitogenically stimulated by exogenous addition of this growth factor. Glioma derived-ECGF may therefore have a dual influence: first, by autocrine growth-stimulation of human gliomas and, second, by paracrine-stimulation of endothelial cell proliferation which results in neovascularization of the tumor tissue. PMID- 3301333 TI - Concepts behind the development of multiple drug therapy regimens in leprosy. PMID- 3301334 TI - Historical outline of ALERT. PMID- 3301335 TI - Fingertip amputations and injuries. PMID- 3301336 TI - Co-operative and allosteric enzymes: 20 years on. PMID- 3301337 TI - Ribonucleotide reductase of Escherichia coli. Cross-linking agents as probes of quaternary and quinary structure. AB - The quaternary structure of ribonucleotide reductase of Escherichia coli was investigated, with the use of purified B1 and B2 proteins and bifunctional cross linking agents. The holoenzyme is known to be an alpha 2 beta 2 tetramer consisting of two dimeric proteins: B1 (alpha 2) and B2 (beta 2). The cross linking data support a model in which both of the beta subunits interact closely with only one of the two alpha subunits. Some of the interactions involving B2 were localized to the C terminus of the protein by use of truncated B2 protein (beta',beta'), a proteolytic cleavage product of B2 in which the 30 carboxy terminal residues are missing from each of the beta subunits. Other interactions were indicated by the ability of glutaredoxin, but not thioredoxin, to inhibit some of the cross-linking reactions. We also asked whether ribonucleotide reductase interacts closely with other proteins inside the cell, by adding cross linkers directly to suspensions of whole bacteria. Proteins in extracts of these cross-linked bacteria were resolved electrophoretically and probed with a monoclonal antibody to the B1 protein. High-molecular-mass products were detected, supporting the utility of this method for identifying intracellular interactions among enzymes of DNA precursor biosynthesis. PMID- 3301338 TI - Biosynthesis and metabolism of pterins in peripheral blood mononuclear cells and leukemia lines of man and mouse. AB - The cellular origin and the control of neopterin release associated with immune stimulation was studied in cell cultures. Using purified human mononuclear cells, the intracellular change in concentrations of GTP and pterins was measured under various kinds of stimulation. Three enzymes involved in tetrahydrobiopterin biosynthesis, i.e. GTP cyclohydrolase I, 6-pyruvoyl tetrahydropterin synthase and sepiapterin reductase, were also determined. Human macrophages stimulated with culture supernatant from activated T-lymphocytes were the main producers of neopterin. In these cells, GTP cyclohydrolase I activity was elevated due to high GTP levels and therefore neopterin accumulated. Human macrophages lack 6-pyruvoyl tetrahydropterin synthase activity. Exogenous tetrahydrobiopterin added to the culture medium of stimulated T cells and macrophages suppressed the elevation of GTP cyclohydrolase I activity and neopterin concentration, but not the elevation of intracellular GTP. Stimulation of macrophages with recombinant human interferon-gamma and neutralization of the effect of T cell supernatants by addition of a monoclonal antibody specific for human interferon-gamma showed that immune interferon induced the alterations in GTP cyclohydrolase I activity and neopterin concentration. In the human macrophage line U-937 and in the leukemia line HL-60, no GTP cyclohydrolase I activity or intracellular pterins were detected, but high levels of GTP. In mouse mononuclear cells, no neopterin was detected, but biopterin and pterin. After stimulation, biopterin was elevated in the same way as neopterin in human mononuclear cells. This is explained by the different regulation of the rate-limiting steps of tetrahydrobiopterin biosynthesis in man and in mouse. These results suggest that neopterin is an unspecific marker for the activation of the cellular immune system. PMID- 3301339 TI - The in vivo stability, maturation and aminoacylation of anticodon-substituted Escherichia coli initiator methionine tRNAs. AB - We have constructed eight anticodon-modified Escherichia coli initiator methionine (fMet) tRNAs by insertion of synthetic ribotrinucleotides between two fragments ('half molecules') derived from the initiator tRNA. The trinucleotides, namely CAU (the normal anticodon), CAA, CAC, CAG, GAA, GAC, GAG and GAU, were joined to the 5' and 3' tRNA fragments with T4 RNA ligase. The strategy of reconstruction permitted the insertion of radioactive 32P label between nucleotides 36 and 37. tRNAs were microinjected into the cytoplasm of Xenopus laevis oocytes, and the following properties were evaluated: the stability of these eubacterial tRNA variants in the eukaryotic oocytes; the enzymatic modification of the adenosine at position 37 (3' adjacent to the anticodon) and aminoacylation of the chimeric tRNAs by endogenous oocyte aminoacyl-tRNA synthetases. In contrast to other variants, the two RNAs having CAU and GAU anticodons were stable and underwent quantitative modification at A-37. These results show that the enzyme responsible for the modification of A-37 to N-[N-(9 beta-D-ribofuranosylpurine-6-yl)carbamoyl]threonine (t6A) is present in the cytoplasm of oocytes and is very sensitive to the anticodon environment of the tRNA. Also, these same GAU and CAU anticodon-containing tRNAs are fully aminoacylated with the heterologous oocyte aminoacyl-tRNA synthetases in vivo. During the course of this work we developed a generally applicable assay for the aminoacylation of femtomole amounts of labelled tRNAs. PMID- 3301340 TI - Hormonal regulation of amino acid transport system N in primary cultures of rat hepatocytes. AB - The transport of histidine and glutamine via system N in cultured hepatocytes was found to be subject to hormonal control. This long-term regulation showed the following characteristics. The transport capacity for histidine and glutamine (system N) increased slowly in response to the combination of dexamethasone and insulin to about 4-fold that of controls after 18-30 h. A similar time course was found for the stimulation of system N (2.5-fold) by dexamethasone and glucagon. In contrast the uptake of alpha-aminoisobutyric acid (system A) was rapidly stimulated 3-fold by dexamethasone and insulin and 5-fold by dexamethasone and glucagon within 3-6 h but decreased towards control rates after 24 h of cultivation in minimal essential medium. Dexamethasone, insulin and glucagon each stimulated glutamine uptake about 2-fold in cultures maintained in W/AB 77 medium, while the combination of dexamethasone with either glucagon or insulin resulted in a 3-4-fold increase. Dexamethasone was most effective at about 0.1 microM. Higher concentrations were less efficient. Insulin reached its optimal effect at concentrations above 1 microM. Kinetic analysis revealed that the increased capacity of glutamine transport in response to hormones was due to an increase in Vmax, while Km was essentially unchanged. The hormone-induced stimulation of system N was prevented by cycloheximide. The induced uptake of glutamine was inhibited by excess amounts of asparagine and histidine but not of alpha-methylaminoisobutyric acid or cysteine. These results clearly differentiate the hormonal regulation of system N from that of system A. PMID- 3301341 TI - Isolation of DNA-protein complexes based on streptavidin and biotin interaction. AB - We describe a method for the purification of proteins binding to specific DNA sites based on the strong interaction between streptavidin and biotin. We tested the efficiency of this method using the Escherichia coli lactose operon operator repressor system. dUTP coupled to biotin is incorporated into a DNA fragment containing the lactose operator. A crude E. coli extract is first incubated with the biotinylated fragment and the reaction mixture is filtered on a streptavidin agarose column. Proteins retained on the column are either eluted alone by high salt or isopropyl beta-D-thiogalactoside, or as a complex with the DNA site by enzymatic digestion of the DNA. We thus obtained a 3400-fold enrichment of the repressor complexed to the operator in one step. The method is simple and makes use of commercially available reagents. The large concentration of biotin-binding sites of the streptavidin-agarose matrix (0.1 mumol/ml packed gel) provides a very high capacity for the concentration and purification of large amounts of proteins. The advantage of this method for the detection and purification of other DNA-binding proteins is discussed. PMID- 3301342 TI - Structural studies of the putative O-specific polysaccharide of Serratia marcescens O9. AB - A polymeric fraction containing the putative O-antigen has been isolated from the lipopolysaccharide of the reference strain (CDC 4534-60) for serogroup O9 of Serratia marcescens. The major component of the fraction was a polymer with a disaccharide repeating-unit of L-rhamnose (Rha) and 2-acetamido-2-deoxy-D galactose (GalNAc) with the following structure:----3)D-GalpNAc(beta 1----3)L Rhap(alpha 1----. Evidence for the presence in the fraction of a similar, minor polymer containing 4-substituted rhamnose residues was provided by the NMR spectra, methylation analysis, and Smith degradation. PMID- 3301343 TI - Production of testosterone from progesterone by rat testicular microsomes without release of the intermediates 17 alpha-hydroxyprogesterone and androstenedione. AB - It has been shown that during the in vitro conversion of progesterone to androstenedione, 17 alpha-hydroxyprogesterone is not an obligatory intermediate which equilibrates with freely diffusible steroids in the incubation medium. Recently a cytochrome P-450 was purified that catalyzed, in addition to hydroxylase/lyase activities, reduction of androstenedione to testosterone. In order to determine whether progesterone could be transformed to testosterone without both intermediates (17 alpha-hydroxyprogesterone and androstenedione) being equilibrated with steroids in the medium, several double-label double substrate experiments were performed. When rat microsomes were incubated with an equimolar mixture of [14C]progesterone and 17 alpha-hydroxy[3H]progesterone, androstenedione was isolated with a 11-fold higher 14C/3H ratio than 17 alpha hydroxyprogesterone, indicating that androstenedione could not be produced from free, diffusible 17 alpha-hydroxyprogesterone. Incubation of an equimolar mixture of 17 alpha-hydroxy[3H]progesterone and [14C]androstenedione with testicular microsomes resulted in the incorporation of 3-4-fold more 17 alpha hydroxyprogesterone into testosterone than of androstenedione, although the latter is the immediate precursor of testosterone. In an experiment in which equimolar concentrations of [3H]progesterone and [14C]androstenedione were incubated with testicular microsomes, the large pool of progesterone inhibited competitively lyase activity, but still the label of progesterone was incorporated into testosterone to the same extent as that of androstenedione. These results indicate that testosterone can be produced by immature rat testicular microsomes from added progesterone on an organized unit without the intermediates equilibrating with the incubation medium. PMID- 3301344 TI - Peptidases in dog-ileum circular and longitudinal smooth-muscle plasma membranes. Their relative contribution to the metabolism of neurotensin. AB - We established the content in neuropeptide-metabolizing peptidases present in highly purified plasma membranes prepared from the circular and longitudinal muscles of dog ileum. Activities were measured by the use of fluorigenic substrates and the identities of enzymes were confirmed by the use of specific peptidase inhibitors. Endopeptidase 24.11, angiotensin-converting enzyme, post proline dipeptidyl aminopeptidase and aminopeptidases were found in both membrane preparations. Proline endopeptidase was only detected in circular smooth muscle plasma membranes while pyroglutamyl-peptide hydrolase was not observed in either tissue. The relative contribution of these peptidases to the inactivation of neurotensin was assessed. The enzymes involved in the primary inactivating cleavages occurring on the neurotensin molecule were as follows. In both membrane preparations, endopeptidase 24.11 was responsible for the formation of neurotensin-(1-11) and contributed to the formation of neurotensin-(1-10); a recently purified neurotensin-degrading neutral metallopeptidase was also involved in the formation of neurotensin-(1-10). A carboxypeptidase-like activity hydrolysed neurotensin at the Ile12-Leu13 peptide bond, leading to the formation of neurotensin-(1-12). Proline endopeptidase and endopeptidase 24.15 only occurred in circular muscle plasma membranes, yielding neurotensin-(1-7) and neurotensin-(1-8), respectively. In addition, the secondary processing of neurotensin degradation products was catalyzed by the following peptidases. In circular and longitudinal muscle membranes, angiotensin-converting enzyme converted neurotensin-(1-10) into neurotensin-(1-8) and tyrosine resulted from the rapid hydrolysis of neurotensin-(11-13) by bestatin-sensitive aminopeptidases. A post-proline dipeptidyl aminopeptidase activity converted neurotensin-(9-13) into neurotensin-(11-13) in circular muscle plasma membranes. The mechanism of neurotensin inactivation occurring in these membranes will be compared to that previously established for membranes from central origin. PMID- 3301345 TI - Processing of a plant vacuolar protein precursor in vitro. AB - A precursor for sporamin A, the storage protein of the tuberous roots of sweet potato deposited in the vacuole, is synthesized on membrane-bound polysomes and has an extra peptide of 37 amino acids at the N-terminus of the mature form, which can be divided into an N-terminal putative signal peptide sequence (residues -37 to -17) and a segment enriched with charged amino acids (residues 16 to -1) [Hattori, T., et al. (1985) Plant Mol. Biol. 5, 313-320]. We examined the in vitro processing of the sporamin A precursor using a messenger RNA derived from a full-length cDNA by the SP6 transcription system. When the in vitro translation in a wheat germ cell-free system was carried out in the presence of dog pancreas microsomal membranes, the precursor polypeptide (Mr = 24,000) was processed into an intermediate form still larger than the mature polypeptide (Mr = 20,000). The processed intermediate form was also produced by addition of microsomal membranes from sweet potato and potato in the translation reaction, although less efficiently compared to dog membranes. Moreover, Escherichia coli cells expressing sporamin precursor accumulated a polypeptide with the same electrophoretic mobility as the intermediate form produced in vitro. The processing by dog membranes is accompanied by translocation of the polypeptide across the membranes as assayed by resistance to externally added proteases. The N-terminal amino acid sequencing analysis of [3H]leucine-labelled intermediate form produced in vitro by dog membranes indicated that co-translational processing of the sporamin precursor by endoplasmic reticulum membranes removes only the signal peptide segment from the extra peptide, and suggested that the charged segment following the signal peptide is removed post-translationally during the transport of sporamin into vacuole. The significance of two-step processing of plant vacuolar protein precursor is discussed in relation to the two-step processing of precursors for yeast vacuolar proteins and animal lysosomal proteins. PMID- 3301346 TI - Studies of the functional topography of Escherichia coli RNA polymerase. Affinity labelling of RNA polymerase in a promoter complex by phosphorylating derivatives of primer oligonucleotides. AB - Amidation of the 5'-phosphate group of the heptanucleotide pdApdApdApdTpdCpdGprC and of its derivatives of the general formula (pdN)npdGprC (n = 0-5) with imidazole, N-methylimidazole, and 4-dimethylaminopyridine afforded a series of phosphorylating affinity reagents. The parent oligonucleotides of this series complementary to promoter A2 of T7 phage over the region (-5 to +2) are known to be efficient primers of the synthesis of RNA by Escherichia coli RNA polymerase with promoter A2 as template. Treatment of the complex RNA-polymerase X promoter A2 with affinity reagents followed by addition of [alpha-32P]UTP resulted in labelling of RNA polymerase by the residues -(pdN)npdGprCprU (p = radioactive phosphate). This affinity labelling was highly selective because elongation of the covalently bound residues (pdN)npdGprC by prU residues was catalyzed by the active center of RNA polymerase. The most efficient reagents were N methylimidazolides. A dramatic change of the pattern of labelling of the subunits beta, beta', and sigma took place with changing n. Maximum labelling of the beta subunit occurred at n = 1 and of the sigma subunit at n = 5. The targets in both the subunits were His residues. The alpha subunit was not specifically labelled. PMID- 3301347 TI - Partial purification and specificity studies of the D-glutamate-adding and D alanyl-D-alanine-adding enzymes from Escherichia coli K12. AB - The D-glutamate-adding and D-alanyl-D-alanine-adding enzymes from Escherichia coli were partially purified by fast protein liquid chromatography on an anion exchanger. Their relative molecular masses, determined by gel filtration on Superose 12, were 54,000 +/- 2000 and 51,000 +/- 2000, respectively. In order to investigate the specificity of these ligases, several compounds derived from their respective nucleotide substrates were prepared. In the case of the D-Glu adding enzyme, DDP-MurNAc-L-Ala (DDP = dihydrouridine 5'-diphosphate) and P1 MurNAc-L-Ala were substrates of the reaction. In the case of the D-Ala-D-Ala adding enzyme, only DDP-MurNAc-L-Ala-D-Glu(-meso-A2pm) was a substrate; P1-MurNAc L-Ala-D-Glu(-meso-A2pm) was neither a substrate nor an inhibitor. Concerning the amino acid site of the D-Glu-adding enzyme, even closely related analogues of D glutamate hardly inhibited the reaction. PMID- 3301348 TI - The high-resolution X-ray crystal structure of the complex formed between subtilisin Carlsberg and eglin c, an elastase inhibitor from the leech Hirudo medicinalis. Structural analysis, subtilisin structure and interface geometry. AB - Triclinic crystals of the complex formed by eglin with subtilisin Carlsberg were analyzed by X-ray diffraction. The crystal and molecular structure of this complex was determined with data that extended to 0.12-nm resolution by a combination of Patterson search methods and isomorphous replacement techniques. Its structure was refined to a crystallographic R value of 0.178 (1.0-0.12 nm) using an energy-restraint least-squares procedure. The complete subtilisin molecule could be traced without ambiguity in the refined electron density. The eglin component, from which an amino-terminal segment is cleaved off, is only defined from Lys8I (i.e. the lysine residue 8 of the inhibitor) onwards. Per unit cell, 436 fixed solvent molecules and 2 calcium ions were located. In spite of 84 amino acid replacements and one deletion, subtilisin Carlsberg exhibits a very similar polypeptide fold to subtilisin BPN'. The root-mean-square deviations of all alpha-carbon atoms (excluding those at the deletion site) from models of subtilisin BPN' [Alden, R. A., Birktoft, J. J., Kraut, J., Robertus, J. D. & Wright, C. S. (1971) Biochem. Biophys. Res. Commun. 45, 337-344] and subtilisin Novo [Drenth, J., Hol, W. G. J., Jansonius, J. N. & Kockoek, R. (1972) Eur. J. Biochem. 25, 177-181] are 0.077 nm and 0.103 nm. Most of these deviations result from global shifts rather than changes of the local geometry. The single-residue deletion at position 56 affects only the surrounding conformation. Two sites of high electron density and close distances to surrounding oxygen ligands have been found in the Carlsberg enzyme which are probably occupied by calcium ions. Eglin consists of a twisted four-stranded beta-sheet flanked by an alpha-helix and by an exposed proteinase binding loop on opposite sides. Around the reactive site, Leu45I-Asp46I, this loop is mainly stabilized by electrostatic/hydrogen bond interactions with the side chains of two arginine residues which project from the hydrophobic core [Bode, W., Papamokos, E., Musil, D., Seemuller, W. & Fritz, H. (1986) EMBO J. 5, 813-818]. The reactive site loop conformation resembles that found in other 'small' proteinase inhibitors. The scissile peptide bond is not cleaved but its carbonyl group is slightly distorted from planar geometry. Most of the intermolecular contacts are contributed by the nine residues of the reactive-site loop Gly40I-Arg48I.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3301349 TI - The renin-angiotensin system in the central control of blood pressure. AB - The results of biochemical, immunohistochemical and autoradiographic studies led to the description of the endogenous brain angiotensin II system as a highly localized network of angiotensin II-containing cell bodies and fibres as well as characteristic sites with high angiotensin II-receptor density. The specific localization of this system predominantly within limbic, hypothalamic and brain stem structures that are known to be involved in central cardiovascular regulation and the control of volume homeostasis, suggests a possible functional role for brain angiotensin II in the control of these homeostatic functions. A role for brain angiotensin II in the central control of blood pressure is further supported by physiological and pharmacological experiments that demonstrate characteristic central angiotensin-induced cardiovascular responses. However, it should be kept in mind that the mechanisms mediating these responses (e.g. sympathetic activation, vasopressin release), as well as the exact functional role of endogenously synthesized angiotensin II in specific brain areas, are not yet completely understood. Pathophysiologically, there is evidence that an activated brain renin angiotensin system may participate in the development and maintenance of primary hypertension. PMID- 3301350 TI - Role of GABAergic mechanisms in the central regulation of arterial pressure. AB - Gamma aminobutyric acid (GABA) may represent the single most prevalent neurotransmitter in the mammalian central nervous system. Consequently, it should come as little surprise that the neural circuitry concerned with regulating systemic arterial pressure through the autonomic nervous system utilizes a number of GABAergic inhibitory mechanisms which are anatomically and functionally distinct. This article will, first, summarize findings from our laboratory and other which suggest some of these roles in the mammalian brainstem, and, second, trace a line of research pointing to a particular GABAergic inhibitory mechanism in the forebrain that may have some relevance to experimental and human hypertension. PMID- 3301351 TI - Evidence for discrete alterations in central cardiovascular catecholamine and neuropeptide Y immunoreactive neurons in aged male rats and in genetically hypertensive male rats of the Lyon strain. AB - A computer-assisted morphometrical and microdensitometrical analysis has been performed on cardiovascular noradrenaline (NA), adrenaline (A) and neuropeptide (Y (NPY) neurons in adult and 24-month-old male rats and on hypotensive (LL), normotensive (LN) and hypertensive (LH) male rats of the Lyon strain using the indirect immunoperoxidase procedures. It was found that in NPY/phenylethanolamine N-methyltransferase (PNMT) costoring neurons of the CI area of the rostral medulla oblongata NPY-like immunoreactivity showed a more marked reduction than the PNMT immunoreactivity. Furthermore, within the parvocellular part of the paraventricular hypothalamic nucleus. NPY immunoreactive nerve terminal profiles were much more affected than the PNMT immunoreactive profiles during aging as revealed by a marked reduction in the number of profiles and by a marked reduction of absorbency values in the microdensitometrical analysis. Thus, in the NPY/PNMT costoring neurons of the A C1 group of the ventrolateral medulla projecting, for example, to the hypothalamus, the peptide transmission line may have a special vulnerability to the aging processes which may contribute to the development of hypertension in old people in view of a vasodepressor role of many central NPY/PNMT neurons. An extensive morphometrical and microdensitometrical analysis of the various catecholamine (CA) cell groups of the medulla oblongata of the LL, LN and LH rats of the Lyon strain was performed. In a comparison between LL and LH rats the A2 cell group of the LH strain showed a trend for an increase in the mean tyrosine hydroxylase (TH) immunoreactive cell body area and the C3 group showed a significant increase in the number of PNMT immunoreactive profiles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301352 TI - Alcohol and hypertension: new insights from population studies. AB - The link between alcohol and blood pressure is now well established. Certain subsets, such as older persons, whites and perhaps men may be at increased susceptibility to an alcohol pressor effect, although considerable interindividual variation in the pressor response probably exists. A threshold may exist at around two drinks per day, but several studies report either different thresholds or more linear relationships. The evidence to date suggests that ethanol, rather than some other constituent of alcoholic beverages or an associated behavior, raises blood pressure. The data available to date are perhaps most compatible with a withdrawal hypothesis, but a straightforward pressor effect cannot be excluded at this time. Whatever the mechanism, the pressor effect appears to be fully reversible. Finally, the available evidence suggests that alcohol induced hypertension will indeed lead to the usual hypertensive sequelae. PMID- 3301353 TI - Sodium and potassium intake and high blood pressure. AB - Much circumstantial and some direct evidence links a high sodium, low potassium intake to the development of essential hypertension. However, studies to prove a definite causative relationship in man are unlikely to be done for the practical reason that they need to be carried out over a whole generation. Restriction of sodium intake does lower blood pressure in many hypertensive subjects. This fall appears to be mediated in part by a diminished renin response to the sodium restriction as blood pressure becomes more severe. Less substantive evidence also suggests that increasing potassium intake may lower blood pressure but this effect seems to be more apparent when both animals and man are on a high sodium intake. It would seem sensible, therefore, in the light of present knowledge, to advise communities that have a high sodium, low potassium diet they they may benefit from a reduction in sodium and an increase in potassium intake. Patients who are already known to have high blood pressure should be advised to reduce sodium intake along with other non-pharmacological advice. In some patients this will be sufficient to control the blood pressure. In others who may then require drug treatment, the blood pressure lowering effect of beta-blockers and converting enzyme inhibitors will be enhanced by the sodium restriction. PMID- 3301354 TI - Dietary calcium and hypertension: population studies. PMID- 3301355 TI - Clinical studies of calcium metabolism in essential hypertension. AB - Many factors can ultimately lead to an increased blood pressure and it is a generally accepted view that an increase in the active tension of arterioles reflects an increase of the free calcium concentration in the cytosol of the vascular smooth muscle cells. Only recently, however, has the possibility been considered that blood pressure regulation could be influenced by calcium homeostasis. A background for these studies has been provided by the epidemiological observations which link hypertension to a low dietary intake of calcium as well as experimental studies in animals, mostly rats, which have demonstrated that various disturbances of calcium metabolism are related to a raised blood pressure. This review is focused on clinical studies of a possible association between systemic calcium metabolism and the regulation of blood pressure. PMID- 3301356 TI - Obesity and hypertension: epidemiological and clinical issues. AB - The relationship between obesity and hypertension has been investigated in a large number of cross-sectional population studies and a smaller number of prospective, observational studies. The results indicate that in most populations, blood pressure increases linearly with increasing body weight or body mass index. The relationship is present across all subgroups, although the magnitude of the association appears greater in whites than blacks and greater in younger than older persons. It is estimated that as much as one-third of all hypertension may be attributable to obesity in populations where hypertension and obesity are widely prevalent. Evidence from prospective studies and clinical trials suggests that hypertension in obese patients increases the risk of cardiovascular disease and that drug treatment of hypertension reduces the risk. However, it is uncertain whether the risks associated with hypertension and the benefits of treatment are as great in obese hypertensives as they are in lean hypertensives. The effects of weight reduction on blood pressure have been investigated in a small number of randomized, controlled trials involving a total of about 600 participants. Overall, the results of the trials indicate that weight reduction lowers blood pressure over intervals of up to one year. The magnitude of the blood pressure response appears to be directly proportional to the amount of weight loss achieved. However, the latter is inversely related to the length of follow-up. Adequate maintenance of weight loss remains a major problem for the much-needed, long-term trials of the effects of weight reduction on blood pressure and the cardiovascular complications of hypertension. PMID- 3301357 TI - Effects of physical training on blood pressure in hypertension. AB - Although initial studies did not allow conclusions on the effects of physical training on blood pressure in hypertension because the groups studied were too small, and because of a mixture of hypertension types, body weight changes and lack of controls, recent studies are not rendered difficult to interpret by such deficiencies. Such studies seem now to allow the conclusion that physical training lowers blood pressure in borderline hypertension by decreasing heart rate and cardiac output, but not peripheral resistance. It is noteworthy that increases of heart rate and cardiac output, as well as a number of other symptoms of increased activity of the central sympathetic nervous system, are characteristic of a large group of subjects with borderline hypertension, and it seems that these subjects are particularly good responders to physical training. Recent studies suggest that physical activity, as well as electric nerve stimulation and acupuncture, sends specific afferent nerve signals to the central nervous system resulting afterwards in increased pain threshold, and lower activity in the central sympathetic nervous system, resulting in lower heart rate and blood pressure. These effects seem to be mediated via endorphin release in the central nervous system because they can be mimicked by local administration of these substances and inhibited by naloxone. It seems an interesting possibility that physical training lowers blood pressure and other expressions of increased sympathetic nervous system activity via such a mechanism. Further studies along this line may be rewarding from different aspects. PMID- 3301358 TI - Nonpharmacologic treatment of hypertension: does it work? AB - Abundant clinical and epidemiological data suggest that hypertension, or high blood pressure is a disease of high prevalence in industrialized societies, with cardiovascular morbidity and mortality directly related to the level of blood pressure. Although efficacious pharmacologic approaches to the control of high blood pressure are available, concern about risk versus benefit in the use of antihypertensive drug therapy for patients with mild hypertension has led to renewed interest in nonpharmacologic interventions. In the U.S.A. the National High Blood Pressure Education Program, an organization comprised of research scientists and a variety of other professionals concerned with the control of high blood pressure, has through a consensus process, recommended some nonpharmacologic approaches to the treatment of hypertension. The pros and cons of nutritional interventions, exercise and biobehavioral treatments are discussed. Nonpharmacologic recommendations in the treatment of hypertension for which there appear to be sufficient requisite data include weight reduction for the obese, moderate sodium restriction (although this is controversial) and restriction of alcohol consumption to less than 57 g of ethanol daily. PMID- 3301359 TI - Dietary fat and blood pressure--a review. PMID- 3301360 TI - A comparison of the acute hemodynamic effects of nifedipine and nisoldipine in patients with ischemic reduced left ventricular function. AB - Nisoldipine (BAY k 5552) like nifedipine, is a dihidropyridine compound with strong calcium blocking activity. The purpose of this study was to measure and compare the absolute hemodynamic effects of these two drugs before and at 30 min, 60 min and 120 min after oral intake in 20 ischemic heart disease patients with radionuclide gated cardiac scintigraphy. No significant change was seen in end diastolic volume index with either of the drugs. With nifedipine the stroke volume index (SVI) increased significantly from the basal value at 30 min (P = 0.004) and 60 min (P = 0.034) yet not significantly at 120 min. The same trend was seen in left ventricular ejection fraction (LVEF) with significant increases at 30 min (P = 0.02) and 60 min (P = 0.025) yet not at 120 min. The cardiac index increased significantly at 30 min (P = 0.001), 60 min (P = 0.002) and 120 min (P = 0.025) but the latter value was significantly lower than the 30 min value indicating the maximal effect had already passed. With nisoldipine the SVI increased significantly at 60 min (P = 0.004) and 120 min (P = 0.001) but not at 30 min. These changes were again reflected by a significant increase in LVEF at 60 min (P = 0.021) and 120 min (P = 0.002) without significant increase at 30 min. The increase in CI was highly significant at 60 min (P = 0.003) and 120 min (P = 0.001) without significant change at 30 min. Nisoldipine proved to be a potent calcium antagonist with slower onset and longer duration of action than nifedipine. PMID- 3301361 TI - Prolongation of graft survival in allogeneic pancreas and liver transplantation by (-)15-deoxyspergualin. AB - (-)15-Deoxyspergualin, originally discovered as an antitumoral drug, was shown to have different immunosuppressive effects, when pancreas and orthotopic allogeneic liver transplantations in rats were compared. In the strong rejection model dark agouti----Lewis (RT1a----RT1(1)) we could only show a minor immunosuppressive effect, as far as pancreaticoduodenal and pancreas segment transplantations are concerned: graft survival was prolonged by 9 days in pancreas segment allografts (p less than 0.01) and by 6 days in pancreaticoduodenal allografts (p less than 0.01), when recipients were treated by ten doses of 2.5 mg/kg deoxyspergualin. Pretreatment of recipients with 15-deoxyspergualin was not efficient. On the contrary, in orthotopic liver transplantation done by the cuff technique, a remarkable prolongation of allograft survival could be demonstrated: about half of the animals showed prolongation of allograft survival for more than 80 days, compared with about 11 days in the control group (p less than 0.01). The substance is considered to be valuable for clinical application. PMID- 3301362 TI - In vivo dynamic 99mTc-HIDA scintigraphy after hepatocyte transplantation: a new method for the monitoring of graft function. AB - In vivo dynamic 99mTc-HIDA scintigraphy was tested as a method for graft function monitoring after hepatocyte transplantation (HTX). Bilirubin uridyldiphosphate glucuronyl transferase-deficient rats received 10(7) viable isolated hepatocytes from congenic nondeficient donors by intrasplenic injection. The transplanted rats were divided into 2 groups. Three months after HTX, one group underwent 99mTc-HIDA scintigraphy, the other was subjected to bile analysis for the detection of bilirubin glucuronides (the presence of which would indicate biochemical activity of transplanted hepatocytes). Histological examination of the spleen of all animals was performed at the end of the experiment. The same experimental protocol was applied to 10 sham-treated enzyme-deficient rats serving as controls. The scintigraphic studies showed that spleens of transplanted rats did accumulate 99mTc-HIDA, this in contrast to sham-treated rats. Furthermore, time-activity curves of liver and spleen of HTX-treated rats showed similar kinetic patterns, suggesting a biologically normal function of the hepatocytes grafted in the spleen. Bilirubin glucuronides were excreted by transplanted rats, not by control rats. Histological examination of the spleen revealed hepatocyte survival in all HTX-treated rats. These findings demonstrated a correlation between increased splenic uptake of 99mTc-HIDA and biochemical activity and morphological survival of intrasplenic donor hepatocytes. In conclusion, in vivo dynamic 99mTc-HIDA scintigraphy appears to be an ideal method for noninvasive graft function monitoring after intrasplenic HTX. PMID- 3301363 TI - Experimental study of argon laser-induced microthrombosis during PGI2 infusion. AB - In order to evaluate the Argon laser-induced microthrombogenesis during prostacyclin (PGI2) infusion on newly formed microcirculation in the rabbit ear chamber, time-space parameters have been calculated in 118 observations subdivided into 4 groups according to the type and size of the vessels irradiated. The observations were carried out without drug treatment, with continuous infusion of pH 10.5 glycine buffer and with continuous infusion of PGI2 at the dosage of 125 ng X kg-1 X min-1 diluted in the glycine buffer. The results indicated that during PGI2 infusion the size of the thrombus, measured by maximal thrombus area, was always significantly less extended than in untreated animals. Moreover, the number of emboli detached during the first 5 min after laser exposure, measured by rate of embolization, during PGI2 infusion in venules and in the larger arterioles was smaller than in untreated animals. The vasoconstriction which usually takes place in the arteriolar vessels--upstream and downstream from the irradiated site--was in no way modified by the infusion of PGI2. Finally, it was noted that glycine buffer infusion showed an unforeseen activity on laser-induced vascular reactivity. PMID- 3301364 TI - Long-term daily study of blood volume in cardiac autotransplanted dogs. AB - Cardiac transplantation is followed by the interruption of afferent nerves to the heart. Knowing that some of the afferent nerves are responsible for the homeostasis of the blood volume, we undertook a serial and long-term study of the blood volume in 25 dogs with denervated hearts. The animals were autotransplanted in order to eliminate repercussions linked to rejection and to its treatment. To discern the effects of surgery and of extracorporeal circulation from those of denervation, a group of 11 control dogs was operated upon and subjected to a period of extracorporeal circulation. In both groups, serial and long-term studies of blood volume were carried out daily with 131I-labeled albumin. Analysis of the results demonstrated that in the hours following surgery, blood volume is significantly decreased by 11% in the control group and by 22% in group 2. By the 5th postoperative day, the blood volume had increased gradually to attain normal values in both groups. At the 2nd postoperative week, the total blood volume remained normal in the control group, whereas blood volume had increased by 5.7% in the autotransplanted dogs, this being due to a 38% increase of the plasmatic phase. This increment persisted from the 14th to the 42nd postoperative day and attained 7.4%. Our conclusion is that the variations in blood volume during the 1st postoperative week in the autotransplanted heart are inherent in surgery and in extracorporeal circulation. Afterwards, the hypervolemia shown in the transplanted dogs is secondary to cardiac denervation. PMID- 3301365 TI - Immunotherapy of xenografted human bladder cancer in nude mice using monoclonal antibody. AB - A murine monoclonal antibody with IgG3 isotype and k-light chains has been produced against a human bladder cancer cell line, TSGH-8301. Radioimmunoassay and immunofluorescent staining revealed that the highly reactive tumor-associated antigen was located on the cell surface of TSGH-8301 transitional cell carcinoma cells. The monoclonal antibody possessed direct and complement-mediated cytotoxicity to TSGH-8301 cancer cells as shown by in vitro microcytotoxicity test. Further trials on the immunotherapy of xenografted tumors in nude mice using the monoclonal antibody demonstrated that the therapeutic efficacy was dose dependent and closely related to tumor burden. PMID- 3301366 TI - The case for high-dose chemotherapy: is it chemotherapy's last gamble? PMID- 3301367 TI - A phase II study of carboplatin in metastatic transitional cell carcinoma of the bladder (a report of the Medical Research Council Working Party on Urological Cancer, Subgroup in Advanced Bladder Cancer). AB - In view of the activity of Cisplatin in bladder cancer a multicentre study of its less toxic analogue Carboplatin was carried out in 48 patients with metastatic transitional cell carcinoma, of whom 30 had received no previous cytotoxic chemotherapy. No complete remissions and only 3 partial responses were observed, suggesting that Carboplatin has only minimal activity in this disease. PMID- 3301368 TI - Germinal centers develop oligoclonally. AB - As part of our studies into the role of germinal centers, we investigated whether each de novo generated germinal center (GC) develops from one single GC precursor cell (GCPC, monoclonal development), a few GCPC (oligoclonal development) or from many GCPC (polyclonal development). Thus, lethally (9 Gy) X-irradiated AO (RT1u) rats were reconstituted with 10(8) thoracic duct lymphocytes (TDL) containing mixtures of AO and AO X BN cells in various ratios. The AO TDL were tolerant for AO X BN cells by using TDL from AO----(AO X BN)F1 (RT1u/n) X-irradiation bone marrow chimeras. To induce GC formation in the spleen of TDL-reconstituted rats, animals were i.v. injected with 10(9) sheep red blood cells. Five days after reconstitution and antigenic challenge spleens were taken for analysis of cellular make up of de novo generated GC. Spleen sections were immunohistochemically stained with monoclonal antibody F17-23-2, recognizing major histocompatibility complex class II antigens of the RT1n haplotype but not the RT1u haplotype, to discriminate between B cells of AO and AO X BN origin. Analysis of the GC in spleens of rats reconstituted with a mixture of AO and AO X BN TDL revealed three types of GC: GC entirely composed of AO cells, GC entirely composed of AO X BN cells and GC containing a mixture of both. The relative frequencies of these three types of GC indicated that in our experimental system, de novo GC developed oligoclonally from one to three GCPC. These data strongly suggest that GC are sites of antigen-driven expansion of peripheral B cells to very large clones. PMID- 3301369 TI - B lymphocyte differentiation in the rat: production and characterization of monoclonal antibodies to B lineage-associated antigens. AB - Three mouse monoclonal antibodies (mAb) directed against rat B lineage antigens were produced. The mAb, designated HIS14 (IgG1), HIS22 (IgM) and HIS24 (IgG2b), were characterized for binding to lymphoid and nonlymphoid tissues by immunoperoxidase staining of frozen sections and by (double-) immunofluorescence staining of single cell suspensions from lymphoid organs. HIS14 recognized a pan B cell determinant: it reacted with virtually all cells of each anatomic B cell compartment and with about 95% of surface (s)Ig+ cells in thoracic duct lymph and in suspensions of spleen and lymph nodes. HIS22 and HIS24 detected B lineage associated antigens expressed by major subpopulations of B cells. HIS22 predominantly stained the lymphocyte corona, but not (or weakly) the germinal centers and splenic marginal zones, whereas HIS24 reacted with both corona and germinal center and not (or weakly) with marginal zone. In accordance with this, substantial proportions of sIg+ cells in spleen cell suspensions did not express HIS22 or HIS24 determinants (20% and 27%, respectively). In bone marrow the vast majority of cytomplasmic mu+ pre-B cells were HIS14+ and HIS24+, and up to one third also HIS22+, indicating an appearance of the determinants early in B lymphocytopoiesis. The antigens recognized by HIS14, HIS22 and HIS24 are lost during the final stage of B cell differentiation: none of the mAb bound to plasma cells. As far as detectable, neither cells of myeloid and erythroid lineages in bone marrow nor thymocytes were stained by HIS14, HIS22, or HIS24. In suspensions of peripheral lymphoid organs (spleen and lymph nodes) but not in thoracic duct lymph, HIS14 and HIS24 labeled a small proportion (12% and 14%, respectively) of Ig- cells. HIS22 did not bind to Ig- peripheral lymphocytes. Reactivity of HIS14, HIS22 and HIS24 with nonlymphoid tissues was virtually absent; HIS22 stained the high endothelial venules in lymph nodes and Peyer's patches. As determined by immunoblotting, the antigenic determinants on lymph node cells recognized by HIS14, HIS22 and HIS24 were present on molecules with an apparent molecular mass of 205 kDa, 210 (and 175) kDa and 205 kDa, respectively, which is similar to the molecular mass of the B cell form of the rat leukocyte common antigen. In addition, the antigens recognized by HIS14, HIS22 and HIS24 co-capped with the leukocyte common antigen. This suggests that each of the three mAb recognize determinants present on the B cell form of the leukocyte common antigen. PMID- 3301370 TI - 5-Hydroxytryptamine stimulates the release of prostacyclin but not thromboxane A2 from isolated rat dental pulp. AB - The effect of 5-hydroxytryptamine (5-HT) on the release of prostacyclin and thromboxane (TX) A2 from isolated rat dental pulp was evaluated. 5-HT (1-1,000 microM) caused a dose-dependent and marked stimulation of the release of prostacyclin but not TXA2. Of the 5-HT-related indolealkylamines tested, only tryptamine had a similar stimulatory effect while tryptophan and 5 hydroxytryptophan had no effect. Neither histamine (100 microM) nor bradykinin (100 microM) had such an effect. Our results suggest the possible involvement of 5-HT receptors in 5-HT-induced stimulation of prostacyclin production in rat dental pulp. PMID- 3301371 TI - 5-year follow-up study of C-peptide secretion in newly diagnosed type I diabetics: relations to HLA-phenotype, insulin requirement and metabolic control. AB - 50 HLA-typed insulin-dependent diabetics were studied at the time of diabetes onset and after 1, 2, 3 and 5 years with regard to C-peptide secretion after combined stimulation with glucose and glucagon, insulin requirement and glycaemic control index. The mean decrease of the residual B-cell reserve was observed within two years. C-peptide secretion was correlated with better metabolic control and lower insulin requirement after more than one year of diabetes duration, but had no influence on this at the time of diabetes onset. The C peptide response sometimes varied between non response and high response in one individual from one investigation to the next. There was no prognostic value of C peptide secretion at diabetes onset for the further development of B-cell function. We found a significantly longer persistence of B-cell function in patients who were older and in those with mild symptoms at diabetes onset. The presence of HLA B8, DR3 antigens was correlated with severe ketoacidosis at manifestation and a more pronounced destruction of B-cell function. PMID- 3301372 TI - LRH-stimulated release of bioactive and immunoreactive LH in a patient with the XX male syndrome. AB - Serum levels of biologically active LH (bLH) and immunoreactive LH (iLH) under basal conditions and in response to the iv injection of 0.1 mg synthetic LRH were measured in a 15-year-old boy with the 46,XX karyotype. LH bioactivity was assessed "in vitro" on mouse Leydig cell preparations, whereas iLH levels were measured by a double antibody RIA technique. High basal levels of both bLH and iLH were shown in the XX male. Following LRH administration, the relative maximum response of LH above basal levels (LH delta %) was higher for iLH than for bLH. Consequently, the LH bioactivity to immunoreactivity (b/i) ratio decreased from basal values. Since a similar decrease in the b/i ratio of LRH-stimulated LH has been observed in patients with Klinefelter's and Turner's syndrome, we can suppose that in the chromosomal disorders of sex differentiation the pituitary gland possesses a lower responsiveness for bLH than the normal pituitary. PMID- 3301373 TI - An evaluation of a commercially available enzyme immunoassay test for the rapid detection of salmonellae in food and environmental samples. AB - A total of 91 food and environmental samples were examined for the presence of salmonellae using a commercially available enzyme immunoassay kit (EIA) and a conventional culture technique. A 78% agreement was obtained, but reexamination of culture-negative, EIA-positive samples gave agreement of 86%. The problem of comparing EIA and culture results is discussed. A partially selective pre enrichment broth was tested in 37 samples and gave better EIA ratios. Artificially contaminated cooked foods gave 100% agreement. PMID- 3301374 TI - Old and new techniques together resolve a problem of infection by Salmonella typhimurium. AB - Isolates of Salmonella typhimurium, recovered over a 9-month period from a child with gastroenteritis, were characterized by biotyping, phage-typing and plasmid profile analysis. Because the data from the different methods were discrepant, it was difficult to establish whether her infection was due to a single strain that had changed character in vivo or was due to recurrent infections with different, unrelated strains. Restriction-enzyme fingerprinting of the plasmids from the different isolates provided an explanation for the initial discrepancy and high lighted a source of potential confusion in epidemiological studies. PMID- 3301375 TI - Comparison of procedures based upon Rappaport-Vassiliadis medium with those using Muller-Kauffmann medium containing Teepol for the isolation of Salmonella sp. AB - A total of 308 samples of different types were examined for the presence of salmonellas by means of three different procedures. The first consisted of pre enrichment in buffered peptone water followed by enrichment in Rappaport Vassiliadis medium (P/RV). The second differed only in that 1% Teepol was added to the pre-enrichment medium (PT/RV). In the third, buffered peptone water with 1% Teepol was followed by enrichment in Muller-Kauffmann tetrathionate broth also containing 1% Teepol (PT/MKT). The first of these combinations (P/RV) proved superior to the others both in terms of isolation rates and in the appearance of suspicious colonies. PMID- 3301376 TI - Investigation of the source of haemolytic Escherichia coli infecting weaned pigs. AB - Attempts were made to discover the source of strains of haemolytic Escherichia coli infecting weaned pigs on a piggery. The organisms were not detected in the faeces of sows in the farrowing house, or in the in the faeces or intestinal tracts of slaughtered bacon pigs or sows. Sows held in a quarantine unit, and their offspring born in the unit, did not excrete haemolytic E. coli until after they were returned to the piggery. The environment of the piggery was the most likely source of infection for weaned pigs, and routine cleaning and disinfection of the accommodation did not prevent infection. Unweaned pigs were however able to transfer haemolytic E. coli to a newly built, previously unused weaning house, and establish a cycle of infection. PMID- 3301377 TI - The assessment of two media for the confirmation of Escherichia coli in water samples in single-tube tests. AB - Two single-tube media, lactose-tryptone-lauryl sulphate broth (LTLSB) and lauryl tryptose-mannitol broth were tested in parallel in a series of 1111 tests on water samples from a variety of sources. LTLSB was found to be superior both in gas and indole production from Escherichia coli when incubated at 44 degrees C and is recommended as the most suitable single-tube confirmatory test for this organism. PMID- 3301378 TI - A food-poisoning incident caused by Clostridium botulinum toxin A in Japan. AB - Food poisoning caused by Clostridium botulinum toxin A occurred in Japan. Eleven (31%) of 36 patients from 14 different areas died of botulism. Most of the patients had eaten commercial fried lotus-rhizome solid mustard without heating. The food, which implicated one of the special local products used for gifts in Kumamoto, was found to have been produced by a manufacturer in Kumamoto prefecture. In Fukuoka prefecture, two of three patients died on days 4 and 8 after eating the food; they had typical symptoms of botulism. A total of 42 packages of the food bought as gifts was collected from different districts in Fukuoka prefecture for examination for both organism and toxin. Thirteen of these (31%) were contaminated with the organism, and in 11 (26%) a small amount of toxin A had been produced. PMID- 3301380 TI - Influenza A and B virus IgG and IgM serology by enzyme immunoassays. AB - Enzyme immunoassays (EIA) for IgG and IgM antibodies against influenza A and B virus are described. One hundred and seven subjects with a clinical diagnosis of acute respiratory infection (influenza, bronchitis or pneumonia) were selected for this study during two epidemics of influenza A which occurred in Finland in 1983 and 1985. Paired sera and nasopharyngeal secretions were obtained from all subjects. The sera were tested for influenza A and B antibodies by IgG and IgM EIAs and by complement fixation tests. The nasopharyngeal secretions were tested by an indirect EIA for influenza A and B antigens. The IgG EIA was found to be better than complement fixation for the diagnosis of influenza A infections: only 22% of the significant increases detected by this test were also positive by complement fixation. The additional contribution of the IgM EIA to the number of positives was minimal. It was also found that testing a single 1/1000 dilution of serum for influenza A and 1/100 dilution for influenza B in the IgG EIA gave as many positives as the conventional method of testing several dilutions. PMID- 3301381 TI - PGI2 and PGE1 induce morphological alterations in human platelets similar to those of the initial phase of activation. AB - The effects of PGI2 and PGE1 on the ultrastructure of human platelets were studied by scanning (SEM) and transmission (TEM) electron microscopy in relation to the record of an optical aggregometer. Addition of PGI2 or PGE1 to citrated platelet-rich plasma (C-PRP) resulted in a permanent slight decrease in percent light transmission (%T) recorded by the aggregometer. SEM investigation of the platelets showed marginal pseudopods and occasional large stomata after application of prostaglandins. These alterations occurred within the initial 30 s and remained constant during the subsequent 20 min of incubation. TEM studies revealed morphological changes of alpha granules and moderately electron-dense material in the dilated profiles of the surface-connected canalicular system (SCCS). Addition of 10 microM ADP to C-PRP preincubated for 30 s with either 2 ng/ml (5 nmol/liter) PGI2 or 30 ng/ml (85 nmol/liter) PGE1 resulted in a further decrease of %T followed by a slight increase. The alterations of the aggregometer tracing were characterized in SEM by platelet shape change and the generation of primary aggregates. C-PRP samples preincubated with 3 and 9 ng/ml (8 nmol/liter and 24 nmol/liter) PGI2 or 40 and 120 ng/ml (113 nmol/liter and 338 nmol/liter) PGE1 did not produce additional changes in the aggregometer curves or in the ultrastructure of platelets in response to ADP. Our morphological study indicates that antiaggregatory prostaglandins induce an early phase of platelet activation but inhibit "shape change" and the formation of aggregates. PMID- 3301382 TI - Megakaryocytic development in liquid cultures of cryopreserved leukocyte stem cell concentrates from chronic myelogenous leukemia patients. AB - The proliferation and differentiation of human megakaryocytes in liquid culture has been obtained using cryopreserved light-density blood cell concentrates from chronic myelogenous leukemia (CML) patients. A large number of megakaryocytes, representing 20%-60% of total cells cultured, developed after 12-14 days in liquid cultures supplemented with human plasma, while fetal calf serum supported the development of cells of the megakaryocytic lineage poorly. Ploidy studies showed the presence of 8N and 16N cells in human plasma-supplemented cultures while very few cells with DNA content greater than 4N were found in those supplemented with fetal calf serum. Using the FACS IV cytofluorometer, 1-2 X 10(6) megakaryocytes/h were sorted after immunolabeling of the human plasma cultured cells with a monoclonal antibody reacting against the platelet glycoprotein complex IIb-IIIa. Thus, cryopreserved CML blood stem cell concentrates seem to offer a reproducible source of human megakaryocytes that retain their capacity to proliferate and differentiate in liquid cultures. These megakaryocytes can be used for the study of platelet glycoprotein biosynthesis as well as the regulation of megakaryocytopoiesis. PMID- 3301383 TI - Alpha-1-proteinase inhibitor: a European overview. PMID- 3301379 TI - A new concept of the epidemic process of influenza A virus. AB - Influenza A virus was discovered in 1933, and since then four major variants have caused all the epidemics of human influenza A. Each had an era of solo world prevalence until 1977 as follows: H0N1 (old style) strains until 1946, H1N1 (old style) strains until 1957, H2N2 strains until 1968, then H3N2 strains, which were joined in 1977 by a renewed prevalence of H1N1 (old style) strains. Serological studies show that H2N2 strains probably had had a previous era of world prevalence during the last quarter of the nineteenth century, and had then been replaced by H3N2 strains from about 1900 to 1918. From about 1907 the H3N2 strains had been joined, as now, by H1N1 (old style) strains until both had been replaced in 1918 by a fifth major variant closely related to swine influenza virus A/Hswine1N1 (old style), which had then had an era of solo world prevalence in mankind until about 1929, when it had been replaced by the H0N1 strains that were first isolated in 1933. Eras of prevalence of a major variant have usually been initiated by a severe pandemic followed at intervals of a year or two by successive epidemics in each of which the nature of the virus is usually a little changed (antigenic drift), but not enough to permit frequent recurrent infections during the same era. Changes of major variant (antigenic shift) are large enough to permit reinfection. At both major and minor changes the strains of the previous variant tend to disappear and to be replaced within a single season, worldwide in the case of a major variant, or in the area of prevalence of a previous minor variant. Pandemics, epidemics and antigenic variations all occur seasonally, and influenza and its viruses virtually disappear from the population of any locality between epidemics, an interval of many consecutive months. A global view, however, shows influenza continually present in the world population, progressing each year south and then north, thus crossing the equator twice yearly around the equinoxes, the tropical monsoon periods. Influenza arrives in the temperate latitudes in the colder months, about 6 months separating its arrival in the two hemispheres. None of this behaviour is explained by the current concept that the virus is surviving like measles virus by direct spread from the sick providing endless chains of human influenza A.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3301384 TI - Failure to demonstrate disruption of ultradian growth hormone rhythm and insulin secretion by dorsomedial hypothalamic nucleus lesions that cause reduced body weight, linear growth and food intake. AB - Weanling male rats received bilateral electrolytic lesions in the dorsomedial hypothalamic nuclei (DMNL rats); sham-operated animals served as controls. At the end of a 39-day postoperative period DMNL rats were lighter and shorter than controls and also exhibited significant hypophagia. Their efficiency of food utilization (weight gained for the amount of food eaten) was normal, however. Subsequent determination of plasma growth hormone (GH) and insulin (IRI) levels every 15 min for 6-h periods from freely moving chronically cannulated rats showed no differences in pulsatile patterns and peaks of GH nor in plasma IRI levels between DMNL rats and controls. There was also no significant difference between mean 6-H GH and IRI concentrations between the two groups. The reduced body weight, length and food intake are apparently unrelated to the normal GH and IRI secretory patterns. In conjunction with previous data indicating normal somatomedin activity and normal responses to various homeostatic challenges, the data make a strong case for the argument that DMNL rats are not "growth retarded". Rather, they are normal animals that are "scaled-down" to a smaller size with maintenance of normal homeostatic capacity. This has been hypothesized to be due to the existence in these animals of an "organismic" set point. PMID- 3301385 TI - An annotated interview with Giuseppe Moruzzi, 1910-1986. Interview by Louise M. Marshall. AB - Utilizing three modes of information exchange, this "annotated autobiography" presents in perspective a picture of an eminent neuroscientist of the 20th century. The reminiscences of Guiseppe Moruzzi, Director of the Institute of Physiology of the University of Pisa for more than thirty years, were combined with contemporary tributes, a review of his major published work, and comments of friends and associates. Such a three-dimensional view of a scientific career illustrates the possibilities of "the medium is the message." PMID- 3301386 TI - Hymenolepis diminuta: interactions of the isolated brush border membrane with proteolytic enzymes. AB - Proteins of the isolated brush border membrane of Hymenolepis diminuta were hydrolyzed in vitro by chymotrypsin, papain, pepsin, subtilopeptidase A (= subtilisin Carlsberg), and trypsin. Neither proteolytic nor amidase activity was demonstrable in the isolated membrane using proteinaceous (casein and hemoglobin) or chromogenic (benzoyl-arginine-p-nitroanilide and succinyl-alanyl-alanyl-propyl phenylalanine p-nitroanilide) substrates, and the membrane preparation did not inhibit the proteolytic and amidase activities of these enzymes. Thus, the isolated tegumental membrane of H. diminuta is not inherently resistant to the action of proteolytic enzymes, and it does not inhibit proteolytic activity. In control incubations containing only buffer, the alkaline phosphatase activity of the brush border membrane decreased in a time dependent manner, but in the presence of chymotrypsin, subtilopeptidase A, and trypsin, the membrane retained greater alkaline phosphatase activity (pepsin and papain could not be tested for this effect on alkaline phosphatase activity). A similar time dependent decrease in activity was also noted for each of the proteolytic enzymes in control assays, but subtilopeptidase A and papain retained greater activity in the presence of the isolated membrane preparation when these assays were compared to controls. PMID- 3301387 TI - Hymenolepis diminuta and H. nana: cross immunity against the lumen phase in BALB/c mice. AB - When BALB/c mice initially given cysticercoids of Hymenolepis diminuta orally (Day 0) were challenged with eggs or cysticercoids of H. nana, almost all the mice became completely resistant to H. nana challenges from Day 30 onward, and no luminal adults of H. nana were established. There was a tendency for the number of tissue cysticercoids recovered 4 days after egg challenge in immunized mice to be much less than that in control mice (P less than 0.001, Student's t test). However, when these cysticercoids recovered from immune group mice were inoculated into uninfected mice, they matured in the lumen. Thus, the cross immunity to H. nana challenge evoked by an initial prepatent infection with H. diminuta appeared to be directed not against the tissue phase but against the lumen phase of H. nana. When BALB/c mice initially given eggs of H. nana were challenged with H. diminuta, they became resistant to H. diminuta from Day 15 onward. When the mice given eggs of H. nana were treated with a cestocide, praziquantel, at the beginning of the expected luminal development of H. nana and experienced a tissue phase only before challenge with H. diminuta, they showed no resistance to H. diminuta. Thus, the cross immunity to H. diminuta challenge evoked by an initial patent infection with H. nana appeared to be due to the immunogens of the lumen phase of H. nana but not those of the tissue phase. The cross immunity may be, therefore, essentially evoked by the lumen phase of these two phylogenetically closely related species and not by or against the tissue phase of H. nana.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301388 TI - Trypanosoma cruzi: inhibition by spirogermanium hydrochloride. AB - Spirogermanium is an antineoplastic agent that has been shown to be useful for the treatment of a variety of solid tumors and Plasmodium falciparum infection. We found that this agent, at concentrations of 1-10 micrograms/ml, markedly inhibited the growth of epimastigotes of Trypanosoma cruzi. This inhibition of growth was seen in liver infusion tryptose cultures as well as on agar where colonial growth was inhibited markedly. Ultrastructural studies demonstrated that affected organisms were round and swollen and contained vacuoles, lamellar structures, and multivesicular bodies. Spirogermanium also significantly decreased the growth of intracellular amastigotes in myotubes. Pretreatment of myotubes with the agent protected them from infection with trypomastigotes but tachyzoites of Toxoplasma sp. readily infected pretreated cells. These data suggest that spirogermanium may be useful as a chemotherapeutic agent against T. cruzi. PMID- 3301389 TI - Trypanosoma cruzi: growth requirements at different temperature in fetal bovine serum or peptide supplemented media. AB - An enriched synthetic medium with low molecular weight peptides allows Trypanosoma cruzi epimastigotes to grow at 26-37 C. Using this medium, the growth requirements of T. cruzi were compared at different temperatures. When supplemented with fetal bovine serum or serum peptides, nine amino acids were absolutely required from the first passage, while additional amino acids and amino acid precursors were needed to support growth during a second passage. Five amino acids (beta-alanine, glutamine, cysteine, ornithine, and threonine) were also required absolutely at temperatures ranging between 30 and 37 C. Nine vitamins were needed at all temperatures, while ascorbic acid and ergocalciferol were not necessary at any temperature. The remaining amino acids and vitamins showed a variable role as growth factors depending on the temperature increase. In peptide supplemented media, requirements for amino acids and their precursors, as well as vitamins and nucleotides, increased markedly when compared with the protein supplemented medium. A peptide composed of one glutamic acid, two alanines, and one lysine can substitute for serum for trypanosomal growth at all temperatures. Several minimum media have been prepared in which epimastigote forms of T. cruzi can grow at 26-37 C for more than 10 passages. PMID- 3301390 TI - Plasmodium berghei and Plasmodium chabaudi: a neutral endopeptidase in parasite extracts and plasma of infected animals. AB - By using a sensitive fluorometric method with Val-Leu-Gly-Arg-3-amino-9 ethylcarbazole (VLGR-AEC) as a substrate, two endopeptidase activities were identified in two fractions of Sephacryl S-200 gel filtration from soluble P. berghei and P. chabaudi extracts. Controls with normal mouse erythrocytes, with leukocytes, and with reticulocyte enriched blood and different washing procedures during the preparation of soluble P. berghei extracts showed that the MW greater than 200 kDa fraction was a contaminant from erythrocytes and exhibited an optimal pH activity of 8.2. In contrast, the fraction 130 kDa was related to P. berghei and P. chabaudi and exhibited an optimal pH activity of 7.4. The two enzyme activities were compared with eight different substrates. The parasite endopeptidase showed a strong activity with Val-Leu-Gly-Lys-AEC (VLGK-AEC) and Ser-Gly-Lys-AEC (SGK-AEC) as substrates; in contrast, the mouse host endopeptidase poorly cleaved the VLGK-AEC and did not cleave SGK-AEC. Presence of the hydrophobic benzyl group on serine reduced the hydrolizing properties of P. berghei endopeptidase: the reverse was observed with host endopeptidase. The hydrolysis of the N-polyhydroxyalcanoyl-VLGK-AEC substrate by the parasite neutral endopeptidase strongly increased with the schizogonic stage, as shown with synchronized P. chabaudi in mice. By its physiological pH and specificity the release of this enzyme in mouse plasma during the infection could be of interest in a peptidyl-drug strategy. PMID- 3301392 TI - Relation between protective potency and specificity of antibodies in sera of tetanus immunized individuals. AB - Out of 157 human sera analyzed for antitetanus antibody content by ELISA, 13 turned out to contain only anti-BIIb antibodies, of which 8 proved to be neutralizing. Of these, the 3 sera 303, 306 and 312 together with a commercially available standard preparation of human antitetanus immunoglobulins were further analyzed as to their antibody composition by ELISA using plates sensitized with either the toxoid or various tetanus toxin-derived fragments. It was verified that the protective potency of these antisera was related mainly to their anti BIIb antibody content. Adsorption experiments confirmed that anti-BIIb antibodies were primarily involved in toxin neutralization, although the presence of high levels of both anti-alpha and anti-Ibc antibodies could confer neutralizing capacity on the sera. A rabbit antiserum raised with the BIIb fragment resulted in a neutralizing antiserum that allowed us to calibrate the ELISA with the anti BIIb antibodies as International Units. PMID- 3301393 TI - Cluster analysis of antibiotic susceptibility patterns of clinical isolates as a tool in nosocomial infection surveillance. AB - Hospital infections represent a major epidemiological problem. The first step in the detection of nosocomial infections consists in assessing the probability that two or more isolates from different patients are similar or different. Many methods are available for typing purposes. Among these, antibiotic susceptibility patterns do not need extra cost or extra work and are available "on line" every moment they are needed. A mathematical technique of elaboration is proposed for disk zone sizes, in order to assess the probability of two or more clinical isolates to be the same strain. Antibiograms performed according to Kirby-Bauer are evaluated detecting zone sizes by a computer controlled device and then submitted to cluster analysis. Similarity of strains is reported in a dendrogram, in which strains are successively fused. Strains that share a common susceptibility pattern are considered a "cluster". At last, epidemiological maps are constructed for each group of strains, in which all the isolates are reported, ordered for patients, plotted on the day the specimen was collected, drawn in a different shape according to the source of specimen, and shadowed by the pattern of its cluster. This method of reporting data directly allows to detect cross infections among patients and can be used as a first typing step before other more expensive procedures. PMID- 3301391 TI - The development of virus-free labile blood derivatives--a review. AB - Human blood plasma derived coagulation factor concentrates carry a substantial risk of virus transmission as traditionally prepared. Intensive investigations during the past 5 years have led to the development of several virus sterilization procedures which can be applied to these concentrates as well as to other labile protein derivatives. This review summarizes detailed information which is now available establishing the virucidal potency of these procedures, particularly with regard to the contaminating viruses of most concern: hepatitis B, non-A, non-B hepatitis and the AIDS virus. Currently utilized virus sterilization procedures have greatly reduced or eliminated the transmission of AIDS virus, HIV. The transmission of non-A, non-B hepatitis virus (NANBHV) has also been greatly reduced by some but not all of these procedures. Additional virus safety data in man will be required to establish whether any of the procedures gives products which are totally safe from NANBHV transmission and to assess their impact on other blood-borne viruses. PMID- 3301394 TI - Epidemiological diagnosis of asthma: methodological considerations of prevalence evaluation. AB - Within an epidemiological survey on Chronic Obstructive Pulmonary Disease, before reporting data on the prevalence of bronchial asthma we checked the group of subjects defined as "pathological" by means of a suitable questionnaire and a group of "normals" as a control. We evaluated the sensitivity and specificity of the questionnaire, in comparison with a clinical evaluation made by two physicians and controlled the relationship among their results, non-specific bronchial hyperreactivity and skin tests. In particular the correspondence between diagnosis made by physicians from a clinical evaluation and that obtained by questionnaire was not satisfactory. We suggest the importance of employing physicians for an epidemiological approach to asthma, in absence of a valid objective criterion. PMID- 3301396 TI - [Anti-inflammatory properties of asperase--a new enzymatic substance with proteolytic action]. AB - The anti-inflammatory effect of asperase was shown on models of protein, aerosil and formalin edemas. The effect was the same as that of trypsin and was more pronounced as compared with that of chymotrypsin. Intramuscular administration of asperase stimulated the growth of granulation tissue as well. Inhibition of the enzyme activity with respect to a high molecular protein (casein) had no influence on the manifestation of its anti-inflammatory effect. PMID- 3301395 TI - Medical significance of the so-called black yeasts. AB - Infections caused by the black yeasts (leveduras pretas) are reviewed with respect to their clinical manifestations, classification under the umbrella term, phaeohyphomycosis, and differentiation from chromoblastomycosis. Data on the prevalence of black yeasts submitted to a national reference diagnostic center are provided. Cases of phaeohyphomycosis caused by Aureobasidium pullulans, Exophiala jeanselmei, E. moniliae, E. spinifera, Phaeoannelomyces werneckii, Phaeosclera dematioides, Sarcinomyces phaeomuriformis, and Wangiella dermatitidis are described. PMID- 3301398 TI - [Possibilities of evaluating the activity of the drug biotransformation system in clinical pharmacology]. PMID- 3301397 TI - [Improved local hemolysis method for evaluating immunotropic agents]. AB - A modification of A. J. Cunningham method (1965) is proposed. Positive characteristics of the modification are: simplicity and availability of the production of chambers, the possibility of their repeated use, the use of the sealing support for incubation and counting of hemolysis zones. Two series of experiments were performed to determine sensitivity and reproducibility of the modification as compared with the method of N. K. Jerne and A. A. Nordin (1963). PMID- 3301399 TI - Synthesis and antifungal activities of N-arylideneaminoimidazole derivatives. AB - The synthesis and microbiological activities of 1-arylideneaminoimidazole derivatives are reported. Antimicrobial data show that some of the tested imidazoles exhibited an interesting activity on Candida albicans. PMID- 3301400 TI - A putative internal promoter in the 16 S/23 S intergenic spacer of the rRNA operon of archaebacteria and eubacteria. AB - The existence of the internal promoter Pi in the 16 S/23 S intergenic spacers of the rRNA operons of an eubacterium Escherichia coli and archaebacterium Halobacterium halobium is proposed. The possible functional significance of these promoters is discussed. PMID- 3301401 TI - Role of Mg2+ in the ribozyme system. AB - Recently, several kinds of catalytic activities have been identified from L-19 IVS RNA or 'ribozyme'. In the catalytic process of ribozyme, Mg2+ is required. We investigated the role of Mg2+ by molecular orbital calculation. Based on the results of the calculation, a model for the self-splicing reaction was constructed. PMID- 3301402 TI - The glucose sensor in HIT cells is the glucose transporter. AB - The nature of the rate-limiting step for glucose utilization by the clonal insulin-producing cell line HIT-T15 has been investigated. In contrast to the situation in islets of Langerhans, we find that the HIT cell glucose metabolism is limited by the rate of entry of glucose into the cell. This is evidenced by the low rate of sugar transport and by the marked reduction in the rate of glucose utilization elicited by inhibitors of the glucose transporter. As judged by competition with glucose, the HIT cell glucose transporter also transports mannose, 2-deoxyglucose and 3-O-methylglucose but not L-glucose or N acetylglucosamine. The Km for glucose of the glucose transporter, measured as the concentration of glucose required for a half-maximal rate of glucose utilization, is 4.3 mM, similar to the concentration reported to give half-maximal insulin release. Glucose-stimulated insulin release from HIT cells is inhibited by phloretin or cytochalasin B but not by mannoheptulose. We conclude that the secretory responses of HIT cells are consistent with the substrate-site hypothesis, but that, in contrast to normal B-cells, the glucose sensor which confers concentration-dependence and specificity to sugar-stimulated insulin release, is the glucose transporter. PMID- 3301403 TI - Prothoracicotrophic hormone has an insulin-like tertiary structure. AB - A three-dimensional model of PTTH-II has been constructed using interactive computer graphics and energy, minimisation techniques, assuming homology with porcine insulin, the structure of which has been determined by X-ray analysis. The model shows that PTTH-II can assume an insulin-like tertiary structure, which is compact with the exception of the sequence variable NH2-terminal amino acids of the B chain. Most of the hydrophobic core residues including A2 Ile, A6 Cys, A11 Cys, A16 Leu, A20 Cys, B11 Leu, B15 Leu and B19 Cys are identical in PTTH-II and insulins. The glycines at A1, B8 and B23 allow the chain to assume the characteristic tertiary interactions of the insulin fold and although polypeptide chains are shorter at the COOH-termini of the A and B chains and extended at the NH2-terminus of the B chain, the insulin-like tertiary structure can still be assumed. It is unlikely that PTTH-II forms either dimers or hexamers, characteristic of porcine and human insulin, and the model is consistent with the inability of PTTH-II to bind anti-insulin antibodies or insulin receptors. A hydrophobic surface region of PTTH-II may be involved in intermolecular actions of physiological relevance. We discuss the implications of our model for evolution of this family of hormones and growth factors. PMID- 3301404 TI - Ile-Ser-bradykinin (T-kinin) and Met-Ile-Ser-bradykinin (Met-T-kinin) are released from T-kininogen by an acid proteinase of granulomatous tissues in rats. AB - An acid proteinase of granulomatous tissues in rats with carrageenin-induced inflammation released kinin from T-kininogen. The kinin isolated by n-butanol extraction was separated by reverse-phase high-performance liquid chromatography into T-kinin and a T-kinin derivative. From determination of its amino acid composition and its immunoreactivity toward anti-bradykinin antiserum, the T kinin derivative was identified as Met-Ile-Ser-bradykinin (Met-T-kinin). PMID- 3301405 TI - Action of rat liver cathepsin B on bradykinin and on the oxidized insulin A chain. AB - Rat liver cathepsin B was tested for its peptide-bond specificity against bradykinin and the oxidized insulin A-chain. Bradykinin was shown to be resistant to the action of cathepsin B. One possible reason for this resistance is the proline content of the peptide and the discrimination against proline residues at three or four subsites of cathepsin B. Oxidized insulin A-chain was degraded by a peptidyl dipeptidase activity. Three dipeptides were cleaved from the C-terminal part of the insulin A-chain after having been incubated for 2 h (molar ration E:S = 1:2800) and six dipeptides were released after a longer digestion (10 h, E:S = 1:575). PMID- 3301407 TI - Rapid changes of heat and desiccation tolerance correlated with changes of trehalose content in Saccharomyces cerevisiae cells subjected to temperature shifts. AB - The trehalose content of exponentially growing Saccharomyces cerevisiae cells rapidly increased in response to a temperature shift from 27 to 40 degrees C and decreased again when the temperature was shifted back from 40 to 27 degrees C. These changes were closely correlated with increases and decreases in the thermotolerance and desiccation tolerance of the cells. Our results support the hypothesis that trehalose functions as a protectant against heat and desiccation. PMID- 3301406 TI - Control of proteolysis in perifused rat hepatocytes. AB - The mechanism by means of which amino acids inhibit intrahepatic protein degradation has been studied in perifused rat hepatocytes. Proteolysis was extremely sensitive to inhibition by low concentrations of amino acids. A mixture of 0.5 mM leucine and 1-2 mM alanine, concentrations found in the portal vein of the rat after feeding, inhibited proteolysis to the same extent as a complete physiological mixture of amino acids. Inhibition by these two amino acids was accompanied by a rise in the intracellular concentrations of glutamate and aspartate, and was largely prevented by addition of glucagon, by addition of the transaminase inhibitor aminooxyacetate, or by omission of K+. Acceleration of proteolysis by K+ depletion was accompanied by a fall in intracellular glutamate caused by an increased rate of transport of this amino acid to the extracellular fluid. It is concluded that intracellular leucine, glutamate and aspartate are important elements in the control of hepatic protein degradation. PMID- 3301408 TI - Studies on interaction of 5 S RNA with ribosomal proteins. AB - Proteins of the large ribosomal subunit of rat liver (TP 60) were immobilized by diffusion transfer onto nitrocellulose after two-dimensional polyacrylamide gel electrophoresis (2-D PAGE). Incubation of the TP 60 blots with 32P-labeled 5 S RNA under defined ionic conditions (300 mM KCl, 20 mM MgCl2) resulted in specific binding to a limited set of ribosomal proteins consisting of proteins L3, L4, L6, L13/15 and--to a lesser extent--L7 and L19. Under identical conditions, blots with proteins of the small ribosomal subunit (TP 40) did not bind 5 S RNA. PMID- 3301409 TI - Binding of low-density lipoprotein to monolayer cultures of rat hepatocytes is increased by insulin and decreased by dexamethasone. AB - Rat hepatocytes were maintained in monolayer culture for 20 h in the presence of 10% (v/v) newborn calf serum and then for a further 1-24 h in serum-free medium containing 2 g bovine serum albumin/l. The specific binding of human 125I-LDL to two distinct sites was then measured at 4 degrees C. Binding to site 1 was displaced by dextran sulphate while that to site 2 was not. The presence of 1-100 nM insulin for 24 h in the second incubation significantly increased binding to site 1. Significant increases were also seen when cells were incubated with 10 nM insulin for 1 h. No significant effects of insulin on binding to site 2 were observed. In contrast, 10 nM-1 microM dexamethasone decreased binding to both sites. The effects of these hormones were mutually antagonistic. PMID- 3301410 TI - Saccharomyces cerevisiae mRNA populations of different intrinsic stability in unstressed and heat shocked cells display almost constant m7GpppA:m7GpppG 5'-cap structure ratios. AB - The half-lives of mRNAs in yeast vary from about 1 to over 100 min. While mRNA stabilities must strongly influence overall gene expression in this organism, very little is known about how they are determined. Labellings of yeast cells were conducted to investigate whether the 5'-cap structures of yeast mRNAs might influence their stability. Variation of the pulse-labelling period from 7.5 min to 120 min did not have any major influence on the relative labelling of m7GpppA (A cap) and m7GpppG (G cap) in total polyadenylated RNA. Whether an mRNA has the A cap or the G cap does not therefore have a marked effect on its stability. During the heat shock response the relative labelling of A caps to G caps in total polyadenylated RNA also does not fluctuate appreciably. This indicates that cap structure alone does not determine the destabilisation of non-heat shock mRNAs and stabilisation of heat shock mRNAs during this stress response. PMID- 3301411 TI - Polyamines inhibit the yeast histone deacetylase. AB - n-Butyrate inhibits the histone deacetylase from higher cells, but has little effect on the enzyme activity in Saccharomyces cerevisiae. Spermine and spermidine were therefore tested as potential yeast deacetylase inhibitors and found to inhibit fully the enzyme at 2 and 5 mM, respectively. The utility of these inhibitors was demonstrated by showing that 2 mM spermine substantially increased the incorporation of [3H]acetate into histone in a yeast nuclear acetyltransferase assay. PMID- 3301412 TI - N-terminal methylation of proteins: structure, function and specificity. AB - A common site for the posttranslational modification of proteins is at the N terminal alpha-amino group. Here we consider the enzymatic addition of one or more methyl groups that has been found to occur in several proteins. Although the methylated proteins have different overall functions, they all appear to be involved in large macromolecular structures such as ribosomes, myofibrils, nucleosomes, pilins, or flagella. Structural features at the N-termini of these methylated proteins suggest that sequences in this region may serve as recognition sites for only a few different types of methylating enzymes. Thus, we propose that three enzymes could account for the N-methylated species so far identified in bacteria, the hypothetical MAK, QP, and pilin methyltransferases, and a single additional enzyme, the hypothetical PK methyltransferase, could account for all of the alpha-amino methylations observed in eukaryotic cells. Finally, we discuss criteria that could be used in conjunction with primary sequence data to predict proteins that might be subject to methylation at their amino termini. PMID- 3301413 TI - Acute changes in myo-inositol uptake and 22Na+ flux in murine neuroblastoma cells (N1E-115) following insulin. AB - myo-Inositol uptake was investigated in a murine neuroblastoma clone (N1E-115) to determine the effect of altered Na+,K+-ATPase activity. The Na+ ionophore monensin, and veratridine, an alkaloid affecting voltage-dependent Na+ entry, increased acute 22Na+ uptake and 22Na+ efflux from pre-loaded cells, concomitant with enhanced myo-inositol uptake. This effect was also seen following insulin. Insulin-stimulated myo-inositol uptake was inhibited by amiloride, ouabain and pyrithiamine. Amiloride inhibition suggests that activation of Na+/H+ exchange preceding Na+,K+-ATPase activation is involved in insulin stimulation of myo inositol uptake. Pyrithiamine inhibition is an indication of prior activation of the Na+,K+-ATPase alpha + catalytic subunit by insulin. The results provide evidence that insulin contributes to the maintenance of Na+,K+-ATPase in neuronal tissue. PMID- 3301414 TI - Tryptophan 54 and phenylalanine 60 are involved synergistically in the binding of E. coli SSB protein to single-stranded polynucleotides. AB - The binding of both wild-type and point-mutated E. coli single-stranded DNA binding (SSB) protein to poly(deoxythymidylic acid) has been studied by fluorescence and optical detection of triplet state magnetic resonance spectroscopy. Involvement of tryptophan residues 40 and 54 in stacking interactions with nucleotide bases has been inferred earlier from such studies. Investigation of a point mutation in the E. coli SSB gene product obtained by site specific oligonucleotide mutagenesis in which Phe-60 is replaced by alanine strongly suggests the participation of Phe-60 in the binding process, possibly by the formation of an extended stacking structure by Trp-54, thymine and Phe-60. This hypothesis is supported by results on the point mutations in which His-55 is replaced by either leucine or tyrosine. PMID- 3301415 TI - Proteolysis rates of a myosin heavy chain site with papain. Evidence for a combined LC2-filament-mediated mechanism. AB - In striated muscle myosin, a proteolysis site at the 25-50 kDa junction, susceptible in the filament and efficiently protected by nucleotides, is similarly protected when myosin is monomeric. Kinetic studies at low ionic strength show a close relationship between LC2 cleavage or degradation rate and cleavage of the 25-50 kDa heavy chain site. The myosin-[(T)-LC2'] species forms normal reconstituted filaments but its 25-50 kDa site susceptibility is closer to that of monomeric myosin, thus becoming practically ionic strength-independent. In this species the absence of the LC2 N-terminal segment induces a significantly greater susceptibility of the papain-sensitive site in LC1. In an LC2-depleted myosin the 25-50 kDa site susceptibility also becomes ionic strength-independent, however, the cleavage rates are then closer to that of filaments. Susceptibility in HMM and S1 is also much less dependent on ionic strength with rates intermediary between those of filament and monomer. These observations show that the maximum susceptibility to papain of the 25-50 kDa site requires both the integrity of the LC2 light chain and the filament structure and furthermore provide evidence that: (i) the LC2 N-terminus interacts specifically with some part of the filament; (ii) this interaction induces a specific transconformation in a region close to the ATPase active site; (iii) there is an interrelationship between LC1 and LC2 light chain N-terminal extremities, at least in the filament structure. PMID- 3301416 TI - Effect of exogenous luteinizing hormone-releasing hormone on hypothalamic pituitary function in women with ovarian failure. AB - Pituitary luteinizing hormone (LH) pulse frequency and amplitude were assessed as an indirect indicator of hypothalamic luteinizing hormone-releasing hormone (LH RH) release in women with evidence of ovarian failure. Exogenous LH-RH (20 micrograms) was administered intravenously every 2 hours for 48 hours to determine the effect on pituitary LH release and the hypothalamic pulse generator for LH-RH secretion. This study design was used to investigate the possibility of an ultrashort negative feedback of LH-RH upon the synthesis and release of endogenous LH-RH. A wide range of LH pulse frequencies (8 to 28 pulses/24 hours) was present in these women. There was no discernible inhibition of hypothalamic LH-RH pulse frequency during or following exogenous LH-RH administration. Mean peripheral LH levels were significantly increased during exogenous LH-RH administration (P = 0.0038), reflecting both an increased baseline and an augmented pituitary LH response to the exogenous LH-RH. There were no differences found in LH pulse amplitude before and after LH-RH treatment. These data indicate that pituitary LH secretion in women with ovarian failure can be further stimulated by exogenous LH-RH. However, there was no evidence for inhibition of either pituitary LH secretion or hypothalamic LH-RH release using this administration schedule of exogenous LH-RH. PMID- 3301417 TI - Homologous artificial insemination for oligoasthenospermia: a randomized controlled study comparing intracervical and intrauterine techniques. AB - Homologous artificial insemination (AIH) is used to treat infertility caused by oligoasthenospermia, despite the lack of controlled studies confirming its benefit. This prospective randomized controlled trial was undertaken to determine whether intracervical (IC-AIH) or intrauterine (IU-AIH) homologous artificial insemination improves pregnancy rates in couples with infertility attributable to oligoasthenospermia alone. Twenty couples were randomized to receive IC-AIH or IU AIH. Sixty-three insemination cycles were completed. During the same study period, 35 cycles with timed vaginal intercourse alone were assessed. Four pregnancies occurred, all following timed vaginal intercourse. No pregnancies resulted from IC-AIH or IU-AIH. This suggests that neither IC-AIH nor IU-AIH is of benefit when oligoasthenospermia is the cause of infertility. Pregnancies previously attributed to AIH may also have been conceived as a result of vaginal intercourse. This confounding effect on the results of AIH should always be considered. PMID- 3301418 TI - [The genesis of respiration-related sensations]. PMID- 3301419 TI - [Hormonal function of the insular apparatus and erythrocyte insulin-binding capacity during adaptation of the rat to high altitude]. AB - Changes in blood glucose, glucagon and insulin as well as changes in insulin binding by specific receptors on blood erythrocytes, were studied in 45 rats on various days of adaptation to high altitude. By the 14th day the levels of blood insulin and glucagon were steadily decreasing, whereas glucose homeostasis remained on the same level. Insulin binding by receptors on erythrocytes increased on the 3rd and particularly on the 14th day. The importance of the said reaction is discussed in connection with its compensatory nature in maintaining increased glycolysis in erythrocytes and 2,3-DFG levels in them which in its turn leads to changes in hemoglobin affinity to oxygen and correction of tissue hypoxia. PMID- 3301420 TI - [Effect of 5,6-hydroxytryptamine and various light schedules on the hypothalamo hypophyseo-gonadal system of the female rat]. AB - Hypothalamic luliberin and plasma lutropin concentration were studied under normal light-darkness cycle or under constant illumination in rats. Some of them were injected with 5,6-dihydroxytryptamine (5,6-HTA) into the lateral brain ventricle. Constant illumination led to a persistent oestrus with a significant drop in plasma lutropin and a decrease in hypothalamic luliberin. Destruction of serotoninergic terminals with 5,6-HTA resulted in an opposite effect and prevented to some extent inhibiting influence of constant illumination. Luliberin synthesis and secretion seem to be suppressed by serotoninergic nerve terminals on the luliberin producing cells as well as by serotonin reaching the hypothalamus from the pineal gland. PMID- 3301421 TI - [The vascular wall as an efferent regulator of immunogenesis, hemostasis, the kallikrein-kinin system and regenerative processes]. AB - Polypeptide factor isolated from vascular wall of the cattle ("vasonin") was shown to affect the immunogenesis and hemostasis, to stimulate kallikrein-kinin system and to accelerate processes of regeneration. PMID- 3301422 TI - The effect of a single transfusion of allogeneic or xenogeneic blood on skin allograft survival in mice. PMID- 3301423 TI - [The effects of carbamylation of hormones on their biological activities--with reference to 3,5,3'-L-triiodothyronine and insulin]. AB - It has been demonstrated that the binding of cyanic acid, formed from urea which is increased in renal failure, to hemoglobin (Hb) results in the formation of HbA1. The combination of Hb and cyanic acid is called carbamylation, a nonspecific reaction between protein and cyanic acid. It is theoretically considered that like glycation, carbamylation may occur between cyanic acid and not only Hb but also various peptides and proteins. In the present study, hormones were subjected to carbamylation, and the effects of carbamylation on the biological activity of the hormones, i.e. 3,5,3'-L-triiodothyronine (T3) and insulin, were investigated. Carbamylated T3 and carbamylated insulin were synthesized in vitro, using KCNO. The carbamylated hormones were isolated by high performance liquid chromatography (HPLC). The biological activities of carbamylated T3 and carbamylated insulin were assayed by employing the metamorphosis of tadpoles (Rana nigromaculata) and the glucose oxidation of fat cells or the receptor binding capacity of rat hepatocytes, respectively. The biological activity of carbamylated T3 was less than about 1/13 of that of T3, and the binding activity of carbamylated insulin was 1/5 of that of insulin. Therefore, carbamylation of hormones may be an important factor in the analysis of clinical conditions, especially the endocrine condition in renal failure. PMID- 3301424 TI - Starting, stopping, and spacing during the early stages of fertility transition: the experience of German village populations in the 18th and 19th centuries. AB - Examination of the reproductive histories of a sample of German married couples during the 18th and 19th centuries provides insights into behavioral changes involved in the shift from natural fertility to deliberate marital fertility control. A simple accounting scheme is used to assess the relative contributions of starting, spacing, and stopping to changes in family size during the initial phases of the fertility transition. The results suggest that in rural Germany, attempts to terminate childbearing prior to the end of the reproductive span were far more important in initiating the onset of fertility transition than efforts to deliberately prolong intervals between births or changes in the timing of the start of childbearing. PMID- 3301425 TI - Metropolitan and nonmetropolitan migration streams: 1935-1980. AB - Results based on an analysis of migration streams involving the metropolitan and nonmetropolitan sectors and covering a longer time interval than previously possible indicate that efforts to describe changes in the volume of movements connecting these sectors could benefit from greater attention to other related streams as well as existing patterns of population concentration. The metropolitanization process continues but is now being affected substantially by regional redistribution trends. Regional differentials in the size of metropolitan and nonmetropolitan migration streams are declining but are still substantial, so an equilibrium balance between the metropolitan and nonmetropolitan sectors will probably not occur in the immediate future. PMID- 3301426 TI - [Preparation of plastic dentures with greater occlusal precision. New from Inkovac. Improvements in a proven system]. PMID- 3301427 TI - [Procedures for improved retention. Flash addition of metal particles]. PMID- 3301428 TI - [Shot peening. An alternative surface preparation]. PMID- 3301429 TI - [Ceragold foil crowns--further development of a proven procedure]. PMID- 3301430 TI - [Skillful dental technic. Path to the "Golden Parallelometer"]. PMID- 3301431 TI - Occlusion in the combination fixed removable prosthodontic patient. AB - The authors provide a review of the critical aspects of occlusion for the combination fixed removable patient. Articular selection and jaw relation techniques are reviewed, and dental materials combinations are recommended for restoring opposing occlusal surfaces. General objectives and specific recommendations for determining and establishing occlusal schemes are made. Tables outlining occlusal scheme, occlusal morphology, and degree of balance are presented. PMID- 3301432 TI - Aspects of metal-ceramic bonding. AB - Despite many problems associated with ceramometal crowns of any alloy composition, their continued widespread use attests to their clinical effectiveness. This is due to the very positive aspects of many of their properties. PMID- 3301433 TI - The provisional restoration. AB - The utilization of properly fabricated provisional prosthodontic appliances will permit a higher rate of success of the definitive treatment. This phase of restorative treatment should not be merely considered a temporary treatment but as a template for the ensuing prosthesis. The information that is obtained in this phase of treatment will reduce the problems that may be encountered in the definitive treatment. This article has discussed the function and requirements of both provisional, fixed restorations and transitional removable partial dentures. The methods of fabrication and the materials employed have been enumerated. PMID- 3301434 TI - Splinting. AB - The definitions of splinting, occlusal trauma, and mobility have been described. The history of splinting as a treatment for periodontal disease has been noted along with the current concepts of the indications and rationale for splinting. Splints have been classified according to their expected length of service: short term splints, provisional splints, and long-term splints. The disadvantages of splinting have been enumerated, and examples of the various types of splints currently employed have been demonstrated. PMID- 3301435 TI - Precision attachments. AB - This article presents an overview of the techniques and rationale of the various impression procedures employed in the fabrication of the removable portion of a combination fixed and removable reconstruction. PMID- 3301436 TI - Impression procedures for the removable component of a combination fixed and removable prosthesis. AB - Several impression techniques for the removable component have been presented to help the dentist select impression procedures and materials appropriate to individual intraoral conditions confronted when constructing intracororonally retained removable partial dentures in combination fixed--removable reconstructions. PMID- 3301437 TI - Hybrid prosthetic appliances. AB - Many partially edentulous situations occur that do not lend themselves to restoration with conventional combination fixed and removable partial dentures. Geriatric patients, as well as patients with congenital and acquired defects, frequently can be best treated with "hybrid prostheses." This article presents an overview of several designs of "hybrid prostheses" and their mechanisms of retention to the abutment teeth. PMID- 3301438 TI - Osseointegrated implants for partially edentulous patients. Interim considerations. AB - Osseointegration is a clinical application of a biologically investigated host bone response to the placement of threaded unalloyed titanium implants using a meticulous surgical procedure. Its documented successful use as an analogue for the periodontal ligament in endentulous patients has already profoundly altered the predicament of being edentulous. Its application as a treatment modality for partial edentulism offers exciting challenges for the dentist. This article reviewed preliminary experiences from the University of Toronto's Clinical Osseointegration Unit in this area. Although it is tempting to extrapolate the successful longitudinal clinical applications with edentulous patients to partially edentulous ones, discretion and prudence demand that dentists remember that osseointegration for routine treatment of partially edentulous patients is still in its infancy. Until the results from long-term clinical trials in different centres are published, the dental profession cannot yet subsume the versatility and routine application of this exciting technique. PMID- 3301439 TI - Preparation and management of full coverage restorations for combination fixed removable prostheses. AB - The understanding of the theories and applications of fixed prosthodontics utilized in conjunction with intracoronally attached removable partial dentures is vital to full-mouth combined reconstructions. Required objectives of fixed full coverage retainers include elimination of pathology, restoration of form and function, as well as enhancement of aesthetics. These topics are discussed in terms of design of full-coverage preparations and tissue management. PMID- 3301440 TI - Periodontal considerations in preparation for fixed and removable prosthodontics. AB - This article has presented many of the newer concepts and techniques that have been developed to treat a problem that has been of major concern to the prosthodontist: the problem of favorable periodontal support and poor or deformed edentulous ridges. In the past, dentists were not aware, or did not believe, that it was possible to reconstruct ridge deformities, and they resorted to prosthetic solutions to solve the problems of tissue reconstruction, function, and aesthetics. New procedures and concepts permit us to extend the range of therapy and hope we are able to offer our patients. It is probably true that prosthodontists are more sensitive to the emotional concerns and needs of patients that have sustained ridge-jaw deformities. These patients bear deep emotional scars. They feel cast apart from "normal" society. Successful treatment for these patients not only restores their deformed ridge and dentition, it helps to erase the mental scars and emotional trauma these patients have had to accept. These procedures enable us to restore their sense of self-confidence and dignity. PMID- 3301441 TI - [Regulation of endocrine pancreas secretions (insulin and glucagon) during the periodic lethargy-waking cycle of the hibernating mammal]. AB - In winter, hibernating mammals enter a long phase of lethargy which is characterized by low body temperature, depressed metabolism and minimal release of metabolic substrates from endogenous fuel stores. Periodically, they spontaneously warm themselves to regain the euthermic state. These arousals are, by contrast, times of high release and consumption of endogenous substrates. Insulin and glucagon may contribute to the control of both contrasting metabolic periods. The secretion and metabolic effects of these two hormones were investigated in two hibernators: the hedgehog (Erinaceus europaeus) and the edible dormouse (Glis glis). During lethargy, blood glucose, insulin and glucagon concentrations were low. In vivo and in vitro studies showed that the secretion of both hormones was markedly depressed by low temperatures. Insulin secretion was not stimulated by glucose, although glucagon secretion remained reactive to arginine. Blood glucose was not regulated by insulin but pharmacological doses of glucagon increased blood glucose concentrations. The tissues were found to be highly insulin-resistant, preventing the fall of blood glucose and consequently limiting the depletion of glucidic substrates during the long periods of starvation. During arousal, blood glucose, insulin and glucagon levels increased at the end of rewarming while glucose turnover gradually increased above a body temperature of 15 degrees C. The effects of glucagon and insulin on glucose metabolism increased markedly beyond this stage. Thus the metabolic effect of both hormones are temperature-dependent. Insulin and glucagon allow an increase in glucose availability for the active metabolic processes which occur during arousal. PMID- 3301442 TI - Erythrocyte sorbitol content in diabetic patients: relation to metabolic control. AB - Since intracellular sorbitol is considered a factor perhaps involved in the pathogenesis of some diabetic complications, erythrocyte sorbitol content was measured in diabetics (IDDM and NIDDM) and in a control group and its relation with metabolic control was investigated. The erythrocyte sorbitol content was significantly increased in diabetic population (p less than 0.001) as compared to the controls. In newly diagnosed IDDMs the erythrocyte sorbitol content changed in parallel with the blood sugar level indicating that the accumulation can be reversed in erythrocytes. In a cross-sectional study a significant positive correlation existed in IDDMs between the concentration of red cell sorbitol and the plasma glucose concentration (r = 0.45; p less than 0.001). Also the HbA1 values correlated (r = 0.44; p less than 0.001) with the erythrocyte sorbitol content. In NIDDMs no correlation with metabolic control could be demonstrated. PMID- 3301443 TI - Insulin resistance in maturity onset diabetes of the young. AB - Insulin resistance was assessed by euglycaemic clamp studies in matched groups of MODY, classical NIDDM patients and non-diabetic control subjects. The MODY patients metabolised less glucose (4.8 +/- 0.3 mg/Kg/min) than the classical NIDDM patients (7.0 +/- 0.5 mg/Kg/min) at an insulin infusion rate of 1.0 mU/Kg/min (p less than 0.05). At an insulin infusion rate 10 mU/Kg/min the differences between the MODY and the classical NIDDM patients were not significant. At both infusion rates the two diabetic groups metabolised less glucose than the control subjects. The results indicate that despite their younger age, the patients with MODY are more insulin resistant than the patients with classical NIDDM. PMID- 3301444 TI - Plasma lipid fatty acids and platelet function during continuous subcutaneous insulin infusion in type I diabetes. AB - Eleven insulin-dependent diabetics exhibiting a fair but less than ideal diabetic control (HbA1 = 10.0 +/- 0.6%) were submitted in a random order to two 6 week study periods of: continuous subcutaneous insulin infusion (CSII) and optimized conventional insulin therapy. Plasma lipids, fatty acids in plasma lipids and platelet function were estimated at baseline and at the end of each study period. Declines in HbA1 were observed at the end of either CSII or conventional period compared with baseline, but the differences were only significant under CSII (P less than 0.02). Plasma lipids and apoproteins remained unchanged at the end of the two study periods compared with baseline. Both CSII and optimized conventional treatment were followed by a significant increase of arachidonate in plasma lipids. A deterioration of the platelet function estimated from ADP or epinephrine-induced platelet aggregation and TxB2 generation by platelets was found under optimized conventional treatment while the platelet function appears to be normal at baseline and under CSII. These data indicate that slight but not sufficient improvements of diabetic control can result in deterioration of the platelet function. It seems that these deleterious effects are mediated through an increased production of arachidonate and in turn of TxB2. PMID- 3301445 TI - [Microalbuminuria in diabetics. I--Definition, significance and physiopathology]. AB - The term "microalbuminuria" qualifies an albumin excretion rate above the upper limit of normal individuals but below values giving positive results with conventional test strips. Its predictive value has been established for diabetic nephropathy in type I Diabetes, and for an excessive risk for mortality in type II Diabetes. Microalbuminuria is of glomerular origin in diabetes. It is secondary both to intra-renal haemodynamic changes and to altered permeability of the glomerular basement membrane. The various parameters involved in its genesis are reviewed. PMID- 3301446 TI - [Microalbuminuria in diabetics. II--Methodological aspects and therapeutic perspectives]. AB - The screening for microalbuminuria in diabetic patients has been made possible by means of sufficiently sensitive and reproducible techniques. Threshold values of albumin excretion rate must be defined according to the type of urine collection and by taking into account the high variability of this parameter. The high variability of albumin excretion rate required that repeated measurements must be considered. The prevalence of microalbuminuria depends on the type of diabetes, the degree of micro- and macrovascular complications, and the presence of associated arterial hypertension. Current attempts to reduce microalbuminuria in the diabetic patients through strict glycaemic control, lowering of high blood pressure and other means, are discussed. PMID- 3301448 TI - The importance of early prenatal diagnosis of thanatophoric dysplasia with respect to obstetric management. AB - A case is described in which prenatal diagnosis of thanatophoric dysplasia was made in the second trimester of pregnancy by ultrasonography and radiography. Early diagnosis allowed elective abortion to be carried out, thus avoiding possible complications later in the pregnancy. PMID- 3301447 TI - Antenatal ultrasonographic diagnosis of a congenital posterolateral diaphragmatic defect. AB - The antenatal ultrasonographic findings in a fetus with a left-sided congenital posterolateral diaphragmatic defect (CPLDD) are presented and discussed. Displacement of the heart towards the right and absence of a normally positioned fluid-filled stomach at repeated examinations are diagnostic. In the event of an intrathoracically displaced fetal stomach, which occurs in about 60% of the cases, a sonolucent area in the left chest may be found. In view of the dynamic nature of fetal stomach filling, more than one examination may be required to detect this feature. Antenatal recognition of congenital diaphragmatic hernia (CDH) has important consequences for perinatal management and can improve neonatal outcome. PMID- 3301449 TI - Benign cystic teratomas of the ovary: a review of seventy-two cases. AB - Seventy-two cases of benign cystic teratoma of the ovary were diagnosed and treated at Northwick Park Hospital between 1970 and 1982. The presentation, clinical features and complications of these tumours presenting at a district general hospital during a period of over 11 years are reviewed. 66% were asymptomatic at presentation, 12.5% presented with the signs and symptoms of acute abdomen. The mean age at presentation was 37 years. Twenty-two patients had pelvic ultrasound which correctly diagnosed ovarian cyst in 9 cases. Eight had previously undergone laparotomy at which the ovaries were apparently normal. PMID- 3301450 TI - Spontaneous rupture of the spleen in third trimester of pregnancy. Report of a case and review of the literature. AB - A case of idiopathic spontaneous rupture of the spleen in the third trimester of pregnancy is presented. The cause remains an enigma; the diagnosis is difficult, but echography may prove to be helpful. The treatment requires early exploration to enhance fetal as well as maternal survival. In this case mother and child did not survive. The etiology and clinical picture are discussed. The literature relating to rupture of the spleen is reviewed, including one particular case of a rupture in the third trimester of pregnancy. PMID- 3301451 TI - Does an intracervical infection influence the fibrinolytic activity and the collagen content of the fetal membranes? A study of ascending infections in pregnant ewes. AB - Apart from solely mechanical explanations, premature rupture of the membranes (PROM) has been suggested to be caused by an ascending infection. In order to investigate the role of infection in the mechanism of PROM, pregnant ewes were experimentally inoculated endocervically with either Bacteroides fragilis, Streptococcus intermedius or group B streptococci. These microorganisms were previously reported to be implicated in PROM in humans. The present investigation concerns the possible effect of an experimentally induced ascending infection on the collagen content and fibrinolytic activity (FA) of the fetal membranes. No relationship was observed between an ascending infection during pregnancy and the collagen content content of the fetal membrane specimens. It was concluded that changes in the collagen content bear no etiological significance in the mechanism of premature membrane rupture irrespective of an ascending infection's being present or not. Concerning FA in only one case, experiencing a Strept. intermedius amnionitis, was an elevated FA value observed. This finding indicates that the involvement of FA in the process of membrane rupture following ascending infection during pregnancy cannot be ruled out. PMID- 3301452 TI - Comparison of a long-acting form of propranolol and conventional propranolol in the treatment of hypertension in elderly patients. AB - Nineteen elderly hypertensive patients already being treated with a diuretic and, where necessary, another anti-hypertensive agent, were studied in a double-blind, randomized, crossover comparison of conventional propranolol, 40 mg three times daily, with a long-acting propranolol formulation, 160 mg once daily, as a second line agent. Patients were assessed before taking the morning's allocated medication. This was done as near as possible to 24 h after the last dose of once daily propranolol and as near as possible to 15 h after the last dose of three times daily conventional propranolol. Assessment was carried out at the time of randomization and after 4 weeks' treatment with both propranolol formulations. Heart rate and blood pressures were measured in the supine and standing positions and after exercise. Both propranolol formulations were effective as second line agents in these elderly patients and both were well tolerated. Patient compliance on both propranolol formulations was very good although the long-acting formulation may be of value in improving this still further. PMID- 3301453 TI - Activity of epomediol in the treatment of hepatopathies: a double-blind multi centre study. AB - A multi-centre study with epomediol discoids (200 mg three times daily for 30 days) versus placebo was carried out in 519 patients either with symptoms attributable to hepatopathy and/or alterations in the hepatic function. Epomediol was given to 257 patients chosen at random and the remaining 262 were given placebo. In cases of hepatopathy in which there was no severe damage to the hepatic parenchyma the symptoms of the disease were reduced and the laboratory parameters were improved on treatment with epomediol, whereas the activity of the drug was low in patients with chronic hepatopathy. This confirms that the clinical use of epomediol is most useful in cases of hepatopathy in which the change in hepatic function is still reversible. PMID- 3301454 TI - Double-blind study of dothiepin versus placebo in the treatment of primary fibromyalgia syndrome. AB - A double-blind study comparing the efficacy and tolerability of dothiepin with that of placebo in the treatment of primary fibromyalgia syndrome was carried out. Dothiepin was shown to improve significantly the condition of patients with primary fibromyalgia syndrome and there was a significant difference between dothiepin and placebo in all the clinical variables measured. Only mild and transient side-effects were reported. Further controlled studies are required to define the effects of dothiepin on fibromyalgia. PMID- 3301455 TI - A double-blind comparison of 0.25% and 0.05% desoxymethasone, 0.1% betamethasone valerate and 1% hydrocortisone creams in the treatment of eczema. AB - The efficacy and acceptability of 0.25% and 0.05% desoxymethasone, 0.1% betamethasone valerate and 1% hydrocortisone creams were compared in patients with eczema. A double-blind parallel group multi-centre design was employed in which 96 patients were recruited by four centres. Patients used one cream for a 3 week period and follow-up assessment visits were made at weekly intervals. Efficacy variables were: erythema/redness, scaling, itching and extent of area affected. These variables were assessed by both the investigator and the patient. The 0.25% desoxymethasone was the most effective treatment, producing the greatest degree of improvement in all clinical parameters, hydrocortisone was the least effective and 0.05% desoxymethasone was of intermediate effectiveness. The 0.1% betamethasone produced similar results to 0.25% desoxymethasone for half the assessments; for the other half the results were similar to 0.05% desoxymethasone. No adverse effects were reported during the study. The results are discussed in terms of physical properties of the vehicles and corticosteroid potency. PMID- 3301456 TI - Effect of atropine on insulin secretion in healthy subjects. AB - The effect of an anti-cholinergic drug (atropine) on insulin secretion was studied in a double-blind manner by the glucagon C-peptide secretion test in five healthy subjects and controlled with saline only (placebo) in four subjects. Blood C-peptide increased only by 157% in the group given atropine and by 252% in the group given placebo. The blood glucose concentration increased by 25% and 32%, respectively. Thus, it is concluded that the cholinergic system, probably through the vagus nerve, has an insulin secretion stimulating effect. The results also suggest that denervation of the vagus nerve, e.g. in gastric surgery, may partly explain post-prandial hyperglycaemia particularly found in dumping. PMID- 3301457 TI - Clinical experience with two twice daily slow release theophylline preparations. Relation between serum theophylline concentrations, effectiveness, tolerability and compliance in elderly patients. AB - The relation between serum theophylline concentrations, effectiveness, tolerability and compliance were evaluated in 14 hospitalized elderly patients with broncho-obstructive pathology, using a new twice daily sustained release theophylline suspension compared to standard twice daily slow release tablets. The results showed that the mean theophylline serum concentration remains within the therapeutic range with both preparations. No significant difference exists between the two treatments with regard to effectiveness. Tolerability and compliance of the theophylline suspension, however, were higher. PMID- 3301458 TI - The comparative efficacy of naproxen sodium and pirprofen in the treatment of post-operative pain. AB - A randomized, single-blind, parallel study involving 100 adults was performed to compare the efficacy and safety of naproxen sodium with that of pirprofen in the treatment of moderate to severe pain after orthopaedic surgery. Fifty patients received 550 mg of naproxen sodium initially and 275 mg every 6 h thereafter, and 50 received 400 mg of pirprofen every 8 h until either their pain was completely relieved or the 3-day trial ended. Patients who required additional analgesia were given 500 mg of paracetamol 2 h after administration of the test medication. Both medications significantly relieved post-operative pain, and there were no statistically significant differences in efficacy between the groups. Six patients receiving naproxen sodium and two patients receiving pirprofen withdrew from the study because of lack of efficacy. Thirteen patients receiving naproxen sodium recorded 17 adverse events and 13 patients receiving pirprofen recorded 20 adverse events, again with no statistically significant differences between groups. Six patients in each group withdrew from the study because of these adverse events. Naproxen sodium and pirprofen were equally safe and effective in relieving post-operative pain following musculoskeletal surgery. PMID- 3301459 TI - Attempts for replacement of asparagine in Sauton's medium by some organic acids in the production of PPD-tuberculins. AB - In the process of obtaining PPD-tuberculins we studied some carbonic acids thus replacing asparagine with them in the original medium of Sauton. The following carbonic acids were used: dibasic saturated carbonic acids--oxalic, malonic and succinic; dibasic non-satured carbonic acids--maleic and fumaric; the dibasic oxycarbonic acid--tartaric. Each of the above mentioned acids was in a concentration equivalent to that of the asparagine in the original Sauton's medium. The tuberculins were obtained through the precipitation of the filtrate of killed liquid cultures by trichloracetic acid. The bovine and avian PPD tuberculins so obtained with the different carbonic acids were assayed on sensitized guinea pigs and hens together with standard tuberculins. The results obtained from the application of the PPD-tuberculins of carbonic acids are almost identical with the ones of the standard PPD-tuberculins. The experimental and standard bovine PPD-tuberculins used contain 50,000 ISU in 1 ml and the avian experimental and standard PPD-tuberculins contain 25,000 ISU in 1 ml. The results obtained give us reason to consider that some of the above mentioned carbonic acids could be used for the production of PPD-tuberculins. PMID- 3301461 TI - MPB70, a unique antigenic protein isolated from the culture filtrate of BCG substrain Tokyo. PMID- 3301460 TI - Search of a standard for the titration of antigen L. AB - The Antigen L is made of the 10 p.100 TCA precipitable proteins that remained after 2 p.100 TCA proteins precipitation of a live BCG culture filtrate. It is 6 times more active in guinea pigs sensitized by living BCG than by inactivated BCG. The reference tuberculin (BR6) is the fraction retained by DEAE-Cellulose chromatography of the purified TP tuberculin described elsewhere (2). The kinetic study of BR6 using guinea pigs sensitized by live or inactivated BCG showed that between the 2nd and 4th month, BR6 had the same activity in both cases in respect to the diameter of the erythema reactions. Therefore, BR6 may serve as reference for the Antigen L between the 2nd and 4th month of sensitization. PMID- 3301462 TI - Dialyzable tuberculins: their abilities to participate in or inhibit immune reactions. AB - Dialyzable components of culture filtrate of Mycobacterium bovis were fractionated by gel filtration on Sephadex G-10 into eight fractions, A through H in order of their elution from the column. None of the fractions produced a visible precipitate when reacted with a hyperimmune antiserum. The first five fractions were further investigated. All were capable of inhibiting precipitation of nondialyzable tuberculin. Fraction E, containing the smallest fragments, totally abolished precipitation and fraction A, which contained the largest molecules inhibited the least. Fractions A and B were the only ones that could induce skin reactions in sensitized guinea pigs but did this poorly. In vitro transformation of PPD sensitized lymphocytes was induced only by fraction A. Only fractions A and B could inhibit transformation of lymphocytes by Concanavalin A but only fraction B could inhibit transformation by tuberculin. Dialyzable components injected intracardially 3 hours prior to skin testing with tuberculin caused a reduction in skin reactivity. Since such substances are present in tissues in late stages of tuberculosis investigations were made to determine if they played a role in the induction of the observed accompanying tolerance to skin test cellular hypersensitivity. Guinea pigs treated with dialyzable components prior to and for four weeks post sensitization did not develop tolerance. PMID- 3301463 TI - Evaluation of difficulties in the standardization of human and bovine tuberculins. AB - The tuberculins are made of mixtures of antigens. Certain elements are common to all tuberculins, others are particular to each one. Bovine and human tuberculins are widely different. This is the reason why the activities of a bovine tuberculin using a human tuberculin standard will be in a ratio of 1 to 5 according to whether the guinea-pigs were sensitized with human or bovine mycobacteria. Also, the activities measured for a given tuberculin might be different if the mycobacteria used in sensitization were inactivated or not, depending on the amount of Antigen L in the tuberculin or in the standard. Because BCG is well defined and used worldwide we propose that a new standard be prepared from BCG cultures, and that the animals be sensitized by live BCG. Two new units are proposed: Bovine Clinical Unit (B.C.U.) and Human Clinical Unit (H.C.U.). PMID- 3301465 TI - Field trials to determine a suitable injection dose of bovine PPD tuberculin for the diagnosis of bovine tuberculosis in naturally infected cattle. AB - Biological assays carried out in the Republic of Ireland in naturally sensitized (M. bovis infected) tuberculous cattle have shown that Rotterdam and Weybridge bovine PPD tuberculins issued for routine use in 1981 and 1982 were equipotent with an estimated potency of about 24,000 Community Tuberculin Units (C.T.U.) per mg of PPD. However, previously it was shown that Weybridge bovine PPD produced in 1978 had only a potency of about 4,000 C.T.U./mg in M. bovis infected cattle. The clinical significance of the latter finding is seen in the results of field trials carried out in the Republic of Ireland in 1978 to determine the relative diagnostic abilities of Weybridge and Rotterdam, routine issue bovine PPD tuberculins. These trials involved the tuberculin testing and slaughter of naturally sensitized cattle. Post-mortem and laboratory examination confirmed that 68 of these animals were infected with M. bovis. It was concluded that the injection dose for the diagnosis of bovine tuberculosis in cattle should not contain less than 2,000 C.T.U. and that the use of an injection of double this dosage was desirable in known M. bovis infected herds. PMID- 3301464 TI - Laboratory assay methods for bovine tuberculin PPD (report of the Expert Group on Veterinary Sera and Vaccines of the European Pharmacopoeia Commission). AB - It had been found that preparations of bovine tuberculin PPD that appeared to be similar in potency when assayed in guinea-pigs sensitized with killed tubercle bacilli could differ markedly in potency when assayed in cattle. In an attempt to define a laboratory assay method that would reflect accurately the performance of bovine tuberculin PPD in cattle, the European Pharmacopoeia Group of Experts on Veterinary Sera and Vaccines carried out a collaborative study of various methods of sensitization. Seven laboratories in 6 countries participated. The only method of sensitization that gave results corresponding to those obtained in cattle was that using living, virulent, bovine, tubercle bacilli. The Group concluded that it was essential to use this method in laboratory assays of bovine tuberculin PPD. PMID- 3301466 TI - [Comparison of Monotest and the intradermal reaction to tuberculin: search for a correlation]. PMID- 3301467 TI - Isolation and characterization of genes for blood proteins. AB - The expression vector lambda gt11Amp3 has been used to construct a cDNA library from rat liver polyadenylated RNA. Clones expressing antigenic determinants for rat albumin, transferrin, transthyretin, apolipoprotein E and apolipoprotein AII have been identified. Albumin clones containing cDNA inserts ranging from 0.9 kb to 1.9 kb were further identified by restriction mapping and nucleic acid sequencing. The largest insert contained the entire coding sequence for albumin. Characterization of the expressed proteins by acrylamide gel electrophoresis followed by immunological detection indicated that the proteins were produced as hybrids linked to the bacterial beta-galactosidase. A cDNA library for human liver polyadenylated RNA has also been constructed. Clones expressing antigenic determinants for human serum albumin, transferrin and apolipoproteins AI, AII, AIV and E have been isolated and their identity established by nucleotide sequencing and restriction mapping. Both rat and human serum protein cDNA clones are currently being used to study the tissue specific expression of serum proteins and for the isolation and characterization of the corresponding genes. PMID- 3301468 TI - Protein C, isolation and potential use in prevention of thrombosis. AB - Protein C and protein S serve as natural anticoagulants. Deficiencies of these proteins are often associated with recurrent deep vein thrombosis and coumarin induced skin necrosis. These two proteins function by selectively inactivating factors Va and VIIIa, two of the "cofactors" of blood coagulation. Hence, inhibition of coagulation by this pathway complements the better known inhibition mediated by the antithrombin III-heparin system. These observations suggest that protein C and/or activated protein C may prove useful in controlling thrombosis and/or DIC. We have developed a Ca2+ dependent monoclonal antibody which allows the rapid isolation of human protein C. This rapid isolation has allowed us to demonstrate that activated protein C can protect baboons from the lethal effects of E. coli/endotoxin and that protein C supplementation can minimize fibrinogen consumption following tissue factor infusion into dogs. PMID- 3301469 TI - The role of heparin cofactor II in the modulation of hemostasis. AB - Human plasma contains two distinct heparin dependent thrombin inhibitors; antithrombin III (ATIII) and Heparin cofactor II (HCII). The latter is also known as antithrombin BM, because of its moderate binding affinity to heparin. The protein is distinct from ATIII by immunological and functional criteria as well as by its amino acid sequence. HCII selectively inhibits thrombin by forming a 1:1 molar complex with the protease and has no activity towards other coagulation serine proteases. Dermatan sulphate, a glycosaminoglycan, specifically activates HCII and increases its thrombin neutralizing activity by over a thousand fold. Dermatan sulphate does not catalyze the activity of ATIII. Human fibroblasts have been shown to accelerate the neutralization of thrombin by HCII. These cells can synthesize proteoglycans containing dermatan sulphate. Current evidence would thus suggest that extravascular tissues are the major sites of action of HCII. The specificity of dermatan sulphate for HCII has allowed the development of functional assays for this protein. Reduced levels have been observed in patients with significant hepatocellular dysfunction and in association with disseminated intravascular coagulation. Two families have been reported with hereditary HCII deficiency and recurrent thrombosis (both venous and arterial). Although these observations suggest a role for HCII in the modulation of hemostatic system, further studies are required to define the importance of HCII deficiency as a marker of thrombosis. PMID- 3301470 TI - Psychobiology and developmental psychology: the influence of T. C. Schneirla on human developmental psychology. PMID- 3301471 TI - Alterations in free radical tissue-defense mechanisms in streptozocin-induced diabetes in rat. Effects of insulin treatment. AB - We investigated the possible involvement of reactive oxygen radical-related processes in chronic (12-wk) diabetes induced in rats by streptozocin (STZ). Diabetes was associated with significantly increased activities of catalase (CAT), glutathione reductase (GSSG-RD), and CuZn-superoxide dismutase (SOD) in the pancreas and of CAT and GSSG-RD in the heart. On the other hand, the liver of diabetic rats showed a generalized decrease in CAT, glutathione peroxidase (GSH PX), and SOD as well as in the levels of reduced glutathione (GSH). Diabetic kidney also showed decreases in CAT and SOD, but the activities of GSH-PX were increased. Insulin treatment (9-12 U/kg body wt) that was started after 8 wk of diabetes and continued for 4 wk reversed all of the foregoing alterations in tissue antioxidant status. Our results suggest the presence of increased oxidative stress in uncontrolled diabetes as manifested by the marked alterations in tissue antioxidant enzyme activities, the magnitude of which increased with the degree of emaciation. The complex patterns of changes observed in the various tissues examined are believed to be the result of compensatory increases in enzyme activities (usually involving enzymes whose activity in control tissues is low) and direct inhibitory effects, possibly resulting from an increased tissue oxidant activity. Our findings support the view that tissue antioxidant status may be an important factor in the etiology of diabetes and its complications. PMID- 3301472 TI - Response of diabetic basement membrane--producing cells to glucose and insulin. AB - The effect of insulin and glucose on the synthesis of basement membrane components was studied in organ cultures of a basement membrane-producing tumor grown in diabetic and normal mice. Tumor tissue grown in diabetic mice produced more protein and basement membrane-specific proteoglycan in response to insulin than tissue grown in normal mice. Addition of high levels of glucose to the culture medium did not alter insulin-stimulated protein synthesis by diabetic or normal tissue but dampened insulin-stimulated production of proteoglycan. These data suggest that basement membrane-producing cells in diabetic hosts may be hypersensitive to insulin and that stimulation of protein production by insulin may play some role in the in situ hypertrophy of basement membranes. PMID- 3301473 TI - Insulin hyperpolarizes rat myotube primary culture without stimulating glucose uptake. AB - Insulin (100 microU/ml) increased the electrical potential difference between the inside and outside of fused myotubes from fetal rat hindlimbs 5-8 days after primary culture. Myotubes were hyperpolarized by 3.5 +/- 1.2 mV (mean +/- SE). Tetrodotoxin (TTX) eliminated spontaneous twitching. With TTX, membrane potentials of myotubes became more negative both in the absence and presence of insulin, and insulin hyperpolarized myotubes by 6.6 +/- 1.7 mV, which is at least as great as the hyperpolarization this concentration of insulin produced in muscles excised from young adult rats. However, insulin did not significantly stimulate uptake of the glucose analogue 2-deoxy-D-glucose, although there was basal D-glucose transport. Specific insulin receptors were present, demonstrated by radioinsulin binding. In summary, in primary cultures of rat myotubes, there are insulin receptors, insulin hyperpolarizes at least as much as it hyperpolarizes muscle excised from young adult rats, but insulin does not stimulate D-glucose transport. PMID- 3301475 TI - Prolonged release of insulin by cholesterol-matrix implant. AB - Insulin dispersed in a pellet disk made by compressing an admixture with cholesterol was found to reduce hyperglycemia in streptozocin-induced diabetic Wistar rats. I evaluated the effect of insulin content. At 3% insulin, two pieces of quarter-disk implant (approximately 50 mg each) lowered blood glucose levels from greater than 22 mM to 17.5 mM for only 3 days. Normalization of hyperglycemia was sustained from approximately 10 days for the implant with 6% insulin content and to 24 +/- 5 days for 8-10% insulin in the composition. Insulin content up to 50% resulted in hypoglycemia and shorter implant service life. Not all of the pellet disks prepared were active, especially those with 3% insulin content. However, when broken further into 1-mm3 chips, all became active, with onset of action in less than 2 h, and the extent of hyperglycemia reduction was reproducible. Three successive subcutaneous insertions of approximately 80 mg chips with 10% insulin maintained normoglycemia for 2.5 mo. Because the implant materials are constituents of tissue, no biocompatibility problem is expected. PMID- 3301474 TI - Insulin and other stimulants have nonparallel translational effects on protein synthesis. AB - Isolated pancreatic acini from streptozocin-induced diabetic rats were used to study the role of insulin on the synthesis of specific cellular proteins. When acini were incubated with 0-100 nM insulin for 2 h and then pulsed with [35S]methionine, a dose-dependent increase in [35S]methionine incorporation into total cellular proteins was observed. When acinar cell lysates were subjected to gel electrophoresis, 12 major newly synthesized protein bands were resolved. Insulin (100 nM) increased the incorporation of [35S]methionine into all bands but with significantly different rates, varying from 84 to 216% of control. Next, specific antibodies to amylase, trypsin, ribonuclease, myosin, and lactate dehydrogenase (LDH) were used to evaluate the biosynthesis of known proteins. Insulin stimulated labeled amino acid incorporation into amylase by 148% over control. Insulin stimulated the synthesis of trypsinogen to a similar degree, but ribonuclease synthesis showed a significantly smaller increase of 53% over control. Insulin stimulated myosin and LDH synthesis by 169 and 184%, respectively. A differential pattern of protein synthesis was also observed when acini were treated with two other stimulators of protein synthesis, cholecystokinin and hemin. Both of these stimulators had a reduced effect on ribonuclease synthesis compared with amylase and trypsinogen synthesis but failed to increase myosin synthesis. When the RNAs extracted from control acini and acini treated with 100 nM insulin were translated in vitro, the proteins synthesized were quantitatively similar. This study therefore indicates that insulin has translational effects on acinar protein synthesis, and these effects are nonparallel for various specific acinar cell proteins. PMID- 3301476 TI - Prolongation of islet xenograft survival by cryopreservation. AB - Our attempt to reduce islet immunogenicity by slow cooling to -40 degrees C, storage at -196 degrees C, and rapid thawing is based on the differential susceptibility of various cell types to a freeze-thaw process. Five hundred rat islets (greater than or equal to 100 micron) were immediately implanted or cryopreserved and then implanted beneath the renal capsule of streptozocin induced diabetic mice with or without an injection of anti-lymphocyte serum at the time of transplantation. Thirteen days after transplantation, all fresh xenografts had rejected, whereas 37.5% of cryopreserved grafts were still functioning. In immunosuppressed mice, 6.2% of fresh xenografts and 54.5% of cryopreserved grafts were functioning 19 days after transplantation. These results show that cryopreservation can extend xenograft survival. PMID- 3301477 TI - Augmentation of mucosal adaptation following massive small-bowel resection by 16,16-dimethyl-prostaglandin E2 in the rat. AB - Survival following massive resection of the small intestine is often possible due to substantial hyperplasia of the mucosal surface in the remaining small intestine. While nutrients provide the major stimulus for hyperplasia in the clinical setting, the availability of drugs to augment this process would have obvious therapeutic implications. We evaluated the ability of 16,16-dimethyl prostaglandin E2 (PGE2 to augment mucosal hyperplasia following massive small bowel resection in the rat. Three groups of 7 Sprague-Dawley rats, 160 g body weight, were subjected to 70% jejunoileal resection. One group was given 150 micrograms/kg of 16,16-dimethyl-PGE2 intragastrically twice daily, a second group 75 micrograms/kg subcutaneously, and a third group was untreated. After 17 days, segmental evaluation of mucosal mass in the remaining small intestine was determined by measuring mucosal protein, DNA, and disaccharidase levels. A significantly greater increase in mucosal mass was developed in the duodenum proximal to the anastomosis in both treatment groups, but neither the proximal nor distal ileum demonstrated significantly more adaptation. Histological examination in the duodenum confirmed the presence of a greater adaptive response in both the intragastrically and subcutaneously treated animals. 16,16-dimethyl PGE2 appears to augment mucosal adaptation following massive small bowel resection in the rat, primarily in the very proximal small intestine. PMID- 3301478 TI - Nadolol for prevention of variceal rebleeding in cirrhosis: a controlled clinical trial. AB - Nadolol, a nonselective beta-blocker, has been shown to decrease portal pressure in patients with cirrhosis at the same degree as propranolol. No data are available, however, about its effect on rebleeding rate and mortality in patients undergoing prevention of rebleeding from esophageal varices. A prospective randomized clinical trial was performed in patients with cirrhosis who survived a documented episode of variceal hemorrhage. 12 patients received nadolol, 12 placebo. Patients with child's C grade, tense ascites, renal failure, contraindications to beta-blocker, or age greater than 70 were not included. After a follow-up of up to 145 weeks, 9 patients in the nadolol group and 4 in the placebo group survived free from rebleeding (log-rank test: chi 2 = 4.35, p less than 0.05). Survival was not statistically different in the two groups (1 death in the nadolol group, 3 in the placebo group). In conclusion, nadolol appears to represent an effective therapy in the prevention of variceal rebleeding in cirrhotic patients. PMID- 3301480 TI - Islet cell and insulin autoantibodies in organ-specific autoimmune patients. Their behaviour and predictive value for the development of type 1 (insulin dependent) diabetes mellitus. A 10-year follow-up study. AB - To evaluate the behaviour and predictive value of islet cell and insulin autoantibodies in patients with organ-specific autoimmune diseases, we followed 21 non-diabetic subjects for a mean period of 84 +/- 27 months. Ten patients were persistently seropositive for complement-fixing islet cell antibodies and high titres of immunoglobulin G islet cell antibodies (greater than or equal to 1:8). The prevalence of persistent insulin autoantibodies in this group was 67%. Seven patients (70%) developed Type 1 (insulin-dependent) diabetes mellitus after a latency period of 2-60 months. The predictive value of complement-fixing islet cell antibodies was 65%, and in the presence of both complement-fixing islet cell and insulin autoantibodies the predictive value rose to 76%. Eleven patients were seronegative for complement-fixing islet cell antibodies and had low immunoglobulin G islet cell antibodies titres (less than 1:8) that were either persistent or transient, or that fluctuated during follow-up. The prevalence of persistent insulin autoantibodies in this group was 45%; only one subject developed Type 1 diabetes. The predictive value of persistent islet cell antibodies (complement-fixing positive/negative) was 54%, and it rose to 70% when both islet cell and insulin autoantibodies were present. Individuals with only insulin autoantibodies or immunoglobulin G islet cell antibodies did not develop diabetes mellitus. A high frequency of HLA-DR3 and/or DR4 was found in patients who developed diabetes mellitus. Thus, the presence of both islet cell and insulin autoantibodies in patients with organ-specific autoimmune disease appears to confer the highest risk of progression toward Type 1 diabetes. PMID- 3301479 TI - The biosociology of pancreatic B cells. PMID- 3301481 TI - Reduction of platelet aggregation induced by euglycaemic insulin clamp. AB - To examine the effect of serum insulin independent of the level of blood glucose in vivo on platelet aggregation in healthy individuals, a euglycaemic insulin clamp was applied up to 4 h. During the clamp, blood glucose at 5.0 mmol/l and insulin levels at 100 microU/ml were maintained. Blood samples were drawn before, 2 and 4 h after the start of the insulin clamp. The platelet aggregation induced by 1 mumol/l and 2 mumol/l ADP, 1 microgram/ml collagen and 2.7 mumol/l epinephrine was measured in the blood samples. Platelet aggregation induced by adenosine diphosphate, collagen and epinephrine in the 4 h sample was significantly reduced from the pre-clamp value of 8.4% to 3.9% (p less than 0.05), 26.2% to 7.0% (p less than 0.01) and 31.8% to 9.1% (p less than 0.01), respectively. On the other hand, when the same individuals were infused with physiological saline and blood glucose (4.4 mmol/l) and insulin level (10 mIU/l) were kept within normal values, there was no difference between the values of induced platelet aggregation in samples drawn before and during the insulin infusion. It was concluded that hyperinsulinaemia reduces platelet aggregation in vivo when euglycaemia was maintained. PMID- 3301482 TI - Derivation of a quantitative measure of insulin sensitivity from the intravenous tolbutamide test using the minimal model of glucose dynamics. AB - Using the decay phase of the glucose response during an intravenous tolbutamide test, a minimal model of glucose dynamics was used to calculate a value for an "index of insulin sensitivity". This index describes the efficiency of insulin in accelerating the instantaneous rate of glucose disposal, and provides a measure of insulin resistance. The validity of estimates of the index of insulin sensitivity obtained from the intravenous tolbutamide test have been assessed with reference to estimates of this index derived from the intravenous glucose tolerance test for which the model was originally designed. There were three studies: (A) estimates of the index of insulin sensitivity obtained from the intravenous tolbutamide test in a group of normal, healthy men and women were compared with results obtained in a comparable group of subjects using the intravenous glucose tolerance test. The two methods gave estimates of the index of insulin sensitivity that were identical; (B) A group of patients taking methandienone, an anabolic steroid previously shown to cause marked insulin resistance, were tested whilst taking the steroid and either before, or at least two months after treatment. Each patient was tested by both intravenous tolbutamide test and intravenous glucose tolerance test on both occasions. Estimates of the index of insulin sensitivity from intravenous glucose tolerance or intravenous tolbutamide procedures both on and off treatment were significantly correlated (off treatment: rs = 0.71, n = 9, p less than 0.05; on treatment: rs = 0.69, n = 9, p less than 0.05); (C) A group of patient undergoing investigations for suspected disturbances in carbohydrate metabolism was studied, each patient having had both an intravenous tolbutamide and intravenous glucose tolerance test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301483 TI - Prolonged incubation in the two-colour immunofluorescence test increases the prevalence and titres of islet cell antibodies in type 1 (insulin-dependent) diabetes mellitus. AB - The conventional indirect immunofluorescence test of islet cell antibodies was recently improved by the development of a two-colour immunofluorescence assay using a monoclonal proinsulin antibody to detect islet B cells. The aim of this study was to test whether in this new assay the prevalence and titre of ICA were affected by the time of incubation carried out in the presence of aprotinin (Trasylol) as an inhibitor of proteolysis. The end-point titre of ICA was therefore determined in sera from 70 children aged 0.6 to 15 years with recent onset Type 1 (insulin-dependent) diabetes mellitus, 50 healthy control subjects and 97 non-diabetic siblings of Type 1 diabetic children. In the conventional two colour assay, ICA was positive in 53/70 (76%) Type 1 diabetic patients, 1/50 control subjects and 2/97 siblings after 30 min incubation. Prolonged incubation for 18 h increased the prevalence of ICA positive samples to 62/70 (89%) in the diabetic patients and to 2/50 in the control subjects, while the prevalence among the siblings was unchanged. Of the ICA positive non-diabetic subjects, one control child has a father with Type 1 diabetes, and one of the siblings subsequently developed Type 1 diabetes. In the diabetic patients the median titre was 1:32 for the 30 min incubation, and it increased to 1:64 for the 18 h incubation (p less than 0.001). A marked prozone effect was seen; 16% of the samples from the Type 1 diabetic children sera were negative at a 1:2 dilution, but were found positive at higher dilutions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301484 TI - Aberrant expression of class II major histocompatibility complex molecules by B cells and hyperexpression of class I major histocompatibility complex molecules by insulin containing islets in type 1 (insulin-dependent) diabetes mellitus. AB - Twenty-three patients with recent onset Type 1 (insulin-dependent) diabetes in whom residual insulin secreting B cells were present and 12 patients with disease of more prolonged duration (maximum 9 years), 8 of whom had residual B cells, were studied. Aberrant expression of Class II major histocompatibility complex molecules was demonstrated immunohistochemically on insulin secreting B cells in 21 out of 23 patients with recent onset disease and 6 of the patients with more prolonged disease. No such expression was seen on glucagon secreting A cells or somatostatin secreting D cells. Islets where there was marked hyperexpression of Class I major histocompatibility complex molecules on islet endocrine cells were seen in all cases in which residual B cells were present. Ninety-two per cent of insulin containing islets but only 1% of insulin deficient islets exhibited this phenomenon (p less than 0.001, Chi-squared test). There was evidence to suggest that both these abnormalities of major histocompatibility complex expression preceded insulitis within a given islet. They also appeared to be unique to Type 1 diabetes, being absent in pancreases of patients with Type 2 (non-insulin dependent) diabetes, chronic pancreatitis, cystic fibrosis, graft-versus-host disease and Coxsackie B viral pancreatitis. The development of autoimmunity to B cells in Type 1 diabetes may be a "multistep" process in which abnormalities of major histocompatibility complex expression on islet endocrine cells are crucial events. PMID- 3301485 TI - Resistance of the insulin crystal to lysosomal proteases: implications for pancreatic B-cell crinophagy. AB - Insulin is thought to be chemically stabilized within beta-granules in the crystal form. The other major products of the beta-granule, proinsulin and C peptide, by contrast, are not thought able to crystallize. The physico-chemical properties of peptides in soluble or crystalline form are dramatically different. The ability of insulin to crystallize in the beta-granule might thus explain why this peptide, but not proinsulin/C-peptide, remains stable even after its introduction into lysosomes as occurs during granulolysis (crinophagy). We have now studied this by exposing proinsulin or insulin to lysosomal proteases in vitro. 125I-insulin in soluble form was found to be degraded at the same rate as 125I-proinsulin. Strikingly, however, when the labelled insulin was crystallized, its rate of degradation was decreased from 1.9 to 0.2 pmol/min. We take these data as confirmation that the insulin crystal is resistant to degradation, thereby possibly accounting for (a) the presence of insulin immunoreactivity within multigranular bodies, and (b) the unusually slow rate of degradation of insulin within B cells compared with that of other hormones in their cells of origin. PMID- 3301487 TI - Analysis of differentiation antigens on normal and carcinogen-altered rat epithelial cells in vivo and in culture. AB - Two murine monoclonal antibodies, 3BG8 and 9BG8, which were raised against a rat tracheal squamous-cell-carcinoma cell line, recognize cell-surface antigens on normal rat squamous epithelium (skin, esophagus, vagina, and cornea) as well as on carcinogen-exposed, immortalized, rat tracheal epithelial cells. Monoclonal antibody 3BG8 binds to a 115-kilodalton cell-surface protein on undifferentiated basal cells of the epithelium, while the binding of the other antibody, 9BG8, occurs in both differentiated and undifferentiated populations of normal squamous epithelium and squamous cell carcinomas. Undifferentiated tracheal carcinomas bound only the 3BG8 antibody. No binding of either antibody was detected on normal tracheal mucociliary epithelium. Only under conditions that induce squamous differentiation of rat tracheal epithelium was binding of 3BG8 and 9BG8 detected. For reasons which are not clear at present, 9BG8 dramatically inhibits the growth of normal tracheal and esophageal cells in primary culture, whereas only 3BG8 affects the growth of carcinogen-altered tracheal cell lines. Based on antigen characterization and distribution, it is concluded that the 3BG8 and 9BG8 epitopes are localized on differentiation antigens which differ from others that have been previously described. PMID- 3301486 TI - Localization and accumulation of fibronectin in rabbit fetal lung tissue. AB - An interaction between mesenchyme and epithelium is required for the normal differentiation of fetal lung tissue. This morphogenic interaction may be mediated, in part, by changes in the composition and/or structure of the extracellular matrix. Therefore, we characterized the localization and accumulation of fibronectin, an extracellular-matrix component, during several stages of lung development in the rabbit fetus in vivo as well as in day-21 rabbit fetal lung explants maintained in vitro. Fibronectin was detected immunocytochemically in the basement-membrane zone beneath the epithelial ducts in lung tissue obtained from rabbit fetuses at 19 and 21 days of gestation. In fetal lung tissue obtained at these early stages of lung development, mesenchymal cells were stained only at their periphery. Immunostaining for connective-tissue fibronectin increased greatly between days 24 and 31 of gestation. A similar increase in the intensity of immunostaining for connective-tissue fibronectin was observed in rabbit fetal lung explants that had been maintained in vitro for 7 days. The concentration of fibronectin in fetal lung tissue obtained at different days of gestation was determined using a specific enzyme-linked immunoadsorbent assay (ELISA) and was found to increase from 1.7 ng/micrograms protein in fetal lung tissue obtained at day 19 of gestation to 7.3 ng/micrograms protein in fetal lung tissue obtained at day 24 of gestation. The levels of fetal lung fibronectin then remained relatively constant through to day 31 of gestation. A similar increase in fibronectin concentration was observed in day-21 fetal lung explants maintained in vitro for 7 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301488 TI - [Therapy of multiple myeloma: present and future]. PMID- 3301489 TI - [Nifedipine-captopril combination in the treatment of refractory arterial hypertension]. PMID- 3301490 TI - [Theophylline in the therapy of non reversible airway obstruction]. PMID- 3301491 TI - [Pure erythrocytosis and elevated erythropoietin. Review of the literature and description of a clinical case complicated by Budd-Chiari syndrome]. PMID- 3301492 TI - [Updating several aspects of liver cirrhosis]. PMID- 3301493 TI - [Efficacy and tolerance of long-term naftidrofuryl treatment of patients with senile dementia. Controlled study versus placebo]. PMID- 3301494 TI - NMR spectroscopy as an investigative technique in physiology. AB - Relating physiological variables on an organ system level to metabolic function within the intracellular environment has been exceedingly difficult because of a paucity of techniques. Most of the tools at our command necessitate either the removal or destruction of tissues before measurements can be made. Recently, NMR spectroscopy has been applied to several important questions relating organ system and cellular physiology. NMR has the distinct advantage of being noninvasive and nondestructive, allowing the investigator to make repetitive measurements of intracellular variables while manipulating experimental variables that are important on the organ system level. In this review we shall present several examples of such NMR investigations so that the reader will gain some appreciation of the potential of this relatively new technique. Cellular acid base homeostatic mechanisms, high-energy phosphate metabolism, and regulation of anaerobic glycolysis will be discussed for such diverse cellular populations as mammalian brain, mammalian heart muscle, salamander skeletal muscle, amphibian skin, and invertebrate muscle. In addition, the role of phosphomonoesters and phosphodiesters in lipid metabolism for several tissues in different species will be evaluated. PMID- 3301495 TI - Fritz Lipmann: in memoriam. PMID- 3301496 TI - Aging effects of vitamin C on a human lens protein produced in vitro. AB - Human lens gamma-crystallin obtained from the expression of a gene construct stably integrated into mouse L cells was incubated with ascorbate in the presence of iron and oxygen. The resulting oxidation of the gamma-crystallin led to more acidic species of this protein. These alterations were similar to the changes seen with aging in the human lens. The results suggest that oxidation of lens crystallins may be responsible for the changes seen on aging and cataract development and that ascorbate may contribute to these alterations. PMID- 3301497 TI - Phenothiazine binding by a homolog of calpactin, the pp60src tyrosine kinase substrate. AB - Microvilli isolated from 13762 mammary ascites tumor cells contain a major calcium-sensitive protein (AMV-p35) that can be isolated with microvillar microfilament cores prepared by Triton X-100 extraction in the presence but not absence of calcium. AMV-p35 can be readily purified from ethylene glycol bis(beta aminoethyl ether)-N,N,N',N'-tetraacetic acid extracts of the microfilament cores by chromatography on an anion exchange column, to which it does not bind. Immunoblot analysis indicates that AMV-p35 is related to calpactin I, the pp60src tyrosine kinase substrate. In the presence of calcium, AMV-p35 binds approximately 4 mol of chlorpromazine per mole of protein in a binding process showing apparent positive cooperativity, similar to calmodulin; however, in contrast to calmodulin, AMV-p35 also binds phenothiazine in the absence of calcium. PMID- 3301498 TI - State-dependent aspects of regulatory physiology. AB - This paper provides a brief and selective review of recent work concerning the alterations in thermoregulation, cardiovascular, and respiratory physiology that occur as a function of different states of sleep and wakefulness. These state dependent changes in physiology were once regarded as a source of unwanted variance to be surgically or pharmacologically eliminated. The research paradigm championed by the work described here, however, requires that the endogenously generated state changes be recognized as potent independent variables influencing physiological control systems. Much evidence suggests that central monoamine containing neurons mediate many of the state-dependent changes in thermoregulatory and cardiopulmonary physiology. A general conclusion emerging from these data is that studies of state-dependent physiology are not merely descriptive; they are essential for a complete characterization of the cellular and molecular mechanisms underlying regulatory physiology. PMID- 3301500 TI - [Hypotensive efficacy of verapamil alone and in combination with a diuretic in the treatment of essential hypertension in geriatric patients]. AB - To evaluate the hypotensive efficacy of Verapamil alone and combined with diuretic, in the treatment of essential hypertension in elderly patients, we studied 54 patients, mean age 67.2 +/- 4.7 years, with essential hypertension, I II WHO class. After a two-week wash-out from previous hypotensive therapies, patients were divided, at random, into three groups and, in double-blind conditions; they were treated as follows: the first group was treated with Verapamil (V) slow-release 240 mg/die, the second group with Chlorthalidone (C) 50 mg/die and the third group with the combination of Verapamil slow-release 240 mg/die and Chlorthalidone 50 mg/die (V + C). In the first group, the therapy (V) statistically reduced (p less than 0.001) either PAS or PAD values in supine position, (respectively -13 +/- 9 mmHg and -12 +/- 4 mmHg) and PAS-PAD values in upright position (respectively -16 +/- 3 mmHg and -10 +/- 3 mmHg). In the group treated with C, a statistically significant reduction (p less than 0.001) of PAS (-12 +/- 3 mmHg in supine position and -16 +/- 3 mmHg in upright position) and of PAD (-11 +/- 5 in supine and -9 +/- 4 mmHg in upright position). In the third group, V + C treatment induced a statistically bigger reduction of PAS and PAD (p less than 0.001) than that of the other two groups either in supine (-24 +/- 3 and -21 +/- 5 mmHg, respectively) or in upright position (-26 +/- 4 and -20 +/- 5 mmHg, respectively). Three patients interrupted the therapy for scarse compliance (I-II group).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301499 TI - Properties and function of caltrin, the calcium-transport inhibitor of bull seminal plasma. AB - Indirect immunofluorescence studies with polyclonal antibodies show that caltrin binds to the plasma membrane over the acrosome and principal tail regions of bovine spermatozoa but not to the postacrosomal area or the midpiece. Calcium influx into bovine epididymal spermatozoa maintained in a simple salt medium containing DL-beta-hydroxybutyrate is prevented by caltrin freshly prepared from bovine seminal plasma through a procedure employing only gel permeation columns. Older preparations, on the other hand, enhance calcium uptake into these cells. Caltrin freshly prepared through a purification scheme that includes a cation exchanger only induces enhancement of calcium uptake into bovine epididymal spermatozoa maintained under identical conditions. It is postulated that early during sperm transit through the female reproductive tract, caltrin bound to the sperm plasma membrane protects the sperm cells from calcium influx. As the cells enter the oviduct where meeting with the egg could take place, factors present in the surrounding milieu may cause caltrin to change from an inhibitor to an enhancer of calcium uptake. The acrosome reaction and possibly hyperactivation, two components of capacitation that require calcium influx as an initial event, then take place. PMID- 3301501 TI - [Role of diltiazem in the post-infarct period]. PMID- 3301502 TI - [Anatomo-physiologic basis for the selection of a coronary bypass. The internal mammary artery versus autologous saphenous vein]. PMID- 3301503 TI - [Ivan Mahaim, cardiologist and anatomopathologist]. PMID- 3301504 TI - [Efficacy of propafenone in the treatment of ventricular hyperkinetic arrhythmias in subjects with a history of myocardial infarction]. AB - A placebo-controlled single-blind study was performed to evaluate the efficacy of oral propafenone on stable potentially malignant ventricular tachyarrhythmias in 13 patients who had suffered a myocardial infarction two months or longer before the trial. All patients exhibited at a 24 hour Holter monitoring a minimum mean frequency of 10 ventricular premature depolarizations (VPDs) per hour and repetitive VPDs. Ventricular tachyarrhythmias characterization was obtained by means of multiple Holter monitorings and exercise stress testings. Propafenone was considered as effective when a well-defined quantitative and qualitative reduction of ventricular tachyarrhythmias was reached. After an initial placebo phase, patients received propafenone 450 mg or 900 mg daily. Acute effectiveness of propafenone was proved in 8 on 13 patients (62%) who showed a significative reduction of VPDs (89%, p less than 0.02) and a suppression of the most complex forms of ventricular tachyarrhythmic events. The efficacy of propafenone was confirmed, three months later, in each patient, side effects were infrequent, minimal and of no clinical consequence. Oral propafenone can be considered as an effective drug for reducing the level of potentially malignant ventricular tachyarrhythmias in patients with previous myocardial infarction. PMID- 3301506 TI - [New inotropic vasodilators: what is their role in the long-term treatment of heart failure?]. PMID- 3301505 TI - [Comparative evaluation of 3 calcium antagonist drugs in patients with stable angina of effort. Double-blind placebo-controlled randomized study]. AB - A study was undertaken in order to compare the effects of Diltiazem, Nifedipine and Verapamil on 11 male adults (aged 44 to 70 yrs: mean age 60 yrs) affected by effort angina with a stable exercise threshold. The study was carried out according to a 4 week double-blind randomized protocol. Diltiazem (300 mg/die), Nifedipine (50 mg/die), Verapamil (400 mg/die) and placebo were administered each for 7 day periods. An ergometric test was performed on the last of each therapeutic cycle in order to evaluate the effects of the treatments. The three active drugs globally provoked an increased tolerance to physical effort with respect to placebo (p less than 0.01); no significant differences, as regards physical performance, could be detected among the three drugs. Treatment with Nifedipine significantly increased heart rate at rest (p less than 0.05), under submaximal (p less than 0.05) and maximal load (p less than 0.05), with respect to treatment with Diltiazem and Verapamil. Systolic and diastolic arterial blood pressure did not vary significantly with any of the three drugs. Rate pressure product under submaximal load (p less than 0.05) and at the end of the exercise (p less than 0.05) was higher with Nifedipine than with the other two drugs. These results show that patient response to Nifedipine is different from that to Verapamil and Diltiazem and suggest that the three drugs exert their anti ischemic effect through different mechanisms. The evaluation of individual response revealed that only one patient showed no increased tolerance to physical effort with any of the drugs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301507 TI - [Hyperkinetic ventricular arrhythmias in the non-cardiopathic athlete: an adverse effect of the sport?]. PMID- 3301508 TI - ["For Aesculapius and the health of my fellow-soldiers": updated synthesis of Roman military medicine]. PMID- 3301509 TI - [Neural control of gastrointestinal motility]. PMID- 3301510 TI - [Effect of trimebutine on the plasma postprandial release of gastrointestinal hormones in the dog]. AB - The injection of trimebutine induces in the dog an increase of plasma motilin during the fasting period as well as after a meal. We studied the effect of trimebutine on several gastrointestinal hormones released into the circulation by the ingestion of a meal. The intravenous administration of trimebutine (10 mg/kg/h) in 4 dogs abolished the postprandial increase in plasma gastrin, pancreatic polypeptide, insulin, glucagon and GIP. Trimebutine could therefore, by its effects on various regulatory peptides, influence several digestive functions. Its mode of action could probably involves complex mechanisms, including paradoxical effects. The possibility that motilin is a mediator of the trimebutine effect on small bowel smooth muscle is discussed. PMID- 3301512 TI - [Menetrier's disease: contribution of x-ray computed tomography and ultrasonic diagnosis]. PMID- 3301511 TI - [New biological indicators of alcoholism]. PMID- 3301514 TI - [Serum lipoproteins and alcoholic diseases of the liver]. PMID- 3301513 TI - [Calcium and cell death]. PMID- 3301515 TI - [Traveller's diarrhea]. PMID- 3301516 TI - Lymphatic distribution of the stomach in normal, inflammatory, hyperplastic, and neoplastic tissue. AB - Prompted by the lack of knowledge of the distribution of gastric lymphatics and the discrepancy between the incidence of lymph node metastases from intramucosal gastric carcinoma versus intramucosal colonic carcinoma, we undertook a study of the distribution of lymphatics in normal, abnormal non-neoplastic, and neoplastic gastric mucosas. The study involved the histologic, immunocytochemical, and electron microscopic evaluation of a total of 47 gastric biopsy, polypectomy, and resection specimens and showed that the gastric lymphatics normally begin as a plexus of vessels immediately superficial to, within, and below the muscularis mucosae. The upper two-thirds of the gastric lamina propria is normally devoid of lymphatics. This distribution is maintained throughout the cardia, fundus, and antrum and is also maintained in hyperplastic and neoplastic tissues. However, in patients with severe atrophic gastritis in which the overall height of the gastric mucosa is markedly decreased, lymphatic capillaries may be found near the surface epithelium. The relevance of these findings to the behavior of early gastric cancer is discussed. PMID- 3301517 TI - Hemodynamic evaluation of isosorbide dinitrate in alcoholic cirrhosis. Pharmacokinetic-hemodynamic interactions. AB - Isosorbide dinitrate, a long-acting organic nitrate, has been shown to decrease portal pressure in the experimental animal and humans. We conducted a double blind randomized hemodynamic evaluation of the effects of placebo and 10 mg and 20 mg isosorbide dinitrate in stable individuals with alcoholic cirrhosis. Baseline values for all three groups were similar. Isosorbide dinitrate resulted in a peak reduction of the hepatic venous gradient of 24.7% +/- 3.0%, with significantly decreased values 4 h after the administration of the 20-mg dose. A reduction of arterial pressure and cardiac index (peak decrease of 25.7% +/- 1.5%) was well tolerated by 13 of 15 patients. Changes in mean arterial pressure were not predictive of modifications in the hepatic vein wedge pressure. There was no relation between the area under the plasma isosorbide dinitrate concentration curve and hemodynamic changes. Levels of isosorbide-5-mononitrate, a vasoactive metabolite, were detectable for an 8-h period. Isosorbide dinitrate significantly reduced portal pressure in stable cirrhotics, in association with systemic hemodynamic changes. Thus, titration of isosorbide dinitrate is required to maximize hemodynamic benefits in individual patients. As the decrease in portal pressure is more predictable than the effect of previously tested pharmacologic agents, isosorbide dinitrate should be evaluated for its efficacy in the management of portal hypertension. PMID- 3301518 TI - Pathology of neuromuscular disorders of the small intestine and colon. AB - A variety of pathological abnormalities of the smooth muscle and myenteric plexus result in clinical syndromes of disordered small intestinal and colonic motility. These pathological abnormalities have been noted by conventional light microscopy and by utilization of Smith's technique for visualizing the myenteric plexus with silver. We have classified the neuromuscular disorders into two major categories, i.e., those affecting the myenteric plexus and those affecting the smooth muscle. The classification is further developed based on the variety of clinicopathological features of the various disorders. Although we can now identify the underlying pathology of these motor disorders and thus understand these illnesses better than we did a decade ago, we have much more to learn. With the great strides being made to understand the normal structure, function, and development of the myenteric plexus and smooth muscle, there is hope that we will be able to learn much more about the etiology and pathogenesis of these neuromuscular disorders in the decade to come. PMID- 3301520 TI - [Behavior of fetal position in the 2d half of pregnancy in labor with breech and vertex presentations]. AB - In a retrospective analysis, presentation behavior during pregnancy of 501 infants with breech presentation at birth was compared with that of a control population (n = 520) with vertex presentation at birth. Since the fetus usually changes position frequently during the sonographic examination prior to the 20th week of pregnancy, and since its presentation behavior is generally unstable, presentation of the fetus was only determined sonographically from this point onward. In both populations it was found in 40% of the cases that the fetus remained in either breech or vertex presentation up to birth; and in both populations there was one change of position to the definitive presentation at birth in 44% of the cases (before the 33rd week of pregnancy in 95%). Seventeen percent of the infants born from breech presentation and 15% of those born from vertex presentation changed position several times during pregnancy. The stability of presentation behavior during pregnancy of infants with breech presentation at birth was similar to that of infants with vertex presentation. At about the 32nd week of pregnancy, 90% of the fetuses in both breech and vertex presentation had assumed their final presentation prior to birth. Even when breech presentation is found between the 33rd and 36th week of pregnancy there is still a 54% probability of a change to vertex presentation at birth. In contrast, the probability of the fetus turning from vertex to breech presentation at birth in this period of pregnancy is only 0.4%. PMID- 3301519 TI - [The corpus luteum in the ultrasound image and its endocrine function]. AB - The corpora lutea of 38 patients with sterility problems were sonographically measured. In a total of 51 cycles the corpus luteum values were compared with the estradiol (E2) and progesterone (P) plasma levels on the day of sonographic examination (SE). In 49 SEs performed immediately following ovulation the corpus luteum was cystic in 26 cases (means = 14.9 mm) and solid in 23 cases (means = 12.8 mm, p less than 0.05). The postovulatory differences between the corresponding E2 and P values, respectively, were not significant. In the midluteal phase the corpora lutea were cystic in 22 cases (means = 18.2 mm) and solid in 14 (means = 13.4 mm, p less than 0.001). Both E2 (means = 362.8 pg/ml) as well as P (means = 27.7 ng/ml) were higher in the women with cystic than in those with solid corpora lutea (E2 means = 222 pg/ml; P means = 19.4 ng/ml; p less than 0.01 in each case). When the patient collective was split into two groups, with and without stimulation therapy, a significantly higher E2 was only found in the "with therapy" group in patients with cystic corpus luteum in the midluteal phase. The size of the midluteal corpus luteum correlated in particular with the E2 plasma concentrations in all patients (p less than 0.005). Thus, in addition to sonographic measurement of the endometrium, sonographic demonstration of the corpus luteum is also useful in assessing the luteal phase. PMID- 3301521 TI - [Spontaneous liver rupture in eclampsia]. AB - We report on a case of a 34-year old nullipara who suffered from rupture of the liver during eclampsia and survived despite most serious complications. Most cases of rupture of a non-traumatic subcapsular haematoma of the liver during pregnancy are associated with symptoms of pre-eclampsia. The pathogenesis of this severe complication as well as diagnostic imaging and surgical treatment are discussed. The classical trias of pre-eclampsia, epigastric pain and sudden circulary collapse may vary considerably. Since early diagnosis is crucial for maternal and foetal outcome, a subcapsular haematoma of the liver should be considered in women during pregnancy and childbed presenting with pre-eclampsia and upper abdominal pain. Here ultrasonographic imaging is a valuable and readily available diagnostic tool for the obstetrician. PMID- 3301522 TI - [Historical retrospective. Lipamin (Agomensin) and luteolipoid (Sistomensin). Animal experiments and preliminary clinical experiences]. AB - In 1914 "Lipamin" and "Luteolipoid", two extracts of corpus luteum, were developed at the University Gynaecological Hospital in Erlangen, Bavaria. The process of their preparation, protected by patents, was exploited soon after that by Ciba, Basel, who named their products Agomensin and Sistomensin. The history of their development, their effects in animal experiments, as well as their early therapeutical application to women are reported. Special reference is made to the patent specifications and to the lectures held at meetings of the Bavarian Society of Gynaecology and Obstetrics. PMID- 3301523 TI - [A. A. Bogomolets and the evolution of views on the effects of transfused blood]. PMID- 3301524 TI - Effect of human insulin administration on urinary acidification in patients with insulin-dependent diabetes. AB - A previous study has shown that oral glucose administration results in a transient fall in urinary acid excretion in humans. The present study was undertaken to determine the effect of physiologic doses of insulin on urinary acidification while maintaining serum glucose concentration constant. This was accomplished by using a euglycemic insulin clamp method. Eight patients with insulin-dependent diabetes and no clinical or laboratory evidence of detectable renal disease were studied. Data obtained during two 2-hour periods of steady state insulin infusion rates of 0.2 and 0.5 mU/kg/min were compared. This resulted in steady state serum free insulin levels of 15 +/- 0.1 and 39 +/- 0.6 uU/ml respectively. Urinary pH and bicarbonate excretion rate rose while the excretion rates of titratable acid, ammonium and net acid fell significantly with increased insulin administration. These changes occurred in the absence of any significant changes in serum glucose, potassium, Ca2+ or phosphorus concentrations or urinary excretion rates of Na+, K+, phosphorus or Ca2+. These data suggest that increased insulin levels within the physiological range can result in a transient fall in the rate of urinary acid excretion. These findings confirm previous observations in animals and suggest that insulin may be the cause of post prandial urinary "alkaline tide". PMID- 3301525 TI - High frequency generalized transduction by miniMu plasmid phage. AB - Deletion derivatives of phage Mu which replicate as multicopy plasmids, and also transpose and package like Mu, have been developed for the in vivo cloning of bacterial genes. We show here that these miniMu plasmid phage are also efficient at generalized transduction and that both in vivo cloning and generalized transduction of a given gene can be accomplished in a single experiment. PMID- 3301526 TI - Spontaneous mutations occur near dam recognition sites in a dam- Escherichia coli host. AB - The mismatch repair system of Escherichia coli K12 removes mispaired bases from DNA. Mismatch repair can occur on either strand of DNA if it lacks N6 methyladenines within 5'-GATC-3' sequences. In hemimethylated heteroduplexes, repair occurs preferentially on the unmethylated strand. If both strands are fully methylated, repair is inhibited. Mutant (dam-) strains of E. coli defective in the adenine methylase that recognizes 5'-GATC-3' sequences (Dam), and therefore defective in mismatch repair, show increased spontaneous mutation rates compared to otherwise isogenic dam+ hosts. We have isolated and characterized 91 independent mutations that arise as a consequence of the Dam- defect in a plasmid borne phage P22 repressor gene, mnt. The majority of these mutations are A:T--- G:C transitions that occur within six base pairs of the two 5'-GATC-3' sequences in the mnt gene. In contrast, the spectrum of mnt- mutations in a dam+ host is comprised of a majority of insertions of IS elements and deletions that do not cluster near Dam recognition sites. These results show that Dam-directed post replicative mismatch repair plays a significant role in the rectification of potential transition mutations in vivo, and suggest that sequences associated with Dam recognition sites are particularly prone to replication or repair errors. PMID- 3301527 TI - Evolution of Escherichia coli during growth in a constant environment. AB - Populations of Escherichia coli, initiated with a single clone and maintained for long periods in glucose-limited continuous culture, developed extensive polymorphisms. In one population, examined after 765 generations, two majority and two minority types were identified. Stable mixed populations were reestablished from the isolated strains. Factors involved in the development of this polymorphism included differences in the maximum specific growth rate and in the transport of glucose, and excretion of metabolites by some clones which were utilized by minority clones. PMID- 3301528 TI - Chromosome specificity of polysomy promotion by disruptions of the Saccharomyces cerevisiae RNA1 gene. AB - Previously, we showed that a disruption of the yeast RNA1 gene with LEU2 sequences promotes polysomy for chromosome XIII. Here we demonstrate that this phenotype is due to sequences specific to the RNA1 gene and that the disruption allele does not affect nondisjunction of three other chromosomes or polysomy of a minichromosome. Hence polysomy appears to be restricted to chromosome XIII. PMID- 3301529 TI - Evaluation and treatment of paranoid syndromes in the elderly: a review. AB - Paranoid symptoms in the elderly patient may be a manifestation of medical, neurologic, psychiatric, or medication-induced illness. Because of the potential for multiple interacting factors between underlying organicity and psychiatric illness precise assessment of the etiology of the patient's psychotic behavior may be difficult. This article reviews the medical and neurologic illnesses often associated with paranoia in the elderly as well as the psychiatric differential diagnosis. Psychotic depression, late-onset schizophrenia, and delusional/paranoid disorders are examined, as are their treatments. Revisions in the nosology of late-onset psychosis as they are affected by revisions in DSM-III R are also discussed. PMID- 3301530 TI - Sequence, structure and promoter characterization of the human thymidine kinase gene. AB - The 12.9-kb human thymidine kinase gene (tk) has been sequenced in its entirety along with flanking regions. Consistent with the previously sequenced chicken tk sequence, the human tk is composed of seven exons. The intron sizes differ substantially, and are responsible for the four-fold greater size of the human relative to the chicken gene. Within the introns are found 13 Alu family repeated sequences and a polypyrimidine stretch. A functional promoter region has been located by fusing sequences from the 5' end of the tk gene to the chloramphenicl acetyl transferase (CAT) gene and assaying CAT activity following transfection into mouse L cells. Several putative transcription signals have been identified in the 5' end including 'TATAA' and 'CCAAT' sequences and 'G-C' elements, two of which are arranged in a 27-bp inverted repeat. There is also a 12-bp repeat, containing an inverted 'CCAAT' element. This repeat shows strong homology to a repeat in the chicken tk promoter as well as the 5' regions of other cell-cycle regulated genes, suggesting that it may be part of the promoter or a regulatory signal. The 5' flanking sequence is G + C-rich and has a high concentration of CpG dinucleotides. PMID- 3301531 TI - The mapping of chromosomes in Saccharomyces cerevisiae. I. A cosmid vector designed to establish, by cloning into cdc-mutants, numerous start loci for chromosome walking in the yeast genome. AB - A series of vectors for cosmid cloning in yeast has been derived from cosmid pHC79. Vectors pMT4 through pMT6 contain two tandemly arranged cohesive end sites (cos) from the genome of bacteriophage lambda. Their design allows the rapid and simple preparation of cosmid arms by linearizing a vector at the unique PvuII restriction site located between the two cos-sequences and then cutting the linearized molecule at one of its unique cloning sites for BamHI, ClaI, PvuI, SalI or ScaI. Cosmids generated with arms from the most advanced vector, pMT6, carry the origin of replication (ori) and the ApR gene from pBR322 and the TRP1/ARS1 and URA1 genes from Saccharomyces cerevisiae. A yeast genomic DNA library was established by packaging in vitro, into bacteriophage lambda preheads, of partially restricted yeast DNA fragments ligated to cosmid arms of vector pMT6. About 80% of the clones thus obtained comprise inserts of contiguous genomic DNA over 30 kb in length. Unique DNA probes for the yeast genes CDC10, CDC39, HIS4, LEU2, and PGK1 have successfully been applied when testing for completeness of this library by isolating a series of overlapping cosmid clones that carry the respective genes. The library will thus be useful for the selection of cosmid clones which carry CDC genes from yeast by complementing first, with the vectorial yeast gene URA1, the pyrimidine auxotrophy of most cdc strains and then, with the respective CDC wild-type genes, of the temperature sensitive mutant alleles. Most CDC clones thus obtained will provide unique DNA probes which serve as randomly distributed start sequences within the yeast genome for overlap hybridization screening in chromosome mapping studies. PMID- 3301532 TI - Expression vector promoting the synthesis and export of the human growth-hormone releasing factor in Escherichia coli. AB - We have studied the synthesis, processing and export of human growth-hormone releasing factor (hGRF) in Escherichia coli transformed with a plasmid constructed for the expression of hGRF as a hybrid protein. A DNA fragment containing the entire sequence of phosphate-binding protein gene (phoS) is fused to a modified hGRF-coding sequence (phoS-mhGRF). The hybrid protein, PhoS-mhGRF, was recovered in the supernatant fluid after spheroplasting treatment indicating correct export to the periplasmic space. Pulse-chase experiments demonstrated that the hybrid protein was similarly processed as the PhoS precursor. PMID- 3301533 TI - Cloning of the 3'-phosphoadenylyl sulfate reductase and sulfite reductase genes from Escherichia coli K-12. AB - The structural genes for 3'-phosphoadenylyl sulfate (PAPS) reductase (cysH) and sulfite reductase (alpha and beta subunits; EC 1.8.1.2)(cysI and cysJ) of Escherichia coli K-12 have been cloned by complementation. pCYSI contains two PstI fragments (18.3 and 2.9 kb) which complement cysH-, cysI-, and cysJ- mutants. Subcloning showed that the cysH gene is located on a 1.6-kb ClaI subfragment (pCYSI-3) whereas cysI and most of cysJ are carried on a 3.7-kb ClaI subfragment (pCYSI-5). The PAPS reductase gene is closely linked to the sulfite reductase genes, but its expression is regulated by a unique promoter. The cysI and cysJ genes, on the other hand, are transcribed as an operon and the promoter precedes the cysI gene. Maxicell analysis demonstrated that pCYSI encodes three polypeptides of Mr 27,000, 57,000, and 60,000, in addition to the tetracycline resistance determinant. The 60- and 57-kDa proteins are most likely the alpha and beta subunits, respectively, of E. coli sulfite reductase while the 27-kDa protein is putatively identified as PAPS reductase. Preliminary data suggest that the alpha and beta subunits of sulfite reductase are encoded by cysI and cysJ, respectively. PMID- 3301534 TI - Nucleotide sequence of a cDNA for a member of the human 90-kDa heat-shock protein family. AB - This paper describes the isolation and sequence of a human cDNA homologous to a class of proteins commonly referred to as 90-kDa heat-shock proteins. The complete nucleotide sequence of 2563 bp and the deduced amino acid sequence are presented. A single long open reading frame encodes a protein of 83,303 Da, the amino acid composition of which correlates well with that determined for the human 90-kDa heat-shock or 'stress' protein [Welch, W.J. and Feramisco, J.R., J. Biol. Chem. 257 (1982) 14949-14959]. Moreover, sequence analysis of this gene reveals extensive homology with the Drosophila 83-kDa and yeast 90-kDa heat-shock proteins. A comparison of the translated product of the human cDNA to the published yeast 90-kDa heat-shock protein reveals more than 60% homology at both the nucleotide and amino acid levels. Several regions of 50 aa or more show greater than 90% identity. This cDNA also hybridizes with an RNA species which increases upon heat shock of HeLa cells. PMID- 3301535 TI - Secondary structure at the bacteriophage G4 origin of complementary-strand DNA synthesis: in vivo requirements. AB - The bacteriophage G4 origin of complementary strand DNA synthesis, G4 ori, contains several regions of potential secondary structure. In this study, we ask whether DNA secondary structure is important for G4 ori function in vivo. Point mutations were generated within a region of potential secondary structure so as to disrupt intrastrand base pairing. These mutations led to a strong temperature dependent reduction in ori function in vivo. A double point mutation which introduces the same base substitutions without destabilizing intrastrand base pairing did not cause a temperature-dependent disruption in ori function. The double mutant did display a slight temperature-independent reduction in ori function compared to the wild-type G4 ori. Based on these findings, we conclude that DNA secondary structure, as well as recognition of specific sequences, is required for G4 ori activity in vivo. PMID- 3301536 TI - Lorist2, a cosmid with transcriptional terminators insulating vector genes from interference by promoters within the insert: effect on DNA yield and cloned insert frequency. AB - Transcription terminators have been included in a phage-lambda-replicon-based cosmid vector, Lorist2, to insulate vector genes against transcriptional interference from cloned insert DNA. DNA yields of recombinant clones containing Escherichia coli genomic DNA inserts are more even for Lorist2 than with its progenitor LoristB. However, the terminators provide only a partial reduction in the over-representation of r X DNA-containing clones generally observed in cosmid libraries of Caenorhabditis elegans DNA, suggesting that causes other than transcriptional readthrough into the vector contribute to this problem. PMID- 3301537 TI - Sequence determinants in the lamB gene of Escherichia coli influencing the binding and pore selectivity of maltoporin. AB - Maltoporin (LamB protein) is a malto-oligosaccharide-selective pore protein in the outer membrane of Escherichia coli. The genetic basis of binding and transport specificity was investigated through cloning, mapping and sequencing lamB genes from seven independent mutants with various changes in maltodextrin binding affinities; these mutants were unchanged in binding phage lambda. Single amino acid substitutions specifically resulting in maltodextrin affinity changes were as follows: Arg8----His in two independent mutants resulted in much reduced affinity for all ligands and a smaller pore no longer selective for maltodextrins. A Trp74----Arg substitution resulted in a lower affinity for starch, a slight increase in maltose affinity but no striking pore changes. An Arg82----Ser resulted in lowered maltodextrin affinity, but increased affinity for sucrose in both binding and pore function. A Tyr118----Phe resulted in a higher affinity for both starch and maltose, a slightly larger pore and increased transport of maltohexaose by the pores. Asp121----Gly in two independent isolates resulted in a higher affinity for large dextrins and a marginally larger pore. These results suggest that the maltodextrin-selective functions reside in the N terminal sequence of maltoporin and are separate from the phage lambda binding domains. PMID- 3301538 TI - The AT spacers and the var1 genes from the mitochondrial genomes of Saccharomyces cerevisiae and Torulopsis glabrata: evolutionary origin and mechanism of formation. AB - Intergenic sequences represent 63% of the mitochondrial 'long' (85 kb) genome of Saccharomyces cerevisiae. They comprise 170-200 AT spacers that correspond to 47% of the genome and are separated from each other by GC clusters, ORFs, ori sequences, as well as by protein-coding genes. Intergenic AT spacers have an average size of 190 bp, and a GC level of 5%; they are formed by short (20-30 nt on the average) A/T stretches separated by C/G mono- to trinucleotides. An analysis of the primary structures of all intergenic AT spacers already sequenced (32 kb; 80% of the total) has shown that they are characterized by an extremely high level of short sequence repetitiveness and by a characteristic sequence pattern; the frequencies of A/T isostichs conspicuously deviate from statistical expectations, and exponentially decrease when their (AT + TA)/(AA + TT) ratio, R, decreases. A situation basically identical was found in the AT spacers of the mitochondrial genome (19 kb) of Torulopsis glabrata. The sequence features of the AT spacers indicate that they were built in evolution by an expansion process mainly involving rounds of duplication, inversion and translocation events which affected an initial oligodeoxynucleotide (endowed with a particular R ratio) and the sequences derived from it. In turn, the initial oligodeoxynucleotide appears to have arisen from an ancestral promoter-replicator sequence which was at the origin of the nonanucleotide promoters present in the mitochondrial genomes of several yeasts. Common sequence patterns indicate that the AT spacers so formed gave rise to the var1 gene (by linking and phasing of short ORFs), to the DNA stretches corresponding to the untranslated mRNA sequences and to the central stretches of ori sequences from S. cerevisiae. PMID- 3301539 TI - Nucleotide sequence of the CLS4 (CDC24) gene of Saccharomyces cerevisiae. AB - The nucleotide sequence of the CLS4 gene controlling Ca2+ regulatory process of bud emergence, which was cloned previously [Ohya et al., J. Bacteriol. 165 (1986) 28-33], was determined. The CLS4 (CDC24) locus encodes a protein consisting of 736 amino acid (aa) residues with an Mr of 83,970. By primer extension mapping, the mRNA start point was located 139 bp upstream from the translation start codon. The predicted CLS4 protein was hydrophilic with two serine + threonine rich domains in the middle and C-terminal regions. It has two putative Ca2+ binding regions, one being partly homologous to the Ca2+-binding domain of the S 100a protein and the other that of alpha-lactalbumin. PMID- 3301540 TI - Sequence of the protease of human subgroup E adenovirus type 4. AB - A fragment of DNA containing the protease gene and 3' and 5' flanking regions of human adenovirus type 4 (Ad4) has been cloned and sequenced. The gene is located between 59 and 62 map units and codes for a protein of 201 amino acids with a calculated Mr of 22,758. The Ad4 protease has a 72% amino acid homology with the Ad2 protease, the divergence being concentrated in the middle of the molecule. Comparison with other mammalian and bacterial proteases failed to reveal any significant homology and in particular a putative active site. The adenoviral proteases may therefore represent a novel class of enzymes. PMID- 3301541 TI - Static bend of DNA helix at the activator recognition site of the ompF promoter in Escherichia coli. AB - Expression of the ompF gene coding for a major outer membrane protein of Escherichia coli is regulated by osmolarity of the medium. The ompF expression is controlled by a transcriptional activation mechanism which requires the ompR gene product acting on a region located upstream from the canonical -35 and -10 regions of the ompF gene. Evidence is presented that the upstream region of the ompF promoter contains a static bend of DNA having two sets of oligo (dA X dT) tracts with periodical spacing. It was demonstrated that the bending region overlaps with the recognition site for the activator protein, OmpR. PMID- 3301542 TI - [In memory of Alexander Tschirch (1856-1939), Berne]. PMID- 3301543 TI - [The anatomo-clinical method: Padua--Paris--Vienna--Padua]. PMID- 3301544 TI - [In memory of Erna Lesky (22 May 1911-17 November 1986)]. PMID- 3301545 TI - [Reading signs and interpreting signs. On the history of medical semiotics]. PMID- 3301546 TI - [Healing forces from machines--electrical and magnetic cures in the 18th century]. PMID- 3301547 TI - [Drugs for epilepsy around 1800]. PMID- 3301549 TI - Pars plana vitrectomy in the management of subluxed and posteriorly dislocated intraocular lenses. AB - The results of pars plana vitreous microsurgery in a series of nine patients with subluxed or posteriorly dislocated intraocular lenses (IOL) are described. Two posterior chamber intraocular lenses were repositioned in the ciliary sulcus anterior to the zonular ring. One posteriorly dislocated anterior chamber IOL was retrieved from the vitreous gel and repositioned into the anterior chamber angle. In three cases, stable repositioning of the dislocated posterior chamber IOL could not be achieved and the lens was exchanged by way of a limbal incision for an appropriate anterior chamber IOL. In three cases, and anterior chamber IOL subluxed into a large basal iridectomy was successfully repositioned using similar instrumentation. PMID- 3301548 TI - L. R. Villerme and Zurich. PMID- 3301550 TI - Cytotoxic effects of daunomycin on retinal pigment epithelium in vitro. AB - Proliferative vitreoretinopathy (PVR), the most severe complication of retinal detachment surgery and posterior segment ocular trauma, is characterized by the intraocular proliferation of non-neoplastic cells with formation of vitreal and periretinal membranes resulting in renewed traction retinal detachment. As retinal pigment epithelial (RPE) cells have been shown to play an essential role in the development of PVR, we investigated the acute and chronic effects of daunomycin on the morphology and viability of porcine RPE cells in vitro. The intense and complete inhibition of cell proliferation reported in this study adds to previous evidence that daunomycin may be useful for pharmacological treatment of human PVR. PMID- 3301553 TI - [Hygienic assessment of iodine radioisotopes]. PMID- 3301552 TI - [The origin of Soviet industrial hygiene (on the 90th anniversary of the birth of S. N. Cherkinskii)]. PMID- 3301551 TI - Bone-marrow transplantation and toxoplasmic retinochoroiditis. AB - A 33-year-old woman underwent bone-marrow transplantation following radiation and chemotherapy for chronic myelocytic leukemia (CML); immunosuppressive therapy was continued for graft-versus-host disease. Five months after successful transplantation, she developed necrotizing retinitis in both eyes with rapid progression over the following weeks. Due to her immunosuppressed state the patient developed pneumonia and died. Postmortem evaluation of the retinal lesions in both eyes disclosed infection by Toxoplasma gondii, which was also found in the brain and myocardium. Multiple viable toxoplasmic cysts were observed at the transition zone from a necrotic to a normal retina. Additionally, cysts of Toxoplasma gondii a normal retina. Additionally, cysts of Toxoplasma gondii were seen in the adjacent intact retina and in areas of necrosis with almost complete absence of retinal or choroidal inflammation. Toxoplasmosis should therefore be considered along with fungi and viruses in the differential diagnosis of necrotizing retinochoroiditis in immunocompromised patients. PMID- 3301554 TI - [Physiological and hygienic problems of using alcohols and other organic solvents in the home and in industry]. PMID- 3301555 TI - Spontaneous movements of embryos and fetuses in the early stage of life. PMID- 3301556 TI - Enkephalinase inhibition by thiorphan and subsequent response of ethanol, normorphine and enkephalins on mouse vas deferens. AB - In this study, a comparison was made between ethanol, normorphine methionine enkephalin and [D-ala2] enkephalinamide and the ability of thiorphan, an enkephalinase inhibitor, to potentiate their in vitro activity to inhibit the electrically induced contractions of mouse vas deferens. Thiorphan did not significantly alter the response of either ethanol or normorphine on mouse vas deferens, whereas it significantly potentiated the response of methionine enkephalin. PMID- 3301557 TI - Migraine and epilepsy. AB - A critical review is presented of the reported data allegedly indicative of a relationship between migraine and epilepsy. These data are considered under five major headings: genetic, epidemiological, clinical, electro-neurophysiological and neurochemical. Genetic data fail to reveal a basis on which to argue for a common single genetic trait. Both disorders pathogenetically are the result of polygenic predisposition and environmental factors. Epidemiological data such as are left after strict analysis indicate that coincidental concurrence of the two disorders show superficial resemblances and fundamental differences. The neurochemical basis of both disorders appears to diverge widely. Electrophysiological data support the conclusion arrived at in the genetic discussion. It is concluded that migraine and epilepsy are not linked in any fundamental function. PMID- 3301558 TI - Trigger factors and natural history of migraine. AB - Trigger factors are important for two main reasons. Firstly, they may provide some clues as to the pathogenesis of migraine. Secondly, by avoidance of them, drug therapy may be obviated. There are at least sixty trigger factors in migraine but the mechanism by which they produce migraine attacks varies. PMID- 3301559 TI - Is there a common pharmacological link between migraine and epilepsy? AB - If Ca2+-entry blocking action is the common mechanism of action of flunarizine in both epilepsy and migraine, other calcium entry blockers (CEB's) should possess anticonvulsant activity and antimigraine drugs should be anticonvulsants. Since spreading depression (SD) is suggested to underlie the aura phase of classical migraine, antimigraine drugs, CEB's and anticonvulsants would be expected to alter SD. Several experiments showed flunarizine to be an effective anticonvulsant; in some conditions, it increased the threshold for SD; it reduced epileptic bursts recorded from brain hippocampus. However, pharmacology of other CEB's and of antimigraine drugs failed to establish a link between anticonvulsant action, actions on SD and on spontaneous epileptic bursts of the hippocampus. PMID- 3301562 TI - [Use of glue compositions in pulmonary surgery (review of the literature and personal data)]. PMID- 3301561 TI - [Congenital absence of the pulmonary valve]. PMID- 3301560 TI - Flunarizine as add-on therapy in epilepsy. Crossover study vs placebo. AB - The anticonvulsive effect of flunarizine was studied in a multicenter trial, by means of a randomized, double-blind, single crossover design. The subjects who entered the study were 51 males and 39 females, aged 15 to 73 years. They were epileptic patients who suffered from at least two generalized seizures per month or more than 4 partial seizures per month. The patients were already being treated with major antiepileptic drugs. Flunarizine was administered in a single evening dose of 10 mg/die in patients who weighed less than 70 kg and of 15 mg/die in patients who weighed more 70 kg. Our results show that flunarizine, given as add-on therapy, produced a slight but significant decrease in the number of monthly seizures at the end of a 3-month period, while placebo did not significantly change the seizures frequency. PMID- 3301565 TI - [Contrast sensitivity in testing visual functions in diabetics]. PMID- 3301564 TI - [Computerized visual field]. PMID- 3301563 TI - A prospective study of the umbilical artery waveform in appropriate-for-date and growth-retarded fetuses. AB - Blood velocity waveforms were obtained by a combination of real-time B-mode and pulsed Doppler (2 MHz) ultrasound from the umbilical artery. In a prospective study, velocity waveforms of the umbilical artery were analyzed from 36 patients with single pregnancies. Sonograms were performed every 2nd week from the 18th week menstrual age onwards till labor. A total of 331 velocity profiles were obtained. Reference values were obtained from 27 patients with uncomplicated pregnancies. Abnormal waveforms were found in 9 cases. A comparison was made between the normal and abnormal group with regard to placental impedance indices [resistance index (RI), A/B ratio and pulsatility index (PI)]. The sensitivity, specificity, predictive values of each mentioned index were determined. The sensitivity of the PI and the RI is the same: 77.8%, the sensitivity of the A/B ratio is 66.7%. The specificity is also slightly higher for the PI and RI than for the A/B ratio (81.5, 81.5 and 77.5%, respectively). The same can be said for the predictive values (predictive value with positive result, 58.3, 58.3 and 50.0%, predictive value with negative result, 91.2, 91.2 and 87.5%). On the basis of these results and theoretical considerations, the PI is preferable to the other two placental impedance indices. It was shown once more that, with certain restrictions, this noninvasive transcutaneous technique reflects fetal well being. PMID- 3301566 TI - [Prostaglandins and diarrheal disorders]. PMID- 3301567 TI - [Hyperglycemia--its relationship to diabetic neuropathy]. PMID- 3301568 TI - [Second-look laparotomy in ovarian cancer]. PMID- 3301569 TI - [Diagnosis and treatment of group A hemolytic streptococcal pharyngitis]. PMID- 3301572 TI - [The pressure suit in emergency medicine]. PMID- 3301571 TI - [Revival of lung transplantation]. PMID- 3301570 TI - [Midazolam as premedication for upper gastrointestinal endoscopy]. PMID- 3301573 TI - [Wound healing]. PMID- 3301574 TI - [Leukocytoclastic vasculitis]. PMID- 3301576 TI - [New immunological aspects in bullous diseases]. PMID- 3301575 TI - [Lung transplantation]. PMID- 3301577 TI - [Real time ultrasonography of the neonatal brain]. PMID- 3301578 TI - [Primary hypercoagulable states]. PMID- 3301579 TI - [Pediatric trauma--update]. PMID- 3301580 TI - [Developmental and therapeutic considerations in infantile heart failure]. PMID- 3301581 TI - [Sex hormones and autoimmune diseases]. PMID- 3301582 TI - [Recent developments in AIDS]. PMID- 3301583 TI - [Human insulin]. PMID- 3301585 TI - [Cardiopulmonary exercise testing--rationale, objectives and methods]. PMID- 3301584 TI - [Reye-like syndrome due to Shigella flexneri in a child]. PMID- 3301587 TI - [Plasmapheresis in neurological diseases]. PMID- 3301588 TI - [Metabolic evaluation of the patient with urinary stones]. PMID- 3301586 TI - [The use of agonist analogues of luteinizing hormone--releasing hormone in the treatment of prostatic carcinoma]. PMID- 3301589 TI - [Inflammatory diseases of the prostate]. PMID- 3301590 TI - [Can quality control be applied to psychotherapy? Review of the literature]. PMID- 3301591 TI - [Inappropriate antidiuretic hormone secretion as a complication of preparation for pelvic ultrasonography]. PMID- 3301593 TI - [The association of infecting agents and autoimmune diseases]. PMID- 3301592 TI - [The early detection of cutaneous malignant melanoma]. PMID- 3301595 TI - [Treatment of carcinoid syndrome]. PMID- 3301594 TI - [Oxygen toxicity]. PMID- 3301596 TI - Phototoxicity testing--in vivo and in vitro. PMID- 3301597 TI - Outbreak of wound infections following outpatient podiatric surgery due to contaminated bone drills. AB - An outbreak of podiatric infections due to an uncommon strain of Proteus mirabilis occurred following outpatient podiatric surgery. An evaluation of the operating room environment failed to reveal the strain of P. mirabilis from any site other than three bone drills. Thus the drills served as the reservoir for the organism that was subsequently inoculated onto the hands of the surgeon or directly to a patient during bone drilling. The gas sterilization procedure that was used to sterilize the drills was found deficient. No additional cases of P. mirabilis infection have been observed since the elimination of the contaminated drills. PMID- 3301598 TI - [The Crystal-Lok system--a new crystal-inducing heating conditioner]. PMID- 3301599 TI - [The Hippocrates and Galen debate]. PMID- 3301600 TI - [Definition of immunologic risk in kidney transplantation]. PMID- 3301602 TI - [Venous digital subtraction angiography. Value in cerebrovascular diseases]. PMID- 3301601 TI - [Theophylline--once or twice daily?]. PMID- 3301603 TI - [Effect of Ginkgo biloba extract in arterial occlusive disease. Randomized placebo controlled crossover study]. PMID- 3301604 TI - [An evaluation of insulin requirement of diabetic patients by glucagon test]. PMID- 3301605 TI - Morphology of the chronic toxicity of busulfan on the islets of Langerhans in the rat. AB - Male Wistar rats were fed Busulfan dissolved in fat milk at a daily dose of 0.35, 0.89, 1.20 mg/kg body weight for a period of four, eight and twelve weeks. Examination by light microscopy, including immunohistochemistry, and by electron microscopy revealed changes in the pancreatic islets which were dependent on dose and time. First, hyperaemia was demonstrated, then perivascular "inbleedings" were followed by organisation and islet fibrosis with centripetal reduction of the islet cells. This resulted in an almost complete loss of A-cells and a reduction in the number of B-cells. A morphological factor analysis suggested additional analogies to type I - diabetes mellitus, so that for the formal pathogenesis, islet haematoma and immunological events have to be discussed. PMID- 3301606 TI - Cisapride: influence on oesophageal and gastric emptying and gastro-oesophageal reflux in patients with reflux oesophagitis. AB - A preliminary, double-blind placebo controlled trial of cisapride in reflux oesophagitis was conducted. Eighteen patients were allocated to treatment with either placebo or cisapride, 10 mg three times daily, orally, before meals. Gastric emptying of a scrambled egg meal, oesophageal transit of a liquid bolus and ambulatory monitoring of oesophageal pH were assessed before and after four weeks' therapy. Overall, gastric emptying rates were not influenced by cisapride, although a small but significant reduction in gastric isotope retention, 20 minutes after meal ingestion was observed in patients on the active drug. Oesophageal transit times were not altered by cisapride. A small but significant reduction in the duration of gastro-oesophageal reflux followed cisapride therapy when compared with placebo. PMID- 3301607 TI - [Present state and prospectives in the diagnosis and therapy of lung neoplasms. 1. Diagnosis of hilar epidermoid carcinoma of the lung--with special reference to cytodiagnosis]. PMID- 3301608 TI - [Present state and prospectives in the diagnosis and therapy of lung neoplasms. 3. Efficacy of mass screening of lung cancer]. PMID- 3301609 TI - [Present state and prospectives in the diagnosis and therapy of lung neoplasms. 4. Application of computer image processing for the diagnosis of hilar neoplasms of the lung]. PMID- 3301610 TI - [Application of digital subtraction angiography (DSA) in the neurosurgical field]. AB - Intraarterial digital subtraction angiography (DSA) was applied 44 times to 39 neurosurgical cases. We emphasize the advantage of DSA in relation to conventional angiography. The examination consisted of 25 aortography and 19 selective arteriography. By single small dose injection of contrast medium using DSA, aortic arch and thoracic major vessels were well visualized, so that we could obtain useful information for catheterization to the selective artery. High time resolution of DSA made possible to recognize dynamics of circulation in very short interval, especially in the case of subclavian steal syndrome and right aortic arch. Major four vessels in the cervical region could be visualized by single injection of contrast medium using DSA. Stenosis of carotid artery was recognized by DSA as well as conventional angiography. By aortic injection using DSA, circulatory dynamics of intracranial vessels including collateral circulation were recognized especially in the case of moyamoya disease. Gradual injection of small dose contrast medium reduced jet-effect of the catheter tip and enabled the selective arteriography. Real time display of DSA reduced the time required for examination and enabled repeated angiography to recognize the change of hemodynamics under the different limb position in the case of thoracic outlet syndrome. PMID- 3301611 TI - [Recent progress in therapy of urinary calculi]. PMID- 3301612 TI - [Basic problems of the injured digital flexor tendon]. PMID- 3301613 TI - [Diagnostic value of digital subtraction angiography (DSA) using Toshiba Digiformer X in the cerebrospinal vascular diseases]. AB - Using TOSHIBA Digiformer X, digital subtraction angiography (DSA) was performed in 286 patients, in whom 229 patients of cerebro-spinal vascular disease was included. The authors emphasize the usefulness of DSA in cerebro-spinal vascular disease in relation to conventional angiography. DSA taken by single small dose injection of contrast medium into the ascending aorta clearly demonstrates not only aortic arch and thoracic major vessels, but also cervical vessels and all intracranial vessels. Therefore, we could rapidly understand gross dynamics of the circulation and obtain useful informations prior to catheterization to the selective artery. This advantage of DSA was particularly useful for occlusive vascular diseases. Gradual injection of small dose of contrast medium obviously reduced recoiling of the catheter tip, which enabled the selective angiography with setting of the tip of the catheter at the entrance of cervical major vessels without its sufficient insertion into the selective vessels. This advantage is particularly beneficial for the patients with severe arteriosclerosis who was found to be difficult for selective catheterization. In our experience, demonstration of a presence of aneurysm by DSA was possible in almost all cases of subarachnoid hemorrhage, although spatial resolution of DSA is said to be inferior to the conventional angiography. Real time display of DSA decreased the time required for examination and enabled repeated angiography. This advantage of DSA is especially useful for the patients with spinal arterio-venous malformation and thoracic outlet syndrome. PMID- 3301614 TI - Acidifying enemas (lactitol and lactose) vs. nonacidifying enemas (tap water) to treat acute portal-systemic encephalopathy: a double-blind, randomized clinical trial. AB - A double-blind, controlled trial to study the efficacy of acidifying enemas of lactitol, a new galactoside-sorbitol disaccharide, and lactose vs. nonacidifying tap-water enemas was performed in 45 episodes of acute portal-systemic encephalopathy. At the time of randomization, all patients had encephalopathy of at least Grade 2+ severity, delay in the performance of number connection tests and hyperammonemia. A sequential analysis was performed which revealed after the inclusion of the first 20 patients, a significant failure of the nonacidifying enemas as compared to the lactitol enemas (p less than 0.004). The tap-water enema group was, therefore, suspended but the rest of the study continued after rerandomization for lactose and lactitol groups. A favorable response to treatment was obtained in 19 (86%) of the patients receiving lactitol enemas and in 14 (78%) of those receiving lactose enemas. A similar significant improvement in portal-systemic encephalopathy parameters and index was observed after both treatments. Both types of acidifying enemas induced a significant pH decrease in stool (p less than 0.05). These data suggest that acidifying agents like lactose and lactitol are effective and superior to tap-water enemas for the treatment of acute nitrogenous portal-systemic encephalopathy. PMID- 3301616 TI - Rat liver endothelial cells have a greater capacity than Kupffer cells to endocytose N-acetylglucosamine- and mannose-terminated glycoproteins. AB - The capacity of rat liver Kupffer and endothelial cells to endocytose glycoproteins with N-acetylglucosamine- or mannose-terminated oligosaccharide chains was studied. For this purpose, agalactoorosomucoid, ahexosaminoorosomucoid and horseradish peroxidase were used as ligands. A reliable determination of the amount of ligand endocytosed in vivo or in vitro was made possible by using the recently developed cold pronase method for the isolation and purification of Kupffer and endothelial cells. Both cell types participated in the uptake of the ligands in vivo as well as in vitro, but their endocytic capacity was several times greater in vivo than in vitro. Under both conditions, endothelial cells possessed a greater capacity to endocytose the ligands than did Kupffer cells. Since the total number of endothelial cells in the liver is at least twice the number of Kupffer cells, the contribution of endothelial cells to the liver uptake of N-acetylglucosamine-terminated glycoproteins in vivo was estimated to be 3 to 7 times higher than that of the Kupffer cells. In vitro experiments showed that the uptake of the glycoproteins followed saturation kinetics and was strongly inhibited at 4 degrees C and in the presence of mannan. Ultrastructural investigations revealed that horseradish peroxidase was taken up by all Kupffer and endothelial cells. These results emphasize the important role liver endothelial cells play in the clearance of specific glycoproteins from the circulation. PMID- 3301615 TI - Interaction of human liver connective tissue cells, skin fibroblasts and smooth muscle cells with collagen gels. AB - Interactions of liver connective tissue cells, skin fibroblasts and smooth muscle cells with collagen gels in vitro were studied and compared. Liver connective tissue cells showed the lowest rate of migration into the gel and the highest speed of gel contraction, reflecting their high adhesiveness to the substrate as compared to the other cell lines studied. The analysis of their ultrastructural morphology showed that liver connective tissue cells and smooth muscle cells developed cytoskeletal and cytoplasmic organelle polarities, in response to the contact with gel surface. This polarity was lost when cells were embedded in the gel. Skin fibroblasts did not show this characteristic, neither on top nor in the gel. Although liver connective tissue cells have been recognized as analogous to smooth muscle cells, they represent a defined cell population, present in fibrotic livers, with specific behavior and with particular relationship to the extracellular matrix. PMID- 3301617 TI - Evidence for the cell-surface localization of antigens cross-reacting with the "mitochondrial antibodies" of primary biliary cirrhosis. AB - Studies with subfractions of Saccharomyces cerevisiae obtained by differential centrifugation showed only two primary biliary cirrhosis-specific antigens. These antigenic species were shown, using preabsorption studies, to have determinants cross-reactive with their mammalian counterpart. Distribution profiles of marker enzymes and primary biliary cirrhosis antigens between sucrose density gradient subcellular fractions of yeast showed that a relatively high concentration of primary biliary cirrhosis-specific antigens was associated with fractions containing plasma membranes, as well as those containing mitochondria. The possible cell-surface localization of the primary biliary cirrhosis antigens was further investigated using an indirect immunofluorescent technique on a number of different mammalian cells. Rat hepatoma cells, isolated rat hepatocytes and human polymorphonuclear leukocytes and lymphocytes stained positively with primary biliary cirrhosis sera, but not with normal sera or primary biliary cirrhosis sera preabsorbed with beef heart mitochondria. However, blood cells from primary biliary cirrhotic patients gave positive immunofluorescence in all tests, which is compatible with prior binding of the patients' own antimitochondrial antibodies to the surface of the cells. PMID- 3301618 TI - Chronic type B hepatitis and the "healthy" HBsAg carrier state. PMID- 3301620 TI - More detailed and timely data sought from hospitals. PMID- 3301619 TI - Female sexual behavior in hypogonadal mice with GnRH-containing brain grafts. AB - Hypogonadal female mice respond to GnRH-containing fetal preoptic area (POA) implants in the third ventricle with vaginal opening and persistent vaginal estrus, ovarian, and uterine development and increased gonadotropin secretion. When these females are mated with normal males, reflex ovulation results in pregnancy. In the present study, POA implants derived from neonatal pups, whether male or female, were also capable of supporting reproductive development in the hypogonadal female mice. Evaluation of female sexual behavior in the mice with grafts showed that these mice responded to normal males with comparable levels of lordosis as are seen in normal female mice on the proestrous days of their cycles. PMID- 3301621 TI - Hospital and physician Medicare payments cut. PMID- 3301624 TI - Going home to die: developing home health care services for AIDS patients. PMID- 3301622 TI - More complications seen for Medicare payment. PMID- 3301623 TI - Court shuts down retroactive rules. PMID- 3301625 TI - Intermediate lymphocytic lymphoma: an immunohistologic study with comparison to other lymphocytic lymphomas. AB - In an immunohistologic analysis of 13 cases of intermediate lymphocytic lymphoma (ILL), the immunophenotype of ILL was compared to the immunophenotypes of other B lymphocytic lymphomas and the normal lymphoid follicle to determine the normal cell in the scheme of B-cell differentiation that corresponds to ILL. The characteristic immunophenotype of ILL was surface IgM +/- D+, cytoplasmic immunoglobulin -, B1+, BA1+, B2-, BA2-, B4+, Leu 14+, HLA-DR+, Leu 1+, and common acute lymphoblastic leukemia associated (CALLA) antigen -. The immunophenotype of ILL was similar to that of lymphocytes in normal primary follicles and the mantle zones of secondary follicles. The "immature" phenotype of ILL was identical to that of small lymphocytic lymphoma, which strongly supports their close lineage relationship. In contrast, the "mature" phenotypes of the follicular center cell and lymphoplasmacytoid lymphomas suggest that they correspond to normal cells at later stages of differentiation. Our findings indicate that B-lymphocytic lymphomas recapitulate the normal stages of B-cell differentiation. The cell of ILL appears to be an immature B cell that homes to, and resides in, primary follicles and the mantle zones of secondary follicles. The cytologic, architectural, immunologic, and clinical features of ILL indicate that it should be included as a separate category in the International Working Formulation. PMID- 3301626 TI - Monoclonal antibodies reactive in routinely processed tissue sections of malignant lymphoma, with emphasis on T-cell lymphomas. AB - The immunoreactivity of eight monoclonal antibodies was evaluated on 45 routinely processed lymphomas (22 T-cell lymphomas, 11 B-cell lymphomas, and 12 cases of Hodgkin's disease). Two antibodies reactive with leukocyte common (T200) antigens (PD7/26 and 2B11) stained most of the B- and T-cell lymphomas but did not stain the Reed-Sternberg cells and variants in Hodgkin's disease. Two antibodies known to stain B cells (LN-1 and LN-2) reacted with some of the B-cell lymphomas, but LN-2 also reacted with the neoplastic cells in six of 22 T-cell lymphomas and with the Reed-Sternberg variants in eight of 12 cases of Hodgkin's disease. The granulocyte antibody anti-Leu M1 reacted with most cases of Hodgkin's disease but also reacted with two of 11 B-cell non-Hodgkin's lymphomas. An antibody to epithelial membrane antigen (anti-EMA) stained some cases of T-cell lymphoma, B cell lymphoma, and Hodgkin's disease. Leu 7 was expressed in one T-cell lymphoma and in one case of Hodgkin's disease. A novel antibody reactive with T cells (L60) stained all cases of T-cell lymphoma but also stained some cases of B-cell lymphoma and one case of Hodgkin's disease. We conclude that none of these antibodies, when used alone on routinely fixed paraffin-embedded material, is completely sensitive and specific for T-cell lymphoma, B-cell lymphoma, or Hodgkin's disease. However, a panel of antibodies is useful in distinguishing Hodgkin's disease from non-Hodgkin's lymphoma and in suggesting the B- or T-cell phenotype of non-Hodgkin's lymphomas. PMID- 3301627 TI - Ultrastructural localization of Leu M1 in Reed-Sternberg cells and normal myeloid cells. AB - An antigen Leu M1 has been localized to myelomonocytic cells and Reed-Sternberg cells by light microscopic immunocytochemical studies. We used both pre- and post embedding immunoelectron microscopy to define the ultrastructural distribution of this antigen. Post-embedding techniques heavily labeled the granules of polymorphonuclear leukocytes and the nonspecific granules of eosinophils. At high concentrations there was labeling of the specific granules of the eosinophil. The antibody consistently labeled the perinuclear granules and vesicles of Reed Sternberg cells. Some Reed-Sternberg cells also exhibited labeling of the endoplasmic reticulum, suggesting that these cells have the capacity to synthesize this antigen. Although plasma membranes were labeled with the post embedding technique, these structures were most heavily labeled with the pre embedding method. These results indicate that Leu M1 is synthesized and packaged by Reed-Sternberg cells and represents an integral structural component of these cells. PMID- 3301628 TI - Cytogenetic studies using Q-band polymorphisms in patients with AML receiving marrow from like-sex donors. AB - After bone marrow transplantation (BMT), it is important to monitor the bone marrow and lymphoid cell populations of the recipient to document engraftment. When donor and recipient are of unlike sex, the sex chromosomes serve as a useful marker to determine cellular origin. When donor and recipient are of like sex, autosomal heteromorphisms can be used to identify the origin of cells in metaphase. Using Q-banding, we found that 17 of 20 patient/donor pairs (85%) examined showed at least one chromosome heteromorphism that distinguished between recipient and donor cells with certainty. Five of the patients were followed up after BMT in order to document engraftment. Donor metaphases could be detected in the marrow within two weeks of BMT when the graft was successful. Chimaerism was detected in the lymphocyte population even when the graft persisted. In a case of graft failure, donor cells did not persist in the marrow, and the lymphocyte population did not convert to donor type. These studies demonstrate that autosomal heteromorphisms are useful in the study of myeloid and lymphoid chimaeric states after BMT. PMID- 3301630 TI - Prevalence of Chlamydia trachomatis infection in homosexual men. AB - Chlamydial cell culture isolation rates from 51 unselected homosexual men were 9.3% from the urethra, 4.3% (pharynx), and 6.5% (rectum). All the positive cultures showed extremely few inclusions. Direct immunofluorescence with the Microtrak reagent (Syva) was an acceptable alternative technique for non-genital sites, whereas the infectious disease enzyme immunoassay (IDEIA) (Boots-Celltech) was unsuitable. PMID- 3301629 TI - Genetic counseling in the epilepsies. I. Genetic risks. AB - Rules are proposed for genetic counseling in the epilepsies. In a first section, some attempts at subdividing epilepsies by dichotomous classifications are discussed critically. Then, the typical EEG patterns found in epileptic diseases as well as their genetic bases are described. The third section comprises various clearly defined and sufficiently well-described epileptic syndromes. In a fourth section, a kind of "record sheet" is suggested to help the genetic counselor in planning his procedure. Throughout this review, we have stressed that genetic counseling in the epilepsies should not be confined to risk assessment but should include considerations on course of the disease, prognosis, and chances of therapy. PMID- 3301631 TI - [Isolation of Mycoplasma and Chlamydia in patients with urogenital infections]. AB - Vaginal/cervical swabs, catheter urine and/or puncture of the bladder (p.b.) from 880 females with urogenital diseases were examined microbiologically. Mycoplasmas (Ureaplasma urealyticum, Mycoplasma hominis) could be isolated from 321 females (36.5%), and Chlamydia trachomatis from 42 (4.8%). Mycoplasmas and C. trachomatis were more frequent in the age between 21 and 30 years (53 and 11.8% respectively). In 32.8% of the entire collective mycoplasmas could be detected in vaginal swabs. In contrast only 23.2% of the patients from whom catheter urine or p.b. was collected showed mycoplasmas. Of 880 females 117 (13.3%) had mycoplasmas in vaginal smear material, and 172 (19.5%) showed mycoplasmas in the vaginal swab as well as in catheter urine or p.b. From 32 (3.6%) females mycoplasmas could be detected only in catheter urine or p.b. Of 410 males mycoplasmas were isolated from urethral, catheter urine/p.b. and/or from ejaculate in 26.3%. Most frequently, positive carriers were in the age between 31 and 40 years (38.1%). C. trachomatis was found in 22 patients (5.4%). The frequency of mycoplasmas in urethral smear was 24.9%, in catheter urine/p.b. 13.6% and in ejaculate 15.6%. In 50 (12.2%) patients mycoplasmas were isolated both from urethral and catheter urine/p.b., in 52 (12.7%) only from urethral smear and in 6 (1.4%) only from catheter urine/p.b. Two species of mycoplasmas could be detected in this non quantitative study: U. urealyticum which was isolated more frequently, and M. hominis. PMID- 3301632 TI - Differential function of LFA-1 family molecules (CD11 and CD18) in adhesion of human monocytes to melanoma and endothelial cells. AB - Human peripheral blood monocytes from normal, healthy donors express the leucocyte function-associated antigen (LFA)-1, CR3 and p150,95. These heterodimeric antigens are members of a glycoprotein family sharing a common beta subunit but endowed with distinct alpha chains. They have been shown to play an important role in cell-cell interactions. In the present study we have investigated the role of these molecules in the interaction of monocytes with endothelial cells and melanoma (tumour) cells. Heterotypic cell-cell interactions were studied in single cell conjugate assays and by adhesion of monocytes to monolayers of cells. The results demonstrate that monoclonal antibodies directed against LFA-1 alpha, CR3 alpha, p150,95 alpha and the common beta chain strongly reduce the number of conjugates (71, 50, 60 and 89% inhibition, respectively), formed between monocytes and melanoma or endothelial cells in a single cell assay. In contrast, adhesion of monocytes to monolayers of the same cells seems only to depend on p150,95, since only antibodies directed to the alpha chain of this molecule and to the common beta chain inhibited adhesion. Interestingly, the number of conjugates formed with melanoma cells in single cell assays was at least twice the number of conjugates formed between monocytes and endothelial cells, whereas no differences were observed in the adhesion of monocytes to monolayers of these cells. However, the basis for this phenomenon is not yet clear. These results indicate that not only LFA-1 but also CR3 and p150,95 can mediate adhesion to target cells in suspension, but that monocyte adhesion to monolayers is caused by a different mechanism in which the p150,95 molecule seems to play a prominent role. PMID- 3301633 TI - Antibody-dependent cytotoxicity on chicken red blood cell targets mediated by the U937 cell line. AB - We have characterized a model system for the study of antibody-dependent cytotoxicity (ADCC) mediated by human macrophages and monocytes. The U937 cell line is used as a source of effector cells. We confirmed a previous report (Gidlund et al., 1981) that U937 can be activated using PMA to kill in ADCC, and the characteristics of the observed cytotoxicity are described. Activation of effectors was maximal after 20-hr preincubation in the presence of 10 ng/ml PMA. In these conditions, lysis was approximately 70% in 2 hr at an effector to target ratio of 5:1. Activation correlated with the expression of complement receptors CR1 and CR3. No antibody-independent cytotoxicity was observed. The effects of various inhibitors of oxygen species were investigated: the lysis obtained in the above conditions was inhibited at 50% in the presence of either 450 mM dimethyl sulphoxide or 30,000 U/ml catalase, but superoxide dismutase (up to 10,000 U/ml) or ferricytochrome c (up to 2 mM) had no effect. The same inhibition was observed with 40 mM desferrioxamine or with 1 mM 0-phenanthroline, which are both iron scavengers, or in the presence of 300 microM colchicine or 1.5 microM dihydrocytochalasin B, which are two inhibitors of cytoskeletal functions. An identical effect was obtained in the presence of 1 TIU/ml bovine pancreas trypsin inhibitor, whereas soya bean trypsin inhibitor, which is more specific, had no effect up to 5000 BAEE U/ml. No inhibition was seen with protein synthesis inhibitors as cycloheximide or puromycin at 40 micrograms/ml. The significance of these results is discussed. PMID- 3301635 TI - The role of the colony-stimulating factors in resistance to acute infections. AB - A set of specific glycoproteins, the colony-stimulating factors, has been identified as regulating granulocyte and macrophage production and function. These colony-stimulating factors have now been purified and mass produced by recombinant technology. These versatile regulators are capable of providing the body both with an ultrarapid and sustained system for responding to infections. The granulocytes, macrophages and eosinophils involved in these responses appear likely to be key cell populations ensuring adequate resistance to acute infections and the colony-stimulating factors may prove to be valuable agents in the clinic for increasing resistance to life-threatening infections particularly in immunologically compromised patients. PMID- 3301634 TI - The Burnetian legacy: scientists as citizens. PMID- 3301636 TI - Animal models of human parasitic diseases and the testing of vaccines. PMID- 3301637 TI - The inconstancy of the milieu interieur. PMID- 3301638 TI - The use of monoclonal antibody conjugates for the diagnosis and treatment of cancer. PMID- 3301639 TI - Coagulation and the expression of cell-mediated immunity. AB - Induction of monocyte/macrophage procoagulants may occur as the result of activation of the cell-mediated immune (CMI) response. Macrophage procoagulant inducing factor (MPIF), a soluble product of stimulated TDTH lymphocytes, may act together with two monokines, interleukin 1 and tumour necrosis factor alpha, which induce thromboplastin on endothelial cells, to initiate the fibrin deposition which is a common feature of many diseases in which CMI plays a role. Murine MPIF is chemically distinct from a number of other well characterized lymphokines in that the two major activities, MPIF alpha and MPIF beta are heparin-binding proteins with high isoelectric points. Fractions highly enriched for MPIF induced interstitial fibrin deposition when injected intradermally. In addition, intense infiltration of polymorphonuclear leucocytes (PWN) and mononuclear cells was seen 4-24 h following intradermal injection. In vitro experiments have confirmed that this lymphokine is a potent chemotactic agent for these cells. These results suggest that MPIF plays a central role in the expression of histopathological features of delayed-type hypersensitivity reactions. Monocyte and macrophage procoagulants induced by MPIF would contribute significantly to the activation of coagulation which not only results in fibrin deposition but also in the production of activated serine proteases and fibrinopeptides which may potentiate an inflammatory response. PMID- 3301640 TI - Human myeloid growth factors. PMID- 3301641 TI - Studies on glycoproteins in the human malaria parasite Plasmodium falciparum- lectin binding properties and the possible carbohydrate-protein linkage. AB - Several glycoproteins of the human malarial parasite Plasmodium falciparum are shown to bind to the lectins concanavalin A, wheat germ agglutinin, Ricinus communis 120 lectin and Bandeirea simplicifolia lectin. There was reduced binding of [125I]-concanavalin A to several red blood cell glycoproteins, including the anion transport protein, in parasitised cells. The carbohydrates of parasite glycoproteins are not typical N-linked oligosaccharides since the enzyme peptide: N-glyconase F fails to cleave them. In contrast, many of the parasite glycoproteins are labelled with [3H]-myristic acid consistent with a possible linkage of carbohydrate to a membrane anchoring phospholipid. PMID- 3301642 TI - Antimicrobial activity of cinnamic acid derivatives. PMID- 3301643 TI - Role of ultrasound in the evaluation of various thoracic radiological opacities: our experience with 152 cases with review of literature. PMID- 3301644 TI - Clinical trial of a sustained release theophylline tablet in adult asthmatics. PMID- 3301645 TI - Bronchial hyperreactivity: measurement and its applications. PMID- 3301646 TI - Resistance to 402AX teratocarcinoma involves immunity to minor histocompatibility antigens. AB - The 402AX teratocarcinoma is a 129/J-derived mouse major histocompatibility complex (MHC) antigen negative tumor that is induced to express H-2b class I antigens during rejection. Resistance to 402AX by MHC allogeneic and syngeneic mice is immunologically mediated and involves the recognition of tumor-associated antigens (TAA) in the context of induced MHC class I antigens. The current studies were undertaken to define the 402AX TAAs. Reconstitution of irradiated susceptible hosts (129/J) with 402AX-primed resistant spleen cells (C57BL/6) results in acute graft-versus-host disease, suggesting that tumor-primed C57BL/6 splenocytes are reactive to tumor genotype (129/J) minor histocompatibility (Hm) antigens. C57BL/6 anti-129/J effector cells, although not directly cytotoxic for 402AX cells, are specifically cold target inhibited by 402AX cells. Genetically susceptible hosts (C3H.SW) immunized to 129/J Hm antigens by skin grafting become resistant to an i.p. challenge of 402AX cells. These results suggest that 129/J Hm antigens may be the TAAs recognized during genetically controlled rejection of the 402AX teratocarcinoma. PMID- 3301647 TI - Multiplicity of chromosome 2 histocompatibility genes: new loci, H-44 and H-45. PMID- 3301648 TI - Genetic control of the target structures recognized in hybrid resistance. AB - Hybrid resistance of lethally irradiated (C57BL/6 X DBA/2)F1 and (C57BL/10 X C3H)F1 hybrid mice to the engraftment of parental C57BL/6 or C57BL/10 bone marrow cells is controlled by the H-2-linked Hh-1 locus. This resistance can be specifically blocked or inhibited by the injection of irradiated spleen cells from lethally irradiated, marrow reconstituted donor mice of certain strains. By testing the ability of regenerating spleen cells from various donor strains to block the resistance, we studied the genetic requirements for the expression of putative cell-surface structures recognized in hybrid resistance to H-2b marrow cells. Strains of mice bearing informative intra-H-2 or H-2/Qa-Tla recombinant haplotypes provided evidence that the Hh-1 locus is located telomeric to the H-2S region complement loci and centromeric to the H-2D region class I locus in the H 2b chromosome. Two mutations that affect the class I H-2Db gene have no effect on Hh-1b gene expression. The H-2D region of the H-2s haplotype contains an allele of the Hh-1 locus indistinguishable from that of the H-2Db region, as judged by the phenotypes of relevant strains and F1 hybrids. Collectively these data indicate that the Hh-1 locus is distinct from the class I H-2D (L) locus in the H 2b or H-2s genome, and favor the view that the expression or recognition of the relevant determinants is not associated with class I gene products. PMID- 3301649 TI - Cell-surface expression of H-2Db requires N-linked glycans. AB - The question of whether beta-2 microglobulin (B2m)-independent expression of the mouse major histocompatibility complex (MHC) antigen H-2Db results from the atypical glycosylation pattern associated with this MHC antigen (i.e., three glycans instead of two) has been addressed. Cell-surface expression of transfected H-2Db in the B2m deficient cell line R1E was completely abolished by the drug tunicamycin (Tm). Introduction of a functional B2m gene by transfection did not re-establish cell-surface expression of Db in the presence of Tm. Tm had no effect, however, on the expression of a truncated Db molecule lacking the alpha 1 and alpha 2 domains which is glycosylated at amino acid position 256, suggesting that the Db molecule, unlike other class I antigens, possesses an unstable conformation in the alpha 1 and/or alpha 2 domains which requires the attachment of glycans before it is transported to the cell surface. Once attached, however, glycans may confer a stable alpha 1/alpha 2 conformation apparently peculiar to Db which allows cell-surface expression in the absence of B2m. PMID- 3301650 TI - A direct approach to determine the ABH phenotype of baboons. AB - A simple and rapid method of ABH phenotyping baboons has been developed which takes advantage of the fact that blood group antigens are expressed on epithelial cells. Use of readily available monoclonal antibodies and phycoerythrin conjugated second antibody permits rapid identification of ABH phenotypes directly on baboon buccal mucosa epithelial cells. This new approach avoids the tedium, time and expense involved in the widely used saliva hemagglutination inhibition assay. PMID- 3301651 TI - Clinical and ultrasound profile of gallstone disease. PMID- 3301652 TI - Characterization of Klebsiella pneumoniae from environmental sources. PMID- 3301653 TI - Immunopathogenesis in tuberculosis, Part I: Cellular mechanisms of resistance. PMID- 3301654 TI - The clinical diagnosis of iron deficiency anemia and related conditions in infancy, childhood and adolescence. PMID- 3301655 TI - Megaloblastic anemia--etiology and management. PMID- 3301656 TI - Diagnosis of red blood cell enzymopathies in infants, children and adolescents. PMID- 3301657 TI - Idiopathic thrombocytopenic purpura of childhood. PMID- 3301659 TI - Disseminated intravascular coagulation: diagnosis and management. PMID- 3301658 TI - Current concepts in the management of thalassemia. PMID- 3301661 TI - Statistical methods in cancer research. Volume III--The design and analysis of long-term animal experiments. PMID- 3301660 TI - Red cell substitutes: present status. PMID- 3301662 TI - Arterial and venous compliance in sustained essential hypertension. AB - Arterial and venous compliances are decreased in men with sustained essential hypertension. The reduced arterial compliance acts to maintain systolic pressure and end-systolic stress, thus contributing to the development of cardiac hypertrophy. Since cardiac output remains within the normal range in the hypertrophied hypertensive heart, elevated left ventricular pressures, and therefore increased cardiac filling pressures, are necessary if an adequate stroke volume is to be maintained. In hypertensive persons, reduced venous compliance acts to maintain the filling pressure of the heart in the presence of reduced intravascular volume. In patients with hypertension, even if compliance changes have been initiated by the elevated blood pressure itself, the reduced arterial and venous compliance observed in cross-sectional studies is not simply the mechanical consequence of the elevated blood pressure, but also reflects intrinsic alterations of the vascular wall. Consequently, blood pressure reduction caused by antihypertensive agents is not constantly associated with a reversion of the decreased vascular compliance. Such observations may be of importance in the consideration of cardiovascular morbidity and mortality in patients treated for hypertension. PMID- 3301664 TI - Central dopaminergic regulation of aldosterone secretion in sheep. AB - Central dopaminergic mechanisms involved in the regulation of plasma aldosterone concentration were investigated in 16 conscious sheep following Na depletion with intramuscularly administered furosemide. Intracerebroventricular infusion of dopamine (20 micrograms/min) decreased plasma aldosterone significantly to 52 +/- 8% of basal level and increased plasma renin activity (PRA) significantly to 172 +/- 25% of basal level in this animal model. In addition, intracerebroventricular infusion of the dopamine antagonist metoclopramide (20 micrograms/min) in artificial cerebrospinal fluid vehicle significantly increased aldosterone levels to 144 +/- 14% of basal level and decreased PRA to 62 +/- 5% of basal value. Neither intracerebroventricular infusion of the vehicle nor intravenous infusions of metoclopramide or dopamine at the same doses changed aldosterone or PRA levels. Intracerebroventricular bolus injections of metoclopramide (20 micrograms/kg in 0.4 ml of vehicle) were also effective, increasing aldosterone levels to 266 +/- 22% of basal level and decreasing PRA to 70 +/- 12% of basal level. Intravenous bolus injections of the same dose of metoclopramide were ineffective. Dopamine was infused intracerebroventricularly into two uniadrenalectomized sheep with the remaining adrenal transplanted to the neck. Aldosterone levels were decreased to 49 +/- 10% of basal level, and PRA was increased to 157 +/- 10% of basal value. None of the infusions or injections changed arterial or intracranial pressure, or plasma K, Na, and cortisol levels. These data indicate that endogenous or exogenous dopamine may act on central dopamine receptors to decrease plasma aldosterone concentration by an unknown humoral mechanism. The known aldosterone regulators, plasma Na, K, angiotensin II, and adrenocorticotropic hormone, are not involved in the regulation. PMID- 3301663 TI - Multiple effects of calcium entry blockers on renal function in hypertension. AB - Characterization of the renal effects of calcium entry blockers has not been easy because the inhibition of Ca2+ cellular influx alters several regulatory functions. The ability of calcium blockers to dilate renal vasculature and to increase glomerular filtration rate is largely determined by the preexisting vascular tone. However, the increments in sodium excretion could occur without alterations in renal hemodynamics. Calcium blockers could increase sodium excretion by inducing a redistribution of renal blood flow toward juxtamedullary nephrons, by inhibiting tubuloglomerular feedback responses, or by a direct action on the tubular transport of sodium. These effects are poorly understood at present. In vitro studies show that the blockade of calcium entry enhances renin secretion and decreases prostaglandin synthesis. This dissociation has not been found during long-term administration, which has been proved to be effective for the treatment of essential hypertension with normal maintenance of renal function. In this respect, there are reports indicating that calcium blockers are particularly effective in a subgroup of patients with essential hypertension who exhibit subtle but detectable alterations in calcium metabolism. Further studies are needed to determine whether this significant response to calcium blockers is due to correction of an early defect of calcium cellular kinetics that initiated the increase in blood pressure. PMID- 3301666 TI - Development and application of a simple microassay for adenosine in rat plasma. AB - Adenosine may be a physiological modulator of vascular smooth muscle tone, sympathetic neurotransmission, renin release, and renal and cardiac function. To facilitate the elucidation of the physiological role of adenosine, a microassay for adenosine was developed that allows accurate quantitation of adenosine in 75 microliters of rat plasma, thus permitting multiple determinations of plasma adenosine levels in an individual rat without inducing hemodynamic perturbations due to blood loss. The technique employs a simple and rapid extraction of plasma with a reverse-phase Sep-Pak cartridge and exploits the increased mass sensitivity of microbore high performance liquid chromatography. The assay was verified by demonstrating a linear relationship between the amount of adenosine added to plasma and the amount detected by the assay, a linear relationship between the rate of adenosine infusion into rats and plasma adenosine levels, and the absence of measurable adenosine levels in plasma incubated with adenosine deaminase. The mean arterial plasma level of adenosine in the anesthetized rat was determined to be 119 +/- 28 (SD) ng/ml (n = 10). With the use of this assay, renal venous plasma levels of adenosine were found to be elevated sixfold in two kidney, one clip Goldblatt hypertensive rats (1 week postclipping) compared with sham-operated controls. Given the known effects of adenosine on renin release, these data support a role for endogenous adenosine as a regulator of renin release in renovascular hypertension. PMID- 3301665 TI - Furosemide augments the effects of captopril on nuclear studies in renovascular stenosis. AB - Captopril facilitates detection of unilateral renovascular hypertension by selectively reducing glomerular filtration rate in affected kidneys. To determine if volume depletion augments this response, we compared the effects of captopril, furosemide, and combined furosemide plus captopril on individual kidney computer derived clearances of 99mTc-diethylenetriamine pentaacetic acid (DTPA) and [131I]o-iodohippurate in two-kidney, one clip Goldblatt hypertensive rats and normal controls. In clipped kidneys, captopril reduced DTPA clearance significantly from baseline (from 0.31 +/- 0.02 to 0.19 +/- 0.04 ml/min/100 g; p less than 0.02) whereas furosemide alone had no effect (0.28 +/- 0.03 ml/min/100 g). Combined furosemide plus captopril further reduced clipped kidney DTPA clearance to a level significantly less than captopril alone (0.10 +/- 0.02 ml/min/100 g; p less than 0.02). Clipped kidney o-iodohippurate clearance was not changed from baseline by any treatment. In contralateral unclipped and normal kidneys, DTPA clearance did not decline from baseline following either captopril or furosemide plus captopril treatment. Since the dose of captopril used (3 mg/kg by intraperitoneal injection) did not reduce systolic blood pressure of hypertensive rats significantly, these changes probably reflect intrarenal rather than systemic hemodynamic effects of converting enzyme inhibition and are consistent with the hypothesis that captopril interferes with glomerular filtration in stenotic kidneys by reducing efferent arteriolar vascular resistance. Prior volume depletion accentuates the effect of captopril on stenotic kidney glomerular filtration rate, providing improved functional discrimination of stenotic kidneys from contralateral unclipped and normal kidneys. These results indicate that furosemide-induced volume depletion may increase the diagnostic sensitivity of captopril-enhanced 99mTc-DTPA renography in the detection of unilateral renovascular hypertension. PMID- 3301669 TI - [Bonded veneers of composite resins]. PMID- 3301670 TI - [Complete removable denture. Stability of the maxillary base and dynamic impression of the coronoid apophysis]. PMID- 3301668 TI - Captopril-induced creatine kinase elevations: a possible role of the sulfhydryl group. PMID- 3301667 TI - Renal scintigraphic captopril test in the diagnosis of renovascular hypertension. AB - Angiotensin converting enzyme (ACE) inhibitor-induced renal failure has been reported in bilateral renal artery stenosis and in stenosis in solitary kidneys, but not in unilateral renal artery stenosis. In these patients, however, a functional impairment of the kidney ipsilateral to the stenosis can often be detected after ACE inhibition by scintigraphic techniques employing glomerular radionuclide tracers like 99mTc-diethylenetriamine pentaacetic acid (DTPA). Dynamic renal scintigraphy with 99mTc-DTPA before and 1 hour after administration of captopril, 25 mg (renal scintigraphic captopril test; RSCT), was performed in a selected series of 39 hypertensive subjects with suspected renovascular hypertension. Changes in glomerular filtration rate induced by captopril on the individual kidney were estimated by assessing the early (120-180 seconds) DTPA uptake by the kidney. Values were expressed as the ratio between the kidney with the lower uptake and the contralateral one in 34 patients and as the ratio of the kidney counts to the injected dose in five patients with solitary kidneys, aortic coarctation, or both. Compared with precaptopril values, postcaptopril uptake decreased markedly in 14 subjects (-62.42 +/- 30.94 [SD]%; range, -25 to -100%) and decreased modestly or even increased in the other 25 (+0.57 +/- 9.83%; range, +28 to -13%). Of the 14 subjects considered to be RSCT-positive diagnostic workup revealed either established (10) or strongly suspected (2) renal artery stenosis in 12 and aortic coarctation in 2 subjects. In another patient with established renovascular hypertension, results of the RSCT were negative when performed in the supine position but became positive when repeated in the sitting position.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301671 TI - [Antibiotic therapy and periodontal treatment]. PMID- 3301672 TI - [Posterior restorations using composite resins. Status of technics in 1987]. PMID- 3301673 TI - [Periodontal preprosthetic surgery: lengthening of the clinical crown]. PMID- 3301674 TI - [Cast crown-root reconstructions]. PMID- 3301675 TI - [Dental study of an ancient population in Laverune of Gallo-Roman origin]. PMID- 3301676 TI - [Partial crowns]. PMID- 3301677 TI - Production, characterization, and protective effect of monoclonal antibodies to Clostridium chauvoei flagella. AB - Monoclonal antibodies to flagella of Clostridium chauvoei were obtained by the fusion of murine myeloma cells (P3-X63-Ag8-U1) and spleen cells from BALB/c mice immunized with partially purified flagella of strain Okinawa. Enzyme-linked immunosorbent assay and Western blot analysis with partially purified flagella, flagellated cells, and nonflagellated mutants were used to show that five monoclonal antibodies are specific for the flagella. In the Western blot analysis, all five antiflagellar antibodies reacted strongly with the 56,000 molecular-weight protein, which corresponds to the flagellin. By using the ELISA derived reactivity of monoclonal antibodies to the various clostridia and the competitive binding assay, we showed that the flagella of C. chauvoei had at least three epitopes. The three antiflagellar monoclonal antibodies (one immunoglobulin G and two immunoglobulin M) demonstrated passive protective effects in mice. These results strongly suggest that the flagella of C. chauvoei are important for protective immunity in mice. PMID- 3301678 TI - Structural and antigenic properties of lipopolysaccharides from serotype reference strains of Campylobacter jejuni. AB - To investigate the molecular basis for heat-stable antigenic diversity in Campylobacter jejuni, lipopolysaccharides (LPSs) from serotype reference strains and serotyped isolates were examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis coupled with silver staining and immunoblotting. By silver staining, only low-Mr components, consisting of one major band and as many as three minor bands ranging in Mr from 4,500 to 5,000, were detected. However, by immunoblotting with homologous antisera, 10 of 34 strains were shown to have a series of high-Mr LPS components characteristic of molecules with O side chains of various lengths. Isolates of the same serotype as the reference strain that had high-Mr LPS molecules were also found to have high-Mr LPS and in one case of cross-reacting strains it was found that the cross-reaction was associated with antibodies against high-Mr LPS. The reactions of LPSs with homologous and heterologous antisera indicated that both high- and low-Mr-type LPSs were strain specific antigens, but in some cases cross-reactions were noted. Evidently, all C. jejuni strains possess low-Mr LPS that is readily detectable by silver staining, but some serotypes also possess high-Mr LPS components that can be visualized by immunoblotting. PMID- 3301680 TI - Small-bowel colonization alone is a cause of diarrhea. AB - Bacterial overgrowth in the small bowel is known to occur in patients with persistent diarrhea, but it has been unclear if colonization alone causes fluid secretion. We studied isogenic, nontoxigenic Escherichia coli strains with colonizing factor antigen II (CFA/II) (1392+) and without CFA/II (1392-) in 18-h rabbit ileal loops. Neither strain produced fluid, but quantitative cultures of rabbit ileal loops with the CFA/II-positive strain had a mean of 10(3) more CFU of bacteria per cm2 than did cultures of rabbit ileal loops with the CFA/II negative strain or a negative control (P less than 0.05). Of 11 rabbits given strain 1392+ via the small bowel in the reversible ileal tie model, 7 became colonized (mean, 10(10.4) +/- 1.6 CFU/cm2) over 72 h, and all 7 developed diarrhea and had gross gut fluid accumulation, versus none of 10 rabbits given strain 1392- (mean, 10(3.6) +/- 1.9 CFU/cm2) (P less than 0.05). Both strains grew equivalently in vitro. The mechanism by which this E. coli strain which colonizes small-bowel mucosa but produces no recognized toxins causes fluid accumulation and diarrhea in a rabbit model at 72 h remains to be elucidated. PMID- 3301679 TI - Activation and binding of C3 by Candida albicans. AB - Interaction with components of the complement system is an important aspect of the pathogenesis of infection by Candida albicans. The key role of C3 as an opsonic ligand and as an element in amplification of complement activation led us to examine several factors that influence the activation and binding of C3 cleavage fragments to the yeast. Activation and binding of C3 were determined by use of normal human serum containing 125I-labeled C3. Incubation of yeast-phase cells in 20% serum led to deposition of 2.5 X 10(5) to 3.0 X 10(5) molecules of C3 per yeast cell. Binding of C3 was absent in serum that was heat inactivated for 30 min at 37 degrees C or in serum that was chelated with EDTA. Chelation of serum with EGTA [ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid] reduced binding of C3 fragments by 31%. These results suggest that the alternative complement pathway is the primary mechanism for activation and binding of C3 fragments to C. albicans. Bound C3 could be partially removed (50%) by treatment with 1.0 M hydroxylamine. In contrast, 1.0 M hydroxylamine removed 98% of the C3 fragments bound to encapsulated Cryptococcus neoformans. These results suggest that ester bonds are the primary mechanism for binding C3 to C. neoformans, whereas binding of C3 to C. albicans involves both ester and amide bonds. Monoclonal antibodies specific for C3c and an iC3b neoantigen were used to identify the fragment of C3 that was bound to C. albicans. The results showed that the primary fragment bound to the yeast was C3b. An examination of the kinetics of activation and binding of C3 fragments showed that activation and binding were very rapid. Near-maximal binding occurred after a 2.5- to 5-min incubation period. In contrast, activation and binding of C3 fragments to C. neoformans proceeded at a slower rate, with maximal binding requiring 10 to 20 min. These results indicate that activation and binding of C3 fragments by the yeasts C. albicans and C. neoformans differ in several important characteristics. PMID- 3301681 TI - In strains of Escherichia coli O167 a single plasmid encodes for the coli surface antigens CS5 and CS6 of putative colonization factor PCF8775, heat-stable enterotoxin, and colicin Ia. AB - Twenty Escherichia coli strains of serogroup O167 were examined. They all produced the two surface antigens CS5 and CS6 of the putative colonization factor PCF8775, together with heat-stable enterotoxin and colicin Ia. A plasmid coding for CS5, CS6, heat-stable enterotoxin, and colicin Ia was demonstrated in each strain. PMID- 3301683 TI - [Antibody to lipoid A in the treatment of septic shock]. AB - The protective effect of high-titer anti-lipid A hyperimmune globulin with respect to the course of the disease and the mortality rate was studied in patients with septicemia verified by positive blood cultures. Six patients were treated with anti-lipid A in an open study. Dramatic improvement in fever curves and clinical condition in some of the patients encouraged us to start a randomized double blind study. So far, 17 patients have entered the study, 16 of whom were evaluable. Immediately after a positive blood culture was found, patients received either high doses of anti-lipid A or placebo (saline solution) on two subsequent days. Before and after each infusion blood samples were taken in order to assess serum bactericidal activity and anti-lipid A titers. Because of the still small numbers of patients the results of both studies were summarized. In all patients treated with anti-lipid A clear-cut increases in anti lipid A titers were shown. Patients with repeated gram-negative infections showed higher median anti-lipid A titers than patients without such a history. The patients treated with anti-lipid A immune globulin ran a significantly milder course than the placebo group. The severe signs of septic shock were reversed in seven of 15 patients on anti-lipid A compared to two of seven patients treated with placebo. In the anti-lipid A-treated group, three of 15 patients died, and in the placebo group two of seven. This difference is not statistically significant. PMID- 3301684 TI - [Incidence of deep respiratory tract infections]. AB - The distribution of respiratory tract infections (RTI) among the general population is not uniform. The incidence in neonates and the elderly (older than 65) is 2 to 3 times higher than that in adults. Examinations to determine the responsible pathogen are conducted in less than 1% of cases of RTI. The overall incidence of Haemophilus influenzae and Streptococcus pneumoniae in hospitalized patients amounts to 13 to 27%. The incidences of Staphylococcus aureus, Klebsiella and Pseudomonas aeruginosa in intensive care units are approximately 20% each. The management of the disease should be based on an aetiological diagnosis, and must take the individual patient's condition into account. Examination of the sputum or bronchial rinsing fluid is still the most reliable form of diagnosis, however, a sufficient number of quantitative methods must be applied. In hospitalized--and especially intensive care--patients these methods are often successful in isolating H. influenzae and pneumococci which we cannot afford to ignore as pathogens. PMID- 3301685 TI - Care of the adult patient during transport. AB - Interhospital transport of the critically ill patient involves maintaining the same quality of care that was present before transport. This requires planning for equipment, space, and personnel needs during transport, and instituting adequate pathophysiologically based treatment and stabilization prior to transport. Under such conditions, transport can be safely accomplished and have a positive impact on patient care. PMID- 3301682 TI - Streptococcus agalactiae (group B) endocarditis--a description of twelve cases and review of the literature. AB - The group B streptococcus has been shown to be a major cause of meningitis in the newborn and an occasional cause of endocarditis and sepsis in postpartum women. Little attention has been devoted to this organism as a cause of bacterial endocarditis. Twelve patients with group B streptococcal endocarditis were seen at The Presbyterian Hospital, New York, NY, between 1974 and 1985. There were seven women, five men. Ages ranged from 32 to 81 years. Serious underlying disease was present in all - diabetes mellitus in seven, carcinoma in three (bladder in two, and breast in one), alcoholism in three, malnutrition in two, heroin addiction in one, tuberculosis in one, serious prior valvular heart disease in two. The aortic valve was affected in four patients - mitral in two, mitral and aortic in one, tricuspid in four, unknown in one. The presentation was acute in seven patients. Metastatic infection occurred in seven, heart failure in six, major emboli in four, septic pericarditis in one, myocardial abscess in one. The group B streptococcus should be considered as a pathogen capable of causing acute endocarditis in certain patients with defects of host defense, particularly patients with diabetes mellitus, carcinoma or alcoholism. Cardiac surgery may be necessary in these patients due to the rapid destruction of the valves which occurs, in spite of the fact that the organisms are usually highly susceptible to penicillin. PMID- 3301686 TI - Effect of whole-body irradiation on precursor frequency of autoantibody-secreting cells and plaque-forming cells specific for bromelain-modified erythrocytes. AB - Murine spleen cells and peritoneal cells were assayed for autoantibody production against bromelain-modified mouse erythrocytes (mouse brom-RBC) after whole-body irradiation at a dose of 5 Gy. Spleens were taken directly from mice 3 days after irradiation, or cultured for 3 days 24 h after irradiation, and assayed. Cells taken directly from irradiated mice had a higher number of plaque-forming cells (PFC) against mouse brom-RBC, compared with unirradiated mice, when the data were expressed as PFC/10(6) viable cells. This apparent increase can be accounted for by the reduced number of cells in the spleens from irradiated mice. In both spleen cells and peritoneal cells cultured in high cell densities, no difference was observed in the number of PFC in cells from irradiated or unirradiated mice. The detected precursor frequency of autoimmune B cells in both cell populations cultured in limiting dilution was found to be lower in cells from irradiated mice. In contrast to other published data, it was concluded from these investigations that whole-body irradiation, at a dose of 5 Gy, does not augment autoantibody production against mouse brom-RBC. It is proposed that the reason for this is the presence of a regulatory cell that is relatively radioresistant and, hence, not removed after whole-body irradiation at a dose of 5 Gy. PMID- 3301687 TI - Cigarette smoking--a possible genotoxic hazard to male germ cells? PMID- 3301688 TI - Hemodialysis-induced symptomatic hypotension. A review of pathophysiological mechanisms. PMID- 3301690 TI - Biocompatibility of synthetic membranes and blood-membrane interaction. PMID- 3301689 TI - Bicarbonate dialysis--pro. PMID- 3301691 TI - A general algorithm for assisting medical diagnosis. AB - An algorithm for assisting medical diagnosis is designed; this algorithm is highly reliable and can be given general use. The method is based on the comparison of the column vector of the symptoms of a given patient with each of the columns of disease symptoms which appear on a matrix. On this matrix, the symptoms have been arranged according to the hierarchic order of each of the symptoms, which facilitates the creation of a file. Moreover, this system undertakes a simultaneous comparison of all the diseases considered in the differential diagnosis, in comparison to the alternate procedures in which the patient's symptoms are compared in separate succession with each of the vectors of the disease under study. PMID- 3301692 TI - Epidermal growth factor stimulates the synthesis of cell-attachment proteins in the human breast cancer cell line PMC42. AB - The human breast cancer cell line PMC42 responds to the addition of epidermal growth factor (EGF) by proliferation and increased frequency of attachment of cell-organoid structures to the culture vessel. Antibodies to fibronectin and laminin reacted strongly, by immunoperoxidase, with the membranes of cells from organoids that became adherent following addition of EGF. This reaction was weak with membranes of cells of non-adherent organoids in cultures containing EGF and was negative with membranes of cells of free-floating organoids from cultures without EGF. An increase in biosynthetic labelling with 35S-methionine was found in cell lysates and supernatants of PMC42 cells cultured in the presence of EGF compared with control cells grown without EGF. One-dimensional SDS-polyacrylamide gel electrophoresis and 2-dimensional NEPHGE-PAGE of labelled cell proteins showed increased synthesis of several cellular proteins and the appearance in EGF treated cells of 2 proteins which were not detected in cells from control cultures lacking EGF. Immunoprecipitation experiments using antibodies to fibronectin and laminin with lysates of 35S-methionine labelled PMC42 cells cultured with EGF showed strong immunoprecipitation at Mr 200 and 400 with anti laminin, and at Mr 200 and 96 with anti-fibronectin. These immunoprecipitates were blocked specifically by purified laminin or fibronectin, respectively. No immunoprecipitates were detected with these antibodies in lysates from cells grown without EGF. EGF thus stimulates increased adherence of cultured PMC42 cell organoid structures together with increased membrane expression of the cell adhesive proteins laminin and fibronectin. These effects may play a role in normal development and neoplastic behaviour of breast epithelia. PMID- 3301693 TI - Tumorigenicity of T24 urinary bladder carcinoma cell sublines. AB - Two sublines of the T24 human urinary bladder carcinoma cell line which differ in tumorigenicity in nude mice have been studied (T24A and T24P). T24A obtained directly from the American Type Culture Collection is non-tumorigenic while T24P obtained after multiple passages in several NCI laboratories produces tumors in 100% of inoculated mice. T24P cells differ morphologically from T24A, have a higher saturation density, are less serum-dependent for growth, and are more sensitive to ouabain toxicity. Cytogenetic studies show that the 2 sublines differ significantly in chromosome number, with a modal chromosome range of 76-89 in T24A and a modal chromosome number of 48-51 in T24P. Southern blot analysis of MspI cleaved T24A and T24P DNAs with the H-ras SmaI probe indicates that both contain only the activated mutant allele originally described in T24. Northern blot analysis shows equal amounts of the 1.2kB ras polyadenylated message, and immunoblotting with rasHa antibody demonstrates no significant difference in the amounts of ras proteins. These results indicate that 2 sublines of a ras oncogene containing tumor cell line can differ greatly in tumorigenicity and other in vitro characteristics of transformation, and yet have similar expression of the ras oncogene. The fact that the tumorigenic cell line contains fewer chromosomes suggests that tumorigenicity may be related to the loss of some regulatory gene. PMID- 3301694 TI - Expression of the c-erbB-2 protein in normal and transformed cells. AB - Two synthetic peptides from the predicted sequence of the human c-erbB-2 protein were synthesized and used to raise antisera in rabbits. The sequences chosen were identical to those in the homologous rat c-neu protein. The antibodies produced reacted with the immunizing peptides in ELISA but showed little or no cross reaction with the partly homologous peptides found in equivalent positions in the human EGF receptor. Both antipeptide antibodies, and a monoclonal antibody (MAb) specific for the rat neu protein, immunoprecipitated a 185-kDa protein from 35S methionine-labelled lysates prepared from a rat cell line known to express high levels of the c-neu protein. The antipeptide antibodies also recognized a protein of the same size in Western blots. In addition, both antipeptide antibodies immunoprecipitated a 190-kDa protein from labelled cell lysates prepared from human and monkey cells. Antibodies to one of the peptides, which showed no detectable cross-reaction with human, rat or monkey EGF receptor, were used to examine the expression of the c-erbB-2 protein on a variety of cultured cell types. Eleven transformed, I non-established and 2 immortalized cell types were examined by immunoprecipitation for their level of expression of the c-erbB-2 protein and of the EGF receptor. The numbers of EGF receptors varied widely between different cell lines, whereas the level of the c-erbB-2 protein, which was found on all of the cell types examined, was more constant. The number of c erbB-2 molecules present was estimated by autoradiography to be about 100,000 per cell. The antibodies were then used to examine the location and level of expression of the human c-erbB-2 and rat c-neu proteins in normal tissues. Immunohistochemical staining showed that the c-erbB-2 protein was highly expressed in rat kidney proximal tubules and loop of Henle. The c-erbB-2 protein was also present on normal human epithelial cells but in some cases with a different distribution to that of the EGF receptor. PMID- 3301695 TI - Overview on atherosclerotic systolic hypertension. AB - Hypertension in older atherosclerotic patients is characterised by a disproportionate elevation of systolic and pulse pressure contrasting with a subnormal diastolic level. Increased systolic pressure is strongly related to the excess of cerebrovascular complications and congestive heart failure observed in these patients. The physiopathological pattern is marked by a strong reduction in compliance of large arteries directly responsible for the predominant high systolic pressure because of the impairment of the buffering function of the arteries on the cardiac pulse wave. Clinical management is directed to the elevation of athero-arteriosclerotic changes of large arteries by means of appropriate non-invasive ultrasonic techniques and specific lowering in systolic pressure. Antihypertensive treatment must specifically decrease systolic pressure without superimposing adverse effects on the generalized and focalized atherosclerotic process. In this respect, new pharmacological agents capable of direct actions on large arteries might be suitable. PMID- 3301696 TI - The relative clinical efficacy of surface-decalcified and wholly decalcified bone alloimplants. AB - The relative clinical efficacy of surface-decalcified and wholly decalcified bone alloimplants was studied by observing radiographically the incorporation of the two types into the recipient bone bed in cases of shelf arthroplasty of the hip joint. In all cases, the decalcified alloimplants were incorporated well in an intraskeletal site. However, in all five cases examined, wholly decalcified alloimplants in a paraskeletal site were resorbed with little or no new bone deposition. In contrast, surface-decalcified alloimplants in a paraskeletal site were consistently incorporated, though their complete integration required more than one year. These findings show that, contrary to the results in experimental animals, increased decalcification of bone alloimplants reduced their clinical efficacy. PMID- 3301697 TI - [Erect dislocation of the shoulder (luxatio erecta humeri). General review apropos of 10 cases]. AB - Subglenoid dislocation of the shoulder is uncommon. The clinical picture is striking and the radiographic appearances are characteristic, with the head of the humerus lying inferior to the glenoid and the shaft directed upwards and internally rotated. Complications such as associated fractures and injury to the brachial plexus or acillary vessels may occur. Fracture of the greater tuberosity or rupture of the rotator cuff is always seen. Post-traumatic frozen shoulder is common and leads to a poor functional result. The authors describe ten cases and review the literature. The mechanism of the injury is discussed and experimental evidence which supports the current concepts of shoulder instability is reviewed. PMID- 3301698 TI - Group psychotherapy of bulimia: a critical review. PMID- 3301699 TI - Efficacy of oral immunization against non-typable Haemophilus influenzae in man. AB - An oral polybacterial vaccine containing 1.5 X 10(9) killed Haemophilus influenzae per tablet stimulated salivary IgA anti H. influenzae antibody compared to placebo control groups according to statistical analysis using parameter estimates for the logistic model of best fit. Significant antibody secretion could only be demonstrated when three-monthly courses were taken, and when the H. influenzae were combined in a polybacterial mix. This latter form of H. influenzae is functionally defined as adjuvenated. Increasing the immunising dose 60 fold in the absence of the non H. influenzae bacterial species did not stimulate a detectable increase in salivary antibody. PMID- 3301702 TI - Cutaneous amyloidoses. PMID- 3301703 TI - Reactions in leprosy. Clinical aspects. PMID- 3301700 TI - Immunopharmacological studies of wen-qing-yin, a Chinese blended medicine: effects on type IV allergic reactions and humoral antibody production. AB - Wen-Qing-Yin, a Chinese blended medicine, is reported to be effective against aphthous stomatitis and ulcus vulvae acutum of Behcet's syndrome, although there are no basic experimental studies supporting its clinical effectiveness. Although pathogenesis of Behcet's syndrome is not known, involvement of cellular immunodeficiency has been suggested. In the present paper, the effect of Wen-Qing Yin on type IV allergic reactions concerned with cellular immunity, and to a lesser extent, formation of humoral antibodies were investigated. Wen-Qing-Yin did not affect the effector phases of type IV allergic reactions including picryl chloride-induced contact dermatitis and footpad reactions induced by sheep red blood cells and tuberculin in mice. However, the induction phases of all these reactions were significantly inhibited with Wen-Qing-Yin. Local graft vs host reaction induced by lymphocytes of Balb/c mice into the footpads of CBF1 mice, was significantly inhibited with Wen-Qing-Yin. The formation of hemolytic plaque forming spleen cells (IgG-PFC and IgM-PFC) from mice were inhibited or tended to be inhibited with Wen-Qing-Yin. Hemolysin formation in the blood of these animals was inhibited or tended to be inhibited with Wen-Qing-Yin. It is suggested that the therapeutic effect of Wen-Qing-Yin on Behcet's syndrome may be mainly due to an inhibitory action on the early phases of the cellular immune response. PMID- 3301701 TI - The concept of posttraumatic stress disorder: a review. PMID- 3301704 TI - Pediatric dermatology: chronologic excursions into the literature. Part II. Dermatology in pediatric texts. PMID- 3301705 TI - Evaluating interventions against tropical diseases. PMID- 3301706 TI - Oral contraceptives in the United States: trends in content and potency. AB - Data from the National Prescription Audit, a nationwide pharmaceutical marketing research data base, were reviewed to study changes in the type of oral contraceptives marketed in the US, their content and their relative oestrogen and progestin potency over the 21-year time period of 1964-84. Three major types and 42 brands of oral contraceptives were marketed in the US during this time period. All oral contraceptives dispensed in the US have contained one of nine different progestins and one of two oestrogens or, in the case of the progestin-only pills, no oestrogen at all. A comprehensive classification listing all 42 brands of oral contraceptives by content and strength is presented. Secular changes in oral contraceptive potency are described in terms of a categorization scheme which simultaneously ranks both the oestrogen and progestin potencies of each oral contraceptive. Over the time period studied, oral contraceptives have evolved from high strength, high potency drugs to much lower strength, lower potency drugs. The epidemiological implications of these shifts in oral contraceptive content and potency are discussed. PMID- 3301709 TI - Does ephedrine promote weight loss in low-energy-adapted obese women? AB - A double-blind cross-over randomized study was performed in 10 selected adult overweight and obese (body mass index greater than 27) women who had been adapted to low-energy intake for a long period of time and who had shown difficulty in losing weight with conventional hypocaloric treatment. Combined with diet therapy (1000-1400 kcal/day), l(-)ephedrine hydrochloride (50 mg three times a day per os) or placebo were administered daily before each meal, after a period of stabilization with diet only for 1 month. Each pharmacological treatment lasted for 2 months. Weight loss was significantly (P less than 0.05) greater during the ephedrine period (2.41 +/- 0.61 kg) than during the placebo period (0.64 +/- 0.50 kg). None of the patients presented clinically important side-effects. These preliminary results seem to suggest a possible role for a thermogenic compound such as ephedrine in promoting weight loss in low-energy-adapted obese women. PMID- 3301708 TI - An important outbreak of human Q fever in a Swiss Alpine valley. AB - We describe an important Q fever human epidemic involving 415 serologically confirmed cases in the Val de Bagnes (Valais, Switzerland) during the autumn of 1983. The ages of the 415 cases with acute Q fever ranged from 8 to 82 years with a mean of 35 years, of whom 58% (240) were men and 42% (175) were women. This outbreak started about three weeks after 12 flocks of sheep (between 850 and 900 animals) descended from the alpine pastures to the valley. Geographically, the epidemic reached all the villages in the lower part of the Val de Bagnes located along the road followed by the sheep. As a result, 21.1% of the population of these villages contracted Q fever during this period. In contrast (p less than 0.001), the inhabitants of the higher villages away from the road followed by the sheep were only slightly affected (2.9%). Better collaboration between physicians and veterinarians would prevent such outbreaks in the future. PMID- 3301707 TI - Distribution of ultrasound examination during pregnancy in France between 1976 and 1981. AB - In France, between 1976 and 1981, the use of ultrasound examination during pregnancy increased from 11.3 to 81.8%. In spite of this dramatic increase, many inequalities observed in 1976 still exist in 1981. Despite a decrease in 1981 of the differences in practice in public maternity units and private care units, large differences remained between general practitioners and specialists. In a logistic regression, the type of practitioner responsible for care appeared to be the most important factor determining access to ultrasound examination. Independent of other inequalities in the type of antenatal care, three groups of women remained disadvantaged in 1981: women under 20 years old, grand multiparas and women of low educational level. The latter group was particularly disadvantaged. Obstetric pathology has little influence on the overall distribution of ultrasound examinations. PMID- 3301710 TI - Femoxetine in the treatment of obese patients in general practice. A randomized group comparative study with placebo. AB - A study was carried out in general practice to compare the effectiveness of femoxetine, a selective serotonin reuptake inhibitor, with the effect of placebo in helper patients more than 20 per cent above their ideal weight to lose weight. Patients were allocated at random to receive either 600 mg femoxetine (36 patients) or placebo (37 patients) daily over a period of 16 weeks. They were also asked to restrict their calorie intake to 1200-1600 kcal. (5.0-6.7 MJ)/day. The results showed that there was no statistically significant greater weight loss in patients treated with femoxetine (median = 8.3 kg) than with placebo (median = 6.2 kg) after 16 weeks. In subgroups of patients with obesity problems for more than 20 years and of patients previously in anorectic treatment, femoxetine tended towards causing a larger weight loss. Side-effects were generally minor in nature, and the incidence and nature of them were almost comparable in the two groups except for gastro-intestinal symptoms, which were reported more often in the femoxetine group. As femoxetine in several randomized group comparative studies in depressive illness has been shown to have an antidepressant efficacy which is comparable with the efficacy amitriptyline and imipramine, femoxetine may be particularly useful in the management of obese patients requiring antidepressant treatment. PMID- 3301711 TI - Antilipolytic action of insulin in abdominal adipocytes of obese subjects before and during energy restriction. Influence of adenosine deaminase. AB - The influence of prolonged energy restriction (1250 kJ for 4 weeks) on insulin's antilipolytic action was investigated in abdominal adipocytes of obese subjects. An attempt was made to discriminate between dietary influences per se and indirect influences caused by changes in the concentration or action of adenosine. Prolonged energy restriction resulted in about a 3.5-fold increase in basal lipolytic rate which was associated with a corresponding increase in maximal response to insulin. Both these effects could be mimicked by adenosine deaminase (1.6 micrograms/ml) which increased glycerol release of adipocytes from fed donors to levels normally seen during starvation suggesting that the improvement of lipolytic responsiveness to insulin during energy restriction was an apparent one only, due to the fact that glycerol release was increased. To identify dietary influences that selectively affect insulin action the effects of insulin were compared with those of other antilipolytic agents in the presence of adenosine deaminase. Maximally effective concentrations of prostaglandin E2, clonidine and N6-phenylisopropyladenosine almost completely suppressed glycerol release before and during starvation. The extent of inhibition produced by these latter compounds was therefore related to basal activity by the same linear relationship in all experimental settings. By contrast insulin only partially depressed glycerol release and the relationships between basal activity and response to maximal concentrations of insulin were significantly different before and during starvation (P less than or equal to 0.01) in the presence of adenosine deaminase indicating that starvation selectively influences insulin action via mechanisms that are unrelated to the effects of other antilipolytic compounds. It is concluded that the main effect of energy restriction on insulin's antilipolytic action is an apparent one which is secondary increased lipolytic activity. Direct dietary effects on insulin action became apparent upon removal of endogenous adenosine. These tend to limit the maximal response to insulin and may be due to changes at the post-binding level but could also reflect an intrinsic property of insulin's antilipolytic action. PMID- 3301712 TI - Diet, exercise, weight loss, and energy expenditure in moderately overweight women. AB - The effect of a moderate energy intake plus exercise (MEEX) vs a low energy intake without exercise (LESD) on weight loss and energy expenditure was examined in two groups of moderately overweight women confined to a metabolic unit. An initial 2-week baseline period was used to determine weight maintenance energy requirement (ER). This was followed by a 6-week weight reduction period. Energy intake was decreased to 0.75 ER in MEEX and treadmill exercise was individually prescribed to increase energy expenditure to 1.25 ER. Energy intake was decreased to 0.5 ER in LESD. Thus, both energy intake and expenditure were manipulated to result in an energy deficit of 50 percent. Although total weight loss was significantly higher in LESD compared to MEEX (7.8 vs 5.7 kg), fat loss did not differ (5.1 vs 4.7 kg) hence the proportion of weight loss due to fat was greater in MEEX. Aerobic capacity, measured by maximum oxygen uptake, significantly improved in MEEX (2.44 to 2.84 l/min) but did not change in LESD (2.51 to 2.50 l/min). Basal metabolic rate, energy cost of standardized activities, and 3-hour thermic response to a test meal did not change in either group throughout the study. Thus, a 50 percent energy deficit, achieved by either diet alone or diet in combination with exercise, did not result in conservation of energy expenditure in moderately overweight women. PMID- 3301713 TI - Effect of cellular glutathione content on the induction of DNA double strand breaks by 25 MeV electrons. AB - The effect of endogenous glutathione (GSH) on the induction of DNA double strand breaks (dsb) by 25 MeV electrons was investigated using stationary haploid yeast cells defective in gamma-glutamyl-cysteine-synthetase (gsh 1) containing less than 5 per cent of the normal GSH content. In gsh 1 cells the induction of dsb is increased by a factor of 1.5 under oxic and 1.8 under anoxic irradiation conditions: whereas the oxygen enhancement ratio was only slightly decreased (1.9) compared to wild-type cells (2.4). PMID- 3301714 TI - Survival of mouse type B spermatogonia for the study of the biological effectiveness of 1 MeV, 2.3 MeV and 5.6 MeV fast neutrons. AB - The most radiation-sensitive cells in the testis are B and intermediate spermatogonia. We have used a histological scoring technique to compare three neutron beams of different mean energies (1 MeV at the ECN, Petten, 2.3 MeV at the Gray Laboratory, Northwood, and 5.6 MeV at the Oncological Centre, Krakow). CBA inbred mice, 14-20 weeks old, were exposed to whole-body irradiation with single doses of either X-rays (0.1-1 Gy) or neutrons (0.2-0.25 Gy). Relative biological effectiveness values, calculated at the level of 50 per cent reduction in survival of B spermatogonia, were 5.7 at the ECN, Petten, 4.6 at the Gray Laboratory and 3.0 at the Oncological Centre in Krakow. The Do value for the B spermatogonia after X-rays was 0.34 +/- 0.02 Gy when the data from the three centres were combined. Do values for neutrons for the examined spermatogonia were 0.08 Gy, 0.09 Gy and 0.11 Gy at the ECN, Petten, the Gray Laboratory and the Oncological Centre, respectively. PMID- 3301716 TI - [Deep venous thrombosis]. PMID- 3301715 TI - Surgical resection of liver metastases from colo-rectal cancers. AB - Surgical resection is currently the only potentially curative treatment in some selected patients with colo-rectal liver metastases (LM). Unfortunately only a minority of patients are candidates for resection. Only solitary or unilobar LM that can be removed by partial liver resection, are considered to be resectable. The second condition for the resection of LM is that the primary cancer must be resected. The third condition for resection is that the patient must be able to undergo a major liver resection if it is necessary. Small metastases which do not exceed 5 cm, and appear on the surface of the liver can be removed by a simple wedge resection. If the tumor is larger than 5 cm, or if multiple unilobar nodules are discovered, a major liver resection becomes necessary. Hospital mortality does not exceed 5% in most published series. Five year survivals are very rare when histologically proven colo-rectal LM are left in place. After surgical resection of LM, five year survival rates are close to 25% and range from 18% to 52%. Surgical resection is of benefit to approximately one fourth of the patients, who survive five years or more, but three fourths of the patients have early recurrences. None of the studied criteria can predict which patients will benefit from surgical resection of LM. In order to try to reduce the rate of early recurrences adjuvant chemotherapy has been proposed. No positive data have yet been obtained. PMID- 3301717 TI - [Epidemiology of venous thromboembolism]. PMID- 3301718 TI - [Clinical aspects of acute leg and pelvic vein thrombosis]. PMID- 3301719 TI - [Physiologic studies of blood coagulation in deep venous thrombosis]. PMID- 3301720 TI - [Therapy of acute ilio-femoral vein thrombosis]. PMID- 3301721 TI - [Manifestations of sarcoidosis in the area of the eye]. PMID- 3301722 TI - [Changes in the fundus oculi in hypertension]. PMID- 3301723 TI - [Uveitis in internal diseases]. PMID- 3301725 TI - [Acute pancreatitis in type III hyperlipoproteinemia]. PMID- 3301724 TI - [Thrombotic thrombocytopenic purpura within the scope of disseminated tumor disease]. PMID- 3301728 TI - [Long-term course of a myocardial disease in Friedreich's ataxia]. PMID- 3301726 TI - [A 41-year-old patient with increasing dyspnea and pulmonary artery hypertension]. PMID- 3301727 TI - [Quincke edema as a manifestation of food allergy]. PMID- 3301729 TI - [Acute kidney failure requiring dialysis in Legionella pneumonia]. PMID- 3301730 TI - Polarized distribution of integrin and fibronectin in retinal pigment epithelium. AB - We have examined the presence and distribution of integrin and fibronectin in the retinas of 21-day chick embryos and adult rats, with particular emphasis on the question of localization in the retinal pigment epithelium (RPE). Isolated sheets of RPE solubilized and separated by gel electrophoresis contain integrin, as indicated by immunoblotting with polyclonal and monoclonal antibodies to the complex. By the same technique, antibodies to fibronectin reacted with a single protein in the isolated RPE. In both chick and rat, integrin and fibronectin were localized by indirect immunofluorescence exclusively to the basement membrane of the RPE, the choriocapillaris and the retinal-vitreal border. When isolated RPE cells from chick retinas were examined, integrin was seen to be present along the basolateral surfaces of the cells as well. Similarly, in the intact rat retina, staining for integrin could be seen along the lateral surfaces of some of the RPE cells. Neither integrin nor fibronectin were present along the apical surfaces of the RPE in either rat or chick. The close similarity between the location of integrin and fibronectin supports the idea that the RPE adheres to the basal lamina at least in part via integrin-fibronectin linkages. A clear implication of our results is that the adhesion between RPE and retina requires a different set of linkage proteins. PMID- 3301731 TI - The distribution and ontogeny of MHC antigens in murine ocular tissue. AB - The distribution of H-2 (Class I) and Ia (Class II) antigens in the mouse eye was determined with the use of monoclonal antibodies and found to be different. H-2 antigen was observed in the corneal epithelium, conjunctival epithelium, choroid, and inner and outer nuclear layer of the retina--in order of decreased intensity of staining. In contrast, Ia was detected most strongly, in a patchy distribution, in the choroid, limbus epithelium, and peripheral corneal stroma, followed by the iris and ciliary body. Thus, distinctively different patterns of distribution of H-2 and Ia were observed in the normal mouse eye. Surprisingly, adult eyes stained more intensely for both H-2 and Ia antigens than neonatal eyes, implying that the expression of MHC antigens varies with ontogeny. Since unique and important immunologic functions have been ascribed to class I and II antigens, their different distribution within the eye may indicate that various ocular structures can play distinctive roles in the immune response. PMID- 3301732 TI - Suppressed cellular cytotoxic response in rats bearing skin implants in the anterior chamber of the eye. AB - The ability of allogeneic skin implants placed into the anterior chamber of the eye to elicit splenic cell cytotoxicity was studied in Le rats. No cellular cytotoxicity was detected in the rats bearing either small (0.5 mm2) or massive (greater than 5 mm2) skin implants, but the injection of allogeneic splenocytes into the anterior chamber readily induced cytotoxic spleen cells. Since the presence of an allogeneic skin implant in the anterior chamber appeared to suppress the production of host cytotoxic cells, studies were performed to determine whether the host's cellular cytotoxic response to an orthotopic allogeneic skin graft could be suppressed by the presence of the implant. It was found that the production of splenic cell cytotoxicity was severely suppressed in rats that were implanted 8-21 days before receiving an orthotopic skin graft from the implant donor strain. No suppression occurred if the implant and the skin graft were performed on the same day. The suppression was specific for the alloantigens present on the implant in the anterior chamber because third party implants did not suppress cytotoxicity. It appears that alloantigen presentation via the anterior chamber of the eye can modulate the host's cellular immune response to systemically administered alloantigens. PMID- 3301734 TI - Prostate cancer. PMID- 3301737 TI - Biographical sketch. Langenbeck. PMID- 3301735 TI - Lymphoglandular complexes of the normal colon: histochemistry and immunohistochemistry. PMID- 3301736 TI - Metastatic carcinoma tumour presenting as a hepatic pseudocyst. PMID- 3301733 TI - Autographa californica nuclear polyhedrosis virus efficiently enters but does not replicate in poikilothermic vertebrate cells. AB - The host range of the insect virus Autographa californica nuclear polyhedrosis virus (AcMNPV) was examined. AcMNPV could not initiate a productive infection in frog, turtle, trout, or codling moth cell lines. After exposure to AcMNPV, neither viral DNA nor RNA synthesis could be detected in these cell lines as assayed by nucleic acid probe hybridization. Entry of AcMNPV nucleocapsids into the cytoplasm and viral DNA into the nucleus, however, was as efficient in the nonpermissive cell lines as it was in a permissive insect cell line. The data suggest that the block in AcMNPV infection in these nonpermissive cell lines is at a stage subsequent to viral DNA entry into the nucleus. PMID- 3301738 TI - The use of isozyme loci as markers in transferring genes for disease resistance in plants. PMID- 3301740 TI - The origin of bile ductular-like structures after transplantation of regenerating hepatocytes into the spleen of syngeneic rats. AB - Normal and 24-h regenerating hepatocytes were transplanted into the spleen of 70% partially hepatectomized, syngeneic rats, which were sacrificed after 2, 4, 6, 10, and 12 months from the transplant. Altogether 50 rats served as recipients. Histological examination of splenic sections showed a small number of surviving hepatocytes both in normal hepatocytes recipients and in the regenerating hepatocytes recipients. In the latter group marked bile ductular proliferation was present from 4 to 12 months after transplantation. This experimental evidence supports the theory that intrahepatic bile duct cells can originate from hepatocytes. PMID- 3301739 TI - Pulmonary and systemic contribution to canine tracheobronchial blood flow. AB - To investigate the quantity and pathophysiological relationship of pulmonary and bronchial artery supply to the tracheobronchial tree in dogs in absence and in presence of increased tissue metabolic requirements, pulmonary and bronchial blood flow to the trachea and bronchi was determined by the radioactive microsphere method in nine adult mongrel dogs. Microspheres were injected into the right atrium of three dogs (pulmonary injection group) and into the left ventricle of four dogs (systemic injection group) just before and three, eight and fourteen days after resection and anastomosis of the right main bronchus. The remaining two dogs served as controls without surgery. After the fourth injection, the tracheobronchial tree was harvested, divided into segments, and the radioactivity counted in each segment. At baseline the systemic flow to the tracheobronchial tree expressed as percentage of cardiac output was 0.188% +/- 0.121 and the pulmonary blood flow was 0.007% +/- 0.004 (mean +/- S.D.). Three, eight and fourteen days after transection and anastomosis of the right main stem bronchus, the systemic blood flow to the bronchial segments proximal and distal to the anastomosis increased significantly whereas pulmonary blood flow did not change. Depending on the anatomical segment considered the systemic contribution was between 5 and 100 times larger than the pulmonary one, both at baseline and after transection and anastomosis of the right main stem bronchus, but the ratio diminished in more distal segments where pulmonary blood flow was larger. It is concluded that the systemic blood contribution to the canine tracheobronchial tree is larger than the pulmonary one and that, in the presence of increased metabolic needs, it responds more promptly with increased blood flow. PMID- 3301741 TI - Some reminiscences of a former medical officer of health and community medicine specialist with an interest in environmental health and communicable disease. PMID- 3301742 TI - [Diagnosis of varicocele with bidirectional Doppler sonography. A contribution to the pathogenesis of varicocele]. AB - A total of 375 patients with varicocele were examined by bidirectional Doppler sonography. Venous reflux was classified as one of two Doppler grades: spontaneous reflux and Valsalva-induced reflux. The Doppler grades were compared with clinical aspects (e.g. size) of the varicocele. Using bidirectional recording, it is possible to describe two hemodynamically different types of varicoceles (the pressure type and the shunt type). On the basis of the Doppler results the pathogenesis of varicocele can be determined. Spontaneous reflux causes the shunt type and the medium-sized and large varicocele, while Valsalva induced reflux causes the pressure type or the stop type and the small and subclinical varicocele. PMID- 3301743 TI - [A finger-saving operation in squamous cell carcinoma of the right thumb. A case report]. AB - A 68-year-old man with squamous cell carcinoma of the right thumb underwent a finger-saving operation. The lesion (2 X 2.3 cm) was located near the IP joint. There were no distant metastases. A wide local excision including the MP joint was performed, and the axillary lymph nodes were dissected. To avoid any loss of length the bone defect was treated with a 2.5-cm-long bone graft from the third rib. The skin defect was closed with a local flap. In the histological examination tumor cells reached the subcutaneous layer; the deeper layers and the bone were not involved. Two years after the operation neither local recurrence nor distant metastases were found and the function of the right hand was good. The good outcome of this case does not allow any general conclusion on the best treatment for such cases; but it does emphasize the difficulties of deciding on the treatment (amputation or excision) to be applied in this area. PMID- 3301744 TI - [Johann Wilhelm Ritter (1776-1810) and the discovery of ultraviolet irradiation 185 years ago]. AB - On 22 February 1801, Johann Wilhelm Ritter discovered UV radiation in Jena. In general, this achievement is less well known than his work on galvanism. Ritter was the creator of modern electrochemistry. Though since described as "the most brilliant physicist of the Romantic period," he was a controversial figure in his own time. His scientific work was not fully acknowledged until after his death. PMID- 3301746 TI - Nursing home cost and ownership type: evidence of interaction effects. AB - Due to steadily increasing public expenditures for nursing home care, much research has focused on factors that influence nursing home costs, especially for Medicaid patients. Nursing home cost function studies have typically used a number of predictor variables in a multiple regression analysis to determine the effect of these variables on operating cost. Although several authors have suggested that nursing home ownership types have different goal orientations, not necessarily based on economic factors, little attention has been paid to this issue in empirical research. In this study, data from 150 Virginia nursing homes were used in multiple regression analysis to examine factors accounting for nursing home operating costs. The context of the study was the Virginia Medicaid reimbursement system, which has intermediate care and skilled nursing facility (ICF and SNF) facility-specific per diem rates, set according to facility cost histories. The analysis revealed interaction effects between ownership and other predictor variables (e.g., percentage Medicaid residents, case mix, and region), with predictor variables having different effects on cost depending on ownership type. Conclusions are drawn about the goal orientations and behavior of chain operated, individual for-profit, and public and nonprofit facilities. The implications of these findings for long-term care reimbursement policies are discussed. PMID- 3301747 TI - Identification of extra-villous trophoblast cells in human decidua using an apparently unique murine monoclonal antibody to trophoblast. AB - Murine monoclonal antibodies were raised to human first trimester trophoblast cells. Eleven antibodies reacted with first trimester trophoblast, tested by immunoperoxidase staining on frozen sections, but only one had apparent specificity for trophoblast after examining reactivities with a panel of other cells and tissues. This antibody, designated FD0161G, bound selectively to syncytiotrophoblast and non-villous trophoblast in first trimester and term placentae. Villous cytotrophoblast was negative. This was clearly demonstrated on freeze-dried, paraffin embedded tissue sections which have superior architecture to frozen sections. FD0161G reacted with extra-villous trophoblast cells in human decidua which are also delineated by a monoclonal anti-cytokeratin antibody. Unlike the latter, however, FD0161G did not react with decidual glands. Thus FD0161G could be used as a specific probe for extra-villous trophoblast in decidual tissue. PMID- 3301745 TI - The substitutability of outpatient primary care in rural community health centers for inpatient hospital care. AB - To determine whether outpatient medical care obtained at federally funded rural community health centers (CHCs) in Maine acts primarily as a substitute or as a complement to inpatient care, a study of 36 communities served by CHCs was conducted. The hospital use of CHC users (age- and sex-adjusted admissions, days, and length of stay) was compared with that of nonusers from the same communities in 1980. Statistically lower rates of hospital admissions and days were observed for all CHC patients and for selected groups based on their age, sex, and insurance status (specifically Medicaid or Medicare). Hospital use of CHC community populations was then compared with that of 24 comparison communities without access to CHCs, using multiple linear regression in a pre/post design. The model tested, which included rates of health center use, insurance penetration, poverty, and hospital availability, among other factors, did not detect any differences in hospital use between CHC community and comparison populations. These results and additional data presented on selected hospital diagnoses and insurance coverage suggest that treatment, and hospitalization incentives, of CHC providers may reduce hospitalization. Clinic providers lack the economic, professional, and institutional incentives to hospitalize. Additional study to determine the actual substitutability effect is indicated. PMID- 3301748 TI - Precision of the doubly labelled water method using the two-point calculation. AB - The intrasubject precision of the doubly labelled water method was investigated as a function of increasing length of the metabolic period and decreasing initial isotope enrichment. This analysis was performed in seven subjects following a single dose of isotope and three subjects who received multiple doses of isotope. The intrasubject precision was 5-6 per cent for periods of up to 14 d. This is only slightly larger than that predicted from our previously published model in which we assumed that analytical error was limiting precision. Intrasubject precision worsened with increasing length of the metabolic period and with decreasing initial isotope enrichment, but the loss of precision was two to ten times greater than that predicted by the model. The use of the intercept method to determine the isotope dilution spaces did not improve precision. We speculate that one cause of the failure of the model is that it does not consider unmeasured changes in natural isotopic abundances associated with dietary intake. Results demonstrate the importance of choosing a dose that provides an initial isotope enrichment that is 500-600 times the analytical error, and a metabolic period that is between one and three biological half-lives of the isotopic tracers. PMID- 3301749 TI - Immunocytochemical localization of calspectin (a non-erythroid spectrin-like protein) in thyroid glands of normal and TSH-treated rats. AB - The localization of calspectin (fodrin, a non-erythroid spectrin-like protein), which is known to bind calmodulin and F-actin, was detected in the thyroid gland of normal and TSH-treated rats by means of light-microscopic immunocytochemistry. Calspectin was demonstrated in the cytoplasm of the follicle epithelial cells especially along the baso-lateral plasma membrane in normal rats. In TSH-treated animals, in addition to the baso-lateral plasma membrane region, the apical plasma membrane region of the follicle epithelial cells also showed positive reaction to the immunostaining. These results suggest that calspectin, in conjugation with calmodulin and actin, play a role in the secretory activities including reabsorption activity of colloid of the follicle epithelial cell. PMID- 3301750 TI - Coexistence of pancreatic polypeptide (PP)-and glucagon-immunoreactivity in pancreatic endocrine cells of mouse. AB - Immunocytochemical double staining techniques were used to study PP- and glucagon like-immunoreactivity in pancreatic endocrine cells of mouse. An antiserum against FMRFamide appeared to react with all PP-immunoreactive endocrine cells. With fluorescence microscopy most PP/FMRFamide-immunoreactive cells also showed glucagon-immunoreactivity, but cells containing only PP- or glucagon-like substances were found as well. The proportion of cells containing PP-, glucagon, and both immunoreactivities varied strongly from islet to islet in all parts of the pancreas. Using an electron microscopical immunogold double staining procedure on Lowicryl-embedded pancreas, PP/FMRFamide- and glucagon immunoreactivity appeared to be present in the majority of endocrine A cells; both immunoreactivities were randomly distributed within the granules of these cells. Cells containing only PP/FMRFamide- or glucagon-immunoreactivity were also found. Glucagon- and a faint FMRFamide-immunoreactivity was also observed in osmicated epon-embedded tissue. Independent of their immunoreactivity all positive cells showed the same round electron dense secretory granules. PMID- 3301752 TI - Methodological dependence in the ultrastructural immunolocalization of laminin in tubular basement membranes of the mouse kidney. AB - The ultrastructural localization of the basement membrane glycoprotein laminin was investigated in basement membranes of proximal tubules of the mouse kidney. The localization of laminin was determined using two different immunoperoxidase and one immunogold preembedding technique and one immunogold postembedding technique on unfixed and formaldehyde fixed tissue. Strong differences in the immunolocalization for laminin were found in the lamina densa of the tubular basement membrane using different techniques. After preembedding immunostaining for laminin using IgG--PO as secondary antibody, a positive reaction for the lamina densa was found in the formaldehyde fixed as well as in the unfixed kidney. After preembedding immunostaining for laminin using Protein-A--PO, staining of the 1. densa was seen in the unfixed, but not in the fixed kidney. It was striking that no clear immunoreaction in the 1. densa of the tubular basement membrane was seen in either the fixed or unfixed tissue after preembedding immunostaining for laminin using protein A-gold. With a direct postembedding immunogold technique laminin was localized only in the 1. fibroreticularis and the 1. rara but not in the 1. densa of basement membranes of proximal tubules of the unfixed and the fixed kidney. PMID- 3301751 TI - Histochemical investigations on the localization of the purple acid phosphatase in the bovine spleen. AB - The localization of the purple tartrate-resistant, iron-containing acid phosphatase in the bovine spleen was studied by enzyme histochemistry at the light and electron microscopic levels as well as by immunohistochemistry. The purple phosphatase was localized only in lysosome-like-organelles of cells belonging to the reticulo-phagocytic system. The same cells were identified as containing large iron(III)-deposits as ferritin in homogeneously granular accumulations and freely in the cytoplasm, or as hemosiderin in siderosomes. The phagocytosing cells containing purple phosphatase and ferritin often had close contact with clusters of aged and deformed erythrocytes. A possible catabolic role of the purple enzyme as a phosphatase degrading phosphoproteins of the erythrocyte membrane and the cytoskeleton was assumed. PMID- 3301753 TI - Glycerol increases the cytochemical detectability of cholesterol in the apical plasma membrane of uterine epithelial cells. AB - The apical plasma membrane of uterine epithelial cells in the rat has been treated with glycerol before fixation and then examined by freeze-fracture cytochemistry using digitonin and filipin. Many more lesions were produced by both cytochemicals following glycerol treatment than in untreated controls, and we suggest that this indicates an increased detectability of cholesterol. We consider the implications of the findings for the way in which glycerol acts on membranes and propose that glycerol promotes increased binding between cholesterol and the cytochemicals. PMID- 3301754 TI - Immunocytochemical characterization of glucagon-immunoreactive cells using monoclonal antibodies to pancreatic glucagon. AB - Monoclonal antibodies raised to pancreatic glucagon were tested for their ability to detect glucagon-containing endocrine cells in material processed for light and electron microscopy. Samples from man, baboon and rat were used in this investigation. Two antibodies were specific for the pancreatic islet A cells, the remainder detected both pancreatic and enteric endocrine cells. In man and baboon the glucagon-containing cells were confined to the pancreas, lower small intestine and colon. In the rat the distribution was extended to include the corpus of the stomach and the jejunum. The cells identified in the ileum and colon were of three morphological types endocrine, paracrine (type 1) with a single basal process and paracrine (type 2) with multiple small cytoplasmic processes. These antibodies also detected cells in material fixed by conventional methods for electron microscopy. The ultrastructural appearance of the baboon pancreatic glucagon-containing ultracellular secretory granules were demonstrated to be clearly distinct from those described previously in man and rat. The secretory granules averaged 330 +/- 23 nm and lacked the characteristic clear outer halo seen in the other two species. PMID- 3301756 TI - [Surgical treatment of the lacrimal apparatus--technics and results]. AB - After a short review of anatomy the clinical and radiological diagnosis of stenoses of the lacrimal duct system are discussed in detail. Microcatheterdacryocystography and high resolution CT are very important in determining the indications for surgery. Microsurgical endonasal dacryocystorhinostomy is preferred for treatment of postsaccal stenoses. It is also the method of choice for one stage definitive therapy of acute lacrimal sac empyema. Surgical reconstruction in cases of presaccal stenoses is difficult and should be handled individually. For intubation of the canaliculi we have developed a special modified pigtail-hollow-probe (Draf-Haag 1981), which reduces damage to the epithelium. If reconstruction of the natural lacrimal duct system is not possible, a conjunctivorhinostomy by Walter's technique is indicated. The different surgical concepts and results are discussed. PMID- 3301755 TI - Application of frozen thin sectioning immunogold staining to the study of the developing neuroepithelial basal lamina. AB - In order to examine the deposition of basal lamina components in the developing neuroepithelium, a technique for frozen thin sectioning and immunogold staining of early embryonic tissue was developed. Different fixatives and buffer systems were evaluated to determine which best retained immunoreactivity and satisfactory ultrastructure of day 9 and 10 mouse embryos. Fixation in sodium phosphate and sodium bicarbonate buffers did not retain antigenicity, and incubations in TBS (trishydroxymethyl-aminomethane buffered saline) in an effort to 'restore' immunoreactivity were similarly unsuccessful. Fixation in sodium cacodylate buffer, however, did retain the antigenicity of basal lamina components; the pattern of type IV collagen and laminin distribution was clearly determined. These results represent the first report of on-grid immunocytochemistry of early embryonic material. PMID- 3301757 TI - Increase in natural killer activity in cyclosporine-treated renal allograft recipients during rejection. AB - Natural killer (NK) activity was assessed in a prospective fashion in 15 renal transplant recipients receiving single HLA-haplotype matched allografts and maintained on cyclosporine (CYA) immunosuppression. There was marked variability in NK activity pretransplantation in this population; however, a strong correlation (r = 0.92, p less than 0.01) was found between determinations in an individual patient upon repeated testing. No significant depression of NK activity occurred within the first 12 weeks following transplantation. Whole blood CYA levels did not correlate with NK activity. Although NK activity prior to transplantation did not predict clinical outcome of the allograft, a marked rise in NK activity was observed in patients undergoing rejection compared with those not rejecting (p less than 0.01). A large increment in activity was seen in eight of 11 rejection episodes; a similar increase was rarely seen in the absence of rejection. These results indicate that NK activity is stimulated during allograft rejection in CYA treated renal transplant recipients. It remains to be determined whether this rise in NK function represents a manifestation of alloreactivity accompanying the rejection process or whether NK cells directly contribute to allograft destruction. PMID- 3301758 TI - Failure of misonidazole-sensitized radiotherapy to impact upon outcome among stage III-IV squamous cancers of the head and neck. AB - As part of the RTOG research effort in the treatment of advanced, inoperable squamous cancer of the head and neck region, the hypoxic cell sensitizer, misonidazole, was selected for investigation as an adjuvant to definitive irradiation. Based upon a pilot experience (78-02) showing a 67% complete response rate among 36 AJC Stage III-IV patients receiving full-dose irradiation and 6 weekly p.o. doses of misonidazole, a phase III trial was carried out from '79-'83. Three hundred and six patients were entered, 42% of whom had oropharyngeal primaries and with 78% of all cases representing T3 or T4 (inoperable) lesions. Only 16% of the entire series presented with N0 necks. Fractionation was altered among the misonidazole-receiving patients, in contrast to "standard" 5 treatments per week among "control" patients, such that 2 separate treatments were given on each day of p.o. misonidazole administration (2.0 gm/m2/wk X 6 doses, 2.5 Gy in a.m., 2.1 Gy in p.m.). Total tumor doses were identical among the two treatment arms except that a limitation of 40.0 Gy to spinal cord was specified for sensitized radiotherapy vs. 45.0 Gy for "control" patients. Primary tumor clearance was observed to be 55-60%, with minor variations according to tumor stage and site. The local regional control rate among radiotherapy-alone patients was 26% at 2 years compared to 22% (2 years) within the misonidazole-receiving group. Analysis of survival revealed no advantage to the sensitized patients, with 55 +/- 2% surviving 1 year and 22 +/- 1% living 3 years following treatment in both treatment categories. Distant metastases as first site of failure (12-13%) and the local failure among initial complete responders (46%) showed no advantage to the misonidazole group. Although a misonidazole dosage of 2.0 gm/m2/wk X 6 (12 gm/m2 total) is well tolerated, no clinical benefit was demonstrated in this randomized trial. Other nitroimidazole analogs (e.g. SR-2508) are now being investigated. PMID- 3301759 TI - Long-term results of low dose total body irradiation for advanced non-Hodgkin lymphoma. AB - Sixty-eight patients received fractionated low dose total body irradiation (LTBI) as treatment for non-Hodgkin lymphoma (NHL) at the Rotterdamsch Radio Therapeutisch Instituut (RRTI) in the period 1973-1979. Ninety percent (61/68) of these patients had advanced disease (Stage III + IV). According to current malignancy grade classifications, 34 patients had low grade NHL, 10 intermediate, and 19 high grade. In 5 cases no exact grading was possible. LTBI was given 3 times a week, midline dose 0.1 Gy, using 6 or 25 MeV photons to a mean total dose of 1.78 Gy. Initial response rate for low, intermediate, and high grade NHL was resp. 84, 42, and 40%. The main prognostic factor for survival and recurrence free survival (RFS) was malignancy grade. Probability of uncorrected survival at 10 years for low, intermediate, and high grade was resp. 34, 0 and 0%. Probability of RFS at 10 years was resp. 19, 0, and 0%. Neither stage nor sex had any influence on survival. Age was reversely correlated with survival, but was not correlated with RFS. Influence of prior therapy (18 patients) on survival and RFS was separately analyzed. Neither survival nor RFS of unfavorable histologic type NHL (high and intermediate grade) was influenced. On the other hand patients with a favorable histologic type NHL (low grade) had a significantly (p less than 0.05) better RFS if they received LTBI as initial treatment, but survival was not significantly influenced. RFS at 5 and 10 years of patients who received LTBI as first treatment was respectively 32% and 27%. No treatment related complications were noted. Subsequent chemotherapy in case of relapse was not hampered by previous LTBI. The high response rate and extended RFS, without maintenance therapy, makes LTBI a preferable first line treatment for patients with advanced stage low grade NHL. PMID- 3301760 TI - Stereotaxic localization of intracranial targets. AB - We report on a useful clinical method for precisely locating intracranial targets. Utilizing the BRW system, the technique is currently used in stereotaxic irradiation of arteriovenous malformations. An intracranial localizer box, with four radio-opaque markers on each face, surrounds the patient's head and is attached to the BRW Head Ring. Two localization films are required. One film includes the target and the eight anterior and posterior markers, whereas the other film includes the target and the eight right and left markers. There are no constraints that the films be orthogonal or parallel to the box faces, only that the target and radio-opaque markers appear on the films. In addition, knowledge of the source-image and source-target distances are not required. Analysis of the projected target and radio-opaque markers gives both the target location and magnification. Simulation with the BRW Phantom Base demonstrates that point targets can be located with respect to the BRW system to within 0.3 mm and magnification determined to within 0.5%. PMID- 3301761 TI - Diagnosing gonorrhea. A comparison of standard and rapid techniques. AB - A timely and accurate technique for diagnosing gonorrhea is necessary if prompt therapy is to be instituted. We screened 567 adolescents who presented for routine gynecologic care or for specific gynecologic or urologic problems. Each patient was tested by standard culture, Gonozyme (Abbott Labs), and Gram's stain. One hundred five patients (18.5%) had an ELISA immunoassay or culture evidence of infection. Overall sensitivity was 90% for Gonozyme and 56% for Gram's stain (females 41%, males 94%). Overall specificity was 97% for Gonozyme and 99% for Gram's stain. No increase in sensitivity of either test was found in women with signs of upper genital tract involvement. The predictive value of a negative Gonozyme was 98% and 85% for a positive result compared to Gram's stain values of 99% and 95%, respectively. Overall clinical efficacy was 96% for Gonozyme and 93% for Gram's stain. Gonozyme, although a sensitive and specific test, has a limited role in the diagnosis of gonorrhea. Gram's stain, although more limited in women, may serve as a useful adjunct in diagnosing gonorrhea. PMID- 3301762 TI - Herd management and prevalence of mastitis in dairy herds with high and low somatic cell counts. AB - Thirty-two dairy herds, 16 with low somatic cell counts (LSCC; Dairy Herd Improvement Association 12-month mean herd SCC less than or equal to 150,000 cells/ml) and 16 with high somatic cell counts (HSCC; Dairy Herd Improvement Association 12-month mean herd SCC greater than or equal to 700,000 cells/ml) were evaluated to determine the relationship between the prevalence of mastitis in each herd and each herd's mastitis control and management practices. Once for each herd, duplicate quarter milk samples were collected from the lactating cows, a survey of herd mastitis control, milking hygiene, and management practices of each herd was performed, and milking-machine function was evaluated. Of the 16 herds with LSCC, 2 (12.5%) had Streptococcus agalactiae isolated and 7 (44%) had Staphylococcus aureus isolated. Both organisms were found in all of the herds with HSCC. In herds with LSCC, the mean percentage of quarters infected with Str agalactiae was 0.1%, the mean percentage infected with streptococci other than Str agalactiae was 1.9%, and the mean infected with S aureus was 0.7%. In herds with HSCC, 25.7% of the quarters were infected with Str agalactiae, 3.7% were infected with streptococci other than Str agalactiae, and 7.6% were infected with S aureus. A program of postmilking teat dipping and treatment of all cows at the beginning of the nonlactating period was practiced more frequently in the herds with LSCC (81.3%) than in the herds with HSCC (37.5%). Major differences were not found between the 2 groups of herds in the use of the more common milking hygiene techniques or in the maintenance and functional characteristics of the milking equipment. PMID- 3301764 TI - Topical wound medications: a review. PMID- 3301765 TI - Misdiagnosis in normal radiographic anatomy: eight structural configurations simulating disease entities in dogs and cats. AB - Radiographic diagnosis is a combination of accurately identifying normal and abnormal variants, projecting anatomic structures, and describing abnormal findings. Disease conditions may easily be confused with normal structures. Eight conditions and normal counterparts that are presented illustrate the similarities and differences between normal and abnormal. PMID- 3301766 TI - Cryptosporidiosis associated with bacterial enteritis in a goat kid. AB - A 7-day-old male Nubian-Alpine crossbred goat was examined because of listlessness, anorexia, and diarrhea. The presumptive diagnosis was severe enteritis. Large numbers of Clostridium perfringens and a non-pathogenic heavily encapsulated Escherichia coli were isolated from the feces. Cryptosporidium parvum was identified on the qualitative fecal examination. The kid improved after treatment with fluids and antibiotics. PMID- 3301767 TI - Marsupialization of an abdominal abscess caused by Serratia marcescens in a mare. AB - An intra-abdominal abscess was diagnosed in a 7-year-old mare by palpation per rectum and from abnormal clinicopathologic findings. Initial treatment with procaine penicillin for 21 days was unsuccessful in halting the deterioration of the physical condition of the mare. Surgical exploration of the abdomen revealed a mass in the wall of the left ventral colon. Drainage was achieved by marsupialization. Serratia marcescens was isolated from the abscess. Recovery appeared complete, and the mare has resumed broodmare capability. PMID- 3301768 TI - Computer use in allied health programs. AB - This article presents a preliminary assessment of computer use in allied health programs. The findings of a survey among 60 allied health programs indicate that computer use in the classroom, in clinical education, and in simulation has increased. In preprofessional education, computers are used by less than 50% of the allied health programs. However, computers are used more in the professional phase for patient management, clinical simulations using branching and logic methods, physiological simulations, and therapeutic planning and management. Students in these programs are required to take three to six semester hours of computer literacy classes. In the classroom, computer-assisted instruction is used to provide remediation, reinforcement, enrichment, and test-taking drills in clinical and didactic learning. Students use microcomputers to gain application experience in health statistics, data bases, abstracting, and diagnosis-related group classifiers. Although progress has been made in computer use, greater efforts must be expended to ensure greater use of computer technology in the next decade in allied health disciplines. Recommendations for increased use of computer technology in allied health programs are provided. PMID- 3301763 TI - Blood selenium concentrations and glutathione peroxidase activities in dairy herds with high and low somatic cell counts. AB - Two groups of dairy herds (16 herds/group) were studied to determine the relationship between the prevalence of mastitis in a herd and mean herd blood concentrations of vitamins A and E, beta-carotene, and selenium (Se). One group had a Dairy Herd Improvement Association 12-month mean herd somatic cell count (SCC) of less than or equal to 150,000 cells/ml. The second group had a Dairy Herd Improvement Association 12-month mean herd SCC of greater than or equal to 700,000 cells/ml. Once for each herd, duplicate milk samples were collected from each quarter of the lactating cows, and blood samples were collected from 21 cows in various stages of lactation. Serum concentrations of vitamin A, beta-carotene, and vitamin E and whole blood concentrations of Se and Se-dependent glutathione peroxidase (GSH-Px) were determined. Significant differences between the 2 groups were not found with respect to serum concentrations of vitamin A, vitamin E, or beta-carotene. However, the herds with the low SCC (less than or equal to 150,000 cells/ml) had significantly higher mean (+/- SEM) blood GSH-Px activity (35.6 +/- 2.95 mU/mg of hemoglobin) than did the herds with the high SCC (20.2 +/- 2.38 mU/mg of Hb). Whole blood concentrations of Se also were significantly higher in the herds with low SCC (0.133 +/- 0.010 microgram/ml of blood) than in the herds with high SCC (0.074 +/- 0.007 microgram/ml of blood). Significant negative correlations were found between the prevalence of intramammary infection with major pathogens and mean herd activity of GSH-Px (r = -0.62) and mean herd concentrations of Se (r = -0.66). PMID- 3301770 TI - Purification and characterization of cloned isopenicillin N synthetase. AB - Isopenicillin N synthetase (IPS) cloned from Cephalosporium acremonium has been isolated from transformed Escherichia coli and purified to homogeneity. The resulting, abundant, recombinant protein, whilst undergoing slightly different N terminal processing to that observed for the fungally-derived protein, has identical kinetics for the conversion of LLD-aminoadipoyl-cysteinyl-valine to isopenicillin N. Recombinant IPS converts analogue substrates into unusual beta lactam antibiotics in exactly the same way as the fungal protein. PMID- 3301769 TI - Modification of the rat sperm flagellar plasma membrane during maturation in the epididymis. AB - Previously, we demonstrated that surface radiolabeling of rat epididymal spermatozoa by lactoperoxidase-catalyzed iodination reveals a major component with an apparent molecular weight of 26,000 to 28,000 daltons (26 kDa) on spermatozoa from the cauda but not the caput epididymidis. To characterize this surface component further, sperm surface constituents radiolabeled by lactoperoxidase-catalyzed iodination were separated by 2-D PAGE. The 26 kDa component was localized by autoradiography and appeared as the major labeled acidic spot on cauda spermatozoa, but neither a radiolabeled spot nor a corresponding stained spot was present on caput spermatozoa. The 26 kDa spot was excised from 2-D gels of plasma membranes from cauda spermatozoa and utilized for immunization. The monospecific antiserum stained a single band of 26 kDa on Western blots of SDS-PAGE-separated plasma membranes from cauda spermatozoa and in a 100,000 X g supernatant fluid of the luminal contents of the cauda epididymidis. Immunohistochemical staining of cauda spermatozoa revealed antigen exclusively on the flagellar domain; the antigen was not seen on caput spermatozoa but first appeared in spermatozoa from the proximal corpus epididymidis. Immunoelectron microscopy confirmed the 26 kDa component was localized to the external face of the flagellar plasma membrane. Immunohistochemical staining of caput spermatozoa incubated in vitro with cauda epididymal luminal fluid revealed the 26 kDa component specifically bound the flagellar domain of immature spermatozoa. PMID- 3301771 TI - Biological activity of nitroguaiacol ether derivatives of streptomycin. AB - The correlation between the "in vivo" and "in vitro" inhibitory properties of six nitroguaiacol ether derivatives of streptomycin is studied. The differential activity of the derivatives is more closely related to differences in efficiency in the transport of the drugs than to their capacity to inhibit poly(U) directed polyphenylalanine synthesis. The results obtained are discussed in relation to the characteristics of the different derivatives. PMID- 3301772 TI - CV-1, a new antibiotic produced by a strain of Streptomyces sp. I. Fermentation, isolation and biological properties of the antibiotic. AB - A new antibiotic, CV-1, was isolated from the culture broth of a Streptomyces sp. by various chromatographies. CV-1 showed antibacterial activity against Escherichia coli in cooperation with spiramycin, a macrolide antibiotic. The mode of action of CV-1 seemed to be the inhibition of lipopolysaccharide synthesis. PMID- 3301773 TI - Studies on the biosynthesis of the alpha-glucosidase inhibitor acarbose: valienamine, a m-C7N unit not derived from the shikimate pathway. AB - Feeding experiments with Actinoplanes sp. SN223/29 showed that 3-amino-5-hydroxy [7-13C]benzoic acid is not incorporated into acarbose (I). The valienamine moiety of I is thus not derived in the same way, from the shikimate pathway, as the m C7N units in the ansamycin, mitomycin and ansamitocin antibiotics. Feeding experiments with [U-13C3]-glycerol followed by analysis of I by multiple quantum NMR spectroscopy support this conclusion and point to formation of the valienamine moiety by cyclization of a heptulose phosphate which arises from a triose phosphate via successive transfer of two 2-carbon fragments by transketolase, as proposed by Pape and co-workers. PMID- 3301774 TI - The mechanism of action of piperacillin-analogues in vitro; effect of the carbon number at the N-4 position of 2,3-dioxopiperazine on the outer membrane permeability, stability to beta-lactamase and binding affinity to penicillin binding proteins. AB - The relationship between the chemical structure and the mode of action of piperacillin-analogues (PIPC-analogues) against Escherichia coli and Klebsiella pneumoniae were investigated. The antibacterial activity of PIPC-analogues increased with an increase in the number of carbon atoms at the N-4 position of 2,3-dioxopiperazine. Their mode of action is discussed on the basis of the results of studies on outer membrane permeability, stability to beta-lactamase and binding affinity to penicillin-binding proteins (PBPs). The outer membrane permeability and stability to beta-lactamase were hardly affected by the chain length of the alkyl group at the N-4 position. On the other hand, the affinity to PBPs, especially to PBP 3, became stronger with increase of the number of carbon atoms at N-4 position. These results suggest that increased affinity to PBPs is the main reason for the increased antibacterial activity of the PIPC-analogues reported here. PMID- 3301775 TI - Factors affecting the onset of inner ear function. AB - The developing inner ear receptors have a very significant influence on the onset of stato-acoustic function and on its evolution. The factors which prevent the stato-acoustic system from functioning are called 'the limiting factors'. At present, it is possible to postulate that these factors are restricted to the inner ear cells and related structures. At least four places are particularly relevant for the onset of function: (1) connections of the apical part of hair cell with the tectorial membrane; (2) the internal structure of hair cell; (3) connections between the base of the hair cell and nerve fibers; (4) the ganglion cell with its processes. Special emphasis is devoted to the apical part of the inner hair cell and its connections to the tectorial membrane which are considered as very important for the onset of the cochlear function. For the labyrinth, it is technically difficult to determine precisely the onset of function because of its early prenatal onset. Nevertheless, it is postulated that the limiting factors for the onset of function are also related to certain components of hair cells. PMID- 3301777 TI - The crossbred sire: experimental results for swine. AB - Experiments aimed at comparing crossbred and purebred boars were reviewed. These experiments showed that crossbred boars matured sexually more quickly than corresponding purebred boars: they exhibited greater testis weight, large ejaculate volume and had better semen quality. Young crossbred boars were more aggressive sexually and achieved a higher conception rate, particularly on first service. Differences between the two types of boars for litter size and weight were generally small and variable in direction. Growth rate, feed efficiency and carcass characteristics of progeny of purebred and crossbred boars were generally similar. In addition, there was little evidence that use of crossbred sires had any effect on variability of pig performance. PMID- 3301776 TI - The crossbred sire: experimental results for sheep. AB - Crossbreeding of sheep is practiced to exploit simultaneously the use of additive and nonadditive genetic effects. The goal is to achieve optimal levels of performance appropriate for defined systems of sheep production and marketing. Although the beneficial effects of individual and maternal heterosis on sheep production have been well documented and widely implemented, considerably less is known about the effects of paternal heterosis. Limited evidence suggests that crossbred rams are more sexually aggressive and exhibit greater testicular growth than do purebred rams. Average estimates of paternal heterosis effects were 1.4, .7 and 2.3% for seasonal fertility, prolificacy and preweaning survival, respectively. The average effect of paternal heterosis on fertility during spring breeding was 29.5%. Progeny of crossbred and purebred sires were similar in birth weight, weaning weight and postweaning growth rate and in phenotypic variation for these growth traits. However, favorable paternal heterosis effects need not exist to warrant the use of crossbred sires. Composite or F1 sires can be used as an effective method to manage the composition of additive breed effects. For example, varying proportions of germ plasm from highly prolific breeds such as the Finnsheep and Romanov can be realized through the use of crossbred sires to set reproductive rates at desired levels. Crossbred sires may be used to a greater extent to optimize additive breed effects than to exploit effects of paternal heterosis. The role of composite breeds in managing both additive and nonadditive effects is discussed. PMID- 3301778 TI - The crossbred sire: experimental results for cattle. AB - Results comparing crossbred bulls relative to straightbred bulls for various reproduction traits (such as puberty, sperm concentration, pregnancy rate and weaning rate) and progeny growth traits (birth and weaning weight) were summarized separately for Bos taurus X Bos taurus (Bt X Bt) and Bos indicus X Bos taurus (Bi X Bt) crosses. The Bt X Bt and Bi X Bt crossbred bulls were 1.8 and 5.0% younger, respectively, at puberty than straightbred bulls. Also, sperm concentration of Bt X Bt and Bi X Bt crossbred bulls was greater than straightbred bulls by 36.4 and 56.0%, respectively. Pregnancy rate and weaning rate of cows exposed to straightbred and crossbred bulls indicated advantage values of .2 and 4.0%, respectively, for Bt X Bt crossbred bulls. Corresponding advantage values for Bi X Bt crossbred bulls over straightbred bulls were 1.4 and 3.7%, respectively, for these two traits. Birth and weaning weights were similar for calves sired by straightbred and Bt X Bt crossbred bulls as well as for calves sired by straightbred and Bi X Bt crossbred bulls. PMID- 3301779 TI - Microbiological hazards of occupational needlestick and 'sharps' injuries. PMID- 3301780 TI - The effect of sucrose on the colonization of acrylic by Candida albicans in pure and mixed culture in an artificial mouth. AB - The roles of sucrose and microbial interactions in the colonization of acrylic by Candida albicans in an artificial mouth were investigated. The acrylic was colonized by pure cultures of the organism but a visible plaque was not produced whether or not sucrose was present. Salivary bacteria had no effect in the absence of sucrose but when sucrose was present the numbers of C. albicans were significantly increased. It is suggested that this phenomenon is related to the production of extracellular polysaccharides by salivary streptococci in the presence of sucrose. In mixed culture of C. albicans and Streptococcus salivarius CJ2, growth of the latter was inhibited in the presence of sucrose. This inhibition was due to factors other than pH, although no such antagonism could be demonstrated on solid media. PMID- 3301781 TI - Antimicrobial therapy of non-typhi salmonella and Shigella infection. PMID- 3301782 TI - Biliary elimination of ceftazidime. AB - When five normal subjects were given ceftazidime 2 g iv, antibiotic concentrations in aspirated duodenal fluid increased progressively during 4 h to a value of 21.2 +/- 9.2 mg/l (mean +/- S.E.M.); 0.05% of the dose given was recovered in duodenal fluid. The same dose was given to 12 patients with an external biliary drain. The mean peak ceftazidime concentration of 36.3 +/- 4.0 mg/l was reached in the collected bile during the second hour after administration. The 12-h biliary recovery was 0.21% of the dose. The respective ceftazidime concentrations in choledochal and gallbladder bile sampled peroperatively in ten patients 1 h after ceftazidime 2 g iv were 78.3 +/- 12.0 and 17.9 +/- 7.5 mg/l. These data compare favourably with the results achieved with other beta-lactam compounds. PMID- 3301783 TI - Treatment of bacillary dysentery: a comparison between enoxacin and nalidixic acid. AB - A prospective randomized study has been conducted in Rwanda to compare the efficacy of enoxacin versus nalidixic acid for the treatment of bacillary dysentery in adults. Seventeen patients received nalidixic acid and 21 received enoxacin. All isolates (37 shigella, 1 campylobacter) were sensitive in vitro to the two drugs. All patients showed a favourable clinical and bacteriological response and the results obtained with both drugs were comparable. Enoxacin seems to be a good alternative to nalidixic acid for bacillary dysentery due to multiresistant shigella. PMID- 3301784 TI - Resistance to beta-lactams in gram-negative bacteria: relative contributions of beta-lactamase and permeability limitations. PMID- 3301785 TI - Colistin inhalation therapy in cystic fibrosis patients with chronic Pseudomonas aeruginosa lung infection. AB - Forty patients with cystic fibrosis and chronic broncho-pulmonary Pseudomonas aeruginosa infection entered a prospective double-blind placebo-controlled study of colistin inhalation. Active treatment consisted of inhalation of colistin one million units twice daily for three months and was compared to placebo inhalations of isotonic saline. Significantly more patients in the colistin inhalation group completed the study as compared to the placebo group (18 versus 11). Colistin treatment was superior to placebo treatment in terms of a significantly better clinical symptom score, maintenance of pulmonary function and inflammatory parameters. We recommend colistin inhalation therapy for cystic fibrosis patients with chronic P. aeruginosa lung infection as a supplementary treatment to frequent courses of intravenous anti-pseudomonas chemotherapy. PMID- 3301786 TI - Does indomethacin affect shunt and its response to PEEP in oleic acid pulmonary edema? AB - We assessed hemodynamics, lobar perfusion, and shunts at base line 1.5 h after unilobar oleic acid edema, 15 min after indomethacin (10 mg/kg iv), and 15 min after positive end-expiratory pressure (PEEP) (10 cm) in 10 dogs. In 10 additional dogs (control) the same measurements were made but no indomethacin was administered. Shunts of the edematous lobe were: 10.6 +/- 6.3, 54.1 +/- 22.8, 30.8 +/- 16.6, and 12.4 +/- 6.3% for dogs administered indomethacin and 10.9 +/- 4.2, 53.8 +/- 13.1, 72.3 +/- 14.6, and 11.5 +/- 4.1% for the controls. Perfusions (% cardiac output) to the edematous lobe were 27.6 +/- 3.6, 14.6 +/- 2.0, 9.9 +/- 1.5, and 27.9 +/- 2.9% in the dogs administered indomethacin and 27.3 +/- 3.1, 14.0 +/- 1.7, 13.2 +/- 1.3, and 26.9 +/- 2.8% in controls. The decrease in lobar perfusion was similar before indomethacin with a further decrease in lobar perfusion and an increase in lobar vascular resistance 15 min after indomethacin. The increase in vascular resistance of the edematous lobe was three times that of nonedematous lobes after indomethacin (149.6 +/- 76% vs. 58.0 +/- 43%). Indomethacin, therefore, decreases shunt possibly by enhancing alveolar hypoxic vasoconstriction and does not block the improvement in shunt with PEEP. PMID- 3301787 TI - Acute increases in anastomotic bronchial systemic to pulmonary blood flow due to generalized lung injury. AB - Since pulmonary blood flow to regions involved in adult respiratory disease syndrome (ARDS) is reduced by hypoxic vasoconstriction, compression by cuffs of edema, and local thromboses, we postulated that the bronchial circulation must enlarge to provide for the inflammatory response. We measured anastomotic bronchial systemic to pulmonary blood flow [QBr(s-p)] serially in a lung lobe in 31 open-chest dogs following a generalized lobar injury simulating ARDS. The pulmonary circulation of the weighed left lower lobe (LLL) was isolated and perfused (zone 2) with autologous blood in anesthetized dogs. QBr(s-p) was measured from the amount of blood which overflowed from this closed vascular circuit corrected by any changes in the lobe weight. The LLL was ventilated with 5% CO2 in air. The systemic blood pressure (volume infusion), gases, and acid base status (right lung ventilation) were kept constant. We injured the LLL via the airway by instilling either 0.1 N HCl or a mixture of glucose and glucose oxidase or via the pulmonary vessels by injecting either alpha-naphthylthiourea or oleic acid into the LLL pulmonary artery. In both types of injury, there was a prompt rise in QBr(s-p) (mean rise = 247% compared with control), which was sustained for the 2 h of observation. The cause of this increase in flow was studied. Control instillation of normal saline into the airways or into the pulmonary vessels did not change QBr(s-p) nor did a similar increase in lobar fluid (weight) due to hydrostatic edema. Neither cardiac output nor systemic blood pressure increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301788 TI - Neural control of contraction in isolated submucosal gland from feline trachea. AB - To determine the autonomic innervation to myoepithelial cells of submucosal gland, we applied electrical field stimulation (FS) to the intrinsic nerves in isolated submucosal glands from feline tracheae. FS induced contraction that was voltage or frequency dependent and abolished by pretreatment with tetrodotoxin. DMPP (1,1-dimethyl-4-phenylpiperazinium iodide) did not produce any significant contraction, and pretreatment with hexamethonium did not alter the response to FS. Atropine inhibited the contractile response to FS and neostigmine augmented the response to FS. Serotonin also augmented the response to FS, whereas the response to methacholine remained unchanged in the presence of serotonin. Phentolamine reduced the response to FS by 15% of control, whereas propranolol induced no significant changes in the response to FS. No significant inhibitory responses were observed by FS. Our findings indicate that the contraction of tracheal submucosal glands is mediated mainly by cholinergic nerves via muscarinic receptors and in small part by adrenergic nerves via alpha-receptors, and serotonin potentiates the contractile response to FS at the postganglionic nerve. PMID- 3301789 TI - Effect of biosynthetic human epidermal growth factor on the synthesis and secretion of mucin glycoprotein from primary culture of rabbit fundal mucosa cells. AB - Biosynthetic human epidermal growth factor (Bh-EGF) induced dose-dependent synthesis and secretion of neutral mucin glycoprotein when the fundal cells isolated from rabbit stomach were cultured in serum-free medium containing Bh-EGF at concentrations as high as 10 to 100 ng/ml. At these high concentrations, Bh EGF had no effect on the cell growth. In marked contrast, much lower concentrations from 0.1 to 1.0 ng/ml of Bh-EGF failed to stimulate mucin synthesis, but enhanced proliferation of the cells. Electrophoretic pattern of the mucin secreted from the cultured mucosal cells was very similar to that of the authentic mucin obtained from rabbit stomach. Maximal secretion of the mucin from the cells was observed at Hour 96 of the culture. Although fetal bovine serum (5%) and insulin (0.5 microgram/ml) also stimulated the mucosal cells, both in growth and in mucin synthesis and release, the enhancing activity of the mucin synthesized and released by Bh-EGF at a concentration of 100 ng/ml per microgram DNA of cultured cells was far superior to that of 5% fetal bovine serum and 0.5 microgram/ml insulin. PMID- 3301790 TI - Optimized medium for clonal growth of human microvascular endothelial cells with minimal serum. AB - An optimized basal nutrient medium, MCDB 131, has been developed that supports clonal growth of human microvascular endothelial cells (HMVEC) with as little as 0.7% dialyzed fetal bovine serum (dFBS) when also supplemented with 10 ng/ml epidermal growth factor (EGF) and 1 microgram/ml hydrocortisone. An extensive initial survey of available media showed that MCDB 402, a medium optimized for low-serum growth of Swiss 3T3 cells, supported the best clonal growth of HMVEC with 10% dFBS. Quantitative adjustment of the composition of MCDB 402 for improved clonal growth of HMVEC with reduced amounts of dFBS resulted in development of MCDB 131. Although many different adjustments contributed to the optimal properties of MCDB 131 for growth of HMVEC, the most unusual feature of this medium is its high magnesium concentration. A major benefit was achieved by increasing Mg2+ from 0.8 mM in MCDB 402 to 10.0 mM in MCDB 131. In the absence of defined supplements, MCDB 131 supports good clonal growth of HMVEC with 2% dFBS. This can be reduced to 0.7% by adding EGF and hydrocortisone, which act synergistically to improve growth with low levels of dFBS. PMID- 3301794 TI - Malaria--any hopes? PMID- 3301791 TI - Growth of myoblasts in lipoprotein-supplemented, serum-free medium: regulation of proliferation by acidic and basic fibroblast growth factor. AB - BC3Hl myoblast cells seeded at low density on gelatin-coated dishes and exposed to a 1:1 (vol/vol) mixture of Dulbecco's modified Eagle's medium and Ham's F12 medium, proliferate actively when exposed to high density lipoproteins (HDL), transferrin, insulin, and basic or acidic fibroblast growth factor (FGF). This serum-free medium combination supported cell multiplication at a rate equal to that of serum-supplemented medium, and at low cell input (10(3) cells/35-mm dish). It also allowed serial transfer of the cultures under serum-free conditions. HDL seems to promote cell survival and to act as progression factor allowing cells to divide when exposed to either basic or acidic FGF. When the potency of basic and acidic FGF were compared, acidic FGF was 20-fold less potent than basic FGF. PMID- 3301792 TI - Enzyme immunoassay for detection of Salmonella in low-moisture foods: collaborative study. AB - A collaborative study was performed in 15 laboratories to evaluate a modification of the enzyme immunoassay (EIA) method for detection of Salmonella in foods (46.B21-46.B29). The modified EIA requires 18-24 h pre-enrichment, 6-8 h selective enrichment, and 14-18 h M-broth post-enrichment prior to performing the assay, which requires 1-2 h. Total assay time is 40-52 h. The modified method was compared with the standard culture method for detection of Salmonella in 5 low moisture foods: nonfat dry milk, milk chocolate, meat and bone meal, dry whole egg, and ground pepper. The modified method has been adopted official first action for use with low-moisture foods. PMID- 3301796 TI - Exercise provocation test for clinical malaria. PMID- 3301793 TI - Limitations of the A-1M method for fecal coliform enumeration in the Pacific oyster (Crassostrea gigas). AB - Use of the A-1M method, which was originally devised for testing water samples, has recently been extended for enumeration of fecal coliforms and Escherichia coli in shellfish and other food products. Results of our study indicate that while this method is reliable for analysis of growing waters, the use of the A-1M method for testing Pacific oysters may be less reliable because bacteria not belonging to the coliform group but which are sometimes present in these animals also give a positive reaction. PMID- 3301795 TI - Clinical presentation of shigellosis during the 1984 epidemic of bacillary dysentery in West Bengal. PMID- 3301797 TI - Hormonal status and endocrine disturbances in newborn. PMID- 3301798 TI - Chronic falciparum cardiomyopathy. PMID- 3301799 TI - Initiation of DNA replication in Escherichia coli. PMID- 3301800 TI - Effects of various single-stranded-DNA-binding proteins on reactions promoted by RecA protein. AB - To relate the roles of Escherichia coli SSB in recombination in vivo and in vitro, we have studied the mutant proteins SSB-1 and SSB-113, the variant SSBc produced by chymotryptic cleavage, the partially homologous variant F SSB (encoded by the E. coli sex factor), and the protein encoded by gene 32 of bacteriophage T4. All of these, with the exception of SSB-1, augmented both the initial rate of homologous pairing and strand exchange promoted by RecA protein. From these and related observations, we conclude that SSB stimulates the initial formation of joint molecules by nonspecifically promoting the binding of RecA protein to single-stranded DNA; that SSB plays no role in synapsis of the RecA nucleoprotein filament with duplex DNA; that stimulation of strand exchange by SSB is similarly nonspecific; and that all members of the class of proteins represented by SSB, F SSB, and gene 32 protein may play equivalent roles in making single-stranded DNA more accessible to RecA protein. PMID- 3301801 TI - Partial purification and some properties of homoserine O-acetyltransferase of a methionine auxotroph of Saccharomyces cerevisiae. AB - A wild-type strain and six methionine auxotrophs of Saccharomyces cerevisiae were cultured in a synthetic medium supplemented with 0.1 mM L-cysteine or L methionine and analyzed for the synthesis of homoserine O-acetyltransferase (EC 2.3.1.31). Among them, four mutant strains exhibited enzyme activity in cell extracts. Methionine added to the synthetic medium at concentrations higher than 0.1 mM repressed enzyme synthesis in two of these strains. The enzyme was partially purified (3,500-fold) from an extract of a mutant strain through ammonium sulfate fractionation and chromatography on columns of DEAE-cellulose, Phenyl-Sepharose C1-4B, and Sephadex G-150. The enzyme exhibited optimal pH at 7.5 for activity and at 7.8 for stability. The reaction product was ascertained to be O-acetyl-L-homoserine by confirming that it produced L-homocysteine in an O acetyl-L-homoserine sulfhydrylase reaction. The Km for L-homoserine was 1.0 mM, and for acetyl coenzyme A it was 0.027 mM. The molecular weight of the enzyme was estimated to be approximately 104,000 by Sephadex G-150 column chromatography and 101,000 by sucrose density gradient centrifugation. The isoelectric point was at pH 4.0. Of the hydroxy amino acids examined, the enzyme showed reactivity only to L-homoserine. Succinyl coenzyme A was not an acyl donor. In the absence of L homoserine, acetyl coenzyme A was deacylated by the enzyme, with a Km of 0.012 mM. S-Adenosylmethionine and S-adenosylhomocysteine slightly inhibited the enzyme, but methionine had no effect. PMID- 3301802 TI - Coordinate initiation of chromosome and minichromosome replication in Escherichia coli. AB - Escherichia coli minichromosomes harboring as little as 327 base pairs of DNA from the chromosomal origin of replication (oriC) were found to replicate in a discrete burst during the division cycle of cells growing with generation times between 25 and 60 min at 37 degrees C. The mean cell age at minichromosome replication coincided with the mean age at initiation of chromosome replication at all growth rates, and furthermore, the age distributions of the two events were indistinguishable. It is concluded that initiation of replication from oriC is controlled in the same manner on minichromosomes and chromosomes over the entire range of growth rates and that the timing mechanism acts within the minimal oriC nucleotide sequence required for replication. PMID- 3301803 TI - Mutational alterations of translational coupling in the L11 ribosomal protein operon of Escherichia coli. AB - The L11 operon in Escherichia coli consists of the genes coding for ribosomal proteins L11 and L1. It is known that translation of L1 does not take place unless the preceding L11 cistron is translated, that is, the two cistrons are translationally coupled, and this is the basis of coregulation of the translation of the two cistrons by a single repressor, L1. Several mutational analyses were carried out to define the region responsible for coupling L1 translation with L11 translation. First, by introducing several amber mutations into the L11 gene by a site-directed mutagenesis technique, it was shown that translation by ribosomes down to a position 21 nucleotides upstream, but not to a position 45 nucleotides upstream, from the end of the L11 cistron allowed the initiation of L11 translation. Second, deletion analysis indicated that a region located 23 to 20 nucleotides from the end of the L11 gene was involved in preventing independent initiation from L1 translation. Third, five different mutations obtained by screening for activation of the masked L1 initiation site were found to be clustered in a small region immediately upstream from the Shine-Dalgarno sequence of L1, and all of them were G-to-A transitions. These results, together with some additional experiments with oligonucleotide-directed mutagenesis, defined the region involved in the coupling and suggest that some special feature of this region, probably different from simple masking of the initiation site by base pairing, is responsible for translational coupling. The present results also suggest that there might be specific differences in the primary nucleotide sequence that distinguish independent translational initiation sites from translationally coupled (i.e., masked) initiation sites. PMID- 3301804 TI - Transcriptional regulation of the DAL5 gene in Saccharomyces cerevisiae. AB - We demonstrate that the DAL5 gene, encoding a necessary component of the allantoate transport system, is constitutively expressed in Saccharomyces cerevisiae. Its relatively high basal level of expression did not increase further upon addition of allantoin pathway intermediates. However, steady-state DAL5 mRNA levels dropped precipitously when a repressive nitrogen source was provided. These control characteristics of DAL5 expression make this gene a good model with which to unravel the mechanism of nitrogen catabolite repression. Its particular advantage relative to other potentially useful genes derives from its lack of control by induction and hence the complicating effects of inducer exclusion. PMID- 3301805 TI - Nucleotide sequence of the uhp region of Escherichia coli. AB - The Escherichia coli uhp region encodes the transport system that mediates the uptake of a number of sugar phosphates as well as the regulatory components that are responsible for induction of this transport system by external glucose 6 phosphate. Four uhp genes have been identified by analysis of the complementation behavior and polypeptide coding capacity of plasmids carrying subcloned regions or transposon insertions. The nucleotide sequence of a 6.5-kilobase segment that contains the 3' end of the ilvBN operon and the entire uhp region was determined. Four open reading frames were identified in the locations expected for the various uhp genes; all were oriented in the same direction, counterclockwise relative to the genetic map. The properties of the polypeptides predicted from the nucleotide sequence were consistent with their observed features. The 196 amino-acid UhpA polypeptide has the composition characteristic of a soluble protein and bears homology to the DNA-binding regions of many regulatory activators and repressors. The 518-amino-acid UhpB and the 199-amino-acid UhpC regulatory proteins contain substantial segments of hydrophobic character. Similarly, the 463-amino-acid UhpT transporter is a hydrophobic protein with numerous potential transmembrane segments. The UhpC regulatory protein has substantial sequence homology to part of UhpT, suggesting that this regulatory protein might have evolved by duplication of the gene for the transporter and that its role in transmembrane signaling may involve sugar-phosphate-binding sites and transmembrane orientations similar to those of the transport protein. PMID- 3301806 TI - Activation of the xylDLEGF promoter of the TOL toluene-xylene degradation pathway by overproduction of the xylS regulatory gene product. AB - The xylS regulatory gene of the Pseudomonas putida TOL plasmid (pWWO) has been cloned under the transcriptional control of the Escherichia coli tac promoter in a broad-host-range controlled-expression vector. Induction with isopropylthiogalactoside allowed overproduction and characterization of the xylS product by specific interaction with the TOL meta-cleavage pathway operator promoter region (OP2) in vivo in E. coli. Examination of plasmid-specified polypeptides in E. coli maxicells led to identification of the xylS product as a 36-kilodalton polypeptide. The operator sequences required for xylS interactions lay upstream of the OP2 transcriptional start, and the xylS gene product recognized this region even in the absence of known coinducers. PMID- 3301807 TI - Identification of flagellar hook and basal body gene products (FlaFV, FlaFVI, FlaFVII and FlaFVIII) in Salmonella typhimurium. AB - The flagellar genes flaFV, flaFVII, and flaFVIII of Salmonella typhimurium were cloned, and their presence on a given plasmid was verified by complementation of Escherichia coli mutants defective in the homologous genes. The gene products were identified by radiolabeling in a minicell system as being proteins of the following molecular masses: FlaFV, 42 kilodaltons (kDa); FlaFVI, 32 kDa; FlaFVII, 30 kDA; and FlaFVIII, 27 kDa. These data, together with isoelectric focusing data, confirm gene product assignments of flagellar components made indirectly from mutant studies. Flagellar components are transported by either a signal peptide-dependent or a flagellar-specific pathway. Consistent with its location in the outer membrane ring of the basal body, protein FlaFVIII seems to use the signal peptide-dependent pathway, since it was synthesized in a precursor form and processed, presumably by peptide cleavage, to a mature form; the maturation process was inhibited by addition of a proton ionophore. Proteins synthesized in minicells were localized as follows: FlaFVI was localized to the soluble fraction (cytoplasm); pre-FlaFVIII and FlaFVIII were localized to the particulate fraction (membrane or high-molecular-weight aggregate); FlaFV and FlaFVII were localized to both fractions. The significance of these locations in terms of known or suspected roles in the flagellar apparatus is discussed. PMID- 3301808 TI - Expression of the cloned coliphage T3 S-adenosylmethionine hydrolase gene inhibits DNA methylation and polyamine biosynthesis in Escherichia coli. AB - We have developed a new research tool for the study of S-adenosylmethionine (AdoMet) metabolism by cloning the coliphage T3 AdoMet hydrolase (AdoMetase; EC 3.3.1.2) gene into the M13mp8 expression vector. The recombinant bacteriophage clones expressed an AdoMetase activity in Escherichia coli like that found in T3 infected cells. High levels of AdoMetase expression impaired AdoMet-mediated activities such as dam and dcm methylase-directed DNA modifications and the synthesis of spermidine from putrescine. Expression vectors containing the cloned AdoMetase gene thus provide an alternate approach to the use of chemical inhibitors or mutants defective in AdoMet biosynthesis to probe the effect of AdoMet limitation. PMID- 3301809 TI - DNA replication initiation, doubling of rate of phospholipid synthesis, and cell division in Escherichia coli. AB - In synchronized culture of Escherichia coli, the specific arrest of phospholipid synthesis (brought about by glycerol starvation in an appropriate mutant) did not affect the rate of ongoing DNA synthesis but prevented the initiation of new rounds. The initiation block did not depend on cell age at the time of glycerol removal, which could be before, during, or after the doubling in the rate of phospholipid synthesis (DROPS) and as little as 10 min before the expected initiation. We conclude that the initiation of DNA replication is not triggered by the preceding DROPS but requires active phospholipid synthesis. Conversely, when DNA replication initiation was specifically blocked in a synchronized culture of a dnaC(Ts) mutant, two additional DROPS were observed, after which phospholipid synthesis continued at a constant rate for at least 60 min. Similarly, when DNA elongation was blocked by thymine starvation of a synchronized culture, one additional DROPS was observed, followed by linear phospholipid accumulation. Control experiments showed that specific inhibition of cell division by ampicillin, heat shock, or induction of the SOS response did not affect phospholipid synthesis, suggesting that the arrest of DROPS observed was due to the DNA replication block. The data are compatible with models in which the DROPS is triggered by an event associated with replication termination or chromosome segregation. PMID- 3301810 TI - Regulation of ergosterol biosynthesis and sterol uptake in a sterol-auxotrophic yeast. AB - Inhibition of sterol uptake in Saccharomyces cerevisiae sterol auxotroph FY3 (alpha hem1 erg7 ura) by delta-aminolevulinic acid (ALA) is dependent on the ability of the organism to synthesize heme from ALA. Sterol-depleted cells not exposed to ALA or strain PFY3 cells, with a double heme mutation, exposed to ALA did not exhibit inhibition of sterol uptake. Addition of ALA to sterol-depleted FY3 stimulated production of a high endogenous concentration of 2,3-oxidosqualene (25.55 micrograms mg-1 [dry weight]) at 24 h, whereas FY3 not exposed to ALA or PFY3 exposed to ALA did not accumulate 2,3-oxidosqualene. The high concentration of 2,3-oxidosqualene in FY3 with ALA decreased, and 2,3;22,23-dioxidosqualene increased to a very high level. The elevation of 2,3-oxidosqualene by ALA was correlated with a fivefold increase in the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase (EC 1.1.1.34). The enhanced activity of 3-hydroxy-3 methylglutaryl-coenzyme A reductase was prevented by cycloheximide but not chloramphenicol and was dependent on a fermentative energy source. Inhibition of sterol uptake could not be attributed to 2,3-oxidosqualene or 2,3;22,23 dioxidosqualene but was due to a nonsaturating level of ergosterol produced as a consequence of heme competency through a leaky erg7 mutation. PMID- 3301811 TI - Cross-induction of the L-fucose system by L-rhamnose in Escherichia coli. AB - Dissimilation of L-fucose as a carbon and energy source by Escherichia coli involves a permease, an isomerase, a kinase, and an aldolase encoded by the fuc regulon at minute 60.2. Utilization of L-rhamnose involves a similar set of proteins encoded by the rha operon at minute 87.7. Both pathways lead to the formation of L-lactaldehyde and dihydroxyacetone phosphate. A common NAD-linked oxidoreductase encoded by fucO serves to reduce L-lactaldehyde to L-1,2 propanediol under anaerobic growth conditions, irrespective of whether the aldehyde is derived from fucose or rhamnose. In this study it was shown that anaerobic growth on rhamnose induces expression of not only the fucO gene but also the entire fuc regulon. Rhamnose is unable to induce the fuc genes in mutants defective in rhaA (encoding L-rhamnose isomerase), rhaB (encoding L rhamnulose kinase), rhaD (encoding L-rhamnulose 1-phosphate aldolase), rhaR (encoding the positive regulator for the rha structural genes), or fucR (encoding the positive for the fuc regulon). Thus, cross-induction of the L-fucose enzymes by rhamnose requires formation of L-lactaldehyde; either the aldehyde itself or the L-fuculose 1-phosphate (known to be an effector) formed from it then interacts with the fucR-encoded protein to induce the fuc regulon. PMID- 3301812 TI - Molybdenum effector of fumarate reductase repression and nitrate reductase induction in Escherichia coli. AB - In Escherichia coli the presence of nitrate prevents the utilization of fumarate as an anaerobic electron acceptor. The induction of the narC operon encoding the nitrate reductase is coupled to the repression of the frd operon encoding the fumarate reductase. This coupling is mediated by nitrate as an effector and the narL product as the regulatory protein (S. Iuchi and E. C. C. Lin, Proc. Natl. Acad. Sci. USA 84:3901-3905, 1987). The protein-ligand complex appears to control narC positively but frd negatively. In the present study we found that a molybdenum coeffector acted synergistically with nitrate in the regulation of frd and narC. In chlD mutants believed to be impaired in molybdate transport (or processing), full repression of phi(frd-lac) and full induction of phi(narC-lac) by nitrate did not occur unless the growth medium was directly supplemented with molybdate (1 microM). This requirement was not clearly manifested in wild-type cells, apparently because it was met by the trace quantities of molybdate present as a contaminant in the mineral medium. In chlB mutants, which are known to accumulate the Mo cofactor because of its failure to be inserted as a prosthetic group into proteins such as nitrate reductase, nitrate repression of frd and induction of narC were also intensified by molybdate supplementation. In this case a deficiency of the molybdenum coeffector might have resulted from enhanced feedback inhibition of molybdate transport (or processing) by the elevated level of the unutilized Mo cofactor. In addition, mutations in chlE, which are known to block the synthesis of the organic moiety of the Mo cofactor, lowered the threshold concentration of nitrate (< 1 micromole) necessary for frd repression and narC induction. These changes could be explained simply by the higher intracellular nitrate attainable in cells lacking the ability to destroy the effector. PMID- 3301813 TI - Evidence for multiple K+ export systems in Escherichia coli. AB - The role of the K+ transport systems encoded by the kefB (formerly trkB) and kefC (formerly trkC) genes of Escherichia coli in K+ efflux has been investigated. The rate of efflux produced by N-ethylmaleimide (NEM), increased turgor pressure, alkalinization of the cytoplasm, or 2,4-dinitrophenol in a mutant with null mutations in both kef genes was compared with the rate of efflux in a wild-type strain for kef. The results show that these two genes encode the major paths for NEM-stimulated efflux. However, neither efflux system appears to be a significant path of K+ efflux produced by high turgor pressure, by alkalinization of the cytoplasm, or by addition of high concentrations of 2,4-dinitrophenol. Therefore, this species must have at least one other system, besides those encoded by kefB and kefC, capable of mediating a high rate of K+ efflux. The high, spontaneous rate of K+ efflux characteristic of the kefC121 mutation increases further when the strain is treated with NEM. Therefore, the mutational defect that leads to spontaneous efflux in this strain does not abolish the site(s) responsible for the action of NEM. PMID- 3301814 TI - Physiological implications of the specificity of acetohydroxy acid synthase isozymes of enteric bacteria. AB - The rates of formation of the two alternative products of acetohydroxy acid synthase (AHAS) have been determined by a new analytical method (N. Gollop, Z. Barak, and D. M. Chipman, Anal. Biochem., 160:323-331, 1987). For each of the three distinct isozymes of AHAS in Escherichia coli and Salmonella typhimurium, a specificity ratio, R, was defined: Formula: see text, which is constant over a wide range of substrate concentrations. This is consistent with competition between pyruvate and 2-ketobutyrate for an active acetaldehyde intermediate formed irreversibly after addition of the first pyruvate moiety to the enzyme. Isozyme I showed no product preference (R = 1), whereas isozymes II and III form acetohydroxybutyrate (AHB) at approximately 180- and 60-fold faster rates, respectively, than acetolactate (AL) at equal pyruvate and 2-ketobutyrate concentrations. R values higher than 60 represent remarkably high specificity in favor of the substrate with one extra methylene group. In exponentially growing E. coli cells (under aerobic growth on glucose), which contain about 300 microM pyruvate and only 3 microM 2-ketobutyrate, AHAS I would produce almost entirely AL and only 1 to 2% AHB. However, isozymes II and III would synthesize AHB (on the pathway to Ile) and AL (on the pathway to valine-leucine) in essentially the ratio required for protein synthesis. The specificity ratio R of any AHAS isozyme was affected neither by the natural feedback inhibitors (Val, Ile) nor by the pH. On the basis of the specificities of the isozymes, the known regulation of AHAS I expression by the catabolite repression system, and the reported behavior of bacterial mutants containing single AHAS isozymes, we suggest that AHAS I enables a bacterium to cope with poor carbon sources, which lead to low endogenous pyruvate concentrations. Although AHAS II and III are well suited to producing the branched-chain amino acid precursors during growth on glucose, they would fail to provide appropriate quantities of AL when the concentration of pyruvate is relatively low. PMID- 3301815 TI - Identification and partial characterization of a novel bipartite protein antigen associated with the outer membrane of Escherichia coli. AB - A study by crossed immunoelectrophoresis performed in conjunction with precipitate excision and polypeptide analysis identified a new antigen complex in the envelope of Escherichia coli ML308-225. This antigen corresponds to antigen 43 in the crossed immunoelectrophoresis profile of membrane vesicles (P. Owen and H. R. Kaback, Proc. Natl. Acad. Sci. USA 75:3148-3152, 1978). Immunoprecipitation experiments conducted with specific antiserum revealed that the complex was expressed on the cell surface and that it contained, in equal stoichiometry, two chemically distinct polypeptides termed alpha and beta (Mrs of 60,000 and 53,000, respectively). The beta polypeptide was heat modifiable, displaying an apparent Mr of 37,000 when solubilized at temperatures below 70 degrees C. Analysis of fractions obtained following cell disruption, isopycnic centrifugation, and detergent extraction indicated that both alpha and beta polypeptides were components of the outer membrane. The two polypeptides were not linked by disulfide bonds, and neither was peptidoglycan associated. The complex contained no detectable lipopolysaccharide, enzyme activity, fatty acyl groups, or other cofactors. Neither correlated with E. coli proteins of similar molecular weight which had previously been shown to be associated with the outer membrane. Antibodies were raised to individual alpha and beta polypeptides. Each of these sera was shown to be subunit specific when tested against denatured membrane proteins. In contrast, each immunoglobulin preparation coprecipitated both alpha and beta polypeptides when tested against undenatured proteins derived from Triton X-100-treated membranes. The results reveal the presence of a novel bipartite protein antigen in the outer membrane of E. coli. PMID- 3301816 TI - Translocation of Vibrio harveyi N,N'-diacetylchitobiase to the outer membrane of Escherichia coli. AB - The gene encoding N,N'-diacetylchitobiase (chitobiase) of the chitinolytic marine bacterium Vibrio harveyi has been isolated. While expression of the chitobiase gene (chb) was inducible by N,N'-diacetylchitobiose in V. harveyi, it was expressed constitutively when cloned in Escherichia coli, suggesting that controlling elements are not closely linked to chb. Chitobiase was found in the membrane fraction of E. coli cells containing plasmids with the cloned V. harveyi chb gene. When membranes of such cells were separated on Osborn gradients, chitobiase activity was found mainly in the outer membrane band. Translocation of the enzyme to the outer membrane was accompanied by cleavage of a signal peptide. A fusion protein, in which 22 amino acids from the amino terminus of prechitobiase were replaced with 21 amino acids from the pUC19 lacZ amino terminus, was not processed, and 99% of the activity was located in the cytoplasmic fraction. A homology to six amino acids surrounding the lipoprotein processing and modification site was found near the amino terminus of prechitobiase. PMID- 3301817 TI - Specialized cell surface structures in cellulolytic bacteria. AB - The cell surface topology of various gram-negative and -positive, anaerobic and aerobic, mesophilic and thermophilic, cellulolytic and noncellulolytic bacteria was investigated by scanning electron microscopic visualization using cationized ferritin. Characteristic protuberant structures were observed on cells of all cellulolytic strains. These structures appeared to be directly related to the previously described exocellular cellulase-containing polycellulosomes of Clostridium thermocellum YS (E. A. Bayer and R. Lamed, J. Bacteriol. 167:828-836, 1986). Immunochemical evidence and lectin-binding studies suggested a further correlation on the molecular level among cellulolytic bacteria. The results indicate that such cell surface cellulase-containing structures may be of general consequence to the bacterial interaction with and degradation of cellulose. PMID- 3301819 TI - Locations of the hydrogenases of Methanobacterium formicicum after subcellular fractionation of cell extract. AB - The F420 hydrogenase of Methanobacterium formicicum was associated with membranes isolated by sucrose density gradient ultracentrifugation of cell extract. The methyl viologen hydrogenase was present in the soluble fractions. Column chromatography with phenyl-Sepharose CL-4B revealed that the F420 hydrogenase was strongly hydrophobic, suggesting that it associates with isolated membranes through hydrophobic interactions. PMID- 3301818 TI - Inhibition of purified Escherichia coli leader peptidase by the leader (signal) peptide of bacteriophage M13 procoat. AB - The leader peptide of bacteriophage M13 procoat inhibited the cleavage of M13 procoat or pre-maltose-binding protein by purified Escherichia coli leader peptidase. This finding confirms inferences that the leader is the primary site of enzyme recognition and suggests a rationale for the rapid hydrolysis of leader peptides in vivo. PMID- 3301820 TI - Chlamydial hemagglutinin identified as lipopolysaccharide. AB - Chlamydial lipopolysaccharide (LPS) agglutinated mouse and rabbit erythrocytes but not human, guinea pig, or pronghorn antelope erythrocytes. Hemagglutination was not specific for Chlamydia spp., as rough LPSs from Coxiella burnetii and Escherichia coli also agglutinated erythrocytes from the same animal species. Nonagglutinated and agglutinated erythrocytes bound equivalent amounts of LPS, indicating that hemagglutination was not due to a specific interaction of chlamydial LPS with erythrocytes. Thus, hemagglutination by chlamydial LPS is not mediated by specific receptor-ligand interactions but is a property of the altered surface of the LPS-coated erythrocytes. PMID- 3301821 TI - fhuC and fhuD genes for iron (III)-ferrichrome transport into Escherichia coli K 12. AB - The nucleotide sequence for a 1,900-base-pair region of the Escherichia coli chromosome that includes the genes fhuC and fhuD was determined. Within this sequence are two open reading frames: nucleotides 127 to 921 and nucleotides 924 to 1811. These coding regions specify a FhuC protein with an Mr of 28,423 and a mature FhuD protein with an Mr of 29,610. The deduced amino acid sequence of FhuC shows extensive homology with those of components of some bacterial transport systems which are peripheral proteins of the cytoplasmic membrane. Because the FhuD protein contains a typical signal sequence of 30 amino acids at the amino terminus and displays characteristics of a soluble protein, it may be exported into the periplasm. PMID- 3301822 TI - Uptake of cell wall peptides by Salmonella typhimurium and Escherichia coli. AB - During bacterial growth, cell wall peptides are released from the murein and reused for the synthesis of new cell wall material. Mutants defective in peptide transport were unable to reutilize cell wall peptides, demonstrating that these peptides are taken up intact into the cytoplasm prior to reincorporation into murein. Furthermore, cell wall peptide recycling was shown to play an important physiological role; peptide transport mutants which were unable to recycle these peptides showed growth defects under appropriate conditions. Using mutants specifically defective in each of the three peptide transport systems, we showed that the uptake of cell wall peptides was mediated solely by the oligopeptide permease (Opp) and that neither the dipeptide permease (Dpp) nor the tripeptide permease (Tpp) played a significant role in this process. Our data indicate that the periplasmic oligopeptide-binding protein has more than one substrate-binding site, each with different though overlapping specificities. PMID- 3301823 TI - Medical evaluation of panic attacks. AB - Panic disorder with or without agoraphobia is dominated by the occurrence of panic attacks. However, panic attacks are also reported to occur as part of the clinical picture in several medical conditions, notably thyroid disease, hypoglycemia, and pheochromocytoma. The authors examine these conditions, review the relevant literature, and offer an evaluation strategy. Routine screening is not recommended. Panic disorder is also associated with mitral-valve prolapse and temporal lobe seizures. The authors explore the possible consequences of this association and outline an evaluation strategy. Again, routine screening is not recommended. PMID- 3301824 TI - Current overview of the borderline diagnosis. AB - The authors review the literature on the diagnosis of borderline personality disorder and describe the core dynamic features that account for its unstable phenomenology and explain in part the complexity of and the controversies associated with the diagnosis. A review of differential diagnosis suggests that the boundary with schizophrenia is well established, that the boundary with affective disorder is becoming clearer, and that the most subtle boundary distinctions lie with other forms of personality disorder. A growing body of evidence about antecedents to and longitudinal aspects of borderline personality disorder confirms its diagnostic validity. PMID- 3301825 TI - Primary structures of M6 and M7 of mugiline beta (Mugil japonicus). AB - Mugiline beta isolated from mature sperm nuclei of the Formosan grey mullet, belonging to Perciformes, was fractionated into seven components (M1-M7), by chromatography on CM-Sephadex C-25. The amino acid sequences of the two major components (M6 and M7) were then determined. M6 contained 33 amino acid residues per molecule: Arg, 21; Thr, 1; Ser, 1; Glu, 1; Pro, 3; Ala, 2; Val, 2; Met, 0.3 and Ile, 1.7. The amino acid sequence of M6 is: Pro-Arg-Arg-Arg-Arg-Glu-Thr-Ser Arg-Pro-Ile-Arg-Arg-Arg-Arg-Arg-Ala-Pro- Ile (Met)-Arg-Arg-Arg-Arg-Arg-Val-Val Arg-Arg-Arg-Arg. Isoleucine at position 22 is partially replaced by methionine. M7 had an amino acid sequence similar to that of M6 except that glutamic acid at position 6 of M6 was replaced by glutamine. A high degree of homology in the sequences was found between mugiline beta from mullet and thynnine from tuna fish, which also belongs to Perciformes. PMID- 3301826 TI - Characteristics of phospholipid transacylase of Escherichia coli. AB - We have previously demonstrated the activity(ies) of phospholipid transacylase in Escherichia coli extract (Homma & Nojima (1982) J. Biochem. 91, 1093-1101), which catalyzed a new type of reaction of acyl transfer from diacylphospholipids to lysophospholipids. In this communication we report the specificities and characteristics of this enzyme activity. The activity catalyzed a reversible transfer of an acyl group between diacylphospholipids and lysophospholipids. The acyl group in the 1-position of the glycerol backbone was selectively transferred, and palmitic acid was the only fatty acid species transferred. Presumably, neutral lipids do not serve as substrates. The transacylase was firmly associated with the envelope fraction of E. coli. Neither potassium chloride nor urea was effective in solubilization of the activity and only about half of the activity was solubilized with Triton X-100. This observation was consistent with the equal distribution of the activity between the outer membrane and the inner membrane of E. coli. Functional aspects of this phospholipid transacylase are also discussed. PMID- 3301827 TI - Public access computing in health science libraries. AB - Public access computing in health science libraries began with online computer assisted instruction. Library-based collections and services have expanded with advances in microcomputing hardware and software. This growth presents problems: copyright, quality, instability in the publishing industry, and uncertainty about collection scope; librarians managing the new services require new skills to support their collections. Many find the cooperative efforts of several organizational units are required. Current trends in technology for the purpose of information management indicate that these services will continue to be a significant focus for libraries. PMID- 3301828 TI - Structural properties of cyanase. Denaturation, renaturation, and role of sulfhydryls and oligomeric structure in catalytic activity. AB - Cyanase is an inducible enzyme in Escherichia coli that catalyzes bicarbonate dependent decomposition of cyanate to give ammonia and bicarbonate. The enzyme is composed of 8-10 identical subunits (Mr = 17,008). The objective of this study was to clarify some of the structural properties of cyanase for the purpose of understanding the relationship between oligomeric structure and catalytic activity. Circular dichroism studies showed that cyanase has a significant amount of alpha-helix and beta-sheet structure. The one sulfhydryl group per subunit does not react with 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB) unless cyanase is denatured. Denaturation is apparently complete in 10 M urea or 6 M guanidine hydrochloride, but is significantly reduced in 10 M urea by the presence of azide (analog of cyanate) and is incomplete in 8 M urea. Denatured cyanase could be renatured and reactivated (greater than 85%) by removal of denaturants. Reactivation was greatly facilitated by the presence of certain anions, particularly bicarbonate, and by high ionic strength and protein concentration. The catalytic activity of renatured cyanase was associated only with oligomer. Cyanase that had been denatured in the presence of DTNB to give a cyanase-DTNB derivative could also be renatured at 26 degrees C to give active cyanase-DTNB oligomer. The active oligomeric form of the cyanase-DTNB derivative could be converted reversibly to inactive dimer by lowering the temperature to 4 degrees C or by reduction of the ionic strength and removal of monoanions. These results provide evidence that free sulfhydryl groups are not required for catalytic activity and that catalytic activity may be dependent upon oligomeric structure. PMID- 3301829 TI - The isolation and characterization from rabbit reticulocytes of two forms of eukaryotic initiation factor 2 having different beta-polypeptides. AB - We have isolated from the high salt wash of rabbit reticulocyte ribosomes two forms of the polypeptide chain initiation factor 2 (eIF-2) which differ with respect to their beta-subunit, GDP content, and sensitivity to Mg2+ in ternary (eIF-2 X GTP X Met-tRNAf) and binary (eIF-2 X GDP) complex formation. The form of eIF-2 eluting first from a cation exchange (Mono S, Pharmacia) column has a beta subunit of lower molecular weight (eIF-2(beta L] and a more acidic pI value than the form eluting at a higher salt concentration (eIF-2(beta H]. These two forms of eIF-2 beta-polypeptides are also detected in reticulocyte lysates when the proteins are resolved by two-dimensional isoelectric focusing-dodecyl sulfate polyacrylamide gel electrophoresis followed by immunoblotting. The peptide mapping of the isolated beta-subunits after limited proteolysis by papain, pancreatic protease, alpha-chymotrypsin, or Staphylococcus aureus V8 protease further demonstrates that the two forms of beta-subunits are not the product of a non-specific proteolytic action that occurred during the purification procedure, but rather reflects the existence in vivo of both forms of eIF-2. The GDP content of eIF-2(beta L) and eIF-2(beta H) is approximately 0.85 and 0.22 mol of GDP/mol of eIF-2, respectively. The KD for GDP of eIF-2(beta L) was lower (2.2 X 10(-9) M) than that of eIF-2(beta H) (6.0 X 10(-8) M). In the presence of 1 mM Mg2+, the activities of eIF-2(beta L) and eIF-2(beta H) in forming a binary and a ternary complex are inhibited 90 and 25%, respectively. The extent of Mg2+ inhibition and its reversal by the guanine nucleotide exchange factor is directly proportional to the amount of GDP bound to eIF-2. No inhibition by Mg2+ is observed when eIF-2 bound GDP is removed by alkaline phosphatase. In the presence of the guanine nucleotide exchange factor, both forms of eIF-2 are equally active in ternary complex formation, and the complex formed is quantitatively transferred to 40 S ribosomal subunits. PMID- 3301830 TI - A functional interaction between the signal peptide and the translation apparatus is detected by the use of a single point mutation which blocks translocation across mammalian endoplasmic reticulum. AB - A functional interaction between the signal sequence and the translation apparatus which may serve as a first step in chain targeting to the membrane is described. To this end, we exploited the powerful technique of molecular cloning in a procaryotic system and the well characterized translocation system of mammalian endoplasmic reticulum. The signal peptide of subunit B of the heat labile enterotoxin of Escherichia coli (EltB) was fused to several proteins. Single base substitutions were introduced in the signal peptide and their effect on protein synthesis and translocation was studied. We sought a single amino acid substitution which may define certain steps in the coordinated regulation of chain synthesis and targeting to the membrane. The substitution of proline for leucine at residue -8 in the signal peptide abolished all known functions of the signal peptide. In contrast to wild type signal peptide, the mutant signal peptide did not lead to arrest of nascent chain synthesis by signal recognition particle or translocation of the precursor protein across the membrane of the endoplasmic reticulum. Furthermore, the mutant signal peptide was not cleaved by purified E. coli signal peptidase. Interestingly, the mutation resulted in about a 2-fold increase in the rate of synthesis of the precursor protein, suggesting a role for the signal peptide in regulating the synthesis of the nascent secretory chain as a means of ensuring early and efficient targeting of this chain to the membrane. This role might involve interaction of the signal peptide with components of the translation apparatus and/or endogenous signal recognition particle. These results were obtained with three different fusion proteins carrying the signal peptide of EltB thus leading to the conclusion that the effect of the mutation on the structure and function of the signal peptide is independent of the succeeding sequence to which the signal peptide is attached. PMID- 3301832 TI - Retinol and extracellular collagen matrices modulate hepatic Ito cell collagen phenotype and cellular retinol binding protein levels. AB - The hepatic vitamin A-storing Ito cell has been implicated as a causative cell in hepatic fibrogenesis. Using a modification of a recent method (Friedman, S. L., Roll, F. J., Boyles, J., and Bissell, D. M. (1985) Proc. Natl. Acad. Sci. U. S. A. 82, 8681-8685), rat Ito cells were isolated and passaged in vitro on collagen coated plastic dishes through cell generation 40-50. The collagen synthetic phenotype for Ito cells grown on various extracellular matrices was demonstrated by immunofluorescence and quantitated by competition enzyme-linked immunosorbent assays. When grown on a type I collagen matrix, Ito cells produced type IV greater than type III greater than type I collagen. When grown on a type IV collagen matrix, the cells produced relatively equal amounts of types I and III collagen. The absolute amounts of type I collagen produced were greater when cells were grown on type IV versus type I matrix. When 10(-5) M retinol was added to cell cultures, there was a uniform increase in type III collagen regardless of matrix type but a decrease in type I collagen when cells were grown on a type IV matrix and a large increase in type I collagen when cells were grown on a type I collagen matrix. The levels of cellular retinol binding protein, a key cytosolic retinol transport protein, were quantitated by high performance liquid chromatography and compared for cells grown on type I versus type IV collagen matrices. It was found that cells on a type I matrix contain 4.96 +/- 2.8 times more cellular retinol binding protein than do cells grown on a type IV matrix. In conclusion, Ito cell collagen synthesis may be altered by underlying extracellular matrix and exogenous retinol. This in vitro culture system should allow the study of regulatory factors and possible therapeutic anti-fibrogenic mediators. PMID- 3301831 TI - Separation and characterization of 5'- and 3'-tRNA processing nucleases from rat liver mitochondria. AB - The 5'- and 3'-tRNA processing nucleases have been isolated from rat liver mitochondria. The two activities co-purified through heparin-agarose and phenyl Sepharose columns and then efficiently separated on a DEAE-cellulose column. The 5' processing nuclease was found in the flow-through fraction, and the 3' processing activity eluted with 0.5 M KCl. Both enzymes were greater than 500 fold purified over the high speed supernatant of a mitoplast extract. The 159 base pre-tRNATyr used as a substrate in this study was synthesized in vitro and contained the Escherichia coli suppressor III tRNATyr plus a 49-base leader sequence and a 25-base trailing sequence. The 5' processing nuclease converted the pre-tRNATyr into two discrete RNA species, identified as the 5'-processed intermediate and the 5' flanking fragment, by endonucleolytic cleavage at the 5' end of the mature tRNATyr sequence. The 3' processing nuclease was inactive with the intact pre-tRNATyr as substrate but efficiently converted the 5'-processed intermediate to the mature tRNATyr, indicating an obligatory order of processing in which 5' maturation was necessary before cleavage by the 3' processing nuclease could occur. The mitochondrial enzymes exhibited optimal activity in the presence of about 2 mM Mg2+, but both enzymes were nearly fully active without addition of exogenous Mg2+ to the reaction mixtures. In contrast, a partially purified 5' processing endonuclease present in the postmitochondrial cytosolic fraction required higher [Mg2+] for activity, thus providing a means for differentiating between these similar enzyme activities obtained from the cytosolic and mitochondrial fractions. PMID- 3301833 TI - Immunological identification of the synaptic plasma membrane Na+-Ca2+ exchanger. AB - The protein moiety responsible for Na+-Ca2+ exchange activity was identified in synaptic plasma membranes (SPM). This was done by raising polyclonal antibodies in rabbits against each one of the detectable proteins present in the purified preparation containing the enriched specific transport activity. Two of the antibody preparations bound specifically to native SPM: antibodies which were raised against the 70,000-Da protein (the most prominent species consistently present in the purified preparation) and antibodies raised against a 33,000-Da protein (inconsistently present in variable amounts in the purified preparation). Both antibodies bound exclusively to a protein of 70,000 Da in native SPM. When, however, the purified 33,000- and 70,000-Da proteins were used as antigens, each one of the antibody preparations bound to both proteins. In addition, both antibody preparations immunoprecipitated Na+ gradient-dependent Ca2+ transport activity from detergent-solubilized SPM. This was obtained by incubation of solubilized SPM with a complex containing antibodies bound to Protein A-Sepharose beads, reconstitution of the material excluded from the beads, and determination of the residual transport activity. The decrease in Na+ gradient-dependent Ca2+ transport activity paralleled the amount of antibody bound to Protein A-Sepharose beads and could reach 82% as compared to the activity remaining in control experiments using preimmune sera. In comparison, ATP-dependent Ca2+ transport activity was unimpaired. These results indicate that the 70,000-Da protein in SPM contains the catalytic Na+-Ca2+ antiport activity. The presence of the 33,000-Da protein in some preparations and its properties may be explained by its being either a degradation product or a subunit of the 70,000-Da protein. PMID- 3301834 TI - Purified crystalloid endoplasmic reticulum from UT-1 cells contains multiple proteins in addition to 3-hydroxy-3-methylglutaryl coenzyme A reductase. AB - The crystalloid endoplasmic reticulum (ER) of UT-1 cells is a specialized smooth ER that houses 3-hydroxy-3-methylglutaryl-CoA reductase, a membrane protein that regulates endogenous cholesterol synthesis. The biogenesis of this ER is coupled to the over production of 3-hydroxy-3-methylglutaryl-CoA reductase. To understand better this membrane system and the relationship between the synthesis of a membrane protein and the formation of membrane, we have purified the crystalloid ER. Purified crystalloid ER did not contain significant amounts of membrane derived from the Golgi apparatus, mitochondria, or plasma membrane. Approximately 24% of the protein in this organelle corresponded to 3-hydroxy-3-methylglutaryl CoA reductase; however, at least eight other proteins were detected by gel electrophoresis. One of these proteins (Mr 73,000) was as abundant as reductase. These results suggest that the biogenesis of this ER involves the coordinate synthesis of multiple membrane and content proteins. PMID- 3301835 TI - A complex of platelet glycoproteins Ic and IIa identified by a rat monoclonal antibody. AB - A rat monoclonal antibody, GoH3, recognizes cell surface antigens on epithelial cells in a variety of tissues in both man and mouse. Furthermore, the antibody showed reactivity with endothelial cells and blood platelets. The molecule recognized by GoH3 on platelets was determined by immunoprecipitation, followed by analysis on one- and two-dimensional sodium dodecyl sulfate-polyacrylamide gels. GoH3 precipitated glycoproteins Ic and IIa from both human and mouse platelets. Glycoprotein Ic consists of disulfide-linked heavy and light chains which both appeared to be glycosylated. As determined by enzymatic digestion followed by gel analyses, both "complex" and "high mannose" type of N-linked oligosaccharides are present on the heavy and light chain of human glycoprotein Ic and on the heavy chain of mouse glycoprotein Ic. The light chain of mouse glycoprotein Ic only carries high mannose type of N-linked oligosaccharides. The N-linked glycans on human and mouse glycoprotein IIa are all of the complex type. The glycoproteins Ic and IIa co-sedimented in sucrose gradients and formed complexes upon treatment of intact platelets with the chemical cross-linking reagent dithiobis(succinimidyl propionate). Dissociation of the complex by chaotropic agents followed by immunoprecipitation establishes that the epitope recognized by GoH3 is located on the Ic molecule. These results provide evidence that the two glycoproteins, Ic and IIa, exist as a heterodimer complex in the platelet membrane. PMID- 3301836 TI - Structure of Escherichia coli dnaC. Identification of a cysteine residue possibly involved in association with dnaB protein. AB - The nucleotide sequence of the Escherichia coli dnaC gene and the primary structure of the dnaC protein were determined. The NH2-terminal amino acid sequence of the dnaC protein matched that predicted from the nucleotide sequence of the 735-base pair coding region. The dnaC gene lacks characteristic promoter structures; neither the "Pribnow box" nor the "-35 sequence" was detected within 222 base pairs upstream from the initiator ATG codon. There is, however, a typical Shine-Dalgarno sequence 7-10 base pairs before the ATG codon. An upstream open reading frame, separated by just 2 base pairs from the coding region of dnaC, encodes the COOH-terminal half of the dnaT product (protein i; Masai, H., Bond, M. W., and Arai, K. (1986) Proc. Natl. Acad. Sci. U. S. A. 83, 1256-1260). The dnaC protein contains 245 amino acids with a calculated molecular weight of 27,894 consistent with the observed value (29,000). Similar to dnaG and dnaT, dnaC uses several minor codons; the significance of these minor codons to the low level expression of the protein product in E. coli cells remains to be determined. The in vitro site-directed mutagenesis method was employed to determine the functional region involved in interaction with dnaB protein. The first cysteine residue located in the NH2-terminal region of the dnaC protein (Cys69) was shown to be important for this activity. Overall sequence homology between dnaC protein and lambda P protein, functionally analogous to the dnaC protein in the lambda phage DNA replication, is not extensive. There are, however, several short stretches of homologous regions including the NH2-terminal eight amino acids and the Cys78 region of dnaC protein. PMID- 3301837 TI - Cytochrome b558 monitors the steady state redox state of the ubiquinone pool in the aerobic respiratory chain of Escherichia coli. AB - The aerobic respiratory chain of Escherichia coli contains two terminal oxidases, the cytochrome o complex and the cytochrome d complex. These both function as ubiquinol-8 oxidases and reduce molecular oxygen to water. Electron flux is funneled from a variety of dehydrogenases, such as succinate dehydrogenase, through ubiquinone-8, to either of the terminal oxidases. A strain was examined which lacks the intact cytochrome d complex, but which overproduces one of the two subunits of this complex, cytochrome b558. This cytochrome, in the absence of the other subunit of the oxidase complex, does not possess catalytic activity. It is shown that the extent of reduction of cytochrome b558 in the E. coli membrane monitors the extent of reduction of the quinone pool in the membrane. The activity of each purified oxidase was examined in phospholipid vesicles as a function of the amount of ubiquinone-8 incorporated in the bilayer. A ratio of ubiquinol-8:phospholipid as low as 1:200 is sufficient to saturate each oxidase. The maximal turnover of the oxidases in the reconstituted system is considerably faster than observed in E. coli membranes, demonstrating that the rate-limiting step in the E. coli respiratory chain is at the dehydrogenases which feed electrons into the system. PMID- 3301838 TI - Identification and nucleotide sequence of a gene encoding 5' phosphoribosylglycinamide transformylase in Escherichia coli K12. AB - 5'-Phosphoribosylglycinamide transformylase (EC 2.1.2.2), encoded by the purN gene of Escherichia coli, catalyzes the synthesis of 5' phosphoribosylformylglycinamide from 5'-phosphoribosylglycinamide (GAR). The mature protein, as deduced from the purN structural gene sequence, contains 212 amino acid residues and has a calculated Mr of 23,241. The purN gene is located adjacent to and immediately downstream from the purM gene encoding 5' phosphoribosyl-5-aminoimidazole (AIR) synthetase where the initiation codon for GAR transformylase overlaps the termination codon of AIR synthetase. Based on polarity studies, the expression of the purN gene originates from the purM control region and thus forms a purMN operon. The E. coli GAR transformylase shows greater homology to the GAR transformylase domain of the trifunctional Gart polypeptide of Drosophila than to the single GAR transformylase of Saccharomyces. Immediately downstream from the purN gene of the purMN operon is a region of dyad symmetry capable of forming a hairpin stem and loop structure characteristic of a rho-independent terminator. PMID- 3301839 TI - Inaccessibility of tryptophan residues of recombinant human renin to quenching agents. AB - The fluorescence quenching of the three tryptophan residues of recombinant human renin was determined using ionic and penetrating quenchers. Tryptophans 44,200, and 312 of recombinant human renin were found to be totally inaccessible to the ionic quenchers cesium and iodide and only partially accessible to the penetrating quencher acrylamide. The renin had a fluorescence emission maximum at 325 nm which was made up of three separate components as determined by second derivative spectroscopy. These data are in accord with solvent accessibility calculations from three-dimensional models of human renin but differ from findings published previously from similar analysis of mouse submandibular gland renin (Quay, S. C., Heropoulous, A., Commes, K., Dzau, V. J. (1985) J. Biol. Chem. 260, 15055-15058), which is 68% identical in sequence to human renin. PMID- 3301840 TI - Determination of the carboxyl termini of the alpha and beta subunits of yeast K1 killer toxin. Requirement of a carboxypeptidase B-like activity for maturation. AB - The carboxyl-terminal sequences of the two polypeptide chains of the Saccharomyces cerevisiae K1 killer toxin were determined by protein sequencing and amino acid analysis of peptide fragments generated from the mature, secreted toxin. The COOH-terminal amino acid of the beta chain is histidine 316, the final residue encoded by the precursor gene. The COOH terminus of the alpha chain is at alanine 147 of the preprotoxin. Amino acid composition data for the purified toxin are consistent with that predicted from the gene sequence of the preprotoxin where the alpha and beta subunits consist of amino acid residues 45 147 and 234-316, respectively. The molecular weight of the mature alpha beta dimer is about 20,658. The COOH-terminal sequence determination completes the location of the toxin subunits in the precursor, and its configuration may be represented as prepropeptide-Pro-Arg-alpha-Arg-Arg-gamma-Lys-Arg-beta, where gamma represents the interstitial glycosylated peptide. The COOH terminal side of the paired basic residues (Arg-148 Arg-149 and Lys-232 Arg-233 of preprotoxin) are endoproteolytic processing sites for the product of the KEX2 gene (Julius, D., Brake, A., Blair, L., Kunisawa, R., and Thorner, J. (1984) Cell 37, 1075 1089), and thus maturation of the alpha subunit of killer toxin apparently requires a carboxypeptidase B-like activity. A possible candidate for this activity is the product of the KEX1 gene (Dmochowska, A., Dignard, D., Henning, D., Thomas, D.Y., and Bussey, H. (1987) Cell, in press). PMID- 3301841 TI - Gene for yeast glutamine tRNA synthetase encodes a large amino-terminal extension and provides a strong confirmation of the signature sequence for a group of the aminoacyl-tRNA synthetases. AB - The gene for the yeast Saccharomyces cerevisiae glutamine tRNA synthetase is shown here to encode a protein of 809 amino acids. This contrasts with the 551 amino acids of the Escherichia coli glutamine tRNA synthetase. The yeast GLN4 transcripts have 5' termini that start approximately 25 nucleotides in front of the long open reading frame. Much of the extra size of the yeast enzyme is due to a large amino-terminal extension. At codon 225, the yeast enzyme aligns with the amino terminus of the E. coli protein. From this point on, the two sequences have an average of 40% identity, with a few small gaps for alignment, until their respective carboxyl termini. At codon 254 of the yeast and codon 30 of the E. coli enzyme, however, there starts an exact 15-amino acid match between the two proteins. This match encompasses and is partially the same as a short sequence which is a signature sequence for the amino acid group of the bacterial aminoacyl tRNA synthetases which are specific for different amino acids. This is the strongest sequence match found between any yeast cytoplasmic or mitochondrial aminoacyl-tRNA synthetase with its bacterial homologue. This region of the structure is associated with a nucleotide fold. The result provides strong validation of the signature sequence, especially for sequences where the homology relationships are less dramatic than in this example. Because the 224-amino acid extension of the yeast enzyme does not align with any part of the E. coli enzyme, we propose that it is not associated directly with the catalytic function of the enzyme. Its possible function is investigated in the accompanying paper. PMID- 3301842 TI - Construction and analysis of deletions in the amino-terminal extension of glutamine tRNA synthetase of Saccharomyces cerevisiae. AB - GLN4 of Saccharomyces cerevisiae encodes an amino-terminal extension of 224 amino acids. This is connected to a polypeptide which is colinear with and 40% identical to Escherichia coli glutamine tRNA synthetase. We examined the potential significance of the amino-terminal extension. Two single base and five multiple base frame shift deletions were constructed in this segment. Each of these mutations is associated with a lethal phenotype. This suggests that the coding sequence for the amino-terminal extension is translated. It also implies that there are no translation restarts downstream of the coding region for the amino-terminal extension which produce active enzyme. Three internal deletions of various sizes, and which preserve the correct reading frame, were constructed in the coding region of the amino-terminal extension. Cells which harbor such in frame deletions on a multi copy plasmid are viable, even when a deletion construct is the only source of GLN4-encoded activity. Extracts of cells which have one of these deletions have reduced, but measurable, glutamine tRNA synthetase activity. We conclude that the catalytic activity resides with the segment which is homologous to the E. coli enzyme and that the amino-terminal extension itself is dispensable for aminoacylation activity. Each of the internal in-frame deletion constructions is respiration-proficient. The amino-terminal extension, therefore, is not used for an essential mitochondrial function of the GLN4 gene product. Within the accuracy of the measurements, activities of four other aminoacyl-tRNA synthetases are not affected by the presence of a GLN4 internal deletion allele as the only source of GLN4-encoded activity. This suggests that the amino-terminal extension does not stabilize a complex which includes one or more of these four enzymes and whose activity depends on proper assembly of the complex. PMID- 3301844 TI - Identification of a meiotic prophase-specific nuclear matrix protein in the rat. AB - We have identified a 110-kDa pI 5.6 phosphoprotein with DNA binding properties in the rat pachytene spermatocyte nuclear matrix. By immunoblotting and indirect immunofluorescence assays using polyclonal antibodies against the 110-kDa protein, we observed that it was germ cell nuclear matrix specific, more prominent in pachytene spermatocytes compared to premeiotic spermatogonia or postmeiotic round spermatids, and present in rat oocytes and in germ cells of mouse and monkey. We propose that this protein could play an important role in the meiotic process. PMID- 3301843 TI - Insulin as a growth factor in rat hepatoma cells. Stimulation of proto-oncogene expression. AB - In a subline of Reuber H35 rat hepatoma cells that becomes quiescent under serum deprived conditions, insulin acts as a growth factor. When added to serum deprived H35 cells, physiologic concentrations of insulin stimulate DNA synthesis, demonstrating that insulin alone is capable of inducing a transition from G0/G1 into S phase. This response, which is induced by nanomolar concentrations of insulin, is mediated directly through the insulin receptor. Here we show that coincident with this growth response, insulin or serum induces dramatic increases in the steady-state levels of c-fos and c-myc mRNAs in serum deprived H35 cells in a time course similar to that observed in the regenerating liver. Other growth factors, including epidermal growth factor, appear not to affect these cells either in terms of DNA synthesis or c-myc mRNA induction. The phorbol ester phorbol 12-myristate 13-acetate (PMA) also induces c-myc and c-fos mRNAs without inducing DNA synthesis. However, the mechanism of this induction appears to be different from the insulin-induced induction since pretreatment of cells with PMA blocks only the PMA-mediated, not the insulin-mediated, induction of c-myc and c-fos. PMID- 3301845 TI - Regulation of urokinase-type plasminogen activator production by cultured human cytotrophoblasts. AB - Cultured human cytotrophoblasts synthesize and secrete urokinase-type plasminogen activator (uPA) during the first 24 h of culture, but secretion declines during the subsequent day. In contrast, synthesis and secretion of fibronectin increases during the 2 days of culture. The levels of uPA mRNA parallel the changes in synthesis and secretion of uPA. Treatment of cytotrophoblasts with 8-bromo-cAMP (1.5 mM) transiently raises uPA mRNA levels and uPA secretion. This treatment reduces fibronectin mRNA levels and causes a sustained increase in beta chorionic gonadotropin mRNA content and chorionic gonadotropin secretion. We conclude that a cAMP-mediated process up-regulates uPA expression in cytotrophoblasts. However, the stimulatory effect of the cyclic nucleotide analog on uPA is transient. PMID- 3301846 TI - Investigation of the role of individual tryptophan residues in the binding of Escherichia coli single-stranded DNA binding protein to single-stranded polynucleotides. A study by optical detection of magnetic resonance and site selected mutagenesis. AB - Fluorescence and optical detection of triplet state magnetic resonance (ODMR) spectroscopy have been employed to study the complexes formed between single stranded polynucleotides and Escherichia coli ssb gene products (SSB) in which tryptophans 40, 54, and 88 are selectively, one residue at a time, replaced by phenylalanine using site-specific oligonucleotide mutagenesis. Fluorescence titrations and ODMR results indicate that tryptophans 40 and 54 are the only tryptophan residues in E. coli single-stranded DNA binding protein that are involved in stabilizing the protein-nucleic acid complexes via stacking interactions. Wavelength-selected ODMR measurements on E. coli SSB reveal the presence of two spectrally distinct tryptophan sites (Khamis, M. I., Casas-Finet, J. R., and Maki, A. H. (1987) J. Biol. Chem. 262, 1725-1733). Our present results indicate that tryptophan 54 belongs to the blue-shifted site, while tryptophan 40 belongs to the red-shifted site of the protein. PMID- 3301847 TI - Purification and characterization of Saccharomyces cerevisiae mitochondrial elongation factor Tu. AB - Yeast mitochondrial elongation factor Tu (EF-Tu) was purified 200-fold from a mitochondrial extract of Saccharomyces cerevisiae to yield a single polypeptide of Mr = approximately 47,000. The factor was detected by complementation with Escherichia coli elongation factor G and ribosomes in an in vitro phenylalanine polymerization reaction. Mitochondrial EF-Tu, like E. coli EF-Tu, catalyzes the binding of aminoacyl-tRNA to ribosomes and possesses an intrinsic GTP hydrolyzing activity which can be activated either by kirromycin or by ribosomes. Kinetic and binding analyses of the interactions of mitochondrial EF-Tu with guanine nucleotides yielded affinity constants for GTP and GDP of approximately 5 and 25 microM, respectively. The corresponding affinity constants for the E. coli factor are approximately 0.3 and 0.003 microM, respectively. In keeping with these observations, we found that purified mitochondrial EF-Tu, unlike E. coli EF-Tu, does not contain endogenously bound nucleotide and is not stabilized by GDP. In addition, we have been unable to detect a functional counterpart to E. coli EF-Ts in extracts of yeast mitochondria and E. coli EF-Ts did not detectably stimulate amino acid polymerization with mitochondrial EF-Tu or enhance the binding of guanine nucleotides to the factor. We conclude that while yeast mitochondrial EF Tu is functionally analogous to and interchangeable with E. coli EF-Tu, its affinity for guanine nucleotides and interaction with EF-Ts are quite different from those of E. coli EF-Tu. PMID- 3301848 TI - Contribution of different organs to increased glucose consumption after endotoxin administration. AB - Glucose utilization of different organs (spleen, liver, ileum, kidney, skin, lung, and testis) was investigated in vivo in conscious rats 3, 24, or 48 h after treatment with 100 micrograms of endotoxin/100 g of body weight. Glucose uptake was determined by the 2-deoxyglucose technique, which was validated by demonstrating that endotoxin treatment did not alter either the intracellular retention of the phosphorylated metabolites (P-2-dGlc) of the tracer or the discrimination against 2-deoxyglucose in pathways of glucose metabolism. At 3 h after endotoxin the accumulation of P-2-dGlc was markedly increased in the liver (4.8-fold), spleen and skin (2.9-fold), lung (2.4-fold), and ileum and kidney (2.1-fold), as compared to time-matched controls. This effect was sustained in the liver at 24 and 48 h, was diminishing but still significant in spleen, ileum, and kidney, and absent in skin and lung. Accumulation of P-2-dGlc in the testis remained unchanged after endotoxin. Glucose uptake by individual organs and their contribution to whole body glucose utilization in control and endotoxin-treated rats were compared based on P-2-dGlc accumulation data. Organs rich in mononuclear phagocytes (liver and spleen) exhibited a marked and prolonged increase in glucose uptake after endotoxin. Yet the bulk of the increment in the whole body glucose disappearance rate (Rd) was due to three large tissues (skin, intestine, and muscle, accounting for more than 80% of the total P-2-dGlc accumulation in soft tissues), which showed a more moderate and transient increase in glucose utilization. PMID- 3301849 TI - Receptor binding properties and insulin-like effects of human growth hormone and its 20 kDa-variant in rat adipocytes. AB - The natural 20 kDa-variant of human growth hormone (hGH) binds with high affinity to IM-9 human lymphocyte receptors, in agreement with its potency in biological assays for growth promoting and lactogenic activities. In contrast, 20 kDa-hGH has only 3% of the potency of 22 kDa-hGH in binding to the receptors of normal and hypophysectomized rat adipocytes. In agreement with the binding potency, 20 kDa-hGH is only 3% as potent as 22 kDa-hGH in stimulating lipogenesis in normal rat adipocytes preincubated for a few hours in hGH-free medium. The 20 kDa-hGH is also much weaker than 22 kDa-hGH in stimulating lipogenesis in adipocytes from hypophysectomized rats. These data strongly support the concept that the rat adipocyte receptor, which mediates the insulin-like effects of growth hormone, is different from the receptor found on human IM-9 lymphocytes. Preincubation of rat adipocytes with hGH induces a refractoriness to subsequent activation of lipogenesis by hGH but does not abolish the response to insulin, while preincubation with insulin slightly potentiates the hGH response and does not change the insulin response. Additivity studies and a detailed comparison of the lipogenic effects of insulin and hGH suggest that hGH shares only a subset of the metabolic pathways activated by insulin. PMID- 3301850 TI - Human apolipoprotein B-100 heparin-binding sites. AB - Seven distinct heparin-binding sites have been demonstrated on human apolipoprotein (apo) B-100 by using a combination of digestion with cyanogen bromide or Staphylococcus aureus V-8 protease and heparin-Sepharose affinity chromatography. Based on fragment analysis, the approximate boundaries of the seven binding sites are as follows: site A, residues 5-99; site B, residues 205 279; site C, residues 875-932; site D, residues 2016-2151; site E, residues 3134 3209; site F, 3356-3489; and site G, residues 3659-3719. In sites E and F, two short regions enriched in basic amino acids have been identified, and it is likely that they are responsible for a major portion of the heparin-binding properties of these sites. The relative binding affinity of each of the seven sites was estimated in two ways. First, the affinity was assessed in a ligand blot assay using a 125I-labeled high-reactive heparin subfraction. Second, apoB 100 fragments generated by cyanogen bromide or S. aureus V-8 protease were separated into low- and high-affinity fractions by gradient salt elution of a heparin-Sepharose column. The distribution of the seven binding sites in the two fractions was determined in an immunoblotting assay using antibodies specific to each site, i.e. antibodies raised against synthetic peptide sequences found within each of the seven sites. The results of these two approaches demonstrate that site E and, to a somewhat lesser extent, site F bind to heparin with the highest affinity. Based on the analogy with apoE, in which the high-affinity heparin-binding site coincides with the domain of the protein that interacts with apoB,E (low density lipoprotein) receptors, the results of this study indicate that site E and site F, either singly or in combination, might constitute the receptor binding domain of apoB-100. PMID- 3301851 TI - Gonadotropin-releasing hormone action upon luteinizing hormone bioactivity in pituitary gland: role of sulfation. AB - The regulation of rat luteinizing hormone (rLH) bioactivity was studied in an in vitro system using isolated pituitaries from male rats. Stored and released rLH was evaluated in terms of mass (I-LH), bioactivity (B-LH), mobility in nonequilibrium pH gradient electrophoresis, and mannose and sulfate incorporation either in the presence or absence of gonadotropin-releasing hormone (GnRH). GnRH increased the biological potency of stored and released rLH. The pituitary content revealed seven I-LH species (pH 7.2, 7.8, 8.5, 9.0, 9.1, 9.3, and 9.7) and five B-LH species (pH 8.5, 9.0, 9.2, 9.4, and 9.7). The major I-LH and B-LH peaks were at pH 9.0 and 9.2, respectively. I-LH peaks at pH 7.2 and 7.8 are devoid of bioactivity; at these pH values, free rLH subunits are detectable. GnRH increases the amount of both I-LH and B-LH material secreted into the medium, and the major component migrates at pH 8.5 and is probably the alpha beta dimer. [3H]Mannose and [35S]sulfate can be incorporated into stored and released rLH (pH 7.2, 7.8, 9.0, 9.1, and 9.3 and 7.2, 7.8, 8.5, and 9.0, respectively). GnRH decreases [2-3H]mannose incorporation into secreted rLH. [35S]Sulfate was incorporated into I-LH released spontaneously into the medium; the form at pH 7.2 has no biological activity and is probably the free alpha subunit. GnRH decreases the [35S]sulfate-labeled rLH content of the pituitary concomitantly with a 500% increase in [35S]sulfate-labeled released rLH, suggesting that, soon after [35S]sulfate is incorporated, sulfated rLH is released. Sulfatase action on released rLH reveals that sulfation may be related to release of rLH but that sulfate residues are not involved in the expression of rLH bioactivity. In conclusion, GnRH stimulates carbohydrate incorporation and processing of the oligosaccharide residues giving the highest biological potent rLH molecule and also increases sulfation; this step is closely related to the step limiting the appearance of LH in the medium in the absence of GnRH. PMID- 3301852 TI - Purification and characterization of human recombinant interleukin-1 beta. AB - A human interleukin-1 (IL-1) beta cDNA was cloned, and the region coding for the mature protein was expressed in Escherichia coli. The 17-kDa biologically active product was purified in 40% yield to apparent homogeneity, without chaotropes, from the soluble fraction of sonicated cell lysates. The recombinant IL-1 beta was characterized by amino acid analysis, NH2- and COOH-terminal sequence analysis, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, spectroscopy, and biological assay. Specific biological activity was 4.6 X 10(8) units/mg in a co-mitogenic IL-2 induction assay using cultured EL-4 T lymphocytes. The molar extinction coefficient was determined to be 10,300 cm-1 M 1 at 280 nm. NH2-terminal sequence analysis revealed that 70% of the product begins with the Ala corresponding to the NH2 terminus of the natural protein, while 30% begins with the following Pro. No initiator Met was observed. Both of the sulfhydryl groups are reactive to Ellman's reagent and to iodoacetamide under nonreducing conditions, indicating that the Cys residues do not form disulfide bonds. S-Carboxamidomethyl-Cys-rIL-1 beta retained biological activity in the IL 2 induction assay. Circular dichroism suggested an extensive beta sheet structure for rIL-1 beta. PMID- 3301853 TI - Activity and phosphorylation state of glucose transporters in plasma membranes from insulin-, isoproterenol-, and phorbol ester-treated rat adipose cells. AB - The counterregulatory action of catecholamines on insulin-stimulated glucose transport and its relation to glucose transporter phosphorylation were studied in isolated rat adipose cells. Plasma membranes exhibiting reduced glucose transport activity were prepared as described previously (Joost, H. G., Weber, T. M., Cushman, S. W., and Simpson, I. A. (1986) J. Biol. Chem. 261, 10033-10036) from cells treated with insulin, and subsequently with isoproterenol and adenosine deaminase. In these membranes, transporter affinity for cytochalasin B binding was significantly reduced (KD = 133.5 +/- 14 versus 89.8 +/- 11 nM, means +/- S.E.) with no change in number of sites or immunoreactivity of the transporter on Western blots. Reconstituted plasma membrane transport was significantly lower with isoproterenol treatment (0.50 +/- 0.12 versus 0.97 +/- 0.27 nmol/mg protein/10 s). In contrast, transport activity reconstituted from corresponding intracellular transporters (from low density microsomes) was unchanged (5.4 +/- 2.2 versus 6.9 +/- 1.2 nmol/mg protein/10 s). Thus, the intrinsic activity change of the transporter produced by catecholamines appears to reflect a structural modification that is confined to the plasma membrane and not recycled into the intracellular compartment. In cells equilibrated with [32P]phosphate, neither insulin nor isoproterenol induced [32P]phosphate incorporation into the glucose transporter immunoprecipitated from plasma membranes. Conversely, phorbol 12 myristate 13-acetate stimulated significant incorporation of [32P]phosphate into the glucose transporter in insulin-stimulated cells without any change in plasma membrane transport activity or transporter concentration. Thus, the phosphorylation state of the glucose transporter does not seem to be involved in either signaling transporter translocation or triggering changes in transporter intrinsic activity. PMID- 3301854 TI - Studies on the role of actin's N tau-methylhistidine using oligodeoxynucleotide directed site-specific mutagenesis. AB - The primary structure of all actins except that isolated from Naegleria gruberi contains a unique N tau-methylhistidine (MeHis) at position 73. This modified residue has been implicated as possibly being important for the post translational processing of actin's amino terminus, the binding of actin to DNase I, and in the polymerization of G-actin. We have investigated the potential role of MeHis in each of these processes by utilizing site-directed mutagenesis to change His-73 of skeletal muscle actin to Arg and Tyr. Wild type and mutant actins were synthesized in vivo, using non-muscle cells transfected with mutant cDNAs, and in vitro by translating mutant RNAs synthesized using SP6 RNA polymerase in a rabbit reticulocyte lysate. We have found that actins containing Arg or Tyr at position 73 undergo amino-terminal processing, bind to DNase I agarose, and become incorporated into the cytoskeleton of a nonmuscle cell as efficiently as wild type actin. Furthermore, using an in vitro copolymerization assay we have found that although there is no difference between the Arg mutant and the wild type actins, the Tyr mutant has a slightly greater critical concentration for polymerization. These results show that MeHis is not absolutely required for any of these processes. PMID- 3301855 TI - "Numatrin," a nuclear matrix protein associated with induction of proliferation in B lymphocytes. AB - To detect nuclear proteins that might be involved in induction of cellular mitogenesis, we examined the effect of various mitogens on early changes in synthesis of nuclear proteins in murine B lymphocytes. Using two-dimensional gel electrophoresis, we found that activation of B cells by mitogens (anti immunoglobulin antibody, lipopolysaccharide, phorbol 12-myristate 13-acetate (PMA)/A23187) was associated with a rapid and prominent (5-20-fold) increase in the synthesis of a 40-kDa/pI 5.0 nuclear protein, here termed numatrin. Numatrin was found to be absent from the cytosol (soluble fraction) of resting as well as activated B cells and was markedly resistant to DNase/RNase digestion and 2 N NaCl extraction, indicating that this protein is tightly bound to the nuclear matrix. Kinetic studies showed that the increase in synthesis of numatrin was detected 60-120 min following mitogen activation, reached a peak at 16 h, and declined to almost control level by 48 h, correlating with the peak of cellular DNA synthesis. The increase in synthesis of numatrin in normal B cells was found to be associated exclusively with cellular commitment for mitogenesis because activation of B cells by stimuli such as B cell stimulating factor 1, PMA alone, and calcium ionophore A23187, which do not stimulate an increase in DNA synthesis, also failed to induce an increase in the synthesis of numatrin. Inhibition of anti-Ig-induced proliferation (by PMA pretreatment) was associated with a 63% inhibition in the synthesis of numatrin. Addition of 8 mercaptoguanosine to these PMA-treated cells was associated with restoration of the increase in synthesis of numatrin, concomitant with induction of proliferation. Elevated synthesis of numatrin was also detected in the malignant B lymphoma cells: Raji, BAL-17, and WEHI-231. Taken collectively, these results suggest that numatrin, a tightly bound nuclear matrix protein, is a growth regulated protein which might have an important role in regulation of cellular mitogenesis in normal and malignant B lymphocytes. PMID- 3301856 TI - The detection of antibodies to recombinant interferon alfa-2a in human serum. AB - Three different procedures have been used for detecting antibodies to Roferon-A (recombinant human interferon alfa-2a, rHuIFN alpha-2a) in the serum of patients who received this interferon as part of ongoing clinical trials: an antiviral neutralization bioassay (ANB), the standard method recommended by the World Health Organization (WHO), and the more recently developed radioimmunoassay (RIA) and enzymeimmunoassay (EIA). Although the three tests are based on different principles, the correlation among them was excellent. The assays show differences in sensitivities with the ANB being the least sensitive of the three. The EIA equals the RIA in sensitivity, reproducibility, accuracy and labor and provides the advantage of safety and convenience in the use of non-radioactive materials. Therefore, the EIA has been selected as the most suitable assay for initial screening of the sera of patients receiving Roferon-A for the presence of antibodies to this interferon. EIA positive sera are then tested in the ANB to determine whether or not neutralizing activities are present. PMID- 3301857 TI - The cardiovascular effects of the neurohypophysial hormone oxytocin. PMID- 3301859 TI - The Gruca operation for congenital absence of the fibula. AB - An alternative to Syme's amputation for congenital absence of the fibula is described in this paper. Nine children have had the ankle reconstructed using the Gruca technique with a very satisfactory result in eight. This procedure is not suitable for every patient and in most unilateral cases the operation can only be regarded as an interim procedure because of progressive leg-length inequality. The decision to remove the foot may be delayed and it allows childhood to be spent without resort to prostheses. However, the procedure can be considered as the definitive operation in cases of bilateral deformity. PMID- 3301858 TI - Prostacyclin immobilized albuminated surfaces. AB - The adhered platelets on artificial surfaces play a crucial role in inducing thrombosis. Therefore, it is very much desirable to have surfaces which can effectively retard platelet adhesion and aggregation. Prostaglandins like PGE2, PGE1 and PGD2 possess potent antiplatelet activity, but have very short half life. A chemically stable prostacyclin analog, 10,10-difluoro-13 dehydroprostacyclin (DF2-PGI2) seems to be promising. Polyelectrolyte (PE) synthesized from natural poly cis-1,4 isoprene has also been found to possess outstanding anticoagulant and antiplatelet activity. Modification of polyetherurethane urea (PEUU) by immobilizing DF2-PGI2 and poly-electrolyte in various combinations using glow discharge technique has been attempted. Surfaces thus modified showed negligible platelet adherence. The inhibition of platelet adherence in presence of inducing agents like fibrinogen, thrombin and ADP was also remarkable. The interactions of albumin and fibrinogen with the modified surfaces were studied using 125I labelled proteins. PMID- 3301860 TI - Does the use of the operating microscope improve the results of peripheral nerve suture? AB - Twenty-four cases of complete division of median or ulnar nerves were assessed on two occasions after direct suture, with an interval of three years between assessments. Clinical, electrophysiological and timed functional tests were used. All the operations had been performed by one surgeon, using the operating microscope for approximately half the cases but not for the other half. The results were analysed, and the patient's age, any delay between injury and suture, and the duration of follow-up were all found to exert strong and consistent effects on the scores obtained. After controlling for these factors, there was no consistent difference between the results of the two surgical methods. It is concluded that, at least in the hands of one particular surgeon, the use of the operating microscope gives no better results than careful epineural suture performed without it. PMID- 3301861 TI - Prospective clinical study of Hydron, a synthetic dressing, in delivery of an antimicrobial drug to second-degree burns. AB - This clinical trial prospectively evaluates the potential beneficial effects of antimicrobial drug delivery from a synthetic dressing (Hydron-AgSD) formed on second-degree burn wounds. A paste composed of polyethylene glycol-400, poly 2-OH ethylmethacrylate, and silver sulfadiazine (AgSD 1%-3%) matured within one hour to form a solid dressing. In 27 patients, comparable areas of second-degree wounds on the same patient were selected at random for test and control (silver sulfadiazine 1% only) sites. The mean total time of the synthetic dressing application per patient was about nine days, and each dressing remained in place for nearly four days. During this interval the control sites required four dressings changes. In 17 tests for infections, the control areas were contaminated but no bacteria were detected under the synthetic dressing; in three tests, the controls had no bacteria, whereas the synthetic dressing did. Healing of burns was similar under both types of dressing. Benefits of Hydron treatment included increased patient comfort because of the reduced number of dressing changes and, in some cases, greater freedom from contaminating bacteria. PMID- 3301862 TI - Return of hand function following major burns. PMID- 3301863 TI - Lamin B constitutes an intermediate filament attachment site at the nuclear envelope. AB - We found that urea extraction of turkey erythrocyte nuclear envelopes abolished their ability to bind exogenous 125I-vimentin, while, at the same time, it removed the nuclear lamins from the membranes. After purification of the lamins from such urea extracts, a specific binding between isolated vimentin and lamin B, or a lamin A + B hetero-oligomer, was detected by affinity chromatography. Similar analysis revealed that the 6.6-kD vimentin tail piece was involved in this interaction. By other approaches (quantitative immunoprecipitation, rate zonal sedimentation, turbidometric assays) a substoichiometric lamin B-vimentin binding was determined under in vitro conditions. It was also observed that anti lamin B antibodies but not other sera (anti-lamin A, anti-ankyrin, preimmune) were able to block 70% of the binding of 125I-vimentin to native, vimentin depleted, nuclear envelopes. These data, which were confirmed by using rat liver nuclear lamins, indicate that intermediate filaments may be anchored directly to the nuclear lamina, providing a continuous network connecting the plasma membrane skeleton with the karyoskeleton of eukaryotic cells. PMID- 3301864 TI - Newly synthesized proinsulin/insulin and stored insulin are released from pancreatic B cells predominantly via a regulated, rather than a constitutive, pathway. AB - The pancreatic B cell has been used as a model to compare the release of newly synthesized prohormone/hormone with that of stored hormone. Secretion of newly synthesized proinsulin/insulin (labeled with [3H]leucine during a 5-min pulse) and stored total immunoreactive insulin was monitored from isolated rat pancreatic islets at basal and stimulatory glucose concentrations over 180 min. By 180 min, 15% of the islet content of stored insulin was released at 16.7 mM glucose compared with 2% at 2.8 mM glucose. After a 30-min lag period, release of newly synthesized (labeled) proinsulin and insulin was detected; from 60 min onwards this release was stimulated up to 11-fold by 16.7 mM glucose. At 180 min, 60% of the initial islet content of labeled proinsulin was released at 16.7 mM glucose and 6% at 2.8 mM glucose. Specific radioactivity of the released newly synthesized hormone relative to that of material in islets indicated its preferential release. A similar degree of isotopic enrichment of released, labeled products was observed at both glucose concentrations. Quantitative HPLC analysis of labeled products indicated that glucose had no effect on intracellular proinsulin to insulin conversion; release of both newly synthesized proinsulin and insulin was sensitive to glucose stimulation; 90% of the newly synthesized hormone was released as insulin; and only 0.5% of proinsulin was rapidly released (between 30 and 60 min) in a glucose-independent fashion. It is thus concluded that the major portion of released hormone, whether old or new, processed or unprocessed, is directed through the regulated pathway, and therefore the small (less than 1%) amount released via a constitutive pathway cannot explain the preferential release of newly formed products from the B cell. PMID- 3301865 TI - Purification and characterization of constitutive secretory vesicles from yeast. AB - We have developed a purification procedure for the isolation of constitutive post Golgi secretory vesicles from Saccharomyces cerevisiae. Although the post-Golgi stage of the secretion pathway is normally very rapid, we have used a temperature sensitive secretory mutant, sec 6-4, to greatly expand the population of secretory vesicles. Following invertase as a marker, intact vesicles are enriched 36-fold from the crude lysate. The final preparation contains few contaminants as assessed by morphologic and biochemical examination. Three proteins (110, 40-45, and 18 kD) co-purify with the vesicle marker enzyme invertase. Metabolic labeling experiments indicate that these vesicle-associated proteins are synthesized during the period of vesicle accumulation. They are not apparent in the corresponding fractions from wild-type cells. Analysis of these proteins indicates that the 110-kD protein is a major glycoprotein residing in the vesicle lumen, while the 40-45- and 18-kD proteins are not glycosylated and are firmly associated with the vesicle membrane, each with at least one domain exposed on the cytoplasmic surface. PMID- 3301866 TI - Two integral membrane proteins located in the cis-middle and trans-part of the Golgi system acquire sialylated N-linked carbohydrates and display different turnovers and sensitivity to cAMP-dependent phosphorylation. AB - The localization and chemical characteristics of two Golgi integral membrane proteins (GIMPs) have been studied using monoclonal antibodies. The two proteins are segregated in different parts of the Golgi system and whereas GIMPc(130 kD) is located in the cis and medial cisternae, GIMPt (100 kD) is confined in the trans-most cisterna and trans-tubular network. Both GIMPs are glycoproteins that contain N- and O-linked carbohydrates. The N-linked carbohydrates were exclusively of the complex type. Although excluded from the trans-side of the Golgi system, where sialylation is believed to occur, GIMPc acquires sialic acid in both its N- and O-linked carbohydrates. Sialic acid was also detected in the N linked carbohydrates of GIMPt. GIMPc is apparently phosphorylated in the luminal domain in vivo. Phosphorylation occurred exclusively on serine and was stimulated by dibutyryl cyclic AMP. GIMPc and GIMPt displayed half-lives of 20 and 9 h, respectively. PMID- 3301867 TI - Assembly and turnover of detyrosinated tubulin in vivo. AB - Detyrosinated (Glu) tubulin was prepared from porcine brain and microinjected into human fibroblasts and Chinese hamster ovary (CHO) cells. Glu tubulin assembled onto the ends of preexisting microtubules and directly from the centrosome within minutes of its microinjection. Incorporation into the cytoskeleton continued until almost all of the microtubules were copolymers of Glu and tyrosinated (Tyr) tubulin. However, further incubation resulted in the progressive and ultimately complete loss of Glu-staining microtubules. Glu tubulin injected into nocodazole-treated cells was converted to Tyr tubulin by a putative tubulin/tyrosine ligase activity. The observed decrease in staining with the Glu antibody over time was used to analyze microtubule turnover in microinjected cells. The mode of Glu disappearance was analyzed quantitatively by tabulating the number of Glu-Tyr copolymers and Tyr-only microtubules at fixed times after injection. The proportion of Glu-Tyr copolymers decreased progressively over time and no segmentally labeled microtubules were observed, indicating that microtubules turn over rapidly and individually. Our results are consistent with a closely regulated tyrosination-detyrosination cycle in living cells and suggest that microtubule turnover is mediated by dynamic instability. PMID- 3301868 TI - Cap Z(36/32), a barbed end actin-capping protein, is a component of the Z-line of skeletal muscle. AB - Various biological activities have been attributed to actin-capping proteins based on their in vitro effects on actin filaments. However, there is little direct evidence for their in vivo activities. In this paper, we show that Cap Z(36/32), a barbed end, actin-capping protein isolated from muscle (Casella, J. F., D. J. Maack, and S. Lin, 1986, J. Biol. Chem., 261:10915-10921) is localized to the barbed ends of actin filaments by electron microscopy and to the Z-line of chicken skeletal muscle by indirect immunofluorescence and electron microscopy. Since actin filaments associate with the Z-line at their barbed ends, these findings suggest that Cap Z(36/32) may play a role in regulating length, orienting, or attaching actin filaments to Z-discs. PMID- 3301869 TI - Involvement of leukocyte function-associated antigen-1 (LFA-1) in the invasion of hepatocyte cultures by lymphoma and T-cell hybridoma cells. AB - We studied the interaction of MB6A lymphoma and TAM2D2 T cell hybridoma cells with hepatocyte cultures as an in vitro model for in vivo liver invasion by these tumor cells. A monoclonal antibody against leukocyte function-associated antigen 1 (LFA-1) inhibited adhesion of the tumor cells to the surface of hepatocytes and consequently strongly reduced invasion. This effect was specific since control antibodies, directed against Thy.1 and against T200, of the same isotype, similar affinity, and comparable binding to these cells, did not inhibit adhesion. This suggests that LFA-1 is involved in the formation of liver metastases by lymphoma cells. TAM2D2 T cell hybridoma cells were agglutinated by anti-LFA-1, but not by control antibodies. Reduction of adhesion was not due to this agglutination since monovalent Fab fragments inhibited adhesion as well, inhibition was also seen under conditions where agglutination was minimal, and anti-LFA-1 similarly affected adhesion of MB6A lymphoma cells that were not agglutinated. The two cell types differed in LFA-1 surface density. TAM2D2 cells exhibited 400,000 surface LFA-1 molecules, 10 times more than MB6A cells. Nevertheless, the level of adhesion and the extent of inhibition by the anti-LFA-1 antibody were only slightly larger for the TAM2D2 cells. PMID- 3301870 TI - Immunoelectron microscopic localization of the neural cell adhesion molecules L1 and N-CAM during postnatal development of the mouse cerebellum. AB - The cellular and subcellular localization of the neural cell adhesion molecules L1 and N-CAM was studied by pre- and postembedding immunoelectron microscopic labeling procedures in the developing mouse cerebellar cortex. The salient features of the study are: L1 displays a previously unrecognized restricted expression by particular neuronal cell types (i.e., it is expressed by granule cells but not by stellate and basket cells) and by particular subcellular compartments (i.e., it is expressed on axons but not on dendrites or cell bodies of Purkinje cells). L1 is always expressed on fasciculating axons and on postmitotic, premigratory, and migrating granule cells at sites of neuron-neuron contact, but never at contact sites between neuron and glia, thus strengthening the view that L1 is not involved in granule cell migration as a neuron-glia adhesion molecule. While N-CAM antibodies reacting with the three major components of N-CAM (180, 140, and 120 kD) show a rather uniform labeling of all cell types, antibodies to the 180-kD component (N-CAM180) stain only the postmigratory granule cell bodies supporting the notion that N-CAM180, the N-CAM component with the longest cytoplasmic domain, is not expressed before stable cell contacts are formed. Furthermore, N-CAM180 is only transiently expressed on Purkinje cell dendrites. N-CAM is present in synapses on both pre- and post synaptic membranes. L1 is expressed only preterminally and not in the subsynaptic membranes. These observations indicate an exquisite degree of fine tuning in adhesion molecule expression during neural development and suggest a rich combinatorial repertoire in the specification of cell surface contacts. PMID- 3301871 TI - Differential expression of nuclear lamin proteins during chicken development. AB - By immunocytochemistry, quantitative immunoblotting, and two-dimensional gel electrophoresis, we have analyzed the distribution of nuclear lamin proteins during chicken embryonic development. Whereas no qualitative differences in the patterns of expression of lamins A, B1, and B2 were observed during gametogenesis in either the female or the male germ line, profound changes in the composition of the nuclear lamina occurred during the development of somatic tissues. Most unexpectedly, early chicken embryos were found to contain little if any lamin A, although they contained substantial amounts of lamins B1 and B2. During embryonic development, lamin A became increasingly prominent, whereas the amounts of lamin B1 decreased in many tissues. Interestingly, the extent and the developmental timing of these changes displayed pronounced tissue-specific variations. Lamin B2 was expressed in fairly constant amounts in all cell types investigated (except for pachytene-stage germ cells). These results have implications for the purported functional specializations of individual lamin proteins. In addition, they suggest that alterations in the composition of the nuclear lamina may be important for the establishment of cell- or tissue-specific differences in nuclear architecture. PMID- 3301872 TI - Autoradiographic study of regional protein synthesis in focal cerebral ischemia with TCA wash and image subtraction techniques. AB - The standard biochemical method of trichloracetic acid (TCA) wash and the image processing technique were combined to differentiate and visualize the distributions of polypeptide-incorporated and unincorporated tracers in an autoradiographic study of regional protein synthesis. The validity of applying TCA wash procedures to cryostat sections was considered by histologic and chemical evaluations. For the autoradiographic study of in vivo protein synthesis, a tracer dose of L-[14C]valine was administered 30 min after occlusion of the posterior communicating artery in gerbils. Images of total (polypeptide incorporated and unincorporated) radioactivity and of polypeptide-incorporated radioactivity were obtained from an identical cryostat section before and after TCA wash. The polypeptide-unincorporated radioactivity image was produced with an image processing system by subtracting pixel by pixel the polypeptide incorporated radioactivity from the total radioactivity. The present study clearly demonstrated that in spite of the sufficient delivery of tracer amino acids, the polypeptide synthesis was completely lost in the ischemic focus. Free tracer was markedly accumulated in the brain adjacent to the ischemic focus. This kind of autoradiographic technique seems to be indispensible in studying the topographical complexity of the altered protein metabolism in the pathologic brain. PMID- 3301873 TI - Tracer disposition kinetics in the determination of local cerebral blood flow by a venous equilibrium model, tube model, and distributed model. AB - Tracer distribution kinetics in the determination of local cerebral blood flow (LCBF) were examined by using three models, i.e., venous equilibrium, tube, and distributed models. The technique most commonly used for measuring LCBF is the tissue uptake method, which was first developed and applied by Kety (1951). The measurement of LCBF with the 14C-iodoantipyrine (IAP) method is calculated by using an equation derived by Kety based on the Fick's principle and a two compartment model of blood-tissue exchange and tissue concentration at a single data point (Sakurada et al., 1978). The procedure, in which the tissue is to be in equilibrium with venous blood, will be referred to as the tissue equilibration model. In this article, effects of the concentration gradient of tracer along the length of the capillary (tube model) and the transverse heterogeneity in the capillary transit time (distributed model) on the determination of LCBF were theoretically analyzed for the tissue sampling method. Similarities and differences among these models are explored. The rank order of the LCBF calculated by using arterial blood concentration time courses and the tissue concentration of tracer based on each model were tube model (model II) less than distributed model (model III) less than venous equilibrium model (model I). Data on 14C-IAP kinetics reported by Ohno et al. (1979) were employed. The LCBFs calculated based on model I were 45-260% larger than those in models II or III. To discriminate among three models, we propose to examine the effect of altering the venous infusion time of tracer on the apparent tissue-to-blood concentration ratio (lambda app). A range of the ratio of the predicted lambda app in models II or III to that in model I was from 0.6 to 1.3. In the future, there may be a need to determine which model should be used to calculate the LCBF based on this discriminator and to develop another discriminator by using multiple data points based on positron emission tomography. PMID- 3301874 TI - Therapeutic progress--review XXVI. Drug therapy for the acute leukaemias. PMID- 3301875 TI - Computer simulation as a teaching aid in pharmacy management--Part 1: Principles of accounting. AB - The need for pharmacists to develop management expertise through participation in formal courses is now widely acknowledged. Many schools of pharmacy lay the foundations for future management training by providing introductory courses as an integral or elective part of the undergraduate syllabus. The benefit of such courses may, however, be limited by the lack of opportunity for the student to apply the concepts and procedures in a practical working environment. Computer simulations provide a means to overcome this problem, particularly in the field of resource management. In this, the first of two articles, the use of a computer model to demonstrate basic accounting principles is described. PMID- 3301876 TI - [Heterotopic segmental autotransplantation of the pancreas with digestive system anastomosis in the dog]. AB - Segmental autotransplantation of pancreas in the heterotopic position, with digestive anastomosis protected by an epiploplasty was performed in a series of 22 dogs. Twenty dogs survived the operation and nine were followed up for 4 weeks: the histologic and morphologic qualities of the graft were very favorable from both endocrine and exocrine points of view. This morphohistologic quality can be related to the digestive anastomosis performed, which failed to provoke any specific complications to a large extent. This study should be completed by improvement in the vascularization of the graft by a splenic arteriovenous fistula and a concomitant study of the endocrine function of the transplanted pancreas in dogs with experimentally-induced diabetes. PMID- 3301877 TI - [Infected arterial aneurysms. Anatomo-clinical and surgical aspects apropos of 12 cases]. AB - Twelve cases of mycotic aneurysm are reported. These rare lesions (2 to 3% of all aneurysms) may affect all arteries. Primary aneurysm is currently the most frequent type observed in France, with onset being related to a bacteremia or septicemia with development on an atheromatous lesion (8 of the 12 cases in this series). Manifestations are often misleading or diagnosis delayed in relation to the infectious process, apart from in rupture, which is the commonest cause of detection of aneurysm (half of the present series). Ideal surgical treatment is exclusion with extra-anatomic revascularization: but revascularization in situ has been reported by many authors (6 of the 12 cases in this series). Localization of aneurysm determines surgical procedure and also very variable mortality rate: 4 of the 12 patients in this series. PMID- 3301878 TI - [Retroperitoneal liposarcoma. Clinical, prognosis and therapeutic aspects apropos of 4 cases]. AB - Four further cases of retroperitoneal liposarcoma are reported. Principal modes of revelation and diagnostic features are discussed, values of different complementary examinations evaluated, and prognostic factors and therapeutic elements of this serious affection outlined. PMID- 3301879 TI - The immunosorbtion of influenza virus nucleocapsids from cell lysates as a technique for the studies on viral RNA synthesis. AB - Radioimmunosorbtion of influenza virus nucleocapsids from lysates of the infected cells was applied for studies on virus-specific RNA synthesis. The method allowed the isolation of intact-labelled viral RNA segments. The procedure included preadsorbtion of antiviral antibodies on protein A containing sorbents. The protein A containing sorbent with attached antibodies was mixed with lysates of influenza virus-infected [3H]uridine-labelled cells. Viral nucleocapsids bound by the antibodies to the sorbent were used for RNA extraction. The isolated RNA was analysed by polyacrylamide gel electrophoresis with subsequent autoradiography. The method allows the isolation of nondegraded labelled virus-specific RNA by means of a relatively simple procedure. PMID- 3301880 TI - An improved immunoblotting procedure for the detection of antibodies against HIV. AB - Immunoblotting ('Western blotting') is routinely used for detection of antibodies against HIV in the diagnosis of HIV infection. We describe an improved procedure, which does not require virus purification and is easy to control for 'false positive' results. The technique also does not produce erroneous results due to reactivity of the developing system with residual cellular proteins or viral antigens and does not give high nonspecific background staining. The technique can be applied to the detection of antibodies to HIV in serum, plasma, and blood products. PMID- 3301881 TI - Quantitative studies of the hepatitis B viral pre-S proteins: lack of correlation with the HBeAg status. AB - Radioimmunoassays for the determination of the relative amounts of hepatitus B viral pre-S proteins present in serum samples have been developed which utilize antibodies against synthetic peptides corresponding to the amino termini of these proteins. The assays were shown to be sensitive and specific. These assays have been used to examine hepatitis B surface antigen positive human plasma samples for the presence and relative amounts of pre-S proteins. Contrary to previously published data, it was found that there is no correlation between the presence of the pre-S proteins and the HBeAg status of the plasma, but that the ability to detect the pre-S proteins is only a function of the hepatitis surface antigen titre of the plasma. It is concluded that the pre-S proteins would not serve as a useful marker for active viral replication. PMID- 3301882 TI - A short note on the history of the randomized controlled trial. PMID- 3301883 TI - Risk factor analysis of screening data. PMID- 3301885 TI - Principles and applications of monoclonal antibodies in pathology and laboratory medicine. PMID- 3301886 TI - Effects of disopyramide on insulin secretion in the perfusion of isolated rat pancreas in situ. PMID- 3301884 TI - The common mucosal immune system and current strategies for induction of immune responses in external secretions. AB - The selective induction of antibodies in external secretions is desirable for the prevention of various systemic as well as predominantly mucosa-restricted infections. An enormous surface area of mucosal membranes is protected primarily by antibodies that belong, in many species, to the IgA isotype. Such antibodies are produced locally by large numbers of IgA-containing plasma cells distributed in subepithelial spaces of mucosal membranes and in the stroma of secretory glands. In humans and in some animal species, plasma-derived IgA antibodies do not enter external secretions in significant quantities and systemically administered preformed IgA antibodies would be of little use for passive immunization. Systemic administration of microbial antigens may boost an effective S-IgA immune response only in a situation whereby an immunized individual had previously encountered the same antigen by the mucosal route. Local injection of antigen in the vicinity of secretory glands is usually accompanied by an undesirable concomitant systemic response and frequently requires the addition of adjuvants that are unacceptable for administration in humans. Immunization routes that involve ingestion or possibly inhalation of antigens lead to the induction of not only local but also generalized immune responses manifested by the parallel appearance of S-Iga antibodies to ingested or inhaled antigens in secretions of glands distant from the site of immunization. Based on extensive studies in animal models as well as in humans, convincing evidence is available that antigen-sensitized and IgA-committed precursors of plasma cells from GALT are disseminated to the gut, other mucosa associated tissues, and exocrine glands. However, due to the limited absorption of desired antigens from the gut lumen of orally immunized individuals, repeated large doses of antigens are required for an effective S-IgA response. Novel antigen delivery systems for the stimulation of such responses are currently being examined in several laboratories. Live attenuated or genetically manipulated bacteria expressing other microbial antigens have also been used for selective colonization of gut-associated lymphoid tissues. Unique antigen packaging and the use of adjuvants suitable for oral administration hold promise for an efficient antigen delivery to critical tissues in the intestine and deserve extensive exploration. The oral immunization route appears to have many advantages over systemic immunization.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3301887 TI - Novel color test for rapid detection of group A streptococci. AB - A novel color test for the rapid detection of group A streptococci has been developed. The test, designed to be suitable for use in clinical laboratories as well as by less experienced personnel, incorporates the simplicity of latex tests with a color change to indicate the presence of group A streptococcal antigen. The test, which takes 5 min, was evaluated with 646 throat swabs, with a 15.6% incidence of group A streptococci; for swabs which yielded 10 or more group A streptococcal colonies in cultures, the sensitivity was 96.8%, and the specificity was 99.1%. In addition, the color test was 100% sensitive and specific when used to detect group A streptococcal antigen in beta-hemolytic colonies from culture plates. PMID- 3301888 TI - Identification of group B streptococcal antigen with lectin-bound polystyrene particles. AB - The lectin of the tomato, Lycopersicon esculentum, or of the potato, Solanum tuberosum, can be passively coupled to amide-modified polystyrene spheres to be used as a detection reagent for the specific identification of group B streptococcal cultures grown in selective or nonselective Todd-Hewitt broth for 5 and 4 h, respectively. Agglutination occurred when the lectin reagents were allowed to react with either the cell suspension, clarified broth, or antigen extracts from group B streptococci grown in Todd-Hewitt broth. No agglutination occurred when these lectins were allowed to react with strains of serogroup A, C, D, F, or G streptococci. False-negative agglutination responses may occur with certain serotype of group B streptococci grown on Columbia sheep blood agar. A 20 min staining time permitted the specific labeling of fixed smears of group B streptococci with fluorescein-conjugated Lycopersicon lectin. The lectin from the solanaceous plant Datura stramonium did not agglutinate group B streptococci or other clinically significant streptococcal serogroups. PMID- 3301889 TI - New bacteriophage typing scheme for subdivision of the frequent capsular serotypes of Klebsiella spp. AB - A bacteriophage typing scheme for hospital isolates of Klebsiella spp. was developed. The scheme was designed specifically as a secondary typing method to discriminate between strains of serotypes K2, K3, and K21 but proved to be an efficient general typing method for strains of most serotypes. The set of 15 phages gave 87.3% typeability on 236 strains of more than 70 different serotypes. Typeability within the K2, K3, and K21 strains was 93, 89, and 91%, respectively. There was a mean of 3.2 reactions strain-1 for all phage-typeable strains. Of the serologically nontypeable strains, 76.7% were susceptible to one or more phages. The most common pattern accounted for only 7% of the strains. The lytic patterns were reproducible if strains were typed on the same day, but differences were observed if strains were stored for 1 week or more before retyping. A total of 96.5% of the strains were typeable by a combination of capsular serology and phage typing. PMID- 3301890 TI - Serodiagnosis of rabies by dot immunobinding assay. AB - A dot immunobinding assay that uses inactivated antigen for the detection of rabies viral antibodies was compared with the rapid fluorescent focus inhibition test. Results of testing pre- and postvaccination sera from humans (n = 33) and canines (n = 22) were identical for both tests. Endpoint titers of positive sera also were approximately the same by both methods. When a mouse monoclonal antibody was used, the dot immunobinding assay antigen was shown to possess detectable rabies virus glycoprotein and core antigens. PMID- 3301891 TI - Effects of cycloheximide and puromycin on cytotoxic activity of Escherichia coli verocytotoxin (Shiga-like toxin). AB - Verocytotoxin (VT)-producing Escherichia coli is closely associated with hemorrhagic colitis and hemolytic uremic syndrome. The diagnosis of this infection requires the demonstration of VT activity in fecal filtrates or the isolation of VT-producing E. coli from stools. To improve the sensitivity of the Vero cell assay for detecting VT, we investigated the interaction between this toxin and cycloheximide and puromycin, agents which, like VT and the related Shiga toxin, are protein synthesis inhibitors. Cycloheximide-treated cells were found to be about eightfold more sensitive to VT, this effect being most pronounced when the drug was added before the toxin. In contrast, puromycin treatment had an antagonistic effect in that it decreased the sensitivity of the cells to VT. In assays of VT in fecal filtrates, the addition of cycloheximide (at 4 to 8 micrograms/ml) increased the sensitivity without affecting the specificity of the assays. Likewise, the use of cycloheximide led to an increase in the sensitivity of the serum VT-neutralizing antibody test by a factor of over eightfold. PMID- 3301893 TI - Delivery volumes of the 1- and 3-mm pins of a Cathra replicator. AB - This study was undertaken to determine the volumes delivered by the 1- and 3-mm pins of a Cathra replicator and to evaluate reproducibility. The weight of broth transferred by these pins served to assess the delivery volume. Repeated transfers with the 1- and 3-mm pins showed, on average, a delivery of 0.1 and 2 microliters, respectively. PMID- 3301892 TI - Epidemic outbreak of Serratia marcescens infection in a cardiac surgery unit. AB - Between 2 February and 16 April 1985, an outbreak of Serratia marcescens infection involving 10 male patients occurred in a cardiac surgery unit. All the patients had surgical wound infection, five also had osteomyelitis (four sternal, one costal), and another had peritonitis secondary to peritoneal dialysis. Three patients had concomitant bacteremia. All Serratia strains isolated produced a cherry-red pigment, and all had the same biochemical and antibiotic susceptibility pattern. An intensive search for the origin of the outbreak was initially unsuccessful, and it proved impossible to isolate S. marcescens from cultures of numerous samples taken from hospital personnel and from the environment. The fact that all patients were male and had been shaved for surgery by the same team of barbers led us to investigate the shaving procedures. We finally isolated a strain of pigmented S. marcescens, corresponding to that involved in the outbreak, from samples taken from the hands and equipment of the barbers. After suitable action had been taken, the epidemic terminated. PMID- 3301894 TI - Inhibition of growth and swarming of Proteus mirabilis and Proteus vulgaris by triclosan. AB - The MICs of triclosan (2,4,4'-trichloro-2'-hydroxydiphenyl ether) and the effect on swarming were determined for 35 isolates of Proteus mirabilis and 7 isolates of P. vulgaris of animal origin. Both species were susceptible to the antimicrobial agent, and growth of all but one isolate was inhibited by less than 1 microgram/ml in broth and on agar without blood. Swarming was inhibited at triclosan concentrations two- to fourfold less than the MICs. Higher concentrations were required with blood agar than with plain agar for inhibition of growth and swarming. PMID- 3301896 TI - Stability of the hip joint after reduction of late-diagnosed congenital dislocation of the hip. AB - Nine children with late-diagnosed congenital dislocation of the hip underwent ultrasonography for determination of the influence of hip flexion on hip stability after reduction. No medication was used, and the investigation was performed in existing abduction splints during active movements of the leg. Redislocation of the joint was related to the minimal degree of flexion (120, 110, 100, or 90 degrees) permitted by the splint. All hips redislocated when flexion was less than 100 degrees. Five joints need 100 degrees and two 110 degrees of flexion for prevention of redislocation, and two hips required as much as 120 degrees. PMID- 3301895 TI - Kinetics study of immunological response to Clostridium botulinum toxin. AB - A double-antibody enzyme-linked immunosorbent assay (ELISA) for detection of humoral antibody to type A botulinal toxin was developed. This assay was used to study the kinetics of antibody response of a volunteer to botulinal toxoid. The circulating type A antitoxin was first detected by the ELISA 2 weeks after the first booster injection of the toxoid. The antibody titer stayed level until the second booster at 12 weeks. The titer then continued to rise throughout the remaining study period. The neutralizing antibody to type A toxin was detected by mouse assay 15 weeks after detection of antitoxin by the ELISA. PMID- 3301897 TI - Congenital scoliosis and urinary tract abnormalities: are intravenous pyelograms necessary? AB - One hundred patients with a diagnosis of congenital scoliosis were reviewed with regard to their urologic history, chemistries, and excretory urography. A 40% incidence of urologic abnormality was found in these asymptomatic patients. Twenty-five additional patients were evaluated by excretory urography and ultrasonography. Of six patients identified by ultrasonography as having abnormalities five had results confirmed by excretory urography. Urologic evaluation of all patients with congenital scoliosis is recommended; however, diagnostic ultrasonographic evaluations of the urinary tract have proven to be an acceptable alternative as an initial screening modality. PMID- 3301898 TI - Blount disease: a review of the English literature. AB - A review of the English literature on Blount disease (osteochondrosis deformans tibiae; tibia vara) revealed that two forms of the disease, infantile and adolescent, are recognized. The cause of Blount disease is probably multifactorial. Most recent evidence on the pathogenesis implicates mechanical factors. The diagnosis can be difficult in very young children and must be based on history, physical examination, and radiographic findings. A proximal tibial metaphyseal-diaphyseal angle of greater than 11 degrees should be observed carefully for the development of Blount disease. Both nonoperative and operative treatment has been used successfully. PMID- 3301899 TI - Skeletal muscle capillary density and fiber type are possible determinants of in vivo insulin resistance in man. AB - We have compared the capillary density and muscle fiber type of musculus vastus lateralis with in vivo insulin action determined by the euglycemic clamp (M value) in 23 Caucasians and 41 Pima Indian nondiabetic men. M value was significantly correlated with capillary density (r = 0.63; P less than or equal to 0.0001), percent type I fibers (r = 0.29; P less than 0.02), and percent type 2B fibers (r = -0.38; P less than 0.003). Fasting plasma glucose and insulin concentrations were significantly negatively correlated with capillary density (r = -0.46, P less than or equal to 0.0001; r = -0.47, P less than or equal to 0.0001, respectively). Waist circumference/thigh circumference ratio was correlated with percent type 1 fibers (r = -0.39; P less than 0.002). These results suggest that diffusion distance from capillary to muscle cells or some associated biochemical change, and fiber type, could play a role in determining in vivo insulin action. The association of muscle fiber type with body fat distribution may indicate that central obesity is only one aspect of a more generalized metabolic syndrome. The data may provide at least a partial explanation for the insulin resistance associated with obesity and for the altered kinetics of insulin action in the obese. PMID- 3301900 TI - Angiotensin II-noradrenergic interactions in renovascular hypertensive rats. AB - This study tested the hypothesis that interactions of endogenous angiotensin II (AII) with the noradrenergic neuroeffector junction are important in renin dependent hypertension. In the in situ blood-perfused rat mesentery, in normal rats exogenous AII potentiated mesenteric vascular responses to periarterial (sympathetic) nerve stimulation (PNS) more than vascular responses to exogenous norepinephrine (NE). In 2-kidney-1-clip (2K-1C) rats with renovascular hypertension mesenteric vascular responses to PNS and NE were greater than in sham-operated rats, and renovascular hypertension mimicked the effects of exogenous AII with respect to enhancing responses to PNS more than responses to NE. In 2K-1C rats, but not in sham-operated rats, 1-Sar-8-Ile-AII markedly suppressed vascular responses to PNS, without influencing responses to NE. Finally, 1-Sar-8-Ile-AII attenuated sympathetic nerve stimulation-induced neuronal spillover of NE in 2K-1C rats, but not in sham-operated rats. These data indicate that renovascular hypertension enhances noradrenergic neurotransmission, and that this enhancement is mediated in part by AII-induced facilitation of NE release. PMID- 3301901 TI - Scintigraphic distribution of complexes of antiinsulin antibodies and 123I insulin. In vivo studies in rats. AB - Clearance of immune complexes made of antiinsulin antibodies and 123I-insulin was studied with scintillation scanning in anesthetized rats. Complexes made with purified guinea pig antiinsulin IgG2 (cytophilic isotype) were rapidly cleared by the liver whereas those made with IgG1 remained in the plasma, as did 123I labeled IgG1 or IgG2 of control animals. Hepatic clearance of insulin-antiinsulin IgG complexes was not inhibited by either an excess of insulin or decomplementation, thereby ruling out interaction with insulin and C3b receptors. Insulin and guinea pig antiinsulin serum or its purified IgG isotypes formed large aggregates exceeding 5 IgG. Antiinsulin antibodies of diabetics, mostly IgG1 and IgG3 (cytophilic isotypes), formed complexes that either remained in plasma (small aggregates) or were cleared by the liver (large aggregates). In conclusion, clearance of insulin-antiinsulin IgG complexes is probably mediated by Fc gamma receptors on macrophages and requires cytophilic subclass composition and formation of large IgG aggregates. PMID- 3301902 TI - Influences of variation in total energy intake and dietary composition on regulation of fat cell lipolysis in ideal-weight subjects. AB - Weight-maintaining fat-rich, "prudent," carbohydrate-rich, as well as energy restricted diets (300 kcal/d) were fed in succession for 7 d to 12 healthy males of ideal body weight under metabolic ward conditions. At the end of each period isolated fat cells were prepared from subcutaneous abdominal adipose tissue and incubated in vitro in the absence or presence of adenosine deaminase, either alone or in combination with various lipolytic or antilipolytic hormones and agents. Variations in total energy intake and dietary composition had characteristic and specific effects on fat cell lipolysis in vitro. High carbohydrate and prudent diets resulted in low rates of nonstimulated glycerol release and impaired insulin action in the presence of adenosine deaminase (320 mU/ml). High-fat and energy restricted diets were characterized by high rates of nonstimulated glycerol release. Sensitivity of antilipolysis to insulin and prostaglandin E2 was 10 to 200 times lower respectively on energy-restricted than on fat-rich diets. The effects of alpha 2- and beta-adrenergic catecholamines and of N6-phenylisopropyladenosine were not affected by the preceding diets. PMID- 3301904 TI - Relaxation training through muscle stretching procedures: a pilot case. AB - The present paper introduces a relaxation procedure based upon muscle stretching exercises. Traditional progressive relaxation training starts from muscle tensing exercises to teach voluntary control of muscle tension, but the literature shows widely varying results. An alternative method of relaxation training starts from muscle stretching exercises. Muscle stretching provides sensation contrasts for learning relaxation in addition to fostering relaxation through the stretching of muscles. The present report documents the rationale for the procedure and presents data from a clinical case study, including six months' follow-up, in support of its efficacy. PMID- 3301903 TI - Recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) shortens the period of neutropenia after autologous bone marrow transplantation in a primate model. AB - The effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on hematopoietic reconstitution after autologous bone marrow transplantation was evaluated in a primate model. Animals were given a continuous intravenous infusion of recombinant human GM-CSF for several days both before and after transplantation or only after the transplant procedure. Marrow ablation was accomplished by total body irradiation. In both groups of animals, the neutrophil count reached 1,000/mm3 by 8-9 d posttransplant compared with an interval of 17 and 24 d for two concurrent controls. After withdrawal of GM-CSF, neutrophil counts fell to values comparable to those observed in untreated controls. Accelerated recovery of platelet production was also observed in four of the five animals. Two additional animals were initially given GM-CSF several weeks posttransplantation because of inadequate engraftment. Prompt and sustained increases in neutrophil and platelet counts were observed. We conclude that GM CSF may be useful in accelerating bone marrow reconstitution. PMID- 3301905 TI - Psychological treatments of dysmenorrhea: differential effectiveness for spasmodics and congestives. AB - Two studies are reported, examining the effectiveness of psychological treatments for dysmenorrhea. In Experiment 1, 33 women with spasmodic dysmenorrhea were treated with relaxation alone, or relaxation plus imagery, or assigned to a waiting-list control condition; and 29 women with congestive dysmenorrhea were treated with relaxation alone, or assigned to a waiting-list control condition. In Experiment 2, 18 additional congestives were treated with a coping skills package, or this package plus relaxation; these two groups were compared with the two congestive groups from Experiment 1. The dependent measures were reports of symptom severity, general discomfort, resting time, and medication use. Consistent with the literature, the main findings of the present studies are: (a) relaxation training (alone or with imagery) effectively reduces resting time for spasmodics; and (b) none of the treatments was shown to be effective for congestive sufferers. PMID- 3301906 TI - Colonic pericrypt sheath cells: characterisation of cell type with new monoclonal antibody. AB - A new monoclonal antibody, PR 2D3, was raised against a crude homogenate of normal colorectal mucosa and found to react with the cells in the pericrypt sheath. It also reacted with smooth muscle throughout the body and, in specific sites, with those mesenchymal cells known as myofibroblasts. It did not react with cardiac or skeletal muscle, nor with fibroblasts. PR 2D3 is an IgG1 antibody and identifies a membrane component of about 140 K molecular weight. The pericrypt cells have been described as fibroblasts, but in view of the specificity of PR 2D3 for smooth muscle, and its selective staining of the colonic pericrypt cells, this cell type was re-examined for other smooth muscle properties. Ultrastructurally, the cells had many characteristics in common with smooth muscle and were identical with the myofibroblasts of the umbilical cord. On immunocytochemical examination they were found to contain desmin, myosin, and filamin. The confirmation that the pericrypt cells are myofibroblasts suggest that they have both contractile and secretory roles. PMID- 3301907 TI - Circulating secretory component in breast neoplasms. AB - The serum concentrations of IgAp and IgMr associated secretory component (SIgA and SIgM) of 98 patients with neoplasms of the breast were measured. Of the 56 patients with carcinomas, 11 had increased concentrations of circulating SIgM, which was almost twice as sensitive as SIgA as a marker for carcinoma. Concentrations of circulating SIgA and SIgM were independent of expression of secretory component, IgA, and carcinoembryonic antigen (CEA); histological tumour grade; and tumour cell DNA ploidy, whereas a weak correlation between SIgA and SIgM and circulating CEA was seen. The three patients who had liver metastases indicated had particularly high concentrations of circulating SIgA and SIgM, whereas no difference was generally seen between patients with malignancy and those with benign tumours. PMID- 3301908 TI - Changes in plasma beta 2 microglobulin concentrations after allogeneic bone marrow transplantation. AB - Plasma concentrations of beta 2 microglobulin (B2M), the light chain of the class I major histocompatibility complex, were measured serially in 26 patients undergoing allogeneic bone marrow transplantation (BMT). The concentrations fell after conditioning treatment, and recovered when the marrow was transplanted. Bacterial infection did not influence B2M concentration, but nine of 22 episodes of acute graft versus host disease were associated with raised concentrations. Increased plasma B2M concentrations were also a feature of eight episodes of chronic graft versus host disease, and these fell after treatment. Reactivation of herpes simplex, varicella zoster, or cytomegalovirus infections were also accompanied by raised B2M concentrations. Three patients with cytomegalovirus pneumonitis had high concentrations of plasma B2M, the rise starting between five and 22 days before onset of symptoms. Although it is non-specific, serial measurement of plasma B2M in patients undergoing BMT may be clinically useful in monitoring chronic graft versus host disease. PMID- 3301909 TI - Isolation of Plesiomonas shigelloides from nutrient broth with brilliant green: its use in screening stool samples from an African population. AB - The suitability and selectivity of nutrient broth with bile salts and varying concentrations of brilliant green as an enrichment medium was tested for the isolation of Plesiomonas shigelloides from faeces. The broth was most effective at a concentration of 0.001 g/l brilliant green, using faeces deliberately contaminated with Plesiomonas. Two hundred and nineteen faecal samples from Nigeria were then examined for the presence of Plesiomonas and other bacterial pathogens. One yielded Plesiomonas following enrichment in bile salts brilliant green broth (BBG broth) whereas no samples were positive on direct plating. PMID- 3301910 TI - Rapid immunofluorescence staining of human renal biopsy specimens using microwave irradiation. PMID- 3301911 TI - Isolation of Campylobacter: what are we missing? PMID- 3301912 TI - Development of gingivitis around different types of composite resin. AB - Earlier studies have demonstrated signs of gingivitis around conventional composite resin restorations. Newly developed resin types differ considerably in composition and surface characteristics. The purpose of this study was to compare the initiation of gingival inflammation around aged restorations of 3 types of composite resins and around enamel, during a 7-day period of experimental gingivitis. Plaque index, gingival index and crevicular exudate were registered at days 0 and 7. There was significantly less exudate around the intact enamel surfaces than around the composite fillings at both registration times. The plaque and gingival indices showed no significant differences among the composite resins and enamel. The results indicate that differences among the resins with regard to surface roughness and composition did not result in clinically measurable differences in the development of plaque and gingivitis. PMID- 3301913 TI - The effects of a 0.2% chlorhexidine gluconate mouthrinse on plaque, toothstaining and candida in aphthous ulcer patients. A double-blind placebo-controlled cross over study. AB - Despite the known effectiveness of 0.2% chlorhexidine gluconate mouthwash in preventing plaque formation, relatively few studies have assessed adjunctive benefit to normal unsupervised oral hygiene measures. Furthermore, there have been few accurate measurements of toothstaining in the presence of normal oral hygiene and little data of effects on oral candidal carriage. This study was a double-blind placebo-controlled cross-over study of a 0.2% chlorhexidine gluconate mouthwash used 3 times daily on plaque, staining and candidal carriage in a group of recurrent aphthous ulcer suffers who maintained normal oral hygiene measures. At the end of 2 6-week treatment periods, baseline plaque scores were reduced by active and placebo mouthwashes. Chlorhexidine significantly reduced plaque compared to the placebo. Staining has markedly and significantly increased during chlorhexidine rinsing. Candidal carriage was present in 22.2% of this group and there was no significant effect of chlorhexidine on the mean number of candidal colonies. The distribution of plaque and staining by tooth was plotted and observationally studied. Baseline and placebo treatment plaque distributions indicated the considerable relevance of toothbrushing behaviour for plaque distribution. The effects of toothbrushing on plaque distribution were minimised during the use of chlorhexidine. Staining associated with chlorhexidine showed a distribution again suggesting the influence of toothbrushing. In conclusion, chlorhexidine has significant adjunctive effects on plaque inhibition in the presence of normal unsupervised oral hygiene, but toothbrushing did not prevent toothstaining. PMID- 3301914 TI - Dentine hypersensitivity. The effects in vitro of acids and dietary substances on root-planed and burred dentine. AB - Evidence indicates that teeth exhibiting cervical dentine hypersensitivity have open dentinal tubules at the dentine surface. The identification of factors which render dentine exposed and tubules open is important both to the prevention and management of dentine hypersensitivity. In this study, recently extracted teeth were root planed or burred to expose the root dentine. Specimens were horizontally sectioned and then using the apical portion as control, the coronal portions placed in a variety of strong and weak acids and dietary fluids. Examination under the scanning electron microscope revealed a smear layer covering completely underlying tubules on the control root planed or burred portions. Test portions exposed to strong and weak acids showed loss of the smear layer and exposure of large numbers of tubules. Formic and tannic acids produced no changes. Some dietary fluids, in particular red and white wine, citrus fruit juices, apple juice and yogurt produced similar etching effects to the acids. The low pH carbonated drink, coca-cola, and a blackcurrent cordial produced no effects. The results of this study in vitro cannot necessarily be extrapolated to the clinical situation, but suggest that certain dietary factors could play a role in the aetiology of dentine hypersensitivity. Dietary advice to patients may prove important in the management of this often recurrent condition. PMID- 3301916 TI - The effect of plaque control after scaling and root planing on the subgingival microflora in human periodontitis. AB - The aim of the present study was to evaluate the effect of a strict supragingival plaque control regimen on bacterial repopulation following scaling and root planing. 7 patients with moderate to severe inflammatory periodontal disease received a full-mouth scaling and subgingival curettage. Using a split-mouth design, 2 sites of opposite quadrants were submitted to professional supragingival plaque control 3 X a week while the contralateral sites served as controls. Clinical and bacterial examination were performed on days 7, 14, 28, 49, 56, 63 and 70 following therapy. All clinical parameters (P1I, GI, probing depth, attachment levels) showed significant improvement after scaling and root planing. Shifts in the subgingival bacterial population observed by dark field were also noticed following curettage: there was a decrease in the proportions of spirochetes and motile rods and an increase in that of coccoid cells. However, bacterial distribution tended to return to base line values towards the end of the observation period. No difference in the pattern of bacterial recolonization of the subgingival area could be detected between the sites under strict supragingival plaque control and the control sites. PMID- 3301915 TI - Clinical efficacy of listerine in inhibiting and reducing plaque and experimental gingivitis. AB - 103 adult subjects completed a supervised 2-week double-blind controlled clinical study to determine the effect of using either listerine antiseptic (LA) or its vehicle control (VC), as the only oral hygiene procedure, in inhibiting the development of and in reducing plaque and experimental gingivitis. Following baseline examinations, half-mouth prophylaxes were performed on each subject, who continued normal oral hygiene and returned 4 or 5 days later for a second baseline. Subjects then rinsed, under supervision, either 2 or 4 times daily for 2 weeks with LA or twice daily with VC, but suspended all other oral hygiene measures. Plaque and gingivitis were evaluated at baselines and after 2 weeks. Subjects using LA 2 or 4 times a day as the only oral hygiene procedure for 2 weeks demonstrated highly significant inhibition and reduction of both supragingival plaque and gingival inflammation compared to those using VC. PMID- 3301917 TI - Localization of choline acetyltransferase-like immunoreactivity in the embryonic chick retina. AB - Putative sites of acetylcholine synthesis in the retina of the embryonic and posthatched chick were localized immunohistochemically with antisera to choline acetyltransferase; the resultant choline acetyltransferase-like immunoreactivity (ChAT-IR) was compared to demonstrated sites of acetyltransferase (AChE) activity, and changes were followed in localization during development. The results confirmed the early and rapid course of development of the chick's retinal cholinergic system described in previous biochemical and morphological studies. Immunoreactivity was first detected at embryonic day 6.5 in cells close to the retina's vitreal surface. By 8 days it was present in cells in two juxtaposed rows; by the ninth day the two rows were separated and immunoreactivity was evident in two subliminae of the inner plexiform layer. On the tenth day distribution was like that in the posthatched chicken, in type I cholinergic cells in the inner nuclear layer and in type II cells in the ganglion cell layer (Millar et al.: Neurosci. Lett. 61:311-316, '85), and similar to that of most vertebrates. Three days before hatching, a third population of weakly immunoreactive cells (type III cells) appeared within the inner nuclear layer. The onset of localizable ChAT-IR occurred in amacrine cells and in their processes, before the period of synaptogenesis. Acetylcholinesterase activity was localized at an earlier age than ChAT-IR, and at all ages was present in more cells. The results obtained support the view that "displaced" cholinergic amacrine cells begin to differentiate at the same time and in the same retinal region as type I cholinergic cells. Separation of the two groups is a consequence of the ramification of processes of amacrine and ganglion cells rather than a result of the secondary migration of cells between layers. PMID- 3301918 TI - Distribution of neurotensin-like immunoreactivity in the diencephalon of the Japanese monkey (Macaca fuscata). AB - The distribution of neurotensin-like immunoreactive (NT-LI) neurons was examined in the thalamus and hypothalamus of the Japanese monkey (Macaca fuscata) by using the peroxidase-antiperoxidase immunocytochemistry technique. In the thalamus, NT LI neuronal perikarya were distributed mainly in the midline nuclear group and the dorsomedial nucleus, and partially in the intralaminar nucleus: Immunoreactive fibers were mainly distributed in the midline nucleus, particularly in the nucleus rhomboidalis. Numerous immunoreactive fibers were also detected in the regions that contain the pathways to extrathalamic areas such as the stratum zonale and inferior thalamic peduncle. In the hypothalamus, many immunoreactive neuronal perikarya were distributed in the lateral hypothalamic area and in the arcuate nucleus. Immunoreactive fibers were disseminated throughout the hypothalamus, but they were dense in the preoptic area and sparse in the ventromedial nucleus. An accumulation of dense immunoreactive endings was also observed in the external layer of the median eminence. NT-LI fibers in the external layer of the median eminence were considered to represent nerve endings near portal vessels. Functional roles of neurotensin in the thalamus and hypothalamus are discussed from the anatomical point of view. PMID- 3301919 TI - Morphometric analysis of serotoninergic bipolar cells in the retina and its implications for retinal image processing. AB - The entire population of retinal serotoninergic bipolar cells in the turtle Pseudemys scripta elegans was labeled by immunocytochemical methods. This allowed a systematic analysis to be made of the morphological variabilities among a functionally homogeneous neuronal population. The analyzed morphological characteristics included: size of the Landolt club, size of the soma, lateral extension of the ramification within the outer plexiform layer, course of the axon across the inner nuclear layer, pattern of the axonal ramification within the inner plexiform layer, lateral extension of these ramifications, and density of the cells. Whereas characteristics 1-4 and 7 show a morphological variability strictly related to the location of the bipolar cell with respect to the visual streak, a fovealike structure, characteristics 5 and 6 show no such correlation. The size of the soma increases by a factor of 4 from the visual streak toward the periphery. The area covered by the ramification in the OPL increases from 330 micron 2 at the visual streak to 50,000 microns 2 at the dorsal and ventral edges of the retina. The coverage factor remains the same throughout the retina, as well as the area covered by the ramifications in the IPL, which is about 2,000 microns 2. At the visual streak and at 110 degrees ventral and 68 degrees dorsal of the visual streak, the bipolar axons cross the INL perpendicularly. In between the axons take an oblique course leading to an axon-induced shift between input and output of up to 250 microns.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3301920 TI - GABA immunoreactive neurons in rat visual cortex. AB - An antiserum to gamma-aminobutyric acid (GABA) was used in a light and electron microscopic immunocytochemical study to determine the morphology and distribution of GABA-containing neurons in the rat visual cortex and to ascertain whether all classes of nonpyramidal neurons in this cortex are GABAergic. The visual cortex used for light microscopy was prepared in such a way that the antibody penetrated completely through tissue sections, and in these sections large numbers of GABA immunoreactive neurons were apparent. The labeled neurons could be identified as being either multipolar, bitufted, bipolar, or horizontal neurons. In layers II through VIa, GABA immunostained cells were distributed uniformly and accounted for approximately 15% of all neurons, but in layer I all neurons appeared to be immunostained. Electron microscopy of GABA immunostained visual cortex prepared to ensure good fine structural preservation confirmed the presence in layers II through VIa of numerous immunoreactive bipolar neurons, both small and large varieties, as well as multipolar and bitufted neurons. Additionally, electron microscopy reveals that astrocytes are frequently GABA immunoreactive. From a correlated light and electron microscopic evaluation of neurons in GABA immunostained visual cortex, it was possible to confirm which kinds of neurons are GABAergic and what proportion of the neuronal population they represent. Thus, from an analysis of some 950 neurons, it was found that pyramidal neurons were never immunoreactive and that except for 20% of the bipolar cell population, all examples of other types of nonpyramidal neurons encountered in this material were GABA immunoreactive. PMID- 3301921 TI - Mapping study of serotoninergic input to diencephalic-projecting dorsal column neurons in the rat. AB - Several lines of evidence indicate that the processing of somatosensory information in the dorsal column nuclei (DCN) is subject to descending controls. Anatomical experiments have demonstrated projections to the DCN from the sensorimotor cerebral cortex and the reticular formation. Physiological studies have shown that the activity of DCN neurons can be altered following stimulation of the cerebral cortex, reticular formation, periaqueductal gray, or raphe nuclei. Recent biochemical and electrophysiological evidence suggests a serotoninergic modulation of DCN neurons. The present study identifies serotonin containing contacts on cells in the DCN that project to the thalamus in the rat. Retrograde labeling of brainstem neurons by horseradish peroxidase demonstrated projections to the DCN from the nucleus reticularis paragigantocellularis lateralis and from several raphe nuclei, including nuclei raphe obscurus (RO), pallidus (RP), and magnus (RM). Double labeling with horseradish peroxidase and antibody for serotonin indicated that the RO, RP and RM are likely to be the sources of the serotoninergic projections to the DCN. Thus, the role of the serotoninergic output from the raphe nuclei includes modulation of activity in the DCN. PMID- 3301922 TI - Computerized dermatopathologic diagnosis. AB - A practical, transferable microcomputer system for differential diagnosis in dermatopathology, called TEGUMENT, has been developed for use by dermatologists on the standard IBM PC, Compaq, and other compatible personal microcomputers. In an interactive computer program a set of information is abstracted from the microscopic study of each specimen by a dermatologist, to compare with a structured knowledge base. The process leads through a relevant sequence of descriptive phrases until the findings can be allocated to a disease class. The microscopic description and diagnosis are then combined with clinical information by the computer and printed, optionally, as a pathology report. The identification and diagnosis of each case are preserved in permanent memory to enable future search and sorting. The results of independent validation are that a pathologist made the same diagnosis as the machine or a similar differential diagnosis in 91.8%, disagreed in 4.8%, and was unable to make a diagnosis from the description furnished by the machine in 3.4% of 147 actual cases. We conclude that a certain critical minimum of information is required for objective diagnosis; more information is needed for definitive than for differential diagnosis; a characteristic feature is necessary to distinguish between differential diagnoses; an objective description may admit of more than one diagnosis; ambiguity may be reduced by presenting for consideration all distinguishing features that characterize closely related diagnoses; and the personal microcomputer, programmed in this way, is of considerable assistance to the dermatologist in the histopathologic diagnosis of diseases and neoplasms of the skin. PMID- 3301923 TI - Comparative trial of a two-dosage schedule of ketoconazole 2% cream for the treatment of tinea pedis. AB - Sixty-two patients with mycologically confirmed tinea pedis received two different treatment regimens of ketoconazole 2% cream on a randomized double blind basis for 1 month with weekly evaluations. A 4-week posttreatment follow-up permitted an assessment of recurrence or improvement. After 1 month of treatment, 90% of the patients treated once daily responded clinically, in comparison with 83% of those treated twice daily. The cure rate was 63% for the once-daily and 60% for the twice-daily group. This rate substantially improved at follow-up (77% and 73%, respectively). One patient from each group discontinued therapy for an adverse reaction. On the basis of both clinical and mycologic assessments, topical treatment with ketoconazole 2% cream was effective as a once-daily therapy. PMID- 3301924 TI - Alopecia areata, endocrine function, and autoantibodies in patients 16 years of age or younger. AB - Forty-five children with alopecia areata were prospectively studied by means of both clinical and laboratory evaluation for evidence of endocrine diseases and autoantibodies. Twenty-four percent had an abnormality as determined by one or more thyroid function studies (thyroxine, triiodothyronine, and thyroid stimulating hormone) and/or elevation of microsomal antibody levels. In 16%, smooth muscle antibody was present, and in 4%, parietal cell antibody was present. Routine thyroid function testing is recommended for all children with alopecia areata. PMID- 3301925 TI - Weekly psoriasis therapy using intralesional fluorouracil. AB - We report the use of weekly intralesional fluorouracil for treatment of entire psoriatic papules and portions of larger psoriatic plaques. Eleven patients participated and responded, with an average of 4.2 cm2 clearing about the injection site in the treated lesions, in comparison with no improvement in the control lesions. We injected 1 ml of fluorouracil (50 mg/ml) to form an intradermal wheal of about 0.8 cm2. Each patient received one to three injections at 1- to 2-week intervals, with an average of two injections per patient. The earliest signs of improvement occurred at 2 weeks; maximum clearing was achieved usually about 4 weeks after treatment began. At 3-month follow-up, four of the nine patients who had favorable response to treatment remained substantially in remission. Toxic effects were limited to local hyperpigmentation in seven patients, slight irritation in two patients, and moderate irritation in one patient. No systemic toxic effects were shown. Weekly pulse doses of fluorouracil given intralesionally instead of topically can greatly speed up response to therapy and can produce similarly good results. Intralesional administration of fluorouracil is locally effective, is often of long-term benefit, and can be tolerated well. PMID- 3301926 TI - Topical minoxidil in male pattern baldness: effects of discontinuation of treatment. AB - Ten men with male pattern baldness who had been treated with 2% or 3% minoxidil for at least 4 months were evaluated for any changes in scalp hair growth on and off drug. Objective assessments by hair counts showed a mean doubling of nonvellus target scalp hairs on topical minoxidil and loss of most of these recruited hairs when the drug was discontinued. Four of ten men had nonvellus hair counts off topical minoxidil that fell below baseline levels. Thus, hair growth on topical minoxidil is not sustained when the drug is discontinued. PMID- 3301927 TI - Aggressive digital papillary adenoma and adenocarcinoma. A clinicopathological study of 57 patients, with histochemical, immunopathological, and ultrastructural observations. AB - Fifty-seven examples of a rare eccrine sweat gland tumor (aggressive digital papillary adenoma and adenocarcinoma) were studied by means of light microscopy, electron microscopy, and immunoperoxidase techniques. The neoplasm occurred as a single, painless mass, almost exclusively on the fingers, toes, and adjacent skin of the palms and soles. Microscopic features were distinct from those of other eccrine sweat gland tumors and often led to the diagnosis of such metastatic carcinoma as that of the breast. The characteristic histologic features included tubuloalveolar and ductal structures with areas of papillary projections protruding into cystic lumina. The stroma varied from thin, fibrous septae to areas of dense, hyalinized collagen. Forty tumors were classified as adenoma (ADPA) and 17 as adenocarcinoma (ADPAca). Histologically, ADPAca was distinguished from ADPA by its poor glandular differentiation and by necrosis, cellular atypia and pleomorphism, invasion of soft tissue and bone, and invasion of blood vessels. Eighteen (50%) patients with ADPA and 8 (47.0%) who had ADPAca developed recurrent lesions (2 months to 9 years) after surgical removal of the tumor. Seven (41.2%) patients with ADPAca developed metastases, of which 5 involved the lung. Three patients died of metastases, 5 to 20 years after surgical treatment of the primary tumor. The histologic malignant features in ADPAca are indicative of potential for distant metastasis and fatality. The recognition of aggressive digital papillary adenoma and adenocarcinoma as a distinct clinicopathological eccrine sweat gland neoplasm is important because of the potential for aggressive local growth and distant metastasis. PMID- 3301928 TI - Peanut agglutinin immunohistochemistry of basal cell carcinoma. AB - 103 biopsies of basal cell carcinomas (BCCs) were studied using peanut agglutinin (PNA), PNA antibody and the peroxidase-antiperoxidase technique; 53 specimens of various skin tumors were examined as controls; 96% of the BCCs showed a band-like peritumorous reaction not seen in any other tumor except for the Pinkus' fibroepithelioma. The peritumorous PNA-binding was continuous in 51% of the BCCs studied and discontinuous in 45%; only 4% were completely negative. Both fibroepitheliomas revealed a discontinuous PNA-positive band. A narrow basement membrane-like positivity was seen around some small hair follicles situated within 2 neurofibromas and under one seborrhoeic keratosis. The PNA-binding band is apparently neither fibronectin, laminin, Type IV or Type V collagen and is not a constituent of normal epidermal, adnexal and vascular basement membranes. PMID- 3301929 TI - Comparison of dry culture medium and conventional plating techniques for enumeration of bacteria in pasteurized fluid milk. AB - Standard plate counts, psychrotrophic bacterial counts, and coliforms were determined by conventional plating techniques and by Petrifilm TM plates, a dry culture medium, for 48 commercially processed milk samples (24 whole milk and 24 skim milk). The Petrifilm SM plate counts were compared with counts on standard methods agar for the standard plate count, psychrotrophic bacterial count, and rapid psychrotrophic bacterial count. The Petrifilm violet red bile plate counts were compared with counts on violet red bile agar for coliform test with a solid medium and the preliminary incubation method for detection of coliforms. Standard plate counts were determined within 24 h of packaging and after 7, 10, and 14 d of storage at 6.1 degrees C. Psychrotrophic bacterial counts and coliform counts were determined with 24 h of packaging and after 7 d storage. There was a strong linear relationship between Petrifilm SM and standard methods agar plates (excluding counts on samples plated within 24 h of packaging) and for the psychrotrophic bacterial count method. Petrifilm SM had a weak linear relationship with Standard Methods Agar plates for the rapid psychrotrophic bacterial count. Coliform counts determined on Petrifilm violet red bile plates were generally within the same range as counts on violet red bile agar plates. The positive predictive values for the Petrifilm violet red bile plates and violet red bile agar plates were essentially the same for samples plated within 24 h of packaging. PMID- 3301930 TI - Growth responses of Staphylococcus aureus and Streptococcus agalactiae to Corynebacterium bovis metabolites. AB - Staphylococcus aureus and Streptococcus agalactiae growth responses to metabolites of Corynebacterium bovis cultured in media containing polyoxyethylenesorbitan monolaurate, monooleate, or trioleate and milk were determined. Filter sterilized metabolites of 48-h C. bovis cultures in synthetic media were added to cultures of Staph. aureus and Strep. agalactiae. Staphylococcus aureus and Strep. agalactiae were inoculated into 12-h C. bovis milk cultures. Growth responses of Staph. aureus and Strep. agalactiae were not affected by C. bovis metabolites of synthetic media. Staphylococcus aureus growth was inhibited during logarithmic and stationary phases in milk containing mixed cultures of C. bovis compared with growth in pure Staph. aureus cultures. Streptococcus agalactiae growth curves were similar in pure and C. bovis mixed cultures. Fatty acid compositions were not different in sterile milk and milk containing bacterial cultures. Growth responses of Staph. aureus and Strep. agalactiae were not related to concentration of C. bovis metabolites or fatty acid content of media in which C. bovis were cultured. PMID- 3301931 TI - Indirect dental laminate veneers--an overview. PMID- 3301932 TI - Dental materials: 1984-85 literature review. Part 2. PMID- 3301933 TI - A comparative study of the effects of dentinal bonding agents and application techniques on marginal gaps in Class V cavities. AB - The effectiveness of eight dentinal bonding agents (DBA's) and four of their combinations in eliminating marginal gaps in class V cavities was evaluated by the bulk method of composite application and two different incrementation techniques. The cavities were prepared one-half in enamel and one-half in dentin. Basic fuchsin 0.5% in propylene glycol was used for detection of the presence of gaps. For each cavity, the presence of gaps was scored as 0 or 1, at five enamel and five dentin locations. Marginal gaps were present in 6% of all enamel locations and in 75% of all dentin locations investigated. The gap frequency was lowest at the enamel occlusal locations, it increased gradually toward the dentin, and attained the highest value at the gingival locations. In enamel, the occurrence of gaps was dependent on the DBA's but independent of the particular technique used. In dentin, there was significant difference in gap occurrence between DBA's with any of the incrementation techniques. The frequency of gap occurrence was not significantly changed by the incrementation techniques. The most effective single agent in producing gap-free restorations was the Gluma, and the most effective combination was the Gluma/Clearfil. PMID- 3301934 TI - Fluoride in dental products: safety considerations. AB - This review summarizes the nature of acute fluoride toxicity, its time-course, and the fluoride doses that are involved. The generally accepted "certainly lethal dose" range for 70 kg adults, i.e., from 5 to 10 g of sodium fluoride or from 32 to 64 mg fluoride/kg, is discussed. Based on recent case reports of fluoride-induced fatalities, it is concluded that this dose range has little utility in cases involving young children. The concept of a "probably toxic dose" (PTD) is advanced. The PTD, 5.0 mg F/kg, is defined as the dose of ingested fluoride that should trigger immediate therapeutic intervention and hospitalization because of the likelihood of serious toxic consequences. The concentrations and quantities of fluoride in selected dental products are discussed in relation to the PTD. It is concluded that, as these products are currently packaged, most of them contain quantities of fluoride sufficient to exceed the PTD for young children. Recommendations are made to reduce the risk of toxicity associated with their use. PMID- 3301935 TI - The neurobiology of facial and dental pain: present knowledge, future directions. AB - This review outlines recent research which has identified critical neural elements and mechanisms concerned with the transmission of sensory information related to oral-facial pain, and which has also revealed some of the pathways and processes by which pain transmission can be modulated. The review highlights recent advances in neurobiological research that have contributed to our understanding of pain, how acute and chronic pain conditions can develop, and how pain can be controlled therapeutically. Each section of the review also identifies gaps in knowledge that still exist as well as research approaches that might be taken to clarify even further the mechanisms underlying acute and chronic oral-facial pain. The properties of the sense organs responding to a noxious oral-facial stimulus are first considered. This section is followed by a review of the sensory pathways and mechanisms by which the sensory information is relayed in nociceptive neurones in the brainstem and then transmitted to local reflex centers and to higher brain centers involved in the various aspects of the pain experience--namely, the sensory-discriminative, affective (emotional), cognitive, and motivational dimensions of pain. Reflex and behavioral responses to noxious oral-facial stimuli are also considered. The next section provides an extensive review of how these responses and the activity of the nociceptive neurones are modulated by higher brain center influences and by stimulation of, or alterations (e.g., by trauma) to, other sensory inputs to the brain. The neurochemical processes, involved in these modulatory mechanisms are also considered, with special emphasis on the role of neuropeptides and other neurochemicals recently shown to be involved in pain transmission and its control. The final section deals with recent findings of peripheral and central neural mechanisms underlying pain from the dental pulp. PMID- 3301936 TI - An expert system for oral diagnosis. AB - Although dentists are beginning to use computers in their offices for billing, insurance, and word processing, applications in computer-assisted diagnosis have not developed as rapidly. In medicine, use of computer-assisted techniques leads to more accurate and timely diagnoses and improves the quality of patient care through reduction in morbidity and increased physician interaction with patients. This article describes and discusses a system which, though developed for medical diagnosis, has very real applicability in dentistry. This PC-based, expert system takes variable input from the patient and links it with a large fixed database that is designed to deal with a specific patient problem. Output in the form of suggested causes and/or management options is delivered to the practitioner. Several modules have been developed and are ready for clinical use. The module "Periapical Radiolucency" will be described in this article to illustrate some of the characteristics of this system. PMID- 3301937 TI - The evolution of skin graft reconstruction. PMID- 3301938 TI - Techniques for split-thickness skin grafting. AB - This article discusses split-thickness skin grafting techniques with emphasis on the use of various electric dermatomes. Indications for grafting, donor and recipient site considerations, as well as complications will be discussed. PMID- 3301939 TI - Refinements in split-thickness skin grafting technique. AB - Modifications for split-thickness grafting techniques are discussed, including the use of incontinuity, semipermeable, biologic dressings during harvesting, spiral basting sutures for graft attachment, and meshing to increase graft coverage. PMID- 3301940 TI - Skin grafting: perioperative technique and management. AB - The transfer and successful "take" of a full-thickness skin graft depends on the critical, early events leading toward graft revascularization. The paper discusses and illustrates operative technique as well as methodology of wound care and dressing design directed toward achieving such a goal. PMID- 3301941 TI - The technique and current status of pinch grafting. AB - Small split-thickness skin grafts, also known as pinch grafts, can provide an effective form of therapy for recalcitrant ulcers of the skin. Several of the new surgical dressings can be combined with the traditional pinch grafting technique to shorten the time for the development of granulation tissue within a clean ulcer base and improve the survival of the grafts themselves. This paper will summarize the surgical technique employed in pinch grafting. PMID- 3301942 TI - Contouring of donor skin in full-thickness skin grafting. AB - Different areas which are multiply contoured require individualized approaches to reconstruction. The contouring of the donor skin specimen is important to the final appearance of full-thickness skin grafts. Graft-bed contours can be matched by trimming the reverse contour on the underside of the donor specimen. The reconstruction of defects on the nasal tip, lateral nose and ala, helical rim of the ear, and eyelid and medial canthal areas are discussed. PMID- 3301943 TI - Surgical treatment of livedo vasculitis. AB - Surgical treatment for livedo vasculitis as a primary approach is not mentioned in the literature. A young female patient suffering from livedo vasculitis (atrophie blanche) was admitted with huge ulcerations and pre-ulcerative, infarcted skin areas of both feet and ankles. The lesions were promptly excised and skin grafted with excellent results. The course of treatment, including several surgical procedures, is described. PMID- 3301944 TI - Simplified surgery with surgical punches. AB - Expedient and simple surgery with excellent cosmetic results can be accomplished by use of Robbins punches. Techniques for excision of very small basal cell carcinomas from the nose, with and without grafting, and rapid excision of multiple lesions such as dysplastic nevi are outlined. PMID- 3301945 TI - Transition and isolation ratios of dermatophytes from house dust of patients with tinea. PMID- 3301946 TI - Increased densities of Langerhans cells in the epidermis of skin tumors. PMID- 3301947 TI - Enhancement of monocyte chemotactic activity in the sera of psoriatic patients after heat treatment. PMID- 3301948 TI - Status of histoid leprosy--a clinical, bacteriological, histopathological and immunological appraisal. PMID- 3301949 TI - Annular elastolytic giant cell granuloma: an unusual case with lesions arising in non-sun-exposed areas. PMID- 3301951 TI - Papulonecrotic tuberculid--report of a case. PMID- 3301950 TI - Treatment of psoriasis vulgaris with oral 1 alpha,25-dihydroxyvitamin D3--report of two cases. PMID- 3301953 TI - Reactive perforating collagenosis--a case report. PMID- 3301952 TI - Disseminated atypical granuloma annulare. PMID- 3301954 TI - Localized pemphigoid: a case report showing in situ deposition as well as presence in serum of IgG and IgA anti-basement membrane zone antibodies. PMID- 3301955 TI - Surgical treatment of a deep fungal infection of the skin by Trichosporon cutaneum. PMID- 3301956 TI - An epithelioma with hair follicle and apocrine differentiation. PMID- 3301957 TI - Solitary angiokeratoma seen in a patient with pretibial epidermolysis bullosa. PMID- 3301958 TI - A time course study of the proliferation of sebaceous glands induced by topically applied tetradecane in rabbit pinna skin: autoradiography and electron microscopy. PMID- 3301959 TI - Fine structural arrangement of fibrous stroma around dermal capillaries. PMID- 3301960 TI - PNA-binding sites in sebaceous tumors. PMID- 3301962 TI - KID syndrome: congenital ichthyosiform dermatosis with keratitis and deafness- report of the first case in Japan. PMID- 3301961 TI - T-cell subsets and NCI (nuclear contour index) of their skin infiltrates in mycosis fungoides (MF)--a comparison of pre-and post-treatments using ACNU [1-(4 amino-2 methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl-3-nitrosourea)] and interferon alpha and the effectiveness of interferon alpha on Sezary cells in vitro. PMID- 3301963 TI - A case of scabies complicated by acute glomerulonephritis. PMID- 3301964 TI - Four primary malignant tumors, including malignant melanoma and malignant lymphoma, in the same adult patient. PMID- 3301965 TI - Immunocyte derived amyloidosis. PMID- 3301966 TI - A case of trichilemmal cyst on the leg. PMID- 3301967 TI - Multiple ulcers with heavy colonization of Candida albicans on the napkin area of an elderly individual. PMID- 3301968 TI - Congenital self-healing reticulohistiocytosis (Hashimoto-Pritzker): a case report with a solitary lesion. PMID- 3301969 TI - The concept of a critical oxygen delivery. AB - In healthy tissues, decreases in oxygen delivery (QO2 = cardiac output X arterial O2 content) do not lower oxygen consumption (VO2) because tissue O2 extraction increases proportionately. When delivery is reduced below a critical threshold, VO2 falls because tissue extraction exceeds a critical threshold, and cannot compensate for the reduction in delivery. In the adult respiratory distress syndrome and perhaps in septicemia, tissue extraction capacity is impaired, leading to O2 supply dependency despite normal or increased overall delivery. This pathologic supply dependency could be caused by a loss in autoregulatory capacity, by disrupted blood flow distribution secondary to peripheral microembolization, or to other factors interfering with efficient tissue distribution of QO2 with respect to VO2. Alternatively, the increased VO2 may be consumed in biochemical pathways not associated with ATP production, or in the production of oxygen radicals or hydrogen peroxide. To the extent this abnormal dependence of VO2 on QO2 reflects tissue hypoxia, clinical interventions which decrease systemic delivery should be evaluated with regard to possible deleterious effects on organ system function. PMID- 3301970 TI - The neurologic effects of thiopental therapy after cardiac arrest. AB - We studied the effect of thiopental loading during resuscitation of 53 patients following cardiopulmonary arrest and compared the outcome with that found in 54 patients treated conventionally in the 30 previous months. Thiopental therapy (10 mg/kg i.v.) was begun within 30 min of the arrest once hemodynamic stability had been established. Thiopental infusion (20 mg/kg over 6 h) was followed by phenobarbital sodium (125 mg every 12 h), tolerance to the initial dose having been assessed. The in-hospital mortality rate for both groups was similar. In patients with ischemic heart disease, the mortality rate within the first 6 h was significantly higher in the thiopental group (p less than 0.05), although for the remaining patients there were more survivors among the thiopental treated patients (p less than 0.05). Excluding the patients who died within the first 6 h, 61% of the patients in the thiopental group survived cardiac arrest with normal cerebral performance, whereas only 37% in the standard treatment group showed normal functional outcome (p less than 0.03). These results suggest a favorable neurologic effect of thiopental loading during resuscitation of patients without ischemic heart disease. In patients with ischemic heart disease, an initial hemodynamic deterioration may contribute to minimising the beneficial effect of barbiturate therapy. PMID- 3301972 TI - Keep your smile ... all your life. PMID- 3301971 TI - Thoracic duct lymph and PEEP studies in anaesthetized dogs. II. Effect of a thoracic duct fistula on the development of a hyponcotic-hydrostatic pulmonary oedema. AB - PEEP impedes thoracic duct drainage (LF). This can be counteracted by a thoracic duct fistula. Consequently, lung oedema (LOE) should develop during PEEP more slowly with LF at atmospheric pressure (LFAP) than with LF against jugular venous pressure (LFJVP). In 12 anaesthetized dogs LOE was produced by Ringer's solution i.v. (2.5 ml/min per kg) for 6 h during PEEP (10 mmHg) with either LFAP or LFJVP. Ringer's + PEEP greatly increased aortic, pulmonary artery and wedge pressures, JVP, and cardiac output. Colloid osmotic pressures in plasma and lymph were drastically reduced, pulmonary effective filtration pressure (EFP) rose by about 20 mmHg. LFJVP increased 7-fold, LFAP about 19-fold, the respective loss of plasma proteins was 1.83 and 1.06 g/kg during 6 h. Thermal-dye extravascular lung water showed an increment of 68 with LFJVP versus 43 microliter/h/g per mmHg with LFAP. Final lung water content was at any delta EFP (12.8-31.9 mmHg) lower with LFAP than with LFJVP amounting 512 with LFJVP versus 377 microliters/g/per mmHg with LFAP. LFAP decreased the development of LOE during PEEP by bypassing the PEEP-induced high JVP and thus facilitating the removal of interstitial fluid. It is hypothesized that a thoracic duct fistula might aid the treatment of patients with LOE due to ARDS and therefore requiring high levels of PEEP. PMID- 3301973 TI - A new look for your smile. PMID- 3301974 TI - The presidents. Fritz Arthur Pierson. 1964-1965. PMID- 3301975 TI - Clinical crown contours: contemporary view. AB - Crown contours represent a group of characteristics critical for the longevity and success of dental restorations. This article presents the theories that have been developed about crown contours, describes each feature in detail, and clarifies potential interrelationships with all components of the mouth. When identified early, crown contours can be incorporated in treatment planning and restorative procedures. PMID- 3301976 TI - New developments in understanding phenytoin-induced gingival hyperplasia. AB - In approximately half of the patients taking phenytoin, gingival fibroblasts proliferate, causing tissue overgrowth and gingival hyperplasia. Recent clinical and basic research is reviewed, describing the conditions associated with phenytoin therapy and gingival hyperplasia. PMID- 3301977 TI - Preventive resin restorations. AB - Literature contrasting the use of composite resin sealants in the preventive resin restoration to the amalgam restoration is reviewed. In selected cases such as those involving anterior pits and fissures with minimal caries, sealants provide a valuable treatment alternative. PMID- 3301978 TI - Dentistry on stamps (Bernard J. Cigrand). PMID- 3301979 TI - The presidents. Maynard Kiplinger Hine 1965-1966. PMID- 3301980 TI - Oral acyclovir and herpes labialis: a randomized, double-blind, placebo controlled study. AB - A study of the effects of oral acyclovir (200 mg), administered five times per day for 5 days in 210 patients who cultured positive for herpes labialis, is made. A total of 149 patients were followed through three episodes each of herpes labialis while taking a placebo or acyclovir. Patients were evaluated for several clinical parameters, including the loss of lesion crust and reduction of the size of the area of the lesion between day 1 and day 5. Acyclovir showed a significant antiviral effect. Results show that oral acyclovir can favorably affect some parameters, but that higher doses or a "loading dose" could improve its efficacy. PMID- 3301981 TI - Autopolymerized versus light-polymerized fissure sealant. AB - This study found that 31 months after placement of a sealant, no significant difference was seen in the clinical performance and retention between the visible light-polymerized and autopolymerized materials. Practitioners can use either material without compromising efficacy. PMID- 3301982 TI - Etched-metal resin-bonded prostheses. Council on Dental Materials, Instruments, and Equipment. PMID- 3301983 TI - Magnesium and hypertension. AB - Essential hypertension (EHT) is one of the most common risk factors for cerebrovascular and cardiovascular disease (CVD), which in turn are among the most common causes of death and disability in developed countries. Drug treatment of EHT has proven effective in lessening the risk of CVD, but has attendant risk of side effects, some of which are of risk to the CV system. Thus, increasing attention is being paid to non-drug treatment of EHT, which includes changing the daily intake of such electrolytes as sodium (Na), potassium (K), calcium (Ca), and magnesium (Mg). Decreasing Na intake to control blood pressure (BP) is well established. On the basis of epidemiologic and experimental studies, increasing K and/or Mg intakes, and increasing of decreasing Ca intakes, have each been proposed to have beneficial effects of BP. Presented here is a review of the background data supporting the rationale for adding Mg to the anti-hypertensive regimen. There is evidence that Mg can exert a favorable effect in EHT, particularly when used in combination with K during diuretic therapy. PMID- 3301984 TI - Inhalation methods for the study of airway responsiveness. PMID- 3301985 TI - Oral immunotherapy in birch pollen hay fever. AB - Previous controlled trials with oral administration of allergen have not demonstrated any treatment effect in patients with allergic rhinoconjunctivitis or asthma. In the present double-blind, placebo-controlled trial, we have tested the effect of oral immunotherapy in adult patients with birch pollinosis. Thirty nine patients completed this 18-month study comprising two birch pollen seasons. The patients received enterosoluble capsules daily, and the actively treated patients reached a cumulated dose of 280 times 10(6) biologic units of birch pollen extract, which is about 200 times higher than the dose used in conventional subcutaneous immunotherapy. We found a significant decrease in eye symptom scores and conjunctival sensitivity to birch pollen, as determined by conjunctival provocation test, as well as a numerical but nonsignificant decrease in nasal symptom scores, nasal sensitivity as determined by nasal provocation test, and antiallergic medication. The treatment was safe, and only a few slight side effects were observed. We thus conclude that our study demonstrates a clinical effect of oral immunotherapy in birch pollinosis. PMID- 3301986 TI - The safety and activity of polymerized ragweed: a double-blind, placebo controlled trial in 81 patients with ragweed rhinitis. AB - Eighty-one patients with ragweed pollinosis were recruited for a double-blind, histamine placebo-controlled study of the safety, immunogenicity, and efficacy of 15 weekly injections of polymerized ragweed (PRW) immunotherapy totaling 1359 allergy units. Patients were paired on the basis of cutaneous end point titration to RAST standardized extracts of giant and short ragweed. One patient of each pair was randomized to receive PRW, and the other patient, a caramelized glucose histamine placebo. Symptom and medication score diaries were completed by 68 patients. All 68 patients received the full maintenance dose. No patient dropped out because of adverse reactions, and there were no systemic reactions. Except for one patient receiving placebo who developed mildly elevated liver function tests, there were no clinically significant changes in routine laboratory tests associated with injections. By Student's test on log-transformed values, blocking antibody rose significantly in the patients receiving PRW but was unchanged in those receiving placebo. By Wilcoxon paired signed-rank test, the symptom and medication scores in the patients receiving PRW were significantly lower than scores in the patients receiving placebo. This study demonstrates the safety, immunogenicity, and activity of PRW in the treatment of ragweed pollinosis. PMID- 3301987 TI - The effects of caffeine on various body systems: a review. AB - Caffeine is the most widely consumed drug in Western society. The intake of caffeine-containing beverages in many adults and children often reaches levels that can induce pharmacological effects. Ninety-nine percent of ingested caffeine is absorbed and distributed to all tissues and organs. The effects of caffeine intake differ greatly according to acute or chronic intake, level of intake, and the development of tolerance. Caffeine administered acutely to non-users or recent abstainers can induce hypertension, arrhythmias, altered myocardial function, increased plasma catecholamine levels, plasma renin activity, serum cholesterol levels, increased production of urine, gastric acid secretion, and alterations in mood and sleep patterns. Tolerance to chronic caffeine intake develops in most individuals, with the cessation of its effects on the renal system, the cardiovascular system, the gastrointestinal system and, to some extent, the central nervous system. Moderate caffeine consumers probably need to have little concern for the effect of caffeine intake on their health if their other life-style habits are also moderate. PMID- 3301988 TI - Pregnancy, diabetes, and Jewish dietary law: the challenge for the pregnant diabetic woman who keeps kosher. AB - One system of management for the pregnant woman with Type I diabetes is to instruct her in the strategies of achieving and maintaining normoglycemia with the use of self blood glucose monitoring, split doses of insulin, and titration of insulin to cover the meal plan. Normoglycemia is achieved only when the meal plan is adhered to in a rigid fashion to facilitate the insulin dose surrounding the meal. A 30 kcal/kg diet is divided into three meals and three snacks, of which 40% is composed of carbohydrate. These frequent small feedings must be perfectly timed to meet the insulin injected. Such systems require 35 hours of intensified training to become skilled in the techniques of diabetes self-care, but still the regimen does not provide much flexibility. When a pregnant woman also wishes to honor her religious beliefs by keeping kosher and so following another set of rigid laws surrounding the meal plan, adherence to both sets of rules becomes a challenge. Specifically, attention to separating milk and meat and eating only kosher foods must be part of the program. This article describes not only the basic diabetes self-care method but also how to adapt the method to the laws of keeping kosher while sustaining normoglycemia. PMID- 3301989 TI - Trial of a geriatric consultation team in an acute care hospital. AB - A controlled trial was conducted to examine the effects of superimposing an interdisciplinary geriatric consultation team upon the conventional patterns of care in medical wards of an acute care hospital. Two hundred and twenty-two patients, aged 69 years of age or older, admitted from the emergency room to two trial wards and 182 similar patients admitted to two control wards where the team did not work, were followed. Evaluations at admission, two and four weeks, and three and six months postadmission by independent evaluators allowed comparisons between the care groups with reference to survival, length of stay, disposition, physical, mental, and social functional levels, and use of services after discharge. Data from charts and treatment logs allowed the care processes to be compared. Findings determined that patients in the two groups were alike on socio demographic and clinical characteristics at entry. Results demonstrated that patients in the trial and control groups fared similarly on the outcome measures at each evaluation point, although a trend toward better survival among team patients was noted. It was concluded that the addition of a consultative geriatric team to the medical wards failed to show a significant impact on patient outcomes. PMID- 3301990 TI - Influenza vaccination in community elderly. A controlled trial of postcard reminders. AB - Available strategies to increase influenza vaccination rates in the elderly have not been tested in the private sector where most elderly receive care. We performed a randomized controlled trial of a postcard reminder in the three private general internal medicine practices. The observed vaccination rates of 55% in experimental patients (N = 262) and 54% in control patients (N = 278) were similar, though much higher than estimated national rates of 20%. The data indicated that the baseline (control group) vaccination rate was high probably because study participants were exposed to many community vaccination cues, separate from the study cue. That vaccination rates were not higher after additional exposure to the study cue suggests that a "ceiling effect" occurred. Including 70 patients not randomized into the trial because they received flu shots prior to randomization, the vaccination rate in patients who had a clinic visit during autumn months was 75% compared to a rate of 52% in patients not visiting the clinic (P less than .001). Our results suggest that vaccination rates can be considerably higher in the private sector than those reported in the past, and that both vaccination cues and direct patient contact appear important to promote vaccination. This and other studies suggest that traditional cues may have a ceiling effect, yielding vaccination rates no higher than 55 to 65%; further increases in rates will require other approaches. PMID- 3301992 TI - [Retinal complications of pseudophakia]. PMID- 3301991 TI - [Calcifications in leukokorias: ultrasonic study]. AB - We have performed an ultrasound study of 46 eyes with Leucocoria. The results obtained demonstrate that 20 eyes (43.5%) were affected by retinoblastoma. Of these, 17 eyes (85%) showed calcifications and 3 eyes (15%) did not show calcifications. In the remaining 26 eyes, in 6 cases there were intraocular calcifications, and in two of these the calcifications were found within the pathological intraocular mass showing retinoblastoma. The eyes with intraocular calcifications were diagnosed as: uveitis, retrolental fibroplasia, Coats disease, retinal dysplasia. Because of these, we conclude that, although the existence of calcifications is a meaningful datum, there are uncalcified retinoblastomas and calcifications in entities other than retinoblastoma. PMID- 3301994 TI - [Cyclosporin A eyedrops in the prevention of high-risk corneal graft rejection. II. Postoperative clinical results]. AB - Twenty-four patients (25 eyes) presenting a high corneal rejection risk have been treated by an association of topical cyclosporine A (2% in castor oil) and Dexamethasone eyedrops 1% 48 h preoperatively, the posology was slowly degressive postoperatively. The mean follow-up is of 12 months. Results are 19 clear grafts among which 4 had a reversible reject reaction, 3 unreversible rejections with a totally cloudy graft (12%), 3 corneal graft oedema of nonimmunologic nature allowing a counting fingers vision. A control group of 25 patients with the same high risks of rejection treated only by topical corticosteroids followed up for the same mean time showed an obvious higher rate of failure (65%). PMID- 3301993 TI - [Use of cyclosporin A eyedrops in the prevention of corneal graft rejection in man. I. Preoperative development of 4 eyes with metaherpetic keratitis]. AB - Topical cyclosporine A (2%) has been used to prevent corneal graft rejection in high risk patients. The treatment was begun 48 h at least before surgery. 3 patients (4 eyes) suffering from metaherpetic keratitis were placed under this treatment for a long time due to the delay to obtain a corneal donor. Their observation while treated showed a remarkable slow-down of the inflammation both in conjunctivae and corneas. This confirms if necessary the role of T lymphocytes in metaherpetic corneal diseases and the clinical modulation effect of cyclosporine A on these T cells. PMID- 3301995 TI - Radiographic evaluation of transchondral dome fractures of the talus. AB - Transchondral fractures of the talar dome have been cited frequently in the literature. The number of radiographic techniques available for the evaluation of these lesions often leads to confusion for the physician. The authors discuss each of the radiographic modalities available for the assessment of this entity. Advantages and disadvantages of these modalities have been presented. This manuscript provides the clinician with the knowledge to perform an appropriate evaluation of the problem. PMID- 3301996 TI - Digital subtraction angiography versus noninvasive testing in the vascular assessment of the ischemic foot. AB - This report discusses the role of digital subtraction angiography as well as noninvasive vascular testing in the evaluation of the ischemic foot. A case history is described presenting the diagnostic modalities and surgical management of an insulin-dependent diabetic man with gangrene. PMID- 3301997 TI - Ultrasound imaging and directed needle biopsy in the diagnosis of selective involvement in muscle disease. AB - Four children investigated for neuromuscular disorder by routine ultrasound imaging showed selective involvement within the quadriceps femoris muscle, with involvement of the vasti and sparing of the rectus femoris. This was confirmed by concurrent needle biopsy of the two muscles. Real-time ultrasound imaging is quick, noninvasive, readily accepted by children, and has the advantage over CT scans of being practical for routine outpatient use. Needle biopsy is relatively atraumatic and enables one to select specific superficial and deep muscles for concurrent biopsy. PMID- 3301998 TI - An experimental flexor tendon repair in zone II that allows immediate postoperative mobilization. AB - An experimental method of approximating severed flexor tendons in zone II that allows immediate postoperative mobilization is described. The repair uses a nonabsorbable suture anchored into the severed tendon in zone III. This experimental repair was performed on one foot in each of 18 adult, white Leghorn chickens. The control side used the modified Kessler technique to repair the zone II laceration. The animals were prevented from weight-bearing activities but were allowed active motion of the foot for 5 to 6 weeks postoperatively. The results demonstrated a marked diminution in flexor tendon adhesions, with intrinsic tendon collagen formation serving to reconstitute tendon continuity on the experimental side. The breaking strengths of the two repair methods were equivalent. These results suggest that this method may allow primary repair of tendon injuries in zone II, with minimal formation of adhesions. PMID- 3301999 TI - Foreign body granuloma and synovitis of the finger: a hazard of ring removal by the sawing technique. AB - A case of chronic digital synovitis and foreign body reaction secondary to metallic filings is reported. The patient had a digital mass and a previous history of a ring finger injury. A saw action ring remover was implicated as a source of foreign bodies produced by ring removal over the open wound. Care should be taken to avoid implantation of metal filings with this technique, and an alternate method of removing rings from injured fingers should be considered. PMID- 3302000 TI - Physicians' decisions to limit Medicaid participation: determinants and policy implications. AB - Although most primary care physicians participate in state Medicaid programs, they may accept all Medicaid patients, or they may choose to limit their participation. This decision allows physicians to adjust their Medicaid caseloads to a desired level, and it has important implications for the access of low income patients to health care. Surveys of pediatricians in 1978 and 1983 indicate that the proportion of pediatricians limiting their Medicaid participation increased significantly from 26 percent to 35 percent (p less than .001). In addition, in both 1978 and 1983, limited participants saw significantly fewer Medicaid patients than full participants. This paper describes a number of strategies available to federal and state policymakers for fostering full Medicaid participation. Multivariate analyses indicate that increasing reimbursement levels is an important strategy for encouraging full Medicaid participation. In addition, full participants will increase their Medicaid caseloads in response to a variety of Medicaid policy incentives, while limited participants are found to respond to fewer policy incentives. The authors conclude that caution will be needed to ensure that health care cost-containment strategies such as capitation or selective contracting do not inadvertently discourage participation among both full and limited Medicaid participants. PMID- 3302001 TI - Implementing change: lessons for Medicaid reformers. AB - Major Medicaid reforms initiated in Arizona, California, and New York in the 1980s form the foundation of this study, which explores issues to consider when implementing change in state Medicaid programs. We prepared case studies of these reforms, describing the innovations and assessing the implementation process in each state. These case studies are used to illustrate broad issues and processes of Medicaid reform. Six lessons emerge from our analysis: Expect reform models to change over time; strive for predictability and continuity in the reform; encourage behavior changes through the use of incentives; use special administrative or political channels to simplify the reform; expect reform models to converge over time; and implementation difficulties can be predicted. These lessons should educate decision makers about how to implement possible future solutions to problems like those seen in Medicaid programs at the start of this decade. PMID- 3302003 TI - Private insurance for Medicaid recipients: the Texas experience. AB - Shifting financial risk from the public to the private sector is an increasingly attractive option to policymakers seeking to constrain Medicaid costs. This paper discusses the potential advantages and disadvantages of private insurance arrangements for Medicaid recipients and examines the Texas Purchased Health Services Program, the oldest and largest private insurance program for Medicaid recipients in the U.S. Our analysis of the Texas program suggests that while the political benefits are real, the administrative costs are substantial and the fiscal benefits uncertain. While overall benefits may outweigh costs in Texas, differing political and fiscal circumstances may alter the balance in other states considering private insurance arrangements. PMID- 3302002 TI - The complexities of managed care: operating a voluntary system. AB - The implementation of state-sponsored voluntary case management programs for public assistance recipients creates provider and recipient recruiting problems that are unique to the state's economic environment, its political climate, its historic relationship with providers, its program goals, and its implementation strategies. This implementation study discusses the factors that influenced the operationalization of the Massachusetts managed care program for AFDC families. The issues of provider recruitment and recipient enrollment are examined in relation to the formal program goals of cost containment and access. The operational and bureaucratic problems the state Medicaid staff has experienced in maintaining the program evokes questions of who should administer the programs, who the best types of providers are in light of program goals, and how recipients can be enrolled in a voluntary program. PMID- 3302004 TI - Prevention of duodenal ulcer occurrence. Double-blind comparison of ranitidine and cimetidine. AB - We compared ranitidine and cimetidine in maintenance therapy to prevent duodenal ulcer recurrence over a period of 24 months. Endoscopic examination at the end of 12 months showed that the ulcers of 26 of 31 patients (84%) on ranitidine in a dose of 150 mg remained healed and of 10 of 13 (77%) patients on cimetidine in a dose of 400 mg at night remained healed. Thirty-four patients continued in an open evaluation of ranitidine in a dose of 150 mg at night for a further 12-month period, and during this time there were four further recurrences. Life table estimates of duodenal ulcer recurrence during the 2-year period showed no significant difference between the two forms of treatment. PMID- 3302005 TI - Prevention of duodenal ulcer recurrence by pirenzepine 50 mg twice daily. AB - Eighty-four patients with healed duodenal ulcers were treated for 1 year with pirenzepine, 50 mg twice daily, or placebo in this double-blind, randomized, multicenter trial. Clinical follow-up and endoscopy were performed before and after 3, 6, and 12 months of treatment. Endoscopy was also carried out whenever symptoms compatible with ulcer recurrence were present for more than 2 days. Both groups were well matched for age, sex, duration of peptic ulcer disease, and smoking habits. There were 21 drop-outs due to lack of compliance. Therefore, 32 patients treated with pirenzepine and 31 with placebo were included in the analysis. Expressed in cumulative percentage of recurrence, with pirenzepine, 28% of the patients had a relapse at 3 months, 41% at 6 months, and 53% at 12 months; with placebo, the recurrence rates were 58% at 3 months, 68% at 6 months, and 71% at 12 months. The mean success time at 1 year is also longer for pirenzepine (7.38 months) than for placebo (5.52 months). These differences are significantly in favor of pirenzepine (p less than 0.05). Both treatments were well tolerated. Dry mouth was more frequently observed with pirenzepine (14 versus 5 patients). We conclude that pirenzepine, 50 mg twice daily, significantly reduces the relapse rate of duodenal ulcers during a 1-year maintenance treatment. PMID- 3302006 TI - Bedside ultrasonography. A low-cost definitive diagnostic procedure in obstructive jaundice. AB - We evaluated real-time ultrasonography carried out by gastroenterologists for its diagnostic accuracy in 89 patients with obstructive jaundice. The positive predictive values for the site and nature of the obstruction were 94.3 and 89.9%, respectively. The advanced stage of disease in our patients and the clinical background of the investigators may have contributed to the high diagnostic accuracy of ultrasonography in this study. Nevertheless, we recommend that gastroenterologists themselves perform bedside ultrasonography for a definitive diagnosis in patients with obstructive jaundice. The high degree of precision achieved by ultrasound in our setting makes more expensive investigations unnecessary as routine procedures. PMID- 3302007 TI - Current therapy for recurrent ulcer. AB - The natural history of peptic ulcer disease shows a high rate of recurrence over the short term, with the recurrence rate decreasing over a period of many years. Drug therapy does not appear to alter the natural history of the disease. Smoking increases the risk of ulcer recurrence by increasing the rate of gastric emptying, diminishing the secretion of pancreatic bicarbonate, decreasing duodenal luminal pH, reducing mucosal blood flow, and inhibiting mucosal prostaglandin synthesis. There is a probable role for routine maintenance therapy in patients with known recurrent ulcer disease. PMID- 3302008 TI - Sucralfate: worldwide experience in recurrence therapy. AB - International studies have shown sucralfate to be a safe and effective short- and long-term treatment for patients with peptic ulcer. Available data suggest that the more convenient dosage schedule of 2 g b.i.d. may be preferable to the conventional 1 g q.i.d. regimen for short-term duodenal ulcer healing, and that a maintenance dose of 2 g at night may be appropriate in the long-term management of patients with gastric or duodenal ulcer disease. Smoking has no adverse effect on healing in sucralfate-treated duodenal ulcer patients, and sucralfate granules do not appear to be more effective than tablets in ulcer healing. PMID- 3302009 TI - Peptic ulcer: factors influencing recurrence. AB - Duodenal ulcer disease is a chronic condition with multiple causes. These causes have in common the ability to increase acid delivery to the duodenum, the ability to decrease duodenal defense against an acid load, or a combination of these abilities. Some causes of duodenal ulcer disease are acquired; others are genetically determined. Ulcer recurrence in smokers is common because nicotine impairs the capacity of the duodenum to buffer an acid load. Duodenal ulcer recurrences are also common in nonsmokers because treatments fail to correct underlying pathogenetic mechanisms of ulcer disease. Optimum therapy should take into account the role of offensive and defensive factors in the development of the disease. PMID- 3302010 TI - Efficacy of sucralfate in the prevention of recurrence of duodenal ulcers. AB - Eighty-four patients who were endoscopically confirmed to have healed duodenal ulcers were entered into this 1-year, double-blind, placebo-controlled trial of sucralfate, 1g twice daily, in the prevention of duodenal ulcer recurrence. Patients remained in the study until recurrence of ulceration was endoscopically confirmed. Sixty-one patients could be evaluated for efficacy of treatment. Within 6 months, 23 of 31 placebo patients (74%) and 6 of 30 sucralfate patients (20%) had ulcer recurrence. At 12 months, 25 of 31 placebo patients (80%) and 8 of 30 receiving sucralfate (27%) had ulcer recurrence. The lower rate of ulcer recurrence in patients receiving sucralfate was significant (p = 0.0001). Survival curves also showed that sucralfate was significantly more effective in preventing relapse (p = 0.0001). Three patients were judged as experiencing drug related side effects, two of which were in the placebo group. The results indicate that sucralfate is significantly more effective than placebo in the prevention of recurrence of duodenal ulcer disease. PMID- 3302011 TI - Mechanisms of gastric cytoprotection. AB - Gastric cytoprotection is a real but relative phenomenon that is induced by both endogenous and exogenous compounds. The key element in acute mucosal protection is the preservation of vascular integrity and the resulting maintenance of blood flow. The critical factors in chronic mucosal protection include the stimulation of bicarbonate and mucus secretion, and the proliferation of epithelial, endothelial, and mesenchymal cells. Investigations are currently underway to identify the biochemical targets of cytoprotection. PMID- 3302013 TI - Changes in surface antigens of Hymenolepis nana during differentiation and maturation in mice. AB - The surface antigens of oncosphere, cysticercoid, adult scolex and adult strobila (other than scolex) of Hymenolepis nana differ critically from one another. When the oncosphere of H. nana undergoes differentiation and development into the mature tapeworm, the infected mouse first produces anti-oncosphere antibody, followed by anti-cysticercoid, anti-adult scolex and finally anti-strobila (other than scolex region) antibodies of IgG, IgM and IgA isotypes as detected by indirect immunofluorescent antibody test. The parasite changed its surface antigens throughout its differentiation and maturation, and all developmental stages were recognized by the infected mouse host. However, there appeared no further changes in surface antigens during aging after maturation. The antibody responses were always delayed compared with the differentiation and maturation of the parasite. PMID- 3302012 TI - The sociological study of AIDS: a critical review of the literature and suggested research agenda. PMID- 3302015 TI - Medical museum notes (Adriel Sylvanus Kingsley). PMID- 3302014 TI - Tschermak: a non-discoverer of mendelism. II. A critique. AB - An examination of Tschermak's two papers of 1900 not only reinforces our conclusion cited in our first paper on Tschermak that he was not a rediscoverer of Mendelism, but also he did not understand Mendel when he had read it. His concept of dominance differed from that of Mendel, and his use of his own concept is inconsistent and contradictory. His discussion of his backcross data indicated that he had no idea of the nature of Mendelian ratios. Nowhere did he develop the ideas of segregation and independent assortment. PMID- 3302016 TI - John Stough Bobbs: the relativly unknown physician who brought organized medical education to life in Indiana. PMID- 3302017 TI - Alex Novikoff: reminiscences. PMID- 3302018 TI - Climbing our family tree. PMID- 3302019 TI - A tribute to Alex B. Novikoff. PMID- 3302020 TI - The efficiency of immunolabel on Lowicryl sections compared to theoretical predictions. AB - The surface of thin sections of aldehyde-fixed biological material shows a specimen-related relief of 2-6 nm with Lowicryl. Epon sections are about three times smoother. The relief is the consequence of thin-sectioning being in reality a cleavage. Epitopes are supposed to be laid open (or set free) because cleavage follows the interfaces between protein and Lowicryl. We have developed a simple theory on this basis and have theoretically estimated the efficiency of on section labeling and compared it with experimental data. For randomly dispersed proteins in cytoplasm, Lowicryl sections will yield significant label only when the concentration of the antigen is about 10 microM or more. The complex situation of more compact proteins, as represented by fibers, sheets, and biological membranes is discussed and the difficulty of significant calculations is explained. Pre-embedding labeling and melted cryosections should give 10-30 times more label. The possible reasons for the observed much smaller gain of not more than two to three times are discussed. PMID- 3302021 TI - Modern acrylics for post-embedding immunostaining techniques. AB - We describe two methods for rapid processing of biological tissues into LR White acrylic plastic. Both methods make use of LR White's compatibility with small amounts of water, enabling non-osmicated tissue to be only partially dehydrated before infiltration with the plastic, a procedure that improves the sensitivity of post-embedding immunocytochemistry. In addition, both methods are designed to reduce the time for which tissue is exposed to the damaging influence of the plastic monomer, which can cause extraction and sudden shrinkage. The tissue example used in the first method is immersion-fixed, surgically removed human pituitary which, by virtue of its thorough fixation, can be processed quickly at 50 degrees C using catalytic polymerization at room temperature. The concentration of the catalyst is critically set to prevent the temperature rising above 60 degrees C in the tissue blocks. Penetration of immunoperoxidase reagents into 330-nm LR White sections is demonstrated and possible modes of action are discussed. When "lightly" fixed tissue is processed as above, serious polymerization artifacts can result from autocatalysis. A second method, based on the first but employing slower polymerization at 0 degrees C, has therefore been developed. The high level of fine structure that can be retained using this method is illustrated by the demonstration of the trans-tubular Golgi in perfusion-fixed kidney of rat. Biotinylated lectin is localized to cells of the kidney proximal tubule with streptavidin-colloidal gold, to illustrate tissue reactivity. In a second example, the structure of the bacterial cell envelope is shown to be similar in appearance after partial dehydration and LR White embedding to that seen after progressive lowering of temperature, dehydration, and Lowicryl embedding. PMID- 3302022 TI - Effect of tissue processing on colloidal gold cytochemistry. AB - The aim of cytochemical techniques is to localize specific biochemical components in particular tissue and cell compartments. However, since preparation of tissues for structural observation results in major alterations of the properties of their components, a major problem is to retain an adequate degree of their biochemical properties as well as adequate structural preservation. In the present study, we describe results obtained using various colloidal gold cytochemical techniques on tissues processed through different approaches. We found that any manipulation of the tissue during its processing can result in modifications of tissue components, leading to problems in cytochemistry. Indeed, washing of the tissue before fixation, the nature of the fixative solution, the chemical basis of the resins, and the physical conditions of embedding can all introduce changes in tissue components which can be cytochemically demonstrated. This has been illustrated with application of the protein A-gold, lectin-gold, and enzyme-gold cytochemical techniques on tissues submitted to different processings: fixation by perfusion or by immersion; glutaraldehyde vs paraformaldehyde fixative solutions; cryo-ultramicrotomy; embedding in epoxy, GMA, Lowicryl, or LR resins. The results obtained have demonstrated that conditions for optimal labeling must be worked out for each class of binding sites, and that no single procedure can be recommended as THE best approach in cytochemistry. PMID- 3302023 TI - A research into homosexuality in The Netherlands. AB - This article presents varying ideologies regarding homosexuality. The history of homosexual research is reviewed from a clinical and sociological perspective. Centers for research in the area of homosexuality in The Netherlands are described in terms of their area of study as well as their differing ideological views. In conclusion, the increased awareness of the Dutch Government and the governance of the Dutch universities of the importance of research into homosexuality is described. PMID- 3302024 TI - Theories on homosexuality among professional therapists. AB - Current viewpoints on homosexuality among Dutch psychiatrists and psychologists in the period of 1945 to 1980 are discussed. In a detailed examination of these differing theories, a change in the approach to therapy with homosexual clients unfolds, incorporating more of a sociodynamic focus as compared to the psychodynamic concepts of earlier theorists. PMID- 3302026 TI - Lesbian emancipation in The Netherlands. AB - In this article the emancipation of lesbian women as a group is reviewed from a historical viewpoint. Their gradual emancipation, along with women in general, is demonstrated by the increasing alliances and support afforded to women over the years. The growth of a unified lesbian movement is evident in publications and the formation of autonomous organizations in the 20th century. PMID- 3302025 TI - The Dutch penal law and homosexual conduct. AB - The history of changes in Dutch penal law regulating homosexual conduct since the 18th century are traced and their effects on homosexual behavior described. Changes in policies and practices regarding enforcement are reviewed. The article discusses the Dutch criminal code of 1886, the criminalization of homosexual contacts involving minors in 1911, the criminalization of male homosexuality from 1941 to 1945, and the progressive relaxation of the law since World War II, resulting in the decriminalization in 1971 of homosexual contacts involving minors and the draft in 1981 for a bill that would prohibit discrimination against homosexuals. PMID- 3302027 TI - Wrong lovers in the 19th century Netherlands. AB - Various styles of "male love" occurring in the 19th century are introduced. Locations and public ordinances relating to these styles of love are discussed. The development of the homosexual role is broached along with the question of whether attitudes and laws of the 19th century were responsible in part for the development of normative expectations for homosexuality which might in turn have repressed its growth. PMID- 3302028 TI - Constitutional protection against discrimination of homosexuals. AB - A brief review of equality for homosexuals prior to 1983 is presented followed by the introduction and explanation of the relevant section of the revised edition of the Dutch Constitution (enacted in 1983). The possible impact of this section on the abolishment of discrimination based on sex and sexual orientation is discussed. PMID- 3302029 TI - Homosexuality in Dutch instruction books for youths. AB - The information on homosexuality was analyzed in the 71 sex-instruction books for youths published in The Netherlands between 1945 and 1982. Within this period, substantial shifts occurred toward a more tolerant attitude regarding homosexuality. Still, quite a few things can be said against the modern instruction books and the authors urge an unremitting critical attitude in evaluating these books. PMID- 3302030 TI - Pedophilia and the gay movement. AB - A history of literature and views existing within the COC (Cultural and Recreational Center), the major Dutch organization of homosexual men and women, regarding pedophilia and its relationship to homosexuality are discussed, beginning with definite separation between the pedophile and homosexual identities and ending with an abolishment of oppression towards pedophilia, for which the COC is in part responsible. The article argues that the homosexual identify is by no means a "constant" but a fluid identity, based on societal views and conditions. By accepting pedophilia, the COC hopefully will broaden the idea of the gay identity. PMID- 3302031 TI - Dutch gay emancipation history (1911-1986). AB - The Dutch homosexual movement is one of the oldest and most influential in the world. The aim of this article is to describe how this success can be explained both by some specific characteristics of Dutch society and ideologies, strategies, and tactics as developed by the gay movement. Although it is always risky to make a comparison with other countries and the homosexual movements there, I try to point out briefly some distinct differences and similarities. PMID- 3302033 TI - Blastomogenic effect of benzene. AB - This paper presents a critical review more than 100 references on the possible leukomogenic (blastomogenic) effects of benzene, based upon clinical, epidemiological and experimental dates. The authors came to conclusion that there exist reliable clinical and epidemiological evidences, concerning increased leukomogenic risk on working place with high benzene concentrations in past years (tens and even hundreds of ppm). Most epidemiological studies, indicate now that this risk is also elevated in more favourable working conditions, although practical valuable dose-effect relationship between benzene concentrations and rate of leukomogenic risks is still unknown. Results of experimental investigations on problem of leukomogenic effects of benzene are contradictory. It was stated recently that there is a lack of adequate experimental models of benzene blastomogenesis. Taking into consideration increasing economic significance of benzene and existence of large contingents of workers dealing with benzene, it is necessary to continue appropriate experimental and epidemiological investigations. PMID- 3302032 TI - Application of toxico-kinetic criteria as a basis for toxicometric parameters. AB - In an experiment with single exposure to benzene and styrene at a level corresponding, to the threshold of harmful effect established by functional indices the intensity of metabolism was found to decrease. Toxico-kinetic characteristics of the substance in a single experiment permit us to prognosticate the risk of developing chronic intoxication. In comparison with indices characterizing general state of the organism, toxicokinetic indices enhance the reliability of toxicometric parameters used in determining Mac's for the air of the working area. PMID- 3302034 TI - On the character of hygienic science. AB - In its nature, ends and purposes, hygiene is a medical science. Consequently, it can be axiomatically accepted that the character of medicine is also the character of hygiene. Traditionally, medicine ranks among biological sciences. The author deliberates on the need to regard the current complex of medical sciences, hygiene included, as socio-biological sciences. PMID- 3302035 TI - Bacterial microcolony--a possible approach for a rapid differentiation of bacteria. AB - A method is developed for cultivating and observing bacteria in an early phase of their growth, when microcolonies were formed. The morphology of the microcolonies, including form, structure, characteristics of its periphery and center, as well as the mode of arrangement of bacteria in it and to each other proved to be typical for a species and often permitted its differentiation from the other species. Photographs are presented of typical microcolonies of S. aureus and of E. coli. A series of photographs is presented also as an illustration of the possibility to differentiate some species in the genus Streptococcus. The microcolonies observation is made 3 hours after material inoculation, that may permit a rapid bacteriological diagnosis. It is believed also, that the microcolony technique could be useful in the characterisation and identification of the species in the general bacteriology and taxonomy. PMID- 3302036 TI - A monoclonal antibody to Mycobacterium kansasii: preparation and properties. AB - An IgG2/kappa monoclonal antibody specific for a subunit protein antigen (mol.w. 32 KD) obtained by means of gel chromatography of the cell-free sonicate of M. kansasii was generated by the fusion of spleenocytes from BALB/c mice immunized with this antigen and Ag-8 myeloma cells. Its specificity was demonstrated by ELISA and dot blot procedures. This MoAb has potential application in taxonomy and species identification of M. kansasii isolates, in studies relating to the molecular pattern of the bound antigen and in serodiagnostics of the mycobacterial disease due to M. kansasii. PMID- 3302037 TI - The fourth Sir George Pickering memorial lecture. The structure of the resistance vasculature in essential hypertension. PMID- 3302038 TI - Haemodynamic and haemorheological effects of hypervolaemic haemodilution in men with primary hypertension. AB - The haemorheological disturbances observed in primary hypertension arise mainly from haemoconcentration, which leads to an elevation of blood and plasma viscosity and increased aggregation of red blood cells (RBCs). We evaluated the rheological properties of blood and central haemodynamic indices in 13 men with untreated primary hypertension (WHO stage I and II), during a baseline period and after intravenous infusion of 1000 ml of 0.9% NaCl (within 12-15 min). The rheological properties studied were: whole blood viscosity (WBV), plasma viscosity (PV), haematocrit (HCT) and plasma fibrinogen concentration (PF). The central haemodynamic indices were: mean intra-arterial blood pressure (MAP), central venous pressure (CVP), cardiac index (CI), stroke volume index (SVI), total peripheral resistance index (TPRI) and the vascular hindrance index (VHI). Plasma renin activity (PRA) and plasma noradrenaline concentration (P-NA) were also measured. Volume expansion with saline caused haemodilution as expressed by a fall in HCT (P less than 0.001), WBV (P less than 0.001) and PV (P less than 0.01). At the same time, CVP, MAP and VHI increased (P less than 0.05) while PRA decreased (P less than 0.05) and P-NA remained unchanged. Mean values of the cardiac index (CI) and stroke volume index (SVI) did not change significantly. We did not observe any significant relationship between haemodynamic and haemorheological parameters, during baseline or between their respective changes after the infusion. The results indicate that although hypervolaemic haemodilution produced by saline infusion in hypertensive patients may improve blood flow properties (HCT, WBV, PV), blood pressure (BP) is not reduced; rather the converse is true. The reduction in HCT and hence the improved blood rheology, did not affect calculated vascular resistance. Thus, correction of WBV does not acutely normalize BP in primary hypertension. PMID- 3302039 TI - Renal prostaglandins and phospholipase A2 in spontaneously hypertensive rats. AB - Phospholipase A2 activity and prostaglandin synthesis were studied in the renal cortex and medulla of stroke-prone spontaneously hypertensive rats (SHRSP) and age-matched normotensive Wistar-Kyoto rats (WKY) aged 10-50 weeks. Enhanced phospholipase A2 activity was found in both the cortical and the medullary microsomes of SHRSP kidneys. Phospholipase A2 activity progressively increased with age in SHRSP, but not in WKY. Prostaglandin E2 (PGE2) and thromboxane A2 (TXA2) were the major prostaglandins found in the cortex, and PGE2 was the major prostaglandin found in the medulla. Prostaglandin l2 (PGI2) was synthesized in both the cortex and medulla, but cortical PGI2 synthesis was much lower than medullary synthesis. Enzymatic activity for all prostaglandin syntheses analysed here were higher in SHRSP. There was a greater age-related increase in prostaglandin synthesis in SHRSP kidneys than in WKY kidneys. In addition, the ratios of PGE2/TXB2 and 6-keto-prostaglandin F1 alpha (PGF1 alpha)/thromboxane B2 (TXB2) decreased in SHRSP. This may produce vasoconstriction and increase vascular resistance in SHRSP. These data suggest that increased prostaglandin synthesis and phospholipase A2 activity have an important role in the development and maintenance of hypertension in SHRSP. PMID- 3302040 TI - Enhanced blood pressure response to isometric handgrip exercise in patients with essential hypertension: effects of propranolol and prazosin. AB - To elucidate whether a difference exists in blood pressure (BP) elevation during isometric handgrip exercise (IHG) between essential hypertensives (EHT) and normotensives (NT), IHG was carried out in 12 NT and 46 EHT under constant sodium intake using a new instrument. The acute effects of propranolol and prazosin on IHG were also examined in EHT. The change in systolic BP (delta SBP) during IHG in EHT, delta SBP = 61 +/- 21 mmHg, was markedly greater than that in NT, delta SBP = 28 +/- 4 mmHg. Among EHT, delta BP increased with increasing severity of hypertension. Neither the changes in plasma norepinephrine nor in epinephrine during IHG showed significant differences between EHT and NT. The pressor response during IHG could not be suppressed by propranolol, but about 30% suppression of BP was observed during IHG with prazosin. It is concluded from these findings that EHT have an exaggerated BP response to IHG that is due to increased post-junctional alpha 1-adrenoceptors. PMID- 3302041 TI - The lymphocyte function-associated antigen (LFA)-1 and CD2/LFA-3 pathways of antigen-independent human T cell adhesion. AB - Human cytotoxic T lymphocyte clones form conjugates with both antigen-positive and antigen-negative lymphoblastoid cells. Conjugates with antigen-negative targets form as rapidly, and are almost as frequent, as those with antigen positive targets; both types are strong. Monoclonal antibodies against lymphocyte function-associated antigen (LFA)-1, CD2, and LFA-3 (or their Fab fragments) each consistently inhibit conjugate formation, but only partially; mixes of alpha LFA 1 with either CD2 monoclonal antibodies or alpha LFA-3 cause complete inhibition. Our previous studies have demonstrated two distinct pathways of antigen independent conjugate (AIC) formation, one involving LFA-1 and the other involving CD2/LFA-3. The present studies showing supra-additive inhibition with mixes of Fab indicate that at least a major fraction of the conjugates involve T cells which utilize both pathways. Preincubation studies (and restricted expression for CD2) demonstrate that in the CD2/LFA-3 pathway, CD2 is critical on the effector and LFA-3 on the target and that in the LFA-1 pathway, LFA-1 is critical on the effector. Analysis of conjugate formation by primary allosensitized T cells confirms the critical findings made with T cell clones. Among a panel of antigen-negative "target" cell lines tested, there is wide variation in the number of AIC formed with cytotoxic T lymphocyte clones; this variation correlates partially with differences in level of expression of LFA-3. Both pathways of adhesion are utilized in AIC formation with all five targets tested, but there was variation between targets in the relative contribution by each pathway. Studies of inhibition of lysis (rather than conjugate formation) support the relevance of the two-pathway model to the lytic process as a whole. These studies demonstrate the general involvement of two pathways of adhesion in human T cell interactions: one involving T cell LFA-1 and the other involving T cell CD2 binding to target cell LFA-3. PMID- 3302042 TI - A monoclonal antibody that inhibits the antimicrobial action of a 57 KD cationic protein of human polymorphonuclear leukocytes. AB - Two monoclonal antibodies (mAb) specific for epitopes of a 57,000 m.w., cationic antimicrobial protein (CAP57) purified from granules of human polymorphonuclear leukocytes (PMN) have been produced. Both were IgG1 mouse antibodies with typical heavy and light chain structure. The mAb reactive with CAP57 failed to react specifically with other heretofore defined PMN or serum proteins as shown by ELISA. Both mAb showed specific reactivity in Western blots with CAP57. One of these mAb (P1G8) inhibited the antimicrobial action of CAP57 by 50% at a ratio of 62.5 micrograms antibody per microgram CAP57. The other mAb, P2A5, had no inhibitory capacity for CAP57. Binding constants of the two mAb for the antigen were determined and were found to be virtually identical. Thus, the greater inhibitory capacity of P1G8 for bacterial killing by CAP57 was not directly related to binding strength of the mAb. Competition experiments showed that unlabeled P1G8 could compete as well against radiolabeled P2A5 as could unlabeled P2A5. In the reverse experiment, it was seen that P1G8 competed with radiolabeled P1G8 for CAP57 better than unlabeled P2A5. These findings could be due to two antibodies that recognize different but adjacent epitopes on CAP57, one of the epitopes (P1G8) being closer to structure(s) of the protein essential to its antimicrobial action. Immunocytochemical studies showed positive staining with both mAb. The reaction was restricted to the cytoplasm of peripheral blood PMN and was of a granular pattern. Other peripheral blood cells (which included red blood cells, eosinophils, monocytes, and lymphocytes) failed to bind either mAb. PMID- 3302043 TI - Species-specific antibodies to Leishmania tropica (minor) recognize somatic antigens and exometabolites. AB - Monoclonal antibodies were raised against membranes of Leishmania tropica (formerly L. tropica minor). These antibodies do not react with membranes or homogenates prepared from any other species of Leishmania examined. The antigens identified by all four monoclonal antibodies reside on the external surface of the promastigote and are released into the culture medium. Immunoprecipitation of metabolically ([3H]glucose, -glucosamine, or [35S]methionine)-labeled, [125I]lactoperoxidase-labeled, or Western blot analysis of the parasites identified species-specific determinants residing on several different molecules with Mr between 12,000 and 140,000. All of the monoclonal antibodies appear to recognize determinants on a common [3H]sugar-labeled glycoconjugate, Mr = 32,000 to 44,000, but also react with additional components of 55,000, 80,000, 92,000, and 130,000 m.w. Antibody binding to the parasites is very sensitive to mild oxidation with periodate, suggesting that the species-specific determinants are carbohydrate in nature. PMID- 3302044 TI - Assays using red cell-labelled antibodies. PMID- 3302045 TI - Immuno slot-blot assay using a membrane which covalently binds protein. AB - The use of a recently available commercial membrane (Immunodyne Immunoaffinity), which covalently binds proteins, in the development of a quantitative immunological slot blot assay is demonstrated. This membrane was found to be valuable in the quantification of polygalacturonase from tomato fruit, a protein which binds weakly to nitrocellulose membrane. The covalent binding of protein to a solid support allows the use of stringent conditions necessary for reduction of non-specific interactions between antibodies and other proteins. This method should prove useful to develop quantitative immunoassays for proteins which elute from nitrocellulose or other membranes during assay conditions. PMID- 3302046 TI - A semi-automated fluorescent (SAF) assay using viable, whole cells for screening hybridoma supernatants. AB - In the production of monoclonal antibodies, a rapid, sensitive, accurate assay is needed for the critical step of screening. We report the modification of an assay using viable whole cells for screening hybridoma supernatants. The modified assay uses fluorescent second antibodies for detection and has been adapted to an instrument capable of automating a number of assay steps. The modified assay is compared to a dot radioimmunoassay developed and used in our laboratory. The fluorescence assay is highly sensitive but shows more background effect, especially in samples with high protein content, such as ascites. The automated fluorescence assay is very rapid, capable of completing an assay in less than 90 min, and can be performed with minimal operator involvement. The assay was performed successfully with several different antibodies and cell types. This screening procedure should be especially useful for laboratories with large numbers of fusions to evaluate. PMID- 3302047 TI - Hybridoma technology: new developments of practical interest. PMID- 3302048 TI - Production of monoclonal antibodies against glucose oxidase, alkaline phosphatase and peroxidase. Their application in a highly sensitive antigen spot microassay. AB - The production of monoclonal antibodies against peroxidase, alkaline phosphatase and glucose oxidase and the use of the respective enzyme monoclonal anti-enzyme complexes in immunoassays are described. A micromethod using nitrocellulose membranes as solid phase was developed. This microassay has the advantage of being a rapid and simple test procedure, using only 0.2 microliter of antigen solution and 25 microliter of test reagents. A high sensitivity was achieved by repeated incubation of monoclonal enzyme anti-enzyme complexes bridged by anti mouse immunoglobulin. As little as 200 pg human IgG and 400 pg human IgM could be detected. The glucose oxidase assay together with the alkaline phosphatase assay displays the highest sensitivity and has significant advantages including easy evaluation due to high color contrast of the enzymatic reaction, availability of non-toxic substrate reactions, and no interference with endogenous enzyme activity in mammalian antigen preparations. PMID- 3302049 TI - High efficiency gene transfer and expression in normal murine B lymphocytes. AB - The introduction of new genetic information into hematopoietic cells offers a new approach for investigating the molecular events controlling differentiation. Retrovirus vectors have been used to transfer new genes with high efficiency into murine hematopoietic cells, primarily of the myeloid lineage. In this report, we show that vectors carrying the dominant, selectable gene for neomycin resistance (neo gene) can successfully infect normal murine B lymphocytes (CFU-B). The infected CFU-B formed colonies in vitro in high concentrations (750 micrograms/ml) of G418, a neomycin analogue. That B lymphocytes contained the neo gene was confirmed by the findings that the putative B cell colonies growing in G418 contained antibody-producing cells and that the cells responding to the B cell mitogen, LPS, were resistant to G418. Infection of normal spleen cells with different vectors containing a variety of transcriptional regulatory sequences resulted in 7-40% of the CFU-B becoming G418 resistant. Introduction of the immunoglobulin heavy chain enhancer into NEO vectors appeared to augment the expression of the neo gene, since the level of G418 resistance was higher in B cells infected with a NEO vector containing the enhancer than in cells infected with a vector lacking the enhancer. PMID- 3302050 TI - A case of rabies with unusual presentation. PMID- 3302051 TI - Enzymatic activation of the Bacillus sphaericus mosquito larvicidal toxin. PMID- 3302052 TI - Antibiotic therapy, endotoxin concentration in cerebrospinal fluid, and brain edema in experimental Escherichia coli meningitis in rabbits. AB - We investigated the effect of cefotaxime and chloramphenicol on endotoxin concentrations in cerebrospinal fluid (CSF) and on the development of brain edema in rabbits with Escherichia coli meningitis. Both antibiotics were similarly effective in reducing bacterial titers. Cefotaxime, but not chloramphenicol, induced a marked increase of endotoxin in CSF, from log10 1.5 +/- 0.8 to log10 2.8 +/- 0.7 ng/ml (P less than .01). This result was associated with an increase in brain water content (405 +/- 12 g of water/100 g of dry weight compared with 389 +/- 8 g in untreated controls; P less than .01), whereas in animals treated with chloramphenicol, brain water content was identical to controls. The cefotaxime-induced increase in endotoxin concentration and brain edema were both neutralized by polymyxin B, which binds to the lipid A moiety of endotoxin, or by a monoclonal antibody to lipid A. These results indicate that treating gram negative bacillary meningitis with selected antibiotics induces increased endotoxin concentrations in CSF that are associated with brain edema. PMID- 3302053 TI - Controlled trial and dose-finding study of ivermectin for treatment of onchocerciasis. AB - Ivermectin, given as a single oral dose, has shown considerable promise as a new treatment for onchocerciasis. We assessed the safety and efficacy of ivermectin and tried to determine the optimal dose. Two hundred Liberians received 100, 150, or 200 micrograms of ivermectin/kg or placebo and were followed up for 12 months. Therapy was associated with only minimal systemic and ocular side effects. A 200 micrograms/kg dose was associated with greater systemic reaction than was a 100 micrograms/kg dose. Each treatment group had significant reduction in skin microfilaria counts by day 3 and a decrease of approximately 95% at three months. At three months the proportion of persons with no microfilariae in a specimen of skin was significantly less in the 100-micrograms/kg group than in the 150 micrograms/kg or 200-micrograms/kg groups. At 12 months, the level of microfilariae in skin was still reduced approximately 80%. Significant reduction in ocular involvement was seen in all groups. These results confirm that single dose ivermectin is effective and well-tolerated and suggest that 150 micrograms of ivermectin/kg may be the optimal dose for initial therapy. PMID- 3302054 TI - Effect of contraceptives on the adhesion of Escherichia coli to uroepithelial cells. AB - We studied the effect of female ovarian hormones present in contraceptive preparations on six strains of Escherichia coli isolated from patients with urinary tract infections. These strains had variable attachment potential. To study this effect in vivo, we gave a woman an oral contraceptive preparation and then compared the amount of attachment to her uroepithelial cells before and after hormone administration. To study the in vitro effect, we exposed uroepithelial cells from this same woman to different hormone concentrations for up to 18 hr and noticed any alteration in adhesion. We observed that in vivo as well as in vitro exposure of uroepithelial cells to hormones enhanced the adhesion of all E. coli strains. PMID- 3302055 TI - Shigellosis in Bangladesh: a reply. PMID- 3302056 TI - Characterization of three species of Escherichia coli-derived human leukocyte interferon A separated by reverse-phase high-performance liquid chromatography. AB - A preparation of recombinant human leukocyte interferon A (rIFN-alpha A) obtained from Escherichia coli cells was found by reverse-phase high-performance liquid chromatography (HPLC) to contain three species. The three species, named Mf-1, Mf 2, and Ms in the order of their elution, were separated and characterized to elucidate their structural differences. The amino acid compositions, the amino terminal amino acid sequences (Cys1-Asp2-Leu3-), and the carboxy-terminal amino acids (Glu) of the three species agreed with those predicted from the cDNA sequence, although the sequence analysis yields of Mf-2 and Ms were extremely low. They were found to have the same disulfide bonds, Cys1-Cys98 and Cys29 Cys138, by amino acid analysis of the tryptic peptides, but the recovery of the peptides linked by a Cys1-Cys98 disulfide bond for Mf-2 and Ms was extremely low. The results demonstrate that although the primary structures of the three species are almost identical, small difference(s) exists among them especially at the amino-terminal portion. PMID- 3302057 TI - Literature update: biofeedback and chronic pain. PMID- 3302058 TI - The surface extracellular coat of the midgut in Triatoma infestans. I. Mechanism of development. AB - The mechanism of formation of the apical surface, extracellular coat, and microvilli of the midgut of adult Triatoma infestans (hematophagous insect) has been studied with the electron microscope after a recent meal and after 10 days postfeeding. In the first case the extracellular coat becomes disorganized and mixed with the intestinal content. At the same time, small basal cells show the appearance of intracytoplasmic lipid droplets surrounded by a well-developed rough endoplasmic reticulum; the droplets increase in size and complexity by incorporation of other smaller droplets. Short microvilli appear at the surface of the newly formed droplets. The homogeneous dense content gradually changes due to development of delicate plexiform membranes. Fusion with similar droplets from the neighbor cells coincides with desquamation of older degenerated superficial cells and their replacement by basal cells. An extracellular coat complex emerges from the fused droplets. At 10 days postfeeding, the microvilli-coat complex attains maximal development. PMID- 3302059 TI - Transmission of leprosy. PMID- 3302060 TI - Seroepidemiological studies in subsided cases of multi and paucibacillary types of leprosy using FLA-ABS test. AB - FLA-ABS test was carried out in 145 subsided cases of multibacillary (BL/LL) and 197 subsided cases of paucibacillary (TT/BT/I) types. The period of subsidence varied from 0-5 years or more. It was observed that percentage positivity decreases with the subsidence of the disease. In multibacillary cases, FLA-ABS positivity was 95% (active cases), 50% (after 1 year of subsidence) and 36% (after 5 years of subsidence) whereas in paucibacillary types FLA-ABS positivity was 80% (active cases), 34% (after 1 year of subsidence) and 19% (after 5 years of subsidence). A significant proportion of multibacillary subsided cases continued to be positive at high titres (1:160 and 1:640) even after 5 years of clinical subsidence. This implies the presence of continuous antigenic stimulus resulting in high antibody titres even after several years of clinical subsidence. On the other hand percentage positivity at high titres gradually decreased with the increased duration in paucibacillary cases. PMID- 3302061 TI - Short term combination therapy for paucibacillary leprosy--histological evaluation & follow-up study. AB - 68 patients with paucibacillary disease were started on various regimes of multi drug therapy, consisting of ethionamide, rifampicin or clofazimine administered with dapsone. Serial skin biopsies were taken from 32 patients at one, two and three years and even later after the initial pre treatment biopsy. Actual material was available for study from 9 patients. All regimens were tolerated well except the one with ethionamide. However the therapeutic response was equal in all combination therapies as supported by histopathology. Compared to that with dapsone monotherapy the response was quicker with combination. Dapsone plus rifampicin combination was best tolerated and it worked out to be economical as well. No relapse was noted in any group during two or more years follow up. PMID- 3302062 TI - Skin smear examination in relation to multidrug therapy campaigns. PMID- 3302063 TI - Bacterial index: Ridley's vs. Dharmendra's scale. PMID- 3302064 TI - [Analyses of the oxygen activation of heme-containing oxygenases by heme substitution technics]. PMID- 3302065 TI - [Structural changes in sugar chains of membrane glycoproteins during hematopoietic cell differentiation]. PMID- 3302066 TI - [Mechanism of axonal transport]. PMID- 3302067 TI - [Congenital cystic adenomatoid malformation of the lung: prenatal diagnosis and management]. PMID- 3302068 TI - [A case report of acardius holosomes hemiclanius]. PMID- 3302069 TI - [An immunohistochemical study with monoclonal antibodies on lymphocytes infiltrating in cervical cancer]. AB - We investigated lymphocytes infiltrating cervical cancer by an immunohistochemical method. Frozen sections (20 with frank invasive cancer, 4 with MIC, 5 with CIS, 6 with dysplasia, 3 normal) were stained by the ABC (avidin biotin-peroxidase complex) method using monoclonal antibodies to identify functional subsets of lymphocytes. The monoclonal antibodies used were anti Leu 1 (T cell), anti Leu 2a (cytotoxic/suppressor T cell), anti Leu 3a (helper/inducer T cell), anti Leu 10 (B cell) and anti Leu 7 (NK cell). The results were as follows: Many lymphocytes infiltrated and surrounded the cancer nests, and there, T cells predominated over B cells. The intensity of infiltration of T cells was not correlated with the grade and prognosis of cervical cancer. The ratio of Leu 2a+ cells to Leu 3a+ cells tended to change with the advance of cancer. Leu 2a+ cells were relatively predominant in early cases and cases with a good prognosis. There were very few B cells close to cancer nests, and they were not correlated with the grade and prognosis of cervical cancer. NK cells were identified in many cases, but they were scattered and were not correlated with grade and prognosis of cervical cancer. PMID- 3302070 TI - [Studies of endometrial granulocytes in early pregnant decidual tissue by means of double immunofluorescent staining and flow cytometry]. AB - Isolated decidual cells, containing endometrial granulocytes, were prepared from human decidual tissue obtained during the first trimester. Surface markers of endometrial granulocytes were analysed by two-color immunofluorescent staining and flow cytometry. Morphological studies of the cells which were sorted according to the presence or absence of CD2 (sheep erythrocyte receptor) and CD3 (mature T cell marker) were also carried out by staining with phloxine tartrazine. The results were as follows. The mean percentage of bone marrow derived cells was 72%, whereas CD2+ cells were up to 50% of isolated cells from decidual tissue. The cells containing cytoplasmic phloxinophilic granules, which were characteristic of endometrial granulocytes, were subpopulation of CD2+ cells. The granules were stained on CD2+/CD3- cells but not on CD2+/CD3+ cells. It was confirmed that endometrial granulocytes did not have the mature T cell marker and differed from the T cell lineage. Only a few cells expressed NK cell markers as well as CD2. It can therefore be concluded that endometrial granulocytes were not of the NK cell lineage. While non-T, non-NK, granulated suppressor cells, which may be analogous to endometrial granulocytes, were observed in mice decidual tissue (Clark et al.), there were very few numbers activated T cells in human decidual tissue. It is possible that endometrial granulocytes are related to the unresponsiveness of T cells in decidual tissue. PMID- 3302071 TI - [Placental specific findings in twin pregnancies with hydramnion]. AB - Eleven of 157 twin pregnancies were complicated with polyhydramnios. Chorionicity, vascular anastomosis and insertion of the umbilical cord were analyzed with relation to polyhydramnios. 1. Polyhydramnios was found commonly in monochorionic placentation. 2. Vascular anastomosis was found in 40% of monochorionic polyhydramnotic placentas, which was lower than the anastomosis of monochorionic non-polyhydramniotic placentas. 3. The placentas with hydramnios had a higher incidence of abnormal umbilical insertion (marginal or velamentous insertion). These data indicate that incompetent vascular connections between the two fetoplacental circulations may be the pathogenesis of polyhydramnios. PMID- 3302072 TI - [Immunohistochemical localization of hCG alpha, hCG beta CTP, hPL and SP1 on villous and extravillous trophoblasts in normal human pregnancy]. AB - Trophoblasts are divided into villous trophoblasts and extravillous trophoblasts, depending on whether they constitute a villous structure, and cell columns intervene between them. We conducted an immunohistochemical localization of human chorionic gonadotropin (hCG) alpha, hCG beta C-terminal peptide (CTP), human placental lactogen (hPL) and pregnancy-specific beta 1-glycoprotein (SP1) on the trophoblasts of normal human pregnancy, using forty-one hysterectomized pregnant uteri (6-22 weeks). In villous trophoblasts, the capacity to synthesize hCG alpha, hCG beta CTP, hPL and SP1 seemed to develop according to the morphological change from mononuclear cells to multinuclear cells. In contrast, the synthetic capacity of these proteins seemed not to correspond with the morphological change in extravillous trophoblasts: The location of hCG alpha, hCG beta CTP and SP1 was restricted to the mononuclear trophoblasts in the superficial decidua, while hPL was present extensively in extravillous trophoblasts, including multinuclear trophoblasts in the deciduomuscular junction. Therefore, it may be reasonably said that extravillous trophoblasts have many biological features distinct from villous trophoblasts and differentiate in an independent manner. Mononuclear trophoblasts in the cell column were negative for these proteins, which, together with morphological observations, strongly suggest the germinative nature of these cells. PMID- 3302073 TI - Expression of vimentin in common epithelial tumors of the ovary. PMID- 3302074 TI - [Comprehensive examination and treatment on reproductive wastage]. PMID- 3302075 TI - [Hydatidiform mole with a surviving coexisting fetus: diagnosed at 8th week gestation]. PMID- 3302076 TI - [Clinical study on ultrasonic diagnosis in field of oral surgery]. PMID- 3302077 TI - Male-factor infertility and in vitro fertilization. AB - In vitro fertilization (IVF) was developed primarily as a treatment for female and idiopathic infertility. However, with the discovery that relatively few sperm are required to achieve fertilization in vitro, it was proposed that IVF could be used also as an effective treatment for male-factor infertility. This review deals with the work that has been carried out by various groups in this area of male-factor infertility. As the standards of classification and the presentation of results vary from group to group, this also shows that there is a need for some standardization of how patient selection and the presentation of results are carried out in the area of male-factor infertility. PMID- 3302078 TI - Are ultrasonic-guided follicular aspiration and flushing safe for the oocyte? AB - Oocyte collection was carried out in 53 patients by ultrasonically guided abdominal puncture under local or epidural anesthesia. Follicles were aspirated and flushed two to six times using a syringe with culture medium. A total of 196 oocytes was collected and 84 of those (42.9%) were found in the flushes. Mechanical damage was observed in 5.1% of the oocytes. Cleavage rates in mature oocytes (157) after 48 hr in culture were similar in the aspirate group (56.5%) and in the flush group (54.2%). Ten clinical pregnancies were obtained, corresponding to a pregnancy rate of 18.9%. PMID- 3302079 TI - EORTC trials in large bowel cancer. PMID- 3302080 TI - Traumatic lesions of the rectum. AB - Twenty-two patients treated for rectal trauma between 1975 and 1985 were reviewed. There were 13 males and nine females, of mean age 38 years (18-72 years). Causes included gunshot (2), sexual trauma (8), road accident (5), impalement (5), polypectomy (2). Two patients died, giving a treatment mortality of 9%. Cases with peritonitis or sphincter injury were treated by defunctioning colostomy and immediate repair of rectum and sphincter. Of 14 such patients the colostomy had been closed in all but one, who accounted for the only failed sphincter repair out of eight performed. The results show the success of a policy of faecal diversion for intraperitoneal rectal injury and sphincter damage and of local repair without diversion for most cases with extraperitoneal rectal injury. PMID- 3302081 TI - Results of coloanal anastomosis. A prospective study. AB - Anterior resection with colo-anal anastomosis was carried out in 40 patients. The main indications were rectal neoplasia (30 cases) and irradiation proctitis (8 cases). Early complications occurred in 12 patients and three died of cardiopulmonary complications. Fistula formation and stenosis were the most frequent late complications. In 23 patients with adenocarcinoma operated for cure there was one recurrence. The functional results were good, although it often took up to 1 year until satisfactory continence, stool consistency and frequency were obtained. Manometry showed a significant decrease in anal canal length and resting tone postoperatively. The method is a practicable alternative to total rectal excision. PMID- 3302082 TI - The missing randomized trial of two surgical treatments for acute obstruction due to carcinoma of the left colon and rectum. An interim report. AB - Between 1978 and 1985, 55 patients with left-sided colonic obstruction presenting as an emergency were randomised to two treatment groups. In Group T (28 patients) a transverse colostomy was performed as a first stage. After recovery, a second stage of resection with anastomosis was carried out and 17 patients had a 'curative' resection. Of these the colostomy was closed as a third stage in 16. In Group R (27 patients) immediate resection with end colostomy and mucous fistula was carried out as a first stage. A 'curative' resection was possible in 25, of whom 5 died postoperatively. Of the 20 remaining patients, 15 underwent a second stage operation in which reanastomosis was carried out. There was no significant difference in cancer-specific survival between the two treatment groups. Six patients having a curative operation in Group T died with recurrence and 1 further death occurred unrelated to cancer, leaving 10 alive at present, 3 of whom have recurrence. Of the 25 patients treated for cure in Group R, 5 died postoperatively, 9 died with recurrence and 11 were still alive at the time of this assessment, 1 of whom has recurrence. The results at this intermediate stage of assessment indicate no advantage for immediate resection in terms of treatment mortality and long-term survival over an initial transverse colostomy. PMID- 3302083 TI - The aetiology of Crohn's disease. PMID- 3302084 TI - Hal Downey, Ph.D. (1877-1959): "Renaissance hematologist". PMID- 3302085 TI - Lipoprotein metabolism in diabetes mellitus. PMID- 3302086 TI - Anatomical and biomechanical characteristics of upper cervical ligamentous structures: a review. AB - Anatomical and biomechanical characteristics of upper cervical ligamentous structures are discussed. These ligaments tend to operate in a manner slightly different from others in the axial skeleton, while still maintaining normal checks in motion. This paper provides review of these ligamentous functions. PMID- 3302087 TI - Neurogenic bladder and spina bifida occulta: a case report. AB - A case report is presented in which a neurogenic bladder, presumably due to spina bifida occulta, is successfully managed by manipulation. PMID- 3302088 TI - A PC-based free text DSS for health care. Case studies and applications. AB - A free text decision support system (DSS) has been constructed for health care professionals that allows the analysis of complex medical cases and the creation of a diagnostic list of potential diseases for clinical evaluation. The system uses a PC-based text management system specifically designed for desktop operation. The texts employed in the decision support package include The Merck Manual (published by Merck Sharpe & Dohme) and Control of Communicable Diseases in Man (published by the American Public Health Association). The background and design of the database are discussed, along with a structured analysis procedure for handling free text DSS systems. A case study is presented to show the application of this technology and conclusions are drawn in the summary that point to expanded areas of professional interaction and new frontiers yet to be explored in this rapidly progressing field. PMID- 3302089 TI - Superoxide dismutase and catalase activities in red cells of patients with Plasmodium falciparum. PMID- 3302090 TI - Bone-marrow transplantation for severe aplastic anemia: the first case report in Thailand. PMID- 3302091 TI - Ultrastructure of outermost layer of cell wall in Candida albicans observed by rapid-freezing technique. PMID- 3302092 TI - Immuno-scanning electron microscopy of macrophage cytoskeleton by using colloidal gold and backscattered electron imaging mode. PMID- 3302093 TI - A placebo-controlled, double-blind trial of erythromycin in adults with acute bronchitis. AB - Sixty-three otherwise healthy adults with acute productive cough and no clinical evidence of pneumonia were randomized to receive a ten-day course of erythromycin or placebo. Fifty-seven of these patients returned completed symptom diaries or returned for a two-week follow-up visit. Patients treated with erythromycin reported a more rapid improvement in subjective ratings of cold symptoms, general health, sputum production, and a mean symptom score. Fewer patients in the erythromycin group required cough or cold medications or were congested by day 10 (P less than .05). The treatment group was also less likely to have purulent sputum (9 percent vs 36 percent, P less than .05) and abnormal lung examinations (0 percent vs 29 percent, P less than .01) at a two-week follow-up visit. These results support the use of erythromycin in acute bronchitis. PMID- 3302094 TI - Specificity of sperm-binding Wolffian duct proteins in the rooster and their persistence on spermatozoa in the female host glands. AB - Unlike those of mammals, chicken spermatozoa can develop their fertilizing ability before they leave the testis to pass into the Wolffian duct; moreover, chicken spermatozoa do not require a period of capacitation in the female tract. A question arises, therefore, as to the significance of secretory proteins shown to bind to the surface of chicken spermatozoa as they pass into and through the Wolffian duct. Using anti-Wolffian duct fluid IgG as a probe visualized by immunoperoxidase staining, the present investigation confirms that testicular spermatozoa of quail and turkey as well as chicken do not have any surface determinants in common with those present in Wolffian duct secretions. By contrast, those in the lower portion of the vas deferens display a strong reaction with anti-Wolffian fluid IgG over their entire surface, and immunoprecipitation studies suggest that this reflects the binding of four Wolffian duct proteins. Since a reaction to the antichicken fluid IgG is shown also by mature quail and turkey, but not duck and pigeon spermatozoa, the Wolffian components that coat spermatozoa in birds appear to have a specificity confined to the same order, in this case the Galliformes. Following vaginal or intramagnal insemination, spermatozoa present 48 hours later in the uterovaginal host glands and infundibulum glands, respectively, still reacted strongly. This finding that Wolffian duct components persist on the surface of spermatozoa in the female tract is consistent with the possibility that they have some role in sperm storage or survival in female birds. PMID- 3302095 TI - Differentiation of the anterior latissimus dorsi muscle of the chicken examined by anti-myosin monoclonal antibodies. AB - Two new monoclonal antibodies (McAbs), ALD-180 and ALD-88, produced against the myosin of the slow anterior latissimus dorsi (ALD) muscle of the chicken are described. Their specificity for myosin heavy chain (MHC) was established by radioimmunoassay, immunoautoradiography, and immunofluorescence. They were used in conjunction with McAbs MF-14 and MF-30 (which have been characterized previously to be directed against MHC of the fast skeletal muscle) to examine the developmental changes of the chicken ALD muscle. At the 16-day embryonic, early posthatch, and adult stages the ALD muscle fibers differed in their reaction pattern with the McAbs; at the embryonic stage all fibers reacted strongly with ALD-180 and weakly with ALD-88 and MF-30; at the early posthatch stage there was a checkerboard pattern with many fibers not reacting with any of these three McAbs; and at the adult stage all fibers reacted strongly with ALD-180 and ALD-88 and weakly with MF-30. The MF-14 antibody did not react with ALD muscle at any developmental stage. The mature pattern of immunoreactivity of the ALD muscle fibers with the antibodies was established only after 9 weeks posthatch, and during this 9-week period the immunofluorescence changes were nonsynchronous. Based on immunocytochemical evidence of changes in myosin isoform expression, this study clearly demonstrates a distinctive neonatal (early posthatch) stage in the development of the chicken slow muscle. PMID- 3302096 TI - Myoblast differentiation is induced by nerve transplanted to chick embryo legs. AB - Chick embryos were denervated early in development in order to disrupt the normal inductive interactions between the nervous system and developing populations of mononucleated myoblasts and their precursors in the leg. Neural tissue, either spinal cord or ciliary ganglion, was transplanted to one leg of the denervated embryos; the other leg remained aneural. Clonal analysis of cell populations in the transplant-containing legs showed that ectopic nerve tissue can recapitulate some of the neuromuscular interactions that occur in normally developing embryos. Chief among these was the observation that transplantation induced the appearance of the CMR-III myoblast class in the leg muscle. Since the process by which CMR III myoblasts are produced from a precursor is dependent on nerve both in vivo and in vitro (Bonner, P.H. and T.R. Adams, Dev. Biol., 90:175-184, 1982), it was concluded that transplanted nerve tissue can also induce myoblast differentiation. PMID- 3302097 TI - Distributions of genetic markers in United States populations: I. Blood group and secretor systems. AB - All published and unpublished population frequency data that could be located for U.S. populations are tabulated and presented for the blood group and secretor systems. Results obtained by combining data for comparable racial/ethnic groups are also presented. The results obtained with combined data may give better information on frequencies for the U.S. population at large than is obtainable from studies conducted in restricted geographic areas. PMID- 3302098 TI - Evidence that "vaginal peptidase" is a bacterial gene product. AB - A peptidase has been described in vaginal samples, termed "vaginal peptidase." This enzyme has been proposed as a tissue specific marker for vaginal debris. We have explored the presence of this enzyme in vaginal swabs from alleged sexual assault victims and volunteer donors as well as bacterial cultures. These studies reveal that "vaginal peptidase" is composed of a family of peptidase isozymes that originate from several bacterial species. The characterization of "vaginal peptidase" as a tissue specific marker for vaginal debris is premature. PMID- 3302099 TI - On the Aesculapion at Pergamum; Pergamum paper; Galen and the caduceus. PMID- 3302100 TI - An epitaph for Medicare. PMID- 3302101 TI - Immunological differences between the envelope glycoproteins of two strains of human respiratory syncytial virus. AB - The envelope glycoproteins of two distinct strains of respiratory syncytial virus (RSV) (Long and 18537 strains) were purified by affinity chromatography and characterized by immunological methods. The fusion (F) proteins from the two strains were similar in molecular weight by gel electrophoresis and were very closely related immunologically. Rabbit antisera to either F protein reacted with near equivalent titres with the heterologous F protein by Western blot, enzyme linked immunoassay (EIA), neutralization and fusion inhibition assays. In contrast to the similarity of the F proteins, the attachment proteins (G) differed significantly. The 18537 G protein had a molecular weight of 78K compared to 84K for the Long G protein. Rabbit antisera to the G proteins clearly reacted preferentially with the homologous protein, although some cross reactivity was noted by Western blot and EIA. Anti-G serum neutralized the homologous strain of RSV in the presence or absence of complement to much higher titre than the heterologous virus strain. The implications for vaccine development are discussed. PMID- 3302102 TI - [True hermaphroditism and double fertilization]. AB - Two cases of true hermaphroditism are presented. Sex differentiation mechanism, X functions in skin development and pigmentation are studied. Lateral gender assignment in hermaphroditism and mythologic concept right side = maleness and left side = femininity are compared. PMID- 3302103 TI - Affinity purification of synenkephalin-containing peptides, including a novel 23.3-kilodalton species. AB - Affinity chromatography has been used for rapid and high-yield purification of synenkephalin (proenkephalin 1-70) containing peptides present in bovine adrenal medulla (BAM) chromaffin granular lysate. A column of CN-Br-activated Sepharose 4B coupled to synenkephalin antiserum bound synenkephalin immunoreactivity which was eluted by a stepwise gradient of 50 mM ammonium acetate containing 20% (vol/vol) acetonitrile over the pH range 7-3. Synenkephalin immunoreactivity emerged as two peaks, eluting at pH 5.5 and 4.5. Characterization of the two peaks by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting indicated that the pH 5.5 peak contained principally low-molecular weight proenkephalin species (8.6 and 12.6 kilodaltons), whereas the pH 4.5 peak contained, in addition, high-molecular-weight proenkephalin species (18.2 and 23.3 kilodaltons). The 8.6- and 12.6-kilodalton species were isolated from the pH 5.5 peak by TSK gel filtration HPLC, whereas the pH 4.5 peak was further purified by passage over successive affinity columns coupled to antiserum against BAM 22P (proenkephalin 182-203) and [Met5]-enkephalin-Arg6-Gly7-Leu8. The former column retains the 23.3-kilodalton species, whereas the latter column retains the 18.2 kilodalton species. The 23.3-kilodalton peptide represents a novel putative proenkephalin intermediate (proenkephalin-1-206), containing [Leu5]-enkephalin at the C-terminus. PMID- 3302104 TI - Autoradiographic evidence of [3H]SCH 23390 binding sites in human prefrontal cortex (Brodmann's area 9). AB - The distribution of dopamine D-1 receptors has been determined in human prefrontal cortex (Brodmann's area 9) by an in vitro light microscopic autoradiographic method. Dopamine D-1 receptors were localized by using [3H]SCH 23390 as a ligand. Our results indicated that [3H]SCH 23390 binding to slide mounted tissue sections of human brain is specific, saturable, and of high affinity. Lamina Va contained the highest density of D-1 receptors, with a Bmax value of 11.2 +/- 1.3 fmol/mg tissue. The KD values for [3H]SCH 23390 in all laminae ranged from 2.6 to 3.2 nM. Competition studies performed with [3H]SCH 23390 indicated a pharmacologic profile consistent with labeling of the D-1 receptor. PMID- 3302105 TI - Angiotensinogen in cerebrospinal fluid corresponds chromatographically to the gamma-form of plasma angiotensinogen. AB - Angiotensinogen (Aogen) (CA 11002-13-14), the prohormone of the neuro- and vasoactive peptide angiotensin II (Ang II) (CA 11128-99-7), is found in dog brain as well as in dog plasma. At 2-4 micrograms/ml CSF, Aogen comprises 1-2% of the total protein in dog CSF. Immunopurified CSF and plasma Aogen were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and anion-exchange HPLC. Two major (alpha- and beta-) forms and one minor (gamma-) form of Aogen were observed in dog plasma. The majority of Aogen in dog CSF was chromatographically identical to the gamma-form of plasma Aogen; alpha- and beta Aogen forms comprised less than 5% of the total CSF Aogen. The N-terminal amino acid sequences of alpha-, beta-, and gamma-Aogen identified these proteins as members of the Aogen family. The N-terminal amino acid sequence of CSF gamma Aogen was Asp-Arg-Val-Tyr-Ile-His-Pro-Phe-Leu-Leu-Val-Tyr-Ser-Lys-Ser-Ser-(X)-Glu . More basic than either alpha- or beta-Aogen, gamma-Aogen was shown to be a glycoprotein with an apparent molecular weight (Mr) of 58,000. CSF [des Ang I] Aogen exhibited a greater anion-exchange HPLC retention. CSF, however, contained only minor amounts of [des Ang I]-Aogen. These analyses have demonstrated that brain overwhelmingly releases one particular Aogen into the CSF; however, very little of this brain Aogen is utilized for the production of Ang I. PMID- 3302106 TI - Poly-N-acetyllactosamine glycans of cellular glycoproteins: predominance of linear chains in mouse neuroblastoma and rat pheochromocytoma cell lines. AB - To study the properties of protein-bound oligosaccharides in neuronally differentiating cells, two model systems were used: murine N1E-115 and N-18 neuroblastoma cells inducible by serum starvation and rat PC12 pheochromocytoma cells inducible by nerve growth factor. Glycopeptides were prepared from cells metabolically labeled with [3H]glucosamine and analyzed by gel filtration. The properties of the high-molecular-weight glycopeptides were studied using enzymatic digestion with neuraminidase and endo-beta-galactosidase. In contrast to other cell lines analyzed, the neuroblastoma and pheochromocytoma lines contained predominantly glycopeptides completely cleavable with endo-beta galactosidase, which indicated that they were linear-type poly-N acetyllactosamine glycans. The proportion of these linear chains in the high molecular-weight fraction increased during neuronal differentiation in both cell systems. The linear nature of the glycans was also correlated with positive anti i and negative anti-I reactivity of the cells in immunofluorescence microscopy. Specific cell surface labeling for poly-N-acetyllactosamine glycans and sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed several glycoprotein components, some of which showed changes during neuronal differentiation. The high proportion of linear poly-N-acetyllactosamine chains in these neuronal cell lines and its increase during neuronal differentiation suggests that these glycans may be a characteristic feature of neuronal or neuronally differentiating cells. PMID- 3302107 TI - Monoclonal antibodies to and immunoaffinity purification of choline acetyltransferase from bovine brain. AB - Three hybridomas producing monoclonal antibodies to bovine brain choline acetyltransferase (ChAT) have been established by fusion of the spleen cells from a mouse immunized with purified enzyme with myeloma NS-1 cells. All three clones produced IgGl antibodies that reacted with enzyme protein denatured with sodium dodecyl sulfate. By using one of the monoclonal antibodies, a rapid and efficient immunoaffinity purification procedure of bovine ChAT has been established. Immunoblot analysis and immunoaffinity purification indicated that bovine ChAT is a single 68-kilodalton protein. The monoclonal antibodies will offer us a good tool to isolate the cDNA clones encoding ChAT. PMID- 3302108 TI - Historical review of porous-coated implants. AB - The implementation of cementless joint replacement prostheses is proving to be a significant advance in orthopedic surgery. The porous-coated implant, stabilized by the biologic fixation resulting from bone ingrowth, is one of several types of cementless devices. A historical review of porous materials reveals that the concepts underlying biologic fixation date back decades. It was the initial concerns about the long-term performance of bone cement that, in the early 1970s, stimulated several groups more actively to pursue the development of porous systems. As a result of their efforts, there are currently many different porous coatings and prosthetic designs undergoing clinical investigation, with generally encouraging results. However, it is becoming clear that the importance of porous coated prosthetic devices is not that they will serve to replace cemented prostheses entirely, but rather that they offer viable alternatives for the treatment of certain populations of patients. An understanding of the evolution of porous-coated implants can help to identify gaps in our knowledge and areas that require additional study, to direct future design modifications of implants, and to foster effective implementation of the prostheses. PMID- 3302109 TI - St Paul and temporal lobe epilepsy. AB - Evidence is offered to suggest a neurological origin for Paul's ecstatic visions. Paul's physical state at the time of his conversion is discussed and related to these ecstatic experiences. It is postulated that both were manifestations of temporal lobe epilepsy. PMID- 3302110 TI - Gabapentin as an antiepileptic drug in man. AB - Gabapentin, 1-(aminomethyl) cyclohexane acetic acid, is a GABA analogue whose antiepileptic properties were tested in a double blind cross-over trial design as add-on therapy in a dose ranging study which compared 300 mg, 600 mg, and 900 mg/day (each dose given for 2 months) in 25 patients with severe partial and generalised epilepsies. A dose related antiepileptic effect was observed. All three doses were well tolerated and no psychometric impairment was noted. No significant drug interactions were seen. The drug appears worthy of further assessment. PMID- 3302111 TI - Serum insulin-like growth factor-I levels in amyotrophic lateral sclerosis. AB - The serum concentrations of the myotrophic hormone insulin-like growth factor-I (IGF-I) in 23 patients with amyotrophic lateral sclerosis were not significantly different from those found in the sera of 13 control patients. There was no difference in binding of 125I-IGF-I by serum from patients with amyotrophic lateral sclerosis in comparison with that found in the controls. These results indicate that immunoreactive IGF-I concentrations are normal in patients with amyotrophic lateral sclerosis and that such patients do not have significant antibodies binding their endogenous IGF-I. PMID- 3302112 TI - Aggravation of Parkinson's disease by cinnarizine. AB - The effect of cinnarizine on motor function in Parkinson's disease was evaluated in a randomised double-blind parallel study of 20 patients. Both groups were comparable in age, duration of the disease, dose of levodopa and degree of disability. A significant worsening of mobility was observed in patients treated with cinnarizine (75 mg bd), whilst no change was recorded in patients receiving placebo. Cinnarizine should be added to the list of drugs capable of aggravating Parkinson's disease. PMID- 3302113 TI - Cerebrospinal fluid and peripheral blood leukocyte subsets in acute inflammation of the CNS. AB - Leukocyte subsets in CSF and peripheral blood (PB) were determined in 21 patients with acute inflammation of the CNS using the monoclonal antibodies OKT3, OKT4, OKT8, Leu12, and OKM1 in an immunoperoxidase slide assay. There was a predominance of OKT3-positive cells in nearly all samples. Significant differences between acute aseptic and bacterial meningitis only were found in CSF and represented by a higher Leu12 and a lower OKT3 percentage in aseptic inflammation and a higher absolute amount of OKT4-, OKM1- and Leu12-positive cells in bacterial meningitis. Comparison between CSF and PB showed significant differences only in aseptic meningitis with a higher percentage of Leu12-positive cells and a lower percentage of OKT8-positive cells in CSF. The OKT4/OKT8 ratio seems to be generally lower in aseptic meningitis but significant differences only were found in comparison with healthy blood donors. In a case of herpes simplex encephalitis the ratio was strongly increased in CSF during the early phase of specific antibody production because of an absolute rise of OKT4 positive cells. PMID- 3302114 TI - The peripheral nervous system in multiple sclerosis. A review and pathogenetic hypothesis. AB - Despite the rarity of such observations in autopsy material, peripheral nervous system involvement in patients with multiple sclerosis is more common than suspected, judging from results of sophisticated electrophysiological and teased nerve fiber studies. The existence of a number of well documented cases of overt peripheral neuropathy in MS patients suggests that an etiological link may exist between the two conditions. The proposal has been made that one of the obligatory steps in the pathogenesis of MS is an alteration of the blood-brain barrier, which results in most instances from an immunologically induced vasculopathy due to a non-specific viral infection. Whereas the CNS responds by the formation of MS plaques, the PNS lesion is that of the typical post-infectious inflammatory polyneuropathy. In some MS patients an unusual degree of immunological vulnerability causes onion-bulb formations to develop as a result of repeated antigenic challenges. In MS patients the onion-bulb formation is the PNS analog of the CNS plaque: both result from the same pathogenetic mechanism. PMID- 3302115 TI - Lysosomal hydrolases in cerebrospinal fluid of multiple sclerosis patients. A follow-up study. AB - The change in activity of lysosomal hydrolases in the brain tissue of patients with demyelinating disease has been suggested to reflect the demyelination process. In this study we measured neutral proteinase (NP), acid proteinase (AP), and beta-glucuronidase (BG) activities in CSF of 32 patients with multiple sclerosis (MS) (remitting, remitting and relapsing, or chronic progressive course of the disease), 62 controls, and 4 patients with chronic inflammatory disease of central nervous system (ID). Samples from MS patients were taken at different clinical conditions of the disease during the 22-month follow-up. Elevated NP activity was found in patients with relapsing course of MS and also in patients with ID (P less than 0.05). NP activity correlated with the number of leucocytes in CSF of both MS (P less than 0.005, r = 0.50) and control (P less than 0.05, r = 0.21) patients. AP activity decreased in the MS group, especially in patients with remitting or remitting and relapsing courses of the disease (P less than 0.05), but even more in patients with ID (P less than 0.01). During the follow-up the increase in NP activity seemed to be associated with the clinical relapses of MS patients. Other enzymes did not fluctuate with the disease. This study suggests that the change in activity of lysosomal hydrolases is not specific for MS. The increase in NP activity in CSF is associated with clinical relapse of individual MS patients during the follow-up and may indicate immunological activation of the demyelination process in the brain. The large intra- and interindividual variation in enzyme activities in the CSF, however, makes the use of these enzymes difficult for diagnosis of MS and follow-up of MS activity. PMID- 3302116 TI - Breakdown of lysosomal glycogen in cultured fibroblasts from glycogenosis type II patients after uptake of acid alpha-glucosidase. AB - Fibroblast cultures from patients with different clinical subtypes of glycogenosis type II were compared with respect to residual acid alpha glucosidase activity and lysosomal glycogen content. Lysosomal glycogen storage was most pronounced in fibroblasts from patients with the rapidly progressive infantile form of the disease, and the most severe enzyme deficiency. In fibroblasts from adult patients with more than 10% of the control activity storage did not occur, and 15% of the total cellular glycogen was found in the lysosomes as in control cells. The strict correlation between residual acid alpha glucosidase activity and lysosomal glycogen accumulation was further illustrated in two adult Pompe patients with an unusually low enzyme activity. The mild clinical course is unexplained in these particular cases. The enzyme deficiency in all the different mutant cell lines was corrected by the uptake of bovine testis acid alpha-glucosidase from the culture medium. As a result of this, the lysosomal glycogen storage disappeared, and the balance between lysosomal and cytoplasmic glycogen was restored to normal. The implications of this study as a model for enzyme replacement therapy are discussed. PMID- 3302117 TI - Microglia are the major cell type expressing MHC class II in human white matter. AB - In normal human white matter the predominant cell type expressing MHC Class II is the microglia. This population of cells reacts with the pan macrophage marker, EBM/11, and constitutes about 13% of the glial cell population. The intensity of staining was enhanced and the absolute number of Class II+ microglia increased in normal appearing white matter from multiple sclerosis (MS) brain. As T cell activation in MS may occur in the brain the upregulation of microglia bearing MHC Class II may reflect their function as antigen presenting cells in the development of inflammatory lesions. PMID- 3302118 TI - Linkage analysis of Charcot-Marie-Tooth neuropathy (HMSN type I). AB - Fifteen HMSN families with 218 members and documented male-to-male transmission and slow motor nerve conduction velocities were informative for linkage to Duffy blood group (Fy), antithrombin III cDNA probe (AT3) and renin (REN). Our data support linkage to Fy in 8 families (lod score = 2.45 at theta = 0) consistent with HMSN type IB. Linkage to AT3 (lod score = 1.28 at theta = 0) and linkage of Fy to AT3 (lod score = 1.61 at theta = 0) is also supported in 3 of the 8 original families. Linkage to REN (lod score = 0.78 at theta = 0), linkage of Fy to REN (lod score = 0.89 at theta = 0), and linkage of AT3 to REN (lod score = 0.88 at theta = 0) is supported in only 2 of the 8 original families. Linkage to Fy was rejected in seven families, consistent with HMSN type IA (lod score = 4.34 at theta = 0.05). Linkage to AT3 was rejected in 12 families (lod score = 9.52 at theta = 0.05). Linkage to REN was rejected in 13 families (lod score = 11.07 at theta = 0.05). Our data provide support for the concept of genetic heterogeneity in CMT hypertrophic neuropathy (HMSN type I). The linkage of HMSN type IB to Fy seems to be tighter than to AT3 and REN, strongly suggesting the mapping of HMSN type IB locus on the proximal part of the long arm of chromosome 1, close to the centromere. PMID- 3302119 TI - An electron microscopic study of GABAergic neurons and terminals in the central nucleus of the inferior colliculus of the rat. AB - Neurons and terminals in the ventral lateral portion of the central nucleus of the inferior colliculus (ICCN) of the rat were labelled immunocytochemically with antisera to GABA or to its synthesizing enzyme, glutamic acid decarboxylase. Four types of GABAergic neuron are described: small, medium-sized and large multipolar neurons, as well as medium-sized bipolar neurons. All sizes of GABAergic multipolar neurons are characterized by highly infolded nuclei, many mitochondria and both asymmetric and symmetric axosomatic synapses. A dense plexus of terminals occurs on the proximal dendrites of GABAergic neurons, and most of these terminals form asymmetric axodendritic contacts. Small GABAergic neurons (diameter less than 15 microns) are multipolar, and have a large nucleus to cytoplasm ratio, prominent nucleoli and usually two to five axosomatic synapses per thin section, with the majority of these contacts being symmetric. Medium sized GABAergic neurons (15-25 microns in diameter) display both multipolar and fusiform shaped somata, have a more abundant cytoplasm than the small neurons and show about ten axosomatic contacts per thin section. Large GABAergic neurons (diameters greater than 25 microns) have eccentrically located, highly infolded nuclei, abundant cytoplasm and a denser plexus of terminals that form axosomatic synapses than the other cell types. These results indicate that four of the six major cell types in the ICCN are probably GABAergic inhibitory neurons. The axon initial segments of GABAergic neurons in the ICCN all have similar features in that they are contacted by only one or two terminals that form symmetric synapses on their proximal portions and are invested by a glial sheath from 3 to 20 microns from the cell body. Many immunoreactive myelinated axons (approximately 0.5 micron in diameter) are observed and some terminals that arise from these axons form synapses with small neuronal somata. Both these and other labelled terminals are shown to form symmetric synapses. These data suggest a complex circuitry for the GABAergic neurons within the ICCN. PMID- 3302121 TI - Adjuvant treatment of Parksinson's disease with budipine: a double-blind trial versus placebo. AB - Budipine, a new 4,4-diphenylpiperidine derivative, and placebo were administered three times daily to 31 patients with Parkinson's disease over a period of 12 weeks. All patients in the two treatment groups received levodopa (plus benserazide) at an optimum and constant dose for at least 2 months before the start of the study and throughout the trial. The additional administration of budipine (daily dose 60 mg) was excellently tolerated by 14 patients, while 2 patients left the study because of mental confusion at an early stage of the trial. The budipine group showed a 22% improvement on the Columbia Rating Scale (median score). Compared with the placebo group (4% improvement), there was a highly significant difference (P less than 0.01, one-tailed test). Of the three main symptoms of Parkinson's disease, the best effect was seen on tremor, and less pronounced effects on bradykinesia and rigidity. Owing to its long half-life (31 h) with little plasma level fluctuations, budipine appears to be an effective agent in the treatment of Parkinson's disease. PMID- 3302120 TI - Neurological complications in AIDS. AB - Neurological complications in the acquired immunodeficiency syndrome (AIDS) are an important aspect of this new infectious disease and occur frequently. The existence of neurotropic variants of the human immunodeficiency virus (HIV), the causative agent of AIDS, is probable. Direct infection of the nervous system with HIV leads to a variety of HIV-induced neurological syndromes, the AIDS dementia complex being its most important representative. In addition, a large number of opportunistic infections and malignancies of the nervous system may complicate the disease. Major aspects of the clinical pictures, rational diagnostic approaches and treatment options of the most important sequels of HIV infection of the nervous system are discussed. PMID- 3302122 TI - Gonadal steroid receptors in meningiomas. AB - Oestrogen receptor (ER) analysis was performed in 70 meningiomas with an enzyme immunoassay, using monoclonal antibodies against human oestrogen receptor protein (oestrophilin) and with a sensitive radioligand binding assay, using 125I oestradiol as radioligand. Low levels of ER immunoreactivity were found in tumours from 51% of patients, whereas ER binding activity was demonstrated in 40% of the meningiomas examined. In 8 (11%) tissue samples multiple binding sites for oestradiol were observed. The immunoreactive binding sites corresponded to the classical, high-affinity ER. In ligand binding studies, however, measurement of classical ER was considerably influenced by a second low-affinity, high-capacity oestrogen binding component even at low ligand concentrations. 3H methylpromegestone and 3H-methyltrienolone, a synthetic gestagen and androgen, were used for concurrent determination of the progesterone receptor (PR) and androgen receptor (AR) binding activity. High concentrations of PR were detected in 53 (76%), whereas moderate levels of AR binding sites were demonstrated in 33 (47%) tumours. A positive correlation between ER immunoreactivity and AR binding activity is indicative for an oestrogen regulation of AR via the ER system. The presence of gonadal steroid receptors in a large proportion of meningiomas and the tendency for a dependence of receptor concentrations on the histological subtype could have implications for tumour therapy. PMID- 3302123 TI - Mechanisms of postsynaptic plasticity: remodeling of the junctional acetylcholine receptor cluster induced by motor nerve terminal outgrowth. AB - Motor nerve terminal outgrowth (NTO) at neuromuscular junctions (NMJs) occurs rapidly in response to denervation changes in muscle. We have previously found that NTO can produce an elongation of the synaptic area of the NMJ as defined by cholinesterase-silver staining. In the present study, we examined the effects of NTO on a postsynaptic muscle membrane component, the usually stable cluster of acetylcholine receptors (AChRs) at the NMJ. NTO was evoked in rat soleus muscles using botulinum toxin. AChRs were demonstrated using immunocytochemistry or autoradiography of alpha-bungarotoxin binding. Our results show that NTO induces rapid elongation of the cluster of AChRs at the NMJ within 7 d of treatment with botulinum toxin. The growth in the size of the AChR clusters was accompanied by an increase in the number of AChRs/NMJ. No elongation of AChR clusters was seen following surgical denervation, suggesting that cluster growth is related to NTO and not to denervation changes in muscle per se. Growth of NMJ-AChR clusters appeared to result primarily from 2 processes: insertion of new AChRs into the NMJ membrane and, surprisingly, redistribution of preexisting NMJ-AChRs. These results show that NTO can cause rapid changes in the normally stable cluster of AChRs at the NMJ. Motor nerve terminals provide a strong and anatomically precise control of AChRs at the NMJ. PMID- 3302124 TI - Heterogeneous distribution of neurotensin-like immunoreactive neurons and fibers in the midbrain periaqueductal gray of the rat. AB - The midbrain periaqueductal gray (PAG) has been shown to be a site where various manipulations induce pain suppression. Recent physiological evidence (Behbehani and Pert, 1984; Behbehani et al., 1987) suggests that neurotensin has pronounced physiological actions in PAG and effects pain suppression. We have performed immunohistochemical studies in order to determine the magnitude and distribution of neurotensin-like immunoreactive (NT-IR) cell bodies and fibers in PAG. NT-IR cell bodies were common throughout PAG, although there were more in the caudal than the rostral half. NT-IR neurons were much more numerous in the ventral than the dorsal half of PAG, and some appeared to be located within the dorsal raphe nucleus. The pattern of NT-IR fibers was analyzed with the aid of image enhancement/analysis and densitometry. The fibers were found to be heterogeneously distributed, being most heavily concentrated in the region adjacent to the cerebral aqueduct in the caudal two-thirds of PAG. The distribution of NT fibers closely matches sites where exogenously applied NT elicits long-lasting excitation of PAG neurons (Behbehani et al., 1987). Based on the known physiological and behavioral actions of NT in PAG, the present anatomical results suggest that NT acts on elements located predominantly in the medial and ventrolateral parts of PAG. Neurons activated by NT may project directly to the nucleus raphe magnus and adjacent ventral medulla (Behbehani and Pert, 1984) to activate neurons that project to the spinal cord and modulate nociceptive circuits. PMID- 3302125 TI - Regional distribution of astrocytes with intense immunoreactivity for glutamate dehydrogenase in rat brain: implications for neuron-glia interactions in glutamate transmission. AB - The principally mitochondrial enzyme glutamate dehydrogenase (GDH) exhibited low intensity, uniform immunoreactivity in neurons and intense heterogeneous labeling of glial cells of rat brain. Simultaneous peroxidase labeling for GDH and immunoautoradiography for glial fibrillary acidic protein (GFAP) confirmed the astrocytic localization of the enzyme. Immunoreactivity in astrocytes, but not in neurons, required the presence of Triton X-100 as a solubilizing agent. Most of the intensely labeled glial processes were localized to regions previously reported as containing moderate to high densities of binding sites for the excitatory amino acids, L-glutamate or L-aspartate, and glutamatergic fibers. These included several forebrain regions, such as the superficial layers of the rostral neocortex, dorsal neostriatum, nucleus accumbens, septohippocampal nucleus, intralaminar thalamic nuclei, and external capsules. However, the central gray of the midbrain, the nuclei of the reticular formation, brain stem regions projecting to the cerebellum, and cranial nuclei of the trigeminal and vagal nerves also exhibited intense glial labeling for GDH, even though some of these regions are known to receive only weak glutamatergic projections. A second factor determining the distribution of GDH appeared to be neuronal activity, as assessed by correspondence with reported high densities of cytochrome oxidase. We conclude that GDH enriched in glial populations exists in a subcellular compartment distinct from that of neurons and may serve as one of the enzymes involved in glutamatergic transmission. Deficiencies of glial GDH and the consequent cytotoxic effects of high levels of excitatory amino acids may contribute to a number of neurodegenerative disorders. PMID- 3302126 TI - Axon pathway boundaries in the developing brain. I. Cellular and molecular determinants that separate the optic and olfactory projections. AB - When optic fibers first approach the chiasmatic region of the diencephalon in the chick embryo on days 3 and 4 (E3-4), they rarely grow rostrally into the olfactory region of the telencephalon. Conversely, olfactory tract axons grow as far as, but never cross the diencephalic/telencephalic (D/T) boundary to enter the optic chiasm. In this study, a region of specialized neuroepithelium, originally named the "knot" in mouse by Silver (1984), has been identified at the D/T border of chick embryos. At pre-axonal stages, the presumptive knot region undergoes a cataclysmic cell death, with concomitant phagocytosis of necrotic debris by the remaining cells. When fibers subsequently appear in the chiasm and olfactory tracts, the knot consists of a very dense, interwoven cluster of non neuronal cells that lack marginal radial processes, and whose cell bodies directly abut the glial limiting membrane. Thus, the morphology of the knot is in sharp contrast to the cell body-free marginal zone and endfoot regions along which axons tend to grow. In addition, we found that the neural cell adhesion molecule (N-CAM), which is expressed on neuroepithelial cell processes within the central optic and olfactory pathways, is not present on cells in the knot region during periods of axon growth. These results suggest that the knot, through its elimination of the marginal zone processes, absence of large extracellular spaces, and relative absence of adhesion molecules, functions as an axon refractory barrier that effectively separates the optic and olfactory projections. PMID- 3302127 TI - Localization of luteinizing hormone-releasing hormone (LHRH) neurons that project to the median eminence. AB - The neuropeptide, luteinizing hormone-releasing hormone (LHRH), is released from nerve terminals in the median eminence and carried via the hypophysial portal system to the anterior pituitary, where it stimulates the release of gonadotropins. LHRH-containing neurons are located in many different regions of the rodent brain, including olfactory, septal, preoptic, and hypothalamic structures. Since those LHRH neurons that project to the median eminence form the final common pathway for the regulation of the pituitary/gonadal axis, we wished to determine which of these cell groups are afferent to this structure. A retrograde tracer, the lectin wheat germ agglutinin (WGA), was placed directly on the exposed surface of median eminence. Following survival times of 8-13 hr, brains were prepared for the dual immunocytochemical detection of WGA and LHRH. Approximately 50% of the LHRH neurons from the level of the septal nuclei caudalward were found to contain WGA immunoreactivity and therefore to project to the median eminence. The remaining single-labeled LHRH neurons were intermingled with the double-labeled cells. The 2 populations were not distinguishable from each other on either cytological or cytoarchitectonic criteria. Those LHRH neurons that were not retrogradely labeled following an injection of tracer into the median eminence are presumed to project to other regions of the central nervous system. We conclude that the LHRH neurons that are directly involved in the regulation of reproductive function are very heterogeneous, widely scattered in telencephalic and diencephalic regions. PMID- 3302128 TI - The postnatal development of the dopamine-containing innervation of dorsal and ventral striatum: effects of the weaver gene. AB - We report here that the pattern of loss of dopamine that occurs in the brains of adult mice carrying the autosomal recessive weaver gene is the consequence both of failed postnatal development of the dopamine-containing mesostriatal innervation and of the disappearance of the early forming dopamine-island system. For these studies, we compared the contents of dopamine extracted from 3 divisions of the striatum, the caudoputamen, nucleus accumbens, and olfactory tubercle, and from the midbrain of weaver and control littermate pups. Catecholamines were extracted from tissues dissected from serial brain slices and were separated and measured using high-performance liquid chromatography followed by electrochemical detection. The anatomical pattern formed by the catecholamine containing innervation of the developing striatum was studied in 8-, 11-, 20-d old, and 1.5-month-old weaver and control mice using tyrosine hydroxylase immunohistochemistry. In weaver neonates (7-8 d old), the dopamine-containing innervation of the caudoputamen is characterized by near-normal concentrations of dopamine and by a normal anatomical arrangement of dopamine islands. Subsequently, however, the weaver disease is expressed in the caudoputamen as a failure of the dopamine islands to persist and of the dopamine-containing innervation of the matrix to develop at a normal rate. Whereas the concentration of dopamine increases 4.4-fold between days 7 and 33 in normal animals, it increases only 1.6-fold in the weaver. In spite of the severe reduction of dopamine, the weaver's caudoputamen grows to near-normal size (85%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302129 TI - Selective cell death of magnocellular vasopressin neurons in neurohypophysectomized rats following chronic administration of vasopressin. AB - Regeneration and functional recovery of the hypothalamoneurohypophysial system (HNS) in neurohypophysectomized rats treated with either saline or vasopressin (VP) were analyzed utilizing specific immunohistochemical and physiological measures. Neural lobe ablation combined with VP administration precipitated a profound diabetes insipidus (following cessation of VP delivery) that persisted for the duration of the experiment. Diabetes insipidus was correlated with a drastic reduction in the number of VP-positive neurons in magnocellular hypothalamic nuclei. In contrast, large numbers of oxytocin (OT)-positive neurons survived neurohypophysectomy in VP-treated neurohypophysectomized rats; OT neurons accounted for the vast majority of magnocellular profiles observed in Nissl-counterstained sections. VP-immunoreactive fibers could be observed in limited quantities in the external lamina of the median eminence of VP-treated neurohypophysectomized rats, with little staining evident in the internal lamina. Saline-treated neurohypophysectomized rats exhibited the recovery of antidiuretic function characteristically seen following this lesion, with evidence of survival of considerable numbers of VP and OT neurons and median eminence hypertrophy. Both the internal and external laminae of the median eminence were densely innervated by large-caliber VP and OT fibers. Sham-operated animals receiving VP treatment did not show any long-term deficit in water metabolism, changes in the complement of VP or OT perikarya in hypothalamus, or changes in the innervation of the median eminence. Results indicate that VP treatment following neurohypophysectomy results in extensive retrograde degeneration of magnocellular VP neurons without affecting the survival of OT cells. PMID- 3302130 TI - Comparison of CT-guided and stereotaxic cranial diagnostic needle biopsies. AB - Needle biopsy of the brain utilizing computerized tomography (CT) scan data is an accepted diagnostic technique that has been performed both with and without the aid of stereotaxic frames. Experience with both techniques has resulted in a specific procedure for CT-guided free-hand biopsy which is performed in the CT suite under local anesthesia. Over the last 6 years the authors have performed 64 CT-guided free-hand biopsies and 13 stereotaxic biopsies with the Brown-Roberts Wells system. Nonspecific gliosis, tumor, infection, radiation necrosis, or vascular malformation, were diagnosed in all but one biopsy, for a clinically accurate diagnostic yield of 92%. A comparison of diagnostic yield, morbidity, and mortality has shown no significant difference between the free-hand and the stereotaxic techniques. The time required for the procedures and their cost have been compared and have been found to be significantly less for the free-hand biopsy group. Thus, CT-guided free-hand biopsy may still represent the method of choice for histological diagnosis of many intracranial lesions. PMID- 3302131 TI - Immunohistochemical investigation of cerebral ischemia after middle cerebral artery occlusion in gerbils. AB - Progression and recovery of ischemic and postischemic damage after occlusion of the middle cerebral artery and subsequent reperfusion were investigated in the gerbil. This study was performed by immunohistochemical reaction testing for tubulin and creatine kinase BB-isoenzyme to visualize the neuronal structure and by immunohistochemical reaction testing for astroprotein (an astrocyte-specific protein) to visualize reactive astrocytes. The earliest ischemic lesion became visible in the frontoparietal cortex after 7 minutes of ischemia as a laminar loss of the reaction for tubulin involving the neuropil, neuronal perikarya, and dendrites. The earliest lesion in the caudoputamen evolved after 30 minutes of ischemia. After reestablishment of cerebral circulation, the immunohistochemical ischemic lesions in the neuronal structure disappeared if the ischemic period was 10 minutes or less and partially disappeared even after ischemia for 15 minutes in the cerebral cortex, while the postischemic lesion in the caudoputamen disappeared even after ischemia for 15 minutes. Reactive astrocytes were detected in the cerebral cortex and caudoputamen as early as 24 hours after reperfusion, both in the areas with and without the neuronal lesions. No lesion was identified in the hippocampus or thalamus. This experimental model is suitable for investigation of rapidly progressive regional ischemia in the cerebral cortex and for comparison with other regional or global cerebral ischemia in the gerbil or other animal species. PMID- 3302132 TI - Bacterial adhesion to cerebrospinal fluid shunts. AB - Bacterial adherence to cerebrospinal fluid (CSF) shunts was analyzed in vivo and in vitro. Scanning electron micrographs (SEM's) of catheters removed from pediatric patients with shunts infected by Staphylococcus aureus or Klebsiella pneumoniae revealed numerous bacterial cells and microcolonies, leukocytes, and erythrocytes attached to the CSF catheters' inner walls, as well as the existence of surface irregularities, such as fissures, rugosities, and holes. Permeability analyses and SEM's demonstrated that catheters develop physical alterations over the period of implantation. Different bacterial strains presented a different in vitro adherence to CSF shunts, suggesting that this attachment may be affected by specific properties of the outer structures of each strain. The attachment of microbial pathogens to CSF shunts seems to contribute to the persistence of bacterial cells within a catheter and the onset of recurrent shunt infection. This study demonstrated that some bacteria can remain attached within shunts in vitro despite a CSF flow at rates up to 200 times higher than those normally demonstrated in vivo. Furthermore, surface irregularities found throughout this study may help to anchor and hide bacterial microcolonies. Based on these findings, it seems advisable to remove an infected shunt and to replace it with a new one after proper antimicrobial therapy, in order to prevent recurrent infections. PMID- 3302133 TI - Radionuclide evaluation pre- and postextracorporeal shock wave lithotripsy for renal calculi. AB - Forty-two patients were evaluated pre- and postextracorporeal shock wave lithotripsy (ESWL) using [99mTc]DTPA renography. A quantitative evaluation showed that the relative renal function decreased 2-3 days post-ESWL on the treated side, and the parenchymal transit time index (PTTI) increased 2-3 days post-ESWL (p less than 0.001) on the treated side and returned to the pretreatment level by 3 wk post-ESWL. The untreated side showed an increase in PTTI 2-3 days post-ESWL (p less than 0.01), which returned to normal by 3 wk post-ESWL. A significantly greater increase in PTTI was seen in patients who received greater than 1,000 shocks as compared with those who received less than 1,000 shocks. Five patients developed obstructing uropathy post-ESWL, when stone fragments caused ureteric obstruction. PMID- 3302134 TI - Characterization of in vivo chemistry of cations in the heart. AB - A variety of laboratory procedures can be used to define the chemistry and pharmacokinetics of myocardial cationic imaging agents. These methods are utilized to define the in vivo chemistry of cationic heart agents, in order to understand the kinetics and mechanisms of: tissue and cellular transport, subcellular distribution, and intracellular localization. Transport across cell membranes can be active, passive or facilitated. Studies performed in erythrocytes, heart cells, slices and isolated perfused hearts using methods for separation of metabolites have shown a high degree of myocardial specificity for [99mTc]hexakis alkyl isonitrile by an uptake mechanism different from 201Tl. These studies demonstrate the importance of in vivo chemistry and pharmacokinetics in the development of new radiopharmaceuticals. PMID- 3302135 TI - Cephalic reflexes: their role in digestion and possible roles in absorption and metabolism. AB - Stimulation of the oral cavity immediately elicits salivation, gastric acid secretion and pancreatic exocrine and endocrine secretions that serve to prepare the alimentary canal for digestion, transport and utilization of ingested nutrients. Oropharyngeal-stimulated responses are reliably initiated by the taste and smell of food. These gastrointestinal reflexes, often referred to as anticipatory or cephalic phase responses, are mediated by the autonomic nervous system and are believed to be independent of the postabsorptive effects of ingested nutrients. A common pathway used by cephalic phase responses to trigger gastrointestinal secretions is the vagus. Several studies have also demonstrated that cephalic stimulation activates both the sympathetic and parasympathetic nervous systems and thus, many cephalic-metabolic reflexes may arise indirectly from more general physiological changes that accompany oropharyngeal stimulation. The present studies suggest that oral stimulation results in alterations in intestinal function. Specifically, oropharyngeal stimulation of conscious, unrestrained rats with sucrose increases the uptake of radioactive glucose from the small intestine into the hepatic portal blood. PMID- 3302136 TI - Sucrose ingestion, insulin response and mineral metabolism in humans. AB - The effects of sucrose ingestion on the excretion of urinary calcium, zinc, phosphorus, sodium and potassium have been investigated and compared among 13 individuals to the magnitude of their postprandial serum insulin response. Fasted subjects consumed a beverage containing 2 g sucrose/kg, and urine and blood samples were taken at intervals during the next 3 h. As a result of sucrose consumption there were significant increases in serum insulin and decreases in serum phosphorus, but no change in serum total or filterable calcium, zinc, sodium or potassium. Urine calcium peaked at 1.5 h and was significantly increased from 10 through 2.5 h. Sucrose-induced increases in serum insulin and urine calcium were highly variable among subjects, and within the group were significantly correlated (r = 0.82, P less than 0.01). Urine calcium excretion was correlated with serum phosphorus (r = 0.41, P less than 0.05) and urine zinc (r = 0.80, P less than 0.01). Sucrose consumption also increased the urinary excretion of zinc and sodium, although renal reabsorption was not impaired. The effects of sucrose on urinary calcium are consistent with the hypothesis that insulin inhibits renal calcium reabsorption. PMID- 3302137 TI - Glucose turnover rate in the lactating rat: effect of feeding a high fat diet. AB - Feeding a high fat diet during lactation should reduce the competition for glucose utilization between the mammary gland and the other maternal tissues, because dietary fat is directly utilized for milk lipid synthesis. Glucose homeostasis was studied in nonlactating and lactating rats fed a high fat diet and compared with that in rats fed a high carbohydrate diet. In nonlactating rats fed a high fat diet, blood glucose concentration was slightly higher, whereas plasma insulin concentration was lower than in nonlactating rats fed a high carbohydrate diet. In the postabsorptive state, plasma free fatty acids and blood ketone bodies were not modified by the nature of the diet consumed. Glucose turnover rate and glucose metabolic clearance rate in the postabsorptive state in nonlactating rats fed a high carbohydrate diet were not different from those in rats fed a high fat diet [9.5 +/- 1.4 vs. 8.8 +/- 0.8 mg/(min X kg) and 8.9 +/- 1.2 vs. 7.9 +/- 0.7 mL/(min X kg)]. In lactating rats, blood glucose and ketone bodies, plasma insulin and free fatty acid concentrations were not affected in the postabsorptive state by the composition of the diet consumed. The glucose metabolic clearance rate in lactating rats fed the high carbohydrate diet was higher than that in nonlactating rats fed the same diet. However, the glucose metabolic clearance rate in lactating rats fed the high fat diet was not different from that in nonlactating rats fed the same diet. PMID- 3302138 TI - History of nutrition: development of the concept of antimetabolites. Introduction. PMID- 3302139 TI - Impact of the pioneer work of Dilworth Wayne Woolley on antimetabolite research. PMID- 3302140 TI - Vitamin K antagonists: the first 50 years. PMID- 3302141 TI - Sulfonamides and folic acid antagonists: a historical review. PMID- 3302142 TI - Relaxation methods in the control of essential hypertension. PMID- 3302143 TI - Survey of nursing research in New York state. IX. PMID- 3302144 TI - Effects of diet and exercise interventions on control and quality of life in non insulin-dependent diabetes mellitus. AB - Evidence suggests that diet and exercise are associated with improved glucose tolerance for patients with non-insulin-dependent diabetes mellitus (NIDDM). Seventy-six volunteer adult patients with NIDDM were each assigned to one of four programs: diet, exercise, diet plus exercise, or education (control). Each program required ten weekly meetings. Detailed evaluations were completed prior to the program and after three, six, 12, and 18 months. Evaluations included various psychosocial measures, measures of the quality of life, and fasting blood glucose, glycosylated hemoglobin, and relative weight determinations. Of the 76 original participants, 70 completed the 18-month follow-up study. At 18 months, the combination diet-and-exercise group had achieved the greatest reductions in glycosylated hemoglobin measures. In addition, this group showed significant improvements on a general quality of life measure. These improvements were largely uncorrelated with changes in weight. The authors conclude that the combination of dietary change and physical conditioning benefits NIDDM patients, and that the benefits may be independent of substantial weight loss. PMID- 3302145 TI - What a difference a day makes: a decision analysis of adult streptococcal pharyngitis. AB - With the availability of group A beta-hemolytic streptococcal (GABHS) antigen detection tests, the management of adult pharyngitis is being reassessed. A decision analytic model was developed which considered four strategies: immediate treatment, no treatment, performing a rapid antigen test, or obtaining a bacterial culture. Patient outcomes were expressed in "well" days, which were reduced by the "sick" days associated with adverse reactions to treatment or complications of GABHS infection. When immediate test results are available, testing is the optimal strategy for probabilities of GABHS between 1 and 49 per cent. This range includes almost all patients, using probability estimates based on clinical criteria. The absolute benefit of testing was 0.1 days. The major advantage of a rapid test is the avoidance of penicillin reactions. Variations in the symptomatic benefits of treatment had minimal effects on the analysis. The analysis supports the use of an antigen test for adult patients with pharyngitis. PMID- 3302146 TI - Preoperative evaluation: the assessment and management of surgical risk. PMID- 3302147 TI - Stopping and restarting medications in the perioperative period. PMID- 3302148 TI - Ketanserin compared to nifedipine and methyldopa in patients aged above 50 years: two international multicentre studies. For the International Study Group. AB - The antihypertensive properties and adverse reactions of ketanserin, nifedipine and methyldopa were compared in hypertensive patients aged above 50 years in two international studies. After a placebo run-in period, patients received for 3 months, either ketanserin or nifedipine retard in study 1, and either ketanserin or methyldopa in study 2. After 1 month of monotherapy, a diuretic was added if necessary. Study 1 had 117 subjects, with 119 in study 2. The changes in systolic and diastolic blood pressure were similar for ketanserin and nifedipine although more patients switched to combination therapy in the ketanserin group. The overall response rate was comparable with ketanserin and nifedipine (96% for both drugs). The decrease in diastolic blood pressure was significantly greater in the ketanserin group compared to methyldopa and more patients responded to ketanserin (82%) than to methyldopa (65%). No rebound hypertension was observed on discontinuation of therapy with any of the drugs. The total incidence of adverse reactions in monotherapy was lower with ketanserin than with nifedipine (34 and 47%) and similar for ketanserin and methyldopa (40 and 45%). For ketanserin no consistent adverse reaction pattern was seen. PMID- 3302149 TI - Relationship of blood pressure to coronary and stroke morbidity and mortality in clinical trials and epidemiological studies. AB - We compared pooled mortality and morbidity results from nine randomized trials of antihypertensive drug treatment (total n = 43,139), in which diastolic blood pressure (DBP) was reduced by a mean of 5.8 mmHg, with mortality and morbidity differences associated with the same DBP difference in two large prospective, observational studies [the follow-up study of the Multiple Risk Factor Intervention Trial (MRFIT) screenees and the Framingham Study]. These results indicate that the effect on stroke of BP reduction in the trials (-36%, 95% confidence interval +/- 10%) was about 80% of that estimated from the epidemiological studies, suggesting that the effects of long-term BP elevation on the cerebral vasculature are mostly reversible over 5-6 years of BP reduction. For coronary heart disease (CHD), the effect of BP reduction in the trials (-9 +/ 10%) was about 36% of that estimated from the epidemiological studies. This difference may reflect chronic processes involved in the pathophysiological association of BP with CHD; however, selective treatment of control patients at high risk of CHD and an adverse effect of diuretics on serum cholesterol may have influenced the effect of treatment in the trials. PMID- 3302150 TI - Systolic Hypertension in the Elderly Program, Pilot Study (SHEP-PS): morbidity and mortality experience. AB - SHEP-Pilot Study, a randomized, double-blind, placebo-controlled trial of drug therapy for isolated systolic hypertension, followed 551 participants aged 60 years or more with untreated blood pressures of greater than or equal to 160/less than 90 mmHg for an average of 34 months. Mean age was 72 years, 63% were female and 82% white. Pretreatment blood pressures averaged 172/75 mmHg. As their Step I drug, 443 participants were assigned chlorthalidone and 108 placebo. Of 512 surviving participants, 80% and 84% of the chlorthalidone and placebo groups, respectively, attended their last clinic visit; 71% and 60% were still taking blinded drug; and 60% and 33% had systolic blood pressures less than 160 mmHg. Final blood pressures averaged 140/67 and 154/72 mmHg for the chlorthalidone and placebo groups, respectively. All-cause mortality rates were 25 and 23 deaths per 1000 participant-years of risk, respectively; rates for 'definite' first strokes were 8.3 and 13 deaths. Differences between chlorthalidone and placebo groups were significant for blood pressure but not for event rates. PMID- 3302151 TI - Elevated plasma catecholamines and adrenal phenylethanolamine N-methyl transferase in experimental renal hypertension. AB - The participation of plasma catecholamine alterations in the development of renal hypertension is uncertain. Therefore, plasma catecholamines and phenylethanolamine N-methyl transferase (PNMT) activity in the adrenal gland were studied in rats with aortic ligation between the renal arteries. Blood pressure reached a plateau after 12 days (mean arterial pressure (MAP): 194 +/- 3 mmHg; P less than 0.001) and its elevation was accompanied by a biphasic elevation in plasma adrenaline. The first elevation (4-fold above control levels; P less than 0.001) occurred at 24 h after aortic ligation and lasted for 4 days. The second elevation commenced on day 6, reached its zenith at day 9 (16-fold increase; P less than 0.005) and lasted for 6 days. The first elevation was associated with the highest levels of plasma renin activity (PRA) (34-fold increase; P less than 0.001) and glucocorticoids (74% increase; P less than 0.001) but plasma noradrenaline, plasma dopamine and adrenal PNMT activity were minimally affected. However, a statistically significant increase in PNMT activity preceded and accompanied the second adrenaline elevation. Despite falling PRA and glucocorticoid levels, marked increases in plasma noradrenaline (5-fold increase; P less than 0.001) and plasma dopamine (2.5-fold increase; P less than 0.010) were observed. These experiments identify an early activation of the sympatho adrenal axis in renal hypertension. Apparently there is a rapid release of the adrenaline pool followed by an elevation in PNMT activity. The results suggest that the sympatho-neuronal axis is also activated leading to increases in both plasma noradrenaline and dopamine levels. PMID- 3302152 TI - The role of the macula densa in renin release: studies by microperfusion. AB - The role of the macula densa in control of renin release and in mediation of tubulo-glomerular feedback was investigated following orthograde microperfusion in Munich Wistar rats. Tubules of surface glomeruli were perfused, drip-fixed with glutaraldehyde and biopsy cores taken containing perfused and non-perfused glomeruli. Serial sections were examined by light and electron microscopy. In some animals dilated basolateral spaces were observed between cells in control maculae densa but no spaces were found following microperfusion with hypertonic NaCl, isotonic mannitol or hypotonic NaCl containing 1 mg/l frusemide. In other animals no spaces were found in control cores, and perfusion with the above solutions had no effect. However, in such animals, tubules perfused with hypotonic NaCl (71 mmol/kg H2O) had prominent basolateral spaces in their maculae densa. The presence of dilated basolateral intercellular spaces is generally associated with osmotically driven water flow. The extent of dilatation of such spaces in the macula densa is correlated with transepithelial osmotic or ionic gradients and may indicate activity of these cells in the recognition of distal tubular fluid composition. PMID- 3302153 TI - Reduction of infectious complications following heart transplantation with triple drug immunotherapy. AB - Infection remains the major cause of mortality and is a significant source of morbidity following heart transplantation. Between March 1978 and March 1986, 62 orthotopic heart transplants were performed at the University of Minnesota. There were 56 clinically significant infectious episodes in 31 of the 58 patients surviving the perioperative period. The era I (1978-1982) experience with antilymphocyte globulin, prednisone, and azathioprine and the era II (1982-1983) experience with high-dose cyclosporine and prednisone were associated with a high incidence of cytomegalovirus and fungal infections. The conversion to low-dose triple-drug immunosuppression with cyclosporine, prednisone, and azathioprine in 1983 (era III) has markedly reduced infectious deaths and altered the spectrum of clinical infection by decreasing serious fungal and cytomegalovirus infections. This protocol has also significantly reduced the incidence of rejection. The reduction of infection and rejection complications with triple-drug immunosuppression has led to improved patient survival of 94% at 1 year and 87% at 2 years. PMID- 3302154 TI - The Registry of the International Society for Heart Transplantation: third official report--June 1986. PMID- 3302155 TI - The influence of acute preoperative pulmonary infarction on the results of heart transplantation. AB - The presence of acute pulmonary infarction is not uncommon in severely ill patients and is considered by some to be a contraindication to heart transplantation. It has been our policy to accept these patients for operation. The purpose of this investigation is to examine the results of this policy in patients receiving immunosuppression with cyclosporine A and azathioprine. Between September 1982 and April 1985, eight patients undergoing heart transplantation demonstrated clinical and radiographic evidence of acute preoperative pulmonary infarction. These patients represented 5.5% of our heart transplantation population during this period (total = 145). The age range in these eight patients was from 22 to 55 years. Congestive cardiomyopathy was present in four patients, and four patients had ischemic cardiomyopathy. All patients were New York Heart Association functional status class IV. Five of the eight patients were on inotropic support, and one patient had associated renal failure. Pulmonary infarcts were located in the right, middle, or lower lung field in seven patients and in the left lower lung field in one patient. All patients were treated perioperatively by intensive physiotherapy and specific antibiotics. In four patients the lesions resolved on medical treatment alone. Three patients developed extensive empyema and required chest drainage with or without decortication. Two of these patients survived with complete resolution of the lung lesions, and one patient died from prolonged renal failure and sepsis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302156 TI - Lung transplantation: effect of cyclosporine A on the frequency of cytolytic lymphocytes recovered from blood and the bronchoalveolar space. AB - The frequency of donor-specific cytolytic cells within the inflammatory infiltrate produced in the graft after canine unilateral lung transplantation was measured using a limiting dilution assay. Two groups of recipient animals were studied; animals in the first group were treated with oral cyclosporine A for 4 days after transplantation, after which the drug was withdrawn thereby allowing acute rejection to begin as evidenced by histologic examination; animals in the second group were treated with cyclosporine A for the duration of the experiment and developed a subacute, alveolar manifestation of rejection. Frequency analysis was performed for lymphocytes isolated from the peripheral blood and, using the technique of bronchoalveolar lavage, lung allograft for each recipient animal both before transplantation and at various times after the operation. The group of recipients that was treated with cyclosporine A for 4 days showed an increase in the frequency of donor-specific cytolytic cells in the blood and lavage derived lymphocyte populations that reached peak values (four to eight and five to eighteen times the preoperative level, respectively) between days 9 and 14 after operation. The frequency of these cells remained constant at a preoperative level into the peripheral blood of recipient animals treated long term with cyclosporine A; however, the frequency within the graft-derived lymphocyte population increased to reach peak values (12 to 25 times the preoperative level) between days 5 and 15 after operation. In conclusion, these results show that although cyclosporine A modifies pulmonary rejection pathologic conditions, this drug does not prevent the sequestration of donor-specific cytolytic cells within the allograft. PMID- 3302157 TI - Transplantation around the world. PMID- 3302158 TI - Effectiveness of minimal dosage cyclosporine in limiting toxicity and rejection. AB - The optimal dose of cyclosporine to achieve minimal toxicity and adequate control of rejection remains undetermined. We initiated our program with an immunosuppressive protocol designed to reduce drug toxicity, to reduce early severe rejection, and to provide adequate long-term immunosuppression. Because of increasing reports of nephrotoxicity associated with cyclosporine, we adopted a protocol of low-dose cyclosporine combined with steroids and equine antithymocyte globulin. The mean preoperative creatinine was 0.12 +/- 0.08 mmol/L and by 1 year after transplant was 0.13 +/- 0.04 mmol/L. Cyclosporine dose at 1 year was 5 +/- 2 mg/kg/day, and the serum cyclosporine level was 120 +/- 40 ng/ml. However, at 1 year 85% of the patients were hypertensive. The incidence of rejection in the first year after transplantation was 1.46 episodes per patient. Incidence of infection was 0.85 episodes per patient. The 3-month survival was 91%, and the actuarial 1-year survival was 76%. Seventy percent of our mortality was due to rejection, and four patients suffered significant graft damage in the period 3 months to 1 year, two requiring retransplantation. Although these low doses of cyclosporine have reduced nephrotoxicity and infectious complications, hypertension remains a significant problem. Moreover, although survival is acceptable, the incidence of graft rejection causing death or loss of function is of concern. This may indicate that cyclosporine at this dosage needs supplementation by a third immunosuppressive agent such as azathioprine. PMID- 3302159 TI - Characteristics of the transplanted heart in the radionuclide ventriculogram. AB - We examined conventional radionuclide ventriculograms of 19 heart transplant patients and 12 control patients. R-to-R intervals were shorter in heart transplant patients (630 +/- 95 msec) than in controls (781 +/- 204 msec, p less than 0.01). The elevated heart rate is associated with a decreased left ventricular ejection fraction (56.7 +/- 10.3% vs 67.4 +/- 6.1%, p less than 0.005) and decreased emptying time (225 +/- 21 msec vs 270 +/- 47 msec, p less than 0.01), a shorter interval from the R wave to end systole (311 +/- 28 msec for heart transplant patients vs 349 +/- 48 msec in controls, p less than 0.01) and decreased filling time (262 +/- 61 msec vs 340 +/- 123 msec, p less than 0.01). The maximal filling rate is significantly increased (4.3 +/- 1.4 end diastolic volume/sec in heart transplant patients) compared with controls (3.0 +/ 1.1 end diastolic volume/sec, p less than 0.01, Student's t test). In those patients for whom the interval between the transplant procedure and the radionuclide ventriculogram study was greater than 360 days, the filling time (231 +/- 34 vs 296 +/- 67 msec) and emptying time (216 +/- 18 vs 235 +/- 20 msec, p less than 0.05) were significantly less than for those transplants in place less than 1 year. Other parameters were not significantly different. Those heart transplant patients having had two or more documented rejection episodes had no significant difference in hemodynamic function when compared with patients with one or no rejection episodes; no measure of the severity of rejection was used in this analysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302160 TI - Hemodynamic and myocardial histologic and ultrastructural studies on baboons from 3 to 27 months following autotransplantation of hearts stored by hypothermic perfusion for 24 or 48 hours. AB - Hemodynamic and myocardial histologic studies have been made in four baboons, each of whom had undergone heart excision and storage, followed by autotransplantation. The excised baboon heart was stored by continuous hypothermic perfusion for 24 or 48 hours and then replaced orthotopically, the baboon being maintained alive in the interim by an orthotopic cardiac allograft. Follow-up of the autotransplanted baboons has been from 3 to 27 months. Cardiac catheterization revealed normal function both early and late after the period of storage. In three animals, myocardial histology was normal on light microscopy, although some dilation of the T tubules was seen on electron microscopy. In the fourth baboon, whose heart had been stored for 48 hours with follow-up for 13 months, light microscopy revealed some variation of staining of the myofibers and mild interstitial edema; ultrastructural studies showed mild intracellular edema, focal scanty loss of myofilaments, and a lack of dilation of the T tubular system. With this one possible exception, this study confirms that the system of hypothermic perfusion storage developed in our laboratory does not have any significant damaging effects on myocardial function or structure. There would appear, therefore, to be no contraindication to its use in clinical heart transplantation. PMID- 3302161 TI - Social work groups on a heart transplant program. AB - Descriptive preliminary findings on three psychoeducational groups conducted in collaboration with team members on a heart transplant program at The Presbyterian Hospital in the City of New York at Columbia-Presbyterian Medical Center are presented. The objectives of such groups are to help patients and families cope more adaptively with pretransplant and posttransplant requirements that involve psychosocial and educational issues. Group participation is voluntary. A major social work role is to support participants' motivations to increase coping skills. Dialogue from actual group sessions reflects group themes, such as coping with the waiting period and reemployment, generated by participants and the social worker for discussion purposes. Patients and families say that groups are valuable to them on a psychologic and practical level. PMID- 3302162 TI - Pericardiectomy for effusive constrictive pericarditis after heart transplantation. AB - The following is a case report of an unusual complication after heart transplantation. The patient was a 37-year-old man who underwent heart transplantation because of idiopathic cardiomyopathy. His postoperative course was complicated by cardiac tamponade, coagulopathy, and chronic constrictive pericarditis. After transplantation, he underwent three subsequent open-chest procedures: the first for tamponade, the second for Serratia mediastinitis, and the third for a pericardiectomy for constrictive pericarditis. Although constrictive pericarditis and pericardiectomy have been described following coronary bypass surgery and valve replacement, they have not yet been reported in a heart transplant recipient. PMID- 3302163 TI - Esophageal electrode for recording recipient atrial activity. AB - Recording of recipient atrial electrical activity may be difficult, and on occasion impossible, on the surface electrocardiogram. A case is described in which distinct recipient atrial activity was recorded in the presence of a donor atrial dysrhythmia using an esophageal electrode. This simple, noninvasive technique is easy to perform and may prove to be extremely useful in the clinical and research electrophysiologic investigation of heart transplant recipients. PMID- 3302164 TI - Heart transplantation in a Jehovah's Witness. AB - Heart transplantation has been successfully performed without blood products in a 45-year-old Jehovah's Witness. Management of this patient is described. The medical, ethical, and religious issues involved in the decision to offer transplantation and to accept it are discussed. PMID- 3302165 TI - Conversion from cyclosporine to azathioprine following heart transplantation. AB - Eleven patients receiving cyclosporine were converted to azathioprine immunosuppression because of persistent creatinine elevation greater than 2 mg/dl 6 months or more following heart transplantation. During conversion, the maintenance steroid dose was doubled for 3 months then tapered to the preconversion dose. Pretransplant renal function in these converted patients was similar to that in a group of azathioprine patients and a group of nonconverted cyclosporine patients. One year following transplant, the nonconverted group had stable but impaired renal function (mean creatinine, 1.45 +/- 0.06 mg/dl; effective renal plasma flow, 407 +/- 39 ml/min; glomerular filtration rate, 68 +/ 8.8 ml/min). The converted patients had evidence of progressive renal dysfunction (mean creatinine, 2.65 +/- 0.19 mg/dl; effective renal plasma flow, 193 +/- 16 ml/min; glomerular filtration rate, 29 +/- 5.1 ml/min). Following conversion, renal function improved toward normal in all patients. There were three episodes of rejection that were successfully treated. An important number of infective and noninfective complications occurred following conversion during the period of steroid augmentation. There were two deaths during the follow-up period. Conversion can be undertaken with low risk of rejection, death, or both, but protocols that employ prolonged periods of steroid augmentation are associated with important morbidity. PMID- 3302166 TI - Bridge to heart transplantation: the Penn State experience. AB - At The Pennsylvania State University, we have performed four bridge-to-heart transplantation procedures in the past year. Two patients were supported with an LVAD, and two patients were supported with a TAH. One patient had a successful transplantation and remains well 10 months after operation; two patients died of sepsis after transplantation. A fourth patient has had a TAH in place for greater than 110 days and is currently awaiting transplantation. The problems that remain to be solved are developing strategies to minimize the risk of infection, defining the indications for use of an LVAD vs a BVAD vs a TAH, developing an effective regimen to prevent thromboembolism, and determining the proper interval for transplantation after the insertion of a mechanical pump as a bridge. PMID- 3302167 TI - Use of the mini Jarvik-7 total artificial heart as a bridge to transplantation. AB - A 40-year-old woman was maintained on a mini Jarvik-7 total artificial heart for 45 days, during which time she recovered from a viral cardiomyopathy and multiple organ failure. The total artificial heart and driver were free of mechanical dysfunction, and there was no evidence of thromboembolic complications. The patient was maintained on hemodialysis for 26 days, at which time kidney function returned to near normal. The patient underwent an uneventful heart transplant and is now alive at 4 months after transplantation. PMID- 3302168 TI - Use of the total artificial heart as an interim device: initial experience in Pittsburgh with four patients. AB - The experimental use of the total artificial heart as an interim device before heart transplantation has demonstrated its potential usefulness. Once again there has been a reaffirmation of the basic principle in transplantation that careful selection of patients is a prerequisite for a high likelihood of success. Our experience suggests that advanced degrees of renal failure and liver dysfunction are not likely to be associated with a consistently useful interim support. Although our numbers of patients are quite small, we continue to be concerned by what appears to be the tendency for the development of severe thrombocytopenia not resulting from the use of heparin. Studies of platelet kinetics and deposition are planned for the future. Although no recipient has had direct evidence of thromboembolic events, systemic anticoagulation with heparin has been aggressively applied, and bleeding complications have been common. All Jarvik-7 hearts on which autopsies have been performed have demonstrated grossly evident platelet fibrin thrombi, especially around the inlet and outlet valve housings. It has not been our purpose to investigate the relative role for univentricular or biventricular assist. It is likely that a number of our patients might have benefited from left ventricular assistance alone. It would appear that additional patients are needed before strong conclusions can be formed regarding the potential benefits and risks of the current Jarvik-7 device or any total artificial heart as an interim method of support before heart transplantation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302169 TI - Three recent cases of the total artificial heart before transplantation. AB - Three recent cases from one institution using the total artificial heart (TAH) before transplantation are reviewed. The first patient was implanted for 12 hours with the pneumatic Phoenix total artificial heart after failure of a donor heart 1 day after transplant. Following retransplantation the patient died from severe pulmonary edema, pulmonary hypertension, right ventricular failure, and Pseudomonas septicemia. The second patient was implanted with the Jarvik-7 total artificial heart for rapidly deteriorating idiopathic cardiomyopathy. Major complications during the 9 1/2-day implant consisted of severe pulmonary edema for the first 4 days and a multifocal cerebral embolic event on the seventh day after implantation from which he fully recovered. Major problems after transplant included disseminated toxoplasmosis and two mild episodes of rejection. The patient was discharged 68 days after surgery and remains well. The third patient was a 40-year-old woman with rapidly progressing acute influenza A viral myocarditis. Despite immunosuppressive and antiviral therapy, cardiogenic shock with multiple organ failure developed. The 70 ml Jarvik-7 was implanted for 4 1/2 days. Acute humoral rejection from autoantibodies and alloantibodies led to a cardiac arrest on the second day after transplantation. A second 70 ml Jarvik-7 implant was followed by severe multisystem and infectious complications. After prolonged intensive care support, the patient recovered and is now awaiting transplantation. Nearly 100% cytotoxic antibody reactivity caused by multiple antigenic stimuli is preventing ready access to donor hearts for this patient. We view the current role of the total artificial heart as a tool to preserve life until a suitable donor heart can be found, reverse the end-organ effects of progressive heart failure and low output, and restore transplant candidacy in selected patients with temporary reversible contraindications to transplantation. PMID- 3302170 TI - Summary of the world experience with clinical use of total artificial hearts as heart support devices. AB - A review of the world experience with the implantation of total artificial hearts has been carried out. Thirteen centers throughout the world have implanted 27 total artificial hearts in 26 patients. Eight different types of total artificial hearts have been employed. As of June 1, 1986, five of these individuals have had implants for permanent support. Of the other twenty-one patients, three patients died while on a total artificial heart, seven patients died following transplantation, two patients are waiting for transplant, and nine patients have successfully been transplanted and are presently alive. Various clinical preoperative and postoperative parameters are analyzed in this investigation. PMID- 3302171 TI - Thyroid hormone levels in heart and kidney cadaver donors. AB - Experimental animal work has shown that thyroid hormone levels become undetectable 9 hours after brain death. It is unknown whether such an acutely hypothyroid state contributes to the hemodynamic instability of brain-dead donors or whether these donors should be resuscitated with thyroid hormone. No previous clinical study has examined thyroid hormone levels in human brain-dead organ donors. We retrospectively examined the thyroid hormone levels as measured by triiodothyronine and thyroxine in 22 human cadaver donors. Eight donors provided heart and kidney allografts, and the remaining 12 were kidney donors only. No donor had a normal triiodothyronine level and 10 were below normal, with undetectable levels in 12. Thyroxine levels were normal in 10 and below normal in 12. In comparing donors with below normal to undetectable triiodothyronine levels and donors with normal to below normal thyroxine levels, no statistically significant differences were found regarding blood pressure during harvest, duration of harvest, or dopamine requirements during harvest. Donors with a closed-head injury plus multiple injuries had statistically lower thyroxine values than donors with only a closed-head injury. For the heart donors, no correlation was found between thyroid hormone levels and the duration or dose of dopamine required for the heart allograft recipients after transplant. The incidence of acute tubular necrosis in the kidney transplants did not correlate with the donor thyroid hormone levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302172 TI - Prolonged heart xenograft survival using combined total lymphoid irradiation and cyclosporine. AB - Total lymphoid irradiation and cyclosporine have profound immunosuppressive properties and permit successful heart allotransplantation. Cyclosporine used alone has not permitted consistently successful transplantation between species in all cases. Total lymphoid irradiation has not been applied to xenotransplantation. The efficacy of total lymphoid irradiation alone and in combination with cyclosporine was examined using an animal model of heart xenotransplantation. Heterotopic heart transplants were performed using inbred Syrian hamsters as donors and Lewis rats as recipients. Total lymphoid irradiation was administered preoperatively over 3 weeks for a total dose of 15 gray. Cyclosporine was started on the day of surgery and was given as a daily intramuscular injection of 2.5, 5, or 10 mg/kg/day until rejection was complete. Neither total lymphoid irradiation nor cyclosporine alone markedly prolonged graft survival. However, combined total lymphoid irradiation and cyclosporine, 5 or 10 mg/kg/day, dramatically prolonged graft survival to greater than 100 days in most recipients. There were no treatment-related deaths. In conclusion, combined total lymphoid irradiation and cyclosporine permit successful long-term survival of heart xenotransplants in this hamster-to-rat model. PMID- 3302173 TI - Hyperacute rejection in a discordant (pig to baboon) cardiac xenograft model. AB - Eight freshly excised pig hearts were hemoperfused by baboons in vivo. Cardiac function ceased in six hearts after a mean period of 90 minutes of perfusion (range 30 to 190 minutes). Two hearts continued functioning for the 4-hour study period. On microscopic examination, seven hearts, including one that continued beating, showed histopathologic features of hyperacute rejection. IgG, IgM, and C3 were strongly present on the myocardium in all cases. Hemoperfusion was associated with significant increases in heart mass (p less than 0.002) and circulating polymorphonuclear leukocytes (p less than 0.03) and reductions in coronary blood flow (p less than 0.0001), circulating lymphocytes (p less than 0.03), and C4 (p less than 0.03). Preformed circulating anti-pig antibodies disappeared in all but one baboon. Hyperacute rejection in this discordant xenograft model that used a nonhuman primate as "recipient" differs in few aspects from that seen in other experimental models. Possible methods of prolonging xenograft survival are discussed. PMID- 3302174 TI - Diagnosis of acute cardiac rejection with antimyosin monoclonal antibody, phosphorous nuclear magnetic resonance imaging, two-dimensional echocardiography, and endocardial biopsy. AB - A cervical heterotopic cardiac allograft model was used to compare noninvasive techniques with endocardial biopsy diagnosis of rejection. The transplant procedure was performed in eight dogs (12 to 16 kg), with a mean ischemic time of 83 minutes. Beginning on the day of the operation each allograft was evaluated daily by palpation, two-dimensional echocardiography, phosphorous nuclear magnetic resonance spectroscopy, and septal endocardial biopsy. At specific intervals after the operation, antimyosin monoclonal antibody (Fab fragment) with an indium-111 label was administered for subsequent gamma camera imaging. Rejection was clinically evident by 2 to 8 days with a mean of 3.5 days. Endocardial biopsy demonstrated moderate to severe rejection by 2 to 4 days. Two dimensional echocardiography demonstrated early loss of wall thickening dynamics in all allografts. Although subtle changes were evident early in some transplants, these findings were not consistent. After recovery from hypothermic ischemia, evaluation of high energy phosphate metabolites with phosphorous nuclear magnetic resonance spectroscopy showed a progressive decrease in phosphocreatine during mild to moderate rejection, dropping to 30% to 40% of baseline levels with severe rejection. Antimyosin antibody uptake directly correlated with endocardial biopsy rejection scores (R2 = 0.97). With mild to moderate rejection, mean total counts and corrected counts were 222,704 and 112,648, respectively, and were significantly different (p less than 0.05) from baseline counts (135,537 and 58,530) without rejection. As a preliminary finding in untreated acute rejection, both antimyosin antibody and phosphorous nuclear magnetic spectroscopy detected changes consistent with mild to moderate rejection, which usually preceded echocardiographic evidence for injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302175 TI - Ultrasonic characterization of acute cardiac rejection from temporal evolution of echocardiograms. AB - Two ultrasonic parameters that characterize cardiac contractile performance were tested for their ability to detect the early stages of acute rejection. Five dogs received heart transplants with a heterotopic abdominal model and were given echographic examinations 1, 4, and 8 days after surgery. The ultrasonic measurements were extracted from pairs of cross-sectional echocardiograms, separated in time by approximately half of a cardiac cycle. The contraction related changes in the portions of the images corresponding to myocardium were characterized by ratio of mean video amplitude and image-pair correlation. Full thickness biopsies were taken from the left and right ventricles after each examination so that the correlations between the ultrasonic measurements and the histologic state of the tissue could be determined. Each biopsy was ranked according to the following scale of increasing levels of rejection: 0 (normal), 1 (lymphocyte infiltration), 2 (focal necrosis), 3 (diffuse necrosis), 4 (presence of hemorrhages). The average histologic state for the left ventricle increased from 0.2 +/- 0.4 for the first examination, to 2.0 +/- 0.7 for the second, and 3.6 +/- 0.5 for the third. Similar results were obtained for the right ventricle. The progressions of mean amplitude ratio and correlation were 1.55 +/- 0.14, 1.49 +/- 0.17, 1.19 +/- 0.15, and 0.22 +/- 0.10, 0.28 +/- 0.10, 0.74 +/- 0.25, respectively. Thus in this experiment, these parameters were useful for distinguishing advanced stages of rejection from the normal state and from mild rejection. PMID- 3302176 TI - Twenty-four-hour isolated heart preservation by perfusion method with oxygenated solution containing perfluorochemicals and albumin. AB - In Experiment 1 the donor hearts (group C) perfused for 24 hours with an intracellular-like solution containing perfluorochemicals, calcium antagonist, and albumin were compared with the hearts immersed for 24 hours in an intracellular-like solution to which calcium antagonist was added (group B) and the hearts in which the ischemic time was less than 1 hour (group A) followed by orthotopic heart transplantation. In Experiment 2 perfusates with (group I) and without (group II) perfluorochemicals and albumin were used for 24-hour isolated heart preservation. Periodic assessment of the hearts was performed during the perfusion. Experiment 1: All transplanted hearts started beating spontaneously. There was no statistically significant functional difference between the three groups. At the end of the preservation the creatinine phosphokinase and lactate releases of group C were at lower levels than those in group B. Electron microscopic examination revealed that the myocardium in group B was damaged more severely than in group C. Experiment 2: The level of the creatinine phosphokinase and lactate dehydrogenase released in group I was lower than that in group II. The lactate concentration was at a lower level in group I. At the end of the preservation the pyruvate concentration was higher in group I. The gain in heart weight in group II was more marked than that in group I. The passive compliance decreased only in group II. It is suggested that the perfusion method is superior to the immersion method for 24-hour isolated heart preservation and that the perfusate containing perfluorochemicals and albumin is useful. PMID- 3302177 TI - Changes of the intramyocardial electrogram after orthotopic heart transplantation. AB - Heart transplantation, including conventional immunosuppression, has allowed the use of the surface electrocardiogram to detect allograft rejection. With the use of cyclosporine this parameter is no longer sensitive, but voltage of the intramyocardial electrogram has correlated repeatedly with rejection. From July 1983 through February 1986, 98 patients had heart transplantation; 13 of those patients had a telemetry pacemaker simultaneously implanted. In previous studies, daytime dependent variabilities of the sum voltage of the surface electrocardiogram were reported. Therefore intramyocardial electrogram was measured at 7, 10, 13, 16, and 20 hours. In addition, the influence of exercise on intramyocardial electrogram voltage was studied in all patients. Analysis of the diurnal intramyocardial electrogram revealed substantial atrial and ventricular variability of both voltage measurements (p less than 0.05). Also, intramyocardial electrogram voltage was influenced by exercise, as demonstrated by a significant decrease after physical work at 25 W (-8%) and 50 W (-12%); p less than 0.05. Therefore we conclude that a high variability of intramyocardial electrogram may be found diurnally and on exercise testing after heart transplantation in humans. If intramyocardial electrogram is used to detect rejection, it should be applied at comparable hours and with the patients in a controlled resting state. PMID- 3302178 TI - Increased expression of class II major histocompatibility complex antigens in untreated and cyclosporine-treated rat lung allografts. AB - Expression of class II antigens was investigated in the normal rat lung and in lung allografts during acute rejection and after cyclosporine treatment. Therefore cryostat sections were stained with an immunoperoxidase technique that used anti-class II antigen monoclonal antibodies. In normal lungs only cells of the lymphoid tissue expressed class II antigens. During acute rejection, class II antigens were expressed by infiltrating recipient lymphocytes and were also induced on the graft's bronchial epithelium. After cyclosporine treatment, signs of rejection in the lung were restricted to the bronchial epithelium, again expressing class II antigens. These results suggest that the class II antigen positivity of bronchial epithelium may be used as a specific index for pulmonary rejection when infection as an inducing factor can be excluded. Furthermore, the epithelium, once it has become class II antigen positive, is likely to be a target for acute or low-grade rejection, resulting in the development of bronchiolitis obliterans. PMID- 3302179 TI - Regression of Kaposi's sarcoma after reduction of immunosuppressive therapy in a heart transplant patient. AB - The de novo development of Kaposi's sarcoma, confirmed by lymph node biopsy 17 months after heart transplantation in an 18-year-old patient, is described. Constitutional symptoms and axillary and inguinal lymphadenopathy were the presenting features. Surveillance for systemic involvement was negative, and the tumor seemed to be confined to the lymphoreticular system alone. Chemotherapy with vincristine and cyclophosphamide resulted in severe leukopenia and was discontinued. Immunosuppressive therapy, consisting of cyclosporine and methylprednisolone, was gradually reduced, resulting in regression of symptoms and lymphadenopathy. One year later the patient was symptom free, and only one extremely small inguinal lymph node was palpable. Microscopic examination of this node, however, revealed persistent Kaposi's sarcoma. The patient's immunosuppressed state would now appear to be sufficient to prevent acute rejection and yet insufficient to lead to growth and spread of the tumor. PMID- 3302180 TI - Xenogeneic and allogeneic canine heart transplantation: a model for cytologic and immunologic monitoring of rejection mechanisms. AB - In the model of heterotopic intrathoracic heart transplantation, rejections of the graft are not lethal for the recipient animal. Therefore it is possible to follow the immunologic rejection mechanism to the final stage. Allogeneic dog hearts (n = 6) and xenogeneic fox hearts (n = 6) were transplanted. Immunosuppression therapy included cyclosporine and methylprednisolone. Cytoimmunologic monitoring was done every second day. Due to fluctuations of lymphocyte subpopulations and their immature forms, endomyocardial biopsies were performed. The transplanted allogeneic hearts survived for 53.2 +/- 14.8 days if treated with cyclosporine (historical control group without immunosuppression 6.8 +/- 0.8 days). Xenogeneic fox hearts stopped beating after 20.2 +/- 4.1 days (historical control 8.4 +/- 1.9 days). The allogeneic grafts were all rejected in an acute cellular fashion, whereas xenogeneic transplanted hearts showed humoral and cellular rejection mechanisms. Monitoring of circulating inflammatory cells allowed differentiation between humoral and cellular rejection, which was confirmed by histology. Both types of rejection were accompanied by an increase of lymphocytes and their activated forms. Differentiation of lymphocyte subpopulations revealed a significant increase of surface IgG-positive B lymphocytes under humoral rejection, whereas acute cellular rejection episodes showed a substantial increase of surface IgG-negative lymphocytes. Humoral rejection that developed even with cyclosporine administration was not influenced, whereas cellular rejections were controlled by increasing methylprednisolone to 250 mg/day for 3 days. PMID- 3302181 TI - Treatment of mediastinitis after heart transplantation. AB - Mediastinal infection carries a high mortality in any heart surgery patient. The risks are even greater after heart transplantation. We present two cases of mediastinitis in heart transplant patients. The first patient was successfully treated with closed mediastinal irrigation. The second patient was initially treated with closed mediastinal irrigation, developed recurrent infection, and subsequently responded to a muscle flap operation. A review of the literature and our own experience suggest that muscle flaps should be applied earlier in heart transplant recipients with severe or recurrent mediastinal infections. PMID- 3302182 TI - Combined heart and kidney transplantation: a case report. AB - A patient with successful combined heart and kidney transplantation is reported. This case suggests that occurrence of kidney rejection may allow diagnosis of simultaneous unsuspected heart rejection, thus indicating an immunologic advantage in combined transplantation of organs from the same donor. PMID- 3302183 TI - Vein graft arteriovenous fistula for long-term venous access in a heart transplant recipient lacking superficial veins: a case report. AB - Construction of a (radial artery) saphenous vein graft arteriovenous fistula for blood sampling after heart transplantation is presented as a solution to the problem of a patient with poor or sclerosed superficial arm veins. Satisfactory experience with one patient over a 12.5 month follow-up is presented. PMID- 3302184 TI - Early recognition of heart transplant rejection by backscatter analysis from serial 2D ECHOs in a heterotopic transplant model. AB - The acute phase of heart transplant rejection was evaluated with two-dimensional echocardiographic (2D ECHO) image analysis in a modified Mann's cervical heterotopic transplant. Serial 2D ECHO images were obtained daily, and myocardial biopsies were obtained on the day of transplant, on day 3 after transplant, and after total rejection. Brightness of serial 2D myocardial ECHO images significantly increased to day 3 after transplant, indicating increased backscatter during hyperacute rejection. Histologically this was associated with myocardial edema. These results suggest a potential noninvasive means of recognizing acute cardiac rejection. Heart transplant rejection is characterized by myocardial edema during the early stages. Myocardial edema resulting from ischemia increases the backscatter of ultrasound, which is seen as increased brightness on 2D ECHOs. Hence we hypothesized that myocardial edema observed histologically during a hyperacute rejection process can be seen on serial 2D ECHOs of the transplanted heart. Serial 2D ECHOs were obtained in five goats that had undergone a modified Mann's cervical heterotopic transplant. Image parameters were kept constant throughout each experiment. After each experiment, 2D ECHOs of a soft-tissue phantom were also recorded with the same image parameters and were used for normalizing the myocardial brightness estimated from 2D ECHO images. Visually, brightness of 2D ECHO images of all transplanted myocardia increased to day 3 after transplantation; thereafter, the brightness decreased but was still greater than on the day of transplantation. The measured mean (+/- SD) relative integrated brightness increased from 0.60 +/- 0.38 on the day of transplantation to 1.05 +/- 0.43 (p less than 0.005) on day 3 after transplantation and decreased to 0.70 +/- 0.33 (p less than 0.05) on day 7 after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302185 TI - Left ventricular assist device as a bridge to heart transplantation: a case study. AB - Stanford University Medical Center has successfully utilized a left ventricular assist device as bridge support for 9 days in a 52-year-old man awaiting heart transplantation. During this time he developed a pericardial tamponade, but no other serious medical complications occurred. Major nursing care issues focused on pain control, vigorous pulmonary toilet, and left ventricular assist device timing. This article outlines the responsibilities of critical care nurses and what was learned from the experience. The recipient was discharged home 106 days after heart transplantation. PMID- 3302186 TI - Contrast injection bradycardia during coronary angiography: effects in the denervated human heart. AB - To assess the contribution of cardiac innervation toward understanding the mechanisms of bradycardia during contrast coronary angiography, heart rate (HR) responses in eight patients after heart transplantation were compared with 10 normal patients (control), 10 patients with coronary artery disease (CAD) and normal ventricular function, and 10 patients with congestive cardiomyopathy and normal coronary arteries. The longest P-P interval was measured beat to beat before (HR 1) and after (HR 2) coronary angiography. The coronary vessel perfusing the sinus node did not influence HR 2 responses within each group. HR 1 was significantly different from HR 2 (p less than 0.05) in the control and CAD groups but was not different in the transplant and cardiomyopathy groups. Compared with the control group, the percent decrease in HR was significantly less in transplant patients than in patients with cardiomyopathy. Thus contrast injection bradycardia is absent in denervated patients after heart transplant, and this response is markedly blunted in cardiomyopathy patients who are known to have diminished vasodepressor reflexes. These findings suggest that the bradycardia response is probably a neurally mediated phenomenon. PMID- 3302187 TI - Diffusing lung capacity and cyclosporine in patients with heart transplants. AB - Pulmonary function studies were performed in 10 patients undergoing surgery for heart transplantation. The study was repeated 6 to 12 months after surgery. The comparison between data before and after transplantation showed an overall improvement in lung function indices, except for the lung diffusing capacity (DLCO). A mean 14% reduction (p less than 0.01) of DLCO was observed. In the absence of evidence of other lung disease or rejection reaction in these patients, this finding may be related to a side effect of cyclosporine on the lung and deserves further investigation. PMID- 3302188 TI - Histologic analysis of costochondral and sternoclavicular grafts in the TMJ of the juvenile monkey. AB - Variability in growth response of the mandible after replacement of the mandibular condyle with the costochondral junction of a rib (CCJ) is common. Other donor graft sites that are more similar to the mandibular condyle might be more suitable for mandibular condylar replacement. Previous studies have shown the histomorphologic and developmental similarities between the sternoclavicular joint (SCJ) and temporomandibular joint (TMJ). The purpose of this study was to evaluate histologically short-term adaptations within the TMJ after replacement of the mandibular condyle with the autogenous sternal head of the clavicle, and to compare these adaptations with autogenous CCJ and mandibular condyle (surgical control) transplants. Bilateral vertical ramus osteotomies were performed in 12 juvenile Macaca mulatta with the left condyle being immediately replaced and the right condyle removed and replaced with either the sternal head of the clavicle or costochondral junction of a rib. All grafts were stabilized with maxillomandibular fixation for five weeks. Two animals in each group were killed at five, 11, and 17 weeks postsurgery and prepared for histologic analysis. The results indicate that: 1) incorporation of all grafts into the recipient site occurred and all animals had good mandibular function and occlusion throughout the follow-up period; 2) the clavicular and mandibular condylar grafts were incorporated sooner than the CCJ grafts; 3) clavicular graft changes resembled those of the condylar grafts histologically while the costal grafts remained inert and unchanged; and 4) a new condylar process with cartilage similar to that of a normal mandibular condyle regenerated in the costal graft animals from cells presumably contributed by the periosteum of the mandibular ramus and TMJ capsule.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302189 TI - Epithelial inclusion cyst in the temporomandibular joint after a dermal graft. PMID- 3302190 TI - Central nervous system structural lesions causing apnea at birth. PMID- 3302191 TI - Outbreak of acute rheumatic fever in northeast Ohio. AB - An outbreak of acute rheumatic fever in 23 patients was seen in northeastern Ohio in 1986, with polyarthritis (78%) and carditis (30%) the major manifestations. Results of a questionnaire completed by the parents of all 23 patients indicated that they were generally nonindigent, with good access to medical care, and from a nonurban setting. Records of inpatients with acute rheumatic fever were reviewed for the 10 years prior to 1986. The clinical manifestations in inpatients from 1976 to 1985 were not significantly different from those of inpatients seen during 1986. Similar outbreaks have been reported elsewhere, and physicians should be aware of a possible resurgence of classic acute rheumatic fever and ensure compliance with an adequate course of therapy for patients with streptococcal pharyngitis. PMID- 3302192 TI - Return of rheumatic fever: consequences, implications, and needs. PMID- 3302193 TI - Clinical trial of vitamin A supplementation in infants susceptible to bronchopulmonary dysplasia. AB - We conducted a randomized, double-blind, controlled trial to determine whether vitamin A supplementation from early postnatal life could reduce the morbidity associated with bronchopulmonary dysplasia in very low birth weight (VLBW) neonates. Forty VLBW neonates (700 to 1300 g birth weight, 26 to 30 weeks gestational age), who were oxygen dependent and required mechanical ventilation for at least 72 hours after birth, were given by the intramuscular route either supplemental vitamin A (retinyl palmitate 2000 IU) or 0.9% saline solution on postnatal day 4 and every other day thereafter for a total of 14 injections over 28 days. The study groups were comparable in gestational maturity, clinical characteristics, initial lung disease, and vitamin A status at entry into the trial. Vitamin A administration resulted in significantly higher mean plasma concentrations of vitamin A and retinol-binding protein in treated infants compared with controls. Bronchopulmonary dysplasia was diagnosed in nine of 20 infants given vitamin A supplement and in 17 of 20 control infants (P less than 0.008). Four of 19 infants in the vitamin A group and 11 of 20 in the control group required mechanical ventilation on study day 28 (P less than 0.029). The need for supplemental oxygen, mechanical ventilation, and intensive care was reduced in infants given vitamin A supplement compared with controls. Airway infection and retinopathy of prematurity were less frequent in the vitamin A group. We conclude that vitamin A supplementation at the dosage used in this trial in VLBW neonates not only improves their vitamin A status but also appears to promote regenerative healing from lung injury, as evidenced by a decrease in the morbidity associated with bronchopulmonary dysplasia. PMID- 3302194 TI - Adolescent marijuana use: concordance between questionnaire and immunoassay for cannabinoid metabolites. PMID- 3302195 TI - Adolescent cocaine use: epidemiology, risk factors, and prevention. PMID- 3302196 TI - Cryptococcal UDP-glucose dehydrogenase: enzymic control of capsular biosynthesis. AB - UDP-Glucuronate, formed through dehydrogenation of UDP-glucose and itself decarboxylated to make UDP-xylose, is the presumed donor for the glucuronyl side groups in biosynthesis of the capsular polysaccharide in Cryptococcus neoformans. A specific radiochromatographic assay for UDP-glucose dehydrogenase shows that the enzyme is present in the cytosol. The enzyme is very labile but is stabilized by 25% glycerol. The enzyme is inhibited strongly by NADH (Ki,NADH = Km,NAD = 0.1 to 0.2 mM). It is also inhibited competitively by UDP-xylose (Ki = 0.3 mM). These results suggest that the rate of production of the capsular precursor, UDP glucuronate, is controlled by the intracellular concentrations of an end product, UDP-xylose, and of a direct product, NADH. Capsule mutants have been screened for activity of this enzyme but none is clearly deficient. PMID- 3302197 TI - Inhibition of germ tube development of Aspergillus fumigatus in cell-free transudate produced in subcutaneous chambers in rabbits. AB - The interaction of Aspergillus fumigatus conidia with host factors produced in rabbits was studied by means of subcutaneous, perforated plastic chambers. Transudate fluid from spore-free chambers, sampled 30 days after implantation, supported germ tube development and rapid hyphal growth of A. fumigatus in an assay in vitro. Inoculation of spores into chambers implanted 30 days previously produced a rapid infiltration of leukocytes, predominately neutrophils, into the chamber fluid. Cell-free supernatants, prepared from transudates collected 5-6 days after inoculation, inhibited germ tube development in vitro. This inhibition was also demonstrated using lysates derived from 3.6 X 10(6) leukocytes obtained from chambers 5 days after inoculation with 1 X 10(7) spores. However, lysates derived from greater than 10(7) leukocytes obtained from pre-inoculated chambers as well as peritoneal exudate cells did not inhibit germ tube development in vitro. The inhibitory activity of cell free supernatants was not altered by heating at 56 degrees C for 30 min but was destroyed by pronase treatment as well as boiling. These results provide evidence for a host defense mechanism against rapid hyphal extension mediated by the extracellular release of inhibitory factors by leukocytes. PMID- 3302198 TI - Disseminated cutaneous Fusarium infection with vascular invasion in a leukemic patient. AB - A 61-year-old male with leukemia manifested multiple cutaneous nodules on his whole body surface, subcutaneous nodules on his arms and a tongue tumor. Septate hyphae were observed microscopically in scrapings from the surfaces of the cutaneous lesions. Fusarium solani and F. anthophilum were isolated from scrapings from the several skin lesions. Histological examination revealed the presence of numerous septate hyphae in the lumina of vessels in the dermis. The fungal elements in the cutaneous tissues were suggested to be Fusarium by an immunoperoxidase method using a genus-specific anti-Fusarium antibody. Although no evidence of fungal infection was found in other organs by clinical examinations, F. solani and/or F. anthophilum were considered to have undergone hematogenous dissemination, because of the presence of thrombi containing abundant fungal elements in the skin lesion. The present case is a case of disseminated cutaneous Fusarium infection, in which fungal elements in skin tissue sections were immunohistochemically regarded as Fusarium, though fungus cultures from biopsied specimens were negative. PMID- 3302199 TI - Portal vein dynamics in biliary atresia. AB - A prospective sonographic investigation of portal vein caliber was done in 40 children with biliary atresia (n = 37) and biliary hypoplasia (n = 3) from 1 to 135 months old. The patients were divided into two groups according to hepatobiliary function (HBF). HBF was determined by serum bilirubin (greater than less than 1.5 mg/dL), serum albumin (greater than less than 3.5 g/dL), and bile bilirubin excretion (greater than less than 6 mg/d). There were 21 patients with "good" and 19 patients with "poor" HBF. The portal vein caliber, measured just proximal to its bifurcation, was 3 to 16 mm (median 7 mm), in the good HBF patients and 2 to 6 mm (median 4 mm) in the poor HBF group, the difference being statistically significant (P less than .01). Sequential studies of portal vein caliber were done in 30 patients. In the 15 patients with good HBF there was a progressive increase in portal vein caliber in nine, no change in six, and no patient had a decrease in caliber. Of the 15 patients with poor HBF, eight patients had a decrease in portal vein caliber, seven had no change, and no patient had an increase in caliber. The results indicate that patients with biliary atresia and poor HBF have an absolute and/or relative decrease in portal vein caliber and that the decrease may be progressive. Since portal vein anastomosis is essential to successful liver transplantation, referral must be done before portal vein shrinkage eliminates this option. PMID- 3302200 TI - Fetal hydronephrosis: selection and surgical repair. AB - Newly developed diagnostic techniques allowed us to select a fetus with potentially reversible renal damage from the usually fatal group with bilateral hydronephrosis and severe oligohydramnios early in gestation. Fetal surgery to marsupialize the fetal bladder at 24 weeks gestation restored normal amniotic fluid dynamics and allowed sufficient pulmonary and renal development to insure survival after delivery near term. PMID- 3302201 TI - Auxiliary transplantation of the fetal liver. II. Functional evaluation of an intraabdominal model. AB - To evaluate the use of the fetal liver as an auxiliary graft, we have developed a model of intraabdominal heterotopic transplantation of late gestational fetal lamb livers into weanling lambs. Thirty-eight transplants have been performed of which 31 were technically successful. Twenty-three grafts functioned for intervals of 5 to 22 days after transplantation. Grafts were functionally evaluated by analysis of total bile acid and bilirubin excretion. To determine whether host liver excretory function would influence function of the graft, common bile duct ligated recipients were compared with recipients with normal host liver function. We found that (1) intraabdominal auxiliary transplantation of the fetal lamb liver is technically feasible; (2) the fetal liver graft is capable of rapid adaptation and can assume a significant portion of host excretory function; and (3) excretory function of the fetal liver is proportional to the functional demands of the host. Auxiliary transplantation of the fetal liver is a promising alternative to current methods of liver transplantation. PMID- 3302202 TI - Fetal response to injury in the rabbit. AB - Fetal, neonatal, and adult tissue response to a standardized injury was studied using subcutaneous wound implants, linear incisions, and punch wounds in New Zealand white rabbits. In the fetus, sutured incisions healed by primary intention without antecedent inflammation. However, neither contraction nor healing by secondary intention was seen in punch or unsutured wounds. Healing both by primary and secondary intention following inflammatory infiltration was observed uniformly in neonatal and adult rabbits. Wound implants were extensively infiltrated with collagen in the adults studied; however, no collagen was seen in fetal implants and collagen hydroxyproline content could not even be detected by high performance liquid chromatography techniques; rather, a matrix rich in hyaluronic acid was found. The fetal tissue response to injury differs from the adult, proceeding in the absence of a classical inflammatory stimulus and lacking contractile capabilities. The deposition of extracellular matrix rich in hyaluronic acid but devoid of collagen suggests that the fetal response to injury may be a process more closely resembling regeneration or growth rather than repair by scar deposition. PMID- 3302203 TI - [New developments in phytotherapy]. PMID- 3302204 TI - "The Pedic Items. Official Organ of Chiropody." 1912. PMID- 3302205 TI - "The Pedic Items. Official Organ of Chiropody." 1912. PMID- 3302206 TI - Site and mechanism of growth inhibition by prostaglandins. III. Distribution and binding of prostaglandin A2 and delta 12-prostaglandin J2 in nuclei. AB - Cyclopentenone prostaglandins (PGs) such as PGA2 and delta 12-PGJ2 (9-deoxy-delta 9,12-PGD2) are taken up by cultured cells and exert growth inhibition. Within cells they are transferred to and accumulate in nuclei by a temperature-dependent process. In this study, the authors analyzed and compared subnuclear distribution and binding of these PGs. Nuclei accumulating either [3H]PGA2 or [3H] delta 12 PGJ2 were extracted successively with a hypotonic solution and with a 1% Triton X 100 solution, and the radioactivities in the two extracts (fractions of nucleoplasm and nuclear membrane, respectively) and the remaining residues (a fraction of chromatin and nuclear matrix) were determined. About three-fourths of PGA2-derived nuclear radioactivity was found in the extracts, and only 20% in the residues. Most of the radioactivity in the extracts was recovered in ethyl acetate under acidic conditions and identified as intact PGA2, suggesting that the majority of PGA2 in nuclei was present as free molecules. On the other hand, more than 70% of delta 12-PGJ2-derived nuclear radioactivity was associated with the residues and resistant to extraction with acidic ethyl acetate. This radioactivity, however, became extractable after brief alkali treatment and was identified as intact delta 12-PGJ2. In order to identify nuclear component binding of this PG, the authors digested the residues with either DNases or proteases. The radioactivity in the residues was almost completely released by digestion with proteases and clearly separated from DNA by ethanol precipitation. These results suggested that most of nuclear delta 12-PGJ2 bound covalently to protein(s) of chromatin and nuclear matrix.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302207 TI - Kappa opioids in rhesus monkeys. II. Analysis of the antagonistic actions of quadazocine and beta-funaltrexamine. AB - In rhesus monkeys, kappa opioid agonists have been shown to increase urinary output, increase tail-withdrawal latencies from warm water and produce distinct discriminative stimulus effects. In order to explore further the relation between these effects and activity at the kappa opioid receptor type, the antagonist activity of quadazocine against several kappa opioid agonists was examined with the tail-withdrawal and drug-discrimination procedures. Quadazocine dose dependently antagonized the increases in tail-withdrawal latency produced by the kappa agonists bremazocine, ethylketazocine and U-50, 488, as well as the discriminative stimulus effects of these drugs. The dose-ratio analysis of Schild revealed apparent pA2 values for quadazocine in combination with bremazocine, ethylketazocine and U-50, 488 of 6.1, 6.4 and 6.4, respectively, with the tail withdrawal procedure and 6.3, 6.4 and 6.1, respectively, with the drug discrimination procedure. Quadazocine also antagonized the effects of a mu agonist (morphine) in the tail-withdrawal procedure, and the apparent pA2 value for these data was 8.2. The activity of the mu-selective alkylating agent, beta funaltrexamine (beta-FNA), was examined alone and in combination with the kappa agonist ethylketazocine in the urinary-output, tail-withdrawal and drug discrimination procedures. At about 30 to 60 min postinjection, beta-FNA alone produced ethylketazocine-appropriate responding under the drug-discrimination procedure and increased urine output but did not increase tail-withdrawal latencies. At 24 to 48 hr postinjection, beta-FNA did not antagonize effects of ethylketazocine in any of the three procedures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302208 TI - Kappa opioids in rhesus monkeys. III. Dependence associated with chronic administration. AB - The kappa opioid agonists, Mr 2033 and U-50, 488, or the mu opioid agonist, morphine, were administered chronically to three separate groups of rhesus monkeys. Tolerance developed to the overt signs of intoxication produced by each compound. Monkeys receiving morphine were not cross-tolerant to Mr 2033 or to U 50, 488, and monkeys receiving U-50, 488 were not cross-tolerant to morphine. Monkeys given Mr 2033 chronically were, however, cross-tolerant to morphine. When administration of U-50,488 was interrupted, or the monkeys receiving this compound were given an opioid antagonist, withdrawal behaviors were displayed that were qualitatively different from deprivation or antagonist-induced morphine withdrawal. These signs were suppressed by kappa agonists but not by morphine. Deprivation-induced withdrawal from Mr 2033 resulted in signs similar to those shown by U-50,488-dependent monkeys and some signs were observed in withdrawn morphine-dependent monkeys. Several antagonists, including the mu-selective antagonist beta-funaltrexamine, precipitated signs of withdrawal normally associated with morphine dependence in Mr 2033-dependent monkeys. Withdrawal from Mr 2033 was suppressed by kappa agonists in a stereoselective manner, and by morphine. The asymmetrical cross-tolerance and cross-dependence between Mr 2033 and morphine, and the appearance of morphine-like signs during precipitated withdrawal, suggest that Mr 2033 is kappa receptor selective but not specific. Dependence to U-50,488, however, was qualitatively and pharmacologically distinct from morphine-dependence and is apparently a consequence of specific activity at kappa receptors. PMID- 3302209 TI - Influence of cartilage on reactivity and on the effectiveness of verapamil in guinea pig isolated airway smooth muscle. AB - The authors have examined the effects of cartilage removal on smooth muscle reactivity and the action of verapamil in guinea pig trachealis. In preparations devoid of cartilage, smooth muscle reactivity to both histamine and KCl was reduced. Reactivity to methacholine was unaffected by cartilage removal. In the absence of cartilage, verapamil had a greater depressant effect on the maximum responses to histamine and methacholine than in intact tissues. Similarly, verapamil was more potent against histamine- and methacholine-induced responses in the absence of cartilage where a greater shift to the right was seen in the concentration-response curves when compared with cartilage-containing controls. The spasmolytic action of verapamil on methacholine-induced responses was greater in the absence of cartilage and was greater than its antispasmogenic activity against methacholine (whether or not cartilage was present). Thus, cartilage removal reduces muscle reactivity and increases the potency of verapamil in guinea pig trachealis. PMID- 3302210 TI - Identification by immunoblotting of three halothane-induced liver microsomal polypeptide antigens recognized by antibodies in sera from patients with halothane-associated hepatitis. AB - Previous studies have demonstrated that sera from patients with severe liver damage after halothane anesthesia ("halothane hepatitis") contain antibodies reacting with novel antigenic determinants expressed on hepatocytes from rabbits exposed previously to halothane. To determine the structure of the halothane induced antigen(s), immunoblotting experiments were performed using patient sera and rabbit liver subcellular fractions. Three polypeptide antigens (Mr 100,000, 76,000 and 57,000) expressed in liver fractions from animals sacrificed 16 hr after exposure to 1% halothane in oxygen for 45 min, but not in fractions from unexposed animals, were identified. Analysis of fractions prepared by differential and sucrose density gradient centrifugation, and characterized by enzyme marker analysis, localized all three antigens to a microsomal subfraction relatively enriched in glucose-6-phosphatase activity, therefore, presumably derived from the endoplasmic reticulum. Antibodies to these antigens were detected in 19 of 24 sera from patients with halothane hepatitis, and four distinct patterns of antibody specificity were observed: 100,000 + 76,000 (seven patients), 100,000 alone (seven patients), 76,000 alone (three patients) and 57,000 alone (two patients). Such antibodies were not detectable in sera from 24 normal blood donors or 36 control patients. Thus, halothane induces expression of three distinct polypeptide antigens in liver, and patients with halothane hepatitis differ in patterns of recognition of these antigens by circulating antibodies. PMID- 3302211 TI - Renal vasoconstrictor response to hypertonic saline in the dog: effects of prostaglandins, indomethacin and theophylline. AB - The role of prostaglandins in the mechanism of the tubuloglomerular feed-back was examined in the anaesthetized dog using the infusion of hypertonic saline to increase renal plasma sodium concentration by 30 mmol/l as the stimulus to activate the tubuloglomerular feed-back. Two sequential infusions of hypertonic saline into the renal artery for 10 min separated by 90 min resulted in equivalent reductions in renal blood flow (264 +/- 32 to 174 +/- 20 ml/min first time; 280 +/- 29 to 200 +/- 15 ml/min second time). Administration of indomethacin, 8 mg/kg, between the two infusions did not alter the renovascular response to hypertonic saline (319 +/- 26 to 226 +/- 35 ml/min vs. 288 +/- 32 to 202 +/- 24 ml/min). Infusion of either prostaglandin E2 (PGE2) or prostaglandin I2 (PGI2) during the second hypertonic saline infusion period also resulted in no change in the renovascular response (251 +/- 37 to 141 +/- 31 ml/min vs. 297 +/- 53 to 184 +/- 51 ml/min; and 223 +/- 31 to 162 +/- 35 ml/min vs. 254 +/- 33 to 186 +/- 39 ml/min, respectively). Intrarenal theophylline, to a concentration of 40 micrograms/ml, however, totally abolished the renovascular response to hypertonic saline (279 +/- 20 to 209 +/- 13 ml/min control vs. 390 +/- 26 to 402 +/- 17 ml/min during theophylline). The systemic hypertensive response during the infusion of hypertonic saline was unaltered by indomethacin or prostaglandins but was totally abolished by theophylline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302212 TI - [Analgesia producing mechanism in acupuncture anesthesia]. PMID- 3302213 TI - Veterans Administration Cooperative Studies Project No. 147. Part IV: Biocompatibility of base metal alloys. PMID- 3302214 TI - Anatomic guide for reduction of enamel for acid-etched retainers. PMID- 3302215 TI - Replacement of lost or broken denture teeth with composites. AB - The replacement of lost or broken denture teeth can be accomplished with a quick, easy, and long-lasting result. The technique provides good esthetics and function, and the dentist can accomplish a replacement without a large inventory of stock teeth and without costly or time-consuming processing. The resultant repair withstands stress and wear comparable to that of acrylic resin denture teeth and is resistant to discoloration. PMID- 3302216 TI - Autoclavable custom-made metal impression trays to improve infection control. PMID- 3302217 TI - Scanning electron microscopy of the marginal fit of ceramometal restorations with facially butted porcelain margins. PMID- 3302218 TI - Effect of die spacer on the seating of cast restorations on composite core preparations. PMID- 3302219 TI - A double-mix cementation for improved esthetics of resin-bonded prostheses. AB - An efficient technique is described for reducing incisal discoloration of abutment teeth without creating a cement line. One disadvantage is the need for both opaque and tooth-colored translucent resin cements, but the complex procedure can be facilitated by increasing the working time of the resin cements. PMID- 3302220 TI - Light-cured porcelain margins: a new technique. PMID- 3302221 TI - Porcelain-fused-to-metal crowns as replacements for denture teeth in removable partial denture construction. AB - A procedure has been described for using porcelain-fused-to-metal crowns in place of denture teeth on a removable partial denture. Improved esthetic results are achieved when replacement denture teeth are made simultaneously with, and visually match, adjacent tooth crowns. This procedure provides a superior treatment result, particularly where multiple unilateral anterior teeth are lost and a removable partial denture is indicated. PMID- 3302222 TI - Rest seat designs for inclined posterior abutments: a photoelastic comparison. AB - Forty-five photoelastic stress analyses were conducted with two-dimensional models of one side of a mandibular Kennedy class III removable partial denture. Fifteen separate rest seat configurations were tested for each of three varied inclinations of the distal second molar abutment. The data indicate that: Rest seat placement on an abutment tooth primarily affects stress concentration of that tooth. There is no direct relationship between rest seat design on one abutment and resultant stress on another. Inclined abutments demonstrate greater resultant bending of interradicular bone than vertical abutments, and the greater the inclination, the greater the bending (as the result of tipping force). Mesial rests on inclined molar abutments demonstrate maximum tipping forces. Channel rests on inclined molar abutments demonstrate the least amount of tipping force. PMID- 3302223 TI - Evaluation of the retention of castings to endosseous dental implants. AB - Many factors contribute to the success or failure of dental implants. The comparative retentive values of various dental cementing agents and dental implants were examined. PMID- 3302224 TI - Magnetic resonance imaging of the temporomandibular joint. Part I: Literature review. PMID- 3302225 TI - Hamartoma of the hypothalamus and tuber cinereum: a brief review of the literature. PMID- 3302226 TI - Buprenorphine and pethidine in the treatment of post-operative pain. PMID- 3302227 TI - Massive oedema of the ovary (a case report). PMID- 3302228 TI - General index to Volumes 151-160 (1983-1987). PMID- 3302229 TI - Contributions of short-wavelength cones to goldfish ganglion cells. AB - There are conflicting reports about the existence and nature of a short wavelength cone (S-cone) contribution to ganglion cells in the goldfish retina. The present study sought to resolve these discrepancies by examining the S-cone contribution while recording from single ganglion cells in the excised, isolated goldfish retina. The effect of variations in the retinal preparation (gas content and type of background lighting during recording) on the S-cone input was also examined. Cells were classified into one of three types based on the responses at light onset and offset, when responses were driven only by the long-wavelength cone system (L-cones) of the receptive field's center (L+/-(on-excitation/off inhibition), L-/+, and L+/+). With rare exceptions, the threshold spectral sensitivities of the centers and surrounds of cells that possessed opposite on and off responses (L+/- and L-/+) exhibited S-cone contributions, either prior to and/or during chromatic adaptation of the middle- and long-wavelength cones; the S-cone response was antagonistic to the L-cone input. The L+/+ center cells also contained a S-cone input, but it was synergistic to the L-cone input at suprathreshold intensities. These findings were robust across all of the retinal preparations employed. The discrepancies in the previous work were probably due to the incomplete classification of cells because of the use of threshold responses only. PMID- 3302230 TI - Meditation as a clinical intervention. PMID- 3302231 TI - Hyposplenism--a review. PMID- 3302232 TI - The clinical assessment of Doppler cardiac ultrasound in valvular heart disease. PMID- 3302234 TI - The great composers: their premature deaths. PMID- 3302233 TI - The discovery of yellow fever in Central Africa. PMID- 3302235 TI - The measurement of autonomic function in clinical practice. PMID- 3302236 TI - Some advances in the diagnosis of respiratory virus infections. PMID- 3302237 TI - Provincial physicians in England 1700-1900. The FitzPatrick lecture for 1986. PMID- 3302238 TI - [Pancreatoblastoma. Ultrasonic and x-ray computed tomographic aspects. Apropos of a clinical case]. AB - A 4 year old child presented with a pancreatoblastoma, a tumor of the pancreas being an exceptional finding in children. Ultrasound and CT scan images of this pancreatic carcinoma are described as well as its course during chemotherapy. Diagnosis is difficult but can be assisted by guided fine needle puncture biopsy. PMID- 3302239 TI - [Isolated tuberculous involvement of a posterior vertebral arch. Value of x-ray computed tomography and puncture under ultrasonography for the diagnosis. Apropos of a case]. AB - A case relative to an isolated tuberculous lesion of a vertebral arch associated with a paravertebral abscess is reported. The authors insist on the rarity of this location. They underline the role of the computed tomography for the positive diagnosis and the precise extent of lesions and the interest of the biopsy under ultrasonography for the bacteriological and histological diagnosis. PMID- 3302240 TI - [Pancreatic cystadenomas. Pitfalls and limitations of radiologic diagnosis]. AB - Pancreatic cystadenoma (CA) are rare tumors. According to the classification described by Compagno and Oertel, microcystic and macrocystic CA are differentiated. The former is a benign tumor with slow growth, but the latter has a malignant potential. According to the literature, these tumors may be differentiated on the basis of US and CT findings in a high percentage of cases. We report a series of 11 cases (5 microcystic CA, 4 mucinous CA, 1 leiomyoblastoma and 1 adrenal cyst) representing all cases of radiologically suspected CA and all cases of histologically proved CA. A correct diagnosis of microcystic CA was possible in 2 out of 5 cases, and in 3 out of 4 cases of mucinous CA. The 2 extra-pancreatic tumors were misinterpreted as mucinous CA. No patient had a false positive diagnosis of microcystic CA. The diagnosis of mucinous CA was made in 7 cases, but only 3 were true positives. There was 1 false negative of mucinous CA. In other cases, laparotomy and resection are mandatory as sonography and CT cannot accurately detect malignancy or differentiate pancreatic CA from adjacent sites tumors. PMID- 3302241 TI - [Infectious aneurysm of the superior mesenteric artery in a 14-year-old child]. AB - A 14-year-old girl developed an infectious aneurysm of superior mesenteric artery secondary to a bacterial endocarditis. Diagnosis was suggested by ultrasound images demonstrating a hypoechogenic structure with imparted turbulent systolic movements in superior mesenteric artery region. Diagnosis was confirmed at operation involving an obliterating endo-aneurysmoraphy. PMID- 3302242 TI - [Multicystic renal dysplasia, peculiar developmental aspects: spontaneous remission followed-up by ultrasonography. Apropos of 2 cases]. AB - Two cases of unilateral multicystic kidney followed an atypical course, the non communicating anechogenic images on ultrasound examination that projected into the renal region disappearing within several months and the infants' condition appearing satisfactory at 2-year follow up review. Analysis of the literature showed the increasing frequency of this outcome, but persistence of a multicystic kidney after the first year of life requires its surgical removal because of risk of degenerative changes. PMID- 3302243 TI - [Cyst of the seminal vesicle. Images on ultrasonography, x-ray computed tomography and magnetic resonance. Apropos of a case]. AB - A case of seminal vesicle cyst is reported. Magnetic resonance (M.R.) appearance of the seminal vesicle cyst is described first. A brief review of the literature for seminal vesicle cysts is made. New imaging modalities (ultrasound, C.T. scan an M.R.) are illustrated, their role is discussed. PMID- 3302244 TI - A study of the intentional use of pit and fissure sealants over carious lesions. AB - This article reports data on the intentional use by dentists of pit and fissure sealants over carious lesions. In early 1985 a random sample of 127 dentists in general practice and 20 pedodontists from Washington State were interviewed by phone. Completed interviews were obtained from 81.9 percent (N = 104) of the general practitioners and 60.0 percent (N = 12) of the pedodontists. Eighteen percent of the dentists who offer sealants in their practice use sealants on "incipient" or "superficial" lesions. The major reasons given for not sealing lesions are: concern about failure or leakage, lack of confidence, or amalgams would be better. Dentists who seal lesions have larger practices in terms of the number of operatories and patients seen per week, place sealants on a larger proportion of their child patients, and more frequently delegate sealants to the hygienist. There is no relationship between placing sealants on lesions and placing sealants on primary teeth, the dentist's year of graduation, the number of years the dentist has used sealants, being a pedodontist, or employing a hygienist. PMID- 3302245 TI - The New Mexico sealant program: a progress report. AB - In 1979, the dental health program of the New Mexico Health and Environment Department began a school-based sealant activity. Children in the first, second, third, sixth, and seventh grades in selected New Mexico communities were offered sealants through this sealant activity. During the 1984-85 school year, program staff began seeing several hundred sixth-grade students who had received sealants in either the first, second, or third grade. Tooth- and surface-specific data on the current condition of all the previously sealed occlusal surfaces were collected from all these previous recipients of sealants. During the 1985-86 school year, we found that sixth-grade students who received sealants as first, second, or third graders had 5.6 percent of the occlusal surfaces of their first permanent molars either decayed, missing, or filled. Their classmates who had not previously received sealants had 26.85 percent of the same tooth surfaces either decayed, missing, or filled. During the 1985-86 school year, the complete retention rates for sealants were found to be 67.36 percent after six years, 78.53 percent after five years, and 93.47 percent after one year. The partial retention rates were found to be 10.46 percent after six years, 10.63 percent after five years, and 3.04 percent after one year. PMID- 3302246 TI - Malaria in Papua New Guinea. Implications for the British Army. AB - Malaria poses the greatest health threat to British soldiers engaged in jungle training in Papua New Guinea. This paper provides detailed epidemiological information gained following a visit to the Papua New Guinea Malaria Research Unit in January 1986. PMID- 3302247 TI - Mood disorders and the menstrual cycle. AB - Since the premenstrual syndromes characteristically present with mood, cognitive and behavioral disturbances, a special relationship between psychiatric disorders and the premenstrual syndromes has been postulated. With a series of questions we attempted to clarify the nature of the relationship between the menstrual cycle and mood and behavior, and we specifically addressed the similarities and differences between the premenstrual syndromes and formal psychiatric disorders. The premenstrual syndromes may serve as a biobehavioral model for the investigation of the biologic contributors to mood state regulation. PMID- 3302248 TI - Efficacy of alpha-tocopherol in the treatment of the premenstrual syndrome. AB - In a preliminary study, alpha-tocopherol supplementation was effective in reducing specific symptoms of the premenstrual syndrome (PMS). To confirm these findings, we performed a randomized, double-blind study using d,alpha-tocopherol and placebo in a carefully screened population of women with PMS. Standardized PMS questionnaires were administered in the luteal phase of the menstrual cycle to all subjects, before and after daily treatment with 400 IU d,alpha-tocopherol or placebo for three cycles. Of the 46 subjects enrolled, 41 completed the clinical trial. A significant improvement in certain affective and physical symptoms was noted in subjects treated with d,alpha-tocopherol. PMID- 3302249 TI - Conditioning exercise and premenstrual symptoms. AB - Exercise is commonly listed as a remedy for the premenstrual syndrome (PMS), although no study has proven that it is an effective therapy. Numerous reports have suggested that exercise is associated with improved mood and symptoms. In those reports, however, the diagnosis of PMS was not clearly documented, nor was the exercise carefully controlled. Preliminary evidence suggests that exercise training in ovulatory, sedentary women and intensified training in women athletes decrease mild premenstrual symptoms. Although conditioning exercise is associated with short luteal phase and anovulatory cycles, decreases in mild premenstrual symptoms occur prior to menstrual cycle changes. Controlled studies of PMS and exercise training may not only document an effective, nonpharmacologic therapy for PMS but also clarify the hormonal etiology of this complex biobehavioral phenomenon. PMID- 3302250 TI - Effect of spironolactone on premenstrual syndrome symptoms. AB - The premenstrual syndrome (PMS) has long been considered one in which fluid retention plays an important role. Detailed studies, however, have failed to reveal good evidence for this assumption, and investigations of weight change and of sodium and water balance have yielded contradictory results. Even so, a number of the etiologic theories and treatment regimens are based on this premise. Many of the endocrine theories depend on the endocrine effect on water balance to explain the mechanism, and the treatment often proposed involves salt and water restriction and the liberal use of diuretics. There is no justification for this advice except for a few well-conducted studies that showed the benefits of diuretic therapy. The evidence from these studies suggests that diuretics, especially spironolactone, have a particular role in the management of the PMS symptoms of bloatedness and abdominal distension despite the fact that the underlying water retention theory remains in doubt. An improvement in the various psychologic symptoms of PMS has also been reported. PMID- 3302251 TI - Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. AB - Many different treatments have been suggested for the premenstrual syndrome (PMS), including such nutritional supplements as vitamins, minerals and essential fatty acids. There is little agreement about the causes or treatments of the syndrome. The effect of a nutritional supplement, at high and low dosage, on premenstrual symptoms was assessed in a double-blind, placebo-controlled study. Also, the nutritional state of 11 women with PMS was evaluated. There was laboratory evidence of significant deficiencies in vitamin B6 and magnesium; other deficiencies occurred frequently, also. The multivitamin/multimineral supplement was shown to correct some of these deficiencies and, at the appropriate dosage, to improve the symptoms of premenstrual tension. PMID- 3302252 TI - Ultrasound-guided paracentesis in the diagnosis of postpartum hemoperitoneum. A report of three cases. AB - Real-time ultrasound and ultrasound-guided paracentesis were used in the diagnosis of hemoperitoneum in three patients. In all three, who had decreasing hematocrits, the possibility of intraperitoneal bleeding was confirmed or excluded with the two techniques. PMID- 3302253 TI - Immunosuppressive therapy in systemic lupus erythematosus. AB - The therapeutic efficacy of immunosuppressive therapy in lupus and lupus nephritis in particular, is reviewed. We have tried to resolve the paradox between the observed immunostimulatory effects of cyclophosphamide and cyclosporin A in vivo and our concept of an immunosuppressive agent. PMID- 3302254 TI - 'D' excision for sacrococcygeal pilonidal sinus disease. AB - A new procedure is described for treating pilonidal sinus by an excision and primary suture technique, and the results reported in 30 consecutive patients so treated--28 with chronic sinuses and 2 with an acute abscess. Seventeen patients (Group 1) had had no previous surgery, while 13 (Group 2) had had multiple previous operations. A total of 24 patients (80%) healed after the operation, their mean hospital stay being 16 days. In Group 1 the success rate was 88% with a mean hospital stay of 15 days; in Group 2 the comparable figures were 69% and 17 days. After additional procedures (usually curettage) all patients healed. PMID- 3302255 TI - Building or extending a hospital department: radiology. A path through the planning minefield (5). PMID- 3302256 TI - Analysis of structure-activity relationships in renin substrate analogue inhibitory peptides. AB - On the basis of the minimal octapeptide sequence of the renin substrate, a series of peptides was synthesized containing (3S,4S)-4-amino-3-hydroxy-6 methylheptanoic acid (statine) or (3S,4S)-4-amino-3-hydroxy-5-phenylpentanoic acid (AHPPA) at the P1P1' position. Some of these peptides also contained Nin formyltryptophan at the P5, P3, or P3' position. Renin-inhibitory potency varied over a wide range (from inactive to IC50 = 3 nM). Potency was reduced by at least 10-fold when the peptide was shortened by two residues at either the amino or carboxy terminus. The AHPPA-containing inhibitors were several-fold less potent than the statine-containing inhibitors. Analysis of models for the three dimensional structure of inhibitors at the active site of human renin suggests that the diminished potency of the AHPPA peptides in comparison with the statine containing peptides was caused by a shift in the peptide backbone due to a steric conflict between the phenyl ring of the AHPPA residue and the S1 subsite. The importance of the side chain and the 3(S)-hydroxyl group of the statine residue was demonstrated by substituting 5-aminovaleric acid for a dipeptide unit at the P1P1' position, which resulted in a peptide devoid of renin-inhibitory activity. Substitutions of other basic amino acids for histidine at the P2 position caused a great loss in potency, possibly due to disruption of a hydrogen bond as suggested by molecular modeling. Studies on the plasma renins of four nonhuman species suggest that the isoleucine-histidine segment at the P2'P3' position is important to defining the human specificity of the substrate. This work suggests a number of properties important to the design of potent renin inhibitors, and demonstrates the usefulness of three-dimensional models in the interpretation of structure-activity data. PMID- 3302257 TI - Synthesis and antifungal activity of new 1-vinylimidazoles. AB - Carbonyl compounds I were subjected to an imidazole transfer reaction with N,N' sulfinyldiimidazole or N,N'-carbonyldiimidazole to obtain the diimidazole II and the monoimidazole III. Various 1-vinylimidazoles IV, derived from o hydroxyacetophenones by imidazole transfer reaction, were alkylated to furnish the title compounds V. The structure-activity relationships of these 1 vinylimidazole compounds V are described. PMID- 3302258 TI - Synthesis and antifungal activity of a series of novel 1,2-disubstituted propenones. AB - To find an antifungal agent other than those of the imidazole and triazole series, a new class of 1,2-disubstituted propenones I and II was prepared and tested for antifungal activity. Comparison of the structure-activity relationships showed that the conjugated structure of carbonyl and exomethylene groups in I and II plays an important role in potent antifungal activity. However, it is noteworthy that compounds 53, 54, and 56, which have a hydroxymethyl or methoxymethyl group instead of an exo-methylene group in I, also showed potent activity. Although many compounds exhibited strong antifungal activity in vitro, none showed activity in vivo of oral efficacy against subacute systemic candidiasis in mice. PMID- 3302259 TI - Endoperoxides as potential antimalarial agents. AB - A number of mono- and bicyclic endoperoxides were prepared and tested for antimalarial activity in search of a simplified analogue of the 5-oxygen substituted 1,2,4-trioxane ring structure 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 P. falciparum. The most active compound in this assay was 2-[((butyloxy) carbonyl)oxy]-1,1,10-trimethyl-6,9-epidioxy-delta 7-octalin (17a), which showed an IC50 of 100 and 57 ng/mL, respectively. For comparison, qinghaosu exhibits a mean IC50 less than 3.4 ng/mL. PMID- 3302260 TI - Lysosomotropic agents. 7. Broad-spectrum antifungal activity of lysosomotropic detergents. AB - Lysosomotropic detergents, which kill mammalian cells by disrupting lysosomal membranes, have now been found to be antifungals also. All strains in our assay are susceptible. The mode of action is as yet undetermined, but intracellular vacuoles may be the primary targets. PMID- 3302261 TI - Comparison of computer-assisted and seminar learning of electrocardiogram interpretation by third-year students. PMID- 3302262 TI - Evaluation report--cardiotocographs. PMID- 3302263 TI - The eighth C. L. Oakley lecture. Pathogenicity and immunobiology of Treponema pallidum. PMID- 3302264 TI - Relationship between pigment production and haemolysin formation by Lancefield group B streptococci. AB - Group B streptococci produce both a pigment and a haemolysin. The requirements of group B streptococci for the formation and release of pigment and haemolysin are similar and have been examined to extend observations on the relationship between the two products. The amount of pigment and haemolysin extractable from actively metabolising washed-cell suspensions of group B streptococci varied with the atmosphere of incubation, the pH at which the extraction was carried out and the presence of Mg2+ ions. Both pigment and haemolysin were produced in significant amounts in all phases of the growth cycle. When conditions were established for obtaining maximum yields of haemolysin, its production correlated closely with pigment yields, but pigment did not function as a carrier for haemolysin. Formation of pigment, but not of haemolysin, increased in the presence of trimethoprim or higher concentrations of glucose. The composition of pigment produced in different conditions differed qualitatively and different strains of group B streptococci formed pigment of different appearance, suggesting that group B streptococcal pigment is composed of several different substances. PMID- 3302265 TI - Use of a standard curve improves precision and concordance of antinuclear antibody measurement. AB - An exchange of sera between 31 laboratories in Australia and 11 other countries has demonstrated problems in measurement of antinuclear antibody by immunofluorescence. Many laboratories lack precision and there is major discordance between laboratories. Four laboratories appeared unable to measure ANA in the concentration range from 2.5 to 20 IU/ml and only 13 out of 28 could discriminate between 7 IU/ml and 15 IU/ml. Incorporation of common standard sera to generate a standard curve for each assay led to improvements. Use of the standard curve to correct for variation between assays improved precision, and conversion of local titres to common units (IU/ml) improved concordance. This inexpensive and simple strategy should improve routine measurement of ANA and thereby increase its diagnostic value. PMID- 3302266 TI - Aberrant expression of a chemokinetic glycoprotein in psoriatic skin. AB - Clinically involved and uninvolved skin samples of 6 psoriatic patients, 4 samples each of normal skin specimens, basal cell carcinoma and keratoacanthoma were studied by an indirect immunofluorescence technique. The monospecific antibody used in this study was directed against a 30 kD glycoprotein, normally expressed by the terminally differentiated corneocytes. Functional characterization of this glycoprotein was evaluated by neutrophil cell movement assays. The involved and uninvolved skin of psoriatic patients expressed the 30 kD glycoprotein not only in the stratum corneum but in all the viable epidermal layers as well. Functional studies revealed this glycoprotein to be a potent chemokinetic molecule. These results suggest that the 30 kD glycoprotein is an intrinsic chemokinetic molecule of the terminally differentiated corneocytes, and its precocious and aberrant expression in psoriatic epidermis is potentially responsible for some of the pathophysiologic aspects of psoriasis. PMID- 3302267 TI - Three-dimensional reconstruction from a single-exposure, random conical tilt series applied to the 50S ribosomal subunit of Escherichia coli. AB - We present a new reconstruction method that takes advantage of the fact that many biological macromolecular assemblies show a preferred orientation with respect to the plane of the specimen grid in the electron microscopic preparation. From one micrograph taken of such a specimen tilted by a large angle, a conical tilt series with random azimuthal angles can be extracted and used for a three dimensional reconstruction. Our technique allows the determination of the molecular structure under low-dose conditions, which are not achievable with reconstruction methods that use conventional tilt series. The reconstruction method combines a number of existing image processing techniques with a newly developed weighted back-projection algorithm designed for three-dimensional reconstruction from projections taken with arbitrary projecting directions. The method is described as it was applied to the three-dimensional reconstruction of the structure of the 50S ribosomal subunit of Escherichia coli (E. coli). PMID- 3302268 TI - Determination of areal densities of blood vessel wall components in histological sections by means of image analysis. AB - A technique is described which allows quantification of specifically stained, intermingled vessel wall components in paraffin-embedded tissue. The dissociation of elastic, muscular and connective tissue and the determination of their areal densities in the superior vena cava and in the ascending aorta of the dog, was performed by automated image analysis. The percentages of elastic+connective tissue, determined by this technique, correlated significantly with the data derived from biochemical measurements. It was further found that the structure of the vena cava wall was a function of the distance from the right atrium. PMID- 3302269 TI - Computer automated cell size and shape analysis in cryomicroscopy. AB - Computer vision techniques have been developed for quantitative analysis of size and shape changes in cells frozen on a cryomicroscope. The analysis is based on implementation of standard serial edge detection algorithms in conjunction with a shape transform to isolate individual cells in complex scenes which may include adjacent and overlying ice crystals. In the present study the sensitivity of the automated analysis procedure is evaluated for images obtained by various microscope optical systems for progressive degrees of subject blurring by defocusing. Size measurements in calibration trials for freezing latex spheres with extracellular ice in the field of view were least sensitive for bright field images, although the most consistent data was obtained by differential interference contrast microscopy. In all cases phase contrast images produced the least accurate data. An example analysis is presented for the freezing of pancreas beta-cells. PMID- 3302270 TI - Effects of laughter and relaxation on discomfort thresholds. AB - Two experiments were conducted to test the proposal that laughter is a pain antagonist. In Experiment I, thresholds for pressure-induced discomfort of 20 male and 20 female subjects were measured after each subject listened to a 20-min long laughter-inducing, relaxation-inducing, or dull-narrative audio tape or no tape. Discomfort thresholds were higher for subjects in the laughter- and the relaxation-inducing conditions. In Experiment II, 40 female subjects were matched for pressure-induced discomfort thresholds. Their discomfort thresholds were measured after they listened to a laughter-inducing, interesting narrative, or uninteresting narrative audio tape, completed a multiplication task, or experienced no intervention. Discomfort thresholds increased for subjects in the laughter-inducing condition. Laughter, and not simply distraction, reduces discomfort sensitivity, suggesting that laughter has potential as an intervention strategy for the reduction of clinical discomfort. PMID- 3302271 TI - Ultraviolet light-induced mutagenesis in the Escherichia coli chromosome. Sequences of mutants in the cI gene of a lambda lysogen. AB - DNA sequences were determined for 56 mutations induced by ultraviolet light in the lambda cI gene of an Escherichia coli uvr+ lysogen, which should reflect those occurring in the E. coli chromosome. The spectrum of mutagenesis was similar to that found in the cI gene of irradiated phase assayed in uvr- host cells, except that the fraction of transversions is about 35% in prophage and about 15% in phage. The cause of this difference is not known. Of 17 frameshifts in phage and prophage, six have an accompanying base substitution. These double mutational events are consistent with a model in which a photoproduct in a template can cause a DNA polymerase to insert a wrong base and destabilize the next few bases added, thus leading to a frameshift by a slippage mechanism. PMID- 3302272 TI - Specific strand loss in N-2-acetylaminofluorene-modified DNA. AB - N-2-Acetylaminofluorene (AAF), a well-known chemical carcinogen, when covalently linked to guanine residues constitutes a premutagenic lesion that is converted in vivo into frameshift mutations. In Escherichia coli, it is thought that -AAF adducts block the replication fork and that the mutagenic processing of the -AAF adducts is mediated by the SOS response. The construction in vitro of plasmids containing -AAF adducts in one strand only of a double-stranded DNA molecule enabled us to investigate the segregation of the strands and the mutagenicity of the lesions in vivo. The two DNA strands were "genetically labelled" by means of a single base-pair mismatch in the tetracycline-resistance gene, one strand carrying the wild-type allele and the other strand a mutant tetracycline sensitive allele. The two strands contained either no -AAF adducts, -AAF adducts in one strand or -AAF adducts in both strands. When such constructions are used to transform bacterial cells the following are found. When no -AAF adducts are present on either strand of the DNA, a mixture of plasmids having information from both parent strands is found in 80% of the transformed bacterial clones. With -AAF adducts present in one strand only, in 90% of the transformants there is a consistent loss of the parent strand information that contained the -AAF adducts. In the constructions having -AAF adducts in both strands, the transformed bacteria carry either one or the other allele in a pure form. Our results suggest that when blocking lesions (-AAF adducts) are present in one strand only, they trigger the specific loss of that strand. The forward mutation frequency (i.e. the tetracycline-resistance gene inactivation frequency) was found to be more than ten times lower when the -AAF adducts are bound to one strand only compared with the situation where both strands carry the premutagenic lesions. Moreover, when the isolated mutants were sequenced, the mutations were found to consist of a mixture of true -AAF-induced mutations (i.e. -1 or -2 frameshift mutation at previously determined mutation hot spots) and of mutations that are not targeted at -AAF adducts. We suggest that these "background" mutants arose from the mutagenic processing of cryptic lesions present in our DNA. The low mutagenic efficiency of -AAF adducts, when present in one strand only of a duplex DNA, most probably results from the above-described loss of the damaged strand.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3302273 TI - Electrostatic effects on modification of charged groups in the active site cleft of subtilisin by protein engineering. AB - The dielectric constant in the active site cleft of subtilisin from Bacillus amyloliquefaciens has been probed by mutating charged residues on the rim and measuring the effect on the pKa value of the active site histidine (His64) by kinetics. Mutation of a negatively charged surface residue, which is 12 to 13 A from His64, to an uncharged one Asp----Ser99) lowers the pKa of the histidine by up to 0.4 unit at low ionic strength (0.005 to 0.01 M). This corresponds to an apparent dielectric constant of about 40 to 50 between Asp99 and His64. The mutation is in an external loop that is known to tolerate a serine at position 99 from homologies with subtilisins from other bacilli. The environment between His64 and Asp99 is predominantly protein. Another charged residue that is at a similar distance from His64 (14 to 15 A) and is also in an external loop that is known to tolerate a serine residue is Glu156, at the opposite side of the active site. There is only water in a direct line between His64 and Glu156. Mutation of Glu----Ser156 also lowers the pKa of His64 by up to 0.4 unit at low ionic strength. This change again corresponds to an apparent dielectric constant of about 40 to 50. The pKa values were determined from the pH dependence of kcat/KM for the hydrolysis of peptide substrates, with a precision of typically +/- 0.02 unit. The following suggests that the changes in pKa are real and not artefacts of experimental conditions: Hill plots of the data for pKa determination have gradients (h) of -1.00(+/- 0.02), showing that there are negligible systematic deviations from theoretical ionization curves involving a monobasic acid: the pH dependence for the hydrolysis of two different substrates (succinyl-L-alanyl-L alanyl-L-prolyl-L-phenylalanyl p-nitroanilide and benzoyl-L-valyl-L-glycyl-L arginyl p-nitroanilide) gives identical results so that the pKa is independent of substrate; the pH dependence is unaffected by changing the concentration of enzyme, so that aggregation is not affecting the results; the shift in pKa is masked by high ionic strength, as expected qualitatively for ionic shielding of electrostatic interactions. PMID- 3302274 TI - Translocation makes the ribosome less compact. AB - Translating ribosomes of Escherichia coli were prepared either in the pre translocation or in the post-translocation states by a special technique based on the use of poly(U)-Sepharose columns where the template was coupled to the matrix through splittable -S-S- bridges. Elongation factors were absent from the final preparations. A neutron scattering study of the translating ribosomes in the two functional states was performed at different contrasts (various 1H2O/2H2O mixtures). Under conditions of a high contrast for the protein constituent the radius of gyration of the post-translocation-state ribosomes was found to be slightly greater than that of the pre-translocation-state ribosomes. Using the results of this study the conclusion can be drawn that translocation is accompanied by a spatial displacement of some parts of the ribosome with a magnitude of several angstrom units. PMID- 3302275 TI - T-even-type bacteriophages use an adhesin for recognition of cellular receptors. AB - Protein 38 of the Escherichia coli phage T4 is thought to be required catalytically for the assembly of the long tail fibers of this phage. It is shown that this protein of phage T2 and the T-even-type phage K3 and Ox2 act differently. It was found that NH2-terminal fragments of the protein, expressed from cloned fragments of gene 38 of phage K3, bind to gene 38 amber mutants of phage T2. Such phage or T2 gene 38 amber mutants, grown on a non-permissive host, possess a complete set of six tail fibers but are non-infectious. Both types of non-infectious phage could be repaired by incubation with an extract of cells harboring a cloned gene 38 of a host range mutant of phage K3, K3hx. The repaired phages had the host range of K3hx and not of T2. Immuno-electron microscopy showed that protein 38 is located at the free ends of the long tail fibers of phages T2, K3 and Ox2. The protein serves the recognition of the cellular receptor, i.e. it acts as an adhesin. PMID- 3302276 TI - DNA sequence of genes 38 encoding a receptor-recognizing protein of bacteriophages T2, K3 and of K3 host range mutants. AB - Genes 38, which code for a receptor-recognizing protein present at the tip of the long tail fibers, have been sequenced from phages T2, the T-even-type phage K3 and its host range mutants K3hx, K3h1 and K3h1h. The genes from phages T2 and K3 code for proteins consisting of 262 and 260 amino acid residues, respectively. Fifty amino-terminal and 25 carboxy-terminal residues are highly conserved. The amino-terminal amino acids are most likely involved in binding to the neighboring protein 37. Between residues 116 and 226 of the T2 protein and residues 116 and 223 of the K3 protein, sequences exist that are similar to sequences present in Escherichia coli outer membrane proteins and which serve as phage receptors. Most likely, all of these regions in the latter proteins are exposed on the cell surface and are part of their phage receptor areas. In the phage proteins, these sequences are flanked by stretches rich in glycine, perhaps providing an increased flexibility for the polypeptide at these sites; some "wobble" may be required during the protein 38-receptor interaction. The mutational alterations in the host range mutants were found in gene 38. In the K3hx protein, a duplication of six base-pairs caused the wild-type sequence -Gly163-Lys-Leu-Ile- to be changed to -Gly163-Lys-Leu-Lys-Leu-Ile-. In the K3h1 protein, a glutamic acid residue at position 203 was substituted by a lysine. Both alterations occurred within areas similar to outer membrane proteins. Mutant K3h1h, derived from K3h1, exhibits an extended host range as compared to K3h1. No mutational alteration, in addition to that found in K3h1, was found in g38 nor was the part of gene 37 that encodes the carboxy-terminal moiety of the protein altered. K3h1h may represent a "trigger-happy" phage. The results of this and other work show that the phage-phage receptor systems under study represent a primitive immune system. PMID- 3302277 TI - Abortive infection of Escherichia coli F+ cells by bacteriophage T7 requires ribosomal misreading. AB - The use of different precisely mapped T3/T7 recombinants strengthens the conclusion that abortive infection by T7 of F plasmid-carrying cells is due to the nucleotide sequence at the end of the T7 gene 1. Furthermore, we demonstrate that the exclusion requires suppression of ochre stop codons, a phenomenon that occurs with low frequency in wild-type cells due to ribosomal misreading. The introduction of rspL mutations in which ribosomal misreading is reduced alleviates the exclusion and the presence of ochre tRNA suppressors increases its severity. PMID- 3302278 TI - Models for the study of arrhythmias in myocardial ischaemia and infarction: the use of the rat. PMID- 3302279 TI - The Afro-American life cycle: success, failure, and mental health. AB - The author examines the Afro-American life cycle from the period of the 1900s to the 1980s and discusses the psychosocial context for a three-generation Afro American family living in America in the 1980s. The specific stresses and successful or maladaptive coping strategies of the members are presented as well as the potential mental health problems arising from ineffective mastery of developmental transitions. PMID- 3302280 TI - The door that opened wide. PMID- 3302281 TI - Liver replacement after massive hepatic trauma. AB - Two patients sustained massive hepatic injuries from blunt trauma in motor vehicle accidents. At the time of operation, nonreconstructable injuries to the porta hepatis were found in addition to destruction of the right lobe. Life threatening hemorrhage was controlled, but both patients were left with nonfunctional or inadequate hepatic remnants. Liver transplantation was performed. Both patients recovered after liver replacement. One died 7 weeks later of cytomegalovirus infection. The other recipient is well 16 months later. Liver transplantation is a reasonable option in patients with lethal hepatic injuries or unreconstructable injuries to the porta hepatis. PMID- 3302282 TI - Penetrating colon injuries: exteriorized repair vs. loop colostomy. AB - Eighty-five patients with penetrating colon injuries, treated either by exteriorized repair (39) or loop colostomy (46), were analyzed. Missile wounds accounted for 75.3% of the injuries. The Penetrating Abdominal Trauma Index (PATI) was the scoring method employed to assess quantitatively the severity of injuries in each patient. Of 21 patients with right colon injuries, eight were treated by exteriorized repair and the remainder by loop colostomy. PATI and other variables were comparable in both groups. Suture line leaks occurred in two patients (25%) with exteriorized repair. The morbidity was similar in both groups. In left colon trauma, exteriorized repair was employed in 31 patients and 33 underwent loop colostomy. The injury severity indices, clinical status, and time lapse to laparotomy were similar in both groups. Colostomy was avoided in 67.7% (21 of 31) patients with exteriorized repair. The incidence of abscesses was significantly higher in the colostomy group compared to the group treated by exteriorized repair (24.2% and 6.4%, respectively; p less than 0.05). The length of hospital stay was shorter after exteriorized repair (17.2 days vs. 23.2 days; p less than 0.05). All three mortalities (3.5%) were related to associated injuries. We conclude that exteriorized repair is a safe and superior alternative to loop colostomy in penetrating colon trauma. PMID- 3302283 TI - Multiple aortic tears treated by primary suture repair. AB - Blunt trauma to the chest with aortic tear is not an unusual sequela of rapid deceleration. Multiple aortic tears in a viable patient are unusual. A case is reported where multiple aortic lacerations were repaired without the use of prosthetic material. The use of a primary suture repair of aortic injuries is advocated for simple aortic tears not extending proximally to the arch whether they be single or multiple. PMID- 3302284 TI - Ultrastructure of spermatozoa of the white-naped crane. AB - Spermatozoa of the white-naped crane were examined with the light and electron microscopes. The relatively simple spermatozoa have a small acrosome, a short midpiece, and a flagellum lacking both dense fibers and fibrous sheath. Crane spermatozoa are unique in that the degree of condensation varies among spermatozoa, but in no spermatozoon does chromatin become highly compacted. Incomplete condensation of chromatin may be responsible in part for the variety of sperm head shapes, including elongate, curved, 'S'-shaped, droplet and spherical forms. Crane sperm may provide a system to better understand the mechanism and function of chromatin condensation in spermatozoa. PMID- 3302285 TI - The treatment of alcoholic methadone patients: a review. AB - Alcoholism is a major problem among methadone maintenance patients. Although alcoholism in the methadone patient is recognized as a problem, few treatment studies have been conducted. Treatment studies have examined abstinence oriented and controlled drinking therapies, voluntary disulfiram treatment, and combined behavioral-pharmacological treatment. The first three treatments were shown to be ineffective in impacting alcohol consumption. The ineffectiveness reported by these studies was attributed to patients' lack of motivation. However, the combined behavioral-pharmacological treatment, which made methadone treatment contingent on antabuse consumption, resulted in decreases in both alcohol consumption and arrests, with increases occurring in employment. Future research should examine the generality of the findings from combined treatment as well as examine whether other contingency management procedures may reduce alcohol consumption in the alcoholic methadone patient. PMID- 3302286 TI - Classics revisited. The shaking of the foundations. By Paul Tillich. PMID- 3302287 TI - Plain radiography and computed tomography in the staging of bronchogenic carcinoma: a practical approach. AB - A determination of the anatomic extent of tumor is important in planning appropriate invasive diagnostic procedures and treatment in patients with bronchogenic carcinoma. In most situations, plain radiographs provide useful anatomic information, but CT is necessary for detailed evaluation. Although some plain film and CT findings strongly suggest that a tumor is unresectable, they are usually nonspecific, and biopsy correlation is necessary before the patient is denied an attempt at a surgical cure. Also, in the light of recent advances in the surgical treatment of lung cancer, some lesions formerly thought to be unresectable because of local or regional metastases are being effectively treated. Close communication between the radiologist and surgeon is necessary in the appropriate management of these patients. PMID- 3302288 TI - Computed tomography of superior vena cava obstruction. AB - Which imaging procedure is best for the diagnosis of the superior vena cava (SVC) syndrome is subject to considerable debate. Available imaging procedures include the plain chest film, SVC phlebography, scintiangiography, digital phlebography, CT digital phlebography, and CT. In our experience the combined technique of contrast enhanced CT axial images, followed by a CT digital phlebogram, is the most informative, cost-effective, and least invasive method available. PMID- 3302289 TI - Mediastinal trauma and other acute mediastinal conditions. AB - Acute mediastinal diseases most often result from penetrating or blunt trauma and from iatrogenic injuries related to the misplacement of tubes and catheters. The commonest chest film findings of mediastinal disease include mediastinal contour alteration, such as obliteration of normal structures, mediastinal widening, and pneumomediastinum. Characteristic mediastinal findings indicating injury to specific mediastinal structures are presented. PMID- 3302290 TI - Iatrogenic trauma to the thorax. AB - With more sophisticated medical procedures and treatment for the critically ill patient, iatrogenic damage to the thorax has become increasingly common. But simple radiologic procedures, such as chest radiography and fluoroscopy, permit diagnosis of unsuspected and clinically silent complications. A very important iatrogenic trauma to the lung depends on the increasing use of overpressure ventilation. Experimental evidence shows that the lung can be damaged with interstitial emphysema at peak pressures as low as 40 cm H2O. The chest radiograph may show and early pathognomonic finding of perivascular air collections. The respirator treatment should then be modified to avoid pneumomediastinum and pneumothorax. The placement of catheters, chest tubes, endotracheal tubes, and feeding tubes as well as pacemaker electrodes and counterpulsation balloons may cause serious complications. Follow-up chest radiography after these procedures is therefore important. PMID- 3302291 TI - Thoracic cardiovascular trauma. AB - Trauma is the third leading cause of death in the United States and the leading cause for persons under 40 years of age; chest trauma accounts for more than 25% of these deaths. Rates of trauma to the chest--both blunt and penetrating--are rising because of the continuing development of high-speed transportation and because of increasing inner-city violence combined with ready availability of handguns. But treatment has improved; even injury to the heart is no longer considered invariably lethal. This review describes the spectrum of injuries to the pericardium, heart, aorta, and thoracic arteries and veins, exclusive of iatrogenic trauma and high-velocity gun shot injuries caused by military weapons. The role of imaging is described. PMID- 3302292 TI - Percutaneous drainage of infected and noninfected thoracic fluid collections. AB - Radiologically guided aspiration and drainage of thoracic fluid collections is an improvement on standard "blind" techniques for chest-tube insertion. Specific indications for radiologic drainage are broadening, and instead of failed surgical cases only, patients now are commonly referred for drainage. Most of these procedures are effective and the complication rate vis-a-vis alternatives is acceptable. Soft 12-F catheters suffice in most cases and are relatively comfortable to large-bore tubes. PMID- 3302293 TI - Ultrasound appearance of extramedullary hematopoiesis. AB - Extramedullary hematopoiesis accompanies a wide variety of diseases and is defined as the abnormal production of blood outside the normal confines of the bone marrow. Most of the time, extramedullary hematopoiesis is found as microscopic foci in soft tissues; however, on occasion this process may reach a size that is detectable with ultrasound. Two forms are possible: "paraosseous"- in which the normal medullary tissue of the bone marrow ruptures through the bone to present as a paraosseous soft tissue mass,--and "extraosseous"--in which extramedullary hematopoiesis occurs within soft tissue. These "masses" of hematopoietic tissue can appear almost anywhere in the abdomen and pelvis and can mimic a wide variety of more serious diseases. PMID- 3302294 TI - Significance of an absent or reversed end diastolic flow in Doppler umbilical artery waveforms. AB - The outcome of nine fetuses in whom Doppler umbilical arterial velocity-time waveforms showed absence or reversal of flow in end diastole was presented. Eight of the nine resulted in either intrauterine or neonatal death. Progressive deleterious changes in the waveforms were evident in three fetuses who had serial evaluation. The remaining infant survived when delivery was expected 2 days later. Our data have indicated that the demonstration of an absent or reversed flow in end diastole in the umbilical arteries carries with it a very specific indication of serious fetal compromise and the need for immediate delivery, although the prognosis of a normal neonatal survival remains guarded. PMID- 3302295 TI - Sonographic evaluation of the kidney following extracorporeal shock wave lithotripsy. AB - We investigated the value of real-time sonography for determination of pelvicaliceal dilatation 24-48 h after extracorporeal shock wave lithotripsy (ESWL) in 369 patients (419 treated kidneys). A varying degree of hydronephrosis was present in 121/419 (29%) kidneys. Fragmented stones post-ESWL were demonstrable in 346/419 kidneys (82%), but were missed by ultrasound in three kidneys (less than 1%). In four kidneys (1%), stone fragments which were shown to be present by ultrasound were not detectable on radiographs. In 25/419 kidneys (6%), evidence of renal trauma caused by ESWL was demonstrated by ultrasound. The most important incidental finding was a small renal cell carcinoma of the contralateral (untreated) kidney. PMID- 3302296 TI - A sonographic sign which predicts which fetuses with hydrocephalus have an associated neural tube defect. AB - We report a sonographic sign which reliably distinguishes those hydrocephalic fetal heads associated with a neural tube defect from those which are not, particularly in the second trimester. This sign involves a "pointed" deformity of the frontal aspect of the skull in fetuses with hydrocephalus, indicating the presence of a neural tube defect. A retrospective review of 36 cases of hydrocephalus demonstrates that this sign is particularly helpful in the second trimester, where it was present in all the fetuses with hydrocephalus and neural tube defect. It was less reliable in the third trimester; however, this sign was not present in any of the fetuses with hydrocephalus who did not have a neural tube defect. Angulation or pointing of the fetal frontal bone when hydrocephalus is present, particularly in the second trimester, seems to be a reliable predictor of an associated neural tube defect and mandates a careful search for this defect. PMID- 3302297 TI - Hemorrhagic cholecystitis. Sonographic appearance and clinical presentation. AB - In this retrospective study of 19 patients with hemorrhagic cholecystitis, 14 (74%) patients demonstrated one of the following unusual sonographic features: focal gallbladder wall irregularity; intraluminal membranes; coarse, nonshadowing, nonmobile intraluminal echoes. The clinical presentation of these cases (abdominal pain, 100%; leukocytosis, 74%; fever, 63%) is identical to the classic presentation of acute cholecystitis. Overt gastrointestinal bleeding did not occur. PMID- 3302298 TI - Kleeblattschadel anomaly. In utero sonographic appearance. AB - Four cases of Kleeblattschadel demonstrated on prenatal ultrasound examinations are reported. Five additional cases from the literature are reviewed. Sonographic features include enlarged trilobed skull, hydrocephalus, polyhydramnios, and frequent association with thanatophoric dwarfism. The most common error in diagnosis was misinterpretation of this skull anomaly as encephalocele. PMID- 3302299 TI - Actinomycosis involving the liver. Computed tomography/ultrasound correlation. PMID- 3302300 TI - Biliary neoplasm simulating dilated bile ducts. Role of computed tomography and ultrasound. PMID- 3302301 TI - "Contained" rupture of a liver hydatid cyst. Sonographic diagnosis and long-term postoperative follow-up. PMID- 3302302 TI - Focal hypoechoic areas in the porta hepatis. PMID- 3302303 TI - Uterine adenomyosis. A difficult sonographic diagnosis. AB - In an effort to distinguish the appearance of generalized uterine adenomyosis from leiomyoma, a retrospective study was performed on 80 patients who had preoperative uterine sonography. A diagnosis of adenomyosis (eight patients) was suggested if the uterus was diffusely enlarged, but the myometrial texture, contour, and central cavity echoes were each normal. Leiomyoma, or other focal uterine pathology (72 patients) was characterized by focal or globular uterine enlargement with abnormal echo texture and contour, as well as nonvisualization or displacement of the central cavity echo complex. Using these criteria, ultrasound was able to suggest adenomyosis with a sensitivity of 63%, a specificity of 97%, and a positive predictive value of 71%. Focal pathology was diagnosed with a sensitivity of 97%, a specificity of 63%, and a positive predictive value of 96%. Although irregular myometrial sonolucent zones have previously been reported as characteristic for adenomyosis, this study did not confirm this finding. PMID- 3302304 TI - Ultrasonography as a differential diagnostic aid in achillodynia. AB - The purpose of the study was to investigate the usefulness of soft-tissue real time ultrasonography (US) for diagnosing sports injuries of the Achilles region. Thirty-eight patients (mean age, 39.9 years) with Achilles tendon problems were studied at Helsinki University Central Hospital. Six patients underwent surgery following ultrasonographic examination. All operative findings corresponded closely with those of ultrasonography. Partial ruptures were found in 11 cases, total tendon rupture in three cases, subachilles bursitis in 11 cases, and peritendinitis in 16 cases. The study showed that real-time ultrasonography can be used reliably for examination of both tendoneal and peritendoneal injuries. The technique is recommended as a routine examination before instigating any specific treatment and for monitoring Achilles tendon injuries. PMID- 3302305 TI - Atherosclerotic plaque at the carotid artery bifurcation. Correlation of ultrasonographic imaging with morphology. AB - Morphologic characteristics of atherosclerotic plaque at the carotid artery bifurcation were compared to the appearance of the plaque on real-time B-mode ultrasonography. Mural plaques propagating along the wall of the carotid sinus had a 72% frequency of recent organizing hemorrhage. Nodular plaques causing local narrowing of the vessel had only a 23% incidence of organizing hemorrhage. This difference was significant (P less than 0.01). The presence of recent organizing hemorrhage in mural plaques may account for the increased frequency of symptoms previously observed to occur ipsilateral to mural plaques compared to nodular plaques. PMID- 3302306 TI - Sonographic features of Brenner tumor of the ovary. AB - The sonographic findings in four patients with benign Brenner tumors of the ovary are described. Computed tomography (CT) was also obtained in one case. The neoplasms were solid, hypoechoic masses, usually exhibiting good through transmission of sound. Two neoplasms contained peripheral calcifications; one was inseparable from the uterus and was misdiagnosed as a leiomyoma; the other was well-demonstrated by CT but only in retrospect was the peripherally located calcification identified. Sonographically, Brenner tumors are similar to other solid ovarian neoplasms, particularly fibromas-thecomas, and can also be confused with pedunculated leiomyomas. PMID- 3302307 TI - The "coffee bean" sign in periappendiceal and peridiverticular abscess. AB - Four cases of right lower quadrant abscess, each a clinical diagnostic dilemma, were recognized as abscesses surrounding a perforated viscus by application of the "coffee bean" sign on sonographic examination. The appearance in the right lower quadrant of a brightly echogenic finger-like projection extending into a cystic mass, with or without scattered internal echoes, should suggest the possibility of periappendiceal or diverticular abscess. PMID- 3302308 TI - Ultrasound diagnosis of a prostatic cyst causing acute urinary retention. PMID- 3302309 TI - Testicular microlithiasis. A unique sonographic appearance. PMID- 3302310 TI - Antenatal diagnosis of fetal pelvic kidneys. PMID- 3302311 TI - Sonographic features of rupture of the pregnant uterus. PMID- 3302312 TI - Meconium plug syndrome. PMID- 3302313 TI - Clavulanate-potentiated amoxycillin: in vitro antibacterial activity and oral bioavailability in calves. AB - The minimal inhibitory concentrations (MIC) of amoxycillin and clavulanate potentiated amoxycillin (amoxycillin:clavulanic acid, 4:1 by weight) were compared for 171 Salmonella, 170 Escherichia coli, and 32 Pasteurella isolates recovered from infected neonatal calves. In the presence of clavulanic acid, the MIC of amoxycillin was reduced to levels less than or equal to 12.5 micrograms/ml for all the Salmonella group B, all the Pasteurella, and for 12 out of the 44 E. coli isolates which were resistant to amoxycillin (MIC greater than or equal to 100.0 micrograms/ml). For isolates sensitive to amoxycillin (MIC less than or equal to 1.56 microgram/ml) there was no change in MIC values in the presence of clavulanic acid. A small proportion of Salmonella and E. coli isolates were resistant to clavulanate-potentiated amoxycillin. In a cross-over trial involving 10 preruminant (2 weeks old) calves, amoxycillin trihydrate and clavulanate potentiated amoxycillin were administered orally at 10 mg/kg. An analysis of serum amoxycillin level data showed that the pharmacokinetic parameters t1/2ab, Cmax, t1/2 beta, AUC, Cp degree, and f' (estimated drug absorption ratio) were the same after treatment with amoxydrate and clavulanate-potentiated amoxycillin. Administration of clavulanate-potentiated amoxycillin and probenecid resulted in elevation and prolongation of serum amoxycillin levels. Computations showed that in preruminant calves serum amoxycillin concentrations sufficient to inhibit sensitive pathogens can be maintained by oral clavulanate-potentiated amoxycillin treatment at 10 mg/kg TID. At two times that dose rate serum drug concentrations capable of inhibiting 50% of all types of pathogens examined can be maintained.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302314 TI - Multistage Friend erythroleukemia: independent origin of tumor clones with normal or rearranged p53 cellular oncogenes. AB - The erythroleukemia induced by Friend virus complex in adult mice is a multistage malignancy characterized by the emergence, late in the disease, of tumorigenic cell clones. We have previously shown that a significant proportion of these clones have unique rearrangements in their cellular p53 oncogene. The clonal relationships among Friend tumor cells isolated in the late stages of Friend erythroleukemia were analyzed by examining the unique integration site of Friend murine leukemia virus and the unique rearrangement in their cellular p53 oncogene. The majority of clones isolated from individual mice infected with Friend virus were clonally related as judged by the site of Friend murine leukemia virus integration. However, Southern gel analysis of DNA from individual Friend cell clones indicated that all of the clones with a normal p53 gene from the same mice were clonally related, but were unrelated to the Friend cell lines with a rearranged p53 gene. These results suggest that Friend tumor cells with rearrangements in their p53 gene arise as the result of a unique transformation event, rather than by progression from already existing tumor cells with a normal p53 gene. They also suggest that such rearrangements in the p53 gene confer a strong selective advantage to these cells in vivo. PMID- 3302315 TI - Real-time duplex ultrasound mapping of the greater saphenous vein before in situ infrainguinal revascularization. AB - From November 1983 through September 1985, 102 greater saphenous veins (GSVs) were assessed and mapped by means of real-time duplex ultrasonic scanning before in situ infrainguinal revascularization. Each GSV was also visually assessed at operation. Eighty-five GSVs were successfully used for infrainguinal revascularization; duplex scanning correctly identified 82 of these GSVs as being acceptable for use in in situ bypass. Seventeen GSVs were unacceptable for in situ bypass; duplex scanning correctly identified 11 of these as being unacceptable. Duplex scanning provides anatomic information about the GSV, including size, patency, course, varicosities, double segments, and tributaries. This information permits the surgeon to perform infrainguinal revascularization expeditiously. PMID- 3302316 TI - A modified technique for use of the intraluminal valve cutter in in situ saphenous vein grafts. AB - A modified technique for the use of the disposable intraluminal valve cutter in the performance of in situ saphenous vein arterial bypass grafts is presented. The technique results in a more physiologic dilatation of the vein and can be expeditiously performed with minimal intimal trauma to the vein graft. Long incisions necessary to expose the entire vein with the use of other techniques can be avoided, thereby decreasing the potential for wound healing problems commonly associated with vascular reconstruction in ischemic limbs. PMID- 3302318 TI - The impact of Medicare's prospective payment system on Wisconsin nursing homes. PMID- 3302317 TI - The role of external carotid endarterectomy in the treatment of ipsilateral internal carotid occlusion: collective review. AB - Complete occlusion of the internal carotid artery (ICA) may result in a variety of clinical states. Neurologic symptoms in the setting of ICA occlusion may be due to embolic events through the external carotid artery (ECA) circulation, hemodynamic insufficiency resulting from inadequate collateral development, or propagation of clot intracranially. External carotid reconstruction has been used to prevent neurologic events from the first two mechanisms. This review attempts to place in perspective the current indications for, techniques of, and results from ECA revascularization. A discussion of the cerebral collateral circulation is included for reference. Twenty-three series were collected from the literature. Cases were excluded in which procedures other than ECA reconstruction were undertaken, leaving 218 cases for analysis. These represented 195 EC endarterectomies and 23 ECA bypasses. Resolution of symptoms was seen in 83% of patients with another 7% showing marked improvement. The perioperative mortality rate was 3%; neurologic deaths accounted for most perioperative deaths. The overall neurologic complication rate was 5%. More recent reports were notable for improved mortality and morbidity. A diseased contralateral carotid artery was associated with higher neurologic morbidity whereas disease in the vertebral arteries had no impact on outcome. The best results were obtained when surgery was performed to relieve specific hemispheric or retinal symptoms as opposed to nonspecific neurologic complaints or previous stroke. The symptomatic patient with ICA occlusion has a poor neurologic prognosis. In selected circumstances ECA reconstruction should be considered among the treatment options in this clinical setting. PMID- 3302319 TI - Soviet medical response to the Chernobyl nuclear accident. AB - The nuclear accident at Chernobyl was the worst in the history of nuclear power. It tested the organized medical response to mass radiation casualties. This article reviews the Soviet response as reported at the 1986 postaccident review meeting in Vienna and as determined from interviews. The Soviets used three levels of care: rescue and first aid at the plant site; emergency treatment at regional hospitals; and definitive evaluation and treatment in Moscow. Diagnosis, triage, patient disposition, attendant exposure, and preventive actions are detailed. The United States would be well advised to organize its resources definitively to cope with future nonmilitary nuclear accidents. PMID- 3302320 TI - Hiroshima and the art of Iri Maruki and Toshi Maruki. PMID- 3302321 TI - Landmark article June 8, 1946: A clinical syndrome following exposure to atomic bomb explosions. By Paul D. Keller. PMID- 3302322 TI - Landmark perspective: Acute radiation syndrome. PMID- 3302323 TI - From the Health Care Financing Administration. PMID- 3302324 TI - How will changes in physician payment by Medicare influence laboratory testing? AB - In-office laboratory testing offers physicians an opportunity to increase their incomes through the potential profit available from technical services. This financial incentive for in-office testing has been altered by Medicare limits on physician payment, legislative changes in physicians' ability to bill Medicare for laboratory tests, and technological advances in office laboratory equipment. While restrictions on payment may make laboratory testing relatively less profitable than other technical services offered in the physician's office, in office laboratory testing still offers potential financial benefit to physicians, particularly if they can influence the demand for tests. Economic theory suggests that physicians may be able to increase the demand for their services, including laboratory testing, but empirical data are not conclusive. As Medicare and other third-party payers consider fundamental reform in physician payment, the effect of different payment schemes on physicians' use of laboratory tests may have important consequences for physicians' income, the quality of care, patients' access to care, and the cost of the Medicare program. PMID- 3302325 TI - The Health Care Financing Administration. PMID- 3302326 TI - Ginevra: turned left or right? Leonardo: straight or gay? PMID- 3302327 TI - A history of the Joint Commission on Accreditation of Hospitals. PMID- 3302328 TI - Doctor as patient advocate. PMID- 3302329 TI - Medical education programs sponsored by government agencies. PMID- 3302330 TI - Medical schools in the United States. PMID- 3302331 TI - Medical schools in Canada. PMID- 3302332 TI - Relation of serum albumin concentration to death rate in nursing home men. AB - Serum albumin was measured in 126 men (average age 70.6; range 40 to 96) of a Veterans Administration Nursing Home, and was correlated with other items in an extensive clinical data base, including death or survival during the year after the analysis. The reason for institutionalization was chronic neurologic disease or other disabling physical condition in 63 men (group A), and psychiatric disorder in 63 men (group B). In group A, the proportions of men with albumin less than 3.5, 3.5-4.0, and greater than 4.0 g/dl were 6%, 37%, and 57%, respectively. In this group, the serum albumin level was significantly (p less than 0.05) correlated with death rate, hemoglobin, hematocrit, serum cholesterol, and serum lactic dehydrogenase. The death rate in group A during the year after the albumin analysis was 25%. For the patients with albumin level less than 3.5, 3.5-4.0, and greater than 4.0 g/dl, the death rates were 50%, 43%, and 11% respectively (p less than 0.01 for comparison of the former two groups with the latter). The subgroup with albumin 3.5-4.0 g/dl represented only 37% of the men in group A, but accounted for 63% of the group's deaths. In group B, serum albumin level was not significantly correlated with any other clinical variable. Death rate during the year after the albumin analysis was only 2% in group B, and did not correlate with the albumin level. These data indicate that, in nonpsychiatric Nursing Home men, the desirable level for the serum albumin concentration is higher than 3.5 g/dl. PMID- 3302333 TI - Actions of prostaglandin I2 and thromboxane A2 on vascular smooth muscle tissues. AB - Actions of prostaglandin I2 (PGI2) and thromboxane A2 (TXA2) on vascular smooth muscles were investigated in relation to the function of the endothelium. In intact vascular smooth muscle tissues of the thoracic aorta, PGI2-Na, used as a substitute substrate of PGI2, relaxed the precontracted tissue, in a dose dependent manner, in intact tissues and also after mechanical ablation of the endothelium. Acetylcholine (ACh) relaxed the tissue precontracted by noradrenaline, in the presence or absence of indomethacin; however, the relaxation required the presence of an intact endothelium. On the other hand, increased amounts of PGI2 with the application of acetylcholine, as estimated from the amount of 6-keto-PGF1 alpha, were markedly attenuated by indomethacin. In smooth muscles of this tissue without the endothelium, ACh synthesized lesser amounts of PGI2, while PGI2-Na increased the amount of cyclic AMP. Thus, PGI2 was synthesized in both the endothelium and smooth muscles. The former produces a larger amount of PGI2 than the latter, but the PGI2 synthesized in smooth muscles may act more potently on the smooth muscle than does that synthesized in the endothelium. In the canine coronary artery, mechanical responses induced by TXA2, as estimated from actions of 9, 11,-epithio-11, 12-methano-thromboxane A2 (STA2) were enhanced after ablation of the endothelium. The minimum concentration of STA2 required to produce the contraction was above 1 nM and the maximum amplitude was evoked with 30 nM. The amplitude of the STA2-induced contraction was reduced in Ca-free solution or with the application of nifedipine. However, prazosin, propranolol or atropine had no effect on the STA2-induced contraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302334 TI - Prostanoids, coronary circulation and coronary artery spasm in open chest dogs and miniature pigs. AB - Effects of prostanoids on coronary circulation were studied in anesthetized open chest dogs with intact coronary arteries or in closed chest Gottingen miniature pigs with denuded vessels. In the latter model, coronary artery spasm was repeatedly provoked at the previously denuded area by histamine i.c. after pretreatment with cimetidine i.v., H2-blocker. In the canine model, prostacyclin (PGI2) dilated to a greater extent the diameter of the large epicardial coronary artery than did PGE2, and both equally reduced the total coronary resistance. Vasoconstrictive effects of carbocyclic thromboxane A2, a stable analogue of thromboxane A2 (TxA2) on the epicardial coronary artery was augmented from 1.1 +/ 0.3 to 6.5 +/- 1.3% (p less than 0.01) after pretreatment with cyclooxygenase inhibitors. In case of Gottingen miniature pigs 3 months after endothelial denudation and cholesterol freeding, neither PGI2 nor indomethacin prevented histamine-induced coronary artery spasm. Thiothromboxane A2, a stable analogue of TxA2, did not provoke coronary artery spasm in the animals. Therefore, prostanoids may not be crucial to the provocation or prevention of coronary artery spasm from which myocardial ischemia ensues. PMID- 3302335 TI - Serum PGI2-regulating factors in acute myocardial infarction. AB - Human serum or plasma contains two factors which regulate PGI2 metabolism. The one is "PGI2-synthesis stimulating factor" which stimulates PGI2 synthesis in the vessel wall. The other is "PGI2-stabilizing factor" which stabilizes PGI2 in the blood. In the very early phase of acute myocardial infarction, the serum levels of these two factors were significantly reduced, which may be related to the thrombus formation in the coronary artery in acute myocardial infarction. PMID- 3302336 TI - [Balanced anesthesia with etomidate, cyclazocine, butorphanol, buprenorphine and N2O and the regulatory function of the renin, angiotensin and catecholamine]. PMID- 3302337 TI - [The role of thromboxane A2 in shock. II. Bacteremic shock]. PMID- 3302338 TI - [Indication of high frequency jet ventilation for respiratory failure]. PMID- 3302339 TI - [Freedom from statistic errors--(3). Non-parametric test]. PMID- 3302340 TI - [Intraoperative monitoring with M-mode transesophageal echocardiography; monitoring of the cardiac function by aortic valve echograms]. PMID- 3302341 TI - [Effect of anaesthesia on the endocrine-metabolic response to lower abdominal surgery]. PMID- 3302342 TI - [Comparative, controlled study on an ampicillin suppository (KS-R 1) with an oral form of ampicillin in urinary tract infections]. AB - Subjects were in-patients with bacterial urinary tract infections, ranging in age 4 months to 11 years 4 months. As a rule, daily dose was either four 125 mg (in potency) suppositories or four 125 mg (in potency) oral form given at 6-hour intervals over a period of 5 days. The number of children subjected to this study was 105. These children were divided into 2 groups (suppository 54; oral form 51) with matched pretreatment background factors. Therapeutic effectiveness rates were 70.4% for the suppository and 66.7% for the oral form, and no significant difference was observed between the 2 groups. Rates of efficacy by severity, presence or absence of underlying and/or complication diseases, daily dose and causative microorganisms did not differ significantly between the 2 groups. There was no significant difference in time-courses of improvement of clinical signs and symptoms between the 2 groups. Eradication rates for causative microorganisms were 65.9% for the suppository and 62.5% for the oral form. Most frequently isolated causative microorganisms were Escherichia coli and Proteus mirabilis. No significant differences were recognized in the therapeutic effect and usefulness evaluated by physicians in charge. The frequency of side effects did not differ significantly between the suppository group (6 with diarrhea and 1 with anal pain: 12.1%) and the oral form group (5 with diarrhea, 1 with displeasure and 1 with vomiting: 12.7%). Abnormal laboratory findings appeared in 6 cases (2 with eosinophilia, 2 with increased GOT and 2 with increased GPT) in the suppository group and 7 cases (2 with eosinophilia, 2 with thrombocytosis, 2 with increased GOT and 1 with increased GPT) in the oral form group. PMID- 3302343 TI - [Effect of metabolites on the human plasma concentration as total activity after oral administration of rokitamycin. Comparison of three different bioassay methods]. AB - Three different bioassay methods for rokitamycin (TMS-19-Q) were compared to each other in vitro and in vivo. Method I was a paper disc method using Micrococcus luteus ATCC 9341 as the test organism in nutrient agar (pH 8.0), method II was a paper disc method using Streptococcus pyogenes Cook in brain heart infusion agar (pH 7.4) and method III was an agar well method using M. luteus ATCC 9341 in the agar medium provided in the Minimum Requirements for Antibiotic Products of Japan (pH 6.5). Ratios of relative potency of TMS-19-Q and its metabolites calculated from standard curves in human plasma using these bioassay methods, were 1.00:1.13:3.34:0.96 (TMS-19-Q:10"-OH-TMS-19-Q:LM A7:LM V) in method I, 1.00:1.58:0.40 (TMS-19-Q:LM A7:LM V) in method II and 1.00:0.51:0.86:0.114 (TMS 19-Q:10"-OH-TMS-19-Q:LM A7:LM V) in method III. The relative potency obtained from method I, generally used for macrolide antibiotics, greatly contradicted MIC values of TMS-19-Q and its metabolites against clinically isolated 190 strains of Staphylococcus aureus. On the other hand, the relative potency obtained from method III reflected closely MIC values of TMS-19-Q and its metabolites. Therefore, method III should be the most suitable bioassay method to measure the plasma concentration of TMS-19-Q. Plasma concentrations measured by these 3 different methods were compared to each other in vivo, after oral administration of TMS-19-Q at a dose of 1,200 mg to each of fasted healthy volunteers. Values obtained from method I were about 4.3 times higher than those method III.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302344 TI - [Clinical trial of forphenicinol for the lung infection with Mycobacterium avium, Mycobacterium intracellulare complex]. AB - Clinical evaluation of forphenicinol, a low molecular weight immunomodulator, in patients with Mycobacterium avium, Mycobacterium intracellulare complex pulmonary infections has been conducted in a multicenter trial participated by 9 institutions in Kyushu during a period of 12 months from July 1982 to August 1983. Forphenicinol was administered for 6 months without changing the regimen of antituberculous drugs used previously. The following results were obtained. 1. Ten out of 33 eligible patients were evaluated as showing good responses; In 5 of them, elimination of M. avium, M. intracellulare complex from sputum was observed. In the other 5 patients, number of bacilli excreted was decreased significantly after treatment. 2. All of the cases with good responses were those which were simultaneously administered with antituberculous drugs. 3. Patients with thick-walled cavities, following cured tuberculosis, which was superimposed with M. avium, M. intracellulare complex, were poorly responded to forphenicinol. 4. Side effects were observed in 3 out of 41 patients; 1 case each with fever, abdominal distension and anorexia. No abnormalities in laboratory test values were observed. PMID- 3302345 TI - [Clinical studies of BRL 28500 (clavulanic acid/ticarcillin) in the treatment of intraperitoneal infections and biliary tract infections]. AB - Clinical studies have been conducted on BRL 28500 (a formulation containing 15 parts ticarcillin (TIPC) plus 1 part clavulanic acid (CVA]. BRL 28500 was administered at doses of 1.6 g or 3.2 g b.i.d., generally for 10 days by drip infusion to patients with intraperitoneal infections or biliary tract infections. Drug concentrations in the ascites were determined. A total of 76 cases was treated with BRL 28500. These cases included 49 intraperitoneal infections (suppurative peritonitis 29, postoperative peritonitis 20) and 18 biliary tract infections (cholecystitis 5, cholangitis 13). Nine cases were excluded from evaluation according to the committee's assessment. The clinical improvement as assessed by surgeons in charge increased with the duration of continued treatment and efficacies were assessed as 57.1% on day 5, 63.1% on day 7 and 77.8% on day 10 in intraperitoneal infections. Corresponding results in biliary tract infections were 38.9%, 40.0% and 42.9%, respectively. From these results, it is clear that the degree of improvement is related to the duration of treatment. The clinical usefulness as assessed by surgeons in charge of the study was 63.8% in intraperitoneal infections (suppurative peritonitis 75.0%, postoperative peritonitis 47.4%) and 58.8% in biliary tract infections (cholecystitis 100%, cholangitis 41.7%). The overall rate of usefulness was 62.5%. The clinical efficacy rates as assessed by the committee were 81.6% in intraperitoneal infections (suppurative peritonitis 93.1%, postoperative peritonitis 65.0%) and 66.7% in biliary tract infections (cholecystitis 100%, cholangitis 53.8%). In cases where causative organisms were isolated, the efficacies were 92.9% in suppurative peritonitis, 58.8% in postoperative peritonitis, 50.0% in cholangitis and overall, 69.2%. In cases from which TIPC-resistant organisms were isolated, the overall efficacy rate was 65.4% (suppurative peritonitis 88.9%, postoperative peritonitis 58.3% and cholangitis 40.0%). Regarding bacteriological effect as assessed by the committee, the eradication rate was 76.9% in intraperitoneal infections and 40.0% in biliary tract infections (71.0% overall). In cases from whom ticarcillin-resistant organisms were isolated the corresponding rates were 68.4% and 33.3% respectively, (63.6% overall). In 4 patients with peritonitis drug levels in the ascites were determined following administration of BRL 28500 by drip infusion. Good levels of both TIPC and CVA were detected 1 to 3.5 hours after administration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3302346 TI - [Revision of the taxonomy of the genera Peptococcus and Peptostreptococcus and a study on their identification system]. PMID- 3302347 TI - [Coagulase-negative Staphylococci and Staphylococcus hyicus subsp. hyicus]. PMID- 3302348 TI - [Studies on the measurement of antibody against the C-polysaccharide antigen of group A Streptococcus by the enzyme-linked immunosorbent assay]. PMID- 3302349 TI - [Immunotherapy of terminal-stage malignant tumors with the immunopotentiator OK 432--a comparison between SU-PS test-responder and -nonresponder patients]. AB - We treated terminal malignant tumor cases with the immunopotentiator OK-432 and determined the absolute numbers of neutrocytes, lymphocytes, and lymphocyte subpopulations, carrying out the SU-PS and PPD skin tests. After the start of therapy, SU-PS test changed to positive in one-third of the patients. The SU-PS responder patients showed an increase in lymphocytes and Leu 11A-positive cells, and an elevation of the OK T4/T8 ratio two weeks later. In the SU-PS-nonresponder group, OKT4-positive cells declined, while OKT8-positive cells increased with time. That is, the OKT4/T8 ratio remained low throughout the test period. In the SU-PS-responder group, OK-432 therapy was found to prolong the survival period. PMID- 3302350 TI - [Recovery of immune function after bone marrow transplantation]. PMID- 3302351 TI - [Severe jaundice and hemophagocytic histiocytosis after autologous bone marrow transplantation in a patient with malignant lymphoma]. PMID- 3302353 TI - [Basic theory and specific character of lasers]. PMID- 3302352 TI - [Prospects of current laser medicine]. PMID- 3302354 TI - [Biological effect of lasers: thermal, photochemical and electromagnetic effects]. PMID- 3302355 TI - [Present status and future prospects of laser surgery--advantages of the laser scalpel]. PMID- 3302356 TI - [Application of lasers in microsurgery]. PMID- 3302357 TI - [Application of lasers in biometry and diagnosis]. PMID- 3302358 TI - [Clinical application of low-intensity lasers. 1. Application of lasers in cardiovascular surgery]. PMID- 3302359 TI - [Clinical application of low-intensity lasers. 3. Therapy of pain and inflammation]. PMID- 3302360 TI - [Photoradiation therapy (PRT). 1. Photochemical action of lasers]. PMID- 3302361 TI - [Photoradiation therapy (PRT). 2. Mechanism of tumor-cell killing effect of photoradiation therapy]. PMID- 3302362 TI - [Photoradiation therapy (PRT). 3. Research and developmental trends in photosensitization substances]. PMID- 3302363 TI - [Photoradiation therapy (PRT). 4. Various effects of PRT using argon dye laser on experimental animals]. PMID- 3302364 TI - [Photoradiation therapy (PRT). 5. N2 dye laser photoradiation therapy]. PMID- 3302365 TI - [Photoradiation therapy (PRT). 6. Excited dimer dye laser PDT]. PMID- 3302366 TI - [Photoradiation therapy (PRT). 7. Clinical study of photoradiation therapy: clinical application and efficacy. c. Bladder neoplasms]. PMID- 3302367 TI - [Laser endoscopy: diagnosis and therapy. 1. Diagnosis of neoplasms and instruments of laser endoscopy]. PMID- 3302368 TI - [Laser endoscopy: diagnosis and therapy. 2. Laser endoscopy and use of the video camera]. PMID- 3302369 TI - [Laser endoscopy: diagnosis and therapy. 3. Development of the contact optic fiber probe]. PMID- 3302370 TI - [Laser endoscopy: diagnosis and therapy. 4. Development of the lateral radiation fiber probe]. PMID- 3302371 TI - [Laser endoscopy: diagnosis and therapy. 5. Laser endoscopy therapy of digestive system neoplasms]. PMID- 3302372 TI - [Laser endoscopy: diagnosis and therapy. 6. Laser endoscopy therapy of lung neoplasms]. PMID- 3302373 TI - [Laser endoscopy: diagnosis and therapy. 7. Laser endoscopy therapy of gastrointestinal hemorrhage and stomach ulcers]. PMID- 3302374 TI - [Clinical application of the thermal effect of lasers. 1. Application of the Nd YAG laser in inducing hyperthermia]. PMID- 3302375 TI - [Clinical application of the thermal effect of lasers. 2. Application of the laser thermal effect to the therapy of liver neoplasms]. PMID- 3302376 TI - [Clinical application of the thermal effect of lasers. 3. Photocoagulation in the field of ophthalmologic diseases and its progress and problems]. PMID- 3302377 TI - [Study of brain function by positron CT]. PMID- 3302378 TI - [Protein engineering in the field of pharmacy]. PMID- 3302379 TI - [Development of high resolution scanning electron microscopy and its application in medical biology]. PMID- 3302380 TI - A case report of adenocarcinoma of the lung in which a partial response was achieved by carboplatin. AB - A 56-year-old housewife was incidentally discovered to have an abnormal shadow in the right B6 area upon a chest X-ray film being taken. A transcutaneous lung biopsy of the mass revealed adenocarcinoma of the lung (WHO classification). A brain computed tomography (CT) scan demonstrated multiple brain metastasis. Following whole brain irradiation, carboplatin (CBDCA) (450 mg/m2) was administered by intravenous drip infusion on March 7, 1986. After three weeks of initial treatment with CBDCA, the size of the tumor in the primary site was found to have decreased on the chest X-ray film by more than 50%, following which, similar doses of CBDCA were administered twice, and reduced (330 mg/m2) doses three times every three to four weeks. She showed a partial response and, for seven months after the beginning of the CBDCA treatment, no progression was seen on the chest X-ray film. It is suggested that there is a need for further phase II studies of CBDCA against non-small cell lung cancer. PMID- 3302381 TI - [PIVKA (protein induced by vitamin K absence or antagonists)]. PMID- 3302382 TI - [Analysis of von Willebrand factor]. PMID- 3302383 TI - [Factor V]. PMID- 3302384 TI - [Molecular structure of abnormal fibrinogen]. PMID- 3302385 TI - [Factor XIII]. PMID- 3302386 TI - [Tissue factor and factor VII]. PMID- 3302387 TI - [Antithrombin III and heparin]. PMID- 3302388 TI - [Analysis of heparin cofactor II]. PMID- 3302389 TI - [Abnormal antithrombin III]. PMID- 3302390 TI - [Abnormal plasminogen]. PMID- 3302391 TI - [alpha 2-Plasmin inhibitor]. PMID- 3302392 TI - [FFDP (fibrin fibrinogen degradation products), D-dimers, and SFMC (soluble fibrin monomer complex)]. PMID- 3302393 TI - [FPA (fibrinopeptide A) and B beta 15-42)]. PMID- 3302394 TI - [Fibronectin]. PMID- 3302395 TI - [Circulating anticoagulants]. PMID- 3302396 TI - [Monitoring in anticoagulant and fibrinolytic therapy]. PMID- 3302397 TI - [Chemical analysis of blood coagulation factors--with special reference to the test using synthetic peptide substrates]. PMID- 3302398 TI - [Immunological detection of blood coagulation factors]. PMID- 3302399 TI - [Rheological examination of thrombus formation and hemostasis]. PMID- 3302400 TI - [Contact coagulation factors]. PMID- 3302401 TI - [Vitamin K-dependent coagulation factors--factors II and X]. PMID- 3302402 TI - [Diagnosis of spinal cord dysfunction--spinal cord conduction velocity]. PMID- 3302403 TI - [Muscle tonus and postural reaction]. PMID- 3302404 TI - [Diagnostic methods of mental functions: event-related potentials]. PMID- 3302405 TI - [Current neurophysiological tests of brainstem functions]. PMID- 3302406 TI - [Immunohistochemical demonstration of S 100 protein in melanin-producing tumors after bleaching for melanin]. PMID- 3302407 TI - [Serial changes in periodic synchronous discharges (PSD) in Creutzfeldt-Jakob disease]. PMID- 3302408 TI - [Effect of albumin on digoxin determination by the TDX system]. PMID- 3302409 TI - [Congenital dysfibrinogenemia and thrombosis]. PMID- 3302410 TI - [The diagnosis of congenital antithrombin III deficiency and abnormality]. PMID- 3302411 TI - [Congenital deficiency and molecular abnormality of protein C]. PMID- 3302412 TI - [Detection of viral nucleic acids and gene products by blotting procedure]. PMID- 3302413 TI - [Designate proposal: from the clinical pediatric standpoint]. PMID- 3302414 TI - [Detection of anti-HIV antibody by enzyme immunoassay using beads coated with products of HIV gene]. PMID- 3302415 TI - [Enzyme immunoassay of urinary albumin and its application for clinical study]. PMID- 3302416 TI - [Radiological interpretation of neonatal lungs for general diagnostic radiologists]. PMID- 3302417 TI - [Magnetic resonance imaging of cystic mass lesions of the pancreas]. PMID- 3302418 TI - [A case of internal jugular vein thrombosis]. PMID- 3302419 TI - [Experience with the use of DSA (digital subtraction angiography) in the diagnosis of a left atrial (LA) thrombus]. PMID- 3302420 TI - [Improvement in a total body irradiation technic as a preparation for bone marrow transplantation in leukemia]. PMID- 3302421 TI - [IVDSA while breathing--breathing technic]. PMID- 3302422 TI - [Identification of infiltrating cells for blister formation in bullous pemphigoid -a newly established method using epidermal sheets]. PMID- 3302423 TI - [Evaluation of intrarectal ultrasonography for assessment of invasion of rectal cancer]. PMID- 3302424 TI - [Multiple liver abscesses in a patient with Crohn's disease]. PMID- 3302425 TI - The association of HLA with diseases in Japanese. PMID- 3302426 TI - Study on IgA, IgA subclass and complement in the glomerulus of IgA nephropathy by the avidin-biotin-peroxidase complex method. PMID- 3302427 TI - Predominant polymeric IgA1 deposition in glomeruli in patients with IgA nephropathy. PMID- 3302428 TI - Scanning electron microscopic examinations of renal stones associated with urinary infections. PMID- 3302429 TI - Visualization of the renal cortex by magnetic resonance imaging. PMID- 3302430 TI - Effects of captopril on the intrarenal hemodynamics of postischemic acute renal failure in anesthetized dogs. PMID- 3302431 TI - The modulation of visceral functions by somatic afferent activity. AB - We began by briefly reviewing the historical background of neurophysiological studies of the somato-autonomic reflexes and then discussed recent studies on somatic-visceral reflexes in combination with autonomic efferent nerve activity and effector organ responses. Most of the studies that have advanced our knowledge in this area have been carried out on anesthetized animals, thus eliminating emotional factors. We would like to emphasize again that the functions of many, or perhaps all visceral organs can be modulated by somato sympathetic or somato-parasympathetic reflex activity induced by a appropriate somatic afferent stimulation in anesthetized animals. As mentioned previously, some autonomic nervous outflow, e.g. the adrenal sympathetic nerve activity, is involved in the control of hormonal secretion. John F. Fulton wrote in his famous textbook "Physiology of the Nervous System" (1949) that the posterior pituitary neurosecretion system (i.e. for oxytocin and vasopressin) could be considered a part of the parasympathetic nervous system. In the study of body homeostasis and environmental adaptation it would seem very important to further analyze the contribution of somatic afferent input to the autonomic nervous and hormonal regulation of visceral organ activity. Also, some immunological functions have been found to be influenced by autonomic nerves or hormones (e.g. adrenal cortical hormone and catecholamines). Finally, we must take into account, as we have briefly discussed, that visceral functions can be modulated by somatic afferent input via various degrees of integration of autonomic nerves, hormones, and immunological processes. We trust that such research will be expanded to higher species of mammals, and that ultimately this knowledge of somato-visceral reflexes obtained in the physiological laboratory will become clinically useful in influencing visceral functions. PMID- 3302432 TI - [Experimental urinary tract infection in beige mice with Chediak-Higashi syndrome]. PMID- 3302433 TI - Preparation of monoclonal antibodies reacting with bovine cortical thymocytes. PMID- 3302434 TI - Ultrastructure of thin and thick capsulated cells in Cryptococcus neoformans. PMID- 3302435 TI - Differential diagnosis of hydronephrosis types I and II in rats by echography. PMID- 3302436 TI - Lectin histochemistry of glycoconjugates in esophageal mucous gland of the chicken. PMID- 3302437 TI - An equine case of granular cell tumor with chondroplasia. PMID- 3302438 TI - A tribute to flight nurses. PMID- 3302439 TI - Preserving the freedom. PMID- 3302440 TI - Flight nursing: opportunities, risks, and rewards. PMID- 3302441 TI - Flight nurse practice: what is the governing body? PMID- 3302442 TI - Starting i.v.s with the "four tourniquet technique". PMID- 3302443 TI - Divided emergency department improves patient satisfaction. PMID- 3302444 TI - Emergency nurse questions drug screening in emergency department. PMID- 3302445 TI - Emergency nursing part time: answer to burnout? PMID- 3302446 TI - Flight nursing: expect the unexpected. PMID- 3302447 TI - History of flight nursing. PMID- 3302448 TI - Comparison of flight nurses' prehospital assessments and emergency physicians' ED assessments of trauma patients. PMID- 3302449 TI - Quality assurance for aeromedical transport. PMID- 3302450 TI - Preparing patients for aeromedical transport. PMID- 3302451 TI - The nine stresses of flight. PMID- 3302452 TI - A prototype flight nurse education program. PMID- 3302453 TI - Aeromedical transconjunctival oximeter hemodynamic monitoring in the trauma patient. PMID- 3302454 TI - Emergency care of the patient with neurogenic pulmonary edema. PMID- 3302455 TI - Interhospital transfer of patients. PMID- 3302456 TI - Incident reports and confidentiality. PMID- 3302457 TI - Helicopter transport of a child with acute seizure activity. PMID- 3302459 TI - Profiles: interview with a chief flight nurse. PMID- 3302458 TI - Flight nursing: living it and loving it. PMID- 3302460 TI - Transition to flight nursing: three experiences. PMID- 3302461 TI - Inside the interview process for hiring flight nurses: how to survive. PMID- 3302462 TI - The purchasing power of emergency nurses. PMID- 3302463 TI - U.S. hospital-based aeromedical programs. PMID- 3302464 TI - [Phosphocalcium metabolism in diabetes mellitus in man and in the BB rat]. PMID- 3302465 TI - [Physiopathologic and clinical aspects of diabetes following pancreatectomy]. PMID- 3302466 TI - [Methods used for studying glucide metabolism and its regulation in vivo]. PMID- 3302467 TI - [Recent physiopathologic findings and therapeutic perspectives in type II diabetes]. PMID- 3302468 TI - [Anti-insulin and anti-insulin receptor antibodies: idiotype-anti-idiotype network and regulation of the immune system]. PMID- 3302469 TI - [Anti-insulin receptor antibodies. Clinical significance in diabetology]. PMID- 3302470 TI - [Cyclosporin in auto-immune pathology. Mechanism of action and first clinical experience]. PMID- 3302471 TI - [Clinical significance of insulin resistance and anti-insulin antibodies]. PMID- 3302472 TI - [Immunosuppression trials in type I diabetes]. PMID- 3302473 TI - [Insulin resistance in type I diabetes]. PMID- 3302474 TI - [Hypoglycemic syndrome of auto-immune origin]. PMID- 3302475 TI - [Contribution of immunology to the early diagnosis of insulin-dependent diabetes]. PMID- 3302476 TI - [Circulating immune complexes containing an insulin of bovine origin in a patient "allergic" to insulin]. PMID- 3302477 TI - [Opiates and non-insulin-dependent diabetes]. PMID- 3302478 TI - [Glucose metabolism in aged persons]. PMID- 3302479 TI - [Poor metabolic control of the adolescent diabetic: an inevitable disease?]. PMID- 3302480 TI - [Metabolism of lipoproteins in healthy humans]. PMID- 3302481 TI - [Epidemiology of non-insulin-dependent diabetes]. PMID- 3302482 TI - [Is insulin-treated diabetes a cause for institutionalization after age 70?]. PMID- 3302483 TI - [Defects in the beta cells of non-insulin-dependent diabetics]. PMID- 3302484 TI - [Insulin therapy in aged patients]. PMID- 3302485 TI - [Hepatic and peripheral resistance to the action of insulin in non-insulin dependent diabetes]. PMID- 3302486 TI - [Natural history and evolution of non-insulin-dependent diabetes]. PMID- 3302487 TI - [Analysis of the effect of a drug. A model for studying the education of patient in the treatment of his disease over a long period]. PMID- 3302488 TI - [Non-insulin-dependent diabetes and gliclazide]. PMID- 3302489 TI - [Update on metformin]. PMID- 3302490 TI - [New aspects of the treatment of non-insulin-dependent diabetes]. PMID- 3302491 TI - [In vivo study of lipolysis and ketogenesis in man]. PMID- 3302492 TI - [Apoproteins and dysliproteinemias]. PMID- 3302493 TI - [Regulation of protein metabolism by cortisol and insulin. In vivo study in man using amino acids labeled with stable isotopes]. PMID- 3302495 TI - [Lipoproteins, diabetes and macroangiopathy]. PMID- 3302494 TI - [Metabolism of lipoproteins in diabetes mellitus]. PMID- 3302496 TI - [Clinical significance of diabetic dyschromatopsia]. PMID- 3302497 TI - [Growth hormone, growth factors and diabetes mellitus]. PMID- 3302498 TI - [How should we view bladder neuropathy in the diabetic male?]. PMID- 3302499 TI - Hypnotherapy for chronic pain. PMID- 3302500 TI - Phenotypes of blasts in acute erythroblastic and megakaryoblastic leukemia- review. PMID- 3302501 TI - Study of the retina: reminiscences of a physiologist. PMID- 3302502 TI - Immunocytochemical identification of cells of megakaryocytic lineage by alkaline phosphatase anti-alkaline phosphatase method. PMID- 3302503 TI - [Clinical significance of the 'renin profile' in patients with essential hypertension]. PMID- 3302504 TI - [Serotonin and blood platelets in angiospasm and hypertension]. PMID- 3302505 TI - Acquired resistance to acute renal failure. PMID- 3302506 TI - Evidence for a stimulatory effect of high potassium diet on renal kallikrein. AB - Considerable evidence indicates that the connecting tubule cells, a type of cell of the distal nephron which seems to participate on potassium secretion, may be the place where renal kallikrein is synthetized. As potassium secretion and kallikrein synthesis may occur in the same cells, we studied the effect of high potassium diet on renal kallikrein production. The kallikrein containing cells from rats fed a normal and high potassium diet were evaluated using a combination of morphometric analysis, conventional electron microscopy, and ultrastructural immunocytochemistry. High potassium diet produced hypertrophy and hyperplasia of the kallikrein containing cells. Hyperplasia was sustained by an increased number of immunoreactive cells/mm2 (151 +/- 14 vs. 86.4 +/- 12, P less than 0.01), an increased number of binucleated immunoreactive cells/mm2 (11.90 +/- 2.1 vs. 3.77 +/- 0.17, P less than 0.005), and by the presence of mitosis. Cell hypertrophy was sustained by an increased cross-sectional area of immunoreactive cells (mu 2) (320.4 +/- 21 vs. 104.5 +/- 6.1, P less than 0.001), by an increased area of basal plasma membrane infoldings, by an hypertrophy of the components of the Golgi complex, hypertrophy of the components of the rough endoplasmic reticulum, and by a larger number of secretory-like vesicles containing kallikrein. The rats fed with high potassium diet had higher values on urinary kallikrein excretion amidase activity (3.70 +/- 0.51 vs. 2.01 +/-0.37 units/day, P less than 0.02), higher values on potassium excretion (18.8 +/- 1.7 vs. 1.31 +/- 0.1 mmol/day, P less than 0.001), and higher urinary volume (51.5 +/- 5.3 vs. 12.2 +/- 1.6 ml/day, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302507 TI - Blood pressure determinants in living-related renal allograft donors and their recipients. AB - We studied 99 living related allograft donors with follow-up information of at least 10 years and the 50 recipients who had successful outcomes. Recipients were younger and had significantly lower blood pressures at follow-up than their donors. Borderline and definite hypertension were present in 22.2% and 4.0% of donors prior to donation, in 14.4% and 21.1% of donors at follow-up, and in 2.0% and 18.0% of the 50 recipients at follow-up. Age, relative weight, and mean arterial pressure (MAP) prior to donation were the key variables in predicting the follow-up ranked MAP of the donors. CPAH prior to donation was inversely correlated with the age of the donors and, indirectly, with the follow-up MAP. Donor CPAH prior to donation was significantly correlated with the renal allograft function of the recipients but not with the recipient ranked MAP at follow-up. No correlation of the ranked MAP or blood pressure outcome categories between donors and recipients was found. We conclude that donation of one kidney can accelerate the development of hypertension in those donors with predisposition to develop hypertension. In addition, the predisposition of the donors to develop hypertension and their age, within the range observed in the study, does not significantly influence the long-term blood pressure status of the recipient. PMID- 3302508 TI - Adherence to HeLa cells of Escherichia coli isolated from urinary tract infections. PMID- 3302509 TI - Endoscopic observation on the process of production of experimental luteal hypoplasia in cows. PMID- 3302510 TI - [Solitary malignant lymphoma of the stomach]. PMID- 3302511 TI - [Arrest of bleeding from a cancerous tumor of the stomach]. PMID- 3302512 TI - [Intraocular inflammatory reactions following implantation of a retropupillary lens]. AB - The implantation of an artificial lens into the retropupillary space, be it the sulcus ciliaris or the capsular bag, has proved to be a safe procedure in the vast majority of cases. However, posterior chamber lens implantation invariable provokes some intraocular inflammatory reaction, though in general only a clinically insignificant one. Occasionally, serious reactions may occur, such as fibrinous exsudates, "toxic lens syndrome", UGH syndrome, and the "intermittent white-out" syndrome. Lens-induced, IOL-induced, or even microbe-induced uveitis or endophthalmitis have also been seen. The clinical pictures of such complications are described. Prophylaxis and appropriate therapeutic measures are outlined. With regard to postoperative inflammatory reactions whose etiology is unclear, the potential role of the following factors is discussed: lens material, lens manufacturing technology, sterilization, and sulcus fixation vs. capsule fixation. Presently, there is no evidence of any obvious relationship between these factors and major inflammatory responses. However, patients suffering from glaucoma, diabetes, or uveitis seem to be more prone to significant postoperative reactions than others. Generally, in cases of unusual intraocular inflammation following posterior chamber lens implantation, the various clinical pictures described here should be taken into consideration. The possibility of a slowly developing microbe-induced endophthalmitis should not be overlooked. PMID- 3302513 TI - [Treatment of choroid melanoma with a radioactive iodine 125 plaque: initial results of a pilot study]. AB - The present paper reports on the treatment of 9 choroidal melanomas with a prominence of 5 to 8.7 mm, using iodine-125 plaque. FOLLOW-UP: 1-1 3/4 years. Radiation dose per hour: 0.3-0.6 Gy, tumor apex 70 Gy, tumor basis 370 Gy; plaque in situ 1 to 2 weeks. Localization of tumor: 2 X close to macula, 2 X extending into macula, 1 X 1 mm from disc. Postoperative regression of all 9 melanomas, by 51% after 1 year. Postoperatively no reduction in bulbus size, rubeosis iridis, cataract, or optic atrophy; however, 2 X reduced visual acuity: 1 X temporary (increase after laser coagulation of neovascularization), 1 X permanent (discrete subretinal gliosis in residual macular half not extending into radiation scar). Visual acuity 6 months postoperatively equal to that after 1-1 3/4 years and in 5 out of the 9 patients 20/100 to 20/30. An attempt is made to correlate the anatomical and functional results with the "tumor surgery in small steps" achieved with iodine-125 plaquing. PMID- 3302514 TI - [New central, epithelial iron deposit following epikeratophakia in high-grade myopia]. AB - Following epikeratophakia for the correction of myopia an epithelial iron dot was observed in the center of the lenticule as early as five months following surgery. Biomicroscopic examination of 55 cases revealed indistinct borders, a yellow to dark brown coloration and a localization in the deep epithelial layers. It was apparent in 100% of the patients one year after surgery, with no tendency to regression over a follow-up period of up to 23 months, and did not appreciably affect postoperative visual acuity. The occurrence of this iron dot is attributed to a localized pooling of tear fluid in the centrally flatter optical zone of the lenticule, since it was not seen in patients who underwent surgery for aphakia or keratoconus. PMID- 3302515 TI - [Biomicroscopy of an intraocular lens. Comparison of specular microscopy findings with the cytologic specimen]. AB - Seventeen months after implanting an anterior chamber intraocular lens the lens had to be removed because of secondary glaucoma and retinal hemorrhage. The lens had been examined 5 days prior to surgery. It appeared that histiocytic giant cells and fibroblasts had settled on its surface. This was subsequently confirmed by cytological studies. It therefore appears possible to describe an in vivo differential cytology and to diagnose the type of inflammatory reaction in vivo. PMID- 3302516 TI - Establishment of primary cell cultures: experiences with 155 cell strains. AB - Cell culture systems allow the examination of cell populations in a functional state. To simulate in vivo conditions as closely as possible freshly established cell strains are superior to permanent cell lines. Different aspects for the establishment of primary cell cultures obtained from various tissues are compared: Disintegration, culture media supplemented with basal additions, special supplements (growth factors, hormones), and attachment factors. The proliferation rates of the attained cell strains were evaluated by determination of cell doubling times. Procedures for how to obtain a relatively high plating efficiency (approx. 70% in our series of 219 attempts) of primary growth in vitro are described: (1) Mechanical disintegration is superior to enzymatic digestion. If mechanical treatment alone did not produce a sufficient number of viable cells, additional digestion with collagenase/dispase revealed a higher number of proliferating primary cultures than with trypsin. (2) Proliferation of cell cultures from normal and tumorous tissues of epithelial origin was superior in Leibovitz L 15 medium (58 of 87 (67%) cases). Cultures from mesenchymal tissues and tumors were found to have shortest cell doubling times in MEM and RPMI 1640 (16 of 23 (70%) cases). The media were supplemented with the basal additions indicated. (3) In approx. 30% of the cases special supplements like growth factors or hormones increased cell replication, although they were almost always not essential for cell growth. (4) Attachment factors only rarely contributed to the initiation of primary monolayer cultures. The application of various culture conditions does not lead to a protocol optimal for all tissues, for all probes of the same type of tumor, or for all tumor specimens of unique differentiation. PMID- 3302518 TI - [Transthoracic administration of antibiotics in acute pneumonia]. PMID- 3302517 TI - Invasive bronchopulmonary aspergillosis leading to rapidly progressive respiratory failure in a patient with severe aplastic anemia. AB - A 22-year-old man with severe aplastic anemia was treated with antilymphocyte globulin, prednisone, and oxymetholone. Fourteen days after initiation of treatment he developed a fulminant mediastinal and subcutaneous emphysema leading to respiratory failure refractory to mechanical ventilation. Fiberoptic bronchoscopy showed nodular lesions typical of aspergillus. Cultures of bronchial mucus revealed Aspergillus fumigatus as the responsible pathogen. PMID- 3302519 TI - [History of the emblem of the Soviet military medicine]. PMID- 3302520 TI - [Psychopathological pattern in the works of Maxim Gorky]. PMID- 3302521 TI - [History of the illness of F.M. Dostoevskii]. PMID- 3302522 TI - [Calcium antagonists in the treatment of arterial hypertension]. PMID- 3302523 TI - [An important stage in the development of military field therapy (from the history of Soviet military field therapy)]. PMID- 3302524 TI - [Membranous glomerulonephritis]. PMID- 3302525 TI - [Effectiveness of intravenous administration of an anti-arrhythmia preparation ethacizine]. PMID- 3302526 TI - [Experience with ultrasonic diagnosis of acute and chronic pancreatitis and its complications]. PMID- 3302527 TI - [Ultrasonic examination of the liver, gallbladder and pancreas in patients with chronic gastritis]. PMID- 3302528 TI - [Biochemical mechanisms of the regulation of arterial pressure]. PMID- 3302529 TI - [Endocrine function of the pancreas in patients with chronic pancreatitis and its relation to exocrine function]. PMID- 3302530 TI - [Microelement metabolism in humans and animals during hypoxic states of different etiologies]. AB - This paper reviews reported data and results obtained by the present authors which describe metabolic pathways of trace elements in humans and animals during hypoxia of different origin, discusses possible causes and symptoms of their deficiency and presents methods of restoring the balance of trace elements. PMID- 3302531 TI - [Physiologic-biochemical aspects of the toxic effects of oxidants found in the human environment (air, water)]. AB - This paper gives a review of published data about physiological and biochemical aspects of the toxic effect of oxygen, ozone, hydrogen peroxide, nitrogen oxide and haloid-containing disinfectants on the human body. The mechanism of action of various oxidants in terms of free radical reactions is analyzed. The oxidant sensitivity of membrane structures, sulphydryl compounds, proteins, enzymes, and the genetic apparatus of the cell is evaluated. The effect of oxidants on the function and structure of erythrocytes, red marrow, blood coagulation, immunity, histological and histochemical structure of organs and tissues is described. PMID- 3302532 TI - [The 20th anniversary of our journal]. AB - This review describes the history of the journal--its establishment and development associated with the advances in space biology and aerospace medicine. The paper summarizes the major areas of research discussed in the publications and emphasizes their relations with other branches of science. It also lists readers' comments, suggestions and recommendations derived form the recent questionnaires. The paper outlines the objectives of the journal as related to further development of space biology and aerospace medicine. PMID- 3302533 TI - Investigations of the pathogenicity of Salmonella enteritidis serotype Amsterdam following a naturally occurring infection in rats. AB - A naturally occurring infection of an unusual Salmonella sp. was detected in research rats during routine health monitoring procedures. The organism, Salmonella enteritidis serotype Amsterdam appeared to have a low pathogenicity and did not cause clinical disease in adult rats. Experimental mouse and guinea pig inoculations suggest that the organism is more pathogenic in mice. PMID- 3302534 TI - Biological and molecular bases of mammary carcinogenesis. PMID- 3302536 TI - On the cover: sexually transmitted diseases. PMID- 3302535 TI - Novel monocyte-like properties of microglial/astroglial cells. Constitutive secretion of lysozyme and cystatin-C. AB - Evidence implicates cells belonging to the mononuclear phagocytic system (MPS) in the development of some forms of amyloidosis (10, 22). Whether or not the MPS is involved in central nervous system amyloidosis is not known. As a first step to address this issue, microglial and astroglial cells isolated from mouse brains were cultured and characterized as to the properties they may share with other members of the MPS. It was shown by light and electron microscopy that both cell types phagocytose latex particles, but that only microglial cells engulf immunoglobulin sensitized erythrocytes. By means of immunohistochemical, immunofluorescence, and immunoblotting techniques, it was established that the cells contain and secrete lysozyme as well as the proteinase inhibitor cystatin-C (-gamma trace). Cystatin-C was distributed in the cytoplasm and the nucleus and was strikingly associated with filaments and bundles of fibrils. Another enzyme, commonly used to distinguish cells belonging to the MPS, is alpha-naphthyl butyrate esterase. Shortly after their isolation, only the microglial cells were positive, but on continued culturing, increasing numbers of astroglial cells became positive for alpha-naphthyl butyrate esterase. By day 22, almost all of the cells were positive. Freshly isolated cells were negative for the monocyte specific antigen Mac-1. However, after 4 days, cells with the morphology of microglia had become positive, whereas astroglia failed to exhibit this antigen with up to 22 days in culture. Thus, both astroglia and microglia have properties in common with cells of the MPS which may be useful for future studies. However, on fresh isolation only microglia were indistinguishable from monocytes for all features tested. PMID- 3302537 TI - Charles Wilson Kollock, 1857-1931. PMID- 3302538 TI - Analysis of steroid- and DNA-binding domains of the calf uterine androgen receptor by limited proteolysis. AB - The DNA-binding form of the calf uterine androgen receptor (AR) was subjected to limited protease digestion using chymotrypsin, trypsin and a rat prostate cytosol protease. The properties of the generated polypeptide fragments were identified and compared with those of the intact AR. Physicochemical characterization was achieved through sedimentation analysis, gel filtration chromatography and DEAE anion exchange chromatography. Intactness of functional binding domains was evaluated by measuring the retention of steroid- and DNA-binding capacity. Under non-denaturing conditions the intact AR is a highly asymmetrical molecule with a Stokes radius (RS) of 45A, a sedimentation coefficient of 4.3S and a relative molecular mass of 80,000 daltons. This form of AR has an intrinsic binding affinity for DNA and was eluted from DNA-cellulose with 9 mM MgCl2. Chymotrypsin produced a more globular polypeptide (RS: 31A; 3.1S; 41,000 daltons) with a decreased net negative charge. This fragment also displayed DNA-binding affinity but required a higher concentration of MgCl2 (14 mM) for DNA-cellulose elution, indicating an increased affinity for DNA. The observed reduction in molecular size upon chymotrypsin treatment was confirmed when analysed by SDS polyacrylamide gel electrophoresis after covalently labelling of the AR with [3H]R1881. Rat prostate cytosol contains a protease which is very active in generating an AR polypeptide with an increased affinity for DNA, without changing the AR net negative charge (RS: 33A; 3.7S; 51,000 daltons). The specificity of this protease remained unknown since none of a large number of inhibitors was able to inactivate this enzyme. The fragment generated is different from that obtained with chymotrypsin since significant differences in size as well as in charge were measured. Trypsin treatment generated a much smaller polypeptide (RS: 25A; 2.9S; 30,000 daltons) which had lost its DNA-binding capacity, but not its steroid binding site. This form probably represents the so-called meroreceptor. When intact AR was treated sequentially with prostate cytosol and trypsin, a polypeptide fragment with identical properties was obtained, indicating the spatial separation of two of the proteolytic cleavage sites. These studies provide evidence for the distinct nature of the molecular domains for androgen and DNA interaction on the calf uterine AR. PMID- 3302539 TI - Structural aspects of steroid-antibody specificity. AB - The paper gives a review of the immunogens most frequently used for preparing antibodies against steroid haptens. The structural concepts of immunological specificity and complementarity are applied to a description of the formation of antibodies in immunized animals and the binding mechanisms of steroid-antibody interactions in systems in vitro. Recent experimental findings show that Ehrlich's lock and key principle is too static for many steroid-antibody complexes and that a more important factor in the binding events is the overall flexibility of these complexes. In this connection a discussion is undertaken of the properties of unsaturated steroid skeletons, the multispecificity of binding sites and further critical factors involved in the formation of the final specificity. Special attention is paid to considerations of the size of steroid determinants in connection with the question of the so-called bridge effect. The relevant expositions of this phenomenon are based in this article more on conformation changes of the steroid ligands than on direct binding interaction of the bridge substituent with the antibody. This interpretation makes it possible to interpret more broadly the experimental facts and gives new stimuli for an improvement of the present strategies of steroid immunoanalysis. PMID- 3302540 TI - Needle aspiration cytologic diagnosis of metastatic malignant melanoma of unknown primary origin: report of a case and review of the literature. AB - A rare case of metastatic malignant melanoma of unknown primary origin in a 49 year-old woman is reported. The swelling, localized in the right inguinal region, was partially immovable and associated with progressively increasing pain. Initial diagnosis was set by needle aspiration cytology and was confirmed postoperatively by histologic examination of a surgical specimen. Cytomorphologic features of metastatic malignant melanomas are described and the difficulties of identification discussed. A brief review of the literature is also made, and the rarity of the case and the value of cytologic diagnosis are emphasized. PMID- 3302541 TI - Systemic rhabdomyosarcoma presenting as leukemia: case report with ultrastructural study and reviews. AB - A 20-year-old white male was initially suspected clinically and pathologically of having an acute lymphoblastic leukemic process because of fatigue, severe anemia, thrombocytopenia, a leuko-erythroblastic peripheral blood picture, and a diffusely infiltrated bone marrow. Subsequent review of the bone marrow material indicated cytologic features consistent with either an embryonal, undifferentiated small cell mesenchymal malignancy or reticulo-endothelial malignancy. Ultimately, the electron microscopic (EM) study of the tumor proved to be diagnostic of rhabdomyosarcoma. An extensive search for a primary site of rhabdomyosarcoma did not show any lesion, although the genitourinary region was clinically suspected. The clinical course was a rapidly downhill one with extensive bone and CNS involvement. The patient died 5 months later. An autopsy permit was not obtained. This case emphasizes the occasional tendency of rhabdomyosarcoma to masquerade as a hematopoietic malignancy at the time of presentation and the usefulness of EM study in confirming a diagnosis. PMID- 3302542 TI - Short-term prophylaxis with cefuroxime in colorectal surgery for cancer. AB - A controlled study of short-term prophylaxis with cefuroxime was performed on a group of 52 patients with colorectal neoplasms who underwent elective surgery. The patients were divided into two groups, A and B. Group A received the antibiotic immediately before surgery, intraincisionally and immediately after the end of operation; group B was treated only postoperatively. Each patient received a total of 5,250 mg of cefuroxime. Wound sepsis was demonstrated in 11.5% of cases of group A and 23.0% of group B (P less than 0.01); another type of sepsis was observed in 34% of group A and 11.5% of group B (P less than 0.001). There was no difference in the operative mortality in the two groups. PMID- 3302543 TI - Measurement of cardiac output in anesthetized rats by dye dilution using a fiberoptic catheter. AB - A method is described for the measurement of cardiac output and oxygen saturation in closed-chest rats using a small (2.4 F) commercially available fiberoptic catheter and a reflection-spectral-photometer. Positioned in the aortic arch, the catheter functions as an oxymeter for oxygen saturation and as a densitometer for measurement of indocyanine green, obviating the need for blood removal and passage through a densitometer. The sensitivity and reproducibility of this method were characterized in 90 rats by thermodilution, radiolabeled microspheres, and electromagnetic flow methods as standard references. Basal cardiac output as well as changes in cardiac output during isoproterenol infusion and blood removal and replacement were measured. In addition, multiple measurements of cardiac output over 1 min were used to document the method's suitability in constructing a ventricular function curve. With the fiberoptic catheter, cardiac output varied predictably with anesthesia, with rats on dial urethane (n = 23) having values of 150 +/- 39 (SD) ml/min/kg and 2 and 1% enflurane (18-35 rats per group) yielding cardiac outputs of 190 +/- 60 and 236 +/- 77 ml/min/kg, respectively. Pentobarbital produced the least cardiovascular depression (n = 15) with an average cardiac output of 322 +/- 22 ml/min/kg. The average cardiac output with this method in 90 rats (regardless of anesthesia) was 214 +/- 91 (SD). This value was comparable to cardiac output values determined in paired experiments from radiolabeled microspheres (9 rats) 220 +/- 43, electromagnetic flow (11 rats) 177 +/- 33, and a subset of rats with thermodilution (231 +/- 45 ml/min/kg). The within measurement (repeat measurements) variability with the fiberoptic method was consistently less than the rat-to-rat variability when compared to the thermal and radiolabeled microsphere methods, but it was comparable to electromagnetic flow. The method can be used when rapid measurements (4 measurements within 60 s) of cardiac output are required, as in constructing a ventricular function curve, and can readily detect small changes in cardiac output during controlled hemorrhage and isoproterenol infusion. In summary, this method gives measurement of oxygen saturation and cardiac output by dye dilution without blood removal. There is less surgical preparation than required for electromagnetic cardiac output, and it is an alternative to the thermodilution method. PMID- 3302544 TI - Development of Chinese medicine based on pharmacology and therapeutics. AB - Chinese medicinal preparation and Chinese patent medicine use traditional medicine and herb drugs as raw materials under the guide of pharmaceutical theory and is progressing into certain dose form according to the prescription book and confined method. It has a long history, and covers a wide variety of kinds and applications. Many of the Chinese patent medicines have been well-known and habitually used, due to their features of curative effect, convenience and inexpensiveness. The development of Chinese patent medicine has been based on clinical pharmacology and therapeutics. This development is one of the important components of Chinese medicine and pharmacy. In this paper, the development will be summarized, and some new achievements will also be introduced. PMID- 3302546 TI - Treatment of diabetes with moxibustion. PMID- 3302545 TI - Immunomodulatory activity of an aqueous extract of Azadirachta indica stem bark. AB - The interference of an aqueous extract of the stem bark of Azadirachta indica with different parts of the human immune system was investigated. The extract showed strong anticomplementary effects which were dose-and time-dependent and most pronounced in the classical complement pathway assay. Moreover, a dose dependent decrease in the chemiluminescence of polymorphonuclear leukocytes was observed and a dose-dependent increase in the production of migration inhibition factor by lymphocytes. PMID- 3302547 TI - Effects of traditional Chinese medicine of different treatment principles on hemagglutination and adhesion of uropathogenic Escherichia coli to uroepithelial cells. PMID- 3302548 TI - Chromosomal analysis of bone marrow stromal fibroblasts in allogeneic HLA compatible sibling bone marrow transplantations. AB - Karyotyping was performed on bone marrow stromal fibroblasts and marrow haemopoietic cells on six patients who received bone marrow transplants from siblings of the opposite sex. Three patients with severe aplastic anaemia received unmanipulated donor bone marrow cells. Three other patients with leukaemia and conditioned with high dose chemotherapy (+ total body irradiation in two patients) received T-cell depleted marrow mononuclear cells. Marrow chromosomal analysis was performed on samples obtained between 6 weeks and 1 yr post-transplant. All marrow fibroblasts studied were of recipient origin, whereas all haemopoietic cells were of donor origin. These results demonstrate that in allogeneic sibling marrow transplantation, recipient bone marrow stromal cells regenerate and repopulate the bone marrow and this is not influenced by the conditioning regimen used, the type and dose of marrow cells given and the pre existing disease. PMID- 3302549 TI - AIDS: from social history to social policy. PMID- 3302550 TI - The role of palaeopathology in modern medicine. PMID- 3302551 TI - Renin secretion in patients with various nephropathies and coexistent arterial hypertension. PMID- 3302552 TI - Sensory reinnervation and sensibility in skin transplants. AB - Reinnervation and sensibility were investigated in patients previously subjected to split thickness skin transplantation after excision of skin and subcutaneous fat for treatment of malignant melanoma. All patients except one showed poor sensibility and no neurofilament positive sensory nerve fibres were detected. Most patients had heat and pain sensibility but with a higher threshold than on the control side. It is suggested that this heat pain sensibility is mediated from nerve fibres in the underlying tissue. In one patient, however, sensibility was encountered and in this patient neurofilament positive sensory nerve fibres were observed in the dermis and epidermis. PMID- 3302553 TI - [Heterosexual transmission of the human immunodeficiency virus]. PMID- 3302554 TI - [Lung infiltrates in the immunodeficient patient (II)]. PMID- 3302555 TI - [Continuous subcutaneous infusion of insulin and intensified conventional treatment in the control of blood glucose in pregnant diabetics]. PMID- 3302556 TI - [Diabetes and pregnancy]. PMID- 3302557 TI - [New orientations in the medical and dietetic therapy of chronic renal insufficiency]. PMID- 3302558 TI - [Epidemiology of rheumatic diseases]. PMID- 3302559 TI - [Acute streptococcal pharyngo-tonsillitis: clinico-microbiological correlation. Prospective study of 271 cases]. PMID- 3302560 TI - [Predominance of Candida albicans serotype A, biotype 15 3/7 in outbreaks of disseminated candidiasis in heroin addicts in Spain]. PMID- 3302561 TI - [Hypertensive crisis: comparative study of oral captopril, sublingual captopril and sublingual nifedipine]. PMID- 3302562 TI - [Regulation of body temperature and accidental hypothermia (II)]. PMID- 3302563 TI - [Current problems in hyperprolactinemia. I. Physiopathology, clinical features, diagnosis and treatment]. PMID- 3302564 TI - The library of Dr John Webster: the making of a seventeenth-century radical. PMID- 3302565 TI - [Psychosomatic medicine--a discipline hard to accept?]. PMID- 3302566 TI - [Malignant melanoma of the uvea--a review]. PMID- 3302567 TI - [The men behind the syndrome: Johannes Peutz and Harold Jeghers. The explorers of an underdiagnosed condition with intestinal polyps and mucocutaneous pigmentations]. PMID- 3302568 TI - [Therapy of sudden deafness--naftidrofuryl (Dusodril) and pentoxifylline (Trental) compared]. AB - In a prospectively randomized trial, conduced jointly by the University ENT Department, Gottingen, and the ENT Department of Zentralkrankenhaus St.-Juergen Strasse, Bremen, the therapeutic efficiencies of naftidrofuryl and pentoxifyllin, both in combination with a basic medication (cortison, dextran), were compared in 151 patients with sudden deafness. Evaluation of the results revealed a decisive influence of cardiovascular risk factors (particularly vascular diseases) on the outcome of therapy. There was no difference between naftidrofuryl and pentoxifyllin with respect to therapeutic success. Since further improvement was evident 6 months later, long-term treatment is recommended for either substance. The therapeutic success rate of our own treatment schedule is not higher than that of other therapeutic schedules given in the literature. PMID- 3302569 TI - [Histologically controlled comparison of palpation and sonography in the diagnosis of cervical lymph node metastases]. AB - During a period of 2 1/2 years palpation and high-resolution real-time sonography were carried out in 83 non-selected patients with head and neck carcinomas to diagnose metastatic involvement of cervical lymph nodes. The findings were compared with the results of the microscopic examination of the lymph nodes from the neck dissection specimen. Sonography is characterized by a high sensitivity in the detection of lymph node metastases. The relatively low specificity of this method proves that many enlarged but not metastatically involved lymph nodes are also displayed by ultrasound. Although there are no specific echomorphological criteria permitting a reliable identification of lymph node metastases, their sonographic visibility cannot be determined only by the size of the lymph node. Lymph node metastases less than 1.5 cm in diameter, in particular, can be detected more often by ultrasound than by palpation. Therefore, it can be presumed that pathological transformations besides the reactive hyperplasia occurring during metastatic involvement will also influence the echographic representation of lymph nodes. The accuracy data of other methods used for detecting lymph node metastases (computed tomography and lymphoscintigraphy) were compiled from the literature and compared with those of palpation in more than 5000 patients. Basing on our experiences with sonography in this field we tried to assess the chances and limitations of ultrasound in the pretherapeutic diagnosis of cervical lymph node metastases. PMID- 3302570 TI - Topography of vestibulocochlear nerve fibers in the posterior cranial fossa. AB - In the posterior cranial fossa, the separation of the vestibular and cochlear subdivisions of the eighth nerve is clear in about 75% of cases. Although in the remaining cases the vestibulocochlear cleavage plane is not visible macroscopically, the large-fibered vestibular subdivision and the small-fibered cochlear subdivision are well recognized in histological sections. Within the cochlear subdivision, some fibers of large caliber are mixed with fibers of small caliber in a region we named the "overlapping zone." We studied, histologically, cross sections of the intracranial portion of six eighth nerves at about 5 mm proximal to the porus acusticus. A computerized video system was used to measure the diameters of the fibers of the vestibular and cochlear subdivisions localized at different distances from the vestibulocochlear cleavage plane. The overlapping zone is located within the cochlear subdivision adjacent to the vestibulocochlear cleavage plane. It has a pear-like shape, with the larger part occupying the anterosuperior part of the cochlear subdivision. The mean cross-sectional area of this zone in our six samples is about 0.4 mm2, which is approximately 23% of the area of the cochlear subdivision. The thickness of the zone in the superior inferior direction ranges from 0.23 mm to 0.55 mm. The parameters of the described overlapping zone should be taken into consideration in vestibular neurectomy, in which complete sectioning of the vestibular fibers is important. PMID- 3302571 TI - Sternocleidomastoid myocutaneous flap. AB - The sternocleidomastoid myocutaneous flap has several applications for reconstruction of defects about the head and neck. It is used for augmentation of facial defects, carotid artery protection, and repair of oral cavity defects. Additional reconstructive efforts suggest the sternocleidomastoid myocutaneous flap can be used for facial reanimation and as an osteomyocutaneous flap incorporating the clavicle for mandibular reconstruction. Reports of unreliable viability and resection of the sternocleidomastoid muscle during neck dissection decreases the applicability of the flap. Twenty-seven sternocleidomastoid flaps were used in 26 patients for head and neck reconstruction. In contrast to the reported 40% to 50% incidence of superficial slough or total flap necrosis, three (11%) flaps developed superficial (cutaneous) slough while two patients developed inclusion cysts. The technique includes elevation of the sternocleidomastoid muscle with the overlying platysma and skin originally described by Owens. The procedure is modified by removing the epithelium on the tunneled portion of the flap. This allows the flap to be used as a one-stage method of reconstruction without sacrificing the additional blood supply from the platysma and overlying dermis. PMID- 3302572 TI - Tips on septal dermoplasty. PMID- 3302573 TI - Cochlear implant: the beginning. PMID- 3302574 TI - Directory of otolaryngologic societies. PMID- 3302575 TI - Otologic manifestations of benign intracranial hypertension syndrome: diagnosis and management. AB - Benign intracranial hypertension (BIH) is a syndrome characterized by increased intracranial pressure (IIP) without focal signs of neurological dysfunction. The diagnosis is essentially made by exclusion of various causes of IIP. The classic presenting symptoms of BIH are headache and/or visual disturbances. Otologic manifestations of this syndrome have not been described in detail. In this thesis, 20 BIH patients with associated otologic symptoms were thoroughly studied over a 5-year period. The author concludes that 1. objective pulsatile tinnitus and low frequency hearing loss can be the major or only manifestation of this syndrome; 2. diagnosis is established by lumbar puncture and elimination of other causes of IIP; 3. medical management is very effective with surgery reserved for patients with deteriorating vision or with disabling tinnitus. PMID- 3302576 TI - [Determining the size of the gallbladder with ultrasound--methods and results]. AB - By ultrasound undistorted two-dimensional pictures of gallbladder sections can be obtained. Determinations of size are performed either from one or from several well defined sonographic images. Studies of gallbladder contraction require at least 2 exposures: usually pictures of the "largest longitudinal section" are taken in the fasting state and 30 min after a stimulus (meal, hormones); for evaluation images are measured and compared. Estimations of gallbladder volume require at least 2 sonographic pictures of the gallbladder. We performed measurements in 250 patients. In most cases fasting volumes were between 10 and 25 ml and between 33 and 40 ml. There was a positive correlation with age and with body weight. Patients with cholelithiasis had larger gallbladder volumes than healthy controls. In 10 persons evacuation and filling of gallbladder after a meal was followed by serial measurements: maximal contraction was found between 20 and 45 min; original volumes were then reached after 180 min. PMID- 3302577 TI - Studies of reactivity of some Sri Lankan population groups to antigens of Mycobacterium leprae. I. Reactivity to lepromin A. PMID- 3302578 TI - Seroreactivity against the Mycobacterium leprae phenolic glycolipid I in mycobacteria infected or stimulated groups of individuals. PMID- 3302579 TI - Co-existence of the enkephalinergic system and the melanotropinergic system in the rat duodenum shown by immunohistochemistry. AB - The immunohistochemical distribution of alpha-melanotropin (alpha-MSH) and Met enkephalin (Met-ENK) immunoreactivities in the rat duodenum was examined by using immunofluorescence microscopy. Alternately staining of adjacent frozen serial sections with specific antisera directed to alpha-MSH or Met-ENK revealed that within a subpopulation of myenteric plexus perikarya alpha-MSH immunostaining co exists with that of Met-ENK. Some myenteric plexus nerve fibres also contain both Met-ENK and alpha-MSH immunoreactivity. These findings might indicate that the genes encoding for the precursors of melanotropins (the pro-opiomelanocortin precursor) and enkephalin (the pro-enkephalin precursor) are generated from a common, large and single ancestor gene which remained conserved during evolution in the rat enteric nervous system. PMID- 3302581 TI - Kupffer cells and their function. AB - The intention of this review is to stress new information regarding the quite versatile functions of Kupffer cells. Although their main function is phagocytosis and defence of the liver against bacteria, endotoxaemia and viral infections, they also fulfil other important roles. They will phagocytose and partially degrade bacterial antigens before handing them on to the hepatocytes for excretion into the bile. They handle LDL lipoproteins, whilst the HDL proceed directly into the hepatocytes. They produce lymphokine mediators that direct protein synthesis by the hepatocytes. Also they normally produce prostaglandins that are cyto-protective for the hepatocytes. Conversely, if they are required to attack infected hepatocytes or cancer cells, then they switch to the production of leukotrienes. Thus they function as specialised macrophages, and it is not surprising that other "activated macrophages" have to be recruited into the liver to support them in inflammatory reactions. PMID- 3302582 TI - Selection criteria and decisions in 375 patients with liver disease, considered for liver transplantation during 1977-1985. AB - We performed a prospective study on 375 patients with liver disease, 60% female, for whom orthotopic liver transplantation (OLT) was considered during 1977-1985. Fifty-four per cent had cirrhosis, 8.5% congenital/hereditary disorders, 25% malignant tumour, 6% benign tumour, 2% Budd-Chiari syndrome, 1.5% acute hepatic failure, 3% other diagnoses, and 10% were under 15 years of age. As of July 1st, 1985, 99 patients (47 chronic active/inactive cirrhosis (CAC/CIC), 28 primary biliary cirrhosis (PBC), five hepatocellular carcinoma (HCC), 19 other diagnoses) were accepted for OLT (median age 40 years, 10% under age 15). By that date, 45 patients (median age 42), had had an OLT (20 CAC/CIC, 15 PBC, three biliary atresia, two HCC, five other diagnoses). Fifty-four per cent (201 patients) were rejected for transplantation. The primary reasons for rejection were: no indication (11%), age (5%), other surgical procedures possible (3%), severe liver failure (14%), extrahepatic spread of liver tumour (11%), cardiovascular or pulmonary problems (2%), severe hepatic bone disease (1%), and miscellaneous (7%). Thirty per cent of the patients with CAC/CIC, 38% with PBC, 88% with HCC and 71% with biliary atresia were rejected. In the CAC/CIC, PBC and biliary atresia patients severe liver failure was the most frequent reason for rejection (62%, 50% and 60%, respectively). In HCC, extrahepatic tumour spread was the most frequent reason (72%) for rejection. In this category only two patients (7%) ultimately underwent liver transplantation. PMID- 3302580 TI - Effects of fatty acids on gap junctional communication: possible role in tumor promotion by dietary fat. AB - Dietary lipids, in particular unsaturated fat, promote the development of many experimental tumors. However, no mechanisms to fully explain these effects have been elucidated. Recent reports, which we summarize here, suggest a role for gap junction-mediated intercellular communication in the process of tumor promotion. We also review tumor-promoting effects of dietary fat on experimental, particularly mammary, carcinogenesis. Our main focus is to review recent data examining the inhibitory effects of unsaturated fatty acids on metabolic cooperation in Chinese hamster V79 cells. These data suggest that inhibition of junctional communication may be involved mechanistically in the promotion of tumors by high levels of dietary unsaturated fat. Finally, potential mechanisms by which unsaturated fatty acids inhibit metabolic cooperation are examined. PMID- 3302583 TI - Phosphate homeostasis. PMID- 3302584 TI - [Functional computer images in the evaluation of the status of the renal parenchyma in children]. AB - The paper is concerned with a detailed description of an algorithm for picturing functional imaging of the kidneys based on the calculation of parenchymal transport time (PTT). The authors discuss the results obtained in a group of patients aged 4 to 14 with conditional normal indices. The method permits quantitative and qualitative assessment of the function of the minimum amount of nephrons of each kidney and facilitates an analysis of gamma scintigraphy results. Clinical importance of the method is discussed. PMID- 3302585 TI - [Radioimmunologic determination of aldosterone and renin in the blood in the diagnosis of different forms of arterial hypertension]. AB - Aldosterone concentration and renin activity in the blood from the ulnar, inferior cava veins at the level of the 12th thoracic vertebra, the left and right renal veins were studied in 60 patients with arterial hypertension by means of a radioimmunoassay kit (France). The patients were divided into 4 groups: with primary and idiopathic hyperaldosteronism, renal-parenchymatous and essential arterial hypertension. A significant increase in aldosterone concentration in the blood from the ulnar vein was detected in all the groups, especially in primary and idiopathic hyperaldosteronism. Hyperaldosteronism in the patients with renal parenchymatous and essential arterial hypertension was regarded as secondary in a stable and malignant course of arterial hypertension. The diagnosis of primary and idiopathic hyperaldosteronism was also confirmed by low blood renin activity. Renin activity in the peripheral venous blood was considerably elevated in renal parenchymatous arterial hypertension and was within normal in essential hypertension. Aldosterone concentration in the blood from the vena cava inferior and renal veins was 1.6-2-fold as high on the affected side as on the contralateral one. PMID- 3302586 TI - [Radiobiological principles of the choice of dose fractionation in the radiotherapy of tumors]. PMID- 3302587 TI - Choosing a micro database for easy retrieval of reprints. PMID- 3302588 TI - A directory of medical software companies. PMID- 3302589 TI - [V. I. Lenin and the health protection of workers]. PMID- 3302590 TI - [Physicians of medieval Armenia on deontology and ethics]. PMID- 3302591 TI - [History of medical education]. PMID- 3302592 TI - [Use of the EOM-01-Ts echo-osteometer ultrasonic unit in obstetrics]. AB - The possibility of application of the ultrasonic unit made in the USSR has been tested on 98 pregnant women. The control group consisted of 35 nonpregnant women. It was found that the ultrasound velocity is lower in the bones of pregnant women. PMID- 3302593 TI - [Milk in the feeding of patients with peptic ulcer]. PMID- 3302594 TI - [The rodent. Akodon arviculoides, Wagner, 1842 (Cricetidae)--importance in plague foci in Brazil]. AB - The occurrence of the rodent Akodon arviculoides Wagner, 1842 in the plague focus of the "Agreste" region of the State of Pernambuco and a report on its ability for survival, reproduction and development in captivity, its susceptibility to Yersinia pestis infection and the role of this rodent species in Brazilian plague foci are reported. PMID- 3302595 TI - [Antidiuretic mechanism in Rhodnius prolixus (Stal, 1859) (Hemiptera, Reduviidae)]. AB - An antidiuretic mechanism is proposed for Rhodnius prolixus, whose activity is manifested when the diuretic phase has terminated and is maintained until the insect has fed again. Presumably this mechanism acts at the level of the proximal rectal sphincter and is inhibited by ingestion, mechanical distension of the gut and central disinhibition by decapitation. It is suggested that the antidiuretic activity is maintained by the nervous system and is modified when there is distention of the gut or when the nervous signal is interrupted by decapitation. It is demonstrated that the excretion of urine in R. prolixus is not controlled exclusively by the diuretic hormone, but rather that factors not linked to the haemolymph maintain the insects in a diuretic or nondiuretic state. PMID- 3302596 TI - DNA sequence analysis of spontaneous mutation in a PolA1 strain of Escherichia coli indicates sequence-specific effects. AB - The sequences of a collection of 261 spontaneous lacI- mutants recovered in a PolA- strain of Escherichia coli have indicated an increase in the frequency of most classes of mutation in this strain. Among base substitutions in lacI, a preference for transversions over transitions was observed. In addition, a single transition in the lac operator was enhanced 8-fold. More significantly, of 18 frameshifts, 12 occurred adjacent to a 5'-GTGG-3' sequence. Likewise, 15 of 24 deletions and 2 of 10 duplications had 5'-GTGG-3' sequences at one or both endpoints. We speculate that the prevalence of mutations at these specific sequences reflects the persistence of strand discontinuities that enhance the opportunity for mutagenic mishaps. Further, 5'-GTGG-3' sequences apparently represent sites where DNA polymerase I is involved in some aspect of DNA metabolism. These results strengthen the view that DNA context contributes an important component to spontaneous mutagenesis and indicate an anti-mutagenic role for DNA polymerase I. PMID- 3302597 TI - Autogenous regulation of the Saccharomyces cerevisiae regulatory gene GAL80. AB - We have suggested previously from Northern blot analysis that transcription of the negative regulatory gene GAL80 was controlled positively by another regulatory gene GAL4, and negatively by GAL80 itself, in similar way to GAL1, GAL7 and GAL10 genes encoding galactose-metabolizing enzymes in Saccharomyces cerevisiae. To study further the controlled expression of GAL80, we have exploited the gene fusion technique. We constructed gene fusions consisting of 5' fragments of GAL80 and a 5' truncated lacZ of Escherichia coli, and introduced the GAL80'-'lacZ fusions into wild-type yeast or various GAL4 or GAL80 mutants using multiple-copy or single-copy plasmid vectors. We then studied beta galactosidase activity in the resultant transformants under uninduced, induced or glucose-repressed conditions. Expression of the GAL80'-'lacZ fusions was clearly under the control of Gal4/Gal80. Next we constructed GAL7'-'lacZ fusions, whose upstream activating sequence (UAS) from GAL7 was replaced with a GAL80 fragment containing a UAS-like sequence located in the 5' flanking region of GAL80. Synthesis of beta-galactosidase directed by the hybrid genes was inducible by galactose exactly like the original GAL7'-'lacZ fusion with a UAS from GAL7. Finally we constructed a GAL7-GAL80 hybrid gene, in which the entire 5' flanking region was derived from GAL7. When the chromosomal GAL80 gene in wild-type yeast was replaced with the hybrid gene, the uninduced level, but not the induced level, of the GAL10-encoded enzyme (uridine diphosphoglucose-4-epimerase) was significantly increased. PMID- 3302598 TI - Expression of F transfer functions depends on the Escherichia coli integration host factor. AB - We present evidence that the Escherichia coli DNA binding protein, IHF, plays an important role in conjugal transfer of the plasmid F. Our results suggest that IHF exerts this effect by positively effecting transcription of the transfer (tra) operon of the plasmid. PMID- 3302599 TI - Retardation of cell cycle progression in yeast cells recovering from DNA damage: a study at the single cell level. AB - Pedigree analyses of individual yeast cells recovering from DNA damage were performed and time intervals between morphological landmark events during the cell cycle (bud emergence and cell separation), were recorded for three generations. The associated nuclear behavior was monitored with the aid of DAPI staining. The following observations were made: All agents tested (X-rays, MMS, EMS, MNNG, nitrous acid) delayed the first bud emergence after treatment, which indicates inhibition of the initiation of DNA replication. Cells that survived X irradiation progressed further through the cell cycle in a similar way to control cells. Progress of chemically treated cells became extremely asynchronous because surviving cells stayed undivided for periods of varying length. Prolongation of the time between bud emergence and cell separation was most pronounced for cells treated with the alkylating agents MMS and EMS. This is interpreted as retardation of ongoing DNA synthesis by persisting DNA adducts. Cell cycle prolongation in the second and third generation after treatment was observed only with MMS treated cells. In all experiments, individual cells of uniformly treated populations exhibited highly variable responses. PMID- 3302600 TI - Effect of DNA superhelicity on transcription termination. AB - Restriction fragments containing either leut (a rho-independent transcription termination site) and/or leut' (a rho-dependent transcription termination site) were cloned into plasmid pOL4. Treatment of plasmid-containing Escherichia coli strains with coumermycin resulted in loss of in vivo plasmid superhelicity 10 min after antibiotic addition. Galactokinase levels specified by these plasmid containing strains were the same regardless of whether functional DNA gyrase was present. These results suggest that transcription termination is unaffected by the superhelical state of DNA. PMID- 3302601 TI - Frameshifts close to the Klebsiella pneumoniae nifH promoter prevent multicopy inhibition by hybrid nifH plasmids. AB - Certain multicopy plasmids bearing promoter sequences of nitrogen fixation (nif) genes inhibit expression of chromosomal genes in Nif+ Klebsiella pneumoniae, hence leading to a Nif- phenotype. This 'multicopy inhibition' has been attributed to the titration of the nif-specific activator protein NifA by the plasmid-borne promoter sequences. We now report that multicopy inhibition by nifH translational fusions is sensitive to frameshifts close to the nifH promoter. Transcriptional nifH fusion plasmids in which translation terminated near the nifH promoter were transcriptionally active and showed multicopy inhibition; introduction of a transcription terminator after the nifH coding sequence in these plasmids prevented their multicopy inhibition. Therefore it seems likely that premature termination of transcription prevents multicopy inhibition by the nifH promoter. PMID- 3302602 TI - Nonsense suppression context effects in Escherichia coli bacteriophage T4. AB - Nonsense suppression by supE44 has been examined in a collection of 14 T4 gene 22 and gene 23 UAG mutants, for which the precise gene location is known. In concordance with previous studies, UAG followed by a pyrimidine was inefficiently suppressed. However, among positions with similar 3' nucleotides, there was considerable variation in suppression efficiency. The competition between supE44 and Release Factor 1 (RF 1) was also investigated following the introduction of a multicopy RF 1 plasmid. An inverse relationship between the efficiency of suppression and RF 1 competition was observed. PMID- 3302603 TI - The effects of ADR1 and CCR1 gene dosage on the regulation of the glucose repressible alcohol dehydrogenase from Saccharomyces cerevisiae. AB - The dosage of the transcriptional activator ADR1 was varied in order to study the regulation of the glucose-repressible alcohol dehydrogenase (ADH II) from Saccharomyces cerevisiae. ADH II activity during glucose growth conditions was shown to increase linearly with increasing ADR1 gene dosage. In contrast, under derepressed growth conditions a 100-fold increase in ADR1 copy number resulted in only a 4-fold increase in ADH II expression. Saturation of ADH II gene expression by ADR1 under derepressed conditions was shown not to result from decreased ADR1 transcription. Increases in ADH2 gene dosage in conjunction with high ADR1 gene dosages resulted in increased ADH II activity, indicating that ADH2 was the limiting factor during derepression. Under glucose-repressed conditions the activator CCR1 was not required for ADR1 activity. During derepression increasing ADR1 dosage could partially compensate for a CCR1 defect. Increasing CCR1 gene dosage, however, had no effect on ADH2 expression regardless of the ADR1 allele present. These results suggest that CCR1 acts through ADR1 in controlling ADH2 expression. It was also observed that high numbers of ADR1, or a few copies of ADR1-5c, substantially increased the cell doubling time under ethanol growth conditions, indicating that increased ADR1 activity is toxic. PMID- 3302604 TI - Transcription of multiple copies of the yeast GAL7 gene is limited by specific factors in addition to GAL4. AB - High levels of the GAL7 gene in the yeast cell appear to titrate regulatory factors and to impair transcription of related sequences. To investigate the role that the GAL regulatory factors GAL4 and GAL80 have in this process we have compared the accumulation of mRNA transcribed from single-copy (plasmid-borne GAL7 and chromosomal GAL10) and high-copy (plasmid-borne GAL7) genes in several GAL regulatory mutants. Our results show that functional GAL4 gene product is required for induction of transcription from the single- and high-copy genes. In a strain containing the GAL4 gene fused to the high expression ADH1 promoter, glucose can replace galactose to induce high levels of transcription of GAL7 and GAL10 genes, although the kinetics of accumulation induced by the two sugars are distinctly different. In the presence of high levels of GAL4, maximum accumulation of mRNA from single and high copy genes is elevated two-fold; disruption of the gal80 gene in combination with high levels of GAL4 results in a further two-fold increase in transcription. In this genetic background, galactose induced transcription of the high copy GAL7 gene results in a greater than 50 fold increase in the levels of GAL7 mRNA, representing 30%-50% of the total cellular mRNA. Our results are consistent with a cooperative effect of saturation of multiple GAL4 DNA binding sites and with a limiting factor, in addition to GAL4, that is required for transcription of the GAL genes. PMID- 3302605 TI - Conditionally lethal tubA alpha-tubulin mutations in Aspergillus nidulans. AB - We have mapped 17 extragenic suppressors of benA33, a heat-sensitive beta-tubulin mutation of Aspergillus nidulans, to the tubA alpha tubulin locus. Fifteen of these tubA mutations cause cold sensitivity in a genetic background with benA33 and appear to cause lethality in a background with the wild-type benA allele. We examined the microtubule-mediated processes, nuclear division and nuclear migration, in seven different cold-sensitive double mutants, each carrying benA33 and a different cold-sensitive tubA allele. Nuclear division and migration were inhibited at a restrictive temperature in each case, suggesting that cold sensitivity is due to the inhibition of microtubule function at low temperatures. A single allele, tubA4, suppressed the heat sensitivity conferred by benA33 but did not confer cold sensitivity in a benA33 background, however in a wild-type benA background, tubA4 conferred supersensitivity to antimicrotubule agents and weak cold sensitivity. TubA4 did not suppress the heat sensitivity conferred by two other benA alleles. The cold sensitivity conferred by tubA4 was suppressed by the microtubule stabilizing agent deuterium oxide, and the suppression of heat sensitivity conferred by four other tubA mutations was reversed by deuterium oxide. These results suggest that these mutations may affect hydrophobic interactions between alpha- and beta-tubulin. PMID- 3302606 TI - Effect of UTP and GTP pools on attenuation at the pyrE gene of Escherichia coli. AB - We have used the galK gene, minus its promoter, to quantitate transcription of the orfE--pyrE operon of Escherichia coli in front of and after the intercistronic attenuator. Expression of the hybrid genes was studied in a bacterium with mutations that permit changes in the UTP and GTP pools during exponential growth. It was found that the greater part of pyrE gene regulation by the nucleotides takes place at the intercistronic attenuator and that promoter control contributes only little, ca. twofold. When pools of both UTP and GTP were high only 5%-6% of the mRNA chains were continued into the pyrE gene. However, when the UTP pool was reduced (from 1.3 to 0.2 mumol/g dry weight) nearly 100% of transcription passed the attenuator. Likewise, a reduction in the GTP pool (from 3.2 to 0.8 mumol/g dry weight) resulted in 25%-30% escape of attenuation. Regulation by attenuation disappeared when a premature stop-codon was introduced near the end of orfE such that translational coupling to transcription was prevented in the attenuator area. Therefore, we attribute the modulation of attenuation to nucleotide-induced variations in the kinetics of mRNA chain elongation. In support for this it was found that an RNA polymerase mutant with reduced RNA chain growth rate transcribed past the pyrE attenuator at a high frequency in the presence of a high UTP pool, but only when coupling of translation to transcription was allowed at the end of orfE. PMID- 3302607 TI - Structure of the yeast HIS5 gene responsive to general control of amino acid biosynthesis. AB - The nucleotide sequence of a 2.1 kb DNA fragment bearing the HIS5 gene of Saccharomyces cerevisiae, which encodes histidinol-phosphate aminotransferase (EC 2.6.1.9), has been determined. An open reading frame of 1,152 bp was found. S1 nuclease mapping indicated that the major transcription starts at position -37 from the ATG codon and the minor (approximately 20%) at -34 in both repressive and derepressive conditions. Northern analysis indicated that transcription of the HIS5 gene is under the general control of amino acid biosynthesis. The 5' noncoding region of the gene, thus far examined up to position -616, contains three copies of sequences homologous to the short repeats of the consensus sequence, 5'-AATGTGACTC-3', suggested for general amino acid control in the HIS1, HIS3, HIS4, and TRP5 at positions -336, -275 and -205. The consensus sequence closest to the open reading frame was shown to be necessary but not sufficient for general amino acid control, by examination of beta-galactosidase appearance in S. cerevisiae cells carrying various mutant HIS5 promoter regions fused to the lac'Z gene and inserted at the leu2 locus of chromosome III. PMID- 3302608 TI - Analysis of the K1 capsule biosynthesis genes of Escherichia coli: definition of three functional regions for capsule production. AB - Transposon and deletion analysis of the cloned K1 capsule biosynthesis genes of Escherichia coli revealed that approximately 17 kb of DNA, split into three functional regions, is required for capsule production. One block (region 1) is required for translocation of polysaccharide to the cell surface and mutations in this region result in the intracellular appearance of polymer indistinguishable on immunoelectrophoresis to that found on the surface of K1 encapsulated bacteria. This material was released from the cell by osmotic shock indicating that the polysaccharide was probably present in the periplasmic space. Insertions in a second block (region 2) completely abolished polymer production and this second region is believed to encode the enzymes for the biosynthesis and polymerisation of the K1 antigen. Addition of exogenous N-acetylneuraminic acid to one insertion mutant in this region restored its ability to express surface polymer as judged by K1 phage sensitivity. This insertion probably defines genes involved in biosynthesis of N-acetylneuraminic acid. Insertions in a third block (region 3) result in the intracellular appearance of polysaccharide with a very low electrophoretic mobility. The presence of the cloned K1 capsule biosynthesis genes on a multicopy plasmid in an E. coli K-12 strain did not increase the yields of capsular polysaccharide produced compared to the K1+ isolate from which the genes were cloned. PMID- 3302609 TI - Sequence of the mglB gene from Escherichia coli K12: comparison of wild-type and mutant galactose chemoreceptors. AB - The mglB gene of Escherichia coli codes for a galactose-binding protein (GBP) that serves both as the galactose chemoreceptor and as the recognition component of the beta-methylgalactoside transport system. The mglB551 mutation eliminates the chemotactic function of GBP without altering its transport or substrate binding properties. To investigate the interaction between GBP and Trg, the chemotactic signal transducer for galactose, we sequenced the mglB genes from wild-type and mglB551 mutant strains. The mutation causes the replacement of Gly74 of GBP by Asp. This residue is located in alpha-Helix III at the tip of the P domain in the GBP tertiary structure farthest removed from the substrate binding cleft between the P and Q domains. We conclude that Helix III must be part of, or at least adjacent to, the recognition site for Trg. Our sequence also included part of the mglA gene, which is immediately distal to mglB. The amino acid sequence deduced for the beginning of the MglA protein showed homology with a family of polypeptides that contain an ATP-binding site and are components of binding-protein-dependent transport systems. PMID- 3302610 TI - Identification and characterization of the functional alpha origin of DNA replication of the R6K plasmid and its relatedness to the R6K beta and gamma origins. AB - The functional R6K alpha origin is composed of two DNA elements, one of 580 bp carrying the alpha origin sequences and the other of 277 bp containing the seven 22 bp direct repeats previously identified as also required for gamma and beta origin activity. These two genetic elements are separated by approximately 3,000 bp of R6K sequences which are dispensable for alpha origin activity. The function of the alpha origin depends on the presence in cis of the 580 bp and the 277 bp fragments and requires that they be oriented as in the intact R6K. Activation of the alpha origin depends on the R6K replication initiation protein pi. Within the 580 bp of the alpha origin, there is a sequence of 98 bp which appears as an inverted repeat of 96 bp in the beta replicon. Deletion of the 96 bp or 98 bp results in inactivation of the alpha and the beta origins respectively. These long repeats are palindromic and it is suggested that these may serve as the recognition signals for initiation of DNA replication in the alpha and the beta origins of R6K. DNA homology analysis performed on alpha, beta and gamma origin sequences, also reveals 10-23 bp sequences in the alpha and the beta origins that are related to the family of 22 bp direct repeats in the gamma origin which were shown previously to be binding sites for the pi protein. PMID- 3302611 TI - Genetic and physical analysis of plasmid genes expressing inducible resistance of tellurite in Escherichia coli. AB - A large (greater than 250 kb) conjugative plasmid, pMER610, specifying resistance to tellurium and mercury was isolated from an Alcaligenes strain and transferred by conjugation to Escherichia coli AB1157. The acquisition of pMER610 by AB1157 increased the resistance to both telurite and tellurate by 100-fold. Expression of tellurite resistance by pMER610 and the cloned Ter determinant was inducible by prior exposure to tellurite at levels sub-toxic to the sensitive AB1157. Physical analysis of the cloned Ter fragment located the resistance determinant to a 3.55 kb region. Insertion of Tn 1000 (gamma delta) into this region produced two classes of sensitive mutations, fully sensitive and intermediate or hyposensitive, which map in adjacent regions and form two complementation groups. Maxicell analysis identified four polypeptides (15.5, 22, 23 and 41 kDa) expressed by the Ter clone. The 23 kDa polypeptide may not be required for resistance since tellurium-sensitive gamma delta insertion mutations were not detected in the 23 kDa coding region. PMID- 3302612 TI - Molecular aspects of genetic instability of an artificial 68 bp perfect palindrome in Escherichia coli. AB - An artificial 68 bp perfect palindrome carried on a plasmid (pAS807) is genetically unstable. An increase in the population of cells harbouring palindrome-deleted pAS807 derivatives (pAS807-V) is observed as the number of cell generations increases. The calculated frequency of palindrome excision events per cell generation and per plasmid replication round in Escherichia coli is 0.95 X 10(-4). Sequence analysis of eight independent isolates of palindrome deleted molecules, reveals two symmetrical deletion types (three of type I and five of type II). The two types of pAS807-v molecules retain 19 bp of the original sequence of the 68 bp palindrome but differ in the content of the central 3 bp. The generation of the two deletion types is best explained by formation of intermediate cruciform structures. Following the fate of the palindrome in various bacterial mutants, we find that the excision events depend on functional polA1, polA(ex1), lig, texA343(recC343) and texA344(recB344) gene products. However, recB21 recC22 mutations do not affect palindrome excision. PMID- 3302613 TI - Chemical synthesis and in vivo hyperexpression of a modular gene coding for Escherichia coli translational initiation factor IF1. AB - An artificial gene encoding the Escherichia coli translational initiation factor IF1 was synthesized based on the primary structure (71 amino acid residues) of the protein. Codons for individual amino acids were selected on the basis of the preferred codon usage found in the structural genes for the initiation factor IF2 of E. coli and Bacillus stearothermophilus, both of which can be expressed at high levels in E. coli cells. We gave the IF1 gene a modular structure by introducing specific restriction enzyme sites into the sequence, resulting in units of three to ten codons. This was conceived to facilitate site-directed mutagenesis of the gene and thus to obtain IF1 with specific amino acid alterations at desired positions. The IF1 gene was assembled by shot-gun ligation of 9 synthetic oligodeoxyribonucleotides ranging in size from 31 to 65 nucleotides and cloned into an expression vector to place the gene under the control of an inducible promoter. Upon induction, E. coli cells harbouring the artificial gene were found to produce large amounts (greater than or equal to 60 mg/100 g cells) of a protein indistinguishable from natural IF1 in both chemical and biological properties. PMID- 3302614 TI - Nucleotide sequence of putP, the proline carrier gene of Escherichia coli K12. AB - The nucleotide sequence of the putP gene coding for the proline carrier in Escherichia coli has been determined and the amino acid sequence of the proline carrier deduced from it. The proline carrier is predicted to consist of 502 amino acids, resulting in a molecular weight of 54,343. The predicted protein is very hydrophobic (70% nonpolar amino acids), and its hydropathy profile suggests that it is composed of 12 hydrophobic segments with a mean length of 24.4 residues/segment. If these segments are assumed to be alpha-helical, the mean length of each domain corresponds to the thickness of the hydrophobic core of the membrane. Potential promoter, catabolite gene activator protein (CAP) binding sites and several palindromic sequences, which might be regulatory regions by the putA gene product, were also found in the 5' flanking region of the postulated putP gene. A typical rho-independent transcription termination signal was found after the terminator codon of the putP gene. PMID- 3302615 TI - Alkaline phosphatase which lacks its own signal sequence becomes enzymatically active when fused to N-terminal sequences of Escherichia coli haemolysin (HlyA). AB - Fusion of the alkaline phosphatase gene (phoA) which lacks its own signal peptide sequence to the N-terminal region of hlyA, the structural gene for Escherichia coli haemolysin, leads to active alkaline phosphatase (AP). AP activity depends on the length of the N-terminal region of hlyA. An optimum is reached when 100 200 amino acids of HlyA are fused to PhoA but fusion of as little as 13 amino acids of HlyA to PhoA is sufficient to yield appreciable AP activity. When cells are treated with lysozyme most of the AP activity is found associated with the membrane fraction but a substantial amount is also found in the soluble fraction, most of which may represent a periplasmic pool of AP. The soluble portion of AP activity is significantly increased when the cells are disrupted by ultrasonication, which indicates that the fusion proteins are only loosely associated with the membrane and that large parts are already located on the outside of the cytoplasmic membrane. The expected fusion proteins were identified in the soluble and the membrane fractions and their amounts in these fractions correlated well with AP activity. PMID- 3302616 TI - The unusual translational initiation codon AUU limits the expression of the infC (initiation factor IF3) gene of Escherichia coli. AB - The expression of infC, the structural gene for translational initiation factor IF3, has been studied in different constructs under the control of the lambda PL and tac promoters. The amount of synthesized IF3 has been determined by a quantitative functional test and the levels of IF3-specific mRNA have been estimated. The synthesis of IF3 is strongly enhanced when the unusual AUU initiation codon is changed to AUG by site-directed mutagenesis. Removal of the sequence upstream from the start codon including most of the Shine-Dalgarno sequence, as well as part of a 10 bp region with potential complementarity to an internal region of the 16S rRNA, which is unique to the IF3 mRNA, reduced but did not completely abolish the high expression of infC obtained after introduction of the AUG initiation codon. The level of IF3 mRNA was found to be positively influenced by the presence of the rplT gene in the plasmid downstream from the infC gene. In vivo accumulation of a large excess of IF3, obtained when the infC gene was placed under the control of an incompletely repressed tac promoter, was not accompanied by any noticeable adverse phenotype. PMID- 3302617 TI - 'So great a cruelty'--historical aspects of Caesarean section. PMID- 3302618 TI - Drug addiction: its effects on mother and baby. PMID- 3302619 TI - Effect of protease on cell surface structure, hydrophobicity and adhesion of tufted strains of Streptococcus sanguis biotypes I and II. AB - Protease treatment of S. sanguis biotype I strains (AKI and CR311) and S. sanguis biotype II strains (CN3410 and PSH1b) reduced cell surface hydrophobicity of all strains by up to 87.7% and reduced adhesion to saliva coated hydroxyapatite beads (S-SHA) by up to 90%. All four strains carried lateral tufts of fibrils of two lengths on the cells. Tuft fibrils and hydrophobicity were lost simultaneously from S. sanguis II CN3410 when these properties were monitored simultaneously over 3 h. A ruthenium red positive layer, 37 +/- 6 nm thick, outside the cell wall of S. sanguis I CR311 was more resistant than the tuft to protease digestion. After 2 h of protease treatment tuft fibrils of S. sanguis I AKI and 311 were gradually digested while still on the cells, whereas most of the tuft fibrils of S. sanguis II PSH1b remained apparently undamaged on the cells, and tuft fibrils of S. sanguis II CN3410 were removed intact from the cell surface and found in the supernatant. PMID- 3302620 TI - The Microcirculatory Society Eugene M. Landis award lecture. Capillaries and cowboys. PMID- 3302621 TI - Pulmonary fibrin deposition and increased microvascular permeability to protein following fibrin microembolism in dogs: a structure-function relationship. AB - The effects of fibrin microembolism were examined using an infusion of a prothrombin activator (Echis carinatus venom, ECV; 30 min, 0.5 NIH thrombin equivalent units/kg) in acute mongrel dogs prepared with a pulmonary lymph cannula (n = 6, 12.3-21.5 kg). Lymph flow increased approximately 2.5-fold after 1-1.5 hr of elevated left atrial pressure (Pla = 20 cm H2O; 26 +/- 7 to 63 +/- 16 microliter/min, P less than 0.01) and the plasma to lymph protein concentration ratio (CP/CL) declined from 0.66 +/- .04 to 0.54 +/- .16 (P less than 0.01, x +/- SE). After Pla was reduced to control levels, the initiation of fibrin microembolism was associated with an approximate 2.7-fold elevation of lymph flow (62 +/- 8 microliters/min, P less than 0.01) and the CP/CL was not changed (0.56 +/- 0.04, P = ns). When Pla was increased following microembolism, lymph flow more than doubled to 117 +/- 24 microliter/min (P less than 0.01) and the CP/CL remained unaltered (0.56 +/- 0.03, P = ns). These changes were associated with afibrinogenemia and the appearance of fibrin degradation products (FDP) in plasma (150 +/- 50 micrograms/ml) and lymph (80 micrograms/ml) in three of the animals tested. No consistent pattern was seen in the CL/CP of separate endogenous plasma proteins after each intervention. These data support the view that pulmonary fibrin microembolism without inhibition of the fibrinolytic system was associated with an early increased pulmonary microvascular permeability to protein. In a separate group of similarly prepared animals (n = 8, 13-21.5 kg) without a lymph catheter, scanning electron microscopic observations showed branching fibrin microemboli to partially occlude some pulmonary arterioles. Mixed thrombus formations in larger precapillary blood vessels were also seen. Ultrastructural observations revealed the deposition of fibrin strands (periodicity = 220-230 A) within the pulmonary capillaries. Some of these deposits were overlaid by lamellar pseudopodia from endothelial cells and the fibrin appeared to be within these cells. Although plasmalemmal vesicles seemed to be more numerous in the endothelial cells with adjacent fibrin deposits, no gaps or breaks were seen in the densely stained interendothelial cell junctions and/or the endothelial cell membrane of the affected lung capillaries. Activated neutrophils and platelets were more numerous in the pulmonary capillaries following EVC. These data suggest that the presence of FDP and/or fibrin deposits within the pulmonary microvasculature may influence the early functional integrity of pulmonary endothelial cells at sites of fibrin accumulation. PMID- 3302622 TI - Physicochemical characterization of A and B subunits of Shiga toxin and reconstitution of holotoxin from isolated subunits. AB - The A and B subunits of Shiga toxin were isolated by high performance liquid chromatography and their physicochemical properties were examined. The A subunit of Shiga toxin purified from culture supernatant was not nicked, but it could be nicked in vitro by trypsin. The isoelectric points of the A and B subunits were determined to be 8.2 and 5.8, respectively. Amino acid compositions of the two subunits were also determined. The isolated A and B subunits were reconstituted to form active holotoxin which showed lethal activity to mice which was similar to that of native Shiga toxin. PMID- 3302623 TI - Comparison of wheat germ agglutinin- and phorbol myristate acetate-mediated triggering for macrophage H2O2 release: susceptibilities to various macrophage inhibitors. AB - Murine peritoneal macrophages (M phi S) elicited by a single injection of zymosan A showed a higher responsiveness to the wheat germ agglutinin (WGA)-mediated triggering for H2O2 release than M phi S activated by double injections of the agent. On the contrary, the response to phorbol myristate acetate(PMA)-mediated triggering was higher in the latter M phi S than in the case of the former M phi S. Furthermore, PMA-triggered M phi H2O2 release was found to be inhibited by sarcoma 180 tumor cell-derived proteinaceous factor in a much more marked fashion than the WGA-triggered H2O2 release. These results indicate some significant differences between the cellular mechanisms of the WGA- and PMA-triggering for M phi oxidative burst. On the other hand, microfilament-inhibitors (cytochalasins B and E) and serine protease-inhibitors (tosyl-L-lysine-chloromethyl ketone and tosylamido-2-phenylethyl-chloromethyl ketone), but not microtubule-disrupting agents (colchicine, vinblastine, and vincristine), suppressed both the WGA- and PMA-triggerings for M phi H2O2 release to a similar degree, thereby indicating that the WGA- and PMA-triggerings for M phi oxidative burst have a common process which is dependent on microfilament and serine protease functions. In relation to this, the WGA- and PMA-triggerings for M phi spreading were also depressed by microfilament- and serine protease-inhibitors but not by microtubule-inhibitors, indicating a participation of common membrane functions in the signal transduction in cases of M phi oxidative burst, and cell spreading induced by the WGA- as well as PMA-triggering. PMID- 3302624 TI - Mechanisms of acquired resistance in mouse typhoid. AB - A polyvalent radiovaccine of Salmonella was shown to induce protective immunity in mice. The results revealed that the immunized mice progressively eliminated the challenged organisms and no Salmonella could be isolated after a period of 21 days. In contrast, Salmonella grew in the control mice and reached levels of 10(8) to 10(9) cfu/spleen resulting in the death of animals. Sera from both control and the immune mice were found to lack bactericidal activity. It was further observed that the vaccine induced delayed type of hypersensitivity and that antibody production as measured by bacterial agglutination and passive hemagglutination were low in response to the vaccine. However, the phagocytic activity of the reticuloendothelial system was considerably enhanced by the immunization. The results of experiments with immunosuppressed mice suggested the role of thymus derived (T) lymphocytes in the protection. PMID- 3302625 TI - Candidacidal effect of peritoneal exudate cells in mice administered with chitin or chitosan: the role of serine protease on the mechanism of oxygen-independent candidacidal effect. PMID- 3302626 TI - Biological activities of chemically synthesized Proteus-type lipid A. PMID- 3302627 TI - [n-Chloroaniline transformation by Escherichia coli under anaerobic conditions]. AB - In a medium without oxygen in the presence of nitrates, E. coli transforms p chloranilin (p-CA) to yield a more hydrophilic compound which cannot be extracted with an organic solvent from water. The conditions for consecutive transformation of p-nitro-chlorobenzene (p-NCB) and p-CA have been determined: the reaction p NCB leads to p-CA is inhibited by nitrates, p-CA transformation occurs in the presence of nitrates in the medium and depends on their concentration. PMID- 3302628 TI - Lithium and immune function. AB - Lithium has potent antiviral and immunostimulating properties which are probably consequences of its actions on prostaglandin synthesis. Although lithium has considerable potential in the prophylaxis of some viral illnesses and other manifestations of defective immune function, it is, paradoxically, capable of activating autoimmune mechanisms in predisposed patients. PMID- 3302629 TI - Theory of the etiology of human toxemia of pregnancy: fetal hyperinsulinemia as a compensatory response to decreased uterine blood flow. AB - Toxemia of pregnancy is a perplexing clinical problem that has defied accurate elucidation of its etiology because the disorder does not occur in undisturbed lower mammalian species that are currently used as animal models of reproductive physiology. We propose that toxemia of pregnancy occurs as the end stage human fetal-placental unit response to decreased maternal uterine blood flow, and that this fetal-placental unit response may be unique to the human species. The human fetus increases insulin secretion in response to progressive intrauterine asphyxia, which may result in decreased fetal-placental prostacyclin production (a vasodilator and inhibitor of platelet aggregation) and increased fetal placental thromboxane A2 production (a vasoconstrictor). This could result in increased uteroplacental perfusion pressure, maternal hypertension, and increased maternal platelet aggregation. We also suggest that women who develop idiopathic toxemia of pregnancy are at increased risk for adult onset diabetes later on in life because they have a mild derangement in glucose-insulin homeostasis during their reproductive years that results in increased uterine vascular damage, that leads to decreased uterine blood flow, and ultimately the fetal hyperinsulinemia prostaglandin pressor release mechanism. Therefore, prevention of toxemia may be possible by correction of mild derangements in glucose-insulin receptor homeostasis before conception occurs. PMID- 3302630 TI - Humoral immunity in measles infection: a critical factor? AB - Cell-mediated immunity is generally regarded as the essential factor in recovery from measles infection. In other viral infections humoral immunity has been considered a critical factor when antibody titres were correlated with outcome or when serum therapy proved protective. A review of available studies of severe-to fatal cases of measles infection having non-neurological symptoms indicate that the antibody response is depressed in virtually all cases. The current view of immune globulin being an ineffective therapeutic agent is based on treatment of measles encephalitis; in fact, the least effect should be expected among encephalitis cases since some already have antibodies from the onset of symptoms. Larger examinations of measles with other than neurological symptoms suggest that immune globulin has a beneficial impact on the clinical course of infection. There are indications that hyperimmune globulin increases the efficacy of this form of treatment. Since measles is still a major cause of hospitalization and mortality, further studies of the therapeutic effect of specific immune globulin are warranted. From our current knowledge, both the humoral and cell-mediated immunity seem to be critical factors in recovery from measles infection. PMID- 3302631 TI - Environmental therapeutic devices for infants. Historical perspective. PMID- 3302632 TI - In vitro ultrasonic imaging of flow through prosthetic heart valves. AB - A rapid, inexpensive, portable technique has been developed for the qualitative and semiquantitative evaluation of in vitro flow characteristics through prosthetic heart valves. The technique combines a cardiac pulse duplicator and any diagnostic, linear sequential array, ultrasonic imaging system. The pulse duplicator has been modified to include an acoustically transparent aortic section which contains the prosthetic valve to be evaluated. The acoustically transparent section is fabricated from Rho-c rubber and enables direct flow imaging for several centimeters on both sides of the prosthesis. Aerated tap water is used as a contrast medium. Forward and reverse flow, laminar flow complex eddy patterns, regurgitation, and jets are easily observed in real time over a wide field of view. Time-exposure photography of sequential images and subsequent off-line calculations enable point-by-point determinations of flow velocities. This work allowed preliminary evaluations of four cardiac valves: Bjork-Shiley, St. Jude, caged disk, and Starr-Edwards. PMID- 3302634 TI - A pocket microprocessor-controlled ECG with LCD display: description, evaluation, and perspectives. PMID- 3302633 TI - An aerosol generator system for inhalation delivery of pharmacologic agents. AB - Most commercially available aerosol generators widely used in medical applications produce aerosols characterized by a large mass median diameter in the 4-8 micron range and the particle size in the 0.1-10.0 microns range. The desirable size of therapeutic and diagnostic aerosols, however, is about 2-4 microns mass median diameter, and less than 2.0 geometric standard deviation; this size increases the reproducibility of inhalation tests and enhances drug efficacy. We combined the commercially available DeVilbiss Model 65 nebulizer with a dilution/mixing chamber developed in our laboratory. The characteristics of this aerosol generator system were examined over a range of operating conditions and concentrations of solutions of three bronchoconstrictive agents- histamine, carbachol, and methacholine. The aerosol generator system produced a polydispersed aerosol with a mass median diameter range of 1.7-2.4 microns and geometric standard deviation of 1.5. The reliable and reproducible operation of the aerosol generator system greatly increases the power of bronchial challenge tests with bronchoconstrictive drugs. PMID- 3302635 TI - Strongyloidiasis is endemic in another Australian population group: Indochinese immigrants. AB - The prevalence of antibodies against Strongyloides in the serum of newly-arrived Indochinese immigrants was determined. Sera that had been stored in the State Health Laboratories, Perth, were stratified according to age and sex, then samples were selected at random. Two hundred and ninety sera that had been obtained from persons between the ages of one and 69 years were examined by an indirect fluorescent antibody test. Five per cent of children who were aged between one and two years gave positive reactions. The positive reaction rate in this population increased by approximately 7% per year until the age of seven to eight years at which point it levelled off. Approximately half of all older children, teenagers and adults had positive antibody responses, indicating past or present infection with Strongyloides stercoralis. This parasite is an extremely unusual worm in that it is able to replicate within the human host. Consequently, infection may persist for years. Furthermore, immunosuppression may result in fatal, disseminated infection. Strongyloidiasis is now recognized in three major Australian population groups: Aborigines who are living in the north of the country; World War II veterans who were prisoners in southeast Asia; and Indochinese immigrants. The salient features of the clinical manifestations, diagnosis and treatment of strongyloidiasis are reviewed. PMID- 3302636 TI - The management of leprosy. PMID- 3302637 TI - Plasmodium falciparum RI resistance to quinine and sulphadoxine-pyrimethamine in the Solomon Islands. PMID- 3302638 TI - The use of oral hypoglycaemic agents in the treatment of diabetes mellitus. AB - Since their introduction into clinical practice about 30 years ago, the popularity of oral hypoglycaemic agents has waxed and waned. Their use should not lead to the neglect of other facets of management in non-insulin dependent diabetes mellitus, such as diet and exercise, and the introduction of insulin should not be delayed in subjects who are not achieving an adequate control of blood glucose levels. In spite of concerns about the long-term safety and efficacy of oral hypoglycaemic agents that have been raised by the University Group Diabetes Program Study, oral hypoglycaemic agents have an established place in the management of non-insulin dependent diabetes. This article discusses briefly the mechanisms of action and clinical pharmacology of the oral hypoglycaemic agents in common use in Australia, and emphasizes practical issues that are relevant to their clinical use. PMID- 3302639 TI - Cotton--the medical silk. PMID- 3302640 TI - [Lubricating oils: a review on their chemical risks]. PMID- 3302641 TI - [Insect stings. Pathomechanisms and therapy]. PMID- 3302642 TI - [How the "Kolevka" got its name]. PMID- 3302643 TI - [Diagnosis of autoimmune insulitis before the clinical manifestation of type I diabetes mellitus]. PMID- 3302644 TI - [Therapy of diabetes mellitus in "secondary failure of sulfonylurea compounds"]. PMID- 3302645 TI - Pheochromocytoma in children and the anesthetic management. PMID- 3302647 TI - Correcting misconceptions in mental health policy: strategies for improved care of the seriously mentally ill. AB - In the decades immediately following World War II a strong coalition of professionals and reformers emerged to shape agendas, debates, and national policy on caring for the mentally ill. The heterogeneity of mental health problems, the demographic shifts in populations at risk, and the realities of designing and implementing effective programs, were often overlooked; yet profound elements of change have taken place. Components essential for maintenance of function and rehabilitation have yet to be linked into a responsible alternative to long-term or episodic hospital care. PMID- 3302648 TI - [Neonatal screening for the congenital adrenogenital syndrome]. PMID- 3302649 TI - [Diagnosis of congenital adrenogenital syndromes]. PMID- 3302650 TI - [Medical therapy of the congenital adrenogenital syndrome]. PMID- 3302651 TI - [Genetic aspects of the adrenogenital syndrome]. PMID- 3302652 TI - [Prenatal diagnosis of the congenital adrenogenital syndrome]. PMID- 3302653 TI - Effect of aspirin on hemostasis and thrombosis. AB - Aspirin inhibits platelet function by acetylating platelet cyclo-oxygenase. When aspirin is administered in doses as low as 40-160 mg per day, it inhibits platelet cyclo-oxygenase activity by more than 80%. The effect of aspirin on platelet function is maintained for the life-span of the platelet and there is evidence that aspirin also acetylates platelets before they are released in the circulation and while they are still within megakaryocytes. Aspirin also inhibits the synthesis of PGI2 by vascular wall cells but compared to the platelet, this vessel wall effect is relatively short-lived and requires slightly larger doses of aspirin. In vivo studies in rabbits indicate that very high doses of aspirin are thrombogenic. However, there is no evidence that aspirin is thrombogenic in man even when administered in high therapeutic doses. The optimal antithrombotic dose of aspirin has not yet been determined. Clinically, impressive results have been obtained with low doses of aspirin (ranging from 100 to 300 mg per day) in preventing aorta coronary bypass thrombosis, in patients undergoing hemodialysis, and in patients with unstable angina. Aspirin is also effective in preventing stroke and death in patients with cerebral ischemia when administered in doses of approximately 1 gram per day. There are trends suggesting that aspirin is effective when administered in doses between 300 mg per day and 1500 mg per day in patients who have survived myocardial infarction. The side-effects of aspirin are mainly gastrointestinal and are dose-related. Generalized bleeding is very uncommon and limited mainly to patients with other hemostatic abnormalities or due to the concomitant use of anticoagulant therapy. PMID- 3302655 TI - Awardees of the XII Annual Congress of the International Association of Allergology and Clinical Immunology; Washington, D.C.; October 24, 1985. PMID- 3302654 TI - Aspirin and methacholine challenges in an ambulatory asthmatic population. AB - Twenty-one low-risk outpatient asthmatics were challenged with 650 mg. of aspirin (ASA) and placebo in a double-blind manner. Methacholine dose response curves were performed after both aspirin and placebo administration. Baseline FEV1 was similar before aspirin and placebo challenges. No adverse clinical reactions were noted. No patient had a positive ASA challenge with a greater than 20% decrease in FEV1. Aspirin had no effect on bronchial reactivity that could be measured by a change in methacholine responsiveness. PMID- 3302656 TI - The role of kinins in human allergic disease. AB - We have provided clear evidence that kinins are generated during local allergic reactions in man and have begun studies on the mechanisms by which kinins are formed during these reactions. Clearly, the extent to which kinins may contribute to the symptomatology of allergic rhinitis remains to be determined, but the levels of kinins detected in the model systems described above are sufficient to cause relatively profound physiologic effects. In addition to its ability to produce vasodilatation and edema, bradykinin has been reported to stimulate fluid production from airway submucosal glands via a reflex action and could function to increase mucus production and cause rhinorrhea. Kinins have also been shown to increase chloride transport in the airway and to stimulate the production of prostaglandin E2 by epithelial cells. Thus we believe kinins must now be considered as potentially important mediators in the pathogenesis of human allergic diseases. PMID- 3302657 TI - Late phase reactions. AB - Our current understanding of LPR has evolved over the past 10-12 years, and there are still many areas where our information is still incomplete and cannot provide solid support for several of the hypotheses presented herein. Each suggestion presented is testable, however, and answers to many of the questions raised should eventually be available. The hypotheses presented provide a framework for understanding how airway inflammation contributes to airway reactivity and how certain irritant exposures can cause delayed-onset asthma. More importantly, they provide a rationale for the use of many of the specific drugs used to treat allergies and asthma. Indeed, if LPR and airway inflammation are as important in asthma (and other allergic diseases) as these hypotheses suggest, the use of agents specifically designed to prevent or treat LPR should increase. Thus, mast cell stabilizing compounds such as cromoglycate, ketotifen, and tranilast and anti-inflammatory agents like GCS might be viewed as specific therapy for asthma (and other allergic diseases), while bronchodilators (like antihistamines, decongestants and antipruritic drugs in other allergic diseases) might be considered as supportive agents. These concepts therefore suggest the early and aggressive use of specific agents in asthma while employing supportive drugs to help maintain lung function. PMID- 3302658 TI - Histamine in foods: its possible role in non-allergic adverse reactions to ingestants. AB - Histamine is well recognized as a product of both mast cells and basophils. Its release from these sources in IgE-mediated reactions unquestionably contributes to the allergic response. It is often stated that ingestion of foods rich in histamine can result in absorption of sufficient histamine to provoke signs and symptoms reminiscent of an allergic reaction. A review of literature relevant to this issue suggests that certain foods do indeed contain histamine as measured by current methodology. Further, histamine ingestion in excess of 36 to 250 mg may or may not result in a clinical response which includes abdominal complaints, feelings of warmth, flushing and headache. Taken together, this evidence supports the hypothesis that ingestion of large amounts of histamine-containing foods or foods which contain the histamine precursor, histidine, under some circumstances can result in adverse reactions. PMID- 3302660 TI - Firsts in allergy, V. Genesis of an academic interdisciplinary allergic disease unit, Part I. PMID- 3302659 TI - Allergy induced eustachian tube and middle ear pathophysiology. AB - While these studies have provided evidence to support the contention that nasal allergy contributes to OME, they have not confirmed the hypothesis in its entirety. The provocative intranasal antigen or histamine challenges have induced eustachian tube obstruction but have not resulted in OME. Because we wanted to minimize the possible risk of creating middle ear pathology following a provocative intranasal challenge, the absence of a resultant OME was anticipated for two reasons: the relatively brief duration of eustachian tube obstruction after challenge and the use of adult study subjects. Following intranasal provocative challenge, the developed tubal obstruction persisted only for several hours to a few days. In monkeys OME does not develop until 1 to 4 weeks after creating a surgical functional eustachian tube obstruction. Thus, eustachian tube obstruction must be sustained for a week or more for OME to develop. Further, a number of studies have suggested that eustachian tube function improves with age and has been related to the fact that OME is more prevalent in younger children. If the younger child has some degree of functional eustachian tube obstruction, then the development of an antigen provoked, histamine mediated eustachian tube obstruction might be expected to have more severe and prolonged effects at a lesser antigen dosage. It is our hypothesis that allergy and other pathophysiologic events that release or generate mediators of inflammation in the nasopharynx play a role in the pathogenesis of middle ear diseases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302661 TI - Firsts in allergy: V. Genesis of an academic interdisciplinary allergic disease unit, Part II. PMID- 3302662 TI - Food allergy, science and reason. PMID- 3302663 TI - Delayed immunologic food reactions. AB - Delayed onset reactions to ingested foods may be difficult to recognize, especially if days or weeks elapse before symptoms appear. More than one immunologic mechanism may be involved and it is often difficult to assess the relative importance of each. Because immunologic responses occur in many healthy subjects who readily tolerate a specific food, little importance can be ascribed to a particular immunologic test unless it is shown that at least 95% of normals with similar exposure do not have such a response. Each food contains multiple antigens and allergic individuals differ considerably both in their immune responses and in the clinical manifestations they display. Because of this, the recognition and management of delayed food reactions is complex and requires an awareness of documented food-related disorders. It is a fruitful area for future research. PMID- 3302664 TI - Adverse reactions to food additives. AB - There are thousands of agents that are intentionally added to the food that we consume. These include preservatives, stabilizers, conditioners, thickeners, colorings, flavorings, sweeteners, antioxidants, etc. etc. Yet only a surprisingly small number have been associated with hypersensitivity reactions. Amongst all the additives, FD&C dyes have been most frequently associated with adverse reactions. Tartrazine is the most notorious of them all; however, critical review of the medical literature and current Scripps Clinic studies would indicate that tartrazine has been confirmed to be at best only occasionally associated with flares of urticaria or asthma. There is no convincing evidence in the literature of reactivity to the other azo or nonazo dyes. This can also be said of BHA/BHT, nitrites/nitrates and sorbates. Parabens have been shown to elicit IgE mediated hypersensitivity reactions when used as pharmaceutical preservatives; however, as with the other additives noted above, ingested parabens have only occasionally been associated with adverse reactions. MSG, the cause of the 'Chinese restaurant syndrome' has only been linked to asthma in one report. Sulfiting agents used primarily as food fresheners and to control microbial growth in fermented beverages have been established as the cause of any where from mild to severe and even fatal reactions in at least 5% of the asthmatic population. Other reactions reported to follow sulfite ingestion include anaphylaxis, gastro intestinal complaints and dermatological eruptions. The prevalence of these non asthmatic reactions is unknown. The mechanism of sulfite sensitive asthma is also unknown but most likely involves hyperreactivity to inhale SO2 in the great majority of cases; however, there are reports of IgE mediated reactions and other sulfite sensitive asthmatics have been found with low levels of sulfite oxidase; necessary to oxidize endogenous sulfite to sulfate. PMID- 3302665 TI - Unproven procedures for diagnosis and treatment of food allergy. AB - The science of allergy and immunology has advanced to the point where effective procedures for diagnosis and treatment of food allergy can be proven to be effective. Currently available procedures of proven effectiveness are sufficiently satisfactory for diagnosis and treatment of food allergy so that ones of unproven effectiveness should not be employed in routine fashion, but rather should be considered experimental and reserved for use with informed consent in controlled trials which have been approved for safety and scientific merit by competent institutional review boards. Leucocytoxic testing, intracutaneous and subcutaneous provocation and neutralization, and sublingual provocation and neutralization are unproven procedures and should be reserved for experimental use only. PMID- 3302666 TI - The restaurant syndromes. AB - The Restaurant syndromes can be caused by five major factors: food allergens, sulfites, monosodium glutamate (MSG), tartrazine, and scombroidosis (and other seafood poisoning). A history of atopy and ingestion of known food allergens such as peanuts, egg, fish, and walnuts, together with positive results of skin tests or RAST to these foods, will favor a diagnosis of food allergy. Allergic reactions to peanuts have produced fatalities in minutes through an IgE mediated reaction. An extremely rapid onset (minutes) of symptoms consisting of flushing, bronchospasm and hypotension is consistent with a sulfite reaction. Burning, pressure, and tightness or numbness in the face, neck, and upper chest following ingestion of Chinese food favors a diagnosis of adverse reaction to MSG. Also, development of late onset bronchospasm (up to 14 hours) may be related to MSG reactions. Bronchospasm and urticaria in a patient with a history of aspirin intolerance suggests tartrazine sensitivity. If everyone ingesting a fish meal develops flushing, urticaria, pruritus, gastrointestinal complaints, or bronchospasm, this implies scombroidosis, ciguatera, or other seafood poisoning. Finally, severe headache or hypertension can result from ingestion of naturally occurring amines, such as tyramine (cheese, red wine) and phenylethylamine (chocolate). A double-blind oral challenge test may be the only way of confirming the diagnosis for most of the etiological factors of the Restaurant syndromes. The treatment of choice for acute reaction is epinephrine followed by antihistamine. Proper labeling and avoidance of these ingredients in sensitive individuals are the best preventive measures. PMID- 3302667 TI - The 1986 Nobel Prize for Physiology or Medicine awarded for discovery of growth factors: Rita Levi-Montalcini, M.D., and Stanley Cohen, Ph.D. PMID- 3302668 TI - An update on treatment of asthma with inhaled steroids. AB - This paper reviews current information on the pharmacology of inhaled steroid preparations, advances in the methods for delivering such agents to the lung, and the clinical experience with these agents during more than a decade of use for treatment of patients with asthma. PMID- 3302669 TI - Co-induction of cytochrome P-450 isozymes in rat liver by 2,4,5,2',4',5' hexachlorobiphenyl or 3-methoxy-4-aminoazobenzene. AB - A multitude of xenobiotics have been demonstrated to co-induce either cytochromes P-450c and P-450d or cytochromes P-450b and P-450e in rat hepatic microsomes. Recently, the compounds 2,4,5,2',4',5'-hexachlorobiphenyl (HCB) and 3-methoxy-4 aminoazobenzene (3-MeO-AAB) have been suggested as selective inducers of cytochrome P-450b (Eur. J. Biochem. 151:67 (1985)) and P-450d (Biochem. Biophys. Res. Commun. 133:1072 (1985)), respectively. Since the identification of inducers with such unique characteristics would have implications with regard to the mechanism of induction of all four isozymes, we have examined the induction of cytochromes P-450b and P-450e by HCB and cytochromes P-450c and P-450d by 3-MeO AAB in liver microsomes from adult male rats. Immunoblot analysis with monoclonal antibodies directed against cytochromes P-450b and P-450e indicate that HCB induces both isozymic species at the three dosage levels examined (10, 90, and 180 mg/kg). Similarly, 3-MeO-AAB does not appear to represent a unique inducer. Immunoblots of hepatic microsomes from animals treated with three different dosage regimens of 3-MeO-AAB demonstrate that, even at the lowest dosage level (50 mg/kg), both cytochromes P-450c and P-450d are induced. Moreover, immunoinhibition of 7-ethoxyresorufin O-deethylase (EROD) activity by monospecific antibody against either cytochrome P-450c or P-450d confirms this result. 3-MeO-AAB increases this enzyme activity 10-fold; approximately one-third of this induced activity is inhibited with monospecific anti-P-450c, while two thirds is inhibited with monospecific anti-P-450d. This study also demonstrates that hepatic EROD activity is not an accurate estimate of cytochrome P-450c content since the majority of this enzyme activity in control and 3-MeO-AAB treated rats is inhibited with monospecific anti-P-450d but not with monospecific anti-P-450c. PMID- 3302670 TI - Inactivation of multiple hepatic cytochrome P-450 isozymes in rats by allylisopropylacetamide: mechanistic implications. AB - In vivo administration of the porphyrogenic agent allylisopropylacetamide (AIA) to phenobarbital-pretreated rats results in marked loss of hepatic cytochrome P 450 content. Using isozyme-selective functional markers, we now show that such loss reflects inactivation of several phenobarbital-inducible and constitutive isozymes. Some of the isozymes (P-450a,b,h and PB-1) are largely reparable by reconstitution with exogenous hemin, indicating that after AIA-mediated loss of their prosthetic heme, their apoprotein moieties are essentially intact and functionally reconstitutable with hemin. On the other hand, after AIA-mediated inactivation, isozymes such as cytochrome P-450p remain refractory to such repair. The cause for such intractability remains somewhat elusive since AIA mediated alkylation of the apocytochrome, proteolytic loss of the hemoprotein, or even irreversible binding of prosthetic heme catabolites to the apocytochrome does not appear to be responsible. PMID- 3302671 TI - Regulatory function of the Saccharomyces cerevisiae RAS C-terminus. AB - Activating mutations (valine 19 or leucine 68) were introduced into the Saccharomyces cerevisiae RAS1 and RAS2 genes. In addition, a deletion was introduced into the wild-type gene and into an activated RAS2 gene, removing the segment of the coding region for the unique C-terminal domain that lies between the N-terminal 174 residues and the penultimate 8-residue membrane attachment site. At low levels of expression, a dominant activated phenotype, characterized by low glycogen levels and poor sporulation efficiency, was observed for both full-length RAS1 and RAS2 variants having impaired GTP hydrolytic activity. Lethal CDC25 mutations were bypassed by the expression of mutant RAS1 or RAS2 proteins with activating amino acid substitutions, by expression of RAS2 proteins lacking the C-terminal domain, or by normal and oncogenic mammalian Harvey ras proteins. Biochemical measurements of adenylate cyclase in membrane preparations showed that the expression of RAS2 proteins lacking the C-terminal domain can restore adenylate cyclase activity to cdc25 membranes. PMID- 3302672 TI - Two genes required for cell fusion during yeast conjugation: evidence for a pheromone-induced surface protein. AB - We characterized two genes, FUS1 and FUS2, which are required for fusion of Saccharomyces cerevisiae cells during conjugation. Mutations in these genes lead to an interruption of the mating process at a point just before cytoplasmic fusion; the partition dividing the mating pair remains undissolved several hours after the cells have initially formed a stable "prezygote." Fusion is only moderately impaired when the two parents together harbor one or two mutant fus genes, and it is severely compromised only when three or all four fus genes are inactivated. Cloning of FUS1 and FUS2 revealed that they share some functional homology; FUS1 on a high-copy number plasmid can partially suppress a fus2 mutant, and vice versa. FUS1 remains essentially unexpressed in vegetative cells, but is strongly induced by incubation of haploid cells with the appropriate mating pheromone. Immunofluorescence microscopy of alpha factor-induced a cells harboring a fus1-LACZ fusion showed the fusion protein to be localized at the cell surface, concentrated at one end of the cell (the shmoo tip). FUS1 maps near HIS4, and the intervening region (including BIK1, a gene required for nuclear fusion) was sequenced along with FUS1. The sequence of FUS1 revealed the presence of three copies of a hexamer (TGAAAC) conserved in the 5' noncoding regions of other pheromone-inducible genes. The deduced FUS1 protein sequence exhibits a striking concentration of serines and threonines at the amino terminus (46%; 33 of 71), followed by a 25-amino acid hydrophobic stretch and a predominantly hydrophilic carboxy terminus, which contains several potential N-glycosylation sites (Asn-X-Ser/Thr). This sequence suggests that FUS1 encodes a membrane anchored glycoprotein with both N- and O-linked sugars. PMID- 3302673 TI - Homologous recombination between single-stranded DNA and chromosomal genes in Saccharomyces cerevisiae. AB - Transformation of Saccharomyces cerevisiae strains was examined by using the URA3 and TRP1 genes cloned into M13 vectors in the absence of sequences capable of promoting autonomous replication. These constructs transform S. cerevisiae cells to prototrophy by homologous recombination with the resident mutant gene. Single stranded DNA was found to transform S. cerevisiae cells at efficiencies greater than that of double-stranded DNA. No conversion of single-stranded transforming DNA into duplex forms could be detected during the transformation process, and we conclude that single-stranded DNA may participate directly in recombination with chromosomal sequences. Transformation with single-stranded DNA gave rise to both gene conversion and reciprocal exchange events. Cotransformation with competing heterologous single-stranded DNA specifically inhibited transformation by single stranded DNA, suggesting that one of the components in the transformation recombination process has a preferential affinity for single-stranded DNA. PMID- 3302674 TI - Fatty acylation is important but not essential for Saccharomyces cerevisiae RAS function. AB - Two proteins in the yeast Saccharomyces cerevisiae that are encoded by the genes RAS1 and RAS2 are structurally and functionally homologous to proteins of the mammalian ras oncogene family. We examined the role of fatty acylation in the maturation of yeast RAS2 protein by creating mutants in the putative palmitate addition site located at the carboxyl terminus of the protein. Two mutations, Cys 318 to an opal termination codon and Cys-319 to Ser-319, were created in vitro and substituted in the chromosome in place of the normal RAS2 allele. These changes resulted in a failure of RAS2 protein to be acylated with palmitate and a failure of RAS2 protein to be localized to a membrane fraction. The mutations yielded a Ras2- phenotype with respect to the ability of the resultant mutants to grow on nonfermentable carbon sources and to complement ras1- mutants. However, overexpression of the ras2Ser-319 product yielded a Ras+ phenotype without a corresponding association of the mutant protein with the membrane fraction. We conclude that the presence of a fatty acyl moiety is important for localizing RAS2 protein to the membrane where it is active but that the fatty acyl group is not an absolute requirement of RAS2 protein function. PMID- 3302675 TI - The ras-like yeast YPT1 gene is itself essential for growth, sporulation, and starvation response. AB - The Saccharomyces cerevisiae gene YPT1 encodes a protein that exhibits significant homology to the mammalian ras proteins. Using gene disruption techniques, we have shown that the intact YPT1 gene is required for spore viability. Lethality caused by loss of YPT1 function, unlike that caused by loss of the yeast ras homologs RAS1 and RAS2 function, is not suppressed by the bcy1 mutation, suggesting that YPT1 does not act through the adenylate cyclase regulatory system. A cold-sensitive allele, ypt1-1, was constructed. At the nonpermissive temperature, mutants died, exhibiting aberrant nuclear morphology, as well as abnormal distribution of actin and tubulin. The mutant cells died without exhibiting classical cell-cycle-specific arrest; nevertheless, examination of cellular DNA content suggests that the YPT1 function is required, particularly after S phase. Cells carrying the ypt1-1 mutation died upon nitrogen starvation even at a temperature permissive for growth; diploid cells homozygous for ypt1-1 did not sporulate. The YPT1 gene is thus involved in nutritional regulation of the cell cycle as well as in normal progression through the mitotic cell cycle. PMID- 3302676 TI - Genetic manipulation of centromere function. AB - A conditional centromere was constructed in Saccharomyces cerevisiae by placing the centromere of chromosome III immediately downstream from the inducible GAL1 promoter from S. cerevisiae. By utilizing growth conditions that favor either transcriptional induction (galactose-carbon source) or repression (glucose-carbon source) from the GAL1 promoter, centromere function can be switched off or on, respectively. With the conditional centromere we were able to radically alter the mitotic transmission pattern of both monocentric and dicentric plasmids. Moreover, it was possible to selectively induce the loss of a single chromosome from a mitotically dividing population of cells. We observed that the induction of chromosome III aneuploidy resulted in a dramatic change in cell morphology. The construction of a conditional centromere represents a novel way to create conditional mutations of cis-acting DNA elements and will be useful for further analysis of this important stabilizing element. PMID- 3302677 TI - Upstream regulatory regions controlling the expression of the yeast maltase gene. AB - The expression of the maltase (MALS) and the maltose permease (MALT) genes in Saccharomyces species is coregulated at the transcriptional level; they are coordinately induced by maltose in the presence of a positively acting regulatory (MALR) gene and carbon catabolite repressed by glucose. We generated a series of deletions in the upstream region of the MAL6S gene to examine the regulatory elements in detail. The results showed that inducible expression by maltose was lost when the region between 320 and 380 base pairs upstream of the translation initiation codon was deleted. This region contained an imperfect inverted repeat sequence (-361 to -327) or four copies of short direct repeats that might serve as components of the upstream activation site (UASM) for the maltase gene, or both. When a stretch of T-rich sequence (-253 to -237) was deleted, the susceptibility of the maltase gene to carbon catabolite repression was affected. PMID- 3302678 TI - Increased copy number of the 5' end of the SPS2 gene inhibits sporulation of Saccharomyces cerevisiae. AB - We found that the introduction into a yeast cell of a high-copy-number plasmid containing the 5' end of the SPS2 gene, a sporulation-specific gene of Saccharomyces cerevisiae, led to a reduction in the efficiency of spore formation. The plasmid pAP290, which contains the sequence from -138 to +152 of the SPS2 gene, caused a fivefold reduction in spore formation; the presence of the plasmid had no effect on transcription of the chromosomal SPS2 gene. A plasmid containing only the sequence upstream of the TATA box of the SPS2 gene ( 350 to -68) was unable to inhibit the completion of sporulation, whereas the downstream sequence, from -70 to +404, although unable by itself to inhibit sporulation, could do so when provided with an upstream fragment containing the CYC1 upstream activation sequence. Deletion of 22 base pairs from pAP290, which introduced a frameshift after codon 17 of the SPS2 gene and reduced the open reading frame to 26 amino acids, generated a plasmid (pAP290 delta Pst) which could no longer inhibit sporulation. The SPS2 inserts of pAP290 and pAP290 delta Pst were found to direct equivalent levels of sporulation-specific transcription. We conclude from these results that the presence of both the SPS2 promoter (or a substitute promoter) and the initial coding sequence of the SPS2 gene is required in the high-copy-number plasmid to generate the asporogenous phenotype. We speculate that the accumulation of a protein containing the amino-terminal portion of the SPS2 gene product, synthesized from the transcripts of the truncated plasmid-borne copies of the SPS2 gene, prevents ascus formation. PMID- 3302679 TI - RNA processing and expression of an intron-encoded protein in yeast mitochondria: role of a conserved dodecamer sequence. AB - The 3' ends of most Saccharomyces cerevisiae mitochondrial mRNAs terminate at a conserved dodecamer sequence, 5'-AAUAAUAUUCUU-3', of unknown function. We have studied the consequences of mutations within a dodecamer found in an 1,143-base pair optional intron of the mitochondrial large (21S) rRNA gene on RNA processing. The dodecamer is situated at the 3' end of an expressed open reading frame (ORF) within that intron, and the mutations are two adjacent transversions that extend the intron ORF by 51 nucleotides. The strain harboring these mutations, L5-10-1, is defective in biased intron transmission in crosses to strains that lack the intron, as are other mutants which contain nucleotide changes within the ORF (I. G. Macreadie, R. M. Scott, A. R. Zinn, and R. A. Butow, Cell 41:395-402, 1985). However, unlike these other mutants, wild-type strains, or petites which retain the intron allele, L5-10-1 is defective in processing at the intron dodecamer. In addition, L5-10-1 lacks a prominent 2.7 kilobase RNA containing both intron and exon sequences and at least two of four RNAs that correspond to various forms of the excised intron. We propose that these RNAs, missing in L5-10-1 but present in all other strains examined, arise in part by processing at the intron dodecamer. In addition, in all strains examined, we have detected a novel processing activity in which precursor 21S rRNA transcripts are cleaved in the upstream exon, about 1,500 nucleotides from the 5' end of the RNA. This activity, together with 3' intron dodecamer cleavage, probably accounts for the 2.7-kilobase RNA species, a candidate for the mRNA for the intron-encoded protein. PMID- 3302680 TI - In vitro splicing of the terminal intervening sequence of Saccharomyces cerevisiae cytochrome b pre-mRNA. AB - A region of the Saccharomyces cerevisiae mitochondrial cytochrome b gene encompassing the entire terminal intron plus flanking exonic sequences has been cloned in an SP6 vector. A runoff transcript prepared from this construct as well as the native cytochrome b pre-mRNA containing the terminal intervening sequence were found to act as substrates for the autocatalytic excision of the intervening sequence in vitro. This reaction proceeds under conditions previously shown by Cech and co-workers to promote protein-independent excision of the Tetrahymena rRNA intervening sequence. The 5' and 3' termini of the excised intervening sequence, determined by S1 nuclease mapping and sequence analysis, are consistent with the known sequence of the cytochrome b mRNA. The same region of the cytochrome b gene from a yeast mutant, defective in splicing due to a mutation in a critical sequence inside the terminal intron, has also been cloned in an SP6 vector. The mutant transcript fails to self-splice in the in vitro assay. These observations provide strong presumptive evidence that in vivo processing of the terminal intervening sequence of the cytochrome b pre-mRNA occurs by an autocatalytic mechanism analogous to that shown for other group I introns. In vivo processing of the terminal intervening sequence of the cytochrome b pre mRNA, however, exhibits complete dependence on a protein factor previously shown to be encoded by the nuclear gene CBP2. PMID- 3302681 TI - Complementation of a threonine dehydratase-deficient Nicotiana plumbaginifolia mutant after Agrobacterium tumefaciens-mediated transfer of the Saccharomyces cerevisiae ILV1 gene. AB - The Saccharomyces cerevisiae ILV1 gene, encoding threonine dehydratase (EC 4.2.1.16) was fused to the transferred DNA nopaline synthase promoter and the 3' noncoding region of the octopine synthase gene. It was introduced, by Agrobacterium tumefaciens-mediated gene transfer, into an isoleucine-requiring Nicotiana plumbaginifolia auxotroph deficient in threonine dehydratase. Functional complementation by the ILV1 gene product was demonstrated by the selection of several transformed lines on a medium without isoleucine and by the identification in these lines of the yeast threonine dehydratase activity. This is the first example illustrating the complementation of a plant auxotroph by transfection with a cloned gene. PMID- 3302682 TI - Complex interactions among members of an essential subfamily of hsp70 genes in Saccharomyces cerevisiae. AB - Saccharomyces cerevisiae contains a large family of genes related to hsp70, the major heat shock-inducible gene of Drosophila melanogaster. One subfamily, identified by sequence homology, contains four genes, SSA1, SSA2, SSA3, and SSA4 (formerly YG100, YG102, YG106, and YG107, respectively). Previous studies showed that strains containing mutations in SSA1 and SSA2 are temperature sensitive for growth. SSA4, which is normally heat inducible and not expressed during vegetative growth, is expressed at high levels in ssa1 ssa2 strains at 23 degrees C. We constructed mutations in SSA3 and SSA4 and analyzed strains carrying mutations in the four genes. Strains carrying mutations in SSA3 SSA4 or SSA3 and SSA4 were indistinguishable from the wild type. However, ssa1 ssa2 ssa4 strains were inviable. SSA3, like SSA4, is a heat-inducible gene that is not normally expressed at 23 degrees C. Nevertheless, an intact copy of SSA3 regulated by the constitutive SSA2 promoter was capable of rescuing a ssa1 ssa2 ssa4 strain. This indicates that SSA3 encodes a functional protein and that the SSA1, SSA2, SSA3, and SSA4 gene products are functionally similar. PMID- 3302683 TI - [Bone marrow transplantation in childhood. Possibilities and risks]. AB - Bone marrow transplantation has attained significant importance in the treatment of serious congenital and acquired disorders of the lympho-hemopoietic system. In this review, some basic principles of this therapeutical approach as well as its main risks and complications are outlined. Therapeutical results, as currently obtained in children undergoing bone marrow transplantation, in children undergoing bone marrow transplantation, are reviewed and current and future developments which are necessary for further improvement are discussed. PMID- 3302684 TI - [Treatment of Fanconi anemia by bone marrow transplantation]. AB - We report on our experience with allogenic bone marrow transplantation in the treatment of Fanconi anemia. Eight patients were treated, ranging in age from 5 to 17 years. Beside severe hemopoietic insufficiency, all patients exhibited typical cytogenetic abnormalities with an increased rate of chromosomal breaks, while constitutional signs of the disorder were rather variable. Marrow donors were HLA-identical siblings. For conditioning, we used cyclophosphamide at 5 mg/kg on 4 consecutive days followed by thoraco-abdominal irradiation at 5 Gy with full lung shielding. For prophylaxis of graft versus host disease, cyclosporin A was given except in 3 cases who received T-cell depleted marrow. In 2 of the latter cases, graft failure was observed, successfully reversed in one by retransplantation. All others showed prompt and stable engraftment of donor cells. Complications of graft versus host disease developed in 2, requiring prolonged immunosuppressive treatment. Of 8 transplanted patients, 7 survive. With the exception of a recently treated girl, they have normal stable marrow functions. Our results confirm that successful treatment of Fanconi anemia is possible in a majority of patients with HLA-identical donors. PMID- 3302685 TI - [Hematuria of tubular origin in human kidney allografts. Tubulo-interstitial circulation of erythrocytes]. PMID- 3302686 TI - [Tubular ultrastructural changes in human kidney allografts]. PMID- 3302687 TI - [Expression of human leukocyte interferon type A in Saccharomyces cerevisiae under the control of regulatory elements of the yeast gene URA3]. AB - Expression of a chromosomal gene for human leucocyte interferon A was obtained due to interaction of 5'-nontranslating region of a cloned interferon gene with the regulatory sequences from UNA3 yeast gene. The sequence of 5'-nontranslating region from interferon gene essential for its expression in yeast is localized within 130 b p. from the initiating codon. Due to increasing of plasmid stability and copy number a 60-fold increase. in interferon yield was obtained in yeast transformants reaching the level of 6 X 10(7) u X 1(-1). The data are presented supposing the existence of functional polycistronic mRNA in yeast. PMID- 3302688 TI - Electronic factors and acridine frameshift mutagenicity--a pattern recognition study. AB - Using the ADAPT and CHEMLAB-II systems for structure-activity analysis, computer calculated electronic properties of molecules were used to derive structure activity relationships for predicting the mutagenicity of a set of substituted acridines in strain TA1537 of the Ames Salmonella assay. A collection of 40 acridines, with a variety of substituents, was examined. A set of 4 electronic descriptors was found which could be used to correctly classify all but two of the compounds as mutagenic or nonmutagenic. A negative correlation was found between the sum of the Hammett aromatic substituent parameters and the level of mutagenicity of the structures, expressed as log(number of revertants/plate + 1) at a 20-micrograms dose. This correlation, however, was not high enough to allow precise estimation of the mutagenicity values. PMID- 3302689 TI - High-frequency spontaneous deletion of DNA sequences flanked by direct DNA repeats which also contain an internal palindrome. AB - The DNA sequences associated with a very high-frequency, spontaneous deletion event have been determined to be two 11-base direct repeats which also contain an internal 6-base palindrome. A parental M13 replicative form (RF) DNA harboring DNA fragments of the T4 denV gene contained these direct repeats and could only be maintained at 5% of the total RF DNA within an infected cell. The remaining RF DNA was deleted for all intervening sequences between the direct repeats (2.2 kb), but one copy of the direct repeat was retained after the deletion had occurred. This site-specific deletion was highly reproducible in that if parental sized M13 RF DNA was gel purified and transformed back into cells, the deletion occurred at precisely the same sequence as before. Electron microscopic analyses of DNA extracted from cells transformed with parental-sized DNA revealed the presence of excised 2.2-kb double-stranded circular DNA molecules. This observation thus rules out a copy choice replication/deletion mechanism to account for this high-frequency deletion event. PMID- 3302690 TI - Thermal resistance to photoreactivation of ultraviolet light induced mutations in the lacI gene of E. coli ung. AB - Ultraviolet light (UV) induced mutations in the lacI gene of Escherichia coli are thought to be targeted by DNA photoproducts. A number of reports suggest that both cyclobutyl pyrimidine dimers and pyrimidine (6-4) pyrimidone photoproducts may be involved. To investigate the potential contribution of each of these DNA photoproducts to mutagenesis in the lacI gene, we held UV-irradiated cells at a temperature of 44 degrees C for 75 min and then exposed them to photoreactivating light (PR). This protocol is expected to preferentially deaminate specifically those cytosines that are contained in cyclobutyl dimers and subsequently monomerize the dimers to yield uracils in the DNA. In a strain deficient for uracil-DNA glycosylase (Ung-), these uracils would not be removed and a G:C--- A:T transition would result at the site of the dimer. This protocol resulted in the enhancement of amber nonsense mutations that result from transitions at potential cytosine-containing dimer sites. The enhanced mutation frequencies resulting from this procedure were used to estimate the probability of dimer formation at the individual sites. A comparison of the dimer distribution with the mutation frequencies following UV alone suggests that both cyclobutyl dimers and (6-4) photoproducts contribute to UV-mutagenesis in the lacI gene. In addition, we conclude that the frequency of mutation at any particular site not only reflects the occurrence of DNA damage, but also the action of metabolic processes that are responsible for DNA repair and mutagenesis. PMID- 3302691 TI - Conditions affecting the mutagenicity of sodium bisulfite in Salmonella typhimurium. AB - Sodium bisulfite is a weak mutagen at pH 5 and 6 in S. typhimurium strains carrying the hisG46 and hisD6610 mutations, but is not mutagenic in strains with the hisC3076 or hisD3052 mutations. The bisulfite-induced base-pair substitution mutations were slightly enhanced by the presence of the plasmid, pKM101, but inhibited by the presence of the uvrB and rfa mutations. The hisO1242 mutation which causes constitutive expression of the histidine operon, produced a slight enhancement of frameshift (hisD6610), but not base-pair substitution (hisG46) mutations. Bisulfite-induced mutations appear to be the result of two different mechanisms which may be a function of the repair capacity of the strains. The data suggest that the deamination of cytosine may not be responsible for frameshift mutations, but may be responsible for base-pair substitution mutagenesis. Because the rate of bisulfite autooxidation appears to play a role in the mutagenic process, we are suggesting that the deamination of cytosine may be the result of oxidative damage rather than through the direct formation of a cytosine-bisulfite adduct. This is further supported by the much lower concentrations of bisulfite needed to cause mutagenicity than the 1 M concentrations cited to produce cytosine-bisulfite adducts. PMID- 3302692 TI - A collaborative exercise on cytogenetic dosimetry for simulated whole and partial body accidental irradiation. AB - An experiment sponsored by the International Atomic Energy Agency was undertaken to compare dose estimation by cytogenetic analysis on aliquots of samples of irradiated blood sent by air to participating laboratories. Accidental acute whole-body irradiations to 0.7 and 2.34 Gy and half-body irradiations to 3.5 Gy were simulated with X- and gamma-rays. For the partial irradiations the size of the irradiated fraction and its dose were estimated by the Qdr and contaminated Poisson techniques. Each laboratory's in vitro dose-response data were fitted to the quadratic model by the iteratively reweighted least squares method. Interlaboratory variations in dose-response curves, and in the aberration yields and dose estimates for the simulated accidents were noted. However, in general, most participants consistently obtained results acceptably close to the true values. PMID- 3302693 TI - Experience with mutagenicity testing of new drugs: viewpoint of a regulatory agency. AB - Quality and quantity of mutagenicity testing were analyzed for drugs with new active compounds which were submitted for registration in the Federal Republic of Germany from mid 1982 to mid 1986. A large variety of deficiencies was found, applying to selection and number of mutagenicity tests as well as to test performances. Only 65 out of the 144 drugs submitted for registration were tested sufficiently in the initial phase of registration. From 1982 to 1986 this situation has not been changed markedly. Inadequate test performance still remains the main reason for insufficient testing, leading in some cases to artificially positive results. For in vivo tests the selection of test species was mainly motivated by technical reasons and not by characteristics of the test compound. Most of the insufficiencies were eliminated during the second phase of registration. In some cases insufficient mutagenicity testing led to consequences concerning risk-benefit assessment of the drug and its regulation. PMID- 3302694 TI - Implication of active oxygen species in the direct-acting mutagenicity of tea. AB - The present study shows that the L-arabinose resistance test with Salmonella typhimurium detects that freshly infused tea is highly mutagenic in the absence of mammalian microsomal activation. Both the mutagenesis protocol (preincubation test) and the additional genetic characteristics of the bacterial tester strain (excision repair deficiency, normal lipopolysaccharide barrier and the presence of plasmid pKM101) were critical factors in the optimal induction by tea of forward mutations to L-arabinose resistance. The TA104 strain--a histidine auxotroph specific to oxidative mutagens--was the most sensitive tester strain of the Ames test to the direct-acting mutagenicity of tea. In comparison with strain TA104, the sensitivity of the Ara forward mutation test was 18 times higher, one cup of tea (200 ml) inducing 3 X 10(6) AraR mutants. More than 90% of the mutagenicity of 150 microliter of a fresh tea infusion, or that of the equivalent amount (1.32 mg) of the corresponding lyophilized residue, was suppressed by 10 units of catalase. In contrast to catalase, superoxide dismutase was rather ineffective. These results indicate that hydrogen peroxide is produced in tea solutions, playing an essential role in its mutagenicity. In comparison, the role of superoxide anion seems negligible. Like catalase, the chelating agent DETAPAC showed a protective effect with respect to the mutagenicity of tea, suggesting the additional implication of hydroxyl radicals. PMID- 3302695 TI - Reaction of chlorine dioxide with amino acids and peptides: kinetics and mutagenicity studies. AB - Chlorine dioxide (ClO2) is currently being considered as an alternate to chlorine as a disinfectant for water treatment. Many organic compounds present in water and food treated with ClO2 are subject to oxidation. 21 amino acids and 3 peptides (L-aspartyl-L-phenylalanine methyl ester (aspartame), L-glycyl-L tryptophan and L-tryptophylglycine) were studied for their reactivity with ClO2. Chlorine dioxide reacted only with 6 amino acids in 0.1 M sodium phosphate buffer, pH 6.0. The reaction with cysteine, tryptophan and tyrosine was too rapid to be monitored either iodometrically or spectrophotometrically. The reaction with histidine, hydroxyproline and proline was found to be pseudo-first order. ClO2 readily reacted with L-glycyl-L-tryptophan and L-tryptophylglycine but not with aspartame. Mutagenicity studies with the Salmonella microsome assay of the reaction mixtures of ClO2 with those 6 reactive amino acids and the 3 peptides indicated that the reaction products of the 3 peptides, hydroxyproline, and tyrosine exerted mutagenic activity toward both tester strains of TA98 and TA100 in the presence and absence of rat-liver S9 mix. PMID- 3302696 TI - Mutagenic potency of some conjugated nitroaromatic compounds and its relationship to structure. AB - The mutagenicities of 12 conjugated non-fused nitroaromatic compounds and 1 amino analogue were determined in strains TA100 and TA98 of Salmonella typhimurium. Reversions by p-nitroaromatics increased in the order of the acetophenone, benzaldehyde, styrene, chalcone, cinnamic acid and stilbene indicating the importance for mutagenic potency of extended conjugation to the p-nitrophenyl substituent. Highest mutagenicity was found with alpha-substituted 4-nitrostyryl derivatives of which the phenyl derivative (31 revertants per nmole in TA100) was the most active. Generally, the TA100 strain was more sensitive than TA98 to these mutagens and S9 treatment was unnecessary for activity, although 4 nitrochalcone required S9 activation. Para-nitro isomers of the cinnamic acids and chalcones were much more active than the corresponding ortho and meta isomers. The 4-aminocinnamic acid analogue was inactive suggesting that complete reduction in Salmonella of 4-nitrocinnamic acid to an active amino derivative is not response for the high mutagenicity of the former. Mutagenicity of these p nitrostyryl compounds may be explained by the covalent interaction of the electrophilic benzylic carbon with Salmonella DNA. PMID- 3302697 TI - Mutagenicity of 7H-dibenzo[c,g]carbazole and metabolites in Salmonella typhimurium. AB - 7H-Dibenzo[c,g]carbazole (DBC) is a potent carcinogen of environmental import. Reverse-mutation plate-incorporation assays for mutagenicity were undertaken in Salmonella typhimurium strains TA98 and TA100. Results were negative when no exogenous activation system was used, as well as when assays incorporated liver homogenates (S9) from rats, mice and rabbits. By contrast DBC was mutagenic in a forward mutation assay in Salmonella strain TM677 using resistance to 8 azaguanine for selection. Metabolites of DBC were generated by incubation with rat-liver microsomes and separated by HPLC. Two of these metabolites were directly mutagenic for Salmonella strain TM 677 while two others were mutagenic upon addition of S9. Synthetic phenolic derivatives of DBC were also mutagenic in this assay when further metabolized. It is likely that metabolites of DBC phenols constitute the biologically active forms. PMID- 3302698 TI - Chemical basis for photomutagenicity in synthetic fuels and correlation with carcinogenicity. AB - Photomutagens (chemicals that enhance the mutagenicity of non-ionizing radiation) have been detected in experimental coal- and oil shale-derived synthetic fuel samples using Salmonella typhimurium strain TA98 and fluorescent light. In this study, photomutagenic activity was measured among distillation and chemical class fractions from a blend of direct coal liquefaction process materials. Photomutagenicity increased with increasing boiling point and was concentrated in fractions enriched in neutral polycyclic aromatic compounds (neutral PACs). The photomutagenic activities of the materials tested correlate well with the previously reported tumorigenic activities of the same samples on mouse skin, but correlate poorly with the previously reported mutagenic activities of the same samples in the Salmonella/mammalian-microsome test (using strain TA98), in which neutral PAC-enriched fractions were not active. These data suggest that relatively high boiling neutral PACs are important chemical photomutagens in synthetic fuels and suggest the potential use of the photomutation assay as an improved, relatively simple, inexpensive and short-term bioassay for detecting carcinogens as mutagens in complex mixtures such as synthetic fuels. PMID- 3302699 TI - Serum creatine kinase isoenzymes in Duchenne muscular dystrophy determined by sensitive enzyme immunoassay methods. AB - Serum levels of creatine kinase (CK) isoenzymes (MM, MB, and BB) were measured by sensitive enzyme immunoassay (EIA) methods in 50 patients with Duchenne muscular dystrophy (DMD) and in 39 controls. MM, MB, and BB levels in DMD patients were higher than in controls, and these three levels decreased with advancing age of DMD patients. Serum MB levels showed a good correlation with serum levels of carbonic anhydrase III (CA-III), but correlated poorly with electrocardiographic findings, suggesting that the main origin of serum MB in DMD is skeletal muscle rather than cardiac muscle. PMID- 3302700 TI - Ultrastructural changes in pathogenic fungi treated in vitro with chlorpromazine. PMID- 3302701 TI - Peptide digest studies of polymorphic proteins of Plasmodium falciparum. AB - Previous work has shown that when a large number of Plasmodium falciparum isolates are examined by two dimensional electrophoresis, over 100 different proteins can be detected, 15 of which show polymorphism in electrophoretic characters. Eight of these proteins have now been subjected to limited proteolysis. Two methods of digestion were used: enzymic, with Streptomyces griseus Pronase E and chemical, using N-chlorosuccinimide to break proteins at tryptophan residues. When different forms of each variable protein were analysed most were found to exhibit similar peptide profiles, a finding indicating that they were determined by alleles of genes at single loci. Two of the proteins, A and K, exhibited higher degrees of polymorphism than the other variable proteins. The possible reasons for this are discussed. PMID- 3302702 TI - Identification of the promastigote surface protease in seven species of Leishmania. AB - Twelve different strains of Leishmania, including L. major, L. donovani, L. infantum, L. tropica, L. mexicana, L. amazonensis, L. braziliensis, and L. enriettii were examined for the presence of an ectoenzyme structurally and functionally related to the promastigote surface protease found in L. major LEM 513. All strains examined possess a protease that is labelled by surface iodination of living promastigotes. The electrophoretic migrations of the labelled proteases are similar in all species showing distinct ectoprotease activity. In addition, proteases that cross-react immunologically with the polypeptide moiety of the surface protease of L. major LEM 513 were found in 10 strains. These proteases were in all cases labelled by surface radioiodination. Two of the strains, L. amazonensis and L. braziliensis, do not show a strict correlation between protease activity, surface iodination, and immunological cross-reactivity with the promastigote surface protease of L. major LEM 513, although both strains possess distinct neutral proteases with electrophoretic behavior similar to that of the enzyme of L. major. The amount of proteolytic activity detected at the surface of living cells depends on the strain tested, and correlates qualitatively with the amount of promastigote surface protease detected on zymograms. We conclude that the proteolytic activity found at the surface of Leishmania promastigotes is a common feature of the species infective for humans and that the promastigote surface protease described in this article is structurally and functionally conserved in Old and New World Leishmania. PMID- 3302703 TI - The use of a highly sensitive electrophoretic method to compare the proteinases of trichomonads. AB - A highly sensitive electrophoretic method involving gelatin-containing polyacrylamide gels has been used to analyse trichomonad proteinases. Multiple forms, optimally active at pH 5-6, were present in all four species examined, but the species could be distinguished from one another by both quantitative and qualitative differences. The intestinal parasites, Trichomitus batrachorum and Pentatrichomonas hominis, had lower specific activities than the urogenital parasites, Trichomonas vaginalis and Tritrichomonas foetus, and, in the case of P. hominis, there were fewer enzyme forms. The high activity proteinases of Tritrichomonas foetus had low apparent molecular weights (less than 25 kDa), while the predominant enzymes of Trichomonas vaginalis were of high apparent molecular weight (68-110 kDa). Distinct differences were also observed between the proteinase patterns of various isolates of T. vaginalis. All of the enzymes were stimulated by dithiothreitol, suggesting that they were cysteine proteinases. This was confirmed for the T. vaginalis and Tritrichomonas foetus proteinases from their inhibition by antipain, leupeptin, TLCK and iodoacetic acid. The method allows the detection of proteinases in samples of Trichomonas vaginalis containing as few as 10(4) cells or as little as 1 microgram protein. It was also possible to detect proteinase activity released into the medium. For both T. vaginalis and Tritrichomonas foetus, the extracellular enzymes present during early log phase were qualitatively different from the intracellular proteinases, although the latter were present in samples of media obtained from later cultures (cell densities greater than 1 X 10(5) parasites ml-1). The results show the potential of this technique for detecting proteinases in trichomonad samples in studies aimed at determining proteinase function in pathogenesis and host-parasite relationships. PMID- 3302704 TI - The effects of vasodilation with prostacyclin on oxygen delivery and uptake in critically ill patients. AB - We hypothesized that inadequate oxygenation of peripheral tissues may be unrecognized in critically ill patients and may worsen their prognosis. To test this hypothesis, we measured oxygen delivery to tissues, oxygen uptake, and the extraction ratio (uptake/delivery) before and during a 30-minute infusion of a vasodilator, prostacyclin (5 ng per kilogram of body weight per minute), in 27 critically ill patients with acute respiratory failure. Prostacyclin produced an increase in oxygen delivery (median value before vs. during infusion, 375 vs. 492 ml of oxygen per minute per square meter of body-surface area, P less than 0.001) that was similar in the 14 patients who survived and the 13 who died. This increase in oxygen delivery was associated with a significantly greater increase in oxygen uptake in the patients who died as compared with the survivors (median increase, 19 vs. 5 percent, P less than 0.001). In the survivors, the oxygen extraction ratio fell (median change, -17 percent; range, -27 to -6 percent) and the mixed venous oxygen tension increased. In the patients who died, the extraction ratio rose (median change, 11 percent; range -24 to +40 percent) and the mixed venous oxygen tension did not change. These data suggest the presence of a substantial oxygen debt in patients who subsequently die. Inadequate tissue oxygenation, which may be difficult to recognize, appears to be an important mechanism contributing to the development of irreversible multiple organ failure and subsequent death in some patients with acute respiratory failure. PMID- 3302705 TI - A pilot trial of Cop 1 in exacerbating-remitting multiple sclerosis. AB - Cop 1 is a random polymer (molecular weight, 14,000 to 23,000) simulating myelin basic protein. It is synthesized by polymerizing L-alanine, L-glutamic acid, L lysine, and L-tyrosine. It suppresses but does not induce experimental allergic encephalomyelitis, an animal model of multiple sclerosis. It is not toxic in animals. In a double-blind, randomized, placebo-controlled pilot trial, we studied 50 patients with the exacerbating-remitting form of multiple sclerosis, who self-injected either 20 mg of Cop 1 dissolved in 1 ml of saline or saline alone daily for two years. Six of 23 patients in the placebo group (26 percent) and 14 of 25 patients in the Cop 1 group (56 percent) had no exacerbations (P = 0.045). There were 62 exacerbations in the placebo group and 16 in the Cop 1 group, yielding two-year averages of 2.7 and 0.6 per patient, respectively. Among patients who were less disabled on entry (Kurtzke disability score, 0 to 2), there were 2.7 exacerbations in the placebo group and 0.3 in the Cop 1 group over two years. Among patients who were more affected (Kurtzke disability score, 3 to 6), there was an average of 2.7 exacerbations in the placebo group and 1.0 in the Cop 1 group. Over two years, less disabled patients taking Cop 1 improved an average of 0.5 Kurtzke units; those taking placebo worsened an average of 1.2 Kurtzke units. More disabled patients worsened by 0.3 (Cop 1 group) and 0.4 (placebo group) unit. Irritation at injection sites and rare, transient vasomotor responses were observed as side effects. These results suggest that Cop 1 may be beneficial in patients with the exacerbating-remitting form of multiple sclerosis, but we emphasize that the study is a preliminary one and our data require confirmation by a more extensive clinical trial. PMID- 3302706 TI - Cop 1 therapy for multiple sclerosis. PMID- 3302707 TI - A. Chekhov, M.D., and Coley's toxins. PMID- 3302709 TI - Current concepts: immunology. Transplantation immunology. AB - The MHC is of overwhelming importance in determining the fate of an allograft. Over the past 10 years, our understanding of the serology of this locus, its role in cellular immunity, its biochemistry, and most recently, its molecular biology has increased enormously. Genes for all the known loci, both Class I and Class II, have been cloned and sequenced, and their evolution and function are therefore now more amenable to investigation at the molecular level. Concomitantly, an understanding of the different populations of immune cells involved in the recognition of the antigens encoded by these loci has permitted a more precise immunologic description of the rejection response. It is now clear that recognition of both Class I and Class II allogeneic differences by both helper and cytotoxic T cells has an important role in graft rejection. The goal of transplantation biologists is to take advantage of this increased understanding in order to design new techniques for specifically modifying the immune response to MHC antigens and achieving specific tolerance. Some exciting approaches are already being studied, including specific modifications of both the antigen and the receptor arms of the immune response. It is hoped that these approaches will have new clinical applications in the near future. PMID- 3302708 TI - Comparison of autologous and allogeneic bone marrow transplantation for treatment of high-risk refractory acute lymphoblastic leukemia. AB - Chemoradiotherapy and transplantation of bone marrow from matched sibling donors have been useful for the treatment of acute lymphoblastic leukemia in patients with a poor prognosis but are not available to some two thirds of patients who do not have a matched allogeneic donor. We undertook this study to compare autologous and allogeneic marrow transplantation in the treatment of such cases. We treated 91 patients with high-dose chemoradiotherapy and followed them for 1.4 to 5 years. Forty-six patients with an HLA-matched donor received allogeneic marrow, and 45 patients without a matched donor received their own marrow taken during remission and purged of leukemic cells with use of monoclonal antibodies. Bone marrow engraftment occurred earlier in patients who received autologous marrow. Recipients of autologous marrow had shorter hospital courses, with significantly fewer peritransplantation deaths than recipients of allogeneic marrow. Post-transplantation relapse of leukemia was the most frequent cause of treatment failure; relapses occurred in an estimated 37 percent of patients with allogeneic grafts in whom graft-versus-host disease developed, 75 percent of patients with allogeneic grafts in whom graft-versus-host disease did not develop, and 79 percent of patients who received autologous grafts. The interval before relapse was significantly shorter in the autologous-marrow group than in the allogeneic-marrow group. Recipients of autologous and allogeneic marrow whose first pretransplantation remissions were short (less than 18 months) had eventual outcomes similar to those whose first remissions were longer than 18 months. Patients with a first remission lasting less than 18 months had an outcome better than that expected with chemotherapy alone. The fractions of "cured" patients were estimated to be 20 percent in the autologous-marrow group and 27 percent in the allogeneic-marrow group--not a significant difference, but because of the limited statistical power of the study, the question of long-term disease-free survival must still be considered open. PMID- 3302710 TI - Transplanted technology: Third World options and First World science. PMID- 3302711 TI - Exogenous reinfection with varicella-zoster virus. PMID- 3302712 TI - Acid-vesicle function, intracellular pathogens, and the action of chloroquine against Plasmodium falciparum. PMID- 3302713 TI - Payment restrictions for prescription drugs under Medicaid. Effects on therapy, cost, and equity. AB - In an attempt to contain costs, 27 Medicaid programs have implemented patient level payment limits for medications, but the effects of these restrictions on quality of care, costs, and health status remain largely unknown. We measured the effect of one state's limit of three paid prescriptions per month and its replacement a year later by a $1 copayment. Using data on 48 months of claims in the study state (New Hampshire) and a comparison state (New Jersey), we employed time-series analysis to evaluate patient-level changes in the number of prescriptions filled for 16 drugs that varied in their clinical importance and cost. Among 10,734 continuously enrolled patients, the limit of three paid prescriptions per month caused a sudden, sustained drop of 30 percent in the number of prescriptions filled (from 1.10 to 0.77 prescriptions per patient per month); no change was observed in the comparison state. The 860 recipients of multiple drugs, who were predominantly female and elderly or disabled, were most severely affected; the number of prescriptions per month dropped from 5.2 to 2.8 (46 percent). The decrease was greatest for "ineffective drugs" (58 percent), but large drops were also observed for "essential" medications, such as insulin (28 percent), thiazides (28 percent), and furosemide (30 percent). Reductions in Medicaid prescriptions were minimally offset by increases in the size of the prescription or in out-of-pocket payments. When a $1 copayment replaced the three prescription cap, prescriptions for most medications increased to just below precap levels. Medicaid's savings on drug costs resulting from both policies were comparable ($0.4 to $0.8 million annually), but the copayment policy had less effect on patients receiving multiple drugs. Because the clinical consequences of such policies cannot be assessed from prescription data alone, further study is needed to determine the effects of cost-containment strategies on health status and the use of other services among poor populations. PMID- 3302714 TI - [Carcinogenic and genotoxic effects of mycotoxins]. AB - Aflatoxin B1 is the most potent hepatocarcinogen among the naturally occurring compounds. It's carcinogenic effect was confirmed by longterm-studies in several animal species. There exists detailed knowledge on the molecular mechanism of the carcinogenic effect caused by aflatoxin B1. At present there does not exist a reliable evidence that human primary hepatocellular carcinoma is caused by aflatoxins. Sterigmatocystin is a hepatocarcinogen too. The genotoxicity of sterigmatocystin likewise as of aflatoxin B1 was detected by short-term-tests with microbial systems and mammalian cells in vitro. It is disputable whether ochratoxin A, citrinin and T-2 toxin are carcinogenic or not. Diacetoxyscirpenol, zearalenone and patulin are estimated as not carcinogenic after longterm-studies with oral toxin administration. Patulin and penicillic acid are genotoxic in microbial systems respectively in mammalian cells in vitro. Luteoskyrin is carcinogenic, but there was not detected any genotoxicity. PMID- 3302715 TI - [The effect of nutrition on the metabolism of glycine]. AB - It can be concluded on the base of data from literature and of our own results, that the metabolism of glycine is localized mainly in liver tissue. The main catabolic pathway of nutritional glycine proceeds via the glycine-cleavage enzyme, serinehydroxymethyltransferase and serinedehydratase or serine-pyruvate aminotransferase and via serine and pyruvate. The physiological significance of this metabolic pathway is estimated. The catabolism via the C1-pool is limited by the regeneration rate of tetrahydrofolic acid. Other pathways (via glyoxylate, SHEMIN-cycle, aminoacetone cycle) are only of minor significance for the catabolism of glycine originating from food. PMID- 3302716 TI - [The effect of oral administration of glycine on metabolism]. AB - Dietary supplied glycine resulted in dose-dependent effects on the growth of experimental animals, on diet-induced thermogenesis and on food efficiency. Furthermore it is possible to influence activities of enzymes involved in glycine metabolism and other enzyme activities in liver tissue by increased glycine supply. Simultaneously, changes occurred in amino acid levels in blood, tissues and urine, in the extent of urea excretion and in glycine metabolism. Based on these results no satisfactory explanation can be given concerning the possible biochemical mechanisms of the glycine-induced reduction in food efficiency at present. PMID- 3302717 TI - Proteolysis by toxigenic Aspergillus nidulans from Nigerian palm produce. AB - The submerged cultures of Aspergillus nidulans had optimal growth and protease production at 37 degrees C and within 6 days of incubation. A rapid drop in pH of the growth medium from 6.9 to 4.8 and a subsequent gradual rise was recorded with the period of incubation. The acid-protease produced was purified by a combination of ethanolic precipitation, ultrafiltration and fractionation on DEAE cellulose and Sephadex G-200. A single peak showing protease activity was subsequently obtained with a 16-fold increase in specific activity and a recovery value of 36%. The purified enzyme had optimal activity on casein and gelatin at pH 5.4 and a temperature of 40 degrees C. PMID- 3302718 TI - Kinetic description of proteolysis. Part 3. Total kinetics of peptide bonds hydrolysis in peptide mixtures. AB - A theoretical analysis of the general kinetics of peptide bond hydrolysis in peptide mixtures has been carried out. It is shown that the equation for the hydrolysis rate must include ensemble-averaged values which change as functions during hydrolysis. Thus the problem of describing the hydrolysis is reduced to finding these functions. As an example of theoretical prediction for the behavior of the averaged functions the procedure of calculating the averaged constant of chymotrypsin substrate specificity as a function of the degree of hydrolysis is presented. The analysis performed enables to find factors responsible for the decrease of hydrolysis rate, in particular, the role of the substrate specificity range and the S/E ratio. The design of specific experiments making it possible to measure the averaged values in the course of hydrolysis has been considered. PMID- 3302719 TI - [A message to the young generation: 2. Tragic history of nursing during the war]. PMID- 3302720 TI - High-altitude walking with YACs. PMID- 3302721 TI - Prevention of autoimmune insulitis by expression of I-E molecules in NOD mice. AB - The NOD (non-obese diabetic) mouse spontaneously develops insulin-dependent diabetes mellitus (IDDM) characterized by autoimmune insulitis, involving lymphocytic infiltration around and into the islets followed by pancreatic beta (beta) cell destruction, similar to human IDDM. Genetic analysis in breeding studies between NOD and C57BL/6 mice has demonstrated that two recessive genes on independent chromosomes contribute to the development of insulitis. One of the two recessive diabetogenic genes was found to be linked to the major histocompatibility complex (MHC). This is of interest, because the NOD strain has a unique class II MHC: it does not express I-E molecules as no messenger RNA for the alpha-chain of I-E is visible in Northern blot analysis; I-A molecules are not detected with any available monoclonal antibodies or by allo-reactive or autoreactive T-cell clones, although their expression is demonstrated with a conventional antiserum to Ia antigens. To examine whether the unusual expression of class II MHC molecules may be responsible for the development of autoimmune insulitis, we attempted to express I-E molecules in NOD mice selectively, without introducing other genes on chromosome 17 by using I-E-expressing C57BL/6 (B6(E alpha d)) transgenic mice. We report here that the expression of I-E molecules in NOD mice can prevent the development of autoimmune insulitis. PMID- 3302722 TI - A c-myc antisense oligodeoxynucleotide inhibits entry into S phase but not progress from G0 to G1. AB - Initiation of T-lymphocyte proliferation by mitogen or antigen involves a cascade of gene activation events. Thus, by the time mitogen-activated T cells have reached the G1/S interface, many genes that are transcriptionally silent in G0, like the c-myc, IL-2, IL-2 receptor (IL-2R) and transferrin receptor (TfR) genes, have been transcriptionally activated. To understand the role of the individual genes in the activation process, one must be able to interfere specifically with the expression or function of each particular gene product. In this way, by blocking the IL-2R with an antibody, it has been demonstrated that IL-2/IL-2R interaction is required to induce TfR expression in activated T cells. When the function or expression of intracellular proteins is to be blocked, however, the need to introduce antibodies into the cytoplasm of viable cells, although possible, is a limiting factor. We have taken another approach, namely the exogenous addition to bulk cell cultures of small antisense oligomers. Sequence specific antisense oligodeoxyribonucleotides have been reported to inhibit intracellular viral replication without interfering with cellular protein synthesis. Similarly, rabbit globin mRNA translation in a cell-free system and in rabbit reticulocytes has been inhibited by oligomers complementary to the globin mRNA initiation codon region. Recently, a pentadecadeoxyribonucleotide complementary to the initiation codon and four downstream codons of human c-myc mRNA was reported to inhibit the proliferation of the human leukaemic cell line HL-60 specifically. We report here that the same c-myc complementary oligonucleotide inhibits mitogen-induced c-myc protein expression in human T lymphocytes and prevents S phase entry. Interestingly, c-myc antisense treatment did not inhibit G0 to G1 traversal as assessed by morphologic blast transformation, transcriptional activation of the IL-2R and TfR genes, or induction of 3H-uridine incorporation. PMID- 3302723 TI - Sequence specificity of retroviral proteases. PMID- 3302724 TI - Rational modification of enzyme catalysis by engineering surface charge. AB - Changing the surface charge of subtilisin by site-directed mutagenesis produces enzymes with significantly shifted pH-activity profiles, higher catalytic activities and altered specificities. Insight into water as a dielectric, the role of ions in electrostatic shielding and the field effects on catalysis is obtained and suggests rules for tailoring pH-activity profiles. PMID- 3302725 TI - Free energy perturbation calculations on binding and catalysis after mutating Asn 155 in subtilisin. AB - Site-directed mutagenesis is a very powerful approach to altering the biological functions of proteins, the structural stability of proteins and the interactions of proteins with other molecules. Several experimental studies in recent years have been directed at estimating the changes in catalytic properties, (rates of binding and catalysis) in site-directed mutants of enzymes compared to the native enzymes. Simulation approaches to the study of complex molecules have also become more powerful, in no small measure owing to the increase in computer power. These simulations have often allowed results of experiments to be rationalized and understood mechanistically. A new approach called the free-energy pertubation method, which uses statistical mechanics and molecular dynamics can often be used for quantitative calculation of free energy differences. We have applied such a technique to calculate the differential free energy of binding and free energy of activation for catalysis of a tripeptide substrate by native subtilisin and a subtilisin mutant (Asn 155----Ala 155). Our studies lead to a calculated difference in free energy of binding which is relatively small, but a calculated change in free energy of catalysis which is substantial. These energies are very close to those determined experimentally (J. A. Wells and D. A. Estell, personal communication), which were not known to us until the simulations were completed. This demonstrates the predictive power and utility of theoretical simulation methods in studies of the effects of site-specific mutagenesis on both enzyme binding and catalysis. PMID- 3302726 TI - The ras protein is not associated with exocytosis. PMID- 3302727 TI - Induction of protective immunity against experimental infection with malaria using synthetic peptides. AB - Synthetic peptides are potential vaccine candidates because they may be able to induce high antibody titres and specific cellular immune responses against native proteins and thus the whole invading organism. In a previous study we showed that immunization with molecules of relative molecular mass (Mr) 155,000 (155K) 83K, 55K and 35K, specific for the late schizont and merozoite stages of Plasmodium falciparum, could elicit either partial or total protection in Aotus trivirgatus monkeys experimentally infected with P. falciparum. Here we have chemically synthesized 18 peptides corresponding to different fragments of these proteins to immunize Aotus trivirgatus monkeys. Some peptides gave partial protection from challenge with P. falciparum parasites, but none provided complete protection individually. A combination of three partially protective peptides gave complete or almost complete protection, however, suggesting that this particular combination of peptides is a good candidate for a malaria vaccine. PMID- 3302728 TI - India carries out large-scale tests of anti-leprosy vaccine. PMID- 3302729 TI - A multiple sclerosis therapy? PMID- 3302731 TI - Roster. North Carolina Medical Society 1987-1988. PMID- 3302730 TI - Breast imaging techniques. Current status. PMID- 3302732 TI - [30 patients with a 'hidden' disease: cryptococcal meningitis]. PMID- 3302733 TI - [The imperative character of medical technology and the significance of 'anticipated decision regret']. PMID- 3302734 TI - [Diagnosis of hypertrophic pyloric stenosis using echography]. PMID- 3302735 TI - [In praise of medicine: 450 years following the demise of Desiderius Erasmus]. PMID- 3302736 TI - Platinum cytostatics influence--the primary antibody response of mouse spleen cells in vitro. AB - The effects of three platinum containing cytostatic drugs--cis-DDP, CBDCA, and OXO--on in vitro primary antibody production after the treatment of mouse spleen cells with these compounds were studied. The technique of Marbrook was employed, the antibody response was assessed according to the number of plaque-forming cells (PFC) after the antigenic stimulation by sheep red blood cells (SRBC) in vitro. All of the three platinum complexes studied had inhibitory effect on antibody response at concentrations of 1 X 10(-5) to 1 X 10(-7) mol/l without affecting the viability of the mouse spleen cells. A comparison of the effectiveness of the three cytostatic drugs showed that cis-DDP was the most potent inhibitor. To obtain a similar inhibitory effect with CBDCA and OXO, concentrations 10 times as high as that in cis-DDP were required, depending on the time relation to antigenic stimulation. The lowest inhibitory effect on antibody production was observed in CBDCA. These drugs acted either after a simultaneous administration or 48 h after the antigen, i.e., at the time of maximal proliferation and differentiation of the cells. DNA synthesis must undoubtedly have been affected as well. PMID- 3302737 TI - Terminal deoxynucleotidyl transferase in acute leukemias by direct immunofluorescence. AB - TdT (terminal deoxynucleotidyl transferase) can be detected by radio enzymatic assay, biochemical assay in cell extracts, serum or plasma, and intracellularly in the smear by indirect immunofluorescent methods. The IgG fraction of anti-TdT serum is conjugated with fluoresceinisothiocyanate and used directly on the cytospin smears of methanol fixed bone marrow/blood smears. The mice thymocytes and peripheral mononuclear cells of healthy donors were used as positive and negative controls, respectively, for TdT. 64% of our cases of ALL were found to be TdT+. The lymphoblasts of L1 morphology (FAB classification) were more frequently positive for TdT as compared to blasts with L2 morphology. 71% of our cALLa positive blasts in acute lymphoblastic leukemias were TdT+ve as compared to 58% of T-ALL blasts. 75% of PAS positive ALL cases were positive for TdT as well. Only 57% of the cases when acid phosphatase showed unipolar positivity (T type) were positive for TdT. 12% of cases with acute myeloid leukemia (6/47) were TdT+ve and 33% of CML in blastic crisis had TdT+ve blasts. Biochemical assay and IF assay for TdT were in good correlation in our study. PMID- 3302738 TI - [Nootropic drugs: effects and effectiveness. A reflection exemplified by a phase III study using piracetam]. PMID- 3302739 TI - Vertebral osteomyelitis with chronic cervical extradural abscess in a heroin addict. AB - Chronic extradural abscess at C5-C6 level due to vertebral osteomyelitis is reported. The patient, a 26-year-old woman who had taken heroin intravenously for four years, developed progressive tetraparesis. Blood cultures and, at operation, the culture of the abscess drainage, grew Staphylococcus aureus. High resolution CT scan allowed for prompt diagnosis. Decompressive laminectomy and complete removal of the extradural mass were performed immediately, followed by multiple subtotal somatectomy (MSS) in order to obtain anterior decompression and mechanical reconstruction of the cervical column. The pathogenetic, diagnostic and surgical problems of spinal extradural abscess are discussed. Multiple subtotal somatectomy and its indication are described. PMID- 3302740 TI - [Amyloid deposits in hemodialysis patients: immunochemical analysis]. AB - We have analyzed 9 amyloid deposits isolated from 7 patients treated by long-term hemodialysis [6] and/or hemofiltration [1] for 8 to 19 years. Amyloid deposits were extracted from carpal tunnel synovitis [7] or femoral bone [2]. Proteins were analyzed by SDS-PAGE, two-dimensional electrophoresis and the identification was made by Western Blotting and specific antibody fixation. Several proteins were found: immunoglobulin light chains, beta 2 microglobulin (B2M), as well as globin chains, albumin and hemopexin. These findings suggest that amyloid deposits are not only made of B2M, but also with other protein species not cleared by dialysis membranes. Among these proteins, B2M and immunoglobulin light chains have well known amyloidogenic properties. We suggest that the role played by the remaining proteins on the pathogenesis of dialysis associated amyloidosis should also be considered. PMID- 3302742 TI - [Multiple sclerosis: new pathogenetic and diagnostic data]. PMID- 3302741 TI - Age-related alterations in the stimulated release in vitro of catecholamines and luteinizing hormone-releasing hormone from the male rat hypothalamus. AB - Using an in vitro perifusion system, the present study investigated the possibility that alterations in catecholamine and luteinizing hormone-releasing hormone (LHRH) secretion from the male rat mediobasal hypothalamus are present during the period of middle-age. The results indicate that, while tissue concentrations and baseline secretion of norepinephrine, dopamine and LHRH were similar between age groups, the patterns of dopamine and LHRH release in response to a series of depolarizing stimuli was different in the older animals. After all challenges, dopamine concentrations in the perifusate declined much more sharply for the middle-aged group, a finding that may be associated with a decrease with age in the pool of transmitter available for ready release. Also, tissue fragments from young adult rats were able to maintain the release of LHRH to a greater extent than tissue from the middle-aged animals, but only for the initial challenge period. The typical episodic pattern of LHRH release appeared to be disrupted in the older group following a second stimulus. It is possible that these age-related changes are early components of a disruption in the hypothalamic mechanisms governing gonadotropin secretion. PMID- 3302743 TI - Prolonged sensitisation of pituitary glands in vitro to repeated administration of luteinising hormone-releasing hormone: effects of pulse frequency, ovariectomy, estradiol and progesterone. AB - Anterior pituitary gland fragments were obtained from female Wistar-derived rats on dioestrus or pro-oestrus and perifused in Biogel columns in vitro. They were subjected at the beginning of each of 5 h of perifusion to a volley of 6 1-min pulses of luteinising hormone-releasing hormone (LHRH, 10 nM), given 4 min apart. Luteinising hormone (LH) was measured by radioimmunoassay in sequential 2-min fractions of the perifusate. Pituitary glands removed at 14.00 h on dioestrus showed a characteristic pattern of sensitisation followed by desensitisation to the repeated volleys of LHRH, whereas tissues removed at 10.00 or 14.00 h on pro oestrus showed no evidence of desensitisation over the 5-hour period, the response to each LHRH volley being greater than the preceding one. Estradiol (E, 3-100 pg/ml) added to the medium from the start of perifusion had no significant effect on the pattern of response from tissues removed on pro-oestrus, but the highest concentration significantly enhanced the response of dioestrus pituitaries to all but the last of the LHRH volleys. Progesterone (P, 1-50 ng/ml) added to the medium produced a dose-related inhibition of the response of pro oestrous tissues to the LHRH volleys. Groups of animals were ovariectomised (OVX) on dioestrus and used for experiment the next morning. OVX at 10.00 h on dioestrus produced the pattern of response characteristic of dioestrus the next morning, but with much higher levels of LH release, which were unaltered by the addition of E to the medium. OVX at 17.00 h on dioestrus produced an entirely different pattern of response the next day, with high basal and moderate LHRH induced LH release, and no evidence of changes in sensitivity of the tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302744 TI - In vivo secretion of LHRH in ovariectomized rats is regulated by a possible autofeedback mechanism. AB - An episodic secretion of LHRH in pituitary portal blood was observed in ovariectomized and hypophysectomized rats under Saffan anesthesia. This anesthetic did not effect the pulsatile release of LH in ovariectomized rats. Third-ventricular administration of an LHRH agonist, at a concentration which did not cross-react in the LHRH RIA, suppressed both the pulse amplitude and frequency of LHRH release. This inhibitory action of the LHRH agonist on LHRH release was blocked by an LHRH antagonist. PMID- 3302745 TI - Membrane mechanism mediates progesterone stimulatory effect on LHRH release from superfused rat hypothalami in vitro. AB - To determine whether the plasma membrane is a primary site for progesterone (P4) action on the neural LHRH apparatus of hypothalamic tissues derived from ovariectomized, estradiol-primed (OVX + E2) immature rats, immobilized P4 was infused directly to these tissues using a superfusion technique. Two kinds of immobilized P4 with bovine serum albumin (BSA) conjugated at positions 3 or 11, or 11-deoxycorticosterone (DOC) immobilized at position 21 of the steroid molecule, respectively, were tested for structural specificity. Among the three immobilized steroids, only P4 with BSA conjugated at position 3 (P4-3-BSA) was effective in stimulating LHRH release in vitro. P4-3-BSA at 0.5 micrograms/ml, approximately 1.7 X 10(-7) M of P4, increased LHRH levels in the superfusates to about 2.5-fold those of pretreatment levels. In addition, no conversion of P4-3 BSA to free progesterone was detected. This observation demonstrated that the plasma membrane is a primary site for the stimulating effect of P4 on LHRH release from hypothalamic tissue in vitro. PMID- 3302746 TI - Immunohistochemical demonstration of proGnRH and GnRH in the preoptic-basal hypothalamus of the primate. AB - An antiserum (ARK-1) specific to the gonadotropin-releasing hormone precursor (proGnRH) was produced by immunizing with a synthetic peptide (proGnRH 6-16; Gly Leu-Arg-Pro-Gly-Gly-Lys-Arg-Asp-Ala-Glu) which bridges the proteolytic cleavage site of proGnRH. When used in the radioimmunoassay, ARK-1 bound 25% of the iodinated 5-16 fragment at a 1:30,000 dilution with a sensitivity of 1 pg/tube. Using immunohistochemical techniques, we observed that in serial and the same sections through the preoptic-basal hypothalamus (POA-BH), the precursor molecule was primarily present in the cell soma, whereas GnRH was found in the cell soma, nerve fibers, and terminals of the same neurons. These data indicate that the processing of proGnRH to biologically active peptides (e.g., GnRH) in the rhesus macaque and the baboon POA-BH primarily occurs in the cell soma. PMID- 3302747 TI - A brain site for the antigonadal action of melatonin in the white-footed mouse (Peromyscus leucopus): involvement of the immunoreactive GnRH neuronal system. AB - Quantitative assessment of immunocytochemical staining for gonadotropin-releasing hormone (GnRH) was undertaken to determine the effects of an intracranial implant of melatonin on the GnRH neuronal system in the male white-footed mouse (Peromyscus leucopus). Melatonin-containing pellets stereotaxically placed in the anterior hypothalamic area (AH) caused a 60% reduction in testes weight relative to control mice with melatonin-free pellets in the AH (p less than 0.01). Subcutaneous melatonin-containing implants had little effect on reproductive state (p less than 0.8). Melatonin pellets in the AH increased significantly both the optical density (OD) for immunostaining of cell bodies in the medial preoptic area and AH (p less than 0.04), and the percentage of area covered by GnRH fibers and beads in the median eminence (p less than 0.01). The melatonin-induced increase in OD of the GnRH cell bodies was independent of the distance of the cells from the melatonin implant, and there was little apparent effect of melatonin on the size and morphology of the GnRH cell bodies, or the trajectories of their fiber pathways. These results support the hypothesis that the antigonadal action of melatonin in the brain involves suppression of the release, rather than the synthesis of GnRH. Also, this effect may not be mediated via a direct action of melatonin on GnRH neurons. The finding that the brain site and time course for melatonin's antigonadal action in male. P. leucopus is similar to that found previously in the female is evidence that melatonin may induce gonadal regression, in part, by helping to suppress the tonic secretion of gonadotropins. PMID- 3302748 TI - GnRH secretion throughout the ovine estrous cycle. AB - In order to define the patterns of gonadotropin-releasing hormone (GnRH) secretion during the estrous cycle of the sheep we sampled hypophysial portal blood from conscious animals on day 1 of the cycle (n = 1), during the luteal phase (n = 8), during the follicular phase (n = 6) and during the preovulatory luteinizing hormone (LH) surge (n = 6). At the same time, we sampled jugular blood to measure plasma LH concentrations. During day 1 we noted regular GnRH pulses, whereas GnRH pulse amplitude and frequency were more variable in the luteal phase of the cycle. In the transition from the luteal phase to the follicular phase the GnRH pulse frequency increased and the amplitude decreased. Around the time of the LH surge we noted 3 types of secretory profiles for GnRH. In one sheep (type 1) there was a large GnRH pulse at the onset of the LH surge followed by very little activity during the surge. In two sheep (type 2) the GnRH profile did not change between the late follicular phase and the onset of the LH surge. In the remaining three sheep (type 3) there was a clear increase in the secretion of GnRH at the onset of the LH surge. With the exclusion of the type 1 sheep the GnRH pulse frequency was maximal (2 pulses/h) at the time of the LH surge; average portal GnRH levels were also maximal at this time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302749 TI - Distribution of enkephalin-containing peptides within bovine chromaffin granules. AB - The distribution of large enkephalin-containing peptides (ECP's) between soluble and membrane components of bovine chromaffin granules was examined by immunoblotting with synenkephalin antiserum which recognizes the NH2-terminus of proenkephalin. Immunoblots showed that the 23.3 and 18.2 kilodalton ECP's were present in both soluble and membrane granule compartments but the 12.6 kilodalton ECP was present only in the soluble fraction. These results suggest that the larger ECP's may be preferentially associated with the granule membrane and may be redistributed to the soluble granule compartment upon proteolytic processing. PMID- 3302750 TI - Multiple forms of biologically active insulin-like material from mouse fetal brain cells in culture. AB - The biological and immunological properties of insulin-like material produced by brain cells from 12 day old mice, cultured in serum-free media were examined. Differences were seen in the rate of appearance, relative amounts and behaviour on HPLC between immunoreactive and biologically active insulin-like material. Excess anti-insulin sera failed to suppress most of the biological activity and the culture medium was shown to contain relatively large quantities of immunoreactive IGF-I (590 ng/30 ml). The elution profile of this material on HPLC overlapped but was not identical with the insulin biological activity, which indicated that other insulin-like growth factors were also present. The relatively high concentration of IGF-I produced by the brain cell cultures suggest that this preparation may be suitable for biosynthetic studies of this growth factor. PMID- 3302751 TI - Computed imaging stereotaxy: experience and perspective related to 500 procedures applied to brain masses. AB - The evolution of more sophisticated imaging techniques has initiated a renewed interest in stereotactic devices, methods, and applications. The Brown-Roberts Wells instrument was available to us early in its prototype stage, and this report reviews the first 500 cases using the system at the University of Southern California Medical Center Hospitals. Procedures were undertaken after recognition of apparent structural alterations on imaging studies, with objectives being both diagnostic and therapeutic. Target locations were predominantly within the cerebral centrum-basal ganglia (284 cases) and diencephalic-mesencephalic regions (129 cases). Operative objectives included: histological and microbiological assay, cyst and abscess aspiration, installation of temporary or permanent drainage conduits, point source and colloid base brachytherapy, cerebroscopy and ventriculoscopy with biopsy, aspiration, and excision, and intraoperative vascular localization. Using multiple instrumentation at the target point (741 point placements), we realized procedural objectives in 95.6% of the cases. The mortality was 0.2% and the morbidity was 1%: hematoma, 2 cases; infection, 1 case; increased deficit, 1 case; intraprocedural seizure, 1 case. A specific diagnosis was not obtained in 4.4% (necrosis, 10 cases; inflammatory response, 9 cases; granuloma, 1 case; gliosis, 1 case; diagnostic error, 1 case). Individual guidelines for case selection, technique, institutional requirements, and applications of the method are discussed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302752 TI - Whatever happened to stereotactic surgery? AB - The field of human stereotactic surgery began when Spiegel and Wycis introduced their stereoencephalotome in 1947, reached its epitome in the early 1960s, and declined sharply after the introduction of L-dopa in 1968. When the development of implantable stimulators provided an abrupt expansion of techniques in nonstereotactic functional neurosurgery, the field became "stereotactic and functional neurosurgery." The marriage of stereotactic surgery with computed tomography has reawakened the use of stereotactic surgery and brought it closer to general neurosurgery than ever before. Stereotactic and functional neurosurgery as a subspecialty has expanded rapidly and will continue to expand at an unprecedented rate, with significant changes reflecting the continuing advances in technology begun 15 years ago. It is becoming an increasingly important part of the field of neurosurgery and has extended its influence in many new clinical areas previously outside the realm of stereotaxis. PMID- 3302753 TI - Tuboovarian abscess presenting as sciatic pain: case report. AB - The authors report the successful conservative treatment of a tuboovarian abscess in a 25-year old woman who presented with low grade fever and severe right sciatic pain. Computed tomography and ultrasonography corroborated a clinical diagnosis of tuboovarian abscess after an initial diagnosis of epidural abscess had been made. This is the first report of a tuboovarian abscess presenting principally as sciatic pain. The diagnosis and treatment of this lesion are discussed. PMID- 3302754 TI - A simple animal holder for the stereotactic device of Riechert and Mundinger. AB - A simple animal holder for stereotactic operations that utilizes the components of Riechert's stereotactic device is presented. The x-ray translucency of the base plate allows preoperative calculations of the target points. The compatibility with computed tomography improves target accuracy. PMID- 3302755 TI - Malignant melanoma metastatic to sphenoid bone with an unknown primary origin: report of a case with an immunohistochemical analysis of the infiltrating lymphocytes. AB - A rare case of hemorrhagic malignant melanoma from an unknown primary origin to the right sphenoid bone in a 37-year-old woman is presented. The tumor occupied an extensive intracranial extradural space with a mild orbital infiltration, but little involvement of the leptomeninges and parenchymal tissues. Immunohistochemical analysis of the tumor-infiltrating lymphocytes showed that the majority expressed pan-T or Leu-1 surface antigens and that the lymphocytes bearing the Leu-3 antigen, or helper phenotype, were predominant compared to the Leu-2 population representing both suppressor and cytotoxic T cells. Furthermore, most of the T lymphocytes stained with HLA-DR antigens. Because few B cells were seen, this observation indicates the presence of T cells in an activated state. The literature pertinent to associated organ involvement of metastatic melanomas and the correlations between the tumor and immunological cellular responses are discussed. PMID- 3302756 TI - Cerebellar medulloblastoma in a 73-year-old woman. AB - A case of a 73-year-old woman with cerebellar medulloblastoma is described. The patient presented with the classical symptoms and signs of a medulloblastoma, and radiological findings were also consistent with this entity. Nevertheless, because of the patient's advanced age, the possibilities of metastatic tumor involving the cerebellum or a primary cerebellar lymphoma were considered before operation. Pathological examination of the operative specimen showed a classical medulloblastoma with occasional areas of early neuroblastic differentiation. Immunoperoxidase strains for neurofilaments were of help in confirming the neurogenic origin of the neoplastic cells. Although medulloblastomas in adults are not rare, onset after the age of 50 is exceptional, with only two cases on record in patients 65 or older. The present patient seems to be the oldest individual with a cerebellar medulloblastoma thus far reported. PMID- 3302757 TI - Detection of unruptured familial intracranial aneurysms by intravenous digital subtraction angiography. Screening of two affected families. AB - The authors discuss the detection of intracranial aneurysms (IA) by means of intravenous digital angiography (ivDSA) in (a)symptomatic first degree relatives of families in which two or more individuals have IA. ivDSA is an almost noninvasive and low-risk diagnostic procedure. Screening, by means of ivDSA, of two affected families is described. In family I which includes 7 members with proven IA, ivDSA has been carried out in 36 asymptomatic individuals: in one, a 6 X 15 mm aneurysm was found at the left posterior communicating artery (PCoA). In family II, including one member with a proven IA and another with a subarachnoid hemorrhage, ivDSA has been carried out in 4 members: one aneurysm with a diameter of 6 mm was found at the left PCoA. Conventional cerebral angiography (CCA) confirmed both IA's. Neurosurgical treatment followed. The advantages and disadvantages of ivDSA vs. CCA as elective screening procedure in such cases are discussed. Screening of asymptomatic first degree relatives of cases with familial IA by means of ivDSA is strongly advocated. PMID- 3302758 TI - CT guided stereotaxy based on scout view imaging. AB - A simple and inexpensive method for CT guided stereotaxy is described. The method requires no extra equipment in the interface between the computer tomograph and the stereotaxic frame, and could therefore easily be adopted in most neurosurgical units. With this method, information from the transaxial CT sections is transferred manually via the scout view image to the operation theater skull x-rays, and thereby to the stereotaxic frame. The method has proved to be sufficiently accurate for all current non-functional stereotaxic procedures in our department during 30 months of testing. PMID- 3302759 TI - Alzheimer's disease: neurofibrillary tangles in nuclei that project to the cerebral cortex. AB - We have used an antibody to the paired helical filament protein to immunohistochemically identify the regional distribution of subcortical nuclei containing neurofibrillary tangles in brains from Alzheimer's disease patients. Sections were examined from the cerebral cortex, diencephalon, midbrain and pons in seven Alzheimer's and three age-matched normal brains. The antibody sensitively stained the many tangles, and senile plaques, in the cerebral cortex of the Alzheimer's brains and the few tangles and senile plaques in the aged normal cortex. Ten subcortical nuclei contained many tangles in the Alzheimer's brains. The tangles were found not only within the locus coeruleus and dorsal raphe nucleus, which often have been shown to be involved in Alzheimer's neuropathology, but also within several other nuclei not previously related to this disease. For example, tangles were found in the nucleus paranigralis, peripeduncular nucleus, medial parabrachial nucleus and several midline thalamic nuclei. All of the nuclei which contained tangles have been shown, in neuroanatomical tracing studies, to project to the cerebral cortex. These data indicate that Alzheimer's disease is a disease of the cerebral cortex and the numerous subcortical nuclei which diffusely innervate it, and are consistent with the hypothesis that the cerebral cortex is the primary target of the disease and the interconnected subcortical nuclei are secondarily affected due to retrograde transport of a cortical pathogen or failure of normal transport of a trophic agent. PMID- 3302760 TI - Neurocircuitry of two types of neurotensin-containing amacrine cells in the turtle retina. AB - The ultrastructural features and synaptic contacts of two types of neurotensin containing amacrine cells in turtle retina were examined by electron immunocytochemistry, and the retinal peptides were characterized using radioimmunoassay and high-pressure liquid chromatography. The two types of cell were distinguished on the basis of their sizes, dendritic arborizations, synaptic connections and cytoplasmic staining characteristics. Type A cells had lightly labeled cytoplasm and large vertically elongated cell bodies which gave rise to a single primary process which in turn branched and ramified as smooth tapering processes in stratum 3 of the inner plexiform layer. Type A cells received approximately equal synaptic input from amacrine and bipolar cells. Type A amacrines had much more overall synaptic input than synaptic output, and they made conventional synaptic contacts onto bipolar, amacrine, and ganglion cells. Type B cells had a much darker-staining cytoplasm and a smaller cell body which gave rise to numerous delicate beaded dendrites which arborized in strata 3, 4 and 5 of the inner plexiform layer. Type B cells received primarily amacrine and some bipolar cell input. Type B cells had equal amounts of synaptic input and output and they made conventional synaptic contacts onto amacrine, bipolar, and ganglion cells. Whereas there were numerous large vesicles (120 nm diameter) that stained for neurotensin in both types of cells, conventional synaptic vesicles (60 nm diameter) were not labeled. In several cases these large labeled vesicles appeared to fuse with the cell membrane in non-synaptic regions and release their contents into extracellular space, which suggested a non-synaptic release of the neurotensin from type A neurons. Immunochemical and chromatographic studies demonstrated that the neurotensin-related material in retina was indistinguishable from neurotensin found in brain. These results are consistent with a neuroactive role for the neurotensin present within the large vesicles. The differences in the synaptic contacts and dendritic arborizations of the two amacrine cell types suggest they play distinctive functions in visual processing. PMID- 3302761 TI - Fragments of neurologic history: Felix Vicq d'Azyr and neuroanatomy. PMID- 3302762 TI - Adrenergic dysfunction in hereditary adult-onset leukodystrophy. AB - We studied the pressor response to norepinephrine infusion in patients with an autosomal dominant adult-onset leukodystrophy. We also examined cardiovascular and catecholamine responses to insulin-induced hypoglycemia. A parallel shift to the left of the norepinephrine dose response curve, in conjunction with low baseline plasma norepinephrine levels, was consistent with denervation supersensitivity, suggesting a distal lesion of sympathetic noradrenergic neurons. Absence of the epinephrine response to insulin-induced hypoglycemia indicated that autonomic neuropathy was attended by severe adrenal medullary dysfunction. PMID- 3302763 TI - Alzheimer's and senile dementia. PMID- 3302764 TI - [Buprenorphine in cancer pain: cross comparison with pentazocine]. AB - In a randomized cross-study analgesic activity and side effects of two narcotics, buprenorphine and pentazocine, administered orally in 91 advanced cancer patients whose pain intensity varied from moderate to severe, have been compared. The number of hours of sleep and hours standing after administration of both the drugs were also assessed and in 16 patients life activity was taken into consideration. The analysis of data showed: a better pain control with buprenorphine, than with pentazocine, with a statistically significant difference of P less than 0.001; an increase in the number of hours of sleep with buprenorphine, in comparison with pentazocine, with P less than 0.001; an increase in the number of hours standing with buprenorphine, in comparison with pentazocine; as for side effects, many more patients had to stop treatment with pentazocine than with buprenorphine. PMID- 3302765 TI - Immunocytochemical labelling of horizontal cells in mammalian retina using antibodies against calcium-binding proteins. AB - Using antibodies against calcium-binding proteins immunocytochemistry revealed quantitative staining of horizontal cells in whole mount preparations. In cat both A- and B-type horizontal cells, and in monkey probable H1- and H2-horizontal cells were labelled with antibodies against parvalbumin. In rabbit and ox two types of horizontal cell were labelled with antibodies against calcium-binding protein (CaBP-28K). In ox retina processes of horizontal cells were observed descending into the inner plexiform layer (IPL). PMID- 3302766 TI - gamma-Aminobutyric acid immunoreactivity in brainstem auditory nuclei of the chicken. AB - Using an antiserum directed against gamma-aminobutyric acid (GABA), the presence of presumed GABAergic neurons is demonstrated in the chicken auditory brainstem nuclei: nucleus laminaris, nucleus angularis, superior olive, and the ventral nuclei of the lateral lemniscus. Nucleus magnocellularis contains no immunopositive neurons but numerous GABA-positive terminals surrounding the cells. Terminal labeling is also present in the other auditory nuclei, though scarcer and not always associated with cell bodies. These data suggest an involvement of GABAergic inhibition in auditory processing in the lower auditory pathway of birds. PMID- 3302767 TI - Cellular distribution of transferrin immunoreactivity in the developing rat brain. AB - The cellular distribution of immunoreactive transferrin has previously been studied in adult rat brain with the conclusion that transferrin is largely confined to oligodendrocytes, although studies in the developing rodent brain indicated some staining of neurons. Detailed investigations of a wider range of ages than studied earlier have shown that in the developing rat brain, transferrin is not only present in oligodendrocytes but also in other glial cell types and in neurons and endothelial cells. The preponderant cell type which is positive for transferrin and its regional distribution are, however, related to the age of the animal except in most circumventricular organs in which strong transferrin immunoreactivity was seen throughout the developmental period studied. PMID- 3302768 TI - Chlamydia trachomatis antigen. PMID- 3302769 TI - Centenary tribute to Sir Robert Robinson (1886-1975). PMID- 3302770 TI - Sir Robert Robinson--his contribution to alkaloid chemistry. PMID- 3302771 TI - Robert Robinson (1886-1975). PMID- 3302772 TI - Steroids and synthetic oestrogens. PMID- 3302773 TI - Sir Robert Robinson and the early history of penicillin. PMID- 3302774 TI - Nature's pathways to the pigments of life. PMID- 3302775 TI - Simple and complex lipids: their occurrence, chemistry, and biochemistry. PMID- 3302776 TI - Phase behaviour of binary mixtures of membrane polar lipids in aqueous systems. PMID- 3302777 TI - Chemical and biochemical manipulation of DNA and the expression of foreign genes in micro-organisms. PMID- 3302778 TI - Chemical systematics. PMID- 3302779 TI - Amaryllidaceae alkaloids. PMID- 3302780 TI - Fatty acids and glycerides. PMID- 3302781 TI - Fatty acid absorption by preterm infants. PMID- 3302782 TI - Clara Davis revisited. PMID- 3302783 TI - Dietary medium-chain fatty acids in adipose tissue of infants. PMID- 3302784 TI - New findings on palm oil. PMID- 3302785 TI - Nutrition classics. Cancer, July 1971: Epidemiology of cancer of the colon and rectum. By Denis P. Burkitt. PMID- 3302786 TI - Pathogenesis of alcohol-induced hypertriglyceridemia. PMID- 3302787 TI - Vitamin C stabilizes ferritin: new insights into iron-ascorbate interactions. PMID- 3302788 TI - Relationship of blood-brain-barrier glucose transport to circulating glucose supply. PMID- 3302789 TI - Function of an intestinal retinol-binding protein in the esterification of retinol. PMID- 3302790 TI - Carbohydrate taste, appetite, and obesity: an overview. AB - This paper reviews previous research on sugar appetite and sugar-induced overeating and obesity in the rat, and previews new findings reported in this issue on the rat's taste and appetite for starch and starch-derived polysaccharides. A variety of behavioral methods demonstrate that rats are very attracted to the taste of sugars. At low molar concentrations their order of preference is maltose greater than sucrose greater than glucose = fructose, while at high concentrations it is sucrose greater than maltose greater than glucose = fructose. New findings indicate that rats are also very attracted to starch derived polysaccharides, such as Polycose. In fact, Polycose is preferred to sucrose and maltose at low concentrations, and is second only to sucrose in preference at high concentrations. Furthermore, rats taste Polycose as qualitatively different from sucrose. These and other findings suggest that rats as well as other rodents have different taste receptors for sugar and starch. The role of these two taste systems in carbohydrate-induced overeating and obesity is discussed. Rats tend to overeat and become obese when fed sugar or polysaccharide diets, but this response depends critically on the form of the diet. Presenting the carbohydrate as a solution or gel supplement to the diet is much more effective in promoting hyperphagia and obesity than is presenting it as a powder supplement or as part of a composite diet. The differential response to hydrated and dehydrated foods may occur because carbohydrates are absorbed at a faster rate in hydrated forms than in dehydrated forms. The postingestive actions of carbohydrates also modulate the rat's preference for carbohydrate tastes and flavors. Other factors that influence carbohydrate appetite and intake include the availability of the carbohydrate source and the macronutrient composition of the diet. Thus, several factors in addition to taste determine the response of rats to carbohydrate foods. PMID- 3302791 TI - Carbohydrate-induced hyperphagia and obesity in the rat: effects of saccharide type, form, and taste. AB - Adult female rats were fed, in addition to chow and water, a carbohydrate source that differed in type (glucose, sucrose, or polysaccharide), form (32% solution, powder, or gel), or taste (very sweet, minimally sweet, or bitter). A control group was fed only chow and water during the 40-day experiment. The groups fed the glucose solution, sucrose solution, or one of three polysaccharide solutions (Polycose, maltose-dextrin 10, maltose-dextrin 42) all overrate and gained more body weight and fat than did the control group. The carbohydrate solution groups did not differ in their total caloric intake, weight gain, percent body fat, or basal insulin level. The polysaccharide groups, however, consumed more carbohydrate than did the sugar groups. The groups fed glucose, sucrose, or Polycose in powder form consumed less carbohydrate and total calories, gained less weight and fat, and had lower insulin levels than did the groups fed the saccharides in solution form. The powder groups did not reliably differ from the control group on these measures. Rats fed Polycose in solution form or in a solid gel form (32% Polycose + 1% agar) were similar in their carbohydrate intake, total caloric intake, weight gain, and percent body fat. Rats fed Polycose solutions that were minimally sweet (32% Polycose), sweet (0.2% saccharin + 32% Polycose), or bitter [0.05% sucrose octa acetate (SOA) + 32% Polycose] did not differ in their Polycose intake, total caloric intake, weight gain, or percent body fat. The results demonstrate that saccharide form is more important than saccharide type or taste in promoting hyperphagia and obesity in rats. The Polycose gel findings further indicate that it is the water of hydration, not liquidity that is responsible for the hyperphagia-inducing effect of carbohydrate solutions. PMID- 3302792 TI - Arthur Donaldson Smith, MD. Physician, explorer, naturalist, and diplomat--Part IV. PMID- 3302793 TI - Medicaid billing. PMID- 3302794 TI - Inching toward prospective payment for outpatient hospital care. PMID- 3302796 TI - Tapping into the medical "information explosion": easier than you think. PMID- 3302795 TI - Is there a need for cavity varnish with today's high-copper alloy? PMID- 3302797 TI - [The role of DNA breaks in the regulation of cell proliferation, differentiation and aging]. AB - The published and author's data on the involvement of DNA breaks in cell proliferation, differentiation and senescence are reviewed. During senescence, exogenous unrepaired DNA breaks are irreversibly accumulated. During differentiation, DNA breaks are also accumulated, but against the background of active reparation processes in the cell on the principle of a dynamic equilibrium between DNA breakage and reparation. When modelling the state of cell quiescence, both types of DNA breaks may take place. It is suggested that DNA breakage in the replicative complex is specific for the state of quiescence. PMID- 3302798 TI - Tumor regression after photocoagulation of malignant melanomas of the choroid: an ultrasonographic study. AB - Ultrasonography was performed in 24 eyes harboring malignant melanomas of the choroid to study tumor regression after xenon-arc photocoagulation at periodic intervals after each photocoagulation session. Ophthalmoscopically, 20 (83%) eyes revealed a complete regression of the tumor after 3 months to 3 years of treatment. However, ultrasonography revealed complete tumor regression in only 13 (65%) out of these 20 eyes while the remaining 7 (35%) 9 eyes had a residual tumor prominence of 0.75-1 microsecond. 14 (70%) out of 20 tumors were completely regressed 1 year after photocoagulation treatment. Most of the eyes revealed complete disappearance of the tumor after 3-5 photocoagulation sessions. Though 4 tumors which did not respond to photocoagulation treatment were located in the central temporal retina within the vascular arcade, no statistically significant difference could be seen between tumor regression and location of the tumor. Complete tumor regression was seen in 4 out of 5 eyes after encircling coagulation alone while 16 out of 19 eyes revealed complete tumor regression after addition of direct treatment of the tumor. Photocoagulation appeared to be a useful tool in the treatment of small choroidal melanomas. PMID- 3302799 TI - New approaches to the detection of locally produced antiviral antibodies in the aqueous of patients with endogenous uveitis. AB - A local synthesis of IgG antibodies against herpes simplex virus, cytomegalovirus, varicella-zoster virus and Chlamydia trachomatis was assayed for in aqueous humor and sera from 226 patients with various clinical types of uveitis. Comparison of the ratios of specific antibodies tested for in aqueous humor and serum (C') and the evaluation of the Goldmann-Witmer coefficient (C) to each specific antibody were simultaneously studied in each case. The combination of these two methods allowed for the diagnosis of viral uveitis in 37.7% of selected uveitis patients and in 13.27% of randomized uveitis patients. PMID- 3302800 TI - Secondary localized amyloidosis of the cornea caused by trichiasis. AB - A 43-year-old woman complained of gradual visual impairment, foreign body sensation, and a white mass in the right eye. Trichiasis and corneal excrescence were observed. A systemic examination revealed no concurrent disease; the family history was noncontributory. A lamellar keratoplasty was performed. An amyloid deposit was found in the excised specimen histopathologically. Secondary localized amyloidosis of the cornea caused by trichiasis is a rare condition. PMID- 3302801 TI - A Doppler-sonographic study in glaucoma. AB - By using dopplersonographic techniques we compared the blood flow of glaucomatous eyes to that of normal eyes. 65 glaucomatous eyes belonging to 33 patients (14 men and 19 women) of an average age of 67.1 years were compared to 38 normal eyes belonging to 19 subjects of an average age of 66.5. We investigated the ophthalmic arteries both in the supertrochlear area and in the lateral superorbital area. We discovered a high statistical difference in the examination of the blood flow velocity in the lateral superorbital area and versus the controls. It is possible that information from posterior ciliary artery flow could be obtained by the Doppler examination at that point of the orbit. PMID- 3302802 TI - A modified technique for the construction of acrylic stent for removal of oral tori. AB - A modified technique for fabricating a maxillary acrylic surgical stent has been described. This simplified technique is not only highly efficient but also simplifies the laboratory procedure. This modified technique may also be used effectively with patients who have mandibular tori. PMID- 3302803 TI - Oncogenic potential of sexually transmitted viruses with special reference to oral cancer. AB - Recent changes in social mores have been accompanied by a noted increase in the frequency of sexually transmitted diseases. Viruses that have been identified as causative agents for a large proportion of these diseases have also been associated with various malignant states. Concomitantly, the number of cases of oral cancer (considered to occur usually around or after the fifth decade of life) reportedly has been increasing among young adults. The oncogenic potential of several sexually transmitted viruses (HSV, HPV, CMV, and LAV/HTLV III) and their possible role in the development of malignant conditions, in particular oral cancer, are discussed in this review. PMID- 3302804 TI - Hodgkin's lymphoma of the oropharyngeal region: report of four cases and diagnostic value of monoclonal antibodies in detecting antigens associated with Reed-Sternberg cells. AB - In a review of more than 500 cases from the Lymphoma Registry, Department of Anatomic Pathology, University Hospital Purpan, Universite Paul Sabatier, Toulouse, France, four cases of primary lesions in the oropharyngeal region were found. There were two lesions in the palatine tonsil, one in the nasopharynx, and one in the parotid gland. The average age of the patients was 54.5 years (range, 37 to 70 years), and all patients were men. The histologic types were lymphocyte predominance (one case), nodular-sclerosis (one case), and mixed cellularity (two cases). The patients were respectively staged as IAa, IIAa, and IIIA. They were treated with radiation, chemotherapy, or both. All four patients are now free of tumor and have been followed from 18 months to more than 6 years after definitive diagnosis and appropriate therapy. Immunohistochemistry significantly contributes to the differential diagnosis of atypical Hodgkin's disease from non-Hodgkin's lymphomas, especially in extranodal sites. Dako-EMA and Leu-M1 monoclonal antibodies are reactive, respectively, with L and H variants (Dako-EMA+, Leu-M1-) in the lymphocyte predominance type (Type 1) and with Reed-Sternberg cells (Dako EMA-, Leu-M1+) in the nodular-sclerosis (Type 2), mixed cellularity (Type 3), and lymphocyte depletion (Type 4) types. PMID- 3302805 TI - Vasculature of the crista ampullaris of the rat as seen in microcorrosion casts. AB - A scanning electron microscope study of corrosion cast preparations of the vessels of the crista ampullaris was carried out in adult rats. This method shows the microvasculature of the cristae in the three-dimensional model. As a result of this technique we have been able to demonstrate on microscopical level a particular microvasculature in the septum cruciatum of the crista in rat. PMID- 3302806 TI - Antimicrobial prophylaxis in head and neck surgery. AB - In this random study, 60 patients were given either cefotaxime, or ceftriaxone as a prophylactic measure in cervicofacial surgery. Each antibiotic was administered during a 48-hour period starting 1 h before the operation. Twenty-three patients underwent major cervicofacial surgery including opening of the pharynx or the buccal cavity by the cervical route. Only a single postoperative infection was observed as a result of a salivary fistula on the 2nd postoperative day. The two antibiotics have turned out to be very efficient as short-term prophylactic treatment in cervicofacial surgery. In other respects, the much longer half-life of ceftriaxone means that a single daily dose can be given. Finally, the cost of the prophylactic treatment is smaller using ceftriaxone than cefotaxime. PMID- 3302807 TI - [Degenerative-dystrophic diseases of the hip joint with cystic reconstruction of the articulating bones]. PMID- 3302808 TI - [Use of the computer for diagnosing the sequelae of congenital hip dysplasia]. PMID- 3302809 TI - [Indications, technical characteristics and results of Chiari's pelvic osteotomy]. PMID- 3302810 TI - [Method of arthrodesis of the hip joint]. PMID- 3302811 TI - [Mental disorders in railroad workers during the heroic age of railroad development in Hungary (1846-1914)]. PMID- 3302812 TI - [Thallium scintigraphy: significance of factors influencing the sensitivity and specificity of the test]. PMID- 3302813 TI - [Jozsef Spielmann (1917-1986)]. PMID- 3302814 TI - [Centenary of the founding of the periodical Egszseg]. PMID- 3302815 TI - [The stone monument at Balatonfured commemorating Henrik Mangold]. PMID- 3302816 TI - [Plasma factors influencing prostacyclin-like activity in diabetic microangiopathies]. PMID- 3302817 TI - [Interventional ultrasound in percutaneous kidney surgery]. PMID- 3302819 TI - [Mano Herczel (1 July 1862--28 November 1918)]. PMID- 3302818 TI - [Risk of heterogeneity and recurrence in congenital hydrocephalus (ventriculomegaly)]. PMID- 3302820 TI - [Remembering Prof. Hatvani]. PMID- 3302821 TI - [Clinical test of midazolam, with special reference to left ventricular function]. PMID- 3302822 TI - [Kassak and the matter of abortion, historical background (Lajos Kassak)]. PMID- 3302823 TI - [History of the Semmelweis statue]. PMID- 3302824 TI - [Critical comments on the article, "Mandible substitution by bone transplantation and a microvascular method"]. PMID- 3302825 TI - [Ultrasonic diagnosis of inflammation of the cerebral ventricles in infancy]. PMID- 3302826 TI - [Diagnostic significance of ultrasonic examination in thrombosis of the portal venous system]. PMID- 3302827 TI - [Video-endoscopy. An electronic image-transmitting system in endoscopy of the gastrointestinal system]. PMID- 3302828 TI - [Life and achievements of Mihaly Lenhossek (1863-1937)]. PMID- 3302829 TI - [On the death of a cardiologist: Ferenc Adorjan, aged 53...]. PMID- 3302830 TI - [The Hungarian variant of the "Uplavici O phenomenon", or:The rehabilitation of Jozsef Antal Horvat]. PMID- 3302831 TI - [Computerized expert systems. Review and example of their use in gastroenterology]. PMID- 3302832 TI - [Urinary excretion of 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha) and its relation to plasma renin activity in hyperthyroidism]. PMID- 3302833 TI - [Gyula Sebestyen (1887-1954), pioneer of modern thoracic surgery in Hungary, was born 100 years ago]. PMID- 3302834 TI - [Who was the Surgeon General of Hont County 200 years ago, or was Weszpremi wrong?]. PMID- 3302835 TI - Pennsylvania Medical Society. 1987 membership directory. PMID- 3302836 TI - [Bacterial colonization of healthy and ill and/or underweight newborn infants. 1. Bacterial colonization of healthy newborn infants]. PMID- 3302837 TI - [Bacterial colonization of healthy and ill and/or underweight newborn infants. 2. Bacterial colonization of hospitalized ill and/or underweight newborn infants]. PMID- 3302838 TI - [Bacterial colonization of healthy and ill and/or underweight newborn infants. 3. Comparison of colonization flora of healthy neonates those with ill and/or underweight, effect of various factors on the kind and degree of bacterial colonization]. PMID- 3302839 TI - Cardiac arrest in children. PMID- 3302840 TI - Some historical aspects. PMID- 3302841 TI - Trazodone hydrochloride in the treatment of dysesthetic pain in traumatic myelopathy: a randomized, double-blind, placebo-controlled study. AB - Dysesthetic pain following traumatic myelopathy is characterized by diffuse burning and tingling sensations distal to the level of spinal injury. The dysesthetic pain syndrome (DPS) can compromise performance of functional abilities and inhibit participation in rehabilitation programs. Recent laboratory evidence suggests that antidepressant medications with selective inhibition of serotonin reuptake in the brain may be associated with superior analgesic effect compared to such non-selective agents as amitriptyline. Trazodone hydrochloride is a potent presynaptic serotonin reuptake blocker with few anticholinergic and cardiovascular side effects. This study was a randomized, double-blind, placebo controlled trial of trazodone hydrochloride for the treatment of DPS. Following a 2-week placebo lead-in period, patients were randomized to a 6-week course of 150 mg trazodone hydrochloride/day or placebo. Evaluations of pain quality and intensity were performed at 2-week intervals, utilizing the McGill Pain Questionnaire, Sternbach Pain Intensity Scale, and Zung Pain and Distress Index. Neurologic examination and assessment of side effects were performed at each evaluation session. No significant changes were noted in reported pain measures between patients allocated to the active drug group and those given placebo during the course of the protocol. However, significantly more patients randomized to trazodone complained of side effects and prematurely terminated their participation in the study. The results of this investigation are consistent with those of other earlier trials which indicate that such antidepressant medications as trazodone hydrochloride which selectively inhibit presynaptic reuptake of serotonin, may not be effective in the control of certain pain syndromes. These results do not preclude the possible utility of these agents in the treatment of other pain syndromes or at higher doses than previously studied. PMID- 3302842 TI - Relaxation training as a treatment for chronic pain caused by ulcerative colitis. AB - Relaxation training was found to be highly successful in ameliorating pain in a population that has not been studied before--individuals with ulcerative colitis. Twenty subjects with chronic pain due to ulcerative colitis received 6 weekly training sessions of 75 min duration in the technique of progressive relaxation, and another 20 subjects with the same condition constituted an attention control group. There were no significant differences between experimental and control subjects before treatment but, immediately after treatment and also at the 6-week follow-up, experimental and control subjects differed significantly on 6 of 7 measures. By comparison with control subjects, experimental subjects: used significantly fewer words on the McGill Pain Questionnaire to describe their pain (P less than 0.001); rated their pain, on a scale of 1-10, as less intense (P less than 0.02); said that their pain was less frequent (P less than 0.04); rated their pain relief, on a scale of 1-10, as greater (P less than 0.001); reported, on the Zung Pain and Distress Scale, less distress due to pain (P less than 0.001). After treatment but not before there were significantly fewer experimental than control subjects taking anti-inflammatory drugs (P less than 0.03). PMID- 3302843 TI - PAG stimulation does not affect primary antibody responses in rats. AB - Adult male rats, which had electrodes chronically implanted in the periaqueductal gray (PAG), were immunized with sheep red blood cells (SRBCs). The number of direct and indirect plaque-forming cells (PFCs) in the group receiving PAG stimulation after immunization did not differ significantly from that in the unstimulated group. Thus, the results indicate that short-term PAG stimulation does not suppress antibody-producing activity in the rat. PMID- 3302844 TI - [Experimental evaluation of the biliary tract passage of ceftriaxone and its hepatic disposition]. AB - The biliary elimination of ceftriaxone was studied by an isolated perfused rabbit liver model (n = 5). After adding of 10 mg of this antibiotic to the circulating blood of this preparation, a mean biliary peak level reaching 120.5 +/- 24.6 micrograms/ml was obtained between the 30th and 60th minutes. The total amount of ceftriaxone eliminated unchanged in the bile collected during a 3h period represents 8.8 +/- 2.6% of the administered dose. At the end of this study period, 32.7 +/- 3.3% of the initial dose remained in the circulating blood. The hepatic tissue concentrated 3.7% of the whole dose. At last, control experiments proved that 36.4% of the added antibiotic has been degraded by the experimental system itself. Thus the remaining 18.4% can be attributed to a hepatic biotransformation of ceftriaxone. PMID- 3302845 TI - [Comparison of the diffusion of ceftriaxone in digestive surgery after a single administration at doses of one and two grams]. AB - Twenty patients undergoing gastrointestinal surgery were randomly allocated to receive either 1 or 2 g of ceftriaxone, a long half-life third generation cephalosporin, as a single dose intravenous prophylaxis on induction of anaesthesia. Plasma and tissue samples were taken 2 hours and analysed with an HPLC procedure. The results of plasma and tissue concentrations of ceftriaxone showed that 1 g dosage was enough for preventing the occurrence of postoperative sepsis. No adverse reaction or side-effects were recorded. PMID- 3302846 TI - [Comparative antibacterial activity of a new monobactam, carumonam (RO 17-2301, AMA 1080) on hospital bacteria resistant to beta lactams]. AB - In vitro activity of a new monobactam, carumonam (RO 17-2301, AMA 1080) was tested against 370 hospital bacterial isolates. Results were compared to aztreonam, cefotaxime, cefmenoxime, latamoxef, ceftazidime, ceftriaxone, pefloxacin against Enterobacteriaceae, to aztreonam, piperacillin, cefoperazone, cefsulodin, ceftazidime, imipenem and pefloxacin against P. aeruginosa. All Enterobacteriaceae strains produced cephalosporinases and all P. aeruginosa strains were ticarcillin resistant. MIC 90% of carumonam against Enterobacteriaceae strains was lower than 0.25 mg/l for P. mirabilis, P. vulgaris, P. stuartii, Salmonella sp., ranged from 0.25 to 0.5 mg/l for Klebsiella sp. and S. marcescens, from 1 to 2 mg/l for E. coli and P. morganii, and from 4 to 8 mg/l for C. freundii and E. cloacae. The rate of strains inhibited with 4 mg/l of carumonam was 95.3%. So carumonam was at the second place from eight tested products, after latamoxef (97.5% of susceptible strains). Carumonam was active against second generation cephalosporins resistant strains when these strains were susceptible or intermediate to cefotaxime. Strains resistant to this compound escaped to its action. Its activity against A. calcoaceticus was weak (22.6% of strains inhibited by 4 mg/l), but was superior to that of cefsulodin against ticarcillin resistant P. aeruginosa strains (54.5 versus 16.1% of susceptible strains). However carumonam was less active against this last species than ceftazidime or imipenem (92.6 and 91% of susceptible strains respectively). PMID- 3302847 TI - [Aminoside sensitivity of bacteria isolated in 1984 at the military hospital complex in the Paris region]. AB - The minimal inhibiting concentrations (MIC) of 5 aminosids have been determined by the microdilution method in liquid medium of 4,582 bacterial strains isolated from various pathological samples: 1,039 Staphylococcus, 2,629 Enterobacteria, 759 Pseudomonas and 155 Acinetobacter. The phenotype of resistance has been defined for each strain by listing the antibiotics for which a resistance was observed. The frequencies of the bacterial resistances varied according to the aminosid (gentamicin, sisomicin, tobramycin, netilmicin and amikacin) and to the species studied. For the bacterial species studied, these frequencies of resistance to the aminosid family of antibiotic were weaker in the military hospitals in the district of Paris, than in different civil hospitals where similar studies were conducted. PMID- 3302848 TI - [Comparison of the bactericidal activity of three aminosides: gentamicin, tobramycin and amikacin]. AB - Bactericidal action of antibiotics seems to be a test for the choice of antibiotic used and its dosage's adjustment. However, its use is limited by the determination's methods employed until now. By a viable bacteria counting micromethod, bactericidal action of three aminoglycosides: gentamicin, tobramycin and amikacin, is studied towards 48 bacterial strains. For each strain and each antibiotic, 11 antibiotic's concentration have been used, in a dilution range varying from 0.06 to 256 mg x l-1. Viable bacteria counting is executed after 1.5 h, 3 h and 5 hours of incubation. These antibiotics have a dose-dependent action. Regarding the smallest concentration of antibiotic permitted to lower to 3 log10 the bactericidal initial population, one can see that a concentration of 4 mg x l 1 is sufficient for 50% of strains with gentamicin and tobramycin, while a concentration of 16 mg x l-1 is necessary for amikacin. This result is corroborated by a statistical analysis carrying out by a variance analysis: it is showing a little significant difference between gentamicin and tobramycin, and very much significant differences between amikacin and the two others antibiotics. PMID- 3302849 TI - [Antibacterial activity of enoxacin in vitro and in urine]. AB - Minimal inhibitory concentrations (MIC) of enoxacin (ENO) were evaluated by agar dilution, in comparison with MIC of nalidixic acid (NAL), pipemidic acid (PIP), oxolinic acid (OXO), pefloxacin (PEF), norfloxacin (NOR), ofloxacin (OFL) and ciprofloxacin (CIP), for eleven Enterobacteriaceae reference strains chosen as a function of sensitivity and level of resistance to NAL. In the four strains susceptible to NAL, MIC of ENO (0.06 to 0.25 micrograms/ml) were similar to those for PEF and NOR, 2 to 4 times inferior to those for OXO, 16 to those for PIP and 32 to those for NAL; this ratio of activity was also seen in the majority of strains resistant to NAL. Measurement of MIC of ENO for 397 recent clinical isolates confirmed efficacy of this substance against Enterobacteriaceae and showed its activity against Pseudomonas aeruginosa (mode MIC: 0.5-1 micrograms/ml), and Gram positive cocci, essentially Staphylococcus aureus (mode MIC: 0.5-1). Antibacterial activity in the urine was measured by the Heilman test in 5 male adults after two doses of 200 mg of ENO administered at 12 hours intervals, two doses of 400 mg of ENO and, in comparison two of 400 mg of PIP administered under the same conditions. Maximal inhibitory dilutions obtained with ENO reached (mean for 5 subjects): 1/64 to 1/128 after 200 mg and 1/128 to 1/512 after 400 mg for a sensitive Providencia strain (MIC ENO: 0.25); 1/32 to 1/128 and 1/64 to 1/256 for an E. coli strain of low level of resistance to NAL (MIC ENO: 2); activity was very low on a Serratia strain highly resistant to NAL (MIC ENO: 16).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302850 TI - [Effect of subinhibitory concentrations of antibiotics on the growth level of bacteria]. AB - The effect of subinhibitory concentrations of 5 antibiotics on the growth rate of 2 bacteria (Staphylococcus aureus and Escherichia coli) has been studied. Chloramphenicol, dibekacin, netilmicin and nalidixic acid have a direct effect on the growth rate. Apparently, aminoglycosides and nalidixic acid have an accompanying effect on the affinity for the energizing substrate. Amoxicillin does not seem to be concerned by this 2 mechanisms. The interest of the estimation of the growth rate by an adaptative algorithm has been pointed out. PMID- 3302851 TI - [Synergy, addition, indifference, antagonism and dominance. Dominance and antibiotic combination]. AB - Six strains of Staphylococcus aureus have been studied using an original method which associate the chessboard's technique to that of bactericidal kinetic's. Associations of pefloxacin and rifampicin, vancomycin and fosfomycin are analysed, and result of each concentration's connection is expressed, at 1.5, 3,5 and 24 h, by a three dimensional representation, which facilitate the phenomenon's dynamic. Interpretation of these diagrams can show the classical phenomena of synergy, addition, indifference and antagonism, and also that of domination of an antibiotic in the association. This one can work, by example, by imposing its bactericidal's speed (vancomycin) or by selecting deficient surviving bacteria (rifampicin). This, the intrinsic and sometimes undesirable characteristics of some antibiotics are not masked by the others antibiotics used in the association. This mechanism must be proved in vivo, but it is sure that during physico-chemical inactivity or during diffusion's deficiency of one of antibiotics, transient relation of concentrations are favorable conditions for domination's expression. PMID- 3302852 TI - [Clavulanic acid. Its effect on Staphylococcus aureus other than its inhibitory effect on beta-lactamases]. AB - The influence of clavulanic acid (CA) on growth kinetics of Staph. aureus strains with MIC values (minimal inhibitory concentration) of penicillin (Pc) between 0,06 and 1 024 IU/ml was examined. Furthermore, it was tried to select mutants of the parent strains with increased resistance to CA and, in the affirmative case, to find out a relationship between Pc and CA resistance. The experiments showed that CA in subinhibitory concentrations induced a considerable increase of the latent phase of Pc sensitive strains but less of the Pc resistant ones. CA delayed also the generation time but this effect was apparently independent of Pc resistance. Successive subculturing of strains in gradually increasing CA concentrations resulted in an increase of CA resistance by a factor of 4 to 8 compared with that of the parent strains. In parallel, the Pc resistance increased by a factor of 16 to 64, however only in case of strains originally sensitive to Pc. A synergistic or additive effect of CA and Pc evaluated by the index of the fractional inhibitory concentration (IFIC) was not only shown in Pc resistant but also in Pc sensitive strains. This effect was equally demonstrable in strains with increased CA resistance. In this case, however, the MIC of Pc in the presence of CA was increased by a factor of 32 to 64 in originally Pc sensitive strains and by a factor of 2 to 4 in the originally Pc resistant ones. These results indicate a possible selection of CA resistant strains with an increased Pc resistance. PMID- 3302853 TI - [In vitro study of a ceftriaxone-fosfomycin combination on 55 strains of methicillin-sensitive and heterogeneous methicillin-resistant Staphylococcus aureus]. PMID- 3302854 TI - [Bactericidal speed of ceftriaxone and cefotaxime on 18 strains of Haemophilus influenzae]. AB - The bactericidal effect of ceftriaxone and cefotaxime was studied by killing curves on 18 Haemophilus influenzae at 2, 4, 6 and 24 h. The MIC of ceftriaxone are between 0.0012 and 0.015 mg/l. The MIC of cefotaxime are between 0.006 and 0.03 mg/l. The MBC of ceftriaxone are between 0.0012 and 0.03 mg/l. The MBC of cefotaxime are between 0.006 and 0.03 mg/l. The bactericidal effect was studied at the concentration of 0.06 mg/l; at this concentration we obtained a reduction of 4 log 10 for 3 strains in 6 hours by both drugs. In 24 h, 16 stains give a 99.99% of killing for ceftriaxone and 18 strains for cefotaxime. Our results do not show a significant difference in the bactericidal effect of the two drugs on Haemophilus. PMID- 3302855 TI - [Study of ampicillin sensitivity of 148 strains of Haemophilus influenzae isolated in 2 general hospitals]. AB - During one year, by disk diffusion, we have studied in two general hospitals, the susceptibility to ampicillin of Haemophilus influenzae isolated from various clinical specimens, CSF (2 strains), blood (1 strain), ears (6 strains), eyes (18 strains), lower respiratory tract specimens (111 strains), genital specimens (7 strains), and various other specimens (3 strains). The beta-lactamase production was researched systematically with a chromogenic test. At all 148 strains of H. influenzae were examined. Drug resistance was observed for 18 strains (12.2%). All strains produced a beta-lactamase. The study of drug resistance of H. influenzae with the regard of the age showed an higher percentage of resistant strains isolated from children than the percentage of resistant strains isolated from adults. From children, 10 out of 50 strains (20%) were resistant to ampicillin, on the other hand 8 out of 98 (8.2%) strains isolated from adults were resistant to ampicillin. PMID- 3302856 TI - [Measure by turbidimetry and bactericidal effect of the speed of action of clavulanic acid, amoxicillin and their combinations on a Haemophilus influenzae producer of beta-lactamase]. AB - The amoxicillin-acid clavulanic acid combination is known to be active on H. influenzae beta-lactamase producer. Clavulanic acid possesses its own antibacterial activity at high concentrations. As the combination of two beta lactams is sometimes antagonist, we studied the action of amoxicillin, clavulanic acid alone and in combination on H. influenzae beta-lactamase producer by kinetic turbidimetry and time-kill curve. Clavulanic acid alone has slowed down the growth at 8 micrograms/ml, has inhibited at 32 micrograms/ml and was bactericidal at 128 micrograms/ml. The amoxicillin-clavulanic acid combination (proportion 4/1) was bactericidal at 2-0.5 micrograms/ml. The speed of bactericidal activity was only slightly dependent on concentrations. The increase in biomass measured by turbidimetry has been important. As for all beta-lactams it was due to the formation of spheroplasts, non viable after 24 h. PMID- 3302857 TI - [In vitro antibacterial activity of ceftizoxime on Pasteurella and EF4]. AB - The in vitro activity of ceftizoxime, a new third-generation cephalosporin, was tested by determining minimal inhibitory concentrations (MIC) by agar dilution method, for 150 strains of genus Pasteurella and group EF4 bacteria from various sources. All the strains were susceptible to ceftizoxime and inhibited by 0.03 micrograms/ml concentration. No significant difference appeared between the 7 species and human and animal strains. Group EF4 bacteria, frequently isolated from animal bite wounds in humans, had higher MIC (O.25-1 micrograms/ml). Results were compared to those obtained with cefotaxime, cephalothin, penicillin G and ampicillin. PMID- 3302858 TI - [Activity of ticarcillin combined with different concentrations of clavulanic acid on 137 Gram-negative bacilli resistant to ticarcillin]. AB - The MIC of ticarcillin exclusively or joined with 3 concentrations of clavulanic acid: (2, 4 and 8 mg/l) was determined by agar dilution in relation to 137 bacilli resistant to ticarcillin (MIC greater than or equal to 256 mg/l) detected between 1985 and 1986 in the Bellevue Hospital in Saint-Etienne. We could study 26 Escherichia coli, 30 Klebsiella, 28 Enterobacter, 36 Serratia and 17 Pseudomonas aeruginosa. The concentration of 2 mg/l of clavulanic acid allows to lower the MIC of ticarcillin over the very large majority of strains of Escherichia coli and Klebsiella resistant to ticarcillin. In those conditions, ticarcillin becomes more active than piperacillin over those species. The concentration of 4 and 8 mg/l of clavulanic acid doesn't bring any real advantage to those bacilli. Moreover the concentrations of 2, 4 and 8 mg/l slightly change the MIC of ticarcillin on the strains of Serratia, Enterobacter and Pseudomonas aeruginosa. PMID- 3302859 TI - [Study of the sensitivity of enteropathogenic bacteria to nifurzide]. AB - Nifurzide, a synthetic antimicrobial agent of the nitrofuran group, was tested on 320 enteropathogenic bacteria. Minimal inhibition concentrations (MIC) (expressed in mg/l) were determined using the standard agar dilution technique. The MICs were excellent for Campylobacter spp. (97 strains), MIC 50:0.5, MIC 90:0.5; slightly higher for Shigella spp. (50 strains) and Aeromonas spp. (22 strains), MIC 50:2, MIC 90:4; and highest for Salmonella spp. (100 strains) and Yersinia enterocolitica (49 strains), MIC 50:8, MIC 90:8. PMID- 3302860 TI - [In vitro study of the effects of oxolinic acid at sub-inhibitory concentrations on the activity of hemagglutinins and adhesion to uroepithelial cells by Escherichia coli isolated from urine]. AB - The aim of the present study was to investigate the effects of sub-MIC doses of oxolinic acid (quinolone), widely used in the treatment of urinary tract infections, on both haemagglutinating activity and adhesion capacity of 13 Escherichia coli strains isolated from urine during acute cystitis or pyelonephritis. All these strains adhered to uroepithelial cells and showed mannose-sensitive and/or mannose-resistant haemagglutinating activity. Sub-MIC doses of oxolinic acid induced filaments in most of the bacterial cultures; however, inhibition of haemagglutination and adhesion was variable in vitro. When inhibition did take place in any one strain, both haemagglutination and adhesion were affected. These results confirm those of other authors and indicate that the effect of sub-MIC doses of a given antibiotic is strain-specific; they also indirectly show the heterogeneity of E. coli strains isolated from urine. It thus seems unlikely that, in clinical conditions, a single antibiotic is capable of reducing adhesion, given the diversity of the adhesins found in pathogenic E. coli strains. PMID- 3302861 TI - [Evaluation of the ATB system and the 32 GN tests for the identification and determination of the antibiotic sensitivity of Acinetobacter calcoaceticus var. anitratum. Comparison with the reference dilution method in a gel medium]. AB - The authors determined the susceptibility to 24 antibiotics of 95 strains of Acinetobacter calcoaceticus variety anitratum with the automated API ATB System in comparison with the agar dilution method for MIC measurement. The strains have been identified with API 32 GN (automated system) and API NE. There was a good agreement between the two sets of identification results. In susceptibility tests the discrepancies ranged from 0.86% to 3% with a mean value of 1.8%. The overall agreement was 95% between the two methods. This study allowed the authors to define susceptibility phenotypes to the three major antibiotic classes: beta lactams, aminoglycosides and quinolones. The use of 32 GN tests and ATB in the automated system seems very useful, especially in epidemiologic studies in order to analyse numerous data in a short time. PMID- 3302862 TI - [Comparative activity of 9 beta-lactamines, clindamycin and metronidazole on strictly anaerobic bacteria]. AB - The in vitro activities of amoxicillin, amoxicillin-clavulanic acid, piperacillin, cefoxitin, cefotetan, cefotaxime, cefmenoxime, ceftizoxime, latamoxef, clindamycin and metronidazole, were determined by agar dilution method for 196 clinical isolates of anaerobic bacteria. No metronidazole resistant strains could be found, 10% of tested strains were resistant to clindamycin. The majority of these strains was susceptible to amoxicillin-clavulanic acid and piperacillin; less than 10% were resistant to latamoxef, cefoxitin, cefotaxime and ceftizoxime; whereas 15 to 20% were resistant to amoxicillin, cefotetan and cefmenoxime. PMID- 3302863 TI - [Activity of fusidic acid on strictly anaerobic bacteria]. AB - Fusidic acid is a well known antimicrobial agent due to its narrow spectrum of activity against Gram positive bacteria and especially staphylococci. Therefore, it is after used preventively against bacterial infection in traumatology, but the susceptibility of anaerobic bacteria is not well known. We have studied, the in vitro activity of sodium fusidate against 147 strains of anaerobic bacteria. This antibiotic has a moderate activity against Bacteroides, more significant against Clostridium, Peptococcus et Peptostreptococcus; it has no bactericidal activity. Clostridium difficile is different from other anaerobic bacteria because of its slow MIC and its MBC near to its MIC. Fusidic acid could be proposed for the treatment of pseudomembranous and antibiotic-associated colitis induced by Clostridium difficile. PMID- 3302864 TI - [Frequency of isolation and antibiotic sensitivity of Bacteroides related to Bacteroides bivius and Bacteroides oralis]. AB - 274 strains of the Bacteroides oralis-bivius group are studied: 112 are identified to Bacteroides bivius or B. disiens, 73 to Bacteroides oralis and 49 to Bacteroides oris or Bacteroides buccae. These strains are isolated from clinical sample: gynecologic suppurations or respiratory tract infections. The susceptibility of 63 strains to 7 antibiotics were determined. Tested antibiotics were: cefalotin, cefoxitine, cefotaxime, mezlocillin, clindamycin, metronidazole and colistine. Cefalotine has a poor activity against these strains. PMID- 3302865 TI - [Implantation of Clostridium difficile in infants during antibiotherapy]. AB - In the adults, it is known that antibiotics allow colonization by C. difficile and its multiplication, in infants this facts is discussed. To study the influence of antibiotic treatment on the colonization of infants' intestinal tract by C. difficile, we searched this bacteria twice a week in hospitalized newborns since their birth. The population was divided in 2 groups: one never received any antibiotic, the other was treated with beta-lactams. C. difficile was isolated on appropriated selective media, and identified by biochemical and enzymatic characters. The antimicrobial susceptibility of the isolated strains was determined by broth dilution method and by broth disk-elution method. In the 2 groups the results did not significantly differ: the colonization rates are 41% in the treated group and 46% in the untreated one. The susceptibility of the strains to the tested antibiotics was similar in the 2 groups. In the environmental and dietetic conditions of our study, the infants' colonization by C. difficile seems to be independent of the antibiotic treatment. PMID- 3302866 TI - [Importance of the study of the minimal bactericidal time of serum in the choice of optimal treatment of neonatal septicemias]. AB - Rapid eradication of bacteria in bloodstream is critical for the outcome in neonatal bacterial sepsis. Two groups of neonates with E. coli K1 sepsis without purulent meningitis were studied. Group I (n = 14) received cefotaxime IV (100 mg.kg-1 D-1) plus netilmicin (4 mg.kg-1 D-1); group II (n = 8) received amoxicillin/clavulanic acid IV (100/10 mg.kg-1 D-1) plus netilmicin (4 mg.kg-1 D 1). Both groups were identical. For all strains MICs of cefotaxime, amoxicillin/clavulanic acid, netilmicin were less than 0.2, 4 and 1 mg/l respectively. Serum bactericidal activity (SBA) was determined for each patient (peak sample). The SBA was defined as the greatest dilution in which 99,99% of the inoculum was killed. Time-kill curves were performed with 1:16 dilutions of peak serum samples to measure the kinetic of bacterial killing. The minimal bactericidal time of serum (MBTS) was defined as the minimal time required to observe a decrease of more than 4 log CFU/ml of the bacterial inoculum. Samples (10 microliters) were taken at 1 h intervals over a 6 h period and at 24 h for quantitative culture. All patients cured. Median SBA were respectively 1/128 and 1/64 for group I and II. However, mean MBTS for groups I and II were respectively 1.2 h +/- 0.8 and 3.9 h +/- 1.4. Killing was more rapid in group I (p less than 0.01). The MBTS may be a clinically useful adjunctive test when optimal therapy would be expected. PMID- 3302867 TI - [Ceftriaxone and severe infections in medical resuscitation]. AB - Ceftriaxone was used in 24 medical intensive care patients to treat 8 pulmonary infections, 12 septicaemias, 3 urinary tract infections, 1 meningitis. It was administered at a single intravenous dose of 2 g every 24 h. The therapy was successful, clinically and bacteriologically in 16 patients. The reasons of the failures are analysed. Plasma concentrations were obtained: they demonstrate that ceftriaxone is effective when given once a day in most cases. PMID- 3302868 TI - [Comparison of the efficacy of cefotaxime alone and the combination cefazolin tobramycin in the treatment of enterobacterial septicemia]. AB - In a prospective, randomized study we compared cefotaxime (C) with tobramycin plus cefazolin (C + T) in the treatment of Enterobacterial septicemia. Twenty five patients received C and twenty two C + T. There are 8 treatment failures, in C + T group, 3 in C group. We observed 5 adverse effects, 2 in the C group (1 reversible collapse and 1 Pseudomonas aeruginosa superinfection) and 3 in the C + T group (acute renal failures). We conclude that C may be more effective and less toxic than cefazolin plus tobramycin for patients with Enterobacterial septicemia. PMID- 3302869 TI - [Pseudomonas cepacia septicemias: therapeutic difficulties]. AB - From Summer 1983 to Summer 1986, 34 cases of septicemia due to Pseudomonas cepacia could be detected in several intensive care units in the university hospital in Clermont-Ferrand (France). Intravascular catheters can be involved in the inoculation of this bacterial agent: a previous respiratory tract infection or a drained abscess can be the portal of entry of the bacteremia. Three patients died from the septicemia and the overall prognosis of the intensive care patients looks significatively worsened. The removing of the catheters and drains, the opening of an infected collection were useful but not sufficient to overcome. The choice of a good antibiotic was not easy; only ceftazidime, minocycline and cotrimoxazole have a fair activity in vitro. We only assessed the good results of ceftazidime. Pseudomonas cepacia is also resistant for many antiseptics. The large use of disinfecting procedures in intensive care units promotes the diffusion of this bacteria. PMID- 3302870 TI - [Treatment of bacterial infections by ofloxacin. 42 cases]. AB - Fourty-two patients with 44 infective sites were treated with ofloxacin alone (22) or associated with an other antibiotic (20). Thirty-five patients (83%) and 37 infective localisations (84%) were cured. The treatment efficacy was similar for ofloxacin alone or associated, and for treatments given with first or second intent. All non-documented infections were cured. Two of the 4 failures were pneumococcal. So, the non-documented infections, the genital and urinary tract infections, the pulmonary infections (second intent) and osteitis seem to be the best indications of ofloxacin therapy. PMID- 3302871 TI - [Antibioprophylaxis of Meningococcus group B meningitis. Must we implicate the use of the spiramycin]. AB - A fatal meningitis due to a spiramycin-sensitive group B Neisseria meningitidis occurred 13 days after interruption of a prophylactic antimicrobial therapy with spiramycin. The efficacy of recommended antimicrobial preventive treatment is discussed with regard to this case, other published cases and to the known partial and short term eradication of the naso-pharyngeal carriage of Neisseria meningitidis. PMID- 3302872 TI - [Treatment of neuro-meningeal listeriosis in patients over 60 with a combination of ampicillin and trimethoprim-sulfamethoxazole]. AB - An open retrospect study, including five patients, has been entered on, in order to estimate the efficacity and the tolerance in a more than sixty years old person, of the association ampicillin-cotrimoxazole for the treatment of the meningitis due to Listeria monocytogenes. In the infectious sphere, all the patients recovered; one death, by pulmonary embolism at the 21sh day of evolution, is to be deplored; two erythematous rashes have been observed. These preliminary results are encouraging and incite to carry on the evaluation of this protocol, which could replace the classical therapy; ampicillin-aminoglycosides, where only the ampicillin reaches effective concentrations on the level in the cerebro-spinal fluid. PMID- 3302873 TI - [Ofloxacin (RU 43280). Clinical study]. AB - Thirty-two patients were treated by ofloxacin on bacteriological documented infections. They were Enterobacterias: n = 15 (MIC less than or equal to 0.06 to 0.5 microgram/ml); Pseudomonas aeruginosa and Acinetobacter: n = 1 (MIC 0.5 and 4 micrograms/ml); Staphylococcus: n = 6 (MIC less than or equal to 0.06 to 4 micrograms/ml); Pneumococcus: n = 1; Mycoplasma: n = 1; Chlamydia psittaci: n = 2; Legionella pneumophila: n = 1; Rickettsias: n = 4 (three mediterranean fevers one query fever). Ofloxacin was given orally from 400 to 800 mg per day (5 to 15 mg/kg/day). It was used alone 26 times and on 6 occasions it was associated with rifampin on 6 staphylococcal infections. On 19 cases it was used after failure or intolerance of initial therapy. Thirty times it was the first antibiotic substance used. Results were good mainly: 1) on nine pneumonitis (enterobacterias: 4; Pneumococcus: 1; Mycoplasma: 1; Chlamydia: 2; Legionella: 1) during a mean duration of twenty days; 2) urinary infections (n:7) provoked by E. coli and Enterobacter cloacae (mean duration: 20 days); 3) 4 osteo-articular infections (mean duration: 77 days); 4) Rickettsial infections (n:4) during a mean duration of 11 days. Results are particularly noteworthy because patients treated had severe infections: 12 bacteremias, 1 endocarditis and 1 purulent meningitis. None severe adverse effect was observed. PMID- 3302874 TI - [Bronchial superinfection. Clinical trial of clavulanic acid-amoxicillin against josamycin]. AB - Authors report a prospective clinical an bacteriological study in 32 patients, almost with a chronic bronchopulmonary disease. A group of 16 patients was treated with the association clavulanic acid-amoxicillin (ACA) and the 16 others with josamycin (J) for an acute exacerbation of bronchitis. Pus and numeration of bacteria in expectorations were the criteria of efficacity. Better results of ACA group were assessed with 14 cures (87%) against 4 (25%) (p less than 0.001) and no failure against 4 in J group (p less than 0.05). They conclude therapy with ACA is more effective and recommended in serious acute exacerbations in chronic bronchopulmonary diseases. PMID- 3302875 TI - [Comparative study of first-line ceftriaxone and amikacin in the treatment of severe urinary tract infections in the adult]. AB - After randomization in 2 groups of 20, 40 adult patients with a severe urinary tract infection (post-urologic surgery, pyelonephritis, prostatitis, neurologic bladder dysfunction, Foley catheter) received as first-line therapy, ceftriaxone (CFX) 1 g/24 h im or amikacin (AMK) 500 mg/24 h im during at least 5 days. The clinical and bacteriological efficiency and the tolerance of the 2 agents are equivalent. In the 2 groups, all patients but one are clinically cured. In the CFX group, 2 patients had resistant organisms (E. cloacae, strepto D) to first line antibiotic. 48 hours after the beginning and at the end of the treatment, the percentage of urine sterilization was respectively 65 and 88 in the CFX group and 50 in the AMK group. In both groups, 60% of the patients showed negative first-month follow-up urine specimen. Underlying urinary tract pathology contributed to persistence of the original infecting organism, reinfection or relapse; the responsible isolate remained sensitive to the first-line antibiotic. PMID- 3302876 TI - [One-dose treatment of male gonococcal urethritis by ofloxacin]. AB - Ofloxacin is a new fluoroquinolone with excellent in vitro activity against N. gonorrhoeae. 32 adult males with acute uncomplicated gonococcal urethritis were treated with a single-dose of orally administered ofloxacin (400 mg). 1 out of 32 isolates was penicillinase-producing N. gonorrhoeae. Urethral cultures were obtained before treatment and on day 3-5. Microbiological cure was achieved in all patients (100%). No side effects were observed. According to these results, single-dose ofloxacin therapy (400 mg) is effective and safe against uncomplicated gonococcal urethritis in adult males. PMID- 3302877 TI - [Bone infections: treatment by ofloxacin. Apropos of 10 cases]. AB - Because of its pharmacokinetic, broad spectrum and oral administration, ofloxacin can be used in the treatment of chronic bone infections. A clinical trial was performed in 10 patients with subacute or chronic osteitis (5 Staphylococcus aureus, 1 Staphylococcus epidermidis, 1 Klebsiella oxytoca, 1 Escherichia coli, 1 Serratia marcescens, 1 Pseudomonas aeruginosa). Patients were given orally 200 mg 12 hourly. Treatment duration went on from 2 to 6 months. In this trial, the evaluation was successful in the 10 cases with a delay of 2 to 13 months (m 8,9) after the end of the treatment. Prosthetic material has been taken off in 1 case out of 4 patients (prosthetic hip) because of persistaet free bacteria outflow. For one patient, a superinfection with a Pseudomonas aeruginosa resistant to ofloxacin was noticed at the second month. Bone levels (microbiological method) were between 1,3 and 9,7 mg/l and always higher to the MIC of the bacteria. Biological tolerance was satisfactory in spite of a rise of transaminase level, a transient renal disfunction whom relationship to the treatment was difficult. 3 transient photosensitivities were also noticed. PMID- 3302878 TI - [Treatment of febrile episodes in neutropenic children by ceftazidime combined with netilmicin. Results of a multicenter study apropos of 88 cases]. AB - Infection is the most important cause of mortality in leucopenic patients. A broad spectrum antibiotic therapy is imperative in febrile and neutropenic patients. In a multicentric study we have used ceftazidime (100 mg/kg/d) and netilmicin (6 mg/kg/d) in 88 children (fever greater than or equal to 38.5 degrees C, neutropenia less than 500/mm3) treated for acute leukemias (59), non Hodgkin lymphomas (13) or solid tumors (16). Median age was 7 years (2 months-16 years). In patients who continued to remain febrile, vancomycin (40 mg/kg/d) was added after 48 hours. The effective treatment was continued until a neutrophil count greater than 1,000/mm3. The first combination (ceftazidime + netilmicin) was effective in 64 children (73%) and the second combination (ceftazidime + netilmicin + vancomycin) in 11 patients. Bacteria were isolated in 39 children: Escherichia coli: 9, Staphylococcus epidermidis: 9, Staphylococcus aureus: 8, Streptococcus: 6, Pseudomonas aeruginosa: 3, Streptococcus pneumoniae: 1, Haemophilus: 1, Klebsiella pneumoniae: 1, Proteus: 1, Serratia: 1, Flavobacterium: 1. In these 39 patients, 30 became apyretic with ceftazidime and netilmicin and 6 after vancomycin. All blood culture were negative after the first combination. The median duration of antibiotic therapy was 14 days (5-9 days: 28, 10-20 days: 43, greater than 20 days: 17). There were no death, no superinfection. Tolerance was good without kidney or liver or biological perturbation. We conclude that the combination ceftazidime and netilmicin is effective in neutropenic children. PMID- 3302879 TI - [Treatment of peritonitis in kidney failure patients under continuous ambulatory peritoneal dialysis by pefloxacine. Results and pharmacokinetics]. AB - Pefloxacin was used as monotherapy in 15 cases of peritonitis occurring in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Antibiotic administration was made intravenously on day 1 (800 mg) and from day 2 to day 4 (400 mg/day), then orally during 10 days (400 mg/day). The dosage of 400 mg gave a mean serum concentration peak (11.2 mg/l) and valley (5.4 mg/l) on the second day and a mean dialysate level of 5 mg/l. The last mean serum concentration (J14) were 5.5 mg/l (peak) and 2.5 mg/l (valley) and the mean dialysate level was 2.6 mg/l. Ten of these patients were cured. We explained pefloxacin therapy failure in two cases by resistant strains (S. sanguis and S. bovis), in one case by an acquired resistance during treatment (S. epidermidis), in an other case by catheter contamination; and in the last case, clinical failure occur despite good sensitivity with in vitro-test (Acinetobacter). PMID- 3302880 TI - [Clinical study and effect of nitroxoline on fecal flora in children]. AB - Twelve children (mean age: 4) are treated in practice office with nitroxoline (200 mg/kg/24 h) during 10 days for urinary tract infection. A study on the effect of nitroxoline against the fecal flora is undertaken in a group of 21 children who receive nitroxoline during 4 days or a long period. Bacteriological and clinical efficacy is checked when urinary concentrations of nitroxoline are greater than 16 mg/l. The results show 8 clinical and bacteriological success one true failure and 3 failure due to a non-compliance to the treatment. No qualitative and quantitative modification of the fecal flora is observed after treatment with nitroxoline. PMID- 3302881 TI - [Influence of vancomycin by venous route on salivary and fecal aerobic floras]. AB - An IV vancomycin treatment induces a reduction of Gram positive cocci (Staphylococcus, Enterococcus) of the aerobic salivary and fecal flora. Some of these strains persisted during and after treatment, but remained susceptible to vancomycin. Others isolated Gram positive cocci were resistant to vancomycin before and after treatment. They were identified as Pediococcus sp., and Leuconostoc sp. There is a reduction of the number of Gram positive cocci, without increase of Gram negative rods, Lactobacillus, or Candida which are always resistant to vancomycin. PMID- 3302882 TI - [Basic mechanisms of the pathogenesis of hemorrhagic shock]. PMID- 3302883 TI - [Disorders of the suspension stability of the blood in burns]. PMID- 3302884 TI - [Histological study of carcinoma of the prostate in patients 51 to 90 years of age. Analysis of 1101 cases of hypertrophic prostate using the step section technique and review of the bibliography]. PMID- 3302885 TI - [Disseminated histiocytosis X. Morphology and immunohistochemistry in 11 autopsy cases]. PMID- 3302886 TI - [Tamm-Horsfall protein. Histological and immunohistochemical study of renal and lymph node pathological deposits]. PMID- 3302887 TI - [Carcinoembryonic antigen (CEA) in carcinoma of the upper urinary tract and bladder. Immunohistochemical study]. PMID- 3302888 TI - Phagocyte functions and defects: a ten-year update. PMID- 3302889 TI - Humoral immunodeficiency: a review. AB - Humoral immunodeficiency is a heterogeneous group of rare disorders. The availability of IVGG has meant significant improvement for many patients, but infections continue to occur even on Ig replacement therapy. This may be partially due to associated T cell defects, the inability of current therapy to provide antibody effectively to mucosal surfaces, or the difficulty of providing antibody of sufficiently high titer, affinity, or specificity during infection. A combination of maintenance Ig replacement coupled with increased amounts of Ig and appropriate antibiotics during specific infections remain the mainstays of current therapy. PMID- 3302890 TI - Advances in the correction of immunodeficiency by bone marrow transplantation. PMID- 3302891 TI - Diagnostic approach to the newborn with ambiguous genitalia. AB - When assessing an infant with ambiguous genitalia, there are some important points to remember: Do not delay the evaluation of a patient with ambiguous genitalia. A delay may expose the patient unnecessarily to a life-threatening situation, such as a salt-losing crisis associated with 21-hydroxylase deficiency or one of the testosterone biosynthetic defects. Also, it is unfair to expect the family to be able to deal emotionally with the uncertainty of unresolved gender assignment. Never perform a buccal smear. There is absolutely no indication for performing a buccal smear at any point in the evaluation of any patient with ambiguous genitalia. Use of a buccal smear to determine gender assignment was helpful decades ago, before analysis of human chromosomes was possible. With current cytogenetic methodologies that can detect chromosomal mosaicism and subtle abnormalities of the X and Y chromosomes, there is never an indication to perform a buccal smear. Never make a gender assignment on the basis of the appearance of the external genitalia alone. The chromosomal sex and gonadal sex need to be determined first. The parents' feelings regarding the desired sex of the child, gender identity and fertility need to be discussed. Once there are sufficient data, gender assignment can be made. Gender assignment should be made as soon as possible after birth, but absolutely should be made by 18 months of age, when children develop gender identity. Never equivocate in the assignment of gender. The parents and the physicians must be absolutely certain of the gender assignment and must view their decision as final. Follow-up visits with the family ideally include an assessment of their acceptance of the gender assignment of the child. If there is ambivalence, steps must be taken to identify the source of ambivalence and to clarify the issues. PMID- 3302892 TI - Disorders of adrenal steroidogenesis. AB - This article reviews the processes of normal adrenal function, including the three main classes of hormones. From there it describes reduced or absent enzyme activity in the stages of steroid synthesis, and proceeds to outline the enzyme deficiency responsible for the clinical effects that manifest themselves in characteristic metabolic disturbances. PMID- 3302894 TI - Evaluating the child with short stature. AB - Short stature is a common pediatric problem that requires us to decide whether a child's small size represents only normal variation or indicates the presence of an underlying disease. In a population of children two standard deviations (SD) below the mean for height (below the third percentile), about 20 per cent may be expected to have pathologic short stature with the remaining 80 per cent about equally divided between familial short stature and constitutional growth delay. In contrast, most children three SD below the mean for height have pathologic short stature. Set forth in this article is an orderly approach to identify normal variants of short stature and to investigate the causes of pathologic short stature. PMID- 3302893 TI - Nonclassic adrenal hyperplasia due to 21-hydroxylase deficiency. AB - Nonclassic adrenal hyperplasia due to 21-hydroxylase deficiency (21-OHD) is an autosomal recessive disorder distinguished from classic 21-OHD by clinical and hormonal criteria. It is most often described as a disorder of adrenal steroidogenesis with onset of virilization in late childhood, peripubertally or postpubertally. An overview of adrenal steroidogenesis is presented elsewhere in this publication. It is the aim of this article to focus on the clinical and hormonal manifestations of the disorder, with discussion of the current methods of diagnosis and management. Recent advances in classic and molecular genetics will follow. PMID- 3302895 TI - Psychosocial correlates of short stature and delayed puberty. AB - Studies relating to the psychosocial aspects of short stature and pubertal delay are reviewed. Although IQ scores show a statistical correlation with stature, significant intellectual, psychological, or academic deficits have not been consistently demonstrated for short children. However, hypopituitary growth failure is associated with poor social adjustment as an adult despite growth hormone therapy. The reasons for this remain unclear. Constitutional pubertal delay in boys can lead to social and academic problems. Treatment with a short course of testosterone can be beneficial in selected cases. Psychosocial considerations should play a major role in the treatment of short stature and pubertal delay. PMID- 3302896 TI - Treatment of short stature and delayed adolescence. AB - The treatment of growth failure in children with documented GH deficiency remains the only noncontroversial indication for GH therapy. There are increasing data suggesting that GH may be useful in treating some children with Turner's syndrome and with NVSS. Further studies, however, are necessary to evaluate the long-term efficacy and safety of GH therapy in these children. The treatment of non-GH deficient children whose heights are within two standard deviations of the mean height for age is clearly inappropriate and should be avoided, despite parental protests. PMID- 3302897 TI - Effectiveness of newborn screening programs for congenital hypothyroidism: prevalence of missed cases. AB - The author reviews the background information and technical developments leading to newborn screening for congenital hypothyroidism as well as the effectiveness and problems of the programs during the past decade. The success of the programs in terms of prevention of mental retardation now is clear. It is also clear, however, that a significant number of affected infants, perhaps 8 to 10 per cent of the total, can be missed in the best of screening programs. Physicians must be aware of the possibility and alert to early clinical evidence of congenital hypothyroidism. PMID- 3302898 TI - Differential diagnosis of goiter. AB - Goiters can be detected in about 5 per cent of school-aged children. Goiters appearing during childhood are the result of distinct diseases and should be investigated rather than attributed to "physiologic hyperplasia." The etiology of the diffuse goiter can often be established by clinical evaluation, performing thyroid function tests, and measurement of serum thyroid antibodies. Unlike diffuse goiters, thyroid nodules frequently require tissue examination to exclude malignancy. The goal in evaluating children with nodular goiters is to be as selective as possible in submitting children to surgery without missing cases of cancer. The decision to perform an open biopsy should be based on detecting increased risk for cancer in the medical history, physical examination, or laboratory tests as outlined in Figure 1. Ultrasonography and fine-needle aspiration of nodules are two new methods that aid in the selection of patients for surgery or a trial of thyroid hormone suppression. PMID- 3302899 TI - Autoimmune thyroid disease: an expanding spectrum. AB - Autoimmune thyroid disease classically has included Hashimoto's thyroiditis and Graves' disease. Hashimoto's thyroiditis probably also includes focal thyroiditis, fibrous thyroiditis, primary myxedema, and Hashitoxicosis as variants. Graves' disease is associated with ophthalmopathy and dermopathy, and recent evidence suggests that these manifestations are autoimmune phenomena as well. Other associated autoimmune disorders include idiopathic thrombocytopenic purpura and antigen-antibody complex nephritis. Nonthyroid endocrine autoimmune deficiency disorders also have been classified as part of the spectrum of thyroid autoimmune disease. With the recent recognition of the spectrum of autoimmune mechanisms and antibody types and methods to distinguish antibody functions or types, our understanding of postpartum and neonatal thyroid disorders has been advanced considerably. The spectrum of neonatal thyroid disorders in the infants of women with autoimmune disease relates to the levels and types of antithyroid antibodies acquired from the mother. Finally, there is suggestive evidence that nonspecific goiter, including simple adolescent goiter and multinodular goiter as well as some cases of sporadic cretinism, may be part of an even more expanded spectrum of autoimmune thyroid disease. PMID- 3302900 TI - Outpatient management of diabetes mellitus. AB - Outpatient encounters form the mainstay of managing type I diabetes mellitus in children and adolescents. Management philosophy rests on the premise that normal physical and emotional growth is attainable and long-term complications minimized by maintenance of metabolic (glycemic) control. Management principles involve a coordinated team approach of physician, nurse-educator, and dietitian interacting with the family unit to educate them in the appropriate use and adjustment of insulin regimens, to recognize and treat the Somogyi and dawn phenomena, adjustment of nutritional needs, short- and long-term monitoring via home blood glucose and glycosylated hemoglobin measurements, and clues from the history and physical examination that permit anticipatory or reactive steps to achieve the treatment goals. PMID- 3302901 TI - Hypoglycemia of infancy and childhood. AB - Hypoglycemia of infancy and childhood represents a treatable cause of mental retardation and seizures. Most neonates with hypoglycemia have transient disorders, but with persistent hypoglycemia one must consider hyperinsulinism, hypopituitarism, or hereditary hepatic enzyme deficiencies. Outside of the neonatal period, ketotic hypoglycemia is the most common cause of hypoglycemia in childhood. One cannot overemphasize the value of obtaining certain diagnostic tests at the presentation of spontaneous hypoglycemia, including blood for insulin, cortisol, growth hormone, and urine for ketone bodies. Supportive treatment with intravenous glucose to maintain the blood glucose greater than 50 mg/dl is important until a diagnosis is established allowing specific therapy aimed at the underlying disorder. PMID- 3302902 TI - Family-focused behavioral approach to weight control in children. AB - To treat the obese child or the child who is becoming obese appropriately, the clinician must determine if the adiposity is temporary or the beginning of a permanent trend that requires intervention. The concept of the "adiposity rebound" helps with this decision. The child's family is important and contributes to his or her body adiposity through both nature--an inherited metabolic tendency towards obesity--and nurture--the eating and activity environment and the family functioning. The activity level and energy intake, which although out of balance for the obese child, may not be low or excessive when compared to recommended amounts for children of that age or to that of peers. A child-family pattern can be defined in overweight children based on presence of a metabolic tendency, energy intake, activity level, and family functioning. In looking at the pattern rather than just the child's weight, the clinician can be much more effective with a weight control program, and with proper referral for changing family functioning prior to such a program if necessary. PMID- 3302903 TI - [Computer-assisted non-invasive measurement of arterial blood pressure by the oscillometric method]. PMID- 3302904 TI - [Current theories on the pathogenesis of pyelonephritis]. PMID- 3302905 TI - The search for the etiology of Kawasaki disease. PMID- 3302906 TI - Detection of group A Streptococcus: comparison of solid and liquid culture media with and without selective antibiotics. AB - Eight hundred thirty-seven consecutive throat cultures from pediatric patients were cultured comparatively on conventional sheep blood agar and selective agar containing 1.25 micrograms/ml trimethoprim and 23.75 micrograms/ml sulfamethoxazole. In two sequential studies the sheep blood agar-sulfamethoxazole trimethoprim plates were significantly (P less than 0.01) more sensitive for Group A Streptococcus (Strep-A) detection than conventional sheep blood agar plates or Todd-Hewitt broth using the fluorescent antibody-antigen detection technique. The selective plates inhibited normal upper respiratory flora but not Strep-A. An incubation time of 18 hours was significantly better than one of 4 hours for the detection of Strep-A antigen in cultures incubated in Todd-Hewitt broth alone or Todd-Hewitt-sulfamethoxazole-trimethoprim broth, resulting in a 24% increase in positives. These studies demonstrate that Strep-A detection in throat swab specimens, by either culture or antigen detection, will be influenced by the use of selective antibiotics and incubation time. PMID- 3302907 TI - Aztreonam: the first monobactam antibiotic. PMID- 3302908 TI - Identification of streptococcal pharyngitis in the office laboratory: reassessment of new technology. PMID- 3302909 TI - Three simultaneously obtained throat cultures for beta-hemolytic group A Streptococcus. PMID- 3302910 TI - Reliability of the latex agglutination test for group A Streptococcus. PMID- 3302911 TI - Rapid office tests for diagnosis of infectious diseases in children. PMID- 3302912 TI - Choosing among the orally administered antibiotics. PMID- 3302913 TI - Options for outpatient management of serious infections. PMID- 3302914 TI - Cryptosporidiosis or an Aesop fable for modern times. PMID- 3302915 TI - Acute respiratory infections in the developing world: strategies for prevention, treatment and control. PMID- 3302916 TI - Adverse and beneficial effects of immediate treatment of Group A beta-hemolytic streptococcal pharyngitis with penicillin. AB - One hundred forty-two children with presumed Group A beta-hemolytic streptococcal (GABHS) pharyngitis were enrolled in a randomized double blind prospective study comparing the consequences of immediate penicillin treatment with treatment delayed for 48 to 56 hours. One hundred fourteen of the enrolled patients were culture-positive. An adverse impact of early antibiotic therapy was noted; the incidence of subsequent infections with GABHS was significantly greater in those treated at the initial office visit with penicillin. In the month following documented evaluation of GABHS, a recurrence occurred 2 times more frequently in those treated with penicillin immediately compared with those for whom treatment was delayed 48 to 56 hours. Late recurrences (beyond 1 month but in the same streptococcal season) occurred 8 times more frequently (P less than 0.035). Delay in penicillin treatment did not increase GABHS intrafamilial spread. Symptoms of both groups were assessed for 2 days following the initiation of treatment. Both placebo-treated and penicillin-treated groups used aspirin or acetaminophen ad libitum. Penicillin was shown to reduce fever and relieve sore throat, dysphagia, headache, abdominal pain, lethargy and anorexia significantly beyond that achieved with aspirin or acetaminophen alone. Penicillin had no effect on culture negative cases. PMID- 3302917 TI - Ceftazidime monotherapy vs. combined therapy in Pseudomonas pulmonary infections in cystic fibrosis. AB - To evaluate whether the addition of an aminoglycoside might enhance the clinical efficacy of ceftazidime in cystic fibrosis patients with acute exacerbations of chronic Pseudomonas lung infections we carried out a prospective, comparative, randomized blind study with three schedules: ceftazidime vs. ceftazidime plus sisomicin (C/S) vs. piperacillin plus sisomicin, for a total of 60 courses of 14 days of treatment. Each treatment led to clinical and radiologic improvement with marked reduction of signs of acute infection. Statistically there was no significant difference in clinical responses among the schedules. No side effect appeared during treatments with ceftazidime or C/S. Hyperpyrexia was seen in 35% of patients receiving piperacillin. Decrease in Pseudomonas aeruginosa count to less than 10(5) colony-forming units/ml of sputum was achieved in 60% of patients treated with C/S and in 30% of patients who received ceftazidime or piperacillin plus sisomicin (statistically not significant). A transient increase in mean geometric minimal inhibitory concentrations for ceftazidime and piperacillin was observed at the end of the combined therapies. A larger percentage of persistent resistant strains of P. aeruginosa was seen after the combined therapies. We conclude that ceftazidime as monotherapy may be an effective alternative in Pseudomonas lung infections in cystic fibrosis patients. Its clinical efficacy seems not to be enhanced by the addition of an aminoglycoside, although reduction of Pseudomonas in the sputum was better achieved by the combination of C/S. PMID- 3302918 TI - Comparative efficacies of erythromycin-sulfisoxazole and cefaclor in acute otitis media: a double blind randomized trial. AB - A prospective double blind trial compared the fixed combination of erythromycin sulfisoxazole (E/S) with cefaclor in the treatment of acute otitis media. One hundred nineteen children in six centers across Canada were studied. Diagnostic tympanocentesis of 134 ears yielded 135 bacterial isolates: Streptococcus pneumoniae (42%); Haemophilus influenzae (21%); Branhamella catarrhalis (10%); Streptococcus pyogenes (5%); and other bacteria (22%). Seventy-seven percent of strains of B. catarrhalis and 14% of strains of H. influenzae were beta-lactamase producers. E/S exhibited greater in vitro activity against H. influenzae and B. catarrhalis. Twenty-three patients had bacteriologically sterile middle ear fluid. The overall clinical outcome at Days 10 and 31 was identical in both treatment groups. Otoscopic findings improved more rapidly in the E/S group than in the cefaclor group at 10 and 31 days (P less than or equal to 0.04). In cases where pre-treatment middle ear fluid was negative on routine bacterial culture, complete cure at 10 days was observed in 75% of patients treated with E/S but only in 14% of those treated with cefaclor (P = 0.02). Side effects were infrequent and comparable between the test drugs. E/S is at least as effective as cefaclor in the management of acute otitis media and may be superior, particularly for cases not yielding bacteria on routine culture. PMID- 3302919 TI - Supportive therapy for bacterial meningitis. PMID- 3302920 TI - Laryngeal tuberculosis in childhood. AB - Laryngeal tuberculosis is an extremely rare condition in childhood, although probably less so in the underdeveloped world. We have described two cases treated concurrently in our wards. The first case showed features of a pharyngopalatotonsillar membrane, an exquisitely painful edematous pharynx and larynx and was initially sputum-negative for acid-fast bacilli. This presentation fits the hematogenous form of disease and stresses that: laryngeal tuberculosis is not confined to cases of far advanced pulmonary tuberculosis; tuberculosis should enter the differential diagnosis of pharyngeal, tonsillar and palatal lesions (especially membranoulcerative lesions); and there is a common association between laryngeal and abdominal tuberculosis. Her treatment included a 1-month course of steroids and to date (12 months after onset) she shows no signs of complications. The edematous form of laryngeal tuberculosis may be yet another indication for the use of steroids in tuberculosis. Our second patient presented with prolonged chest symptoms, initial positive sputum for acid-fast bacilli and localized granulomatous laryngeal disease, features of far advanced "adult" disease and bronchogenic laryngeal spread. Laryngeal tuberculosis usually responds rapidly to antituberculosis chemotherapy. This was clinically and endoscopically confirmed in both our cases. PMID- 3302921 TI - Etiologic diagnosis of cellulitis: comparison of aspirates obtained from the leading edge and the point of maximal inflammation. PMID- 3302922 TI - Minor head trauma in children: an intervention to decrease functional morbidity. AB - Minor head trauma is common among children and evokes strong parental reaction. Parents often rush the child to an emergency department or consult their pediatrician by telephone despite the minor nature of the injury. In a previous report we showed that children with minor head trauma appear to have limitations in their usual daily activities and a high rate of school absenteeism. This study was a prospective, randomized trial of an intervention designed to reduce this functional morbidity after head trauma. Parents in the control group (n = 168) received routine discharge instructions. Parents in the intervention group (n = 153) received a discharge interview during which the nurse gave more explicit and behaviorally oriented instructions. The nurse also called intervention parents the next day to reassure them and to urge that the children return to their usual routine. One month after the injury a questionnaire was administered by telephone to assess physical health status, social or functional limitations, and behavior problems. The majority of parents (85%) were anxious, and this was not alleviated by previous experience with head trauma. Triage nurses incorrectly rated one third of the parents as not anxious. Physical health status, role activity indices, and behavior problems, were similar for the intervention and control groups 1 month after the head injury. Subsequent morbidity was highly correlated with parental anxiety. In managing children with minor head trauma, pediatricians and emergency department physicians must focus their discharge instructions on the parent's anxiety, emphasize the minor severity of the injury, and urge that the children return to their usual routine. PMID- 3302923 TI - Does developmental content influence the effectiveness of anticipatory guidance? AB - We conducted a prospective, controlled study to evaluate the value of discussing developmental stages with mothers while providing anticipatory guidance during health maintenance visits. Eighty-three inner city mothers and their healthy, first-born infants were recruited within three days of birth and randomly assigned to either a control or intervention group. All mother-infant pairs were seen by the same pediatric provider for health maintenance visits when the infants were 2 weeks, 2 months, 4 months, and 6 months of age. At each visit, anticipatory guidance for all mothers included discussions of such age appropriate issues as nutrition, safety, sleep, and common problematic behaviors. For the 39 intervention group mothers, the basis for such information was explained through age-specific discussions of affective, cognitive, and physical development. Dependent variables measured after the 6-month visit included maternal-infant interaction; maternal perceptions of infant temperament, family adaptation and adjustment, and satisfaction with the infant's behavior and development; and maternal satisfaction with pediatric services. Analyses of variance demonstrated no significant effect of treatment group on any of the outcome measures. These results do not support the importance of routinely discussing developmental stages during anticipatory guidance and suggest that specific, age-appropriate issues may be discussed without emphasizing the developmental basis for such information. PMID- 3302924 TI - Intravenous methylprednisolone efficacy in status asthmaticus of childhood. AB - Forty-nine nonsteroid-dependent children hospitalized with status asthmaticus were randomized to receive IV placebo or methylprednisolone treatment (1 mg/kg every six hours). All patients received nebulized isoetharine inhalations and continuous IV aminophylline infusion. Twenty-four hours after admission, the methylprednisolone-treated patients demonstrated a greater rate of improvement in their clinical scoring index than did placebo-treated children. However, the duration of hospital stay was not significantly shortened. Twenty-eight of the patients performed serial bedside spirometry at 0, 12, 24, and 36 hours after admission. The methyl-prednisolone-treated patients experienced a more rapid recovery from peripheral airway obstruction as measured by forced expiratory flow rate during 25% to 75% of forced vital capacity (FEF25-75). The magnitude and rate of improvement in FEF25-75 was significantly greater at 36 hours (P less than .05) and independent of changes in peak expiratory flow rate, forced vital capacity, or forced expiratory volume in the first second of forced vital capacity. Placebo-treated patients had a higher incidence of asthma relapse within 4 weeks of discharge (eight v two relapses, P less than .05). Findings of this study indicate that IV corticosteroid therapy is beneficial in treating pediatric status asthmaticus. PMID- 3302925 TI - Children with influenza A infection: treatment with rimantadine. AB - Treatment with rimantadine of influenza in children and the potential development of resistance in clinical isolates associated with therapy have not been previously studied. We compared rimantadine to acetaminophen therapy in a controlled, double-blind study of 91 children with influenza-like illness. Of 69 children with proven influenza A/H3N2 infection, 37 received rimantadine and 32 received acetaminophen for five days. Children receiving rimantadine showed significantly greater reduction in fever and improvement in daily scores for symptoms and severity of illness during the first three days. Viral shedding also diminished significantly during the first two days but subsequently increased such that by days 6 and 7 the proportion of children shedding virus, as well as the quantity of virus shed, was significantly greater in the rimantadine group. During the seven-day study, of the 22 children in the rimantadine group with serial isolates tested, ten (45.5%) had resistant isolates compared with two (12.5%) of those with serial isolates in the acetaminophen group (P less than .03). Thus, of the total 37 children in the rimantadine group, 27% were found to have resistant isolated compared with 6% in the total group receiving acetaminophen (P less than .04). Furthermore, the mean inhibitory concentration of rimantadine increased with time in the rimantadine group (r = .4, P = .002) but not in the acetaminophen group. Rimantadine therapy, thus, appears to be significantly more effective than acetaminophen in ameliorating the clinical signs and symptoms of influenza in children. Treatment with rimantadine was also associated with increased viral shedding after the medication was discontinued and with the development of resistance in the clinical isolates, the significance of which is unknown. PMID- 3302926 TI - [Status of hemodynamics and plasma renin activity in children with vesico ureteral reflux]. PMID- 3302927 TI - [Glucose homeostasis in the neonatal period]. PMID- 3302928 TI - [Vaccination: from Pasteur to biotechnology]. PMID- 3302929 TI - Liposomes in treatment of infectious diseases. AB - In reviewing the literature about the potential of liposomes in the therapy of infections caused by protozoa, bacteria, fungi and viruses, it can be concluded that liposomal encapsulation may improve the therapeutic index of anti-infectious drugs. The improved therapeutic index may be a result of a reduction in drug toxicity and/or an enhanced drug delivery at the intracellular site of infection. Furthermore, attention is paid to the therapeutic utility of liposome encapsulated immunomodulators in treatment of infections. PMID- 3302930 TI - The influence of gamma-irradiation upon the chemical and biological properties of insulin. AB - Partially purified insulin preparations of bovine and porcine origin, were subjected to gamma-irradiation with doses ranging from 1.0 up to 25 kGy (0.1-2.5 Mrad) at 0 degrees C or ambient temperature. The susceptibility of insulin to the irradiation was determined by chromatography, electrophoresis and assay of the biological activity. The sterilizing effect of the gamma-irradiation was investigated for Bacillus pumilus as well as for artificial mixtures of lactose and several bacilli. It is concluded that the sterilizing dose for the investigated insulins was greater than or equal to 2.2 kGy. At doses up to 25 kGy at 0 degree C no specific radiolytic products were detectable, whereas the biological activity was fully retained. The content of dimers and the content of related peptides appeared to increase gradually with the irradiation dose absorbed. No effects of long-term storage could be demonstrated on biological and chemical properties of insulin after 2.2, 4.5 and 7.5 kGy. PMID- 3302932 TI - [Development and clinical evaluation of peak hold DSA]. PMID- 3302931 TI - Effects of amines, monensin and nigericin on the renin release from isolated superfused rat glomeruli. AB - Renin release (RR) in vitro has been shown to depend upon exocytosis, which is brought about by osmotically induced swelling of the acidic secretory granules. Since granule acidity has been suggested to be responsible for the exocytosis of other secretory granules (the chemiosmotic hypothesis), experiments were designed to test its possible significance in the RR from isolated superfused rat glomeruli. Each experiment comprised 5-6 series each of 14 consecutive 12 min periods. Changes in the extracellular pH from 7.4 to 7.8 by an increase in the concentration of bicarbonate inhibited the RR transiently. Alkalinization of the cell interior was achieved with weak permeable bases and ionophores. At low concentrations (5 mM NH4Cl; 0.2 mM chloroquine) the weak bases caused a delayed inhibition of the RR, while at higher concentrations (15 and 30 mM NH4Cl; 10 mM methylamine) the inhibitory effect was overlaid with a transient stimulation. 1.5 mM NH4Cl and 10 and 20 microM chloroquine had no effect. Addition of 10 microM of the Na-H ionophore monensin also caused a transient stimulation followed by a progressive inhibition. 0.1 microM monensin had no effect. The above procedures cause increases in both the granular and the cytosolic pH. The K-H ionophore nigericin will cause an increase in the granular pH but a decrease in the cytosolic pH because of the prevailing ionic gradients. Since the effect of 10 microM nigericin was similar to that of monensin, it is concluded that the above effects are due to the increase in the intragranular pH. Thus, the maintenance of a low intragranular pH is of importance for a continuous RR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3302933 TI - [Assessment of the spasm at the puncture site in transbrachial digital subtraction angiography (DSA)]. PMID- 3302934 TI - [Reminiscences about the development of photofluorography on its 50th anniversary]. PMID- 3302935 TI - Single exposure energy subtraction chest radiography in the diagnosis of pulmonary cancer. PMID- 3302937 TI - Baccalaureate and master's degree programs in nursing accredited by the NLN 1987 88. PMID- 3302936 TI - [Ultrasonographic study of gallbladder wall thickness in relation to hypoalbuminemia, liver dysfunction and ascites]. PMID- 3302938 TI - State-approved schools of nursing R.N. 1987. PMID- 3302939 TI - [Individual porcelain laminates--an alternative to composite facings and crowns?]. PMID- 3302940 TI - [Methods of evaluating residual disease in bone marrow in malignant hemopathies. Prospectives]. PMID- 3302941 TI - [Influence of stromal cells on the development of allogeneic bone marrow grafts]. AB - The development of long-term in vitro marrow culture techniques has allowed in vitro characterization of the cellular composition and functional attributes of the human bone marrow stromal microenvironment. Interest in these studies has increased because the interactions between hematopoiesis and the microenvironment through direct cellular contact or production of inhibiting or stimulating factors are better known. The role of the microenvironment in bone marrow transplantation needs further study. The main points of interest are: the role of the host microenvironment in sustaining engraftment, the influence of marrow manipulations on the microenvironment of the donor marrow inoculum, the role of the microenvironment on the establishment of complete chimerism and in the host donor interactions. PMID- 3302942 TI - [Myelofibrosis. Pathology of the microenvironment]. AB - Myelofibrosis is the most representative model of the association between the hemopoiesis failure end the abnormalities of the myeloid microenvironment. Long term culture in Dexter's liquid system is a good model for the in vitro study of myeloid differentiation. An experimental in vitro system using an irradiated under layer and aplastic patients plasma has yielded some preliminary results allowing the production of megakaryocytic colonies. Close contact between these colonies and the fibroblasts or stromal cells in the adherent layer could probably be used for the study of the interrelation between the stromal abnormalities and myeloid pathology. PMID- 3302943 TI - Effect of point mutations on in vitro transcription from the promoter for the large ribosomal RNA gene of yeast mitochondria. AB - Initiation of transcription on mitochondrial DNA of Saccharomyces cerevisiae was studied in an in vitro system with a mtRNA polymerase fraction reconstituted from separately purified components and with DNA templates containing the promoter of the gene coding for large rRNA. The effect of various point mutations in this promoter region was quantitated in assays containing a wildtype promoter in equimolar amount as internal control. Despite the strong conservation around the position at which RNA initiation occurs (ATATAAGTApuTA, initiation nucleotide underlined), none of the single point mutations abolished transcription initiation completely. Some reduce the efficiency of initiation to 10-20% compared to the wild type promoter, while others have a much less pronounced effect. A change of the A at position +4 into a G even results in a promoter up mutation. Remarkably, alteration of the A at position +1 into a G or a T affects the efficiency of initiation only slightly and initiation is maintained at the same position. PMID- 3302944 TI - Homologous recombination intermediates between two duplex DNA catalysed by human cell extracts. AB - Using as substrates, 1: the replicative form (RF) of phage M13 mp8 in which the reading frame of the lac Z' gene was disrupted by insertion of an octonucleotide, and 2: a restriction fragment one kb long, containing the functional lac Z' gene (isolated from wild type M13 mp8), we show that nuclear extracts from human cells (3 lines tested) promote the targeted replacement of the altered sequence by the functional one. Following incubation with the extracts, the DNA's were introduced in JM 109 bacteria (rec A- and lac Z'-) which were grown in presence of a colorimetric indicator of beta-galactosidase activity. Homologous recombination gives rise to the genotypical modification: lac Z'+ instead of lac Z'- in the bacteriophage DNA. This is revealed by phenotypical expression of the lac Z' gene product in replicating bacteriophage, i.e. the formation of blue instead of white plaques. The frequency of recombination (blue/total plaques) is increased by a factor of 50-80 as a function of protein concentration and of incubation time. The maximal frequency observed is 5 X 10(-5). There is no increase over the background when extracts are boiled. Electrophoresis and electron microscopy of DNA's incubated with the extracts show the formation of recombination intermediates with single strand exchange. Restriction analysis of recombined DNA confirms that the process corresponds to targeted sequence exchange. These data allow to propose three steps for homologous recombination between two duplex DNA's: i) unpairing of the two duplexes; ii) single-strand exchange and synaptic pairing; iii) resolution of the cross-junctions. The three steps correspond to those predicted by the gene conversion model of Holliday. PMID- 3302945 TI - The requirement for the A block promoter element in tRNA gene transcription in vitro depends on the ionic environment. AB - When yeast cell extracts that faithfully transcribe class III genes are provided with different electrolyte ions, the pattern of transcripts changes. A transcription unit in pBR322, silent with 0.1M potassium chloride, becomes active in the presence of 0.1M potassium acetate. This pseudogene depends on transcription factors B and C and RNA polymerase III like a tRNA gene. The transcribed region contains the only sequence in pBR322 homologous to the modified B block consensus sequence GTTCRDNNC found in normal tRNA genes. The presence of a block A sequence is less evident. When a block A deleted tRNA(GLU) gene was constructed, it behaved similarly: poorly transcribed with 0.1M potassium chloride, well transcribed with 0.1M potassium acetate. In fact, the deletion of the A block promoter element from the tRNA(GLU) gene did not dramatically lower its transcription when tested with potassium acetate, while it had a strong negative effect when tested with potassium chloride. Consequently the requirement for this promoter element is not constant but is a function of the electrolyte composition. PMID- 3302948 TI - Quest. Computers without fear. PMID- 3302947 TI - Sequence of the region 5' to the negative regulatory gene PHO80 of Saccharomyces cerevisiae. PMID- 3302946 TI - Crosslinking of elongation factor Tu to tRNA(Phe) by trans diamminedichloroplatinum (II). Characterization of two crosslinking sites in the tRNA. AB - Trans-diamminedichloroplatinum (II) was used to induce reversible crosslinks between EF-Tu and Phe-tRNA(Phe) within the ternary EF-Tu/GTP/Phe-tRNA(Phe) complex. Up to 40% of the complex was specifically converted into crosslinked species. Two crosslinking sites have been unambiguously identified. The major one encompassing nucleotides 58 to 65 is located in the 3'-part of the T-stem, and the minor one encompassing nucleotides 31 to 42 includes the anticodon loop and part of the 3'-strand of the anticodon stem. PMID- 3302949 TI - No laughing matter. PMID- 3302950 TI - Nursing Aid. Unsung heroines. PMID- 3302951 TI - Ultrasound: just a routine matter? PMID- 3302952 TI - Emily Strangford: champion of the non-professionals. PMID- 3302953 TI - Coping with chronic respiratory difficulty. AB - The major point of this article is that the pathologic process of chronic respiratory disease interacts with psychologic and psychosocial factors as determinants of the respiratory patient's quality of life. The assessment, support, and reinforcement of a patient's psychosocial assets and ability to cope with chronic respiratory difficulty can help enhance that quality. This outcome should be a primary consideration of the nurse caring for a respiratory patient despite the fact that, in this era of cost containment, improved life quality may be an outcome that is overlooked, ignored, or undervalued. PMID- 3302954 TI - Coping with hypertension. AB - Helping patients with hypertension achieve effective coping outcomes entails the implementation of multiple, autonomous nursing interventions specifically related to teaching and support. By teaching specific cognitive and behavioral strategies, the nurse assists the patient in developing effective means of incorporating the treatment regimen into a more healthful lifestyle. The supportive nursing actions help the patient make the necessary changes by providing the environment in which change may occur. As a result, the patient may reappraise the diagnosis of hypertension and its therapeutic regimen as less threatening and may consequently assume a more active role in its management. PMID- 3302955 TI - Self-care and the chronically ill patient. AB - The care of patients coping with chronic illness is a major priority and challenge to nursing. This is a result of the increased incidence of chronic illness and a recognition that effective care can significantly retard its progression and interference in the life of the patient. However, because most care in chronic illness is on an ambulatory basis, effective care is directly related to the extent to which patients practice self-care. As a result, the role of the nurse in working with chronically ill patients is less as a provider of treatment and more a facilitator of self-care by the patient. In addition, characteristics of chronic illness and treatment emphasize the complexity of factors and variables that impact on care. The model of self-care in chronic illness has been described to guide nurses in assessing the major issues that influence patients' participation in self-care. Regular assessment of patients' perceptions and circumstances relative to the variables identified by the model will guide nurses in promoting and supporting self-care by chronically ill patients. PMID- 3302956 TI - Adaptation to chronic illness. Analysis of nursing research. AB - The review of reported nursing research on chronic illness has many implications for nursing practice. Results of these studies may be implemented in many of the interventions provided for chronically ill patients. There needs to be collaboration between the researcher and practitioner to share knowledge of interventions that promote adaptation to chronic illness, and to investigate new and innovative therapies. Another contribution to nursing practice is the psychosocial variables that affect adaptation of chronically ill patients. Depending on the health problem and practice setting, nurses need to identify which variable may increase the effectiveness of their interventions and how they can best promote adaptation. Particularly noticeable was the absence of studies on the prevention of chronic illness. Although there is documented evidence of the relationship between stress and illness, and predictions that future environments will be even more stressful, a needed area for nursing research is prevention of chronic health problems. Areas such as stress management, health promotion, relaxation training, and behavior modification are timely subjects for nurses to research for prevention of these problems. There are merits to studying a particular chronic health problem in depth and in studying the commonalities among several chronic illnesses. With knowledge of both the physical and psychosocial, nurses are in an ideal position to contribute to the knowledge base of human responses to chronic illnesses. PMID- 3302958 TI - Pain: advances and issues in critical care. AB - The milieu of the critical care unit is stressful for both the patient and health care professionals. As such, it has the potential to increase pain perception in patients, and decrease the nurse's awareness of pain relief needs of the patient. Several physical and pharmacologic methods of pain relief were discussed in this article. Nontechnologic analgesia such as hypnosis and relaxation were introduced as adjuncts or alternatives to more familiar methods of pain relief. Although critically ill patients are not always able to express their discomfort, it is the responsibility of the nurse to recognize the potential for pain, and plan treatment accordingly. This article suggests several strategies for dealing with pain in critically ill patients. PMID- 3302957 TI - Issues and advances in pain control in children. AB - Increased interest in the topic of pain has resulted in pharmacologic advances that provide new possibilities for pain relief in children. It has also resulted in new nonpharmacologic therapies that are now being used more frequently with children. It is hoped that these advances will continue so that health care providers will have a larger repertoire of pain control methods effective with children, and so that the traumatic aspects of hospitalization and health care can be reduced greatly. The pain experienced by children has heretofore been on the backroads of scientific and scholarly development. As a result, we actually know very little about pediatric pain, its measurement, and its treatment. The literature and research cited previously are strikingly limited for providing a base of knowledge to guide clinical practice. We avoided a "cookbook" approach to the discussion on pain control, because there are many of those available. Instead, we presented a summary of the research that is currently available in the attempt to help nurses better recognize the limitations in what we know with certainty about this important topic. We hope that this knowledge will spur readers to examine their own beliefs and knowledge, question former assumptions about pediatric pain, and promote a more inquiring approach to assessment and management of children's pain. Pain is a multidisciplinary problem. Although health care providers from the various disciplines each approach the pain problem from different angles, each approach has its place in the overall picture of solving the problems of pediatric pain control. Nurses have been and will continue to be a vital part of clinical and scientific advancements to move pediatric pain out of the realm of mystery and into the realm of the known. PMID- 3302959 TI - The use of therapeutic touch in the management of pain. AB - Nursing by definition is in part nurturing. It is the care of human beings- people who should be viewed and treated as a unified whole, people who interact with the environment and those around them on many levels. Nursing as a profession offers a unique service to those who are ill and in pain. That service takes form in many ways, among them a deep caring for the patients. The caring component in nursing is one of the most valuable intangibles, and TT is one of the most basic of the caring skills. TT provides the patient with extra care and puts the "art" back in nursing. But TT is also something much more than that. TT is a very personal act of caring, of giving to another person. To the patient with pain, TT affirms that you care and that you are acknowledging their pain. That, in and of itself, can be a source of great comfort to someone with pain. The management of pain is a complex and inexact science at best. The pain experience is a complex and often frustrating one. Patients look to various members of the health care profession for assistance and affirmation of their pain. But there are no "magic bullets" in the treatment of pain; even TT is not a universally effective therapy. There is a great deal to learn about pain, about the treatment of pain, and about TT. The challenge now is to continue the research to better understand pain, to understand the human response to pain, and to explain the phenomenon of TT, one modality in the treatment of pain. In implementing this research effort, it is important to recognize that objective scientific information is a necessary but insufficient component in understanding pain. Subjective information, the pain experience, is just as necessary for fully understanding the problem of pain. Until research provides better approaches, the treatment of the patient with pain, regardless of modality, demands multiple approaches, a commitment to keep trying, engaging the patient in the treatment plan, and moving at the patient's pace, not that of the care giver or health care team. PMID- 3302960 TI - Trends in breast cancer mortality and diet in England and Wales from 1911 to 1980. AB - A paper in a previous volume of this journal (Ingram, DM, Nutr Cancer 3, 75-80, 1981) reported that at the beginning of World War II there was a marked decrease in breast cancer mortality in England and Wales that coincided with a marked reduction in the consumption of sugar, meat, and fat, and a marked increase in the consumption of cereals and vegetables. Reexamination of the mortality data described in that paper shows that the apparent sudden decrease in breast cancer mortality at the beginning of World War II is an artefact caused by a change in the method of selecting the cause of death from jointly stated causes, which was introduced in 1940. After adjusting for this change, trends in age-specific mortality rates are described. Breast cancer mortality rates were greater in 1980 than in 1911 in the age group of 35-84 years, but this overall increase was interrupted by a period of decreasing mortality between the 1930s and the 1950s in the age group of 50-69 years. It is possible that some of this decrease was due to dietary changes; however, the evidence is poor and other factors that affect incidence and survival must be considered. PMID- 3302961 TI - Gut-CNS peptide hormones, digestive dysfunction, and colon cancer. AB - Dietary modification as protection against coronary heart disease and diet related cancers has been recommended, yet the central nervous system (CNS) neuroendocrine control of eating behavior and digestion is poorly understood. Maintenance of nutritional homeostasis (and therefore of an ideal body weight) requires a balance between appetite and satiety that currently appears to be related to CNS-peptide hormones stimulating feeding counteracted by the release of gut satiety peptide hormones. This review stresses the importance of the composition of luminal nutrients on colonic motility and the release of peptide hormones; it also discusses the interaction of the CNS and environmental factors on colonic activity and the relationship to diet-related diseases. PMID- 3302962 TI - [Current theories on the role of fibronectin in the pathology of the respiratory system]. PMID- 3302963 TI - Stomatologic complications of bone marrow transplantation in a pediatric population. PMID- 3302964 TI - Lichens, compositae and photosensitivity. PMID- 3302965 TI - Solar exposure in the etiology of cutaneous melanoma. AB - Several lines of evidence suggest a role for solar exposure in the etiology of cutaneous melanoma. Increased incidence rates in light-complexioned, easily burning, poor tanning individuals; lower rates in Blacks and Orientals; higher rates geographically within countries as the equator is approached; and site differences by sex, which appear to be related to clothing differences, all support a role for solar exposure. Migration data and case control studies have emphasized the importance of intense exposures early in life rather than cumulative total lifetime exposure, which appears to be more important with the nonmelanoma forms of skin cancer. With the recognition of dysplastic nevi as precursors to melanoma, the causation of melanoma appears multifactored. The mechanisms by which sunlight may be involved in melanoma etiology are considered. PMID- 3302966 TI - Mutagenic response of the Ames Salmonella tester strain (TA 100) to different types of electromagnetic radiation used in dermatological therapy. PMID- 3302967 TI - [Department of Roentgenodiagnosis of the Child Health Center]. PMID- 3302968 TI - [Myelography and computerized tomography in the diagnosis of spinal cord compression in children]. PMID- 3302969 TI - [Ultrasonography in the diagnosis of sequelae of perinatal anoxia and intracranial hemorrhage]. PMID- 3302970 TI - [CT image of intraorbital diseases in children. I. Intraocular diseases]. PMID- 3302971 TI - [CT image of intraorbital diseases in children. II. Diseases of extraocular location]. PMID- 3302972 TI - [Ultrasonographic evaluation of abscess development in infants]. PMID- 3302973 TI - [Developmental anomalies of the nervous system in ultrasonography and CT images]. PMID- 3302974 TI - [Echocardiography versus angiocardiography of congenital heart defects]. PMID- 3302975 TI - [New classification of osteogenesis imperfecta]. PMID- 3302976 TI - [Unusual venous anomalies in twins]. PMID- 3302977 TI - [Evaluation of the usefulness of cardiac CT in the diagnosis of congenital anomalies of the pulmonary and systemic veins]. PMID- 3302978 TI - [Digital subtraction angiography of extracranial segments of the carotid arteries]. PMID- 3302979 TI - [Diagnostic effectiveness of CT in the detection of recent changes after injuries of the larynx]. PMID- 3302980 TI - [Computer-assisted analysis of the ultrasonographic evaluation of gallbladder contractility]. PMID- 3302981 TI - [Value of axillary lymphoscintigraphy using technetium 99Tcm Nanocoll in the diagnosis of breast cancer]. PMID- 3302983 TI - [Current teaching of radiology in graduate stomatological studies]. PMID- 3302982 TI - [In vivo proliferation of bone marrow stem cells of mice after combined long-term and acute irradiation with gamma- and X-rays]. PMID- 3302984 TI - [The main objectives of teaching graduate stomatological studies]. PMID- 3302985 TI - [Importance of the training of stomatologists in general medicine]. PMID- 3302986 TI - [Current needs of radiological diagnosis in maxillofacial and stomatological surgery]. PMID- 3302987 TI - [Program of teaching general and stomatological radiology in graduate stomatological studies in medical schools]. PMID- 3302988 TI - [Physicians against nuclear dangers]. PMID- 3302989 TI - [Preventive measures in atherosclerosis]. PMID- 3302990 TI - [Disorders of heme biosynthesis as an early indicator of liver damage caused by long-term exposure to xenobiotics]. PMID- 3302991 TI - [Anastomosis of the large intestine: effect of surgical technics and sutures]. PMID- 3302992 TI - [Primary liver cancer: epidemiologic and pathogenetic aspects]. PMID- 3302993 TI - [Edward Szczeklik]. PMID- 3302994 TI - [Amezinium in disregulation of arterial blood pressure]. PMID- 3302995 TI - [Autologous bone marrow transplantation]. PMID- 3302996 TI - [Role of copper in the physiology and pathology of the hematopoietic system]. PMID- 3302997 TI - Scoliosis: how big are you? PMID- 3302998 TI - A double blind trial of NSAID versus placebo during rehabilitation. AB - Forty patients participated in a randomized, parallel, double blind study of piroxicam, 20 mg daily, versus placebo, given orally for 10 days following open partial meniscectomy. On day 1, 3, 7, 11, and 21 after surgery the following parameters were studied: quadriceps torque measured isokinetically; patients' assessment of pain; active and passive range of motion measured with goniometer; degree of swelling and irritation of the operated knee; and efficacy of the medication. The mean values for all parameters, except for pain assessment, were in favor of the piroxicam group. This difference was most marked on day 7 and 11 and on these days highly significant. Our findings indicate that piroxicam may be able to improve early postoperative rehabilitation. PMID- 3302999 TI - Invasion of Salmonella typhimurium into the cecal wall of gnotobiotic chickens with Eimeria tenella. AB - Salmonella typhimurium was recovered from cecal contents and the cecal wall of gnotobiotic chickens infected with S. typhimurium (10(4) cfu/bird) 2, 4, 6, or 8 days after Eimeria tenella infection (5 X 10(4) oocysts/bird) and killed 1 day after S. typhimurium infection. Bacterial counts in the cecal contents of chickens killed 5, 7, and 9 days after S. typhimurium and E. tenella infection were significantly greater than those in chickens infected with S. typhimurium alone. Number of S. typhimurium in the cecal wall of birds killed 5 or 7 days after coccidial infection were significantly greater than those of birds infected with S. typhimurium alone. It appears that S. typhimurium easily invaded the cecal wall, which had been damaged by coccidial infection. PMID- 3303000 TI - The Simmons-Harvard Graduate Program in Public Health Nursing, 1953-1961: an experiment in nursing education. PMID- 3303001 TI - High-dose metoclopramide and chlorpromazine in the treatment of cisplatin-induced emesis. AB - Twenty patients with lung cancer, treated with cisplatin and etoposide, were divided into two groups at random and given antiemetic therapy consisting of either high-dose metoclopramide (MCL) intravenously (8 mg/kg over 7 hours) and chlorpromazine (CPZ) (50 mg orally), or a reduced dose of MCL (6 mg/kg over 7 hours) and CPZ (50 mg orally). Serum MCL concentrations were monitored during the infusions. In the two groups, 33% and 38% vomited during and after the courses, and antiemetic control was achieved in 83% and 75% of the patients. There was no significant difference between the groups, and side effects were negligible. MCL concentrations exceeded 0.7 microgram/ml in all patients, with great inter individual variation. PMID- 3303002 TI - Genetic instability and tumor progression. PMID- 3303003 TI - The pathology of testicular atrophy. PMID- 3303004 TI - [Bruno Bettelheim's milieu therapy approach. The orthogenic school of the University of Chicago--a model for child psychiatry and home child rearing?]. PMID- 3303005 TI - Ultrasound evaluation of pregnancies at risk for homozygous alpha-thalassaemia-1. AB - Twenty-six pregnant Chinese women who were at risk of giving birth to a fetus affected with homozygous alpha-thalassaemia-1 were examined serially by ultrasound. Six of these 26 pregnancies were affected. In one third of the affected pregnancies progressive fetal ascites appeared before 24 weeks gestation and these pregnancies were terminated. In the remaining two thirds abnormal estimated fetal weight-placental volume (EFW-PV) ratio and fetal growth retardation as evidenced by a falling biparietal diameter (BPD), femur length (FL) but a normal abdominal circumference (AC) was apparent by 28 weeks gestation. Increased transverse cardiac (TC) diameter was another consistent finding but appeared late. All these features appeared before the onset of fetal ascites. A normal EFW-PV ratio and fetal growth until 28 weeks gestation was a reassuring sign of normality. Abnormal EFW-PV ratio was the earliest sign to appear in affected pregnancies and a normal ratio until 28 weeks gestation had a 100 per cent predictive value. PMID- 3303006 TI - Incidence of fetal chromosome abnormalities in 2264 low-risk women. AB - Among a population of 6305 pregnant women, aged 25 to 34 years and estimated to be at no increased risk of genetic disease in the fetus, 4606 women participated in a randomized controlled trial of genetic amniocentesis between 1980 and 1984. In the study group having amniocentesis (2264 women), 23 fetal chromosome abnormalities (1.0 per cent) were found: eight autosomal aneuploidies, seven sex chromosome aneuploidies, seven balanced structural rearrangements and one case of a marker chromosome. The structural rearrangements and the marker chromosome were all shown to be inherited. The study group seemed representative for the whole population of younger women at low genetic risk. Therefore, a 1.0 per cent total rate of fetal chromosome abnormalities, consisting of one-third autosomal aneuploidies, one-third sex chromosome aneuploidies and one-third structural rearrangements, may be expected in the second trimester in younger low-risk women. In the same period of time, 562 women in the same age group were offered amniocentesis because of an estimated increased risk of fetal genetic disease. The total rate of fetal chromosome abnormality in this 'high-risk' group was 0.9 per cent and thus no different from the rate in the low-risk group. PMID- 3303007 TI - Misdiagnosis of omphalocele associated with Edwards syndrome and congenital heart disease. AB - We present a case in which an apparent omphalocele, diagnosed at 30 weeks gestation by ultrasound, led to identification of fetal trisomy 18 and congenital heart disease. At delivery, the fetus had the features of trisomy 18 and congenital heart disease but the omphalocele was absent. We suggest that the appearances seen are easily confused with a small omphalocele and could potentially result in unnecessary further investigations being performed. PMID- 3303008 TI - [Recommendation for uniform definition of an immunoreactive score (IRS) for immunohistochemical estrogen receptor detection (ER-ICA) in breast cancer tissue]. PMID- 3303009 TI - [Legionella pneumonia in an autopsy study sample. On the diagnosis and pathology of legionellosis]. PMID- 3303010 TI - [Immunohistologic markers in the diagnosis and prognosis of malignant melanomas]. PMID- 3303011 TI - ["Paraffinage" by Volkmar Kohler]. PMID- 3303012 TI - Monoclonal antibody GB36 raised against human trophoblast recognizes a novel epithelial antigen. AB - Monoclonal antibody GB36, which was raised against human term syncytiotrophoblastic microvilli, was found to recognize a novel epithelial antigen. The antibody immunoprecipitated several membrane proteins from BeWo (choriocarcinoma) and HT-29 (colon adenocarcinoma) cells. Under non-reducing conditions, four peptides of 180, 155, 135 and 130 kDa were revealed by SDS-PAGE analysis. Three peptides of slightly higher molecular weights were revealed under reducing conditions; these three peptides had identical pI (6.2) as shown by two dimensional gel electrophoresis. By immunofluorescence, GB36 reacted with villous cytotrophoblasts and cytotrophoblasts of chorion laeve, as well as with the basal surface of syncytiotrophoblast and amniotic epithelium. Extravillous trophoblasts of cytotrophoblastic shell in the basal plate and the cytotrophoblastic cell island were non-reactive. It is suggested that the antigen of GB36 may play a role in the polarity of epithelial cells and the adhesion of epithelial cells to extracellular matrix. PMID- 3303013 TI - [Isolation and properties of immobilized alkaline phosphatase from E. coli]. AB - Preparations of alkaline phosphatase from E. coli, immobilized on Sepharose, with a specific activity of 40-60 U/g wet weight were obtained. The immobilized enzyme was stable up to 50 degrees C; at higher temperatures it was inactivated. At 70 degrees most of the activity was lost for 1 h. The substrate (AMP) stabilized the enzyme. In the temperature range from 30 to 40 degrees C activation of the enzyme was observed, especially pronounced in the presence of the substrate. The pH optimum of the immobilized enzyme activity (7.8-8.2) is shifted towards the acid region, as compared to the soluble enzyme (8.0-8.6). The kinetic parameters for inhibition by the reaction product were determined using the integral Michaelis Menten equation. KmAMP was found to be higher in case of the immobilized enzyme as compared to the soluble one (5.02 X 10(-4) M and 1.85 X 10(-5) M, respectively), which seems to be associated with diffusion limitations. PMID- 3303014 TI - [Experience with the use of lasers in tuberculosis surgery]. PMID- 3303015 TI - [Control and correction of the formation of fibrothorax after pulmonectomy using ultrasonic echotomography]. PMID- 3303016 TI - [Acquired immunodeficiency syndrome (its clinico-morphological aspects)]. PMID- 3303017 TI - Pathophysiology of hypoxia in mice infected with Plasmodium berghei. AB - Pathophysiological significance of hypoxia in malarial infection was investigated in mice infected with Plasmodium berghei NK65. Intraperitoneal inoculation of mice with 1 X 10(7) parasitized red blood cells resulted in death of the hosts 6 7 days later. Anaemia of infected animals developed on day 4 after inoculation and oxygen affinity of whole blood, measured as P50 act pH, increased simultaneously. This change may be a physiological adaptive response to a reduction in oxygen delivery to the tissues to day 5. However, the blood oxygen supply on day 6 appeared to be deteriorating and this is thought to be an important factor contributing to the death of the host. The value of adenylate energy charge in red cells during malarial infection, however, was comparatively well-maintained. Allopurinol stimulated the multiplication of malaria parasites and seems to have induced collapse in host-parasite balance more rapidly. Decrease in blood pH and in blood oxygen transport may be important factors for the pathogenesis of the allopurinol-treated hosts. PMID- 3303018 TI - A fluorometric sensitivity test for chloroquine in Plasmodium falciparum isolates from patients. AB - A new technique for assessment of in vitro growth of Plasmodium falciparum by fluoroassay was used to determine the sensitivity to chloroquine of parasites from cases of malaria imported into Japan. The technique was reliable, giving comparable results to the Rieckmann test, and is also applicable in the field. PMID- 3303019 TI - In vitro growth and chloroquine sensitivity of Plasmodium falciparum (FCR-3 strain) in red blood cells containing HbC. AB - Freshly drawn AA and CC red cells were more suitable for in vitro development of Plasmodium falciparum than red blood cells (RBC) stored for 13 days before use. Growth rate inhibition in CC red cell cultures reached 31% in freshly drawn red cells and 57% in aged red cells of the same donor. Ultrastructural studies of CC cells revealed very important irregular cavities sometimes occupied by a granular content. Parasites in CC cells were generally normal but occasionally showed signs of functional impairment. P. falciparum growing in CC red cells was less sensitive in vitro to chloroquine than in AA red cells. This phenomenon may be explained either by the type of the hemoglobin of the host cell or to abnormal haematological parameters of the HbC homozygote donor, particularly the high proportion of neocytes. As metabolism of reduced glutathione is higher in young RBC and as chloroquine lyses parasitized RBC by reducing the regeneration capacities of this compound, the increased rate of young RBC in the CC red cell population was probably related to the decreased chloroquine sensitivity of P. falciparum growing in these cells. PMID- 3303021 TI - Polymorphonuclear leukocyte defects in infections. PMID- 3303020 TI - Babesia bovis: vaccination studies with three groups of high molecular weight antigens from lysate of infected erythrocytes. AB - A void volume fraction and fractions of mean sizes 800 kdalton and 300 kdalton were isolated by gel filtration from lysate of bovine erythrocytes infected with Babesia bovis. All fractions had good serological activity, as assayed by ELISA and IFA. Groups of four splenectomized calves were vaccinated with each fraction and then challenged, together with groups of four control calves, with a homologous strain of B. bovis. The group vaccinated with the 300 kdalton fraction showed some protection, as indicated by delayed and significantly lower parasitaemias and by a 75% survival in the group. In contrast, all animals in the relevant control group died from infection. No evident protection was obtained with the other two fractions. PMID- 3303022 TI - Host factors in early onset periodontitis. PMID- 3303023 TI - Juvenile periodontitis in Finland. PMID- 3303024 TI - Crevicular fluid and periodontal disease activity. PMID- 3303025 TI - Epithelial cells of the gingiva. PMID- 3303026 TI - Fibroblasts-bacteria interactions. PMID- 3303027 TI - Lactose permease of Escherichia coli: properties of mutants defective in substrate translocation. AB - Mutants of lactose permease of Escherichia coli with amino acid changes (Gly-24-- -Glu; Gly-24----Arg; Pro-28---Ser; Gly-24, Pro-28----Glu-Ser and Gly-24, Pro-28-- -Arg-Ser) within a putative membrane-spanning alpha-helix (Phe-Gly-Leu-Phe-Phe Phe-Phe-Tyr-Phe-Phe-Ile-Met-Gly- Ala-Tyr-Phe-Pro-Phe-Phe-Pro-Ile) are incorporated into the cytoplasmic membrane. The mutant proteins retain the ability to bind galactosides, and the affinity for several substrates is actually increased. However, the rate of active transport is decreased to 0.01% of the wild-type rate in the mutants carrying Arg-24 or Arg-24, Ser-28. Kinetic analysis demonstrates that the two mutants require 10 min to cause occupied binding sites for galactoside and H+ to change their exposure from the periplasm to the cytoplasm as compared to 50 ms in the wild type. The effect is less pronounced when these sites are unoccupied. PMID- 3303028 TI - Escherichia coli contains a soluble ATP-dependent protease (Ti) distinct from protease La. AB - The energy requirement for protein breakdown in Escherichia coli has generally been attributed to the ATP-dependence of protease La, the lon gene product. We have partially purified another ATP-dependent protease from lon-cells that lack protease La (as shown by immunoblotting). This enzyme hydrolyzes [3H]methyl casein to acid-soluble products in the presence of ATP and Mg2+. ATP hydrolysis appears necessary for proteolytic activity. Since this enzyme is inhibited by diisopropyl fluorophosphate, it appears to be a serine protease, but it also contains essential thiol residues. We propose to name this enzyme protease Ti. It differs from protease La in nucleotide specificity, inhibitor sensitivity, and subunit composition. On gel filtration, protease Ti has an apparent molecular weight of 370,000. It can be fractionated by phosphocellulose chromatography or by DEAE chromatography into two components with apparent molecular weights of 260,000 and 140,000. When separated, they do not show proteolytic activity. One of these components, by itself, has ATPase activity and is labile in the absence of ATP. The other contains the diisopropyl fluorophosphate-sensitive proteolytic site. These results and the similar findings of Katayama-Fujimura et al. [Katayama-Fujimura, Y., Gottesman, S. & Maurizi, M. R. (1987) J. Biol. Chem. 262, 4477-4485] indicate that E. coli contains two ATP-hydrolyzing proteases, which differ in many biochemical features and probably in their physiological roles. PMID- 3303029 TI - Purification and characterization of an activity from Saccharomyces cerevisiae that catalyzes homologous pairing and strand exchange. AB - An activity that catalyzes the formation of joint molecules from linear M13mp19 replicative form DNA and circular M13mp19 viral DNA was purified 1000- to 2000 fold from mitotic Saccharomyces cerevisiae cells. The activity appeared to reside in a Mr 132,000 polypeptide. The reaction required that the substrates be homologous and also required Mg2+. There was no requirement for ATP. The reaction required stoichiometric amounts of protein and showed a cooperative dependence on protein concentration. Electron microscopic analysis of the joint molecules indicated they were formed by displacement of one strand of the linear duplex by the single-stranded circular molecule. This analysis also showed that heteroduplex formation started at the 3'-homologous end of the linear duplex strand followed by extension of the hybrid region toward the 5'-homologous end of the linear duplex strand (3'-to-5' direction). PMID- 3303030 TI - Cloning of the alpha chain of human platelet glycoprotein Ib: a transmembrane protein with homology to leucine-rich alpha 2-glycoprotein. AB - Glycoprotein Ib is a surface membrane glycoprotein of platelets that functions as a receptor for von Willebrand factor. It is a heterodimer composed of an alpha and a beta chain linked by a disulfide bond(s). A phage lambda gt11 cDNA expression library prepared from mRNA from a human erythroleukemia cell line, HEL, was screened using an affinity-purified antibody to the glycocalicin portion of the alpha chain of glycoprotein Ib. Eleven positive clones were isolated and plaque-purified. The largest cDNA insert was 2420 nucleotides in length and coded for a leader sequence of 16 amino acids, a mature protein of 610 amino acids, and a stop codon. It also contained 42 nucleotides of 5' noncoding sequence and 497 nucleotides of 3' noncoding sequence, including a poly(A) tail. The amino acid sequence of the alpha chain of GPIb predicted from the cDNA agreed completely with the sequence of 156 amino acids that was determined by Edman degradation of peptides isolated from human platelet glycocalicin after digestion with trypsin or Staphylococcus aureus V8 protease. The extracytoplasmic domain of the alpha subunit of GPIb contains several noteworthy structural features, including a region of seven tandem repeats of 24 amino acids that are homologous with those present in leucine-rich alpha 2-glycoprotein. The extracytoplasmic domain also contains two hydrophilic regions, one rich in charged amino acids and a second rich in serine and threonine residues. The region rich in serine and threonine includes five repeats of nine amino acids as well as the majority of the O-linked carbohydrate sites present in the molecule. The extracytoplasmic domain is followed by a potential transmembrane segment of approximately 29 amino acids and a potential intracellular domain of approximately 100 amino acids located at the carboxyl end of the molecule. PMID- 3303031 TI - Three-dimensional structure of the bifunctional enzyme N-(5' phosphoribosyl)anthranilate isomerase-indole-3-glycerol-phosphate synthase from Escherichia coli. AB - N-(5'-Phosphoribosyl)anthranilate isomerase-indole-3-glycerol-phosphate synthase from Escherichia coli is a monomeric bifunctional enzyme of Mr 49,500 that catalyzes two sequential reactions in the biosynthesis of tryptophan. The three dimensional structure of the enzyme has been determined at 2.8-A resolution by x ray crystallography. The two catalytic activities reside on distinct functional domains of similar folding, that of an eightfold parallel beta-barrel with alpha helices on the outside connecting the beta-strands. Both active sites were located with an iodinated substrate analogue and found to be in depressions on the surface of the domains created by the outward-curving loops between the carboxyl termini of the beta-sheet strands and the subsequent alpha-helices. They do not face each other, making "channeling" of the substrate between active sites virtually impossible. Despite the structural similarity of the two domains, no significant sequence homology was found when topologically equivalent residues were compared. PMID- 3303032 TI - Structure of the reaction center from Rhodobacter sphaeroides R-26: the cofactors. AB - The three-dimensional structure of the cofactors of the reaction center of Rhodobacter sphaeroides R-26 has been determined by x-ray diffraction and refined at a resolution of 2.8 A with an R value of 26%. The main features of the structure are similar to the ones determined for Rhodopseudomonas viridis [Michel, H., Epp, O. & Deisenhofer, J. (1986) EMBO J. 5, 2445-2451]. The cofactors are arranged along two branches, which are approximately related to each other by a 2-fold symmetry axis. The structure is well suited to produce light-induced charge separation across the membrane. Most of the structural features predicted from physical and biochemical measurements are confirmed by the x-ray structure. PMID- 3303034 TI - Retraction. PMID- 3303033 TI - Expression of herpes simplex virus 1 glycoprotein B by a recombinant vaccinia virus and protection of mice against lethal herpes simplex virus 1 infection. AB - The herpes simplex virus 1 (HSV-1) strain F gene encoding glycoprotein gB was isolated and modified at the 5' end by in vitro oligonucleotide-directed mutagenesis. The modified gB gene was inserted into the vaccinia virus genome and expressed under the control of a vaccinia virus promoter. The mature gB glycoprotein produced by the vaccinia virus recombinant was glycosylated, was expressed at the cell surface, and was indistinguishable from authentic HSV-1 gB in terms of electrophoretic mobility. Mice immunized intradermally with the recombinant vaccinia virus produced gB-specific neutralizing antibodies and were resistant to a lethal HSV-1 challenge. PMID- 3303035 TI - Evidence for the existence of a luteal cell type that is steroidogenic and releases relaxin. AB - Secretion of relaxin from cultured luteal cells derived from pregnant sows was detected by a reverse hemolytic plaque assay. In this method, luteal cells are cultured in monolayers together with protein-A-conjugated ovine red blood cells. In the presence of porcine relaxin anti-serum and complement, relaxin-releasing cells become surrounded by an area of hemolysis--a plaque--which can be microscopically visualized. After fixation, these same luteal cells in monolayers were stained for the presence of 3 beta-hydroxysteroid dehydrogenase, an enzyme marker for steroidogenic cells. Cells could then be classified by their ability to form plaques (relaxin-releasing cells) and/or steroidogenic capability (positive staining). Dual-secretors (large luteal cells that were steroidogenic and released relaxin) could be identified in dispersed luteal cells derived from pigs at all stages of pregnancy examined (Day 22-112 of gestation, n = 9; term is Day 114 +/- 2 days). In addition, luteal cells were detected that were either steroidogenic only or released relaxin, and finally, cells that appeared to possess neither endocrine capability. Frequency analysis of functional subtypes indicated approximately equal representation of each in the first half of pregnancy, but an apparent fall in relaxin-releasing cells in the preparturient period. It is suggested that dual-secretors may represent one mechanism that allows the corpus luteum to express multiple endocrine function during pregnancy without the requirement for increased cell numbers. PMID- 3303036 TI - The blood flow to the islets of Langerhans in different regions of the rat pancreas. AB - Pancreatic blood flow (PBF) and islet blood flow (IBF) have been determined separately in two different regions of the rat pancreas, namely, that perfused by the superior mesenteric artery (SMA) and that perfused by the coeliac artery (CA). Although there were no differences in either the PBF or the IBF between these two regions, the IBF, when expressed as a percentage of PBF, was significantly higher in the region perfused by the SMA. It is concluded that glucose regulation of the blood flow to the islets and exocrine parenchyma is similar in the two regions perfused by SMA and CA. In the SMA region the percentage of blood supply to the islets, in relation to the acinar part, is, however, somewhat higher than in that of the CA region. PMID- 3303037 TI - Structure and function in yeast alcohol dehydrogenases. AB - The structure and kinetics of the isozymes from Saccharomyces cerevisiae (ADH I, II, III) have been compared, and the ADH I gene was specifically mutagenized in order to substitute amino acid residues of particular interest. A model of the yeast enzyme was constructed on the basis of the structure of the homologous horse liver enzyme. Steady state kinetic studies, at pH 7.3 and 30 degrees C, showed that the enzymes follow the Ordered Bi Bi mechanism. ADH II has a Michaelis constant for ethanol that is 10-fold smaller than the constants found for ADH I or III. Replacement of Met-294 (liver numbering) in the substrate binding pocket of ADH I with Leu, as found in ADH II, could be responsible for the different kinetics. However, the mutant enzyme, ADH I-Leu, had constants with ethanol that were similar to those of ADH I. Nevertheless, the Leu enzyme had better catalytic activity with longer chain alcohols than did the Met enzyme. Other substitutions must account for the differences between ADH I and II. His-47 binds the pyrophosphate of coenzyme, and replacement with Arg (as in the liver enzyme) decreases turnover numbers by 6-fold and dissociation constants for NAD+ and NADH by only 2 to 4-fold. The lower turnover number explains why yeast harboring the mutant Arg enzyme are resistant to poisoning by allyl alcohol. ADH I and ADH I-Arg have maximal activity on ethanol at pH values above a pK of about 7. Replacement of His-51 with Gln reduces activity 12-fold and abolishes the pK value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3303038 TI - Microbial aromatic alcohol and aldehyde dehydrogenases. PMID- 3303039 TI - Lung carbonyl reductase in the mouse: biochemical and catalytic properties. AB - Two major forms of aldehyde reductase (AHR) activity were resolved following zone electrophoresis of mouse lung homogenates and distinguished by their differential substrate and inhibitor specificities: alcohol dehydrogenase (ADH) C2 and carbonyl reductase (CBR). CBR was purified to homogeneity by DEAE-cellulose chromatography, affinity chromatography using Blue-sepharose, followed by gel filtration on Sephacryl S-200. The enzyme exhibited a native MW of 122,000, comprising 4 identical subunits. Kinetic and inhibition characteristics resembled those reported by Nakayama and coworkers (1982) for guinea pig lung CBR. Mouse lung CBR exhibited optimal activity at pH 5.0; a preference for NADPH as coenzyme, although reactive with NADH at an order of magnitude higher concentration; poor activity as an ADH, but was strongly inhibited by 4-methyl pyrazole; and was inhibited by quercitin, dithiothreitol and p-OH mercuribenzoate, but was insensitive to valproate or sorbinil. These properties, coupled with the activity of CBR with a range of aliphatic and aromatic aldehydes, ketones and quinones, distinguish it from other AHRs. The unique localization in lung tissue suggests a possible role for CBR in the detoxification of xenobiotics and of toxic aldehydes derived from lipid peroxidation processes. PMID- 3303040 TI - Microsomal carbonyl reductase in rat liver. Sex difference, hormonal regulation, and characterization. PMID- 3303041 TI - Granulocyte elastase and white cell counts in septic pigs. AB - Our data are consistent with the assumption that in early septicemia polymorphonuclear granulocytes are sequestered and release lysosomal elastase locally into the respiratory tract and into the circulation. PMID- 3303042 TI - Local activation of the kallikrein-kinin system in the lung following E. coli sepsis in sheep. PMID- 3303043 TI - Multitherapy: a new treatment regimen in endotoxemia. PMID- 3303044 TI - Hemodynamic consequences of multitherapy pretreatment in experimental endotoxemia. PMID- 3303045 TI - Increased hemodynamic and survival with endotoxin and septic shock with ibuprofen treatment. PMID- 3303047 TI - Endotoxin shock model in the dog: a reevaluation. PMID- 3303046 TI - Efficiency of prostacyclin in rabbit endotoxin shock. PMID- 3303048 TI - Endotoxin-induced generation of oxygen free radicals in freshly drawn human blood. PMID- 3303049 TI - Increased systemic microvascular permeability in septic shock. PMID- 3303050 TI - Differences in regional oxygen supply, oxygen consumption and blood flow during the onset of E. coli sepsis. PMID- 3303051 TI - Wound inflammatory mediators and multisystem organ failure. PMID- 3303052 TI - Modern strategies of ventilatory management in shock. PMID- 3303053 TI - Therapeutic approaches: haemodynamic and respiratory complications in septic shock. PMID- 3303054 TI - Plasma exchange in septic shock. PMID- 3303055 TI - Glucose-insulin-potassium (GIK) in hypodynamic septic shock. PMID- 3303056 TI - Effects of endotoxin and gadolinium chloride on acute septic peritonitis and septic shock in rats. PMID- 3303057 TI - Dr. Helen Ranney. PMID- 3303058 TI - Pathophysiological aspects of sickle cell vaso-occlusion. Proceedings of the Helen Ranney Symposium. Tarrytown, New York, April 30-May 1, 1986. PMID- 3303059 TI - Staphylococcus aureus V8-protease catalyzed segment exchange reaction of alpha chain of hemoglobin S: a semisynthetic approach for the preparation of variants of alpha-chain. AB - The Glu(30)-Arg(31) peptide bond of alpha-chain of hemoglobin is readily and quantitatively hydrolyzed by Staphylococcus Aureus V8-protease at pH 4.0 and 37 degrees C. This region of the alpha-chain represents a 'permissible discontinuity region' of the chain within its tertiary interactions. Protease catalyzed reformation of peptide bonds in such permissible discontinuity regions of fragment complementing systems of proteins appears to be a useful procedure for the preparation of variants of the protein. Therefore, attempts have been now made to 'restitch' the segments alpha 1-30 and alpha 31-141 using V8-protease. The alpha-amino group of alpha 1-30 was selectively dihydroxypropylated (DHP) using [14C]-glyceraldehyde to follow the protease catalyzed reformation of globin. V8-protease catalyzed the condensation of N alpha-DHP-alpha 1-30 and alpha 31-141 to generate N alpha-DHP-alpha 1 141 in the presence of 30% propanol at pH 6.0 and 4 degrees C. The synthetic yield of N alpha-DHP-alpha 1-141 is about 55% in 48 hrs and remained nearly the same even after seven days. Under the same conditions alpha-globin was digested at the Glu(30)-Arg(31) peptide bond to nearly 40%. Thus, the amount of Glu(30)-Arg(31) peptide bond formed in 48 hrs appears to be the result of an equilibrium in the V8-protease catalyzed hydrolytic and synthetic reactions. The reformation of Glu(30)-Arg(31) bond appears to be very selective. V8-protease did not catalyze the peptide bond formation in an equimolar mixture of alpha 31-141 with either alpha 1-23, alpha 1 27, or alpha 28-30 all of which have glutamic acid as the carboxy terminal residue just as in alpha 1-30. The high selectivity in the protease catalyzed formation of Glu(30)-Arg(31) peptide bond suggests that the segment alpha 1-30 of the intact alpha-globin could be exchanged with synthetic analogs of alpha 1-30 using V8-protease without actually isolating the fragment alpha 31-141. Incubation of [14C]-N alpha-DHP-alpha 1-30 with alpha-globin at pH 6.0 and 4 degrees C along with V8-protease in 30% n-propanol indeed resulted in the exchange of the segment alpha 1-30 of alpha-globin with [14C]-N alpha-DHP-alpha 1 30. This V8-protease catalyzed 'segment exchange reaction' should facilitate the preparation of alpha-chains with double mutations from the large number of naturally occurring alpha-chains with single mutation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3303060 TI - Determinants of vaso-occlusive severity in sickle cell disease. PMID- 3303061 TI - Effects of multiple low doses of flunixin meglumine on repeated endotoxin challenge in the horse. AB - Previous work has shown repeated low doses of flunixin meglumine (FM) inhibit thromboxane production in normal horses. Enhanced concentrations of thromboxane in serum occurred after the drug therapy was discontinued. Our study was performed to evaluate the effects of low doses of FM in horses repeatedly challenged with endotoxin. Group I horses received E. coli endotoxin (0.1 microgram/kg IV) at 0 and 90 h. Group II horses received endotoxin and were also treated with FM (0.25 mg/kg IV) at 2, 10, 18, 26, 34, and 42 h after the initial administration of endotoxin. Clinical signs of endotoxemia were observed in all horses, but FM treated horses recovered more rapidly. The leukopenic response after endotoxin was attenuated in Group II following the second dose. Serum thromboxane (TxB2) decreased after the initial administration of endotoxin and remained below baseline values throughout the study. Serum TxB2 concentrations were not different between the groups. Plasma TxB2 and 6-keto-PGF1 alpha concentrations were increased after the initial endotoxin injection. In Group II, plasma TxB2 levels declined rapidly after FM administration and remained low. After the second dose of endotoxin, Group I horses had a mild rise and decline in TxB2 and 6-keto-PGF1 alpha concentrations, respectively. Thromboxane B2 levels in Group II changed little after the second dose of endotoxin, but a dramatic increase in 6-keto-PGF1 alpha concentrations occurred. These results suggest that multiple low doses of FM to horses with endotoxemia cause a selective and sustained suppression of TxB2 production and an enhancement of 6-keto-PGF1 alpha. PMID- 3303062 TI - [Friedrich von Bruchhausen--principles of his academic development and influence]. PMID- 3303063 TI - [The history of the relation of Johann Bartholomaus Trommsdorff (1770-1837) to Jons Jakob Berzelius (1779-1848)]. PMID- 3303064 TI - [An appreciation of Martin Heinrich Klaproth as a mineral chemist]. PMID- 3303065 TI - The regulation of gene expression by 2,3,7,8-tetrachlorodibenzo-p-dioxin. PMID- 3303066 TI - Perspectives in platelet-activating factor research. PMID- 3303067 TI - Pharmacotherapy of psychiatric disorder in pregnancy and during breastfeeding: a review. AB - The literature in most European languages was consulted for guidelines regarding the drug treatment of psychiatrically disturbed pregnant or lactating women. The available information allows only a few conclusions. Lithium exposure during the first trimester seems to increase the risk of congenital heart disease, especially Ebstein's anomaly. As there is still insufficient evidence to prove the safeness of other psychoactive drugs for the fetus, caution seems warranted here too. A causal link between pharmacotherapy of the mother-to-be and malformation of the baby is difficult to prove. But toxic and withdrawal symptoms in infants born to women treated regularly until shortly before confinement are well documented for most psychoactive drugs. PMID- 3303068 TI - Tricyclic antidepressants in the treatment of cancer pain: a review. AB - The role of tricyclic antidepressants (TCAs) in the treatment of cancer pain is of growing interest. Various studies, all but one of them open, have suggested that TCAs are effective and safe in the treatment of pain caused by different types of cancer. The mechanisms of action by which TCAs decrease the pain perception are not fully clear. However, there are two main hypotheses. The first suggests that the drugs act primarily on the emotional component of pain, thus breaking the vicious circle of the perception of pain; the second suggests that the TCAs themselves have a specific analgesic action linked to a direct activity on the structures of the CNS. Further clinical studies, and in particular double blind studies, are clearly necessary to provide more convincing and definitive results. PMID- 3303069 TI - 1985 Douglas Lea memorial lecture. Hyperthermia in the treatment of cancer. AB - There are sound biological reasons for using hyperthermia in the treatment of malignant disease. This review includes a discussion of this rationale and describes effects of hyperthermia either given alone or in combination with ionising radiation to cells in vitro, tumours or normal tissues. Topics discussed include thermotolerance, step-down sensitisation, fractionation, re-treatment of previously irradiated sites, thermal enhancement ratio and thermal dose. Problems of heat delivery and temperature measurement are considered and the current status of clinical studies is stated briefly. PMID- 3303070 TI - Computer-assisted instruction in curricula of physical therapist assistants. AB - This article compares the effectiveness of computer-assisted instruction (CAI) with written, programmed instruction between two groups of physical therapist assistant students. No significant difference in the amount of material learned or retained after completion of testing using either CAI or a written, programmed text was found in this group of 16 subjects. Learning style or attitude about computers did not correlate strongly with performance after the CAI. Findings suggest that more research is needed to support decisions related to fiscal allotments for computer use in college curricula. PMID- 3303071 TI - [Hommage to Jean-Francois Merlen. Honorary President. 1912-1986]. PMID- 3303072 TI - Photomodification of biological membranes with emphasis on singlet oxygen mechanisms. AB - This review discusses photomodification of biological membranes and model membrane systems. Current concepts of membrane structure are first reviewed briefly. The role of preillumination association of sensitizer with membranes as it relates to photomodification rate is discussed, as well as the role of singlet oxygen in membrane photomodification. Finally the characteristics of singlet oxygen generation in membranes are considered. The evidence clearly indicates that membrane photomodification cannot be understood based only on the properties of sensitizers and singlet oxygen in aqueous solution. Rather the properties of sensitizers in association with membranes are the determinants of membrane photomodifcation. These properties differ significantly in aqueous solution and in membranes. PMID- 3303073 TI - Photochemical modifications of lac repressor--II. Tryptophan photochemistry as a probe in studying the allosteric behaviour of the protein. AB - Irradiation of lac repressor under aerobic conditions in the near UV region (295 400 nm) decreases the Trp fluorescence of the protein. A total loss of fluorescence corresponds to the destruction of all tryptophanyl residues. Irradiation with light of wavelength between 250 and 400 nm quenches fluorescence completely when only half of the Trp residues ae destroyed. An internal photodynamic effect, in which N-formylkynurenine, a principal photoproduct of Trp, sensitizes further the destruction of the other Trp residues, accounts for our results. Experiments performed in the presence of sodium azide suggest that singlet oxygen is not involved in the destruction of Trp, but may be responsible for histidine degradation. Irradiating the repressor complexed with non-operator E. coli DNA has the same effect on Trp residues as irradiating repressor alone. On the contrary, when repressor is complexed to lac operator, both tryptophanyl residues seem to be destroyed simultaneously. This indicates that binding of specific operator DNA at the DNA site induces changes in the environment of the tryptophanyl residues (mainly tor Trp 220) which cannot further transfer in excitation energy to the photoproduct of the other Trp. A prolonged irradiation destroys the complex, leading to the same result observed for non-specific complex or for repressor alone. These results are discussed in terms of the proximity of Trp from the inducer binding site and the allosteric behaviour of the repressor. PMID- 3303074 TI - Elimination of residual tumor cells from autologous bone marrow grafts by dye mediated photolysis: preclinical data. AB - MC540-mediated photolysis has several features that make it potentially attractive as a clinical purging procedure. (1) The experience with experimental tumors suggests that MC540-mediated photolysis is effective against a broad range of leukemias and solid tumors, including drug-resistant tumors (Sieber et al., 1984b). Drug-resistant tumor cells are likely to occur in heavily pretreated patients. (2) MC540-mediated photolysis is not cell-cycle dependent (Manna and Sieber, 1985). It kills both resting and cycling cells. In this regard, MC540 mediated photolysis is a valuable complement to cell-cycle specific cytotoxic drugs. (3) There is a large differential in sensitivity between normal pluripotent hematopoietic stem cells and leukemia and neuroblastoma cells. (4) The mechanism of action of MC540-mediated photolysis is different from that of lectins, antibodies and most cytotoxic drugs. MC540 binds to the lipid portion of the plasma membrane and membrane lipids are probably a primary target of the toxic photoproducts. Antibodies and lectins react with proteins and carbohydrates and most drugs have intracellular targets (e.g., nuclear DNA). We would therefore expect little cross-resistance if MC540-mediated photolysis were used in combination with other purging procedures.(5) The small amounts of dye that remain associated with the marrow graft and are infused into the patient are approximately 100,000-fold less than the LD(10) (in mice) and therefore unlikely to cause any harm. The outcome of the first clinical application of the technique supports this view (Sieber et al., 1986c). A better understanding of the underlying molecular mechanisms will undoubtedly lead to more effective applications of the technique and perhaps to the identification of more potent analogs of MC540. PMID- 3303075 TI - Salt effects on bacteriophage T7-I. AB - The thermal denaturation as a measure of the structural stability of the nucleoprotein in bacteriophage T7 has been studied in dependence of the ionic environment. Optical density and circular dichroism melting curves measured at wavelengths characterizing either the DNA or protein conformational changes were compared to identify different steps of the denaturation and to follow the effect of the ions. Monovalent salts strengthen the helical structure of intraphage DNA logarithmically in the way as they do in the case of isolated double-stranded DNA. Mg2+ and Ca2+ at very low concentrations stabilize the DNA helicity. Higher divalent ion concentrations decrease the stability of the double helix because of the repulsive ionic interactions. The high structural sensitivity of DNA in the presence of Mg2+ and Ca2+ in this "in situ" environment can be related to the biological role of these ions. PMID- 3303076 TI - Salt effects on the bacteriophage T7-II structure and activity changes. AB - Optically detected thermal stability and biological activity of phage T7 has been compared as the function of the ionic composition and strength of the buffers. The ionic strength range was studied between 20-140 mmol/1. In Tris buffer containing only monovalent ions the biological activity of the phages decreases abruptly below 50 mmol/1 ionic strength. Structural studies show a logarithmic dependence between the ionic strength and the intraphage DNA stability and no significant change in the thermal stability of the whole phage. Mg2+ and Ca2+ ions at low concentration (1 mmol/1) given into a Tris buffer of 20 mmol/1 original ionic strength highly stabilize the biological activity, which stabilization is also to be seen in the intraphage DNA and also in the whole phage thermal denaturation process. PMID- 3303078 TI - A vector for construction of gene libraries and the expression of heterologous genes in Saccharomyces cerevisiae. AB - We have constructed a convenient new vector, YEp-DE, for the construction of gene libraries and the expression of heterologous genes in Saccharomyces cerevisiae. The vector contains the yeast LEU2 gene, the 2 mu origin of replication, and a region from pUC18 that includes the ampr gene, the Escherichia coli origin of replication (ori), and the LacZ gene with multiple cloning sites. Five sites (Sac1, Sma1, BamH1, Sal1, Sph1) in this region are unique. This vector has advantages over similar yeast-E. coli shuttle vectors: small size (7291 bp, entirely sequenced), convenient cloning sites, and lacZ selection for detecting recombinant plasmids. PMID- 3303077 TI - Identification of the minimal replication region of the multicopy Streptomyces plasmid pSL1. AB - The 1.52-kb minimal replication origin of the 3.9-kb Streptomyces plasmid pSL1 was determined using a bifunctional derivative, pMCP44, of pSL1. Plasmids with linker insertions into the pSL1 part of pMCP44 were isolated from Escherichia coli. The sites of insertion were determined by restriction enzyme analysis and the ability of the mutant plasmids to replicate in S. lividans 66 was determined. All except one of the inserts in the 1.52-kb essential region inactivated replication. A 104-bp segment from this region could function as a replication origin in the presence of a helper plasmid containing a nonoverlapping pSL1 fragment. The sequence of this 104-bp fragment shows similarities to those of known plasmid replication origins. PMID- 3303079 TI - Distribution of neuropeptide Y immunoreactivity in the forebrain of the rat. AB - The distribution of neuropeptide Y (NPY) like immunoreactivity was investigated in the forebrain of the rat with immunohistochemical methods. Specificity of the antisera was established by the absence of all immunoreactive staining in tissue incubated in antisera which had been preabsorbed with the pure NPY antigen. NPY containing cells were distributed widely in the forebrain. These included neocortex, basal forebrain, septum, bed nucleus of the stria terminalis, neostratium, hypothalamic arcuate nucleus, and intergeniculate leaflet. This study also demonstrated an extensive network of NPY fibers in various areas of the forebrain such as the prepotic area, the hypothalamus and the paraventricular nucleus of the thalamus. The distribution of avian pancreatic polypeptide and NPY was compared, and the possible importance of NPY is briefly discussed. PMID- 3303081 TI - Dream work and the general public. PMID- 3303080 TI - [The curriculum vitae of Rafal Radziwillowicz]. PMID- 3303082 TI - Pseudoanaphylactic reaction to procaine penicillin and kindling. PMID- 3303083 TI - Caution against 'the asylum'. PMID- 3303084 TI - Association for the Study of Dreams, International Dream Conference III. June 26 29, 1986, Ottawa, Ontario, Canada. Proceedings. PMID- 3303086 TI - The depth of dreams: some data and a model. PMID- 3303085 TI - "Everyone who dreams has a bit of shaman": cultural and personal meanings of dreams--evidence from the Amazon. PMID- 3303087 TI - Joining the dreamer in having the dream. PMID- 3303088 TI - Linguistic devices in metaliteral dreams. PMID- 3303089 TI - Dream and metaphor. PMID- 3303090 TI - Nightmares in the sexually abused female teenager. PMID- 3303091 TI - Self-psychology and dreams: the merging of different perspectives. PMID- 3303092 TI - Current issues in electroconvulsive therapy. PMID- 3303093 TI - Disturbed personality and psychosocial adjustment in myotonic dystrophy: relationship to intellectual/cognitive function and underlying affective disorder (depression). PMID- 3303095 TI - Note on the history of early intervention programs in Ohio. PMID- 3303094 TI - Height and occupational success: a review and critique. PMID- 3303096 TI - Biofeedback, competitive set, and type A/type B interactions with female college students. PMID- 3303097 TI - Influence of aerobic exercise training and relaxation training on physical and psychologic health following stressful life events. AB - An experiment was conducted to determine whether aerobic exercise training or relaxation training would be effective for reducing the deleterious effects of life stress on physical and psychologic health. Over 1000 college students were surveyed, and 55 of those who reported experiencing a high number of negative life events over the preceding year were assigned to an aerobic exercise training condition, a relaxation training condition, or a no-treatment control condition. Physical and psychologic health were assessed with self-report measures before, halfway through, immediately following, and 8 weeks after the 11-week training (and control) period. Heart rate data collected during a treadmill test indicated that the aerobic exercise training was effective for improving cardiovascular fitness. Psychologic measures indicated that the exercise training condition was more effective than the other two conditions for reducing depression during the first 5 weeks of training. No differences were found among the conditions on self report measures of physical health. These findings suggest that aerobic exercise training may be useful for reducing the severity and duration of depressive reactions following stressful life change. PMID- 3303098 TI - Multiple microcomputers for data entry and analysis. PMID- 3303099 TI - Calming the statistician's nightmares: making analysis of nonrectangular files easier. PMID- 3303100 TI - Clinical management--imipramine/placebo administration manual. NIMH Treatment of Depression Collaborative Research Program. PMID- 3303101 TI - A categorical approach to depression by a three-dimensional system. AB - Depressed moods do not arrive already hallmarked 'endogenous'. Depressions do, however, arrive as perceivable phenomena and the domain of clinically important and conceptually connected items includes about 20 items. This domain can be subdivided into items relevant for the severity of the depression and items relevant for the diagnosis of depression. It has been argued that Rasch models rather than multivariate analysis are the adequate models when studying the internal consistency of rating scales. Applying the Rasch models, it was found that 10 items have an additive relationship for the severity of depression and that 5 items were additively related for endogenous depression, whereas five other items were additively related for reactive depression. Moreover, it was found that the dimension of severity should be transformed to three categories: no depression, minor depression and major depression. The two dimensions: endogenous and reactive depression, respectively, should be transformed to the categories: definite endogenous depression, combined endogenous and reactive depression, definite reactive depression, probable endogenous depression and probable reactive depression. These categories for severity and for the diagnosis of depression have a high internal consistency. However, we still need studies to verify the external validity of these concepts. PMID- 3303102 TI - [A basic work of Galen. Essay review]. PMID- 3303103 TI - Galen's Methodus medendi in the Middle Ages. PMID- 3303104 TI - Eugenics and basic genetics in H.J. Muller's approach to human genetics. PMID- 3303105 TI - Heredity/development in the United States, circa 1900. PMID- 3303106 TI - [Ceramic anchor implant as a bridge-end abutment (Brinkmann's Class II)--report of 10 years' experience in clinical use]. PMID- 3303107 TI - [Indications of the inverse transverse tooth curve in problem complete denture care--occlusal physiological studies with prosthetic emphasis (II)]. PMID- 3303108 TI - [New veneering technics with the use of castable apatite-ceramic materials. I. Theoretical principles]. PMID- 3303109 TI - [New nomenclature for marginal periodontal diseases and their definitions]. PMID- 3303110 TI - 5-Fluorouracil treatment after irradiation impairs recovery of bone marrow functions. AB - In mice, persisting radiation-induced growth retardation of hematopoietic tissue suggested that at least part of the surviving stem cells are genetically injured. Additional mitotic stress some time after the radiation insult might remove injured stem cells, thus improving the overall recovery of the irradiated bone marrow. Mice were treated with 5 Gy whole-body gamma irradiation. Two weeks later half of the animals were injected i.v. with 150 mg/kg 5-fluorouracil (5-FU), the other half remained untreated (5 Gy-controls). 2 or 10 weeks later, femoral cellularity and CFU-S content, proliferation ability of transplanted bone marrow and the compartment ratio (CR; ratio of splenic IUdR incorporation at day 3 and number of CFU-S transfused) were determined. Four weeks after 5 Gy and 2 weeks after 5-FU treatment all parameters showed significant impairment of recovery. 12 weeks after 5 Gy and 10 weeks after 5-FU CFU-S and CR were still reduced compared to the 5 Gy-controls. 5-FU treatment of unirradiated mice did not produce permanent effects on the quality of stem cells or the hematopoietic microenvironment. It is concluded, therefore, that an increased proliferation stimulus does not aid in the removal of injured CFU-S and may even impair recovery of bone marrow functions by increasing the proportion of genetically injured stem cells which continue proliferation. PMID- 3303111 TI - [Radiation inactivation of alpha-chymotrypsin in aqueous solutions. The nature of the dose-response relationship]. AB - A study was made of possible reasons for deviations of the dose--response curves from the exponential function at low (less than or equal to 10(-6) M) and high (greater than or equal to 10(-4) M) initial concentrations of the enzyme. Factors influencing the degree of the deviation and type of the dependence of the radiation and chemical yield on the initial concentration of the enzyme are discussed. The data obtained are compared with those reported in the literature. PMID- 3303112 TI - [Dynamic changes in kidney function after the whole-body gamma irradiation of rats at a dose of 7.4 Gy]. AB - In experiments on female Wistar rats it was shown that whole-body gamma irradiation (7.4 Gy) impairs the hemodynamics and function of kidneys, particularly their filtering capacity, the dynamics of which was of an undulatory character. The most pronounced changes occurred during the first 30 days following irradiation, later on the functional status normalized. PMID- 3303113 TI - [Effect of ionizing radiation on the turnover of catalase-degrading proteinase in rat hepatocytes]. AB - A study was made of the influence of whole-body X-irradiation (8 Gy) on the turnover of an individual protein, alkaline proteinase, initiating inactivation of a catalase protein in rat liver. It was shown that the extent to which metabolism of this enzyme in the exposed animals is impaired depends upon its localization. The authors discuss the possibility of a correlation between the decrease in the catalase protein degradation and the level of proteinase activity in hepatocytes of irradiated rat liver. PMID- 3303114 TI - [Electrophoretic mobility of UV-irradiated bacterial cells]. AB - Electrophoretic mobility of Escherichia coli cells exposed to various doses of UV radiation was investigated. The method of free flow electrophoresis was used to study a correlation between membrane protein charge and cell surface electric charge. The change in the cell surface charge and electrophoretic motility was associated with the damage to membrane proteins and the survival of UV-irradiated bacteria. PMID- 3303115 TI - [Retrospective analysis of the use of imaging procedures in the diagnosis of renal cysts]. PMID- 3303116 TI - Creation of atheromatous plaques in experimental animals. AB - Research of the dissolution of atheromatous plaques requires animal testing before any delivery system can be used on human beings. Using Flemish Giant rabbits, atheromatous plaques are created in our radiology research laboratory by a surgical air drying technique and a high cholesterol diet. Plaque development is monitored by ultrasound scanning and serial angiography. PMID- 3303117 TI - Colorectal carcinoma: detection with indium-111 anticarcinoembryonic-antigen monoclonal antibody ZCE-025. AB - A phase I and II clinical trial with indium-111-labeled anticarcinoembryonic antigen monoclonal antibody ZCE-025 (In-111 ZCE-025) was initiated. Fifteen patients with colorectal tumors underwent external scintigraphy following the administration of 5.5 mCi (203.5 MBq) In-111 ZCE-025 at doses of 2.5-80.0 mg. Eighteen of 20 documented tumor sites, excluding those in the liver, were detected with In-111 ZCE-025. Lesions less than 1.5 cm could not be detected. Twenty-five percent of liver metastases exhibited positive accumulation of In-111 ZCE-025 at doses of 40-80 mg. No side effects were encountered. Because of the high detection rate of lymph node metastases from colorectal carcinoma with In 111 ZCE-025, this technique may be helpful in preoperative staging of patients with colorectal tumors, as well as in distinguishing recurrent tumors from postoperative or postradiation changes seen on computed tomography scans or other radiologic images. PMID- 3303118 TI - Agenesis of the right lobe of the liver. AB - In five patients with agenesis of the right lobe of the liver, computed tomography or sonography demonstrated absence of the right lobe with compensatory hypertrophy of other segments. In three patients, the caudate lobe was also absent. The radiologic differential diagnosis includes lobar atrophy due to cirrhosis or hilar cholangiocarcinoma. Nineteen other cases have been reported in the world literature since 1956. This interesting congenital anomaly may be associated with biliary tract disease (12 patients), portal hypertension (seven patients), and other congenital anomalies (four patients), or it may be an incidental finding (five patients). PMID- 3303119 TI - Normal anatomy and pathologic changes of the small bowel mesentery: US appearance. AB - The ultrasonographic (US) appearance of the normal small bowel mesenteric leaves was evaluated in two in vitro studies and in 30 patients. Such structures had an elongated shape, echogenic surfaces, and small vessels in their center and could be recognized in 28 of the 30 patients. They did not show active movements, and at their distal end, the small bowel loops could be seen and peristalsis detected. Doppler signals were obtained from the small vascular structures in their center in three additional cases. On the basis of these anatomic findings, pathologic changes such as lymphoma, desmoid tumor, metastatic lesions, dilated vessels, and edema could be detected in 15 patients. When examining with US patients with diseases prone to involve the mesentery, careful attention should be given to this structure, since useful information about the abdominal spread of the disease can be obtained. PMID- 3303120 TI - Self-expanding endovascular prosthesis: an experimental study. AB - A new type of endovascular prosthesis was inserted in 28 animals and evaluated for several factors, including thrombogenicity, tendency to migrate, critical implant zones, and incorporation into the vascular wall. The new prosthesis is a woven, multifilament structure of stainless steel alloy; its inherent elastic, self-expanding characteristics hold it against the vessel walls. Forty-seven endoprostheses (3-5 mm in diameter, 15-50 mm long) were percutaneously implanted with either a 6-F introducer sheath, a coaxial 9-F catheter, or a 0.014-inch (0.036-cm) guide wire into the femoropopliteal, coronary, carotid, and renal arteries and iliac veins. Anticoagulant or platelet antiaggregating agents were not used before or after implantation. Angiographic and histologic analyses showed that the prosthesis had a very low thrombogenicity when it was well adapted to the native vessel diameter and that it was incorporated into the vessel wall by a new intima by the 3d week after implantation. No migration occurred, and branch vessel flow was preserved even in those vessels in which ostia were traversed by the prosthesis. This prosthesis has potential for clinical application in the treatment of postangioplasty restenoses, particularly in the coronary arteries. PMID- 3303121 TI - Clinical outcomes of patients with suspected pulmonary embolism and low probability aerosol-perfusion scintigrams. AB - The clinical outcomes of 183 patients with suspected pulmonary embolism (PE) and a "low probability of PE" interpretation of aerosol-perfusion scintigrams were reviewed. Based in part on the scintigraphic findings, 173 of the patients (94.5%) were not treated with anticoagulants. Over a mean follow-up period of 8.4 months, only one patient (who was from the untreated group) had clinical evidence of PE. These results suggest that a low-probability interpretation of the aerosol perfusion scintigram is generally reliable and a suitable indicator for clinical decision making in patients suspected of having PE. PMID- 3303122 TI - Arnold-Chiari II malformation: intraoperative real-time US. AB - Nineteen cases in which high-resolution, intraoperative, real-time sonography was performed during decompression of an Arnold-Chiari II malformation were reviewed. The variations of the often complicated hindbrain anatomic features, well known from autopsy series, were shown in detail with intraoperative sonography. The extent of herniation of the cerebellar vermis, the medulla, and the fourth ventricle into the cervical spinal canal, as well as fourth ventricular dilatation, arachnoid cysts, and cervical hydromyelia, were also demonstrated sonographically. Real-time imaging was useful in guiding the neurosurgeon in decompression of the hindbrain, especially the fourth ventricle, in an anatomic area often obscured visually by intense fibrovascular adhesions. PMID- 3303123 TI - Neonatal duodenum: fluid-aided US examination. AB - In 261 infants with vomiting, 11 duodenal abnormalities were diagnosed with fluid aided ultrasound (US). These abnormalities included duodenal obstruction, malrotation with and without associated volvulus, incomplete rotation, and duodenal stenosis. US was the initial modality used in the evaluation of vomiting in these neonates and young infants. The overall sensitivity and specificity of fluid-aided US evaluation of duodenal abnormalities were 100% and 99%, respectively. (Workup bias limits the reliability of these figures.) Fluid-aided US examination of the stomach and duodenum provided a dynamic view of duodenal rotation and anatomy, and at the very least provided a method of triaging those infants who may require surgery, upper gastrointestinal series, or follow-up US to make a definitive diagnosis. PMID- 3303124 TI - Breast imaging: dual-energy projection radiography with digital radiography. AB - Dual-energy projection radiography was applied to breast examinations. To perform the dual-energy subtraction radiography with use of a digital radiography unit, high- and low-energy projections were made at an appropriate time interval under differing x-ray exposure conditions. Dual-energy projection radiography appears to offer clear, detailed images and may be a useful supplement to standard mammography. PMID- 3303125 TI - Cefotetan (Cefotan): a new cephalosporin. PMID- 3303126 TI - Neurohypophyseal hormones and behavior. PMID- 3303127 TI - Neuroendocrine aspects of adaptation. PMID- 3303128 TI - The role of peptides in affective disorders: a review. PMID- 3303129 TI - Neuropeptides and dementia. PMID- 3303130 TI - Modulation of brain aging correlates by long-term alterations of adrenal steroids and neurally-active peptides. PMID- 3303131 TI - The neuropeptide concept. PMID- 3303132 TI - Interfacial instability at cell membranes. PMID- 3303133 TI - Interactions between metallothionein and trace elements. AB - Metallothionein is an important metal-binding protein which occurs in varying amounts in a wide range of tissues but particularly in liver, kidneys, intestine and pancreas. Synthesis of the protein is induced by zinc and copper and also by cadmium and many other non-essential elements. The concentration of the protein in tissues depend on zinc and copper status and on patho-physiological state. A variety of stress factors stimulate metallothionein synthesis, particularly in liver. The turnover rate of metallothionein in tissues is relatively high but depends to a large extent on its metal content. There has been much speculation as to the function of the protein and one important role appears to lie in the cellular detoxification of copper, zinc and other metals. Metallothionein also appears to participate in metabolic interactions between zinc and copper. The protein occurs in small amounts in blood and urine and assay of these concentrations may be used in the assessment of trace element status. PMID- 3303134 TI - Vitamin A in human nutrition. AB - Vitamin A, an unsaturated 20 carbon cyclic alcohol, has a variety of physiological functions including a role in vision, reproduction, growth and maintenance of epithelial and bone structures. The main sources of vitamin A are from preformed vitamin A in animal foods or from -carotene in green plants. Carotene is cleaved in the intestinal mucosa to retinol, which is transported in chylomicrons mainly to the liver which is the major storage site of vitamin A, where stores are mainly of retinyl palmitate. Utilization of vitamin A appears to be a highly regulated process; retinol is transported in the serum bound to a specific binding protein. There also may be some control of the level of retinol in cells possibly through membrane receptors or of excretion from the cell. Intracellular cytosolic retinol binding proteins transport retinol to the nucleus where specific receptors for retinol have been found. Intracellular binding proteins for retinoic acid and retinal, metabolites of retinol have also been found, and an interstitial protein transporting retinol is present in the eye. Vitamin A deficiency causes cessation of growth, night blindness, and renders the organism more susceptible to infection, and vitamin A supplementation has been shown to enhance immune response. Epidemiological studies have shown low vitamin A and carotene to be correlated with incidence of cancer. Excess vitamin A intake results in hypervitaminosis with severe detrimental effects. Vitamin A requirements appear to be met in most developed countries although in the populations at greatest risk, newborns and pregnant and nursing women, cases of deficiency are observed. However, in large areas of the world vitamin A deficiency is endemic, causing widespread blindness and mortality. PMID- 3303135 TI - Biological and health implications of toxic heavy metal and essential trace element interactions. AB - Human civilization and a concomitant increase in industrial activity has gradually redistributed many toxic metals from the earth's crust to the environment and increased the possibility of human exposure. Among the various toxic elements, heavy metals cadmium, lead, and mercury are specially prevalent in nature due to their high industrial use. These metals serve no biological function and their presence in tissues reflects contact of the organism with its environment. They are cumulative poison, and are toxic even at low dose. Studies of metabolism and toxicity of these elements have revealed important interactions between them and some essential dietary elements like calcium, zinc, iron, selenium, copper, chromium, and manganese. In general, a deficiency of these essential elements increases toxicity of heavy metals, whereas an excess appears to be protective. While most of the observations are on laboratory animals, limited human data are in agreement with the results of animal experiments. These suggest that the dietary presence of the essential elements may contribute to the protection of man and animal from the effects of heavy metal exposure, while their deficiency may increase toxicity. Appropriate dietary manipulation thus may be valuable in the prevention and treatment of heavy metal toxicity. PMID- 3303136 TI - Calmodulin and its role in intracellular calcium regulation. PMID- 3303138 TI - [Biocomputer and molecular electronic devices]. PMID- 3303137 TI - [Heritable factors in carcinogenesis--cancer causing mutations]. PMID- 3303139 TI - [Database of conformational elements of protein]. PMID- 3303140 TI - [Structure and function of immunoglobulins]. PMID- 3303141 TI - [Regulation of immunoglobulin gene expression]. PMID- 3303142 TI - [Laminin B1 chain; its structure and gene expression]. PMID- 3303143 TI - [The scanning tunneling microscope and the soft X-ray microscope: a challenge to atomic/molecular image of biomaterials]. PMID- 3303144 TI - [An energy-supplying pathway for sperm maturation, arginine degradation cascade]. PMID- 3303145 TI - [The Chlamidiazyme immunoenzyme test (Abbott) in the diagnosis of urogenital infections]. PMID- 3303146 TI - [Medical directors of the Departments of Dermatology and Venereology at the Brothers of Mercy Hospital in Cracow]. PMID- 3303147 TI - [Basic treatment of arthropathic psoriasis]. PMID- 3303148 TI - [Compensatory structures in Rilke's poetry]. PMID- 3303149 TI - [Effect of physical and psychological rehabilitation on arterial pressure in patients with primary arterial hypertension]. PMID- 3303150 TI - [Nifedipine as an emergency drug in arterial hypertension]. PMID- 3303151 TI - [Vitamin E--expectations and disillusionments]. PMID- 3303152 TI - [Use of immunoglobulin preparations in hematology]. PMID- 3303153 TI - [Effect of psychophysical training on the behavior of women during labor]. PMID- 3303154 TI - [Stein-Leventhal syndrome]. PMID- 3303155 TI - [Fatty liver and obesity]. PMID- 3303156 TI - [Polymyositis--dermatomyositis: advances in diagnosis and therapy]. PMID- 3303157 TI - [Defects and disorders of collagen biosynthesis in the collagenosis-like syndrome]. PMID- 3303158 TI - [The achievements of Teodor Heryng in the treatment of laryngeal tuberculosis]. PMID- 3303159 TI - Dosimetry for total body irradiation. AB - Total body irradiation (TBI) is becoming increasingly prominent as a major component of therapy for patients with hematological diseases requiring bone marrow transplantation. This review considers some of the special dosimetric problems associated with TBI. Basic beam dosimetry and factors affecting dose variation within the patient are discussed and compared to conventional radiotherapy. The delivery of an accurate dose to the patient requires phantom measurements to be related to the dose at the prescription point. The use of treatment planning dose calculation procedures, including inhomogeneity corrections, is described specifically for large field treatments. Finally, some questions for future research are considered. PMID- 3303160 TI - Blood cell kinetics and total body irradiation. AB - The early response of blood cells to irradiation has been studied in leukemia patients who received total body irradiation (TBI) prior to cyclophosphamide and bone marrow transplantation. After a single session treatment (10 Gy in 4 h) the most dramatic variation was observed in the granulocytes. At the end of the irradiation their concentration was 2 to 6 times higher. Because of a subsequent rapid decline, the peak may be overlooked if the blood counts are delayed. Lymphocytes decreased to 50% at the end of the single session TBI and continue to decrease exponentially, with a half time of 30 h. During a fractionated irradiation (11 X 1.2 Gy in 4 days) the lymphocyte number dropped to 60%, 13 h after the first fraction and this decline continued with a half time of 30 h during the treatment. From the data obtained in vivo, a lymphocyte D0 value of 1.2 Gy was computed. The lymphocyte subsets (B.T. OKT4 OKT8) did not exhibit different radiosensitivities either in vivo or in vitro. The disappearance of lethally hit lymphocytes from the blood exhibits a biphasic kinetic: 50% of the cells disappear in a few hours and 50% with a half time at 30 h. Lymphocytes irradiated either in vitro or in vivo when in culture disappear slowly, contrasting with the in vivo findings. It may suggest that lethally hit lymphocytes are quickly removed from the circulating pool in vivo. PMID- 3303161 TI - Late effects of total body irradiation. AB - Late effects of chemo-radiotherapy conditioning before bone marrow transplantation (BMT) are being increasingly recognised in long-term survivors, particularly children. They can be divided into two categories: those affecting hormonal status and those affecting specific organ function. All women treated develop ovarian failure with low levels of beta-oestradiol and raised values of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). In males, raised FSH and LH values are found with normal testosterone levels but most patients have azoospermia. In children, puberty is usually but not invariably delayed by treatment but can be induced by appropriate hormone replacement. Compensated hypothyroidism was found in 6/30 children. Growth hormone secretion may be impaired especially if previous cranial irradiation has been given. In children, a reduction in sitting height has been observed. Cataract has occurred in 20% of children between 3 and 6 years after treatment. Two second tumours have been observed. No other major organ toxicities have been encountered. PMID- 3303163 TI - Radiosensitization in vitro by cis-diammine (1,1-cyclobutanedicarboxylato) platinum(II) (carboplatin, JM8) and ethylenediammine-malonatoplatinum(II) (JM40). AB - The radiosensitizing ability of two analogues of cisplatin have been tested in vitro. The analogues, CBDCA (JM8) and EDMP (JM40), are currently undergoing clinical tests in the search for an active but less toxic cancer chemotherapeutic agent than cisplatin. The compounds were cytotoxic to log phase RIF1 cells in culture, but at higher concentrations than the parent compound. Both analogues were radiosensitizers of oxic cells when given as 1 h exposures beginning either 3 h before, 1 h before or 2 h after irradiation, giving modest enhancements of approximately 1.2. Each drug caused an inhibition of the repair of sublethal damage which was greatest after CBDCA treatment. Although neither analogue was as good a radiosensitizer as cisplatin, CBDCA appears to show promise as a potential radioenhancing platinum compound. PMID- 3303164 TI - Proceedings: Symposium on Total Body Irradiation. Fifth ESTRO meeting. European Society for Therapeutic Radiology and Oncology. Baden-Baden, September 8-10, 1986. PMID- 3303162 TI - The management of primary lymphoma of bone. AB - From October 1962 through April 1982, 21 patients with the diagnosis of primary lymphoma of bone (18 monostotic, stages IE and IIE; 3 polyostotic) were treated with curative intent. A combination of chemotherapy and radiation therapy was used in 11 patients, local treatment alone in 9 patients, and chemotherapy alone in one patient. Overall 5-year survival for the patients treated with curative intent was 56%. Standard work-up has changed over the 20-year study period. Five year survival for the subset of eight stage I and II patients with full pretherapy staging was 83%. Prognosis was significantly correlated with extent of pretherapy staging. Treatment parameters that also seemed to predict outcome were the aggressiveness of chemotherapy and the use of irradiation or surgery for local-regional disease; the only local failure occurred in the patient who received chemotherapy alone. Complications of radiation therapy alone and in combination with chemotherapy are discussed and correlated with irradiation dose. Radiation therapy techniques are described, and a management approach is recommended. PMID- 3303165 TI - Total body irradiation for treatment of haematological diseases. AB - The present status of total body irradiation (TBI) as a part of the treatment of haematological diseases was discussed during a separate symposium at the 5th Annual ESTRO meeting at Baden-Baden. The experimental techniques applied in Europe, the dosimetry for TBI, the radiobiological aspects and the late effects after TBI have been reviewed. For specific geometries, precautions have to be taken to avoid increased dose contributions at the skin due to electrons scattered from the wall behind the patient. CT data can be useful for the individualization of the exposure regimen of patients with extreme variations in lung anatomy or lung density. An appreciable number of centres apply in vivo dosimetry, however, special care is needed for the correct interpretation of the dosimeter readings. A number of late effects, including induction of cataract and secondary tumours has been observed after TBI. The techniques applied for TBI at the various centres and the temporal administration of the dose show wide variations. At present, the patient material is too heterogeneous to draw any conclusion about an optimum schedule for a TBI regimen. Further cooperation between clinicians, radiobiologists and radiation physicists has to be established to achieve consistency and further improvement of the results after TBI. PMID- 3303166 TI - Total body irradiation--review of treatment techniques in Europe. AB - In treatment of acute leukaemia and other disseminated diseases, high dose total body irradiation (TBI) combined with intensive chemotherapy and bone marrow transplantation (BMT) is used more and more successfully. Reflecting the complex clinical, biological, physical and technical situation of TBI, a large variety of TBI treatment techniques has been developed. In order to review the techniques applied in Europe and to report about common methods as well as about new ideas in TBI, a questionnaire was prepared and mailed to medical physicists in Europe responsible for TBI. The topics of this questionnaire are general information: TBI technique (beams, fields, treatment conditions); basic TBI dosimetry; physical treatment planning (patient dosimetry, heterogeneity correction, dose modification, dose homogeneity, dose precision, confirmation measurements); TBI treatment planning (dose prescription, localization, documentation, verification, in vivo dosimetry); requirements (additional staff, time, equipment) and recommendations for improvement of TBI. Most questionnaires (34/45) were returned in time with detailed information from TBI centres in 15 European countries. These data as well as results of the "Meeting of Leiden, 1982" of the "Meeting of Essen, 1985" and of the "Meeting of Toulouse, 1986" are summarized and discussed. There are many interesting methods to plan and perform exact TBI. However, anterior-posterior TBI is preferred to achieve sufficient homogeneity of dose and effective lung shielding. While the development of TBI has reached a high level of exactness, further improvement will require a better knowledge of the dose effect relationships. PMID- 3303168 TI - Safety assurance margins for food additives currently in use. AB - Toxicity data for a subset of food additives are combined (by means of a "Monte Carlo" computer analysis) with exposure information to indicate the characteristics of an overall profile of "safety assurance margins" for additives currently in use in the United States. It is demonstrated that safety concerns for (noncarcinogenic) toxic effects for these substances can seldom be expected a priori if they disappear into the U.S. food supply at levels of less than about 100,000 pounds annually. PMID- 3303167 TI - Evaluation of the nitrate drinking water standard with reference to infant methemoglobinemia and potential reproductive toxicity. AB - In view of published results of epidemiologic studies which suggested an association between nitrate in drinking water and human malformations, an assessment of the toxicology of nitrates and nitrites in relation to possible adverse effects on reproduction and development was performed. The current water standard for nitrate is based on protection from methemoglobinemia. A review of the animal data failed to provide evidence for teratogenic effects attributable to nitrate or nitrite ingestion. Adverse reproductive effects reported occurred at doses that were about one thousand times and higher than the estimated human intake. Neither nitrate nor nitrite in experimental animals concentrated in the mammary gland or milk. The present assessment concludes that the maximum contaminant level of 45 ppm nitrate ion, or 10 ppm nitrate-nitrogen, adequately protects the very young from nitrate-induced toxicity, both pre- and postnatally. PMID- 3303169 TI - Cholinergic muscarinic receptor characterization and regulation in tissues innervated by the autonomic nervous system. PMID- 3303170 TI - Biochemical regulation of airway smooth muscle tone: current knowledge and therapeutic implications. AB - Evidence collected during the last decade indicates that the molecular processes responsible for smooth muscle contraction are fundamentally different from those responsible for skeletal muscle contraction. Furthermore, because of the diverse functional roles of various smooth muscles, it would not be surprising if significant differences in regulatory processes also exist among different smooth muscles. Such diversity may already be exemplified by differences in cross-bridge kinetics and sources of activator Ca2+. Additional unique regulatory features of various smooth muscle types will undoubtedly be uncovered by further research. A convincing body of data suggests that activation of the adenylate cyclase/protein kinase cascade is responsible for the bronchodilation produced by beta adrenoceptor agonists. Although the exact mechanism by which the activation of cAMP-dependent protein kinase induces relaxation is not clear, the phosphorylation of multiple substrates may be involved. Phosphorylation of these substrates can promote relaxation by decreasing the myoplasmic Ca2+ concentration, decreasing the Ca2+ sensitivity of the contractile apparatus, or both. Thus, because beta-adrenoceptor agonists act as physiologic antagonists of broncho-constriction, they should relax airway smooth muscle regardless of the mediator(s) responsible for the bronchospasm. Perhaps this is the major reason that the beta-adrenoceptor agonists have become the premier class of drugs used in the treatment of bronchial asthma. As useful as the sympathomimetic bronchodilators have been, they are not without liabilities. These liabilities include: cardiovascular and skeletal muscle side effects, an inherent subsensitivity of the asthmatic patient population to beta-adrenoceptor agonists, the development of tolerance and a loss of efficacy during severe asthmatic episodes. The fact that these drawbacks are probably shared by all sympathomimetic bronchodilators suggests that little therapeutic advantage will be gained by developing new beta-adrenoceptor agonists. The task of developing novel bronchodilators will be facilitated by an understanding at the molecular level of the diversity among smooth muscles and the processes that regulate smooth muscle tone. Hopefully, such knowledge will lead to a new generation of highly effective, tissue-selective bronchodilators with significant therapeutic advantages over those currently available. PMID- 3303171 TI - [Description of a case of cysts of the mesenterium diagnosed by echography]. PMID- 3303172 TI - [Computer tomography-guided stereotaxic biopsy of intracranial lesions. Simple technic for the calculation of coordinates; method for the reduction of operative risk in the critical areas of the brain]. AB - The authors describe an original technique to calculate the coordinates for CT guided stereotactic biopsies of brain lesions. On the basis of simple trigonometric formulas it is possible to get an accuracy of +/- 1 mm. By means of the standard software of a high precision CT and with a CT-compatible stereotactic apparatus the x, y, and z coordinates are obtained in a quick and reliable way. A further development of the trigonometric approach to the stereotactic calculations is the "double target technique". It allows to preset the path of the biopsy-device through a selected point, to reach the final target: in this way a valuable reduction of the surgical risk is afforded especially in critical areas of the brain (brain stem, pineal region etc.). PMID- 3303173 TI - [Doppler spectrum analysis and traditional angiography in the study of the extracranial tract of the internal carotid artery]. AB - Examination of 88 extracranial carotid arteries using CW Doppler spectrum analysis is compared with the findings of transfemoral conventional arteriography. There is no significant difference (P greater than 0.05) between CWD and angiographic results, although sensitivity, specificity and accuracy are superior for the latter technique. CWD spectrum analysis can underestimate complete occlusion and misinterpret the degree of stenosis, however it is a cheap and rapid procedure that can be used to judge whether particular symptoms are due to identifiable disease and whether selective carotid arteriography is advisable. PMID- 3303174 TI - [Aneurysms of the hepatic artery. Clinico-radiologic study]. AB - A series of 7 cases of hepatic artery aneurysm is reported, pointing out the different features for etiology, localization, shape and size. The diagnostic imaging methods are then analyzed. Conventional radiology is actually useless. Sonography is hardly ever conclusive, even if the association of real time-US with echo-Doppler is likely to be promising. CT often concludes the diagnostic procedure, though the small size of aneurysms may limit its efficacy. Arteriography is the only method fit to occasionally find out small aneurysms and clear eventual diagnostic doubts; it's also mandatory before surgical treatment and allows percutaneous embolization. MR is likely to offer interesting perspectives. PMID- 3303175 TI - [Echographic study of 116 lesions of the digestive tract]. AB - The value of US in the diagnosis of the alimentary tract diseases is discussed on the basis of a personal series of 116 cases, including 58 lesions detected by US as first investigation. The findings observed are: signet ring; pseudokidney or cockade; tram lines; solid mass; pseudokidney + solid mass. The value of the method is stressed in the staging of malignancies, in the evaluation of palpable masses, in the correct interpretation of some phlogistic diseases and in the follow up. Finally, emphasis is given to its high possibility of topographic definition. US are more and more employed in the diagnosis of abdominal diseases. Concerning the alimentary tract they still remain an investigation complementary to radiology and endoscopy. But the author's opinion is that, when employed a first investigation, one should not exclude the systematic detection of any possible unknown lesion of the alimentary tract: a good example are the 32 positive cases (24 neoplastic) in the present report. PMID- 3303176 TI - [Percutaneous pancreato-gastrostomy in the treatment of pancreatic pseudocysts. Presentation of 2 cases]. AB - The authors describe a new method for the treatment of pancreatic pseudocysts using a personal technique: the percutaneous pseudocystogastrostomy. Under US and fluoroscopy guidance at first a percutaneous drainage is introduced in the pseudocyst using a transgastric approach. For seven days the drainage catheter is flushed with antibiotic solution (Rifocin), then under fluoroscopy and endoscopy guidance doubled pig-tail catheter is placed with its curlend ends in the lumen of the stomach and pseudocyst respectively. After 60 days the double pig-tail catheter is removed endoscopically. Two patients with pancreatic pseudocysts were treated successful by this method. No complications or recurrences were observed. PMID- 3303177 TI - [Difficulty in the differentiation of renal parenchymal hyperechogenicity]. AB - One hundred patients were examined: 70 with diffuse increased parenchymal echogenicity and 30 with focal increased echogenicity. The increase of echogenicity was assessed in degree and in diffuse increased parenchymal echogenicity were considered persistence or disappearance of the corticomedullary boundary. An increased diffuse echogenicity with distinctness of the corticomedullary boundary was observed in chronic GNF (36), nephroangiosclerosis (15) and amyloidosis. Diffuse increased echogenicity without distinctness of the corticomedullary boundary was observed in uratic interstitial nephropathy (13) and in chronic GNF with advanced lesions (4). Focal increased echogenicity occurred in chronic pyelonephritis (11), in tumors (18) and in renal tuberculosis (1). Renal carcinomas showed an echogenicity of I degree in 7 cases and an echogenicity of II degree in 1 case. The angiomyolipomas always showed an echogenicity of II degree, as did the liposarcoma. Differential diagnosis among parenchymal renal diseases which are responsible for diffuse increased echogenicity is impossible; in fact there is no correlation between the degree of renal parenchymal echogenicity and type of the disease. The focal increased echogenicity caused by chronic pyelonephritis is correctly diagnosed using ultrasound. The hyperechogenic tumors, at present, cannot be characterized on the basis of the sonographic features. PMID- 3303178 TI - [Comparative study of 1% prilocaine and 1% mepivacaine in axillary plexus anesthesia]. AB - In a randomized double-blind study, the latency period and spread of axillary brachial plexus block using 40 ml mepivacaine hydrochloride (1% solution), or prilocaine (1% solution) was studied in 60 patients scheduled for surgery of the hand and forearm regions. The sensory block of the axillary, musculocutaneus, radial, median, ulnar and medial brachial cutaneous nerves was recorded using the pin-prick test every 5 min after injection and the motor block was assessed by testing the power of the corresponding muscles up to 30 min after injection. The degree of intraoperative analgesia attained was also determined. The venous methemoglobin level was determined before and 2 h after the administration of the local anesthetic agent. The development of sensory blockade was significantly faster after 10 min and 15 min in the radial nerve, and the development of motor blockade after 15 min and 20 min in the axillary nerve, using mepivacaine. After 30 min, there were no significant differences in the degree of sensory or motor block attained between the two groups. Intraoperative analgesia was attained in 27 patients of the mepivacaine group, versus 23 patients of the prilocaine group (NS). The methemoglobin level was always elevated following prilocaine, but not following mepivacaine. Two patients had an increase of the methemoglobin concentration to more than 11% after the administration of prilocaine. Neither the higher toxicity to the central nervous and cardiovascular systems from mepivacaine, nor the methemoglobin formed by prilocaine seems to be of clinical significance with the dosage and technique employed. PMID- 3303179 TI - Biological half-lives of chemicals in fishes. PMID- 3303180 TI - Propylene chlorohydrins: toxicology, metabolism, and environmental fate. PMID- 3303181 TI - Pesticide fate from vine to wine. PMID- 3303182 TI - Acceptance of the distinguished contribution award of the Society for Risk Analysis. PMID- 3303183 TI - [Ultrasonic and anatomical correlation of the normal hip in the newborn infant]. AB - Ultrasound studies were made on the cadavers of seven normal new-born foetuses. The sonographic images obtained were compared with anatomical sections made in corresponding planes. An accurate analysis of the anatomy of the cartilaginous acetabular roof and labrum in these hips confirmed the accuracy of ultrasonography. Ultrasonography has made it possible to resolve certain doubts about the radiographic examination of infants between birth and the third month. PMID- 3303184 TI - [French Society of Orthopedic and Traumatologic Surgery. Membership list]. PMID- 3303185 TI - [Arterial hypertension in newborn infants]. PMID- 3303186 TI - [Interventional radiology in the treatment of abdominal abscesses: results]. PMID- 3303187 TI - [Pyogenous spondylodiskitis. Study of 9 patients]. PMID- 3303188 TI - [Paroxysmal nocturnal hemoglobinuria: current concepts and controversies]. PMID- 3303189 TI - [LDL receptors]. PMID- 3303190 TI - [Can indirect immunofluorescence produce results in the diagnosis of legionellosis?]. PMID- 3303191 TI - [Wegener's granulomatosis: initial form of prostatic involvement]. PMID- 3303192 TI - [Electrocardiographic changes during orthotopic liver transplantation in swine]. PMID- 3303193 TI - [Morbidity and mortality in the clinical practice of anesthesiology and resuscitation. An updated review and recommendations for our country]. PMID- 3303194 TI - [Thrombocytosis and digestive neoplasms]. PMID- 3303195 TI - [Intestinal Escherichia coli infections]. PMID- 3303196 TI - [Diagnosis of gastroesophageal reflux]. PMID- 3303197 TI - [Medical treatment of chronic intestinal inflammatory disease]. PMID- 3303198 TI - [Effect of chronic consumption of alcohol on the hypothalamo-pituitary-testicular axis in the rat]. AB - An experimental model of chronic alcohol abuse is developed, in order to study the hypothalamic-pituitary testicular axis in the rat. For this purpose basal plasma prolactin, gonadotropins, testosterone and estradiol have been measured. Also these hormones were studied after LHRH or hCG stimulation. This experimental model allows us to study the role of alcohol in hypogonadism induction. Chronic alcohol administration resulted in an inconstant decrease in plasma testosterone levels and very diminished response of it to hCG. Along with these modifications, there was an increase in basal plasma estrogen levels, as has been shown in the human. The decrease in plasma LH levels in alcoholic rats together with a normal response to LHRH suggest a toxic role of alcohol at higher levels than the pituitary. The existence of a hyperprolactinemic state under chronic alcohol ingestion is confirmed. The decrease in plasma prolactin levels after LHRH administration suggests that prolactin and gonadotropin secretion are very closely related. PMID- 3303199 TI - [Direct and indirect pulp capping. Indications, contraindications and medicaments]. PMID- 3303200 TI - [Inflammatory mechanisms of bronchial asthma]. AB - The definition of asthma brings with it the idea of inflammation, as bronchial obstruction, which characterises it, is associated with bronchospasm, hypersecretion and oedema. In the asthmatic, awareness of the bronchial inflammation at the time of diagnosis is essential, as it contributes to prognosis and therapeutic orientation. The diagnosis of bronchial inflammation begins with the clinical assessment, such as cough, expectoration and the worsening of symptoms in the morning alerts the clinician. In the course of certain clinical forms of asthma the absence of any relief of airflow obstruction by bronchodilators, although it is proved to be reversible after a few days of glucocorticoids, is evidence of inflammation. Fibreoptic bronchoscopy extends the clinical examination and enables a direct observation of airways inflammation. In addition it allows sampling, such as bronchial biopsy and/or broncho-alveolar lavage. The mechanism of bronchial inflammation are well understood; some mastocytes (mucous) are present in the broncho-alveolar contents and are probably the origin of inflammatory reaction, whether the stimulus be allergenic or not. The mediators liberated lead in part to the bronchial obstruction but equally to cellular recruitment and thus to an amplification of the initial reaction. Probably the eosinophils play a fundamental role ar this stage. The alveolar macrophages are equally implicated in this inflammatory reaction. Bronchial inflammation appears as a result of complex cellular reactions, regulated by chemical mediators. The most obvious consequence of bronchial inflammation is the delayed bronchial reaction. The experimental model contributes to physio pathological understanding and a characterisation of the inflammatory components is observed principally in those patients with severe asthma. Agents capable of causing or aggravating bronchial hyper-reactivity can also induce bronchial inflammation. From this observation the idea is born of a relation between the concept of bronchial hyper-reactivity and bronchial inflammation. Acquired bronchial hyper-reactivity evolves in parallel to the symptoms and its intensity is correlated with the severity of the asthma. An understanding of the inflammatory mechanisms without doubt will bring new therapeutic perspectives. PMID- 3303201 TI - [Historical development of rehabilitation of cancer patients in the Hamburg area]. AB - It had been particularly noticeable in the post-war years that a surprisingly large number of women who had undergone cancer treatment (mostly for uterine and breast cancer) had to be readmitted in poor general health soon after their initial discharge home. Although the full treatment regimen then available was applied (such as blood transfusions, vitamin-glucose-infusions, and antibacterial medication), a larger number of deaths occurred, without any trace being found of the presence of residual cancer, early recidive, or second carcinoma. Close medical observation, finally, lead us to conclude that these patients' stamina had been too deeply undermined to be able to overcome the disease and treatment aftermath, caused mainly by chronic under-nourishment, both quantitatively and qualitatively, by often disastrous housing conditions (in refugee camps, cellars, etc.), the emotional strain experienced due to death or imprisonment of the closest relatives, and, in particular, by the resulting obligation to maintain the family, usually through work under very strenuous conditions, as well as by flight and hence loss of the accustomed environment. In cooperation with the social security administrations, these insights brought about the provision of "convalescent cures" of 4-6 weeks duration, with repeat health resort treatments being possible till the end of the third year post-discharge. Again involving the social security institutes, these measures, in the process of our growing knowledge of fact and inter-relationships, were extended to become the disease specific aftercare treatment provided in rehabilitation clinics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3303203 TI - [Etiopathogenesis of chronic nutritional pancreatitis]. AB - The most current form of chronic pancreatitis, i.e. chronic calcifying pancreatitis, is often related to nutritional causes. This disease is characterized by formation within the pancreatic ducts and the lumina of accini of precipitates and calculi composed of calcium carbonate and of a newly discovered protein, the pancreatic stone protein (PSP). The formation of precipitates depends on two mechanisms: (1) a non etiological disorder reducing the secretion of PSP. This small phosphoglycoprotein is a calcium stabilizer which prevents the crystallization of calcium carbonate in a super saturated solution such as pancreatic juice, (2) modifications of the pancreatic juice related to the cause of the disease. In Occidental countries the main etiological factor is alcohol consumption associated with protein-and-fat-rich or fat-poor diets. Like hypercalcaemia, another cause of the disease, a chronic consumption of alcohol increases the pancreatic secretion of secretory proteins (enzymes) via its action on the cholinergic nerves. In some tropical countries, chronic pancreatitis is observed in children and associated to malnutrition. However, according to recent studies neither kwashiorkor nor manioc consumption seem to be responsible for the occurrence of this disease. PMID- 3303202 TI - [New transportable CPAP respiratory aid]. AB - A mobile respiratory aid has been developed for a 7-year-old child in cooperation with the Institute for Electromechanical Construction of Darmstadt Technical University. Born prematurely in week 27 with bronchopulmonary dysplasia, she has thus been enabled to leave the ward without any major technical difficulties, opening up numerous opportunities for development to the child notwithstanding her continuing dependence on the breathing aid. The robust, handy device weights less than 10 kg, and is housed in an aluminum case the size of a briefcase. It is battery-driven, a charging lasting for some 7 to 8 hours of operation. All parts subject to wear, such as filter, tubings, and bellows, are commercially available through the medical equipment market. Reported is a period of use of more than 2000 hours, and it is hoped that other pediatric centres looking after children with similar problems will cooperate in further developing this mobile CPAP respiratory aid. PMID- 3303204 TI - Synthetic arterial grafts cause prolonged increase in the in vivo formation of thromboxane and prostacyclin in humans. AB - To evaluate the in vivo production of thromboxane A2 and prostacyclin their major urinary metabolites were measured in patients following graft replacement of the abdominal aorta. Specific methods based on gas chromatography-mass spectrometry were used to measure the urinary excretion of 2,3-dinor-TxB2 and 2,3-dinor-6-keto PGF1 alpha. The excretion of these metabolites increased tenfold and almost fortyfold during post-operative Day 1 and remained elevated 6-10 days p.o. In a group undergoing cholecystectomy smaller changes of shorter duration were seen. It is concluded from this study that synthetic grafts cause prolonged increase in the in vivo formation of thromboxane A2 and prostacyclin. The reason for the increased TxA2 formation is probably platelet interaction with the foreign surface, whereas the increase of PGI2 could be part of a vascular defense against induced thrombotic activity. Those increases may have pathophysiologic implications. PMID- 3303205 TI - The pathology and pathogenesis of Salmonella stanley infection in experimental chicks. AB - Experimental infection with Salmonella stanley was produced by oral, intravenous and intramuscular routes in day-old chicks. The earliest evidence of the presence of the organisms was in duodenal mucosa six hours after oral infection. Following oral infection the organisms were detected in the duodenum from six hours to five days, in the caecum from 12 hours to nine days, liver, spleen and blood from 24 hours to seven days. The resistance to infection was found to be significant after 10 days old, but not up to six days old. The work confirmed that the survival time of birds given S stanley by the intravenous or intramuscular routes was inversely proportional to the dose up to a maximum beyond which the survival time was not further decreased by dose increase. The presence of S stanley in tissues and blood was detected by isolation and by the fluorescent antibody technique. PMID- 3303206 TI - Cryptosporidiosis and the follicle-associated epithelium over the ileal Peyer's patch in calves. AB - Three calves were studied in stages of spontaneous cryptosporidial infection with particular reference to the relation of the cryptosporidia to the follicle associated epithelium (FAE) over the ileal Peyer's patch (IPP). In early infection scanning electron microscopy and streptavidin immunoperoxidase staining showed marked predilection of cryptosporidia for the FAE. Cryptosporidial antigen was also found in subepithelial tissue, both in the domes over the IPP and in villi, apparently in macrophages, where the parasites seemed to be progressively degraded. The FAE showed long tightly spaced microvilli, replacing normal low folds and protrusions, particularly in late infection. Endocytosis of indian ink was restricted to the cell periphery in late infection, contrasting the normal, more even distribution of endocytosis in the FAE apical cytoplasm. Few parasites were seen in the intestinal mucosa at this stage. At convalescence the FAE was normal, but all stages of infection were characterised by elongation of microvilli in absorptive cells. PMID- 3303207 TI - Ochratoxicosis A in young Khaki Campbell ducklings. AB - Ochratoxin A (OA), a potent nephrotoxic mycotoxin, was fed at 2 ppm in the diet to Khaki Campbell ducklings from hatch to 18 days old. It caused retarded growth, enlargement of the kidneys and liver and regression of the thymus. Light and electron microscopical changes seen in the liver included an accumulation of glycogen and the presence of mis-shapen mitochondria in the hepatocytes. OA caused thickening of the glomerular basement membrane and in infiltration of lymphoid cells into the kidney. There was an increased deposition of IgG in the glomeruli. OA-fed ducklings had normal levels of circulating IgG in their sera and there was a subepithelial migration of IgG-positive cells in the bursa of Fabricius. In general, OA-induced changes seen in ducklings, both with the light and electron microscopes, were similar to, but less pronounced than those seen in the fowl and turkey. PMID- 3303208 TI - The Y chromosomal lampbrush loops of Drosophila. PMID- 3303209 TI - Contributions of electron microscopic spreading preparations ("Miller spreads") to the analysis of chromosome structure. PMID- 3303210 TI - Replication of DNA in eukaryotic chromosomes. PMID- 3303211 TI - Gene amplification in dipteran chromosomes. PMID- 3303212 TI - Arrangement of chromosomes in interphase cell nuclei. PMID- 3303213 TI - Heterochromatin and the phenomenon of chromosome banding. PMID- 3303214 TI - Multiple nonhistone protein-DNA complexes in chromatin regulate the cell- and stage-specific activity of an eukaryotic gene. PMID- 3303215 TI - Polytene chromosomes. PMID- 3303216 TI - Genetics of sex determination in eukaryotes. PMID- 3303217 TI - Lampbrush chromosomes as seen in historical perspective. PMID- 3303218 TI - The sp-I genes in the Balbiani rings of Chironomus salivary glands. PMID- 3303219 TI - [Respiratory heat loss and water loss]. PMID- 3303220 TI - [Surgical treatment of tachyarrhythmias]. PMID- 3303221 TI - [Respiratory changes in the obstructive sleep apnea syndrome during nasal continuous positive airway pressure]. PMID- 3303222 TI - [The work of breathing and the load of respirators during intermittent mandatory ventilation]. PMID- 3303223 TI - [Prevention of blindness in Chad. Effects of a difficult conjuncture. First measures]. PMID- 3303224 TI - [Cornea transplant in the treatment of pterygia. Preliminary note]. PMID- 3303225 TI - [Role of the Armed Forces Health Services in the fight against trachoma and blindness in Africa]. PMID- 3303226 TI - [Homage to Prof. Roger Nataf 1901-1986]. PMID- 3303227 TI - [Pharynx closure by autosuture in pharyngolaryngeal surgery]. PMID- 3303228 TI - Pathology of growth hormone-producing tumors of the human pituitary. AB - This paper reviews the morphologic features of growth hormone-producing tumors of the human pituitary. These tumors are associated with elevated blood growth hormone levels and acromegaly or gigantism and can be classified into the following morphologically distinct entities by the combined application of histology, immunocytology, and electron microscopy: densely granulated growth hormone cell adenoma; sparsely granulated growth hormone cell adenoma; mixed growth hormone cell- prolactin cell-adenoma; acidophil stem cell adenoma; mammosomatotroph cell adenoma; growth hormone cell carcinoma; plurihormonal adenoma with growth hormone production. PMID- 3303229 TI - Pathology of prolactin cell adenomas of the human pituitary. AB - Prolactin (PRL) cell adenoma is the most common tumor type in the human pituitary. It accounts for 30% of surgically removed adenomas, while its prevalence is even higher (45%) among incidental pituitary tumors observed at autopsy. Most PRL cell adenomas are highly differentiated with a characteristic ultrastructure. Administration of bromocriptine, a dopaminergic agonist, evokes profound morphologic changes in responsive PRL cell adenomas, while it leaves the fine structure of unresponsive tumors unchanged. The importance of immunocytochemical and electron microscopic investigation of pituitary biopsies is emphasized as tumors with different cell derivation, biological behavior, and therapeutic responsiveness may mimic PRL cell adenomas clinically. PMID- 3303230 TI - The human thyrotropic adenoma: pathologic diagnosis in five cases and critical review of the literature. AB - Five out of 400 surgically removed pituitary tumors (frequency: 1.2%) were identified as thyrotropic adenomas according to the following criteria: identification of tumoral thyrotropic cells by immunocytochemistry and ultrastructural study; elevated serum TSH levels with decrease after surgery; and elevated concentration of TSH in the tumor. Four patients presented with hyperthyroidism and one with euthyroidism. From these five cases and 11 similar observations extracted from a critical review of literature, the morphologic, immunocytochemical, and hormonal characteristics of thyrotropic adenoma are described. Thyrotropic adenomas are more often large tumors but may also be microadenomas. The diagnosis is asserted by immunoreactivity with anti-TSH antisera. The TSH positive tumor cells are numerous. In some tumors, rare cells of other types are also found (PRL, GH, FSH, or ACTH cells). Some morphologic characteristics strongly suggest the diagnosis. The cells are often large with thin processes. They show argyrophil granulations in a slightly basophil cytoplasm and signs of secretory activity. Their secretory granules are round and small without striking variations in size, shape, and electron density. Elevated concentration of TSH in the tumor confirms the diagnosis. The presence of high serum TSH levels and a molar ratio of alpha hTSH to the whole TSH molecule greater than one are other good criteria. Decrease of TSH after surgery may not be observed in invasive tumors. TSH adenoma is most often associated with hyperthyroidism but it can also be associated with hypothyroidism or euthyroidism. PMID- 3303231 TI - The pathology of nonfunctional pituitary adenomas. AB - The nonfunctional adenomas also known as undifferentiated, null cells, or nonsecretory adenomas are endocrinologically silent neoplasms of the anterior lobe of the pituitary gland. They constitute 50% of all pituitary adenomas in the present report. Most tumors are large, often growing beyond the confines of the sella turcica and characterized anatomically by displacement and compression of the adjacent sellar structures including the optic chiasm, hypothalamus, and third ventricle. Others may be truly invasive when they locally or diffusely infiltrate the adjacent structures. They may grow through the dura and the bone into the cranial cavity and/or the sphenoidal sinus and the nasopharynx or infiltrate one or both cavernous sinuses. Seventy-six adenomas were divided into 48 nononcocytic adenomas and 28 oncocytic adenomas or oncocytomas occurring in older patients. By light microscopy using conventional histologic stains, the majority of nononcocytic tumors were chromophobic. The oncocytomas were slightly acidophilic with a large granular cytoplasm. With the peroxidase-anti-peroxidase (PAP) method with anti-sera for the anterior pituitary hormones, the adenoma cells show no immunostaining. Ultrastructurally, the nononcocytic tumors possess a modest number of small secretory granules but no specific ultrastructural features. The oncocytic tumors are characterized by an excessive number of mitochondria in their cytoplasm. With the PAP method using cytochrome C oxidase antiserum, specific identification of mitochondria can be made. As the nonfunctional adenomas are devoid of anterior pituitary hormones they have been called "null cell" adenomas. However, most of the null-cell adenomas are positive for chromogranin. The diagnosis of nonfunctional adenoma can be suspected clinically when in the absence of signs of hypersecretion of pituitary hormones, there is radiologic evidence of ballooning of the sella and bulging of its diaphragm. An invasive adenoma can be detected by radiologic signs of destruction of the sella turcica and its boundaries or by neurosurgical intervention when there are findings of invasion of the dura, the parasellar, and suprasellar structures. PMID- 3303232 TI - Sequestrations of the lung. AB - Sequestration of the lung is a well-recognized entity usually subclassified into one of two groups based on its location: intralobar sequestration (ILS), within the normal pleural investment, and extralobar sequestration (ELS), outside the normal pleural investment. ELS is clearly congenital in origin; it is seen most frequently in the neonatal period, is associated with other anomalies, and is supplied by systemic and/or pulmonary arteries. ILS, on the other hand, in the majority of cases, probably results from repeated episodes of chronic pneumonia producing, through the process of granulation tissue formation, parasitization of normally occurring pulmonary ligament arteries resulting in a systemic artery supply to the infected area of lung. Its location (almost exclusively in the lower lobes) is dependent on the availability of systemic arteries situated only in pulmonary ligaments between the lower lobes and the mediastinum. Further support for the acquired nature of this lesion is its almost complete absence in neonates and infants, the infrequency of associated anomalies, and the consistent features of chronic inflammation and fibrosis within resected specimens. PMID- 3303233 TI - The diagnosis and prognosis of soft tissue tumors. AB - In this review, we present our experience on the clinical, radiographic, and morphologic diagnosis of soft tissue tumors gathered over a quarter of a century. Included is a brief presentation of our principles for surgical therapy and the results of multivariate statistical analysis performed to assess which clinical and morphologic variables determine prognosis. PMID- 3303234 TI - Epithelioid hemangioendothelioma and related lesions. AB - Epithelioid hemangioendothelioma (EH) is the prototype of a group of vascular tumors characterized by an epithelioid or histiocytoid endothelial cell. This family also includes the epithelioid hemangioma (angiolymphoid hyperplasia with eosinophilia) and epithelioid forms of angiosarcoma. This review discusses the principal clinical, pathologic, and biologic differences among these three lesions. In particular the various manifestations of EH of soft tissue, bone, lung (previously called intravascular bronchioloalveolar tumor), and liver are discussed. Long-term follow-up data of EH of soft tissue and lung are provided. PMID- 3303235 TI - Cartilage- and bone-forming tumors of the soft tissues. AB - Benign and malignant cartilage- and bone-forming tumors arising in soft tissues are unusual. Hyaline cartilage tumors may easily be mistaken as malignant if the histologic criteria of intraosseous lesions are applied directly. Other chondroid and bone-forming tumors also may be difficult to recognize. The correct pathologic diagnosis within this group of neoplasms requires close clinical correlation, as well as familiarity and careful interpretation of a broad histologic spectrum. PMID- 3303236 TI - Immunohistochemistry of cytoskeletal filaments in the diagnosis of soft tissue tumors. AB - There is abundant evidence that intermediate filaments can be used as cell type specific markers both for normal tissue and for tumors. The results of intermediate filament typing in soft tissue tumors and its diagnostic relevance is shown. This system can also be used to solve other problems in surgical pathology. One of the most useful applications of intermediate filament typing is to differentiate the round cell tumors of children; thus, rhabdomyo-sarcomas are desmin positive, malignant lymphomas contain only vimentin, and neuroblastomas show positivity for neurofilaments. PMID- 3303237 TI - Ultrastructural studies in the preoperative cytologic diagnosis of soft tissue tumors. AB - A consecutive series of 100 patients operated on for lesions that were assumed to be soft tissue tumors, all of whom had been the subject of fine-needle aspiration in the preoperative investigation, is described. A correlative study of smears and the light- and electron-microscopic findings of embedded fine-needle aspirates and the histopathology of the surgical specimens was performed. Eighty of the lesions were found to be genuine soft tissue tumors, of which 51 were sarcomas. The other 20 cases were either metastatic carcinoma, malignant melanoma, or malignant lymphoma. The embedding technique produced additional light-microscopic information about tissue structure and growth pattern, and electron-microscopic information about tissue and cell differentiation of importance to the diagnosis. In the case of certain types of soft tissue tumor, such as lipoma, neurilemmoma, liposarcoma, and malignant fibrous histiocytoma, and for well-differentiated metastatic carcinoma and pigmented malignant melanoma, the diagnosis may be strongly suggested by the appearance of the smears; the embedding technique serves to further support the diagnosis. In the case of small round-cell malignancies, the ultrastructural examination proved to be of special value, ie, in the distinction of rhabdomyosarcoma, poorly differentiated metastatic small cell carcinoma and malignant melanoma, and occasional cases of malignant lymphoma. Spindle cell sarcomas, such as leiomyosarcoma when well differentiated, biphasic synovial sarcoma when it includes glandular structures, and malignant hemangiopericytoma, could be recognized ultrastructurally, although electron-microscopy generally failed to reach a definite diagnosis as to the subtype in most cases of poorly differentiated spindle-cell sarcoma. PMID- 3303238 TI - Prevention and treatment of the abnormalities in divalent ion metabolism in renal failure. PMID- 3303239 TI - The hemodynamic basis of progressive renal disease. PMID- 3303240 TI - Magnetic resonance measurements of renal metabolism, structure, and function. PMID- 3303241 TI - New insight into hemofiltration. PMID- 3303242 TI - New therapeutic protocols in kidney transplantation. PMID- 3303243 TI - Current thinking on the management of the uremic diabetic. PMID- 3303245 TI - [Hypereosinophilia: from basic data to clinical aspects]. PMID- 3303244 TI - [Effects of discontinuous intravenous infusion of ramified amino acids on blood insulin, blood glucagon and protein metabolism in cirrhotic patients after 10 days. Results of a controlled comparative study with sorbitol]. AB - In order to evaluate the effects of ramified amino acids on insulinaemia, glucagonaemia and protein metabolism, a 3-hour infusion of ramified amino acids (24 g in a 750 ml solution) was given daily during 10 days to 10 cirrhotic patients without hepatic encephalopathy (group I). Changes between the first and tenth day in plasma concentrations of plasma insulin, glucagon, ammonium, ramified and aromatic amino acids and 3 proteins (albumin, prealbumin and transferrin) markers of protein malnutrition were measured comparatively with 10 other cirrhotic patients who received daily a 750 ml infusion of 5 p. 100 sorbitol (group II). The patients, who had been randomized to group I or II, had a 2,200 calorie/day diet representing a 6 to 12 g nitrogen intake. The ramified amino acid infusions were well tolerated. They produced a significant (p less than 0.001) increase in glucagonaemia without significant change in insulinaemia, and a non-significant decrease of the plasma insulin/glucagon molar ratio. The arterial blood ammonium level was significantly (p less than 0.05) lowered in group I as compared to group II. The plasma ramified/aromatic amino acid molar ratio significantly (p less than 0.01) increased in group I but did not reach normal values; this increase was not significant when compared to group II. Finally, plasma concentrations of the 3 proteins indicating protein malnutrition remained low in both groups. These results suggest that daily intravenous administration of ramified amino acids for 10 days, to supplement a conventional diet failed to correct the protein hypercatabolism associated with cirrhosis; induced, however, a decrease in arterial blood ammonium levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3303246 TI - [Some current morphological aspects of glomerulopathies in humans]. PMID- 3303247 TI - Effect of methylcobalamin in accommodative dysfunction of eye by visual load. AB - The effect of methylcobalamin on the accommodative function of subjects with deteriorated accommodation by induced experimental visual work was studied by measuring small fluctuations of accommodation. The deterioration of small fluctuations of accommodations were difficult to find after visual work in the group receiving methylcobalamin. However, a significant difference of small fluctuations of accommodation was recognized in the non-administered group and in the placebo group (P less than 0.05), and that change was higher in the non administered group than in the placebo group. Although, the placebo effect of methylcobalamin was undeniable, it was objectively confirmed that methylcobalamin produced a good effect on deteriorated accommodation induced by the visual work. PMID- 3303248 TI - [Fifty-six cases of human dirofilariasis reported in Japan--a complied table]. AB - Since the first reported case of human dirofilariasis in 1964, a total of 56 cases have been recorded from Japan, including 39 pulmonary and 16 extra pulmonary cases. The difference in case number between pulmonary and extre pulmonary sites is statistically highly significant (P = 0.001). Distribution of the lesion in pulmonary dirofilariasis is mainly concentrated in the right lung (P less than 0.001). The rapid increase of human dirofilariasis within the last 5 years indicates that this disease is one of the important anthropozoonoses. PMID- 3303249 TI - Evaluation of a new commercial kit (UROBACT) for detection of bacteriuria. AB - A new commercially available method (UROBACT, AB Dermaci, Sweden) for detection of bacteriuria was compared to a conventional semiquantitative bacteriological method. The kit consisted of two tubes, which were inoculated with urine in two different dilutions. Positive tests were recorded as a colour change from red to yellow in both tubes, and the test was considered negative if one or both tubes remained red. When studying 556 urine samples, the test detected 153 of 163 samples with greater than or equal to 10(5) colony forming units (CFU) of bacteria per ml, i.e. the sensitivity was 93.9%. Among the samples containing less than 10(5) CFU/ml, 347 of 357 were recorded as negative, giving a specificity of 97.2%. Although relatively few urine samples containing Staphylococcus saprophyticus and Pseudomonas pyoceanea were tested the results indicated that the method was less reliable for these species. However, compared to dip-slides, which also give poor results with S. saprophyticus, the new test has several advantages, including a more simple interpretation, i.e. a distinct colour change. PMID- 3303250 TI - Accumulating evidence from independent studies: what we can win and what we can lose. AB - When asking 'what is known' about a drug or therapy or program at any time, both researchers and practitioners often confront more than a single study. Facing a variety of findings, where conflicts may outweigh agreement, how can a reviewer constructively approach the task? In this discussion, I will outline some questions that can only be answered by examining a group of independent studies. I will also discuss some pitfalls that sometimes swamp the benefits we can gain from synthesis. Most of these pitfalls are avoidable if anticipated early in a review. The benefits of a quantitative review include information about how to match a treatment with the most promising recipients; increasing the statistical power to detect a significant new treatment; telling us when 'contextual effects' are important; helping us to assess the stability and robustness of treatment effectiveness; and informing us when research finds are especially sensitive to investigators' research design. The pitfalls include aggregating data from studies on different populations; aggregating when there is more than one underlying measure of central tendency; and emphasizing an average outcome when partitioning variance gives far more useful information. PMID- 3303251 TI - An overview of six clinical trials of aspirin in coronary heart disease. AB - Data from six randomized, placebo-controlled clinical trials of aspirin, involving a total of 10,703 post-myocardial infarction patients, have been compared and combined. An apparent heterogeneity of findings among the six trials with respect to all-cause mortality is noted (P = 0.08). The reasons for this heterogeneity are explored. Two common methods of combining the results of several trials--the logrank and the log odds ratio methods--yield two-sided P values of 0.112 and 0.110, respectively, for the aspirin-placebo effect on all cause mortality. Alternative statistical methods of combining the results of the six trials give two-sided P-values ranging from 0.017 to 0.487. PMID- 3303252 TI - [Precocious puberty]. PMID- 3303253 TI - [Diagnostic and therapeutic value of monoclonal antibodies in nephrology]. PMID- 3303254 TI - [Value of isotope labeling of platelets in tests for thromboembolic pathology]. PMID- 3303255 TI - [Bone marrow allografts and autografts. Principles and indications]. PMID- 3303256 TI - [Marrow transplantation: preliminary results at the University Hospital Center]. PMID- 3303257 TI - [Risk of developing cancer in ulcer hemorrhagic rectocolitis]. PMID- 3303258 TI - [Rehabilitation treatment of patients with arteritis of the lower limbs]. PMID- 3303260 TI - [Detection of cancer of the breast]. PMID- 3303259 TI - [Scabies]. PMID- 3303261 TI - [Pancreatic transplantation in 1986]. PMID- 3303262 TI - [Sonography in thyroid gland diagnosis]. PMID- 3303263 TI - [A case from the practice (83). Patient: Mr. M.E., born February 1, 1899]. PMID- 3303264 TI - [A case from the practice (84). Patient: male, 25 year-old]. PMID- 3303265 TI - [Abdominal pain and hypertension]. PMID- 3303266 TI - [Digital subtraction angiography in arteriovenous fistulas of patients on hemodialysis]. AB - Our experience in about fifty explorations performed in patients with arterio venous fistulas for hemodialysis is presented. The method of exploration is widely detailed. We think that the acquisition of the digital subtraction angiography in the diagnostic of this specific pathology is a great advance because the images are of excellent quality and the volume of contrast administered is low. PMID- 3303267 TI - [Epidemiology of Alzheimer's type dementia]. AB - Although still fragmentary, currently available epidemiologic data allow an analysis of the magnitude of the problem raised by Alzheimer type dementia. Its prevalence after 65 years of age varies between 1 and 5.8 p. 100, increasing markedly with advancing age to reach, from about 0.1 p. 100 between 55 and 65 years, 1 p. 100 between 65 and 74 and 10 p. 100 beyond 85 years. Based on these data it can be estimated that there are presently about 300,000 patients 60 years of age or over with Alzheimer type dementia (ATD) in France. The only risk factor for ATD identified at the present time is age but a family history of dementia could constitute a further risk factor for the disease. Progress in the field of epidemiology of ATD requires the development and validation of diagnostic criteria and standardized measuring instruments, allowing comparison of results of studies conducted by different teams in different countries, nearly impossible up to the present. PMID- 3303268 TI - [Synthesis of gingival retraction technics]. PMID- 3303269 TI - Gaze stabilization in the primate. The interaction of the vestibulo-ocular reflex, optokinetic nystagmus, and smooth pursuit. PMID- 3303270 TI - Renal prostaglandins and leukotrienes. PMID- 3303271 TI - Damage to mammalian cells by proteins that form transmembrane pores. PMID- 3303272 TI - [Subcutaneous mastectomy. Indications and surgical technics]. AB - After having specified basic anatomy notions (excision line, vascularization, innervation), technics of under cutaneous mammectomy are presented with their alternatives and their difficulties. The opportunity and methods of the prosthetic restoration are debated. Present indications of the under cutaneous mammectomy are related in detail in the malignant and preneoplastic pathology and under other circumstances. PMID- 3303273 TI - [Improvement in the prenatal etiologic diagnosis of severe 2d trimester oligo amnios by intra-amniotic injection of physiologic solution]. AB - In reference to 4 severe cases of oligo-amnios of the second trimester of pregnancy, the authors advocate a method in order to improve the pre-natal diagnosis by intra-amniotic injection of a normal saline solution. This method facilitates the morphological exploration of the fetus by sonogram and enables to obtain a fetal karyotype by umbilical or amniotic tap. The potential risk of this technique are described. PMID- 3303274 TI - [Diabetes in pregnancy]. AB - Following a review of the literature, often too conflicting, the authors are attempting to define a coherent approach to the problem of diabetes in pregnancy. Described as a diabetic condition occurring during pregnancy, diabetes should be looked for in all pregnant women, using the O'Sullivan's screening test performed between the twenty sixth and thirtieth weeks of amenorrhea. The diagnosis of diabetes will only be confirmed by an oral glucose tolerance test. PMID- 3303275 TI - [Polyradiculoneuritis and pregnancy. Apropos of 1 case]. AB - The authors report a case of severe Guillain-Barre syndrome that appeared during the eighteenth week of a second gestation which evolved to full term without complication. The particularity of this observation was that the follow-up of the foetus was made possible for the first time by echography which showed normal active foetal movements even during maximum maternal paralysis. From of review of thirty three cases recorded in the literature, it seems clear that the interrelationship between the neurological disorder and pregnancy is nil or minimal beside an increased risk of prematurity childbirth can proceed normally and cesarean section is not indicated. Plasmapheresis proposed as an early treatment is discussed in the case of pregnant women. Today pregnancy is no longer a particular contraindication of such management. PMID- 3303276 TI - Upper extremity injuries in athletes: an overview. PMID- 3303277 TI - Sports related knee injuries in the pediatric and adolescent athlete. PMID- 3303278 TI - One-dose beclomethasone dipropionate aerosol in the treatment of seasonal allergic rhinitis. A preliminary report. AB - Forty-one patients were treated during the birch pollen season for three weeks in a randomized, double-blind placebo controlled preliminary study. Ten patients were treated with beclomethasone dipropionate aerosol 400 micrograms once daily, 10 patients with placebo once daily, 10 patients with 400 micrograms beclomethasone dipropionate in the morning and placebo in the evening and 11 patients with 200 micrograms beclomethasone twice daily. The severity of the nasal symptoms was compared before the trial, during the pollen season without treatment, at the time of peak pollen counts and at the end of the treatment. Symptoms were equally controlled by beclomethasone dipropionate 400 micrograms once daily (two puffs of 100 micrograms per nostril), and 200 micrograms twice daily (two puffs of 50 micrograms per nostril twice). All active drug regimens were better than placebo. In conclusion, this study shows that one-dose beclomethasone dipropionate of 400 micrograms is effective in the treatment of seasonal allergic rhinitis. PMID- 3303279 TI - Ultrasonography of the paranasal sinuses. A new computerized equipment using LCD display and capture mode. AB - Ultrasonography of the paranasal sinuses is a well established method. However, no technical development in this field has taken place during the last five years. In order to improve the method a new computerized equipment with a graphic liquid crystal display (LCD) and capture mode has been designed. PMID- 3303280 TI - Histologic changes in nude mouse skin and human skin xenografts following exposure to sulfhydryl reagents: arsenicals. AB - This report documents the histological changes in nude mouse skin and in human skin xenografts on nude mice following exposure to phenyldichloroarsine (PDA), a vesicant arsenical. Under light microscopy, we observed in PDA-treated human skin grafts: 1) degeneration of epidermal cell nuclei (apparent by 2 hr after exposure with increasing severity through 48 hr); 2) loss of epidermal cytoplasmic basophilia (apparent by 4 hr, maximal within 12 hr); 3) epidermal cytoplasmic vacuolization (vacuoles appeared within 4 hr and increased in size through 24 hr); 4) cleft formation within the basement membrane zone (apparent by 12 hr, increasing in severity through 24 hr); 5) inflammation evidenced by polymorphonuclear leukocyte (PMN) infiltration (apparent by 4 hr and increasing through 48 hr). The PMNs frequently formed a wall around the lesion, but did not infiltrate the treated area. Nude mouse skin reacted faster to PDA than did the grafts, but the histological changes were similar. Nude mouse hair follicles and sebaceous glands showed similar cellular changes at approximately the same time as did epidermal cells. Transmission electron microscopy of mouse skin exposed to PDA revealed a widening of intercellular spaces with attenuation of desmosomes. The subepidermal clefts resulted from separation within the lamina lucida with the lamina densa forming the base of the cleft. Diphenylchloroarsine caused lesions histologically indistinguishable from those of PDA. Lesions resulting from exposure to other sulfhydryl-binding compounds were very different from arsenical lesions. The arsenical-sensitive cellular constituents were not identified. PMID- 3303281 TI - A nurse's guide to mechanical ventilation (continuing education credit). PMID- 3303282 TI - When the transplant patient is your husband. PMID- 3303283 TI - [Evaluating transplant kidneys: nuclear magnetic resonance tomography in comparison with sonography]. AB - In a prospective study we compared the results of MRI and ultrasound in assessing renal dysfunctions in 22 patients with renal allografts. The current diagnostic criteria are presented and the range of indications is evaluated in relation to perfusion scans. PMID- 3303284 TI - [Case examples of rare locations of aneurysms]. AB - We describe four cases of rare aneurysm localisations, one case of an aneurysm of the hepatic artery, two cases of aneurysms of the superior mesenteric artery and its branches and, as an extreme rarity, one case of an aneurysm of the superior gluteal artery (only three known cases up to now). All cases were documented by arteriography/DSA, ultrasonography and computed tomography. We refer to incidence, aetiology, symptomatology, and possible complications as indicated by literature. PMID- 3303285 TI - C5b-9 deposition in children with glomerular diseases. AB - Kidney biopsies were obtained in 28 children with glomerular diseases and studied using indirect immunofluoreoscence and immunoperoxidase for the detection of IgG, IgA, IgM, Clq, C3c, C4, Fibrinogen and the neoantigens of the terminal C5b-9 complement complex. An affinity-purified rabbit IgG was used to recognize the neoantigens of the assembled terminal components of the complement system into the C5b-9 complex. The immunohistochemical studies were correlated to the clinical data and laboratory investigations. Fourteen of the 28 patients presented specific C5b-9 glomerular deposits; they were also present at the tubular sites in 8 patients and at the vascular sites in 12 patients. An unfavourable evolution was observed for patients presenting C5b-9 deposits in contrast to those without such deposits, even of the same histopathological pattern of glomerulonephritis. The presence of C5b-9 complex at the site of glomerular injury suggests a pathological involvement of the "in situ" complement activation and could be a marker in the prognosis of the glomerular diseases. PMID- 3303286 TI - [Specific antibodies of soluble nuclear antigens in autoimmune vasculitis]. AB - In order to assess the clinical value of antinuclear antibody (ANA) assays in classifying vasculitis, 136 sera from 28 patients with cutaneous vasculitis alone, and 80 patients with vasculitis associated with a connective tissue disease or an unclassified arthritis were tested. ANAs were assayed by indirect immunofluorescence, anti-ENA and anti-histone antibodies were tested by immunodiffusion. ANAs are seldom in patients with cutaneous vasculitis alone (1 positive serum/28 = 3.5%). ANAs are more generally observed in vasculitis associated with systemic lupus erythematosus (SLE) (15 positive sera/16 vasculitis associated with SLE = 94%), rheumatoid arthritis (RA) (8 positive/30 RA with vasculitis = 27%), or a Sjogren syndrome (SS) (9 positive/19 vasculitis with SS = 47%). ANAs in SS are correlated with vasculitis or Raynaud's phenomenon. ANAs are not detected in vasculitis associated with other connective tissue diseases or unclassified arthritis. Anti-ENA antibodies are only found in vasculitis associated with SLE (11 positive sera/13 = 85%) or SS (3 positive sera/19 = 16%). Contrasting with the findings of other groups, our results show no anti-ENA antibodies in RA with vasculitis. Anti-RNP in SLE are correlated with cutaneous vasculitis (p less than 0.005). An antibody different from anti-Ro (SS A) antibodies but precipitating with a trypsinized human spleen extract was observed in 2/11 sera from RA with vasculitis and not in other sera. Its significance is not established yet; this antibody would have a clinical interest only if further studies showed a high prevalence in rheumatoid vasculitis. PMID- 3303287 TI - [Nicardipine in the treatment of Raynaud's phenomenon]. AB - The efficacy of the calcium-channel blocker nicardipine in the treatment of Raynaud's phenomenon was assessed in a double-blind, randomised, crossover trial in 20 patients. Each patient received 2 weeks of nicardipine 20 mg three times daily and 2 weeks of placebo. Nicardipine significantly improved the frequency and severity of Raynaud's phenomenon. An open study during 2 months in 30 patients confirmed the effectiveness of nicardipine (20-40 mg 3 times daily). Side effects (headache, flushing, ankle oedema) were frequent but usually mild. We conclude that nicardipine is effective in the treatment of Raynaud's phenomenon. PMID- 3303288 TI - [Repair of loss of facial substance due to firearm injury]. AB - Injury to the face as a result of firearm wounds differs as a function of whether the injury was due to a bullet or lead shot. In the first case treatment is usually that of a mandibular or maxillary comminuted fracture and is principally orthopedic. In the case of hunting guns the damage is considerable and requires reconstitution of soft tissue with the use of a distant flap (purely cutaneous or musculo-cutaneous), bone repair, when necessary, being by costal or iliac grafts. PMID- 3303289 TI - [The place of composite flaps in maxillofacial surgery]. AB - The preferred composite flap is the musculocutaneous flap from pectoralis major for repair of loss of mucocutaneous substance due to cancer or injury. In rare indications the musculocutaneous flap from sternocleidomastoid muscle is used. When loss of bone substance combined with a cutaneous or mucosal defect has to be corrected use is made of the bone-muscle-skin flap from pectoralis major to include the 5th rib, or the bone-muscle-skin flap from sternocleidomastoid to include internal portion of clavicle. Reliability on use of these two flaps has led to their application in surgery for mandibular osteoradionecrosis. In addition to allowing repair of bone continuity, the vascular and cellular capacities of the flap provide colonization and rehabilitation of the borders of lost substance with live tissue, as shown by subsequent bone remodelling. Results of statistical analysis of 50 cases are presented. PMID- 3303290 TI - Mechanisms of mucosal injury in the stomach and duodenum: time-sequence analysis of morphologic, functional, biochemical and histochemical studies. AB - This review is based on results from our laboratory and those published by others, and is focused on the early stages of pathogenesis that can be studied mostly in animals. Gastric mucosal injury is analysed on the examples of ethanol- and aspirin-induced lesions. Ethanol (50-100%) rapidly penetrates the mucosa, causes directly and/or indirectly (e.g., release of vasoactive products) endothelial damage in superficial and deep capillaries and venules. The vascular damage results in increased vascular permeability and decrease in blood flow leading to complete circulatory standstill in superficial capillaries 1-2 min after intragastric administration of concentrated ethanol. The direct chemical damage to surface mucosal epithelium is then followed by hypoxia and deep hemorrhagic necrosis in 1-5 min (erosion or ulcer). Unionized aspirin initiates a similar and complex yet slower progressing and less extensive erosion than alcohol. Duodenal erosion and ulcer produced by cysteamine, mepirizole or MPTP are preceded by excess acid in the proximal duodenum. This could be due to increased gastric acid output (1-4 hr), decreased bicarbonate secretion or duodenal dysmotility (0.5-8 hr) preventing the proper mix of acid and base in duodenal bulb. Necrosis and desquamation of absorptive cells in duodenal villi are evident 2-4 hr, followed by villus amputation (4-8 hr), erosion and ulcer (8 24 hr). The pathogenesis of gastroduodenal mucosal injury can thus be reconstructed from results obtained with animal models and from human studies. The results should serve as a basis to design protective drugs that are active on the basis of pathogenetic events. PMID- 3303291 TI - Gastroduodenal mucosal defence mechanisms and the action of non-steroidal anti inflammatory agents. AB - This review summarises gastroduodenal protective mechanisms, the actions of non steroidal anti-inflammatory (NSAI) agents on mucus and HCO3 secretions, and the basis of gastric mucosal injury induced by acetylsalicylic and salicylic acids (ASA and SA). Resistance to autodigestion by acid and pepsin present in gastric juice is multifactorial involving pre-epithelial (mucus-bicarbonate barrier) and post-epithelial (blood flow, acid-base balance) factors in addition to properties of the surface cell layer per se. The latter includes mucosal re epithelialisation, a property which appears particularly important with respect to recovery from acute injury. A range of NSAI agents (ASA, fenclofenac, ibuprofen and indomethacin) inhibit gastric HCO3 transport in isolated mucosal preparations. Inhibition of duodenal HCO3 transport has been demonstrated in response to indomethacin in vitro and in vivo. These effects on secretion can be antagonised by exogenous prostaglandins of the E series. The layer of secreted mucus gel overlying the epithelial surface is not affected by NSAI drugs in the short term. However a number of these agents have been shown to inhibit glycoprotein biosynthesis by the epithelial cells. Thus loss of this protective coat could be anticipated during chronic drug exposure since erosion of adherent mucus by luminal shear and proteolysis would not be compensated by continued secretion. Detailed analysis of the gastric mucosal injury induced by salicylates both in vitro and in vivo reveals that much of the damage previously attributed to ASA is in fact due to the metabolic product SA. In this respect it is concluded that mucosal injury caused by ASA is due to a combination of two factors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3303292 TI - Cytoprotective drugs. Focus on essential fatty acids and sucralfate. AB - Cytoprotection has been defined as an ability of prostaglandins to prevent gastric mucosal injury produced by a variety of ulcerogenic and necrotizing agents without inhibition of gastric acid secretion or without neutralizing intragastric acidity. Since the first demonstration of cytoprotection by prostaglandins many other agents have been claimed to be cytoprotective. Essential fatty acids: arachidonic and linoleic, licorice products, sucralfate, antacids and sulfhydryl compounds all possess cytoprotective properties. All of these compounds are able to prevent or reduce gastric mucosal necrosis produced by absolute ethanol, a necrotizing agent which injures mucosa independently of the luminal pH. Gastric mucosal protection by essential fatty acids is mediated by their conversion by the gastric mucosa to protective prostaglandins. Sucralfate and antacids are also cytoprotective compounds which stimulate release of endogenous prostaglandins from the gastric mucosa. PMID- 3303293 TI - Treatment of acute duodenal ulcer--a Swedish multicenter study. AB - Medical ulcer therapy focuses on enhancing mucosal defence mechanisms or reducing intraluminal acidity. In this Swedish multicenter, randomized double-blind study these two principles were compared in the treatment of acute duodenal ulcerations. Sucralfate (Andapsin 1g X 4) or cimetidine (Tagamet 400mg X 2), together with antacid tablets (Novalucol), were supplied to patients with acute ulcerations in the pyloric ring or duodenal bulb. Endoscopy was performed at inclusion, after four weeks and in some patients also after eight weeks. Besides healing rate, symptoms and antacid intake, smoking and side effects were recorded on a special protocol. 371 patients from 15 centers completed the trial. At inclusion the patient groups did not differ in any essential aspect. At four weeks 71% of 177 patients on sucralfate and 77% of 194 on cimetidine were healed. The corresponding figures for eight weeks were 86% (suc) and 92% (cim). The difference is not significant, the 95% confidence interval for the difference in ulcer healing efficacy of sucralfate compared with cimetidine at eight weeks was 12% to +5%. Antacid intake and symptoms decreased rapidly and equally in both groups. Side effects related to the treatments were uncommon. It is concluded that sucralfate and cimetidine, representing two different principles in medical ulcer treatment, are both very effective and compare well in the short term treatment of acute duodenal ulcer. PMID- 3303294 TI - Swedish multicenter study on prepyloric and gastric ulcer. AB - A double-blind, randomized, multicenter study was performed to compare the effects of sucralfate and cimetidine for the short-term treatment of gastric and prepyloric ulcers. Ulcer healing was evaluated endoscopically at 4-week intervals up to 8 weeks in the PPU study and up to 12 weeks in the GU study. A total of 142 PPU and 134 GU patients completed the study. The overall healing rates after 8 weeks in the PPU study were 83% for the sucralfate group and 90% for the cimetidine group (NS), while the cumulative healing rates after 12 weeks in the GU study were 98% for the sucralfate group and 94% for the cimetidine group (NS). The confidence interval means that the 95% confidence limit ranges from 11% in favour of sucralfate to 2% in favour of cimetidine in the GU study and corresponding figures of 4% 19% in the PPU study. There were significantly more patients in the cimetidine group taking antacid tablets after 3 weeks in the GU study. Symptomatic relief did not differ significantly. Reported side effects and symptoms, pooled together with our duodenal ulcer study, were mostly non-specific and in some part related to the ulcer disease. In conclusion, sucralfate and cimetidine are both excellent healing agents for the short-term treatment of PPU and GU. Both give rapid and good symptomatic relief with no side effects of any importance. PMID- 3303295 TI - The role of eicosanoids in the gastrointestinal tract. AB - Exploring the role of eicosanoids in the gastrointestinal tract entails fundamental problems of methodology and interpretation. Most important are the difficulties inherent in the choice of an experimental design which prevents non specific stimulation of eicosanoid formation, because any perturbation of cell membranes will initiate eicosanoid synthesis. In addition to cyclic nucleotides, prostaglandins may serve as intracellular mediators for the stimulus of secretion coupling via intracellular free calcium in the gastrointestinal epithelial cells. By contrast, the effects of supraphysiological doses of prostaglandins parallel those of cyclic AMP-dependent secretagogues such as VIP, which increases calcium through activation of the mucosal adenylatecyclase. The question of whether patients develop gastric or duodenal ulcers as a result of a prostaglandin deficiency remains open. The synthetic prostaglandin analogues available commercially for anti-ulcer therapy appear to be unable to accelerate the healing of peptic ulcers unless they are administered in anti-secretory doses, and are unlikely to have a substantial effect on patients with bleeding from ulcerative lesions in the gastro-duodenal mucosa. Prostaglandins of the E type mediate, at least partly, the diarrhoea associated with a large number of clinical conditions and various pharmacological agents. Several types of secretory diarrhoea respond to drugs that inhibit prostaglandin biosynthesis. Whether eicosanoids are mediators, or merely epiphenomena, of inflammation in ulcerative colitis and Crohn's disease remains unclear. Improved knowledge of their functional role of eicosanoids has nevertheless allowed a reinterpretation of the rationale behind current therapy. Uncontrolled formation of eicosanoids may not only be the source of diarrhoea in colonic inflammation, but may also be critical for cell proliferation and the development of dysplasia in long-standing disease. PMID- 3303296 TI - Medical and surgical prophylaxis for duodenal ulcer, the role of sucralfate. AB - The risk of recurrent duodenal ulcer is high, 70-80% of duodenal ulcer patients having a recurrence during the first year after initial healing. Surgery has so far been the main method for preventing a relapse, but recent studies have shown that it is possible to reduce the risk and the need for surgery with medical maintenance therapy. Five controlled studies are available on the efficacy of sucralfate in prophylaxis for duodenal ulcer. 294 patients participated, 154 having received sucralfate treatment, usually 1 g twice daily. The summarized results indicate that initially healed duodenal ulcers recurred in six months in 60% of cases and in 12 months in 79% of cases in groups receiving placebo therapy or no treatment, the corresponding figures in the groups treated with sucralfate being 21% and 31%. The choice between surgical and medical prophylaxis is discussed, and more liberal use of medical prophylaxis is advocated. PMID- 3303297 TI - Treatment of peptic ulcer induced by non-steroidal anti-inflammatory drugs. AB - Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are often associated with peptic ulcer. A consecutive series of patients with rheumatic disease treated with NSAIDs entered a clinical trial after endoscopic diagnosis of gastric or duodenal ulcer. Three objectives were pursued: comparison between the healing capacities of sucralfate and ranitidine; evaluation of the influence of continuous NSAID administration during ulcer treatment; and determination of the peptic ulcer recurrence rate during a one-year follow-up. Average healing times were identical for 25 patients given sucralfate (4.6 weeks) and 27 patients given ranitidine (4.9 weeks). Ten patients with persistent ulcers after nine weeks of treatment received ulcer therapy for a further 3-9 weeks and healing was obtained in seven cases. Thirty patients continued on NSAID, and the ulcers healed in 23, whereas NSAID was withdrawn in 32 patients, of whom ulcer healing was documented in 29 (p greater than 0.10). 14 symptomatic recurrences were observed during the follow-up period. Adverse reactions were non-significant, and there were no cases of severe gastrointestinal bleeding. PMID- 3303298 TI - Cytoprotection by sucralfate in acid-exposed esophagus: a review. AB - Sucralfate is protective against acid or acid-pepsin injury to rabbit and cat esophagus. Its beneficial action is due in part to enhanced mucosal defense (cytoprotection) since it can occur in the absence of luminal buffering of hydrogen ion. The limited prospect for this effect to be prostaglandin-mediated is discussed and candidate mechanisms for its action enumerated. PMID- 3303299 TI - Isolation of fungi in blood cultures. A review of fungal infections in the western part of Sweden 1970-1982. AB - Relevant data were analysed from 185 patients treated for various diseases in the Goteborg area, Sweden, between 1970 and 1982 and in whom fungi were isolated in blood cultures. The increase in isolations during the first part of the study seemed to coincide with extended use of central venous catheters. However, with greater awareness of factors contributing to yeast colonization, the annual incidence fell during the latter part of the period. A disseminated fungal infection was found in 45% of cases, with a mortality of 58%. 4/42 patients with transient fungemia died; 3 from concomitant bacterial septicemia. The mortality rate was 30% in patients with antimycotic treatment because of disseminated infection. Candida albicans, followed by C. glabrata, were the most commonly isolated strains (70% and 13%, respectively). C. albicans predominated in patients with fungal endophthalmitis (100%) and in neonatal infections (95%). PMID- 3303300 TI - Water-melon as a vehicle of transmission of shigellosis. AB - An epidemic of Shigella sonnei infection is described in which the only common source of infection was the ingestion of water-melon. Bacteriological studies demonstrated that S. sonnei bacteria injected into water-melons could multiply to infective doses. Therefore water-melons should not be excluded as a possible source of S. sonnei infection. PMID- 3303301 TI - Causes of frequency and dysuria in women. AB - Bacteria in excess of 10(4) colony-forming units per ml (CFU/ml), were isolated from voided urine specimens from 127 (79%) of 160 women, 15-45 years of age, consulting in general practice due to frequency and dysuria. Escherichia coli was the species most frequently isolated, followed by Staphylococcus saprophyticus. Chlamydia trachomatis was isolated from 8 (5%) patients, in 6 of whom greater than 10(4) CFU/ml urine were isolated. A 2-fold titre increase in micro immunofluorescence antibodies to C. trachomatis was demonstrated in 8 cases, the organism itself being isolated in 1 case only. No viruses were isolated in any of 18 women with negative urine cultures. Proteinuria and/or haematuria was found more frequently in patients with S. saprophyticus than in patients with gram negative rods. Tests for nitrite indicated bacteriuria in only 58% of the patients with greater than 10(4) CFU/ml urine, which can be partly explained by the fact that S. saprophyticus only occasionally reduces nitrate. Cocci were noted in urine sediment in 75% of patients in whom S. saprophyticus was isolated. PMID- 3303302 TI - Experimental bacterial meningitis in the rabbit: cerebrospinal fluid changes and its relation to leukocyte response. AB - This study was focused on cerebrospinal fluid (CSF) manifestations in experimental Streptococcus pneumoniae and Escherichia coli meningitis in rabbits. An increased (p less than 0.001) CSF lactate concentration was found in infected animals, mostly not accompanied by a decrease in CSF glucose concentrations. Despite a marked difference in CSF cellular response between the 2 etiological groups no significant difference in CSF lactate levels was found. Neither did CSF lactate levels correlate to CSF polymorphonuclear cell counts. CSF concentrations of albumin were with large variations above control levels in all infected animals. Also a small or moderate increase in CSF albumin levels was generally associated with a marked increase in CSF lactate concentration. The concentration of total amino acids in the CSF was above control values (mean + 2 SD) in 9/21 infected animals. Halothane/N2O anesthesia for 25 min increased (p less than 0.05) CSF levels of glucose, partly independent of alterations in plasma glucose concentrations, in both infected rabbits and in controls. PMID- 3303303 TI - Septicemia in a university pediatric hospital: a five-year analysis of the bacterial and fungal isolates and outcome of the infections. AB - A 5-year analysis comprising all positive blood culture isolates from a 222-bed university pediatric hospital in Helsinki revealed 369 bacteremic but only 8 fungemic cases. Haemophilus influenzae and Staphylococcus aureus, 19% of the total material each, were the most common pathogens isolated, followed by S. epidermidis (11%), Escherichia coli (8%), pneumococci (8%), and group B beta hemolytic streptococci (6%). Remarkable differences in distribution of the pathogens were observed in different hospital units. However, 5 most common microorganisms covered 62-86% of the spectrum in each unit. Two bacteria, H. influenzae in the unit for infectious diseases and S. aureus in the hematology oncology unit were significantly (p less than 0.001 or less than 0.01, respectively) more common than any other organism in those units. The average case fatality rate was 14% with a range from 1.5% to 40%, depending upon the causative agent isolated. Also, the mortality was much higher in neonates than in other age groups. We conclude that by monitoring the blood isolates separately in each unit one can find remarkable differences in the same hospital. On the other hand, characteristics of an individual hospital may vary significantly from those described in textbooks. These characteristics should be recognized and taken into account in the antimicrobial policy. PMID- 3303304 TI - Culture from epipharynx of little value in bacterial pneumonia. AB - In 75 patients with acute pneumonia of moderate severity a comparative study between transtracheal aspiration (TTA), sputum culture and epipharynx culture was carried out. Organisms considered as the probable etiological agent were found in 53% with TTA. The same organisms were found in only 27% in sputum samples and in 21% in epipharynx samples. No serious complications with TTA was noted. PMID- 3303305 TI - Longitudinal study of group B streptococcal carriage during late pregnancy. AB - 152 women were cultured for group B streptococci (GBS) weekly from the 37th week of gestation and at admission to hospital for delivery. Matched rectal, urethral and urine specimens were collected for study (mean 4 times). In the 37th week of gestation, 33 women (22%) harboured GBS in rectal specimens, 28 women (18%) in urethral specimens, 16 women (11%) in urine specimens, and 37 women (24%) in at least one of the 3 specimens. All cultures considered, a total of 46 women (30%) yielded GBS in at least one culture. In the 37th week of gestation, women subsequently found to be GBS colonized at labour (positive in at least one site) had a higher rate of positive cultures in rectal specimens (77%) than in either urethral (67%) or urine specimens (41%). Chronic GBS carriage was more frequent in rectum than in urethra or urine. The results of the present investigation support the gastrointestinal tract as being the predominant source of GBS. PMID- 3303306 TI - An outbreak of invasive aspergillosis in a haematologic unit. AB - Within a period of 15 months 8 cases of invasive pulmonary aspergillosis were seen in a haematologic unit; 7 of them between January and October 1984. No previous cases of invasive aspergillosis had been encountered during the existence of the unit since 1979. Environmental studies did not prove a single likely source for the fungal spores. Previous window renovation with concomitant fiber deposits on ventilation grids, poor sealing of air filter fittings in patient rooms, occasional ventilation through windows in the ward, and low speed of booster fans in the ventilation system may have created a condition favourable for the entry of Aspergillus fumigatus spores into the patient rooms. Environmental sanitation including cleaning of the ventilation ducts and change of filters in the ventilation system stopped the outbreak. Two sporadic cases have appeared during a follow-up period of 26 months. PMID- 3303307 TI - Ultrasonographic diagnosis of renal stones. AB - To illucidate the diagnostic accuracy of ultrasound in the detection of renal stones we performed a blind comparative study of ultrasonography and i.v. urography. In 92 kidneys with 58 stones, 10 stones smaller than 6 mm were overlooked by ultrasound, whereas all stones 6 mm or larger were correctly detected. In one case of uric acid stone disease i.v. urography was inconclusive in determining the true nature of a renal pelvic filling defect, whereas ultrasound correctly diagnosed a stone. We conclude that ultrasonography has a place in diagnosis and control of renal stones. PMID- 3303308 TI - Influence of normal central venous pressure on onset of function in renal allografts. AB - The central venous pressure was kept above 5 cmH2O during the perioperative and early postoperative period as guidance for fluid replacement in 31 patients receiving a renal graft (group B). In 30 other transplant recipients the central venous pressure was not measured (group A). The two groups were otherwise comparable. Onset of graft function within the first 3 postoperative days was significantly more frequent in group B than in group A (62% vs. 30%), despite absence of difference in the measurable warm and cold ischemic periods. Fluid replacement guided by the central venous pressure thus is concluded to reduce the number of kidneys with delayed function in the immediate postoperative period. PMID- 3303309 TI - Preservation of high energy phosphates during ischaemic cardiac arrest with glucose. AB - The possible myocardial protection by glucose-insulin-potassium infusion prior to cardioplegic ischaemic arrest was studied in rats. One group of animals was given intravenous infusions of high concentrations of glucose during 3 days. A control group received the same amount of saline. The isolated hearts were subjected to Langendorff perfusion followed by cardioplegic arrest at 15 degrees C for a period of 2 or 3.5 hours. The hearts were then subjected to reperfusion for a period of 45 min for those sustaining 2 hours of ischaemia and 60 min for those sustaining 3.5 hours of ischaemia. In the hearts that suffered 2 hours of ischaemia there were no differences in myocardial content of high energy phosphate compounds between the pretreated and controls, and there was no evidence of creatine kinase release. In the hearts exposed to 3.5 hours ischaemia, myocardial content of high energy phosphates was significantly higher in the pretreated than in the controls. The release of creatine kinase was also less, but this difference was not significant. The study indicates that preoperative treatment with glucose-insulin-potassium may improve myocardial tolerance to ischaemia. PMID- 3303310 TI - The youngest successful heart transplant in the U.K. A case report. AB - We report a case of dilated cardiomyopathy in a 7 year-old boy who was assessed and treated medically, but failed to respond. A successful orthotopic cardiac transplantation was performed. PMID- 3303311 TI - Is passive smoking increasing cancer risk? AB - Although the amounts of environmental tobacco smoke absorbed by passive smokers are small in comparison to those absorbed by active smokers, the fact that (almost) everybody in modern society is exposed makes it an important public health problem. The many published epidemiologic studies are all consistent with a 30% increase in the risk of lung cancer. This increase is plausible in relation to the exposure levels derived from various biological dose indicators. The risks of passive smokers are, of course, smaller than those of active smokers, but it is generally accepted that involuntary risks should be much smaller than those that are self-inflicted. Even a relative risk for lung cancer of 1.3 due to passive smoking would constitute an increase on the order of 1 in 1,000 in the lifetime risk. Normally, this level would be considered "unacceptable," and preventive measures should be taken. PMID- 3303312 TI - The intermediate filament cytoskeleton of macrophages. AB - This study characterizes two- and three-dimensional ultrastructure and surface topography of polymerized networks of intermediate filaments (IF) isolated from mouse peritoneal macrophages. Isolated IF bound to monoclonal anti-IF antibodies in enzyme-linked immunosorbent assays. Immunogold labeling of IF with specific antibodies revealed that epitopes are distributed along filaments particularly at junctions where filaments interconnect. Networks of IF, viewed by scanning electron microscopy, organized as ropelike groups of interconnecting filaments which swirl and encircle each other to form three-dimensional lattices containing ellipsoidal-, circular-, and vacuole-shaped cavities. Cavity diameters were similar in size to organelles and vacuoles; diameters were grouped as small (12 288 nm), medium (0.3-1.7 micron), and large (2-3 micron). The walls of the cavities appeared as beaded structures with alternating globular and linear regions. Linear regions were 14 nm. Repeat distances taken from the central axis of globular regions were 23-27 nm. The lattice organization of IF observed in vitro was similar to images seen in vivo in Triton-insoluble cytoskeletons immunofluorescently labeled with specific antibodies. In whole cells processed for TEM, swirling bundles of IF were found encircling membranous vacuoles. Based on the lattice architecture of IF, cavity dimensions, and IF location, we postulate that intermediate filaments may function in the mechanical and spatial distribution of vacuoles in the cell cytoplasm. PMID- 3303313 TI - Morphological criteria for comparing effects of X-rays and neon ions on mouse small intestine. AB - Several techniques have been used to assess changes in different parts of mouse small intestine three days after a single dose of either 16.5 Gy X-rays or 11 Gy neon beam. The doses were chosen to be approximately equivalent in terms of their effect on the number of microcolonies present. In qualitative terms, villous damage was seen after both types of radiation exposure: collared crypts, similar to those seen in biopsies taken from patients suffering from coeliac disease, were conspicuous after neon irradiation. In semi quantitative terms the doses used, although estimated from previous work to give biologically equivalent damage, produced a greater drop in microcolony numbers after X-irradiation. This makes all the more important the fact that significantly greater changes were seen after neon irradiation-a greater drop was seen in the number of villous profiles and the number of goblet cells per villus. There was also greater breakdown in the integrity of the villous basement membrane. Different responses after the two types of irradiation are therefore seen in the cryptal and villous compartment. Progress is being made towards identifying and quantitating radiation induced changes in different populations of cells or tissues in the small intestine. PMID- 3303314 TI - [Hypertensive crisis after withdrawal of clonidine and nadolol. Case report and review of the literature]. AB - The clonidine withdrawal syndrome occurs in at least 1.2% of patients following withdrawal of the drug. Its frequency is influenced by length of treatment, daily dosage and degree of hypertension. The combination of clonidine with beta blockers favours the development of hypertensive crisis following clonidine withdrawal. The case is presented of a 49-year-old female who had had chronic renal insufficiency and hypertension for several years and who developed a hypertensive crisis after cessation of therapy with clonidine and nadolol. An overshoot hypertension after clonidine withdrawal should be treated with vasodilatatory drugs such as nitroprusside; calcium antagonists and ACE inhibitors also offer a possible new approach. It is advisable to reduce the clonidine dose slowly, and combination with labetalol or calcium antagonists during clonidine withdrawal seems to have favourable results. Beta blockers should be discontinued well before the cessation of clonidine treatment. PMID- 3303315 TI - [Pleural empyema due to Streptococcus milleri]. AB - Thus far little attention has been focused on the precise identification of Streptococcus viridans to species level and the clinical relevance of Streptococcus milleri, yet there is growing evidence that closer identification would be of significant clinical value. Streptococcus milleri was identified in 142 isolates from approximately 120 patients over a period of 12 months (June 1984-May 1985) at the Institute of Medical Microbiology, Zurich University Hospital. Pleural empyema was the source in eleven patients (10%). The presentation of six cases of pleural empyema in which Streptococcus milleri played a role, together with a review of the literature, may serve to emphasize the importance of an organism whose taxonomic status is still unclear. PMID- 3303316 TI - [Interleukin-2: molecular, physiological and pathophysiological bases and possible significance for clinical practice]. AB - Interleukin-2, a lymphokine produced by T lymphocytes in response to antigenic or mitogenic stimulation, is necessary for the proliferation and differentiation of various cell populations including activated T lymphocytes, natural killer cells (NK), lymphokine-activated killer cells (LAK), B lymphocytes and macrophages. In addition, IL2 induces or increases the production of important cytokines and thus plays a central role in regulation of the immune response. A number of studies have demonstrated that in patients with primary and secondary immunodeficiency disease, including patients with human immunodeficiency virus infections, decreased immune response was associated with impaired production of, or abnormal reaction to, IL2. Furthermore, IL2 has been assessed, alone or in combination with IL2-activated killer cells ("adoptive immunotherapy"), for its anticancer potential in several animal models and in patients with various forms of advanced cancer. A brief synopsis of biochemical and biological properties of IL2 is presented. The potential pathophysiological role of IL2 in a variety of immunodeficiency states and its possible therapeutic use in cancer therapy are discussed. PMID- 3303317 TI - [Rapidly progressive presenile dementia and death]. PMID- 3303318 TI - [Sonographic screening for hip dysplasia in newborn infants]. AB - The hips of 335 unselected newborn children have been examined sonographically to evaluate the general use of ultrasound in screening programs for early recognition of hip dysplasia. Ultrasound findings indicating the need for treatment in 4% of the children were surprisingly high compared to earlier data on the frequency of hip dysplasia from purely clinical studies. However, this is to be seen in relation to the still significantly late diagnoses of dysplasias or even luxations in later childhood, adolescence and adults. Because of the importance of early recognition of hip dysplasia for treatment and outcome, it can be concluded even from the limited data available that ultrasound examination of the hips should be included in health surveillance programs of newborns. PMID- 3303319 TI - [Comparison of 3 ECG computer programs with interpretation by physicians]. AB - Three ECG computer programs-Hewlett Packard analog program (HP), Telemed analog program (T) and Marquette 12 SL digital program (MAC)-were evaluated and their accuracy of ECG reading compared with the reading of 4 experienced interpreters on 140 ECGs of patients with various clinical abnormalities. Major disagreement with effect on patient management, and minor disagreement were defined at a joint session with a senior (consensus). The computers identified all normal ECGs correctly (sensitivity 100%). The percentage of major agreements (full agreements and minor disagreements) between consensus and computer was 79% for HP, 90% for T and 93% for MAC. The number of disagreements varied widely between readers and in relation to the different computers. Major problems for the computers were the interpretation of rhythm disturbances and the diagnosis of myocardial infarction, T-wave changes and ventricular hypertrophy: major diagnoses missed by the readers were first degree AV block, QT prolongation, and myocardial infarction. Although there was a considerable difference of accuracy between the 3 computer systems, all of them are sufficiently accurate to be useful to most clinicians. However, every ECG should be over-read by a physician, particularly if a clinical decision is based on the ECG diagnosis. PMID- 3303320 TI - [Long-term temporary dentures. Long-term provision of temporary gold-cap plugged dentures]. PMID- 3303321 TI - [Temporary prosthesis fixation. The preservation of tooth roots for the temporary fixation of partial and hybrid dentures]. PMID- 3303322 TI - [Problems of pathology in the chamois and ibex of the Alps]. PMID- 3303323 TI - The clonal-selection theory. PMID- 3303324 TI - [Determination of the degree of stenosis in carotid artery stenoses: ultrasound and i.v. DSA in comparison to surgical findings]. AB - The specimens from 116 consecutive carotid thrombendarterectomies were taken as "gold standard" to evaluate the accuracy of ultrasound methods (duplex scanning + extra-/transcranial Doppler sonography) and intravenous digital subtraction angiography (i.v. DSA) in carotid artery stenoses. In 65 cases, in which the specimens could be gauged reliably, sonography estimated the degree of stenosis in 85% within a range of +/- 10%, in 97% within +/- 20% i.v. DSA was accurate in 52 respectively in 94%. High-grade stenoses were correctly assessed by ultrasound in 90%, by i.v. DSA in 64%. Sonography identified 4/10 kinkings and coilings of the carotid artery, i.v. DSA 9/10. Current available ultrasound methods enable estimation of the diameter reduction of carotid artery stenoses with low deviations. I.v. DSA seems to be less reliable, but can be used favourably as a complementary method to sonography. PMID- 3303325 TI - Relationships between ionizing radiation, bone marrow transplantation and leukemogenesis. AB - Studies of the relationships between ionizing radiation, bone marrow transplantation and leukemogenesis were carried out in 343 LACA mice. The recipients (female) were given whole-body irradiation with 7 or 8 Gy of Co-60 gamma-rays, while the donors (male) were given whole-body irradiation with 3, 1.5, 0.5, 0.1, 0.05 and 0 Gy of Co-60 gamma-rays. Each recipient was intravenously infused with 1-3 X 10(7) of the mixed marrow cells of donors. In the result, the average incidence of surviving over 1 month was 86% in the recipients. Myelocytic leukemia developed in all the transplanted groups, the average incidence being 88.5%. Leukemia was observed in 1.5-2.5 months after transplantation in the recipients receiving marrow cells from donors exposed to 3 Gy, but in 5-8 months in other groups. It was demonstrated by the analysis of Y chromosome that the leukemic cells were derived from the donor's marrow cells. The results suggest that marrow transplantation for the mice irradiated by Co-60 gamma-rays of lethal dose can protect them from death, but promote the development of leukemia. Radiation can induce production of factors which lead to leukemic transformation of engrafted normal marrow cells in the irradiated mice; the direct damage of DNA caused by radiation is not the unique factor that gives rise to leukemia. PMID- 3303326 TI - NIH moves to debar cholesterol researcher. PMID- 3303327 TI - National Institutes of Health: the centennial year. PMID- 3303328 TI - Recollections on the war on cancer. PMID- 3303329 TI - NIH through the years. PMID- 3303330 TI - The National Institutes of Health: some critical years, 1955-1957. AB - It has been my pleasure to participate in the conversion of a small but superb federal institution into a driving force for the development of excellence in the nation's biomedical sciences. The initial step was the establishment of an adequate science base for the developing enterprise. Given this, it was agreed that the nation's medical establishment could use the evolving support system effectively. What follows is a brief consideration of some events contributing to the reduction of a possibility to reality. Much of the material that follows was derived from a presentation to a presidential commission established by President Gerald Ford in 1975 and later published as a supplement to the Journal of Medical Education. The latter encompassed what happened during the critical years of development. But it seemed too recent at that time to discuss with grace the "how" of program changes. It is the "how of things" that will be treated in this article. PMID- 3303331 TI - The National Institutes of Health in its centennial year. AB - The laboratory of which the National Institutes of Health (NIH) is a lineal descendant was founded in 1887. During discussions of our plans for a year-long centennial observance with members of our House and Senate appropriations subcommittees, congressional members urged us to set two specific objectives: making NIH better known to the American people, and presenting the attractions of the many roles in health-related research to young people who have not yet formulated career plans. When I was invited to prepare an article for Science dealing with my personal experiences as director of NIH since April 1982, it seemed an opportunity to address the same objectives for the scientific community, for in my view there is much misinformation and far too much pessimism throughout the country about the state of biomedical research and its support. PMID- 3303332 TI - Multiple global regulators control HIS4 transcription in yeast. AB - Gene expression is dependent on the interaction of DNA binding factors with distinct promoter control elements to activate RNA synthesis. The expression of the HIS4 gene in yeast is under two different control systems. One of these, general amino acid control, involves a DNA binding protein, GCN4, that stimulates transcription in response to amino acid starvation by binding to 5'-TGACTC-3' sequences in the HIS4 promoter region. A second system, the basal level control, stimulates HIS4 transcription in the absence of amino acid starvation. The basal level transcription of the HIS4 gene is under the control of two genes, BAS1 and BAS2, which are also required for the control of purine biosynthesis. In addition, BAS2 is required for the utilization of organic phosphates in the growth medium. Genetic mapping and DNA sequence analysis show that BAS2 is PHO2, a gene previously identified as a regulator of phosphate metabolism. Direct biochemical analysis shows that the BAS2 gene encodes a protein that binds to both the HIS4 and PHO5 promoters. The involvement of a single DNA binding protein in the regulation of histidine, adenine, and phosphate metabolism suggests that yeast may use a few key DNA binding proteins to coordinate the regulation of diverse metabolic pathways. PMID- 3303333 TI - Fish oil prevents insulin resistance induced by high-fat feeding in rats. AB - Non-insulin-dependent diabetes mellitus is an increasingly prevalent disease in Western and developing societies. A major metabolic abnormality of non-insulin dependent diabetes is impaired insulin action (insulin resistance). Diets high in fat from vegetable and nonaquatic animal sources (rich in linoleic acid, an omega 6 fatty acid, and saturated fats) lead to insulin resistance. In rats fed high fat diets, replacement of only 6 percent of the linoleic omega-6 fatty acids from safflower oil with long-chain polyunsaturated omega-3 fatty acids from fish oil prevented the development of insulin resistance. The effect was most pronounced in the liver and skeletal muscle, which have important roles in glucose supply and demand. The results may be important for therapy or prevention of non-insulin dependent diabetes mellitus. PMID- 3303334 TI - The catalytic role of the active site aspartic acid in serine proteases. AB - The role of the aspartic acid residue in the serine protease catalytic triad Asp, His, and Ser has been tested by replacing Asp102 of trypsin with Asn by site directed mutagenesis. The naturally occurring and mutant enzymes were produced in a heterologous expression system, purified to homogeneity, and characterized. At neutral pH the mutant enzyme activity with an ester substrate and with the Ser195 specific reagent diisopropylfluorophosphate is approximately 10(4) times less than that of the unmodified enzyme. In contrast to the dramatic loss in reactivity of Ser195, the mutant trypsin reacts with the His57-specific reagent, tosyl-L-lysine chloromethylketone, only five times less efficiently than the unmodified enzyme. Thus, the ability of His57 to react with this affinity label is not severely compromised. The catalytic activity of the mutant enzyme increases with increasing pH so that at pH 10.2 the kcat is 6 percent that of trypsin. Kinetic analysis of this novel activity suggests this is due in part to participation of either a titratable base or of hydroxide ion in the catalytic mechanism. By demonstrating the importance of the aspartate residue in catalysis, especially at physiological pH, these experiments provide a rationalization for the evolutionary conservation of the catalytic triad. PMID- 3303335 TI - AIDS vaccine trial OKed. PMID- 3303336 TI - Characterization by tandem mass spectrometry of structural modifications in proteins. AB - Tandem mass spectrometry can be used to solve a number of protein structural problems that are not amenable to conventional methods for amino acid sequencing. Typical problems that use this approach involve characterization of peptides with blocked amino termini or peptides that have been otherwise posttranslationally processed, such as, by phosphorylation or sulfation. The structure and homogeneity of synthetic peptides can also be evaluated. Since peptides can be selectively characterized in the presence of other peptides or contaminants, the need for extensive purification is reduced or eliminated. PMID- 3303337 TI - [Antimicrobial properties of dressing material on a silicone base]. PMID- 3303338 TI - [Value of sonography in blunt abdominal trauma. A contribution based on an animal experiment study]. PMID- 3303339 TI - SPECT instrumentation: performance, lesion detection, and recent innovations. AB - The use of a gamma camera for single photon emission computed tomography (SPECT) imaging places greater demand on camera performance than does planar imaging, since camera specifications that are adequate for planar imaging may produce serious image artifacts in SPECT. Manufacturers have responded to the challenge with improvements in both hardware and software, but the user must pay careful attention to quality control procedures. Field nonuniformity is caused mainly by spatial distortion, which may vary during rotation; some cameras incorporate a means of automatically correcting for angular changes. The purpose of performing SPECT is to improve lesion detection, ie, to improve contrast, which is influenced by many factors. Attenuation corrections may be applied either before or after reconstruction. For Tc-99m an attenuation coefficient less than that for water, ie, either 0.11 or 0.12, would appear to give better results; the visual appearance is improved but the effect on contrast is minimal. Scattered photons are the major cause of loss of contrast in SPECT images. Recent developments in on-line energy corrections allow the use of narrower photopeak windows as well as asymmetric energy windows. Offpeak energy windows have demonstrated significant improvements in contrast; however, the increase in nonuniformity can cause artifacts which may limit their use. Simultaneous collection of separate images, one in the photopeak region and the other in the scatter region (92 to 125 keV) may enable a transaxial scatter image to be subtracted from the transaxial photopeak image. This may permit quantification of the true radioactivity distribution. New collimator designs introduced to improve SPECT resolution include cast collimators which can be made with more uniform hole construction than the lead-foil type; for brain imaging, long bore parallel hole and converging fan beam collimators as well as astigmatic collimators which converge in both planes with different lines of focus. Some of these improve both sensitivity and resolution compared to parallel hole collimators. Noncircular orbits have also been introduced in order to improve resolution, but their use presents many problems which require careful monitoring. Transaxial multicrystal systems have been developed over many years, but have not been widely used, primarily because of their inherent complexity, high costs, and limited applicability. Some of these drawbacks may be overcome by a new type of SPECT camera currently under development by several different groups.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3303340 TI - Evaluation of myocardial perfusion and function by single photon emission computed tomography. AB - Although planar radionuclide techniques provide accurate, noninvasive measurements of myocardial perfusion and function that are of proven clinical value in the evaluation of the cardiac patient, they are limited by poor object contrast and superimposition of surrounding structures. Due to incomplete angular sampling and significant longitudinal distortion, limited angle tomography did not solve these problems. Single photon emission computed tomography (SPECT) can acquire scintillation information over very small angles of rotation and, thus, improve both object contrast and delineation of overlying or adjacent structures without distortion. The early SPECT systems were cumbersome, dependent on individual user developed software, and had extremely long acquisition and processing time. Improved camera design, new software algorithms, and the use of array processors have simplified and standardized quality control, decreased processing time, and minimized the number of user interventions. New image display formats and quantitative methods of analysis have made interpretation less cumbersome, more reliable and highly reproducible. Cardiac SPECT has been used with thallium-201 and gated blood pool imaging in both research and clinical applications and shown an improvement over planar methods of acquisition. PMID- 3303341 TI - Abdominal SPECT imaging. AB - Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. PMID- 3303342 TI - Bone SPECT. AB - Single photon emission computed tomography (SPECT) is a valuable addition to bone scintigraphy. SPECT removes from the diagnostic image unwanted activity which originates from in front and behind the tomographic plane of medical interest. This tomographic procedure allows one to examine with greater contrast and anatomic clarity such structures as the spine, hips, knees, and temporomandibular joints (TMJ). Abnormalities also seen on planar bone scintigrams often are more convincingly identified and better localized by SPECT. SPECT may even detect skeletal abnormalities not evident on planar views. These advantages of SPECT must be weighed against the superior resolution of planar bone scintigraphy. For this reason, SPECT complements, but does not replace planar bone scintigraphy. Including SPECT as an additional component of the skeletal examination does not place excessive demands on either gamma camera use or technologist time. Those nuclear medicine facilities offering bone SPECT for the evaluation of back, hip, knee, and TMJ pain should anticipate a larger volume of patient referrals. PMID- 3303343 TI - Thallium 201/99mTc parathyroid subtraction scintigraphy of the neck: multiple areas of increased thallium uptake. PMID- 3303344 TI - Familial intrahepatic cholestatic syndromes. AB - This discussion has illustrated the enormous variety found within the category of familial intrahepatic cholestasis. It has also demonstrated how much more there is to learn about these fascinating disorders, which may be examples of experiments in nature on bile formation. This analysis should be recognized to be the author's own, and there is much debate about this classification. For example, some workers in this field contend that North American Indian cholestasis is in reality Byler's syndrome. Such an identity seems unlikely, given the differences between the two syndromes (Table 2). This is a field that is changing rapidly. Recently, a new cholestatic syndrome, bearing some similarities to benign recurrent intrahepatic cholestasis, but dissimilar in several ways, has been reported. There is evidence that cholestasis of pregnancy may be inherited as an autosomal dominant, sex-limited trait. If further studies confirm a genetic etiology, this syndrome would be the most common form of familial intrahepatic cholestasis. The assessment of any individual case remains difficult, particularly early in the course. Table 2 can serve as a guide to the differential diagnosis of these conditions. When faced with a neonate with jaundice, all of the usual causes must be ruled out first. The pattern of bile acids in serum is useful for ruling out Zellweger's syndrome. A good family history and physical examination, particularly of the heart, are important. An ophthalmologic examination by a specialist, often under anesthesia, and a spine radiograph can be useful in confirming a diagnosis of Alagille's syndrome. A liver biopsy, carefully interpreted with input from the clinician, is useful in pointing toward one direction or another. Often a firm conclusion cannot be reached, or is reached prematurely, so the clinician would be advised to inform the parents of all diagnostic possibilities in order to avoid false hopes or unwarranted depression. The diagnostic pitfalls to be avoided in this evaluation are many. No histologic findings are clearly pathognomonic for one syndrome or another. Giant cell transformation and paucity of intrahepatic bile ducts may be found in several syndromes. Biliary atresia, or at least failure to demonstrate a patent biliary tree from the liver to the cystic duct, may be present in patients with Alagille's syndrome. In that syndrome, the eye findings, particularly the posterior embryotoxon, may not be appreciated except on extensive ophthalmologic testing, including gonioscopy. Butterfly vertebrae may not be visible at birth and may be no longer evident in adulthood.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3303345 TI - Neonatal cholestatic conditions requiring surgical reconstruction. AB - Obstructive jaundice in infancy and childhood can arise from a variety of causes. Recognition of the importance of persistent jaundice beyond 2 weeks of age in the infant or elevation of the conjugated bilirubin more than 2 mg/dl will allow the timely evaluation of neonates with possible biliary atresia prior to the development of irreversible hepatic damage. Episodes of intermittent jaundice or persistent conjugated hyperbilirubinemia should be investigated at any age to exclude obstructive lesions of the extrahepatic biliary tract. In all cases, a rapid but carefully coordinated evaluation can be undertaken by a pediatric gastroenterology and surgical team, allowing optimum economy of effort and preservation of hepatic function. In nearly all cases with obstructive lesions of the extrahepatic biliary tree, satisfactory hepatic function can be preserved through appropriate surgical intervention. Results with biliary atresia continue to improve but are dependent on early diagnosis and treatment. In cases in which hepatic function deteriorates and hepatic failure becomes inevitable, orthotopic hepatic transplantation can be lifesaving and should be undertaken prior to the onset of irreversible hepatic decompensation. Although the terminology may be somewhat confusing and its etiology uncertain, the entity of choledochal cysts, taken within the context of its modern classification, accurately describes a group of cystic anomalies of the extrahepatic (and intrahepatic) biliary tree, which have many common features. The vast majority can be expeditiously dealt with by surgical excision and hepaticoenteral reconstruction. Two particular associations with choledochal cysts are important to note. When it occurs with infancy, choledochal cysts can be difficult to diagnose, but very important to define and treat expeditiously in order to prevent serious impairment of hepatic function. In all patients, but particularly in adults, the risk of associated carcinoma necessitates extremely careful definition of the biliary tree and urges one to advocate complete excision of the cyst at initial operation. PMID- 3303346 TI - Cholangiopathies: past, present, and future. PMID- 3303347 TI - Determinants of bile formation during development: ontogeny of hepatic bile acid metabolism and transport. AB - The studies cited in this brief review stress that the development of hepatic transport processes is extraordinarily complex. Important changes in hepatic morphology and synthetic capacity are required before maturation of membrane carriers for bile acids. Transport systems at both poles of the hepatocyte develop independently. An increase in bile acid synthesis at several stages during the development appears to be an ontogenic event that is programmed to occur in concert with functional maturation of the enterohepatic circulation. Expression of specific membrane transporters for bile acids can be observed in fetal liver and postnatal ileum during periods of expansion of the bile acid pool. It is likely that specific defects, such as congenitally absent or defective bile acid transport proteins, will eventually be discovered in rare patients with undefined cholestatic syndromes. The absence of active ileal bile acid transport has recently been demonstrated in several children with congenital bile acid malabsorption. Whether bile acids can actually induce or regulate production of their own carriers during development has not been determined, but an increase in bile acid pool through feeding of exogenous bile acid has been shown to stimulate an increase in plasma membrane carriers for bile acids in adult rat liver. Thus, a number of factors, including available driving forces for transport, bile acid pool size and composition, effectiveness of intracellular compartmentation and transfer, and the function of membrane carriers, can all contribute to low rates of bile flow and bile acid secretion, depending on the stage of development. PMID- 3303348 TI - Inborn errors of bile acid synthesis. PMID- 3303349 TI - "Close-up" versus "distant" ethics: deciding the care of infants with poor prognosis. PMID- 3303351 TI - Ultrasonic investigation of the hip in newborns in the diagnosis of congenital hip dislocation: classification and results of a screening program. AB - The method of ultrasonic examination of the hip is described, the latest updated Graf classification is explained, and the results of a prospective screening program are described. One thousand four hundred and sixty newborn infants were examined by ultrasound and clinically by independent observers. The distribution of the ultrasound types was determined. Recommendations are given for the use of ultrasonic investigation of the hip for groups at risk in the neonatal period. PMID- 3303352 TI - Evaluating medical expert systems. AB - Approximately 90% of all computerized medical expert systems have not been evaluated in clinical environments. This paper: identifies the principal methods used to assess the performance of medical expert systems in both laboratory and clinical settings, describes the different research strategies used in the evaluation of medical expert systems at different development stages, and discusses past evaluation efforts in relationship to future applications of different decision support technologies and expert systems in health care. PMID- 3303350 TI - Selective digital subtraction arteriography in necrosis of the femoral head. AB - Selective digital subtraction arteriographic investigations of the arteries of the femoral head in 31 patients with traumatic and 34 patients with nontraumatic femoral head necrosis (FHN) were compared with investigations in a control group of 35 patients without hip disease. In the control group and in patients with nontraumatic FHN atypical arteriographic findings were found only in one third of cases. In traumatic FHN, however, vascular alterations could be detected in 97% of cases. This evidence suggests that damage to the femoral head vessels is a major etiological factor in traumatic, but not in nontraumatic, FHN. In late arterial phases of DSA a perinecrotic hypervascularization was the common feature in all nontraumatic necroses and could be observed in 71% of traumatic necroses. Its pathophysiological mechanism is discussed. PMID- 3303353 TI - The demand for health inputs and their impact on the black neonatal mortality rate in the U.S. AB - Relatively high birth rates among black adolescents and unmarried women as well as inadequate access to medical care are considered primary reasons why the black neonatal mortality rate is almost double that of whites. Using household production theory, this paper examines the determinants of input utilization and estimates the impact of utilization on the survival of black infants across large counties in the U.S. in 1977. The results indicate that expanding the availability of family planning clinics increases the number of teenagers served resulting in a lower neonatal mortality rate. Accessibility to abortion services operates in a similar manner. Moreover, the use of neonatal intensive care, which is strongly related to its availability, is an important determinant of newborn survivability whereas the initiation of early prenatal care is not. Overall, the results suggest that lowering the incidence of low-weight and preterm births among blacks by helping women to avoid an unwanted birth, may be the most cost effective way of improving black infant health. PMID- 3303355 TI - [Doing some historical research into nursing care]. PMID- 3303354 TI - Development, use and evaluation of drugs: the dominating technology in the health care system. AB - The article presents various perspectives of drug technology and health care policy in Denmark. Drugs dominate as the most widely used treatment technology in the health care system and the use of drugs is steadily increasing. The pharmaceutical industry's development of drugs is based on an economic estimate of developments, expenditures, marketing costs and the anticipated share of the market. Controlled clinical trials have become the main form of documentation required by the health authorities. This method is insufficient to evaluate the (side) effects of the drugs when in actual use. Drugs fit perfectly the technical perception of disease, a perception which prevails in the pharmaceutical industry, medical science and in the treatment of disease. This perception believes that a disease is due to an attack or dysfunction in the biological mechanical conditions of the individual. Drugs offer a standard solution to health problems independent of the individuals' social life. Thus drugs become a tool which function in agreement with the disintegrated and achievement orientated approach to disease as it is organized today. In general the statements in this article are not limited to special Danish circumstances but are valid for other countries as well [1, 2]. (Norris R. Pills, Pesticides & Profits. North River Press, 1982; Braithwaite J. Corporate Crime in the Pharmaceutical Industry. Routledge & Kegan Paul, London, 1984) The empirical data in this article derive from Denmark, however. PMID- 3303356 TI - [Chronic pain and behavior therapies]. PMID- 3303357 TI - Biliary antibiotics: clinical utility in biliary surgery. PMID- 3303358 TI - Dial M for MEDLINE: a how-to guide for the clinician. PMID- 3303359 TI - Medical education in 19th century France: impact on American physicians in Parisian hospitals. PMID- 3303360 TI - Nontuberculous mycobacterial skin infection resembling lepromatous leprosy. AB - A leg ulcer in a 52-year-old renal transplant patient yielded foamy histiocytes containing acid-fast bacilli subsequently identified as a Runyon group III Mycobacterium. Skin infection with these organisms is unusual, and the histologic appearance in this case suggested lepromatous leprosy. PMID- 3303361 TI - Acute pancreatitis caused by ampicillin. PMID- 3303362 TI - Evaluation of fever in infants less than 8 weeks old. AB - We evaluated fever in 342 hospitalized infants less than 8 weeks of age. Sixteen infants (5%) had bacteremia or bacterial meningitis. Fifty-two percent of the infants were admitted during the months of July through September. We found no significant relationship between season, sex, height of fever, or erythrocyte sedimentation rate and the recovery of bacteria from the blood or CSF. A WBC less than or equal to 5,000/cu mm or a ratio of immature to total neutrophils greater than or equal to 20% correlated significantly with bacteremia or bacterial meningitis, though the sensitivities of these tests were unacceptably low. Prospectively, of 61 infants whose clinical appearance did not suggest sepsis, none had bacterial pathogens in the blood or CSF, whereas four of 36 infants with a septic appearance did have pathogens. Recent investigations support the initial clinical impression as important in assessing these febrile infants. We found that bacteremia is more likely to occur in infants less than 4 weeks of age (8%) than in the older infants (2.9%). PMID- 3303364 TI - Functional hyposplenism. AB - In the past 15 years, it has become increasingly evident that diverse conditions may be linked with hyposplenism and that hyposplenic individuals are susceptible to overwhelming infection, particularly by the encapsulated organisms such as pneumococci, meningococci, and Haemophilus influenzae. Identification of Howell Jolly bodies in the peripheral blood smear is the most important clue to the diagnosis. Associated diseases include gastrointestinal disorders, hemoglobinopathies, autoimmune disorders, amyloidosis, neoplasms, circulatory disturbances, and other diseases. Hyposplenic patients should be instructed to report immediately to their physician if they suspect any infection. These patients should receive empiric treatment with antibiotics on an emergency basis at the earliest sign or symptom of infection, and they should also receive prophylactic vaccination against pneumococcal microorganisms. PMID- 3303363 TI - Gallstones: a comparison of real-time ultrasonography and cholecystography with surgical correlation. AB - Real-time ultrasonography is more accurate and technically more efficient than gray scale ultrasonography in establishing the diagnosis of cholecystolithiasis. In prospective studies accuracy may be as high as 96%, and reflects the use of specific sonographic diagnostic criteria. Retrospective studies, however, reveal a lower accuracy rate of 90%, suggesting that practicing radiologists are not ready to accept these restricting criteria. On the other hand, oral cholecystography (OCG) is well tolerated and gives a reproducible, reliable result independent of technical expertise. It is 96% accurate in detecting the presence of gallstones and carries a sensitivity of .97. Both studies are prone to overinterpretation, which skews specificity and adversely affects diagnostic accuracy. In this retrospective review of 234 consecutive cases of cholecystectomy, real-time ultrasound was 90% accurate with a sensitivity of .96 in determining the presence of cholecystolithiasis. Oral cholecystography was 95% accurate with a sensitivity of .97. PMID- 3303365 TI - ["Pravda" and the health protection of the people]. PMID- 3303366 TI - [Pages from the life of staff physician G. N. Belynskii--the father of V. G. Belinskii]. PMID- 3303367 TI - [Incorporation of bone grafts in the surgical treatment of deformities of the spine]. PMID- 3303368 TI - Alterations of bone and mineral metabolism in diabetes mellitus. Part I. An overview. AB - A critical review of the literature leads to the conclusion that alterations of bone and mineral metabolism occur both in diabetic patients and in animals with experimentally induced insulin deficiency syndromes. The coexistence of juvenile insulin-dependent diabetes mellitus (type 1) and radiological evidence of decreased bone mass (osteopenia) appears to be firmly established. Available data support the view that these patients have an increased propensity to skeletal fracture. Adult-onset, non-insulin-dependent diabetic populations, more heterogeneous as regards the type of diabetes, the therapy and the presence of complications or coexistent disease, are characterised by subpopulations with either a decreased, a normal or an increased bone mass. The pathogenesis of diabetic osteopenia is multifactorial. Data obtained from studies employing appropriate animal models of chronic insulin deficiency indicate that various metabolic and hormonal abnormalities may be involved. PMID- 3303369 TI - Ultrasound diagnosis in intussusception of the bowel. A case report. AB - Ultrasound examination is at present a subsidiary aid in the definition of bowel lesions. There are, however, echographic features suggestive or diagnostic of intussusception. These should be borne in mind during ultrasound examination of the patient with a tender abdominal mass or intermittent diffuse abdominal pain. PMID- 3303370 TI - Thomas Sydenham, 1624-1689. AB - Thomas Sydenham, widely regarded as the leading English physician of the second half of the 17th century, was a soldier before he became a physician. This may account for his very practical attitude to medicine, which he believed should be learned by observing patients rather than by reading books. His treatment was largely traditional and he tended to ignore contemporary advances in medical science, but his meticulous records of patients and of their response to treatment paved the way for the clinical approach which was to prevail in the future. PMID- 3303371 TI - An unusual infection in acute leukemia. PMID- 3303372 TI - Leucocytosis in acute Plasmodium falciparum malaria. PMID- 3303373 TI - Vibration syndrome: a missed diagnosis. AB - Operators of chain saws, rock drills, chipping hammers, pedestal grinders, and other power tools and machines have long been aware of the tingling, blanching, and numbness of their fingers. The effects of this syndrome on the worker can range from mild or occasional discomfort or inconvenience to severe social or occupational disability. PMID- 3303375 TI - Antigen preparation for the patch test. AB - At this time patch testing is the most important tool in the evaluation of patients with dermatoses. From 70 to 80% of all cases of contact allergy are estimated to be discovered by using the standard trays with just 20 to 30 different substances and mixes. PMID- 3303374 TI - AIDS in the workplace. A new dilemma. AB - The AIDS epidemic continues to spread at a rapid rate with a doubling of the number of reported cases every 9 to 12 months. The impact of AIDS in the workplace is just beginning to be felt and the number of disabled workers will increase substantially over the next few years. Employees who have been infected with the AIDS retrovirus can be allowed to work without risk to fellow employees. The CDC has published recommendations for preventing the transmission of AIDS in the workplace. PMID- 3303376 TI - Standardizing spirometry: problems and prospects. AB - Pulmonary function tests, as well as clinical tests of other physiologic functions, have been adopted from the clinical setting for use in epidemiologic studies. Because these tests require an individual's maximal effort, they present a challenge to conventional standards of measurement validity. The author demonstrates that attempts to standardize spirometry in current epidemiologic studies reveal a bias that causes underestimation of adverse pulmonary effects of occupational hazards. PMID- 3303377 TI - Occupational pulmonary disease. PMID- 3303378 TI - Evaluation of impairment and disability in occupational lung disease. AB - At least 260,000 workers suffer from work-related respiratory diseases in the United States. For physicians who wish to determine whether a respiratory disease is caused or aggravated by a patient's occupation, the diagnosis is followed by questions of attribution, impairment and disability, which are addressed in this article. PMID- 3303379 TI - Cardiopulmonary exercise testing to assess respiratory impairment in occupational lung disease. AB - Exercise testing can answer several pertinent questions for the physician. It can determine whether a worker's aerobic performance is limited by respiratory or by other factors. It can also help decide whether an individual can perform a job without undue physiologic limitations and fatigue. Exercise testing has its limitations. It cannot determine the etiology of the impairment nor can it make a specific diagnosis except in rare cases. Interpretation of exercise data is not always precise, especially when the VO2max is normal but several physiologic measurements are abnormal. The VO2max achieved under laboratory conditions is probably too simplistic an estimate of the complex energy requirements of any occupation. Future research is needed to develop portable devices to assess both aerobic and anaerobic potentials of workers on the job to better determine job specific impairment and disability. Patients who have unexplained symptoms or abnormal, but not severely reduced, static pulmonary function tests benefit most from exercise testing. For now, the AMA criteria for impairment as defined by static and exercise pulmonary function testing are the most appropriate to follow. Exercise testing has provided valuable data for epidemiologic research. Descriptive and case-control studies have documented minor physiologic abnormalities and rare respiratory limitations in workers with asbestos exposure and simple coal worker's pneumoconiosis. Additional studies are necessary to further elucidate pathophysiologic findings in patients with asbestosis and other occupationally induced pulmonary diseases. PMID- 3303380 TI - Controversies in asbestos-related lung cancer. AB - Despite clear agreement that asbestos exposure causes lung cancer and despite prodigious research efforts in clinical, epidemiologic, toxicologic and mineralogic aspects of the problem, wide disagreement exists in the scientific community on many crucial points. Put in the simplest way neither the biologically relevant measure of dose nor the full shape of the dose-response curve at either the high or (especially) low end is understood. Nor is the relationship between the carcinogenic potential of the fibers and their fibrogenic properties. In the long run, full resolution of these issues will probably require the unravelling of the basic mechanisms by which the fibers induce cancer; unfortunately, despite recent progress, this understanding is probably too far off to be of use in the solution to the very real, omnipresent clinical and public health cancer-control problems. Decisions will have to be made using data sets far less satisfactory. Hopefully, by pursuing some of the avenues suggested in the sections above, enough can be learned to facilitate more rational approaches to the problems at hand. PMID- 3303381 TI - Occupational lung cancer. AB - The author addresses the attribution of lung cancer to cigarette smoking and the problems of confounding synergistic effects of occupational and other carcinogenic risk factors, as well as the divergent trends of declining smoking rates and increasing rates of lung cancer. He also reviews the existing literature to document associations between lung cancer and occupational exposures. Finally, interventions for prevention of occupational lung cancer are discussed. PMID- 3303382 TI - Acute inhalational injury. AB - Recent events, such as the Bhopal, India tragedy, dramatically illustrate the potential consequences of acute exposure to toxic inhalants. This article covers problems in clinical management of the toxic gases, mists and fumes that are capable of inducing acute lung injury or systemic toxicity. PMID- 3303383 TI - Silicosis. AB - Silicosis, which is an ancient disease, is still epidemic in the United States. The author reviews current problems related to exposure to silica, the incidence and prevalence of silicosis in modern American industry, the causal association between silica exposure and cancer, and methods of prevention. PMID- 3303384 TI - Respiratory effects of hard-metal dust exposure. AB - Workers exposed to hard-metal dust are at risk of developing interstitial pulmonary fibrosis. Focusing on the lung parenchymal disorders that result, the author thoroughly reviews the background of the problem, animal studies and recent environmental data related to "hard-metal disease," the clinical presentation, and finally its etiology. PMID- 3303385 TI - Occupational asthma: natural history, evaluation and management. AB - A variety of occupational circumstances are capable of inducing asthma by specific exposure to airborne dusts, gases, vapors and fumes. The authors review the clinical history of the disease, including detection of exposures and diagnostic tests. The natural history of occupational asthma, its management and finally its prevention are then discussed. PMID- 3303386 TI - The pleural manifestations of asbestos exposure. AB - Pleural abnormalities are the most common disease manifestations of asbestos exposure and have both clinical and epidemiologic implications. Benign pleural processes include pleural thickening, which can be discrete (plaques) or diffuse, rounded atelectasis (pseudotumor), and benign exudative asbestos effusions. Asbestos is the most significant cause of diffuse malignant mesothelioma. Most patients with discrete pleural thickening have normal pulmonary function. Patients with extensive pleural involvement, however, can have significant restrictive impairment with no or only minimal interstitial disease. For any given radiological grade of parenchymal disease, pulmonary function is more impaired when pleural thickening is present. The presence of typical pleural changes can serve as a reliable marker for asbestos exposure in epidemiologic studies. Individuals with pleural plaques are more likely to develop parenchymal involvement than similarly exposed workers without pleural disease. Once present, pleural changes are likely to progress even in the absence of further exposure. PMID- 3303387 TI - Agricultural exposures to organic dusts. AB - Occupational respiratory hazards in agriculture are varied and widespread, and farm workers have been found to have high rates of respiratory disability compared with other industrial sectors. The common denominator in most agricultural exposures is organic dust. The author reviews agricultural respiratory syndromes and their diseases, including acute febrile syndromes, asthma, hypersensitivity pneumonitis and chronic bronchitis and airway obstruction. PMID- 3303388 TI - [Analysis of bacteremia and fungemia occurring in hematology patients]. PMID- 3303389 TI - [Salvage treatment of non-Hodgkin's lymphomas]. PMID- 3303390 TI - Fast facts and figures about Social Security. PMID- 3303391 TI - Clinical hyperthermia: five year's experience. PMID- 3303392 TI - Hyperthermia as an adjuvant to radiotherapy. Review of the randomized multicenter studies of the European Society for Hyperthermic Oncology. PMID- 3303393 TI - German Multicentric Hyperthermia Study. PMID- 3303394 TI - Congenital esotropia. AB - Congenital esotropia represents the most common type of strabismus. Its pathogenesis, however, remains uncertain. It is typically characterized as a large angle, constant esotropia with onset during the first six months of life. Associated clinical findings include normal refractive errors for age, amblyopia, dissociated vertical deviation, inferior oblique muscle overaction and nystagmus. It must be distinguished from Duane's retraction syndrome, Moebius syndrome, nystagmus blockage syndrome, and early onset accommodative esotropia, as well as other causes of esotropia in infancy. The surgical management may involve recession of both medial recti muscles, unilateral recession of a medial rectus muscle and a resection of a lateral rectus muscle or three or four muscle surgery. PMID- 3303395 TI - Acquired immunodeficiency syndrome (AIDS). AB - The Acquired Immunodeficiency Syndrome (AIDS), caused by the human immunodeficiency virus (HIV), also called the human T-lymphotropic virus type III/lymphadenopathy-associated virus [HTLV-III/LAV], has affected over 23,000 people; more than half of those with the disease have died. The actual case fatality rate approaches 100%. AIDS affects all groups and classes of people, although some are at special risk. Distribution of the disease is worldwide. The illness' effects on the body are widespread; of special interest are the ophthalmologic manifestations. The eye may be infected by various viruses (cytomegalovirus, varicella-zoster virus, herpes simplex virus or HIV itself), toxoplasma gondii, candida sp, cryptococcus neoformans, M. tuberculosis, or M. avium-intracellulare. Kaposi's sarcoma may affect the eye as well. Retinal vascular abnormalities (e.g., cotton-wool spots, vasculitis) are not uncommon in AIDS. The syndrome may present with neuro-ophthalmologic manifestations. No effective treatment for the illness is currently available, although several hold promise and there is hope for an AIDS vaccine. Prevention of infection through reduction of risks appears to be the only defense against AIDS at this time. PMID- 3303396 TI - Bile enhances release of insulin: an incretin-mediated effect. AB - Ingestion of food stimulates secretion of bile and release of gut hormones that enhance nutrient-stimulated release of insulin. The extent of physiologic participation of bile in the enteroinsular axis was examined in seven conscious dogs (weight: 20 +/- 2 kg) that were prepared for study with chronic cannulas placed in the duodenum opposite the ampulla of Vater. On separate days, a meal consisting of 10 gm (MG-10), 25 gm (MG-25), or 62 gm (MG-62) of glucose (dextrose) was given orally in the presence of normal bile flow or during bile diversion. Bile diversion was achieved by catheterization of the common bile duct via the duodenal cannula. The insulin responses (given as ng [0-120] min/ml) to the different glucose meals, with bile present (BP) or absent (BA) in the lumen, were as follows: MG-10, 81 +/- 8 BP and 72 +/- 11 BA; MG-25, 172 +/- 25 BP and 100 +/- 6 BA (p less than 0.05); and MG-62, 390 +/- 79 BP and 153 +/- 32 BA (p less than 0.05). Only MG-25 and MG-62 produced a significant elevation of plasma glucose concentrations. Release of gastrin was not affected by either the presence of bile or the glucose content of the meal. We conclude that endogenous bile enhances nutrient-stimulated release of insulin, this effect is glucose dependent with a threshold of approximately 1 gm/kg of glucose, and bile may facilitate the release of insulinotropic hormones other than gastrin. PMID- 3303397 TI - A single dose of endotoxin activates neutrophils without activating complement. AB - Both complement (C) and neutrophils (PMN) are activated in critically ill patients. To evaluate the role of endotoxin in this response, we studied C activation products and PMN cell surface receptors in seven normal subjects before and after endotoxin (USRef 20 U/kg) or saline solution administered on separate occasions. By 4 hours, with endotoxin only, all subjects had myalgia, headache, an increase in body temperature and heart rate, and leukocytosis that returned to normal by 24 hours. At the same time, PMN cell surface receptors for the complement opsonin C3b increased, as measured by indirect immunofluorescence, rising to 251 +/- 44% of baseline by 4 hours (p less than 0.01) and remaining elevated at 24 hours (237 +/- 16%, p less than 0.01). PMN receptors for iC3b increased to 308 +/- 49% of baseline by 4 hours (p less than 0.02) and returned to normal by 24 hours. There was no change in plasma of C3a desArg, C4a desArg, and C5a desArg (4 hours: mean C3a: 153.4 +/- 11.5 ng/ml versus 176.2 +/- 16.2 ng/ml for saline solution, p = ns; C4a: 159.6 +/- 32 ng/ml versus 151.4 +/- 21 ng/ml, p = ns; C5a: undetectable). To confirm the lack of C activation, we examined PMN chemotaxis (CTX) to C5a for any impairment caused by prior in vivo exposure to C5a. CTX to C5a was unaffected (4 hours: 109% +/- 22% of normal versus 114% +/- 10% for saline solution, p = ns). PMN CTX to formyl-methionyl leucine-phenylalanine and PMN phagocytosis and killing of S. aureus were also unaffected by endotoxin. Thus, a single dose of endotoxin produced a subjective febrile illness and precipitated sustained PMN activation as indicated by increased PMN cell surface complement receptor number in the absence of C activation. PMID- 3303398 TI - Synergistic effect of nonspecific immunostimulation and antibiotics in experimental peritonitis. AB - To assess the role of combined immunomodulator and antibiotic therapy in sepsis, glucan--a beta 1,3 polyglucose--and gentamicin were administered in a model of murine peritonitis. ICR/HSD mice received one of four treatment regimens: 5% dextrose; gentamicin 0.02 mg intramuscularly (sub-MIC) 2 hours before peritonitis; glucan 0.1 mg intraperitoneally 24 hours before peritonitis; combined glucan-gentamicin treatment. All animals were challenged with 1 X 10(8) Escherichia coli intraperitoneally. Long-term survival was significantly enhanced in the combined therapy group (56%, p less than 0.05) when compared with D5W (0%), gentamicin alone (0%), or glucan alone (9%). Macrophage secretory activity, as assayed by interleukin-1 (IL-1) production, was significantly enhanced by combined therapy when compared with the other three treatment groups. Combined therapy significantly reduced E. coli bacteremia at 8 hours after inoculation, when compared with the other three groups. Availability of host neutrophils was assessed by peripheral counts and bone marrow proliferation assay. Combined glucan-gentamicin significantly enhanced bone marrow proliferation when compared with the other three groups and this enhancement correlated with increased circulating neutrophils. Combined immunomodulator and antibiotic therapy had synergistic effects on survival in E. coli peritonitis. This combined therapy enhanced macrophage secretory activity and bone marrow proliferation. Clinical use of immunomodulators may alter conventional use and dosage of antibiotics. PMID- 3303399 TI - Augmentation of experimental skin flap survival via postoperative phosphocreatine replacement. AB - Despite improvements in our understanding of cutaneous vascular territories, clinical skin flap necrosis resulting from ischemic compromise is still a reality. Therapy with vasodilators has been generally unsuccessful, but replacement of high-energy phosphometabolites through the use of ATP-MgCl2 and fructose 1,6-diphosphate has been effective. Recently we reported that phosphocreatine is the major high-energy phosphometabolite in mammalian skin and that ATP levels and cellular well-being in skin flaps are dependent on adequate supply of this phosphometabolite. We report herein the successful augmentation of survival of ischemically compromised skin flaps through postoperative phosphocreatine infusion. This metabolite effectively circumvents the nonfunctioning mitochondrial creatine-phosphocreatine energy shuttle without disturbing the delicate [ATP]/[ADP] balance in the cytosol. In addition, phosphocreatine may favorably redistribute blood flow from muscle to the ischemically compromised skin. PMID- 3303400 TI - Extravascular lung water changes following smoke inhalation and massive burn injury. AB - During a 3-year period (1984 through 1987), 40 patients with smoke inhalation, cutaneous burns, or a combination of both injuries were studied. Injuries were assigned to the three categories on the basis of bronchoscopic findings and clinical history. Eleven patients had simultaneously sustained a common smoke inhalation injury without burns while trapped in a burning ship; twelve patients had massive cutaneous burns over 50% of the total body surface area (TBSA); and seventeen patients had cutaneous burns over more than 30% of the TBSA and inhalation injury. Colloid oncotic pressure was maintained with salt-poor albumin infusion. Central venous pressure, arterial saturation, inspired oxygen, arterial pressure, and urine output were continuously monitored. Extravascular lung water (EVLW) and cardiac output were measured by the double indicator (thermal dye dilution) technique. EVLW remained normal throughout the study period in the group of patients with burns alone. In the first 24 hours after injury, EVLW increased in both groups with smoke injury and remained elevated for more than 48 hours after injury in patients with smoke injury only. The group with both smoke inhalation and burn injuries showed an early increase in EVLW, which returned to normal by 28 hours after injury and which remained normal until 5 days after injury. The EVLW level then increased again until the end of the study period. In this study, lung edema formation is attributed to the toxic effect of smoke inhalation. PMID- 3303401 TI - Does bacteremia pose a direct threat to synthetic vascular grafts? AB - This study was undertaken to determine the significance of graft lumen exposure to blood-borne organisms in the development of graft infection. Three groups of dogs were studied. In group I (n = 20), the infrarenal aorta was dissected from surrounding tissue, divided, and reconstructed with a Dacron tube interposition graft. In group II (n = 9) the aorta was similarly isolated, but Dacron graft material was wrapped around the intact aorta. In group III (n = 13) the infrarenal aorta was isolated, but no graft material was placed. All dogs were given intravenous 1 X 10(7) Staphylococcus aureus at the completion of surgery. Group I grafts were harvested 8 hours, 1 day, or 21 days after bacterial challenge. Group II and III grafts were harvested 1 day or 21 days after infusion. At the time of harvest, selective cultures of the periaortic tissue (PAT), periaortic graft (PAG), and interposition graft lumen (GL) were taken. The overall infection rates were similar, with 17 of 20 (85%) dogs in group I, 6 of 9 (67%) in group II, and 11 of 13 (85%) in group III found to be culture positive. In group I, 3 of 3 dogs at 8 hours, 2 of 2 on day 1, and 12 of 15 on day 21 had positive PAT cultures. Only 4 of 15 on day 21 had positive GL cultures. In group II, 4 of 5 dogs on day 1 and 2 of 4 on day 21 had positive PAT and PAG cultures. In group III, 9 of 9 animals on day 1 and 2 of 4 on day 21 had positive PAT cultures. All aortic lumen cultures were negative in groups II and III. The difference between GL and PAT cultures was statistically significant in all groups (I, p = 0.01; II, p = 0.05; III, p = 0.01). Serial quantitative blood cultures revealed a mean bacterial load of 10.5 +/- 4.5 CFU/ml at 15 minutes postinfusion, which fell steadily until no bacteria were detected at 3.5 hours. Lymphangiography demonstrated periaortic pooling of lymph in the immediate postoperative period. These data suggest that the bacteremia in this model is transient and rapidly clears. Periaortic tissues quickly sequester bacteria, possibly because of lymphatic leakage. The GL appears to be secondarily infected. PMID- 3303402 TI - Lipoprotein modification achieved by partial ileal bypass: five-year results of The Program on the Surgical Control of the Hyperlipidemias. AB - The Program on the Surgical Control of Hyperlipidemias (POSCH) is a multicentered, randomized, secondary intervention trial assessing the effect of lipoprotein modification achieved by partial ileal bypass (PIB) on overall mortality rates and the course of coronary heart disease. Of the 838 participants, 396 (196 control and 200 surgical patients) have complete 5-year lipoprotein results and are the basis of this report. After PIB, total cholesterol level decreased 24 +/- 1.2% (mean +/- SEM) and low-density lipoprotein cholesterol level fell 38 +/- 1.5% in comparison with control subjects. High-density lipoprotein (HDL) cholesterol level was not changed by PIB; however, a significant decrease in HDL occurred over 5 years in the control group (41.7 +/- 0.7 mg/dl versus 39.5 +/- 0.6 mg/dl, p less than 0.05). This led to consistently higher HDL levels in the surgical group in comparison with control subjects after PIB. Very low-density lipoprotein cholesterol and triglyceride levels were higher in the surgery group than in control subjects (24 +/- 7.6% and 21 +/- 5.4% at 5 years). Apolipoprotein B-100 was significantly lower, and apolipoprotein A-I and HDL-2 were significantly higher in the surgery group. These lipoprotein changes are greater than have been reported from any previous trial of dietary or pharmacologic intervention, including the Lipid Research Clinics-Coronary Primary Prevention Trial, which used cholestyramine. Based on available epidemiologic data, these changes predict a marked reduction in morbidity and mortality rates associated with coronary heart disease after PIB. PMID- 3303403 TI - [Historical perspective: changed knowledge ideal and 2 nursing groups]. PMID- 3303404 TI - [When we too were called up]. PMID- 3303406 TI - [The purpose is that nurses shall be stronger]. PMID- 3303405 TI - [These are my best memories. At that time we still had leprosy patients in Norway]. PMID- 3303407 TI - [Childrens' health. 20. Children who see father beat mother build up a mental defense]. PMID- 3303408 TI - [Alternative treatment. Hard to teach that raising before consciousness and body follows]. PMID- 3303409 TI - [Children's health. 25. Rearing of children to useful citizens in homes for the mentally retarded]. PMID- 3303410 TI - [Dental treatment needs of the elderly]. PMID- 3303411 TI - [Functional aspects and indications for prosthetic treatment in the elderly]. PMID- 3303412 TI - [Use of the ES-1045 computer for the assessment of the integral status of patients with large-focus myocardial infarct during treatment and rehabilitation. Initial experiences]. PMID- 3303413 TI - [Clinico-echographic parallels in diffuse liver diseases]. AB - The authors stressed the point that investigations conducted by them, showed a high value of ultrasonic scanning in the recognition of diffuse liver lesions. Ultrasonic diagnosis of persisting and active forms of chronic hepatitis can be only hypothetical because of the absence of pathognomonic echographic signs of this type of pathology. On echography fatty degeneration was characterized by hepatomegaly, blurred liver contours, preserved elasticity of the organ and diffuse homogeneous enhancement of its structure. Diffuse focal enhancement of the echo structure of the liver, its irregular surface, and an increase in the liver elasticity and echo permeability indicated a possibility of liver cirrhosis, and the combination of these signs with ascites or dilatation of the portal veins confirmed it. There was no relationship of an ultrasonic picture with clinical symptoms and laboratory findings. PMID- 3303414 TI - [Prevention of recurrence of duodenal ulcer]. PMID- 3303415 TI - [Traveller's diarrhea: diagnosis, prevention and treatment]. PMID- 3303416 TI - [Irritable colon--diagnosis and therapy]. PMID- 3303417 TI - [Screening for colorectal carcinoma?]. PMID- 3303418 TI - [Radiology of cholestasis]. PMID- 3303419 TI - Hepatic resection for tumour. PMID- 3303420 TI - [Endoscopic therapy of bile duct diseases]. PMID- 3303421 TI - [Diagnosis and management of patients with chronic hepatitis]. PMID- 3303422 TI - [Management of the complications of portal hypertension]. PMID- 3303423 TI - Solute permeability of the alveolar capillary barrier. PMID- 3303424 TI - Trial of ketoconazole in non-invasive pulmonary aspergillosis. AB - A one year study of the efficacy of the antifungal agent ketoconazole in non invasive pulmonary aspergillosis was carried out. Ten patients, seven with allergic bronchopulmonary aspergillosis and three with mycetoma, were studied. They were randomly allocated to receive 400 mg daily or placebo orally in a double blind fashion. In the treated group (n = 6), concentrations of serum IgG specific for Aspergillus fumigatus fell significantly during treatment (mean reduction 42% (SEM 2.2%) compared with determinations preceding the study). This effect was evident by three months and continued for the 12 months of treatment. Patients receiving placebo (n = 4) showed no significant change in serum IgG concentration (mean change + 10% (SEM 5.3%]. Asthmatic patients treated with ketoconazole (n = 4) had significantly lower symptom scores than those receiving placebo (n = 3) (+0.45%/month (SEM 6.9%) versus +27%/month (SEM 6.5%); p less than 0.001). None of the patients treated with ketoconazole reported any adverse effects. Ketoconazole may cause serious liver damage but its use may be justified in bronchopulmonary aspergillosis if further experience confirms its ability to alter the course of a potentially serious disease. PMID- 3303425 TI - Effect of betamethasone on airway obstruction and bronchial response to salbutamol in prednisolone resistant asthma. AB - Twelve patients with chronic severe asthma, having previously shown an FEV1 increase of less than 20% of the predicted value with prednisolone treatment (20 60 mg daily for 10 days), took part in a double blind crossover comparison of equipotent anti-inflammatory doses of betamethasone and prednisolone. Betamethasone (8 mg) and prednisolone (40 mg) were administered daily for 10 days with a washout period of 10 days between. In this first part of the study betamethasone was administered intramuscularly and prednisolone orally. Placebo injections and tablets were used. Mean FEV1 was not significantly different before each period. There was a significant increase in FEV1 while they were taking betamethasone but not prednisolone. Individual analysis of the data showed that FEV1 increased with betamethasone in nine patients and remained stable or decreased in three. During treatment with prednisolone baseline FEV1 increased moderately in three patients (FEV1 0.3, 0.5 and 0.6 l) and remained stable or decreased in nine. There was no significant difference between the bronchodilator responses to cumulative doses of inhaled salbutamol when they were measured immediately before, on the last day of treatment with each steroid, and between steroid treatment periods. The same protocol was followed four months later in five of the 12 patients but both drugs were administered orally on this occasion. Similar results were obtained. The greater effect of betamethasone on bronchial obstruction may be due to its longer biological half life or to some unidentified property of its metabolites. The bronchial response to inhaled beta 2 agonist appears not to be influenced by either steroid in these patients. PMID- 3303426 TI - Calcitonin gene related peptide immunoreactivity in rat lung: light and electron microscopic study. AB - Calcitonin gene related peptide immunoreactivity was investigated in the rat lung. Immunoreactive material was observed in nerve fibres surrounding bronchi, bronchioli, and blood vessels, and also in neuroendocrine cells and neuroepithelial bodies. In addition, the peptide was identified by immunoelectron microscopy in dense cored vesicles of granulated cells of the neuroepithelial bodies. These observations suggest that calcitonin gene related peptide plays a part in the regulatory function of the rat respiratory tract, exerting its influence by endocrine, paracrine, neurosecretory pathways, or a combination of these. PMID- 3303427 TI - Effect of nebulised aerosol size on lung deposition in patients with mild asthma. AB - A radioaerosol technique has been used to investigate whether the size distribution of aerosols released from a jet nebuliser affects the amount of aerosol delivered to the lungs. Six subjects with mild asthma (FEV1 81% of predicted) were studied on three occasions. On each visit they received one of three aerosols tagged with technetium-99m in 0.9% saline. The aerosols were generated by either (A) a Turret nebuliser operated at 8 l min-1 (mass median diameter (MMD) 1.8 micron); (B) an Upmist nebuliser operated at 6 l min-1 (MMD 4.6 microns); or (C) an Inspiron Mini-neb operated at 4 l min-1 (MMD 10.3 microns). The aerosols were given in a randomised single blind manner and inhaled under identical conditions of inspiratory volume and frequency. The mean (SD) percentage of aerosols A, B, C released from the nebulisers during inhalation that was recovered in an expiratory filter was 23 (6), 25 (4), and 24 (4) respectively. Of the aerosols released from the nebuliser and deposited in the body, the percentage deposited in the lung was 79 (3) for aerosol A, 59 (4) for aerosol B, and 44 (5) for aerosol C. The remaining aerosol was deposited in the oropharynx and swallowed. It is concluded that small nebulised aerosols (MMD less than 2 microns) deliver a larger dose to the lungs and should be used to maximise lung deposition. PMID- 3303429 TI - Deleterious effects of purulent sputum sol on human ciliary function in vitro: at least two factors identified. AB - Patients with chronic bronchial sepsis have impaired mucociliary clearance. A study was carried out on the effect of sputum sol (obtained by rapid centrifugation of purulent sputum) from 20 patients with chronic bronchial sepsis on the beating of human nasal cilia in vitro by a photometric technique. Thirteen sols caused significant (p less than 0.001) ciliary slowing. Two patterns of slowing were observed: firstly, a gradual onset associated with epithelial disruption (inhibited by alpha 1 antiprotease) and, secondly, an immediate onset associated with ciliary dyskinesia and ciliostasis (inhibited by chloroform extraction). The ciliary slowing activity of sputum sols was associated with the isolation of Pseudomonas aeruginosa (p less than 0.01). It is concluded that purulent sputum contains at least two factors that impair ciliary beating--one a serine protease, which is probably a product released by the host's phagocytic defences, and the other, which is chloroform extractable and probably a bacterial product. PMID- 3303428 TI - Immune and inflammatory function in cigarette smokers. PMID- 3303430 TI - Role of cryoanalgesia in the control of pain after thoracotomy. AB - Thoracotomy causes severe postoperative pain, which is difficult to manage since the use of systemic analgesics often causes respiratory depression. Cryoanalgesia of the intercostal nerves has been advocated as an effective means of local analgesia without serious side effects. A prospective randomised blind trial to investigate the efficacy of the technique was carried out. A total of 53 patients undergoing thoracotomy were allocated to either the trial or a control group. At thoracotomy the surgeon was informed of the patient's trial allocation. The trial group received one minute of direct cryotherapy to at least five intercostal nerves related to the incision. All patients received methadone via the lumbar epidural route in a dose calculated according to their weight. A linear analogue assessment of postoperative pain was made by the patients as soon as they were sufficiently awake. An independent record of all postoperative analgesia was kept. After discharge from hospital further assessments were made at least six weeks after operation. Statistical analysis of the scores of postoperative pain and analgesic consumption showed that there was no significant difference between the trial and the control group. There was, however, a suggestion of an increase in the long term morbidity, although these figures were not amenable to statistical analysis. Thus is has not been possible to demonstrate a role for cryoanalgesia in the control of post thoracotomy pain. PMID- 3303431 TI - [Influence of fluidifying agents on the penetration of antibiotics in respiratory secretions]. PMID- 3303432 TI - [Verapamil in arterial hypertension]. PMID- 3303433 TI - [Myasthenia induced successively by pyritinol, then by captopril, in rheumatoid polyarthritis]. PMID- 3303434 TI - Inhibition of a proteolytic activity from the coelomic fluid of the sea urchin Strongylocentrotus droebachiensis by antithrombin III is potentiated by heparin. PMID- 3303435 TI - [Foot-and-mouth disease. By the Hollandsche Maatschappij van Landbouw. 1863]. PMID- 3303436 TI - [Pharmacology. By J.J.Hinze. 1875]. PMID- 3303437 TI - [Veterinary pharmacotherapy: from retrospect to future expectations]. AB - To begin with, a review paper on apomorphine, published by J.J. Hinze in 1875, is discussed. Subsequently, the development of pharmacology and rational pharmacotherapy is described. The progress of veterinary pharmacotherapy during the sixties and seventies is recalled on the basis of instances, and recent additions such as aditoprim, florphenicol and flumazenil are also referred to. Finally, the possibilities of biotechnology, particularly polypeptides which are produced using the recombinant DNA technique, such as interferons, interleukins and somatotropins (which are of interest from the point of view of zootechnics) are discussed. The recombinant DNA technique also makes it possible to synthesise receptor proteins, and thus offers new and interesting possibilities for future pharmacological studies. PMID- 3303438 TI - [Neonatal adrenal gland hemorrhage. The importance of echography in diagnosis and follow-up]. AB - Neonatal Adrenal Haemorrhage (NAH) is a condition, which often presents with a palpable abdominal mass and prolonged jaundice. Supra-renal calcifications, seen on routine X-ray films, often result from adrenal haemorrhage in early life. Disturbed renal function at the ipsilateral side, as can be seen from excretory urography and renal scintigraphy, is a much less known condition in association with NAH. The case history of three patients is described. The presentation, diagnostical approach and course of NAH is discussed. Echography is the most important diagnostic tool. Echographic follow up discriminates NAH from other conditions presenting with a palpable abdominal mass and allows for a waiting attitude. PMID- 3303439 TI - The influence of HLA-A,B and -DR matching on leucocyte infiltration in renal allografts. AB - The influence of donor and recipient HLA-A,B and -DR matching on the cellular infiltration in renal allografts was examined in 78 transplant recipients who received either cyclosporin (Cy) or azathioprine and low-dose prednisolone (AP) immunosuppression. Transplant biopsies (n = 161) were routinely obtained up to 40 days after transplantation, and biopsy material was therefore available from both rejecting grafts and grafts with stable function. Tissue sections were labelled with a panel of monoclonal antibodies and stained using an indirect immunoperoxidase technique. Cellular infiltration was assessed using a morphometric point counting technique. In AP-treated patients with well functioning grafts, poor HLA-AB and HLA-DR matching was associated with increased leucocyte infiltration, while in patients receiving Cy therapy the effect of matching on cellular infiltration was seen only during rejection in grafts poorly matched for HLA-AB antigens. In addition, where an effect of HLA-AB matching on cellular infiltration was found, CD8+, but not CD4+ cells, were significantly increased in number, while when an HLA-DR matching effect was seen, a significant increase was observed in the CD4+ and not the CD8+ infiltration. Thus, HLA matching may influence the magnitude of the cellular response in renal allografts and the phenotype of the infiltrating cells. PMID- 3303440 TI - [Congenital portosystemic shunt in dogs and cats]. AB - An overview of the circulation of the liver and of the pathogenesis of hepatic encephalopathy as a result of portal vascular anomalies is given. Clinical signs associated with portal systemic shunts are described on the basis of 16 cases, 14 dogs and 2 cats. These animals ranged in age at the time of presentation from 4 months to 7 years. The predominant abnormality observed were central nervous signs, which differed in severity. The different techniques of contrast angiography allowing demonstration of a portal systemic shunt are presented along with a discussion of the pros and cons of each. Additionally the significance of making portal venous pressure measurements prior to each angiography is also explained. In most cases mesenteric portography was chosen. Based on their location the anomalies could be categorized as intrahepatic (4 dogs) or extrahepatic (10 dogs, 2 cats). In both groups breeds of various size are represented. The extrahepatic shunts could be further described as portal-caval (n = 5), portal-phrenic (n = 4) and portal-azygos (n = 3). In five of the older animals angiography showed in addition some hepatic perfusion by the portal vein. Laboratory evaluation revealed increased resting blood ammonia concentrations (greater than 200-912 micrograms/100 ml) in all animals. Seven dogs had definitely subnormal BUN concentrations (less than 10 mg%) and ten dogs low total plasma protein levels (less than 5.4 g%). Free amino acids (24) were determined in four dogs and a lowered hepatic encephalopathy index (less than 1.64) found. Medical palliative therapy to control the clinical signs is discussed. The only effective long term therapy is, however, surgery. The shunt vessel is narrowed so that a greater volume of portal blood reaches the liver. Experience gained from the surgical therapy of 14 animals is presented. Ten of these survived well without requiring further therapy at a later time. Finally the etiology, prognosis, and differential diagnosis are summarized. PMID- 3303441 TI - [Megakaryocytic leukemia in three cats]. AB - The present report describes a myeloproliferative disease, type megakaryocytic leukemia in three cats, 4, 8 and 11 years old. Clinically, the animals showed severe anemia. Neoplastic infiltrates were present in bone marrow, spleen, lymphnodes, liver and kidney. Two animals were FeLV positive. PMID- 3303442 TI - The significance of pre-operative diagnosis of esophageal cancer using esophageal mediastinal ultrasonography. AB - Esophageal ultrasonography (EUS) is a new diagnostic method which allows improved preoperative diagnosis of esophageal cancer. Careful examination of EUS findings and comparison of these findings with operative and pathological findings yielded criteria useful for the determination of tumor depth and lymphnode metastasis. Concerning tumor depth, EUS findings of 30 patients were reviewed and compared with operative and pathological findings. Based on this comparison some diagnostic criteria were then chosen; it was found that the accuracy was around 87% and that the differentiation between intramural and extraluminar invasion could be easily made using these criteria. Regarding the lymphnodes, at the time of operation, the site and size of each lymphnode (a total of 267 nodes) were recorded. These findings were grouped according to the site and size. We found the range of sizes of metastatic lymphnodes to be great and not so different from that of normal nodes. We then compared these anatomical findings with the EUS findings in an attempt to determine appropriate diagnostic criteria, which would include size as well as intrinsic and extrinsic echocharacteristics. When these criteria were used, the accuracy was about 90%. Although this preliminary study must be confirmed by further prospective studies with a large number of patients, we can conclude that EUS allows accurate determination of tumor depth and node metastasis in patients with esophageal cancer. PMID- 3303443 TI - A solid-phase enzyme immunoassay for rat albumin and its application. PMID- 3303444 TI - What is a peroxisome? PMID- 3303445 TI - Mechanisms of rodent liver carcinogenesis. AB - Stimulation of DNA synthesis by peroxisome proliferators, including DEHP, should be viewed differently from the stimulation of DNA synthesis by xenobiotic chemicals which stimulate restorative hyperplasia after hepatic necrosis induced by the toxicity of the chemical. The emerging picture of the control mechanisms for hepatocyte proliferation suggests that rather few and distinct factors are involved. The stimulation of DNA synthesis by peroxisome proliferators should be examined in the context of the effects of these factors. Comparisons with other xenobiotics show that induction of DNA synthesis at rates comparable to those of peroxisome proliferators is not sufficient to explain the rates of carcinogenicity associated with peroxisome proliferators. These considerations lead to the conclusion that although DNA synthesis enhances the incidence of neoplasia, it should not be viewed as a complete carcinogen, nor should it be considered as resulting in initiation at rates that can explain the carcinogenic potency of compounds such as peroxisome proliferators. PMID- 3303446 TI - The potential role of chemically induced hyperplasia in the carcinogenic activity of the hypolipidemic carcinogens. AB - Di(2-ethylhexyl)phthalate (DEHP) is a widely used plasticizing agent resulting in substantial human exposure and environmental contamination. In a chronic bioassay, high doses of DEHP induced hepatocellular carcinomas in female Fischer 344 rats and male and female B6C3F1 mice. Thus, there is considerable concern as to the species specificity, mechanism of action, and human risk assessment of DEHP. DEHP belongs to a class of agents described as hypolipidemic hepatocarcinogens. These chemicals share the ability to induce hepatic peroxisomal proliferation and range from very weak to very potent hepatocarcinogens. Unlike most identified carcinogens, the hypolipidemic carcinogens lack DNA reactivity in sensitive cell culture systems such as the Ames test. It has been proposed that active oxygen radicals, produced as a result of peroxisomal proliferation, induce DNA damage. While this is an attractive hypothesis, no genotoxic activity has been observed in hepatocytes with peroxisomal proliferation in treated animals. Another biological activity shared by this class of compounds is their ability to stimulate liver growth or hyperplasia. This additive hyperplasia results from direct mitogenic stimulation rather than regenerative growth following liver toxicity. This hyperplasia can be dramatic, with liver to body weight ratios from treated animals reaching two to three times normal. The degree of induced hyperplasia correlates well with the carcinogenic potency of these agents, whereas genotoxicity does not correlate at all. Increased cellular growth may result in spontaneous mutational events or promotional effects. While some feedback mechanism eventually inhibits liver growth, it is possible that key genes related to the regulation of cellular growth and cancer remain stimulated during continued administration of the chemical. Thus, determination of hyperplastic activity represents an attractive first-step approach to the short-term detection and study of the mode of action of nongenotoxic carcinogens. PMID- 3303447 TI - In vivo studies on the mechanism of di(2-ethylhexyl)phthalate carcinogenesis. AB - In a study sponsored by the National Toxicology Program, di(2 ethylhexyl)phthalate (DEHP) fed in the diet at 1.2% significantly increased the incidence of female rats with hepatocellular carcinomas. Extensive evaluation of DEHP for carcinogenicity has yielded negative results. The present investigations were designed to elucidate the mechanism of DEHP hepatocarcinogenesis under the conditions of the original bioassay. Short-term studies designed to evaluate the promoting capability of DEHP, when administered after initiation, were negative when livers of female Fischer-344 rats were evaluated using multiple histochemical stains to identify foci of cellular alteration. Two different protocols were used to evaluate the initiating potential of DEHP in the liver using histochemically defined foci as the endpoint. In both experiments the results were negative. Chronic exposure to DEHP at 1.2% in the diet for 2 years resulted in elevation of hepatic peroxisomal enzymes while DNA replication, an indication of cell proliferation, was not affected in hepatocytes. The number of foci was not elevated in the DEHP group compared to the controls, even though a low incidence of rats with liver tumors occurred in the treated group. The results of this series, as well as other published results, suggest that DEHP and other peroxisomal proliferating chemicals have unique effects on the development of hepatic neoplasms. The absence of altered foci after chronic administration or in initiation-promotion protocols distinguishes DEHP and perhaps other peroxisomal proliferating chemicals from both classic liver carcinogens and promoters. PMID- 3303448 TI - Interspecies differences in peroxisomes and peroxisome proliferation. PMID- 3303449 TI - Species specific sensitivity towards the hemorrhagin of Ophiophagus hannah (Elapidae). AB - The filtration pattern of Ophiophagus hannah venom on Sephadex G-75 shows several peaks. The first peak, S1, includes high molecular weight proteins and contains the hemorrhagic and proteolytic activities. The proteolytic fractions overlap the hemorrhagic fractions, but are not identical with them. The crude venom and the high molecular weight peak have caseinase, benzoyl-L-arginine ethyl ester hydrolase and kallikrein-like activities, but not collagenase, gelatinase, thrombin, plasmin or urokinase-like activities. The hemorrhagin of Ophiophagus hannah shows species specific differences in its hemorrhagic effects: it causes hemorrhages in rabbits and hares (Lagomorpha), but not in rats, mice or guinea pigs (Rodentia). PMID- 3303450 TI - Pathogenesis of hemorrhage induced by hemorrhagic proteinase IV from timber rattlesnake (Crotalus horridus horridus) venom. AB - The effects on the vascular system of a purified toxin, hemorrhagic proteinase IV, from Crotalus horridus horridus venom were studied with emphasis on the pathogenesis of hemorrhage. White mice were injected intramuscularly with sublethal doses of the hemorrhagic toxin, and tissue samples were obtained at 5 and 30 min, 3 and 24 hr after the injection. There was a good correlation between amount of toxin injected and amount of hemorrhage. Microscopically, extensive areas of hemorrhage around muscle and adipose cells were observed just 5 min after injection. At later time periods the changes were similar, but the hemorrhage was more extensive. Many vessels were plugged by aggregations of platelets. Electron microscopy showed that endothelial cells of capillaries were affected to various degrees. Some were swollen and had plasma membranes that formed large blebs; others were thin and disrupted. In vessels where the intercellular junctions could be observed, they were intact even when the endothelial cells were damaged or ruptured, indicating hemorrhage per rhexis instead of per diapedesis. Basal lamina were often disorganized or absent. Both intravascular and extravascular fibrin deposition were commonly observed. Hemorrhagic proteinase IV from C. h. horridus venom induces hemorrhage per rhexis and platelet aggregation within 5 min of intramuscular injection into mice, and marked fibrin deposition within 30 min of injection. PMID- 3303451 TI - Assessment of potential therapies for acute T-2 toxicosis in the rat. AB - The efficacy of a variety of approaches for the treatment of animals with acute T 2 toxicosis was assessed utilizing young female rats. A single large dose of the water soluble salt of methylprednisolone significantly prolonged survival times in T-2 toxin treated animals. The use of diltiazem hydrochloride, dazemgrel, N acetylcysteine, dimethyl sulfoxide, adenosine triphosphate (ATP), ATP combined with magnesium chloride, ascorbic acid, and aprotinin did not prolong survival times at the dosages administered. Trichodermin, a trichothecene similar in structure and biochemical activity to T-2 toxin but much less acutely toxic, had a detrimental effect on survival times whether given 1 hr prior to or after T-2 toxin. PMID- 3303452 TI - Immunohistochemical demonstration of the binding of Bothrops asper myotoxin to skeletal muscle sarcolemma. AB - The binding of Bothrops asper myotoxin to mouse skeletal muscle was studied at both the light and electron microscope levels using the peroxidase anti peroxidase technique. The toxin binds to muscle cell sarcolemma, and there are no intracellular binding sites. This study corroborates previous observations which suggested that the sarcolemma is the first site of action of B. asper myotoxin. PMID- 3303453 TI - Remembering Alexander Alexandrowitsch Maximow. PMID- 3303454 TI - PAS staining of eosinophils in semi-thin sections of bone marrow embedded in glycol methacrylate. AB - The usual periodic acid-Schiff (PAS) reaction of glycosaminoglycans is applicable to paraffin embedded material. A modification for water-miscible methacrylate embedded tissue suitable for correlative light and electron microscopic studies, which makes it possible to find the same stained cell in a semi-thin tissue section, is described. Eosinophil leukocytes in semi-thin sections from bone marrow were verified by electron microscopy after staining with the PAS reaction. Immature eosinophil leukocyte granules reacted with and without previous salivary treatment. This method facilitates the search for localization of glycosaminoglycans in scattered blood cells. PMID- 3303455 TI - Continuous ambulatory peritoneal dialysis (CAPD) policy for renal transplantations in adults. AB - In Japan CAPD in cases of renal transplantation used to be feared because of CAPD peritonitis occurring under conditions of immunosuppression. We experienced two cases of CAPD with renal transplantation. Case 1 was a 27-year-old woman who underwent living related renal transplantation on March 7, 1986 after 4 months CAPD without CAPD peritonitis. In this patient the CAPD catheter was removed on the 17th POD with a good graft function. Case 2 was a 38-year-old woman who underwent living related renal transplantation on November 8, 1985. The graft deteriorated due to acute rejection and ALG allergy. On February 1, 1986 the graft was removed after insertion of a CAPD catheter. The patient began CAPD. Therefore, CAPD was found to be a safe procedure for renal transplantation. Our policy concerning CAPD for renal transplantation is as follows: A patient should not be transplanted for 1 month after successful treatment of an episode of peritonitis. After renal transplantation the catheter is removed on completion of the transplantation procedure in cases of two haploidentical living related transplants and electively 2-12 weeks after renal transplantation in cases of one haploidentical living related transplant or cadaveric transplants. The CAPD catheter is used again when there is temporary or permanent graft failure. PMID- 3303456 TI - A quick enzyme squash technique for detailed studies on female meiosis in Solanum. AB - A simple enzyme squash technique that enables detailed studies of meiosis in potato ovules has been developed. Fixation of ovules in iron-propionic-ethanol followed by enzymatic maceration and squashing in acetocarmine yielded numerous well preserved megasporocytes with nicely spread chromosomes. Resolution was sufficient, allowing detailed analysis of chromosome pairing and chiasma formation and readily permitting distinction between normal and desynaptic mutant plants. Whereas the use of previously developed ovule squash techniques has been restricted to cytogenetic analyses of plant species with relatively large megasporocytes and large chromosomes, the present technique is potentially more useful for analyses of species with small megasporocytes and small chromosomes. PMID- 3303457 TI - A simplified technique for low temperature methyl methacrylate embedding. AB - A simplified method for low temperature methyl methacrylate embedding with inhibited methyl methacrylate monomer is demonstrated using proper concentrations of benzoyl peroxide and N,N-dimethylaniline. The polymerized tissue blocks cut well and the tissue sections obtained show excellent acid phosphatase activity when demonstrated with the newly improved technique and Goldner's staining. Likewise, double tetracycline labels are well revealed by fluorescence microscopy. PMID- 3303458 TI - [Shaping of the occlusal surface of the teeth in fixed dentures in treating patients with a generalized form of heightened tooth abrasion]. PMID- 3303459 TI - [Use of stump pin inserts in premolar and molar crown destruction]. PMID- 3303460 TI - [Preparation of porcelain crowns without using metal caps for their firing]. PMID- 3303461 TI - [Adhesion between thermoplastic and silicone casting materials in producing double combined molds]. PMID- 3303462 TI - [Trauma in transportation by water]. PMID- 3303463 TI - [Priority in the ideological battle over the false scientific theory of C. Lombroso]. PMID- 3303464 TI - The sociological study of suicide: methodological issues. AB - This paper is a critical review of selected methodological issues in the sociological study of suicide. It first distinguishes between two broad research orientations: the micro and macro approaches to the subject. The paper than focuses on a critical assessment of the dominant macro-level methodology. Three recurrent problems are identified: measurement issues on four key variables (suicide and parasuicide, economic conditions, religion, and political conditions such as war); problems in studying the effect of mass media stories on suicide; and reasons why we need to adopt a cross-national method in order to test sociological theories for contextual effects. Partial remedies to many of these problems are discussed. PMID- 3303465 TI - Youth suicide: a psychosocial perspective. AB - I draw on my studies in different cultures and subcultures and in different age groups to develop a psychosocial perspective for viewing youthful suicide. This perspective utilizes disciplines ranging from demography to psychodynamics to discuss the relationship of violence to suicide; the role of families in producing youngsters who become preoccupied with death and suicide; and the directions that seem most profitable for future research. PMID- 3303466 TI - Evaluation of the effectiveness of suicide prevention programs: a methodological perspective. AB - Many studies that attempt to evaluate the effectiveness of treatment programs for suicidal patients are methodologically deficient in one or more areas. This paper outlines six criteria that should be met in designing such investigations: Patients should be randomly assigned to groups; at least 80% of the subjects who were initially enrolled should be followed up; the results should be both statistically significant and clinically important; all clinically relevant outcomes should be reported; the patients must be adequately described; and the new intervention should be feasible in other settings. It is shown that these criteria are both necessary and achievable. PMID- 3303467 TI - Identifying patients who might benefit from free phenytoin monitoring. AB - Guidelines for measuring free drug concentrations in serum have become necessary due to the easy availability of these assays as a result of the introduction of commercial kits. The present study was performed to identify patients or groups of patients in whom the serum free phenytoin fraction varied from normal, such that they might benefit from measurement of serum free phenytoin. Three hundred fourteen samples submitted for routine phenytoin analysis were studied by enzyme modified immunoassay technique (EMIT). Thirty-eight patients on phenytoin monotherapy and without other factors thought to affect protein binding of this drug had a mean (+/- SD) free phenytoin fraction of 9.8 +/- 1.8% of total concentration (mean serum albumin concentration 43.4 +/- 3.9 g/L). The free fraction was elevated by administration of comedications which are themselves highly protein bound, and in those patients who were hypoalbuminaemic (serum albumin less than 30 g/L). The groups studied were not mutually exclusive, but stepwise regression analysis showed that other factors known to affect serum albumin (e.g., age greater than 65 years, liver or renal disease, or pregnancy) did not, in themselves, produce a significant effect on free phenytoin fraction. Similarly, an elevated total serum phenytoin concentration was not a significant factor in producing an elevation in free phenytoin fraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3303468 TI - Calibration, quality control, and stability of a quantitative enzyme immunochromatographic method for therapeutic drug monitoring. AB - We describe a noninstrumented quantitative method for therapeutic drug monitoring (AccuLevel test) that uses a factory-calibrated unit test format and a novel single-level approach to quality control. The AccuLevel method is based on the principles of immunochromatography, which provides a number of convenient protocol advantages without sacrificing assay performance or quality assurance. Most of the benefits of the immunochromatographic method derive by virtue of the fact that quantification is dependent on enzyme migration rather than enzyme activity. Since migration height is almost solely a function of a highly stable, immobilized, dry antibody reagent, the AccuLevel test is extremely insensitive to environmental factors. The predictable and uniform dependence of quantification on antibody site concentration allows complete reliability with a single-level control. These features of stability, factory calibration, and unitized test components make the AccuLevel immunochromatography method amenable to new quality control schemes. PMID- 3303469 TI - Quantitative determination of phenobarbital and phenytoin by dry-phase apoenzyme reactivation immunoassay system (ARIS). AB - We assessed the performance of the apoenzyme reactivation immunoassay system (ARIS) reagent strip tests for determination of phenobarbital (PB) and phenytoin (PHT) with the Seralyzer reflectance photometer. In the assay, the drug of the sample competes with a flavine adenine dinucleotide (FAD)-drug conjugate for binding to a specific antibody; the unbound conjugate then activates apoglucose oxidase to reconstitute glucose oxidase, whose activity is kinetically monitored by a coupled chromogenic reaction. Within-run coefficients of variation (CVs) were less than or equal to 5.0% for PB and less than or equal to 5.6% for PHT; between-run CVs were less than or equal to 6.1% for PB and less than or equal to 6.5% for PHT. Mean analytical recoveries were 100.3% for PB and 100.2% for PHT. Test results were not significantly affected by bilirubin (5 mg/dL), hemoglobin (25 mg/dL), triglycerides (500 mg/dL), uric acid (15 mg/dL), or elevated levels of other antiepileptic drugs. Reagent strip tests correlated very well with substrate-labeled fluorescent immunoassay (r = 0.9923 and 0.9944 for PB and PHT, respectively), enzyme multiplied immunoassay technique (r = 0.9941 and 0.9919), and gas-liquid chromatography (r = 0.9980 and 0.9960). These homogeneous competitive colorimetric immunoassays are particularly suitable for emergency use, for testing small batches of samples, wherever prompt results are needed. PMID- 3303470 TI - Psychology of ageing. An overview of research in the Netherlands. AB - This review is dedicated to psychogerontology in the Netherlands, allowing systematic attention to the development of this discipline. It also offers an opportunity to describe the views which have been developed in psychogerontology in the course of time. Next a number of subjects concerning the older individual are dealt with, followed by a review of psychogerontological instruments developed in the Netherlands. Finally attention is paid to research into intervention-gerontology and to longitudinal research. This contribution concludes with a brief summary of current research and some future perspectives. PMID- 3303471 TI - Sociological research on age, aging and the aged in the Netherlands. AB - A review is given of the socio-gerontological research in the Netherlands. According to a frame work, organising this area of research, first an overview is presented of the studies on age and ageing and next the research on the aged is summarized. The research on age and ageing is limited. Some publications analyse the social meaning of age, some cohort studies have been conducted and recently the life course approach is getting attention. Concerning the research on the aged, the main areas studied are: living circumstances, age stratification, family and social contacts, housing, work and retirement, formal and informal care, death and dying. Since 1970 the amount of socio-gerontological research has increased. It became prominent in the eighties with the promotional activities of a special committee for gerontological research. Several universities are identified with their special areas in the sociology of ageing and the aged. PMID- 3303472 TI - Biomedical gerontology in the Netherlands. AB - In this review a brief historical view on biomedical gerontological research in the Netherlands is given. In the sixties and seventies this research, started in 1953, was mainly done at the TNO Institute for Experimental Gerontology and devoted to the topics pathology, immunology and organ and cell physiology (mainly the liver). Current research mainly concentrates on the brain, the immune system, the liver, the cardiovascular system, the locomotor system and the eye. It can be concluded that due to the SOOM (Steering Committee for Research on Aging) and ZWO (Fundamental Scientific Research) the amount and quality of biomedical gerontological research in the Netherlands has greatly increased. It is hypothesized that in the near future no spectacular developments are to be expected. Nevertheless, in the long term, on the basis of advances in molecular biology, the mechanisms of the aging process may be elucidated. Consequently, pathological changes can be recognized so that diagnosis, prevention or therapy may be possible. Especially, the prevention or therapy of the Alzheimer's disease or of osteoporosis looks promising. PMID- 3303474 TI - Forty years of gerontological research in the Netherlands. Appendix A: Directory of research institutes. PMID- 3303473 TI - Research and development in geriatrics in the Netherlands. AB - This article presents a survey on the developments of geriatrics in the Netherlands in the past few decades. It is described how a small number of pioneers in the sixties and seventies indicated the necessity for special care of geriatric patients. This, finally, lead to full recognition of geriatrics as a clinical specialism in 1983. The developments appear to be fast now. Considerable growth of geriatricians and geriatric hospital beds is necessary to cope with the increased numbers of elderly patients in the future. Scientific research has to be continued with much effort. From this literature survey it becomes clear that in the beginning especially epidemiological research with emphasis on care facilities, was done. Research on particular subjects followed, such as nutrition, drugs, cardiovascular diseases, neoplasms, infections, dementia, etc. The number of geriatric textbooks and monographs has grown in recent years and raises expectations for the future. Bottle-necks at this moment are the relatively small numbers of training possibilities for geriatricians-to-be and lacking structural attention for medical gerontology and geriatrics in the medical curricula of our universities. PMID- 3303475 TI - Issue dedicated to Colonel H. E. Shortt, FRS, on the occasion of his 100th birthday on 15 April 1987. PMID- 3303476 TI - Infection and disease due to the environmental mycobacteria. AB - Saprophytic mycobacteria are widely distributed in the environment and contact between them and man is unavoidable. Immunologically effective contact is responsible for cross-reactivity to tuberculin and there is increasing evidence that it also profoundly affects the nature of subsequent responses to BCG vaccination and to infection by the tubercle and leprosy bacilli. Some environmental mycobacteria occasionally cause overt disease. Two species, Mycobacterium ulcerans and M. marinum, cause characteristic named diseases: Buruli ulcer and swimming pool granuloma respectively. Other species cause pulmonary and non-pulmonary lesions that resemble those of tuberculosis. Disease often, but not always, occurs in individuals with predisposing factors such as damaged lungs or immunosuppressive disorders including AIDS. Diagnosis rests on the isolation and identification of the causative species and treatment is based on antituberculous therapy for extended periods or combinations of various other drugs. In contrast to tuberculosis, the incidence of these diseases appears to be on the increase in the Western world and they merit serious consideration. PMID- 3303477 TI - Opsonizing and agglutinating antibodies against Plasmodium falciparum schizont infected erythrocytes in Gambian sera. AB - The presence of an IgG antibody to autologous schizont-infected red blood cells (SIRBC) in the sera of Gambian children with acute malaria and a positive direct anti-globulin test (DAT) was demonstrated by two methods: IgG quantitation using 125I-labelled anti-IgG and phagocytosis of these SIRBC. A similar antibody could not be demonstrated in sera of children with acute malaria and a negative DAT. When a laboratory strain of parasite was used there was a more variable pattern of IgG uptake but the highest was from sera of immune adult Gambians and Gambian children with acute malaria and a positive DAT. The uptake of IgG by SIRBC may be a useful test to determine the specificities of antibodies against different isolates of P. falciparum. PMID- 3303478 TI - Isoenzyme changes during the life cycle of Trypanosoma cruzi. AB - The isoenzyme profiles, for 14 enzymes, of amastigotes, trypomastigotes and epimastigotes were compared in various cloned and uncloned T. cruzi stocks belonging to different zymodemes. A culture method with a human diploid cell line was developed and produced either pure amastigotes or trypomastigotes in high yields. Trypomastigotes were also isolated from rat blood and from liquid culture. Epimastigotes were harvested from various acellular media and from the overlay of cell monolayers. The isoenzyme patterns of each life-cycle stage showed consistent differences in the number, position and intensity of the electrophoretic bands for certain enzymes. With the single exception of one peptidase, the variable patterns were stage-specific regardless of whether the organisms were harvested from animals or from various cultures at different temperatures. PMID- 3303479 TI - Plasmodium falciparum malaria in an asplenic man. AB - An asplenic man with no prior exposure to malaria was infected with Plasmodium falciparum on a visit to Kenya. The peripheral blood showed a parasitaemia of 5% and displayed all developmental stages of the parasite, resembling the asplenic simian model of malaria. PMID- 3303481 TI - The effect of dapsone-pyrimethamine on immunoglobulin concentrations in malaria chemoprophylaxis. AB - Immunoglobulins IgG, IgM, IgA were estimated on 3 occasions in 59 male volunteers who were taking dapsone-pyrimethamine once weekly (dapsone: 100 mg + pyrimethamine: 12.5 mg) for malaria chemoprophylaxis. Immunoglobulins IgG and IgM measured at the 7th week of chemoprophylaxis were significantly lower than baseline values (using Students' t-test for paired data), but none of the values were below 700 mg% for IgG or 30 mg% for IgM. Immunoglobulin concentrations estimated in 45 of the 59 men 6 weeks after discontinuation of chemoprophylaxis showed a return to baseline for IgM but not IgG, which remained low. On all 3 occasions there was no significant change in the IgA concentrations. The clinical implication of these findings is not known. Further studies are required to define the effects of antimalarial drugs on the antibody response to infection and immunization. PMID- 3303480 TI - In vitro susceptibility of Plasmodium falciparum malaria to pyrimethamine, sulfadoxine, trimethoprim and sulfamethoxazole, singly and in combination. AB - Two isolates of Plasmodium falciparum (F 32 and K 1) were tested against sulfadoxine (SDX), sulfamethoxazole (SMZ), pyrimethamine (PYR) and trimethoprim (TMP), using a 48 h microtest, with RPMI-1640 low in PABA and folic acid. The IC50 for F 32 was: PYR 6.1 X 10(-9) M (mol/litre), TMP 1.3 X 10(-7) M, Fansidar (SDX/PYR 80:1) less than 10(-8) to 1.3 X 10(-10) M and cotrimoxazole (SMZ/TMP 20:1) 2.6 X 10(-7) to 1.3 X 10(-8) M. The IC50 for K 1 was: PYR greater than 10( 6) M, TMP 8.2 X 10(-7) M, Fansidar 4.1 X 10(-7) to 1.1 X 10(-9) M and cotrimoxazole 1.8 X 10(-6) to 9.0 X 10(-8) M. The difference in IC50 between F 32 and K 1 against TMP and cotrimoxazole is much less than the difference between the IC50 values against PYR and Fansidar, indicating that cross-resistance between PYR and TMP exists, but is not complete. A method for calculating the IC50 by linear regression analysis is described. PMID- 3303482 TI - Diagnosis of systemic lupus erythematosus in Jamaica by Crithidia luciliae indirect immunofluorescence test. AB - The Crithidia luciliae indirect immunofluorescence test (CL-IFT) was compared with the DNA-binding assay for confirmation of the presence of double-stranded DNA (dsDNA) antibodies in cases of systemic lupus erythematosus (SLE). The study involved 142 patients whose sera had anti-nuclear antibodies (ANA). In 62 patients with clinical or suspected SLE, 66% gave positive CL-IFT results as against 69% by DNA-binding. Two patients who had negative CL-IFT results but positive DNA-binding were only marginally positive (31% and 36%). Anti-dsDNA antibody was not found in any ANA negative sera. C. luciliae is easily maintained in culture and the test is relatively easy to perform in any laboratory with facilities for doing fluorescence microscopy; we recommend it for confirmation of the diagnosis of SLE, especially in laboratories with limited resources. PMID- 3303483 TI - A study of the sensitivity of Plasmodium falciparum to chloroquine and mefloquine using the in vitro microtechnique in Peninsular Malaysia. AB - Plasmodium falciparum drug sensitivities to chloroquine and mefloquine were assessed with WHO in vitro microtechnique test kits in 5 localities near the border with Thailand in Peninsular Malaysia. 105 of 113 (92.9%) parasite isolates were successfully tested and 103 (98.1%) showed resistance to chloroquine with parasite growth even at greater than or equal to 5.7 pmol of the drug. All these isolates were sensitive to mefloquine, parasite growth being inhibited at less than or equal to 11.3 pmol of the drug. PMID- 3303484 TI - Pyrimethamine-sulfadoxine still effective against Plasmodium falciparum in Jayapura, Irian Jaya: RI-type resistance in 2 of 18 patients. AB - The sensitivity of Plasmodium falciparum infections to pyrimethamine-sulfadoxine was studied in 18 Indonesian patients in Jayapura, Irian Jaya. In 16 of the 18 patients parasitaemia was cleared by day 6 and the patients remained without parasitaemia through day 28. Two of the 18 patients had late recrudescences consistent with RI-type resistance; one each on days 14 and 21. Pyrimethamine sulfadoxine is still an effective antimalarial for most patients with falciparum malaria in Jayapura. PMID- 3303485 TI - The aetiology of diarrhoea in children at an urban hospital in Bangladesh. AB - Enteric pathogens were studied in 104 cases with acute diarrhoea and in 74 age and sex matched concurrent controls. One or more pathogens were isolated from 59.1% of cases compared with 20.4% of controls (P less than 0.001). Single enteropathogens were detected in 33.7% and multiple enteropathogens in 25.4% of the cases. Enteropathogenic Escherichia coli (EPEC), Campylobacter jejuni, rotavirus, Vibrio cholerae non-O1 and enterotoxigenic Escherichia coli were the major pathogens detected. The high rate of isolation of EPEC from diarrhoea cases (23.1%) indicated a definite role for this pathogen in causing endemic diarrhoea in Bangladesh. PMID- 3303487 TI - Liver transplantation in children. PMID- 3303486 TI - The British National Health Service: foil, not prototype. PMID- 3303489 TI - Liver disorders in children: the indications for liver replacement in parenchymal and metabolic diseases. PMID- 3303488 TI - Pediatric liver transplantation. AB - Liver transplantation, which once was an experimental procedure of no practical interest, has become the preferred treatment for infants and children dying of almost all non-neoplastic end-stage liver diseases. Liver replacement is being provided by many well-trained teams on all of the continents, as is evident from the program today--the first international symposium on pediatric liver transplantation. I have been honored in giving the first paper in the process of introducing the remarkable work of a gifted younger generation of physicians and surgeons. PMID- 3303490 TI - Liver transplantation in children--indications in cholestatic states. PMID- 3303491 TI - Pediatric liver transplantation: Cambridge/King's series, December 1983 to August 1986. PMID- 3303492 TI - Liver transplantation in children: the Boston Center experience in the first 30 months. PMID- 3303493 TI - Pediatric liver transplantation: the Dallas experience. PMID- 3303494 TI - Pediatric liver transplantation at UCLA. PMID- 3303495 TI - Liver transplantation in children: report of 2 1/2 years' experience at the University of Louvain Medical School in Brussels. PMID- 3303496 TI - Pediatric liver transplantation using combination immunosuppressive therapy. PMID- 3303497 TI - Volume reduction of the liver graft before orthotopic transplantation: report of a clinical experience in 11 cases. PMID- 3303498 TI - Monitoring of orthotopic liver transplantation in children by means of serial graft biopsies. PMID- 3303499 TI - Contribution of histopathology to the differential diagnosis of liver graft dysfunction. PMID- 3303500 TI - Anesthesia for pediatric hepatic transplantation: experience of 33 cases. PMID- 3303502 TI - Liver transplantation in children: role of the radiologist in the preoperative assessment and the postoperative follow-up. PMID- 3303501 TI - Postoperative care in pediatric orthotopic liver transplantation. PMID- 3303503 TI - Psychological evaluation and support of pediatric patients and their parents. PMID- 3303504 TI - Cost of liver transplantation: financing and social aspects. PMID- 3303505 TI - Role of nursing in the establishment of a liver transplantation program: impact on nursing or nursing's impact? PMID- 3303506 TI - Large granular lymphocyte subsets in long-term renal allograft recipients. PMID- 3303507 TI - Symptoms in end-stage renal disease: dialysis v transplantation. PMID- 3303508 TI - The relationship of renal transplant survival to cellular and humoral responsiveness. PMID- 3303509 TI - Role of class I and class II HLA antigens in cadaveric renal transplantation. AB - HLA matching at MT and DQ appears to be an important predictor of allograft survival. Allografts with no MM at MT and DQ have a good outcome while a known MM at MT and DQ appears to be associated with poor allograft outcome. Thus, our priority should be to avoid an MM for these broad-reacting specificities and then to minimize incompatibilities at DR and HLA-B. Furthermore, our data indicate that allografts with MM at DQ and two MMs at HLA-B appear to be at a higher risk. Perhaps these latter transplants should not be performed with conventional immunosuppressive therapy. PMID- 3303510 TI - Type II hyperlipoproteinemia, hyperapobetalipoproteinemia, and hyperalphalipoproteinemia following renal transplantation: implications for atherogenic risk. PMID- 3303511 TI - Renal transplantation in primary hyperoxaluria/oxalosis: a report of two cases. PMID- 3303512 TI - The impact of multiple organ retrieval on renal allograft function: experience of a Canadian center. PMID- 3303513 TI - Influence of donor-recipient lymphocyte crossmatch and ABO status on rejection risk in cardiac transplantation. PMID- 3303514 TI - Prolactin as a marker of rejection in human heart transplantation. PMID- 3303515 TI - Temporary diastolic noncompliance with preserved systolic function after heart transplantation. PMID- 3303516 TI - Hemodynamic benefits of "artificial reinnervation" of the homotransplanted heart. PMID- 3303517 TI - Profiles of donor major histocompatibility complex antigen expression in rat cardiac allograft rejection. PMID- 3303518 TI - Adverse effects of cyclosporine therapy following liver transplantation. PMID- 3303519 TI - Role of cyclosporine A in the treatment of acute renal allograft rejection. PMID- 3303520 TI - Cyclosporine-associated nephrotoxicity is not intractable. PMID- 3303521 TI - Cyclosporine metabolites suppress T cell proliferation induced by concanavalin A. PMID- 3303522 TI - Effect of cyclosporine on microvascular endothelial cell growth in culture. PMID- 3303523 TI - A simplified technique for segmental pancreas autotransplantation in dogs: exocrine drainage established by pancreatic duct-esophageal anastomosis. PMID- 3303524 TI - Immunological monitoring by lymphocyte electrophoretic mobility in renal transplant recipients. PMID- 3303525 TI - The inhibition of interleukin 2 (IL-2) gene expression at the level of messenger RNA by in vivo cyclosporine treatment in kidney transplant recipients. PMID- 3303526 TI - Drug-induced tolerance to allografts in mice. XI. Tolerance induction using F1 (donor x recipient) spleen cells as a tolerogen. PMID- 3303527 TI - Second International Symposium on the Perioperative Care of Liver Transplant Recipients. September 13-14, 1986, Pittsburgh, Pennsylvania. Proceedings. PMID- 3303528 TI - Some further notes on venous bypass for orthotopic transplantation of the liver. PMID- 3303529 TI - Blood transfusion requirements and renal function in patients undergoing liver transplantation without venous bypass. PMID- 3303530 TI - The changing indications for liver transplantation. PMID- 3303531 TI - Postoperative care and problems in liver transplantation. PMID- 3303532 TI - Is multiple organ failure a contraindication for liver transplantation in children? PMID- 3303533 TI - Sources of increased serum potassium following reperfusion of liver allografts. PMID- 3303534 TI - Postreperfusion syndrome: cardiovascular collapse following hepatic reperfusion during liver transplantation. PMID- 3303535 TI - Whole-body oxygen consumption during liver transplantation. PMID- 3303536 TI - Acid-base status during and after orthotopic liver transplantation. PMID- 3303537 TI - HLA histocompatibility and liver transplant survival. PMID- 3303538 TI - Major histocompatibility complex class I antigens on hepatocytes in human liver grafts. PMID- 3303539 TI - Update on anesthesia for adult liver transplantation. PMID- 3303540 TI - Reperfusion coagulopathy during human liver transplantation. PMID- 3303541 TI - Liver transplantation: effect of washing bank blood on intraoperative control of hyperkalemia. PMID- 3303542 TI - The world experience in clinical pancreas transplantation. Proceedings of the Second International Workshop on Clinical Pancreatic Transplantation. December 7 10, 1986, Munich/Spitzingsee, FR Germany. PMID- 3303543 TI - Pancreas transplantation: the Cambridge experience. PMID- 3303544 TI - Pancreas transplantation--University of Cincinnati. PMID- 3303545 TI - Pancreas transplantation--the Detroit experience (Mount Carmel Mercy Hospital). AB - In our preliminary series of pancreas transplants, the best results were obtained when kidneys were transplanted with pancreas allografts. The use of CyA together with combined kidney and whole pancreas transplants has significantly improved the graft survival in our program. It is difficult to draw conclusions as to the best technique for ductal management with the limited number of patients in each group. However, in our experience, ductocystostomy and pancreaticoduodenocystostomy have so far yielded the best results. Pancreaticocutaneous fistula with delayed ductal occlusion yielded the worst results and is not recommended. The effect of pancreas transplantation on the secondary complications may not be well discerned at this point in time until more long-term survivors are obtained. Some of our current results reflect the acceptance of high-risk transplant candidates into our program as well as the search for an improved pancreatic drainage technique. PMID- 3303546 TI - The pancreas transplant program--Gothenburg, Sweden. PMID- 3303547 TI - Pancreas transplantation--the Innsbruck experience. PMID- 3303548 TI - University of Iowa experience in pancreatic transplantation. PMID- 3303549 TI - Experience in pancreatic renal transplantation at Liverpool, UK. PMID- 3303550 TI - Results of simultaneous pancreaticorenal transplantation--Lyon, France. PMID- 3303551 TI - The University of Wisconsin experience in pancreas transplantation. AB - This paper describes the Madison experience in pancreas transplantation. With the use of pancreaticocystostomy, overall mortality could be decreased to a level similar to the results reported for kidney transplantation in diabetic patients. Particularly encouraging are the results obtained in combined kidney and pancreas transplantation, with current actuarial graft survival rates for kidneys of 95% and pancreatic grafts of 85%. Overall, the quality of life for patients receiving a pancreatic transplant has been good, and in cases where no postoperative complications were encountered, a tremendous feeling of well-being from a physiological and psychological standpoint was achieved. It is our conclusion that pancreatic transplantation should be pursued as a viable form of therapy in selected patients and centers with large experience in the transplantation of diabetic patients. PMID- 3303552 TI - Pancreas transplant registry report. PMID- 3303553 TI - Pancreatic transplantation--University of Michigan. PMID- 3303554 TI - Pancreas transplantation at the University of Minnesota: donor and recipient selection, operative and postoperative management, and outcome. PMID- 3303556 TI - Pancreatic transplantation in Czechoslovakia. PMID- 3303555 TI - Clinical pancreatic transplantation using the prolamine duct occlusion technique- the Munich experience. PMID- 3303557 TI - Pancreatic transplantation with enteric exocrine diversion--the Stockholm experience. PMID- 3303558 TI - Experience in clinical pancreas transplantation--University of Zurich. PMID- 3303559 TI - The Second International Alexis Carrel Conference: Transplant Atherosclerosis. March 25-27, 1987, Washington, DC. PMID- 3303560 TI - Platelet-derived growth factor and prostacyclin in kidney transplant rejection. PMID- 3303561 TI - Will atherosclerosis limit clinical xenografting? PMID- 3303562 TI - Cardiac transplantation in France--current problems. PMID- 3303563 TI - Antibody deposition in liver allografts with chronic rejection. PMID- 3303564 TI - Nitroprusside-induced vascular relaxation is attenuated in organ-transplanted animals treated with cyclosporine. PMID- 3303565 TI - Cardiac transplant atherosclerosis. PMID- 3303567 TI - Alexis Carrel, triumph and tragedy. PMID- 3303566 TI - Infections and atherosclerosis. PMID- 3303568 TI - Nucleotide-free diet and suppression of immune response. PMID- 3303569 TI - Hyperlipidemia following heart transplantation: natural history and intervention with mevinolin (lovastatin). PMID- 3303570 TI - Vascular rejection and arteriosclerosis. PMID- 3303571 TI - Lipid mediators in organ transplantation: does cyclosporine accelerate coronary atherosclerosis? PMID- 3303572 TI - The effect of antiplatelet drugs on graft atherosclerosis in rat heterotopic cardiac allografts. PMID- 3303573 TI - Therapeutic effect of antiplatelet agents on obstructive vascular lesions after kidney transplantation with cyclosporine. PMID- 3303574 TI - Prevention of kidney arteriosclerosis: heparin, dipyridamole, warfarin, and plasma exchange. PMID- 3303575 TI - Alexis Carrel: Nobel Prize for physiology and medicine, 1912. By Professor Jules Akerman, member of the Medical Nobel Committee. PMID- 3303576 TI - Estradiol protects against experimental cardiac transplant atherosclerosis. PMID- 3303578 TI - [Reorganization of the system of intermediate filaments and detection of the organization centers after centrifugation of cells attached to a substrate]. AB - Cultured pig kidney epithelial cells were centrifuged at 20,000 gav so that the centrifugation force was oriented parallel to the substrate, fixed and processed for indirect immunofluorescent staining with tubulin and vimentin antibodies. After a 2 hour centrifugation vimentin filaments aggregated in the centripetal parts of the cells (probably, because of their association with floating lipid vesicles). Microtubule-organizing centers were found near the centripetal poles of the nuclei, which migrated in the direction of the centrifugal force. The distribution of the cytoplasmic microtubules did not change during centrifugation. The staining of the cultures one hour after centrifugation revealed vimentin-containing spots with radiating intermediate filaments in most of the cells. These spots were localized near the cell nuclei; double immunofluorescent staining with tubulin and vimentin antibodies showed that their position was identical to that of the microtubule-organizing centers. Similar foci of vimentin filaments were seen in the cells after a 3-4 hour centrifugation. Probably, these structures participate in organizing the intermediate filament cytoskeleton in cells. PMID- 3303579 TI - [Incompetent use of complex instrumental methods of morphological analysis]. PMID- 3303577 TI - [Intermediate filaments: structure, regulation of expression and possible function]. AB - New data are reviewed on intermediate filaments, i.e. on one of the cytoskeleton components. Structural proteins of intermediate filaments, their enzymatic modification, filament-associated proteins and the peculiarities of filament assembly are dealt with. The regularities of expression of intermediate filament proteins in normal tissues are analysed, as well as during differentiation and cultured cell growth. In the final part of the paper possible functions of intermediate filaments are discussed. PMID- 3303581 TI - Ultrasound in developing countries. PMID- 3303580 TI - Adult neuroblastoma of bone: a case report. AB - Adult neuroblastoma is an uncommon tumor and it is rare for one to present as a primary bone lesion. We report the case of a 23-year-old man in whom the tumor initially appeared in the right scapula. Light microscopic, immunocytochemical, and electron microscopic findings were typical of neuroblastoma. PMID- 3303582 TI - Symptomatic hyponatremia after gynecologic ultrasonography. PMID- 3303583 TI - Doppler assessment of aortic stenosis: Bernoulli revisited. AB - The application of Bernoulli's law allows the non-invasive estimation of pressure drops across stenotic valves from Doppler velocity measurements. However, several assumptions are to be made, which influence the accuracy of the pressure drop estimation. Energy losses, non-uniform velocity profiles, pressure recovery, unsteady flow and omission of the upstream velocity affect accuracy and are critically reviewed. In vitro experiments, published in the literature, show good correlations between estimated and actual pressure drop. In only one of these studies does the data allow a comparison between theory and practice and to study the relationship between the pressure drop at the inlet of the obstruction and the Doppler velocity measurement. It appears that this relationship is not completely described by the simplified Bernoulli equation. In vivo verifications of Bernoulli's law show favourable correlations. However, the expected differences between peak pressure drops measured by cardiac catheterization and the pressure drops estimated by Doppler echocardiography may be as high as 25 mmHg. PMID- 3303584 TI - Effects of MHz ultrasound on electrical pain threshold perception in humans. AB - An electrode system was developed consisting of two 8 mm long 0.2 mm diameter silver-coated copper wires arranged parallel to each other 8 mm apart and held in contact with the skin by means of an acoustically transparent plastic adhesive tape. This system was attached to the upper arms of young adult volunteers who increased the voltage of the rectangular electrical pulses supplied to the electrodes until a reproducible sharp prickling pain sensation was perceived. A one inch diameter physiotherapy transducer was positioned over the electrode site so that ultrasound could be administered throughout the measurement period. The experiments were performed single blind to eliminate any subjective bias on the part of the volunteers. Preliminary experiments established that highly reproducible (+/- 3 to 4%) pain threshold perception values could be obtained, and that these values were not affected by changes in (a) the duration of the "on" time of the electrical pulses between 1.5 and 48 ms, (b) the contact pressure between the transducer and the electrode site, (c) the time interval between successive threshold measurements (providing that an unacceptable level of oedema was not produced around the electrodes), and (d) whether or not a test measurement was preceded by a control. Ultrasound exposure via a direct contact technique consistently produced a statistically significant (p less than 0.05) decrease in the perception threshold for electrical pain. This effect usually developed within 30-60 s and its magnitude increased both with increasing intensity (rising to 20.7 +/- 0.57% at an SATA intensity of 0.43 W/cm2 at 1.1 MHz) and with increasing frequency at the same ultrasonic intensity. Delivering the same amount of ultrasonic energy in the form of 2 ms bursts at several different peak intensities produced exactly the same reduction in pain threshold perception. These results indicate a thermal interaction mechanism, and similar threshold changes could be obtained by heating or cooling the electrode site by nonacoustic means. The inclusion of a thermocouple junction between the electrode wires showed that temperature increases of up to 10 degrees C could be produced when the transducer was in direct contact with the tape over the electrodes. The volunteers were not aware of these temperature increases which were primarily caused by heating of the transducer face. If the temperature of the skin surface is kept constant by interposing a thermostatted water path between the transducer and the electrode system, then similar ultrasound exposures had no detectable effects upon the electrical pain perception threshold.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3303585 TI - A linear array system for deep vessel explorations. AB - A system for the exploration of deep vessels is proposed. This device is based on a single 300 element linear array in which a "Doppler area" is selected to electronically steer a Doppler beam. Characteristics of the equipment are excellent and it is as easy to handle as a simple linear array scanner. A real time spectrum analyser is used to process the Doppler signals. The probe and the associated electronics are described and some results are given to illustrate the capabilities of the device such as blood flow estimation and deep vessel studies. PMID- 3303586 TI - Bibliography of biomedical ultrasound. No. 65. PMID- 3303587 TI - Labelling of ultrasono-tomograms of heart. PMID- 3303588 TI - A procedure for cutting soft tissue specimens of regular shape. PMID- 3303589 TI - Doppler ultrasound in aortic stenosis: in vitro studies of pressure gradient determination. AB - Torricelli's equation expresses a simple relationship between fluid velocity and pressure gradient in orifice flow and is currently used in conjunction with noninvasive Doppler ultrasound to determine gradients in mitral stenosis, and aortic stenosis, as well as other cardiovascular orifices. In theory, however, the Torricelli equation overestimates the gradient in aortic stenosis and the Borda equation should be more applicable. A brief tutorial derivation of the Borda and Torricelli equations is presented. The applicability of Torricelli's equation in aortic stenosis was studied experimentally with a rigid wall, pulsatile flow analogue. Doppler ultrasound and manometric data were collected simultaneously. Percent stenosis, peak flow rate and fluid viscosity were varied. The results demonstrated that the Torricelli equation consistently overestimated the pressure gradient. At 61% area stenosis, the overestimation exceeded 100%. In vivo studies are required to determine the relevance of the observations to clinical situations. PMID- 3303590 TI - Exploration of the fetal cerebral blood flow by duplex Doppler--linear array system in normal and pathological pregnancies. AB - The umbilical circulation can be investigated by Doppler ultrasound techniques very easily. The Doppler frequency spectrum from the umbilical arteries provides information on the placental circulation. The diastolic flow amplitude is directly related to the vascular resistances of the placenta (Rp). In cases of pathological pregnancies with hypertension the decrease of the diastolic flow and the increase of the resistance index Rp have been correlated with intrauterine fetal growth retardation. Fetal cerebral arteries have also been explored during normal pregnancies (n = 40). The index of cerebral resistance (Rc) as defined by Pourcelot is Rc = S-D/S (with S systolic amplitude and D diastolic amplitude) and shows variations similar to the placental index. During normal pregnancy, the cerebral index is higher than the placental index and the cerebro-placental ratio (Rc/Rp) is greater than 1. This preliminary study of both umbilical and cerebral circulation seems to demonstrate that during pathological pregnancies with hypertension (n = 21), with fetal growth retardation one of the indices, Rc or Rp may be out of the normal range but the cerebro-placental ratio (CPR) is always less than 1. However a larger number of patients should be explored in order to evaluate the clinical usefulness of such an observation. PMID- 3303591 TI - Bibliography of biomedical ultrasound. No. 66. PMID- 3303592 TI - Epithelial membrane antigen as an immunohistochemical marker for transitional cell carcinoma of the urinary bladder. AB - Epithelial membrane antigen (EMA) was immunohistochemically localized in transitional cell carcinomas of the bladder to clarify EMA staining pattern's relationship to the histological grading and staging of tumors and patient prognosis. Formalin-fixed, paraffin-embedded sections from 101 patients with bladder carcinoma were stained by the indirect immunoperoxidase method. In the lower histological grade and stage of transitional cell carcinoma, the localization of EMA was restricted to the luminal surface of the superficial cells. Membrane and cytoplasmic staining of EMA was frequently found in the intermediate and basal layers of the tumor cells, and the incidence of cytoplasmic staining increased with advancing grade and stage. Stromal staining was frequently observed in cases of higher grade and stage. In addition, these distribution patterns of EMA were well correlated with patient survival. Thus, we differentiated three types of EMA distribution: a luminal type, with very good prognosis; a cytoplasmic type, with fair prognosis; and a stromal type, with relatively poor prognosis. These findings suggest that EMA distribution in bladder cancer could be a valuable indicator for histological grading or staging in pathological diagnosis and for predicting the survival of bladder cancer patients. PMID- 3303593 TI - The operation of lithotomy in ancient Greece. AB - Opening the bladder via the perineum in order to remove a bladder stone was practised by the ancient Greek surgeons in very early times, probably from the days of Homer. The technique of lithotomy was described for the first time by Celsus in the first century AD and has come to be known as the lesser operation or 'apparatus parvus', so called because only to instruments are needed for it, a knife and a hook. Two fingers of the surgeon's left hand were introduced into the patient's rectum while an assistant pressed on the lower abdomen to encourage descent of the stone near the neck of the bladder. A slightly curved incision was made in the skin near the anus and a second transverse incision was made through or immediately above the prostate, opening the bladder neck. The calculus was extracted from the wound by the fingers or by a hook. This ancient method of lithotomy as described by Celsus was the only one performed until the middle of the 16th century, and many surgeons advised the apparatus parvus as the operation of choice in young patients until the middle of the 18th century. PMID- 3303594 TI - Adenocarcinoma of the kidney in childhood. AB - Renal adenocarcinoma in children is a rare tumor. A case report is presented and review of the available literature. There is no difference in symptomatology, therapy and prognosis between children and adults. PMID- 3303595 TI - Varicocele. AB - Approximately one third of infertile men present with varicocele, while the incidence among males in the general public is approximately 15 per cent. The etiology may be a longer left spermatic vein with its right-angle insertion into the left renal vein and/or absence of valves, which causes a higher hydrostatic pressure in the left spermatic vein causing dilatation. The nutcracker phenomenon is also a possible etiology. Much of the pathophysiology is still unknown, but increased blood flow causing an elevated intratesticular temperature may be of significance. Though there are many recent reports on the importance of a subclinical varicocele, we are not convinced of its significance. The best method for diagnosis remains a good clinical examination. The incidence of adolescents with varicocele is about the same as men with varicocele (approximately 15 per cent). Adolescents with varicocele should be treated if the testicular mass is decreased or if they are symptomatic. Surgical ligation is still the preferred method of treatment. Percutaneous treatment of varicoceles has an approximately 11 per cent incidence of minor complications and an occlusion rate of 73 per cent with a recurrence rate of 5 per cent. We reserve percutaneous treatment for recurrent varicoceles after surgical ligation, but primary percutaneous therapy is a reasonable approach. PMID- 3303596 TI - Vasovasostomy. AB - The popularity of vasovasostomy in recent years can be attributed to improvements in operative techniques, instruments, optics, and most importantly, results. This article addresses the evolution of vasovasostomy, a method of training, the equipment necessary to perform the procedure, and various operative techniques, both macroscopic and microscopic. A brief comparison of postoperative results is included. PMID- 3303597 TI - Vasoepididymostomy. AB - Epididymal obstruction can occur from a variety of causes. Over the past decade, new techniques for bypassing the obstruction have been described and appear to have improved both patency and pregnancy rates. These microsurgical methods are quite tedious to perform, and a good deal of laboratory and clinical experience is necessary in order to achieve the best results. The level at which the epididymis is obstructed plays a crucial role with regard to sperm maturation and the potential for fertilization. PMID- 3303598 TI - XY sperm separation for sex selection. AB - At present, laboratory methods that can successfully differentiate X- from Y bearing sperm do exist; namely, staining with quinacrine mustard and DNA flow cytometry. However, methods that can successfully and reproducibly separate X- from Y-bearing sperm with resultant functionally intact sperm have yet to be developed. The area of sex selection is under intensive investigation, and a reliable method of separation will undoubtedly become available in the near future. To the extent that these techniques would be used to help couples avoid sex-linked genetic diseases, preimplantation gender selection is ethically justifiable. Social and ethical factors are important considerations in justifying other applications of these techniques. PMID- 3303599 TI - New areas of research in male infertility. AB - Recent research in male reproduction holds much promise for future clinical application. Research on the relationship between sperm, semen, and the immune system may provide novel approaches to treating immune-related infertility. Investigations of sperm motility have shed new light on these complex mechanisms and may lead to rational approaches to the improvement of sperm function. New assays for secretory products unique to the testis show potential as markers for specific testicular cellular functions. In-vitro fertilization promises to become a viable treatment option for couples with male-factor infertility. Research on male contraception may lead to the development of safe and reversible male contraceptives. PMID- 3303600 TI - [Plastic surgery of the urethra in children with hypospadias]. PMID- 3303602 TI - [Prevention of bladder cancer in relation to epidemiological data]. PMID- 3303601 TI - [Clinical significance of antibodies reacting with the endothelium of peritubular capillaries in patients with chronic renal failure and after allotransplantation of a cadaveric kidney]. PMID- 3303603 TI - Scrotal ultrasound. AB - Since its development in the late 1970s, scrotal ultrasound has been used successfully to diagnose and evaluate many pathologic processes. At present, except for evaluation of a few entities, it is the diagnostic imaging modality of choice. Differentiation of normal from abnormal scrotal contents is possible with great accuracy. The technique is capable of differentiating cystic from solid lesions and testicular from extratesticular disease with an accuracy approaching 100%. It has also been used successfully for evaluation of some causes of male infertility and various congenital abnormalities. Evaluation of spermatic cord torsion and undescended testes is generally better done with other techniques. Scrotal ultrasound, however, is still used as a complementary, but not the primary, study for these diagnoses. PMID- 3303604 TI - Adrenal gland and nonrenal retroperitoneum. AB - Ultrasound, as the initial cross-sectional imaging technique, confirmed the value of axial records. Although computerized tomography and possibly magnetic resonance offers better resolution, ultrasonography has the advantage of being less expensive, convenient, and highly portable. With these specific indications and reservations, ultrasonography of the adrenal and retroperitoneum has an accepted role in imaging. PMID- 3303605 TI - Sonography of renal inflammatory disease. AB - The sonographic findings and differential diagnoses of a wide spectrum of acute and chronic renal inflammatory processes are reviewed. These include focal and diffuse forms of bacterial nephritis, pyonephrosis, intra- and extrarenal abscess, renal tuberculosis and fungal infection, xanthogranulomatous pyelonephritis, and renal parenchymal malakoplakia. The role of ultrasound in the diagnostic and therapeutic management of patients with these diseases is discussed. PMID- 3303606 TI - Sonographic evaluation of renal masses. AB - Basic technique of evaluating renal mass lesions is presented. The analytic criteria of separating cystic from solid lesions are reviewed along with the differential points of the intermediate mass lesion that does not meet the classical hallmark of a simple cyst. Experience has shown that sonography could be the first evaluation step in a renal mass since it is not invasive, does not employ ionizing radiation, and is cost effective. PMID- 3303607 TI - Diagnostic sonography of the fetal genitourinary tract. AB - Fetal diagnosis has vastly improved over the last decade. Ultrasound has become the imaging modality of choice. As real-time equipment has improved technologically, the ability to deduce subtle abnormalities has greatly increased. The fetal genitourinary tract may be evaluated for renal dysplasias, anomalies, or obstruction. Points of obstruction and, at times, the exact cause of obstruction may be deduced. Abnormalities of the ureter, bladder, urethra, scrotum, or reproductive system can be detected. Early diagnosis allows for proper individual or family counseling for hereditable disorders and chromosomal abnormalities. The perinatology team can be alerted to an abnormality that may require early neonatal surgical or medical intervention. Early treatment can prevent significant deterioration of renal function. The possibilities of prenatal intervention may be considered. PMID- 3303609 TI - Small bilateral renal cell carcinomas. AB - A case of multicentric bilateral small renal cell carcinomas is presented. The two largest tumors were detected by computerized tomography (CT) and the diagnosis confirmed by ultrasound and fine needle biopsy. PMID- 3303608 TI - Pediatric urosonography: an update. AB - Improvements in ultrasound technology have brought marked changes in the work-up of common pediatric clinical problems. This paper reviews the impact of ultrasound on genitourinary problems in infants and children. PMID- 3303610 TI - Renal transplantation in children with oculorenal syndrome. AB - The association of tapetoretinal degeneration with familial juvenile nephronophthisis is a rare oculorenal syndrome. Without treatment all children die of renal failure prior to adulthood. Information regarding renal transplantation is lacking in these children. This article reflects our experience in two children affected with this syndrome who achieved excellent functional results following living-related kidney transplants. Surgery can be done safely in these children with little or no morbidity. We believe that children with this syndrome benefit from transplantation and that this offers a significant improvement in their quality of life. PMID- 3303611 TI - Investigations on urinary bladder reinnervation. Historical perspective and review. AB - Although nerve crossover surgery to bypass a spinal cord lesion and recentralize the decentralized bladder was first conceptualized in 1907, surprisingly few studies concerning this goal have been reported since. In addition to direct implantation of nerves into the detrusor, the studies reviewed have investigated the crossover of mixed roots (with and without nerve grafts), dorsal roots, ventral roots, pelvic, obturator and hypogastric nerves both in animal models, in human cadavers, and in human patients. Restoration of the micturition reflex through the use of nonsacral nerves has been achieved in cats. In addition, we have shown that the axons of a suprasacral mixed root (L7) when anastomosed to a sacral mixed root (S1) via a nerve graft can regenerate and recentralize the unilaterally decentralized bladder in the cat. The return of the micturition reflex after reconstruction of severed pelvic nerves has been documented, while the results of obstruction or hypogastric crossover have given diminished returns of bladder function. The direct implantation of nerves into the detrusor has not resulted in restoration of function. In addition, return of useful bladder function in humans after nerve crossover surgery has not been predictable. In part, present inability to achieve restoration of urinary bladder function may be a consequence of the complexity of micturition reflex organization and the inability to use techniques in humans that have given success in animals. Although, some of the technical aspects of nerve crossover surgery to bypass a spinal cord injury and restore functional micturition in those with neurogenic bladder dysfunction have been elucidated, further work is required to develop techniques that will enhance appropriate axonal regeneration to achieve reinnervation and return of useful function. Indeed, restoration of function may be limited by current microsurgical methodologies. Studies directed at understanding the neuropathophysiology of nerve injury and nerve surgery may be more fruitful in identifying factors than can be manipulated to achieve consistent return of useful function. In general, however, the results of the animal and human studies surveyed may be viewed with cautious optimism. PMID- 3303612 TI - American Clinical and Climatological Association. Present Members. PMID- 3303613 TI - Ernest Lovell Becker. PMID- 3303614 TI - John Hutchinson's mysterious machine. PMID- 3303616 TI - Familial Mediterranean fever--an update. PMID- 3303615 TI - Antiplatelet agents and diabetic vascular disease. PMID- 3303617 TI - Tantalus revisited--the search for the ideal anti-thrombotic dose of aspirin. PMID- 3303618 TI - The mitral valve prolapse epidemic: fact or fiction. AB - In spite of two decades of research, the precise relationship of anatomic mitral valve prolapse (floppy valve) to the neuroendocrine disorder (MVP syndrome) remains unclear. In all likelihood they are two separate genetic disorders which travel together in some fashion. Mitral valve prolapse is a common disorder but progressive mitral regurgitation usually occurs late in life and in only a few patients. Other complications such as bacterial endocarditis, stroke, and sudden death are far less common but can occur at younger ages. The neuroendocrine syndrome in civilian life is mainly seen in young females (interestingly the peak incidence years correspond to peak female sex hormone output) but can be seen in males when subjected to unusual stress such as military service. More recent echocardiographic studies have questioned whether all prolapsing valves are truly abnormal. It has been shown that echographic prolapse can be produced in normal subjects by reducing venous return and impaired venous return may be present in some patients with the MVP syndrome. However, clicks and murmurs are apparently not heard when normal valves prolapse. It is our opinion that the presence of a click or typical murmur requires some anatomic abnormality of the mitral valve. One wonders if minimal valve abnormality (noted and dismissed by Davies) is the valve abnormality present in many young females with MVP syndrome, and that it may remain a mild abnormality throughout life. Recent psychiatric studies suggest that MVP is present in 30% of patients with Panic Disorder. It is not clear that this psychiatric syndrome is the same thing as the MVP syndrome. In Devereux's study, anxiety proneness was no different in the MVP cohort than in relatives without MVP. It is possible that diagnostic mixing of two similar but separate disorders has occurred, as has been the case since World War I. Perhaps the most important question is whether young patients with MVP syndrome and no echocardiographic criteria for "floppiness" will develop progressive mitral regurgitation or other complications in later life. In other words, how often is MVP syndrome in a young individual without echocardiographic evidence of a floppy valve a precourser to eventual progressive mitral regurgitation? Are there two different populations? Because of the long course of the disorder, several more years of observation (and, it is hoped, prospective longitudinal study) will be required to answer this question. PMID- 3303620 TI - [Otoneurological symptomatology in patients with acute neurosensory deafness]. PMID- 3303619 TI - The Gordon Wilson lecture. Why kidneys fail: an unifying hypothesis. PMID- 3303621 TI - [Variants of plastic surgery using the flaps in the area of the Achilles tendon]. AB - Operations were performed on 10 patients with persistent ulcers of the scars in the zone of Achilles tendon. Plasty with L-shaped whole thickness flap raised from the area of the external surface of the foot, ankle and lower third of the shin with a proximal pedicle was fulfilled in 9 patients after a radical dissection of ulcerated scars. In one patient plasty was fulfilled by translocation of a two-pedicle flap. Different variants of operations and results of treatment are described. A conclusion is made that scarry-trophic ulcers in the zone of Achilles tendon can be successfully treated by plasty with a whole thickness flap raised in the area of the lower third of the shin, external ankle and the lateral surface of the foot. PMID- 3303622 TI - [Cysts of the appendix]. PMID- 3303623 TI - [High-frequency artificial ventilation of the lungs]. PMID- 3303624 TI - [Treatment of injuries of the major blood vessels in children and adolescents]. AB - An analysis of treatment of injured vessels in 136 children is presented. Good results were noted in 32 of 53 patients observed at remote terms after trauma. PMID- 3303625 TI - [Subcutaneous rupture of tendons and muscles of the extremities]. AB - Under study there were 278 patients with 285 subcutaneous ruptures of tendons and muscles of the upper and lower extremities. The tendon of the long head of the humeral biceps muscle and Achilles tendon are most liable to subcutaneous ruptures (123 patients--43.2% and 97 patients--34% respectively). Pathohistological examinations have shown that subcutaneous ruptures of tendons and muscles usually take place against the background of dystrophic alterations reducing their mechanical strength. The authors find it expedient to use polymer materials (kapron, lavsan) for the restoration of injured tendons and muscles. PMID- 3303626 TI - The use of electrical current in the treatment of nonunions. AB - The use of electrostimulation in the treatment of nonunions in human beings is gaining in popularity. Increased understanding of the electrophysiology of fracture healing has lead to advances in the utilization of electric currents to stimulate nonunions to heal without resorting to major orthopedic surgery and its attendant risks. Most workers report success rates of 75 to 85 per cent, which are comparable to rates achieved by more routine orthopedic techniques. Brighton suggested that the risk/benefit ratio was lower for direct-current treatment of nonunion than that associated with conventional bone-graft surgery in human beings. Such information is not yet available for the veterinary surgeon. However, some authors have questioned the glowing reports of successful electric stimulation of clinical nonunions, citing poor design of clinical trials, erratic or inappropriate selection of patients, and empiricism in interpretation of results. Although the use of electrotherapy for treatment of nonunions appears promising, much more work is needed to define those patients best able to respond favorably to such techniques. Nonunions in dogs and cats are now only rarely treated with electric current. To date, no major clinical studies have been published concerning such techniques, although much of the basic research in this area was done on animals. It would appear that the totally implantable stimulators have the most potential for use in small animals because minimal cooperation is required of the patient and client. Furthermore, such devices cannot be easily damaged or dislodged. Whether electric stimulation of nonunions in dogs and cats will replace or supplant conventional orthopedic techniques remains to be seen. PMID- 3303627 TI - Nonunion. AB - The recognition and treatment of delayed union or nonunion of a fracture is an orthopedic salvage procedure that all veterinary surgeons eventually experience. The major factor in determining whether a fracture becomes a nonunion or goes on to unite is the degree of stabilization of the fracture site. Infection (osteomyelitis) also contributes significantly to the formation of a nonunion. Nonunions can usually be classified clinically and radiographically as either vascular (capable of biologic activity) or avascular (incapable of biologic activity). Once this determination has been made, treatment regimens include application of rigid internal fixation (vascular nonunions) and installation of autogenous cancellous bone grafts after decortication (avascular nonunions). With the complication of osteomyelitis, microbiologic evaluation and antibiotic therapy should be considered even though a fracture will heal in the presence of infection if it is stable. PMID- 3303628 TI - Bone grafting. AB - Bone grafts in clinical practice are primarily used to help achieve bony union in cases of indolent healing of fractures or pseudoarthrosis; to supplement the healing of certain fresh fractures; to promote fusion (arthrodesis) of joints damaged by injury, disease, or deformity, and to fill defects in bone created by tumors, chronic infection, or injury. This article considers the types and functions of bone grafts. PMID- 3303629 TI - Arthrodesis. AB - Arthrodesis is the surgical fixation of a joint designed to accomplish fusion of the joint surfaces by promoting the proliferation of bone cells. This article considers indications for arthrodesis and techniques for arthrodesis of individual joints. PMID- 3303630 TI - Treatment of post-traumatic osteomyelitis. AB - Osteomyelitis is an inflammation of the bone, cortex, and/or periosteum. The author discusses the pathophysiology, clinical manifestations, diagnosis, and treatment of post-traumatic osteomyelitis. PMID- 3303631 TI - Excision arthroplasty of the femoral head and neck. AB - An abnormality of the coxofemoral joint is recognized when the articular cartilage sliding interface between the femoral head and the acetabulum is interrupted. The article considers the pathologic conditions that may affect the normal coxofemoral articulation and are responsive to excision arthroplasty. Techniques of excision arthroplasty and the biceps femoris muscle sling technique are described. PMID- 3303632 TI - Congenital elbow dislocations. AB - Three categories of congenital elbow dislocations are described in the literature: humeroulnar, humeroradial, and dislocation or joint laxity with other congenital anomalies. Congenital humeroulnar dislocation is a well-defined problem that occurs predominantly in small breeds of dogs and causes severe limb deformity and dysfunction. Early reduction and stabilization are simple to achieve and have provided good results. Radial head dislocations occur most often as a result of growth disturbance of the radius and ulna. There is a lack of conclusive information on congenital radial head dislocations. Regardless of the etiology, radial head dislocation causes rather mild deformity and lameness and can be treated by conservative management, surgical correction, or radial head ostectomy. Dislocation of the elbow may occur concurrently with other rare congenital anomalies and has been described with ectrodactyly and polyarthrodysplasia. PMID- 3303633 TI - Limb preservation in dogs with primary bone tumors. AB - This article presents methods currently used for limb preservation in dogs with primary bone sarcomas. Emphasis is placed on diagnosis, proper patient selection, and perioperative management. PMID- 3303634 TI - Growth deformities. AB - This article discusses principles of corrective osteotomy and describes operative plans for specific growth deformities such as premature closure of the distal ulna, asynchronous growth of the radius and ulna in achondroplastic breeds, retarded growth of the distal radius, retarded growth of the proximal radius, and synostosis of the radius and ulna. PMID- 3303635 TI - Chronic luxations. AB - Chronic joint luxations may result from either traumatic injuries or congenital defects. Traumatic luxations are the most common and most amenable to surgical correction. Several surgical techniques for repair of hip, shoulder, and elbow luxations will be presented in this article. PMID- 3303636 TI - Total hip replacement. AB - Total hip replacement in the dog has proved to be a highly successful method of restoring normal, pain-free motion to the coxofemoral joint. In a prospective study done at The Ohio State University College of Veterinary Medicine and the Berwyn Veterinary Associates Hospital, the indications and contraindications, the most effective surgical technique, the complication rate, and the long-term functional evaluation have been established for canine total hip replacements. This study has established that a 95 per cent success rate for function of the hip joint can be achieved if the established guidelines are followed. PMID- 3303637 TI - Quadriceps contracture and fracture disease. AB - Fracture disease, which is a complication of fracture treatment and immobilization, is defined as atrophy of bone, soft tissues, nail, skin, and cartilage. This condition is most often seen in dogs with quadriceps contracture. Distal femoral fractures treated by extension splints often result in a stiffened stifle in immature dogs, which is a common and often irreversible postsurgical complication. The clinical signs, surgical anatomy, etiology, pathophysiology, and treatment of this syndrome are reviewed. PMID- 3303638 TI - Attaching and effacing bacteria in the intestines of calves and cats with diarrhea. AB - Histopathologic and electron microscopic examination of intestines of three calves and two cats revealed attaching effacing bacteria characteristic of enteropathogenic Escherichia coli (EPEC) in ileum, cecum, and colon. The attaching effacing bacteria in one of the calves contained bacteriophages, and an E. coli isolate from that calf was shown to produce Shiga-like toxin. These findings contribute to emerging evidence that attaching effacing intestinal bacteria are globally distributed pathogens in a variety of host species and that bacteriophage-mediated production of Shiga-like toxin is related to the virulence of such bacteria. PMID- 3303639 TI - Immunohistochemical and electron microscopic study of meningeal granular cell tumors in rats. PMID- 3303640 TI - Clinical observations on the use of BCG cell wall fraction for treatment of periocular and other equine sarcoids. AB - Clinical observations on the use of BCG cell wall fraction in oil for treating seven horses with periocular sarcoids and five horses with sarcoids in other regions are described. Therapy was successful when used for periocular or solitary and smaller sarcoids. For sarcoids previously treated with cryosurgery, therapy appeared to be less efficient. A horse with a sarcoid on the stifle developed a septic gonitis due to necrosis of the sarcoid tissue adjacent to the joint. Sarcoids of the axilla appeared to be more aggressive than sarcoids at other locations and did not respond favourably to this form of therapy. PMID- 3303641 TI - Intramammary preparations and cephalosporin resistance in S typhimurium. PMID- 3303642 TI - Clinical trial of halofuginone lactate for the treatment of East Coast fever in Kenya. AB - A field trial was undertaken to test the efficacy of halofuginone lactate in the treatment of East Coast fever under farming conditions in Kenya. The drug was administered orally at a dose of 1.2 mg/kg bodyweight and treatment was repeated after 48 hours. Of 293 cases treated 236 (80.5 per cent) recovered and 49 (16.7 per cent) died. Five animals were disposed of by the owners and three became chronically infected. No differences were recorded in recovery rate between uncomplicated cases and cases with concurrent anaplasmosis or babesiosis, nor were there any significant differences in recovery rates between animals of different types. However, zebu cattle (Bos indicus) tended to respond more rapidly to treatment than exotic cattle (Bos taurus). Younger animals had a poorer recovery rate than adults. Early treatments were more successful than those administered late. It was concluded that with early detection and treatment, coupled with efficient tick control, halofuginone lactate is effective in the treatment of clinical East Coast fever under field conditions. PMID- 3303643 TI - Nasogastric intubation of the horse. PMID- 3303644 TI - Spontaneous primary myopathies in domestic mammals: a review. AB - By reviewing the literature concerning primary myopathies in man and animals, a classification of spontaneous primary myopathies in domestic mammals is made. This classification is based on aetiological factors. Primary myopathies are divided into metabolic, immunologic, toxic, nutritional, congenital, inherited, and inflammatory myopathies. Muscular dystrophies, in accordance with the definition in human cases, are considered as a separate entity. In the description of the different muscle disorders the emphasis is on the structural changes and the pathogenesis. Clinical signs and diagnostic criteria are considered only briefly. PMID- 3303645 TI - Coccidiosis in sheep and goats. AB - Coccidiosis is one of the most important diseases of sheep and goats in the United States because of its effect of productivity, especially in the growing of lambs and kids. Control of coccidiosis is dependent on management techniques to reduce overcrowding, fecal contamination and stress, and on proper use of effective coccidiostats, such as lasalocid and decoquinate, to prevent clinical disease. The sheep and goat industries need two unrelated effective coccidiostats approved for use in these species. PMID- 3303646 TI - Coccidiosis of ducks and geese. PMID- 3303647 TI - Overview of usefulness of pharmacokinetics in minor species/use applications in the Center for Veterinary Medicine. PMID- 3303648 TI - Systemic availability and pharmacokinetics of some drugs in ruminant animals. PMID- 3303649 TI - Potential applications of pharmacokinetics toward minor species-use approvals: human food safety. AB - Pharmacokinetic studies may provide useful information in terms of drug disposition but there has not been enough basic work done to enable CVM to use pharmacokinetics to predict tissue residues and assign withdrawal periods. Much carefully controlled work would need to be conducted to determine the correlations between tissue residues and plasma concentrations for a single drug, for a class of drugs, for differing dose levels, and for extrapolations between species. Conducting good pharmacokinetic studies requires expertise in the area and is not simply a matter of taking blood samples and measuring levels of a drug. In addition, CVM has not established any criteria for determining which studies are adequate to define the relationship between plasma levels of a drug and tissue residues. At this point, for drug approvals in minor species, it is much easier and less time consuming to conduct tissue residue studies in the target animal. PMID- 3303651 TI - Immunity against anaerobic bacterial infections. PMID- 3303650 TI - [Interstitial lung diseases caused by immune disorders]. PMID- 3303652 TI - Monoclonal antibodies to sheep MHC class I and class II molecules: biochemical characterization of three class I gene products and four distinct subpopulations of class II molecules. AB - The availability of a panel of monoclonal antibodies to sheep MHC class I and class II gene products has allowed for the first time an assessment of the relative complexity of the sheep MHC. By using four monoclonal antibodies to MHC class I, and seven monoclonal antibodies to MHC class II molecules together with one-dimensional SDS-PAGE, sequential immunoprecipitation and 2-dimensional gel analysis, three class I gene products and four distinct subsets of class II molecules have been identified. Sheep class I molecules showed heterogeneity on 2 dimensional gels and as in mouse and man, represented the products of at least three different non-allelic class I genes. Interestingly, the sheep beta 2 microglobulin molecule also displayed heterogeneity, consistent with either two primary gene products or allelic variation. Four sheep class II monoclonal antibodies identified distinct, non-overlapping subsets of sheep class II molecules of Mr 32-36 K (alpha chain) and 25-28 K (beta chain). These class II molecules were co-expressed on sheep B lymphocytes and represented the primary products of different sheep MHC class II genes. The class II molecules within three of these subsets displayed allelic polymorphism essentially restricted to their beta polypeptides, while the fourth subset of class II molecules showed allelic variation in both their alpha and beta polypeptides. The results of this study represent the first evidence for gene duplication and heterogeneity within the sheep MHC. The identification of three primary class I gene products and four distinct subsets of class II molecules suggests three class I loci and up to four distinct class II subregions within the sheep MHC. Potentially large numbers of allelic variants of these different gene products may be expressed in normal sheep. PMID- 3303653 TI - Immune mechanisms in infections of poultry. AB - Resistance to infectious agents may depend upon innate mechanisms or acquired immune responses. Inflammation, phagocytosis, cell-mediated immunity and antibodies are components of a complex reaction which result either in resistance or in susceptibility. Most infectious organisms stimulate immune responses within every compartment of the immune system. In rather few infections of poultry, it is possible to pinpoint a limited number of immune reactions that are primarily responsible for resistance. In some situations, autoimmunity may contribute to the pathology associated with infections. PMID- 3303654 TI - [Adsorption of antigens K88 and K99 on aluminum hydroxide gel]. AB - Studied was the effect of the pH value of the medium, of the concentration of the antigen and the adsorbent on the adsorption of K 88 and K 99 on aluminium hydroxide-gel. Use was made of strains O 45:K 88 and O 14:K 99. The optimal parameters of pH and the concentration of aluminium oxide as well as of aluminium hydroxide-gel as an adjuvant, substantiating the maximum adsorption capacity of the latter with regard to the two Escherichia coli antigens used. Established was the maximum amount of the antigens which could be adsorbed by as much as 1 cm3 of aluminium hydroxide-gel. According to the authors such amount could serve to indicate the way how to produce effective preparations to be deposited with the two-antigen adjuvant. PMID- 3303655 TI - [Dynamics of the antibiotic resistance of E. coli strains isolated from cows on 2 dairy farms]. AB - Studied was the dynamic of antibiotic resistance of Escherichia coli strains as isolated from fecal samples taken from 5-day-old calves that had not been offered antibacterial means. The resistance manifested was compared to that of E. coli organisms isolated from calves that had been given antibacterial agents in the course of 36 months as well as to the resistance of E. coli strains isolated from calves at 1, 3, and 5 months of age and from dam cows in the last 12 months of the experiment. A varying period was established for receding of the signs of resistance of the strains to antibiotics--6 months for E. coli to kanamycin and furazolidone, 9 months to tetracycline, chloramphenicol, and gentamycin, and 15 months to streptomycin. Strains isolated from newborn calves on farms with no records of infection were shown to be susceptible to all antibiotics, while those isolated from calves on farms where enteritis was recorded remained polyresistant up to 36 months. No correlation was found between the antibiotic resistance of fecal E. coli strains from the dams and their calves. PMID- 3303656 TI - [Mixed coli-rotavirus and Cryptosporidium infection in newborn piglets]. AB - Complex morphologic, parasitologic, virologic, and bacteriologic studies on pigs and fecal samples from pigs were carried out on a farm where an enteritis infection in newborn pigs was recorded. A mixed coli-rotavirus and cryptosporidium infection was established in 10--20-day-old pigs of the Camborough hybrid with a clinically manifested enteritis syndrome. Morphologically, the cryptosporidium component of the infection substantiated atrophic and dystrophic changes in the intestinal epithelium. Developmental forms of the parasite were also found in the border wall of the enterocytes. PMID- 3303657 TI - [Use of genetic engineering methods to create viral vaccines]. PMID- 3303658 TI - [Church and monastery medicine during the Bulgarian Renaissance]. PMID- 3303659 TI - [Unrecognized worldwide contribution of Stefan S. Nicolau]. PMID- 3303660 TI - Molecular biology of the visual pigments. AB - With the identification and structural characterization of several visual pigments has come a new era of investigation. The above comparisons of amino acids sequences predict specific functional domains that may be tested to tell us how visual pigments function to absorb light and transform this "signal" to trigger a neural response. The details of how rod and cone pigments differ are now known for human pigments. The striking similarities between vertebrate and invertebrate pigments are remarkable for pigments that have been subject to divergence for over 500 million years. There are yet challenges ahead of us. The true tertiary structure of visual pigments must be obtained from a 3-dimensional crystal structure. The predictions for functional domains of interaction with the GTP binding protein must be confirmed or redefined. A rigorous definition of the chromophore environment and the properties that control the wavelength of absorption of 11-cis retinal chromophore are certainly still on the drawing boards. Specific genetic alteration through in vitro mutagenesis promises much insight, but the technology for expressing these membrane proteins in functional form has yet to be achieved. We may expect, however, these problems will be addressed and in the next few years facts should replace what are now speculations. Finally, it is a delightful observation that nature has capitalized on a general biochemical mechanism for control of second messengers in the cytoplasm of cells. Protein structural data deduced from genetic information now document the hypothesis that the structure and function of receptors for the catecholamines and that of visual pigments are similar. The receptors for serotonin, leukotrienes, prostaglandins, histamine and acetylcholine (muscarinic) are expected to belong to this same family. The lessons learned about visual pigments can be applied broadly to a general set of membrane receptors. PMID- 3303661 TI - Biochemistry of vision--a perspective. PMID- 3303662 TI - Retrospective review of retinal circuitry. PMID- 3303663 TI - The central visual system. PMID- 3303664 TI - Eye movement. PMID- 3303665 TI - Human visual suppression. PMID- 3303666 TI - The search for the site of visual adaptation. PMID- 3303667 TI - Temporal impulse response. PMID- 3303668 TI - Electroretinography. PMID- 3303669 TI - Evoked potentials in vision research 1961-86. PMID- 3303670 TI - Aging and vision. PMID- 3303671 TI - Physiological optics during the first quarter-century of Vision Research. PMID- 3303673 TI - A unifying presentation of photopigment spectra. PMID- 3303672 TI - Spatial vision then and now. PMID- 3303674 TI - Spectral sensitivity, intense spectral light studies and the color receptor mosaic of primates. PMID- 3303676 TI - Neural mechanisms of binocular vision. PMID- 3303675 TI - Eye disease and color defects. AB - The groundwork for understanding color defects in eye disease was established by the end of the nineteenth century. Thereafter the field was neglected as scientists concentrated on studies of normal color vision and congenital color vision defects. Spurred by the development of the Farnsworth 100 hue-test, interest was renewed in the 1950s. The past 25 years have seen an explosion of interest in color defects in eye disease. The International Research Group on Color Vision Deficiencies has played an important role in this activity. The development of new clinical tests and instruments as well as refinement of laboratory techniques are among the important developments. PMID- 3303677 TI - Stereoscopic vision. PMID- 3303678 TI - Double-label analysis of GAD- and GABA-like immunoreactivity in the rabbit retina. AB - Rabbits were injected intravitreally with colchicine and the retinas were subsequently processed for simultaneous visualization of GAD-like and GABA-like immunoreactivity (LIR) at the light microscopical level. The use of specific antisera from unrelated species minimized the possibility of crossreactivity between the two markers. Colocalization of GABA-LIR and GAD-LIR was observed in approximately 32% of somata on the inner border of the inner nuclear layer (INL) and roughly 15% of the somata in the ganglion cell layer (GCL). All GAD-positive cells were double labeled whereas 15% of the GABA-LIR cells in the INL and 52% of those in the GCL were negative for GAD-LIR. Both markers were seen throughout the inner plexiform layer. In addition, processes coursing through the OPL, perhaps from interplexiform cells, and horizontal cell bodies were double-labeled with these GABAergic probes. PMID- 3303679 TI - A whole mount method for sequential analysis of photoreceptor and ganglion cell topography in a single retina. AB - Photoreceptors (PR) in human and monkey retina are visible in whole mounts cleared with glycerol or dimethyl sulfoxide and viewed with Nomarski differential interference contrast microscopy. These preparations substantially decrease the large tissue volume changes associated with dehydration and sectioning and reveal many details of PR organization and cytology with great clarity. Tissue may be subsequently stained to reveal ganglion cells so that the topography of both cell types may be studied in the same retina. PMID- 3303680 TI - [Effectiveness of soap as a medium for removing the pathogens of acute intestinal infections from the hands]. PMID- 3303681 TI - [Organization of medical services in a rifle regiment during the Lvov-Sandomierz offensive]. PMID- 3303682 TI - [Surgical method of preventing urination disorders in women following operations for rectal cancer]. AB - The paper discusses a procedure for prevention of urination disorders in females undergoing combined surgery for rectal cancer. The procedure is based on suturing the round ligaments of the uterus. PMID- 3303683 TI - [Markers of the formation of carcinogenic nitroso compounds]. PMID- 3303684 TI - [Autonomic reactions of young female workers in the textile industry]. PMID- 3303685 TI - [Zonal rheoplethysmography in determining ventilation and blood flow in the lungs (a review of the literature)]. PMID- 3303686 TI - [Stomach diseases in alcoholism patients with concomitant pulmonary tuberculosis]. PMID- 3303687 TI - [Middle molecules--a marker of endogenous intoxication (a review of the literature)]. PMID- 3303688 TI - [Acute surgical pathology in cancer patients]. PMID- 3303689 TI - [Inactivation of tumor cells photosensitized by porphyrins--the basis for laser photodynamic therapy (review of the literature)]. PMID- 3303690 TI - [New findings on the etiology and pathogenesis of inflammatory rheumatic diseases]. PMID- 3303691 TI - [Emergency endoscopy in hemorrhage from the upper portions of the digestive system]. PMID- 3303692 TI - [Morphologic changes in the heart conduction system after sudden cardiac death from ischemic heart disease]. PMID- 3303693 TI - [Treatment of stomach ulcer with the Bulgarian preparation Farmaxolon]. AB - Thirty-four patients with gastric ulcer were treated with the new Bulgarian preparation pharmaxolon-Pharmachim, for 20 days under clinical conditions. A favourable effect on the clinical symptoms by the pharmaxolon treatment was established but the differences with the control placebo group were statistically insignificant. A total of 47.1% from the gastric ulcers were healed after 20-day treatment and in 32.3% were reduced in size but here the difference from the control placebo group was insignificant. Pharmaxolon, with its therapeutic effect equals the related foreign (Biogastrone, Ultranyl, Caved-S) and Bulgarian preparations (Alcid-V), hence it is recommended for the practice. Elevated transitory arterial pressure was observed in 41% of pharmaxolon-treated patients, not necessitating the discontinuation of the treatment. That requires a periodic control of the arterial pressure of the patients, treated with that new Bulgarian preparation. PMID- 3303694 TI - Treatment of severe hypertension and hypertensive crises with nifedipine. AB - The calcium channel blocker nifedipine is an effective antihypertensive agent for the treatment of severe hypertension and hypertensive crises. It produces a prompt, predictable and consistent reduction in systemic arterial pressure with minimal adverse effects. The blood pressure reduction is inversely correlated with the pretreatment blood pressure level. Various nonparenteral administration forms-oral, sublingual, buccal and rectal-permit a versatile, noninvasive, cost effective alternative to parenteral antihypertensive therapy and continuous hemodynamic monitoring. Blood pressure is reduced to the goal level in 98% of patients with a 10- to 20-mg dose of nifedipine. Hemodynamic changes are favorable and morbidity is uncommon. PMID- 3303695 TI - [Vascular encephalopathy caused by congenital developmental anomalies of the arteries of the aortic arch]. PMID- 3303696 TI - [Peritoneal dialysis in the treatment of acute pancreatitis]. PMID- 3303697 TI - [Chronic mucocutaneous candidiasis]. PMID- 3303698 TI - [Acetylation phenotype and biotransformation of various drugs]. PMID- 3303699 TI - [Subtotal colectomy in neoplastic obstruction of the left part of the colon]. PMID- 3303700 TI - [Cesarean section in Poland in the 19th century]. PMID- 3303701 TI - [Education of the elite physician--the legacy of Theodor Billroth from the contemporary viewpoint]. PMID- 3303702 TI - [Metastasizing, endocrine active pancreatic tumor with hormone conversion from gastrin to insulin]. PMID- 3303703 TI - [Bullous photodermatitis following contact with the stem sap of the giant bear claw (Heracleum mantegazzianum)]. PMID- 3303704 TI - [The hospital in the time of Napoleon I. A medical history viewpoint]. PMID- 3303705 TI - [Lysotype changes in multiple drug-resistant plasmids of S. typhimurium strains from hospitals of different countries]. PMID- 3303706 TI - [Bacteriostatic effectiveness of a series of cation active surfactants on Staphylococcus aureus]. PMID- 3303707 TI - [Electrically induced thrombosis--its experimental and clinical use]. AB - Electrically induced thrombosis is favoured for using in experimental medicine like experimental atherosclerosis and myocardial infarction and in testing pharmacological substances because of the sure effect of inducing thrombosis, because of it's good controlling, standardization, reproduction and localization. In clinical practice it is already used but the possibilities of clinical applications could be enlarged. PMID- 3303708 TI - Prolongation of skin allograft survival in mice after pretreatment with an extract of human platelets in combination with donor antigen. AB - Intraperitoneal injection of human platelets or of an extract released from these cells in mice results in significant prolongation of skin allograft differing in H-2 locus. We differentiated between a primary phase (optimum after about 20 h) and a secondary phase (optimum after 2-3 months). The extract was injected twice together with spleen cells as donor antigen, twelve weeks later skin grafting was done. The average transplant survival was 21.4 days in contrast to 11.4 days in the zero-control. The repeated graft of second set reaction also had a prolonged survival. A sensibilization in the second set was not observed. The xenogeneic origin of the platelets used was against the assumption of the participation of original superficial antigens from platelets in the described immune modulation process. PMID- 3303709 TI - [On the 125th anniversary of the birth of Emerich Ullmann (1861-1937)]. PMID- 3303710 TI - [Inflammatory skin diseases and hypereosinophilia]. AB - Among the dermatoses associated with tissue eosinophilia are pemphigus vegetans, bullous pemphigoid, granuloma facial and Wells' syndrome. Eosinophilic spongiosis can occur in the early stage of pemphigus. Pemphigus herpetiformis, a recently introduced term, does not represent a well defined entity but develops into either pemphigus vulgaris or pemphigus foliaceus. Granuloma facial is basically vasculitis. Eosinophilic cellulitis or Wells' syndrome shows numerous eosinophils which degranulate and through confluence of their granules form the so-called flame figures. PMID- 3303711 TI - [Problematic aspects of placebo-controlled double-blind studies with highly effective drugs such as etretinate]. AB - Highly potent drugs should be studied by means of double placebo experiments rather than by semi-blind trials. In semi-blind trials, possible side effects induced by the placebo might not be sufficiently registered, and those induced by the verum cannot be adequately evaluated. PMID- 3303712 TI - [Urticaria-vasculitis with bullous eruptions in visceral lupus erythematosus]. AB - In a 25-year-old female patient, persistent urticaria led to the diagnosis of acute systemic lupus erythematosus. Herpetiform vesiculous and bullous lesions erupted under corticoid medication and responded very well to additional therapy with DADPS (= diaminodiphenylsulphone). PMID- 3303713 TI - [Various aspects of the surgical therapy of cancer of the lower lip]. AB - A safety distance of 1 cm from the excision margin as well as, frequently, removal of the regional cervical lymph nodes are usually recommended to ensure radical excision of carcinomas of the lower lip. Investigations on 32 such carcinomas revealed that a safety distance of 3-5 mm is sufficient, if the edge of the excised tissue is histologically controlled. 109 carcinomas of the lower lip were re-examined in order to settle the question of prophylactic dissection of the lymph nodes. The low metastasis rate of 1.8% suggests that prophylactic dissection of the lymph nodes is not necessary in these patients. However, 95% of all tumors classified as T1 according to the current T-classification by the IUAC for carcinomas of the lower lip occurred in this group of patients. PMID- 3303714 TI - [Benign and malignant granular cell tumors. An immunohistochemical classification of tumor cells]. AB - Eight benign and three malignant granular cell tumors were characterized by means of antibodies and antisera against keratin, desmin, epithelial membrane antigen, factor VIII-related protein, lysozyme, myelin basic protein, myoglobin, neurone specific enolase, S 100 protein, myelin-associated protein (Leu 7), glial fibrillary acidic protein, vimentin, and neurofilament. All benign granular cell tumours showed positive staining of the tumor cells to antibodies against vimentin, S 100 protein, and neurone-specific enolase; myelin-associated protein (Leu 7), in contrast, was only detectable in a few tumor sections. Histogenetically the granular cells may be classified as Schwann's cells which lost their expression of laminin. The three malignant granular cell tumors showed a staining pattern significantly different from that of the benign tumours. Thus, only neurone-specific enolase was detectable in all the tumors, whereas S 100 protein and vimentin could not be demonstrated but in one and two, resp., out of three tumors. PMID- 3303715 TI - [Heart transplantation--postoperative management]. AB - Heart transplantation represents a widely accepted therapeutic modality for patients with end-stage myocardial failure. With increasing experience, 1-year survival rates of over 75% and 5-year survival rates of over 60% have been achieved, mainly due to patient selection, standardized surgical techniques as well as improved postoperative management. During early follow-up, particular attention should focus on diagnosis and treatment of graft rejection and infection, which require individualized immunosuppression, while in the later postoperative course coronary atherosclerosis, hypertension, chronic renal insufficiency and malignancy become more important as potential complications. The general principles in the management of these patients are discussed. PMID- 3303716 TI - [Radical surgery and vertebral body replacement in aneurysmal bone cysts of the spine]. AB - 6 cases of aneurysmal bone cyst of the spine are presented. The clinical picture, diagnostic procedures and operative treatment will be discussed. Although aneurysmal bone cyst is a benign, non-neoplastic lesion its spreading tumor growth with destruction of important bony structures of the vertebral body, consecutive instability and cord compression presents a considerable menace to the mostly teenage-patient. Spinal computerized tomography is the diagnostic method of choice. The goal of surgical therapy of the aneurysmal bone cyst of the spine should include radical tumor excision in order to avoid recurrent tumor growth followed by vertebral body replacement and osteosynthetic stabilisation. PMID- 3303717 TI - [Reconstruction of the iliac crest using homologous femur head transplants]. AB - Corticocancellous bone grafts from the iliac crest are suitable for anterior fusion of the spine in various indications. The remaining defect in the iliac bone often causes pain an is mostly unsatisfactory. To repair this defect we use homologeous bone from human femoral heads. The bone is cut and a slice is well fitted in and than fixed with sutures or Kirschner wires. Complete bone remodeling and reconstruction of the iliac crest occurs within six months after this procedure, which is easy to perform. PMID- 3303718 TI - [Acetabuloplasty by pedicled transfer of the iliac crest apophysis in the dog]. AB - Appositional incremental acetabuloplasty using a self growing iliac crest graft pedicle on its epipyseal vessels was performed in 54 puppies 3 months old. Remodeling an adaptation to the shape of the acetabulum is excellent in most of the cases, issuing into a spherical composite cavity. Persistance of a hyaline cartilage is noted until the end of the first years, but long term morphological transmission electronmicroscopy studies demonstrate a progressive transformation into fibrocartilage. This experimental study demonstrates the possibility to use remodeling and growth properties of a pedicled iliac crest, transplanted as an iland flap on the extraarticular acetabular roof. This new surgical technique can be proposed for the care of difficult dysplastic hips in children. PMID- 3303719 TI - [Accuracy of length and angle measurements in the roentgen image and sonogram of the pediatric hip joint]. AB - The results of measurement of length and angles in the x-ray and ultrasound image of the infantile hip joint are dependent on the different shape of the joint but also on different x-ray projections, on a limited accuracy and incorrect technique in measurement. From our investigations on the accuracy of measurement a differentiation between normal and pathological infantile hip joints is not possible by measuring geometrical data in the x-ray resp. ultrasound image. In the x-ray the greatest possible error of the acetabular angle is +/- 3 degrees, that of the so-called "AMC-angle" +/- 5 degrees and of the Alpha- and Beta-angle in the ultrasound image +/- 10 degrees. Thus the collection of geometrical data in the x-ray and ultrasound image of the infantile hip joint is not more reliable than a qualitative assessment orientated on the osseous resp. cartilaginous corner of the acetabulum. PMID- 3303720 TI - [Pathogen changes in bacterial bone and joint infections (osteomyelitis, spondylitis, arthritis)]. AB - With regard to germ mutation in osteomyelitis, spondylitis, and arthritis it has been established that the frequency of Mycobacterium tuberculosis and the gram positive pathogens (S. albus, Streptococci) has decreased in the last 20 years. To varying degrees, S. aureus and the gram-negative, aerobic organisms are the most important pathogens of bone and joint infections. Overall, there has been an increase in the frequency of infections with gram-negative, aerobic organisms. In the majority of cases the bone and joint inflammations were caused by exogenous factors, their course was chonic, and the typical localization was the lower extremity. There was a positive trend toward shorter periods of hospitalization and a shorter duration of illness. PMID- 3303721 TI - The legacy of Arabic medicine. PMID- 3303722 TI - [To whom should fatherhood of the IUD be attributed?]. PMID- 3303723 TI - [Prostaglandin F2 alpha, prostacyclin and thromboxane in benign and malignant breast tumors]. PMID- 3303724 TI - [Experience in using the laser in surgery of the esophagus and intestines]. PMID- 3303725 TI - [A computer system in a cardiac postoperative intensive therapy department]. PMID- 3303726 TI - [Experience with 800 kidney allograft operations]. PMID- 3303727 TI - [Effectiveness of experimental 16-day accelerated methods of the treatment of early forms of syphilis]. PMID- 3303728 TI - [What and how the neuron learns]. PMID- 3303729 TI - Malaria control and the development of the Ok Tedi mining project in the Star Mountains of Papua New Guinea: the initial construction phase. PMID- 3303730 TI - Epidemic malaria in the hyperendemic North Fly region of Western Province, Papua New Guinea. PMID- 3303731 TI - Malaria chemoprophylaxis: an update. PMID- 3303732 TI - Inhibitory effects of essential oil components on growth of food-contaminating fungi. AB - The antifungal activity of several components of essential oils were evaluated using a paper-disk method. The substances investigated are structurally related to eugenol. Equimolar amounts were tested on more than ten fungal strains known to contaminate food. Iso-eugenol, cinnamaldehyde, carvacrol, eugenol and thymol revealed the strongest antifungal activity. The most resistant strain appeared to be Penicillium verrucosum var. cyclopium, and the most sensitive was P. viridicatum. Some of the structural effects were considered, including a free hydroxyl group in connection with an alkyl substituent which seemed to represent an especially active configuration of phenolic compounds and which rendered antimicrobial activity. PMID- 3303733 TI - [New developments and trends in the surgical treatment of hypospadias]. AB - New trends in the treatment of hypospadias consist on the one hand in conceptional tactics such as earlier operation, shorter hospitalization, one stage procedures and meatal advancement in distal forms, and on the other hand in operative techniques such as the island-flap procedure for primary and the bladder-mucosa graft for secondary urethroplasty, artificial erection for chordectomy, as well as xylocaine-adrenaline injection for glanduloplasty. PMID- 3303734 TI - [Personal experiences with the MAGPI technic in the correction of distal hypospadias]. AB - Between 1 January 1983 and 31 January 1986, 18 patients with distal hypospadias underwent corrective surgery using the MAGPI technique. The age of the young patients varied from 2 months to 12 years. Indication for an operation was mandatory by the presence of meatal stenosis (3 patients), which included the correction of the glans as well as the resection of the foreskin at the same time, or in case of the other children at the request of the parents who wished to prevent social discrimination. 12 patients were operated on using the simple MAGPI technique, whereas 6 underwent an operation extended by the rotation flap technique according to Byars. 16 of the 18 small patients showed excellent results regarding function (miction) as well as cosmetics. In 2 patients the cosmetic results were not entirely satisfactory although their parents were content with the outcome of the operation. PMID- 3303735 TI - [Long-term results of Ombredanne hypospadias operations]. AB - Experience during twenty years with the Ombredanne method for the correction of hypospadias demonstrates that good functional and cosmetic late results are achieved with the surgical technique of our days. The disadvantage of the two stage procedure is compensated by the advantage of safer operation technique with low risk of fistula formation and by the fact that no catheter is necessary. PMID- 3303736 TI - Traumatic splenic cyst. AB - The authors report two cases of traumatic rupture of splenic cyst. In each case a previous abdominal trauma was found responsible for the presence of the cyst. A new minor abdominal trauma provoked a major haemoperitoneum. In both cases laparotomy revealed the rupture of a large cyst of the upper pole of the spleen, with extension of the lesion into healthy splenic parenchyma. Conservative splenic surgery with cystectomy was possible in both cases; microscopic examination confirmed a true pseudocyst in case 2. In presence of haemoperitoneum and ultrasonographic view of a splenic cyst, the treatment should be surgical in contrast to the more conservative attitude now recommended for the usual splenic trauma. PMID- 3303738 TI - Culturing stick- and leaf-insects (Phasmida)--a review. PMID- 3303737 TI - [The Munch biolox immediate and delayed implants. 6 years' clinical experiences]. PMID- 3303739 TI - [Metabolism of C14-labelled urea in conventional, germ-free and specifically associated rats]. PMID- 3303740 TI - [Italian researchers reconstruct the face of a Renaissance princess (Isabella of Aragon)]. PMID- 3303741 TI - [Content, form and methods of clinical evaluation of the quality of technical prosthetic services]. PMID- 3303742 TI - [Theoretical and technological principles in telescopic dentures]. PMID- 3303743 TI - [Planning of material needs in dental technical laboratories on the basis of material use standards for "special dentures"]. PMID- 3303744 TI - [Problems with opaqueing materials in relation to composite and veneering materials during the use of the silicoater technic in the GDR]. PMID- 3303745 TI - [Pressure investing]. PMID- 3303746 TI - [A simplified silanization method]. PMID- 3303747 TI - [Allogeneic transplantation of the small intestine--animal experiments and a clinical retrospect]. AB - Allogenic transplantation of small intestine has proved to be an alternative therapy for complex failure of intestinal functions. Attempts in that direction had been made over many years, but impressive were obtained only under conditions of modern immunosuppressive therapy. Hence, wider clinical application is imminent at an international scale. Reference is made in this paper to the authors' own experience obtained from mongrel dogs for an account of indications, surgical technique for collection of intestine and transplantation, perfusion and preservation of the donor organ as well as of various pathophysiological, functional, and immunological aspects. Results obtained at different centres are discussed, with reference being made to individual cases and clinical findings recorded from them. The survival rate of animals which have undergone transplantation of the small intestine provides evidence for the possibility of such organ transplantation and means a challenge to all involved in conventional intestinal surgery and modern medical transplantation. PMID- 3303748 TI - [Our surgical heritage. 1987 surgical historical memorial calendar]. PMID- 3303749 TI - [Surgical indications, timing and method in acute pancreatitis]. AB - Treatment for acute pancreatitis was received by 462 patients at the Surgical Hospital of Greifswald University, between 1976 and 1986. Surgical therapy was applied to 117 of 141 patients with necrotising pancreatitis. Lethality rates were 46 per cent in a group with partial necrosis and 86 per cent in another with total necrosis. The Ranson approach was used in operations on 63 of 90 patients with partial necrosis. Their lethality amounted to 23 per cent. 27 patients were given surgical treatment, in spite of unfavourable prognosis, only up to ten days from onset of acute pancreatitis. Lethality in this group was 78.5 per cent. Proper localisation of the necrotic focus is important to prognosis, just as good timing of surgical intervention. Lethality rates were 25 per cent for resection in the caudal region and 38 per cent for necrosectomy of the pars lienalis. Necrosis in the head region entailed a lethality rate of 90 per cent in response to necrosectomy and a rate of 64 per cent with additional lavage. The prognosis of pancrease necrosis is affected by timing and method of surgery. Timing should depend on the clinical pattern, laboratory parameters as well as on findings recorded by computed tomography and ultrasound. Aetiological aspects and location of the process must be considered for choice of surgical techniques. Necrectomy, lavage, and revision of bile ducts seem to be adequate surgical methods. PMID- 3303751 TI - [Our surgical heritage. Hermann Kummell (1852-1937)]. PMID- 3303750 TI - [Pathology, diagnosis and therapy of liver abscess]. AB - Bacterial hepatic abscesses are a rare but serious disease. They develop either secondary to injuries or ischemia of the liver, infections in the drainage area of the portal vein, systemic sepsis or biliary infections. An abscess secondary to injuries or ischemia of the liver or infections in the drainage area of the portal vein, is usually caused by a mixed flora consisting of gramnegative aerobes and anaerobic bacteria. Hepatic abscesses secondary to systemic sepsis contain Staphylococci or Streptococci, while in abscesses on the basis of biliary infections gramnegative organisms are found. Clinically, one can find signs of systemic sepsis, pain in the right upper quadrant and a tender enlarged liver. Jaundice is absent unless a biliary obstruction is present simultaneously. The diagnosis is confirmed by ultrasonography or computerized tomography. An uncertain diagnosis can be confirmed by aspiration under ultrasonographic or computertomographic guidance. The therapy consists of administration of antibiotics and surgical or percutaneous drainage. Surgical drainage via laparotomy is always mandatory if one suspects a primary infectious focus within the abdomen. The mortality of multiple liver abscesses is 20 per cent, that of single abscesses 10 per cent. Amebic abscesses have been observed in nonendemic regions sporadically after travel or spontaneously. Clinical and radiological manifestations are the same as for bacterial abscesses. They are differentiated from bacterial abscesses by positive serology for amebiasis or aspiration which yields the typical anchovy paste. Most important complications are hepato bronchial fistulae, empyema and amebic pericarditis. The therapy consists of a nitroimidazole and a luminal amebicide. Except for diagnostic reasons aspiration is only indicated for large abscesses of the left lobe of the liver. Mortality of an uncomplicated amebic liver abscess should be under one per cent. PMID- 3303752 TI - [Prognostic value of sonography in breast cancer]. AB - The prognostic value of sonography was tested in 108 cases of breast carcinoma. The criteria of prognosis were the low-risk and high-risk groups of histological and cytological gradings, the positive or negative hormone receptors as well as the nodal positive and nodal negative clinical stages. In the low risk group there were mostly elderly women with smaller carcinoma. Under the sonography these tumors were polycyclic and had a dorsal ultrasonic shadow. In the high risk group were younger women with bigger tumors. When scanned they mostly showed branches, a lateral ultrasonic shadow and sound intensification. In general, the different risk groups couldn't be clearly distinguished by sonography. As high disintegrate scanners have not been used long enough, there are no studies to prove their accuracy. We suppose, however, that the accuracy of prognosis can be improved with the new generation of scanners. PMID- 3303753 TI - [Intra-arterial chemotherapy in advanced ovarian cancer. 1. Study conditions and prognostic factors]. AB - The significance of intra-arterial chemotherapy in connection with progressive ovarial carcinomas was investigated within a prospective-randomized study. The patients were selected according to strict precaution in consideration of the factors of prognosis. After operative staging 43 patients got an intra-arterial infusion of MTX and 5-FU, later systematically CMFV (therapy arm A). 42 women were only systematically treated with the CMFV combination (therapy arm B). The histological grading proved as most important feature for the judgement of the malignant power of the tumors. A reliable correlation was found between stage, typing and grading of the tumor which is significant for the individual planning of therapy. A significant improvement of the results of survival could be achieved by intra-arterial therapy in a comparable initial state in both particular groups. This comes close to DDP containing combined schedules. Thus second-line drugs were available during repeated tumor progredience. PMID- 3303754 TI - [Psychotherapeutic aspects in gynecologic ambulatory care?]. AB - The author reports on the iatrogeneous chronification of a functional disturbance in the gynaecological field caused by an approach to it that had been restricted to the somatic sector only. She aims at making the reader think about similar problems among his own patients. This, for comparison, is followed by a report on the successful treatment of a patient suffering from dyspareunia by a therapy of relaxation in connection with talks focused on the existing conflict. The latter patient was discharged from treatment after 12 hours of therapy, free from physical complaints and psychologically matured, whereas the first one had not been free of symptoms even after 155 gynaecological consultations. In the long term, the efficiency of a causal therapy of psychosomatic disturbances is obvious, and we should consider whether--by integrating psychosomatic ways of thinking in our therapy--we could save considerable economic means while contributing to an improvement of the doctor-patient relations. PMID- 3303755 TI - Loss of resistance to the tetracyclines from porcine Escherichia coli in contact with dietary bacitracin methylene disalicylate. PMID- 3303756 TI - Tuberculous infection in cattle not detected by slaughterhouse inspection. PMID- 3303757 TI - [Origin and evolution of peptide-protein bioregulators]. AB - Possible evolutionary pathways of cellular regulatory systems are discussed. Analysis of animal evolution suggests that peptide and protein bioregulators emerged at an early stage during formation of biochemical systems in prokaryotic cells involving protein synthesis on ribosomes, the processes of exo- and endocytosis and limited proteolysis reactions. Primary autocrine bioregulators are compared with growth factors. Models for cellular bioregulation are discussed in which both cell receptors and peptide/protein ligands, primarily immunoglobins, act as prehormones. Their internalization and limited proteolysis can lead to formation of low-molecular peptides (tetines) acting as autocrine or paracrine bioregulators. Basing on the concept of biochemical universality, it is suggested that the effects of many growth factors, hormones, immunoglobulins, mono- and lymphokins are mediated by identical or similar (carrying the same signatures) fragments which are produced in cells due to limited proteolysis reactions and which are directly involved in activation of biochemical systems in these cells. PMID- 3303758 TI - [Functional evolution: origin and problems]. AB - In the article the history of comparative and evolutionary physiology since the early XIX is given. The most substantial methods of evolutionary physiology are described. In the mid-50ies Orbely put forward the suggestion concerning two tasks facing evolutionary physiology, namely the study of evolution of functions and functional evolution. In the present work attention is given to the principles underlying evolution of functions on different levels of physiological systems. The main aspects of functional evolution are discussed. PMID- 3303759 TI - [Use of factor-H sera for the differentiation of the flagellar antigens of Escherichia coli serological variants]. AB - The use of factor sera permitting the differentiation of the variants, described in earlier. works, among the flagellar antigens of E. coli, formally denoted as H2, H4, H7, H10 and H34 in accordance with their official nomenclature, has made it possible to reveal that each of these variants is widely spread among E. coli and occurs in bacteria of different O-groups. Besides, this study has shown the possibility of subdividing a number of formal H: O types into 2 or more serovars on the basis of differences in the factor composition of their antigens. The results obtained in this study suggest that in the process of the evolution of E. coli H-antigen variants differing in their factor composition have been formed as independent varieties; therefore, these variants do not reflect the features characteristic of individual strains, but constitute one of the diagnostic signs of serological classification, i. e. the differentiation of the species into various serovars. PMID- 3303760 TI - [Genetic determination of the vibriocinogenicity trait in Vibrio cholerae of the El Tor biotype]. AB - In two different strains of cholera vibrios two recA-dependent plasmids, pVib I (1.9-2.2 Md) and pVib II (5.2-5.8 Md), have been detected. These plasmids determine the synthesis of vibriocin, coagulase and fibrinolysin, which has been established by the cotransformation of the DNA of plasmids pVib I and pBR322 and by the transfer mobilization with the use of plasmid RP4. PMID- 3303761 TI - [Distribution of epitheliocytes by the number of Candida albicans adhered to them and assessment of the intensity of the adhesion in an in vitro test]. AB - The study of the adhesion test in suspensions, carried out with 9 C. albicans strains and human buccal epithelial cells, has revealed that these cells are exponentially distributed by the number of C. albicans cells adhered to them. To characterize adhesion, the use of the index of the exponent describing the distribution of epithelial cells is proposed. With the use of this index, 5 C. albicans strains isolated from candidiasis patients have been found to possess, on the average, higher adhesiveness with respect to epithelial cells than 4 strains isolated from persons without symptoms of candidiasis. PMID- 3303762 TI - [Phage sensitivity of Streptococcus group A strains isolated in glomerulonephritis]. AB - The study of phage-sensitive strains of group A streptococci of different serological types, isolated from glomerulonephritis patients in Czechoslovakia, has confirmed the data previously obtained in Moscow. As revealed in this study, all strains of type 12, containing M-antigen, are sensitive to group 1 phage from the phage collection used in the investigation. Some of the strains of type 12, containing M-antigen and isolated from healthy carriers, have also proved to be sensitive to group 1 phages. Thus, streptococcal strains of type 12, containing M substance and found to be the main causative agents of glomerulonephritis, have shown similar phage sensitivity when isolated in different geographical zones. For this reason, group 1 phages can be used for the detection of some "nephritogenic" strains among the population. PMID- 3303763 TI - [Modern methods in the serological diagnosis of toxoplasmosis]. AB - A total of 235 sera from patients suspected for toxoplasmosis were examined in the enzyme immunoassay (EIA), complement fixation, indirect immunofluorescence (IIF) and indirect hemagglutination (IHA) tests carried out in parallel. Good correlation between all tests was noted. As confirmed by the data obtained in this investigation, EIA showed the highest sensitivity. In IIF and IHA tests the maximum titers (1:512) were obtained in 2% of cases, while in EIA 17.5% of sera were positive in titers of 1:800 to 1:25,000. High sensitivity and good reproducibility of this assay suggest the necessity for its standardization and automation, which will permit its further use in laboratories at any level. PMID- 3303764 TI - [Determination of the binding constants of immune serum antibodies to human IgG]. AB - The possibility of using two variants of the enzyme-linked fluorescent cofactor immunoassay for the determination of antibody binding constants has been demonstrated. The determination of binding constants for antibodies isolated by affinity chromatography techniques has been carried out. These techniques permit the isolation of fractions, differing in their affinity by 5-10 times, from the whole population of antibodies. PMID- 3303765 TI - [Ecological problems of the rickettsiae]. PMID- 3303766 TI - [Role of complement in protecting the macroorganism from bacteria]. PMID- 3303767 TI - [Prediction of various categories of recovery in craniocerebral injuries and the informative value of clinical signs]. AB - The authors studied the informative value of clinical signs of craniocerebral trauma (CCT) in relation to the prediction of different categories of recovery. Using a package of applied programmes MEDSTAT-85 a clinical pool of the findings about the status of 302 patients examined by a uniform technique was subjected to clinical analysis. The optimal set of clinical indicators for predicting different categories of recovery in the first 24 hours after the CCT with an average accuracy of 80% is described. PMID- 3303768 TI - [The role of K.I. Noishevskii in the development of Soviet clinical neurology]. PMID- 3303769 TI - [Clinico-genetic aspect of the relation of the schizoid character anomaly and schizophrenia (review of the literature)]. PMID- 3303770 TI - Abdominal hernioplastics sewn by horizontovertical mattress sutures. AB - An abdominal reconstruction made by overlapping is reported. Operation was performed by horizontovertical mattress sutures. It did not significantly impair the vascularization and innervation of the tissues, representing, therefore, both anatomically and functionally favourable type of reconstructive operation of the abdominal wall. PMID- 3303771 TI - Two cases of traumatic denudation of the penile and scrotal skin. AB - Two cases of denudation injuries of the penis and the scrotum are reviewed. In the first case a total skin erosion of the penis and scrotum has happened. In the second injury, the major part of the skin was lost. The reconstructive operations are shown in a series of photographs. Replacement of the total skin deficiency was performed by placing a split-thickness graft on the penis, while reconstruction of the scrotum was carried out by using a thigh pedicle flap. In the second case partial loss of the skin could be replaced by mobilizing the free skin edges. PMID- 3303772 TI - [Breast-sparing surgery in T1 breast carcinoma]. AB - 31 female patients with a T1 No N1a Mo breast tumour (diameter smaller or equal to 2 cm) were treated by segmental resection with complete axillar dissection, followed by radiotherapy. Chemotherapy was given in any case of axillary lymph node involvement. The mean follow-up period was 44 months. Absolute survival is 100%. One patient (3%) developed distant metastasis, 2 patients (6%) had a loco regional recurrence and 3 presented with a metachronous tumour in the contralateral breast. 97% of the patients are actually alive and free of disease. PMID- 3303773 TI - [Current status of fibrinolysis--a literature review of 25 years of fibrinolytic treatment]. AB - Thrombolytic therapy is an effective, rapid method in treatment of massive lung embolism and major deep venous thrombosis extending to the caval vein. Besides resolution of the thrombus and improving hemodynamics, it prevents evolution to chronic pulmonary hypertension or postphlebitic syndrome. To have a beneficial effect in the early course of acute myocardial infarction, thrombolytic therapy should be instored within about three hours after the onset of pain; a real brief time limit. Intracoronary or systemic fibrinolysis later than the three hours period does not improve cardiac wall motion and hemodynamics and cannot assure infarct size reduction in spite of reestablished coronary flow. In peripheral arterial disease, fibrinolytic therapy of thrombosed grafts or vessels facilitates detection and unmasking of the underlying anatomical lesion permitting definite therapy (graft revision, percutaneous transluminal angioplasty). Selective intraarterial infusion has given encouraging results. Thrombolysis is a reasonably safe therapeutic method, on the condition of respecting all contraindications and avoiding unnecessary punctions. Allergy and hyperthermia are mostly benign and responsive to medical treatment. Cost effectiveness renders streptokinase the most applicated thrombolytic agent. PMID- 3303774 TI - Organ donation in Belgium: discrepancy between offer and demand. AB - Belgium shows one of the highest numbers of patients with terminal renal failure, treated by means of dialysis, compared to other European countries. Transplantation accounts for only one third of the therapeutic modalities in these patients. As the number of new patients, presenting with terminal renal failure, is equally rising, an always growing discrepancy exists between offered kidneys and patients, desperately waiting for these organs. The same holds true for other organs, as heart, pancreas and liver. This study examines the multiple causes that induce this growing discrepancy and points to some solutions and suggestions that can deal with it. PMID- 3303775 TI - [Multiorgan procurement]. AB - Standardization of the organ procurement techniques, as initiated by Starzl, allows an equal protection of all thoraco-abdominal organs. Therefore in each donorcenter, every potential donor has to be considered as a multi-organ donor. In order to reduce the percentage of primary non-functioning grafts, specialized procurement teams should be formed and further research for adequate donor assessment criteria is needed. PMID- 3303777 TI - Arterioenteric fistula. Review of a vascular emergency. AB - Fistula between the arterial system and the gastrointestinal tract is rare, but can give rise to life-threatening bleeding. The fistula may be primary or secondary. A review of cases in the literature is presented and a classification based on type and cause is proposed. The collected series comprised 249 cases of primary, and 631 of secondary arterioenteric fistula. The dominant cause was aortic aneurysm in the primary and vascular reconstructive surgery in the secondary cases. As the prognosis is poor and aortoiliac reconstructive surgery is increasingly performed, awareness of arterioenteric fistula as a possible cause of gastrointestinal haemorrhage is important. PMID- 3303776 TI - Surgical complications in human orthotopic liver transplantation. AB - Between March 1, 1980 and December 31, 1984, 393 orthotopic liver transplantations (OLT) were performed in 313 consecutive recipients. Technical complications were responsible for a substantial morbidity (41/393 allograft loss -10.4%) and mortality (26/313 patient loss--8.3%). Failure of the biliary tract reconstruction, mainly expressed as leakage and obstruction, is the most frequent complication of OLT (52/393 grafts--13.2%). Biliary tract complication (BTC) was directly responsible for 5 deaths (9.6%). Reliance upon standardized methods of direct duct-to duct repair with T-tube (CC-T) and Roux-Y choledocho-jejunostomy (RYCH-J), appropriate postoperative investigation and treatment will reduce morbidity and mortality of BTC. A complicated CC-T will be conversed to a RYCH-J; a complicated RYCH-J needs surgical correction. Hepatic artery thrombosis (HAT) has become the "Achilles heel" of OLT. HAT is expressed by three different patterns: fulminant hepatic necrosis, delayed bile leakage and relapsing bacteremia. Diagnosed in 27 grafts (6.8%), HAT was responsible for 16 deaths (16/25 pat: 64%). The only chance to rescue patients presenting HAT is an early diagnosis and prompt retransplantation before occurrence of septic complications. Aneurysm of the hepatic arterial supply (4/393 grafts--1%) also needs aggressive surgery because of the high rate of fatal rupture (3/4 pat--75%). The incidence of thrombosis of the reconstructed portal vein (PVT) was only 2.2% (7 pat.), three inferior vena caval thromboses (0.9%) (CVT) were diagnosed after OLT. Four of the 7 patients whose portal veins clotted are alive. Three have their original graft. One patient, presenting both PVT and CVT, was rescued by prompt retransplantation. PVT was responsible for 3 patient (3/7 pat--42.8%) and 4 graft losses (4/7 pat--57%). The rate of graft (3/3) and patient loss (2/3) was even higher after CVT. PMID- 3303778 TI - [Anti-Leishmania monoclonal antibodies of hybridoma origin]. PMID- 3303779 TI - Acta Clinica Belgica: forty years. PMID- 3303780 TI - Memories of a half century professional life. PMID- 3303781 TI - Can desensitization of the B-cell to D-glucose be simulated in cultured pancreatic islets? AB - In order to investigate the phenomenon of B-cell desensitization to D-glucose, rat pancreatic islets were cultured for 20-44h in the presence of increasing concentrations of D-glucose in the 5.6 to 27.8 mM range, and then incubated for 30 to 120 min for measurement of secretory, metabolic and ionic variables. After culture in the presence of 5.6 mM D-glucose, the release of insulin evoked by D glucose (16.7 mM) was less marked than that seen in islets cultured in the presence of 11.1 mM D-glucose. In the latter islets, the secretory response to D glucose (8.3 mM or more) was still modest, especially over short periods of incubation, but was markedly enhanced by either theophylline or forskolin. The release of insulin evoked by D-glucose in the presence of theophylline was little affected by either Ca2+ concentration of the culture medium or length of culture period (20h vs 44h). The culture-induced alteration in the responsiveness to D glucose coincided with a smaller relative increase of D-[5(3)H]glucose utilization, D-[U-14C]glucose oxidation or net 45Ca uptake at increasing concentrations of the hexose. It contrasted with a well-preserved secretory response to nonnutrient secretagogues. Although these findings could be interpreted as evidence of B-cell desensitization to D-glucose, the fact that the secretory behavior of the islets was not vastly different whether they were first cultured at physiological (8.3 mM) or higher (11.1 to 27.8 mM) concentrations of D-glucose suggests that this experimental design may not be an optimal model for the functional alteration of the B-cell in hyperglycemic non-insulin-dependent diabetic subjects. PMID- 3303782 TI - Renal lesions in a strain of spontaneously diabetic WBN/Kob rats. AB - In WBN/Kob strain rats, only males spontaneously develop hyperglycemia, glycosuria, hypoinsulinemia and glucose intolerance from about nine months of age. The kidneys of male rats of this strain were histopathologically studied to evaluate the changes which appeared as complications of diabetes mellitus. Thickening of the basement membrane, increase of the mesangial matrix and fibrin cap lesions were noted in the glomeruli. Armanni-Ebstein degeneration was occasionally found in the tubules. Linear deposition of plasma components such as IgG and albumin in the basement membrane of the glomeruli, tubules and Bowman's capsule characterized the immunohistological pattern. These findings are similar to the findings in diabetic nephropathy in humans. Since the onset of diabetes mellitus in the strain is slow and symptoms are generally mild, insulin administration is usually not necessary for survival. This strain, therefore, appears to be an important animal model for the study of complications of diabetes in humans. PMID- 3303784 TI - Effect of antithyroid autoantibodies on pancreatic islet-cell function. AB - Insulin-dependent diabetes mellitus is frequently associated with organ-specific autoimmune diseases and/or high titers of organ-specific autoantibodies. The effects of thyroid autoantibodies on islet-cell function were examined in the present study. Islet cell surface antibody (ICSAb) was detected in sera from 6 of 40 patients with autoimmune thyroid disease (AITD) who were positive for thyroid microsomal autoantibodies (TMA). Furthermore, all of the ICSAb-positive patients had high TMA titers. In vitro study using isolated rat pancreatic islets revealed that TMA positive sera significantly suppressed glucose-induced insulin release. Only one of 19 (5%) AITD patients showed complement-dependent antibody-mediated cytotoxicity and only one of 6 AITD patients (17%) was positive for antibody dependent cellular cytotoxicity. These results suggest that TMA has an effect on an antigen of the islet cell membrane in which insulin releasing mechanism might be involved. PMID- 3303783 TI - Early and late effects of thyroid-stimulating hormone treatment. Studies on pancreas cytology, blood sugar, serum insulin and free fatty acids. PMID- 3303785 TI - Continuous insulin infusion therapy and retinopathy in patients with type I diabetes. AB - The effect of continuous subcutaneous insulin infusion (CSII) and conventional injection therapy (CIT) on retinopathy was evaluated in a 1-year crossover study (6 + 6 months) with 54 type I diabetic patients. The glycaemic control improved significantly but did not reach euglycaemic levels during CSII (P less than 0.01 0.001), whereas no change was observed during CIT. At baseline, 50% of the patients had no retinopathy, 20% had only minimal changes, 26% had moderate background retinopathy, and 2 patients had proliferative changes. During CSII, the retinopathy grade impaired in 7 patients, whereas no deterioration occurred during CIT. Improvement of retinopathy grading was observed in 2 patients during CSII and in 5 during CIT, respectively. Individual retinal lesions also progressed more and improved less during CSII (12:3) as compared with CIT (10:9). The net impairment in both retinopathy grading and individual lesions was significant during CSII as compared with CIT (P less than 0.05). There was no difference in the baseline characteristics (severity of retinopathy, age, sex, duration of diabetes, insulin dose, blood pressure, serum creatinine), in the fall of glycosylated haemoglobin or number of hypoglycaemic episodes between the patients with and without worsening of retinopathy during CSII. The present study suggests that even a moderate improvement in metabolic control induced by CSII may be associated with a risk of progression of retinopathy during the first months of therapy. PMID- 3303786 TI - Are Leydig cells of neural origin? Substance P-like immunoreactivity in human testicular tissue. AB - Using the immunocytochemical peroxidase-antiperoxidase method we observed strong and selective staining of Leydig cells after incubation of human testicular tissue with an antiserum against substance P and a slightly weaker immunoreactivity against methionine-enkephalin. These results indicate that the embryologic origin of Leydig cells may require reconsideration and also offer a new perspective for research upon the local control mechanisms of spermatogenesis. PMID- 3303787 TI - Differential effect of desglycinamide9-(Arg8)-vasopressin on cognitive functions of diabetes insipidus and alcoholic patients. AB - Intranasal treatment with desglycinamide9-(Arg8)-vasopressin (DGAVP) improved certain aspects of cognitive functions of patients with acquired and congenital diabetes insipidus and of alcoholic patients with mild cognitive impairments. Patients with Korsakoff's syndrome, presenting with severe cognitive impairments, were resistent to DGVP treatment. DGAVP treatment did not affect blood pressure and water metabolism. The action of DGAVP on cognitive functions is probably mediated by centrally located target sites and may be expressed only in patients in whom these target sites are unimpaired. PMID- 3303788 TI - Effects of high-dose ketoconazole treatment on adrenal mineralocorticoid biosynthesis in dogs and rats. AB - At high doses, ketoconazole blocks both testicular and adrenal androgen biosyntheses and partially inhibits the glucocorticoid production. To investigate the effects of this imidazole derivative on the mineralocorticoid biosynthesis, 7 male mongrel dogs received a single oral dose of 15 mg/kg of ketoconazole or placebo, in a cross-over way. From 2 to 4 h after treatment, an iv infusion of angiotensin II (10 ng/kg per min) was performed. Ketoconazole treatment significantly blunted the aldosterone and cortisol increment, whereas 18 hydroxycorticosterone, corticosterone, 11-deoxycorticosterone (DOC), progesterone, and 17 alpha-hydroxyprogesterone rose to peak concentrations, respectively 2.5-, 6-, 8-, 2.5- and 1.5-fold higher than those observed after placebo administration. Plasma 11-deoxycortisol and renin activity levels remained similar in both groups. On the other hand, 2 X 2 groups of 10 male adult rats each were fed with a normal or a sodium-depleted diet. Of the two sets of groups, one was treated ip with ketoconazole (20 mg/kg twice a day), the other with vehicle solution. In animals on either diet, ketoconazole lowered 18 hydroxycorticosterone and aldosterone concentrations. Plasma DOC rose up to 25 fold in the salt-deprived animals. Serum Na+, Cl-, corticosterone and plasma renin activity remained unaffected by the treatment. These results show that high dose ketoconazole treatment partially inhibits the biosynthesis of aldosterone by affecting the cytochrome P-45011 beta.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3303789 TI - Thyroid cell MHC class II antigens: a perspective on the aetiology of autoimmune thyroid disease. AB - An association exists between certain MHC polymorphisms and autoimmune thyroid disease in animals and humans. The observation of MHC class II antigen expression by the thyroid suggests that such associations may have mechanistic explanations at the level of the thyroid cell. Such class II antigen expression, rather than being a constitutive property of thyroid epithelium, appears to be primarily mediated by lymphokine secretion from intrathyroidal T lymphocytes and a variety of agents, for example TSh and TSH receptor antibodies, may amplify such lymphokine action. Thyroid cell class II antigens participate in activation and amplification of T cells and are involved in presentation of thyroid antigen to the immune system. The relationship between these local immune interactions and the initial events leading to the development of autoimmune thyroid disease requires a more fundamental understanding of the workings of the immune system at the site of antigenic stimulation. PMID- 3303790 TI - Growth factor receptors in thyroid follicle cells. PMID- 3303791 TI - Insulin and insulin-like growth factor-I (IGF-I) regulate differentiation as well as growth in FRTL-5 cells. PMID- 3303792 TI - Effects of high and low doses of methimazole in patients with Graves' thyrotoxicosis. AB - In spite of the long-established use of antithyroid drugs, there are many unsettled questions connected with this treatment of Graves' disease. There is a lack of controlled prospective trials studying the results of antithyroid drug therapy while considering the many variables such as disease heterogeneity, regional differences, drug dosage and duration of treatment. Therefore, a multicenter study has been set up in order to compare the effects of two fixed doses of methimazole (10 vs 40 mg) with thyroid hormone supplementation on the clinical, biochemical and immunological course of Graves' disease and on remission rates. Experience accumulated so far suggests that treatment is safe using either 10 or 40 mg of methimazole. While there is a tendency for an advantage of the higher dose within the first weeks (higher effectiveness in controlling hyperthyroidism), this difference is not significant. The impact of dosage on remission rates remains to be shown. PMID- 3303793 TI - Ciamexon-treatment in endocrine ophthalmopathy. AB - In severe cases of e.o. IV to VI combined treatment with Cyclosporin A and corticosteroids is most effective whereas Ciamixon alone appears to be less effective. Patients who received Ciamexon some time after termination of Cyclosporin A treatment showed slight ophthalmological improvement or stabilization of the status (judged after short time of therapy). Patients with e.o. III (IV), treated ineffectively with only corticosteroids before, showed a tendency of improvement under Ciamexon treatment. PMID- 3303794 TI - Concept of a multigenic basis for the pathogenesis of spontaneous autoimmune thyroiditis. AB - The review presents a concept for the pathogenesis of spontaneous, organ-specific autoimmune diseases that take into account an altered immune regulation, modulating hormonal influences and a genetically determined primary susceptibility of the target organ for the autoimmune attack. The concept is exemplified by means of the Obese strain (OS) chicken model which develops a spontaneous hereditary autoimmune thyroiditis. In respect to the the altered function of the immune system both, MHC associated (Ir) and non-MHC associated genes are involved. The MHC, i.e. a certain haplotype, only plays a modulatory role in determining the frequency and severity of spontaneous autoimmune thyroiditis, while the presence of certain non-MHC associated genes is a absolute prerequisite for the emergence of the disease. The latter is also true for the genetically determined target organ susceptibility, while hormonal factors, notably sex-steroids and glucocorticoids, again only have a facultative, modulatory effect. Only if an appropriate genetic constellation concerning the non-MHC encoded aberrant immunological function and genes coding for the susceptibility of the thyroid gland for the autoimmune process is present, severe autoimmune thyroids develops. PMID- 3303795 TI - [Clinical value of endotoxin determination in infection. Comparison of the Limulus amebocyte lysate test with detection of bacterial pathogens]. AB - To evaluate usefulness of Limulus amoebocyte lysate test and blood culture in the diagnosis of septicemia both tests were performed in 27 intensive care patients. Test results were compared with a clinical sepsis score. Ten (62%) out of 16 patients with clinical diagnosis of septicemia showed a positive endotoxin test and 11 (69%) a positive blood culture. In 14 patients (87%) either endotoxin test or blood culture revealed a positive result. Two out of 11 patients (20%) classified by the sepsis score as non-septic showed positive blood cultures as well as positive endotoxin tests. 4 patients with gram-positive bacteria in the blood cultures showed a positive endotoxin test. Due to lack of sensitivity and specificity the Limulus amoebocyte lysate test is of rather low value in the diagnosis of septicemia. Simultaneous performance of Limulus amoebocyte lysate test and blood culture is able to improve the sensitivity, which then over-rules the one obtained when only blood cultures are performed. PMID- 3303796 TI - [The best time for surgery in leprous neuritis from today until the year 2000]. PMID- 3303797 TI - [Surgical aspects of perforating plantar lesions and mutilations of the foot]. PMID- 3303798 TI - A mobile shoemaker's in Senegal to prevent plantar leprosy ulcers. PMID- 3303799 TI - [Reconstructive surgery in paralysis of the intrinsic muscles of the fingers: I. The Palande operation for the correction of paralysis of the intrinsic muscles of the fingers]. PMID- 3303800 TI - [New technic of palliative intervention in paralysis of the intrinsic muscles of the hand (cubital paralysis in Hansen's disease)]. AB - On a single poster, drawings explain a surgical technique we performed for some time in the Institut Marchoux on souple clawed fingers in hansenian ulnar palsy. Sketches at first recall anatomy physiopathogeny's principles and hence usual operations yet performed, then the main steps of our method. Its qualities are simplicity, speediness and compatibility with other treatments. In spite of being too recent for a proper view, results are already hopeful. PMID- 3303801 TI - [Treatment of perforating plantar lesions by decompression of the posterior tibial nerve and the vessels of the tarsal canal]. PMID- 3303802 TI - [Instruction sheet for palliative surgery in leprosy]. PMID- 3303803 TI - [The evolution of endemic leprosy throughout the world]. PMID- 3303804 TI - [Short-term clinical and histological evaluation of combination drug therapy of leprosy in Mayotte]. AB - Leprosy in Mayotte affects 480 persons in a population of 80,000 inhabitants. 229 patients have been treated every day by association of Rifampicin, Clofazimine and Isoniazide. This study make a clinical, histological and bacteriological valuation after treatment, during a period of 3 years. With paucibacillary patients, whom received 1 year of mean treatment and after 2 years under observation, histology for short-dated can stay positive and active. With multibacillary patients, whom received 26 months of mean treatment and most of the time after 1 year under observation, the all of morphological index is negative, sometime bacteriology is positive, less often than histology. For middle- and long-dated, histology should allow a good valuation for disease evolution, specially for interpolar leprosy patients. PMID- 3303805 TI - Histoid leprosy--a histopathological reapparel. AB - Twenty three clinically diagnosed histoid leprosy patients were subjected to histopathological and histochemical investigations. The histopathological features were comprise of a well-formed lesion surrounded by a pseudocapsule. In addition, a free, midly eosinophilic, uninvolved sub-epidermal zone, and variously arranged spindle-shaped histiocytes were noted in the lesion. Polygonal and foamy histiocytes were also sited in a few sections. The lesion also had a large number of solid staining acid-fast lepra bacilli. The latter might have stimulated a peculiar histiocytic tissue response almost identical to that seen in histiocytoma(cutis) but for the absence of haemosidrin and lipids. PMID- 3303806 TI - [The long and difficult research for indications and methods of treatment of leprous neuritis]. PMID- 3303807 TI - [Suspicion of paucibacillary leprosy resistant to dapsone: importance of follow up]. AB - Behind the story of one paucibacillary patient treated by dapsone monotherapy, the authors discussed on the possibility of relapse. But the therapy course, observed by DDS/Urine examination shows a default of the patient. The problems of follow up and attendance of the patient are discussed. PMID- 3303808 TI - [The history of leprosy]. PMID- 3303809 TI - Studies on the prevalence of paralysis agitans by tracer methodology. AB - The present study was motivated by the methodological issues revealed by a review of previous studies on Paralysis Agitans (PA) epidemiology. The study was given the following aims: To identify an easy available, inexpensive marker of PA frequency in populations; to develop, standardize and validate a model for measurement of PA prevalence by using that tracer; to study the geographical distribution of PA in Sweden, and to use the model in environmental risk analysis (ERA) for PA. Information on diagnoses and anti-parkinsonian drugs (APD) utilization from Swedish registers was analyzed, in order to select the group of APD which would best fulfill the prerequisites of specificity and preference of choice, and combined with prevalence data from direct surveys. Levodopa drugs were found to be the most suitable tracer for PA prevalence. A mathematical model was formulated to generate annual estimates for average age specific prevalences from total sales of levodopa, age specific population and figures for infant mortality rates. The following was required in order for the model to yield accurate estimates: high quality of the information to be used, good availability of levodopa drugs, a minimal size of the studied population of 100,000, an IMR lower than 28.8 per 1000 and that levodopa diffusion had reached the late adoption phase. Underdiagnosis was found to constitute an important cause of bias in classical surveys. Standardization for age and health services effectiveness by using infant mortality rates was shown to improve comparability of prevalence figures. The model was validated and showed internal consistency for age specific data on levodopa sales and on prevalence from Sweden and six Chinese towns, respectively. Estimates for prevalence for Iceland and Sardinia fitted historical data from direct surveys. The results of the ERA study showed that a high latitude and a low population density in 1900-20 were correlated with an increase in PA prevalence as measured by surveys or estimated by the use of the tracer method. Further analysis indicated that several so-called risk factors or concomitant diseases are associated with low population density. The geographical distribution of standardized PA prevalences in Swedish counties was studied for the period 1977-84. The findings were in accordance with the figures expected from the natural characteristics of the disease as determined by latitude and population density except in the county of Gavleborg which showed a significantly higher, and continuously increasing prevalence.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3303811 TI - The University of Bergen School of Dentistry 1962-1987. PMID- 3303810 TI - Expression of glial fibrillary acidic protein in human glioma cell lines as detected by molecular hybridization. AB - The expression of glial fibrillary acidic protein (GFAP) in continuous glioma and non-glioma cell lines was evaluated by molecular hybridization and immunocytochemistry. RNA transcripts from the GFAP gene were detected in two of six cell lines by Northern blot analysis of cellular RNAs using a cloned mouse GFAP cDNA probe. The probe recognized a single GFAP RNA species of 2.7 kilobases under high-stringency washing conditions. The presence of GFAP transcripts as determined by molecular hybridization corresponded to the immunocytochemical detection of GFAP using two different monoclonal antibodies to this protein. These data indicate that GFAP expression in human cells can be detected by molecular hybridization using a murine GFAP cDNA probe, illustrating the high degree of inter-species conservation of GFAP. Molecular hybridization represents a reliable and sensitive method for the detection of GFAP expression in vitro, which can be used in conjunction with or as an alternative to immunocytochemistry. PMID- 3303812 TI - The effect of maxillary protraction on front occlusion and facial morphology. AB - The intention of this work was to study the dentoalveolar and basal jaw changes in a group of children (aged 5-10 years) with nonforced anterior crossbite treated with maxillary protraction from a face mask and to compare the changes with those found in a control group with normal dentoalveolar and basal maxillomandibular relationship. The data were obtained from lateral cephalograms of 22 children taken before treatment, after a treatment period of 3-12 months, and after an observation period of 6-48 months. A group of children (n = 40) with normal maxillomandibular relationship served as controls. During treatment the mandibular prognathism was reduced, and a positive overjet was established in 18 children. The changes during the observation period were generally comparable to those found in the control group, and thus indicated a very small relapse tendency. The posttreatment comparison of the groups showed fewer significant differences than before treatment, indicating that the treatment had a normalizing effect not only on the negative overjet but also on the general face morphology. PMID- 3303813 TI - Oxytocin- or low-dose prostaglandin F2 alpha-infusion for stimulation of labor after primary rupture of membranes. A prospective, randomized trial. AB - One hundred consecutive women with singleton pregnancies and primary rupture of membranes (PROM) after 36 weeks of gestation were included in a prospective, randomized trial of intravenous infusion of oxytocin (up to 30 mIU/min) versus low-dose prostaglandin F2 alpha(PGF2 alpha, up to 6.0 micrograms/min). Cesarean section was performed in 12 patients because of suspected disproportion or intra uterine asphyxia. Effective contractions or labor progress failed to become established within 8 hours in another 4 women stimulated with PGF2 alpha and 2 stimulated by oxytocin. The stimulation delivery time (hours) for the remaining 82 women treated with PGF2 alpha or oxytocin, respectively was 8.7 against 12.1 for initial Bishop score less than 5 (p less than 0.01), (Mann-Whitney test), 7.2 vs. 7.1 for Bishop score 5-8 and 5.7 vs. 4.2 for Bishop score greater than 8. Patients with initial Bishop score less than 5 seemed to need analgetics less often when treated with PGF2 alpha than with oxytocin. Frequencies of side effects and instrumental deliveries as well as the fetal outcome were similar for the two treatment schedules. The results of the study suggest that low-dose PGF2 alpha infusion may be the more appropriate treatment for women with an unfavorable initial Bishop score. PMID- 3303814 TI - Longitudinal ultrasonic biometry of various parameters in fetuses with abnormal growth rate. AB - The growth rate of various organs and parameters was evaluated by ultrasound examination in one group of small-for-gestational age (SGA) and another group of large-for-gestational age (LGA) fetuses. Three different patterns of growth were selected in the SGA group and two different types of growth acceleration were observed in the LGA group. On the basis of these results, it has been concluded that the type of intra-uterine growth retardation or acceleration is dependent more on the time at which the insult which brings it on, appears, and less on the specific etiological factor. PMID- 3303815 TI - Ruptured episiotomia resutured primarily. AB - In a randomized study, 35 patients with ruptured episiotomy were treated in two ways. One group, treated with Clindamycin and primary resuture, did better than the other group, not resutured but spontaneously healed. PMID- 3303816 TI - Herpes gestationis. AB - A case of clinically typical herpes gestationis is presented. The diagnosis was confirmed by light microscopy and immunofluorescence studies. The symptoms subsided at delivery, but recurred during subsequent oral contraceptive medication. The newborn infant was affected temporarily. The treatment, the fetal risk and the implications of the diagnosis on future pregnancies and contraceptive therapy are discussed. PMID- 3303817 TI - Corneal transplantation using 4-week banked donor material. Long-term results. AB - Thirty-six corneal transplantations employing banked donor material maintained during prolonged storage (mean: 29.5 days) in organ culture at 31 degrees C were followed for 5 years. The overall graft survival was 80% , and graft failures were almost exclusively found in a pre-operatively defined risk group where the survival rate was 49.6% compared with 95.5% in the non-risk group. Five years after transplantation the mean central thickness of surviving grafts was 0.52 mm and the mean endothelial cell density 862 cells/mm2. All grafts were optically clear judged by slit-lamp appearance even though a higher degree of light-scatter was demonstrated compared with controls. The functional results were satisfactory with an over-all mean visual acuity of 0.67 cc. Excluding cases where low visual performance had non-corneal causes, 88% of patients obtained 0.5 cc or better. The median spherical equivalent of corneal curvature was 8.23 mm and the median astigmatism 4 diopters. Intraocular pressure was normal, and all grafts had obtained some degree of sensibility, although reduced compared with controls. The study demonstrates that banked donor material can be successfully employed for corneal transplantation achieving favourable long-term results. PMID- 3303819 TI - Immunological barriers in the nose and paranasal sinuses. AB - This review deals mainly with lymphocyte subsets in the human nasal mucosa, and with the common cold. Lymphocytes have recently been characterized in biopsy specimens by an immuno-histochemical method (the avidin-biotin, monoclonal antibody peroxidase technique). In summary, the overall T:B cell ratio was 3:1 and that of T helper cells to T suppressor was 2.5:1; topographical differences within the nasal mucosa were identified. Non-specific defence systems, such as interferon, provide some protection against rhinovirus infection, but most important is the presence of specific antibodies against a given antigenic type of virus. Recent results have suggested that a rhinovirus infection does not cause a marked destruction of the epithelial lining, that it is spotty in the nasal mucosa, and that it is most prominent in the nasopharynx. Increased knowledge about the site of infection and how symptoms are produced is essential for a rational approach to the development of anti-viral therapy. PMID- 3303818 TI - Immunobarriers of the tubotympanum. AB - The tubotympanum is protected by an immune system in addition to the mucociliary, secretory (antibacterial substance), and phagocytic defense systems. The immune protection is provided by innate and adaptive immune systems. With the latter, the tubotympanum is protected by both the local (humoral and cellular) and the systemic immunity. The major immunoglobulins involved are IgG, IgM (SIgM), and SIgA, although IgE and IgD may also be involved. PMID- 3303820 TI - Tonsils and lympho-epithelial structures in the pharynx as immuno-barriers. AB - The tonsils are mucosa-associated lymphoid organs. Several details regarding their normal function and pathological alteration are still unknown. In this review the relationship of the tonsils to similar lymphoid organs is discussed, the possibilities of antigen uptake (M cells and micropores of the crypt epithelium) are demonstrated, and alterations of the crypt epithelium due to recurrent tonsillitis are described. Further studies are required for the better understanding of tonsillar diseases. PMID- 3303821 TI - Critical evaluation of the immunofluorescence microscopic test for identification of serum antibodies against human inner ear tissue. AB - One hundred and nineteen serum samples from patients with bilateral sensorineural hearing loss of unknown etiology were investigated for the presence of antibodies against homologous inner ear tissue. 54% of all investigations revealed a binding of serum immunoglobulins even after repeated checks, whereas the investigation of 25 control sera of healthy subjects revealed a false-positive result in only one single case: in this control subject, a manifest rheumatism could be diagnosed later. A correlation between the positive result of the immunofluorescence test and clinical parameters which might indicate a pathoimmune mechanism could not be detected. The question arose as to whether immunologically induced alterations in the region of the human inner ear can be demonstrated at all with the methods of investigation in clinical use today to detect a systemic pathoimmune mechanism. PMID- 3303822 TI - Langerhans' cells in chronic otitis media. AB - Langerhans cells (LCs) were studied in chronic otitis media (COM) by the immunoperoxidase technique and monoclonal antibodies. The LCs were a regular finding in both thin and thick cholesteatoma epithelium, and in open cavity skin. OKT-6 positive cells were also found in smaller numbers in subepithelial connective tissue and lymphoid follicles, and in cuboidal secretory epithelium. LCs form an important part of the immune defence system of the skin, which lacks the humoral secretory IgA defence mechanism of the mucous membranes. There is no proof that LCs are connected with the keratinization process and possible reformation of cholesteatoma. PMID- 3303823 TI - A randomized phase III trial of cisplatinum, methotrexate, cisplatinum + methotrexate, and cisplatinum + 5-fluoro-uracil in end-stage head and neck cancer. AB - In a previous phase III trial of chemotherapy for patients with end-stage squamous cell carcinoma of the head and neck we have shown that Bleomycin shortened the survival period, compared with untreated controls. The survival of patients treated with Cisplatinum and Bleomycin did not differ significantly from untreated patients, but Cisplatinum significantly prolonged survival. A further similar trial is reported here, the four treatment arms were Methotrexate alone, Cisplatinum alone, Cisplatinum + Methotrexate, and Cisplatinum + 5-Fluoro-uracil. The response rates were: Methotrexate alone 19%, Cisplatinum alone 40%, Cisplatinum + Methotrexate 31%, and Cisplatinum + 5-Fluoro-uracil 33%. The median survival time for the Cisplatinum alone group, 260 days, was significantly longer than the 80 days for the Methotrexate alone group. The median survival times for Cisplatinum + Methotrexate (160 days) and for Cisplatinum + 5-Fluoro-uracil (200 days) did not differ significantly from that for Cisplatinum alone. PMID- 3303824 TI - [Automatic analysis of vestibular response using microcomputers: application in roto-acceleratory tests]. PMID- 3303825 TI - [Pharmaco-pupillometry with methacholine in Meniere's disease]. PMID- 3303826 TI - Alveolar destruction in experimental Klebsiella pneumonia. AB - Sequential histological changes of the lungs were studied in experimental Klebsiella pneumonia, using untreated control mice, cyclophosphamide-treated mice, and carrageenan-treated mice. Cyclophosphamide was used to deplete polymorphonuclear leukocytes and monocytes, and carrageenan was used to deplete mononuclear phagocytes selectively. At 72 hours, varying degree of alveolar necrosis could be seen in untreated control mice. However, the lung lesions of cyclophosphamide- or carrageenan-treated mice were significantly different from those of the control mice. The lung lesions of cyclophosphamide-treated mice indicated that destruction of the alveolar septa was not induced by K. pneumoniae itself but by inflammatory cells, because the alveolar walls were preserved very well in spite of considerable bacterial multiplication in alveolar lumina until infiltration of inflammatory cells occurred. The lung lesions of carrageenan treated mice showed that alveolar spaces were packed with polymorphonuclear leukocytes, but the alveolar walls were preserved very well as far as the authors could tell after examining the lung lesions by silver impregnation staining. These results suggest that macrophages rather than polymorphonuclear leukocytes and organisms play an important role in alveolar injury in experimental Klebsiella pneumonia. PMID- 3303827 TI - Atherosclerosis and endothelium. Part 1. A simple method of endothelial cell culture from human atherosclerotic aorta. AB - A simple and highly reproducible culture method of aortic endothelial cells from cadaver is herein reported. Major bacterial contamination could be prevented by administration of an antibiotic cocktail consisting of gentamicin, ampicillin, and amphotericin B. Endothelial cells from the thoracic aorta were viable up to 17 hours postmortem and successfully culturable from the aorta by dispase desquamation from the subendothelial substrate. The cultured cells varied in size and shape depending on the degree of individual atherosclerotic severity and could be divided into two major subtypes. The first type is a small and polygonal uniform cell (typical endothelial cell) and the second type is a mixture of spindle and giant bizarre cells often associated with multinuclei (variant endothelial cell). Both types of endothelial cells have characteristics specific for endothelium, such as factor VIII related surface antigen, Weibel-Palade body, and high productivity of prostacyclin. PMID- 3303828 TI - An altered lectin binding to mucus glycoprotein in goblet cells of human tracheobronchial epithelium among former mustard-gas workers. AB - Lectins, which are well known to have an ability to bind with specific carbohydrate residues of glycoprotein, have been used to examine cellular changes associated with malignant transformation. For the analysis of mucus glycoprotein of goblet cells in the tracheobronchial epithelium, 192 paraffin-embedded sections from 54 autopsy cases including the cases with a history of mustard-gas (MG) exposure were stained with seven plant lectins using PAP method. PNA binding with no neuraminidase treatment as well as BSA-1 binding was observed most frequently in MG-exposed lung cancer cases. The proportion of cases positive for SBA binding in MG-exposed and/or lung cancer cases had a statistical difference from non-MG-exposed non-lung cancer cases. These observations may indicate a large heterogeneity in oligosaccharide chains of mucus glycoprotein and suggest its incomplete or abnormal synthesis, which is most likely to be due to previous exposure to carcinogen, such as MG. PMID- 3303829 TI - Renal cell carcinoma of lower nephron origin. AB - Thirty-four renal cell carcinomas, including 4 small tumors localized in the medulla were studied by means of histochemical and immunohistochemical methods using the markers for the lower nephron. Seven tumors had binding sites for soybean and peanut agglutinins and showed positive reactions to monoclonal antibodies to epithelial membrane antigen and cytokeratin. All these markers normally exist in the epithelial cells of distal and collecting tubules. There was no tumor from the thick ascending limb in our materials because of negative reaction to the monoclonal antibody against Tamm-Horsfall protein. Also negative was to CEA, which means there was no adenocarcinoma of colonic metaplastic origin from the renal pelvic mucosa. There were two histologically different types of cancers derived from the lower nephron, papillotubular adenocarcinoma with partial transitional differentiation, and papillary adenocarcinoma. All seven patients were males, aged between 30 and 84 years. The prognosis was quite poor since all six patients with known follow-up died of tumor. PMID- 3303830 TI - A light microscopical study of isolated follicular dendritic cell-clusters in human tonsils. AB - In order to re-examine the cellular structure of isolated FDC-culsters in the germinal centers of human tonsils, a light microscopical analysis was made. Approximately 14 FDC-clusters were recovered from one enucleated germinal center using the enzyme digestion technique. The minimum unit of the FDC-clusters was composed of one FDC and 8 to 9 lymphocytes. Most of the FDC-clusters were representative of the microenvironment of the light zone at the germinal center in situ. Half of the engulfed centrocytes were supposed to be at the Go phase, and the others at the G1 to G2 phase. It is suspected that the helper-T cell has some relationship to the FDC microenvironment, and that the suppressor-T cell does not. Most of the CIgG-containing cells in the germinal centers were considered to have infiltrated into the interspace of the FDC microenvironment. PMID- 3303831 TI - Production of collagen fibrils in adrenocortical adenoma with Cushing's syndrome. AB - The production of collagen fibrils, especially collagen type III, was studied with regard to eight adrenocortical adenomas with Cushing's syndrome. Anti-type III procollagen amino-terminal peptide serum (procollagen III) was employed for the PAP method. In areas of clear-type cells, the parenchymal cells were negative for procollagen III, but the stroma exhibited an intense reactivity and were arranged in an alveolar fashion. On the other hand, it was obvious that not only interstitial cells or spindle-shaped cells but also the parenchymal cells synthesized procollagen III in areas of compact-type cells, and the stroma showed a strongly positive reaction to it. PMID- 3303832 TI - CEA and carbohydrate antigens in normal and neoplastic colon mucosa. An immunohistochemical study. AB - Antibodies raised against tumour-associated antigens have been assessed for tumour selectivity using an indirect immunohistochemical peroxidase staining of formalin-fixed, paraffin-embedded tissue from colon carcinomas, colon polyps and normal mucosa. The following antibodies were used: 1) Unabsorbed polyclonal antibody to carcinoembryonic antigen (poly-CEA). 2) Monoclonal antibodies to CEA (mabs 3851 and 27). 3) Monoclonal antibodies to protein-bound carbohydrates (mabs C 216 and C 242) or to lipid- and protein-bound carbohydrates (C 50 and 19-9). These antibodies had been produced by hybridization of lymphocytes from mice, immunized with colon carcinoma cell lines or colon cancer tissue. All antibodies were used in one concentration only, preselected by initial titration experiments. No antibody was completely tumour-specific, but four antibodies, mabs 3851, 27, C 216 and C 242, showed statistically significant tumour selectivity. Using these antibodies, respectively 19, 19, 19, and 18 of 20 colon cancer were stained compared with 3, 4, 4, and 8 of 15 specimens of colon mucosa from normal controls. An increased frequency of staining was also noted in dysplastic polyps (statistically significant using mabs 3851 and C 216) and in dysplastic mucosa adjacent to a tumour (statistically significant using mabs 3851 and 27). The staining frequency of normal colon mucosa in cases of colon cancer did not differ from that in the normal controls. Poly-CEA and the anti ganglioside mabs C 50 and 19-9 revealed no tumour selectivity. A pronounced goblet cell staining was seen using C 50, C 242 and 19-9. PMID- 3303833 TI - Role of heparin in realization of the hypoglycaemic action of insulin. AB - A temporary resistance to the hypoglycaemic action of insulin has been found after preliminary binding of heparin in the blood of animals by 1 mg/200 of protamine sulphate (PS). This effect was observed after 5-30 min PS treatment before the insulin injection or endogenous increase of insulin stimulated by sugar load. PS did not influence the concentration of immunoreactive insulin in blood plasma. 2,5-ionene, a synthetic antagonist of heparin, induced temporary resistance to the hypoglycaemic action of insulin. Intravenous injection of heparin in corresponding doses after PS administration restored the hypoglycaemic effect of insulin. The results suggest that the presence in the circulation of reactive heparin may be necessary for insulin reception by the target tissue. PMID- 3303834 TI - Action of GnRH on steroid secretion by luteal cells of cyclic and early pregnant sows in vitro. AB - The effect of GnRH was studied on progesterone (P4), oestradiol-17 beta (E2) and testosterone (T) secretion by porcine luteal cells from the 13th day of the oestrous cycle and the 18th day of pregnancy. Trypsin-dispersed luteal cells (5 X 10(4) cells/ml) were incubated in medium 199 with 10% calf serum with or without GnRH in doses of 0.1, 1, 10 and 100 mg/ml and with 1 microgram LH and 50 U/ml hCG. The concentration of P4, E2 and T in the medium was estimated by radioimmunological method after 6 hours of incubation. The results showed that GnRH had no effect on the secretion of the investigated steroid hormones by luteal cells from cyclic sows. GnRH at a dose of 10 g inhibited E2 secretion and at a dose of 1 ng T secretion by cells from pregnant sows. LH and hCG stimulated release of P4 by luteal cells in both physiological stages. The conclusion drawn was that GnRH does not act directly on luteal cells of cyclic sows but may inhibit E2 and T secretion by cells of pregnant sows. PMID- 3303835 TI - Computer-aided analysis of the epileptic EEG. AB - An introductory review of a comprehensive approach to the problem of automatic evaluation of the epileptic EEG in the frame of syntactic analysis is presented. The aims and merits of the syntactic approach are discussed and the viability of the method is demonstrated on a few chosen examples. Working procedures for automatic segmentation and classification of patterns in single- as well as in multi-channel case of the epileptic EEG are briefly described. These include algorithms for segmentation by a finite-state automaton technique (single channel) and, in multi-channel case, a sparsely updated Kalman filter algorithm. Inherent possibilities of the approach presented are shown to open the way for a global description of a seizure in terms of the Markov chains theory. PMID- 3303836 TI - The methods of automatic analysis of epileptic EEG. AB - The methods of automatic evaluation of epileptic EEG are reviewed. The aims of the computer analysis of seizure activity and different approaches to this problem are presented. PMID- 3303837 TI - [Renal venous hilar anatomy. Apropos of 110 nephrectomies for transplantation]. PMID- 3303838 TI - [Prosthetic treatment of a dentition affected by Capdepont's disease]. PMID- 3303839 TI - [Evolution of orthodontics from 1950 to 2000]. PMID- 3303840 TI - [Coloration of dental enamel. Classification and causes of abnormal color]. PMID- 3303841 TI - Oncotrophoblast gene expression: placental alkaline phosphatase. PMID- 3303842 TI - HPLC for therapeutic drug monitoring and determination of toxicity. PMID- 3303843 TI - Element-selective plasma emission detectors for gas chromatography. PMID- 3303844 TI - High-performance hydrophobic interaction chromatography of proteins. PMID- 3303845 TI - Glucose metabolism in acute renal failure. PMID- 3303846 TI - Contrast-induced acute renal failure. PMID- 3303847 TI - Structural-functional correlates in acute renal failure. PMID- 3303848 TI - The hepatorenal syndrome (HRS). PMID- 3303849 TI - Hemolytic uremic syndrome. PMID- 3303851 TI - Post traumatic acute renal failure. PMID- 3303850 TI - Post-transplant acute renal failure. PMID- 3303852 TI - Acute renal failure in pregnancy. PMID- 3303853 TI - Amelioration of the ischemic damage of the dog kidney subjected to 90 minutes of warm ischemia by lidocaine pretreatment and low-dose dopamine infusion on revascularization. PMID- 3303854 TI - Pathogenesis of acute renal failure. PMID- 3303855 TI - Catabolism in acute renal failure: importance of glucocorticoids and lysosomal enzymes. PMID- 3303856 TI - Water, electrolyte and acid-base disturbances in acute renal failure. PMID- 3303857 TI - Serine and metallo proteinases in acute renal failure. PMID- 3303858 TI - Effects of endotoxin on hemodynamics of isolated dog kidney. PMID- 3303859 TI - Toward new viral vaccines for man. PMID- 3303860 TI - Cryptic plant viruses. PMID- 3303861 TI - Molecular studies of brome mosaic virus using infectious transcripts from cloned cDNA. PMID- 3303862 TI - Viral oncogenes, v-yes and v-erbB, and their cellular counterparts. PMID- 3303863 TI - The diagnosis of adverse medical events associated with drug treatment. PMID- 3303864 TI - Unopposed oestrogens. PMID- 3303865 TI - [Fibronectin in cultured chick retinal pigment epithelial cells. 2. Localization on cell surface]. PMID- 3303866 TI - [Experimental lens-induced endophthalmitis--a histopathologic and immunohistochemical study]. PMID- 3303867 TI - [Evaluation of ultrasonography prior to vitreous surgery]. PMID- 3303868 TI - Growth of the human embryonic hand. PMID- 3303869 TI - [A case of testicular rupture]. AB - A case of testicular rupture is reported. A 26-year-old man was referred to our hospital because of testicular trauma. Ultrasound of the testis was performed preoperatively. Ultrasonography revealed a disruption of the tunica albuginea and dense clusters of echoes in the tunica vaginalis. In the case of acute testicular trauma, this echo pattern suggests testicular rupture. PMID- 3303870 TI - [Surgical management of primary aldosteronism--progress in localization studies and operative treatment]. AB - Primary aldosteronism due to an adrenocortical adenoma is commonly known as surgically correctable hypertension. Forty-three cases of primary aldosteronism were treated operatively at our Department between 1960 and 1985. Forty of them were operatively, found to have aldosteronoma with a mean size of 1.88 cm and weight of 2.67 g. The patients average age was 39.4 years old and the male to female ratio was 1 to 3. Adrenal phlebography, selective adrenal venous sampling, adrenal scintigraphy, CT and echography were used to preoperatively locate the tumor, and their diagnostic value was 83, 78, 76, 87 and 60%, respectively. Unilateral adrenalectomy or unilateral partial adrenalectomy was performed extraperitoneally with lumbar oblique incision in 32 of the 43 operated patients. Since the application of the preoperative diagnosing studies above mentioned, tumor localization has been clearly demonstrated in about 90% of the patients and the unilateral extraperitoneal approach is proved as a safe operative method with minimal blood loss of less than 200 ml and performed within two hours. Unilateral adrenalectomy by the flank approach has now become the operation of choice for the treatment of an aldosterone-producing adrenal adenoma. PMID- 3303871 TI - [Natural cell-mediated cytotoxicity of kidney allograft recipients]. AB - Natural cell-mediated cytotoxicity (NCMC) displayed by peripheral blood mononuclear cells of kidney allograft recipients was examined against K562 cells to demonstrate the kinetics of NCMC activity in the posttransplant period. On 44 kidney allograft recipients 301 NCMC assays were performed between 1 and 84 months after transplantation. These patients were treated with the conventional immunosuppressive treatment consisting of steroid and azathioprine. NCMC activity sharply decreased after transplant surgery. A decreased NCMC activity continued during the first 6 months and the mean NCMC value was 19.2 +/- 14.1. In the second 30 months, NCMC activity also constantly decreased, almost to 10. It was lower than that of the first 6 months (P less than 0.01). After 37 months, some patients restored a normal NCMC activity and others showed a decreased NCMC activity. The mean value was 27.4 +/- 20.6 in the third 48 months. The depression of NCMC activity might be caused by the large dose of steroid and azathioprine in the first 6 months. In the third 48 months, NCMC activity might be dependent on the dosage of azathioprine alone. The activation of NCMC activity might be caused by acute rejection crisis. PMID- 3303872 TI - [Metastatic renal tumors: clinical report of three cases and review of 136 cases including 38 cases from the Japanese literature]. AB - Three cases of metastatic renal tumor are reported. The first case was of a 61 year-old man, who had a Miles' operation for rectal adenocarcinoma 30 months before, and suffered from high fever and right flank pain. Right nephrectomy was carried out and the kidney was found to contain an adenocarcinoma identical to the one previously removed from the rectum. He died 1 year after nephrectomy. The second case was of a 35-year-old man, who had undergone left pneumonectomy for a squamous cell carcinoma of the bronchus. One month later, he was readmitted with cloudiness of consciousness and high fever. Investigations revealed right kidney, adrenal gland and brain malignancies, and which were ectomized totally. On pathological examination all ectomized tissues were metastatic squamous cell carcinoma. He died 1 month after the second operation. The third case was of a 48 year-old man, who had undergone left pneumonectomy for a squamous cell carcinoma of the bronchus. One year after pneumonectomy, abdominal CT showed a left renal tumor. Right nephrectomy was performed and pathological examination revealed a metastatic squamous cell carcinoma. He is now alive 4 months after nephrectomy without any sign of recurrence. A total of 136 cases of metastatic renal tumors including 38 cases from the Japanese literature, are reviewed. PMID- 3303873 TI - Selective intraarterial DSA of the parathyroid glands in patients with hyperparathyroidism after parathyroidectomy. AB - Eighteen patients with recurrent hyperparathyroidism after parathyroidectomy were prospectively examined with selective intraarterial digital subtraction angiography (DSA) of the brachiocephalic arteries. The results were compared with findings at reoperation. Seventeen of the 21 remaining abnormal parathyroid glands were correctly detected by selective DSA (sensitivity = 81%). In the neck and mediastinum, sensitivities were 73% (8/11) and 90% (9/10), respectively. All patients with histopathologic confirmation of primary hyperparathyroidism (17/18) became normocalcemic postoperatively. We conclude that selective intraarterial DSA is indicated in patients with recurrent hypercalcemia after parathyroidectomy when the results of noninvasive imaging techniques are uncertain. PMID- 3303874 TI - Cholangiographic findings in hepatic artery occlusion after liver transplantation. AB - Because the hepatic artery provides the only blood supply to the biliary tree of a liver allograft, posttransplantation arterial occlusion may result in a biliary complication. Cholangiograms were reviewed retrospectively in 31 transplant patients who had proved complete or partial occlusions of the hepatic artery (thrombosis in 29 and marked stenosis in two). Cholangiograms were abnormal in 26 (84%). The most common abnormality, seen in 16 patients, was nonanastomotic contrast leakage from the donor intra- or extrahepatic bile ducts. Strictures of the donor biliary tree occurred in 14 patients, four of whom also had a nonanastomotic bile leak. In 12 of the 14, the strictures were nonanastomotic. Other findings included poor filling of the intrahepatic bile ducts, generalized donor ductal dilatation and irregularity, and intraductal filling defects. Sixteen (89%) of 18 transplants with nonanastomotic contrast leakage had occlusions of the hepatic artery. Of 21 transplants with nonanastomotic strictures, 12 (57%) had occlusions of the hepatic artery. Only two (10%) of 20 transplants with biliary anastomotic strictures had arterial occlusion. We conclude that liver transplant recipients who exhibit nonanastomotic contrast leakage or nonanastomotic strictures on cholangiography should be evaluated for occlusion of the hepatic artery as the probable cause. PMID- 3303875 TI - Focal fatty change of the liver adjacent to the falciform ligament: CT and sonographic findings in five surgically confirmed cases. AB - Five cases of surgically confirmed focal fatty infiltration of the liver were detected by CT and sonography. In all five cases, the abnormality was located at the anterolateral edge of the medial segment of the liver. It was seen as a small area of low attenuation adjacent to the falciform ligament on CT and as an echogenic area next to the ligamentum teres on sonography. Dynamic CT performed during infusion of contrast medium via the superior mesenteric artery (arterial portography) showed portal blood flow within the lesion and was useful for excluding the presence of a hepatic tumor. Focal fatty infiltration of the liver adjacent to the falciform ligament constitutes a diagnostic pitfall on CT and sonography. PMID- 3303876 TI - The inferior accessory hepatic fissure: sonographic appearance. AB - The inferior accessory hepatic fissure, a coronal or parasagittal fissure through the parenchyma of the posterior segment of the right hepatic lobe, was observed sonographically in 15 of 2000 patients. The fissure was seen as a thin, echogenic membrane stretching downward from the right branch of the portal vein to the inferior surface of the right hepatic lobe. On cadaveric sections, the fissure was an invagination of peritoneum directed laterally and slightly posteriorly from the medial inferior surface of the right hepatic lobe below the porta hepatis. PMID- 3303877 TI - Sonographic features of amebic and pyogenic liver abscesses: a blinded comparison. AB - We blindly compared the sonographic findings in amebic (112 lesions) and pyogenic (30 lesions) liver abscesses. Two sonographic features were significantly more prevalent in amebic abscesses: the lesions had a round or oval shape and the lesions had an echogenicity that was lower than that of normal liver and were internally homogeneous on high-gain scans. Amebic abscesses were round or oval in 92 instances (82%), while 18 pyogenic abscesses (60%) (p less than .01) had these shapes. Fifty-nine (58%) of 101 amebic abscesses displayed low echogenicity and homogeneous internal echoes with high-gain settings compared with nine (36%) of 25 pyogenic abscesses (p less than .04). Despite these different sonographic patterns, image findings alone were inadequate in distinguishing pyogenic from amebic liver abscesses. However, when the sonographic findings were coupled with clinical and laboratory data, a correct diagnosis was possible in 83 (86%) of 96 patients with amebic abscess. It appears that, although some sonographic features of amebic abscess differ from those of pyogenic abscess, these differences are not sufficient to allow a specific diagnosis on the basis of sonography alone. Sonography can expedite abscess detection and, when coupled with clinical and laboratory data, can aid in differentiating pyogenic from amebic liver abscesses. PMID- 3303878 TI - Pancreas transplantation with pancreatico-duodeno-cystostomy for exocrine drainage: cystographic findings. AB - Pancreatic transplantation is becoming accepted therapy for a select subset of patients with type 1 insulin-dependent diabetes. At many centers, whole-organ transplants with pancreatico-duodeno-cystostomy for drainage of exocrine secretions is the preferred surgical procedure. We obtained 21 cystograms in nine patients who underwent this procedure who were suspected of having anastomotic leaks and possible abscess. Positive findings included extrinsic bladder compression (nine patients), filling of the transplanted duodenal segment (three patients), edematous bladder wall (four patients), intraperitoneal (two patients) and extraperitoneal (four patients) leaks, and fistulae (two patients). Intraperitoneal extravasation resulted in abscess formation and cutaneous fistulae, and these transplants were subsequently removed. We conclude that cystography is a useful technique in evaluating the site and extent of anastomotic leaks and fistulae. PMID- 3303879 TI - The distinction between acute renal transplant rejection and cyclosporine nephrotoxicity: value of duplex sonography. AB - Although sonography is useful in the evaluation of renal transplants, there are no objective sonographic findings for reliably differentiating acute rejection from cyclosporine nephrotoxicity. This study was undertaken to determine the role of pulsed Doppler flow analysis (duplex sonography) in making this distinction. Duplex Doppler sonography was performed in 106 patients with normally functioning transplanted kidneys and in 34 patients with renal transplant dysfunction who underwent percutaneous biopsy. Renal vascular impedance was estimated in the segmental, interlobar, and arcuate arteries by calculating the ratio of end diastolic minimum velocity to systolic peak velocity (diastolic/systolic ratio). In the healthy control subject, the diastolic/systolic velocity ratios varied in the different arterial segments, ranging from a mean of 0.23 in the segmental arteries to a mean of 0.32 in the arcuate arteries. Seventeen patients experienced acute rejection: eight of the nine with acute vascular rejection had abnormal Doppler ratios; eight patients with acute cellular rejection had normal ratios. Nine patients with cyclosporine nephrotoxicity all had normal duplex scans. Seven patients with chronic rejection had normal ratios. One patient with hemolytic-uremic syndrome had an abnormal flow pattern. These findings indicate that duplex sonography may be useful in differentiating acute vascular rejection from cyclosporine nephrotoxicity in the transplanted kidney. PMID- 3303880 TI - Sonography in the detection of meniscal injuries of the knee: evaluation in cadavers. AB - We evaluated the ability of high-resolution, real-time sonography to identify and characterize artificially produced lesions in the menisci in human cadaveric knee specimens. In total, 20 lesions created in 10 specimens from five knees were prepared and examined sonographically. Four different types of lesions were created: eight vertical concentric tears, four horizontal tears, four vertical radial tears, and four complex lesions including displaced or amputated meniscal edges. All 20 (100%) of the lesions were visualized sonographically. The vertical concentric tears were the easiest to locate and identify, and appeared as highly echogenic lines in the menisci. Tears of this type as small as 2 mm could be visualized. The vertical radial tears were the most difficult to visualize, and no lesions of this type smaller than 5 mm could be seen. Our study shows that under optimal experimental conditions, sonography is capable of reliably demonstrating even small meniscal tears. On this basis, we believe that further clinical studies of the efficacy of meniscal sonography are both reasonable and necessary. PMID- 3303881 TI - Sonographic measurements of the normal bladder wall in children. AB - The thickness of the bladder wall was measured sonographically in 410 children (1 day to 19 years old) and in 10 adults. None had complaints related to the urinary tract. The bladder wall thickness varied mostly with the state of bladder filling and only minimally with age and gender. The normal bladder wall had a mean thickness of 2.76 mm when the bladder is almost empty and 1.55 mm when it is distended. There is a linear relationship between bladder fullness and bladder wall thickness; the upper limits are 3 and 5 mm for a full or empty bladder respectively. PMID- 3303882 TI - Penetrating injuries of the thoracic aorta and brachiocephalic arteries: angiographic findings in 18 cases. AB - Eighteen patients with surgically proved penetrating injuries to the thoracic aorta or brachiocephalic arteries were evaluated preoperatively with angiography. Fifteen injuries resulted from direct penetration of a vessel and three were concussion or blast injuries. Arteriography correctly showed vessel damage in 16 (89%), although one was identified only in retrospect. There were two false negative examinations. False aneurysms were present in nine. Other findings included occlusion, wall irregularity, and an arterial-arterial fistula. Our results show that angiography is an accurate means of detecting penetrating injuries to the thoracic aorta or brachiocephalic arteries. PMID- 3303883 TI - Management of the postdates pregnancy. PMID- 3303884 TI - Industrial hygiene involvement in occupational epidemiology. PMID- 3303885 TI - A single-blind, placebo-controlled study of effects of atenolol on transient ischemia in "mixed" angina. AB - The efficacy of atenolol in preventing episodes of transient ischemia during daily life was evaluated in 10 patients with "mixed" angina who underwent a 4 week, single-blind, double-crossover placebo-controlled trial. On day 6 and 7 of each treatment phase, continuous ambulatory electrocardiographic monitoring was performed for 48 hours. On day 7 an exercise test was also performed. Two-hundred and sixty-four ischemic episodes (79% "silent") were recorded during placebo treatment; 98 were recorded during atenolol treatment (63% decrease, p less than 0.01). In agreement with previous observations, most ischemic episodes observed during placebo (156 or 59%) were not preceded by an increase in heart rate. Surprisingly, the beneficial effects of atenolol were more pronounced for these episodes than for those preceded by an increase in heart rate and apparently caused by an increase in myocardial demand (decreases of 72% and 48%, respectively). Painful and painless episodes were decreased by a similar extent. In all patients, the heart rate recorded at the beginning of ST-segment depression was widely variable and significantly lower with atenolol (64 +/- 14 beats/min) than with placebo (81 +/- 13 beats/min, p less than 0.05). During both placebo and atenolol treatment, the highest incidence of ischemic events was observed between 6 A.M. and 9 P.M., in coincidence with the highest levels of the heart rate resting.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3303886 TI - Prognostic significance and beneficial effect of diltiazem on the incidence of early recurrent ischemia after non-Q-wave myocardial infarction: results from the Multicenter Diltiazem Reinfarction Study. AB - Of 576 patients with non-Q-wave acute myocardial infarction enrolled in the Diltiazem Reinfarction Study, 246 (43%) had 1 or more episodes of angina at rest or with minimal effort during 10.5 days of treatment with either diltiazem (90 mg every 6 hours) or placebo. Reinfarction (12.2% vs 3.6%, p less than 0.0001) or death (6.1% vs 1.5%, p = 0.003) was more likely to occur within 2 weeks of randomization in patients with postinfarction angina than in those without angina. Based on serial electrocardiographic data, 115 of the 246 patients with angina had transient ST-T changes and 131 did not. Comparison of the 14-day event rates in these 2 groups showed that the 115 patients with electrocardiographic evidence of ischemia had a higher frequency of reinfarction (20% vs 5.3%, p less than 0.001), more extensive damage as assessed by peak MB-creatine kinase levels (91 +/- 76 vs 37 +/- 19 IU/liter, p = 0.059 [Wilcoxon rank sum]) and a higher mortality rate (11.3% vs 1.5%, p = 0.001). Angina associated with transient ST-T changes occurred in 70 of the 289 patients in the placebo group but in only 45 of the 287 patients in the diltiazem group--a 28% reduction in cumulative life-table incidence (p = 0.0103 [2-tail, log rank]; 95% confidence interval, 9.3 to 53.8%). It is concluded that patients with early postinfarction angina are at increased risk of reinfarction and death, and angina associated with transient electrocardiographic changes identified a very high risk subset. This subset appeared to have a larger area of viable but jeopardized myocardium and benefited from prophylactic therapy with diltiazem. PMID- 3303887 TI - Value of exercise testing in determining the risk classification and the response to coronary artery bypass grafting in three-vessel coronary artery disease: a report from the Coronary Artery Surgery Study (CASS) registry. AB - To determine whether exercise testing can identify higher risk patients with 3 vessel coronary artery disease (CAD) whose survival might be prolonged by coronary artery bypass grafting (CABG), the results of CABG were compared with those of medical therapy in 1,249 nonrandomized patients with 3-vessel CAD from the Coronary Artery Surgery Study (CASS) registry who underwent exercise testing. Analysis of 28 variables by Cox's regression model for survival revealed an independent effect of the left ventricular (LV) score, the final exercise stage, and treatment received on survival. Seven-year survival rates between medical and surgical therapy were compared among subsets of patients according to the LV function and the results of exercise testing. Among patients with normal LV function, those with at least 1 mm of ischemic ST-segment depression or low exercise capacity had better 7-year survival if treated by surgical rather than medical therapy (p less than 0.05). Survival was not different between the medical and surgical groups in patients without ischemic ST depression or with good exercise capacity. Among patients with impaired LV function, surgery improved survival in most subsets of patients with the exception of patients with a preserved exercise capacity. These results support the use of exercise testing in the risk stratification of patients with 3-vessel CAD. PMID- 3303888 TI - Development of congestive heart failure and alterations in left ventricular function in patients with sustained ventricular tachyarrhythmias treated with amiodarone. AB - The interaction between the efficacy and tolerance of amiodarone and the degree of left ventricular (LV) dysfunction was assessed in 126 patients with sustained ventricular tachyarrhythmias. In all patients radionuclide angiographic LV ejection fraction (EF) was measured before and after 8 to 12 months of amiodarone therapy. At baseline mean EF was 25 +/- 13% and 86 patients had an EF of 30% or less. In patients receiving amiodarone at steady state, there was a small but significant increase in EF (23 to 26%, p less than 0.05). Congestive heart failure (CHF) was present in 43 patients before amiodarone therapy. In 16 patients new (9 patients) or worsened (7 patients) CHF developed during the first year of amiodarone therapy. Development of CHF was not consistently related to a change in EF or heart rate. The clinical efficacy and tolerance of amiodarone were affected by the baseline EF and development of CHF. Efficacy and tolerance was 80% in patients with an EF of more than 30% and 60% in those with an EF of 30% or less. Among the 16 patients in whom new or worsened CHF developed, 6 (38%) died and 9 (56%) had recurrent ventricular tachyarrhythmias. Both baseline EF and development of CHF during amiodarone treatment significantly affect the prognosis in patients with ventricular tachyarrhythmias. PMID- 3303889 TI - Heterogeneous myocardial catecholamine concentrations in patients with congestive heart failure. AB - Left ventricular catecholamine and plasma norepinephrine levels were assayed in 39 patients undergoing cardiac transplantation to test the hypothesis that in congestive heart failure (CHF) the normally high concentration of myocardial norepinephrine is depleted while dopamine is increased because dopamine conversion to norepinephrine is the rate-limiting step in norepinephrine synthesis. Plasma norepinephrine was elevated in all patients (average 741 +/- 472 micrograms/ml), but myocardial norepinephrine was variable, ranging from 79 to 2,127 ng/g (average 512 +/- 392). Myocardial dopamine also varied considerably (range 0 to 713 ng/g, average 143 +/- 150). Nineteen patients had the expected pattern of low cardiac norepinephrine and elevated dopamine levels. However, myocardial catecholamine levels were normal (high norepinephrine, low dopamine) in 7 patients; both norepinephrine and dopamine were low in 6 patients; and norepinephrine levels were preserved but dopamine high in 7 patients. Cardiac norepinephrine level correlated only weakly with peripheral vascular resistance (r = 0.39, p less than 0.05), and examination of multiple other variables failed to reveal likely causes of the differences in cardiac norepinephrine and dopamine between patients. Thus, myocardial norepinephrine is not uniformly reduced in patients with severe CHF, and further attempts to delineate the factors regulating myocardial catecholamine concentration and adrenergic function in such patients are needed. PMID- 3303890 TI - Detection of intracardiac left-to-right shunting in adults: a prospective analysis of the variability of the standard indocyanine green technique in patients without shunting. AB - Intracardiac left-to-right shunting may be detected and quantitated by an oximetric analysis of blood from the right-sided cardiac chambers and prominent early recirculation of indocyanine green after it is injected into the central venous circulation and sampled from a systemic artery. Although the variability of oximetric measurements has been established in patients without shunting and a range of normal has been determined for the technique, the variability of the indocyanine green method among persons without shunting has not been clarified; as a result, a range of normal for indocyanine green has not been established. In 66 adult patients in whom hydrogen inhalation (an extremely sensitive technique for detecting even very small intracardiac left-to-right shunts) revealed no shunting, indocyanine green curves were generated by injection into the pulmonary artery as blood was sampled from a systemic artery. In these patients the percentage left-to-right shunt (that is, the percentage of pulmonary blood flow reaching the lungs through an intracardiac shunt) (determined with the equation of Carter et al) ranged from -9% to +26% (+7 +/- 8%, mean +/- standard deviation). There was no definable relation between the percentage left-to-right shunt and the indicator dilution measurement of cardiac output. Thus, these data establish a range of normal for the indocyanine green technique of detecting and measuring intracardiac left-to-right shunting. If this technique is to be used reliably to detect shunting, its results must demonstrate a percentage shunt in excess of +26%. PMID- 3303891 TI - Effect of one year of thiazide therapy on plasma volume, renin, aldosterone, lipids and urinary metanephrines in systolic hypertension of elderly patients. PMID- 3303892 TI - Role of lymphostasis in accelerated atherosclerosis in transplanted hearts. PMID- 3303893 TI - Immunocytochemical localization of oxytocin and neurophysin in human corpora lutea. AB - Corpora lutea, corpora albicantia, and ovarian stroma from normal human premenopausal ovaries were examined for the presence of oxytocin and neurophysin by using highly specific antisera and peroxidase-antiperoxidase light-microscopic immunohistochemistry. Oxytocin and neurophysin immunoreactivity was found in some but not all cells of the corpora lutea obtained on days 19 to 24 of the menstrual cycle. Stromal tissue and corpora albicantia did not give a positive reaction for either of these peptides, and negative results were also obtained with corpora lutea of mid- and term-pregnancy and preovulatory follicles. Specificity of the immunohistochemical reaction was confirmed by immunoabsorption tests. The specific localization of immunoreactive oxytocin and neurophysin in corpora lutea of the human menstrual cycle directly demonstrates the presence of oxytocin- and neurophysin-positive cells within the human corpus luteum. PMID- 3303895 TI - Quantitative morphology of the primate peripheral retina (Macaca irus). AB - By using electron microscopy to study the quantitative morphology of the retina, it was possible to determine the spatial density of all principal retinal cells at a defined retinal location. In two retinas of cynomolgus monkeys at a position of 30 degrees nasal of the fovea centralis, the following cell densities were determined from composite electron micrographs: retinal pigment epithelium: 3,400 cell/mm2; rod cells: 115,000 and 168,000 cells/mm2; cone cells: 8,200/mm2; horizontal cells: 7,000/mm2; bipolar cells: 50,000/mm2; amacrine cells: 11,500/mm2; Muller cells: 16,000/mm2; and ganglion cells: 5,350 and 6,750/mm2. PMID- 3303894 TI - Passive Heymann nephritis induced by rabbit antiserum to membrane antigens isolated from rat visceral yolk-sac microvilli. AB - Passive Heymann nephritis (PHN) is an animal model of immune-complex-induced renal disease resembling human membranous glomerulonephritis. It was induced in rats by injecting rabbit antiserum directed against glycoprotein antigens isolated from rat embryonic visceral yolk-sac microvilli (VYS-MV). The glycoprotein antigens were isolated by extracting the VYS-MV with detergent Nonidet P-40 followed by gel filtration in Sephacryl S-300 and finally by lectin affinity chromatography with Ricinus communis agglutinin I. In vitro immunofluorescent localization studies demonstrated that the nephritogenic antibodies were localized along the apical region of the visceral yolk-sac endodermal cells and the brush border of the proximal tubular cells of the kidney. Rats injected with a single dose of the antiserum manifested proteinuria. Indirect immunofluorescent studies showed that the injected rabbit IgG was localized in vivo along the capillary walls of the glomerulus in a granular fashion. Electron microscopic examination of the same kidney glomeruli revealed numerous electron-dense deposits along the lamina rara externa of the glomerular basement membrane. Fusion of the epithelial foot processes was also present. These findings represent the typical immunopathological characteristics of Heymann nephritis. Furthermore, with the aid of Ouchterlony analysis, the antiserum against the isolated VYS antigens exhibited an immunoprecipitin band which was in common with that formed by the antiserum against the homogeneous nephritogenic antigen (gp330) of renal brush border origin. Thus, the nephritogenic antigens which have been found to be associated with the brush border of the renal proximal tubules may also be present or cross-reacted in the microvilli of the rat embryonic visceral yolk-sac. PMID- 3303896 TI - Hair analysis in clinical and experimental medicine. AB - Each year approximately 9800 papers on trace elements are published. Of these, approximately 75 deal with trace elements and hair. Review articles appear annually. Some of these studies demonstrate that the mean concentration of an essential trace element is lower or that of a potentially toxic element is higher in the hair of a group of people afflicted with a specific disease. Associations between hair analyses and demographic variables have been found. Fewer studies have shown a correlation between essential elements in hair of animals and the same elements in organs. It is possible to measure trace elements in hair to satisfy the skeptical chemist. Although such measurement is a necessary prelude toward medical utility, it is not sufficient. Hair analysis seems potentially useful in experimental medicine but its use in clinical medicine for diagnosis, prognosis, and therapy will remain limited until validation by the standard methods of clinical investigation is achieved. PMID- 3303897 TI - Plasma amino acid, glucose, and insulin responses to moderate-protein and high protein test meals in pregnant, nonpregnant, and gestational diabetic women. AB - Test meals providing two levels of dietary protein (13% or 26% of the energy) were fed to eight pregnant (P), nine nonpregnant (NP), and two gestational diabetic (GDM) women. Plasma levels of amino acids were measured at 0 h and 2 h. Glucose and insulin were measured at 0, 1/2, and 2 h after the meals. In the fasting state, P women had significantly lower fasting concentrations of most of the amino acids. After the high-protein meal, rises of arginine, ornithine, and branched-chain amino acids (BCAAs: leucine, isoleucine, and valine), were significantly smaller in P women. Changes in BCAAs were normal in GDM women. P women had greater rises of insulin in response to both test meals than did NP women. This may facilitate increased BCAA uptake from the circulation. Rises in plasma glucose tended to be higher in P than NP women, suggesting that insulin's effects on glucose and BCAA uptake may be mediated separately. PMID- 3303898 TI - Comparison of mackerel-oil and lard-fat enriched diets on plasma lipids, cardiac membrane phospholipids, cardiovascular performance, and morphology in young pigs. AB - Purified mackerel-oil extract or lard fat (9.1% wt/wt) was added to a basal diet of young pigs for 8 wk. Effects on plasma lipids, glucose and insulin, cardiac membrane phospholipids, cardiovascular performance, and morphology were studied. A time-dependent reduction of plasma triglyceride (62%), total cholesterol (41%), and HDL cholesterol (47%) was found in the mackerel-oil-fed pigs. The postprandial glucose and insulin response may indicate a mackerel-oil-induced resistance of insulin receptors. Although the polyunsaturated fatty acid composition of cardiac sarcolemma widely differed between the two groups, all determined indices of heart function were equal. It is concluded that consumption of a fish-oil diet with a low content of monoenes and supplemented with antioxidants reduces plasma lipid levels without producing pathological side effects. PMID- 3303899 TI - Plasma glucose and insulin responses to starchy foods in Australian aborigines: a population now at high risk of diabetes. AB - We compared plasma glucose and insulin responses to an Aboriginal bushfood and its western equivalent in healthy Aborigines and Caucasians. Bush potato (Ipomoea costata), an Aboriginal bushfood which is slowly digested in vitro, and potato (Solanum tuberosum), which has a high glycemic index, were studied. The areas under the glucose and insulin curves for Aborigines were 34% and 42% smaller, respectively, after bush potato than after potato (p less than 0.05). In Caucasians only the insulin response to bush potato was lower (by 19%) than that to potato (p less than 0.05). Compared with Caucasians, Aborigines produced 2.5 times greater glucose and insulin responses to potato (p less than 0.025). Their insulin responses to bush potato were also twice as large (p less than 0.05) although glucose responses were not significantly different. These findings add weight to the hypothesis that rapidly digested carbohydrate in western diets may be one of the factors in the lifestyle change which precipitates diabetes in indigenous populations. PMID- 3303900 TI - Iron deficiency and the immune response. AB - The importance of iron deficiency as a public health problem is based ultimately on the seriousness of its consequences on health. The most extensively investigated consequences of iron deficiency involve work performance and immune function. The significance of the effects on work performance are generally accepted. In contrast, data on the influence of iron deficiency on immune function are often perceived as being confusing and contradictory. From reexamination of relevant literature, it seems safe to conclude that abnormalities in cell-mediated immunity and ability of neutrophils to kill several types of bacteria are well established under experimental conditions in iron-deficient patients. It remains uncertain whether these abnormalities result in an increased incidence and duration of infections. This area still requires careful study. PMID- 3303901 TI - sIgA- and IgM-containing cells in the intestinal mucosa of iron-deficient rats. AB - The effect of iron deficiency on the jejunal mucosa was studied in postweaning rats that had received a 3-wk regimen of either iron-deficient or iron-sufficient diet (iron content 6 and 50 mg/kg diet) and in rats given the iron-sufficient diet for 1 wk after the initial 3-wk iron-deficient diet. Morphometric analysis showed little difference in villous height but a significant decrease in mitotic index of the crypt epithelial cells in the iron-deficient group. Direct immunoperoxidase studies showed that iron-deficient rats had substantially fewer sIgA- and IgM-containing cells than iron-sufficient rats. This abnormality was reversed after a 1-wk iron-sufficient diet. We conclude that iron deficiency may impair local immunity in the intestinal mucosa, sensitizing the surface epithelial cells to damage by noxious agents. Similar changes might lead to the syndrome of iron-deficiency anemia and hypoproteinemia in children. PMID- 3303902 TI - CT-guided stereotaxic biopsy of brain tumors: new technology for an old problem. AB - On 63 patients, we used stereotaxic surgery combined with computer tomographic (CT) technology, for reasonably safe and precise biopsy of brain lesions. Histological confirmation was possible in 97% of the cases. More recently, we have also been using the CT-guided stereotaxic technique for brachytherapy, consisting of introduction of an array of radioactive isotope seeds (192Ir). The after-loading cannulas used for the isotope seeds are now also being used for introduction of probes for localized hyperthermia of brain tumors. CT-guided stereotaxic technique is proving to be a major technological advance both diagnostically and therapeutically. PMID- 3303903 TI - Confounding factors in clinical studies of gliomas. AB - Clinical investigation of gliomas is difficult because the investigator must compensate for factors that confound data analysis. The investigation of glioma therapy is affected by a number of factors that influence the outcome of the patients' disease: the tumor grade and location, the extent of surgical resection, the dose and portal for radiation therapy, and the patient's functional status at presentation. Either an observational or an experimental (clinical trial) strategy may be used to compensate for confounding factors. Matching for the characteristics known to influence disease history strengthens the conclusions from an observational study, but cannot compensate for unknown influences. Randomization in a clinical trial will minimize unknown influences, but clinical trials are not always feasible. To be conclusive, glioma studies should either match patient populations for known confounding factors in an observational study or randomize patients in a clinical trial. PMID- 3303904 TI - Interstitial stereotactic irradiation of astrocytomas. AB - History, rationale, methods, and problems of irradiation of astrocytomas by stereotactic implantation technique are briefly outlined. The literature indicates that this method appears to be suitable to help increase survival and improve quality of life for high-grade glioma patients. PMID- 3303905 TI - A randomized clinical trial of combination chemotherapy in advanced colorectal cancer. AB - One hundred and sixty-five patients with advanced colorectal cancer were entered into a prospectively randomized trial of combination chemotherapy comparing three 5-fluorouracil plus methyl CCNU (FM)-based regimens: FM plus ICRF-159 (FMI), FM plus triazinate (FMT), and FM plus vincristine (FMV). Patients were stratified according to performance status, anatomic site of primary indicator lesion, and prior chemotherapy. Those with abnormal kidney or liver function were randomized between FMI and FMV because triazinate depends on both hepatic and renal mechanisms for elimination. There were no significant differences between the treatment regimens in objective response rate (11%-17%), interval to progression (median, 10-14 weeks), or survival (median, 5-6 months). The primary side effect observed was hematologic toxicity, which tended to increase in severity with repeated courses of therapy. Although ICRF-159 and triazinate have been shown to have limited single-agent phase II activity against colorectal cancer in previous trials, neither agent combined with 5-fluorouracil plus methyl CCNU has an improved treatment effect compared with FMV. We do not recommend the further use of these regimens in the treatment of advanced colorectal cancer. PMID- 3303906 TI - Laboratory quality assurance testing of microbiologic media from commercial sources. AB - Culture media that perform as intended are crucial to accurate work by a clinical microbiology laboratory. As cost-containment becomes an increasingly important pressure in clinical laboratory management, the value of each laboratory performing its own quality assurance testing of media has been challenged if the media are purchased from a manufacturer who is required to perform quality assurance testing. In the past ten years of using commercially prepared media from eight different national and regional suppliers, the authors have encountered an average of six types (15 shipments) of media each year that failed to meet their laboratory's performance criteria, which reinforces the need for clinical laboratories to continue their own performance testing of media manufactured commercially, particularly when the media are used for primary isolation. Quality control testing of media can be performed most cost effectively by purchasing in the largest lots and shipments that shelf life and storage requirements allow, streamlining test procedures while keeping detailed records of performance characteristics, and purchasing media from firms that have demonstrated competence and integrity. PMID- 3303907 TI - Preservation of pathology specimens by silicone plastination. An innovative adjunct to pathology education. AB - The authors have used the process of plastination to preserve gross anatomic specimens for teaching purposes. A specimen is fixed in 10% buffered formalin and dehydrated in increasing grades of ethanol. Thereafter it is saturated with methylene chloride and then impregnated in vacuo at -20 degrees C with silicone rubber. Final steps involve drainage and exposure to a curing agent. The total time required is approximately 16 weeks. The finished plastinated specimen is dry to the touch, odorless, and nontoxic, yet it maintains its original shape and, in many cases, is reasonably close in color and consistency. It resists deterioration and can be stored at room temperature indefinitely. The authors have found plastinated specimens to be superior to those preserved in formalin for teaching anatomic pathology to undergraduate medical students. PMID- 3303908 TI - Hepatitis B virus serology. Loss of antibody to surface antigen. AB - A retrospective review of hepatitis B serologies from 6,686 patients was conducted to determine the incidence of loss of antibody to hepatitis B surface antigen (anti-HBs) with retention of antibody to the core antigen of hepatitis B virus (anti-HBc) activity. In a subgroup of 48 multiply tested patients who were presumed to have resolved their acute or subacute hepatitis B virus infection, 9 (19%) were found to have lost anti-HBs while retaining anti-HBc activity. PMID- 3303909 TI - Concepts on functional appliances' mode of action. AB - Several working hypotheses have been conceived to explain the mode of action of various functional appliances. A review of the different concepts is presented and these concepts are tested by means of data from basic scientific research. Furthermore, a general concept is postulated that could unite the working principles of several functional appliances. Finally, the clinical relevance of scientific research in this area is evaluated. PMID- 3303910 TI - Ovarian cyst of the newborn. PMID- 3303911 TI - Fever without localizing signs and group B streptococcus bacteremia in two patients 90 days of age and older. PMID- 3303913 TI - Supernumerary nipples and renal anomalies in neonates. AB - A high rate of association between supernumerary nipples (SNNs) and hidden renal anomalies has previously been reported. We examined 2035 term infants and detected SNNs in 49. Only one patient, at age 4 months, was found to have a renal anomaly, as determined by ultrasound examination. The likelihood of finding a renal anomaly in a term infant with an SNN is likely to be lower than previously reported. PMID- 3303912 TI - Vesicoureteral reflux and urinary tract infections in renal transplant recipients. AB - Fifty-six children who received kidney transplants were evaluated for postoperative vesicoureteral reflux and frequency of urinary tract infection. Two methods of ureteral implantation were compared: a nonantireflux extravesicular ureteroneocystostomy and an antireflux intravesicular ureteroneocystostomy. Reflux was found in 79% of children who had the nonantireflux procedure vs 19% of children who had the antireflux procedure. This disparity was present regardless of sex and age. Infections occurred at a rate of one per 11 patient-months after the nonantireflux procedure vs one per 40 patient-months after the antireflux procedure. Regardless of surgical technique, the incidence of infection was higher in children with reflux. The potentially harmful effect of infection with reflux warrants concern. Because of the need to maximize allograft function for a longer time period, an antireflux procedure is recommended in all pediatric kidney transplants. PMID- 3303914 TI - Does a supernumerary nipple/renal field defect exist? AB - In 65 patients evaluated for suspected genetic and/or developmental problems, a roentgenographic study of the kidneys was performed because of the presence of a supernumerary nipple (SNN). Seven of 65 (11%) had a significant renal lesion that included conjoined kidneys in a female with Fanconi's anemia. Four of these patients did not have signs or symptoms suggestive of an underlying urinary tract pathologic condition. These results indicate that an SNN/renal field defect probably exists, although the significance of this association is significantly weaker than that originally proposed by Mehes. One variable influencing this association appears to be racial differences, as evidenced by the absence of renal defects in blacks with an SNN. Based on our findings, the identification of additional minor phenotypic abnormalities may represent an additional mediating variable in this association. However, the discovery of an SNN in an otherwise normal individual, or an individual with a recognizable pattern of human malformation not associated with renal anomalies or central nervous system dysfunction alone, does not appear to be an indication for additional diagnostic studies of the urinary tract. PMID- 3303915 TI - Increased sex concordance of sibling pairs with Behcet's disease, Hodgkin's disease, multiple sclerosis, and sarcoidosis. PMID- 3303916 TI - Predictors of cardiovascular events and mortality in the Systolic Hypertension in the Elderly Program pilot project. AB - Do the established cardiovascular risk factors for younger persons remain important predictors of cardiovascular disease events and mortality in those who are older? The authors examined this question in the Systolic Hypertension in the Elderly Program pilot project which prospectively followed 551 men and women 60 years of age and older with pretreatment systolic blood pressure greater than or equal to 160 mmHg and diastolic blood pressure less than 90 mmHg who were enrolled between May 1981 and July 1982. Mean age was 72 years, 37% were men, 82% were white, and 24% had attended college. The vital status of all 551 participants was known at the end of follow-up, an average of 34 months after entry; there were 39 deaths from all causes, 66 first cardiovascular events, 18 strokes, and 20 episodes of myocardial infarction/sudden death. Univariate Cox proportional hazard analysis revealed that age was a predictor (p less than 0.05) of all-cause mortality, first cardiovascular event, and stroke. Less than college education was a predictor of all-cause mortality and first cardiovascular event, smoking was a predictor of first cardiovascular event and myocardial infarction/sudden death, cholesterol was a predictor of first cardiovascular event, and lower body mass index was a predictor of increased all-cause mortality. After adjustment for covariables, age, lower education, lower body mass index, and baseline electrocardiographic abnormalities were significant predictors of all-cause mortality, and age, lower education, history of cardiovascular event, and smoking remained significant predictors of first cardiovascular event. Sex was not a risk factor, and the ability to examine hypertension as a risk factor was impaired by the fact that the entire cohort had systolic hypertension at baseline, and most were treated. These findings, combined with prior evidence, suggest that smoking, low education level, and perhaps serum cholesterol are risk factors for cardiovascular disease in the elderly. Although the excess risk conveyed by these factors is large, its reversibility needs to be demonstrated by intervention studies. PMID- 3303917 TI - Glycosylated hemoglobin in a population-based study of diabetes. AB - Glycosylated hemoglobin was measured in persons who participated in a population based study of diabetic retinopathy in southern Wisconsin. There were 996 persons who were diagnosed prior to 30 years of age and who were taking insulin (younger onset), and 1,370 persons who were diagnosed at 30 years of age or older (older onset) who were examined from 1980-1982. Glycosylated hemoglobin was measured using a microcolumn technique. Mean glycosylated hemoglobin was highest in younger onset persons (10.9%), and lowest in older onset persons not taking insulin (9.0%). Only a small percentage of values for the diabetic persons fell within the range of values found in a nondiabetic comparison group. Mean glycosylated hemoglobin was found to be associated with retinopathy status but not with proteinuria. PMID- 3303918 TI - Influenza B in households: virus shedding without symptoms or antibody response. AB - In the fall of 1983, 53 households were enrolled in a double-blind trial of alpha 2-interferon as an intranasal spray to prevent common colds. During the winter/spring of 1984, 26 households were infected with influenza type B, as shown by isolation of the virus (19 households) and/or significant antibody titer rises (seven households). Interferon did not prevent influenza B infection or modify resulting illness. Of 37 persons shedding virus, 12 were asymptomatic. All were older than age 12 years, and 10 did not respond with antibody by any of the five test methods employed (complement fixation, hemagglutination inhibition, enzyme-linked immunosorbent assay (ELISA), neutralization, and Western blot). In contrast, of 13 symptomatic persons shedding virus from whom sera were available, 11 had significant antibody titer rises. Infection rates were highest among teenagers, but also surprisingly high among the 11 persons observed who were aged 50 years or older, four of whom were infected. The case-to-case interval in household transmission varied between one and nine days. Longer intervals of one, two, and four months between infections among family members were also observed, suggesting repeated introductions. Neither virus isolation alone nor serologic tests was sufficient to estimate infection rates. PMID- 3303919 TI - In vitro induction of myeloid surface markers in a rare case of acute leukemia. AB - The phenotypic marker profile of a case of acute leukemia is described; its immunophenotype is unique in that the blast cells were initially negative for a wide panel of monoclonal antibodies (McAbs) to surface and intracytoplasmic antigens and for the nuclear enzyme terminal deoxynucleotidyl transferase. Morphological and cytochemical examination suggested an acute myeloid leukemia (AML), but the cells were unreactive with anti-myeloid McAbs. Treatment with the phorbol ester 12-O-tetradecanoylphorbol 13-acetate (TPA) induced the cells to differentiate morphologically to macrophage-like cells and led to the expression of surface antigens that could be detected by antimyeloid McAbs. It is not clear whether these cells represent a rare subclass of leukemic cells that are void of any characteristic surface markers but have the potential to differentiate along the myeloid axis, or whether the antigens were masked by an unknown process. PMID- 3303920 TI - Hemoglobin E: an emerging hemoglobinopathy in the United States. PMID- 3303921 TI - Laurence Hasbrouck Snyder: pioneer in human genetics. PMID- 3303922 TI - Regulation and the use of "negative" results from human reproductive studies: the case of ethylene dibromide. AB - This paper examines the regulatory usefulness of five studies of the reproductive effects of occupational exposure to ethylene dibromide. None of the studies found a statistically significant adverse effect. Results from an epidemiologic study can find no adverse effect either because there is in fact no association between the outcome and the exposure being studied or because the study was not powerful enough to detect an association between the two. This distinction is especially important when "negative" studies are offered as evidence that a chemical is not harmful to workers. General reasons for low power in reproductive studies are discussed, and each of the studies is examined to see if the results were in fact negative and what factors were operating to affect the power of each study. Four of the studies showed potential reproductive impairments that were not large enough to be judged statistically significant by the authors. The power of all of these studies was then examined and found to be low for a number of reasons. These studies therefore do not represent evidence that ethylene dibromide is harmless; on the contrary, they may indicate the opposite. In general, when regulating potentially harmful chemicals in a low-power situation, power should be raised by raising the alpha level of the study, especially when animal data show a strong positive effect. PMID- 3303923 TI - Hospital diversification: bibliography on pharmaceutical services. AB - A pharmacy diversification bibliography is presented. The bibliography includes a selection of references to descriptive reports, research papers, editorials, letters, and commentaries on diversified pharmaceutical services. This bibliography represents important literature from the past 12 years on diversification strategies as well as specific diversified services. For additional information, references have also been included to articles that suggest opportunities for diversification, describe pharmacists' roles in specific services, discuss legal or reimbursement aspects of a service, or could be used to help justify the implementation of a service or "sell' a service to hospital administrators or consumers. The bibliography can be helpful to pharmacy managers and clinicians who are interested in becoming involved in diversification of pharmaceutical services. PMID- 3303924 TI - Culture and antibiotic monitoring service in a community hospital. AB - A culture-antibiotic monitoring service (CAMS) established by the pharmacy in a 254-bed community hospital is described. CAMS was offered as a clinical pharmacy consultation service to reduce the delay between availability of culture-report results in the laboratory and evaluation of these results by the physician. The pharmacist reviews culture results in conjunction with the patient's antibiotic therapy and clinical condition and contacts the physician regarding changes in therapy according to predetermined criteria. The pharmacist is also able to promote appropriate antibiotic prescribing and generate cost savings through interactions with physicians facilitated by CAMS. More than 98% of physicians agreed to participate in CAMS. During a one-year period, physicians implemented 87.1% of pharmacist-recommended changes in antibiotic therapy in 202 patients. The projected cost savings through a reduction in inappropriate prescribing of ceftazidime alone during a 10-month period enabled the pharmacy to easily justify hiring an additional clinical pharmacist. The culture-antibiotic monitoring service has enabled the pharmacy department to foster appropriate use of antibiotics and to realize substantial cost savings. PMID- 3303925 TI - Multicenter collaborative evaluation of a standardized serum bactericidal test as a predictor of therapeutic efficacy in acute and chronic osteomyelitis. AB - Forty-eight episodes of osteomyelitis, 30 acute and 18 chronic, were evaluated in a prospective multicenter collaborative study to determine whether a standardized serum bactericidal test could predict outcome of infection. All centers used a microdilution test method that defined the recognized important test variables, including inoculum size, culture medium, dilution technique, incubation time, method of subculture, and bactericidal endpoint. In patients with acute osteomyelitis, peak serum bactericidal titers had no predictive value; however, trough titers of 1:2 or greater accurately predicted cure, whereas trough titers of less than 1:2 predicted therapeutic failure. In patients with chronic osteomyelitis, peak serum bactericidal titers of 1:16 or greater and trough titers of 1:4 or greater accurately predicted cure, whereas peak titers of less than 1:16 and trough titers of less than 1:2 accurately predicted failure. It is concluded that this standardized serum bactericidal test provides good prognostic information in patients with osteomyelitis, and it is recommended that patients with acute osteomyelitis have serum bactericidal titers of 1:2 or greater at all times and that patients with chronic osteomyelitis have serum bactericidal titers of 1:4 or greater at all times. PMID- 3303927 TI - Gene therapy: current status. AB - The bone marrow is the probable first target for gene therapy of genetic diseases. The candidate diseases are those involving mutant enzymes, such as adenosine deaminase. A consensus strategy has evolved utilizing RNA viral vectors to introduce new genes into marrow cells. Two major obstacles still preclude application of this technology to humans: extremely inefficient expression of a new gene in the host cell, and the lack of a convenient and clinically acceptable method of returning the genetically altered cells to the patient. Even before the technical problems of gene therapy have been solved, other technologies such as organ transplantation, are helping to ease the burden of many genetic diseases. PMID- 3303926 TI - Toxicity of amphotericin B plus flucytosine in 194 patients with cryptococcal meningitis. AB - A multicenter prospective randomized trial of four versus six weeks of amphotericin B, 0.3 mg/kg per day, plus flucytosine, 150 mg/kg per day, was performed with 194 patients with cryptococcal meningitis. One or more toxic drug reactions developed in 103 patients: azotemia (51), renal tubular acidosis (two), leukopenia (30), thrombocytopenia (22), diarrhea (26), nausea/vomiting (10), and hepatitis (13). The four- and six-week regimens were complicated by toxicity in 44 percent and 43 percent of cases, respectively. Toxicity appeared during the first two weeks of therapy in 56 percent and during the first four weeks in 87 percent. Azotemia did not occur more frequently in renal transplant recipients or diabetic patients. Cytopenias did not appear more often in patients with hematologic malignancies or those receiving immunosuppressive therapies. Toxic reactions that contributed to death developed in five patients (two with azotemia, one with pancytopenia, one with hepatitis, one with ileus). Amphotericin B-induced azotemia was not a significant risk factor for the subsequent development of bone marrow, gastrointestinal, or hepatic toxicity attributable to flucytosine. Flucytosine toxicity was associated with peak serum flucytosine levels of 100 micrograms/ml or more during two or more weeks of therapy (p = 0.005). Peak 5-fluorouracil levels were not predictive of toxicity. An initial dose of flucytosine is recommended based on the creatinine clearance: 150 mg/kg per day at a creatinine clearance above 50 ml/minute, 75 mg/kg per day at a creatinine clearance of 26 to 50 ml/minute, and 37 mg/kg per day at a creatinine clearance of 13 to 25 ml/minute. The serum creatinine level should be monitored twice weekly and the creatinine clearance weekly during therapy in order to anticipate changes in serum flucytosine concentration. In addition, it is recommended that the serum flucytosine level be determined two hours after an oral dose once a week, and that the dose be adjusted to maintain a level of 50 to 100 micrograms/ml. PMID- 3303929 TI - Successful therapy of Pseudomonas aeruginosa endocarditis with ceftazidime and tobramycin. PMID- 3303928 TI - Hypercalcemic hyperparathyroidism complicating oncogenic osteomalacia. Effect of successful tumor resection on mineral homeostasis. AB - Described herein is a case of oncogenic osteomalacia that ran a course of at least 16 years before curative resection of a mixed mesenchymal tumor. Hypercalcemic hyperparathyroidism developed in the patient, and review of the literature indicated that this occurs in about 10 percent of reported cases. Changes in serum parathyroid hormone levels with and without phosphate supplement therapy and before and after tumor resection suggested that both the high intake of phosphate and the effect of the neoplasm on vitamin D bioactivation engendered the parathyroid overactivity. Despite marked hyperparathyroidism, serum 1,25 dihydroxyvitamin D levels were subnormal preoperatively but showed a sevenfold increase within 48 hours of tumor resection. Thereafter, a gradual increase in the maximal tubular reabsorption of phosphate occurred during several months. Biopsy of the iliac crest confirmed that tumor removal was followed by resolution of osteomalacia, but there was no accompanying increase in vertebral mineral density as assessed by quantitative computed tomography or in total-body bone mineral as measured with dual-photon absorptiometry. The findings presented are consistent with secretion by the tumor of a factor with a short half-life that is potent enough to inhibit renal 25-hydroxyvitamin D-1 alpha-hydroxylase despite hyperparathyroidism. The resulting subnormal circulating 1,25-dihydroxyvitamin D levels may have secondarily contributed to decreased renal tubular reabsorption of phosphate. PMID- 3303930 TI - Diagnosis of prostatic abscess. PMID- 3303931 TI - Using the componential method to train mentally retarded individuals to solve analogies. AB - The applicability of the componential method developed by Sternberg (1977a) to the study of the processes used by mentally retarded subjects to solve analogies was examined in two experiments. In both experiments, prior training was found to improve performance and enhance maintenance of that performance level over time. In Experiment 1, however, subjects experienced difficulty in using "precued" analogy terms, the means by which separate estimates of the processes used to solve the analogies were made using the componential method. In Experiment 2, use of an alternative method of presenting the analogies significantly increased the use of these terms by the subjects, which, in turn, improved the applicability of the componential method to the data obtained from the subjects. This alternative method, however, also increased the overall difficulty level of the task. PMID- 3303932 TI - Sonographic features of the triploid fetus. AB - The sonographic characteristics of six viable triploid fetuses, with gestational ages ranging from 16 to 33 weeks, are presented. Each pregnancy was associated with decreased amniotic fluid volume, a significant lag in biparietal diameter and femur length, and severe head-to-body disproportion. No placental abnormalities were noted on ultrasound and only one placenta demonstrated hydropic change (15% to 20% of villi) on pathologic examination. Since the nonmolar triploid fetus often presents with unexplained intrauterine growth retardation, identification of its characteristic sonographic features allows for karyotype confirmation and the avoidance of inappropriate obstetric management. PMID- 3303933 TI - Successful fetal therapy for cystic adenomatoid malformation associated with second-trimester hydrops. AB - Fetal hydrops secondary to cystic adenomatoid malformation was detected in a second-trimester fetus. In utero thoraco-amniotic shunt placement resulted in resolution of the hydrops. At term, there was no evidence of pulmonary hypoplasia. PMID- 3303934 TI - A screening test (GBS-Test) for urogenital carriage of group B streptococci. AB - A commercial kit for the detection of group B streptococci (GBS-Test) is described. The test is based on orange pigment production after 2 days' incubation at 37 degrees C. It showed a 100% specificity and a sensitivity superior to that of a conventional selective broth method. PMID- 3303935 TI - Increased fetoplacental active renin production in pregnancy-induced hypertension. AB - Since pregnancy-induced hypertension is associated with impaired uteroplacental blood flow, we studied fetoplacental and maternal renin production in controls and subjects with pregnancy-induced hypertension. We measured total, active, and inactive (pro-) renin in maternal serum, fetal arterial and venous blood, and chorion homogenate in eight normotensive term patients and 18 patients with pregnancy-induced hypertension. No differences in active or prorenin were found in maternal blood from normal women or patients with pregnancy-induced hypertension. In contrast, fetal artery and vein, as well as chorionic tissue, contained significantly higher active renin in pregnancy-induced hypertension compared with normal subjects. No difference in fetal or chorionic prorenin was seen in the two groups. Thus active to total renin ratio was higher in the fetus and chorion of subjects with pregnancy-induced hypertension, which suggests enhanced active renin production. These results suggest that pregnancy-induced hypertension is associated with increased activity of the renin-angiotensin system in the fetoplacental unit, which is not reflected in the maternal circulation. This may be an attempt by the fetus and chorionic membranes to maintain vascular homeostasis in the face of altered uteroplacental blood flow. PMID- 3303936 TI - A study on intrauterine fetal resuscitation with terbutaline. AB - A randomized study on the effect of terbutaline on fetal distress was carried out in 20 patients who showed evidence of ominous fetal heart rate patterns and fetal scalp blood pH values of less than 7.25. Of those, 11 received terbutaline (study group) and nine did not (control group). There was a significant improvement in the acid-base status of the fetus in the study group compared with those in the control group (p less than 0.01). No significant maternal or fetal morbidity occurred in the study group. Apgar scores at 1 minute were 7 or greater in 10 of the 11 study subjects whereas only four of the nine control subjects had a score of 7 or greater. These results suggest that terbutaline may become a useful agent in the treatment of intrauterine fetal distress. PMID- 3303937 TI - A randomized trial of ritodrine tocolysis versus expectant management in patients with premature rupture of membranes at 25 to 30 weeks of gestation. AB - Expectant management was compared with similar management plus ritodrine tocolysis in a randomized controlled trial in patients with premature rupture of membranes at 25 to 30 weeks of gestation. In the tocolysis group intravenously administered ritodrine was instituted at the onset of labor and then changed to the oral form if successful. Tocolysis was discontinued or not instituted after 31 weeks of gestation. Seventy-nine patients were randomized over a 4-year period, 39 in the tocolysis group and 40 in the expectant group. Twenty-three patients in the tocolysis group actually received ritodrine. No difference between the two groups was demonstrated in the interval between premature rupture of membranes and delivery or in reaching 32 weeks of gestation. No statistical difference was seen in maternal morbidity. Birth weights and gestational ages at delivery were similar between the two groups as were the incidences of neonatal morbidities caused by prematurity and infection and in the duration of neonatal hospital stays. Despite being conducted in those gestational ages in which prolongation of pregnancy might be expected to be of most benefit, no difference could be demonstrated with the addition of tocolytic therapy over expectant management alone. PMID- 3303939 TI - In utero ponderal index as a prognostic factor in the evaluation of intrauterine growth retardation. AB - The in utero ponderal index has become a method of estimating fetal growth. Several methods have been used in the formulation of the in utero ponderal index. In the present study, 1040 pregnant women underwent ultrasonic examination between 24 and 41 weeks of gestation, and the in utero ponderal index was determined by dividing the estimated fetal weight by the third power of the femur length, rendering a relatively constant value of 8.345 +/- 2.5 (2 SD). Fifty-one cases were defined as intrauterine growth retardation due to an estimated fetal weight lower than the tenth percentile for gestational age. The in utero ponderal index proved to be a valuable index in the prediction of fetal outcome in those cases of intrauterine growth retardation in which the in utero ponderal index was smaller than 1 SD from the average of 8.345. Fetal and neonatal well-being was clearly compromised when intrauterine growth retardation was associated with a low in utero ponderal index. PMID- 3303938 TI - Detection of Chlamydia trachomatis cervical infection: a comparison of Papanicolaou and immunofluorescent staining with cell culture. AB - We compared tissue culture with Papanicolaou-stained cervical smears, endocervical cytologic smears stained with immunofluorescent monoclonal antibody, and a direct immunofluorescent stain of cervical specimens (MicroTrak) for detection of Chlamydia trachomatis in cervical specimens. Fifty-one (21%) of 245 women had positive cultures for C. trachomatis, 14 (27%) of whom had clinical evidence of cervicitis. With the criteria of intracytoplasmic coccoid inclusion bodies within metaplastic cells, 45 (34%) of 130 Papanicolaou smears were read as suggestive for C. trachomatis. Seventeen of the 45 positive Papanicolaou smears were positive on culture and 28 were negative (sensitivity 54%, specificity 71%). In contrast, 48 of 51 women with positive cultures and one woman with a negative culture had positive immunofluorescent-stained cytologic smears (sensitivity 94%, specificity 99%, with positive predictive value of 98%). Similarly, 47 of 51 women with positive cultures also had positive results with MicroTrak direct immunofluorescent stain, with only one positive specimen in 196 women with negative cultures (sensitivity 92%, specificity 99%, with positive predictive value of 98%). This study demonstrates that immunofluorescent staining of cervical specimens or of cytologic smears is a more sensitive and specific method than routine Papanicolaou smear for detection of chlamydia infection in a high prevalence population. PMID- 3303940 TI - Disruption of embryonic and fetal development due to preimplantation chemical insults: a critical review. AB - Descriptive teratology has developed several fundamental precepts, two of which can now be challenged on the basis of experimental evidence. The first is that prior to implantation the developing embryo is not susceptible to survivable defects from chemical injury. The second is that developmental defects cannot be due to mutational events since rare events seem unlikely to explain alterations in large populations of cells. This review presents current experimental evidence demonstrating that the effects of chemical exposure on blastocyst stage embryos may be manifest long after the time of insult and that subtle nonlethal mutations may have a role in poor fetal performance after early chemical exposures. PMID- 3303941 TI - Single-agent therapy for women with acute polymicrobial pelvic infections. AB - Pathogens that cause acute polymicrobial female pelvic infections usually do not differ from those that compose the normal flora of the lower reproductive tract. Accurate identification of these bacteria is difficult because cultures obtained via the lower tract can easily be contaminated. Although use of a double-lumen catheter-protected brush culture cannot completely eliminate the risk of contamination, it is the least invasive method for obtaining culture material from the upper reproductive tract. Compounding the problem of accurately identifying pathogens that cause acute upper tract infections is the fact that bacteria appear to be present in the upper tracts of asymptomatic women with normal examinations. Because of these problems and because of the polymicrobial nature of these infections, empiric therapy frequently includes more than one antimicrobial agent. Newer, semisynthetic penicillins and cephalosporins have expanded spectrums of in vitro activity against most of the bacteria frequently recovered from pelvic infection sites. Comparative clinical trials have shown these agents to be as effective when used alone as is combination therapy. With few exceptions, empiric monotherapy with one of these newer antimicrobials will be curative for women with acute upper tract infection, will have less potential toxicity, will require less space, materials, and manpower to administer, and will be less expensive. PMID- 3303942 TI - Changing concepts in obstetric antibiotic prophylaxis. AB - The evolution of antibiotic prophylaxis in cesarean section is traced from the discovery of sulfa compounds in the 1940s to the present. Prolonged courses of antibiotics, initiated before the surgical incision, have given way to shorter, three-dose and even single-dose regimens administered after clamping of the umbilical cord. Several factors have been proposed to help identify patients at greatest risk of infection. Guidelines for antibiotic prophylaxis are reviewed. The effects of antibiotics on host flora are described, and the implications of bacterial resistance for selection of a prophylactic agent, particularly with respect to induction of the Richmond-Sykes type I beta-lactamase enzyme, are discussed. PMID- 3303943 TI - Single-dose prophylaxis for vaginal and abdominal hysterectomy. AB - The practice of administering perioperative antimicrobials to uninfected patients undergoing elective surgical procedures has been subjected to careful prospective investigative scrutiny during the past two decades. A wound classification system was developed, helping to identify procedures for which prophylaxis did not provide benefit to the patient. Guidelines for prophylaxis in hysterectomy were proposed and risk factors were sought. Pharmacokinetics and spectrum of antibacterial activity, although variables of paramount importance in predicting success in the treatment of established infections, were discovered to have questionable impact on prophylactic efficacy. Duration of antimicrobial administration has gradually diminished from the total length of hospital stay to a single preoperative dose without increased risk of infection; efficacy may be related to route of administration. The wisdom of using newer agents for prophylaxis is addressed and questioned. PMID- 3303944 TI - Single-dose versus multiple-dose piperacillin prophylaxis in primary cesarean operation. AB - A prospective, randomized double-blind study was undertaken to determine the safety and efficacy of single-dose versus multiple-dose piperacillin for primary cesarean operation prophylaxis. After informed consent was obtained, patients received either 4 gm of piperacillin intravenously as a single dose or three 2 gm doses of piperacillin intravenously 4 hours apart. One hundred sixteen patients were evaluated for response; postoperative infection at the operative site was prevented in 52/60 (86.6%) who received the single dose and 53/56 (94.6%) who received multiple doses. The types of postoperative infections that occurred were similar in those patients in each group who developed infection and all responded well to therapeutic drugs. No adverse reactions to piperacillin were noted. Demographic characteristics and risk factors for infection were comparable for the two groups. These data support the efficacy of single-dose prophylaxis with an appropriate antibiotic agent. PMID- 3303945 TI - Definitions of sensitivity, specificity, false negative results, and false positive results. PMID- 3303946 TI - Unesterified cholesterol in Schnyder's corneal crystalline dystrophy. AB - We examined a 51-year-old woman who had bilateral corneal crystalline deposits unassociated with xanthelasma or systemic involvement. Her son had similar corneal lesions. Plasma cholesterol and apolipoprotein A-I and B levels were normal in both patients. Histopathologic examination of the corneal button in the mother obtained at the time of keratoplasty disclosed lipid deposits that stained with oil red O as well as with filipin, a fluorescent probe that specifically detects unesterified cholesterol. Electron microscopy showed abnormal accumulation of lipid and cholesterol in the central and paracentral basal epithelium, Bowman's layer, and superficial stroma. PMID- 3303947 TI - Corneal transplantation in microphthalmic eyes. AB - We performed corneal transplantation in nine microphthalmic eyes of five patients, who ranged in age from 1 to 63 months. The anteroposterior diameter of the eyes ranged from 12.5 to 16 mm. Complications from the surgery included superficial epithelial erosions in three eyes, leading to superficial scarring in one eye, glaucoma, and suture microabscesses. Despite these complications, seven of nine grafts have remained clear and vision developed in all eyes. PMID- 3303948 TI - Recurrent crystal deposition after keratoplasty in nephropathic cystinosis. PMID- 3303949 TI - Lacrimal gland abscess. PMID- 3303950 TI - Secondary intraocular lens implantation vs epikeratophakia for the treatment of aphakia. PMID- 3303951 TI - An immunohistochemical and serum ELISA study of type I and III procollagen aminopropeptides in primary biliary cirrhosis. AB - By means of ELISA methodology, the aminopropeptides of Type I and Type III procollagen were measured in the serum of a group of patients with primary biliary cirrhosis. The corresponding liver biopsies were graded blindly for degrees of fibrosis and inflammation. When available, paraffin-embedded liver specimens underwent immunoperoxidase staining for mature Type I and III collagen as well as the aminopropeptides of Type I and III procollagen. Regardless of the degree of fibrosis or inflammation, serum levels of the aminopropeptide of Type I remained within normal limits. In contrast, serum levels of the aminopropeptide of Type III procollagen were elevated uniformly. Immunohistochemistry demonstrated that the aminopropeptide of Type III procollagen persists extracellularly. This finding may explain the previously reported relationship between levels of inflammation and serum levels of the Type III aminopropeptide. PMID- 3303952 TI - Rat urinary bladder denuded of urothelium. An in vivo model for the epithelial stromal interactions in carcinogenesis. AB - To investigate epithelial-stromal interactions in bladder carcinogenesis, the authors developed an experimental model using a heterotopically transplanted rat urinary bladder (HTB). A rat urinary bladder which was completely denuded of epithelial cells ex vivo with hypotonic shock and a nonionic detergent was transplanted into a syngeneic recipient. No reepithelialization occurred during the 8-week posttransplant period. The basal lamina remained intact throughout this period and showed linear immunofluorescence with antibodies against laminin, Type IV collagen, and heparan sulfate-proteoglycan. When 1 X 10(5) to 5 X 10(5) dispersed normal urothelial cells were delivered into the HTB through an attached reservoir 4 days after transplantation, complete resurfacing by inoculated cells occurred within a few days. A transient hyperplasia was followed by a normal 2-3 cell-thick urothelial organization in 4 weeks. Cultured bladder carcinoma cells also resurfaced the denuded bladder basal lamina; the progressive growth of this neoplastic epithelium resulted in carcinoma in situ as well as foci of invasive carcinoma within 4 weeks following inoculation. This in vivo system has an advantage over other in vivo and in vitro models in that complete removal of epithelial cells can be achieved easily and completely; the course after reepithelialization can be modified by subsequent treatment, progression of neoplastic development can be closely observed by a change in the color of the aspirate, its cytology, and biochemical analysis of secretions; and an adequate amount of tissue can be available for subsequent examinations. The model is potentially useful not only for studying epithelial-stromal interactions during carcinogenesis, but also for examining the mechanisms of tumor invasion and metastasis. PMID- 3303953 TI - The non-obese diabetic (NOD) mouse. PMID- 3303954 TI - Psychosocial resilience and protective mechanisms. AB - The concept of mechanisms that protect people against the psychological risks associated with adversity is discussed in relation to four main processes: reduction of risk impact, reduction of negative chain reactions, establishment and maintenance of self-esteem and self-efficacy, and opening up of opportunities. The mechanisms operating at key turning points in people's lives must be given special attention. PMID- 3303955 TI - Retromolar foramen of the human mandible. AB - Analysis of retromolar foramen (RMF) in a large series of mandibles (N 2500) was undertaken to provide descriptive statistics for this variant. RMF of diameter 0.5 mm or greater were scored. Consistent with other data on accessory canals in the facial skeleton, RMF was found to occur more commonly in native populations of North America than in other populations (Africa, Europe, India, northeast Asia). The ratio of bilateral to unilateral occurrences was shown to increase with population incidence, a pattern consistent with the theoretical model of an epigenetic (threshold "quasicontinuous") variant. Male-female differences were not found. Age profiles were characterized by a marked peak in the adolescent cohort. In some populations RMF showed a positive intertrait correlation with accessory mandibular foramen and with accessory mental foramen, but correlations with presence/absence of third molar and three-rooted first molar were not found. With refinements in scoring criteria and, ideally, better evidence of its heritability, RMF should be useful along with other minor cranial variants for ethnohistorical studies. PMID- 3303956 TI - More lingual surface attrition of the maxillary anterior teeth in American Indians: prehistoric Panamanians. AB - Lingual surface attrition of the maxillary anterior teeth (LSA-MAT) has been found in additional prehistoric Latin American Indian skeletons. LSAMAT was first observed in crania from an Archaic Brazilian site. This second finding occurs in teeth from Venado Beach, a late prehistoric site in Panama. LSAMAT is also present in some fragmentary specimens from the Archaic Cerro Mangote site in Panama. LSAMAT at Venado Beach is present in 57% of 28 adult crania. As in the Brazilian study, LSAMAT is associated with a high caries rate (82% of 50 adults; 11.7% of 852 permanent teeth). As first suggested, eating and processing of some type of abrasive carbohydrate food, such as manioc, is the possible cause of LSAMAT. However, other possible causes relating to habitation on or near marine coasts cannot be totally ruled out. PMID- 3303957 TI - La Ferrassie 6 and the development of Neandertal pubic morphology. AB - Functional interpretations of the mediolateral elongation and superoinferior flattening of the superior pubic ramus of Neandertals require knowledge of its ontogeny. Metric comparisons between the La Ferrassie 6 Neandertal infant, aged 3 5 years, and a sample of modern infants reveal that the acetabulosymphyseal length of La Ferrassie 6, relative to femoral length and iliac breadth, falls at the limits of the range of variation of the modern infants, while the relative height of its superior pubic ramus is indistinguishable from that of the modern sample. It appears that acetabulosymphyseal elongation of the Neandertal pubis is a feature which is expressed quite early in ontogeny, well before puberty. Superoinferior flattening and ventral margin thinning of the superior ramus probably appear later in Neandertal ontogeny. PMID- 3303958 TI - Late Pleistocene and Holocene population history of East Asia based on dental variation. AB - The purpose of this communication is to provide a summary description and analysis of 28 dental traits studied in a number of skeletal samples that originated in eastern Asia. The objectives of the analysis are to define the nature of Mongoloid dental variation, use it to measure Asian intergroup relationships, and develop in greater detail and with larger samples a dental anthropological model of the late Pleistocene and Holocene population history of eastern Asia. PMID- 3303959 TI - Health and agricultural intensification in the prehistoric Valley of Oaxaca, Mexico. AB - The effects of agricultural intensification on health are examined in prehistoric populations of the Valley of Oaxaca, Mexico. Agriculture was practiced in the Valley of Oaxaca by the beginning of the Early Formative period (ca. 1400 B.C.), and had intensified by the Late Formative (ca. 500 B.C.). Skeletal remains from 14 archaeological sites in the Valley are pooled by temporal affiliation into a nonintensive agriculture group (1400-500 B.C.) and an intensive agriculture group (500 B.C.-1400 A.D.). The health effects of agricultural intensification are assessed by comparing the frequency of periosteal reactions, cribra orbitalia, and enamel hypoplasia between the intensive and nonintensive agricultural groups. Overall, no significant differences (alpha = 0.05) are found between the nonintensive and intensive groups. Power analyses of the chi-square tests indicate that the tests have a high probability of rejecting a false null hypothesis. The intensification of agriculture does not appear to have had a deleterious effect on the health of the prehistoric population of the Valley. The differences between this study and previous studies of health and agricultural development may be explained by differences between the processes of intensification and development or by differences between primary and secondary centers of agricultural development. PMID- 3303960 TI - Patterns of approximal wear in cheek teeth of a Romano-British population. AB - The approximal surfaces of premolars and molars of 376 adult British-Romano skulls were examined for wear facets. The type of wear was designated as convex, concave, sigmoid, or flat, and the degree was categorised on a three-point scale. Concave wear facets were more frequently seen in the older age groups, but the type of wear was similar on right and left sides. Taking all teeth together or as individual tooth types, concave wear was significantly more likely on mesial rather than distal surfaces. The degree of wear was age related and similar on right and left sides in both males and females. It is suggested that the distribution of concave facets may be related to movements between adjacent teeth. PMID- 3303961 TI - Characteristics and functions of Na-K-Cl cotransport in epithelial tissues. AB - This review summarizes our present understanding of Na-K-Cl cotransport and its physiological role in absorption and secretion of electrolytes and water in epithelial tissues. In the past several years an extensive literature about this cotransporter has developed due to its widespread distribution in a variety of cell types and its essential role in fluid and electrolyte transport in several epithelial tissues. We summarize this literature and speculate on the future characterization of this transport system. Although this review focuses on cotransport as it relates to absorptive and secretory processes in epithelia, important information concerning the pharmacology, stoichiometry, and regulation of Na-K-Cl cotransport in nonepithelial systems (i.e., erythrocytes, fibroblasts, squid axon, etc.) has been included to supplement areas that are less well established in the epithelial literature. PMID- 3303962 TI - Mechanical properties of skinned single fibers of identified types from rat diaphragm. AB - Maximum isometric tension (Po), maximum velocity of shortening (Vmax), and tension-pCa (i.e., -log[Ca2+]) relationships were determined in single skinned fibers from rat diaphragm. Histochemistry (myosin-ATPase) and sodium dodecyl sulfate (SDS) gel electrophoresis were performed on these same fibers to determine fiber type and protein composition. Physiologically fast fibers were found to have larger cross-sectional areas (CSA) and produced more tension per CSA and were less sensitive to [Ca2+] than physiologically slow fibers. Fast fibers were typed histochemically as type II and contained myosin heavy chains (MHC) and light chains (LC) of the fast type, whereas the slow fibers contained slow MHC and LC. There were also corresponding differences in the regulatory protein composition of these two fiber types. The histochemical sections confirmed a significant fiber size difference between the type IIa and IIb fibers. When fiber size was used to separate the fast fibers into two groups, type IIb fibers were found to have significantly greater Vmax and tension per CSA than the type IIa fibers. Although there were no noticeable differences in MHC composition between the type IIa and IIb fibers, there were some differences in the myosin LC and regulatory protein content. PMID- 3303963 TI - High NaCl induces stable changes in phenotype and karyotype of renal cells in culture. AB - Extracellular fluid in the renal medulla normally is hyperosmotic. To test adaptation to such an environment, a continuous line of rabbit renal inner medullary epithelial cells (GRB-PAP1), which had been established in isosmotic medium, was switched to a medium containing high NaCl. The origin of these cells is described. When the osmolality was raised from 300 to 600 mosmol/kg by adding NaCl, cells eventually survived and proliferated, but unexpectedly, they underwent major changes in phenotype and karyotype that persisted during proliferation in isosmotic or hyperosmotic medium for at least 7 months. The threshold concentration for the changes was approximately 500 mosmol/kg. Cells of a typical strain (PAP-HT25) that formed in hyperosmotic medium were much larger and more often multinucleated than were GRB-PAP1. GRB-PAP1 cells were near diploid; PAP-HT25 cells were polyploid. The changes, since they occurred in most clones, were due to adaptation of the majority of cells and not to selection of a minority of cells already having these characteristics. Cloning efficiency was higher for GRB-PAP1 than PAP-HT25 in isosmotic medium, but the reverse occurred in hyperosmotic medium. Thus exposure to the hyperosmotic medium induced greater ability to clone in it. We suggest that these changes may involve persistent alterations in gene regulation, possibly like those previously reported in chicken embryo fibroblast cells after hyperosmotic NaCl (Cell 30: 131-139, 1982). PMID- 3303964 TI - IP3-dependent Ca2+ release in permeabilized hepatocytes of endotoxemic and septic rats. AB - Inositol trisphosphate-dependent Ca2+ release was measured in saponin permeabilized hepatocytes isolated from acutely (2 mg/100 g body wt iv) or chronically (0.1 mg X 100 g body wt-1 X 24 h-1 for 30 h) endotoxin-treated (ET, Escherichia coli) rats or from animals rendered septic by cecal ligation and puncture. A decrease of this parameter was observed in acutely ET-treated rats (52%, P less than 0.01) and after 30 h of continuous ET infusion (33%, P less than 0.01). Sepsis was associated with an elevated Ca2+ release (34%, P less than 0.01) as compared with the sham-operated animals. We conclude that during endotoxicosis and sepsis alterations of intracellular Ca homeostasis take place, reaching sites beyond the level of the plasma membrane. Such alterations could account in part for metabolic and functional changes associated with these pathologic states. In addition, ET treatment provides the first known intervention resulting in the modulation of inositol trisphosphate-dependent Ca2+ release. PMID- 3303965 TI - Insulin resistance during suckling period in rats. AB - Glucose metabolism was studied in 13- to 15-day-old suckling rats and 28- to 30 day-old rats weaned at 19 days on a high-carbohydrate, low-fat diet. The glucose turnover rate in the basal state was similar in suckling and weaned rats (14 mg X min-1 X kg-1). Glucose infusion (20 mg X min-1 X kg-1) produced a moderate hyperglycemia in weaned rats (150 mg/dl), whereas the suckling rats developed a high hyperglycemia (280 mg/dl), despite a large increase of plasma insulin concentration. The effect of insulin on glucose kinetics was then assessed by the euglycemic-hyperinsulinemic clamp technique. The plasma insulin levels reached were 736 +/- 87 microU/ml in the suckling and 444 +/- 34 microU/ml in the weaned rats, despite similar insulin infusion rates. Hepatic glucose production was suppressed by 90% in the weaned rats, whereas it remained at 40% of basal value in the suckling rats. The increase of glucose utilization above basal was fourfold higher in the weaned than in the suckling rats. Thus an insulin resistance state is present in the suckling rats and disappears after weaning onto a high-carbohydrate diet. PMID- 3303966 TI - Cold exposure potentiates the effect of insulin on in vivo glucose uptake. AB - The effects of cold exposure (48 h at 4 degrees C) and insulin injection (0.5 U/kg iv) on the rates of net 2-[3H]deoxyglucose uptake (Ki) in peripheral tissues were investigated in warm-acclimated rats (25 degrees C). Cold exposure and insulin treatment independently increased Ki values in skeletal muscles (soleus, extensor digitorum longus, and vastus lateralis), heart, white adipose tissue (subcutaneous, gonadal, and retroperitoneal), and brown adipose tissue (P less than 0.01). The effects of cold exposure were particularly evident in brown adipose tissue where the Ki increased greater than 100 times. When the two treatments were combined (insulin injection in cold-exposed rats), it was found that cold exposure synergistically enhanced the maximal insulin responses for glucose uptake in brown adipose tissue, all white adipose tissue depots, and skeletal muscles investigated. The results indicate that cold exposure induces an "insulin-like" effect on Ki that does not appear to be specifically associated with shivering thermogenesis in skeletal muscles, because that effect was observed in all insulin-sensitive tissues. The data also demonstrate that cold exposure significantly potentiates the maximal insulin responses for glucose uptake in the same tissues. This potentialization may result from an enhanced responsiveness of peripheral tissues to insulin, possibly occurring at metabolic steps lying beyond the insulin receptor and an increased tissue blood flow augmenting glucose and insulin availability and thereby amplifying glucose uptake. PMID- 3303967 TI - Fasting-mediated alteration studies in insulin action on lipolysis and lipogenesis in obese women. AB - The effects of fasting on insulin-induced antilipolysis and lipogenesis were investigated in vitro in isolated human fat cells of 11 obese females. Glycerol release and lipogenesis were determined simultaneously in the same test tube and related to methylglucose transport and specific insulin binding. Insulin binding and sensitivity and the responsiveness (maximum effect) of insulin-induced antilipolysis were enhanced by fasting. The latter was strongly correlated with an enhancement in the lipolysis rate. The effects of fasting on antilipolysis were not dependent on the glucose concentration, unlike insulin-stimulated lipogenesis. At 1 mumol/l of glucose, where hexose transport is rate limiting, sensitivity and responsiveness of insulin-induced lipogenesis were inhibited by fasting. Similar results were obtained with methylglucose transport. At 1-10 mmol/l of glucose, where hexose metabolism is rate limiting, insulin stimulated lipogenesis before fasting but was totally ineffective after fasting. In conclusion, fasting induces multiple alterations in insulin action on lipolysis and lipogenesis in adipocytes. Antilipolysis is enhanced because of stimulation at the receptor and postreceptor levels, which may be associated with an enhanced rate of lipolysis. Fasting inhibits the lipogenic effect of insulin due to postreceptor changes involving both transport and metabolism of glucose, making lipogenesis unresponsive to insulin at physiological glucose concentrations. PMID- 3303968 TI - Hyperglucagonemia during insulin deficiency accelerates protein catabolism. AB - Hyperglucagonemia coexists with insulin deficiency or insulin resistance in many conditions where urinary nitrogen excretion is increased, but the precise role of glucagon in these conditions is controversial. The purpose of this study was to evaluate the effect of hyperglucagonemia on protein metabolism in insulin deficient subjects. We used the stable isotope of an essential amino acid (L-[1 13C]leucine) as a tracer of in vivo protein metabolism. A combined deficiency of insulin and glucagon was induced by intravenous infusion of somatostatin. Hyperglucagonemia and hypoinsulinemia were induced by infusions of somatostatin and glucagon. When somatostatin alone was infused leucine flux increased, indicating a 6-17% increase in proteolysis. When somatostatin and glucagon were infused, leucine flux increased, indicating a 12-32% increase in proteolysis. The increase in leucine flux during the infusion of somatostatin and glucagon was higher than the increase during infusion of somatostatin alone. Somatostatin alone did not change leucine oxidation, whereas the somatostatin plus glucagon increased leucine oxidation 100%. We conclude that hyperglucagonemia accelerates proteolysis and leucine oxidation in insulin-deficient humans. PMID- 3303969 TI - Glucagon and insulin metabolism in a portal-hypertensive rat model. AB - The role that portosystemic shunting plays in inducing the alterations of glucagon and insulin metabolism, which are observed in chronic liver disease, was studied in a rat model of prehepatic portal hypertension induced by portal vein constriction. Net splanchnic output of the hormones into the portal circulation was calculated from the difference between portal and systemic concentrations multiplied by portal plasma flow. Metabolic clearance rate was calculated as the ratio between output and systemic concentration. Portal blood flow was measured by the radioactive microsphere technique. Glucagon output in the portal vein ligated rats was higher than in the sham-operated controls (5.9 +/- 1.5 vs. 2.0 +/- 0.2 ng/min, P less than 0.05). The metabolic clearance rate of glucagon was not significantly different between the two groups. Insulin output was not significantly different between the two groups; however, the metabolic clearance rate of insulin in the portal vein-ligated rats was reduced in comparison with the sham-operated group (9.5 +/- 1.5 vs. 18.4 +/- 3.3 ml/min, P less than 0.05). Our results indicate that portosystemic shunting per se is sufficient to cause an increased splanchnic output of glucagon into the portal system and a decreased metabolic clearance of insulin. PMID- 3303970 TI - Cardiac receptor modulation of blood flow and fluid transport in feline jejunum. AB - The aim of the study is to determine the effects of selective cardiac receptor unloading on vascular resistance and net fluid transport in the small intestine. In anesthetized cats, cardiac receptors were unloaded by positive pressure ventilation (PPV). Arterial baroreceptor activity was artificially maintained constant. To test if the observed responses were due to a vagal reflex, experiments were performed both in animals with intact vagal nerves (n = 9) and after bilateral cervical vagotomy (n = 8). PPV-induced decreases in central blood volume (CBV) significantly increased intestinal vascular resistance (IVR) and net fluid absorption rate and decreased the transmural potential difference (PD). Cervical vagotomy per se also increased IVR and absorption rate and decreased PD. In vagotomized animals, decreases in CBV had no consistent effects on IVR, net fluid absorption rate, or PD. The results are compatible with cardiac receptor modulation of both blood flow and fluid absorption rate in the feline jejunum. Differences in the response patterns for the vascular and absorptive effects suggest that they may be mediated by separate efferent pathways. PMID- 3303971 TI - Endocrine pancreatic morphology and function in exocrine insufficiency in rats. AB - Exocrine pancreatic insufficiency was induced in rats by injection of oleic acid into the pancreatic duct. Six weeks after a single injection of 50 microliters oleic acid, the exocrine tissue was reduced by 98%. The islets of Langerhans remained intact and showed no changes in the relative distribution of beta-, alpha-, D-, and PP-cells. In rats fed ad libitum, plasma insulin levels and pancreatic insulin content did not differ between oleic acid-treated animals and controls. The dynamic insulin response was evaluated in the isolated perfused pancreas. The biphasic pattern of insulin release after stimulation by glucose was preserved. The half-maximal (10 mM) glucose-induced insulin release was reduced to 49% after onset of exocrine atrophy. After stimulation of insulin secretion by a maximal glucose load (20 mM), the insulin output from the perfused pancreas was reduced to 56%. A reduction in insulin release to 24% occurred with respect to the arginine (15 + 10 mM glucose)-stimulated secretion. To evaluate the significance of these findings in intact animals, glucose tolerance tests were performed. There were no differences between oleic acid-, saline-, or untreated animals with respect to serum glucose or plasma insulin levels during the oral glucose tolerance test. The insulin response after intravenous glucose in oleic acid-treated rats was not statistically different from controls. Nevertheless, the serum glucose levels in rats with exocrine atrophy were above controls, indicating a slight impairment of glucose tolerance. PMID- 3303972 TI - Chloride transport by the cortical and outer medullary collecting duct. AB - The processes by which chloride is transported by the cortical and outer medullary collecting tubule have been most extensively studied using in vitro microperfusion of rabbit tubules. Chloride appears to be transported by three major mechanisms. First, Cl can be actively reabsorbed by an electroneutral Cl HCO3 exchanger localized to the apical membrane of the HCO3-secreting (beta-type) intercalated cell. Cl exits this cell via a basolateral Cl channel. This anion exchange process can also operate in a Cl self-exchange mode, is stimulated acutely by beta-adrenergic agonists and cAMP, and is regulated chronically by in vivo acid-base status. Second, Cl can diffuse passively down electrochemical gradients via the paracellular pathway. Although this pathway does not appear to be selectively permeable to Cl, it is large enough to allow for significant passive reabsorption. Third, Cl undergoes recycling across the basolateral membrane of the H+-secreting (alpha-type) intercalated cell. HCO3 exit from this cell brings Cl into the cell via electroneutral Cl-HCO3 exchange; Cl then exits the cell via a Cl channel. Cl transport is thus required for acidification and alkalinization of the urine. Both of these processes exist in the cortical collecting tubule. Their simultaneous operation allows fine tuning of acid-base excretion. In addition, these transport systems, when functioning at equal rates, effect apparent electrogenic net Cl absorption without changing net HCO3 transport. These systems may play an important role in regulating Cl balance. PMID- 3303973 TI - Renal effects of endotoxin in the male rat. AB - A new model of acute reduction in renal function induced by a 2-h infusion of endotoxin (Escherichia coli 026:B6 lipopolysaccharide, 5 mg X kg-1 X h-1) was developed in the anesthetized male rat. In the absence of significant glomerular fibrin deposition, inulin clearance (glomerular filtration rate, GFR) was reduced from 8.50 +/- 0.34 to 4.01 +/- 0.45 ml X kg-1 X min-1 (P less than 0.0005), and p aminohippuric acid clearance was reduced from 23.7 +/- 0.8 to 15.0 +/- 1.8 ml X kg-1 X min-1 (P less than 0.0005), indicating a hemodynamic basis for the reduction in GFR. The lack of morphological tubular injury and a decreased fractional Na excretion (from 2.63 +/- 0.27 to 0.54 +/- 0.09%, P less than 0.00005) exclude a significant contribution of tubular mechanisms to the reduction in GFR. Administration of theophylline, a competitive adenosine receptor antagonist, concurrently with or immediately after the endotoxin infusion, restored inulin and PAH clearances and fractional Na excretion toward normal. Moreover, the renal effects of endotoxin were mimicked by intravenous administration of N6-(L-phenylisopropyl)-adenosine (L-PIA), an adenosine receptor agonist, and the effects of L-PIA in turn were also antagonized by theophylline. These data suggest that adenosine plays a significant role in mediating the hemodynamic derangements of this model. PMID- 3303974 TI - Purification of rat papillary collecting duct cells: functional and metabolic assessment. AB - Rat renal papillary collecting duct (PCD) cells were isolated using collagenase and hyaluronidase digestion and a three-step low-speed centrifugation. As assessed by binding of the lectin Dolichos biflorus and determination of vasopressin-sensitive adenylate cyclase and Na+-K+-ATPase, the enrichment of PCD cells over a crude papillary cell preparation was 1.8, 2.4, and 1.4, respectively. Microscopic evaluation indicated that the preparation was greater than 90% pure PCD cells. The isolated cells were viable as evident from the high K/Na ratio of intracellular electrolytes measured by electron probe analysis (5.3), from the high ATP/ADP ratio (2.15), and the metabolic response to alterations in Na transport. Exposure to 2 mM ouabain or removal of Na reduced O2 consumption by 25-35%; the uncoupler carboxylcyanide-m-chlorophenylhydrazone more than doubled O2 consumption. In the presence of 14 mM glucose and at a PO2 of 100 Torr the cells produced substantial quantities of lactate. This aerobic glycolysis may account for greater than 20% of the ATP production. In the presence of rotenone, glycolysis increased by 56% and was able to maintain the cellular ATP level at 65% of control. In the absence of any exogenous substrate PCD cells respired normally and had a close to normal ATP content, but lactate production was markedly decreased. These results demonstrate that viable PCD cells can be isolated from rat kidney. At normal PO2 and in the presence of D glucose the cells show a substantial amount of aerobic glycolysis, although their mitochondrial respiration is not rate limiting. In the absence of glucose the cells derive the majority of their energy from an as yet unidentified endogenous substrate. PMID- 3303975 TI - Tunneling cell processes in myocytes of stretched mouse atria. AB - Serial section electron micrographs of mouse atria stretched in vitro show that myocytes have cell processes which tunnel into adjacent myocytes for 8 microns or more. The tunneling cell processes (TCP) (diam 4-6.2 microns) lack myofibrils and organelles associated with atrial peptide secretion. The glycogen-rich TCP cytoplasmic matrix contains conspicuous tubules and vesicles originating from endoplasmic reticulum and resembling free sarcoplasmic reticulum (SR). TCP are surrounded by a plasmalemma derived from their myocyte of origin, the plasmalemma of the tunneled myocyte, and an intervening narrow compartment continuous with the interstitial space. Profiles having the characteristics cytoplasmic structure of TCP are also found both in the interstitial space between myocytes and near the longitudinal terminations where myocyte ends about on the interstitial space. We suggest that TCP tubules and vesicles may proliferate and/or transport in response to stretch, might be free SR, and may respond to stretch-activated changes in ionic composition or potential of the surrounding myocyte and narrow intercellular compartment. PMID- 3303976 TI - Randomized trial of brief individual treatment for smoking using nicotine chewing gum in a workplace setting. AB - In a controlled trial of brief treatment for smoking using nicotine chewing gum in a workplace setting, 270 of 334 cigarette smokers who expressed interest were invited to take part in the program, which consisted of two individual consultations; 172 attended. The remaining 64 smokers constituted a no intervention control group. Using a criterion of sustained one-year abstinence with biochemical validation, success rates were 12 per cent among participants, 1 per cent among those who were invited but did not attend, and 2 per cent in the control group. PMID- 3303977 TI - Potentiation of autoimmune response in rats infected with Toxoplasma gondii. AB - The influence that an infection with Toxoplasma gondii in thymus proximity produces on the autoimmune response was studied. Rats infected with 3 X 10(3) trophozoites of T. gondii in thymus proximity were immunized with 5 mg/ml of chemically modified rat male accessory glands saline extract (MRAG) and/or human serum albumin (HSA) emulsified in complete Freund's adjuvant (CFA) at 6 days after infection. A second immunization was performed 30 days later. Four experimental groups were made: group 1-rats were immunized with MRAG-CFA and HSA CFA; group 2-rats were infected and immunized with MRAG-CFA and HSA-CFA; group 3 rats were infected and immunized with MRAG-CFA; group 4-rats were infected and immunized with HSA-CFA. The cellular immune response was evaluated at 15 days after first immunization by delayed type hypersensitivity (DTH) test and the humoral response was studied by passive haemagglutination test at 45 days after first immunization. The results indicate that the cellular and humoral immune response against MRAG were significantly potentiated in infected rats (p less than 0.02, p less than 0.05, respectively). The response to HSA did not show significant differences between the infected and uninfected groups. Concomitantly, the histopathological alterations produced by T. gondii in thymus gland were studied at 6 and 52 days after infection. Cortical depletion and presence of parasites in the thymic cortex were detected in both cases. Involution thymic was demonstrated in infected rats killed at 52 days after infection. The possible participation of the thymus gland in the enhancement of the autoimmune response to MRAG is discussed. PMID- 3303978 TI - Effect of electrical stimulation on quadriceps strength after reconstructive surgery of the anterior cruciate ligament. AB - The effect of prolonged daily electrical stimulation (ES) on quadriceps strength in 22 patients during the 6 weeks following anterior cruciate reconstruction was investigated. Patients were randomly assigned to receive either a combination of ES and exercise or exercise alone. Isometric quadriceps strength was measured at the 7th, 8th, and 9th postoperative weeks. No significant difference in strength existed between the groups as a result of ES. A significant difference in strength did exist between competitive and recreational athletes regardless of treatment. Further research is needed to determine if the addition of ES to isometric exercise during immobilization can significantly retard strength loss after anterior cruciate reconstructive surgery. PMID- 3303979 TI - A biomechanical comparison of different surgical techniques of graft fixation in anterior cruciate ligament reconstruction. AB - Different surgical methods of graft fixation in ACL reconstruction were examined to determine the effects on mechanical properties of the reconstructed ACL. Ten human cadavers were used in this study. Six different types of grafts were studied. The tendon grafts were removed from each cadaver and fixed to femurs and tibias as ACL substitutes with different surgical fixation methods, leaving femur reconstructed graft-tibia preparations. The surgical techniques used were staple fixation, tying sutures over buttons, and screw fixation. In the latter, the screws were introduced through femoral and tibial drill holes from the outside in order to achieve interference fit as described by Lambert. Tensile testing demonstrated that the original ACL is significantly stronger than the graft used for reconstruction in linear load, stiffness, and maximum tensile strength. All of the failures of the reconstructed ACL grafts occurred at the fixation site, indicating that the mechanically weak link of the reconstructed graft is located at the fixation site. Among the different methods of fixation, one-third of the patellar tendon secured with a cancellous screw, especially with a custom designed large diameter screw, showed significantly higher values. Although many other factors affect the success of ACL reconstruction, our study indicates that the method of surgical fixation is the major factor influencing the graft's mechanical properties in the immediate postoperative period. PMID- 3303980 TI - The medical aspects of soccer injury epidemiology. AB - In this article, the six major studies of soccer injury epidemiology are reviewed. Strengths and weaknesses of each epidemiologic design are critiqued and the crucial importance of the definition of injury is emphasized. The effect of age, sex, and intensity of play on injury rates is discussed. Our present knowledge of injury rate by anatomical site, player position, and the type of playing surface are reviewed. We examined the importance of player factors such as flexibility, joint laxity, weakness, and incomplete rehabilitation from other injuries. In addition, we reviewed the role played by inadequate equipment, field conditions, and rule violations. A successful program for soccer injury prevention is described, and guidelines for future soccer injury epidemiology research are proposed. PMID- 3303981 TI - Hinged cast after knee ligament surgery. AB - One hundred thirteen patients scheduled for repair of knee ligament injuries were randomized to postoperative immobilization in either a hinged or a long leg cast. The time of disability (i.e., sick leave) was significantly shorter (6 weeks) with a hinged cast, but only in ACL cases. All types of injuries regained their range of motion more rapidly after use of a hinged cast. There was no evidence that the motion permitted in a hinged cast hampers the result as regards to stability. PMID- 3303982 TI - Follicular lymphoma with abundant PAS-positive extracellular material. Immunohistochemical and ultrastructural observations. AB - A finding of large amounts of extracellular amorphous material is rare in malignant lymphomas. We report four such cases of follicular lymphoma that were investigated by electron microscopy and immunohistochemistry using monoclonal antibodies. This extracellular material was clearly different from the sclero hyalinosis commonly found in malignant lymphomas. Our observations revealed that the material is ultrastructurally composed of membranous structures, membrane bound vesicles, and electron-dense bodies. Immunohistochemistry confirmed its neoplastic cell origin and its identity with cell membrane antigens (Dako-LC+, anti-B antibodies positive). In one case investigated using frozen sections, it showed the same immunophenotype as the neoplastic cells: SB4+ (CD19), SB2+ (CD21), TO15+ (CD22), SB3+ (CD37), IgML+, and Calla+. The mechanism for accumulation of this extracellular amorphous material is probably a function of a deregulation of cell wall synthesis and an exocytosis of cell membranes. PMID- 3303983 TI - Effects of steam inhalation on nasal patency and nasal symptoms in patients with the common cold. AB - The effects of steam inhalation on nasal patency and on nasal symptoms were studied in 62 patients with the common cold by a double-blind, randomized, placebo-controlled clinical trial. Treatment consisted of two 20-minute sessions, during which the patient inhaled saturated, hot (42 degrees to 44 degrees C) air through the nose. The subjective response was recorded by each patient during the week following treatment on a daily symptom score card. Nasal patency was determined before treatment, the following day, and 1 week later by measuring peak nasal expiratory and inspiratory air flow. Highly reproducible results were obtained by using these objective methods. Steam inhalation resulted in alleviation of cold symptoms and increased nasal patency in a significantly higher percentage of patients in the actively treated group than in the placebo treated group. Possible explanations for the effectiveness of treatment are discussed. PMID- 3303984 TI - John Wesley Hardin, adolescent killer: the emergence of a narcissistic behavior disorder. PMID- 3303985 TI - Arthur Rimbaud: the poet as an adolescent. PMID- 3303986 TI - The mystery of adolescence. PMID- 3303988 TI - [Echographic changes in uterine and ovarian size in the postmenopausal period]. PMID- 3303987 TI - [Current theories on the neuroendocrine control of menstrual cycle]. PMID- 3303990 TI - [Scientific activities of military gynecologists during World War II 1941-1945]. PMID- 3303989 TI - [Indicators of carbohydrate metabolism and its regulation in patients with hyperprolactinemia]. PMID- 3303991 TI - [Physiology and pathology of the thymus gland]. PMID- 3303992 TI - [Estriol changes in the serum and urine of pregnant women with habitual abortions and skin grafts]. PMID- 3303993 TI - [Epidemiological and diagnostic problems of osteoporosis in the menopause]. PMID- 3303994 TI - [Follow-up of placental alkaline phosphatase activity---a test for determining the functional state of the placenta]. PMID- 3303995 TI - [Pre-eclampsia and prostacyclins (on the pathogenesis of pre-eclampsia)]. PMID- 3303996 TI - The value of specific ANA determination in rheumatology. Update 1986. PMID- 3303997 TI - Diagnosis and immunotherapy of mould allergy. VI. IgE-mediated parameters during a one-year placebo-controlled study of immunotherapy with Cladosporium. AB - The IgE-response was evaluated by skin prick test, bronchial provocation test and RAST in a 1-year placebo-controlled double-blind immunotherapy study. Eleven adult asthmatics were treated with a Cladosporium allergen preparation and 11 comparable patients received histamine placebo. The bronchial sensitivity (PC20) decrease greater than 0.5 log step in 8/11 (73%) Cladosporium-treated versus 3/11 (27%) in the placebo group. Corresponding figures for skin prick test sensitivity was 10/11 (91%) and 1/11 (9%) respectively. Circulating IgE showed a temporary boost in the Cladosporium group and then values approaching the pretreatment value. Only minimal and insignificant changes were found in the placebo-treated patients. Changes in IgE-reactivity were not related to allergen dose, clinical efficacy or to the occurrence of side effects. Some interrelation between changes in skin prick test, bronchial provocation test and RAST was found indicating a differentiated effect of immunotherapy on various IgE compartments. In spite of the pathogenetic role of IgE in allergic diseases, changes in IgE-reactivity do not seem directly involved in the mechanisms underlying the clinical efficacy of immunotherapy but might be of importance in a complex interaction with other immunological parameters. PMID- 3303998 TI - [In memoriam. Dr. Rosendo Poch Vinals]. PMID- 3304000 TI - [Development and current status of the surgical treatment of breast cancer]. PMID- 3303999 TI - [Theory and medical health practice concerning occupational diseases, with reference to historical and present lead poisoning. Critical comments]. PMID- 3304001 TI - [The genetic code (Severo Ochoa de Albornoz)]. PMID- 3304002 TI - [The University of Salamanca and the message of its stones]. PMID- 3304004 TI - Epidural catheter migration during labour. AB - A study was undertaken to determine the incidence, magnitude and direction of catheter migration in 100 patients who had epidural analgesia for pain relief in labour. Over 50% of catheters migrated from the original position at siting. The relevance of this migration and the usefulness of its measurement are discussed. PMID- 3304003 TI - Premedication for day case surgery. A study of oral midazolam. AB - A double-blind, between-patient trial was used to assess midazolam 7.5 and 15 mg as oral premedication for day case surgery. Midazolam 7.5 mg did not produce significant anxiolysis or sedation in comparison to placebo as measured by patient self-assessment linear analogue scales and observer scores. Midazolam 15 mg caused significant anxiolysis and sedation pre-operatively but also at 2 hours following awakening. Psychomotor performance assessed by digital-symbol substitution tests was significantly impaired by midazolam, in both doses, throughout the period of investigation. Midazolam 15 mg orally provides good premedication but the prolonged effects make it unsuitable for short-stay patients. PMID- 3304005 TI - Current approaches to DNA sequencing. PMID- 3304006 TI - Sialyltransferases as specific cell surface probes of terminal and penultimate saccharide structures on living cells. AB - Rat liver beta-galactoside alpha-2,6-sialyltransferase and Vibrio cholerae sialidase were used, in conjunction with CMP-N-acetyl-[3H]neuraminic acid, to probe the glycoconjugate distribution, sialylation state, and level of penultimate Gal beta 1-4GlcNAc residues on the surfaces of murine thymic lymphocytes. We report a detailed characterization of this sialyltransferase mediated labeling system. Exogenous sialylation of intact cells is dependent on transferase, sugar nucleotide donor, cell number, and incubation time. Additionally, we have demonstrated that the system labeling the cell surface is noncytotoxic and nonmetabolic and is interacting with the entire cell population. Analysis of the exosialylated structures indicates that the sialyltransferase specifically produces an alpha 2-6 linkage on N-linked oligosaccharides. Using this labeling system, we have probed the cell surface saccharide structures of murine thymocytes and demonstrated that most Gal beta 1-4GlcNAc residues are sialylated in the native state. However, one antigen, T200 (Ly-5), is strikingly undersialylated when compared to other cell surface glycoproteins (e.g., Thy 1.2). Upon analysis of exogenously sialylated oligosaccharides, labeled sialic acid was found almost exclusively on monosialylated structures with the remainder on bisialylated oligosaccharides. This suggests that the purified sialyltransferase is very precise in its recognition of oligosaccharides present on the surface of living thymic lymphocytes. This paper illustrates the combined uses of specific glycosidases and glycosyltransferases and how they can be employed in the detailed study of selected cell surface saccharide structures on living nucleated cells. PMID- 3304007 TI - Production of monospecific antibodies to a low-abundance hepatic membrane protein using nitrocellulose immobilized protein as antigen. AB - Membrane proteins from primary cultures of rat hepatocytes were separated by two dimensional polyacrylamide gel electrophoresis. The proteins were transferred to nitrocellulose paper which was then dissolved in dimethyl sulfoxide and this mixture was used as a primary immunogen in rabbits. Subsequent immunizations were performed using nonsolubilized protein immobilized on nitrocellulose paper. A monospecific polyclonal antibody was generated against a specific mitochondrial membrane protein (MP-73) for which de novo synthesis appeared to be induced by amino acid starvation of the hepatocytes. A minimum of 15-20 micrograms of protein antigen was required to elicit significant antibody production. Serum antibody titer was sufficient to allow detection of MP-73 at a serum dilution of 1:2000. PMID- 3304008 TI - Renin activity determination using human plasma as a substrate. AB - A method for human renin activity determination using human plasma as the substrate is described. Angiotensin I is generated by incubating renin with human plasma, which is available along with the commercial radioimmunoassay kit for angiotensin I. The method obviates the need to isolate and purify the substrate, human angiotensinogen, from human plasma. In addition, the assay is highly renin specific, sensitive, and convenient to use for the routine determination of active human renin during its isolation and purification from tissue extracts or from genetically engineered bacterial and nonbacterial expression systems. PMID- 3304009 TI - Industrial hygiene. PMID- 3304010 TI - Forensic science. PMID- 3304012 TI - Pesticides. PMID- 3304011 TI - Pharmaceuticals and related drugs. PMID- 3304013 TI - Food. PMID- 3304014 TI - Air pollution. PMID- 3304015 TI - Clinical chemistry. PMID- 3304016 TI - Determination of trace amounts of thallium in commercial radioactive 204Tl samples by the redox sub-superequivalence method of isotope dilution analysis. PMID- 3304018 TI - The role of function in the development of human craniofacial form--a perspective. AB - As an anatomical region the head combines great diversity of function with close integration of structure. Consequently no structural component has autonomy of form. There is a sequence of maturation of functions and their related structural components, and in this sequence the nervous system and its supportive structures mature first. The nasal airway matures next in response to increasing body mass, and the masticatory system constitutes the last major functional system to reach maturity. The later the maturation of the function, the greater is the requirement for its related morphology to adapt to preceding skeletal templates. These matters of developmental sequence, and extrinsic as well as intrinsic craniofacial functions, are paramount considerations in interpreting the form of any component of head anatomy. PMID- 3304019 TI - Demonstration of expanding cell populations in mouse pancreatic acini and islets. AB - The acinar and islet cells of the adult mouse pancreas were examined by radioautography after continuous infusion of 3H-thymidine, for periods varying from 1 to 60 days, to determine whether they behaved like renewing or expanding cell populations. The labeling of both cell types increased with the duration of the continuous infusion and reached 2.22% and 12.0%, respectively, after 60 days. The rate of acinar and islet cell labeling was estimated from the regression line of the labeling index versus time and given as 0.039% and 0.20% cells per day, respectively. The rate of cell labeling was relatively low in these acinar and islet cells in comparison to the relatively high rate in duct cells. Occasionally, acinar cell labeling was not uniform, showing high labeling in the outer peripheral region of a lobe and at the periphery of the islets. Both acinar and islet cells increased in number in the adult, and at a rate indicating they are expanding cell populations. Their doubling times were estimated as 2,564 days (7.0 years) and 500 days (1.3 years), respectively. Duct epithelial cell populations were dividing at a rate indicating that they are renewing cell populations. PMID- 3304017 TI - The anatomical basis for the immune function of the gut. AB - The barrier function of the gut wall can be divided into different histotopographically defined lines of defence. These consist not only of lymphoid cells but also of goblet cells, entero-endocrine cells, macrophages and mast cells. Subsets of lymphoid cells are found preferentially within the epithelium (T suppressor) or in the lamina propria (T helper). Most plasma cells produce IgA. Peyer's patches are described in detail as typical organized lymphoid structures of the gut. In man, they are present well before birth and are found in large numbers even in old age. They are not only typical for the ileum but are also present in the duodenum and jejunum. The four compartments in Peyer's patches, i.e. follicle, corona, interfollicular area and the dome, are defined by the typical localization of lymphocyte subsets and by their different functions. Typical features of the epithelium of the dome are the lack of villi and goblet cells and the presence of specialized epithelial cells (M cells) which are important for the uptake of particulate antigen from the gut lumen. Precursor cells of IgA producing plasma cells leave the intestinal wall via the lymphatics and return preferentially to the gut mucosa, and this is summarized by the term gut-associated lymphoid tissue (GALT). Other organs with mucous membranes, such as mammary and salivary glands, bronchial and genital tract, are also included in this circulatory route and this is expressed by the term mucosa-associated lymphoid tissue (MALT). Mast cells in the gut mucosa can be classified as connective tissue or mucosa mast cells. These differ in their sensitivity to formaldehyde as a fixative, contain different granules and mediators, have different origins, and show major differences in the effectiveness of antiallergic compounds on the stabilizing of the cell membrane. Mucosa mast cells have also been demonstrated in the human gut. The histotopographical relationship of many cell types such as goblet and M cells in addition to cells of the immune system such as lymphoid cells, macrophages and mast cells, is essential in the understanding of the barrier function of the gut wall. PMID- 3304020 TI - Maintenance of adult rat ventral prostate in organ culture. AB - Androgens postpone the involution of prostatic tissue cultured in a chemically defined medium. However, after 1 week quantitative changes are accentuated and qualitative signs of involution appear. Other factors in addition to androgens are obviously needed for the adequate maintenance of the tissue. This study was aimed at the improvement of the culture conditions by adding insulin, corticosterone, epidermal growth factor, prolactin, and transferrin alone or in different combinations with testosterone and each other. A morphometric model developed for prostate culture was used, and maintenance and proliferation of the tissue were further followed by weighing the cultured explants and by measuring the incorporation of (3H) thymidine into DNA. The androgen dependency was seen in all the studied morphometric parameters at least for 2 weeks-i.e., in volume density and height of epithelium (VVEP and h), reflecting the epithelial maintenance, in volume density and width of interacinar tissue (VVIT and lambda AP), reflecting stromal tissue, and in volume density and diameter of lumen (VVLU and DLU), reflecting the secretory function. Testosterone (10(-7) M) also prevented partially the quantitative involution of the tissue within 2 weeks. Insulin, acting independently of androgen, was a potent mitogen, which, according to morphometric results, exerted its effect mainly on prostatic epithelium. Stratification of epithelium was frequently seen. Corticosterone had no effect on epithelian proliferation, but it probably stimulated secretion and inhibited the growth of stroma. By combining these three hormones it was possible to maintain not only the structure but also the amounts of tissue components practically unaltered at least for 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304021 TI - High-frequency oscillatory ventilation in premature infants with respiratory failure: a preliminary report. AB - High-frequency ventilation has been used successfully to manage life-threatening complications in premature infants with lung disease. Here we report a preliminary assessment of the efficacy and safety of high-frequency oscillatory ventilation-(HFO-A, A = active expiratory phase) when used as a primary ventilator in 11 infants of 24-34 weeks gestation who required ventilatory support. HFO-A was initiated after no more than 5.5 hr of conventional mechanical ventilation (CMV). HFO-A at 15 Hz was used for 12-203 hr following a protocol designed for rapid reduction of FI02 requirements. CO2 elimination was easily achieved in all infants. Oxygenation was satisfactory, except in one infant with congenital pneumonia. There were four deaths during HFO-A: two pulmonary (one congenital pneumonia; one pulmonary hemorrhage) and two nonpulmonary. The HFO-A protocol utilized lung volume recruitment maneuvers plus mean airway pressures (MAwP) greater than those generally used early in the course of CMV. Therefore, in a subset of infants less than or equal to 29 weeks' gestation with respiratory distress syndrome (RDS), ventilator pressures and gas exchange were compared in infants treated with either HFO-A or CMV. Maximum MAwP levels were reached earlier in six infants on HFO-A (5.2 +/- 2.5 hr; mean +/- SD) than in a comparable group of 9 CMV-treated infants (36 +/- 1 hr). This earlier use of high MAwP lowered the FI02 to less than 0.4 by 18.9 +/- 11 hr with HFO-A as compared with 64 +/- 6 hr using CMV, without any evidence of an increase in pulmonary complications. There were 17 complications in the nine CMV-treated infants; and four in the six HFO-A treated ones. We conclude that HFO-A, instituted early and used with a protocol designed for early reduction in FI02 requirements, demonstrates sufficient efficacy and safety to warrant further clinical trials in the routine management of infant RDS. PMID- 3304022 TI - Comparison of high-frequency jet ventilation with conventional mechanical ventilation for bronchopleural fistula. AB - In seven patients with acute respiratory failure and a bronchopleural fistula, the authors compared gas exchange and volume of gas lost via the chest tube during conventional mechanical ventilation (CV) and high-frequency jet ventilation (HFJV). After the initial comparison, patients were randomized to HFJV or CV, unless one mode of ventilation was clearly superior based on preestablished criteria. In six of the seven patients, oxygenation deteriorated after the switch from CV to HFJV. The ratio of PaCO2 to FI02 declined from 227 +/ 167 to 133 +/- 100 (mean +/- SD, P less than 0.05), and the PaCO2 increased from 47 +/- 13 to 56 +/- 18 mm Hg (P less than 0.05). The mean chest tube leak did not change significantly. Randomization of the mode of ventilation was not performed in any patient because CV was superior by a priori criteria. We conclude that when acute respiratory failure is complicated by a bronchopleural fistula, HFJV with mean airway pressures comparable to those provided during conventional ventilation does not provide satisfactory gas exchange. PMID- 3304023 TI - Influence of age on vascular absorption of lidocaine from the epidural space. AB - The purposes of this study were to evaluate the effect of age on the vascular absorption of local anesthetics during epidural anesthesia and to corroborate the clinical observations of other investigators with respect to age. Using the arbitrary definition of significance (P less than 0.05), the maximum serum levels of lidocaine (Csmax) did not differ significantly with age, however, P values were equal to 0.06. Furthermore, the time to Csmax was significantly faster in elderly patients (P less than 0.00001). In conclusion, the mass of local anesthetic solution should be reduced in elderly patients undergoing epidural anesthesia because there is a greater segmental spread, and serum levels of local anesthetics are increased. PMID- 3304024 TI - Anesthesia for spinal decompression for metastatic disease. PMID- 3304025 TI - Pericardial and subcutaneous air after maxillary surgery. PMID- 3304026 TI - [The microflora of goat Mallophaga]. AB - 48 bacterial isolates were gained from Bovicola spp. of Capra hircus. The distribution of the isolates among males, females and larvae suggests first conclusions on the specificity of the microflora. PMID- 3304027 TI - Shunt thrombosis prevention in hemodialysis patients--a double-blind, randomized study: pentoxifylline vs placebo. AB - Previous studies demonstrated a high incidence of local thrombosis in patients in whom external arteriovenous shunts were used for vascular access. This procedure provides, therefore, a useful model for the evaluation of potential antithrombotic agents. The effect of the hemorheologically and hemostasiologically active drug Pentoxifylline on the incidence of thrombosis of arteriovenous shunts (Ramires shunt) was investigated in a long-term, double blind, placebo-controlled study in 51 patients on chronic hemodialysis. The two treatment groups were comparable in age, sex, concomitant medication, and dialysis program (three times per week for four hours). Drugs known to affect platelet function or coagulation were excluded, with the exception of heparin, during the dialysis procedure. All shunts were placed in the forearm and inserted into the distal part of the radial artery and basilic antebrachial vein. Simultaneously, for medical reasons, in all patients an arteriovenous fistula was performed (proximal part of radial artery and cephalic antebrachial vein). Shunt thrombosis was assumed when the flow in the shunt discontinued under visual and auscultatory control. Thrombi were documented by physical removal from the arterial part of the shunt by use of gentle suction or by complete shunt thrombosis (both arterial and venous part of the shunt). Thereafter, the patients' trial period terminated. The total number of thrombi during the observation period was 44 in the pentoxifylline group (26 patients), compared with 82 in the placebo group (25 patients). The mean number of thrombi per patient was 1.69 +/- 1.29 in the pentoxifylline group, significantly lower than that in the placebo group (3.28 +/- 1.99/p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304029 TI - Placebo-controlled trial of ketanserin in the treatment of intermittent claudication. AB - The effect of ketanserin on the symptoms of 21 patients with stable intermittent claudication was examined in a double-blind, placebo-controlled, parallel-group study. Benefit was assessed by repeated treadmill exercise tests, recording claudication and total walking times. After three months' treatment with ketanserin (mean dose 167 mg/day) there was no significant change in claudication time (mean change + 12%, 95% CI -9; + 33%) or total walking time (mean change 14%, 95% CI -47%; + 19%). The confidence intervals show that ketanserin treatment is unlikely to be associated with clinically important improvement. PMID- 3304028 TI - Acute and short-term effects of clonidine in heart failure. AB - The authors performed a randomized, double-blind, placebo-controlled trial to assess the tolerance and effects of chronic oral clonidine administration on the clinical status, exercise tolerance, and ventricular function of 10 male patients with chronic heart failure. Patients were given either oral clonidine (400 micrograms/day) or matching placebo for twelve weeks and then tapered off medication over a two-week period. Results are summarized as follows: Profiles over time between groups were significantly different for resting heart rate (p = 0.0005), were different for arterial pressure (p = 0.04), were different for left ventricular ejection fraction (p less than 0.006), and were different for mean accumulated workload (p = 0.076). Exercise double product at 25 watts changed little in three patients and showed a decrease in 2 patients following six weeks of oral clonidine; after twelve weeks, it decreased in three patients, increased in 1, and changed little in another. After washout, double product returned toward baseline values. In the placebo groups, double product showed little change. Resting of the heart by decreasing heart rate, systemic arterial blood pressure, and venous tone are thought by the authors to be major contributing factors to the observed beneficial effect of chronic oral clonidine in chronic heart failure. PMID- 3304030 TI - Validity of continuous-wave Doppler sonography of the vertebrobasilar system. AB - To assess the value of continuous-wave Doppler sonography for detection and exclusion of lesions in the vertebrobasilar system, the ultrasonic and angiographic findings were compared in a prospective study. Altogether, 200 vertebral arteries in 176 patients were evaluated by both methods. Insonation of the vertebral arteries was performed at the mastoid slope and at the origin of the vessel. Of 62 angiographically proven lesions, 45 were detected by ultrasound. Of 138 normal vertebral arteries, 129 were correctly diagnosed. Sensitivity for all lesions was 72.5%, and for hemodynamically relevant lesions it was 91%. Overall specificity was 93.5%. A positive predictive value of 83.3% and a negative predictive value of 88.4% for all lesions shown by angiography demonstrate the high reliability and accuracy of doppler ultrasound of the vertebrobasilar system. PMID- 3304031 TI - House dust mite asthma in China: a review. AB - House dust mites are ubiquitous but no publications on disease associated with them are readily available from China. A review of published research in China is presented. A mean of 1,328 mites/g of dust was detected in homes: D. farinae and D. pteronyssinus (D. pt.) predominated. Mixed house dust mite solution elicited a positive skin test in 78% of asthmatics but D. pt. and D. farinae antigens in only 40%. Desensitization of house dust-sensitive asthmatics has been successful in 71% with IgG blocking antibodies being predictive of a successful outcome. PMID- 3304032 TI - Bronchial inhalation tests. II. Measurement of allergic (and occupational) bronchial responsiveness. AB - In summary, controlled allergen and occupational inhalation challenge tests represent a major undertaking with a predictable degree of patient discomfort and a significant risk of dangerous side effects. Tests must be well controlled so the responses can be differentiated from nonspecific (nonallergic) effects. There is probably very limited routine clinical usefulness for allergen inhalation tests. These tests, however, remain valuable for investigations into the pathogenesis of asthma and for studies on new therapeutic agents. Occupational challenge tests may be used for the diagnosis of occupational asthma, although safer more convenient methodologies may become available in the future. Occupational challenges, however, remain the only way to definitively document sensitivity to certain low molecular weight chemicals that cause occupational asthma by a process of sensitization but in which the immunopathogenesis has not been entirely worked out. PMID- 3304033 TI - [Gas-liquid chromatography in microbiological diagnosis]. AB - With gas-liquid chromatography, it is possible to detect chemical compounds which are specific of micro-organisms: either metabolic products, or structural components. This technique permits to simplify the diagnosis: it is the case for anaerobic bacteria, where the analysis of the fermentation acids produced in a 48 hours liquid culture enables to rapidly establish the diagnosis, at least as far as the genus is concerned. It may also increase the accuracy of the diagnosis by searching such or such metabolite or structural component which are specific of a species or a sub-species. Some authors have already determined automatic systems of bacterial identification; these systems are based on a computer analysis of the chromatographic profile of cellular fatty acids. Finally it is important to emphasize that liquid-gas chromatography may markedly shorten the delay of identification by allowing, in some cases, a direct diagnosis in pathological samples. PMID- 3304034 TI - [Detection of Chlamydia trachomatis in various pathological products. Comparison between direct IF-Chlamydiazyme and cultured cells]. AB - Two immunologic technics of Chlamydia trachomatis detection: IF (Microtrack Syva Bio-Merieux) and ELISA (Chlamydiazyme Abbott) are compared with cell cultures revealed by giemsa on 177 and 210 samples respectively. Sensibility, specificity, agreement among methods and predictive values are given for each nature of prelevement. The direct fluorescent antibody test is globaly more sensitive (94.7%) than Chlamydiazyme (78.9%), but less specific (96% against 100%). Two major inconveniences of IF are not recovered with Chlamydiazyme (extreme fastidiousness and subjective reading). The discordances between the three methods are discussed, as well as their respectives advantages and inconveniences. PMID- 3304035 TI - [Liver transplantation in children. Blood transfusion and metabolic disorders]. AB - Metabolic disorders during hepatic transplantation can be partly induced by blood transfusion. A retrospective survey of perioperative biological data recorded in patients under 18 years of age having liver transplantation was performed. Blood transfusion was also studied. For this evaluation, patients were divided in a paediatric group I (n = 20; mean age: 3.7 years) and an adolescent group II (n = 11; mean age: 14.3 years). Blood transfusion was significantly (p less than 0.05) more important in group I (302 +/- 286 ml X kg-1) than in group II (148.5 +/- 156 ml X kg-1). Autotransfusion of washed red cells was performed in six patients, allowing a mean 17 +/- 7% saving in blood transfusion. Severe hypernatraemia over 152 mmol X l-1 due to blood transfusion was observed only in five patients in group I. Hyperglycaemia increasing till the revascularization of the new liver was constant in both groups, but significantly more pronounced in group II. Cardiac arrest occurred twice in group I at initial revascularization. In group I, children with biliary atresia were not significantly different from the others for the duration of operation and the volume of blood transfusion; however the latter was more abundant. Conversely, in group II, the duration of operation was longer (p less than 0.05) in patients with previous abdominal surgery than in others. Finally the paediatric group differs from the adolescent group by obvious differences in anaesthesia and intensive care and specifically in hepatic transplantation by larger volume of blood transfusion leading to severe hypernatraemia. In further studies, adolescents should be distinct from the paediatric group and included in the adult group. PMID- 3304036 TI - [Laryngeal complications of endotracheal intubation]. PMID- 3304037 TI - [Asphyxic pulmonary edema caused by upper airway obstruction in adults]. AB - A case of pulmonary oedema following acute pharyngo-laryngeal obstruction is reported. The case is compared with the results of the literature. The haemodynamic data suggested a non-cardiogenic effect, with low pulmonary arterial occlusion pressure of 1 mmHg and right-to-left shunting. Positive end-expiratory pressure was used with success. The mechanisms underlying such oedema are not well known, and may include disturbances in the balance of transpulmonary forces or hypoxia. However the outcome is usually favourable. PMID- 3304038 TI - Torsades de pointes: atypical rhythm, atypical treatment. AB - For the present, treatment of the acquired Torsades de Pointes consists of removal of the causative agent, correction of the underlying electrolyte imbalance, and initiation of direct therapy. Unresponsive dysrhythmias may need magnesium therapy or cardioversion. PMID- 3304039 TI - Cricoarytenoid arthritis: a cause of laryngeal obstruction. AB - Cricoarytenoid arthritis, principally as a result of long-standing rheumatoid arthritis, is a disorder that may present to the emergency physician with a number of symptoms and signs referable to the larynx. The presentation of this disorder as acute laryngeal obstruction and collapse is uncommon. It is important to recognize early cricoarytenoid joint involvement and not mistakenly diagnose mild cases as asthma or psychoneurosis. The use of steroids in mild cases has been beneficial at times, but progressive airway obstruction and fatalities have occurred during their administration. PMID- 3304040 TI - The incarcerated gravid uterus. AB - The case of a 28-year-old multiparous woman with an incarcerated gravid uterus is presented. This largely unknown entity invariably results in spontaneous abortion if untreated. Patients present with a characteristic and readily recognizable sign and symptom complex and ultrasonographic findings. Early diagnosis is emphasized and therapy is outlined. PMID- 3304041 TI - Repair of parallel lacerations. PMID- 3304042 TI - Henry Goddard and the Kallikak family photographs. "Conscious skulduggery" or "Whig history"? PMID- 3304043 TI - Immunoregulatory functions of human alveolar macrophages. PMID- 3304044 TI - Mechanisms of macrophage accumulation in the lungs of asbestos-exposed subjects. AB - Chronic asbestos exposure is associated with the accumulation of mononuclear phagocytes in the lower respiratory tract. This process can be both protective and injurious, since macrophages can aid in asbestos clearance yet also modulate structural derangements of the alveolar walls. To understand why macrophages accumulate in the lungs of asbestos-exposed persons, 2 possible mechanisms were evaluated using alveolar macrophages from subjects with histories of chronic high exposure to airborne asbestos: enhanced recruitment of blood monocytes to the lung, and an increased rate of replication of macrophages in situ. Monoclonal antibody analysis with antibodies that detect surface antigens on the majority of circulating blood monocytes but only on a minority of mature alveolar macrophages demonstrated that an increased proportion of alveolar macrophages of asbestos workers expressed monocyte lineage antigens, suggesting the presence of "young" newly recruited macrophages and thus enhanced recruitment. Culture of the alveolar macrophages from these subjects with [3H]thymidine followed by autoradiography demonstrated an increased proportion of alveolar macrophages synthesizing DNA, suggesting the macrophages are replicating at an increased rate in situ. These observations are consistent with the concept that both enhanced recruitment of blood monocytes and increased local proliferation of alveolar macrophages contribute to the accumulation mononuclear phagocytes in the lung of persons with chronic asbestos exposure. PMID- 3304045 TI - Viscosity and spinability of nasal secretions induced by different provocation tests. AB - In the human nose, secretions can be experimentally induced in vivo and sampled by simple means for biophysical and biochemical analyses. It was the aim of the present study to compare viscosity and spinability of nasal secretions induced by different types of stimulation, i.e., provocation with methacholine, histamine, and allergen. The results showed considerable inhomogeneity of the samples with regard to both parameters, increased viscosity with time after consecutive allergen provocations (p less than 0.01), lower viscosity of methacholine- than of histamine- and allergen-induced secretions (p less than 0.05), comparable spinability of the 3 types of secretions, and a positive correlation between viscosity and spinability (p less than 0.01). PMID- 3304047 TI - Metabolism and turnover of lung surfactant. AB - Despite the grave difficulties that beset researchers who are trying to isolate and characterize the various intracellular and extracellular forms of lung surfactant; despite the serious ambiguities of interpretation of experimental data caused by the multicomponent nature of the surfactant; despite the inaccessibility for diagnostic purposes of this material, which functions deep in the lungs; despite the fact that incisive methods of protein chemistry and molecular biology have only recently been brought to bear on lung surfactant; despite all these problems, our knowledge and understanding of lung surfactant are rapidly increasing. We know now that it is a dynamic system with many parts, and that the reserves of these are normally not large and are recycled. We believe that tight metabolic control must exist to maintain these reserves, and we already have experimental techniques to raise or lower the reserves. Heroic methods of surfactant substitution are now being tested in patients whose deficiency or risk thereof is sufficiently desperate, and the results of these clinical trials, if they are carefully documented with lung function data, will add a new dimension to our knowledge of surfactant dynamics. We may expect in the future that more subtle alterations in surfactant function will become detectable and more sophisticated methods to manipulate the system will be invented. Essential to these will be a deeper understanding of surfactant forms, pathways, kinetics, and controls. Fortunately, research on surfactant structure, metabolism, and turnover intrigues many investigators. They, we may hope, will soon provide the necessary information. PMID- 3304046 TI - Bronchoalveolar cell profiles of asthmatic and nonasthmatic subjects. AB - Asthma is associated with increased airway responsiveness to pharmacologic agents such as methacholine. Increases in airway responsiveness after exposure to allergen or ozone are associated with increased inflammatory cells in bronchoalveolar lavage both in human and in animal studies. We studied the total and differential cell counts in 10 stable atopic asthmatics who had airway hyperresponsiveness but no clinical features of airway inflammation and 10 nonasthmatic subjects, using a conventional 100-ml lavage and a 20-ml washing. Metachromatic cell numbers and eosinophils were increased in both the lavage (p less than 0.01 for metachromatic cells; p = 0.05 for eosinophils) and washing (p less than 0.025 for metachromatic cells and p = 0.03 for eosinophils) compared with those in nonasthmatics. In asthmatics, metachromatic cell numbers in the lavage and washing, and total cell count and, to a lesser extent, eosinophils in lavage were significantly correlated with measurements of airway responsiveness. Major basic protein in lavage and blood did not differ between asthmatics and nonasthmatics. The washing, although it revealed a different cell profile from the lavage in both normal subjects and asthmatics, did not show differences between asthmatics and nonasthmatics undetected by the lavage specimen. We conclude that there is evidence of cellular inflammation in the airway of stable asthmatics and that small volume washings do not add to the information concerning the cell profile of asthmatics and nonasthmatics provided by conventional lavage. PMID- 3304048 TI - Mycobacterioses and the acquired immunodeficiency syndrome. Joint Position Paper of the American Thoracic Society and the Centers for Disease Control. AB - AIDS and HIV infection have now been recognized as conditions causing immunosuppression associated with an increased risk of mycobacterial disease, caused especially by M. avium complex and M. tuberculosis. In addition, disseminated disease due to other mycobacteria, heretofore considered nonpathogenic, is now being reported. The epidemiologic and clinical features of mycobacteriosis in patients with AIDS or HIV infection are unusual and distinctive. The high incidence of disseminated disease due to M. avium complex and the extent of infection, with abundant organisms in tissues and overwhelming mycobacteremia, is certainly unprecedented. Currently available treatment for this infection is unsatisfactory. The clinical features of tuberculosis in these patients with AIDS or HTLV III/LAV infection are often unusual, with a high frequency of extrapulmonary disease, and a relative infrequency of classical apical, cavitary disease in the lung. Nevertheless, tuberculosis in these individuals appears to respond to therapy and is potentially preventable. The interaction of tuberculous infection with HIV infection in the population has created new clinical syndromes that present a challenge to the diagnostic and therapeutic skills of clinicians. PMID- 3304049 TI - Emergency liver transplantation for fulminant hepatitis. AB - Orthotopic liver transplantation was done in 17 patients with fulminant hepatitis. The cause of the liver disease was infection with hepatitis B virus, or co-infection with hepatitis B virus and hepatitis D virus, or infection with hepatitis A virus in 6 patients; drug hepatotoxicity in 5; and indeterminate in 6. Grafts from incompatible blood groups, steatotic grafts, or reduced-size grafts were used in 5, 4, and 4 patients, respectively. Of the 17 patients, 5 died: 2 of early liver failure due to the poor quality of the graft, 1 presumably of accidentally transmitted acute infection with the human immunodeficiency virus, and 2 of decerebration occurring during or immediately after surgery. The 12 other patients were alive 2 to 15 months after transplantation. PMID- 3304050 TI - Methotrexate in rheumatoid arthritis. Indications, contraindications, efficacy, and safety. AB - Evidence on the safety and efficacy of methotrexate as a second- or third-line agent for treating patients with rheumatoid arthritis is reviewed. Four placebo controlled clinical trials have documented short-term benefit from methotrexate; although true remission is rare, patients receiving methotrexate showed a 26% (95% confidence interval [CI], 17% to 35%) greater improvement in their inflamed joint count and a 39% (95% CI, 26% to 51.5%) greater improvement in pain than did controls receiving nonsteroidal anti-inflammatory agents with or without prednisone. With respect to long-term benefit, improvement usually occurs within 1 month, reaching a maximum at 6 and then leveling off for the duration of treatment; in some patients, the benefit may wane after an initial satisfactory response in the first 4 to 6 months. In one third of those given methotrexate, treatment had to be discontinued because of adverse effects, less than 1% of which were life threatening. Careful baseline and follow-up monitoring is recommended until more data on the safety of methotrexate are available. PMID- 3304051 TI - Intravenous immunoglobulins as therapeutic agents. AB - Intravenous immunoglobulins are stable monomeric pooled human IgG preparations for therapeutic use. Three intravenous immunoglobulins licensed in the United States are generally therapeutically equivalent. Intravenous immunoglobulin is the preferred agent for replacement therapy for most patients with primary or secondary antibody immunodeficiency because of the rapidity and ease of giving large quantities of IgG, even by self-administration. Disadvantages of intravenous immunoglobulins include frequent (approximately 10%) but usually not serious side effects, the need for venous access (often difficult in infants and young children), and high cost. Intravenous immunoglobulins are also beneficial in the prevention of certain viral infections, such as cytomegalovirus pneumonia and varicella; they may also have a synergistic effect with antibiotics in certain bacterial diseases. Intravenous immunoglobulin has also been used successfully in the management of idiopathic thrombocytopenia purpura, Kawasaki disease, and certain autoimmune diseases. Intravenous immunoglobulin may also be of use in certain high-risk and premature newborns. PMID- 3304053 TI - Kidney donation: exclusion criteria. PMID- 3304052 TI - Immunology of infection with the human immunodeficiency virus (HIV). A view from the III International Conference on AIDS. PMID- 3304054 TI - Kidney donors and protein intake. PMID- 3304055 TI - [Liver transplantation]. PMID- 3304056 TI - [Acute anxiety attacks and phobia. Historical aspects and clinical manifestations of the agoraphobia syndrome]. AB - This article describes the evolution of the concept of agoraphobia since its initial description in 1871 until its inclusion in the most recent american diagnostic classifications. In most cases, agoraphobia appears to be secondary to the occurrence of repeated panic attacks, that may also lead to the development of chronic generalized anxiety or hypochondriac syndromes. The main clinical, biological and therapeutic features of panic disorders, a clinical entity that is part of the previous syndromes, are reviewed and discussed according to the most recent studies. Panic disorders appear to be distinct from mood disorders but their relationship to other anxiety disorders is still a matter of controversy. PMID- 3304057 TI - [Notes on Emmanuel Chabrier's disease]. PMID- 3304058 TI - Ascorbic acid distribution patterns in human brain. A comparison with nonhuman mammalian species. PMID- 3304059 TI - Ascorbate-like factor from embryonic brain. Role in collagen formation, basement membrane deposition, and acetylcholine receptor aggregation by muscle cells. PMID- 3304060 TI - Interaction of ascorbate and alpha-tocopherol. AB - Vitamins C and E function as water-soluble and lipid-soluble chain-breaking antioxidants, respectively, and protect lipids, proteins, and membranes from oxidative damage. Vitamin C scavenges oxygen radicals in the aqueous phase, whereas vitamin E scavenges oxygen radicals within the membranes. Vitamin C regenerates vitamin E by reducing vitamin E radicals formed when vitamin E scavenges the oxygen radicals. This interaction between vitamin C and vitamin E radicals can take place not only in homogeneous solutions but also in liposomal membrane systems where vitamins C and E reside separately outside and within the membranes respectively, and vitamin C can act as a synergist. PMID- 3304061 TI - Effect of vitamin C on tubulin tyrosinolation in polymorphonuclear leukocytes. PMID- 3304062 TI - A biological role for ascorbate in the selective neutralization of extracellular phagocyte-derived oxidants. PMID- 3304063 TI - Vitamin C and airways. PMID- 3304064 TI - Evaluation of the effects of vitamin C on ozone-induced bronchoconstriction in normal subjects. PMID- 3304065 TI - Is there a physiological role of vitamin C in iron absorption? AB - Nonheme iron usually constitutes more than 90% of the dietary iron. Its absorbability is a resultant of the balance between factors enhancing and inhibiting the absorption. Ascorbic acid is the most potent enhancer, and is the same for native and synthetic AA. The enhancing effect is strongly dose related (log dose/effect), and is different for different meals probably mainly due to varying content of inhibitors in the meals. AA also increases the iron absorption from simple meals with no known inhibitor, probably because AA impairs the formation of unavailable iron complexes with ligands normally present in the gastrointestinal lumen. The effect of AA is so unequivocal and marked that it must be considered as a physiological factor essential for the absorption of dietary iron. PMID- 3304066 TI - Inhibition of nitrosamine formation by ascorbic acid. PMID- 3304067 TI - Ascorbic acid, alcohol, and environmental chemicals. PMID- 3304069 TI - Requirement for vitamin C based on metabolic studies. PMID- 3304068 TI - Measurement of vitamin C in blood components by high-performance liquid chromatography. Implication in assessing vitamin C status. AB - The fact that platelets, PMN leukocytes, and MN leukocytes concentrate ascorbic acid suggests that vitamin C has an important role in their physiological functions. The question still remains as to which one of the cells best reflects vitamin C status. The ascorbic acid content of PMNs and platelets correlates positively with plasma concentration and supplementation with vitamin C, as shown in Evans et al. They also found that MN leukocytes, in contrast, do not show any such relationship; however, MN leukocytes maintain the highest levels of ascorbic acid and play a very important function in immunocompetence. We have found that with a limited number of subjects, ascorbic acid content of MN and PMN leukocytes correlates positively with plasma ascorbic acid, but there was no correlation between platelets and plasma ascorbic acid (unpublished results). Therefore, further work is necessary to evaluate these three blood components for the best cellular marker of vitamin C status. We have developed a reversed-phase HPLC method for ascorbic acid that can be used in conjunction with our cellular differential centrifugation technique for the determination of ascorbic acid in relatively pure blood cell fractions. The chromatographic method is simple, sensitive, and automated. It clearly resolves ascorbic acid, which is the major form of the vitamin found in vivo and is not prone to interference by sugars, carbohydrates, or nucleotides. PMID- 3304070 TI - Ascorbic acid: the concept of optimum requirements. AB - Experiments with enzymes in situ that are dependent on ascorbic acid for maximum activity will provide critical information about ascorbic acid requirements. Our work with chromaffin tissue as a model system eventually will result in the determination of two dose-response curves for norepinephrine biosynthesis, representing cytosolic ascorbic acid and intragranular ascorbic acid (Fig. 11). These curves for norepinephrine biosynthesis can be combined with curves for other enzymatic events that are also dependent on ascorbic acid for maximal activity. These dose-response curves (Fig. 2) will allow determination of optimum ascorbic acid requirements based on specific product formation and minimum toxicity. These principles are adaptable to other vitamins as well as ascorbic acid, and could form the basis for a new approach to vitamin requirements. PMID- 3304071 TI - Safety of high-level vitamin C ingestion. PMID- 3304072 TI - Ascorbic acid and acetylcholine receptor expression. PMID- 3304073 TI - An overview of the status of evolutionary cell symbiosis theories. PMID- 3304074 TI - Structural diversity of eukaryotic small subunit ribosomal RNAs. Evolutionary implications. AB - The phylogenetic diversity of the eukaryotic kingdom was assessed by comparing the structural and evolutionary diversity of 18-20S ribosomal RNA genes. The coding regions for cytoplasmic small subunit ribosomal RNA genes vary in length from 1753 to 2305 nucleotides, and they appear to be evolutionary mosaics in which highly and partially conserved sequences are interspersed among regions that display very high rates of genetic drift. Structural similarities between these gene sequences were used to establish a phylogenetic framework for the eukaryotes. The extent of sequence variation within the eukaryotes exceeds that displayed within the eubacterial or archaebacterial lines of descent. The kinetoplastids and euglenoids represent the earliest branchings among the eukaryotes. These branchings preceded the divergence of lineages leading to the slime molds and apicomplexans and far antedate a radiative period that gave rise to the plants, animals, fungi, and other protists. PMID- 3304075 TI - Prokaryotic origin of undulipodia. Application of the panda principle to the centriole enigma. PMID- 3304076 TI - Bacterial viruses, prophages, and plasmids, reconsidered. AB - Prophages and plasmids offer to the bacterial cells generalized access to each other's genes. The result is an extremely rich, available gene bank. It has successfully supported the original bacterial life since its beginnings and therefore it has conditioned all bacterial cells. Thus, most of the basic mechanisms for the living world, the richest variety of new genes, and particularly the improved ways of using DNA as an extremely adaptable genetic material happened in bacteria with the help of prophages and plasmids. This fact has profoundly marked all the biosphere. The ancestor of the nucleus probably started as an accumulation of prophages and plasmids integrated in the growing "chromosome" of the outer symbiont of the first eukaryotes. Many bacterial vestiges were probably retained in eukaryotes, mostly those related to the dominant and lasting role of small replicons in all their bacterial precursors. These vestiges may, for example, serve as an endogenic source for some DNA viruses in eukaryotes. The other animal and plant viruses seem to derive directly or indirectly from prophages or plasmids. In the case of RNA viruses they may have originated from probable RNA small replicons present in the first forms of life on earth. Some confusion arose in biology, as viruses were discovered first and therefore their most probable ancestors, the plasmids and the prophages which were discovered later, were thought to be viruslike, or viruses, as is the case with prophages. PMID- 3304077 TI - Initiation and control of the bioluminescent symbiosis between Photobacterium leiognathi and leiognathid fish. PMID- 3304078 TI - Transmission modes and evolution of the parasitism-mutualism continuum. AB - An analysis of fitness costs and benefits associated with pathogenicity suggests that modes of transmission are key determinants of evolution toward severely pathogenic, benign, or mutualistic symbioses. Specifically, this approach suggests that symbionts with mobile life history stages should evolve toward extremely severe parasitism, vector-borne symbionts should evolve toward severe parasitism in vertebrate hosts and benign parasitism in the vectors, waterborne symbionts should evolve toward severe parasitism, symbionts transmitted by predation should evolve toward severe parasitism in prey hosts and benign parasitism in predator hosts, and vertically transmitted symbionts should evolve toward benign parasitism and mutualism. Detailed reviews of the literature on human diseases support the hypothesized severity of vector-borne and waterborne transmission. Evaluation of the other associations is less detailed, but each association appears to be present. This framework draws attention to the need for detailed reviews of relationships between transmission modes and the nature of symbiotic interactions, and experimental manipulations of transmission. PMID- 3304080 TI - Compartmentation of calcium and energy metabolic pathways. Implications for eukaryote evolution and control of cell proliferation. PMID- 3304081 TI - Gene transfer. Mitochondria to nucleus. PMID- 3304079 TI - Change of cellular "pathogens" into required cell components. PMID- 3304082 TI - Cell division cycles and circadian clocks. Modeling a metabolic oscillator in the algal flagellate Euglena. PMID- 3304083 TI - Endocytobiotic coordination, intracellular calcium signaling, and the origin of endogenous rhythms. PMID- 3304084 TI - The simultaneous symbiotic origin of mitochondria, chloroplasts, and microbodies. PMID- 3304085 TI - Use of Healon in eye muscle surgery with adjustable sutures. AB - Adhesions between the contacting surfaces of conjunctiva, Tenon's capsule, and muscle produce "tissue drag" which can complicate procedures with adjustable muscle sutures. The use of Healon is recommended to minimize this tissue drag and facilitate the "adjustment phase" of muscle surgery with adjustable muscle sutures. Data on 14 consecutive cases demonstrate the utility of Healon in adjustable strabismus surgery. PMID- 3304086 TI - [44 years' experience in clinical obstetrics and gynecology]. PMID- 3304087 TI - [Clinical view and echography in the evaluation of expanding pelvic pathology: review of 312 clinical cases]. PMID- 3304088 TI - Drug permeability of the endolymphatic sac. AB - Intravenously injected kanamycin sulfate (KM) was located in the endolymphatic sac (ES) of guinea pigs by an immunohistologic method. Kanamycin sulfate had passed through the capillaries in the subepithelial layer and reached the epithelial layer as early as 1 minute after injection. The amount of KM in the epithelial layer gradually increased with time (until 30 minutes after injection). The KM also accumulated in floating cells in the ES. These results tend to indicate that the ES is rather easily permeable to systemically administered drugs, which readily get into the regional endolymph. In conclusion, much more attention should be paid to the ES and drug ototoxicity associated with drug therapy in the management of patients with inner ear disturbances. PMID- 3304089 TI - Secretory IgA and serum type IgA in nasal secretion and antibody activity against the M protein. AB - We studied IgA immunoglobulins in nasal secretions in order to clarify mucosal immunity of the nasal cavity and paranasal sinuses during chronic nasal infection. Secretory IgA and serum type IgA of 165 samples of nasal secretions were analyzed quantitatively by use of electroimmunodiffusion techniques, and the specific antibody activity of secretory IgA against the M protein of Streptococcus pyogenes was investigated by use of enzyme-linked immunosorbent assay. Results show that although the secretory IgA content in nasal secretions was elevated in chronic sinusitis, its specific antibody activity against the M protein was lower than that in normal subjects. This evidence suggests that nonspecific secretory IgA antibodies are predominantly produced in chronic sinusitis, and that mucosal immunity preventing the adherence of bacteria is impaired in the diseased mucosa. PMID- 3304090 TI - Silicone tracheal cannula. Update. AB - The Montgomery silicone tracheal cannula is a current alternative to the standard tracheotomy tube. This paper extends the 1986 report to include unusual indications for its use, complications and their management, and further recommendations on its use gathered from recent experience. PMID- 3304091 TI - [Method of histological control of the edges of surgical specimens of basal cell epitheliomas]. AB - For histologic control of excisional margins, routinely fixed tumor specimens or under certain conditions, specimens fixed immediately in warm formalin are processed in the histology laboratory. Strips are then cut from the undersurface, edge and cross section of the specimen and processed further by routine paraffin techniques until HE-stained sections of the entire periphery and midsection are available. The average follow-up time was of 4 years with a recurrence rate of 0.4 per cent. PMID- 3304092 TI - [A case for diagnosis: Degos' malignant atrophic papulosis]. PMID- 3304093 TI - [Idiopathic bullous disease in diabetics]. PMID- 3304094 TI - [Sneddon-Wilkinson subcorneal pustulosis]. PMID- 3304095 TI - [Oral aspects of cicatricial pemphigoid. What is left of "desquamative gingivitis"?]. PMID- 3304096 TI - [Determination of the chemosensitivity of Plasmodium falciparum: methodology and interpretation]. PMID- 3304097 TI - [Resistance of Plasmodium falciparum to antimalarials. Preventive and therapeutic consequences for malaria in children]. PMID- 3304099 TI - [Intestinal malabsorption and giardiasis]. PMID- 3304098 TI - [Parasitic and fungal complications of bone marrow grafts in children]. PMID- 3304100 TI - [8 cases of Greenfield filters in the right heart cavities. Their surgical treatment]. PMID- 3304101 TI - A computer and automatic method for the determination of vessel diameters. PMID- 3304102 TI - Duplex ultrasonography, intravenous digital subtraction angiography, intraarterial digital subtraction angiography and conventional angiography in assessing carotid atherosclerosis. PMID- 3304103 TI - [Preliminary study of the video dilution curves of the nephrograms during intravenous digital angiography for hypertension]. PMID- 3304104 TI - Digital subtraction angiography in gastrointestinal disease. PMID- 3304105 TI - Pulmonary embolism--diagnosis by lung perfusion scintigraphy or digital subtraction angiography? PMID- 3304106 TI - [Limitations of staging of testicular tumors by imaging]. PMID- 3304107 TI - [Value of imaging of the complications of hydatidosis]. PMID- 3304108 TI - [Intramural hematoma of the duodenum. Apropos of a case]. PMID- 3304109 TI - [Non-traumatic circumscribed myositis ossificans with cervical localization. Contribution of x-ray computed tomography]. PMID- 3304110 TI - Hog cholera virus: art and facts. AB - The aim of this review is to summarize the informations accumulated during the two last decades on hog cholera virus, a member of the pestivirus genus. Different aspects concerning the virus-host cell interactions, and the structural and antigenic properties of the virion itself are successively analyzed. Despite numerous works, many basic informations are still lacking, which can be explained by the difficulties inherent to the study of this virus. PMID- 3304111 TI - Pathogenesis and epidemiology of hog cholera. AB - A review is given on the infection with hog cholera (HC) virus resulting in various courses due to variabilities of the virus and the porcine host organism. Mechanisms by which the virus causes prenatal death or postnatal disease in pigs are considered. Epidemiological features relating to various courses of infection and disease patterns resulting from prenatal or postnatal contacts with the virus are discussed. PMID- 3304112 TI - [Combination Papineau's operation and intertibio-fibular graft in the treatment of septic pseudoarthrosis of the leg. Apropos of 14 cases]. PMID- 3304113 TI - [Repeated aortic valve replacement and infectious destruction of the aortic ring. A new technic]. PMID- 3304114 TI - [Prospective study comparing ultrasonics and digital subtraction angiography in arterial bypass of the lower limbs. Apropos of 54 cases]. PMID- 3304115 TI - [Radioisotope and ultrasonic diagnosis of a localized form of infarction of the right ventricle]. AB - We are reporting the case of a localized form of right ventricle infarction. The right catheterization, on which the diagnosis usually rests, is completely normal. Cardiac gamma-angiography and bi-dimensional sonography demonstrate, on the contrary, a localized dyskinesis of the inferior wall of the right ventricle which is not dilated and retains its ejection fraction. The failure of right catheterization in the diagnosis of infarction of the right ventricle is usually attributed to hypovolemia or a delay in the performance of the catheterization, which is not the case here. Therefore, this case demonstrates the existence of infarction of the right ventricle without total diastolic or systolic dysfunction, the diagnosis of which may be made with isotopic and sonographic methods. PMID- 3304116 TI - [Primary pulmonary arterial hypertension]. AB - Primary pulmonary hypertension (PPH) currently remains an entity of which the precise mechanism, most likely vasospastic, is not completely explained. The diagnosis of PPH remains an exclusion diagnosis; it will be considered only after ruling out a secondary pulmonary hypertension. Non-invasive techniques such as sonography, cardiac Doppler should permit an earlier diagnosis and an easier monitoring of these patients whose prognosis remains poor in spite of the sporadic efficacy of a treatment with vasodilators. Heart-Lung transplant could be a future prospect; however, if the first reports seem encouraging, the follow up is currently insufficient to appreciate the possible long-term advantage. PMID- 3304117 TI - [Comparative effect of atenolol and verapamil in exertion angina. A single-blind crossed study with computerized exercise test]. AB - The anti-ischemic activity of Verapamil (360 mg/24 h) is compared with a cardioselective betablocker, Atenolol (100 mg/24 h), in a single blind study with computerized stress tests. Although acting through different mechanisms, and are evaluated indirectly by measurements with equal cardiac work and frequency, the improvement of the performance, the decrease of the sub-denivellation at the end of the stress and the frequency of interruption because of pain, seem approximately similar for both medications. PMID- 3304118 TI - A controlled, double-blind, cross-over study of terodiline in motor urge incontinence. AB - In a placebo-controlled, randomized, double-blind, cross-over study, terodiline (50 mg/d) was compared with emepronium (600 mg/d) in 20 patients with motor urge incontinence. Evaluation of clinical efficacy was based on changes in micturition pattern, flow measurements, residual urine, cystometry and patient preferences, and safety on adverse reactions, blood chemistry, urine examinations and ECG. The number of voluntary micturitions decreased from a mean of 21.5 per 48 h on placebo by 1.6 on terodiline and 2.8 on emepronium. Involuntary micturitions decreased from 3.6 per 48 h by 1.3 on both treatments (p less than 0.05). The maximal flow rate decreased from a mean of 24.5 ml/sec to 19.6 ml/sec on emepronium and increased to 25.4 ml/sec on terodiline. Residual urine decreased from a mean of 54 ml to 49 ml on terodiline and increased to 60 ml on emepronium. Volume at first desire to void in the supine position increased on emepronium by 44 ml (p less than 0.05) and on terodiline by 3 ml, on the upright position by 11 ml and 18 ml, respectively. Bladder capacity increased in the supine position on emepronium by 32 ml and decreased on terodiline by 8 ml, in the upright position increased by 9 ml and 5 ml, respectively. The bladder pressure at first desire to void in the supine position increased on emepronium by 2 cmH2O, and decreased on terodiline by 2 cmH2O. The intravesical pressure at strong desire to void decreased on emepronium by 6 cmH2O and on terodiline by 7 cmH2O, in the upright position by 2 cmH2O and 1 cmH2O, respectively. 39% of the patients preferred terodiline, 39% emepronium and 22% placebo.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304119 TI - Immunological approaches to the study of oral cancer. Shortcomings and promises. PMID- 3304120 TI - Tori in ancient Chileans. PMID- 3304121 TI - The management of trigeminal neuralgia. A review. PMID- 3304122 TI - The caudal regression syndrome in infants of diabetic mothers. AB - Ultrasonography as part of the pre-natal diagnosis in high risk pregnancies may detect a number of fetal malformations that need to be re-evaluated for continuation or termination of pregnancy. Two fetuses, in two different patients with diabetes mellitus, were found to have significant intrauterine malformations detected by ultrasonography at 18 and 20 weeks gestational age, respectively. Post-mortem examination on both fetuses demonstrated the findings known as the caudal regression syndrome. The clinico-pathological features and obstetrical management of diabetic mothers whose pregnancies are complicated with this rare malformation are discussed. PMID- 3304123 TI - Iron-deficient medium for selective isolation and presumptive identification of enterococci. AB - An Enterococcus Selective Agar (ESA; basal medium plus 0.01% NaN3, pH 9.6, Fe ion restricted) was applied to a direct, single-step, isolation and presumptive identification of enterococci from clinical urine. The ESA was examined as to rate of colony formation and selectivity together with two conventional culture media, Pfizer Selective Enterococcus Agar (PSE) and Phenyl Ethyl Alcohol Agar (PEA). Significant differences were observed in the rate of colony formation after 14, 17, and 20 hr of incubation at 35 degrees. The size of colonies on ESA was consistently larger than on the other two media. Biochemical testing showed that isolates from ESA conformed more closely to the definition of enterococci than isolates from either PSE or PEA. The improved selectivity of ESA was in large part due to the reduced presence of Fe ions. The medium offers advantages for an expeditious and accurate isolation of enterococcal pathogens. PMID- 3304124 TI - Interrelationships between dietary carbohydrates, B cell function and rate of ketogenesis during underfeeding in obese patients. AB - Six matched groups of obese patients underwent 3-week selective hypocaloric regimens which consisted of a 240 or 480 kcal/day liquid formula diets for groups 1-4 and an 800 kcal/day conventional diet for groups 5 and 6. Carbohydrate intake ranged from 19 to 112 g/day so that for each energy level two different amounts of carbohydrates were administered. Body weight loss was similar in groups 1-4 and significantly lower in groups 5 and 6. During treatment fasting serum insulin (but not serum C-peptide) levels and the daily urine excretion rate of C-peptide showed quite a similar fall in all groups. Fasting glucagon levels did not change. The rate of ketogenesis which developed during each nutritional treatment was inversely related to the amount of dietary carbohydrates; moreover, a significant correlation was found between percent variation of ketoacids and those of fasting IRI (r = -0.42; p less than 0.01) and glucose (r = -0.52; p less than 0.01) concentrations, but not with those of fasting C-peptide and its daily urine excretion rate. In conclusion, it seems that during underfeeding (1) low- and high-carbohydrate-containing regimens are substantially equipotent stimuli secretagogues of insulin secretion, and (2) carbohydrate (or glucose) availability affects ketogenesis even through noninsulin-mediated mechanisms. PMID- 3304125 TI - [Ultrasonography of subclinical primary testicular tumors. Apropos of a Sertoli cell tumor]. AB - The authors report an original case of an adult presenting with a bilateral Sertoli cell testicular tumour in whom one of the impalpable lesions was detected by routine ultrasonography. This appears to be the first reported description of the ultrasonographic appearance of such a subclinical tumour. The review of 20 published cases reporting the appearance of impalpable primary tumours reveals that in the great majority of cases the echostructure is hypoechoic and therefore does not present any histological specificity, and that these tumours tend to be essentially seminomas or Leydig cell tumours. The indications for scrotal ultrasonography in the detection and follow-up of scrotal tumours are discussed. PMID- 3304126 TI - [Restoration of urinary tract continuity in a non-functioning bladder after renal transplantation]. AB - The restoration of the continuity of the urinary tract after renal transplantation in anuric patients, an increasingly frequent situation, raises a number of theoretical problems: is it possible to use a bladder which has been non-functioning, sometimes for many years (20 years)? What should be performed during pre-operative assessment? Which surgical technique should be used? The authors try to answer these questions on the basis of their experience of 116 transplanted anuric patients. Anuria, even of long duration, does not prevent the use of the bladder, provided that the bladder was originally normal and is not infected. The pre-operative assessment is the same as for other patients and urodynamic investigations are not required. The optimal reimplantation technique is the Leadbetter-Politano open bladder technique and every effort should be made to obtain abundant diuresis immediately. Under these conditions, reimplantation into these non-functioning bladders is not associated with more complications than in the case of normal bladders. PMID- 3304128 TI - [Extracorporeal piezoelectric lithotripsy by ultra-short waves using the EDAP LT01 device]. AB - Three hundred and sixty one extracorporeal lithotripsies for renal, ureteric and bladder stones have been performed by means of a system of ultrasonographic detection and piezoelectric destruction (EDAP LT01). The localisation of the stone is achieved by a 5 MHz real time sectorial transducer situated in the centre of a small dish containing 320 piezoelectric elements concentrated in a source 5 mm wide by 15 mm high. The pressure recorded in vitro is 900 bars. The stone is easily detected in 87.2% of cases, difficult to detect in 10% of cases and impossible to detect in 28% of cases. By using a frequency of 1.25 to 5 per second, extracorporeal lithotripsy can be performed without any local, regional or general anaesthesia and without premedication in the 120 patients with a renal stone, reviewed between 1 and 3 months, 88 (73%) were considered to be complete successes. Ten (8%) were considered to be failures and 19 (21%) were considered to be partial successes. The best results were obtained in stones of the renal pelvis less than 20 mm in diameter. These results relate to a mean series which must take into account the successive improvements made to the lithotripter. Today, stone fragmentation is obtained in 93% of cases. Thirty six stones of the lumber and pelvic ureter were treated with success rates of 93% and 50%, respectively. Six bladder calculi were treated with a 50% success rate. Forty two patients were treated without being admitted to hospital.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304127 TI - [Idiopathic spontaneous adrenal hematoma in adults: echography and x-ray computed tomography. Apropos of 5 cases]. AB - The five patients presented with sudden lumbar pain, transient collapse, and a right hypochondrium palpable mass. The location and the type of the mass could be determined by ultrasonography which showed a septated heterogenous mass displacing the retroperitoneal fat anteriorly. Computed tomography showed in two cases tiny parietal calcifications and a spontaneous hyperdensity in one case. All the patients underwent surgery and no tumoral tissue could be found. PMID- 3304129 TI - [Polycystic renal dysplasia in children]. AB - Ultrasonography has profoundly modified the diagnostic conditions of polycystic renal dysplasia in children. Non-palpable forms, which were previously most frequently missed, can now be detected during the antenatal period. In infants, ultrasonography generally provides a definite diagnosis, which can be confirmed by aspiration-opacification of the cysts. On the basis of a series of 40 cases and a review of the literature, the authors discuss the therapeutic implications of these new data. Surgery remains essential in cases of palpable polycystic renal dysplasia, especially when it is complicated. However, in the sub-clinical forms, as the risks of malignant degeneration and the incidence of post-operative complications are minimal in the one case and undefinable in the other, surgical excision is possible but not essential. PMID- 3304130 TI - Summing up. PMID- 3304131 TI - Aminoacyl tRNA synthetases: general scheme of structure-function relationships in the polypeptides and recognition of transfer RNAs. PMID- 3304132 TI - Inositol trisphosphate and diacylglycerol: two interacting second messengers. PMID- 3304133 TI - Fractionation and structural assessment of oligosaccharides and glycopeptides by use of immobilized lectins. PMID- 3304134 TI - Enzymes of general recombination. PMID- 3304135 TI - Transfer RNA modification. PMID- 3304136 TI - Ferritin: structure, gene regulation, and cellular function in animals, plants, and microorganisms. PMID- 3304137 TI - Intracellular proteases. PMID- 3304138 TI - The structure and function of the hemagglutinin membrane glycoprotein of influenza virus. PMID- 3304139 TI - Intracellular calcium homeostasis. PMID- 3304140 TI - Dynamics of membrane lipid metabolism and turnover. PMID- 3304141 TI - DNA mismatch correction. PMID- 3304142 TI - Alternative splicing: a ubiquitous mechanism for the generation of multiple protein isoforms from single genes. PMID- 3304143 TI - Inhibitors of the biosynthesis and processing of N-linked oligosaccharide chains. PMID- 3304144 TI - The nucleus: structure, function, and dynamics. PMID- 3304145 TI - Topography of glycosylation in the rough endoplasmic reticulum and Golgi apparatus. PMID- 3304146 TI - Molecular genetics of myosin. PMID- 3304147 TI - ras genes. PMID- 3304148 TI - Biosynthetic protein transport and sorting by the endoplasmic reticulum and Golgi. PMID- 3304149 TI - Protein glycosylation in yeast. PMID- 3304150 TI - P450 genes: structure, evolution, and regulation. PMID- 3304151 TI - Dislocation and/or congenital malformation of the shoulder joint. Observations on a Mediaeval skeleton from Denmark. AB - The purpose of this paper is to present a Mediaeval skeleton of an approximately 16 year old boy, which was excavated at a Danish cemetery containing ca. 150 graves. The skeleton reveals several pathologic changes, probably due to congenital malformation. The most intriguing find is seen at both scapulae, and the changes are bilateral symmetric. Both the glenoid cavities are placed posterior but at the normal height of the bone. The joints are almost perpendicular to their normal direction. The size of the glenoid cavities is normal and the shape is rather flat in accordance to the development stage of the skeleton, where the epiphysis of the rim has not yet appeared to form the gently concave fossa as normally seen in adults. Both the surface and the borderlines of the glenoid cavities are, however, more irregular than normally at that age. The position of the joints may be caused by dislocation and/or congenital malformation which is discussed. Due to the shape of the cavities, to the symmetric bilaterality, and to the minor congenital malformations, it is primarily believed to be caused by congenital malformation. Probably the young man was not much affected by the malformation of the shoulder joints, which is indicated by the normal form and size of the humeri and the well-developed muscle attachments of the bones. The claviculae seem shorter and more twisted than normal, which may be caused by a twisting of the scapulae. So the glenoid cavities may have pointed almost in the normal direction in spite of the malformation. Other minor malformations are spina bifida of the atlas and the 5. lumbar vertebra, multiple minor changes of the joints of both feet and malformations of one metatarsal bone in both feet. Agenesi of the praemolars is also seen. Although our study of the literature, we have not succeeded in correlation our finds with any known congenital syndrome, and as far as we know no similar case has been described in clinical observation or in skeletal finds. PMID- 3304152 TI - Survey of anthropological features of the Illyrians. AB - The purpose of this paper is to bring to evidence the physical traits of the ancient inhabitants of Albania, the Illyrians, through an anthropological study of 93 human skeletons of different periods. Based on the available typological data the author comes to the conclusion that the Illyrians of the Albanian territory constituted an Adriatic-Mediterranean population with Nordic and Alpine minorities. The results of this study throw light on certain historical phenomena, which are linked with the origin and formation of the Illyrians. PMID- 3304153 TI - Biological relationships derived from morphology of permanent teeth: recent evidence from prehistoric India. AB - Morphological variation in permanent teeth of prehistoric populations yields clues to their relationships with other prehistoric and living people. This paper documents variation in fourteen variants of the permanent tooth crown for the late Chalcolithic skeletal series from Inamgaon (1600-700 BC), an early farming settlement in western India. In comparison of the dental morphology profile at Inamgaon with American Indians and American Whites, the people of Inamgaon were found to more closely resemble American Whites. However, specific traits deviated in the direction of Amerindian dental trait frequencies, suggesting gene flow from north and east Asian populations. The dental morphology of the Inamgaon sample is similar to dental patterns characteristic of prehistoric Pakistani samples from Sarai Khola and Timargarha. However, Inamgaon and Timargarha exhibit somewhat more complex crown morphology than the Sarai Khola sample, suggesting a closer relationship between them and greater antiquity of residence in the subcontinent, in contrast to Sarai Khola sample. PMID- 3304154 TI - Treatment of human immunodeficiency virus infections. PMID- 3304155 TI - Paradoxical antibacterial activity of cefmenoxime against Proteus vulgaris. AB - The growth-inhibitory effect of cefmenoxime against Proteus vulgaris was studied by using the broth dilution and paper disk diffusion methods. Cefmenoxime showed growth-inhibitory activity against Proteus vulgaris at low concentrations but not at high concentrations up to a certain limit. This paradoxical antibacterial activity was not observed with cefoperazone and cefbuperazone. The induction of beta-lactamase by cefmenoxime and the rate of hydrolysis of cefmenoxime in the culture broth were proportional to the initial concentration of this antibiotic. At high initial concentrations, cefmenoxime was rapidly inactivated. On the other hand, neither cefoperazone nor cefbuperazone was inactivated irrespective of concentration. We conclude that cefmenoxime induces beta-lactamase in P. vulgaris, perhaps accounting for its paradoxical antibacterial effect. PMID- 3304156 TI - Ampicillin versus cefamandole as initial therapy for community-acquired pneumonia. AB - One hundred seven patients with community-acquired pneumonia thought to be of bacterial etiology by the admitting physician but whose initial sputum Gram stain was inadequate to direct specific therapy were randomized to receive either intravenous ampicillin or cefamandole as empiric therapy. Patients were excluded if the initial sputum Gram stain was highly suggestive of infection with Streptococcus pneumoniae, Staphylococcus aureus, or an enteric gram-negative bacillus. The two study groups had comparable demographic and presenting clinical features. The mean age of the patients evaluable for determination of clinical efficacy was 69 years, and greater than 75% had at least one serious underlying medical disorder. In the 90 evaluable patients, there were 11 therapeutic failures (12%), including 5 deaths (5%). Cefamandole, a broad-spectrum antibiotic, was not more efficacious than ampicillin in producing a satisfactory clinical response or in shortening the duration of parenteral therapy. Patients received an average of only 4 days of intravenous antibiotics before changeover to oral therapy and were hospitalized for a mean of 7 days. No patient experienced a relapse of pneumonia following successful completion of parenteral drug therapy. We conclude that cefamandole is not a more effective agent than ampicillin for empiric therapy of community-acquired bacterial pneumonia of uncertain etiology. PMID- 3304157 TI - Does prolonged exposure to antibiotic-resistant bacteria increase the rate of antibiotic-resistant infection? AB - The magnitude of the risk of acquiring infections due to antibiotic-resistant bacteria, as a consequence of prolonged contact with such bacteria, is unclear. We compared antibiotic resistance patterns of Escherichia coli isolated from the urine of bacteriuric female abattoir workers with resistance patterns of E. coli cultured from 190 poultry taken from the processing line. We found E. coli in 181 (95%) of the poultry cultures; 96% of the isolates were resistant to one or more antibiotics, and 87% were multiply resistant. Of the 649 women whose urine was cultured and who had not recently received antibiotic therapy, 69 (10.6%) had positive urine cultures, with E. coli accounting for 67% of the isolates. Of the 46 E. coli isolates, 8 (17.4%) were resistant to one or more antibiotics. All of the antibiograms of the urinary isolates were unique, and only one, a strain with resistance only to streptomycin, matched those of any of the poultry isolates. Of the women tested for bacteriuria, 74 had taken antibiotics within 3 months of culture, and these women were analyzed separately. Among the recent antibiotic users, six (8.1%) had positive urine cultures, all with E. coli. Four of these isolates were resistant to at least one antibiotic; all had patterns that matched at least one of the poultry isolates. Therefore, in a population of female abattoir workers who were not receiving antibiotic therapy, despite a high exposure to resistant microorganisms of animal origin, infections were infrequently caused by organisms with resistance patterns characteristic of the livestock to which the women were heavily exposed. PMID- 3304158 TI - Spread of SHV-1 beta-lactamase in Escherichia coli isolated from fecal samples in Africa. AB - Ninety-seven (42%) Escherichia coli strains isolated in Senegal from fecal samples produced beta-lactamases. Among them, 29 (30%) isolates produced SHV-1 beta-lactamase that was plasmid mediated. The plasmids belonged to four incompatibility groups. Various degrees of TEM-1 expression in the presence of SHV-1 were observed. PMID- 3304159 TI - Efficacy of high dose-short duration ribavirin aerosol in the treatment of respiratory syncytial virus infected cotton rats and influenza B virus infected mice. AB - Fifteen to 20 mg/ml ribavirin administered as a small particle aerosol for 10-18 h per day is currently the regimen generally used to treat experimental or naturally-occurring respiratory syncytial (RS) or influenza virus infections in humans. To determine if such prolonged treatment schedules could be reduced, cotton rats and mice were inoculated with RS or influenza B virus, respectively, and then treated with different concentrations of ribavirin small particle aerosols. Aerosols generated from reservoirs containing 60 mg/ml ribavirin given 2 h twice daily, protected cotton rats from RS virus and mice from influenza B virus as well as aerosols generated from reservoirs containing 20 mg/ml ribavirin given 11 h daily. Aerosols generated from reservoirs containing 40 or 20 mg/ml given 2 h daily were less efficacious. There was no evidence of intolerance or pulmonary histopathology in infected or uninfected animals exposed to any of the doses of ribavirin tested. These studies indicate that use of aerosols containing higher concentrations of ribavirin than generally used to treat respiratory virus diseases may permit significantly shorter treatment schedules without loss of efficacy or increase in toxicity. PMID- 3304161 TI - Lars Leksell--a portrait by a friend. PMID- 3304162 TI - Irving S. Cooper. PMID- 3304160 TI - Regeneration of nicotinamide cofactors for use in organic synthesis. AB - The high cost of nicotinamide cofactors requires that they be regenerated in situ when used in preparative enzymatic synthesis. Numerous strategies have been tested for in situ regeneration of reduced and oxidized cofactors. Regeneration of reduced cofactors is relatively straightforward; regeneration of oxidized cofactors is more difficult. This review summarizes methods for preparation of the cofactors, factors influencing their stability and lifetime in solution, methods for their in situ regeneration, and process considerations relevant to their use in synthesis. PMID- 3304163 TI - Gouda frame redesigned specifically for computed tomographic compatibility. AB - The Gouda stereotactic frame has been redesigned for use with computed tomography. The patient is attached to the frame, is scanned, and is moved to the operating room for stereotactic biopsy. The Gouda frame permits accurate biopsy of otherwise inaccessible tumors of the brain. PMID- 3304164 TI - Stereotactic computed tomographic--guided functional neurosurgery using the redesigned Gouda frame. PMID- 3304165 TI - Glycosphingolipids of human umbilical vein endothelial cells and smooth muscle cells. AB - Glycosphingolipids (GSLs) represent an important class of immunogens and receptors. Although cell surface antigens and receptors of endothelial cells (ECs) have been the subject of extensive biochemical investigation, no information is available about their GSLs. We report here the characterization by chromatographic and immunological techniques of GSLs of cultured human umbilical vein ECs and, for comparison, umbilical vein smooth muscle cells (SMCs). The most abundant neutral GSLs of both cell types were lactosylceramide, Gb3, and Gb4, and both cells contained complex lacto and globo series compounds. Immunostaining revealed that ECs, but not SMCs, contained long chain GSLs bearing a type 2 blood group H determinant. ECs also contained more long chain GSLs bearing an unsubstituted terminal lactosamine structure than SMCs. Labeling with galactose oxidase/NaB3H4 demonstrated that neutral glycolipids that contained three or more sugars were accessible on the cell surface. The major gangliosides of both cell types were GM3 and IV3NeuAcnLc4. Immunostaining following neuraminidase treatment revealed that most of the long chain gangliosides in both types of cells contained a lacto core structure, and that ganglio series compounds were more abundant in SMCs than ECs. Gangliosides that contain a polyfucosyllactosamine core and a globo core were also present in both cell types. These results demonstrate that endothelial and smooth muscle cells contain a large diversity of GSL structures, and provide the basis for investigation of the role of these GSLs as cell surface antigens and receptors for blood components. PMID- 3304166 TI - Cathepsin E from rat neutrophils: its properties and possible relations to cathepsin D-like and cathepsin E-like acid proteinases. AB - An extract of rat neutrophils was found to contain a high hemoglobin-hydrolyzing activity at pH 3.2, about 70% of which does not cross-react with anti-rat liver cathepsin D antibody. A neutrophil non-cathepsin D acid proteinase was successfully isolated from cathepsin D and characterized in comparison with the properties of rat liver cathepsin D. The neutrophil enzyme differed from cathepsin D in chromatographic and electrophoretic behaviors as well as immunological cross-reactivity, and its molecular weight was estimated to be 98,000 by gel filtration on Toyopearl HW 55. These findings strongly suggest that the neutrophil enzyme could be classified as cathepsin E. The enzyme, now designated rat cathepsin E, had an optimal pH at 3.0-3.2, preferred hemoglobin to albumin as substrate, and was markedly resistant to urea denaturation. Rat cathepsins D and E cleaved the insulin B-chain at six and eight sites, respectively; five sites were common for both enzymes. Possible relations among cathepsin E and cathepsin D-like or E-like acid proteinases reported so far were discussed. PMID- 3304167 TI - Purification of cysteine proteinases from adult Schistosoma mansoni. AB - Proteolytic activity against hemoglobin and low molecular weight synthetic substrates has been previously found in homogenates and excretion/secretion products of adult Schistosoma mansoni worms. This activity is stimulated in the presence of thiol compounds and is maximally active at acidic pH. To characterize further this proteolytic activity, lyophilized adult worms were extracted, and proteinases were isolated and purified. From extracts prepared in 0.2 M citrate buffer, pH 4.9, two proteinase species were purified to homogeneity by centrifugation, gel filtration, dialysis, and chromatofocusing chromatography. The proteinases, designated SMw32 and SMw28, have apparent molecular weights (SDS PAGE) of 31,700 +/- 1400 and 27,800 +/- 1700, respectively. Both are thiol dependent, acidic endopeptidases that cleave hemoglobin and a synthetic substrate, CBZ-arg-arg-AFC. A statistical comparison of amino acid compositions reveals that the proteinases are highly related. PMID- 3304169 TI - [Effects of recombinant human interferon-alpha A/D on the growth of experimental tumors in mice]. AB - The effects of recombinant human interferon-alpha A/D (rIFN-alpha A/D, a subtype of recombinant human leukocyte interferon with biological activities against murine tumor cells) on the growth of murine tumors were studied. rIFN-alpha A/D significantly inhibited the growth of mouse M5076 reticulum cell sarcoma, MOPC 104E myeloma, colon carcinoma 26 and Meth A fibrosarcoma by dose-dependent fashion. rIFN-alpha A/D also inhibited the metastases and growth of Lewis lung carcinoma and showed a synergistic effect with combination of cyclophosphamide. The antitumor activity of rIFN-alpha A/D was observed by intra-muscular, intravenous, subcutaneous, intraperitoneal injections or by the injection at the site of the tumors. PMID- 3304168 TI - The role of aspartic and cysteine proteinases in albumin degradation by rat kidney cortical lysosomes. AB - We have investigated the degradation of 125I-labeled bovine serum albumin by lysates of rat kidney cortical lysosomes. Maximal degradation of albumin occurred at pH 3.5-4.2, with approximately 70% of the maximal rate occurring at pH 5.0. Degradation was proportional to lysosomal protein concentration (range 100-600 micrograms) and time of incubation (1-5 h). Dithioerythritol (2 mM) stimulated albumin degradation 5- to 10-fold. Albumin degradation was not inhibited by phenylmethanesulfonyl fluoride (1 mM) or EDTA (5 mM), indicating that neither serine nor metalloproteinases are involved to a significant extent. Pepstatin (5 micrograms/ml), an inhibitor of aspartic proteinases, inhibited albumin degradation by approximately 50%. Leupeptin (10 microM) and N-ethylmaleimide (10 mM), inhibitors of cysteine proteinases, decreased albumin degradation by 34 and 65%, respectively. Combinations of aspartic and cysteine proteinase inhibitors produced nearly complete inhibition of albumin degradation. Taken together, these data indicate that aspartic and cysteine proteinases are primarily responsible for albumin degradation by renal cortical lysosomes under these conditions. In keeping with the above data, we have measured high activities of the cysteine proteinases, cathepsins B, H, and L, in cortical tubules, the major site of renal protein degradation. Using the peptidyl 7-amino-4-methylcoumarin (NHMec) substrates (Z-Arg-Arg-NHMec, for cathepsin B; Arg-NHMec for cathepsin H; and Z Phe-Phe-CHN2-inhibitable hydrolysis of Z-Phe-Arg-NHMec corrected for inhibition of cathepsin B activity for cathepsin L) values obtained were (means +/- SE, mU/mg protein, 1 mU = production of 1 nM product/min, n = 6): cathepsin B, 2.1 +/ 0.34; cathepsin H, 1.35 +/- 0.19; cathepsin L, 14.49 +/- 1.26. In comparison, the activities of cathepsins B, H, and L in liver were: 0.56 +/- 0.03, 0.28 +/- 0.04, and 1.27 +/- 0.16, respectively. PMID- 3304170 TI - [Clinical investigation of carbohydrate antigen CA-50]. AB - The CA-50 enzyme immunoassay kit (EIA kit) that has been developed with the use of C-50 monoclonal antibody prepared by L. Lindholm et al. was evaluated for diagnosis of human cancer. The levels of CA-50 in the sera were determined using this kit supplied from Mitsui Pharmaceuticals, Inc. Co. in 759 healthy donors, 728 patients with benign disease and 1,263 untreated patients with cancer. A CA 50 concentration of 40 U/ml of serum was used as the cut-off value. Patients with pancreatic cancer and patients with bile duct cancer had high positive incidence of 75% and 68%, respectively, compared with a low positive incidence of under 40% in patients with other cancers. On the other hand, positive rates in patients with benign disease were as low as 13%. Comparison of the serum levels of CA-50 with CA19-9 in the same samples did not exhibit complete positive correlation in patients with pancreatic cancer, patients with bile duct cancer and patients with liver cancer. These findings indicated that C-50 antibody reacted with two epitopes of CA19-9 and sialosyllactotetraose. From the above results, the usefulness of CA-50 as a tumor marker for pancreatic cancer and bile duct cancer was recognized with this EIA kit. PMID- 3304171 TI - [5-Fluorouracil--recent advances in clinical studies]. PMID- 3304172 TI - Comparison of four pancreatic extracts in cystic fibrosis. AB - Four different pancreatin products, Pancrease, Creon, Pancrex V Forte, and Pancreatin Merck, were compared in a random crossover trial in children with cystic fibrosis. The results of our study showed that patients who received Creon and Pancrease had fewer gastrointestinal symptoms than patients who received Pancrex V Forte and Pancreatin Merck. Fat absorption was significantly improved with Pancrease when compared with Pancrex V forte and Pancreatin Merck. Also the fat absorption with Creon was superior to that with Pancrex V Forte. There was no significant difference in fat absorption between Pancrease and Creon. Pancrex V Forte and Pancreatin Merck, or Pancreatin Merck and Creon. Faecal nitrogen content was less with both Creon and Pancrease compared with Pancreatin Merck. Creon and Pancrease allow the patient with cystic fibrosis to take a high energy diet without any dietary restrictions. PMID- 3304173 TI - Recovery from neonatal myocardial dysfunction after treatment of acute hypertension. AB - Echocardiography showed gross cardiac dysfunction in a neonate with hypertension secondary to renal artery thrombosis. Cardiac recovery was dramatic after control of hypertension with captopril. PMID- 3304174 TI - Prolonged flare and periventricular leucomalacia (PVL) in preterm neonates. PMID- 3304175 TI - Hydrogen selenide poisoning: an illustrative case with review of the literature. AB - Hydrogen selenide is a non-metallic compound currently receiving attention in both medicine and electronics. Toxicity results in multiple symptoms, the most characteristic of which is a garlicky odor of the breath. A young woman exposed repeatedly to hydrogen selenide gas developed gastrointestinal complaints, dental caries, conjunctivitis, nail deformities, and garlicky breath. Other reported cases are discussed along with various proposed treatments. PMID- 3304176 TI - Hand reconstruction following avulsion of all dorsal soft tissues. A cutaneo tendinous free tissue transfer. AB - Restoration of function following mutilating injuries to the extensor surface of the hand has traditionally involved staged reconstruction with distant pedicle flaps, followed by tendon grafting. Advances in microsurgery now permit the transfer, in one operation, of vascularized composite tissues such as skin and muscle, or skin and bone. For dorsal hand reconstruction a composite flap of skin, tendons and nerves from the dorsum of the foot was transferred in one stage soon after injury, avoiding unnecessary disabling scar formation, prolonged hospitalization and resulting in the rapid restoration of near normal function and appearance of the hand. Donor site morbidity was minimal. PMID- 3304177 TI - [Surgical treatment of cutaneous ulcerations related to anticancer chemotherapy]. AB - Surgical treatment of skin ulcers from extravasation of chemotherapeutic agents produces a chronic ulcer. The origin of the disease and the techniques of wide local excision and of skin cover are discussed. PMID- 3304178 TI - Cardiac transplantation: first-year experience in a community hospital. AB - The issue of decentralizing heart transplant services, formerly restricted to a few large medical centers, is currently under review by federal and state governments. We present the results of the first year of cardiac transplantation at a 385-bed community hospital. Twelve patients were selected according to generally accepted criteria from a pool of 24 referrals, all from within 75 miles of our institution. All patients were in New York Heart Association Class IV preoperatively. The one-year survival rate was found to be 82%, which is equivalent to that reported by established centers. All surviving patients were fully rehabilitated. Rates of infection and rejection were lower than expected, and costs were about half the national average. This series, in all likelihood, tests the limits to which the decentralization of cardiac transplant services can be taken. We conclude that cardiac transplantation can be accomplished at a community hospital with results, even for the first patients undergoing transplantation, comparable to those obtained by established programs at major medical centers. PMID- 3304179 TI - Funnel stitch closure of the limited pulmonary excision defect. AB - A technique to close small defects in lung tissue resulting from local excision of lung lesions is described. The technique, called the spiral funnel stitch, is a conical suture started in the depth of the defect and tied at the surface. It minimizes air leaks. PMID- 3304180 TI - A new technique for permanent pacemaker implantation in infants and children. AB - Permanent pacemaker implantation in the infant or young child presents the surgeon with many technical problems unique to this population. A new technique of implantation is described that was used successfully in 6 pediatric patients. The technique is simple to perform and gives very satisfactory results. PMID- 3304181 TI - Malignant clinical behavior of cardiac myxomas and "myxoid imitators". AB - The clinical experience with cardiac myxomas and "myxoid imitators" at the Humana Heart Institute International is reviewed and contrasted with a comprehensive review of the world literature. Twenty-two patients with primary cardiac tumors have been treated at our institution. Three (13.6%) of them had myxoid imitators, and 19 had classic myxomas. One of the 19 patients with a classic myxoma had recurrence on two occasions (recurrence rate, 5.3%). The cases of 57 patients from the world literature are reviewed. Recurrence and/or metastases (including formation of mycotic aneurysm) occurred in approximately 50% of these patients. The overall mortality in these patients was 47%. This review provides documentation of the malignant clinical behavior of cardiac myxomas and myxoid imitators. Neither local recurrence nor regrowth of the tumor in a new location, whether intracardiac or extracardiac, can be predicted from the microscopic appearance of the primary tumor. Resection of the myxoma with a wide margin is the recommended surgical procedure but does not ensure a cure. Therefore, long term follow-up is mandatory. PMID- 3304182 TI - Biological properties and mode of action of clavams. AB - The clavams valclavam and hydroxyethylclavam were both bacteriostatic and fungistatic. The molecular basis for growth inhibition of Escherichia coli was a non-competitive inhibition of homoserine-O-succinyltransferase (EC 2.3.1.46), thus blocking methionine biosynthesis. Eucaryotes such as Saccharomyces cerevisiae were inhibited by a different mode of action. Instead of interfering with methionine biosynthesis, the clavams inhibited the formation of RNA in living cells, although the RNA-polymerases of isolated yeast nuclei were not inhibited. The action of valclavam on E. coli was dependent on functional peptide transport systems. PMID- 3304184 TI - [Antenatal diagnosis of 2 cases of intra-abdominal solitary cyst]. AB - On the occasion of 2 cases, torsion of an ovarian cyst and volvulus of a cystic intestinal duplication, the authors emphasize the usual benignity of fetal intra abdominal solitary cystic pictures, among which the most frequent are the ovarian cysts. Antenatal diagnosis allows for detection of complications, especially torsions and for early neonatal management always leading to surgical treatment. PMID- 3304183 TI - Glycerol production in relation to the ATP pool and heat production rate of the yeasts Debaryomyces hansenii and Saccharomyces cerevisiae during salt stress. AB - Changes in glycerol production and two parameters related to energy metabolism i.e. the heat production rate and the ATP pool, were assayed during growth of Saccharomyces cerevisiae and Debaryomyces hansenii in 4 mM and 1.35 M NaCl media. For both of the yeasts, the specific ATP pool changed during the growth cycle and reached maximum values around 10 nmol per mg dry weight in both types of media. The levels of glycerol were markedly enhanced by high salinity. In the presence of 1.35 M NaCl, D. hansenii retained most of its glycerol produced intracellularly, while S. cerevisiae extruded most of the glycerol to the environment. The intracellular glycerol level of S. cerevisiae equalled or exceeded that of D. hansenii, however, with values never lower than 3 mumol per mg dry weight at all phases of growth. When D. hansenii was grown at this high salinity the intracellular level of glycerol was found to correlate with the specific heat production rate. No such correlation was found for S. cerevisiae. We concluded that during salt stress, D. hansenii possesses the capacity to regulate the metabolism of glycerol to optimize growth, while S. cerevisiae may not be able to regulate when exposed to different demands on the glycerol metabolism. PMID- 3304185 TI - [Insulin-dependent diabetes in children and adolescents. An endocrine disease difficult to treat]. PMID- 3304186 TI - [True precocious puberty in non-tumor hydrocephalus. An analysis of 16 cases]. AB - True precocious puberty occurred in 16 children (15 girls and 1 boy) with non tumoral shunted hydrocephalus at a mean age of 6.8 years. They had mild clinical manifestations of precocious puberty, and the other pituitary functions were found to be normal. Except for one child, precocious puberty did not correlate with raised intracranial pressure or lack of cerebral drainage by the shunt. Growth was the main concern in this group as the predicted height fell at a mean value of 1.7 SD below the parental target height, and even more in children with myelomeningocele. This growth retardation is due to an early progression of bone age observed even prior to the appearance of breast or pubic hair. Therefore we suggest that these children might benefit from early treatment by an LHRH analogue as soon as precocious puberty occurs. PMID- 3304187 TI - Perspectives on occupational exposure to antineoplastic drugs. AB - This review has attempted to focus on the salient features of the potential risks of occupational exposure to the major antineoplastic agents that have broad utility in cancer chemotherapy, as well as in the treatment of a spectrum of refractory non-malignant conditions. An initial focus centered about the classes (primarily alkylating agents, antimitotics, antibiotics, and antimetabolites), types of action and their carcinogenicity, genotoxicity, and reproductive effects exhibited by many of these agents in animals and treated patients. Nurses, pharmacists, and oncologists are the principal individuals with a potential risk to these agents primarily during the preparation and administration of these agents. Although the number at potential risk are not known precisely, they are believed to be relatively small in the aggregate, perhaps numbering several thousand. The measurement of exposure has generally been attempted on a relatively small number of nurses and pharmacists by biological monitoring employing urinary mutagenicity assays and cytogenetic analysis with conflicting results. The levels of exposure currently found are low compared to the therapeutic doses employed and are probably much lower than that which may have occurred earlier before the employment of vertical laminar flow hoods and the more recent implementation of guidelines and/or recommendations. The long-term effects of exposure to occupational personnel at potential risk of exposure to chemotherapeutic agents and waste are not known. Although studies to date have failed to show conclusively that nurses and pharmacists are at risk to the carcinogenic, genotoxic and reproductive effects of these agents, prudence would dictate that every effort be taken to minimize their exposure during the handling and disposal of antineoplastic drugs. PMID- 3304188 TI - [Chemoprevention of cancer--present status, problems and trends]. AB - The most desirable way of eliminating the cancer incidence is by prevention. While the removal of causative agents is the primary goal of cancer prevention, for the foreseeable future it is likely to be incomplete. Therefore the development of a second line of cancer prevention based on chemoprevention assumes importance. During the past decade a growing number of naturally occurring and synthetic chemicals have been found which prevent or reduce the occurrence of cancer especially in experimental animals. These compounds belong to more than 20 different classes of chemicals. The mechanisms of action of most of them are up to now poorly understood. Classifying inhibitors of carcinogenesis according to the time during the carcinogenic process at which they are effective it is possible to divide them into 3 main categories: Substances that prevent the formation of carcinogens from precursors, blocking agents and suppressing agents. There are also several classes of chemicals that inhibit the phase of tumor promotion. But many anticarcinogens only act in combination with specific carcinogens or in distinct species, specific organs, tissues or situations, and completely different effects under other circumstances cannot be ruled out. In terms of application of the existing data to prevention of human cancer there has been a focus on 2 types of efforts: To select compounds that have little toxicity (i.e. ascorbic acid, beta-carotene), but which have not been shown to have broad inhibitory capacities, or to select compounds (i.e. retinoids) which have inhibitory efficacy but also can produce toxic side effects. When one evaluate a chemopreventive compound, considerations of its projected use are highly relevant. If the compound seems to be very potent but has significant toxicity, it may be useful for high-risk individuals but not for the general population. PMID- 3304189 TI - Electron microscopic cytochemistry of catecholaminergic innervation of LHRH neurons in the medial preoptic area of the rat. AB - The synaptic interactions between catecholaminergic terminals and luteinizing hormone releasing hormone (LHRH)-containing neurons in the medial preoptic area of the rat was studied by electron microscopy using LHRH immunocytochemistry combined with 5-hydroxydopamine labeling or autoradiography after injection of 3H dopamine or 3H-noradrenaline in the same tissue section. Axon terminals labeled with 5-hydroxydopamine, 3H-dopamine or 3H-noradrenaline were found to make synapse-like contacts with LHRH-immunoreactive nerve cell bodies and fibers in the medial preoptic area and also 5-hydroxydopamine-labeled terminals made synaptic contacts with the same LHRH-immunoreactive nerve fibers with unlabeled terminals. These findings suggest that catecholaminergic neurons may innervate LHRH-containing neurons to regulate LHRH secretion via synapses with other unknown neurons in the medial preoptic area of the rat. PMID- 3304190 TI - An immunohistochemical study of chromaffin cells and nerve fibers in the adrenal gland of the bullfrog, Rana catesbeiana. PMID- 3304191 TI - Fixation of osteotomies of the lateral femoral condyle and tibial cortical bone grafts with the aid of plastic material on the rat. AB - Plastic is used in addition to metallic osteosynthesis in fracture treatment. The object of the present study was to test the usefulness of plastic as the sole fixation material in experimental osteotomies of cancellous bone and in tibial cortical bone grafts. A total of 32 rats were used. In the first group, consisting of 12 rats, the lateral condyle of the right femur was detached and refixed with Silar. In the second group, a tibial cortical bone graft was detached and refixed with Silar in 12 rats and left unfixed in eight. In the first group fixation of the condyle was successful in all cases but one, but in the second group sufficiently stable fixation of the cortical bone graft was not attained and fractures occurred in half the cases. PMID- 3304192 TI - The foreign body reaction in total hip arthroplasties. A correlated light microscopy, SEM, and TEM study. AB - An in vivo histological and ultrastructural study of the cellular reaction to particulate material currently used in orthopaedic surgery produced evidence that, on a strictly cellular level, the main damage is done by the smallest particles produced by hip prostheses, i.e. metal particles, irrespective of differences in their chemical composition. Particle size and release rate are the critical factors, although other mechanisms of cellular damage may be active once granulation tissue is formed. PMID- 3304193 TI - Unicameral bone cysts--comparison between surgical and steroid injection treatment. AB - Two series of 20 patients each with unicameral bone cysts were compared, one treated before 1975 by curettage and bone grafting and the other treated after 1975 with methylprednisolone acetate (MPA) injections. At follow-up, the majority of patients were at the end of skeletal growth. In the MPA-treated series, the average age of the patients at diagnosis was 9.1 years, whereas the average age at follow-up was 16.7 years. The average follow-up interval was 7 years. The steroid-treated series had better radiographic final results than the surgically treated series, with a lower recurrence rate. The number of MPA injections required to heal the lesion ranged from one to six, with 70% of the patients requiring a maximum of three injections. Steroid injection treatment should be preferred to surgical treatment for the better final results, for the virtual absence of complications, and for the greater simplicity of execution and postoperative care. PMID- 3304194 TI - Lateral patellar release and bone grafting of the tibial plateau in total condylar knee arthroplasties. A technical note. AB - In a review of 50 primary total condylar knee arthroplasties in 25 female and in 14 male patients the factors affecting the necessity of lateral patellar release and bone grafting of the medial tibial plateau were established. Lateral patellar release was performed in 18 of 33 arthroplasties in female patients, in only two of 17 operations in male patients, and on all but one of the knees with preoperative valgus deformity. Bone grafting of the medial tibial plateau was necessary mainly in small knees, i.e., for six of 18 small prostheses in contrast to one of 15 standard-sized implants in female patients and in none of the operated knees in males. PMID- 3304196 TI - Ambulation in the adolescent with myelomeningocele. I: Early childhood predictors. AB - Birth records identified 192 children with myelomeningocele born in Minnesota in the years 1966-1970. In 1981 current ambulation, neurologic level, and early motor achievement were determined in 77 of the surviving 80 children by chart review and questionnaire. Of these 77, 20 were not walking at all, one was walking only in therapy, and the remaining 56 were community ambulators (16 of these occasionally used wheelchairs). The actual distance walked daily varied from 100 to 5,000 meters in this group, with 19 of these community ambulators never walking as far as around a block. Five children never walked, 16 had stopped walking by 1981, and another six, although still walking, were doing less than they had previously. In 20 of the 22 who showed a decrease in total walking between the ages of ten and 15, the beginning of the decline was associated with a period of immobilization, demonstrating the potentially adverse effects of immobilization in these children. The ability to walk outdoors independently and to use a wheelchair by age seven predicted ambulation as an adolescent correctly for 87% of the children. In contrast, neurologic level predicted adolescent mobility correctly for only 71%. PMID- 3304195 TI - Acid and alkaline proteolytic activities of cast-immobilized rat hind-limb muscles after electric stimulation. AB - The activities of cathepsin D (CD), beta-glucuronidase (beta-GU), alkaline protease (AKP), and the rate of acid autolysis (AA) were measured in gastrocnemius, soleus, and tibialis anterior muscles of the rat after bilateral cast immobilization in the middle position for one and three weeks. The effects of daily indirect electric stimulation on the proteolytic activities of immobilized muscles were also studied. In gastrocnemius and tibialis anterior, electric stimulation partially prevented the loss of muscle weight after immobilization for one week. Activities of CD and beta-GU were highest in the soleus, but the activities did not change therein after immobilization or electric stimulation. In gastrocnemius, the activities of CD and AKP and the AA rate increased significantly after immobilization. Electric stimulation during immobilization seemed to prevent the increase of CD and AKP activities significantly after one (CD) and three (AKP) weeks immobilization. In tibialis anterior, the activities of CD and AKP and the AA rate increased significantly in the stimulated muscles after immobilization for three weeks. Both in the gastrocnemius and tibialis anterior the beta-GU activity increased significantly in the stimulated muscles. The results suggest that during the disuse atrophy process and electric stimulation of immobilized muscles, rat hind-limb muscles differ in acid and alkaline proteolytic responses. PMID- 3304197 TI - Kidney transplantation in the cyclosporine era. AB - Seventy-seven patients underwent transplantation, using a cyclosporine-prednisone immunosuppression protocol. No recipients died, and graft survival at one year was 100% for living related donor (LRD) recipients and 84% for cadaver donor (CD) recipients. Nineteen percent of locally harvested, flush-cooled kidney recipients required dialysis, whereas imported kidneys had a 66% dialysis rate. Infectious complications occurred in 17% of patients. Mean hospitalization was 12.8 days for LRD recipients and 13.6 days for CD recipients. Twenty-eight patients required 37 readmissions, mostly for treatment of rejection and infections. Total two-year cost for LRD transplants was +21,400; for CD transplants, +23,900. PMID- 3304198 TI - The treatment of generalized peritonitis by closed postoperative peritoneal lavage. A critical review of the literature. AB - Thirty-nine studies of closed postoperative peritoneal lavage were reviewed, including four prospective, randomized studies, eight nonrandomized comparative studies, and 27 noncomparative studies. Mortality rates and abscess rates were determined for various subsets of patients. Despite the large number of studies performed, the therapeutic value of this procedure remains unknown. It is unlikely that further noncomparative or nonrandomized studies will yield useful information. There remains a need for a large-scale, prospective, randomized study to evaluate closed postoperative peritoneal lavage. Smaller prospective, randomized studies can contribute meaningfully if data on the specific causes of peritonitis, severity of disease, and patient age and chronic health status are provided in the form of widely used and well-validated stratification systems. PMID- 3304200 TI - Localization and retrieval of bullets under ultrasound guidance. AB - From May 1985 to February 1986, high-frequency B-mode real-time ultrasound examinations proved helpful in localizing bullets that were not palpable externally in the extremities and body wall of six patients. Of these, four patients had bullets removed successfully with the ultrasonically guided needle puncture technique. The entire procedure was carried out independently at the bedside by the surgical team. We further concluded that surgeons would benefit by learning and using ultrasound, a technique that is relatively easy to acquire and that has broad potential for surgical application, especially in the operating room. PMID- 3304199 TI - Cyclosporine therapy and refractory Pneumocystis carinii pneumonia. A potential association. AB - In surveillance of 75 patients receiving renal transplants in 1984 at our institution, five cases of Pneumocystis carinii pneumonia were detected. All five cases occurred in a subgroup of 11 patients who had received cyclosporine. A retrospective epidemiologic survey of the infected patients revealed all five were heterosexual white men with onset of Pneumocystis pneumonia two to six months after cadaveric transplantation. All received cyclosporine and corticosteroids, and four of five patients also received azathioprine; none was neutropenic or had evidence of concurrent cytomegalovirus infection. Only one of these patients responded to therapy with sulfamethoxazole and trimethoprim, one patient responded to pentamidine therapy, and the remaining three patients died. Cyclosporine use may be related to development of Pneumocystis infections that are refractory to conventional antiprotozoal therapy, and transplantation programs should closely survey patients for such complications. PMID- 3304201 TI - Laudatio to Herbert Remmer. PMID- 3304202 TI - Cellular effects of reactive intermediates: nephrotoxicity of S-conjugates of amino acids. AB - Several cysteine S-conjugates are potent nephrotoxins and require enzymatic activation to produce cytotoxicity. Strategies based on the knowledge that renal cysteine conjugate beta-lyase is apparently a pyridoxal phosphate (PLP)-dependent enzyme have been exploited to test the hypothesis that a beta-lyase-dependent activation is required for the expression of cysteine S-conjugate-induced toxicity. First, the toxicity of the model conjugate S-(1,2-dichlorovinyl)-L cysteine (DCVC) is blocked both in vivo and in isolated, renal proximal tubular cells by aminooxyacetic acid, an inhibitor of PLP-dependent enzymes. Second, the nonmetabolizable alpha-methyl analogue S-(1,2-dichlorovinyl)-DL-alpha methylcysteine is not toxic. Third, to test the hypothesis that the toxicity of DCVC is associated with the metabolic formation of a reactive thiol, S-(1,2 dichlorovinyl)-L-homocysteine (DCVHC), which may undergo a PLP-dependent gamma elimination reaction to produce an identical thiol, was studied. DCVHC is a potent nephrotoxin, and, similar to DCVC, its toxicity was blocked by aminooxyacetic acid and the alpha-methyl analogue S-(1,2-dichlorovinyl)-DL-alpha methylhomocysteine was not toxic. Moreover, exposure of renal proximal tubular cells to propargylglycine, a suicide substrate for PLP-dependent enzymes that catalyze gamma-elimination reactions, blocked the toxicity of DCVHC. Fourth, the renal mitochondrial beta-lyase is localized in the outer membrane; therefore, although DCVC was toxic to mitochondria, no toxicity was produced in mitoplasts, which shows that a suborganelle site of activation is involved in the mitochondrial toxicity of DCVC. Finally, the toxicity of both DCVC and DCVHC was blocked by probenecid, indicating a role for the anion transport system. DCVC and DCVHC inhibit cellular and mitochondrial respiration, indicating that mitochondria are primary intracellular targets for nephrotoxic S conjugates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304203 TI - Intact organ spectrophotometry and single-photon counting. AB - In toxicology, it is of interest not only to assess enzyme levels and capacities for potential fluxes, but it is also useful to develop methods for determining actual concentrations and fluxes in the intact cell and organ. To this end, several noninvasive techniques have been developed over the years. Our interest has been largely in photometric techniques. Transmission spectrophotometry through solid organs permits monitoring of the cytochromes of the mitochondrial respiratory chain and cytochrome P-450 as well as other pigments of biological interest. Furthermore, the steady state level of catalase Compound I in liver provides information on rates of H2O2 production. These are in the nM to microM concentration range. More recently, the monitoring of photoemission from intact organs has been useful in toxicological problems. The major photoemissive species, singlet molecular oxygen and excited carbonyls, can now be monitored with good signal/noise ratio. Redox cycling of quinones and the generation of photoemissive species were studied in menadione metabolism. Inhibition of phase II led to a significant increase in the steady state level of singlet oxygen, as did the inhibition of two-electron reduction by using the inhibitor dicoumarol for DT diaphorase. Conversely, the induction of DT diaphorase by pretreatment with BHA protected by decreasing the level of reactive oxygen species. PMID- 3304204 TI - Oxidative stress in chemical toxicity. AB - The toxic effects of compounds which undergo redox cycling via enzymatic one electron reduction are reviewed. First of all, the enzymatic reduction of these compounds leads to reactive intermediates, mainly radicals which react with oxygen, whereby superoxide anion radicals are formed. Further oxygen metabolites are hydrogen peroxide, singlet oxygen and hydroxyl radicals. The role of these oxygen metabolites in toxicity is discussed. The occurrence of lipid peroxidation during redox cycling of quinonoide compounds, e.g., adriamycin, and the possible relationship to their toxicity is critically evaluated. It is shown that iron ions play a crucial role in lipid peroxidation induced by redox cycling compounds. DNA damage by metal chelates, e.g., bleomycin, is discussed on the basis of findings that enzymatic redox cycling of a bleomycin-iron complex has been observed. The involvement of hydroxyl radicals in bleomycin-induced DNA damage occurring during redox cycling in cell nuclei is claimed. Redox cycling of other substances, e.g., aromatic amines, is discussed in relation to carcinogenesis. Other chemical groups, e.g., nitroaromatic compounds, hydroxylamines and azo compounds are included. Other targets for oxygen radical attack, e.g., proteins, are also dealt with. It is concluded that oxygen radical formation by redox cycling may be a critical event in toxic effects of several compounds if the protective mechanisms of cells are overwhelmed. PMID- 3304205 TI - Alcohol-inducible cytochrome P-450 (P-450ALC). AB - Of the family of P-450 cytochromes occurring in rabbit liver microsomes, only isozyme 3a (P-450ALC) is induced by alcohol administration and is effective in catalyzing the reaction: ethanol +02+NADPH+H+----acetaldehyde +2H2O+NADP+. As judged by immunochemical quantitation, P-450ALC is also induced in the animals by other diverse agents, including imidazole, trichloroethylene, acetone, pyrazole, and isoniazid. Evidence has been obtained for the occurrence of a protein immunochemically related to P-450ALC in human liver microsomes and of a similar alcohol-inducible protein in the rat and in the normal and alcohol dehydrogenase deficient deer-mouse. P-450ALC catalyzes the activation of foreign compounds such as acetaminophen, various nitrosamines, and carbon tetrachloride and is therefore believed to play an important role in the enhanced toxicity of these substances accompanying alcohol administration. PMID- 3304206 TI - Significance of various enzymes in the control of reactive metabolites. AB - Most chemical carcinogens are relatively inert and need metabolic activation to the ultimately carcinogenic species. The concentration of such species is controlled by several different enzymes. Especially well studied is the important group of enzymes responsible for the control of reactive epoxides. Many natural, as well as man-made foreign compounds, including pharmaceuticals, possess olefinic or aromatic double bonds. Such compounds can be transformed to epoxides by microsomal monooxygenases present in many mammalian organs. By virtue of their electrophilic reactivity, such epoxides may spontaneously react with nucleophilic centres in the cell and thus covalently bind to DNA, RNA and protein. Such alterations of critical cellular macromolecules may disturb the normal biochemistry of the cell and lead to cytotoxic, allergic and/or carcinogenic effects. Whether such effects will be manifested depends on one hand, on the chemical reactivity as well as other properties such as geometry and lipophilicity of the epoxide in question. On the other hand, enzymes controlling the concentration of such epoxides represent a further important contributing factor: for example, several microsomal monooxygenases exist, differing in substrate specificity. With respect to large substrates, certain monooxygenases preferentially attack at a specific site different from that attacked by others. Some of these pathways lead to reactive products, whilst others are detoxification pathways. Moreover, enzymes metabolizing such epoxides represent a further determining factor. These enzymes include epoxide hydrolases and glutathione transferases. These enzymes are not solely inactivating but can also in some cases act as activating enzymes. Finally, precursor-sequestering enzymes contribute indirectly but substantially to the control of reactive metabolites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304207 TI - Initiation and promotion in hepatocarcinogenesis. AB - Initiation and promotion have been recognized as essential parts of the multi stage concept of chemical carcinogenesis. In the liver, initiation by genotoxic carcinogens results in appearance of foci of phenotypically altered hepatocytes. Accelerated growth and phenotypic changes of these foci during tumor promotion by phenobarbital are described, and possible mechanisms of initiation and promotion considered. PMID- 3304209 TI - Toxicology and food safety regulations. PMID- 3304208 TI - Effects of bile acids on the mutagenicity and recombinogenicity of triethylene melamine in yeast strains MP1 and D61.M. AB - When Saccharomyces cerevisia MP1 was treated with bile acids alone or in combination with triethylene melamine (TEM), cholic acid was found to be comutagenic and antirecombinogenic while lithocholic acid had the opposite effect. Other bile acids enhanced the mutagenic and recombinogenic effects of TEM. Chenodeoxycholic acid, deoxycholic acid and ursodeoxycholic acid had stronger comutagenic than corecombinogenic effects; hyodeoxycholic acid did not show this difference. Ox gall and a mixture of bile acids antagonized the genotoxic effect of TEM, and it therefore seems plausible that in normal composition bile acids neutralize each other, i.e., the comutagenic (corecombinogenic) effect of one substance is antagonized by the antimutagenic (antirecombinogenic) effect of another one. However, when the composition is altered, bile acids may become harmful. Experiments with yeast strain D61.M were performed in order to test for aneuploidy caused by bile acids; no effects were observed. PMID- 3304210 TI - Overdose toxicity studies versus threshold: elements of biology must be incorporated into risk assessment. AB - The estimation of risk and evaluation of risk/benefit are traditionally and by necessity oriented at the current state of science and technology to ensure contemporary rights of safety. This demands a careful development in the methodology of hazard identification and risk assessment and its continuous updating and involvement. Compounds, e.g. erythrosine, 2,4,5-T, TCDD, and antioxidants, have still to be judged case-by-case, taking into account all available information on dosage, effect, kinetics, and mechanism of action, i.e., matters of biology rather than of mathematics alone. Considerations of mechanism of action and kinetics, especially recognition of low-dose/high-affinity assumptions in vitro, are necessary. This might lead to a new view upon thresholds which appears to apply for promoters. As accepted in pharmacology the dose-dependent magnitude of response observed in vivo is often a composite effect. Composite effects in toxicology can be viewed as having similar characteristics in vivo as in vitro in terms of potency, slope, maximal efficay and variability. Composite vectors can be antagonistic, leading to toxic and carcinogenic results, but also to protection. A continuous updating of scientific expertise supported by own experimental work is required for the regulator. PMID- 3304211 TI - The role of conjugation reactions in detoxication. AB - The role of conjugating enzymes is best understood by looking at the interaction between phase I (mostly cytochromes P-450) and phase II (conjugation) enzymes of drug metabolism. A balance between phase I and II enzymes of detoxication largely determines the disposition to drug toxicity. Reactive electrophilic metabolites, generated by phase I enzymes, are often controlled by GSH-transferases, whereas nucleophilic metabolites such as phenols are controlled by UDP glucuronosyltransferases (GT) and sulfotransferases. It is more and more recognized that the control of the more stable and more abundant nucleophiles is as important as the control of electrophiles, since the former can be readily converted to electrophiles. For example, phenols and quinols can undergo quinone/quinol redox-cycles with the generation of reactive oxygen species. In the case of benzo(a)pyrene-3,6-quinol toxicity can be prevented by glucuronidation. Conjugating enzymes consist of families of isoenzymes with distinct but overlapping substrate specificity. Rather than dealing with individual isoenzymes, adaptive programs are emphasized by which gene expression of a battery of phase I and II enzymes is turned on by certain types of inducing agents. Mechanistically best known is the program turned on by 3 methylcholanthrene-type inducers which includes enhanced synthesis of certain isoenzymes of cytochrome P-450, GT and probably GSH-transferase. The program may adapt the organism to efficiently detoxify and eliminate aromatic compounds such as benzo(a)pyrene. Evidence is presented that this program exists in both rodents and humans.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304212 TI - Contribution of toxicology towards risk assessment of carcinogens. AB - In the last decade many tests have been designed to detect possible carcinogenicity of compounds. Presently, many more or less simple and convenient systems are available to detect mutations, effects on chromosomes, DNA binding and damage and malignant transformation. These systems, which have been extensively refined during the last years, often show reasonably good relevance to carcinogenicity. Although inconsistencies in the patterns of response do indicate that their role as predictive indicators of carcinogenicity remains still uncertain, the use of such short-term tests in carcinogen risk assessment does seem feasible. Factors other than these tests should also be taken into consideration, since other characteristics like chemical structure, biotransformation, toxicokinetics, qualitative and quantitative physiological and/or morphological effects, species, strains, organ specificity, dose-response relation and information on studies in man, if available, are of importance too. In conjunction with the results of adequately performed carcinogenicity tests in mammals, one may attempt to classify carcinogens. Current knowledge does not permit a rigid classification, but may warrant a subclassification into carcinogens acting via a genetic or a non-genetic mechanism. It is emphasized that on theoretical and practical grounds a different extrapolation system should be used for the different types of carcinogens in risk assessment procedures. Evaluations on individual compounds should be made to decide whether such genotoxic or non-genotoxic compounds should be permitted in the human environment. PMID- 3304213 TI - Principles and problems in assessing prenatal toxicity. AB - The terminology to be used in reproductive (or in prenatal) toxicology has to be in accord with other fields and principles of toxicology; the reasons are briefly discussed. In addition it is essential to assess prenatal toxicity in comparison to adult (maternal) toxicity. Since pharmacokinetics in laboratory animals (e.g. rodents) usually differ considerably from that in man, this fact has to be considered when planning and evaluating studies on prenatal toxicity. Up till now this aspect has seldom been taken into account. A special problem in prenatal toxicity is the inter- and intralitter variability of the toxic manifestation (especially in polytocal animals). This problem has to be recognized by the investigators and means of dealing with it have to be developed. Like all other toxic effects, embryo-/fetotoxic manifestations occur dose dependently. Little information is available in the literature on clean dose-response-curves for teratogenic effects. Some data from our laboratory are presented. Risk assessment of teratogenic effects up till now represents a major problem. While qualitative risk assessment for man on the basis of animal data is possible, quantitative extrapolation from such data to the situation possibly existing in man is still difficult, because basic principles and strategies are largely lacking (e.g. may a "threshold" be assumed or not?). The results of some activities towards this goal are presented from our laboratory. PMID- 3304214 TI - "A" esterases and their role in regulating the toxicity of organophosphates. AB - Esterases which can hydrolyse organophosphates without being inhibited by them are termed "A" esterases. Using paraoxon and pirimiphos-methyl oxon as substrates, high "A" esterase activity is found in the liver and plasma or serum of a range of mammalian species. In a study of serum "A" esterases of sheep and humans, over 80% of the activity separated into the high density lipoprotein (HDL) fraction following ultracentrifugation. When HDL fractions from sheep serum were run on Sepharose gel columns, most of the paraoxonase activity separated as a single peak of estimated molecular weight 360,000, which corresponds to that of HDL2 of humans. During the course of purification of "A" esterases by three different column procedures, contrasting esterase elution profiles were obtained with organophosphate and pyrethroid substrates. This was strong evidence for the existence of multiple forms of HDL "A" esterases. Levels of "A" esterase activity in plasma and liver of birds were much lower than those of mammals. This appears to be the main reason why birds are much more susceptible than mammals to organophosphates such as pirimiphos-methyl and diazinon which form active oxons that are good substrates for mammalian "A" esterases. No "A" esterase was detected in strains of rust red flour beetle (Tribolium castaneum) which were resistant to organophosphates. Similar observations have been made with strains of other insects resistant to organophosphates, raising the question to what extent esterases of this type are present in insects. PMID- 3304215 TI - Role of gut in xenobiotic metabolism. AB - The gastrointestinal tract forms the first line of defense in the body against the main load of xenobiotics. The gastrointestinal mucosa has several mechanisms through which the xenobiotics are modified. The monooxygenase activities in most species are relatively low in the mucosa as compared to the liver, but conjugation, for example, via glucuronide formation proceeds efficiently. UDP glucuronosyltransferase activities can exceed those in the liver. Glutathione S transferase activity is also high. The biotransformation activities are readily inducible in the mucosa and this is, at least partly, responsible for the oral aboral gradient seen in enzyme activities. In rainbow trout glutathione S transferase is, however, significantly higher at the aboral third than in two oral segments, although in rats the intestinal glutathione S-transferase shows a clear oral-aboral gradient. The gradient is independent of the presence of microflora at least in the case of carboxylesterase and glutathione S transferase. A similar gradient can also be found from the gut lumen, in both germ-free and specific pathogen-free rats. The cells in the middle of the villi appear to be most responsive under the influence of inducers. The readily occurring induction in the mucosa provides a suitable model for studies on biological effects to defined compounds and mixtures. PMID- 3304216 TI - Drug transport in intestine, liver and kidney. AB - Drug transport in intestine, liver and kidney is similar, because in each case transport occurs across a barrier of epithelial cells. However, the physiological conditions differ in each organ: intestinal drug absorption is largely influenced by physicochemical conditions in the intestinal lumen; actual transport across the epithelial barrier occurs mainly by diffusion; carrier-mediated transport plays a subordinate role. In contrast, hepatic uptake is mediated by specific carriers, which transport a wide variety of drugs into the liver cell and then release them either into bile, or back into the portal blood. It is unclear how many carrier systems are involved, how they are organized in the liver cell membrane, and to what extent their substrate specificities overlap. Renal secretion and reabsorption of drugs is mediated by highly active carrier systems for cations and anions. Their cooperative action results in either active reabsorption or active secretion of drugs. PMID- 3304217 TI - Activation mechanisms to chemical toxicity. AB - The pathobiology of chemical toxicity may involve "acute lethal injury" (necrosis), "autoxidative injury" (oxygen toxicity), "immunological injury" (neoantigen formation), and malignancy. Toxic chemicals may be activated by reduction, conjugation, radical formation, or oxidation. Oxidative activation may be effected by cytochromes P-450/P-448, flavoprotein monooxygenases, or hydroxyl radicals. The alternative pathways of oxidative metabolism of toxic chemicals, namely, detoxication and activation, are catalysed by the phenobarbital-induced cytochromes P-450 and by the 3-methylcholanthrene-induced cytochromes P-448 respectively. Oxidative metabolism by cytochromes P-450 is followed by conjugation and detoxication, whereas oxidative metabolism by cytochromes P-448 yields reactive intermediates which are not readily conjugated, and thus react with vital intracellular macromolecules, resulting in necrosis, redox cycling and oxygen radical formation, neoantigen production, and mutations. The molecular dimensions of specific substrates, inhibitors and inducers of the PB-cytochromes P-450 indicate that they are globular and are different from those of the cytochromes P-448 which are planar, suggesting that the active sites of the two families of enzymes are different. Oxidative metabolism of planar substrates of cytochromes P-448 results in conformationally-hindered oxygenations, which inhibits subsequent conjugations. Cytochrome P-448 activity may be quantified by the oxidative deethylation of 7-ethoxyresorufin which, unlike benzo(a)pyrene hydroxylation (AHH) is a specific reaction for this family of enzymes. Oxidative metabolism of chemicals varies inversely with the body weight of the animal species, so that chemical toxicity involving oxidative activation, redox cycling, and reactive oxygen is greater the smaller the animal species. PMID- 3304218 TI - A general theory of chemical cytotoxicity based on a molecular model of the living cell, the Bhopalator. AB - To define the molecular processes underlying toxicological manifestations experimentally measured on the cellular level, it is essential to have available a molecular model of the living cell itself. The Bhopalator is a molecular model of the living cell formulated by integrating the three major branches of biology within a coherent theoretical framework - the Watson-Crick molecular genetics, the conformon theory of enzymic catalysis, and the theory of dissipative structures developed by I. Prigogine. According to this model, the living cell is a self-moving, self-thinking and self-reproducing machine (automaton) that receives information and energy from its environment, processes them according to the genetic programs stored in DNA, and generates output signals to environment in order to realize teleonomically designed functions. The Bhopalator suggests a set of general statements useful in toxicological research, and these statements have been utilized to provide possible answers to several fundamental questions raised by recent experimental findings on chemically-induced cell injury and death. PMID- 3304219 TI - [Bronchial hyperreactivity to methacholine in workers in an aluminum electrolysis potroom]. PMID- 3304221 TI - [Results and prospects for the study of the morphologic basis of microcirculation of the blood]. AB - The survey of the works, performed during the 11th five-year period in studying general biological regularities of microcirculation, demonstrates certain success in investigations developed in the following directions: functional geometry of the hemo-microcirculatory bed; elaboration of quantitative and qualitative analysis methods of the microcirculatory system elements; functional morphology of the vascular endothelium; experimental analysis of adaptive mechanisms of the microcirculatory bed; clinical-morphological investigations of microcirculation. Formation of structural-functional units, ensuring specialization of microcirculation in organs, forms the base of the functional geometry of the microcirculatory bed. This makes necessary conditions for compartmentalization of some micro-region in an organ and spatial distribution of various liquid media in dependence of certain topology of microvessels. The most perspective ways in development of morphological investigations, concerning the general biological regularities of microcirculation, are discussed. PMID- 3304220 TI - Alterations in prostacyclin and thromboxane formation following chronic exposure to high and low nicotine cigarettes in rats. AB - Chronic exposure to cigarette smoke causes an imbalance in both PGI2 and TXA2 production which is believed to favor the development of atherosclerosis. Nicotine, a major constituent of smoke, has been shown to adversely alter arachidonic acid metabolism. To determine whether varying doses of nicotine in cigarettes would influence the extent of PGI2/TXA2 alterations, male Sprague Dawley rats were chronically exposed (7 days/wk/6 mo.) to smoke from University of Kentucky Reference cigarettes containing "low" nicotine (3A1), "high" nicotine (2R1) and "low" nicotine cigarettes spiked with enough nicotine to deliver amounts equivalent to the 2R1. COHb levels were monitored to confirm smoke inhalation. No differences in body weights were observed between treatment groups, but all were significantly lower than sham. Aortic PGI2 formation was not significantly depressed by any of the treatment groups compared to shams. Platelet TXA2 production was elevated in all treatment groups compared to shams, irrespective of nicotine content. In the rat smoking model, low nicotine cigarettes do not appear to be an advantage over higher nicotine cigarettes. PMID- 3304222 TI - [Establishment of folliculogenesis in the neonatal period of ovarian development]. PMID- 3304223 TI - [The system of evaluation of changes in the epithelial reticulum in the physiological and pathological transformation of the thymus gland]. AB - The system for the immunomorphological evaluation of the degree of the human and animal thymus transformation is suggested. The degree of the epithelium demasking and the character of lymphocyte emigration were revealed due to the increase of the surface and alteration of the size of epithelial cells which under normal conditions are completely screened by lymphocytes. This was done by means of the fluorescent antibodies to the cells of epithelial reticulum of the thymic lobule cortex and some cells of the medulla layer (prekeratins). This system permits a more circumstantial characteristics of the histological changes in the thymus when the cortical part of the lobule loses the capacity for lymphocyte retention in the epithelial reticulum. PMID- 3304224 TI - [Morphological changes in the neuroendocrine system during experimental infection of animals with L-forms of group B Streptococcus]. AB - White rats and mice were subjected to a single intraperitoneal inoculation with a stable L-form of Streptococcus B (strain 090). The hypothalamus, hypophysis and adrenal cortex of the animals were subsequently studied during one year. Progressive degenerative, inflammatory, necrotic and sclerotic changes found in the system hypothalamus-hypophysis-adrenals were due to the bacteria persistence in these organs leading to the disturbance of hormonal homeostasis and development of the system deficiency. There was also the tendency (in 6-12 months after the inoculation) to intensifying regeneration with partial recovery of the organs function. PMID- 3304225 TI - [Controversial problems in the nosology of atherosclerosis]. AB - Atherogenic dislipoproteinemia and the disturbances of vascular permeability are considered to be the main etiologic factors of atherosclerosis according to the current concept of the pathogenesis of this disease. The authors suggest that the following nozological forms of atherosclerosis should be distinguished (basing on relevant morphological features): classical (Anichkow-Khalatov disease), autoimmune, genetically predetermined, and symptomatic secondary atherosclerosis. Each form has its special leading pathogenetic link and particular morphologic development. This requires a differential approach to the choice of treatment and prevention in each individual case of atherosclerosis. PMID- 3304226 TI - Liver preservation techniques for transplantation. AB - The development of optimal methods for preservation is important for the advancement of liver transplantation. This study compares hypothermic storage (HS) and hypothermic pulsatile perfusion (HPP) with various solutions, using an isolated normothermic perfusion model (LIPM). Canine livers were removed from mongrel dogs without warm ischemia and flushed with either heparinized Ringer's lactate (control and HPP-preserved groups) or the solution used for hypothermic storage (TP-V or modified Collins). The type of preservation and solution for each of the experimental groups was as follows: group I (n = 7), no preservation, fresh; group II (n = 7), 24-h HS with TP-V (a hyperosmolar colloid solution containing sucrose, dextrose, and ATP-MgCl2); group III (n = 7), 24-h HS with modified Collins (C-2), an intracellular crystalloid solution; group IV (n = 5), 24-h HP with TP-V; group V (n = 6), 24-h HPP with Belzer solution, containing ATP MgCl2; group VI (n = 3), 24-h HPP with albumin. After the preservation period, livers were placed on HPP at 37 degrees C with albumin-mannitol solution for 3-h testing in an LIPM. Perfusate samples were taken at 1-h intervals to assess liver function. LDH, SGOT, alkaline phosphatase, lactic acid, LAP, GGT, pO2, pCO2, pH, osmolarity, AMP, ADP, and ATP were studied. Histologic studies were performed, as were representative HIDA scans. Using the LIPM, livers preserved by HS and HPP with TP-V solution appeared to be superior to those preserved with modified Collins, Belzer, and albumin solutions. In these non-TP-V groups, the greatest cellular and organ damage was observed. TP-V HPP appeared to give the best overall liver functional response and histologic results and is recommended as the preferred method for 24-h liver preservation. PMID- 3304227 TI - Cerebrospinal fluid immunoglobulins and beta 2-microglobulin in lymphoproliferative and other neoplastic diseases of the central nervous system. AB - Humoral immune aberrations may occur in the cerebrospinal fluid (CSF) of patients with lymphoproliferative and other neoplastic diseases infiltrating the central nervous system (CNS). Such aberrations may be of diagnostic importance. We therefore studied CSF and serum from 47 patients with lymphoproliferative diseases and from 16 patients with various nonlymphoid neoplasias; 17 patients and 12 patients, respectively, had neoplastic CNS involvement. Elevated CSF IgM index and oligoclonal IgG bands in CSF and serum were commonly found, especially in patients with CNS involvement. Cerebrospinal fluid IgG and IgA indexes were usually normal. Increased CSF to serum albumin ratio, reflecting blood-brain barrier dysfunction, and increased CSF beta 2-microglobulin concentration were most common in patients with CNS involvement. The results indicate that neoplastic CNS disease should be borne in mind when CSF humoral immune aberrations are found. PMID- 3304229 TI - Early days at the neurological unit at Boston City Hospital. PMID- 3304228 TI - Normal memory after damage to medial thalamus. AB - We studied two patients with nonhemorrhagic infarcts of the thalamus and assessed their cognitive functions comprehensively using standardized neuropsychological probes. Neither patient had any discernible memory impairment for verbal or nonverbal material. Analysis of magnetic resonance images with a stereotaxic method revealed that one subject had a right-sided lesion involving about 15% of the dorsomedial nucleus (DM). The other had bilateral lesions that affected about 15% of the left DM and less than 5% of the right DM. The mamillothalamic tract appeared intact in both patients. Considering that medial thalamic lesions commonly cause amnesia in human beings as well as nonhuman primates, there are two possible reasons, alone or in combination, that may explain why these patients failed to have amnesia: the amount of DM damage was less than required to cause amnesia; or the amnesia related to thalamic lesions requires damage to a second structure, such as the mamillothalamic tract or the anterior nucleus. PMID- 3304230 TI - Triple procedure for intraocular lens exchange. PMID- 3304231 TI - Management of pseudophakic corneal edema with reconstruction of the anterior ocular segment. AB - The following surgical techniques were used to treat pseudophakic corneal edema in 13 consecutive eyes: penetrating keratoplasty (13 eyes), mechanical anterior vitrectomy (ten eyes), removal of intraocular lens (13 eyes), gonioplasty with opening of peripheral anterior synechiae using a dental mirror (seven eyes), iridoplasty using a round needle (six eyes), and insertion of a replacement intraocular lens (12 eyes). The most common intraoperative complication was hemorrhage in the angle. Although the angle was open 360 degrees to the ciliary body in 12 of the 13 eyes at the end of surgery, a few peripheral anterior synechiae recurred in six eyes at six weeks. Short-term results suggest that this technique can restore the structure of the anterior ocular segment, decrease progressive peripheral anterior synechiae and glaucoma, and possibly decrease cystoid macular edema. PMID- 3304233 TI - Australian Council on Hospital Standards--Education and Resources Unit. PMID- 3304232 TI - Synaptic alterations in the acoustic cortex of the rat following insulin-induced hypoglycemia. AB - Hypoglycemia was induced by intracarotid insulin infusions in adult Lewis rats. Electron microscopy of the acoustic cortices in these animals revealed that hypoglycemia provoked marked morphological and morphometric alterations in the pre- and postsynaptic terminals present, as well as in the astrocytic processes seen. The number of the synaptic vesicles in the "active zone" of the synapses was dramatically decreased, with most of the vesicles loosely dispersed in the entire presynaptic profile. Some of the pre- and postsynaptic terminals were enlarged and contained dilated cisternae of smooth endoplasmic reticulum, as well as mitochondria exhibiting a marked internal disorganization. The synaptic clefts in a large number of synapses were dilated and contained fibrillary material. The most striking morphological alterations seen involved a membrane discontinuity of the postsynaptic terminal and was found mostly in the synapses of the superficial layer of the acoustic cortex. Most of the morphological alterations observed in the acoustic cortex following uncomplicated hypoglycemia are seen in sensitive areas of the brain after ischemia or hypoxia. PMID- 3304234 TI - Genetics and oral health. PMID- 3304235 TI - Clinical evaluation of an electronic root canal measuring device. PMID- 3304236 TI - Acquired immunodeficiency syndrome: a perspective. PMID- 3304237 TI - The effects of stress release in indices of mandibular dysfunction. PMID- 3304238 TI - Dental handpiece history. PMID- 3304239 TI - The threshold of malignancy. The roles of oncogenes and anti-oncogenes in cancer. PMID- 3304240 TI - A comparative study of T-cell depleted and non-depleted marrow transplantation for hematological malignancy. AB - Sixteen patients with hematological malignancy received cyclophosphamide (120 mg/kg), fractionated total body irradiation (12 Gy), oral cyclosporin, and an HLA identical sibling marrow transplant depleted of T cells by incubation with the monoclonal antibody anti-HuLy-m1 (CD2) and rabbit complement with (five patients) or without (11 patients) anti-HuLy-m8). These 16 patients were compared historically to 84 patients with hematological malignancy receiving cyclophosphamide (120 mg/kg), fractionated total body irradiation (12 or 14 Gy), oral cyclosporin, and unmanipulated HLA-identical sibling marrow, for parameters of engraftment and graft-versus-host disease (GVHD). Graft failure occurred in one of the 16 T-cell depleted recipients and in one of the 84 nondepleted recipients. Engraftment was slightly but significantly slower in the T-cell depleted group and bacterial infections significantly more frequent and severe than in the unmanipulated group. There was a suggestion that the severity of acute GVHD was reduced in those receiving T depleted marrow. Randomized trials will be necessary to determine if marrow T-cell depletion results in superior long-term leukemia-free survival. PMID- 3304241 TI - Lower postprandial plasma glucose and insulin after addition of Acacia coriacea flour to wheat bread. AB - Many Australian Aboriginal bushfoods contain slowly digested carbohydrate which elicit low postprandial blood glucose and insulin responses compared to Western foods, such as wheat bread. This study has shown that incorporation of flour made from a slowly digested seed, Acacia coriacea, into wheat bread (18 g/82 g wheat flour) significantly reduces the initial rise in plasma glucose levels (p less than 0.05) and the area under the plasma glucose curve (p less than 0.005) in six healthy subjects. Insulin values were also lowered at 60 minutes (p less than 0.025) and 90 minutes (p less than 0.05). Our findings suggest that Acacia flour, when used to dilute wheat flour in the manufacture of breads, produces a very palatable food which could be useful in the diets of diabetic individuals. PMID- 3304242 TI - Initial experience with a new fibrinolytic agent (APSAC) in patients with major pulmonary embolism. PMID- 3304243 TI - Enoxacin in the treatment of complicated urinary tract infections. PMID- 3304244 TI - Is there a place for bee venom desensitization in children? PMID- 3304245 TI - The enigma of aspirin. PMID- 3304246 TI - The immunochemical characterisation of circulating immune complex constituents in Candida albicans osteomyelitis by isoelectric focusing, immunoblot, and immunoprint. AB - Circulating immune complexes present in the serum of a patient with systemic lupus erythematosus, end-stage renal failure, and thoracic vertebral Candida albicans osteomyelitis were sequentially analysed by isoelectric focusing, immunoblotting, and immunoprinting. Candida antigens (including mannoproteins), Clq and C3 complement components, and specific anti-Candida antibody were detected within polyethylene glycol precipitated complexes. An antigen of 47K molecular weight was amongst those demonstrated by polyacrylamide gel electrophoresis to be present within the complexes. It has been proposed elsewhere that a serologic response to a 47K protein is predictive of recovery from Candida albicans infection. Free antibody had specificity for Candida antigens ranging in molecular weight from 18K to more than 100K including a 47K component. The analytical techniques employed allowed rapid and precise identification of the components of one particular immune complex system and will be widely applicable to the dissection of other diverse systems. PMID- 3304247 TI - Treatment of acute renal allograft rejection with a monoclonal antibody to a T cell antigen (HuLy-m2). AB - The progress of five patients with recurrent renal allograft rejection who were treated with anti-HuLy-m2 (anti-T cell subset monoclonal antibody) is described. The therapy was without significant side effects and all patients responded to therapy with a diminution of OKT3+ and HuLy-m1+ (identical to E-RFC) peripheral blood lymphocytes. Three of the five patients had improvement in renal rejection. One patient demonstrated long term improvement in renal function, in another two patients renal function improved temporarily, and the remaining two patients had no significant benefit from anti-HuLy-m2 therapy. This limited trial has demonstrated the potential value of a monoclonal anti-T cell antibody, reactive with a subset of T cells, for immunotherapy of renal rejection in patients previously treated with anti-rejection therapy. PMID- 3304248 TI - Clinical aspects of infection with Yersinia enterocolitica in adults. AB - Yersinia enterocolitica was isolated from the feces of 29 patients over a three year period following the introduction of a selective culture medium. Y. enterocolitica was the third most common enteric pathogen after Campylobacter jejuni and Salmonella in this series of 3795 specimens from a predominantly adult population. The isolation rate of Y. enterocolitica was 0.9% and this represented 15.8% of positive cultures. The usual symptoms of Yersinia infection were diarrhea (93%) and abdominal pain (72%), often associated with tenderness in the right iliac fossa and fever. Fourteen patients required admission to hospital and four came to surgery for possible appendicitis. Acute terminal ileitis and mesenteric lymphadenitis were noted in each case. Two patients who were HLA-B27 positive had a reactive arthritis as their dominant complaint. In conclusion, Y. enterocolitica has emerged as a common cause of diarrhea in adults. It is an important cause of symptoms resembling those of acute appendicitis and is occasionally complicated by reactive arthritis. PMID- 3304249 TI - Meningitis due to Branhamella catarrhalis. AB - We report a case of Branhamella catarrhalis meningitis which was unusual in that the patient was a healthy immunocompetent adult, the onset was subacute, and the cerebrospinal fluid pleocytosis was predominantly lymphocytic. Following treatment with intravenous penicillin, recovery was complete apart from residual cortical dysarthria. PMID- 3304250 TI - College heraldry: the three Royal Colleges and their arms. A story told at the combined meeting in Vancouver. PMID- 3304251 TI - The evolution of functional and reconstructive surgery of the nose. PMID- 3304252 TI - Thallium-201-technetium-99m subtraction scanning: its value in 50 cases of hyperparathyroidism submitted to surgery. AB - Parathyroid surgery was performed on 50 patients following thallium-technetium subtraction scanning. Parathyroid adenomata were correctly localized in 34 (83%). Of eight patients with hyperplastic glands, 15 (75%) of these glands were correctly localized. There were seven (17%) false negative scans and one (2%) false positive result. Thallium-technetium subtraction scanning is a valuable technique in the pre-operative assessment of patients with clinical evidence of hyperparathyroidism. PMID- 3304254 TI - Cranial ultrasound screening of preterm and term neonates. AB - A cranial ultrasound examination was performed between 48 and 96 h of age on 580 neonates of 25-42 weeks gestation. The incidence of cerebroventricular haemorrhage (CVH) in infants less than 32 weeks gestation was 37%, compared with an incidence of 2.7% in infants of 32 weeks or more. The incidence of CVH unselected healthy term infants (between 37 and 42 weeks) was only 1.1%. Of the 13 infants of 32 weeks or more who were found to have a haemorrhage, nine had a small (Grade I) haemorrhage (69%) and none of these infants had abnormal neurological signs in the neonatal period. The remaining four infants with Grade II, III or IV haemorrhage developed either seizures or episodes of apnoea. Two of the 13 infants of 32 weeks or more with a haemorrhage died, one during the newborn period and the other at 5.5 months of age. CVH in asymptomatic infants of 32 weeks or more gestation is uncommon and does not justify routine cranial ultrasound scanning. PMID- 3304253 TI - The use of epidural bupivacaine for the relief of childbirth pain. AB - Epidural anaesthesia is now a widely used method for pain relief in childbirth, particularly using the drug Bupivacaine. There are nevertheless differing opinions in the research literature about the advisability of its routine use. While it is clearly very effective in relieving labour pain, there are some consistent, troublesome patterns; for example, a strong association between epidural use and other interventions, such as instrumental delivery. Further, there are no clear answers from the research to date concerning the risks and benefits of epidural anaesthesia for infant and mother. Answers could be provided by randomized clinical trials, but meanwhile a conservative approach to its use is recommended for uncomplicated labours. PMID- 3304255 TI - Familial renal abnormalities associated with the oligohydramnios tetrad secondary to renal agenesis and dysgenesis. AB - Thirty-four families of index cases with the oligohydramnios tetrad secondary to renal agenesis/dysgenesis were screened for renal abnormalities using Real Time ultrasonography. The index cases were separated into two groups. Group 1 consisted of cases of perinatally lethal renal disease and Group 2 of cases of renal dysgenesis secondary to the urethral obstruction malformation. Renal ultrasound screenings of 23 families in Group 1 demonstrated two previously unidentified cases of unilateral renal agenesis in siblings. Screening of 11 families in Group 2 revealed one sibling with a hydronephrotic kidney and one parent with an ectopic pelvic kidney. There is a recurrence risk of 3.5-5% in families with perinatal lethal renal disease and an increased risk of silent renal anomalies in first degree family members. The recurrence risk is low in families of infants with renal dysgenesis secondary to the urethral obstruction malformation, but immediate family members are at increased risk of structural and functional urinary anomalies. Routine renal ultrasound screening of first degree relatives of infants with lethal renal agenesis and dysgenesis is recommended. PMID- 3304256 TI - Cryptosporidiosis in childhood. PMID- 3304257 TI - Escherichia coli epididymitis in rams. PMID- 3304258 TI - Biparietal diameter measurements: is there an optimal level for these? PMID- 3304259 TI - Ultrasound examination of the normal pyloric sphincter in neonates. PMID- 3304261 TI - Association of a gravid uterus with a myoma. A case report. PMID- 3304260 TI - Ultrasonography in acute upper abdomen. PMID- 3304262 TI - Tracheal mucus transport rate and bacterial clearance in turkeys exposed by aerosol to La Sota strain of Newcastle disease virus. AB - Tracheal mucus transport rate (TMTR) and quantitative clearance of aerosolized Escherichia coli from the trachea, lung, and air sac were measured in healthy unanesthetized turkeys and in turkeys exposed by aerosol to a La Sota vaccine strain of Newcastle disease virus (NDV). The TMTR of uninfected turkeys was 42.4 +/- 14.7 cm/min. The TMTR of NDV-infected turkeys was depressed on days 3 through 7 postexposure (PE); depression was significant (P less than or equal to 0.05) on day 7 PE. Tracheal E. coli clearance in NDV-infected turkeys was reduced on days 4 through 9 PE, significantly so on day 5 PE (P less than or equal to 0.01). Depression of TMTR and tracheal E. coli clearance were associated histologically with replacement of normal pseudostratified columnar epithelium by 3 to 8 layers of immature nonciliated cells. E. coli clearance by the lung and air sac of NDV infected turkeys was depressed on days 5 through 9 PE. PMID- 3304264 TI - Prospective study of 3 metabolic regimens in pregnant diabetics. AB - Three tight regimens to maintain blood sugar values of 5.6 SI (group A), 5.6-6.7 SI (group B), and 6.7-8.9 SI (group C), were studied in 60 pregnant diabetic patients. The perinatal salvage rate was 96.6%. Maternal hypoglycaemia occurred only in group A. The group C regimen produced more complications than occurred in the other 2 groups. Very tight control of blood sugar is not necessary for successful management of diabetes in pregnancy and blood sugar value between 5.6 6.7 SI offers the best outcome. PMID- 3304263 TI - Failure of chloroquine malaria prophylaxis in pregnancy. AB - Women in a hyperendemic malarious area of Papua New Guinea are supplied with weekly chloroquine chemoprophylaxis at antenatal clinics. A study of 180 women in late pregnancy failed to show any difference in Plasmodium falciparum parasite rates between regular and irregular clinic attenders. Nor was anaemia in late pregnancy associated with parasitaemia; however, grandmultiparas exhibited significantly more prevalent parasitaemia and anaemia in late pregnancy. This study reveals a need for a more detailed investigation of the effects and usefulness of chemoprophylaxis with chloroquine in areas where P. falciparum chloroquine resistance is present. PMID- 3304265 TI - The spherical sac: a suggestive early sign of abdominal pregnancy? PMID- 3304266 TI - Ultrasound-guided fetal blood exchange transfusion for severe erythroblastosis. PMID- 3304267 TI - Combined effects of hyperbaric oxygen and antifungal agents on the growth of Candida albicans. AB - The effects of hyperbaric oxygen (HBO) and antifungal agents on Candida albicans were studied. Growth curves at O2 tensions of 160 mm Hg, 900 mm Hg, and 1800 mm Hg for prolonged exposures showed no effect of pressure alone. There was a significant dose response to increasing O2 tension; growth inhibition occurred at 900 mm Hg O2 and killing at 1800 mm Hg O2. Minimum inhibitory concentrations (MIC) and minimum cidal concentrations (MCC) at 160 and 900 mm Hg O2 were done using amphotericin B, nystatin, clotrimazole, miconazole, ketoconazole and 5 fluorocytosine. MIC and MCC's were done with amphotericin B at 90-min exposures to 1800 mm Hg O2. There was no enhancement of MIC or MCC at 900 mm Hg O2. However, ketoconazole was ineffective at killing at 900 mm Hg O2 indicating a protective effect of HBO with this drug. Oxygen tensions of 1800 mm Hg for 90 min in the presence of amphotericin B showed an enhancement of both MIC and MCC. Closer quantitation of this effect upon the in vitro growth and survival of the organism showed an additive but not synergistic effect. PMID- 3304268 TI - Development of anti-G suits and their limitations. AB - Initial anti-G suits were based on the belief that decreased venous return was the critical effect of increased weight of blood during acceleration. Cumbersome water filled, pneumatic gradient or pulsatile pressure suits resulted. Subsequent centrifuge studies implicated arterial pressure, rather than venous return, as the major determinant of G tolerance in the sitting position. Consequently, methods of increasing arterial pressure were developed. Findings that the hypertensive, associated anti-blackout and discomfort effects of suit inflation all increase with bladder system pressure up to arterial occlusive levels resulted in the simplified G-suit used in W.W.II to the present. Recent +Gz loss of consciousness crashes indicate current straining maneuvers plus this suit are inadequate. Furthermore, because of very high pressures to maintain cerebral circulation in the sitting position, very high G suit protection is hazardous. If piloting is essential for full use of super performance fighters, the prone position with counter-weighted head support plus omni-directional surveilance is the surest strategem to obtain this advantage. PMID- 3304269 TI - [Comments on foot diseases and podiatrists in the Age of Enlightenment]. PMID- 3304270 TI - [Implantation instruments for bone chips--report of experiences with their use in the Eden-Hybinette-Lange operation]. PMID- 3304271 TI - [Obituary of Prof. (em.) Dr. med. habil. Peter Friedrich Matzen]. PMID- 3304272 TI - [Results of allogeneic bone transplantation]. PMID- 3304273 TI - [Anatomico surgical aspects of scoliosis operations by dorsal approach]. PMID- 3304274 TI - [Is halothane an inert substance? Review and personal research]. PMID- 3304275 TI - [A short history of Spanish veterinary medicine]. PMID- 3304276 TI - Protection of mumps in children with various underlying diseases: application of a live attenuated mumps and trivalent measles-rubella-mumps (MRM) vaccines in these children. AB - A live attenuated mumps and trivalent measles-rubella-mumps (MRM) vaccines have been applied to 887 and 148 children with various underlying diseases at the vaccine clinic of Osaka University Hospital between 1975 and 1985, respectively. Clinical reactions after mumps vaccination occurred in only 7 children (0.8%) and those after MRM vaccination in 28 children (19%), but their underlying diseases were not deteriorated by either vaccination. Clinical follow up study revealed that 2 of the 430 children immunized with mumps vaccine had contracted the disease during 7 year period and 2 of the 123 children immunized with MRM vaccine had contracted clinical mumps or rubella during 3 year period. The seroconversion rates after mumps vaccination were 70% and 61% by the hemagglutination inhibition (HI) test and neutralization (NT) test, respectively, while 94% by the fluorescent antibody to membrane antigen (FAMA) test. Those after MRM vaccination were 87% for measles, 96% for rubella by the HI test and 89% for mumps by the FAMA test. Serological follow up study revealed that antibodies elicited by mumps vaccination were sustained without substantial decline for at least 7 years. These results suggest that a live attenuated mumps and MRM vaccines are safe and effective in children with various underlying diseases. PMID- 3304277 TI - Application of Biken test (modified Elek test) for sampling of heat-stable enterotoxin of Escherichia coli isolated in Bangladesh. AB - The usefulness of Biken Agar 2 as a source of heat-stable toxin for the suckling mouse assay was examined. Escherichia coli (E. coli) strains isolated in Bangladesh from patients with gastroenteritis found to produce heat-stable toxin (n = 152), both heat-stable and heat-labile toxin (n = 60) and not to produce heat-stable or heat-labile toxin (n = 25) by standard suckling mice assay using broth culture were tested. Sampling from Biken Agar 2 gave comparable results to those obtained using standard broth cultures. This is the first field survey of evaluation of the Biken test for sampling heat-stable toxin of E. coli. The result further clarifies the applicability of the Biken test for sampling heat stable toxin, and the usefulness of the Biken test for detections of heat-labile and heat-stable toxin produced by E. coli. PMID- 3304278 TI - Induction of gametocytogenesis in Plasmodium falciparum by the culture supernatant of hybridoma cells producing anti-P. falciparum antibody. AB - There have been many unsuccessful attempts to induce gametocytogenesis in vitro. In the present experiment, however, we found that RPMI-CS medium and RPMI-FS medium prepared by dissolving powdered RPMI 1640 medium in the culture supernatants of hybridoma cells, hybrid line D21 and 219.5, respectively, that produce anti-P. falciparum antibody induced gametocytogenesis. Gametocytogenesis was consistently observed from 3 days after addition of these media. The culture supernatant of anti-P. falciparum antibody producing hybridoma cells did not induce gametocytogenesis in the absence of RPMI 1640 medium. RPMI-MS medium, prepared by dissolving powdered RPMI 1640 medium in the culture supernatant of myeloma cells, SP2/O-Ag 14, which was used as a control, induced a few gametocytes. PMID- 3304279 TI - Comparison of purified acid phosphatase allozymes in Drosophila virilis: differences in carbohydrate content and composition of the allozymes. AB - Three acid phosphatase (EC 3.1.3.2) allozymes (ACPH1, ACPH2, and ACPH4) of Drosophila virilis show different activities as measured by electrophoretic techniques. Recently, it was suggested that these differences are attributable to the variable ability of the allozymes to be incorporated into lysosomes (Narise, S., Genet. Res. Cambr., 45:143, 1985). Immunoelectrophoresis demonstrated that the activity differences between these electrophoretic variants coincided with differences in the amount of the enzyme protein in soluble fractions but not in whole cell-free extracts. These results support the idea that acid phosphatase allozymes in D. virilis are cell-localization variants. We examined the problem by structural analysis of both the protein and the carbohydrate moieties of these allozyme glycoproteins, since lysosomal enzymes are known to become localized in lysosomes through their carbohydrate moieties. The three ACPH allozymes were purified to homogeneity from their respective homozygotes and compared with respect to amino acid composition and carbohydrate content and composition. Amino acid compositions were similar, while content and compositions of neutral sugars were significantly different. The neutral sugar content of ACPH1 was 9.2%; that of ACPH2, 21.0%; and that of ACPH4, 7.3%. A trace of hexosamines, but no N acetylneuraminic acid, was found in the ACPH allozymes. Isoelectric points varied corresponding to their electrophoretic mobilities, which were not changed by treatment with alkaline phosphatase and neuraminidase. PMID- 3304280 TI - Resynthesis of insulin from its A and B chains in the presence of denaturants. AB - Reoxidation of the reduced insulin A and B chains in 8 M urea leads to a recovery of native insulin of 2-7% whereas in 6 M guanidine or 0.5 mM dodecylsulfate very little, if any, resynthesis of insulin could be detected. Considering all the possibilities of different oligomeric forms containing one or both of the chains, the yield in 8 M urea is well over the yield as calculated from random joining of the chains and the yield in guanidine or dodecylsulfate is to be expected. It is concluded that some interaction and pairing of the chains occur even in the presence of 8 M urea. PMID- 3304282 TI - Effect of simultaneous administration of betamethasone and triiodothyronine (T3) on the development of functional pulmonary maturation in fetal rabbit. AB - Recent experimental evidence suggests that a combination of glucocorticoid and thyroid hormone may be more effective than either hormone alone in accelerating morphologic as well as biochemical mammalian fetal lung maturation. We have demonstrated that IM administration of T3 to the rabbit doe is associated with enhanced functional fetal lung maturation. We investigated the effect of simultaneous administration of T3 and betamethasone on the development of functional fetal lung maturation and the duration of survival after premature delivery. On day 25 and 26 of pregnancy, T3 (175 micrograms/kg/dose) betamethasone (85 micrograms/kg/dose), T3 plus betamethasone or the appropriate amount of the vehicles were injected. The functional fetal pulmonary maturity and the duration of survival after premature delivery were assessed on day 27 of gestation. Although enhanced functional fetal lung maturation was observed after T3 or betamethasone administration, there was no additive effect after simultaneous administration of both. The duration of survival on premature delivery was enhanced in betamethasone but not T3 or T3 plus betamethasone group when compared to control. Further animal experimentation seems necessary before a clinical trial of T3 plus betamethasone therapy is considered. PMID- 3304281 TI - Expression of cDNA encoding human basic fibroblast growth factor in E. coli. AB - The cDNA encoding human basic fibroblast growth factor was expressed in E. coli under the control of trp promoter. Bacterially synthesized hbFGF was highly purified using a heparin affinity HPLC column. By this chromatography, hbFGF was eluted as four distinct forms, which were indistinguishable by SDS polyacrylamide gel electrophoresis, amino acid composition, and partial terminal sequence analysis. These molecules stimulated the growth of fibroblasts and endothelial cells although their specific activities varied. The angiogenesis activity of these molecules was also confirmed. PMID- 3304283 TI - Degradation of a cAMP-binding protein is inhibited by human c-Ha-ras gene products. AB - Incubation of the particulate fraction of cell extract prepared from NIH3T3 mouse fibroblasts resulted in preferential proteolytic degradation of a cAMP-binding protein. The proteolysis was inhibited by human c-Ha-ras gene products produced by Escherichia coli. The proteolysis was observed at pH 6 to 7, and inhibited by antipain and leupeptin. These results suggest that cAMP-binding proteins might be cleaved by thiol proteinases. In fact, c-Ha-ras gene products were proved to inhibit the cathepsin B-like activity present in the particulate fraction. PMID- 3304284 TI - Isolation and primary structure of the eclosion hormone of the tobacco hornworm, Manduca sexta. AB - Eclosion hormone was isolated from trimmed pharate adult heads of Manduca sexta by an eight step purification procedure using a Heliothis virescens in vivo bioassay. The neuropeptide was active in second stadium M. sexta. The primary structure was determined by sequence analyses of the intact peptide and fragment peptides generated by lysyl endopeptidase, endoproteinase Glu-C, and proline specific endopeptidase. The nature of the carboxyl terminus as a free acid was elucidated by analysis of amino acids from digestion of the intact peptide with lysyl endopeptidase, which liberated leucine, but no leucine amide. The complete primary structure of M. sexta closion hormone is H-Asn-Pro-Ala-Ile-Ala-Thr-Gly Tyr-Asp-Pro-Met-Glu-Ile-Cys-Ile-Glu-Asn-Cy s-Ala- Gln-Cys-Lys-Lys-Met-Leu-Gly-Ala Trp-Phe-Glu-Gly-Pro-Leu-Cys-Ala-Glu-Ser- Cys-Ile Lys-Phe-Lys-Gly-Lys-Leu-Ile-Pro Glu-Cys-Glu-Asp-Phe-Ala-Ser-Ile-Ala-Pro- Phe-Leu-Asn-Lys-Leu-OH. PMID- 3304285 TI - Partial structure of an insulin-sensitive glycophospholipid. AB - The structure of a glycophospholipid, which has been involved in insulin action, has been investigated using H35 cells and rat liver membranes. The present evidence indicates that this molecule contains a phosphatidyl-chiro-inositol moiety, glycosidically linked to a non-N-acetylated glucosamine. In addition, the polar head group of the lipid contains galactose, probably four residues, and a total number of three phosphates. PMID- 3304286 TI - Translational regulation of the expression of zein cloned in yeast under an inducible GAL promoter. AB - Yeast cells transformed by a plasmid containing a zein sequence fused to an hybrid yeast promoter GAL1-10/CYC1 accumulate, during a batch growth in galactose minimal medium, large amounts of zein only during a growth-limited phase that precede the entering into the stationary phase. We found that zein is fairly stable in yeast cells and the increased accumulation of zein polypeptide depends mainly upon a marked increase of its rate of synthesis. The increase of the rate of heterologous protein synthesis is not dependent on variation in the plasmid copy number and it is not related to the relative level of zein mRNA, indicating the existence of a postranscriptional regulation that modulates the translatability of this messenger RNA in function of the growth conditions. A possible explanation of this modulation is discussed in terms of a codon bias effect that slow-down the translation of heterologous mRNAs during the exponential phase of growth. PMID- 3304287 TI - Non-enzymatic formation of insulin-glutathione mixed disulfides: evidence for a transient species by plasma desorption mass spectrometry. AB - Formation of insulin-glutathione mixed disulfides takes place under the conditions of 0.1 M ammonium acetate, neutral pH and without the presence of any enzyme. Using a SH-free glutathione-agarose column it is demonstrated that the interaction of insulin with glutathione is specific, and increasing the incubation time between these two peptides results in the reduction of insulin disulfide bonds and the production of A and B chains. PMID- 3304288 TI - Computer-assisted predictions of signal peptidase processing sites. AB - Computer programs are presented which incorporate 2 different algorithms for predicting the site of signal peptide cleavage for eukaryotic preproteins. These programs can be used to identify sites of signal peptidase cleavage of putative preproteins to facilitate the design and interpretation of signal peptide mutagenesis experiments, and to engineer artificial prepolypeptides. PMID- 3304289 TI - Short-term control of the pentose phosphate cycle by insulin could be modulated by the NADPH/NADP ratio in rat adipocytes and hepatocytes. AB - The short-term activation of the pentose phosphate cycle by insulin in rat adipocytes and hepatocytes has been studied. This NADPH-producing pathway is regulated by the activation or inhibition of different NADPH-consuming pathways. The stimulation of the fatty acid synthesis by insulin produced an increase in the flux through the pentose phosphate cycle. Kynurenate produced a decrease in the fatty acid synthesis and, consequently a diminution in the flux through the pentose phosphate cycle. Incubation of adipocytes and hepatocytes in presence of kynurenate (10 mM and 3 mM respectively) and insulin (5 nM), prevents both insulin activation on fatty acid synthesis and pentose phosphate cycle. These results suggest that insulin activates the pentose phosphate cycle through the activation of fatty acid synthesis. PMID- 3304290 TI - Reversion of 7-methylguanosine 5'-phosphate inhibition of mRNA translation by polysomal and soluble factors isolated from Saccharomyces cerevisiae. AB - Protein fractions that overcome m7GMP inhibition of mRNA translation have been purified from the yeast S. cerevisiae. An active fraction isolated from polysomes contains two polypeptides of 220- and 190-kDa. The active fraction isolated from postribosomal supernatant contains a major polypeptide of 28-kDa and other species of 32-, 24-, 22- and 21-kDa, and sediments in sucrose gradients as a high molecular weight complex of about 200,000. This fraction restored yeast mRNA translation in reticulocyte lysates under conditions of yeast and globin mRNA competition; however, this effect was not observed with the 220- and 190-kDa polypeptides from polysomes. Nevertheless, translation of yeast mRNA was stimulated by a partially purified fraction containing a 28-kDa polypeptide from polysomes. PMID- 3304291 TI - Synthesis of hemopexin and cysteine protease inhibitor is coordinately regulated by HSF-II and interferon-beta 2 in rat hepatoma cells. AB - Rat hepatoma (H-35) cells respond to hepatocyte-stimulating factors by increased expression of major acute phase plasma proteins. The synthesis of hemopexin is stimulated 10-fold by either hepatocyte-stimulating factor-II of human squamous carcinoma cells or hepatocyte-stimulating factor/interferon-beta 2 of activated human blood monocytes. The hormone specificity, time course and dose-dependence of hemopexin regulation is closely correlated with that of cysteine protease inhibitor. The coordinate expression of hemopexin and other type II acute phase proteins suggests the existence of common molecular regulatory mechanisms. PMID- 3304292 TI - Isolation of the Candida tropicalis gene for P450 lanosterol demethylase and its expression in Saccharomyces cerevisiae. AB - We have isolated the gene for cytochrome P450 lanosterol 14 alpha-demethylase (14DM) from the yeast Candida tropicalis. This was accomplished by screening genomic libraries of strain ATCC750 in E. coli using a DNA fragment containing the yeast Saccharomyces cerevisiae 14DM gene. Identity of this gene was confirmed by a) observing a heme binding region common to all P450s after sequencing the 3' portion of the gene, and b) based upon tests of its expression in strains of Saccharomyces cerevisiae. PMID- 3304293 TI - Pituitary cells secrete calcitonin in the reverse hemolytic plaque assay. AB - Rat pituitary cells were evaluated in the reverse hemolytic plaque assay for calcitonin (CT) secretion. The secretion of CT could be demonstrated by the formation of hemolytic plaques around single pituitary cells when a specific CT antibody was used. Approximately 0.1 percent of the cells secreted CT in the basal state. Phorbol stimulated CT secretion by up to 25-fold. The diameter of the hemolytic plaques around pituitary cells from genetically obese (Zucker) rats was significantly greater than normal rats (24 versus 37 microns). This study demonstrates that pituitary cells secrete CT and that the secretion may be regulated by pharmacological agents (phorbol) and physiological signals (obesity). PMID- 3304294 TI - Antiestrogens inhibit the mitogenic effect of growth factors on breast cancer cells in the total absence of estrogens. AB - The antiproliferative effect of antiestrogens in breast cancer is believed to be entirely due to the inhibition of estrogen induced growth. We show here that non steroidal antiestrogens inhibit the growth of the human breast cancer MCF7 cells in the complete absence of estrogens (phenol-red-free medium) when cell proliferation is stimulated by insulin or epidermal growth factor. This non antiestrogenic effect of antiestrogens is, however, mediated by accessible estrogen receptor sites, as it is not observed in receptor negative hormone independent breast cancers, and is rescued by estradiol but not by insulin. We conclude that antiestrogens inhibit cell proliferation by inhibiting growth factor action as well as estrogen action and that in both cases, accessible estrogen receptors are required. PMID- 3304295 TI - Improvements of Western blotting to detect monoclonal antibodies. AB - A comparison of the effects of different factors on the sensitivity of Western blotting technique to detect monoclonal antibodies is described. The major improvements were obtained by: A) renaturating the antigen in the gel before transferring it in carbonate buffer at pH 10 onto nitrocellulose and B) using alkaline-phosphatase-conjugated second antibody instead of peroxidase-conjugated second antibody. PMID- 3304296 TI - Enhanced potency dipeptide glycol renin inhibitors: studies in vitro and in the conscious rhesus. AB - We prepared a series of novel dipeptide amides of the formula Boc-Phe-Leu-X, where X is a 3-amino-3-alkyl-1,2-propanediol with lower alkyl substitutions at C 1, in order to probe accessory binding sites in the enzyme renin. This approach was successful in generating potent inhibitors of human and hog renin in vitro. Moreover, these inhibitors were able to effect in vivo reduction of plasma renin activity (PRA) in the conscious salt-depleted rhesus monkey (i.v. route); this effect was related to the size of the C-1 alkyl group. PMID- 3304297 TI - Chemotactic response of rat mammary adenocarcinoma cell clones to tumor-derived cytokines. AB - A cytokine with an apparent molecular weight of 53,000 daltons was isolated from serum-free medium conditioned by MTLn3 cells or from homogenates of MTLn3 cells, a highly metastatic variant of the rat 13762NF mammary adenocarcinoma. The chemotactic responses of MTLn3 and the low metastatic variant MTLn2 cells to this cytokine were tested in vitro using modified Boyden chambers. Both the chemotactic and chemokinetic movements of MTLn3 cells were stimulated by the MTLn3-derived cytokine. In addition, the MTLn3-derived cytokine stimulated a relatively small, but significant chemotactic migration of MTLn2 tumor cells, while these cells did not respond to medium conditioned by MTLn2 cells. MTLn3 cells themselves did not respond chemotactically to type I collagen or medium conditioned by MTLn2 cells. These results suggest that the chemotactic response may be a function of metastatic potential of the invading tumor cells. The production of tumor cytokines that enhance tumor cell motility may thus represent a phenotypic difference between 13762NF tumor cell subpopulations of high and low metastatic potential. PMID- 3304298 TI - [Synthesis of p-nitroanilides of acylated peptides catalyzed by thermolysin]. AB - Thermolysin-catalysed synthesis of p-nitroanilides of acylpeptides of general formula Z-A1-A2-pNA (A1 = Thr, Ala, Val, Leu; A2 = Leu, Phe) and stepwise synthesis of p-nitroanilides of acyltetrapeptides of general formula Z-A1-A2-A3 A4-pNA (A1, A2 = Gly,Ala; A3, A4 = Ala, Leu, Phe) from Z-A1-A2-OH and A3-pNA and then from Z-A1-A2-A3-OH and A4-pNA have been carried out; pNA group was eliminated enzymatically. Increase in solubility of the product in the reaction mixture diminishes its yield. Minimal amount of thermolysin providing a substantial yield of reaction product depends on structure of both amino and carboxylic components. In many cases the molar ratio of the enzyme and starting substances could be decreased to 1:10(6) as compared with the generally used ration 1:10(3)-1:10(4). PMID- 3304299 TI - Stimulation of B cell differentiation by adherent mononuclear cells in systemic lupus erythematosus. AB - We studied B cell proliferation and differentiation in response to factors released by adherent monocytes in patients with systemic lupus erythematosus (SLE). Adherent cell supernatants (ACS) were added to peripheral blood mononuclear cells, and the effects on IgG synthesis, the number of Ig-secreting cells (ISC), and proliferation were determined. Exposure of SLE mononuclear cells to autologous ACS caused an increase (approximately two-fold) in IgG production and ISC numbers. In contrast, exposure of normal mononuclear cells to autologous ACS did not significantly increase IgG production or ISC numbers. Addition of SLE ACS to cultures of normal mononuclear cells did not stimulate ISC production. There was no significant level of 3H-thymidine uptake by cultures of SLE or normal mononuclear cells in response to either SLE or normal ACS. In the presence of an excess number of autologous T cells, ACS stimulation of IgG synthesis was further enhanced. These findings indicate that adherent monocytes contribute to B cell hyperactivity in SLE by stimulating B cell differentiation. SLE mononuclear cells appear to be more responsive to ACS stimulation than are normal mononuclear cells. PMID- 3304300 TI - D-penicillamine treatment of lung involvement in patients with systemic sclerosis (scleroderma). PMID- 3304301 TI - [Dihydroergotamine in the treatment of patients with symptomatic hypotension during regular hemodialysis]. AB - The efficacy and safety of dihydroergotamine (DHE, Ditamin) in the treatment of symptomatic hypotension in regularly dialysed patients were tested in comparison to placebo in a single-blind, randomised clinical trial. Ten adult uremic patients (5 men and 5 women) with acute hypotension during hemodialysis, at least once weekly associated with symptoms of cerebral hypoperfusion, were included into the study. The administration of DHE during hemodialysis in a dose of 10 micrograms/kg body weight intravenously resulted in an increase in blood pressure (BP) from 91 +/- 13 to 114 +/- 14 and from 60 +/- 12 to 78 +/- 11 mmHg for systolic and diastolic BP, respectively (p less than 0.01). The maximum effect on BP (systolic and diastolic) was achieved 15 to 30 min after DHE administration; thereafter a gradual decline of effect on BP was observed, the t1/2 of disappearance of effect being 46 min. The use of isotonic or hypertonic saline solution in the treatment of hypotension decreased under the administration of DHE from 1200 +/- 600 ml to 70 ml and from 34 +/- 28 to 10 +/- 17 ml per patient and dialysis, respectively (p less than 0.01). In spite of a higher ultrafiltration rate resulting in a greater body weight reduction after hemodialysis, the incidence of symptomatic hypotension decreased after DHE administration from 1.46 +/- 0.52 to 0.14 episodes per patient and dialysis (p less than 0.01). It may be concluded that the resistance of uremic patients to hypovolemic stress occurring during hemodialysis is markedly increased after intravenous administration of DHE in a dose of 10 micrograms/kg. PMID- 3304302 TI - Effects of dipyridamole on prostaglandin synthesis in human fibroblasts. AB - The effect of varied doses of dipyridamole (Persantin) on the arachidonic acid metabolites prostaglandin (PG)I2, PGE2 and thromboxane (TX)A2 has been studied in human skin fibroblasts cultured in vitro. A 24-h exposure to the drug induced a dose-dependent increase of all the examined prostaglandins (PG's). Bradykinin stimulation of cells that had been preexposed to the drug induced a continuous increase in PG-production as compared to controls, despite the absence of the drug. In addition, an acute 5-min exposure to dipyridamole produced an increased thromboxane production, but no consistent changes of PGI2 or PGE2, and it inhibited significantly and dose-dependently the comcomitant bradykinin stimulated production of all the examined PG's. The implications of a combined dipyridamole-acetylsalicylic acid therapy is discussed. PMID- 3304303 TI - [Effect of benzydamine on release of prostaglandin E2 and prostacyclin from rabbit gastric mucosa cells]. AB - The effect of the antiinflammatory drug benzydamine (Tantum) on prostaglandin E2 (PGE2) release from rabbit gastric mucosal cells was investigated. Up to 1 mmol/l benzydamine had no significant effect on PGE2 and prostacyclin (PGI2) formation and release. The lack of interference with gastric mucosal prostaglandin synthesis might explain the non-ulcerogenicity of this compound compared to other non-steroidal antiinflammatory drugs (e.g. indomethacin). PMID- 3304304 TI - [New aspects on the clinical use of benzydamine]. AB - Recent results of research show that benzydamine (Tantum) has a different biochemical and pharmacological therapeutic mechanism in comparison with other non-steroidal antiinflammatory drugs (NSAID). The inhibition of the generation of reactive oxygen species, the membrane-stabilising effect and the reduction of vascular permeability causes the anti-edematous and antiinflammatory effects. Contrary to the indications and contra-indications of NSAID, benzydamine can be used in the following diseases: inflammatory and edematous diseases of the gastrointestinal tract, of the kidney and genitourinary tract, of the stoma and oropharynx and of the respiratory tract, after soft-tissue injuries and surgical interventions. It is not necessary to exclude patients with acetylsalicylic acid induced asthma from the therapy with benzydamine. PMID- 3304305 TI - [New pharmacologic and biochemical findings on the mechanism of action of the non steroidal antiphlogistic, benzydamine. A synopsis]. AB - Benzydamine (Tantum) is an indolic non-steroidal antiinflammatory drug (NSAID) for systemic use in acute traumatic lesions and locally as mouth gargle wash. Benzydamine is lipophilic at pH 7.2, has an affinity for membranes and shows membrane stabilizing properties with local anaesthetic effects. Contrary to other NSAID, benzydamine does not inhibit the cyclo- nor the lipoxygenase (10(-4) mol/l) and is also not ulcerogenic in the rat. Phospholipase A2 is slightly inhibited as well as the lysophosphatide-acyltransferase (greater than 10(-4) mol/l). Macrophage PGE2 synthesis is enhanced at 10(-4) mol/l. The production of reactive oxygen species by phagocytes is effectively inhibited (10(-5)-10(-4) mol/l). Phagocyte degranulation and aggregation are also inhibited (10(-4) mol/l). The strongest in vitro effect is the inhibition of leukocyte adhesion to vascular endothelium (3-4 X 10(-6) mol/l). Benzydamine is also antithrombotic in the rat (ED35 8.5 mg/kg p.o.) and reduces PAF (platelet activating factor) induced mortality in the mouse (50 mg/kg p.o.; p less than 0.05). It is concluded that benzydamine is antiinflammatory by preventing vessel wall damage from activated, adhering and emigrating leukocytes i.e. being vasoprotective. PMID- 3304306 TI - Effectiveness of a curriculum for preschool language intervention specialists. PMID- 3304307 TI - Prevention of communication disorders: a position statement. PMID- 3304308 TI - Ethanol and hypogonadism. PMID- 3304309 TI - The role of glucose and insulin in the effect of ethanol on protein synthesis in isolated rat hepatocytes. AB - The incorporation of 14C-valine into liver protein was studied in isolated rat liver parenchymal cells. Various glucose levels in the incubation media did not affect the rate of 14C-valine incorporation into proteins. The insulin stimulated incorporation of 14C-valine into proteins was also unaffected by the various glucose levels. Ethanol decreased the incorporation of 14C-valine into liver proteins, affecting stationary and export proteins to the same extent. This inhibitory action of ethanol on valine incorporation was reversed by increasing exogenous glucose concentrations. The combination of insulin and high glucose level totally prevented the ethanol inhibition. PMID- 3304310 TI - The use of two automated neuropsychological tests, Cogfun and the Perceptual Maze Test, with alcoholics. AB - Forty-eight male detoxified alcoholics completed the automated neuropsychological tests, Cogfun II and the Perceptual Maze Test. On both tests, the younger group of patients performed better than the older group. No differences were found between short- and long-term drinkers, although there was some indication that older long-term drinkers performed less well than younger long-term drinkers. Control subjects performed significantly better than alcoholic subjects. Thus characteristics found by others using conventional psychometric tests were also apparent when using new, automated tests, and baselines were established from which to measure change over the passage of time. PMID- 3304311 TI - Drinking motivation and the causes of alcoholism: an overview of the problem and a multidisciplinary model. PMID- 3304312 TI - The human platelet as a model for calcium metabolism in central nerve endings in the study of alcoholism. PMID- 3304313 TI - Fetal alcohol-induced brain damage and the problem of determining temporal vulnerability: a review. PMID- 3304314 TI - [Use of immunohistochemistry in clinical cytology]. AB - The purpose of this study was to evaluate the usefulness of immunocytochemical methods of diagnosis in cytology. Pleural effusions and ascites fluids were analyzed from 16 patients in whom the possibility of a malignant effusion was suspected. Cells obtained from the effusions were examined following routine staining by the Papanicolaou method and immunocytochemical staining to determine the presence of tissue specific antigens, i.e. common leucocyte antigen (CLA), cytokeratins (CAM 5.2, AE1), a determinant of the Human Milk Fat Globule (HMFG2) and carcinoembryonic antigen (CEA). The results of the immunocytochemistry studies were compared with the cytologic diagnosis obtained from Papanicolaou stained smears. Good agreement was observed between the diagnosis based on the interpretation of the immunocytochemical studies and the morphological diagnosis. In particular the malignant as well as the benign cells were stained with the epithelial and leucocyte markers according to their tissue origin. Anti cytokeratin antibody stained epithelial and mesothelial cells, antibody against HFMG2 and anti-CEA stained epithelial (adenocarcinoma) but not mesothelial cells. However macrophages were also positive with anti-CEA antibody. Anti-CLA antibody stained lymphocytes, granulocytes and macrophages but did not distinguish between benign and malignant cells. Based on the results of the present study, immunocytochemical methods using a panel of tissue specific antibodies represent a useful tool in the differential diagnosis of cellular effusions. PMID- 3304315 TI - [Histopathology of microsurgical arterial repair. Use of fibrin cryoprecipitates]. AB - The increasing practice of small arteries anastomosis especially in neurosurgery entails improvements in suture techniques. Classical suture is slow and needs a prolonged clamping. The stitches are responsible for severe necrotic lesions in the arterial wall. A biological glue made of cryoprecipitated human fibrinogen, factor XIII and fibronectin, locally activated by thrombin, is tested here on rabbit's common carotid. The application of the glue on intact or sectioned arteries appears innocuous, notably with regard to its thrombogenic potential. Comparison of classical sutures and sutures with glue and a greatly reduced number of stitches shows histological results of equivalent quality. At the early stages, the fibrin glue doesn't exceed in volume the usual perianastomotic hematoma. It is completely resorbed within two weeks. Later the scar is thinner than after classical suture, although no ruptures or aneurysms were observed. This method shortens the surgical procedure, with presumed benefit for the drained territories. It diminishes the lesions caused by the stitches. Moreover it allows an easy application of an arterial patch on the sectioned vessel: a comparative series with sutured patches shows on the contrary poor results. Although aggresive for the tissues, a minimal number of stitches remains necessary: it is actually the only available means of correctly positioning the anastomosis area. PMID- 3304316 TI - [Immunolabeling methods in cutaneous histopathology. Principles and practical applications]. AB - Immunohistochemical methods, introduced more than 40 years ago, represent a favourite technique in the histological diagnosis of cutaneous diseases. Their practical applications, that initially concerned merely auto-immune dermatoses, have spread over many other nosologic groups of skin pathology. The improvement of immunolabelling techniques and of reagents has rendered the immunohistochemical methods much more reliable and has contributed to their spreading. Enzymatic techniques, by virtue of their advantages over fluorescent techniques, are being used more and more frequently. The continuous production of new antibodies (polyclonal but mainly monoclonal) renders possible the immunohistochemical detection of the different cellular or extracellular, epidermal and dermal components of the skin. The main chapters of cutaneous pathology, aside from auto-immune diseases, that concretely benefit from immunolabelling techniques, concern: a) the diagnosis and histogenetic study of tumoural lesions, b) the diagnosis and classification of bullous diseases, c) infectious diseases. PMID- 3304317 TI - Central embolization of needle fragments: a complication of intravenous drug abuse. AB - Central embolization is a known complication of catheter and needle fragments that enter the intravenous space. These events are associated with a number of complications including sepsis, thrombus formation with embolization, arrhythmia, and sudden death. This report reviews the case of a drug abuser who sought medical attention in the emergency department after breaking a needle in her left supraclavicular area. Initial efforts to explore the region were delayed. The delay resulted in embolization of the needle fragment to the lung periphery. This case illustrates the complications of central drug abuse and prompts a review of existing techniques to remove intravascular foreign bodies nonsurgically. PMID- 3304318 TI - Nitrous oxide in the emergency department. PMID- 3304319 TI - Initial management of hand injuries in the emergency patient. AB - Failure to develop a proper routine for complete examination and documentation of the injured hand may result in the inability to make the proper diagnosis. Less than optimal treatment may result. Ultimately, the end result is unnecessary functional loss and, frequently, medical-legal difficulties. Initial emergency department management of acute hand is reviewed: recognition of surgical emergencies, proper initial treatment of tendon and nerve injuries, splinting, and record keeping are emphasized. PMID- 3304320 TI - An autopsy-proved case of AIDS in Taiwan. AB - The first case of AIDS positively identified in a non-foreigner in Taiwan was a 25-year-old unmarried male who had practiced homosexuality for ten years. The patient began to have abdominal pain accompanied with loose stools and weight loss in June 1985, followed by fever, cough, headache, dizziness, and loss of memory. Facial hyperpigmentation and extensive oroesophageal candidiasis were noted. Laboratory studies showed severe lymphopenia with a reversed T-helper to T suppressor ratio, cutaneous anergy and polyclonal gammopathy. Human immunodeficiency virus (HIV) antibodies were positive by ELISA and Western blot, and the virus was isolated from the blood. At autopsy, disseminated cytomegalovirus infection, extensive CNS toxoplasmosis and early lesions of Kaposi's sarcoma were demonstrated. The detection of HIV in the adrenal medulla supports the consensus that the virus is neurotropic. PMID- 3304321 TI - The relationship between reactivities to lepromin A (Fernandez and Mitsuda) and a soluble protein antigen of Mycobacterium leprae. AB - Three methods of evaluation were used to investigate the relationship between skin test reactions elicited by different antigens of Mycobacterium leprae. The latter were the Fernandez and Mitsuda reactions to lepromin, and that to a Soluble Protein Antigen (SPA) of M. leprae. All three methods of evaluation demonstrated some degree of relationship though not as high as would be expected. The closest correlation was between Mitsuda and SPA reactions; while Fernandez and Mitsuda, and Fernandez and SPA reactions showed more or less similar coefficients of correlation. PMID- 3304322 TI - Antinuclear antibodies in Thai patients with connective tissue diseases. AB - A study of antinuclear antibodies (ANA) among Thai patients with various connective tissue diseases revealed that the prevalence of ANA was similar to that in other countries, but that the ANA patterns showed interesting contrasts in most diseases. Rather than the predominant homogeneous pattern seen elsewhere in systemic lupus erythematosus and rheumatoid arthritis, the speckled pattern was commonest among Thai patients with these two diseases (67.9% and 76.9% respectively). Patients with scleroderma exhibited a much lower percentage of the nucleolar pattern (17%) than reported elsewhere. The discrepancy between our findings and those from other studies may reflect differences in genetics, the environment or the severity of disease. PMID- 3304323 TI - Anti-HIV positivity in Thailand: the usefulness of another ELISA test kit and Western blot as confirmatory tests. AB - Sera from 47 individuals repeatedly reactive in one screening ELISA system (designated as ELISA-A) for antibodies against human immunodeficiency virus (HIV) were evaluated by a second ELISA system (designated as ELISA-B) as well as by the Western blot technique. Both ELISA systems and the Western blot were positive in all of the 14 patients with clinical diagnoses of AIDS and AIDS-related persistent generalized lymphadenopathy (PGL). Of the 7 asymptomatic gays whose sera were repeatedly reactive in ELISA-A, 5 were also reactive in ELISA-B and these were the ones with positive Western blot tests. Eight and 17 ELISA-A reactive individuals were uncovered during a survey of 2,699 female prostitutes and 15,210 potential workers for Saudi Arabia respectively. All of these 25 individuals were ELISA-B and Western blot negative, an indication of false positive reactivity with ELISA-A. Our studies indicate that the prevalence of HIV infection among the general Thai population is still low, and that the specificity of two ELISA test kits for anti-HIV may differ considerably. We concluded that evaluation of test kits should include studies in tropical countries where ecological conditions, climate and background endemic disease patterns are different than in the countries producing the diagnostic systems. Such studies are needed to identify the most sensitive and specific kits for worldwide application. We did discover that concordant positivity of two different ELISA test kits served as a reliable and inexpensive confirmatory test for anti-HIV. PMID- 3304324 TI - Wound dressing adherence: a clinical comparative study. AB - This prospective study was undertaken to compare the adherence of dressings currently used as non-adherent dressings. Four different dressings were studied on a total of 40 patients. An overall adherence of 50% was encountered, Silicon Polymer Foam being the most successful under the trial conditions. PMID- 3304326 TI - Segmentation of scenes in tissue sections. AB - The segmentation of scenes of fixed tissue sections for quantitative histopathology is the crucial step for further image processing. Different segmentation methods for the separation of nuclei, nucleoli and whole cells in methacrylate-embedded sections of rat liver were investigated. Reasonable segmentation results were obtained using a contrast-enhanced polar-coordinate transformation to distinguish nuclei, a compactness algorithm to distinguish nucleoli and a skeletonization algorithm to delineate cells when a priori information on the morphometric and photometric properties of the liver tissue was included. PMID- 3304325 TI - Factors affecting the plasma insulin concentration shortly after accidental injury in man. AB - There are conflicting reports on plasma insulin concentrations in the acutely injured. Plasma insulin and glucose concentrations have been measured in 504 patients within 8 h of injury, and related to the severity of injury as assessed by the injury severity score (ISS). As in previous surveys of injured patients, an extremely wide range of insulin concentrations was found (2-141 mU/l). Most of the variability occurred at lower severities of injury. In very severely injured patients (ISS greater than or equal to 30), insulin concentrations were uniformly suppressed (less than 20 mU/l), especially in relation to the hyperglycaemia in these patients. Two small subgroups, patients dying within 3 h of injury and known psychiatric patients on psycho-active drugs, differed from the general pattern in displaying elevated insulin concentrations despite very severe injuries. The results bear out the idea that insulin secretion is usually acutely suppressed by adrenaline after severe injury; after less severe injuries, however, the response is much less uniform. PMID- 3304327 TI - Segmentation of microscopic cell scenes. AB - Different methods for the automated segmentation of microscopic cell scenes are presented with examples. The techniques discussed include edge detection by thresholding, "blob" detection by split-and-merge algorithm, global thresholding using gray-level histograms, hierarchic thresholding using color information, global thresholding using two-dimensional histograms and segmentation by "blob" labeling. Methods are more robust against insignificant changes in the scene and perform more reliably as more a priori knowledge about the scene is incorporated in the segmentation algorithm. The inclusion of both photometric and geometric a priori knowledge can result in a high level of correct segmentations, the cost of which is increased computation time. PMID- 3304328 TI - The measuring of cell features. AB - The usefulness of various feature sets for discriminating between different cell populations cannot be assessed without considering the entire automated cytology system, from specimen preparation through scanning, cell search, cell segmentation, artifact rejection and feature extraction to object classification and multivariate data analysis methods. These different stages in the analysis procedure are discussed in this paper and illustrated by examples from the author's experience of cell analysis studies, ranging from single-cell classification experiments to a test of a complete automated system under realistic conditions on a set of 397 cell specimens. PMID- 3304329 TI - Preparation of cells from paraffin-embedded tissue for cytometry and cytomorphologic evaluation. AB - A method is described for the preparation of monolayer smears from paraffin embedded tissue. The smears are suitable for automated image analysis and DNA measurements while still allowing interpretation of nuclear morphology. The proposed technique uses enzyme treatment and syringing for cell dispersal. The preparation of cell monolayers is performed by cytocentrifugation. After staining the specimens with gallocyanin, nuclear DNA can be measured. Automated DNA measurements using the Leyden Television Analysis System (LEYTAS) showed coefficients of variation of 4.5% for the diploid cell population of suspended benign tissue. After DNA measurements, the specimens are counterstained using orange G and eosin. Since gallocyanin has spectral properties similar to those of hematoxylin, the obtained end product is comparable to specimens stained according to the routinely used Papanicolaou procedure. Using this technique, image cytometry can be applied to paraffin-embedded tissue in combination with conventional cytomorphologic study of the cells. PMID- 3304330 TI - Alcohol-related ERP changes in cognition. AB - This paper reviews five separate experimental studies concerning the acute or chronic effects of alcohol on late ERP components related to cognitive processes. The studies are evaluated for their adequacy in two arenas: (a) task relevance from a behavioral viewpoint, and (b) their ability to clarify the functional significance of alcohol-related ERP changes. Based upon the general trends of the results reported from the five individual laboratories conducting the investigations, it can be concluded that the P3 component is the most consistently altered of the four late ERP components considered (N1, N2, P2, P3). The finding of a reduced P3 amplitude was more reliable than the finding of increased P3 latency. Alterations in ERP components, when they did occur, occurred under the acute influence of ethanol, as well as in abstinent chronic alcoholics. All of the ERP findings reported were obtained using variations of signal detection procedures. Changes in ERP components did not always parallel performance changes, suggesting that aspects of psychological processes (e.g., attention and stimulus evaluation), presumed to underly ERPs' functional significance, did not directly reflect these processes. PMID- 3304331 TI - Electrophysiological action of ethanol at the cellular level. AB - To examine how ethanol interferes with brain function on the global levels of brain activity reflected by event-related potentials, we summarize here our recent efforts to characterize the acute cellular effects of ethanol. Four regions of the rodent brain (cerebellum, hippocampus, locus coeruleus and inferior olive) have so far been examined. The effects of acute parenteral ethanol on specific identifiable neurons within these 4 regions are highly consistent, dose-related, and spontaneously reversible. Furthermore, different patterns of response are seen in each responsive region, ranging from general increased firing in inferior olive to generally depressed synaptic transmission in hippocampus, and with more subtle effects within the cerebellum and within the locus ceruleus. This survey of consistent but differing patterns of responsiveness to ethanol at specific time points after acute exposure, suggests that the global effects of ethanol must be composed of several distinct effects both within and across many cellular systems. PMID- 3304333 TI - [The design of the framework]. PMID- 3304332 TI - The magnetoencephalographic localisation of source-systems in the brain: early and late components of event related potentials. AB - The application of magnetoencephalography (MEG) to the analysis of sources in the brain responsible for early and late components of evoked potentials is discussed. Representative data are presented and discussed which demonstrate localisation of sources assuming single equivalent dipoles. Distributed systems as sources for some steady-state responses are discussed in relation to the broader issue of the usefulness of equivalent single dipole models. These issues are related to the use of MEG for the analysis of source systems influenced by alcohol and other drugs. PMID- 3304335 TI - Molecular cloning and expression of a synthetic DNA coding for the antimicrobial protein of bull seminal plasma. AB - A DNA carrying the coding sequence for the antimicrobial protein from bull seminal plasma (SAP) was obtained by enzymic ligation of six synthetic oligonucleotides. The 162 bp synthetic DNA fragment was cloned into the C terminal part of the lacZ-gene employing the vector pUR289. Expression in E. coli in the presence of the inducer isopropylthiogalactoside (IPTG) led to the formation of a fusion protein, which was shown by immuno-blotting to contain immuno-reactive antimicrobial protein. Approximately 90 min after induction, the cells stopped growing and the culture was found to contain no viable cells 3 h after induction. We conclude from this observation that the beta-galactosidase antimicrobial protein fusion product was toxic for the E. coli cell and that the SAP-residue attached to beta-galactosidase was responsible for the cytotoxicity. PMID- 3304334 TI - Generation of oligomeric insulin receptor forms by intramolecular sulfhydryl disulfide exchange. Involvement of masked sulfhydryl groups. AB - Insulin receptors from rat liver membranes were labelled with a 125I-labelled photoreactive insulin analogue or by iodination using lactoperoxidase and analysed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Under nonreducing conditions different receptor forms with Mr 400,000 (alpha 2 beta 2), 360,000 (alpha 2 beta beta'), 330,000 (alpha 2 beta' beta'), 320,000 (alpha 2 beta), 280,000 (alpha 2 beta'), 240,000 (alpha 2), 210,000 (alpha beta), 165,000 (alpha beta') and 115,000 (alpha) were detected. The subunit composition of these receptor forms was determined by two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis in the absence and presence of dithioerythritol. During denaturation in sodium dodecyl sulfate in the absence of reductants, the Mr 400,000 receptor form (alpha 2 beta 2) was converted into the Mr 320,000 (alpha 2 beta) and Mr 240,000 (alpha 2) receptor form. This conversion was prevented either by N-ethylmaleimide, oxidants, or low pH. In contrast, alkylation of the receptor with N-ethylmaleimide under non-denaturing conditions did not prevent the appearance of intermediate-sized receptor forms. Furthermore, the inhibition of receptor cleavage by N-ethylmaleimide during denaturation was also observed when the amount of free sulfhydryl groups was reconstituted by the addition of an unlabelled and non-alkylated receptor sample to the alkylated and photoaffinity-labelled receptor. These results suggest, that the generation of different oligomeric receptor forms detected by sodium dodecyl sulfate polyacrylamide gel electrophoresis is due at least in part to the cleavage of one or both beta-subunits from the insulin receptor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304336 TI - Methionine residue accessibility in native subtilisin DY. AB - The three methionine residues of subtilisin DY were specifically modified into methionine sulfoxide using increasing amounts of chloramine T. By means of subsequent treatment with cyanogen bromide, gel chromatography, Edman degradation of the obtained peptides and the known structure of subtilisin DY it was established that Met222 is exposed to the surrounding solution, Met124 is partially exposed and Met199 is buried. The data obtained were confirmed on a computer graphics space movable model of subtilisin Carlsberg where Met222 was seen to be on the surface of the molecule and Met199 shielded by Tyr262, Ala179 and Leu196. Upon oxidation of Met222 of subtilisin DY by chloramine T, 25% of its caseinolytic activity was lost. This can be explained by the immediate adjacency to the active-site Ser221. An additional 5% loss of activity was observed at each subsequent methionine modification. PMID- 3304337 TI - Hemoglobin sequences. PMID- 3304339 TI - The amino-acid sequences of the double-headed proteinase inhibitors from cat, lion and dog submandibular glands. AB - Cat and lion submandibular glands each contain a double-headed secretory proteinase inhibitor. Their amino-acid sequences were determined, and the amino acid sequence of the inhibitor of dog submandibular glands was revised. Extensive homologies were found between these inhibitors in both domains. The trypsin inhibiting domains of cat and lion inhibitors, however, contain a Lys residue in the reactive site in contrast to an Arg residue in the dog inhibitor. Domains I and II of cat, lion, and dog inhibitors are structurally related both to each other and to the sequenced monovalent secretory pancreatic trypsin inhibitors, Notable differences in inhibitory properties of canine and feline inhibitors are discussed with respect to sequence differences. PMID- 3304338 TI - Shortened insulin with enhanced in vitro potency. AB - After it has been shown that removal of residues B26-B30 leaves insulin with full biological activity, provided the new C-terminus is amidated (Fischer et al. (1985) Biol. Chem. Hoppe-Seyler 366, 521-525), it is demonstrated here that it does not even preclude enhancement of potency. 7 analogues of des-(B26-B30) insulin-B25-amide were prepared by trypsin-mediated semisynthesis, the replacements being D-PheB24; HisB25, D-PheB25, TrpB25, TyrB25; D-PheB24,B25 and D PheB24, TyrB25. Mere conversion of the configuration of B25-phenylalanine reduces in vitro potency to 0.5%. If B25-phenylalanine is, however, substituted by histidine or tyrosine activity is increased to 310 or 230, respectively. According to the features common to these two side chains, the favourable effect should be due to their ring structure with balanced aromatic and polar or H bonding properties, respectively. The results indicate that in the complete insulin molecule the C-terminal pentapeptide modulates the subtle role that residues B24 and/or B25 play in receptor binding and activity; its presence may have a positive or negative effect. The drastic differences in activity between the shortened analogues are in no ways reflected in the CD spectra which are very similar, though clearly different from that of native insulin. PMID- 3304340 TI - Electron microscopical investigation of citrate lyase single molecules. AB - Electron micrographs of citrate lyase from Rhodopseudomonas gelatinosa and Klebsiella aerogenes reveal two characteristic molecular forms. The "basket" form and the "star" form were subjected to two-dimensional image reconstruction using a technique involving averaging of superposed single molecular images after rotational correlation. A three-dimensional image reconstruction shows that the images of these forms can be interconverted by rotation and that they therefore represent different views of the same structure. PMID- 3304341 TI - Effect of diabetes on the metabolism of chenodeoxycholic acid in isolated perfused rat liver. AB - The formation of alpha-muricholic acid and beta-muricholic acid from chenodeoxycholic acid was comparatively investigated in livers isolated from normal, streptozotocin-diabetic, and insulin-treated diabetic rats. [24 14C]Chenodeoxycholic acid or [24-14C]alpha-muricholic acid was infused into the perfused livers. There was no difference in biliary excretion of 14C among the different groups of rats after the infusion of each 14C-labelled bile acid. Biliary [14C]bile acids were chromatographed on a thin-layer plate and the distribution of radioactivity on the plate was measured by radioscanning. In the diabetic group, the formation ratio of alpha-muricholic acid and beta-muricholic acid from [24-14C]chenodeoxycholic acid and also that of beta-muricholic acid from [24-14C]alpha-muricholic acid were much smaller than in the normal group. Treatment of the diabetic group with insulin cancelled the difference in the infusion of each [24-14C]bile acid. The results indicate that not only 6 beta hydroxylation of chenodeoxycholic acid to alpha-muricholic acid but also 7 epimerization of the latter acid to beta-muricholic acid is suppressed in an insulin-deficient state in rats. PMID- 3304342 TI - Studies on immunoassays of peptide factors. II. Fluorescence enzyme immunoassay for human little-gastrin. AB - The fluorogenic chymotrypsin substrate N alpha-(4-carboxybutyryl)-L-phenylalanine (4-methyl-7-coumaryl)amide was converted to a thiol-containing compound via its condensation at the carboxyl function with cystamine followed by reduction of the resulting disulfide compound to a cysteamine derivative. By subsequent reaction of the thiol group with N alpha-maleoyl-beta-alanyl-human-little-gastrin-I-[2-17] a fluorogenic substrate-labeled gastrin, fully immunoreactive against antigastrin antisera, was obtained. This tracer was then applied for developing a fluorescence immunoassay based on separation of bound and free tracer followed by chymotryptic digestion of the fluorogenic substrate in the supernatant. The fluorescence intensity of the extracted fluorophore i.e., 7-amino-4-methyl coumarin, was found to monitor gastrin concentrations in a reproducible manner. With the model peptide hormone human little-gastrin-I the sensitivity of this alternative immunoassay procedure was well documented. PMID- 3304343 TI - Studies on immunoassays of peptide factors. IV. New synthesis of a gastrin/peroxidase conjugate. AB - We have shown that structurally well-defined homogeneous maleoyl-peptides are synthetically accessible. These anchor-modified peptide derivatives allow their selective covalent linkage to thiol-containing proteins via the maleimide-thiol procedure. Correspondingly mercaptosuccinylated horseradish peroxidase was reacted with N alpha-maleoyl-beta-alanyl-human-little gastrin-I-[2-17] to produce the gastrin/peroxidase conjugate in good yields at 1:1 stoichiometry. The conjugate exhibited full enzymatic activity and identical binding affinity to antigastrin antisera as the parent gastrin. This approach proved to be well suited for the preparation of enzyme labeled peptide factors as tracers for immunoassays. PMID- 3304344 TI - Biocompatibility of artificial organs: an overview. AB - Papers that are presented in this symposium on biocompatibility of foreign surfaces used in artificial organs are commented upon and set in an overall context of the biocompatibility of foreign surfaces to blood. A working formulation of the events comprising lack of biocompatibility of hemodialysis membranes to the complement system is given as a possible model to which other foreign surfaces may be compared. PMID- 3304345 TI - Long term antibody production in cultures of peripheral blood lymphocytes. AB - Antigen stimulated cultures of rabbit and human peripheral blood lymphocytes (PBL) were maintained in active antibody synthesis for at least a month. When rabbit PBL were used, the response to a particulate antigen (SRC) was not affected by a change of medium and/or by disruption of the cell to cell contact during culture. On the other hand, the response to a soluble antigen (OA) was markedly increased by changing the medium after the onset of the response. When human PBL were used, any handling that caused disruption of cellular contacts was detrimental for continuation of the specific response. In both the rabbit and the human system the overall cell number did not increase during culture, but an enrichment in the specific cells occurred. These cultures represent a powerful tool both for studies of late events of the immune response and for the aim of establishing antibody producing cell lines. PMID- 3304346 TI - [Indirect immunofluorescence in the serodiagnosis of Trichomonas vaginalis infections]. AB - By using immunofluorescent technique the Authors have observed that high titer circulating antibodies reacting with membrane or cytoplasmic structures of T. vaginalis occur in the majority (42/45) of women presenting because of trichomonas vaginitis. Only exceptionally high titer antibodies have been detected in serum of male subjects affected by urethral trichomoniasis. Low titer antibodies are found in serum of noninfected subjects and are supposed to be induced by cross reacting flagellate group antigens. The contribution of these findings to a better understanding of the natural history of trichomoniasis is briefly discussed. PMID- 3304348 TI - Antibiotic prophylaxis for facial fractures. A prospective, randomized clinical trial. AB - Although antibiotics are widely used in an attempt to decrease the incidence of infections after facial fractures, no systematic prospective study of their efficacy has been performed. In this study, all adult patients with facial fractures who had not received antibiotics were asked to participate in a clinical trial. There were 101 patients with facial fractures enrolled into the study and randomized prospectively into two groups. One group received no antibiotics. The other group received cefazolin sodium, 1 g intravenously, one hour prior to the surgical procedure, and a similar dose eight hours later. Of the 101 patients enrolled in the study, 79 had mandibular fractures, 18 had zygoma fractures, and four had Le Fort fractures. When all facial fractures were considered, perioperative intravenous cefazolin reduced the incidence of postoperative infections; 42.2% in the no-antibiotic group became infected, and 8.9% in the antibiotic group became infected. On the basis of this study, we conclude that cefazolin, used perioperatively, diminished the incidence of postoperative infections in facial fractures. PMID- 3304347 TI - Milan as possible starting point of LAV/HTLV III epidemic among Italian drug addicts. AB - Sera collected between 1978 and 1985 from 716 parenteral drug-addicts admitted to our Clinic with viral hepatitis were tested for antibodies to HTLV III. None of the patients was showing symptoms suggestive of LAV/HTLV III infection at the time of sera collection. Positivity for HTLV III antibody was found and confirmed (by ELISA) in 212 subjects (29.6%). The earliest positivity appeared in a serum sample collected in February 1979. These and other data point to Milan as to the actual source of the Italian PDAs-linked LAV/HTLV-III epidemic. PMID- 3304349 TI - Studies of the process of renaturation and assembly of Escherichia coli succinyl CoA synthetase from its alpha and beta subunits. AB - Succinyl-CoA synthetase catalyzes the substrate-level phosphorylation step of the tricarboxylic acid cycle. The enzyme, as isolated from Escherichia coli, has an alpha 2 beta 2 subunit structure. It is known that substrate-binding sites are distributed between both subunit types and that the active enzyme is the nondissociating tetramer. This paper describes a study of the process of assembly of the enzyme from its denatured constituent subunits. Starting with equimolar mixtures of the subunits that are prepared in denaturing conditions (6 M urea, 5% acetic acid), rapid renaturation to produce virtually a fully active enzyme occurs after neutralization and dilution under suitable conditions. This process occurs most efficiently in the presence of either ATP or Pi, indicating that occupation of the phosphoryl-binding site on the refolding alpha subunit facilitates productive intrasubunit interactions. We have determined conditions of protein concentration, pH, temperature, final urea concentration, and buffer compositions that optimize both the rate and extent of production of active enzyme. The final refolded product is indistinguishable from the native species with respect to its specific catalytic activity, size, and other physical properties. To probe further the mechanism and route of renaturation, we have shown that the rate of appearance of activity has first-order dependence on each of the two subunits. The step that determines the rate of assembly is thus bimolecular, such as the association of structural monomers to form a dimeric transient species. The highly specific mutual interactions between the refolding transient species of subunits must be essential for the correct assembly of this enzyme from the two gene products in vivo. PMID- 3304350 TI - Fusimotor action during natural movement. A peripheral link between motor and sensory 'set'? PMID- 3304351 TI - Evaluation of a standard scrubbing method for the recovery of aerobic skin flora. AB - The most reliable method for sampling skin flora is still a matter of debate, although the subject is of importance in many fields ranging from clinical to basic research. For the evaluation of normal skin flora, Williamson and Kligman's scrub method is the most commonly used. In order to determine the value of this method, standardized for the evaluation of topical antimicrobial agents on aerobic skin flora, we compared its results to those obtained both from bacterial counts and from microscopic studies on biopsies performed at the same site. After different experiments had established the optimal experimental conditions on human and pig skin, a comparative study on six healthy subjects was carried out in the peri-umbilical area. The mean log numbers of aerobic bacteria in the scrub samples and in the biopsies were respectively, 3.1 and 2.9, which were not statistically significant. These numerical results were similar to those obtained by electron microscopy. Hence, the standard scrub method may be considered satisfactory for the recovery of aerobic bacteria from healthy human skin. PMID- 3304352 TI - Resistance of attached Escherichia coli to acrylic acid and its significance for the survival of plasmid-bearing organisms in water. AB - As previously reported, free organisms of Escherichia coli are sensitive to damage and killing when exposed to acrylic acid in water. The effect of the agent was greatest in distilled water, but there was a marked effect in effluent and seawater also. The effect was temperature-dependent, with organisms exposed at 4 degrees C being much less affected than those exposed at 20 degrees C. The above sensitivity was for free organisms, but those attached to glass beads were resistant to acrylate. This resistance applied equally to attached plasmid-free and attached plasmid-bearing organisms, but is likely to be more significant for plasmid-bearing strains because some plasmids studied here stimulated bacterial attachment. The likely significance of the acrylate resistance of attached organisms for enterobacterial survival in the aquatic environment, e.g. in the vicinity of shellfish beds, is discussed. PMID- 3304353 TI - Etiological concepts in cervical carcinogenesis. AB - Substantial progress has been made in elucidating the etiology and epidemiological distribution of cervix uteri cancers in women. Foremost among the advances is a clarification of the role of the herpes genitalis virus as a necessary, though not sufficient, causal factor. The epidemiological data in the United States confirm the essential role of exfoliative cytological screening in the successful control of this disease. PMID- 3304354 TI - The spectrum of pathology in osteomalacia. AB - A classification and discussion of the histology of osteomalacia and the current histological techniques used in its identification are presented. Three categories of histologic features of osteomalacic bone are proposed: (1) increased osteoid, elevated osteoblast and osteoclast numbers and marrow fibrosis; (2) increased osteoid and osteoblast numbers, and (3) increased osteoid associated with few osteoblasts. Clinical conditions for which quantitative bone histomorphometric data are available are presented and related to the three categories. The consistency of clinical pathophysiology and histologic bone features is emphasized. PMID- 3304355 TI - Osteopetrosis--multiple pathways for the interception of osteoclast function. AB - Osteopetrosis is a metabolic bone disease inherited in a number of species including human beings and characterized by a generalized increase in skeletal density detected radiographically. This condition results primarily from reduced osteoclast function which produces partial or complete absence of marrow spaces, a variable compensatory hepatosplenomegaly, interferences with tooth eruption and certain neurological complications. Experimental investigations of some mutations have shown that restoration of bone resorption and recovery from the disease follow bone marrow transplantation. These data indicate that in these mutations, including some children, the defect is intrinsic to osteoclasts or their stem cells. In other mutations in animals and children, bone marrow transplants do not restore bone resorption and the defect is believed to be one of local environmental products or signals whose importance in cell differentiation and regulation is becoming increasingly appreciated. These data, reviewed with respect to the emerging cell biology of the osteoclast, indicate that osteopetrotic mutations have much to teach us about the regulation of bone metabolism. PMID- 3304356 TI - Analysis of human serum antibodies to human immunodeficiency virus (HIV) using recombinant ENV and GAG antigens. AB - Recombinant proteins representing gag and env amino acid sequences of the Human Immunodeficiency Virus (HIV) (HTLV-IIIb) were produced in Escherichia coli and used to analyze sera for the presence of antibodies to HIV. ENV-9 is a protein representing the carboxy terminus of gp120 and part of gp41 which is highly immunoreactive. GAG-1 represents 83% and GAG-55 100% of the amino acids of the gag open reading frame. The purified proteins allow sensitive detection by enzyme linked immunosorbent assay (ELISA) of antibodies directed against either env or gag of HIV. We have determined the reactivity of sera from several HIV exposed individuals, either form high risk populations or with clinically defined conditions, in the ENV-9, GAG-55, and GAG-1 assays and found that two major seropositive groups are observed. The quantitative analysis of sera with env and gag antigens by ELISA showed AIDS patients had very low gag reactivity while retaining high env reactivity. Results obtained with authentic p24 viral protein in both ELISA and radioimmunoassay correlated to those from the GAG-55 ELISA. This correlation and the analysis of sera with both the ENV and GAG ELISAs indicate that the antibodies reactive to gag are specifically affected relative to env reactivity and that different levels of antibodies to separate viral components in these sera may correlate with disease state. PMID- 3304357 TI - Radioimmunoprecipitation and Western blotting with sera of human immunodeficiency virus infected patients: a comparative study. AB - The sensitivity and specificity of radioimmunoprecipitation assay (RIPA) and Western blot (WB) test were compared by use of a collection of 183 sera, representing different categories of individuals, noninfected or infected with the human immunodeficiency virus (HIV). The sera were subdivided on the basis of their reactivity in at least two anti-HIV enzyme-linked immunosorbent assays (ELISA); 53 sera were negative and 61 sera were positive in both tests, whereas 69 sera showed ambiguous reactions. The reaction patterns in RIPA could be divided into 6 different groups. The same grouping could to some extent be applied to the results of WB test. RIPA provided the most efficient means for identification of the large viral envelope glycoproteins, gp120/160, whereas gp41 was detected more effectively by WB. Internal virus components reacted to a varying extent with specific antibodies in the two tests. The reaction with pol products was more pronounced with the WB tests in which extracellular material was used as antigen. In a few WB tests, however, the reaction with internal components did not reflect a prior HIV infection. No such ambiguity was observed with RIPA, reflecting the advantage of a test that uses a minimally denaturated antigen and provides appropriate conditions for identification of the large viral glycoproteins. The practical choice of confirmatory tests to be used in diagnostic laboratories requires evaluation of both the sensitivity and specificity of the tests but also their economy and convenience. PMID- 3304359 TI - [Basic pattern of the cardiac nerves in vertebrates]. PMID- 3304358 TI - [Morphological consideration of the branchial nerves]. PMID- 3304360 TI - [Somatotopical localization of motor neurons]. PMID- 3304361 TI - [Immunohistochemical study of human brain tumors with vimentin and astroprotein (GFAP)]. AB - Distributions of two different subclasses of intermediate filaments, vimentin and glial filaments, were studied immunohistochemically in human brain tumors using specific antiserum to each protein subunit, vimentin and astroprotein (GFAP), Surgical specimens (5 meningiomas, 4 ependymomas, 5 benign astrocytomas, 5 anaplastic astrocytomas and 7 glioblastomas) were fixed in 95% ethanol or ethanol acidic acid (95:5) and embedded in paraffin Avidin biotin peroxidase-complex (ABC) method (Vectastain) was carried out on 6 microns-thick paraffin sections. All meningioma cells were negative for astroprotein (GFAP) and positive for vimentin. Ependymoma cells showed various patterns of immunoreaction for astroprotein (GFAP) but were invariably positive for vimentin. In benign astrocytomas, many cells (or cell body and processes) were positive for astroprotein (GFAP). Immunoreaction for vimentin was, however, less frequent and intense. In anaplastic astrocytomas, population of astroprotein (GFAP)-positive cells decreased and vimentin-positive cells increased. Astroprotein (GFAP) positive cells were further decreased in glioblastomas and the population of vimentin-positive cells varied among tissues. The present study suggests that the anaplastic change of astrocytoma cells were associated with decreased expression of glial filaments and increased expression of vimentin filaments. It was also suggests that the expression of both intermediate filaments may be suppressed in highly-malignant glial tumor cells. PMID- 3304362 TI - Badges of the dental profession. Community Dental Services Group. PMID- 3304363 TI - Badges of the dental profession. The British Society for the Study of Orthodontics. PMID- 3304364 TI - Psychiatric aspects of dentistry. I. PMID- 3304365 TI - Psychiatric aspects of dentistry. II. PMID- 3304366 TI - The history of coronary care units. PMID- 3304368 TI - Isolation of the left common carotid or left innominate artery. AB - Isolation of the left common carotid or left innominate artery from the aortic arch is rare. A six week malformed infant with a right aortic arch had isolation of a left innominate artery and connection to the pulmonary artery by a left ductus arteriosus. A right ductus arteriosus had been ligated. Another infant with a right aortic arch and ostium primum atrial septal defect was shown to have an aberrant left subclavian artery arising from the lower descending aorta. The left common carotid artery filled retrogradely and drained into the pulmonary artery by a left ductus arteriosus. This abnormality has not been reported before. PMID- 3304367 TI - Medical treatment of patients with severe exertional and rest angina: double blind comparison of beta blocker, calcium antagonist, and nitrate. AB - The role of medical treatment of patients who had resting nocturnal angina as well as exertional angina was investigate. The effects of atenolol 100 mg a day, nifedipine 20 mg three times a day, and isosorbide mononitrate 40 mg twice a day were investigated in a double blind, triple dummy randomised study. Nine patients with coronary artery disease, early positive exercise tests, and transient daytime and nocturnal ambulatory ST segment changes were initially assessed off all antianginal medication. They were then treated with each drug for three five day periods. Angina diaries were reviewed and maximal treadmill exercise tests and 48 hour ambulatory ST segment monitoring were performed at the end of each treatment period. Resting and exercise heart rate and blood pressure were significantly lower on atenolol than on either isosorbide mononitrate or nifedipine. The duration of exercise to 1 mm ST segment depression was significantly greater on atenolol than on isosorbide mononitrate. Only one patient had an improvement in exercise tolerance on nifedipine that was greater than the improvement on atenolol; this patient had single vessel disease. The total number and duration of episodes of ST segment change during ambulatory monitoring were significantly lower with atenolol than on either isosorbide mononitrate or nifedipine. Nocturnal ST segment changes were abolished in six patients on atenolol, in six patients on nifedipine, and in five patients on isosorbide mononitrate. When nocturnal ST segment changes occurred, their frequency was reduced with all three drugs. Pain was abolished in four patients on atenolol and pain relief was significantly better on atenolol than on isosorbide mononitrate. There was no significant difference in pain relief between isosorbide mononitrate and nifedipine. Thus beta receptor blockade with atenolol was the most effective means of reducing myocardial ischaemia both during exercise and at rest at night without causing deterioration in any patient. Nocturnal myocardial ischaemia in patients with severe coronary artery disease can be effectively treated with beta receptor antagonists and vasodilators. PMID- 3304370 TI - A comparison of symptoms and intra-arterial ambulatory blood pressure during long term dual chamber atrioventricular synchronous (DDD) and ventricular demand (VVI) pacing. AB - Fifteen patients with dual chamber pacemakers implanted for atrioventricular block (11) or sinoatrial disease (4) completed a single blind within-patient comparison of symptoms and 24 hour intra-arterial blood pressure during long term atrioventricular synchronous (DDD) pacing and long term ventricular demand (VVI) pacing. The patients reported significantly less breathlessness, fatigue, and dizziness and a significantly greater sense of general well-being during DDD pacing than during VVI pacing. Twelve of the fifteen patients expressed a strong preference for DDD pacing. Systolic blood pressure tended to be lower and was significantly more variable during VVI pacing than during DDD pacing (mean (SD) daytime systolic blood pressure 132.4 (17.1) and 140.4 (13.1) mm Hg respectively). Accordingly, episodes of hypotension were more common during VVI pacing, which may partly explain why the patients reported more symptoms during this mode of pacing. PMID- 3304369 TI - Cardiac imaging 50 years on. PMID- 3304371 TI - Preoperative myocardial ischaemia: its relation to perioperative infarction. AB - One hundred consecutive patients undergoing coronary artery bypass surgery were randomly allocated to a preoperative (24 h) intravenous infusion of isosorbide dinitrate (1.5-15 mg/hr) (50 patients) or to placebo (50 patients). The characteristics of the two groups were similar. Evidence of acute myocardial ischaemia was sought by continuous electrocardiographic Holter recordings and acute myocardial infarction by the appearance of new Q waves and increased activity of the creatine kinase MB isoenzyme. Episodes of acute myocardial ischaemia were found in 18% of patients in the control group and in none of those who received isosorbide dinitrate. None the less, the frequency of perioperative myocardial infarction was similar (22% and 18% respectively) in the two groups. Perioperative infarction was significantly more common in women, in patients with unstable angina or poor left ventricular function, in those who had coronary endarterectomy, and in those in whom the aortic clamping time was greater than 50 minutes. These factors may have obscured any effect that prevention of preoperative ischaemia had on perioperative infarction. Preoperative infusion of isosorbide dinitrate eliminated preoperative ischaemia but did not influence the occurrence of perioperative infarction. The probable benefits of prevention of preoperative ischaemia on postoperative left ventricular function, which is a determinant of long term survival, remain to be established. PMID- 3304373 TI - Dilated cardiomyopathy: diagnostic accuracy of endomyocardial biopsy. AB - A histopathological index of contractility failure, which was reported to be accurate for the diagnosis of idiopathic dilated or congestive cardiomyopathy in Japan, was used to assess endomyocardial biopsy specimens from 41 Dutch patients with suspected dilated cardiomyopathy. The calculated index had a sensitivity of 62.5% and a specificity of 68% for idiopathic dilated or congestive cardiomyopathy. These disappointing results indicate that the histopathological index of contractility failure does not reliably distinguish between idiopathic dilated cardiomyopathy and other diseases that cause congestive heart failure. PMID- 3304372 TI - Felodipine in patients with chronic heart failure: discrepant haemodynamic and clinical effects. AB - Previous open studies have suggested that felodipine, a selective calcium antagonist and vasodilator, may be useful in the treatment of heart failure. A double blind placebo controlled crossover trial was therefore conducted to investigate the clinical and haemodynamic effects of felodipine in 15 patients with chronic ischaemic heart failure in New York Heart Association symptom class III. Felodipine significantly increased resting and exercise (25W bicycle ergometry) cardiac output without producing concomitant changes in resting or exercise heart rate or right and left ventricular filling pressures. Felodipine did not significantly improve symptom scores or exercise capacity in the group as a whole. It also resulted in significant fluid retention as shown by a rise in ankle circumference, body weight, and a fall in haematocrit. Further research is required to elucidate the mechanism that is responsible for the discrepancy between the haemodynamic and clinical effects of felodipine in patients with moderately severe heart failure. PMID- 3304374 TI - A review of studies of anaesthetic risk, morbidity and mortality. AB - In the past two to three decades, advancing knowledge in the areas of physiology, pharmacology and scientific technology have allowed diversification from the purely technical aspects of administration of anaesthesia towards more accurate assessment of outcome for the individual in terms of both anaesthetic-induced morbidity and mortality. In addition, elucidation of the aetiology of the morbidity and mortality produced by anaesthesia, as opposed to that from surgery or concomitant medical or surgical disease processes, is assuming increased importance as a result of the expansion in medical litigation, where anaesthetists find themselves amongst the higher risk specialties in medicine. The morbidity produced by anaesthesia is relatively easy to define for specific populations, but the prediction of risk in an isolated individual remains elusive. For example, there are many studies indicating the incidence of postoperative myocardial infarction following surgical procedures in defined groups; but for the individual patient, more sophisticated risk assessments have so far failed to predict more accurately than the well-established ASA grading system. Nonetheless, it is expected that in future, studies in this area will permit increased precision in the assessment of risk, thereby permitting better consideration by both surgeon and patient of the options available regarding surgical and non-surgical therapy. Increasing emphasis on the safer administration of anaesthesia has been greatly aided by the use of the critical incident technique. By assessing near-misses in addition to existing morbidity and mortality, the technique increases the size and extent of the database, and by removal of the reticence inherent in an anaesthetist's confession of his mistakes, it increases the reporting of potential mishaps. Amongst the useful findings to have emerged from such studies is the previously unforeseen and unsuspected observation that the most dangerous period of anaesthesia is not during induction and recovery, but during the maintenance period. However, perhaps one of the more valuable aspects of this type of methodology is its potential use in quality control and audit within departments. There are undoubted problems and universally acknowledged difficulties in epidemiological research into anaesthetic mortality. Comparison of data between studies is rendered difficult owing to variations in procedure, including its prospective or retrospective nature, the definition of death, the perioperative time period studied, and the patient and hospital populations encompassed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3304375 TI - Anaesthetic contribution to maternal mortality. PMID- 3304376 TI - Human factors in accidents. PMID- 3304378 TI - Essential monitoring. PMID- 3304379 TI - Safer design of anaesthetic equipment. PMID- 3304377 TI - Anaesthesia and the law: the North American experience. AB - The professional liability climate in the United States can best be described as tempestuous in most areas of the U.S. The major strategy of organized anaesthesia and the professional liability insurance industry is to attempt to reduce patient injury. In the unlikely eventuality that human error and equipment failure in anaesthesia can be eradicated, some patient injury will inevitably still occur. For this reason tort reform is necessary, and alternatives to the tort system need to be developed to compensate injured parties adequately without bankrupting the medical system. PMID- 3304380 TI - Education in anaesthetic safety. PMID- 3304382 TI - Calcitonin suppresses gastric emptying of a radiolabelled solid meal in humans. AB - The effects on gastric emptying of calcitonin/i.v. 1.5 i.u. kg-1 body mass bolus or 10 i.u. followed by infusion to overall 1.5 i.u. kg-1 body mass dose vs placebo were studied in four healthy volunteers and in four patients with an active peptic ulcer. Gastric emptying of a radiolabelled solid meal was surveyed. Pronounced delay in gastric emptying was observed in all studied subjects, mean transit time MTT90 calcitonin 39.2 +/- 0.85 min vs placebo 32.8 +/- 1.31 min, P less than 0.001. PMID- 3304381 TI - Does regular treatment with ketotifen inhibit bronchoconstriction induced by isocapnic hyperventilation? AB - Eight asthmatic patients completed a 12-week, double-blind, placebo controlled study to assess the efficacy of ketotifen, 1 mg twice daily, in the inhibition of bronchoconstriction induced by isocapnic hyperventilation (IH). There was no significant difference in the degree of bronchoconstriction produced by IH after treatment with ketotifen or placebo. PMID- 3304383 TI - Immediate effects of bumetanide on systemic haemodynamics and left ventricular volume in acute and chronic heart failure. AB - 1 The haemodynamic and radionuclide effects of i.v. bumetanide (25 micrograms kg 1) were prospectively studied in 24 patients with angiographically documented coronary artery disease and either acute exercise-induced (Group I, n = 12) or chronic (Group II, n = 12) heart failure. 2 Bumetanide at rest increased systemic arterial blood pressure and vascular resistance index; cardiac index and pulmonary artery occluded pressure (PAOP) were reduced at an unchanged heart rate in all patients. The left ventricular ejection fraction fell in patients with normal resting left ventricular filling pressure without change in those with chronic heart failure. The cardiac volumes were unchanged in either group. 3 During constant-load supine bicycle exercise, there were similar effects on systemic arterial pressures, vascular resistance index and PAOP; however the cardiac index was maintained at a reduced left ventricular filling pressure and unchanged ejection fraction and volumes. 4 These data demonstrate immediate mild pressor and vasoconstrictor actions of bumetanide which appear independent of the state of cardiac function; they suggest that any immediate improvement in patient symptomatology following bumetanide may be consequent on the reduction in PAOP; short-term reductions in volume may not occur. PMID- 3304384 TI - Observations on spontaneous improvement in patients with podagra: implications for therapeutic trials of non-steroidal anti-inflammatory drugs. AB - 1 The natural history of acute gouty arthritis was studied in 11 volunteers with podagra. 2 Two patients withdrew from the study on day 4 because of severe persistent pain. Of the remaining patients all showed some improvement in pain by day 5 and in swelling by day 7. Tenderness improved in seven patients by day 7 but two continued to experience the same amount of discomfort as at trial entry. In spite of these improvements only three patients noted resolution of their pain during the study period. 3 These data indicate that while the majority of patients show spontaneous improvement, resolution is unlikely over a period of 7 days without the use of effective non-steroidal anti-inflammatory medication. 4 Documentation of the natural history of the acute gouty attack may assist clinical investigators in interpreting the results of uncontrolled evaluations of non-steroidal anti-inflammatory drugs. PMID- 3304385 TI - Studies of mefloquine bioavailability and kinetics using a stable isotope technique: a comparison of Thai patients with falciparum malaria and healthy Caucasian volunteers. AB - 1 A mefloquine hydrochloride tablet (250 mg base equivalent to 4.8 +/- 0.6 mg kg 1; mean +/- s.d.) and deuterium labelled mefloquine hydrochloride solution (250 mg base) were given to six adult male Thai patients with acute falciparum malaria and six healthy Swiss adult male volunteers (equivalent to 3.5 +/- 0.1 mg kg-1). 2 The relative bioavailability of the tablet formulation derived from comparison of the areas under the plasma concentration-time curves was similar in both groups; 87 +/- 11% and 89 +/- 10% (mean +/- s.d.). 3 The rate of drug absorption appeared to be similar in the two groups but peak plasma mefloquine concentrations were approximately three times higher in the Thai patients (1004 +/- 276 ng ml-1 for the tablet and 1085 +/- 280 ng ml-1 for the suspension) compared with the Swiss volunteers (319 +/- 73 ng ml-1 for the tablet, and 369 +/ 121 ng ml-1 for the suspension). 4 Estimates of the oral clearance CLpo of unlabelled mefloquine were significantly lower (17.5 +/- 4.4 ml h-1 kg-1) in the Thai patients compared with 28.8 +/- 3.5 ml h-1 kg-1 in the Swiss volunteers; P less than 0.05). Terminal elimination half-lives were significantly shorter in the patients (10.3 +/- 2.5 days) than in the volunteers (16.7 +/- 1.9 days; P less than 0.005). Differences of a similar magnitude were observed when comparing the pharmacokinetic parameters derived from the deuteromefloquine plasma concentrations. 5 Both genetic and disease related factors are likely to account for the large pharmacokinetic differences between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304386 TI - Glucose tolerance in hypertensive patients during treatment with the calcium antagonist, felodipine. AB - 1 Twelve non-diabetic hypertensive male patients insufficiently controlled by a diuretic were included in a double-blind, randomised study. In addition placebo or felodipine was given for 4 weeks followed by a 2 week wash-out period, after which the alternative treatment was given for another 4 weeks. At the end of each treatment period an oral glucose tolerance test (OGTT) was performed and blood pressure, plasma noradrenaline and felodipine levels were measured. 2 There was no change in either glucose, insulin or glucagon levels during the OGTT after felodipine compared with placebo. Blood pressure was significantly reduced during the dosage interval of felodipine (12 h). Plasma noradrenaline increased significantly after felodipine. Side effects were few. 3 In a separate open study 58 hypertensive patients were treated with felodipine in addition to a diuretic and a beta-adrenoceptor blocker for up to 1 year. There were no significant changes in fasting blood glucose levels during the study. PMID- 3304387 TI - Collagen IV staining pattern in bladder carcinomas: relationship to prognosis. AB - A prospective study of type IV collagen in urothelial tissues was undertaken using an immunoperoxidase method on 125 ethanol fixed specimens. In normal and non cancerous urothelium, the basement membrane was continuously stained and the same pattern was seen in the 27 superficial carcinomas. In the 48 invasive bladder carcinomas, we observed two patterns of staining for collagen IV: in the first one, the staining line was conserved or partially fragmented (28 tumours), while in the second one the staining line was widely fragmented or absent in more than 5% of the tumour area (20 tumours). We found a highly significant statistical correlation between the pattern of staining and short term prognosis. Twenty-nine patients had an assessable follow-up of three years at least. All 16 patients with pattern I staining were alive at two years while only two out of 13 patients with pattern II staining survived two years (P less than 0.0001). At three years, all the patients with pattern II staining died while 11 patients with pattern I were still alive (P less than 0.001). These data provisionally indicate that the type IV collagen staining pattern may be of prognostic value in assessing the short term behaviour of invasive bladder carcinomas. It is thus logical to envisage that the treatment decisions may be influenced by the results of collagen IV staining. PMID- 3304388 TI - Human breast cancer cells share antigens with the myeloid monocyte lineage. AB - We have examined the expression of several myeloid cell associated antigens, some of which are involved in myelomonocyte adhesion, in seven well characterized human breast cancer cell lines, since common properties of adhesiveness and migration are found in haemopoietic cells and epithelial cancer cells. Five of these cell lines were of metastatic origin and two were derived from primary breast carcinoma. Antigenic expression was evaluated by immunofluorescence (IF), flow cytometry (FCM), radioimmunoassay on live cells (RIA) and immunoperoxidase staining. None of these cell lines expressed T or B lymphoid specific antigens. Myeloid antigens My4, MO1, and MOF11 (derived from the hybridization of mouse X63 - Ag8 cells with spleen cells from Balb/c mice immunized with purified human monocytes) were expressed in the 7 cell lines. Leu M1, Leu M3, My9, and MO2 antigens were expressed in some of the cell lines. Leu M2 and My7 antigens were not expressed or at very low levels. The expression of these myeloid antigens was also tested by immunoperoxidase staining, and found on frozen sections of normal mammary gland, fibroadenoma of the breast, primary breast cancer, and lymph node and skin metastases of breast tumours. This common expression in epithelial breast cells and in myeloid cells might be related to common biological functions such as interaction with extracellular matrix which precedes cell migration, a normal function of macrophages and an abnormal function expressed or amplified in human cancer epithelial cells. PMID- 3304389 TI - Chronic lymphocytic leukaemia: case control epidemiological study in Yorkshire. AB - This is the second report of a large case control study of lymphoma/leukaemia occurring in Yorkshire during 1979-84, and deals with chronic lymphocytic leukaemia presenting either in its haematological (CLL) or more solid lymphomatous (malignant lymphoma-lymphocytic or MLL) forms. In all, 330 cases and 561 controls were interviewed. The results support the concept that CLL/MLL is a condition of multiple aetiologies with evidence for genetic predisposition through an excess of family cases, immune perturbation demonstrated by excessive previous skin diseases and phenylbutazone use, and viral involvement shown by links with infectious diseases and multiple sclerosis. PMID- 3304390 TI - Pulmonary embolism. AB - Contemporary concepts in the diagnosis, treatment and natural history of pulmonary embolism are reviewed, and a practical rationale for investigation and therapy is outlined. PMID- 3304391 TI - The bone marrow in human cerebral malaria: parasite sequestration within sinusoids. AB - Bone marrow aspirates from patients with cerebral malaria were studied with the light and electron microscopes. Various abnormalities were found including: (1) an increase in plasma cells and macrophages, sometimes to a marked degree; (2) phagocytosis of parasitized red cells by macrophages and of merozoites by neutrophil metamyelocytes, neutrophil granulocytes and macrophages; (3) an increase in the proportion of eosinophil granulocytes and their precursors; (4) the presence of giant metamyelocytes; and (5) morphological abnormalities of erythroblasts, particularly irregularly-shaped nuclei and karyorrhexis. A high percentage of the red cells within marrow sinusoids were parasitized and the parasitized cells were attached to the endothelium. Some marrow sinusoids were packed with and completely obstructed by parasitized cells. Strands of electron dense material were sometimes found connecting the knobs of parasitized red cells to endothelial cells or to the knobs of adjacent parasitized red cells. A striking finding was a complex interdigitation between cytoplasmic processes developed by some of the parasitized red cells and those developed by the endothelial cells to which they were attached. Occasionally, cytoplasmic processes arising from marginated parasitized red cells completely penetrated the endothelial cell and emerged extravascularly. Several parasitized red cells were also found extravascularly between haemopoietic cells. Sequestration of parasitized red cells within small blood vessels may play a part in the pathogenesis not only of the encephalopathy of cerebral malaria but also of the bone marrow dysfunction in severe malaria. PMID- 3304392 TI - Beta 2-microglobulin, lysozyme and lactoferrin in cerebrospinal fluid in patients with lymphoma or leukaemia: relationship to CNS involvement and the effect of prophylactic intrathecal treatment with methotrexate. AB - Central nervous system (CNS) involvement in patients with leukaemia or lymphoma presents a diagnostic problem. This study was conducted to test whether combined measurements of various cellular markers such as beta 2-microglobulin (beta 2m), lactoferrin (LF) and lysozyme (LYS) in the cerebrospinal fluid (CSF) might aid in the diagnosis of CNS involvement in such patients. Forty-two patients were studied. Sixteen were considered to have CNS involvement and 26 showed no signs of such involvement. In the group with symptoms or signs of CNS involvement, nine patients out of 12 had increased total protein in CSF, 14 of 14 increased beta 2m, 14 of 16 increased LYS and five of 15 increased LF. In patients without CNS involvement total protein was increased in four of 25, beta 2m in three of 21, LYS in four of 28 and LF in one of 28 patients. The differences were statistically significant (P less than 0.01, P less than 0.001, P less than 0.001 and P less than 0.05, respectively). Prophylactic intrathecal methotrexate treatment in patients with acute lymphoblastic leukaemia caused an increase in the CSF of beta 2m, LYS and LF but not of total protein, which may reflect a drug induced inflammatory reaction in the CNS. We conclude that combined measurements of the three cell markers add to our understanding of the cellular reaction to malignant cells in the CNS in leukaemia and lymphoma and may be valuable supplements in the diagnosis of this CNS involvement. PMID- 3304394 TI - Platelet reactions after interaction with cultured Plasmodium falciparum infected erythrocytes. AB - An in vitro model for studying the interaction between normal human platelets and Plasmodium falciparum infected erythrocytes in culture is described. After the interaction, changes in platelet function such as enhanced aggregation response to exogenous ADP and increased secretion of dense granule contents were reproduced. Some of these responses represented manifestations of platelet hypersensitivity described earlier in acute malaria infections in man and mice. Preliminary investigations of the mechanisms involved in such reactions revealed that ADP and thromboxane A2 mechanisms contributed about 79% and 18.5% of the enhanced aggregation response to exogenous stimuli in the system. PMID- 3304393 TI - A microplate ELISA for the detection of platelet alloantibodies: comparison with the platelet immunofluorescence test. AB - An enzyme-linked immunoassay (ELISA) for the detection of platelet alloantibodies has been compared in detail with the platelet immunofluorescence test (PIFT). The ELISA appeared much simpler to perform than the PIFT. Both tests were comparable with regard to reproducibility and sensitivity. Alloantibodies were detected with ELISA and PIFT in 13 out of 14 patients who were refractory to random donor platelets. The value of these tests as a platelet crossmatch assay was determined in a retrospective comparison of the test results and the clinical transfusion responses expressed as the 1 h post-transfusion platelet recovery. 39/41 (95%) negative ELISA crossmatches and 30/33 (91%) negative PIFT crossmatches appeared to be associated with a successful platelet transfusion, whereas 7/10 positive ELISA crossmatches and 2/4 positive PIFT crossmatches appeared to be associated with transfusion failures. The high frequency of 'correct' negative tests indicates the importance of both assays in the prospective selection of compatible platelet donors for alloimmunized patients. However, because of its simplicity, the ELISA appears the method of choice for this purpose. PMID- 3304396 TI - [Insulin secretion and utilization of insulin in piglets after insulin, arginine and glucose loads]. AB - The insulin secretion and utilization dynamics have been investigated in 35 six weeks old healthy piglets in order to find the connection with spontaneous hypoglycemia. The trial to load piglets with insulin showed an average time t1/2 = 4.93 minutes accepted as normal in 10 piglets with the mean increase in body weight equal to 0.19 kg/day, prolonged time t1/2 = 7.56 minutes in 7 piglets with the decreased gain of body weight to 0.108 kg/day, and short time t1/2 = 2.78 minutes with the poor gain of body weight in 6 piglets at the age of 6 weeks. In 10 weeks old piglets the noted time t1/2 was 14.7 minutes. The trial to load piglets with L-arginine--HC1 showed a high insulin secretion amounting to 105.5 microU/ml of plasma in 3 piglets only, assumed as correct, and a low insulin secretion amounting to an average of 20.5 microU/ml of plasma in 10 piglets corresponding, according to the criteria of diagnostics, to the subclinical form of human diabetes mellitus. The glucose tolerance test enabled to distinguish 7 strongly reacting piglets (over 100 microU/ml of plasma), 10 moderately responding piglets (from 20 to 100 microU/ml), and 2 piglets not responding (16 microU/ml) by means of increase in insulin concentration. The differentiated results with the individuals deviations to subclinical values observed in healthy piglets, point to serious difficulties in the maintenance of the equilibrium between insulin secretion and utilization. Excessive secretion lasting over 2 hrs and very fast utilization of insulin as well as the level of glucose not compensated by gluconeogenesis, can be the cause of hypoglycemia. PMID- 3304397 TI - Review: locus of control as a predictor of outcome of psychotherapy. AB - The last 10 years have shown a notable increase in the consideration of locus of control as a variable pertinent to the explanation of outcome in psychotherapy. In particular, a body of research has provided evidence that an internal locus of control orientation facilitates both positive assessments of therapy and favourable outcomes, and that successful outcomes for clients with particular control orientations are facilitated by the degree of structure and directiveness in therapy. There appear to be a number of difficulties with the methods of measurement employed in these studies; in particular, the selection of subject groups and indexes of outcome as well as manipulation of treatment structures may have limited the generalizability of research findings. The possible therapeutic and clinical applications of locus of control in psychotherapy are considered. PMID- 3304395 TI - Occupational hazards in hospitals: risk of infection. AB - In this review of the risk of infection to hospital staff, attention is drawn to the continuing risk presented by hepatitis B and pulmonary tuberculosis, which are more common than diseases such as typhoid fever, brucellosis, histoplasmosis, whooping cough, infectious gastroenteritis, measles, and parotiditis. Other items considered include the susceptibility of female hospital staff to rubella and the importance of their undergoing screening and vaccination; the risks currently presented by epidemic keratoconjunctivitis and by herpes viruses (herpes simplex, varicella zoster, and cytomegalovirus); and the risk of contracting the new infectious diseases (Legionnaires' disease, Marburg disease, Lassa fever, and the acquired immune deficiency syndrome). PMID- 3304398 TI - Stroke and minute distance in pregnancy: a longitudinal study using Doppler ultrasound. AB - Using Doppler ultrasound directed at the aortic arch, stroke and minute distance were measured in 45 normal singleton pregnancies and compared with 42 controls. In the non-pregnant controls, stroke distance was 5% more in the supine than in the left lateral position (P less than 0.01) and during pregnancy this relativity was maintained until 36 weeks gestation. In the supine and left lateral positions respectively, stroke distance was increased by 8% (both) at 4 weeks (P less than 0.05 and NS), by 14 and 11% at 8 weeks (P less than 0.001 and P less than 0.01) and showed a maximum increase of 21 and 20% at 16 weeks gestation (both P less than 0.001). At 40 weeks, supine stroke distance was 14% less than the non pregnant control value (P less than 0.001), and 6% less than the value in the left lateral position (P less than 0.05), which was itself not significantly different from that in the non-pregnant controls. The maximum increase of heart rate was at 32 weeks, by 24% in the supine and by 19% in the left lateral position (both P less than 0.001). Minute distance was maximally increased by 37% in the supine at 16 weeks (P less than 0.001) and by 30% in the left lateral position at 24 weeks (P less than 0.001). Thereafter, minute distance, measured in both positions, declined until at 40 weeks it was not significantly different from the non-pregnant control value. PMID- 3304399 TI - The effect of position and delay on stroke and minute distance in late pregnancy. AB - Stroke and minute distance were measured in 12 women in late pregnancy using Doppler ultrasound. In each patient two sets of measurements were made every 2 min for 20 min in the supine and left lateral positions, the sequence of positions being reversed on the second occasion. Within each of the four 20 min measurement periods there were no significant changes with time in stroke distance, heart rate, or minute distance, or in their coefficients of variation. From this evidence there is no justification for delaying the measurement of cardiac output until a 'steady state' is reached. The measurements were influenced both by the sequence and the position in which they were taken, the effects being additive. Overall, stroke distance was 5.1% greater in the left lateral than in the supine position, heart rate was 3.7% less and minute distance not significantly different. Independent of posture, stroke distance was 6.5% greater in the second period of measurement than in the first, heart rate was 3% less and minute distance 2.8% more. In late pregnancy the relative magnitude of cardiac output in the left lateral and supine positions has to be interpreted in the light of a stepwise increase of aortic blood flow with change of posture. PMID- 3304400 TI - Oestradiol-17 beta and progesterone level changes in peritoneal fluid around the time of ovulation. AB - In 15 women, peritoneal fluid was obtained by either culdocentesis (n = 20) or laparoscopy (n = 3), before (n = 9) and after (n = 14) ovulation. Ultrasound was used for ovulation detection. Before ovulation the mean oestradiol-17 beta level in plasma and peritoneal fluid was not essentially different; the mean progesterone level was significantly higher in peritoneal fluid. After ovulation both the mean oestradiol-17 beta and progesterone levels were significantly higher in peritoneal fluid than in plasma. In peritoneal fluid, there was a wide distribution of individual oestradiol-17 beta values before and after ovulation; no significant difference existed between the mean pre- and postovulatory oestradiol-17 beta level. More consistent changes were seen in peritoneal fluid progesterone levels; the mean level was significantly higher after ovulation. In three subjects, a low postovulatory progesterone level in peritoneal fluid was associated with a cystic luteal structure observed by ultrasound, suggesting a reduced leakage of fluid from the ovulation stigma. PMID- 3304401 TI - Control of menorrhagia by the cyclo-oxygenase inhibitors naproxen sodium and mefenamic acid. AB - Thirty-five patients with menorrhagia were treated in a double-blind crossover study with naproxen sodium and mefenamic acid after measurement of their blood loss during control menstrual cycles. Treatment with these compounds reduced the excessive bleeding by an average of 46 and 47% respectively. Drugs in the prostaglandin synthetase inhibitor group are considered to have an important place in the treatment of menorrhagia. PMID- 3304402 TI - Cord prolapse--can we save more babies? Case reports. PMID- 3304403 TI - The Newbury Maternity Care Study: a randomized controlled trial to assess a policy of women holding their own obstetric records. AB - To assess a policy of women holding and thus having constant access to their own obstetric records, 290 women attending a peripheral consultant clinic in Newbury, West Berkshire, were randomly allocated to hold either their full case notes, or the more usual co-operation card. Women holding their full records were significantly more likely to feel in control of their antenatal care (rate ratio 1.45; 95% confidence interval 1.08-1.95) and to feel it was easier to talk to doctors and midwives (rate ratio 1.73; 95% confidence interval 1.16-2.59). No other beneficial effects were detected. Asked about their preferences for any subsequent pregnancies, women holding their own records in the index pregnancy were more likely to say they would prefer to hold the same kind of record again in a subsequent pregnancy than were women holding a co-operation card (rate ratio 1.56; 95% confidence interval 1.34-1.81). There was no evidence of negative effects. In particular, women holding their case notes did not feel more anxious than co-operation card holders. The policy of women holding their notes resulted in savings in clerical time, without evidence of an increase in the rate of lost notes. PMID- 3304404 TI - The effect of fetal heart rate on umbilical artery flow velocity waveforms. AB - Umbilical artery flow velocity waveforms were obtained using continuous wave Doppler ultrasound in 85 normal pregnancies (25 antepartum, 60 intrapartum) to examine the relation between fetal heart rate, end systolic/end diastolic ratio (A/B ratio) and resistance index (RI). Our results demonstrated a significant negative correlation between fetal heart rate, A/B ratio and RI (in the antepartum group r = -0.49, and in the labouring group r = -0.65). It is therefore important when performing mathematical analysis of umbilical artery flow velocity profiles to make a statistical allowance for fetal heart rate. PMID- 3304405 TI - Mortality and morbidity in infants born between 20 and 28 weeks gestation. AB - Of 149 infants with ultrasound evidence of gestational age, born in Ninewells Hospital at between 20 and 28 weeks gestation over a 5-year period, 50 were alive at birth. Of these infants, 21 died within 1 week, a further three died within 1 month and a further two within 18 months. Of the 24 survivors, 8 (33%) have significant handicap. The obstetric factors leading to delivery and the mode of delivery are discussed. PMID- 3304406 TI - Amniotic fluid and fetal tissues are not heated by obstetric ultrasound scanning. AB - Amniotic fluid temperature in first trimester pregnancies and fetal subcutaneous tissue and amniotic fluid temperature in second trimester pregnancies, measured by a thermocouple probe, did not increase during sector, linear-array or Doppler ultrasound scanning. The mean fetal muscle temperature was higher (36.9 degrees C) than mean amniotic fluid temperature (36.6 degrees C) during the second trimester. PMID- 3304407 TI - An immunohistochemical study of steroid binding by endometrial glandular epithelial cells throughout the menstrual cycle. AB - An immunohistochemical technique was used to demonstrate oestrogen and progesterone binding by endometrial glandular epithelial cells at various stages of the menstrual cycle. A cross-section of steroid binding sites, including low affinity, concentration dependent Type II and III binding sites, were demonstrated but only in cells which contain the classical high affinity receptor. The technique demonstrated both free binding sites and receptor-hormone complexes within the cytoplasm but was poorly effective in demonstrating nuclear complexes. Oestrogen binding sites were shown to reach a peak during the late proliferative and early secretory phases of the cycle: oestrogen binding capacity remained high during the mid and late secretory phases. Progesterone binding capacity rose progressively throughout the proliferative and early secretory phase. PMID- 3304408 TI - Pregnancy and delivery by caesarean section in a patient with transposition of the great arteries and single ventricle. Case report. PMID- 3304409 TI - An evaluation of the anti-inflammatory effect of flurbiprofen after cataract extraction. AB - Thirty-eight patients requiring cataract extraction were randomly assigned to receive either flurbiprofen 100 mg twice daily in addition to routine postoperative therapy or the routine therapy alone. The trial was single blind with clinical assessments at postoperative days 1, 3, 7, 14, and 28. All measures of inflammatory response were significantly less in the group of patients receiving flurbiprofen, and in most cases the clinician's assessment as to which group each patient belonged to was correct. This trial suggests that flurbiprofen reduces inflammatory response in the eye in the first few days following cataract extraction and may therefore reduce the risk of severe and potentially disastrous reactions which sometimes occur. PMID- 3304410 TI - A study of aqueous and serum levels of ceftazidime following subconjunctival administration. AB - Patients undergoing cataract surgery may develop an infective endophthalmitis postoperatively which may result in the loss of an eye. This study was carried out to measure aqueous humour levels and to assess patients' tolerance of ceftazidime, a potent antipseudomonal cephalosporin, given subconjunctivally. Eighteen patients received 125 mg ceftazidime subconjunctivally before they underwent routine cataract surgery. A further two patients received 62.5 mg subconjunctivally. The results show good penetration into the aqueous humour well above the minimum inhibitory concentrations (MICs) of possible pathogens. There were no postoperative infections, no local irritation, and no systemic side effects. PMID- 3304411 TI - Clearing media for the eye. AB - Non-ionic radiological contrast media have a high refractive index and are not toxic to living cells. They can be used as clearing media for unfixed ocular tissues. Corneal opacities in the rabbit could be made transparent, on a temporary basis, by soaking the stroma in contrast media, and no ill effects on the eye were noted. PMID- 3304413 TI - Necrotising fasciitis caused by dental infection. AB - A case of necrotising fasciitis caused by dental infection is presented, which resulted in severe mutilation but the patient survived. The diagnosis and management of this condition is discussed. PMID- 3304412 TI - The influence of methylprednisolone on post-operative swelling following oral surgery. AB - This study compares the influence of methylprednisolone with that of a placebo on post-operative pain and swelling, and on healing. Twenty patients undergoing the removal of symmetrically placed bilateral lower third molar teeth under local analgesia by the same operator one side at a time were used. In each individual patient, for one side 40 mg methylprednisolone (Solumedrone Upjohn Limited) was given intravenously immediately preoperatively and for the other side a placebo was given on a double-blind random basis. The results showed that the mean post operative swelling at 24 hours was reduced by 56% (p = .0003) when methylprednisolone was used compared with the opposite side of the same patient when the placebo was used. The severity of pain also was reduced over the first day but healing was similar for each side. Sixteen patients indicated a preference for the overall post-operative course when methylprednisolone was used. PMID- 3304414 TI - Necrotising fasciitis of the orbit. AB - A rare case of necrotising fasciitis affecting the face is described which, following prompt treatment and reconstruction, resulted in a successful outcome. PMID- 3304415 TI - Diet composition and lipoprotein lipase (EC 3.1.1.34) activity in human obesity. AB - 1. Adipose tissue lipoprotein lipase (EC 3.1.1.34; AT-LPL), a rate-limiting enzyme in triglyceride storage in adipose tissue, is hormonally regulated and may be important in the maintenance of obesity. 2. In twelve obese women, AT-LPL activity was measured before weight loss, during weight loss and after 1 and 2 weeks of weight maintenance on either a high-carbohydrate or a high-protein diet. 3. When related to tissue weight, AT-LPL activity during the 2 weeks of weight maintenance was higher than the initial AT-LPL activity; there was no difference when activity was expressed per cell. 4. Changes in AT-LPL activity were not affected by diet composition. AT-LPL activity correlated with insulin levels and a change in insulin sensitivity of AT-LPL was observed after weight loss. PMID- 3304416 TI - Effects on plasma insulin of intermittent infusions of propionic acid, glucose or casein into the alimentary tract of non-lactating cows maintained on a liquid diet. AB - 1. An experiment was conducted using three non-lactating cows completely maintained by infusions of volatile fatty acids into the rumen, and casein into the abomasum. Plasma insulin responses to propionic acid, glucose or casein were recorded. Further information was obtained using protein-free infusions. 2. When part of the propionic acid was infused into the rumen in a twice-daily 3 h dose and the remainder infused continuously with acetic and butyric acids and casein, there were large increases in the concentrations of propionic acid and insulin in the jugular blood. When glucose, corresponding in energy to that supplied by the intermittent propionic acid infusions was similarly infused, the plasma levels of glucose and insulin were increased. Glucose appeared to stimulate a greater increase in insulin than did propionic acid. Casein infused into the abomasum in intermittent doses produced a rise in plasma insulin, but smaller than that observed with propionic acid or with glucose. 3. The protein-free infusion was characterized by a lower concentration of insulin in the blood plasma, a reduction in plasma urea and free amino nitrogen and unchanged plasma glucose. PMID- 3304417 TI - Microbial protein and peptide metabolism in rumen fluid from faunated and ciliate free sheep. AB - 1. Protease and deaminase activities and the metabolism of peptides were measured in rumen fluid from ciliate-free sheep and from sheep with a limited population of small entodinia. The same measurements were repeated following inoculation of the latter group with a more typical mixed ciliate population. 2. Protease and dialanine uptake activities of mixed rumen micro-organisms were not significantly influenced by protozoa. Trialanine uptake, leucine aminopeptidase (EC 3.4.11.1), deaminase and trypsin-like protease activities were 70, 107, 73 and 91% higher with the limited population, and 72, 58, 64 and 55% higher when mixed protozoa were present, indicating a major role for the protozoa in these activities. PMID- 3304418 TI - Use of site-directed mutagenesis to study the mechanism of a membrane transport protein. PMID- 3304420 TI - An engineered disulfide bond in dihydrofolate reductase. AB - Substitution of cysteine for proline-39 in Escherichia coli dihydrofolate reductase by oligonucleotide-directed mutagenesis positions the new cysteine adjacent to already existing cysteine-85. When the mutant protein is expressed in the E. coli cytosol, the cysteine sulfur atoms are found, by X-ray crystallographic analysis, to be in van der Waals contact but not covalently bonded to one another. In vitro oxidation by dithionitrobenzoate results in formation of a disulfide bond between residues 39 and 85 with a geometry close to that of the commonly observed left-handed spiral. Comparison of 2.0-A-refined crystal structures of the oxidized (cross-linked) and reduced (un-cross-linked) forms of the mutant enzyme shows that the conformation of the enzyme molecule was not appreciably affected by formation of the disulfide bond but that details of the molecule's thermal motion were altered. The disulfide-cross-linked enzyme is at least 1.8 kcal/mol more stable with respect to unfolding, as measured by guanidine hydrochloride denaturation, than either the wild-type or the reduced (un-cross-linked) mutant enzyme. Nevertheless, the cross-linked form is not more resistant to thermal denaturation. Moreover, the appearance of intermediates in the guanidine hydrochloride denaturation profile and urea-gradient polyacrylamide gels indicates that the folding/unfolding pathway of the disulfide-cross-linked enzyme has changed significantly. PMID- 3304419 TI - Epidermal growth factor binding protein: identification of a different protein. AB - Partial amino acid sequence analysis of epidermal growth factor binding protein (EGF-BP), an arginine esteropeptidase that specifically associates with EGF to form a high molecular weight complex in male mouse submandibular glands, has revealed a single, distinct protein that is different from three previously reported forms of EGF-BP. This protein shows substantial sequence homology with these other putative forms of EGF-BP as well as with a large family of kallikreins expressed in the mouse submandibular gland. Purified EGF-BP contains three polypeptide chains as a result of two internal cleavages at residues 87-88 and 140-141. These modifications may represent processing events that are critical for determining the binding specificity of EGF-BP, since they occur within regions surrounding the substrate binding site. PMID- 3304421 TI - Amino acid sequence of sialic acid binding lectin from frog (Rana catesbeiana) eggs. AB - The complete amino acid sequence of sialic acid binding lectin from frog (Rana catesbeiana) egg is presented. The 111-residue sequence was determined by the analysis of peptides generated by digestion of the S-carboxymethylated protein with Achromobacter protease I, chymotrypsin, or cyanogen bromide. The sequence is unique and not homologous to any known protein sequence. The protein may represent a new type of lectin. PMID- 3304422 TI - Kinetic studies of recA protein binding to a fluorescent single-stranded polynucleotide. AB - Fluorescence spectroscopy was used to investigate the binding of Escherichia coli recA protein to a single-stranded polynucleotide. Poly(deoxy-1,N6-ethenoadenylic acid) was prepared by reaction of chloroacetaldehyde with poly(deoxyadenylic acid). The fluorescence of poly(deoxy-1,N6-ethenoadenylic acid) was enhanced upon recA protein binding. The kinetics of the binding process were studied as a function of several parameters: ionic concentration (KCl and MgCl2), pH, nature of the nucleoside triphosphate [adenosine 5'-triphosphate or adenosine 5'-O (gamma-thiotriphosphate)], protein and polynucleotide concentrations, polynucleotide chain length, and order of sequential additions. The observed kinetic curves exhibited a lag phase followed by a slow binding process characteristic of a nucleation-elongation mechanism with an additional slow step governing the rate of the association process. The lag phase reflecting the nucleation step was not observed when the protein was first bound to the polynucleotide before addition of adenosine 5'-triphosphate. Adenosine 5' triphosphate induced a dissociation of the recA protein, which was immediately followed by binding of the recA-adenosine 5'-triphosphate-Mg2+ ternary complex. The origin of this "mnemonic effect" and of the different kinetic steps is discussed with respect to protein conformational changes and aggregation phenomena. PMID- 3304423 TI - Molecular cloning of human cathepsin G: structural similarity to mast cell and cytotoxic T lymphocyte proteinases. AB - Human cathepsin G is a serine proteinase with chymotrypsin-like specificity found in both polymorphonuclear leukocytes (neutrophils) and the U937 leukemic cell line. Utilizing RNA from the latter, we have constructed a cDNA library in lambda gt11 and isolated a clone which apparently codes for the complete amino acid sequence of this enzyme. Analysis of the sequence reveals homology with rat mast cell proteinase II (47%) but a greater degree of identity (56%) with a product of activated mouse cytotoxic T lymphocytes. The close relationship between the three proteins indicates similarities in substrate specificity and in biosynthesis which we predict involves removal of a two amino acid activation peptide during or just before packaging into their respective storage granules. PMID- 3304424 TI - In vitro synthesis of 16S ribosomal RNA containing single base changes and assembly into a functional 30S ribosome. AB - Functional 30S ribosomes were reconstructed from total Escherichia coli 30S ribosomal proteins and 16S ribosomal RNA synthesized in vitro by T7 RNA polymerase. Up to 700 mol of RNA/mol of template could be obtained. The transcript lacked all ten normally modified bases and had three additional 5' G residues, an A----G change at position 2, and, in 22% of the molecules, one or two extra 3' residues. The synthetic 16S RNA could be assembled into a particle that cosedimented with authentic 30S and was indistinguishable from 30S by electron microscopy. When supplemented with the 50S subunit, the particles bound tRNA to the 70S P site in a codon- and Mg2+-dependent manner. The specific binding activity was 94% that of particles reconstituted with natural rRNA and 52% that of native 30S. Cross-linking to P site bound tRNA was also preserved. Changing C-1400, the residue known to be close to the anticodon of P site bound tRNA, to A had little effect on reconstitution, but the C----G substitution caused a marked inhibition of assembly. tRNA could bind to both reconstituted mutants, but cross-linking was greatly reduced. These results show that none of the modified bases of 16S RNA are essential for P site binding and that position 1400 may be more important for ribosome assembly than for tRNA binding. Base specific in vitro mutagenesis can now be used to explore in detail the functional properties of individual residues in ribosomal RNA. PMID- 3304425 TI - Molecular cloning of a human gastric lipase and expression of the enzyme in yeast. AB - The molecular cloning of a cDNA coding for human gastric lipase and its expression in yeast is described. A lipase present in human gastric aspirates was purified and its N-terminal amino-acid sequence was determined. This was found to be homologous with the N-terminal sequence of rat lingual lipase. A cDNA library was constructed from mRNA isolated from human stomach tissue and probed with cloned rat lingual lipase DNA. One clone, pGL17, consisting of approximately 1450 base-pairs, contained the entire coding sequence for a human gastric lipase. The amino-acid sequence from the isolated protein and the DNA sequence obtained from the cloned gene indicated that human gastric lipase consists of a 379 amino acid polypeptide with an unglycosylated Mr of 43,162. Human gastric lipase and rat lingual lipase amino-acid sequences were closely homologous but were unrelated to porcine pancreatic lipase apart from a 6 amino-acid sequence around the essential Ser-152 of porcine pancreatic lipase. A yeast expression plasmid containing the phosphoglycerate kinase promoter and terminator sequences together with the human gastric lipase gene was constructed. Yeast transformed with this vector synthesised the lipolytically active enzyme. PMID- 3304426 TI - Purification, characterization and substrate specificity of a basic proteinase in the venom of habu (Trimeresurus flavoviridis). AB - A basic proteinase was purified and characterized from the venom of Habu (Trimeresurus flavoviridis). Its molecular weight, isoelectric point and optimum pH were approx. 24,000, 9.2 and 9, respectively. Susceptibility to several reagents was examined. The proteinase had endopeptidase activity cleaving the Gly Leu bond in synthetic peptides but no exopeptidase activity. It did not hydrolyze a peptide, Z-Gly-Pro-Leu-Gly-Pro, which had been a good substrate for the major proteinase in the venom. The proteinase cleaved oxidized insulin B chain at five positions: His10-Leu11, Ala14-Leu15, Tyr16-Leu17, Gly23-Phe24 and Phe24-Phe25. From the disappearance of intermediate peptides and the peptides accumulated, the order and the intensity of cleavage of these positions were determined, and the substrate specificity was compared with those hitherto described for hemorrhagic and nonhemorrhagic venom proteinases. PMID- 3304427 TI - Activation of serine sulphydrase from baker's yeast (Saccharomyces cerevisiae) by vanadate. AB - Vanadate stimulates the liberation of H2S from cysteine in intact cells of baker's yeast (Saccharomyces cerevisiae) with a maximal increase of 60% at 10 microM NH4VO3. Protein separation from crude yeast extract yielded two active protein fractions which were found to catalyze the degradation of cysteine to H2S, pyruvate and ammonia or H2S and serine, respectively, thus characterizing them as cysteine desulphydrase and serine sulphydrase. Only the latter enzyme was found to be activated by vanadate, showing optimal enhancement of about 100% at 10 microM NH4VO3. PMID- 3304428 TI - Purification and properties of a proteinase from Vipera lebetina (snake) venom. AB - A proteinase from the venom of Vipera lebetina was purified by chromatography on Sephadex G-100 and CM-cellulose. The purified proteinase was homogeneous on SDS polyacrylamide gel electrophoresis and consisted of a single chain with molecular weight of 37,000 +/- 1500. The isoelectric point of the proteinase was over 10. The enzyme was active on casein but not on esters and amides of arginine. It split the oxidized insulin B-chain at the peptide bonds of Tyr16-Leu17, Phe24 Phe25 and Phe25-Tyr26, and glucagon at the bonds Tyr10-Ser11, Leu14-Asp15 and Leu26-Met27. The enzyme was inhibited by DFP and PMSF, and partially by soybean trypsin inhibitor, but not with EDTA. PMID- 3304429 TI - The effect of insulin, serum and dexamethasone on mRNA levels for the insulin receptor in the human lymphoblastoic cell line IM-9. AB - The effect of insulin, serum and dexamethasone on mRNA levels in the insulin receptor in the human lymphoblastoic cell line IM-9 was examined. To this end, mRNA levels were quantitated by Northern blot analysis using a labeled cDNA probe for the insulin receptor. The presence of 0.1 microM dexamethasone in the medium had a strong stimulatory effect on mRNA levels in insulin receptor, suggesting the presence of a glucocorticoid inducible enhancer element near the insulin receptor gene. Also, the nature of the serum had an effect on insulin receptor mRNA levels, as cells maintained in 10% fetal calf serum had insulin receptor mRNA levels that were 40-50% of those found in IM-9 cells maintained in 1% newborn serum. Variations in insulin receptor mRNA levels led in each situation to concordant variations in insulin binding. Insulin levels of up to 1 microM had no effect on hybridizable insulin receptor mRNA levels making an insulin-induced feed-back mechanism on gene expression or mRNA stability unlikely. PMID- 3304430 TI - [Effect of copper ions on the photochemical activity of quinacrine and its interaction with DNA]. AB - The influence of cuprum ions on the interaction between the antimalarial drug quinacrine (QA) and DNA is studied by polarized laser luminescence spectroscopy and fluorescence microscopy at molecular and cellular levels. An alteration of quinacrine luminescence intensity in complex with DNA caused by cuprum ions is explained in terms of redistribution of QA molecules from quenching GC- to fluorescent AT-DNA binding sites due to the competition of Cu2+ with the dye. Mechanisms of component interactions in the triplex "DNA-QA-Cu2+" in model and cellular systems are shown to be in qualitative agreement. QA photodynamic activity change caused by Cu2+ action is explained on the basis of the ideas being developed. PMID- 3304431 TI - [Protein damage after treatment with ozone of protoplasts and isolated E. coli membranes]. AB - The features of ozone-induced damage of E. coli plasma membrane proteins are investigated. A conclusion is made that protein fluorescence quenching is connected with modification of amino acid residues in the vicinity of tryptophane residues. Such modification may be a consequence of reaction with either ozone itself or products of its interaction with membrane lipids and/or proteins. The suggestion of Goldstein and McDonagh that ozone has a predilection for more hydrophilical membrane domains is confirmed. The data obtained are in agreement with a supposition about the leading role of proteins in deleterious action of ozone on cells. PMID- 3304432 TI - [Fluorescence of rhodopsins and its relation to primary processes of light energy transformation]. AB - A new area of the investigation of visual and bacterial rhodopsins--fluorescence spectroscopy of the pigments is discussed. Fluorescence properties are considered in relation to photochemical transformations of the pigments at low temperatures. A number of fluorescent states of the pigments are described. It is shown that the excited states of bacteriorhodopsin and visual rhodopsin are characterized by a series of common features. The analysis of general properties of the pigments excited states allows a conclusion that the singlet excited states take part in the photoreaction. The photoreaction scheme is discussed in which structural changes of the chromophore take place already in the excited state. PMID- 3304433 TI - [Analysis of the interpopulational interactions in a 2-component bacterial system of Micavibrio admirandus--Escherichia coli]. PMID- 3304434 TI - [Reaction of the hematopoietic system in mice to the administration of virulent and avirulent strains of Shigella flexneri 2A]. AB - The influence of live bacteria and antigenic preparations of virulent and avirulent stains of Shigella flexneri 2a on the endogenous splenic colony formation in murine hematopoietic cells has been studied. The different stimulating activity of live microbial cells of virulent and avirulent strains Shigella flexneri 2a and their antigenic preparations on the endogenous colony formation has been shown. The effect observed depends on the preparation doses and time of their administration before irradiation of the animals. The stimulating influence on the development of hemopoiesis endogenous foci may be conditioned by the action of heat-labile products of the live microbial cells and closely correlates with the virulence of strains studied. PMID- 3304435 TI - Effect of aryl 4-guanidinobenzoates on the acrosin activity of human spermatozoa. AB - Certain aryl 4-guanidinobenzoates (AGs; inhibitors of proteinases, including the sperm enzyme acrosin) have been shown to be more potent vaginal contraceptives in rabbits and less toxic than nonoxynol-9, the active ingredient of most marketed vaginal contraceptive formulations. To determine if these AGs can contact sperm and inhibit acrosin when mixed with the entire human ejaculate for a short period of time (roughly imitating clinical conditions), the inhibitors were added to semen at various concentrations for 2 min, after which the seminal plasma and unbound inhibitor were removed from the sperm by Ficoll centrifugation. Subsequently, the total arginine amidolytic activity of the spermatozoa was determined spectrophotometrically after a combined treatment that resulted in extraction, proacrosin activation, and reaction with substrate. Dose-response curves were prepared. All AGs studied were effective inhibitors of the amidolytic activity under these conditions, with ED50 values (the dose levels at which half of the acrosin associated with 10(6) sperm is inhibited) ranging from 10(-5) to 10(-7) M. To determine the effect on the proteolytic activity of individual spermatozoa, the experiment was repeated with 4'-acetamidophenyl 4 guanidinobenzoate (AGB), and the protease released from the sperm was measured by the gelatin-plate assay. The inhibition results were similar to those obtained by extraction of the spermatozoa and measurement of amidolytic activity. Thus, when mixed with the human ejaculate, AGs interact rapidly with spermatozoa to inhibit both their arginine amidolytic and proteolytic activity (probably due primarily or only to inhibition of acrosin) and remain bound even after removal of the seminal plasma. These data encourage further study of the compounds for contraceptive purposes. PMID- 3304436 TI - Steroid feedback inhibition of pulsatile secretion of gonadotropin-releasing hormone in the ewe. AB - The long-term negative feedback effects of sustained elevations in circulating estradiol and progesterone on the pulsatile secretion of gonadotropin-releasing hormone (GnRH) and luteinizing hormone (LH) were evaluated in the ewe following ovariectomy during the mid-late anestrous and early breeding seasons. GnRH secretion was monitored in serial samples of hypophyseal portal blood. Steroids were administered from the time of ovariectomy by s.c. Silastic implants, which maintained plasma concentrations of estradiol and progesterone at levels resembling those that circulate during the mid-luteal phase of the estrous cycle; control ewes did not receive steroidal replacement. Analysis of hormonal pulse patterns in serial samples during 6-h periods on Days 8-10 after ovariectomy disclosed discrete, concurrent pulses of GnRH in hypothalamo-hypophyseal portal blood and LH in peripheral blood of untreated ovariectomized ewes. These pulses occurred every 97 min on the average. Treatment with either estradiol or progesterone greatly diminished or abolished detectable pulsatile secretion of GnRH and LH, infrequent pulses being evident in only 3 of 19 steroid-treated ewes. No major seasonal difference was observed in GnRH or LH pulse patterns in any group of ewes. Our findings in the ovariectomized ewe provide direct support for the conclusion that the negative-feedback effects of estradiol and progesterone on gonadotropin secretion in the ewe include an action on the brain and a consequent inhibition of pulsatile GnRH secretion. PMID- 3304438 TI - Cooperative lengths of DNA during melting. PMID- 3304437 TI - Luteinizing hormone secretion from the quail pituitary in vitro. AB - An enzymatically dispersed pituitary preparation from Japanese quail (Coturnix coturnix) was used to study the dynamics of gonadotropin release. After an 18-h incubation, the cells were challenged with different luteinizing hormone releasing hormones (LHRH) for 90 min. Using pituitary cells from mature males, mammalian and chicken LHRH I (Gln8-LHRH) had approximately equal luteinizing hormone (LH)-releasing activity whereas chicken LHRH II (His5, Trp7, Tyr8-LHRH) was 8-9 times more potent. The LHRH agonist (Trp6, Pro9-NEt-LHRH) had 15 times greater potency than chicken LHRH I. Pre-incubation with an LHRH antagonist (D Phe2, D-Trp6-LHRH) significantly suppressed LH release. Acid extracts of median eminence released LH from pituitary cells, extracts from short-day and long-day males had equal activity, while tissue extracts from castrated males had significantly greater LH-releasing activity. Pituitary cells from sexually immature males released LH in response to chicken LHRH I in a similar profile to cells from mature males. These data indicate that the quail LHRH receptor in the male recognizes several different molecular species of LHRH and the response to LHRH is comparable between short- and long-day males. Pituitary cells from ovulating females were variably sensitive to LHRH peptides, possibly due to changes in pituitary sensitivity during the ovulatory cycle. Pituitary cells from immature females did not release LH in response to chicken LHRH I. However, pituitary cells from immature females photostimulated for 1 wk displayed a response to chicken LHRH I and II similar to that of pituitary cells from males.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304439 TI - [Chemical resistance of Plasmodium falciparum in Africa. Current situation, implications for chemoprophylaxis]. AB - Resistance of Plasmodium falciparum to antimalarial drugs is a growing worldwide problem in endemic areas. This is particularly obvious with chloroquine resistance which has been spreading throughout Africa since 1978. Initially localized on the Eastern coast of the continent, it has recently reached the Atlantic coast although Western Africa is as yet unaffected. This resistance has most probably arisen in the autochtonous population under the selective pressure of insufficient curative treatments as a result of self medication. It is most prevalent in children of urban areas but is often revealed in non immune expatriates. In addition, moderately resistant parasites in expatriates under chemoprophylaxis may lead to an insidious clinical form with a low or even negative parasitemia which raises diagnostic problems. Prophylactic and therapeutic schemes must take this new situation into account. PMID- 3304441 TI - Burn injury. PMID- 3304440 TI - [Demonstration of anti-laminin antibodies in the serum of healthy subjects]. AB - Antibodies directed against laminin, a glycoprotein of basement membranes, have been sought for in the sera of 347 healthy subjects by a method relying on the agglutination of laminin-coated latex particles. Fifty-five subjects (15.9%) hae been found to be positive, 37 with a titre of 2, 14 with a titre of 4 and 4 with a titer of 8. Applied to 106 patients whose a renal biopsy had been examined by immunofluorescence, the test yielded positive results in 91% of patients with linear deposits as compared to 10.3 and 15.4% respectively in patients presenting with and without granular deposits along the glomerular basement membrane. The titers in anti-laminin antibodies observed in these patients ranged from 2 to 8. The discovery of circulating anti-laminin antibodies in serum from subjects without clinical or subclinical sign of renal impairment rises several questions regarding the pathogenicity of these auto-antibodies and their possible association with genetic or environmental factors. PMID- 3304442 TI - Proton microprobe analysis of 15 elements in pancreatic B cells and exocrine pancreas in diabetic Chinese hamsters. AB - Diabetes mellitus spontaneously develops in certain sublines of non-obese Chinese hamsters, and the diabetic L-subline is known for subnormal pancreatic insulin release in vitro. The cause of the secretory defect is unknown. Freeze-dried pancreas sections from genetically diabetic Chinese hamsters and normal controls were subjected to proton bombardment and the concentration of 15 elements in B cells and acini was calculated from the X-rays emitted. Diabetic B cells contained significantly less Al (-61%) and significantly more Cu (+92%), Mg (+6%) and Rb (+13%) than their normal counterparts. The diabetic acini showed similar, significant changes. The molar ratio between K and Na was about 10 in endocrine as well as exocrine pancreas from both groups of animals, implying that neither sample preparation nor irradiation had induced significant diffusive changes. In conclusion, the high K/Na ratio suggests that the diabetic B cell has a well functioning Na+/K+ pump. However, significant and parallel changes in Al-, Cu-, Mg- and Rb-levels were found in both the B cells and acinar portion of the diabetic pancreas. It is not clear whether these elemental changes cause the islet secretory defect or result from it. PMID- 3304443 TI - Punctualism, non-adaptationism, neutralism and evolution. AB - In its further development the theory of evolution will incorporate molecular biology, synergetics and the theory of information. Using a simple model it is shown that speciation can be similar to phase transition. This is a thermodynamical statement which does not say anything concerning the sharpness and kinetic features of transition. Hence there is no contradiction between punctuated equilibrium and phyletic gradualism. The notion of punctualism can be used in the sense of phase transition. Evolution is directional because of constraints of natural selection due to the structure of organisms already existing and to the possible pathways of development. Correspondingly many characters are non-adaptative. Not only are the structures of proteins important for speciation but also the exact answers to the questions: "how much", "where" and "when"? These answers can be obtained as the results of regulation of genes, particularly of homeiotic regulation. The basis features of the structure of proteins are considered and the sense of the neutral theory is discussed in connection with degeneracy of correlation between the primary structure of a protein, its spatial structure and biological function. Informational aspects of evolution are discussed. Punctualism, non-adaptationism and neutralism form the triad of internally connected features of evolution. The Darwinian theory preserves its fundamental significance. PMID- 3304444 TI - Late effects of polio: historical perspectives. PMID- 3304445 TI - The impact of life support technology upon psychosocial adaptation to the late effects of poliomyelitis. PMID- 3304446 TI - Quantitative electromyography after poliomyelitis. PMID- 3304447 TI - Investigations of neuromuscular performance in post-polio patients: a practical approach. PMID- 3304448 TI - Clinical subtypes, DNA repair efficiency, and therapeutic trials in the post polio syndromes. PMID- 3304449 TI - Glossopharyngeal breathing and noninvasive aids in the management of post-polio respiratory insufficiency. PMID- 3304450 TI - [Permeability of biological barriers of the endocrine organs to serum proteins in guinea pigs]. AB - The experiments on guinea-pigs have established that the vessels of endocrine organs are permeable for autogenic and heterogeneous serum proteins. Parenchymatous cells of these organs play the role of barriers for serum proteins. These parenchymatous cells are responsible for the type of barrier in each endocrine organ. PMID- 3304451 TI - [Cultivation of epidermocytes of experimental animals and man]. AB - Experimental animal and human biopsy material has been evaluated for the possibility of culturing skin epidermocytes. Insulin and hydrocortisone were used as biostimulants of adequate cell proliferation. Morphological studies revealed that the culture obtained exists as a monolayer of epidermocytes free of other skin elements. PMID- 3304452 TI - [Receptors for the secretory component on human thymic lymphocytes. Stimulation of their expression as affected by adenosine, theophylline and a thymic lymphocyte supernatant]. AB - It has been established by indirect immunofluorescence that thymic lymphocytes bear receptors for secretory component (Rsc). The bound secretory component, i. e., in the molecule of secretory IgA, was found to react with a greater number of thymocytes than free secretory component. Such difference may indicate that T-Rsc have higher affinity to the bound secretory component than to free secretory component. However, this needs detailed investigation. The ability of thymocytes to express Rsc depends on the cellular cAMP level, as the treatment with adenosine and theophylline increases the number of cells with Rsc. Supernatant of a 3-hour thymocyte culture was also capable of stimulating the expression of Rsc. It is assumed that secretory component contained in great amounts in the thymus membrane system takes part in the differentiation of T alpha and Tsc cells of the thymus, which repopulate lymphoid organs and regulate their immune reactions. Rsc may also be useful in assessing the state of Tsc subpopulation in different pathological conditions. PMID- 3304453 TI - [Proliferative activity of the hematopoietic stem cell in antigenically stimulated splenectomized mice]. AB - Proliferative activity of hemopoietic bone-marrow stem cells has been studied in splenectomized mice in response to sheep red blood cells (2 X 10(8], pneumococcal polysaccharide (100 micrograms) and lipopolysaccharide E. coli (100 micrograms) injections. Spleen and its lymphoid cellular elements were shown to be of great importance for the regulation of the functional activity of hemopoietic stem cells under the antigenic influence. PMID- 3304454 TI - [Preparation of monoclonal antibodies to nuclear DNA of mammalian cells by immunization with group A streptococcal polysaccharide conjugated with synthetic polyelectrolytes]. AB - Monoclonal antibodies (MAb) were obtained by hybridization of spleen cells from BALB/c mice immunized with streptococcal group A polysaccharide (A-PS) conjugated with synthetic polyelectrolytes (PEL). These MAb reacted with nuclei from human and mouse cells. MAb reacting with nuclei were obtained after prolonged immunization with conjugates and were not formed by hybridization of spleen cells from non-immunized mice or by the immunization with PEL. The investigation of Mab (B1/2 and A5/2) reacting with nuclei has shown that these Mab are directed against DNA and do not react with other tissue substances. No cross-reactions of Mab with A-PS used for immunization have been revealed. Mab B1/2 and A5/2 belong to autoantibodies. PMID- 3304455 TI - [Complementation analysis of derepressed mutants of F-like plasmids of Escherichia coli]. AB - Complementation analysis of a number of conjugative transfer functions was performed in derepressed (drd) mutants of E. coli F-like plasmids. The major part of double plasmid complexes investigated has revealed the formation of complementation transfer inhibitor of Fin V-type, or less frequently--the formation of Fin U-type inhibitor. An additional complementation analysis of drd plasmids defective at Fin V region genes has demonstrated at least three genes (denoted A, B, C) in the structure of this region. PMID- 3304456 TI - Structure-function relationship of human von Willebrand factor. PMID- 3304457 TI - Bipotential cell differentiation of KU-812: evidence of a hybrid cell line that differentiates into basophils and macrophage-like cells. AB - KU-812-F is a subclone of KU-812, which has cytological features similar to the parent clone, and which carries the Philadelphia chromosome. We studied the effects of various chemical agents and serum-free culture (SF-C) condition on its differentiation. The KU-812-F subclone differentiated into macrophage-like cells with phorbol myristate acetate (PMA), but not with other agents. Unexpectedly, under SF-C, KU-812-F cells differentiated into mature basophil-like cells, and the histamine content of cell lysates increased in proportion to maturation. The addition of the condensed supernatant of SF-C promoted the cloning efficiency of KU-812-F cells in semisolid SF-C, whereas the cloning efficiency was reduced in SF-C alone. KU-812-F cells expressed myelomonocytic antigens. Additionally, My4 was induced with PMA and SF-C, but less often. HLA-DR was not expressed in any culture conditions, despite blastic morphology of KU-812-F cells or macrophage like cells induced with PMA. The IgE receptor could not be demonstrated under any conditions. Correspondingly, immature and mature KU-812-F cells did not respond to anti-IgE or concanavalin A (con A), while histamine release was induced with PMA. In conclusion, KU-812-F belongs to the myeloid cell lineage and is at least a bipotential cell that can differentiate into basophils and macrophage-like cells. Although the functions appear to be dissimilar to those of normal basophils, the KU-812-F cell line may be a good model for basophil differentiation. Moreover, KU-812-F cells may provide new insights because they grow in semisolid culture by an autostimulating mechanism. PMID- 3304459 TI - The effects of three recombinant growth factors, IL-3, GM-CSF, and G-CSF, on the blast cells of acute myeloblastic leukemia maintained in short-term suspension culture. AB - The blast stem cells of acute myeloblastic leukemia (AML) respond in cell culture to growth factors by both self-renewal and terminal divisions. Both of these functions have been shown to be stimulated by the recombinant growth factors granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony stimulating factor (G-CSF). In this paper, recombinant gibbon interleukin-3 (IL 3), homologous to human IL-3, was tested on blast cells and compared with the effects of GM-CSF, G-CSF, and medium conditioned by the bladder cell line 5637 (5637-CM). We found that IL-3 was an effective stimulator of blast renewal and terminal divisions. However, great patient-to-patient variation was found. A graphic method of presenting complex comparisons between growth factors is also included. PMID- 3304458 TI - Monoclonal antibody Ki-B3 detects a formalin resistant antigen on normal and neoplastic B cells. AB - A new monoclonal antibody Ki-B3 produced by a fusion with leukemic cells of a centroblastic/centrocytic lymphoma (m.l. follicular) is introduced. This antibody predominantly recognizes B cells of follicular mantle and germinal center cells, as well as plasma cells in normal lymphoid tissue. Furthermore, 80% of all low- and high-grade B cell lymphomas are stained, whereas among T cell lymphomas, only four of 15 T lymphoblastic lymphomas were positive to Ki-B3. All peripheral T cell lymphomas showed a negative reaction. Additionally, Ki-B3 detects a small percentage of monocytes and some myelomonocytic leukemias. All epithelial tissues as well as all sarcomas tested were invariably negative. Ki-B3 precipitates a 220 kiloDalton (kD) molecular weight antigen similar to the leukocyte common antigen. Presumably Ki-B3 detects a subtype of the leukocyte common antigen that is predominantly expressed on mature and immature B cells. As the antigen is formalin resistant, Ki-B3 can be used in routine hematology on paraffin sections for the detection and differential diagnosis of B cell lymphomas. PMID- 3304460 TI - Immunologic reconstitution after haploidentical bone marrow transplantation for immune deficiency disorders: treatment of bone marrow cells with monoclonal antibody CT-2 and complement. AB - Patients with congenital T lymphocyte deficiency disorders received transplants with parental bone marrow depleted of mature T cells by the use of an anti-T cell monoclonal antibody (CT-2) and complement. Our results with 16 consecutive patients (20 transplants) showed rapid engraftment of donor cells; cytoreduction (busulfan, cytosine arabinoside [ara-C], cyclophosphamide) was used in six transplants, and marrow ablation was used in six (ara-C, cyclophosphamide, 1,365 cGy total body irradiation). No patient received prophylactic anti-graft-v-host disease (GVHD) therapy posttransplant, and only one patient developed significant GVHD, which involved the skin, liver, and gastrointestinal tract. Seven others showed some manifestations of GVHD, but these were of minimal clinical significance and required only occasional steroid therapy. Overall, eight patients are alive and well; eight did not survive. Polyclonal immunoglobulin synthesis by donor memory B cells was seen shortly after transplantation, with peak donor-derived serum levels seen approximately 2 months after transplantation. After this initial immunoglobulin synthesis waned, another wave of B cell responses developed. This immunoglobulin response appears to be permanent. T cell functions appeared as soon as 3 weeks after transplantation. This experience in a variety of patients with combined immunodeficiency who received transplants with monoclonal antibody T cell-depleted marrow shows gratifying results with a consistent T and B cell benefit. PMID- 3304462 TI - Biotinylated erythrocytes: in vivo survival and in vitro recovery. AB - Rabbit erythrocytes were biotinylated by reaction with N hydroxysuccinimidobiotin; the average level of biotinylation was 25,000 molecules per erythrocyte. These biotinylated cells exhibited a normal survival rate when reinfused into rabbits. Two studies demonstrated that the biotin label was stable in vivo. The first was a double-labeling experiment where the biotinylated erythrocytes were also labeled with 14C-cyanate; on reinfusion, the loss of biotinylated erythrocytes and 14C-cyanate label occurred in unison. The second study demonstrated that biotinylated erythrocytes that had been reinfused into rabbits could later be selectively isolated by attachment to an avidin support. This technique will facilitate a variety of studies that require the ability to label a specific cohort of cells in vitro and then reisolate those same cells after in vivo recirculation. PMID- 3304461 TI - Long lasting IgG subclass and antibacterial polysaccharide antibody deficiency after allogeneic bone marrow transplantation. AB - Serum IgG subclasses were measured by a competitive indirect immunoassay with monoclonal antibodies in 31 leukemic patients before and after bone marrow transplantation. Antibodies to Hemophilus influenzae type b (Hib) capsular polysaccharide were determined in 28 cases. Abnormally low or borderline subclass (mostly IgG2 and IgG4) levels were found late after transplant in 23 infected and noninfected patients. These levels persisted for as long as 25 months, in association with low or borderline IgA levels in 78% of the cases. IgG2, IgG4, and IgA often showed a parallel evolution, whereas IgG1, IgG3, and IgM often varied together in the opposite way. Class but not subclass deficiencies were more frequent in patients with graft-v-host disease (GVHD). Subclass abnormalities predominated in infected patients, with mean levels correlating with the severity of infections; however, the abnormalities are not clearly predictive of infections in individual cases. Most patients with Hib pneumonia showed virtually no IgG antibody response to Hib, and one-half of the patients had a moderate IgM and IgA response. In the whole series, many sera collected greater than 1 year after graft contained very low or undetectable antibodies. Correlation between anti-Hib antibody and IgG2 levels was significant but weak because of discrepancies that were only partially explained by the subclass distribution of the antibodies. PMID- 3304463 TI - The regulation of human factor V by a neutrophil protease. AB - Neutrophils activated with serum opsonized zymosan, soluble heat-aggregated IgG, and ionophore A23187 in the presence of calcium release a material capable of initially activating factor V. Subsequent inactivation of factor V was only observed with neutrophil releasate derived from IgG and ionophore. In this study we examine the nature of this neutrophil activity and investigate its role in the regulation of factor V/Va. From early in the fractionation it was apparent that the cells contained different enzymes capable of cleaving factor V. The most active of these was isolated and found to be an isomer of human neutrophil elastase. The purified protease caused a dose-dependent activation of isolated factor V to a maximum of threefold. On sodium dodecyl sulfate-polyacrylamide gel electrophoresis, single-chain factor V was cleaved to form intermediates of 100 and 91 kilodaltons (kD). Coagulant activity correlated with the formation of a 97 kD heavy and 77-kD light chain. On prolonged incubation the formed factor Va(e) was inactivated in association with proteolysis of the 97-kD band to smaller peptides and cleavage of the 77-kD light chain to a molecular weight of 75 kD, which is similar to thrombin-activated factor Va light chain. Neutrophil elastase also caused rapid inactivation of thrombin-activated factor V, factor Va(t). These observations suggest that elastase cleaves factor V at sites distinct from that by thrombin and therefore represents a novel factor V activation pattern. It is proposed that upon neutrophil activation elastase is secreted into the plasma milieu to initiate factor V activation. This serves to generate small amounts of thrombin that, in turn, by positive feedback fully activates factor V and thus amplifies the coagulation reaction. PMID- 3304464 TI - Neutrophil elastase produces 52-kD and 30-kD glucocorticoid receptor fragments in the cytosol of human leukemia cells. AB - Characterization of glucocorticoid receptors in leukemia cells is important to understand mechanisms of glucocorticoid resistance but has been impeded by receptor fragmentation in cytosol extracts. We recently found that formation of 52- and 30-kilodalton (kD) glucocorticoid receptor fragments in cytosol of leukemia cells is due to proteolysis and is blocked by diisopropylfluorophosphate (DFP). In the present study, we identify a 28-kD serine protease in cytosol of leukemia cells that binds [3H]DFP and correlates with the formation of 52- and 30 kD receptor fragments. This protease is immunoprecipitated by antiserum to neutrophil elastase. Limited digestion of [3H]dexamethasone-21-mesylate-labeled receptors by purified neutrophil elastase produces 52- and 30-kD receptor fragments. Receptor fragmentation in the cytosol of leukemia cells in inhibited by methoxysuccinyl-alanyl-alanyl-prolyl-valyl-chloromethylketone, a highly specific inhibitor of neutrophil elastase. The addition of as few as 5% neutrophils to a lymphoid cell suspension provides sufficient elastase to produce receptor fragmentation. Our findings indicate that neutrophil elastase is responsible for receptor fragmentation in the cytosol of leukemia cells. The neutrophil elastase may be endogenous to the leukemia cells or may come from neutrophils that contaminate leukemia cell suspensions. PMID- 3304466 TI - Molecular analysis of relapse in chronic myeloid leukemia after allogeneic bone marrow transplantation. AB - Four patients with Philadelphia (Ph') positive chronic myeloid leukemia (CML) were studied before, after, and on relapse following allogeneic bone marrow transplantation (BMT). Southern analysis of DNA from cells collected before and at relapse after BMT was performed in order to investigate the origin of the leukemia at relapse. Using minisatellite probes we showed that the relapse occurred in cells of host origin in all four patients and this was confirmed with a Y chromosome specific probe in two male patients who had a female donor. Furthermore, using two probes for the breakpoint cluster region (bcr) on chromosome 22, we showed that leukemic cells at relapse bore identical rearrangements to those in the disease at time of presentation of each patient. We conclude that relapse in all four patients is due to re-emergence of the original leukemic clone. PMID- 3304467 TI - Unrelated donor bone marrow transplantation therapy for chronic myelogenous leukemia. AB - Eight patients received allogeneic bone marrow transplantation (BMT) as therapy for chronic myelogenous leukemia (CML) using marrow from unrelated donors. In all cases donors and recipients were HLA DR identical and had low MLC reactivity. In three cases recipients received marrow that was identical at the HLA A,B loci. In five cases HLA identity differed for one HLA A locus antigen. The unrelated donor search interval ranged from 2 to 28 months (median, 3 months). All recipients were prepared with a combination of cyclophosphamide, 60 mg/kg/d administered intravenously (IV) (days -6,-5) and with total body irradiation administered in 165 cGy fractions twice daily for four days (days -4, -3, -2, -1). Engraftment occurred in all cases (range, 18 to 48 days; median, 35 days), and return to a complete Philadelphia chromosome (Ph') negative state was documented in six of eight cases. Moderate or severe acute graft v host disease (GVHD) occurred in seven of eight cases, and extensive chronic GVHD in four of six evaluable recipients. A B cell lymphoproliferative disorder developed in one patient. Four recipients have died within 2 to 4 months of transplant. Four of eight patients survive at 11+ to 24+ months following transplantation (median, 15+ months) with normal peripheral blood counts and without evidence of leukemia. Current Karnofsky activity assessments are 90% or 100% in all survivors. Curative therapy of CML has been available only to the minority of patients eligible for sibling donor BMT. Unrelated donor BMT can be effective in the treatment of CML and may be particularly useful in this disorder since the prolonged stable phase of disease offers an opportunity to locate suitable donors. PMID- 3304465 TI - High-dose chemoradiotherapy and autologous bone marrow transplantation for resistant multiple myeloma. AB - Seven patients with advanced multiple myeloma, refractory to therapy with alkylating agent-VAD (vincristine-adriamycin-dexamethasone), received a regimen combining high-dose melphalan with total body irradiation supported by autologous bone marrow transplantation. Very rapid, usually greater than 90% tumor mass reduction was achieved in six patients, regardless of prior chemotherapy responsiveness and marrow plasmacytosis up to 30%. Despite signs of early relapse in three patients (median remission duration of all patients, 15 months), five remain alive and well without further cytotoxic therapy from 2 to 21 months (median, 9+ months). Two patients died, one from surgical complications after transplantation and a second due to persistent neutropenia with fatal pneumonia. This treatment provides meaningful disease control for selected patients with resistant myeloma and a poor prognosis. PMID- 3304468 TI - Molecular genetic rearrangements distinguish pre- and post-bone marrow transplantation lymphoproliferative processes. AB - Chronic myelocytic leukemia (CML) may display a lymphoproliferative phase (lymphoid blast crisis) that is generally of B cell phenotype. Since lymphoproliferative disorders may occur following bone marrow transplantation (BMT), it may be difficult to distinguish posttransplant relapse of CML lymphoid blast crisis from de novo lymphoproliferation. Lymphoid blast crisis cells from a patient with CML displayed immunoglobulin heavy chain gene (C mu) rearrangement before BMT. Following BMT the patient developed a lymphoproliferative disorder involving multiple organs. Clonal rearrangement of C mu was demonstrated in several involved tissues. The rearranged C mu restriction fragment was distinct from that displayed before BMT. Additionally, rearrangement of the breakpoint cluster region (bcr) was demonstrated in the pretransplant blast crisis sample, but not in the posttransplant lymphoproliferation samples, thus confirming that these lymphoproliferative disorders were distinct. Molecular genetic techniques offer powerful diagnostic tools for monitoring the course of patients with CML undergoing BMT. PMID- 3304469 TI - Rejection of allogeneic bone marrow cells. PMID- 3304470 TI - Bone marrow biopsy in chronic lymphocytic leukemia: a review of its prognostic importance. AB - In recent years important advances have been made in predicting the survival of patients with chronic lymphocytic leukemia (CLL). Other prognostic factors in addition to clinical staging systems have proved to be of value. Among them, bone marrow biopsy has emerged as a particularly useful prognostic tool. Patients with nondiffuse bone marrow involvement survive longer than those with diffuse involvement. This parameter is useful for subclassifying clinical stages in low- (nondiffuse patterns) and high- (diffuse patterns) risk groups. The use of a combined clinicopathological staging system for CLL seems advisable. PMID- 3304471 TI - A review of the prognostic role of cytogenetic, phenotypic, morphologic, and immune function characteristics in chronic lymphocytic leukemia. AB - Recent reports of successfully completed cytogenetic studies using polyclonal B cell activators demonstrate that trisomy-12 and 14 q+ are the most frequently observed chromosomal abnormalities in B-cell chronic lymphocytic leukemia (CLL). It appears that when trisomy-12 is accompanied by yet another abnormality, the prognosis of patients is uniformly poor. Patients in early stages of CLL retain delayed hypersensitivity reactivity, while those in advanced stages are usually anergic. The lymphocytes from venous blood of patients with CLL appear to retain at least some ability to respond to stimulation with mitogens in early stages, whereas in advanced stages they show no response to mitogens. Serum immunoglobulin levels are normal in the early (0 and I) stages, are markedly decreased in the advanced (III and IV) stages, and are somewhat between these extremes in the intermediate (II) stage of CLL. Prolymphocytic leukemia and prolymphocytoid transformation of CLL are indicators of poor prognosis, while a morphological variant characterized by large granular lymphocyte is associated with good prognosis. At this time it is not possible to ascribe strong prognostic significance to phenotypic features of lymphocytes in B-CLL; however, studies currently in progress may soon provide important insights on this subject. We have reviewed the pertinent literature and we also present a summary of results from our laboratory. PMID- 3304472 TI - Modulation of chronic lymphocytic leukemia (CLL) lymphocyte phenotypes by in vitro incubation with alpha 1 thymosin. AB - In this study an attempt was made to elucidate (1) the level(s) of differentiation arrest of B cells, and (2) whether T-cell functional defects in CLL patients are related to their defective maturation. In addition, an attempt was also made to induce and/or correct maturation of T cells in CLL patients by in vitro incubation with alpha 1 thymosin. In CLL patients and controls, we determined the percentage of T and B cells with T11, T8, T4, C3, and mouse erythrocyte (ME) receptors, along with T-cell functional reactivity (measured by local xenogeneic graft vs host reaction), before and after incubation with alpha 1 thymosin. In about 60% of stable CLL patients, and in 80% of those in the progressive phase of disease, T cells possess receptors for ME and/or C3. After incubation with alpha 1 thymosin, separate analysis of surface markers on T and B cells revealed (along with the induction of T11 receptors on T-cell surface) induction of ME receptors on T and B cells in stable phase and selective loss of ME receptors on B cells in the progressive phase of CLL. After incubation of normal lymphocytes with alpha 1 thymosin, we observed an increase of T8 receptors, no change in expression of T11, and a decrease of T4 receptors along with the increase of the intensity of T-cell functional reactivity. In contrast, in CLL patients following incubation with alpha 1 thymosin, the induction of T8 receptors was less prominent in the progressive than in the stable phase of disease. Furthermore, induction of T8 receptors in CLL patients in the stable phase was accompanied by recovery of impaired or increase of preserved functional T-cell reactivity. In the progressive phase, however, T-cell functional areactivity remained unchanged. The findings suggest that different levels of B cell-differentiation arrest along with defective maturation of T cells might be responsible for the spectrum of disease evolution in CLL. PMID- 3304473 TI - New trends in CLL treatment. AB - We review here results obtained from the various treatment modalities that have been used in CLL patients: chemotherapy; radiotherapy; splenectomy; leukapheresis; monoclonal antibodies and other immunomodulating agents. We conclude that it is still unclear whether patients in stage A (good prognosis) should be treated; intermediate forms of the disease (stage B) should, in most cases, be treated, but a better treatment than chlorambucil has not emerged; results from the Cooperative Group on CLL of Societe Francaise d'Hematologie indicate that significant progress in the therapy of the advanced stage (stage C) has been achieved with the introduction of the CHOP regimen, using low doses of adriamycin; radiotherapy, splenectomy and immunomodulators such as levamizol, interleukins or interferons, and possibly monoclonal antibodies, are now being actively tested; the results are not yet conclusive. PMID- 3304474 TI - Dopamine: precursor or neurotransmitter in sympathetically innervated tissues? AB - Dopamine represents 1-5% of the total catecholamine pool in sympathetically innervated tissues. A substantial proportion of this dopamine is located in vesicles, and nerve activation results in liberation of dopamine as well as noradrenaline. In certain tissues, there is neurochemical and functional evidence for the existence in addition of separate populations of dopaminergic sympathetic nerves. Some of the unsolved questions relating to the neural release of dopamine are: Is intravesicular dopamine in noradrenergic nerves a stable storage pool? Do noradrenergic nerves release dopamine and noradrenaline by identical mechanisms? What physiological roles do the sympathetic dopaminergic nerves play? What are the diagnostic and therapeutic implications of neural dopamine release? PMID- 3304475 TI - Thrombosis and atherosclerosis: regulatory role of interactions among blood components and endothelium. AB - Complex interactions among constituents of blood and components of the vessel wall are involved in the pathogenesis of atherosclerosis and its subsequent thrombotic complications. Alterations in the endothelium are central both to the slowly progressive process of atherogenesis and to the acute events leading to thrombotic occlusion. Recent data, obtained by systematic evaluation of chronologic events that occur in diet-induced atherosclerosis, have extended our understanding of interactive processes among endothelium, monocytes, platelets, vascular smooth muscle cells, and humoral hemostatic elements in atherogenesis. PMID- 3304476 TI - Nuclear DNA content and prognosis in human breast cancer: a static cytophotometric study. AB - Nuclear DNA content was measured by static cytophotometry in smears from breast carcinomas from 80 women, and the results were correlated with other prognostic variables and survival using multivariate statistical analysis. 49% of patients had diploid tumors and 51% hyperdiploid tumors. There was a strong correlation between DNA ploidy and axillary lymph node status, tumor size, ER status, and short term survival (median follow-up 40 months). Of all parameters measured, ploidy showed the strongest correlation with survival, and was a significant prognostic indicator even when other prognostic factors were taken into account. PMID- 3304477 TI - [Mechanisms of malignant transformation]. AB - A meeting sponsored by the Societe Francaise du Cancer has been held on October 3rd 1986 in Villejuif. Some of the most recent developments in the study of malignant transformation were presented. The molecular cloning of the gene altered in the human retinoblastoma, and the role of the myc gene in the shut-off of the immune response illustrated the cellular oncogenes field. The implication of viruses like the HTLV1, the papillomaviruses or the hepatitis B virus in human cancer was largely documented. The hamster papovavirus and some avian leukemogenic viruses were presented as models of animal oncogenic viruses. Finally the biochemical properties of growth factors like the interleukin II or the platelet-derived growth factor (PDGF) were described. PMID- 3304478 TI - [Low-dose aminoglutethimide (500 mg/day) and hydrocortisone (30 mg/day) in advanced cancer of breast]. AB - One hundred-twenty-seven advanced breast cancer patients who had been -for most of them- heavily pretreated with chemo- and/or hormone therapy received 500 mg aminoglutethimide and 30 mg hydrocortisone/day. The response rate was 20% (58% when stabilizations were included); the best responses were observed in skin and node metastases. The response rate in bone metastasis was 16%. The general condition of the patient (according to the Karnofsky index) was improved in 50% of the responders (including stabilizations) and in 23% of the non-responders. The survival of patients who were only stabilized was close to the survival of responders. The tolerability of this treatment was very good. PMID- 3304479 TI - [Metastatic breast cancer. Modality of association of chemotherapy and hormonotherapy. Results of a controlled trial]. AB - Two hundred forty-seven patients with metastatic breast cancer entered into the controlled trial. Its aim was to define the optimal modality of association between hormonotherapy and chemotherapy. Chemotherapy was given a monthly course of an association including: adriamycin: 45 mg/m2 on day 1; cyclophosphamide: 400 mg/m2 on days 1, 2, 3; 5 fluoro-uracil: 500 mg/m2 on days 1, 2, 3; methyl prednisolone: 80 mg/m2 on days 1, 2, 3. Hormonotherapy was tamoxifen (TAM) at the daily dose of 30 mg. 82 patients in group I were given TAM alone for 4 months and then chemotherapy + TAM; 83 patients in group II were given simultaneously TAM + chemotherapy; 82 patients in group III were given chemotherapy alone for 8 months and then TAM + chemotherapy. The response rates in groups I, II and III were respectively of 59, 74 and 62%. The difference in favour of group II was marginally significant. The survival curves were significantly higher in group II and III than in group I (P = 0.04). This result appears as the consequence of the poor prognostic of the sub-group of 45% patients who did not respond to TAM. These results seem to emphasize that target cells of hormonotherapy are not target cells of chemotherapy and that this difference is persisting for long time under treatment, that others modalities of association between chemotherapy and hormonotherapy must be studied with the aim of reducing the kinetic's implication of chronic administration of TAM. PMID- 3304480 TI - Quality of care assessment for breast cancer: how to measure benefits of prevention and therapy in oncology. AB - Over the last few years evaluation of quality of diagnostic and therapeutic care has become one of the most controversial and fastest growing fields of research in many areas of medicine. In this situation, oncology represents a model case as the conditions in which new therapeutic strategies are tested and implemented largely differ from routine practice, both in terms of availability of sophisticated technology and comparability of patient populations. The promising role of health care research for the understanding of factors through which research advances can be generalized to routine clinical practice has only recently being appreciated. From this point of view, the paper discusses the rationale and key findings of a multi-annual++ evaluation program on breast cancer care, underway in Italy since 1980. Special attention is given to how results (such as data on diagnostic delay or non-adherence to recommended treatment guidelines) can be used for the implementation of educational programs, controlled studies and ad hoc demonstration projects. PMID- 3304481 TI - Clinical evaluation: how does it influence medical practice? AB - This paper reviews reports of the effects of clinical evaluations on physician awareness and behavior. Among the reviewed papers, there are 28 studies of the effect of specific randomized clinical trials (RCTs) on 19 different medical practices. After analyzing these 28 papers, there remain two (7%) where the RCT has clear implications for practice, where the pattern of practice reported quantitatively over time conforms fully to the RCT findings, where the RCT preceded the change in the pattern of practice, and where findings from the RCT differ from the results of other forms of evaluation. The majority of the reviewed papers do not support an inference that RCTs have a strong, direct influence in changing established clinical practices. Clinical evaluation is one among many factors bearing on changes in medical practices. Improving the care of patients requires both improved methods of evaluation and more effective translation of the results of evaluation into practice. Evaluations are likely to exert a greater impact on medical practices if they are buttressed by attention to other controllable factors, like channels of communication and environmental constraints and incentives, that affect the adoption and abandonment of medical practices. PMID- 3304482 TI - Alan Gregg and the Rockefeller Foundation's support of Franz Alexander's psychosomatic research. PMID- 3304483 TI - Medical science in thirteenth-century Castile: problems and prospects. PMID- 3304484 TI - Experimental physiology, medical reform, and the politics of education at the University of Heidelberg: a case study. PMID- 3304485 TI - Public health and the production and use of diphtheria antitoxin in Philadelphia. PMID- 3304487 TI - In memoriam: D. V. Subba Reddy (1899-1987). PMID- 3304486 TI - Twins as monsters: Albertus Magnus's theory of the generation of twins and its philosophical context. PMID- 3304488 TI - Stimulus, recording and subject factors influencing ABR diagnostic criteria. AB - If the diagnostic potential of ABR is to be fully realised, then diagnostic criteria applicable in any clinic and with any equipment are needed. The factors, which may vary between clinics and which can influence the value of a diagnostic criterion, are considered and evaluated. The variables in stimulation and recording parameters and the patient variables which must be taken into consideration in order to achieve internationally applicable standards are detailed. Using the I-V interpeak interval as an example of a parameter for which an international standard may be formulated, the effects of both physical and subject variables and the interactions which they show are given. The interactions between these parameters can account for many of the differences found between different clinics and laboratories. The normative data required by each clinic are outlined and suggestions which could lead to an international standard are made. PMID- 3304489 TI - Speech comprehension in the elderly: the effects of cognitive changes. PMID- 3304490 TI - Academic child psychiatry: a personal view. PMID- 3304491 TI - John Shaw Billings, 1838-1913: nineteenth century giant. PMID- 3304492 TI - Postmenopausal osteoporosis. AB - Postmenopausal osteoporosis is a common disabling condition, which is almost completely preventable with oestrogen therapy. Unfortunately unjustified anxiety about the safety of oestrogens still limits the acceptability of this therapy. The role of calcium and the calcium-regulating hormones in the aetiology, prevention and treatment remains unproven. PMID- 3304493 TI - Depression in middle-aged women. PMID- 3304494 TI - Female prostitutes and sexually transmitted diseases. AB - The epidemiology of HIV infection emphasizes the need to be able to identify and communicate with female prostitutes as a group. Health education, screening and the prevention of STD in female prostitutes remains an essential priority for the well-being of the prostitutes, their clients and the health of society. However, these goals will not be achieved by compulsory screening, as this will miss the highest risk group. Instead, increased official recognition and measures to encourage female prostitutes to participate in and communicate with the health care system may result in an improvement in our management of these women. PMID- 3304495 TI - Dementia. AB - Dementia describes the syndrome of generalized cognitive impairment in an alert patient. There are many causes, some of which are treatable and so full investigation is necessary. The main causes are Alzheimer's disease and vascular disease and although no specific treatments are yet available important advances have been made in understanding the biochemical abnormalities involved. PMID- 3304496 TI - How illness affects patients' families. AB - This review describes the impact of illness on patients' families and the importance of this for doctors who wish to involve relatives in rehabilitation programmes. It is essential that studies of such impact employ reliable methodology in assessing patient outcome and relatives' functioning. PMID- 3304497 TI - A computer-based method of measuring facial asymmetry. Results from an assessment of the repair of cleft lip deformities. AB - The appearance of the nose, mouth and nostrils was analysed in two series of unilateral, complete cleft lip patients. A programme was written for use on a BBC microcomputer to measure the symmetry of facial features traced from photographs. Symmetry was measured using one of two methods: determining the area of non overlap when one side was reflected on the other (area method) or calculating the distance from regularly spaced points on the outline of one side to the nearest point on the reflection of the opposite side (curve method). The rankings of the photographs based on these results were compared with the subjective rankings given by a lay panel. The results based on the curve method agreed well with the subjective rankings (P for Spearman Rank Correlation Coefficients = less than 0.02). The technique provides a cheap, simple and quick method of comparing symmetry in groups of patients. PMID- 3304498 TI - Configurational changes within the dermis of meshed split skin grafts: a histological study. AB - By placing a series of vertical cuts through the skin graft, the meshing process increases the area of exposed dermis. This extra dermis contains the cut ends of vessels derived from the subpapillary plexus. Histological examination has shown that each of the skin bridges within the mesh changes shape so that these vessels come to open on to the undersurface of the graft, where they are advantageously placed to participate in revascularisation of the graft. PMID- 3304499 TI - The properties and uses of non-expanded machine-meshed skin grafts. PMID- 3304500 TI - A new approach to the problems encountered with Opsite as a donor site dressing: systemic ethamsylate. PMID- 3304501 TI - A new method using ultrasound for measuring femoral anteversion (torsion): technique and reliability. AB - This paper reports details of a new method using medical ultrasound for measuring femoral anteversion (strictly torsion), and a reliability study of the method separately on each of 10 healthy children and 20 adults. The method involves using a static-image B-mode ultrasound scanner to obtain scans at the hips and knees of the lower limbs. A technique using bone-surface contours is reported for defining, on each hip scan, the head-neck line and, on each knee scan, the transcondylar line. By superimposing the transcondylar line on the head-neck line, the angle of femoral anteversion (torsion) was calculated for each limb. In the reliability study, scans were obtained three times at both hips and knees of each subject. The femoral anteversion was measured for each limb. The intra observer error was within +/- 2.3 degrees (95% confidence limits) between scans, which was not statistically significant for the measured anteversion in each of the right and left femora of children and adults separately. To test the validity of the tracing method used to calculate femoral anteversion, one set of scans from the hip and knee of each subject was measured four times; no significant difference was found between tracings for the measurements of femoral anteversion. The ultrasound method is recommended for clinical use. We consider the static-image B-mode scanner to be the instrument of choice for measuring femoral anteversion in living subjects. PMID- 3304502 TI - Changes in transplanted kidney volume measured by ultrasound. AB - A simple ultrasonic method was used for measuring transplanted kidney volume in 29 patients. Five of these patients developed diabetes mellitus and six women became pregnant following transplantation. Serial measurements were performed over periods of 6-12 months after transplantation. The kidney volume became stable 6 months after transplantation and this volume correlated positively with the renal function. Renal hypertrophy was noted in those transplant patients who developed diabetes mellitus following transplantation and this hypertrophy was associated with improvement in graft function. Transplant volume also rose in acute rejection and returned to normal after appropriate treatment. During pregnancy following transplantation, the transplant volume increased early in pregnancy to return to normal before delivery. This volume increase was also associated with graft function improvement. PMID- 3304503 TI - A new technique for renal allograft biopsy. PMID- 3304504 TI - Peripheral versus central venous contrast injection in digital subtraction angiography. PMID- 3304505 TI - Proceedings of the British Medical Ultrasound Society. Eighteenth annual meeting. Coventry, December 16-18, 1986. Abstracts. PMID- 3304506 TI - The importance of appropriate frequency selection in sonographic gallstone detection. AB - A prospective study was performed on 161 patients referred for gallbladder ultrasound to determine whether routine use of a 5 MHz probe in addition to a standard 3.5 MHz probe provided useful additional information. Seventy-two patients were found to have gallstones. In 26.4% of these patients (19 cases) a confident diagnosis of gallstones was possible only when the 5 MHz probe was used. These results confirm theoretical assertions on the value of high-frequency probes in the evaluation of superficially located organs such as the gallbladder. Our findings lend support to their routine use in cholecystosonography. PMID- 3304507 TI - Scrotal ultrasonography: a clinical evaluation. AB - Two hundred and thirty patients had scrotal ultrasonography over an 18-month period. We report the ultrasound findings, correlation with the clinical diagnosis and, where possible, with the pathological diagnosis. The results show the value of scrotal ultrasonography in clinical practice. Of particular interest is the ultrasonic examination of the clinically normal or impalpable testis and the correct ultrasound diagnosis of testicular tumour in five cases (2% of all cases, 28% of tumours detected) thought clinically to be benign. A brief review of abnormal appearances is included. PMID- 3304508 TI - Ultrasonographic patterns of focal hepatic and splenic lesions in Hodgkin's and non-Hodgkin's lymphoma. AB - The sonographic patterns of focal lesions of the liver and spleen in 26 patients with Hodgkin's disease and non-Hodgkin's lymphoma are described. Thirteen out of 19 hepatic lesions and nine out of 11 splenic lesions corresponded to a nodular lymphomatous involvement. The remaining cases involved benign focal lesions of the liver and spleen. The vast majority of the hepatic and splenic lymphomatous nodules had a hypoechoic pattern with indistinct edges. Target lesions of the liver were seen only in non-Hodgkin's lymphoma. Echogenic lymphomatous nodules could not be detected. All echogenic lesions (three) were biopsied and found to be benign. Whereas a focal liver involvement almost always occurred in combination with hepatomegaly, only two out of nine patients with splenic foci had splenomegaly. The response of hepatic and splenic lymphoma to chemotherapy is described from follow-up examinations in 11 cases. Because of the inherent risk of over-treatment of the false positive interpretation of hepatic nodules, the large-scale use of needle biopsy in sonographically equivocal lesions is strongly advocated. PMID- 3304509 TI - Ultrasonically guided percutaneous inactivation of parathyroid tumours. AB - Four patients with hyperparathyroidism and one parathyroid tumour detected ultrasonically were treated by ultrasonically guided percutaneous injection of ethanol (96%) into the tumour. Normocalcaemia was achieved for a follow-up of 10 months in one patient and of 3 months in another. One patient had a lowered serum calcium level for a follow-up of 5 months. One patient showed no clinical response to treatment but was subsequently shown to have multiglandular involvement at surgical exploration. Ultrasonically guided percutaneous inactivation of solitary parathyroid tumours as an alternative to surgery is discussed. PMID- 3304510 TI - Validation of a digital videodensitometric program analysis for measurement of left ventricular ejection fraction. AB - Left ventricular (LV) function was studied in 30 patients using digital subtraction angiography by the intravenous approach. Each ventriculogram was processed with a specific videodensitometric analysis to determine LV ejection fraction. The program was verified in an experimental set-up consisting of nine latex balloons filled with contrast medium. Its validation has been established by comparing videodensitometric results with classical results supplied by geometric methods. A good correlation was obtained (r = 0.9449) and, furthermore, with experimental models, videodensitometric analysis seemed to be more accurate than geometric analysis. Digital videodensitometry appears to be a valuable and accurate method for quantifying LV function, and a promising technique for determination of the real volumes. PMID- 3304512 TI - Erectile dysfunction: diagnosis and treatment. PMID- 3304511 TI - Misleading technetium-99m DTPA renogram in renal carcinoma. PMID- 3304513 TI - The accuracy and limitations of ultrasound in the assessment of venous extension in renal carcinoma. AB - Ultrasound was used to assess venous extension in 28 patients with renal carcinoma, with particular reference to involvement of the inferior vena cava. The findings were correlated with surgical findings in all except two patients who had gross caval involvement and metastatic disease and in whom surgery was considered inappropriate. In 10 of the 28 patients (36%), a diagnostic ultrasound examination of the cava from the renal veins to the diaphragm was obtained. In four of these, ultrasound showed tumour involvement of the vena cava. In 12 cases (43%) only the intrahepatic part of the cava was seen, but the examination nonetheless excluded tumour involvement of the upper cava. Visualisation of the vena cava was impossible in six cases (21%), usually because of bowel gas or obesity; CT scanning provided valuable additional information in two of these cases. Inferior vena cavography confirmed the findings of the less invasive imaging procedures in 10 patients and was falsely positive once. Cavography is now seldom necessary in the assessment of renal carcinoma. PMID- 3304514 TI - Urine eosinophil cationic protein in painful bladder disease. AB - Urine eosinophil cationic protein (U-ECP), blood eosinophils and eosinophils in bladder biopsy specimens were studied in 30 patients with painful bladder disease (15 with detrusor mastocytosis, i.e. interstitial cystitis (IC) (greater than or equal to 28 mast cells/mm2 in the detrusor muscle) and 15 patients without detrusor mastocytosis). In patients with IC the median concentration of U-ECP was 140 arbitrary u/l versus 14 arb. u/l in the remaining patients (P less than 0.001). The mean peripheral leukocyte count was significantly lower in the IC group (P less than 0.05). Tissue infiltration with eosinophils was found in 43% of the bladder biopsies from patients with IC compared with 4% of the biopsies in the remaining patients (P less than 0.05). A negative correlation between peripheral eosinophils and U-ECP was found in the patients with IC (r = 0.52, P less than 0.05). These results suggest that eosinophils are attracted to the inflammatory site in the bladder wall where ECP is released. Eosinophils thus seem to participate actively in the inflammatory process. U-ECP seems to provide valuable diagnostic information when diagnosing IC in patients with painful bladder disease. It is suggested that ECP might be involved in the process of tissue destruction in IC. PMID- 3304515 TI - Intravesical prostaglandin F2 for promoting bladder emptying after surgery for female stress incontinence. AB - Prostaglandin F2 alpha 10 mg was administered intravesically in a double-blind placebo-controlled study to promote micturition in cases of urinary retention after operative treatment of urinary stress incontinence in women. Fifteen of 18 patients (83%) succeeded in voiding after treatment with prostaglandin F2 alpha, but the placebo was ineffective in all 18 patients (P less than 0.001). Although the effect of prostaglandin F2 alpha on bladder muscle contraction was short lived, it seemed to enhance the restoration of bladder motor function with no serious side effects, and thus to be clinically useful in the treatment of post operative urinary retention. PMID- 3304516 TI - Intravesical migration of a rectal foreign body. PMID- 3304517 TI - Appraisal of the management of bile duct stones. PMID- 3304518 TI - Five year results of a randomized trial of adjuvant 5-fluorouracil and levamisole in colorectal cancer. AB - Following curative surgery for colorectal cancer 141 patients were randomized to receive a 6 month course of 5-fluorouracil (5FU) with or without postoperative levamisole or supportive treatment only. The patients have been followed up for a minimum of 5 years and 52 per cent of patients in the control group, 44 per cent of the 5FU group and 32 per cent of the 5FU/levamisole group have died of tumour recurrence. This represents a significant survival advantage in the patients receiving levamisole, even when other patient and tumour factors are allowed for. PMID- 3304519 TI - Early surgical history of phaeochromocytoma. PMID- 3304520 TI - Balloon tamponade for the control of Mallory-Weiss haemorrhage in patients with coagulation defects. PMID- 3304521 TI - Use of ultrasound scan as a bedside diagnostic aid. PMID- 3304522 TI - Prospective randomized controlled trial of urethral versus suprapubic catheterization. AB - Sixty-six patients requiring catheterization in the course of general surgical operations were randomly allocated into two groups. Of the 34 patients catheterized urethrally 16 developed urinary tract infections whereas of the 32 suprapubically catheterized patients only 2 developed an infection (P less than 0.001). Five patients required recatheterization after removal of their urethral catheters. There were no major complications associated with the use of suprapubic catheters. We propose that, when catheterization is required during a general surgical procedure, the suprapubic route is to be preferred. PMID- 3304523 TI - Controlled trial of occlusive dressings in healing chronic venous ulcers. AB - Fifty-six patients with chronic venous ulcers present for a mean of 2.4 years were randomized to either a new occlusive hydrocolloid dressing (Granuflex, Squibb Surgicare) or a porous non-adherent dressing (N A, Johnson and Johnson). In all patients, dressings were applied beneath a standard graduated compression bandage. There was no difference between the two groups, with complete healing in 21 out of 28 (75 per cent) of occlusive dressing patients and 22 out of 28 (78 per cent) with N A dressings by 12 weeks. Careful graduated compression bandaging achieves healing even in the majority of so-called resistant chronic venous ulcers; there was no additional benefit from applying occlusive dressings which tend to be expensive. PMID- 3304524 TI - Ascaris lumbricoides and intestinal perforation. PMID- 3304525 TI - Cryptogenic Candida albicans cholecystitis. PMID- 3304526 TI - Regressive events in brain development and scenarios for vertebrate brain evolution. AB - The problems of the evolution of varying brain size, the specialization of particular functional systems and overall differences in the relative complexity of brain organization are discussed in terms of alterations of regressive events in neurogenesis (cell death and axon retraction). Three scenarios for evolution, cascade reorganization, parcellation and heterochrony, are considered in light of regressive mechanisms during development. PMID- 3304527 TI - Corticotropin-releasing factor-containing afferents to the inferior colliculus of the rat brain. AB - Using a modified cobalt-glucose oxidase-diaminobenzidine (Co-GOD) method in a combination of horseradish peroxidase (HRP) retrograde tracing and immunohistochemistry, a widespread localization of corticotropin releasing factor like immunoreactive (CRFI) structures in the rat inferior colliculus (IC), and a CRFI-containing pathway from the subthalamus and the hypothalamus to the IC have been observed. By means of the modified Co-GOD method, CRFI cells were detected in almost all the subdivisions of the IC, including the dorsomedial part of the central nucleus, the ventrolateral part of the central nucleus, the pericentral nucleus and the external nucleus. Neural processes with CRFI were observed in all of the above areas. Following HRP injection into the IC, double-labeled cells which contained a homogeneous brown immunoreaction product of CRF and a granular black reaction product of retrogradely transported HRP were identified in the lateral hypothalamic area (LH), zona incerta (ZI) and perifornical hypothalamic area (PeF). These double-labeled cells provide direct evidence for CRFI projections from the LH, ZI and PeF to the IC. Thus, the present study supports the view that CRF may act as a neurotransmitter or neuromodulator in the brain. PMID- 3304528 TI - Effects of L-cysteine-sulphinate and L-aspartate, mixed excitatory amino acid agonists, on the membrane potential of cat caudate neurons. AB - Responses evoked by L-cysteine-sulphinate (L-CSA) and L-aspartate (L-Asp) were recorded with intracellular electrodes from caudate neurons in halothane anesthetized cats. L-CSA and L-Asp were applied microiontophoretically to caudate cells and their effects on membrane and action potentials, as well as on cortically evoked synaptic potentials were evaluated. L-CSA and L-Asp induced depolarizations accompanied by regular firing resembling kainate (KA)- or quisqualate (QUIS)-induced excitation patterns (type 1) in 82% and 72% of the recorded neurons, respectively, and a mixed pattern consisting of a N-methyl-D aspartate (NMDA)-like excitation (type 2) followed by a regular type 1 pattern in the remaining cells. In about a quarter of the cells the effects of L-CSA and L Asp, but not those of KA or QUIS, were partially antagonized by 2-amino-7 phosphonoheptanoate (AP-7), a specific NMDA receptor antagonist. Kynurenate, a broad spectrum excitatory amino acid antagonist, blocked responses elicited by either L-CSA or QUIS. The actions of L-CSA and L-Asp on the firing pattern and membrane potential of cat caudate neurons in situ provide evidence in favor of their mixed agonist nature with respect to NMDA and non-NMDA excitatory amino acid receptors. PMID- 3304529 TI - Accessory olfactory bulb transplants correct hypogonadism in mutant mice. AB - Transplantation of normal fetal gonadotropin-releasing hormone (GnRH) neurons from the accessory olfactory bulb (AOB) to the third ventricle of GnRH-deficient adult mutant mice reverses the genetically determined reduction in pituitary hormones and poorly developed gonads. The transplanted heterotopic AOB neurons adapt their morphology and secretory functions to what is observed with preoptic GnRH neurons when transplanted into deficient mice and in the normal intact mature animal. This suggests the presence of median eminence trophic factors affecting the growth, terminal sprouting, and functional behavior of the transplanted neurons. PMID- 3304530 TI - Evidence for a glycinergic pathway connecting the two cochlear nuclei: an immunocytochemical and retrograde transport study. AB - A combined retrograde transport and immunocytochemical study was carried out to determine the projections of the large glycine-immunoreactive neurons in the ventral cochlear nucleus of the guinea pig. Horseradish peroxidase (HRP) was injected into the contralateral cochlear nucleus, and cochlear nucleus sections were developed for HRP activity followed by staining for glycine using affinity purified anti-glycine antibodies. These studies show that glycine-immunoreactive neurons in the ventral cochlear nucleus project to the contralateral cochlear nucleus and suggest that this pathway may be glycinergic. PMID- 3304531 TI - Characterization of the blood-brain barrier: glycoconjugate receptors of 14 lectins in canine brain, cultured endothelial cells, and blotted membrane proteins. AB - The avidin-biotinylated peroxidase complex (ABC) method was used to detect binding of 14 lectins in tissue, cultured cells, and nitrocellulose blots. When applied to frozen sections of canine cerebral cortex and pituitary and evaluated by light microscopy, these lectins produced distinct staining patterns as determined by their individual carbohydrate specificities. Major saccharide residues detected in the endothelium of these cerebral tissues include alpha- and beta-galactose, alpha-mannose and/or alpha-glucose, and N-acetylglucosamine. Application to cells cultured from the canine cerebral endothelium gave staining results similar to those of microvessels in tissue. Thus, these characteristics of intact capillaries are retained in cultured cells and define fundamental properties of the blood-brain interface. Visual comparison of these staining patterns to those obtained for electrophoretic blots of solubilized membrane proteins identified multiple glycoprotein receptors and illustrated the vast quantity and variety of surface carbohydrate residues and the complexity of the cerebral endothelial cell glycocalyx. This carbohydrate-rich layer, which extends into the capillary lumen, may be of significant importance to the unique function of the blood-brain barrier. PMID- 3304532 TI - Distribution of choline acetyltransferase-containing neurons of the hypothalamus. AB - A system of small to medium size choline acetyltransferase (ChAT)-containing neurons has been identified in rat, monkey and human hypothalamus. A highly sensitive polyclonal anti-human placental ChAT rabbit serum, combined with a nickel ammonium sulfate second antibody intensification method, was used to identify these relatively weakly staining ChAT-positive neurons. The most prominent hypothalamic group consisted of small neurons in the infundibular (arcuate) nucleus. Fibers extended towards the infundibulum. Other ChAT-positive cells were not identified with specific hypothalamic nuclei but were scattered loosely in the surrounding matrix. They fell into two broad complexes: a medially distributed one close to the third ventricle and running rostrocaudal to caudoventral; and a lateral one distributed principally in the region of the medial forebrain bundle. The most laterally placed hypothalamic ChAT-positive neurons slightly overlapped with the large, intensely staining cells of the medial basal forebrain cholinergic complex. The identification of these cells helps to account for previous biochemical and pharmacological studies which have strongly indicated the presence of intrinsic cholinergic neurons in the hypothalamus. PMID- 3304533 TI - Neurotensin in the rat median eminence: the possible sources of neurotensin-like fibers and varicosities in the external layer. AB - The possible sources of neurotensin-like immunoreactive axons in the median eminence were studied after several experimental surgical approaches including unilateral lateral retrochiasmatic area transection, midsagittal knife cut through the median eminence, complete surgical isolation of the medial basal hypothalamus and bilateral paraventricular nucleus lesions. Both immunohistochemical and radioimmunoassay data demonstrate that neurotensin containing neuronal somata located in the hypothalamic arcuate nuclei represent the main source of neurotensin occurring in the external zone of the median eminence of the rat: neither the complete isolation of the medial basal hypothalamus nor the transection of the major neuronal input channel to the median eminence in the lateral retrochiasmatic area altered neurotensin-like immunoreactivity in the median eminence; bilateral lesioning of the paraventricular nucleus resulted in insignificant changes of neurotensin level in the median eminence; and two days after lesioning the median eminence an increased amount of retrogradely accumulated neurotensin-like immunoreactivity was found in several perikarya of the arcuate nuclei due to the blockage of axonal transport in the transected fibers. Retrograde accumulation of neurotensin like material in other cells scattered in the anterior hypothalamus (in the paraventricular, periventricular and anterior hypothalamic nuclei) indicates that in addition to the arcuate neurons these neurons may also participate in the neurotensin innervation of the median eminence. PMID- 3304534 TI - Projections of bombesin-like immunoreactive fibers from the rat stomach to the celiac ganglion revealed by a double-labeling technique. AB - Gastrofugal bombesin (BOM)-like immunoreactive (BOMI) structures in the rat were studied by immunocytochemistry combined with retrograde labeling. Transection of the mesenteric nerve peripheral to the celiac ganglion resulted in the complete disappearance of BOMI nerve terminals, whereas transection of the splanchnic nerves did not alter the immunoreactivity. Injection of biotinylated wheat germ agglutinin into the celiac ganglion labeled several neurons in the myenteric ganglion of the stomach. Simultaneous staining with antiserum against BOM showed that some of them are BOMI-positive. These findings demonstrate that BOMI neurons in the myenteric ganglion of the rat stomach project to the celiac ganglion. PMID- 3304535 TI - Immunohistochemical localization of gamma-aminobutyric acid- and aspartate containing neurons in the guinea pig vestibular nuclei. AB - The immunohistochemical distributions of gamma-aminobutyric acid (GABA)- and aspartate-containing neurons were studied in the guinea pig vestibular nuclei using purified antisera to GABA and aspartate, respectively. Most GABA-containing neurons had small cell bodies and were scattered throughout all regions of the vestibular nuclei. The largest number of these cells was found in the medial nucleus. Intraventricular injection of colchicine markedly increased GABA-like immunoreactivity in these cell bodies. GABA-containing terminals were distributed throughout all 4 subdivisions of the nuclei, with the richest localization found around the floor of the fourth ventricle. Various sized aspartate-containing neurons were noted in the vestibular nuclei and small cells were present in the superior, medial and lateral nucleus. Medium-sized cells were observed throughout the vestibular nuclei. Giant cells in the lateral nucleus also contained aspartate and were surrounded by GABA-like immunoreactive terminals, thereby suggesting the modulation of aspartate-containing neurons by GABAergic fibers from Purkinje cells. PMID- 3304536 TI - Fast spiking cells in rat hippocampus (CA1 region) contain the calcium-binding protein parvalbumin. AB - Fast spiking cells in the CA1 region of the rat hippocampus were revealed as gamma-aminobutyric acid (GABA)ergic non-pyramidal cells containing the calcium binding protein parvalbumin by intracellular injection of Lucifer yellow in vitro in combination with postembedding parvalbumin immunohistochemistry. PMID- 3304537 TI - The regional distribution of glycogen in rat brain fixed by microwave irradiation. AB - Glycogen concentrations were measured by fluorescence enzymatic assay in rat brains fixed by focused microwave irradiation Regional glycogen concentrations varied 2.5 fold, ranging from 27.1 nmol glucosyl units/mg protein in the striatum to 52.3 nmol/mg protein in the cerebellum and 69.9 nmol/mg protein in the pons medulla; other regions were intermediate in concentration. Since glycogen is contained primarily within astrocytes, this regional variation may reflect regional differences in astrocyte energy metabolism. PMID- 3304538 TI - Differentiation of the cerebellar granule cell: expression of a synaptic vesicle protein and the microtubule-associated protein MAP1A. AB - The expression of the microtubule-associated protein MAP1A and the synaptic vesicle protein p65 by rat cerebellar granule cells developing in vivo and in vitro was examined. MAP1A in common with a series of previously described cytoskeletal proteins was present in immature parallel fibres and began to disappear from parallel fibres around P15. From the earliest age (P6) at which the molecular layer could be identified parallel fibres throughout the molecular layer expressed p65 with no evidence of any gradient of expression from young to mature axons. Granule cells in culture did not express p65 until later than 1 day in vitro. By 7 days in vitro numerous p65 containing varicosities were present on granule cell processes though MAP1A was still expressed. The results show that transport of synaptic vesicles and formation of varicosities is an early event in granule cell differentiation and precedes a major reorganisation of the axonal cytoskeleton. PMID- 3304539 TI - Effects of postnatal hypoxia-ischemia on cholinergic neurons in the developing rat forebrain: choline acetyltransferase immunocytochemistry. AB - We studied the effect of early postnatal hypoxia-ischemia on cholinergic neurons in the developing rat forebrain using immunohistochemistry for choline acetyltransferase (ChAT). In 7-day-old rat pups, hypoxia-ischemia was induced in one cerebral hemisphere by combining unilateral carotid ligation with exposure to 8% oxygen for 2.5 h. This procedure caused brain injury in the hemisphere ipsilateral to ligation, most prominent in the corpus striatum, hippocampus and overlying cortex. In animals sacrificed 2-3 weeks after the insult, at approximately 3 weeks of age, the density of cholinergic cell bodies was slightly higher in the lesioned rostral caudate-putamen than the opposite side (+12%, P less than 0.05). In the more caudal portion of caudate-putamen, this effect was greater. In contrast, the size of the cholinergic perikarya in the injured striatum was significantly reduced. Cholinergic neurons in the septum (Ch1, Ch2), globus pallidus and nucleus basalis (Ch4) were relatively unaffected. Considered together with previously reported neurochemical data, these observations suggest that the immature cholinergic neurons are less vulnerable to death from hypoxia ischemia than other components of the striatum. However, differentiation of surviving cholinergic perikarya and possibly their axonodendritic processes may be disrupted by the early insult. PMID- 3304540 TI - Immunocytochemical localization of cholecystokinin and glutamic acid decarboxylase during normal development in the prepyriform cortex of rats. AB - Immunocytochemical localization of specific neurotransmitters in the brain is becoming increasingly important in studies of maturation. We have used the trilaminar prepyriform cortex (PC) of rats to study the distribution, patterns and relative number of cells, fibers and terminals during postnatal development using antisera to cholecystokinin (CCK) and glutamic acid decarboxylase (GAD). Both antisera show distinct patterns of immunoreactivity at birth and subsequent periods of distinct changes in these patterns. CCK immunoreactivity is rare but present at birth mostly in layer II. There is a dramatic increase of CCK-labeled structures between postnatal (PN) days 6 and 9 and between PN 13 and 21. The adult pattern is observed by PN 21 with large numbers of labeled cells in layer II, numerous terminals in layers II and deep I and large immunoreactive fibers in the lateral olfactory tract. At birth GAD-immunoreactive terminals are present mainly in layer I, forming a distinct pattern of superficial and deep bands. Subsequent major changes occur in this pattern between PN 9 and 13 and again between PN 13 and 21. By PN 21 there appears to be a loss in deeper laminae of GAD positive terminals which are possibly replaced by the increasing numbers of CCK terminals in the same sublaminae. The adult pattern of GAD immunoreactivity is established by PN 21 with terminals and a few cells in layer I. Therefore, throughout development of the rat PC, there is a distinct complementary and changing distribution of GAD and CCK. Factors that may influence these changes in immunoreactivity are discussed. PMID- 3304541 TI - Development of serotonin immunoreactivity in the rat spinal cord and its plasticity after neonatal spinal cord lesions. AB - The postnatal maturation of spinal pathways may account for the gradual time course of postnatal development of behavior and also account for the greater anatomical reorganization which often follows damage to the developing CNS compared to the mature CNS. The purpose of the current study was to examine (1) the prenatal and postnatal development of the descending serotonergic (5-HT) projection to the spinal cord and (2) the effects of a neonatal spinal cord lesion on this development. In addition, we wished to determine (3) whether transplants of fetal spinal cord tissue placed into the neonatal lesion site alter the plasticity of the 5-HT projection to the cord. Peroxidase antiperoxidase immunocytochemical techniques were used. At embryonic day 14 (E14), no 5-HT immunoreactive fibers could be identified at any spinal cord level. By E18 the first axons were identified in the white matter only at all spinal cord levels. At birth, 5-HT immunoreactive fibers were present both in the white matter and in the gray matter at all cord levels. The projection within the gray matter was diffuse and considerably less dense than in the adult. The postnatal maturation of the 5-HT projection within the gray matter of the spinal cord followed rostral to caudal and ventral to dorsal gradients. During the first weeks postnatal, the 5-HT immunoreactivity within the cord increased to attain an adult pattern and density by 14 days in the cervical cord and 21 days in the thoracic and lumbar cord. The effect of a spinal cord hemisection at birth on the anatomical reorganization of the descending serotonergic innervation of the cord was compared with the effect of the same lesion in the adult. In the adult animal, mid-thoracic hemisection decreased the 5-HT content of the ventral horn of the lumbar spinal cord caudal and ipsilateral to the lesion to 8% of that on the intact side. When this same lesion was made in the newborn animal, the innervation was 43% of that on the intact side. When a transplant of fetal spinal cord tissue was inserted into the lesion site in the newborn animals, there was even greater 5-HT innervation caudal to the lesion, 83% of that on the intact side. These results indicate that there is considerable postnatal development and plasticity of the descending serotonergic projection to the spinal cord, and this plasticity is enhanced by the presence of a spinal cord transplant at the site of the lesion. PMID- 3304542 TI - Transient expression of choline acetyltransferase-like immunoreactivity in Purkinje cells of the developing rat cerebellum. AB - The expression of choline acetyltransferase (ChAT)-like immunoreactivity was studied immunohistochemically in the cerebelli of developing rats. Brains were examined from the day of birth (postnatal day 1: P1) until adulthood. From P4 through P21, several Purkinje cells in the uvula, nodule, and flocculus of the cerebellum demonstrated ChAT-like immunoreactivity. After P23, no ChAT-positive neurons were observed in any region of the cerebellum. This finding paralleled the transient expression of acetylcholinesterase in Purkinje cells of these same cerebellar areas during development. PMID- 3304543 TI - Glutamate decarboxylase-like immunoreactive neurons in the rat caudate putamen. AB - GAD-IR neurons were roughly divided into those with medium sized perikarya and large perikarya. The medium-sized GAD-IR neurons accounted for about 85% of the GAD-IR neurons. The medium-sized perikarya were further divided into two, those with a smooth nuclear membrane and those with an indented nucleus. The former were very similar to medium-sized spiny neurons and the latter corresponded to medium-sized aspiny neurons. The GAD-IR large cells that were identified by light microscopy, had nuclear indentations and were divided into two classes based on their ultrastructural features, type 1 large cells received few synaptic inputs and type 2 large cells received many synaptic contacts from non-immunoreactive or immunoreactive boutons. The former resembles Type I large cells and the latter Type II large cells identified recently by Chang and Kitai; the latter are also similar to the second type of projecting neurons identified by Bolam et al. PMID- 3304546 TI - Spectrin expression during mammalian brain ontogeny. AB - At least 2 distinct spectrin subtypes, brain spectrin(240/235) and brain spectrin(240/235E), are contained in the mammalian brain. Evidence that these subtypes are differentially expressed during mouse brain development is reviewed. Brain spectrin(240/235) is detected in fetal brain tissues, and increases 2-fold to adult levels. This subtype is enriched in the cortical cytoplasm of germinative neural cells, and is also associated with fibers resembling axons in the fetus. Brain spectrin(240/235E), a brain subtype specifically detected with antibodies to red blood cell spectrin, is below the limits of detection in the fetal and neonatal brain rapidly increases in concentration during the second postnatal week. Brain spectrin(240/235E) is found in the cell body and dendrites of differentiating neurons and glial cells, but is not expressed in mitotic cells. This subtype is especially prominent in granules cells of the cerebellum and dentate gyrus. The potential function of these spectrin subtypes during neuro ontogeny is discussed. PMID- 3304544 TI - Locomotion-inducing sites in the vicinity of the pedunculopontine nucleus. AB - The mesencephalic locomotor region (MLR) was identified physiologically by inducing controlled locomotion on a treadmill in the precollicular rat following application of low amplitude current pulses to areas of the pontomesencephalic tegmentum. The same brains were processed using either of two techniques known to label neurons of the pedunculopontine nucleus (PPN)-choline acetyltransferase (ChAT) immunocytochemistry or nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase histochemistry. Histological reconstruction of locomotion-inducing sites were localized within or adjacent to ChAT or NADPH-diaphorase labeled cell groups. Three dimensional reconstructions of the PPN were used to visualize the colocalization of low threshold locomotion-inducing stimulation sites within PPN neuronal aggregates. These findings lend further support to the suggestion that the PPN is part of the MLR. A theoretical framework is proposed to account for results derived from various lines of research on this area. PMID- 3304545 TI - Spectrin isoforms in mammalian brain. AB - In this brief review we discuss the structure, location, developmental expression and potential functions of the spectrin isoforms [spectrin(240/235) and spectrin (240/235E)] within mammalian brain. We also contrast the structure and location of mammalian and avian brain spectrin isoforms. PMID- 3304547 TI - [Significance of Setaria cervi antigens in the diagnosis of human filariasis]. PMID- 3304551 TI - [Reflections on the micro-processor health card]. PMID- 3304550 TI - [Digestion of a maltitol-rich hydrogenated syrup in conscious pigs]. PMID- 3304548 TI - [Diagnosis of chlamydial urethritis in males]. PMID- 3304549 TI - [A new look at aerosol therapy]. PMID- 3304552 TI - [Reflections on the training of occupational physicians]. PMID- 3304553 TI - [Limitations of historical and geographic comparisons of birth rate]. PMID- 3304554 TI - [AIDS and hepatitis B in the prison population: an unavoidable epidemiologic reality]. PMID- 3304555 TI - [In memoriam Maurice Deparis (1906-1986)]. PMID- 3304556 TI - [Pregnancies after freezing of human ova at Tenon Hospital]. PMID- 3304557 TI - [Treatment compliance]. PMID- 3304558 TI - [Inborn errors of metabolism and "unexplained" sudden infant death]. PMID- 3304559 TI - [Refractive surgery, problems of ethics and professional ability]. PMID- 3304560 TI - [A constant preoccupation: the struggle against alcoholism]. PMID- 3304561 TI - Female disorders and nineteenth-century medicine: the case of vesico-vaginal fistula. PMID- 3304562 TI - An evaluation of some early obstetrical instruments. PMID- 3304563 TI - McDowell House, Apothecary and Gardens. PMID- 3304564 TI - [Comparative use of thiopental and methohexital in patients anesthesized for E.N.T. endoscopy. Apropos of 60 cases]. AB - The clinical effects of methohexital versus thiopental are studied in 60 randomized patients anaesthetized for E.N.T. endoscopy or laser surgery of the larynx. Thiopental is injected by I.V. bolus (5 mg/kg) and methohexital is administered by continuous infusion (0.1 mg/kg/min). Fentanyl is the analgesic and succinyl-choline is used for curarisation. All patients are ventilated by a conventional ventilator or by high frequency ventilation. Side-effects, extubation time, and recovery estimated by the Newman-test modified by Weber are studied. The only difference between methohexital and thiopental is a better recovery-score at 30 minutes for the methohexital group. PMID- 3304565 TI - [Addition of fentanyl to adrenalinized lidocaine for the brachial plexus block]. AB - This study was designed to investigate the effects of fentanyl associated with lidocaine in a solution used to perform axillary brachial plexus nerve block. Adrenergic, sensory and motor nerve blocks have been studied separately and compared to a control group receiving lidocaine without fentanyl. For each type of fibre, the degree of block was measured on, 2, 3, 4, 5 and 10 minutes after injection and the result were studied by variance analysis. Axillary nerve blocks were performed in two different hospitals by two anesthesiologists. After giving informed consent, the patients were randomly allocated in two groups receiving 30 ml 1.5% lidocaine with 1/200,000 epinephrine, with or without fentanyl 100 mu. There were no statistical differences between the two groups as far as adrenergic nerve block was concerned, whereas sensory and motor nerve blocks were significantly more important as soon as five minutes after injection and lasted longer when fentanyl was added to the solution. This enhancement of intensity and duration of sensory and motor nerve blocks when fentanyl is added allows a reduction of the quantity of lidocaine required, and shortens the delay between injection and complete blockade. PMID- 3304566 TI - [Heparin-induced thrombopenia]. PMID- 3304567 TI - Examination of cerebrospinal fluid in the horse. AB - The examination of cerebrospinal fluid (CSF) is often part of the diagnostic work up of a patient exhibiting signs of disease involving the central nervous system. Awareness of the capabilities and limitations of these laboratory tests is important in assessing the benefit-to-risk ratio of performing such procedures. Collection of CSF is a relatively simple procedure, and together with a thorough history, physical examination, and other diagnostic tests, may be a valuable aid in arriving at a diagnosis or prognosis. PMID- 3304568 TI - Indication and use of electrodiagnostic aids in neurologic disease. AB - Electrodiagnostic aids, electromyography, auditory brainstem response testing, and electroencephalography are extensions of the neurologic examination and provide valuable information about the nervous system. This article discusses the use and interpretation of electrodiagnostic aids in equine neurology as well as the equipment that is employed. It is hoped that with a better understanding of the available electrodiagnostic aids, they will come into greater use. PMID- 3304569 TI - Convulsive and allied syndromes of the neonatal foal. AB - This article discusses the clinical signs, etiology, management, and prognosis for the neonatal foal afflicted with a convulsive or allied syndrome. PMID- 3304570 TI - Equine degenerative myeloencephalopathy. AB - This article discusses the history and signalment, clinical signs, differential diagnosis, pathology, etiology and pathogenesis, and treatment and prevention of equine degenerative myeloencephalopathy. PMID- 3304571 TI - Cervical vertebral malformations. AB - Cervical vertebral malformations are recognized clinically when they result in spinal cord compression causing neurologic deficits. Confirmation of diagnosis is based on radiographic and myelographic evidence of cord compression. Medical therapy is not usually successful. Several successful surgical treatments are described. PMID- 3304572 TI - Behavioral genetics. AB - Certain farm animal behaviors are subject partially to genetic control. This article provides examples of how knowledge of genetic differences and genetic modification of farm animal behavior might enhance both human and animal welfare. The first part of the article deals with genetic differences among species or breeds, and the second part considers differences that exist within a particular breed or population. PMID- 3304573 TI - Maternal and neonatal behavior. AB - Maternal and neonatal behavior differs among food-producing mammals, and our management must reflect these differences. Sows will show more elaborate preparturient behavior than the other species as they attempt to build a nest that will last for several days. Because the nest is the focal point of maternal behavior for several days, the sow does not need to recognize her piglets until they are about 1 week of age. Although this facilitates the fostering of piglets between litters, the teat order developed by piglets during the first day or two makes it difficult for alien piglets to suckle when first fostered. Piglets are weaned at a relatively early age, and this results in conflict as neonatal behavior persists in an environment that requires better developed feeding patterns. Restrictions placed on ewes and cows by confinement at the time of parturition may result in their being unable to select an appropriate birth site. Our management must accommodate these needs by providing sites that are protected from the harsh environment and also allow separation from the rest of the flock. This is particularly important for ewes bearing multiple young, for lambs frequently become separated from the ewe while she is caring for another lamb. Both cows and ewes must be allowed to bond to their offspring soon after birth if they are to provide adequate maternal care. Fostering in these species involves manipulation of identifying stimuli to overcome the dam's ability to recognize her own young shortly after birth. Suckling problems, due to pendulous udders on cows and multiple lambs in sheep, may require attention by the stockman shortly after birth. Weaning does not result in major behavioral problems in sheep or beef cattle that are weaned after the young are consuming solid feed on a regular basis. Dairy calves, which are initially weaned onto milk replacer at a very early age, may develop inappropriate sucking behaviors that persist beyond weaning onto a solid diet. Despite our growing knowledge of maternal and neonatal behavior, mortality among piglets, lambs, and calves is still high. However, many of the most recent findings have yet to be incorporated into management procedures or standard practice. As this occurs, we should be able to reduce losses of young animals. PMID- 3304574 TI - Early experience. AB - Because regulatory mechanisms are not fully developed in neonates, they are particularly susceptible to environmental influences on behavior. Events early in life have the potential for multiplicative effects. Perinatal stress appears to alter the function of the HHA axis in an adaptive manner. Optimal levels of stress might therefore be used in the rearing of domestic animals. Further research, including an assessment of animals' welfare, is needed. The early social environment is of critical importance in behavioral ontogeny. Social conditions other than those with which a species has evolved, such as isolation, rearing without conspecifics, or rearing in single-sex groups, can alter later behavior. Effects on agonistic and sexual behavior, in particular, have been well researched. The types of learning involved in primary socialization are not directly known for most farm species, although other features of socialization are well documented. Nutrition plays an obvious role in physical development. Less obviously, it appears that a low plane of nutrition or protein deficiency can permanently impair learning ability through a decrease in the number of brain neurons. PMID- 3304575 TI - Learning and the training of farm animals. AB - The focus of learning studies shifted considerably about 30 years ago. Research moved away from using farm species as experimental animals (that is, as a tool) in which to study learning theory, to a genuine interest in the learning abilities and training processes of individual species. Growing use is being made of operant conditioning and other learning techniques to assess how animals learn from experience and their ability to control their environment to improve their well-being. The processes involved in extinguishing undesirable behaviors and establishing behaviors more compatible with farming operations, the use of handling during early sensitive periods, and the careful habituation of animals to intensive farming conditions and modern automated systems complement the on going genetic selection of farm animals more suited to modern farms. Learning is an important way for animals to cope with and adapt to changing environments and, as such, is fundamental to their general well-being. Learning in farm animals is of vital concern to veterinarians, agricultural engineers, and those involved with animal husbandry and welfare. PMID- 3304576 TI - Aggressive behavior. AB - This article considers the major fighting-related activities of the most common food animals. Instead of being seen as a largely pathologic phenomenon born solely of frustration and pain, aggressive behavior is now regarded as a natural part of an animal's behavioral equipment for survival and reproduction. There is a need, spurred by consideration for both productivity and animal well-being, to understand the fundamentals of the aggressive behavior of domestic species so that one can accommodate for this behavior in systems of livestock management. PMID- 3304577 TI - Social organization. AB - Because animal agriculture is largely concerned with the most efficient management of groups of animals, an understanding of the function and characteristics of social organization associated with each species is important for the optimal design of production systems. PMID- 3304578 TI - Animal handling. AB - Handlers with an understanding of animal behavior can handle livestock more efficiently and safely than handlers that lack an appreciation for the behavior of animals and their welfare. For example, four good handlers in a well-designed circular cattle-handling facility with a hydraulic squeeze could place an ear implant every 15 seconds or brand, vaccinate (up to four injections), place an ear implant, and castrate one animal every 45 seconds. Handlers that yelled at and prodded cattle excessively usually required more time to process each animal, due to wasted time when excited cattle escaped or became jammed in the squeeze. Veterinarians should teach clients the principles of animal behavior that relate to animal handling. Quiet, efficient handling will reduce stress and injuries to both people and livestock. PMID- 3304579 TI - Human-animal interactions. AB - The objective of this article is to discuss the human-animal relationship in animal production, emphasizing the importance of this relationship to the productivity and welfare of the animal, some of the factors that may regulate the relationship, and how to manipulate this relationship to improve the productivity and welfare of the animal. PMID- 3304580 TI - Abnormal behavior. AB - Farm animals exhibit abnormalities of sexual, maternal, and other social behaviors as well as many stereotyped behaviors. The types and incidence of these abnormal behaviors may depend on the species, its diet, and the environmental conditions under which it is normally maintained. An understanding of the causes of various abnormal behavior patterns will enable the producer and veterinarian to better manage populations of livestock and improve their well-being. PMID- 3304581 TI - Animal well-being and animal care. AB - To know how to care for animals, one must understand their needs. Physiologic and safety needs of farm animals are reasonably well fulfilled. Behavioral needs have yet to be determined and used as bases for animal care. The concept of the welfare plateau is important for the design and operation of facilities for agricultural animals. Current issues in the care of farm animals include standard agricultural practices, stockmanship and the human-animal bond, and standards of design for animal-production equipment. PMID- 3304582 TI - Behavior of sick animals. AB - The behavior of the sick animal is not necessarily a result of physical debilitation; it can be viewed as part of a highly organized adaptive strategy that is at times critical to survival if the animal were living in the wild state. Domestic ruminants appear to have retained this behavioral mode when they are sick. This article brings together several lines of current research about depression, appetite control, and the role of fever in facilitating an animal's ability to combat viral and bacterial infections. PMID- 3304583 TI - Endocrine systems and behavior. AB - Estradiol, either directly from the ovary of females or as a metabolite of testosterone from the testes of males, seems to be the necessary and probably sufficient endocrine signal for sexual differentiation and adult sexual expression. Progesterone, in females, may play an important priming or facilitative role prior to estrus, especially following pregnancy, when blood estrogen levels are high for a prolonged period. At high doses, progesterone clearly inhibits the expression of sexual behavior. PMID- 3304584 TI - Male sexual behavior. AB - This article considers causes of variability in male sexual performance and identifies management techniques that can be used to improve the reproductive success and efficacy of our captive animal populations. PMID- 3304585 TI - Sexual behavior of female domestic mammals. PMID- 3304586 TI - Roles of the olfactory and vomeronasal systems in behavior. AB - The chemosensory experiences of farm animals involve a stimulus world that we are incapable of appreciating through our own limited olfactory system and nonexistent vomeronasal system. It is obvious that to domestic ruminants as well as their wild counterparts these systems are an important element in day-to-day activities and in social encounters. As we come to learn more about the role of chemosensory analysis by both the olfactory system and the vomeronasal system, we will eventually have the opportunity to utilize such information more effectively to manage the reproduction, growth, and welfare of our domestic livestock species. PMID- 3304587 TI - Sources and sinks of light-evoked delta [K+]o in the vertebrate retina. AB - In the vertebrate retina, recordings of light-evoked changes in extracellular K+ concentration delta [K+]o are of particular interest because this tissue is complex and multilayered, yet can be activated routinely with its "natural" stimulus (i.e., light). This review identifies the components of the spatiotemporal profile of retinal light-evoked delta [K+]o and then presents evidence concerning the specific neural origins of these components as well as the mechanisms by which these delta [K+]o are dispersed from extracellular space. Finally, to gain improved resolution of K+ sources and sinks, the technique of ion source density is introduced and applied to both model and real spatiotemporal distributions of delta [K+]o. PMID- 3304588 TI - Thirty years of ion-selective microelectrodes: disappointments and successes. AB - The need to know the intracellular activity of an ion and how it changes under controlled conditions is as important today as it was 30 years ago. In 1956, one could fabricate only a H+-selective microelectrode and with a tip size not much smaller than 100 micron. Today, one can fabricate microelectrodes selective to H+, Na+, K+, Cl-, HCO3-, Ca2+, or Mg2+ (plus others) and with active tips less than 1 micron. The reduction of active tip size can be attributed mainly to the introduction of liquid ion exchanger (LIX) and neutral carrier ligands. Unfortunately, the LIX microelectrodes, as currently fabricated, do not yet function optimally as reliable and stable electrochemical measuring devices. A durable bond between the active membrane and its insulated container continues to remain the major design problem even after 30 years of development. PMID- 3304589 TI - Design of ionophores for ion-selective microsensors. AB - Requirements for a reliable use of liquid membrane microelectrodes are discussed in terms of stability, response time, and lifetime on the basis of membrane technological considerations. The selectivity of H+, Li+, Na+, K+, Mg2+, Ca2+, and Cl- microelectrodes is critically evaluated using the Nikolskii-Eisenman formalism. Recent progress in the design of new ionophores is presented. A novel neutral carrier-based Ca2+-selective microelectrode with a detection limit of about 5 X 10(-10) M Ca2+ at a background of 125 mM K+ has been realized. An neutral carrier-based microelectrode for H+ with extended pH range of the sample solution is now available. Promising developments in the field of Li+-, Mg2+-, and Cl--selective ionophores are discussed. PMID- 3304590 TI - Surface pH and the control of intracellular pH in cardiac and skeletal muscle. AB - Both surface pH (pHs) and intracellular pH (pHi) were measured using single- and double-barreled pH-sensitive microelectrodes in isolated sheep cardiac Purkinje strands, rabbit and cat papillary muscle, and mouse and rat soleus muscle. Superfusion of the preparations with a relatively low buffered solution (containing 5 mM HEPES buffered to control pH) causes surface acidosis that correlates with efflux of metabolically produced acids in the unstirred layer of fluid surrounding the tissue. Acidification of the surface layer induces a slower acid change of pHi and depresses the rate of proton extrusion following an imposed intracellular acid load. In cardiac preparations, the lowering of pHi correlates with depression of twitch tension. Transient changes of pHs and pHi are seen when a weak acid or base is suddenly added to, or removed from the superfusion solution. Indirect evidence of the presence of carbonic anhydrase in the extracellular surface layer is obtained from analysis of transient pHs changes in presence and absence of acetazolamide. PMID- 3304591 TI - Hemolytic uremic syndrome in renal allografted patients treated with cyclosporin. AB - The classical triad of hemolytic uremic syndrome (microangiopathic hemolytic anemia, severe thrombopenia, and renal failure) developed de novo in three of our renal transplanted patients under cyclosporin A treatment. The predominant morphologic findings in the grafts consisted of glomerular and arteriolar thrombosis as well as arteriolonecrosis, all features of the syndrome. In one instance, ischemic bowel disease supervened after graft removal and was associated with persistent low grade microangiopathic process. De novo hemolytic uremic syndrome has been reported in patients treated with cyclosporin A following bone marrow or liver transplantation as well as in a few renal graft recipients. This peculiar form of cyclosporin A nephrotoxicity should not be confused with acute rejection of the renal transplant. PMID- 3304592 TI - Selected papers from the thermal physiology symposium. Calgary, Alta., Canada, July 21-25, 1986. A satellite symposium of the XXX International Congress of the International Union of Physiological Sciences. Dedicated to the memory of Edward Alexander Sellers. September 14, 1916-August 28, 1985. PMID- 3304593 TI - Gastric inhibitory polypeptide, dietary-induced thermogenesis, and obesity. AB - Blood glucose, plasma concentrations of gastric inhibitory polypeptide, insulin, glucagon, cortisol, and thyroid hormones were measured in nonobese and obese human subjects at 30 and 22 degrees C ambient temperature (Ta). Oxygen consumption (VO2), carbon dioxide output (VCO2), and temperatures in the external auditory meatus (Tc) and on the skin surface (Tsk) were also measured. After 1 h, near naked at the chosen Ta, an oral dose of sucrose (approximately 1.5 g/kg) was given and the subjects were then monitored for a further 60 or 90 min. Following sucrose ingestion, both in the nonobese and obese, there were significant (p less than 0.001) increases in the following: glucose, gastric inhibitory polypeptide, insulin, VO2, and respiratory quotient. The effect of Ta on these responses in the nonobese was that gastric inhibitory polypeptide rose more at Ta 30 than at Ta 22 (p less than 0.05) and VO2 rose more at Ta 22 than at Ta 30 (p less than 0.05). In the obese, glucose rose more at Ta 30 than at Ta 22 (p less than 0.02), VO2 rise was less than in the nonobese at Ta 22 (p less than 0.05), and the respiratory quotient was lower than in the nonobese at both Ta 30 and 22 (p less than 0.001). Gastric inhibitory polypeptide changes with respect to Ta in the obese were inconsistent. It is concluded that responses to oral sucrose are modified by environmental temperature. PMID- 3304594 TI - Thermoregulatory physiology of menopausal hot flashes: a review. AB - Hot flashes during the climacteric years have long been a frequent clinical complaint, generally considered within the realm of the internist, gynecologist, or endocrinologist. Yet the underlying mechanism of hot flashes remains unknown. Only within the past 10 years has there been significant research on hot flashes as a disturbance of thermoregulation. This paper focuses on thermoregulatory aspects of hot flashes, reviewing current knowledge of the thermoregulatory physiology and endocrinology of hot flashes and discussing future avenues for research. Hot flashes are compared with fever in terms of thermoregulatory changes and speculated mechanisms. Although several substances in the peripheral circulation are found in increased concentrations during hot flashes, none is a trigger for a hot flash. The pattern of hot flash occurrence is striking in its regularity, and the possibility of endogenous rhythmicity is discussed. Recently, investigators have begun to explore a primate model of menopausal hot flashes. These studies are summarized. Finally, the multiple effects of estrogen on various systems of the body and their interrelationships are discussed. An understanding of the mechanism of hot flashes would not only be of importance to women suffering with hot flashes but would further our knowledge of thermoregulatory function and the interactions between thermoregulatory and reproductive systems. PMID- 3304595 TI - Vasopressin and fever: evidence supporting the existence of an endogenous antipyretic system in the brain. AB - Vasopressin administered into the ventral septum exerts a dose-related antipyresis. This site of action is similar in a number of species. The fever reducing properties of vasopressin are both site and neuropeptide specific. Evidence supporting a role for endogenous vasopressin in fever suppression is the demonstration that the release of the peptide from the ventral septal area is altered during fever: the amount released correlates negatively with febrile changes in body temperature. In addition, changes in the concentration of vasopressin in the septum and amygdala have been demonstrated immunocytochemically during fever: an activation of vasopressinergic neurons occurs which is similar to that observed in pregnant animals at term when fever is absent. Specific antibodies directed against vasopressin or specific vasopressin antagonist analogues (e.g., d(CH2)5Tyr(Me)AVP) enhanced the febrile response to a pyrogen challenge when injected into the ventral septum. The same antagonist also can antagonize the antipyretic effect of exogenously administered vasopressin. The use of relatively specific antagonists and agonists of vasopressin, directed against the V1 and V2 subtypes of the peripheral vasopressin receptor, suggests that the central receptor responsible for the antipyretic effect of vasopressin may resemble the V1 subtype. Recent experiments using electrophysiological techniques have demonstrated the existence of thermoresponsive units in the ventral septal area whose activity may be altered by vasopressin which is possibly derived from the paraventricular nucleus and bed nucleus of the stria terminalis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304596 TI - Diabetes mellitus and thermoregulation. AB - Diabetes mellitus is accompanied by a variety of alterations in metabolic, cardiovascular, and neuronal function. This paper provides a comprehensive review of the ways in which these pathophysiological aspects of diabetes may impair thermoregulatory function. The influence of diabetic neuropathy and vasculopathy on the control of peripheral blood flow is reviewed and the additional effects of changing levels of blood glucose and insulin are discussed. Both hypoglycaemia and diabetic ketoacidosis are associated with hypothermia, but the reasons for this in ketoacidosis are not clear. Impairment of heat conservation may contribute to and could be a consequence of autonomic neuropathy. The final section of the paper describes a study of our own in which metabolic stability was maintained by infusing insulin intravenously before and during the determination of the thermoregulatory responses to acute cold stress. Under these conditions, there was impairment of reflex vasoconstriction in the limbs of diabetics with neuropathy. This failure to reduce heat loss resulted in half the diabetics with neuropathy shivering in response to moderate cooling, which in some subjects was accompanied by a fall in core temperature. Diabetics without neuropathy and nondiabetics neither shivered nor dropped core temperature. PMID- 3304597 TI - Cardiac transplantation. PMID- 3304598 TI - Growth of Escherichia coli in a pulp and cardboard mill. AB - The coliform flora of a pulp and cardboard mill that uses birch as the raw material and ammonium sulphate as the process chemical was studied. Escherichia coli was observed to multiply in the mill. It persisted as the dominant thermotolerant coliform in the effluent. Klebsiellae were encountered among total coliforms only. The E. coli strains isolated had the biochemical characteristics and maximum growth temperatures typical to the species. However, serotyping and hemolysin test differentiated these strains from pathogenic and fecal E. coli. PMID- 3304599 TI - Why does cirrhosis belong to Laennec? AB - It is well known that Laennec gave cirrhosis its name from the Greek word kirrhos (tawny), in a brief footnote to his treatise De l'auscultation mediate (1819), but the eponym "Laennec's cirrhosis" is rarely used in France. This article explores the reasons why North American physicians commemorate a French chest specialist in their name for a hepatic lesion that had first been recognized in England more than a century earlier. It traces the content and fortunes of Laennec's essay on cirrhosis, part of an incomplete manuscript, including its eventual partial publication by a British editor in the original French. A survey of 19th-century literature on cirrhosis revealed that it was not until the publication of William Osler's textbook that the eponym came into common use. The geographic patterns of influence of Osler's book and the differing preoccupations of physicians on the two sides of the English Channel probably combined to result in the paradoxic employment of this eponym. PMID- 3304601 TI - Panhypopituitarism secondary to an aneurysm of the anterior communicating artery. PMID- 3304600 TI - Changes in endogenous microflora among febrile granulocytopenic patients receiving empiric antibiotic therapy: implications for fungal superinfection. AB - The ecologic effect of empiric systemic antibiotic therapy on the endogenous microflora was evaluated in 83 febrile granulocytopenic patients with cancer who were randomly allocated to receive moxalactam plus ticarcillin (45 patients) or tobramycin plus ticarcillin (38 patients) for suspected infection. Serial surveillance cultures of the nasal passages, oropharynx and feces performed twice a week showed that patients who received the former regimen had higher elimination rates and significantly lower acquisition rates (p = 0.027) for aerobic gram-negative bacilli than did patients who received the latter regimen. However, therapy with moxalactam plus ticarcillin also resulted in significantly higher acquisition rates for yeasts (p = 0.004). This was associated with a significantly higher fungal superinfection rate among these patients than among those who received tobramycin plus ticarcillin (40% v. 16%) (p less than 0.05). Moxalactam plus ticarcillin therapy created a greater microbial ecologic vacuum by the elimination of intestinal anaerobes, which, in turn, permitted fungal colonization and an increased risk of superinfection. Our results support the recommendation that an antipseudomonal penicillin plus an aminoglycoside be selected as empiric therapy for suspected infection in febrile granulocytopenic patients with cancer. Such a regimen would spare the anaerobic intestinal microflora, thereby reducing the risk of fungal colonization and infection. PMID- 3304602 TI - The role of health education in medical management of asthma. Some program applications. PMID- 3304603 TI - School health education programs for asthma. PMID- 3304604 TI - Compliance and self-help in an office practice. PMID- 3304605 TI - Compliance with medical regimens, self-management programs, and self-care in childhood asthma. AB - Compliance with medical regimens is as poor or poorer in childhood asthma than it is for other chronic illnesses. A spate of self-management programs for childhood asthma has been developed to counteract nonadherence and to enable patients to be more confident and competent in their ability to prevent or control asthmatic episodes. The programs offer promise and report some encouraging results, but the programs are still unproven, and they are neither widely available nor widely used. The individual physician remains the key player in mounting effective self management programs; but if the physician is to function effectively in this role, drastic changes are called for in the way that both medical practice is conducted and patient-health care provider relationships are managed. Steps and strategies that would help providers establish effective individual self management programs for asthmatic patients are outlined. PMID- 3304606 TI - Collaborative asthma self-management. Evaluation designs. PMID- 3304607 TI - Psychological issues in assessing and managing asthma in children. PMID- 3304609 TI - Evaluation of estrogen receptors by immunocytochemistry on fine-needle aspiration biopsy specimens from breast tumors. AB - The estrogen receptor (ER) content of 31 surgically removed breast tumors (26 duct carcinomas, one lobular carcinoma, one papillary carcinoma, one colloid carcinoma, one duct carcinoma in situ, and one atypical fibroadenoma) was determined by a commercially available immunocytochemical method (Abbott Laboratories, ER-ICA) on cytologic material obtained by fine needle aspiration biopsy (FNAB) of surgical specimens. Immunocytochemical staining of cells by a peroxidase-antiperoxidase technique was evaluated on the basis of the percentage of positive cells and the intensity of staining. An immuno-staining score for cytologic (IS-CYTO) and histologic (IS-HISTO) material was defined and a threshold of positivity determined to facilitate the semi-quantitation of results and the comparison of cases. The results of immunostaining of cytologic material were compared with the evaluation of ER in corresponding tissue samples as determined by the radioligand binding assay using the dextran-coated charcoal procedure (ER-DCC) and by ER-ICA using cryostat sections of frozen tissue. The sensitivity, specificity, predictive value of a positive test, and test efficiency of ER-ICA in cytologic material as compared to ER-DCC was 96%, 83%, 96% and 93%, respectively. The IS-CYTO was significantly correlated with the IS HISTO in corresponding histologic material (r = 0.72, P less than 0.001). In conclusion, the combination of ER-ICA with FNAB represents a useful new technique for the evaluation of ER which may be applied to small primary tumors, tumor recurrences, and metastases. PMID- 3304608 TI - The young Damocles. The adolescent at high risk for serious or fatal status asthmaticus. AB - The most vulnerable population in the recent increase in morbidity and mortality in asthma is the preteen and teenaged group. This particular group, remarkably resistant to outside input, would seem the most likely audience for programs dealing with asthma self-care. We have postulated 4 problem areas for this group that may be important in patients who have severe or refractory disease. These problems involve physiology, noncompliance with the medical regimen, stress, and depression and suicide. Each problem requires a specific intervention strategy and should be amenable to treatment in a comprehensive management plan. PMID- 3304611 TI - Response to tamoxifen in estrogen receptor-poor metastatic breast cancer. AB - While hormone receptor values are extremely valuable in breast cancer management, many variables leading to falsely negative receptor results should be considered before clinical decision making in the setting of metastatic disease. At the Papanicolaou Comprehensive Cancer Center in Miami, Florida 271 patients with metastatic breast cancer received tamoxifen over a 4-year period. Only 40 of the 204 patients (19.6%) with available estrogen receptor assay information had pretreatment receptor values classically considered receptor-poor. While four patients had inevaluable tamoxifen trials and 12 patients had "compassionate" use in end-stage situations, 24 patients received tamoxifen therapy in the face of receptor-poor values because of clinical or histopathological correlates suggesting the possibility of false negative assay results. Six of 36 evaluable patients (16.6%), including those treated on "compassionate grounds," responded to tamoxifen, while 6 of 24 more highly selected patients (25%) responded. Response durations in these six patients were 11, 12, 28, 28+, 49, and 51 months, respectively; two of these six also had significant, objective tamoxifen withdrawal responses of 9 and 14 months. Based on these results, it is urged that receptor values are studied and integrated with classical clinical and histopathologic variables before making a clinical decision so that patients with receptor-poor assay results are not prematurely labeled hormonally unresponsive. PMID- 3304610 TI - Chemotherapy as a substitute for surgery in the treatment advanced resectable head and neck cancer. A report from the Northern California Oncology Group. AB - This trial determines the feasibility for patients with resectable Stages III/IV head and neck cancer who achieved a complete response to induction chemotherapy of eliminating surgery from their treatment program. Thirty patients were treated with three cycles of cisplatin and 5-fluorouracil (5-FU), followed by reendoscopy and biopsy. Twelve patients achieved a complete pathologic response at the primary and received radiation (interstitial and/or external beam) only. The remainder underwent surgical resection and postoperative radiation. At 2 years, the relapse-free survival was 52%, and the survival was 53% for the entire group. For the 12 complete responders who had surgery eliminated, the relapse-free survival was 60%, and the survival was 70%. This pilot study suggests that for patients with resectable disease who achieve a complete pathologic response to induction chemotherapy at their primary, it is feasible to omit surgery and treat with primary radiation without compromise in survival. This approach warrants further study in a randomized trial. PMID- 3304612 TI - Radiation-induced leiomyosarcoma of the great vessels presenting as superior vena cava syndrome. AB - A patient with a pleomorphic intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presented clinically with a superior vena cava syndrome. A latent period of 29 years elapsed between receiving orthovoltage radiation to the neck and right side of chest to treat recurrent ganglioneuroblastoma, and the appearance of a leiomyosarcoma and subsequent recurrences. The patient underwent partial resection of the tumor, received adjunct chemotherapy, and was shown to be free of disease by clinical tests and by magnetic resonance imaging (MRI) 17 months after completion of chemotherapy. The criteria for the diagnosis of radiation-induced sarcomas are reviewed in relation to the present case. The critical role of magnetic resonance imaging in both the diagnosis and continued follow-up of the patient is described. This would appear to be the first reported case of radiation-induced intravascular leiomyosarcoma of the great vessels of the neck and mediastinum presenting as a superior vena cava syndrome. PMID- 3304613 TI - Quality of life measurement in testicular cancer patients. AB - The linear-analogue self-assessment (LASA) technique was used to assess acute toxicity and other pertinent attributes relative to quality of life (QL) in patients with advanced testicular cancer who were entered into chemotherapy trials with either velban, Actinomycin-D, bleomycin, cisplatin, and cytoxan (VAB 6), etoposide and cisplatin (EP), or both regimens. Results showed significantly less nausea, vomiting, mucositis, and a earlier return to normal physical activity with EP versus VAB-6. The LASA method appears to be a valid measure of acute toxicity to chemotherapy in testicular cancer patients and provides objective QL information for patients entered into prospective clinical trials. PMID- 3304614 TI - The sensitivity of bladder wash flow cytometry, bladder wash cytology, and voided cytology in the detection of bladder carcinoma. AB - The sensitivity of voided urinary cytology (VUC), bladder wash cytology (BWC), and bladder wash flow cytometry (BWFCM) in detecting cancer was studied in 70 patients with biopsy-proven bladder tumors. There were 11 Grade I papillomas, 14 Grade II TA, 18 Grade II-III TIS, 19 Grade II-III T1, and eight Grade II-III T2 carcinomas. One to five VUCs per patient (mean, 2.63) were obtained within the 24 hours preceding biopsy. At endoscopy a bladder wash specimen was obtained and divided for cytologic and flow cytometric examinations. For all tumor categories combined, the sensitivity for one, two, and three voided cytology examinations per patient was 41%, 41%, and 60%, respectively. The sensitivity of a single BWC was 61%, of a single BWFCM, 83%. Thus, one BWFCM is more sensitive than three VUC (binomial test; P = 0.006); one BWC is more sensitive than two VUC (P = 0.01); and one BWFCM is more sensitive than one BWC (P = 0.003). These findings remain significant when papillomas are excluded from the analysis (P less than or equal to 0.03) and when papillomas and T2 tumors are jointly excluded (P less than or equal to 0.02). Only four of 70 patients (6%) had their cancers detected by VUC and/or BWC rather than BWFCM. In summary, irrigation cytology specimens are more sensitive than voided urinary cytology, and bladder wash flow cytometry is more sensitive than either in diagnosing bladder cancer. Flow cytometry is more sensitive because of the better sampling of bladder irrigation compared with voided urine and because of the measurement technique itself. PMID- 3304615 TI - Estrogen and progesterone receptor determination in the papillary cystic neoplasm of the pancreas. With immunohistochemical and ultrastructural observations. AB - Two cases of papillary cystic neoplasm (PCN) of the pancreas occurring in 18- and 34-year-old women are described. In both, the clinicopathologic features were typical. Immunohistochemical staining for neuron-specific enolase (NSE), S100 protein (S100), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and several peptide hormones was negative. Alpha-1-antitrypsin immunoreactivity was prominent, and its significance is discussed. Ultrastructural features were most compatible with partial acinar differentiation. Of the well-described cases of PCN, approximately 95% have occurred in women between the ages of 12 and 35, suggesting a role for hormonal factors in the pathogenesis of this tumor. Consequently, tumor tissue from one patient was assayed for estrogen and progesterone receptors: significant levels of high-affinity receptors were demonstrated for both hormones. Assays for the same receptors in five normal pancreases were negative. This constitutes the first reported measurement of these receptors in the PCN; the results indicate that the PCN may be another hormone-sensitive tumor. PMID- 3304616 TI - Mutagenicity of gingerol and shogaol and antimutagenicity of zingerone in Salmonella/microsome assay. AB - Ginger extract and its constituents gingerol, shogaol and zingerone were tested in Salmonella typhimurium strains TA 100, TA 98, TA 1535 and TA 1538 in the presence and in absence of S9 mix. It was observed that ginger extract, gingerol and shogaol were mutagenic on metabolic activation in strains TA 100 and TA 1535, but zingerone was non-mutagenic in all the four strains with or without S9 mix. When mutagenicity of gingerol and shogaol was tested in presence of different concentrations of zingerone it was observed that zingerone suppressed mutagenic activity in both the compounds in a dose dependent manner. PMID- 3304617 TI - Biological and therapeutic potential of membrane lipid modification in tumors. AB - The membrane fatty acid composition of cancer cells can be modified either in culture or during growth in animals without disrupting basic membrane or cellular integrity. Only fatty acids are affected; no changes occur in membrane cholesterol, phospholipid, or protein content. There are changes in membrane physical properties and certain cellular functions, including carrier-mediated transport, receptor binding, ion channels, and eicosanoid production. Fatty acid modification also can enhance the sensitivity of the cells to hyperthermia and Adriamycin. This technique provides a new approach to understanding the membrane properties of neoplastic cells. Membrane fatty acid modification also may be of potential value as a therapeutic approach designed to augment the cytotoxicity of other antineoplastic therapies. PMID- 3304618 TI - Monoclonal antibody against human gallbladder carcinoma-associated antigen. AB - Monoclonal antibody HI-531 of immunoglobulin G2b subclass was produced against a human gallbladder carcinoma cell line. HI-531 was investigated for reactivity with a panel comprising ten types of different origin in fluorescence-activated cell sorter analysis. The antibody reacted with the gallbladder carcinoma cell line G-415 used for immunization and with four unrelated tumors. HI-531 was further shown, with the use of the avidin-biotin complex-immunoperoxidase technique and surgically resected tissues, to be strongly reactive with carcinoma of the gallbladder, pancreas, bile duct, and gastrointestinal tract. The antibody was reacted with several types of normal epithelial cells but often more weakly expressed than on corresponding tumors. One of six fetal lung tissues was weakly stained. All other fetal organ tissues tested showed negative staining reactions. These observations suggest that HI-531 may be of value in identifying the tumor associated antigen expressed in gallbladder carcinoma. HI-531 immunoprecipitated the Mr 43,000 molecule from extracts of Na125I- or [35S]methionine-labeled tumor cells, but not from those of [3H]glucosamine-labeled tumor cells. In addition, cytofluorometric analysis showed that cells treated with trypsin or protease greatly decreased a reactivity to the antibody. The findings suggest that the antibody recognizes a Mr 43,000 protein molecule. Sequential immunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis studies and analyses by nonequilibrium pH gradient and polyacrylamide gel electrophoreses showed that the Mr 43,000 molecule defined by HI-531 was not a Mr 43,000 heavy chain of HLA-A,B,C antigens detected by monoclonal antibody W6/32. PMID- 3304619 TI - Effects of mycophenolic acid on detection of glial filaments in human and rat astrocytoma cultures. AB - Expression of glial fibrillary acidic protein (GFAP) was assayed in 11 glioma derived cell cultures. Treatment of cells with an inhibitor of guanine nucleotide biosynthesis, mycophenolic acid, enhanced detection of GFAP by indirect immunofluorescence microscopy. Quantitation of GFAP and vimentin demonstrated that enhanced fluorescence occurs without an increase in the level of intermediate filament proteins. Immunoblots provided the most sensitive method for monitoring GFAP expression and showed the limitations of using immunofluorescence detection methods. GFAP was detectable in cultures derived from malignant Grade IV astrocytomas and its expression was stable during the course of the study. While mycophenolic acid has been reported to induce differentiation in leukemia cells at low concentration (D.L. Lucas et al., J. Clin. Invest., 72: 1889-1990, 1983), its effect on glioma cultures at concentrations of 100 microM was consistent with a role as an inhibitor of DNA synthesis, and as an effector of altered intermediate filament organization. PMID- 3304620 TI - Production of human hematopoietic survival and growth factor by a myeloid leukemia cell line (KPB-M15) and placenta as detected by a monoclonal antibody. AB - Fifty-five hematopoietic cell lines, including 19 T-, 16 B-, 5 pre-B-, 5 non-T non-B-, 1 erythroid, and 9 myeloid-monocytoid cells, were screened for production of human hematopoietic survival and stem cell growth factor (SCGF) by enzyme immunoassay using anti-SCGF monoclonal antibody. The KPB-M15 myeloid cell line constitutionally secreted a considerable quantity of SCGF, while other T- or myeloid-monocytoid cell lines did not secrete SCGF. Other biomaterials investigated were fetal calf, horse, and human serum; granulocyte-macrophage colony-stimulating factor and erythropoietin preparations; human placental conditioned medium; lectin (phytohemagglutinin, concanavalin A, and pokeweed mitogen); and mixed leukocyte reaction-stimulated leukocyte-conditioned medium. SCGF was detected only in human placental conditioned medium. SCGF produced by the KPB-M15 cells was a protein with a molecular weight of 20,000. The molecule, highly purified by immunoadsorbent affinity chromatography, retained SCGF activity in vitro, e.g., erythroid burst-promoting activity and granulocyte macrophage-colony potentiation. With the availability of purified SCGF, it is now possible to study in detail the mechanisms regulating hematopoietic stem cells. PMID- 3304621 TI - Liver tumour promotion by chemicals: models and mechanisms. AB - Tumour promotion is defined as the process whereby a carcinogen initiated organ develops focal proliferations such as nodules, polyps or papillomas, one or more of which become precursors for subsequent steps in the carcinogenic process. The available models for a sequential analysis of carcinogenesis in liver have been examined within the framework of this operational definition with respect to the models themselves as well as the promoted hepatocytes. Using initiation-promotion protocols, several promoters which differ in the biological responses they elicit have been identified. The key issue in promotion pertains to the mechanisms involved in the focal proliferation of the initiated hepatocytes. The resistant hepatocyte model and perhaps the phenobarbital model suggest that focal proliferation of the initiated hepatocyte is induced by exerting a selective mitoinhibitory effect on the surrounding cells while permitting the initiated hepatocyte to respond to the proliferative stimulus, whether it is exogenous or endogenous. The promoter orotic acid, on the other hand, is a natural precursor of pyrimidine nucleotide biosynthesis and is neither an inducer nor an inhibitor of liver cell proliferation but it creates an imbalance in cellular nucleotide pools. Since nucleotides are intermediates in DNA synthesis as well as in the glycosylation of proteins and lipids including that of membranes, it has been postulated that the promotional effect of orotic acid is mediated through this imbalance affecting both DNA and membranes. There is some experimental evidence for this. The importance of this hypothesis is that it raises the possibility of achieving promotion in several organs by disturbing the normal nucleotide pool patterns. Indeed orotic acid has also been found to promote duodenal cancer. The finding that hepatic nodules, regardless of how they have been promoted, exhibit a common biochemical pattern with resistance to several agents has raised some important issues. For example, what is the basis for the resistant phenotype and how is it related to cancer development? Are all initiated hepatocytes identical? If not, do all promoters exert their effect on the same population of initiated hepatocytes? Is the heterogeneity of the initiated hepatocyte population generated by the carcinogen due to the induction of more than one critical lesion: a primary lesion responsible for initiation and secondary lesions in which different types of initiated cells are selected by different promoters?(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304622 TI - Dexamethasone therapy and cortisol excretion in severe pediatric head injury. AB - Glucocorticoids are used in an attempt to reduce brain edema secondary to head injury. Nevertheless, their usefulness remains uncertain and contradictory. In a randomized study of 24 children with severe head injury, urinary free cortisol was measured by radioimmunoassay. Twelve patients (group 1) received dexamethasone and 12 (group 2) did not. All patients were treated with a standardized regimen. In group 1 there was complete suppression of endogenous cortisol production. In group 2 free cortisol was up to 20-fold higher than under basal conditions and reached maximum values on days 1-3. Since the excretion of cortisol in urine reflects the production rate closely and is not influenced by liver function and barbiturates, the results in group 2 show that the endogenous production of steroids is an adequate reaction to severe head injury. Exogenous glucocorticoids are thus unlikely to have any more beneficial effects than endogenous cortisol. PMID- 3304623 TI - A cohort study of neural tube defects (NTD) in Denmark covering the first seven years of life. AB - In the County of Fyn, Denmark, which is a well-delimited region comprising a 10% representative sample of the total population, ten complete one year cohorts of newborn were scrutinized for neural tube defects (NTD). Among 66,000 births, 71 cases with NTD were observed. The total prevalence at birth was 1.08/1,000; 0.29 for anencephaly; 0.20 for encephalocele, and 0.59 for spina bifida (SB). This is at the same level as in other Scandinavian countries. Considering only neonates born alive, 57% of the total survived until the age of 7 years, disregarding anencephaly, but only 4 of 18 SB cases and 6 of 11 encephalocele cases had no handicaps at age 7. On the average, SB patients spent 9% of their life before the age of 7 years in hospitals and encephaloceles 2%. The SB cases occupied 25 times more beds per year than the comparable age group in general and many were likely to need continued medical and social care. PMID- 3304624 TI - Arachnoid cysts: diagnosis and treatment. AB - Twenty supratentorial and 10 infratentorial arachnoid cysts are reported. The patients were from 0 to 15 years of age. The commonest presenting symptoms in children were cranial enlargement, epileptic seizures, and psychomotor retardation. Neuroradiological evaluation included CT, metrizamide CT, cisternography, and angiography. Echography was performed in 5 newborns. Therapeutic criteria according to the clinical and neuroradiological findings are reviewed. Cystoperitoneal shunting in combination with ventriculoperitoneal shunting for associated hydrocephalus is considered the treatment of choice. PMID- 3304625 TI - Prospective randomized cooperative medulloblastoma trial (MED 84) of the International Society of Paediatric Oncology (SIOP) and of the (German) Society of Paediatric Oncology (GPO). AB - This international, prospective, randomised therapeutic study is based on previous, separate studies of the two societies. The study asks two principal questions: Is it possible to improve the results of therapy by inserting, between surgery and post-operative irradiation, an intensive course of chemotherapy consisting of vincristine, procarbazine and methotrexate, followed by citrovorum factor rescue? In "low risk" patients (i.e. those with macroscopically "complete" resection and absence of metastases at diagnosis), can the radiotherapy to CNS areas outside the primary tumour site be reduced by 10 Gy with the aim of reducing late sequelae of irradiation but without compromising survival results? The study also aims at standardising diagnostic methods, neurosurgical procedure and radiotherapeutic technique employed in this tumour. For statistical reasons, results can only be disclosed after the end of the recruitment phase. It is intended to include approximately 350 patients in the study, which is planned to continue until the end of 1988. PMID- 3304627 TI - Stereotactic surgery in the management of deep intracranial lesions in infants and adolescents. AB - Over a period of 5 years, 34 pediatric patients underwent stereotactic surgery for deep-seated brain lesions: 32 patients proved to have a brain tumor, and in 2 cases the lesion was not tumoral; 15 patients with low-grade astrocytomas were treated with 125I interstitial radiotherapy. The importance of stereotactic surgery is emphasized because of its relative safeness, diagnostic reliability, and the possibility of eventual brachytherapy. PMID- 3304626 TI - Medulloblastoma: histological evaluation and prognosis. A clinical, immunohistochemical and electron microscopic study. AB - Eighty-four cases of medulloblastoma were examined immunohistochemically and 12 by electron microscopy to assess differentiation in these tumors. Based upon the largest series of medulloblastoma studied to date, we demonstrated glial fibrillary acidic protein (GFAP) positivity, in 25% (21/84) of these tumors showing glial differentiation. GFAP-positive cells were seen more frequently in the desmoplastic variant of medulloblastoma (7/10). Under electron microscopy, the major part of the 12 tumors studied appeared primitive and undifferentiated. In 7 cases, groups of cells were found with primitive neuronal and/or glial features. GFAP positivity was confirmed at light microscopy level in all cases where cells showed glial differentiation in the form of glial-like filaments in cytoplasma. However, a follow-up questionnaire study of those patients who had received only surgical treatment revealed no difference in mean survival time between GFAP-positive and GFAP-negative medulloblastoma. PMID- 3304629 TI - A collection of papers dedicated to Karl Freudenberg, Burckhardt Helferich, Hermann O. L. Fischer on the centenary of their births. PMID- 3304630 TI - [Is it possible to evaluate right ventricular function by the determination of ventricular T? Study in humans and animals]. PMID- 3304628 TI - Karl Freudenberg, Burckhardt Helferich, Hermann O. L. Fischer: a centennial tribute. PMID- 3304632 TI - [Clinico-hemodynamic evaluation of endomyocardial fibrosis. Description of a case]. PMID- 3304631 TI - [Treatment of arterial hypertension with a new calcium antagonist: nicardipine]. PMID- 3304633 TI - [Diabetes mellitus and myocardial infarction]. PMID- 3304634 TI - Anniversary issue. 50 years of CARDIOLOGY. PMID- 3304635 TI - CARDIOLOGY 50th birthday--editorial thoughts. PMID- 3304636 TI - Future directions in cardiology. PMID- 3304637 TI - Perspectives for the primary prevention of coronary heart disease. AB - A massive body of scientific evidence from clinical, experimental, pathological and epidemiological studies as well as from risk factor intervention trials and community studies has emerged until the 1980s; interpreted as a whole it leaves no more doubt about the major role of hyperlipidaemia, hypertension, cigarette smoking and some other modifiable factors in the aetiology of atherosclerosis and CHD, and about the great potential for primary prevention of CHD. In response to this challenge, the World Health Organization Expert Committee in its report in 1982 outlined the general principles and strategies for the primary prevention of CHD, and these principles and strategies have then been reinforced and further developed toward practical action plans by international and national experts groups. The perspectives for the primary prevention during the future decades may be envisaged to include: (1) further strengthening of preventive action in those countries with high or relatively high CHD rates in which favourable changes in life-styles and risk factor levels are already going on and CHD rates are declining; (2) development and implementation of effective plans for preventive action in those countries with high or relatively high CHD rates in which these rates are not yet declining or even increasing, and (3) development and implementation of effective plans for a real primordial prevention of CHD, i.e., preventing the appearance of unhealthy life-styles and elevated risk factor levels, in those developing countries in which CHD threatens to emerge in connection with socio-cultural changes toward urbanization and industrialization. PMID- 3304638 TI - Clinical trials of antiarrhythmic therapy--an improper answer to a proper question? AB - Pharmacologic prevention of ventricular fibrillation (VF) and sudden cardiac death (SCD) is based on the assumption that the abnormal impulse that causes premature ventricular complexes (PVCs) may trigger VF and that antiarrhythmic drug therapy will thus inactivate the trigger. However, results available from secondary preventive trials of antiarrhythmic agents, including the Ghent Rotterdam Aprindine (GRAP) study, have not established conclusively the value of antiarrhythmic therapy. A number of factors could explain this failure, e.g., PVCs and VF might not be causally related, thus, antiarrhythmic drugs might not prevent VF; the number of patients enrolled in investigations might have been too small to accommodate statistical proof of benefit; or the subjects might have been poorly selected. A serious design defect that could interfere with demonstrating a benefit for treatment might arise from the fact that all patients in the GRAP and similarly designed studies had to show complex ventricular arrhythmias at randomization and that antiarrhythmic treatment was usually continued regardless of its effect on the underlying arrhythmias. Given the variability of arrhythmias, it would be expected that arrhythmias would persist in only a fraction of patients randomized to placebo. However, arrhythmias also persisted, although to a lesser extent, in treated patients. If one considers that SCD risk may be reduced in the face of arrhythmia suppression but that it may be increased if the arrhythmia persists due to a toxic or proarrhythmic drug effect, any advantageous effects of successful antiarrhythmic drug therapy would be offset by the negative effects of unsuccessful arrhythmia suppression, which would distort the comparison with placebo.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304639 TI - Random walk type models for indicator-dilution studies: comparison of a local density random walk and a first passage times distribution. AB - The relative merits of the local density random walk and the first passage times distributions were compared with respect to their practical applicability in cardiovascular research and clinical practice. Open indicator-dilution curves of varying shape were used, and reference values for area and mean transit times were calculated numerically. Curves not perturbed by recirculation were obtained in two different ways. Thermodilution curves were obtained in an animal model at the left and the right side of the heart respectively and conductivity curves with 0.5% NaCl solution as indicator were obtained in a hydrodynamic circulation model. The fits of the two types of distribution were equally accurate for the more symmetrical curves; for very skewed curves the local density random walk fit proved to be more accurate. This result could be related to the greater difference in shape between the first passage times and local density random walk distribution for a large degree of asymmetry. For this reason the local density random walk distribution for fitting indicator-dilution curves was used in a variety of other experimental conditions. PMID- 3304640 TI - Doppler blood velocity in the pulmonary artery of infants, children, and adults. AB - A pulsed, range gated, directional, ultrasonic, Doppler blood velocity meter was used to record signals from the pulmonary artery in 52 normal subjects ranging in age from less than 1 week to over 30 years. Signals were obtained from an unfocused transducer in the second or third left intercostal space using a 2.25 MHz instrument. The increase in mean velocity at the start of systole followed a linear pattern for at least the first 45 ms of ejection, irrespective of the age or size of the subject. The value for the acceleration at the start of systole decreased during childhood, reaching less than half that in the aorta in adults, and the duration of the linear increase in velocity increased. The pulmonary arterial signals in newborn infants closely resembled those in the aorta. The range of frequencies seen in the sample volume in the adult pulmonary arterial signals was greater than that in the aorta, whereas in infants it was indistinguishable from that in the aorta. PMID- 3304641 TI - Effects of changes in airway pressure on the left ventricle and left atrium of dogs. AB - The effects of negative and positive airway pressure were examined in eight closed chest, chronically instrumented dogs to determine beat to beat changes in left ventricular pressure, left ventricular dP/dt, left ventricular dimensions, and oesophageal pressure. As an index of afterload, systolic transmural pressure was calculated by subtracting oesophageal pressure from left ventricular pressure. With each change in airway pressure left ventricular end systolic minor axis diameter and left ventricular end diastolic minor axis diameter increased significantly. Left atrial end diastolic dimension increased significantly with negative airway pressure and did not change with positive airway pressure. Left ventricular dP/dt and left ventricular fractional shortening did not change. With the Mueller manoeuvre left ventricular systolic pressure decreased significantly from 106(4.2) mm Hg to 100.9(4.2) mm Hg and systolic transmural pressure increased significantly from 105.1(4.6) mm Hg to 110.4(4.3) mm Hg. With a transient increase in positive airway pressure of 30 mm Hg (4.0 kPa), left ventricular pressure increased significantly from 106.9(4.8) mm Hg to 113.9(5.9) mm Hg and systolic transmural pressure decreased significantly from 106.6(4.9) mm Hg to 99.8(4.6) mm Hg. The addition of positive end expiratory pressure of 10 cm H2O (0.98 kPa) or autonomic blockade with atropine and propranolol did not alter these results. Thus manoeuvres which cause opposite effects on systolic transmural pressure produce similar increases in left heart dimensions, suggesting that increases in pulmonary venous return and not changes in afterload may be the important determinants of left ventricular dimensional changes during changes in airway pressure. PMID- 3304643 TI - Vasoactive intestinal polypeptide immunoreactivity in the spinal cord of the guinea pig. A mapping study. AB - The distribution of vasoactive intestinal polypeptide-immunoreactive (VIP-IR) neurons in the lower medulla oblongata and the spinal cord has been analyzed in guinea pigs. This study includes results obtained by colchicine treatment and transection experiments. In the spinal cord, numerous VIP-IR varicosities were observed in the substantia gelatinosa of the columna dorsalis; some were also found in the substantia intermedia and the columna anterior. The spinal VIP-IR nerve fibers were mainly of intraspinal origin and oriented segmentally. VIP-IR nuclei in the spinal cord extended dorsally into corresponding regions of the caudal medulla oblongata, namely from the substantia intermedia medialis and lateralis into the vagus-solitarius complex and from the nucleus spinalis lateralis into the area of the nucleus reticularis lateralis. Additional VIP-IR perikarya were observed in the pars caudalis of the nucleus spinalis nervi trigemini. The VIP-IR nuclei within the caudal medulla oblongata probably form a continuous system with those localized within the spinal cord. They may be involved functionally in the modulation of cardiovascular and respiratory regulation in the guinea pig. PMID- 3304642 TI - Distribution of nerve fibers immunoreactive to neurofilament protein in rat molars and periodontium. AB - The distribution of nerve fibers in molars, periodontal ligament and gingiva of the rat shows a complex pattern. Decalcified material including the alveolar bone was sectioned in three different planes and stained by means of immunohistochemistry for detection of the neurofilament protein (NFP); the immunoreactive neural elements were clearly visualized in three-dimensional analyses. NFP-positive nerve fibers formed a subodontoblastic plexus in the roof area of the dental pulp; some of them entered the predentin and dentin directly through the dentinal tubules. This penetration was found mainly in the pulp horn, and was limited to a distance of about 100 micrometers from the pulpo-dentinal junction. In the periodontal ligament, NFP-positive nerve fibers were found densely distributed in the lower half of the alveolar socket. Two types of nerve terminals were recognized in the periodontal ligament: free nerve endings with tree-like ramifications, and expanded nerve terminals showing button- or glove like shapes. The former tapered among the periodontal fibers, some even reaching the cementoblastic layer. The latter were located, frequently in groups, within the ligament restricted to the lower third of the alveolar socket. A well developed plexus of NFP-positive nerves was revealed in the lamina propria of the free gingiva, the innervation being denser toward the epithelium of the gingival crevice. The characteristic distribution of NFP-immunoreactive nerve fibers revealed in this study is discussed in relation to region-specific sensations in the teeth and surrounding tissues. PMID- 3304644 TI - Ontogeny of gonadotropin releasing hormone and gonadotropin immunoreactivity in brain and pituitary of normal and estrogen-treated guppies, Poecilia reticulata Peters. AB - Gonadotropin releasing hormone (GnRH) and gonadotropic hormone (GTH) were identified by immunohistochemistry in the brains and pituitaries of neonate, juvenile and adult guppies. GTH was present in some cells of the pars intermedia (pi) and proximal pars distalis (ppd) of all animals. GnRH was found in the perikarya of the nucleus olfactoretinalis. In the pituitaries of juvenile 30-day old guppies, GnRH-immunoreactive cells existed in a "juvenile pattern", whereas in adult animals GnRH was recognized in only a few cells. GnRH-immunoreactive fibers were seen in the pituitaries of animals that were 30 days or older. In adult guppies, the ventral and lateral ppd (the gonadotropic region) contained a dense network of GnRH-immunoreactive fibers. Pituitary cells staining for either GnRH or GTH were located in different places. After immunohistochemical double staining of adult pituitaries, none of the GnRH-immunoreactive cells were LH immunoreactive, although both cell types were often found in close proximity. After 20 days or more of ethinylestradiol treatment, less immunoreactive GnRH was detected in the pituitary cells of juvenile guppies, and fewer animals exhibited the "juvenile pattern" of GnRH-immunoreactive pituitary cells, when compared with untreated controls. The results indicate that GnRH-immunoreactive pituitary cells in the guppy are distinct from gonadotropes and that these cells are involved in regulatory processes along the juvenile brain-pituitary-gonad axis. PMID- 3304645 TI - The cytoskeleton of isolated murine primitive erythrocytes. AB - Cytoskeletons of primitive erythrocytes have been isolated from the embryos of day 12 pregnant C57/Bl mice and examined by transmission electron microscopy, immunofluorescence microscopy, and SDS-polyacrylamide gel electrophoresis. Microtubules are the most prominent cytoskeletal component. They are found either singly or organized into loose bundles just under the plasma membrane, but do not form classical marginal bands in most cells. Immunofluorescence with a polyclonal tubulin antiserum confirms this distribution and further reveals numerous mitotic figures among cells. Rhodamine-conjugated phalloidin and heavy meromyosin labeling reveal that actin is localized in the cortex of the primitive erythrocyte in the form of 6 nm filaments. Antibody directed against avian erythrocyte alpha spectrin demonstrates that spectrin is also found in the cortex. Occasional 10-nm intermediate filaments, observed in the primitive erythrocytes by electron microscopy, are believed to be of the vimentin class based on positive reaction of the cells with vimentin-specific antiserum. In addition, a band in erythrocyte cytoskeletons comigrates in SDS-polyacrylamide gels with vimentin isolated from mouse kidney. Spectrin and actin were also found to be associated with the membrane of primitive erythrocytes when membrane ghost preparations were analyzed by SDS-polyacrylamide gel electrophoresis. PMID- 3304647 TI - Demonstration of rod and cone photoreceptors in the lamprey retina by freeze replication and immunofluorescence. AB - In common with other cyclostomata, the Japanese river lamprey (Lampetra japonica) has a retina consisting of distinct types of photoreceptor cells called long and short photoreceptor cells. After freeze-fracture, disc membranes of these photoreceptor cells were characterized in common by a homogeneous distribution of intramembrane particles on the protoplasmic fracture faces, in contrast to those of the myeloid bodies bearing scattering particles. Immunofluorescent examination was applied to the retina with monoclonal antibodies raised against bovine and chicken rhodopsins. Positive immunoreactivity was found to be limited to outer segments of the short cell, leaving the entire body of the long cell and all other components of the retina negative. The results suggest that the short cell is more closely related to a rod-type photoreceptor cell characterized by rhodopsin as its visual pigment. PMID- 3304646 TI - Oxytocin-like immunoreactive nerves are associated with insulin-containing cells in pancreatic islets of anglerfish (Lophius americanus). AB - Recent reports indicate that oxytocin exerts direct effects on the release of insulin and glucagon from the endocrine pancreas of the rat. The purpose of this study was to determine whether oxytocin-like immunoreactivity is present in the anglerfish islet, and if it is associated with subsets of hormone-producing cells. Antisera against oxytocin, insulin, glucagon, somatostatin, neuropeptide Y, and the 200-kd neurofilament polypeptide were applied to serial 5 micrometers sections of pancreatic islets. The antiserum to the 200-kd neurofilament polypeptide labeled nerve bundles and axons, some of which were also stained with the oxytocin antiserum. Oxytocin immunoreactivity was observed in large nerves that branched into varicose fibers. These fibers were consistently associated only with clusters of insulin-producing cells. Successive application of oxytocin and insulin antisera to the same section provided additional verification of this relationship. Oxytocin-labeled nerves were not associated with cells immunoreactive to glucagon, somatostatin, or neuropeptide Y (anglerfish peptide Yg). The results demonstrate that oxytocin or an oxytocin-like peptide is located in fibers that surround only insulin-producing cells in the anglerfish islet. Although the functional significance of this observation remains to be determined, the results imply that oxytocin, or an oxytocin-like peptide, may affect the synthesis or release of insulin from anglerfish islets. PMID- 3304648 TI - The effect of progesterone on the localization of progesterone receptors in the nuclei of chick oviduct cells. AB - The location of occupied and unoccupied progesterone receptors (PR) in chick oviduct cells was studied by immuno-electron microscopy with the use of a highly specific polyclonal anti-PR antibody and pre-embedding modifications of the peroxidase-anti-peroxidase- (PAP-) or immunogold-silver methods. Both methods revealed a nuclear localization of the PRs. The location of the PR in the nucleus was studied in detail by means of the immunogold-silver method. The most intense labelling for unoccupied PRs was in the condensed chromatin. After occupation of PRs with progesterone (P), decondensation or dispersion of chromatin was observed. At the same time, the labelling in the border area of condensed and dispersed chromatin, and in the dispersed chromatin, increased. The changes were statistically significant. The results can be explained by conformational changes of the PR-containing chromatin rather than by translocation of PRs from one site to another. PMID- 3304649 TI - Effects of extracellular osmolality on renin release and on the ultrastructure of the juxtaglomerular epithelioid cell granules. AB - Superfusion with hypoosmotic solutions stimulates renin release from rat epithelioid cells adherent to isolated glomeruli. This stimulatory effect may be related to the observed swelling of the secretory granules; the swelling may markedly increase the probability of pre-exocytotic fusions between the granule and cell membranes, and consequently increase the frequency of exocytotic events. PMID- 3304651 TI - S-100 protein in Schwann cells of the developing human peripheral nerve. An immunohistochemical study. AB - From approximately 7 weeks gestational age in developing human peripheral nerve, as in adult nerve, S-100 protein was found to be expressed solely and uniformly by Schwann cells associated with axons. In embryos younger than 7 weeks S-100 was much less constant and many cells did not show clear staining. The trigger for the initial appearance of the protein at around this age remains unclear although a relationship of S-100 expression in Schwann cells to close axonal contact is suggested. The value of S-100 protein in distinguishing Schwann cells from perineurial cells in normal nerves and nerve sheath tumours remains unclear. PMID- 3304650 TI - Ultrastructural characterisation of vasopressinergic terminals in the lateral septum of murine brains by use of monoclonal anti-neurophysins. AB - Synapses in the lateral septum of the murine brain have been investigated by ultrastructural immunocytochemistry, using monoclonal anti-neurophysins in both immunoperoxidase and immunogold techniques. In the region shown by light microscopy to be rich in vasopressinergic innervation, synaptic boutons containing approximately 30 nm clear vesicles and occasional approximately 100 nm dense-cored granules (granules) were stained by pre-embedding immunoperoxidase procedures with antisera to vasopressin-neurophysin, but not oxytocin neurophysin; reaction product was diffusely distributed in the terminals. Terminals were symmetrical, and both axosomatic and axodendritic in type. Postembedding immunogold procedures by use of anti-vasopressin-neurophysin labeled only the approximately 100 nm diameter granules in the terminals. Sodium meta-periodate treatment 'bleached' immunoreactive granules, indicating the presence of a carbohydrate residue. The quantum of peptide packaged in the granules appears to be smaller than that in magnocellular neurones; nevertheless, the results indicate that, as in the magnocellular neurosecretory system, vasopressin and its neurophysin are packaged exclusively in granules, and that vasopressin in the septum is likely to be derived from a precursor comprising vasopressin, vasopressin-neurophysin and a glycosylated residue. PMID- 3304653 TI - [A seroepidemiological survey of the natural infection of pseudotuberculosis in human beings and animals]. PMID- 3304654 TI - [Studies on the role of residual microfilaremia in Bancroftian filariasis transmission in controlled areas]. PMID- 3304652 TI - Glial cells positive for glial fibrillary acidic protein in the neurohypophysis of the Djungarian hamster (Phodopus sungorus). An immunohistochemical and ultrastructural study. AB - The presence and distribution of the glial fibrillary acidic protein (GFAP; an astrocytic marker protein associated with glial filaments) in the neurohypophysis of the Djungarian hamster (Phodopus sungorus) were investigated immunohistochemically. Our study revealed characteristic GFAP-staining patterns within the median eminence, infundibular stem and neural lobe. In the whole neurohypophysis, few glial cells showed immunoreactivity. In the neural lobe, immunopositive pituicytes appeared preferentially in the periphery. At the ultrastructural level, we found some pituicytes containing filaments, most notably in their processes. We thus demonstrated that, in contrast to the GFAP immunoreactivity of cultured pituicytes, pituicytic GFAP-expression in vivo coincides with the presence of electron-microscopically detectable filaments. PMID- 3304655 TI - Translumbar coronary and brachiocephalic arteriography using a modified Desilets Hoffman sheath. AB - A translumbar sheath is described that is suitable for performance of selective coronary and brachiocephalic arteriography when the extremity arteries are blocked. The sheath has been adapted to a needle and catheter, which are introduced as a unit into the aorta at the T-12 level. With the needle and catheter removed, the sheath can be used safely to exchange catheters for left ventriculography and selective studies of branches of the thoracic aorta without excessive retroperitoneal bleeding. PMID- 3304656 TI - Influenza virus A pathogenicity: the pivotal role of hemagglutinin. PMID- 3304657 TI - MAT alpha 1 protein, a yeast transcription activator, binds synergistically with a second protein to a set of cell-type-specific genes. AB - We show by electrophoresis mobility shift and by DNAase I footprinting assays that the alpha 1 product of the yeast alpha mating-type locus binds to homologous sequences within the control regions of the three known alpha-specific genes. Binding requires both alpha 1 and a second yeast protein(s) (called PRTF) that is present in all three cell types (a, alpha, and a/alpha); neither protein binds alone. Binding and competition experiments using synthetic oligonucleotides indicate that PRTF binds to only part of the homology found at alpha-specific genes and imply that alpha 1 binds to the remainder. Our results suggest that alpha 1 renders gene expression alpha-specific by creating a binding site for PRTF. Similar experiments lead to the idea that PRTF also plays a role in transcription of a-specific genes. Perhaps a-specificity is achieved through the occlusion of the PRTF binding site by alpha 2, the negative regulator encoded by the alpha mating-type locus. PMID- 3304658 TI - Identification of invasin: a protein that allows enteric bacteria to penetrate cultured mammalian cells. AB - Bacterial strains harboring the Yersinia pseudotuberculosis inv locus were analyzed in order to investigate the mechanism of host cell penetration by an invasive pathogen. The inv locus was found to be necessary for Y. pseudotuberculosis to enter HEp-2 cells and sufficient to convert E. coli into a microorganism able to penetrate cultured cells. Both E. coli and Y. pseudotuberculosis strains harboring inv mutations were defective for entry into HEp-2 cells. Furthermore, molecular clones containing inv, and little additional DNA, converted E. coli into a microorganism that was indistinguishable from the parental Yersinia strain with regard to the entry of cultured cells. Data from in vitro protein synthesis indicated that a 103 kd protein was synthesized from inv, saturating the coding capacity of the locus. The nucleotide sequence shows an open reading frame corresponding to a protein of similar size. This protein, called invasin, is necessary for the microorganisms to penetrate HEp-2 cells, and is compartmentalized on the outer surface of the bacterium. PMID- 3304659 TI - Functional redundancy and structural polymorphism in the large subunit of RNA polymerase II. AB - The RNA polymerase II large subunit contains tandem copies of the sequence Pro Thr Ser Pro Ser Tyr Ser at its carboxyl terminus, the number of which varies from 26 in yeast to 52 in mice. Our results indicate that the heptapeptide repeat sequence is unique and essential to RNA polymerase II. We have determined that a portion of the heptapeptide repeat domain is essential for viability by constructing and analyzing unidirectional deletions of the carboxy-terminal coding sequence in yeast. Cells containing an RNA polymerase II large subunit with less than 10 complete heptapeptide repeats are inviable, those containing 10 12 complete repeats are conditionally viable, and those with 13 or more complete repeats are unconditionally viable. The inviable deletion mutants studied here have truncated RNA polymerase subunits that are stable, but functionally deficient. Finally, the number of repeat units is polymorphic in wild-type yeast strains. These results have implications for the function of this unusual sequence in transcription. PMID- 3304660 TI - Initiation of transcription at the bacterial glnAp2 promoter by purified E. coli components is facilitated by enhancers. AB - The initiation of transcription from the nitrogen-regulated promoter glnAp2 requires RNA polymerase containing sigma 54, the transcriptional activator NRI, and the protein kinase NRII, responsible for the conversion of NRI to the active NRI-phosphate. NRI-phosphate does not increase the ability of sigma 54-containing RNA polymerase to bind to the promoter, but rather stimulates the conversion of an initial promoter:polymerase complex to the transcriptionally active open complex. The presence on the DNA template of high-affinity binding sites for NRI/NRI-phosphate, normally located 130 and 100 bp upstream of the site of transcription initiation, results in a 4- to 5-fold lowering of the concentration of NRI required for the formation of the open complex. These high-affinity NRI binding sites facilitate open complex formation when they are moved to positions 700 bp further upstream or 950 bp downstream of glnAp2 on linear DNA templates. PMID- 3304662 TI - Hemimethylation prevents DNA replication in E. coli. AB - The DNA adenine methylase of E. coli methylates adenines at GATC sequences. Strains deficient in this methylase are transformed poorly by methylated plasmids that depend on either the pBR322 or the chromosomal origins for replication. We show here that hemimethylated plasmids also transform dam- bacteria poorly but that unmethylated plasmids transform them at high frequencies. Hemimethylated daughter molecules accumulate after the transformation of dam- strains by fully methylated plasmids, suggesting that hemimethylation prevents DNA replication. We also show that plasmids purified from dam+ bacteria are hemimethylated at certain sites. These results can explain why newly formed daughter molecules are not substrates for an immediate reinitiation of DNA replication in wild-type E. coli. PMID- 3304661 TI - Distinguishing between mechanisms of eukaryotic transcriptional activation with bacteriophage T7 RNA polymerase. AB - To distinguish between mechanisms of eukaryotic transcriptional activation, we tested whether yeast upstream promoter elements can stimulate transcription by a heterologous transcription machinery, bacteriophage T7 RNA polymerase. The gal enhancer-like element recognized by GAL4 protein or the ded1 poly(dA-dT) element was placed upstream of the T7 promoter and his3 structural gene, and T7 RNA polymerase was produced in yeast cells. Under conditions where the gal element would normally be either activating or nonactivating, his3 transcription by T7 RNA polymerase was not stimulated above the level observed in the absence of any upstream element. In contrast, the ded1 poly(dA-dT) element stimulated transcription 7-fold, similar to the enhancement observed on the native ded1 promoter. Activation by the ded1 element thus may involve effects on the chromatin template that facilitate entry of the transcription machinery, whereas activation by the gal element may involve specific contacts between GAL4 and the transcriptional machinery. PMID- 3304663 TI - Developmental strategies of the angiosperm pollen: a biochemical perspective. AB - The current state of our knowledge of the biochemistry and biochemical cytology of normal pollen development and embryogenic transformation of pollen grains of cultured anthers of angiosperms is reviewed. Recent research shows that normal pollen development is characterized by gene activity for the synthesis of specific mRNAs associated with the gametophytic program. As a result of the trauma of excision and culture of anthers in a mineral salt medium, a small number of the enclosed pollen grains probably synthesize new mRNAs which code for the proteins involved in embryogenic divisions. Since these conclusions are based on the study of a small number of species, the need for sustained investigations on the molecular biology of pollen developmental transformations is emphasized. PMID- 3304664 TI - Differential expression of mouse embryonic antigens TEC-1 and TEC-2 in the epididymis of four rodent species. AB - The expression, properties and relationship of two mouse embryonic antigens (TEC 1 and TEC-2), which are defined by monoclonal antibodies, were investigated in the epididymis of four rodent species. Absorption analysis, indirect immunofluorescence microscopy and immunohistochemistry revealed that all the species studied contained in their epididymides, but not in testes, either TEC-1 (Chinese hamster), TEC-2 (guinea pigs, rats) or both TEC-1 and TEC-2 (mice) antigens. In an indirect immunofluorescence assay, the antigens were found on spermatozoa isolated from caudae epididymides of guinea pigs, rats and Chinese hamsters but not mice. On the other hand, the TEC-2 antigen, which is expressed on mouse eggs, was not detected on eggs from the other species studied. Immunolabeling of epididymal extracts separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis revealed that both epididymal antigens have apparent molecular weights of greater than 200,000. In guinea pigs, rats and mice, the antigens were detected by a two-site sandwich radioantibody-binding assay in which the antigen is immobilized and detected with the same antibody; this indicates that several antigenic determinants were present on the same carrier. In mice, some carriers seem to express both TEC-1 and TEC-2 epitopes. In Chinese hamsters, TEC-1 antigen was only detected by the solid-phase assay, suggesting that in this species there are markedly fewer antigenic determinants per carrier molecule. Interspecies differences in the activities of epididymal glycosyltransferases and/or glycosidases appear to be the biochemical mechanism of the species-specific expression of these antigens. PMID- 3304665 TI - Impaired recruitment and differentiation of osteoclast progenitors by osteocalcin deplete bone implants. AB - This is a report of an experimental system to study differentiation of bone resorbing osteoclasts and demonstrates that osteocalcin, an extracellular bone specific component, is necessary for the recruitment of osteoclast progenitor cells. The subcutaneous implantation of devitalized bone particles (BPs) elicits the recruitment and differentiation of osteoclasts that resorb the BPs. In a previous study, we showed by histomorphometric analysis that BPs that were deficient in osteocalcin were resorbed only 60% as well as normal BPs. In this study, the mechanism of this difference was investigated by measurements of recruitment, differentiation and activity of bone resorbing cells by normal and osteocalcin-deficient BP. Mononuclear cells were attracted to control BPs soon after implantation. In dramatic contrast, cellularity was depressed around osteocalcin-deficient BPs with very few mononuclear cells within the implant on day 5 (35% of control cellularity). In implants of normal BPs, tartrate-resistant acid phosphatase-positive multinucleated cells were evident by day 5; very few appeared in implants of osteocalcin-deplete BPs even by day 12. The amount of tartrate-resistant acid phosphatase activity in homogenates of the osteocalcin deficient bone particle specimens not only lagged behind controls but never reached the maximum activity of control BP specimens. These data support the hypothesis that osteocalcin may function as a matrix signal in the recruitment and/or activation of cells for bone resorption. PMID- 3304666 TI - Cellular and molecular events underlying the proliferative arrest associated with the leukemic phenotype in myeloid blast cells. PMID- 3304667 TI - Sensitivity of cultured fibroblasts to human, bovine and porcine insulins. AB - We have studied the effects of human, bovine and porcine insulin on sugar transport by cultured chicken embryo fibroblast monolayers. For a 30 min. association time, human and bovine insulin at a concentration of 5.10(-8) M stimulated 2-deoxy-D-glucose uptake. (respectively by an average 58 p.cent and 55 p.cent over basal). Porcine insulin was less potent since a concentration of 5.10(-7) M was necessary to obtain similar stimulation. Moreover, the maximal effect of porcine insulin occur only after 60 min. association time instead of 30 min. for the other peptides. The differences between the effects of insulin from different sources is related to species-dependent differences in their structure. PMID- 3304668 TI - Reflexes elicitable in jaw muscles and their role during jaw function and dysfunction: a review of the literature. Part II. Central connections of orofacial afferent fibers. PMID- 3304669 TI - Effect of insulin on murine megakaryocytopoiesis in a liquid culture system. AB - To examine the influence of insulin on megakaryocytopoiesis, we tested its effect on murine bone marrow cultures in a liquid culture system. In the presence of pokeweed mitogen-stimulated spleen cell conditioned medium in culture, insulin markedly enhanced megakaryocyte colony formation and increased the number and size of free megakaryocytes seen after 7 days. Many of the cells in cultures with insulin, however, were classified as immature, since they had a basophilic cytoplasm, a low cytoplasmic/nuclear ratio and low acetylcholinesterase activity. It is suggested that insulin potentiates murine marrow megakaryocytopoiesis in vitro, but that this is not accompanied by differentiation of the cells from the immature to mature state. PMID- 3304670 TI - Selective expression of cholera toxin-receptor in rat medullary thymocytes. AB - Cholera toxin binding sites in frozen sections of rat thymus were studied by indirect immunofluorescence and were found to be localized selectively in the medulla of thymic lobules. By flow cytometric analysis, two populations of thymocytes differing in size and reactivity towards cholera toxin were detected; the small thymocytes comprising 15% of the total thymocytes were found to express the receptor. The two kinds of cells isolated were not however, distinctly different in morphology. But ganglioside GM1, the cholera toxin binding site in the small thymocytes, when quantified by TLC-immunostaining, was contained at a higher concentration than in the large thymocytes. These results indicate that GM1 should be a useful marker for analysis of thymocyte differentiation, and that cholera toxin-mediated thymocyte proliferation might only occur in the small medullary thymocytes. PMID- 3304671 TI - Trypanosoma cruzi: phagolysosomal fusion after invasion into non professional phagocytic cells. AB - Parasite-containing endocytic vacuoles are formed during the process of in vitro interiorization of the trypomastigote forms of Trypanosoma cruzi by primary culture of mouse fibroblasts, heart and skeletal muscle cells. Fusion of these vacuoles with host cell lysosomes takes place. The process of T. cruzi-muscle cell interaction was analysed by ultrastructural cytochemistry. Two lysosomal enzymes, acid phosphatase and aryl sulphatase and the fusion of peroxidase labeled secondary lysosomes with the parasitophorus vacuoles were studied. These finding indicate that the basic mechanism of interaction of T. cruzi with the so called non phagocytic cells is similar to that which occurs with phagocytic cells. PMID- 3304672 TI - [Advances in the immunological study of viral hepatitis]. PMID- 3304673 TI - [Advances in the treatment of epilepsy by traditional Chinese medicine]. PMID- 3304674 TI - [An abdominal tumor of unusual nature. Synovial cyst in the iliopsoas bursa]. AB - The authors report a case of tumour of the right iliac region in a 14 years old girl, disclosed by a light traumatism, without appreciable antecedents, nor locomotor disfunction. Ultrasonography and computed tomography showed its cystic constitution. Surgically, there was a synovial cyst of the ilioinguinal area, cyst of the iliopsoas bursa, with a hip joint communication. It was resected and a partial recurrence occurred, corrected surgically three years later. A recent MRI showed the spontaneous development of a same cyst on the left side, asymptomatic at all. A non exhaustive survey of literature confirmed the iliopsoas synovial bursa is uncommonly pathologic, but a constant natural formation in man. Pathology occurs only in over sixty years old adults. This case seems to be the first pediatric case. The cyst of the psoas bursa is generally revealed by an inguinal swelling; abdominal growing is rare. Imaging with ultrasonography, computed tomography and RMI such as in this case, showed the cyst issued between the coxofemoral joint and the iliac psoas terminal tendon. It can grow in a retroperitoneal way. Pathogenic hypothesis are debated. In this bilateral case, etiology evoke an anatomic anomaly, in relation a joint communication. PMID- 3304675 TI - Splenic function: physiology and splenic hypofunction. AB - A wide variety of disorders can result in diminished splenic function. The pathophysiology appears to be clearly defined in some instances, such as congenital asplenia and disorders of splenic vascular obstruction or congestion. In others, such as the autoimmune and GI disorders, the mechanism remains poorly defined. Further research is needed. The hyposplenia which occurs in many of these disorders has been associated with an increased risk of life-threatening, overwhelming bacterial sepsis. In other instances, this complication has not been reported. This certainly should not be interpreted to mean that it cannot occur. The risk of septicemia in hyposplenic disorders is rarely above 10 to 15%. In disorders with minimal inhibition of splenic function, the incidence of sepsis would presumably be less than the 1.5% incidence following surgical splenectomy for trauma. Considering these data, a very large number of patients would have to become asplenic before it would be likely that one would develop sepsis. Furthermore, the lack of awareness of the possibility of hyposplenia-related sepsis in many of these disorders may cause such occurrences to go unrecognized. Finally, since the risk of sepsis is probably less in hyposplenic adults as compared to children, studies on adults may underestimate the incidence of this complication in children. Many of the disorders reported to cause hyposplenia in adults have not been noted to do so in children. In instances such as celiac disease, it may take many years for the complication to manifest so that it would be unlikely for a child to manifest hyposplenia during childhood. However, in other instances, not enough children have been studied to be confident that the hyposplenia and its associated risk of sepsis are not complications that occur in children. Hyposplenia-related bacterial septicemia is a catastrophic complication. If a patient develops a disorder that is potentially associated with hyposplenia, the patient should be observed for signs of asplenia in the peripheral blood. If the technique is available, quantitation of red cell pits should be performed. If not, other studies of splenic function such as radionuclide scans should be considered, depending on the incidence of hyposplenia in that particular disorder. If evidence of asplenia develops, pneumococcal vaccine should be administered, penicillin prophylaxis should be considered, significant febrile episodes should be managed aggressively, and probably most importantly, the patient and family should be carefully educated about this complication. Most deaths from hyposplenia-related septicemia are preventable. PMID- 3304676 TI - Autoimmune neutropenia of childhood. AB - Autoimmune neutropenia (AIN) of infancy is an underreported disease because of its benign nature. In addition, the relative unavailability of neutrophil antibody testing prevents confirmation of suspected diagnoses. Small children do not have life-threatening infections, do not have associated diseases, respond to i.v. gamma globulin with increased neutrophil counts, and tend to improve on their own. Older children with AIN have associated diseases such as hepatitis or Hodgkin's disease, often have other immune cytopenias, and respond poorly to any therapy. Immune deficiency states, especially those of the humoral arms, are associated with development of AIN. PMID- 3304677 TI - Inhibitors of coagulation in children. AB - Acquired inhibitors of coagulation factor interaction in nonhemophilic children are usually nonspecific, transient, and unassociated with clinical bleeding. They occur with some frequency and are the most common cause for a prolonged APTT found by routine testing. In children, some association with viral infections and treatment with penicillin has been noted, but their interrelationship with the development of antibodies remains unclear. The exact nature of these antibodies, usually directed against coagulant factor phospholipid, is not clear and multiple antibodies both specific as well as nonspecific may occur. No therapy is generally required. Rarely has the acute development of antibodies directed against specific coagulation factors occurred. The laboratory evaluation of the type of inhibitor is, therefore, most important as specific inhibitors may be associated with life-threatening bleeding situations. Their therapy should probably include attempts at eradication of the inhibitor by immunosuppressive agents or other newer modalities. Unfortunately, little information is available regarding the nature and outcome of specific inhibitors in children. Acquired inhibitors in hemophilic patients occur in about 6 to 10% of patients. Newer approaches to their therapy include activated PCC which have generally improved the outlook for such patients. Treatment regimens involve a knowledge of inhibitor response and the concomitant use of plasmapheresis, high-dose or continuous i.v. Factor VIII, and porcine Factor VIII, followed by activated PCC. The role of immunosuppressive agents and other newer modalities appears promising, however, prospective controlled studies are necessary to evaluate their role in the overall management of such patients. PMID- 3304678 TI - [A reservoir of Shigella of avian origin: herons and birds of prey of the zoological garden in Tananarive]. AB - The authors record the bacteriological characters of four Shigella strains: S. dysenteriae 2 and S. boydii 9, respectively isolated in a bird-of-prey and in three herons, kept in the zoological Garden in Antananarivo. The significance of this Malgasian avian reservoir of Shigella is discussed. PMID- 3304680 TI - [The allogeneic second set syndrome. Apropos of a case]. PMID- 3304679 TI - [Transient monocular blindness and carotid ultrasonographic evaluation]. PMID- 3304681 TI - [Modern concepts in surgery of the spleen. A. Experimental studies. 1. Scarring of splenic tissue after reparative surgery--experimental study in the rat]. PMID- 3304682 TI - Paediatric surgery, past, present, and future. PMID- 3304684 TI - [Liver transplantation in childhood. Indications, results]. PMID- 3304683 TI - Hirschsprung's disease: a historical review. PMID- 3304685 TI - [Kidney transplantation in the child]. PMID- 3304686 TI - Medicaid reimbursement for certified nurse-midwives: the continuing odyssey. PMID- 3304687 TI - Phase I clinical trial of ethyl 6-deoxy-3,5-di-O-methyl 6-(3 methyl-3 nitrosoureido)-alpha-D-glucofuranoside (CGP 6809). AB - A phase I study of single i.v. doses of a new sugar containing nitrosourea 6 deoxy-3,5 di-O-methyl 6-(3 methyl-3-nitrosoureido)-alpha-D-glucofuranoside (CGP 6809, EDMN) has been carried out in 47 patients with advanced solid tumors. Nine dose levels between 200 and 4500 mg/m2 were examined. Nausea and vomiting were seen in most patients but were controlled with antiemetics. Myelosuppression was minimal. The dose-limiting toxicity was hepatotoxicity, occurring early (peak at days 2-4) and resolving rapidly. No cumulative toxicity was seen with an every 6 weeks schedule. Other toxicities were abdominal pain, diarrhea, arm pain, restlessness, and headache. Pharmacokinetic studies in 20 patients using an HPLC assay and in 5 patients using [14C]EDMN showed a short half-life, rapid plasma clearance, rapid metabolism, and minimal excretion of unchanged drug. There was one partial response in a patient with colon carcinoma. The recommended dose for phase II studies in 3750 mg/m2 every 6 weeks. PMID- 3304688 TI - A randomized trial of two types of adjuvant chemotherapy in radiotherapy-treated patients with clinical stages I and II high-grade non-Hodgkin's lymphoma. AB - This paper reports the 8-year results of comparing the use of two types of adjuvant chemotherapy following involved field radiotherapy for clinical stages I and II high-grade non-Hodgkin's lymphoma. Twenty-four patients received 6 weeks of VAP plus 2 years of oral maintenance chemotherapy, and 30 had six cycles of CMOPP. Four patients were not in complete remission at completion of i.v. chemotherapy (CR rate 91%). Ten patients (18.5%) have relapsed (VAP/M = 5; CMOPP = 5), with only two of these remaining alive, both of them being disease free. There have been three deaths from intercurrent causes, one from malignant melanoma and the other two from myocardial infarction. The relapse-free survivals at 2, 5 and 8 years were 80%, 76% & 76% respectively. The overall survivals at the same time points were 86%, 72% & 68%. There were no significant differences in either relapse-free or overall survival for either of the two treatment groups. The shorter period of weekly intravenous chemotherapy (VAP/M) was better tolerated than 36 weeks of CMOPP, and the former appears to produce equivalent results. PMID- 3304689 TI - Relationship between systemic 5-FU passage and response in colorectal cancer patients treated with intrahepatic chemotherapy. AB - The study described herein was conducted to analyze the relationship between tumor exposure to 5-FU and clinical response. Six patients were placed on continuous 5-day intrahepatic 5-FU chemotherapy for colorectal cancer metastasized to the liver. The starting dose was 600-800 mg/m2 per day; cycles were repeated at 4-week intervals. The 5-FU dose was increased by 250 mg/day at each cycle. All six patients received 3 or more cycles, for a total of 37 cycles. Response was evaluated after each cycle by ultrasonography or computed tomography (CT). Pharmacokinetic data revealed a high individual cycle-to-cycle variability for all six patients in the 5-FU area under the curve (AUC day 1 to day 5) corrected for the dose. These variations in drug biodisposition, reflecting hepatic 5-FU uptake, were significantly related to measurable modifications in the tumor mass in 71% of cycles. The correlation between the reduction in local drug exposure and tumor regrowth was better than that between the increase in local drug exposure and tumor reduction. These findings constitute an original illustration in humans of the experimental concept of the drug exposure/tumor response relationship for 5-FU. PMID- 3304690 TI - Enhancement of dimethylnitrosamine-initiated hepatocarcinogenesis in hamsters by subsequent administration of carbon tetrachloride but not phenobarbital or p,p' dichlorodiphenyltrichloroethane. AB - The effect of phenobarbital (PB), p,p'-dichlorodiphenyltrichloroethane (DDT) or carbon tetrachloride (CCl4) on dimethylnitrosamine (DMN)-induced hepatocarcinogenesis in Syrian golden hamsters was examined. Hamsters were given a single injection of DMN (6 mg/kg body wt) followed by either PB or DDT in the diet or repeated CCl4 gavage for 30 weeks. The numbers of both altered liver cell foci and hepatocellular neoplasms in the hamsters given 0.1 ml CCl4, i.g. once every 2 weeks after the DMN were significantly higher than in the animals given DMN alone. PB or DDT (500 p.p.m. in the diet) after DMN did not produce a significantly higher incidence of altered foci or hepatocellular neoplasms compared to DMN alone. Thus, an enhancing effect of CCl4 on DMN-induced hepatocarcinogenesis in the hamster was demonstrated, but neither PB or DDT--both liver neoplasm promoters in rats and mice--displayed promoting activity under the conditions of study. PMID- 3304691 TI - Site-specific covalent binding of stilbene-type and steroidal estrogens to tubulin following metabolic activation in vitro. AB - Both the steroidal estrogen, 2-hydroxy estradiol, and the stilbene-type estrogen, diethylstilbestrol, bind covalently and selectively to the C-terminal domain of beta-tubulin after peroxidative activation in vitro. The binding probably has to be attributed to quinonoid metabolites, as estrogens such as estradiol and hexestrol, which are unable to form quinones under these conditions, fail to bind. Albumin is not simultaneously modified, demonstrating the selectivity of the binding. The observed protein binding is discussed with respect to estrogen induced aneuploidy and neoplastic cell transformation. PMID- 3304692 TI - Immunochemical determination of an initial step in thymine dimer excision repair in xeroderma pigmentosum variant fibroblasts and biopsy material from the normal population and patients with basal cell carcinoma and melanoma. AB - A monoclonal antibody specific for u.v.-induced thymine-thymine dimers in single stranded DNA has been used in an enzyme immunoassay to investigate the loss of antigenicity associated with repair of this lesion in the first 2 h following 10 J/m2 254 nm radiation. Variances of +/- 10% for the method and +/- 6.5% for individuals were established using primary cultures of biopsies from healthy individuals. No differences in the rate of loss of antigenicity was observed between 20 normal lymphocyte samples and 10 normal skin biopsies. Of three xeroderma pigmentosum (XP) variant cell lines tested, GM3617 could not be distinguished from normal cells but GM1227 and GM3053 showed lower rates of loss than any of the healthy samples. When the group mean values were compared there was no significant difference between normals and biopsies from sun-shielded skin areas from 16 basal cell carcinomas but similar material from 10 melanoma patients showed a significantly reduced (P = 0.001) rate of loss of antigenicity. Since the rate of loss of antigenicity in normal and XP variant cells reflected their relative abilities to perform unscheduled DNA synthesis, our results suggest that some melanoma patients may also have a minor deficiency in an early stage of excision repair. PMID- 3304693 TI - Tissue binding of 1,2-dibromoethane in the cynomolgus monkey (Macaca fascicularis). AB - Autoradiography at different levels of resolution was used to study the tissue binding of 1,2-dibromo[14C]ethane (DBE) in the cynomolgus monkey (Macaca fascicularis) in vivo (i.p. injection) and in vitro. The results show that DBE is metabolized to products which become bound to the tissues, preferentially in the liver and the kidney tubules. A distinct binding of radioactivity was also found in the adrenal zona reticularis. The binding of radioactivity in the surface epithelia of the respiratory and upper alimentary tract was not as high and striking as that previously observed in rodents. The results show that the sites of tissue-binding of DBE in the cynomolgus monkey correspond to the sites of tissue lesion observed in humans poisoned with DBE. PMID- 3304694 TI - Linking prenatal and perinatal adversities with child development. AB - Several professional groups share an interest in the effects of prenatal and perinatal adversities on children's development. The aim is to present a conceptual and methodological framework which will foster multidisciplinary study in this area. Recent evidence and principles about early life adversities, and developmental processes, are reviewed. The limitations of studies which address discrete variables at single points in time are highlighted. The proposal is that reproductive adversities are most effectively conceptualized as perturbations of infants' endogenous and social regulatory systems, which lead to adaptive developmental processes. The origins of maladaptations are to be found not simply in fixed, within-the-child, characteristics but in an understanding of regulatory processes; particularly the regulatory exchange between child and caregivers. A study is used to illustrate the translation of the model into research design. PMID- 3304695 TI - Influence of indomethacin on the endotoxin-induced cardiodepressant effect of serum and steroid hormone changes in male rats. AB - Escherichia coli endotoxin has been shown to induce a cardiodepressant effect (CDE) and changes in steroid hormone concentrations in the serum of male rats, especially increases in estrogens and a decrease in testosterone. Pretreatment of rats with indomethacin (INDO) abolished these responses to endotoxin. Direct addition of INDO to primary cultures of rat heart cells blocked the cardiodepressant response of these cells to endotoxin-treated rat serum. These data, together with previous results, suggest that relationships between estrogens and CDE are possible, while these two parameters have different time courses and dose dependencies; in any case, the prostanoid system is likely involved since INDO is able to suppress both of them. PMID- 3304696 TI - Immunoregulation in aging. AB - Senescence of the immune system leads to a decline of functional capacities of lymphoid cells. In this regard, evidence has been provided for a reduction of T and B cell-mediated responses. T-B regulation is also affected by the aging process. Since the proportion of lymphocytes is similar to that observed in young donors, either intracellular or extracellular factors may play an important role in the impaired immunoresponsiveness. An intrinsic defect of T or B cells has been in fact postulated. However, soluble suppressive factors or decreased LK production seem to represent the key events involved in the decline of the immune response. Nevertheless, over the past few years emphasis has been given to the increased lymphocyte membrane microviscosity in the elderly [Rivnay et al: Mech Ageing Dev 10: 71-79, 1979]. All together, these findings suggest a multifactorial therapeutic approach for the correction of the impaired immune response in aged individuals. PMID- 3304697 TI - Microcytotoxicity assay for platelet antibodies using fresh and frozen fluorescein-labeled target platelets. AB - We describe our results with a microtoxicity assay that uses fluorescein-labeled platelets for the detection of auto-, iso-, and allo-immune platelet antibodies. The system has a number of advantages in that it is not only rapid but can accommodate multiple test specimens, requires minimal reagents, and can utilize both fresh or frozen donor platelets as the target cells. The latter attribute may allow for the development of a platelet blood banking system with more efficient platelet cross-matching capabilities. PMID- 3304698 TI - Transitions in cardiac isomyosin expression during differentiation of the embryonic chick heart. AB - The expression of different isoforms of the contractile protein myosin plays a major role in determining contractile characteristics in both cardiac and skeletal muscle in the adult. There is little evidence pertaining to putative changes in myosin phenotype during cardiac embryogenesis or if such changes could play a role in modulating the contractile characteristics of the developing heart. We examined isomyosin expression during cardiogenesis in the chick by indirect immunofluorescence microscopy with monoclonal antibodies to adult ventricular and atrial myosin heavy chains. Antibody specificity was characterized in the adult on the basis of immunofluorescence localization, ELISA, and protein blot immunoassay. Results show that the early embryonic chick heart has a different myosin phenotype than the later embryonic or adult heart. Both the embryonic ventricular and atrial myocardia initially expressed a myosin heavy chain that was recognized by antibody specific (in the adult) for ventricular myosin heavy chain. The ventricles remained reactive throughout life with the ventricular antibody, but reactivity of the atrial myocardium was confined to the initial 6 days of embryonic development. On the other hand, reactivity of the embryonic heart with multiple antibodies specific (in the adult) for atrial myosin was confined to the atrial myocardium throughout development. Thus, the distribution of myosin isoforms became similar to that of the adult myocardium by the time the embryonic heart achieved a 4-chambered configuration at 6 days in ovo. PMID- 3304699 TI - [Determination of circulating antigens in human filariasis by means of a modified sandwich enzyme-linked immunosorbent assay (MS-ELISA) using monoclonal antibodies]. PMID- 3304700 TI - [Analysis of the epidemic characteristics of falciparum malaria in South Henan]. PMID- 3304701 TI - [Experimental study on the effect of Plasmodia on the erythroid colony forming unit (CFU-E)]. PMID- 3304702 TI - [Research on primaquine]. PMID- 3304703 TI - The origin of the heart beat: a tale of frogs, jellyfish, and turtles. PMID- 3304704 TI - Review of lipid-lowering clinical trials in relation to observational epidemiologic studies. AB - A review of the experimental clinical trials and observational cohort evidence relating serum cholesterol level and its reduction to risks of coronary heart disease (CHD) discloses strong similarities among the quantitative and qualitative relationships found in these studies. Not only are the risk functions similar, but the percent reduction observed is the same as that predicted from the population experience and is proportional to the degree of cholesterol lowering. Furthermore, the risk function is continuous from the highest to the lowest serum cholesterol levels studied. These findings confirm the lipid hypothesis and indicate that lowering serum cholesterol reduces CHD risk. The understanding and control of CHD requires a dual approach: (1) identification and treatment of high-risk individuals, and (2) modification of environmental and behavioral determinants to achieve more favorable distributions of serum cholesterol in populations. PMID- 3304705 TI - Nitrate tolerance: the lack of effect of N-acetylcysteine. AB - The hemodynamic and antianginal effects of 30 mg of isosorbide dinitrate (ISDN) were assessed in 12 patients with chronic stable angina after initial dosing and after 7 to 10 days of therapy four times daily. During early therapy, ISDN produced significant hemodynamic and antianginal effects that persisted over a 3 hr observation period. During sustained therapy there was attenuation of the hemodynamic effects at rest, and treadmill exercise time to the onset of angina and to the development of moderate angina was increased 1 hr after dosing; no effect was apparent at 3 hr. During this state of nitrate tolerance, patients were treated with an infusion of normal saline or 100 mg/kg N-acetylcysteine and exercise testing was repeated. N-Acetylcysteine did not change the hemodynamic findings at rest or during exercise and there was no improvement in exercise tolerance. It is apparent that the short-term administration of reduced sulfhydryl groups does not reverse tolerance to the hemodynamic and antianginal effects of isosorbide dinitrate in an exercise test model. PMID- 3304706 TI - Beneficial effects of timolol on infarct size and late ventricular tachycardia in patients with acute myocardial infarction. AB - This investigation was undertaken to study the effects of beta-adrenergic blockade with timolol on infarct size and on the incidence of late ventricular tachycardia in patients with acute myocardial infarction of less than 6 hr of evolution. Patients were assigned randomly either to a placebo-treated group (98 patients) or to a timolol-treated group (102 patients). The patients were treated with 5.5 mg iv timolol (or matched placebo) as a bolus divided into four doses during the first 2 hr followed by 10 mg orally twice daily for 1 month. Cumulative total creatine kinase (CK) release, which reflects the amount of myocardial necrosis was 1677 +/- 132 IU/liter in the placebo group (n = 83) and 1274 +/- 73 IU/liter in the timolol group (n = 81, p less than .01), a 24% reduction. Cumulative release of CK-MB was 138 +/- 8 IU/liter in the placebo group and 106 +/- 8 IU/liter in the timolol group (p less than .01), a 23% reduction. Twenty-four hour Holter electrocardiograms were obtained on days 7, 14, 21, and 28 after the onset of the acute myocardial infarction in 80 patients in the placebo group and 82 patients in the timolol group. The incidence of ventricular tachycardia was lower in the timolol than in the placebo group (7 vs 16 patients, p = .05). We conclude that early administration of intravenous timolol followed by oral treatment in patients with acute myocardial infarction reduces infarct size as assessed by CK and CK-MB serum activity, and decreases the occurrence of late ventricular tachycardia. PMID- 3304708 TI - Epidemiological approach to bronchial responsiveness. PMID- 3304707 TI - Reconstruction of the mitral anulus. AB - The mitral anulus was reconstructed with autologous pericardium in nine patients. Six patients had infective endocarditis with one or more abscesses in the anulus, and three had an iatrogenically damaged anulus. In patients with disruption of the mitral anulus limited to its posterior portion, a semicircular patch of pericardium was sutured directly to the endocardium of the left ventricle. In patients with multiple defects in the anulus, circumferential reconstruction of the mitral ring with pericardium was performed. In cases in which abscesses involved the central fibrous body, pericardium was used to reconstruct both the mitral anulus and the aortic root. Eight patients survived and have remained well for a mean of 8 months. There has been no prosthetic or patch dehiscence. All patients experienced substantial functional improvement. This experience indicates that the disrupted mitral anulus can be successfully reconstructed with autologous pericardium that is sutured directly to the endocardium of the left ventricle. PMID- 3304709 TI - Pattern of specific airway response in asthma due to western red cedar (Thuja plicata): relationship with length of exposure and lung function measurements. AB - In order to investigate the relationship between the pattern of response (immediate, late and dual) to specific bronchial challenge test with plicatic acid or red cedar extract and the clinical features of asthma, 332 patients with asthma induced by western red cedar dust were examined at the time of diagnosis. Specific challenge test induced in thirty-one patients (9.3%) an isolated immediate reaction, in 144 patients (43.4%) an isolated late reaction and in 157 patients (47.3%) a dual reaction. Patients with a dual reaction had a longer period of exposure to red cedar dust between the onset of the respiratory symptoms and the time of the definitive diagnosis, a lower FEF 25-75% and a greater degree of non-specific bronchial hyperresponsiveness compared to patients with isolated immediate or isolated late reactions; the difference in bronchial hyperresponsiveness to methacholine among the three groups persisted when the values were adjusted for the different baseline value of FEV1. There was no difference in the prevalence of specific serum IgE antibodies to plicatic acid human serum albumin conjugate among the three groups of patients with different type of response to red cedar. Except for the greater degree of non-specific bronchial hyperresponsiveness, patients with isolated late reactions were not different from those with isolated immediate reactions in other clinical findings. These findings indicate that a dual reaction in patients with occupational asthma due to simple chemical agents is indicative of a greater severity of disease at diagnosis. The pathogenetic mechanism of various types of asthmatic reaction is unknown and it is likely to be different between isolated immediate and isolated late reactions. PMID- 3304710 TI - Phase-separation immunoassays. AB - Solid-phase-based immunoassays have traditionally been plagued by nonspecific binding to the solid phase and by slow reaction kinetics relative to reactants that are free to diffuse in solution. We have developed two novel immunoassays in which the solid phase is generated in situ after the specific binding reaction has occurred, thereby enhancing reaction kinetics and minimizing the opportunities for non-specific binding. In the first system, the capture antibody is conjugated to an organic monomer, polymerization of which to form insoluble polymer particles is initiated by a reaction involving free radicals. The amount of signal-labeled antibody incorporated into the resulting particles is directly proportional to the concentration of antigen. The principle is illustrated for the simultaneous assay of IgG and IgM in a single sample. In the second system, capture antibody is conjugated to a polymer, the solubility of which is a function of temperature. Specific binding is conducted below the critical solution temperature of the polymer, which is then separated from solution by increasing the temperature above the critical temperature. The incorporation of signal-labeled antibody into the precipitated polymer is directly proportional to the concentration of antigen. This principle is illustrated for the assay of hepatitis B surface antigen and Chlamydia trachomatis. PMID- 3304711 TI - Immunochemiluminometric assay of creatine kinase MB with a monoclonal antibody to the MB isoenzyme. AB - Previous two-site immunometric assays for creatine kinase (CK; EC 2.7.3.2) MB isoenzyme have been based on formation of a "sandwich" complex involving CK-MB and antibodies that recognize the CK-MM and the CK-BB isoenzymes. Single incubation model assays of CK-MB with these antibodies were susceptible to interferences by CK-MM and CK-BB. We produced two anti-CK-MB monoclonal antibodies and studied their suitability for two-site assays. Both antibodies were compatible with anti-CK-MM and anti-CK-BB, but not with each other. Using anti-CK-MB as the tracer antibody eliminated the interference by both CK-MM and CK-BB. Labeling anti-CK-MB with acridinium ester and immobilizing anti-CK-BB on paramagnetic particles, we developed a rapid and highly sensitive chemiluminescent/magnetic separation CK-MB assay. As little as 1 microgram of CK MB per liter was detectable after 10- or 30-min incubation at room temperature, and the standard curve was linear up to 400 micrograms/L. Results for serum samples by the new assay correlated well (r = 0.94) with those by Corning electrophoretic and the Hybritech Tandem-E immunoenzymometric CK-MB methods. Sera containing macro CK-1 or high concentrations of CK-MM and CK-BB did not interfere. The combined advantages of a more-specific antibody, paramagnetic solid phase, and chemiluminescent label endow this two-site CK-MB assay with performance characteristics and ease of use superior to those of previous assays. PMID- 3304712 TI - An internal clock reaction used in a one-step enzyme immunochromatographic assay of theophylline in whole blood. AB - We describe the development and performance of a second-generation enzyme immunochromatography method for visually quantifying theophylline in whole blood without the use of instrumentation. We have developed the novel concept of an internal chemical clock reaction to combine the capillary-migration and color generation protocol of the two-step immunochromatographic assay into a single step, simultaneous protocol. The two assay components are (a) chromatographic paper to which glucose oxidase (EC 1.1.3.4) and monoclonal antibody to theophylline have been immobilized, and (b) an enzyme reagent consisting of glucose, dicarboxidine, ascorbate, and theophylline-labeled horseradish peroxidase (EC 1.11.1.7). The ascorbate acts as an internal clock by inhibiting premature color formation until the ascorbate has been completely consumed in the peroxidase-mediated reaction. Color is then generated rapidly, producing a clearly visible front on the paper. Performance evaluations of the 20-min one step assay show very good precision, analytical recovery, specificity, and accuracy. This simplified protocol is reliable and convenient for therapeutic drug monitoring in the physician's office. PMID- 3304713 TI - Use of liposome encapsulation in a combined single-liquid reagent for homogeneous enzyme immunoassay. AB - A technique has been developed to permit mutually reactive macromolecular reagents used in immunoassays to be combined without premature reaction. A conjugate of glucose-6-phosphate dehydrogenase (EC 1.1.1.49) and theophylline has been encapsulated in 0.2-micron-diameter bi-lamellar liposomes. Suspensions of these liposomes had excellent stability. Whereas the enzyme activity of the free conjugate is rapidly inhibited by anti-theophylline antibody, a suspension of the encapsulated conjugate in a solution of the antibody and NAD+ (6.0 mmol/L) retained greater than 92% of the initial enzyme activity after standing for one year at 4 degrees C. At higher NAD+ concentrations the liposomes aggregated, and enzyme activity was inhibited by leakage of the NAD+ hydrolysis product, adenosine diphosphoryl 5-ribose (ADP-ribose), into the liposomes. Inhibition by ADP-ribose could be blocked and partly reversed by adding semicarbazide. The liposomes were efficiently lysed by Triton X-100, deoxycholate, or octyl glucoside, the kinetics and extent of lysis being affected by liposome size and correlating with the acid strength of various cholate derivatives. Addition of a serum sample and a solution of buffer, substrate, and detergent to a single reagent containing the liposomes and anti-theophylline antibody provided assay results equivalent to those obtained by conventional two-reagent EMIT homogeneous enzyme immunoassay for theophylline. PMID- 3304714 TI - HLA-B27 typing by use of flow cytofluorometry. AB - We describe the use of flow cytofluorometry to type lymphocytes for HLA-B27 antigens. We modified the cytotoxicity test of Terasaki and McClelland [Nature (London) 1964;204:998] for use with a flow cytofluorometer. In a second assay we used a commercially available monoclonal anti-HLA-B27 antibody and indirect immunofluorescence staining of cell surfaces. Although this antibody cross reacts with B7 and Bw22 antigens, the results for HLA-B27 and the cross-reacting antigens can be separated. Comparison of our results with those by a HLA-typing laboratory for 100 patients showed total agreement of the assigned typings. PMID- 3304715 TI - Capillary blood, dried on filter paper, as sample for monitoring cyclosporin A concentrations. AB - For monitoring the immunosuppressive drug cyclosporin A by radioimmunoassay (Sandoz Ltd.) we propose a simple method of sampling in which 20 microL of capillary blood is dried on filter paper. Patients can collect their own samples and mail or bring them to the laboratory. Results for such samples, and their variability, correspond to those for conventional methods of sampling (collection of venous or capillary blood into buffer). Capillary blood can be stored on paper at room temperature for more than four weeks with no effect on assay results. PMID- 3304716 TI - Immunoblotting on polyvinyldifluoride improves detection of oligoclonal IgG bands in CSF. PMID- 3304717 TI - A protocol for EMIT-st reagents with a centrifugal analyzer. PMID- 3304718 TI - Henry Bence Jones (1813-1873): the best "chemical doctor" in London. PMID- 3304719 TI - Comparison of the precision of seven analytical methods for the H2O concentration in human serum and urine. AB - In order to calculate a true renal H2O clearance (U X V/P), serum and urine H2O concentrations have to be known. In this investigation we compared the precision (repeatability) and the ease of performance of 7 H2O assays in human serum and urine. The 3 gravimetric assays (oven-drying, freeze-drying or freeze-drying as well as oven-drying) had a very high precision (coefficients of variation (CV) 0.2-0.4%) and were easy to perform. The precision of mass spectrometry, gas chromatography and titrimetry (Karl Fischer) was better in urine than in serum (ranges of CV 1.2-1.5% in urine vs. 2.4-4.3% in serum), but the precision of osmometry was better in serum than in urine (CV 1.0 vs. 1.6%). Accuracy was not determined as storage effects at 4 degrees C and at -20 degrees C caused insuperable logistic problems. Only small sample volumes are used in titrimetry and gas chromatography, making them more suitable for determinations in babies and animal studies. With titrimetry determinations can be done in a short time. The gravimetric assays appear to reflect the true H2O content of serum and urine, thus enabling calculation of the true renal H2O clearance, which can be of clinical importance in liver, renal and cardiac disease. PMID- 3304720 TI - Sandwich enzyme immunoassay for human interleukin-1 beta (hIL-1 beta) in urine. AB - A highly sensitive sandwich enzyme immunoassay for human interleukin-1 beta (hIL 1 beta) in urine is described. Rabbit anti-hIL-1 beta IgG-coated polystyrene balls were incubated with urine samples and subsequently with affinity-purified rabbit anti-hIL-1 beta Fab'-horseradish peroxidase conjugate. After washing, the peroxidase activity bound to the polystyrene ball was assayed by fluorimetry using 3-(4-hydroxyphenyl)propionic acid as a substrate. The detection limit of hIL-1 beta was 0.5 pg/tube (30 amol/tube) or 5 ng/1 of urine when 0.1 ml of urine sample was used. The molecular weight of hIL-1 beta in normal urine was shown to be 17,000 by gel filtration, and levels of urine hIL-1 beta in healthy subjects aged 19-87 yr were 0-146 ng/1 or 0-88 ng/g of creatinine. PMID- 3304721 TI - A large molecular form of glucagon-like peptide-1 (GLP-1) immunoreactivity is co released with glucagon from pancreas by arginine in normal subjects. AB - Plasma immunoreactivities of glucagon-like peptide-1 (GLP-1IR) in normal subjects were measured with a specific radioimmunoassay during the arginine tolerance test. Plasma GLP-1IR after arginine infusion showed a 3-fold increase in parallel to plasma glucagon immunoreactivity and plasma glucagon-like immunoreactivity, measured with a glucagon C-terminal specific antiserum (OAL 123) and an N terminal and/or central region specific glucagon antiserum (OAL 196), respectively. This finding suggested that the increased immunoreactivities of GLP 1 as well as that of glucagon were of pancreatic origin. Upon gel chromatography, plasma at the basal state showed three GLP-1 immunoreactive peaks, eluted in the position of void volume, synthetic GLP-1(72-108), and a smaller molecular fraction. Gel chromatography of plasma after an arginine load showed an additional peak (Mr 13,000-15,000) with little change in other GLP-1 immunoreactive peaks. This large molecular form of GLP-1IR was also shown to exist in the human pancreatic extract. Moreover, the free GLP-1 concentrations in plasma before and after an arginine load were shown to be about equal by reverse phase HPLC. These data suggested that in normal subjects arginine stimulation co releases GLP-1IR, predominantly large molecular form, with glucogen from the pancreas. PMID- 3304722 TI - A simple differential immunoprecipitation assay of urinary acid and neutral alpha glucosidases for glycogenosis II. AB - A specific assay for acid alpha-glucosidase in urine was developed to facilitate the diagnosis of glycogenosis II. This enzyme activity was calculated as a difference between the alpha-glucosidase activities before and after immunoprecipitation with antiserum to acid alpha-glucosidase. Acid alpha glucosidase accounted for 86% of the total activity in control urine. All the cases of various clinical types of glycogenosis II showed either a marked decrease or a complete deficiency of this enzyme activity. A marked decrease of acid alpha-glucosidase was demonstrated by immunoblotting of the urine from patients with late-onset forms of this disease. These results indicate that assays of urinary acid alpha-glucosidase by this immunological method are useful for detection of the various types of glycogenosis II. PMID- 3304723 TI - Competitive enzyme immunoassay for human serum apolipoproteins C1, C11, and C111. PMID- 3304725 TI - Dosage-related effects of danazol on sex hormone binding globulin and free and total androgen levels. AB - Danazol is known to cause marked suppression of sex hormone binding globulin (SHBG) levels in plasma and to increase the proportion of plasma testosterone unbound to protein but the effect on the concentration of total and free testosterone is unclear. Twenty-five patients with endometriosis were treated daily for 6 months with doses of danazol ranging from 50 to 600 mg. The fall in SHBG and rise in percent free testosterone was dose-related during the early part of treatment. Suppression of total testosterone and 5 alpha-dihydrotestosterone levels occurred and was probably due to increases in metabolic clearance rates. The observed fall in androstenedione levels was related to the incidence of menstrual abnormality, suggesting that this might be due to reduced ovarian activity. The concentration of free testosterone increased by a factor of two in the first week but subsequently returned to levels of between 25 and 50% above pretreatment levels. This pattern of changes may be due to the rise in metabolic clearance rates being dependent on induction of enzymes of androgen metabolism. PMID- 3304724 TI - Hypersecretion of proinsulin does not explain the hyperinsulinaemia of patients with liver cirrhosis. AB - A radioimmunoassay using a proinsulin-specific antiserum that does not react preferentially with the split forms of proinsulin has been used to compare the response of circulating proinsulin to low (25 g) and high (75 g) oral glucose loads in healthy subjects and in patients with liver cirrhosis. The patients were divided into two groups: Group A (n = 7) with normal glucose tolerance and Group B with diabetic (n = 5) and impaired (n = 1) glucose tolerance. There was no apparent correlation between glucose tolerance and the results of quantitative liver function tests. In the fasted state, the concentrations of serum proinsulin did not differ significantly in patients of Group A (0.022 +/- 0.002 nmol/l) or Group B (0.026 +/- 0.004 nmol/l) from those in healthy subjects (0.021 +/- 0.002 nmol/l). After 75 g glucose, the rise in serum proinsulin to a maximum concentration of 0.082 +/- 0.012 nmol/l in patients of Group A and to 0.070 +/- 0.019 nmol/l in Group B was not significantly different at any time point up to 180 min from the rise in healthy subjects (to 0.063 +/- 0.005 nmol/l). After 25 g glucose, the response of serum proinsulin in Group B patients (maximum concentration 0.035 +/- 0.003 nmol/l) was not significantly different from that in healthy subjects (maximum concentration 0.032 +/- 0.003 nmol/l) but a slightly enhanced release was observed in the Group A patients (maximum concentration 0.049 +/- 0.003 nmol/l) that was significantly greater (P less than 0.05) at 60 min post-glucose. In contrast, the concentrations of serum immunoreactive insulin and immunoreactive C-peptide in all patients with cirrhosis were significantly elevated compared with healthy subjects both in the fasted state and at several time points following high and low oral glucose. In the fasted state, the serum proinsulin/C-peptide molar ratio, an index of the relative state of secretion of proinsulin and insulin, was significantly lower (P less than 0.05) in both groups of cirrhotic patients than in healthy subjects. After high and low glucose, this ratio fell in all patients and in the healthy subjects. We conclude that cirrhosis of the liver is associated with a hypersecretion of insulin but hyperproinsulinaemia does not contribute appreciably to the elevated concentration of immunoreactive insulin in the peripheral circulation. PMID- 3304726 TI - Potential use of DA1 and DA2 receptor agonists in the treatment of hypertension. AB - Will dopamine (DA) agonists have a role in the treatment of hypertension? Recent advances of medicinal chemistry and receptor pharmacology have suggested a positive answer. First, the division of DA receptors into two subtypes, DA1 and DA2, and the differentiation of these receptors from other receptors have resulted in the synthesis of relatively selective agonists and antagonists. Second, agonists of DA1 and DA2 receptors have been shown to decrease blood pressure in experimental animals and hypertensive patients. Review of clinical data with DA1, DA2, and combination of DA1 and DA2 agonists not only has demonstrated efficacy, but has revealed problems in the use of these compounds. Finally, possible solutions of these problems will be discussed. PMID- 3304727 TI - Stimulation of vascular dopamine receptors: status and future strategies. AB - The ability to stimulate dopamine receptors in the heart and blood vessels with selective receptor agonists, such as fenoldopam, has been an important advance. Fenoldopam is a selective DA1 receptor agonist and is currently in clinical trials for cardiovascular disease therapy. An alternative approach to stimulating dopamine receptors, while at the same time blunting sympathetic nervous system activity, would be by inhibiting the enzyme dopamine beta-hydroxylase (D beta H), thus increasing the cardiovascular and renal ratio of dopamine to norepinephrine. SK&F 102698, (1-[3',5'-difluorobenzyl]-2-mercaptoimidazole), is a potent inhibitor of D beta H with a Ki of 40 nM against D beta H in vitro. In the spontaneously hypertensive rat SK&F 102698 100 mg/kg orally, increases the dopamine/norepinephrine ratio approximately 5-fold and lowers blood pressure approximately 30 mmHg to normotensive levels. Antihypertensive activity can be achieved with single daily oral administration and neither tolerance nor reflex tachycardia occur. Stimulation of dopamine receptors by inhibition of dopamine beta-hydroxylase is a unique approach toward cardiovascular and renal therapeutics. PMID- 3304728 TI - Is stimulation of prejunctional dopamine receptors an antihypertensive principle? AB - Bromocriptine and co-dergocrine (Hydergine R) reduce blood pressure and heart rate in experimental animals largely by stimulating DA2 receptors. A stimulant effect on DA1 receptors can be demonstrated in isolated tissues, but this action does not appear to make an important contribution to the depressor response to the two compounds, since effects are abolished by DA2 receptor blockade. Although both compounds are known to penetrate the brain, their antihypertensive effects, and the concomitant reductions in plasma noradrenaline levels produced in hypertensive patients can be prevented by domperidone, confirming a peripheral site of action. A review of the data available concerning the cardiovascular effects of bromocriptine and co-dergocrine in animals and man suggests that a DA2 receptor stimulant is effective in the treatment of hypertension. PMID- 3304729 TI - Experimental and clinical approaches to treatment of hypertension by dopamine receptor agonists. AB - The action of several dopamine agonists on blood pressure was investigated. In dogs, apomorphine induced a decrease in blood pressure and an increase in heart rate. These effects were suppressed by intravenous haloperidol or phentolamine. Intravenous but not intracisternal domperidone suppressed the hypotensive responses elicited by intravenous or intracisternal apomorphine. Furthermore, the hypotensive effect of bromocriptine or apomorphine was abolished in adrenal demedullated dogs. Apomorphine and bromocriptine decreased adrenal catecholamine levels. In men, the acute hypotensive property of apomorphine (but not the long term effect of bromocriptine) was suppressed by pretreatment with domperidone. In hypertensive Parkinsonians, bromocriptine reduced blood pressure, induced an increase in inulin clearance, a decrease in plasma creatinine concentration and in renal vascular resistances. These results suggest that dopamine agonists (like apomorphine or bromocriptine) reduce blood pressure through both a decrease in sympathetic tone and an improvement in renal function. However, the mechanism of the acute and long term hypotensive effects could be different only involving peripheral mechanisms after acute administration and both peripheral and central structure under chronic treatment. In addition, preliminary results suggesting the potential interest of dopamine antagonists in the management of orthostatic hypotension are discussed. PMID- 3304730 TI - Role of prolactin in pregnancy hypertension. AB - In 51 patients with pregnancy hypertension (H) and 51 normotensive gravid women (N), matched for age of gestation, plasma prolactin was measured at 8.30 am (PRL1) and 9.30 am (PRL2) in basal conditions and after 10 minutes of upright posture (PRL3). While in N there was a fall from PRL1 to PRL2 which was nonsignificant, in H there was a significant fall from PRL1 to PRL2. With upright posture there was a further decrease in prolactin in N and a significant increase in H. With multiple regression analysis, systolic and diastolic blood pressure did not show any independent relations with PRL1, PRL2 and PRL3, while serum proteins and proteinuria showed a significant relation with PRL1, as did serum proteins, serum potassium and serum urate with PRL2 and serum urate with PRL3. As has been suggested in primary hypertension, a certain increase in peripheral sympathetic tone, dependent on a decreased central dopaminergic activity, may be present in patients who develop pregnancy hypertension compared to normotensive pregnant controls and may be involved in the pathogenesis of pregnancy hypertension. PMID- 3304731 TI - Endogenous renal dopamine and control of blood pressure. AB - Activation of specific receptors for dopamine in the renal vasculature and tubules leads to increases in glomerular filtration, and to diuresis and natriuresis. There is evidence for intrarenal production and release of dopamine, which may originate from two sources: tubular decarboxylation of plasma l-DOPA and a population of dopaminergic sympathetic neurons that innervate the renal cortex. Studies of plasma and urinary catecholamine levels indicate that dopamine is released within the kidney in response to sodium loading and to activation of sensory pathways related to nociception and chemoreception. There is also evidence for deficient renal release of dopamine in patients with renovascular or essential hypertension. Collectively, the available data suggest that intrarenal dopamine has a physiological function in control of blood volume and blood pressure, and that defects in this control may be implicated in the aetiology of some hypertensive states. PMID- 3304732 TI - Antihypertensive action of melatonin in the spontaneously hypertensive rat. AB - The effects of melatonin on blood pressure and heart rate were studied in 23-week old male spontaneously hypertensive rats. Melatonin infused i.p. at a dose of 6 mg/rat per day for 5 days using an osmotic minipump produced a significant reduction of blood pressure and a slight but significant decrease of heart rate in the conscious and unrestrained state. These cardiovascular effects of melatonin developed gradually. Plasma renin concentration tended to decrease after melatonin treatment. These results demonstrate that melatonin has an antihypertensive action. The mechanism of the antihypertensive action of melatonin requires further study. PMID- 3304733 TI - Vasopressin in end-stage renal disease: relationship to salt, catecholamines and renin activity. AB - The blood pressure changes and behavior of vasoactive hormones after various stimuli were studied in eighteen patients with end-stage renal disease maintained on chronic hemodialysis. Group A patients (n = 9) were not subject to intra- or post-dialysis hypotensive episodes, and Group B (n = 9) frequently had such episodes. A 500 ml hypertonic saline infusion produced no change in blood pressure in either group, despite significant rise of vasopressin levels in both. Plasma renin activity levels were similar and became appropriately suppressed by the infusion in both groups, whereas norepinephrine rose significantly only in Group A, but not Group B where it was already higher at baseline. The regular dialysis session produced, as expected, a significantly more profound hypotensive effect in Group B, but was accompanied in both groups by decrease in vasopressin and increase in plasma renin activity. Norepinephrine change differed in the two groups: it decreased in Group A as expected from its capacity to be dialyzed, but rose in several hypotensive patients in Group B, indicating appropriate response to baroreceptor stimulation and leading to an unchanged average. These findings suggest that dialysis-induced hypotensive episodes are not necessarily associated with autonomic neuropathy or with abnormal patterns of vasopressor hormone response to stimuli. They also shed new light on the factors regulating vasopressin secretion under these circumstances, since they indicate that the osmoreceptor and/or sodium-sensitive receptor may be a more dominant mechanism in the regulation of vasopressin release than the volumetric mechanism responding to fluid volume changes. PMID- 3304734 TI - Genetic history: I. The Schneersons of Lubavich. AB - Genetic history in pedigree form is a useful tool in historical studies. This is illustrated by the Schneerson family dynasty, which has led the Lubavich sect of ultra-orthodox Hasidic Jews since its inception in the 18th century. The current leader is the seventh successive Schneerson to head the Lubavichers. PMID- 3304735 TI - The detection and characterization of renal brush border antigen (gp108) in various rat tissues. AB - We recently reported that an injection of antibody raised against renal brush border glycoprotein, gp108, in rats induced passive Heymann nephritis with acute and severe proteinuria. In this study, the distribution of gp108 in various rat tissues was investigated. On enzyme immunoassay, anti-gp108 antibody reacted to extracts of small intestine, lung, spleen, thymus, liver, epididymis, stomach, pancreas and heart. It also reacted to sera and extracts of peripheral blood cells, especially lymphocytes. These antigens, which are cross-reactive to kidney gp108 have similar biochemical properties: a molecular weight of about 108,000 and an isoelectric point of 4.8-5.4. These results show that immunologically and biochemically related antigens to renal glycoprotein, gp108, are present in various rat tissues. PMID- 3304736 TI - Immunological reconstitution after bone marrow transplant with Campath-1 treated bone marrow. AB - Immunological reconstitution after allogeneic bone marrow transplant (BMT) was studied in 20 patients who received Campath-1 treated bone marrow. The peripheral blood lymphocyte phenotype was analysed with a panel of monoclonal antibodies at 3, 6 and 12 months. T cell proliferative capacity was evaluated by stimulation with PHA and Con A and in the mixed lymphocyte reaction (MLR). Natural killer (NK) cell activity was analysed against the K562 cell line at specified times after BMT in nine patients. Absolute numbers of T lymphocytes were reduced in all patients at 3 and 6 months. A marked decrease in the number of CD4+ cells persisted beyond 12 months. CD8+ cells regenerated more rapidly and reached normal at 6 months. No correlation was found between changes in lymphocyte subpopulations and the presence of graft-versus-host disease or cytomegalovirus infection. B cells recovered rapidly and maintained normal numbers throughout the study. A moderate increase in HNK1+ (Leu7) cells was observed at 3 and 6 months simultaneously with a low expression of NK15 (Leu11) and OKM1 antigens at 3 and 6 months, suggesting the presence of immature NK cells early after the transplant. A profound decrease of T cell proliferative capacity was observed both after mitogen stimulation and in the mixed lymphocyte reaction. NK cell activity was raised during the first month after transplant in all but one patient but no correlation was found with the presence of GVHD or cell marker analysis. PMID- 3304737 TI - Changes in rectal leucocytes after allogeneic bone marrow transplantation. AB - Using immunohistological techniques the number of leucocytes present in the epithelium and lamina propria of the rectal mucosa were assessed in 16 allogeneic bone marrow transplant recipients, with and without evidence of graft-versus-host disease (GVHD), and compared with a non-transplant group of patients. Samples were obtained between 15 and 198 days after transplant. In marrow recipients without GVHD, compared with non-transplant cases, there was a decrease in T lymphocytes in the lamina propria due to a reduction in the helper-inducer (T4+) subset with no change in suppressor-cytotoxic (T8+) cells or epithelial leucocytes. In GVHD, the number of T lymphocytes increased both in the lamina propria and epithelium due to an increase in T8+ cells with no change in T4+ cells. Lymphocytes did not express the activation markers detected by Tac, OKT10 or HLA-DR. Macrophages and natural killer cells were not changed after transplant or in GVHD. Epithelial HLA-DR expression was detected in seven out of eight in the GVHD group, three out of eight in the non-GVHD transplant group and two out of eight in the non-transplant cases. These findings show several differences from those we have observed in cutaneous and hepatic GVHD. Although elevated numbers of T8+ cells are common to GVHD in all three sites, the precise role of these cells in producing epithelial damage is not clear. PMID- 3304738 TI - Dominant cell wall proteins of Mycobacterium leprae recognized by monoclonal antibodies. AB - A cell wall fraction of Mycobacterium leprae has enhanced potency in activating immune T cells. By using a panel of monoclonal antibodies (MoAb), the dominant immunogen in this preparation was shown to be a complex of proteins of apparent molecular weight (Mr) 65 to 50 kD with a major antigen of 65 kD. Antigen capture assays supported the results of immunoblots and ELISA that this protein was concentrated in the cell wall. By varying the MoAb used as capture or tracer antibody, one of the three MoAb-defined epitopes on the 65 kD protein proved to be unique to M. leprae while the other two were shared by M. bovis (BCG) and M. tuberculosis. The cross-reactive epitope defined by MoAb L22 was present on a protein of Mr 12 kD as well as the 65 kD protein. The 12 kD protein was strongly radiolabelled with 125I and was immunoprecipitated by L22 but not by two other MoAb, L12 or L14. By contrast the higher molecular weight forms were only weakly precipitated by the three MoAb. Competitive inhibition assays with lepromatous leprosy sera demonstrated that the MoAb-defined epitopes were recognized by human B cells. The proteins bearing one of the cross-reactive determinants was purified from M. bovis (BCG) sonicate by affinity chromatography with MoAb L22 coupled to Sepharose 4B. This antigen fraction stimulated proliferation in peripheral blood mononuclear cells from BCG vaccinated, mantoux positive individuals indicating that the cell wall protein has cellular as well as humoral reactivity. The three MoAb defined epitopes are encoded by the DNA clone Y3178 recently isolated from M. leprae. PMID- 3304739 TI - Ligand-binding and idiotypic cross-reactions between anti-DNA antibodies and antibodies to Klebsiella K30 polysaccharide in patients with systemic lupus erythematosus or rheumatoid arthritis. AB - Antibodies to DNA and K30p were purified by affinity procedures and tested for their ability to cross-react with K30p and DNA, respectively. Anti-ssDNA antibodies were shown to react with solid-phase K30p and be inhibited in a dose dependent manner by soluble ssDNA and K30p. Conversely, anti-K30p antibodies were found to bind immobilized ssDNA and be inhibited with soluble inhibitor. These results show that certain subpopulations of anti-ssDNA and anti-K30p antibodies overlap in their ligand-binding specificities. Idiotypic (Id) analysis showed that anti-K30p antibodies did not react significantly with an anti-Id reagent directed against a common anti-DNA framework Id (AM Id), thus clearly separating K30p-binding anti-DNA antibodies into an AM Id-negative population. When anti-DNA antibodies were probed with an anti-Id reagent directed against a framework Id present on anti-K30p antibodies (SP Id), substantial reactivity was found. Thus the SP Id identifies a subpopulation of antibodies capable of binding both K30p and DNA. These results show that a subset of anti-ssDNA antibodies cross-react with K30p antigen and are idiotypically related to a subset of antibodies reactive with K30p. PMID- 3304740 TI - Reconstitution of T- and B-cell function after T-lymphocyte-depleted haploidentical bone marrow transplantation in severe combined immunodeficiency due to adenosine deaminase deficiency. AB - A 4-month-old male received a T-lymphocyte-depleted haploidentical bone marrow transplant (BMT) for correction of severe combined immunodeficiency (SCID) due to adenosine deaminase (ADA) deficiency. Although previous haploidentical bone marrow transplants have been attempted in ADA-deficient SCID, complete reconstitution of both B-lymphocyte and T-lymphocyte function has not been obtained after a single transplant. In this patient, however, rapid, complete, and persistent engraftment occurred. Potential reasons for this successful reconstitution include the use of ablation by chemotherapy (busulfan, cyclophosphamide, and cytosine arabinoside), the in vitro technique of using monoclonal antibody (CT-2) and complement to deplete the donor cells of T lymphocytes, and the relative good health of the patient prior to the transplant. Further trials using this method of haploidentical BMT may prove it to be a successful method of immunologic reconstitution in ADA-deficient SCID patients for whom an HLA-identical marrow is not available. PMID- 3304741 TI - A quick and easy chairside technique to improve posterior palatal seal in maxillary full dentures. PMID- 3304742 TI - Classification and terminology of periodontal diseases--an overview. PMID- 3304743 TI - The Interagency Council on Library Resources for Nursing: changes in the information environment of nursing. PMID- 3304744 TI - Single-dose response kinetics of cyclosporine. AB - Cyclosporine (Cy) dose-response kinetics were studied in 8 renal failure patients awaiting kidney transplantation. All patients received a single oral dose of Cy (7 mg/kg). Blood samples were drawn frequently before and until 4 days after Cy administration. Cy blood levels were measured by radioimmunoassay (RIA). OKT3 induced in vitro proliferation of simultaneously isolated lymphocytes was determined by H3-thymidine incorporation. T cell subpopulations were enumerated using a peroxidase-antiperoxidase method. Mean Cy blood level reached its peak (Cmax = 1,466 +/- 186 ng/ml) at 4 to 6 hours, the elimination half life (t1/2) measured 31 +/- 7.2 hours. The T4/T8 cell ratio did not change during the study, the total numbers of T3, T4 and T8 positive lymphocytes showed well known circadian variations without an apparent influence of Cy. There was a strong relationship between Cy blood levels and the inhibition of in vitro lymphocyte proliferation (y = 21.1 -0.007x, r = -0.91, p less than 0.001). With decreasing Cy blood concentrations the proliferative potency of lymphocytes was restored without delay in time. In conclusion circulating T cell subpopulations are not influenced by a single dose of Cy, the strong correlation between drug levels and the inhibition of lymphoproliferation suggest that RIA derived Cy blood concentrations are a valuable tool for estimating immunosuppression. PMID- 3304745 TI - Studies on glucose intolerance in chronic renal failure: estimation of insulin sensitivity before and after initiation of hemodialysis. AB - Using the euglycemic insulin clamp technique, we quantified insulin resistance in the genesis of the glucose intolerance observed in patients with CRF. Tissue sensitivity to insulin was evaluated in 11 patients with CRF (just before, and at one and four weeks after initiation of hemodialysis). The glucose infusion rate in patients with CRF (4.38 +/- 0.28 mg/kg/min) was significantly lower than in 28 controls (7.40 +/- 0.21 mg/kg/min) (p less than 0.001). The decreased glucose infusion rate in patients with CRF increased to 5.63 +/- 0.44 mg/kg/min (p less than 0.02) one week after starting hemodialysis and further improved to 7.46 +/- 0.90 mg/kg/min (p less than 0.02) after four weeks of hemodialysis. During the insulin clamp study, free fatty acid (FFA) decreased more rapidly in patients with CRF (both before and after initiation of hemodialysis) than in the controls (p less than 0.05-0.001). Glycerol decreased gradually in both groups, showing only a 50-60% reduction in 120 min. These results confirm that glucose intolerance in patients with CRF can be improved by the initiation of hemodialysis. PMID- 3304746 TI - Stephen Hales: theologian, botanist, physiologist, discoverer of hemodynamics. PMID- 3304747 TI - The limitations of current therapy in peptic ulcer disease. AB - The current therapeutic approach to peptic ulcer disease includes agents that reduce gastric acidity and hence peptic activity, inactivate or adsorb pepsin, create a physical barrier against the effects of acid and pepsin, or enhance mucosal defence. Profound gastric acid reduction may predispose to infection, and it has been suggested that carcinogenesis is possible, although a cause-effect relationship has never been established. The side-effects of therapy are well described, and may limit the therapeutic approach. Healing rates correlate closely with acid suppression in duodenal ulcer, but not entirely in gastric ulcer. Maintenance therapy lowers the relapse rate, but does not alter the ulcer diathesis. The optimal strategy for long-term management remains unclear, but in the future one should consider outcome measures which include a decrease in pain, improvement in the quality of life, reduction work loss, and a reduction of complications, in addition to ulcer healing. The ideal therapy should be efficacious, safe, and convenient--with no side-effects--and cost-effective. New agents should suppress acid and peptic activity, while enhancing the gastric mucosal defence mechanisms (such as mucosal blood flow, mucus, and bicarbonate secretion) and stimulating gastric cellular regeneration and restitution. PMID- 3304748 TI - Gastric mucus, bicarbonate and pH gradients in mucosal protection. AB - The evidence is reviewed that mucus has the capacity to delay diffusion of acid across it. It may provide an environment adjacent to the gastric mucosa in which the relatively small amounts of bicarbonate secreted by the epithelium are able to nullify acid diffusing towards the mucosa. This combination creates a near neutral zone immediately adjacent to the epithelium. Evidence in favour of this hypothesis is supports the idea that mucus and bicarbonate may together afford a first-line defence against luminal acid and pepsin, but equally it seems likely that this "barrier" can provide only part of the complete picture of mucosal protection. PMID- 3304750 TI - Gastric mucosal defense after superficial injury. AB - Breaking of the "gastric mucosal barrier" has classically been perceived as an event with deleterious consequences. The implications have been that these disruptions may lead to gastric ulceration. Contrary to this view, recent experimental evidence has shown that the superficial epithelium is not only focally disrupted during alcohol, drug, and food ingestion, but, under non pathological conditions, the epithelial barrier is rapidly repaired in about one hour or less by migrating mucous cells. After an initial insult to the superficial mucosa, which does not produce a hemorrhagic lesion, the interfoveolar necrotic epithelium exfoliates slightly into the gastric lumen covering the damaged mucosa. This layer of mucus and dead cells shields the mucosa from further damage by luminal necrotizing agents, in addition to trapping alkaline exudate from the capillaries next to the newly forming epithelium. Each of these responses to superficial injury--formation of a protective mucoid layer, flow of alkaline "mucosal fluid" to dilute luminal noxious agents, rapid epithelial restitution of the superficial cells--appears to prevent the formation of deeper hemorrhagic lesions. These data suggest that factors which facilitate or impede these 3 mucosal defense mechanisms may be of greater concern in the etiology of acute gastric erosions than the "integrity of the gastric mucosal barrier," as classically viewed. PMID- 3304749 TI - Membranes and barriers: with a focus on the gastric mucosal barrier. AB - In this review I have discussed the importance of barriers retarding the transport of electrolytes, non-electrolytes, proteins, and water to the maintenance of physiological homeostasis, and how disruption of these barriers can lead to severe pathological consequences. At the cellular level, I have discussed the potential localization of these barriers to molecular diffusion as being at the intercellular junction, plasmalemmal membrane, and at the extracellular surface of the plasma membrane. The presence of barriers in the major organ systems of the body is noted and these are listed, together with the physiological need for their restrictive-permeability properties. Emphasis is then placed on 2 of these barriers, the blood-brain barrier and the gastric mucosal barrier, and common characteristics of these systems are discussed. I have outlined our present knowledge of the molecular basis of the gastric mucosal barrier and, specifically, the contribution of the surface barrier constituents: mucus, bicarbonate, and surface-active lipids (glycolipids and phospholipids). Lastly, I have discussed our recent experiments pertaining to the possible importance of a hydrophobic water-repellent lining to the stomach's resistance to luminal acid. PMID- 3304751 TI - Gastric blood flow and mucosal defense mechanisms. AB - Recent experimental studies have demonstrated that gastric mucosal blood flow is an essential factor in mucosal defense against acute ulceration. Clinically, most patients who develop stress ulcers have experienced an episode of shock from hemorrhage, sepsis, or cardiac dysfunction. Diminished mucosal blood flow is also a common denominator in animal experiments that employ restraint, hemorrhage, or endotoxemia for the production of acute lesions. The mechanisms by which ischemia produces ulceration have been examined extensively. The leading hypothesis is that gastric mucosal blood flow plays an important role in the disposal, or buffering, of the H+ entering the tissue. Ischemia reduces the capacity of the gastric mucosa to neutralize acid that enters the tissue. This, in turn, leads to accumulation of H+ within the tissue, mucosal acidification, and ulceration. Ischemia may also render the stomach more susceptible to acute ulceration by a severe energy deficit of the gastric mucosa. Using a rat hemorrhagic shock model, a series of experiments demonstrated a profound reduction in mucosal ATP and other high-energy phosphate intermediates that coincided with the development of epithelial cell necrosis. In recent years, many of these experimental observations have been applied clinically in the management of critically ill patients at high risk for development of stress lesions. These include the correction of abnormalities in cardiac output and intravascular volume, careful attention to systemic acid-base balance, adequate nutritional support, and the use of antacids or antisecretory agents. As a result of these preventive measurements, the incidence and prevalence of stress ulcers have decreased significantly in recent years. PMID- 3304753 TI - Non-steroidal anti-inflammatory drugs (NSAIDs) cause gastrointestinal intolerance and major bleeding--or do they? AB - Non-steroidal anti-inflammatory drugs are a mainstay of treatment of the inflammatory arthritides. Unfortunately, they are often associated with dyspepsia, and this troublesome side-effect is a limitation to their chronic use by many patients. The use of enteric-coated preparations has improved the ability of this large group of patients to use these drugs. The appearance of suppository preparations has further improved tolerability of these medications. Though dyspepsia is a common adverse effect, there is little correlation between this side-effect and the prevalence of relevant gastrointestinal bleeding in practice. The latter is an uncommon event, but is of particular concern in the elderly. The introduction of concomitant use of a number of gastroenterologic medications has improved the rheumatologist's ability to give non-steroidal anti-inflammatory drugs to these patients. Despite this, no combination has been proven to be absolutely safe. Cytoprotection by a number of gastroenterologic preparations offers a means of avoiding, or decreasing, troublesome gastritis, and reducing the risk of relevant bleeding. Non-steroidal anti-inflammatory drugs must be used in this (elderly) population with caution, and prospective studies are needed to confirm the role of potential cytoprotective therapy in clinical practice. PMID- 3304752 TI - Gastrin. AB - Gastrin is the most important peptide in the regulation of gastric acid secretion. This communication reviews important new developments in our knowledge of its synthesis, action, and pathophysiology. The gene for human gastrin has been isolated, and it encodes a pre-pro-gastrin which is a 101-aminoacid peptide containing within it the structure of big gastrin (G34) with a C-terminal glycine extension. Post-translational processing by alpha-amidation of the glycine extended progastrin results in generation of the active forms of the peptide (G34, G17). When gastrin binds to its receptor on the parietal cell, phosphatidylinositol biphosphate (IP2) in the plasma membrane is converted to inositol 1,4,5-triphosphate (IP3), which acts as the secondary intracellular messenger to increase intracellular calcium and initiate the process that eventually leads to acid secretion. Although an abnormality in gastrin release or action is not thought to be crucially important in the genesis of duodenal ulcer, these patients nevertheless demonstrate increased postprandial gastrin release, and a greater sensitivity of their parietal cells to gastrin. Hypergastrinemia is the cause of peptic ulceration in the Zollinger-Ellison syndrome, in primary gastrin cell hyperplasia or hyperfunction, and in the retained antrum syndrome. Ulcerogenic hypergastrinemia must be distinguished from hypergastrinemia that is secondary to hypoacidity or anacidity, as is seen in atrophic gastritis or postvagotomy. PMID- 3304754 TI - How do non-steroidal anti-inflammatory drugs affect gastric mucosal defenses? AB - The gastric mucosa possesses a number of mechanisms permitting resistance to damage from its own secreted acid. No single mechanism can account for gastric mucosal defense. Mucosal permeability to acid, active ion transport, blood flow, mucus secretion, epithelial restitution, and prostaglandin synthesis are among the multiple factors involved in gastric mucosal defense. Non-steroidal anti inflammatory drugs (NSAIDs) cause gross mucosal damage by affecting these defenses. The net effect of NSAIDs is to make the mucosa more susceptible to the damaging effects of acid in the lumen. Acid plays a dual role in this process, by increasing drug absorption (which in turn increases mucosal permeability) and by diffusing from the lumen into the mucosa. If a sufficient amount of acid entering the tissue is unbuffered, necrosis occurs. NSAIDs affect tissue bicarbonate in several ways. These drugs decrease cellular production and secretion of bicarbonate, but increase tissue entry of bicarbonate from blood. NSAIDs also have a dual effect on blood flow. Microvascular stasis occurs at sites of gross mucosal damage, but blood flow increases at visibly normal sites. Mucus is impermeable to pepsin, slows acid diffusion to some degree, traps bicarbonate to create an alkaline interface, and traps cell slough, forming another putative barrier. NSAIDs inhibit mucus secretion and modify its structure. Perhaps related to mucus is the hydrophobic property of the mucosa attributable to an absorbed layer of surfactant. Aspirin reduces surface hydrophobicity, an effect that may increase ion permeability. In addition to secreting mucus, the cells lining the luminal surface also play a key role in maintaining the permeability and active transport properties of the mucosa.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304755 TI - Gunshot wounds. Incidence, cost, and concepts of prevention. AB - The United States has the highest incidence of firearm-related deaths among the Western industrialized nations. Firearms are the second leading cause of injury death. In 1982, the National Center for Health Statistics showed that firearms killed more than 33,000 individuals: 1,756 unintentionally, 16,573 by suicide, 13,841 by homicide, 376 by legal action, and 540 of undetermined intent. In terms of the total number of years of life lost, trauma in general contributed more years than heart disease and cancer combined for the year 1975. The southern regions of the United States tend to have higher firearm-related death rates than other regions of the country. Data collected within Arkansas are consistent with this trend. Handguns are the most frequently used firearms in fatal injuries. Unfortunately, data on nonfatal injuries are lacking. The emotional and economic costs of firearm-related death and injury are staggering. The estimated daily cost of hospitalization is $2100, and the average length of hospitalization is 10 days. The emotional impact of a gun-related injury or death will be felt immediately by 950,000 people per year. The economic loss resulting from "premature" deaths due to firearms is estimated to be nearly $4 billion annually. Unfortunately, the firearm is so ingrained in the American experience that one must conclude gunshot injuries and fatalities are simply part of the cost of living in America today. PMID- 3304756 TI - The prevention of injury secondary to motor vehicle accidents. AB - Motor vehicle accidents are a common cause of death for all age groups but are the most serious threat to life for patients aged one to 34 years. Major progress has been made in reducing these losses through improved highway design, improved laws, adjudication of laws controlling the drunk driver, and the advent of vehicle safety design standards. A federal law enacted in 1966 established the National Highway Traffic Safety Administration (NHTSA) and the Federal Motor Vehicle Safety Standards (FMVSS). Motor vehicles, particularly passenger cars, now provide effective protection for occupants because of vehicle safety design features required by the FMVSS. Safety belts are the single most effective safety device available and are required equipment in virtually all motor vehicles sold in the United States. Passive protection for nonusers of safety belts is rapidly improving with the availability of air bags and automatic belt systems, improved windshields, steering wheels, dashboards, and seats, and other vehicle crashworthiness features. Motorcyclists, bicyclists, and pedestrians are also provided with improved protection because of the FMVSS. PMID- 3304757 TI - Effects of bone graft and electrical stimulation on the strength of healing bony defects in dogs. AB - Autogenous cancellous bone graft alone or in combination with electrical stimulation is commonly employed yet there exists no conclusive data that the strength of the healing defect is actually modified. The authors examined three groups of paired canine femurs that were torsion tested to failure. Group I (in vitro): an intact femur was compared to a standard defect; Group II (in vivo): a defect alone was compared to a defect plus graft killed at eight weeks; Group III (in vivo): a defect plus graft was compared to a defect graft plus Osteostim (BGS Medical Corp., Milwaukee, Wisconsin) implantable stimulator killed at eight weeks. In Group I the defect decreased the average strength 45% (p = 0.005); in Group II the grafted defect decreased the strength 20% (p = 0.121); in Group III the defect graft plus electrical stimulation increased strength 4% (p = 0.669). At eight weeks, bone grafting, alone or with electrical stimulation did not statistically increase the torsional strength of the healing bony defect. PMID- 3304758 TI - The classic. Scurvy treated with ascorbic acid. By Leonard G. Parsons. 1933. PMID- 3304759 TI - Prevention of osteoporosis. AB - Osteoporosis is a major public health problem, and its prevalence may be increasing. Unfortunately, once spinal fractures occur, the treatment of osteoporosis is less than satisfactory. Prevention is thus the preferred approach. To initiate a prevention program would require identification of those at greatest risk. Usually, small, thin, white or Asian women who have had an early menopause (or oophorectomy) can be considered most at risk. Other factors may include low calcium intake, inactivity, alcohol and cigarette consumption, and nulliparity. For those clinically thought to be at greatest risk, bone mass measurements may be used to more clearly define the population for whom preventive therapy would be indicated. Prevention consists of dietary and lifestyle alterations, primarily increases in calcium intake and exercise, and the judicious use of estrogens. Estrogen therapy remains the single most effective method for prevention of bone loss. PMID- 3304760 TI - General principles in the prevention of surgical complications in orthopedic surgery. AB - Preventive measures in orthopedic surgery are best accomplished by full knowledge of potential complications, thoughtful preoperative planning, the careful and precise execution of the operative procedure, meticulous hemostasis, and the implementation of appropriate measures in the postoperative period. PMID- 3304761 TI - Osteoarthrosis. What is known about prevention. AB - Views of the general nature and cause of osteoarthrosis have changed over the past two decades. Osteoarthrosis is not a condition of relentless progression. It is not a disease, but rather the result of an imbalance between the mechanical stresses on the joint and the ability of the tissues of the joint to withstand those stresses. Effective treatment of osteoarthrosis is generally mechanical. In many cases, the progression of the condition can be halted with appropriate intervention. PMID- 3304762 TI - Prevention of sepsis. AB - One of the goals of modern surgery is to avoid a postoperative infection. This can only be accomplished by a surgeon's thorough understanding of the factors that may contribute to infection. Its prevention requires strict adherence to aseptic surgical technique, control of a favorable operating room environment, identification and treatment of the high-risk patient, prophylactic antibiotics, and correction of any nutritional derangements prior to surgery. The use of antibiotic acrylic composites also plays a role that is less well understood. The present low incidence of infection in total arthroplasty can only be maintained or improved by identifying and correcting all factors that may lead to infection. PMID- 3304763 TI - Congenital dislocation of the hip. Early detection and prevention of late complications. AB - Most congenitally dislocated hips (CDHs) are inapparent and asymptomatic during the neonatal period, although at that time a high percentage can be detected. Treatment during this period can decrease the late sequelae of CDH. Although the abduction tests of Ortolani and Barlow are the standard methods of detection in the neonate, their value and their use in screening programs have been overemphasized. There is no evidence that the use of these tests in screening programs applied to large populations can consistently reduce the late sequelae of CDH. This overemphasis on neonatal screening results in a false sense of security with resultant lack of continued vigilance throughout the period of infancy. PMID- 3304764 TI - The prevention of genetically determined orthopaedic defects. AB - Prevention of genetically determined orthopaedic disorders requires five steps: detection, the establishment of an accurate and specific diagnosis, the establishment of the pattern of inheritance, counseling, and management by early treatment, avoidance of pregnancy, or elective abortion. Elective abortion should only be considered after the diagnosis has been confirmed in utero by one or more diagnostic tests, which include radiography, ultrasound, amniocentesis, fetoscopy, fetal blood sampling, and chorionic villi biopsy sampling. PMID- 3304765 TI - Prevention of complications in orthopedic surgery secondary to nutritional depletion. AB - One of the major factors in the prevention of complications in orthopedic surgery patients is the maintenance of adequate nutrition. Trauma and elective surgery patients have nutritional requirements that are far greater than is generally realized. The use of nutritional assessment profiles will help to reveal patients who are malnourished or becoming malnourished, and will help to assess nutritional replacement. Protein and calorie malnutrition has a significant effect on wound healing, immunocompetence, and fracture healing. Surgeons should have the nutritional status of their patients in mind at all times and thereby avoid the complications associated with malnutrition. PMID- 3304766 TI - Prevention of venous thromboembolism. AB - Pulmonary embolism is still the largest single cause of postoperative mortality (1%-3%) from major reconstructive lower extremity joint surgery. It is imperative that the surgeon who deals with trauma and musculoskeletal disorders be informed about the prevention of venous thromboembolic disease, recognize the magnitude of the problem, and then take effective steps. Attention must be given to the use of physical methods and the administration of effective antithrombotic agents, including anticoagulants and antiplatelet agents as well as combination agents, to prevent thromboembolic disease. PMID- 3304767 TI - [Plasmapheresis-pulse therapy in chronic stage of Guillain-Barre syndrome- controlled study]. PMID- 3304771 TI - Transplacental pharmacokinetics of the antituberculosis drugs. PMID- 3304770 TI - Pharmacokinetics of long acting propranolol. Implications for therapeutic use. AB - Beta-adrenoceptor antagonists are among the most commonly prescribed classes of drugs. They are indicated for the treatment of diseases such as hypertension and angina pectoris, in which long term therapy is often required. Since many beta adrenoceptor antagonists have short plasma elimination half-lives, divided daily dosing has often been necessary in order to provide continuous beta-blockade throughout the day. However, such multiple-dose schedules may promote patient non compliance and failure of the prescribed regimen. Long acting propranolol is a sustained release formulation of propranolol which has been developed to maintain therapeutic plasma propranolol concentrations throughout a 24-hour period while allowing once-daily dosing. Compared with conventionally formulated propranolol, long acting propranolol has a prolonged terminal half-life (8 to 11 hours), due to slower absorption from the gut. Systemic bioavailability of long acting propranolol is 30 to 50% less than that of the conventional formulation. This difference may result from increased hepatic metabolism. Peak drug concentrations are significantly lower than following identical doses of conventional propranolol, and the time to peak drug concentrations following administration is delayed. Relatively constant plasma concentrations and clinically significant inhibition of exercise-induced tachycardia are maintained throughout a 24-hour dosing interval following once-daily long acting propranolol. Once-daily long acting propranolol is as effective as divided doses of conventional propranolol for the treatment of hypertension and angina pectoris. Efficacy also appears comparable with once-daily administration of long acting conventional beta adrenoceptor antagonists such as atenolol and nadolol. Once-daily long acting propranolol provides clinically significant sustained beta-adrenoceptor blockade and offers the potential for improved patient compliance due to once-daily dosing. Since provision of sustained beta-adrenoceptor blockade appears to be particularly important in the treatment of angina, this may be the principal indication for which long acting propranolol has a therapeutic advantage independent of its potential to improve compliance. PMID- 3304772 TI - The pharmacokinetics and pharmacodynamics of newer inotropic agents. AB - In the past few years an intense effort has been directed toward the development of new inotropic agents for the treatment of chronic cardiac failure. Traditionally, therapy of this disease has included treatment with digitalis glycosides, diuretics, sodium restriction and vasodilators. While digitalis has proven to be an effective inotropic agent, it possesses a low therapeutic index and many patients remain symptomatic or 'refractory' despite its inotropic effects. This review focuses on the pharmacokinetics and pharmacodynamics of newer inotropic agents that have been developed or which are currently undergoing investigation. Amrinone and milrinone are two bipyridine derivatives which have been shown to be effective in the short term treatment of cardiac failure. Milrinone is currently being evaluated for its long term efficacy. The mechanism of action of amrinone and milrinone appears to be unrelated to the cardiac glycosides and sympathomimetic agents, and they are rapidly and well absorbed following oral administration. The bioavailability of milrinone appears to be somewhat reduced in patients with chronic cardiac failure. The distribution of these drugs to extravascular tissues is very rapid; the volume of distribution suggests that they are not extensively bound to tissues. While the volume of distribution of amrinone appears to be unaffected by the presence of heart failure, that of milrinone appears to be somewhat enhanced. The major route of elimination of both drugs appears to be excretion into urine as unchanged drug. A substantial fraction of the amrinone dose, however, undergoes hepatic metabolism to many metabolites, including an N-acetyl derivative. Clearance of amrinone and milrinone is dramatically reduced in patients with chronic cardiac failure compared with normal volunteers, resulting in proportionate increases in the serum half-lives of these drugs. Studies examining the acute and chronic disposition of these agents in cardiac failure patients have not demonstrated changes in their pharmacokinetics secondary to improvements in cardiocirculatory function. Both drugs show strong correlations between mean improvements in haemodynamics and drug serum concentrations, although considerable intrapatient variability may exist. It is currently unclear as to whether the site for the pharmacological action of amrinone is pharmacokinetically distinguishable from plasma. Enoximone and its sulphoxide metabolite, piroximone, are two compounds currently undergoing investigation for the treatment of chronic cardiac failure.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3304768 TI - Clinical pharmacokinetic considerations in the treatment of increased intracranial pressure. AB - Life-threatening increased intracranial pressure can be reversed by a variety of drugs. These compounds all have some disadvantages, producing rebound effects, severe coma or cardiovascular depression and electrolyte imbalance. However, reduction of intracranial pressure is a prerequisite for recovery and the benefits of treatment outweigh the risks. Dexamethasone is rapidly eliminated, the short half-life (about 3 hours) indicating that dosage intervals should be kept small. As yet, however, its therapeutic efficacy has not been clearly demonstrated. Therefore, an association between pharmacokinetics and pharmacodynamics cannot be established. Osmotic diuretics are the most widely used agents for reduction of intracranial pressure. Pharmacokinetics show a very close relationship to changes in serum osmolality, but there are large variations in the clearance. For the use of osmotics, the blood-brain barrier must be intact. Osmotic diuretics may lead to intracerebral oedema or to acute renal failure as serum osmolality increases. Considering the pharmacokinetics of each drug, and the dynamics of intracerebral pressure and osmolality, an intermittent, individually titrated dosage should be administered, with simultaneous monitoring of intracranial pressure. Frusemide (furosemide) can be used as an adjunct, to enhance the effect of osmotic diuretics. Its pharmacokinetics are limited by renal function, depending on age as well as on the extent of renal impairment. Altered renal elimination of concomitantly administered drugs, and electrolyte imbalances should be anticipated when diuretics are used. Barbiturates are certain to decrease intracranial pressure in humans by an as yet unknown mechanism. Their administration is recommended for patients that do not respond to conventional therapy. As barbiturates can result in deep coma, knowledge of their pharmacokinetics is of great importance for recovery. Following single doses, pentobarbitone has a relatively long elimination half-life (about 22 hours). However, after repeated administration for several days, its elimination may be enhanced due to autoinduction. Thiopentone kinetics are characterised by distribution and redistribution into deep peripheral compartments. Administration of high and frequent doses leads to considerably delayed recovery. This is not true for methohexitone, which shows comparable pharmacokinetics after single and multiple dose administration. Elimination depends on liver blood flow. Thus, recovery from methohexitone-coma is rapid. Rapid elimination is also an important characteristic of etomidate and alphaxalone/alphadolone, two non-barbiturate hypnotics.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3304773 TI - Bacterial meningitis in children: diagnosis and therapy. A review of recent developments. PMID- 3304774 TI - Detection and identification of myoglobin in serum by immunoblotting. Effect of exercise on patients with Duchenne muscular dystrophy. AB - The diurnal changes and the effect of pre- and postexercise on serum myoglobin (Mb) levels and creatine kinase (CK) activity were investigated and compared in 11 male patients with Duchenne muscular dystrophy (DMD) and 11 normal male controls. The Mb levels and the CK activity in patients with DMD were significantly higher (p less than 0.001) than in the controls under both resting and exercise conditions. No correlation was found between serum Mb levels and CK activity in patients with DMD. The results indicate that Mb is also a useful parameter in both the RIA and the immunoblotting technique for diagnosing muscle fiber degeneration and screening DMD. PMID- 3304769 TI - Neonatal bilirubin toxicity. A review of kernicterus and the implications of drug induced bilirubin displacement. AB - Kernicterus, the primary manifestation of neonatal bilirubin toxicity, remains an important complication of unconjugated hyperbilirubinaemia despite advances made with phototherapy and exchange transfusions. It results from the penetration of bilirubin into neuronal tissues of the CNS with subsequent damage to the mitochondrion. A number of factors may modify or potentiate bilirubin toxicity, including drugs administered to the infant. The importance of drug-bilirubin interactions in the pathogenesis of kernicterus was first realised quite inadvertently in the 1950s, and the potential risk for significant drug-bilirubin interactions has since become an important consideration in neonatal drug therapy. All drugs intended for use in newborn infants should be evaluated for their capacity to displace bilirubin. A number of techniques have been developed which have facilitated investigation of the mechanisms mediating the bilirubin displacing effects of drugs and the pharmacokinetics of drug-bilirubin interactions. Further, the clinical risk for inducing kernicterus has been investigated for many of the drugs to which neonates may be exposed by direct administration, transplacentally, or through breast milk. This review summarises the available knowledge concerning the physicochemical properties and toxicities of bilirubin, reviews the methodologies used in evaluating drug-bilirubin interactions, and focuses on the mechanisms, pharmacokinetics and clinical significance of the bilirubin displacing effects of antibiotics, anticonvulsants, diuretics, and other important drug classes used in the treatment of neonates. PMID- 3304775 TI - Serum stimulation of prostacyclin synthesis in aortically, venously and microvascularly derived endothelial cells. AB - The existence of factors in plasma and/or serum that can stimulate prostacyclin production in endothelial cells has been reported. An absence or deficiency of these factors has been suggested as a contributory factor in certain disease states involving microvascular thrombosis. The ability of aortic, venous and microvascular-derived endothelial cells to respond to serum stimulation was investigated. All of the endothelial cells were stimulated by serum, regardless of their origin. However, the microvascular cells produced the least amount of prostacyclin and the venous cells produced the most. PMID- 3304776 TI - Human steroid receptors and erb-A gene products form a superfamily of enhancer binding proteins. AB - Steroid hormones exert potent effects on development and differentiation, and their actions are mediated as a consequence of their interaction with specific, high-affinity binding proteins referred to as receptors. To initiate the analysis of the molecular mechanisms by which steroid receptor molecules regulate transcription, we have recently cloned the human glucocorticoid receptor cDNA. The structural analysis of receptor clones reveals 2 protein forms termed 'alpha' and 'beta' which differentiate their carboxy termini. The alpha-receptor is equivalent to the major form of the human glucocorticoid receptor and appears to be the molecule that confers transcriptional control. This protein contains a cysteine-rich region which we believe defines the DNA-binding domain. Structural analysis reveals the receptor to be related to a novel family of proto-oncogenes termed 'erb-A'. To examine this relationship, we have cloned certain members of the erb proto-oncogene family which reveals strong relatedness to the DNA-binding domain of the glucocorticoid receptor. Based on these homologies, we proposed that erb-A protooncogenes are transacting factors that may be candidates for enhancer sequence binding proteins. The unexpected indication from this study is that the steroid receptors and the erb-A proto-oncogenes share a common primordial archetype and therefore appear to be members of new super family of regulatory proteins. PMID- 3304778 TI - Topical antiinflammatory therapy against periodontal disease: a historical survey. PMID- 3304777 TI - Efficacy and limitations of a self-repair kit. PMID- 3304779 TI - Laboratory and physiologic post-palatal seal. PMID- 3304780 TI - An SEM study of fissure surfaces conditioned with a scraping technique. PMID- 3304781 TI - Human islet cell antibodies: immunoglobulin class and subclass distribution defined by monoclonal antibodies. AB - Utilizing defined monoclonal antibody reagents, the immunoglobulin class and subclass distribution of human islet cell antibodies (ICA) were evaluated by means of an indirect immunofluorescence technique. ICA positive sera from 14 subjects with Type 1 diabetes and 10 with "Pre-Type 1 diabetes mellitus" (ICA positive, currently non-diabetic "high risk" subjects, mostly first degree relatives, with varying degrees of beta cell dysfunction) were analyzed. ICA were confined solely to the IgG class, the majority of the subjects (17/24) demonstrating an ICA response restricted to one IgG subclass only (IgG1). The remainder (7/24) showed an IgG subclass distribution extending to no more than 2 subclasses only (IgG1 + IgG2 or IgG1 + IgG3). There was no relationship between specific ICA-IgG subclass response and the age, sex, stage and duration of diabetes mellitus. An ICA-IgM response was not seen in any of the subjects, including those studied during the early preclinical phase of insulin-dependent diabetes mellitus. PMID- 3304782 TI - A comparison of the pharmacokinetics of human protamine sodium insulin with human isophane insulin following subcutaneous injection in normal subjects. AB - The pharmacokinetics of human protamine sodium insulin 0.6 mg% were compared with those of human isophane zinc insulin using the glucose clamp technique. The insulin preparations were administered subcutaneously at a dose of 0.5 U/kg in 7 normal subjects; a placebo injection served as control. Plasma insulin and C peptide concentrations were then measured over 24 hours. After correction of the results to allow for endogenous insulin secretion the two insulin preparations gave similar values throughout the study except that protamine sodium insulin achieved an earlier peak in plasma insulin concentration (90 minutes) compared to isophane (120 minutes). When measured by an index of the dextrose infusion rate required to maintain euglycaemia the two insulin preparations gave similar values for the first 16 hours, maximum values being obtained during the fourth hour after administration. Using this index isophane zinc insulin gave higher values during the 17th, 19th and 21st hours following administration suggesting it may have a slightly more prolonged action than protamine sodium insulin. PMID- 3304784 TI - Possible differences in potency of purified pork insulins: confirmation by the euglycemic clamp technique. AB - A 33-year-old female with insulin-dependent diabetes mellitus (IDDM) for 14 yr had been taking a constant insulin dose for 2 yr. She experienced frequent hypoglycemic reactions when switched from purified pork insulin Iletin II NPH (LILLY) to Protophane (NOVO) which could not be explained by a change in either diet or body wt. A 75% reduction in dose led to a restoration of prior control. The euglycemic clamp technique was utilized to determine whether a difference in potency existed between the 2 commercially available purified pork insulins in this patient and 4 additional subjects, one of whom was not diabetic. There was an 18% difference in potency between insulins in the patient leading to these studies. A difference of more than 10% was noted in 3 of the 5 paired tests, suggesting increased potency (18, 29, 55.1%) of Actrapid (NOVO) compared with Iletin II Regular (LILLY). Until these preliminary observations are confirmed or denied, it is prudent to observe patients closely when switching from one brand of insulin to another even when the species of origin and purity are the same. PMID- 3304786 TI - [Digital subtraction angiography of patients with Marfan's syndrome]. AB - Marfan's syndrome is a rare inborn error of metabolism. Marfan patients are prone to aneurysms of the ascending aorta and run a high risk of rupture of the aortic arch. The diameter of the aneurysm is the most important predictor of the risk and therefore the leading point for surgical interventions. IV and IA-DSA according to our experiences are simple and effective methods in pre- and postoperative evaluation of patients with the syndrome. PMID- 3304783 TI - A comparative study of sulphonylurea and insulin therapy in non insulin dependent diabetics who had failed on diet therapy alone. AB - 20 patients with non insulin dependent diabetes mellitus (NIDDM), and within 20% of their ideal body weight were studied. They had failed to achieve adequate diabetic control following 3 months of dietary therapy. They were randomly allocated to insulin or sulphonylurea therapy for 3 months and then "crossed over" for the same period of time. Patients were maintained at euglycaemia (plasma glucose 4-7 mmol/l) for 24 hr using an open-loop intravenous insulin infusion, and then underwent a standard 75 gm oral glucose tolerance test (OGTT) following each mode of therapy. Mean glycosylated haemoglobin and preprandial blood glucose were 8.7% and 7.7 mmol/l respectively after sulphonylurea, and 7.8% (p less than 0.05) and 6.6 mmol/l (p less than 0.05) after insulin therapy. There was no significant difference in change in body weight. Following a 75 gm OGTT mean plasma insulin at 1/2 hr and 1 hr was 14.0 mu/l and 16.5 mu/l after sulphonylurea, and 23.4 mu/l (p less than 0.05) and 22.1 mu/l (p less than 0.05) after insulin therapy. Plasma C-peptide responses were also improved at 1/2, 1 and 1 1/2 hr after a period of insulin therapy being 0.61 nmol/l, 0.65 nmol/l and 0.59 nmol/l respectively. After sulphonylurea therapy comparable plasma C-peptide responses were 0.31, 0.41 and 0.37 nmol/l respectively (p less than 0.05). There was no significant difference in the total amount of intravenous insulin required for 24 hr euglycaemia. Our study shows that short term insulin therapy in patients with NIDDM who had failed on diet alone has advantages over sulphonylurea therapy in that it achieves better diabetic control and an improved B-cell response to glucose stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304785 TI - Control of diabetes through a subcutaneous peritoneal access device (SPAD) in patients with resistance to subcutaneously injected insulin. AB - In 2 patients with insulin dependent diabetes and resistance to subcutaneously injected insulin, adequate glucose homeostasis was achieved following the administration of insulin through a subcutaneous peritoneal access device (SPAD). Fasting and post-prandial plasma glucose concentrations fell to near normal levels and HbA1 fell from 17.8% to 9% and from 15.4% to 8% respectively. Insulin requirements fell from 3,000 and 8,000 units to 160 and 100 units per day, respectively. Measurements of sequential free insulin concentrations in serum following subcutaneous and intraperitoneal insulin injection (100 i.u.) showed a significant increase in serum free insulin following intraperitoneal injection, but none after subcutaneous injection. Glucose concentrations fell after intraperitoneal injection of insulin, but not after subcutaneous injection. It is concluded that: intraperitoneal insulin administration is an effective alternative to subcutaneous injections of insulin in patients with this form of insulin resistance; and in patients with this form of insulin resistance, subcutaneous injections of insulin are not followed by an increase in serum free insulin. PMID- 3304788 TI - Ultrasound changes of the gallbladder wall in cholecystitis: a sonographic pathological correlation. AB - To assess the pathological basis of the changes seen on ultrasound examination of the gallbladder wall in cholecystitis, the appearances of the gallbladder wall were analysed in 17 patients with acute cholecystitis and 27 patients with chronic cholecystitis, and correlated with the pathological specimens removed at surgery. A thin echo reduced layer within the echogenic gallbladder wall corresponds to a complex of subserosal oedema, haemorrhage and inflammatory cell infiltration, or to muscular hypertrophy. Indistinctness or a low echogenicity rind along the inner margin represents mucosal sloughing or obliteration of the mucosal folds. Uniformly decreased echogenicity of the wall is caused by severe inflammatory change with sloughing of the mucosa or obliteration of the mucosal folds. These ultrasound signs are considered to be valuable signs of cholecystitis. PMID- 3304787 TI - A comparison of computed tomography and ultrasound in the assessment of parotid masses. AB - Computed tomography (CT) and ultrasonography were compared in the evaluation of parotid masses. The findings in 18 patients are presented. Both techniques proved equally effective at locating and predicting malignancy in lesions confined to the superficial lobe of the gland. Tumours in the deep lobe, medial to the ramus of the mandible and those extending beyond the confines of the gland were more reliably assessed by CT. It is recommended that CT is reserved for such problems, and that ultrasonography should be the initial investigation for the evaluation of parotid masses. PMID- 3304789 TI - Ultrasound diagnosis of splenic injuries in children--the importance of free peritoneal fluid. AB - Three cases of injury to the spleen in children are presented. The value of ultrasound in the diagnosis and monitoring of treatment of such splenic injuries is described, and the importance of free peritoneal fluid is stressed. Since splenectomy disturbs the immune mechanisms of the body, treatment should, if possible, be medical. PMID- 3304790 TI - Low dose low osmolar intravenous urography. AB - A prospective double blind randomised trial using 25 ml of Hexabrix 320 (ioxaglate, May and Baker), Niopam 370 (iopamidol, Merck) or Omnipaque 350 (iohexol, Nycomed) intravenous urography was carried out. The results showed no perceptible difference in the diagnostic quality of urograms with each of the media. An additional 25 ml of contrast medium was required by 4% of patients in order to obtain a satisfactory examination. We recommend that a dose of 25 ml of low-osmolar medium be used for all patients with the exception of the obese, those taking diuretics or those who have renal impairment. PMID- 3304791 TI - Digital subtraction venography of the upper extremity. AB - Seventy four digital subtraction venograms of the upper extremity and mediastinum were performed in 69 patients. The indications included idiopathic arm and shoulder swelling, difficulties with a central venous catheter, chronic venous access device, or dialysis fistula, superior vena cava syndrome, or pre-operative anatomical mapping. Clinically useful information was obtained in all studies. The digital subtraction technique allows the simple and rapid performance of venography, especially in patients with limited venous access. PMID- 3304792 TI - Low osmolar contrast media. PMID- 3304793 TI - Midgut malrotation diagnosed by ultrasound. PMID- 3304794 TI - Poor correlation between the erythrocyte sedimentation rate and clinical activity in juvenile rheumatoid arthritis. AB - Despite questions regarding its validity as an estimator of inflammatory disease activity, monitoring of the erythrocyte sedimentation rate (ESR) continues to be routine practice among pediatric rheumatologists caring for children with juvenile rheumatoid arthritis (JRA). We studied a large group of patients with JRA in order to determine the degree of correlation between clinically apparent inflammation and the ESR. regression and correlation analyses and descriptive statistical techniques were used to establish the relationship between 1) the ESR and the amount of clinically apparent inflammation at a point in time, and 2) changes in the ESR and the corresponding changes in apparent inflammation. One hundred fifty-nine children with JRA who were participants in a double-blind, controlled trial of two antirheumatic drugs were assessed for clinical and laboratory evidence of inflammatory disease activity at an initial visit, and then periodically for the duration of the one year study. Results showed that, at the initial assessment, neither the total number of joints with active arthritis nor the severity score correlated well with the ESR (r = .196 and .245 respectively). These findings were independent of the course type of JRA and age of the child. Changes from baseline in inflammation showed little correlation (r less than .25) with changes in the ESR. These findings suggest that the ESR is a relatively poor indicator of the amount of articular inflammation present, and that changes of disease activity are not reflected closely by changes in the ESR among children with JRA. PMID- 3304795 TI - William Heberden the elder (1710-1801): the compleat physician and sometime rheumatologist. PMID- 3304796 TI - Arthroplasty for temporomandibular joint ankylosis secondary to ankylosing spondylitis. AB - Although temporomandibular joint involvement is frequent in ankylosing spondylitis, ankylosis seldom ensues. A patient with a temporomandibular joint ankylosis secondary to ankylosing spondylitis is presented. Treatment consisted of an osteoarthrectomy, followed by a costochondral ribgraft. A follow-up period of 39 months showed a satisfactory result. PMID- 3304797 TI - Possible description of Lasegue's sign in the Edwin Smith Surgical Papyrus. PMID- 3304798 TI - Molecular and biochemical basis for the characterisation of antinuclear and anticytoplasmic antibodies. PMID- 3304799 TI - Purification of antigens and monoclonal antibodies. PMID- 3304800 TI - Clinical significance of antibodies to double stranded DNA (dsDNA) for systemic lupus erythematosus (SLE). AB - In sera of patients with systemic lupus erythematosus (SLE) a wide variety of antibodies against nuclear antigens can be found, including antibodies to nucleic acids, histones and non-histone nuclear proteins. Among these, antibodies to double stranded DNA (dsDNA) appear to be mainly restricted to SLE. Yet, in daily practice one also finds patients that have antibodies to dsDNA during a long time ( greater than 5 years) but have not developed SLE. These anti-dsDNA positive non SLE patients often fulfil several of the ARA criteria for SLE though one may not conclude that they form a specific clinical subset of SLE. It has often been tried to discriminate between clinical subsets of this heterogeneous disease by studying differences within the population of anti-dsDNA antibodies. Immunospecificity, complement-fixing ability, avidity, immunoglobulin (sub)class composition have all been the subject of different studies; yet, conclusions from these studies are often contradictory and more work will be necessary to elucidate this. The prognostic significance of anti-dsDNA levels in prospective studies has been proven valuable. A continuous increase in anti-dsDNA level correlates well with the appearance of an exacerbation of the disease. In other studies merely the amount of antibodies was found to be correlated with disease activity. Therapeutical consequences of these findings are still discutable. The role of anti-dsDNA antibodies in the pathogenesis of the disease is merely based on the above mentioned correlations and on the specificity of the antibodies to SLE. Questions regarding the etiology of SLE or the mere existence of anti-dsDNA antibodies in this kind of patients are unresolved.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304801 TI - Antinuclear antibody (ANA) substrates and quantification techniques. PMID- 3304803 TI - Practical problems in routine and research laboratory techniques: antinuclear antibodies. PMID- 3304802 TI - Systemic diseases and the detection of antinuclear and anticytoplasmic antibodies. An historical review. PMID- 3304804 TI - Physics and physiology in the hyperbaric environment. PMID- 3304806 TI - Body composition of fasting obese patients measured by in vivo neutron activation analysis and isotopic dilution. AB - The masses of fat, water, protein and minerals in ten obese patients (seven women and three men) have been measured, by in vivo neutron activation analysis and isotopic dilution, before and after four weeks of starvation. Mass of skeletal muscle was estimated from measured total body potassium (TBK) and nitrogen (TBN). Before starvation the patients weighed, on average, 56.5 kg more than predicted from sex, age and height. The composition of their excess tissue was consistent with that of adipose tissue. During starvation the patients lost, on average, 12.1 kg of tissue containing more water and potassium than adipose tissue. Regression analysis of the measured changes in potassium and protein suggested that approximately 230 mmol of potassium was lost independently of protein, the remainder being lost with 'non-muscle' fat-free tissue. Because some potassium was lost without protein, the change in muscle mass calculated from the changes in TBK and TBN overestimated the true mass of muscle lost. After starvation the patients still had 44.5 kg of excess tissue. Their composition was consistent with an excess of adipose tissue and a deficit of potassium. PMID- 3304805 TI - Comparison of laser Doppler and Doppler ultrasound in lower limb vascular diagnosis. AB - This study represents a preliminary investigation into the use of laser Doppler flowmetry in lower limb vascular diagnosis. The method is compared with the accepted method of continuous wave Doppler ultrasound. Fifty-six patients with symptoms of lower limb vascular disease were investigated consecutively and independently using both techniques. In approximately two-thirds of patients the two methods showed broad agreement in their classification of disease severity (correlation coefficient = 0.63, P less than 0.001, n = 41). However, about 30% of those studied had impaired microvascular responses on laser Doppler evaluation with no detectable major vessel disease on continuous wave ultrasound investigation. The results indicate that more information is obtained about a subject's vascular status when results from both methods are combined. Thus laser Doppler flowmetry may be useful adjunct to Doppler ultrasound and segmental pressure measurements in the vascular laboratory. PMID- 3304807 TI - A survey of anti-platelet antibody detection--report of the UK Platelet and Granulocyte Serology Working Group, 1985. AB - In 1985, serum samples were distributed to 27 laboratories within the UK and Eire with the objective of determining the current state of anti-platelet antibody detection. The sera included five unknown samples for blind assessment and four well-characterized reference reagents. The laboratories involved used a wide range of different methods but the most commonly used techniques were the fluorescent antiglobulin test and the enzyme-linked immunosorbent assay. In the trial, all responding laboratories were able to detect potent anti-platelet alloantibodies but there was a 43% incidence of 'false positive' results with samples which had been designated as inert. There were no apparent differences in performance between assays using fluorescein- or enzyme-labelled antiglobulin reagents or between assays which utilized PFA-treated rather than untreated platelets. PMID- 3304808 TI - A computer system for a blood transfusion laboratory. AB - A modified Phoenix data processing system has been introduced into the haematology laboratories in the Leicestershire District Health Authority. In the three blood transfusion laboratories the computer system has been fully operational for a year and has been found to aid the management of data within the department as well as improving the quality of the service. PMID- 3304809 TI - Interleukin 1, tumour necrosis factor-alpha (cachectin) and the pathogenesis of cancer cachexia. AB - Soluble proteins synthesized and released by phagocytic cells may be responsible for the protein and energy wasting frequently observed during catabolic states, including cancer cachexia. This hypothesis is based upon the observation that many of the hosts's metabolic responses to infection, inflammation, accidental trauma and some forms of cancer are remarkably similar. Anorexia and degradation of skeletal and connective tissue protein, as well as increases in hepatic protein synthesis and energy expenditure, can all be reproduced by the administration of activated macrophage products. During inflammatory states, including active tumour growth, increased production of some cytokines, including interleukin 1 and tumour necrosis factor-alpha (cachectin), have been observed. If these monokines serve as metabolic inducers, then efforts to block therapeutically the actions of macrophage-secreted substances may play a role in slowing the progression of tissue-wasting associated with catabolic states, particularly due to malignant tumours. PMID- 3304810 TI - Cough: differential diagnosis and treatment. AB - Cough is a complex physiologic event that protects the lungs from mechanical, chemical, and thermal injury. It is a normal reflex and therefore helps humans to adapt to an ever-changing environment. Cough can also be a pathologic reflex in that it may be an important and often the only sign of serious disease, may significantly contribute to the spread of airborne infection, and in some instances, may result in severe functional or structural damage to the organism. This article focuses on the pathophysiology of the afferent limb of the cough reflex, including a discussion of the causes, the diagnostic workup, and the treatment of cough. PMID- 3304811 TI - Mechanisms of dyspnea. AB - An unpleasant sensation of difficulty in breathing is a common complaint in a variety of disease states. The psychophysical approach to the study of respiratory sensations has contributed greatly to the understanding of the mechanisms of dyspnea. Although dyspnea, in large part, is an expression of the sense of the effort of breathing, the intensity and quality of the subjective experiences during breathing are also dependent on afferent feedback primarily from receptors in the respiratory muscles. These inputs may act either by changing the level and pattern of respiratory motor activity or by a direct effect on higher brain centers. Finally, the expression of the symptoms of dyspnea in patients with cardiopulmonary disease is shaped by individual behavioral styles, personality, and emotional state. All of these factors must be taken into consideration in the management of the dyspneic patient. PMID- 3304812 TI - Dyspnea: diagnosis and management. AB - Multiple physiologic and psychologic factors contribute to the sensation of acute as well as chronic dyspnea. The causes of acute dyspnea frequently can be established by a brief history, physical examination, and chest radiograph. Appropriate therapy should be directed to reversing the specific etiology leading to the acute onset of breathlessness. Chronic dyspnea is probably the most common respiratory complaint of patients seeking medical care. Both aging and deconditioning may influence the development and severity of breathlessness in healthy and disease states. Pulmonary function testing, measurement of respiratory muscle strength, and cardiopulmonary exercise testing may be required to investigate the problem of chronic dyspnea. Once the diagnosis has been made, it is useful to measure or quantify breathlessness using clinical rating methods. This baseline assessment provides objective information for evaluating response to treatment. Initial therapy for improving chronic breathlessness should be directed at the specific cause of the problem. Additional strategies for reducing dyspnea include breathing techniques, exercise training, nutritional manipulations, psychologic interventions, respiratory muscle training, respiratory muscle rest, and sedative/hypnotic medications. PMID- 3304813 TI - Wheezing and stridor. AB - Wheezes are defined as high-pitched, continuous, adventitious lung sounds. They are produced by oscillation of opposing airway walls whose lumen is narrowed. Although asthma is the most common cause of wheezing, a wide variety of disease processes may result in wheezing due to airway obstruction. This obstruction may be caused by airway edema, smooth muscle constriction, increased secretions, vascular congestion, mass lesions, scarring, or foreign bodies. Stridor is a special kind of wheeze described as a loud musical sound of constant pitch, which is heard in patients with tracheal or laryngeal obstruction. The full differential diagnosis of airway obstruction should be carefully considered in any patient with wheezing or stridor. PMID- 3304814 TI - Chest pain: cardiac and noncardiac causes. AB - The perception and interpretation of pain in the thoracic cavity may be extremely variable. In this article the differential diagnosis of chest pain is reviewed with emphasis on the historical features that allow for a precise diagnosis. Beginning with the neural transmission of chest pain, the discussion continues with the various sources of chest pain, including pain arising from the heart, the pericardium, and the great vessels; the gastrointestinal tract; the lungs and the pleura; the chest wall; and miscellaneous causes. PMID- 3304815 TI - Snoring and apnea. AB - Clinical investigation over the last decade has demonstrated that sleep may not be the benign rejuvenating state it was once considered. With the discovery of repetitive episodes of sleep obstruction during sleep, there has been an increased interest in what happens to breathing during sleep. Classically, snoring and apnea have not been listed under pulmonary signs and symptoms, but research has provided a better understanding of normal ventilatory changes during sleep as well as the pathologic changes associated with sleep apnea and other cardiopulmonary disorders. PMID- 3304816 TI - The cardiac exam in lung disease. AB - The physical examination, that is, inspection, palpation, and auscultation, is as valuable today as it ever was, even for structures as inaccessible as the heart and pulmonary circulation. Examination of the heart in patients with lung disease aims to detect changes in the structures or function of the right heart that are secondary to the pulmonary process and to detect the circulatory status of the patient. The most important cause of changes in the right ventricle in patients with lung disease is increased afterload caused by pulmonary hypertension. Auscultation remains one of the most sensitive means of detecting pulmonary hypertension, and the physical signs allow assessment of right ventricular function as well as response to therapy. PMID- 3304817 TI - Clubbing and hypertrophic osteoarthropathy. AB - Acquired clubbing of the digits and hypertrophic osteoarthropathy are closely related disorders of unknown etiology that derive special significance from their frequent association with serious underlying diseases of the thorax or abdomen. Most importantly, clubbing or HOA may provide the first clinical indication of a chronic infection or an intrathoracic neoplasm. However, clubbing is easily overlooked on physical examination, and hypertrophic osteoarthropathy is often mistaken for some other disorder. The diagnosis of clubbing is based on the finding of an increase in the soft tissue at the base of the finger or toenails. Of the several objective criteria that have been proposed for the diagnosis of digital clubbing, the best documented and most practical is an increase in the ratio of the distal phalangeal depth (DPD) to the interphalangeal depth (IDP) of the index finger to 1.0 or greater. Hypertrophic osteoarthropathy is characterized in advance cases by the combination of digital clubbing, periostitis of the long bones, arthritis-like changes in the knees, elbows, ankles, and wrists, and swelling of the soft tissues in the distal extremities. Bone scintigraphy has emerged as the most sensitive test for HOA; in fact, a bone scan may show evidence of periostitis in patients with no other signs, symptoms, or radiographic abnormalities of the disorder. The symptoms of HOA respond to anti-inflammatory agents, and to ablation or cure of the underlying disorder. PMID- 3304818 TI - Update: signs and symptoms of pulmonary disease in children. AB - A few pulmonary diseases that occur only during childhood are associated with clinical manifestations rarely seen in adults. Most of the manifestations of pulmonary disease unique to children are probably explained by growth and development rather than by unique features of the diseases themselves. Therefore this article is oriented more toward growth and development than toward disease. This discussion is limited to relatively new knowledge, much of it a product of applied technology. The intent is to help those interested in pediatric lung disease to develop new clinical perceptions or to "calibrate" some they already have. PMID- 3304820 TI - Chromosomal localization of human collagen genes. PMID- 3304819 TI - Idiopathic thrombocytopenic purpura: an update. PMID- 3304821 TI - Reproducibility of an assessment scale of denture quality. AB - Assessment of denture quality is important in prosthetic research. The aim of this investigation was to determine the intra- and interexaminer reliability of denture quality assessment. Three groups of patients with full maxillary and mandibular dentures and two dentists participated. The patients in group 1 (n = 195) were examined by the two dentists independently, in group 2 (n = 35) twice by one of the dentists and in group 3 (n = 20) twice by the other dentist. A denture quality scale was constructed containing nine variables. The internal consistency (coefficient alpha) of this scale was 0.60. The intra- and interexaminer reliability was between 0.59 and 0.86. For individual items of this scale these values were between 0.22 and 1.00. PMID- 3304822 TI - Incidence of abortions caused by leptospirosis in sheep and goats in Spain. AB - From 1970 to 1985, 973 outbreaks of abortion in sheep and 262 outbreaks of abortion in goats from southern Spain were studied. Of these, 1.7 and 2.6% respectively were caused by leptospiras, chiefly by the serovar pomona (11 flocks of sheep, 64.7%, and six herds of goats, 75.0%) and in a lower proportion the serovars sejroe (three flocks of sheep 17.6%, and one herd of goats, 12.5%), icterohaemorrhagiae (two and one outbreaks respectively) and grippotyphosa in one ovine flock (5.8%). The mean rates of attach (X + SD) of abortions by leptospirosis have been estimated as 16.9 + 6.5% in ovine outbreaks and 20.7 + 8.3% among goats. PMID- 3304823 TI - Regulation of myelopoiesis. AB - Myeloid cells are produced by the bone marrow from stem cells and progenitor cells. This review summarizes the current understanding of how this process is regulated. Regulation of progenitor cell proliferation and differentiation occurs in microenvironments present within the bone marrow as well as on the systemic level by the release of regulators into the circulation. The regulators of central importance to myelopoiesis are growth factors necessary for the proliferation and differentiation of progenitors. These growth factors have recently been characterized and studies indicate that there is a hierarchy of factors acting upon successive differentiation stages of progenitors. Endotoxin appears to be a major modulator of myeloid growth factor production. Other inhibitors of myelopoiesis are also discussed. Regulation of myelopoiesis therefore involves a balance between growth factor production and inhibition by other factors. PMID- 3304824 TI - Aerobic and anaerobic glycolysis in mammals and reptiles in vivo. PMID- 3304825 TI - Acidic amino acid transport in animal cells and tissues. AB - 1. The occurrence and characterization of acidic amino acid transport in the plasma membrane of a variety of cells and tissues of a number of organisms is reviewed. 2. Several cell types, especially in brain, possess both high- and low affinity transport systems for acidic amino acids. 3. High-affinity systems in brain may function to remove neurotransmitter amino acid from the extracellular environment. 4. Many cell systems for acidic amino acid transport are energized by an inwardly directed Na+ gradient. Moreover, certain cell types, such as rat brain neurons, human placental trophoblast and rabbit and rat kidney cortex epithelium, respond to an outwardly directed K+ gradient as an additional source of energization. This simultaneous action may account for the high accumulation ratios seen with acidic amino acids. 5. Rabbit kidney has been found to have a glutamate-H+ co-transport system which is subject to stimulation by protons in the medium. 6. Acidic amino acid transport in rat brain neurons occurs with a stoichiometric coupling of 1 mol of amino acid to 2 mol of Na+. For rabbit intestine, one Na+ is predicted to migrate for each mol of amino acid. 7. Uptake in rat kidney cortex and in high-K+ dog erythrocytes is electrogenic. However, uptake in rabbit and newt kidney and in rat and rabbit intestine is electroneutral. 8. Na+-independent acidic amino acid transport systems have been described in the mouse lymphocyte, the human fibroblast, the mouse Ehrlich cell and in rat hepatoma cells. 9. In a number of cell systems, D-acidic amino acids have substantial affinity for transport; D-glutamate, in a number of systems, however, appears to have little reactivity. 10. Acidic amino acid transport in some cell systems appears to occur via the "classical" routes (Christensen, Adv. Enzymol. Relat. Areas Mol. Biol. 49, 41-101, 1979). For example, uptake in the Ehrlich cell is partitioned between the Na+-dependent A system (which transports a wide spectrum of neutral amino acids), the Na+-dependent ASC system (which transports alanine, serine, threonine, homoserine, etc.), and the Na+-independent L system (which shows reactivity centering around neutral amino acids such as leucine and phenylalanine). Also, a minor component of uptake in mouse lymphocytes occurs by a route resembling the A system. 11. Human fibroblasts possess a Na+-independent adaptive transport system for cystine and glutamate that is enhanced in activity by cystine starvation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3304826 TI - Purification and properties of a neutral thiol protease from larval trematode parasite Paragonimus westermani metacercariae. AB - 1. A neutral thiol protease was isolated from the extract of larvae of the mammalian trematode parasite, Paragonimus westermani metacercariae, by arginine Sepharose, Ultrogel AcA-54 and DEAE-toyopearl column chromatography, measuring its activity by the hydrolysis of Boc-Val-Leu-Lys-MCA as a substrate. 2. The molecular weight of the purified enzyme was estimated to be 22,000 as a single polypeptide by SDS-polyacrylamide gel electrophoresis and was estimated to be 20,000 by size exclusion high-performance liquid chromatography. 3. The activity was suppressed by antipain, E-64, leupeptin, chymostatin, N-tosyl-L-lysine chloromethyl ketone, but was not affected by metallo protease inhibitors or serine protease inhibitors. 4. Studies on the substrate specificity showed that the enzyme hydrolyzed Boc-Val-Leu-Lys-MCA, Z-Phe-Arg-MCA, fluorescein isothiocyanate-labeled collagen, azocoll and casein. 5. The enzyme was found to hydrolyze peptide bonds of oxidized insulin B chain preferentially at the carboxy side of hydrophobic and basic amino acids. PMID- 3304827 TI - Clinical performance of copper-T-200, multiload-250 and Nova-T: A comparative multicentre study. AB - A randomized multicentre study of Copper-T-200 (CuT), Multiload-250 (ML) and Nova T (NoT) was conducted to evaluate the clinical performance of these three IUDs in the hands of general practitioners with varying experience in the different insertion techniques. After 36 months of use a total of 19,821 treatment cycles was accumulated. The continuation rate was 69.7% for CuT, 60.9% for ML and 61.8% for NoT. The cumulative expulsion rate after 36 months was 5.0% and equally distributed among centres and types of IUD. Removal for medical reasons was 11.4% and also equally distributed among the centres and the types of IUD. The pregnancy rate was insignificantly higher for the NoT compared with the two other types. PMID- 3304828 TI - Rabies virus infection: genetic mutations and the impact on viral pathogenicity and immunity. PMID- 3304829 TI - Immunobiology of relapsing fever. PMID- 3304830 TI - Antigenic variation in African trypanosomes. PMID- 3304831 TI - Antigenic variation and antigenic diversity in malaria. PMID- 3304832 TI - Antigenic variation in influenza viruses. PMID- 3304833 TI - Mechanisms of immune evasion in schistosomiasis. AB - An unusual property of schistosomes is their capacity to survive intravascularly for many years in the face of an ongoing antiparasite immune response by the infected host. This ability to evade the immune system appears to be due to several unusual parasite adaptations occurring soon after infection is initiated. Foremost amongst these are processes which result in reduced surface antigenicity and the development of a tegument intrinsically resistant to immune damage. The unusual ability of the schistosome surface membrane to escape immune recognition and damage suggests that attempts to vaccinate against this important parasite either should be directed against very early schistosomula which have yet to achieve the refractory state, or involve stimulation of effector mechanisms, such as killing by activated macrophages, which do not require recognition or interaction with parasite surface antigens. PMID- 3304834 TI - Biologic and molecular variations in AIDS retrovirus isolates. PMID- 3304835 TI - Monitoring of immunological parameters before and after heart transplantation. AB - At the immunological examinations carried out prior to heart transplantation, it is crucial to check the compatibility in the ABO blood group system (regardless of the Rh factor) and to perform the cross match (which must be negative). In time pressure, cross match can be omitted provided the patient does not possess cytotoxic antibodies against a representative panel of lymphocytes. Other immunological tests before transplantation are of an auxiliary nature and should provide information whether the patient is a low or high responder, whether he does not suffer from an autoimmune disease or latent viral infection. In 37 out of 44 potential cardiac graft recipients, a strongly suppressed cell-mediated immune response was observed already in the pre-transplantation period. In the post-transplantation period, patients treated with corticoids and Cyclosporin A display a marked prolonged decrease in the absolute values of T4 positive lymphocytes. The absolute values of T3 and T4 lymphocytes represent a reliable parameter to assess the degree of achieved immunosuppression. Long-term monitoring did not reveal a significant association between the values of the T4/T8 index and the rejection episodes. PMID- 3304836 TI - Liver alcohol dehydrogenase. AB - The article deals with the structure and function of liver alcohol dehydrogenase and reviews mainly literature published after 1979, i.e., summarizes progress made in the field since Klinman presented her review on alcohol dehydrogenases. The emphasis will be on high-resolution crystallographic data, results obtained with metal-substituted enzyme derivatives, and on the mechanism and pH dependence of the catalytic reaction. PMID- 3304837 TI - A randomized clinical trial comparing ranitidine and antacids in critically ill patients. AB - In a randomized trial of gastric pH control for stress ulcer prophylaxis, 200 mg/day ranitidine iv was compared to antacids in 86 patients admitted to an ICU. Six (15%) patients receiving ranitidine and six (13%) given antacids failed to maintain greater than 50% of the hourly gastric pH measurements at or above 4. Increasing the ranitidine dosage to 300 mg/day did not provide additional control. One patient in the antacid group developed an overt upper GI bleed secondary to endoscopically proven erosive disease. We conclude that iv ranitidine in a dosage of 200 mg/day is as effective as antacids in reducing gastric acidity and preventing stress ulcer disease in critically ill patients. PMID- 3304838 TI - Collateral ventilation of obstructed lung during high-frequency oscillation in dogs and pigs. AB - To determine if collateral ventilation (CV) occurs in pigs and dogs during intermittent positive-pressure ventilation (IPPV) and high-frequency oscillation (HFO), seven pigs and seven dogs were studied by measuring Xenon 133 washout (XeW) from an occluded subsegmental bronchus. The rate constant/min (K) for Xe blood uptake (KXeb) was derived, and when subtracted from K for XeW (KXeW) gave K for removal of Xe by CV (KXecv). Pig XeW were single exponentials with mean KXew = 0.25/min during IPPV and 0.12/min with HFO. In pigs, mean K of XeW was no different from KXeb so that all XeW occurred by blood uptake and none by CV. XeW in dogs had two exponentials. Dogs had over 11 times greater mean KXeW than pigs during IPPV and over 24 times greater during HFO. In dogs, on average, 79% (IPPV) and 87% (HFO) of XeW occurred by CV. CV is a means of gas exchange during HFO and IPPV in dogs but not in pigs. PMID- 3304839 TI - Improved arterial oxygenation by diaphragmatic pacing in quadriplegia. AB - Despite increased alveolar ventilation, positive-pressure ventilation (PPV) reproducibly resulted in less efficient arterial oxygenation as compared to diaphragmatic pacing in a quadriplegic patient with respiratory paralysis. Volume loading acutely restored arterial oxygenation during PPV. This report emphasizes the important interaction between the cardiovascular and pulmonary systems in effecting gas exchange, particularly in quadriplegics. In this respect, diaphragmatic pacing seems to perform better than PPV. PMID- 3304840 TI - Adult respiratory distress syndrome associated with acute liver allograft rejection: resolution following hepatic retransplantation. PMID- 3304841 TI - Cryopreservation of mouse pancreatic islets: effects of different glucose concentrations in the post-thaw culture medium on islet recovery. AB - It was the aim of this study to investigate the influence of the glucose concentration of the post-thaw culture medium on islet B-cell survival after cryopreservation by the combined assessments of islet recovery, islet DNA and insulin contents, and insulin release. Collagenase isolated mouse islets were kept in culture for 3 days in the presence of 11.1 mM glucose and then transferred to freezing ampoules containing Hanks' solution supplemented with 10% calf serum and 2 M dimethyl sulfoxide. After a 20-min incubation at 0 degrees C the islets were cooled at a rate of 25 degrees C/min to -70 degrees C and subsequently plunged into liquid nitrogen. After 2 hr the frozen islets were rapidly thawed at 37 degrees C, transferred to culture dishes, and cultured for another 3 days in the presence of 2.8, 5.6, 11.1, 16.7, or 28 mM glucose. Nonfrozen control islets were treated identically after a preceding 3-day culture at 11.1 mM glucose. The percentage recovery of cryopreserved islets was decreased compared to that of nonfrozen islets, but was increased when higher glucose concentrations were used in the post-thaw culture medium. Since the DNA content of the cryopreserved islets was slightly decreased, the overall survival rate of the cryopreserved B-cells, when cultured at the higher glucose concentrations after thawing, was found to be about 75%. The insulin content of the cryopreserved islets was decreased but the glucose-stimulated insulin release was essentially the same as that of the nonfrozen islets.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304842 TI - Properties and functions of stabilizing agents in food emulsions. AB - This review outlines the state of knowledge concerning the basic processes which underlie the behavior of food stabilizers in practical applications. The stability of emulsions is discussed in terms of the forces acting between macroscopic colloidal particles. These forces include the van der Waals force of attraction, which is always present, and the electrostatic, steric, and hydration forces which may stabilize an emulsion since they can be repulsive. The adsorption behavior at the liquid/liquid interface of classes of typical food stabilizers and the influence of the absorbed layer on the droplet-droplet interactions in emulsions are discussed. Finally, the important effects of the surface-active properties of stabilizers on the mechanisms involved in emulsion formation are described. PMID- 3304843 TI - Initiation of lipid peroxidation in biological systems. AB - The direct oxidation of PUFA by triplet oxygen is spin forbidden. The data reviewed indicate that lipid peroxidation is initiated by nonenzymatic and enzymatic reactions. One of the first steps in the initiation of lipid peroxidation in animal tissues is by the generation of a superoxide radical (see Figure 16), or its protonated molecule, the perhydroxyl radical. The latter could directly initiate PUFA peroxidation. Hydrogen peroxide which is produced by superoxide dismutation or by direct enzymatic production (amine oxidase, glucose oxidase, etc.) has a very crucial role in the initiation of lipid peroxidation. Hydrogen peroxide reduction by reduced transition metal generates hydroxyl radicals which oxidize every biological molecule. Hydrogen peroxide also activates myoglobin, hemoglobin, and other heme proteins to a compound containing iron at a higher oxidation state, Fe(IV) or Fe(V), which initiates lipid peroxidation even on membranes. Complexed iron could also be activated by O2- or by H2O2 to ferryl iron compound, which is supposed to initiate PUFA peroxidation. The presence of hydrogen peroxide, especially hydroperoxides, activates enzymes such as cyclooxygenase and lipoxygenase. These enzymes produce hydroperoxides and other physiological active compounds known as eicosanoids. Lipid peroxidation could also be initiated by other free radicals. The control of superoxide and perhydroxyl radical is done by SOD (a) (see Figure 16). Hydrogen peroxide is controlled in tissues by glutathione-peroxidase, which also affects the level of hydroperoxides (b). Hydrogen peroxide is decomposed also by catalase (b). Caeruloplasmin in extracellular fluids prevents the formation of free reduced iron ions which could decompose hydrogen peroxide to hydroxyl radical (c). Hydroxyl radical attacks on target lipid molecules could be prevented by hydroxyl radical scavengers, such as mannitol, glucose, and formate (d). Reduced compounds and antioxidants (ascorbic acid, alpha-tocopherol, polyphenols, etc.) (e) prevent initiation of lipid peroxidation by activated heme proteins, ferryl ion, and cyclo- and lipoxygenase. In addition, cyclooxygenase is inhibited by aspirin and nonsteroid drugs, such as indomethacin (f). The classical soybean lipoxygenase inhibitors are antioxidants, such as nordihydroguaiaretic acid (NDGA) and others, and the substrate analog 5,8,11,14 eicosatetraynoic acid (ETYA), which also inhibit cyclooxygenase (g). In food, lipoxygenase is inhibited by blanching. Initiation of lipid peroxidation was derived also by free radicals, such as NO2. or CCl3OO. This process could be controlled by antioxidants (e).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3304844 TI - Rhinoscleroma: a naso-oral dermatosis. PMID- 3304845 TI - Differentiating vesicular linear lichen planus and lichen striatus. AB - We present a case of vesicular linear lichen planus in a 62-year-old woman. This unusual presentation of lichen planus and other conditions in the differential diagnosis are discussed. PMID- 3304846 TI - Inverse ratio ventilation. PEEP in disguise? PMID- 3304847 TI - Biofilms on right heart flow-directed catheters. AB - This study was designed to detect biofilm and bacteria on right heart flow directed catheters using scanning electron microscopy and culture following scraping and dispersion of biofilm by sonication. We examined 20 consecutive catheters removed from 18 critically ill patients, an average of 2.6 days after insertion. On scanning electron microscopy, all catheters were found to be covered by a biofilm, with bacteria visible on 50 percent of them. Cultures of specimens from 40 percent of the catheters grew skin organisms (Staphylococcus warneri, Diphtheroid), anaerobes (Propionibacterium), and other potential pathogens (Proteus vulgaris, Enterobacter cloacae). Combination of the two techniques produced a bacterial detection rate of 75 percent. This study demonstrates that the presence of biofilm with bacterial adherence is common on right heart flow-directed catheters. The phenomenon could play a significant role in endogenous infection in critically ill patients. PMID- 3304848 TI - Provocative dose and dose-response curve to inhaled propranolol in asthmatic patients with bronchial hyperresponsiveness to methacholine. AB - This study was carried out to compare bronchial responses to inhaled propranolol (P) and methacholine (M) in a group of asthmatic subjects with mild to moderate bronchial hyperresponsiveness to M; to determine the short term reproducibility of bronchial response to propranolol; and to examine the shape of dose-response curve to P relative to that of M. Doses of M and P were given in mumoles and bronchial responses to both agents were expressed as the provocative dose that induced a 20 percent fall in FEV1 (PD20 FEV1). In 16 asthmatic patients, there was no correlation between the PD20 of the two agents. Mean PD20 M (+/- SD in log scale) was approximately nine times lower than mean PD20 P (0.64 +/- 0.96 and 5.80 +/- 1.65, respectively). This difference was statistically significant (t = 4.58, p less than 0.001). In six asthmatic patients, the reproducibility of PD20 P was similar to that of M (intraclass correlation coefficient 0.969 and 0.957, respectively). The shape of the dose-response curves to P was different from that of M in five of nine asthmatic patients when all experimental points were analyzed by double-reciprocal plot. We noticed that even small doses of inhaled P may cause a severe bronchoconstriction. Therefore, special caution should be taken to increase P doses very gradually, when studying the dose-response curve. We demonstrated that P inhalation induced a measurable bronchoconstriction in subjects with mild to moderate hyperresponsiveness and it was reproducible. However, the bronchial sensitivity to P was lower than to M. Our findings suggest that P and M have different mechanisms of action. PMID- 3304849 TI - A continuous monitoring technique for management of acute pulmonary failure. AB - Continuous monitoring of mixed venous oxygen saturation (SvO2) and arterial oxygen saturation (SaO2) was used to guide cardiovascular and pulmonary physiologic manipulations in three patients. An index, termed the "shunt index" (SI), of venoarterial admixture (Qva/Qt) was calculated at the bedside. SI correlated significantly in each patient with Qva/Qt (p less than .01). In one of the patients, continuous end-tidal CO2(ETCO2) was also monitored, allowing rapid titrations of ventilator settings and cardiovascular support free from the need to sample arterial and mixed venous blood to assess the effect of each intervention. PMID- 3304850 TI - Continuous positive airway pressure and supplemental oxygen in the treatment of cardiogenic pulmonary edema. AB - The efficacy of continuous positive airway pressure (CPAP) administered with a face mask was compared to oxygen supplementation in 40 patients with acute cardiogenic pulmonary edema. Baseline arterial blood gas values and pH, heart rate, respiratory rate, and blood pressure were recorded after patients breathed 28 percent oxygen with an ambient airway pressure for ten minutes. Thereafter, inspired oxygen concentration (FIO2) was increased by 0.10 and airway pressure was increased by 10 cm H2O in random sequence. Cardiopulmonary function was reassessed after a five-minute stabilization period at each level of oxygen supplementation and airway pressure. An increase in FIO2 and the application of CPAP both produced significant elevation in arterial blood oxygen tension. Use of CPAP was consistently associated with a decrease in respiratory rate, blood pressure, and rate pressure product, which were not observed with a mere enhancement of oxygen therapy. The improvement in the measured cardiopulmonary variables associated with CPAP therapy cannot be achieved by reversing hypoxemia with supplemental oxygen only. PMID- 3304851 TI - Lung immunogenicity, rejection, and obliterative bronchiolitis. AB - Evidence suggests that obliterative bronchiolitis (OB) following human heart-lung transplantation is a form of allograft rejection related to augmented expression of class II major histocompatibility complex antigens (MHCII) on airway epithelium and mediated by activated T cells. Other forms of OB, including those related to viral infection and autoimmune disease, may reflect a similar mechanism. PMID- 3304852 TI - Periodic breathing during exercise in severe heart failure. Reversal with milrinone or cardiac transplantation. PMID- 3304853 TI - Patent foramen ovale complicating heart transplantation. A window on posttransplantation hemodynamics. AB - A patient developed refractory hypoxemia and right-to-left shunt across a patent foramen ovale after orthotopic cardiac transplantation. The right-to-left shunt was produced by volume overload of the donor right ventricle during the period of early postoperative myocardial depression and resolved with preload reduction and diuresis. Increased preload of the right heart needs to be considered in the early postoperative management after cardiac transplantation. The foramen ovale of the donor and recipient should be evaluated at operation by visual and probe examination and securely closed if either is patent, since this pattern of hemodynamic changes is common following cardiac transplantation. PMID- 3304854 TI - Reasons for bruxism and bruxism in children. PMID- 3304855 TI - [Talleyrand's clubfoot. Etiology and genetic considerations]. PMID- 3304856 TI - [History of wounds of the colon. 150 years ago Lucien Baudens published the 1st suture to be followed by recovery]. PMID- 3304857 TI - [Technical modification facilitating low colorectal anastomosis by mechanical suturing]. PMID- 3304859 TI - [Ultrasonic diagnosis of intracerebral hemorrhage in neonates]. PMID- 3304858 TI - [Technical modification facilitating low colorectal anastomosis by mechanical suturing]. PMID- 3304860 TI - [Ultrasonic measurement and clinical verification of fetal weight in the second and third trimesters of pregnancy]. PMID- 3304862 TI - [Clinical analysis of 162 cases of real-time ultrasonic diagnosis of congenital fetal anomalies]. PMID- 3304861 TI - [Ultrasonic measurement of femur length in estimating the fetal gestational age]. PMID- 3304863 TI - [Oral manifestations and management of graft-versus-host disease]. PMID- 3304864 TI - [The "internal interarch stent" for reconstruction of large mandibular defects]. PMID- 3304865 TI - [Clinical uses of coronoid process transplantation in the temporomandibular arthroplasty]. PMID- 3304866 TI - [Revascularization after anterior maxillary and mandibular osteotomy]. PMID- 3304868 TI - [Computed tomography of parotid neoplasms]. PMID- 3304867 TI - [Analysis of mechanics on direct bonding of fixed bridges]. PMID- 3304869 TI - [Advances in serum enzyme tests in the diagnosis of liver diseases]. PMID- 3304871 TI - [Preliminary report on EMG biofeedback therapy in mental health care services]. PMID- 3304870 TI - [Comparison of the therapeutic effects between haloperidol and insulin coma in schizophrenia and optimal blood levels of haloperidol]. PMID- 3304872 TI - [Clinical use of a portable microcomputerized diagnostic system]. PMID- 3304873 TI - [Digital subtraction angiography in the diagnosis of renal cell carcinoma]. PMID- 3304874 TI - [Value of B-scan ultrasonography in the diagnosis of thyroid nodules]. PMID- 3304875 TI - [Real-time ultrasonography in the diagnosis of acute abdomen]. PMID- 3304876 TI - [Value of renal puncture under B-mode echo-scan and induced diuresis for urinary diseases]. PMID- 3304877 TI - [Osteoarthropathy in patients with diabetes mellitus]. PMID- 3304878 TI - [Advances in spontaneous pneumothorax]. PMID- 3304879 TI - [Test of airway response and its clinical applications]. PMID- 3304880 TI - A rapid analytical technique for flow cytometric analysis of cell viability using calcofluor white M2R. AB - Analysis of dead versus live cells is shown to be possible using Calcoflour White M2R (CFW), a fluorescent brightener. Comparison of CFW with both propidium iodide (PI) and fluorescein diacetate (FDA) was performed on a FACS 440 dual laser flow cytometer on several populations of cultured rat and mouse cell lines, peripheral leukocytes, splenocytes, diatoms, and plant protoplasts. As a measure of cell viability, staining results with CFW were strongly associated with PI (correlation coefficient of 0.9886) and FDA (inverse correlation coefficient of 0.9647). With plant and algal cells, controls are necessary as CFW does stain live cells to some extent. CFW (excitation: UV, emission max: 435 nm) can be used in conjunction with two-color immunofluorescence analysis using fluorochromes excited at 488 nm with no interference. PMID- 3304881 TI - Viable sorting of intact multicellular spheroids by flow cytometry. AB - A flow cytometric method has been developed for sorting viable, intact multicellular spheroids in order to obtain uniformly-sized populations with diameters in the range of 50-100 microns. A FACS II instrument was modified for this purpose by installing a 200-microns-diameter exit orifice and by making adjustments in the sheath flow, oscillator frequency, and number of droplets sorted. Polystyrene microspheres (44 and 88 microns diameter) and 41-96-microns diameter spheroids could be sorted and recovered with 70-100% efficiency, an improvement over previous reports. Unstained, viable spheroids were simultaneously analyzed for small-angle forward light scatter, 90 degree light scatter, and autofluorescence using a 488-nm laser operating at 100 mW. Analysis of the data demonstrated a considerable variation in both the 90 degrees light scatter and the autofluorescence signals for a given forward angle light scattering signal. By setting narrow sort windows on the forward angle light scattering signal and either the 90 degree light scatter or autofluorescence signals, uniformly spherical spheroid populations could be recovered. These sorted populations had coefficients of variation of the mean diameter in the range of 5-9%. This represents a variation of less than one cell diameter, and is a major improvement over any other technique. There was no significant difference in the subsequent growth rates of sorted spheroids compared to the unsorted spheroids. This technique will apply when uniform populations of small spheroids are required, such as investigations of the contact effect or in the initiation of growth curve studies. PMID- 3304882 TI - The effect of an intraluminal tube used as an internal drain on the healing of the rat colon. AB - The effect of an intraluminal tube on the healing of an inadequately constructed colonic anastomosis was evaluated. An anastomosis using a single suture was constructed in 78 rats divided into four experimental groups. In one, a latex tube was sited intraluminally at the level of the anastomosis and removed transanally after six days. In the second, a soft tube consisting of rat duodenum preserved in 5 percent formalin was similarly sited and allowed to pass spontaneously. In the third group, the formalin tube was placed outside the colon surrounding the anastomosis. The fourth group was a control. The mortality of the latex intraluminal tube group was 48 percent, the intraluminal duodenum in formalin group 29 percent (significantly less than the control group, P less than .02), the extraluminal tube around the anastomosis group 100 percent, and the control group 75 percent (P less than .02). There was no significant difference among the experimental groups in the mean breaking strength of the colonic anastomosis in the 28-day survivors. PMID- 3304883 TI - Treatment of recurrent colonic pseudo-obstruction by endoscopic placement of a fenestrated overtube. Report of a case. AB - The case of a 73-year-old man who developed acute colonic pseudo-obstruction (Ogilvie's syndrome) following chemotherapy for lymphoma is reported. Cecal dilatation resolved after a single colonoscopic decompression. Following his next course of chemotherapy, colonic dilatation again developed. The recurrence was treated successfully by introducing a fenestrated colonoscopic overtube transanally for continuous decompression. The literature concerning acute, colonic pseudo-obstruction is reviewed. The colonoscopic overtube is a convenient and effective treatment for recurrent colonic distention. PMID- 3304884 TI - Classic articles in colonic and rectal surgery. Percivall Pott 1741-1788. The chirurgical works of Percivall Pott. PMID- 3304885 TI - Immunoscintigraphy in the follow-up of patients operated on for carcinoma of the sigmoid and rectum. Preliminary report with a new monoclonal antibody: B72.3. AB - Thirty patients who had curative surgery for sigmoid and rectal carcinoma were studied by immunoscintigraphy using a new monoclonal antibody: B72.3 radiolabeled with Iodine-131 (I-131) or Indium-111 (In-111). Results were compared with other conventional diagnostic procedures such as computed tomography, ultrasound, endoscopy, and tumor markers. Seven patients had local recurrences and/or distant metastases. Immunoscintigraphy identified all local recurrences (five cases) that were confirmed by CT and was able to localize three of five liver metastases (two false-negatives). Furthermore, immunoscintigraphy also recorded a false-positive. Preliminary use of B72.3 shows good potential for the evaluation and detection of neoplastic sites. PMID- 3304886 TI - Colonoscopy in ostomy patients. Results at the first postoperative examination. AB - Patients with a personal history of rectal cancer are considered at high risk for metachronous large-bowel primaries. Since a malignant growth was the main reason for performing a colostomy in patients followed at the centers of the authors' association (AISTOM), a correct follow-up approach for these patients is very important. A multicentric clinical trial was thus carried out to evaluate the efficacy of transstomal endoscopic exploration (TEE) of the residual colon, and data collection began on May 31, 1984. Nine hundred fifty-seven patients were submitted to TEE after curative abdominoperineal resection (Miles) for rectal cancer. The male-female ratio was 1.3; 89.6 percent of the patients were over 50 years of age. A family history of large-bowel cancer was present in 18 percent, and in 23 percent of the patients the cancer was associated with synchronous adenomas. Only 31 percent of the patients had colonoscopy or double-contrast barium enema x-ray beyond the neoplastic area before surgery. TEE was done in 96.8 percent of the patients; in 3.3 percent the examination was not possible, mainly for stenosis of the stoma (in 2.3 percent). In 82 percent of the patients a complete large-bowel exploration was possible: a new large, bowel cancer was found in 22 patients (2.2 percent) and an adenoma in 183 patients (19.1 percent). These results show that, because it is safe, practical, and effective, endoscopy plays an important role in the follow-up of ostomates. PMID- 3304887 TI - Abdominal tuberculosis. AB - The recent literature on abdominal tuberculosis is comprehensively reviewed, and seven cases of abdominal tuberculosis are reported, including four belonging to three generations of the same family. Possible explanations for this familial incidence are discussed. Abdominal tuberculosis is not so rare; 135 cases have recently been reported from the United States and Canada. This review dissipates four common misconceptions: abdominal tuberculosis is rare, tuberculosis is a stigmata of the poor, abdominal tuberculosis is always associated with active pulmonary tuberculosis, and chronic abdominal pathology is synonymous with regional enteritis. Since the description of regional enteritis, more and more cases of chronic intestinal pathology have been labeled "regional enteritis." The fact that intestinal tuberculosis is rather uncommon should not automatically lead to the diagnosis of regional enteritis. The possibility that many cases of so-called regional enteritis may, in fact, be a stage or a variant of abdominal tuberculosis, is worth considering. Abdominal tuberculosis is not a relic of the past. It remains a real challenge to the diagnostic acumen and therapeutic skills of both the internist and the surgeon. PMID- 3304888 TI - Binding of E. coli heat-stable enterotoxin to rat intestinal brush borders and to basolateral membranes. AB - We studied the binding of E. coli heat-stable enterotoxin (STa) to rat brush borders (BB) and to basolateral membranes (BLM) using a biologically active monoiodinated radioligand [( 125I]STa) and highly enriched BB and BLM preparations free of other significant organelle contamination. Binding of [125I]STa to BB was specific; time-, temperature-, and pH-dependent; saturable; and partially reversible. Nonlabeled toxin competitively inhibited the binding of radioligand to BB in a dose-related manner. Scatchard analysis revealed a single class of receptors with an apparent affinity constant of 8.7 +/- 1.5 X 10(8) l/mol. Binding was not affected by amino acids, sugars, and lectins. Proteolytic enzymes significantly decreased binding, although several did so by modifying the radioligand. Trypsin inhibited binding without modifying the radioligand thus supporting the proteinaceous nature of the receptor. Since the enrichment in binding activity in the BB over the homogenate was significantly lower than the enrichment in sucrase activity, we concluded that binding activity is probably associated with other membranous domains, but direct examination revealed no binding activity on basolateral membranes. PMID- 3304890 TI - Pseudomonas aeruginosa liver abscesses following endoscopic retrograde cholangiography. Report of a case without biliary tract disease. AB - We report a case of Pseudomonas aeruginosa liver abscesses following endoscopic retrograde cholangiopancreatography (ERCP) in a patient without evidence of biliary tract disease and of any known cause of hepatic infection. Computer tomography (CT) scan was the best method of diagnosis, allowing, through guided percutaneous puncture of the abscesses, isolation of the organism, which was sensitive to carbenicillin. One month of antibiotherapy with repeated aspirations of the largest abscesses was successful. This report suggests that ERCP may induce cholangitic sepsis by inoculating pathogens in the biliary tree even in the absence of extrahepatic obstruction. PMID- 3304889 TI - Acid-base disturbances in gastrointestinal disease. AB - Gastrointestinal disorders are associated with severe and often complex acid-base disturbances. We review the most important types of metabolic alkalosis and metabolic acidosis associated with gastrointestinal disorders, excluding liver disease. Special emphasis is placed on pathophysiologic mechanisms. This information may help the clinician understand the generation and maintenance of these disorders and to plan an effective therapeutic approach. PMID- 3304891 TI - Gastric secretion in massive obesity. Evidence for abnormal response to vagal stimulation. AB - Studies in animals and man suggest involvement of the vagal nerve in the pathophysiology of massive obesity. An abnormal vagal response pattern has been found in the obese rat, but corresponding functional studies in obese man are nonexistent. The gastric acid secretion was therefore examined in 13 nondiabetic grossly obese patients (average body weight 120 kg) and compared to 16 age matched controls of normal body weight. The gastric acid response to modified sham feeding was significantly (P less than 0.05) reduced in obese patients, being on average 60% of the control output. The obese patients had a higher maximal gastric acid response to graded intravenous pentagastrin, 36.6 +/- 2.9 mmol/hr, compared to 27.1 +/- 2.4 mmol/hr in controls (P less than 0.05). In addition, the patients seemed to need less pentagastrin to reach a secretory plateau. Basal acid secretion rates were similar in obese and control groups. Plasma gastrin and blood glucose were not significantly different in obese patients and controls, but patients had significantly elevated plasma insulin levels. The change of plasma insulin during the sham-feeding procedure correlated with the magnitude of the secretory response in obese and control subjects. The reduced gastric acid response to vagal stimulation in the absence of impaired parietal cell function in obese patients is indicative of an association between massive obesity and altered vagal function in man. PMID- 3304892 TI - Comparison of predictive capabilities of diabetic exchange lists and glycemic index of foods. AB - To determine whether the diabetic exchange lists or the glycemic index of foods better predicts postprandial responses to carbohydrate-containing foods eaten as part of a mixed meal, three test meals were developed and fed to 12 subjects with non-insulin-dependent diabetes mellitus (NIDDM) and 13 healthy subjects. Each test meal contained exactly the same exchanges (1 milk, 4 starch, 2 fruit, 2 meat, 3 fat, 1 vegetable). In one meal, foods of high glycemic index (GI) were used, in a second meal, foods of intermediate GI were used, and in a third meal foods of low GI were used. The total GIs of the meals were: high, 184; intermediate, 131; and low, 107, thus predicting responses to intermediate and low GI, which were 71 and 58%, respectively, of the responses to high GI. Although some of the observed differences in the glycemic responses to the test meals were statistically significant, primarily in healthy subjects, the differences were usually much less than predicted by the GIs of the meals. In NIDDM subjects, peak postprandial plasma glucose, plasma glucose area, plasma glucose area increment, and mean plasma glucose responses after intermediate and low GI were greater than 90% of the corresponding responses to high GI. In healthy subjects, only the plasma glucose area increment after the low-GI meal was close to the predicted response. High GI produced significantly greater insulin responses than low GI in healthy subjects. We conclude that the diabetic exchange lists more accurately predict postprandial responses to carbohydrate containing foods eaten as part of a mixed meal than does the GI of foods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3304893 TI - Effect of source of dietary carbohydrate on plasma glucose and insulin responses to mixed meals in subjects with NIDDM. AB - It has been demonstrated that carbohydrate-rich foods result in different plasma glucose responses when eaten alone by normal subjects and patients with non insulin-dependent diabetes mellitus (NIDDM). This study was designed to test if the glycemic response to mixed meals can be altered by selecting carbohydrate rich foods based on their glycemic potency. Consequently, three test meals were developed that should have yielded high-, intermediate-, and low-glycemic responses based on the published glycemic index of all the carbohydrate foods in the meals. The test meals were consumed by normal individuals and patients with NIDDM, and the resultant plasma glucose and insulin responses were determined. The results indicated that the plasma glucose responses after the meals did not vary as a function of their glycemic potency in either the normal or NIDDM subjects. There were no significant differences in the plasma insulin responses for either group. These results indicate that the plasma glucose response to mixed meals did not vary as a function of the calculated glycemic potencies. Therefore, the glycemic response to a mixed meal was not predicted on the basis of the published values of the glycemic index of the individual carbohydrate foods included in the meal. PMID- 3304894 TI - Renal excretion of prostaglandin E2 and plasma renin activity in type I diabetes mellitus: relationship to normoglycemia achieved with artificial pancreas. AB - To determine the effect of normoglycemia on renal prostaglandin synthesis and renin-angiotensin system activity, prostaglandin E2 (PGE2) urinary excretion, plasma renin activity (PRA), and glomerular filtration rate (GFR) were studied in seven patients with insulin-dependent diabetes mellitus (IDDM) without complications, both in basal conditions and after a 20-h treatment with an artificial pancreas. Normoglycemia induced a significant reduction in PGE2 excretion (88 +/- 23 vs. 55 +/- 25 ng/12 h, P less than .05) and GFR (138 +/- 34 vs. 105 +/- 20 ml X min-1 X 1.73 m-2, P less than .05) and a nonsignificant increment of PRA (0.52 +/- 0.48 vs. 0.83 +/- 0.92 ng X ml-1 X h-1). The results enhance the hypothesis that renal prostaglandins play a role in the renal functional alterations observed in IDDM during hyperglycemia. PMID- 3304895 TI - Dawn phenomenon: its frequency in non-insulin-dependent diabetic patients on conventional therapy. AB - The frequency of the dawn phenomenon has been studied in non-insulin-dependent diabetic (NIDDM) patients while they continued with their conventional therapy. Plasma glucose (PG) and immunoreactive insulin (IRI) were estimated hourly from 0300 to 0900 h in 19 NIDDM patients; 9 patients were treated by diet alone (group 1), and 10 patients were treated by diet and oral hypoglycemic agents (group 2). The dawn rise of plasma glucose was demonstrated in 17 (89.5%) of the 19 patients with mean +/- SE plasma glucose at 0300 h of 7.0 +/- 0.5 mM and at 0800 h of 8.4 +/- 0.6 (P less than .01). IRI in all patients rose from 14.7 +/- 1.3 microU/ml at 0500 h to 18.1 +/- 1.8 microU/ml at 0700 h (P less than .05). The changes in IRI levels at any time from 0300 to 0800 h in groups 1 and 2 when considered separately were insignificant. Thus, the dawn phenomenon occurs commonly in NIDDM patients taking their conventional therapy. PMID- 3304896 TI - Absorption kinetics and action profiles after sequential subcutaneous administration of human soluble and lente insulin through one needle. AB - The effects of sequential administration through one needle of human soluble and human lente insulin on plasma insulin levels and action profiles, assessed with glucose clamping, were studied in six healthy volunteers. Insulin kinetics after administration of human soluble insulin (0.22 IU/kg) alone were compared with those after sequential administration of 1) human soluble insulin followed by human lente insulin and 2) human lente insulin followed by human soluble insulin. Total insulin dose in both sequences was 0.55 IU/kg, 40% of which was short acting insulin. Plasma insulin levels were not significantly different at any time point between 0 and 240 min after soluble insulin compared with either combination. Although insulin levels were slightly but significantly lower at 30 and 105 min after lente followed by soluble insulin compared with soluble followed by lente insulin, these differences probably reflect chance occurrences. Glucose requirements were not significantly different after either of the three administrations. We therefore conclude that the unwanted retarding effect after mixing of human soluble insulin with human lente insulin in the syringe on the onset of action of the soluble insulin can be prevented by sequential subcutaneous injection of these insulins with two syringes through one needle. PMID- 3304897 TI - Insulin absorption accelerated by alpha-adrenergic blockade at injection site. AB - The effect of the addition of phenoxybenzamine to a regular insulin preparation on the absorption of insulin and plasma glucose concentrations was investigated in five normal subjects. The addition of phenoxybenzamine (20 micrograms) to insulin (0.2 U/kg body wt) resulted in an acceleration of insulin absorption, with a higher and earlier peak insulin concentration at 45 min and higher insulin concentrations throughout the 180 min of investigation. With phenoxybenzamine, plasma glucose concentrations fell more rapidly; nadirs were lower and more rapidly achieved. Two subjects experienced hypoglycemic symptoms when phenoxybenzamine was added to insulin. It is concluded that the addition of phenoxybenzamine to subcutaneously injected insulin increases the bioavailability of insulin for at least 3 h, which leads to a greater fall in plasma glucose concentrations. PMID- 3304898 TI - Miscibility of human semisynthetic regular and lente insulin and human biosynthetic regular and NPH insulin. AB - The miscibility of human semisynthetic regular and lente insulins (Actrapid human/Monotard human) and human biosynthetic regular and NPH insulins (Humulin regular/Humulin NPH) was studied in vitro and in 16 insulin-dependent diabetic patients. In vitro a decrease of regular insulin was found immediately after mixture with semisynthetic lente insulin in proportions 1:4, 1:3, 1:2, 1:1, and 2:1. This was not found after mixture with human biosynthetic regular and NPH insulins. Free insulin and blood glucose were determined over 8 h after the morning injection of regular/lente (n = 9) or regular/NPH (n = 7) insulins in proportions used by the patients (approximately 1:2) mixed in one syringe or in separate syringes. Mixing the regular/lente preparations in one syringe immediately before injection resulted in a significant loss of the early rise in free insulin (P less than .01), with a tendency to a higher free insulin in the afternoon. A corresponding change in the blood glucose profile was seen. No changes were observed in free insulin or blood glucose after mixing regular and NPH preparations compared with separate injections. We conclude that mixing human semisynthetic regular and lente insulins (Actrapid human/Monotard human) instantly results in a decrease of regular insulin, probably due to formation of a longer-acting preparation, whereas no such changes occur with human biosynthetic regular and NPH insulins (Humulin regular/Humulin NPH). PMID- 3304899 TI - Correlations between fasting plasma C-peptide, glucagon-stimulated plasma C peptide, and urinary C-peptide in insulin-treated diabetics. AB - This study correlated fasting plasma C-peptide (CP), plasma CP 6 min after stimulation with 1 mg glucagon i.v., and the mean of three 24-h urinary excretions of C-peptide (UCP)/creatinine in 132 insulin-treated diabetics. Patients were divided into three groups: group 1, stimulated CP less than 0.06 nM (n = 51); group 2, stimulated CP 0.06-0.60 nM (n = 48); and group 3, stimulated CP greater than 0.60 nM (n = 33). In all patients fasting CP was closely correlated to stimulated CP (r = .988, P less than .001), whereas the correlations between UCP and both fasting CP (r = .904, P less than .001) and stimulated CP r = .902, P less than .001) were slightly less pronounced. The associations between UCP and both fasting CP (r = .716, P less than .001) and stimulated CP (r = .731, P less than .001) were modest in group 2, and even more so in group 3 (r = .557, P less than .001 and r = .641, P less than .001, respectively). In conclusion, fasting CP is closely correlated to glucagon stimulated CP in insulin-treated diabetics and can probably be used equally well in the assessment of beta-cell function. The associations between UCP and both fasting and glucagon-stimulated CP are less pronounced, especially in patients with well-preserved beta-cell function. PMID- 3304900 TI - Manually operated insulin injector. PMID- 3304901 TI - Prolonged sera incubation to improve sensitivity of double-immunofluorescent monoclonal BISL-32 FITC-protein A assay. PMID- 3304902 TI - Decreased serum C-peptide-to-insulin molar ratios after oral glucose in hyperthyroidism. PMID- 3304903 TI - Simulating clinical situations: interactive videodisc. PMID- 3304904 TI - Facilitating research in critical care. PMID- 3304905 TI - Pharmacotherapy of circulatory shock. AB - The rubric "shock" encompasses a wide spectrum of critical events, which if untreated, result in morbidity and mortality. Understanding of the various forms of shock has evolved rapidly in the past 20 years as new laboratory and clinical observations have been published. In this article, the authors discuss the physiology of the shock state, review the circumstances in which shock becomes likely, and review the etiologies and diagnostic characteristics of distributive (septic, spinal, anaphylactoid/anaphylactic), cardiogenic, hypovolemic, and obstructive shock. The rationale and applications of conventional and controversial therapies are discussed. The therapeutic potentials of current lines of shock research are also discussed. PMID- 3304906 TI - Effects of intranasal insulin in non-obese type II diabetics. AB - The comparative effects of intranasal and subcutaneous insulin on blood glucose and insulin levels are described in non-obese type II diabetics, in the fasting state and following a standard meal. In the fasting studies, intranasal insulin (30 units) produced a single early insulin peak. Elevated insulin levels and their hypoglycaemic effect persisted for less than 2 h whereas with subcutaneous insulin (8 units) elevated insulin levels and evidence of hypoglycaemic action were still present at 4 h. By contrast, in the meal studies both forms of insulin had similar effects on serum insulin levels and blood glucose. Moreover elevated insulin levels and evidence of reduction in post-prandial hyperglycaemia were now present at 4 h with both intranasal and subcutaneous insulin administration. Intranasal insulin in combination with a test meal now produced a biphasic insulin profile more closely resembling the normal insulin response to a meal, and reflecting the combined effects of endogenous and exogenous insulin. PMID- 3304907 TI - The absorption kinetics of subcutaneously infused U 40 and U 100 insulin in diabetics. AB - The influence of U 40 and U 100 insulin on the insulin kinetics during continuous subcutaneous insulin infusion (CSII) was investigated in eight insulin-dependent diabetics. CSII was started at t = -1.5 h with a bolus of 2 IU at the individual treatment infusion rate (22-35 IU/24 h), followed at t = 0 h by a premeal dose of 6 IU. Insulin delivery was interrupted for 120 min at t = 4 h and reinitiated with a loading dose of 2 IU for another 2 h. The incremental peak plasma free insulin levels and the time to reach these levels after the premeal insulin dose were not significantly different: 17 +/- 2 vs. 16 +/- 2 mU/l and 144 +/- 22 vs. 129 +/- 9 min for U 40 and U 100 insulin, respectively. During the 2 h interruption of insulin delivery plasma free insulin levels declined by 5.0 +/- 1.6 and 7.2 +/- 1.3 mU/l (NS) for U 40 and U 100 insulin, respectively. The blood glucose profiles were virtually identical throughout the studies for either insulin concentration. These results indicate that varying the insulin concentration in the range between U 40 and U 100 does not affect the insulin kinetics during CSII in insulin-dependent diabetics. PMID- 3304909 TI - IgG subclasses of islet cell surface antibodies and their cytotoxic activity against pancreatic islet cells. AB - IgG subclasses of islet cell surface antibodies (ICSA) and their cytotoxic activities against pancreatic islet cells in the presence of complements were simultaneously investigated in ICSA-positive patients with insulin-dependent diabetes mellitus (n = 15). ICSA (IgG class) and ICSA-IgG subclasses were determined by flow cytometry using a fluorescence-activated cell sorter (FACS). Complement-dependent antibody-mediated cytotoxicity (CAMC) was measured by release of 51Cr from target cells. For these assays, rat insulinoma (RINr) cells were used as antigenic or target cells. Sera from 11 out of 15 patients who were positive for ICSA possessed at least one positive ICSA-IgG subclass, though these sera did not always exert positive CAMC activities. When the relationship between ICSA-IgG subclasses and CAMC was tested by chi-square analysis, a significant relationship (P less than 0.01) was observed between ICSA-IgG3 and CAMC. In sera from the other four patients, not any positive ICSA-IgG subclass or CAMC activity was found. The data suggest that (1) ICSA (IgG class) found in diabetics are not always cytotoxic to pancreatic islet cells, (2) the IgG subclass of ICSA varies with the patients, and (3) ICSA-IgG3 have a significantly higher association with CAMC to pancreatic islet cells. Thus, ICSA (IgG class) might not always be responsible for the impairment of pancreatic islet cells, at least in part, because of the heterogenous ICSA-IgG subclass. PMID- 3304908 TI - Cholesterol biosynthesis in nonketotic diabetics before and during insulin therapy. AB - A previous study demonstrated that the net steroid balance, i.e., the total rate of cholesterogenesis, was within the normal range in insulin-treated patients with both insulin-dependent and noninsulin-dependent diabetes mellitus (NIDD). In contrast, the corresponding findings in diet-treated patients with NIDD were above normal regardless of whether sulfonylurea was also given. The aim of the current study was to reinvestigate nine patients with NIDD 3-38 months after the institution of insulin therapy. At the doses used there were no significant effects on blood glucose control but the bile acid formation and net steroid balance decreased in seven patients. It is suggested that insulin therapy depresses the rate of cholesterogenesis in NIDD. This effect may be achieved without normalizing blood glucose. PMID- 3304910 TI - Post-prandial glucose and insulin responses to different types of spaghetti and bread. AB - The glycemic response following ingestion of carbohydrate in various forms is different. The factors involved are not fully elucidated. In this study the glycemic and insulin responses to 50 g of carbohydrate in the form of white bread (WB), semolina bread (SB), white spaghetti (WS) and wholemeal spaghetti (BS) were compared in ten noninsulin-dependent diabetics. The responses were assessed by calculating the area under the curve. WB and SB had significantly higher glycemic responses compared with WS and BS (P less than 0.01). There was no difference in glycemic response between either form of bread, or either type of spaghetti. Similarly WB and SB had greater insulin responses than WS and BS (P less than 0.05). There was no difference in insulin response between WB and SB but BS had a greater response than WS (P less than 0.01) attributed to the higher protein content of BS. Thus, in this study the physical form of the food was a major factor influencing the glycemic response, and other factors such as particle size and fibre content had negligible effects. PMID- 3304912 TI - [Accumulation of artificial minichromosomes in a Saccharomyces cerevisiae mutant with impaired segregation process]. PMID- 3304911 TI - [Cooperative interaction of monoclonal antibodies with insulin dimer]. PMID- 3304913 TI - [The structure of hydrogenase microcrystals from Thiocaspa roseopersicina]. PMID- 3304915 TI - [The role of directed cell modification in creating highly effective biocatalysts]. PMID- 3304914 TI - [Cloning and primary structure of Shigella toxin genes]. PMID- 3304916 TI - Relationship between chemical structure of antibiotics and pharmacokinetics. AB - Modifications to the chemical structure of antibiotics can modify nearly all pharmacokinetic parameters: digestive absorption, half-life, protein binding, tissue distribution, metabolic biotransformation, biliary and renal elimination. Examples of increased oral bioavailability are given for beta-lactams, macrolides, tetracyclines, fosfomycin, quinolones and acyclovir. The structural modifications responsible for prolonged or shortened half-life, increased or decreased biliary excretion, increased or decreased renal clearance for the different families of antibiotics are reviewed. PMID- 3304917 TI - Enzymatic modification of aminoglycoside antibiotics by Branhamella catarrhalis carrying an R factor. AB - Fifteen out of 89 clinical strains of Branhamella catarrhalis isolated from patients at the University Hospital of Zaragoza were resistant to aminoglycosides and other antimicrobials. In two strains, B. catarrhalis 220 and B. catarrhalis 115, the resistance to aminoglycosides was associated with synthesis of aminoglycoside-modifying enzymes, namely 3"-O-phosphotransferase [APH(3")] and 3' O-phosphotransferase [APH(3')]. B. catarrhalis 115 was resistant to ampicillin, streptomycin, kanamycin, neomycin, butirosin, lividomycin, ribostamycin, paromomycin and trimethoprim-sulfamethoxazole and harboured a 32 megadalton (Md) plasmid. The resistance determinants of the latter were transferred to Neisseria subflava by conjugation and to Escherichia coli by transformation. The transconjugant strain presented an antibiotic resistance pattern similar to the donor strain and carried the same plasmid. The transformant strain acquired the 32 Md plasmid but presented, besides the resistance pattern already mentioned, resistance to tetracycline, gentamicin and tobramycin. Resistance to gentamicin and tobramycin was mediated by the synthesis of a 3-N-acetyltransferase. This resistance and the related enzyme were expressed neither in the donor B. catarrhalis strain nor in the transconjugant N. subflava strain. PMID- 3304918 TI - Susceptibility in vitro of gram-positive aerobe and anaerobe bacteria to ofloxacin. AB - Ofloxacin is a new fluoroquinolone derivative active against Gram-positive and Gram-negative bacteria including obligate anaerobes. In this study the in vitro activity of ofloxacin was evaluated against 325 Gram-positive organisms freshly isolated from clinical specimens, in comparison with that of ampicillin, erythromycin, clindamycin and ceftazidime. Susceptibility tests indicated that the MIC90 was 2 mg/l (range 0.25-2) against both methicillin-susceptible (MS) and methicillin-resistant (MR) Staphylococcus aureus. A value of 2 mg/l (range 0.5-4) was also found for all other staphylococci. The MIC of ofloxacin was 8 mg/l for 90% of Streptococcus faecalis (range 1-16), Str. faecium (range 2-8) and members of JK group (range 0.5-16). Propionibacterium acnes strains were all inhibited by 2 mg/l and 90% of Clostridia spp. (range 2-16) by 8 mg/l. Ofloxacin activity compared favourably with that of ampicillin, erythromycin, clindamycin and ceftazidime determined on the same isolates. MBC and time-kill studies indicated that this compound is rapidly bactericidal against enterococci. The great intrinsic activity against MS and MR staphylococci, refractory enterococci and JK bacteria may make ofloxacin a useful adjunct to the therapeutic arsenal. PMID- 3304919 TI - [Platelet and coronary disease]. PMID- 3304920 TI - [Determination of myocardial myosin in the diagnosis of myocardial infarction]. PMID- 3304921 TI - [A control trial of flavonoids of Hippophae rhamnoides L. in treating ischemic heart disease]. PMID- 3304922 TI - [The life story of Johann Christian Doppler]. PMID- 3304923 TI - [The analgesic-damaged kidney. Importance of the imaging procedure]. PMID- 3304925 TI - [Antibodies against HIV-2 (LAV-II) in Africa and West Germany]. AB - Antibodies against HIV-2 were tested by indirect immunofluorescence in over 2000 sera from Africa and the Federal Republic of Germany. The specificity of the test for HIV-2 was established by absorption of the sera with HIV-1 infected cells. Antibodies against HIV-2 were found in sera from two of 51 Africans who are living in the FRG. In addition, antibodies against HIV-2 were occasionally found in two of 1396 sera from Central Africa and two of 322 from West Africa. Cross reacting antibodies were found in four of 189 high risk patients from the FRG who had HIV-1 infection, these antibodies no longer being present after absorption. It would therefore seem that HIV-2 infections are still rare among German risk groups. PMID- 3304924 TI - [Gallstone ileus]. PMID- 3304926 TI - [Differential diagnosis of cholestasis]. PMID- 3304927 TI - [Neoadjuvant chemotherapy of sarcoma. The experiences of the German Society for Pediatric Oncology studies on osteosarcoma, Ewing's sarcoma and rhabdomyosarcoma]. PMID- 3304928 TI - [Myocardial resting ischemia after intravenous infusion of a thromboxane-receptor antagonist]. PMID- 3304929 TI - [Ofloxacin in the therapy of Campylobacter pylori-positive duodenal ulcer. A prospective controlled randomized study]. AB - 50 patients with duodenal ulcer and Campylobacter pylori cultured from the antral mucosa were randomly divided into two groups of 25. They received either ranitidine 300 mg at night or the same dose of ranitidine combined with twice daily 200 mg ofloxacin. Endoscopic check and biopsy for histological and microbiological tests were performed every two weeks until demonstrable cure of the ulcer. After two weeks the cure rates were 44 and 80%, respectively, after four weeks 68 and 92%, and after six weeks 88 and 100%. The difference in healing time between ranitidine alone and ranitidine plus ofloxacin was statistically significant (P less than 0.025). Campylobacter pylori was no longer demonstrable in two of 25 patients after ranitidine alone and in 24 of 25 after ranitidine ofloxacin. The minimal inhibitory concentration of ofloxacin against tested Campylobacter pylori strains was 0.5-1.0 micrograms/ml. Both groups were comparable as to age and sex distribution; duration of history of ulcer, and number of previous ulcers; nicotine and alcohol consumption; intake of nonsteroidal antirheumatic drugs; other previous treatment; size and complications of the ulcers; and number of accompanying diseases. The results speak for Campylobacter pylori playing a role in the pathogenesis of duodenal ulcer. PMID- 3304931 TI - [Diagnosis of pheochromocytoma]. PMID- 3304932 TI - [Therapy of pheochromocytoma]. PMID- 3304930 TI - [Hemodynamic effect of intravenous diltiazem and nifedipine in acute myocardial infarct. A randomized study]. AB - In a prospective, randomized trial of 28 patients with acute myocardial infarction nifedipine or diltiazem were administered intravenously and hemodynamic parameters and drug plasma levels measured for 24 hours. Both drugs lowered arterial blood pressure and peripheral resistance. Only diltiazem reduced heart rate and the heart rate x arterial pressure product, as pointer to a reduction in myocardial oxygen consumption. On the other hand, nifedipine is more likely to cause a (reflex) increase in heart rate. In no patient was there evidence of drug-induced hemodynamic impairment. Left ventricular filling pressure was reduced in those patients in whom it had been elevated. While a steady-state plasma concentration was quickly reached with nifedipine, in some patients diltiazem infusion produced a continuous rise in plasma concentration and, in two patients with posterior-wall infarction, high-grade a-v block (reversible after discontinuation of the drug). The results indicate that under ECG control both drugs can be used intravenously without much risk. The hemodynamic profile of diltiazem (reduction in peripheral resistance and heart rate) would seem to be particularly favorable in acute infarction, while nifedipine is preferred in acute infarction plus hypertension. The possible effect on a-v conduction is to be watched on intravenous administration of diltiazem, while in normotensive patients nifedipine may cause an undesirable (reflex-mediated) sympathetic activation. PMID- 3304933 TI - [Unemployment and health]. PMID- 3304935 TI - [Present status of the diagnosis of schizophrenia]. PMID- 3304934 TI - [Diagnosis of systemic vasculitis]. PMID- 3304936 TI - [Conjunctivitis and disorders of general health status in humans caused by infection with Newcastle disease virus]. PMID- 3304937 TI - [Tolerance of Wellcare emulsion by horses with special reference to red blood cell formation and locomotion]. PMID- 3304939 TI - [Fertility consultation in dairy herds. II. Reflections on the changes in fertility status after a consultation]. PMID- 3304938 TI - [Fertility consultation in dairy herds. I. Assessment of the effect of the consultation and its determining factors]. PMID- 3304940 TI - [The status of monoaminoxidase in myocardial, diaphragm and liver mitochondria in swine breeds of different constitutions]. PMID- 3304941 TI - A depigmentation phenomenon in the Himalayan rabbit. PMID- 3304942 TI - [Use of a luteolytic prostaglandin in rabbit meat production]. PMID- 3304943 TI - [Urolithiasis in a mare]. PMID- 3304944 TI - Studies on the fluoride contents in water and soil, urine, bone and teeth of sleep, and urine of human from eastern and western parts of Turkey. PMID- 3304945 TI - [The effect of feed form (meal, pelleted, liquid) and season on the concentration and particle size distribution of airborne dust particles in fattening pig sties]. PMID- 3304946 TI - [Use of high-fat diets in the feeding of pregnant and lactating sows]. PMID- 3304947 TI - [Comparative studies on the occurrence of Chlamydia psittaci in organ samples of birds using the mouse infection test and ELISA]. PMID- 3304948 TI - [The suitability of Xenopus laevis as an alternative to European frogs caught in open country for student training]. PMID- 3304949 TI - [Interruption of the drinking water supply for turkey hens by production of slime (case report)]. PMID- 3304950 TI - Comparative efficacy of cyclandelate versus flunarizine in the prophylactic treatment of migraine. AB - In a double-blind, parallel-group randomised trial of 3 months' duration, the efficacy of cyclandelate 800 mg twice daily in migraine prophylaxis was compared with that of flunarizine 5mg daily in 40 patients. In comparison with placebo and baseline values, both drugs significantly relieved symptoms of migraine as assessed by indices of pain total index, headache index, analgesic consumption and number of migraine days. Patients taking flunarizine experienced side effects such as drowsiness, weight gain and asthenia, while the most common complaint reported with cyclandelate was gastric upset. These results suggest that cyclandelate may be a useful alternative in migraine prophylaxis. PMID- 3304951 TI - Clinical experience with cyclandelate in insulin-dependent diabetic patients with neuropathy. AB - Previous trials have demonstrated a clinical and electrophysiological improvement of diabetic peripheral polyneuropathy in diabetic patients treated with cyclandelate at a dosage of 1600 mg/day. Hence, a double-blind randomised trial was started in 16 insulin-dependent diabetic patients presenting with symptoms of neuropathy, an increased vibration perception threshold (VPT), disturbed tendon reflexes at lower limbs and an EMG showing a significantly decreased motor nerve conduction velocity (MCV) of the peroneal nerves. The placebo-treated group and the cyclandelate-treated group were not significantly different regarding age, duration of diabetes and level of metabolic control (measured as total HbA1), which remained unchanged during the year of observation. In the cyclandelate treated group, pathological sensation improved significantly in 7 of 8 patients. MCV, measured under standardised conditions, increased significantly during the first 6 months of treatment, while mean VPT did not change. In the placebo group 3 of 8 patients showed an improvement of sensation, 3 did not feel any change and 2 worsened. Neither mean MCV nor VPT changed significantly. No severe side effects were observed during the study period. PMID- 3304952 TI - The effect of cyclandelate on cholesterol metabolism in patients with familial hypercholesterolaemia. AB - Heterozygous familial hypercholesterolaemia (HtFH) is associated with an increased risk of coronary artery disease. Prevention is possible by increasing the number of functioning receptors of low density lipoproteins (LDLs) in the liver. This is partly achieved by treatment with bile acid sequestrants, such as cholestyramine, but the effect is limited because of a concomitant increase in cholesterol synthesis. It was the purpose of this study to determine whether the increase in cholesterol synthesis could be influenced by treatment with cyclandelate, since it is known that cyclandelate inhibits cholesterol synthesis in rats. Ten patients received cyclandelate (3.2 g daily in 2 doses) or placebo in a double-blind cross-over study, with each treatment period of 3 months' duration. During these periods, treatment with cholestyramine (16 g daily) was continued. No evidence was found of inhibition of cholesterol synthesis by cyclandelate, as indicated by the serum concentration of the cholesterol precursor, lanosterol, which remained unchanged. Neither the serum concentration of LDL, nor those of high density lipoprotein (HDL) cholesterol, apolipoprotein B, A-I or A-II, were affected. Thus, it can be concluded that treatment with cyclandelate was not effective in lowering serum cholesterol concentrations in patients with familial hypercholesterolaemia who received concomitant cholestyramine therapy. PMID- 3304953 TI - Primary and secondary blood hyperviscosity syndromes, and syndromes associated with blood hyperviscosity. AB - Despite the methodological difficulties of evaluating the role of a single rheological component, some clinical situations characterised by an increase of blood viscosity can be identified. These are classified as 'blood hyperviscosity syndromes' and can be divided into 2 groups. The first includes pathophysiological conditions in which a primary blood abnormality causes a decrease of blood flow, as occurs in polycythaemic, sclerocythaemic and seric hyperviscosity syndromes, and may be referred to as 'primary blood hyperviscosity syndromes'. The second group includes pathological conditions in which a primary reduction of blood supply to tissue provokes tissue ischaemia, and an impairment of rheological properties of blood can be observed at microcirculatory level. Thus, these situations have been described as 'secondary blood hyperviscosity syndromes'. Patients with peripheral obliterative arterial disease, ischaemic cardiopathies and cerebrovascular insufficiencies show a diminution in blood fluidity during spontaneous or provoked ischaemic conditions which disappears after reperfusion of the tissue. The pathogenesis of this rheological damage is unclear, but may arise from the complex relationship among blood cells (red cells, leucocytes, platelets), endothelium and plasma components. In addition to these 2 groups of blood hyperviscosity syndromes, several pathological states such as diabetes, shock, surgery, and rheumatic disease have been described in which an increase of blood viscosity can be observed. For these situations, which require much further investigation, the term 'syndromes associated with blood hyperviscosity' could be proposed. PMID- 3304955 TI - Effect of cyclandelate on prostacyclin release and cytosolic free calcium concentrations in human endothelial cells. AB - An increase in the concentration of cytosolic calcium plays a pivotal role in the stimulation of endothelial cells to release various mediators that are involved in vasodilatation and haemostasis. When these cells become damaged, a larger irreversible influx of calcium ions can cause 'calcium overload' and cell death. Cyclandelate may affect the influx of calcium ions in cells and act as a calcium overload blocker. Therefore, the effects of cyclandelate on prostacyclin (PGI2) release and cytosolic free calcium were investigated in cultured human endothelial cells. Cyclandelate did not inhibit the production of 6-keto-PGF1 alpha, a stable metabolite of prostacyclin. Similarly, cyclandelate (10(-6) to 10(-4) mol/L) and flunarizine (10(-6) to 10(-5) mol/L) had no effect on the increased concentrations of cytosolic free calcium in cells stimulated by bradykinin or thrombin, or on non-stimulated cells as evaluated with the calcium indicator fura-2. This was found both in serum-free conditions and in the presence of 10% human serum. It is likely that the rise in cytosolic free calcium concentration upon stimulation of cultured human endothelial cells depends on the influx of calcium ions from an intracellular storage pool. PMID- 3304954 TI - Inhibition of human platelet functions by cyclandelate. AB - The effects of cyclandelate and two of its metabolites, cyclandelate alcohol and acid, on several human platelet functions in vitro were investigated. Platelet aggregation was measured turbidimetrically using platelet-rich plasma. 14C Serotonin (5-hydroxytryptamine) release from preloaded platelets, and thromboxane B2 (TxB2) formation were evaluated simultaneously with platelet aggregation. Cyclandelate and cyclandelate alcohol, but not cyclandelate acid, in a dose dependent fashion prevented platelet aggregation and the concomitant 14C serotonin release and TxB2 formation induced by adenosine diphosphate, platelet activating factor and collagen. In other experiments, inhibitory synergistic activities of cyclandelate and prostacyclin (PGI2) on platelet aggregation were demonstrated; cyclandelate alcohol and PGI2 showed a somewhat less pronounced synergism. The hypothesis that the calcium modulating property of cyclandelate is responsible for the inhibition of blood platelet functions is strengthened by the inability of the drug to inhibit the calcium-independent platelet aggregation induced by ristocetin. PMID- 3304956 TI - Cyclandelate versus flunarizine. A double-blind study in a selected group of patients with dementia. AB - A double-blind, double-dummy clinical trial was conducted in which the efficacy of cyclandelate 1600 mg daily was compared with that of flunarizine 10mg daily in 40 patients (25 men and 15 women) with dementia of cerebrovascular origin. Parameters were assessed before treatment, and after 45 and 90 days of therapy. At 90 days, significant improvements were observed in patients given cyclandelate in measurements of P100 latency in the left eye, neurological impairment, dementia scores, ischaemia scores, Gottfries mental deterioration scale, Hamilton depression scores, short term visual memory, long term memory, Bender-Gestalt test and Koh's blocks test. In flunarizine recipients, improvements were observed in neurological impairment, ischaemia scores, Gottfries scale and Hamilton depression scores. Patients treated with cyclandelate showed significantly greater ameliorations in symptoms as assessed by the ischaemia scale, evoked visual potential, visual memory and Koh's block test compared with those given flunarizine. However, in none of the parameters was flunarizine superior to cyclandelate. PMID- 3304957 TI - Use of nitrates in the treatment of unstable and variant angina. AB - Unstable angina is a clinical syndrome that includes patients with new onset of angina, a change in a previous stable pattern, or the development of chest pain at rest. Generally, more than 90% of patients with this syndrome have significant fixed atherosclerotic coronary artery disease. Other complex, interacting pathophysiological mechanisms may include coronary vasoconstriction, plaque rupture and thrombosis. Therapeutic strategies aim at either reduction of myocardial oxygen demand or restoration of coronary blood flow. Both alternatives have been suggested as treatment of choice. However, as long as the pathophysiological mechanism(s) is unknown in the individual case, the treatment will mainly be empirical or based on results from clinical trials of heterogeneous groups of patients with unstable angina with probably varying aetiology. The results from such studies indicate that some strategies may be of value, but others may even be harmful in treatment of patients with this unstable syndrome. In this situation nitrates seem to be a safe drug which may be used in most forms of irrespective of the underlying pathophysiological mechanism(s). PMID- 3304958 TI - Nitrates in acute myocardial infarction. AB - Nitrates relieve symptoms and improve left ventricular haemodynamics during acute myocardial ischaemia. The ability to increase cardiac output appears to be greatest in those patients with the most severe left ventricular failure. In humans and in animal experiments it has been demonstrated that indices of infarct evolution are reduced by early (less than 6 hours) administration of nitrate. Glyceryl trinitrate reduces myocardial oxygen consumption and improves delivery of oxygen to the ischaemic subendocardium. In addition, nitrates dilate epicardial coronary vessels with improvement of collateral flow Glyceryl trinitrate appears to have a more favourable effect on coronary collateral flow, pulmonary artery pressure, myocardial oxygen consumption and lactate production than other vasodilators. The effect of glyceryl trinitrate is dose dependent; doses larger than 100 micrograms/min may cause a paradoxical increase in the ischaemic condition. Hypovolaemic patients or patients with right heart infarction seem especially susceptible to hypotension. Nitrate-induced hypotension occurs in 15 to 20% of all patients with acute myocardial infarction. Administration of glyceryl trinitrate appears to offer most benefit in acute myocardial infarction complicated by significant left ventricular dysfunction. There is evidence that morbidity and mortality are reduced by early administration of nitrates; however, a properly conducted randomised double-blind trial remains to be performed. PMID- 3304959 TI - Use of nitrates in acute and chronic congestive heart failure. AB - The literature available on the use of nitrates (glyceryl trinitrate, isosorbide dinitrate and isosorbide 5-mononitrate) as various formulations (oral, buccal, sublingual, transdermal and intravenous) in the treatment of acute and chronic congestive heart failure is reviewed. There are adequate data on the acute haemodynamic effects of these preparations, but little information is available on the long term use of nitrates in chronic congestive heart failure. The exception is isosorbide dinitrate, which, in combination with hydralazine, has been shown to reduce mortality. PMID- 3304960 TI - Various administration forms of nitrates and their possibilities. AB - This article reviews the development and pharmacokinetics of a number of new dosage formulations (e.g. transdermal patches and buccal tablets) and new active substances (e.g. isosorbide 5-mononitrate) which have recently been introduced to overcome some of the problems inherent in conventional formulations of organic nitrates. PMID- 3304961 TI - Haemodynamic effects of nitrates, with special reference to the coronary circulation. AB - The pathophysiology of coronary circulation and its effects on myocardial oxygen supply in angina are discussed and reviewed in relation to the haemodynamic effects of nitrates, with special reference to the action of nitrates on coronary circulation. PMID- 3304962 TI - Combination of nitrates with other antianginal drugs. AB - The choice between beta-blockers, long-acting nitrates, and calcium antagonists for prophylactic treatment of stable angina pectoris is determined by several factors, including specific indications for and contraindications to a particular drug. In severe cases of angina, combined treatment is common. The theoretical advantages of combined therapy seem attractive; however, studies documenting the effects of some combinations are few or lacking. Combined use of nitrates and beta-blockers is a rational approach, because the pharmacological actions of the 2 drugs produce complementary haemodynamic effects. In short term studies favourable effects have been documented. Positive, but more variable effects have also been reported during long term treatment. Additive effects of nitrates and calcium antagonists have been found in angina produced by coronary artery spasm, but the effects of the combination in stable angina pectoris are not well documented. The combination may be more or less attractive, depending on the profile of action of the particular calcium antagonist used. It should be stressed that there are no studies of the efficacy of long term treatment with the combination of nitrates and calcium antagonists. Triple treatment is based more on clinical experience than on the effect documented in properly designed clinical studies. Even if additional beneficial effects can be obtained in patients on maximal doses of beta-blockers and nitrates when receiving calcium antagonists, it has been shown that triple therapy may not be optimal for certain patients. PMID- 3304963 TI - Nitrate tolerance. A relevant clinical problem? AB - Tolerance to nitrates has been shown to develop rapidly during therapy in experimental animals and in man. Although tolerance to the haemodynamic effects was originally considered to be of no clinical significance, it has now been demonstrated to have a major effect on the management of patients with angina. The mechanism of tolerance is not clear, but the hypothesis that it is related to depletion of reduced sulfhydryl groups, with resultant decreased production of S nitrosothiols and cyclic guanosine monophosphate, is not supported by our investigation. Although the mechanism of action is unknown, dosage strategies providing intermittent therapy with nitrates appear to be effective in preventing nitrate tolerance. PMID- 3304964 TI - Haemodynamic aspects of nitrate tolerance. AB - Development of tolerance to the haemodynamic effects of nitrates is influenced by the degree of left ventricular dysfunction and a number of other factors related to the circulatory system. Patients with angina pectoris and normal cardiac function at rest differ in response compared with patients with chronic congestive heart failure. Several studies have shown that haemodynamic tolerance to nitrates will develop in patients with angina pectoris. Slow-release oral nitrates and transdermal nitrates, as well as higher dosages, are more likely to induce tolerance. Patients with congestive heart failure will usually not develop tolerance after oral nitrate therapy. With transdermal therapy, however, tolerance frequently develops even in these patients. The individual response of patients to the effects of nitrates and the development of tolerance is variable, regardless of clinical status. Future studies on the development of tolerance must consider the complexity of the effects of nitrates and the various factors that may affect the haemodynamic changes. PMID- 3304966 TI - Cefmenoxime. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use. AB - Cefmenoxime is an aminothiazolyl cephalosporin administered intravenously or intramuscularly. Like other 'third-generation' cephalosporins it is active in vitro against most common Gram-positive and Gram-negative pathogens, is a potent inhibitor of Enterobacteriaceae (including beta-lactamase-producing strains), and is resistant to hydrolysis by beta-lactamases. Cefmenoxime has a high rate of clinical efficacy in many types of infection and is at least equal in clinical and bacteriological efficacy to several other cephalosporins in urinary tract infections, respiratory tract infections, postoperative infections and gonorrhoea. Cefmenoxime, like latamoxef, cefoperazone and cefamandole, has an N methyltetrazole side chain at the 3-position of the cephalosporin nucleus and thus possesses the potential for producing hypoprothrombinaemic bleeding and disulfiram-like reactions. However, these reactions have been reported very rarely and the antibacterial is generally well tolerated. It is likely that cefmenoxime will most closely resemble cefotaxime and ceftizoxime in therapeutic profile and usefulness. PMID- 3304969 TI - Infective endocarditis. Current recommendations for prophylaxis. AB - Antibiotic prophylaxis is indicated for any patient with a predisposing cardiac lesion who undergoes a procedure likely to produce bacteraemia with an organism having the propensity to cause bacterial endocarditis. Cardiac abnormalities have been ranked according to their approximate risk and it is known that the organisms most likely to cause endocarditis are viridans streptococci, Group D streptococci and staphylococci. The procedures likely to induce bacteraemia with each of these are, respectively, dental and upper respiratory with bleeding, urinary and gastrointestinal, and cardiac valve surgery. Antibiotic prophylaxis is impractical when bacteraemia cannot be anticipated and is unnecessary when it is due to organisms such as anaerobes and Gram-negative bacilli which rarely colonise the endocardium. A variety of prophylactic antibiotic regimens, directed against the common aetiological organisms, have been evaluated in animal models of infective endocarditis and it is on the basis of this kind of indirect evidence that several expert committees have made and regularly update their recommendations. Because infective endocarditis is an uncommon disease, a controlled clinical trial to prove the efficacy of prophylaxis would require the enrolment of a prohibitive number of patients. Consequently, there is room for differences of opinion over what constitutes optimum prophylaxis in any particular situation. This review examines the rationale for prophylaxis and compares and contrasts several authoritative recommendations, among which the trend in recent years has been towards simpler oral regimens. PMID- 3304970 TI - Case report of an atypical presentation of falciparum malaria. PMID- 3304968 TI - Current management of hypertensive emergencies. AB - A number of potent and rapidly acting pharmacological agents are available to achieve safe, rapid, and controlled blood pressure reduction in most hypertensive crises. While sodium nitroprusside remains the drug of choice in many hypertensive emergencies, several newer agents are now available that may prove to be acceptable alternatives in the management of certain cases. Glyceryl trinitrate (nitroglycerin) and labetalol may be advantageous in patients with significant coronary artery disease. When adequate facilities to monitor continuous infusion of sodium nitroprusside are not immediately available, the intermittent minibolus administration of diazoxide or labetalol or the use of sublingual or oral nifedipine prove useful. A thorough knowledge of the pharmacological properties and proper indications of the currently used agents is essential for optimum management of the critically ill hypertensive patient. PMID- 3304967 TI - Ticlopidine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy in platelet-dependent disease states. AB - Ticlopidine is an inhibitor of platelet action that has been used in the treatment of a variety of disease states in which platelets play a prominent role. Studies in animals and man have demonstrated that ticlopidine is a potent inhibitor of platelet aggregation induced by adenosine diphosphate (ADP), and variably inhibits aggregation due to collagen, adrenaline (epinephrine), arachidonic acid, thrombin, and platelet activating factor. Inhibition of platelet aggregation is both dose- and time-related, with its onset of activity being 24 to 48 hours, its maximal activity occurring after 3 to 5 days, and its activity still being present 72 hours after a final dose. Ticlopidine also inhibits the release reaction of platelets, prolongs bleeding time, reduces plasma levels of platelet factor 4 and beta-thromboglobulin in patients in whom these proteins are elevated, and may also inhibit platelet adhesion, increase red cell filtrability and decrease whole blood viscosity. In a large number of animal models, ticlopidine markedly inhibits thrombus formation or graft occlusion. Ticlopidine is well absorbed after oral administration. It is extensively metabolised and at least one of its metabolites is pharmacologically active. Therapeutic trials in patients with chronic arterial occlusion due to thrombangitis obliterans or arteriosclerosis obliterans, post-myocardial infarction, cerebrovascular thromboembolic disease, subarachnoid haemorrhage, vascular shunts or fistulas for haemodialysis, and sickle cell disease have shown promise for the use of ticlopidine. However, trials of patients with intermittent claudication, angina pectoris, diabetes mellitus with microvascular disease, aortocoronary bypass grafts, and vascular prostheses have had conflicting results or have shown an unfavourable side effect profile. Further studies are clearly required to establish the role of ticlopidine in many of these areas, some of which are already in progress. Overall, side effects occur in 10 to 15% of patients receiving ticlopidine. The most common side effects are gastrointestinal disturbances and skin rashes. Neither of these necessarily require discontinuation of therapy in most patients. Agranulocytosis, thrombocytopenia, and cholestatic jaundice have also been reported. Bleeding is infrequent except possibly in patients receiving ticlopidine prior to some surgical procedures. PMID- 3304971 TI - Recolonization of subgingival microflora and its clinical significance. PMID- 3304972 TI - Effect of varnish on microleakage and bond strength of cemented crowns. PMID- 3304973 TI - The luting efficacy of cements in bonding dowels of different metals. PMID- 3304965 TI - Disopyramide. A reappraisal of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in cardiac arrhythmias. AB - Disopyramide is a widely used class IA antiarrhythmic drug with a pharmacological profile of action similar to that of quinidine and procainamide. Over the past 10 years disopyramide has demonstrated its efficacy in ventricular and atrial arrhythmias. In therapeutic trials, usually involving small numbers of patients, the efficacy of disopyramide was comparable with that of mexiletine, perhexiline, tocainide, propafenone or prajmalium. Recent comparisons with quinidine have confirmed the similar efficacy and better tolerability of disopyramide. The suggestion from initial studies that disopyramide may be less effective than amiodarone or flecainide requires further investigation. In addition, studies have failed to demonstrate that the early administration of disopyramide after acute myocardial infarction decreases important arrhythmias or early mortality. Thus, disopyramide is now well established as an effective antiarrhythmic drug in ventricular and supraventricular arrhythmias although its role in therapy relative to that of recently introduced antiarrhythmic agents is not clear. PMID- 3304974 TI - Biphasic insulin release as the expression of combined inhibitory and potentiating effects of glucose. AB - The dynamics of insulin release were investigated in vitro in order to determine the regulatory processes governing its biphasic shape. When subjected to a square wave glucose stimulation, the isolated perfused rat pancreas responded with typical biphasic insulin release. Both the duration of the nadir between the two phases and the slope of recovery of insulin release during second-phase secretion exhibited glucose dose dependency. Successive 40-min stimuli with glucose (8.3 and 16.7 mM), separated by a 20-min rest period, resulted in 2.6- 3.3-fold potentiation of the early phase insulin release rate, previously described as glucose-primed time-dependent potentiation (TDP) of insulin secretion. A linear relationship (r = 0.89, P less than 0.001) was observed between the degree of TDP and the slope of second-phase insulin release. Successive short stimuli with glucose (5-10 min long, 5-10 min apart; 6.9, 8.3, and 16.7 mM) resulted in the inhibition of the response to the second stimulus; this effect was termed time dependent inhibition (TDI) of insulin release. Arginine also induced TDI; this was completely overcome by synergistic interaction with glucose (8.3 mM). The glucose-arginine interaction was utilized to demonstrate that the interphasic nadir of insulin release was the expression of TDI. Thus, introduction of an arginine stimulus during the nadir in glucose-induced insulin release abolished the silent phase, the secretion rate reaching the level expected for the combined glucose-arginine stimulus. However, the continued presence of TDI could be demonstrated by removal of the arginine stimulus, at which time, despite ongoing glucose stimulation, insulin secretion was markedly inhibited. These observations support the concept that the biphasic dynamics of insulin release is the net expression of three regulatory processes: 1) the acute stimulus-secretion coupling system, best observed as the immediate, first-phase response to a stimulus; 2) TDI of insulin release, a relatively rapid signal responsible for the silent period; and 3) TDP of insulin release, a slow rising signal responsible for recovery from the silent phase, building up the second-phase of secretion. PMID- 3304975 TI - The ionic, electrical, and secretory effects of protein kinase C activation in mouse pancreatic B-cells: studies with a phorbol ester. AB - The phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) was used to study the effects of protein kinase C activation on stimulus-secretion coupling in mouse pancreatic B-cells. At a nonstimulatory concentration of glucose (3 mM), 100 nM TPA, but not 10 nM TPA, slightly and slowly increased insulin release and 45Ca2+ efflux and decreased 86Rb+ efflux, but did not affect the membrane potential of B-cells. At a threshold concentration of glucose (7 mM), 100 nM TPA markedly increased insulin release without triggering electrical activity in B cells. At a stimulatory concentration of glucose (10 mM), TPA caused a dose dependent irreversible increase in insulin release, 45Ca2+ efflux, and 86Rb+ efflux and slightly augmented islet cAMP levels. Omission of extracellular Ca2+ abolished the effects of 10 nM TPA and partially inhibited those of 100 nM TPA on insulin release and 45Ca2+ efflux. In contrast, their effect on 86Rb+ efflux was paradoxically augmented. Glucose-induced electrical activity in B-cells was only marginally affected by TPA; the duration of the slow waves with spikes was not modified, but a small shortening of the polarized intervals raised their frequency and slightly increased the overall activity. This increase was significant only with 10 nM TPA, whereas only 100 nM TPA brought about a minute increase in 45Ca2+ influx. These results thus show that TPA induces insulin release or potentiates glucose-induced insulin release without mimicking or amplifying the initial ionic and electrical signals triggered by glucose. They suggest that protein kinase C activation affects stimulus-secretion coupling by modulating intracellular and/or nonelectrogenic membrane events. PMID- 3304976 TI - A physiological role for luteinizing hormone release-inhibiting factor of hypothalamic origin. AB - A 12 KD peptide, LH release-inhibiting factor (LHRIF), extracted from rat hypothalamus has been shown to inhibit LHRH-stimulated LH release from cultured anterior pituitary cells. In the present study this partially purified material also blocks LHRH-stimulated LH release in pentobarbital-blocked proestrous rats. Administration of a polyclonal antiserum to partially purified LHRIF potentiates estrogen-induced LH release and antagonizes the inhibitory effect of estrogen and progesterone on LH release in ovariectomized rats. These results suggest that a hypothalamic LHRIF plays a physiological role in regulating LH release in the rat. PMID- 3304977 TI - Down-regulation of cell surface insulin receptors in primary cultured rat adipocytes by sodium vanadate. AB - Sodium vanadate, a potent phosphotyrosine phosphatase inhibitor, was found to down-regulate the number of cell surface receptors in primary cultured adipocytes (50% receptor loss by 24 h; 65% loss by 48 h; ED50, 17 and 9 microM, respectively). The characteristics of vanadate-induced down-regulation were distinguished by three salient features. First, time-course studies revealed a lag period of 4-6 h preceding vanadate-induced receptor loss. This lag period was not due to slow diffusion of vanadate into the cell, since it could not be shortened using a very high dose of vanadate (1 mM). Second, vanadate was found to trigger receptor loss, such that down-regulation continued after vanadate removal. Thus, no immediate down-regulation was observed in adipocytes exposed to 80 microM vanadate for 6 h. However, when cells were washed and reincubated in vanadate-free medium for an additional 18 h (24 h total), a 50% receptor loss was seen. Lastly, we found that vanadate-induced down-regulation was not readily reversible, since receptor recovery was not observed when 24-h down-regulated cells were reincubated in vanadate-free medium for an additional 24 h. These three features of vanadate-induced receptor loss are remarkably similar to the characteristics of insulin-induced down-regulation. In studies examining the relationship between protein synthesis and vanadate-induced down-regulation, we found that vanadate markedly stimulated the overall rate of protein synthesis in 24-h treated adipocytes (a 42% increase; ED50, 3 microM), and that cycloheximide treatment markedly blunted vanadate-induced loss of cell surface receptors. Overall, these studies are consistent with the hypothesis that tyrosine phosphorylation plays a role in regulating the number of cell surface insulin receptors. PMID- 3304978 TI - Monoclonal antibodies to human progesterone receptor: characterization by biochemical and immunohistochemical techniques. AB - Progesterone receptor (PR) from a human endometrial carcinoma (EnCa 101) grown in nude mice consists of two hormone-binding proteins with mol wt around 116,000 and 85,000. To generate monoclonal antibodies against this receptor, PR was partially purified from EnCa 101 and used to immunize Robertsonian mice. Immune mouse spleens were fused with HL-1 Friendly myeloma-653 cells, and hybridomas were screened by solid phase dot-blot assay and double antibody precipitation. Seven stable hybridomas were obtained, designated hPRa 1-7. Subisotyping revealed that hPRa 1 and 6 were immunoglobulin G2b, while the remainder were immunoglobulin G1. Ultracentrifugation in high salt sucrose gradients showed that six of the seven antibodies effected a shift of [3H]progestin-labeled PR from EnCa 101; only hPRa 4 was ineffective in this regard. Protein blots of EnCa 101 cytosols and DEAE eluates revealed that hPRa 1, 3, 4, 5, and 7 recognized both PR proteins equally. hPRa 2 recognized principally the 116,000 mol wt PR protein; it recognized the lower mol wt PR protein very poorly if at all, whereas hPRa 6 recognized only the 116,000 mol wt protein. Interestingly, the latter was consistently detected as a closely migrating triplet. Immunolocalization of PR by hPRa 1-7 in tissue sections was confined to nuclei of target tissues and varied in intensity: hPRa 7 greater than 3 = 5 greater than 6 = 2 greater than 1 greater than 4. In proliferative phase uterus, the intensity of staining was ranked: endometrial gland nuclei (3+) greater than myometrial cell nuclei (2-3+) greater than endometrial stromal cell nuclei (0-1+). Thus, seven monoclonal antibodies directed against human PR have been prepared, and their suitability for the study of PR by biochemical and immunohistochemical techniques has been demonstrated. PMID- 3304979 TI - Characterization of a cytosolic inhibitor of calf estrogen receptor binding to nuclei. AB - An inhibitory component that diminishes estrogen receptor (ER) binding to nuclei in vitro is present in cytosol prepared from calf uterus. The inhibitor is heat stable and resistant to enzymatic treatment with trypsin, chymotrypsin, proteinase K, deoxyribonuclease I, or ribonucleases A, T1, and U2. Results of chromatography on DEAE-cellulose and Sephadex G-150 indicate that the factor is a negatively charged macromolecule. Inhibitory activity is sensitive to sequential digestion with chondroitinase ABC, hyaluronidase, and heparinase. Approximately 70% of the inhibitory activity is destroyed by treatment with heparinase alone. Heparitinase destroys only 30% of this activity. Furthermore, the addition of pure hyaluronic acid or chondroitin sulfate to the ER-nuclei binding assay results in little inhibition, whereas addition of heparin inhibits 75% of receptor binding. Overall, these results indicate that glycosaminoglycans, present in bovine uterine cytosol, are capable of inhibiting ER-nuclei interactions. The most potent inhibitory glycosaminoglycan displays heparin-like characteristics. PMID- 3304980 TI - A bone-derived growth factor isolated from rat calvariae is beta 2 microglobulin. AB - Rat calvariae are known to secrete a bone-derived growth factor (BDGF) that stimulates bone DNA and collagen synthesis. BDGF was purified from calvarial culture medium with dialysis, gel filtration and HPLC. Amino acid composition of BDGF was compatible with murine beta 2 microglobulin (beta 2 m), and amino terminal sequence analysis revealed identity with mature murine beta 2 m. This was confirmed by Western blot analysis using a polyclonal antibody to beta 2 m. Like BDGF, human beta 2 m stimulated bone DNA, collagen and noncollagen protein synthesis. Thus, BDGF, an autologous regulator of bone formation, is homologous to beta 2 m. PMID- 3304981 TI - Glucose and insulin reverse the effects of fasting on 3,5,3'-triiodothyronine neogenesis in primary cultures of rat hepatocytes. AB - The cellular mechanisms by which carbohydrate refeeding reverses the effect of fasting on T3 metabolism were studied in primary cultures of hepatocytes (24 h) harvested from 48-h fasted rats. Net T3 neogenesis (T3 generated from T4) in the fasted hepatocyte preparations (9.2 +/- 0.9 pmol/min X 100 mg protein) was significantly less (P less than 0.001) than that in hepatocyte cultures derived from 72-h glucose-fed rats (41 +/- 0.8 pmol/min X 100 mg protein). Preincubation (18 h) with either glucose (2.5-10 mM) or insulin (10-500 nM) significantly increased the fasted hepatocyte T3 levels to 28 +/- 0.6 and 22 +/- 1.3 pmol/min X 100 mg protein, respectively. Furthermore, incubation with both of these agents demonstrated a greater effect on hepatic T3 neogenesis than with either alone. Fasted hepatocyte T3 neogenesis was enhanced by enrichment with dithiothreitol (5 mM), but the T3 generation remained significantly less than that in cells exposed to glucose or insulin. Studies with glucose analogs demonstrated that preincubation with 2-deoxyglucose (5 mM) significantly increased (P less than 0.001) hepatocyte T3 neogenesis, but 3-O-methylglucose (5 mM) had no effect. In contrast, the insulin-mimetic compounds Concanavalin-A or spermine did not stimulate T3 neogenesis in the fasted hepatocyte cultures. Thus, rat hepatocytes sustained in primary culture for 24 h retain the T3 metabolic characteristics of the intact animal. Glucose and insulin reverse the effect of fasting on hepatocyte T3 neogenesis. The additive response to glucose and insulin suggests that T3 neogenesis is modulated through different mechanisms. The replication of the glucose effect by 2-deoxyglucose and the inability of dithiothreitol to reverse the effect of fasting on hepatocyte T4 5'-deiodinase activity suggest that neither intermediates in the glycolytic pathway nor thiol cofactors mediate the glucose effect. Thus, the restoration of liver T3 metabolism consequent to carbohydrate refeeding of the fasted rat may be mediated by the glucose and insulin responses. PMID- 3304982 TI - Gonadal-independent activation of enhanced afternoon luteinizing hormone release during pubertal development in the female rat. AB - In the present study we investigated the extent to which expression of the diurnal pattern of LH secretion in prepubertal female rats is driven by an ovarian-independent neuroendocrine mechanism. To remove gonadal influences, rats were ovariectomized (OVX) during early juvenile, late juvenile, or peripubertal phases of development (20-22, 26-27, and 32-33 days of age, respectively), and blood samples were collected throughout the day (every 30-60 min) 2 or 4 days after surgery. Morning plasma LH levels were relatively low 2 days after ovariectomy (30-120 ng/ml), but rose during the afternoon to reach levels ranging from 180-300 ng/ml. This afternoon elevation was sustained both in late juvenile and peripubertal rats, but not in early juvenile rats. The predominant change observed 4 days after ovariectomy was an overall 3- to 6-fold increase in plasma LH levels, which masked the afternoon elevation. Analysis of plasma LH profiles from individual rats, however, revealed that at each of the three ages studied the peak plasma LH levels occurred in the afternoon, and these were most pronounced in the peripubertal animals. To further clarify the existence of such a diurnal pattern of LH release in the 4-day OVX animals pulsatile LH release profiles were obtained from individual animals, using a 5-min bleeding paradigm, at either 24 days (in the morning) or 36 days of age (in either the morning or the afternoon). LH release was episodic in all of the animals studied, with pulses occurring on average of about once every 30 min. Analysis of the plasma LH profiles using the PULSAR algorithm revealed that the overall mean plasma LH levels of the peripubertal animals was enhanced during the afternoon, compared to that in the morning or to the afternoon LH levels in the early juvenile rats. Mean nadir and mean peak LH levels were also greater. No differences in LH pulse amplitude and only marginal differences in LH pulse frequency were detected among the three groups studied. The enhancement of afternoon LH secretion in the OVX rats could not be attributed to age-related or diurnal changes in adenohypophyseal responsiveness to LHRH. The results suggest that the initiation of enhanced afternoon LH secretion, previously shown to occur in intact female rats during the juvenile-peripubertal transition period, results primarily from the activation of a central neuroendocrine mechanism. Although the ovaries might play a role in the development of this diurnal pattern, it is clear that its activation is ovarian independent. PMID- 3304984 TI - Identification of the intact insulin receptor using a sequence-specific antibody directed against the C-terminus of the beta-subunit. AB - An antibody was raised against a synthetic peptide corresponding to the carboxyl terminal amino acids of the human insulin receptor (Anti-R beta C). Immunoprecipitation of the human insulin receptor and immunoblotting to the beta subunit by Anti-R beta C could be inhibited by competition with the corresponding peptide. However, even at saturating concentrations, anti-R beta C could not completely immunoprecipitate or immunodeplete insulin receptors compared to a human autoantibody (anti-R B2). Using receptor labeled directly by 125I, evidence of multiple forms of the beta-subunit was found. When the receptor could be immunoprecipitated by anti-R beta C, the beta-subunit migrated with an apparent mol wt (MW) of 96,000 (at or above the phosphorylase b MW marker). However, in preparations where anti-R beta C was not able to immunoprecipitate the insulin receptor, the beta-subunit migrated at a significantly lower MW of 91,000 (below phosphorylase b), as detected by immunoprecipitation with Anti-R B2. Intermediate forms could also be detected. Phosphorylation of partially purified insulin receptor did not affect is ability to be immunoprecipitated by anti-R beta C, although insulin-stimulated phosphorylation increased the apparent MW of the beta subunit. However, insulin receptor that was phosphorylated in solubilized extracts of whole cells had a beta-subunit that migrated at lower MW and was not immunoprecipitated by anti-R beta C. One possible explanation for this is that the beta-subunit may be degraded during preparation. When the MW of insulin receptor that has been purified to homogeneity from human placenta is compared to our data, it is clear that many of these insulin receptor preparations contain lower MW beta-subunits. These results must be taken into account when the sites of phosphorylation and kinase activity of purified insulin receptor preparations are studied. PMID- 3304983 TI - Phorbol ester inhibition of insulin-stimulated deoxyribonucleic acid synthesis in BC3H-1 myocytes. AB - Insulin and 12-O-tetradecanoyl phorbol 13-acetate (TPA) each acutely stimulates hexose transport, amino acid uptake, and pyruvate dehydrogenase activity in the BC3H-1 myocyte in a nonadditive fashion, suggesting that the acute effects of insulin and TPA are mediated through a common mechanism of action. Here we have demonstrated that while chronic incubation with insulin stimulated DNA synthesis by 3- to 6-fold, TPA, in contrast, did not stimulate DNA synthesis and, indeed, caused a 70% inhibition of insulin-stimulated DNA synthesis in a dose-dependent fashion. In differentiated myocytes, insulin maximally stimulated hydroxyurea sensitive [3H]thymidine incorporation into DNA at 200-400 nM with an ED50 of 5-8 nM, suggesting that insulin stimulates DNA synthesis via the insulin receptor rather than through growth factor receptors. Phorbol ester inhibition of insulin stimulated DNA synthesis was specific for the active tumor-promoting phorbols and the synthetic diacylglycerol 1-oleoyl-2-acetyl-sn-glycerol. Maximal TPA inhibition of insulin-stimulated DNA synthesis was observed at 100 nM with an ID50 of 30 nM TPA, values analogous to those required for TPA stimulation of hexose transport in the myocyte. Chronic incubation with TPA did not inhibit insulin-stimulated protein synthesis, acute K+ flux, K+ accumulation, cytosolic thymidine levels, or insulin binding, indicating that TPA inhibits a specific intracellular event mediating DNA synthesis and suggesting that the acute and chronic effects of insulin in BC3H-1 myocytes are regulated by distinct pathways. PMID- 3304986 TI - Diminutive lateral incisor as replacement for an avulsed permanent central incisor tooth. PMID- 3304985 TI - Morphological evidence of endogenous digitalis-like substance (EDLS) in the rat and macaque hypothalamus, using digoxin-immunohistochemistry. AB - Morphological investigation of the endogenous digitals-like substance (EDLS) characterized as a natriuretic humoral agent has not been carried out to date; but EDLS can be detected indirectly by immunohistochemistry using cross reactivity with digoxin-antibody. In this report, the brain and other organs of the rat and macaque were immunostained using commercially supplied digoxin specific antibodies. The immunoreactive substances were mainly observed in the neurons of hypothalamic paraventricular and supraoptic nuclei, and varicose fibers in some areas of the hypothalamus and infundibulum. No immunopositive substances were detected in the pituitary anterior lobe, adrenal gland, or kidney of the rat. PMID- 3304987 TI - The making of an antibiotic. PMID- 3304988 TI - Per-endoscopic bipolar diathermy coagulation of visible vessels using a 3.2 mm probe--a randomised clinical trial. AB - Forty-four patients who had bled from peptic ulcers and whose ulcers showed stigmata of haemorrhage (bleeding, visible vessel or adherent clot) entered a trial of treatment with a 3.2 mm bipolar diathermy probe. Two patients had spurting haemorrhage when endoscoped and both were treated with the probe, control being obtained in one. The remaining patients were randomised to treatment or control groups. One patient who was treated was withdrawn because the ulcer proved to be malignant. Six of 20 treated patients rebled compared with 8 of 21 controls (relative risk 0.79; 90% CI 0.26-1.97). The operation rate, transfusion requirement and hospital stay were similar in the two groups. One perforation occurred in the treatment group. Per-endoscopic bipolar diathermy treatment confers little benefit in bleeding peptic ulcer disease. PMID- 3304989 TI - Pancreatitis associated with congenital duodenal duplication cyst in an adult. AB - A case is reported of an adult patient with a history of relapsing pancreatitis. A soft duodenal submucosal lump was found by endoscopic retrograde cholangio pancreaticography (ERCP). Endoscopic ultrasonography (endo-US) showed an anechoic lesion covered with normal duodenal wall structure. Histology of the surgically resected cyst confirmed the diagnosis. Since surgery no further attacks of pancreatitis have occurred. PMID- 3304990 TI - The simulated dynamics of the insulin monomer and their relationship to the molecule's structure. AB - Insulin crystallizes in different forms, some of which show different conformations for the different molecules in the asymmetric unit. This observation leads to the question as to which conformation the molecule will adopt in solution. Molecular dynamics computer simulations of rhombohedral 2 Zn pig insulin have been carried out for both monomers (1 and 2) independently in order to study their behaviour in the absence of quaternary structure and crystal packing forces. These preliminary 120 ps simulations suggest that both monomers converge in solution to very similar conformations which differ from the X-ray structures of both monomer 1 and 2 (Chinese nomenclature), but are closer to the former, as has previously been suggested by an analysis of the crystal packing (Chothia et al. 1983) and by energy minimization (Wodak et al. 1984). The secondary structure of the molecules is basically preserved, as expected. A detailed description of the conformational changes is given. PMID- 3304991 TI - Concanavalin A changes not only the number of insulin binding sites but also the binding affinity in rat hepatoma cells in culture. AB - When rat hepatoma cells (R-Y121B) were first incubated with labeled insulin, followed by concanavalin A, at 500 micrograms/ml at 23 degrees C, the total cell associated radioactivity increased. At 4 degrees C, however, this increase was not observed. Scatchard analysis revealed that concanavalin A increased insulin binding affinity. The bound insulin was internalized together with concanavalin A. When the cells were incubated with concanavalin A prior to insulin addition, however, the total cell-associated radioactivity decreased at both temperatures. This was caused by the masking of insulin binding sites by the lectin. PMID- 3304992 TI - Etiologic and preventive aspects of epilepsy in the child--bridging the gap between laboratory and clinic. AB - Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms. PMID- 3304993 TI - Epileptogenesis and the immature brain. AB - Epidemiological studies indicate that the incidence of seizures is highest early in life. This report discusses the experimental data derived from studies of focal epileptogenesis of the immature brain in tandem with ongoing maturational changes. During development, neurons have characteristic neurophysiological properties. Local interictal discharges are long in duration, lack a stereotypic morphology, and have limited fields. Yet the immature brain is very susceptible to the development of bilateral, although asynchronous, seizures and status epilepticus induced by amygdala kindling or by convulsant drugs. This increased seizure susceptibility may be due to a functional immaturity of a substantia nigra, GABA-sensitive output system. The morbidity of convulsions occurring early in life may not be as grave as previously thought in terms of subsequent acquisition of "normal" developmental milestones. The propensity to develop recurrent convulsions in adulthood is not related to the severity of a single seizure in infancy. Although multiple severe seizures may predispose animals to the development of seizures later in life, this is not a unique feature of the immature brain, since it also occurs in the adult brain. Finally, there is evidence that the immature brain may respond to anticonvulsant drugs differently from its mature counterpart; these findings emphasize the need to develop new antiepileptic therapies that take into account the maturational state of the brain. PMID- 3304994 TI - Special pharmacokinetic considerations in children. AB - Pediatric patients have greater degrees of pharmacokinetic variability and unpredictability than adults. This variability results from the effects of pharmacogenetics, age and growth, prior and current comedication, and disease. Newborns with seizures have the least predictable dosage requirements, and their needs change as drug-eliminating mechanisms mature in the neonatal period. Infants have the highest relative capacities to eliminate antiepileptics of any age group and require the largest relative doses. In addition to age-related trends, children demonstrate the same drug-specific, pharmacokinetic phenomena that adults do, including nonlinear phenytoin elimination, nonlinear valproate binding, and autoinduction of carbamazepine. Intercurrent illness and drug interactions further modify the age-related pharmacokinetic patterns in children and make dosage requirements even more unpredictable. Recent studies have shown that febrile illness can affect drug elimination, sometimes decreasing drug levels by 50% or more. Intermittent treatment with benzodiazepines administered either orally or rectally can be an important adjunct and help minimize this type of problem for children with marginally controlled epilepsy. Intermittent benzodiazepines are also helpful for children who have febrile seizures and who need only occasional antiepileptic protection. PMID- 3304995 TI - Pediatric epilepsy surgery. AB - The use of implantable arrays of epidural electrodes has made it possible to carry out extraoperative electrocorticography (ECoG) and functional localization in the awake child. This has permitted cortical excisions that are determined by criteria similar to those obtained during surgical procedures performed under local anesthesia in adults. In addition, the method also permits simultaneous ECoG and video monitoring during the child's symptomatic seizures, providing additional important localizing information that is impractical to obtain in operations under local anesthesia. We report our experience with 75 children, ages 5 months to 15 years, whom we have managed with epidural electrode arrays. The method of extraoperative ECoG is described and illustrative cases are presented to demonstrate its feasibility and utility in children. In addition, we call attention to gliomas as a common cause of chronic focal seizures in children. Of 49 children undergoing resection and followed for from 1 to 14 years (mean of 5.8 years), 32 (65%) are either seizure free or have had a significant reduction in seizure frequency that has unambiguously improved their quality of life. The results are analyzed further by relating the surgical outcome to each of the pathologic entities that caused the seizures. This analysis reveals the variety of neurological conditions that commonly cause intractable focal seizure disorder in children and distinguishes those pathologic entities in which the seizure disorder is apt to respond to surgical intervention from those that will not. PMID- 3304996 TI - Teratological research using in vitro systems. I. Mammalian whole embryo culture. AB - Approximately 390 literature references (through spring 1986) were reviewed for mammalian whole embryo culture procedures, with particular attention to the development of those cultures as systems for teratogenicity testing. The existing procedures could be conveniently divided into three groups, which are defined by the periods of embryogenesis that they embrace: preimplantation, peri implantation, and post-implantation culture systems. The literature on peri implantation embryo culture was sparse, and it did not appear that this procedure is being actively developed as a teratogen screening test. The extensive literature on both preimplantation and postimplantation embryo culture suggested considerable use of these two methods in evaluating embryotoxicants. The following discussion was compiled from information gleaned from all references. However, in the interest of brevity, only representative articles are specifically cited. Because the background and methodology for each system are distinct, each system will be discussed separately. PMID- 3304997 TI - Teratological research using in vitro systems. II. Rodent limb bud culture system. AB - This review represents a compilation of information related to the rodent limb bud culture system from approximately 80 publications after 1969 and conversations with workers in the field. Most of these papers and book chapters refer exclusively to studies with the mouse limb bud. Sections in this review include historical review, end point measurements, activating systems, types of compounds studied and dose response, reproducibility, statistical analysis, equipment and personnel requirements, mechanisms, and summary. PMID- 3304998 TI - Report on cancer risks associated with the ingestion of asbestos. DHHS Committee to Coordinate Environmental and Related Programs. AB - This report is an assessment of all available literature that pertains to the potential risk of cancer associated with ingestion of asbestos. It was compiled by a working group to assist policy makers in the Department of Health and Human Services determine if adequate information was available for a definitive risk assessment on this potential problem and evaluate if the weight of evidence was sufficient to prioritize this issue for new policy recommendations. The work group considered the basis for concern over this problem, the body of toxicology experiments, the individual epidemiologic studies which have attempted to investigate this issue, and the articles that discuss components of risk assessment pertaining to the ingestion of asbestos. In the report, the work group concluded: that no direct, definitive risk assessment can be conducted at this time; that further epidemiologic investigations will be very costly and only possess sufficient statistical power to detect relatively large excesses in cancers related to asbestos ingestion; and that probably the most pertinent toxicologic experiments relate to resolving the differences in how inhaled asbestos, which is eventually swallowed, is biologically processed by humans, compared to how ingested asbestos is processed. The work group believes that the cancer risk associated with asbestos ingestion should not be perceived as one of the most pressing potential public health hazards facing the nation. However, the work group does not believe that information was sufficient to assess the level of cancer risk associated with the ingestion and therefore, this potential hazard should not be discounted, and ingestion exposure to asbestos should be eliminated whenever possible. PMID- 3304999 TI - The toxicologic effects of the carbamate insecticide aldicarb in mammals: a review. AB - Aldicarb, 2-methyl-2-(methylthio)propionaldehyde-O-methylcarbamoyloxime, is an oxime carbamate insecticide manufactured by the Union Carbide Corporation and sold under the trade name Temik. It is a soil-applied systemic pesticide used against certain insects, mites, and nematodes, and is applied below the soil surface for absorption by plant roots. It is generally applied to the soil in the form of 5, 10, or 15% granules, and soil moisture is essential for the release of the toxicant. Uptake by plants is rapid. Aldicarb is currently registered for use on cotton, sugar beets, sugar cane (Louisiana only), potatoes, sweet potatoes, peanuts, oranges, pecans (Southeast only), dry beans, soybeans, and ornamental plants. Home and garden use is not permitted. Discovery of aldicarb and its oxidative sulfoxide and sulfone metabolites in well or ground water in Florida, Wisconsin, and New York, and accidental poisonings from ingesting contaminated watermelons and cucumbers in the South and West have spurred interest and concern about this pesticide. The primary mechanism of toxic action of aldicarb is cholinesterase inhibition. However, unlike the relatively irreversible anticholinesterase activity of the organophosphate pesticides, the carbamylation process which produces the anti-AChE action is quickly reversible. Aldicarb is readily absorbed through both the gut and the skin, but is rapidly metabolized and excreted in the urine almost completely within 24 hr. Although it is acutely toxic to humans and laboratory animals, aldicarb is not known to be carcinogenic, teratogenic, conclusively mutagenic, or to produce other long-term adverse health effects. In cases of accidental poisoning, the cholinergic symptoms have generally subsided within 6 hr, with no side effects or complications. PMID- 3305001 TI - Some metabolic and hormonal changes associated with general anaesthesia and surgery in the horse. AB - Three different anaesthetic techniques were studied in normal, healthy Thoroughbred or Thoroughbred type horses. These were (a) acepromazine, thiopentone and suxamethonium; (b) acepromazine, glyceryl guaiacolate and a 'half dose' of thiopentone; and (c) xylazine and ketamine. Anaesthesia was maintained with halothane vaporized in oxygen and nitrous oxide. All horses underwent either laryngeal or body surface surgery. Heart rate, packed cell volume, blood glucose and lactate, plasma non-esterified fatty acids, insulin and cortisol were measured before, during and after surgery. The greatest metabolic and hormonal changes occurred immediately after anaesthetic induction and were different in each group. The combination of acepromazine, glyceryl guaiacolate and a 'half dose' of thiopentone was associated with the least change in the physiological and metabolic variables measured. PMID- 3305000 TI - Effects of cigarette smoking on metabolic events in the lung. AB - Nicotine and cigarette smoke extract show acute physiological effects: increasing tracheal pressure (PTR), pulmonary artery pressure (PPA), systemic blood pressure (PSYST), and left atrium pressure (PLA); and decreasing cardiac output (QAORTA) and blood flow to the left lower lobe (QLLL). In addition, cigarette smoking induces bronchoconstriction, thus decreasing peak flow, FVC, and FEV1.0 in healthy subjects. It has also been demonstrated that cigarette smoking caused temporary slowing of mucociliary clearance in the lung and that cigarette smoke increases the activity of aryl hydrocarbon hydroxylase which metabolizes benzo[alpha]pyrene. We demonstrated that serum angiotensin I converting enzyme (ACE) activity showed a significant increase immediately after smoking and returned to the control level 20 min after smoking. We also demonstrated that plasma histamine levels showed a marked decrease after smoking. Furthermore, the effects of cigarette smoke and related substances on prostaglandin, thromboxane, testosterone, cyclic nucleotides metabolism, and protein synthesis were also investigated. PMID- 3305002 TI - The effect of oral supplementation with L-carnitine on maximum and submaximum exercise capacity. AB - Two trials were conducted to investigate the effects of L-carnitine supplementation upon maximum and submaximum exercise capacity. Two groups of healthy, untrained subjects were studied in double-blind cross-over trails. Oral supplementation of 2 g per day L-carnitine was used for 2 weeks in the first trial and the same dose but for 4 weeks in the second trial. Maximum and submaximum exercise capacity were assessed during a continuous progressive cycle ergometer exercise test performed at 70 rpm. In trial 1, plasma concentrations of lactate and beta-hydroxybutyrate were measured pre- and post-exercise. In trial 2, pre- and post-exercise plasma lactate were measured. The results of treatment with L-carnitine demonstrated no significant changes in maximum oxygen uptake (VO2max) or in maximum heart rate. In trial 1, there was a small improvement in submaximal performance as evidenced by a decrease in the heart-rate response to a work-load requiring 50% of VO2max. The more extensive trial 2 did not reproduce the significant result obtained in trial 1, that is, there was no significant decrease in heart rate at any given submaximal exercise intensity, under carnitine-supplemented conditions. Plasma metabolic concentrations were unchanged following L-carnitine, in both trials. It is concluded, that in contrast to other reports, carnitine supplementation may be of little benefit to exercise performance since the observed effects were small and inconsistent. PMID- 3305003 TI - Perspectives on the potential for successful development of outer membrane protein vaccines. PMID- 3305005 TI - Neonatal septicemia in Stockholm. AB - In a prospective study to determine the incidence and etiology of neonatal septicemia at Karolinska Hospital, Stockholm, all cases of neonatal septicemia in infants born at the hospital from 1981 to 1985 were reviewed. There were 4.0 cases of neonatal septicemia per 1,000 live births during the study period. During the five year period the incidence of septicemia tended to increase, mainly due to the increasing incidence of septicemia in infants with a birth weight below 1,500 grams. The single most common causative organism was group B streptococci with an incidence of 1.4 per 1,000 live births, Staphylococcus aureus accounting for 1.1 cases, Staphylococcus epidermidis for 0.7 cases, and gram-negative rods for only 0.4 cases per 1,000 live births. In a retrospective study of the incidence of neonatal septicemia in a non-selected patient population, all cases in the Stockholm area in 1983 were reviewed. In that year there were 17,586 live births in the area and the incidence of neonatal septicemia was 2.6 per 1,000 live births. Group B streptococci, Staphylococcus aureus, Staphylococcus epidermidis and gram-negative rods were equally common as causative agents. PMID- 3305006 TI - Enzyme-linked immunofiltration assay for rapid serodiagnosis of syphilis. AB - A new rapid technique for detection of serum treponemal antibodies is described which is based on an enzyme-linked immunoassay using nitrocellulose as solid phase. With this technique antigen-antibody binding is accelerated by the filtration of the antibody solution through the antigen-coated nitrocellulose filter instead of its remaining over the solid phase for incubation. Test results are available in less than 15 min. Serum specimens from 255 syphilitics and 829 non-infected subjects were investigated. The sensitivity and specificity of the Treponema pallidum enzyme-linked immunofiltration assay were comparable to those of the Treponema pallidum haemagglutination assay and the fluorescent treponemal antibody absorption test. PMID- 3305004 TI - Development of resistance during antibiotic therapy. AB - The frequency of development of resistance during antibiotic therapy was evaluated by reviewing the literature according to prescribed criteria. Mean resistance rates were calculated to be 9.2% for broad spectrum penicillins, 8.6% for second and third generation cephalosporins, 10.0% for latamoxef, 4.7% for imipenem, 11.8% for ciprofloxacin and 13.4% for aminoglycosides. Emergence of resistance of the infecting organism was associated with therapeutic failure in about half of the cases with the exception of patients treated with aminoglycosides in whom development of resistance resulted in treatment failure in 85% of the cases. The possible benefit of combination therapy in terms of resistance development is discussed. PMID- 3305007 TI - Serological studies in Crohn's disease. AB - ELISA and immunofluorescence tests were carried out on sera from patients with Crohn's disease and ulcerative colitis. The results indicate that mean antibody levels to Yersinia enterocolitica types O:9 and O:3 and Klebsiella pneumoniae, but not Pseudomonas maltophilia, are significantly higher in these patients than in control subjects. There are differing antibody levels in ileal and colonic disease, and there is a significant fall in antibody levels 9-12 months after remission from clinical symptoms in patients providing serial serum samples. However, there is no correlation between the severity of the disease and antibody titres. PMID- 3305008 TI - Multicentre evaluation of a direct coagglutination test for group A streptococci. AB - A coagglutination test for detection of group A streptococci in throat samples was evaluated in a multicentre study and found to be about 95% sensitive when applied to swabs taken from symptomatic patients which yielded more than 100 colonies per plate on culture. The sensitivity of the test dropped significantly when it was applied to swabs giving fewer than 100 colonies on culture. The specificity of the test was high regardless of colony count on conventional media. PMID- 3305009 TI - Controversies in hospital infection control. PMID- 3305010 TI - New microbiological techniques for hospital epidemiology. AB - Infection control teams rely on microbiology laboratories for accurate, reproducible data to trace the spread of microorganisms in the hospital. Since few problems are recognized immediately, laboratories should save important nosocomial pathogens so that outbreak strains will be available for analysis by more sophisticated techniques, particularly since automation has reduced the amount of epidemiologically useful data generated by routine procedures. Traditional supplemental reference procedures include phage typing, biotyping, serotyping and bacteriocin typing. Recently, analysis of antibiotic resistance determinants has provided the hospital epidemiologist with additional tools. Resistant strains have been characterized by their production of specific antibiotic inactivating enzymes. Agarose gel electrophoresis and restriction endonuclease analysis of plasmid DNA have permitted precise characterization of nosocomial strains, and the spread of antibiotic resistance genes can now be followed by sensitive and specific DNA probes. DNA probes also show promise for distinguishing nosocomial strains bearing known virulence factors from strains with less pathogenic potential. Molecular genetics techniques have found an additional role in elucidating the epidemiology of nosocomial viruses, especially the herpesviruses. PMID- 3305011 TI - Setting priorities: nationwide nosocomial infection prevention and control programs in the USA. AB - Approximately two million nosocomial infections occur annually in patients admitted to acute-care hospitals in the USA. Factors that should be considered in setting national priorities for nosocomial infection prevention and control efforts include incidence, mortality, prolongation of stay, cost of treatment, and potential for prevention of infections at different sites. National nosocomial infection priorities in the USA cover infections caused by emerging pathogens, infections at selected sites including the bloodstream, infections in intensive-care units, infections resulting from contaminated devices and products, development of the capability to analyze surveillance data in a timely fashion, dissemination of information on effective prevention strategies to infection control personnel, and training of infection control personnel, including physicians. The mechanism used to disseminate information on effective prevention strategies is the series of CDC 'Guidelines for the Prevention and Control of Nosocomial Infections'. These guidelines address prevention of nosocomial infections at the four major sites, handwashing and environmental control issues, infection control in personnel health, and isolation precautions. PMID- 3305012 TI - Amino acid sequence of chicken liver cathepsin L. AB - The complete amino acid sequences of the heavy and light chains of chicken liver cathepsin L have been determined by automated gas-phase Edman degradation. The heavy and light chains contained 176 and 42 amino acid residues respectively. A glucosamine-based oligosaccharide group was attached to Asn-109 of the heavy chain. Chicken liver cathepsin L had high sequence homology with rat cathepsin H, but exhibited less similarity with rat cathepsin B. Comparisons of cathepsin L with plant cysteine proteinases, such as papain, actinidin and aleurain, reveal high degree of homology. PMID- 3305013 TI - Improved purification of pyruvate decarboxylase from wheat germ. Its partial characterisation and comparison with the yeast enzyme. AB - An improved procedure was developed for the isolation of pyruvate decarboxylase from wheat germ. Its final step, an electrophoresis of the native apoenzyme in concave pore gradient polyacrylamide gels, followed by superficial activity staining, produced two bands of different molecular masses and chain compositions. The high-molecular-mass band occurred in low quantity and consisted of, probably eight, apparently identical chains of Mr = 33,000, as judged from sodium dodecyl sulfate electrophoreses. The low-molecular-mass band contained two types of chains with Mr alpha = 63,000-65,000 and Mr beta = 61,000-62,000. The N termini of both chains were threonine, whereas their C-terminal sequences were different: alpha, -(Val)-(Ser)-(Ala)-Leu; beta, -(His)-(Asp)-(Ala)-Ser. Their amino acid composition was too different to be compatible with our original concept of one chain being produced from the other by proteolytic shortening. Limited proteolysis by Staphylococcus aureus V8 proteinase yielded peptides partly identical size and partly quite different. In all properties investigated, the low-molecular-mass enzyme largely resembled yeast pyruvate decarboxylase; the holoenzyme appeared to possess (alpha beta)2 structure, the apoenzyme alpha beta. SH reagents inactivated the enzyme. Binding and fluorescence of 2-p toluidinonaphthalene-6-sulfonate indicated a similar lipophilicity of the active site as found earlier for the yeast enzyme. 2-Hydroxy-5-nitrobenzyl modification of exposed tryptophan residues left the holoenzyme intact, but in the apoenzyme it destroyed most of the cofactor-binding ability and hence the activity. The strength of cofactor binding and the maximal specific activity were found somewhat lower than in yeast pyruvate decarboxylase. PMID- 3305014 TI - Characterization of cDNA coding for the complete light meromyosin portion of a rabbit fast skeletal muscle myosin heavy chain. AB - Myosin-heavy-chain-specific cDNA clones have been isolated from a cDNA library prepared from hind leg muscle of a 14-day-old rabbit. According to restriction enzyme analysis these can be grouped into at least two, probably three different classes. RNA dot-blot hybridization shows that all of these clones correspond to mRNAs expressed in fast skeletal muscle. The clones of the most abundant form, class I, can be aligned to cover the complete light meromyosin portion of myosin heavy chain. The sequence of the coding and the 3'-untranslated region, together comprising 2143 base pairs, has been determined. The class I clone detects a multigene family of 8-12 members on a Southern blot of rabbit genomic DNA. PMID- 3305015 TI - Probing the heparin-binding domain of human antithrombin III with V8 protease. AB - From structural analysis on genetically abnormal and chemically modified human antithrombin III [Koide, T., Odani, S., Takahashi, K., Ono, T. and Sakuragawa, N. (1984) Proc. Natl Acad. Sci. USA 81, 289-293; Chang, J.-Y. and Tran, T. H., (1986) J. Biol. Chem. 261, 1174-1176; Blackburn, M. N., Smith, R. L., Carson, J. and Sibley, C. C. (1984) J. Biol. Chem. 259, 939-941], the heparin-binding site of antithrombin III has been suggested to be in the region of Pro-41, Arg-47 and Trp-49. In this study the heparin-binding site was probed by preferential cleavage of V8 protease on heparin-treated and non-treated native antithrombin III. The study has been based on the presumption that the heparin-binding site of antithrombin III is situated at exposed surface domain and may be preferentially attacked during limited proteolytic digestion. Partially digested antithrombin III samples were monitored by quantitative amino-terminal analysis and amino acid sequencing to identify the preferential cleavage sites. 1-h-digested antithrombin III was separated on HPLC and peptide fragments were isolated and characterized both qualitatively and quantitatively. The results reveal that Glu-Gly (residues 34-35), Glu-Ala (residues 42-43) and Glu-Leu (residues 50-51) are three preferential cleavage sites for V8 protease and their cleavage, especially the Glu-Ala and the Glu-Leu sites, was drastically inhibited when antithrombin III was preincubated with heparin. Both high-affinity and low-affinity antithrombin III-binding heparins were shown to inhibit the V8 protease digestion of native antithrombin III, but the high-affinity sample exhibited a higher inhibition activity than the low-affinity heparin. These findings (a) imply that the segment containing residues 34-51 is among the most exposed region of native antithrombin III and (b) support the previous conclusions that this region may play a pivotal role in the heparin binding. PMID- 3305016 TI - Amino acid sequence of endothiapepsin. Complete primary structure of the aspartic protease from Endothia parasitica. AB - The amino acid sequence of endothiapepsin, the aspartic protease from Endothia parasitica has been determined. The enzyme consists of 330 residues. The sequence determination was performed exclusively at the protein level. The homology of this fungal milk-clotting enzyme with aspartic proteases is demonstrated by alignment with pepsin, chymosin, gastricsin, renin, and cathepsin D from various vertebrates and proteinase A from Saccharomyces cerevisiae showing 25-30% identity. The identity with mucor rennin from Mucor pucillus was 21% and with penicillopepsin from Penicillium janthinellum 53%, the fungal enzymes thus representing the lowest as well as the highest degree of homology. PMID- 3305017 TI - Plakoglobin is a component of the filamentous subplasmalemmal coat of lens cells. AB - The plasma membranes of the cells of the superficial layer of the eye lens and the lens fibres are in close intercellular contact, leaving an intermembrane space of approximately 20 nm or less throughout their entire length. This plasma membrane is underlaid by a filamentous, cytoplasmic web containing actin, proteins of the spectrin and band 4.1 families, alpha-actinin and vinculin. Using immunofluorescence microscopy and immunoblotting of gel electrophoretically separated proteins, we show that plakoglobin, the plaque protein common to desmosomal and nondesmosomal adhering junctions, is present in lens cells and is also a component of the subplasmalemmal coat of these cells. Plakoglobin also exists in the extended regions of intercellular contacts between cultured lenticular cells where it often colocalizes with vinculin but does not occur in other vinculin-rich plasma membrane regions such as the focal adhesions at the ventral cell surface. Plakoglobin associated with plasma membrane regions can also be identified in various other adhesive cultured cells, but it is not detected in cells and tissues that do not establish firm intercellular junctions such as erythrocytes, platelets, cultured myeloma cells and smooth muscle tissue. We conclude that plakoglobin occurs, at least in lens cells, throughout the entire subplasmalemmal coat, coexisting in this situation not only with vinculin but also with spectrin and 4.1 protein(s). This colocalization infers the presence of a distinct, complex type of membrane-skeleton assembly involving the actin filament-associated junctional plaque elements plakoglobin and vinculin together with actin-associated proteins of the spectrin and band 4.1 protein families. PMID- 3305018 TI - Reappearance of immune complex binding sites on macrophages after internalization and its inhibition by monensin. AB - Receptor-mediated endocytosis of IgG and immune complexes in macrophages is terminated with digestion of the ligand in lysosomes. However, there are controversial data on whether Fc receptors are degraded together with the ligand or recycled to the cell surface. In the present study, rat peritoneal macrophages were incubated at 4 degrees C with rat peroxidase-antiperoxidase (PAP) complex for 1 h, washed and warmed up to 37 degrees C for different time periods and reincubated with new PAP at 4 degrees C. In another series of experiments, the cells were preincubated with 50 nM monensin, then cooled to 4 degrees C and reincubated with PAP in the presence of monensin. The cells were fixed and processed for electron microscopy at different stages of the experiments. Quantitative data were obtained by measuring PAP-binding membrane lengths on electron micrographs (morphometry) and by determining surface-bound PAP with spectrophotometry. In macrophages which had bound PAP at 4 degrees C and were warmed up for 5 min, the PAP was cleared from the cell surface and was found in endosome-like structures. When reincubated with PAP at 4 degrees C, such cells again bound the ligand on the cell surface, mainly in labyrinthic invaginations of the plasma membrane (synonyms: lacunae, caveolar indentations). Macrophages which had been warmed up for longer periods (30 and 60 min) showed the bound ligand all along the plasma membrane. Treatment of cells with monensin did not affect internalization of PAP, however, it decreased the ligand binding ability of macrophages considerably. These findings led us to assume an Fc receptor replenishment from a cytoplasmic pool. PMID- 3305019 TI - High sensitivity immunolocalization of double and single-stranded DNA by a monoclonal antibody. AB - A monoclonal antibody (AK 30-10) is described which specifically reacts with DNA both in double and single-stranded forms but not with other molecules and structures, including deoxyribonucleotides and RNAs. When used in immunocytochemical experiments on tissue sections and permeabilized cultured cells, this antibody detects DNA-containing structures, even when the DNA is present in very small amounts. Examples of high resolution detection include the DNA present in amplified extrachromosomal nucleoli, chromomeres of lampbrush chromosomes, mitochondria, chloroplasts and mycoplasmal particles. In immunoelectron microscopy using the immunogold technique, the DNA was localized in distinct substructures such as the "fibrillar centers" of nucleoli and certain stromal centers in chloroplasts. The antibody also reacts with DNA of chromatin of living cells, as shown by microinjection into cultured mitotic cells and into nuclei of amphibian oocytes. The potential value and the limitations of immunocytochemical DNA detection are discussed. PMID- 3305020 TI - Intact microtubules are necessary for complete processing, storage and regulated secretion of von Willebrand factor by endothelial cells. AB - The importance of intact microtubules in the processing, storage and regulated secretion of von Willebrand factor (vWf) from Weibel-Palade bodies in endothelial cells was investigated. Human umbilical vein endothelial cells treated for 1 h with colchicine (10(-6) M) or nocodozole (10(-6) M) lost their organized microtubular network. Stimulation of these cells with secretagogues (A23187, thrombin) produced only 30% release of vWf in comparison to control cells containing intact microtubules. The nocodazole treatment was reversible. One-hour incubation in the absence of the drug was sufficient for microtubules to reform and restore the full capacity of the cells to release vWf. Long-term incubation (24 h) of endothelial cells with microtubule-destabilizing agents had a profound effect on vWf distribution. In control cells, vWf was localized to organelles in the perinuclear region (i.e., endoplasmic reticulum and Golgi apparatus) and to Weibel-Palade bodies. In drug-treated cells vWf staining was dispersed throughout the cytoplasm, and Weibel-Palade bodies were absent. The vWf synthesized in the absence of microtubules contained significantly less large multimers than that produced by control cells. Since Weibel-Palade bodies specifically contain the large multimers, we hypothesize that the structural defect in vWf secreted by cells in the absence of microtubules is due to the lack of Weibel-Palade bodies in these cultures. PMID- 3305021 TI - Immunocytochemical localization of myosin during ciliogenesis of quail oviduct. AB - Myosin has been localized during ciliogenesis of quail oviduct by immunocytochemistry (immunofluorescence, immunoperoxidase, immunogold labeling) using a previously characterized monoclonal antibody. In ovariectomized quail oviduct many undifferentiated epithelial cells present a primary cilium arising from one of the diplosome centrioles. Myosin is associated with material located between the two centrioles. In contrast, in estrogen-stimulated quail oviduct, the material preceding the procentioles is never labeled. Basal bodies become labeled just before their migration toward the apical plasma membrane. During the anchoring phase, the labeling is mainly associated with the basal feet. In mature ciliated cells, myosin appears associated with an apical network embedding the basal bodies. This network is connected to a myosin-rich belt associated with the apical junctional complex which differentiates at the beginning of centriologenesis. The association of myosin with migrating basal bodies suggests that myosin could be involved in basal body movements. PMID- 3305022 TI - Surface proteins localized in ruffling membranes and filopodia of human glioma cells detected using Mab S-11E10. AB - We prepared mouse monoclonal antibody (Mab S-11E10) for the surface antigen specifically distributed in ruffling membranes and filopodia of cultured human glioma cells. The antibody reacted to the specified structures of other glioma cells (U251MG, KNS 60) as well as those of KNS 42 cells, which were the immunizing source. The antigens, identified by Mab S-11E10, had molecular weights of 65 and 66 kDa. Immunohistochemically, the antibody reacted only to astrocytes in the human brain, but the cross-reactivity was noted in extraneural tissues such as lymphocytes and epithelium of the bowel ducts. In 5 out of 6 low grade astrocytomas, most of the tumor cells were strongly stained, while tumor cells of highly cellular areas of anaplastic astrocytomas and glioblastomas were either not stained or only weakly stained. The specific localization of 65-66 kDa doublet proteins may suggest relation to spreading and locomotion of cells, and may correlate to astrocytic differentiation and/or function. PMID- 3305023 TI - Subcellular localization of the 84,000 dalton heat-shock protein in mouse neuroblastoma cells: evidence for a cytoplasmic and nuclear location. AB - Using affinity-purified antibodies, the 84,000 dalton heat-shock protein (hsp) has been localized in mouse N2A neuroblastoma cells by immunocytochemical techniques. Immunofluorescence microscopy showed that hsp84 was present both in the cytoplasm and in the nucleus. The nucleoli were found to be unlabelled. Immunogold labelling on ultrathin cryosections revealed that hsp84 was evenly distributed throughout the entire cytoplasm. No preferential association of hsp84 with the plasma membrane or with membranes from organelles was observed. In the nucleus the hsp84 was present in both the euchromatin and heterochromatin. In the nucleolus only the fibrillar part was labelled and virtually no gold particles were observed in the granular part. A long-term hyperthermic treatment of 3 h at 42.5 degrees C was found to induce an accumulation of hsp84 inside the nucleus. No alterations in hsp84 distribution were observed during a treatment of the cells with 75 microM sodium arsenite for 3 h. Drastic alterations were observed in the nucleoli after both stress treatments. The granular part had totally disappeared and only remnants of the fibrillar part which contained hsp84, were found. Besides the nuclear accumulations of hsp84 during heat shock, no additional changes in the hsp84 location in stressed cells were observed. During a recovery from the heat shock by replacing the cells at 37 degrees C, a decrease in the nuclear location of hsp84 was observed, indicating the reversibility of this process. The significance of these results for the role of hsp84 in normal and in stressed cells is discussed. PMID- 3305024 TI - Localization of viral-specific 21 kDa protein in nucleoli of herpes simplex infected cells. AB - Viral-encoded 21 kDa protein has been localized in herpes simplex virus type 1 (HSV-1) infected cells by immunocytochemical techniques using peroxidase and colloidal gold as markers. During early infection, 21 kDa protein was shown to be in cytoplasmic areas rich in ribosomes located near the nucleus and in the viral DNA-containing fibrillo-granular material of the virus-specific electron translucent region in the nucleus. Late in infection, an additional marked accumulation occurred in both fibrillar and granular components of the nucleolus. Host chromatin and the nuclear dense bodies remained unlabeled. No immunolabeling was obtained in the absence of DNA replication. In contrast, inhibition of RNA synthesis did not modify the distribution of the protein. On the other hand, persistence of cytoplasmic and nuclear immunolabeling following the inhibition of protein synthesis performed late in infection indicated that the distribution of 21 kDa protein represented, at least in part, sites of accumulation and retention of preexisting molecules. PMID- 3305025 TI - The identification of vimentin in human blood platelets. PMID- 3305026 TI - Endogenous polyamines are intimately associated with highly condensed chromatin in vivo. A fluorescence cytochemical and immunocytochemical study of spermine and spermidine during the cell cycle and in reactivated nuclei. AB - Polyamines are low molecular weight aliphatic polycations essential for cell proliferation and differentiation. By immunocytochemistry, as well as by two independent fluorescence cytochemical methods, we show that polyamines are associated with highly condensed chromatin in nucleated erythrocytes and in metaphase and anaphase chromosomes. In other cells, polyamines mainly occur in cytoplasm. The association between polyamines and DNA in condensed chromatin is so close that DNase treatment is necessary for making polyamines available for reaction with antibodies. Studies of chick/HeLa cell heterokaryons reveal that polyamines disappear from the chick erythrocyte nuclei concomitantly with DNA decondensation and initiation of RNA synthesis. Our data strongly suggest that polyamines are important for chromatin condensation in vivo. PMID- 3305027 TI - Investigations on circumferential microfilament bundles in rat retinal pigment epithelium. AB - The presence of contractile proteins in normal rat retinal pigment epithelium has been studied using fluorescence and electron microscopy. Investigations using the F-actin binding toxin, phallacidin, coupled to the fluorochrome nitrobenzoxadiazole, revealed a band of fluorescence at or near the cell membrane. Immunofluorescent observations with anti-myosin and anti-alpha-actinin antisera gave similar results. Electron microscopy employing glutaraldehyde-8% tannic acid fixation revealed the presence of a circumferential microfilament band beneath the pigment epithelial apical surface that is closely associated with the plasma membrane and junctional complexes. Freeze-fracture studies confirmed the relationship of this band to the junctional complexes. The microfilament band measures approximately 0.5 micron +/- 0.2 micron in width and is composed of numerous 6 to 7 nm filaments. Some microtubules are seen in regions around the band, but no organelles appear to be associated with this structure. In en face sections through the zonula adherens, the circumferential microfilament band is associated with 30-nm electron-dense particles that are bound to the internal side of the membrane. Morphological evidence suggests that these may serve in anchoring the band to the membrane and assist in aligning the microfilament bands of adjoining cells. In the subapical cytoplasm, a microfilament bundle network was detected that interfaced with the circumferential microfilament band. In some cases, pigment epithelium was incubated in media-199 containing 25 to 50 ng/ml phallacidin prior to fixation. Circumferential microfilament bands of tissues treated in this manner exhibited a striated appearance. PMID- 3305028 TI - Noninvasive assessment of pulmonary arterial hypertension in chronic lung disease: why and how? PMID- 3305029 TI - Abnormal myocardial texture demonstrated by ultrasound in two patients with idiopathic haemochromatosis. AB - We studied by cross-sectional echocardiography seven patients affected by idiopathic haemochromatosis without clinical signs of heart failure. In two patients the heart muscle showed a peculiar echocardiographic texture at the level of the endocardium. No differences were noticed in clinical and haematological findings of the patients with and without abnormal texture. Increased echogenicity of the subendocardial myocardium should be looked for in patients with idiopathic haemochromatosis. PMID- 3305030 TI - Tracers for aerosol ventilation scintigraphy: Tc-99m versus In-113m. AB - 113mIn has been proposed as a suitable tracer for aerosol ventilation scintigraphy in combination with 99mTc pulmonary perfusion scintigraphy. The high energy (393 keV) of 113mIn allows it to be detected in the presence of 99mTc, but degrades the spatial resolution which can be achieved. We have compared the resolution obtained with 99mTc and 113mIn in phantom experiments and in aerosol ventilation scans in 14 patients with airways disease. The resolution at the distances from the collimator encountered in lung scintigraphy was 10-20 mm for 99mTc and 15-40 mm for 113mIn. Aerosol ventilation images were abnormal in all patients. The 99mTc images showed peripheral defects and frequently central hot spots reflecting increased local aerosol deposition. In the 113mIn images, the lower resolution had a smoothing effect, the central hot spots were less striking, and the distribution of activity appeared more uniform, some detail was lost in the periphery. It is suggested that 113mIn is useful for ventilation scintigraphy in the diagnosis of pulmonary embolism, but that 99mTc is the tracer of choice if aerosol ventilation scintigraphy is used to study airways disease. PMID- 3305031 TI - Fetal sex and distribution of peri-intraventricular hemorrhage in preterm infants. AB - Peri-intraventricular hemorrhage (PIVH) is an important complication of the brain in immature newborn infants. In a real-time ultrasound study with frequent scanning of 78 preterm infants (50 with birth-weight less than 1,500 g and 28 weighing more than 1,500 g), we examined the influence of sex on the occurrence of PIVH. A significant difference between sexes was only found in the group with birth-weight below 1,500 g. PIVH occurred in 72% of male infants and in 28% of females (p less than 0.001). This effect is probably due to a difference in the timing of cerebral vascular maturation in males leading to a difference in the risk of developing PIVH between the sexes before 34 weeks of gestation. PMID- 3305032 TI - Serum creatine kinase B levels in diseases of the central nervous system. AB - The creatine kinase B (CK-B) subunit was determined by our own highly sensitive solid-phase direct immunoassay in three neurological diseases which represent models of central nervous system (CNS) involvement: idiopathic epilepsy (18 patients), a disease characterised by a transient neuronal hyperactivity; Parkinson's disease (17 patients), a degenerative disorder of the CNS, and multiple sclerosis (21 patients), which represents a model of demyelination of the CNS. A group of 50 controls was also studied. The results showed that in patients with epilepsy and multiple sclerosis the CK-B activity was considerably lower than in the controls (p less than 0.01 and p less than 0.005, respectively), while no differences were found between the controls and the patients with Parkinson's disease. It is suggested that the low CK-B activity observed might be due to the medication taken or to the disease process itself. The present findings have to be considered as an indication for further CK isoenzyme studies in systematic disorders of the nervous system. PMID- 3305033 TI - Monocyte-mediated immunosuppression in chronic multiple sclerosis: implications for therapy. AB - The goal of immunotherapy in multiple sclerosis (MS) is to halt disease progression by correcting an immunologic abnormality. The experiments described here sought an abnormality of immunoregulation. Specifically, the immunosuppressive activity of adherent monocytes in an in vitro assay of immunoglobulin-secreting cells was tested. Although the peak response was slightly lower, the induction, development and shutdown of the response by MS cells reproduced that of control cells. Most importantly, adherent monocytes from patients with MS exerted the same maximal suppression as did monocytes from controls. Further experiments are required to determine if the adherent monocyte is an appropriate target for immunotherapy in MS. PMID- 3305034 TI - Hemorheologic parameters in correlation to extracranial carotid artery disease in patients with acute cerebrovascular disorders. AB - In order to determine possible correlations to the extent of extracranial carotid artery disease (ECAD), the hemorheologic parameters (hematocrit, fibrinogen, whole blood and plasma viscosity, induced platelet aggregation) of 120 patients with acute cerebrovascular disorders (CVD) were studied and their carotid arteries were investigated by means of Duplex scanning. Plasma viscosity was only significantly elevated in CVD patients with severe ECAD (stenosis greater than 80% lumen reduction and/or occlusion) in comparison to CVD patients with normal to minimally diseased carotids and 67 normal controls. These results suggest that high plasma viscosity is an indicator for the existence of severe ECAD in CVD patients during the acute stage. PMID- 3305035 TI - Non-steroidal anti-inflammatory drugs and the classical arthritides: focus on five-years of piroxicam experience. AB - In recent years, we have seen immense progress in our understanding of rheumatic diseases. As we learn more about the pathogenetic mechanisms of disease, we can begin to classify the disorders more rationally. However, treatment lags behind understanding; we still direct our attention toward inflammation in a non specific manner. At the beginning of the century, aspirin became a widely used treatment for all forms of arthritis. By the early 1960s, phenylbutazone and then indomethacin were introduced, and later, ibuprofen, naproxen, sulindac, and a variety of other agents had become available. Within the last five years two new agents were introduced that were characterised by a once-a-day regimen. One piroxicam - worked by attacking the cyclooxygenase pathway. The other- benoxaprofen--inhibited both the cyclooxygenase and lipoxygenase pathways, but had to be withdrawn because it was toxic. Since piroxicam was introduced in 1980, eight nonsteroidal anti-inflammatory drugs (NSAIDs) have been withdrawn from the market in the United Kingdom. By contrast, piroxicam is now available in over 90 countries and has been used safely and successfully in millions of people of different ages and in different clinical settings. Short-term open studies, controlled studies, and more recent long-term studies lasting over periods of more than three years give further evidence of effectiveness and tolerance. PMID- 3305036 TI - Piroxicam in acute musculoskeletal disorders and sport injuries. AB - In two multicentre double-blind, parallel studies, piroxicam was found to be as well tolerated and significantly more effective than placebo in relieving moderate and severe pain, swelling, and limitation of movement resulting from acute musculoskeletal injuries. The efficacy and toleration of piroxicam were then compared with those of indomethacin and naproxen in two international multicentre double-blind trials involving 1,004 patients suffering from acute sprains or tendinitis resulting from sports injuries; a common study protocol was used in all centres. In all treatment groups, spontaneous pain, pain on movement, joint swelling, and tenderness were reduced significantly as early as three days after the start of treatment, and overall assessment of efficacy was excellent or good in more than 80% of patients. The study results indicated that the efficacy of all drugs was comparable, but analysis of side effects reports showed that piroxicam was significantly (p less than 0.005) better tolerated by the patients. PMID- 3305038 TI - Piroxicam: new dosage forms. AB - Patient acceptance of medications often depends upon individual and cultural preferences for particular dosage forms. A variety of dosage forms also provides the patient and the physician with greater convenience and flexibility. Thus, multiple formulations increase the clinical utility of a drug. In addition to the capsule, dosage forms of piroxicam now available or in an advanced stage of clinical development include a suppository, dispersible tablet, topical gel, and parenteral formulation. (Ed.: The parenteral and topical formulations were launched after the symposium was held, and are now available). The piroxicam suppository offers an alternative to the oral route of administration. Pharmacokinetic studies demonstrate that the 20-mg suppository is bioequivalent to the 20-mg capsule, and clinical studies have shown that it is equal to the capsule in efficacy and toleration. Piroxicam is the only non-steroidal anti inflammatory drug (NSAID) that is available as a dispersible tablet. This dosage form is also well tolerated by patients and equally effective as the capsule. Intramuscular administration of piroxicam is in development. All these dosage forms offer the convenience of once-a day administration. Piroxicam topical gel (0.5%) has been demonstrated to have anti-inflammatory activity in several animal models. In double-blind clinical trials involving patients with osteoarthritis of the knee, the topical gel was found to be significantly more effective than placebo and well tolerated. PMID- 3305039 TI - Postprandial changes in supine and erect heart rate, systemic blood pressure and plasma noradrenaline and renin activity in normal subjects. AB - The haemodynamic effects of a standard meal were assessed in a balanced cross over study in eight normal fasting subjects, investigated under conditions applicable to many drug tests. Both the supine and erect diastolic blood pressure were reduced on average by 10 mmHg over the 4 h following the meal. The supine systolic pressure was increased on average by 2 mmHg, a difference of no biological relevance. Erect systolic blood pressure was not affected by eating. Supine heart rate was slightly but significantly increased, but the erect heart rate did not change. Postprandial plasma renin activity was increased. Venous plasma noradrenaline levels in the supine position were not affected by eating and after standing erect, and immobile for 5 min they were only slightly and not significantly increased. A food-induced vasodepressor response combined with baroreceptor resetting is considered to have occurred in this population. The changes had a gradual onset, reaching their maximum about 2 h after eating and they were still evident after 3 h. Eating should be considered as an important potential source of bias in cardiovascular studies. PMID- 3305037 TI - Toleration and safety of piroxicam. AB - The purpose of this review is to define the toleration profile of piroxicam through the clinical experience gathered in 109,495 patients and to estimate how it compares with that of other commonly prescribed non-steroidal anti inflammatory drugs (NSAIDs) in 37 comparative clinical trials involving 3,580 patients. The estimated total exposure to piroxicam in clinical trials reported here is approximately 2.6 million patient days. The toleration profile of piroxicam is typical of an inhibitor of prostaglandins, with a relatively low reported incidence of adverse events necessitating discontinuation of therapy. Pharmacokinetics are not age- or sex-dependent, and - with the exception of oedema - the incidence of adverse events does not increase with age. Piroxicam exhibits better toleration than indomethacin (75 to 150 mg daily), naproxen (1,000 mg daily), and enteric coated acetylsalicylic acid (3.5 to 5 g daily), and is as well tolerated as diclofenac (75 to 150 mg daily), naproxen (500 to 750 mg daily), and ibuprofen (2.4 g daily). Piroxicam has the advantage that once-daily dosage is sufficient to provide efficacy equal to or better than these comparative agents. PMID- 3305040 TI - Effect of sparteine sulphate upon basal and nutrient-induced insulin and glucagon secretion in normal man. AB - Infusion of a therapeutic dose of sparteine sulphate, increased the basal plasma insulin level and lowered plasma glucose. When an intravenous glucose tolerance test was performed with the infusion, the total insulin AUC was significantly larger than in absence of sparteine (2025 vs 1464 microU/ml X min), plasma glucose levels were lower and improved glucose utilization was observed (kg:1.55 vs 1.39%). In the presence of arginine, sparteine sulphate stimulated both beta and alpha cells, increasing both the total insulin (1907 vs 1516 microU/ml X min p less than 0.02) and total glucagon AUCs (7616 +/- 654 vs 6789 +/- 707 pg/ml X min p less than 0.01). Thus, sparteine sulphate increased both basal and nutrient induced insulin and glucagon secretion in normal man. PMID- 3305041 TI - Interleukin-HP1-related hybridoma and plasmacytoma growth factors induced by lipopolysaccharide in vivo. AB - Serum of lipopolysaccharide (LPS)-treated mice was found to support the growth of interleukin-HP1 (HP1)-dependent hybridoma and plasmacytoma cell lines. This growth-promoting activity, which was undetectable in normal serum, rose more than 1000-fold within 2 h after i.v. injection of the toxin and disappeared in less than 1 day. It could be traced to a single component, which behaved like HP1 in sodium dodecyl sulfate-polyacrylamide gel electrophoresis and reverse phase high performance liquid chromatography, and was completely inhibited by a rabbit anti HP1 antiserum. The LPS-induced factor was apparently not of T cell origin, as indicated by the strong activity found in the serum of LPS-treated nude mice. In vitro, LPS also considerably enhanced the production by macrophages of a factor with similar characteristics. PMID- 3305042 TI - Stimulation of adenylate cyclase activity via A2-adenosine receptors in isolated tubules of the rabbit renal cortex. AB - Adenylate cyclase activity in a tubular fraction obtained from rabbit renal cortex was stimulated by typical adenosine receptor agonists with a rank order of potency NECA (5'-(N-ethyl-carboxamido)-adenosine) (EC50 = 0.48 mumol/l) greater than R-PIA [(-)N6 (R-phenylisopropyl)-adenosine] (3.22 mumol/l). The stimulatory effect of NECA was competitively antagonized by 8-phenyltheophylline. Contamination of the tubular fraction with glomeruli and microvessels was less than 2%, as verified by tissue renin determination and could, therefore, be ruled out as being responsible for the observed effect. Tubular A2-adenosine receptors are probably involved in the control of renal electrolyte secretion and may represent the site of action of methylxanthines. PMID- 3305043 TI - Exaggerated pressor response to centrally administered renin in freely moving, spontaneously hypertensive rats. AB - The cardiovascular responses to intracerebroventricular (i.c.v.) injection of renin were compared between freely moving normotensive Wistar Kyoto rats (WKY) and spontaneously hypertensive rats (SHR). The i.c.v. injection of renin (0.05 1.0 mU) produced a dose-dependent and a long-lasting rise in mean blood pressure associated with variable changes in heart rate (HR) in both WKY and SHR. However, the blood pressure and HR were not affected by intravenously injected renin (0.1 mU). The pressor response to i.c.v. injected renin was greater in SHR than in WKY, the dose-response curve for renin in SHR being to the left of that in WKY. Central (i.c.v.) pretreatment with [Sar1, Ile8]angiotensin II (50 micrograms) largely abolished the pressor response to i.c.v. injected renin in both WKY and SHR. The i.c.v. injection of angiotensin II (ANG II) (10-100 ng) induced a dose dependent pressor response which was antagonized by central pretreatment with [Sar1, Ile8]ANG II (50 micrograms). The pressor response to ANG II was also greater in SHR than in WKY. These results suggest that the pressor response to centrally administered renin as well as to ANG II, which is mediated via ANG II receptors located in the brain, is enhanced in SHR. PMID- 3305044 TI - The CDC8 transcript is cell cycle regulated in yeast and is expressed coordinately with CDC9 and CDC21 at a point preceding histone transcription. AB - Using cultures synchronized by elutriator size selection or a feed-starve protocol, we have shown that the CDC8 gene is periodically expressed in the Saccharomyces cerevisiae cell cycle. The transcript level increases some 30-fold in late G1, reaching a peak at approximately the G1/S phase boundary. The timing of this event was compared with those of CDC9 and CDC21, which are already known to be periodically transcribed, and all three genes were found to be expressed at the same time in the cell cycle. In contrast, the histone H2A gene appeared to be expressed distinctly later in the cell cycle than these three genes and this was further investigated by examining expression of all four genes in a cdc4 mutant, held at the restrictive temperature. CDC8, CDC9, and CDC21 were once again expressed together and a complete fluctuation in levels occurred, whereas the histone gene was not expressed, presumably because the cdc4 block point precedes the point of histone expression. The three CDC genes may therefore be coordinately controlled, while the histone gene is regulated separately. PMID- 3305045 TI - Immunocytochemical demonstration of kinetochores in human sperm heads. AB - CREST sera have been used to identify kinetochores in mature mammalian sperm heads. It is necessary to decondense the sperm heads artificially to permit access of the reagents before the kinetochores can be demonstrated immunocytochemically. The distribution of kinetochores in the sperm heads appears to be random. These results show that the kinetochore antigen recognized by the CREST sera used here is retained during spermiogenesis and is passed on to the zygote at fertilization. PMID- 3305047 TI - Immunoelectronmicroscopic localization of extracellular matrix components produced by bovine corneal endothelial cells in vitro. AB - Bovine corneal endothelial cells deposit an extracellular matrix in short-term cultures, which contains various morphologically distinct structures when analysed by electron microscopy after negative staining. Amongst these were long spacing fibers with a 150 nm periodicity, which appeared also to be assembled into more complex hexagonal lattices. Another structure was fine filaments, 10-40 nm in diameter, which occasionally exhibited 67 nm periodic cross-striation. Non striated 10-20 nm filaments sometimes formed radially oriented bundles arranged in networks and fuzzy granular material was associated with the filaments in the bundles. Often, these bundles extended into solitary filaments, 10-20 nm in diameter, with a smooth surface. In addition, amorphous patches were seen, which contained dense aggregates of fibrillar and granular material. In longer-term cultures, some of the structures coalesced to form large fibrillar bundles. By using specific antibodies to various extracellular matrix components and immunolabeling with gold some of these structures could be identified as to their protein composition. Whereas fibronectin antibodies labeled a variety of structures--fine filaments with granular materials, radially oriented bundles, patchy amorphous aggregates and small granular material scattered throughout the background--type III collagen antibody predominantly labeled filaments with periodic banding (10-40 nm in diameter). A small amount of type III specific labeling was also observed over the networks of radially oriented fibrils and fine filaments associated with granular material. Type IV collagen and laminin antibodies localized in areas of the patchy amorphous aggregates. Type VI collagen antibodies, on the other hand, labeled fine filaments and the gold particles showed a pattern of 100 nm periodicity. Many of the fine 10-20 nm filaments exhibited a tubular appearance on cross-section, but they were not reactive with any of the antibodies used. Also negative were the long-spacing fibers and assemblies--including hexagonal lattices--containing this structural element. PMID- 3305046 TI - Regulation of growth of cultured hepatic epithelial cells by transferrin. AB - Late-passage cells of a nontumorigenic and anchorage-dependent hepatic epithelial line (WB-F344), which produce insulinlike growth factor II and transforming growth factor beta constitutively, grow in serum-free medium supplemented only with transferrin. In the presence of transferrin, epidermal growth factor further augments population growth, although epidermal growth factor alone is without effect. Insulin, platelet-derived growth factor, and several inorganic iron salts are also ineffective in supporting cell growth in the absence of transferrin; furthermore, these factors do not augment the action of transferrin. The population growth-promoting effect of transferrin occurs at concentrations of 0.5 nM or greater and the maximal effect is reached with a concentration of approximately 6 nM. A lipophilic iron chelator, ferric pyridoxal isonicotinoyl hydrazone (FePIH), can fully mimic the effect of transferrin on the proliferation of WB-F344 cells, but the molar concentration of transferrin. These results suggest that the critical function of transferrin in the proliferation of WB-F344 cells may be in the delivery of iron to the cells. In the absence of transferrin the proliferation of WB-F344 cells is arrested in serum-free medium in the G0/G1 phase, and a period of protein synthesis after the addition of transferrin is necessary before the cells can proceed to S phase and initiate DNA synthesis. Replacement of transferrin causes quiescent WB-F344 cells to cycle parasynchronously. Epidermal growth factor does not alter the length of the latency period prior to S phase but appears to stimulate the uptake of [3H]thymidine subsequently. Transferrin may act as a "competence" and/or "progression" factor, allowing the replication of these epithelial cell in vitro. PMID- 3305048 TI - A novel fibrillar structure in cultured cells detected by a monoclonal antibody. AB - Using a monoclonal antibody, we have detected an antigen present in a unique fibrillar structure in the cytoplasm of cultured cells by immunofluorescence. These structures have been identified by transmission electron microscopy and ultrastructural immunocytochemistry as large single paracrystalline arrays of individual filaments morphologically similar to intermediate filaments. The antibody detects these structures in fibroblastic and epithelioid cultured cell lines of mouse, rat, bovine, and human origin but not of avian origin. Only a small percentage of the cells in a culture contains these structures; each cell usually contains only one, although two or more have been observed in a single cell. The structures are elongated vermiform arrays of filaments in the cytoplasm (approximately 0.5 X 3 microns) which have a thread-like or toroidal appearance. Because of this shape, we have named the putative antigen recognized by this antibody "nematin." Double-label experiments showed that these structures had no relationship to tubulin or vimentin. Immunocytochemical localization in human tissues revealed a high concentration of a reactive antigen in the stratum granulosum of skin and in what probably are neuroglial cells in the central nervous system. This monoclonal antibody may detect a novel intermediate filament protein and/or a shared determinant of different intermediate filament proteins. PMID- 3305049 TI - Heat shock gene expression and cytoskeletal alterations in mouse neuroblastoma cells. AB - The cytoskeleton of neuroblastoma cells, clone Neuro 2A, is altered by two stress conditions: heat shock and arsenite treatment. Microtubules are reorganized, intermediate filaments are aggregated around the nucleus, and the number of stress fibers is reduced. Since both stress modalities induce similar cytoskeletal alterations, no thermic denaturation of one or more cytoskeletal components can be involved in this process. Heat shock proteins are induced both by heat and by arsenite. However, cells treated with arsenite synthesize hsp28 which is not detected in heat-treated cells. Synthesis of all hsps is prevented by addition of actinomycin D or cycloheximide. Under these conditions no alterations are observed in the organization of microtubules and intermediate filaments during heat or arsenite treatment. However, these drugs are not able to prevent the rapid loss of stress fibers. A re-formation of the cytoskeleton during the recovery period proceeds within 3 h and is also found to occur in the presence of a protein synthesis inhibitor. These data suggest that reorganization of microtubules and intermediate filaments during a stress treatment requires the synthesis of a new protein(s), probably hsp(s). PMID- 3305050 TI - Effect of tunicamycin on cell cycle progression in budding yeast. AB - Tunicamycin, an inhibitor of one of the earliest steps in the synthesis of N linked oligosaccharides, prevents bud formation and growth in Saccharomyces cerevisiae cells that are either growing exponentially or recovering from different cell cycle arrests at start. Analysis of tunicamycin-treated cells by flow microfluorometry clearly shows that cells have a postsynthetic DNA content, but there is no evidence of an increase in binucleate cells. Therefore tunicamycin affects bud emergence and initiation of DNA synthesis, two events correlated under physiological conditions, in different ways. A bulk glycoprotein synthesis is shown to be required for bud emergence and localized chitin deposition, probably to sustain directional secretory vesicle transport, which allows polar growth of the bud. No evidence for a glycoprotein requirement for entrance into the S phase is obtained from the present experiments. PMID- 3305051 TI - Comparison of major cytoskeletons among normal human fibroblasts, immortal human fibroblasts transformed by exposure to Co-60 gamma rays, and the latter cells made tumorigenic by treatment with Harvey murine sarcoma virus. AB - Immortally transformed human fibroblasts in general acquire an epithelial shape, while normal human fibroblasts demonstrate a spindle-shaped feature. In order to investigate this difference, three types of major cytoskeletal elements, namely, F-actin, tubulin, and vimentin of immortal human fibroblasts were morphologically compared with those of normal human fibroblasts. As a result, a significant difference was observed in the distribution and in the number of F-actin fibers between immortal and normal fibroblasts. The cells of three immortally transformed fibroblast lines, KMST-6, WI-38 VA-13, and SUSM-1, showed a striking reduction in the number, and an altered pattern of organization, of actin fibers. On the other hand, in the normal fibroblasts, actin fibers ran parallel to each other along the long axis of the cells. Tubulin and vimentin showed no significant difference between the immortal and normal cells. Our present data show that the morphological changes seen in the immortally transformed cells are due to the disorganization and the decrease in number of actin fibers. Interestingly, both the immortal cells (KMST-6), which were not tumorigenic, and the Harvey murine sarcoma virus-transformed KMST-6 cells, which were tumorigenic and demonstrated an enhanced expression of the ras gene, revealed an overall similarity in the organization pattern and the number of actin fibers. These findings seem to indicate that the immortally transformed cells have already acquired some cancer characteristics. PMID- 3305052 TI - Erythroid differentiation of K562 cells: mixed colonies as an index of delayed expression of commitment. AB - K562 cells demonstrate commitment, defined as the clonal expression of a differentiated phenotype coupled with a limitation in proliferation. Upon exposure to certain agents, K562 cells are induced to synthesize hemoglobin, detectable by benzidine staining. If plated in semisolid medium, they produce benzidine-positive colonies, benzidine-negative colonies, and mixed colonies, the latter containing both positive and negative cells. To test whether or not mixed colonies represent a delay in the expression of commitment, we conducted two types of experiments. The first type showed that, following inducer removal, a delay in plating causes not only a decline in the number of mixed colonies, but also a rise in the proportion of negative colonies, with no change in the proportion of positive colonies. To explain this result, we propose that a plating delay can conceal a negative cell producing a positive cell if that cell division has occurred before plating. Instead of one mixed colony, one observes one positive colony and one other colony, either negative or mixed (depending on subsequent negative-to-positive events). Thus delay does not change the proportion of positive colonies, presumably because they breed true. But delay causes an increase in negative colonies to balance the decrease in mixed colonies due to concealment of negative-to-positive events and provides evidence that the converse, positive-to-negative events, do not occur. The second type of experiment utilized cordycepin, which inhibits commitment. We predicted that, if mixed colonies represent a delay in the expression of commitment, the addition of cordycepin to cells already exposed to thymidine should increase the percentage of mixed colonies. We found that cordycepin does indeed preferentially increase the proportion of mixed colonies. These two types of experiments provide evidence that mixed colonies represent a delay in expression of commitment. Such an inducible system, in which the commitment event and its expression can be separated in time by a generation or more, may provide an opportunity to more fully characterize the commitment process. PMID- 3305053 TI - Binding of erythropoietin to CFU-E derived from fetal mouse liver cells. AB - The binding of recombinant erythropoietin (EPO) to fetal mouse liver cells (FMLC) was investigated using a radioiodinated derivative which retained full biological activity. FMLC were fractionated using a preformed Percoll density gradient. Using the fractionated FMLC, the ability to form CFU-E colonies in a semisolid culture was examined, and the binding of [125I]EPO was measured. The highest specific binding of [125I]EPO was observed in a fraction with a density between 1.062 and 1.076 g/ml. The same fraction showed the highest ability to form CFU-E derived colonies. After suspension culture of FMLC with EPO for 2 days, differentiated erythroid cells with higher density markedly increased. The specific binding of [125I]EPO to these cells almost disappeared with differentiation. Scatchard analysis with cells of the CFU-E-enriched fraction showed a nonlinear curve, suggesting the existence of two classes of binding sites. One binding site was high-affinity (Kd1 = 0.41 nM), and the other low affinity (Kd2 = 3.13 nM). These results suggest that the expression of EPO receptors on the erythroid cells is highest in CFU-E. PMID- 3305054 TI - Detection of murine hemopoietin-1 in media conditioned by EMT6 cells. AB - We have previously reported replating experiments which demonstrated the existence of subpopulations of murine high-proliferative-potential colony-forming cells (HPP-CFC). One population of HPP-CFC, termed HPP-CFC-1, is stimulated by the combination of macrophage colony-stimulating factor (CSF-1) plus hemopoietin 1 (H-1), and actively generate a second population of HPP-CFC, termed HPP-CFC-2, which is responsive to CSF-1 plus interleukin-3 (IL-3). These reclonal experiments represent an assay system that discriminates between the two types of synergistic factors, namely H-1 and IL-3. To date H-1 has only been detected in medium conditioned by human cells. In this paper we have utilized these recloning experiments to study the synergistic factor(s) present in media conditioned by the murine mammary carcinoma cell line EMT6. Colony formation in secondary cultures containing cells picked up from primary cultures incubated in CSF-1 plus EMT6-conditioned medium was identical to that seen in secondary cultures containing cells picked up from primary cultures incubated in CSF-1 plus a source of H-1. Both sets of cultures demonstrated the generation of HPP-CFC-2 in the primary cultures, indicating the presence of a molecule in EMT6-conditioned medium that is the murine equivalent of H-1. PMID- 3305055 TI - In vivo radiosensitivity and recovery pattern of the hematopoietic precursor cells and stem cells in mouse bone marrow. AB - Survival curves were determined for colony-forming hematopoietic stem cells (CFU Mix and CFU-S10) as well as precursor cells (CFU-E, CFU-C, CFU-F, and BFU-E) in bone marrow of the mouse at various times up to 4 weeks after whole-body irradiation (1.5 or 3.0 Gy) in order to elucidate in vivo radiosensitivity and recovery patterns. These measurements represented the first attempts to examine CFU-Mix simultaneously with the other cell populations. CFU-E (D0 = 53 rad) and BFU-E (D0 = 68 rad) were the most radiosensitive. CFU-S10 (D0 = 81 rad) had intermediate radiosensitivity. CFU-Mix (D0 = 144 rad) and CFU-C (D0 = 157 rad) were relatively radioresistant. CFU-F (D0 = 257 rad) was the most radioresistant. The precursor and stem cells could be classified into three groups based on the recovery pattern. The first group, consisting of CFU-Mix, BFU-E, and CFU-S10, showed very slow recovery and did not reach normal levels even after day 28. CFU E, the second group, showed the most severe depletion immediately after irradiation, and recovered most quickly with an overshoot at day 5. CFU-C and CFU F cells, forming the third group, decreased more gradually and slightly, and recovered to the normal level after a transient rise by day 10-14. PMID- 3305056 TI - Cloning of murine megakaryocyte progenitor cells in a fibrin clot culture system. AB - A fibrin clot culture system was applied to the cloning of mouse megakaryocyte colony-forming cells (CFU-Meg). The culture medium in this new method consists of Iscove's minimal essential medium containing fetal bovine serum, bovine fibrinogen, bovine thrombin, and pokeweed mitogen-stimulated mouse spleen cell conditioned medium (PWM-SCM). CFU-Meg colony frequency with 10% PWM-SCM was maximal on days 5-6 of culture. Plating efficiencies averaged 36.1 +/- 3.9 and 51.9 +/- 6.0 per 1.5 X 10(5) BDF1 bone marrow cells and 1.0 X 10(6) spleen cells, respectively. The addition of bovine serum albumin to the culture medium had no effect on the efficiency of megakaryocyte colony growth in this culture system. This simplified and reproducible culture system supported not only the growth of colonies composed of megakaryocytes in "synchronous maturation," but also so called "heterogenous" megakaryocyte colonies composed of cells in all stages of maturation. PMID- 3305057 TI - No influence of acetylcysteine on gas exchange and spirometry in chronic asthma. AB - Non-smoking patients (n:25) with stable symptomatic asthma were investigated with regard to the pulmonary effects of N-acetylcysteine (NAC), peroral dose 200 mg three times daily, in a crossover double-blind study. They were studied once a week for 9 weeks, with a run-in period and periods with NAC and placebo (3 weeks each). Functional residual capacity and specific airway resistance were 19 and 53% larger, respectively, and forced expiratory variables (FEV%, MEF25) were 20 and 53% lower than reference values. Distribution of ventilation-perfusion ratios (VA/Q), assessed by multiple inert gas elimination technique with peripheral venous sampling, was abnormal, although arterial PO2 and PCO2 were within normal limits. NAC medication had no effect on any spirometric, lung mechanic or gas exchange variable, nor on the frequency of pulmonary symptoms. PMID- 3305058 TI - LHRH messenger RNA in neurons in the intact and castrate male rat forebrain, studied by in situ hybridization. AB - The purpose of the present study was to localize luteinizing hormone-releasing hormone (LHRH) mRNA within the male rat forebrain using an in situ hybridization approach. The expression of LHRH mRNA was compared in castrate and intact males to approach questions on the chronic influences of circulating testicular steroids on the gene expression of the peptide. Frozen 10 micron sections fixed in paraformaldehyde were obtained from the forebrain region of intact and 2 week post-castrate adult male rats. LHRH mRNA was autoradiographically detected using an oligomer (59mer) complementary to the mRNA coding for amino acids -5 to 15 of the human LHRH preprohormone. Individual brain sections were incubated in prehybridization buffer for 2 h to reduce nonspecific binding. Following this, 20 microliter of hybridization buffer containing 65,000-120,000 cpm of the 59mer were applied to sections and hybridized at 37 degrees C for 3 days. The sections were then rinsed over a 48 h period, dehydrated, dipped in Kodak NTB2 liquid emulsion and exposed for 22 days. Autoradiograms were developed and counterstained with fast green and cresyl violet. As reported in the female, LHRH message-containing cells were localized in ventral septal regions, the diagonal bands of Broca, preoptic area and anterior hypothalamus. On occasion, LHRH gene expressing cells were found to appear in loose clusters. Labeled cells were never found in control sections treated with hybridization buffer lacking the 59mer. The total number of LHRH mRNA-containing cells localized in intact rats did not differ significantly from the castrate group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305061 TI - Immunohistochemical localization of monoamine oxidase-B in the cat brain: clues to understanding N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) toxicity. AB - The immunohistochemical localization of monoamine oxidase-B in normal cat brain was examined. The enzyme was localized in both neural and nonneural elements of the cat brain. Neurons in the hypothalamus (lateral, dorsal, ventromedial, dorsomedial, and supraoptic nuclei), raphe system, dorsal tegmental nucleus, locus ceruleus, Kolliker-Fuse nucleus, dorsal parabrachial region, and central tegmental field were positive. No substantia nigra pars compacta, retrorubral, or ventral tegmental neurons stained positively. Glial cells (astrocytes) stained positively for monoamine oxidase-B in many regions of the central nervous system, however, there was a significantly greater number of monoamine oxidase-B-positive glial cells in the substantia nigra pars compacta than in other adjacent dopaminergic regions. Because nigra compacta neurons are specifically damaged by the neurotoxin MPTP and because the toxicity of the drug is expressed only in the presence of monoamine oxidase-B, it is possible that the preferential loss of substantia nigra pars compacta neurons in the cat brain may be related to the regional and cellular localization of monoamine oxidase-B. PMID- 3305060 TI - Electrophysiological characterization of the pineal gland of golden hamsters. AB - In one of the most-widely used species in pineal gland research, the strongly photoperiodic golden hamster, Mesocricetus auratus, no electrophysiological data on pinealocytes are currently available. To fill this gap, in the present study 185 spontaneously active pinealocytes from male golden hamsters were recorded extracellularly, both during day- and night-time (light: dark cycle 12: 12, lights on at 07.00 h). As in other species, pinealocytes exhibited action potentials of 1-2 ms duration. An irregular firing pattern was observed in 95% of the pinealocytes, the remainder fired more regularly or showed a phasic discharge pattern. The firing frequencies ranged from 0.2 to 25 Hz and showed clear time dependent differences. From 07.00 h to 22.00 h the mean firing frequencies were identical, i.e. in the range of 2 Hz; between 22.00 h and 01.00 h mean discharge rate increased to 5 Hz and exhibited a peak of 7 Hz between 01.00 h and 04.00 h, followed by a decrease to 4 Hz between 04.00 h and 07.00 h. Electrical stimulation of the superior cervical ganglion during day-time resulted in an augmentation of firing frequency in some pinealocytes and a decrease in others; during night-time, inhibitory responses only were observed. Photic stimulation, or electrical stimulation of either the optic chiasm or the habenular nuclei mostly decreased the firing rate of pinealocytes. Compared to other mammalian species, the electrophysiological properties of golden hamster pinealocytes appear to be basically similar. PMID- 3305062 TI - Cardiovascular lesions in experimental acute and chronic renal failure in the rat. AB - Adult Wistar rats were subjected to partial or total nephrectomy or injected with mercuric chloride to induce a state of acute or chronic renal failure. They developed sequential pathological changes in the cardiovascular system characterized by fibrin deposition in the pericardium and fibrinoid changes in many systemic arteries and arterioles. Focal myocardial necrosis and interstitial fibrosis were a feature of long term chronic renal failure. Increased vascular permeability was evident in the pericardium of rats with chronic renal failure especially when autologous blood was also injected into the pericardial sac of previously nephrectomized rats. PMID- 3305059 TI - Human fetal tissues grafted to rodent hosts: structural and functional observations of brain, adrenal and heart tissues in oculo. AB - The potential for growth and development of human tissue grafts was explored by transplantation to the anterior chamber of the eye of rats and mice. Tissues were obtained from therapeutic abortions, performed in the eighth to twelfth week of gestation, using a slight modification of routine vacuum aspirations. Recipients were either adult rats immunosuppressed with cyclosporin A and protected with antibiotics, or nude immunodeficient Balb C mice. Catecholamine-rich tissues such as chromaffin cells from the adrenal medulla, sympathetic ganglia, central dopamine neuroblasts from the substantia nigra, and noradrenaline neuroblasts from the locus coeruleus all survived grafting, and in many cases formed nerve fibers that invaded the host iris. Similarly, central serotonin neurons from developing raphe nuclei grafts were able to innervate host irides. Human fetal cerebellar and cerebral cortical transplants continued their development in rat host eyes. Extracellular recordings from such cerebellar and cortical grafts revealed spontaneously active cells with immature action potential waveforms. Spinal cord grafts also survived and contained substance P-immunoreactive neurons. Dorsal root ganglia were able to form nerve fibers invading the host iris, as evidenced by neurofilament immunohistochemistry. Heart tissue survived and manifested spontaneous rhythmic contractions in oculo. Both human cortex cerebri and heart tissue grafts became innervated by sympathetic adrenergic nerve fibers from the rat host iris. Thus both graft-to-host and host-to-graft neuronal connections may be established between man and rat. Taken together, these data suggest that transplantation of human fetal nervous tissues to the anterior chamber of immunosuppressed or immunodeficient rodent hosts yields a unique model system for studies of human brain development, developmental disturbances, connectivity, and the action of drugs. PMID- 3305064 TI - Protective effect of vitamins against trichothecene toxicity towards Saccharomyces cerevisiae. AB - Several trichothecene mycotoxins were shown to inhibit the growth of Saccharomyces cerevisiae. This effect was most pronounced with the macrocyclic trichothecenes, especially verrucarin A. Much less growth inhibition was observed with T-2 toxin. Verrucarol, diacetoxyscirpenol, acetyl T-2 toxin, HT-2 toxin, T-2 tetraol and neosolaniol were inactive at a concentration of 75 micrograms of toxin per disc. Incubation of S. cerevisiae with verrucarin A together with vitamins resulted in a decrease in toxicity. Pyridoxine-HCl, Ca-pantothenate, thiamine-HCl and alpha-tocopheryl acetate were amongst the most potent of the vitamins tested which reversed growth inhibition, overcoming the inhibitory potential of the toxins. PMID- 3305065 TI - Occurrence of thiaminase II in Saccharomyces cerevisiae. AB - It was found that cell-free extracts of Saccharomyces cerevisiae contain thiaminase II which hydrolyzes thiamine and thiamine analogs. The possible involvement of this enzyme and thiamine-synthesizing enzymes in thiamine production from thiamine antagonists is discussed. PMID- 3305063 TI - Amoeboid movement: a review and proposal of a 'membrane ratchet' model. AB - Diverse cell types, including Amoebae, leukocytes, embryonic cells and tumour cells move about on solid surfaces to accomplish such activities as feeding, bacterial destruction, embryological development and metastasis. Theories of the mechanism of this movement are reviewed and a model is proposed which invokes the existence of specific, laterally mobile, transmembranous structures in the cell membrane, which are reversibly adhesive for both the contractile apparatus of the cell internally, and the substratum externally. By this model, the movement of all these cell types can be explained. PMID- 3305066 TI - Reversible reduction in bone blood flow in streptozotocin-diabetic rats. AB - Tibial growth and blood flow were both found to be markedly reduced in anaesthetised streptozotocin-diabetic rats compared to controls. Insulin treatment restored tibial growth to approximately control values and increased tibial blood flow to above control values. The observations are likely to be related to reduced bone turnover in uncontrolled diabetes. PMID- 3305067 TI - Decidua and the control of corpus luteum function, follicular development and pituitary LHRH-responsiveness in pseudopregnant and pregnant rats. AB - The mid-pregnancy rescue of corpora lutea can be mimicked in the pseudopregnant rat by induction of decidual tissue in the uterus: in such rats, around day 10, there is neither luteolysis, nor resumption of follicle-development or increase of the pituitary responsiveness to LHRH. The results suggest that the mid pregnancy rescue of corpora lutea is caused by a maternal factor. PMID- 3305068 TI - Cyclosporine resistant effector cells in rabbit skin allografts. AB - Histoincompatible skin grafts in rabbits treated with cyclosporine can permanently engraft but show a transient mononuclear cellular infiltrate. This transient cyclosporine-resistant infiltrate consists of cells which are sensitive to steroids, radiation and cryopreservation. They have the same ACM-1 phenotype and the same characteristics as cyclosporine-sensitive cells. PMID- 3305069 TI - Multiple organ-reactivity of monoclonal autoantibodies to mouse erythrocytes. AB - Autoantibodies reacting with bromelain-treated autologous mouse red blood cells (Br-MRBC) are spontaneously produced by normal mice. In order to understand the biological significance of these autoantibodies, anti-Br-MRBC monoclonal autoantibodies have been prepared and studied for reactivity with a panel of frozen tissue sections from organs of normal mice by direct immunofluorescence. It has been found that the anti-Br-MRBC monoclonal autoantibodies are polyspecific, since they react with cells in multiple organs. PMID- 3305070 TI - Risking the future: a symposium on the National Academy of Sciences report on teenage pregnancy. PMID- 3305071 TI - Families and the origins of child behavior problems. AB - This article reviews recent research into the relationship between family variables and child behavior. Although a diversity of factors may be associated with the development and maintenance of conduct/oppositional disorders in children, of primary importance are the moment-to-moment interactions that the child has with his or her primary caregivers. These are often marked by coercive, aggressive behaviors that may be functional for parents and children within the family system. However, the likelihood that parents will engage in coercive interactions with the child is also related to the latter's personal adjustment, which, in turn, is often dependent upon the parents' perceptions of the quality of marital and social support available to them. The goal for clinicians working with families of oppositional/conduct-disordered children is to retain the demonstrated efficacy of direct intervention into parent-child interactions while developing methods of assessment and treatment that attend to broader family variables, for example, marital disorder, interfering in-laws, and social isolation that may be functionally related to the occurrence of coercive parent child interactions. PMID- 3305072 TI - Two additional bacteriophage-associated glycan hydrolases cleaving ketosidic bonds of 3-deoxy-D-manno-octulosonic acid in capsular polysaccharides of Escherichia coli. AB - Two bacteriophages degrading 3-deoxy-D-manno-2-octulosonic acid-(KDO)-containing capsules of Escherichia coli strains were identified. Using modifications of the thiobarbituric acid assay, it was shown that each phage contains a glycan hydrolase activity cleaving one type of ketosidic linkage of KDO. Thus, the enzyme from phage phi 95 catalyzes the hydrolysis of beta-octulofuranosidonic linkages of the K95 glycan; and phi 1092, the alpha-octulopyranosidonic linkages of the K? antigen of E. coli LP1092. No cross-reactivity of the phage enzymes with other KDO-containing capsular polysaccharides was observed. PMID- 3305073 TI - Evolution of an inducible penicillin-target protein in methicillin-resistant Staphylococcus aureus by gene fusion. AB - A new beta-lactam-inducible penicillin-binding protein (PBP) that has extremely low affinity to penicillin and most other beta-lactam antibiotics has been widely found in highly beta-lactam(methicillin)-resistant Staphylococcus aureus (MRSA). The gene for this protein was sequenced and the nucleotide sequence in its promoter and close upstream area was found to show close similarity with that of staphylococcal penicillinase, while the amino acid sequence over a wide range of the molecule was found to be similar to those of two PBPs of Escherichia coli, the shape-determining protein (PBP 2) and septum-forming one (PBP 3). Probably the MRSA PBP (Mr 76462) evolved by recombination of two genes: an inducible type I penicillinase gene and a PBP gene of a bacterium, causing the formation of a beta-lactam-inducible MRSA PBP. PMID- 3305074 TI - Repressor gene, blaI, for Bacillus licheniformis 749 beta-lactamase. AB - The repressor gene, blaI, for the beta-lactamase of Bacillus licheniformis 749 was functional when cloned in Escherichia coli, but addition of a beta-lactam did not lead to induction. One plasmid contained fragments from the inducible strain (source of repressor), the other carried fragments from the blaI- mutant 749/C (target). blaI lies just 5' to the promoter for the structural gene, blaP, and the target is the promoter region between the two genes. Interaction with both promoters seemed necessary for full repression. BlaI is a hydrophilic protein (Mr 15036) with the some structural similarities to repressors from Gram-negative bacteria. PMID- 3305075 TI - Recombinant human B cell stimulatory factor 2 (BSF-2/IFN-beta 2) regulates beta fibrinogen and albumin mRNA levels in Fao-9 cells. AB - Conditioned medium from human monocytes contains a partially characterized hepatocyte-stimulating factor that simultaneously elevates the mRNA levels of the acute-phase protein beta-fibrinogen and decreases albumin mRNA in rat hepatoma cells. We demonstrate that recombinant human B-cell stimulatory factor 2, which is identical to interferon-beta 2/26 kDa protein and interleukin-HP1, exhibits the same activity as hepatocyte-stimulating factor. Furthermore, a specific antibody against B-cell stimulatory factor 2 was able to inhibit hepatocyte stimulating factor in conditioned medium from human monocytes. Our data show that hepatocyte-stimulating factor and B-cell stimulatory factor 2 are functionally and immunologically related proteins. PMID- 3305076 TI - Biosynthesis and activity of DNA polymerase throughout the mitotic cycle of Physarum polycephalum. AB - Measurements of DNA polymerase protein levels and polymerase activity through the naturally synchronous mitotic cycle of Physarum polycephalum show that active DNA polymerase-alpha is synthesized throughout the G2 phase, in step with the profile of general protein biosynthesis. Three main components of P. poly-cephalum DNA polymerase of 200, 112 and 70 kDa were found to be immunologically related. PMID- 3305077 TI - The primary structure of iron superoxide dismutase from Escherichia coli. AB - The complete amino acid sequence of iron superoxide from Escherichia coli has been determined. The sequence was deduced from analysis of peptides obtained after cleavage of the carboxymethylated apoenzyme with trypsin. Stapholococcus aureus protease or CNBr. The polypeptide chain is made up of 192 residues and is easily aligned with the other known amino acid sequences of iron and manganese superoxide dismutases from various sources. The iron superoxide dismutase from E. coli shows a significantly higher homology with the iron enzyme from a different organism than with the manganese isoenzyme from E. coli. PMID- 3305078 TI - 2,3-Bisphosphoglycerate inhibits ATP-stimulated proteolysis. AB - Intracellular protein breakdown could be regulated at the substrate level by changes in the environment. Under in vitro conditions, ATP increases the proteolytic susceptibility of several mitochondrial and cytosolic proteins, while 2,3-bisphosphoglycerate not only has the opposite effect but also prevents the ATP-stimulated proteolysis. ATP and 2,3-bisphosphoglycerate, present at relatively high levels in many tissues, provide a good model of environmental components that may influence intracellular proteolysis. PMID- 3305079 TI - Hormone (pheromone) processing enzymes in yeast. The carboxy-terminal processing enzyme of the mating pheromone alpha-factor, carboxypeptidase ysc alpha, is absent in alpha-factor maturation-defective kex1 mutant cells. AB - Carboxy-terminal processing of the mating pheromone alpha-factor of the yeast Saccharomyces cerevisiae has been assumed to be due to the action of carboxypeptidase ysc alpha [(1985) EMBO J. 4, 173-177]. Here it is shown that a mutant (kex1) defective in alpha-factor maturation is defective in carboxypeptidase ysc alpha activity, indicating that the enzyme is indeed the processing catalyst. It is proposed that carboxypeptidase ysc alpha is the product of the KEX1 gene. PMID- 3305080 TI - Is it useful to remove internal mammary nodes in operable breast cancer? AB - From September 1963 to January 1968, 243 patients with operable breast cancer were included in a randomized trial designed to compare classical radical mastectomy (RM) alone to extended mastectomy (EM), i.e. RM plus internal mammary dissection. One hundred and seventeen patients underwent RM, and 126 EM. After a mean follow-up time of 20 years, no significant differences were observed between the two treatment groups for overall survival, for the relapse-free survival rates, nor for distant metastasis, or locoregional recurrence rates. From a regression model, significant interactions were found between risk of death, EM, and both nodal status and site of the tumour. When compared to RM, EM significantly decreased the risk of death for patients with internal or medial tumour and positive axillary nodes (P = 0.05). No beneficial effect of EM was observed for any of the other patients; on the contrary, EM seemed to increase the risk of death for the patients with external tumour and negative axillary nodes (P = 0.07). PMID- 3305081 TI - Diagnostic efficacy of the clinical-radiological-cytological triad in solid breast lumps: results of a second prospective study on 631 patients. AB - The clinical-radiological-cytological triad was used for diagnostic evaluation in 631 women over 30 years old with a solid breast lump, excluding clinically obvious cancers. All the lumps were subsequently removed surgically, except for 105 cases which spontaneously regressed within 2 months. 285 of the 526 nodules removed were cancers, and 162 of 285 (57%) did not exceed 20 mm in size. The sensitivity of the individual tests (physical examination, mammography and fine needle aspiration cytology) of the malignant lumps was respectively 0.83, 0.73 and 0.60, and it increased to 0.95 when they were associated. Of the remaining 346 benign lumps the specificity of the three tests was respectively 0.60, 0.78 and 0.98. The predictive value of a positive response (certain or probable) to the three tests was 0.63, 0.74 and 0.94. The certain positive responses of cytology (131 of 285 cases) reached a predictive value of 1.00. The predictive value of a negative response for the three tests was respectively 0.81, 0.80 and 0.82; in the absence of positive responses, the predictive value for benignancy of the triad was 0.93 (177 of 190 cases). The systematic use of the diagnostic triad and the organizational platform allowed the clinicians to select malignant cases and plan inpatient/outpatient surgical treatment. PMID- 3305082 TI - [G. I. Sokol'skii--an outstanding Russian clinician]. PMID- 3305083 TI - [P. P. Malinovskii--outstanding Russian psychiatrist]. PMID- 3305084 TI - Drug abuse and reproduction. AB - It is clear that a number of CNS agents, including drugs of abuse, can inhibit reproductive function. Figure 1 shows the chemical diversity of some of the drug groups that affect reproductive hormones. Their structural dissimilarity to the steroid hormones is also readily apparent in the figure. These chemically diverse drugs share an important pharmacologic property: they are highly potent neuroactive drugs, and they can disrupt hypothalamic-pituitary function. Although it is frequently difficult to distinguish between direct drug actions on the hypothalamic-pituitary axis and subsequent effects on gonadal hormones and sex accessory gland function, the distinction is an important one. Most neuroactive drugs produce only transient effects on the central nervous pathways necessary for normal gonadotropin secretion. The disruptive effects of these drugs are likely to be transient and completely reversible, and tolerance to the inhibitory drug effects may occur even with continued drug use. Under these circumstances, normal adults may experience only subtle changes in sexual function. However, individuals with compromised reproductive function may exhibit major problems. It is also likely that adolescents may be at substantial risk for reproductive damage from these neuroactive drugs since the endocrine events associated with puberty are dependent on the normal development of the hypothalamic-pituitary axis. PMID- 3305085 TI - Gonadotropin-releasing hormone-induced changes in testosterone secretion in normal women. AB - This study investigated the pattern of testosterone (T) secretion in spontaneous (n = 14) and gonadotropin-releasing hormone (GnRH)-treated (n = 6) menstrual cycles in normal women. In spontaneous cycles, T was found to increase progressively over the follicular phase (P less than or equal to 0.001), with the peak T value occurring on cycle day 0 (luteinizing hormone [LH] surge). The mean (+/- standard error of the mean [SEM]) T values on cycle day -14 and cycle day 0 were 35 +/- 4 and 51 +/- 4 ng/dl, respectively. GnRH was administered intravenously to six women at 1.3 to 1.7 micrograms per dose every 30 minutes in a study that assessed the ovarian effects of a rapid gonadotropin pulse frequency. In three of the women, the T levels followed a normal follicular phase pattern, whereas in the remaining three GnRH-treated women, there were marked increases in T with peak levels of 97, 123, and 81 ng/dl on day 0. The GnRH treated subgroup with increased T levels had significantly increased follicular levels of LH, follicle-stimulating hormone (FSH), LH-bio and number of preovulatory ovarian follicles. This study demonstrated that increased levels of LH, FSH, and LH/FSH are capable of acutely increasing the secretion of ovarian androgens. PMID- 3305086 TI - Ultrasonographic monitoring of follicular growth for luteal phase defects. AB - In the evaluation of 39 patients with untreated and treated luteal phase defect (LPD), serial ultrasonographic monitoring of follicular development identified three morphologically distinct growth patterns: normal-sized follicles, small follicles, and luteinized-unruptured follicles. All three patterns were observed in both untreated (46% had normal-sized follicles, 39% had small follicles, 15% had luteinized-unruptured follicles) and treated patients. A small follicle was observed uncommonly in histologically corrected LPD patients (6%). However, a luteinized-unruptured follicle (38%) may persist or be induced in situations where clomiphene citrate has been used to correct LPD or induce ovulation. Ultrasonographic evaluations of follicular growth in luteal phase defect support the theory that luteal phase defect represents a spectrum of normal and abnormal ovarian cycle events. PMID- 3305087 TI - Clinical trial of gossypol as a male contraceptive drug. Part I. Efficacy study. AB - The main objective of the research is to study the effectiveness and safety of gossypol as a male contraceptive drug. Using a double-blind, randomized, controlled study design, gossypol was found to be an effective male antifertility drug, with no adverse effects on libido nor appetite. In terms of serum potassium levels, there were no statistical differences between gossypol and placebo groups at the end of the loading phase. However, through the ensuing 12 months of maintenance phase, a statistically significant trend toward reduced serum potassium level was evident. PMID- 3305088 TI - Clinical trial of gossypol as a male contraceptive drug. Part II. Hypokalemia study. AB - A randomized controlled study was designed to evaluate the merit of whether ingesting potassium salt or potassium (K) blocking agent while using gossypol contraceptive drug could alleviate the symptom of hypokalemia. Results indicate that K salt supplementation did not reverse the gossypol-related hypokalemia and that the blocking agent triamterene did not prevent loss of or enhance the retention of serum K. PMID- 3305089 TI - Prevalence of sperm surface antibodies in the male partners of infertile couples as determined by immunobead screening. AB - A single simple laboratory test for the detection of sperm surface antibodies is described. Spermatozoa from 300 men who were investigated for infertility were tested for sperm surface antibodies using the Immunobead test (IBT). IBTs for IgG, IgA, and IgM were performed on each sample as well as an IBT using an Immunobead with activity against both light and heavy immunoglobulin chains and therefore capable of detecting any of the three isotypes ("GAM-IBT"). An excellent correspondence was found between GAM-IBT-positive samples and those positive by one or more of the isotype-specific Immunobeads. In 29 of 32 positive tests, the GAM bead binding was within 5% of the most positive isotype-specific bead's binding. There were no false-positive or false-negative tests comparing the GAM-IBT with the isotype-specific IBTs. PMID- 3305090 TI - Anaphylactic reaction to synthetic luteinizing hormone-releasing hormone. AB - Synthetic LH-RH is a polypeptide that is structurally identical to natural LH-RH. It has been used as a safe ovulation induction agent. A case is presented in which a patient had an anaphylactic reaction when treated with LH-RH by IV infusion. Positive skin testing confirmed this as an IgE-mediated reaction. This is the first reported case of such a reaction and stresses that careful precautions be taken when administering all medications. PMID- 3305091 TI - [Effect of naftusia mineral water on insulin and gastrin secretion]. PMID- 3305093 TI - [Mechanisms of O2 transport in the microcirculatory system]. AB - The O2 transport in erythrocytes was shown to depend mostly on the form of erythrocyte, concentration of hemoglobin and its interaction with O2. The O2 transport in microvessels and capillaries depends on distribution of erythrocytes over the blood flow and their velocity, whereas intensity of O2 consumption and architectonics of capillary net determine the velocity and amount of O2 supply in tissues. Study of intricate processes of the O2 transport in microcirculation is only possible when using modern physical-chemical and mathematical techniques revealing the complicated interactions among the parameters under study. PMID- 3305092 TI - [Insulin receptor function of the fat cell plasma membranes with an elevated thyroid hormone content in humans and animals]. PMID- 3305095 TI - [Role of biomechanical properties of blood vessels in the development of vasodilatation]. AB - The ability to enlarge circumferentially varied in dependence on the equality of geometrical characteristics and degree of relaxation of smooth muscle in the segments of human middle cerebral artery. The most informative biomechanical parameter characterizing arterial ability to vasodilatation was found to be the parameter B. The latter was shown to change at different values of the pressure, thus determining the changes of vasoactive drugs effectiveness in different conditions. PMID- 3305094 TI - [Relation between hormones of the hypothalamo-hypophyseal-gonadal system and peripheral blood serotonin levels]. AB - The LHRH, human chorionic gonadotropin (hCG) or testosterone affected the peripheral serotonin (5HT) concentration in the blood. I. p. injection of LHRH or hCG resulted in an increase of testosterone and in a decrease of 5HT levels in the blood. The influence of these peptides on the 5HT concentration in the peripheral blood appears to be complex. On the one hand, the 5HT level depended on the level of testosterone in the blood since castration was followed by an increase of the 5HT content in the blood. On the other hand, treatment of the castrated mice with hCG resulted in an increase of the blood 5HT concentration as wall. The GHs seem to exert multiple effect on peripheral 5HT including both a direct effect and their action through testosterone. PMID- 3305096 TI - The effect of microwave radiation on the primary IgM response to sheep red blood cells in mice. AB - We investigated the changes in the number of plaque-forming cells (PFC) in spleens of CBA mice after microwave (MW) irradiation. The mice were immunized with sheep red blood cells, the number of PFC was determined on days 4 and 5 after immunization. Mice received single doses of MW irradiation on days 1, 2, or 3 after immunization (exposure duration 1 to 9 min). It was found that the number of PFC was changed after MW irradiation and that this effect depended on the absorbed dose. Shorter exposures for 1, 3, and 5 min (SA = 4, 12, and 20.1 kJ/kg) stimulated the formation of PFC, exposures for 7 and 9 min did not change the number of PFC. After MW heating (exposure 5 min), the rectal temperature of mice was elevated by 2.5 degrees C. If the same thermal effect was induced by elevating the environmental temperature, the number of PFC was not increased. The observed changes in PFC number are probably due to the specific effect of MW radiation. PMID- 3305097 TI - Cellular composition of spleen and peritoneal exudate in mice after injection of cyclophosphamide-treated L 1210 leukemia cells. AB - The composition of peritoneal exudate and spleen cells of CD2F1 mice after fourfold i.p. administration of L 1210 leukemia cells treated with cyclophosphamide (L 1210-CY cells) were examined. The number of cells in peritoneal cavity did not increase, however, the spleen weight rose after administration of L 1210-CY cells. The per cent of lymphocytes T was increased 2.5 times but the content of macrophages and lymphocytes B was normal in the peritoneal cavity after L 1210-CY cells injections. In the spleen an 1.4 times increase of the per cent of lymphocytes B, but normal level of macrophages and lymphocytes T were observed. PMID- 3305099 TI - Organ donation: the gift of sight, the gift of life. PMID- 3305100 TI - [Differential fluorescence immunology diagnosis of acquired subepidermal bullous dermatoses caused by artificial NaCl separation of the dermoepidermal junction zone]. PMID- 3305101 TI - [Johann Wolfgang von Goethe--the first promoter of dermatovenerologic moulage art]. PMID- 3305102 TI - Serum complement systems of ectothermic vertebrates. PMID- 3305098 TI - [Preparation of an immunoadsorbent interacting specifically with cortisol-binding globulin (CBG) and its application to the interaction between CBG and cortisol- evaluation of the association constant (Ka) between CBG and cortisol in normal subjects]. AB - We have developed a simple method for the evaluation of the association constant (Ka) between cortisol binding globulin (CBG) and cortisol using immunoadsorbent and a small amount of serum. Immunoadsorbent was prepared as follows; gamma globulin fraction was obtained from goat anti-human CBG antiserum by salting out using 50% ammonium sulfate, followed by coupling to CNBr-activated Sepharose 4B. Immunoadsorbent thus prepared was used for the evaluation of Ka value between cortisol and CBG. Sera obtained from 5 healthy subjects (3 males and 2 females) were treated with charcoal (Norit A) to remove endogenous cortisol. Each of 10 microliter of serum was incubated with a constant amount of 125I-cortisol and different concentrations of unlabelled cortisol for 12 hours at 25 degrees C, pH 7.4. Then, 50 microliter of anti-CBG-Sepharose 4B (immunoadsorbent) was added to each incubation mixture, followed by incubation for another 4 hours at 25 degrees C. After centrifugation, radioactivity of the precipitate was counted and the results were analyzed using Scatchard plot. The Ka value between serum CBG and cortisol in 5 healthy subjects was 1.70 X 10(8)M-1 (SD = 0.24), which is comparable with that of a previously reported value using purified CBG from a large amount of serum. Interassay variation of this method was satisfactory with CV value of 10.1%. Our present method is considered to be clinically relevant, since it does not require purification of CBG from serum, and a relatively small amount (total amount, less than 200 microliter) of serum is enough to evaluate Ka value between CBG and cortisol. PMID- 3305103 TI - Molecular fragmentation. Some applications in immunology. PMID- 3305104 TI - Activity and preliminary characterisation of a hemagglutinin from the hemichordate Saccoglossus ruber. AB - Examination of whole body homogenates of the hemichordate, Saccoglossus ruber, has revealed the presence of a hemagglutinin with specificity for carbohydrates containing a D-galactose configuration. An analysis of the chemical and physical properties of the agglutinin showed it to be a non-dialysable, heat-labile protein, susceptible to the action of pronase E, but resistant to trypsin. Oxidation by periodate had no effect on agglutination and activity was not dependent upon the divalent cations, Ca2+ or Mg2+. The agglutinin was associated with the proboscis, collar and trunk regions, and was also detected in mucus covering the body surface. A possible role for the agglutinin in the defence system of the animal is discussed. PMID- 3305106 TI - The use of ceramics in prosthetic heart valves. PMID- 3305105 TI - Influence of cell sources, stimulating agents, and incubation conditions on release of interleukin-1 from chicken macrophages. AB - Experiments were conducted to determine the cell source, stimulating agents, and incubation conditions that maximize interleukin-1 (IL-1) release by chicken macrophages/monocytes. Thymocyte co-mitogen proliferation was used to assay IL-1 activity of conditioned or partially purified supernatants. Monolayers of a transformed chicken macrophage cell line, HD11, released greater amounts of IL-1 than adherent cells isolated from peripheral blood, peritoneal cavity, or spleen. E. coli endotoxin and heat-killed S. aureus induced greater release of IL-1 by HD11 and splenic macrophages than latex or a super induction protocol with mezerien. Blocking macrophage eicosanoid synthesis with indomethacin did not influence IL-1 release from HD11 macrophages. Removing low molecular weight compounds from conditioned supernatants by dialysis did not influence IL-1 activity. IL-1 release was increased by incubating macrophages at 42 C compared to 39 C. Thymocyte co-mitogenic activity of IL-1 was increased by incubating thymocytes at 42 C compared to 39 C. Species cross reactivity between chicken and mammalian IL-1 was also investigated. Chicken IL-1 had slight co-stimulation activity on murine thymocytes, but murine and human IL-1 were without activity on chicken thymocytes. PMID- 3305107 TI - Computers in biochemical education: MBT-NET, the Liverpool biochemistry/microbiology teaching network. PMID- 3305108 TI - Interactive videodiscs in the life sciences: the use of 'generic' discs in the teaching of cell biology. PMID- 3305109 TI - Characterization of the estrogen-sensitive cells expressing progesterone receptor in the bursa of Fabricius. AB - Cells expressing the progesterone receptor (PR) in the bursa of Fabricius (BF) were studied with immunohistochemistry at light-microscopic level, with immunoelectron microscopy (immuno-EM) and with non-specific esterase histochemistry. The antibody (IgG-RB) directed to the B component of the chick oviduct progesterone receptor was shown by immunoblotting to be specific for the PR and to recognize the PR also in the bursa. Two cell types in the BF contain the PR: stromal cells in the interfollicular-subepithelial area and smooth muscle cells lining the BF. The PR was localized in the nuclei of these cells. The bursal epithelium and the cells inside the follicles were not stained for PR. Electron microscopically the immunoreaction precipitate was localized on condensed heterochromatin and on dispersed euchromatin. The cells expressing the PR resembled electron microscopically fibroblasts. Their cytoplasm was rich in rough endoplasmic reticulum indicating active protein synthesis. By non-specific esterase histochemistry we showed that the PR-containing cells were not macrophages, which are morphologically indistinguishable from stromal cells. In the bursae of young untreated chicks the PR was not seen, but was inducible by estradiol treatment and was spontaneously expressed after the onset of sexual maturation. It is concluded that both the stromal fibroblasts and the smooth muscle cells in the BF are estrogen and progesterone sensitive. The expression of PR after the onset of sexual maturation indicates that the BF is directly affected by sexual maturation-associated factors. We suggest that estrogen and progesterone participate in tissue remodelling during bursal involution via the stromal cells and may affect bursal functions via the smooth muscle cells. PMID- 3305110 TI - The cellular basis of myosin heavy chain isoform expression during development of avian skeletal muscles. PMID- 3305111 TI - Distribution of alpha- and beta-myosin heavy chains in the ventricular fibers of the postnatal developing rat. AB - Four monoclonal antibodies, two raised against alpha-myosin heavy chain (MHC) and two against beta-MHC, have been used to investigate in situ the fiber distribution of alpha- and beta-MHC in rat cardiac ventricles during postnatal development. Eighteen ventricles from 2-day-old to 1-year-old rats were analyzed. Three fiber populations were determined according to their immunofluorescent labeling: one with only alpha-MHC, one only beta-MHC, and one with mixed alpha- and beta-MHC. Large variations in the proportions of these three fiber populations according to age indicate that: (1) alpha-MHC are expressed in all fibers until the second month; they then disappear in a small endocardial fiber population and in a few apparently conductive fibers around the vessels. (2) beta MHC are also first expressed in all fibers and then disappear gradually from epicardium to endocardium between the second and fourth weeks, except in the conductive fibers; they reappear during the second month sequentially from endocardium to epicardium; and they are then expressed in almost all fibers, except in a small epicardial fiber population, proportionally larger in the right ventricle than in the left. Immunological characterization of MHC isolated from a 22-day-old-rat ventricle, using anti-beta immunoaffinity chromatography, suggests that MHC of conductive fibers are probably at least partially in an alpha beta heterodimeric form. PMID- 3305112 TI - The guinea pig sperm plasma membrane protein, PH-20, reaches the surface via two transport pathways and becomes localized to a domain after an initial uniform distribution. AB - The PH-20 protein is first detected in the Golgi complex at the start of differentiation of round spermatids into a polarized cell (spermiogenesis), and next appears in the membrane of the developing secretory granule (the acrosome). Thereafter, a second population of PH-20 is inserted directly into the plasma membrane. Initially, both the acrosomal membrane (PH-20AM) and the plasma membrane (PH-20PM) populations are uniformly distributed in each membrane. Subsequently, PH-20AM is restricted to the inner acrosomal membrane, and during epididymal passage PH-20PM becomes localized to the posterior head surface domain. Therefore, the PH-20 protein does not become localized to either domain by intracellular sorting and insertion into a localized domain, but by restriction following uniform insertion. When the sperm undergoes Ca2+-regulated exocytosis (the acrosome reaction), the inner acrosomal membrane becomes confluent with the plasma membrane. Consequently, the population of PH-20AM is now inserted into the plasma membrane. The PH-20 protein isolated from developing testicular cells contains a major form, approximately 66 kDa, and a minor form, approximately equal to 56 kDa, but it remains to be determined if each form enters only one or both pathways. The developmental control of surface expression of PH-20 during spermiogenesis in the guinea pig may reflect the regulation of a protein involved in sperm-egg adhesion. (Primakoff, P., Hyatt, H., and Myles, D. g. (1985), J. Cell. Biol. 101, 2239-2244). PMID- 3305114 TI - Continuous 24-hour intragastric pH monitoring in the evaluation of the effect of a nightly dose of famotidine, ranitidine and placebo on gastric acidity of patients with duodenal ulcer. AB - In 11 duodenal ulcer patients, the antisecretory effects of bedtime famotidine 40 mg were compared to those obtained with ranitidine 300 mg and placebo by means of continuous 24-hour intragastric pH monitoring. The 24-hour areas under the curve of pH profiles of the two H2 blockers were significantly different from those related to placebo (p approximately 0 for ranitidine and p = 0.00001 for famotidine), but not from each other (p = 0.51). Onset and duration of the famotidine action, however, were respectively earlier and longer lasting (12 vs. about 9 h) than those of ranitidine. Famotidine was also significantly superior (p approximately 0) to ranitidine in keeping intragastric pH at high values (especially those comprised between 6 and 8 pH units), although theoretically equipotent doses of the two H2 antagonists were used. PMID- 3305113 TI - The establishment of hepatocyte cell surface polarity during fetal liver development. AB - Antibodies to six glycoproteins present in different domains of the hepatocyte plasma membrane were used to study the establishment of cell surface polarity during rat fetal liver development. The proteins were immunoprecipitated from fetal liver homogenates between 14 and 21 days of gestation and quantified by immunoblotting. Aminopeptidase N, CE 9, and HA 321, which reside in the apical, basolateral, and lateral plasma membrane in the adult hepatocyte, respectively, were present in high concentrations at 14 days of gestation and remained high until birth. In contrast, two apical proteins (HA 4 and dipeptidyl peptidase IV) and two basolateral proteins (ASGP receptor and EGF receptor) were first detected between 16 and 18 days of gestation and increased linearly until birth. HA 4 was the only molecule for which the fetal and adult forms differed, with the former having a faster mobility on SDS-PAGE, due to differences in N-linked oligosaccharides. With two exceptions, the localization of the molecules from earliest detection was restricted to the same domain as that in the adult. At 15 days of gestation, HA 321 and a small portion of aminopeptidase were detected on the basolateral membrane. By 21 days both molecules had assumed their adult localization pattern. Our results indicate that the biogenesis of cell surface polarity is an early event, implying that the mechanisms for sorting plasma membrane molecules are functional very early in development. Furthermore, the different patterns of appearance of the six molecules, irrespective of domain, indicate that the biochemical composition of the cell surface changes dramatically during fetal liver development. PMID- 3305115 TI - Endoscopic retrograde pancreatography and exocrine pancreatic function. AB - The incidence of pancreatitis has been increasing during the last decennium paralleling a rapid enhancement in alcohol consumption. For many years, diagnostic criteria of chronic pancreatitis were exclusively based on the estimation of the exocrine pancreatic function. New valuable information is provided from endoscopic retrograde pancreaticography (ERP) and pancreatic ultrasonography. In a consecutive series of patients with chronic alcoholism changes in the pancreatogram were demonstrated in approximately 44% of the patients. A comparative study of ERP and exocrine pancreatic function showed that only patients with advanced pancreatic lesions had a significant reduction in pancreatic function. It is suggested that 'subclinical pancreatitis' is frequent among alcoholics. Complementary use of pancreatic ultrasonography and ERP gives a differentiated picture of pancreatic disease and is recommended among the first steps in the diagnostic chain for pancreatic disease. PMID- 3305116 TI - Nutrient malassimilation after total gastrectomy and possible intervention. AB - Malnutrition is common after total gastrectomy. Different pathophysiological reasons have been reported. We have investigated malabsorption in patients after total gastrectomy and Roux-Y esophagojejunostomy, analyzing the orocecal transit time, the bacterial flora of the upper intestine, and the small intestinal carbohydrate fermentation. Furthermore, we studied the benefit of pancreatic enzymes in this condition. The orocecal transit time was found to be short in 5/11 patients. In 4/11 patients upper intestinal bacterial overgrowth was probable. In the remaining 3/11 patients with steatorrhea, pancreatic dysfunction, due to understimulation, was suspected to be the reason for malassimilation. A subsequent double-blind, cross-over trial on supplementary treatment with pancreatic enzymes was performed in 15 patients. This treatment did not significantly reduce the degree of steatorrhea in these patients. PMID- 3305117 TI - Colloidal bismuth subcitrate in peptic ulcer--a review. AB - De-Nol (colloidal bismuth subcitrate, CBS) precipitates in an acid environment and adheres to the exudate layer covering an ulcer crater; moreover, CBS blocks pepsin activity, retards hydrogen-ion back-diffusion and stimulates prostaglandin synthesis. The average healing rate in duodenal ulcer (DU) after 4 weeks' treatment with CBS is 78% versus 63% with cimetidine. In a direct comparison, CBS gives 84% healing as opposed to 78% with ranitidine. The average healing rate after 4 weeks' treatment with CBS in gastric ulcer (GU) is 68% compared to 54% with cimetidine. The percentage of relapse-free patients, 1 year after DU or GU healing, with CBS is substantially higher than is the case with H2-receptor blockers. PMID- 3305118 TI - Maintenance therapy with colloidal bismuth subcitrate in duodenal ulcer disease. AB - Various investigators have reported that relapses after healing of duodenal ulcers with colloidal bismuth subcitrate (CBS, De-Nol) occur less frequently than after healing with H2-antagonists. To date, treatment with CBS has been limited to 8 weeks. After a volunteer study showed that prolonged administration of CBS did not cause safety problems, a trial was undertaken in which the effects of additional maintenance CBS treatment with 120 mg of CBS daily is compared with placebo. Interim results showed that after 6 months endoscopically confirmed relapse occurred in 5 (38.5%) of the 13 patients as compared to 12 (80%) of the 15 placebo-treated patients (p = 0.05). Besides 3 cases of transient constipation, no side effects, neurological, biochemical or hematological changes were observed. PMID- 3305119 TI - Myomesin and M protein: differential expression in embryonic fibers during pectoral muscle development. AB - By applying immunocytochemistry using monoclonal antibodies, we found that the myofibrillar M band of both presumptive type-I and -II fibers in the pectoralis major muscle of chickens contains two high-molecular-weight proteins, i.e., myomesin (Mr, 185,000) and M protein (Mr, 165,000), early in embryonic development (7 days in ovo), even though adult type-I fibers lack M protein. The developmental expression of M protein is unusual in that, from 10 to 14 days in ovo, it is gradually suppressed not only in presumptive type-I fibers but also in presumptive type-II fibers formed from primary-generation myotubes. This latter suppression is transient, as M protein is expressed in all adult type-II fibers derived from both the primary- and second-generation myotubes. Myomesin, on the other hand, is continuously expressed in all myotubes throughout development. This finding shows that myomesin and M protein expression is regulated independently in different myotube populations, and that the suppression of M protein in primary-generation myotubes accounts for the delayed accumulation of M protein during development, as previously revealed by biochemical analysis. Presumptive type-I fibers, which form in the deep portion of the muscle, become concentrated in a narrow band known as the red strip. PMID- 3305120 TI - Oral disease and its effect on the quality of life. PMID- 3305122 TI - [Echography and clinical aspects in the differential diagnosis of hepatic cysts]. PMID- 3305121 TI - Andrija Stampar and the concept of positive health. AB - The literature in the health and medical care field contains a heavy burden of obscure rhetoric and semantic slight of hand. Terms gain a usage which belies the reality to which they refer, code words come to serve as a substitute for thought, and concepts seemingly acquire a life of their own. Such is the case with the concept of positive health. For almost four decades this concept has been bandied about. Often it is raised only to be disclaimed or with the intent to depreciate its relevance. However, it is probably invoked with equal frequency as an ambiguous but reassuring kind of appeal. Discussions of the concept rarely deal with its operational implications and never seem to manifest appreciation of its origin. Attention is here directed to its original formulation and to Andrija Stampar, the person most directly responsible for this, in order to facilitate consideration of its current significance. PMID- 3305123 TI - [Acute administration of calcium antagonists: effects on various parameters of glyco-lipid metabolism]. PMID- 3305124 TI - Pulsed Doppler sonography as an aid in ultrasound-guided aspiration biopsy. AB - Six cases demonstrating the utility of pulsed Doppler sonography as an aid in avoiding complications of aspiration and biopsy are presented. Duplex sonography combined with ultrasound needle guidance was helpful in identifying the vascular nature of masses in 3 cases and positively identifying and avoiding vascular structures within the needle path in 3 cases. The selective use of duplex sonography prior to aspiration biopsy provides information that should serve to minimize further the risks of hemorrhage associated with modern biopsy techniques. PMID- 3305125 TI - Doppler ultrasound in the diagnosis of intestinal ischemia. AB - Conventional ultrasound is unreliable in detecting narrowing of the visceral arteries. Two cases are reported in which duplex Doppler ultrasound correctly identified severe narrowing of the celiac artery. Doppler ultrasound promises to be more accurate than conventional ultrasound in the diagnosis of visceral ischemia and may help to identify those patients who may require angiography. PMID- 3305126 TI - Endosonographic staging of rectal carcinoma. AB - Transrectal ultrasonography (US) scanning facilitates the ultrastructural differentiation of the various histologic layers of the rectal wall. In particular, the muscularis propria is represented by the 4th sonographic layer. Rectal carcinoma appears on US as a low echogenic area that suddenly interrupts the regular sequence of parietal layers. Sixty-five patients suffering with carcinoma of the lower two-thirds of the rectum underwent preoperative linear endosonography for staging. The reliability of such a method in assessing the extrarectal spread was evaluated in our study, at the end of which 55 sonographic/histologic correlations were obtained. Four false-negative and 1 false-positive determinations of the presence or absence of extrarectal spread proved that sonography has a sensitivity and specificity of 91%, with a positive predictive value of 97% and a negative predictive value of 71%. Lower results are obtained in lymph node staging: enlarged lymph nodes are seen in only 11/22 C1/C2 patients (11 false negatives) while we were aware of 3 false positives. PMID- 3305127 TI - Hepatic lipomas: ultrasound and computed tomographic findings. AB - Five cases of solitary hepatic lipoma are described. These rare tumors have ultrasound (US) and computed tomographic (CT) characteristics that suggest the diagnosis. As imaged by US, hepatic lipomas always correspond to a highly echogenic, well-limited lesion with posterior attenuation. Precontrast CT scans reveal a low-density lesion (-20 to -70 HU); following contrast material injection, the tumor density may either remain negative (pure hepatic lipoma) or become positive (limit, 40 HU) when there is an associated adenomatous component. Hepatic lipomas involve no risk of degeneration, and follow-up by US is sufficient. A case of lipoma of the falciform ligament and a case of a hepatic pseudolipoma are also described; sonograms were negative in both instances, and CT was required for diagnosis. PMID- 3305129 TI - Venous hemangioma of the gallbladder. AB - An 11-year-old girl presenting with right upper quadrant abdominal pain was found to have a venous hemangioma of the posterior wall of the gallbladder. Radiographic, ultrasonographic, and angiographic findings of this entity, along with a review of the literature, are presented. PMID- 3305128 TI - Pseudoaneurysm of anomalous right hepatic artery as a cause for hemosuccus pancreatitis. AB - A pseudoaneurysm from the right hepatic artery was associated with chronic pancreatitis in an elderly patient with recurrent episodes of bleeding into the pancreas. Preoperative ultrasonography and enhanced computed tomographic scan revealed the nature of lesion but angiography was required to demonstrate the causative right hepatic artery, which was anomalous. PMID- 3305131 TI - Duodenal hematoma: CT demonstration of the ring sign. AB - This case illustrates the computed tomographic (CT) and sonographic features of duodenal hematoma. In addition, the CT scans demonstrate the ring sign, a characteristic feature noted previously only by magnetic resonance imaging. PMID- 3305130 TI - Diagnosis and treatment of choledochocele complicated by choledocholithiasis (case report). AB - We report a case of choledochocele associated with choledocholithiasis. The patient became symptomatic when a gallstone was trapped within the choledochocele, causing intermittent biliary obstruction. Endoscopic retrograde cholangiography (ERC) provided the diagnosis and endoscopic sphincterotomy was performed for definite nonoperative treatment. The lesion could not be identified on ultrasound even after its demonstration by ERC. The importance of direct cholangiography in the diagnosis of a choledochocele is discussed. PMID- 3305132 TI - Accessory spleen: presentation as a large abdominal mass in an asymptomatic young woman. AB - Accessory spleen hypertrophy is usually related to hematologic, lymphomatous, and rheumatoid diseases. We describe here the case of an 18-year-old asymptomatic woman who presented with a very large accessory spleen occupying the lower abdomen. Its appearance on abdominal sonogram, computed tomogram, and hepatosplenic scintigraphy is correlated with the resected specimen. PMID- 3305133 TI - Value of sonographically guided fine needle aspiration biopsy in evaluating the liver with sonographic abnormalities. AB - This retrospective study was undertaken to evaluate the diagnostic usefulness of 97 sonographically guided fine needle aspiration biopsy cytologies in 92 patients with one or more hepatic lesions suspicious of malignancy. Results of the fine needle aspiration biopsy were then compared with the definitive results obtained by histologic examination, or with the subsequent course of the patient. A final diagnosis of malignancy was established in 65 cases, of which fine needle aspiration biopsy cytology revealed a concordant diagnosis in 54 cases. The diagnostic sensitivity of this technique was 83% for malignant lesions with 93% specificity. Of the 54 cases with malignant cytology, it was possible to distinguish between a primary or secondary lesion in 31 cases (57%). Benign lesions were aspirated in 32 cases, of which 30 cases concorded with the final diagnosis. This study confirms the usefulness of sonographically guided fine needle aspiration biopsy cytology in diagnosing malignant hepatic tumors. PMID- 3305134 TI - Evidence for platelet-activating factor as a mediator of endotoxin-induced gastrointestinal damage in the rat. Effects of three platelet-activating factor antagonists. AB - The potential role of platelet-activating factor (PAF) as a mediator of gastrointestinal ulceration associated with septic shock was examined in the rat. The damaging effects of both PAF and Escherichia coli endotoxin in the stomach and small intestine were compared, as were their effects on plasma leakage into the lumen of the gastrointestinal tract. Intravenous administration of either endotoxin or PAF produced extensive necrosis and vascular congestion in the stomach and small intestine, but not the distal colon. With either agent, the duodenum and jejunum were the tissues most susceptible to damage and in which the greatest plasma leakage was observed. The prolonged hypotension and gastrointestinal damage induced by PAF or endotoxin were significantly inhibited by three structurally dissimilar PAF antagonists (CV-3988, BN-52021, and Ro 193704). CV-3988 (10 mg/kg) significantly (p less than 0.05) reduced both endotoxin- and PAF-induced plasma leakage in the stomach and small intestine. Of the three antagonists, only CV-3988 significantly reduced ethanol-induced gastric mucosal damage, perhaps reflecting actions of this compound unrelated to antagonism of PAF receptors. These studies support the hypothesis that PAF is an important mediator of the hypotension and plasma leakage observed during endotoxic shock and its endogenous release may contribute to the gastrointestinal ulceration associated with this syndrome. Thus, PAF receptor antagonists may be useful for prevention of such ulceration. PMID- 3305135 TI - Gastric proteases in Barrett's esophagus. AB - Precursors of the gastric proteases pepsinogen A (pepsinogen I) and pepsinogen C (pepsinogen II) and slow-moving protease were demonstrated in biopsy specimens from Barrett's epithelium in 21 of 22 patients with Barrett's esophagus; in 14 of them, in variable combinations at different sites. In 13 of 19 patients (68.4%) with detectable pepsinogen A, different isozymogen patterns were found between the Barrett's epithelium and the gastric corpus mucosa. Discrepancies consisted mainly of a stronger pepsinogen 5 band in the Barrett's epithelium, with a higher incidence in biopsy specimens with features of dysplasia than with no or indefinite dysplasia; the difference was, however, not statistically significant. Zymograms of 69 biopsy specimens from Barrett's epithelium were correlated with the histologic type: pepsinogen A and C were most frequently found in the fundic type, least often in the specialized intestinal type. In control gastric corpus biopsy specimens, pepsinogen A and C as well as slow-moving protease were always detectable. The observed variability of gastric protease patterns, in particular of pepsinogen A isozymograms, may be due to differences in expression within the pepsinogen A cluster, suggesting a deregulation of gene expression or partial deletion of the pepsinogen A gene cluster. PMID- 3305136 TI - Usefulness of manometric assessment of varices in maintenance sclerotherapy. A controlled trial. AB - In a prospective controlled study, 68 patients undergoing maintenance sclerotherapy were randomized to have intravariceal sclerotherapy based on either manometric assessment (n = 35) or visual assessment (controls, n = 33) of varix patency. For manometric assessment, a perfused variceal needle punctured each variceal column and, if low pressures fluctuating with respiration were obtained, the varix was injected. Control patients had patent varices injected based on visual assessment alone. During a mean follow-up of 13 mo (range 4-16 mo), 1 manometrically assessed patient bled once (0.002 bleeds/patient month) and 7 visually assessed patients bled 14 times from varices (0.03 bleeds/patient-month) (p less than 0.05). Two and nine episodes of ulceration occurred in manometric and visually assessed patients, respectively, (p less than 0.05). Varices were obliterated (i.e., disappeared) in 11 patients undergoing manometric assessment and in 2 patients undergoing visual assessment (p less than 0.01). Comparing results of visual and manometric assessment within "manometric" patients showed a consistent 25% error rate in diagnosing patency or thrombosis by visual assessment. Manometric assessment of varices during maintenance sclerotherapy reduces rebleeding and ulceration to very low levels. PMID- 3305138 TI - [Effect of chronic alcohol administration on the adrenals thyroid, pancreatic islands and liver of male albino rats]. AB - In response to chronic oral ethanol administration, the adrenals, thyroid glands, pancreatic islets, and livers of male white rats show histological and chemomorphological reactions. Cytological, karyometrical, and histochemical findings from adrenal medulla indicate increased secretion and synthesis of catecholamines. Adrenal cortex shows morphokinetic changes within the meaning of progressive transformation. About 1 h after the last ethanol administration, there are no signs of inappropriate insulin secretion in the B-cells of pancreatic islets. In addition to a small lipid storage and a marked decrease of glycogen contents, the hepatocytes show karyometrical sign of an increased cell metabolism. PMID- 3305137 TI - Distribution and characterization of calcitonin gene-related peptide immunoreactivity in the digestive system of normal and capsaicin-treated rats. AB - The distribution and characterization of calcitonin gene-related peptide immunoreactivity in the digestive system of normal, capsaicin-treated, and littermate control rats were studied by radioimmunoassay, chromatography, and immunohistochemistry. The highest concentrations of calcitonin gene-related peptide immunoreactivity were found in the stomach (45 +/- 2.8 pmol/g wet wt, nonsecretory region; 38.7 +/- 4.4 pmol/g wet wt, secretory region) and rectum (30.9 +/- 1.6 pmol/g wet wt). Significant amounts of peptide were also found in the other regions of the gut and in the pancreas. Neonatal treatment with capsaicin, which causes a permanent degeneration of most of the small-diameter sensory neurons, reduced calcitonin gene-related peptide content by greater than 95% in the esophagus and stomach, by 60% in the pancreas, and by less than 50% in the intestine, when compared with littermate controls. Separation of extracts from the gut, pancreas, and brain by chromatography gave major peaks corresponding to the predicted rat calcitonin gene-related peptide and small unidentified peaks, which presumably arise from metabolism of the peptide. Immunohistochemical studies demonstrated that in the esophagus and stomach, calcitonin gene-related peptide immunoreactivity is restricted to nerve fibers, whereas in the intestine it is localized in both nerve fibers and enteric ganglion cells. In capsaicin-treated rats there was a virtually complete elimination of calcitonin gene-related peptide immunoreactive fibers innervating the esophagus and stomach, whereas in the small and large intestine there was a dramatic reduction and often a complete elimination of those associated with blood vessels and a slighter reduction of the nonvascular immunoreactive fibers. The results of this study indicate that calcitonin gene-related peptide immunoreactive nerve fibers innervating the rat digestive system originate from both intrinsic (enteric) and extrinsic (presumably sensory) sources and that both the intrinsic and extrinsic components appear to contain a substance that corresponds to the predicted calcitonin gene-related peptide. PMID- 3305139 TI - The terminal organ of the subcommissural complex of chordates: definition and perspectives. AB - The subcommissural organ (SCO) exhibits anatomical characteristics of an endocrine organ: The secretion is released either into the blood (hypendymal capillaries) or the CSF of the 3rd ventricle; excretory ducts are absent; the active secretory activity of the ependymal cells can be regulated by humorally transmitted messages or by neural input. The rate of production of the Reissner's fibre (RF) by the SCO is rather fast, and the secretory material is stored in the ampulla caudalis (AC) and must be continuously discharged accordingly. Structures jointly involved in depletion of the AC and the decomposition and removal of the massa caudalis (MC) are collectively called the terminal organ (TO). The TO of the SCO-complex is formed by an assemblage of different structures in the caudal segment of the spinal cord (neurogenic part) and in the tissues (non-neurogenic part) which encompass this part of the cord. The different parts of the TO are characterized, even at the cellular level, by specializations which support the discharge as well as the dissolution of the material of the MC. The RF may be a detoxicator for the CSF, but also a carrier of hormonally active substances. In this case the TO is a site of release of hormones. The function of the entire complex is still under discussion, particularly its role in endocrine integration. PMID- 3305140 TI - [Bioenergetics]. AB - As introduced previously, the information field can serve as a base for inferences in terms of dynamics but also of relativity, with the latter being discussed regarding the possibility of transformation between information and energy (and mass as well). An energy equivalent of information is obtained: b, a new constant of nature, patterned after the mechanical equivalent of heat. Some approaches to the calculation of b are considered. Proceeding from the laws of transformation, a more general rule of information conservation is obtained, which may also be written as an equation of matter. The transformations can be presented also by geometrical means. In the m-W-I model space, all biological processes seem to be functions of time. By letting time be x4 = ict with a view to the spatial coordinates of the model space, the Minkowski space is shown to apply to biology too, where it seems to have implications similar to those it has in physics. In 2 tables, a systematic listing of origins and results of biodynamics and bioenergetics (biorelativity) is given. PMID- 3305141 TI - [Acute hydramnios in the 2d half of pregnancy]. AB - 95 patients were prospectively examined from 1982-1986 in a diagnostic programme. These patients showed a clinically and ultrasonically established acute hydramnios during the second half of their pregnancy period. Possible important causes of an acute hydramnios can be confirmed or excluded via on-target sonography; at the same time, a diabetic condition must be excluded and the amniotic fluid must be examined to exclude acute viral or specific bacterial infections. In 8 cases (8%) we found that the mother had diabetes mellitus requiring insulin, the hydramnios being the main pointer towards the metabolic disturbance. Gestation diabetes was confirmed in 23 patients (25%) on the basis of the polyhydramnios. Chromosomal anomalies were seen in 12 eucyeses (13%) and in 2 polycyeses. In 8 pregnancies (8%) we found a pattern of non-immunological hydrops fetalis with pleural effusions and ascites. In three patients (3%) there was an immunological hydrops fetalis with polyserositis within an Rh incompatibility pattern. Severe foetal malformations associated with a normal karyotype were sonographically found in 12 pregnancies--encyeses and twins- (12%). Cardiac disturbances (tachyarrhythmia) resulted in polyhydramnios in 8 cases of eucyesis (8%). Finally, 10 cases only remained unclarified (11%). 14 cases (15%) had twin pregnancy. In this connection we observed on the average an earlier onset of acute hydramnios (27 weeks) compared with the eucyeses (on the average during the 30th week). Timely and adequate treatment may become possible if we know the aetiology of the acute hydramnios, especially in cases of diabetes mellitus and gestation diabetes, as well as in certain foetal malfunctions, such as e.g. pleural effusions and generalised hydrops fetalis and disturbances of cardiac rhythm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305142 TI - [Transcervical chorion biopsy--hitherto experiences and results of more than 200 cases]. AB - This is a report on more than 228 chorionic biopsies performed at the Department of Gynaecology of the University of Heidelberg. After having completed the pilot study (about 100 cases before planned termination of pregnancy) with a success rate of 87% in obtaining useful chorionic villi we initiated chorionic biopsy for diagnostic purposes. A cytogenetic result was obtained in 95% of all cases after the villi had been sampled, using the method of transcervical aspiration. In 1% of the cases the obtained tissue could not be used; in another 1% a chromosomal mosaic-like pattern was seen, whereas in 3% of the cases no cytogenetic result was obtained despite the fact that partly the available tissue quantities were quite sufficient. No false sex diagnosis was made in any of the examined cases. In 98% of all instances of sampling of chorionic villi, a sufficient amount of useful chorionic villi tissue was obtained. Vaginal bleeding after chorionic biopsy occurred only in about one-third of the cases within 1-7 days after sampling. In another third of the patients questioned accordingly, no vaginal bleeding was reported following chorionic villi sampling. The remaining patients stated that there had been only short-term haemorrhages after biopsy. 122 of 226 patients have since delivered, 39 are at present in the 16th to 28th week of gestation, 41 beyond the 28th week and the remaining 13 were before the 16th week at the time they were questioned. Abortion or foetal death after chorionic biopsy was seen in four cases only (1.8%). No malformations were seen so far in the delivered infants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305143 TI - [Amniocentesis in the 2d trimenon: comparison of 2 technics]. AB - The results of 1245 amniocenteses performed by the "free hand needle" technique and ultrasonic control are discussed. The use of ultrasonic control showed a much lower incidence of blood-stained amnionic fluid as well as a decreased number of repeated punctures of the amnion. The abortion rate was almost the same in both groups. According to our experience ultrasonic controlled puncture seems to be more reliable in terms of safety and success. PMID- 3305144 TI - [Placental chorioangioma--case report and discussion of possible complications]. AB - A big chorioangioma in an uncomplicated pregnancy and delivery in the 39th week of pregnancy is reported. The child was completely normal. The prevalence, aetiology, pathological and sonographic differential diagnoses and possible complications are discussed. PMID- 3305146 TI - [Advantages of endosonographic diagnosis in gynecology and obstetrics]. AB - By echographic standards, the first applications of endosonography in gynecology and obstetrics are already in the distant past. However, only the continued development of ultrasonographic scanners and the improved imaging of endosonographic findings resulting from this have made it possible to establish that, with many indications, endosonography is superior to abdominal sonographic diagnosis. Vaginosonography in particular offers much additional information in examination of the true pelvis, especially in patients with extensive adhesions following surgery or radiation therapy, or with inflammations and endometrioses. As a result of the higher resolution, made possible by the use of higher frequencies for examination, there are also advantages in early detection of pregnancy, in assessment of cervix insufficiency, placenta previa, and especially for measurement of the pelvis. Vaginosonography has also enhanced diagnosis in folliculometry, demonstration of the endometrium, and echographically aimed punctures in the true pelvis. However, it also offers an important advantage for the gynecologist, in that he can use it immediately after palpation to clarify any uncertainties (the patient need not have a full bladder). The principal applications of hysterosonography, rectosonography, and cystosonography are in the staging of corpus and cervix carcinomas and in detecting recurrences. PMID- 3305145 TI - [Value of gynecologic sonography within the scope of preoperative diagnosis. I. Retrospective evaluation of clinically and sonographically suspected diagnoses in 1,168 patients]. AB - In 1168 women patients operated on between January 1981 and July 1984 at the Department of Gynaecology of the University of Tubingen it was possible to control retrospectively the suspected diagnoses that had been made preoperatively, both clinically as well as sonographically, the control being based on an examination of the site of operation and/or the histological preparation. Sonographic examination was mostly effected after clinical examination while being aware of the clinically suspected diagnosis. Preoperative clinical diagnosis was found to be mostly correct in 816 patients (69.9%). After subsequent sonographical examination the proportion of correct diagnoses rose to 961 cases (82.3%). The diagnostic "positive addition"--a total of 145 cases (12.4%)--represents a significant improvement in preoperative clinical diagnosis (p less than 0.001), especially also in the diagnosis of carcinoma of the ovary (p less than 0.05). No impairment of sonographic diagnosis was seen as a result of obesity. In addition, it was also possible to clarify by sonography another 73 cases of 107 that had remained unclear after clinical examination (68%). The results are discussed in detail, broken down according to 19 typical gynaecological diagnoses. For the clinician it is quite evident that there are clear indications for the additional use of sonography after clinical examination. In the following prospective part II of the study this result is analyzed in respect of its causes by clinical and sonographic examination conducted independent of each other. PMID- 3305147 TI - [Vaginal sonography of intact pregnancy in the first trimester]. AB - The experiences in vaginal sonography in early pregnancy are reported and the first results concerning the dimensions of various structures in relation to gestational age are given. Intra-uterine structures can be identified and evaluated from a measured minimum diameter of 2-3 mm. Visualization of the chorionic cavity which proves an intra-uterine pregnancy, is possible with 4 complete weeks p.m. With 10 weeks p.m., it reaches a mean diameter of nearly 50 mm. The yolk sac which normally measures 4-5 mm and excludes a blighted ovum, is reliably seen from 5 to 10 weeks p.m. The embryo and its cardiac action which proves viability of the gestation, is recognized with 6 weeks p.m. With 10 weeks p.m., the crown-rump-length measures approx. 40 mm. Thus with vaginal sonography, the mentioned important parameters of early gestation are visible 1-2 weeks earlier than with abdominal ultrasound examination. Furthermore, other structures like amnion, umbilical cord, cranial pole of the embryo etc., can be identified earlier and in more detail. The corpus luteum is frequently recognized in the ovary as an echo-free structure with a more echo-dense border. If a non-viable early pregnancy is suspected, long hospitalization and expensive hormonal investigations are avoided by the early demonstration of a viable intra-uterine pregnancy. PMID- 3305150 TI - [Prospects for the practical use of liposomes]. PMID- 3305149 TI - [Uterus didelphys and vagina duplex with pregnancy to full term]. AB - Report on a case of uterus didelphys and vagina duplex in which the fetus was carried to full term. The importance of this anomaly with regard to fertility and various problems in the course of pregnancy are discussed. PMID- 3305148 TI - [Ca 125 values in inflammatory adnexal disease and endometriosis]. AB - The serum concentration of the tumour marker CA 125 was determined during an inflammatory adnexitis of a young woman of 22 years of age, the measured value being 478 kU/l. After the inflammation had subsided, a malignoma was largely excluded by laparoscopy; the CA 125 value had dropped to 70 kU/l. In a woman of 34 years of age who had an endometriosis that had been identified for the last ten years, as well as an acute suppurative fibrinous peritonitis, the CA 125 value was found to be 205 kU/l. On the fourth postoperative day the value was around 165 kU/l, on the 13th and 26th postoperative day 273 kU/l and 168 kU/l, respectively. There were no signs of an inflammation. PMID- 3305151 TI - Tissue management: a new solution to an old problem. PMID- 3305152 TI - Water uptake by Rana temporaria: effects of diuretics and the renin--angiotensin system, and nephrectomy. AB - Adult Rana temporaria, acclimated to tap water or hyperosmotic (0.9% NaCl saline) media, were injected with Acetazolamide, Frusemide, or Captopril, or were nephrectomized and injected with captopril. Saline-injected animals served as controls. Total water flux and drinking rates were determined by body weight changes and by the rate of accumulation of an environmental marker (phenol red) in the gut, respectively. Changes in plasma corticosteroids and ion concentrations were also assessed. Acetazolamide and frusemide produced hyponatraemia in tap water-acclimated animals, but induced increased aldosterone levels in frogs in both environments. Captopril reduced body weight and aldosterone levels of tap water frogs, but had no effect on plasma ion composition. Animals treated with captopril on immersion in saline had plasma hypoosmotic to their environment. Saline-acclimated frogs drank less environmental water than did those in tap water. Captopril, acetazolamide, and frusemide all stimulated drinking rates of saline-acclimated frogs; captopril, however, had no effect on the drinking rates of nephrectomized animals, indicating that the dipsogenic actions of this drug are probably reflected by inhibition of the renin-angiotensin system. In tap water animals, acetazolamide stimulated drinking, while frusemide stimulated integumental water uptake. No correlation was apparent between plasma aldosterone and corticosterone concentrations, or between changes in body weight and drinking rates. This suggests that there are independent mechanisms controlling aldosterone and corticosterone secretion, as well as integumentary and buccal uptake of water in R. temporaria. PMID- 3305153 TI - Localization of G cells in the antral mucosa of Rana temporaria: immunocytochemical and electron microscopy study. AB - G cells of the frog antral mucosa are described both in deplasticized semithin sections treated with antigastrin/CCK COOH terminal serum and in subsequent thin sections observed under the electron microscope. G cells are quite abundant in the antral mucosa, located between mucosecretory cells in the lateral aspects of glands. They bear irregular, occasionally round granules, with a 190-nm mean diameter. PMID- 3305154 TI - Brain distribution of radioimmunoassayable gonadotropin-releasing hormone in female goldfish: seasonal variation and periovulatory changes. AB - A radioimmunoassay (RIA) for [Trp7, Leu8]gonadotropin-releasing hormone (sGnRH) was developed to determine the gonadotropin-releasing hormone (GnRH) content in discrete brain areas of female goldfish at different stages of ovarian development. Temporal changes in serum gonadotropin (GtH) and GnRH concentrations in discrete brain areas were measured during spontaneous ovulation. There were no clear parallel changes in brain GnRH with seasonal ovarian development in goldfish. However, under a 10 degrees temperature acclimation regimen, the GnRH content in the hypothalamus and pituitary decreased as the ovary progressed from the regressed to the mature condition; on the other hand. GnRH content in the spinal cord increased in sexually mature fish compared with that in regressed fish. Significant decreases in GnRH concentration were observed in certain brain areas (olfactory bulbs, telencephalon, hypothalamus, and pituitary) of fish undergoing spontaneous ovulation compared with those of nonovulatory fish. The simultaneous changes of GnRH concentration in these brain areas suggested that the GnRH neuronal system may function as an integrated unit for the activation of GtH secretion during ovulation in goldfish. PMID- 3305156 TI - Doing behavioral genetics with bacteria. PMID- 3305155 TI - Peptidyl-glycine alpha-amidating monooxygenase is present in islet secretory granules of the anglerfish, Lophius americanus. AB - Anglerfish islet secretory granules have been examined for the presence of an enzyme which could perform C-terminal amidation of glucagon-like peptide II and possibly anglerfish peptide Y. Using [125I]D-Tyr-Val-Gly as substrate, a peptidyl glycine alpha-amidating monooxygenase (PAM) was detected in islet secretory granule lysates. The enzyme is active between pH 6.0 and 8.5 and exhibits maximal activity near pH 7.0. The islet PAM requires Cu2+, ascorbate, and molecular oxygen for activity. Other divalent metal ions and redox cofactors were tested and found to be inactive in the assay. Even though added Cu2+ and ascorbate are required for detecting islet PAM activity, when these factors were incubated with substrate in the absence of secretory granule lysate, no activity was observed. It was also found that the addition of higher than optimal concentrations of either Cu2+ or ascorbate inhibited amidating activity. The results demonstrate that a PAM is present in secretory granules of anglerfish islet tissue. The characteristics of the islet PAM are similar to those of PAMs identified and characterized in other tissues which produce bioactive C-terminally amidated peptides. PMID- 3305157 TI - The identification and characterization of ADR6, a gene required for sporulation and for expression of the alcohol dehydrogenase II isozyme from Saccharomyces cerevisiae. AB - The alcohol dehydrogenase II isozyme (enzyme, ADHII; structural gene, ADH2) of the yeast, Saccharomyces cerevisiae, is under stringent carbon catabolite control. This cytoplasmic isozyme exhibits negligible activity during growth in media containing fermentable carbon sources such as glucose and is maximal during growth on nonfermentable carbon sources. A recessive mutation, adr6-1, and possibly two other alleles at this locus, were selected for their ability to decrease Ty-activated ADH2-6c expression. The adr6-1 mutation led to decreased ADHII activity in both ADH2-6c and ADH2+ strains, and to decreased levels of ADH2 mRNA. Ty transcription and the expression of two other carbon catabolite regulated enzymes, isocitrate lyase and malate dehydrogenase, were unaffected by the adr6-1 mutation. adr6-1/adr6-1 strains were defective for sporulation, indicating that adr6 mutations may have pleiotropic effects. The sporulation defect was not a consequence of decreased ADH activity. Since the ADH2-6c mutation is due to insertion of a 5.6-kb Ty element at the TATAA box, it appears that the ADR6+-dependent ADHII activity required ADH2 sequences 3' to or including the TATAA box. The ADH2 upstream activating sequence (UAS) was probably not required. The ADR6 locus was unlinked to the ADR1 gene which encodes another trans-acting element required for ADH2 expression. PMID- 3305158 TI - A method for gene disruption that allows repeated use of URA3 selection in the construction of multiply disrupted yeast strains. AB - In this paper, we describe a 3.8-kb molecular construct that we have used to disrupt yeast genes. The construct consists of a functional yeast URA3 gene flanked by 1.1-kb direct repeats of a bacterial sequence. It is straightforward to insert the 3.8-kb segment into a cloned target gene of interest and then introduce the resulting disruption into the yeast genome by integrative transformation. An appropriate DNA fragment containing the disruption plus flanking homology can be obtained by restriction enzyme digestion. After introducing such fragments into yeast by transformation, stable integrants can be isolated by selection for Ura+. The important feature of this construct that makes it especially useful is that recombination between the flanking direct repeats occurs at a high frequency (10(-4)) in vegetatively grown cultures. After excision, only one copy of the repeat sequence remains behind. Thus in the resulting strain, the Ura+ selection can be used again, either to disrupt a second gene in similar fashion or for another purpose. PMID- 3305159 TI - Characterization of null mutants of the RAD55 gene of Saccharomyces cerevisiae: effects of temperature, osmotic strength and mating type. AB - RAD55 belongs to a group of genes required for resistance to ionizing radiation, RAD50-RAD57, which are thought to define a pathway of recombinational repair. Since all four alleles of RAD55 are temperature conditional (cold sensitive) for their radiation phenotype, we investigated the phenotype produced by null mutations in the RAD55 gene, constructed in vitro and transplaced to the yeast chromosome. The X-ray sensitivity of these null mutant strains was surprisingly suppressed by increased temperature, osmotic strength of the growth medium and heterozygosity at the mating-type locus. These first two properties, temperature conditionality and osmotic remediability, are commonly associated with missense mutations; these rad55 null mutants are unique in that they exhibit these properties although the mutant gene cannot be expressed. X-ray-induced mitotic recombination was also cold sensitive in rad55 mutant diploids. Although mitotic growth was unaffected in these strains, meiosis was a lethal event at both high and low temperatures. Whereas the phenotype of rad55 null mutants is consistent with a role of RAD55 in recombination and recombinational repair, there is evidence for considerable RAD55-independent recombination, at least in mitotic cells, which is influenced by temperature and MAT. We discuss models for the role of RAD55 in recombination to explain the unusual properties of rad55 mutants. PMID- 3305160 TI - [Mutants of Saccharomyces cerevisiae characterized by increased level of induced mutagenesis. I. Isolation and preliminary characterization of mutants]. AB - 6 mutants with enhanced nitrous acid-induced reversibility of the ade2-42 allele were isolated and designated hm (high mutagenesis). Apart from sensitivity to the mutagenic exposure to nitrous acid, hm mutants were also spontaneous mutators and hypermutable under the action of UV-light and 6-N-hydroxyaminopurine. All these effects were detected not only when analysing reversibility of the ade2-42 allele, but also when scoring forward mutations in the ADE1, ADF2 genes. Gamma mutagenesis, however, was not affected by hm mutations. PMID- 3305161 TI - [Induced mutagenesis in Salmonella typhimurium AG262 strain constructed for screening the mutagens]. AB - The Salmonella typhimurium strain AG262 has been constructed for screening of SOS mutagens, such as UV-light and 4NQO, the Ames plasmidless tester strains of S. typhimurium being mutation-proof under the action of this class of mutagens. The strain AG262 has also been successfully used for screening of induced base pair change mutations occurring independently of cellular SOS-system of mutagenesis (MNNG, EMS, nitrofuran derivatives), and of the mutations induced by frame-shift mutagens (benzo/a/pyrene 7,12-dimethylbenzo/a/antracene ICR-191, 9AA, DDDTDP). PMID- 3305163 TI - [Inheritance and expression of dominant genes with variable penetration: the evolutionary aspect]. AB - According to up-to-date literature, one of the approaches to elucidating the essence of evolutionary events consists in admitting the importance of events which change genome activity. A crucial way of reorganization of gene activity is the inhetrited activation or inactivation of the genes. "Dormant" gene hypothesis and related data are reviewed in this connection. Most attention is concentrated on the study of inheritance and penetrance of fused gene in mice. By means of individual genetic analysis, it became possible to make a clear-cut distinction between the phenomenon of the lowered gene penetrance and its inherited inactivation. It was shown that low penetrance is a more frequent event which seems to mask the inherited inactivation of the gene. A general scheme of the phenomena studied is proposed. The classical conceptions claiming the existence of a reserve of hereditary variability concern mainly the recessive and codominant mutations. However, the role of dominant and semidominant mutations in the course of functional reconstruction of species may be important. During animal domestication, for example, everyone can see a lot of dominantly inherited characters appearing de novo. D.K. Belyaev's conception about "dormant" gene reserve is of great importance in this connection. Opening of the reserve at a particular evolutionary stage may drastically increase the genetic variability and lead to appearance of evolutionary novelty. PMID- 3305162 TI - [Identification of idiotrophs for 3'-deoxykanamycin B synthesis in Streptomyces tenebrarius (Higgens a. Kastner)]. AB - Mutants of Streptomyces tenebrarius with the blocked synthesis of 3' deoxykanamycin B were obtained by treating the producer with NTG and chloramphenicol, or after gamma-irradiation. These mutants (idiotrophs) were distributed into three groups by means of the cosynthesis experiments on agar plates: convertors, secretors and "neutral" strains. Five idiotrophs represented five complementation groups for biosynthesis of the antibiotic. Three of these were defective in 2-deoxystreptamine synthesis, the fourth was defined as neamine negative, and the fifth was probably blocked in regulation of enzymes responsible for conversion of neamine or paromamine into kanamycins. Localization of mutations has been shown on the scheme of kanamycins' biosynthesis. PMID- 3305164 TI - [Molecular mechanisms of stress-induced hereditary variability]. AB - The molecular mechanisms of generation of stress-induced genetic recombinations and point mutations are considered. Due to the oxidative, temperature, radiation and other forms of stress, intensive modification of DNA bases occurs. Excision of the modified bases (hypoxanthine, uracil, pyrimidine photoproducts, methylated purines) leads to the formation of single-stranded gaps in DNA. If one DNA strand is damaged, there is high probability of its primary structure being completely restored. When the rate of lesions increases, the DNA can be damaged in the gap related opposite sites of both strands. It is shown that in this case, the excision repair leads to a burst of recombinations and point mutations which may be concerned with the mispairings, double-stranded breaks, induction of SOS response. With the increase in the rate of lesions, the possibility of the damage in self-complementary DNA sequences is also enhanced. This leads to formation of hairpin structures in the single-stranded DNA stretches. It is demonstrated that in these cases the repair results in development of deletions, insertions and clusters of point mutations predetermined by the primary DNA structure. Independent means of stress-induced mutations' occurrence seem to be the transposable elements. The stress-induced outbreaks of recombinations provide conceivably new variants of genotypes to be selected for the adaptation to new extreme conditions. PMID- 3305165 TI - [Genetics of human behavior: problems, results and prospects]. AB - In this paper, the main problems of modern behaviour genetics of man are formulated and methods for their study proposed. As a result of the Mendelian analysis of some psychometric scales of personality inventories, a major-gene mode of inheritance is found for 20% of scales of three questionnaires: MMPI, 16 PF and the Pathocharacterologic Diagnostic Inventory (PDI). Perspectives of further studies in the field of human behaviour genetics are outlined. PMID- 3305166 TI - [Problems and perspectives of studies on animal genetics and breeding. A festschrift for Dmitrii Konstantinovich Beliaev]. PMID- 3305167 TI - [Current approaches to the synthesis and reconstruction of genetic material]. AB - Advanced approaches to the synthesis and reconstruction of genetic material developed in the Institutes of Molecular Biology and Genetics during the past years are summarized. The evolution of methods for oligonucleotide synthesis and scopes for their use in gene production are discussed. The principles of localised mutagenesis methods developed in the Institute are described, such as: a) mutagenesis directed to the regulatory gene regions; b) segment-localized mutagenesis; c) mutagenesis directed by phosphotriester analogues of oligonucleotides. Examples of employing these methods for induction of regulatory mutants of phage lambda, production of fused genes, mutant interferon genes, construction of new DNA vectors, construction of hybrid H1-H3 subtype haemagglutinine gene of influenza virus etc. are presented. The approach to in vivo site-directed mutagenesis is experimentally substantiated. PMID- 3305168 TI - [The problem of morphogenesis and integrity in the context of destabilizing selection]. PMID- 3305169 TI - [Genetico-evolutionary aspects of the problem of fertility homeostasis in mammals (illustrated by minks)]. PMID- 3305170 TI - Antisuppressor mutations in Aspergillus nidulans: cold-resistant revertants of suppressor suaC109. PMID- 3305171 TI - Measurement of cat expression from growth-rate-regulated promoters employing beta lactamase activity as an indicator of plasmid copy number. AB - Many promoter-fusion vectors contain an intact beta-lactamase (BLA) gene (bla) to allow measurement of BLA activity as an internal control for plasmid copy number. This approach rests on the assumption that bla is constitutively expressed. To use such vectors for comparison of promoter activity at different growth rates it was necessary to confirm that this is the case under all physiological conditions. The relationship between plasmid copy number and BLA activity at different steady-state growth rates in Escherichia coli HB101 transformed with a ColE1-type plasmid (pBR325) was examined. Both BLA activity and plasmid copy number decreased in a parallel fashion as growth rate increased. This finding was tested further by measuring the growth-rate-regulated expression of the chloramphenicol acetyltransferase (CAT) gene under the control of the rrnB P1 promoter in a plasmid pKK231-1 fusion. The results indicate that BLA activity is a reliable indicator of copy number at a wide range of growth rates and that CAT/BLA ratios can be employed as a valid measure of promoter-specific activity in such plasmid fusions under these different physiological conditions. PMID- 3305172 TI - Positive selection vectors based on xylose utilization suppression. AB - High levels of xylose isomerase activity in wild-type Escherichia coli strains results in a Xyl- phenotype. This phenomenon was exploited for the development of a versatile positive selection system. The xylA promoter was deleted with the exonuclease BAL 31 and the resulting structural gene was inserted into the SmaI site of pUC9, yielding the prototype vector, pLX100. In this construct xylA expression is placed under the transcriptional control of the lac promoter. Transformation of any wild-type E. coli strain with pLX100 results in high levels of xylose isomerase and a Xyl- phenotype. Decreasing the activity below a critical level (approx. 100 u) restores the Xyl+ phenotype. pLX100 contains contiguous restriction sites for HindIII, PstI, BamHI and XhoI, suitable for positive selection cloning experiments. E. coli transformants containing pLX100 cannot grow in minimal medium with xylose unless a DNA fragment is inserted into any one of the unique restriction sites. This makes the plasmid an ideal positive selection cloning vector. PMID- 3305173 TI - [The Austrian hygienist and occupational pathologist Ludwig Teleki (1872-1957)]. PMID- 3305174 TI - [Hygienic problems in the use of technical teaching media in universities and schools]. PMID- 3305175 TI - [Working conditions and the health status of nurses conducting pharmacotherapy]. PMID- 3305176 TI - [Current aspects of the use of antioxidants to increase resistance of the body exposed to environmental chemical pollutants]. PMID- 3305177 TI - [Use of display terminals and the health status of schoolchildren]. PMID- 3305178 TI - [History of occupational medicine in the United States]. PMID- 3305179 TI - The single-electron shift as a basis of organic reactivity. AB - The configuration mixing (CM) model is applied to the building of a simple reaction profile for nucleophilic addition to a carbonyl group. The analysis leads us to conclude that essentially all the so-called polar reaction pathways in organic chemistry are single-electron shift processes and intimately related to the class of electron transfer (ET) reactions. The implication of this finding to a variety of organic reactions, including oxidation-reduction of the NADH/NAD+ coenzyme couple, is discussed. PMID- 3305180 TI - Mathematical models from laws of growth to tools for biologic analysis: fifty years of "Growth". AB - Mathematical models of size and shape have played a prominent role in the first half century of Growth. In honor of the fiftieth anniversary of the journal, this paper reviews the development of these models. An historical perspective is taken with a focus on the changing context in which mathematical models have been studied. Early models were thought to represent principles or laws of growth. Today, models are viewed as tools for biologic analysis. We trace this contextual shift through specific models developed and used in Growth. PMID- 3305181 TI - Hormonal and nutritional determinants of catch-up growth in hamsters. AB - Exercise accelerates somatic and skeletal growth in mature nondeprived hamsters and induces catch-up growth when food restriction during exercise is followed by ad libitum realimentation. The hypothesis that nutrient availability controls the rate of growth through changes in anabolic hormone release was tested through measurements of serum growth hormone (GH) and insulin concentrations at the same time of day in exercising and sedentary hamsters subjected to acute fasts, chronic food restriction, and to acute and prolonged realimentation. Concentrations of GH and insulin increased in ad libitum-fed exercising hamsters, but these increases were abolished by 12 and 4 h of fast, and restored by 4 and 2 h of refeeding, respectively. Four h of refeeding restored exercise-induced increases in serum GH, but not in serum insulin concentration in chronically food restricted hamsters. During catch-up growth, the growth rate was double that of ad libitum fed exercising hamsters, but the increases in serum GH concentration in the two situations were similar. I conclude that increases in serum GH rather than in serum insulin concentration are the most probable determinant of exercise induced growth and catch-up growth because they are relatively refractory to short-term nutritional perturbations. PMID- 3305182 TI - [Victor Ivanovich Struchkov and his role in the development of lung surgery in the USSR (on his 80th birthday)]. PMID- 3305183 TI - Variceal sclerotherapy: further progress. PMID- 3305184 TI - Variceal bleeding: does variable delay in trial entry invalidate comparison between trials? AB - Variation in time of patient admission to studies of prognosis after variceal haemorrhage has been proposed as a major factor in the wide range of reported results. A study of 144 unselected subjects with a low initial mortality (3% at two days) suggests that the effect has been overemphasised and studies in which time of entry is later than the date of bleeding may be usefully compared. Reanalysis of previous work suggests that even in populations with a high initial mortality limited comparisons between studies can still be usefully made. It is stressed that survival analysis must be started from the date of study entry and not from the date of the index bleed which involves incorporating a retrospective period of survivorship. PMID- 3305186 TI - Clinical trial of etoposide and cisplatin as salvage therapy in advanced ovarian carcinoma. AB - The combination of etoposide and cis-platinum was evaluated in the treatment of advanced ovarian cancer. Of 13 treated patients, 4 demonstrated complete clinical responses and 3 demonstrated partial clinical responses. The mean progression free interval was 14 months+ for the complete responders and 8.3+ months for the partial responders. The 100 mg/m2 dose of etoposide appears to be critical in attaining response. This etoposide and cisplatinum combination appears to be effective as a salvage regimen in ovarian carcinoma. PMID- 3305187 TI - Acute nonlymphocytic leukemia in adults: pathophysiology, status of current therapy, and new approaches. PMID- 3305185 TI - Intravariceal versus paravariceal sclerotherapy: a prospective, controlled, randomised trial. AB - Fifty four consecutive patients with oesophageal variceal bleeding were randomised to undergo intravariceal (28 patients) or paravariceal (26 patients) sclerotherapy, every three weeks. Intravariceal technique was found significantly (p less than 0.01) more effective in controlling active variceal bleeding than the paravariceal technique (91% v 18.7% respectively). The mean (+/- SD) time taken for variceal eradication by intravariceal sclerotherapy (15.4 +/- 5.3 weeks) was significantly (p less than 0.001) less than paravariceal (26.8 +/- 6.6 weeks) technique. The number of sclerotherapy sessions needed with intravariceal technique were also significantly less. Rebleeding was seen in 38.5% patients after para and 14.3% after intravariceal injections (NS). Except for retrosternal pain, which occurred more often (p less than 0.01) with paravariceal technique, there was no difference in the incidence of other complications or mortality between the two groups. Variceal recurrence was seen in seven patients (25%) in the intra and one (3.9%) patient in the paravariceal group (p less than 0.01) after a mean follow up of 29.4 +/- 9.1 weeks. Intravariceal sclerotherapy was superior to paravariceal in the control of active variceal bleeding and for total variceal obliteration, but was associated with a higher variceal recurrence. PMID- 3305188 TI - Risk groups in adult acute lymphoblastic leukemia. PMID- 3305190 TI - Therapy for adolescent and adult acute lymphoblastic leukemia: randomization of induction and consolidation therapies (preliminary results of EORTC Study 58791). PMID- 3305191 TI - The BFM relapse studies in childhood ALL: concepts of two multicenter trials and results after 2 1/2 years. PMID- 3305192 TI - Stratification by prognostic factors in the design and analysis of clinical trials for acute lymphoblastic leukemia. PMID- 3305189 TI - Treatment of adult acute lymphoblastic leukemia. Preliminary results of a trial from the French Group. AB - We present here the results of a cooperative trial in 244 adult patients with acute lymphoblastic leukemia. Induction therapy with vincristine, cytoxan, and prednisone (VCP) gave the same complete remission rate after one course as more aggressive induction with vincristine, rubidazone, araC, and prednisone (VRAP) due to increased toxic death in the aggressive arm. Because of high efficacy of salvage therapy with VRAP regimen in patients failing to achieve CR with VCP regimen, patients initially randomized to receive VCP had a significantly higher CR rate than patients initially receiving VRAP (87% vs. 73%, p = 0.01). Patients randomized to receive postremission consolidation using adriamycin, araC, and asparaginase (AAA) prior to maintenance had a significantly longer remission than patients not receiving consolidation (p less than 0.005). At the time of analysis allogeneic bone marrow transplantation does not significantly increase disease free survival when compared with intensive consolidation chemotherapy. PMID- 3305193 TI - Strategies for the treatment of children with acute lymphoblastic leukemia and unfavorable presenting features. PMID- 3305194 TI - Infection prevention and immediate antibiotic therapy in the neutropenic patient. PMID- 3305195 TI - The role of bone marrow transplantation in acute myelogenous leukemia. PMID- 3305197 TI - Morphological and cytochemical classification of adult acute leukemias in two multicenter studies in the Federal Republic of Germany. PMID- 3305196 TI - Allogeneic marrow transplantation for treatment of leukemia: results of the Munich Cooperative Group. PMID- 3305198 TI - Bone marrow transplantation in acute leukemia. AB - In Essen 142 bone marrow transplantations were carried out between December 1975 and February 1985. In 74 cases the indication was acute leukemia in relapse (n = 23) or in first or consecutive remission (n = 51). The conditioning regimen consisted of cyclophosphamide or the combination of cyclophosphamide and total body irradiation. All patients were treated under strict gnotobiotic care. To mitigate the risk of CMV infections, intravenous CMV-hyperimmune globulin and CMV negative blood products have been applied routinely for 2 years. MTX was used as prophylaxis against GvHD. In the prognostically unfavorable group of acute leukemia in relapse, only one patient showed long-term survival. In this patient, leukemic relapse occurred 6 years after transplantation. The survival rate of AML patients grafted during the first remission is 55% (16/29) with a median observation time of 41 months. For patients grafted in first or consecutive remission of acute lymphoblastic leukemia, the survival rate is 50% (7/14) with a maximal observation time of 34 months. The overall incidence of GvHD in patients at risk was 28% in aplastic anemia, 26% in AML, 9% in ALL, and 63% in CML. In aplastic anemia, no patient developed an interstitial pneumonia. In leukemia, the risk of fatal interstitial pneumonia was 34%. PMID- 3305199 TI - Bone marrow transplantation in childhood leukemia in West Germany. PMID- 3305201 TI - Treatment of patients with acute myeloid leukemia in first remission with marrow ablative therapy and autologous bone marrow transplantation. PMID- 3305200 TI - Allogeneic, syngeneic, and autologous bone marrow transplantation in the acute leukemias--Baltimore experience. AB - In presentation of our data in context of other clinical series, we have identified a few bone marrow transplant preparative regimens that appear to have a superior advantage over others as far as their antileukemic effects are concerned. So far, the delayed and late effects of the treatment appear to be quite acceptable considering the ultimate fatal outcome in the acute leukemias, in particular those in their second remission. GvHD and viral infections account for about two-thirds of the mortalities in series where leukemic relapse is very low. It is hoped that solutions or at least partial solutions will not only improve the overall therapeutic results, but will allow us to extend the procedure to older patients. It is suggested that the need for unrelated HLA "matched" donors may be supplanted by the use of autologous bone marrow transplants, particularly in the older patients. PMID- 3305202 TI - Abnormal production and release of ferritin by immature myeloid cells in leukemia. PMID- 3305203 TI - Therapeutic strategies in acute myelocytic leukemia: a status report of the experience of CALGB. Cancer and Leukemia Group B. PMID- 3305204 TI - Phase I/II trial of high-dose cytosine arabinoside and mitoxantrone in adult refractory acute myeloid leukemia. PMID- 3305205 TI - Mitoxantrone and VP-16 in refractory acute myelogenous leukemia. PMID- 3305206 TI - Remission induction with cytarabine and daunorubicin with or without 6 thioguanine in adult patients with acute myelocytic leukemia. PMID- 3305207 TI - Long-term results of two Swiss AML studies. AB - The Swiss group for clinical cancer research (SAKK) completed two first line protocols for the treatment of acute myelogenous leukemia (AML). In the first protocol (SAKK AML 74, from August 1974 to April 1977; 107 patients) the effectiveness of immunization with viral oncolysate during maintenance treatment was tested. After successful induction treatment, the patients were randomized in two groups: Group A: monthly maintenance chemotherapy for 2 years and group A+IT, which received the same maintenance chemotherapy regimen plus, on day 15, injection of viral oncolysate. Of the 107 patients, 57 (53%) achieved complete remission, 29 then being randomized to group A, 28 to group A+IT. As of August 1984, there is no statistical difference between the survival times of the two groups (p = 0.288). Ten years after the start of the study there is still no clear plateau of the survival curve. Nine percent of all patients (18% of the remission patients) are alive today. With the treatment of the mid-seventies, therefore, the cure of a patient suffering from AML was a rare event. The second protocol (SAKK AML 77, from April 1977 to April 1982; 162 patients) was designed to evaluate the usefulness of a prolonged maintenance treatment after early consolidation. The 74 patients who were still in remission after early consolidation treatment were assigned to either maintenance chemotherapy or to observation only. At 3.5 years after the last patient's entry there was no difference between the groups in duration of survival (p = 0.332).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305208 TI - Treatment of childhood acute nonlymphocytic leukemia with individually scheduled high doses of cytarabine: preliminary results of study ANLL-82 of the Dutch Childhood Leukemia Study Group (DCLSG). PMID- 3305209 TI - Aclacinomycin-A in the induction treatment of childhood acute myelogenous leukemia. PMID- 3305210 TI - Progress in treatment of children with non-Hodgkin lymphoma: a report of the Polish Leukemia and Lymphoma Study Group. PMID- 3305211 TI - Addition of rubidomycin to induction treatment with vincristine, prednisone, and L-asparaginase in standard-risk childhood acute lymphocytic leukemia (study ALL V): a report on behalf of the Dutch Childhood Leukemia Study Group. PMID- 3305212 TI - Medical Research Council Childhood Leukaemia Trial VIII compared with trials II VII: lessons for future management. AB - This improvement in medium disease-free survival is probably a result of sustained early cell kill, and UKALL VIII has enabled us to define risk categories requiring even further continuous intensification, as now introduced in MRC UKALL X. Thanks to the greater availability of blood products, for example, the rational use of antibiotics and the development of expertise amongst nurses and doctors, such sustained therapy can now be delivered on a multi-centre basis, but only in experienced centres. The monitoring and removal of morbidity are essential if the advantages of this more sustained chemotherapy are to be realised. All elements of therapy require controlling and patients, parents and, above all, doctors must comply with protocol requirements in order to build further upon these initial promising results. PMID- 3305213 TI - Intermediate-risk childhood acute lymphoblastic leukemias: amsacrine + cytosine arabinoside versus intermediate-dose methotrexate for consolidation, and 6 mercaptopurine + methotrexate + vincristine versus monthly pulses for maintenance. PMID- 3305214 TI - Treatment of acute lymphoblastic leukemia in children with the BFM protocol: a cooperative study and analysis of prognostic factors. PMID- 3305215 TI - Results of acute lymphoblastic leukemia therapy in childhood with a modified BFM protocol in a multicenter study in the German Democratic Republic. AB - Between 1 September 1981 and 31 December 1985, 382 previously untreated children with ALL were entered into study VII/81, a multicentric and randomized study with a modified BFM protocol. Patients were divided into three risk groups according to the initial lymphoblast count and liver and spleen enlargement: standard- (SR), medium- (MR), and high-risk (HR) groups. Of all patients, 94% attained complete remission. The actuarial probability of event-free survival is 0.62 +/- 0.04 (SR group, 0.66 +/- 0.06; HR group, 0.29 +/- 0.12). Sixty-one patients relapsed, 10 had isolated CNS relapses, and 11 CNS relapses were combined with bone marrow relapses. Concerning the duration of maintenance therapy, patients were randomized into two groups of 18 and 24 months respectively. Up to now, there has been a slight advantage for the 18-month group. Two different methods of CNS preventive therapy for SR patients (irradiation plus intrathecal methotrexate and intermediate-dose methotrexate (IDMTX) plus intrathecal methotrexate) were used and revealed a higher rate of CNS relapses but a lower rate of bone marrow relapses in the intermediate-dose MTX group. PMID- 3305216 TI - Aggressive combination chemotherapy of bone marrow relapse in childhood acute lymphoblastic leukemia containing aclacinomycin-A: a multicentric trial. AB - An intensive 7-day combination chemotherapy protocol was designed to reinduce children with early bone marrow relapse of acute lymphoblastic leukemia (less than 6 months after the end of or during preceding treatment). This aggressive approach seemed to be justified for a group of patients who were at the highest risk for ultimate treatment failure. In all, 38 children were enrolled for study. The ratio of male (median age, 10 years) to female (median age, 13 years) subjects was 27:11. Thirty patients were treated for their first relapse and eight for their second or subsequent relapse. Isolated bone marrow involvement was present in 24 cases. All patients had received heavy pretreatment including anthracyclines with cumulative doses of between 120 and 240 mg/m2. 22 of these patients, achieved complete remission, ten did not respond to therapy, and six died from the toxicity of the protocol. Cardiac failure was the cause of death in one child (after additional radiotherapy for a mediastinal mass). No further clinical manifestation of cardiomyopathy could be observed. The other five patients died from hemorrhages or infectious complications. The main side effects were fever, gastrointestinal problems, stomatitis, and severe bone marrow aplasia lasting for about 2 weeks with nadirs of platelets and white blood count around days 10-14. The remission rate of 60% was acceptable, though not satisfactory. Only four children survived disease-free for 13+, 14+, 20+, and 22+ months after diagnosis of relapse. PMID- 3305218 TI - On the fate of leukemic cells infused with the autologous marrow graft. PMID- 3305217 TI - Remission induction and maintenance modalities in acute myeloid leukemia: a multicenter randomized study. PMID- 3305219 TI - Depletion of T cells from bone marrow grafts with soybean agglutinin and sheep red blood cells for prevention of graft-versus-host disease. PMID- 3305220 TI - Bone marrow transplantation for chronic granulocytic leukemia: results of the French Cooperative Group (GEGMO). PMID- 3305221 TI - Postinduction and preremission chemotherapy alternatives for adult AML: three multicenter studies of the AML Cooperative Group. AB - Major chemotherapeutic alternatives for AML have been implemented and compared in three multicenter studies, including a total of 877 adult patients of all ages. The results strongly suggest that myelosuppressive postinduction treatment is a prerequisite for the achievement of long-term remissions. In addition, it was possible to establish an important antileukemic effect of monthly maintenance chemotherapy. Initial results from an intensive two-course preremission therapy concept revealed good practicability and acceptable toxicity, as well as promising response and remission durations by this new approach. PMID- 3305222 TI - An HLA lost mutation may lead to leukemic relapse of recipient type six years after bone marrow transplantation. PMID- 3305223 TI - Toxoplasmosis after bone marrow transplantation. PMID- 3305224 TI - Neuraminidase-treated allogeneic blasts for maintenance in acute myelogenous leukemia: results of a prospective randomized trial. AB - Between July 1, 1981, and July 1, 1985, 167 patients with acute myelogeneous leukemia (AML) were treated with one or, if necessary, two courses of a modified TAD regimen (TAD9) for induction. 96 patients (58%) achieved a complete remission (CR); 62 achieved CR after one and 34 patients after two courses of TAD9. 29 patients (17%) were considered early deaths, and 42 patients (25%) nonresponders. For CR maintenance 64 patients were eligible according to protocol criteria; 33 patients were randomized to chemotherapy, only, (CT) by monthly courses of cytosine arabinoside (ARA-C) alternatingly combined with daunorubicin or thioguanine or cyclophosphamide, while 31 patients were randomized to receive immunotherapy in addition to chemotherapy (CIT) by intradermal injections of 10(10) neuraminidase-treated viable allogeneic blasts per immunization interspersed between the CT courses. Maintenance therapy was given for up to 3 years. The median survival in CT patients is 23 months, while in CIT patients the median has not been reached after 54 months; corresponding median relapse-free survival is 15 months for the CT patients as opposed to 40 months for the CIT group. The differences are not significant. Comparing CT with CIT, the survival data show a persistent trend in favor of CIT; under the conditions of the study, however, a substantial benefit of immunotherapy may be restricted to a certain subset of patients with low risk for early relapse. PMID- 3305225 TI - The childhood AML studies BFM-78 and -83: treatment results and risk factor analysis. PMID- 3305226 TI - Improved treatment results in childhood acute nonlymphoblastic leukemia with the BFM-AML protocol 78 in a multicenter study in the GDR. AB - Eighty-seven children with acute nonlymphoblastic leukemia were treated with the AML protocol BFM 78 between June 1979 and February 1986 in a multicenter study in the GDR. Seventeen children (20%) died from early complications, eight did not respond to therapy. Fifty-eight patients (70%) achieved a complete remission. Twenty-three patients relapsed. The life table analysis revealed after 5 years a probability for event-free survival of 36% (SD = 6%) and an event-free interval of 51% (SD = 8%). Six patients were transplanted in first remission. Two of them died; one (M 1) on day + 19 from encephalopathy and one (M 4) on day + 60 from acute GVHD. The overall results are in good correlation with the original BFM study, but there are differences in the subtypes. Results are superior to other AML protocols in our group. PMID- 3305228 TI - [Routine microbiologic diagnosis of inflammatory gynecologic diseases including sexually transmitted diseases]. PMID- 3305227 TI - A comparison of cytokinetically based versus intensive chemotherapy for childhood acute myelogenous leukemia. PMID- 3305230 TI - Intrauterine balloon catheter for ultrasound evaluation of pelvic masses. Enhancement of uterus localization. AB - Pelvic masses can be diagnosed by pelvic ultrasonography. Difficulties may be encountered to identify the organ origin of a pelvic mass. An intrauterine marker is proposed to facilitate the diagnosis by the exact localization of the uterus and its relationship to other pelvic findings. PMID- 3305229 TI - [Effectiveness of Alphastria cream in the prevention of pregnancy stretch marks (striae distensae). Results of a double-blind study]. PMID- 3305231 TI - Release of plasminogen activator by batroxobin. AB - In the isolated perfused pig ear, batroxobin caused a dose-dependent increase in the release of plasminogen activator. The activator-releasing effect required the presence of the active enzyme. The activator released was of the tissue-type. PMID- 3305232 TI - [Detection of urinary tract infection by bioluminescence of bacterial ATP]. PMID- 3305233 TI - [Osmoregulation of thirst and ADH secretion]. PMID- 3305235 TI - [Prognostic aspects in chronic obstructive pulmonary disease (COPD)]. PMID- 3305234 TI - [Carotid sinus hypersensitivity]. PMID- 3305236 TI - [Value and limitations of electrophysiologic studies in the management of ventricular tachycardia]. PMID- 3305237 TI - [Throat culture--outdated?]. PMID- 3305238 TI - [Mucociliary transport in obstructive lung disease]. PMID- 3305239 TI - [Anti-hypertensive therapy and its influence on the blood]. PMID- 3305240 TI - [Adverse reactions to aspirin in bronchial asthma]. PMID- 3305241 TI - [Duodenitis]. PMID- 3305242 TI - [Endocardial fibroelastosis]. PMID- 3305243 TI - [Experimental models for studying the avoidance response in mice and the anti amnesic effect of prolyl endopeptidase inhibitors]. AB - Prolyl endopeptidase (PPCE) plays an important role in the degradation of biologically active peptides such as vasopressin which facilitates the process of learning and memory. Here, the effect of synthetic PPCE inhibitors (Z-Pro-, Suc Pro-, Suc-Pyr-, Suc-Sar- and Z-prolinal) on the acquisition and retention of avoidance response was studied. Using mice of the ddY strain, tests were performed both in repeated trials of an active avoidance task and in a newly contrived one-trial passive-active avoidance task. The applicability of both tests for the evaluation of the anti-amnesic effect of the drugs was confirmed by the effect of scopolamine and arginine vasopressin (AVP). The most potent inhibitor, Z-Pro-prolinal, facilitated the acquisition of active avoidance response and retarded the extinction of the response. Other inhibitors also facilitated the retention of the acquired response. In the one-trial passive active avoidance test, the facilitating effect of the PPCE inhibitors on the acquisition was parallel to their activity as a PPCE inhibitor. Scopolamine induced amnesia was also improved by the inhibitors. These results suggest that the anti-amnesic effect of PPCE inhibitors is partially attributed to their inhibitory effect on the breakdown of AVP in the brain. PMID- 3305244 TI - [Anti-amnesic effect of prolyl endopeptidase inhibitors in mice]. AB - Based on the results of a previous report that prolyl endopeptidase (PPCE) inhibitors facilitated the acquisition of active avoidance response and retarded the extinction of the response, further studies were made on the effect of PPCE inhibitors on learning and the memory process. Using mice, tests were performed both in the light-dark discrimination Y-maze task and the lever-press task of the water reinforcement schedule, and mice were also tested in the acquisition and retention of one-trial "step-through" passive avoidance task. The effect of PPCE inhibitors were investigated both in control and electroconvulsive shock- or scopolamine-induced amnesic animals. Z-Pro-p, the most potent inhibitor among 5 compounds tested in this study, and arginine vasopressin (AVP) facilitated the learning process and retarded the extinction of the acquired response in all tests. Suc-Pro-p was also effective in the Y-maze and passive avoidance test. Thus, the effect of the test compounds were parallel with their in vitro activities as PPCE inhibitor. These results suggest that the anti-amnesic effect of PPCE inhibitors is partially attributable to their effect on the breakdown of the biologically active peptides which are involved in the memory process, such as AVP, in the brain. PMID- 3305245 TI - Inhibition of mutation induction and unchanged mutational specificity in Escherichia coli K12 overproducing the RecA protein. AB - Induced mutagenesis was studied in Escherichia coli K12 cells in relation to the level of RecA-protein (P-RecA). In experiments strains AB2497, AB2497(pBR322) and AB2497(pX02) were used. The multicopy plasmid pX02 is a recombinant of pBR322 and recA+ gene of E. coli K12. Cells carrying this plasmid overproduce the P-RecA constitutively. Mutagenesis was induced by the decay of incorporated 6-3H thymidine. Mutations of the argE3 (ochre) to Arg+ prototrophy were followed. Besides the frequency of mutations, mutagenic specificity was determined. In cells AB2497(pX02) which overproduce the P-RecA the yield of Arg+ revertants was markedly reduced compared with that in strains AB2497 or AB2497(pBR322), whereas the mutagenic specificity was not changed. In all the strains studied the predominant type of mutation produced was the base substitution in the A:T base pair. PMID- 3305246 TI - Effect of ammonium ions on delta 5,7-sterol synthesis in Saccharomyces cerevisiae. AB - The effect of ammonium concentration in the medium on delta 5,7-sterol synthesis was examined. Higher concentrations of this nitrogen source in the medium decreased sterol synthesis and accumulation during growth. An intermittent supply with ammonium resulted in a proportional synthesis of delta 5,7-sterols and biomass. The carbon to nitrogen molar ratio of greater than or equal to 40 allowed the maximum accumulation of delta 5,7-sterols with our strain of baker's yeast. PMID- 3305248 TI - Figurative language: assessment strategies and implications for intervention. PMID- 3305247 TI - Perspectives on the mechanism of action of the splenic toxicity of aniline and structurally-related compounds. AB - Aniline and several structurally-related aromatic amines produce spleen tumours in rats given high doses of compound in 2-year bioassay studies. Evaluation of the pathogenesis of the splenic lesions and characterization of the disposition of radiolabelled aniline in animals suggests that the spleen tumours may be a secondary response resulting from chemically-mediated erythrocyte toxicity. It is proposed that compound-derived toxicity to erythrocytes results in scavenging of damaged red blood cells by the spleen, initiating a series of events which may contribute to the development of spleen tumours. These events potentially include (i) specific accumulation of the parent compound or toxic metabolite(s) carried to the spleen by erythrocytes; (ii) deposition of erythrocytic debris, particularly iron, which may catalyse tissue-damaging free-radical reactions; and (iii) induction of splenic hyperplasia resulting from erythrocyte overload. Linkage of the splenic tumorigenicity of these aromatic amines to an initial toxic event in the erythrocyte suggests that the carcinogenicity of such compounds may be determined by a definable threshold dose, i.e. the events leading to the carcinogenicity are not initiated until the capacity of the red blood cell to cope with the toxic insult is exceeded. PMID- 3305249 TI - Planning the archaeological recovery of evidence from recent mass graves. AB - Mass graves commonly contain hundreds of putrefying bodies, which bear evidence of torture and extrajudicial execution. These require careful excavation using archaeological techniques to recover the bodies for identification and to obtain associated evidence which document human rights abuses. In order to derive forensically defensible conclusions, exhumation of a mass grave may take weeks or months. Specialized protective suits and breathing apparatus will permit the investigating team to take the time required to retrieve even subtle evidence from repellent remains. Strategies for sampling tissues and bodies which reduce the magnitude of the recovery operation are described. PMID- 3305251 TI - [Ultrasonic studies using the maxillary sinus as an example]. PMID- 3305250 TI - [Historical development of the radiologic diagnosis of the oromaxillofacial region]. PMID- 3305252 TI - [Experimental anatomic study on the clinical application of sonography of the floor of the mouth]. PMID- 3305253 TI - [B-scan sonography in oromaxillofacial surgery]. PMID- 3305254 TI - [Value of B-scan sonography in the diagnosis of abscessed inflammations]. PMID- 3305255 TI - [Ultrasonic morphology of inflammatory swellings in the neck and face region]. PMID- 3305256 TI - [Place of ultrasound in A-scan procedures in the diagnosis of maxillary sinus diseases]. PMID- 3305257 TI - [Ultrasonic diagnosis of fractures of the bony orbit]. PMID- 3305258 TI - [Application of Doppler ultrasound sonography to pedicled flap plastic surgery of the oromaxillofacial region]. PMID- 3305259 TI - [Diagnostic possibilities of sonography in therapy planning and follow-up of patients receiving surgery, chemo- and radiotherapy of malignancies of the oromaxillofacial area]. PMID- 3305260 TI - [Real-time sonography of malignancies of the area of the floor of the mouth and tongue]. PMID- 3305262 TI - [The bone scintigram for demonstration of blood circulation in microsurgically revascularized bone grafts]. PMID- 3305261 TI - [Sonographic visualization of fetal facial structures in pregnancy]. PMID- 3305263 TI - [Sensitivity and specificity of sialography in relation to the diagnosis of inflammatory and calculous diseases of the salivary glands]. PMID- 3305264 TI - [Postmortem HLA typing of corneal transplantations]. PMID- 3305265 TI - [Infantile nephropathic cystinosis: electro-ophthalmologic findings in kidney transplant patients and their mothers]. PMID- 3305266 TI - [Interferon in the treatment of malignant melanoma. Results of clinical studies]. PMID- 3305267 TI - [Oral hyposensitization]. PMID- 3305268 TI - [The family physician and self-help groups. 1: Self-help in health--principles, current structures and forms of organization]. PMID- 3305269 TI - [Diagnostic value of the transesophageal Doppler echocardiography]. AB - Transesophageal echocardiography has been proven to be of particular value in all patients with transthoracic echocardiograms of low quality related to pulmonary emphysema, obesity and chest deformation as well as in intensive care unit patients. Similarly, transesophageal Doppler echocardiography is of particular value in all cases in which the transthoracic Doppler, due to methodological problems, is of limited value. Mitral regurgitation can be detected and quantified and flow direction described. Only in 12/25 patients with mild, 11/12 patients with moderate and 5/8 patients with severe insufficiency was regurgitation detected by transthoracic echocardiography as compared to transesophageal echocardiography with which the lesion was consistently detected. In two patients with severe and clinically-inapparent mitral regurgitation related to papillary muscle rupture, the diagnosis was established only by the transesophageal approach in an emergency situation. Atrial septal defects were detected in 8/15 patients and the size of the defect analyzed. With transesophageal Doppler echocardiography, the relation of left-to-right and right to-left shunts could be described. In 7/16 patients with aortic dissection, true and false lumen were differentiated by analysing the flow pattern within both lumina. In 9/16 patients differentiation was enabled through delineation of the false lumen which was filled with thrombotic material. Detection of aortic regurgitation and tricuspidal regurgitation is possible but analysis of flow patterns is difficult because flow direction is nearly orthogonal to the ultrasound beam. First attempts to quantify cardiac output have been performed. For the future, transesophageal color flow Doppler mapping appears to be a most promising method. PMID- 3305270 TI - Trends in Medicare physician participation and assignment. PMID- 3305271 TI - Are some surgical procedures overpaid? PMID- 3305272 TI - Regulation by insulin of cyclic nucleotide phosphodiesterase (PDE) from rat luteal cells. AB - The effect of insulin on cyclic nucleotide phosphodiesterase (PDE) in rat luteal cells was studied. Cells were obtained from PMSG/hCG primed rats and further incubated or not with insulin. The hormone produced an increase of enzyme activity after a 10 min incubation of intact cells. Maximal stimulation was achieved at 0.2 nM of insulin. Two peaks of cyclic nucleotide phosphodiesterase activity were resolved after chromatography of cell cytosolic extracts on DEAE cellulose. These peaks (I and II) were active with cAMP as substrate but only peak I was active with cGMP. The enzyme activity of both peaks was increased in cells treated with insulin. Phosphodiesterase activity in the two peaks show two kinetic components for cAMP hydrolysis, one of high affinity (Km 2-4 microM) and the other of low affinity (47-56 microM). Treatment of the cells with insulin produced a 2 to 8 fold increase of the Vmax of these peaks. In addition after stimulation with insulin, the activation of peak I phosphodiesterase by calmodulin was less effective. PMID- 3305273 TI - Disparate effects of acute administration of dopamine receptor antagonists on plasma aldosterone and prolactin levels in the rat. PMID- 3305274 TI - Increase in insulin secretion induced by plasma from mice injected with allogeneic lymphocytes. AB - Plasma from BALB/c mice bled 90 minutes after allogeneic lymphocyte injection significantly rises glucose induced insulin secretion. This rise is observed in pancreas either from non-treated or from allogeneized mice. This rise is time and dose-dependent. An 1/40 dilution is enough to bring about a significant increase on insulin secretion. This effect is seen when mice are bled between 60 and 180 minutes after injection with a maximum effect at 90-120 minutes. Plasma from BALB/c mice injected with C57BL/6 J lymphocytes rises insulin secretion from BALB/c, C57BL/6 J, C3h and C57BL/KsJ mice pancreas. Plasma from streptozotocin diabetic BALB/c mice and from genetically diabetic C57BL/KsJ mdb-mdb mice injected with allogeneic lymphocytes stimulates glucose induced insulin secretion but to a lesser extent than plasma from normal non-diabetic mice does. PMID- 3305275 TI - Islet cell antibodies, circulating immune complexes and antinuclear antibodies in diabetes mellitus. AB - Serum samples of patients suffering from diabetes mellitus were tested for complement-fixing and non complement-fixing islet cell antibodies, antinuclear antibodies and circulating immune complexes. There was no correlation between circulating immune complexes or antinuclear antibodies and secondary diabetic complications. A close relationship was found between the ICA titer and complement fixation of ICA. The incidence of ICA at the onset of the disease was higher in the patients under the age of 10 (85%) and decreased with increasing age up to 45% in patients with onset above age 20. In five patients being positive and four patients being negative for ICA at onset of disease, changes and fluctuations in antibody titers were observed over 38 months. Since manifestation of diabetes mellitus is believed to be an endpoint of a long lasting autoimmune process, our observations indicate that the autoimmune phenomena are merely indicators of ongoing autoimmune reactions not necessarily reflecting the state of autoaggression or islet cell destruction. PMID- 3305276 TI - The effect of high-glucose condition on insulin binding to IM-9 lymphocytes. AB - The long-term effect of high-glucose condition on insulin binding to IM-9 cells was studied by incubating the cells in RPMI-1640 medium containing 450 mg/dl of glucose. Insulin binding began to decrease after incubation for 6 days in high glucose-treated cells, and significantly decreased after 14 days due to the reduction of receptor affinity. The number of binding sites for insulin did not change by the treatment. Thus, high-glucose condition per se does not appear to induce the decrease of the number of insulin receptors on target cells, as observed in diabetic patients. PMID- 3305277 TI - The euglycemic clamp in patients with thalassaemia intermedia. AB - In order to evaluate the influence of haemosiderosis on the glucose metabolism we studied tissue sensitivity to insulin and the metabolic clearance rate (M.C.R.) of this hormone by means of euglycemic clamp technique using an artificial endocrine pancreas in 8 patients with thalassaemia intermedia and 8 control subjects. During the steady-state of euglycemic-hyperinsulinemic clamp (40 mU/m2/min) plasma insulin values were significantly lower and the insulin M.C.R. was significantly higher in thalassaemic patients compared to the controls. To achieve a comparable steady-state insulin concentration to the controls, we performed for a second time the euglycemic clamp in the thalassaemic patients increasing the insulin infusion rate to 80/mU/m2/min. The insulin M.C.R., the M index and the M/IRIs-s ratio were significantly higher in the thalassaemic patients compared to the controls. These results are indicative of an increased tissue peripheral sensitivity to insulin as well as the metabolic clearance rate of this hormone. PMID- 3305278 TI - Fluid-electrolyte shift and renin-aldosterone responses to exercise under hypoxia. AB - In order to describe fluid-electrolyte shift and endocrine response to exercise under moderate acute hypoxia, 8 healthy male subjects (24 +/- 3 years old) were evaluated at 40, 60, 80 and 100% VO2 max in normoxic (N) and hypoxic (H) conditions (14.5% O2). VO2 max decreased from 55.5 +/- 1.3 to 45.8 +/- 1.4 ml/kg X min in H condition. Plasma volume reductions with increasing relative workloads were similar in N (9.4%) and H (9.9%) conditions. The rise in plasma osmolality was in part related to blood lactate accumulation which occurred in both conditions. However, variations in plasma solute content and osmolality suggested that exercise under hypoxia results in a greater electrolyte loss from vascular space and in a greater K+ loss from working skeletal muscles. Increase in catecholamine concentrations were similar in normoxic and hypoxic conditions except for lower maximal norepinephrine concentration under hypoxia. Finally, although plasma renin activity increased with workload in both conditions, plasma aldosterone did not significantly change. This dissociation between renin and aldosterone suggest that aldosterone release during exercise might depend upon other factors. However, changes in plasma potassium concentration do not appear as an important stimulus for aldosterone secretion during exercise. PMID- 3305279 TI - Aldosterone responsiveness to an acute potassium load in diabetes mellitus and chronic renal insufficiency. AB - The aldosterone response to increments in plasma potassium concentration in disease states associated with abnormal potassium tolerance remains undefined. We evaluated the plasma aldosterone response to an acute oral potassium load (0.25 0.50 mmol/kg body weight) in 30 patients (19 with chronic renal failure (CRF) and 11 with diabetes mellitus) with normal or decreased baseline plasma aldosterone levels and in 12 control subjects. In control subjects, plasma aldosterone levels increased initially and then declined below baseline, whereas in the patients the late decrease was not observed. In patients with CRF with and without hypoaldosteronism (5 undialyzed and all 9 dialyzed patients), plasma aldosterone increased significantly. Eight of the diabetic subjects had normal and 3 had low baseline aldosterone levels. In the former, plasma aldosterone levels did not increase above baseline following the KCI load. We conclude that diabetic patients and those with CRF manifest several abnormalities in aldosterone potassium responsiveness that may contribute to the disturbed potassium homeostasis observed in these conditions. PMID- 3305280 TI - Flow cytometric detection of B-clonal excess in fine needle aspirates for enhanced diagnostic accuracy in non-Hodgkin's lymphoma in adults. AB - Fine needle aspiration (FNA) cytology is a valuable aid to diagnosis and tumour staging in patients with non-Hodgkin's lymphoma. These tumours are often multicentric and involve sites such as the liver or the spleen which are not easily accessible to surgical biopsy. Particularly with splenic involvement, there is a diagnostic problem of morphologically distinguishing the lymphoma cells in an admixture of normal lymphocytes. Since most lymphomas in adults are of B-cell origin, we studied the diagnostic value of adding a surface immunoglobulin (sIg) light chain analysis to the cytological evaluation of FNAs. B-clonal excess was determined by flow cytometric analysis of the sIg light chain distribution and a monoclonal finding was considered diagnostic of lymphoma. In primary diagnostic procedures the light chain analysis established a diagnosis of lymphoma in 5/14 (36%) aspirates from patients with poorly differentiated tumours. Fine needle aspirates performed as part of staging procedures were morphologically normal or inconclusive in 19 cases; in seven of these (37%) lymphoma involvement was diagnosed by the light chain analysis. Diagnostic precision was enhanced by combining morphological and immunological evaluation of fine needles aspirates in patients with established or suspected non-Hodgkin's lymphoma. PMID- 3305281 TI - Characterization of a monoclonal antibody (BG3C8) that reacts with basal cells of stratified epithelia. AB - Monoclonal antibodies were produced against a suspension of formaldehyde fixed human epidermal cells. The supernatant fluid of one clone (BG3C8) yielded a bright immunofluorescent staining of basal cells both in cryostat sections of human split skin and in preparations of purified basal cells. As determined by one- and two-dimensional gel immunoblotting of epidermal basal cell proteins the antibody recognized a minor basic polypeptide of 55,000 apparent molecular weight that was not present in extracts of cultured cell lines of epithelial, fibroblast and lymphoid origin. The distribution of the 55,000 molecular weight protein in normal human tissue was determined by immunohistological staining of cryostat tissue sections that included: central nervous, endocrine, female and male reproductive, alimentary, lymphatic-haemopoietic, respiratory and urinary systems, skin and its appendages, mesenchymal tissue (bone, cartilage, muscle, connective tissue, blood vessels, nerves and synovia) as well as placenta and umbilical cord. The results showed a restricted distribution of this antigen which was found only in basal cells of most stratified or pseudostratified epithelia and in myoepithelial cells. This antibody may be useful in the study of normal and pathological differentiation in various epithelial disorders. PMID- 3305282 TI - An immunohistochemical study of the tissue distribution of the breast cyst fluid protein, zinc alpha 2 glycoprotein. AB - Zinc alpha 2 glycoprotein is one of the proteins present in breast cyst fluids, being found at levels 30-50 times its plasma concentration. Using an immunoperoxidase technique the distribution of this glycoprotein has been studied in a range of non-mammary tissues and carcinomas, as well as in normal, benign and malignant breast specimens. The breast cyst fluid protein was detected in all apocrine cells of skin and in the apocrine metaplastic epithelium lining of breast cysts. A progression was apparent from normal to hyperplastic breast in the number of cells reacting, particularly of cystically dilated acini, to a final consistent staining of apocrine-lined cysts. Zinc alpha 2 glycoprotein was demonstrated in 16 of 33 invasive carcinomas, 15 of which were eosinophilic on haematoxylin and eosin staining, and in one of three non-invasive carcinomas. No staining was apparent in other non-mammary tissues and carcinomas apart from weak reactivity of serous cells of the parotid gland. Zinc alpha 2 glycoprotein is, therefore, a reliable immunohistochemical marker of apocrine cell differentiation. PMID- 3305283 TI - Apocrine carcinoma of the breast containing foam cells. An electron microscopic and immunohistological study. AB - The detailed light and electron microscopic and immunohistological features of an invasive apocrine carcinoma of the breast developing in a 78-year-old woman are presented. The stroma of the tumour contained non-neoplastic lipid-filled (foam) cells. To our knowledge, these cells have not been described before in invasive breast carcinoma. Their electron microscopic and immunohistological features confirm their histiocytic nature. PMID- 3305284 TI - Soft tissue gliomatosis--heterotopic glial tissue in the subcutis: a case report. AB - A subcutaneous nodule composed of heterotopic glial tissue is reported. The lesion was present in the subcutaneous tissue of the chest wall in a 2-year-old female. Histologically it was composed of loosely textured fibrillary neuroglial tissue in a densely hyalinized collagenous stroma. Immunohistochemical staining for glial fibrillary acidic protein was positive. The possible origin of this soft tissue glial heterotopia is discussed and the subject of heterotopic glial tissue is reviewed. PMID- 3305285 TI - Pathology of the lung in the fetus and neonate, with particular reference to problems of growth and maturation. AB - The major forms of lung pathology in the perinatal period are reviewed with emphasis on disturbances of growth and maturation. Lung hypoplasia results from impairment in the physiological control of lung growth during the fetal period. It is more common than organogenetic defects which are discussed only briefly. Hyaline membrane disease is now seldom seen in a pure form due to improvements in perinatal care. However, its complications and sequelae such as interstitial emphysema, pneumothorax and bronchopulmonary dysplasia are encountered more frequently. In addition, a wide variety of pathological processes may localize to, or be expressed in, the lung of the newborn, notably asphyxial changes, persistent pulmonary hypertension, haemorrhage and infection. PMID- 3305286 TI - Chordomas--ultrastructure and immunohistochemistry: a report based on the examination of six cases. AB - Six chordomas (three classic and three chondroid) were examined ultrastructurally and with a panel of monoclonal antibodies. The three classic tumours showed the presence of desmosomes and intermediate filaments on electron microscopy, findings which gave a direct positive correlation when the tumours were stained with monoclonal antibodies against low molecular weight cytokeratin proteins. These results suggest that chordomas are essentially epithelial neoplasms and underline the fact that monoclonal antibodies to cytokeratins cannot be used in the differential diagnosis of classic chordoma vs carcinoma. Furthermore, the epithelial characteristics are lost as the tumour undergoes chondroid differentiation. PMID- 3305287 TI - Severely atypical changes in renal epithelium in biopsy and graft nephrectomy specimens in two cases of cadaver renal transplantation. AB - Severely atypical metaplastic and dysplastic changes were noted in the lining epithelium of collecting tubules and pelvis of the graft kidneys in two cases of cadaver renal transplants on immunosuppressive treatment with azathioprine and prednisolone. These changes were observed in case 1 in a needle biopsy and a nephrectomy specimen, 3 and 3.5 years after transplantation respectively. In a second case, the patient received two cadaver grafts, and both transplants showed similar changes 2 years after transplantation. The risk of malignant disease in kidney transplant recipients is now well recognized. The implications of the severe dysplastic changes noted in these two cases are discussed. PMID- 3305289 TI - Glycogen-rich clear cell carcinoma of the breast: a solid variant with mucus. A light microscopic, immunohistochemical and ultrastructural study of a case. AB - The light microscopic, immunohistochemical and ultrastructural features of a clear cell carcinoma of the breast have been studied. Both intraductal and invasive components were found. Histochemistry showed large amounts of intracytoplasmic glycogen and sparse neutral mucin in the tumour. The tumour cells were stained by antisera to carcinoembryonic antigen, keratin and epithelial membrane antigen, but not by antisera to alpha-lactalbumin, desmin or vimentin. Ultrastructurally, the epithelial derivation of the tumour was confirmed. Only a few intracytoplasmic lumina were demonstrated. The tumour was classified as a mucin-containing variant of glycogen-rich, clear cell carcinoma of the breast. PMID- 3305288 TI - Neurogenous hyperplasia leading to appendiceal obliteration: an immunohistochemical study of 237 cases. AB - A series of 237 appendices was studied immunohistochemically for neurogenous hyperplasia. This was observed in 195 cases. It was possible to trace a continuum from appendices with intact lumens, featuring intramucosal neurogenous hyperplasia often with co-existent submucosal and muscular nerve growth, to obliterated specimens whose axial portions were composed of varying proportions of nerve tangles and fibrous tissue. Predominantly fibrotic specimens were considered as end-stages of this process. Stromal, argyrophilic cells lying amidst the nerve elements were prominent in the early, non-obliterated cases; their number decreased in the obliterated nerve rich specimens and such cells became inapparent in the late fibrotic stage. Repeated minimal subclinical attacks of inflammation are thought to trigger this lesion. PMID- 3305291 TI - Rural, urban hospitals win in budget action. PMID- 3305290 TI - Spindle cell squamous carcinoma of the lung. Immunocytochemical and ultrastructural study of a case. AB - A case of squamous cell carcinoma of the lung showing extensive spindle transformation is presented. On light microscopy, the tumour showed sheets and fascicles of elongated fusiform cells resulting in a growth pattern which closely resembled a sarcoma. Immunocytochemistry using tissue-specific antibodies against intermediate filaments demonstrated exclusive labelling of the tumour cells with prekeratin antibodies. Electron microscopy showed well-formed intercellular junctions and thick bundles of tonofilaments within the cytoplasm of the cells further confirming the squamous epithelial nature of the neoplasm. The findings in the present case point to the existence of a non-metaplastic spindle cell variant of squamous carcinoma of the lung. The possible mechanisms which may account for the spindle shape of the cells are reviewed. PMID- 3305292 TI - Patient "dumping" regulations offer little guidance. PMID- 3305293 TI - States become creative with Medicaid expansion. PMID- 3305294 TI - Amnesty law's impact on Medicaid unclear. PMID- 3305295 TI - Electronic billing can speed up cash flow. PMID- 3305296 TI - PPS refinements sought to improve DRG payments. PMID- 3305297 TI - Hospital retail pharmacies: new limits. PMID- 3305298 TI - Are risk HMOs just too risky? PMID- 3305299 TI - Common ground unites unlikely coalition. PMID- 3305300 TI - [Photoelastic analysis of stress on alveolar bone of abutment of a fixed bridge under oblique loading]. PMID- 3305301 TI - [Clinical value of serum CEA measured by the McAb-enzyme immunoassay in cancer patients]. PMID- 3305302 TI - [Competitive enzyme immunoassay for human serum apolipoprotein CIII]. PMID- 3305304 TI - [Gray scale real-time ultrasound imaging for evaluating the function of the biliary system]. PMID- 3305303 TI - [Preliminary study of the effects of diagnostic ultrasound in early pregnant women on the chorionic villi]. PMID- 3305305 TI - Lymphocytic lymphoma of intermediate differentiation--mantle zone lymphoma: a distinct subtype of B-cell lymphoma. PMID- 3305306 TI - Oncogenes, suppressor genes, and carcinogenesis. PMID- 3305307 TI - Responsibilities of the pathology laboratory. PMID- 3305308 TI - Steroid sulphatase levels are higher in males than in females of the root vole (Microtus oeconomus). Yet another rodent with an active Y-linked allele? AB - Steroid sulfatase (STS; EC 3.1.6.2) levels were assayed in cultured fibroblasts of root voles captured in the wild. Four independent experiments were performed using two different substrates (DHEAS and E1S). Evidence is presented that in this species, STS levels are significantly higher in males than in females (ratio 1.6:1). We discuss our findings on a comparative basis and suggest that in the root vole the STS gene(s) is X- and Y-linked (as in the mouse) and that it is subject to X-inactivation, or partially so, on one of the X chromosomes in the female. PMID- 3305310 TI - Homoeopathic medicines and antidotes: some controlled investigations. PMID- 3305311 TI - Production of monoclonal antibody probes specific for nonbasement membrane glomerular capillary wall antigens in the rat. AB - To examine the characteristics of discontinuously represented antigens within the rat glomerular capillary wall, we have developed monoclonal antibodies against basement membrane-depleted glomerular plasma membrane preparations. These reagents exhibited granular binding patterns on normal rat glomeruli when examined by indirect immunofluorescence. By limited purification of the primary immunogen and the use of this material for the initial screening by micro-ELISA, the production and selection of monoclonal antibodies (McAbs) of the desired specificity was enhanced. Intrasplenic immunisation was usefully employed to reduce the time interval from immunisation to fusion without lessening the percentage of positive hybridomas generated. The potentiality for in situ immune responses to discretely arrayed non-basement membrane glomerular capillary wall antigens which produce granular immunofluorescence is further exemplified by these studies. PMID- 3305313 TI - An adaptive controller for closed-loop management of blood pressure in seriously ill patients. PMID- 3305312 TI - Production and characterization of a monoclonal antibody to bovine estrogen sulfotransferase. AB - A murine IgGl (k) monoclonal antibody, termed 33-11, was produced against purified bovine estrogen sulfotransferase. After the enzyme was separated into its four isoenzyme forms by native polyacrylamide gel electrophoresis, a Western blotting analysis indicated that the antibody reacted to a similar extent with each of the isoenzymes. An immunoprecipitation and SDS-poly acrylamide gel electrophoresis analysis was performed with an I-125-labeled enzyme preparation. Antibody 33-11 precipitated protein in the molecular weight range 70,000-74,000, the size of native estrogen sulfotransferase, plus additional bands with molecular weights of 29,000, 54,000, and 61,000. The lower molecular weight polypeptides may represent fragments, bearing a common epitope, produced by limited endogenous proteolysis of the intact enzyme. Solid-phase radioimmunoassay testing demonstrated strong and specific binding of the antibody to the bovine enzyme. No cross-reactivity was observed with a panel of nine other purified bovine proteins. An immunohistochemical analysis with the antibody was performed on two bovine tissues with high levels of enzyme activity. Placenta showed strong, specific staining of fetal giant cells of chorionic villi, while adrenal had weak but widespread staining which tended to be more concentrated in the inner cortex. Monoclonal antibody 33-11 has potential utility in the purification, detection, and quantitation of bovine estrogen sulfotransferase. PMID- 3305314 TI - Continuous drug delivery system design using nonlinear decoupling: a tutorial. PMID- 3305309 TI - Diagnosis of genetic disease using recombinant DNA. Supplement. AB - Recombinant DNA methodology has greatly increased our knowledge of the molecular pathology of the human genome at the same time as providing the means to diagnose inherited disease as the DNA level. We present here a list of recent reports of both direct and indirect analysis of human inherited disease which is intended to serve as a guide to current molecular genetic approaches to diagnostic medicine. PMID- 3305315 TI - Sarah Jones. A special nursing student. PMID- 3305316 TI - Maintenance of pancreatic endocrine B cells of neonatal rat. Part XI. Effect of 2 deoxyglucose-6-phosphate. PMID- 3305317 TI - Total skin electron irradiation for mycosis fungoides: report of two cases and review of literature. PMID- 3305318 TI - Ultrasound and surgical correlation of isotopically solitary cold lesion of the thyroid gland. PMID- 3305319 TI - Drug-induced tolerance to allografts in mice. X. Augmentation of split tolerance in murine combinations disparate at both H-2 and non-H-2 antigens by the use of spleen cells from donors preimmunized with recipient antigens. AB - In a fully allogeneic murine combination of C3H/HeSlc (C3H) (H-2k) and C57BL/6CrSlc (B6) (H-2b), C3H mice were primed i.v. with 1 X 10(8) spleen cells from B6 mice preimmunized i.v. with 5 X 10(7) C3H spleen cells and then were given i.p. 200 mg/kg cyclophosphamide (CP) 2 days later (Im-B6-Sc plus CP group). The tolerant state in those recipient mice was compared with that in mice made tolerant conventionally with 1 X 10(8) naive B6 spleen cells plus 200 mg/kg CP (naive-B6-Sc plus CP group). B6 skin was rejected in an almost normal fashion in both the naive-B6-Sc plus CP group and the Im-B6-Sc plus CP group. However, EL4 tumor allografts (B6 origin) inoculated after complete rejection of B6 skin grafts were specifically accepted in both groups. Moreover, the tumor growth in the Im-B6-Sc plus CP group was faster than that in the naive-B6-Sc plus CP group. Mixed lymphocyte reaction, cytotoxic T lymphocyte activity, and antibody production against the tolerogen were depressed more profoundly in the Im-B6-Sc plus CP group than in the naive-B6-Sc plus CP group. These observations were consistent with the results from tumor allografting. The other immunological parameters examined in the present study, including helper T cell activity and delayed foot-pad reaction, were retained in the Im-B6-Sc plus CP group at the same levels as in the naive-B6-Sc plus CP group. These observations were consistent with the results from skin allografting. In conclusion, tumor allograft tolerance was made more profound by the use of spleen cells from donors preimmunized with recipient antigens as the tolerogen than by the use of naive spleen cells. However, skin allograft tolerance was not achieved at all by these same treatments. The contribution of graft-versus-host disease to this phenomenon was excluded by the chimeric analysis in AKR/JSea (H-2k) mice given the preimmunized (with AKR antigens) B6 spleen cells plus CP. These results strongly support the existence of a less proliferative lymphocyte population which does not evoke cell divisions to mature even after the strong stimulation with the preimmunized spleen cells and is resistant to tolerance induction. PMID- 3305320 TI - Antigenic analysis of Strongyloides ratti infective larvae and adult worms. AB - The protein composition of Strongyloides ratti infective larvae and adult worms extracted sequentially in water, sodium deoxycholate and sodium dodecyl sulphate (SDS) and their excretory/secretory products were analysed by both one- and two dimensional SDS-polyacrylamide gel electrophoresis. While many bands common to all preparations and both stages of the worm were seen, a number of bands unique to each stage and preparation were identified. Western blot analysis of these larval and adult preparations for reaction with IgG and IgM antibodies in hyperimmune mouse sera revealed a large number of antigens. These data provide a framework for analysis of protective and diagnostically useful antigens. PMID- 3305321 TI - Specificity of a mouse monoclonal antibody raised against acute myeloid leukaemia cells for mast cells in human mucosal and connective tissues. AB - A mouse monoclonal antibody raised against acute myeloid leukaemia cells (YB5.B8 monoclonal antibody; Gadd, S. J. and Ashman, L. K. (1985): Leukaemia Res. 9, 1329 1336) has been found by an indirect immunoperoxidase technique to bind to scattered cells in frozen sections from a number of human tissues. They have been identified as mast cells in fixed sections of skin, tonsil and duodenum by simultaneous staining of glycosaminoglycan with Alcian blue in 0.7 N HCl. The antibody does not distinguish mast cells in mucosal tissues from those in connective tissue, although the level of expression by cells at both sites appears to be heterogeneous. With the exception of low affinity binding to B lymphocytes, no other bone marrow-derived cells were found to bind the antibody. In particular, basophils and eosinophils were not stained, suggesting that they are not related closely to mast cells and that the antigen detected by YB5.B8 monoclonal antibody is not an IgE Fc receptor. Therefore, among all mature haemopoietic lineages, the antibody is specific for mast cells. PMID- 3305322 TI - [Chronology of the cicatrization process in localized cicatricial pemphigoid type Brunsting-Perry. Preliminary study]. PMID- 3305323 TI - A semiquantitative measure of immune responses against erythropoietic stem cell antigens. AB - A semiquantitative assay was developed and used to measure the effects of immune responses against 16 independent non-H-2 antigenic loci on erythropoietic stem cells. The assay compares repopulation in genetically anemic WBB6F1-W/Wv recipients that have normal immune responses, and in lethally irradiated WBB6F1 +/+ mice whose immune responses are suppressed by the irradiation. The differences in repopulating ability between these two types of recipients measure how immune responses affect erythropoietic stem cells. Stem cell repopulating abilities for the cells with antigens specified by the Thy-1, H-1, H-24, Ly-1, H 37, and H-17 loci were affected slightly, if at all. Repopulating abilities were moderately reduced by responses against antigens specified by H-15, 16, Ea-2, and Ly-2, 3 loci, and against the differences between the B6 and B10 genotypes, although marrow of these types cured W/Wv recipients. A surprising result occurred for the antigen specified by the H-8 locus, in which immune responses strongly reduced repopulating abilities, although this type of marrow cell cured W/Wv recipients. A comparison of these results with skin graft survival times suggests that the antigens specified by the H-17 and H-24 loci are strongly immunogenic on skin but not on marrow stem cells, while those specified by the H 12 and H-8 loci are strongly immunogenic on marrow stem cells but not on skin. PMID- 3305324 TI - Relationship between the expression of class I antigen and reactivity of chicken thymocytes. AB - The expression of major histocompatibility complex (MHC) class I antigens in ontogenesis and the distribution of B-F+ cells, defined by means of a monoclonal antibody, were studied by indirect membrane immunofluorescence tests on suspensions of thymus, bursa, spleen, peripheral blood lymphocytes (PBL) and red blood cells (RBC) from 18-day-old chicken embryos and chickens from 1-90 days after hatching. At 18 days of incubation and at the first day after hatching, RBC, PBL, and the cells from bursa and thymus are negative. The percentage of positive PBL and bursal cells increases up to 9 days after hatching. By 2 weeks after hatching almost 100% of the RBC, PBL, bursa, and spleen cells were positive whereas the thymus showed only 20% positive cells. Analysis on 4-micron-thick, frozen acetone-fixed tissue sections of thymus showed that medullary cells are positive, while the cortical area is negative. The graft-versus-host (GvH) competence of these thymus subpopulations was compared after sorting by the fluorescence-activated cell sorter and injection into MHC incompatible embryos. GvH reactivity was associated primarily with the B-F+ population. Double staining studies with peanut agglutinin (PNA)-fluorescein isothiocyanate and a rabbit-anti Ig tetramethyl isothiocyanate-conjugate proved that the PNA- thymocytes are identical with B-F+ thymocytes. PMID- 3305325 TI - Anti-hormonal and anti-nuclear antibody (ANA) responses of mice immunized with estradiol. AB - Sera of female mice, immunized with estradiol-albumin conjugates, were tested for restricted heterogeneity of the anti-estradiol antibody response and for the development of antinuclear antibody (ANA). We found sera with the highest estradiol binding capacity gave clear evidence of clonal dominance when analyzed by isoelectric focusing. A sub-set of the immunized animals, approximately one third, developed positive ANA serologies within 12 weeks of the primary immunization. All positive sera gave homogeneous patterns of staining in an avidin-biotin amplified indirect immunofluorescence assay. Our results point to a spontaneous production of ANA in at least some animals immunized with a ligand which binds to a nuclear receptor. PMID- 3305326 TI - Cytotoxic Escherichia coli. PMID- 3305327 TI - Serodiagnosis of pulmonary & extrapulmonary tuberculosis by enzyme linked immunosorbent assay of IgG antibodies using BCG 'pressate' antigen. PMID- 3305328 TI - Urinary bradykininase activity during normal menstrual cycle. PMID- 3305329 TI - Tobacco: an overview of health effects. PMID- 3305331 TI - Overview of cancer time-trend studies in relation to changes in cigarette manufacture. AB - The chief purpose of the present chapter is not to review lung cancer trends in general, but merely to consider the extent to which trends in national lung cancer rates can help assess any differences between the carcinogenic effects of different types of cigarette. For this limited purpose, the British data are uniquely informative, for British male lung cancer rates were already high but stable before the cigarette tar levels were halved, and British male cigarette consumption remained stable for some years thereafter. Against this apparently stable background, an otherwise unexplained decrease of about one-half in British male lung cancer mortality in early middle age has followed the decrease in cigarette tar deliveries, which is consistent with Stellman's conclusion (this volume), based on review of the case-control and prospective studies, that cigarette-induced lung cancer risks are approximately proportional to machine measured tar deliveries. Lung cancer trends are also reviewed for males from the USA (where cigarette tar deliveries have been greatly reduced) and from the USSR (where they have not). PMID- 3305330 TI - Cigarette yield and cancer risk: evidence from case-control and prospective studies. PMID- 3305332 TI - Experimental studies on the mutagenicity and related effects of low-tar and high tar cigarettes in relation to smoker exposures. PMID- 3305333 TI - Influence of cigarette yield on risk of coronary heart disease and chronic obstructive pulmonary disease. PMID- 3305335 TI - Low-tar cigarettes--possibilities and limitations. PMID- 3305334 TI - A double-blind randomized controlled trial of the effect of a low- versus a middle-tar cigarette on respiratory symptoms--a feasibility study. AB - A feasibility study of a double-blind, randomized controlled trial of the effect of a low-versus a middle-tar cigarette on respiratory symptoms is described. A smoking questionnaire was sent to 19,366 households. Returned questionnaires (64%) yielded 604 middle-tar cigarette smokers aged 20-44 years; 342 replied to a health warning stating that they did not want to or had failed to stop smoking and of these 183 volunteered for the trial. Thus about every 100 households originally mailed yielded one volunteer. Of the volunteers, 95 men were randomly allocated to be sold a middle-tar cigarette and 88 to be sold a low-tar cigarette of identical appearance. The cigarettes were sold at three different reduced prices and the men were asked to smoke them for five weeks. There was a 22% drop out and this was unrelated to type of cigarette smoked. A reduction in price of 20% was sufficient incentive for volunteers to participate. Cigarette butts were collected weekly or fortnightly and urine samples were collected initially and after three and five weeks. Compliance with the trial cigarettes was good. The excretion of nicotine metabolites, number of cigarettes smoked and average butt weight for men allocated the low-tar cigarette was not significantly different from that of those allocated the middle-tar cigarette. This suggested that the former compensated for the 37% reduction in the nicotine yield of their cigarette by taking more frequent or deeper puffs from their cigarette. The implications of these results for a large-scale, randomized controlled trial are discussed. PMID- 3305336 TI - Smokeless tobacco and cancer: an overview. PMID- 3305337 TI - Cigarette smoking and cardiovascular diseases. AB - That cigarette smoking is causally associated with development of cardiovascular disease is recognized unequivocally. Epidemiological studies worldwide have documented the many pathways of influence and synergism by which this ubiquitous but artificial habit exerts its ill effects on cardiorespiratory and other body systems, leading not only to cardiovascular disease but to cancer and other ailments. Current investigations among college alumni, women, elderly, and other subgroups provide data on how various independent influences combine with smoking to establish risk and promote pathogenesis of cardiovascular disease. Their findings also confirm that cigarette smoking is one of the strongest instigators. All of this knowledge has implications for the design and implementation of effective intervention programmes. PMID- 3305338 TI - Smoking and respiratory disease excluding lung cancer. PMID- 3305339 TI - Bioassays for carcinogenicity in animals. Assays for initiating and promoting activities. PMID- 3305340 TI - Short-term assays to predict carcinogenicity. DNA damage and repair. PMID- 3305343 TI - Short-term assays to predict carcinogenicity. Assays for genetic changes in mammalian cells. PMID- 3305341 TI - Long-term assays for carcinogenicity in animals. PMID- 3305344 TI - Short-term assays to predict carcinogenicity. Assays for germ-cell mutations in mammals. PMID- 3305342 TI - Short-term assays to predict carcinogenicity. Short-term assays using bacteria. PMID- 3305345 TI - Short-term assays to predict carcinogenicity. Mammalian cell transformation in culture. PMID- 3305346 TI - Short-term assays to predict carcinogenicity. In-vitro assays that may be predictive of tumour-promoting agents. PMID- 3305347 TI - Short-term assays to predict carcinogenicity. Assays for genetic changes in fungi. PMID- 3305348 TI - Short-term assays to predict carcinogenicity. Short-term assays for the analysis of body fluids and excreta. PMID- 3305349 TI - Short-term assays to predict carcinogenicity. Metabolic activation. PMID- 3305350 TI - Short-term assays to predict carcinogenicity. Statistical analysis of data from in-vitro assays of mutagenesis. PMID- 3305351 TI - Testing of complex chemical mixtures (for carcinogenicity). PMID- 3305352 TI - Use of structure-activity relationships in predicting carcinogenesis. PMID- 3305353 TI - Deployment of short-term assays for the detection of carcinogens: genetic and molecular considerations. PMID- 3305355 TI - Insulin and blood pressure during weight loss in obese adolescents. AB - The role of insulin in the regulation of blood pressure was evaluated in 50 obese adolescents before and after a 20-week weight loss program. When compared with 10 nonobese adolescents, the obese subjects had significantly higher systolic, diastolic, and mean arterial pressures (p = 0.005), an elevated 24-hour urinary sodium excretion (p = 0.002), an elevated fasting insulin concentration (p = 0.001), and an abnormal insulin response to an oral glucose tolerance test (sum of the insulins at 0, 1, and 2 hours post-oral glucose load; p = 0.001). We also observed a significant correlation between systolic and diastolic blood pressure (age and sex normalized) and body weight (r = 0.57, p less than 0.01 and r = 0.7, p less than 0.01), fasting insulin (r = 0.49, p less than 0.01 and r = 0.54, p less than 0.01), and sum of insulins (r = 0.42, p less than 0.01 and r = 0.46, p less than 0.01). To study the effect of weight loss on the relationship between blood pressure and insulin, the obese subjects were randomly assigned to three groups: 15 to a diet and behavior change group, 18 to a diet, behavior change, and exercise group, and 17 to an obese control group. Compared with the obese control group, the two weight loss groups each experienced a significant decrease in insulin (p less than 0.01), sum of the insulins (p less than 0.01), and blood pressure (p less than 0.01). The decrease in blood pressure during the weight loss program significantly correlated with the change in both insulin and body weight.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305354 TI - Bioassays for carcinogenicity in animals. Early preneoplastic lesions. PMID- 3305356 TI - Aspirin enhances the antihypertensive effect of captopril in spontaneously hypertensive rats. AB - Activation of renal or vascular prostaglandin mechanisms (or both) has been proposed to contribute to the antihypertensive action of captopril. In conscious spontaneously hypertensive rats (SHR) studied in the established phase of hypertension, the blood pressure-lowering effect of captopril, 30 mg/kg/12 hr p.o. given for 7 days, was greatly enhanced by the addition of aspirin, 200 mg/kg/day s.c. Systolic blood pressure decreased from 185 +/- 6 and 182 +/- 4 to 135 +/- 3 mm Hg in rats treated, respectively, with captopril and aspirin or captopril alone, and was unaltered by either vehicle or aspirin alone. Water intake was inconsistently affected by captopril but was increased (p less than 0.01) by aspirin and was even higher after captopril-aspirin treatment (p less than 0.01). Urine volume was elevated in all 3 drug-treated groups, increasing threefold after captopril-aspirin treatment. Excretion of sodium and potassium was unchanged by any treatment regimen. In the vehicle group, prostaglandin F2 alpha excretion, measured by radioimmunoassay, ranged between 65 and 93 ng/8 hr and was twofold to fourfold higher than that of prostaglandin E2. Prostaglandin F2 alpha was unaffected during captopril treatment, whereas prostaglandin E2 excretion decreased to 12 +/- 2 ng/8 hr (p less than 0.01) by Day 7. Long-term aspirin treatment, either with or without captopril, did not cause sustained inhibition of renal prostaglandin excretion, although a transient effect occurred within the first four hours of administration. These results indicate 1) aspirin potentiates the blood pressure-lowering effect of captopril in SHR, an effect that is associated with a threefold increase in urine flow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305357 TI - Local and systemic antibody responses accompany spontaneous resolution of experimental cystitis in cynomolgus monkeys. AB - Cynomolgus monkeys were infected intravesically with two different strains of uropathogenic Escherichia coli. A quantitative enzyme-linked immunosorbent assay method was used to monitor secretory and serum immune responses to the induced cystitis. Anti-E. coli secretory immunoglobulin A (sIgA) and IgG urinary antibodies were generated as a result of the cystitis. Urinary sIgA levels against the E. coli strains tested were highest at 25 to 31 days after cystitis induction, and urinary IgG levels were highest at 31 to 45 days after induction. Anti-E. coli IgM was not detected in the urine. The antibody response in serum was characterized by IgM, IgG, and IgA immunoglobulin production. IgM levels in serum rose at 14 days after cystitis induction and were sustained for another 1 to 2 weeks. Increases in serum IgG levels began at 7 to 21 days of infection and persisted in some cases for up to 70 days. Serum IgA to the infecting E. coli was produced within 1 week after cystitis induction and remained at elevated levels throughout the course of the cystitis. These results demonstrate the capacity of primates to spontaneously resolve a cystitis and to mount both local and systemic immune responses against the infecting bacteria. PMID- 3305358 TI - Isolation and characterization of an extracellular proteinase of Coccidioides immitis. AB - A proteinase isolated from the respiratory pathogen, Coccidioides immitis, was shown to have collagenolytic and elastinolytic activity, as well as the ability to cleave human serum immunoglobulin G and secretory immunoglobulin A. Proteolytic activity was demonstrated with a bovine casein digestion assay in conidial culture exudates, mycelial and spherule culture filtrates, conidial and spherule wall material, and Sephacryl S-300 fractions of the isolated soluble conidial wall material described previously. One of the latter fractions (fraction 2) demonstrated high proteolytic activity. The proteinase was purified from this chromatographic fraction by cold acetone extraction followed by Sephadex G-50 gel filtration and was identified as a polypeptide band of 36,000 Mr by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. By means of tandem two-dimensional immunoelectrophoresis, the proteinase was identified as antigen 11 on the basis of its reaction in the coccidioidin/anticoccidioidin reference system. The proteinase is characterized by a broad substrate specificity, optimal activity at 35 to 40 degrees C (pH 8.0) in the presence of human collagen, elastin, or hemoglobin, an isoelectric point of pH 4.5, and inhibition by organofluorides, N-tosyl-L-phenylalanine chloromethyl ketone, chymostatin, and alpha-1-antitrypsin. These features of the enzyme are comparable to those of chymotrypsinlike serine proteinases. Demonstration that the proteinase can cleave human immunoglobulins and digest ubiquitous tissue structural proteins (e.g., collagen and elastin) suggests that it may play a role in the virulence of the fungal pathogen. PMID- 3305359 TI - Colonization and pathogenesis of Cryptococcus neoformans in gnotobiotic mice. AB - Congenitally immunodeficient nude (nu/nu) mice and their immunocompetent littermates (nu/+) were used to determine whether the absence of thymus-matured T cells would alter the capacity of Cryptococcus neoformans to colonize their mucosal surfaces or enhance their susceptibility to systemic cryptococcosis, or both, following oral challenge. We present data demonstrating that an encapsulated strain of C. neoformans serotype A colonized the alimentary tracts of germfree, conventional, and antibiotic-treated conventional nu/nu mice. Scanning electron microscopy showed that C. neoformans adhered to the epithelial surfaces of the oral cavities, esophagi, and gastrointestinal tracts of monoassociated nu/nu and nu/+ mice, and culture data showed that there were more viable C. neoformans cells in the alimentary tracts of nu/nu mice than of nu/+ mice. Tetracycline-treated conventional nu/nu, but not nu/+, mice were also colonized with C. neoformans following intragastric challenge. C. neoformans monoassociated and tetracycline-treated conventional nu/nu mice succumbed to disseminated cryptococcosis with cerebral involvement 3 to 4 weeks after oral challenge, whereas no mortality was observed for similarily challenged nu/+ mice. These results demonstrate that an encapsulated strain of C. neoformans can colonize mucosal surfaces and cause systemic cryptococcosis in immunodeficient nu/nu mice, suggesting that the alimentary tract can be a portal of entry for C. neoformans in an immunodeficient host. These data also indicate that functional T cells play an important role in resistance to systemic cryptococcosis of endogenous origin. PMID- 3305360 TI - Plasmid-encoded expression of lipopolysaccharide O-antigenic polysaccharide in enteropathogenic Escherichia coli. AB - The role of a plasmid in the virulence activity of an enteropathogenic Escherichia coli (EPEC) strain belonging to serotype 0111:NM was examined. EPEC strain B171, which is resistant to chloramphenicol, streptomycin, sulfathiazole, and tetracycline, harbors a 54-megadalton plasmid, pYR111, and exhibits localized adherence (LA) with HeLa cells. Curing the plasmid yielded strain B171-4, which had lost the ability to exhibit LA, resistance to the antibiotics, and the lipopolysaccharide (LPS) O-antigenic polysaccharide. To confirm that these phenotypic characteristics were specified by pYR111, the plasmid was transferred by conjugation into a nalidixic acid-resistant strain of E. coli HB101. LA and antimicrobial resistance were expressed in most of the transconjugants examined. The O-polysaccharide side chains, antigenically reactive with O111-specific antiserum, were also expressed by the transconjugants. Although EPEC plasmids coding for both drug resistance and LA have been described, an EPEC plasmid encoding the expression of an LPS O antigen has not been previously reported. Similar findings described for some Shigella and Salmonella strains suggest that plasmid-encoded modification of the LPS in some enteric bacterial species may be more common than previously recognized and may contribute to the characteristic virulence activity of the organism. PMID- 3305361 TI - Protease degradation of Escherichia coli heat-stable, mouse-negative, pig positive enterotoxin. AB - Enterotoxigenic Escherichia coli produces three enterotoxins: heat-labile toxin, a mouse-positive heat-stable toxin, and a mouse-negative heat-stable toxin (STb). The only species in which a response to STb has been documented is the pig, and this response is inconsistent. When STb was placed in 60 ligated jejunal segments (loops) in six pigs, a positive response (net secretion) was observed in only 40 loops. In contrast, when the jejunal lumen was pre-rinsed with 50 ml of saline, the same STb preparation induced net secretion in 60 of 60 loops. STb did not induce secretion in rinsed loops when jejunal luminal washings were collected and mixed with STb in vitro. The anti-STb activity of jejunal luminal washings was filterable through 0.45-micron-pore-size filters, was destroyed by heating at 100 degrees C for 15 min, and was blocked by soybean trypsin inhibitor. STb was inactivated when incubated with trypsin in vitro for 60 min at 37 degrees C. It is concluded that STb is susceptible to trypsin degradation and that variable amounts of trypsin-like activity in swine jejuna are responsible for inconsistent responses to STb in jejunal loops of swine. These results also suggest that the concept of species specificity of the STb response should be reexamined. PMID- 3305362 TI - Activation of the classical and alternative pathways of complement by Treponema pallidum subsp. pallidum and Treponema vincentii. AB - Both in vivo and in vitro studies have indicated that complement plays an important role in the syphilitic immune responses. Few quantitative data are available concerning activation of the classical pathway by Treponema pallidum subsp. pallidum, and no information is available on treponemal activation of the alternative pathway. Activation of both pathways was compared by using T. pallidum subsp. pallidum and the nonpathogen T. vincentii. With rabbit and human sources of complement, both organisms rapidly activated the classical pathway, as shown by hemolysis of sensitized sheep erythrocytes and by the generation of soluble C4a. With human sources of complement, both organisms also activated the alternative pathway, as shown by hemolysis of rabbit erythrocytes and by the generation of soluble C3a in the presence of magnesium ethylene glycol-bis(beta aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA). During incubation, organisms remained actively mobile and did not lyse, indicating that activation was a function of complement reactivity with the intact outer treponemal surface. In addition, freshly harvested T. pallidum subsp. pallidum immediately activated both pathways of complement; preincubation of organisms did not enhance complement reactivity. T. vincentii was a more potent activator of this pathway. T. pallidum subsp. pallidum contained almost four times as much surface sialic acid as T. vincentii did. When sialic acid was enzymatically removed from T. pallidum subsp. pallidum, enhanced activation of the alternative pathway was detected. It is proposed that T. pallidum subsp. pallidum retards complement mediated damage by the alternative pathway through surface-associated sialic acid. This may be an important virulence determinant that enables these organisms to readily disseminate through the bloodstream to infect other tissues. PMID- 3305363 TI - Effects of fibronectin and other salivary macromolecules on the adherence of Escherichia coli to buccal epithelial cells. AB - The effect of saliva and fibronectin (Fn) on the adherence of a type 1 fimbriated strain of Escherichia coli to human buccal epithelial cells was studied. Saliva pretreatment of epithelial cells led to a dose-dependent increase in adherence that was inhibited by alpha-methyl mannoside, which is typical of a type 1 fimbria-mediated event. The molecules responsible for affecting this increased adherence were nondialyzable and were recovered after lyophilization. E. coli adherence was stimulated by individual saliva samples from each of 11 volunteers. Fn inhibited E. coli adherence to saliva-treated buccal cells by more than 60%. Biotinylated E. coli and Fn were reacted with Western blots of whole saliva to identify the receptors that might explain the phenomenon described above. Both E. coli and Fn bound to 57- and 62-kilodalton (kDa) protein bands in Western blots of sodium dodecyl sulfate gels of whole saliva. The binding of E. coli to these bands was inhibited by pretreatment with unlabeled Fn. To study these salivary components, samples of saliva were electrophoresed on sodium dodecyl sulfate gels, strips corresponding to the appropriate molecular weights were cut out, and the proteins were eluted electrophoretically. Material that eluted from strips at 57 and 62 kDa, but not that from a control strip, stimulated E. coli adherence to buccal cells. Alternatively, saliva was fractionated over 100- and 50-kDa cutoff filters. Of the three fractions obtained, only the fraction passing through the 100-kDa filter and retained by the 50-kDa filter stimulated E. coli adherence to buccal cells. This fraction also increased the binding of Fn to buccal cells. These observations suggest the possibility that one or more salivary components bind to the surface of buccal cells and serve as receptors for type 1 fimbriated E. coli. Fn also binds to this isolated material; and it is apparently by these interactions, at least in part, that saliva stimulates and Fn inhibits E. coli adherence. The way in which these interactions may affect bacterial adherence in vivo remains to be elucidated. PMID- 3305364 TI - Substitutions of cysteine residues of Escherichia coli heat-stable enterotoxin by oligonucleotide-directed mutagenesis. AB - The Escherichia coli 18-amino-acid, heat-stable enterotoxin STp has six cysteine residues linked intramolecularly by three disulfide bonds. These disulfide bonds are important for toxic activity, but the precise role of each bond is not clear. We substituted cysteine residues of STp in vivo by oligonucleotide-directed site specific mutagenesis to dissociate each disulfide bond and examined the biological activities of the resulting mutants. The Cys-6----Ala and Cys-17--- Ala mutations caused a complete loss of toxic activity. The Cys-5----Ala, Cys-10- --Ser, and Gly-16, Cys-17----Cys-16, Gly-17 mutations caused a large decrease in toxic activity. These results mean that all three disulfide bonds formed at fixed positions are required for full expression of the biological activity of STp. However, a weak but significant toxicity still remained after three mutations, Cys-5----Ala, Cys-10----Ser, and Gly-16, Cys-17----Cys-16, Gly-17. This indicates that STp has some flexibilities in its conformation to exert toxic activity and that the role of each disulfide bond exerting toxic activity is not quite the same. PMID- 3305365 TI - Ultrastructural localization of an intracellular Toxoplasma protein that induces protection in mice. AB - We report the ultrastructural localization of Toxoplasma antigens recognized by monoclonal antibody F3G3, which protects mice against lethal challenge. By using colloidal immunogold labeling, F3G3 failed to react with the surface of intact Toxoplasma cells, confirming previous observations that it recognizes an intracellular antigen. Immunoperoxidase labeling with F3G3 was obtained only when Toxoplasma cells were previously exposed to Triton X-100. A specific immunoperoxidase reaction was located beneath the surface membrane in the region of the pellicle and within the elaborate network of vesicles which are extruded from the surface of Toxoplasma cells during entry into host cells. Similar results were obtained with mouse polyclonal sera and a second monoclonal antibody, 6-86-1E11, both of which were produced against the F3G3 affinity purified protein. The location of the epitope recognized by F3G3 was confirmed by purifying T. gondii-derived surface membrane vesicles, separating these proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and immunoblotting. Monoclonal antibody 6-86-1E11 and the analogous polyclonal sera reacted with the antigenically related proteins of 58 and 28 kilodaltons that were found both in the intact organisms and in the purified surface membrane vesicles. These results indicate that the epitope recognized by F3G3 is located beneath the Toxoplasma cell surface membrane and is contained within plasma membrane-derived vesicles. PMID- 3305366 TI - Respiratory burst facilitates the digestion of Escherichia coli killed by polymorphonuclear leukocytes. AB - We examined factors that may limit degradation of bacterial protein of Escherichia coli S15 killed by polymorphonuclear leukocytes (PMN). Both human and rabbit PMN degraded up to 40% of [14C]amino acid-labeled protein of ingested and killed E. coli in 2 h as determined by loss of acid-precipitable radioactivity. In contrast, equally bactericidal broken-PMN preparations or isolated granules degraded only about 10% of bacterial protein regardless of pH. To determine whether activation of the respiratory burst contributes to digestion, we compared degradation by intact PMN in room air and under N2. Depletion of O2 by N2 flushing had no effect on the bactericidal activity of either human or rabbit PMN but reduced degradation by approximately 50%. Protein degradation during phagocytosis was also reduced in the presence of cyanide or azide, inhibitors of myeloperoxidase (MPO). PMN of two patients with chronic granulomatous disease ingested and killed E. coli S15 as well as did normal PMN but degraded bacterial protein as did normal PMN incubated under N2. The low degradative activity of PMN disrupted by sonication could be raised to nearly the level of intact PMN incubated in room air by preincubation of the PMN with 10(-7) M formyl-methionyl leucyl-phenylalanine (fMLP) before sonication and by pretreatment of E. coli with MPO. Depletion of O2 or chloride during these preincubations with formyl methionyl-leucyl-phenylalanine respectively, virtually abolished and markedly diminished stimulation of bacterial protein degradation. We conclude that enhanced MPO-mediated O2 metabolism of intact PMN plays a role in the digestion of killed E. coli. PMID- 3305367 TI - Identification of two different hemolysin determinants in uropathogenic Proteus isolates. AB - DNA sequences similar to those of the Escherichia coli hemolysin genes were detected among uropathogenic isolates of Proteus vulgaris and Morganella morganii by using the Southern blotting technique and hly gene-specific DNA probe. Immunoblotting revealed that among the hemolytic P. vulgaris and M. morganii isolates there was expressed a polypeptide species similar in molecular size (110 kilodaltons) and antigenicity to Escherichia coli HlyA. A plasmid-mediated P. vulgaris hemolysin determinant identified by Southern blotting analysis was molecularly cloned, and the recombinant plasmid (pWPV100) was characterized by restriction endonuclease fragment mapping. A second recombinant library of genomic DNA prepared from a hemolytic, urinary tract isolate of Proteus mirabilis was constructed in E. coli. A 5.5-kilobase XhoI fragment encoding an extracellular hemolytic activity was molecularly cloned (pWPM100), and this plasmid was subjected to transposon-mediated mutagenesis with TnphoA. The P. mirabilis hemolytic phenotype was determined to be encoded by a polypeptide species (HpmA) with an estimated molecular size of 140 kilodaltons based on minicell polypeptide analysis of pWPM100 and its mutant derivatives. Southern blotting analysis with a HpmA-specific DNA probe revealed that this novel determinant is commonly found in both Proteus species but is not present in hemolytic isolates of M. morganii, E. coli, Citrobacter freundii, and Serratia marcescens. PMID- 3305368 TI - Changes in the cell surface properties of Treponema pallidum that occur during in vitro incubation of freshly extracted organisms. AB - We previously reported that a number of Treponema pallidum membrane proteins appear to reside on the cell surface, since intact treponemes radiolabeled by overnight incubation in medium containing [35S]methionine bind immunoglobulin G (IgG) antibodies directed against these proteins. In the present study, it was found that freshly extracted organisms radiolabeled in vitro for only 2 h inefficiently bound IgG antibodies directed against just two proteins of molecular weights 40,000 and 34,000. An in vitro incubation period of greater than 8 h was required before IgG antibodies present in rabbit syphilitic serum could recognize additional protein antigens on the cell surface. Treatment of aged treponemes, but not freshly extracted organisms, with 0.04% sodium dodecyl sulfate selectively removed a membranous layer from the treponemal surface. Only three treponemal proteins were found associated with this structure, including the same 40,000- and 34,000-molecular-weight proteins mentioned above. These two proteins most likely represent endoflagellar subunits, since they were precipitated with rabbit antisera prepared against purified endoflagellar subunits of the cultivable treponemal strain Treponema phagedenis. Further evidence also was obtained that cells of T. pallidum actively secrete into their extracellular environment a unique class of low-molecular-weight proteins. PMID- 3305370 TI - Marker exchange mutagenesis of the aerolysin determinant in Aeromonas hydrophila demonstrates the role of aerolysin in A. hydrophila-associated systemic infections. AB - We report here on the isolation of isogenic strains of Aeromonas hydrophila AB3 deleted for a segment of the aerolysin gene. All aer mutants obtained lacked the 49-kilodalton aerolysin gene product and were neither hemolytic for blood erythrocytes nor cytotoxic for Chinese hamster ovary tissue culture cells. One such mutant, AB3-5, was used in a mouse toxicity model to evaluate the role of aerolysin in the pathogenesis of A. hydrophila infections. The strain had a 50% lethal dose (LD50) of greater than 10(9) as compared with the parental strain which had an LD50 of 5 X 10(7). Reintegration of the deleted segment into AB3-5 resulted in an LD50 of 6 X 10(7) cells for this revertant. Furthermore, all mice injected with a sublethal dose of the parental strains developed necrotic lesions; this was never obtained with the aerolysin-deficient strain AB3-5. More importantly, specific neutralizing antibody to aerolysin was detected in mice surviving A. hydrophila infection, demonstrating that aerolysin is produced during the course of systemic A. hydrophila infections. PMID- 3305369 TI - Association of an abnormality of neutrophil chemotaxis in human periodontal disease with a cell surface protein. AB - Localized juvenile periodontitis (LJP) is characterized by severe, early-onset, molar and incisor bone loss; neutrophil chemotaxis disorders; and a high prevalence of Actinobacillus actinomycetemcomitans infection. LJP is further characterized by significant familial aggregation of the disease. Recent work in our laboratory has demonstrated the selective depletion of a surface glycoprotein of 110,000 Mr (GP110) from LJP neutrophils by using surface labeling with [14C]formaldehyde and autofluorography. The function of GP110 is unknown; however, it does not appear to be a chemotactic factor receptor. Rather, it is bound by a monoclonal antibody (NCD-1) that recognizes a neutrophil differentiation antigen and which itself alters neutrophil chemotactic and secreting functions. To quantify GP110 on LJP and normal neutrophils, fluorescein labeled NCD-1 was bound to neutrophils and the amount of fluorescence was evaluated by using cytofluorography. Our results indicate that there is a quantifiable reduction (40%) of GP110 on the surface of LJP and GJP neutrophils, compared with controls. Other patients with neutrophil defects express normal quantities of GP110, suggesting disease specificity. Our data suggest that GP110 may be a useful disease marker for LJP and may provide a useful probe for the study of neutrophil chemotactic function and dysfunction. PMID- 3305371 TI - Release of lactoferrin by polymorphonuclear leukocytes after aerosol challenge with Escherichia coli. AB - Mice with cyclophosphamide-induced granulocytopenia were challenged with aerosolized Escherichia coli, their lungs were lavaged at 1 and 4 h, and total cell counts, differential counts, and levels of lactoferrin, transferrin, and albumin were measured in the lung lavage fluid. Lung lavage fluid from cyclophosphamide-treated mice had few neutrophils and no increase in lactoferrin levels, whereas control mice had significant increases in both. Transferrin levels did not change in either group. Neutrophils are the source of increased lactoferrin levels in lung lavage fluid after aerosol challenge. PMID- 3305372 TI - Purification of actin from Candida albicans and comparison with the Candida 48,000-Mr protein. AB - Actin was purified from Candida albicans cells by affinity chromatography by DNase-Sepharose and was recognized by immunoblotting with monoclonal antibody directed against chick muscle actin. The C. albicans 48-kilodalton protein recognized by sera from patients with invasive candidiasis was shown by DEAE chromatography and immunoblotting not to be identical with the purified C. albicans actin. PMID- 3305373 TI - Immunological monitoring and early prediction of rejection in renal allograft recipients. AB - Graft rejection remains the major problem complicating renal allograft transplantation. A reliable posttransplant predictor of impending rejection will be valuable to help maintain better graft function. We monitored 47 patients with end-stage renal disease treated by renal allograft starting 1 day pretransplantation and continuing for up to 90 days postgrafting. Peripheral blood mononuclear cells (PBMC) from both patients and 71 healthy subjects were compared for: (1) DNA synthesis in T and B lymphocytes in response to mitogens; (2) interleukin-2 (IL-2) production; (3) natural killer (NK) and antibody dependent cell-mediated cytotoxic (ADCC) activities; (4) induced augmentation of NK and ADCC activities by the biological response modifiers (BRM), lymphoblastoid interferon, recombinant alpha-2-interferon, gamma-interferon and recombinant IL 2. During the 2 weeks preceding rejection we found lower than normal levels of IL 2 production (p less than 0.0005) and DNA synthesis (p less than 0.01) in concanavalin A-stimulated PBMC. IL-2 yield reached its lowest level on the day of rejection and increased sharply the following week after antirejection therapy was started. Mitogen-stimulated DNA synthesis rose in parallel with increasing levels of IL-2 production. Both NK and ADCC activities increased during rejection (p less than 0.05). The ADCC response to BRM activation measured during the first 2 weeks postgrafting was found to correlate with the stability of the graft. Recipients whose graft function remained stable had a minimal ADCC response to BRM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305375 TI - Transient elevation of serum IgE after allogeneic bone-marrow transplantation. AB - Serum IgE levels were followed longitudinally twice a week for up to 100 days in 60 children treated for leukemia, severe aplastic anemia or severe combined immunodeficiency: 52 underwent allogeneic bone-marrow transplantation and 8 immunosuppressive treatment. In 55 of 58 treatment periods which could be analyzed (95%), a transient sharp increase of serum IgE was detected, irrespective of the initial diagnosis and mode of treatment. A second IgE peak was recorded in 16% of evaluable treatment periods. In the transplanted leukemia and aplastic anemia patients, the rise of serum IgE levels occurred at the same time, i.e. at a mean of 14 days after transplantation; it occurred significantly later in children grafted for severe combined immunodeficiency. In children who received immunosuppression for the treatment of severe aplastic anemia, IgE elevations were always seen within 2 weeks after institution of therapy. No relation was found between either the occurrence of clinically acute graft-versus host disease or infections after treatment, and the time of onset of IgE elevations. It is suggested that the phenomenon of IgE peaks in the population of patients investigated was due to disturbance of T-cell regulation, i.e. a temporary impairment of T-suppressor cell activity. PMID- 3305374 TI - Evidence for an activated subpopulation of T8-bearing cells in male homosexuals with lymphadenopathy. AB - Data are presented that male homosexuals with chronic lymphadenopathy and reduced numbers of T4-antigen-bearing cells have an increased incidence of activated T8 antigen-bearing cells. Evidence suggesting an increase in activated T cells in these subjects includes an increase in incidence of T10-antigen-bearing cells, an increase in Ia-bearing T cells and an increase in the intensity of staining of a fraction of the T8-antigen-bearing cells with fluorescein-labeled OKT8 monoclonal antibody. It was shown by double staining that most of the Ia-bearing T cells also bore the T8 marker. The heterogeneity of the Ia, assayed by reactivity with several monoclonal anti-Ia antibodies which detect different epitopes on the Ia molecule, was comparable in lymphadenopathy subjects and controls. PMID- 3305376 TI - Canine unilateral lung transplantation: effect of ciclosporin A on the frequency of donor-lytic lymphocytes. AB - Limiting dilution analysis showed that the frequency of precursor donor-lytic cytolytic lymphocytes increased dramatically within the leucocyte population recovered by broncho-alveolar lavage in dogs after unilateral lung transplantation. The increases for animals experiencing acute pulmonary rejection (11.5-24.8 times pre-operative level) and for those receiving long-term ciclosporin A therapy (5.4-17.6 times pre-operative level) were similar. Therefore, it appears that ciclosporin A does not prevent the sequestration of precursor donor-lytic cytotoxic cells within lung allograft tissue. PMID- 3305377 TI - Diet and artery diseases. PMID- 3305378 TI - Trichotillomania: a new treatment. PMID- 3305379 TI - A comparative randomized double-blind clinical trial of hexapneumine and clistine as antitussive agents. AB - The efficacy and safety of a new antitussive expectorant drug hexapneumine was compared with that of an already marketed and functionally related clistine in a double-blind, randomized, parallel design clinical trial. A total of 100 patients with cough associated with chest diseases participated in the trial. Five patients (hexapneumine 3 and clistine 2) were lost to follow-up. Ninety-five patients (hexapneumine 46, clistine 49) completed the trial. Hexapneumine was significantly more effective (p less than 0.02) than clistine in suppressing cough as recorded from the patient's subjective improvement in the severity of the symptom. The side-effects observed were mild in nature and did not require reduction in dosage or withdrawal of the drug in any of the patients. Drowsiness and dryness of mouth were the predominant side-effects and were relatively more common in the clistine group as compared to hexapneumine. In the experimentally induced cough in 8 healthy human volunteers subjected to crossover design of study at weekly interval, hexapneumine and clistine were equally effective in suppressing cough. It is concluded that hexapneumine is a more effective antitussive as compared to clistine in naturally occurring cough. However, in experimentally induced cough the two drugs were equally effective. Hexapneumine exhibited relatively fewer side-effects. PMID- 3305380 TI - Pharmacokinetics of ceftazidime and netilmicin in patients with sepsis. AB - The pharmacokinetics of ceftazidime and netilmicin were evaluated under septicemic conditions. In a longitudinal study, both drugs were administered simultaneously (ceftazidime 2.0 g 20 min constant i.v. infusion and netilmicin 150 mg i.v. bolus injection) every 12 hours to patients who had a positive blood culture and hyperdynamic circulatory functions. Twenty-four hours after the first period of this pharmacokinetic study, identical parameters were evaluated under dipyrone induced normothermic conditions. The mean residence time and the volume of distribution was significantly altered during septicemia compared to normal conditions. With respect to the relative distribution properties ceftazidime tended to be distributed to a greater extent to the tissue compartment, whereas netilmicin showed an opposite behaviour. Beside significant correlations of absolute values, i.e. blood volume vs. volume of distribution, and relative values, i.e. total peripheral resistance vs. extraction rate, all other attempts failed to show any meaningful correlation. Owing to the heterogenous alterations of metabolic and hemodynamic functions and pharmacokinetic parameters, respectively, the data gained from this study do not allow any statistically validated conclusion regarding the pathophysiological mechanisms involved, although these findings are in accordance with animal experiments. PMID- 3305381 TI - Effects of captopril on circulating T lymphocyte subsets. AB - Six patients treated with captopril for severe essential hypertension were studied to determine whether the drug significantly altered circulating peripheral blood T (Thymus derived) lymphocytes and T lymphocyte subsets. OKT3+ (functionally mature T lymphocytes), OKT4+ (class II major histocompatibility complex [MHC] reactive T lymphocytes) and OKT8+ (class I MHC reactive T lymphocytes) T lymphocytes were monitored using monoclonal antibodies and flow cytometry before commencement of treatment and then at intervals during 14 months of captopril administration. Results showed a significant increase in the absolute numbers of OKT4+ cells at 2 h (p less than 0.05) and a decrease at 12 weeks (p less than 0.01) during captopril treatment. These findings indicate that captopril has an effect on cellular immunity in vivo. PMID- 3305382 TI - Effect of various disease states on theophylline plasma levels and on pulmonary function in patients with chronic airway obstruction treated with a sustained release theophylline preparation. AB - Theophylline plasma levels and FEV1 were measured in patients affected by chronic obstructive pulmonary disease and a concomitant disease state (congestive heart failure, chronic cor pulmonale, obesity, peptic disease, hepatic cirrhosis, chronic renal failure) and treated with a sustained release theophylline preparation. Our results indicate that, only in patients affected by congestive heart failure and chronic cor pulmonale, is there a decreased plasma clearance of the drug. Low levels of plasma theophylline were measured in obese patients probably because they received an inadequate posology. PMID- 3305383 TI - General index. Vols. 1-10 (1977-1986). PMID- 3305384 TI - [Use of allografts in oncology and traumatology]. AB - Fresh allografts of bone are commonly used for repairing small defects, but preserved grafts are required for replacing large sections of long bones. We have collected these grafts in sterile conditions and then preserved the specimens in liquid nitrogen at minus 196 degrees Celsius. Biological, histological and biomechanical studies have confirmed the value of this technique. The method preserves the normal architecture of bone and viable cartilage cells. The medullary cells are gradually destroyed in situ leaving a protein matrix to which mineral components are fixed. Neither of these are antigenic in allografts and immunological problems are rarely encountered. When the recipient site is well vascularised the graft becomes fully integrated within two or three years. Doubt has been expressed as to the functional viability of the cartilage in large allograft joint replacements, and is has been suggested that metal prostheses might be better. Research is in progress in the use of ligament allografts and on the use of bank bone with large prostheses. The functional results are satisfactory in more than 90% of patients treated with these large allografts. PMID- 3305385 TI - Autoimmunity and chondrolysis of the hip. A report of two cases. AB - Two patients with rapidly progressive chondrolysis of the hip are reported. Immunofluorescent staining showed deposits of immunoglobulins and complement components in the synovium and the remaining femoral head cartilage. Seven patients with osteoarthritis of the hip and knee, or femoral neck fractures, were used as controls and all had a negative immunofluorescent staining reaction in the synovium. We suggest that an autoimmune reaction against articular cartilage antigens may play a role in the development of chondrolysis. PMID- 3305386 TI - Decrease of mononuclear phagocyte cell functions and prolongation of graft survival in experimental transplantation by (+/-)-15-deoxyspergualin. AB - The new anti-tumor substance 15-deoxyspergualin was shown to have immunosuppressive properties. Immunosuppression seemed to be predominantly directed against mononuclear phagocytes and to monocyte dependent lymphocyte effector functions. The substance was shown to be effective in the prevention of the rejection of allogeneic transplants. This was shown in a rat tail skin transplantation model (LEW----Fischer). Prolongation of graft survival time was increased about two fold after either i.p. or p.o. administration of 15 deoxyspergualin. Suppression of monocyte activity would thus be a novel mode of action for an immunosuppressive substance being effective in organ transplantation. PMID- 3305387 TI - Recent developments in occupational health policy in Italy. AB - On two occasions in the past, Italy has been in a leading position regarding occupational health: in 1700, thanks to work carried out by Dr. B. Ramazzini, and at the beginning of this century, with the founding of the first "Clinica del Lavoro" in Milan. Experience with and considerations of the interaction between the workplace, society as a whole, and the various institutions in the field of occupational health have played an important role in the general political discussion since the 1960s. In this article, we describe the effects of the workers' model of inquiry into health hazards on work organization, the National Health Service, workers' health conditions, and the scientific milieu. We also provide an analysis of present conditions and difficulties, particularly with regard to environmental problems and perspectives. PMID- 3305388 TI - Tobacco or health in the Third World: a political economy perspective with emphasis on Mexico. AB - In response to declining cigarette sales in the United States and Europe, transnational tobacco conglomerates have turned to the underdeveloped world to promote their unhealthy products for consumers who are at best only vaguely aware of the health risks associated with cigarette smoking. While cigarette sales in the Third World are growing "healthily," the consumers of these cigarettes generally are not. Along with the already difficult problems of malnutrition and communicable diseases, underdeveloped countries are facing the probability of a smoking epidemic, which is directly related to the penetration of capitalist tobacco interests into new markets. While the tobacco companies are quick to suggest that these people who can least afford cigarettes (both financially and in terms of health risks) are exercising their "free choice" as consumers in an "open marketplace," the author suggests that political and economic factors are central. Aided by two months of fieldwork in Mexico in 1986, the author examines smoking behavior and perceptions of associated health consequences. In addition, the influence of the tobacco companies and the Mexican government on tobacco production and consumption is analyzed. PMID- 3305389 TI - Abdominal complaints and gastrointestinal function during long-lasting exercise. PMID- 3305391 TI - Mast cells and their mediators. Emphasis on their role in type I immediate hypersensitivity in canines. PMID- 3305390 TI - Recombinant interferon alfa-2a, an active agent in advanced cutaneous T-cell lymphomas. AB - The cutaneous T-cell lymphomas including mycosis fungoides and the Sezary syndrome, are indolent lymphomas with early systemic dissemination. Like the indolent B-cell lymphomas, they cannot be cured by currently available systemic chemotherapy so new systemic therapies need to be developed. A study of very high dose recombinant interferon alfa-2a was, therefore, initiated in 20 patients with advanced cutaneous T-cell lymphoma (5 in stage II, 2 in stage III and 13 in stage IV). All patients were refractory to at least 2 standard therapies, including topical nitrogen mustard (18 patients), psoralens and ultraviolet A light (12 patients), total skin electron irradiation (14 patients) and systemic chemotherapy (16 patients). Nine out of 20 patients (45%; 95% confidence interval 25-69%) had either objective partial or complete responses within 3 months of starting treatment. Maximal response, however, often did not occur for at least one year. The median duration of response was 5.5 months and all complete responses lasted more than 2 years. Response frequencies were equal at both cutaneous and extracutaneous sites and in patients with or without prior chemotherapy. Toxicity was exhibited primarily as a flu-like syndrome consisting of fever, malaise, fatigue, anorexia and weight loss which necessitated dose reductions in all patients. Transient elevations in liver function and decreases in renal function and granulocyte counts occurred in some patients. It is concluded that interferon alfa-2a is highly active against advanced cutaneous T cell lymphomas and that it should be studied in its early stages. It should also be evaluated in combination with other biological agents and with chemotherapy. PMID- 3305392 TI - A new risk factor in vascular disease. Excessive solar and other actinic radiation in giant-cell arteritis and atherosclerosis. PMID- 3305393 TI - The substitution of glucose-antiglucose oxidase complex (GAG) for peroxidase antiperoxidase (PAP) in immunohistochemical studies of skin. AB - The substitution of glucose-antiglucose oxidase complex (GAG) for peroxidase antiperoxidase (PAP) in the Sternberger three-layer unlabeled antibody method avoids the problems associated with the use of the chromogen 3,3,diaminobenzidine (DAB). The blue final reaction product obtained using the GAG complex is not obscured by melanin granules, which is often the case when using the PAP-DAB combination. The replacement of PAP with GAG complexes facilitates the detection of melanocytes in melanoma and blue nevi. The absence of endogenous glucose oxidase in mammals provides for greater image contrast, which is not possible using alternative chromogens and immunoperoxidase. PMID- 3305395 TI - Pediatric dermatology: chronologic excursions into the literature. Part III. Dermatologic texts. PMID- 3305394 TI - Cefuroxime axetil in the treatment of cutaneous infections. AB - A multicenter clinical trial was conducted in 125 out-patients with skin and skin structure infections due to bacteria in order to compare the safety and efficacy of cefuroxime axetil and cefaclor. Patients with a median age of 32 years were randomly allocated to treatment for 10 days with one of three treatments: cefuroxime axetil 250 mg b.i.d., cefuroxime axetil 500 mg b.i.d., or cefaclor 250 mg t.i.d. Clinical evaluations of each patient were done pre-treatment, 2 to 4 days intra-treatment, and within 3 days post-treatment. One patient discontinued cefuroxime axetil due to severe urticaria and one patient discontinued cefaclor due to a persistent headache and vomiting. Cefuroxime axetil was an effective antibacterial agent for treatment of common skin infections. Clinically beneficial outcome was achieved for 92% (cefuroxime axetil 250 mg b.i.d.), 95% (cefuroxime axetil 500 mg b.i.d.), and 97% (cefaclor 250 mg t.i.d.) of patients. Since the study failed to demonstrate a significant advantage of higher dosage, cefuroxime axetil should be prescribed in a regimen of 250 mg twice a day for patients with skin infections. PMID- 3305396 TI - Conformation and stability of two recombinant human interferon-alpha analogs. AB - Structural features of a recombinant E. coli derived interferon-alpha analog, interferon consensus1, was studied by circular dichroism and fluorescence spectroscopy. Circular dichroic spectra of the purified protein showed that it has about 70% alpha-helix and a distinct tertiary structure. These structural features are similar to those for a natural interferon-alpha subtype, interferon alpha 2, indicating that the amino acid substitutions in interferon consensus1 apparently did not alter the protein structure. Another analog, interferon consensus5, which has Ser instead of Cys at residues 1 and 99 but is otherwise identical to interferon consensus1, was prepared to study the role of the disulfide bond between Cys 1 and 99. Circular dichroic and fluorescence spectra indicated similarity in the structure of these two analogs. However, interferon consensus1 was significantly more stable than interferon consensus5 against denaturation. pH unfolding experiments indicated that the former protein is more stable in the transition region by about 1.6 kcal/mol, which was interpreted in terms of the increased free energy of the denatured state due to an extra disulfide bond in interferon consensus1. PMID- 3305397 TI - Synthesis and use of peptide substrates for the isolation and characterization of proenkephalin processing enzymes. AB - Classical methods of peptide synthesis in solution were used for the preparation of the two tetrapeptides alanyl-lysyl-arginyl-tyrosine and acetyl-alanyl-lysyl arginyl-tyrosine-(N-methylamide). The two compounds were able to be recognized as substrates by proenkephalin processing enzymes and were used for the development of a quantitative assay for these enzymes. The first substrate proved to be convenient, although it was also partially degraded by amino- and carboxypeptidases under the conditions of the assay. The second was found to be hydrolyzed by the endopeptidases at too slow a rate to allow its routine use in the assay. PMID- 3305398 TI - In vivo enzyme control through a strong stationary magnetic field--the case of thymidine kinase in mouse bone marrow cells. AB - The influence of a strong homogeneous and stationary magnetic field (SMF) on the activity of the enzyme thymidine kinase (TdR-K) in bone marrow cells, and as a consequence of this on the incorporation of 125I-labelled 5-iodo-2-deoxyuridine (125IUdR) into DNA of mice and into isolated bone marrow cells in vitro, was assayed after exposure of immobilized mice. No effect could be elicited in moving mice, in cells in suspension or in enzyme in solution. The response depended on the body temperature during exposure: at 27 degrees C and 29 degrees C there was an increase and at 37 degrees C and a depression of enzyme activity. The TdR-K activity at low temperature increased with the field strength ranging from 0.2 to 1.4T. Thirty minutes were required for full expression of the effect at 1.4T; 5 10 min were needed after exposure for a return to base-line levels. Mice were given total-body irradiation at a dose of 0.1 Gy 137Cs gamma rays and then exposed immediately to a magnetic field at 1.4T for 30 min at a body temperature of 27 degrees C; gamma irradiation no longer inhibited the enzyme. Exposure to the magnetic field further removed from the time of gamma irradiation, did not negate the inhibitory effect of gamma irradiation. The observed responses to given challenges in this complex system support the hypothesis that the magnetic field affects TdR-K activity by way of a mediating structure, such as a membrane. PMID- 3305399 TI - Laryngomalacia. A review and the surgical management for severe cases. AB - Laryngomalacia with its characteristic inspiratory collapse of lax supraglottic tissues into the laryngeal inlet may on occasion cause obstruction of such severity as to require airway intervention. The anatomy of the condition and the physiological explanation for its clinical presentation are examined and the pathological changes that precipitate a life-threatening situation discussed. Surgical correction of the abnormal tissue represents an acceptable alternative to tracheostomy in this situation. Simply 'trimming' the lax tissue over the arytenoid mounds may suffice in some cases but complications can occur and stabilisation of the epiglottis should be attempted as well. A series of 11 infants on whom such surgery was performed is presented with discussion of the surgical procedures performed and the complications experienced. The current uniformly successful surgical management of severe laryngomalacia by 'supraglottic trimming' combined with 'anterior epiglottopexy' is advocated for correction of severe laryngomalacia. PMID- 3305400 TI - Development of the chick columella: immunohistochemical studies with anti collagen monoclonal antibodies. AB - Developmentally regulated changes in the extracellular matrices of the columella have been immunohistochemically analyzed with anti-collagen, type-specific monoclonal antibodies. In the 12-day chick embryo, the ossicle is entirely cartilagenous. By using immunohistochemical methods, we found that the 12-day columella contains type II collagen within the cartilagenous matrix and type I collagen in the surrounding perichondrium, but no type X collagen. Previous studies have shown that type X collagen is specific for hypertrophic cartilage (i.e., the site of future marrow cavity formation and ossification). By 16 days, hypertrophic cartilage is evident, type X collagen is present, and ossification has started medially adjacent to the oval window. These results both confirm and extend those of other chick endochondral bones that have been studied. Thus, the columella can serve as a model system for analysis of ossicular development and the associated temporal and spatial changes which occur within its extracellular matrices. PMID- 3305401 TI - Nutrients, brain biochemistry, and behavior: a possible role for the neuronal membrane. AB - Nutrients can modify brain biochemistry and behavior. Many studies indicate that one possible mode of action of nutrients is to induce alterations in the bioavailability of neurotransmitter precursors within the brain. However, a series of studies has also indicated that: (a) learning induces a decrease in the level of cholesterol in specific brain regions; (b) an iron-deficient diet induces changes in dopaminergic D receptor activity and in dopamine-associated behaviors (thermoregulation and motor activity) as well as in learning and memory capacities; and (c) dietary manipulation of a specific type of fatty acid resulted in an improved learning capacity, modification of the pain threshold level, and in thermoregulatory response. The most parsimonious explanation for these results seems to be that the treatments (learning, iron-deficient and fatty acid diets) induced changes in the lipid composition of the neuronal membrane. Such changes, in turn, resulted in changes in the membrane functions. Supportive evidence for this hypothesis is presented in this review. The "neuronal membrane functional modification hypothesis" should not be considered as contradictory to the accepted "brain neurotransmitter precursors bioavailability rates model" of nutrient effects, but as a complementary hypothesis. PMID- 3305403 TI - Strain variation among Candida species: application of various typing methods to study the epidemiology and pathogenesis of candidiasis in hospitalized patients. PMID- 3305402 TI - The hypothalamus in Tourette's syndrome. AB - Although a recent report by Devinsky (1983) has suggested that dysfunction at a midbrain levels is most likely to underlie the major symptoms of Tourette's syndrome, several features of the disease including alterations in the severity of the disease during puberty and premenstrually, disorders of appetite, amelioration of tics with rise in body temperature, and sleep point to hypothalamic involvement in the pathophysiology of the disease. PMID- 3305404 TI - Recurrent pseudobacteremias traced to a radiometric blood culture device. AB - Five clusters of pseudobacteremias over a seven-month period were traced to a BACTEC radiometric device. Four episodes were due to enterococcus and one involved Staphylococcus aureus. Each cluster began with multiple positive blood cultures from a patient with clinical evidence of bacteremia. On subsequent days each bottle in sequence yielded growth of the identical organism, as shown by phage typing and antibiograms. Cultures from patients believed to be infected with the organisms tested positive earlier (mean = 1.4 days) than those patients believed to be pseudobacteremic (mean = 4.8 days). Investigation pointed toward the BACTEC device as the most likely source. Resin beads were found in the needle on several occasions and were shown to be transferred from bottle to bottle. We postulated that contaminated resin beads or liquid from a positive bottle remained in the needle above the portion that was heat-sterilized, contaminating the next bottle when it was sampled. PMID- 3305405 TI - [New concept of systemic acid-base regulation--significance of the liver]. PMID- 3305407 TI - [Disorders of water homeostasis in liver cirrhosis]. PMID- 3305406 TI - [Endocrine changes in chronic liver diseases]. PMID- 3305408 TI - [Diagnosis and therapy of ascites]. PMID- 3305409 TI - [Prevention of hemorrhage from esophageal varices]. PMID- 3305410 TI - [Sonography in the diagnosis of liver cirrhosis and its complications]. PMID- 3305411 TI - Relevance of host-derived and bacterial factors in Pseudomonas aeruginosa corneal infections. AB - Two pathogenic mechanisms of Pseudomonas aeruginosa corneal infections are discussed, one involving bacterial exoenzymes, the other involving polymorphonuclear leukocyte (PMN)-derived lysosomal enzymes. The objective of the present study was (1) to show the relative importance of the two mechanisms and (2) to evaluate the effect of active immunization against P. aeruginosa exoenzymes on ocular damage. Rabbits were immunized against P. aeruginosa alkaline protease (AP) or elastase (Ela) and challenged with the respective enzymes. Corneal damage was studied by light photography (LP). In another group, rabbits were immunized against AP, Ela and exotoxin A (ExoA) and challenged with P. aeruginosa strains PA01 or PA103. Corneal damage was studied with LP, light microscopy, and electron microscopy. Immunized animals were totally protected against intracorneal inoculation of P. aeruginosa proteases. Twelve hr and 24 hr after challenge with whole bacteria, immunized rabbits revealed less corneal damage than non-immunized animals. However, after 48 hr corneal damage (ie severe corneal ulceration) was comparable in both groups. The study suggests that corneal damage involving lysosomal enzymes from stimulated PMN is more important after bacterial infection than direct damage by P. aeruginosa exoenzymes. PMID- 3305412 TI - Positron emission tomography. Prospects for clinical utility. PMID- 3305414 TI - Wet and dry high-speed cutting procedures used by recent Iowa graduates. Comparison of dental school and post-dental school practices. PMID- 3305413 TI - Comparison of observer and videodensitometric measurements of simulated coronary artery stenoses. AB - To test the applicability of an automated vessel measurement technique to coronary arteriography, a videodensitometric method with caliper measurements on digital subtraction images of a moving coronary artery phantom was compared. Percent diameter stenosis was determined by both methods, revealing a twofold improvement in reproducibility with the videodensitometric method, with percent stenosis being determined within +/- 10% for two different iodine concentrations injected during continuous flow into the simulated coronary arteries. Absolute diameters were also measured by the videodensitometric method, showing a high degree of correlation between measured and true diameter for vessels between 0.5 3.0 mm. PMID- 3305415 TI - Childhood gastroenteritis in Ireland and England. PMID- 3305416 TI - Clinical manifestations and laboratory data of subacute cutaneous lupus erythematosus. AB - Nine patients with subacute cutaneous lupus erythematosus (SCLE) are described, all of whom had systemic involvement of the disease although usually milder than in systemic lupus erythematosus. None of the patients had renal disease or died of SCLE. PMID- 3305417 TI - Localized chronic pemphigoid as an unusual cause of circulatory eosinophilia. PMID- 3305418 TI - Behavioral treatment of palmar hyperhidrosis. PMID- 3305419 TI - The Medicare payment system: a conceptual approach to the problem of controlling profitability. AB - Various components combine to determine the variance in the net income or loss resulting from the provision of inpatient care to Medicare beneficiaries. The variances in the income and the full costs assigned to beneficiaries are attributable to external forces or factors that may be controlled by an individual or group associated with the hospital. PMID- 3305420 TI - Academic health center hospitals: alternative responses to financial stress. AB - Academic health center hospitals face challenges to their survival in an increasingly competitive, challenging, and entrepreneurial environment. University hospitals face a number of major stresses and are responding in various ways to ensure their financial viability. PMID- 3305421 TI - Acrylic frontal cranioplasty. AB - The correction of contour defects of the frontal bone has been accomplished with a variety of autogenous and alloplastic materials. We report our experience in reconstructing 11 cases of congenital, traumatic, and postsurgical frontal defects with acrylic. The acrylic was cured intraoperatively within the defect in some patients, or prefabricated into a prosthesis and wired into position in others. The operative techniques for both methods of repair are detailed. The reconstruction was successful in all cases and there were no complications. The acrylic implant has been found to be well tolerated after 2-10 yr follow-up. The value of the construction of a facial moulage is stressed, especially when restoration of the orbital rim is required. PMID- 3305422 TI - Ultrasound B-scans in the follow-up of head and neck tumors. AB - In recent years, diagnostic ultrasound has become established in head and neck surgery. Modern equipment allows high resolution imaging of neck tissue masses, cervical vessels, and lymph nodes. The major advantage of B-mode sonography is its ability to detect neoplasms in solid scarred neck tissue, commonly seen in patients with radical neck surgery. Postoperative or radiogenic edema, tumor recurrence, and lymph node involvement can be differentiated. Inflammatory and neoplastic lymph node diseases detected by echography must be differentiated by biopsy. Tumor recurrence was seen in 21 of 152 patients by echography. Twelve patients were diagnosed by clinical examination and 17 were diagnosed by computed tomography. Two false positive and one false negative sonographic diagnoses were made. B-mode sonography is an important instrument in the follow-up examination of head and neck tumors for early detection of tumor recurrence or tumor persistence. PMID- 3305423 TI - Ultrasonographic study of the relation of metastatic nodes to the carotid artery. AB - Ultrasonographic studies of the neck were performed in four patients with metastatic lymph nodes that exhibited limited mobility or fixation to the surrounding tissues on palpation to obtain information about the relationship of nodes to the carotid artery. Comparison of the ultrasonograms with the operative findings disclosed that when a metastatic lymph node adhered to the carotid artery, the lymph node pulsated with flattening of the carotid artery and the echoes between the metastatic lymph node and carotid artery were attenuated. PMID- 3305424 TI - A classic paper revisited--Polya and von Navratil (1902). AB - In 1902, Polya and von Navratil published a paper in German describing lymphatic drainage of buccal mucosa, alveolus, fauces, and lips. In addition, they discussed patterns of local tumor spread and metastasis to lymph nodes, on the basis of which they gave a rational plan for surgical treatment of buccal carcinoma with the aim of both cure and conservation of uninvolved tissues. Much of that paper was ignored in the English language literature and some of the contents have been misquoted. This has been to the great detriment of the surgical treatment of intraoral cancer in the English-speaking world, which has only recently accepted similar principles and practice to that described by Polya and von Navratil. This paper reviews their publication in an attempt to put their contribution into proper perspective. PMID- 3305425 TI - Immunoperoxidase characterization of extramedullary plasmacytoma of the head and neck. AB - A retrospective analysis of 18 cases of extramedullary plasmacytoma (EMP) was done to characterize the type of immunoglobulin being synthesized by the neoplastic cells. The immunoperoxidase stain can be performed on previously fixed tissue and offers a means of predicting the likelihood of progression to multiple myeloma (MM). Tumors producing IgG make up the majority of cases of EMP in the literature and only 9% have progressed to MM. Smaller numbers of tumors producing other immunoglobulin classes have been studied, but it is clear that their prognosis is much more grave. PMID- 3305426 TI - Medicare and the nurse. The denial dilemma. PMID- 3305427 TI - [Sports during the growing years--a burden or pleasure?]. PMID- 3305428 TI - Blood pressure, plasma renin activity and aldosterone concentrations in vegans and omnivore controls. AB - Blood pressure, plasma renin activity and the concentrations of aldosterone and cholesterol in plasma and sodium and potassium in urine (48-h collections) and nutrient intakes were determined in 22 vegans (11 male and 11 female) and omnivore controls matched for age, sex and body build. The vegan diets contained less protein, sodium, calcium and sulphur but more carbohydrate, potassium and fibre than the diets of their controls. The mean urinary potassium sodium ratio was 1.13 in the vegans compared with 0.64 in the omnivores. Plasma renin and cholesterol concentrations were lower in the male but not female vegans compared with their respective controls. Blood pressures of the vegan subjects were inside the normal range but they tended to have higher mean diastolic blood pressures than their controls. PMID- 3305429 TI - Catering and nutrition: an educational approach to support a healthier diet. AB - The value of nutritionally-informed caterers should not be overlooked in the practical implementation of healthy eating. A description of a new course on nutrition for caterers is presented. It is designed to satisfy the requirements of students with varied, non-scientific backgrounds. Social and applied aspects of nutrition are emphasised. Information technology is used extensively to support concentrated learning activity. The qualitative evaluation by students of the 'pilot implementation' of the course indicated a successful educational outcome. Such initiatives need the support of up-to-date software. PMID- 3305430 TI - Human specific anti-type IV collagen monoclonal antibodies, characterization and immunohistochemical application. AB - This paper describes two new monoclonal antibodies reactive with human specific type IV collagen epitopes in frozen as well as routinely fixed and processed tissue sections. The antibodies (1042 and 1043) were raised against human placental type IV collagen and were shown by immunoblotting and ELISA tests to react exclusively with type IV collagen determinants. Extensive immunohistochemical survey studies on panels of tissues from various species, using unfixed cryostat sections, demonstrated that antibody 1042 reacted only with human type IV collagen whereas antibody 1043 in addition reacted with rabbit type IV collagen. All tissues showed homogeneous staining of the basement membrane, indicating that the detected epitopes did not show organ-specific distribution. Tissue processing protocols for using these monoclonal antibodies on routinely processed paraffin embedded tissues were developed. It was found that whereas polyclonal anti-type IV collage antisera required pepsin digestion, our monoclonal antibodies required pronase or papain digestion to restore type IV collagen immunoreactivity in paraffin sections. It is concluded that these monoclonal anti-type IV collagen antibodies detect species specific epitopes which can be detected in routinely processed paraffin embedded tissues after appropriate enzyme pretreatment. PMID- 3305431 TI - Estradiol-17 beta and progesterone regulate secretion of uteroglobin through different pathways. AB - Uteroglobin, the primary secretory protein of rabbit uterine epithelium, was localized by the direct immunoperoxidase method in uteri of control ovariectomized rabbits and of ovariectomized rabbits injected with progesterone or estradiol-17 beta. In control rabbits, staining for uteroglobin was almost entirely abolished six weeks after bilateral ovariectomy. Two days following progesterone injection of ovariectomized rabbits, intense staining for uteroglobin could be detected within the endoplasmic reticulum, Golgi complexes, and compact secretory vesicles of most endometrial epithelial cells. Estradiol-17 beta injection resulted in a different intracellular pattern of uteroglobin distribution. Two days following treatment with that steroid hormone, intense staining for uteroglobin was localized within large apical mucous droplets and moderate staining was present in the endoplasmic reticulum and Golgi complexes of these cells. The increased mucin content of the endometrial epithelium following treatment with estradiol-17 beta was confirmed by a periodic acid-Schiff histochemical reaction in the presence of diastase. Quantitation by radioimmunoassay of uteroglobin production in vitro by uterine fragment confirmed that progesterone had a greater effect on enhancing uteroglobin production than estradiol-17 beta and that both steroid hormones did not have any effect after 30 min of incubation in vitro. We suggest that progesterone not only regulates uteroglobin production at the transcriptional level, but that it also regulates the mode of uteroglobin secretion by the induction of a different pathway, compared with the one used when estradiol-17 beta is administered alone. PMID- 3305432 TI - Identification of oestrogen receptors in cells of paraffin-processed breast cancers by IGSS. AB - Oestrogen receptor (ER) analysis of breast cancers by the standard dextran coated charcoal (DCC) method and the oestrogen receptor immunocytochemical assay (ERICA), shows that ERICA is more sensitive. We find that the immunogold-silver staining technique (IGSS), which is used on paraffin sections, is applicable to the ERICA antibody and that the DCC and IGSS methods have comparable sensitivity. Reasons for wishing to develop an improved method for oestrogen receptor localisation in paraffin sections and its advantages are given. PMID- 3305434 TI - [Experiences with the augmentation of vocal cords]. AB - Augmentation of a vocal fold serves to improve glottic closure and may be indicated for paresis of the recurrent nerve and after tumor resection. Methods include injection of viscous fluids (paraffin, liquid silicone, polyvinyl alcohol, gelatin, sesame oil, collagen and particularly teflon paste) and operations to tighten the vocal cord or displace it medially. The disadvantages of the former include the danger of overcorrection, tissue irritation and possible systemic absorption of the material. As an alternative, solid material such as cartilage or synthetics may be used for augmentation. Experience obtained so far has shown that chips of porous polyethylene (PHDPE) are particularly suitable: they are easy to use, show good tissue tolerance and are anchored by ingrowth of connective tissue. The value of photokymography of the larynx in the assessment of therapeutic results after vocal-fold augmentation is discussed. PMID- 3305433 TI - Immunological characterization of chromogranins A and B and secretogranin II in the bovine pancreatic islet. AB - Antisera against chromogranin A and B and secretogranin II were used for analysing the bovine pancreas by immunoblotting and immunohistochemistry. All three antigens were found in extracts of fetal pancreas by one dimensional immunoblotting. A comparison with the soluble proteins of chromaffin granules revealed that in adrenal medulla and in pancreas antigens which migrated identically in electrophoresis were present. In immunohistochemistry, chromogranin A was found in all pancreatic endocrine cell types with the exception of most pancreatic polypeptide-(PP-) producing cells. For chromogranin B, only a faint immunostaining was obtained. For secretogranin II, A- and B-cells were faintly positive, whereas the majority of PP-cells exhibited a strong immunostaining for this antigen. These results establish that chromogranins A and B and secretogranin II are present in the endocrine pancreas, but that they exhibit a distinct cellular localization. PMID- 3305435 TI - [Incidence of maxillary sinusitis in intensive care patients with nasal intubation--ultrasonic diagnosis as a screening test]. AB - Acute maxillary sinusitis due to nasotracheal intubation during intensive care is seldom considered as a cause of fever of unknown origin. Forty six patients admitted to a post-operative intensive care unit had their maxillary sinuses examined using a mobile "A-scan" ultrasonic scanner. Follow-up examinations were performed regularly. As early as the 5th day of treatment 36 out of 46 patients who had undergone nasotracheal intubation showed pathological ultrasonic results. Bilateral involvement was most frequent. In unilateral findings at the first examination, the intubated side was three times as often affected as the other side. Early extubation, early partial mobilisation and/or early administration of antibiotics did not prevent the occurrence of pathological ultrasonic findings. Acute maxillary sinusitis must thus be considered a frequent complication of nasotracheal intubation. PMID- 3305436 TI - Origin of major histocompatibility complex polymorphism: the trans-species hypothesis. PMID- 3305438 TI - Neuropharmacological strategies for understanding psychobiological determinants of cognition. AB - Psychopharmacological methods that have proven useful in exploring brain processes can be helpful in describing the psychobiological determinants of distinct cognitive processes. The methods and theory in current cognitive science can be exploited by neuropharmacologists interested not only in describing brain function but in building a viable picture of brain-behavior (cognitive) relationships. This paper provides a sketch of our knowledge about the neuropharmacology of cognitive processes. It also cites some questions, problems and approaches for further research efforts that would help us describe the psychobiology of cognition. PMID- 3305437 TI - Two alloantigens on human monocytes: a diallelic system? AB - A positive monocyte crossmatch and therefore anti-monocyte antibodies are negative factors in bone marrow and renal transplantation. When the monocyte antigens themselves can be recognized, matching for the antigens involved here may become a possibility. In order to find useful anti-monocyte sera as typing reagents, human sera were screened against panel cells. Several monocyte specific sera were obtained. These sera recognized two monocyte antigens, HMA-1 and HMA-2. No similarity with any of the HLA antigens was observed. Every individual tested was positive for at least one of these two monocyte antigens, suggesting that HMA 1 and HMA-2 constitute a diallelic system. PMID- 3305439 TI - Cognitive evoked potentials as modulatory processes in human memory formation and retrieval. AB - The complex experiential nature of human cognitive memories implies that their formation and retrieval result from neural activity that is widespread and patterned. This integration of widespread activity into coherently patterned gestalts is accompanied by event related brain potentials (ERPs). ERP component N4, reflecting associative activation, declines as words or faces become more familiar. ERP component P3, reflecting cognitive closure, generally grows larger with familiarity. Similar changes in the N4/P3 are seen to familiarity in remote semantic memory. The N4/P3 may be generated directly by the multitude of specific neuronal interactions that constitute associative activation and contextual closure. Alternatively, the N4/P3 may be generated by diffuse modulatory pathways exerting non-specific control over these same interactions. In any case, the N4 and P3 appear to be generated simultaneously in several neocortical and subcortical structures, including the medial temporal lobe (MTL), where lesions are known to produce a profound deficit in learning new cognitive material. The MTL in the dominant hemisphere is necessary for the extratemporal N4/P3 generators to alter their response to words that are familiar in context. The mechanism whereby the MTL controls cortical activation is unknown. However, some hippocampal neurons are activated by particular words, suggesting that the MTL contributes specific information to the cortex during memory retrieval. These properties of the N4/P3 bear a close similarity to modulatory processes which have been found to aid formal associative networks in creating patterns that best represent current input in light of past experience. These modulatory processes consist of an initial generalized activation that encourages partially specified widespread elements to emerge as a network, followed by inhibition that focuses the emerging pattern into a coherent gestalt. PMID- 3305440 TI - Focal and diffuse memory activation assessed by localized indicators of CNS metabolism: the semantic-episodic memory distinction. AB - Methods for in-vivo measurement in humans of local brain activation are reviewed, to assess their potential contribution to the understanding of the brain organization of memory. Methodologically, it is argued that the instructive studies are those: (a) using fully normal subjects; (b) using sufficient sample sizes to account statistically for individual differences; and (c) using properly designed control tasks to isolate relevant independent variables that determine the brain response. The review of emerging data concentrates on the regional cerebral blood flow literature and proposes certain hypotheses for further test, based on extant findings. These include: (a) that hyperfrontality of cortical activation signals the type of processing that converts material from episodic to semantic memory; (b) that semantic remembering itself is likely to engage focal association areas relevant to the particular task (e.g. Wernicke's area in language tasks); but (c) that episodic remembering, even when task components such as language are controlled, will engender a less focal but more diffuse activation pattern than would a control semantic remembering task. PMID- 3305441 TI - Multiple memory systems and consciousness. AB - This Introduction to the Special Issue on Human Memory discusses some of the recent and current developments in the study of human memory from the neuropsychological perspective. A problem of considerable current interest, that of multiple memory systems, is a problem in classification. Much of the evidence for it is derived from clinical and experimental observations of dissociations between performances in memory tasks. The distinction between short-term and long term memory is considered as an example of classification by dissociation. Current conceptualizations of multiple long-term memory systems are reviewed from the vantage point that distinguishes among three major kinds of memory--episodic, semantic, and procedural. These systems are briefly described and compared, and current views concerning the relation between them are discussed. The role of consciousness in memory is raised against the backdrop of the suggestion that it may be necessary to differentiate among several kinds of consciousness. PMID- 3305442 TI - Treatment of patients with "minimal" stage IIIA Hodgkin's disease. AB - Treatment recommendations for patients with upper abdominal Stage IIIA Hodgkin's (III1A) disease have varied widely. The current study reports on a combined institutional retrospective review of 85 patients with surgically staged III1A Hodgkin's disease. Twenty-two patients received combined modality therapy (CMT), 36 patients were treated initially with total nodal irradiation (TNI), and 27 with mantle and para-aortic radiotherapy (MPA). Patients treated with CMT had an actuarial 8-year freedom from relapse (FFR) of 96% as compared to a FFR of 51% in TNI treated patients (p = 0.002), and a FFR of 54% in MPA treated patients (p = 0.004). Of the 11 relapses in MPA treated patients, 7 had a component of their failure in the untreated pelvic or inguinal nodes. The patients treated with CMT had an 8-year actuarial survival of 100% as compared to 79% in TNI treated patients (p = 0.055) and 78% in patients treated with MPA (p = 0.025). Histology and the number of splenic nodules were the most important prognostic variables. Patients with MC/LD histology and greater than or equal to 5 splenic nodules have a high risk of relapse (10/13) when treated with radiation alone (TNI or MPA). We recommend CMT for this group of patients. Patients with NS/LP histology and 1-4 splenic nodules represent a favorable subset of Stage III1A patients. Only 4/21 patients have relapsed and all 21 patients are currently alive without disease regardless of treatment. We currently feel that patients with Stage III1A Hodgkin's disease with NS/LP histology and splenic disease limited to 1-4 nodules are good candidates for MPA as an alternative to TNI or CMT. PMID- 3305444 TI - Lung damage following bone marrow transplantation: II. The contribution of cyclophosphamide. AB - The effect of high-dose cyclophosphamide (Cy), either alone or in combination with irradiation, upon the development of interstitial pneumonitis (IP) after bone marrow transplantation (BMT) was investigated in a Brown Norway rat model. The parameters that were examined included ventilation rate, mortality, and histopathology. No damage to the lungs was observed in rats given Cy alone in supralethal dosages plus BMT, and mortality resulted from severe aplasia of hemopoietic and lymphoid tissues with multifocal hemorrhages, secondary infections, and sepsis. Two separate periods of mortality were observed within the first 180 days following whole thorax irradiation with a high dose rate (HDR; 0.8 Gy/min) or a low dose rate (LDR; 0.05 Gy/min). The addition of Cy prior to irradiation resulted in an increased mortality in the first period (before day 100) in all experimental groups. The influence of Cy on mortality at 180 days however, was different for the HDR and LDR experiments. The LD50-180 after HDR irradiation, dose range 8 to 18 Gy, was not significantly altered by the addition of Cy (100 mg/kg) 1 day prior to irradiation, whereas Cy (100 mg/kg) 1 day prior to LDR irradiation, dose range: 16 to 24 Gy, caused an enhancement of radiation damage with a decrease of the LD50-180 by 1.33 Gy. The dose modification factor (DMF) was 1.07. This enhancement was no longer significant after splitting up the dose of Cy in two dosages of 50 mg/kg given on 2 consecutive days prior to irradiation with a LDR. The extrapolation of the data in this rat model to available dose-response curves on IP after BMT and radiation pneumonitis in humans, implied that non-infectious IP is a radiation pneumonitis that is only slightly enhanced by Cy. PMID- 3305443 TI - Central nervous system (CNS) prophylaxis in children with low risk acute lymphoblastic leukemia (ALL). AB - Five hundred four children with low risk acute lymphocytic leukemia (previously untreated, age 3 to 6 years with white blood counts less than 10,000/mm3 at diagnosis) were randomized into two different central nervous system prophylaxis regimens. One regimen (250 patients) consisted of cranial radiation and intrathecal methotrexate (IT MTX). The second regimen (254 patients) consisted of IT MTX only. Median follow-up time for surviving patients is currently 54 months from randomization. Life table analysis of central nervous relapse, marrow relapse, disease-free survival, and survival shows very similar outcome for both treatment groups. The results indicate that maintenance IT MTX as described in this report can be substituted for cranial radiation in children with low risk ALL. PMID- 3305446 TI - Fractionation: a paradigm for clinical research in radiation oncology. PMID- 3305445 TI - Therapeutic and diagnostic uses of modified monoclonal antibodies. PMID- 3305447 TI - The role of proto-oncogenes in human cancer: implications for diagnosis and treatment. AB - Proto-oncogenes are normal genes which affect normal cell growth and proliferation, but which have the potential to contribute to cancer development if their expression is altered. A variety of events may activate proto-oncogenes and convert them from benign genes to cancer genes. These events include mutations of nucleic acid sequences, chromosomal rearrangements, and amplification of the number of genes. The observations that alterations in specific gene sequences frequently accompany neoplasia have provided the first insights into the pathogenesis of human cancer at the molecular level. These insights offer new opportunities for developing cancer diagnostics and therapeutics. PMID- 3305448 TI - Evaluation of mouse lip mucosa reactions after combinations of cis-diammine-1,1 cyclobutanedicarboxylate platinum (II) (CBDCA) and irradiation: single and fractionated treatments. AB - The influence of CBDCA (JM8) on the radiation-induced mouse lip mucosal reactions has been tested. Both single and fractionated drug doses were used intraperitoneally at 60 mg/kg and 5 X 25 mg/kg respectively. A single injection of CBDCA did not alter the response to a single radiation dose, whether the drug was given at different time intervals from 24 hr prior, to 96 hr after irradiation. A concomitant treatment of daily CBDCA injections and irradiations for 5 consecutive days demonstrated no change of the capacity to repair sublethal radiation damage. When two equal sized radiation doses were separated by 10 days and CBDCA was administered daily from day 3 to 7, the ability to repopulate the lip mucosa epithelium during the radiation-free period was not influenced. PMID- 3305449 TI - Postgraduate training in radiation oncology in the United States, 1986. AB - The thirteenth survey of training in Radiation Oncology in the United States, conducted in the first half of 1986, revealed a reduction in the number of approved programs, but little change in the number of positions offered. For the first time, every program had trainees, and every available training position was filled. The proportion of foreign exchange students in training fell from 52% 20 years ago, to 12% a decade later, to less than 1% at present. The proportion of foreign medical graduates fell from 29% in 1984 to 18% at present. The proportion of women in residency remained unchanged from 1982 and 1984. Approximately 150 physicians can be expected to complete training and enter the practice of radiation oncology each year for at least the next 4 years. PMID- 3305450 TI - Does radiotherapy have a role in hemangiopericytoma management? Report of 14 new cases and a review of the literature. AB - From 1948 to 1984, 14 adult patients received radiation therapy as a part of their treatment for hemangiopericytoma at the University of Texas M.D. Anderson Hospital and Tumor Institute at Houston. In addition to radiation therapy 11 patients were treated with surgery, with or without chemotherapy--5 as primary management and 6 after recurrence following surgical excision. Although 9 of these 11 patients had macroscopic and 1 had definite microscopic disease at the time of irradiation, none suffered local recurrence and 9 have survived from 3.5 years to 20 years free of disease. Two of the 11 patients died of distant metastases. Two patients completed treatment for palliation and 1 of them survived for 2 years after treatment. The results suggest that postoperative radiation therapy should be considered as an integral part of the primary treatment of hemangiopericytoma. PMID- 3305452 TI - Deoxyspergualin, a potent antitumor agent: further studies on the cytobiological mode of action. AB - Under otherwise identical conditions, deoxyspergualin preferentially inhibits the growth of the T-cell leukemia line L5178y; an effective dose for a 50% inhibition (ED50) of 0.0007 microM was determined. A much weaker cytostatic activity was found for murine lymphocytes (ED50: approximately 25 microM) and for CV-1 monkey kidney cells (ED50: 16.3 microM). Deoxyspergualin causes biphasic and differential effects on DNA metabolism of murine T and B lymphocytes. At lower concentrations (0.3 approximately 5 microM) the [3H]TdR incorporation into nonactivated or lipopolysaccharide-activated lymphocytes is significantly stimulated by the compounds; this effect was not observed with lymphocyte cultures stimulated with concanavalin A. This change of TdR incorporation rates was found to parallel with the variations of DNA polymerase alpha activity. Deoxyspergualin causes an additive effect together with bleomycin and a significant synergistic cytostatic effect in combination with avarol and avarone. Moreover, it is reported that deoxyspergualin causes neither a selective inhibitory effect on DNA-, RNA- or protein synthesis nor an alteration of the intracellular distribution pattern of the Ro and La antigens. However, detailed enzymic studies revealed that deoxyspergualin reduces DNA polymerase alpha but not beta activity in lymphocytes at the ED50 concentration of this compound. These results support previous documentations that deoxyspergualin is of potential clinical usefulness (a) in treatment of certain tumors and (b) in organ transplantation. PMID- 3305451 TI - Comparison between proteinases of human seminal plasma and of sperm origin. AB - A comparison of the alkaline proteinase activity of human seminal plasma, the seminal non-gamete cellular material and spermatozoa was made by gelatin-sodium dodecyl sulfate-polyacrylamide gel electrophoresis (gelatin-SDS-PAGE) zymography. Several major (molecular weights = greater than 56,000) and minor (35,000 to 44,000) bands of proteinase activity were seen in the seminal plasma samples from nonvasectomized and vasectomized, healthy donors. Similar activity profiles were observed in the nongamete cellular material of vasectomized donor ejaculates. The major proteinase activity in sperm extracts was in the 47,000 to 55,000 (proacrosin-acrosin) and 34,000 to 37,000 (sperminogen-spermin) molecular weight ranges. These results suggest that the proacrosin-acrosin and sperminogen-spermin systems are of sperm origin and that there are considerable amounts of larger molecular weight trypsin-like enzymes in the soluble and nongamete cellular material of human seminal plasma. PMID- 3305453 TI - Bacterial DNA reactivity of the novel antitumor antibiotics PD 114,759 and PD 115,028 (veractamycins A and B). AB - The novel antitumor antibiotics PD 114,759 and PD 115,028 were evaluated for their ability to cause repairable DNA damage and the induction of SOS functions in bacterial systems. PD 114,759 and PD 115,028 were preferentially toxic to DNA repair-defective Escherichia coli WP100 uvrA recA in comparison to wild-type E. coli WP2 at concentrations of 10 approximately 30 micrograms/ml in agar diffusion assays. Both compounds were inducers of cell filamentation and prophage lambda (two E. coli SOS functions) at concentrations of 0.1 approximately 1 microgram/ml. In addition, the ability of PD 114,759 and PD 115,028 to retain their filamentation-inducing effects under both aerobic conditions and anaerobic conditions suggests that a bioreductive, rather than an oxygen-requiring, mechanism is involved in the DNA-reactive effects of these agents. PMID- 3305454 TI - Fumifungin, a new antifungal antibiotic from Aspergillus fumigatus Fresenius 1863. PMID- 3305455 TI - Blastogenic responses and the release of interleukins 1 and 2 by spleen cells obtained from rat skin allograft recipients administered with 15-deoxyspergualin. PMID- 3305456 TI - Cochlear damage following interrupted exposure to high-frequency noise. AB - Four groups of chinchillas were exposed to an octave band of noise with a center frequency of 4 kHz and a sound pressure level of 80 or 86 dB SPL on interrupted schedules with 18, 42 or 162 h of rest between successive 6-h exposures. Damage in these ears was compared to that in ears receiving continuous exposures which were equal in total energy. The same pattern of cell loss was found in ears damaged by continuous and interrupted exposures. However, both the incidence and average size of the lesion in the basal turn were reduced in all ears receiving interrupted exposures. Eighteen hours of rest between successive 6-h, high frequency noise exposures was found to provide significant protection from damage for the basal turn of the chinchilla cochlea. PMID- 3305458 TI - The effect of sodium chloride and temperature on the rate and extent of growth of Clostridium botulinum type A in pasteurized pork slurry. AB - A selective medium was used to enumerate Clostridium botulinum growing in the presence of natural spoilage organisms in a model cured pork slurry. The growth responses of a mixed spore inoculum of six strains of Cl. botulinum type A were studied at 15 degrees, 20 degrees and 27 degrees C with 1.5, 2.5, 3.5 or 4.5% (w/v) salt added (aw range 0.961-0.990). Gompertz and logistic curves, which have a sigmoid shape, were fitted to the data and lag times, growth rates, generation times and time to maximum growth rates were derived. Variation in germination rates of the spores occasionally gave a falsely extended lag time resulting in an exceptionally high estimate for growth rate. Products containing 4.5% (w/v) NaCl would be capable of supporting growth of proteolytic strains of Cl. botulinum, even at 15 degrees C, although the lag period would be extended. In products where absence of Cl. botulinum cannot be assured additional preservative measures are essential. The information obtained provides a framework to investigate the effects of a wider range of additives or variables on the growth responses of Cl. botulinum. PMID- 3305457 TI - Gonadotropin releasing hormone-induced secretion of luteinizing hormone during the milk-ejection reflex in the postpartum beef cow. AB - A study was conducted to determine the effect of the milk-ejection reflex on exogenous gonadotropin releasing hormone (GnRH)-induced release of luteinizing hormone (LH) after short-term calf removal. Twenty-four postpartum multiparous beef cows were assigned randomly to groups arranged in a 2(3) factorial arrangement. Factors consisted of two levels of suckling [suckled (S) or nonsuckled (NS)], treatment with GnRH [saline (C) or 200 micrograms GnRH] and days postpartum (d 1 and 14). Dams were isolated from their calves for 4 h on d 1 and 14 postpartum. At the end of 4 h dams were reunited with their calves in S + C and S + GnRH groups, while dams of calves in NS + C and NS + GnRH groups remained separated an additional 2 h. Cows were injected iv with saline or GnRH following the 4-h isolation period, 5 min after calves had begun suckling or nuzzling the udder. Sera from jugular blood samples collected 15 min prior to the end of the 4-h isolation period, immediately prior to injection (0 h) and at 15 min intervals thereafter for 120 min were analyzed for LH. Serum concentrations of LH in control cows did not differ due to suckling or stage of the postpartum period and averaged 2.3 +/- .1 ng/ml. Pituitary response to GnRH was determined by computing the rate of LH release. Rate of LH release (ng LH.ml-1.min-1) in response to GnRH on d 14 was greater (P less than .001) than on d 1 in both suckled and nonsuckled groups (S + GnRH, 37.1 +/- 3.9 vs 18.3 +/- 5.0; NS + GnRH, 34.7 +/- 5.9 vs 14.5 +/- 1.1). However, GnRH-induced release of LH did not differ between suckled and nonsuckled cows on either d 1 or 14 postpartum. These data indicate that response of the bovine pituitary to GnRH during the postpartum period is not influenced by the act of suckling but is enhanced with time after parturition. PMID- 3305459 TI - Surface properties of lactobacilli isolated from the small intestine of pigs. AB - One hundred wild-type strains of the genus Lactobacillus were isolated from the small intestine of newly-slaughtered pigs up to 6 months of age. Cell surface hydrophobicity and capsule formation were studied on a number of strains. Strains showing high surface hydrophobicity as measured by the salt-aggregation test and hydrophobic interaction chromatography on Octyl Sepharose were commonly found to adhere in high numbers to isolated pig intestinal epithelial cells. Heat and protease treatment of bacteria of high surface hydrophobicity, including autoaggregating strains in phosphate-buffered saline, showed a drastic decline in this surface property. Three hydrophilic strains (LBp 1044, 1068 and 1073) also showed binding to intestinal cells but at a lower level (approx. 5 bacteria/cell) as compared with the best binding hydrophobic strain (LBp 1063, approx. 11 bacteria/cell). These findings suggest that different or multiple adhesion mechanisms may be involved in the colonization of the small intestinal mucosa of pigs. Cultures of selected strains grown in liquid media rich in carbohydrates did not affect their hydrophobic cell surface character. Therefore it seems less likely that carbohydrate capsule polymers are the major determinants of intestinal colonization of lactobacilli in pigs. PMID- 3305460 TI - Treatment of septicaemia in immunocompromised patients with ceftazidime or with tobramycin and cefuroxime, with special reference to renal effects. AB - Fifty-two immunocompromised patients with suspected septicaemia were randomized on 61 occasions to treatment with ceftazidime or with tobramycin and cefuroxime. Most (90%) of the patients had haematological malignancies and were neutropenic (granulocytes less than 1 X 10(9)/1 in 40 of the 61 episodes). Blood cultures were positive in 22 (39%) febrile episodes and in four other instances positive cultures were obtained from other sources. Clinical cure or improvement was noted in 10 of 12 culture verified infections in the tobramycin and cefuroxime group and 11 of 14 episodes in the ceftazidime-group. The effect on the kidney of the two antibiotic regimens was studied by following the serum levels of creatinine, urea and beta 2-microglobulin and the urinary excretion of alanine aminopeptidase, N-acetyl-beta-D-glucosaminidase (beta-NAG) and beta 2 microglobulin. No clinically important renal side effects were observed. However, an increase in the urinary excretion of AAP was seen in both groups with significantly greater elevation in the tobramycin and cefuroxime group. Urinary beta-NAG increased only in the tobramycin and cefuroxime group. PMID- 3305461 TI - Studies on a new formulation of ceftazidime--ceftazidime arginine--in patients with recurrent chest infections. AB - One hundred hospital patients with respiratory infections were treated with 1 or 2 g intramuscular injections of ceftazidime sodium or of a new formulation of ceftazidime with arginine three times daily. Clinical and microbiological assessments showed no significant differences in efficacy between the two preparations. Local pain necessitating lignocaine was noted in five of 49 evaluable patients given ceftazidime sodium (10.2%) but in none of the 50 receiving ceftazidime arginine. No other unwanted effects were recorded. The pharmacokinetic results after the 1 g injections showed slightly higher Cmax values with ceftazidime arginine with correspondingly greater 0-7 h AUC values. The mean AUCs were almost identical after the 2 g injections. PMID- 3305462 TI - Plasmid ecology and the elimination of plasmids by 4-quinolones. PMID- 3305463 TI - Effect of a diazaborine derivative (Sa 84.474) on the virulence of Escherichia coli. AB - The scope of selective inhibition of lipopolysaccharide (LPS) biosynthesis in virulent organisms with a diazaborine derivative (Sa 84.474) as a means to render them avirulent was explored. A serum resistant Escherichia coli 0111:B4 became serum sensitive following its cultivation in vitro in media containing 1.5 mg/l of Sa 84.474, a concentration shown previously to inhibit over 95% of normal LPS biosynthesis in its mutant J5 strain. An encapsulated E. coli 01:K1 was also converted to serum sensitivity. In addition, Sa 84.474-pretreatment increased the efficiency with which the previously resistant organisms were opsonized in normal human serum and subsequently phagocytosed by granulocytes. In vivo, intravenously inoculated, Sa 84.474-pretreated bacteria were rapidly removed from the blood circulation and were significantly (P less than 0.05) less virulent in inducing lethal peritoneal infections in mice (LD50 4.9 +/- 1 X 10(6) cfu) when compared to untreated control bacteria (LD50 2.2 +/- 0.97 X 10(6) cfu). The results suggest that the LPS plays an important role in the virulence of the two bacterial strains and imply that agents acting in a similar manner but with acceptable selective toxicity might be novel drugs for therapy of Gram-negative bacterial infections. PMID- 3305464 TI - A prospective randomized trial of ceftazidime versus cefazolin/tobramycin in the treatment of hospitalized patients with pneumonia. AB - Ceftazidime and cefazolin/tobramycin were compared in the treatment of hospitalized patients with pneumonia. Iv doses 8-hourly were: ceftazidime--2 g, cefazolin--1.5 g, tobramycin--1.7 mg/kg. For patients with pseudomonas infection randomized to cefazolin/tobramycin, ticarcillin (3 g iv 4-hourly) was used instead of cefazolin. One hundred and ten of 129 patients were evaluable (ceftazidime = 52, cefazolin/tobramycin = 58). Seventy five cases (68%) had documented pathogens of which 81% were aerobic Gram-negative bacilli. Analysis of clinical response showed no difference in overall results (P = 0.77), or separate outcomes: cured (P = 0.85), improved (P = 0.62), failed (P = 0.53), or relapsed (P = 0.50). No differences in bacteriological response were noted either: eradication (P greater than 0.10), elimination with recurrence (P greater than 0.10), persistence (P greater than 0.10). The incidence of enterococcal and fungal colonization and superinfection was the same for both regimens. There was a greater incidence of Coombs' test positivity with ceftazidime (P less than 0.01) but greater nephrotoxicity with cefazolin/tobramycin (P less than 0.02). Ceftazidime appears to be as efficacious as cefazolin/tobramycin in the treatment of hospitalized patients with pneumonia, and is less nephrotoxic. PMID- 3305465 TI - Cardiac, respiratory, and renal responses to stimulation of the external cuneate nucleus. AB - The cardiac, respiratory, and renal responses of electrical stimulation and microinjection of excitatory amino acids into the external cuneate nucleus were investigated in 57 cats anesthetized with pentobarbital sodium, paralyzed, and artificially ventilated. Trains of rectangular cathodal pulses of 40-100 microA at 50 Hz and 0.1 ms duration were delivered through monopolar glass microelectrodes with a tip diameter of 10-20 micron, filled with indium-Woods metal alloy. Electrical stimulation at 232 histologically identified sites within the external cuneate nucleus could evoke changes in arterial blood pressure, heart rate, and efferent renal sympathetic nerve activity. In a further set of experiments, a change in respiration was observed at 74 identified sites. An increase or decrease in all parameters measured could be elicited at different stimulus sites within the external cuneate nucleus. Repositioning of the electrode (0.2-0.4 mm) in depth or laterally could result in a different response with stimulation. Microinjections of D,L-homocysteic acid or glutamate could mimic the evoked changes in blood pressure, heart rate, efferent renal sympathetic nerve activity, and respiration. This suggests that the external cuneate nucleus contains cell bodies that may modulate components of various cardiac, respiratory and renal reflexes. It is proposed that the external cuneate nucleus may be involved in the integration of somato-autonomic reflex responses. PMID- 3305466 TI - Plasma renin system during exercise in normal men. AB - The exercise-related increase in plasma renin activity (PRA) and in the plasma concentration of angiotensin II (ANG II) and aldosterone (Aldo) was studied in 43 healthy volunteers whose 24-h urinary sodium excretion (UVNa) ranged from 10 to 250 mmol. Arterial blood samples were obtained at rest and during bicycle ergometry. Compared with rest, PRA, ANG II, and Aldo rose to a similar extent during light and moderate exercise. However, at peak exercise ANG II increased significantly more (P less than 0.001) than PRA and Aldo. Thus, with increasing intensity of exercise, the slope of the linear regression of ANG II on PRA became significantly (P less than 0.001) steeper, whereas at maximal exercise the Aldo response did not follow the acute rise in ANG II. At rest as well as during exercise, Aldo rose with increasing ANG II, but the stimulatory effect of ANG II on Aldo was attenuated with higher sodium intake, as estimated from UVNa. Finally, independent of the level of physical activity, UVNa was negatively correlated with PRA, ANG II, and Aldo. PMID- 3305467 TI - Canine bronchoconstriction, gas trapping, and hypoxia with methacholine. AB - The effects of an intravenous methacholine infusion on cardiovascular-pulmonary function were measured in seven mongrel dogs (22.0 +/- 2.8 kg), anesthetized with chloralose and urethan and beta-adrenergically blocked with propranolol. In a volume-displacement plethysmograph, physiological measurements were made at base line and 25 min after establishing a methacholine infusion (0.1-1.0 mg X kg-1 X h 1). Methacholine significantly (P less than 0.05) increased airways resistance (1.9 +/- 0.8 to 8.2 +/- 2.9 cmH2O X l-1 X s), decreased static lung compliance (84.7 +/- 18.5 to 48.2 +/- 9.4 ml/cmH2O), depressed arterial PO2 (81 +/- 17 to 56 +/- 10 Torr), and lowered blood pressure (132 +/- 10 to 69 +/- 18 Torr) and cardiac output (5.7 +/- 1.9 to 4.1 +/- 1.2 l/min). These effects persisted during a further 80 min of methacholine infusion conducted in five of the animals. During the initial 25-min period of methacholine, the end-expired volume (volume displacement Krogh spirometer) rose in all animals, indicating an increase in functional residual capacity from 997 +/- 115 to 1,623 +/- 259 ml (P less than 0.0005). Analysis of pulmonary pressure-volume curves revealed no change in total lung capacity but an increase in residual volume from 489 +/- 168 to 1,106 +/- 216 ml (P less than 0.001). Thus methacholine caused 617 ml of gas trapping, which was not detected by the Boyle's law principle, presumably because gas was trapped at high transpulmonary pressure. We suggest that intravenous methacholine induced canine bronchoconstriction, which causes gas trapping and hypoxia, may be a useful animal model of clinical status asthmaticus. PMID- 3305468 TI - Progressive elevations in muscle blood flow during prolonged exercise in swine. AB - Distribution of muscle blood flow has not been measured in man during prolonged exercise, but progressive elevations in skin flow coupled with constant cardiac output (QT) have suggested muscle blood flow may be compromised. However, previous experiments with rats demonstrated progressive increases in muscle blood flow over time during prolonged submaximal exercise. The present study was performed to study muscle blood flow in miniature swine during long-term exercise to shed light on this apparent anomaly. QT and distribution of QT were studied with radiolabeled microspheres while pigs ran on a level treadmill at a speed (10.5 km/h) requiring 71 +/- 4% of maximal O2 consumption (VO2 max). QT increased 23% from the 5th to the 30th min of exercise, whereas total skeletal muscle flow increased by 49%. Increases in flow in the muscles resulted from decreased resistance, since mean arterial pressure declined over this time period (-7%). In addition, the proportional increases in muscle flow were similar within synergistic muscle groups independent of fiber type composition (e.g., elbow extensors: 59-78%; elbow flexors: 26-40%). The factor that limited continued exercise appeared to be body temperature. Colonic temperature rose in linear fashion over time; the animals became exhausted at approximately 42 degrees C. These flow data are similar to previous findings in rats and indicate that during prolonged treadmill locomotion in quadrupedal animals muscle blood flow increases over time to near maximal levels. PMID- 3305469 TI - Alexander M. Kellas and the physiological challenge of Mt. Everest. AB - Alexander M. Kellas (1868-1921) was a British physiologist who made pioneering contributions to the exploration of Everest and to the early physiology of extreme altitudes, but his physiological contributions have been almost completely overlooked. Although he had a full-time faculty position at the Middlesex Hospital Medical School in London, he was able to make eight expeditions to the Himalayas in the first two decades of the century, and by 1919 when the first official expedition to Everest was being planned, he probably knew more about the approaches than anybody else. But his most interesting contributions were made in an unpublished manuscript written in 1920 and entitled "A consideration of the possibility of ascending Mount Everest." In this he discussed the physiology of acclimatization and most of the important variables including the summit altitude and barometric pressure, and the alveolar PO2, arterial oxygen saturation, maximal oxygen consumption, and maximal ascent rate near the summit. On the basis of this extensive analysis, he concluded that "Mount Everest could be ascended by a man of excellent physical and mental constitution in first-rate training, without adventitious aids [supplementary oxygen] if the physical difficulties of the mountain are not too great." Kellas was one of the first physiologists to study extreme altitude, and he deserves to be better known. PMID- 3305470 TI - Growth of mouse vaginal epithelial cells in culture: effect of sera and supplemented serum-free media. AB - Normal mouse vaginal epithelial cells isolated from ovariectomized ca. 35-d-old BALB/cCrgl mice were grown in primary culture using collagen gel matrix and a serum-free medium composed of a 1:1 mixture of Dulbecco's modified Eagle's medium and Ham's F12 (D:H) medium supplemented with insulin (IN), epidermal growth factor (EGF), cholera toxin, transferrin, and bovine serum albumin V (BSA). Three dimensional cellular outgrowths occurred inside the collagen gel matrix. The contribution of each factor to cell growth was examined by individual addition to the basic D:H medium and by individual deletion from the complete serum-free medium. When added individually, only IN promoted growth. Deletion of IN from the complete serum-free medium markedly diminished growth; deletion of EGF or BSA slightly diminished growth. When horse, fetal bovine, or chicken serum was added to the basal D:H medium, only with increasing doses of horse serum was there enhanced cell growth. The effect of 17 beta-estradiol and diethylstilbestrol on the growth of cells was also tested, using a suboptimal medium of D:H supplemented with BSA and IN, or a minimal medium supplemented with IN alone. During the 8-d time period, addition of estrogen did not enhance cell growth in either medium. To date, we have been unable to demonstrate a mitogenic effect of estrogen; rather a dose-dependent inhibition of proliferation is seen. PMID- 3305472 TI - Heart rate variability power spectrogram as a potential noninvasive signature of cardiac regulatory system response, mechanisms, and disorders. AB - This paper attempts to provide evidence that the heart rate variability power spectrum (HRVPS) reflects the presence of neural control of cardiac regulation. A normal individual is seen to have a characteristic HRVPS (comprising a 0.1-Hz peak and a respiratory peak at 0.25-0.34 Hz), which is altered in a predictable manner in response to orthostatic stress and exercise, while in two patients with autonomic neuropathy, the HRVPS failed to demonstrate such a characteristic alteration in response to orthostatic stress. Postinfarct HRVPS signatures were studied in two patients with anterior and inferior infarcts so as to lend insight using non-invasive means into both the healing process and the dominant deliterious sympathetic or protective vagal tone due to the infarct. When subjects with transplanted hearts were studied, their HRVPS did not exhibit the characteristic pattern of a normal individual; rather, the HRVPS energy was spread over a wider and higher frequency range. However, one of the transplanted patients surprisingly but consistently revealed the characteristic HRVPS; the post-transplant time at the time of the study was 33 months and the patient had the typically high resting heart rate of a transplant recipient but a wide standard deviation like that of a normal individual. This could be the first noninvasively demonstrated evidence in humans of reinnervation of a transplanted heart. Thus, the HRVPS constitutes a simple non-invasive method to assess cardiac neuroregulatory response and disorders and it is proposed that it be referred to as the heart rate variability cardiogram (HRVC). PMID- 3305471 TI - Effects of acute pressure overload on prostacyclin release and myocardial blood flow in canine hearts: inhibition of prostacyclin synthesis with 15-hydroperoxy eicosatetraenoic acid. AB - This study was undertaken to evaluate the effects of acute pressure overload on prostacyclin (PGI2) release and the influences of 15-hydroperoxy-eicosatetraenoic acid (15-HPETE), an inhibitor of PGI2 synthetase, and indomethacin, an inhibitor of cyclo-oxygenase, in canine hearts. Gradual stenosis of the ascending aorta was performed in 24 anesthetized open-chest dogs. The mongrel dogs were divided into three groups, which received indomethacin, 15-HPETE, and no drug. Changes in the hemodynamics, regional myocardial blood flow (MBF) by the method of H2 gas clearance, and plasma immunoreactive 6-keto-prostaglandin (PG) F1 alpha level in the descending aorta (AO) and great cardiac vein (GCV) were measured. Five minutes after aortic stenosis, the plasma immunoreactive 6-keto-PGF1 alpha level in the GCV and MBF increased from 162 +/- 23 to 289 +/- 37 pg/ml and from 87 +/- 5 to 107 +/- 8 ml/min/100 g, respectively, and the calculated coronary vascular resistance (CVR) decreased significantly from 0.93 +/- 0.08 to 0.77 +/- 0.08 mmHg/ml/min/100 g. These significant changes persisted thereafter. Continuous infusion of 15-HPETE (66 pg/kg/min) into the coronary artery simultaneously prevented significant changes in MBF and the plasma immunoreactive 6-keto-PGF1 alpha level in the GCV and CVR. Intravenous infusion of indomethacin (5 mg/kg), on the other hand, induced a significant decrease in the plasma immunoreactive 6 keto-PGF1 alpha level in both the GCV and AO; significant changes in MBF 5 to 15 min after aortic stenosis and CVR were not affected. From these results, it is suggested that PGI2 plays an important role in the regulation of coronary blood flow in canine hearts with acute pressure overload.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305473 TI - Recommendations for establishment of reference standards for recombinant-DNA derived proteins and polypeptides. AB - An integrated approach is presented for the establishment of purified protein and peptide reference standard materials suitable for both biological and chemical assays. Preliminary considerations, handling and storage conditions, and a variety of chemical methods for defining the reference standards are examined in detail. Of the chemical methods, liquid chromatography (LC), amino acid analysis, Kjeldahl protein assay, electrophoresis, and ion chromatography are key assays in determining the potency, purity, and identity of the reference standard preparation. Finally, the role of liquid chromatography in assessing reference standards for identity and chemical purity is examined and correlated with other methods. PMID- 3305474 TI - Standardization of bacterial numbers of penicylinders used in disinfectant testing: interlaboratory study. AB - An interlaboratory study was conducted to evaluate a method of standardizing bacterial numbers on penicylinders used in the AOAC use-dilution method (4.007 4.015) of disinfectant testing. Eight participating laboratories followed a broth adjustment method using their media and stock cultures of Staphylococcus aureus ATCC 6538, Salmonella choleraesuis ATCC 10708, and Pseudomonas aeruginosa ATCC 15442. The culture broths that were used to inoculate the penicylinders were incubated for 48 h at 37 degrees C after several (4-6) 24 h passages. McFarland turbidity standards of 1.0 and 0.5 were used to adjust visually the cultures of S. aureus and P. aeruginosa, respectively. S. choleraesuis was used undiluted. The results showed significant variability in numbers of test bacteria which adhered to the penicylinders, with mean values of 1.6 X 10(6) for S. choleraesuis, 3.5 X 10(6) for S. aureus, and 8.2 X 10(6) for P. aeruginosa. The results from collaborating laboratories attempting standardization of bacterial numbers on penicylinders demonstrated significant interlaboratory and cylinder variation for all 3 test organisms. PMID- 3305475 TI - Purification and in vitro complementation of mutant histidinol dehydrogenases. AB - The biochemistry of interallelic complementation within the Salmonella typhimurium hisD gene was investigated by in vitro protein complementation of mutant histidinol dehydrogenases (EC 1.1.1.23). Double-mutant strains were constructed containing the hisO1242 (constitutive overproducer) attenuator mutation and selected hisDa or hisDb mutations. Extracts from such hisDa986 and hisDb1799 mutant cells failed to show histidinol dehydrogenase activity but complemented to produce active enzyme. Inactive mutant histidinol dehydrogenases were purified from each of the two mutants by ion-exchange chromatography. Complementation by the purified mutant proteins required the presence of 2 mercaptoethanol and MnCl2, and protein-protein titrations indicated that heterodimers were strongly preferred in mixtures of the complementary mutant enzymes. Neither mutant protein showed negative complementation with wild-type enzyme. The Vmax for hybrid histidinol dehydrogenase was 11% of that for native enzyme, with only minor changes in Km values for substrate or coenzyme. Both purified mutant proteins failed to catalyze NAD-NADH exchange reactions reflective of the first catalytic step of the two-step reaction. The inactive enzymes bound 54Mn2+ weakly or not at all in the presence of 2-mercaptoethanol, in contrast to wild-type enzyme which bound 54Mn2+ to 0.6 sites per monomer under the same conditions. The mutant proteins, like wild-type histidinol dehydrogenase, behaved as dimers on analytical gel filtration chromatography, but dissociated to form monomers in the presence of 2-mercaptoethanol. This effect of 2-mercaptoethanol was prevented by low levels of MnCl2. It thus appears that mutant histidinol dehydrogenase molecules bind metal ion poorly. The complementation procedure may allow for formation of a functional Mn2+-binding site, perhaps at the subunit interface. PMID- 3305476 TI - Membrane-murein attachment at the leading edge of the division septum: a second membrane-murein structure associated with morphogenesis of the gram-negative bacterial division septum. AB - Electron microscopy of plasmolyzed cells of Salmonella typhimurium revealed a continuous zone of membrane-murein attachment at the leading edge of the division septum at all stages of septal invagination. The membrane-murein attachment site had a characteristic ultrastructural appearance and remained as a bacterial birth scar at the new pole of each of the two daughter cells after cell separation. The continuous zone of membrane-murein attachment at the leading septal edge represents the second organelle based on a topologically ordered domain of membrane-murein adhesion to be described at the site of cell division. PMID- 3305477 TI - Characterization of 2,3-dihydroxybenzoic acid from Nocardia asteroides GUH-2. AB - Culture filtrates of virulent Nocardia asteroides GUH-2 after growth in acetate minimal medium displayed an absorbance maximum at 320 nm. After isolation by polyamide extraction and anion chromatography, a UV-active compound with this absorbance was shown to be 2,3-dihydroxybenzoic acid (DHB) by nuclear magnetic resonance, gas chromatographic, and mass spectrometric techniques. DHB production under several culture conditions was quantified by a standard high-pressure liquid chromatography assay. Under iron deficiency conditions, N. asteroides GUH 2 excreted up to 11 mg of DHB per liter into the culture medium. No DHB was detected when N. asteroides GUH-2 was grown in an iron-rich medium. With the less virulent strain N. asteroides 10905, DHB was not found under any condition tested. PMID- 3305478 TI - Identification of the structural gene for dipeptidyl aminopeptidase yscV (DAP2) of Saccharomyces cerevisiae. AB - Mutants of Saccharomyces cerevisiae lacking dipeptidyl aminopeptidase yscV were isolated from a strain already defective in dipeptidyl aminopeptidase yscIV, an enzyme with overlapping substrate specificity. The mutants were identified by a staining technique with the chromogenic substrate Ala-Pro-4-methoxy-beta naphthylamide to screen colonies for the absence of the enzyme. One of the mutants had a thermolabile activity, indicating that it contained a structural gene mutation. The 53 mutants analyzed fell into one complementation group that corresponded to the yscV structural gene, DAP2. The defect segregated 2:2 in meiotic tetrads, indicating a single chromosomal gene mutation, which was shown to be recessive. Diploids heterozygous for DAP2 displayed gene dosage effects with respect to yscV enzyme activity. The absence of dipeptidyl aminopeptidase yscV or the combined loss of both dipeptidyl aminopeptidases yscIV and yscV did not affect mitotic growth under rich or poor growth conditions. In contrast to the dipeptidyl aminopeptidase yscIV lesion (ste13), which leads to alpha sterility because strains secrete incompletely processed forms of the alpha factor pheromone, the dipeptidyl aminopeptidase yscV lesion did not affect mating, and strains produced fully active alpha-factor pheromone. dap2 mutants did not show any obvious phenotype under a variety of conditions tested. PMID- 3305479 TI - Isolation and properties of extracellular proteinases from Sporothrix schenckii. AB - Sporothrix schenckii, mainly in the yeast form of the organism, produced extracellular proteinases when cultivated in liquid media containing albumin or collagen as a nitrogen source, but did not do so in brain heart infusion medium. Isolation of two extracellular proteinases from albumin-containing medium was performed by chromatography on DEAE-Sepharose CL-6B and Sephacryl S-200. Proteinase I had a molecular weight of 36,500, an optimal pH at 6.0, and a pI at 4.8. Despite its activities in weakly acidic conditions, proteinase I demonstrated chymotrypsinlike characteristics, these being indicated by strong inhibitory activity by phenylmethylsulfonyl fluoride and chymostatin and good kinetic constants for a synthetic chymotrypsin substrate, Suc-Ala-Ala-Pro-Phe MCA. Proteinase II had a molecular weight of 39,000, an optimal pH at 3.5, and a pI at 3.8. Proteinase II showed cathepsin D-like characteristics, these being indicated by strong inhibitory activity by pepstatin, an acidic optimal pH, and good kinetic constants for hemoglobin. These two enzymes hydrolyzed natural substrates such as stratum corneum, type I collagen, and elastin although not type IV collagen. Proteinase production and cell growth in collagen-containing medium and the enzymatic digestion of skin constituents by isolated proteinases suggested that these two proteinases cooperatively enable the organism to invade skin and to obtain peptides from insoluble proteins. PMID- 3305480 TI - Overproduction of Escherichia coli integration host factor, a protein with nonidentical subunits. AB - Integration host factor (IHF) is a small, basic protein that is needed for efficient recombination of bacteriophage lambda, as well as for other host and viral functions. We have constructed strains in which the two subunits of IHF, encoded by the himA and hip genes of Escherichia coli, are expressed under the control of the lambda rho L promoter. Separate overexpression of himA and hip led to the production of unstable and insoluble peptides, respectively. In contrast, the overexpression of both genes conjointly led to the accumulation of large amounts of active IHF. Extracts of such cells provided the starting material for a rapid purification procedure that results in milligram quantities of apparently homogeneous IHF. PMID- 3305481 TI - Suppression of rpoH (htpR) mutations of Escherichia coli: heat shock response in suhA revertants. AB - Temperature-resistant pseudorevertants were isolated from rpoH (htpR) mutants of Escherichia coli K-12 that cannot grow at a high temperature owing to a deficiency in sigma 32 required for the induction of heat shock proteins. Among them was a class of revertants carrying a suppressor mutation, designated suhA, that suppressed all the nonsense and missense rpoH mutations tested. suhA is located at 77 min, about 1 min away from rpoH, on the genetic map. In contrast to the rpoH mutants, the suhA revertants that contained both rpoH (nonsense) and suhA mutations were fully or partially proficient in the induction of heat shock proteins upon exposure to a high temperature. Under these conditions, transcription from two heat shock promoters as determined by operon fusion was transiently activated. In one of the rpoH(Am) suhA revertants studied in detail, an increase in temperature caused the synthesis of significant amounts of sigma 32, accompanied by increased stability and accumulation of rpoH mRNAs. On the other hand, the same mutation (suhA6) only weakly suppressed the rpoH deletion mutant; however, two of the major heat shock genes, dnaK and groE, were apparently induced in the absence of sigma 32. Thus, suhA6 seems to bring about the induction of heat shock genes by at least two mechanisms, one increasing the level of sigma 32 synthesis, and the other activating some transcription factor other than sigma 32. PMID- 3305482 TI - Genetic characterization and regulation of the nadB locus of Salmonella typhimurium. AB - The nadB locus encodes the first enzyme of NAD synthesis. It has been reported that this gene and nadA are regulated by a positive regulatory protein encoded in the nadB region. In pursuing this regulatory mechanism, we constructed a fine structure genetic map of the nadB gene. The region appears to include a single complementation group; no evidence for a positive regulatory element was found. Several mutations causing resistance to the analog 6-aminonicotinamide mapped within the structural gene and probably cause resistance to feedback inhibition. Regulatory mutations for nadB were isolated. These mutants mapped far from nadB near the pnuA gene, which encodes a function required for nicotinamide mononucleotide transport. The regulatory mutations appear to affect a distinct function encoded in the same operon as pnuA. PMID- 3305483 TI - Export of protein in Escherichia coli: a novel mutation in ompC affects expression of other major outer membrane proteins. AB - A mutation within the ompC structural gene of Escherichia coli K-12 which affects expression of outer membrane proteins was characterized. The mutation consisted of a 6-base-pair deletion near the 3' end of the gene which removed the amino acids Val-300 and Gly-301 of the mature coding sequence but otherwise left the reading frame intact. The deletion occurred within a region highly conserved among the porins. No protein product was detected from a single copy of the mutant gene. The mutation caused a trans-dominant decrease in the expression of a wild-type ompC allele. The mutation caused a similar decrease in the amounts of OmpA, OmpF, LamB, and Lc proteins, yet it did not appear to affect the minor outer membrane proteins. It had no significant effect on transcription from either ompF or ompC promoters as measured with lacZ operon fusions. The effects of the mutation on other proteins were completely eliminated when the signal sequence was disrupted so that the mutant protein no longer interacted with the secretion machinery of the cell but instead accumulated as precursor in the cytoplasm. A model is proposed involving the translocation of proteins to the outer membrane and the importance of protein conformation in this process. PMID- 3305484 TI - Tunicamycin inhibition of epispore formation in Saccharomyces cerevisiae. AB - The ascopore wall of Saccharomyces cerevisiae was found to contain more protein, polymeric glucosamine, and beta-glucan than the vegetative cell wall, which was enriched in mannoprotein relative to ascospore walls. Tunicamycin inhibited sporulation, as judged by the absence of refractile ascospores visible by phase contrast microscopy, but cells completed meiosis, as demonstrated by the presence of multinucleate asci. Such spores lacked the dense outer layer characteristic of normal spores. Thus, the tunicamycin effect was similar to that of glucosamine auxotrophy (W. L. Whelan and C. E. Ballou, J. Bacteriol. 124:1545-1557, 1975). PMID- 3305485 TI - Integration host factor and conjugative transfer of the antibiotic resistance plasmid R100. AB - Transfer of plasmid R100-1 was reduced 100-fold in the absence of integration host factor. PMID- 3305486 TI - Different levels of DNA methylation in yeast and mycelial forms of Candida albicans. AB - Isotope dilution gas chromatography-mass spectrometry analysis of genomic DNAs isolated from three Candida albicans isolates showed significant differences in the amounts of 5-methyldeoxycytidine (m5Cyt) in DNA from yeast-form and from mycelial-form cells; the moles percent m5Cyt were 0.11, 0.11, and 0.097 for yeast form DNA and 0.045, 0.053, and 0.047 for mycelial-form DNA for the three isolates Sh8, 9938, and B311, respectively. The lower m5Cyt values for mycelial-form cells suggest that those cells may exhibit significantly greater gene activity than yeast-form cells. PMID- 3305487 TI - Suppression of mutations conferring penicillin tolerance by interference with the stringent control mechanism of Escherichia coli. AB - Mutations in Escherichia coli previously reported (R. E. Harkness and E. E. Ishiguro, J. Bacteriol. 155:15-21, 1983; L. C. Shimmin, D. Vanderwel, R. E. Harkness, B. R. Currie, A. Galloway, and E. E. Ishiguro, J. Gen. Microbiol. 130:1315-1323, 1984) as conferring a temperature-dependent tolerance to lysis induced by inhibitors of peptidoglycan synthesis were suppressed by treatment with inhibitors of the stringent response or by introduction of a relA mutation. The relA+ derivatives of the mutants exhibited a stringent response at the nonpermissive temperature. The consequent inhibition of the autolytic enzyme system (W. Kusser and E. E. Ishiguro, J. Bacteriol. 164:861-865, 1985) was apparently responsible for the lysis-tolerant phenotypes of these mutants. PMID- 3305488 TI - Comparative efficacy of propranolol, chlordiazepoxide, and placebo in the treatment of anxiety: a double-blind trial. AB - The efficacy and safety of propranolol in the treatment of anxiety was compared with those of chlordiazepoxide and placebo in a 3-week, double-blind study of 212 patients. After a 1-week, single-blind placebo-washout period, patients were randomized to receive either propranolol (80, 160, or 320 mg/day), chlordiazepoxide (30, 45, or 75 mg/day), or placebo. Patients were evaluated by three physician-rated scales--Hamilton Rating Scale for Anxiety (HAM-A), Covi Anxiety Scale (CAS), and Clinical Global Impressions scale--and two patient-rated scales--Symptoms Checklist 90 and Profile of Mood States. Patients in all groups demonstrated significant improvement in their level of anxiety at all time points compared with their baseline level. At Week 1 propranolol and chlordiazepoxide patients were significantly better than placebo patients, as measured by the HAM A and CAS. At Week 2 only propranolol was superior to placebo, based on HAM-A and CAS scores. Fifteen patients prematurely terminated because of adverse reactions (4 taking propranolol, 4 taking placebo, and 7 taking chlordiazepoxide). The incidence of side effects was similar for the two active drugs; fatigue, drowsiness, and change in libido were significantly more frequent with chlordiazepoxide and drowsiness and indigestion were more frequent with propranolol compared with placebo. PMID- 3305489 TI - Antidepressant drug therapy for bulimia: current status revisited. PMID- 3305490 TI - Neuropharmacology of the extrapyramidal system. AB - The neuropharmacology and neuroanatomy of the extrapyramidal system are complex; however, in its most reductionistic state, this system is often described as a balance between the actions of dopamine and acetylcholine. In this paper, a thorough investigation of the neuroanatomy and neuropharmacology of the extrapyramidal system is undertaken, and an attempt is made to delineate the roles of other neurotransmitters and neuromodulators that play an important role in its functioning. To demonstrate the therapeutic complexity of extrapyramidal system movement disorders, clinical literature is briefly reviewed to show the relative efficacies of anticholinergic and prodopaminergic antiparkinsonian agents in treating neuroleptic-induced extrapyramidal side effects and to show how drugs that affect alternative neurotransmitter systems have also been used to treat these same side effects. PMID- 3305491 TI - Regulation of the mitochondrial outer membrane channel, VDAC. AB - The channel-forming protein, VDAC, located in the mitochondrial outer membrane, is probably responsible for the high permeability of the outer membrane to small molecules. The ability to regulate this channel in vitro raises the possibility that VDAC may perform a regulatory role in vivo. VDAC exists in multiple, quasi degenerate conformations with different permeability properties. Therefore a modest input of energy can change VDAC's conformation. The ability to use a membrane potential to convert VDAC from a high (open) to a low (closed) conducting form indicates the presence of a sensor in the protein that allows it to respond to the electric field. Titration and modification experiments point to a polyvalent, positively charged sensor. Soluble, polyvalent anions such as dextran sulfate and Konig's polyanion seem to be able to interact with the sensor to induce channel closure. Thus there are multiple ways of applying a force on the sensor so as to induce a conformational change in VDAC. Perhaps cells use one or more of these methods. PMID- 3305492 TI - Acyl-peptide hydrolase from rat liver. Characterization of enzyme reaction. AB - Acyl-peptide hydrolase, which catalyzes the hydrolysis of an N-terminally acetylated peptide to release an N-acetylamino acid, was isolated from rat liver and found to be N-terminally blocked. The kinetics of the hydrolysis of acetyl (Ac)-Ala-Ala, Ac-Ala-Ala-Ala, acetylalanine p-nitroanilide, and acetylalanine beta-naphthylamide were investigated. The Km values were between 1 and 9 mM, and the Vmax values were between 100 and 500 nmol/min/micrograms of enzyme. The enzyme activity toward acetylalanine p-nitroanilide and acetylalanine beta naphthylamide was activated by the presence of Cl- and SCN- at concentrations between 0.1 and 0.5 M. By contrast, the activity toward Ac-Ala-Ala and Ac-Ala-Ala Ala was inhibited by these anions. Among a series of divalent cations, Zn2+ was demonstrated to be the most potent inhibitor. The enzyme was inactivated by the addition of diisopropyl fluorophosphate, diethyl pyrocarbonate. Woodward's Reagent K, and glycine methyl ester/carbodiimide. Titration by diisopropyl fluorophosphate showed 0.7 mol of active serine/mol of enzyme subunit, which was confirmed by the incorporation of [3H]diisopropyl fluorophosphate into the enzyme. Acetylalanine chloromethyl ketone inactivated the enzyme following pseudo first order kinetics; and Ac-Ala, a competitive inhibitor, protected the enzyme from this inactivation. Acyl-peptide hydrolase appears to be a serine protease utilizing a charge relay system involving serine, histidine, and, probably, a carboxyl group(s). Two series of acetyl dipeptides, acetylamino acid p nitroanilides and acetylamino acid beta-naphthylamides, were prepared in order to determine enzyme specificity. The enzyme preferentially removed Ac-Ala, Ac-Met, and Ac-Ser, the most common acetylated N-terminal residues (Persson, B., Flinta, C., von Heijne, G., and Jornvall, H. (1985) Eur. J. Biochem. 152, 523-527). The enzyme was shown to be useful for deblocking peptides (e.g. alpha-melanocyte stimulating hormone and acetyl-renin substrate), and the crude enzyme/substrate mixtures were amenable to direct protein sequence analysis. PMID- 3305493 TI - Isoproterenol and insulin control the cellular localization of ATP citrate-lyase through its phosphorylation in adipocytes. AB - The enzyme ATP citrate-lyase of the fatty acid synthesis pathway is phosphorylated in vitro and in isolated cells. However, no effect of phosphorylation on the enzyme activity has been detected. It is demonstrated that the beta-adrenergic agonist isoproterenol or insulin both promote an immobilization of ATP citrate-lyase, detected in digitonin-permeabilized adipocytes. This effect was reproduced by the cyclic AMP analog cyclic 8-bromo AMP. The beta-adrenergic antagonist propranolol blocked, but failed to reverse, the isoproterenol-directed effect. Propranolol also failed to reverse the isoproterenol-induced increased phosphorylation of ATP citrate-lyase specifically. In response to increasing concentrations of isoproterenol, an increased extent of phosphorylation of ATP citrate-lyase was paralleled by an increased immobilization of the enzyme. It is suggested that the state of phosphorylation of ATP citrate-lyase in adipocytes controls the localization in the cell. PMID- 3305494 TI - Mitogen-activated S6 kinase is stimulated via protein kinase C-dependent and independent pathways in Swiss 3T3 cells. AB - Soluble extracts prepared from quiescent Swiss mouse 3T3 cells that had been briefly exposed to various mitogens exhibited a 2- to 3-fold elevation in phosphorylating activities toward ribosomal protein S6 and a synthetic peptide, Arg-Arg-Leu-Ser-Ser-Leu-Arg-Ala (RRLSSLRA), patterned after a phosphorylation site sequence from S6. Optimal activation of the phosphorylating activity occurred within 15-20 min of exposure of the cells to platelet-derived growth factor (10 ng/ml), epidermal growth factor (100 nM), and insulin (100 nM), and 2 5 min after 12-O-tetradecanoylphorbol-13-acetate (TPA) (100 nM) treatment. Fractionation of the cytosolic extracts from mitogen- or TPA-treated cells on Sephacryl S-300, TSK-400, and DEAE-Sephacel columns gave results suggesting that a single stimulated kinase accounted for the enhanced S6 and RRLSSLRA phosphorylating activities. The mitogen-activated kinase had an apparent Mr of about 85,000 as determined with Sephacryl S-300, but eluted with an apparent Mr of 26,000 from a TSK-400 high pressure liquid chromatography column. The S6 kinase was also stimulated in cytosols from insulin-like growth factor 1- (100 nM), vasopressin- (250 nM), prostaglandin F2 alpha- (250 nM), and 10% fetal calf serum-treated cells but not from quiescent cells exposed to beta-transforming growth factor (2 ng/ml). TPA, vasopressin and prostaglandin F2 alpha appeared to stimulate this kinase via a protein kinase C-dependent mechanism, since the responses to these hormones, but not to platelet-derived growth factor, epidermal growth factor, and insulin, were lost in protein kinase C-depleted cells. PMID- 3305495 TI - The molybdate-stabilized nonactivated glucocorticoid receptor contains a dimer of Mr 90,000 non-hormone-binding protein. AB - A glucocorticoid receptor-associated Mr approximately 90,000 non-hormone-binding protein was purified and characterized. The molybdate-stabilized nonactivated rat liver glucocorticoid-receptor complex (Mr approximately 300,000) was immunoadsorbed on cyanogen bromide-activated Sepharose 4B to which a monoclonal IgG 2a antibody directed against the activated rat glucocorticoid receptor (Mr approximately 94,000) had been coupled. Following removal of molybdate and thermal activation of the receptor immobilized on the immunoaffinity matrix, an Mr approximately 90,000 non-hormone-binding protein was specifically eluted. This protein was further purified to homogeneity using high performance ion exchange chromatography and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, sucrose gradient ultra-centrifugation, and high performance size exclusion chromatography. Hydrodynamic characterization under nondenaturing conditions revealed that the purified glucocorticoid receptor-associated protein represents a molecular species with a sedimentation coefficient of 6.1 S, a Stokes radius of 6.9 nm, and a calculated Mr approximately 184,000. These results, combined with analysis on denaturing electrophoresis indicate that, under certain conditions, the Mr approximately 94,000 steroid-binding protein is associated with a dimer of Mr approximately 90,000 non-hormone-binding protein. PMID- 3305496 TI - Purification and characterization of a glycine betaine binding protein from Escherichia coli. AB - A major component of the Escherichia coli response to elevated medium osmolarity is the synthesis of a periplasmic protein with an Mr of 31,000. The protein was absent in mutants with lambda placMu insertions in the proU region, a locus involved in transport of the osmoprotectant glycine betaine. This periplasmic protein has now been purified to homogeneity. Antibody directed against the purified periplasmic protein crossreacts with the fusion protein produced as a result of the lambda placMu insertion, indicating that proU is the structural gene specifying the 31-kDa protein. The purified protein binds glycine betaine with high affinity but has no affinity for either proline or choline, clarifying the role of proU in osmoprotectant transport. The amino-terminal sequence of the mature glycine betaine binding protein is Ala-Asp-Leu-Pro-Gly-Lys-Gly-Ile-Thr-Val Asn-Pro. PMID- 3305498 TI - The role of translocation in ribosomal accuracy. Translocation rates for cognate and noncognate aminoacyl- and peptidyl-tRNAs on Escherichia coli ribosomes. AB - The ribosomal translocation, as measured in vitro by peptide formation on poly(U) programmed Escherichia coli ribosomes in the presence of ternary complex, deacylated tRNA or N-acetyl-Phe-tRNA, and elongation factor G, is the rate limiting step of protein synthesis. Elongation factor G stimulates the spontaneous translocation by a factor of about 500. N-Acetyl-Phe-Phe-tRNA(Phe E. coli) is translocated with a rate constant of 1-2 s-1 at 25 degrees C. Translocation of N-acetyl-Phe-Phe-tRNA(Phe yeast) and N-acetyl-Phe-Leu-tRNA(Leu E. coli) under identical conditions proceeds with a rate by about a factor of 2 and 10, respectively, more slowly. The translocation rate, therefore, is influenced by the nature of the tRNAs in the A-site. We can show, furthermore, that also the tRNA in the P-site, and presumably in the E-site as well, influences the rate of translocation. Reduced rates of translocation of noncognate peptidyl-tRNAs are accompanied by preferential dissociation of these tRNAs at the beginning of the translation of a mRNA. PMID- 3305497 TI - Membrane glycophorins of Dantu blood group erythrocytes. AB - Glycophorins of erythrocytes of two unrelated individuals who exhibit the Dantu blood group phenotype were studied. Immunoblots indicated that erythrocytes of each individual contained a complement of a normal alpha-glycophorin (glycophorin A) and a variant N-glycophorin. delta-Glycophorin (glycophorin B) was present in one donor's cells but not the other's; the s and N phenotypes of the latter's erythrocytes may derive from the variant glycophorin. The variant glycophorin is of a smaller size, does not bind to Lens culinaris lectin agarose, and lacks residues approximately 40-60 of alpha-glycophorin and its single asparagine linked carbohydrate; it contains approximately 2 less O-glycosidically bound units whose structures are identical to those found in alpha-glycophorins. All these properties are characteristic of delta-glycophorin. The variant is related to alpha-glycophorin in the carboxyl-terminal region as shown by reaction with a specific antiserum. Sequence analyses of a mixture of chymotryptic peptides of a CNBr fragment of the variant glycophorin identified the sequence Val-His-Arg-Phe Thr-Val-Pro-Glu-Ile-Thr-Leu-Ile-Ile that contains the junction point of delta- and alpha-glycophorins spanning residues 33-38/39 of delta-glycophorin and residues 71/72-77 of alpha-glycophorin. Sequence analysis of a mixture of CNBr fragments allowed us to conclude that the variant originates from delta-s- rather than delta-S-glycophorin. The quantity of the variant Dantu glycophorin when compared to alpha-glycophorin differed in the two individuals, the ratio being 2/1 in one individual's cells and 0.5/1 in the other's. This may reflect that the two donors belong to different varieties of Dantu phenotypes. Together, the evidence indicates that both donors' erythrocytes contain a (delta-alpha) variant glycophorin, whose amino terminus originates from delta-s-glycophorin and the carboxyl end from alpha-glycophorin with a junction point around residues 39 of delta- and 71 of alpha-glycophorins. The results suggest that the unique junction region may be characteristic of the Dantu phenotype. PMID- 3305500 TI - Shunting of insulin from a retroendocytotic pathway to a degradative pathway by sodium vanadate. AB - Adipocytes route internalized insulin through two major pathways, a degradative pathway and a retroendocytotic pathway. To examine whether sorting of incoming insulin-receptor complexes can be altered, we assessed the effect of vanadate on the intracellular processing of both insulin and insulin receptors. After cells were pretreated with vanadate (1 mM for 30 min at 37 degrees C), 125I-insulin was loaded into the cell interior. When the net efflux of insulin from cells into the medium was then monitored, vanadate was found to slow the efflux of insulin from a t1/2 of 6.2 min (controls) to 11 min. Since efflux reflects both the rapid extrusion of intact insulin and the slower release of degradative products, we proposed that vanadate diverts more insulin into the degradative pathway. Further evidence in support of this idea included the following: 1) when intracellular degradation of insulin was impaired by chloroquine, undegraded insulin accumulated faster within vanadate-treated cells, consistent with greater flux through a degradative pathway; 2) vanadate increased the percentage of degraded insulin released from cells from 61 and 72%; and 3) under steady-state binding conditions, more insulin resided in the cell interior of vanadate-treated cells (44.8% versus 34.5%), and the time required for the intracellular pool to reach equilibrium was prolonged (t1/2 of 5.5 min versus 4.0). Neither insulin internalization nor degradation was impaired by vanadate alone. In related studies Tris was found to inhibit insulin-mediated receptor recycling by only 10%, whereas in the presence of vanadate (plus Tris) almost all incoming insulin receptors were prevented from recycling. Vanadate alone had no effect on the ability of insulin receptors to recycle. Based on these results we conclude that: 1) vanadate shunts incoming insulin from a more rapid retroendocytotic pathway to a slower degradative pathway and diverts insulin receptors from a Tris insensitive recycling pathway to one that can be completely inhibited by Tris; 2) these effects are selective, in that vanadate impairs neither insulin degradation nor receptor uptake and recycling. Considered together, these findings support the idea that a sorting mechanism exists for the intracellular routing of incoming insulin-receptor complexes. PMID- 3305499 TI - A heparin binding site in antithrombin III. Identification, purification, and amino acid sequence. AB - A heparin-binding peptide within antithrombin III (ATIII) was identified by digestion of ATIII with Staphylococcus aureus V8 protease followed by purification on reverse-phase high pressure liquid chromatography using a C-4 column matrix. The column fractions were assayed for their ability to bind heparin by ligand blotting with 125I-fluoresceinamine-heparin as previously described (Smith, J. W., and Knauer, D. J. (1987) Anal. Biochem. 160, 105-114). This analysis identified at least three fractions with heparin binding ability of which the peptide eluting at 25.4 min gave the strongest signal. Amino acid sequence analysis of this peptide gave a partially split sequence which was consistent with regions encompassing amino acids 89-96 and 114-156. These amino acids are present in a 1:1 molar ratio which is consistent with a disulfide linkage between Cys-95 and Cys-128. High affinity heparin competed more effectively for the binding of 125I-fluoresceinamine-heparin to this peptide than low affinity heparin. Chondroitin sulfate did not block the binding of 125I fluoresceinamine-heparin to the peptide. These data strongly suggest that the isolated peptide represents a native heparin-binding region within intact ATIII. Computer generation of a plot of running charge density of ATIII confirms that the region encompassing amino acid residues 123-141 has the highest positive charge density within the molecule. A hydropathy plot of ATIII was generated using a method similar to that of Kyte and Doolittle (Kyte, J., and Doolittle, R. F. (1982) J. Mol. Biol. 157, 105-132). This plot indicates that amino acid residues 126-140 are exposed to the exterior surface of the molecule. Based on these data, we suggest that the region corresponding to amino acid residues 114 156 is a likely site for the physiological heparin-binding domain of ATIII. We also conclude that the proposed disulfide bridges within the protein are suspect and should be re-examined (Petersen, T. E., Dudek-Wojiechowska, G., Sottrup Jensen, L., and Magnussun, S. (1979) in The Physiological Inhibitors of Coagulation and Fibrinolysis (Collen, D., Wiman, B., and Verstaeta, M., eds) pp. 43-54, Elsevier Scientific Publishing Co., Amsterdam). PMID- 3305501 TI - Role of the COOH-terminal B-chain domain in insulin-receptor interactions. Identification of perturbations involving the insulin mainchain. AB - Previous studies have suggested that the COOH-terminal pentapeptide of the insulin B-chain can play a negative role in ligand-receptor interactions involving insulin analogs having amino acid replacements at position B25 (Nakagawa, S. H., and Tager, H. S. (1986) J. Biol. Chem. 261, 7332-7341). We undertook by the current investigations to identify the molecular site in insulin that induces this negative effect and to explore further the importance of conformational changes that might occur during insulin-receptor interactions. By use of semisynthetic insulin analogs containing amino acid replacements or deletions and of isolated canine hepatocytes, we show here that (a) the markedly decreased affinity of receptor for insulin analogs in which PheB25 is replaced by Ser is apparent for analogs in which up to 3 residues of the insulin B-chain have been deleted, but is progressively reversed in the corresponding des-tetrapeptide and des-pentapeptide analogs, and (b) unlike the case for deletion of TyrB26 and ThrB27, replacement of residue TyrB26 or ThrB27 has no effect to reverse the decreased affinity of full length analogs containing Ser for Phe substitutions at position B25. Additional experiments demonstrated that introduction of a cross link between Lys epsilon B29 and Gly alpha A1 of insulin decreases the affinity of ligand-receptor interactions whether or not PheB25 is replaced by Ser. We conclude that the negative effect of the COOH-terminal B-chain domain on insulin receptor interactions arises in greatest part from the insulin mainchain near the site of the TyrB26-ThrB27 peptide bond and that multiple conformational perturbations may be necessary to induce a high-affinity state of receptor-bound insulin. PMID- 3305503 TI - The primary structures of ribosomal proteins S14 and S16 from the archaebacterium Halobacterium marismortui. Comparison with eubacterial and eukaryotic ribosomal proteins. AB - The amino acid sequences of two ribosomal proteins, S14 and S16, from the archaebacterium Halobacterium marismortui have been determined. Sequence data were obtained by the manual and solid-phase sequencing of peptides derived from enzymatic digestions with trypsin, chymotrypsin, pepsin, and Staphylococcus aureus protease as well as by chemical cleavage with cyanogen bromide. Proteins S14 and S16 contain 109 and 126 amino acid residues and have Mr values of 11,964 and 13,515, respectively. Comparison of the sequences with those of ribosomal proteins from other organisms demonstrates that S14 has a significant homology with the rat liver ribosomal protein S11 (36% identity) as well as with the Escherichia coli ribosomal protein S17 (37%), and that S16 is related to the yeast ribosomal protein YS22 (40%) and proteins S8 from E. coli (28%) and Bacillus stearothermophilus (30%). A comparison of the amino acid residues in the homologous regions of halophilic and nonhalophilic ribosomal proteins reveals that halophilic proteins have more glutamic acids, asparatic acids, prolines, and alanines, and less lysines, arginines, and isoleucines than their nonhalophilic counterparts. These amino acid substitutions probably contribute to the structural stability of halophilic ribosomal proteins. PMID- 3305502 TI - Non-adenylylated bis(5'-nucleosidyl) tetraphosphates occur in Saccharomyces cerevisiae and in Escherichia coli and accumulate upon temperature shift or exposure to cadmium. AB - A new set of bis(5'-nucleosidyl) tetraphosphates, the Bp4B' nucleotides (B and B' = C, G, or U not equal to A), are demonstrated in living cells. In exponentially growing Saccharomyces cerevisiae, cellular concentrations of Cp4U, Up4U, Gp4G, Cp4C, Gp4U, and Gp4C are 210, 200, 60, 50, 40, and 30 nM, respectively. It is likely that these nucleotides originate from the action of diadenosine-5',5"' P1,P4-tetraphosphate alpha,beta-phosphorylase, an enzyme recently found in yeast. Upon temperature shift or exposure to cadmium, the Bp4B' nucleotides strongly accumulate in the yeast cells. In Escherichia coli, the same nucleotides occur, and similar effects of temperature shift or of cadmium are observed. However, in the bacterium, the origin of these nucleotides is not known. To quantitate these nucleotides in cellular extracts, specific procedures were developed. In the first step, after purification of the mixture of Np4N' (N and N' = A, C, G, or U) nucleotides, the Ap4N nucleotides are specifically removed by incubation with lysyl-tRNA synthetase. In the second step, the Bp4B' species are resolved with the help of anion-exchange high performance liquid chromatography. In the third step, the concentration of each Bp4B' is measured using three coupled enzymatic reactions to produce ATP and bioluminescence. With this strategy, 0.01 pmol of any Bp4B' nucleotide can be reliably detected. PMID- 3305504 TI - A preliminary crystallographic study of recombinant human interleukin 1 beta. AB - Recombinant human interleukin 1 beta which is expressed in Escherichia coli has been crystallized by the method of vapor diffusion using ammonium sulfate as the precipitant. The space group is P4(1) or P4(3) with a = b = 55.0 A and c = 77.1 A and one molecule in the asymmetric unit. The crystals diffract to beyond 2.4 A and are suitable for a three-dimensional x-ray structure determination. PMID- 3305505 TI - NAD(P)H:flavin oxidoreductase of Escherichia coli. A ferric iron reductase participating in the generation of the free radical of ribonucleotide reductase. AB - The active form of one subunit of Escherichia coli ribonucleotide reductase (protein B2) contains an organic free radical localized to tyrosine 122 of its polypeptide chain. When this radical is scavenged, e.g. by treatment with hydroxyurea, the enzyme is inactivated (protein B2/HU). E. coli contains an enzyme system consisting of at least three proteins that in the presence of NADPH, FMN, dithiothreitol, and oxygen introduce the tyrosyl radical into B2/HU (Eliasson, R., Jornvall, H., and Reichard, P. (1986) Proc. Natl. Acad. Sci. U. S. A. 83, 2373-2377). One of the three proteins was identified as superoxide dismutase. We now identify a second protein, previously provisionally named Fraction c, as an NAD(P)H:flavin oxidoreductase (flavin reductase). After 4,000 fold purification the protein moved as a single band on sodium dodecyl sulfate gel electrophoresis with a molecular weight of 28,000-29,000. The enzyme contained no flavin but reduced riboflavin, FMN, and FAD by NADH, or riboflavin and FMN by NADPH. It is a powerful ferric iron reductase. We propose that its complementing activity during radical generation involves participation in the reduction of the ferric iron center of protein B2/HU. Radical formation is then linked to the reoxidation of iron by oxygen. The flavin reductase may also participate in other aspects of iron metabolism of E. coli. PMID- 3305506 TI - Interactions of the bacteriophage T4 gene 55 product with Escherichia coli RNA polymerase. Competition with Escherichia coli sigma 70 and release from late T4 transcription complexes following initiation. AB - The bacteriophage T4 gene 55 protein endows Escherichia coli RNA polymerase core with the ability to recognize T4 late promoters. In these experiments, we show that T4 gene product (gp) 55, like the major E. coli RNA polymerase initiation subunit sigma 70, is released from elongating transcription complexes and is thus capable of cycling among molecules of RNA polymerase core. We also show that, paradoxically, sigma 70 is able to displace T4 gp55 from its site of binding to E. coli RNA polymerase core. After T4 infection, the core enzyme is ADP ribosylated in each alpha subunit, and a T4-coded 11.4-kDa protein (rpbA) binds tightly to it; these modifications do not save gp55 from displacement by sigma 70. However, open T4 late promoter complexes, containing gp55, are resistant to attack by sigma 70. PMID- 3305507 TI - Tyrosine 70 increases the coenzyme affinity of aspartate aminotransferase. A site directed mutagenesis study. AB - The crucial step in enzymatic transamination is the tautomerization of aldimine/ketimine intermediates, formed between the pyridoxyl coenzyme and the amino/keto acid substrate, which is catalyzed primarily by the active site residue Lys-258 (Malcolm, B. A., and Kirsch, J. F. (1985) Biochem. Biophys. Res. Commun. 132, 915-921; W. L. Finlayson and J. F. Kirsch, in preparation). Tyr-70 is localized in close proximity to Lys-258 and, in addition, forms a hydrogen bond with the coenzyme phosphate. Tyr-70 has been postulated to have an important role in the tautomerization (Kirsch, J. F., Eichele, G., Ford, G. C., Vincent, M. G., Jansonius, J. N., Gehring, H., and Christen, P. (1984) J. Mol. Biol. 174, 497 525). This hypothesis has now been tested by the construction and analysis of a mutant Escherichia coli aspartate aminotransferase in which Tyr-70 has been changed to Phe (Y70F). Y70F retains at least 15% of the maximal activity of the wild type enzyme (WT) (kcat = 170 +/- 15 s-1 for WT versus greater than or equal to 26 +/- 3 s-1 for Y70F and shows increased Michaelis constants for both substrates (KmAsp = 2.5 +/- 0.4 mM; Km alpha Kg = 0.59 +/- 0.08 mM for WT versus KmAsp = 3.9 +/- 0.3 mM; Km alpha Kg = 2.70 +/- 0.02 mM for Y70F (where alpha Kg is alpha-ketoglutarate) ). The spectrophotometrically determined pK a values of the internal aldimines formed between pyridoxal 5'-phosphate (PLP) and Lys-258 are identical for WT and Y70F. In assays where excess L-aspartate and excess PLP are incubated with either WT or Y70F, the mutant enzyme converts the free PLP to free pyridoxamine 5'-phosphate 80-fold faster than WT (k = (3.75 +/- 0.23) X 10( 2)s-1 for Y70F versus (4.90 +/- 0.02) X 10(-4)s-1 for WT). Y70F also converts free pyridoxamine 5'-phosphate to free PLP faster than WT. Thus, Y70F dissociates coenzyme more readily than does WT. It therefore appears that the role of Tyr-70 is mainly in preventing the dissociation of the coenzyme from the enzyme. Tyr-70 does not function in an essential chemical step. PMID- 3305508 TI - Human renin is correctly processed and targeted to the regulated secretory pathway in mouse pituitary AtT-20 cells. AB - Renin is formed by intracellular processing of prorenin and catalyzes the conversion of angiotensinogen to angiotensin I, the precursor to angiotensin II. Several tissues synthesize prorenin. However, in man, the kidney is the only known source of circulating renin, raising the possibility that the processing enzyme is unique to that tissue. We have transfected a gene that directs prorenin synthesis in pituitary AtT-20 cells, which are capable of processing other prohormones. The results demonstrate that transfected AtT-20 cells can secrete inactive prorenin, accurately process prorenin to active renin, and be stimulated to release active renin in response to a secretagogue. These data imply that cellular elements capable of directing the processing of prorenin to renin and its correct subcellular compartmentalization may be present in nonrenal cell types and that critical elements of the regulated release of renin that occur in the kidney can be reconstituted in cells in culture. PMID- 3305509 TI - Expression of cDNAs encoding the precursor and the mature form of chicken mitochondrial aspartate aminotransferase in Escherichia coli. AB - Both the precursor and the mature form of chicken mitochondrial aspartate aminotransferase were synthesized in Escherichia coli. The precursor was found to sediment quantitatively together with insoluble cell material. In contrast, mature mitochondrial aspartate aminotransferase could be readily extracted from the cells and was indistinguishable from the enzyme isolated from chicken heart in all respects tested: specific activity 230 units mg-1; Mr 2 X 45,000; pI greater than 9; NH2-terminal sequence SSWWSHVEMG, the initiator methionine having been removed by the bacteria. Thus, the polypeptide chain representing mature mitochondrial aspartate aminotransferase is an autonomous folding unit which attains its functional spatial structure independently of the presence of the prepiece, trans-membrane passage, and proteolytic processing. PMID- 3305510 TI - Inhibition of the RNA polymerase-catalyzed synthesis of RNA by daunomycin. Effect of the inhibitor on the late steps of RNA chain initiation. AB - In vitro RNA synthesis from the A promoters of T7 bacteriophage by Escherichia coli RNA polymerase is strongly inhibited by daunomycin. Under the conditions of the assay for total RNA synthesis, daunomycin has no effect on the formation of the binary enzyme-template complex. The major inhibitory effect may be exerted during incorporation of the first few nucleotides into the nascent RNA chain. We report here that daunomycin has little effect on the substeps leading to the formation of abortive dinucleotide from the A promoters. A large part of the inhibitory effect of daunomycin is therefore specifically targeted toward a very small final portion of the process of initiation, which may be described as the addition of nucleotides to the initial dinucleotide (and its subsequent translocation) until a stable ternary complex has been formed. The level at which this inhibition is exerted is more precisely defined by examining the effect of daunomycin on the synthesis of the first few oligonucleotides synthesized from the A3 promoter. The major inhibitory effect of daunomycin is found to be specifically exerted during the transformation of the initial dinucleotide to the corresponding trinucleotide. The remainder of the inhibition may be evenly divided among a large number of nucleotide addition steps that transform the nascent trinucleotide to a completed RNA chain. One of the fundamental levels at which transcription is controlled is initiation. In slow-start promoters, e.g. the lac UV5 promoter, the late stages of initiation (when the enzyme has the option of either producing an abortive di- or trinucleotide or proceeding with the formation of a stable ternary complex) may be involved in this control. Inhibitors which specifically act on this stage of initiation may thus prove useful for the study of such systems, as well as transcription in general. PMID- 3305511 TI - Purification and properties of the MalT protein, the transcription activator of the Escherichia coli maltose regulon. AB - Expression of the Escherichia coli maltose regulon is controlled by MalT, a transcriptional activator (Mr = 102,288) encoded by the malT gene. Activation of transcription depends on the presence of the inducer, maltotriose. Using an in vitro transcription/translation assay to monitor the protein, we have purified MalT in native form from MalT-overproducing bacteria. The purified protein is able to promote transcription from different MalT-controlled promoters in well defined in vitro systems. Maltotriose and the MalT protein suffice to stimulate initiation of transcription at malPp by the E. coli RNA polymerase holoenzyme. In contrast, both MalT protein and cAMP receptor protein are required with their respective effectors, maltotriose and cyclic AMP, for activation of malEp. These data are in agreement with in vivo observations. In addition, we present evidence that MalT is an ATP-binding protein, a result suggesting that ATP may play a role in transcription initiation. PMID- 3305512 TI - Identification of a chloroplast-encoded 9-kDa polypeptide as a 2[4Fe-4S] protein carrying centers A and B of photosystem I. AB - An improved procedure is reported for large-scale preparation of photosystem I (PS-I) vesicles from thylakoid membranes of barley (Hordeum vulgare L.). The PS-I vesicles contain polypeptides of molecular masses 82, 18, 16, 14, and 9 kDa in an apparent molar ratio of 4:2:2:1:2. The 18-, 16-, and 9-kDa polypeptides were purified to homogeneity after exposure of the PS-I vesicles to chaotropic agents. The isolated 9-kDa polypeptide binds 65-70% of the zero-valence sulfur of denatured PS-I vesicles, and the remaining 30-35% is bound to P700-chlorophyll a protein 1. The N-terminal amino acid sequence (29 residues) of the 9-kDa polypeptide was determined. Comparison with the nucleotide sequence of the chloroplast genome of Marchantia polymorpha (Ohyama, K., Fukuzawa, H., Kohchi, T., Shirai, H., Sano, T., Sano, S., Umesono, K., Shiki, Y., Takeuchi, M., Chang, Z., Aota, S.-i., Inokuchi, H., and Ozeki, H. (1986) Nature 322, 572-574) and of Nicotiana tabacum (Shinozaki, K., Ohme, M., Tanaka, M., Wakasugi, T., Hayashida, N., Matsubayashi, T., Zaita, W., Chunwongse, J., Obokata, J., Yamaguchi Shinozaki, K., Ohto, C., Torazawa, K., Meng, B. Y., Sugita, M., Deno, H., Kamogashira, T., Yamada, K., Kusuda, J., Takaiwa, F., Kato, A., Tohdoh, N., Shimada, H., and Sugiura, M. (1986) EMBO J. 5, 2043-2049) identified the chloroplast gene encoding the 9-kDa polypeptide. We designate this gene psaC. The complete amino acid sequence deduced from the psaC gene identifies the 9-kDa PS-I polypeptide as a 2[4Fe-4S] protein. Since P700-chlorophyll a-protein 1 carries center X, the 9-kDa polypeptide carries centers A and B. A hydropathy plot permits specific identification of the cysteine residues which coordinate centers A and B, respectively. Except for the loss of the N-terminal methionine residue, the primary translation product of the psaC gene is not proteolytically processed. P700-chlorophyll a-protein 1 binds 4 iron atoms and 4 molecules of acid-labile sulfide/molecule of P700. Each of the two apoproteins of P700 chlorophyll a-protein 1 contains the sequence Phe-Pro-Cys-Asp-Gly-Pro-Gly-Arg-Gly Gly-Thr-Cys (Fish, L. E., Kuck, U., and Bogorad, L. (1985) J. Biol. Chem. 260, 1413-1421). The stoichiometry of the component polypeptides of PS-I indicates the presence of four copies of this sequence per molecule of P700. Center X may be composed of two [2Fe-2S] centers bound to the 8 cysteine residues contained in these four segments. PMID- 3305513 TI - Purification and properties of a nuclease from Saccharomyces cerevisiae that cleaves DNA at cruciform junctions. AB - An endonuclease specific for cruciform junctions has been purified from yeast cells treated with a DNA-damaging agent. The activity was followed through five chromatographic steps by assaying for the linearization of supercoiled plasmid DNA, which extrudes cruciform structures in vitro. The sites of cleavage on pColIR215 were sequenced, and nicks were located to positions symmetrically opposed across the cruciform junction. The products of cleavage were unit length linear duplexes that contained terminal hairpin loops. In contrast to pColIR215, the cleavage patterns of pXG540 plasmid DNA were found to be complex, and cuts were found up to 40 bases from an (A-T)34 sequence that extrudes into a cruciform. Little or no activity could be detected on single-stranded DNA, linear duplex DNA, or nicked circular duplex DNA. The nuclease was insensitive to RNase but was inactivated by treatment with proteinase K. Mg2+ was required as cofactor and could not be replaced by Mn2+, Ca2+, Co2+, or Cu2+. The native molecular weight of the activity was approximately 200,000 as estimated by gel filtration. PMID- 3305514 TI - Electron microscopic visualization of the RecA protein-mediated pairing and branch migration phases of DNA strand exchange. AB - The RecA protein of Escherichia coli will drive the pairing and exchange of strands between homologous DNA molecules in a reaction stimulated by single stranded binding protein. Here, reactions utilizing three homologous DNA pairs which can undergo both paranemic and plectonemic joining were examined by electron microscopy: supertwisted double-stranded (ds) DNA and linear single stranded (ss) DNA, linear dsDNA and circular ssDNA, and linear dsDNA and colinear ssDNA. Several major observations were: (i) with RecA protein bound to the DNA, plectonemic joints were ultrastructurally indistinguishable from paranemic joints; (ii) complexes which appeared to be joined both paranemically and plectonemically were present in these reactions in roughly equal numbers; and (iii) in complexes undergoing strand exchange, both DNA partners were often enveloped within a RecA protein filament consisting of hundreds of RecA protein monomers and several kilobases of DNA. These observations suggest that, following RecA protein-ssDNA filament formation, strand exchange proceeds by a pathway that can be divided structurally into three phases: pairing, envelopment/exchange, and release of the products. PMID- 3305515 TI - Cloning and gene expression of Schistosoma mansoni protease. AB - Schistosomes utilize proteases (termed hemoglobinases) for degradation of host globin. cDNA clones encoding Schistosoma mansoni protease were isolated by immunologically screening an expression cDNA library with antisera raised against purified hemoglobinase. Confirmation of the identities of the clones was obtained immunologically and biochemically. The bacterially produced fusion protein encoded by one clone, lambda Hb2, degraded hemoglobin in vitro. The sequence of this clone suggested that this S. mansoni protease is synthesized in a precursor form in vivo. Gene titrations indicated that S. mansoni contains multiple genes corresponding to this cDNA. The expression of these genes may be regulated during the organism's life cycle since adult, female worms contained the highest abundances of homologous mRNA and protein compared to other stages. PMID- 3305516 TI - Review of medical biosensors and associated materials problems. AB - Developers of biosensors as medical devices are using emerging technologies that incorporate chemical assays with fiber optics and semiconductors. These biosensors will eventually become indwelling catheters for monitoring blood analyte concentrations as well as functioning as controlled feedback elements for artificial organs. Materials used in these devices are subject to problems of manufacture and reliability as well as those induced by the human body's response to these "foreign agents." The Division of Mechanics and Materials Science in the Center for Devices and Radiological Health at the Food and Drug Administration has initiated a program to investigate factors that effect sensitivity, selectivity and reliability of sensors used in biological applications. Our group's principle focus is on sensors of chemical processes. This article is an outgrowth of our research efforts and is a review of some of the technologies that are currently available or becoming available for these applications. The goal of our research is to identify factors that will have an impact on the reliability of long-term implanted medical devices with particular attention to sensors used in feedback-controlled therapeutic systems. PMID- 3305517 TI - Myosin isoform expression in rat rhabdomyosarcoma induced by Moloney murine sarcoma virus. AB - Myosin isoform expression was analyzed in experimental rhabdomyosarcoma (RMS) using monoclonal antibodies (mAbs) and immunofluorescence techniques. Tumors induced by inoculating newborn rats with Moloney murine sarcoma virus (Mo-MSV) were examined 30-90 days after birth. Nine tumors and two lymph node metastases were studied by direct, indirect, and double immunofluorescence assays using a panel of five anti-myosin mAbs. The mAb BF-45 was specifically reactive with embryonic myosin heavy chain (MHC), mAb BF-34 was specific for a neonatal MHC epitope, mAb BF-B6 was directed against an epitope present in both embryonic and neonatal MHC, and mAbs BF-F3 and BF-32 detected epitopes present in adult MHC isoforms. Anti-desmin antibodies were also used for comparison. The results of this study show that: (1) the majority of neoplastic cells stained for desmin while only a minority of neoplastic cells were labeled by anti-myosin antibodies; (2) myosin positive tumor cells contained predominantly embryonic and neonatal MHC types but rare RMS cells reacted exclusively with anti-adult myosin antibodies; and (3) adult and embryonic MHC phenotypes were occasionally detected within the same tumor cell especially in RMS with the longest latencies. Together these results would suggest that the mechanism(s) regulating MHC gene expression in skeletal muscle cells can be altered by the transforming activity of Mo-MSV. PMID- 3305518 TI - Effects of inhibition of proteoglycan synthesis on the differentiation of cultured rat Schwann cells. AB - Schwann cells synthesize two heparan sulfate proteoglycans, one that is a component of the Schwann cell basement membrane and a smaller one that is an integral component of the Schwann cell plasma membrane. To determine the functions of these molecules, Schwann cell-nerve cell cultures were grown in medium containing a specific inhibitor of proteoglycan biosynthesis, 4 methylumbelliferyl-beta-D-xyloside. Treatment with 1 mM beta-D-xyloside caused a 90% reduction in the accumulation of 35SO4-labeled proteoglycans in the cell layer of the cultures. Gel filtration analysis revealed that both the basement membrane and plasma membrane proteoglycans were affected. Inhibition of proteoglycan biosynthesis was accompanied by an inhibition of laminin deposition into extracellular matrix as determined by immunostaining of cultures and by immunoblotting of cell-associated proteins. This occurred even though there was no decrease in the amount of laminin detected in the medium of beta-D-xyloside treated cultures. Deposition of collagen type IV was similarly affected. In addition, there was no myelin produced in beta-D-xyloside treated cultures. However, when beta-xyloside-treated cultures were supplied with exogenous basement membrane, Schwann cells produced numerous myelin segments. These results indicate that Schwann cell proteoglycans play an essential role in basement membrane assembly, and that the integral plasma membrane proteoglycan is not required for the basement membrane to exert its effects on Schwann cell differentiation. PMID- 3305519 TI - Thrombospondin: a modular adhesive glycoprotein of platelets and nucleated cells. PMID- 3305520 TI - A yeast mutant defective at an early stage in import of secretory protein precursors into the endoplasmic reticulum. AB - We have devised a genetic selection for mutant yeast cells that fail to translocate secretory protein precursors into the lumen of the endoplasmic reticulum (ER). Mutant cells are selected by a procedure that requires a signal peptide-containing cytoplasmic enzyme chimera to remain in contact with the cytosol. This approach has uncovered a new secretory mutant, sec61, that is thermosensitive for growth and that accumulates multiple secretory and vacuolar precursor proteins that have not acquired any detectable posttranslational modifications associated with translocation into the ER. Preproteins that accumulate at the sec61 block sediment with the particulate fraction, but are exposed to the cytosol as judged by sensitivity to proteinase K. Thus, the sec61 mutation defines a gene that is required for an early cytoplasmic or ER membrane associated step in protein translocation. PMID- 3305522 TI - Tubulin interaction with kinetochore proteins: analysis by in vitro assembly and chemical cross-linking. AB - The sera from patients with the CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) variation of the autoimmune disease scleroderma contain autoantibodies that specifically recognize the kinetochore by immunofluorescence. Two major antigens of molecular masses 18 and 80 kD are consistently identified by Western blotting of proteins of isolated chromosomes using CREST sera. In this paper, the possible roles that these two proteins play in the interaction of metaphase chromosomes with tubulin and microtubules are examined using two different procedures. In one set of experiments. Chinese hamster ovary (CHO) chromosomes were extracted with 1-2 M NaCl before incubating with phosphocellulose-purified tubulin under in vitro microtubule assembly conditions. After this treatment, the kinetochores of the residual chromosome scaffolds can still initiate the in vitro assembly of microtubules. Immunoblots of the chromosome scaffold proteins demonstrate that the 18-kD protein has been solubilized by the 1-2 M NaCl extraction, suggesting that this protein is not essential for microtubule assembly at the kinetochore. In a second approach, tubulin was covalently cross-linked to kinetochores of CHO chromosomes using the reversible cross-linking reagent dithiobis (succinimidyl propionate). After DNase I digestion, the chromosomes were solubilized and subjected to anti-tubulin affinity chromatography. Tubulin-kinetochore protein complexes were specifically eluted and analyzed by PAGE and immunoblotting with scleroderma CREST serum. Only a small number of proteins were eluted from the antitubulin affinity column as shown by Coomassie Blue-stained gels. In addition to tubulin, an 80-kD polypeptide, bands at 110 and 24 kD, as well as a faint band at 54 kD, can be resolved. Several minor bands can also be seen in silver-stained gels. The 80-kD protein band from whole metaphase chromosomes reacted with scleroderma CREST serum by immunoblotting and therefore probably represents the major centromere antigen CENP-B. This report provides evidence for a specific protein complex on metaphase chromosomes that is contiguous with kinetochore bound tubulin and may be involved in microtubule-kinetochore interactions during mitosis. PMID- 3305521 TI - Identification of an endosomal antigen specific to absorptive cells of suckling rat ileum. AB - A membrane fraction enriched in apical endosomal tubules was isolated from absorptive cells of suckling rat ileum and used as an immunogen to generate anti endosome monoclonal antibodies. By immunofluorescence, one of these antibodies bound exclusively to the region of the apical endocytic complex in ileal absorptive cells, but not to other cell types. Immunoblot analysis showed the antigen as a diffuse 55-61-kD band which was highly enriched in the endosome fraction over whole-cell homogenate. The antigen appears to be an intramembrane glycoprotein: it partitioned primarily in the detergent phase after TX-114 extraction, and shifted to 44 kD after chemical deglycosylation. EM immunocytochemistry showed that the antibody bound to the luminal side of endosomal tubule membranes, a portion of endosomal vesicle membranes, and in endocytic pits of apical plasma membranes. However, it did not bind to multivesicular bodies, the giant lysosome, or other organelles. Immunocytochemistry after uptake with adsorbed or soluble tracer proteins showed that the antigen labeled portions of both prelysosomal pathways previously described in these cells (Gonnella, P.A., and M. R. Neutra, 1984, J. Cell Biol., 99:909-917). The function of this glycoprotein is not known, but inasmuch as it has been detected only in absorptive cells of suckling rat ileum, it may serve a function specific to these cells. Nevertheless, this endosomal antigen, designated glycoprotein (gp) 55-61, will serve as a useful marker for exploring membrane dynamics in early stages of the endocytic pathway. PMID- 3305523 TI - Interzone microtubule behavior in late anaphase and telophase spindles. AB - We have studied microtubule behavior in late anaphase and telophase spindles of PtK1 cells, using fluoresceinated tubulin (DTAF-tubulin), microinjection, and laser microbeam photobleaching. We present the results of two novel tests which add to the evidence that DTAF-tubulin closely mimics the behavior of native tubulin in vivo. (a) Microinjected DTAF-tubulin was as effective as injected native tubulin in promoting division of taxol-dependent mitotic mutant cells that had been deprived of taxol. (b) Microinjected colchicine-DTAF-tubulin complex was similar to injected colchicine-native tubulin complex in causing depolymerization of spindles. Immediately after microinjection of DTAF-tubulin into wild-type cells during late anaphase or telophase, fluorescence incorporation by microtubules was seen in chromosomal half-spindles and just behind the chromosomes, but there was no fluorescence incorporation near the middle of the interzone. Over the next few minutes, tubulin fluorescence accumulated at the center of the interzone (the equator), becoming progressively more intense. In other experiments, cells were microinjected with DTAF-tubulin at prophase and allowed to equilibrate for 30 min. Cells that had progressed to late anaphase were then photobleached to reduce the fluorescence in the central portion of the interzone. Over a period of several minutes, the only substantial redistribution of fluorescence was the appearance of a bright area at the equator of the interzone. Both the site of fluorescence incorporation and the photobleaching data suggest that tubulin adds to the elongating spindle interzone near the equator where the plus ends of the interdigitated microtubules are located. In further experiments, several dark lines were photobleached perpendicular to the pole-to-pole axis of fluorescent anaphase-telophase spindles. Time-dependent changes in the spacings between the lines indicated that the two halves of the interzone lying on opposite sides of the spindle equator moved away from one another. This shows that the interdigitated microtubules, which make up most of the interzone, can undergo antiparallel sliding. Our data support a model for anaphase B in which plus end elongation of interdigitated microtubules and antiparallel sliding contribute to chromosome separation. PMID- 3305525 TI - In vitro morphogenesis of chick embryo hypertrophic cartilage. AB - Dedifferentiated chick embryo chondrocytes (Castagnola, P., G. Moro, F. Descalzi Cancedda, and R. Cancedda, 1986, J. Cell Biol., 102:2310-2317), when transferred to suspension culture on agarose-coated dishes in the presence of ascorbic acid, aggregate and remain clustered. With time in culture, clusters grow in size and adhere to each other, forming structures that may be several millimeters in dimension. These structures after 7 d of culture have the histologic appearance of mature hypertrophic cartilage partially surrounded by a layer of elongated cells resembling the perichondrium. Cells inside the aggregates have ultrastructural features of stage I (proliferating) or stage II (hypertrophic) chondrocytes depending on their location. Occurrence and distribution of type I, II, and X collagens in the in vitro-formed cartilage at different times of culture, show a temporal and spatial distribution of these antigens reminiscent of the maturation events occurring in the cartilage in vivo. A comparable histologic appearance is shown also by cell aggregates obtained starting with a population of cells derived from a single, cloned, dedifferentiated chondrocyte. PMID- 3305524 TI - Basal body reorientation mediated by a Ca2+-modulated contractile protein. AB - A rapid, Ca2+-dependent change in the angle between basal bodies (up to 180 degrees) is associated with light-induced reversal of swimming direction (the "photophobic" response) in a number of flagellated green algae. In isolated, detergent-extracted, reactivated flagellar apparatus complexes of Spermatozopsis similis, axonemal beat form conversion to the symmetrical/undulating flagellar pattern and basal body reorientation (from the antiparallel to the parallel configuration) are simultaneously induced at greater than or equal to 10(-7) M Ca2+. Basal body reorientation, however, is independent of flagellar beating since it is induced at greater than or equal to 10(-7) M Ca2+ when flagellar beating is inhibited (i.e., in the presence of 1 microM orthovanadate in reactivation solutions; in the absence of ATP or dithiothreitol in isolation and reactivation solutions), or when axonemes are mechanically removed from flagellar apparatuses. Although frequent axonemal beat form reversals were induced by varying the Ca2+ concentration, antiparallel basal body configuration could not be restored in isolated flagellar apparatuses. Observations of the photophobic response in vivo indicate that even though the flagella resume the asymmetric, breaststroke beat form 1-2 s after photostimulation, antiparallel basal body configuration is not restored until a few minutes later. Using an antibody generated against the 20-kD Ca2+-modulated contractile protein of striated flagellar roots of Tetraselmis striata (Salisbury, J. L., A. Baron, B. Surek, and M. Melkonian, 1984, J. Cell Biol., 99:962-970), we have found the distal connecting fiber of Spermatozopsis similis to be immunoreactive by indirect immunofluorescence and immunogold electron microscopy. Electrophoretic and immunoblot analysis indicates that the antigen of S. similis flagellar apparatuses consists, like the Tetraselmis protein, of two acidic isoforms of 20 kD. We conclude that the distal basal body connecting fiber is a contractile organelle and reorients basal bodies during the photophobic response in certain flagellated green algae. PMID- 3305527 TI - Membrane phospholipid organization as a determinant of blood cell reticuloendothelial cell interactions. PMID- 3305526 TI - Casein secretion by mammary gland epithelia from collagen gel cultures and lactating glands. AB - Amino acid incorporation experiments show that epithelial cells from lactating mouse mammary glands and from collagen gel culture both synthesize and secrete four principal phosphocaseins (p45, p40, p27, and p23 kD). In both cases, however, the casein production is largely dominated by the p27 species. The average percentage distribution of the above casein species in medium from cultured epithelia is approximately 13%, 6%, 68%, and 14%, respectively; for milk the distribution is approximately 23%, 7%, 54%, and 16%. The predominance of the p27 species is not a consequence of extensive extracellular differential degradation of the secreted caseins since no significant casein degradation was observed in culture medium, either in contact or isolated from epithelial cell monolayers. Synthesis and secretion of all the caseins by cultured epithelia is dependent upon insulin, prolactin, and hydrocortisone. Presumably some intracellular events result in the secretion of p27 as the principal casein in mouse milk. Apparently, some selection factor(s) operate to make p27 a major nitrogenous nutritional component for a newborn mouse. In addition, on a quantitative basis, the relative levels of various caseins secreted by epithelia from lactating mammary glands is essentially duplicated by epithelia in collagen gel culture. PMID- 3305528 TI - Therapeutic progress--review XXVII. High dose chemotherapy in haematological malignancy. AB - Having reviewed conventional chemotherapy of acute leukaemia in the preceding article, a discussion of high dose chemotherapy in haematological malignancy is presented. The indications and side-effects of high dose methotrexate, ifosfamide and etoposide (VP-16) are summarized in tabular form. The toxicity and effectiveness of high dose cytosine arabinoside in the treatment of refractory acute leukaemia is discussed. The use of high dose melphalan to treat patients with multiple myeloma or other tumours is reviewed. The most widely used cytoreductive regimes in bone marrow transplantation, high dose busulphan, high dose cyclophosphamide and total body irradiation are described. PMID- 3305529 TI - Therapeutic progress--review XXVIII. Platelet function and calcium channel blocking agents. AB - Platelets play a major role in the pathogenesis of vascular disorders such as coronary heart disease. The control of platelet function centres on the concentration of free intra-cellular Calcium ions (Ca2+). Increases in intracellular Ca2+ will result in platelet activation and release of substances such as thromboxane A2 which will stimulate further platelet activation and vasoconstriction, leading to vascular damage, thrombosis and ischaemia. Calcium channel blocking agents (CCB's) have the ability to reduce Ca2+ availability and may have potentially beneficial effects on platelet function. CCB's have been convincingly shown to have anti-platelet properties in vitro. They have also shown anti-platelet properties in vivo although this finding has not been consistent. In addition they have been shown to act synergistically with other anti-platelet agents. In the light of the available information it is likely that CCB's have only minor anti-platelet properties in vivo when used alone. Combining CCB's with other anti-platelet agents, however, may allow lower doses of drugs to be used to achieve a satisfactory inhibitory effect on platelet function. Such combination therapy may be of value in the treatment of vascular disorders; however, further studies are required to evaluate these effects in the clinical situation. PMID- 3305530 TI - Endotoxin testing. AB - Parenterals, sterile preparations intended to be injected in man or animal, should be free from pyrogenic substances which are able to raise the thermostatic setting in the hypothalamus. This article gives an up-to-date review of the principal detection and quantification methods for these agents, with special attention on the chromogenic Limulus Amebocyte Lysate assay. PMID- 3305531 TI - A comparison of two incubation temperatures for the isolation of gram-negative contaminants from raw materials and non-sterile pharmaceuticals. AB - Selective and non-selective broth enrichment techniques may be used in the isolation of microbial contaminants from pharmaceutical products. A non-selective method may give better recovery rates for damaged organisms. A trial was carried out to determine whether the recovery of Gram-negative contaminants could be improved by using an incubation temperature of 30 degrees C for 48 h, rather than the more widely used 37 degrees C for 24 h. Contaminants were isolated from 3.2% of samples incubated at the lower temperature compared with 0.8% at the higher temperature. The recovery rate from raw materials improved noticeably (9.0% compared with 0.9%). PMID- 3305532 TI - Micropreparative purification of recombinant human interleukin-2. AB - Recombinant Interleukin-2 (IL-2) is expressed in E. coli as insoluble aggregates; a protocol has been developed for solubilization, renaturation and purification of IL-2 from such aggregates at the 5-10-mg level. IL-2 aggregates were isolated from soluble proteins by centrifugation, subjected to a 1 M guanidine hydrochloride wash and a butan-1-ol wash (the latter to remove lipid), dissolved in 8 M guanidine hydrochloride-10 mM dithiothreitol and partly purified by gel permeation chromatography. Refolding/oxidation was then performed by dilution into Tris-HCl, pH 8.5 containing 1.5 microM copper sulphate to accelerate autoxidation. Final purification was by successive cation-exchange and reversed phase high-performance liquid chromatographic steps, yielding over 99.5% pure IL 2 with an overall recovery of 20%. PMID- 3305533 TI - Purification of the lipopolysaccharide fraction from Klebsiella pneumoniae O1 K2 by high-performance liquid chromatography. AB - An high-performance liquid chromatography technique was applied to purify the lipopolysaccharide fraction from a lysate of Klebsiella pneumoniae O1 K2 (NCTC 5055). The separation of the lipopolysaccharide fraction from the proteins was carried out with a reversed-phase column. By this method the lipopolysaccharide fraction was obtained in a pure state, devoid of proteins but possessing the same biological properties as the lipopolysaccharide fraction prepared by the classical phenol-water technique. PMID- 3305534 TI - Purification and quantitative analysis of urinary prostanoids in human and in rat by packed and capillary gas chromatography-negative-ion chemical-ionization mass spectrometry. AB - We describe a method for the quantitative analysis of prostaglandin (PG) E2 and the major urinary metabolites PGI2 and thromboxane (Tx) A2 in human and in rat by combined gas chromatography and negative-ion chemical-ionization mass spectrometry. The procedure is based on the sequential use of small columns with distinct properties combined with a thin-layer chromatography step, for the extraction and the purification of urinary prostaglandins. The compounds are then analysed as their pentafluorobenzyl ester-O-methyloxime-trimethylsilyl ether derivatives, using either packed or capillary columns. Deuterated analogues are used as internal standards. The method was established by using tritiated prostaglandins covering the extremes of polarity in order to optimize the recovery of prostanoids as well as the quality of the chromatograms and spectra. The overall recovery was 24%. Standard curves were obtained by the same procedure and found to be reproducible, with a maximal day-to-day variation of +/- 5%. The relatively simple approach required for the sequential extraction and purification of prostaglandins on small columns of distinct properties, combined with the highly specific and highly sensitive method of detection, places this procedure among the most reliable method for measuring urinary prostanoids in both humans and animals. In addition, the procedure is faster than classical approaches and necessitates smaller amounts of samples and solvents. PMID- 3305535 TI - Combined high-performance liquid chromatography and enzyme immunoassay for active metabolites of a sleep inducer (rilmazafone), a ring-opened derivative of benzodiazepines, in human plasma. PMID- 3305536 TI - High-performance liquid chromatographic assay for pteroylpolyglutamate hydrolase. AB - A highly sensitive assay for pteroylpolyglutamate hydrolase is described employing high-performance liquid chromatography (HPLC) with ultraviolet detection at 280 nm. The method is based on the separation of pteroylpolyglutamates containing various glutamyl residues on a C18 muBondapak reversed-phase column. Individual pteroylpolyglutamates are eluted by a gradient of 2.5-8.5% acetonitrile in 0.1 M potassium phosphate buffer (pH 6.0) within 20 min. The polyglutamates with higher glutamyl residues were less well retained in the reversed-phase column. The relationship between the peak area and the amount of pteroylpolyglutamate was observed to be linear over the range 10 pmol to 2.5 nmol. Human serum pteroylpolyglutamate hydrolase was studied using pteroylpentaglutamate as substrate in 0.1 M sodium acetate buffer (pH 4.5). The enzyme appeared to function as an exopeptidase based on the detection of intermediates, pteroyltetra-, tri-, and -diglutamate, and the product, pteroylmonoglutamate. Using the HPLC assay, extracts of Plasmodium falciparum were found not to contain detectable enzyme activity. PMID- 3305537 TI - Sensitive method for determination of captopril in biological fluids by gas chromatography-mass spectrometry. AB - A sensitive method for the determination of captopril in blood and urine by gas chromatography-mass spectrometry is described. In order to prevent oxidative degradation of captopril, its sulph-hydryl group was immediately protected by treatment with N-ethylmaleimide (NEM), and the resulting NEM adduct was then converted into the bis(pentafluorobenzyl) derivative. Derivatized captopril was separated on a 2% OV-1 column, exhibiting a single peak of the correct theoretical shape. The detection limit was estimated to be 100 pg by using S benzylcaptopril as an internal standard. The blood level and urinary excretion of unchanged captopril orally administered to dogs were determined by the proposed method. In addition, epimerization of the proline moiety and formation of the sulphoxide or sulphone through the esterification step are also described. PMID- 3305538 TI - Chromatography of complex protein mixtures. AB - This review has shown that a variety of chromatographic techniques are available for fractionating proteins. Fortunately, high-quality columns of every type described in this review are commercially available. Most water-soluble proteins may be eluted from size-exclusion, hydrophobic-interaction, ion-exchange, metal chelate, and bioaffinity columns with ease. When this is the case, high recovery and retention of biological activity are the norm. The exception is reversed phase chromatography where the organic solvents and acids used in polypeptide elution denature many proteins. When problems do occur, they are generally the result of unique structural features of the protein. Very hydrophobic proteins have presented the biggest problem in that they are difficult to solubilize, particularly with retention of biological activity. It has been found that zwitterionic and non-ionic detergents are the most suitable solubilizing agents, but urea has also been used in cases where hydrophobic interacts are not as strong. Unfortunately, there is still an element of trial-and-error in selecting the most suitable solubilizing agent. Heterogeneous glycosylation of proteins also presents a problem. Both neutral and charged monosaccharides can be incorporated into proteins through multiple steps at several sites. Thus, there is the potential in a sample for a large number of glycoprotein species which have the same polypeptide backbone and differing amounts of oligosaccharide. A problem arises when size-exclusion, ion-exchange, hydrophobic-interaction, reversed-phase and bioaffinity systems begin to discriminate between these very similar glycoprotein species. Chromatographic peaks can become very broad, due to incomplete fractionation, and the polypeptide chain of interest can be associated with multiple peaks. The separation of glycoproteins requires much more study before logical procedures can be suggested for column selection and operation. Aggregated species are another class of proteins which present occasional problems. Multimeric proteins are adsorbed to sorbents by a series of forces, among which are hydrogen bonding, hydrophobic interactions, and electrostatic forces. These forces are also responsible for the maintenance of quaternary structure in proteins. When the same forces dominate both retention of protein structure and adsorption at the sorbent surface, the quaternary structure of the protein can be disrupted during elution. Very basic proteins also present a problem in some cases. Columns with residual negative charges, such as a silica based reversed-phase column, adsorb anionic species so strongly that they are difficult to elute.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3305539 TI - Two-dimensional gel electrophoresis of proteins. AB - The high-resolution capacity of two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) makes it an excellent tool for the analysis and characterisation of complex protein mixtures. The evolution of two-dimensional electrophoresis is briefly described. The various steps involved in 2-D PAGE, the identification and characterization of proteins separated by 2-D PAGE and the quantitative and qualitative analysis of 2-D patterns are discussed in detail and some new approaches are described. In the final section a brief outline of some of the biomedical applications of 2-D PAGE to screening of body fluids, genetic diseases, inborn errors of metabolism, cancer and neoplastic transformation are discussed. PMID- 3305540 TI - Extracellular mammalian polysaccharides: glycosaminoglycans and proteoglycans. AB - This review of the mammalian extracellular matrix polysaccharides covered the glycosaminoglycans (GAGs) and their association into proteoglycans. As they necessarily pertain to the chromatographic and electrophoretic separations of these molecules, the structural features of the five principal GAGs were briefly reviewed. Much of the current structural work as well as the separation technology has been concerned with the sulfation state and copolymeric sequences of the individual classes of GAGs. The separation methods discussed included electrophoresis by agarose, acrylamide and cellulose acetate, high-performance liquid chromatography (HPLC), ion-exchange, gel permeation and biospecific affinity methods. Since detection systems are an integral part of chemical separation technology, current thoughts about the best methods to assay GAGs or detect column fractions were discussed. These included polysaccharide-specific detection systems such as Alcian blue dye, 1,9-dimethylmethylene blue, bovine serum albumin-Coomassie blue, as well as non-specific carbohydrate detection systems such as the carbazole or indole hydrochloride methods. Instrumentation used in the detection of chromatography fractions for these molecules was discussed, since the usual ultraviolet detector, standard with HPLC equipment, is often unsatisfactory. The most sensitive specific detection method for GAGs is the use of monoclonal antibodies, which are only now becoming commercially available. The use of these antibodies, combined with HPLC separation, appears to be the best available biochemical technology for studying the extracellular matrix polysaccharides. Finally, the association between proteoglycans, GAGs and mammalian disease processes was reviewed, emphasizing mucopolysaccharidoses and arthritis. The early detection of both of these diseases is desired for effective counselling and treatment. Many of the methods discussed here have been applied, but others are yet to be tried in efforts to further that goal. PMID- 3305541 TI - Column liquid chromatography of integral membrane proteins. AB - Biological membranes have as a major function the compartmentation of biological processes in cells and organelles. They consist of a bilayer of phospholipid molecules in which proteins are embedded. These integral membrane proteins, which cross the bilayer once or several times, generally have a higher than average hydrophobicity and tend to aggregate. Detergents are needed to remove integral membrane proteins from the lipid bilayer and they have to be present during further chromatographic purification. Predominantly, four modes of HPLC have been used alone or in combination for the purification of integral membrane proteins. These are based on differences of proteins in size (size-exclusion chromatography, SEC), electrostatic interaction (ion-exchange chromatography, IEC), bioaffinity (bioaffinity chromatography, BAC) and hydrophobic interaction (reversed-phase chromatography, RPC, and hydrophobic-interaction chromatography, HIC). SEC, IEC, BAC and HIC are used under relatively mild conditions, and buffer systems generally contain a non-ionic detergent. RPC generally has a denaturing effect on the protein and should preferably be used for the purification of integral membrane proteins smaller than 50 kD. PMID- 3305542 TI - Separation of protein hormones. AB - The purpose of this review is to highlight modern techniques in HPLC and electrophoresis used for protein hormone separations. The advent of biotechnological methods for production of synthetic polypeptides and recombinant proteins will have a significant future impact on the types of therapeutics and metabolites that need to be monitored in the clinical laboratory. The protein hormone examples given in this work were selected because of the comprehensive body of separation science literature and not necessarily for their future importance in medicine. The intention was to present an array of general methods and techniques which may be useful to the clinical investigator for analysis of any protein hormone. PMID- 3305543 TI - Sample preparation and column regeneration in biopolymer separations. AB - Successful use of high-performance liquid chromatography (HPLC) for biopolymer separations requires adequate sample preparation procedures for prefractionation of complex mixtures, solubilization of the compounds of interest, or removal of contaminants which would interfere with chromatography or damage the HPLC column. Rapid techniques have been described for solid-phase and liquid-liquid extraction, desalting, detergent removal, concentration, and filtration. A number of commercial products are available for off-line batch sample preparation and for on-line automated sample processing. These include ultracentrifugation cartridges and a wide variety of sorbents sold in bulk form or packed in disposable cartridges or minicolumns. In cases where HPLC column performance has degenerated to unacceptable levels, procedures have been described to achieve partial or complete recovery of performance. These include addition of material to fill voids caused by compaction or dissolution of the packing, replacement or cleaning of contaminated frits, regeneration of lost stationary phase material, and stripping of strongly retained contaminants from the stationary phase with suitable strong solvents. PMID- 3305544 TI - Separation of hemoglobins and hemoglobin chains by high-performance liquid chromatography. AB - This paper evaluates various high-performance liquid chromatographic (HPLC) procedures useful for the detection and evaluation of numerous hemoglobin abnormalities in adults and in newborn infants. Two major approaches are discussed. The first concerns the analyses of hemoglobins in red cell lysates by anion- and cation-exchange chromatography; this type of HPLC has great potential in a routine laboratory, as quantitative data for numerous abnormalities can readily be obtained. The second concerns the separation of globin chains by reversed-phase HPLC that is most useful for the identification of hemoglobinopathies in adults, newborns, and fetuses. PMID- 3305545 TI - General strategies in the separation of proteins by high-performance liquid chromatographic methods. AB - General fractionation strategies for the high-resolution purification of proteins are described. The impact of different separation parameters and resolution optimisation approaches with tandem-based systems on retention and recovery behaviour is reviewed. Procedures for the successful linkage of different chromatographic steps into a preferred sequence of operations are discussed in terms of the underlying principles and modus operandi of high-performance liquid chromatographic purification of proteins and related biomacromolecules. PMID- 3305546 TI - Gel electrophoresis of intact subcellular particles. AB - The review describes the application of gel electrophoresis to the characterization and separation of viruses, ribosomes, vesicles and other subcellular particles. The preparation of the sample, the choice of the buffer, the gel medium, the apparatus and the detection of the particle (staining and scanning) as well as the necessary theory are discussed. This includes the mathematical evaluation of experimental data on the basis of Ferguson plots using the extended Ogston theory. Simple methods and sophisticated computer simulation techniques are described and exemplified in application to the determination of particle size and charge, the pore size of the gel (unpublished data) and the two dimensional agarose electrophoresis (unpublished). It is shown that the nature of the particle (e.g. spherical or rod-shaped, pliable or rigid texture) determines the shape of the non-linear Ferguson plot. In addition, the review gives a number of practical applications of gel electrophoresis, isoelectric focusing, titration curves and immuno-electrophoresis to subcellular particles. Pros and cons are evaluated. A comparison with other analytical procedures is made. The review is concluded by a futuristic outlook. PMID- 3305547 TI - Agarose gel electrophoresis of bacteriophages and related particles. AB - Viruses and related particles have been fractionated by electrophoresis through gels. For agarose gels, the radius at the exclusion limit for spheres varies from 1500 nm in a 0.04% gel to 3.6 nm in a 4.0% gel. Thus, the size of the gel's pores can be adjusted to sieve all known viruses. By measurement of electrophoretic mobility (mu) as a function of agarose concentration, the mu in the absence of a solid support (mu 0) can be determined for any particle. From the shape of a semilogarithmic plot of mu as a function of agarose percentage, a rod-shaped particle can be discriminated from a spherical particle. The sphere's radius can be determined from this plot with an accuracy of +/- 8%. Accuracy of +/- 1% has been more recently achieved using two-dimensional agarose gel electrophoresis. Though bacteriophages have been the primary object of study, the above techniques of agarose gel electrophoresis have also been applied to plant viruses and should be applicable to animal viruses. The mu 0 values measured for bacteriophages with and without their tail fibers suggest a mechanism of controlling attachment to a host. A related mechanism is proposed for the control of the virulence of animal viruses. Measurement of outer radius for different forms of the capsid of bacteriophage P22 reveals variability in outer radius too small to be detected by electron microscopy. PMID- 3305548 TI - Electrophoretic separation of cells. AB - There are several kinds of cell electrophoresis. The most important are free-flow electrophoresis, scaled-up free-flow electrophoresis and column electrophoresis. All kinds of cell electrophoresis, especially free-flow electrophoresis, have been improved to a very high standard of separation accuracy, and their application possibilities are extended when antigen-specific electrophoretic cell separation is performed, or when cell electrophoresis is combined with other physical methods for cell separation. Cell electrophoresis and other physical cell separation methods have the advantage that the functional state of the cells remains virtually unchanged during the isolation procedure. With the help of cell electrophoresis monocytes, T-lymphocytes, platelets and other cells from human peripheral blood could be purified. Other human cells were enriched for immunological characterization. Furthermore, cells that secreted human plasminogen activators or human antibodies were electrophoresed to give cell fractions with increased frequencies of the cells of interest. PMID- 3305549 TI - Non-histone chromatin proteins that recognize specific sequences of DNA. AB - Numerous chromatographic procedures have recently been developed to purify to near homogeneity various eukaryotic non-histone chromatin proteins that recognize and bind to specific sequences of DNA. In this brief review we have discussed a number of these different methods that we feel are important and probably represent the starting points for much of the future research work in this area. We view this coverage as being only an introduction, however, and strongly recommend that the reader consult the original papers for details of methods and protocols. We, nevertheless, hope that the information presented here will be of some assistance to those researchers and students who wish to become acquainted with the latest developments in this rapidly advancing field of chromatography. Although it is evident from what has been presented that the purification of each DNA sequence-specific non-histone chromatin protein initially starts with common or classical isolation and fractionation procedures, the final (and often crucial) steps of enrichment and purification often involve distinctive or unique procedures for each individual protein of interest. In many cases these final steps involve new techniques such as DNA sequence-specific bioaffinity and photoaffinity chromatography which not only ensure the isolation of specific protein species from complex mixtures but also result in a tremendous enrichment for nuclear proteins that are often present in the nucleus in extremely low concentrations. Furthermore, the entire process of protein purification has been remarkedly facilitated with the advent of high-performance liquid chromatographic and fast protein liquid chromatographic techniques which now allow for the very rapid separation and purification of proteins in a matter of minutes from mixtures that in the recent past would have required hours or days to purify. Thus, separation and purification techniques are now available that set the stage for the rapid isolation of rare, DNA sequence-specific, NHC nuclear proteins from almost any cellular source. It is therefore reasonable to anticipate that in the near future there will be major advances made in our understanding of the specific nuclear proteins that regulate gene expression in eukaryotic cells. PMID- 3305550 TI - Physiological concentrations of cholecystokinin stimulate amino acid-induced insulin release in humans. AB - After a meal, hormones released from the gut potentiate insulin release. This study was undertaken to determine if physiological concentrations of plasma cholecystokinin (CCK) stimulate insulin secretion in man. Employing a specific CCK bioassay, postprandial CCK levels were determined in normal subjects. Ingestion of a mixed liquid meal stimulated an increase in circulating CCK from a mean fasting level of 0.9 +/- 0.2 (SEM) pmol/L to a mean peak level of 7.1 +/- 1.1 pmol/L within 10 min of feeding. After 30 min the mean CCK level fell to 3.5 pmol/L and remained elevated for the remainder of the 90-min experiment. Eight subjects underwent 40-min infusions of either arginine (15 g), mixed amino acids (15 g), or glucose (30 g) with or without the simultaneous infusion of CCK-8. Since CCK-8 has full biological potency, this form was chosen for infusion to reproduce total CCK bioactivity in plasma. CCK-8 was infused at rates of 12 or 24 pmol/kg X h, producing steady state plasma CCK levels of 4.5 +/- 0.7 and 8.2 +/- 1.1 pmol/L, respectively, spanning the range of normal postprandial levels. CCK alone had no effect on insulin, glucose, or glucagon levels. Administration of arginine alone stimulated insulin from a mean basal level of 12.8 +/- 1.3 microU/mL to a peak level of 41.3 +/- 5.4 microU/mL. Infusion of CCK at 12 and 24 pmol/kg X h augmented arginine-stimulated insulin levels to peaks of 62.5 +/- 13.9 and 63.0 +/- 4.0 microU/mL, respectively. Moreover, CCK nearly doubled the total amount of insulin secreted during the arginine infusion. A similar potentiation of glucagon release was found with both doses of CCK. In addition, infusion of a mixture of amino acids with and without concomitant CCK infusions revealed that CCK potentiated the insulin release induced by mixed amino acids. In contrast to the potent effect of CCK on amino acid-induced insulin release, infusions of CCK together with glucose caused no enhancement of glucose stimulated insulin release. These results demonstrate that physiological concentrations of CCK potentiate amino acid (but not glucose)-induced insulin secretion in man. These data suggest, therefore, that CCK may have a role in man as a modulator of insulin release. PMID- 3305552 TI - Secretory endometrial and decidual proteins: studies and clinical significance of a maternally derived group of pregnancy-associated serum proteins. AB - In contrast to our ability to monitor placental function during pregnancy, due to the availability of a range of placentally derived secretory products such as HCG, HPL, SP1, PAPP-A, etc. the equivalent monitoring of the endometrial function in implantation and pregnancy has been impaired by a lack of equivalent endometrial products. Decidual diamine oxidase and prolactin have been extensively characterized but each have clinical drawbacks and may indeed be minor products of the endometrium. Recent developments in the characterization of the major secretory protein products of the endometrium, and a re-assessment of the origin of a number of placental proteins, radically alter our ability to monitor endometrial function, offer a new clinical window on pregnancy and might provide new knowledge on the extent of feto-maternal dialogue at implantation and during pregnancy. In this review, aspects of many scientific studies, and the function and possible clinical significance of these endometrial and decidual protein products are assessed. PMID- 3305551 TI - Characterization of groups of hyperandrogenic women with acanthosis nigricans, impaired glucose tolerance, and/or hyperinsulinemia. AB - This study examined the prevalence of both basal and glucose-stimulated hyperinsulinemia and acanthosis nigricans (AN) as well as the relationship between insulin and androgen levels in hyperandrogenic women. Sixty-two women who had an elevation of 1 or more plasma androgen levels were studied. The results in these women, grouped for analysis on the basis of obesity and ovulatory status, were compared to those in 36 control women of similar ages and weights. The anovulatory hyperandrogenic women had the clinical and biochemical features of the polycystic ovary syndrome (PCO). Oral glucose tolerance tests were performed with measurement of glucose, insulin, sex hormone-binding globulin (SHBG), and total and non-SHBG-bound sex steroid levels. AN was present in 29% of the hyperandrogenic women, the majority of them obese. Fifty percent of obese PCO women had AN, but they did not otherwise differ from PCO women lacking this dermatological change. Only women with PCO had significant hyperinsulinemia independent of obesity, and obese PCO women with AN had the highest serum insulin levels. Plasma glucose values during the oral glucose tolerance test were significantly increased in obese PCO women independent of the presence of AN, and 20% of these women had frank impairment of glucose tolerance. Ovulatory hyperandrogenic women had normal insulin levels and glucose tolerance. Obese and nonobese women had different relationships between sex steroid and insulin levels; obese women had significant correlations between insulin and non-SHBG testosterone levels (r = 0.30; P less than 0.05), whereas nonobese women had significant correlations between insulin and FSH (r = 0.40; P less than 0.01), dehydroepiandrosterone sulfate (r = 0.33; P less than 0.05), and SHBG (r = 0.37; P less than 0.05) levels, suggesting that the mechanisms underlying the association between sex steroid and insulin levels are complex. These findings suggest that 1) only women with PCO have hyperinsulinemia independent of obesity; hyperinsulinemia is not a feature of hyperandrogenic states in general; 2) AN is a common finding in obese hyperandrogenic women, particularly those with PCO; 3) only obese PCO women are at risk for impairment of glucose tolerance, independent of the presence of AN, suggesting that the negative impact of PCO and obesity on insulin action is additive; and 4) PCO women with AN can be considered as a subgroup of PCO and do not appear to have a distinct endocrine disorder. PMID- 3305553 TI - Causes of early embryonic loss in human pregnancy. PMID- 3305554 TI - Human fertilization in vivo, with special reference to progression, storage and release of competent spermatozoa. AB - Whilst very large numbers of spermatozoa accumulate in the cervical mucus and crypts in the hours following coitus, evidence is offered from species with comparable gonadotrophin surge-to-ovulation intervals to suggest that the cervix is not the site of the functional sperm reservoir in women. On the contrary, human spermatozoa involved in the events of fertilization may spend the greater part of the pre-ovulatory interval in the distal portion of the Fallopian tube, that is in the intra-mural segment. This would enable spermatozoa to be arrested within reach of the site of fertilization in the ampullary region of the tube, and to be activated and released close to the time of ovulation by means of a local transfer of high concentrations of ovarian follicular hormones. The clinical importance of confirming this proposed role for the intra-mural segment of the tube is stressed, as is the possibility of specific micro-environments within the lumen of the duct. PMID- 3305555 TI - Gene transfer into mammalian embryos. AB - Transgenic mice provide a unique system fusing classical genetics with molecular biology. They enable the dissection of molecular mechanisms underlying the control of growth and differentiation, issues we only dreamed of 20 years ago. The transgenic technology can be expected to be applied also in areas like eugenetics of animal production systems as well as genetic farming. The technology does not give an acceptable alternative for the direct treatment of human disease. However it provides unique possibilities to study genetic defects in a genetically well-defined mammalian model system. The years to come will teach us which of these expectations will come true. PMID- 3305556 TI - Historic trials: Montreal Tramways v. Leveille (1933) 4 DLR 338. AB - This trial concerned an injury in a newborn child which was allegedly caused by an accident involving the mother during her pregnancy. The trial is widely accepted as a turning-point in law related to fetal injury, conferring the right of a child to claim compensation at birth for injuries inflicted during pregnancy. This material is reproduced with the permission of the publisher, Canada Law Book Inc., 240 Edward Street, Aurora, Ontario L4G 3S9, Canada. PMID- 3305557 TI - Simplified acetylcysteine-alkali digestion-decontamination procedure for isolation of mycobacteria from clinical specimens. AB - During our attempts to reevaluate and improve mycobacteriology laboratory procedures, we found that isolation of mycobacteria from undecontaminated specimens through the use of selective media was unrewarding and that specimen decontamination was an essential step. A reevaluation of the N-acetyl-L-cysteine sodium hydroxide (NALC-NaOH) decontamination procedure (G. P. Kubica, W. E. Dye, M. L. Cohn, and G. Middlebrook, Am. Rev. Respir. Dis. 87:775-779, 1963) indicated that this method could be simplified and shortened without affecting the isolation rate or growth and without increasing the contamination rate. The modified NALC-NaOH procedure effectively combines the decontamination step with the concentration step: specimens are mixed with the NALC-NaOH solution on a Vortex mixer and, without any waiting or addition of buffer or water to the digested specimens, centrifuged at 3,000 X g for 15 min, and the sediment is suspended in phosphate buffer (pH 5.3). The modified method is simpler, faster, and safer than the original procedure, and the reduced manipulation is also likely to minimize the chance for cross-contamination in sequential specimen processing. The total alkali exposure time in the modified NALC-NaOH method should be kept to a minimum; if necessary or feasible, the concentration of NaOH in the digestion solution may be reduced from the usual strength of 2% to about 1.5% to compensate for the longer alkali exposure time in the modified method to maintain the isolation rate or to improve it. PMID- 3305558 TI - Evaluation of passive particle agglutination test for antibody to human immunodeficiency virus. AB - A gelatin particle agglutination assay was compared with indirect immunofluorescence by using 663 serum samples from acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related complex patients and asymptomatic male homosexuals in the United States and from hemophiliacs and healthy adult controls in Japan. The results showed that all 104 samples which were positive by indirect immunofluorescence were also positive by particle agglutination, while 5 additional samples were positive by particle agglutination only. The coincidence rate for antibody-positive and antibody-negative specimens was 99% (658 of 663) between particle agglutination and immunofluorescence. Four of the five samples which were positive by particle agglutination only were found by radioimmunoprecipitation to contain anti-env gene products of human immunodeficiency virus. Antibody titers of samples giving a positive reaction by particular agglutination varied from low (titer, 256) to remarkably high (256 X 10(5)). All specimens having particle agglutination titers of more than 10(5) were positive by immunofluorescence. A high correlation (r = 0.66) was observed between the titers of antibodies determined by particle agglutination and those determined by immunofluorescence. After fractionation of a serum sample from an individual at high risk by using high-performance liquid chromatography, it was shown that immunoglobulin M as well as immunoglobulin G human immunodeficiency virus antibody was detected by particle agglutination. Additional serum samples with a potential risk of giving false-positive results, such as heat-treated specimens, specimens containing antibodies to HLA, specimens containing auto antibodies, and serum samples from individuals with a history of multiple blood transfusions, were shown to be clearly negative by particle agglutination. PMID- 3305560 TI - Comparison of sensitivity of BHK-21 and murine neuroblastoma cells in the isolation of a street strain rabies virus. AB - The sensitivities of BHK-21 (C-13) and murine neuroblastoma (C-1300; clone NA) cells for the isolation of small quantities of a street strain rabies virus were compared. Suspensions of brain from mice sacrificed prior to the onset of clinical signs of rabies were used to stimulate weakly positive diagnostic specimens. The results of cell culture isolation were compared with those of the direct fluorescent-antibody test and virus isolation in weanling mice. Neuroblastoma cells were more sensitive to the street strain rabies virus than were BHK-21 cells. Neuroblastoma cell virus isolation, the mouse inoculation test, and the fluorescent-antibody test all showed comparable sensitivity. PMID- 3305561 TI - Pseudoepidemic of aspergillosis after development of pulmonary infiltrates in a group of bone marrow transplant patients. AB - During February and March 1985, seven patients in the pediatric bone marrow transplant unit (PBMTU) of a 350-bed cancer hospital developed pulmonary infiltrates. Five of the patients had Aspergillus spp. isolated from the respiratory tract, and two of these patients had histologic evidence of aspergillosis. Between 26 February and 22 April, Aspergillus spp. were isolated in a total of 70 cultures from 39 hospitalized patients. Of the 70 cultures, 14 (group 1) were from respiratory specimens of PBMTU patients with pulmonary infiltrates and were submitted to the laboratory intermittently over the 56-day period. However, of the other 56 Aspergillus-positive cultures (group 2), 41 (73%) were submitted on six days during this period (P less than 0.001, chi square goodness of fit), including 8 blood cultures submitted on one day. When Aspergillus sp. was recovered from group 1 cultures early during this period, the isolates were stored in the culture-processing room. Aspergillus isolates were not handled in a biological safety cabinet, and blood cultures were done by using a system which requires opening of an evacuated bottle to room air. The presence of stored Aspergillus isolates was associated with a markedly elevated concentration of airborne fungi in the culture-processing room. After removal of the stored Aspergillus isolates from the culture-processing room, the concentration of airborne fungi returned to background level and there were no further Aspergillus-positive cultures. These findings suggested that group 2 cultures had been contaminated by stored Aspergillus isolates. No evidence for a common source of infection was found in the PBMTU patients with pulmonary infiltrates. PMID- 3305559 TI - Identification of enterotoxigenic Escherichia coli with synthetic alkaline phosphatase-conjugated oligonucleotide DNA probes. AB - Alkaline phosphatase-conjugated (AP) 26-base oligonucleotide DNA probes were compared with the same probes labeled with gamma-32P for the identification of heat-labile (LT) and heat-stable (ST) enterotoxigenic Escherichia coli (ETEC). The AP oligonucleotide probes were as sensitive as the radiolabeled (RL) probes in detecting LT and STA-2 target cell DNA, but the AP ST probe, which differed from STA-1 by two bases, was less sensitive than the RL probe in detecting STA-1 DNA (6.25 versus 0.78 ng). Of 94 ETEC that were identified with the RL probe, the AP probes detected 93% (28 of 30) of ST, 73% (25 of 34) of LT, and 67% (20 of 30) of LTST ETEC. When colony lysates of these ETEC were examined, the AP probes identified all 94 ETEC. In examinations of stool blots, the RL and AP probes were shown to have sensitivities of 71 and 59%, specificities of 91 and 86%, positive predictive values of 87 and 73%, and negative predictive values of 86 and 74%, respectively. AP oligonucleotide probes to detect ETEC were less sensitive in detecting ETEC by colony or stool blot hybridization than the RL probes but could be used by laboratories without access to radioisotopes to examine colony lysates. PMID- 3305562 TI - Two-site immunoradiometric assay for detection of Plasmodium falciparum antigen in blood using monoclonal and polyclonal antibodies. AB - Three systems of immunoradiometric assays (IRMAs), a two-site monoclonal antibody sandwich IRMA (MAb-IRMA), two-site polyclonal antibody-monoclonal antibody sandwich IRMA (PAb-MAb-IRMA), and two-site polyclonal antibody sandwich IRMA (PAb IRMA), were developed to detect low-grade infections with Plasmodium falciparum. The assays showed good correlation with parasitemia when tested against parasites from in vitro cultures (r = 0.996, 0.994, and 0.998 for MAb-, PAb-MAb-, and PAb IRMA, respectively), with the ability to detect as few as 0.24, 0.67, and 1.82 parasites per 10(7) erythrocytes, respectively. The assays were specific for P. falciparum, since a serially diluted specimen from a patient with vivax malaria with an initial parasitemia of 0.8% and almost all of the undiluted specimens from five other vivax malaria patients were negative. The assays were performed on patients with falciparum malaria before and after treatment with antimalarial drugs. Before treatment, all 24 patients were positive by all three systems of two-site sandwich IRMAs. Two weeks after treatment, 81.8% (18 of 22) of the patients were positive by microscopic examination, but the IRMA positivity rates were 90.9% (20 of 22), 86.4% (19 of 22), and 81.8% (18 of 22) for MAb-, PAb-MAb-, and PAb-IRMA, respectively. Four weeks after treatment, all 19 patients were negative by microscopic examination, but 52.6% (10 of 19) of the patients were still positive with MAb- and PAb-MAb-IRMA and 31.6% (6 of 19) were positive with PAb-IRMA. Comparison between the three systems of IRMA showed that the MAb-IRMA was superior to the other two systems for three reasons. First, it gave a lower count when tested with blood from healthy individuals. Second, it gave a higher count when tested with blood from patients with falciparum malaria. Third, it gave better correlation with parasitemia when blood from falciparum malaria patients was tested. MAb-IRMA is recommended for use for the detection of low grade P. falciparum infection. PMID- 3305563 TI - HeLa cell-adherent enteropathogenic Escherichia coli in children under 1 year of age in Thailand. AB - Enteropathogenic Escherichia coli (EPEC) was isolated from 11% of 148 Hmong children under 1 year old with diarrhea at a refugee camp in northern Thailand. Of 16 children with EPEC-associated diarrhea, 11 were infected with EPEC that adhered to HeLa cells in a diffuse pattern, 3 were infected with EPEC that adhered to HeLa cells in a localized adherence (LA) pattern, and 2 were infected with EPEC that were nonadherent. In Bangkok, EPEC was isolated from 6% of 64 children under 1 year old with diarrhea and 7% of 56 children of the same age without diarrhea. Of four children with diarrhea, two were infected with EPEC with an LA pattern, and two were infected with nonadherent EPEC. Of four children without diarrhea, one was infected with EPEC with an LA pattern, one was infected with EPEC that adhered in a diffuse pattern, and two were infected with nonadherent EPEC. The 21 EPEC isolates with an LA pattern hybridized with the EPEC adherence factor DNA probe. EPEC was the only enteric pathogen identified in 16 (80%) of 20 children with EPEC-associated diarrhea. EPEC was as frequently isolated from children under 1 year old as were other bacterial enteric pathogens. The problem of identifying EPEC with pools of polyvalent antisera are described, and the need to identify additional enteropathogenic determinants of EPEC is discussed. PMID- 3305564 TI - Unusual verotoxin-producing Escherichia coli associated with hemorrhagic colitis. AB - All strains of Escherichia coli isolated from cases of hemorrhagic colitis and sent to the Centers for Disease Control, Atlanta, Ga., over a 3-year period were assayed for toxicity in Vero cell cultures. Strains that produced moderate or high levels of verotoxin were characterized by serotype, biotype, antimicrobial resistance, plasmid profile, and adherence to HeLa cells. Over 200 isolates were typical O157:H7 strains. Six isolates were atypical O157:H7 strains; two were resistant to antimicrobial agents; one was indole negative, two were citrate positive, and one was urea positive. Six isolates were nonmotile O157 strains. All of these isolates were similar to typical O157:H7 strains by plasmid profile and negative or slow sorbitol fermentation. Eleven other verotoxigenic isolates did not possess the O157 antigen, had a variety of plasmid profiles, and were sorbitol positive. Two of the eleven were enteropathogenic serotypes (O111:NM and O26:H11), yet none were adherent to HeLa cells. We conclude that verotoxigenic E. coli associated with hemorrhagic colitis includes atypical O157 strains and other serotypes. Hence, investigators should use current screening methods with caution. PMID- 3305565 TI - New infectious spirochete isolated from short-tailed shrews and white-footed mice. AB - A spirochete with two periplasmic flagella was isolated from the blood or tissues of spleens and kidneys from short-tailed shrews (Blarina brevicauda) and white footed mice (Peromyscus leucopus) in Connecticut and Minnesota. After inoculation, the shrew-mouse spirochete infected Swiss mice and Syrian hamsters. This spirochete is morphologically and serologically distinct from the species of Treponema, Borrelia, Leptospira, and Spirochaeta examined. PMID- 3305566 TI - Prevalence of Borrelia burgdorferi in white-footed mice and Ixodes dammini at Fort McCoy, Wis. AB - Borrelia burgdorferi, the causative agent of Lyme disease, was isolated from 15 of 17 white-footed mice (Peromyscus leucopus) and 54 of 82 subadult Ixodes dammini from Fort McCoy, Wis. Of the 47 isolates tested, all reacted in indirect fluorescent-antibody tests with monoclonal antibodies directed against a surface protein of B. burgdorferi (approximate molecular weight, 31,000) and flagellins that are common to all Borrelia species. Indirect fluorescent-antibody reactions were variable when an antibody that binds to a surface protein with an approximate molecular weight of 34,000 was tested. The major proteins of isolates from ticks and mice had approximate molecular weights of 31,000, 34,000, and 41,000. Antibodies to B. burgdorferi were present (titer, greater than or equal to 1:64) in 16 of 97 white-tailed deer (Odocoileus virginianus). The mean number of subadult I. dammini on mice captured in June 1986 was 6.5, and the mean number of adult I. dammini on deer killed in November 1986 was 5.9. The presence of ticks and the high prevalence of I. dammini and mice infected with B. burgdorferi establish that Fort McCoy is an area in which the Lyme disease agent is highly endemic, even though there have been relatively few documented cases in humans. The low number of reported cases in humans may be a result of National Guard and reserve unit personnel returning home to civilian life and having symptoms expressed subsequently, or it could be due to misdiagnosis or nonreporting. PMID- 3305567 TI - HeLa cell adherence and cytotoxin production by enteropathogenic Escherichia coli isolated from infants with diarrhea in Thailand. AB - Enteropathogenic Escherichia coli (EPEC) strains isolated from hospitalized infants with diarrhea in Thailand were examined for HeLa cell adherence and cytotoxin production. Of 101 strains examined, 56 adhered to HeLa cells in a localized pattern (LA), 27 adhered in a diffuse pattern (DA), and 18 did not adhere. All 56 LA EPEC strains were O:K serotype O119:K69. A total of 20 (83%) of 24 EPEC O86:K61 strains and 7 (38%) of 19 EPEC strains belonging to six other O:K serotypes exhibited DA. All LA EPEC strains hybridized with a DNA probe for genes encoding EPEC adherence factor, whereas none of the 27 DA or 18 nonadherent EPEC strains hybridized with EPEC adherence factor probe. Sonic extracts of 57 (58%) of 98 EPEC strains tested at a dilution of 1:100 caused greater than 25% mortality of HeLa cell monolayers. A total of 50 (88%) of 57 cytotoxic sonic extracts were inhibited to various degrees by a 1:500 dilution of polyclonal rabbit antisera to purified Shiga toxin. The mean percent inhibition of cytotoxic sonic extracts by anti-Shiga toxin was 67% (range, 29 to 89%). Fifty percent (38 of 56) of LA EPEC strains, fifty-two percent (14 of 27) of DA EPEC strains, and fifty-three percent (8 of 15) of nonadherent EPEC strains produced Shiga-like toxins. Both adherence and low levels of cell-associated cytotoxins were identified in EPEC strains from Thailand, but there did not appear to be an association between these two factors. PMID- 3305568 TI - Subgroup characteristics of respiratory syncytial virus strains recovered from children with two consecutive infections. AB - Respiratory syncytial virus strains from 13 children who had repeat infections at least 1 year apart were identified as either subgroup A or subgroup B according to reaction patterns with several monoclonal antibodies directed against the large surface glycoprotein (G), fusion protein (F), nucleoprotein (NP), and matrix protein (M). The virus strains were characterized by enzyme immunoassay, polyacrylamide gel electrophoresis, and immunofluorescence procedures. During the first infection, 10 children had subgroup A strains and 3 had subgroup B strains. Of the 10 children with subgroup A strains during their first infection, 6 had subgroup B and 4 had subgroup A strains during the second infection. Of the three children with subgroup B strains during their first infection, one had subgroup A and two had subgroup B strains during their second infection. No child experienced unusually severe respiratory tract illnesses during second infections with respiratory syncytial virus. Fourfold or greater rises in serum antibody as determined by enzyme immunoassay were as common after the first infection as after the second infection among the seven children tested. Thus, second infections with strains of either subgroup of respiratory syncytial virus did not potentiate respiratory illness, and infection with subgroup A strains of respiratory syncytial virus provided some protection from a second infection with the homologous, but not the heterologous, subgroup of the virus. PMID- 3305569 TI - Serogrouping single colonies of beta-hemolytic streptococci with achromopeptidase extraction. AB - Achromopeptidase (TBL-1; Wako Chemicals, USA, Inc., Dallas, Tex.) prepared as a 2,000-U/ml solution will extract the serogroup antigens from single colonies of groups A, B, C, F, and G streptococci in 1 min at room temperature. This enzyme extraction is not effective for the serogrouping of all group D streptococcus species. Achromopeptidase extracts can be used with latex or coagglutination reagents. PMID- 3305570 TI - Differential response of rat splenic lymphocytes to short-term and long-term neuroendocrine challenges: possible desensitization of the cellular immune response to corticosteroids. AB - The effects of acute or chronic in vivo or in vitro exposures to supra physiologic doses of isoproterenol, insulin or dexamethasone on rat splenic lymphocyte proliferation were investigated. Acutely, all in vivo challenges inhibited mitogen-induced lymphocyte proliferation, and correlated to increased corticosterone levels. However, chronic in vivo exposure to dexamethasone resulted in lymphocyte activity which was equivalent to controls, while chronic isoproterenol treatment enhanced the lymphocyte response to mitogen. These data suggest that chronic stress may result in a desensitization of the immune system to corticosteroids as well as a direct in vivo modulation by isoproterenol to enhance lymphocyte proliferation. PMID- 3305571 TI - How hyperventilation alters the electroencephalogram: a review of controversial viewpoints emphasizing neurophysiological mechanisms. AB - This paper reviews the literature on the EEG effects of hyperventilation, with particular emphasis on the literature concerning the mechanism of EEG slowing with hyperventilation. We suggest that there is no definite evidence to support the theory that the EEG slowing and "activation" are caused by hypoxia secondary to cerebral vasoconstriction induced by hypocapnia during voluntary hyperventilation. Since it is known that hypocapnia produces decreased activity in the mesencephalic reticular formation and that lesions of the thalamus abolish the hyperventilation response, we propose a strong, albeit speculative, analogy between awake-sleep transitory states and the mechanism of EEG "activation" by hyperventilation. Furthermore, it is proposed that both the EEG changes and the associated clinical symptomatology (as well as changes in level of anesthesia, which vary with arterial PCO2) may be explained by altered arousal, and that the vasoconstriction observed during hyperventilation is a central neurogenic response to hypocapnia at a brainstem level. PMID- 3305572 TI - Intraoperative evoked potential monitoring. AB - There has been a tremendous growth in the use of evoked potential techniques in the orthopedic and neurosurgical operating rooms. The popularity of evoked potential monitoring has evolved from the surgeon's need to know the impact of surgical manipulations on the central nervous system. It is safe and practical to monitor the electrophysiological function of the cortex, brainstem, cranial nerves, and motor and sensory pathways in the spinal cord utilizing evoked potential techniques. This paper presents a review of these techniques. PMID- 3305573 TI - Generators of human spinal somatosensory evoked potentials. AB - Somatosensory evoked potentials recorded over the spine with a noncephalic reference following posterior tibial nerve stimulation have several components. (1) A stationary, synapse-dependent, negative potential (N22) occurs synchronously with a positive potential, P22, recorded ventral to the spinal cord and is localized to the lumbar region overlying the lumbar root entry zone. The N22/P22 complex is attributed to activation of interneurons in the dorsal gray of the lumbar cord. (2) A traveling negative potential with a gradually increasing latency may be recorded from the sacral to the cervical region. Its short refractory period indicates that it is not dependent on transmission across a synapse. This activity is attributed to transmission of the afferent volley through the lumbosacral plexus, roots, and the dorsal columns of the spinal cord. (3) N29, a stationary, synapse-dependent negative potential, localizes to the rostral cervical spine and is attributed to activation of the gracile nucleus relay cells. Following stimulation of the median nerve or fingers, the waveforms recorded over the cervical spine with a noncephalic reference include (1) the proximal plexus volley, a traveling negative potential reflecting transmission through the proximal brachial plexus and roots; (2) the dorsal column volley (DCV), the latency of which gradually increases from the caudal to rostral cervical region (the DCV is attributed to transmission of the afferent volley through the dorsal columns of the cervical cord); and (3) N13, a stationary negative waveform, with a long refractory period consistent with its dependence on transmission across a synapse. Experimental animal and human studies indicate that the N13 waveform is dependent on activity of at least two generator sites, namely the dorsal gray of the cervical cord and the cuneate nucleus. PMID- 3305574 TI - Sonographic measurement of vertebral dislocation in spondylolisthesis. AB - The vertebral dislocation in spondylolisthesis was measured by both sonography and roentgenography in 20 patients with spondylolysis and 6-28 mm of spondylolisthesis. The two methods were applied independently of each other. The difference between the sonographic and roentgenographic measure of vertebral dislocation was 0-3 mm (mean 1.3 mm). The accuracy of sonography is sufficient for clinical work. The advantage of sonography is that the radiation burden of patients with spondylolysis can be decreased by replacing roentgenographic follow up with sonography. PMID- 3305575 TI - Estradiol modulates the pulsatile secretion of biologically active luteinizing hormone in man. AB - We investigated the effects of estradiol on bioactive luteinizing hormone (LH) release in normal men using two complementary strategies: (i) steady state intravenous infusions of estradiol at its endogenous production rate, and (ii) oral administration of the antiestrogen, tamoxifen HCl. Immunoreactive and biologically active LH were monitored by radioimmunoassay and the rat interstitial cell testosterone bioassay, respectively. Estradiol infusions significantly suppressed mean plasma bioactive LH concentrations and decreased the bio/immuno LH ratio. Conversely, antiestrogen treatment enhanced spontaneous bioactive LH pulse frequency, increased bioactive LH pulse amplitude, and augmented plasma intrapulse and interpulse bio/immuno LH ratios. Low-dose pulsed injections of exogenous gonadotropin-releasing hormone (GnRH) also increased plasma bio/immuno LH ratios. However, tamoxifen attenuated the ability of exogenous GnRH to further enhance the bio/immuno LH ratio, which suggests that endogenous LH release was already maximally enriched in LH bioactivity during antiestrogen administration. We conclude that estradiol modulates the pulsatile secretion of LH molecules enriched in biological activity in man. PMID- 3305576 TI - Purified cytochrome b from human granulocyte plasma membrane is comprised of two polypeptides with relative molecular weights of 91,000 and 22,000. AB - A new method has been developed for purification of cytochrome b from stimulated human granulocytes offering the advantage of high yields from practical quantities of whole blood. Polymorphonuclear leukocytes were treated with diisopropylfluorophosphate, degranulated and disrupted by nitrogen cavitation. Membranes enriched in cytochrome b were prepared by differential centrifugation. Complete solubilization of the cytochrome from the membranes was achieved in octylglucoside after a 1-M salt wash. Wheat germ agglutinin-conjugated Sepharose 4B specifically bound the solubilized cytochrome b and afforded a threefold purification. Eluate from the immobilized wheat germ agglutinin was further enriched by chromatography on immobilized heparin. The final 260-fold purification of the b-type cytochrome with a 20-30% yield was achieved by velocity sedimentation in sucrose density gradients. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of the purified preparation revealed two polypeptides of Mr 91,000 and Mr 22,000. Treatment of the 125I labeled, purified preparation with peptide:N-glycosidase F, which removes N linked sugars, decreased relative molecular weight of the larger species to approximately 50,000, whereas beta-elimination, which removes O-linked sugars, had little or no effect on the mobility of the Mr-91,000 polypeptide. Neither of the deglycosylation conditions had any effect on electrophoretic mobility of the Mr-22,000 polypeptide. Disuccinimidyl suberate cross-linked the two polypeptides to a new Mr of 120,000-135,000 by SDS-PAGE. Antibody raised to the purified preparation immunoprecipitated spectral activity and, on Western blots, bound to the Mr-22,000 polypeptide but not the Mr-91,000 polypeptide. Western blot analysis of granulocytes from patients with X-linked chronic granulomatous disease revealed a complete absence of the Mr-22,000 polypeptide. These results (a) suggest that the two polypeptides are in close association and are part of the cytochrome b, (b) provide explanation for the molecular weight discrepancies previously reported for the protein, and (c) further support the involvement of the cytochrome in superoxide production in human neutrophils. PMID- 3305578 TI - An appreciation of Paul Tessier. PMID- 3305577 TI - Enzyme immunoassay measurement of thymosin beta 4. AB - An enzyme immunoassay for the measurement of thymosin beta 4, a chemically characterized thymic polypeptide, is described. A limited amount of reagent antiserum to synthetic thymosin beta 4 is incubated with liquid-phase thymosin beta 4. Unbound antibody is then incubated with solid-phase thymosin beta 4. The method is specific, sensitive, highly reproducible and capable of detecting as little as 2.5 ng/ml of thymosin beta 4. PMID- 3305579 TI - A long time ago... PMID- 3305580 TI - Elective osteotomies and bone grafting of irradiated midfacial bones. AB - Elective osteotomies of post-irradiated midfacial bones to correct the resulting facial deformities can be safely performed. When there is an associated radiation induced enophthalmos, improvement in appearance can be achieved, but the results often falls short of an ideal restoration. Transposing a temporalis flap into the orbit is an excellent means of freeing the irradiated, contracted, enucleated orbital socket. PMID- 3305581 TI - Changes in zygomatic arch position following experimental lateral displacement. AB - In order to obtain information about the stability of augmentation procedures in the area of the zygomatic arch, the zygomatic arch on one side was displaced laterally in eight rhesus monkeys by an osteotomy of the anterior portion of the arch and placement of an 8 mm bone graft obtained from the supraorbital ridge. The other side served as a control. The post-operative changes were studied on submento-vertex head films during a 24 month follow-up period. Three months post operatively the amount of lateral displacement was reduced by 55%. During the next 9 months of follow-up only small changes occurred in the individual animals, and the mean values remained predominantly unchanged. Between 12 and 24 months the distance from the zygomatic arch to the midline increased with growth. On the control side this distance increased from three months on. At 24 months only 18% of the difference in width that was created by the surgical repositioning remained. PMID- 3305582 TI - Shortening and lengthening the chin. AB - Methods of altering the vertical dimension of the chin by subtraction or addition of bone are discussed. Results of chin lengthening have improved with the use of miniplate fixation, and the technique currently preferred utilizes an interpositional bone graft from outer table calvarium. PMID- 3305583 TI - Expression of class II major histocompatibility complex antigens on alveolar epithelium in interstitial lung disease: relevance to pathogenesis of idiopathic pulmonary fibrosis. AB - To determine whether expression of class II major histocompatibility complex antigens on alveolar epithelium is relevant to the pathogenesis of idiopathic pulmonary fibrosis (IPF) lung biopsy specimens were investigated from nine patients with IPF with or without connective tissue disease, four patients with sarcoidosis, eight patients with lung disease of presumably infectious origin, and five controls. The alveolar epithelium stained strongly with anti-Ia (HLA-DR) or Leu 10 (HLA-DS) monoclonal antibodies, in eight of nine biopsy specimens from patients with IPF, in three of four biopsy specimens from patients with sarcoidosis, in all six biopsy specimens from patients with presumably viral, mycobacterial, or pneumocystic lung disease, but not in control lung tissue, nor in two biopsy specimens from patients with bacterial pneumonia. Mononuclear cell infiltrates consisted of T4 positive (helper/inducer) lymphocytes, predominantly present in a nodular arrangement in the interstitium, and T8 positive (cytotoxic/suppressor) cells, distributed equally in the interstitium and subepithelially or intraepithelially. T8 cells outnumbered T4 cells in six of nine biopsy specimens from patients with IPF, but in none of the biopsy specimens from patients with sarcoidosis or interstitial lung disease of infectious origin. Although the expression of class II antigens on the alveolar epithelium which is infiltrated by T8 cells in IPF is consistent with local presentation of autoantigens and an ensuing local immune response, class II expression is also present in interstitial lung disease of sarcoidosis and microbial infections: its role in the pathogenesis of IPF must therefore remain speculative. PMID- 3305584 TI - Immunohistology of oestrogen receptor and D5 antigen in breast cancer: correlation with oestrogen receptor content of adjacent cryostat sections assayed by radioligand binding and enzyme immunoassay. AB - Two monoclonal antibodies recognising epitopes associated with oestrogen receptor protein were evaluated against the assayable soluble oestrogen receptor concentration in a series of 149 breast carcinomas. One antibody (anti-ER) recognises the hormone binding unit of oestrogen receptor and gives nuclear staining; the other antibody (anti-D5) was raised to a component of soluble oestrogen receptor and gives cytoplasmic staining. To minimise variations attributable to tumour heterogeneity and sampling error immunohistology using the two monoclonal antibodies, radioligand binding assays, enzyme immunoassays, and quantitative histology were done on adjacent frozen sections. Thirty nine per cent, 48%, 54%, and 43% of the tumours were found to be oestrogen receptor positive by radioligand binding assay, anti-ER and anti-D5 immunohistology, and enzyme immunoassay, respectively. Strong correlations (p less than 0.0005) were found between anti-ER immunohistology and the radioligand binding assay. Only weak correlations were found between anti-D5 immunohistology and the results of other assay methods for oestrogen receptor. Nuclear staining of human breast cancers with the anti-ER monoclonal antibody thus seems to be an acceptable alternative to biochemical assays, with the additional advantage of showing intercellular and regional heterogeneity for oestrogen receptor content. PMID- 3305585 TI - Lymphoid stromal reaction in gastrointestinal lymphomas: immunohistochemical study of 14 cases. AB - The lymphoid stromal reaction, particularly the T lymphoid reaction, was studied immunohistochemically on cryostat sections in 14 cases of primary gastrointestinal B lymphomas, and compared with the type and distribution of lymphoid cells in three cases of gastric lymphoid hyperplasia. A pronounced T lymphoid reaction, mainly of the T helper phenotype, occurred in both lesions. Most of these T cells bore HLA-DR antigens, but only a few of them had the receptor for interleukin 2. The T lymphoid reaction was observed inside the lymphomas in seven of a total of 14 cases, and around the lymphomas in four of the six cases clinically classified as stage I. Perivascular mucosal and submucosal nodules, entirely composed of T cells, seemed characteristic of gastric lymphoid hyperplasias. A T lymphoid reaction in lymphoid hyperplasias suggests an amplification of the cell mediated immune response; in lymphomas it could represent a host reaction against the lymphomatous infiltrate, therefore favouring a better prognosis. PMID- 3305587 TI - Comments on Oxoid Signal blood culture system. PMID- 3305586 TI - Ulcerative colitis and Escherichia coli with adhesive properties. AB - A quantitative assessment of the mannose resistant, adhesive property of Escherichia coli from patients with ulcerative colitis and from controls was made using a buccal epithelial cell adhesion assay, which also permitted assessment of adhesion to cells from other host sources. E coli from patients with ulcerative colitis adhered to buccal epithelial cells to a greater extent than those obtained from controls (p less than 0.0001), but did not show an increased affinity for the buccal epithelial cell of their host, compared with those obtained from other sources. The mannose resistant adhesive property of E coli raises the possibility that it has a role in the pathogenesis of ulcerative colitis. PMID- 3305588 TI - Corynebacterium CDC group D2 bacteraemia. PMID- 3305589 TI - Two-dimensional gel electrophoresis of dog crevicular fluid proteins. AB - The ligature-induced periodontitis model was used in beagle dogs to compare and contrast profiles of crevicular fluid (CF) proteins collected from gingivitis and periodontitis sites. The protein profiles of CF and serum were determined by 2 dimensional gel electrophoresis (2-D PAGE) using a silver stain. 2-D PAGE showed that CF contained proteins with molecular weight 16 K or less and many proteins with molecular weights between 64 K and 16 K in the isoelectric pH between approximately 5.8 and 6.8. The number of such proteins was greater in samples collected from the ligated (periodontitis) side compared to the non-ligated (gingivitis) side. Thus, analysis by 2-D PAGE revealed differences between CF samples from gingivitis and ligature-induced periodontitis sites. This study suggests that analysis of human CF by 2-D PAGE may be useful in diagnosis and investigation of the pathogenesis of periodontitis. PMID- 3305590 TI - Effect of folate on phenytoin hyperplasia. AB - There have been some reports that folic acid inhibits phenytoin-induced gingival hyperplasia. The purpose of this double-blind study was to quantify clinically the effects of both systemic and topical administration of folic acid on phenytoin-induced gingival overgrowth in man. For a period of 6 months, one group of phenytoin patients received 2 daily topical applications of a folate solution. An additional group received 2 daily doses of systemic folate while a control group received placebo medication. Results indicate that throughout the 180-day period of the study, the topical folate significantly inhibited gingival hyperplasia to a greater extent than either systemic folate or placebo groups. PMID- 3305591 TI - Piracetam and dyslexia: effects on reading tests. AB - Previous research has suggested that dyslexics treated with piracetam have shown improvements in reading skills, verbal memory and verbal conceptualizing ability, feature analysis, and processing of letter-like stimuli. Two hundred twenty-five dyslexic children between the ages of 7 years 6 months and 12 years 11 months whose reading skills were significantly below their intellectual capacity were enrolled in a multicenter, 36-week, double-blind, placebo-controlled study. Children of below average intelligence, with abnormal findings on audiologic, ophthalmologic, neurologic, psychiatric, and physical examinations, who were emotionally disturbed or educationally deprived and who had recently been treated with psychoactive medication were excluded from the trial. Piracetam was well tolerated, with no serious adverse clinical or laboratory effects reported. Piracetam-treated children showed significant improvements in reading ability (Gray Oral Reading Test) and reading comprehension (Gilmore Oral Reading Test). Treatment effects were evident after 12 weeks and were sustained for the total period (36 weeks). PMID- 3305593 TI - History of implantology. PMID- 3305592 TI - Treatment of refractory depression with combination reserpine and tricyclic antidepressant therapy. AB - Chronic reserpine use has been reported to precipitate severe depression in some individuals as a result of its amine-depleting action. However, early clinical studies demonstrated that acute administration of high doses of parenteral reserpine in combination with a tricyclic antidepressant could produce rapid improvement in depressive symptoms. Because these early studies defined treatment resistance as failure to respond to a brief course of treatment with a single tricyclic antidepressant, we performed a more stringent, placebo-controlled evaluation of high dose reserpine in nine depressives refractory to at least six previous drug treatments. Overall, neither reserpine nor placebo produced a meaningful decrease in depression ratings within 1 week of treatment; however, one patient did respond to a second course of reserpine. Side effects were mild to moderate in severity, and there were no cases of profound hypotension. Although the efficacy of this drug combination in severely refractory depressives was not confirmed, reserpine may still prove a useful adjunctive agent in some tricyclic-resistant depressed patients. PMID- 3305594 TI - Perceptions of body size and obesity: a selected review of the literature. AB - In this article, the literature on body image and related obesity perceptions is discussed. Research findings which span a 20 year period are summarized. Initially, Cheryl Rittenbaugh's concept of obesity as 'a culture bound syndrome' serves as a rationale for understanding sociocultural dimensions of body size perceptions. In this regard, the premise that perceptions of obesity and overweight have cultural determinants is substantiated in the reviewed literature. Societal preferences for body build and size and attitudes about weight are examined as a framework for understanding the impact that social perceptions have on individuals who are either overweight or obese. As a result of negative attitudes toward fatness, stigmatization of overweight people has been consistently documented. In related studies, investigators have centered on self-perceptions of obese and overweight individuals. According to the data, the existence of body image disturbance among extremely overweight individuals is a common phenomenon. However, evidence is also presented that suggests that normal weight individuals (especially women) may also have difficulty in accurately assessing their body size. The final focus of this paper is the relationship between body image and weight change behavior. As indicated in the discussion, this area of research has received the least amount of attention in the literature, and the present findings are contradictory. The paper concludes with recommendations for future research directions. PMID- 3305596 TI - Assessing asbestos exposure potential in nonindustrial settings. AB - The presence of asbestos containing materials (ACM) in office and commercial buildings is a significant environmental problem. Asbestosis, mesothelioma and lung cancer have been linked with industrial exposure to airborne asbestos. The extensive use of asbestos products in buildings has raised concerns about the widespread exposure of the general public to asbestos in nonoccupational settings. The presence of asbestos in a building does not necessarily mean that significant exposure of the occupants of the building has occurred, but it is important that the asbestos be monitored regularly to ensure that fibers do not become airborne. If ACM are contained within a matrix and not disturbed, exposure is unlikely. However, if the asbestos becomes friable (crumbling) or if building maintenance, repair, renovation or other activities disturb ACM, airborne asbestos fibers may be a source of exposure to the occupants of the building. Currently, asbestos exposure assessment is conducted by a phase contrast light microscope (PCM) technique. Due to its inherent limitation in resolution and the generic counting rules used, analysis by the PCM method underestimates the airborne asbestos fiber concentration as compared to analysis by transmission electron microscopy (TEM). It is important that the air monitoring results analyzed by PCM be interpreted carefully in conjunction with a survey by a professional to judge the physical condition of the ACM in buildings. Exposure levels to airborne asbestos fibers vary from day to day and depend on the physical condition of the material involved and the type of operating and maintenance program in place.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305597 TI - Sir William Petty: modern epidemiologist (1623-1687). AB - William Petty, physician, epidemiologist, political economist, demographer, cartographer, and administrator was an intellectual product of the seventeenth century. Petty was born in the year 1623 in Romsey, England of lower middle class parents; however, by the time of his death in 1687 he had become a knight of the realm, founder of the Royal Society, and friend of kings. Petty's life reflected the northern renaissance which induced such dramatic changes in science, technology, politics, and entrepreneurship. His education was eclectic, nonetheless he took his Doctor of Physic degree from Oxford in 1649 and became an Oxford don, where he spent the next few years as an academic before undertaking a definitive survey of Ireland on behalf of the Cromwell government. Ireland changed Petty's destiny and he became a man of the world and entrepreneur which stimulated his interest in public policy formulation and economics. It was Petty's peculiar genius to be innovative in the application of measurement, statistics, and mathematics to socioeconomic and demographic phenomena. As a physician he related his knowledge of health and disease to these phenomena in what in the modern context would be called human ecology or social epidemiology. These relationships and their measurement were employed to establish an objective set of data which could be analyzed for the purpose of rational public policy planning by the state. This scientific approach to public policy places Petty squarely in the context of modern epidemiologic and public health practice and marks the initiation of a major use of the epidemiologic method. PMID- 3305595 TI - Wellness health care and the architectural environment. AB - The stress management-wellness health care environment is emerging as a distinct facility type in the 1980s. Yet the idea is not a new one, with roots based in the Greek Asklepieon dating from 480 B.C. This and later Western transformations for health promotion embraced the therapeutic amenity inherent in meditation, solace and communality with nature based on the premise that the need for refuge from the stress inherent in one's daily life is deep-rooted in humans. A two phase study is reported on wellness health care provider priorities, relative to the architectural features of stress-wellness centers. Representatives of 11 health care organizations responded to a telephone survey questionnaire, and 128 respondents completed a user needs questionnaire. Four major issues were addressed: image and appearance, location and setting, services provided and costs, and patterns of use. Convenience to one's place of work, a balanced mixture of clinical and nonclinical programs, a noninstitutional retreat-like environment, and membership cost structures were found to be major user considerations with respect to planning and design concepts for wellness health care environments. Directions for further research are discussed. PMID- 3305598 TI - Morphology and quantitative changes of transient NPY-ir neuronal populations during early postnatal development of the cat visual cortex. AB - The early postnatal development of neuropeptide Y-containing neurons in the visual cortex of the cat was analyzed. Immunohistochemistry reveals several stages of morphological differentiation and degeneration. Completely undifferentiated neurons have very small somata with nuclei surrounded by a thin rim of cytoplasm and processes unclearly differentiated into dendrites and axons. Processes bear growth cones. Differentiating neurons show an increase in soma size and complexity of processes. Axons are recognizable. Fully differentiated neurons have well-defined axonal and dendritic patterns. Degenerating neurons are identified by thick, heavily beaded processes covered by hairy appendages and vacuolar inclusions in the somata. Cell death is expressed by shrunken somata and lysed, fragmented processes. According to their postnatal time course of differentiation and/or degeneration, NPY-immunoreactive neurons, which form several morphologically distinct cell types, are grouped into 3 neuronal populations. (1) Pseudopyramidal cells, bitufted "rectangular" cells with wide dendritic fields, unitufted cells, and small multipolar cells are located in the gray matter and have a rather primitive morphology resembling cell types found in lower vertebrate cortex and tectum. They constitute a first transient neuronal population, because all neurons are fully differentiated at birth and become largely eliminated by postnatal day (P) 12. (2) Axonal loop cells are mainly located in the white matter. Their most prominent feature is an often long hairpin loop formed by either the main axon itself or by a major collateral. The axonal branches pass through the cortex to connect the white matter and layer I. Axons do not form local plexusses and terminal elements in the gray matter. Neurons differentiate perinatally, form a first peak from P6 to P10, followed by a decrease in cell number and innervation density at P12, followed by a second peak from P15 to P20. After P20 the number of axonal loop cells steadily decreases, and they become eliminated by P48. (3) A third population consists of neurons with a higher degree of axonal ramification and a variety of axonal patterns. Early members are located mainly at the layer VI/white matter border, differentiate during the first postnatal week, and give rise to a diffuse innervation of the gray matter without forming specific terminal elements. Some of the early axonal patterns persist into adulthood, whereas others are not found in the adult brain.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3305599 TI - Immunocytochemical distribution of met-enkephalin-Arg6-Gly7-Leu8 in the rat lower brainstem. AB - The distribution of methionine-enkephalin-Arg6-Gly7-Leu8, a unique peptide derived from proenkephalin A in the rat brainstem, was studied immunocytochemically by using a highly specific antiserum to this octapeptide sequence. Immunoreactive perikarya with various shapes and sizes were detected in many regions of the rat brainstem. Dense accumulation of immunoreactive perikarya and fibers was seen in the nuclei associated with special sensory and visceral functions, such as the interpeduncular nucleus, the parabrachial nucleus, the nucleus of the solitary tract, and the nucleus of the spinal tract of the trigeminal nerve. Clusters of methionine-enkephalin-Arg6-Gly7-Leu8-like immunoreactive perikarya and fibers were observed in certain areas considered to play a role in nociception and analgesia, such as the central gray of the midbrain central gray and the raphe magnus nucleus. Some methionine-enkephalin Arg6-Gly7-Leu8-like immunoreactive perikarya were distributed in the lateral reticular nucleus, the nucleus of the solitary tract, and the raphe magnus nucleus, where monoaminergic neurons were also detected. In addition to the previously reported enkephalinergic cells, we found many methionine-enkephalin Arg6-Gly7-Leu8 containing neurons; the rostral and caudal linear nucleus of raphe, the median raphe nucleus, entire length of the raphe magnus nucleus, the medial longitudinal fasciculus, the cuneate nucleus, the external cuneate nucleus, the gracile nucleus, and the area postrema. The wide distribution of this octapeptide-like immunoreactivity reflected neurons expressing the preproenkephalin A gene distributed more widely than previously reported and that innervated many regions. PMID- 3305600 TI - Vasopressin cells in the medial amygdala of the rat project to the lateral septum and ventral hippocampus. AB - The rat brain contains a large number of vasopressin (VP) immunoreactive fibers, the sites of origin of which have not yet been established completely. For instance, the sources of VP fiber systems in the amygdala, ventral hippocampus (VH), mediodorsal thalamic nucleus, ventral tegmental area, and dorsal raphe yet remain obscure. These VP fibers may originate in any of the recently described extrahypothalamic VP cell groups, viz., medial amygdaloid nucleus (AME), dorsomedial hypothalamic nucleus, or locus coeruleus, since VP efferents from these cells still remain to be demonstrated. In search of AME VP efferents three approaches were followed: (1) the Phaseolus vulgaris anterograde tracing method, (2) immunocytochemistry after AME lesioning, and (3) retrograde transport of a fluorescent dye in combination with immunofluorescence. The results demonstrate that VP cells in the AME project to (1) the lateral septum (LS) by the ventral amygdalofugal pathway and (2) the VH via the amygdalohippocampal transition zone. In addition, the VP projection from the bed nucleus of the stria terminalis (BST) to the LS was confirmed. There was no indication that VP cells in the AME project through the amygdalotegmental pathway to the medulla oblongata and spinal cord. The results support the possibility that the BST and AME are an anatomical entity that may be part of the central loci controlling sexual processes in the rat. PMID- 3305601 TI - Alteration of mouse cerebellar circuits following methylazoxymethanol treatment during development: immunohistochemistry of GABAergic elements and electron microscopic study. AB - Methylazoxymethanol (MAM) injected postnatally affects cerebellar development in mice. A single injection at the fifth postnatal day produces hypogranular cerebella whereas a single injection at birth produces, in addition, a disorderly cytoarchitecture of the folium and alteration of Purkinje cell positioning (Bejar et al.: Exp. Brain Res. 57:279-285, '85). In the present study we have used immunohistochemistry with anti-GABA immune serum and electron microscopy to further characterize these alterations. In addition to the already-described nonoccupied dendritic spines of Purkinje cells both in mice injected the day of birth and or at the fifth postnatal day, we have observed, in animals injected at birth, the absence of pericellular baskets around Purkinje cells and the presence of heterologous synapses between mossy fibres and Purkinje cell dendrites. These heterologous synapses apparently disappear after postnatal day 20. By using an appropriate timing of MAM injection, different types of hypogranular cerebella, phenocopies of different mutants, can be obtained in large enough number to carry out extensive biochemical studies at each developmental age. PMID- 3305603 TI - Treatment of telangiectasia: a review. AB - Telangiectasias are thought to occur through the release or activation of vasoactive substances under a multitude of conditions. Patients seek therapy for telangiectasias principally because of the unsightly visual appearance. This paper discusses the etiology, histology, and treatment of telangiectasias, emphasizing microsclerotherapy. Specifically, the indication for sclerotherapy, mechanism of action of the various sclerosing agents, microinjection technic, and the advantages and disadvantages of the most commonly used sclerosants, sodium morrhuate, sodium tetradecyl sulfate (Sotradecol), hypertonic saline, hydroxypolyethoxydodecane (polidocanol; Aethoxysklerol), and, Sclerodex (a mixture of dextrose and sodium chloride) are reviewed. PMID- 3305604 TI - Actinic cheilitis: a review of the etiology, differential diagnosis, and treatment. AB - With today's increase in sun worshippers, the number of sun-induced skin lesions is increasing. Actinic cheilitis is the counterpart of actinic keratosis of the skin and can also develop into squamous cell carcinoma. In this article we review the etiology, clinical spectrum, histology, differential diagnosis, and treatment of actinic cheilitis. Actinic cheilitis needs to be differentiated from many other lip conditions, and the dermatologist must be attune to its possibility whenever assessing scaly lips. Because of its potential to develop into squamous cell carcinoma, treatment should be instituted as soon as possible. PMID- 3305602 TI - Synaptic organization of GABAergic neurons in the mouse SmI cortex. AB - Immunocytochemical methods were used to examine GABAergic neurons in the barrel region of the mouse primary somatosensory cortex. GABAergic neurons occur in all layers of the barrel cortex but are more concentrated in the upper portion of layers II/III and in layers IV and VI. Nine cells in layer IV were examined with the electron microscope, and portions of their dendrites were reconstructed from serial thin sections. These cells are of the nonspiny, multipolar or bitufted varieties, and some of them have beaded dendrites. The labeled cell bodies and their reconstructed dendrites were postsynaptic at asymmetrical synapses with thalamocortical axon terminals labeled by lesion-induced degeneration and with unlabeled axon terminals. Each cell also received symmetrical synapses from GABAergic axon terminals and from unlabeled axon terminals. Our results indicate that GABAergic cell bodies and processes receive synapses from thalamocortical axon terminals but that different cells display marked differences in the proportion of thalamocortical and other synapses they receive. These results indicate that GABAergic cells form a heterogeneous population with respect to their morphologies and patterns of synaptic inputs. The synaptic sequences revealed here for GABAergic neurons represent an anatomical substrate for various inhibitory processes known to occur within the cerebral cortex. PMID- 3305605 TI - Burow's grafts. AB - The Burow's graft is a useful technic for wound reconstruction with the use of a full-thickness skin graft obtained from skin adjacent to the wound. This donor site provides skin with a better color, texture, and thickness match than traditional donor sites. The indications, technic, and disadvantages are discussed. PMID- 3305606 TI - Photodermatoses. PMID- 3305607 TI - Group B streptococcal blistering distal dactylitis in an adult diabetic. PMID- 3305608 TI - Cryptococcal cellulitis with multiple sites of involvement. AB - Cryptococcal cellulitis is an uncommon cutaneous manifestation of generalized cryptococcal disease. We describe the only reported incidence with multiple sites of cutaneous involvement. In an immunosuppressed patient an apparent cellulitis, even with multiple sites of involvement, that does not respond to appropriate antibiotics should alert one to the possible diagnosis of cryptococcal cellulitis. PMID- 3305609 TI - Extensive congenital erosions and vesicles healing with reticulate scarring. AB - We describe two children with extensive erosions and vesicles at birth that healed with reticulate scarring. These add to the three other cases reported previously. Our two patients also have extensive neurologic deficits, which may represent another feature of this syndrome. Possible causes are discussed. PMID- 3305610 TI - Superficial epithelioma with sebaceous differentiation. AB - Five cases of superficial epithelioma with sebaceous differentiation (SESD) are reported. They occurred as solitary papules on the face of 5 patients, aged 57 to 72. The tumor is characterized by a superficial platelike proliferation of basaloid to squamoid cells with broad attachments to the overlying epidermis. Clusters of mature sebaceous cells are present within the tumors. None of the tumors have recurred or spread following simple excision. SESD is a non aggressive tumor of uncertain histogenesis with a tendency toward sebaceous differentiation. PMID- 3305611 TI - A comparison of the dermal lymphoid infiltrates in discoid lupus erythematosus and Jessner's lymphocytic infiltrate of the skin using the monoclonal antibody Leu 8. AB - Jessners lymphocytic infiltration of the skin (14 cases) and discoid lupus erythematosus (13 cases) were studied and the lymphoid infiltrates in the dermis were compared in the two conditions, using a standard immunoperoxidase technique. Mouse monoclonal antibodies were used to identify T helper lymphocytes, T suppressor lymphocytes and, using the antibody Leu 8, "immunoregulatory lymphocytes". It was shown that the proportions of Leu 8 positive cells was significantly different in the two conditions. The average percentage of Leu 8 positive lymphocytes in the dermal infiltrate found in the cases of Jessner's was 65% (range 40-80%) whereas the average percentage in the cases of discoid LE was 15% (range 2-30%). This observation is further evidence that Jessner's lymphocytic infiltration and chronic discoid lupus erythematosus should be regarded as separate entities. PMID- 3305612 TI - Extramedullary (skin) presentation of acute monocytic leukemia resembling cutaneous lymphoma: morphological and immunological features. AB - Acute monocytic leukemia has been noted to exhibit a predilection for extramedullary involvement (gums, skin, and lymph nodes) at presentation. More unusual is the occurrence in an extramedullary site in the absence of bone marrow involvement. A case is reported with initial presentation in skin preceding a subsequent evolution to a leukemic phase by one year. The skin tumor was initially diagnosed and treated as a lymphoma. A second skin tumor, biopsied one year later was immunophenotyped as a T cell lymphoma using a screening panel of antisera (OKT4 positive, OKMI negative). Shortly thereafter a monocytic leukemia (M5) was discovered. Using a larger panel of antisera and enzyme markers on the second skin biopsy confirmed the monocytic rather than lymphocytic nature of the skin tumor. This case illustrates the importance of using an expanded panel of monoclonal antisera in certain hematopoietic tumors. PMID- 3305613 TI - Medullary carcinoma of the thyroid metastatic to the skin: report of two cases. AB - The skin is a rare site for metastases from the thyroid. We report 2 cases of skin metastases from a thyroid medullary carcinoma. This is the first report of metastasis to the skin from a medullary carcinoma. The diagnosis was confirmed by immunocytochemical studies performed on the skin biopsy specimens. PMID- 3305614 TI - Blood flow to hindquarters of steers measured by transit time ultrasound and indicator dilution. AB - The objective was to compare blood flow to the hindquarters of steers measured by transit time ultrasound with blood flow determined by indicator (p aminohippurate) dilution. Five Hereford steers had ultrasonic flow probes on the abdominal aorta and catheters in the abdominal aorta and inferior vena cava inserted through both sets of circumflex iliac vessels. Indicator was infused continuously into the abdominal aorta through both arterial catheters simultaneously, then through each of the arterial catheters in succession. Samples of blood from the inferior vena cava and jugular vein were taken during infusion for measurement of p-aminohippurate. Blood flow determined by the ultrasonic flow probe was averaged over each blood sampling interval. Compared with the ultrasonic flow probe there was no difference in mean blood flow measured by p-aminohippurate, regardless of method of infusion. Correlation of individual values between ultrasound and p-aminohippurate was .87 when p aminohippurate was infused into both arterial catheters, .44 when p aminohippurate was infused into the left arterial catheter, and .78 when p aminohippurate was infused into the right arterial catheter. The respective ranges for ultrasonic measurements and p-aminohippurate were 3.62 to 10.99 L/min and 2.25 to 30.43 L/min. Although means by the two methods do not differ, there is a greater range and incidence of occasional high values with p-aminohippurate dilution. PMID- 3305615 TI - Transport and fate of spermatozoa after insemination of cattle. AB - Sperm capable of fertilizing ova reach the isthmus of cows about 8 h after mating and remain in the caudal 2 cm of the isthmus until ovulation. Then small numbers of sperm move to the site of fertilization at the junction of the isthmus and ampulla. Within a few hours after deposition of semen in the uterine body, most sperm have drained to the exterior in cervical mucus. By 12 to 24 h after insemination, only a few percent of the sperm remain in the reproductive tract, and most of these are in the vagina. Contractions of the reproductive tract appear to be the primary mechanism of sperm transport. Flagellation of sperm is probably required for sperm to enter the folds of the cervix, and flagellation may be helpful or essential for sperm to pass through the uterotubal junction, move from the isthmus to the ampulla, and penetrate ova. High proportions of sperm undergo the acrosome reaction only in the ampulla on the side of ovulation and only after ovulation. The fertilization rate in cattle can be improved by use of semen from high fertility bulls and perhaps by timing insemination with semen from lower fertility bulls after the end of estrus. PMID- 3305616 TI - Calcium-binding proteins in fungi and higher plants. AB - Calcium has long been known to be required for many vital processes in fungi and plants. High levels of calcium are found in cell walls, vacuoles, and most organelles. In contrast, very low levels of calcium are present in the cytosol of fungal and plant cells. The most recent evidence indicates that calcium is a true second messenger in fungi and plants. Because cyclic AMP does not appear to be a second messenger in plants, calcium is the only known second messenger. Calcium binding proteins are involved in the events that accompany the action of calcium as a second messenger; three types have been identified in fungi and plants. The first group includes several proteins that bind 45 Ca2+ and are not known to have any enzymatic activity. A second type includes the many enzymes from fungi and plants stimulated by millimolar levels of calcium. The third type of calcium binding protein, calmodulin, responds to micromolar levels of Ca2+ by binding to certain enzymes and stimulating them. Calmodulin has been detected in every eukaryote thus far examined. The amino acid composition of several fungal and plant calmodulins have been elucidated and found to be very similar to calmodulin from animals. Eight enzymes from fungi and plants have been reported to be regulated either directly or indirectly by calmodulin. Calmodulin antagonists have been used to study the possible involvement of calmodulin in many cellular processes in fungi and plants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305617 TI - Possible mechanisms involved in the immunoregulation of chronic inflammatory periodontal disease. AB - It is generally agreed that immunological mechanisms are involved in the pathogenesis of periodontal disease; however, regulation of these mechanisms has hitherto received scant attention. Regulatory networks exist at both a cellular and a molecular level. At the cellular level, the existence of helper (T4 positive) and suppressor (T8-positive) T lymphocytes, the expression of Class II major histocompatibility complex antigens, and the heterogeneity of macrophage subpopulations are central to an understanding of the regulatory mechanisms involved. It is only recently that studies of these separate components, in both humans and experimental animals, have begun to provide a basis for understanding the complex interactions occurring in periodontal disease. Studies using the human experimental gingivitis model have shown an immunoregulatory picture consistent with a controlled immunological reaction with an essentially normal T4:T8 ratio of 2.0. In contrast, studies utilizing cells extracted from adult periodontitis lesions have shown a reduced T4:T8 ratio (approximately 1.0) and an inability to respond in, or to stimulate, an autologous mixed lymphocyte reaction. Animal studies using athymic nude rats have supported the concept of a central role for T-cell control in periodontal disease and the possibility of an imbalance in this control with disease progression. These results are reviewed and areas of future research explored. PMID- 3305618 TI - A simplified diagnostic system for cultural detection and enumeration of Streptococcus mutans. AB - A simple dip-slide test (Cariescreen SM) based on MSB selective agar was devised for detection and quantitation of Streptococcus mutans in oral samples. For this test, a bacitracin tablet is dissolved in a vial containing buffered saline diluent. Paraffin-stimulated saliva is collected in this diluent vial. A dip slide which incorporates a modified MSB agar (minus bacitracin) is immersed briefly in the diluted saliva. After addition of a CO2-generating tablet, the screw-cap dip slide is closed tightly in the vial and incubated for two days at 37 degrees C and one day at room temperature. S. mutans populations in saliva are estimated by comparison with a colony density chart. Growth of reference strains of S. mutans was equivalent on Cariescreen SM dip slides and on MSB agar plates. Reference strains of Streptococcus sanguis, Streptococcus salivarius, Streptococcus mitis, and Streptococcus milleri did not grow on Cariescreen SM dip slides. Aliquots of saliva from 50 schoolchildren and 51 adults were tested by the dip-slide method and by conventional plating methods in MSB agar. Very good correlation (0.93) between the two methods was obtained. This simplified S. mutans detection system is suitable for use by clinical personnel in dental clinics or other non-laboratory settings for identification of subjects potentially at risk for caries. PMID- 3305619 TI - Morphometric analysis of teeth with inflamed pulp. AB - The most common method of evaluating pulp tissue reactions to injury is by a qualitative assessment of pulp tissue alterations. This evaluation method is subjective and difficult to quantify; stereological methods are more suitable, for they can quantify important tissue components, and so more objectively describe pulp tissues. This study compares a morphometric and a descriptive method of classification for pulp tissue analysis by using 15 teeth with inflamed pulp tissue, and 12 teeth experimentally pulp-capped with calcium hydroxide. Morphometric analysis allowed for volumes of remaining dentin, pulp tissue, inflamed pulp tissue, and reparative dentin to be calculated. In addition, volume densities of polymorphonuclear and mononuclear leukocytes, odontoblasts, fibroblasts, erythrocytes, vessels, and residual tissue were calculated for comparison among different experimental teeth. The morphometric method provided a quantitative description of tissue reactions. The descriptive method of classification was adequate when inflamed tissue subjacent to the cavity was evaluated, but was less precise than the morphometric method in describing reactions deeper in the tissue. The descriptive method could delineate the amounts and types of inflammatory cells only in non-quantified terms, while the morphometric method could quantify and locate them. It also yielded a quantified evaluation of the healing sequence of experimentally pulp-capped teeth. In conclusion, a morphometric method can yield more quantitative data on pulp tissue reactions than can a descriptive method of classification. PMID- 3305620 TI - Microbial aspects of preventive regimes in patients with overdentures. AB - The aim of this study was to test effects of preventive regimes using fluoride and chlorhexidine to prevent caries and periodontal diseases in 34 patients with overdentures. The patients, who were treated with immediate overdentures, were distributed at random into three experimental groups. In these groups, different gels--a placebo, a fluoride, and a chlorhexidine-fluoride gel--were tested by daily application. Supragingival plaque samples from selected surfaces of two abutment teeth were taken at one week, and at one, three, and six months after initial insertion of the overdenture. The placebo and fluoride gel influenced neither total CFU nor S. sanguis and A. viscosus/naeslundii counts. In the placebo group, but not in the fluoride group, S. mutans levels increased significantly, indicating the caries risk involved in overdentures. The use of chlorhexidine-fluoride gel resulted in a long-term suppression of total CFU. Further, S. mutans was found to be selectively suppressed to below detection level. A. viscosus/naeslundii was initially strongly suppressed, but after three months a partial return of the population was noticed. S. sanguis was relatively insensitive to the chlorhexidine-fluoride gel. It is concluded that a daily application of a chlorhexidine-fluoride gel is effective against plaque formation and S. mutans on abutment teeth in overdentures. PMID- 3305622 TI - The proper role of nerves in salivary secretion: a review. AB - Consideration of the history of this subject has created a perspective which helps one to appreciate how errors in thinking have occurred and why some have persisted, despite subsequent improvements in information. The most enduring misconception has been that the drying of the mouth under stress is due to sympathetic inhibitory fibers, a view that must be eradicated, for such fibers do not exist. The inhibition is due to central influences from higher centers acting on the salivary centers and thereby suppressing reflex activity. Wide variations exist in the neuro-effector arrangements and in the cellular responses in different glands from different species. Myoepithelial cells are usually contracted by both parasympathetic and sympathetic nerves. The blood vessels also receive a dual innervation, but parasympathetic impulses cause vasodilatation as part of secretion, whereas the sympathetic vasoconstrictor fibers are part of a more generalized vascular control system and not a direct part of the reflex secretory sympathetic pathway. Parasympathetic drive usually provides the main stimulus for fluid formation by parenchymal cells, whereas sympathetic nerves tend to increase the output of pre-formed components from certain cells. Absence of nerve impulses causes variable atrophic and other metabolic effects on the parenchymal cells. Evidence is beginning to accrue that certain nerve impulses may influence resynthetic activities. Vacuolation, often found experimentally after strong stimulation, also occurs to a variable extent in certain cells as a normal part of reflex secretion and may therefore have an effect on the components entering the saliva. If rupture of vacuoles occurs, then this may contribute to the salivary amylase that is present in the blood. Recent evidence points to the possibility that, even in a monomorphic gland, not all of the components necessarily enter nerve-induced saliva in "parallel" proportions. Consideration of current information has enabled some provisional generalizations about the roles of the secretory nerves to be suggested in the summary, but they must not be considered immutable. PMID- 3305623 TI - Salivary gland changes in disease. AB - Ultrastructural alterations occurring in human salivary glands as a result of a variety of diseases are described. Major changes in these organs in cases of cystic fibrosis are probably the result of duct blockage, as indicated by study of chronically inflamed salivary glands. A new disease of salivary glands is reported in which parotid serous granules are distorted by bundles of fine filaments, which may be due to the untoward polymerization of a secretory protein, perhaps proline-rich protein. Finally, a clear-cell adenocarcinoma of palatine gland origin is described in which the nuclei display complex pseudoinclusions and the cytoplasm contains numerous herpes-type viruses. PMID- 3305621 TI - Evaluation of biochemical validation measures in determination of smoking status. AB - This study was designed to evaluate the use of salivary cotinine, salivary thiocyanate, and expired-air carbon monoxide as biochemical validation measures for assessing the smoking status of adults. The participants were 20 known non smokers plus 216 admitted smokers and 102 proclaimed quitters participating in a clinical trial of approaches to facilitate smoking cessation. Conventional analytical procedures were utilized. By use of data from known non-smokers and admitted smokers, the sensitivity and specificity of the validation measures were as follows: salivary cotinine, 99% and 100%; expired-air carbon monoxide, 96% and 100%; and salivary thiocyanate, 67% and 95%, respectively. The salivary cotinine and expired-air carbon monoxide tests confirmed smoking cessation for 55% and 74%, respectively, of the proclaimed quitters. The length of time since quitting was significantly related to the results observed with the latter measures. Consideration of these observations along with various practical factors suggests that expired-air carbon monoxide assays may be the validation measure of choice for most clinical trials. PMID- 3305624 TI - Current diagnostic uses of saliva. AB - Most of the information which has been collected on salivary composition in different disease states (with the notable exception of that in digitalis intoxication) has proved of little practical diagnostic value. Diagnostic use of saliva has become more extensive in recent years, particularly in relation to estimation of systemic levels of lipid-soluble drugs and hormones. Thiocyanate levels have been used to validate self-reported frequency of tobacco-smoking, and nitrate levels have been assayed to estimate dietary nitrate intakes. The estimation of steroid hormone concentrations in saliva is now generally recognized as a means of determining systemic steroid levels which offers many advantages over estimation in serum or urine samples. Immunoassay methods now permit measurement of very small concentrations of biologically active substances in saliva. PMID- 3305625 TI - Physiological factors influencing salivary clearance of sugar and fluoride. AB - The salivary clearance of sugar and fluoride is influenced by several physiological factors not yet fully investigated or understood. There are reasons to believe that these factors influence both the acid production by sugar fermentation in the dental plaque and the cariostatic action of fluoride on the enamel surface and its immediate environment. This paper presents theoretical and experimental considerations of physiological factors which influence the kinetics of sugar and fluoride in the oral cavity. PMID- 3305626 TI - Structural aspects of salivary glycoproteins. AB - The protective functions of saliva are attributed, in part, to its serous and mucous glycoproteins. We have studied, as representative molecules, the proline rich glycoprotein (PRG) from human parotid saliva and the high (MG1) and low (MG2) molecular weight mucins from submandibular-sublingual saliva. PRG (38.9 kDa) contains 40% carbohydrate consisting of 6 triantennary N-linked units and a single peptide chain of 231 amino acids, 75% of which = PRO + GLY + GLN. PRG's secondary structure is comprised of 70% random coil (naked regions) and 30% beta turns (glycosylated domains). MG1 (greater than 10(3) kDa) contains 15% protein (several disulfide linked subunits), 78% carbohydrate (290 units of 4-16 residues), 7% sulfate, and small amounts of covalently linked fatty acids. MG2 (200-250 kDa) contains 30% protein (single peptide chain), 68% carbohydrate (170 units of 2-7 residues), and 2% sulfate. The major carbohydrate units of MG2 are: NeuAc alpha 2,3Gal beta 1,3GalNAc,Gal beta 1,3GalNAc, and Fuc alpha 1,2Gal beta 1,3GalNAc. MG1 contains hydrophobic domains, as evidenced by its ability to bind fluorescent hydrophobic probes; MG2 does not. Collectively, the biochemical and biophysical comparisons between MG1 and MG2 indicate that these two mucins are structurally different. Several functional properties of MG1, MG2, and PRG have been examined, including their presence in two-hour in vivo enamel pellicle, binding to synthetic hydroxyapatite, lubricating properties, and interactions with oral streptococci. The data presented suggest that these glycoproteins may have multiple functions which are predicated, in part on their carbohydrate units. The potential significance of the structure-function relationships of these glycoproteins to the oral ecology is discussed. PMID- 3305627 TI - Structural and genetic aspects of proline-rich proteins. AB - Considerable advances have been made in the genetics of salivary proline-rich proteins (PRP). The genes for acidic, basic, and glycosylated PRP have been cloned. They code for precursor proteins that all have an acidic N-terminal followed by proline-rich repeat sequences. Structural studies on secreted proteins have demonstrated that not only acidic but also some basic PRPs have this general structure. It is possible that mRNA for different PRP may have originated from a single gene by differential mRNA splicing, but post translational cleavages of the primary translation product apparently also occur. In vitro translation of salivary gland mRNA results in a single precursor protein for acidic PRP. Such in vitro translated protein can be cleaved by salivary kallikrein, giving rise to two commonly secreted acidic PRPs, and kallikrein or kallikrein-like enzymes may be responsible for other post-translational cleavages of PRPs. Acidic as well as some basic PRPs are phosphorylated. A protein kinase has been demonstrated in salivary glands which phosphorylates the PRPs and other secreted salivary proteins in a cAMP and Ca2+-calmodulin-independent manner. Knowledge of the conformation of PRPs is limited. There is no conclusive evidence of polyproline-like structure in the proline-rich part of PRPs. Ca2+ binding studies on acidic PRPs indicate that there is interaction between the Ca2+ binding N-terminal end and the proline-rich C-terminal part. This interaction is relieved by modification of arginine side-chains. 1H, 32P, and 43Ca NMR studies have further elucidated the conformation of acidic PRPs in solution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305628 TI - The growth of oral bacteria on saliva. AB - The present experiments were aimed at studying the degradation of salivary glycoproteins by the oral microflora. To this end, S. sanguis I strain Ny476 and S. sanguis II (S. mitior) strain Ny581 were grown continuously in human-whole saliva. Under these conditions, the strains produced a variety of cell-associated hydrolytic activities, including glycosidases, exo- and endopeptidases, and esterases. S. sanguis II generally exhibited higher levels of enzyme activity than did S. sanguis I, in particular of neuraminidase that was produced only by S. sanguis II. In accordance, S. sanguis II had a higher cell yield and consumed a higher proportion of the sugars and sialic acid in the glycoproteins than did S. sanguis I. Interestingly, S. sanguis I, which is devoid of neuraminidase, is known to have a lectin with specificity for sialic acid, whereas S. sanguis II has affinity for galactose residues in the glycoproteins. We propose that specific binding of glycoproteins by oral bacteria constitutes a mechanism to collect nutrients in the vicinity of the cell. The special ability of S. sanguis II to utilize saliva for growth was further exemplified by its selection in batch wise enrichments of dental plaque on saliva. The microflora in these enrichment cultures always consisted of Peptostreptococcus micros, S. sanguis II, and Fusobacterium nucleatum as the dominant organisms. Further, S. mitis and Gemella haemolysans were generally found to be present. The enrichment cultures produced a wide variety of mainly cell-bound hydrolytic enzymes. This resulted in almost complete breakdown of salivary glycoproteins in the culture. PMID- 3305629 TI - Nerve interactions in salivary glands. AB - In the salivary reflex, not only secretory cells are activated, but also myo epithelial cells are contracted to support these cells and promote the flow of saliva, and blood vessels dilate to meet the increased demands of the tissues. The various effector cells often receive nerves from both parts of the autonomic system, and interactions may occur when the nerves act on the same type of effector, or on different types of effectors. While in an experiment electrical stimulation of the sympathetic trunk may decrease a parasympathetic salivary flow by causing marked vasoconstriction, this does not occur in the salivary reflex, since the vasoconstrictors do not take part. On the contrary, the normal sympathetic vasoconstrictor tone of the resting gland is easily overcome by activity in parasympathetic vasodilator nerves when secretion starts. Pronounced synergism can be demonstrated between sympathetic and parasympathetic secretory nerves. In dogs, for instance, in which sympathetic secretion is beta adrenoceptor-mediated, this is marked in the case of fluid secretion. In rats and rabbits, in which beta-receptors elicit secretion of amylase, the potentiating interaction among the nerves is striking when amylase secretion is considered. Even the random release of acetylcholine from the post-ganglionic parasympathetic axons, by itself insufficient to evoke secretion, can increase the sympathetic effects. Motor nerves interact with secretory nerves by causing myo-epithelial contraction, mechanically promoting secretion. Interactions between the nerves in their long-term regulatory function on the sensitivity of the acinar secretory and myo-epithelial cells can also be demonstrated. PMID- 3305630 TI - Mobilization of intracellular calcium by methacholine and inositol 1,4,5 trisphosphate in rat parotid acinar cells. AB - In the rat parotid acinar cell, methacholine caused an increase in [Ca2+]i as determined by quin-2 fluorescence. The increase in [Ca2+]i was initially independent of, and subsequently dependent on, the presence of extracellular Ca2+, indicating mobilization of intracellular Ca2+, as well as activation of Ca2+ entry. Methacholine mobilization of the internal Ca2+ pool and stimulation of the initial transient phase of K+ efflux have similar concentration dependencies; the EC50 value for Ca2+ mobilization is 80 nmol/L, the EC50 value for K+ efflux is 200 nmol/L. In a permeable parotid cell preparation, inositol 1,4,5-trisphosphate, inositol 2,4,5-trisphosphate, and inositol 4,5-bisphosphate were able to release Ca2+ from an ATP-dependent, oligomycin-insensitive pool. These observations, when taken with the previous finding that methacholine stimulates Ca-independent inositol trisphosphate formation, support the view that inositol 1,4,5-trisphosphate acts as a second messenger mediating the release of an intracellular Ca2+ pool following muscarinic receptor activation in the parotid gland. PMID- 3305631 TI - Influence of human whole saliva on bacterial aggregation. PMID- 3305632 TI - Dental papilla cells synthesize but do not deposit fibronectin in culture. AB - The dental papilla cells play a major regulatory role during tooth morphogenesis, and they are the only mesenchymal cells capable of differentiating into odontoblasts secreting dentin. In this paper, we have extended our studies on the behavior of cultured dental papilla cells which have been disaggregated from 17 day mouse embryo teeth. Quite unexpectedly, we observed that these cells, which in vivo are embedded in a fibronectin-rich extracellular matrix, lose all surface associated fibronectin when cultured as monolayers. Fibronectin was, however, detected intracellularly, and metabolic labeling and immunoprecipitation studies indicated that the dental papilla cells continued to synthesize fibronectin in culture. Furthermore, when purified plasma fibronectin was added at 50 micrograms/mL to the culture medium, it became incorporated as fibrillar matrix on the surfaces of dental papilla cells. This indicates that the cells are not deficient in cell-surface receptors or other surface-associated molecules which bind fibronectin. When pieces of dental papillae were cultured as explants, an abundant matrix containing fibronectin was deposited on their surfaces. This matrix was gradually lost as the cells migrated from the explants. Furthermore, when the cells were disaggregated and cultured at high cell density, the cells in the central area of the pellet were covered by fibronectin containing fibrillar structures which were lost as the cells spread out. This indicates that the maintenance of close contacts between the dental papilla cells is required for the assembly of fibronectin into the extracellular matrix.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305633 TI - Immunocompetent cells in the normal dental pulp. AB - The existence and location of various immunocompetent cells in the human dental pulp were investigated. Pulp tissue for analysis was obtained both from clinically intact pre-molars and from third molars without restorations or caries. Frozen and acetone-fixed pulp tissue sections were subjected to indirect immunohistochemistry with monoclonal antibodies to the following cell types: all peripheral T cells, helper/inducer T cells, cytotoxic/suppressor T cells, macrophages, B cells, and Class II antigen-expressing cells. Dendritic cells expressing Class II antigens (HLA-DR, -DQ), indicating a capacity for presentation of antigen to T helper cells, were seen in the odontoblastic layer as well as in the central portions of the pulp tissue. T lymphocytes, divided into helper/inducer and cytotoxic/suppressor cells, were observed in all pulp specimens. B cells were not seen in any of the pulp samples examined. The data demonstrate that the human dental pulp is equipped with immunocompetent cells essential for the initiation of immunological responses. PMID- 3305635 TI - Effect of incompatibility stress on the fit of metal-ceramic crowns. AB - The interactive effect of coping thickness and a positive thermal contraction mismatch between metal and porcelain on the fit of metal-ceramic crowns has not yet been experimentally determined. Previous studies have suggested that marginal distortion may be due to contraction differences, although finite element analyses indicate that these distortion effects should be negligible. The marginal gap between metal-ceramic crowns and prepared dies was determined under conditions designed to exaggerate distortion effects. These included the use of thin metal copings (0.1 and 0.2 mm), a chamfer preparation, an alloy with relatively poor creep resistance, and a large thermal contraction mismatch between the alloy and porcelain layers. Gap changes which resulted during porcelain firing cycles were relatively small, but larger marginal discrepancies developed in crowns prepared with a compatible porcelain during grinding and abrasive blasting procedures. This study conclusively demonstrates that incompatibility stress induced by a positive contraction mismatch is not a primary cause of marginal or generalized distortion of metal-ceramic crowns and suggests that external grinding and internal abrasive blasting of crowns are more likely causes of this effect. PMID- 3305634 TI - Hyaluronidase activity of rabbit skin wound granulation tissue fibroblasts. AB - The objective of this work was to identify and compare hyaluronidase activities of normal dermal and dermal wound granulation tissue fibroblasts. Direct evidence of the fibroblast as a source of tissue hyaluronidase was obtained. Fourth passage rabbit dermal fibroblasts were harvested on culture days 4, 8, 14, 18, and 22. Hyaluronidase activity and [35S]-sulfate- or [3H]-glucosamine-labeled glycosaminoglycans (GAGs) were monitored. Hyaluronidase assays were performed on medium and cellular fractions at the designated intervals. Enzyme activity of cellular fractions for both normal dermal and 14-day post-wound granulation tissue fibroblasts increased progressively through culture day 8. Thereafter (days 14-22), an eight-fold drop in cellular activity was coupled with cell death and emergence of hyaluronidase activity in medium fractions. Marked increases in degradation of secreted matrix components were concurrent with lysis-induced release of hyaluronidase. In this culture system, hyaluronidase activity was confined exclusively to cellular fractions and was released into the medium only under non-physiological conditions conducive to cellular death and lysis. Accordingly, this work suggests that previously reported skin wound hyaluronidases may be of fibroblastic origin and that susceptible GAGs are not degraded extracellularly, but, rather, must be internalized as a prerequisite to depolymerization. PMID- 3305636 TI - Evaluation of biangular reflection photometry for quantitative study of etched alloy surface roughness. AB - Biangular reflection photometry was correlated with quantitative stereology and direct pit-depth measurements for an electrolytically etched nickel-chromium beryllium alloy. Effects of viewing angle, viewing aperture, and plane polarization of incident and viewing light were also studied. The results showed that architectural changes in the etched metal surface could be quantitatively described with the use of reflection photometry. An off-specular peak, located at an angle of reflection considerably different from the angle of incidence, was observed to have an intensity comparable with that of the specular reflection peak. Viewing aperture was found to affect one's ability to distinguish among degrees of surface roughness. PMID- 3305637 TI - Adhesion of resins to Ag-Pd alloys by means of the silicoating technique. AB - The purpose of the investigation was to study the effect of water storage on the bond strengths between silanized, silicoated Ag-Pd alloys and veneered composites, in comparison with the bond strengths of systems with conventional retention beads. Furthermore, the mechanism of the bonding was examined. The bond strength of silanized, silicoated dry specimens and similar specimens stored in water was measured by four-point bending. Water storage for 90 days at 37 degrees C reduced the bond strength by approximately 30% to about 15-20 MPa. Mechanical retention beads caused bond strengths of approximately 16-18 MPa which were unaffected by water storage. SEM and microprobe investigations showed that sandblasting with AI2O3 prior to silanization caused substantial numbers of cracks and porosities in the surface layer of the alloy, partly filled with Al2O3. Some particles of silicon oxide in these surface defects were produced by the flame-spraying of the so-called silicoating technique. Further painting of the surface with a silane adhesion primer provided chemical bonding to the composite at the densely spaced Si-O-H-containing silica particles. Many cracks were observed in the interfaces between these particles; thus, water is likely to penetrate the interface with time. The bond strength is most likely reduced by reaction between water and the composite/Si-O structure. The silicon oxide particles are probably attached to the alloy substrate by mechanical retention. Without sandblasting, no bonding was obtained by means of the silicoating technique. PMID- 3305638 TI - Corrosion of ferromagnetic alloys used for magnetic retention of overdentures. AB - Three ferromagnetic casting alloys intended for use with magnetically retained overdentures (compositions in wt%: #1, Pd 50, Co 47, Ga 2, Pt 1; #2, Pd 60, Co 37, Ga 2, Pt 2; #3, Pd 49, Co 46, Ga 2, Pt 2) were investigated. A 0.9% saline solution and an artificial saliva (Meyer) were used for evaluation of the electrochemical corrosion behavior of these alloys, utilizing standard potentiodynamic techniques. All alloys investigated possessed a good corrosion resistance in the potential range of the oral environment (from -100 to 300 mV versus SCE). In addition, alloys #1 and 3 appeared to be susceptible to pitting above +300 mV (SCE), while #2 was resistant to pitting and was found to passivate in 0.9% saline solution. PMID- 3305639 TI - Shear strength of the composite bond to etched porcelain. AB - The shear bond strength of composite resin to porcelain was investigated to optimize variables for bonding porcelain laminate veneers. Scanning electron microscopy was initially used to examine the surface configuration of porcelain prepared under various conditions. A factorial experiment was undertaken to determine the effects of three different bonding methods on both etched and non etched porcelain. Composite resin was bonded to the porcelain groups using (a) unfilled resin, (b) silane, and (c) silane with dentin adhesive. The results indicated a significant difference in shear bond strength for the three bonding groups, depending on the porcelain surface condition. For the unetched samples, significant differences in bond strength were obtained for all three bonding conditions. However, for the etched group, there were no differences between the silane and silane-with-dentin-adhesive groups. Porcelain etching significantly increased bond strength across all three bonding methods and was the main contributor to the obtained values. PMID- 3305640 TI - Etching patterns of Co-Cr alloys for bonded cast restorations. AB - Resin-bonded bridges may replace missing teeth and act as splints in periodontal treatment. The objective of this study was to investigate the etch pattern after electrolytic etching of selected Co-Cr alloys in hydrochloric acid and to assess the changes in alloy composition after different etching times. The alloys investigated were Vitallium, Wironit, Wironium, Nobilium Hard, and Niranium NN. Alloy specimens were electrolytically etched in a hydrochloric acid solution for 1, 2, 5, and 10 min. The etched specimens were examined in a light microscope and a scanning electron microscope (SEM). Different etching patterns were revealed in the various alloys. Microprobe analyses after the etching of Vitallium showed generally that Co was released and that Cr content increased at the surface. PMID- 3305641 TI - Stress distribution in metal-ceramic crowns with a facial porcelain margin. AB - The use of metal-ceramic restorations with porcelain butt-joint facial margins has increased in the past several years. Although these crowns exhibit improved esthetics compared with metal-ceramic crowns which display a metal gingival collar or metal knife-edge margin, the effectiveness of this design in resisting intra-oral forces is not known. The objective of this study was to analyze the stress distribution induced by simulated intra-oral loads on crowns with variable coping configurations. The copings, with a thickness of either 0.1 or 0.3 mm, were modeled with a facial termination of metal at three locations: at the gingival floor, 0.9 mm above the gingival floor, and 4.2 mm above the gingival floor. The coping and crown dimensions were based on a prepared maxillary central incisor with a facial shoulder and a lingual chamfer. Both Ni-Cr and Au-Pd alloy copings were employed in the crown models. Finite element stress and analyses were performed on crowns which were subjected to several loading conditions. A cement film thickness of 0.030 mm was assumed. For all cases, the stresses which developed in porcelain and cement near the facial and lingual margins due to a vertical load of 200 N were predominantly compressive in nature. For the crowns with Ni-Cr copings, the tensile stress in porcelain ranged from 11.0 MPa (for crowns with a facial metal thickness of 0.3 mm) to 12.5 MPa (for a metal thickness of 0.1 mm). The corresponding stresses for crowns with Au-Pd alloy copings were 8.3 MPa and 8.6 MPa, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305642 TI - Ion transport and water movement. AB - Secretion of water and electrolytes in salivary glands occurs by a dual process involving the formation of a plasma-like, isotonic primary secretion in salivary acini and its subsequent modification in salivary ducts by the removal and addition of specific ions. The mechanisms underlying the formation of primary acinar secretion have been investigated with a number of experimental approaches such as electrophysiology, the measurement of ion transport in gland fragments and dispersed acinar cells, and the evaluation of the ionic requirements for secretion in isolated, perfused gland preparations. The accumulated evidence suggests that salivary secretion is formed by a complex interaction between passive and active ion movements across acinar cell membranes, resulting in the trans-acinar movement of Cl- and Na+ and, by the osmotic gradient which develops, of water. A major consequence of stimulation is the release of K+ through Ca++- and voltage-sensitive channels and its subsequent recycling back into the cells by ouabain- and furosemide-sensitive transport systems. This results in NaCl uptake across the basolateral cell membrane and the subsequent efflux of Cl through luminal membrane channels, which also appear to be sensitive to cellular Ca++. The rates of these various ion movements appear to be, therefore, closely linked and interdependent. Ductal modification of the primary secretion has been studied in microperfused duct preparations. The evidence likewise indicates that it involves interactions between complex conductance pathways in the luminal cell membrane and a Na, K pump present in the basolateral cell membrane and that it is under autonomic and hormonal control. Activation of ductal transport mechanisms results in NaCl reabsorption and KHCO3 secretion. Final saliva thus differs from primary secretion in electrolyte composition and, because water permeability is low in the duct epithelium, becomes hypotonic. Alterations in fluid and electrolyte secretion such as those observed in disease can result, therefore, from disturbances in one or more of these complex transport processes in acinar or duct cells. PMID- 3305643 TI - Inflammatory and obstructive disorders of salivary glands. AB - Obstructive and inflammatory diseases of the salivary glands can have a congenital, traumatic, metabolic, or infectious-inflammatory cause. The acute inflammatory conditions include bacterial and viral infections, and the chronic conditions include sialoliths, strictures, chronic sialadenitis, sialectasis, and lymphoepithelial disease. The neoplastic disease can cause obstruction and/or infection and often make the diagnosis elusive. In addition to a working knowledge of possible etiology, one needs experience with clinical examination, salivary analysis, sialography, CT scans, MRI, and fine-needle aspiration and cytology in order successfully to evaluate and manage patients with these conditions. PMID- 3305644 TI - Iatrogenic causes of salivary gland dysfunction. AB - Saliva is important for maintaining oral health and function. There are instances when medical therapy is intended to decrease salivary flow, such as during general anesthesia, but most instances of iatrogenic salivary gland dysfunction represent untoward or unavoidable side-effects. The clinical expression of the salivary dysfunction can range from very minor transient alteration in saliva flow to a total loss of salivary function. The most common forms of therapy that interfere with salivation are drug therapies, cancer therapies (radiation or chemotherapy), and surgical therapy. These therapies can affect salivation by a number of different mechanisms that include: disruption of autonomic nerve function related to salivation, interference with acinar or ductal cell functions related to salivation, cytotoxicity, indirect effects (vasoconstriction/dilation, fluid and electrolyte balance, etc.), and physical trauma to salivary glands and nerves. A wide variety of drugs is capable of increasing or decreasing salivary flow by mimicking autonomic nervous system actions or by directly acting on cellular processes necessary for salivation: drugs can also indirectly affect salivation by altering fluid and electrolyte balance or by affecting blood flow to the glands. Ionizing radiation can cause permanent damage to salivary glands, damage that is manifest as acinar cell destruction with subsequent atrophy and fibrosis of the glands. Cancer chemotherapy can cause changes in salivation, but the changes are usually much less severe and only transient. Finally, surgical and traumatic injuries interfere with salivation because of either disruption of gland innervation or gross physical damage (or removal) of glandular tissue (including ducts). PMID- 3305645 TI - Comparison of cosmesis following healing by surgical closure and second intention. AB - When deciding on whether to surgically close a wound or allow granulation and epithelialization to occur, it is necessary to evaluate each patient individually. The patient's needs and desires, along with cost effectiveness, immediate versus delayed gratification, and convalescent time must all be considered. Also, the skill of the surgeon and the resources available to both the surgeon and the patient must be taken into consideration. PMID- 3305646 TI - The dermatologist and liposuction--a history. PMID- 3305647 TI - The suspension suture. AB - The suspension suture is a tension-reducing stitch that anchors the undersurface of a flap or elliptical wound edge to the underlying periosteum. The technique of placing the stitch is described and the indications for and the benefits derived from its use are discussed. PMID- 3305648 TI - Stimulus intensity and loudness recruitment: neural correlates. AB - An abnormally rapid rate of loudness growth for given increments in stimulus intensity is seen both in patients with cochlear pathology and in normal listeners under conditions of wide-spectrum noise masking. The phenomenological similarity between these psychophysical observations raises the question of whether a single mechanism, or set of mechanisms, underlies them. Recent neurophysiological studies in animals have addressed the effects of cochlear pathology and noise masking on the neural correlates of stimulus intensity in the central auditory nervous system. A comparison of the data presented in those studies reveals that there are sequelae of cochlear pathology seen in the discharges of auditory-nerve fibers that might reasonably be expected to contribute to a steepened loudness function. These sequelae are not seen at the same locus in normal animals studied with noise masking paradigms. Noise masking, however, may have effects on the tonal sensitivity of more central neurons that mimic some of the sequelae of cochlear pathology seen in the auditory nerve. These data suggest that the mechanisms underlying the two manifestations of recruitment may be quite different, one having a uniquely cochlear site, while the other reflects purely central processes. PMID- 3305650 TI - Alabama dentist of the year (Carl Eugene Brown Jr.). PMID- 3305649 TI - Joseph Francis Volker. Alabama's most distinguished adopted son. Part V--Vice President and President. PMID- 3305651 TI - Report of the Executive Director to the Board of Regents, American College of Dentists. PMID- 3305652 TI - A treasury of dentistry. Collection methods, suits and judgments--from earlier days. PMID- 3305653 TI - The presidents. William Andrew Garrett 1966-1967. PMID- 3305654 TI - Preventing enamel decalcification after orthodontic treatment. AB - As enamel decalcification can occur in conjunction with orthodontic treatment, suggestions are offered for ways to prevent this condition from manifesting. A review of the literature shows the problem is widespread. Preventive programs must be emphasized. PMID- 3305655 TI - Endodontic and restorative management of a resorbed eight-unit fixed partial denture abutment tooth: report of case. AB - Treating internal resorption is one of dentistry's most difficult challenges. This pathological process is difficult to manage in an advanced stage. The usual treatment involves surgery or, in many cases, extraction of the resorbed tooth. It is often difficult for the patient to understand and accept such a radical treatment approach. This report of case illustrates severe internal resorption that destroyed a major portion of a key abutment tooth supporting an eight-unit fixed partial denture. The resorptive pathosis was treated by a nonsurgical endodontic approach. The severely damaged abutment was reinforced and restored so that the existing eight-unit fixed partial denture could be preserved. The patient was pleased with the method of treatment and was commended for seeking regular recall professional care. It would have been easy to postpone treatment as the problem was asymptomatic. However, to do so probably would have resulted in loss of the resorbed abutment tooth, thus creating a complex restorative situation. The original prosthesis is currently 14 years old, functioning well, and showing no apparent evidence of pathosis. Costly and time-consuming remake procedures were avoided and patient satisfaction was maintained. PMID- 3305656 TI - Health science on stamps (Moriz Kaposi). PMID- 3305657 TI - Root surface caries: a critical literature review. AB - Little information is available on the prevalence and clinical appearance of root surface caries. The literature shows that root surface caries is thought to be similar to coronal caries, but that certain diet-bacterial interactions might predispose to root surface caries. A scan of the literature concerning the epidemiology, etiology, microbiology, periodontology, as well as reporting methods and restoration treatment of root surface caries shows current practices and suggests future research. PMID- 3305658 TI - Dentistry on stamps (J. Tandler). PMID- 3305659 TI - The presidents. Floyd Darl Ostrander 1967-1968. PMID- 3305660 TI - The use of a direct bonded microfilled composite resin veneer. AB - This technique creates a direct bonded microfilled composite resin veneer that replicates the complex color distribution and surface texture of the natural tooth structure. Duplicating the complexity of natural tooth color can be repeated by recording the different layers of color used in their sequence of placement. PMID- 3305661 TI - Red, blistering, and erosive lesions of the oral mucosa. AB - Clinical diagnosis among the vesiculobullous diseases is difficult. Benign mucous membrane pemphigoid is a chronic condition, whereas bullous pemphigoid and erythema multiforme are self-limiting. Oral lesions can be the initial appearing feature of the disease. Therefore, routine histological examination with immunofluorescent studies and a good medical history will aid in differentiating among them. The case report described here shows a benign mucous membrane (cicatricial) pemphigoid in a 52-year-old female whose initial symptoms involved the oral mucosa with subsequent skin lesions. There is no other apparent mucosal involvement at this time. The symptoms are palliated with use of topical fluocinonide, but continued follow-up care is indicated. PMID- 3305662 TI - Helen Brooke Taussig: 1898 to 1986. PMID- 3305663 TI - A new method of inhalation challenge with propranolol: comparison with methacholine-induced bronchoconstriction and role of vagal nerve activity. AB - To establish a safe procedure for examining propranolol-induced bronchoconstriction, we have developed a new method for performing inhalation challenge with propranolol. Monitoring respiratory resistance during tidal breathing with continuous inhalation of propranolol in 1.5-fold increasing concentrations from 0.78 to 30 mg/ml for 1 minute at each concentration, we tested 43 subjects with stable asthma and 10 normal subjects. We also compared bronchial responsiveness with responsiveness to inhaled methacholine on separate days. In addition, to determine the role of vagal nerve activity in propranolol induced bronchoconstriction, we studied the effect of atropine. Inhaled propranolol caused dose-related bronchoconstriction in all subjects with asthma but not in normal subjects. None of the subjects suffered severe asthmatic attack during the test, which was performed in 15 minutes or less. The minimum cumulative dose of methacholine and of propranolol, at the point where respiratory conductance began to decrease, was not significantly correlated. Increased respiratory resistance was reversed by atropine in 70% of the subjects with asthma with marked individual differences. These data suggest that, although in most subjects with asthma, vagal nerve activity contributes in varying degree to bronchoconstriction, other constricting factors may contribute in the remaining subjects. It is also suggested that the mechanism of bronchial response to propranolol differs from that of the nonspecific airway reactivity estimated by methacholine challenge. PMID- 3305664 TI - Allergens in Hymenoptera venom. XVIII. Immunoblotting studies of venom allergens. AB - Pure venoms from yellow jackets and bees were used to evaluate denaturing and nondenaturing immunoblot techniques and to compare results of IgE antibody stained immunoblots to RAST with highly purified allergens. Significant differences in IgE antibody binding were observed among all three techniques, suggesting that tertiary conformation is a major factor in the allergenic determinants of venom allergens. IgG antibodies from hyperimmunized animals and from specimens obtained from allergic patients before and after venom immunotherapy appeared to exhibit less conformational dependence for binding. The conformational dependence of IgE antibody binding to bee and yellow jacket phospholipases was confirmed by direct and inhibition RAST studies. The allergens studied were all single polypeptide chains. PMID- 3305665 TI - Mucosal immunity: the immunology of breast milk. AB - The mammary glands represent one part of the mucosal immune system, a definable, subunit of humoral and cellular immune functions in man that appears to have developed particular qualities well suited to guard our interface with the environment. As our understanding of secretory immunoglobulins and lymphocyte migration patterns continues to develop, the immunologic components found in breast milk appear increasingly likely to play a specific immunologic role in the protection of the nursing infant. The biologic basis for the observed protective effect of breast-feeding is reviewed with an emphasis on the mechanisms involved in the development and maintenance of mucosal immunity in general. PMID- 3305667 TI - Asthma mortality: England and Wales. PMID- 3305666 TI - Historical perspectives: the epidemic of asthma deaths in the United Kingdom in the 1960s. PMID- 3305668 TI - Asthma morbidity and mortality: New Zealand. PMID- 3305669 TI - History of asthma deaths from antiquity. AB - Death from asthma has been known to occur since its original descriptions in ancient times. Even in the eighteenth century some risk factors for death, such as delayed or inadequate treatment, were recognized. Autopsies performed on some patients dying of asthma in the seventeenth and eighteenth centuries did not show the characteristic gross pathologic findings, suggesting that some inappropriate therapy might have contributed to the demise of the patients. In the nineteenth and twentieth centuries, before 1920, death from asthma was considered to be rare by many leading authorities. However, asthma mortality rates in young people were stable for a century before the "epidemic" of asthma deaths in the latter 1960s. Since then, despite many advances made in our understanding of the underlying pathophysiologic mechanisms and in our ability to treat with newer drugs, deaths from asthma in young patients have not declined and in some areas of the world have indeed increased. PMID- 3305670 TI - Review of asthma self-management programs. PMID- 3305671 TI - The value of regular replacement of low water content contact lenses for extended wear. AB - Adverse effects were evaluated in 48 myopic patients who wore low water content hydrogel lenses for an average of 48 +/- 19 weeks. Only one acute "red eye" occurred in the regular replacement group (2% of patients), whereas seven cases (15%) occurred in the non-replacement lens wearing eye. The major cause of clinical failure was giant papillary conjunctivitis (GPC), but the incidence was similar in both the replaced (15%) and non-replaced (15%) lens wearing eyes. These findings indicate that the acute red eye incidence can be reduced by regular replacement, that unilateral lens replacement does not reduce the incidence of GPC and that regularly replacing low water content lenses does not minimize the chronic corneal changes that occur during extended wear. PMID- 3305672 TI - Acanthamoeba keratitis in soft contact lens wearers. AB - Two wearers of soft cosmetic contact lenses developed corneal infection by the protozoa Acanthamoeba. Contact lens solutions were found to be contaminated in both cases. The clinical course and management are described in this report. Factors that may predispose contact lens wearers to infection by Acanthamoeba and preventative measures are discussed. PMID- 3305673 TI - Cost effective outreach surgery for rural communities. PMID- 3305674 TI - Optometric parity legislation under Medicare. AB - On April 1, 1987, optometrists became eligible for reimbursement under Medicare for the services optometrists are authorized to provide under the laws of the state in which this service is performed. The optometric parity language did not expand or change the current coverage and reimbursement rules, but rather expanded which providers could be reimbursed under Medicare. For the service to be covered by Medicare, the service must be one which is currently covered by Medicare if furnished by a doctor of medicine or osteopathy, and must be within the services the optometrist is authorized to perform under the licensure laws of the state in which the service is performed. Optometric parity was included as part of the Omnibus Reconciliation Act of 1986, which was signed by President Reagan on October 21, 1986. PMID- 3305675 TI - Hepatic sympathetic denervation potentiates glucagon-stimulated glycogenolysis and hyperinsulinaemia in the rat. AB - The influence of hepatic nerves on glucagon-stimulated hyperglycaemia and hyperinsulinaemia was studied in rats. Using microsurgical techniques, hepatic sympathectomy (resulting in approximately 80% reduction of liver noradrenaline content) or hepatic vagotomy was performed. Glucagon (10 micrograms/kg b.wt.) was injected i.v. one week after the operative procedure. Plasma levels of glucose and insulin rose more rapidly and to a higher level in rats subjected to hepatic sympathectomy than in sham-operated or non-operated control animals. In contrast, hepatic vagotomy did not influence the plasma glucose or insulin response to glucagon. In conclusion, our findings suggest a role for the hepatic sympathetic nerves in glucagon-stimulated glycogenolysis and insulin secretion in the rat. PMID- 3305676 TI - Ultrastructural identification of vasoactive intestinal polypeptide- and neuropeptide Y-containing nerve fibres in the vas deferens of the guinea-pig. AB - Vasoactive intestinal polypeptide (VIP)-like and neuropeptide Y (NPY)-like immunoreactive nerve fibres were identified by electron microscopic immunohistochemistry in the guinea-pig vas deferens. Labelled nerve fibres were observed in all layers of the wall. However, the NPY-like immunoreactive nerve fibres were most numerous in the muscle layer, and only a few labelled nerve processes were found in the tunica mucosa. In contrast, many of the VIP-like immunoreactive nerve fibres were found in close relation to the blood vessels, especially in the tunica mucosa. In the muscle layer, most immunoreactive nerve fibres were found in close relation to the smooth muscle cells; in these situations the separation between axon and muscle cell membranes was nearly always less than 100 nm, and in many cases as little as 20 nm. The ratio of large to small vesicles in the VIP-like immunopositive axons was 1:3.1, while in the NPY-like immunoreactive nerve terminals the ratio was 1:6.2. These ultrastructural observations confirm that VIP- and NPY-like immunoreactive nerve fibres exist in vas deferens and provide a morphological basis for the possibility that these fibres may participate in the regulation of smooth muscle activity and may influence blood flow in the vas deferens. PMID- 3305677 TI - [Theoretical formulas for the power of artificial lenses]. AB - After having recalled the principles of lens power calculation, we analyse in detail the parameters of the (Formula: see text). Corneal power K read on keratometers has to be modified, for it is about one diopter too strong. Evaluation of the anterior chamber depth C is analysed and corrected of 0.08 mm for the 1st C and of 0.06 mm for the 2nd C. Ultrasonic axial length L should be increased by the retinal thickness; the error induced by neglecting this correction is concealed by the overestimation of K in usual formulas. The equivalent power of the lens De is slightly underestimated relative to back surface power supplied by the manufacturer. The various formulas available in the Literature are commented and compared. A new formula is proposed, which is more particularly adapted to contact ultrasound probes, such as Digiecho II, which seem to under-evaluate L and C values. PMID- 3305678 TI - [Evaluation of the performance of an automatic objective refractometer on 3,618 eyes]. AB - The RM 5000 Auto-refractor was evaluated for one year on 3,618 eyes of 2,037 non selected patients undergoing refraction. The objective automatic refractor showed a high degree of reliability and repeatability in determining the needed refractive correction. The performances were at least equivalent to the results given by keratometry and retinoscopy with an appreciable saving of time (about 4 minutes per patient) turned to account for clinical examination. The results were especially useful among aphakic patients and children under atropine. Automatic refractors are expected to become an essential tool in current ophthalmological. PMID- 3305679 TI - [Value of adjustable sutures in the treatment of diplopia]. AB - Adjustable sutures have been used as a curative procedure in 31 cases of diplopia, 16 cases of plegic causes, 4 cases of acute concomitant squint and 11 cases of mechanical strabismus: thyroid myopathy, orbital fracture, oculomotor imbalance after scleral indentation. In oculomotor paralysis if a few functional motor units remained at plegic muscle level, we were able to obtain new rotational balance by combining, with adjustable sutures, recession and resection of the couple agonist-antagonist. On the other hand, if no functional motor unit remained, it was then necessary to turn to the muscular translocation process modulated by adjustable surgery. In acute concomitant strabismus, adjustable retroposition of the medial rectus enabled us to fall back into an area controlled by fusional vergencies. Lastly, in mechanical strabismus by passive limitation, adjustable sutures usually enabled hyperaction of the contralateral synergists to be controlled and to bind a new rotational balance, compatible with a simple binocular field of vision. The advantage of this technique was to adapt, on adjustment, the motor response to the new innervational background which had disappeared under anaesthesia. PMID- 3305680 TI - [The corneal endothelium and keratoplasty]. PMID- 3305681 TI - Initial treatment of thyrotoxic Graves' disease with methimazole: a randomized trial comparing different dosages. AB - We evaluated the efficacy of different doses of methimazole (MMI) as the initial therapy for Graves' disease. Fourteen patients were treated with 15 mg/die of the drug (group A) and 14 with 30 mg/die (group B). Blood samples for T3, T4, FT3 and FT4 were obtained before beginning therapy, every 48 h during the first 12 days and on the 45th day of treatment. All these hormonal parameters fell significantly from the 2nd day of therapy in both groups. All the patients, except for one in group B, had normal or subnormal levels of thyroidal hormones on the 45th day of treatment. The comparison between the two groups of regression coefficients over the first 12 days showed no significant differences. The absolute decrease of each examined parameter on day 12 was positively correlated with the relevant pretreatment value. These results demonstrate that doses of MMI (15 mg/die) much lower than those commonly recommended are able to rapidly control thyroidal overproduction as effectively as 30 mg/die. PMID- 3305682 TI - Insulin receptors on circulating blood cells from patients with pancreatogenic diabetes: a comparison with type I diabetes and normal subjects. AB - We studied 125I-insulin binding to erythrocytes from 14 patients with diabetes secondary to chronic pancreatitis or pancreatectomy and compared the results with those found in 10 patients with type I diabetes and 25 normal controls. Patients with pancreatogenic diabetes had higher 125I-insulin binding and enhanced tissue sensitivity to exogenous insulin measured with the glucose clamp technique as compared with patients with type I diabetes. Similar binding data were obtained with monocytes from 3 patients with pancreatogenic diabetes. The increase in insulin binding seemed due mainly to an increase in receptor number. The increase in insulin binding to cells from patients with pancreatogenic diabetes in comparison with cells from normal subjects was also seen in young-erythrocyte rich fractions and in old-erythrocyte-rich fractions obtained from the mixed population of circulating erythrocytes by centrifugation in density gradient of Percoll-Pielografin. These data, in the absence of any sign of major hematological disorders, suggest that the increase in insulin receptors seen in erythrocytes and in monocytes from patients with pancreatogenic diabetes, can mirror a general phenomenon on tissues throughout the body, including major target cells for insulin and correlate with the heightened sensitivity to insulin characteristic of these patients. In conclusion, patients with pancreatogenic diabetes have increased insulin binding as compared to controls and to patients with type I diabetes with chronic hypoinsulinemia of the same degree. Thus, in addition to insulin deficiency, other factor (s), such as glucagon deficiency, are responsible for the clinical and metabolic differences between these two conditions of insulin deficiency. PMID- 3305683 TI - Reduction of glycogen stores in a rat model of chronic hyperinsulinism. AB - To assess a suitable model for the study of the mechanisms of development of insulin resistance in vivo, liver and muscle glycogen levels (as a metabolic index of tissue insulin sensitivity) were investigated in rats with functioning islet cell adenomas induced by streptozotocin and nicotinamide. These rats have basal moderate hyperinsulinemia and hypoglycemia and show a remarkable increase in insulin secretion after glucose administration. Plasma glucagon concentrations are normal. Nevertheless, in tumor-bearing rats, a reduction of tissue glycogen stores occurs, related to plasma glucose concentrations, and liver glycogen fails to increase even after a glucose load. The lack of excess fat in tumor-bearing rats also suggests a certain insulin insensitivity of the adipose tissue and distinguishes this model of chronic hyperinsulinism from other reported models, such as genetically obese animals. PMID- 3305686 TI - [Eulogy of Prof. Henri Pigeaud, 1897-1987]. PMID- 3305685 TI - The gerontological decline of the renin-aldosterone system: a chronobiological approach extended to essential hypertension. AB - The circadian (about 24-hr) oscillating function of the renin-angiotensin aldosterone system (RAAS) was investigated as a function of age in clinically healthy participants and in essential hypertensive patients. A peculiar age related decline in the RAAS circadian mesor (rhythm-adjusted mean) and amplitude (variability from mesor) was found in the essential hypertensive patients. This finding suggests a nonphysiologic evolution in the tonic (24-hr mean level) as well as phasic (oscillating amplitude) circadian activity of the RAAS with increasing age. A relative hyperreninemic aldosteronism characterized the aged essential hypertensive patients. PMID- 3305684 TI - Estrogen and catechol amine metabolism: possible interaction during pregnancy. PMID- 3305687 TI - [Percutaneous ultrasound-guided sampling of fetal blood]. AB - The authors give their experience of percutaneous ultrasound-guided sampling of fetal blood carried out over a period of two years. They suggest a modification of the technique, using linear screening scanning. This has made it possible to reduce the number of unsuccessful attempts at sampling. An analysis of the indications and of the results in 49 attempts at puncture shows how to select the indications better. This is particularly so when fetal abnormalities have been found on ultrasound examination. The authors think that this method, because of its reliability and the speed with which results are obtained, should be a method of choice for screening for chromosome abnormalities which might be thought to exist from the pictures obtained by ultrasound. PMID- 3305688 TI - [Malaria and pregnancy. Comparative study of Central Africa and Western Africa]. AB - The transmission of malaria occurs mainly in and following the rainy season (intermittent transmission) in the Sahelian zone of Africa. On the other hand in rainy Equatorial Africa the transmission of malaria is continuous so that it is stable and can give rise to continuous antigenic stimulation in pregnant women which in turn gives rise to passive early high level immunity in the infant. 150 couples of mother and cord blood and 206 placentae were studied. We found 12.1% of carriers of blood parasites in the blood as compared with 1.6% in the cord bloods (exclusively P. falciparum). Where there were medium quantities of fluorescent antibodies in the mothers 74% could be found in the cord serum. Two methods were used to measure antimalarial antibodies as evidence of infection and also partly protective: the first method was indirect immunofluorescence, and the second was co-electrosyneresis. There was a narrow correlation between the level of precipitant antibodies in the mothers who were infected and in the fetal cord bloods. Anatomo-pathological examination of the placenta showed that 2 out of the 206 had parasites in them, 9 out of the 206 had fibrin deposits around the villi and 6.8% of the placentae showed lesions of malaria. On the other hand, in West Africa there was very little maternal morbidity as evidence by fever and anaemia, or of fetal morbidity. There was no single case of congenital malaria. The levels of the plasma indices in the towns could be explained because of prophylaxis which was both controlled and uncontrolled. PMID- 3305689 TI - An unusual case of neonatal myasthenia. AB - An unusual case of neonatal myasthenia gravis is reported in an infant who had respiratory failure due to diaphragmatic weakness. Although power and tone in the limbs were normal, fatiguability of both diaphragm and peripheral muscles was demonstrated. Acetylcholine receptor antibodies were absent in the mother, which suggests that an alternative humoral mechanism may have been responsible for the transient (6-week) neonatal weakness. PMID- 3305690 TI - Emergency transcutaneous pacing in the management of patients with bradyasystolic rhythms. AB - Survival rates in cases of bradyasystolic cardiac arrest are uniformly low, being reported at from 0% to 3%. Recent advances in technology and microcircuitry have produced lightweight, portable external pacing devices that are less painful to the patient. In an on-going clinical trial of early transcutaneous pacing, five cases were seen in which transcutaneous pacing was begun at the onset of the patients' rhythm disturbance. All five patients survived to leave the hospital. Three of the patients were treated in the prehospital setting. Because of the rapidity with which pacing can be implemented, the ease of application and simplicity of operation, transcutaneous pacing has several advantages over the placing of transvenous pacemakers in the field or emergency department setting. In hemodynamically-compromising bradydysrhythmias unresponsive to pharmacologic intervention, the early use of transcutaneous pacing may improve survival in a group of patients who might otherwise die. PMID- 3305692 TI - Disseminated intravascular coagulation: pathogenesis, diagnosis, and therapy. AB - Disseminated intravascular coagulation (DIC), resulting in an acute bleeding diathesis, is always a secondary complication of an underlying disease. Coagulation triggered by the primary process causes consumption of clotting factors and platelets, and ischemic damage secondary to fibrin deposition. Concurrent activation of the fibrinolytic system results in additional clotting factor consumption and the production of fibrin-degradation products (FDP). The combination of decreased clotting factors, FDP, and thrombocytopenia may ultimately culminate in a bleeding diathesis. The balance between the thrombotic and hemorrhagic processes results in a constellation of signs and symptoms. Diagnosis depends on an awareness of predisposing pathologic states and the application of appropriate laboratory tests. Therapy consists of treating the underlying disease and temporizing with an appropriate replacement therapy. Heparin infusion may be of benefit under certain circumstances. The pathogenesis, diagnosis, and treatment of DIC, including new laboratory tests and experimental therapy, are reviewed. PMID- 3305691 TI - Anesthetic properties and toxicity of bupivacaine and lidocaine for infiltration anesthesia. AB - The purpose of this study was to measure the toxicity and anesthetic properties of two anesthetic agents, bupivacaine and lidocaine. These anesthetic agents did not damage tissue defenses or invite infection in experimental animals. In addition, the pain of subdermal injection, the onset of anesthesia, and the frequency of satisfactory anesthesia in human volunteers were remarkably similar. Because the duration of anesthesia induced by bupivacaine was nearly four times longer than that by lidocaine, bupivacaine is recommended for infiltration anesthesia of lacerations treated in the emergency department. PMID- 3305693 TI - Role of de Vries in the rediscovery of Mendel's paper. II. Did de Vries really understand Mendel's paper? AB - In this paper, we discuss briefly three of the several lines of evidence that we believe demonstrate de Vries's lack of understanding of Mendel's paper. In our view, at least part of de Vries's failure of understanding derives from the fact that he appears to have viewed Mendel's paper as being mainly about the inheritance of characters that was his own interest. Therefore, he looked at it to see whether Mendel had found any laws of inheritance. Mendel had done his research for another purpose, to find the laws describing the formation of hybrids and the development of their offspring. Thus, de Vries started his examination of Mendel's paper with a very fundamental misunderstanding of what it was about. PMID- 3305694 TI - Genetic variability and mapping of peptidase-4 in Anopheles albimanus. AB - Field-collected and laboratory populations of Anopheles albimanus were analyzed for the presence of variability for the enzyme, peptidase. Four zones of peptidase electromorphs were observed. The Peptidase-4 (Pep-4) locus was analyzed genetically and assigned to a location adjacent to the centromere on the right arm of chromosome 2 by employing crosses involving morphological mutants, allozyme markers, a holandric translocation, and pericentric inversions. The gene sequence (and map distances) on chromosome 2 beginning from the left arm is: brown larva--40--ebony (eb)--centromere--pep-4--?--bent(be)--?--Glutamate oxaloacetate transaminase (Got)--11--Glucose oxidase-2(Go-2)--17--green larva (gl)--9--amber (am)--2--propoxur resistance (prr)--2--red eye (re)--21--6 Phosphogluconate dehydrogenase (6-Pgd)--1--yellow. The crossover frequencies between eb and Pep-4 and Pep-4 and Got were 34 and 16, respectively. PMID- 3305696 TI - A 1759 spotted fever epidemic in North Carolina. PMID- 3305695 TI - Koch's postulates and the etiology of rickettsial diseases. PMID- 3305697 TI - American medicine and Selective Service in World War II. PMID- 3305698 TI - The history of Alzheimer's disease: three debates. PMID- 3305699 TI - Immunohistochemical localization of a thyroid hormone-binding protein (p55) in human tissues. AB - We have localized p55, a thyroid hormone-binding protein found in the endoplasmic reticulum in cultured cells, in samples of normal human and monkey tissues, using a monoclonal antibody with cryostat sections and immunoperoxidase histochemistry. Large amounts of p55 were found in many tissues, generally corresponding to the amount of endoplasmic reticulum contained in each cell type. Intense localization of p55 was found in cells of the anterior and intermediate pituitary lobes, in epithelial cells of thyroid follicles, in the glandular epithelium of mammary gland, in hepatocytes, in Paneth cells and Brunner's glands in duodenum, in acinar cells of pancreas, in adrenal cortical cells, and in scattered interstitial fibroblastic cells in many tissues. These results suggest a potential role for thyroid hormone and p55 in regulating protein synthesis or secretion in multiple organs. PMID- 3305700 TI - Localization of glycoproteins in insulin secretory granules by ultrastructural autoradiography. AB - To determine whether or not the secretory granules of insulin-secreting cells contained glycoproteins, isolated rat pancreatic islets were incubated for 2 and 4 hr in a medium containing L-[3H]-fucose. Quantitative analysis of high resolution electron microscopic autoradiographs of the insulin-secreting beta cells demonstrated that glycoproteins with fucose residues are contained within the insulin secretory granule. PMID- 3305702 TI - Immunocytochemical studies of desmin and vimentin in pericapillary cells of chicken. AB - The composition of intermediate filaments in pericytes was examined by immunofluorescent and immunoelectron microscopic labeling of frozen sections of various chicken microvascular beds in situ. Pericytes in capillaries of cardiac muscle, exocrine pancreas, and kidney (peritubular capillary) were found to contain both desmin and vimentin. In some capillaries where pericytes do not exist, cells apposed to endothelial cells--the Ito cell in the hepatic sinusoid and the reticular cell in the splenic sinusoid--were shown to contain both of the intermediate filament proteins. In contrast, podocytes and mesangial cells around renal glomerular capillaries contained only vimentin. The presence of desmin supports the hypothesis that pericytes may have a contractile apparatus similar to that of vascular smooth muscle cells. Our results also revealed that even in microvascular beds where pericytes are not found, cells having both desmin and vimentin exist next to endothelial cells and may assume similar functions to pericytes. PMID- 3305701 TI - Glucokinase in B-cell-depleted islets of Langerhans. AB - Glucose phosphorylation was studied in B-cell-enriched or in B-cell-depleted pancreatic islets from normal or streptozotocin-diabetic rats, respectively, using quantitative histochemical procedures. The data indicate that B-cell enriched preparations from normal animals and whole islets from normals, diabetics, and insulin-treated diabetic animals have comparable glucokinase activities. Average maximum velocities were (mmol/kg dry tissue/hr) 134.1 +/- 7.3 for whole islets and 125.6 +/- 10.7 for the B-cell-enriched preparations from normal rats, 143.1 +/- 13.6 for B-cell-depleted islets from diabetic rats, and 124.4 +/- 10.7 for B-cell-depleted islets from insulin-treated diabetic animals. The Kmax for glucose of the enzyme in islets from untreated diabetic rats was 16 mM, comparable to the Kmax found for glucokinase from normal rat islets. Mannoheptulose, previously shown to be a competitive inhibitor of glucokinase from liver and normal islets, also inhibited glucokinase in B-cell-depleted islets from diabetic rats. The data indicate that glucokinase is not selectively located in the B-cell, as was previously assumed, but is also found in A- and/or D-cells of diabetic rats. This observation raises significant questions about the functional role of islet glucokinase under control and diabetic conditions. PMID- 3305703 TI - Early stages of synthesis of thyroglobulin (Tg), thyroxine (T4), and triiodothyronine (T3) in fetal rat thyroid. An immunoelectron microscopic study. AB - Immunoelectron microscopy was applied for detection of Tg, T4, and T3 in fetal rat thyroid gland during the early stages of synthesis of these compounds, in order to elucidate the subcellular aspects of onset of their production. Tg was detected in the perinuclear space, rER, and Golgi apparatus as early as the sixteenth day of gestation when no follicles had yet formed. When primitive follicles had formed after the seventeenth day of gestation, both T4 and T3, as well as Tg, appeared on the surface of microvilli and occasionally in their core portions. These findings provide evidence to suggest that follicles are essential to extracellular synthesis of T4 and T3 in fetal rat thyroid gland. PMID- 3305704 TI - Combined method of PAP immunocytochemistry and autoradiography: application to cell kinetic study in plasma cell dyscrasias. AB - The plasma cell labeling index (LI), in spite of being a reliable indicator for diagnosis and prognosis of multiple myeloma, has been measured in a limited number of laboratories because of technical difficulties. We have developed a new combined technique, using the peroxidase-antiperoxidase (PAP) method and autoradiography, which has several advantages over previously described methods. The primary advantages of our method in the determination of lymphoid-plasma cell LI% are: (a) no damage to slides during storage of more than 1 year; (b) an exact LI measurement in each morphological variety of pleomorphic immunoglobulin containing cells; (c) no problem in differentiation of lymphoid plasma cells from early red cell precursors; and (d) a separate LI measurement for those lymphoid plasma cells composed chiefly, if not exclusively, of monoclonal or neoplastic cells. Because of these advantages, this accurate and less difficult technique will facilitate performance of lymphoid plasma cell LI in a number of laboratories. PMID- 3305705 TI - The stable and permanent expansion of functional T lymphocytes in athymic nude rats after a single injection of mature T cells. AB - Athymic nude rats (PVG.rnu/rnu) were injected at 6 to 10 wk of age with 1 to 200 million thoracic duct lymphocytes (TDL) containing 40 to 60% mature T cells. Thereafter TDL-injected nude recipients were monitored for evidence of T cell function for up to 2 yr. W3/25+ T helper (Th) cells in lymph nodes (LN) increased from 7% at 2 wk to 30% at 8 wk after TDL transfer. The percent of W3/25+ cells remained elevated for the life of the recipient (up to 2 yr), approximating normal levels. The total size of the recirculating pool expanded in TDL-injected nude rats to reach 2/3 the level of euthymic controls by 16 wk, an increase of 10 fold to 15-fold in W3/25+ cells. The expansion of the W3/25+ population was independent of initial TDL dose. With time spleen and LN acquired a normal histological appearance including the development of germinal centres and a marked increase in cellularity in T cell traffic areas. TDL-injected nude rats rejected skin allografts with near normal kinetics. In addition graft vs host (GVH) responsiveness, assessed by the popliteal LN assay, progressively increased reaching a level 9 mo to 1 yr after replacement that resembled the GVH activity in euthymic controls. PMID- 3305706 TI - Monoclonal antibodies that recognize lacto-N-fucopentaose III (CD15) react with the adhesion-promoting glycoprotein family (LFA-1/HMac-1/gp 150,95) and CR1 on human neutrophils. AB - A variety of monoclonal antibodies has been used to study the roles of surface proteins in neutrophil function. Many monoclonal antibodies that bind to human neutrophils react with the oligosaccharide lacto-N-fucopentaose III. Sequential immunoprecipitation of radiolabeled proteins from extracts of neutrophils labeled at the cell surface with 125I, and partial proteolysis peptide mapping studies were used to compare the proteins recognized by several widely used monoclonal antibodies that react with human neutrophils. The monoclonal antibodies that react with lacto-N-fucopentaose III (CD15) immunoprecipitated five distinct neutrophil surface proteins. The data indicate that CD15 monoclonal antibodies react with a subset of the LFA-1/HMac-1/gp 150,95 glycoprotein family as well as with CR1 on human neutrophils. The CD15 antibodies studied differed in their avidities for these proteins. The molecules immunoprecipitated by the CD15 antibodies tested were more resistant to proteolysis than the homologous proteins immunoprecipitated by the other monoclonal antibodies studied that react directly with the alpha M (CD11) or beta (CD18) chains of the LFA-1/HMac-1/gp 150,95 glycoprotein family. Some of the differences in antibody reactivity and protease sensitivity of the membrane proteins recognized by these antibodies may be due to differences in glycosylation. The data suggest that the antibodies studied can detect differences in post-translational modification among copies of certain surface proteins. PMID- 3305707 TI - The role of interferon-beta 1 and the 26-kDa protein (interferon-beta 2) as mediators of the antiviral effect of interleukin 1 and tumor necrosis factor. AB - This study confirms our earlier finding that human interleukin (IL)-1 beta exerts an antiviral effect on diploid fibroblasts and on MG-63 osteosarcoma cells. It also extends the observation in that a similar effect was noted on aged but not freshly trypsinized HEp-2 cells, and that not only IL-1 beta but also IL-1 alpha and tumor necrosis factor (TNF)-alpha exerted similar antiviral effects on cells. The antiviral effects of these cytokines were neutralized by addition to the assay system of an antibody that was specific for interferon (IFN)-beta 1, indicating that IFN-beta 1 or a structurally or functionally related substance is involved in the antiviral activity observed. Both IL-1 and TNF were able to induce production of the 26-kDa protein, also known as IFN-beta 2, hybridoma/plasmacytoma growth factor (HPGF) or B-cell stimulatory factor-2 (BSF 2) and previously proposed as an alternative to IFN-beta 1 for mediating the antiviral effect of TNF. However, no good correlation was found between the antiviral effects of TNF and its potential to induce production of the 26-kDa protein. Furthermore, the anti-IFN-beta 1 serum which neutralized the antiviral activity of IL-1 and TNF did not cross-react with the 26-kDa protein. Conversely, the antiviral effect of IL-1 and TNF was only weakly neutralized by an antibody that did react with the 26-kDa protein and showed low cross-reactivity with IFN beta 1. These observations, together with the low specific activity of the 26-kDa protein as an antiviral agent (less than 10(5) U/mg protein) provide strong arguments against this protein and in favor of IFN-beta 1 (or still another IFN beta 1-related molecule) as the ultimate mediator of the antiviral effect of IL-1 and TNF. PMID- 3305708 TI - Expansion of human tumor infiltrating lymphocytes for use in immunotherapy trials. AB - The potential utility of tumor-infiltrating lymphocytes (TIL) in the adoptive immunotherapy of human tumors has been suggested by murine experiments showing these cells to be 50-100 times more powerful than LAK cells in treating advanced metastatic disease. A method for the large-scale expansion of human TIL for the use of these cells in clinical trials is described in this report. TIL were successfully expanded on an experimental scale from 24 of 25 consecutive human tumors, including six melanomas, ten sarcomas, and eight adenocarcinomas. Tumors were digested enzymatically to yield single cell suspensions which were cultured in RPMI 1640 medium with 10% human serum and 1000 U/ml recombinant interleukin-2. Lymphocytes constituted from 3% to 74% of single cell tumor suspensions, and expanded from 2.9-fold to 9.1 X 10(8)-fold over a culture period ranging from 14 to 100 days. Nine of 24 TIL cultures lysed fresh autologous tumor targets in 4 h chromium release assays. Cell surface phenotyping identified cultured TIL as activated cytotoxic/suppressor T cells. Subsequently, large-scale expansion of TIL was successful in generating more than 10(10) lymphocytes in five of eight consecutive cases. Clinical trials employing the adoptive transfer of expanded TIL to patients with metastatic disease have begun. PMID- 3305709 TI - Antibodies to native and denatured DNA. Quantitation using an immuno-slot-blot technique. AB - The attachment of DNA to nitrocellulose by suction filtration has been used as a prelude to DNA hybridization experiments, and several filter manifolds for this purpose are available. One suction manifold, the 'Minifold II slot-blotter', creates small, rectangular slots of bound DNA which can be probed using immunoenzymatic techniques and then evaluated with quantitative scanning densitometry. We applied this technique to the detection and quantitation of naturally occurring anti-DNA antibodies. After probing slot-blots of native or denatured DNA with human sera, the slot-blots were stained using an alkaline phosphatase second antibody system. The serum concentration of anti-DNA antibodies was determined by comparing the peak areas of the positive blots to a standard IgG curve. When native DNA was used as a substrate, these serum concentrations correlated well with the anti-DNA titer as measured by the Crithidia luciliae indirect immunofluorescence assay. PMID- 3305710 TI - Characteristics of chemically aggregated IgM in an immunoglobulin class-specific immune complex assay. AB - Immune complexes have been implicated in the pathogenesis of a number of infectious diseases. The predominant immunoglobulin class associated with circulating immune complexes is IgG, although immune complexes containing IgM have been described. The role of IgM immune complexes in disease pathogenesis has been difficult to characterize due to the lack of a reliable in vitro model. Immunoglobulins aggregated with bis-diazotized benzidine (BDB) are known to function as model immune complexes. We have developed an IgM immune complex using BDB-aggregated IgM which can be used as a reference in a conglutinin-based immune complex assay. Using this assay system, humans and chimpanzees with acute hepatitis A were found to have circulating immune complexes that contained IgM as the predominant antibody. PMID- 3305711 TI - A new ELISA-based assay for quantitation of human T-lymphocyte subpopulations. AB - In order to circumvent the problems associated with the available methods, we have developed a simple, reliable ELISA for quantitation of T-cells and their subpopulations, T-helper/inducer and T-suppressor/cytotoxic cells. Standard curves with three concentrations of sheep anti-mouse IgG-coupled beads for each T cell population were used for the determination of the T-cell content in blood. Enzyme-labelled monoclonal antibodies against T-Pan, T-S and T-H cell surface markers were readily able to bind to such beads and the test system was calibrated with T-lymphocytes by comparing cytofluorographic and enzyme immunometric results. Purified preparations of monocytes and granulocytes were negative in the test. Lymphocytes from 50 healthy blood donors gave results which correlated closely with cytofluorograph determinations. PMID- 3305713 TI - Genes within the major histocompatibility complex influence the response to ampicillin therapy and severity of relapse in H-2 congenic, susceptible Itys mice infected with virulent Salmonella typhimurium. AB - Control by genes within H-2 of natural resistance to fully virulent salmonellae in susceptible mice was studied by the typhoid relapse model. Susceptible (Itys), H-2 congenic C57BL/10 (B10) lines were infected with a lethal dose of the virulent S. typhimurium C5 and rescued from death by ampicillin therapy, inducing a chronic infection. The response to therapy and its cessation, both early and late in the infection, varied in different strains. B10 (H-2b) and B10.D2 (H-2d) responded less well to therapy, and were more prone to relapse on its removal, than B10.A (H-2a) or B10.M (H-2f) mice. This haplotype distribution is the same as that previously reported for H-2 linked resistance and susceptibility of similar mice to salmonellae of low virulence. The results indicate that resistance to a virulent salmonella capable of causing natural infection is influenced by genes within the MHC. PMID- 3305712 TI - Abrogation of lethal graft-versus-host reaction directed against non-H-2 antigens: role of Mlsa and K/I region antigens in the induction of unresponsiveness by alloimmunization. AB - A graft-versus-host reaction (GVHR) directed against DBA/2 non-H-2 antigens alone can be induced by grafting B10.D2 bone marrow and spleen cells intravenously to heavily irradiated, H-2d compatible (DBA/2 X B10.D2)F1 adult mice. Under the experimental conditions used, only 0-10% of recipients survive, but the survival is greatly increased by donor alloimmunization, a few days prior to grafting, against host-specific (DBA/2) non-H-2 antigens and non-specific (foreign) H-2 antigens. The increased survival is mediated by alloimmunization-activated suppressor cells which can decrease the intensity of the immune reaction developed by normal B10.D2 cells both in vivo (GVHR) and in vitro (proliferative response measured in mixed lymphocyte culture, MLC). The present experiments were designed to explore the antigenic requirements for inducing suppression. The results showed that in GVHR the protective effect induced by donor alloimmunization against the specific non-H-2 antigens, which leads to 70-80% survival, is due primarily, if not entirely, to immunization against Mlsa antigens. Results of MLC experiments confirmed this conclusion, showing that immunization against Mlsa antigens is sufficient to account for the suppressive effect induced by the specific immunization. In addition, they indicated that the non-specific protective effect induced by donor alloimmunization against foreign H-2 antigens, which leads to 20-30% survival, is due to immunization against antigens encoded by the K and/or I region(s) of the H-2 complex; immunization against D region encoded antigens alone has no effect. PMID- 3305714 TI - [Ureteral stenoses after renal transplantation]. AB - Out of 953 kidney transplantations performed in Lyon up to the end of 1984, we observed 28 (2.9%) post-operative ureteral stenoses. Most of them were diagnosed during the first year post-transplantation. Surgical reparation of the stenosis involved either ureterovesical reimplantation or pyeloureteral anastomosis with the patients' own ureter. Return to normal renal function was observed in 64.2% of our patients while in 10.7% renal function was stabilized. Actuarial postoperative graft survival was 66% at one year and 58% at two years of follow up. PMID- 3305715 TI - A histologic study on the fate of intradermally implanted epidermal cells in guinea pigs: a new method for evaluation of skin allograft survival. AB - The fate of allogeneic (strains 13, 2, and JY-1) and autologous epidermal cell (EC) suspensions injected intradermally was investigated histologically in JY-1 strain guinea pigs. Epidermal cells were found to proliferate actively in the dermis and form EC nests with central keratinization. The significant reject reaction associated with necrosis of the epidermal structures was seen in due time in the animals implanted with allogeneic ECs. We attempted to assess the effect of cyclosporin A (CYA) on skin allograft survival by observing the fate of strain 13 ECs implanted intradermally into the CYA-treated JY-1. Successful prolongation of allograft survival with CYA was clearly demonstrated by this method. This is considered to be a useful experimental way for evaluation of skin allograft survival and to be suitable for routine use. PMID- 3305716 TI - Effect of skin pretreatment with vehicle alone or drug in vehicle on flux of a subsequently applied drug: results of hairless mouse skin and diffusion cell studies. AB - Clinical and in vitro evidence suggest that pretreatment of skin with a drug or vehicle can influence topical drug delivery. In this study, hairless mouse skin in diffusion cells was treated for 48 h with topical applications of vehicle alone (oleic acid (OA), isopropyl myristate, octanol (OCT), dimethylformamide, propylene glycol (PG), ethylene glycol (EG), formamide), or mixtures of OA and PG, or with 5-fluorouracil (5-FU) suspensions in each of these vehicles. Twenty four hours after removing the initially applied agent, a standard suspension of theophylline in PG was applied to the skin surface and the flux of theophylline was determined over the next 48 h. Skin pretreatment with vehicle alone increased theophylline flux 1.6-(EG) to 122-fold (OCT) over control experiments in which the skins were not pretreated. Pretreatment with nonpolar vehicles with lower solubility parameters (OA, OCT, or mixed vehicles containing one of these) had the greatest effect on subsequent theophylline flux. Pretreatment with 5-FU in various vehicles caused a subsequent increased theophylline flux similar to the effect of vehicle alone, except for pretreatment with 5-FU in vehicles which did not have much effect themselves. In those instances, theophylline fluxes up to 16 fold over the effect of those vehicles alone were observed. PMID- 3305718 TI - Coagulase-negative staphylococcal adherence and persistence. PMID- 3305717 TI - Stimulatory effect of prostaglandin E2 on the configuration of normal human melanocytes in vitro. AB - Normal human epidermal melanocytes became swollen and more dendritic when they were cultured for 6 days with prostaglandin (PG) E2, but not with PGE1, although the amount of immunoreactive tyrosinase in the melanocytes did not appear to be increased markedly after these treatments. From these data we suggest that PGE2 may be one of the factors responsible for the induction of postinflammatory hyperpigmentation of the skin. PMID- 3305719 TI - An enzyme-linked immunosorbent assay for quantifying adherence of Candida to human vascular endothelium. AB - Success in elucidating the pathogenesis of certain bacterial infections through studies of bacterial adherence to host cells has stimulated interest in parallel investigations of fungal adherence. Fungal adherence differs from bacterial adherence, especially when fungal coadherence (adherence of fungal cells to each other) is a factor. Using human umbilical vein endothelial cells cultured in a living monolayer in microtiter plates, we developed an ELISA to study adherence of Candida albicans to endothelial cells in the absence of yeast coadherence. A rabbit antibody to Candida detected the adherent Candida, and an alkaline phosphatase-conjugated antibody to rabbit IgG was the developing antibody. A linear relationship between the log of the optical density and the log of the number of adherent organisms was seen for wells containing 3 X 10(4)-1 X 10(6) organisms (r = .923- .965). In addition to measuring adherence of living Candida to living target cells and avoiding Candida coadherence, this assay makes it possible to investigate adherence limited to lumenal surfaces, conserves reagents, and facilitates the testing of large numbers of potential adherence modifiers. PMID- 3305720 TI - Use of a direct fluorescent antibody test for detecting Chlamydia trachomatis cervical infection in women seeking routine gynecologic care. AB - We determined the sensitivity, specificity, and predictive value of a direct fluorescence test for Chlamydia trachomatis infection compared with culture of the endocervix in women seeking routine gynecologic care. Of 527 patients seen in a hospital-based practice, 23 (4.4%) had a positive culture for C. trachomatis. The overall sensitivity of the direct test was 70%, and the specificity was 98%. When five or more endocervical cells were present on the direct test slide, the sensitivity increased to 92%, and the specificity decreased to 96% (P less than .05). When the presence of any columnar epithelial cells, five or more elementary bodies, or both was used as the criteria for accepting specimens, the sensitivity and specificity of the direct test were 80% and 96%, respectively. However, 44% of the specimens would be rejected if these criteria were used. The overall probability that an individual with a positive direct test would have a positive culture was 62%. PMID- 3305722 TI - Ivermectin in the successful treatment of a patient with Mansonella ozzardi infection. PMID- 3305721 TI - Immunoprophylaxis of postnatally acquired group B streptococcal sepsis in neonatal rhesus monkeys. PMID- 3305723 TI - Identification of spotted fever group rickettsiae from human and tick sources in the People's Republic of China. PMID- 3305724 TI - HeLa cell-adherent Escherichia coli in children with diarrhea in Thailand. PMID- 3305725 TI - Oncogene expression in myelopoiesis. AB - Oncogenes are a class of genes hypothesized to be causally related to neoplasia. To date, specific oncogenes have been recognized chiefly by their ability to transform test cells to a neoplastic phenotype. This has been accomplished largely through mutational analysis of the genotype of retroviruses or through the analysis of tumor cell DNA by in vitro transfection of rodent fibroblasts. Oncogenes are believed to arise by some genetic alteration from normal cellular genes called proto-oncogenes. Although the normal function of most proto oncogenes is unknown, it has been proposed that they may function as tissue specific and temporally specific regulators of differentiation. The role of oncogenes in lymphoid malignancies has been extensively analyzed. Less is known about their role in myeloid leukemias and especially in normal myelopoiesis. Space limitations permit discussion of only salient features of a limited number of oncogenes; we have arbitrarily selected myc, myb, fos, fms, fes, sis, and abl. PMID- 3305726 TI - Cell surface antigens on human marrow cells: dissection of hematopoietic development using monoclonal antibodies and multiparameter flow cytometry. AB - A single sample of bone marrow includes the entire range of the developmental process, since cells of all stages and lineages are present. By selecting appropriate monoclonal antibodies, marrow cells of different lineages can be identified, even in their immature forms. Maturationally different bone marrow cells can be distinguished on the basis of their cell surface antigen expression and physical characteristics on a flow cytometer. Antigenic markers can be used within a lineage to trace the development from colony-forming cells to functional blood cells. Changes in cellular markers are observed as smooth, quantitative increases or decreases in cellular antigen expression. After defining the composition of normal marrow, it is possible to identify perturbations from the steady state and to monitor the return to homeostasis. Cells at various stages can be enumerated, then isolated for further study. In particular, these studies provide for the identification, purification and manipulation of the earliest hematopoietic progenitor cells. PMID- 3305727 TI - Biology of myelodysplastic syndromes. AB - Myelodysplastic syndromes (MDS) represent a diverse spectrum of disorders ranging from refractory anemia to a preleukemic state. Peripheral cytopenias, cellular marrow, dysplasias and dysfunctions of myeloid and lymphoid cells constitute hematological hallmarks, and are caused by ineffective hemopoiesis. Investigations of cell cultures and cellular functions indicate that the disease originates in a stem cell pluripotent to all myeloid cells and possibly lymphoid cells as well. The disease commonly runs a chronic indolent course, often terminating in acute leukemia or nonleukemic death, notably infections and/or hemorrhage due to cytopenias and cellular dysfunctions. Clonal expansion or clonal evolution appears to be related to the disease progression with a greater degree of malignancy. However, the initial sequence of events causing damage to stem cells is still undefined. PMID- 3305728 TI - [Biochemistry of sialic acids]. PMID- 3305729 TI - [Cell growth inhibitors and TGF-beta masking protein in platelets]. PMID- 3305730 TI - [Gene expression in transgenic mice]. PMID- 3305731 TI - [Recent topics about colony-stimulating factors (CSF)]. PMID- 3305732 TI - [Calcium binding to tubulin (tubulin-colchicine complex)]. PMID- 3305733 TI - [Production and stabilization in Escherichia coli of some variable gene products]. PMID- 3305735 TI - Somatic cell variants of the murine major histocompatibility complex. PMID- 3305734 TI - Comparison of the primary structure of class I molecules. PMID- 3305736 TI - Tla-region genes and their products. PMID- 3305737 TI - Structure and expression of polypeptides encoded in the mouse Qa region. PMID- 3305738 TI - Class I major histocompatibility complex genes in vertebrate species: what is the common denominator? PMID- 3305740 TI - The saga of the International Union of Angiology. PMID- 3305741 TI - [Role of nuclear medicine in orthopedic surgery]. PMID- 3305739 TI - Analysis of structure/function relationships among major histocompatibility complex class I antigens. PMID- 3305742 TI - [New trends in the study of vitamin D and related hormones]. PMID- 3305743 TI - Transcutaneous electrical nerve stimulation in acute hand infections. AB - Twenty-six patients with severe hand infections requiring operative drainage and admission to hospital were entered into a prospective, randomised, placebo controlled trial. This was to test the use of a functioning transcutaneous electrical nerve stimulator and a non-functioning transcutaneous electrical nerve stimulator for pain relief in the first three postoperative days. Those patients with a functioning transcutaneous electrical nerve stimulator required significantly less analgesia. They also demonstrated highly significant improvement in their range of total active movement over those patients with a non-functioning transcutaneous electrical nerve stimulator. We recommend the use of transcutaneous electrical nerve stimulator after operation to reduce pain and improve mobility. PMID- 3305744 TI - Clinical trials in colorectal cancer: experience of the Gastrointestinal Tumor Study Group and the Southwest Oncology Group. AB - Clinical trials in patients with metastatic and locally advanced colorectal carcinoma performed by the Southwest Oncology and Gastrointestinal Tumor Study Groups are reviewed. Therapy of metastatic disease remains unsatisfactory, with new agents and biochemical modulation being studied at present. Adjuvant trials have demonstrated the need for randomization and the inclusion of control groups. Preliminary results are consistent with potential usefulness of a combined modality approach in rectal carcinoma patients (stages B2 and C), with no effects on survival and/or recurrences in colon cancer. PMID- 3305745 TI - Brachiocephalic artery stenosis presenting with objective tinnitus. PMID- 3305748 TI - [J.F. Merlen (1912-1986)]. PMID- 3305746 TI - Macrophage migration inhibition induced by MDP, LPS, PMA, and MIF/MAF: reversal by macrophage migration enhancement factor (MEF), L-fucose, L-fucosyl BSA, D mannose, and D-mannosyl BSA. AB - Our data establish that migration inhibition factor (MIF) and migration enhancement factor (MEF) mutually neutralize the effect of each other in a concentration-dependent manner. The monosaccharides L-fucose and D-mannose were also shown to reverse MIF and additionally to stimulate alveolar macrophage (AM) migration in the absence of MIF. The specific activity of these sugars was increased 200-fold when conjugated to bovine serum albumin (BSA). Macrophage activation is usually observed concurrently with migration inhibition when macrophages are incubated with MIF preparations. Migration inhibition occurred also when AM were incubated in the presence of known metabolic activators (MDP, PMA, and LPS). It was found that L-fucose, D-mannose, L-fucosyl BSA, and D mannosyl BSA could reverse migration inhibition caused by MIF as well as by these metabolic activators. These observations suggest that reversal of MIF by L-fucose is unexplained solely on the basis that L-fucose is functioning as a competitive inhibitor; instead, they suggest that MEF and the above sugars and their conjugates stimulate AM through a receptor system different from the MIF receptor. These observations support the concept that MEF is an important macrophage modulator in CMI responses. PMID- 3305747 TI - Role of epidermal cell thymocyte-activating factor in the proliferation and differentiation of murine B cells. AB - The role of antigen nonspecific cytokines in T- and B-lymphocyte responses is now well established. Interleukin-1 (IL-1) has been shown to augment B-cell maturation and proliferation. While the major source of IL-1 is from monocytes or macrophages, other cell types have been shown to produce IL-1-like cytokines. Epidermal cells produce a cytokine termed "epidermal cell-derived thymocyte activating factor" (ETAF) which is similar if not identical with monocyte-derived IL-1. In this report we show that ETAF induces polyclonal stimulation of murine B cells. We show that ETAF augments B cell proliferation and differentiation in the absence of any added antigens or mitogens. This activity can be partially inhibited by anti-IL-1 antibodies. ETAF appears to activate B cells directly, although its activity is increased in the presence of T cells. Thus, ETAF may be involved in local polyclonal antibody responses occurring in the skin. PMID- 3305749 TI - [Value and place of real-time ultrasonic diagnosis combined with continuous-wave Doppler in the diagnosis and follow-up of thromboembolic disease]. AB - The authors compared the results of real time ultrasound imaging and continuous wave Doppler (Echography-Doppler with bilateral venography and ilio-cavography in the diagnosis and the follow-up of deep venous thrombosis (D.V.T.). Diagnosis of D.V.T. The value of echography-Doppler (ED) compared to venography is studied on 297 patients (590 legs) suspected of D.V.T. (221) or pulmonary emboli (76). The two methods give concording results in 95% (563/590). Discrepancies (27) are more often located in distal veins. If we refer to venography as the gold standard, sensitivity of ED is 98% (236/242) and specificity is 95% (327/344). Other diagnosis are possible: hematoma (9), extrinsic compression (15), Baker's cyst (4), muscular problems (3)... Topographic value Sensitivity in isolated calf vein thrombosis is 90% (54/60 are detected, 22 are bilateral). 4/6 false negatives are located in the presumable healthy legs. Sensitivity in proximal D.V.T. is excellent 100% (182 D.V.T. with 28 bilateral). The upper extremity of the thrombus is located exactly by ED whatever the topography (35 in the inferior vena cava, three of them beyond the renal veins), the degree of obstruction (partially occluded veins: 32), and even if it's extended or not (27). Follow-up of D.V.T. Assessment of the results in 80 patients under treatment is identical with the two methods, whatever the topography, the degree of obstruction and the evolution of thrombosis. E.D. predictive value in therapeutic efficiency is discussed according to the evolution data in 260 patients. Screening of D.V.T. ED is compared to venography (13) and/or Fibrinogen test (15), in 23 patients (46 legs) with high risk of thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305750 TI - [Chronic venous insufficiency and microcirculation. Physiopathologic and therapeutic reflections]. AB - In patients with chronic venous insufficiency, tissular damage occurs as a consequence of microcirculatory disturbances. Venular distension, venulo arteriolar reflex and probably valves in collecting venules are the only microcirculatory protective mechanisms against venous pressure overload. Edema is primarily a consequence of increased capillary hydrostatic pressure. However, the increase of endothelial macromolecular transport and a true lymphatic microangiopathy are important contributive factors. Venous ulceration is hypoxic although the amount of total blood flow is normal in the surrounding tissue. Several hypothesis were proposed for explaining this nutritional steal: arterio venous shunt vessels have never been shown consistently, peri-capillary fibrin deposition might block oxygen diffusion, and last but not least, the abnormal geometrical arrangement of the capillary bed is facilitating functional shunting. On a therapeutic point of view, behind the classical hemodynamic therapy, the microvascular approach to chronic venous insufficiency supports the use of lymphatic manual drainage for controlling edema and rheologic therapy for improving skin capillary perfusion. PMID- 3305751 TI - A mathematical analysis of small mammal populations. AB - Populations of Microtus montanus, the montane vole, have been extensively studied. It is known that their reproductive activity is closely linked to the availability of the chemicals in growing plants. We use a mathematical model here to study how the length of the vegetative season and the natural reproduction rhythm of voles are involved in the long term dynamics of the population numbers. In particular, we use data obtained from Timpie Springs, Utah, and from Jackson Hole, Wyoming, to formulate a model. The novelty of this model is its use of littering curves that highlight the temporally discrete nature of vole reproduction. The model shows how the timing of the vegetative season can influence vole population sizes. PMID- 3305752 TI - Organized medicine's challenges today: "the good, the bad, and the ugly". PMID- 3305753 TI - Host-parasite relationship in superficial mycoses. PMID- 3305754 TI - An attempt to detect melanoma-associated antigen by labelled monoclonal antibodies in deparaffinized tissue sections. PMID- 3305755 TI - Ultrastructural localization of wheat germ agglutinin-binding sites in Escherichia coli with wheat germ agglutinin-gold complexes. PMID- 3305756 TI - An improved method for embedding with Quetol 651 and ERL 4206 for stereoscopic observation of thick sections under 400 kV transmission electron microscope. PMID- 3305757 TI - Receptors for lactogenic hormones in the ovine corpus luteum. II: Specific inactivation of ovine prolactin. AB - Sheep corpus luteum homogenates and membrane fractions discriminate between 125I labelled human GH (hGH) and ovine prolactin (oPRL). The present studies were designed to establish whether ovine luteal tissue possessed a prolactin-specific inactivating enzyme. Preincubation of sheep luteal microsomes and cytosol fractions with 125I-labelled hGH had little effect on the ability of the hormone to rebind to pig luteal lactogenic receptors. In contrast, sheep luteal tissue fractions markedly decreased the binding ability of 125I-labelled oPRL. However, despite the profound loss of receptor-binding activity, there was no change in protein-bound radioactivity, nor in the elution profile of 125I-labelled oPRL by gel chromatography on Sephadex G-100. Moreover, the disparity between 125I labelled hGH and oPRL was not overcome by preincubation of sheep luteal membranes with protease inhibitors of differing specificities. We conclude that the disparity between the binding of hGH and oPRL in ovine tissues was due to the selective inactivation of oPRL. However, the activity responsible did not degrade the hormone extensively, nor was its action blocked by a range of protease inhibitors. PMID- 3305758 TI - Changes in gonadotrophin-releasing hormone and LH in Japanese quail during the first few days of photostimulation. AB - Castrated Japanese quail responded to a single long day with a five- to eightfold increase in plasma LH levels. A rise in LH secretion appeared 19-24 h after dawn and LH levels were still increased 3 days later, despite the fact that the birds had been returned to a short daylength. Pituitary LH content decreased, reflecting these changes in secretion, although significant falls in content were only found 36-96 h after dawn, when LH secretion was maximal. Hypothalamic gonadotrophin-releasing hormone content was not altered. One interpretation of this is that increased synthesis of the peptide compensates fully for the increased secretion. PMID- 3305760 TI - Effects of ovarian inhibin on pulsatile release of gonadotrophins and secretion of LHRH in ovariectomized rats: evidence against a central action of inhibin. AB - Intraperitoneal administration of bovine follicular fluid (bFF) decreased plasma concentrations of FSH in ovariectomized rats after 2-3 h, while plasma LH and prolactin were unaffected. In untreated ovariectomized animals the concentrations of these hormones were found to show pulsatile variations. Concomitant occurrence of peak values of LH and FSH was found in about 40% of the pulses. No pulses of FSH were observed after i.p. treatment with bFF or partly purified preparations of inhibin from bFF, but the pulsatile release of LH and prolactin remained similar. Infusion of bFF into the lateral ventricle of the brain did not alter the concentrations of FSH, whereas administration of bFF into the pituitary gland diminished the plasma concentrations of FSH. Anaesthesia (urethane plus xylazine) did not prevent the occurrence of the pulses of FSH and LH, but it reduced the pulse amplitude and clearance. During this anaesthesia, the concentrations of LHRH in the hypophysial stalk plasma decreased by 30% after administration of bFF, but did not alter after treatment with partly purified preparations of inhibin. It is concluded that the inhibin-like activity in bFF suppresses pulsatile FSH secretion in ovariectomized rats by an action on the pituitary gland, but has no effect on the pulsatile release of LH and prolactin. PMID- 3305759 TI - Hormone profiles for progesterone, oestradiol, prolactin, plasma renin activity, aldosterone and corticosterone during pregnancy and pseudopregnancy in two strains of rat: correlation with renal studies. AB - Plasma samples were obtained throughout pregnancy and pseudopregnancy from Sprague-Dawley (SD) rats and during pregnancy from rats of the Munich Wistar (MW) strain. The concentrations of progesterone, oestradiol, prolactin, plasma renin activity (PRA), aldosterone and corticosterone were measured by radioimmunoassay to establish hormonal profiles in the two strains of rat. Circulating progesterone concentrations in both strains of rat were significantly higher during pregnancy than in virgin controls, except at term in the SD group. The hormonal pattern for pseudopregnancy was similar to that of the first half of pregnancy. Oestradiol concentrations were similar to, or lower than, those in virgin controls throughout pseudopregnancy and for the first 2 weeks of pregnancy in both strains of rat. Increased concentrations of steroid were seen only in the pregnant groups towards term. In SD rats, highest prolactin concentrations were apparent during the first half of pregnancy and pseudopregnancy, and at term in the pregnant group. Pregnant MW rats showed a different profile for this hormone, with low levels throughout pregnancy except at term. In all groups PRA rose to a peak at day 9 and decreased to day 16. Pregnant SD rats also showed a significant increase at term. Aldosterone concentrations were significantly increased at several stages of pregnancy in both strains of rat, particularly during the second half of gestation. Pseudopregnant animals showed a different hormone profile, with no significant changes until day 16 when lower concentrations were recorded. There was little variation in the circulating corticosterone concentration except in pregnant rats at term when levels fell. These findings are discussed in relation to the known renal changes of pregnancy and pseudopregnancy. PMID- 3305761 TI - Accumulation, organization and deployment of oogenetically derived Xenopus yolk/nonyolk proteins. PMID- 3305762 TI - Development of Ly-1+ B cells in immunodeficient CBA/N mice. AB - Spleen cells from CBA/N mice developing a systemic autoimmune disease after daily injection of CsA during an autologous bone marrow reconstitution were transferred into unmanipulated syngeneic recipients. Adoptive transfer allowed the development of Ly-1+ B cells, which shared Mac-1 differentiation antigen expression with the myelomonocytic lineage. Interestingly, expansion of formerly absent Ly-1+ B cells was paralleled by a severe reduction in common, Ly-1-, B cell development in the recipient. We conclude that precursors for Ly-1+ B lineage do exist in CBA/N mice. PMID- 3305764 TI - Seminar: Pathobiochemistry of shock. In honor of Prof. L. Roka. Giessen, 28-29 April 1987. Abstracts. PMID- 3305763 TI - Identification of three stage-specific proteinases of Plasmodium falciparum. AB - We have identified and characterized three stage-specific proteinases of Plasmodium falciparum that are active at neutral pH. We analyzed ring-, trophozoite-, schizont-, and merozoite-stage parasites by gelatin substrate PAGE and characterized the identified proteinases with class-specific proteinase inhibitors. No proteinase activity was detected with rings. Trophozoites had a 28 kD proteinase that was inhibited by inhibitors of cysteine proteinases. Mature schizonts had a 35-40 kD proteinase that also was inhibited by cysteine proteinase inhibitors. Merozoite fractions had a 75 kD proteinase that was inhibited by serine proteinase inhibitors. The stage-specific activity of these proteinases and the correlation between the effects of proteinase inhibitors on the isolated enzymes with the effects of the inhibitors on whole parasites suggest potential critical functions for these proteinases in the life cycle of malaria parasites. PMID- 3305765 TI - Hyponatremia resulting from pelvic ultrasound preparation. PMID- 3305767 TI - Chronic pelvic pain. AB - Chronic pelvic pain is one of the most challenging gynecologic problems seen in primary care practice. Important causes of this problem include endometriosis, pelvic adhesions, chronic pelvic inflammatory disease, and the syndrome of chronic pelvic pain without obvious pathology. The diagnostic approach to chronic pelvic pain begins with a careful medical history and physical examination in conjunction with a comprehensive psychosocial assessment. Laboratory evaluation may include pelvic ultrasonography, psychometric testing, and diagnostic laparoscopy. Optimal management of these patients may require a multidisciplinary approach, integrating chronic pain management techniques with specific therapy. PMID- 3305766 TI - Is maternity care different in family practice? A pilot matched pair study. AB - In this pilot study, 81 patients booked for delivery by family physicians were matched to patients booked for delivery by obstetricians. Patients in both groups were at low obstetric risk. They were matched by age, parity, blood pressure, gestational age at delivery, and socioeconomic status. Patients booked with family physicians experienced fewer artificial rupture of membranes, inductions of labor, episiotomies, and forceps deliveries than those booked with obstetricians. These patients also spent a shorter time in hospital in spite of longer second stages of labor. Infant outcomes were equivalent in the two groups. A simple method of audit of maternity care that permits comparisons of the care provided by family physicians and obstetricians for obstetrically similar patients is described. This methodology employs matching within a given institution and facilitates the multicentered studies required to obtain the large populations needed to compare the process and outcome of infant and maternal care provided by these two types of physicians. PMID- 3305768 TI - Medical teaching in South Florida. How it started and how it got on its feet. PMID- 3305769 TI - Attempts at cooperative approaches to graduate medical education--the saga of J.H.E.P. (Jacksonville Hospitals Education Program). PMID- 3305770 TI - The Florida East Coast Railway Hospital: a study of early corporate medicine, 1906-1963. PMID- 3305771 TI - Camp Miami, 1898. PMID- 3305772 TI - History of graduate medical education at the University of Florida. PMID- 3305773 TI - The residency program at the University of South Florida. PMID- 3305774 TI - History of the Pensacola Educational Program. PMID- 3305776 TI - [Allogeneic bone marrow transplantation in the treatment of leukemia--a preliminary report]. PMID- 3305775 TI - CME in Florida: an historical overview. PMID- 3305777 TI - Effect of alkylating agents on the expression of inducible genes of Escherichia coli. AB - Increasing doses of alkylating agents such as N-methyl-N'-nitro-N nitrosoguanidine, diethyl sulphate and ethylmethane sulphonate cause an inhibition of the expression of the recA and sfiA genes of wild-type Escherichia coli. This behaviour was not observed in a lexA56 mutant which has a defective LexA repressor that is unable to bind to the SOS operator. Furthermore, an ada-1 mutant showed the same behaviour as the wild-type strain indicating that the adaptive proteins are not responsible for the inhibition of recA and sfiA at high doses of alkylating agents. These results suggest that the inhibitory effect of these alkylating agents may be found in the interaction between the LexA repressor and the control regions of sfiA and recA. On the other hand, high doses of either UV light or mitomycin C produced only a slight decrease in the induction of recA and sfiA, whereas bleomycin had no effect. The fact that a repressor structurally related to LexA repressor, such as LacI protein, showed the same behaviour as the LexA repressor when a Lac+ strain was treated with alkylating agents, suggests that these compounds can modify the binding abilities of repressors to DNA, producing a limited or even abolished release of repressors, and so decreasing the expression of inducible genes. PMID- 3305778 TI - A cooperative taxonomic study of mycobacteria isolated from armadillos infected with Mycobacterium leprae. AB - Seventeen strains of mycobacteria, recovered from six armadillos experimentally infected with Mycobacterium leprae, were examined in ten different laboratories. This collaborative study included use of conventional bacteriological tests, lipid analyses, determination of mycobactins and peptidoglycans, characterization by Py-MS, and immunological, metabolic, pathological and DNA studies. These armadillo-derived mycobacteria (ADM) formed five homogeneous groups (numbered ADM 1 to 5) on the basis of phenetic analyses. However, DNA studies revealed only four homogeneous groups since group ADM 1 and one of the two strains in group ADM 3 showed a high level of DNA relatedness. The phenetic and DNA studies confirmed that the ADM strains differed from all other known mycobacteria. Cultural, biochemical, metabolic and pathogenic properties as well as DNA-DNA hybridizations clearly differentiated these ADM from M. leprae. PMID- 3305780 TI - Subdivision of daughter strains of bacille Calmette-Guerin (BCG) according to secreted protein patterns. AB - In order to identify proteins secreted by live organisms, daughter strains of the Bacillus Calmette-Guerin (BCG) were grown for 4-7 d in a defined medium containing [35S]methionine. Secreted components were then separated by polyacrylamide gel electrophoresis under both denaturing and non-denaturing conditions, and analysed by autoradiography and in an Ambis beta-scanner. The results indicate that BCG daughter strains can be subdivided into two groups according to their secretion of a 46 kDa protein dimer consisting of two similar 23 kDa subunits. High-producer strains (Japanese, Brazilian and Russian) secrete very large quantities of this material, which constitutes approximately 23% of all secreted protein. These findings correlate with earlier studies in which degradation products of the protein dimer may have been identified, and with the data from patterns of cell wall lipids. PMID- 3305779 TI - Changes in the plasma membrane of regenerating protoplasts of Candida albicans as revealed by freeze-fracture electron microscopy. AB - Modifications occurring in the plasma membrane and their relationship to newly synthesized microfibrils were examined in regenerating protoplasts of Candida albicans by freeze-fracture electron microscopy. Freshly prepared protoplasts showed no residual wall material, and long invaginations covered the surface of the plasma membrane. Analysis of the external face (E-face) of the plasma membrane showed a significant decrease in the number of intramembranous particles (IMP) in comparison with the original cells. After 40 min incubation in regeneration medium, newly synthesized microfibrils which seemed to originate from protrusions in the plasma membrane were observed. The plasma membrane showed important modifications with respect to IMP. After 3 h 45 min, the cells were covered by an abnormal wall which showed isolated fibrils partially embedded in the matrix material. The plasma membrane of these partially regenerated protoplasts was similar to that of original cells. After 8 h, regeneration of the protoplasts seemed to be complete as no differences from the original cells were detected in the plasma membrane or the wall. Calcofluor white altered the deposition of wall polymers during regeneration, but did not modify the plasma membrane of the protoplasts. PMID- 3305781 TI - Development of Candida albicans hyphae in different growth media--variations in growth rates, cell dimensions and timing of morphogenetic events. AB - In six liquid culture media, all of which stimulated Candida albicans to grow in the hyphal form, the rates of hyphal extension and increase in cellular ATP concentration, hyphal diameters, times of evagination of hyphae, times of septum formation and positions of septa in the hyphae appeared to vary independently. There were no discernible associations between properties such as length or volume of hyphal compartments at the time of septation and temporal parameters of hyphal growth. The results suggest that growth environment influences many of the processes contributing to hyphal development, but that these processes are not necessarily interrelated. PMID- 3305782 TI - The phosphonium ion efflux system of Escherichia coli: relationship to the ethidium efflux system and energetic studies. AB - The extent of accumulation of methyltriphenylphosphonium ion by Escherichia coli was shown to be dependent on the permeability of the outer membrane and the activity of an efflux system for this compound. Evidence consistent with the operation of a single efflux system for compounds such as phosphonium ions, phenanthridiniums and flavines is presented. Studies on the energy coupling mechanism for this efflux system indicated that it was driven by the transmembrane proton electrochemical gradient. PMID- 3305783 TI - Nutritional variation in Escherichia coli. AB - Nutritional tests were carried out on 62 strains of Escherichia coli as part of a study on the genetic basis of natural nutritional variation. The ability of these strains to utilize 84 compounds as carbon, nitrogen and carbon plus nitrogen sources was tested using an auxanographic method. The tests revealed polymorphic characters which are suitable for genetic analysis. Very few of these strains grew on the amino acids classified as 'essential' for humans. PMID- 3305784 TI - The cellular location of proteases in Candida albicans. AB - Vacuoles prepared from yeast cells of Candida albicans were enriched in proteinase ycaB (EC 3.4.21.48) but not in aminopeptidase or beta-glucosidase. Proteinase ycaB, assayed in situ, increased 1.5-fold during starvation whereas aminopeptidase activity decreased by 25%. Proteinase ycaB increased a further 1.5 fold during germ-tube formation. PMID- 3305785 TI - Monoclonal antibodies demonstrate heterogeneity in the G glycoprotein of prototype strains and clinical isolates of respiratory syncytial virus. AB - In order to study variation among prototype strains and clinical isolates of respiratory syncytial (RS) virus, four prototype strains (Long, A2, CH18537, 9320) were used to produce monoclonal antibodies to this virus. The majority of monoclonals reacted with all four prototype strains by fluorescent antibody staining. Among the non-cross-reacting monoclonals, five additional patterns of reactivity with the prototype strains were recognized. Fourteen monoclonals, including ones representative of each of the patterns of reactivity with the prototype strains, were selected to use for typing prototype strains and community isolates. All 14 were found by immunoprecipitation to recognize the RS virus G glycoprotein. These monoclonals could uniquely identify each of the prototype strains. In addition to the antigenic differences among the prototype strains detected by the monoclonals, differences were also detected in the migration of the G glycoprotein of the prototype strains in polyacrylamide gel electrophoresis. Fluorescent antibody staining with panels of monoclonals distinguished two antigenic types among 114 isolates of RS virus recovered from children in St. Louis during the period 1981-86. The predominant type (80% of isolates) had a pattern of reactivity that resembled but differed from that of either the Long or A2 strains. The second type had a pattern of reactivity identical with that of 9320. The possible significance of this heterogeneity must be considered in developing diagnostic tests as well as active or passive immunotherapy for infections caused by RS virus. PMID- 3305786 TI - Correlation of serum HIV antigen and antibody with clinical status in HIV infected patients. AB - An enzyme immunoassay (EIA) has been developed which detects antigen(s) (Ag) of the human immunodeficiency virus (HIV) in the serum of patients with the acquired immunodeficiency syndrome (AIDS), AIDS-related complex (ARC), and patients at high risk for HIV infection. The test has a sensitivity of approximately 50 pg/ml of HIV protein. The specificity of the assay was determined with various virus infected cell lines, normal human sera/plasma, and serum from patients not known to be at risk for HIV infection. No false-positive HIV-Ag results were seen. Sera from 69% of patients with AIDS were positive for HIV-Ag as were 46% of patients with ARC and 19% of asymptomatic, HIV-antibody-positive individuals. There were significant associations between the stage of HIV infection--ie, AIDS vs ARC vs asymptomatic--and the detection of HIV-Ag in serum (p less than 0.0001) and the lack of detection of antibody to HIV core Ag (p less than 0.0001). HIV-Ag was also found in the serum of two asymptomatic antibody-negative individuals who were at high risk for AIDS and who later developed HIV antibody. The presence of HIV-Ag in sera was confirmed by an inhibition procedure. Thus, HIV-Ag can be detected in the serum of infected individuals prior to antibody production and correlates with the clinical stage of HIV infection. PMID- 3305787 TI - Low-dose vaccination against hepatitis B in children: one-year follow-up. AB - Six hundred forty-three children, negative for markers of hepatitis B virus (HBV) infections, were given three X 2-micrograms doses of Merck, Sharp and Dohme (MSD) plasma derived hepatitis B vaccine (H-B-Vax) at monthly intervals. Twelve months after the first dose of vaccine, antibody to hepatitis B surface antigen (anti HBs) was detected in 89% of children by radioimmunoassay (RIA) and in 83% by enzyme immunoassay (EIA). Seroconversion rates and anti-HBs titres were significantly greater in 1-4-year-olds than in older children (p less than 0.01). Eighteen children with no anti-HBs or other markers of HBV at this time were given 10 micrograms of vaccine and tested one month later. Seventeen developed anti-HBs, 12 at levels consistent with an anamnestic response. Forty-nine HBV marker-negative children seroconverted for antibody to hepatitis B core antigen (anti-HBc) in the 8-month period before or the 12-month period following vaccination. Forty-six of these children were positive for anti-HBs, and one has been confirmed as a chronic carrier of hepatitis B surface antigen (HBsAg). Three cases of clinical hepatitis B in children have been seen in the community since the vaccination programme began. Two of these were amongst the estimated 5% of children who were not vaccinated. The third was in a vaccinee and occurred 4 1/2 months after the last dose of vaccine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305789 TI - Insulin binding and effects on pyrimidine nucleoside uptake and incorporation in cultured mouse astrocytes. AB - Binding of 125I-insulin to primary cultures of differentiated mouse astrocytes was time-dependent, reaching equilibrium after 2 h at 22 degrees C, with equilibrium binding corresponding to 20.79 fmol/mg of protein, representing approximately 5,000 occupied binding sites/cell. The half-life of 125I-insulin dissociation at 22 degrees C was 2 min, with an initial dissociation rate constant of 4.12 X 10(-2) s-1. Dissociation of bound 125I-insulin was not accelerated significantly in the presence of unlabeled insulin (16.7 microM). Porcine and desoctapeptide insulins competed for specific 125I-insulin binding in a dose-dependent manner, whereas growth hormone, glucagon, and somatostatin did not. For porcine insulin, Scatchard analysis suggested multiple-affinity binding sites (high-affinity Ka = 4.92 X 10(8) M-1; low-affinity Ka = 0.95 X 10(7) M-1). After incubation with insulin (0.5 microM) for 2 h at 37 degrees C, increases above basal values of 254 +/- 23 and 189 +/- 34% for [3H]uridine uptake and incorporation, respectively, were observed. After incubation with insulin (0.5 microM) for 24 h at 37 degrees C, there were increases of 145 +/- 6% for [3H]thymidine uptake and 166 +/- 11% for thymidine incorporation. Basal and stimulated uridine and thymidine uptake and incorporation were inhibited by 50 microM dipyridamole. These studies confirm that mouse astrocytes in vitro possess specific insulin receptors and demonstrate an effect of insulin on pyrimidine nucleoside uptake and incorporation. PMID- 3305788 TI - Monoamine oxidase in rat and bovine endocrine tissues. AB - Monoamine oxidase (MAO) was characterized in tissue homogenates from rat pancreatic islets, rat neurohypophysis and adenohypophysis, and rat and bovine adrenal medulla and adrenal cortex. Phenylethylamine was preferentially deaminated by rat pancreatic islet and bovine adrenal medulla MAO and with slight preference by rat neurohypophysis MAO, whereas 5-hydroxytryptamine was preferentially deaminated by MAO from all other endocrine tissues. Tyramine was a good substrate for all tissues. Clorgyline, a selective inhibitor of MAO-A, preferentially inhibited deamination of 5-hydroxytryptamine by all tissue homogenates, whereas deprenyl, a selective inhibitor of MAO-B, preferentially inhibited deamination of phenylethylamine. Km values for 5-hydroxytryptamine and tyramine were higher by one to two decimal powers than for phenylethylamine in homogenates from all endocrine tissues. Km values were significantly lower for 5 hydroxytryptamine and significantly higher for phenylethylamine in rat and bovine adrenal cortex than in adrenal medulla. According to these results, the contributions of MAO-B to total enzyme activity were 70% for rat pancreatic islets, 45% for rat neurohypophysis, 15% for rat adenohypophysis, 20% for rat adrenal medulla, 10% for rat adrenal cortex, 60% for bovine adrenal medulla, and 20% for bovine adrenal cortex. PC 12 cells also contained predominantly MAO-A (90%); however, an increased Km for phenylethylamine and a sensitivity of deamination of this MAO-B substrate to inhibition by clorgyline are indicators of abnormal behavior of MAO in this clonal rat pheochromocytoma cell line. PMID- 3305790 TI - Incidence and prevalence studies in epilepsy and their methodological problems: a review. AB - Epidemiological studies in epilepsy have a number of specific problems, discussed here with reference to the published literature. Case ascertainment may pose difficulties because of deficiencies in patients reporting and in the diagnosis of seizures, and inherent methodological problems; the classification of epilepsy is often arbitrary and definitions variable; unsuspected selection bias may markedly influence incidence and prevalence rates. The major published incidence and prevalence studies are reviewed and the factors influencing these rates discussed. PMID- 3305791 TI - Arrest of proteolipid transport through the Golgi apparatus in Jimpy brain. AB - Immunocytochemical investigations were performed on Jimpy and control mouse brains using three specific anti-myelin proteolipids antisera: immunoaffinity purified multivalent anti-(PLP + DM-20) proteolipid antibodies, anti-C-terminal hexapeptide 271-276 and anti-tridecapeptide 117-129 antisera. The results show that oligodendrocytes and myelin sheaths in normal mouse brain are labelled to the same extent by the three specific antisera; in contrast, in Jimpy brain these cellular structures are only stained by the multivalent antibodies and the site specific, anti-tridecapeptide antiserum. The absence of labelling with C-terminal hexapeptide antiserum in mutant brain is interpreted as the result of either a large deletion or a point mutation producing a frameshift in the C-terminal part of the sequences of the proteolipids PLP and DM-20. Furthermore, we show that this mutation prevents the normal transport of proteolipid molecules through the Golgi apparatus. The existence of a minor, extra-Golgi apparatus metabolic route for proteolipids to myelin structures is also discussed. PMID- 3305792 TI - Repeated high-dose chemotherapy followed by purged autologous bone marrow transplantation as consolidation therapy in metastatic neuroblastoma. AB - Among 62 children over 1 year of age at diagnosis, who were treated for stage IV neuroblastoma, 33 entered complete remission (CR) or good partial remission (GPR) after conventional therapy and received high-dose chemotherapy (HDC) with in vitro purged autologous bone marrow transplantation (ABMT) as consolidation therapy. The HDC was a combination of carmustine (BCNU), teniposide (VM-26), and melphalan. Thirty-three patients received one course of this regimen, and 18 received two courses. At present, 16 of the 33 grafted patients are alive in continuous CR, with a median follow-up of 28 months. Toxicity of this regimen was tolerable, principally marked by bone marrow depression and gastrointestinal (GI) tract complications. Four complication-related deaths were observed. Relapse post ABMT occurred most often in the bone marrow. Under this treatment, actuarial disease-free survival is improved compared with that observed under conventional therapy. PMID- 3305793 TI - Treatment of malignant lymphoma in 100 patients with chemotherapy, total body irradiation, and marrow transplantation. AB - Between July 1970 and January 1985, 100 patients with malignant lymphoma were treated with high-dose chemoradiotherapy and bone marrow transplantation. Twenty eight of the 100 are alive and the actuarial probability of disease-free survival 5 years from transplantation is 22%. The most common reason for treatment failure was disease recurrence, with an actuarial probability of 60%. A proportional hazards regression analysis showed that the likelihood of disease-free survival was less in those patients transplanted in resistant relapse and in those previously treated with chest radiotherapy. Neither disease histology (Hodgkin's disease, high-grade lymphoma or intermediate-grade lymphoma), nor source of marrow (syngeneic, allogeneic, or autologous) significantly influenced either disease-free survival or probability of relapse. The use of high-dose chemoradiotherapy and marrow transplantation appears to offer a better chance for long-term survival than any other form of therapy for young patients with disseminated malignant lymphoma whose disease has progressed after initial combination chemotherapy. The best results with marrow transplantation were obtained in patients transplanted in early relapse or second remission who had not received prior chest radiotherapy. PMID- 3305794 TI - Allogeneic bone marrow transplantation for acute lymphoblastic leukemia in remission: prolonged survival associated with acute graft-versus-host disease. AB - Forty remission patients with high-risk acute lymphoblastic leukemia (ALL) underwent matched allogenic bone marrow transplantation (BMT) following preparation with cyclophosphamide and fractionated total body irradiation (TBI). As of March 1987, the median follow-up is more than 3 1/2 years. Thirteen patients are alive (11 relapse free) between 2 and 4 1/2 years post-BMT. Neither age, sex, remission number, prior extramedullary leukemia, nor WBC at diagnosis of ALL was statistically significant as a predictor of relapse-free survival. The development of acute graft-v-host disease (GVHD) in 17 patients was found, with time-dependent Cox regression analysis, to be associated with a significant reduction in post-BMT relapse risk (P = .04) and improved disease-free survival (P = .11). A prospective, randomized trial of maintenance chemotherapy with oral methotrexate and mercaptopurine did not demonstrate improvement in relapse risk or survival for those assigned maintenance chemotherapy (P = .7). These results suggest that allogeneic BMT can result in extended relapse-free survival for some patients with high-risk ALL. More effective preparative chemoradiotherapy and exploitation of the apparent graft-v-leukemia effect may be useful in future trials. PMID- 3305795 TI - An EORTC Gastrointestinal Group phase III evaluation of combinations of methyl CCNU, 5-fluorouracil, and adriamycin in advanced gastric cancer. AB - In a prospective phase III multicenter trial, 189 patients with advanced measurable and nonmeasurable gastric cancer were randomized to receive 5 fluorouracil (5-FU) combined with Adriamycin (FA) or FA plus methyl-CCNU (MeFA). The response rate in patients with measurable disease was 10% (three of 29), and 18% (five of 28), respectively. No difference in the duration of survival was detected (P = .14; log rank test). Median survivals were 21 and 32 weeks, respectively. Toxicity was moderate, but there have been two toxic deaths among the patients who received FA. Because of the low response rate and the short survival, neither regimen can be recommended for the treatment of advanced gastric cancer. PMID- 3305796 TI - 5-Fluorouracil and folinic acid in the treatment of metastatic colorectal cancer. PMID- 3305797 TI - Monoclonal antibodies specific for fixative-modified aspartate: immunocytochemical localization in the rat CNS. AB - Aspartate is a putative excitatory amino acid neurotransmitter that is widely distributed in the CNS. To study its distribution, monoclonal antibodies were produced against beta-L-aspartyl-L-aspartate (beta-Asp-Asp) conjugated to keyhole limpet hemocyanin (KLH) using glutaraldehyde-borohydride. Three monoclonal antibodies, Asp1-3, were obtained with high degrees of selectivity for aldehyde fixed aspartate. The immunocytochemical staining pattern of rat CNS was found to be similar for all 3 antibodies but differed in some regions from staining patterns produced by Glu1, a monoclonal antibody with high selectivity for a form of amide-linked glutamate. Tissue staining produced by Asp1-3 could be inhibited using aspartate conjugated to carrier proteins. Staining by Asp1 and Asp2 was also inhibited by free small molecules containing aspartate. Specificity of the 3 antibodies was evaluated by enzyme-linked immunoassay (ELISA) as follows: (1) reactivity of antibodies for conjugates of small molecules coated on ELISA plates; (2) ability of free small molecules to inhibit reactivity of antibodies for beta-Asp-Asp/KLH coated on ELISA plates; and (3) ability of conjugates to inhibit reactivity of antibodies for beta-Asp-Asp/KLH coated on ELISA plates. In all 3 types of assays, Asp1 and Asp2 displayed strong reactivity for small molecules and conjugates containing aspartate and little reactivity for small molecules and conjugates containing glutamate or GABA. Asp3 was highly reactive with conjugates containing aspartate using both directed and inhibition ELISA assays. For all 3 antibodies the precise staining pattern varied with the fixative used. Following glutaraldehyde fixation, dense immunocytochemical staining was observed in cerebral cortical neurons, some cerebellar granule cells, hippocampal pyramidal cells, and neurons of the inferior olivary nucleus. In addition, some putative GABAergic neurons, e.g., cerebellar basket and stellate cells, appeared to be stained. In general, acrolein fixation resulted in a more selective staining pattern in the CNS. For example, putative GABAergic neurons were no longer immunoreactive nor were hippocampal pyramidal cells. PMID- 3305798 TI - Light and electron microscopic localization of a cell surface antigen (NG2) in the rat cerebellum: association with smooth protoplasmic astrocytes. AB - Immunofluorescence and immunoperoxidase techniques were used to localize a cell surface chondroitin-sulfate proteoglycan antigen, termed NG2, in the developing and adult rat cerebellum. In the adult, both polyclonal and monoclonal anti-NG2 antibodies labeled cells throughout the cerebellar cortex, with the labeled cells being especially prominent in the molecular layer. The labeled cells had small, irregularly shaped cell bodies from which thin highly branched processes radiated in a stellate array. The NG2-labeled cells were not labeled with antibodies against glial fibrillary acidic protein (GFAP), vimentin, or S-100 protein, intracellular markers for astrocytes. However, electron microscopic immunocytochemical analysis of NG2 immunoreactive cells revealed a cell morphology consistent with that of protoplasmic astrocytes. Labeled cell bodies contained a thin rim of organelle-poor cytoplasm surrounding a euchromatic nucleus. Thick processes originating from the cell soma tapered to form thin branches with highly irregular surface contours that extended between adjacent neuronal elements. The labeled processes did not form synapses in the neuropil, and no synaptic profiles onto anti-NG2-labeled cell bodies or processes were observed. Thus, we conclude that the NG2 antigen is a cell surface marker for a class of smooth protoplasmic astrocytes. Immunoreactive cells were seen in the developing cerebellum beginning at embryonic day 16. The number of labeled cells increased during the early stages of cerebellar development, reaching a peak at about postnatal day (PND) 4 or 5 and declining thereafter. In the developing cerebellum, labeled cells lying within the forming molecular layer resembled the cells seen in the adult, whereas cells lying deeper within the folia had an immature appearance with fewer processes and less branching. This apparent gradient of morphological maturation suggests that an interaction with parallel fibers in the developing molecular layer may play a role in the terminal cytodifferentiation of the NG2-labeled smooth protoplasmic astrocytes. PMID- 3305799 TI - Plasticity of developing cerebellar cells in vitro studied with antibodies against the NG2 antigen. AB - The NG2 antigen, a chondroitin-sulfate proteoglycan, is a cell surface marker for a class of smooth protoplasmic astrocytes found throughout the brain and at high frequency in the cerebellar molecular layer (Levine and Card, 1987). To study the development of the cerebellar astrocytes at the level of the single cell, we have analyzed the distribution of the NG2 antigen by indirect immunofluorescence in dissociated cell cultures prepared from postnatal cerebella and compared that distribution to the distribution of several other cell surface and intracellular antigens that identify specific cell types in cultures of nervous tissue. When cerebellar cells from 5 d rat pups were grown in a medium containing 10% fetal calf serum, the NG2-labeled cells, which constituted 0.1-1.0% of the total glial cells present, contained glial fibrillary acidic protein (GFAP)-immunoreactive filaments and bound monoclonal antibody A2B5, a surface marker for neurons and some astrocytes. Approximately 30% of the NG2-labeled cells were also labeled with tetanus toxin, an additional surface marker for neurons and immature astrocytes. Less than 2% of the cells were labeled with antibodies against galactocerebroside or with monoclonal antibody O1, both of which are surface markers for oligodendrocytes. About half the NG2-labeled cells exhibited high affinity uptake of 3H-GABA, and this uptake was partially inhibited by both beta alanine and DABA. Thus, the NG2 antigen is a cell surface marker for a subpopulation of the type II or fibrous astrocytes present in the cultures. When the cerebellar cells were grown in a chemically defined, serum-free medium, the NG2-labeled cells had a stellate morphology and between 50-60% of the cells bound tetanus toxin. Although almost all the cells bound antibody A2B5, less than 5% of the cells expressed either of the oligodendrocyte surface markers or GFAP immunoreactivity. As was the case with cells grown in serum-containing medium, 60% of the NG2-labeled cells had high-affinity uptake of 3H-GABA. However, this uptake was inhibited by DABA but not by beta-alanine. This phenotype may be the in vitro analog of the NG2-labeled, filament-lacking, smooth protoplasmic astrocytes identified in the intact adult cerebellum. The expression of these 2 phenotypes could be reversed by switching the tissue culture medium within 5 d of plating the cells. These results demonstrate that the in vitro environment can influence the phenotypic properties expressed by developing cerebellar astrocytes and suggest that smooth protoplasmic astrocytes may be developmentally related to glial cells of the O-2A lineage. PMID- 3305800 TI - Bipotential glial precursor cells of the optic nerve express the NG2 proteoglycan. AB - We have studied the expression of the NG2 chondroitin sulfate proteoglycan on bipotential glial precursor cells in cultures of postnatal rat optic nerve. Purified populations of these precursor cells were prepared by panning dissociated optic nerve cells on dishes coated with monoclonal A2B5 antibody. Using immunofluorescence double staining, we found that NG2 was present on almost 95% of the purified A2B5+ precursor cells. The NG2 core protein from optic nerve cells was identified by immune precipitation and PAGE and was found to be identical to the 300,000 Da NG2 core protein from a clonal rat cell line B49. Over a culture period of 5 d in medium containing 10% fetal calf serum, more than 80% of the NG2+ precursor cells acquired the glial fibrillary acidic protein (GFAP), an astrocyte-specific marker. Under these conditions, fewer than 10% of the NG2+ cells expressed galactocerebroside (GC), an oligodendrocyte-specific marker. These GFAP+GC- type II astrocytes continued to express the NG2 antigen for up to 10 d in culture. During a 5 d culture period in hormonally supplemented, serum-free medium, fewer than 15% of the NG2+ cells expressed GFAP, while up to 40% expressed GC. The NG2 antigen continued to be expressed for only a short period of time by these GFAP-GC+ oligodendrocytes, so that mature oligodendrocytes in the cultures became NG2-. These results support our previous suggestion that the NG2 antigen is found on a class of neural cells that can differentiate along more than one pathway. PMID- 3305801 TI - Distribution of synaptic specializations along isolated motor units formed in Xenopus nerve-muscle cultures. AB - The capacity of individual muscle cells and neurons to establish synaptic specializations along the entire extent of their neurite-muscle contacts was assessed in culture. Spinal cord neurons derived from embryos of Xenopus laevis were plated at low density in cultures of Xenopus myotomal muscle cells in order to obtain isolated motor units whose neuron and muscle cells were not contacted by any other neuron. These isolated motor units were examined for localization of acetylcholine receptors (AChRs) after staining with fluorescent alpha bungarotoxin and, in some cases, for localization of a synaptic vesicle antigen by immunofluorescence. The neurite-muscle contacts formed by competent neurons exhibited discontinuous sites of AChR localization occupying about 25% of the contact length as compared with 2% for incompetent neurons. Competent neurons, unlike incompetent ones, established these neurite-associated receptor patches (NARPs) on virtually all the muscle cells they contacted and functionally innervated them. These and other observations on the distribution of NARPs throughout the isolated motor units indicate that the capacity of competent neurons to establish NARPs extends to the limits of growth of most if not all of their neurites, that this capacity is least in the most proximal portions of initial neuritic segments, and that the overall capacity of muscle cells to generate NARPs can be saturated by long lengths of neurite-muscle contact. The results also suggest that even in the absence of competitive interactions between neurons there are spatial discontinuities in neuritic action and/or muscle response during the establishment of NARPs. Synaptic vesicle antigen patches (SVAPs) occurred along the neuritic arbor of all neurons, but their distribution in competent neurons (those which established NARPs) and in incompetent ones differed. For competent neurons the percentage of neurite length occupied by SVAPs was 4.8-fold greater on muscle cells than off, whereas the corresponding value for incompetent neurons was only 1.5-fold. This large preferential localization of SVAPs along neurite-muscle contacts of competent neurons was further associated with a colocalization of SVAPs and NARPs that was greater than predicted by chance. These results suggest that muscle cells are much more effective in influencing the distribution of synaptic vesicles along the neuritic arbor of competent neurons than along the arbor of incompetent neurons and that this influence is greatest at sites of postsynaptic differentiation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3305802 TI - Induction of a neural phenotype in a serotonergic endocrine cell derived from the neural crest. AB - The thyroid parafollicular cell is an endocrine cell derived from the neural crest that stores 5-hydroxytryptamine (5-HT). In common with serotonergic neurons, but in contrast to 5-HT-storing cells that are not neurectodermal derivatives, parafollicular cells also contain a specific 5-HT binding protein. Despite this similarity to serotonergic neurons, parafollicular cells in situ were found to express an endocrine phenotype with few neural characteristics. Thus, the cells costore 5-HT with calcitonin, not calcitonin gene-related peptide (CGRP), which is the product of the calcitonin gene expressed in neurons, and they do not contain neurofilaments. The ability of adult parafollicular cells to respond to microenvironmental perturbations by expressing neuronal characteristics was examined. Sheep thyroid glands were dissociated, and parafollicular cells were purified by affinity chromatography. The purified parafollicular cells were grown in culture on a variety of substrates in the presence or absence of the beta subunit of nerve growth factor (beta-NGF). Parafollicular cells survived in culture for at least a week but retained a roughly spherical shape. Nevertheless, a subset of the cultured parafollicular cells began to display CGRP immunoreactivity. The addition of beta-NGF to the cultured parafollicular cells induced a number of them to extend neurites and increased the proportion of cells in which CGRP immunoreactivity could be found. Neurite-bearing parafollicular cells appeared not to survive for more than 2 d. While their survival was not enhanced when they were grown on collagen, polylysine, laminin, or reconstituted basal lamina, parafollicular cells that had extended neurites in response to beta-NGF survived for at least a week when cocultured with an explant of aneuronal chick hindgut. The effect of the gut was local and only those neurite-bearing parafollicular cells that were growing in direct contact with the explant survived. The thyroid parafollicular cell therefore resembles another crest-derived endocrine cell, the adrenal chromaffin cell, in being able to manifest neural properties in culture. For the parafollicular cell these neural properties include the processing of RNA encoded by the calcitonin gene to express CGRP and neurite outgrowth in response to beta NGF. PMID- 3305803 TI - Right occipital cerebral abscess caused by Aspergillus fumigatus. AB - A rare case of intracerebral abscess caused by aspergillus fumigatus located in the right occipital region is described; pathogenesis, prognosis and treatment of this particular infection are discussed. PMID- 3305804 TI - Single-dose captopril scintigraphy in the diagnosis of renovascular hypertension. AB - Renal scintigraphy with [99mTc]diethylenetriaminepentaacetic acid (DTPA) and/or sodium-iodine-131-o-iodohippurate (HIP) was performed before and after an oral dose of captopril (50 mg) in 18 patients with renovascular hypertension (RVH) due to renal artery stenosis (RAS) and 18 controls. In every patient with RVH, captopril induced, enhanced or sustained abnormal findings on HIP scintigraphy depending on the degree of RAS. With DTPA scintigraphy, renal function decreased after captopril in ten kidneys with RVH-related RAS and adequate baseline renal function, but this phenomenon was not evident in 11 kidneys with RVH and poor renal function. Captopril did not influence HIP or DTPA studies of kidneys with patent renal arteries (patients after successful renal angioplasty, patients with essential hypertension, contralateral kidneys of patients with unilateral RVH) or ipsilateral kidneys with mild and subcritical (less than 60%) RAS in patients without hypertension and/or normal renal vein renin activity. When HIP and DTPA scintigraphy were compared in the same patients, HIP demonstrated greater sensitivity and specificity than DTPA, particularly in patients with poor renal function. HIP scintigraphy before and after a single dose of captopril may provide a rapid sensitive and minimally invasive test for screening patients with hypertension. PMID- 3305805 TI - Measurement of effective renal plasma flow: a comparison of methods. AB - We have compared two in vitro methods and three variations of kidney background (BG) subtraction within a gamma camera method (41 examinations, 31 patients) for determination of effective renal plasma flow (ERPF) using 131I orthoiodohippurate (OIH). Method I: plasma samples at 20 and 45 min after OIH injection, ERPF = dose X slope/intercept; Method II: 45-min plasma sample, ERPF = -51.1 + 8.21x + 0.019x2, x = dose/45-min plasma activity/I. Individual kidney and total ERPF were determined from gamma camera (GC) methods using renal uptake 1-2 min after injection. All methods were compared against Method I (previously validated against paraaminohippurate (PAH) clearances). Method II, which requires one blood sample is more accurate than GC methods. GC methods are insensitive to operator variability in placement of renal and BG regions of interest. They may be useful to follow changes in relative or total ERPF, but accurate depth correction of renal data is suggested. In vitro, blood sample-based methods are more accurate. PMID- 3305806 TI - Technetium-99m DTPA uptake and transit in bone: effect on blood clearance in rabbits. AB - The purpose of this study is to explain the initial "plateau" distribution of [99mTc]DTPA in the forearm found when using serial external counting for kidney clearance measurements. A study by a MIRD task group, McAfee et al. 1979 (1), measured the biologic distribution of [99mTc]DTPA(Sn) in most body tissues but omitted bone, which we believe is a major contributor to this initial "plateau". Using MIRD criteria, measurements were carried out on rabbit humeri and these were compared with results obtained from human subjects. It would appear that initial accumulation of the compound by interstitial bone is the reason for the "plateau" and explains why blood sampling for GFR studies should not be undertaken over the first 2 hr. In addition, the results of this study provide valuable information relevant to bone perfusion studies and the biologic distribution and concentration of i.v. administered drugs during the first 2 hr postinjection. PMID- 3305807 TI - Iodine-123 HIPDM brain imaging findings in subacute spongiform encephalopathy (Creutzfeldt-Jakob disease). AB - Decreased perfusion of the left frontal and left temporoparietal cortex has been shown in [123I] HIPDM planar and single photon emission computed tomographic images of a patient with Creutzfeldt-Jakob disease (CJD) that was proven by brain biopsy and subsequent autopsy. An EEG showed diffuse, periodic discharges most prominent to the left hemisphere. Concurrent head computed tomography (CT), nuclear magnetic resonance (NMR), and cerebral angiographic studies were negative. Abnormalities demonstrated by [123I]HPDM imaging and by EEG may represent changes in neurophysiological and neurochemical status while cerebral angiography, CT, and possibly NMR register only anatomic or structural lesions. Premortem diagnosis of CJD depends on brain biopsy; the availability of the [123I] HIPDM study may provide regional cerebral neurochemical and neurophysiological information, guiding or avoiding brain biopsy in the appropriate clinical setting. PMID- 3305808 TI - In vivo inorganic chemistry of technetium cations. AB - Technetium-99m cations are of interest because of their potential use as myocardial perfusion imaging agents. These species can undergo in vivo reactions which markedly affect their biodistribution patterns. Four such cases of reactions are presented and discussed: (1) simple ligand substitution; (2) metal centered redox processes; (3) reactions of coordinated ligands; (4) outer sphere association reactions. New experimental techniques appropriate for investigating these reactions at the 10(-10) M concentration level of technetium encountered in vivo are also presented and discussed. The latter three classes of reactions are illustrated by examples taken from the recent literature and from unpublished data. PMID- 3305810 TI - Computerizing orientation. PMID- 3305809 TI - Renal scintigraphy in the evaluation of renovascular hypertension: a note of optimism yet caution. PMID- 3305811 TI - JONA's Semiannual Directory of Consultants to Nursing Administration. PMID- 3305812 TI - Dating pregnancy. Gathering and using a reliable data base. PMID- 3305813 TI - Social coercion for weaning. PMID- 3305814 TI - Intestinal calcium absorption: mechanisms and applications. AB - Calcium absorption from the intestine involves two sets of events. One, a saturable transcellular process is regulated by vitamin D via its molecular product, the calcium-binding protein (CaBP, MW = 8800). This transcellular movement is largely confined to the proximal portion of the intestine. The second process is nonsaturable, occurs throughout the length of the intestine and is paracellular. Evidence in support of these statements is discussed, with emphasis on kinetic considerations. It is proposed that CaBP acts as a ferry, amplifying the intracellular movement of calcium by a factor of about 60, thereby enabling transcellular calcium transport to reach the measured values of Vm = 22 mumol/h per gram (wet) duodenum, with Km = 3.9 mM. The transcellular process is subject to down-regulation and is influenced by functional or nutritional factors such as age or calcium intake. The nonsaturable process, on the other hand, is not directly influenced by these or related events. Vitamin D therapy alters active calcium transport, but may lead to undesirable effects at other target organs, e.g., kidney or bone. An increase in calcium intake is the simplest method for increasing the amount absorbed. Future research may show whether paracellular pathway alterations are a practical approach to changing the amount of calcium absorbed by the nonsaturable process. PMID- 3305816 TI - Amino acid requirements in the adult human: how well do we know them? PMID- 3305815 TI - Dietary mackerel oil in pigs: effect on plasma lipids, cardiac sarcolemmal phospholipids and cardiovascular parameters. AB - The influence of substitution of eicosapentanoic acid to the diet has been investigated in juvenile domestic pigs (7-8 kg) fed either a mixture of 4.5% (wt/wt) mackerel oil and 4.5% (wt/wt) lard fat (n = 12, ML group) or a 9% (wt/wt) lard fat (n = 12, L group) diet for 16 wk. Plasma triglyceride and total cholesterol did not change in L, but had decreased in ML to 51 +/- 8 and 81 +/- 8% of the initial values, respectively, at the end of this period; the largest decreases already occurred during the first 8 wk. HDL cholesterol of both L and ML were not affected. After 16 wk, postprandial responses of plasma triglyceride, total cholesterol and glucose and insulin, determined at hourly intervals during the first 8 h postfeeding, did not show any differences for the two dietary groups. In spite of a marked replacement of n-6 fatty acids by n-3 fatty acids in cardiac sarcolemmal membranes in ML, there were no major differences in cardiovascular performance (myocardial contractility, pre- and afterload, cardiac output and myocardial work) between L and ML, when measured under baseline conditions and after the heart was stressed by atrial pacing (heart rate: 160 beats/min). In conclusion, feeding moderate amounts of mackerel oil [0.3 g 20:5 n 3/(kg body weight.d)] to pigs during 16 wk produces decreases of the plasma levels of total cholesterol and triglyceride, but does not affect plasma HDL cholesterol and routine cardiovascular parameters. PMID- 3305817 TI - Differences in the pathogenesis of first-set allograft rejection and acute xenograft rejection as determined by sequential morphologic analysis. AB - To examine the pathogenesis of unmodified heart xenograft and allograft rejection, a sequential morphologic analysis was undertaken. Heterotopic cardiac allografts and xenografts were performed by implanting donor hearts into the abdomen of Lewis rats. Xenograft donors were Golden Syrian hamsters and allograft donors were ACI rats. Both xenografts and allografts were excised and examined by light microscopy at specific postoperative intervals. Allograft rejection was found to be a cell-mediated process, beginning with interstitial infiltrates and perivascular cuffing, which progressed to focal myocyte necroses. Ultimately, complete replacement of the myocardium by mononuclear cells was noted in fully rejected hearts. Xenograft rejection was markedly different. Although xenograft rejection was characterized first by interstitial mononuclear cell infiltrates, unlike allografts there was only minimal progression of cellular rejection. Instead, subsequent rejection was characterized by marked interstitial edema and arteriolar vasculitis and thrombosis, leading to extensive infarcts and hemorrhage in fully rejected hearts. Fibrinoid arteriolar changes and the rapid development of edema in the absence of significant cellular infiltrate suggest that cytotoxic antibodies alter xenograft vascular permeability. These data suggest that humoral immunity is largely responsible for acute concordant xenograft rejection, whereas first-set allograft rejection is mainly a cell mediated process. PMID- 3305818 TI - Morphology of cyclosporine nephrotoxicity in human heart transplant recipients. AB - The morphologic findings of renal biopsies (four cases studied by electron microscopy) and renal specimens obtained from 44 autopsies of patients who died after heart transplantation are reviewed. Eight patients treated postoperatively with cyclosporine (serum concentration of 100 to 150 ng/ml), with a survival rate of 1 to 24 months, constantly had renal lesions of variable severity. Correlated with functional renal disturbances, these changes predominantly affect the proximal convoluted tubule: vacuolization, calcifications, and tubular atrophy. The interstitial fibrosis, increasing parallel to tubular alterations, occurs only after 3 months after transplantation. The hypertrophy of juxtaglomerular apparatus and the arteriolar sclerosis noted on and after the fourth month were associated with arterial hypertension. Among the other inconstant and mild lesions (attrition of vascular endothelium and arteriolar or glomerular thrombi), the partial sclerosis of glomerular flocculus, probably correlated with tubular lesions, seems more significant. Thus these findings corroborate the nephrotoxicity of cyclosporine (principally against the proximal convoluted tube), the increase of lesions with time, and the possible irreversibility of the lesions despite appropriately decreasing the dosage of cyclosporine to eliminate toxic side effects. PMID- 3305819 TI - Heart allograft rejection under varying immunosuppressive protocols as evaluated by endomyocardial biopsy. AB - Rejection episodes in 259 heart allograft recipients and 29 heart-lung transplant patients at Stanford University were examined from the viewpoint of endomyocardial biopsy. The patients were divided into the following six groups by immunosuppressive regimen: Group 1 (100 patients) was treated with conventional immunosuppression. Group 2 (26 patients) was treated with cyclosporine in combination with low-dose corticosteroids and an initial 3- to 4-day course of rabbit antithymocyte globulin. Group 3 (76 patients) was treated with cyclosporine and low-dose corticosteroids. Group 4 (34 patients) was treated with low-dose cyclosporine, azathioprine, and low-dose corticosteroids. Group 5 (23 patients) was treated with low-dose cyclosporine and azathioprine, but initially without low-dose corticosteroids. Group 6 was composed of 29 heart-lung transplant recipients. Groups 1, 2, and 6 had significantly less rejection episodes than group 3, and groups 4 and 5 had more rejection episodes than group 3. In patients with a diagnosis of mild acute rejection on cyclosporine, a repeat biopsy shows progression to a moderate acute rejection in 21% to 43% of cases, emphasizing the importance of this diagnosis even in cyclosporine-treated patients. The characteristics of acute heart allograft rejection as assessed by endomyocardial biopsy are important to recognize. In part as a result of the data presented here, further modifications in the immunosuppressive regimen of the Stanford heart and heart-lung transplant recipients are being undertaken. PMID- 3305820 TI - Successful six-hour cardiopulmonary preservation with simple hypothermic crystalloid flush. AB - Combined heart and lung transplantation was performed in 12 cynomolgus or rhesus monkeys. The donor heart was preserved with 10 ml/kg of cold crystalloid potassium cardioplegia. The lungs were preserved by perfusing the pulmonary artery over 4 minutes with 60 ml/kg donor weight of cold Euro-Collins solution modified with 8 mEq/L of MgSO4. For six animals in group A, the heart and lungs were immediately transplanted with a mean ischemic time of 1 hour 54 minutes. For six animals in group B, the heart and lungs were stored in a cold extracellular electrolyte solution at 2 degrees to 3 degrees C and transplantation was delayed, with a mean ischemic time of 6 hours and 15 minutes. Anesthesia and mechanical volume ventilation were continued for 8 hours postoperatively with the Fio2 regulated to 40% and with 2 cm positive end-expiratory pressure. Arterial Po2 was sampled at 1, 2, 3, 4, 6, and 8 hours after removal of the aortic cross clamp. Animal survival and cause of death were recorded. All animals were successfully extubated by 10 hours after transplantation. The mean arterial Po2 for group B was initially depressed (89 mm Hg 1 hour after removal of the aortic cross clamp) but rapidly recovered. The mean Po2 for both groups A and B was 184 mm Hg 8 hours after reperfusion. There was no significant difference in the mean hourly Po2 between groups A and B except for the first hour after reperfusion. One animal in each group died of pulmonary insufficiency in the early postoperative period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305821 TI - Recovery of heart function following 24 hours preservation and ectopic transplantation. AB - We examined the capacity of hearts injured during 24 hours of preservation to recover function over 96 hours when placed in an ectopic transplant configuration. Standard Langendorff techniques employing an intraventricular balloon and fixed perfusion pressure of 80 mm Hg were used to measure parameters of myocardial function, including maximal systolic pressure, left ventricular end diastolic pressure, and left ventricular balloon volume. Hearts preserved for 24 hours and held ischemic for 1 hour at room temperature exhibited significantly depressed contractility (maximal systolic pressure decreased by 26%) and diastolic compliance (left ventricular balloon volume decreased by 61%). During 96 hours in the ectopic transplant configuration, 24-hour preserved hearts recovered 52% of the lost diastolic compliance. These data demonstrate that 24 hour preserved and transplanted hearts recovered function over 96 hours. PMID- 3305822 TI - Effects of steroids in combination with other pharmacologic immunosuppressive agents. AB - Steroids are commonly employed as immunosuppressive agents following organ transplantation. They may be given in large doses at the time of transplantation and also at times of rejection. At lower doses they are commonly used as maintenance therapy. The justification for these forms of treatments has been critically examined, and the author refers to his own experimental studies and clinical trials of steroids following kidney transplantation. The conclusion reached is that steroids are usually effective in reversing rejection, but there is no good evidence that they are required at the moment of transplantation or for long-term administration afterward if patients are already receiving cyclosporine. PMID- 3305824 TI - Acute right ventricular failure following heart transplantation: improvement with prostaglandin E1 and right ventricular assist. AB - Development of significant pulmonary hypertension following orthotopic heart transplantation can result in death caused by irreversible right ventricular failure. Despite determination of acceptable preoperative pulmonary vascular resistance, this complication may still occur. This report illustrates the technique of right ventricular assist and concomitant infusion of intrapulmonary prostaglandin E1 for the treatment of postoperative right ventricular failure resulting from pulmonary hypertension. PMID- 3305823 TI - Role of the carrier solution in cyclosporine pharmacokinetics in the baboon. AB - Although numerous investigational models have demonstrated the potent immunosuppressive properties of cyclosporine, the effectiveness of any given dosage may vary with the metabolism of the animal, the route of administration, and the carrier solution of the drug. We investigated the pharmacokinetics of intramuscular cyclosporine administration in the baboon using three carriers: polyoxethylated castor oil (Cremophor), a mixture of octanoic and decanoic acids (Miglyol), and olive oil. Cyclosporine prepared in Cremophor, Miglyol, or olive oil was injected intramuscularly into the hindlegs of baboons. Specimens for cyclosporine assay were obtained 2, 4, 6, 12, 18, and 24 hours after single intramuscular injection of 10 mg/kg or 15 mg/kg. In addition, weekly, then monthly, levels were obtained on animals receiving daily intramuscular injections following heterotopic heart xenografts. Attempts at oral administration proved unreliable and were discontinued. Cyclosporine assay was performed on stored serum using the RIA-KIT (Sandoz Pharmaceuticals Corporation, East Hanover, N.J.). Cremophor provides a more bioavailable form of cyclosporine than Miglyol when administered intramuscularly. (Area under curve = 7776 +/- 1437 for Cremophor 15 mg/kg vs 1837 +/- 726 for Miglyol 15 mg/kg; 2579 +/- 694 for Cremophor 10 vs 1123 +/- 393 for Miglyol 10.) Long-term daily intramuscular administration of Cremophor provides a sustained drug serum trough level with wide variability between individual animals (80 to 825 ng/ml). Toxicity was limited to injection site inflammation. There was no biochemical evidence of renal toxicity; however, some animals did demonstrate early histologic changes of cyclosporine effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305825 TI - Self-reported change in physical symptoms from cyclosporine-based therapy to azathioprine-based therapy in heart transplant recipients. AB - Since the introduction of cyclosporine, 183 heart transplants have been performed at Stanford University Medical Center. Although cyclosporine has improved survival rates, it is also associated with progressive renal dysfunction. Seventeen of these recipients have been converted from cyclosporine-based therapy to azathioprine-based therapy because of significant nephrotoxicity. Fourteen of these recipients participated in a study to examine change in physical symptoms since immunoconversion. Most reported little change in physical symptoms following conversion, although 79% experienced rejection following the drug change. Overall, the change in immunosuppressive medications had little impact on perceived symptoms. PMID- 3305826 TI - Combined transplantation of heart and liver from two different donors in a patient with familial type IIa hypercholesterolemia. AB - A 12-year-old child with terminal ischemic heart disease as a result of homozygotous familial type IIa hypercholesterolemia received an orthotopic heart transplant and, 21 days later, an orthotopic liver transplant. Six months after heart transplantation, the patient is asymptomatic and evidences normal liver function and cholesterol levels; there are no signs of heart rejection. To our knowledge, this is the first instance of two-step heart-liver transplantation with organs from different donors. PMID- 3305827 TI - Transposition of the greater omentum for management of mediastinal infection following orthotopic heart transplantation: a case report. AB - A case of mediastinal infection following orthotopic heart transplantation is presented. A general survey of the available surgical management of this complication is given and an alternative operation involving extra-abdominal transposition of the greater omentum pedicled on the left gastroepiploic vessels is suggested for treating difficult cases. PMID- 3305828 TI - The effect of heart transplantation on Cheyne-Stokes respiration associated with congestive heart failure. AB - Cheyne-Stokes respiration occasionally accompanies the terminal stages of congestive heart failure. We describe this association in a patient requiring heart transplantation. The gradual abatement of Cheyne-Stokes respiration after transplantation supports the delayed circulatory time theory as the mechanism for Cheyne-Stokes respiration in these patients. PMID- 3305829 TI - Bridging circulatory support before heart transplant without invasion of the mediastinum. AB - Heart transplantation is becoming a useful tool in the clinical treatment of patients with end-stage cardiac decompensation. Donor organs are not always available at a critical time for a patient waiting for a transplant. Bridging techniques have been described that use mechanical support systems. This article describes the use of femoral-venous to femoral-arterial bypass over a period of 50 hours in a 38-year-old woman waiting for a donor heart. Because the patient sustained cardiopulmonary arrest before organ availability, mechanical circulatory support that used femoral-venous to femoral-arterial bypass was instituted. The patient's own lungs were used as an oxygenator. Pump flow levels were determined by the level of central aortic oxygen saturation. Successful transplant was performed, and bridging, therefore, was done without invasion of the mediastinum. PMID- 3305831 TI - Combined Registry for the clinical use of mechanical ventricular assist pumps and the total artificial heart: first official report--1986. PMID- 3305830 TI - The Registry of the International Society for Heart Transplantation: fourth official report--1987. PMID- 3305832 TI - Feasibility of discontinuation of corticosteroid maintenance therapy in heart transplantation. AB - Corticosteroid maintenance immunosuppression therapy was successfully discontinued in 24 of 46 patients (52%) who underwent orthotopic heart transplantation between March 8, 1985 and September 1, 1986. In the remaining 22 patients three or more rejection episodes occurred within a 4-month period, and these patients were subsequently maintained on low to moderate dosages of corticosteroids. Patients successfully withdrawn from corticosteroid maintenance (group 1) have remained rejection free for 208 +/- 33 days (mean +/- SEM) after discontinuation of the maintenance therapy with corticosteroids, and their immunosuppression therapy has consisted only of cyclosporine (mean overall cumulative dose 198 +/- 11 mg/m2/day [5.17 +/- 0.35 mg/kg/day]) and azathioprine (mean overall cumulative dose 67.7 +/- 5.4 mg/m2/day [1.74 +/- 0.13 mg/kg/day]), with the most recent serum cyclosporine level and white blood cell count being 146 +/- 10 ng/ml and 5400 +/- 200/microliters, respectively. In contrast to the patients who continue to require maintenance therapy with corticosteroids (group 2), group 1 patients developed their first episode of rejection later (46.8 +/- 8.3 days versus 25.4 +/- 6.1 days, p = 0.040) and reject less frequently during the first 4 months after transplantation (1.7 +/- 0.2 episodes versus 2.6 +/- 0.2 episodes, p = 0.005) as well as during the entire follow-up period (0.21 +/- 0.02 episodes/month versus 0.30 +/- 0.02 episodes/month, p = 0.005). The decreased propensity to reject and subsequent corticosteroid discontinuation resulted in a decreased cumulative dose of corticosteroids in group 1 patients (10.9 +/- 1.9 mg prednisone equivalent/m2/day [0.28 +/- 0.04 mg/kg/day] versus 17.0 +/- 1.2 mg prednisone equivalent/m2/day [0.42 +/- 0.04 mg/kg/day], p = 0.011 [p = 0.026]).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305833 TI - Antithymocyte gamma globulin, low-dosage cyclosporine, and tapering steroids as an immunosuppressive regimen to avoid early kidney failure in heart transplantation. AB - Cyclosporine is a powerful immunosuppressive agent that unfortunately has significant renal toxicity. Two risk factors associated with a high incidence of kidney failure in patients receiving cyclosporine have been described in the literature. In an effort to decrease the possibility of renal toxicity with the use of cyclosporine, we use low-dosage cyclosporine, antithymocyte gamma globulin, and tapering dosages of steroids as an immunosuppressive regimen. Twenty-one patients had orthotopic heart transplants from January 1985 to January 1986. Sixteen of 21 patients or 70% had at least one high risk factor for kidney failure. There were no episodes of acute kidney failure, and the blood urea nitrogen and creatinine levels that were recorded over an average of 8.5 months per patient did not increase significantly from preoperative values. Seventeen of 21 or 81% of the patients are alive and functioning fully. The incidence of rejection per patient was 0.9, and there were no biopsy-proven severe rejections. One patient died at 5 months; the autopsy showed generalized moderate rejection. There were 0.24 episodes of infection per patient, with one patient who died from Pneumocystis pneumonia. With this immunosuppression protocol, early postoperative kidney dysfunction was avoided. The incidences of rejection and infection were within acceptable range, and the quality of life in the 17 survivors is excellent. PMID- 3305835 TI - Early, aggressive open lung biopsy in heart transplant recipients. AB - Fourteen open lung biopsies were done in 13 patients out of a total of 63 heart transplant recipients. All of the patients were receiving cyclosporine and azathioprine (Imuran) and had received prophylactic antithymocyte globulin or murine antihuman mature T cell (OKT3). Eight of the patients were receiving steroids, and five of the patients had been weaned off steroids. A fever of greater than 38.5 degrees C was present in all 13 patients. Hypoxia, defined as PO2 less than 60 on room air, was present in 11 of the 13 patients. One patient had to be intubated before surgery for respiratory failure. The chest x-ray film most often revealed bilateral interstitial infiltrates. The operative approach was by a small anterior thoracotomy in 12 patients and a posterolateral thoracotomy in two patients. A definitive diagnosis was made in 11 of the 14 open lung biopsies: three patients had Legionella, one had cytomegalovirus (CMV), one had a Pseudomonas infection, three had Pneumocystis, one patient had CMV and Pneumocystis, one patient had a pulmonary infarct, and one patient had a pulmonary infarct and CMV. Specific therapy was instituted in all these patients. In the three patients in whom no specific diagnosis was made, therapy was also changed and the use of antibiotics discontinued. There was no mortality in this group. Morbidity was minimal. No patient had excessive bleeding, and none of the patients required the transfusion of blood or blood products. Three patients required mechanical ventilatory support for longer than 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305836 TI - The stability of Le Fort I maxillary osteotomies in patients with simultaneous alveolar cleft bone grafts. AB - A retrospective study was performed on 20 patients who had been treated with Le Fort I maxillary osteotomies and simultaneous alveolar cleft bone grafts. The age range was 11 to 23 years, and there were 11 males and nine females. Changes in both anterior-posterior (A-P) and vertical direction were investigated using preoperative, immediate postoperative, and long-term postoperative lateral cephalometric radiographs. The results indicated little change between the immediate postoperative and long-term postoperative position of the maxilla in an A-P dimension, but in a vertical direction there was a great tendency for relapse. PMID- 3305837 TI - Arteriographic assessment of patency of the inferior alveolar artery and its relevance to alveolar atrophy. AB - Patency of the inferior alveolar artery was investigated on 84 patients who had undergone selective external carotid angiography with digital subtraction. Patency of the artery was lost earlier in males than females, but the presence or absence of teeth did not appear to affect the outcome. The artery was visualized less well on patients with medical conditions that may predispose to early or excessive atherosclerotic disease. PMID- 3305834 TI - Use of cyclosporine and ketoconazole without nephrotoxicity in two heart transplant recipients. AB - A cyclosporine-ketoconazole drug interaction was first described in 1981. It has been suggested that the two drugs should not be used concomitantly because of the danger of severe nephrotoxicity. Two reported cases indicate that cyclosporine and ketoconazole can be safely coadministered, provided that the dosage of cyclosporine is reduced appropriately. Two patients were initially given 8 mg/kg/day of cyclosporine at the time of heart transplantation, and the dosage was tapered to meet appropriate blood levels (250 to 350 ng/ml by whole blood high-performance liquid chromatography). During ketoconazole therapy (400 mg daily for 4 weeks), patient 1 received 80 to 100 mg/day of cyclosporine, which is equal to approximately 1 mg/kg/day, and patient 2 received between 40 and 80 mg/day of cyclosporine, which is equivalent to 0.4 to 0.8 mg/kg/day. Neither patient exhibited a creatinine value above 1.4 mg/dl while on combined therapy, and there were no problems with allograft rejection. Both patients had inappropriately high cyclosporine blood levels even with this marked reduction in dosage (patient 1, 520 to 1310 ng/ml and patient 2, 320 to 600 ng/ml). Thus it appears that cyclosporine and ketoconazole can be administered together safely, provided that there is an appropriate reduction in the dosage of cyclosporine; this results in the maintenance of adequate immunosuppression without development of nephrotoxicity. PMID- 3305839 TI - Painless swelling of the anterior maxillary gingiva. PMID- 3305838 TI - Inhibitory and cidal antimicrobial actions of electrically generated silver ions. AB - One promising alternative to antibiotics in the treatment of localized infections is the generation of antimicrobial silver ions by the use of low intensity direct current from a pure silver anode implanted at the site of an infection. This study investigates the in vitro bacteriostatic and bactericidal properties of this system on a variety of organisms. PMID- 3305840 TI - Resistance to horizontal forces of dowel and amalgam-core restorations: a comparative study. AB - Four designs of amalgam-core anchorage were compared in a laboratory study for the inability to withstand the horizontal component of occlusal force. Amalgam cores were constructed for extracted teeth with either composite resin-cemented Dentatus dowels, or with Para-post or Flexi-post dowels cemented with phosphate cement. All the posts were of comparable length and diameter. These anchorage designs were compared with each other and to a self-threading (TMS) pin-retained amalgam core, by application of horizontal force and recording forces causing failure. Flexi-post-retained amalgam cores failed at a mean force of 36.5 (+/- 8.5) kg while Dentatus-retained and Para-post-retained cores failed at 41.7 (+/- 8.0) kg and 46.6 (+/- 11.4) kg, respectively. TMS-retained cores resisted forces up to a mean force of 53.5 (+/- 4.5) kg. Patterns of failure varied widely among these groups. Composite resin-cemented Dentatus dowels were retained in the tooth in nine out of ten samples, while none of the ten Flexi-post dowels and only one of the ten Para-post dowels did so. Tooth fracture on failure occurred in seven out of ten Flexi-post-retained cores, while only three out of ten of the Para post-retained cores and none of the Dentatus dowel-retained cores presented this unrepairable type of failure. Possible reasons for these differences are discussed. PMID- 3305841 TI - Treatment times for adhesive bridges. AB - The aim of this study was to collect information about the mean working time needed to accomplish the clinical procedures in applying an adhesive bridge, and to gain an insight into the factors that influence the working time. The study was carried out as part of a clinical trial. One hundred and fifty-one patients needing one adhesive bridge were selected for this study and divided between five operators. Clinical procedures were carried out following a written protocol. The statistical method consisted of an ANOVA after log-transformation of the working times. The total mean working time needed to accomplish the clinical procedures for adhesive bridges was 60.7 min (s.d. +/- 16.5 min). The mean working time increased by 30% where the abutment teeth were restored with class II or class III restorations. No influence was found related to: type of bridge (i.e. macromechanical versus micromechanical), type of luting resin and location of the bridge. A significant effect on the working times was found for: operator, tooth preparation and occlusal adjustments. With increasing experience of the operator the median working time decreased by up to 35%. The data from this study are considered as useful basic information for efficient planning in the dental practice and for a further cost-benefit analysis. PMID- 3305842 TI - A study of the occlusal plane orientation in complete denture construction. AB - A cephalometric study was conducted on eighteen dentulous subjects and fifty-six complete denture wearers to determine the location of the natural and artificial occlusal planes as related to Camper's plane. The results indicated that both the natural and artificial occlusal planes were not parallel to Camper's plane. However, the final anteroposterior inclination of the artificial occlusal plane in complete dentures was almost the same as the inclination of the natural occlusal plane. PMID- 3305843 TI - Experimental vascularized bone grafts: histopathologic correlations with postoperative bone scan: the risk of false-positive results. AB - A positive bone scan in an experimental model of bilateral ulna diaphyseal bone grafts demonstrated early bone repair in both vascularized and nonvascularized orthotopic ulna autografts. A positive bone scan did not correlate with the perfusion of the vascularized and nonvascularized grafts as measured by microangiograms done 1 week postoperatively. In this model, if the bone scan is intended to monitor the circulatory status and viability of the bone graft, it must be done earlier than 1 week postoperative prior to the onset of creeping repair in both vascularized and nonvascular ulna autografts. PMID- 3305844 TI - The effect of proximally and fully porous-coated canine hip stem design on bone modeling. AB - Porous coated canine femoral hip replacement implants were evaluated for biological fixation by bone ingrowth and the effect of the extent of porous coating on bone modeling. The Co-Cr alloy implants were either fully porous coated or coated only on the proximal 40% of the stem. Two implants of each type were studied 9, 16, and 36 months after surgery. Implant fixation and bone modeling were assessed radiographically throughout the implant periods and histologically after the test animals were killed. All 12 implants appeared stably fixed within the femur and were bone-ingrown in the porous region. Radiographic features such as proximal medial and anterior cortical thinning, proximal cancellous bone hypertrophy, and new endosteal bone formation near the stem tip were noted within the first postoperative year, with no appreciable change thereafter. The extent of proximal cortical thinning varied from virtually none to as much as 40%, being more prominent with the proximally coated implants at 16 months and with the fully coated implants at 36 months. Of consistent note was cancellous hypertrophy at the junction of porous and smooth implant surfaces with proximally coated implants and new endosteal bone formation and ingrowth at the stem tip of fully coated implants. These results indicate that the proximally porous-coated implant design causes increased proximal stress transfer, but this does not necessarily preclude proximal cortical resorption. PMID- 3305845 TI - Use of the monoclonal antibody WR17, identifying the CD37 gp40-45 Kd antigen complex, in the diagnosis of B-lymphoid malignancy. AB - The distribution of the gp40-45 Kd antigen bound by the WR17 monoclonal antibody of IgG2 subclass in normal lymphoid tissue was characterized by immunohistochemistry and immunofluorescence staining with flow cytometric analysis. The predominant staining pattern observed was characteristic of an anti pan-B-lymphocyte reagent. Weak reactions were observed by immunofluorescence staining of viable cell suspensions with all neutrophils and T-lymphocytes in some normal donors. In tissue sections, B-lymphocytes were stained and no cross reactions were observed with T-lymphocytes, although macrophages stained in some sections. A range of T- and B-cell malignancies were stained with WR17 and the reactivity compared to that observed with other monoclonal antibodies in the CD19, CD21 and CD22 clusters. All B-non-Hodgkin's lymphomas, B-chronic lymphocytic, prolymphocytic and hairy cell leukaemia cells examined were stained by WR17 in indirect immunofluorescence assays, whilst the T-cell tumours were negative. The same pattern was observed in cryostat sections of malignant tissue and in addition some tissue macrophages expressed the CD37 antigen cytoplasmically. Intra-tumour heterogeneity of staining was observed with all the monoclonal antibodies tested, although overall WR17 consistently stained B-cell tumours even when expression of the CD19 pan-B-lymphocyte antigen could not be detected with some monoclonals. Monoclonal antibodies, such as WR17, within the CD37 cluster and binding to the gp 40-45 Kd molecule, bind to mature B lymphocytes and identify the majority of B-cell malignancies. PMID- 3305846 TI - Pathogenicity of HIV in lymphatic organs of patients with AIDS. AB - HIV antigens were searched for in the thymus, lymph nodes, bone marrow, and spleen of AIDS patients, by means of immunofluorescence technique. Human IgG against HIV and monoclonal antibodies against viral gag P24 protein yielded strong cytoplasmic fluorescence of cells in sections of the thymus, lymph nodes and spleen. Some cells containing HIV antigens were morphologically multinucleated giant cells. They reacted with monoclonal antibodies against helper/inducer T-cells (OKT4+), and were complexed with antibody or with complement as demonstrated by double-staining immunofluorescence technique. A large number of inflammatory cells infiltrated the thymus in areas containing cells expressing HIV antigens. These studies demonstrated an association of HIV virus with cytopathic and immunopathogenic reactions in lymphatic organs of AIDS patients, and are consistent with previous results, as well as indicative of a primary aetiologic role for the virus. PMID- 3305847 TI - Endotoxin induced hepatic necrosis in rats on an alcohol diet. AB - The role of endotoxin in the pathogenesis of progressive liver disease is receiving increasing attention, but remains controversial. Similarly, although alcoholic hepatitis is now recognized as the transitional link between alcoholic fatty liver and advanced alcoholic liver disease, the aetiology of liver cell necrosis in alcoholic hepatitis is not known. Rats fed a nutritionally adequate liquid alcohol diet according to the formula of Lieber and DeCarli developed fatty livers. Littermates fed an identical diet and challenged with small IV doses (1 microgram/g body weight) of E. coli lipopolysaccharide endotoxin (LPS) developed focal necrotizing hepatitis. Control littermates fed an identical calorie balanced but alcohol free diet and challenged with identical doses of LPS did not develop any liver lesions. The hepatocyte necrosis with associated inflammatory changes induced by LPS in fatty livers has some features of early human alcoholic hepatitis and suggests that progressive alcohol induced damage may be multifactorial in origin. PMID- 3305848 TI - Cerebral ventricular dilation in congenital myotonic dystrophy. AB - Ultrasonography or computed tomography scanning of the brain was performed in 10 infants with congenital myotonic dystrophy between the age of 1 day and 2 months, and showed intracranial abnormalities in all. Ventricular dilation was diagnosed in eight (80%), subarachnoid hemorrhage in one, and white matter infarcts in one. The common finding of ventricular dilation is probably related to developmental brain abnormality dating back to fetal life, because it was already present in three infants scanned on the first day of life. Neonatal asphyxia was present in seven infants, associated with intraventricular hemorrhage in two. The relationship between these changes and mental retardation, which is a common feature in this disease, is unclear. PMID- 3305849 TI - Association of supernumerary nipples with renal anomalies. PMID- 3305850 TI - Oral theophylline and diuretics improve pulmonary mechanics in infants with bronchopulmonary dysplasia. AB - We studied the effects of orally administered theophylline and diuretics (chlorothiazide and spironolactone) on pulmonary mechanics in 16 infants with bronchopulmonary dysplasia. Their gestational age (mean +/- SD) was 28.5 +/- 3.4 weeks, and postnatal age at the time of study 19.5 +/- 10.7 weeks. The infants were randomized to two groups. Group 1 received successively placebo, theophylline, and theophylline plus diuretics; Group 2 received theophylline, placebo, and placebo plus diuretics on successive 4-day periods. Pulmonary function was measured before beginning the study (baseline) and at the end of each 4-day period. No significant changes in pulmonary function were noted after treatment with placebo. After treatment with theophylline, dynamic compliance (Cdyn) increased from baseline (mean +/- SD) 0.075 +/- 0.017 to 0.091 +/- 0.028 mL/cm H2O/cm (P less than 0.01), airway resistance (Raw) decreased from 67.19 +/- 36.71 to 41.44 +/- 22.50 cm H2O/L/sec (P less than 0.001), maximal expiratory flow at functional residual capacity (VmaxFRC) increased from 0.261 +/- 0.240 to 0.357 +/- 0.299 thoracic gas volume (TGV)/sec (P less than 0.01), and time constant decreased from 0.312 +/- 0.224 to 0.275 +/- 0.247 sec (P less than 0.02). After treatment with combined placebo and diuretics, Cdyn increased to 0.103 +/- 0.023 mL/cm H2O/cm (P less than 0.05), Raw decreased to 31.76 +/- 24.90 cm H2O/L/sec (P less than 0.001), VmaxFRC increased to 0.638 +/- 0.595 TGV/sec (P less than 0.02), and time constant decreased to 0.180 +/- 0.141 sec (P less than 0.05). After treatment with combined theophylline and diuretics, Cdyn increased to 0.118 +/- 0.017 mL/cm H2O/cm (P less than 0.001), Raw decreased to 35.98 +/- 25.85 cm H2O/L/sec (P less than 0.02), VmaxFRC increased to 0.479 +/- 0.377 TGV/sec (P less than 0.02), and time constant decreased to 0.180 +/- 0.137 sec (P less than 0.01). We conclude that theophylline and diuretics have additive effects on the improvement of pulmonary function in infants with bronchopulmonary dysplasia. PMID- 3305851 TI - Effects of theophylline on learning and behavior: reason for concern or concern without reason? PMID- 3305853 TI - A survey of Bancroftian filariasis in the Dominican Republic. PMID- 3305852 TI - Macrophage function in patients with American cutaneous leishmaniasis: in vitro cytotoxicity and interleukin-1 production. AB - Monocyte-derived blood macrophages of untreated patients with Leishmania braziliensis or Leishmania mexicana amazonensis infections show anomalies in their nonspecific immune functions. Their ability to kill HeLa cells or to produce interleukin-1 in vitro in response to lipopolysaccharide plus Candida albicans is lower than controls indicating that acquired or innate macrophage deficiencies may be involved in the course of the disease. PMID- 3305854 TI - Cyclosporin-A-induced gingival enlargement. A case report. AB - Cyclosporin-A (CsA)-induced gingival enlargement has been reported in a small number of cases but may involve up to one third of all patients taking CsA. The present study reports a case of CsA-induced gingival enlargement during suppressive therapy for myasthenia gravis. Gingival tissues were examined histologically, histochemically, and immunohistologically. The basic tissue response seemed to be a dental plaque- and trauma-induced fibroblastic response characterized by large aggregations of plasma cells, macrophages and helper T lymphocytes. The reactive areas rapidly matured into noninflamed fibrocytic tissue. The suppressive effect of CsA appears responsible for removal of sectors of the normal immune response and, in combination with an elevated number of macrophages, may be instrumental in initiating a fibrous hyperplastic response. PMID- 3305855 TI - Ultrastructural and immunocytochemical characterization of polymorphonuclear leukocytes from gingival crevice in man. AB - Polymorphonuclear leukocytes from the gingival crevicular fluid (CF-PMNs) of patients with generalized severe periodontitis were examined using electron microscopy and immunocytochemical techniques. CF-PMNs were found to contain numerous phagocytic vacuoles. This suggests that CF-PMNs actively phagocytized various substances from the environment. Immunocytochemical staining with FITC conjugated IgG, IgM, and IgA reagents and TRITC-conjugated C3 reagent was applied to CF-PMNs as well as peripheral blood PMNs incubated with cell-free crevicular fluid. The cytoplasm of PMNs exhibited numerous granular foci of immunofluorescence. This finding suggests that these proteins were acquired from the environment by PMNs. The coincidental appearances of immunoglobulins and C3 in a single cell were considered to be immune complexes phagocytized by CF-PMNs in generalized severe periodontitis. PMID- 3305856 TI - Tissue localization of Actinobacillus actinomycetemcomitans in human periodontitis. I. Light, immunofluorescence and electron microscopic studies. AB - Invasion of periodontal tissues by different bacterial morphotypes has been reported in human periodontitis; however, limited information is available as to prevalence, localization and the bacterial species involved. The present study determined prevalence and gingival localization of Actinobacillus (Haemophilus) actinomycetemcomitans in periodontal lesions of juvenile periodontitis patients. Thirty-five gingival biopsies were obtained from 12 juvenile periodontitis patients at the time of periodontal therapy. One additional control biopsy was obtained from each of two adult periodontally healthy subjects, one adult periodontitis patient and one periodontally healthy monkey (Macaca fosibolius). The biopsies were carefully processed to avoid mechanical introduction of bacteria into the tissues and were examined using light and electron microscopy. Rabbit antisera specific for the three A. actinomycetemcomitans serotypes were used for immunofluorescence microscopic localization of A. actinomycetemcomitans antigens in the gingival sections. Immunofluorescence microscopy showed A. actinomycetemcomitans specific antigens in the gingival tissues of 11 of the 12 juvenile patients examined. None of the control specimens showed evidence of A. actinomycetemcomitans antigens in the gingival connective tissue. One specimen from a periodontally healthy subject and the monkey biopsy, however, showed A. actinomycetemcomitans antigens in bacterial plaque on the surface of the crevicular epithelium. Transmission electron microscopic examination showed microcolonies of small gram-negative rods in the connective tissue, as well as single bacterial cells between collagen fibers and in areas of cell debris. In addition to these extracellular bacterial cells, evidence of bacterial cells was also found within gingival connective tissue phagocytic cells. The data from the present study suggest that the gingival tissue in juvenile periodontitis lesions harbors A. actinomycetemcomitans. PMID- 3305857 TI - Tissue localization of Actinobacillus actinomycetemcomitans in human periodontitis. II. Correlation between immunofluorescence and culture techniques. AB - Recent immunohistological studies have suggested that Actinobacillus actinomycetemcomitans is present in the gingival tissues in juvenile periodontitis lesions. The present study examined tissue bound A. actinomycetemcomitans by bacterial culture and immunohistological demonstration of antigen in tissue. A total of 14 periodontitis lesions were examined. Eleven biopsies were obtained from gingiva adjacent to A. actinomycetemcomitans infected pockets, while the remaining three control biopsies were obtained from gingiva adjacent to pockets where subgingival A. actinomycetemcomitans infection could not be detected. Each biopsy was hemisected, one half was used for immunofluorescence microscopic examination while the other half was processed for culture of A. actinomycetemcomitans. The latter section was surface-disinfected, repeatedly washed and then minced to release bacteria from within the tissues. Aliquots from the serial washings and the minced tissue suspension were cultured on medium selective for A. actinomycetemcomitans. Surface disinfection and serial washings gradually decreased cultivable A. actinomycetemcomitans in the washings aliquots. Following tissue disruption, an increase in colony-forming units of A. actinomycetemcomitans was seen from eight of the 11 test biopsies. This bacterium could not be detected in washings or minced tissue suspensions from the control biopsies obtained from lesions in which subgingival A. actinomycetemcomitans was previously not detected. A positive correlation was seen between the presence of A. actinomycetemcomitans antigens in the gingival biopsies and; (1) A. actinomycetemcomitans colony-forming units released from the minced tissues (r = 0.90, p = 0.000), as well as; (2) the colony-forming units from the periodontal pocket (r = 0.62, P = 0.017).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305858 TI - Alteration in gastric mucosal acid protease activity induced by necrotizing agents and prevention by prostaglandin E2. AB - Tissue levels of two gastric mucosal acid proteases, pepsinogen and cathepsin D like acid proteinase, were determined in rat gastric mucosa damaged by various necrotizing agents and the protective effects of prostaglandins against these biological alterations were investigated. Gastric mucosal damage by each necrotizing agent used was associated with a marked decrease in tissue level of cathepsin D-like acid proteinase. Particularly, ethanol ingestion caused its significant reduction parallel to the production of gastric lesions in a time dependent manner. On the other hand, mucosal pepsinogen level increased markedly only in ethanol-damaged gastric mucosa, indicating that this change was mediated by a different mechanism from that for cathepsin D-like enzyme. In rats pretreated with prostaglandin E2 and prostaglandin inducers before ethanol administration, these biological alterations of two enzymes were effectively prevented as were gastric lesions. However, ethanol ingestion caused these changes to occur to the same degree in both the necrotic and non-necrotic areas of glandular mucosa. It was considered that cathepsin D-like acid proteinase was released from damaged gastric mucosa through a direct action on cellular membrane different from vasoconstrictor and platelet aggregating actions mediated by arachidonic acid metabolites. PMID- 3305859 TI - Variances in pharmacokinetic parameters due to assay methods for beta methyldigoxin. AB - A digoxin radioimmunoassay (RIA) or fluorescence polarization immunoassay (FPIA) kit is frequently used in routine therapeutic drug monitoring (TDM) of beta methyldigoxin (MD) by applying a calibration curve made using the corresponding digoxin calibrators. The variances in the plasma levels (61 samples) and pharmacokinetics (5 patients) due to these two different assay methods for MD were examined in our patients with congestive heart failure. Although the plasma levels of MD measured by these methods were well correlated (r = 0.956, p less than 0.001) to each other over a wide range, RIA showed significantly lower values (p less than 0.01) in the subtherapeutic range (less than 0.80 ng/ml), but significantly higher values (p less than 0.002) in the therapeutic and toxic ranges (0.80-2.00 and 2.00 less than ng/ml), respectively than FPIA. This trend occurred with increasing concentrations. When MD samples, spiked in normal human plasma, were analyzed by these methods, RIA showed almost true MD values and gave larger values than FPIA with a mean ratio of FPIA to RIA of 0.83. In contrast, normal plasma samples, each spiked with a MD metabolite such as digoxigenin bisdigitoxide or digoxigenin-monodigitoxide, showed higher values by 10 to 22% in FPIA. These observations are in good agreement with the findings obtained in a pharmacokinetic study that RIA gave significantly higher levels than FPIA, only in the early stage after MD administration, resulting in a smaller total volume of distribution and a larger beta value in the elimination phase, as compared with FPIA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3305860 TI - Regulation of L-carnitine metabolism in Escherichia coli. AB - The metabolization of L-carnitine was studied using whole cells of Escherichia coli 044 K74. It showed features of an epigenetical control. L-carnitine and crotonobetaine were able to induce the carnitine-reducing system. Oxygen and nitrate as electron acceptors, gamma-butyrobetaine as final product of carnitine transformation in E. coli as well as glucose repress the carnitine metabolization. Other betaines and structurally related compounds did not show any effect neither as inductors nor as repressors. PMID- 3305861 TI - Drinking water microbiology. Committee on the Challenges of Modern Society (NATO/CCMS). PMID- 3305863 TI - Celebrating 75 years of APMA 1912-1987. PMID- 3305862 TI - Kinetics of hepatic transport of 4-methylumbelliferone in rats. Analysis by multiple indicator dilution method. AB - Hepatic elimination of 4-methylumbelliferone (4-MU), which has been used as a model compound for conjugative metabolism, was studied by means of a multiple indicator dilution (MID) method in the isolated perfused rat liver. Using this method, three intrinsic hepatic clearances, CLint,inf, CLint,eff, and CLint,seq, which represent the influx, efflux, and sequestration processes, respectively, were obtained. When the dose was increased from a low dose (50 micrograms/rat liver) to a high dose (3000 micrograms/rat liver), the hepatic availability of 4 MU increased from 0.11 to 0.73. With increasing dose, the CLint,eff value increased approximately two times, while the CLint,seq value decreased to approximately one-third. The remarkable dose dependence of hepatic availability was due to nonlinearity in both CLint,eff and CLint,seq values. However, the CLint,inf value was almost independent of dose. The dose-dependent change in CLint,seq might be explained by the saturation of conjugative metabolism of 4-MU, while the increase in the CLint,eff value with increasing dose might be partly explained by the nonlinear tissue binding of 4-MU, since the tissue unbound fraction determined by an ultrafiltration method using liver homogenate increased approximately 1.5 times at higher concentration of 4-MU compared to that at lower concentrations. In addition, based on a comparison of the individual intrinsic clearances, i.e., CLint,inf, CLint,eff, and CLint,seq, the major determining process of the apparent hepatic intrinsic clearance of 4-MU is thought to be the sequestration process at the high dose. However, at the low dose, the membrane transport process (influx and efflux processes) as well as the sequestration process also determine the apparent hepatic intrinsic clearance. PMID- 3305865 TI - History of podiatric medical education. An update. PMID- 3305864 TI - Observations on clinical research in podiatric medicine. PMID- 3305866 TI - The evolution of a specialty. A study of podiatric surgery. PMID- 3305867 TI - Surgical treatment of the bunion deformity. Yesterday, today, and tomorrow. PMID- 3305868 TI - Deep space infections in the diabetic patient. PMID- 3305869 TI - Longitudinal study of postoperative astigmatism. AB - A prospective longitudinal study of 503 eyes that had extracapsular cataract extraction with posterior chamber intraocular lens implantation was conducted. Each patient was followed for a minimum of one year. Data were collected, analyzed, and the following information ascertained: temporal behavior of induced keratometric and cylindrical changes, induced with-the-rule, against-the-rule, and oblique astigmatism, comparison of keratometric and refractive astigmatism, and the effect of cutting sutures upon induced astigmatism. Though a large amount of with-the-rule astigmatism was immediately induced after surgery, by the end of one year over 60% of patients shifted toward against-the-rule. PMID- 3305871 TI - Unwanted optical effects caused by intraocular lens positioning holes. AB - The positioning holes in posterior chamber intraocular lenses (IOLs) are the source of many complaints from postoperative cataract patients with well-placed posterior chamber IOLs and otherwise excellent surgical results. Factors influencing which patients are most bothered are (1) size and reactivity of the pupil, (2) distance between the posterior surface of the iris and the anterior surface of the IOL, and (3) diameter of the IOL's clear optical zone. Eliminating the positioning holes is the best way to reduce or prevent the unwanted effects of these lenses. PMID- 3305870 TI - Gull-wing haptic design for posterior chamber intraocular lens. AB - The current trend toward implantation of posterior chamber lenses within the capsular bag rather than the ciliary sulcus seems logical in light of the increasing evidence of uveal damage from sulcus fixated posterior chamber lenses. However, long-term, successful capsular bag fixation has not been demonstrated with current popular looped lenses of either flat or angulated styles. This report evaluated a new gull-wing loop design that seems to have advantages of both planar and angulated loop styles for support of posterior chamber lenses. PMID- 3305872 TI - Le sens du futur or reading behind the writing on the wall. PMID- 3305873 TI - Visual aberrations caused by optic components of posterior chamber intraocular lenses. AB - A 58-year-old airline pilot had cataract surgery with implantation of a posterior chamber intraocular lens with four positioning holes around the optic edge. During periods of maximum pupil dilation, such as at night, visual aberrations including glare, monocular diplopia, and haloes occurred and he was unable to work in his occupation. The symptoms were severe enough that lens exchange was required, and a posterior chamber lens with no positioning holes was successfully implanted. The symptoms immediately subsided postoperatively and his last known visual acuity was 20/15. This case, and the report of another patient with similar postoperative problems, illustrates that implantation of lens optics with a larger effective optical zone for posterior chamber lens implantation is desirable. This is particularly true now that younger, more active patients, many still engaged in occupations, are having lens implantations. PMID- 3305875 TI - Static orthoses for the management of microstomia. AB - Microstomia is a complication of facial burns, traumatic injuries, scleroderma, or surgical reconstructions involving the oral aperture. A variety of orthoses for the correction or prevention of microstomia are offered by dentists, occupational therapists, physical therapists, and other specialists. This paper provides an overview of the structural and clinical features of 12 common tissue borne or tooth-borne microstomia appliances. The review is intended to facilitate the selection of suitable orthoses, and to indicate the need for interdisciplinary management of microstomia patients. PMID- 3305874 TI - Synaptic inputs to immunohistochemically identified neurones in the submucous plexus of the guinea-pig small intestine. AB - 1. Electrophysiological recordings were made from neurones in the submucous plexus of the guinea-pig small intestine, and these neurones were classified according to their synaptic inputs. 2. The neurones from which recording were made were filled during the recording period with the fluorescent dye, Lucifer Yellow, so they could be re-identified after processing for immunohistochemical localization of vasoactive intestinal peptide (VIP). 3. The presence or absence of VIP-like immunoreactivity was determined for a total of 130 neurones whose synaptic inputs had been fully characterized and eighty-two were found to be VIP reactive. After the VIP reactivity had been assessed, the preparations were reprocessed to reveal immunoreactivity for neuropeptide Y (NPY) and a further twenty-three neurones (none of which were reactive for VIP) were found to be reactive for this peptide. Of the remaining twenty-five neurones, nineteen were not reactive for either VIP or NPY and six could not be re-identified after reprocessing. 4. Electrical stimulation of internodal strands evoked excitatory synaptic potentials lasting 20-30 ms (fast responses) in all but one of the 130 neurones studied. 5. Almost all the VIP-reactive neurones (seventy-eight of eighty-two cells) exhibited inhibitory synaptic potentials, ranging in amplitude from 2 to 30 mV and lasting 150-1500 ms, but few of the VIP-negative neurones had such responses (six of forty-eight cells). No inhibitory synaptic potentials could be evoked in any of the NPY-reactive neurones. 6. Most VIP-reactive neurones (sixty-nine) had a slow excitatory synaptic potential which could be evoked by a single stimulus, lasted 5-20 s and was associated with an increase in input resistance. Only one NPY-reactive neurone had a slow excitatory potential, but such potentials were seen in nine of the nineteen VIP-negative, NPY-negative neurones. 7. In nine of the twenty-three NPY-reactive neurones a single stimulus evoked an excitatory synaptic potential (intermediate excitatory synaptic potential) lasting 500-1500 ms and associated with a fall in the input resistance. None of the VIP-negative, NPY-negative neurones exhibited the intermediate excitatory potentials but it was not possible to determine whether such potentials could be evoked in VIP-reactive neurones because the inhibitory synaptic potentials would obscure such events. 8. It is concluded that neurochemically distinct populations of submucous neurones can be distinguished physiologically on the basis of the differing combinations of types of synaptic input they receive. PMID- 3305876 TI - Dynamic orthoses for the management of microstomia. AB - Oral wounds and burns may result in microstomia with significant management problems. An important early management decision involves the selection of an appliance capable of applying forces that will halt and reverse the condition. A selection appropriate to the patient may be based on the need for teeth suitably placed to retain and position a particular device. Limited access to the patient's mouth because of recent trauma, surgery, wiring, inability to tolerate anesthetic, etc., may further restrict choices. Thus, the process of selection involves a weighing of the specific patient's condition and program of treatment against an understanding of the unique features, including complexity of fabrication and durability, of the range of prostheses available. This article provides an overview of the structural and clinical characteristics of seven dynamic intraoral and extraoral microstomia appliances. The need for interdisciplinary management of microstomia with appliances has been noted, and opportunities for research have been pointed out. PMID- 3305877 TI - Improved color matching of metal-ceramic restorations. Part I: A systematic method for shade determination. AB - The inherent problems in present shade matching procedures and communication between dentist and ceramist have been discussed. These five areas of weakness include the observer, variable viewing conditions, commercially available shade guides, inadequate technology, and poor communication. A systematic procedure that breaks down shade selection to the elements of opaque, body, and incisal porcelain shades was presented. This method simplifies and adds clarity in the registration of shades, improving the communication chain between dentist and ceramist. The system is suggested as a means to overcome many of the inherent problems in shade selection and communication. This approach enhances the dentist ceramist team's ability to esthetically match metal-ceramic restorations to the natural dentition. Future parts of this series will present procedures for improved communication and a system for porcelain application. PMID- 3305878 TI - The hemisected mandibular molar: a strategic abutment. AB - The loss of a strategic distal abutment can result in the patient wearing a removable partial denture. The indications and techniques necessary to retain a hemisected mandibular molar as a fixed partial denture abutment are presented. PMID- 3305879 TI - Considerations for furcation treatment. Part III: Restorative therapy. PMID- 3305880 TI - A photoelastic study of stresses on porcelain laminate preparations. PMID- 3305882 TI - The sealing capacity of intermediary base materials. PMID- 3305881 TI - A comparison of three restorative techniques for endodontically treated anterior teeth. AB - An in vitro study of 45 teeth compared the failure loads of endodontically treated teeth restored with pin and amalgams, Para-Post dowel and composite, and glass ionomer/amalgam alloy coronal-radicular buildups. The following conclusions were made. The Para-Post and composite buildups exhibited the highest mean failure load, 35.3 kg. The mean failure load for pin and amalgam buildups was 27.9 kg. Glass ionomer/amalgam alloy coronal-radicular buildups exhibited the lowest mean failure load, 14.1 kg. Restoration of endodontically treated anterior teeth with glass ionomer/amalgam alloy coronal-radicular buildups is contraindicated. PMID- 3305883 TI - Comparing effects of tray treatment on the accuracy of dies. AB - The effects of tray treatments on the accuracy of dies from addition silicone impressions were investigated. Tray treatments included custom acrylic resin tray with adhesive, perforated custom acrylic resin tray without adhesive, and perforated custom acrylic resin tray with adhesive. No appreciable differences were found in the complete crowns among the three tray treatments on the first pours. Significant statistical differences observed in the MOD and occlusal inlays were nonetheless of questionable clinical significance. Adhesives are advisable if the impressions are poured repeatedly, however, to minimize accidental separation of the impression from the tray. The second casts were less accurate with complete crowns and MOD inlays when perforated trays were used without adhesives. PMID- 3305884 TI - Cast aluminum denture base. AB - The laboratory procedures for a cast aluminum base denture have been presented. If an induction casting machine is not available, the "two-oven technique" works well, provided the casting arm is kept spinning manually for 4 minutes after casting. If laboratory procedures are executed precisely and with care, the aluminum base denture can be cast with good results. PMID- 3305886 TI - Significance of abutment tooth angle of gingival convergence on removable partial denture retention. AB - The angle of gingival convergence is one of the many factors that influence the retention capability of removable partial denture clasps. A geometric evaluation of the retention properties of this angle has been presented. PMID- 3305885 TI - An investigation of shear bond strengths of various resin-bonded inner surface rest seat designs for removable partial dentures. AB - Results and conclusions that can be drawn from this study are: All smooth, mesh, and seating preparation groups produced mean bond strengths significantly greater than that of the control group (p less than 0.01). The cast mesh rest seats exhibited significantly greater bond strengths at 24 hours (p = .0072). However, at 30 days, statistically significant differences between the three groups were not evident. Mean bond strengths for the electrolytically etched rest seat groups increased significantly at 30 days compared with the 24-hour means (p less than .05). These results suggest that an electrolytically etched resin-bonded rest seat can easily withstand the functional stresses exerted by a removable partial denture. The incorporation of seating preparation on an abutment tooth for an etched resin-bonded lingual rest seat seems to offer no advantage in terms of retentive strength. PMID- 3305887 TI - A technique for the obturation of anterior maxillary defects with accompanying midfacial tissue loss. PMID- 3305889 TI - Fabrication of a provisional complete denture. PMID- 3305888 TI - Limiting wax pattern distortion caused by setting expansion. PMID- 3305890 TI - Effectiveness and durability of repaired acrylic resin joints. PMID- 3305891 TI - Internal venting of castings to improve marginal seal and retention of castings. PMID- 3305892 TI - Microleakage pattern of a resin-veneered glass-ionomer cavity liner. PMID- 3305893 TI - Visual and instrumental discrimination steps between two adjacent porcelain shades. AB - Two different porcelain systems were compared over the B1 to B2 shade ranges visually and spectrophotometrically. Six samples of each porcelain were made by blending weighed increments of opaque and body porcelain and firing the blended compositions onto Option metal disks according to manufacturer's instructions. Compositional blends varied incrementally by 20% in steps. Selective blending of porcelain shades was shown to have an effect in improving the range of choices within the shade guide system. The human eye was capable of detecting small-step changes between two steps of the Vita shade guide. Systematic color changes occurred with compositional changes between B1 and B2. It appears from the overall results observed that a desired blending of porcelains at smaller intervals than full shade guide steps could be done more easily with Jelenko than with Vita porcelain. The visual rankings agreed more closely with the manufacturer's expectations than did the instrumental measurements. PMID- 3305894 TI - The effect of metal retentive designs on resin veneer retention. PMID- 3305895 TI - Measuring the thickness of a paint-on die spacer. PMID- 3305896 TI - Effects of various cementation methods on the retention of prefabricated posts. AB - Para-Post dowels were cemented by using combinations of cement, cleansing agents, and dentinal treatments. The comparative retentive strengths were as follows: 1. Para-Post posts cemented with composite into mechanically corrugated post spaces recorded the greatest retention. 2. The retention of the posts cemented with composite into post spaces rinsed with 1 ml of 17% EDTA with a pH of 7.5 and followed immediately by 1 ml of 5.25% NaOCl was lowest. 3. The retention of the posts secured with zinc phosphate into mechanically corrugated post spaces was significantly higher than with untapped post spaces. 4. The retentive strength of the posts placed with glass-ionomer cement into post spaces, irrigated with 1 ml of 40% polyacrylic acid solution, and rinsed with distilled water was comparable to that of posts secured with zinc phosphate cement without roughened post spaces. PMID- 3305897 TI - Using metal bases in making complete dentures. PMID- 3305898 TI - A classification of precision attachments. AB - This overview of attachments is intended to provide an explanation of the design characteristics of 13 different groups. The clinical situation for which an attachment is intended will place specific demands that can be met more closely if the forces acting on the prosthesis are considered. No universal or ideal design is available, so if attachments are used, they should be selected from the group with the most suitable characteristics for the task required. The stress breaking effect of attachments is vague. They offer a potential for rotational and resilient movement between the prosthesis and the abutment teeth, but the amount of stress that must be broken to protect the periodontium of the teeth may exceed the capabilities of any particular attachment used. Nevertheless, attachments can provide an effective answer to prosthesis stability and retention in a way that is cosmetically pleasing. PMID- 3305899 TI - Effect on the fit of removable partial denture frameworks when master casts are treated with cyanoacrylate resin. AB - Master casts of improved dental stone were made from irreversible hydrocolloid impressions of a metal model. Half of the master casts were treated with cyanoacrylate resin and half were untreated controls. They were sent to a dental laboratory for framework fabrication. The returned frameworks were examined for acceptability and their completeness of seating was determined. The frameworks fabricated on the treated master casts fit significantly better than the controls. The improved seating may be attributed to an increased surface hardness, increased abrasion resistance, and improved surface morphology, but further study is necessary. PMID- 3305900 TI - Fatigue failure in acrylic resin retaining minor connectors. PMID- 3305901 TI - Design variations of the rotational path removable partial denture. AB - The rotational path removable partial denture is a convenient design to use when restoring anterior edentulous spaces and can produce excellent esthetic results. In situations that are not ideal for the conventional rotational path, design alterations can be made that will allow the same excellent results to be achieved. PMID- 3305902 TI - Coordinated intraoral and extraoral prostheses in the rehabilitation of the orofacial cancer patient. PMID- 3305903 TI - A radiographic analysis of a mandibular anterior vestibuloplasty with free skin graft. PMID- 3305904 TI - Transcutaneous electrical nerve stimulation in dentistry: a report of a double blind study. PMID- 3305905 TI - The effect of an air polishing device on sealant bond strength. PMID- 3305906 TI - An investigation of the adhesion of acrylic resin teeth to dentures. PMID- 3305907 TI - An aid for swing-lock partial denture removal. PMID- 3305908 TI - The influence of psychiatric, psychological and social factors on the control of insulin-dependent diabetes mellitus. PMID- 3305909 TI - Post-translational acquisition of ligand binding- and tyrosine kinase-domain function by the epidermal growth factor and insulin receptors. AB - The epidermal growth factor receptor (EGFR) and insulin receptor undergo slow post-translational modification by which they acquire hormone binding and tyrosine kinase (EGFR) function. The half-time for acquisition of EGF or insulin binding activity is 30-40 min and of tyrosine kinase activity (EGFR), is 10-15 min. Tunicamycin, an inhibitor of N-linked oligosaccharide addition, blocks acquisition of both EGF and insulin binding activity. With EGFR, activation precedes acquisition of resistance to endoglucosaminidase H (t1/2 approximately equal to 75 min), a medial Golgi event. Treatment of active high mannose receptor with endo H generates fully active aglyco-receptor; thus, core oligosaccharide addition is a prerequisite for activation, but not for EGF binding per se. EGFR is activated in and translocated from the endoplasmic reticulum (ER) slowly (t1/2 approximately equal to 75 min). Since translocation rate equals the rate for acquisition of endo H resistance, transit from the ER is rate limiting for EGFR maturation. Tunicamycin inhibits exit from the ER parallel to its effect on acquisition of binding activity. Insulin proreceptor, a 210 kDa high-mannose glycopolypeptide, acquires insulin binding function (t1/2 approximately equal to 45 min) then is proteolytically cleaved (t1/2 approximately equal to 3 hr) into subunits of the mature alpha 2 beta 2 receptor. Modification giving rise to insulin binding activity is due to a conformational change in the binding domain, since human autoimmune antibody recognizes only the active species, while rabbit polyclonal antibody recognizes all forms. Newly-translated EGF proreceptor lacks a functional tyrosine domain capable of autophosphorylation; 30-40 min after translation, while still in the ER, tyrosine kinase activity is acquired. Since the kinase domain is cytoplasmic, the receptor may become phosphorylated on tyrosine before reaching the plasma membrane. PMID- 3305911 TI - Control of GnRH secretion. PMID- 3305910 TI - The human insulin receptor cDNA: a new tool to study the function of this receptor. AB - The human insulin receptor (hIR) is an integral transmembrane glycoprotein comprised of two alpha and two beta subunits. An immediate consequence of insulin binding to the extracellular alpha subunit is the autophosphorylation of tyrosine residues on the intracellular domain of the beta subunit. The placental hIR cDNA has been cloned and sequenced, providing the primary structural features of the protein. In order to investigate the functions of the beta subunit and particularly the role of autophosphorylation and tyrosine phosphokinase (TPK) activity (a feature shared by other receptors and oncogene proteins) in transmembrane signalling, we designed an expression system of the hIR cDNA in eucaryotic cells. Superexpressing CHO cell lines that contain about 10(6) functional hIR/cell have been developed. In these cells half maximum stimulation of glucose uptake occurs at 5 X 10(-10)M insulin, whereas normal CHO cells require 5 X 10(-12)M insulin. In this expression system we have carried out site directed mutagenesis experiments in which domains of the molecule have been deleted or particular amino acids have been replaced by others. The replacement of either or both the tyrosine residues 1162 and 1163 compromise an autophosphorylated site that is important for kinase function and the insulin response. Expression of an isolated membrane-bound form of the beta-subunit produces a 6 fold increase in glucose uptake. This insulin-independent effect disappears if the twin tyrosines are mutated or if the beta subunit is expressed in the cytoplasm. These studies also show that the C terminal 112 amino acid portion of the beta subunit is important for the stability of this protein. PMID- 3305912 TI - Spermatogenesis and Sertoli cell numbers and function in rams and bulls. AB - The two main types of cellular associations (type I, 2 generations of spermatocytes + 1 of spermatids; type II, 1 of spermatocytes and 2 of spermatids) occupy, respectively, more than half and about a third of the seminiferous epithelium cycle in rams and bulls. However, the duration of the cycle of the seminiferous epithelium and that of spermatogenesis differ between the species. A1 spermatogonia and Sertoli cell total numbers are highly correlated in adult rams and bulls. Mitosis in Sertoli cells occurs mostly in utero but may still occur for a short period after birth. Between birth and puberty there is about a 5-fold increase in the number of Sertoli cells. After that there are no seasonal- or age-related increases in the number of adult Sertoli cells. Some factors (season of birth; nutrition; genetics; hormones) affect mitosis of Sertoli cells in prepubertal animals. Sertoli cells differentiate after cessation of mitosis. Their differentiation is affected by cryptorchidism, nutrition, genetics and hormones. Their adult function is only poorly known. ABP and rete testis fluid secretions and nuclear Sertoli volume fluctuate under the influence of the same factors, but they are not always linked together. This reinforces the need for more knowledge of Sertoli cell secretions and function. PMID- 3305914 TI - Changes in sperm surfaces associated with epididymal transit. PMID- 3305913 TI - Function of the epididymis in bulls and rams. PMID- 3305915 TI - In-vitro fertilization of ruminants. PMID- 3305916 TI - Endocrine regulation of puberty in cows and ewes. AB - Sexual maturation in cows and ewes is modulated through changes in hypothalamic inhibition. This inhibition results in little or no stimulation of the release of gonadotrophins from the anterior pituitary. The ovary has a primary role in inhibiting gonadotrophin secretion during the prepubertal period and the responsiveness to the negative feedback effects of oestrogen decreases during the peripubertal period. There is also an increased secretion of ovarian progesterone during the peripubertal period but its role in the process of sexual maturation is not clear. Photoperiodic cues and dietary intake act upon the hypothalamus to modulate gonadotrophin secretion during sexual maturation and, in turn, influence the time when puberty occurs. PMID- 3305917 TI - Neurotransmitter regulation of luteinizing hormone and prolactin secretion. PMID- 3305918 TI - Photoperiodic control of the onset of breeding activity and fecundity in ewes. PMID- 3305919 TI - Function of the hypothalamic-hypophysial axis during the post-partum period in ewes and cows. AB - During pregnancy the hypothalamic-hypophysial axis is suppressed by the high concentrations of progesterone and oestradiol in the circulation. The high concentrations of these steroids appear to inhibit secretion of GnRH from the hypothalamus, resulting in inadequate stimulation of pituitary gonadotrophs to maintain synthesis of LH. This produces a depletion of LH in the anterior pituitary gland that must be restored after parturition before normal oestrous cycles can begin. PMID- 3305920 TI - Short light cycles induce persistent reproductive activity in Ile-de-France rams. AB - European breeds of rams appear to be responsive to photoperiodic changes even though there are large differences between breeds in the timing and amplitude of endocrine (LH and testosterone) and gametogenetic variations before the sexual season. Light regimens such as 6-month light cycles or alternations of constant short and long days every 12-16 weeks are able to entrain the parameters of sexual activity. In these regimens in which the period of the light cycle is shortened, LH release is markedly stimulated during decreasing daylength and evidence is presented, from the relationship of LH and testosterone patterns, that the dampening of LH stimulation could simply result from the effect of steroid feedback. However, there is a gap of several weeks between the maximum LH and testosterone concentrations during which testis growth occurs. Experiments were conducted with Ile-de-France rams, markedly seasonal breeders, in which the period of the light cycle was decreased, in different groups of animals, from 6 to 4, 3, 2 or 1 month. Rams submitted to the three light regimens with the longest periods presented testicular variations which paralleled those of the photoperiod, but those kept in the two regimens with the shortest periods had a progressive increase in testicular weight up to the maximum value (300-350 g) with no further major changes. Therefore, in rams kept in 2-month light cycles, testicular weight remained constant for twelve successive cycles (2 years). LH and testosterone plasma measurements indicated that LH was sufficiently stimulated to maintain testicular development during each decreasing daylength phase but that the stimulation was shifted before testosterone could reach levels at which feedback effects could be exerted. However, all the measures of sperm production were at values characteristic of the sexual season. Similar testicular weight maintenance was also obtained in rams submitted to a regimen in which short days (8L:16D) alternated every month with a split photoperiod interpreted as a long day (7L:8D:1L:8D). It is concluded that short light cycles are able to induce persistent reproductive activity in Ile-de-France rams, which may have practical applications in sheep production systems. PMID- 3305921 TI - Transgenic livestock. AB - Single genes can now be added routinely to the genome of mice by molecular manipulation as simple Mendelian dominants; this complements the normal process of reproduction to give 'transgenic' animals. Success in ruminants is limited to a few examples in sheep and although gene expression has yet to be documented, there is every reason to expect that it will be achieved. The application of this technology to livestock improvement depends on the identification of circumstances in which the phenotype is limited by the deficiency of a single protein. While there is little evidence to indicate that single dominant genes are in general likely to have favourable effects, it is argued that there are likely to be exceptions. These include particular combinations of promoter and structural gene sequences to alter feedback control, for example through a change in tissue specificity, and the alteration of definitive proteins such as those of milk. A mouse model has been established to study the molecular manipulation of sheep milk proteins. The sheep beta lactoglobulin gene has been incorporated and the sheep whey protein is secreted by the mammary gland of transgenic mice. For the future, means to delete or reduce the expression of existing genes are likely to be important, as are more effective means of incorporation such as retroviral based methods and the incorporation of multigene constructs. The resources required to test transgenic livestock will, however, be greater than those required to create them. PMID- 3305922 TI - Use of chimaeras to study development. PMID- 3305923 TI - Detection of early pregnancy in domestic ruminants. AB - Tests for the detection of pregnancy early after insemination have not yet reached their full potential. Currently, the milk progesterone assay provides the earliest possible test, at an interval of one oestrous cycle after insemination, i.e. 17, 21 and 21 days in sheep, goats and cows respectively. This assay is pregnancy non-specific and rate of detection of pregnant animals is acceptable but less than desirable. Detection of activity of early pregnancy factor may develop into an excellent early test for many species, but the rosette inhibition test which is currently required has limited development and use. Pregnancy specific protein B has been developed as a radioimmunoassay and is reliable under laboratory situations for ruminants. It can be used after 24 days of gestation in the cow. Application to field testing awaits development. Other pregnancy associated or specific substances which are found in maternal body fluids might develop as pregnancy markers. Ultrasonic devices might provide very early detection in cattle but the expense of a test will limit application. All tests for pregnancy early after insemination have an inherent inaccuracy. Presence of an embryo at the time the test is applied will not assure pregnancy at the time of a confirmatory test, such as birth of live young or rectal examination in cows after 35 days of gestation. Therefore, no matter how early the test, a follow-up examination might be desirable in intensively managed herds or flocks. The animal industry is on the verge of new biotechnological approaches to reproductive management. The potential seems as great as the imagination. PMID- 3305924 TI - Heterogeneous cell types in the corpus luteum of sheep, goats and cattle. AB - Data on the structure, quantitation, origins and functions of the large luteal (LL) and small luteal (SL) cells of sheep, goats and cattle are reviewed. Both LL and SL cells show ultrastructural features consistent with a steroidogenic function. However, in addition to differences in size and shape, LL cells differ from SL cells primarily in possessing large numbers of secretory granules, suggesting an additional protein/polypeptide synthetic and secretory function. In sheep, morphometric estimates show that the corpus luteum (CL) contains approximately equal to 10 X 10(6) LL cells and approximately equal to 50-60 X 10(6) SL cells: individual LL cells are approximately equal to X 6 greater in volume than SL cells. During formation of the CL, granulosa and theca cells are incorporated, and evidence suggests that granulosa cells give rise to LL cells and theca cells to SL cells. However, SL cells, or cells of thecal origin, may also give rise to some LL cells. Both LL and SL cells produce progesterone in vitro. On a per cell basis, LL cells produce more progesterone than do SL cells, but SL cells show a much greater progesterone-secretory response to LH. Oxytocin is synthesized, and secreted in granule form, only by the LL cells, and relaxin, whose presence has been demonstrated convincingly only in cattle, also appears to be produced only by LL cells. The two types of luteal cell in ruminants therefore show major differences in function: the occurrence of any significant functional interaction remains to be established. PMID- 3305925 TI - Luteal peptides and intercellular communication. AB - The variety of peptides synthesized by the corpus luteum (relaxin, vasopressin, oxytocin and oxytocin-related neurophysin) and their possible intracellular effects are reviewed. After luteinization of the granulosa cells and in response to LH and FSH, the output of oxytocin is increased. In addition, insulin-like growth factor is a very potent stimulus of oxytocin secretion. Although luteal cells respond to gonadotrophins by increased production of progesterone, there is no further secretion of oxytocin. Oxytocin is localized in large luteal cells which seem not to be under the direct control of gonadotrophins. Synthesis of luteal oxytocin seems to occur during the early luteal phase according to measurements of oxytocin mRNA. Highest tissue concentrations and secretion under in-vitro conditions were observed during the mid-luteal phase, and so synthesis, storage and secretion are unlikely to occur concomitantly. Under in-vitro conditions, oxytocin is secreted concomitantly with neurophysin and progesterone, and there appears to be some form of communication between small and large luteal cells for the secretion of progesterone and oxytocin under in-vivo conditions. Evidence has been obtained that oxytocin may have local effects in the ovary by inhibition of secretion (synthesis ?) of progesterone, especially during the early luteal phase. A mechanism can be suggested whereby, under physiological conditions, oxytocin may delay the increase of progesterone by inhibition of progesterone secretion and therefore delay down regulation of its own receptor. This would prolong the life-span of the CL and the oestrous cycle. Exogenous progesterone given on Days 1-4 shortens the cycle to about 12 days. The best evidence that oxytocin may be involved in controlling luteolysis comes from immunization experiments in ewes and goats, but there is no clear evidence of this type for cattle. Basal concentrations of oxytocin at the end of the luteal phase may interact with oxytocin receptors after the inhibitory effect of progesterone in the uterus is reduced, thus initiating synthesis of PGF-2 alpha. PMID- 3305926 TI - Reactivity of human trophoblast with an antibody to the HLA class II antigen, HLA DP. AB - Cytotrophoblast cells in term amniochorion and in first trimester chorionic villi were shown by immunohistology of frozen tissue sections to bind B7/21, an antibody specific for the MHC Class II antigen, HLA-DP. This binding was shown to be specific, as adsorption of the B7/21 antibody with a B cell line expressing HLA-DP prevented subsequent binding to trophoblast. When tested with a variety of other antibodies reacting with HLA-DR, HLA-DQ or the common sequences of HLA-DR, DQ and -DP, trophoblast was negative, thus confirming previous reports. The significance of this unique pattern of reactivity of trophoblast is discussed. PMID- 3305927 TI - Frederick P. Zuspan, M.D. A festschrift. PMID- 3305928 TI - Ultrasound needle guidance for amniocentesis in pregnancies with low amniotic fluid. AB - In six pregnancies accompanied by oligohydramnios (three cases) or decreased amniotic fluid and maternal obesity (three cases), needles specifically designed for use with ultrasound were successfully utilized in combination with real-time ultrasound guidance for amniocentesis. There was successful fluid retrieval in all six, with two requiring more than one needle pass. All three cases accompanied by oligohydramnios later resulted in fetal death. In the three cases accompanied by decreased amniotic fluid and maternal obesity, the amniocentesis results were helpful in ensuring the existence of a normal pregnancy. A specially designed ultrasound needle used in combination with a real-time guidance system is helpful in the performance of difficult amniocentesis. PMID- 3305929 TI - Familial acanthosis nigricans. A longitudinal study. AB - The triad of hyperandrogenism, insulin resistance and acanthosis nigricans (HAIR AN) is known to have a familial tendency. In order to better understand the natural history and possible treatment of this disorder, we studied the clinical course of two families in which all female progeny were affected. A rapid progression of the HAIR-AN syndrome was apparent during the peripubertal period and early reproductive years. Beyond this period, the progression of HAIR-AN appeared quite variable. Rapid weight gain was a major stimulant for increasing insulin resistance and hyperandrogenemia. In the one subject with a postmenarcheal onset of the syndrome, prolonged weight reduction was associated with an improvement in the dermatologic manifestation as well as in the hyperandrogenism and insulin resistance. Oral contraceptives appear to improve the dermatologic symptoms of the HAIR-AN syndrome. PMID- 3305930 TI - Amniotic fluid volume assessment with the four-quadrant technique at 36-42 weeks' gestation. AB - An ultrasound approach was developed to identify normal amniotic fluid volume. The uterine cavity was divided into four quadrants. With the use of linear-array, real-time B-scanning, the vertical diameter of the largest pocket in each quadrant was measured. The sum of these four quadrants was used to provide a single number for the amniotic fluid volume and termed the amniotic fluid index. This approach is simple, requires little time and gives a semiquantitative estimate of amniotic fluid volume. Based on our observations, the normal amniotic fluid index in term gestation is 12.9 +/- 4.6 cm. Evaluation of the relationship between amniotic fluid volume and fetal outcome is under investigation. PMID- 3305931 TI - The MACTAR Patient Preference Disability Questionnaire--an individualized functional priority approach for assessing improvement in physical disability in clinical trials in rheumatoid arthritis. AB - A new approach to assessing disability in arthritis that quantifies the functional priorities of the patient is described. Comparison against global improvement suggests that this instrument has the potential to detect small clinically important changes in function. PMID- 3305932 TI - Association of limited joint mobility with Dupuytren's contracture in diabetes mellitus. AB - Limited joint mobility is a relatively recent addition to the list of other well known rheumatic disorders that may be associated with diabetes mellitus. In our study of 109 patients with diabetes, a higher prevalence of Dupuytren's contracture was found compared to nondiabetic subjects, but the difference was not statistically significant (p less than 0.1). An association between limited joint mobility and Dupuytren's contracture was shown. Patients with diabetes with Dupuytren's contracture showed no difference compared to those without Dupuytren's contracture with regard to sex, insulin dosage, metabolic control and presence of shoulder capsulitis. Limited joint mobility and Dupuytren's contracture may be associated with retinopathy. PMID- 3305933 TI - Proteoglycans from experimental osteoarthritic cartilage: degradation by neutral metalloproteases. AB - This study deals with the analysis of the structure of cartilage proteoglycans in experimental osteoarthritis. We have demonstrated that chondrocytes in osteoarthritic cartilage synthesize proteoglycans which have the same functional characteristics as those of normal cartilage. Osteoarthritic cartilage contains metallodependent proteoglycan degrading enzymes, in both active and latent forms. These enzymes degrade both synthesized and endogenous proteoglycan macromolecules, as indicated by the reduced hydrodynamic size found in both proteoglycan populations in osteoarthritic cartilage treated with APMA. Our results also suggest the possibility that proteolytic degradation can occur at both the hyaluronate-binding region and in the chondroitin-sulfate-rich region of the proteoglycan core protein. PMID- 3305934 TI - Degradation of extracellular matrix in osteoarthritis: 4 fundamental questions. AB - The destruction of articular cartilage is a hallmark of osteoarthritis. In this process, cartilage fibrillation and eventual erosive lesions result from altered biomechanics generally thought to be preceded by alterations in the cartilage extracellular matrix. The irreversible cartilage changes are, in part, mediated by elevated proteolytic activities of acid and neutral metalloproteases that degrade proteoglycan and Type II collagen. Interestingly, an identical enzyme class is believed to participate in normal turnover of these extracellular matrix constituents. Thus, the control of synovial and cartilage protease activation has become of paramount importance in understanding the role these enzymes play in osteoarthritic pathology. PMID- 3305936 TI - Proteoglycan-degrading metalloproteases of human articular cartilage. AB - Two metalloproteases have been purified from human articular cartilage. These attack the core protein of proteoglycan with pH optima of 5.3 and 7.2. The acid protease retains 40% of its activity at physiological pH. The two proteases are related in their properties of latency, activation, substrate specificity, and inhibitor pattern. They differ in pI, pH optimum, molecular weight, calcium requirement, and action on gelatin. Both activities are elevated 3-5 fold in osteoarthritic cartilage. Both proteases attack Ala-Leu and Tyr-Leu bonds in the B-chain of insulin. It is postulated that the entire family of metalloproteases acting on extracellular matrix shares a common specificity for Gly(Ala)-Leu(Ile) bonds. PMID- 3305935 TI - The proteoglycanase from human cartilage and cultured rabbit chondrocytes and its relation to osteoarthritis. AB - The neutral metal dependent proteoglycanase predominates as the chief neutral protease present in human patellar cartilage or released by cultured rabbit chondrocytes into the culture medium. The cultured chondrocytes released the proteoglycanase mostly in latent form. Its activation resulted in splitting off a 10,000 dalton fragment. The chondrocytes also released inhibitory activity against the proteoglycanase. Most of it was released in the first 24 hours of culture, while most of the enzyme was released in the following 48 hours. Both the human cartilage and the rabbit chondrocyte enzyme occur in two molecular weight sizes, in equilibrium with each other. PMID- 3305937 TI - Neutral proteases in human osteoarthritic synovium: quantification and characterization. AB - In this study, we measured the levels of neutral metallo- and serine proteases in human osteoarthritic synovium. These enzymes degrade both collagen and proteoglycan macromolecules. They were analyzed by tissue culture methodology and direct extraction. We have demonstrated that in human osteoarthritic synovium, there is a correlation between neutral enzyme activity and the severity of synovial inflammation. Tissue culture studies have shown that the human osteoarthritic synovial membrane produces metalloproteases, such as collagenase, proteoglycanase and gelatinase. These enzymes were further characterized by their molecular weight. Extracts of osteoarthritic synovial tissues showed the presence of serine proteases, with apparent Mr of 25,000. PMID- 3305938 TI - Matrix metalloproteinases 1, 2, and 3 from rheumatoid synovial cells are sufficient to destroy joints. AB - A neutral metalloproteinase has been isolated and purified from adherent rheumatoid synovial cells in culture. This protease, named matrix metalloproteinase 3, (MMP-3) degrades gelatin, proteoglycan, fibronectin, type IV collagen, laminin, and the N propeptide of type I procollagen. It can be separated from MMP-2 (a potent gelatinase), and MMP-1, an interstitial collagenase. MMP-3 is released from cells as a proenzyme of 55 Kda. Activation by trypsin or organic mercurials produces 2 active species of 45 Kda and 28 Kda. The enzyme contains zinc as an intrinsic component and requires calcium for conformational stability. In concert, active MMP-1, -2, and -3 can destroy all significant structural proteins of joint structures. PMID- 3305939 TI - Levels of metalloproteases and tissue inhibitor of metalloproteases in human osteoarthritic cartilage. AB - Human articular cartilage contains 2 distinct metalloproteases which degrade proteoglycan. One protease acts optimally at pH 5.3 and the other at pH 7.2. In addition, cartilage contains a tissue inhibitor of metalloproteases (TIMP) that inhibits both proteases. Methods have been developed for the estimation of metalloproteases and TIMP in extracts of cartilage prepared in buffered 2 M guanidine-HCl. In osteoarthritic cartilage, levels of the 2 metalloproteases increase 3-fold or more, while the level of TIMP remains constant. It is postulated that a balance is maintained between inhibitor and metalloprotease levels in normal cartilage and that in osteoarthritis increased secretion of proteases upsets this balance and results in degradation of the extracellular matrix. PMID- 3305940 TI - The role of serine proteinase in cartilage damage. AB - Arthritic cartilage from experimental animals has been shown to have a decreased proteoglycan content, a decreased rate of proteoglycan synthesis, and a marked increase in an active serine proteinase when compared with normal articular cartilage. The serine proteinase is transferred from PMN cells into cartilage during the inflammatory response where it increased the rate of proteoglycan degradation and is eventually removed by interaction with the chondrocyte surface. The interaction also results in an inhibition of proteoglycan synthesis by the chondrocytes. Both these factors contribute to the loss of proteoglycan from arthritic cartilage. PMID- 3305941 TI - Immunologic modulation of cartilage metabolism. AB - Preservation of the structural integrity of cartilage requires that metabolic homeostasis be maintained between chondrocyte anabolic and catabolic functions. This critical balance is perturbed in osteoarthritis (OA) in which synovial tissue and subchondral intratrabecular marrow often contain a focal and at times more diffuse mononuclear cell infiltration. Cytokines derived from T lymphocytes and monocytes have a capacity to: a) cause qualitative changes in and reversibly suppress chondrocyte proteoglycan, collagen, and non-collagen protein synthesis, and b) induce the synthesis and release of chondrocyte proteinases. Factors having comparable metabolic regulatory activity are produced by synovial tissue derived from idiopathic and secondary forms of OA. PMID- 3305942 TI - The role of mononuclear cell products as modulators of cartilage degradation. AB - Human articular cartilage cultured in the presence of interleukin 1 (IL-1) produced from activated peripheral blood mononuclear cells, exhibits the concomitant release of a latent metalloproteinase and fragments of proteoglycan. The manner in which the activated form of the metalloproteinase degrades proteoglycan subunit and link protein suggests a role for this enzyme in cartilage degradation in vivo. While cartilage cultured in the continuous presence of purified IL-1 shows sustained release of metalloproteinase, tissue cultured in the presence of the total products released by activated mononuclear cells from some individuals showed initial stimulation followed by a decline, suggesting the presence of a modulator of IL-1 action. PMID- 3305943 TI - Osteoarthritis, insulin and bone density. AB - We earlier explored the crush and shear forces, associated with periarticular fibrous thickening, in nodal and other forms of osteoarthritis (OA). Looking for a generally acting growth stimulus, we described an association between hyperinsulinemia and DISH. In this study this association was confirmed, and a similar association between low insulin values and osteopenia emerged. A strong association between insulin levels and body weight was confirmed, which explained much of the difference in insulin levels between males and females. Very different kinds of OA were found in robust, hyperinsulinemic subjects as compared with osteopenic, hypoinsulinemic individuals, in which the arthropathy was more deforming, inflammatory, and erosive. PMID- 3305944 TI - Graft-versus-host disease: a review. PMID- 3305946 TI - New inhibitors of human renin that contain novel Leu-Val replacements. AB - Stereoselective syntheses of several nonpeptide fragments that function as Leu10 Val11 scissile bond replacements in human angiotensinogen are presented. The opening of N-protected aminoalkyl epoxide 3 with a variety of sulfur, oxygen, nitrogen, and carbon nucleophiles is a key reaction in the preparation of these novel fragments 4-8. The coupling of these fragments to protected dipeptides that mimic positions 8 and 9 in angiotensinogen produces inhibitors of human renin even though the molecules contain no functionality beyond what is formally the Val11 side chain of angiotensinogen. R groups that closely resemble that of the Val side chain are preferable; thus, isopropyl greater than or equal to higher alkyl greater than phenyl greater than substituted phenyl. Sulfur is the best X group; oxidation leads to slight (X = SO2) and significant (X = SO) decreases in inhibitory potency. One such inhibitor, 60, has an IC50 of 13 nM when tested with purified human renin at pH 6.0. The significant activity of these small inhibitors is thought to be due in part to the hydroxyl group of the fragment functioning as a transition-state analogue. Of these, the inhibitors that contain histidine show marked selectivity toward renin over a related aspartic proteinase, pepsin. PMID- 3305945 TI - Structure-activity relationships in an imidazole-based series of thromboxane synthase inhibitors. AB - Analogues of 4-[[2-(1H-imidazol-1-yl)-1-[[(4-methoxyphenyl)methoxy]methyl] ethoxy]methyl]benzoic acid (5m) were prepared and evaluated as thromboxane synthase inhibitors. A series of esters of 5m showed a parabolic relationship between lipophilicity and inhibition of TxB2 generation in intact platelets, with activities up to 50 times greater than that of dazoxiben. However, on administration to rabbits the ethyl ester 5d had a short duration of action, due to rapid metabolism and excretion via deesterification and beta-glucuronidation. Attempts at replacing the carboxylate group with other potential pharmacophores were unsuccessful. PMID- 3305947 TI - Fluoro ketone containing peptides as inhibitors of human renin. AB - The pentapeptide BOC-Phe-Phe-difluorostatone-Leu-Phe-NH2 has been prepared and found to be a potent inhibitor of human renin. This compound contains a difluoromethylene ketone group that exists predominantly in the hydrated form in water. The difluorostatone-containing peptide is 7-fold and 22-fold more potent than the analogous statine- and statone-containing peptides, respectively. Structure/activity analysis of the most potent inhibitor was carried out by replacing some of the peptide bonds with trans-alkenes. In all cases, a dramatic loss in binding to renin was observed. A number of statine-containing inhibitors of renin have been reported and this work suggests that the replacement of statine with difluorostatone will yield more potent compounds. PMID- 3305948 TI - Newly recognized route of arbovirus dissemination from the mosquito (Diptera: Culicidae) midgut. PMID- 3305950 TI - A review of the genus Meringis (Siphonaptera: Hystrichopsyllidae). PMID- 3305949 TI - Field evaluation of enzyme-linked immunosorbent assays for Plasmodium falciparum and Plasmodium vivax sporozoites in mosquitoes (Diptera: Culicidae) from Papua New Guinea. PMID- 3305951 TI - [Echographic changes in the wall of the gallbladder in hepatitis]. PMID- 3305952 TI - A computerized method for processing of spectrally analysed Doppler-shifted signals from insonated arteries. AB - A microcomputer-based technique is described for processing blood-velocity signals after they have been spectrally analysed. The system consists of a real time dual channel spectrum analyser interfaced to a BBC model B microcomputer. The microcomputer is programmed to store and display in real-time spectral information received from the analyser. Stored sonograms can be readily retrieved from memory on request and displayed on the microcomputer's TV-monitor for viewing and/or subsequent numerate interogation. The proposed system is software controlled and is therefore both versatile and expandable, enabling accommodation of future sonagram processing methods and new diagnostic parameters. PMID- 3305953 TI - The Automatic Implantable Cardioverter Defibrillator (AICD)--a clinical and technical review. PMID- 3305954 TI - Bovine tuberculosis in a wild baboon population: epidemiological aspects. AB - A follow-up of an outbreak of Mycobacterium bovis in a population of feral baboons in Kenya was undertaken after one year by necropsy of euthanized, clinically ill animals, and tuberculin testing of others. It was concluded that the source of the infection was animals feeding on village slaughterhouse offal of M. bovis infected cows. Secondary (direct) baboon-baboon transfer of the disease appeared to be minimal or nonexistent. PMID- 3305955 TI - The construction and operation of a simple inexpensive slam freezing device for electron microscopy. AB - A simple and inexpensive slam freezing device has been constructed that allows consistently good rapid freezing of uncryoprotected tissue. The device employs a dry liquid-nitrogen-cooled cooper surface and a slamming plunger designed to provide rapid and uniform tissue to metal contact. PMID- 3305956 TI - Measurement of increased uptake of osmium in skin and in a gelatin model 'tissue' treated with tannic acid. AB - The effect of tannic acid (TA) on the deposition of osmium was studied in discs of hamster skin and in fixed gelatin. Pieces of skin treated with 1.0% TA before OsO4 fixation absorbed almost twice as much as untreated pieces. Gelatin, used here as a model 'tissue' showed an even greater degree of enhancement. Treated gelatin capsule halves and strips took up 4-6 times as much osmium as untreated ones. The deposition of osmium was verified by neutron activation analysis. PMID- 3305958 TI - Preparation of the mammalian organ of Corti for scanning electron microscopy. AB - The effect of various standard tissue preparation procedures for scanning microscopy on the morphology of the mammalian organ of Corti has been examined. Comparison was made of (i) different fixatives: glutaraldehyde (GA) alone, osmium (Os) alone, GA and Os together and GA followed by Os; (ii) freeze-drying (FD) versus critical point-drying (CPD); (iii) ligand binding of osmium with thiocarbohydrazide (TOTO procedure) versus sputter coating to provide a conductive coat. Results were assessed in terms of known structural parameters in fresh tissue. It is shown: (i) that double fixation, either GA, Os together or GA followed by Os, consistently produced less tissue distortion than either fixative alone, (ii) that FD produced less shrinkage of the tissue than CPD, and (iii) that the TOTO procedure appeared to rigidify the tissue and enhanced preservation of the morphology. PMID- 3305957 TI - Techniques for combining light microscopy and scanning electron microscopy: a survey of the literature. AB - A survey of methods combining light microscopy and scanning electron microscopy is presented. A simple correlation is made when two preparations from adjacent parts of one specimen are investigated in two different microscopes. A more sophisticated method is the consecutive investigation of one specimen with two microscopes. A major problem in this method is the relocation of the area of interest. Several authors have presented solutions for this problem. It is preferable when one preparation is investigated in only one instrument, combining the two microscopical (LM and SEM) techniques, thus making relocation redundant. PMID- 3305959 TI - Influence of neighbouring base sequence on N-methyl-N'-nitro-N-nitrosoguanidine mutagenesis in the lacI gene of Escherichia coli. AB - N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced forward mutations within the first 540 base-pairs of the lacI gene of Escherichia coli were cloned and sequenced. In total, 167 MNNG-induced independent mutations were characterized, with G.C to A.T transitions accounting for all but three of the mutations. This mutagenic specificity is consistent with the mispairing predicted by the methylation of the O6 position of guanine. The characterization of such large numbers of mutations permitted an analysis of the influence of local DNA sequence on mutagenesis. This analysis revealed a strong influence by the 5' flanking base. On average, guanine residues preceded (5') by a guanine or an adenine residue were, respectively, nine times and five times more likely to mutate after treatment with MNNG than those preceded by a pyrimidine residue. PMID- 3305960 TI - Statistical test for the comparison of samples from mutational spectra. AB - The Monte Carlo estimate of the p value of the hypergeometric test is described and advocated for the testing of the hypothesis that different treatments induce the same mutational spectrum. The hypergeometric test is a generalization of Fisher's "exact" test for tables with more than two rows and two columns. Use of the test is demonstrated by the analysis of data from the characterization of nonsense mutations in the lacI gene of Escherichia coli. Unlike the chi-square test, the hypergeometric test remains valid when applied to sparse cross classification tables. The hypergeometric test has the most discrimination power of any statistical test that could be employed routinely to compare samples from mutational spectra. Direct application of the hypergeometric test to large cross classification tables is excessively computation intensive, but estimation of its p value via Monte Carlo techniques is practical. PMID- 3305961 TI - Transcription termination sites at the distal end of the leu operon of Salmonella typhimurium. AB - Transcription terminates at two different sites at the distal end of the leucine operon of Salmonella typhimurium. The first of these sites (leut), located 140 base-pairs past the end of leuD, contains a G + C-rich palindrome followed by a run of T residues in the non-coding strand. Termination at leut, both in vitro and in vivo, is independent of rho protein, but is stimulated by the NusA protein. The second termination site (leut'), located 145 base-pairs beyond the first, is rho-dependent both in vitro and in vivo, and is not influenced by NusA protein. The organization of transcription termination sites at the distal end of the leu operon (a rho-independent site followed by a rho-dependent site) is similar to that for the trp operon of Escherichia coli. PMID- 3305963 TI - The calcium antagonists. The Fleckenstein symposium. I.S.H.R. 12th congress. International Society for Heart Research. 9-13th February, 1986, Melbourne. Proceedings. PMID- 3305962 TI - Recognition and cleavage of the bacteriophage P1 packaging site (pac). I. Differential processing of the cleaved ends in vivo. AB - The packaging of bacteriophage P1 DNA into viral capsids is initiated at a specific DNA site called pac. During packaging, that site is cleaved and at least one of the resulting ends is encapsidated into a P1 virion. We show here that pac is located on a 620 base-pair fragment of P1 DNA (EcoRI-20). When that fragment is inserted into the chromosome of cells that are then infected with P1, packaging of host DNA into phage particles is initiated at pac and proceeds down the chromosome, unidirectionally, for about five to ten P1 "headfuls" (about 5 X 10(5) to 10 X 10(5) bases of DNA). Using an assay for pac cleavage that does not depend on DNA packaging, we have identified a set of five amber mutations that are mapped adjacent to pac, and that define a gene (gene 9) essential for pac cleavage. Amber mutations that are located in genes necessary for viral capsid formation (genes 4, 8 and 23), or in a gene necessary for "late" protein synthesis (gene 10), do not affect pac cleavage. The latter result suggests that the synthesis of the pac cleavage protein is not regulated co-ordinately with other phage morphogenesis proteins. The products of pac cleavage were analyzed using two different DNA substrates. In one case, a single copy of pac was placed in the chromosome of P1-sensitive cells. When those cells were infected with P1, we could detect the cleavage of as much as 70% of the pac-containing DNA. The pac end destined to be packaged in the virion was detected five to 20 times more efficiently than was the other end. Since this result is obtained whether or not the infecting P1 phage can encapsidate the cut pac site, the differential detection of pac ends is not simply a consequence of one end being packaged and the other not. In a second case, pac was located in cells on a small (5 X 10(3) bases) multicopy plasmid. When those cells were infected with P1, neither pac end was detected efficiently after P1 infection, unless the cells carried a recBCD- mutation. In recBCD- cells, the results with plasmid-pac substrates were similar to those obtained with chromosomally integrated pac substrates. We interpret these results to mean that, following pac cleavage, the end destined to be packaged is protected from cellular nucleases while the other end is degraded by the action of at least two nucleases, one of which is the product of the host recBCD gene.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3305964 TI - Ca2+ in the heart. AB - Ca research in the heart was historically surveyed. First, reference was made to the development of the concept involving Ca2+ in the contraction of skeletal muscle. This was followed by an overview of studies on Ca regulation in cardiac muscle. Emphasis was laid on the fact that the "Ca era" today originated from Ca research in muscle initiated by Ringer and expanded by Heilbrunn. PMID- 3305965 TI - Model experiments on anticalcinotic and antiarteriosclerotic arterial protection with calcium antagonists. PMID- 3305966 TI - Calcium channel blockers and early ischemic ventricular arrhythmias: electrophysiological versus anti-ischemic effects. AB - Calcium antagonists are able to reduce the incidence of early ischemic arrhythmias when given as pretreatment in a variety of models of acute myocardial regional ischemia. Two possible modes of action are electrophysiologic and anti ischemic. First, a direct electrophysiologic effect of the calcium antagonist agents on the inward calcium current could inhibit four calcium-dependent phenomena, each of which has been linked to the development of ischemic arrhythmias: the slow response, delayed afterdepolarizations (DADs) and calcium dependent automaticity, enhanced membrane depolarization and conduction slowing. The special circumstances in which each of these could occur are delineated. An anti-ischemic effect of calcium antagonists must also be considered in some models, because of the negative inotropic, negative chronotropic and coronary and peripheral vasodilator properties. Thus far a specific role for the calcium current in early ischemic arrhythmias has only been shown in a few models and not tested in man. PMID- 3305967 TI - Calcium antagonist drugs in the treatment of coronary spasm, effort angina and hypertension. AB - The clinical use of calcium antagonist drugs in coronary artery disease preceded knowledge of the mechanism of their action. Basic research into their pharmacological actions and development of a wide range of compounds which block calcium entry into cells enabled clinicians to greatly expand the indications for their use. Thus the calcium antagonists were rediscovered and found to be potent anti-anginal drugs when used in adequate dosage for effort related angina. Knowledge of their potent relaxing action on vascular smooth muscle led to their use in coronary artery spasm. The exact trigger mechanism/s for spasm and the reason for enhanced vascular reactivity remain unclear, perhaps explaining the failure of specific antagonist therapy. Calcium antagonists acting nonspecifically inhibit both induced and spontaneous attacks of vasospastic angina. They may favourably influence the prognosis and are now drugs of first choice for this condition. The vasodilator action of these drugs has most recently been utilized to treat hypertension, with efficacy confirmed in many controlled trials. Unlike other vasodilators, the calcium antagonists reduce blood pressure without salt and water retention, and with mild or no stimulation of renin, aldosterone, or sympathetic nervous overactivity, and without postural effects. This spectrum of action makes them ideal therapeutic agents, and current guidelines are changing to include calcium antagonists as first or second line therapy. PMID- 3305968 TI - Poisons and poisoning: implication of physicians with man and nations. PMID- 3305969 TI - Severe hepatotoxicity from Escherichia coli L-asparaginase. AB - A 51-year-old black woman with diabetes mellitus developed severe hepatotoxicity after receiving high-dose L-asparaginase (Elspar) for acute lymphatic leukemia. Patients with diabetes should be given this drug cautiously. Glutaminase-free L asparaginase from Vibrio succinogenes has been reported to be less hepatotoxic in mice; it might be a safer product for this group of patients. PMID- 3305970 TI - Transplant-derived astrocytes migrate into host lumbar and cervical spinal cord after implantation of E14 fetal cerebral cortex into adult thoracic spinal cord. AB - Fourteen-day gestation fetal cerebral cortex homografts were transplanted into the thoracic (T6) spinal cord between the left dorsal column and dorsal horn of adult host rats. The transplants were soaked in 2.0 micrograms/ml of the lectin Phaseolus vulgaris leucoagglutinin (PHAL) prior to implantation. Transplanted host spinal cords were utilized at 7, 14, and 24 d and at 1 and 2 months postimplantation. Paraffin-sectioned spinal cords were double labeled for PHAL and glial fibrillary acidic protein (GFAP) by using FITC- and RITC-conjugated secondary antisera, respectively. Montages of FITC- and RITC-positive cells were analyzed for cells containing both fluorescences. Double-labeled cells (PHAL GFAP) were transplant-derived astrocytes. Transplant-derived astrocytes were observed to initiate migration in the white matter columns of the host at approximately 14 d after transplantation. Double-labeled astrocytes were observed in cervical and lumbar spinal cord of the host (ca. 3.5 cm away from the center of the transplant) at 2 months postoperative. These astrocytes migrated at approximately 0.76 mm a day (after a 14-d delay). At 2 months, transplant-derived astrocytes composed as much as 50% of the astrocytes in the white matter of the host 2.0 mm from the transplant. The migrated astrocytes were hypertrophied and appeared reactive. Astrocytes in spinal gray matter only migrate about 1.0 mm from the graft-host interface. Transplant-derived astrocytes can migrate the entire length of the spinal cord white matter. PMID- 3305971 TI - Monoclonal antibodies to a brain dopamine binding protein: production, specificity, and immunohistochemistry. AB - A dopamine binding protein (DABP) has been purified from the rat brain synaptic membrane to homogeneity by affinity chromatography and gel electrophoresis. The monoclonal antibodies against the DABP were produced by the mouse-mouse hybridoma technique and characterized for their specificity to dopamine receptors by displacement of dopamine receptor binding. These monoclonal antibodies have been used to localize DABP in rat brain by immunohistochemistry. A specific linear structure of reaction product was seen in both caudate nucleus and cerebral cortex. This finding suggests that the DABP is present in the cerebral cortex and caudate nucleus as a membranous component of the neurons or their processes. PMID- 3305972 TI - Carcinogenicity testing of chemicals. PMID- 3305973 TI - The present state of health in Africa. PMID- 3305974 TI - The prudent use of diagnostic ultrasound. PMID- 3305975 TI - Evaluation of fetal femur length for prediction of gestational age in a racially mixed obstetric population. AB - In a retrospective study, a group of 314 patients between 19 and 32 completed weeks' gestation were evaluated for differences in sonographic measurement of femur length vs. gestational age between the following racial categories: Hispanic, black, Oriental, and Caucasian. Selection criteria included known last menstrual period, singleton gestation, and a historic absence of maternal diabetes, hypertension, or renal disease or fetal anomalies. The gestational age against which the femur length was judged was determined from the last normal menstrual period, provided that this date differed by less than 2 weeks from age determined by fetal biparietal diameter and evaluation of the newborn. No statistically significant difference in femur length vs. gestational age was noted between the various racial categories. PMID- 3305976 TI - Absorption of fetal intraperitoneal blood after intrauterine transfusion. AB - We reviewed the sonograms and medical records of all patients who underwent intrauterine transfusions between December 1981 and December 1984 in order to determine the time course for disappearance of the intraperitoneal blood. Seventy two sonographic examinations were performed on 22 patients who underwent 51 intrauterine transfusions. Nonhydropic fetuses who received less than or equal to 50 cc of intraperitoneal blood exhibited no ultrasonic evidence of intraperitoneal fluid after 8 days. Nonhydropic fetuses receiving greater than 50 cc of intraperitoneal blood showed resolution of intraperitoneal fluid after 12 days. Hydropic fetuses, after intraperitoneal transfusion, all demonstrated persistence of intraperitoneal fluid. Intraperitoneal fluid was seen as long as 24 days after transfusion in hydropic fetuses. PMID- 3305977 TI - Healing of a muscle trauma. Correlation of sonographical and histological findings in an experimental study in rats. AB - Healing of a partially ruptured gastrocnemius muscle was studied in rats with sonographical and histological techniques. Ultrasonography was performed 1-21 days after injury using a 7.5-MHz linear scanner. Following ultrasonography, the injured muscles were examined histologically. The injured area and development of hematoma were visualized during the first 5 days after trauma with ultrasonographical and histological observations. Later, disorganization of regenerating muscle fibers appeared sonographically more clearly than the scar tissue area demonstrated histologically. The present study points out the accuracy of ultrasonography in the examination of a muscle trauma, especially during the early phases of healing. PMID- 3305978 TI - Significance of ultrasound measurements of the head of the breech fetus. AB - Ultrasound measurements of head shape and size in 451 fetuses presenting as a breech were compared to those obtained in 1,880 fetuses presenting as a cephalic between 15 and 40 weeks' gestation. No statistically significant differences were found for the biparietal diameter (BPD), head circumference (HC), or cephalic index (CI) measurements between the two groups in uncomplicated pregnancies. The mean values for the CI were found to be lower for breech presenting fetuses in complicated pregnancies, indicating a trend for these fetuses to have a more dolichocephalic head shape. PMID- 3305979 TI - Sonography of the hand and foot in foreign body detection. AB - To evaluate the possibility that sonography might be effective in the clinical detection of foreign bodies in the soft tissues, we used high-resolution sonography to study 10 patients with suspected foreign bodies in the hand and foot. Using ultrasound, we detected foreign bodies (glass, metal wire) in the sole of the foot of two patients and glass in the hand of another. Seven patients were proved to be free of foreign bodies. In an experimental model to ascertain which types of foreign bodies could be detected by ultrasound, wood, glass, and metallic foreign bodies 2.5 cm in length that had been inserted into the flesh of a chicken breast were immediately identified by high-resolution sonography. Ultrasound also pinpointed the surface beneath which the foreign bodies lay and localized all precisely as to depth from the surface. While detection of a foreign body is important, precise localization is crucial to avoid miscalculation of surgery leading to increased tissue damage, blood loss, and an increased risk of complications. This initial study suggests that high-resolution sonography has applicability in both the detection and the precise localization of foreign bodies in the soft tissues, but the sensitivity and specificity of the procedure remains to be determined. PMID- 3305980 TI - Sonographic diagnosis of lipoma of the corpus callosum. PMID- 3305982 TI - Sonographic findings of a spermatic cord lipoma. Case report and review of the literature. PMID- 3305981 TI - Posttransplant lymphoma. Sonographic characteristics of renal allograft involvement. PMID- 3305983 TI - Antenatal sonographic detection of benign dacrocystoceles (lacrimal duct cysts). PMID- 3305984 TI - Preoperative sonographic localization of a migrated transosseous stabilizing wire in the hand. PMID- 3305985 TI - Asymptomatic cysts of the fetal choroid plexus in the second trimester. PMID- 3305986 TI - Prenatal diagnosis of cystic CNS lesions in neonatal isoimmune thrombocytopenia. PMID- 3305987 TI - Sequela of continuous ambulatory peritoneal dialysis (CAPD) mimicking primary gynecologic pathology. PMID- 3305988 TI - Antigenic relatedness between glycoproteins of human respiratory syncytial virus subgroups A and B: evaluation of the contributions of F and G glycoproteins to immunity. AB - The degree of antigenic relatedness between human respiratory syncytial virus (RSV) subgroups A and B was estimated from antibody responses induced in cotton rats by respiratory tract infection with RSV. Glycoprotein-specific enzyme-linked immunosorbent assays of antibody responses induced by RSV infection demonstrated that the F glycoproteins of subgroups A and B were antigenically closely related (relatedness, R approximately 50%), whereas the G glycoproteins were only distantly related (R approximately 5%). Intermediate levels of antigenic relatedness (R approximately 25%) were seen in neutralizing antibodies from cotton rats infected with RSV of the two subgroups. Immunity against the F glycoprotein of subgroup A, induced by vaccinia-A2-F, conferred a high level of protection which was of comparable magnitude against challenge by RSV of either subgroup. In comparison, immunity against the G glycoprotein of subgroup A, induced by vaccinia-A2-G, conferred less complete, but significant, protection. Importantly, in vaccinia-A2-G-immunized animals, suppression of homologous challenge virus replication was significantly greater (13-fold) than that observed for the heterologous virus. PMID- 3305989 TI - Comparative value of ultrasonography, computerized tomography, angiography and excretory urography in the staging of renal cell carcinoma. AB - From 1982 to 1985, 225 patients with renal cell carcinoma were treated by nephrectomy. To evaluate the diagnostic significance of ultrasonography in predicting tumor stage the results of ultrasonography, computerized tomography, renal angiography and excretory urography were compared to the histopathological findings. Since local tumor extension has a considerable impact on the operation strategy evaluation of the T classification was of particular interest. All 4 diagnostic procedures were performed in 73 of the 225 patients. The T stage was determined correctly by ultrasonography in 77.8 per cent of the patients, while the tumor was not identifiable in only 0.6 per cent. Computerized tomography was almost as reliable as ultrasonography (the T stage was predicted correctly in 72.3 per cent of the examinations). In contrast, the tumor was staged correctly by angiography in only 57.2 per cent of the patients and by excretory urography in only 59.2 per cent. From these results ultrasonography appears to be an effective, noninvasive, inexpensive and safe procedure to evaluate the T stage of renal tumors. PMID- 3305990 TI - Use of fine needle aspiration for detection of stage A prostatic carcinoma before transurethral resection of the prostate: a clinical trial. AB - The incidence of stage A prostatic carcinoma is approximately 10 per cent. We performed a clinical trial to determine if pre-prostatectomy fine needle aspiration could detect reliably stage A prostatic carcinoma. In 102 men with clinically staged benign disease by digital examination we performed a 4-quadrant fine needle aspiration of the prostate before prostatectomy. The cytological diagnosis of the aspirate was compared to the pathological diagnosis obtained at prostatectomy in all patients. The incidence of stage A prostatic carcinoma in this group of patients was 18.6 per cent (19 of 102 men). Sufficient aspirate material for cytological diagnosis was obtained in 98 of 102 men (96 per cent), including 17 with a diagnosis of carcinoma. When adequate diagnostic material was obtained, fine needle aspiration detected all cases of clinical stage A2 prostatic carcinoma but it did not detect stage A1 prostatic carcinoma. There were no false positive diagnoses. We conclude that routine pre-prostatectomy fine needle aspiration of the prostate can be safe, cost-effective and clinically useful. PMID- 3305991 TI - No-incision pubovaginal suspension for stress incontinence. AB - We describe a modified needle suspension for urinary incontinence that eliminates all incisions. The anterior vaginal wall is suspended from the rectus fascia with 2 heavy nonabsorbable monofilament mattress sutures. The sutures pass down through and back up through the full thickness of the vaginal wall, and are tied suprapubically to bury the knot into the fat in the suprapubic puncture site. The technique is based on our laboratory observation that in rats and guinea pigs monofilament mattress sutures that are tied under tension to include the outside abdominal skin will cut through the skin, and become internalized and accepted without any residual inflammation if the knot is buried initially. The simplified technique makes routine use of outpatient surgery and allows for the use of local anesthesia only in selected patients. At 2 1/2 years the continence rate in the first 38 patients exceeded 87 per cent. There were no failures among the last 14 patients after the technique was modified to include an extra full thickness pass of the mattress suture through the vaginal wall. There have been no significant complications. PMID- 3305992 TI - A modest proposal for the diagnosis and treatment of urinary incontinence in women. PMID- 3305993 TI - Barium granuloma: an unusual cause of unilateral ureteral obstruction. AB - A small amount of barium extravasated at the time of colonic surgery led to the development of a barium granuloma that caused unilateral ureteral obstruction. Although the barium was not detected on radiography or urography preoperatively, it was clearly visible at the time of ureteral exploration and ureterolysis. PMID- 3305994 TI - Unusual urological presentations of acquired immune deficiency syndrome: large cell lymphoma. AB - We describe 2 patients with unrecognized acquired immunodeficiency syndrome who presented with acute urological conditions. One patient had inapparent obstructive anuric renal failure and the other had a testicular mass. The etiology in each case was large cell lymphoma. Recognition of the acquired immunodeficiency syndrome by urologists requires an awareness of its many unusual presentations. PMID- 3305995 TI - Identification of "tumor-associated" nucleolar antigens in human urothelial cancer. AB - Nucleoli isolated from HeLa S3 cells were used to produce rabbit antisera capable of binding nucleoli of transitional cell carcinomas (TCCa) of the bladder. Cross reactivity of the rabbit antiserum with normal nucleoli was reduced by absorption with fetal calf serum, normal human serum, and human placental nucleoli. This antinucleolar antiserum exhibited strong reactivity in immunoperoxidase assays performed on specimens of human bladder cancer. In frozen tissue sections of 24 patients with TCCa and eight individuals without tumor, nucleolar staining was observed in all malignant specimens, but was not observed in seven of the normal specimens. Cytologic examination of bladder washing specimens from 47 normal individuals showed absence of nucleolar staining in 43 (91%) of 47 normal specimens while 12 (86%) of 14 specimens from patients with TCCa were positive. These results suggest that there are antigens associated with the nucleoli of HeLa cells and transitional cell carcinomas which are generally absent (or in low concentration) in normal human urothelial cells, and that antisera to these antigens may be useful in the cytologic diagnosis of human transitional cell carcinoma. PMID- 3305996 TI - Improved identification of renal arteries in patients with aortic aneurysms by means of high-resolution computed tomography. AB - Suprarenal extension of abdominal aortic aneurysms (AAAs) has been reported to be present in less than 10% of patients. Its preoperative demonstration is of value in planning the aneurysm repair; however, the most appropriate radiologic method of assessment remains controversial. Although many practitioners advocate angiography, recent advances in noninvasive techniques challenge this approach. To determine the optimal method of assessment, a retrospective study of CT, ultrasonography, and angiography was undertaken in a group of 101 patients with AAA. Conventional CT was used in all patients and high-resolution CT through the region of the renal vein was used in 45 of these patients. Ultrasonography was used in 27 patients and angiography in 23. Conventional CT detected the renal artery origins in 76% of the cases--results that improved to 98% when thin section high-resolution CT was used. These improvements in CT make the delineation of the relationship of the renal arteries to the aortic aneurysms almost as accurate as angiography at approximately half the cost. Its accuracy, safety, and cost effectiveness make CT the modality of choice in the preoperative assessment of suprarenal aortic aneurysms. PMID- 3305997 TI - Selection of kidney recipients. PMID- 3305998 TI - The provision and financing of medical care for AIDS patients in US public and private teaching hospitals. AB - The National Association of Public Hospitals and the Association of American Medical Colleges' Council of Teaching Hospitals conducted a detailed survey on hospital care to patients with acquired immunodeficiency syndrome (AIDS) in major US public and private teaching institutions in 1985. The 169 hospitals treating patients with AIDS that responded to the survey reported providing inpatient services to 5393 patients with AIDS. These patients accounted for 171,205 inpatient days and 8806 inpatient admissions, with an average length of stay of 19 days. The average costs and revenue for patients with AIDS per day were $635 and $482, respectively, with Medicaid representing the most frequent third-party payer. The average inpatient cost per patient per year was $20,320. Using Centers for Disease Control estimates of 18,720 patients diagnosed as having AIDS and alive during any part of 1985, we estimate that the total cost of inpatient care for patients with AIDS was $380 million for that year. We also found significant regional and ownership differences in source of payment for patients with AIDS and regional differences in revenues received for AIDS treatment. Results indicate that the costs of treating patients with AIDS will profoundly affect major public and private teaching institutions, but that public teaching hospitals in states with restrictive Medicaid programs will be most adversely affected. PMID- 3305999 TI - In vivo diagnostic testing and immunotherapy for allergy. Report I, Part I, of the allergy panel. Council on Scientific Affairs. AB - The diagnosis and treatment of allergic disease constitute a particularly difficult and complex field in medicine, a field that has been complicated further by the promulgation and the use of unproved procedures and/or the inappropriate use of proved procedures. This report is the first in a series of reports prepared by a multidisciplinary panel appointed by the Council on Scientific Affairs of the American Medical Association. It discusses the necessity for proper clinical trials to generate reproducible results under similar conditions to adequately prove the validity of various diagnostic and therapeutic procedures. In vivo immunologic tests have been shown to be reliable and valid diagnostic tools and include skin tests with standardized allergenic extracts by prick, puncture, and intradermal techniques, skin end-point titration, and patch testing for contact allergic dermatitis. Other clinically useful physiologic tests include the exercise tolerance test, methacholine and/or histamine inhalation challenge test, and other inhalation tests utilizing either nasal or bronchial delivery. Oral challenge testing has also been utilized and includes open, single-blind, or double-blind techniques, depending on the requirements of the patient being studied. The second article is a continuation of the first report, and describes other challenge tests and unproved procedures. The third report of this series evaluates in vitro tests for allergy. PMID- 3306000 TI - The differential diagnosis of depression. Relevance of positron emission tomography studies of cerebral glucose metabolism to the bipolar-unipolar dichotomy. PMID- 3306001 TI - Quest to improve marrow transplant success yields new approaches to graft-vs-host disease. PMID- 3306002 TI - The first school of medicine in the country. PMID- 3306003 TI - In vivo diagnostic testing and immunotherapy for allergy. Report I, Part II, of the Allergy Panel. Council on Scientific Affairs. AB - The first article in this series discussed the importance of properly designed clinical trials to validate various diagnostic and therapeutic procedures and also described clinically accepted and proved tests. This article discusses other challenge tests and unproved procedures. The value of provocation-neutralization procedures has been controversial; two promising clinical models have been developed that may allow definitive trials of efficacy. Immunotherapy with allergenic extracts has been shown to be a safe and effective procedure in carefully selected patients treated with potent, well-standardized antigens administered in adequate dosage. It has been proposed that many nonspecific signs or symptoms could be caused by exposure to Candida albicans or low-dose environmental substances. The cause-and-effect relationships between exposure to C albicans or other environmental substances and the disorders that are alleged to be associated with them are, for the most part, unproved. PMID- 3306004 TI - Approval of zidovudine (AZT) for acquired immunodeficiency syndrome. A challenge to the medical and pharmaceutical communities. PMID- 3306006 TI - Screening for abdominal aortic aneurysms: the U-boat in the belly. PMID- 3306005 TI - Dermatologic changes associated with interleukin 2 administration. AB - We have prospectively evaluated the skin changes that occurred in ten patients who were undergoing immunotherapy with interleukin 2 (IL-2) and autologous lymphokine-activated killer cells to treat cancer. Serial skin biopsy specimens were obtained before therapy (baseline), during IL-2 administration, and during IL-2/lymphokine-activated killer cell infusion. All patients developed an eruption that was characterized by macular erythema, with burning and pruritus of the skin. It began after two or three days of IL-2 infusion and was usually localized to the head and neck; it occasionally became generalized (ie, erythroderma). The eruption resolved with desquamation within 48 to 72 hours after cessation of infusion of IL-2. Histologically, the changes were not specific. The only consistent immunohistological finding noted was the presence of DR+/Leu-4+ lymphoid cells surrounding blood vessels in the papillary dermis, with fewer of these cells in the epidermis. There was no difference between the clinical or histological features of the eruption that occurred with IL-2 alone and that which occurred with IL-2 and lymphokine-activated killer cell infusion, suggesting that the cutaneous effects were mediated by IL-2 alone. PMID- 3306007 TI - Article brings censure recommendation. PMID- 3306008 TI - Chlorosis lives!--and slips through MeSH. PMID- 3306009 TI - Diagnosis of human immunodeficiency virus infection in seronegative homosexuals presenting with an acute viral syndrome. AB - Early diagnosis of acute human immunodeficiency virus (HIV) infection is difficult because patients may be seronegative for HIV at the time of presentation. We have used a serum HIV antigen (HIV-Ag) enzyme immunoassay (EIA) to diagnose acute HIV infection in four high-risk patients. The clinical syndrome in these four patients was characterized by fever (four), rash (three), myalgias arthralgias (three), and pharyngitis (two). All patients had spontaneous resolution of their symptoms within eight to 12 days. Serum HIV antibody, as measured by a commercially available screening EIA and by Western blot analysis, was negative in all patients at time of presentation and all seroconverted on subsequent testing. Human immunodeficiency virus was isolated from two of two patients during the acute illness. Initial serum samples from all four patients were positive for HIV-Ag. Serum samples of three of four patients became negative for HIV-Ag and positive for HIV antibody. These data suggest that serum HIV-Ag detection by EIA may be useful in the diagnosis of the acute syndrome caused by HIV infection. PMID- 3306011 TI - Effects of sodium intake on the captopril test for primary aldosteronism. AB - The validity of the captopril test for primary aldosteronism (PA) was tested in patients with surgically verified PA (n = 12) or essential hypertension (EHT, n = 20) with different levels of sodium intakes. The patients were scheduled on 7 days each of three regimes of the prepared diet containing 34, 120 and 340 mEq of sodium chloride per day, and the captopril test was repeated in each period. For the test, captopril (50 mg) was administered orally at 9:00 A.M. after 1 hour of rest in a supine position, and venous blood samples were obtained before and 90 min after drug administration. Plasma aldosterone concentration (PAC; ng/dl) and plasma renin activity (PRA; ng/ml/h) were measured by radioimmunoassay. Under the three different sodium intakes, a PAC/PRA ratio greater than 20 at 90 min after captopril administration was sufficiently sensitive (0.95, 19/20) and specific (0.92, 55/60) to identify PA. Similarly, PA was associated with a PAC above 15 ng/dl 90 min after captopril. There were no complaints associated with the antihypertensive effects of the drug even when patients were sodium-restricted. These results confirmed that the captopril test is safe and useful for screening out-patients for PA, independent of individual differences in sodium intake. PMID- 3306010 TI - Hypertension in patients on chronic hemodialysis: the role of the renin angiotensin system. AB - The effects of volume-loading and removal on mean blood pressure were evaluated in patients with high blood pressure and on chronic hemodialysis. Simultaneous measurements of plasma renin activity, plasma angiotensin II and plasma norepinephrine were made. The patients were divided into two groups according to their levels of plasma renin activity. Group 1 (n = 10) had a basal plasma renin activity below 2.5 ng/ml/hr while the level in group 2 (n = 5) exceeded 2.5 ng/ml/hr. The mean blood pressure of the two groups was 105 +/- 5 mmHg and 107 +/ 4 mmHg, respectively. On the day of hemodialysis, saline loading (0.5 ml/kg/min for 20 min) was followed by routine hemodialysis. The mean blood pressure rose to 113 +/- 6 mmHg in group 1. However, the patients in group 2 did not respond to volume loading and hemodialysis. The plasma renin activity, plasma angiotensin II and plasma norepinephrine were not changed by volume loading in both group 1 and 2. Volume removal by hemodialysis caused a reduction in mean blood pressure in group 2 without alteration of vasoactive hormones. In group 1, the mean blood pressure was not reduced by hemodialysis, accompanied by increases in plasma renin activity, plasma angiotensin II, and plasma norepinephrine. In the high renin group, elevated circulating angiotensin II maintained a high blood pressure and in the low renin group, the renin-angiotensin system influenced the prevention of fall in blood pressure after hemodialysis. These results suggest that the renin-angiotensin system plays an important role in the regulation of blood pressure in relation to volume status regardless of whether the plasma renin activity is high or low. PMID- 3306012 TI - [Comparison of chemical and immunological methods in fecal occult blood testing]. AB - Conventional occult blood testing using the chemical method has been compared with newly developed immunological testing methods; the Hemoccult slide II (HEM II) test has been widely accepted as a guaiac test but such recent tests as the Latex agglutination test (Latex) and the Enzyme Immunoassay method (EIA) have also come to be employed. Thirty colorectal cancer patients, 30 gastric cancer patients and 30 healthy persons were subjected the three above described tests during 3 consecutive days while under no restricted diet. False positive rates during this three-day testing period were 26.7% in HEM II, 93.3 in Late and 8.3% in EIA. Although the immunological testing method has the advantage of reducing the false positive rate without the need for a restricted diet it is time consuming and expensive. Considering these results as well as our previous knowledge accrued from a mass survey, it is suggested that a new flow-chart may be found necessary, in which an initial screening is given by the chemical method and then followed by a secondary screening by the immunological method. This new flow-chart, if routinely employed, would greatly facilitate the mass screening of colorectal cancer. PMID- 3306013 TI - The functional significance of the carbohydrate moiety of plasma glycoproteins. PMID- 3306014 TI - [Chronic neutrophilic leukemia]. PMID- 3306015 TI - [Non-steroidal anti-inflammatory drugs. Mechanism of action of non-steroidal anti inflammatory drugs]. PMID- 3306016 TI - [Non-steroidal anti-inflammatory drugs. Suppression of biological response and non-steroidal anti-inflammatory drugs]. PMID- 3306017 TI - [Rheology of erythrocyte sedimentation]. PMID- 3306018 TI - [Granuloma formed as a biological response]. PMID- 3306019 TI - [Biological production of interleukin 1 induced by stress]. PMID- 3306020 TI - [Inflammation and production of monokines. Origin of interleukin 1]. PMID- 3306021 TI - [Inflammation and production of monokines. Hyperthermia induced by interleukin 1, endogenous pyrogen]. PMID- 3306022 TI - [Inflammation and production of monokines. Role of interleukin 1 and relations to prostaglandins]. PMID- 3306023 TI - [Extra-hepatic effect of monokines and other substances. Interleukin 1 and immune system]. PMID- 3306024 TI - [Extra-hepatic effect of monokines and other substances. Metabolic response to inflammation]. PMID- 3306026 TI - [Renal transplantation]. PMID- 3306027 TI - [Legislation related to the management of kidney failure]. PMID- 3306025 TI - [Extra-hepatic effect of monokines and other substances. Brain, muscles, connective tissue and interleukin 1]. PMID- 3306028 TI - [Dementia due to cerebrovascular disorders in Japan]. PMID- 3306029 TI - [Detection of oncogenes and its application to clinical medicine]. PMID- 3306030 TI - [Mechanism of metastasis: an electron microscopic study]. PMID- 3306031 TI - [The role of platelets in hemostasis and thrombus formation]. PMID- 3306032 TI - [Biochemistry of blood platelets]. PMID- 3306033 TI - [Actin and myosin (platelet skeletal proteins)]. PMID- 3306034 TI - [Determination of free Ca2+ concentrations in platelets]. PMID- 3306035 TI - [Study of platelet kinetics--isotope and MDA (malondialdehyde) methods]. PMID- 3306037 TI - [Platelet aggregation]. PMID- 3306036 TI - [Analysis of platelet membrane glycoproteins]. PMID- 3306038 TI - [Platelet ATP, ADP and serotonin]. PMID- 3306040 TI - [The morphology of platelets]. PMID- 3306039 TI - [Platelet factor 3]. PMID- 3306041 TI - [Anti-platelet antibody and HLA]. PMID- 3306042 TI - [Platelet-derived growth factor (PDGF)]. PMID- 3306043 TI - [Platelet size]. PMID- 3306044 TI - [Platelet adhesiveness (membrane charges)]. PMID- 3306045 TI - [Monitoring of the action of anti-platelet agent]. PMID- 3306046 TI - [The morphology of megakaryocytes]. PMID- 3306047 TI - [Megakaryocyte rotation]. PMID- 3306048 TI - [Immunological testing of blood platelets]. PMID- 3306049 TI - [Classification of platelet disorders]. PMID- 3306050 TI - [Methods of platelet collection]. PMID- 3306051 TI - [Phosphorylation reaction of platelets]. PMID- 3306052 TI - [Prostaglandin]. PMID- 3306053 TI - [Studies on the pathogenesis of staphylococcal scalded skin syndrome (SSSS)]. PMID- 3306054 TI - [Immunohistochemical study of the distribution of blood group antigens A, B and H in tumors of the epidermis]. PMID- 3306055 TI - [Distribution of DNase and RNase in psoriasis and their changes following PUVA--a study using immunohistochemical methods]. PMID- 3306056 TI - [Lectin-binding pattern of myrmecia warts--histochemical investigation using the avidin-biotin-peroxidase complex (ABC) method]. PMID- 3306057 TI - Intra- and inter-species transmission and antigenic difference of Pneumocystis carinii derived from rat and mouse. AB - Pneumocystis carinii (Pc) derived from nude mice (MPc) and hypercorticonized rats (RPc) was subjected to transmission experiments via intranasal (i.n.) route into athymic nu/nu mice (BALB/c background) and run/rnu rats (Rowett hooded strain) and their euthymic heterozygotes rnu/+ rats. Although all these recipient animals received intensive cortisone treatment, MPc propagated only in nu/nu mice. In contrast, RPc strains from three different sources were transmitted successfully to both rats and mice irrespective of their athymicity. The MPc strain could not be transmitted to the other three rat strains used. When RPc organisms were successively propagated in nu/nu mice they lost their pathogenicity to rats after five passages. An antigenic difference between MPc and RPc was suggested by cross reaction of rabbit-raised antiMPc and antiRPc sera against MPc and RPc organisms. An absorption experiment of the sera with both MPc and RPc revealed cross reactivity as well as specific reactivity. The mouse passaged RPc seemed to change the antigenic characteristic to that of MPc. PMID- 3306058 TI - [Real tubular reabsorption of pancreatic secretory trypsin inhibitor]. PMID- 3306060 TI - [Diagnosis of prostatic cancer in the aged by solid phase enzyme immuno assay]. PMID- 3306059 TI - [Study of activated pancreatic protease in experimental caerulein-induced pancreatitis]. PMID- 3306061 TI - [Learning from the practice and progress made by midwives of the past: experiences through interviews with midwives who were active during the Taisho period and the first half of the Showa period]. PMID- 3306063 TI - [Learning from the practice and activities of midwives in the past (3). Through interviews with midwives who were active during the Taisho period and in the first half of the Showa period]. PMID- 3306062 TI - [A report on the activities of the Organization of Women's Pre-clinical Care in the past 3 years]. PMID- 3306064 TI - [Transitions in the midwifery profession. Pre-war birth control movements and the concept of eugenics]. PMID- 3306065 TI - [Re-estimation of renal function with 99mTc-DTPA by the Gates' method]. PMID- 3306066 TI - [Quantitative and clinical evaluation of the whole CSF-axis RI image with particular reference to the significance of spinal stasis]. PMID- 3306067 TI - [Fundamental and clinical evaluation of an immunoradiometric assay for serum TSH using the Ventrex TSH kit]. PMID- 3306068 TI - Clinical effect of danazol in patients with IgA nephropathy. AB - A multi-center study on the clinical effect of danazol in patients with IgA nephropathy is described. Two different doses of oral administration, including 200 mg or 300 mg per day, were employed in the present study. Urinalysis and measurements of complement components, i.e. C3 and C4, were performed before, and in the eighth and 20th week after the administration of danazol. It was demonstrated that 200 or 300 mg of danazol administration was effective in reducing the amount of proteinuria and in increasing the levels of serum complement components in the patients. It is concluded that the administration of danazol may be useful for treatment of patients with IgA nephropathy. PMID- 3306069 TI - Issue dedicated to Professor Minoru Yokoyama to commemorate his retirement. PMID- 3306070 TI - [A factor analytic study of the acceptance of relaxation through Dohsa training (psychological rehabilitation training)]. AB - This study was designed to identify factors which contribute to the acceptance of relaxation. Using the Dohsa Training technique, each of 58 female undergraduate students was given a relaxation procedure applied to the trunk and back. Following this relaxation procedure, subjects were asked to complete a 20 item questionnaire in which a five point rating scale served as an index of the degree of acceptance of relaxation. Factor analysis of the results led to identification of the following three factors: (I) psychological acceptance of the experimental situation; (II) differentiated and integrated bodily awareness; and, (III) feeling of generalized relaxation. A comparison of the factor scores of training and non-training experienced subjects revealed higher scores for the former on Factors I and II. On the other hand, non-training experienced subjects scored higher on Factor III. In addition, the difference in factor scores between concentrated and non-concentrated subjects indicated that volitional concentration on the relaxation process is indispensable for reorganizing self body-image. PMID- 3306071 TI - Size disparity between donor and recipient in canine heart transplantation. AB - To assess the feasibility and function of small donor hearts for large recipients, small donor hearts were orthotopically transplanted into large recipients. Thirty adult mongrel dogs were used to form donor-recipient (D-R) combinations with the D-R heart weight ratio ranging from 0.47 to 1.78. In the D R heart weight ratio of 0.8 or above (mean 1.11, Group I), the successful transplantation rate was 57 per cent, while it was 81 per cent in cases of less than 0.8 (mean 0.67, Group II) (no statistical difference). In 10 dogs (5 with D/R heart weight ratio greater than or equal to 0.8, 5 with less than 0.8) a recovery rate in cardiac function of the transplanted small heart was studied 2 hours following transplantation. There was no significant difference, hemodynamically in the normal range of left atrial pressure (LAP) between the two groups. The close relationship between cardiac output (CO) and volume load in the range of 10 to 15 mmHg of LAP was transformed to a linear function in the over 0.8 group. It was technically and hemodynamically possible to transplant small dog hearts to larger recipients up to the D-R heart weight ratio of 0.47. The importance of an adequate heart rate for the increase of CO in transplanted smaller donor hearts was emphasized. PMID- 3306072 TI - Gallstone ileus diagnosed preoperatively using ultrasonic tomography. AB - We treated a man with gallstone ileus and a correct diagnosis was made preoperatively. In this report, emphasis was placed on the usefulness of application of ultrasonic tomography for diagnosing an acute abdomen. PMID- 3306073 TI - Mobile unit for use in mass screening for breast cancer. AB - Since 1977, mass screening for breast cancer has been carried out in Miyagi prefecture, Japan. The main activities involve itinerant screening in the communities and group screening at the workplaces. The first step in this screening is the physical examination; the second step, for women with suspicious findings, is examination by mammography and ultrasonography, in a specially equipped mobile unit. The number of subjects screened over a seven-year period ending in March, 1984, was 94,953. Mammography was performed on 4,485 subjects (4.7 per cent) Breast cancer was detected in 116 subjects (0.12 per cent). Since 1980, 2,292 high risk subjects have undergone mammography as the first step screening. The detection rate (0.35 per cent) for this group was higher than for the general subjects examined. Therefore, mammography performed in a mobile unit is a suitable approach for the detecting and diagnosing of breast cancer. PMID- 3306074 TI - Analysis of tissue lymphocytes by double fluorescent staining--gastric cancer tissue and regional lymph nodes. AB - An immunohistochemical study was performed on human lymphocytes in the tissue of gastric cancer, and also in the regional lymph nodes, by double fluorescent staining, using monoclonal antibodies. Leu3a+8+ cells (inducer T cells) which consist about 30 per cent of Leu 3a+ cells were seen in the tissue surrounding the gastric cancer. The other 70 per cent of Leu 3a+ cells were Leu3a+8- cells (helper T cells). In the lymph nodes they were noted in T cell areas in almost the same proportions, while in germinal centers, only Leu3a+8- cells were found. On the other hand, OKT8+Leu15- cells (cytotoxic T cells) were noted in a large number, while OKT8+Leu15+ cells (suppressor T cells) were few. Further, an increase of OKT8+Leu15- cells was seen around gastric cancer or metastatic cancer in lymph nodes. These immunohistochemical findings suggest that cytotoxic T cells are the main component in the tissue of gastric cancers and the regional lymph nodes. Increases in inducer T cells and helper T cells are probably required to induce cytotoxic T cells around the cancer tissue. PMID- 3306075 TI - Malignant lymphoma associated with reactive lymphoreticular hyperplasia of the stomach--a case report. AB - We report a case of early malignant lymphoma of the stomach, associated with reactive lymphoreticular hyperplasia. This case seems to prove that there is some evidence of sarcomatous change in reactive lymphoreticular hyperplasia. PMID- 3306076 TI - Anterior perineal anorectoplasty for intermediate and high imperforate anus. AB - Anterior perineal anorectoplasty is a new technique for the repair of high imperforate anus. This technique allows direct access and clear visualization of the puborectalis sling and rectal pouch; division of the fistula and mobilization of the rectum can be precisely performed under direct vision, thereby reducing injury to surrounding structures; the pull-through of the rectum is readily facilitated; it obviates the need to change the position of the patient during the procedure; and mobilization of the rectum required to pull the rectum through is minimal, hence the late complication of mucosal prolapse is avoided. Details of the operative procedure are described herein. PMID- 3306078 TI - [Evaluation of aortocoronary bypass graft patency by transbrachial intra-arterial digital subtraction angiography--application to outpatients]. PMID- 3306077 TI - Intrathoracic application of the latissimus dorsi muscle for esophageal cancer operation. AB - In order to reinforce the difficult closure of the bronchial stump, or esophageal anastomosis, a pedicle flap, taken from the latissimus dorsi muscle, was applied to 7 patients with tracheal repairs, and 11 patients with extensively dissected areas, at the time of esophageal cancer surgery. Utilizing this technique, the complications associated with extended esophagectomy could be minimized. Intrathoracic application of the latissimus dorsi muscle flap is a useful method of supporting extended esophagectomy for esophageal cancer. PMID- 3306079 TI - Ultrasonogram of hepatic abscess in cattle inoculated with Fusobacterium necrophorum. PMID- 3306080 TI - Immunocytochemical studies on the cytodifferentiation of the adenohypophysis of the domestic fowl. PMID- 3306081 TI - Natural case of Aujeszky's disease in the dog in Japan. PMID- 3306083 TI - The Kansas Medical Society. Membership directory 1987. PMID- 3306082 TI - A history of orthopedic surgery at UKSM-KC. PMID- 3306085 TI - [Clinical immunology of tuberculosis]. PMID- 3306084 TI - [Therapeutic effect of ofloxacin on mice challenged by ofloxacin-resistant Mycobacterium bovis strains]. PMID- 3306086 TI - [Medical topics: bone marrow transplant for fetus of 17 weeks/tumor necrosis factor]. PMID- 3306087 TI - [Forty years of Japanese Nursing Association as professional organization of nurses]. PMID- 3306088 TI - [The LDL receptor: its role in maintaining cholesterol homeostasis and in arteriosclerosis]. PMID- 3306089 TI - [Basic principles and variants of computing the volumetric indices of the left ventricle based on 2-dimensional imaging data]. PMID- 3306090 TI - [Methods for the hemodynamic correction of the single heart ventricle]. AB - Experience with hemodynamic correction of the only heart ventricle is presented. Four operations have been performed: plastic closure of the right atrioventricular opening and formation of a direct right atrial--pulmonary anastomosis using a pericardial autograft patch in 3 patients, and the suture of atrioventricular opening with the formation of an anastomosis between the right atrium and the pulmonary artery, using an avalvular prosthesis, in 1 patient. The results are quite satisfactory in all cases. PMID- 3306091 TI - [Current aspects of aortocoronary shunting]. AB - Current ideas relating to patient selection for surgical treatment are reviewed. Indications for surgery and the scope of intervention are determined in the light of modern knowledge. Multiple shunting of coronary arteries is known to be essential for adequate myocardial revascularization. The importance of individual expertise and skills for the improvement of the results of surgical treatment of coronary patients is emphasized. Average myocardial revascularization was 3-3.8 shunts per patient. Intraoperative myocardial infarction (5.2-3.9%) and hospital mortality (4.3%) rates have decreased. Seven year survival rate is 97.4% for cases of damaged left coronary arterial trunk and 88.4% for multiple aortocoronary shunts. PMID- 3306092 TI - [Effect of respiratory and circulatory hypoxia on the insulin-producing function of the pancreas and on insulin transport and utilization in tissue in congenital heart defects]. AB - Radioimmunoassays of plasma C-peptide, and plasma and erythrocyte insulin were made in mixed venous-arterial blood specimens of normal children and those with congenital heart diseases. In all cases, insulin level was higher in erythrocytes, as compared to plasma specimens, obviously due to active insulin deposition by erythrocytes. Venous-arterial difference in insulin may be indicative of tissue insulin uptake. Respiratory and circulatory hypoxia is associated with decreased erythrocyte capacity for insulin deposition and tissue insulin uptake. It is suggested that plasma C-peptide content may be an indicator of pancreatic function. PMID- 3306093 TI - The clinical significance of inhibition of renal prostaglandin synthesis. PMID- 3306094 TI - Glomerular deposition of cross-linked fibrin in human kidney diseases. AB - The immunofluorescent localization of cross-linked fibrin (XFb) in kidneys from 87 patients with renal diseases was evaluated using a monoclonal antibody that discriminates XFb from fibrinogen and its derivatives. Glomerular deposition of XFb, along the endothelial surface and in the mesangium, was frequently observed in patients with IgA nephropathy, Henoch-Schonlein purpura nephritis (HSPN), lupus nephritis, and hemolytic uremic syndrome (HUS), which was confirmed by immunoelectron microscopy. Dual-label immunofluorescent studies showed that XFb was deposited in limited areas among the sites reactive with anti-fibrinogen antibodies; XFb was not present in the crescents, Bowman's capsule or interstitium. The localization of XFb was generally discordant with that of the platelet membrane antigen and von Willebrand factor (factor VIII-related) antigen. Subendothelial co-deposition of XFb and immunoglobulins (IgA with or without IgG) occasionally accompanying C3 was found in the glomeruli of some of the patients with IgA nephropathy and HSPN. The distribution of XFb observed by immunoelectron microscopy was similar to that of electron dense deposits. The glomerular population of monocytes/macrophages in patients with XFb deposition was similar to that of those without deposition. Urinary XFb derivatives were detected by the latex agglutination test in three of the 16 patients with glomerular XFb deposition, and in two of the 18 patients without it. These data indicate that the coagulation system is activated in the kidney of patients with IgA nephropathy, HSPN, lupus nephritis and HUS, and support the concept that glomerular fibrin deposition is associated with endothelial/subendothelial and mesangial injury. The activation of the coagulation system in IgA nephropathy and HSPN seems to be mediated by immune complexes rather than monocytes/macrophages. Determination of urinary XFb derivatives is not helpful for assessing glomerular XFb deposition. PMID- 3306095 TI - Hemodialysate composition and intradialytic metabolic, acid-base and potassium changes. AB - We compared the effects of dialysate composition on changes in intermediary metabolites, acid-base balance, and potassium removal during hemodialysis. Patients were dialyzed against dialysates containing acetate or bicarbonate, each with or without glucose, in a four-way cross-over study. Dialysates containing acetate were associated with significant perturbations in intermediary metabolism, including increases in blood citrate, acetoacetate and beta hydroxybutyrate and a decrease in pyruvate. In contrast, bicarbonate-containing dialysates caused minimal perturbations in intermediary metabolism. Addition of glucose to the dialysate decreased the changes in intermediary metabolites; however, the magnitude of this effect was less than that observed for the change from acetate to bicarbonate. Use of acetate also resulted in lower post-dialysis blood-concentrations of base equivalents than obtained with bicarbonate; this difference was unaffected by the presence or absence of glucose. Although pre- and post-dialysis potassium concentrations were unaffected by the dialysate formulation, total potassium removal was significantly greater when glucose was omitted from the dialysate. Our results suggest that both bicarbonate and glucose should be included in the dialysate, particularly for those patients whose capacity for metabolism may be limited because of highly efficient dialysis, intercurrent illness, or starvation. However, addition of glucose to the dialysate may require a reduction in dialysate potassium to maintain proper potassium homeostasis. PMID- 3306096 TI - Glomerular hemodynamics and hormonal participation on cyclosporine nephrotoxicity. AB - The mechanism of cyclosporine A (CyA) nephrotoxicity is unclear. In order to evaluate renal microcirculation seven euvolemic Munich-Wistar (MW) rats were studied after acute CyA treatment (50 mg/kg, i.v.). Both total glomerular filtration rate (GFR, 0.96 +/- 0.04 vs. 0.47 +/- 0.07 ml/min) and single nephron GFR (27.90 +/- 3.39 vs. 14.02 +/- 3.49 nl/min) declined significantly (P less than 0.001). It was observed an increase in afferent (RA, increases 188%) and efferent (RE, increases 360%) arteriolar resistances that caused a decrease on glomerular plasma flow rate (QA) from 100.99 +/- 17.09 to 44.37 +/- 13.37 nl/min (P less than 0.001). Mean glomerular capillary hydraulic pressure (PGC) increased from 45 +/- 1 to 55 +/- 4 mm Hg (P less than 0.05) and the glomerular ultrafiltration coefficient (Kf) decreased by 70% (0.096 +/- 0.030 to 0.031 +/- 0.010 nl/sec X mm Hg, P less than 0.05). Additionally, in order to study hormonal participation in this nephrotoxicity, other three groups of MW rats were previously treated with captopril (2 mg/kg, i.v.), verapamil (20 micrograms/kg/min, i.v.) or indomethacin (2 mg/kg, i.v.). Both captopril and verapamil minimized the renal effects of CyA, with a decline of approximately 25% instead of approximately 50% on GFR and RPF. Moreover, two groups of Brattleboro rats were studied. Acute CyA administration in homozygote Brattleboro rats produced a decline of only approximately 22% and approximately 31%, respectively, in GFR and renal plasma flow (RPF), when compared with MW rats (P less than 0.05). Similar results were observed in heterozygote Brattleboro rats when compared with MW rats, disclosing differences due to a different strain of rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306097 TI - Procoagulant activity in kidneys of normal and bacterial lipopolysaccharide treated rabbits. AB - Fibrin formation in the kidney is frequently associated with clinically significant renal dysfunction. We therefore measured and characterized the procoagulant activity (PCA) which is present in normal kidneys and in kidneys of rabbits with the Shwartzman phenomenon induced by two injections of bacterial lipopolysaccharide (LPS; E. coli LPS 055:B5,25 micrograms/kg and 50 micrograms/kg administered 24 hrs apart with rabbits sacrificed 12 hrs after the second injection). PCA was measured in sonicated tissue by one-stage coagulation assay. In normal kidneys the amounts of PCA in the inner medulla, outer medulla and inner cortex were 18.2 +/- 3.2, 44.1 +/- 3.8 and 78.5 +/- 5.7 percent, respectively, of that in the outer cortex (N = 31). Glomeruli (purified by the iron oxide magnetic method to greater than 95 percent homogeneity) contained 21.6 +/- 8.8 arbitrary units/micrograms protein compared with tubular fragments which contained 13.9 +/- 2.6 U/micrograms protein (N = 9). In LPS-treated rabbits PCA (in units/micrograms) increased in outer cortex from 33.7 +/- 3.9 (control) to 73.4 +/- 10.4 (LPS, P less than 0.01), in inner cortex from 26.7 +/- 2.9 (control) to 83.3 +/- 17 (LPS, P less than 0.02), in outer medulla from 12.9 +/- 2.4 (control) to 54.5 +/- 16.5 (LPS, P less than 0.05), and in inner medulla from 12.2 +/- 2.4 (control) to 32.1 +/- 4.9 (LPS, P less than 0.01). Glomerular PCA increased from 21.6 +/- 8.8 (control) to 88.8 +/- 20.7 (LPS) units/micrograms (P = 0.01), while tubular fragment preparation PCA increased from 13.9 +/- 2.6 (control) to 44.6 +/- 12.7 (LPS) U/micrograms (P = 0.02) (N = 9 per group).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306098 TI - Renal selectivity properties towards endogenous albumin in minimal change nephropathy. AB - It is well accepted that the molecular charge and conformation of serum proteins are major determinants of their glomerular filtration, but few studies characterizing the molecular features of circulating proteins in renal diseases are currently available. In 11 children affected by minimal change nephropathy (MCN) we determined the electrical charge and the fluorescence quantum yield of Tyrosine (Tyr) and Tryptophan (Trp) (taken as index of conformation) of serum and urinary albumin before and after steroid-induced remission of proteinuria. In all proteinuric children at the onset of the disease, urinary albumin was formed by one band with an isoelectric point (pI) of 4.7 (pI of the native protein), and by numerous other, less anionic bands with pIs between 4.8 and 5.5 accounting for about 50% of the total amount of this protein. The normalization of proteinuria which followed steroid therapy was characterized by the disappearance in urines of the less anionic fraction and by the appearance of numerous isoforms with a pI still more anionic (pI less than 4.7) than normal. At the same time, in the proteinuric phase, the fluorescence quantum yield of Trp of urinary albumin was markedly quenched, returning to near normal levels after steroid-induced remission of proteinuria. These data indicate that in MCN the charge-dependent renal selectivity properties are partially maintained and that the less anionic isoforms of albumin are a main component of urinary albumin. Together with the electrical charge, the conformation of albumin as a major determinant of its urinary excretion in MCN must also be considered. PMID- 3306099 TI - Physiology of sweat secretion. PMID- 3306100 TI - Transport processes in the eccrine sweat gland. PMID- 3306101 TI - Water metabolism in historical perspectives: its research in the past and present. PMID- 3306102 TI - Anatomical basis of thirst and vasopressin secretion. PMID- 3306103 TI - Cellular handling of water. PMID- 3306104 TI - Thirst and the renin-angiotensin system. PMID- 3306105 TI - Brain mechanisms and drinking: the role of lamina terminalis-associated systems in extracellular thirst. AB - Concomitants associated with alterations in body fluid balance serve as stimuli to appraise the brain of the momentary status of body salt and water. Extracellular fluid osmolality and the peptide ANG II have been identified as the humoral components that act as stimuli to trigger central receptors related to cellular and extracellular thirst, respectively. In the case of extracellular thirst, information about pressure/volume status is also obtained from systemic vascular receptors. It is proposed that peripherally-derived neural information is integrated with ANG II-related input within structures located in periventricular tissue of the AV3V. PMID- 3306106 TI - The renal concentrating mechanism. PMID- 3306107 TI - Morphological aspects of the action of ADH. AB - Early studies employing biophysical techniques provided a model for ADH-induced water flow in which the number of small water-conducting channels in the outer facing membrane is increased by the hormone. With the development of new concepts and techniques in cell biology, the problem of ADH action now centers on organelle movement, fusion, endocytosis and vesicular traffic with the cell. In this review, endocytosis and vesicular traffic are discussed, and their application to the action of ADH is considered. PMID- 3306108 TI - Vasopressin antagonists: present and future. PMID- 3306109 TI - Vasopressin biosynthesis--from gene to peptide hormone. PMID- 3306110 TI - Hormonal regulation of water metabolism in children with nephrotic syndrome. AB - The roles of the antidiuretic hormone arginine-vasopressin (AVP), atrial natriuretic peptide (ANP), renin, aldosterone and catecholamines in the pathogenesis of impaired water excretion were studied in edematous children with nephrotic syndrome. Compared to non-proteinuric children with nephrotic syndrome in remission, edematous children during relapse had lower serum concentrations of sodium and chloride with lower plasma osmolality, but had higher hematocrit values (P less than 0.05, each). Plasma concentration of AVP was higher in edematous children (P less than 0.01). Compared to healthy, normal children, edematous nephrotic children had higher plasma concentrations of AVP, aldosterone, renin, noradrenaline, and adrenaline (P less than 0.01, each), but had similar levels of plasma ANP. Head out water immersion and infusion of 5 ml/kg 20% human serum albumin solution, both procedures known to increase central blood volume, resulted in a reduction of elevated hormone concentrations to near normal levels and caused a rise in sodium and water excretion. Following albumin infusion, mean ANP rose fivefold, and plasma concentrations of this hormone correlated positively with urine flow (r = 0.64, N = 18, P less than 0.01) and with sodium excretion (r = 0.62, N = 18, P less than 0.01). It is concluded that AVP, renin, aldosterone and catecholamines are stimulated in edematous children with nephrotic syndrome by reduction in effective circulatory blood volume. Central blood volume expansion induced either by water immersion or by infusion of concentrated albumin solution is able to correct elevated hormone levels and to induce salt and water excretion. Plasma ANP appears to trigger the diuretic and natriuretic effects of central volume expansion. PMID- 3306111 TI - Fluid metabolism in exercise. PMID- 3306112 TI - Impaired fluid and electrolyte balance in hot climates. PMID- 3306113 TI - [Virus infections. 2. Possibilities of treatment]. PMID- 3306114 TI - [Possibilities and limits of gene technology diagnosis of cystic fibrosis]. PMID- 3306116 TI - [Surgical tactics in undeveloped external intestinal fistulas in children]. PMID- 3306115 TI - [Necrotizing enterocolitis in the newborn infant. A review. 3. Surgical aspects]. PMID- 3306117 TI - [Prognosis and surgical treatment of vasorenal hypertension (review of the literature)]. PMID- 3306119 TI - [Heart surgery today and tomorrow]. PMID- 3306118 TI - [Simultaneous esophagogastroplasty (review of the literature)]. PMID- 3306120 TI - [Diagnosis and surgical treatment of cardial insufficiency]. PMID- 3306122 TI - [Our experience with the monitored cyclosporin A treatment of kidney transplant patients]. PMID- 3306121 TI - [Use of echography in diagnosing postoperative abdominal complications in childhood]. PMID- 3306123 TI - [Implants in surgery]. PMID- 3306124 TI - [Congenital diaphragmatic hernia--its pathophysiology and the pharmacological treatment of pulmonary hypertension]. PMID- 3306125 TI - [Angiographic studies on the blood supply of the pancreas with a view to forming the optimal transplant]. PMID- 3306126 TI - [Ocular involvement in ectodermal dysplasia]. AB - The authors describe the ophthalmological findings and clinical course in two patients with EEC syndrome and one patient with anhydrotic ectodermal dysplasia. A retinal complication was seen in a 43-year-old patient which seems to be associated with the EEC syndrome and has not yet been described. A review of the literature indicates the frequency of ocular findings. So far, primary ocular changes in anhydrotic ectodermal dysplasia have never been observed. The older the patient, the more severe the secondary complications affecting the lids and cornea can be; the eye may even be lost. PMID- 3306127 TI - [Special supportive measures in pediatric oncology]. PMID- 3306128 TI - [Treatment of acute lymphoblastic leukemia in childhood and adolescence: results of the multicenter therapy study ALL-BFM 81]. AB - In therapy study ALL-BFM 81 633 previously untreated patients with acute lymphoblastic leukemia (ALL) less than 18 years of age have been recruited from April 1, 1981 to September 30, 1983 and treated in 37 institutions throughout West-Germany and Austria. Here only therapy results of 611 patients with non-B ALL are presented. Patients with ALL of B-type are described elsewhere. In this fourth consecutive trial of the BFM study group three major questions have been asked: 1. Is it possible to assess the individual risk for relapse more accurately by the use of a risk factor rather than by the risk score which was the discriminator in studies ALL-BFM 76 and ALL-BFM 79? Does this risk factor discriminate more precisely patients at the highest risk for relapse? Offers more intensive risk-adapted therapy to this patient group a better chance for disease free survival? 2. In patients at a standard risk for relapse with a risk factor below 1.2--approximately 60% of patients with non-B-ALL--can radiotherapy for prevention of CNS disease effectively be replaced by chemotherapy (intermediate dose Methotrexate)? 3. It is possible to reduce duration of maintenance therapy by 6 months to a total duration of 18 months with no unfavorable effect? To assess the radiation problem in standard risk patients and to evaluate the importance of duration of maintenance therapy two randomisations have been utilized. After a median duration of study ALL-BFM 81 of 4 1/2 years and 3 1/4 years after the study had been closed (date of evaluation January 1, 87) the answers are as follows: 1. For the majority of patients risk-adapted therapy had a curative effect. The probability for event-free survival (EFS) in standard risk patients in slightly above 70%, in medium risk patients 67%. In high-risk patients risk-adapted therapy did not improve prognosis, the EFS being still in the order of 50%. A good assessment of the individual risk for relapse is possible by the newly introduced risk factor. This principle is superior to the risk score used in former studies ALL-BFM 76 and ALL-BFM 79 because a low risk group (risk factor below 0.8) could be identified including approximately 25% of all patients with non-B ALL. Selection, quality, and timing of therapy elements remain the decisive prognostic factors, however. 2. Standard risk patients with a risk factor below 0.8 can effectively be protected for CNS relapse by treatment with intermediate dose Methotrexate.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306130 TI - [Delayed development of chimerism following T-cell depleted bone marrow transplantation]. AB - Comparison of cytogenetic chimaerism was performed in two children after bone marrow transplantation (bmt) with resp. without T-cell depletion for ANLL. It showed a marked delay of full bone marrow function in the patient with a T depleted graft. Host type bone marrow cells persisted over many months, whereas they disappeared quickly when undepleted marrow was transplanted. Donor-T-cells apparently interact with remaining host cells and thus they might more efficiently eliminate leukaemia. Therefore total removal of T-cells from the graft seems risky in bmt for leukaemia. PMID- 3306129 TI - [Corticosteroid-dependent reduction of leukocyte count in blood as a prognostic factor in acute lymphoblastic leukemia in childhood (therapy study ALL-BFM 83)]. AB - In therapy study ALL-BFM 83 a total of 630 patients with acute lymphoblastic leukemia (ALL) have prospectively been evaluated for initial response on therapy with corticosteroids. It was the aim to qualify the in vivo cytoreduction as a new predictor for therapy failure. All patients were exposed for 7 days to prednisone before combination chemotherapy at day 8 has been started. At day 0 one additional dose of Methotrexate was given intrathecally. Therapy for all patients with non-B-ALL has been stratified according to initial tumor burden (risk factor) providing four therapy branches: standard risk low (SR-L), standard risk high (SR-H), medium risk (MR), high risk (HR). After a median duration of study of 21 months, event-free survival (EFS) is for all 630 patients 73%, 81% for SR-L, 76% for SR-H, 69% for MR, and 35% for HR patients (date of evaluation Jan. 1, 1987). In this prospective study, a small subgroup of patients (n = 48; 7.6% of total group) is characterized by greater than 1000 leukemic blasts/mm3 peripheral blood at day 8 after exposure to prednisone. In this subgroup the EFS is only 43% in contrast to 76% in the complementary group of 582 patients with less than 1000 leukemic blasts/mm3 peripheral blood at day 8. Patients of that risk group are derived from therapy branches SR-H, M and HR, the latter contributing relatively most patients. In this negatively selected group all patients with an initial high white blood count, CNS disease at diagnosis, immune subtypes as prae-T-ALL (n = 6), T-ALL (n = 18), null-ALL (n = 5), and males clearly dominate. Of 48 patients with greater than 1000 blasts/mm3 at day 8 4 subsequently failed to enter remission and 8 were qualified as lateresponders. 18 patients relapsed, most of them earlier compared to those of the complementary group. The initial in vivo response on corticosteroid therapy is considered a supplementary prognostic predictor for early failure. It will be utilized in trial ALL/NHL-BFM 86 to qualify patients at the highest risk for relapse. This group of patients is supplemented in addition by non- and lateresponders and children with acute undifferentiated leukemia (AUL). The in vivo corticosteroid test is simple, generates early and reliable results and can be obtained almost always. Thus it may be recommended for use in a multicenter trial. PMID- 3306131 TI - [Medulloblastoma therapy studies MBL 80 and MED 84 of the Society of Pediatric Oncology and the Societe Internationale d'Oncologie Pediatrique (SIOP)]. AB - In both trials the principle of "sandwich" chemotherapy (administered between surgery and postoperative irradiation) is studied in medulloblastoma. GPO-MBL 80 was essentially a one-arm trial; results after a mean observation period of 3 years show an expected event-free survival rate of 46% at 6 years. "Maintenance" chemotherapy with CCNU and vincristine did not further improve the results. Preliminary results of the joint, prospective, randomised forearm SIOP-GPO trial MED 84 are presented. It is apparently too early to answer any of the two main questions asked by this trial: a) is "sandwich" chemotherapy (as administered) of any value? b) can radiotherapy doses to the supratentorial area and to the spine be moderately reduced in so-called "low risk" patients without compromising long term results? Thus far, we cannot observe any prognostic influence of the "classical" risk factors as established by other studies. PMID- 3306132 TI - [High-dose chemoradiotherapy with bone marrow transplantation as a consolidation treatment of neuroblastoma. Results in 49 unselected patients with stage IV cancer and older than 1 year. Report of the LMCE neuroblastoma group]. AB - 65 consecutive children over one year of age presenting with neuroblastoma stage IV were unselectively treated with an induction regimen alternating Cis Platinum/VM 26 and Cyclophosphamide/Adriamycin/Vincristin. After primary surgery two to four months post diagnosis, consolidation consisted of continuous Vincristin, high dose Melphalan and fractionated total body irradiation, followed by bone marrow transplantation (autologous except for 3 allogeneic). Of the 49 children transplanted up to evaluation date, 31 were in partial remission (PR) and 18 in "very good partial remission" (VGPR) or complete remission (CR) at the time of transplantation. The toxic mortality was 20% (14% early, 6% late), the relapse rate 29% and the progressive disease rate 6%. The event-free survival from graft (events being relapse, progression or death) was 33% after a median of 17 months (range: 2-45) without a significant difference between a status at transplantation of PR versus VGPR/CR. The overall actuarial progression-free survival of the complete group of children with neuroblastoma stage IV was 24% after 27 months, including 10 patients who died or relapsed before massive therapy as well as 6 children still in induction. This result must be compared with 6% survival in a similar group diagnosed at the same institutions and treated with conventional chemotherapy before the onset of this trial. PMID- 3306134 TI - [Use of digital subtraction angiography in localizing an anomalous pulmonary vein return in a case of congenital shunt disease]. AB - The exact analysis of an anomalous pulmonary venous return in patients with congenital shunt disease can lead to some difficulties when using the standard catheterization techniques. A left-sided anomalous pulmonary vein was suspected in a case with atrial and ventricular septal defects, but could not be evaluated during the catheterization procedure. The pathological vessel could be demonstrated exactly only by venous digital subtraction angiography. Thus, the digital subtraction angiography showed a diagnostic benefit in this complex shunt disease and should be considered in further problematic cases. PMID- 3306133 TI - Cell-mediated autoimmunity at the onset of insulin-dependent diabetes mellitus (IDDM). AB - Peripheral blood lymphocytes have been investigated in 20 newly diagnosed type-I diabetics and 10 healthy subjects using monoclonal antibodies. Mononuclear cells were marked with anti-T-lymphocytes (Leu2, 3, 4, 12) and anti-Ia-antibodies (K14, L243) using indirect immunofluorescence. The percentage of circulating K14- and L243-positive cells was significantly higher in all diabetics than in normal controls. An increase in the number of K14-bearing cells was found in newly diagnosed patients with duration of less than 7 days (n = 10) compared with diabetics of longer duration (1 to 8 months; n = 10). Using dual-color immunofluorescence with fluorescein-conjugated anti-T-lymphocytes and rhodamin conjugated anti-Ia-antibodies it was not possible to identify Ia-antigen bearing cells (Ia cells) as helper or suppressor lymphocytes. In addition, there was no significant difference in the number of Ia cells in diabetics with and without islet cell antibodies. It is concluded that there is evidence of activation of cellular immune response in type I diabetes, particularly in the early days of manifestation. However, previous assumptions that Ia cells represent T-cell activation have to be questioned. PMID- 3306135 TI - [Reversible azathioprine associated dysmyeloproliferative syndrome after kidney allotransplantation]. AB - Three recipients of kidney allotransplants developed dysmyeloproliferative syndromes which were fully reversible after switching from azathioprine to cyclosporin A for immunosuppression. Similar bone marrow changes described in the literature progressed to leukemia. Whether the abnormalities observed in our patients could be early stages of the disease described in the literature and whether a fatal development can be prevented by changing the immunosuppressive therapy remains to be elucidated. PMID- 3306136 TI - Proteases and antiproteases related to the coagulation system in plasma and ascites--influence of dexamethasone. AB - Fibrinolysis induced by the infusion of plasminogen activators into the circulation has been shown to cause coagulation disorders in ascites retransfusion. Dexamethasone is known to inhibit the synthesis of plasminogen activators by peritoneal macrophages. We therefore assessed its potential in preventing the occurrence of fibrinolysis by injecting 16 mg dexamethasone intraperitoneally in 10 patients 24 h before ascites retransfusion was performed. In addition, the effect of dexamethasone upon the activity or concentration of several proteases and antiproteases related to coagulation in plasma and ascites was analyzed on 15 occasions. An increase of the activity of plasminogen, alpha 2 antiplasmin, and antithrombin III, and in the concentration of alpha 1-protease inhibitor in ascites was induced by the dexamethasone injection. However, the reaction was not identical in all patients. Those patients having an increase of plasminogen activities of 0.6 CTA U/ml or more did not show signs of fibrinolysis during retransfusion. The results obtained indicate that intraperitoneal injection of dexamethasone decreases the concentration of plasminogen activators in ascites and thereby reduces the risk of coagulation disorders during retransfusion procedures. Since the effect is variable and not sustained, assessment of preoperative plasminogen concentrations is mandatory in order to prevent complications. PMID- 3306137 TI - A reliable method for immunocytochemical characterization of CSF cells. AB - A technically convenient and reliable method for immunoenzymatic staining of cerebrospinal fluid (CSF) cells is described. Compared with immunofluorescence techniques this method has the advantage that the immunocytochemical preparations can be counterstained and stored indefinitely. PMID- 3306138 TI - Natural IFN-alpha therapy in hairy-cell leukaemia (namalva-type IFN--Wellferon). AB - More than 50 patients with hairy-cell leukaemia have now been entered into the British Wellferon (IFN) study, at different centres under the coordination of the Wellcome Research Laboratories. While the treatment duration and dosage varied between patients, the initial dose was usually 3 megaunits daily by intramuscular or subcutaneous injection. Although flu-like symptoms and mild somnolence were commonly experienced side-effects; cessation of IFN treatment as a result of such effects was necessary in only three patients. All patients irrespective of previous treatment showed some response and a complete (less than 5% hairy cells, HCs) bone marrow response was observed in 17. The degree of response was related to the duration of therapy. Immunological markers showed that there was no apparent increase in natural killer (NK) cells and no return of normal B lymphocytes. Light-chain-restricted B cells became reduced in parallel with the disappearance of morphological HCs. Absolute numbers of T cells were reduced, Leu2a+ preferentially, resulting in an increase in helper/suppressor ratios. The ratios (saturation index, SI) of saturated to unsaturated 18 carbon fatty acids (C18FA) of erythrocyte or leukocyte membranes, while abnormal in untreated patients, approached normal levels during IFN therapy. It is concluded that prolonged alpha IFN therapy is highly effective in HCL. The mechanism of action of IFN remains unknown, but indirect surface-marker data favours a direct effect on HCs. PMID- 3306139 TI - [Beta interferon therapy in hairy cell leukemia]. AB - Eleven patients with histologically proven hairy-cell leukemia were treated for 2 to 6 months with a natural beta-interferon (beta-IFN) preparation (3 X 4 million units week i.v.). Three of the eight evaluable patients experienced a partial response, two a minor response, and three no improvement. A reduction of the hairy-cell infiltration of the bone marrow was observed in one patient. Typical IFN side-effects with flu-like symptoms were noted. These results demonstrate that IFN-beta has some clinical efficacy in hairy-cell leukemia. PMID- 3306140 TI - [General symptomatology of enteritis and colitis (the 90th anniversary of presenting enteritis as a separate clinical entity]. PMID- 3306141 TI - [Peptic ulcer and hereditary constitutional factors]. PMID- 3306142 TI - [Cimetidine treatment of gastroduodenal erosions and ulcers]. PMID- 3306143 TI - [Ultrasonic examination of the stomach]. PMID- 3306144 TI - [V. P. Obraztsov (on the centenary of description of methodical deep sliding palpation of the abdominal organs]. PMID- 3306145 TI - Animal research protocol review in the Veterans Administration. PMID- 3306146 TI - Animal Care and Use Committees: history and current national policies in the United States. PMID- 3306147 TI - Case studies of ethical dilemmas: Animal Care and Use Committee. PMID- 3306148 TI - Carbohydrate abnormalities of N-linked plasma glycoproteins in liver disease. AB - Glycoproteins are proteins with covalently attached carbohydrate which is enzymatically added during the biosynthesis of the polypeptide. Attachment of carbohydrate to the polypeptide may involve either an N-glycosidic or an O glycosidic bond. Most of the plasma glycoproteins have N-linked oligosaccharides attached to appropriate asparagine moieties of the peptide core. The biosynthesis of the N-linked glycoproteins proceeds through three sequential phases which include (a) dolichol-mediated oligosaccharide assembly, (b) oligosaccharide linkage to the polypeptide, and (c) oligosaccharide processing with the addition of peripheral sugars. Much of the diversity in carbohydrate structure of plasma glycoproteins results from variations in processing and addition of peripheral sugars. The terminal monosaccharide of N-linked plasma glycoproteins is usually sialic acid, a negatively charged sugar which markedly affects the physicochemical and biologic characteristics of glycoproteins. Liver disease induces alterations in both the level and structure of many plasma glycoproteins, particularly those which are synthesized by the hepatocyte. Quantitative changes in the concentration of plasma glycoproteins are relatively easy to assess due to the availability of many types of clinical assays. Furthermore, quantitation of the level of a particular glycoprotein in the plasma often provides clinically useful information pertinent to diagnosis and progression of disease. The determination of functional abnormalities of glycoproteins and the correlation of these functional changes with potential alterations in carbohydrate structure is more difficult, however, due to the need for accurate functional assays and sophisticated methods for analysis of the carbohydrate structure of the abnormal molecules, which are themselves often scarce. Liver disease-induced alterations in the oligosaccharide moieties of plasma glycoproteins involve mainly hyperglycosylation or hypoglycosylation defects. These changes can often be traced to increases or decreases in the amount of sialic acid present within the abnormal structure. Since sialic acid plays such a key role in the biology of glycoproteins, changes in the amount of this monosaccharide frequently result in marked alterations in the physicochemical and biologic behavior of the abnormal molecule. The exact mechanisms responsible for the changes in sialic acid are not entirely known, since the complete oligosaccharide structure of any of the abnormal glycoproteins of liver disease has not been determined.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306149 TI - The role of mesangial complement in the hematuria of experimental IgA nephropathy. AB - We sought to determine if codeposits of IgG and IgM and glomerular complement, observed in most cases of human IgA nephropathy, might be important for inducing hematuria. All combinations of three binary variables, the protein immunogen, the duration of oral immunization, and the protein used for intravenous challenge, were accommodated by eight groups of BALB/c mice in an active model of IgA nephropathy. Mice drank 0.1% solutions of either of two proteins for either 6 or 14 weeks, and then were challenged intravenously with either the same protein or the alternate protein. After 6 weeks, all mice had significant increases of serum IgA, IgG, and IgM antibody to the oral immunogen. At 14 weeks, IgG and IgM antibodies were reduced, presumably due to the onset of oral tolerance, but IgA titers persisted. Nearly all mice had mesangial deposits of IgA and oral immunogen. However, only mice immunized for 6 weeks and challenged with the same protein had significant IgG and IgM deposits (100%), C3 deposits (76%), and significant microhematuria. To distinguish between the role of IgG/IgM codeposits and C3 in the pathogenesis of the hematuria, we induced passive IgA nephropathy with immune complexes of monoclonal IgA anti-dinitrophenyl antibody, dinitrophenyl-bovine albumin as antigen, and one of two monoclonal IgG antibodies specific for dinitrophenyl; one of the IgGs fixes complement, the other does not. Despite comparable mesangial deposits of IgA, IgG, and antigen, only mice given immune complexes containing the complement-fixing IgG had glomerular C3 and hematuria. Furthermore, when mice depleted of serum complement via cobra venom factor were given immune complexes containing the complement-fixing IgG, no glomerular complement was observed and no hematuria ensued. We conclude that IgG/IgM codeposits in murine IgA nephropathy do not directly cause hematuria but do induce the deposition of complement, which is in turn required for glomerular injury. PMID- 3306150 TI - Clip-ablation. A model of experimental hypertension in the rat. AB - A model of experimental hypertension has been developed in which the features of the two kidney-one clip and renal ablation models are combined in a single rat. It has been designated the clip-ablation model. It is produced by the placement of a silver clip with an opening of 0.13 mm on a branch of the left renal artery supplying one-third of that kidney, followed by right nephrectomy. In this way the effects of renin-dependent hypertension may be studied in glomeruli which are undergoing compensatory changes in response to reduction in renal mass. Clip ablation rats were compared to rats with 1 1/3 reduction of renal mass at various intervals up to 28 days after operation. Systolic blood pressure rose with increasing time after operation in both groups with the increase being greater in the clip-ablation rats (177 +/- 10 mm Hg) as compared to the ablation rats (153 +/- 6 mm Hg) at 28 days. Plasma renin activity was increased slightly at 3 days in the ablation rats but had returned to normal levels by 28 days. By contrast, the plasma renin activity rose throughout the experimental period in the clip ablation rats and attained a level of 32.3 +/- 8.0 ng/ml/hour by 28 days. Urine protein was significantly higher than normal only in the 28-day clip ablation rats (71.2 +/- 23.9 mg/24 hour). Glomerular damage index (GDI), a measure of glomerular injury, increased with longer intervals from operation in both experimental groups, paralleling the rise in systolic blood pressure. Beginning on day 14 and onward the GDI was always numerically higher in the clip-ablation rats than in the ablation rats. Stepwise multiple regression analysis indicated that the strongest predictor of GDI was the change in blood pressure. Plasma renin activity had an additional independent effect on GDI in the clip-ablation rats. The finding of more glomerular damage in the clip-ablation rats than in those with simple removal of comparable amounts of renal tissue is in contrast to the lesser amount of damage found in the two kidney-one clip model when compared with the model of removal of renal substance. It is likely that the compensatory hemodynamic changes in response to reduction in renal mass in the glomeruli of clip-ablation rats make them more vulnerable to injury when exposed to a renin angiotensin induced hypertension. PMID- 3306151 TI - Comparative evaluation of some enzymic digestion procedures in the release of basic drugs from tissue. AB - The relative efficiency of four enzymic-digestion procedures in the release of eight basic drugs from tissue has been studied. Enzymes employed include: subtilisin Carlsberg, trypsin, papain, and neutrase. The results obtained on recovery show that papain digestion gives highest recovery for most of the drugs studied. Papain is suggested as the enzyme of choice. The application of neutrase, a neutral proteinase from B. subtilis, is reported for the first time. PMID- 3306152 TI - Serotonin release is mediated by muscarinic receptors on duodenal mucosal cells. AB - Serotonin (5-HT), found in abundance in intestinal enterochromaffin cells, has been shown to be released in response to neural, humoral, and intraluminal stimuli but the mechanisms controlling release are poorly understood. The purpose of this study was to determine whether 5-HT release induced by the muscarinic agonist, methacholine, is mediated by enteric nerves or is a direct action at the mucosal cell level. We mounted rabbit mucosal sheets containing intact submucosal neural elements, but stripped of muscularis propria and myenteric plexus, in modified Ussing chambers and measured the release of 5-HT in response to 5 X 10( 5) M methacholine added to both mucosal and serosal surface bathing solutions, in the presence and absence of selective neural blockade with 1 X 10(-6) M tetrodotoxin. 5-HT release in control tissues (no drugs) as measured by radioimmunoassay was 25.7 +/- 6 ng/cm2/30 min (mean +/- SEM). In the presence of mucosal and serosal methacholine, total 5-HT release increased significantly (P less than 0.05) to 66.7 +/- 9 ng/cm2/30 min. When tetrodotoxin alone was applied, 5-HT release significantly increased to 55.2 +/- 9 ng/cm2/30 min compared to matched control. In the presence of tetrodotoxin, methacholine increased 5-HT release to 79.3 +/- 9 ng/cm2/30 min, which was significantly greater than with tetrodotoxin alone. These results provide evidence of an inhibitory neural regulation of basal 5-HT release since release increased in the presence of neural blockade. They also suggest that a muscarinic receptor at or near the enterochromaffin cells mediates mucosal 5-HT release since 5-HT is further increased by methacholine even in the presence of neural blockade. PMID- 3306153 TI - Animal models of pigment gallstone disease. PMID- 3306154 TI - Factors influencing enlargement rate of small abdominal aortic aneurysms. AB - The purpose of this study was to determine the factors influencing enlargement rate of small abdominal aortic aneurysms. Fifty-seven high-risk patients with asymptomatic abdominal aortic aneurysms initially measuring 3.5 to 5.9 cm in the largest transverse diameter were followed with serial echographic measurements for 6 to 78 months (mean 24). The mean enlargement rate (MER) and the occurrence of sudden change in size (SCS) for each aneurysm were correlated to 23 variables. MER ranged from 0 to 1.8 cm/year (mean 0.48). During the study period 17 aneurysms showed SCS. The results of univariate analysis indicated that 8 variables were statistically correlated to the degree of MER and 5 to the occurrence of SCS. A multiple regression model was generated by stepwise regression analysis and demonstrated that 2 variables were independent predictors of the degree of MER: (1) the absence of distal arterial occlusive disease and (2) the ratio of the diameter of the aneurysm to that of the aorta (RD). The overall model P value was less than 0.001. A statistically valid multiple regression model to predict the occurrence of SCS was not feasible (P = 1.0). We conclude that the occurrence of SCS of small abdominal aortic aneurysms is often unpredictable and that the RD rather than the value of the aneurysmal diameter per se must be considered in selecting high-risk patients for echographic follow up. PMID- 3306157 TI - Tennessee Dental Association. Directory and membership roster 1987-1988. PMID- 3306156 TI - Non-surgical periodontal therapy for AIDS patient with periodontal involvement. A periodontal case management in a general practice. PMID- 3306155 TI - Insulin response following intravenous glucose administration in dogs with obstructive jaundice. AB - In order to further clarify the circulating insulin kinetics in obstructive jaundice, five anesthetized dogs were given a 15-min intravenous infusion of 1 g/kg glucose before and during the first 1 to 2 weeks after a common bile duct ligation. Significantly higher blood glucose levels, a lower insulin response in femoral vein blood, and a lower initial insulin response in portal vein blood were observed following glucose administration in the animals with jaundice. The ratio of (integrated portal insulin response-integrated femoral insulin response)/(integrated portal insulin response) was significantly increased in the animals with jaundice when compared with that of the control animals. These results suggest that a low peripheral insulin response following glucose administration in obstructive jaundice is induced by an augmented insulin extraction in the liver and/or peripheral tissue as well as by an insulin hyposecretion from the pancreas. PMID- 3306159 TI - Adjuvant chemotherapy in high-risk malignant melanoma. AB - Fifty-nine patients with regional or hematogenous recurrence of malignant melanoma following resection of all the gross tumor were randomized to observation or chemotherapy. The chemotherapy consisted of BCNU 80 mg/M2 I.V. every 4 weeks, actinomycin-D 0.01 mg/kg and vincristine 1.0 mg/M2 I.V. every 2 weeks, for a total of 6 months. The chemotherapy protocol was tolerated well without appreciable objective side effects. At a median follow-up period of 11.5 months, the disease-free survival time for the chemotherapy treated group is significantly longer than for the control group (P = 0.01). The estimated median disease-free survival time is 4 months in the surgical control group and 9 months in the chemotherapy group. At present, the proportion of patients remaining disease-free is 43% for the surgical control and 55% for the chemotherapy treated group. More patients and follow-up are needed, but this preliminary report suggests that nitrosourea-based protocols need to be evaluated further as adjuvant treatment of malignant melanoma. PMID- 3306160 TI - A model for the control of testosterone secretion. AB - We produce here a model to explain the control of testosterone secretion. In this model the hypothalamic secretion of the hormone LHRH (luteinizing hormone releasing hormone) is controlled by a combination of local testosterone concentration and of the local concentration of the pituitary hormone LH (luteinizing hormone). Since LHRH stimulates the release of LH, and LH in turn stimulates the release of testosterone, the three hormones constitute a three component "feedback" network. We show how this model is able to account for the pulsatility of the release of these three hormones. Furthermore, the model is consistent with results obtained from a wide range of experimental manipulations of the system. For example, it accounts for the changes observed in hormone release patterns after castration. In particular, it follows that no "neural clock", or "neural pulse-generator", is required to force the system into pulsatile behaviour. PMID- 3306158 TI - Triple lumen venous access for pediatric bone marrow transplantation candidates. AB - Multiple routes of vascular access are required in children undergoing bone marrow transplantation to facilitate total parenteral nutrition (TPN); blood withdrawal; and administration of blood products, antibiotics, fluids, and immunosuppressive drugs. Placement of multiple catheters frequently requires multiple venotomies in separate vessels. We have found that both a Broviac catheter and pediatric dual-lumen Raaf catheter can be placed through separate venotomies in the external jugular vein, which provides sufficient routes of vascular access without complications. This technique places only one vessel at risk while minimizing the chance for infection by utilizing two exit sites. We consider this to be the procedure of choice in young patients requiring multiple routes of vascular access. PMID- 3306161 TI - Probing into the mechanism of action, metabolism and toxicity of gossypol by studying its (+)- and (-)-stereoisomers. AB - The chemistry of gossypol is very relevant to its unique actions. The two aldehyde groups can easily bind to proteins via aldehyde-amino group linkage. Gossypolone, the in vivo oxidation product of gossypol, may form a redox system with its corresponding hemiquinone, leading to free radical generation. There are marked differences in the disposition and metabolism between (+)- and (-) gossypol. The elimination half life of (+)-gossypol was much longer than that of (-)-gossypol. The higher rate of elimination of (-)-gossypol may be due to its lower rate of binding to tissue proteins, since the Vd of (-)-gossypol was much smaller than that of the (+)-isomer. A single intratesticular injection of 200 micrograms of (-)-gossypol caused a 70.4% decrease of the sperm count along with marked atrophy of the testes. However, neither a significant decrease in sperm count nor atrophy of the testes was observed after a similar injection of (+) gossypol, suggesting that there is a strict stereochemical requirement for the interaction between gossypol and the testicular target molecules. Racemic gossypol stimulated superoxide free-radical formation when incubated with either rat liver or kidney microsomes, but not with those of the heart or testes. Pretreatment with phenobarbital potentiated this effect in liver microsomes, while incubation with metyrapone decreased in renal microsomes. Both (+)- and (-) gossypol exhibited similar potencies in renal or hepatic microsomes in vitro. At 100 mg/kg, both (+)- and (-)-gossypol were able to cause increases in SGPT in rats 12 and 24 h following the administration. The equipotency between the two isomers in causing toxic effects to some of the somatic tissues and the stereo selectivity of (-)-gossypol to induce antispermatogenic effects indicate that gossypol may actually exhibit two categories of cytotoxic effects to different organs and tissues. This suggests that one may be able to eliminate one effect while keeping the other. PMID- 3306162 TI - Histologic assessment of bronchial anastomotic healing in canine lung transplantation. AB - Postoperative wound healing of the bronchial anastomosis was studied in dogs with autotransplantation (20 dogs, 7 days to 6 years postoperatively) and allotransplantation (62 dogs, 5 to 174 days postoperatively) of the left lung. In the group undergoing lung allotransplantation, the relationship among three histologic parameters was studied: the grade of lung allograft rejection, the degree of changes in the epithelium, and submucous lymphocyte infiltration along the donor bronchus within approximately a 0.5 cm area distal to the anastomosis. In lung autotransplantation, mucosal continuity began to be observed 1 week postoperatively. Mucosal continuity and apparent collagen formation on any bronchial contiguous site were demonstrated in most animals studied more than 3 weeks postoperatively. Bronchial anastomotic healing tended to be slower in lung allotransplantation than in autotransplantation, although a mucosal continuity at the anastomosis was sporadically observed in immunosuppressed dogs surviving more than 3 weeks postoperatively with a lung allograft. There were significant rank correlations among the three histologic parameters, which showed that lung allograft rejection is closely connected with wound healing of the bronchial anastomosis in lung allotransplantation. Meticulous mucosal approximation is most necessary during bronchial anastomotic procedures. Establishment of an exact method for early monitoring of lung allograft rejection is absolutely necessary for lung allotransplantation. PMID- 3306163 TI - Predictors, prevention, and long-term prognosis of atrial fibrillation after coronary artery bypass graft operations. AB - Multiple trials have suggested the use of digoxin, digoxin and propranolol, or timolol to prevent atrial fibrillation after coronary artery bypass grafting. No trial has evaluated the efficacy of digoxin verus propranolol. Furthermore, the predictors of postoperative atrial fibrillation and the long-term consequence of atrial fibrillation that reverts to sinus rhythm have not been established. One hundred fifty patients were randomized to receive no drug, propranolol (20 mg every 6 hours), or digoxin (0.5 mg followed by 0.25 mg daily). Twenty-seven patients were excluded from data analysis. In the remaining 123 patients, no preoperative parameter (age, sex, diabetes, hypertension, smoking, electrocardiographic p wave morphology, or preoperative digoxin or propranolol therapy), intraoperative parameter (bypass time, aortic cross-clamp time, or number of vessels bypassed), or postoperative parameter (peak creatinine kinase, congestive heart failure, or pericarditis) by univariate or multivariate analysis predicted patients at risk for atrial fibrillation. Sustained atrial fibrillation developed in 37.5% of control and 32.6% of digoxin-treated patients. Only 16.2% of propranolol-treated patients had sustained atrial fibrillation (p less than 0.03). There were no in-hospital complications in those patients with atrial fibrillation. After 26 +/- 7 months follow-up, those patients with postoperative atrial fibrillation had no increased incidence of angina, cerebral vascular accident, myocardial infarction, or sudden death. Therefore, in this select population, propranolol prophylaxis is effective but discretionary. PMID- 3306165 TI - Migration of temporary epicardial pacer wire fragment retained after a cardiac operation. AB - Reported complications of retained temporary epicardial pacer wires after cardiac operations have been confined to infections. We report the migration of the retained fragment into the free peritoneal cavity after 6 years of stability in the precordium. PMID- 3306164 TI - A surgical preparative technique for coronary bypass grafts of human saphenous vein which preserves medial and endothelial functional integrity. AB - Measurements of adenosine triphosphate concentration and adenosine triphosphate/diphosphate ratio provided quantitative markers for medial integrity and stimulated (vortex-mixing) prostacyclin production for endothelial function. Freshly isolated vein had an adenosine triphosphate concentration of 470 +/- 60 nmol X gm-1 wet weight and an adenosine triphosphate/diphosphate ratio of 2.50 +/ 0.13; it produced prostacyclin at a rate of 9.3 +/- 1.0 pg X min-1 X mg-1 wet weight. Vein subjected to dissection, proximal anastomosis, and distention with the patient's own arterial pressure had an adenosine triphosphate concentration of 490 +/- 70 nmol X gm-1 wet weight and an adenosine triphosphate/diphosphate ratio of 2.29 +/- 0.13; it produced prostacyclin at a rate of 10.4 +/- 2.2 pg X min-1 X mg-1 wet weight. All values were indistinguishable from those in freshly isolated vein. In vein subjected to dissection, distention at less than 300 mm Hg with patient's heparinized blood, and distal anastomosis, adenosine triphosphate concentration, adenosine triphosphate/diphosphate ratio, and prostacyclin production (5.5 +/- 0.6 pg X min-1 X mg-1 wet weight) were all significantly (p less than 0.001) reduced. These results demonstrated that surgical preparation by first proximal anastomosis preserved both medial and endothelial function. PMID- 3306166 TI - Mucoepidermoid bronchial adenoma in a 6-year-old girl: a case report and review of the literature. AB - A rare case of a mucoepidermoid bronchial adenoma discovered in a 6-year-old girl with recurrent pneumonia is presented. A review of the literature suggests that less than 15 cases in the pediatric age group have been reported. Although primary lung carcinomas are rare in children, this case illustrates that recurrent lobar pneumonia in children should be aggressively investigated and that the proper therapy is conservative surgical resection. PMID- 3306167 TI - Chromosome studies of hematopoietic colonies for distinct diagnosis of megakaryoblastic crisis of chronic myelogenous leukemia: a case report. AB - Chromosome studies of cells from megakaryocytic colonies (CFU-Meg) as evidenced by a megakaryocyte-specific monoclonal antibody, TP80, from a patient with chronic myelogenous leukemia (CML) in the blast crisis (BC) revealed the same aberrant karyotype, 52,XY,+9,+9,+18,+19,+21,+22,t(9;22)(q34;q11),t(9;22), as that having newly appeared in the peripheral blood. Cells from erythroid bursts (BFU E) showed only the standard 46,XY,t(9;22) karyotype, and cells from granulocyte/macrophage colonies (CFU-GM) had either of these karyotypes. These results demonstrated that the whole megakaryocytic line and part of the granulocyte/macrophage line had been involved in the BC while the erythroid line totally belonged to the original clone. Chromosome analysis coupled with immunophenotyping of hemopoietic colonies was useful for a definite diagnosis of megakaryoblastic crisis of CML in this patient. PMID- 3306168 TI - Balloon-like platelets in myelodysplastic syndromes--a feature of dysmegakaryopoiesis? AB - Large bizarre platelets are a frequent finding in the peripheral blood of the myelodysplastic syndrome (MDS). In this study we describe a distinct subpopulation of platelets in MDS which by phase contrast microscopic examination seems to have a balloon-shaped bulge of the cell membrane. Increased numbers of these atypical platelets were found in 24 of 27 MDS patients (89%). Only 3 patients, all with ringsideroblastic anemia, had normal platelet morphology. The number of atypical platelets were negatively correlated (r = 0.44; p = 0.021) to the peripheral platelet counts in MDS. Among 48 patients with acute leukemia, chronic lymphoproliferative or chronic myeloproliferative disorders, 13 (27%) had atypical platelets. Here, but not in the MDS group, atypical platelets seemed to be associated with recent chemotherapy. In a group of patients with benign hematological disorders abnormal platelet morphology was seen only occasionally. The described atypical platelets most likely reflect maturation disturbances of the megakaryopoiesis. An increased value (greater than 1%) in a cytopenic patient would suggest a diagnosis of MDS, unless associated with recent cytotoxic therapy. PMID- 3306169 TI - A two-step t(4;der(15)) t(15;17) complex translocation in an acute promyelocytic leukaemia and review of the literature. PMID- 3306170 TI - Feasibility of electrical recordings from unconnected vertebrate CNS neurons cultured in a three-dimensional extracellular matrix. AB - Single, i.e. unconnected spinal or cerebral neurons from chick embryos rapidly regenerate morphologically identifiable axons and dendrites when cultured in a three-dimensional (3-D) extracellular matrix (ECM) consisting of a hydrated native collagen lattice. We now show that it is possible to study the intrinsic electrophysiological properties of such neurons as early as 2 days in culture. Cells were plated at 10(5) cells/dish using Medium 199 containing 10% fetal calf serum but no other supplements or antibiotics-antimycotics. A patch-clamp/whole cell voltage clamp system was used to record single-channel currents from cell attached patches, transmembrane potentials during the injection of rectangular currents, and whole-cell currents during voltage clamp. After 2-4 days in culture, isolated cerebral and spinal neurons exhibited single-channel currents. Within 7 days, rectangular currents injected through the recording electrode evoked action potentials. These results demonstrate that unconnected CNS neurons quickly display at least some properties of excitability when cultured in a 3-D ECM. This culture system should facilitate investigation of intrinsic electrical properties of single CNS neurons, and how extrinsic factors including neurotransmitters, hormones, pharmacological agents and contacts with other cells influence electrical activity. PMID- 3306171 TI - An in vitro slice preparation of the cat lateral geniculate nucleus. AB - A slice preparation of the cat thalamus containing the lateral geniculate nucleus and the terminal portion of the optic tract is described. Ultrastructurally the slices remain relatively normal for only a short time after cutting. Indeed most cellular elements deteriorate quickly with time but patches of relatively intact tissue were still present even 10 h after cutting and maintenance in a storage bath. However, for 4-5 h after cutting long-lasting intracellular recordings of high quality and stability were obtained, and intrasomatic injection of horseradish peroxidase used for the morphological identification of recorded neurones as X or Y cells. PMID- 3306172 TI - Non-pharmacological effects of the use of microelectrophoresis and pressure ejection of drugs in combination. AB - Pressure ejection of physiological saline from multibarrel micropipette assemblies has been shown to selectively reduce responses of rat spinal cord neurones to electrophoretic ejection of kainate, N-methyl-aspartate and 4-methyl homoibotenate, but not of quisqualate or L-glutamate. Reduction of response to an excitatory amino acid therefore appears to be correlated with the absence of an active transport system for that amino acid. PMID- 3306173 TI - A method for automatic classification of large and small myelinated fibre populations in peripheral nerves. AB - The statistical analysis of morphometric data collected from biopsies of human superficial peroneal nerve is complicated by the heterogeneity of the population of myelinated fibres. In order to make separate statistical analyses of the subpopulations of large and small fibres we have developed a computer program (written in PASCAL) for their automatic separation. The method is based on a dynamic centres clustering algorithm and was applied to the multifactorial space defined by the principal component analysis of the morphometric variables: axonal diameter, myelin sheath thickness, circularity index and g-ratio. The classification technique was applied to measurements obtained from 5 control nerves, and to simulated data, and in each case it gave consistent Gaussian subpopulations with no need for the introduction of supplementary variables. PMID- 3306174 TI - A simple device for the computer quantification of depth measurements in thick light microscope sections. AB - The use of computerized techniques to characterize quantitatively the anatomy of individual neurons has been increasing. One difficulty has been the quantification of the z-axis or depth measurements within thick light microscopic sections. In the present report we describe a simple device which employs an incremental optical encoder to transduce the movements of the focusing knob of the microscope so that depth information can be recorded directly by a computer. A resolution of 0.13 micron over a range of approximately 8.5 cm is achieved. The mechanical interface to the microscope is simple and applicable to a wide variety of microscopes. Interfacing circuits which allow the optical encoder to be used with an IBM-PC compatible computer are presented and described. The accuracy of the depth measurements is limited only by the mechanical tolerances of the focusing mechanism and by the optics of the microscope. PMID- 3306175 TI - Tumor necrosis factor induced stimulation of granulopoiesis and radioprotection. AB - Human recombinant tumor necrosis factor, TNF, was used to assess its ability to stimulate granulopoiesis and to protect mice against lethal irradiation, effects known to be inducable with TNF-rich postendotoxin serum from BCG infected mice (BCG/ET serum). Although the endotoxin contamination of this TNF preparation is extremely low its effects were compared in endotoxin low responder C3H/HeJ mice and susceptible NMRI mice. TNF is a potent inducer of serum colony stimulating activity, CSA, in both mouse strains. In peripheral blood a marked granulocytosis with a concomitant decrease in lymphocytes and monocytopenia occurs at 2 hours after injection of TNF. Moreover, TNF induces an increase in the number of splenic myelopoietic committed stem cells (GM-CFC, granulocyte-macrophage colony forming cells) determined five days after injection. The lethality rate, registered over 30 days after exposure to 660 cGy whole body X-irradiation is reduced to 40% in C3H/HeJ mice as compared to 75% in control animals. The reduction in lethality is observed both, when TNF was injected 24 hours before or after irradiation. In vitro, TNF significantly increases the number of colonies in the presence of CSA in bone marrow cultures. TNF per se does not effect colony growth. The studies reported here demonstrate that TNF is a myelopoiesis stimulating factor in mice which may be related to the reduction in lethality following whole body irradiation. PMID- 3306176 TI - Whole-body exposure to ultraviolet radiation results in increased serum interleukin-1 activity in humans. AB - Human volunteers given one minimal erythemal dose of ultraviolet radiation (UVR) from fluorescent sunlamps developed increased serum interleukin-1 (IL-1) activity as assessed by the thymocyte co-stimulator assay. This activity peaked 1 to 4 hours after exposure and returned to baseline by 8 hours after exposure. Six to 12 months later, some of the same subjects had blood samples taken over the same time course but without exposure to UVR; no elevation in serum IL-1 was observed. In addition to lymphocyte activating activity, IL-1 has been reported to have endogenous pyrogen activity, chemotactic activity for neutrophils and mononuclear cells, and inflammatory activity when injected subcutaneously in vivo. Elevations in serum IL-1 activity after exposure to ultraviolet radiation may account for some of the manifestations of the sunburn response. PMID- 3306177 TI - Growth factor, viruses, and oncogenes in human lymphoid neoplasia. PMID- 3306178 TI - Magnesium as a regulatory cation: criteria and evaluation. AB - Of the two major intracellular divalent cations, Ca2+ has been studied much more extensively than Mg2+ and is now well accepted as a major intracellular regulator. This review focuses instead on some recent advances in the understanding of the physiology and biochemistry of Mg2+. For purposes of discussion, four criteria have been developed that should be fulfilled if Mg2+ is to be accepted as an important intracellular regulatory cation: cellular processes must exist which are sensitive to free Mg2+ within the physiological concentration range; a (transport) mechanism(s) must exist which is capable of altering free Mg2+ concentration within a cell; if Mg2+ is compartmented within cells, any potentially regulated system or process and any change in intracellular free Mg2+ concentration must be shown to occur within the same compartment; and any change(s) in free Mg2+ concentration and any alteration(s) in a Mg2+-sensitive process must occur in a sequential manner. These criteria are largely but not completely met at the present time. Criteria 1 and probably 2 can be shown in at least some systems to be fully met. Criteria 3 and 4 are partially met but neither can be fully examined until methods for measuring intracellular free Mg2+ concentrations on an appropriate time scale are further developed. Thus, there exists strong but as yet incomplete evidence that Mg2+, like Ca2+, can play an active, regulatory role within cells. Finally, it is suggested that Ca2+ plays the specific role of the acute, transient regulatory element while Mg2+ plays the complementary role of a more long-term regulatory element which controls the set point or gain of a system or process. PMID- 3306180 TI - Graded exercise testing and training after renal transplantation: a preliminary study. AB - Aerobic exercise training has been used as part of the treatment for a variety of chronic disorders, most notably cardiovascular disease. In order to determine the feasibility and utility of regular exercise after renal transplantation, the responses of 10 patients to graded exercise testing were compared before training (T1), immediately after a program of supervised exercise training (T2), and a mean of 2.2 years after completion of the supervised program (T3). Supervised exercise sessions began a mean of 17 days postoperatively and continued for a mean of 5.5 weeks. Patients were encouraged to continue regular unsupervised exercise thereafter. All patients easily tolerated the supervised exercise sessions, which consisted of treadmill walking and cycle ergometry. Exercise capacity improved 90% between T1 and T2 and an additional 12% between T2 and T3. On the average, patients achieved a normal exercise capacity by 8 weeks after transplantation. Of the 10 patients, 7 had continued regular exercise training at T3. The observed increase in aerobic exercise capacity was probably related to improved renal function, an increased hemoglobin concentration, and the surgical healing process as well as the exercise training. We conclude that supervised exercise training for selected patients after renal transplantation is feasible and worthwhile. PMID- 3306179 TI - Magnesium and pregnancy. AB - Human pregnancy is characterized by several cardiovascular changes, among them a 50% increase in cardiac output, a decrease in the systemic vascular resistance, a 40% blood volume expansion, a decrease in mean arterial blood pressure and a 10 15 beats/min increase in heart rate. It is possible that alterations in magnesium metabolism may be responsible for some of the physiological changes seen during pregnancy and in many diseases related to cardiovascular abnormalities. Magnesium (Mg2+) has been used extensively in obstetrics for the treatment of alterations of uterine contractility (premature labor) or increased neuronal and vascular smooth muscle activity (pre-eclampsia). This review focuses on some of the alterations seen in Mg2+ metabolism during pregnancy. In addition, some of the problems regarding Mg2+ metabolism and parenteral administration of Mg2+ in the treatment of pre-eclampsia and eclampsia are discussed. The use of Mg2+ during labor and as prophylaxis to prevent rupture of membranes and premature labor are also reviewed and discussed. PMID- 3306181 TI - The penicillins. AB - The penicillin family of antibiotics is ever expanding and remains an important part of our antimicrobial armamentarium. These medications generally have bactericidal activity, excellent distribution throughout the body, low toxicity, and efficacy against infections due to susceptible organisms. The clinical introduction of aqueous penicillin G for treatment of streptococcal and staphylococcal infections was an important pharmacologic landmark. The emergence of penicillinase-producing staphylococci prompted the development of the penicillinase-resistant penicillins (methicillin, oxacillin, nafcillin, and others), in which the acyl side chain prevented disruption of the beta-lactamase ring. The aminopenicillins (ampicillin, amoxicillin, and others) were later developed because of the need for gram-negative antimicrobial activity. Their spectrum included Escherichia coli, Proteus mirabilis, Shigella, Salmonella, Listeria, and Haemophilus. The search for a penicillin with even further antimicrobial activity against the Enterobacteriaceae and Pseudomonas aeruginosa led to the development of the carboxypenicillins, ureidopenicillins, and piperazine penicillins. Recently, the combination of a beta-lactamase inhibitor (clavulanic acid or sulbactam) and an amino-penicillin or ticarcillin has resulted in further extension of their antibacterial spectra. The development of an ideal penicillin that is nonsensitizing, bioavailable, beta-lactamase resistant, rapidly bactericidal, nontoxic, and inexpensive and that has high affinity to penicillin-binding proteins and no inoculum effect remains the goal. PMID- 3306182 TI - Cephalosporin, carbapenem, and monobactam antibiotics. AB - Cephalosporin and related antibiotics are highly effective bactericidal agents of relatively low toxicity. The spectrum of activity varies with the drug but is usually broad. The first-generation cephalosporins, and especially cefazolin, are most active against sensitive staphylococci and streptococci. Most second generation (except cefoxitin) and third-generation cephalosporins show substantial activity against Haemophilus influenzae. All cephalosporins (except cefsulodin) are active against Klebsiella, Escherichia coli, and Proteus mirabilis, whereas only the third-generation agents have pronounced activity against the other Enterobacteriaceae. Imipenem (a carbapenem) is active against essentially all pathogenic organisms, but aztreonam (a monobactam) is active against only aerobic gram-negative bacilli. Advantages associated with some of the new cephalosporins are once-daily administration and high cerebrospinal fluid levels. With the development of new cephalosporins, however, new toxicities have become apparent, and superinfections and induction of resistance have become greater problems. The cephalosporins are among the most expensive antibiotics in use today; thus, use of these expensive agents must be justified by lower toxicity, greater efficacy, or both in comparison with drugs of more reasonable cost. PMID- 3306183 TI - Monitoring of coagulation during liver transplantation--how much is enough? PMID- 3306184 TI - Argentinian paleontologist contributes to the understanding of humans and the environment. PMID- 3306185 TI - A formal mortality analysis for populations of unicellular organisms (Saccharomyces cerevisiae). AB - A theoretical analysis of the reproductive capacity of yeast (Saccharomyces cerevisiae) under different experimental settings reveals interesting patterns and inter-experimental relations of mortality in yeast. The data on yeast lifespan were derived from experimental research by Meisel (Untersuchungen ueber die Korrelation von Abtoetung und Lebensspannenverkuerzung durch mutagene Agentien bei Hefezellen (Thesis) Cologne, 1984). The analysis is based on the formulation of a "weak senescence principle". From this the structure of age specific mortality is defined and employed as the functional constituent of three hierarchical types of mortality models. Model A consists of one such constituent, model B includes many of these, and in model C mortality is given a phase structure in addition. The models incorporate a few basic hypotheses on "damage" and "ageing", on partitions into subpopulations, and on mortality "shifts", according to the particular experimental treatment. It is shown that the theoretical distributions derived from these models and hypotheses yield extremely good fits to the experimental data. PMID- 3306186 TI - [Current problems of hyperprolactinemia. II. Selection and systematization of the treatment]. PMID- 3306187 TI - [Strain variations of Candida albicans and sensitivity to antifungal agents]. PMID- 3306188 TI - [Value of captopril in systemic lupus erythematosus with arterial hypertension and renal insufficiency]. PMID- 3306189 TI - [Graft versus host disease. Analysis of 131 cases of bone marrow transplant]. PMID- 3306190 TI - [Comparison of radioimmunoassay with enzyme immunoassay in the detection of serum antibodies against the human immunodeficiency virus]. PMID- 3306191 TI - [Prognosis in acute non-lymphoblastic leukemia]. PMID- 3306192 TI - [The placebo effect]. PMID- 3306193 TI - [Resistance of urinary flora from sources outside the hospital]. PMID- 3306194 TI - [Effects of antibiotics on phagocytic cells: clinical importance]. PMID- 3306195 TI - [Diagnosis of invasive pulmonary aspergillosis]. PMID- 3306197 TI - [Reconsideration of plasmapheresis treatment of renal post-transplant recurrence of segmental and focal hyalinosis]. PMID- 3306196 TI - [Captopril: is it useful in the hypertensive crisis?]. PMID- 3306198 TI - [Captopril and nifedipine: comparative study of the immediate arterial pressure response in various grades of hypertension]. PMID- 3306199 TI - [Endoscopic papillotomy. Comparative analysis of the effect of ceruletide and octylonium bromide as modifiers of the motility of the duodenum and the papillary sphincter]. PMID- 3306200 TI - [Infections caused by Salmonella and acquired immunodeficiency syndrome]. PMID- 3306201 TI - Myths about hypertension in the elderly. AB - Many of the traditional concepts concerning hypertension in the elderly have turned out to be myths. Large randomized clinical trials have shown that antihypertensive therapy reduces the risk of cardiovascular mortality for elderly patients with diastolic hypertension. Elderly patients adhere well to prescribed regimens and they tolerate antihypertensive drugs as well as younger patients do. An oral diuretic is the agent of choice to initiate treatment for elderly patients with either diastolic or isolated systolic hypertension. PMID- 3306202 TI - Hypertension in blacks. AB - Hypertension represents a problem of special importance in the black patient primarily because of frequency and increased severity. Differences between hypertension in blacks and whites in the United States seem to be mostly epidemiological, pathophysiological, and in responsiveness to drug therapy. Black hypertensives seem to have more of a salt-sensitive, volume-dependent type of hypertension and, therefore, diuretic therapy appears to be particularly useful. Agents that seem to depend more on a stimulated renin-angiotensin-aldosterone system are generally less effective as monotherapy in this group of patients. However, proper combinations of low dose diuretics, with almost any other therapeutic agent, seems to produce a responsiveness in the black hypertensive that is equal to comparable white patients. PMID- 3306203 TI - Hypertension in pregnancy. AB - This article reviews the hypertensive complications of pregnancy, focusing on the pathophysiology and management of pre-eclampsia. These are areas where data are sparse and authoritative disagreements loud. We advocate an intermediate approach where treatment regimens aim at a successful conclusion of the pregnancy, without residual pathology in the mother. PMID- 3306204 TI - Epidemiologic considerations in defining hypertension. AB - Definitions of hypertension have historically been based on at least one of three concepts. The first approach identifies thresholds of hypertension based on the frequency of occurrence in the population. The statistical approach designates a point in the distribution (e.g., the 95th percentile), as the threshold for hypertension. This distribution method identifies different limits for hypertension depending on the age, sex, and race, of the population, all of which affect the average pressure. Although distribution curves do not by themselves identify thresholds for intervention, they are useful for examining changes in population groups over time. The second approach to defining hypertension relates pressures to the risk of morbidity and mortality and is characterized by a continuously graded curve with no clear categorical thresholds. Studies correlating both diastolic and systolic pressures with cardiovascular complications demonstrate continuous risks from lowest to highest values for both sexes, all ages, and both blacks and whites in the United States. The blood pressure-risk relationship provides a compelling rationale for treatment but does not by itself define thresholds for the initiation of therapy. The third approach uses data from clinical intervention trials to identify thresholds where the benefits of therapy outweigh the costs and side effects of long-term treatment. Although results of large randomized trials have clearly demonstrated reductions in morbidity and mortality by lowering blood pressures, consensus on the lowest threshold within the mild range for which antihypertensive drug treatment is recommended has not been reached. Because an optimal definition of hypertension must encompass all three approaches and the resultant classification scheme must be sufficient for all purposes, attempts to refine and improve upon the presently recommended thresholds will undoubtedly continue. PMID- 3306205 TI - Vascular changes in hypertension. AB - Hypertension can directly damage blood vessels, and leads to renal failure, intracranial bleeds, and lacunar infarctions. Of equal importance is the effect of hypertension on the development of atherosclerosis. Specific changes in both the microvasculature and macrovasculature vary depending on the degree and rapidity of blood pressure elevation. Changes in the intima and media can lead to significant narrowing of vessels and ischemia in various tissues. In addition, changes in small-resistance vessels contribute to changes in peripheral vasculature resistance and thus affect blood pressure regulation. Treatment of moderate to severe elevation in blood pressure clearly results in a decrease in the incidence of stroke. However, evidence that treating mild hypertension reduces coronary events is less convincing. Antihypertensive therapy may result in partial regression of vascular changes, especially fibrinoid necrosis seen in malignant hypertension, but more work needs to be done to clearly define the roles of specific drugs in preventing or regressing hypertensive vascular disease. PMID- 3306207 TI - Cations and hypertension: sodium, potassium, calcium, and magnesium. AB - The association between sodium intake and hypertension has been studied for almost a century. More recently, it has been suggested that abnormalities in dietary intake of potassium, calcium, and magnesium may play a major role in the pathogenesis of hypertension. A critical analysis of selected data from animal and human studies is discussed. PMID- 3306206 TI - Renal parenchymal involvement in essential hypertension. AB - This article has reviewed the involvement of the kidney as a target organ of essential hypertension. Since Bright first made the association of renal disease and hypertension in 1836, the nature of this relationship has been debated. Although there is evidence implicating abnormalities of renal function in the pathogenesis of essential hypertension, hypertension frequently precedes histologic evidence of alterations in renal structure. Nephrosclerosis, or hardening of the kidney, is the term used to describe the histologic changes occurring in the kidney as the result of hypertension. It can be though of as an acceleration of the normal aging process of the renal vasculature. Glomerular and tubular changes have been traditionally thought to be ischemic in origin. Experimental evidence supports the notion that, as renal function is lost, intraglomerular hypertension develops and may be responsible for additional nephron loss in hypertension. This idea may have therapeutic implications for hypertensive patients with renal insufficiency in that agents that reduce both systemic and intraglomerular pressure may be preferable. Hemodynamically, early hypertension is often characterized by normal peripheral and renal vascular resistance and an increased cardiac output. In established hypertension, cardiac output is usually normal, and peripheral and renal vascular resistances are increased. Renal blood flow is reduced, glomerular filtration rate is maintained, and the filtration fraction rises. In the absence of an accelerated malignant phase, renal failure is uncommon in essential hypertension. Males and blacks are most sensitive to the vascular damage of essential hypertension. Essential hypertension remains an important cause of end-stage renal disease, especially in blacks. Atherosclerotic obstruction of the renal arteries may be a more common cause of renal failure in patients with essential hypertension than has been previously recognized. There are few sensitive markers of early renal involvement in essential hypertension. Several studies of sensitive markers are promising and may detect patients who are prone to renal injury and deserve more aggressive treatment. Malignant hypertension is characterized pathologically by vascular changes of proliferative endarteritis and fibrinoid necrosis. Fortunately, its frequency is decreasing because of early identification and effective treatment of essential hypertension. Effective treatment of severe and malignant hypertension clearly leads to stabilization (and occasionally improvement) of renal function.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306208 TI - The renin-angiotensin systems. AB - The renin-angiotensin systems are important regulators of cardiovascular homeostasis and participate in a variety of pathological conditions. Recent advances have not only clarified the functioning of the systemic renin cascade but have also indicated the importance of the generation of angiotensin in tissues. PMID- 3306209 TI - Essential hypertension: neural considerations. AB - Current evidence suggests that the sympathetic nervous system plays a predominant role in some fraction of essential hypertension. Patients in whom such mechanisms are likely to be operative are young people with mild or labile hypertension. These mechanisms are expressed clinically through orthostatic hypertension, rapid heart rate, modestly elevated cardiac output, and normal or slightly elevated peripheral vascular resistance. The vascular resistance is inappropriately high for the level of cardiac output, and this is reflected in a mildly elevated blood pressure. This evidence carries therapeutic implications and suggests that sympatholytic drugs should be the first line of therapy. An additional pressor mechanism may arise from increased sympathetic activity along renal efferent nerves that impairs sodium excretion and another possible mechanism is stimulation of brain centers through impulses from the kidneys carried in renal afferent nerves. PMID- 3306210 TI - Clinical aspects of endocrine hypertension. AB - Distinct hypertensive syndromes clearly related to overproduction of certain hormones are increasingly being recognized. The ability to recognize these disorders has come as a result of better understanding of their pathophysiology and the availability of sensitive and accurate diagnostic tools. The particular appeal of making the diagnosis centers around the potential curability of the hypertension with correction of the hormonal abnormality. PMID- 3306211 TI - Nonpharmacologic therapy of hypertension. AB - At least seven nondrug therapies have been shown to reduce the blood pressure in some hypertensive patients. Although each has its detractors, I believe most should be utilized in the therapy of most hypertensives. Some, such as weight reduction for the obese, decreased saturated fat intake, regular isotonic exercise, and moderation of alcohol, can be enthusiastically advocated for everyone, since they may accomplish additional improvements in overall cardiovascular risk beyond their effect on blood pressure. Others such as moderate sodium restriction, adequate dietary sources of potassium, magnesium, and calcium, and relaxation therapy, can be helpful in at least some hypertensives and should be appropriately applied to the therapy of those who may benefit. To varying degrees, nondrug therapies should be included in the treatment of all patients with hypertension. PMID- 3306212 TI - Diuretics in the management of hypertension. AB - Thiazide diuretics have been in use for over 30 years in the treatment of hypertension. Their action results in a reduction in peripheral resistance without a significant decrease in cardiac output or a major shift in plasma volume. They are as or more effective than any of the other antihypertensive agents when used as monotherapy and can serve as baseline therapy in combination with any of the available adrenergic, converting enzyme-inhibiting agents, or calcium-entry blockers. There is a high degree of patient acceptance; titration to an effective dosage is relatively easy; and cost, relatively low. Although certain undesirable metabolic changes may occur following the use of these agents, most of them are controllable, and there is no evidence to date that they offset the benefits achieved by blood pressure lowering. Asymptomatic elevated uric acids have not been shown to be of great significance. If gout occurs, it can be managed. Alterations in glucose metabolism may occur, and in some patients, it appears that blood glucose levels are elevated over time. This is not a desirable metabolic change, but is one of doubtful prognostic significance. Changes in lipids are generally short-term, and in the major clinical trials, lipid levels have not remained elevated with a continuation of diuretic therapy. Although diuretics produce hypokalemia in a fairly high percentage of patients, this is not generally severe (less than 3.3 mEq per liter) and usually does not produce symptoms. There is no firm evidence that the hypokalemia produced by diuretics predisposes the patient to severe arrhythmias or sudden death, although this point has been emphasized repeatedly in recent publications. Diuretics can usually be given without potassium-maintenance therapy. However, hypokalemia should be prevented in the elderly, in patients with ischemic heart disease, left ventricular hypertrophy and those on digitalis, or with diabetes. We prefer potassium-sparing agents along with a diuretic over supplements to prevent hypokalemia; the number of pills is kept at a reasonable level, and cost is minimized. Physicians should continue to prescribe diuretics as first-step therapy in the majority of patients to maximize therapeutic outcome. PMID- 3306213 TI - Obesity hypertension. AB - Obesity and hypertension are two major risk factors for the cardiovascular system. Whereas arterial hypertension increases afterload to the left ventricle, obesity produces an increase in stroke volume and increases preload. As a result of this double burden, the heart adapts with eccentric left ventricular hypertrophy. Contractility becomes impaired early in the course of obesity hypertension, and ventricular ectopy is observed. As a consequence, the obese hypertensive patient is at a high risk for congestive heart failure and sudden death. Despite the synergistic effects of obesity and hypertension on the heart, patients appear to be relatively protected from nephrosclerosis and coronary artery disease. These epidemiologic observations are supported by the pathophysiologic changes that take place in obesity hypertension. At any given level of arterial pressure, cardiac output and renal blood flow are elevated in obese hypertensive patients, whereas systemic and renal vascular resistance are decreased when compared to lean hypertensive patients. Because total peripheral resistance is considered the hemodynamic hallmark of arterial hypertension, systemic vascular complications may be less pronounced in obesity hypertension. Weight loss decreases preload, afterload to the left ventricle, and the sympathetic drive to the heart. Protecting the heart from these hypertrophic stimuli should be a major goal of preventive cardiology. PMID- 3306214 TI - High performance for expert systems: I. Escaping from the demonstrator class. AB - An investigation was performed to elucidate the problems of converting a demonstrator expert system for leukaemia diagnosis into a large high-performance system. Analysis of the logical completeness of the demonstrator system revealed only minor errors and a limited representation of the domain. Most of its test cases were quite simple and correction of the minor errors raised the performance to 94%. However, the remaining cases were very complex and it is doubtful whether the system could handle them without fundamental changes to its representation of the domain. Demonstrator systems can function with an imperfect view of the domain since the small sacrifice of accuracy is of little consequence; but in a high-performance system the imperfections must be corrected before extra detail is added. The use of default mechanisms for making specific conclusions was harmful because they concealed errors, and a numerical method for handling uncertainty contributed nothing of value to the system. PMID- 3306215 TI - High performance for expert systems: II. A system for leukaemia diagnosis. AB - A system for diagnosing leukaemia subtypes from monoclonal antibody test results has been programmed directly from the expertise of one immunologist. It gives an acceptable conclusion for 400 past cases, with summaries of its reasoning and suggestions for further tests. Its development included three major components: elicitation of the basic items of knowledge, formulation of a coordinated overall scheme, and representation in a computer language. All three were interdependent and required many cycles of trial and error, involving further discussions with the expert at all stages. By far the most difficult component was the formulation of a comprehensive specification for the problems of the domain, and this was only achieved when the knowledge engineer had gained a fair understanding of the application. The system is a tree-structured logic program written in PROLOG. This format facilitated experimentation with different knowledge representations, control of the interrelationships between rules and the elimination of errors. The problems of quality control and maintenance are of paramount importance for high-performance systems. PMID- 3306216 TI - Drugs for the treatment of traumatic brain injury. PMID- 3306218 TI - Optimistic analysis--chemical embryology in Cambridge 1920-42. PMID- 3306217 TI - Structures and biological activities of vitamin D metabolites and their analogs. PMID- 3306219 TI - Making a long story short: a note on men's height and mortality in England from the first through the nineteenth centuries. PMID- 3306220 TI - Obstetrical research in The Netherlands in the nineteenth century. PMID- 3306221 TI - The meaning of fractures: orthopaedics and the reform of British hospitals in the inter-war period. PMID- 3306222 TI - A provincial surgeon and his obstetric practice: Thomas W. Jones of Henley-in Arden, 1764-1846. PMID- 3306224 TI - Illustrations from the Wellcome Institute Library. The Sami Haddad collection of Arabic medical manuscripts. PMID- 3306223 TI - A surgeon's private practice in the nineteenth century. Sir William Fergusson's Edinburgh day books 1832-39, with some extracts from his London day books 1839 77. PMID- 3306225 TI - [Plague--a forgotten but uneradicated disease]. PMID- 3306226 TI - [First aid and ambulances--some historical observations]. PMID- 3306227 TI - [Diagnosis of peritoneovenous shunt occlusion]. AB - Reaccumulation of ascitic fluid after peritoneovenous shunt implantation demands accurate diagnostic procedure. Between 1973 and 1985 81 peritoneovenous shunts have been implanted at the IInd Surgical Department of the University of Vienna. In the same time 34 reoperations in 17 patients have been performed for reasons of shunt-dysfunction. Besides thorax x-ray, diagnosis was established in 11 cases by means of Doppler ultrasound investigation, in 26 cases by technetium scan and in 15 cases by shunt angiography. Shuntography proved to be the method of choice, with no false results. Doppler ultrasound results were unclear in a high percentage, thus this method is not used any more. PMID- 3306228 TI - [Problems in the reconstruction of bile flow in orthotopic liver transplantation]. AB - In hepatic transplantation complications of the biliary drainage were frequently observed. Ischemia of the extrahepatic bile duct which occurs for anatomical reasons can cause necrosis of the bile duct. The reconstruction of biliary drainage by biliodigestive anastomosis results in ascending infections of the graft. Biliary sludge could obstruct the intra- or extrahepatic bile duct. Recently, operation methods are mainly applied in which the function of Oddi's sphincter is preserved, i.e. choledocho-choledochostomy or gallbladder conduit method. If it is not possible to perform these methods the Roux-y-jejunum loop is used. Finally, an immediate operative revision of the biliary drainage is indicated if its complication is diagnosed. PMID- 3306229 TI - [Role of the lateral nasal wall in the pathogenesis, diagnosis and therapy of recurrent and chronic rhinosinusitis]. AB - In the vast majority of cases infections of the paranasal sinus system are rhinogenic. Usually these spread via the middle nasal meatus and the anterior ethmoid to the dependent larger sinuses, especially to the frontal and/or maxillary sinus. If a sinusitis does not heal or is constantly recurring, a focus of infection has remained in a stenotic cleft of the lateral nasal wall, irritating nasal function and where from infection time and again may spread to the dependent sinuses. These Infection foci may be very circumscribed and limited, and not always must present with the typical triad of sinusitis symptoms: pathological secretion, nasal obstruction and cephalgia. Frequently only one of these symptoms prevails. By the means of nasal endoscopy and polytomography these foci can exactly be localized. After clearing the infection foci, which easily can be achieved under endoscopic guidance, mucosal function usually is restored and the dependent larger sinuses heal without having been touched. PMID- 3306230 TI - [Immunohistological demonstration of the intermediate filaments in a laryngeal carcinosarcoma: considerations on its histogenesis]. AB - A carcinosarcoma of the larynx was analysed by means of a light microscope and by immunohistological staining technique using antibodies against various intermediate filament proteins. Whereas tumour areas of an epithelial character reacted with antibodies against keratin, the spindle cells demonstrated a positive immunofluorescence with vimentin antibodies. Inside some tumour cells a coexpression of keratin and vimentin (intermediate filaments of mesenchymal cells) could be demonstrated. It is likely that these double stained cells represent the primitive stem cell of the carcinosarcoma, differentiating during further development either into epithelial or mesenchymal tumour cells. PMID- 3306231 TI - [Etiology of the ear disease of the composer Bedrich Smetana]. AB - As far back as 1964 Professor Dr. H. Feldmann, Director of the Department of Otorhinolaryngology of the Westphalian Wilhelms University of Munster claimed on the basis of his Prague studies that the Czechoslovakian composer Bedrich Smetana suffered from untreated syphilis with which he is said to have infected himself in 1874. The authors of the article presented here are members of the scientific research group of the Museum of Bohemian Music in Prague. On the occasion of the centenary of Smetana's death they were given an opportunity to examine and assess written and factual posthumous documents from Smetana's estate. This research did not yield any pointer towards Smetana's ear disease as being due to a luetic infection. PMID- 3306232 TI - Corrosive esophageal injuries. I. A study of nine cases of concurrent accidental caustic ingestion. AB - Treatment of corrosive injuries of the esophagus remains largely unsatisfactory, and severe esophageal burns still frequently result in stricture with accompanying morbidity or death. The nine patients presented here with 3-year follow-up accidentally drank a concentrated alkaline solution. All were teenagers or young adults who drank from the same bottle while at a party. The problems encountered in these patients led us to conclude that all patients with moderate to severe corrosive injury of the esophagus should have assessment of the entire esophagus and stomach at the time of initial assessment. Six patients underwent diagnostic laparotomy and one underwent thoracotomy as well for assessment of his esophageal injuries. Had we followed the traditional approach of esophagoscopy only to the level of the first circumferential burn, more severe and potentially life-threatening injuries would have been missed. Early endoscopic evaluation of the esophagus and stomach remains the standard for diagnosis; however, complete assessment may require laparotomy or thoracotomy. Early resection of necrotic tissue in the esophagus or stomach can lead to increased survival. PMID- 3306233 TI - Large vessel sealing with the argon laser. AB - This study compared the histology, biochemistry, and tensile strength of laser welded and sutured canine venotomies, arteriotomies, and arteriovenous fistulas. Twelve animals had bilateral femoral vessels studied, with one repair (control) closed with interrupted 6-0 polypropylene sutures, and the contralateral repair (experimental) welded with the argon laser. Specimens were examined at weekly intervals from 1 to 4 weeks (four animals for each type of repair), and were evaluated histologically by hematoxylin and eosin, elastin, and trichrome stains; biochemically by the formation of [3H]hydroxyproline as an index of collagen synthesis; and mechanically by tensile strength determinations. At removal, all experimental closures were patent without hematomas, aneurysms, or luminal dilatation. Histologic and biochemical examination and tensile strength determinations suggest that laser welding may be an alternative to sutures for repair of large-diameter venotomies, arteriotomies, and arteriovenous fistulas, as healing is comparable to that seen with suture repairs up to 4 weeks postoperatively. PMID- 3306234 TI - Pulmonary procedures assisted by optosurgical and electrosurgical devices: comparison of damage potential. AB - Electrosurgical devices have been used widely in thoracic surgery to assist in dissection and to reduce hemorrhage. Recent experimental data have shown that lasers may be used to resect and control small air leaks while conserving normally functioning lung. This investigation quantitates the amount of damage produced by the electrosurgical unit (ESU), the carbon dioxide laser (CO2), and the neodymium: YAG laser (YAG) compared to standard suture (SU) techniques. Six dogs were anesthetized, intubated, and ventilated. The left chest was opened and the lower lobe exposed, where four sets of lesions were created using each device. All lesions were visually similar to those lesions that would be created for sealing at the time of a pulmonary resection. The lesions were harvested immediately following wounding as well as at 1, 3, and 6 week intervals. They were examined histologically and ranked from least to most damage produced at each interval. A grading system (0-4+) was also devised to compare the injury to simultaneously harvested normal lung. Immediately following injury, histologic ranking was: CO2 (2+), suture (2+), ESU (3+), YAG (4+). By 6 weeks, the suture damage had become minimal and the ranking was: suture (1+), CO2 (2+), YAG (4+), ESU (4+). The ESU consistently produced more extensive damage than any other device. It appears that the most suitable long-term adjunctive devices to assist in pulmonary surgery are suture and the CO2 laser. The YAG laser may have specific indications in circumstances when significant blood loss may be encountered. ESU usage should be minimized when attempting to preserve functioning lung tissue. PMID- 3306235 TI - Interleukin-1 and osteoarthritis. AB - Il-1, a multifunctional monokine, can stimulate both synoviocytes and articular chondrocytes to release neutral proteases and prostaglandin E2. It is also capable of promoting bone resorption. Therefore, this molecule (or family of molecules) is likely to play an important role in the mechanism of articular cartilage destruction that occurs in degenerative arthropathies. The synovial tissue itself can produce Il-1 (Catabolin) in some conditions, such as a slight traumatism, so that the presence of local inflammation is not necessary for "Il-1 cartilage" interaction to occur. Fundamental macromolecules of cartilage (collagens, proteoglycans) exert a stimulatory effect on Il-1 production, either as such or in the form of immune complexes. Some activated complement fractions (C3a and C5a) may also be actively involved. Studies on the mechanisms which regulate Il-1 synthesis and release, as well as investigations on the response of target cells to Il-1, are presently fascinating goals that could lead to new strategies in therapeutic research. PMID- 3306236 TI - Saturable transport of peptides across the blood-brain barrier. AB - Peptides can be transported across the blood-brain barrier by saturable transport systems. One system, characterized with radioactively labeled Tyr-MIF-1 (Tyr-Pro Leu-Gly-amide), is specific for some of the small peptides with an N-terminal tyrosine, including Tyr-MIF-1, the enkephalins, beta-casomorphin, and dynorphin (1-8). Another separate system transports vasopressin-like peptides. The choroid plexus has at least one system distinguishable from those above that is capable of uptake and possibly transport of opiate-like peptides. The possibility of saturable transport of other peptides has been investigated to a varying degree. Specificity, stereo-specificity, saturability, allosteric regulation, modulation by physiologic and pharmacologic manipulations, and noncompetitive inhibition have been demonstrated to occur in peptide transport systems and suggest a role for them in physiology and disease. PMID- 3306237 TI - Metabolism in humans of cis-12,trans-15-octadecadienoic acid relative to palmitic, stearic, oleic and linoleic acids. AB - Mixtures of triglycerides containing deuterium-labeled hexadecanoic acid (16:0), octadecanoic acid (18:0), cis-9-octadecenoic acid (9c-18:1), cis-9,cis-12 octadecadienoic acid (9c, 12c-18:2) and cis-12,trans-15-octadecadienoic acid (12c,15t-18:2) were fed to two young-adult males. Plasma lipid classes were isolated from samples collected periodically over 48 hr. Incorporation and turnover of the deuterium-labeled fats in plasma lipids were followed by gas chromatography-mass spectrometry (GC-MS) analysis of the methyl ester derivatives. Absorption of the deuterated fats was followed by GC-MS analysis of chylomicron triglycerides isolated by ultracentrifugation. Results were the following: (i) endogenous fat contributed about 40% of the total fat incorporated into chylomicron triglycerides; (ii) elongation, desaturation and chain-shortened products from the deuterated fats were not detected; (iii) the polyunsaturated isomer 12c,15t-18:2 was metabolically more similar to saturated and 9c-18:1 fatty acids than to 9c,12c-18:2; (iv) relative incorporation of 9c,12c-18:2 into phospholipids did not increase proportionally with an increase of 9c,12c-18:2 in the mixture of deuterated fats fed; (v) absorption of 16:0, 18:0, 9c-18:1, 9c,12c 18:2 and 12c,15t-18:2 were similar; and (vi) data for the 1- and 2-acyl positions of phosphatidylcholine and for cholesteryl ester fractions reflected the known high specificity of phosphatidylcholine acyltransferase and lecithin:cholesteryl acyltransferase for 9c,12c-18:2. These results illustrate that incorporation of dietary fatty acids into human plasma lipid classes is selectively controlled and that incorporation of dietary 9c,12c-18:2 is limited. These results suggest that nutritional benefits of diets high in 9c,12c-18:2 may be of little value to normal subjects and that the 12c,15t-18:2 isomer in hydrogenated fat is not a nutritional liability at the present dietary level. PMID- 3306238 TI - Plasma bilirubin pigments in health and disease. PMID- 3306239 TI - The hepatocellular uptake of bilirubin: current concepts and controversies. PMID- 3306240 TI - Genetic deficiency of bilirubin glucuronidation in rats and humans. PMID- 3306241 TI - Phototherapy and the chemistry of bilirubin. PMID- 3306242 TI - Crigler-Najjar syndrome types I and II. Clinical experience--King's College Hospital 1972-1978. Phenobarbitone, phototherapy and liver transplantation. PMID- 3306243 TI - Bilirubin metabolism in cholestasis. PMID- 3306245 TI - History of contraception in Baltimore. PMID- 3306244 TI - The active roles of cells of the blood vessel wall in health and disease. PMID- 3306246 TI - [Psychological evaluation of patients with Peyronie's disease]. PMID- 3306247 TI - [Epidemiological peculiarities of pernicious attacks by Plasmodium falciparum in the context of a malaria epidemic. Vanuatu, 1975-1985]. AB - A retrospective study of the cerebral malaria cases occurred in five hospitals from 1975 to 1985 was conducted in the Republic of Vanuatu (ex-New Hebrides). The situation in this archipelago since 1980 of the epidemic type, with a dramatic increase in Plasmodium falciparum incidence and prevalence. A considerable increase of the incidence of cerebral malaria has been evidenced in the whole group, in parallel with that of the P. falciparum incidence. Moreover, an unusual age distribution has been noted, with a maximum incidence in the adult age group, and a minimum in the infant one. The most evident misleading factors have been excluded, and possible explanations for this particular distribution are discussed. Finally, this increase in cerebral malaria incidence did not appear to be directly due to the concomitant spread of chloroquine resistant P. falciparum over the country, but rather to the resulting increasing incidence of this parasite. PMID- 3306248 TI - [Resistance of Mycobacterium leprae to dapsone and rifampicin: apropos of a survey carried out in the Cape Verde region (Senegal)]. AB - Since 1983, primary resistance of M. leprae to DDS and rifampicin has been evaluated in new cases of lepromatous leprosy observed in the Cap-Verde region in Senegal. Out of the 13 strains isolated, 10 (77%) have been found resistant to DDS, 7 at low level, 2 at intermediate level, 1 at high level; all of them have been found sensible to rifampicin. Similar results have been obtained with 57 strains isolated from patients not yet treated coming from different geographical areas, seeing that 37, i.e. 65%, were resistant to DDS, 27 at low level, 5 at intermediate level and 5 at high level; all of them were sensible to rifampicin. Level of resistance to DDS is very different in case of acquired resistance. In 69 lepromatous patients treated for more than 5 years and showing a relapse, M. leprae was 62 times, i.e. 90%, resistant to DDS, 6 times at low level, 21 at intermediate level and 35 at high level; in addition, 13 times M. leprae was resistant to rifampicin. In order to avoid and to solve problems set by resistance of M. leprae to antibiotics, strict application of polychemotherapy of leprosy is compulsory. PMID- 3306249 TI - [Salmonella bacteremia and generalized cryptococcosis, a double indicator of African AIDS]. AB - A male Rwandese adult with proven A.I.D.S. died from generalized cryptococcosis six months after episodes of recurrent fever with isolation of Salmonella enteritidis from the blood culture. The authors discuss the frequent and precocious appearance of Salmonella septicaemia in patients with A.I.D.S. They propose the inclusion of nontyphoidal Salmonella bacteraemia in the provisional W.H.O. case definition of adult A.I.D.S. in countries with limited diagnostic resources. PMID- 3306250 TI - [Distomatosis of the bile ducts, value of ultrasonics (apropos of a new case)]. AB - The authors report on a new case of distomatosis localized in the main biliary duct. It has been revealed by a repeated angiocholitis, diagnosed only by endoscopic retrograde cholangiopancreatography. They draw attention on the difficulties to diagnose this clinical form of distomatosis, and underline the interest of ultrasonography in the diagnosis and the selection of therapeutic means. PMID- 3306251 TI - [Increase in the size of an hepatic amebic abscess treated with metronidazole: value of immunologic surveillance with the ELIFA method]. AB - The authors report a case of amoebic liver abscess regularly increasing in size for a period of 20 days (iterative controls by echography), in spite of a metronidazole treatment. Immunological studies by the ELIFA method, on the successive sera of the patient, show IgG, IgM, IgE and IgA antibodies within one particular precipitating system; the specific IgA disappeared after surgical drainage of the abscess. PMID- 3306252 TI - Pathogenesis of adhesion formation/reformation: application to reproductive pelvic surgery. AB - Pelvic adhesions are a major contributing factor to infertility in women with tubal peritoneal disease. Surgical treatment of such adhesions often does not resolve their presence. Such postoperative adhesion formation occurs despite the use of microsurgical techniques in a wide variety of surgical adjuvants. The process of adhesion formation represents a variation of the normal healing process of the peritoneum. However, rather than normal mesothelial healing, the fibrinous mass resulting from the peritoneal defect is infiltrated by fibroblasts with subsequent adhesion formation. A description of the pathophysiology of this process is described. The current understanding of the pathologic/pathophysiologic interaction of the surgical adjuvants with this process is described. PMID- 3306253 TI - Microsurgical reconstruction of congenital tubal anomalies. AB - Significant numbers of infertile women have congenital anomalies or anatomical distortion of the fimbrial-gonadal mechanism in their otherwise healthy oviducts. The diagnosis and surgical treatment of multiple congenital accessory tubal ostia, the elongated fimbria-ovarica syndrome, and management of paratubal cysts is described. Microsurgical correction of these defects was followed by term pregnancies in 46%, 57% and 28% of the three entities respectively and this data indicates that significant numbers of women with these defects may be helped by microsurgery. Failure to recognize these abnormalities may otherwise result in patients being diagnosed as idiopathic infertility, a decision which may exclude them from the possibility of undergoing a successful form of microsurgical treatment. PMID- 3306254 TI - Comparison between tubouterine implantation and tubouterine anastomosis for repair of cornual occlusion. AB - Forty-four patients with partial or complete cornual occlusion of their tubes had undergone microsurgical repair in the form of either tubouterine implantation or tubouterine anastomosis. Eighteen of these patients had undergone the implantation procedure and 26 the anastomosis procedure. None of the patients in the implantation group had previous tubal sterilization, while in the anastomosis group 16 had tubal cauterization and 10 had other causes blocking the cornual end of their tubes. The patency rate in the implantation group was 70% and the pregnancy rate was 39%, while in the anastomosis group the rates were 94% and 69%, respectively. It is concluded that, when feasible, tubouterine anastomosis should be the procedure of choice for the repair of the cornual occlusion of the tube irrespective of the cause of obstruction. PMID- 3306256 TI - [Genetic component of the immune response to Mycobacterium leprae in healthy subjects]. PMID- 3306255 TI - [Changes in carbohydrate and lipid metabolism in obesity]. PMID- 3306257 TI - [Hypothermia, shock and coagulation disorders in a kidney transplant]. PMID- 3306258 TI - [Treatment of hematosis disorders in chronic obstructive bronchitis with almitrine bismesylate]. PMID- 3306259 TI - Small-airways disease in recipients of allogeneic bone marrow transplants. An analysis of 11 cases and a review of the literature. AB - In a retrospective review of 116 consecutive allogeneic bone marrow transplants (BMT), severe obstructive airways disease was identified in 11 patients. Lung pathology demonstrated bronchiolitis in 9 patients and physiologic studies showed small-airways disease consistent with bronchiolitis in the other 2. None of the 5 patients with associated infection survived, while 3 of the 6 patients without an identified pathogen stabilized or improved. Analysis of the 11 cases presented and all 25 cases reported in the literature (1982 to 1985) supports the conclusion that graft-versus-host disease is a major risk factor for bronchiolitis in BMT recipients. Among the proposed mechanisms for the development of bronchiolitis after allogeneic BMT, the 2 most likely are graft versus-host disease directly causing bronchiolitis, and increased immunosuppressive therapy given for graft-versus-host disease predisposing to viral bronchiolitis. The available evidence would suggest that it is prudent to obtain serial pulmonary function tests even in asymptomatic patients post-BMT, and particularly in those with chronic graft-versus-host disease, in the hope that early detection will allow for early intervention that will arrest or reverse the progression of the obstructive airways disease. PMID- 3306260 TI - Extra-intestinal manifestations of salmonella infections. AB - While salmonellosis is often considered to affect primarily the gastrointestinal tract, infection at other sites may occur, producing characteristic clinical syndromes. We reviewed cases from our institutions and the literature on focal manifestations of salmonella infections. In the past, most extra-intestinal salmonella infections were caused by S. choleraesuis; however, we found S. typhimurium to be the predominant serotype. The mortality rate for patients in our series was considerably lower than the rate described for focal infections in other reviews. This may in part be due to lower proportion of infections due to S. choleraesuis, improved microbiologic and diagnostic techniques, increased use of ampicillin, and improved surgical techniques. Salmonella endocarditis usually occurs in patients with preexisting heart disease. Unlike other salmonella infections, S. choleraesuis is the most frequent serotype. Salmonella endocarditis is often very destructive, with a fatality rate of 70%. Nonvalvular (mural) endocarditis occurs in one-fourth of patients and survival has not been reported. While antibiotic therapy should be tried initially, if response is not prompt the clinician should look for an associated site of infection (intra- or extra-cardiac abscess), which will often require surgery. Salmonella pericarditis often presents with cardiac or pulmonary symptoms, but typical signs of pericardial disease (pulsus paradoxus, friction rub) or characteristic electrocardiographic changes (low voltage, elevated ST segments) are uncommon. Early diagnosis, before infection involves other areas of the heart, is crucial for survival. In addition to antibiotic therapy, pericardiocentesis or pericardiectomy is required. Salmonella may infect the peripheral or visceral arteries, but the abdominal aorta is the most frequent site of vascular infection. Most patients are men over age 50 with preexisting atherosclerosis of the aorta who do not have a previous history of gastroenteritis. About one-fourth of patients have associated lumbar osteomyelitis. No patients have been reported to survive with medical therapy alone. Specific guidelines for surgical removal of infected aneurysms have been proposed and these (in addition to increased use of ampicillin) may be responsible for higher survival rates in recent years. Due to the high incidence of relapses, postoperative blood cultures should be done routinely. Arterial infection should be considered in any elderly patient with salmonella bacteremia especially with prolonged fever or bacteremia after an "adequate course" of antibiotic therapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306262 TI - The T cell receptor and autoimmune diseases. PMID- 3306261 TI - [Work-related diseases. A new program of the World Health Organization]. AB - Work-related diseases are multifactorial diseases in which the work environment plays a partial role in causation. They include chronic noncommunicable disease affecting working populations. There is evidence that such diseases as musculoskeletal disorders, hypertension, chronic bronchitis, and several psychosomatic disturbances affecting workers can be attributed to a variety of risk factors, including those in the workplace. Examples of investigations and the occurrence or various work-related diseases are cited from several countries. Occupational health is evolving to deal with multifactorial health problems from combined exposure to occupational and other environmental factors, life-style, and individual susceptibility. More attention should be given to psychosocial factors and ergonomics in the workplace, workers' participation and life-style, multifactorial occupational epidemiology, and new approaches to legislation. A list of research areas is given to cover the present gaps in knowledge. The World Health Organization has started a program of work in this field to identify the magnitude of these diseases in various parts of the world, to stimulate epidemiologic research, and to develop guidelines for control measures. PMID- 3306263 TI - Molecular genetic techniques for mapping the human genome. PMID- 3306264 TI - High-level expression in Escherichia coli of a soluble and fully active recombinant interleukin-1 beta. AB - A complementary DNA sequence encoding monocyte interleukin-1 (IL-1), beta form/pI7, was expressed in Escherichia coli. Recombinant plasmid pDP516 was constructed by cloning and rebuilding the mature IL-1 coding sequence into an E. coli expression vector. Bacteria transformed with pDP516 constitutively produced recombinant IL-1 (r-IL-1) at 15-20% of total E. coli protein. The r-IL-1 was found to be in the soluble fraction of sonicated E. coli Bacterial r-IL-1 (DP516) has been purified to homogeneity by anion exchange and sizing column chromatography, with an apparent molecular weight of 17,500. The identity of the purified r-IL-1 was confirmed by amino acid and DNA sequencing analyses. Purified recombinant IL-1 DP516 exhibits biological activity similar to that of native monocyte IL-1 (3 approximately 4 X 10(7) units/mg). An amino-terminal deletion mutant completely abolishes the biological activity, indicating that the integrity of the IL-1 molecule might be important for its function. PMID- 3306265 TI - Rare and serious adverse reactions. PMID- 3306266 TI - Clinical features and management of poisoning due to antimalarial drugs. AB - The toxicities of antimalarial drugs vary because of the differences in the chemical structures of these compounds. Quinine, the oldest antimalarial, has been used for 300 years. Of the 200 to 300 compounds synthesised since the first synthetic antimalarial, primaquine in 1926, 15 to 20 are currently used for malaria treatment, most of which are quinoline derivatives. Quinoline derivatives, particularly quinine and chloroquine, are highly toxic in overdose. The toxic effects are related to their quinidine-like actions on the heart and include circulatory arrest, cardiogenic shock, conduction disturbances and ventricular arrhythmias. Additional clinical features are obnubilation, coma, convulsions, respiratory depression. Blindness is a frequent complication in quinine overdose. Hypokalaemia is consistently present, although apparently self correcting, in severe chloroquine poisoning and is a good index of severity. Recent toxicokinetic studies of quinine and chloroquine showed good correlations between dose ingested, serum concentrations and clinical features, and confirmed the inefficacy of haemodialysis, haemoperfusion and peritoneal dialysis for enhancing drug removal. The other quinoline derivatives appear to be less toxic. Amodiaquine may induce side effects such as gastrointestinal symptoms, agranulocytosis and hepatitis. The main feature of primaquine overdose is methaemoglobinaemia. No cases of mefloquine and piperaquine overdose have been reported. Overdose with quinacrine, an acridine derivative, may result in nausea, vomiting, confusion, convulsion and acute psychosis. The dehydrofolate reductase inhibitors used in malaria treatment are sulfadoxine, dapsone, proguanil (chloroguanide), trimethoprim and pyrimethamine. Most of these drugs are given in combination. Proguanil is one of the safest antimalarials. Convulsion, coma and blindness have been reported in pyrimethamine overdose. Sulfadoxine can induce Lyell and Stevens-Johnson syndromes. The main feature of dapsone poisoning is severe methaemoglobinaemia which is related to dapsone and to its metabolites. Recent toxicokinetic studies confirmed the efficacy of oral activated charcoal, haemodialysis and haemoperfusion in enhancing removal of dapsone and its metabolites. No overdose has been reported with artemesinine, a new antimalarial tested in the People's Republic of China. The general management of antimalarial overdose include gastric lavage and symptomatic treatment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306267 TI - Adverse reactions to thrombolytic agents. Implications for coronary reperfusion following myocardial infarction. AB - The use of thrombolytic agents to dissolve coronary artery thrombi causing acute transmural myocardial infarctions has been shown to decrease short term mortality, and improve left ventricular function, in patients with acute transmural myocardial infarction. Several thrombolytic agents are currently available which differ mainly in cost, antigenicity, and mechanism of action. Current investigations are being directed at finding safer, more effective thrombolytic agents and at developing optimal therapy following thrombolysis. The complications of thrombolytic therapy are for the most part minor and reversible. Immediate and delayed hypersensitivity to streptokinase is rare. Hypotension and arrhythmias commonly accompany myocardial reperfusion and are usually benign and self-limited. Haemorrhagic complications are the most frequent and serious problems following the use of thrombolytic agents. They can be lessened by the proper selection of patients to avoid those at high risk of bleeding. The avoidance of unnecessary arterial and venous punctures will decrease the incidence of minor but annoying local bleeding. Those agents which are activated at the site of thrombi will hopefully cause fewer bleeding episodes, but early experience with these agents has not been able to demonstrate a lower rate. With careful attention to patient selection and follow-up, thrombolytic agents can be safely and effectively used in the management of patients with acute myocardial infarction. PMID- 3306268 TI - Systemic reactions to ophthalmic drug preparations. AB - Adverse systemic reactions associated with the use of topical ophthalmic timolol, chloramphenicol, phenylephrine and cyclopentolate are surveyed, with special emphasis on precautions and contraindications for these ophthalmic drug preparations. Systemic reactions secondary to timolol, a beta-adrenergic antagonist indicate that it should be used with caution in patients with asthma or a history of asthma, chronic obstructive pulmonary disease or cardiovascular disease and in those patients receiving systemic administration of beta-blockers or verapamil. Because significant blood dyscrasias or aplastic anaemia have been reported following topical ophthalmic chloramphenicol, the only absolute indication in ocular conditions is an organism that is resistant to all other antibiotics. Both 2.5% and 10% phenylephrine have been associated with cardiovascular effects and should be used with caution in selected patients on monoamine oxidase inhibitors, tricyclic antidepressants or atropine or in those with hypertension, advanced arteriosclerotic changes, aneurysms, orthostatic hypotension, long-standing insulin-dependent diabetes and in children with low bodyweights. Central nervous system toxicity secondary to cyclopentolate is dose related and can be avoided by use of minimal concentrations and avoidance of unnecessary repetition of administration. Occlusion of the nasolacrimal passage with finger pressure immediately after instillation of any eyedrop also decreases the amount of drug that is absorbed systemically. PMID- 3306269 TI - Role of extracorporeal drug removal in acute theophylline poisoning. A review. AB - Theophylline, with its narrow therapeutic margin, is a common cause of iatrogenic and deliberate overdose. Most cases of self-poisoning are with sustained release preparations, with peak concentrations occurring up to 12 or more hours after overdose. Toxic symptoms are often seen at concentrations above 15 mg/L. Theophylline is metabolised within the cytochrome P-450 system, with an average total body clearance of 50 to 60 ml/min. Clearance is, however, affected by many factors such as other drugs or disease, and in overdose zero order kinetics may result in prolonged half-lives. Toxicity is characterised by agitation, tremor, nausea, vomiting, abdominal pains, seizures, and tachyarrhythmias. Hypokalaemia and metabolic acidosis are more profound in acute toxicity, and hypercalcaemia is usually present. Seizures occur at lower concentrations after chronic over medication than after acute overdose. Gastric lavage should be performed in all patients presenting early, and an oral multiple dose charcoal regimen started with 50 to 100g charcoal, repeating with 50g doses and checking theophylline concentrations at 2- to 4-hour intervals. Multiple dose charcoal can be expected to double the clearance of theophylline, being as effective as a haemodialysis. Of the invasive techniques available, charcoal haemoperfusion is the most effective, increasing clearance 4- to 6-fold. Supportive care is particularly important. The aggressive supplementation of potassium, treatment of emesis with droperidol and ranitidine, and treatment of tachyarrhythmias and hypotension (possibly with propranolol), together with oral multiple dose charcoal may obviate the need for haemoperfusion. Seizures suggest increased morbidity and mortality. Charcoal haemoperfusion should be considered if plasma concentrations are greater than 100 mg/L in an acute intoxication or greater than 60 mg/L in a chronic intoxication. The decision to haemoperfuse should not be based on plasma concentrations alone, but an overall evaluation of the patient's laboratory and clinical status. PMID- 3306270 TI - Sterling D. Garrard Memorial Symposium: Community health care services for adults with mental retardation. November 18, 1986, Auburn, Massachusetts. Proceedings. PMID- 3306271 TI - Some thoughts in memory of Sterling Garrard. PMID- 3306272 TI - Recollections about Sterling Garrard. PMID- 3306273 TI - The thinking of Sterling Garrard. PMID- 3306274 TI - Medicaid after 20 years: promise, problems, potential. PMID- 3306275 TI - Bibliography of principal references on health and medical concerns for adults with mental retardation. PMID- 3306276 TI - Abnormal calcium handling by perifused pancreatic islets from neonatal streptozotocin diabetic model rats. AB - To elucidate the mechanism of impaired insulin release in case of non-insulin dependent diabetes (NIDDM), we investigated insulin release and 45Ca++ efflux from perifused islets obtained from neonatal streptozotocin diabetic model rats. The model rats were prepared by the intraperitoneal administration of 65 mg/kg streptozotocin (STZ) to neonatal males. Rats treated with STZ did not differ from controls in body weight from 1 week to 16 weeks. The model rats had significant hyperglycemia both in the fasting state and after intraperitoneal administration of 2 g/kg glucose. Although the diameter of the islets from the model rats was not significantly different from that of controls, immunoreactivity to anti insulin was slightly diminished, and degranulation was slightly observed in B cells. Insulin content was reduced to 45.6% of the control. Insulin release from the perifused islets of STZ-treated rats responded little to 16.7 mmol/L glucose, but normally to 20 mmol/L arginine in the presence of 5.5 mmol/L glucose. In experiments to test the 45Ca++ efflux from the perifused islets prelabeled with 45Ca++, a rise of 45Ca++ efflux concomitant with the second phase of insulin release from the islets of the model rats was inhibited although a sharp increase of 45Ca++ efflux concomitant with the first phase of insulin release was maintained. 45Ca++ uptake for 30 minutes was reduced in the islets from the model rats in the basal and stimulated state of insulin secretion although the incremental 45Ca++ uptake was similar. It is possible that the abnormal calcium handling in pancreatic B-cells may be one of the causes of defect in insulin release in our model rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306277 TI - Association of serum lipids and lipoproteins with plasma C-peptide concentration in non-insulin-dependent diabetic and non-diabetic subjects. AB - Serum lipids and lipoproteins were studied in 149 non-insulin-dependent diabetic subjects treated with diet or oral drugs (75 men, 74 women) and in 101 nondiabetic control subjects (49 men, 52 women) in relation to endogenous insulin secretion capacity measured by plasma C-peptide response to intravenous glucagon. Serum HDL- and HDL2-cholesterol concentrations were lower and VLDL-cholesterol and total and VLDL-triglyceride concentrations higher in subjects with high C peptide response (above the median) than in subjects with low C-peptide response (lower or equal to median) both in diabetic and control subjects of both sexes. Adjustment for the effect of obesity abolished these differences in serum lipids and lipoproteins in diabetic subjects but not in control subjects. This may indicate that obesity has stronger influence on serum lipids in diabetic subjects than in nondiabetic subjects. PMID- 3306278 TI - Selective in situ pancreatic perfusion via chronic in vivo celiac artery catheterization. AB - A new technique to catheterize the celiac artery has been developed. This has opened the possibility for direct in vivo, in situ study of pancreatic endocrine cell function in a conscious experimental animal. The catheter is small, soft and placed without arterial ligation so that celiac artery, hepatic, splenic, and pancreatic blood flows were essentially not compromised. Arterial vessel integrity, absence of inflammation, and thrombosis as well as catheter patency were achieved for periods exceeding eight months. Metabolically and hormonally, the presence of the catheter had no effect on the fasting status. However, we found somewhat lower glucose levels and higher insulin levels in the response to oral glucose challenges after catheterization, but these differences were statistically not significant. Glucose loads of 50 mg/kg (0.75 g) administered directly to the pancreas via the celiac artery produced peak insulin levels similar to peripheral glucose loads some tenfold larger. We suggest that this technique may be useful to selectively study the first-pass pancreatic response to a variety of hormones, drugs or metabolic substrates. PMID- 3306279 TI - Net hepatic lactate balance following mixed meal feeding in the four-day fasted conscious dog. AB - The present experiments were undertaken to determine whether four days of fasting and marked hepatic glycogen depletion would alter the effect of mixed meal feeding on net hepatic lactate balance in the conscious dog. Dogs were fasted for four days and were then fed a mixed meal over a ten-minute period. Net hepatic glucose and lactate balance were monitored for the next eight hours using the A-V difference technique. The arterial plasma glucose level rose to a maximum of 121 +/- 3 mg/dL three hours after feeding and then decreased. Net hepatic glucose output declined to 0.44 +/- 0.44 mg/kg/min but the liver never became a net consumer of glucose. The arterial blood lactate level rose from 678 +/- 71 to 1000 +/- 158 mumol/L as the liver switched from net lactate uptake (12.2 +/- 2.0 mumol/kg/min) to net lactate production (4.3 +/- 1.7 mumol/kg/min). Over the course of the eight-hour postprandial period 25 g of glycogen were deposited in the liver. The net hepatic uptake of the gluconeogenic amino acids rose from 6.1 +/- 1.2 mumol/kg/min to a peak of 15.4 +/- 4.3 mumol/kg/min one hour after feeding. Net hepatic uptake of glycerol fell from 3.0 +/- 0.3 mumol/kg/min to an average of 1.5 +/- 0.4 mumol/kg/min. The plasma insulin level increased from 13 +/- 2 microU/mL at 3.5 hours and fell to 32 +/- 7 microU/mL by 8 hours. The plasma glucagon level rose from 22 +/- 3 pg/mL to 93 +/- 12 pg/mL 1.5 hours after feeding and fell to 68 +/- 6 pg/mL 8 hours after feeding.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306280 TI - Possible role for the glucose-fatty acid cycle in dexamethasone-induced insulin antagonism in rats. AB - This study was undertaken to elucidate the mechanism(s) involved in glucocorticoid-induced insulin antagonism. Male Sprague-Dawley rats (200 to 210 g) were injected with 1 mg/kg dexamethasone-phosphate (Dex) or the vehicle every other day for 10 days. Two days after the last injection, fasted anesthetized animals were infused (per kg body weight per min) with 8 mg glucose, 5 mU porcine insulin and 1.4 micrograms somatostatin with blood sampling before, and at 10 min intervals between 90 and 130 min after the pancreatic suppression test was begun. At the end of the test, abdominal muscle was quickly freeze-clamped and the substrate and products of the rate-determining reactions of glycolysis and glycogenesis were measured. Dex-treated rats had higher basal (0 min) and steady state levels (90-130 min) of both glucose and insulin signifying insulin antagonism. The pattern of muscle tissue metabolites revealed no free intracellular glucose in either group and concentrations of all other metabolites in the Dex-treated rats were less than those in the control animals (except for a small increase in glycogen). These results suggest a site of insulin antagonism between (and including) insulin binding and glucose transport. Further studies in the Dex-treated rats revealed normal: a) insulin binding to freshly isolated hepatocytes; b) basal and insulin-stimulated xylose transport in soleus muscle; c) basal and insulin-stimulated glucose uptake in hemidiaphragms. These normal in vitro results suggested that a circulating factor may be responsible. Repeat pancreatic suppression tests in the Dex-treated rats revealed blunted suppression of serum FFA concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306281 TI - Human blood-brain barrier transferrin receptor. AB - The kinetics of binding and endocytosis of 125I-human holotransferrin by isolated human brain capillaries was examined using this system as a model of the human blood-brain barrier (BBB). Both binding and endocytosis of the peptide by human brain capillaries was temperature-dependent and the binding was saturated by holotransferrin, but not by insulin, somatostatin, or vasopressin. Scatchard analysis of the binding reaction revealed a dissociation constant of 448 +/- 110 ng/mL (5.6 +/- 1.4 nmol/L) and a maximal binding constant (Ro) of 8.0 +/- 1.5 ng/mg protein. Thus, the affinity and capacity of the BBB transferrin receptor is within the same order of magnitude as the affinity and capacity of the BBB receptors for insulin, insulinlike growth factor-I, or insulinlike growth factor II. The human brain capillary transferrin receptor was also detected with a mouse monoclonal antibody to the receptor using the avidin/biotin/peroxidase technique. In conclusion, these studies characterize the human BBB transferrin receptor and support the hypothesis that this receptor acts as a transport system which mediates the transcytosis of transferrin-bound iron through the brain capillary endothelial cell in man. PMID- 3306283 TI - Elastin: an overview. PMID- 3306282 TI - Modulation of the enzymic activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase by multiple kinase systems involving reversible phosphorylation: a review. AB - This report summarizes the current concepts regarding the in vitro and in vivo modulation of the enzymic activity of HMG-CoA reductase and mevalonate formation in rat and human liver, as well as in cultured fibroblasts from normal and familial hypercholesterolemic subjects. Three separate mechanisms for the short term modulation of hepatic HMG-CoA reductase activity by covalent phosphorylation have been described. These mechanisms involved three separate specific kinase systems including reductase kinase, protein kinase C, and a Ca+2, calmodulin dependent kinase. The conceptual schemes presented in this report will provide a basis for future research as well as an overview for improved understanding of the complex and multifaceted short-term regulation of this key enzyme in the biosynthetic pathways of mevalonate, ubiquinones, dolichols, isopentenyl-tRNAs, and cholesterol. PMID- 3306284 TI - Immunology of elastin. PMID- 3306285 TI - Elastin degradation. PMID- 3306286 TI - The collagens: an overview and update. PMID- 3306287 TI - Proteoglycans: an overview. PMID- 3306288 TI - Catabolism and turnover of proteoglycans. PMID- 3306289 TI - Long-term placebo-controlled efficacy and safety study of Org OD 14 in climacteric women. AB - In a randomized, double-blind, placebo-controlled efficacy and safety study of Org OD 14 [(7 alpha,17 alpha)-17-hydroxy-7-methyl-19-norpregn-5(10)-en-20-yn-3 one] in 60 post-menopausal women, the effects of treatment on clinical parameters (hot flushes and associated complaints) and laboratory parameters (routine haematology and biochemistry) were evaluated. Assessments were made before treatment and after 1, 3, 6, 9 and 12 mth of therapy (in the case of the laboratory parameters after 6 and 12 mth only). In total, 17 patients dropped out, 6 of whom were on Org OD 14 and 11 on placebo. Clinical parameters were evaluated by means of the Yates test. Org OD 14 had a significantly better effect than placebo on hot flushes and sweating at all stages of assessment. A similar effect, albeit to a lesser extent, was seen on sleeplessness, fatigability, irritability and psychic instability. Serum levels of alkaline phosphatase, triglycerides, high-density lipoprotein cholesterol and phosphate decreased during Org OD 14 treatment. It was concluded that Org OD 14 provides a new, efficient and safe means of treating the post-menopausal syndrome. PMID- 3306290 TI - Clinical profile of Org OD 14. AB - The clinical profile of Org OD 14 ((7 alpha,17 alpha)-17-hydroxy-7-methyl-19 norpregn-5 (10)-en-20-yn-3-one) is remarkable in that the compound demonstrates simultaneous weak oestrogenic, androgenic and progestational activity after oral administration to animals. It was therefore studied to evaluate its efficacy in the treatment of the climacteric syndrome. Clinical data demonstrating these combined hormonal effects are reviewed in this paper: Administration of 2.5 mg/day Org OD 14 suppressed gonadotrophins in post-menopausal women and inhibited ovulation in fertile women. In post-menopausal women virtually no endometrial proliferation was induced, only occasional, very slight proliferation being seen. Even after 2 yr of therapy no endometrial hyperplasia was observed. A weak stimulatory effect on the vaginal mucosa was apparent. In addition, Org OD 14 prevented post-menopausal bone loss and alleviated vasomotor climacteric symptoms effectively. It also had a beneficial effect on mood and libido. Org OD 14 was well tolerated. The incidence of side effects (changes in body weight, vaginal bleeding) was low and similar to that with placebo treatment. Extensive safety studies of up to 5 yr duration, including liver function tests and metabolic studies, indicated no untoward effects. It was concluded that Org OD 14 is an effective and safe new preparation for the treatment of climacteric patients. PMID- 3306291 TI - Use of Org OD 14 for the treatment of climacteric complaints. AB - The effects of treating climacteric complaints in post-menopausal women were studied in an open trial in which Org OD 14, a placebo and no treatment were compared. In addition to the symptomatic effects, clinical and laboratory parameters were also studied. One hundred and twenty-four women who had undergone a natural or surgical menopause completed 4 mth of randomized treatment; 35 received Org OD 14 (2.5 mg/day, per os), 46 a placebo, and 43 no treatment. The mean ages and time in years since menopause were comparable for each group. The parameters were assessed before treatment and after 4 mth. The results in the group treated with Org OD 14 were compared statistically with those for the other two groups using the chi 2 test, Student's t test or analysis of variance. A beneficial effect on clinical parameters was seen following Org OD 14 treatment. The results as regards hot flushes and sweating were significantly better statistically than those in the other groups. Org OD 14 was found to have no effect on the endometrium, breasts, body weight or blood pressure, while vaginal atrophy was slightly improved. Serum levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and phosphate were slightly reduced by Org OD 14. Liver function tests, clotting factors and the other routine laboratory parameters were not affected by Org OD 14 treatment. It was concluded that Org OD 14 is an effective and safe compound for the treatment of climacteric syndrome. PMID- 3306292 TI - Coagulation and fibrinolysis in post-menopausal women treated with Org OD 14. AB - The effects of a new synthetic steroid Org OD 14 on the haemostatic mechanism were investigated in 60 post-menopausal women, randomly allocated to 12 weeks of treatment with either 2.5 mg/day of Org OD 14 or a placebo in a double-blind, group-comparative study. Assessments were made 2 weeks before and just prior to the start of treatment, at weeks 6 and 12 during treatment, and 2 weeks after its cessation. No significant differences between the two groups were found with regard to prothrombin time, kaolin cephalin clotting time (KCCT), clotting factors VII, VIII and X, white blood count (WBC) or transaminases (ASAT, ALAT). The following statistically significant differences were seen in the Org OD 14 group: higher plasminogen, antithrombin III, haemoglobin, haematocrit and platelet count, and increased fibrinolytic activity on fibrin plates, as well as lower fibrinogen and alkaline phosphatase values. These findings indicate that Org OD 14 displays no adverse effects on coagulation, while changes in fibrinolysis seem to be beneficial for post-menopausal women. PMID- 3306293 TI - Adherence to and penetration of cultured cells by an invasive strain of Escherichia coli: an ultrastructural study. AB - The penetration process of an enteroinvasive strain of Escherichia coli 0124 into HEp-2 cells has been studied by electron microscopy. Bacteria penetrated into cultured cells by a phagocytosis-like mechanism, and multiplied within the vacuoles as well as in the cytoplasmic matrix. On the whole, the infection cycle of EIEC appeared to be similar to that described for Shigella. The stain examined has also been found to elaborate a 40 nm-thick glyocalix, which is probably involved in the recognition of host surface receptors and therefore in the attachment of microorganisms to the cell membrane. PMID- 3306294 TI - A new chromogenic test for the detection of urokinase in the genus Shigella. AB - A simple test for detection of urokinase in Shigella is described. The test is performed by suspending a loopful of bacteria in 100 microliters of a buffered 1mM solution of benzoyl-beta-alanyl glycyl-arginyl-4-nitroanilide acetate (Chromozym U). Enzymatic activity is revealed by formation of a yellow colour after 24 h of incubation at 37 degrees C. The test is able to differentiate serotypes of Shigella dysenteriae, Shigella flexneri, Shigella boydii. The results suggest the possibility of including this chromogenic test in the biochemical assay of Shigella genus. PMID- 3306295 TI - A personal history of the progress in contraception during the past 60 years. PMID- 3306296 TI - Infant feeding in the Bible. PMID- 3306297 TI - Comparison of computer-assisted learning with tutorial teaching in a group of first-year dental students. AB - Two identical groups of first-year dental students were instructed in the pathology of dental caries and periodontitis using computer-assisted learning (CAL) or tutorial teaching (TT). A cross-over arrangement, in which the first group was taught about dental caries by CAL and periodontitis by TT and the second group in the reverse order, allowed comparison of the two methods. The comparison included a knowledge test and completion of a questionnaire. CAL and TT were equally effective as far as acquisition of knowledge was concerned. Students felt pressurized with CAL and had problems with note-taking. They liked a teacher to be present. Nevertheless, CAL was an acceptable method of instruction and was more economical, in terms of staff involvement, than TT. PMID- 3306298 TI - The clinical effects of mixing short- and intermediate-acting insulins in the treatment of non-insulin-dependent diabetes. AB - Premixing short- and intermediate-acting insulins in one syringe, with refrigerated storage before injection, is practised by some centres in the treatment of older patients with non-insulin-dependent diabetes. Because other studies have reported the loss of the short-acting insulin component after mixing with intermediate-acting insulins, we examined the clinical effect of mixing soluble insulin with lente or isophane insulins in subjects with non-insulin dependent diabetes. When soluble and lente insulins were mixed in the same syringe and injected immediately, the peak level of insulin was very similar to the peak level after separate injections but occurred at five hours instead of three hours after the injection. As a result, the plasma free-insulin profile over three hours was lower with premixed insulin than after separate injections of the two insulins (incremental insulin area, 88 +/- 20 mU.L-1.h, and 129 +/- 37 mU.L-1.h, respectively; P less than 0.05). This delay in the absorption of soluble insulin caused a greater rise in plasma glucose levels such that the incremental glucose area over eight hours was 25.5 +/- 4.4 mmol.L-1.h for premixed insulin compared with 10.4 +/- 6.2 mmol.L-1.h for separate injections (P less than 0.05). Soluble and isophane insulins had similar absorption profiles whether injected separately or premixed (incremental insulin area, 0 to 3 h, 176 +/- 44 mU.L-1.h and 156 +/- 29 mU.L-1.h, respectively). Our results indicate that the absorption of soluble insulin is delayed when it is mixed with lente insulin but not with isophane insulin. Even in subjects with endogenous insulin secretion, this effect may have clinical importance and should be taken into account when insulin therapy is adjusted for patients with non-insulin-dependent diabetes. PMID- 3306299 TI - Relevance of the salt-hypertension hypothesis to the community control of hypertension. AB - By applying the Framingham data to the distribution of blood pressure in the Australian population, it can be shown that almost half the morbidity from strokes and ischaemic heart disease that is attributable to blood pressure would be expected to occur in subjects who are "normotensive" by the current World Health Organization (WHO) definition. The steadily increasing risk with every increment of diastolic blood pressure above 70 mmHg supports the contention that the dividing line between "normotension" and "hypertension" is artefactual, and that the basic problem is the tendency for blood pressure levels to rise with age. The rise with age occurs exclusively and invariably in salt-eating societies, and the most promising hypothesis that is awaiting evaluation is that this rise could largely be prevented by the universal adoption of the Australian Recommended Dietary Intake for sodium of 40-100 mmol/day. Two factors that may limit the prophylactic effect of avoiding salt are self-sustaining hypertension and teratogenic hypertension, both of which are seen when rats are fed salt. In Australia and several other countries it is already official policy to recommend a lower intake of salt. Although we support this, we consider that interventions with such massive implications are incomplete without a serious attempt to measure the outcome. Double-blind conditions would be impossible, but a large scale population-based trial with randomization would be feasible. The first stage of the trial should consist of a campaign of salt reduction in patients with established hypertension, in collaboration with medical practitioners and the food industry, because it is unrealistic to expect good dietary compliance from several thousand "normotensive" persons until those who want to avoid salt are catered for more adequately. PMID- 3306300 TI - Topical minoxidil for baldness. PMID- 3306301 TI - Interleukin-2. PMID- 3306302 TI - [Experimental evaluation of the methodology for titrating outbred mice to quantitatively measure the rickettsial burden of Ixodoidea ticks]. PMID- 3306303 TI - [Dynamics of proteolytic enzyme activity in the culture medium of Musca domestica L. housefly larvae]. PMID- 3306305 TI - Estimation of tissue parameters derived from reflected ultrasound. AB - We propose a method of estimating two tissue parameters, that is, the reflection coefficient and attenuation coefficient from the reflected ultrasound for the purpose of improving the resolution of ultrasonic images and obtaining information on tissue characterization. The reflection coefficient is estimated by deconvolution technique using Kalman filter taking into account the distortion of the propagating pulse due to the frequency-dependent attenuation. The attenuation is estimated by adaptive processings based upon the criterion function calculated using estimates of the reflection coefficient. Simulated signals are used to investigate the ability of this method. Additionally, actual reflected signals from soft tissues are processed by the method. The results show that the method can be applied in clinical cases. PMID- 3306304 TI - Envelope amplitude analysis following narrow-band filtering: a technique for ultrasonic tissue characterization. AB - Ultrasonic waveforms backscattered from tissue simulating phantoms and from normal and cirrhotic human livers in vivo were digitized to a standard dynamic range prior to envelope detection and determination of envelope amplitude distributions. For 11 individual narrow-band Gaussian-shaped filters of -6 dB bandwidth 200 kHz, and of center frequencies from 2 to 4 MHz, envelope amplitude distributions were plotted and mean values of the values distributions computed. Analysis of data was performed for data from a phantom containing only relatively small graphite scatters (less than 170 mu), and a similar phantom to which glass spheres 0.5 mm in diameter had been added homogeneously. For lower center frequency narrow-band filters, significantly more high-amplitude occurrences were observed for data from the phantom to which glass spheres had been added. Higher center frequency narrow-band filters gave significantly more high-amplitude occurrences for the phantom containing only small scatters. Similar data analysis was performed for in vivo human liver data from ten normal subjects and five patients with known cirrhosis of the liver. For the cirrhotic and normal livers, data analysis using narrow-band filters of relatively low center frequency resulted in more high- amplitude occurrences for cirrhotic, compared to normal liver; the converse was true for narrow-band filtration at relatively high center frequencies. Determination of mean amplitude following narrow-band filtration with a filter centered at 3.4 MHz was found to be quite repeatable for the normal and cirrhotic liver data; analysis of variance showed the measurement was 94.1% a function of the subject examined, and 5.9% related to the data acquisition session.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306306 TI - Recent progress of technology in obstetrics and gynecology, particularly in perinatal medicine in Japan. PMID- 3306307 TI - [Surgical preparation and technic and perioperative therapy in colorectal interventions: state of the art review]. PMID- 3306308 TI - [Intracranial hypertension following craniocerebral trauma]. PMID- 3306309 TI - History of anesthesia in Jordan. PMID- 3306310 TI - Criteria of brain death--a review. PMID- 3306311 TI - A.R.D.S. at King Hussein Medical Centre. PMID- 3306312 TI - Pathogenesis of renal stones. AB - The process of stone formation within the urinary tract involves multiple etiologic factors. Metabolic and/or ion transport abnormalities, either primary or secondary, provide relative solute excess. Multiple changes in the physical chemistry of the urine follow, leading to crystal formation and the potential for stones to occur. The states of saturation, sites and mechanism of crystal retention, and modifiers of crystal formation influence directly this process. In the evaluation of a patient with stones, etiologic factors, be they in the areas of metabolism, ion transport or physical chemistry should be identified. Treatment is then designed to correct these specific abnormalities. The remainder of this article will be devoted to considerations of these principles. PMID- 3306313 TI - Incidence of upper urinary tract stones. AB - During the last few decades there has been a steady rise of the incidence of upper urinary tract stones in the industrialized countries. Dietary factors, mainly an increased consumption of animal protein, probably explain part of this dramatic change. Little is, however, known how other components of the altered life styles might affect the propensity for stone formation. The prevalence of renal stones, as obtained in postmortem or radiographic studies, is 1-3% without apparent sex differences. In several unselected population surveys the life time risk for males approaches 20% while for females it is 5-10%. The recurrence rate is high and around 50% will experience another stone within 5 years from the onset. The annual incidence is around 1% in males with a peak in the fifth decade. Thus upper urinary tract stones are much more common than is generally appreciated, but most studies of their pathophysiology are only concerned with the small fraction of patients that is investigated in specialized research clinics. PMID- 3306314 TI - Diet and calcium stones. AB - Urolithiasis is a worldwide problem which appears to be aggravated by the high dairy-produce, highly energy-rich and low-fibre diets consumed in most industrialised countries. Together these factors lead to urine with a high risk of calcium oxalate and uric acid crystalluria. Epidemiological evidence points, in particular, to a high-meat protein intake as being the dominant factor within this combination. Such a diet not only increases the risk of stones in the population as a whole through its general effect on the urinary risk factors for stones but also may select out certain individuals who are metabolically more sensitive to this dietary stimulus and who show an exaggerated biochemical response to it. On the basis of epidemiological and biochemical studies, a move towards a more vegetarian, less energy-rich diet would be predicted to reduce the risk of stone formation in the population. PMID- 3306315 TI - Primary hyperparathyroidism and idiopathic hypercalciuria. AB - Primary hyperparathyroidism and idiopathic hypercalciuria are important causes of calcium stone disease. Hypercalcemia is usually the clue to the presence of primary hyperparathyroidism, but a minority of patients are intermittently or persistently normocalcemic. In these patients there appears to be a resistance to the effect of parathyroid hormone on renal calcium transport, to which calcitriol may contribute. Such patients mimic those with idiopathic hypercalciuria, the commonest metabolic cause of stone formation. The pathophysiology of idiopathic hypercalciuria remains controversial, but abnormalities of renal tubule function and disordered vitamin D metabolism are commonly present. The separation into so called renal and absorptive types does not appear to be of practical importance, since thiazide diuretics provide effective prophylaxis regardless of type. PMID- 3306316 TI - Hyperoxaluria. AB - Urinary oxalate is considered to play a crucial role in the formation of renal stones. In this respect hyperoxaluria constitutes a special problem, mainly because of the specific physicochemical properties of oxalate. The appropriate management of patients with this disorder must be based on a thorough understanding of the absorption, metabolism and excretion of oxalate. Different reasons for high oxalate excretion as well as analytical problems and our current therapeutic possibilities are covered in this review. PMID- 3306317 TI - The hyperuricosuric calcium oxalate stone former. AB - Hyperuricosuric patients may form uric acid kidney stones and mixed stones containing both calcium oxalate and uric acid. Some of these patients form pure calcium oxalate stones. Explanation of this syndrome was based on the plausibility of epitaxial growth of calcium oxalate on uric acid crystals acting as substrates. In spite of convincing crystallographic consideration, laboratory experiments did not demonstrate any growth of calcium oxalate on uric acid seeds. An amino acid evidently adsorbing on uric acid seeds and attracting calcium ions could act as a mediating agent, thus realizing the potential of the epitaxial growth of calcium oxalate on uric acid crystals. Administration of allopurinol to hyperuricosuric calcium oxalate stone formers reduced the level of uric acid, consequently preventing the creation of uric acid crystals in urine. It should have removed the direct cause for the formation of calcium oxalate stones. Though undoubtedly more effective than placebo, the therapy with allopurinol was not unequivocally successful. Combined therapy using allopurinol and other drugs which were proved to be beneficial for idiopathic calcium oxalate stone formers, seems to give improved results. The use of procedures for evaluating the effect of therapy on risk factors has been started to predict success in individual cases. PMID- 3306318 TI - Citrate and renal calculi. AB - Potassium citrate is a new and exciting therapeutic approach which has considerably broadened our capability for the medical control of stone disease. The discussion summarizes the data supporting utility of potassium citrate in the management of renal tubular acidosis with calcium stones, hypocitraturic calcium oxalate nephrolithiasis ('idiopathic', or secondary to chronic diarrheal syndrome or thiazide therapy) and uric acid lithiasis with or without calcium stones. PMID- 3306319 TI - Glycoprotein calcium oxalate crystal growth inhibitor in urine. AB - Urine is normally supersaturated with respect to calcium oxalate. Inhibitors of the growth and aggregation of calcium oxalate crystals are present in urine and probably protect against calcium stone formation. These inhibitors are deficient in stone formers. The major inhibitor of calcium oxalate crystal growth is a non dialyzable, anionic macromolecule. An acidic glycoprotein has been isolated from urine and human kidney tissue culture medium which inhibits calcium oxalate crystal growth in vitro. This glycoprotein crystallization inhibitor has a molecular weight of 14,000 daltons and contains 2-3 residues of gamma carboxyglutamic acid. The dissociation constant for the calcium oxalate crystal inhibitor complex is about 10(-7) M. The glycoprotein isolated from the urine of calcium stone formers has a decreased affinity for crystal surface, and a proportionally weaker inhibitory activity; it also lacks gamma-carboxyglutamic acid. PMID- 3306320 TI - Glycosaminoglycans as inhibitors of stone formation. AB - The presence of glycosaminoglycans in the kidney, bladder and urinary tract exerts influence on stone formation through prevention of growth and aggregation. The source of the urinary glycosaminoglycans is contentious with respect to the relative contribution of the kidney and bladder secretions to the overall inhibitory power. Mechanisms have been advanced for the action of glycosaminoglycans, and the active species involved appears dependent upon the degree of sulfation of the molecule. Thus, the ultimate role of glycosaminoglycans as urinary inhibitors of stone formation may well be dictated by the specific nature of the glycosaminoglycan present and its inherent acidic properties. The overall contribution of urinary glycosaminoglycans to protect against urolithiasis however still needs to be evaluated. PMID- 3306321 TI - Infection (urease) stones. AB - Infection-induced stones in man probably form solely as a consequence of urealysis which is catalyzed by the bacterial protein urease. Urease stones composed of struvite and carbonate-apatite may form primarily, or as secondary stones or pre-existent metabolic stones. Struvite stones form and grow rapidly owing to (a) supersaturation of urine with stone forming salts, (b) 'salting out' of poorly soluble organic substances normally dissolved in urine and (c) ammonia induced destruction of the normally protective urothelial glycosaminoglycan layer. Immature (predominantly organic) matrix stones mature into densely mineralized stones. Curative treatment is possible only by eliminating all of the stone and by eradicating all urinary and parenchymal infection. A variety of operative and pharmaceutical approaches are available. Patient treatment must be individualized inasmuch as some patients are better candidates for one type of treatment than another. PMID- 3306322 TI - [Recurrent infantile multifocal periostosis. Description of a case]. PMID- 3306323 TI - [Oxyuriasis in childhood. Epidemiologic considerations and diagnostic methods in a sample of symptomatic subjects]. PMID- 3306324 TI - [Clinical and microbiological effects of a single ultrasonic scaling session in periodontal pockets of different depths]. PMID- 3306325 TI - [Type 1 diabetes mellitus and juvenile periodontopathies]. PMID- 3306326 TI - [Protection of the palate after removal of the fibrous mucosa in free gingival grafts]. PMID- 3306327 TI - [Salivary acidity as an index of periodontal disease in pregnancy. A clinical contribution]. PMID- 3306328 TI - [Current indications for the use of the bone denudation technic. Report of a clinical case]. PMID- 3306329 TI - Meditation: uses and methods in psychiatric nurse education. PMID- 3306330 TI - Tuberous sclerosis. AB - Tuberous sclerosis is a multisystem disorder characterized by changes primarily involving the skin, eye, and central nervous system. Although the disease often produces mental retardation and seizures, this is not universal, and some patients with tuberous sclerosis lead a relatively normal life. PMID- 3306332 TI - Dermatomyositis. AB - Dermatomyositis is a condition that combines an inflammatory myopathy with characteristic cutaneous disease. This disorder is closely related to polymyositis, which has all the muscular features of dermatomyositits without the presence of skin disease. Both dermatomyositits and polymyositis may occur in the presence of other collagen vascular diseases such as lupus erythematosus, scleroderma, Sjogren's syndrome, rheumatoid arthritis, and various vasculitides. Dermatomyositis seems to be characterized by an increased frequency of internal malignancy and both dermatomyositis and polymyositis are associated with morbidity and mortality. Therefore, prompt and aggressive therapy is necessary. PMID- 3306331 TI - Incontinentia pigmenti. AB - Incontinentia pigmenti (IP) is an unusual genodermatosis occurring almost exclusively in female patients. IP is characterized by swirling hyperpigmented skin lesions and associated with a high incidence of systemic defects. Nearly one third of patients present with neurologic complications. Consequently, neurologists and other clinicians involved in the care of these patients must be able to identify the cutaneous markers and systemic findings of IP. This article discusses the clinical presentations, laboratory findings, and pathogenesis of IP. A systematic approach to the evaluation and management of patients with IP is presented. PMID- 3306334 TI - Behcet's disease. AB - Behcet's disease is a complex, multisystem disease that was first described in 1937 by the Turkish dermatologist, Hulusi Behcet, but may have been recognized since ancient times. In his original description, Behcet referred to a symptom complex of recurrent oral aphthous ulcers, genital aphthae, and iritis that could lead to blindness. Additional clinical manifestations include the pathergy phenomenon (the induction of a cutaneous pustular neutrophilic vascular reaction after intradermal trauma), arthritis, thrombophlebitis, erythema nodosum-like cutaneous lesions, and neurologic signs and symptoms ranging from benign intracranial hypertension to a condition resembling multiple sclerosis. The author discusses epidemiology, diagnosis, clinical aspects, pathology, clinical course of the disease, and therapy. PMID- 3306333 TI - Sjogren's syndrome. Cutaneous, immunologic, and nervous system manifestations. AB - The studies recounted in this review have demonstrated that cutaneous vasculitis is a frequent extraglandular manifestation of primary Sjogren's syndrome. Two histopathologic types of vasculitis have been detected. One type, a leukocytoclastic angiitis, is found in association with high-titer anti-Ro(SS-A) antibodies, rheumatoid factor, hypergammaglobulinemia, and hypocomplementemia. The second type, a mononuclear inflammatory vasculopathy, in sharp contrast, is found in association with low-titer Ro(SS-A) antibodies, normocomplementemia, and absence of hypergammaglobulinemia and rheumatoid factor. Both types of vasculitis are found in association with peripheral nervous system and CNS disease. The peripheral nervous system and CNS disease involves the entire neuroaxis and preliminary data indicate that a vasculopathy is the cause of the peripheral nervous system and CNS disease. Evoked sensory response testing, CSF analysis, and MRI have proved to be very valuable techniques in investigating these patients with Sjogren's syndrome. Preliminary data suggest that high doses of prednisone or immunosuppressive agents are effective in treating these patients. PMID- 3306336 TI - Epidermal nevus syndrome. AB - Epidermal nevi are linear hamartomas of epidermal structures that usually appear at birth or during infancy. Patients with the epidermal nevus syndrome have epidermal nevi with abnormalities of the central nervous system, eyes, and bones, and other cutaneous alterations. PMID- 3306335 TI - Ataxia-telangiectasia. AB - Ataxia-telangiectasia is an autosomal recessive disorder characterized by early ataxia, oculocutaneous telangiectasias, sinopulmonary infections, selective immunodeficiency, and a high risk of malignancy. The appearance of the telangiectasias often allows the diagnosis to be made in a child with ataxia. PMID- 3306337 TI - Cutaneous manifestations of neurologic infections in children. AB - Neurologic infections in children are frequently accompanied by cutaneous findings that may direct the physician toward the correct diagnosis. In some instances, the appearance of an eruption (such as erythema chronicum migrans and Lyme disease) is specific or a rapid bedside diagnostic test (Tzanck preparation for herpes simplex) is extremely helpful in sorting out the differential diagnosis of a child's illness. In this article, cutaneous clues to some of the more important childhood infections will be reviewed. PMID- 3306338 TI - The psyche and the skin. AB - The concept of psychosomatic disorders has been undergoing great evolutionary changes during the past 20 to 30 years. There is no longer any significant or reasonable disagreement that the brain and body mutually interact, and the pathways of those interactions are being explored and explained. Enormous amounts of work are being done to unravel the workings of the brain, which is more complex than any other organ because of neural connections and networking of astronomic proportions. PMID- 3306339 TI - [People who supported progress of cardiovascular surgery]. PMID- 3306340 TI - [Clinicohistopathological and immunohistochemical studies on intrapancreatic spread of pancreatic carcinoma]. AB - Clinicohistopathological and immunohistochemical studies on intrapancreatic spread of pancreatic carcinoma were performed on 30 cases with total pancreatectomy accompanied by portal vein resection. In the observation of HE stained tissue sections of 25 cases of carcinoma of head of the pancreas, the intrapancreatic spread from the head to body or tail was observed in 9 out of 25 cases (36%). However, by the immunostaining of CEA, CA19-9 and Dupan 2, small cancer nests surrounded by fibrous tissues could be easily detected and intrapancreatic continuous spread from the head to body or tail was observed in 15 out of 25 cases (60%). The intrapancreatic spread of the carcinoma correlated with portal invasion of carcinoma, hardness of the body and tail, obstruction of main pancreatic duct and irregular pancreaticogram. The intraoperative quick immunostaining on the cryostat sections of the pancreatic tissue, together with the HE staining, is useful to determine the intrapancreatic spread of the carcinoma. The indication of total pancreatectomy for pancreatic carcinoma can be determined by these results. PMID- 3306341 TI - [Long-term follow-up study of renal autotransplantation in reno-vascular hypertension]. AB - Therapeutic effects of heterotopic renal transplantation for renovascular hypertension were evaluated in ten patients with a follow-up period of more than three years. These ten patients consisted of 4 males and 6 females with the range of age from 21 to 55. The causes of renovascular hypertension were fibromuscular dysplasia in five patients, atherosclerosis in 3 and aortitis syndrome in 2. All the ten patients had a unilateral stenosis of the renal artery. At 3 years after operation, the blood pressure fell to normal range without any medication in 9 patients (90%) and it could be controlled with antihypertensive drugs in the remaining one patient. Operative mortality or deterioration of graft function was not experienced in any of them. One of the female patients had three deliveries after operation. The heterotopic renal autotransplantation is a therapeutic method to be selected for renovascular hypertension, since excellent and stable long-term results can be achieved. PMID- 3306342 TI - [The procurement technic from the same donor in heart and liver transplantation]. PMID- 3306343 TI - [Study on optimal size of tricuspid valve annular area in annuloplasty]. PMID- 3306344 TI - Synthesis of hybrid bisnucleoside 5',5"'-P1,P4-tetraphosphates by aminoacyl-tRNA synthetases. AB - Aminoacyl tRNA synthetases, by means of a back reaction, are able to synthesize certain 5', 5"'-P1, P4-bisnucleoside tetraphosphates of biological importance, such as Ap4A. Here it is shown that HisRS and TrpRS (Bacillus stearothermophilus) and AlaRS (E. coli) also synthesize the hybrid compounds Ap4G, Ap4C, and Ap4U. GlnRS (E. coli) is unable to synthesize any of the above compounds. AlaRS synthesizes Ap4U very poorly, and Ap4C and Ap4G almost as effectively as Ap4A. HisRS and TrpRS synthesize Ap4G, Ap4U and Ap3U quite effectively, and Ap4C very poorly. The fact that hybrid bisnucleoside tetraphosphates can be made by the same enzymes, and at rates comparable to Ap4A, suggests that these compounds may also occur in vivo. PMID- 3306345 TI - Cell type-specific expressions of c-ras gene products in the normal rat. AB - Expression of proteins encoded by the ras proto-oncogenes was examined immunohistochemically in formalin-fixed, paraffin-embedded tissues of the normal rat using anti-ras p21 antibodies generated against synthetic peptides. Cell type specific expressions of ras gene products were detected in distal tubules of kidney, megakaryocytes in spleen, neural cells in cerebrum, Purkinje cells in cerebellum, cells lining the pulmonary alveoli and cells in the epithelium of intestinal villi. Region specific expressions of the ras proteins were observed in spleen and thymus, where the ras proteins were detected in splenic nodules including germinal centers and thymic medulla, respectively. These findings suggest that the c-ras gene products in normal rat organs are expressed in specific cell-types within a tissue and may be associated with degree of cellular differentiation. PMID- 3306346 TI - Glycolysis--new concepts in an old pathway. AB - A survey of the existing data on the interactions of glycolytic enzymes with the cellular structure in mammalian tissues has substantiated the occurrence of an extensive degree of such associations in all tissues and during all stages of development. Furthermore, a considerable specificity was evident between the individual multiple forms of the enzymes in relation to these associations. In reviewing these data, a model has been developed which proposes that the glycolytic sequence is best described as consisting of a number of segments in vivo, each segment formed by a cluster of isozymes, many of which can interact with the actin containing filaments of the cytomatrix. The novel features of this segmentation and compartmentation have been described, and evidence has been provided that these phenomena collectively play a key role in meeting the different types of energy requirement in the cytoplasm of divergent cell types, with the wide selection of isozymes in this system offering the potential for increased flexibility and control in this important area of metabolism. PMID- 3306348 TI - [Pictures from the world of the child]. PMID- 3306347 TI - [Identification in utero of malformations of the 1st brachial arch]. PMID- 3306349 TI - [Diagnosis of gynecologic diseases in childhood and adolescence]. PMID- 3306350 TI - Reassessment of LAK phenomenology: a review. PMID- 3306351 TI - [The "side-effects" of plasmids (R-plasmids and virulence)]. AB - Many plasmids affect the host cells. Their effects cannot be explained only by the expression of the well-known genes coding for antibioticresistance, bacteriocinogeny and hemolysis or the analogous genes (side-effects). The side effects are not characteristic of all plasmids operating under similar conditions. Forecasting of the side-effects inducikility by any definite plasmid is impossible now. Sometimes the same functions exert the contrary effects on the bacterial cell. The connection between the presence of plasmids, especially R plasmids and the complex cellular property, virulence, is of great interest. Often, bacteria become less virulent obtaining the plasmids. Two possible reasons causing such an effect are discussed. The first one is a direct effect of plasmids on cellular physiology. The second reason is connected with population shifts caused by the fact that the cells with initial low virulence possess the recipient ability predominantly. The decreased virulence of bacteria harbouring R plasmids, in authors opinion, is quite a natural phenomenon based on plasmid host cells adaptation to the existence in "the realm of antimicrobial agents". PMID- 3306353 TI - Chemical and biological characterization of hazardous industrial waste. II. Eukaryotic bioassay of a wood-preserving bottom sediment. AB - The eukaryotic haploid and diploid forms of Aspergillus nidulans were used to detect gene mutations and various types of chromosome damage, respectively, in the acid, base and neutral fractions of a wood-preserving bottom sediment. The corresponding response to prokaryotic mutagenicity assays and major chemical constituents of the 3 waste fractions were described by Donnelly et al. (1987). The haploid methionine system detected genotoxic compounds in all 3 primary waste fractions without metabolic activation. With metabolic activation, the maximum response observed in the gene mutation assay was induced by the base fraction. In the diploid assay without metabolic activation, the acid fraction induced the maximum number of major chromosome abnormalities, while the base fraction induced the maximum number of minor deletions or insertions. These results appear to reflect the different composition of the waste fractions since each fraction induced a different type of genetic damage in the two bioassays employed. Alternately, because exposure in the diploid assay was during a growth stage, the results may reflect a varying response at different points of the cell division cycle. The results obtained using eukaryotic bioassays indicate that the wood preserving waste contains compound(s) capable of inducing point mutations, chromosome damage, recombination, and compound(s) acting as spindle poisons. PMID- 3306352 TI - Effects of UV repair, error-prone repair and critical site of mutation on mutagenesis induced by N-nitrosamines. AB - Many N-nitrosamines have been assayed for mutagenic activity in bacteria but few have been systematically compared in a series of strains. In this study through the use of several Salmonella tester strains, we have examined the effects of Uvr repair, error-prone repair, and the critical site for mutation (GC or AT base pair) on the mutagenic activities of a diverse group of N-nitrosamines. We have employed the histidine autotrophs, TA1975 (uvrB+), TA1535 (uvrB-) and TA100 (uvrB /pKM101) which are hisG46 strains, sensitive mainly to G-C base damage, and TA104 (uvrB-/pKM101), a hisG428 strain, which can be reverted at the hisG428 locus by damage to A-T base-pairs, or by suppression at G-C base pairs. The N-nitrosamines studied were, N-nitroso: dimethylamine, diethylamine, dipropylamine, dibutylamine, pyrrolidine, piperidine, morpholine, methylbenzylamine, bis-(2 hydroxypropyl)amine, bis-(2-oxopropyl)amine and 3,4-dichloropyrrolidine. For all of the nitrosamines larger than diethylnitrosamine (except for methylbenzylnitrosamine) mutagenesis was greatly enhanced (3-20 X) by the lack of uvrB activity, indicating that the DNA adducts produced by these nitrosamines can be classified as "bulky adducts". For most nitrosamines the plasmid, pKM101, enhanced mutagenesis in hisG46 strains, several fold, suggesting that error-prone DNA repair plays a role in mutagenesis by these compounds. All of the compounds tested were more mutagenic in TA100 than TA104 except diethylnitrosamine and methylbenzylnitrosamine which were more potent in TA104. Revertants induced by all of the nitrosamines in TA100 were due predominantly to damage at G-C base pairs. Revertants induced by all the nitrosamines except diethylnitrosamine and dibutylnitrosamine resulted mainly from damage to G-C base pairs in TA104. PMID- 3306354 TI - Evidence for the presence of mutagenic compounds other than chromium in particles from mild steel welding. AB - A modified Salmonella/microsome liquid culture assay was used to investigate the mutagenicity of the particulate fraction from mild steel welding. Previous reports have implicated compounds of chromium VI as the mutagenic and toxic agents in welding fumes, since only the particles from welding on stainless steel, which contains 15-25% chromium, were mutagenic, whereas particles from welding on mild steel, which contain less than 0.1% chromium, were not mutagenic or toxic. In this investigation, mild steel particles were shown to contain direct-acting and promutagenic compounds that induced frameshift mutations. The mutagenic agents, which were insoluble in sodium phosphate buffer, did not include chromium VI or organic compounds. Further, the expression of mutation appears to require a cell-particle interaction for the release of the mutagenic species from the particles. PMID- 3306355 TI - Inhibitory effects of thiols on a mutagenic contaminant from the synthesis of N nitrosothiazolidine. AB - The effect of S9 and various thiols were studied for potential modifying effects on a mutagenic trace artifact ('NTHZ') formed during the synthesis of N nitrosothiazolidine (NTHZ) from cysteamine, formaldehyde and nitrite. Induced and uninduced S9 prepared from Syrian hamster livers reduced mutagenic activity in Salmonella TA100. Incorporation of boiled S9 into the preincubation medium produced similar effects, indicating a non-enzymatic mechanism for the detoxification reaction. Thiols alone also lowered revertant yields, and inhibitory efficacy was, in general, related to the pKa of the compound. At equimolar concentrations mutagenic activity was reduced in the following order (pKa values in parentheses): Thioglycolate (10.7) greater than mercaptoethanol (9.6) greater than reduced glutathione (8.8) greater than cysteine (8.35) greater than cystine (8.2). N-Acetylcysteine (9.52) and cysteamine (8.35), however, did not fit this pattern. The results of this study suggest that normal hepatic mechanisms may minimize 'NTHZ' genotoxicity thereby reducing potential health risks associated with its exposure. PMID- 3306356 TI - Mutants of Saccharomyces cerevisiae deficient in adenine phosphoribosyltransferase. AB - Spontaneous and ethyl methanesulfate induced mutants of Saccharomyces cerevisiae, with partial and complete deficiency of adenine phosphoribosyltransferase (APRT, EC 2.4.2.7), were isolated by selection for resistance to 8-azaadenine. Matings between totally deficient mutants and tester strain resulted in diploid heterozygotes that were sensitive to azaadenine. Upon sporulation and tetrad analysis, azaadenine resistance (and APRT deficiency) segregated as expected for a single Mendelian gene. Hypoxanthine-guanine phosphoribosyltransferase (EC 2.4.2.8) activity in the mutants was similar to that in the wild-type cells. There was no detectable activity of adenine aminohydrolase (EC 3.5.4.2) in the wild-type or mutant cells. PMID- 3306357 TI - Molecular aspects of DNA repair. PMID- 3306358 TI - Sodium arsenite inhibits spontaneous and induced mutations in Escherichia coli. AB - Sodium arsenite at a non-toxic concentration was found to inhibit strongly mutagenesis induced by ultraviolet light (UV), 4-nitroquinoline-1-oxide (4NQO), furylfuramide (AF-2) and methyl methane-sulfonate (MMS) as well as spontaneous mutation in the reversion assay of E. coli WP2uvrA/pKM101. The effect was not, however, seen in the case of the mutagenesis induced by N-methyl-N'-nitro-N nitrosoguanidine (MNNG). In order to elucidate the mechanism of the mutation inhibitory effect of sodium arsenite, its action on umuC gene expression and DNA repair systems was investigated. It was found that sodium arsenite depressed beta galactosidase induction, corresponding to the umuC gene expression. For UV irradiated E. coli strains possessing different DNA-repair capacities, sodium arsenite decreased the UV survival rates of WP2, WP2uvrA[uvrA] and WP67[uvrA polA], increased those of SOS-uninducible strains having either the recA+ or uvrA+ such as CM571 [recA], CM561 [lexA(Ind-)] and CM611[uvrA lexA (Ind-)], and did not affect that of the uvrA recA double mutant, WP100. From these results, we assume that sodium arsenite may have at least two roles in its antimutagenesis: as an inhibitor of umuC gene expression, and as an enhancer of the error-free repairs depending on the uvrA and recA genes. PMID- 3306359 TI - Are mitochondrial DNA mutations involved in the carcinogenic process? PMID- 3306360 TI - Oncogene activation by chromosomal rearrangement in chronic myelocytic leukemia. AB - A considerable number of human tumors, especially leukemias and lymphomas is associated with a consistent specific chromosome translocation. At a number of the breakpoint regions of these specific aberrations are c-oncogenes (c-onc) located. The structure and/or expression of some of these c-onc is altered as a result of the specific translocation. In the CML-specific (9;22) translocation the transposition of the c-abl oncogene to the chromosome 22 bcr sequences results in the production of a chimeric bcr/c-abl fusion protein. This result strongly suggests that tumor-specific chromosomal aberrations can lead to the activation of cellular oncogenes. PMID- 3306361 TI - N-nitrosamines: bacterial mutagenesis and in vitro metabolism. AB - Many nitrosamines are potent mutagens. The rate-limiting step in their in vitro metabolism to mutagens is usually a single enzymatic reaction catalyzed by one or more of the many cytochrome P-450-dependent mixed-function oxidases present in the microsomal cell fraction. Current evidence indicates that this reaction activates nitrosamines to alpha-hydroxynitrosamines, which have half-lives on the order of seconds. This product decomposes to an aldehyde and a much shorter-lived ultimate metabolite which is probably an alkyl diazonium ion or an alkyl carbocation. This may react with DNA leading to premutagenic adducts. Such adducts represent a very small fraction of the ultimate mutagen, with the rest reacting with water to yield the corresponding alcohol. Evidence for this pathway includes (1) the observation of deuterium isotope effects in metabolism and mutagenesis, (2) products (aldehydes, alcohols, and N2) consistent with this pathway, (3) studies on metabolism of nitrosamines using purified cytochrome P 450, (4) formation of DNA adducts such as O6-alkylguanines which are consistent with those expected from the ultimate mutagen, (5) expected products and genotoxic effects of other sources of activated nitrosamines, e.g., alpha acetoxynitrosamines, alkanediazotates and related compounds. Hydroxylation of nitrosamines at other positions also occurs in vitro (usually to a lesser extent), but these products are generally stable and must be further metabolized to exert mutagenic effects (with the exception of N nitrosoalkyl(formylmethyl)amines, which are direct-acting mutagens). Because only low percentages of nitrosamines are metabolized in vitro, the contribution to mutagenesis by secondary metabolism is small. In this respect, in vitro metabolism can differ significantly from in vivo metabolism. Bacterial mutagenesis by nitrosamines has most often been studied in Salmonella typhimurium and to a lesser extent E. coli. Mutagenesis by nitrosamines generally requires a source of microsomes (a 9000 X g supernatant fraction is often used), and NADPH. Liver fractions from Aroclor-1254- or PB-induced rodents have been most frequently employed but liver fractions from untreated animals, and homogenates of other organs (lung, kidney, nasal mucosa, and pancreas) have also been utilized. Liver homogenates from humans are generally similar to those from untreated rats in metabolizing nitrosamines to mutagens but large interindividual variations are observed. Mutagenesis is often most effective using a liquid preincubation, a slightly acidic incubation mixture and hamster liver fractions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306362 TI - Base-substitution and frameshift mutagenesis by sodium chloride and potassium chloride in Saccharomyces cerevisiae. AB - Sodium chloride (NaCl) and potassium chloride (KCl) are both capable of inducing lethality and mutations when each is administered at a molarity of two for different lengths of time to logarithmic phase cells of the yeast Saccharomyces cerevisiae. Analysis of the revertants indicates that the reversions can be base substitutions, of both the transition and the transversion type, as well as frameshift mutations. At equal molarity, with the frequency of mutations as the criterion, KCl and NaCl are equally efficient in inducing all types of mutations. PMID- 3306364 TI - In vitro testing as a step in the evaluation of in vivo genotoxicity. PMID- 3306363 TI - N-chloropiperidine and calcium hypochlorite: possible examples of toxicity dependent clastogenicity in vitro. AB - N-Chloropiperidine (NCP) has been reported to be both toxic and mutagenic in a wide range of in vitro and in vivo genotoxicity assays, however, few experimental details or numerical data have been presented to support these claims. The latter facts, together with the lack of any clear structural precedent for the mutagenicity of this agent, led us to re-evaluate it using the Salmonella mutation assay and the mouse bone marrow micronucleus test. The absence of mutagenic activity observed in both of these systems indicates that the genotoxicity of NCP and related chloramines remains to be unequivocally established. In particular, the potent clastogenicity to CHO cells reported for NCP may be related solely to oxidative denaturation of cellular proteins induced by hypochlorous acid, a hydrolysis product of NCP. Separate reports indicate that calcium hypochlorite (bleaching powder) is also clastogenic in vitro but not in vivo. We therefore suggest that N-chloropiperidine may prove of value as a model compound for studies designed to distinguish genotoxic clastogenicity (specifically DNA-reactive) from general toxicity-mediated clastogenicity. PMID- 3306365 TI - Peroxidative activation of 3,3'-dichlorobenzidine to mutagenic products in the Salmonella typhimurium test. AB - The direct and H2O2-dependent mutagenicity of 3,3'-dichlorobenzidine (DCB) were compared in Salmonella tester strains TA98, TA98/1,8-DNP6, TA100 and TA102 using the Ames test. DCB exhibited both direct and H2O2-dependent mutagenicity to both tester strains TA98 and TA98/1,8-DNP6. This H2O2-dependent mutagenicity of DCB was prevented by horseradish peroxidase. DCB, in contrast to its effects in tester strains TA98, was not mutagenic to TA100 and TA102 either directly or in the presence of H2O2. These results suggest that mechanisms, perhaps enzymes endogenous to tester strains TA98, may play a role in the activation of DCB. PMID- 3306367 TI - Recent views on amyotrophic lateral sclerosis with emphasis on electrophysiological studies. AB - Peripheral electrophysiological studies are of particular value of elucidating the anatomy and pathophysiology of neuromuscular diseases, but they can also help in providing clues to the etiology of the disease. Recent studies of the motor units in chronic denervating conditions including amyotrophic lateral sclerosis (ALS) are reviewed. These indicate that reinnervation is a relatively active process which compensates for the progressive loss of motoneurons in ALS until more than 50% of the motoneurons have died. There seems to be no predilection for death of motoneurons of any particular size in ALS. Fasciculations may arise both proximally and distally. The dying-back change is not a major feature of ALS. These and other data cast doubt on the etiological theories that ALS arises from premature aging of motoneurons, deficiency of motoneuron trophic factors, or an inhibitor of a motoneuronal sprouting factor, and point to the need to study metabolic changes intrinsic to the motoneuron in ALS. PMID- 3306366 TI - Plant cells at different stages in their growth curve differentially activate promutagens. AB - Mutagenic activity of the promutagens 2-aminofluorene (2AF) and a contaminant of 4-nitro-o-phenylenediamine (NOP-X) was followed in Ames Salmonella strain TA98 following metabolism by cotton and carrot cell suspension cultures using the plant cell/microbe coincubation assay. Both cell lines were capable of activating each chemical. However, activation capacities of the cell lines differed relative to their respective stage of growth when used. For 2AF activation early-log phase cotton cells and mid-log phase carrot cells proved superior while mid-log phase cotton cells and stationary phase carrot cells proved superior for NOP-X activation. These data indicate that the phase of the growth cycle at which plant cells are harvested can significantly affect their promutagen activation potential. PMID- 3306369 TI - Candida albicans and Candida tropicalis antigens studied by SDS polyacrylamide gel electrophoresis and Western blot. PMID- 3306368 TI - Trial of a cysteine proteinase inhibitor, EST, in experimental chloroquine myopathy in rats. AB - The administration of 50 mg/kg/day of chloroquine to rats for 8 weeks produced the chloroquine myopathy characterized by autophagic vacuole formation and increases in lysosomal enzymes, especially cathepsins B & L. Coadministration of 10 mg/kg/day of a potent cysteine proteinase inhibitor, EST, and chloroquine prevented the induction of the chloroquine myopathy. Rats already suffering from the chloroquine myopathy were treated with 10 mg/kg/day of EST together with chloroquine injections for 5 weeks and also recovered remarkably from the myopathy. Thus, EST may be beneficial for myopathies associated with autophagic vacuoles. PMID- 3306370 TI - Inhibitory effect of antifungal agents on germ tube formation in Candida albicans. PMID- 3306371 TI - Resistance of nematode secretory products to cleavage by mast cell proteinases. AB - Mast cell proteinases are known to be released in response to helminth infection, and are, in particular, characteristic of the immune rejection of intestinal nematode parasites. In intestinal mucosal tissue the relevant enzyme is rat mast cell proteinase II (RMCP II) and that of other tissues, including the lung, is rat mast cell proteinase I (RMCP I). The function of these enzymes is unknown, and we have examined the possibility that they directly attack the parasites. This was done by examining the cleavage patterns produced by both proteinases on 125I-labelled excretory/secretory (ES) products of two intestinal nematodes (the infective larva of Ascaris suum, and adult Nippostrongylus brasiliensis) and one which has a pulmonary migration route (the third/fourth stage larva of A. suum). It was first established that all the labelled molecules were proteinaceous, by their susceptibility to broad spectrum proteinases, and that none were host components carried over into culture, by their antigenicity to infected hosts. All the nematode ES products were found to be remarkably resistant to RMCP I and II, only one major component of the infective larva of A. suum being cleaved by both enzymes. This was not found to reflect a resistance to serine proteinases in general, since selected ES components were cleaved by chymotrypsin and trypsin. This would, therefore, argue that, if the enzymes play any direct role in the immune expulsion of nematodes, it is unlikely to be successfully directed at their secretions. PMID- 3306372 TI - The interaction of a Trypanosoma cruzi surface protein with Vero cells and its relationship with parasite adhesion. AB - Previous studies have shown that adhesion to fibroblastic cells of cell culture derived trypomastigotes of Trypanosoma cruzi probably occurs through a ligand receptor interaction. The results now obtained indicate that solubilization with a mild detergent ('Chaps', 0.8%) of 125I-surface proteins of trypomastigotes, followed by detergent removal and interaction of the solubilized proteins with a monolayer of intact Vero cells, brings about binding to the cells of a parasite surface protein, which exhibits a molecular weight of 83,000 and isoelectric point of 8.1-8.6 upon two-dimensional polyacrylamide gel electrophoresis. This polypeptide was detected in extracts of highly adherent, extracellularly incubated parasites, but not in extracts of poorly adhesive, recently released trypomastigotes. The detergent-free extracts of incubated trypomastigotes inhibit attachment of live parasites to Vero cells, while extracts of fresh trypomastigotes are nearly ineffective. Binding of the parasite polypeptide to the cells is stimulated by parasite trypsinization or activation in the presence of tunicamycin, and it is inhibited by the presence of mannan or by Vero cell trypsinization, thus showing a similar behaviour to that observed for parasite attachment to Vero cells under these conditions. These results suggest that the surface membranes of activated, highly adherent T. cruzi trypomastigotes contain an 83 kDa polypeptide which acts as a lectin-like protein that can interact with the surface of Vero fibroblasts, probably through mannose residues of a glycoprotein receptor of the host cell. PMID- 3306374 TI - A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. AB - The use of high-dose corticosteroids in the treatment of severe sepsis and septic shock remains controversial. Our study was designed as a prospective, randomized, double-blind, placebo-controlled trial of high-dose methylprednisolone sodium succinate for severe sepsis and septic shock. Diagnosis was based on the clinical suspicion of infection plus the presence of fever or hypothermia (rectal temperature greater than 38.3 degrees C [101 degrees F] or less than 35.6 degrees C [96 degrees F]), tachypnea (greater than 20 breaths per minute), tachycardia (greater than 90 beats per minute), and the presence of one of the following indications of organ dysfunction: a change in mental status, hypoxemia, elevated lactate levels, or oliguria. Three hundred eighty-two patients were enrolled. Treatment--either methylprednisolone sodium succinate (30 mg per kilogram of body weight) or placebo--was given in four infusions, starting within two hours of diagnosis. No significant differences were found in the prevention of shock, the reversal of shock, or overall mortality. In the subgroup of patients with elevated serum creatinine levels (greater than 2 mg per deciliter) at enrollment, mortality at 14 days was significantly increased among those receiving methylprednisolone (46 of 78 [59 percent] vs. 17 of 58 [29 percent] among those receiving placebo; P less than 0.01). Among patients treated with methylprednisolone, significantly more deaths were related to secondary infection. We conclude that the use of high-dose corticosteroids provides no benefit in the treatment of severe sepsis and septic shock. PMID- 3306373 TI - Circumsporozoite gene of a Plasmodium falciparum strain from Thailand. AB - The nucleotide and deduced amino acid sequences of the CS gene of a Plasmodium falciparum strain from Thailand (T4) are presented. Comparison with the nucleotide sequences of two other P. falciparum CS genes, 7G8 from Brazil and Wellcome from West Africa, shows that: the coding regions outside the repeats of T4 and 7G8 are co-extensive and lack 30 nucleotides present in the Wellcome strain 5' to the repeats; in this region, T4 also differs at 3 nucleotide positions from the 7G8 and the Wellcome strains; in the region 3' to the repeats, T4 differs at two positions from 7G8 and at two other positions from the Wellcome strain--remarkably, all of these differences result in amino acid substitutions; the structure of the tandem repeats in the CS gene of T4 is, 5' to 3', [NANP NVDP] X 3, [NANP] X 38, which is different from that of the two other strains. Due to the use of synonymous codons, the repetition of the sequence is more precise at the amino acid level than at the nucleotide level. These features contrast with those observed in the CS genes of other plasmodial species. PMID- 3306375 TI - A prospective study of ultrasonography in the diagnosis of appendicitis. AB - The diagnosis of appendicitis is frequently difficult. We studied prospectively the diagnostic accuracy and clinical impact of abdominal ultrasonography in 111 consecutive patients thought to have appendicitis. Ultrasonography was performed with small high-resolution, linear-array transducers, with the abdomen compressed to displace or compress bowel and fat. Among 52 patients later shown in surgery to have appendicitis, ultrasonography was unequivocally positive in 39 (sensitivity, 75 percent). Of 31 patients in whom appendicitis was definitely excluded, none had a positive ultrasound examination (specificity, 100 percent). The sensitivity in those with a perforated appendix (28.5 percent) was much lower than in those with acute nonperforating appendicitis (80.5 percent) or appendiceal mass (89 percent), but the low sensitivity did not influence clinical management, since the need for surgery in patients with a perforated appendix was clinically obvious. Ultrasonography resulted in changes in the proposed management in 29 of the 111 patients (26 percent). It also led to the correct diagnosis in the 16 patients who were found to have a disease other than appendicitis. We conclude that ultrasonography is a useful aid in the diagnosis of appendicitis. PMID- 3306377 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 37-1987. A 50-year-old man with bilateral pneumonia and respiratory failure. PMID- 3306376 TI - Dynamic alteration in splenic function during acute falciparum malaria. AB - Plasmodium-infected erythrocytes lose their normal deformability and become susceptible to splenic filtration. In animal models, this is one mechanism of antimalarial defense. To assess the effect of acute falciparum malaria on splenic filtration, we measured the clearance of heated 51Cr-labeled autologous erythrocytes in 25 patients with acute falciparum malaria and in 10 uninfected controls. Two groups of patients could be distinguished. Sixteen patients had splenomegaly, markedly accelerated clearance of the labeled erythrocytes (clearance half-time, 8.4 +/- 4.4 minutes [mean +/- SD] vs. 62.5 +/- 36.5 minutes in controls; P less than 0.001), and a lower mean hematocrit than did the patients without splenomegaly (P less than 0.001). In the nine patients without splenomegaly, clearance was normal. After institution of antimalarial chemotherapy, however, the clearance in this group accelerated to supernormal rates similar to those in the patients with splenomegaly, but without the development of detectable splenomegaly. Clearance was not significantly altered by treatment in the group with splenomegaly. Six weeks later, normal clearance rates were reestablished in most patients in both groups. We conclude that splenic clearance of labeled erythrocytes is enhanced in patients with malaria if splenomegaly is present and is enhanced only after treatment if splenomegaly is absent. Whether this enhanced splenic function applies to parasite-infected erythrocytes in patients with malaria and has any clinical benefit will require further studies. PMID- 3306378 TI - Tempering the technological diagnosis of appendicitis. PMID- 3306379 TI - Efficacy of Haemophilus influenzae type b polysaccharide-diphtheria toxoid conjugate vaccine in infancy. AB - Haemophilus influenzae type b capsular polysaccharide-diphtheria toxoid conjugate vaccine has recently been shown to be capable of inducing antibodies to H. influenzae in infants. In an evaluation of its clinical efficacy, 60,000 children were enrolled in an open trial in Finland. Children born on odd-numbered days between October 1, 1985, and September 30, 1986, received the vaccine at 3, 4, 6, and 14 months; those born on even-numbered days served as controls. The geometric mean antibody titer measured in a cohort of 99 children rose from a prevaccination level of 0.08 microgram per milliliter at three months of age to 0.42 microgram per milliliter at seven months. Only minor adverse reactions were reported. Up to February 1987, two cases of invasive H. influenzae infection had occurred among the children who had received three doses of vaccine, whereas 12 cases had occurred among the controls (P = 0.0005 by Poisson one-tailed test). The rate of short-term (average follow-up time, five months) protection provided by this conjugate vaccine in infancy was thus 83 percent. PMID- 3306381 TI - Cyclosporine for myasthenia gravis. PMID- 3306380 TI - Effect of gradual withdrawal on the rebound sleep disorder after discontinuation of triazolam. AB - Sixty volunteers with insomnia participated in a randomized, double-blind, controlled clinical trial. After an initial six nights of placebo, 30 subjects (the abrupt-withdrawal group) received 0.5 mg of triazolam nightly for 7 to 10 nights, after which they received placebo. The other 30 subjects (the tapered dosage group) received the same initial placebo treatment, then triazolam at 0.5 mg for seven nights, at 0.25 mg for two nights, and at 0.125 mg for two nights, and then placebo. As compared with the initial placebo period, the triazolam period significantly reduced the interval before the onset of sleep (sleep latency), and it prolonged sleep duration, reduced the number of awakenings, and improved the self-rated soundness of sleep in all cohorts. In the abrupt withdrawal group, plasma levels of triazolam were undetectable the morning after the first night of placebo substitution, and subjects reported prolongation of sleep latency (57 minutes longer than base line), reduction in sleep duration (1.4 hours less than base line), and increased awakenings (1.2 per night above base line). The symptoms of rebound sleep disorder lasted one or possibly two nights, and there was a reversion toward base line on subsequent placebo nights. In the tapered-dosage group, however, plasma triazolam levels fell gradually to zero, and rebound symptoms were decreased or eliminated. Thus, rebound sleep disorder following abrupt discontinuation of triazolam can be attenuated by a regimen of tapering. PMID- 3306382 TI - Lack of effect of ABO blood-group antigens on survival after cardiac transplantation. PMID- 3306383 TI - Allogeneic bone marrow transplantation in a patient with chemotherapy-resistant progressive histiocytosis X. PMID- 3306384 TI - The use of ketoconazole as an inhibitor of steroid production. PMID- 3306385 TI - Propranolol in the prevention of first upper gastrointestinal tract hemorrhage in patients with cirrhosis of the liver and esophageal varices. AB - We conducted a prospective, randomized, multicenter, single-blind trial of propranolol as compared with placebo in the prevention of first upper gastrointestinal tract bleeding in patients with cirrhosis of the liver. A total of 230 patients (90 percent with alcoholism and 46 percent with a Child-Pugh grade C classification) with large esophageal varices without previous bleeding were randomly assigned to receive either propranolol (n = 118) or placebo (n = 112), after they had been divided into two groups according to the severity of their liver disease. The end points of the study were bleeding and death. The dose of propranolol was progressively increased to decrease the heart rate by 20 to 25 percent. The final doses were 40 mg of conventional propranolol and 160 and 320 mg of long-acting propranolol daily in 22 percent, 60 percent, and 18 percent of patients, respectively. The mean (+/- SD) follow-up time among survivors without bleeding was 436 +/- 172 days. The cumulative percentages of patients free of bleeding two years after inclusion in the study were 74 percent (95 percent confidence limits, 61 and 83) in the propranolol group and 39 percent (95 percent confidence limits, 15 and 69) in the placebo group (P less than 0.05). Cumulative two-year survival was 72 percent (95 percent confidence limits, 60 and 81) in the propranolol group and 51 percent (95 percent confidence limits, 37 and 64) in the placebo group (P less than 0.05). The advantage of propranolol over placebo was maintained when potentially confounding variables were adjusted with use of the Cox model. Side effects occurred in 17 percent of the patients who received propranolol and led to the stopping of treatment in 11 percent. We conclude that propranolol can decrease the incidence of first bleeding and death during a period of two years in patients with cirrhosis and large varices. PMID- 3306386 TI - Central nervous system toxicity after liver transplantation. The role of cyclosporine and cholesterol. AB - We describe severe central nervous system (CNS) toxicity, manifested by confusion, cortical blindness, quadriplegia, seizures, and coma, associated with cyclosporine treatment in three patients undergoing liver transplantation. CT and magnetic resonance studies disclosed a severe, diffuse disorder of the white matter. All side effects and radiographic findings were reversed with discontinuation or a reduction in the dose of cyclosporine. We also observed an inverse association between CNS side effects and total serum cholesterol levels after transplantation. A retrospective analysis of 54 liver transplantations performed in 48 patients revealed that 13 patients had symptoms of CNS toxicity associated with the use of cyclosporine. These patients' total serum cholesterol levels in the first week after transplantation were reduced as compared with those in patients without symptoms (mean +/- SE, 94 +/- 4 mg per deciliter vs. 132 +/- 6, or 2.44 +/- 0.10 mmol per liter vs. 3.43 +/- 0.16). We conclude that cyclosporine therapy for immunosuppression in liver transplantation may cause a syndrome of encephalopathy, seizures, and white-matter changes and that this is most likely to occur in patients with low total serum cholesterol levels after transplantation. PMID- 3306387 TI - How did Medicare's prospective payment system affect hospitals? AB - Using data from 1982 and 1984, we examined how Medicare's prospective payment system affected hospitals. The study showed that hospitals paid through the prospective payment system had significantly lower increases in Medicare costs and greater declines in Medicare use than did other hospitals. Unlike these other hospitals, for which Medicare costs approximately equaled Medicare revenues, hospitals receiving prospective payment kept Medicare costs from rising as fast as Medicare revenues, earning the profit that the prospective payment system allowed. The opportunity to earn a profit led hospitals to slow increases in Medicare costs, regardless of the level of revenue constraint. However, the more the prospective payment system constrained hospitals' revenues, the more hospitals slowed increases in Medicare costs. In the most constrained hospitals, slower increases in Medicare costs were accompanied by slower increases in total hospital spending. The least constrained hospitals slowed Medicare cost increases the least and did not show their overall spending. These hospitals nevertheless increased their profit margins the most, since the prospective payment system's federal rate paid them the highest rates relative to base-year costs. Since federal rates produced extra profits, not extra cost containment, their appropriateness is questionable. The prospective payment system should be modified to eliminate windfalls while continuing to promote cost containment. PMID- 3306388 TI - Serologic studies in the diagnosis and management of meningitis due to Sporothrix schenckii. AB - Eight patients have previously been reported to have central nervous system infections caused by Sporothrix schenckii. In those patients the fungus proved quite difficult to culture, delaying correct diagnosis and treatment. We describe seven additional patients with sporotrichosis meningitis, all of whom had antibody to this fungus in cerebrospinal fluid and serum. The antibody in the cerebrospinal fluid was most likely produced locally, as evidenced by its oligoclonality and the relatively high ratio of immunoglobulin to albumin in the cerebrospinal fluid as compared with the serum. Only one of these seven patients, who had active sporotrichosis of the knee joint, had obvious extrameningeal infection. None of 130 patients with meningitis known to be caused by other agents and none of 170 patients with other neurologic disorders had antibody to S. schenckii in their cerebrospinal fluid. We suggest that cerebrospinal fluid should be tested for S. schenckii antibody (in addition to other fungal agents) in any patient with chronic meningitis for which no cause is discovered by the usual diagnostic tests. PMID- 3306389 TI - Kidney transplantation from anencephalic donors. PMID- 3306390 TI - Bone marrow transplantation for thalassemia. PMID- 3306391 TI - Medicare-designated centers for cardiac transplantation. PMID- 3306392 TI - Natural occurrence of Nocardia in soil of Tucuman: physiological characteristics. AB - This is the first study initiated in Argentina to establish the presence of species of Nocardia from soil samples. These samples were gathered in different areas of Tucuman. Thirty three pathogenic strains of Nocardia were isolated by the paraffin bait method. Out of them, 28 were N. brasiliensis, 3 N. asteroides and 2 N. caviae. N. brasiliensis was widely distributed in the soil of the areas tested. It is proved that N. caviae, so rarely found in other regions of the world, occurs in Tucuman. A detailed study of the morphological and physiological characteristics for identification is discussed. PMID- 3306393 TI - Interaction between Candida agglutinins and antifungal agents. AB - Antifungal agents alter the function and morphology of Candida cell membranes and cell walls. We observed that brief (30 minute) exposure to either amphotericin B or clotrimazole inhibited the agglutination of Candida blastoconidia by murine bronchoalveolar lavage fluid. This inhibition required continuous drug presence. Neither amphotericin nor clotrimazole inhibited Candida agglutination by concanavalin A or pooled human serum. These results demonstrate that antifungal drugs can produce rapid changes in the surface characteristics of some fungi. PMID- 3306394 TI - International Commission on the Taxonomy of Fungi (ICTF). Code of practice for systematic mycologists. AB - Fourteen points which mycologists dealing with the systematics of fungi (including yeasts) are encouraged to adhere to in their work are presented as a Code of Practice for Systematic Mycologists. Adoption of these will encourage both stability in nomenclature and uniformity in approaches to the descriptions of fungi. PMID- 3306396 TI - Cancer nursing in South Africa: a general overview. PMID- 3306395 TI - Selective inactivation of heterokaryons of Candida albicans by anaerobiosis. AB - Heterokaryons (hets), but not monokaryons of Candida albicans die when grown anaerobically on minimal medium. Their rates of inactivation increase with decreases in growth temperatures from 37 degrees C to 25 degrees C. At 10 degrees C, however, anaerobiosis is not lethal and suppresses the inactivation which normally occurs among hets cultured aerobically at that temperature. Killing of hets by anaerobiosis can be altered significantly by certain exogenously provided amino acids or intermediates of oxidative respiration. Aspartic acid alone promotes inactivation whereas alanine, glutamic acid or lysine individually have no effects. However, glutamate and lysine combined afford slight protection against inactivation while aspartate and glutamate combined, with or without lysine, are highly protective: the activity of the aspartate-glutamate combination is completely negated by the addition of alanine. Other common amino acids have no effects on het responses to anaerobiosis other than the ability, when combined, to relieve the antagonism of alanine for the aspartate-glutamate combination. Anaerobic survivals are also enhanced by oxalacetic acid or alpha ketoglutaric acid, and even more so by a combination of these two intermediates. The resistances to inactivation elicited by the oxalacetate alpha-ketoglutarate or aspartate-glutamate combinations are not additive. These relationships are interpreted to signify that inactivation of hets by anaerobic growth is largely, if not exclusively, due to depletion of their oxalacetic acid and alpha ketoglutaric acid contents for amino acid biosyntheses, and the unique inability of het cells to replenish those keto acids upon subsequent return to aerobic conditions. The observations are consistent with previous indications that mitochondria formed by hets are functionally abnormal. PMID- 3306397 TI - Blood transfusion and autotransfusion during liver transplantation. PMID- 3306398 TI - Trials of vaccine against AIDS to begin in humans. PMID- 3306400 TI - History of optics: John Elliot MD (1747-1787). PMID- 3306399 TI - Prokaryotic and eukaryotic cell-cycle proteins. PMID- 3306401 TI - Kidney problems. PMID- 3306402 TI - Heat shock factor is regulated differently in yeast and HeLa cells. AB - When cells are exposed to elevated temperatures, transcription of a small set of genes, the heat-shock genes, is activated. This response is mediated by a short DNA sequence, the heat-shock element (HSE), which is thought to be the binding site for a specific transcription factor. Studies with Drosophila show that this protein binds to HSEs only in heat-shocked cells, suggesting that changes in factor binding are responsible for gene activation. We have investigated the properties of HSE-binding proteins from yeast and HeLa cells. In HeLa cells, binding activity is present only after heat shock. In contrast, control and heat shocked yeast cells yield the same amount of HSE-binding activity; however, the mobility of protein-HSE complexes on polyacrylamide gels is altered following heat shock. This mobility difference can be significantly reduced by treatment of crude extracts with phosphatase. We propose that the yeast heat-shock factor binds constitutively to DNA but only activates transcription after heat-induced phosphorylation. PMID- 3306403 TI - Cell biology. Ubiquitous cycles of repair. PMID- 3306404 TI - The yeast DNA repair gene RAD6 encodes a ubiquitin-conjugating enzyme. AB - The RAD6 gene of the yeast Saccharomyces cerevisiae is required for a variety of cellular functions including DNA repair. The discovery that the RAD6 gene product can catalyse the covalent attachment of ubiquitin to other proteins suggests that the multiple functions of the RAD6 protein are mediated by its ubiquitin conjugating activity. PMID- 3306405 TI - Failure of familial Alzheimer's disease to segregate with the A4-amyloid gene in several European families. AB - The gene coding for the amyloid protein, a component of neuritic plaques found in brain tissue from patients with Alzheimer's disease, has been localized to chromosome 21, and neighbouring polymorphic DNA markers segregate with Alzheimer's disease in several large families. These data, and the association of Alzheimer's disease with Down's syndrome, suggest that overproduction of the amyloid protein, or production of an abnormal variant of the protein, may be the underlying pathological change causing Alzheimer's disease. We have identified a restriction fragment length polymorphism of the A4-amyloid gene, and find recombinants in two Alzheimer's disease families between Alzheimer's disease and the A4-amyloid locus. This demonstrates that the gene for plaque core A4-amyloid cannot be the locus of a defect causing Alzheimer's disease in these families. These data indicate that alterations in the plaque core amyloid gene cannot explain the molecular pathology for all cases of Alzheimer's disease. PMID- 3306407 TI - Production of recombinant insulin begins. PMID- 3306406 TI - A liver-stage-specific antigen of Plasmodium falciparum characterized by gene cloning. AB - The liver phase of development of malaria parasites has been studied only recently and remains poorly understood compared to the other stages such as sporozoites, merozoites and gametes. Access to liver forms of Plasmodium falciparum has been improved by the development of in vivo and in vitro propagation methods, but the yield of mature schizonts remains limited and does not allow a detailed antigenic analysis. To date, only immunofluorescence assays (IFA) have permitted a description of a species and liver-stage-specific antigen(s) (LSA; ref. 3). Monospecific antibodies to these antigens have not been obtained due either to difficulty in immunizing mice (against LSA), or to poor stability of human monoclonal antibodies. Therefore, as a means of characterizing the LSA, we used an alternative immunological approach to identify clones of the corresponding LSA genes. We describe here the isolation of a DNA sequence coding for a P. falciparum liver-stage-specific antigen composed of repeats of 17 amino acids, which is immunogenic in man. PMID- 3306408 TI - Catalysis of protein folding by prolyl isomerase. AB - Rates of protein folding reactions vary considerably. Some denatured proteins regain the native conformation within milliseconds or seconds, whereas others refold very slowly in the time range of minutes or hours. Varying folding rates are observed not only for different proteins, but can also be detected for single polypeptide species. This originates from the co-existence of fast- and slow folding forms of the unfolded protein, which regain the native state with different rates. The proline hypothesis provides a plausible explanation for this heterogeneity. It assumes that the slow-folding molecules possess non-native isomers of peptide bonds between proline and another residue, and that crucial steps in the refolding of the slow-folding molecules are limited in rate by the slow reisomerization of such incorrect proline peptide bonds. Recently the enzyme peptidyl-prolyl cis-trans isomerase (PPIase) was discovered and purified from pig kidney. It catalyses efficiently the cis in equilibrium trans isomerization of proline imidic peptide bonds in oligopeptides. Here we show that it also catalyses slow steps in the refolding of a number of proteins of which fast- and slow-folding species have been observed and where it was suggested that proline isomerization was involved in slow refolding. The efficiency of catalysis depends on the accessibility for the isomerase of the particular proline peptide bonds in the refolding protein chain. PMID- 3306409 TI - A novel HLA class II molecule (DR alpha-DQ beta) created by mismatched isotype pairing. AB - Human major histocompatibility complex (MHC) class II molecules are heterodimeric glycoproteins composed of non-covalently associated alpha and beta chains. Only isotype-matched alpha-beta associations have been described in man; these can occur either by cis- or trans-complementation (HLA-DR, DQ, DP). Here evidence is provided for the existence of a new type of hybrid molecule (DR alpha-DQ beta) arising by mixed-isotype pairing in human B-cell lines. Class II isotype mismatched heterodimers have been recently reported in the mouse after transfection of class II genes, and our data demonstrate that such interisotypic pairing can occur in untransfected cells. This crosspairing greatly enhances the repertoire of the class II antigens that regulate immune responses and leads us to reconsider the HLA-disease association. PMID- 3306410 TI - The heat shock response of E. coli is regulated by changes in the concentration of sigma 32. AB - Cells subjected to a heat shock, or a variety of other stresses increase the synthesis of a set of proteins, known as heat shock proteins. This response is apparently universal, occurring in the entire range from bacterial to mammalian cells. In Escherichia coli heat shock protein synthesis transiently increases following a shift from 30 degrees C to 42 degrees C as a result of changes in transcription initiation at heat shock promoters. Heat shock promoters are recognized by RNA polymerase containing a sigma factor of relative molecular mass (Mr) 32,000 (32K) E sigma 32 and not E sigma 70, the major form of RNA polymerase holoenzyme. To determine whether changes in the concentration of sigma 32 regulate this response, we measured the amount of sigma 32 before and after shift to high temperature and found that it increased transiently during heat shock as a result of changes in sigma 32 synthesis and stability. Our results indicate that sigma 32 is directly responsible for regulation of the heat shock response. PMID- 3306412 TI - What progress has been made in creating a national system for organ procurement and transplantation? PMID- 3306413 TI - H.R. 2470, the Medicare Catastrophic Protection Act of 1987. PMID- 3306411 TI - A structural model for the retroviral proteases. AB - In many retroviruses the 5' end of the pol gene codes for a protease vital for the processing of the gag polyprotein into the separate core proteins. In some viruses this protease is encoded at the 3' end of the gag gene, or between the gag and pol genes in a different reading frame to either. A sequence, Asp-Thr Gly, which is conserved in retroviral proteases is also conserved in the active sites of aspartic proteases, an observation which has led to the suggestion that the retroviral proteases could belong to this family. We have examined the sequences of the aspartic and retroviral protease families, using pattern recognition, structure prediction and molecular modelling techniques, and conclude that the viral protease sequences probably correspond to a single domain of an aspartic protease and may function in a dimeric form. We have constructed a model of the pol-protease of human immunodeficiency virus 1 (HIV-1) to test this hypothesis. PMID- 3306415 TI - A case of reactive arthritis following Yersinia pseudotuberculosis enteritis. PMID- 3306414 TI - Is dose adjustment of non-steroidal anti-inflammatory drugs necessary in the elderly? A review of the pharmacokinetics of NSAID in the aged. PMID- 3306416 TI - An evaluation of the dialysate solutions for continuous ambulatory peritoneal dialysis. PMID- 3306417 TI - Oxalate dynamics in chronic renal failure. Comparison with normal subjects and patients with primary hyperoxaluria. AB - In order to separate the effect of oxalate retention in primary hyperoxaluria with renal failure from that of excessive oxalate synthesis and to determine the optimum time for renal transplantation in primary hyperoxaluria, we have studied a series of patients with different degrees of renal failure due to other causes. The results were compared with those obtained in studies on 8 patients with primary hyperoxaluria at different levels of residual overall renal function. In the patients with renal failure unrelated to primary hyperoxaluria, oxalate retention increases rapidly when the glomerular filtration rate (GFR) decreases below about 20 ml X min-1. These results suggest that the reduced renal excretory contribution to oxalate accumulation in primary hyperoxaluria would be expected to be particularly important in this range of GFR. In primary hyperoxaluria, oxalate retention occurs when GFR is only a little below the reference range and measures to remove oxalate from the body should be considered when the GFR falls below 40 ml X min-1 X 1.73 m-2, with a view to their introduction when the GFR is in the range 20-25 ml X min-1 X 1.73 m-2. PMID- 3306418 TI - Anti-HTLV-III antibodies in dialyzed or transplanted patients in Spain. PMID- 3306420 TI - Immunosuppression and renal transplantation. PMID- 3306419 TI - Captopril therapy in preeclampsia. PMID- 3306421 TI - OKT3: First-dose safety and success. AB - Orthoclone OKT3 is a murine monoclonal antibody that has been shown to be effective in reversing acute rejection episodes. In a randomized, multicenter trial, Orthoclone OKT3 reversed 94% of acute rejection episodes; conventional treatments reversed only 75%. However, early trials also disclosed some limitations of OKT3 therapy, such as a severe febrile or bronchospastic response following the initial injection, recurrent rejection episodes after discontinuation of OKT3 administration, or the host's production of antibodies to the murine immunoglobulin. In later experiments modifications and precautions applied to the therapeutic helped to control first-dose reactions and decrease antibody production from 86 to 39%. Furthermore, recurrent rejection episodes occurring after discontinuation of OKT3 therapy in azathioprine-prednisone treated patients have been shown to be reversible in most cases: a 75% rate of long-term (14- to 26-month) allograft survival has been achieved in these patients. More recently, OKT3 treatment administered to allograft recipients receiving cyclosporin has been shown to benefit 15-20% of patients when administered at the time of rejection. This combination approach not only reverses the rejection, but also seems to significantly reduce the incidence of subsequent rejection episodes. OKT3 has raised clinical immunosuppressive specificity to a higher level than previous therapies such as steroids or cytotoxic agents. OKT3 appears to be safe and effective therapy for patients receiving cyclosporin or azathioprine-prednisone therapy. Despite certain unresolved limitations, it may be a successful prototype for future, even more highly specific, immunosuppressive protocols. PMID- 3306423 TI - OKT3 rescue in refractory renal rejection. AB - A community hospital-based transplant program participated in the study of Orthoclone OKT3 as a treatment for refractory renal rejection. A total of 16 patients receiving varied oral immunosuppressive regimens, and developing steroid resistant acute rejection, were treated with OKT3. Thirteen of the 16 patients completed a 10-day course of therapy with reversal of rejection in all 13. Rerejection occurred in 1 of the 13 patients; the remaining 12 have normal renal function. Fever, chills, and diarrhea were the most common side effects, lasting an average of 72 h. Based on this experience, OKT3 was found to be an effective drug in refractory rejection with minimal complications or risks of administration. PMID- 3306422 TI - Use of OKT3 with cyclosporin and steroids for reversal of acute kidney and liver allograft rejection. AB - OKT3 monoclonal antibody therapy was added to preexisting baseline immunosuppressive treatment with ciclosporin and steroids to treat rejection in 52 recipients of cadaveric livers and 10 recipients of cadaveric kidneys. Rejection was controlled in 75% of patients treated, often after high-dose steroid therapy had failed. Rejection recurred during the 17-month follow-up period, after completion of OKT3, in only 25% of the patients who had responded. The safety and effectiveness of this monoclonal therapy, added to ciclosporin and steroids, has been established in this study. PMID- 3306424 TI - Therapeutic use of OKT3 monoclonal antibody for acute renal allograft rejection. AB - OKT3, a murine monoclonal anti-T-cell antibody, was used to treat acute renal allograft rejection crises in 140 patients. When used for primary treatment of initial rejections, it was effective in all 20 recipients of related-donor (RD) grafts and in 70 of 74 recipients of cadaver-donor (CD) grafts. OKT3 was also used for resistant rejection unresponsive to conventional antirejection drugs and was effective in 11 of 13 RD and in 26 of 33 CD recipients. Rerejection occurred in 58% of patients in the OKT3 primary treatment group and in 35% of patients in the OKT3 rescue group. Fifty-nine percent of the patients produced anti-OKT3 antibodies. Nearly all recipients experienced a flu-like syndrome following the first and second daily doses of OKT3. Two-year actuarial patient survivals were 100 and 96% for RD and CD recipients, respectively. In the OKT3 primary treatment group, two-year actuarial RD and CD graft survivals were 91 and 76%, respectively. In the OKT3 rescue group, the two-year actuarial RD and CD graft survivals were 85 and 55%, respectively. A proposed immunosuppressive effect of OKT3 is T-cell inactivation by blocking antigen receptors linked to OKT3-reactive molecules. Reuse of OKT3 for recurrent rejection or subsequent organs may be hampered by anti-OKT3 antibody production. OKT3 is an effective steroid-sparing treatment for renal allograft rejection. PMID- 3306425 TI - Comparison of antimouse and antihorse antibody production during the treatment of allograft rejection with OKT3 or antithymocyte globulin. AB - Antimouse antibody is produced from 40 to 68% of the time after administration of Orthoclone OKT3. In patients treated with OKT3, however, if the concomitant immunosuppression is not decreased, the incidence of the antibody production is reduced to 40%. Similarly, 33% of patients developed antihorse antibody after the initial antithymocyte globulin (ATG) administration. Most of the time, the antibody production is low-titered for both OKT3 and ATG. PMID- 3306427 TI - Lipoprotein lipid abnormalities in healthy renal transplant recipients: persistence of low HDL2 cholesterol. AB - There is disagreement about the prevalence and character of lipoprotein lipid abnormalities in renal transplant patients. To test the hypothesis that these abnormalities may be related to the coexistence of medical conditions and medications which affect lipoprotein metabolism in these patients, triglyceride (TG), cholesterol (C), high-density lipoprotein (HDL) and HDL-C subfractions were measured in 26 transplanted patients (10 F/16 M), control subjects matched for age, sex, weight and race and uremic patients being treated with hemodialysis. Female transplant recipients had higher TG (181 +/- 47 vs. 68 +/- 6 mg/dl; p less than 0.001), C (242 +/- 19 vs. 165 +/- 9 mg/dl; p less than 0.01), and low density lipoprotein (LDL)-C (155 +/- 15 vs. 93 +/- 8 mg/dl; p less than 0.01) than controls. Levels of HDL-C were similar, but HDL2 was significantly lower in the transplanted patients (9 +/- 2 vs. 19 +/- 2 mg/dl; p less than 0.01). Compared to the uremic patients, female transplanted patients had higher C (242 +/- 19 vs. 178 +/- 22 mg/dl; p less than 0.01), LDL-C (155 +/- 15 vs. 94 +/- 18 mg/dl; p less than 0.01), HDL-C (51 +/- 5 vs. 32 +/- 4 mg/dl; p less than 0.001) and HDL3-C (42 +/- 4 vs. 26 +/- 2 mg/dl; p less than 0.001); however, HDL2-C levels were not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306426 TI - Monoclonal antibody therapy with ciclosporin and steroids in nonmatched cadaveric renal transplants. AB - Thirty-six ciclosporin-prednisone-treated recipients of nonmatched cadaver renal allografts were given a course of Orthoclone OKT3 monoclonal antibody for steroid resistant cell-mediated rejection. Although side effects were common, only 2 patients had to be withdrawn from therapy and there were no deaths related to therapy. Twenty-three (63.9%) allografts were rescued with OKT3 therapy and 21 (58.3%) of the grafts have continued to function well. We conclude that OKT3 is an effective agent for the treatment of steroid-resistant cell-mediated rejection and that rebound rejection can be prevented in most patients if adequate therapy with ciclosporin-prednisone is maintained. PMID- 3306428 TI - Membranous nephropathy accompanied by angiolymphoid hyperplasia of the skin. AB - A 24-year-old female developed a painless swelling adjacent to the left ear. This was shown to be eosinophilic angiolymphoid hyperplasia (ALH). Three months later she developed a nephrotic syndrome. Renal biopsy revealed membranous nephropathy. This is the first non-Japanese case of dermal eosinophilic ALH and nephrotic syndrome; steroid treatment followed by surgical removal of the tumour resulted in complete remission in the renal lesion. PMID- 3306429 TI - Correlation between blood prostaglandins and blood pressure in chronic renal failure. AB - Plasma prostaglandins (PGs; PGE2, PGF2 alpha, 6-keto-PGF 1 alpha and TXB2) and plasma renin activity (PRA) were measured in 94 end-stage renal disease (ESRD) patients including 15 undialyzed, 74 maintenance-hemodialyzed and 5 anephric patients, and in 27 healthy controls. In the healthy controls, 6-keto-PGF 1 alpha inversely correlated with age, while TXB2 and the TXB2/6-keto-PGF 1 alpha ratio correlated with age. In the ESRD patients, 6-keto-PGF 1 alpha showed a tendency to decrease with age, and the TXB2/6-keto-PGF 1 alpha ratio significantly correlated with age. The undialyzed group showed significantly higher blood pressure and TXB2 but significantly lower 6-keto-PGF1 alpha compared to the other groups. In the dialyzed group, PGE2 and 6-keto-PGF1 alpha tended to be lower and TXB2 higher compared to the healthy control group. In the dialyzed group, 6-keto PGF1 alpha correlated inversely with blood pressure independently from PRA. As for PGF2 alpha, it was higher in the undialyzed, dialyzed and anephric groups than in the healthy control group. These results suggested that PGs were involved in blood pressure abnormalities, and that PGI2 played an important role in controlling blood pressure in ESRD patients as one of the depressor factors. PMID- 3306430 TI - Human immunodeficiency virus-associated Kaposi's sarcoma in a pediatric renal transplant recipient. AB - An 11-year-old boy developed Kaposi's sarcoma and progressive T lymphocyte deficiency 5 years after cadaveric kidney transplantation for end-stage renal disease. He had received 17 individual red blood cell transfusions prior to and during transplantation in 1980. Human immunodeficiency virus (HIV) was cultured from blood in cerebrospinal fluid and HIV antibodies were detected with enzyme immunoassay and immunoblot techniques. The recipient of the donor's other kidney was well and HIV antibody-negative. The patient was treated with etoposide with excellent although transient regression of tumor. Allograft function has remained stable despite minimal immunosuppressive therapy and the need for high-dose anticonvulsant therapy. This case represents the first pediatric patient with acquired immune deficiency syndrome (AIDS) and Kaposi's sarcoma following kidney transplantation. PMID- 3306431 TI - Alpha interferon clinical trial for multiple sclerosis: design considerations. AB - The design and course of a placebo-controlled alpha-2 interferon trial in MS patients are described. No beneficial effect of the interferon on the course of MS could be shown. PMID- 3306433 TI - Calcium and the aging nervous system. AB - Many aspects of calcium homeostasis change with aging. Numerous calcium compartments complicate studies of altered calcium regulation. However, age related decreases in calcium permeation across membranes and mobilization from organelles may be a common fundamental change. Deficits in ion movements appear to lead to altered coupling of calcium-dependent biochemical and neurophysiological processes and may lead to pathological and behavioral changes. The calcium-associated changes during aging probably do not occur with equal intensity in all cell types or in different parts of the same cell. Thus, cells or compartments with a high proportion of calcium activated processes would be more sensitive to diminished calcium availability. These age-related changes may predispose the brain to the development of age-related neurological disorders. The effects of decreased ion movement may be further aggravated by an age-related decline in other calcium-dependent processes. Depression of some of these calcium dependent functions appears physiologically significant, since increasing calcium availability ameliorates age-related deficits in neurotransmission and behavior. A better understanding of the interactions between calcium homeostasis and calcium-dependent processes during aging will likely help in the design of more effective therapeutic strategies. PMID- 3306434 TI - [Corticotropin-releasing factor (CRF)]. PMID- 3306432 TI - Senile plaques in aged squirrel monkeys. AB - Aged squirrel monkeys develop senile plaques in the brain that are similar to those occurring in aged rhesus monkeys and aged humans. These plaques consist of abnormal, swollen neurites around an amyloid core. In whole-hemisphere coronal sections through the level of the rostral temporal lobe, plaques are present in temporal cortex, amygdala, hippocampal formation and, occasionally, in other cortical regions. In more rostral sections through the frontal lobe, plaques are most common in orbitofrontal and frontal opercular cortical regions. In immunocytochemical preparations, some neurites show immunoreactivity with antibodies directed against phosphorylated neurofilaments and neuropeptide Y. Thus, plaques in these New World primates are similar in distribution and composition to those occurring in aged Old World primates. PMID- 3306435 TI - Neuropeptide Y stimulates the release of luteinizing hormone-releasing hormone from medial basal hypothalamus in vitro: modulation by ovarian hormones. AB - These studies investigated the effects of neuropeptide Y (NPY) on in vitro release of luteinizing hormone-releasing hormone (LHRH) from the medial basal hypothalmus (MBH) and tested whether ovarian steroids modulate the LHRH response to NPY. Ovariectomized rats were implanted with 20-mm-long Silastic capsules containing a low concentration of estradiol (E2) (150 micrograms/ml oil), a high concentration of E2 (250 micrograms/ml oil), or sesame oil vehicle. Additional animals received high-dose E2 capsules plus an injection of progesterone (15 mg) concomitantly. Two days later, individual MBH fragments were incubated in medium alone for a 30-min period to obtain the basal rate of LHRH release, followed by a second 30-min period in medium containing NPY or saline. Exposure to NPY (10(-6) M) increased the release of LHRH from MBH of ovarian hormone-treated, but not from hormonally untreated rats. The LHRH response was most pronounced from the MBH of rats treated with either high-dose E2 or E2 plus progesterone. The increase in LHRH release was also elicited by 10(-7) M, but not by 10(-8) M NPY concentrations, using MBH from E2 plus progesterone-treated rats. In addition, NPY markedly potentiated the KCl-evoked release of LHRH from MBH of ovariectomized, hormonally untreated or low-dose E2-treated rats, under conditions when there was little or no effect of NPY on the basal LHRH release. Further, the release of LHRH stimulated by NPY was not accompanied by increase in the release of norepinephrine or of dopamine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306436 TI - Ultrasonic vocalization in rat pups: effects of early postnatal exposure to SCH 23390 (a DA1-receptor antagonist) and sulpiride (a DA2-receptor antagonist). AB - Early postnatal administration of SCH 23390 and sulpiride induced marked changes in the ultrasonic vocalization elicited by the removal of rat pups from their nest. In particular, SCH 23390 produced a significant increase in the length, as well as in the sound pressure level, of ultrasonic calls; moreover, a significant decrease in minimum and maximum frequency values was found in pups treated with this DA1-receptor antagonist. Sulpiride significantly reduced the rate of calling, as well as the pressure level of sounds, whereas it did not influence other parameters of the ultrasonic emission. These behavioural alterations seemed to be the consequence of an impaired functional maturation of the dopamine (DA) system; however, the different changes caused by SCH 23390 and sulpiride, respectively, suggest that DA1- and DA2-receptor populations could play a distinct role in the ultrasonic calling during early postnatal life. PMID- 3306437 TI - Treatment of some nonstationarities in the EEG. AB - In many situations, EEG recordings cannot be assumed to be second-order stationary. The definition of stationarity is reviewed and the implications of the nonstationarity of the EEG are investigated. Some methods to overcome the problem caused by the nonstationarity are discussed. They include measures of variability, condensed time series and segmentation. The discussion is restricted to FFT spectral estimators and broad-band parameters derived thereof. PMID- 3306438 TI - Plasma insulin, tryptophan and serotonin levels during the glucose tolerance test among habitually violent and impulsive offenders. AB - Insulin activity in plasma and the concentrations of tryptophan and serotonin were measured during the glucose tolerance test (GTT) in habitually violent and impulsive male offenders and in psychiatric personnel as controls. Insulin was enhanced in the intermittent explosive disorder; at the same time the concentration of plasma tryptophan and the ratio of tryptophan to large neutral amino acids were on a high level and tryptophan even increased in many cases during GTT. Serotonin values did not differ. Many offenders with enhanced insulin secretion displayed abnormal neuroglycopenic symptoms during GTT. PMID- 3306439 TI - Double-blind study of oxaprotiline versus clomipramine in the treatment of depressive inpatients. AB - In a double-blind study on 38 unselected depressive inpatients (19 per group) suffering from endogenous and psychogenic depression, oxaprotiline, a new tetracyclic compound, a hydroxylized maprotiline with a highly selective norepinephrine reuptake inhibition, was compared with clomipramine over a period of 28 days in a daily dosage of 150 mg. Both drugs were found to be approximately equivalent and with no significant differences due to the overall assessment of the reduction of depression severity and amelioration of goal symptoms. This was also reflected in the results of the Hamilton Depression Scale and the self rating scales for depression (SDS, Bf-S, ESTA). PMID- 3306441 TI - EEG data acquisition. AB - This paper is a compressed version of a tutorial which was presented during the 1986 training course of the International Pharmaco-EEG Group, in Santa Margherita Ligure, Italy. The paper starts with a discussion of some basic features of the encephalograph, sketches the frequency modulation recording technique and presents some fundamental rules and concepts concerning digital data acquisition. Patient safety is a further aspect of the tutorial. Finally, two calibration procedures are outlined. PMID- 3306440 TI - Calcium-channel-blocking agent in the treatment of acute alcohol withdrawal- caroverine versus meprobamate in a randomized double-blind study. AB - We present a randomized double-blind study on the efficacy of caroverine in the treatment of alcohol withdrawal symptoms. The group B Ca2+ channel blocking agent caroverine was tested against meprobamate in inpatient treatment of alcohol withdrawal. Patients of both groups were similar in age, weight, duration of drinking, ingested quantities of alcohol and intensity of withdrawal symptoms in both groups. The symptoms were quantified daily by Syndromkurztest (SKT), Nurses' Observation Scale for Inpatient Evaluation (NOSIE), NGI; the Webster scale was applied to rate tremor, speech and coping. Duration of study was scheduled for 5 days after which other medication, e.g., levopromazine was applied if needed. As caroverine is registered and used as a spasmolytic drug in Austria, patients' verbal consent was sufficient. In both compounds we registered no difference of clinical efficacy, though caroverine presented less sedative side effects. This may be an important factor in the treatment and management of alcohol withdrawal symptoms. Dose ranges were 120 mg/day vs. 2,400 mg/day of caroverine and meprobamate, respectively. Thus, drug loading and metabolism can be thoroughly reduced by the application of caroverine--another important point in treatment of alcoholism. In 4 cases of manifest delirium tremens the infusional application of caroverine was openly tested with dose ranges of 2.5-5.0 mg/kg (24 h). Clinical effects were estimated to be similar with oral application as was therapeutic efficacy. This novel indication of a group-B Ca2+ channel blocker presents an interesting feature, which seems to warrant further investigation. PMID- 3306442 TI - Spectral analysis of the EEG. Some fundamentals revisited and some open problems. AB - This tutorial was presented during the 1986 training course of the International Pharmaco-EEG Group (IPEG) in Santa Margherita Ligure, Italy. During recent years spectral analysis has been increasingly used in experimental EEG. However, to avoid misinterpretations of results, its limitations must still be carefully considered. The tutorial starts with revisiting the fundamentals of the technique, emphasizes the practical estimation of auto- and cross-spectra, discusses the assumptions underlying the spectral analysis of stochastic processes, and ends with a brief discussion concerning the postprocessing of spectral data. PMID- 3306443 TI - Pathogenesis of tremor in parkinsonism studied by computerized spectral analysis of the EMG envelope. PMID- 3306445 TI - Effect of luliberin on the secretion of the luteinizing hormone depending on the phase of the menstrual cycle in intact and castrated female Papio hamadryas. PMID- 3306446 TI - Limbic lymphoma. AB - Two cases of metastatic malignant lymphoma confined to the limbic-hypothalamic region are presented. The non-specific nature of the neurological symptoms associated with these lesions such as memory loss, impotence and confusion made neurological localization of the disease process difficult. While non-contrast computed tomography (CT) was unremarkable, contrast CT was diagnostic, showing bilateral homogenous enhancement of specific limbic-hypothalamic structures without significant mass effect. Since lymphomatous involvement of the limbic hypothalamic area tends to be infiltrative without attendant mass effect, detection of metastasis may be elusive unless special attention is directed to this region. As lymphoma is often chemoresponsive and highly radiosensitive, early recognition of limbic-hypothalamic involvement of this disease is important. PMID- 3306444 TI - Receptor binding of estradiol and testosterone in female rat pituitary. PMID- 3306448 TI - Purification of specific antibody against aspartate and immunocytochemical localization of aspartergic neurons in the rat brain. AB - The distribution of L-aspartate known as a putative excitatory neurotransmitter in the central nervous system was investigated immunocytochemically in the rat brain. Anti-aspartate antiserum was raised in rabbits using L-aspartate covalently conjugated to rabbit serum albumin with glutaraldehyde as the immunogen and was found to be cross-reactive with an L-glutamate conjugate. Monospecific anti-L-aspartate antibody was successfully purified using affinity gels coupled with several amino acids including L-aspartate and L-glutamate and with the L-glutamate conjugate. Putative aspartergic neurons were generally immunoreactive to the purified antibody, but epithelia of the choroid plexus were also stained. These results show that the antibody is a useful tool for the immunocytochemical demonstration of possible aspartergic neurons in the central nervous system, although the immunochemical expression of L-aspartate not used as a neurotransmitter must be taken into consideration. PMID- 3306449 TI - Gamma-aminobutyrate-like immunoreactivity in the thalamus of the cat. AB - Serial sections of the cat's thalamus were incubated with a purified antiserum raised against gamma-aminobutyric acid conjugated to bovine serum albumin by distilled glutaraldehyde. This serum has been extensively characterized and appears to react selectively with fixed gamma-aminobutyric acid in brain tissue treated with glutaraldehyde. Adjoining sections were stained with thionin and served as invaluable guides for a correct evaluation of the immunolabelling pattern. In the neuropil the intensity of the immunostaining varies considerably between thalamic nuclei and even between nuclear subdivisions. The neuropil staining appears particularly dense in the nuclei parataenialis, periventricularis, centralis medialis, reuniens, rhomboideus, habenularis lateralis, centrum medianum, parafascicularis, subparafascicularis, submedius, dorsal and ventral parts of the lateral geniculate body, the dorsal part of the medial geniculate body, the posterior complex, suprageniculate nucleus, pulvinar and parts of the lateral posterior nucleus. The pulvinar/lateralis posterior complex shows a particularly well-differentiated staining pattern which closely matches Updyke's [Updyke (1983) J. comp. Neurol. 219, 143-181] parcellation of this region. In several thalamic nuclei or subareas--and notably in those relay nuclei which are known to project upon non-primary sensory cortical areas--the immunostained neuropil is characterized by many puncta encircling an unstained profile. With few exceptions all thalamic nuclei displayed immunoreactive nerve cell bodies. Several examples were found of a mismatch between the number of such cells and the staining intensity of the neuropil. Thus the nuclei periventricularis, parafascicularis, subparafascicularis, parataenialis, limitans and centrum medianum although being very rich in neuropil staining have practically no immunostained perikarya. Rough estimates were made of the size and the proportion of gamma-aminobutyric acid labelled neurons in all major--and some minor--thalamic nuclei and their subdivisions. In some thalamic nuclei, notably the nuclei reticularis, anterior dorsalis, lateralis dorsalis, centralis lateralis, ventralis posterior and the dorsal lateral geniculate body, the population of immunoreactive neurons is distinctly heterogeneous with regard to soma size. The findings are discussed with regard to previous immunocytochemical studies of the distribution of gamma-aminobutyric acid and its synthesizing enzyme in the thalamus. Particular emphasis is put on the great species differences which appear to exist in this respect. PMID- 3306450 TI - Distribution of the C-terminal glycopeptide of the vasopressin prohormone in rat brain: an immunocytochemical study. AB - The distribution of the C-terminal glycopeptide of the vasopressin prohormone was mapped in rat brain by an immunocytochemical method using antibodies to the sheep glycopeptide. The antibodies did not react with vasopressin, oxytocin or their related neurophysins. Stained neural perikarya were observed in the hypothalamus (suprachiasmatic, paraventricular, and supraoptic nuclei) and in the bed nucleus of the stria terminalis. Fibres were detected in the hypothalamus and in extrahypothalamic regions (the frontal cortex, the lateral septum, the bed nucleus of the stria terminalis, the medial nuclei of the thalamus, the lateral habenula, the amygdala, the mesencephalic central gray, the raphe nucleus of the solitary tract and the cervical spinal cord). The distribution of glycopeptide immunoreactive cells was generally similar in young rats (8 weeks old) to the distribution in older rats (13 weeks old) except in the bed nucleus of the stria terminalis where stained neurons were relatively sparse or absent in the younger animals. Similarly, in the young rats the density of fibres containing the glycopeptide was reduced in territories innervated by the bed nucleus. In both young and old rats the neuronal distribution of the glycopeptide was identical to the distribution of vasopressin, which suggests that the glycopeptide and vasopressin are co-transported from the sites of biosynthesis to the sites of release. PMID- 3306451 TI - Acetylcholinesterase exhibits trypsin-like and metalloexopeptidase-like activity in cleaving a model peptide. AB - Acetylcholinesterase (EC 3.1.1.7) has been shown to possess an intrinsic peptidase activity. [Chubb et al. (1983), Neuroscience 10, 1369-1383]. To examine this activity further, the breakdown of a model hexapeptide (leu-trp-met-arg-phe ala) LWMRFA was studied. Affinity-purified eel acetylcholinesterase rapidly cleaved the hexapeptide in a trypsin-like manner to produce two peptides (LWMR and FA). Acetylcholinesterase more slowly cleaved the C-terminal alanine residue from the peptide to yield LWMRF. Although the enzyme showed preference for cleaving the hexapeptide at its C-terminal, it was also able to cleave the N terminal leucine residue form the tryptic product LWMR. Hydrolysis of the peptide at the tryptic site (arg4-phe5) was strongly inhibited by the trypsin inhibitor diisopropylfluorophosphate. Cleavage of the C-terminal alanine was only poorly inhibited by diisopropylfluorophosphate, but more strongly inhibited by metal-ion chelating agents, and it was increased in the presence of Zn2+ and Co2+. The pH optimum for cleavage at the tryptic site was 6, while that for the carboxypeptidase site was 8-9. These results show that acetylcholinesterase can hydrolyse peptides like a trypsin-like endopeptidase and a Zn2+- or Co2+ dependent exopeptidase, and they suggest that these two peptidase activities are associated with two separate active sites on the acetylcholinesterase molecule. As both peptidase activities eluted with acetylcholinesterase from a TSK 4000SW column when it was chromatographed by high-performance liquid chromatography, it is unlikely that the presence of either peptidase activity could be attributable to a contaminant in the acetylcholinesterase preparation. We suggest that acetylcholinesterase may be involved in the breakdown of bioactive peptides or their precursors in neuroendocrine cells. PMID- 3306447 TI - Cholinergic amacrine cells of the chicken retina: a light and electron microscope immunocytochemical study. AB - Cholinergic amacrine cells of the chicken retina were detected by immunohistochemistry using an antiserum against affinity-purified chicken choline acetyltransferase. Three populations of cells were detected: type I cholinergic amacrine cells had cell bodies on the border of the inner nuclear and inner plexiform layers and formed a prominent laminar band in sublamina 2 of the inner plexiform layer, while type II cholinergic amacrine cells had cell bodies in the ganglion cell layer, and formed a prominent laminar band in sublamina 4 of the inner plexiform layer. Type III cholinergic amacrine cell bodies were located towards the middle of the inner nuclear layer, and their processes were more diffusely distributed in sublaminas 1 and 3-5 of the inner plexiform layer. Type I and type II cells were present at densities of over 7000 cells/mm2 in central areas declining to less than 2000 cells/mm2 in the temporal retinal periphery. The cells were organized locally in a non-random mosaic, with regularity indices ranging from 3 peripherally to over 5 centrally. Neither at the light nor electron microscopic levels was a lattice of cholinergic dendrites of the kind reported by Tauchi and Masland [J. Neurosci. 5, 2494-2501 (1985)] detectable. Within the two prominent dendritic plexuses, a major feature of the synaptic interactions of the type I and type II cholinergic cells was extensive synaptic interaction between cholinergic processes. Apart from this, there was little, if any, input to cholinergic processes from non-cholinergic amacrine cells, but there was input from bipolar cells. Output from the cholinergic amacrine cell processes was directed towards non-cholinergic amacrine cells as well as other cholinergic amacrine cells, and ganglion cells. PMID- 3306452 TI - Cytochrome b561 can be detected in many neuroendocrine tissues using a specific monoclonal antibody. AB - CG7 is a monoclonal antibody that recognizes cytochrome b561, a major protein component of adrenal medullary chromaffin granules. Immunocytochemical studies using this antibody have demonstrated that cytochrome b561 is present in many neural and endocrine tissues and that its distribution is correlated with the presence of either catecholamines or amidated peptides in the tissue. These tissues include neuronal cell bodies and/or fibers in the gut, blood vessels, retina, and posterior pituitary, endocrine cells of the gut, anterior and intermediate lobes of the pituitary, heart muscle, and all adrenal medullary chromaffin cells. The discovery of cytochrome b561 in many neuropeptide containing tissues regardless of the presence of catecholamines is consistent with a general role for cytochrome b561 as a secretory granule membrane electron carrier. Its expression may be linked to an ascorbic acid requirement by both catecholamine and neuropeptide biosynthetic enzymes. PMID- 3306453 TI - Implantation of fetal preoptic area into the lateral ventricle of adult hypogonadal mutant mice: the pattern of gonadotropin-releasing hormone axonal outgrowth into the host brain. AB - Transplantation of fetal preoptic area tissue containing gonadotropin-releasing hormone neurons into the third ventricle of male hypogonadal mice resulted in an elevation of pituitary gonadotropin levels and correction of hypogonadism. This reversal of the neuroendocrine deficit was correlated with innervation of the median eminence by gonadotropin-releasing hormone axons. The specificity of fiber outgrowth suggested that local neuromodulatory factors might guide these axons to the nearby median eminence. To test this hypothesis, 14 adult hypogonadal males received unilateral fetal preoptic area grafts into the lateral ventricle, a site distant from the median eminence. After four months, healthy grafts containing numerous gonadotropin-releasing hormone neurons were seen in 9 hosts. However, none of these grafts corrected the hypogonadism of the host and there was no gonadotropin-releasing hormone innervation of the median eminence in any of these animals, thus demonstrating that the presence of gonadotropin-releasing hormone neurons in the ventricular space is itself not sufficient to stimulate the pituitary-gonadal axis. Instead, gonadotropin-releasing hormone axons coursed in the host fimbria, fornix, corpus callosum, and stria terminalis. These fibers could be traced into the anterior hippocampal area, medial and lateral septum, and the anterior hypothalamus. The distribution of these fibers included a number of regions which receive gonadotropin-releasing hormone fiber input in the normal mouse. These findings show that gonadotropin-releasing hormone neurons transplanted into the lateral ventricle can survive and extend processes into the host brain, often projecting to sites of normal gonadotropin-releasing hormone innervation. Their success in contacting these sites suggests that gonadotropin releasing hormone fiber outgrowth may be influenced by regionally specified trophic and/or guidance factors. PMID- 3306455 TI - Iatrogenic Creutzfeldt-Jakob disease. AB - Over the past 2 years, Creutzfeldt-Jakob disease (CJD) has affected several patients who received cadaver pituitary-derived growth hormone (pit-hGH) and one patient who received a cadaveric dura mater graft. The risk of iatrogenic transmission of CJD has long been recognized, but until recently, the low prevalence of the disorder and minimal use of therapeutic products derived from human tissues may have limited the risk. From 1963 to 1985, approximately 10,000 children received pit-hGH. These patients, exposed to pooled products potentially contaminated with the CJD agent, may have significantly increased the number of individuals whose blood and tissues could transmit CJD. This possibility as well as data on the pathophysiology of CJD and scrapie, a related disease of animals, should guide the development of practices that would limit iatrogenic spread of CJD. PMID- 3306456 TI - Cerebral auscultation: origin of a forgotten art. PMID- 3306454 TI - Positive rolandic sharp waves in the EEG of the premature infant. AB - Ninety-seven EEGs from 30 premature infants found to have multifocal white matter necrosis on ultrasound (US) or autopsy were reviewed retrospectively. Twenty infants had intraparenchymal echodensities on US that developed into cystic lesions, a finding consistent with periventricular leukomalacia; 8 had intraparenchymal hemorrhages; and 2 had white matter necrosis at autopsy. Four of these infants had no intraventricular hemorrhage. Positive sharp waves in the central (rolandic) regions (PRS) were identified in 22 of these 30 infants (73%) and in 0 of 30 age-matched controls (p less than 0.001). The presence of PRS on the EEG of the premature infant has a high correlation with white matter necrosis rather than with intraventricular hemorrhage. In all cases, this EEG pattern was present prior to the development of cavitations when echodensities were present on US. PMID- 3306458 TI - [Extensive indications for the use of Swan-Ganz catheter in anesthesia and intensive therapy in the field of cardiac surgery]. PMID- 3306457 TI - Cerebral lactic acid delivery and uptake during and after ischemia in the piglet. AB - To determine whether lactic acid is a cerebral substrate during and after partial ischemia in piglets, cerebral blood flow and arteriovenous differences of O2 and substrates were measured during control, after hemorrhagic hypotension, and 10 and 90 minutes after reperfusion with blood. During and following ischemia, alterations in cerebral O2 and glucose uptake indicated disturbed oxidative metabolism. Cerebral lactic acid uptake was similar at control, hypotension, and 90 minutes postreperfusion, but rose 10 minutes postreperfusion. Absent cerebral production of lactic acid during and net uptake following ischemia do not support lactic acid as a substrate since insufficient O2 was available for oxidation. PMID- 3306459 TI - [Guidelines in the technic for closing laparotomies]. PMID- 3306460 TI - [Permanence and gastric transit time of artificial food. Monitoring of alginic acid using real time echotomography]. PMID- 3306461 TI - [Placental tissue maturity and the presence of fibronectin. Immunohistochemical study]. PMID- 3306462 TI - [Echographic diagnosis of obstructive fetal uropathy]. PMID- 3306463 TI - [Echographic diagnosis of fetal hydrops and ascites. Description of 2 cases of fetal hydrops and ascites caused by congenital immunodeficiency and feto-fetal transfusion syndrome. Etio-pathogenic considerations]. PMID- 3306465 TI - [Long-term antibiotic prophylaxis in cesarean section]. PMID- 3306464 TI - [Microbiologic culture findings on intrauterine devices]. PMID- 3306466 TI - [Antibacterial activity of amniotic fluid]. PMID- 3306467 TI - [Colonization of pregnant women by group B streptococci in Trieste]. PMID- 3306469 TI - [Ultrasonic diagnostic studies of the post-menopausal uterus in patients treated with tamoxifen]. PMID- 3306468 TI - [Stimulation and hyperstimulation of the ovary. Comparison of 2 pharmacologic protocols for induction of ovulation]. PMID- 3306470 TI - Origin and postnatal development of nerves showing 5-hydroxytryptamine-like immunoreactivity supplying major cerebral arteries of the rat. AB - Nerve plexuses showing 5-hydroxytryptamine (5-HT)-like immunoreactivity (5-HTLI) have been demonstrated in all the major cerebral arteries of the rat using fluorescence immunohistochemistry on whole-mount stretch preparations. Following bilateral superior cervical ganglionectomy, nerves disappeared from all the vessels studied with the exception of the vertebral and basilar arteries where fibres remained. Using image analysis, the density of nerves containing 5-HTLI showed little change between vessels from 3 to 4-week-old and 6 to 7-week-old animals, in contrast to another study which has shown marked reductions in 5-HT immunoreactive neuronal cell bodies in the superior cervical ganglion over the same period of early development. It was concluded that while the terminals of cerebrovascular nerves retain the capacity to synthesise and/or store 5-HT throughout life, their cell bodies may lose this function soon after birth. PMID- 3306471 TI - The immunocytochemical localisation of 'substance-P-degrading enzyme' within the rat spinal cord. AB - The regional distribution of a neural endopeptidase ('substance-P-degrading enzyme', SPDE) within the rat spinal cord, as visualised by immunocytochemistry, closely paralleled the distribution of major substance P-containing nerve fibre systems. Thus, SPDE-immunoreactivity was present in laminae I and II of the dorsal horn, in large diameter neurones of the ventral horn and in the ependymal cells which line the central canal. The pattern of immunostaining, particularly in the dorsal horn, is consistent with the view that SPDE may function in the metabolism of substance P. PMID- 3306472 TI - Immunohistochemical evidence for the adrenergic medullary longitudinal bundle as a major ascending pathway to the hypothalamus. AB - Three weeks after unilateral electrolytic lesion of the longitudinal axon bundle in the medulla oblongata of the rat, we observed a decrease in the number of phenylethanolamine-N-methyltransferase (PNMT)-immunoreactive (IR) nerve fibers in virtually all the regions of the diencephalon ipsilaterally to the lesion, especially in the dorsomedial nucleus and the paraventricular nucleus of the hypothalamus. These results indicate that the hypothalamic PNMT-IR terminal-like fibers originate in the ipsilateral medulla oblongata presumptive adrenaline containing (Ad) neurons especially through ascending projections provided in majority by the longitudinal axon bundle. Further, no PNMT-IR cell bodies were detected in the hypothalamus even after colchicine treatment. PMID- 3306473 TI - Dorsal root axonal regeneration in the adult frog spinal cord. A model of vertebrate CNS regeneration. AB - The frog dorsal root provides a useful model for the study of axonal regeneration in an adult vertebrate CNS. We have used the model to compare the regeneration of two very different types of axons within the same CNS environment and have found that regenerating dorsal root, as well as rerouted motoneuron axons, display similar growth patterns in the spinal cord. Both sensory and motor axons grow preferentially in some regions and not in others. They both regenerate effectively longitudinally as well as radially within the dorsolateral fasciculus (DLF). By contrast, fewer sensory and motor axons regenerate longitudinally or radially in the dorsal funiculus (DF). This similar preferential growth of two very different populations of axons suggests that the growth patterns reflect regional differences in the cellular environment of the cord. The DLF has fascicles of unmyelinated axons separated by radial glial processes and, after dorsal root injury, is mildly gliotic. By contrast, DF has very large myelinated axons, which widely separate the radial glial processes that traverse the region. After dorsal root injury, this region is markedly gliotic and contains myelin, debris and oligodendroglia, and microglial macrophages. Our data suggest that unmyelinated axons and radial glial processes are more preferred substrates for axonal growth than myelin debris, oligodendroglia and macrophages. It is not surprising, then, that regions of the adult mammalian CNS that are characterized by large myelinated axons fail to support axonal growth. Moreover, there is some evidence that regions of the adult mammalian CNS that are characterized by unmyelinated axons support axonal growth. PMID- 3306474 TI - Regeneration of the frog optic nerve. Comparisons with development. AB - Developing and regenerating frog optic axons grow within optic pathways and form connections only with optic targets. However, unlike normal development, many regenerating optic axons in the adult frog are misrouted within optic pathways, including axons that grow into the opposite retina. Many of the axons misrouted during regeneration appear to be collaterals of axons that grow in normal directions. Ganglion cell loss of up to 60% occurs after optic nerve damage, beginning prior to reinnervation of optic targets. Massive axonal collateralization also takes place near the point of nerve damage, causing the normal order found within the nerve to be lost. Collaterals are eliminated as selective reinnervation is completed, and the smaller complement of optic cell axons remaining after regeneration form an expanded projection within optic targets. Evidence is reviewed that suggests that factors involved in axonal guidance and target recognition during development remain intact in the adult frog brain. Additional conditions resulting from nerve injury causes axonal guidance to be less successful during regeneration. PMID- 3306475 TI - Mechanisms contributing to sparing of function following neonatal damage to spinal pathways. AB - When spinal pathways are damaged in newborn animals and their behavior is examined in adulthood, motor function is superior to that seen in animals in which the same lesion was made in adulthood. This is the infant lesion effect. After neonatal sensorimotor cortex ablation, spinal hemisection, or spinal transection, sparing of contact placing is observed; in adults, all three lesions abolish contact placing permanently. The anatomical correlates of the infant lesion effect are different in each case. After neonatal unilateral cortical ablation, an exuberant crossed corticorubral pathway from the other cortex fails to retract (as it does normally), giving the remaining cortex a path for mediating contact placing. After neonatal spinal hemisection, late-developing corticospinal axons take an aberrant course around the lesion and mediate contact placing. After neonatal transection, the spinal inhibitory GABA-ergic system fails to develop to a normal extent. This may result in abnormal enhancement of spinal reflex pathways, especially since some dorsal roots increase their input after that lesion. Thus, a number of factors may influence the outcome of damage to the developing nervous system. PMID- 3306476 TI - Gangliosides in the nervous system during development and regeneration. AB - Gangliosides are present in nervous tissues of echinoderms and chordates, but the amounts and patterns differ widely. There are changes in the ganglioside contents of nervous tissues during development in most animals studied. To a large extent, regional differences and changes with development and degeneration in ganglioside composition reflect changing and different proportions of cellular types and subcellular organelles within the tissue. GM1 and GM4 are enriched in myelin; GD1a may be a marker for dendritic arborization. During regeneration of fish optic nerve and rat sciatic nerve there is an increased amount of ganglioside proximal to the regenerating axon tips, which may largely be a result of accumulation. This could provide a relatively large reservoir of ganglioside to become incorporated into the sprouting axolemma. Gangliosides added exogenously to growth medium can induce neuritogenesis of several types of neurons. The mechanisms of this action are unknown but may be related to nerve growth factor, microskeletal organization, membrane fluidity, and other factors. Gangliosides injected into young animals affect brain development, but further studies are required to determine these effects more specifically. Ganglioside administration increases the number of sprouts in regenerating peripheral nerves, but does not seem to accelerate axonal elongation. Parenterally administered gangliosides alter the recovery of brain tissue from a variety of types of lesions, and clinical trials are in progress to determine if they are of benefit in human neurological disorders. The biochemical mechanisms of these in vivo ganglioside effects are poorly understood, but may involve modulation of several enzyme systems as well as other properties of neural membranes, such as fluidity. It is possible that gangliosides may play similar roles and operate through some of the same mechanisms in developing and regenerating nervous tissues. PMID- 3306477 TI - Control of neuron shape during development and regeneration. AB - We have examined the ability of Mueller reticulospinal neurons in the CNS of the larval sea lamprey to sprout following axonal and dendritic injury. Axotomy induces regenerative sprouting exclusively from the axon stump if it occurs at a site distant from the soma in the spinal cord. However, axotomy within the hindbrain at a site close to the soma results in profuse neuritic sprouting from the dendrites. The gross morphology and trajectories of these "dendritic" sprouts resemble those of regenerating axons. Amputation of Mueller cell dendrites (dendrotomy) without axotomy does not result in neuritic sprouting from either the axon or dendrites, indicating that axotomy is specifically required for sprouting to occur. However, dendrotomy is capable of altering the distribution of sprouting in a previously axotomized Mueller cell by inducing sprouting at the site of the dendrotomy lesion. Sprouts of both dendritic and axonal origin tend to follow linear, rostrocaudally oriented paths along or near the ventral surface of the hindbrain. Some sprouts form very large, palmate growth cones on the marginal surface, which in turn give rise to many branches that continue to grow either rostrally or caudally along the surface of the brain. We discuss the possibility that both dendritic and axonal sprouts evoked by axotomy of Mueller neurons are recapitulating initial axonal development during embryogenesis, and that their trajectories are determined by developmental guidance cues persisting in the ventral hindbrain. PMID- 3306478 TI - Presynaptic elements on artificial surfaces. A model for the study of development and regeneration of synapses. AB - Recently a model has been developed to study the synapse formation in which the components of a synapse can be isolated and examined independently. The observation of neurites forming presynaptic elements on polylysine-coated surfaces is a model for which the formation of presynaptic elements can be studied independently of a cellular postsynaptic element. Studies with neurons from both cell cultures and the intact cerebellum have shown that beads coated with poly-basic proteins can serve as a "postsynaptic element." With use of this system, observation have shown that the presynaptic element can form quickly, within 3 h, and contain many of the characteristics of a mature presynaptic element, such as synaptic vesicle antigens. Additional studies have shown that astrocytes appear to be involved in the loss or removal of the presynaptic elements on beads. Thus, synaptogenesis may involve the development of inappropriate synaptic contacts, which are eliminated by astrocytes. The lack of regeneration in the central nervous system (CNS) also may involve the astrocyte's ability to remove immature and/or inappropriate presynaptic elements and growth cones as they attempt to cross the lesion site. PMID- 3306479 TI - Ammonia: key factor in the pathogenesis of hepatic encephalopathy. AB - There is substantial clinical and experimental evidence to suggest that ammonia toxicity is a major factor in the pathogenesis of hepatic encephalopathy associated with subacute and chronic liver disease. Ammonia levels in patients with severe liver disease are frequently found to be elevated both in blood and cerebrospinal fluid (csf). Hepatic encephalopathy results in neuropathological damage of a similar nature (Alzheimer type II astrocytosis) to that found in patients with congenital hyperammonemia resulting from inherited defects of urea cycle enzymes. Following portocaval anastomosis in the rat, blood ammonia concentration is increased 2-fold, and brain ammonia is found to be increased 2-3 fold. Administration of ammonia salts or resins to rats with a portocaval anastomosis results in coma and in Alzheimer type II astrocytosis. Since the CNS is devoid of effective urea cycle activity, ammonia removal by brain relies on glutamine formation. Cerebrospinal fluid and brain glutamine are found to be significantly elevated in cirrhotic patients with encephalopathy and in rats following portocaval anastomosis. In both cases, glutamine is found to be elevated in a region-dependent manner. Several mechanisms have been proposed to explain the neurotoxic action of ammonia. Such mechanisms include: Modification of blood-brain barrier transport; alterations of cerebral energy metabolism; direct actions on the neuronal membrane; and decreased synthesis of releasable glutamate, resulting in impaired glutamatergic neurotransmission. PMID- 3306480 TI - The role of astrocytes in hepatic encephalopathy. AB - The Alzheimer type II astrocyte change is the distinctive morphologic alteration in brain of humans and experimental animals succumbing to hepatic encephalopathy (HE). Whether this change is a primary event in the pathogenesis of HE or whether it is secondary to injury of some other component(s) of the CNS has not been clarified. Studies in a rat model of HE have revealed early reactive changes in astrocytes characterized by cytoplasmic hypertrophy. During the later phases, degenerative changes ensue corresponding to the Alzheimer type II change observed by light microscopy. In view of the role of astrocytes in ammonia detoxification and the importance of ammonia in the pathogenesis of HE, we have suggested that the initial astrocytic changes are the morphological correlates of ammonia detoxification. We have speculated that the later degenerative alterations could lead to failure by astrocytes to carry out key functions (e.g., neurotransmitter uptake, ion regulation, and the like) and contribute the development of the encephalopathy. Recently, the potential involvement of astrocytes in HE has been further investigated, using primary astrocyte cultures. Exposure of cultures to ammonia at clinically relevant concentrations has shown morphologic changes closely resembling those observed in experimental HE in vivo. These deleterious effects can partly be prevented by raising cyclic AMP levels in cells. Other potential toxins (octanoic acid, phenol) have shown pathologic changes as well. Although some alterations were common to all three, they each possessed distinctive pathological effects. A synergistic interaction has also been demonstrated with these toxins. Functional studies of ammonia-treated astrocytes have shown the following: With low doses or short-term exposure, the uptakes of K+, glutamate, and GABA remained unchanged or slightly increased, whereas with higher doses or longer treatment, those activities diminished. A fall in ATP values occurred with prolonged ammonia treatment. Preliminary findings have shown no significant derangements in the beta-adrenergic receptor, except for a slight decrease in receptor affinity. However, cyclic AMP production was diminished following stimulation with isoproterenol. A slight rise in the number of benzodiazepine receptors was found. These studies indicate that profound changes occur in astrocytes following exposure to ammonia and other putative toxins. It is proposed that toxins and factors involved in the precipitation of HE do so by affecting astroglial properties. Derangements in such properties may lead to glial dysfunction (primary gliopathy), resulting in an encephalopathic state. PMID- 3306481 TI - Changes in brain metabolism in hepatic encephalopathy. PMID- 3306482 TI - Lean body mass-body fat interrelationships in humans. PMID- 3306483 TI - Human colonic starch metabolism. PMID- 3306484 TI - Products of lipolysis in human milk destroy parasites. PMID- 3306485 TI - Nutrition classics. Naturwissenschaften, Vol. 25, 1937: On cocarboxylase. By K. Lohmann and P. Schuster. PMID- 3306486 TI - Influence of diet on fatty acid composition of red cell and neural membranes. PMID- 3306488 TI - Medicaid recordkeeping requirements and professional misconduct. PMID- 3306487 TI - Ethical dilemmas imposed by the Medicare hospice regulations. PMID- 3306489 TI - [Transplantation--history of a liver]. PMID- 3306490 TI - I.v. infusion pumps. PMID- 3306491 TI - Maternal ocular adaptations during pregnancy. PMID- 3306492 TI - Clinical management and the neoplastic sequelae of trophoblastic embolization associated with hydatidiform mole. AB - The clinical presentation, diagnosis, and management of pulmonary embolization of trophoblastic tissue associated with hydatidiform mole is discussed with particular emphasis on invasive cardiac monitoring at the time of mole evacuation and the immediate use of high-dose steroid therapy. Trophoblastic embolization appears to have a nearly invariable association with subsequent nonmetastatic trophoblastic neoplasia. PMID- 3306493 TI - Calcium supplementation reduces blood pressure during pregnancy: results of a randomized controlled clinical trial. AB - Fifty-two healthy pregnant women were enrolled in a double-blind, randomized, controlled clinical trial. After the 26th week of gestation, the women were given either 1.5 g of elemental calcium per day or a placebo. Subjects in the calcium group, after adjustment for race and initial blood pressure (BP), had a term mean systolic and diastolic BP value of 4-5 mmHg lower than those in the placebo group (P less than .05). The incidence of pregnancy-induced hypertension was 11.1% in the placebo group and 4.0% in the calcium group, a nonsignificant difference. Combining these values with previous data, we found a dose-effect relationship between calcium intake and BP reduction during the third trimester of pregnancy. Further research should be directed at understanding the mechanism of this effect and trying to demonstrate a reduction in pregnancy-induced hypertension with calcium supplementation in a larger population. PMID- 3306494 TI - A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy. AB - Sixty peripartum patients with diastolic blood pressures (BP) 110 mmHg or higher were randomized in a 2:1 ratio to receive repeated intravenous injections of either labetalol (20-80 mg) or hydralazine (5 mg) until the diastolic BP was below 100 mmHg. There were four treatment failures in the labetalol group (N = 40) and none in the hydralazine group (N = 20). Hydralazine lowered mean arterial pressure (MAP) more than did labetalol (33.3 +/- 13.2 versus 25.5 +/- 11.2 mmHg; mean +/- SD), but labetalol had a more rapid effect. There was considerable interpatient variability in the dose of labetalol required to control BP, which could not be predicted by any clinical characteristic before therapy. The duration of action also varied in the labetalol group, with the shortest duration occurring in those patients who required the highest dosage for BP control. No significant fetal or neonatal problems ascribable to drug treatment were noted in the 13 instances in which labetalol was given before delivery. However, fetal distress occurred in two of the six cases involving antenatal hydralazine. We conclude that labetalol appears to be a safe and effective alternative to hydralazine for treating hypertension in the peripartum period, but serious rare side effects have not yet been quantified. PMID- 3306495 TI - Underestimation of gestational age by conventional crown-rump length dating curves. AB - Inaccuracies in gestational age assignment based on published crown-rump length data were noted in patients with known ovulation dates. In this study, we tested the hypothesis that crown-rump length data derived from pregnancies with known ovulation dates differ from those of menstrually timed pregnancies. Seventy-two previously infertile women with known dates of ovulation had crown-rump length measurements from 35-79 days postovulation. We transformed the data to menstrual age (gestational age) by adding 14 days to the date of ovulation and compared our crown-rump length values with those of two previous reports. At corresponding crown-rump length values, the gestational ages from our data differed from those in the previous studies. We suggest using crown-rump length dating curves based on ovulation-timed pregnancies because crown-rump length data derived from menstrually dated pregnancies underestimate true gestational age. PMID- 3306496 TI - Ultrasound placental grading and amniotic fluid quantitation in prolonged pregnancy. AB - Serial ultrasound examinations were performed every three to five days to monitor 200 singleton pregnancies with gestations of 42 weeks or longer. Scanning was used to measure the deepest amniotic fluid pool and to grade placental echogenic changes. Oligohydramnios, defined as an amniotic fluid pool less than 30 mm, was detected in 33 patients (17%) and was an indication for intervention. Grade III placenta was found in 53 patients (27%), and no grade could be assigned in 13 (7%). Intrauterine growth retardation and meconium-stained or absent amniotic fluid at amniotomy occurred significantly more often in association with oligohydramnios than with grade III placenta, which was found before spontaneous labor in only 24% of cases. Ultrasound placental grading appears to offer little useful additional information to amniotic fluid quantitation in satisfactory monitoring of prolonged pregnancies. PMID- 3306497 TI - The four-quadrant assessment of amniotic fluid volume: an adjunct to antepartum fetal heart rate testing. AB - Amniotic fluid volume assessment using a semiquantitative four-quadrant technique, the amniotic fluid index, was evaluated in relationship to fetal heart rate (FHR) testing and perinatal morbidity in 330 high-risk pregnancies. An inverse relationship was found between the amniotic fluid index and nonreactive nonstress tests (NST), FHR decelerations, meconium staining, cesarean section for fetal distress, and low Apgar scores. More important, adverse perinatal outcome was significantly more frequent with diminished compared with normal amniotic fluid volume, even if the NST was reactive. PMID- 3306499 TI - Ultrasound evaluation of the distal femoral epiphyseal ossification center as a screening test for intrauterine growth retardation. AB - In a heterogeneous group of 226 pregnant women, a retrospective study was done of the relation between the distal femoral epiphyseal ossification center detected by ultrasound and the birth weights of the infants. The ossification center of the femur was detectable in 202 of the 208 infants appropriate for gestational age; it was undetectable in 15 of the 18 infants small for gestational age. Because our results compared favorably with those reached by more complicated methods in the literature, we propose that the distal femoral epiphyseal ossification center be used as a screening test for intrauterine growth retardation. PMID- 3306498 TI - Fetal biophysical profile and perinatal death. AB - Antepartum assessment of 5034 high-risk pregnancies to predict perinatal death included five biophysical variables (nonstress test, fetal breathing movements, fetal movements, fetal tone, and amniotic fluid volume) which combined to form a biophysical profile score. We assessed 4148 fetuses within seven days of delivery. The ability of each variable to predict perinatal death was expressed as the likelihood ratio, which incorporates sensitivity and specificity into one number. The predictive ability was most accurate with fetal movement (likelihood ratio 48.1) and the combined biophysical profile score (likelihood ratio 51.0). The biophysical profile score was more likely to predict perinatal death due to asphyxia (seven of eight) than lethal anomaly (six of 19). The overall perinatal mortality was 7.6 per 1000 total births. The perinatal mortality rate was 1.0 for a normal biophysical profile score, 31.3 for an equivocal score, and 200.0 for an abnormal score. The false-negative rate for the biophysical profile score was 0.7 per 1000. PMID- 3306500 TI - Antibiotics and suction drainage as prophylaxis in vaginal and abdominal hysterectomy. AB - A randomized prospective study compared the efficacy of a three-dose perioperative course of intravenously administered cefuroxime and metronidazole versus suction drainage of the vaginal vault for preventing postoperative infection in abdominal and vaginal hysterectomies. In vaginally operated patients, a significant difference in the rate of vaginal cuff abscess formation was found between the drain group and the antibiotic group (33 versus 0%). In the abdominally operated patients, no significant difference was found (7 versus 0%). The rate of cystitis was not influenced by the prophylactic method. A positive correlation was found between Bacteroides sp isolated from the vaginal fluid and vaginal cuff abscesses in the vaginally operated women. The complications of infection are explained by the decrease in host defense, occurring more frequently in patients treated with the vaginal approach than with the abdominal technique. PMID- 3306501 TI - Survey of ultrasound training in obstetrics and gynecology residency training programs in the United States. AB - A survey was mailed to all 292 nonmilitary obstetrics and gynecology residency programs in the United States. The extent and type of ultrasound training and degree of compliance with recommended guidelines was evaluated from the 230 (78.8%) responses. Criteria for evaluation were based on guidelines from the American Institute of Ultrasound in Medicine Joint Task Group on Training for Diagnosis in Obstetrical and Gynecological Ultrasound, and on recommendations from The American College of Obstetricians and Gynecologists. Although almost 98% of respondents claimed to have ultrasound "training" in their programs, more than 55% indicated no resident experience with either reading or writing ultrasound reports, and only 39% of program chiefs claimed greater experience than 200 ultrasound scans per resident over four years. Overall, it appears that current suggested guidelines are not being met. PMID- 3306502 TI - Duplex Doppler ultrasound in the evaluation of growth in twin pregnancies. AB - Fifty-six multiple pregnancies were evaluated for evidence of discordant growth using traditional ultrasonic methods and duplex Doppler ultrasound. The pregnancies consisted of 52 sets of twins and four sets of triplets. Duplex Doppler ultrasound predicted normal growth in 44 of 45 normal sets of fetuses, and correctly predicted discordant growth in nine of 11 discordant sets of twins. Among those nine abnormal sets, Doppler ultrasound predicted that six would become discordant before this was recognized by traditional ultrasonic measurements. Duplex Doppler ultrasound is useful in predicting and confirming concordant and discordant growth, and defining the cause of fetal discordancy. PMID- 3306504 TI - Fetal malignant melanoma: ultrasound presentation and review of the literature. AB - Malignant melanoma is an infrequently described type of congenital neoplasm. We report a case of primary fetal malignant melanoma. A review of the literature yielded six previous cases, four of which were due to metastasis from advanced maternal disease, and two of which were fetal (primary) in origin. Recommendations are discussed for management of this rare fetal malignancy. PMID- 3306503 TI - Transvaginal ultrasonographic study of the fallopian tube. AB - The use of transabdominal/transvesical sonography in gynecologic diagnosis is limited by the physical properties of the transducers used as well as the lack of sufficient acoustic interfaces. Therefore, delicate tubal structures cannot be visualized adequately. Transvaginal application of a 6.5-MHz transducer probe (with a 10-mm crystal) enables the effective use of higher frequencies, enhancing resolution. This higher resolution improves picture quality and increases potential diagnostic power in evaluating the female pelvis in general and the fallopian tube in particular. This report presents the sonographic picture of the normal and pathologic tube. Tubal pathology should be described in terms of the tubal cavity, walls, and content, as well as location and mobility. The more frequently encountered clinical entities, such as the fluid-filled tube, tubo ovarian inflammatory processes, and tubal gestation are discussed. PMID- 3306505 TI - Cardiac output in a fetus with erythroblastosis fetalis: assessment using pulsed Doppler. AB - Pulsed Doppler studies of left and right ventricular outputs were obtained over time in a hydropic fetus with erythroblastosis fetalis. Despite severe anemia, cardiac outputs were within the normal range and remained normal after in utero percutaneous intravascular transfusions, which reversed the hydrops. The measurement of cardiac output in utero provides direct evidence that high-output failure due to anemia is not the mechanism for hydrops in erythroblastosis fetalis. PMID- 3306506 TI - Postpartum group B streptococcal endocarditis associated with mitral valve prolapse. AB - Although group B streptococci frequently colonize the birth canal of pregnant women, and cause puerperal sepsis in approximately 0.2% of deliveries, recommendations for endocarditis prophylaxis do not include uncomplicated vaginal delivery. Mitral valve prolapse has been reported to represent a low risk for endocarditis and an uncertain risk/benefit ratio for prophylaxis. As the case presented here illustrates, group B streptococcal endocarditis after uncomplicated vaginal delivery can be associated with mitral valve prolapse; patients with additional risk factors for group B streptococcal infection are at particular risk. PMID- 3306507 TI - Postpartum polyhydramnios: a unique complication of advanced abdominal pregnancy. AB - After delivering a surviving infant from an abdominal pregnancy at 34 weeks' gestation, the patient described developed a cystic mass, which appeared and enlarged during the postoperative period. Several months postpartum, a 20 X 16-cm cyst and attached placenta were excised. PMID- 3306508 TI - Recurrent anaphylaxis in menstruating women: treatment with a luteinizing hormone releasing hormone agonist--a preliminary report. AB - Recurrent idiopathic anaphylaxis is an illness consisting of recurring anaphylactic or anaphylactoid attacks of unknown cause. A patient has been described whose attacks appeared to be associated with endogenous progesterone secretion and who was treated successfully with an analog of luteinizing hormone releasing hormone (LHRH). This report summarizes the treatment of four additional women with recurrent anaphylaxis in a randomized, double-blind trial of an LHRH agonist and placebo. Two out of the four women experienced remission of their symptoms with the LHRH analog. The patients who responded to therapy had experienced systemic anaphylactoid reactions after provocation with an LHRH infusion and the intradermal injection of medroxyprogesterone; the nonresponders had no adverse reactions to either challenge. Ovarian suppression with LHRH agonist may benefit a subset of women with recurrent idiopathic anaphylaxis. PMID- 3306509 TI - Melphalan with and without doxorubicin in advanced ovarian cancer. AB - In October 1978, the Swedish Cooperative Ovarian Cancer Study Group started a randomized comparison of doxorubicin 40 mg/m2 and melphalan 0.4 mg/kg with melphalan 1 mg/kg every four weeks in International Federation of Gynecology and Obstetrics (FIGO) stages III and IV ovarian cancer of serous and anaplastic histology. One hundred sixty-eight patients entered the study, and 148 were evaluable at five years or longer. All had residual tumors larger than 10 cm, with appropriate stratification according to stage, histologic grade, and age. Definition of response was according to World Health Organization (WHO) criteria except that we required three months' regression of all clinically detectable tumors instead of one month. Seventy-three women treated with doxorubicin plus melphalan had a significantly higher response rate than 75 patients treated with melphalan alone (54.7 versus 26.7%; P less than .0001), median duration of response (13.0 versus 7.3 months; P less than .0057), and median survival time (18.5 versus 10.5 months; P less than .0001). Combined treatment produced significantly more complete remissions than single-agent therapy (30 versus 6.7%; P less than .001). At 60 months, ten patients were alive in the doxorubicin plus melphalan group, compared with three in the melphalan group. Temporary bone marrow depression was significantly more frequent in the melphalan-treated patients, but subjective side effects were the same in both groups. PMID- 3306510 TI - Prophylactic insulin in gestational diabetes. AB - Patients with gestational diabetes were divided into two groups according to the results of three-hour oral glucose tolerance tests. Those with fasting euglycemia (serum glucose 95 mg/dL or lower) on oral glucose tolerance test (class A) were treated with diet alone, whereas those with fasting hyperglycemia on oral glucose tolerance test (class A/B) were treated with both diet and insulin (15 U neutral protamine Hagedorn insulin before breakfast). The frequency of macrosomia (birth weight more than 4000 g) among class A/B gestational diabetics was 16.2%, which was significantly greater than the 5.6% incidence in class A diabetics and the 6.4% incidence in controls. After controlling for potential confounding risk factors, it was determined that class A diabetics had a frequency of macrosomia no different from that of nondiabetics. Nonobese gestational diabetics with fasting hyperglycemia (class A/Bs), who were treated with diet and prophylactic insulin, also had a frequency of macrosomia no different from that of nondiabetics or class A diabetics. However, the diet and insulin regimen did not prevent excess macrosomia in class A/B diabetics who were obese. PMID- 3306511 TI - Intrinsic intrathoracic malformations of the fetus: sonographic detection and clinical presentation. AB - Intrinsic intrathoracic malformations are a rare group of congenital anomalies associated with high fetal and neonatal mortality rates. The antenatal sonographic appearance and the adequacy of diagnosis in 15 affected fetuses were evaluated. An accurate prenatal diagnosis was made in 12 cases; the precise nature of the intrathoracic defect was incorrectly categorized in two fetuses, and the defect was missed entirely in one affected fetus. Antenatal detection and characterization of intrinsic intrathoracic congenital malformations seems possible, but requires a high index of suspicion, familiarity with their sonographic appearances, and meticulous attention to detail. PMID- 3306513 TI - Growth of the fetal stomach in normal pregnancies. AB - Fetal stomach dimensions were measured sonographically in 152 fetuses with gestational ages ranging from nine to 40 weeks. Nomograms of the mean +/- 2 standard deviations (SD) for the longitudinal, anteroposterior, and transverse diameters of the fetal stomach were generated throughout pregnancy. A linear growth function was observed across gestational age, and a high degree of correlation existed between gestational age and the transverse (r = 0.809, P less than .0001), anteroposterior (r = 0.798, P less than .0001), and longitudinal (r = 0.749, P less than .0001) diameters. These data provide a method by which variations from the norm can be assessed, and offer potential prenatal diagnosis of a variety of gastrointestinal lesions. PMID- 3306512 TI - Fetal omphalocele: associated malformations and chromosomal defects. AB - Fetal karyotyping was performed in 35 cases of omphalocele diagnosed by ultrasonography at 16-36 weeks' gestation. Nineteen fetuses (54%) had chromosomal abnormalities; 17 had trisomy 18, one triploidy, and one Klinefelter's syndrome. Twenty-six (74%) of the fetuses were male. Detailed ultrasound examination of the fetuses revealed an additional malformation in 73% of the cases; the most frequent was congenital heart disease (47%). Twenty-two pregnancies were aborted electively, four resulted in intrauterine or neonatal death, and nine infants are alive. These findings contrast with the low rates of associated defects and high survival rates reported in the pediatric literature. PMID- 3306514 TI - Cordocentesis for diagnostic indications: two years' experience. AB - Cordocentesis was performed 96 times over a two-year interval, for a variety of diagnostic indications, in 55 completed pregnancies of 16-40 weeks' duration. There were four unsuccessful procedures, two associated with severe hydramnios and posterior placentas in which the available needles were too short. Sixty three percent of procedures were successful on the first try; 95% succeeded within three attempts. Sixty-four percent of the samples were obtained from the placental cord origin, 27% from a free-floating loop, and 9% from the fetal cord origin. There were no maternal or significant fetal complications, and bleeding from the puncture site was not a problem. The present series confirms previous reports suggesting that in the proper hands, cordocentesis for diagnosis is a safe, rapid, and efficient means of obtaining access to the fetal circulation. PMID- 3306515 TI - Changes in lipoproteins with various sex steroids. AB - Menopausal symptoms are a consequence of the decline in sex hormone production, and hormone replacement therapy aims not only to relieve these symptoms but also to prevent the development of diseases of old age such as osteoporosis. The general opinion taken from a wide variety of publications is that the serum lipid concentrations change during hormone replacement therapy with estrogen, progesterone, and testosterone, or when oral contraceptives are administered. The intolerance of many women to oral contraceptives and the many side effects developed from the birth control pill lead us to suggest that pure crystalline estrogen pellets for subcutaneous implantation are an excellent method of contraception, adding beneficial influence upon lipid metabolism by increasing HDL concentration. The use of progestogens (nortestosterone or hydroxysteroid derivatives) in order to induce withdrawal periods and to avoid endometrial hyperplasia is recommended. But it is important to note that the nortestosterone derivatives (norgestrel and norethindrone acetate) differ markedly from the nonadrogenic 17-alpha hydroxyprogesterone derivative in that the former lowers HDL levels noticeably more than the latter. PMID- 3306517 TI - Absorption and metabolic effects of different types of estrogens and progestogens. AB - The classes of estrogens and progestogens currently in use and their routes of administration have been considered. The decision to prescribe any given estrogen or progestogen and by a particular route has a significant impact on cardiovascular risk factors. Among the estrogens, native estradiol and estrone are favored over equine and synthetic estrogens. Given this choice, oral and systemic routes of administration are not sufficiently different clinically to endorse one method over the other, except for the unusual hypertensive woman or the patient with a history of thromboembolic phenomena. Among the progestogens, oral micronized progesterone offers much promise for use in postmenopausal women. However, the oral use of lower doses of other progestogens seems appropriate at the present time. With the availability of oral micronized progesterone and in time a transdermal system, the need for alternate routes of administration for other progestogens seems unnecessary. PMID- 3306516 TI - Exercise, nutrition, and the coagulation effects of estrogen replacement on cardiovascular health. AB - Estrogen therapy has been used safely by millions of women. Yet, there will be a small minority of women in whom a venous or arterial thrombus will develop. Given the other benefits of estrogen replacement therapy, this risk is extremely small and can be reduced to a minuscule level by encouraging postmenopausal women to eat judiciously and well and to engage in a regular and meaningful exercise program. PMID- 3306518 TI - Diagnosis and management of perimenopausal and postmenopausal bleeding. AB - The menopausal years are characterized by a deficiency of progesterone and relative hyperestrogenism. This hormonal imbalance creates an environment favorable for the development of endometrial hyperplasia. The pathologic progression of hyperplasia to endometrial carcinoma can be arrested with progestogen therapy. A simple diagnostic approach for peri- and postmenopausal bleeding disorders is presented, along with a rational treatment regimen. Some of the risks and benefits of hormonal replacement therapy are discussed. PMID- 3306519 TI - Sex steroids and cancer. AB - Hormones, particularly estrogens, have been suspected for many years of being carcinogens. Retrospective studies from the mid-1970s indicate that unopposed estrogen replacement therapy increases the risk for endometrial cancer. However, recent reports have failed to incriminate even unopposed estrogens for any significantly increased risk of breast cancer. Added progestogen, in proper duration and dosage, almost completely negates the estrogen-increased risk for adenocarcinoma of the endometrium. There is increasing evidence that progestogen added to estrogen replacement may decrease the risk for carcinoma of the breast in some women. PMID- 3306520 TI - Contraception for the perimenopausal patient. AB - All the existing data show that combination estrogen/progestogen therapy is mandatory if any replacement therapy is to be given to the woman over age 40. Sufficient evidence has indicated that estrogen alone is inadequate; progestogen must be given to prevent endometrial hyperplasia, lower the risk of breast cancer, and prevent bone loss. In the premenopausal woman, such therapy should also provide contraception. Because of the lack of minimal dose products fulfilling such criteria, many physicians will allow women to continue with their contraceptive if they do not smoke and have no other contraindications. It will remain to be seen if a product close to ideal can be found to fulfill the contraceptive and therapeutic needs of women traversing the most physiologically hazardous period of their lives. PMID- 3306521 TI - Hormone pellet implantation for the menopause and premenstrual syndrome. AB - Sex hormone implants have been available for almost 50 years, but only a few clinicians administer them regularly. Implants represent a physiologic mode of therapy with many metabolic advantages over other routes. Surprisingly, they are relatively ignored by physicians. This may well reflect their surgical nature, although the technique of hormone implantation is simple and fast and obviates daily oral medication. As the list of indications for hormone pellets grows, more patients will take advantage of the benefits they offer. PMID- 3306522 TI - Nonoral routes of estrogen administration. AB - Thus, the effects that a specific estrogen has on the liver is the summation of several mechanisms, including the first pass mechanism and the enhanced delivery of circulating estrogens to this organ. For example, the major estrogen in conjugated estrogen is estrone sulfate. Based on the present data, very little circulating estrone sulfate is available to the brain or uterus (Fig. 25). Since most of the hypothalamus is behind the blood-brain barrier, it is unlikely estrone sulfate exerts a direct action on gonadotropin-releasing hormone (GnRH) neurons to reduce its secretion and, subsequently, gonadotropin levels. Estrone sulfate also does not interact with the estrogen receptor. It is possible the small amount of estrone sulfate that crosses the blood-brain barrier is converted to unconjugated estrogens locally and these could have function. More likely, the major mechanism by which estrone sulfate suppresses GnRH release is through conversion to unconjugated estrogens, principally estrone, in the liver. The large extraction of estrone sulfate by the liver allows accessibility of the hepatocyte for this conversion. Based on this concept, conjugated estrogen must enter the liver to be converted to its active forms. The route of administration then should have little impact on changing the relative potency of this preparation on hepatic and nonhepatic markers of estrogen action. For ethinyl estradiol, the preparation is orally active because it is rapidly and almost completely absorbed from the stomach and undergoes limited hepatic metabolism before entry into the general circulation (Fig. 26). This limited hepatic metabolism reduces the impact of the first pass mechanism on ethinyl estradiol. Thus, the enhanced hepatic action of ethinyl estradiol is principally related to the greater entry of this estrogen into the liver than other organs (Fig. 27). Consequently, the route of administration should have little impact on the exaggerated hepatic actions of this estrogen. Orally administered estradiol undergoes substantial hepatic metabolism to less active forms, principally estrogen conjugates. The amount of estradiol leaving the liver following oral administration is substantially less than that which enters it through the portal vein. The systemic administration of estradiol avoids this initial hepatic metabolism. Furthermore, only 25 per cent of nonorally administered estrogen will go to the liver at each pass, and nonhepatic tissues would be exposed to a greater extent than after oral administration. Thus, peripheral administration of estradiol reduces the exaggerated hepatic responses in comparison to nonhepatic actions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306523 TI - The effects of estrogens and progestogens on the endometrium. Modern approach to treatment. AB - The major hazard of postmenopausal cyclic estrogen therapy is endometrial hyperstimulation. The incidence of hyperplasia is dose dependent; the incidence of carcinoma is both dose and duration dependent. The risk of carcinoma is small. Invasive procedures such as endometrial biopsy to detect those patients with hyperplasia and carcinoma are unlikely to be cost-effective and have other disadvantages. With cyclic estrogens, biopsies should be performed at regular intervals irrespective of the bleeding pattern. The possible alterations to cyclic treatments to reduce the risk of endometrial hyperstimulation have been reviewed; only progestogen addition has been shown to be effective. Maximal effects are obtained when progestogens are added for 12 to 13 days each calendar month. To reduce the risk of side effects, the minimum dose of progestogen should be prescribed, and with the nor-testosterone derivatives, a small dose of norethindrone, approximately 1 mg daily, is as effective as 5 mg daily. The smaller doses cause minimal lipid changes. Interpatient variation in response to the 17-hydroxyprogesterone derivatives can occur, and at high doses, adverse lipid effects have been reported. With sequential estrogen/progestogen therapies, the endometrial histology appears to correlate with the bleeding pattern, thereby, perhaps, obviating the need for biopsy. The development of regimens to induce endometrial atrophy and amenorrhea is suboptimal, and further research is required. PMID- 3306524 TI - Prevention of postmenopausal osteoporosis. AB - Prevention of osteoporosis is clearly the preferred approach, since treatment of the established disorder is less than satisfactory. However, accurate identification of those at risk for fractures is impossible at present. By judicious use of risk assessment and the addition of bone mass measurements in the postmenopausal patient, the physician can define a group of patients who will be at some increased likelihood of subsequent osteoporosis. Since estrogen therapy is the most effective single agent for prevention of bone loss, estrogens can be recommended for this group of patients, if otherwise not contraindicated. The addition of a progestogen to the regimen may add to the effect of estrogen by stimulating bone formation. Estrogen therapy may have other effects in the postmenopausal patient population that must be considered when deciding about the introduction of therapy. PMID- 3306525 TI - Treatment of osteoporosis. AB - In type I ("postmenopausal") osteoporosis, there is an excess loss of trabecular bone, resulting in fractures of the wrist and vertebrae. This type of osteoporosis occurs mainly in women 50 to 65 years of age. In either men or women over the age of 75 years, cortical and trabecular bone is lost, resulting in hip fractures; this is termed type II ("senile") osteoporosis. This article considers the treatment of established type I osteoporosis associated with vertebral fractures, the type of osteoporosis commonly encountered in clinical practice. PMID- 3306527 TI - [Ophthalmological manifestations of hypercorticism]. PMID- 3306526 TI - Cardiovascular disease and hypertension in older women. AB - Cardiovascular disease is extremely rare in premenopausal women except for those who have diabetes or hypertension. It can be surmised, but is not yet proved, that protection from atherosclerotic coronary artery disease is an action related to the production of estrogen. In the consideration of hypertension, true systemic hypertension must be differentiated from blood pressure that is elevated spuriously from excessive sclerosis of the large arteries, which is more common in elderly patients. Both types of hypertension tend to increase with advancing age, and women have a greater incidence overall. All hypertensives should be actively treated. PMID- 3306528 TI - A practical approach for physicians to MAAC issues. PMID- 3306529 TI - [Clinical relevance of immunotyping of oncologic and hematologic diseases]. AB - Progress in immunology and molecular biology have provided a better understanding of etiology, pathogenesis and biology of many oncological and hematological diseases. In clinical practice, certain new methods of immunotyping (IT) are of diagnostic importance in assigning undifferentiated tumors to lymphoid, epithelial or mesenchymal origin and in defining subgroups of leukemias and lymphomas. The demonstration of rearrangements of gene coding for immunoglobulins or T-cell receptors assigns hematological malignancies of early differentiation to the B- or T-cell lineage, discriminates between reactive lymphoid changes and clonal lymphoid expansion and detects persistent clonal growth after therapy. In certain clinical entities (e.g. ALL) the immunological subtypes are of importance for differential therapy. By means of IT new clinical entities have been defined (Ki-1-lymphoma, T gamma-lymphoproliferative, LFA-1-deficiency) and the pathomechanisms of others have been elucidated (Bernard-Soulier-disease Syndrome, Glanzmann-Nageli thrombasthenia). Of immediate therapeutic importance is the identification by IT of receptors for specific hormones or biological response modifiers on malignant cells. In-vivo diagnosis by monoclonal antibodies opens a way to define more exactly the extent of malignant disease by scintigrams or NMR. PMID- 3306530 TI - [Perspectives in the use of monoclonal antibodies in the therapy of neoplastic diseases]. AB - In order to improve the efficiency of monoclonal antibodies against tumor associated antigens, conjugates with toxins, cytostatics or radionuclides have been tested. Furthermore, antibody genes or gene segments can be altered or exchanged to reach enhanced specificity or novel biological functions of immunoglobulin molecules. In addition, monoclonal antibodies have been used recently for the direction, stimulation and activation of T lymphocytes, which are able to generate cytolytic potential against tumor cells. In this study we demonstrate selective activation and expansion of T-cell subpopulations by cross linking the T-cell receptor complex with other differentiation antigens. PMID- 3306531 TI - [Molecular genetics of the pathogenesis and classification of chronic myelocytic leukemia]. AB - The Philadelphia (Ph) translocation in CML is molecular-genetically characterized by a rearrangement of the c-abl oncogene with sequences of the bcr gene on the Ph chromosome. In leukemic cells this recombination results in the transcription of a 8.5 kb bcr/c-abl hybrid RNA which is translated into a p210 abl protein. The p210 abl protein contains, in contrast to its normal 145 abl counterpart, associated tyrosine kinase activity which is not physiologically controlled. Both genes do not participate in the acceleration of CML from chronic state into blast crisis. The majority of CML patients without cytogenetically detectable Ph chromosome also lack a bcr/abl rearrangement. However, some cases of Ph-negative CML could be reclassified into the group of Ph-positive CML by demonstration of a bcr gene rearrangement. One patient exhibited a bcr gene recombination without translocation of c-abl sequences. A similar heterogenous pattern is observed in Ph-positive acute leukemias. About 50% of cases are characterized by a bcr/abl rearrangement, as is likewise observed in Ph-positive CML. It is tempting to speculate that these patients represent Ph-positive CML cases that initially presented themselves for treatment with CML blast crisis. Particularly in pediatric Ph-positive ALL, the majority of cases show a c-abl oncogene translocation without bcr rearrangement. Precise molecular-genetic analyses of those cases are still pending. Molecular-genetic analyses have already been proven to be of clinical value 1) in the diagnosis of Ph-positive CML in the absence of cytogenetic methods, 2) in the subclassification of Ph-negative CML or Ph-positive acute leukemias.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306532 TI - [Diagnostic and therapeutic applications of gene technology methods in thalassemia]. AB - By applying gene technology, great progress has been made in defining the molecular basis of thalassemias. While the prevention of thalassemias through prenatal diagnosis has improved significantly, advances for molecular therapy have been rather limited until now. PMID- 3306533 TI - [Immune regulation of hematopoiesis]. AB - Effective hematopoiesis is a multistep phenomenon. It consists in the presence of pluripotent hematopoietic stem cells (HSC), their proliferation and self maintenance, their differentiation into various committed lineages of specific progenitors, their orderly maturation into functional cells that are released into the circulation in an orderly fashion in response to the body's demand. Increasing numbers of hematopoietic factors are being purified to homogeneity and/or cloned. The availability of sufficient quantities of these regulators promises a new area for research into the physiology and pathophysiology of the hematopoietic system. The purpose of this overview is to consider some newly developed concepts in the field of hematopoiesis, with regard to regulatory control mechanisms and cellular interactions. PMID- 3306534 TI - [Serum factors and their effect on hematopoiesis]. AB - Human serum contains stimulators of hemopoietic precursor cells. Isolation of "factors" from serum is technically more difficult than from supernatants due to interactions of "factors" with the high molecular weight serum proteins. On the other hand, serum factors are naturally occurring activities which are likely to play a role in regulation of hemopoiesis. Two hemopoietic stimulators which differ from the known colony stimulating factor have been found in human serum. One of them is an indirect "releaser" activity, which induces the release of granulocyte colony stimulating factor (G-CSF) from normal peripheral blood lymphocytes. In patients whose cells release abnormally low amounts of G-CSA, this serum activity is elevated, indicating a feedback mechanism between "releaser" activity and the actual release. G-CSA itself does not circulate in serum. Thus, we assume that releaser activity has a local effect in the bone marrow on the release of G-CSF. These observations suggest that hemopoiesis is regulated by multi-step hormonal mechanisms, in analogy to other known hormone systems. PMID- 3306535 TI - [Importance of HLA systems in the regulation of hematopoiesis]. AB - Human hematopoiesis is known to be influenced by local microenvironments, as well as by a large number of specific soluble inhibitory or stimulatory mediators. It has been suggested that the HLA system plays an important role in the regulation of physiological and pathological hematopoietic cell proliferation and differentiation. The quality and quantity of HLA-antigen expression have been shown to influence interactions of colony-inhibitory factors with hematopoietic precursor cells. It is also assumed that HLA antigens mediate regulatory mechanisms of T-lymphocytes on the production of hematopoietic factors, as well as on hematopoietic cell proliferation and differentiation. The HLA antigens may thus participate in regulatory functions of the immune system in hematopoiesis. PMID- 3306536 TI - Marrow transplantation: what determines success or failure of hematologic reconstitution? AB - The technique of marrow transplantation serves to replace diseased marrow by normal hemopoiesis. Successful restoration of hemopoiesis is predicated upon the ability of the preparative regimen to ablate both the diseased marrow and the host immune system and upon the capacity of the injected undifferentiated self renewing stem cells to produce progeny. If these conditions are met, hemopoiesis and an immune system consisting almost exclusively of donor cells will be established although a minority of patients may show a mixture of host and donor cells. If not, graft failure may ensue, a clinical syndrome having at least two etiologies: spontaneous graft resistance and transfusion-induced sensitization. The present report contrasts the immunological findings made with successful hemopoietic engraftment to those seen with graft failure. PMID- 3306537 TI - Aplastic anemia: pathogenesis and treatment. AB - Treatment of severe aplastic anemia (SAA) in Europe between 1970 and 1986 is reviewed. 487 patients received an HLA-identical BMT: results are encouraging and currently suggest a 65% survival. However, many patients cannot be offered this procedure because of the absence of an appropriate donor. Forty-five patients were given a non-HLA identical BMT: results are dependent on the degree of mismatch. Immunosuppression (IS) was given to 509 patients: 50% of these survive. Some mechanisms regulating in vitro hematopoiesis are discussed, together with their relevance in the treatment of SAA. PMID- 3306538 TI - [Disorders of hematopoiesis in immunodeficiencies]. AB - There is increasing experimental evidence for the influence of the immune system on the regulation of hematopoiesis. The question is how much information on the basic pathomechanisms we can gain when we study the disturbances of hematopoiesis observed in congenital and secondary immunodeficiencies. Frequently, there is a contradiction between in vitro results and in vivo observations. Only in some cases (e.g. the development of eosinophils), are experimental results supported by clinical observations. All concepts of regulation and influence of the immune system on hematopoiesis have to be measured against the disturbances seen in the patients. PMID- 3306539 TI - Amalgam post and core: a simplified technique for endodontically-treated posterior teeth. PMID- 3306540 TI - Is it real or is it Cerestore--or is it Dicor? PMID- 3306541 TI - Preventing conjunctival prolapse and tarsal eversion following large excisions of levator muscle and aponeurosis for correction of congenital ptosis. AB - Mattress sutures placed from the superior fornix conjunctiva through levator muscle and aponeurosis can be used to reconstruct the superior fornix following extensive dissection and resection of levator muscle and aponeurosis for severe congenital ptosis. This placement of sutures differs from the full-thickness mattress sutures from conjunctiva through skin commonly recommended by many textbooks in oculoplastic surgery, and appears to be more successful in preventing some of the complications that follow this type of oculoplastic surgery. PMID- 3306542 TI - Macrocystic enlargement of orbital dermis-fat grafts. AB - Acquired cysts represent an unusual but significant complication of orbital dermis-fat grafts. We report two cases of late postoperative enlargement of dermis-fat grafts: First, macrocystic enlargement occurring in both orbits with severe microphthalmia; second, cystic enlargement occurring in a dermis-fat graft for anophthalmia following an earlier evisceration. Both graft enlargements were due to epithelial-lined cysts that developed within the graft tissue. These cysts were treated by excising the cysts walls and allowing the resultant cavity to heal spontaneously. Light microscopy of the excised tissue revealed that the clear cysts were lined by a non-keratinizing, stratified squamous epithelium. The histogenesis of the cysts is unclear, but most likely they are the result of incompletely removed or implanted conjunctival or corneal epithelium. Several other possibilities are discussed. Due to the difficulty of removing all corneal and conjunctival epithelium, cystic complications of dermis-fat grafts make unattractive their use for volume enhancement in patients with microphthalmia or following evisceration. PMID- 3306543 TI - Trabeculectomy flap suture lysis with endolaser probe. AB - Enhancing filtration after trabeculectomy with scleral flap sometimes requires cutting of the nylon suture. A new use of the endolaser probe to cut the nylon suture through hemorrhagic and edematous conjunctiva and Tenon's capsule is described. The probe compresses the tissue so that it is close to the suture for delivery of the laser energy. This application of the endolaser probe as an "ecto laser" succeeded in enhancing filtration, raising the conjunctival bleb, and lowering intraocular pressure. PMID- 3306544 TI - Penetrating keratoplasty for the treatment of pseudophakic corneal edema associated with posterior chamber lens implantation. PMID- 3306545 TI - Corneal epithelial healing after penetrating keratoplasty using topical Healon versus balanced salt solution. AB - The authors conducted a prospective study of 38 consecutive corneal transplant patients over a five-and-one-half month period in order to evaluate the effect of intraoperative hydration with topical Healon versus balanced salt solution on postoperative epithelial healing in the corneal graft. Eight independent variables, including patient age, sex, operating room time, donor age, donor time in McCarey-Kaufman media, intraoperative hydration with balanced salt solution versus Healon, and the amount of postoperative punctate epithelial keratitis measured on postoperative day 1, day 2, and at one week were compared using a multiple linear regression method. While the correlation between donor age (p = .060) and patient age (p = .088) with the amount of punctate epithelial keratitis at one week post graft approached statistical significance, only the Healon treated group showed a high correlation to more complete graft healing one week postoperatively (p = 0.002). Topical Healon during keratoplasty may foster epithelial healing, but it also may present technical challenges of which the surgeon should be aware. PMID- 3306546 TI - Plasma levobunolol levels following topical administration with reference to systemic side effects. AB - We determined the plasma level of levobunolol in normal volunteers after a single topical instillation of 0.5 or 1% levobunolol in both eyes, and after twice-daily instillations for 1 week. Levobunolol levels were detected within 1 h following acute instillation. During the study, mean plasma levels ranged from 0.1 to 0.3 ng/ml for the 0.5% group and 0.3 to 0.6 ng/ml for the 1% group. The highest individual plasma level was 1.2 ng/ml, which occurred in 1 patient receiving 1% levobunolol. After 1 week of twice-daily instillation mean plasma levels were similar to those observed after acute instillation. Minimal cardiovascular changes were observed in the 0.5% group while decreases in heart rate and systolic blood pressure were observed in the 1% treatment group. PMID- 3306548 TI - Amblyopia and strabismus. PMID- 3306547 TI - Historic review of retinoblastoma. AB - Retinoblastoma was first described as a specific entity by James Wardrop in 1809, with enucleation as his suggested treatment. Histologic studies including those of Flexner and Verhoeff and subsequent electron microscopy have given insights into its pathogenesis. The establishment of cell lines of retinoblastoma, the "nude" mouse model, and other animal models have contributed additional information. Classic genetic and epidemiologic studies have led to a broad and intense interest in the tumor despite its relative infrequency. Attempts now in progress to identify and characterize the oncogene for retinoblastoma may prove to be the most exciting part of the history of retinoblastoma. PMID- 3306549 TI - Immunization of sheep against the larval stage of Taenia multiceps. AB - A trial with 200 ewes and 127 lambs showed that vaccination of lambs with 2 doses of Oncosphere Secretory Antigen (OSA) 4 weeks apart, at either 4-8 and 8-12 weeks or at 12-16 and 16-20 weeks of age, was equally effective in protecting them against infestation with the larval stage of Taenia multiceps. In this trial, the lambs of ewes, vaccinated with OSA when they were 90 and again 120 days pregnant, were as susceptible to infestation as the lambs of untreated control ewes. Another trial to provoke passive immunity in lambs gave inconclusive results. In a 3rd trial 2 doses of regular OSA and 2 doses of freeze-dried OSA protected all the lambs in each group, while a single dose of regular OSA protected 9 out of 10 lambs against cerebral lesions. PMID- 3306550 TI - Two field strains of Haemonchus contortus resistant to rafoxanide. AB - Two field strains of Haemonchus contortus, one from Pretoria on the Highveld and the other from White River in the Lowveld of the Transvaal, showed pronounced resistance to rafoxanide at a dosage rate of 7.5 mg/kg live mass per os. Both of these strains originated from kikuyu pastures under irrigation. Resistance in South Africa to rafoxanide and other anthelmintics, namely, closantel, ivermectin and the benzimidazoles is reviewed. It is concluded that apart from avoiding farming practices where integrated worm control is not possible, there is at present no solution to the problem of worm resistance in the country. PMID- 3306551 TI - Some features of coagulase positive staphylococci from bovine milk. II. Comparison of conventional techniques and the API Staph system. AB - A total of 150 isolates of Staphylococcus aureus were subjected to the tests on the API Staph system. Of these, 50 were also tested by conventional methods, using the same tests as those found on the API Staph strips. Applying the principles of numerical taxonomy, the relationship between these isolates was 82% and more. Tests for the metabolism of sucrose and N-acetyl-glucosamine and for the production of argenine dihydrolysate and urease appear to be superfluous in the identification of S. aureus in this system. PMID- 3306552 TI - Synergistic effect of sialagogues in management of xerostomia after radiation therapy. AB - The combined effects of two sialagogues, with proposed different mechanisms of action, were studied in a phase I/II trial in the management of xerostomia. Improvement in saliva-flow rates and subjective symptoms were seen in the patients. PMID- 3306554 TI - Experimental inoculation of Klebsiella rhinoscleromatis bacilli in albino mice. AB - 72 albino mice were intranasally inoculated with Klebsiella rhinoscleromatis suspension with or without the addition of hog mucin. Scleroma-like lesions developed in their lungs more frequently with hog mucin. A liver affection was detected only in 1 animal. K. rhinoscleromatis organisms were recovered from the lung lesions. A possible potentiating effect of hog mucin is discussed. PMID- 3306553 TI - Artifacts in ultrastructure of respiratory cilia caused by various fixation procedures and different types of handling. AB - The ciliary ultrastructure with different fixatives and buffer combinations and artifacts caused by handling the specimens was studied in samples from respiratory mucosa. After different standard fixatives the ciliary ultrastructure did not vary much. Glutaraldehyde in cacodylate gave the best result; the contrast was good and the cell membrane did not show undulation and so many blebs as with other fixatives. With old 4% formaldehyde + 1% glutaraldehyde inphosphate the cytoplasm was darker and the contrast was not as good as with a fresh fixative. Mechanical damage caused rupture of the cell membrane and sometimes changes in axonemal architecture. These findings are similar to those often seen in human samples. The axonemal architecture was always intact if the cell membrane was intact. PMID- 3306555 TI - [A method of anterior spondylodesis of the lumbo-sacral segment of the spine]. PMID- 3306556 TI - [60th anniversary of the journal "Ortopediia, Travmatologiia i Protezirovanie"]. PMID- 3306557 TI - [Embryogenesis of congenital abnormalities of the spine (review of the literature)]. PMID- 3306558 TI - Chemical evolution and the origin of life. Bibliography supplement 1983. PMID- 3306559 TI - Chemical evolution and the origin of life. Bibliography supplement 1984. PMID- 3306560 TI - Radionuclide detection and differential diagnosis of left-to-right cardiac shunts by analysis of time-activity curves. PMID- 3306561 TI - [The place of ultrasonic studies in the state of the art diagnosis of ovarian tumors]. PMID- 3306562 TI - [The role of real-time sonography in the differential diagnosis of postoperative complications]. PMID- 3306563 TI - [Care of epileptic patients]. PMID- 3306564 TI - [Histology of the implant-bone interface in cemented and uncemented endoprostheses]. AB - The introduction of bone cement into endoprosthetic surgery was a significant step forward from the 'pre-cement' era. Nonetheless, its disadvantages soon stimulated the search for better means of anchoring implants without cement. Interest focuses on the so-called interface zone, which is the area between bone and foreign body. On the basis of light-microscopical findings our understanding of the biological and biomechanical interactions has influenced the principles of prosthetic design and the implant materials selected for use. The present article gives a synopsis of the histomorphology of the interface, with special reference to stability, tissue reactions, wear products, and implant fixation at bone surfaces (concerning bony ingrowth, osseointegration, and bonding). In all, 127 histological specimens of total hip and knee revisions were reviewed, in addition to a total of 24 non-cemented polyethylene cups retrieved at autopsy. PMID- 3306565 TI - Remodelling the cornea. PMID- 3306566 TI - Origins of colour vision standards within the transport industry. AB - Colour vision standards should reflect changes in our understanding of the nature of these defects as well as technological advances that place less importance upon the visual senses of the human operator. Therefore it is suggested that visual standards be subject to routine reviews in order to assess their suitability for modern work environments. This paper gives a chronological account of the introduction of colour vision standards by several national transport authorities and identifies historical reasons that led to their implementation. It is concluded that the same factors that gave rise to the adoption of early colour vision standards are still relevant for modern transport systems. However the recent deployment of automatic or semi-automatic control or navigational systems has substantially altered man's role from being the primary source of information input to one of a monitoring process. This has generated a good deal of debate and uncertainty regarding the level of responsibility that a human operator has for the control of modern transport vehicles. Nevertheless, it is argued that in the absence of complete automation some type of visual standard is needed whenever visual judgements must be made by human observers. PMID- 3306567 TI - Pitt School of Medicine celebrates centennial. PMID- 3306568 TI - Centennial prompts recall of school's history. University of Pittsburgh School of Medicine. PMID- 3306569 TI - Monoclonal antibodies that distinguish Trypanosoma congolense, T. vivax and T. brucei. AB - Monoclonal antibodies (MoAbs) were derived against in-vitro-propagated procyclic forms of Trypanosoma congolense, T. vivax, T. brucei brucei and T.b. rhodesiense in order to identify antigens for use in immunodiagnosis of African trypanosomiasis. The antibodies have been tested against procyclic and bloodstream form trypanosomes of 13 T. congolense, six T. vivax six T.b. brucei, four T.b. rhodesiense, five T.b. gambiense and three T. simiae isolates from different geographical areas by indirect immunofluorescent antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA). The MoAbs raised against T.b. brucei reacted with all the brucei group of trypanosomes but not with T. congolense, T. simiae or T. vivax. Likewise, MoAbs against T. congolense reacted with T. congolense and T. simiae but not with any of the other species, while those against T. vivax reacted with T. vivax only. The antigens recognized by these MoAbs were present in lysates of bloodstream trypanosomes as well as midgut (for T. congolense and T. brucei) and epimastigote forms from infected Glossina morsitans centralis. There was no reactivity of the MoAbs with Theileria parva, Anaplasma marginale, Babesia bigemina or Plasmodium falciparum. These antibodies and the antigens they recognize should, therefore, prove useful in the development of assay systems for immunodiagnosis of African trypanosomiasis. PMID- 3306570 TI - [The aging of biological rhythms in man]. AB - The characteristics of the rhythms of some biological variables (peak location in the time scale, mean level, amplitude...) may be modified in elderly subjects when compared with young ones in the three spectral fields (ultradian, circadian and infradian). The purpose of this review is to round up the question of such possible modifications with age of endocrine functions (adrenals, gonads, pituitary, parathyroid, pineal, vitamin D...) and of others (body temperature, plasma proteins, cations...). These modifications, if any, may be interpreted as a change in the adaptability of aged subjects to environmental factors. The loss or decrease of adaptation capacity with aging is of course worth quantifying. The concept of biological rhythms has thus to be taken into account in any study dealing with aging. PMID- 3306572 TI - [Basic mechanisms of chronopharmacology]. AB - Many animal and human studies have demonstrated time-dependent changes in the effects and kinetics of drugs that can be explained in part by parallel changes in their absorption, metabolism and excretion. Although food influences drug absorption, its presence in the stomach does not explain the circadian rhythms in the absorption of xenobiotics. Circadian rhythms in blood flow, biliary secretion and the physico-chemical properties of drugs seem to be very important factors involved in the circadian rhythms of drug absorption. Time-dependent changes have been reported in the activity of hepatic enzyme involved in drug metabolism and they can explain the circadian rhythms in the effect of hexobarbital and in the kinetics of acetaminophen. However, circadian changes in blood flow, biliary secretion and in the binding to plasma proteins must be investigated thoroughly because they could explain many circadian rhythms in drug metabolism. The role of hepatic extraction ratio must also be looked at carefully. Finally, circadian changes in urinary pH, glomerular filtration and in other mechanisms of drug elimination by the kidneys can account for the circadian rhythms in the elimination of drugs such as the salicylates and furosemide. Future research on the molecular mechanisms of the circadian variations in the effects and kinetics of drugs must be carried out to give health professionals a better understanding of the phenomenon. Concepts and findings from investigative chronopharmacology are becoming now indispensable to solve problems of drug optimization. PMID- 3306573 TI - [Recent data in chronopharmacokinetics]. AB - Time of drug administration may be responsible among other factors for nonlinearity in pharmacokinetics. More than a hundred studies have reported on chronokinetics. Absorption, distribution, metabolism and elimination rate of a drug depend on temporal variations: drug absorption processes vary with time of day even in fasting conditions. Temporal changes in membrane permeability may be involved in temporal variations of distribution such as in protein binding. Circadian variations of the metabolism of a drug may also depend on circadian changes of metabolizing enzymes activities or on blood flow variations in the concerned organs. Finally the elimination rate of drugs depends on timing of administration according to renal blood flow, glomerular filtration and pH variations. Such chronokinetic studies are needed for a better understanding of nonlinearity of kinetics and may explain, in part at least, chronopharmacological data. PMID- 3306571 TI - [Chronobiology and chronopharmacology. Concepts and definitions]. AB - Circadian (congruent to 24 h), circannual (congruent to 1 year) and other biological rhythms of endogenous origin, detectable at all levels of organization, constitute a temporal structure in all animal species, including man. Circadian, circannual and other rhythmic changes in biological susceptibility and response of organisms to a large variety of physical as well as chemical agents including medications and foods are rather common phenomena. Modern chronopharmacology investigates drug effects: a) as a function of biological timing and b) upon parameters characterizing the endogenous bioperiodicities. A better understanding of periodic and thus predictable changes in drug effects can be attained through consideration of three complementary concepts: the chronokinetics of a drug (rhythmic changes in its pharmacokinetics); the chronesthesy (rhythmic changes in susceptibility of target biosystem to this drug), and the chronergy (the drug-integrated overall effects). One of the aims of chronopharmacology is solving problems of drug optimization. Knowledge of those administration times coinciding with best effectiveness or tolerance is required to optimize both timing(s) and dosage(s) of a medication. PMID- 3306574 TI - [Modeling in chronopharmacology]. AB - The concept of rhythm can be introduced in the mathematic models describing pharmacological phenomena. The modelling can take into account periodic fluctuations in the pharmacokinetic parameters (chronopharmacokinetics), or periodic fluctuations in the susceptibility of an organism to a drug (chronesthesy). It allows to choose the theoretical cases when chronotherapy could be particularly usefull, and also to propose protocols of administration taking into account the time (injection clock-time for example), in the same way that drug amount and route of administration. Modelisation also shows up the complex relationship between a temporally structured organism and an exogenous substance which has not been designed to be integrated into a set of biological rhythms. PMID- 3306575 TI - [The chronobiology of inflammation]. AB - The inflammatory reaction is characterized by a multifrequency time structure with prominent circadian, ultradian and infradian rhythms in cell proliferation and cell function. The circulating blood cells show highly reproducible circadian rhythms in human and in animals. Daily fluctuations of concentrations of haematologic chemical and endocrinological parameters are described. Circannual variations of several hematologic parameters are presented. Chronobiological studies of plasma exudation in carrageenan paw oedema show a circadian and a circannual rhythm. Daily and annual changes in migration of polymorphonuclear leucocyte produced by BCG are studied in mice. Differences in response are observed in adrenalectomized and castrated animals. The susceptibility of cells and tissues at different stages of their circadian or circannual rhythms lead to the development of a chronotherapy of inflammation. PMID- 3306576 TI - [Chronobiology and biochemical markers of human cancer]. AB - The author reviewed available data from the literature related to the presence of biological rhythms in human tumor markers. Those rhythms appeared frequently disrupted with regard to the controls in presence of cancer. In some instances, they appeared as specific criterion of underlying malignancy (CEA, ferritin); the reappearance of "normal" rhythmicity after therapy could also reflect the favorable outcome of the disease. PMID- 3306577 TI - [Chronobiology and cancer]. AB - Circadian rhythms characterize murine tolerance for 18 anticancer agents, including radiations and chemotherapeutic drugs. Such rhythms usually exhibit a large amplitude. Moreover, the circadian time of highest host tolerance for several cytostatics was similar to that of their optimal antitumor effectiveness in four different experimental models. Mechanisms of such rhythms involve predictable temporal changes in drug pharmacokinetics as well as rhythms in the susceptibility of both tumor and host tissues. Studies performed in mice or rats led to an adequate prediction of the optimal time to administer adriamycin, 4'tetrahydropyranyl-adriamycin and cis-dichlorodiammine platinum, provided that the rest-activity cycle of either species be considered. Since the dosing time of these agents also influenced largely the extent of human tolerance for these drugs, the extension of circadian timed therapy appears as inescapable. Programmable delivery systems have been developed to render such goal feasible, and their need has been emphasized in preliminary studies. Since interindividual differences may characterize, to some extent, host chronotolerance, and to a larger extent, tumor chronosusceptibility, a circadian monitoring of marker variables ("marker rhythms") constitutes a further challenge for individualizing cancer chronotherapy. PMID- 3306578 TI - [Chronotherapy and allergic diseases]. AB - The author presents a study synthesizing chronobiological data on allergic diseases and their treatment. It is referred to circannual and circadian chronobiological progress in the field of neurovegetative and immunological respiratory functions. Optimization of treatment is described for inhaled medication, adrenergic and anticholinergic bronchodilators, anti-inflammatory corticoids and cromoglycate derivatives. Importance of ingestion of corticoids at the beginning of activity and of long acting theophylline when diurnal activity ceases is described at endocrinian and pharmacodynamic level. It is finally followed by a presentation of optimization of rhinitis treatment with non sedative antihistaminics, mequitazine, terfenadine, which when taken in the evening are more efficient and better tolerated. PMID- 3306579 TI - [Chronobiology and renal physiopathology]. AB - This review presents our recent knowledge in renal chronobiology, considering physiology, pathology, pharmacology and toxicology. In a first part, are described renal chronophysiological data, pointing out particularly urinary excretion rhythms, largely described for last century. Such physiological observations lead to conclude that renal structures and functions present large temporal variations. Endogenous and exogenous origins of these rhythms are widely discussed. Evidence of such circadian and circannual variations in these renal structures and functions permit to understand why different agents, pathogeneous, toxic or medicamentous, will present time-dependent effects at renal level. So, a second part presents some recent experimental and clinical data in chrononephrology, chronopharmacology and chrononephrotoxicity. Finally, the concept of renal chronesthesy is presented and discussed, in order to explain these temporal variations in renal target susceptibility to different substances acting at this level. PMID- 3306580 TI - [Biological rhythm and thromboembolic disease. Physiological, epidemiological and pharmacological aspects]. AB - Arterial and venous thromboembolic disorders are the leading cause of death in most of the advanced nations. The study of physiologic, epidemiologic and pharmacologic relationships of these disorders to biological rhythms, may lead to a better understanding and perhaps a better treatment. Chronophysiologic studies have shown that hemostatic variables follow circadian rhythms. The level of platelets aggregation and of blood coagulation has been found to be increased in the morning and decreased at night, whereas fibrinolytic activity is lower in the morning than in the evening. Chronoepidemiologic studies demonstrated a morning peak for arterial thromboembolic disorders and an evening peak for cerebral bleedings. These facts might partially be explained by circadian variations in hemostasis and suggest a chronotherapeutic approach in thromboembolic disorders. Unfractionated heparin, because of its antithrombotic effect, is one of the major drugs used to treat this disease. However, with such a treatment venous thrombosis recurs or bleeding complications occur yet in about 30% of patients. Chronopharmacologic studies indicate that anticoagulant effect of heparin is minimum in the morning and maximum at night, following the physiologic circadian variation of blood coagulation. Such results suggest that the heparin doses should be modulated as a function of administration times in order to increase its effectiveness and to minimize both bleeding risk and thrombosis. Further studies are needed to evaluate such a proposal. PMID- 3306581 TI - Chronobiology and epidemiology. AB - Epidemiology and chronobiology are two emerging scientific disciplines of the 20th century. In the United States and certain European and Asian countries, epidemiology is a well-developed science; however, in many countries the field is not yet well practiced. Too, in several European countries and certain centers in the United States, chronobiology is quite well known and respected as a science. Yet, in many countries this field is just now being recognized. Although epidemiologists are concerned with temporal patterns in illnesses, primarily in terms of the prevalence and incidence of human disease, for the most part they do not consider biological rhythmic phenomena relevant to their pursuits. The symptoms, signs and tests which document illness and determine prevalence and incidence all may be influenced by when evaluations are conducted with respect to the staging of biological rhythms. Chronobiologists, on the other hand, have in too many instances been overly concerned with the elucidation and quantification of human bioperiodicities without regard to their relevance to temporal patterns in the occurrence of exacerbation of illness and matters of particular importance to epidemiologists. Herein, the topic of epidemiology and chronobiology is discussed in terms of the relevance of each field to the other. PMID- 3306582 TI - [Essence and basic mechanisms of the occurrence of post-resuscitation brain pathology]. PMID- 3306583 TI - [Effect of hormones on the recovery processes after clinical death in an experiment]. PMID- 3306585 TI - [Computer analysis of mechanocardiograms]. PMID- 3306584 TI - [50th anniversary of the Institute of General Resuscitation Studies of the Academy of Medical Sciences of the USSR]. PMID- 3306586 TI - [Method of assessing the pathological changes in the plasma membrane in children with different diseases]. PMID- 3306588 TI - [Behaviour of immunohistochemically demonstrated HBV antigens in chronic HBsAg positive hepatitis in children]. PMID- 3306587 TI - [Adenolymphomas of the parotid gland. Immunocytochemical study]. PMID- 3306589 TI - [Multiple morphologic monitoring of a liver transplant]. PMID- 3306590 TI - Sonographic diagnosis of lissencephaly. AB - Lissencephaly, a developmental malformation characterized by absence of sulci, may be suggested in dysmorphic or epileptic infants. Real time ultrasonographic findings correlated with typical electroencephalographic abnormalities establish the diagnosis. PMID- 3306591 TI - Investigation of childhood blunt abdominal trauma: a practical approach using ultrasound as the initial diagnostic modality. AB - During a 5.5-year retrospective study (1979-84) 170 children with blunt abdominal trauma were investigated with intravenous urography (IVU), ultrasound (US) and scintigraphy. For the investigation of the last 71 children (after 1982) a 4th generation CT scanner was available in the same department. The results of radiologic investigations were compared with clinical outcome in 157 and results at laparotomy in 13 children. During the study period, real time US became the first line screening tool, and was combined with IVU in suspected renal trauma. In spite of permanent accessibility of CT since November 1982, the latter was used only in complex diagnostic problems or in children with multiple injuries (8% of the series). There were no deaths resulting from abdominal trauma. During the study, the incidence of splenectomy and exploratory laparotomy decreased, and no diagnostic peritoneal lavage were performed after 1980. PMID- 3306592 TI - Ventriculitis in congenital rubella: ultrasound demonstration. AB - A female infant with proven congenital rubella infection was referred for cranial ultrasound examination. Intraventricular strands and debris with periventricular echogenic foci were demonstrated. These findings, typical of ventriculitis, have not previously been reported in congenital rubella. Mental retardation is the rule in symptomatic cases and therefore early recognition of central nervous system involvement is of benefit in assessing the long-term neurodevelopmental outcome. PMID- 3306593 TI - Gaucher disease of the liver: CT appearance. AB - We present a child with Gaucher disease with hepatic involvement that caused portal hypertension. Computerized tomography (CT) showed distortion of liver parenchyma and central necrosis of the liver. PMID- 3306594 TI - An unusual encapsulated collection of urine (urinoma) in an infant with vesicoureteral reflux. AB - We describe an unusual case of encapsulated collection of urine (urinoma) in a 7 month-old female infant. The clinical diagnosis was urinary tract infection. The retrograde cysto-urethrogram revealed grade III vesicoureteral reflux, which we believe was the cause of the urinoma. The investigation was completed with isotope and ultrasound studies. High pressure reflux was the cause of the urine extravasation in the perirenal space. PMID- 3306595 TI - Sonography of slipped humeral epiphysis due to birth injury. AB - Sonographical diagnosis of slipped epiphysis of the proximal humerus is reported in a newborn with birth traumatic etiology. In these rare conditions sonography is recommended as method of choice. PMID- 3306596 TI - Unusual clinical presentations of bilateral renal artery aneurysms in a child. The value of ultrasound in diagnosis. PMID- 3306597 TI - Immunogenicity of Haemophilus influenzae type b capsular polysaccharide vaccines in 18-month-old infants. AB - Haemophilus influenzae vaccine containing polyribosyl ribitol phosphate (PRP) or PRP covalently linked to diphtheria toxoid (PRP-D) was given to 94 healthy infants 17 to 22 months of age at the same time, but not at the same site, as a diphtheria-tetanus-pertussis booster. Systemic reactions were similar in the two vaccine groups and resembled those expected with the diphtheria-tetanus-pertussis injection alone. Six (13%) and seven (14%) of the PRP and PRP-D recipients, respectively, had minor local reactions to the Haemophilus vaccine. Among the 77 children who were not already naturally immune (ie, anti-PRP antibody concentration of less than or equal to 0.15 micrograms of protein per milliliter) before vaccination, PRP-D was significantly more effective than PRP in inducing protective levels of antibody. Only 15 (43%) of the 35 nonimmune PRP recipients achieved a concentration of greater than or equal to 0.15 microgram/mL and only seven (20%) reached a concentration greater than or equal to 1.0 micrograms/mL following vaccination. In contrast, 34 (81%) of the 42 nonimmune recipients of PRP-D had a concentration of greater than or equal to 0.15 microgram/mL following vaccine and 32 (62%) had a concentration of greater than or equal to 1.0 micrograms/mL (P less than or equal to .001). These results suggest that more than one-half of nonimmune 18-month-old infants will not respond to PRP with protective levels of antibody. In light of the current data, recommendation for revaccination at 24 months of age for those immunized at any younger age is appropriate. PMID- 3306599 TI - Nucleotide sequence of cDNA encoding the light-harvesting chlorophyll a/b binding protein from maize. PMID- 3306598 TI - Dependence of intracellular effects of GTP gamma S and inositoltrisphosphate on cell membrane potential and on external Ca ions. AB - Single cells from rat lacrimal glands were studied with the tight-seal whole-cell recording method. Ca-dependent K and Cl currents were measured in response to dialysis with inositoltrisphosphate or GTP gamma S, two compounds known for elevating internal Ca2+ concentration. The activation of the Ca-dependent currents elicited by either compound was partially inhibited by sustained depolarization or by removal of external Ca2+. Conversely, hyperpolarization or removal of external Mg2+ led to augmentations of the Ca-dependent currents. These effects became apparent about 1 min after initiation of cell dialysis with inositoltrisphosphate- or GTP gamma S-containing solutions, and they further developed during the ensuing 10 min. Holding potential and external divalent cations did not affect the Ca-dependent currents elicited by dialysing the cells with strongly buffered solutions containing 0.5 microM free Ca2+. In Ca2+-free external saline, cell currents were independent of the holding potential. It is suggested that InsP3 augments intracellular Ca2+ levels not only by releasing Ca2+ from internal stores but also by slowly increasing the Ca permeability of the plasma membrane. The results indicate that Ca2+ entry through the plasma membrane increases with hyperpolarization. The similarity of the effects seen in InsP3- and GTP gamma S-dialysed cells gives support to the hypothesis that production of the former depends on a GTP-binding protein. PMID- 3306600 TI - Analysis of transcripts of the major cluster of tRNA genes in the mitochondrial genome of S. cerevisiae. AB - The transcripts of a 6Kbp region of the mitochondrial genome of S. cerevisiae, localized in the 21S rRNA-OXI1 span and including 12 tRNA genes (from tRNA(thr) to tRNA(ala)) and several G+C clusters, have been studied by analysis of in vitro capped primary transcripts and by fine mapping of the 5' ends of transcripts. The study was performed in the w.t. strain D273-10B and in several rho- mutants retaining different, partially overlapping portions of the studied region; the mutants accumulate incompletely-processed precursors of tRNAs due to the absence of the tRNA synthesis locus. Results show the presence in the region of four sites at which initiation occurs at a consensus nonanucleotide ATTATAAGTA (or a minor variant of the same); however different initiation sites are used in different strains, and several differences as compared to initiation in vitro can also be observed. Termini arising by processing are often localized at AATATAA or AATATATTTT sequences localized immediately adjacent to a G+C cluster or a tRNA sequence. PMID- 3306601 TI - Characterization of rat c-myc and adjacent regions. AB - Rat genomic regions covering c-myc were cloned from the DNA of both normal liver and two lines of Morris hepatomas, one of which had c-myc amplification. The three restriction maps showed perfect agreement within the overlapping regions. The 7 kb regions, which included the entire normal rat c-myc and the region 2.2 kb upstream, and one from the hepatomas, were sequenced and found to be identical. The coding regions of exons 2 and 3 were highly conserved between rat, mouse and man, but some differences in amino acids were noted. Exon 1 and the non coding region of exon 3 showed limited homology between the three species. Rat exon 1 contained several nonsense codons in each frame and no ATG codon, indicating there to be no coding capacity in this exon. The 2.2 kb upstream regions and the introns compared showed unusual conservation between the rat and human genes. Some motifs, previously proposed as having a functional role in human c-myc, were also found in equivalent positions of the rat sequence. Nucleas S1 protection mapping revealed the second promoter to be preferentially used in most tissues or in hepatoma cells, and the second poly A addition signal to be the only one functional in all the RNA sources examined. PMID- 3306602 TI - Purification of the FLP site-specific recombinase by affinity chromatography and re-examination of basic properties of the system. AB - The FLP protein, a site-specific recombinase encoded by the 2 micron plasmid of yeast, has been purified to near homogeneity from extracts of E. coli cells in which the protein has been expressed. The purification is a three column procedure, the final step employing affinity chromatography. The affinity ligand consists of a DNA polymer with multiple FLP protein binding sites arranged in tandem repeats. This protocol yields 2 mg of FLP protein which is 85% pure. The purified protein is highly active, stable for several months at -70 degrees C and free of detectable nucleases. The molecular weight and N-terminal sequence are identical to that predicted for the FLP protein by the DNA sequence of the gene. Purified FLP protein primarily, but not exclusively, promotes intramolecular recombination. Intermolecular recombination becomes the dominant reaction when E. coli extracts containing no FLP protein are added to the reaction mixture. These extracts are not specifically required for recombination, but demonstrate that some properties previously attributed to FLP protein can be assigned to contaminating proteins present in E. coli. PMID- 3306604 TI - A simple and rapid method for preparing yeast chromosomes for pulsed field gel electrophoresis. PMID- 3306605 TI - Nucleotide sequence of the serine protease gene of Staphylococcus aureus, strain V8. PMID- 3306603 TI - Adenosine deaminase mRNA expression is regulated posttranscriptionally during differentiation of HL-60 cells. AB - The expression of the enzyme adenosine deaminase (ADA) decreases in the course of the differentiation of the human promyelocytic leukemic cell line HL-60, dependent on the pathway chosen. Differentiation to monocytes as induced by the phorbol ester TPA leads to a 50% reduction of enzyme activity. Induction to myeloid cells as induced by DMSO has a slower and less extensive (75% remaining activity) effect. The reduction in ADA enzymatic activity is preceded by a 5-10 fold reduction in ADA-specific mRNA which is also more rapid during TPA-induced differentiation. In contrast, c-myc mRNA expression is both in TPA- and DMSO induced differentiation reduced to less then 5% of its initial level within 4h. Nuclear run-on analysis revealed that the reduction of c-myc-mRNA expression during both TPA- and DMSO-induced differentiation could be ascribed to the abolition of transcription of the third exon, whereas no change in the transcription of the first exon could be observed. No change could be detected in the rate of transcription of either the 5' and 3' parts of the ADA gene during TPA- and DMSO-induced differentiation, indicating that the expression of the ADA gene in HL-60 is controlled at a posttranscriptional level. PMID- 3306606 TI - [Ventilation/perfusion scintigraphy in pneumology]. PMID- 3306607 TI - Ventilation-perfusion scintigraphy. PMID- 3306608 TI - [Evaluation of polychemotherapy including cisplatin in patients with advanced ovarian cancer]. PMID- 3306609 TI - Nursing 2020: a study of nursing's future. PMID- 3306610 TI - A social support measure: PRQ85. AB - The Personal Resource Questionnaire (PRQ) was developed in 1981 to measure situational and perceived social support. This article presents the history of its development and the latest psychometric evaluation of the tool. Nurturance subscale items were rewritten to reflect a broader context of behaviors toward persons of any age. Content validity was further established by correlations between the PRQ and two mental health measures. Factor analysis indicated that a three-factor structure for the perceived social support scale may be more appropriate than the hypothesized five-subscale structure. PMID- 3306611 TI - Studies of nurse practitioner effectiveness. PMID- 3306613 TI - The way we were. PMID- 3306612 TI - Delineation of nursing administration research priorities. AB - The purposes of this national study were to determine: (a) a definition of nursing administration research and (b) priority nursing administration research questions. Brainstorming was used initially with Council on Graduate Education for Administration in Nursing (CGEAN) members in 1984, to delineate concepts for definitions. Definitions and research questions were generated and rated in a three-round Delphi survey by 129 experts from nursing and health administration. According to the most widely supported definition, nursing administration research is concerned with establishing costs of nursing care, examining the relationships between nursing services and quality patient care, and viewing problems of nursing service delivery within the broader context of policy analysis and delivery of health services. The research question of most importance was: What are the cost-effective components of clinical nursing care that yield high patient satisfaction, decrease the number of complications, and shorten hospital stay for identified groups of patients? In a scenario exercise at the 1985 CGEAN meeting, additional priorities identified were vulnerable populations and equity. PMID- 3306615 TI - Before the baby boom. PMID- 3306616 TI - Effect of bonding agents on gap formation in dentin cavities. PMID- 3306614 TI - Beating the burn-out. PMID- 3306617 TI - Bond strengths of repaired composite resins. PMID- 3306618 TI - Dentin bonding: the effect of surface roughness on shear bond strength. PMID- 3306619 TI - [The respiratory muscles and their role in lung diseases]. PMID- 3306620 TI - [Clinical and bacteriological evaluation of the effectiveness of cefadroxil in the treatment of respiratory tract infections]. PMID- 3306621 TI - [Total body irradiation, vincristine in continuous infusion and high-dose melphalan with transplant of autologous bone marrow in the treatment of neuroblastoma]. AB - High dose chemo-radiotherapy followed by autologous bone marrow transplantation (ABMT) is known to be an effective treatment in stage IV neuroblastoma (NB). Since October '84, 19 children with NB (12 relapsed or resistant: Group A; 7 in first CR: Group B) received ablative therapy (AT) consisting of VCR (4 mg/mg), L PAM (140 mg/mg) and fractionated TBI (1000 Rads). Induction strategy at diagnosis or at relapse included high dose Peptichemio, 2-3 cycles of Vincristine Cyclophosphamide--high dose Platinum and surgery. Bone marrow was harvested after 2 evaluation proved negative by cytomorphology, histology and immunofluorescence. Mononuclear cells (median 6.7 x 10(7)/kg) were cryopreserved and reinfused without purging. At the time of AT in Group A8 children were in CR, 4 had minimal diseases; in Group B 6 were in CR and one in PR. One toxicity-related death occurred on day 7 in a child in first CR; median duration of granulocytopenia 0.5 x 10(9)/l and thrombocytopenia less than 50 x 10(9)/l were 20 days (R: 9-40) and 27 days (R: 11-51) respectively. Persistent immune thrombocytopenia occurred in 4 children. Fever higher tha 38 degrees C developed in all patients: sepsis was documented in 6 patients. Extramedullary toxicity was moderate: GI tract was the most affected. Two out of 5 children who received AT having residual disease achieved CR; relapse or progression of disease occurred in all these patients. Four out of 8 children in second or subsequent CR and 4 out of 5 in first CR are alive and well at 3-12 months (median 7).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306622 TI - Determinants of antibiotic-associated hypoprothrombinemia. AB - Hypoprothrombinemia is a relatively uncommon event in the hospitalized patient. When it does occur, it often is associated with surgery, dietary vitamin K deficiency, renal dysfunction, malignancy, and broad-spectrum antibiotic therapy. Several mechanisms have been proposed to account for antibiotic-associated hypoprothrombinemia, including eradication of gastrointestinal bacteria, direct inhibition of vitamin K-dependent coagulation, and indirect inhibition of coagulation. The anecdotal reports and comparative studies of antibiotic associated hypoprothrombinemia were reviewed; these usually implicated broad spectrum or the use of several antibiotics. The increased frequency of hypoprothrombinemia associated with moxalactam and cefoperazone also raises questions about the role of their N-methylthiotetrazole (NMTT) side chains. The hypoprothrombinemia associated with NMTT antibiotics does not occur in healthy volunteers and is rare in patients without complicating conditions. Although NMTT inhibits vitamin K-dependent carboxylation in vitro, the parent cephalosporins do not. It is not clear whether NMTT-containing antibiotics liberate sufficient amounts of NMTT in vivo to antagonize clotting in patients. Thus, although moxalactam, and possibly cefoperazone, may in some cases be responsible for increases in prothrombin time, most important question for further study is whether the newer NMTT-containing antibiotics pose a risk of hypoprothrombinemia that is greater than that of antibiotics lacking this side chain. PMID- 3306623 TI - The role of cholecystokinin octapeptide in the central control of food intake in the dog. AB - Cholecystokinin octapeptide (CCK-8, 1, 190 pmol/5 min) decreased food intake and water consumption in two models of ingestive behavior, i.e., food deprivation induced feeding and insulin-induced feeding, when administered into the third (3V) and lateral (LV) cerebral ventricles. In fasted dogs, the suppression of food intake was more prominent after 3V CCK-8, whereas intravenously administered CCK-8 was without effect. Neuropeptide Y (NPY, 1, 190 pmol) had no significant stimulatory effect on food intake and water consumption in fasted as well as satiated dogs, and actually reduced both food and water intake in insulin-treated dogs. There was a slight but significant decrease in food and water intake after 275 nmol naloxone administration in both feeding models, and some of the dogs vomited. In insulin-treated animals, CCK-8 reversed, but NPY potentiated the hypothermic phase of temperature response observed after saline administration, whereas naloxone failed to alter rectal temperature. These results suggest that the effect of CCK-8 on feeding seems to involve central mechanisms in the dog, and that the mechanisms by which CCK-8, NPY and naloxone affect feeding behavior are different. PMID- 3306625 TI - [Acetohydroxamic acid in the treatment of kidney calculi caused by an infection with urease-producing microorganisms]. PMID- 3306624 TI - Changes in populations of LHRH-immunopositive cell bodies following gonadectomy. AB - One day after castration of male rats, plasma LH rose and the number of LHRH immunopositive neuronal perikarya decreased. As plasma LH continued to rise six days and three weeks post-castration, the number of LHRH immunopositive neurons also increased. The largest population of LHRH immunopositive neurons was detected three weeks post-castration and the cell group that showed the greatest increase was in the rostral preoptic area. In females, the largest population of LHRH immunopositive neurons was observed one day post-ovariectomy; at this time plasma LH levels were not significantly elevated above diestrous levels. Six days post-ovariectomy, LH levels were elevated and the number of LHRH immunopositive cells decreased. As LH levels continued to rise three weeks post-ovariectomy, the population increased in size. In males, primarily LHRH cells of the rostral preoptic area increased in in number; in females, the cell groups that increased were scattered over the diagonal band of Broca, preoptic and anterior hypothalamic areas. Although LHRH neurons demonstrated these variations following gonadectomy, there was no evidence of alteration(s) in molecular processing of precursor hormone. PMID- 3306627 TI - [Radioisotope studies of the bones in renal osteodystrophy]. PMID- 3306626 TI - [Acute non-inflammatory renal failure after captopril treatment of a patient with renovascular hypertension]. PMID- 3306628 TI - [Subclinical lead poisoning as a cause of nephropathy and arterial hypertension]. PMID- 3306629 TI - Solitary polypoid hamartoma of the oxyntic mucosa of the stomach. AB - A solitary pedunculated polyp of the oxyntic mucosa removed from a 66-year-old patient with atrophic gastritis and achlorhydria exhibited distinctive histological features consisting of submucosal, mostly oxyntic-type glands with a smooth muscular framework. Histochemical and immunohistochemical studies demonstrated that the glands were composed of well differentiated chief, parietal, and endocrine cells. Moreover, less frequent glands of the antro pyloric type were also seen. The lesion was regarded as a previously unrecognized variety of gastric hamartoma. PMID- 3306630 TI - A comparative study of IgA nephritis in Japan and Germany. An approach to its geopathology. AB - A comparison of clinical and pathological features in 357 Japanese cases and 29 German cases of primary IgA nephritis was performed. Male population was higher than female in the German cases (2.6:1), while it was almost even in the Japanese (1.07:1) (p less than 0.05). Age distribution was similar. At the time of detection of the disease, asymptomatic patients were more frequent in Japanese (78%) than in German cases (60%) (p less than 0.05). The most common findings were mild mesangial proliferative glomerulonephritis in both series (65% in Japanese, 61% in German cases), but severe histological changes were more frequent in German patients (25%) than in the Japanese (16%). The incidence of IgA nephritis in primary glomerulonephritis was 38.8% in Japanese and 11.9% in German cases, and the incidence in mesangial proliferative glomerulonephritis was 65.6% in Japanese and 29.2% in German patients (p less than 0.01). It is considered that the divergent incidence of IgA nephritis may be a real geopathological event, although its variability may be intensified by different indications for biopsy or different population. It is suggested that various possible pathogenetic agents may be irregularly distributed throughout the world, which may contribute to the divergent clinical and pathological manifestations. PMID- 3306631 TI - Morphometrical findings from human and animal liver cells in physiological and pathological conditions. AB - An account is given in this paper of morphometric findings obtained from animal hepatocytes, following immersion and perfusion fixation, after enzyme induction, as well as during postnatal development and aging, together with findings recorded from human liver in preserved condition and after transplantation. The results are related to qualitative and functional changes. The following conclusions are drawn: Morphometric studies at cellular level and, in particular, studies into pathological changes for good success depend on the availability of control values which still have to be prepared primarily with regard to human liver. Given observance of optimum preparation conditions, the quantitative data obtainable from immersion fixation for all cell organelles are identical to those obtained from perfusion fixation. Generally, it is not sufficient to determine merely morphometrical data for individual cell organelles, since in many cases the pathological process does actually originate from displacement of relations among cell organelles. If misinterpretation is to be avoided, determination of quantitative data will not be sufficient for adequate assessment of functional or pathological changes, but additional qualitative description will be necessary of cell organelles and cellular correlations. PMID- 3306632 TI - Metastatic atypical fibroxanthoma of skin. AB - Metastases from an atypical fibroxanthoma of skin have been reported but are very few in the literature. We had a personal case which, originally localized on the nostril, gave metastases to the cervical regional lymph node with no local recurrence. We examined both the primary and metastatic tumor by conventional histological stains and by immunoperoxidase technique to localize lysozyme, alpha 1-antitrypsin, ferritin and factor VIII antigens. The results show a clear correspondence between the primary and metastatic tumor. PMID- 3306633 TI - Ganglion cyst within the quadriceps muscle: evaluation with computed tomography and ultrasound. A case report. PMID- 3306634 TI - Arthroscopically aided meniscal repair. PMID- 3306636 TI - Management of peripheral neuropathy in diabetes mellitus. Recent research findings and their therapeutic implications. AB - Peripheral neuropathy in diabetes begins as a physiologic aberration related to hyperglycemia and its subsequent effects of endoneurial hypoxia, elevated sorbitol levels, and decreased myoinositol levels. Resultant decreases in sodium potassium-adenosine triphosphatase levels ultimately lead to structural alterations at the nodes of Ranvier. Aldose reductase inhibitors and dietary myoinositol supplementation are being used in long-term clinical studies to monitor the possibility that they may prevent or reverse these abnormalities. In the meantime, symptomatic treatment remains the mainstay of management. PMID- 3306635 TI - Vitamins and cancer prevention. How much do we know? AB - Foods rich in vitamins, especially those containing beta carotene and vitamin C, lower the risk of cancer in humans. Whether vitamins alone are responsible for this reduced risk is not known. They may work synergistically with increased dietary fiber and decreased fat intake. Vitamin supplementation at doses higher than the recommended daily allowance is, at present, an unknown factor in preventing cancer and may cause toxic effects in some instances. Consuming megadoses doses of any vitamin or mineral as a cancer preventive should be discouraged. Physicians need to take a more aggressive stance against alternative health care providers who recommend questionable dietary or nutritional regimens. Because of the proliferation of food quacks in recent years and the danger they represent to the general public, physicians need to make preventive health care an important part of their responsibility. This includes educating patients on proper nutrition. PMID- 3306637 TI - Osteopathic medicine 1947-1987. A PGM retrospective. PMID- 3306638 TI - Renal disease 1947-1987. A PGM retrospective. PMID- 3306639 TI - Prediction of spontaneous coronary reperfusion in myocardial infarction. AB - To investigate the possibility of predicting the occurrence of spontaneous coronary reperfusion in acute myocardial infarction we studied 91 patients in a randomized trial on the clinical efficacy of intracoronary streptokinase compared to conventional treatment. Of the 46 patients treated conventionally 40 had catheterization 6 weeks after the infarction. Spontaneous coronary reperfusion was found in 19 patients (48%). The time to peak CK-MB in these patients was considerably longer than in patients with streptokinase-induced coronary reperfusion and similar to the time in patients without spontaneous coronary reperfusion. Spontaneous coronary reperfusion was associated with a relative improvement of radionuclide ejection fraction from day 1 to day 14 after admission. There was no difference in the occurrence of ventricular arrhythmia or recurrent ischaemic events between the patients with and those without spontaneous coronary reperfusion. Thus, spontaneous coronary reperfusion is not uncommon in traditionally treated myocardial infarction, but its occurrence cannot be predicted by enzymatic or clinical parameters. PMID- 3306641 TI - Assessment of neutrophil function--I. PMID- 3306643 TI - Subregions and functions of the chicken major histocompatibility complex. AB - The chicken major histocompatibility complex (MHC) exerts genetic influence over a variety of important biological functions including immune response, disease resistance, growth and development, aging, and reproduction. The chicken MHC possesses at least three subregions encoding distinct gene products. The B-G subregion encodes antigens unique to erythrocyte surfaces. The B-L and B-F subregions encode cell surface glycoproteins homologous to mammalian Class II and Class I antigens, respectively. Class I and Class II molecules are crucial for recognition of self vs. nonself and for cell communication, and therefore are fundamental for all immune responses. Studies of chromosomal recombinants have been particularly useful in eliciting the structure and function of subregions of the chicken MHC. PMID- 3306642 TI - Chromosomal localization of the major histocompatibility (B) complex (MHC) and its expression in chickens aneuploid for the major histocompatibility complex/ribosomal deoxyribonucleic acid microchromosome. AB - By the cytogenetic method of trisomy mapping, the major histocompatibility complex (MHC) (B) was located on the microchromosome that also contains all of the ribosomal ribonucleic acid (rDNA) genes that are detected as a nucleolar organizer region. Crosses involving aneuploid chickens homozygous or heterozygous for particular B haplotypes yield an F1 of disomic, trisomic, and tetrasomic offspring suitable for studies of gene dosage effects and gene regulation. Studies to date show that MHC genes are expressed on each chromosome in aneuploid cells unlike the rDNA gene cluster, which is regulated to produce only diploid levels of mature rRNA. Biological effects of extra MHC chromosome dosage range from altered cell surface content of glycoproteins to altered growth potential of chickens. In addition, enhanced MHC-encoded cell surface products may influence the progression of B-cell differentiation and cell population dynamics in the developing bursa of Fabricius. Recent research shows a possible mechanism to account for the formation of unequal products in meiosis within the rDNA and MHC gene clusters. Unequal recombinational events may be promoted in the meiotic process in trisomic chickens. PMID- 3306644 TI - Major histocompatibility complex and cell cooperation. AB - We have studied the role of major histocompatibility antigens on cell cooperation in the immune response of the chicken. In the 1970's, shortly after the initial discoveries in the mouse, we demonstrated that the T cell-B cell interaction is major histocompatibility complex (MHC)-dependent in the chicken and requires at least one haplotype identity between the collaborating cells. Later, by using MHC congenic and MHC-recombinant lines, we demonstrated that the T-B cell interaction in antibody response is MHC-restricted, and more precisely, Class II MHC-antigen restricted. Furthermore, we proved that T-B cell cooperation in splenic germinal center formation is likewise class II MHC antigen-restricted. Recently, we have focused our studies on MHC antigen identity requirements during antigen presentation by macrophages to T cells. In these studies, Class II antigens were found to serve as restriction elements in antigen recognition by T cells. Cytotoxic T cells of the chicken have been shown to be MHC-restricted in their function. Whether Class I or Class II MHC antigens serve as restriction molecules has not yet been determined. In conclusion, it is obvious that the function of the avian immune response is controlled by the polymorphic MHC gene products in the same way as that in the mammalian species. PMID- 3306645 TI - Influence of the major histocompatibility complex on disease resistance and productivity. AB - Publications in which chickens of different B haplotypes were studied for differences in disease resistance or productivity traits are reviewed. The most prominent effects on diseases are those involving tumors, but other examples involving autoimmune disease and microbial infections not resulting in neoplasia or autoimmunity are also cited. Each referenced disease paper is briefly defined with regard to: population used, B alleles present, and the most resistant B types. Studies citing B haplotype influences on productivity and reproductive fitness traits are summarized and the most desirable B genes in each referenced population are given. Plausible mechanisms of the B haplotype's influence on the traits are briefly discussed. Based on the evidence reviewed for disease resistance and productivity traits and the central role of B-complex genes in immune function, it is concluded that poultry breeders should develop B-genotype information in their base breeding populations and use those types yielding optimal performance. PMID- 3306640 TI - Systemic zygomycosis. PMID- 3306646 TI - Influence of the major histocompatibility complex on tumor regression and immunity in chickens. AB - A number of studies show that major histocompatibility complex (MHC) genes control host immune responses to viral-induced chicken tumors. The MHC gene controlled responses to malignant neoplasms caused by Rous sarcoma virus, lymphoid leukosis virus and Marek's disease virus are reviewed. Genes that determine regression of Rous sarcomas and resistance to development of lethal Marek's disease lymphomas appear to map within the B-F region of the MHC. In some cases, genetic complementation of both MHC genes and non-MHC genes may be responsible for regression of tumors. Metastasis of Rous sarcoma cells is also influenced by the host's MHC genotype. Background genes can modify the specific MHC gene effect on resistance to progressive growth of Rous sarcomas and Marek's disease lymphomas. Studies showing that MHC-restricted immunity may be important in cytotoxic T cell reactions to virus-infected and/or transformed chicken cells are discussed. The MHC-restricted cytotoxicity, whereby the T cells and target cells must share one MHC haplotype for in vitro killing to occur, suggests that the T cells have receptors that recognize virus-altered self MHC antigens. This may be an important immune surveillance mechanism for limiting the proliferative growth of virus-induced tumors in chickens. PMID- 3306647 TI - [Surgical problems with blade-shaped intraosseous implants]. PMID- 3306648 TI - [Autopsy bacteriology--a forgotten tradition?]. PMID- 3306649 TI - [Malignant lymphomas with multilobulated cell nuclei]. PMID- 3306650 TI - [Rapid paraffin embedding in routine diagnosis by microwave stimulation with kitchen equipment]. PMID- 3306651 TI - A simplified method of production of choline oxidase suitable for choline assay. AB - A method of production of choline oxidase from Cylindrocarpon-didymum which is of sufficient purity to be used in the enzymatic assaying of choline has been described. The extraction and purification techniques used were ultrasonic disintegration, tangential ultrafiltration, and chromatography on DEAE-Sepharose Fast-Flow and on Sephacryl S 200 gel. The specific activity of the preparation obtained was 7.4 UI/mg of protein. The activity recuperation yield from the cellular extract was 56%. In the course of this purification, a protein displaying catalase activity was also obtained. PMID- 3306652 TI - Dietary fats and lipids of adipose tissue and cell membranes in carcinogenesis. PMID- 3306653 TI - Cell turnover and colon tumor development. AB - The proliferative characteristics of the large bowel are determined genetically and can vary over a wide range, the lower range being resistant to chemically induced tumors and the upper range expressing susceptibility. Basically, the colon has a relatively high level of cell renewal. It can be further elevated or depressed by a number of dietary and environmental conditions. A hyperproliferative state has been induced by the presence of carrageenan, Citrobacter freundii, nonspecific injury, or dietary factors such as high levels of bile acids. The effect of high proliferation levels is to produce more S-phase cells, which are sensitive to DNA damage, to increase the risk of neoplastic transformation and to shorten the tumor latency period. In animal models, hyperactivity has meant enhanced tumor incidence. A hypoproliferative state has been induced in the colon of man and mouse. Experimentally, the net effect of lower proliferative levels has been to reduce colon tumor incidence. It remains to be determined whether clinical trials involving hypoproliferation can be maintained chronically and are an effective means of reducing colon tumor incidence in high-risk groups. PMID- 3306654 TI - Holistic health techniques to increase individual coping and wellness. PMID- 3306655 TI - Relaxation and positive imagery for the surgical patient: a research study. PMID- 3306656 TI - [Determining IgG antibodies to Mycobacterium tuberculosis antigens in patients with pulmonary tuberculosis by the immunoenzyme analysis method]. PMID- 3306657 TI - [Production of monoclonal antibodies against Mycobacterium antigens]. PMID- 3306658 TI - [Effectiveness of tuberculin in the complex treatment of patients with destructive pulmonary tuberculosis over 50 years of age]. PMID- 3306659 TI - Morphology, cytochemical features, and membrane phenotype of HLA-DR+ interstitial cells in the human pancreas. AB - The morphology, histological distribution, surface, and enzymatic phenotype of pancreatic HLA-DR+ cells were studied on seven human pancreata, removed from cadaver donors. Frozen and paraffin-embedded pancreas sections were stained with a battery of monoclonal antibodies by indirect immunofluorescence, immunoperoxidase, and immunophosphatase techniques. Two type of cells were found to express HLA-DR surface molecules: endothelial cells and nonfibroblastic non-B and non-T interstitial elements. The latter cells, which were localized both in the exocrine and endocrine portions of the organ, were distinguished in two main families (macrophagic and dendritic) according to their morphology, surface phenotype, and lysosomal enzymatic activities. The phenotype of cells belonging to macrophagic cell family was the following: Leu M1+, Leu M2+, Leu M3+, OKM1+, and OKT6-. In addition these cells were positive for the expression of lysosomal enzymes such as alpha-naphthyl acetate esterase (ANAE) and acid phosphatase (AP). The "dendritic" cell family comprised, among others, cells that were characterized by the presence of numerous finger-like projections, the absence of Leu M1, Leu M2, Leu M3, OKM1, OKT6 surface antigens, and by the negativity for ANAE and AP. These "dendritic looking cells" (DLC) constituted the most represented DR+ cell type within pancreatic islets. The demonstration of dendritic cells within human islets may justify, in humans also, in vitro procedures of intra-islet dendritic cell removal prior to transplantation, in the attempt of islet rejection prevention. PMID- 3306660 TI - Relationship between morphological changes detected by ultrasonography and pancreatic exocrine function in chronic pancreatitis. AB - We have studied the degree of pancreatic secretory alterations assessed by secretin-cerulein test (S-C) in relation to various morphological changes detected by real-time ultrasonography (US) in 42 patients affected by chronic pancreatitis. Exocrine insufficiency was found in 41 patients (97.6%), while morphological alterations were detected in 32 (76.1%). In the 10 patients with normal US, a mild or moderate exocrine insufficiency was present. Significant negative linear correlations of decreasing volumes of duodenal aspirate (r = 0.528, p less than 0.001) and output of bicarbonate (r = 0.635, p less than 0.001), lipase (r = 0.583, p less than 0.001), and chymotrypsin (r = 0.592, p less than 0.001) were found with increasing ultrasonographic alterations. However, a wide overlap was found in the secretory behavior in the various categories of change as determined by ultrasound. Hence, the attempt to predict exocrine function on the basis of morphological alterations proved unsuccessful. PMID- 3306661 TI - Workshop report: gut-islet-pancreatic acinar interaction. PMID- 3306663 TI - Localization of progestin receptors in the islets of Langerhans. AB - Autoradiographic studies using the synthetic progestin [3H]ORG-2058 (16 alpha ethyl-21-hydroxy-19-nor-[6,7-3H]pregn-4-ene-3,20-dione) were conducted on female baboons. Numerous silver grains from the exposed photographic emulsion appeared discretely localized over the nuclei of the islets of Langerhans of the pancreases of baboons injected with [3H]ORG-2058. These observations indicate that islet cells might contain receptors for progestins and, combined with clinical observations by others, suggest that progestins have a direct effect on the islet cells and may modulate the release of insulin and/or other islet hormones. PMID- 3306662 TI - Decreased glucose stimulation threshold, enhanced insulin secretion, and increased beta cell coupling in islets of prolactin-treated rats. AB - In order to determine the effect of lactogen on insulin secretion and junctional coupling among islet beta cells, ovine prolactin (oPRL) was infused by Alzet minipumps into female rats for 4 days. This treatment produced an oPRL level of 994 +/- 122 ng/ml which, combined with residual rat PRL (rPRL) (12 +/- 2 ng/ml), represented nearly a 20-fold increase from control (rPRL: 53 +/- 17 ng/ml). In addition, plasma insulin was increased nearly 50% (control: 21.9 +/- 3 microU/ml; experimental: 30.3 +/- 3 microU/ml; p less than 0.05). When pancreata from lactogen-treated and control animals were perfused with linear 30-200 mg/dl glucose gradients, the apparent glucose threshold for insulin secretion in the experimental group was nearly 33% lower than that of the controls (i.e., 70 +/- 4.6 mg/dl vs. 104 +/- 7.5 mg/dl; p less than 0.01). The oPRL treatment also increased dye coupling among beta cells. Central cells in islets isolated from lactogen-treated and control animals were injected with Lucifer Yellow CH to estimate the extent of gap junctional coupling. There was nearly a twofold increase in the projected area of dye transfer per injection in the experimental vs. the controls: 4,607 +/- 575 micron 2 vs. 2,302 +/- 474 micron 2, respectively; p less than 0.02. The effects of oPRL decreased the apparent glucose threshold for insulin release, increased the above-threshold glucose induced insulin secretion, and increased the extent of dye coupling among beta cells. These changes in insulin secretion and dye coupling closely resemble those observed in islets from pregnant rats. PMID- 3306664 TI - Ultrasonic monitoring of Wirsung duct following secretin in controls and in chronic pancreatitis patients. AB - Ultrasonic monitoring of the pancreas following secretin stimulation has shown to cause a marked dilatation of Wirsung duct; whether this phenomenon is due to the stimulation of pancreatic secretion and/or to the effect of secretin on the sphincter of Oddi (SO) motility is unknown. In the present study pancreatic scan after secretin was performed in 11 patients with nonpancreatic diseases after premedication with glucagon (inhibition of both pancreatic secretion and SO motility) or tyropramide (inhibition of SO motor function) and in patients with different degrees of pancreatic insufficiency. Serum immunoreactive trypsinogen (IRT) levels were measured in all the subjects during the test. Premedication with glucagon completely abolished both Wirsung enlargement and serum IRT increase, while tyropramide significantly reduced, but did not abolish, the response to secretin. These results suggest that both stimulation of pancreatic secretion and the increase of SO pressure are prerequisites for a full-blown occurrence of the secretin-induced modifications of Wirsung. Within chronic pancreatitis patients, the response to secretin was exaggerated in those with a still preserved pancreatic function and it was lacking in those with severe pancreatic insufficiency. PMID- 3306665 TI - Successful long-term exocrine and endocrine function of the autotransplanted pancreas in humans. AB - Segmental pancreatic autotransplantation has been performed to prevent the severe metabolic complications of total pancreatectomy. To date 15 segmental pancreatic autotransplants have been reported, 11 of which have been performed for relief of the abdominal pain of chronic pancreatitis. The major problem with segmental pancreatic graft relates to the handling of the pancreatic duct and its secretion. In all the reported cases, the autotransplanted duct was either ligated, stapled, or occluded with synthetic polymers. In this article we present a patient who has undergone a total pancreatectomy with segmental pancreatic autotransplantation and subsequent Roux-en-Y anastomosis to the transplanted duct. Physiologic studies indicate normal endocrine function 7 years following transplant. The patient is insulin-independent and tolerates a normal meal, requiring no oral pancreatic enzyme supplementation. To our knowledge this is the first long-term report of a patient with an autotransplanted pancreas who is presently both insulin sufficient and with intact exocrine function. PMID- 3306666 TI - Presence of endocrine cells in pancreatic ducts. AB - Pancreatic endocrine cells were found in close contact with epithelial cells (either the centro-acinar or those lining the ducts). Junctional specializations were present between both cell types, demonstrating that they are structurally associated. In some instances, the endocrine cells present in the wall of the ducts reached the luminal space having direct contact with the pancreatic juice. These cells may well be responsible for the secretion of islet hormones directly in the duct lumen. The islet hormones present in the pancreatic juice as reported previously, seems to play a significant role in the interactions between the gut and the pancreas for optimal regulation of digestive activity. PMID- 3306667 TI - High sensitivity and specificity of CA 19-9 for pancreatic carcinoma in comparison to chronic pancreatitis. Serological and immunohistochemical findings. AB - The serum carbohydrate antigenic determinant (CA 19-9) was assayed in patients with various diseases (87 patients with pancreatic carcinoma, 747 patients with benign diseases, and 547 patients with extrapancreatic malignant growths) and it proved to be particularly sensitive for adenocarcinoma of the pancreas (80 of 87, 92%) as compared to only 14% in the group of patients with benign diseases. Twenty-seven percent of the patients with chronic pancreatitis and 28% of the patients with acute pancreatitis showed elevated CA 19-9 concentrations of more than the upper normal value of 37 U/ml. In 38% and 32% of our cases with carcinoma of the stomach and colorectal carcinoma, respectively, CA 19-9 was estimated as being above the normal range. The preoperatively raised CA 19-9 concentration in patients with pancreatic carcinoma decreases after curative resection of the carcinoma to values within the normal range. However, in no CA 19-9 estimation following a palliative surgical intervention or in cases of inoperable carcinomas a serum concentration of less than 37 U/ml was recorded. In immunohistochemical specimens we found a difference between CA 19-9 antigen concentrations on the cell surface and secretion in pancreatic carcinoma and chronic pancreatitis. PMID- 3306668 TI - Pancreas Transplant Registry: history and analysis of cases 1966 to October 1986. AB - From December 1966 to October 1986, 1001 pancreas transplants in 932 diabetic patients were reported to the International Pancreas Transplant Registry. One year actuarial graft function (insulin-independent) and recipient survival rates for all cases were 35% and 75%, respectively. In an analysis by era of 1966-77 (n = 64), 1978-82 (n = 201), 1983-84 (n = 298) and 1985-86 (n = 438) cases, 1 year graft function rates were 3, 21, 39, and 44% and recipient survival rates were 42, 72, 76, and 83, respectively (p less than 0.05 all comparisons, except 1983 84 vs. 1985-86). In an analysis of 1983-1986 cases only (n = 736), the overall 1 year graft function and patient survival rates were 42 and 79%, respectively. During this period, graft functional survival rates were similar (p greater than 0.8) for the most common duct management methods, 43% for duct injection (n = 254), 42% for enteric drainage (n = 254), and 47% for bladder drainage (n = 196) at 1 year. Graft function rates were also similar (p greater than 0.6) for whole (n = 280) and segmental (n = 456) pancreas transplants (41 vs. 42% at 1 year). Functional survival rates according to duration of preservation for grafts stored less than 6 h (n = 460), 6-12 h (n = 146) and greater than or equal to 12 h (n = 52) were 46, 39, and 30% at 1 year, and the difference was significant for the less than 6 vs. the 6-12 h preservation time (p = 0.023). Graft functional survival rates were significantly higher (p less than 0.05) in recipients who received azathioprine (AZA) and cyclosporine (CSA) in combination (n = 408) than in those who received CSA without azathioprine (n = 262) or AZA without cyclosporine, (n = 56), with 1 year graft functional survival rates of 47, 38, and 34%, respectively. For technically successful grafts, the functional survival rates were also significantly higher (p less than 0.05) in recipients treated with CSA + AZA (n = 309) than in those who received CSA without azathioprine (n = 186) or AZA without cyclosporine (n = 44), with 1 year function rates of 63, 53, and 41%, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306669 TI - Consequences of detailed balance in a model for sensory adaptation based on ligand-induced receptor modification. AB - A model for exact sensory adaptation has been published by Segel and co-workers in several papers [e.g., Knox, B. E., Devreotes, P. N., Goldbeter, A. & Segel, L. A. (1986) Proc. Natl. Acad. Sci. USA 83, 2345-2349]. The model comprises a pair of states whose relative probabilities are determined by the binding of a ligand. A second pair of states related by the same ligand binding is accessible as a consequence of either a conformational change or a "covalent modification." By taking proper account of detailed balance, we show that the notion of covalent modification in this context includes three cases, two of which involve dissipation of metabolic energy. The condition for exact adaptation is dependent on metabolite concentrations in all cases of covalent modification. The performance of the model is critically examined on thermodynamic and kinetic grounds. PMID- 3306670 TI - Use of a synthetic peptide antigen to generate antisera reactive with a proteolytic processing site in native human proinsulin: demonstration of cleavage within clathrin-coated (pro)secretory vesicles. AB - Polyclonal antibodies reactive with a cleavage site in human proinsulin (HPI) (C peptide-A-chain junction) have been raised (rabbit, guinea pig) using a synthetic peptide antigen coupled with keyhole limpet hemocyanin. These antisera recognize native HPI and des-31,32-HPI equally well but react 20-50 times less well with des-64,65-HPI, the intermediate cleaved at the C-peptide-A-chain junction and lacking the Lys-Arg pair. The guinea pig antisera did not recognize insulin but reacted weakly with C peptide at high concentrations; the rabbit antisera reacted with neither insulin nor C peptide. Immunocytochemical studies with human islet tissue localized the immunoreactivity of these antisera to clathrin-coated (pro)secretory vesicles derived from the trans Golgi, indicating that cleavage of the C-peptide-A-chain junction of proinsulin occurs mainly, if not exclusively, in this compartment of the beta cell. PMID- 3306671 TI - Recombinational substrates designed to study recombination between unique and repetitive sequences in vivo. AB - Three recombination events, reciprocal recombination, sister-chromatid recombination, and gene conversion, were studied using substrates designed in vitro. Each type of recombination event can be monitored at any chromosomal location. We have shown that sister-chromatid recombination is induced mitotically by DNA damaging agents, such as methyl methanesulfonate and gamma rays, but is decreased mitotically in strains defective in rad52. Reciprocal recombination by which circular plasmids integrate into the genome is unaffected by rad52 defective alleles and occurs by a different recombination pathway. Mechanisms are suggested by which gene conversion between sister chromatids can generate chromosome rearrangements. PMID- 3306672 TI - Spectra of spontaneous mutations in Escherichia coli strains defective in mismatch correction: the nature of in vivo DNA replication errors. AB - We have determined the DNA sequence changes in 487 spontaneous mutations in the N terminal part of the lacI gene in mutH, mutL, and mutS strains of Escherichia coli. These strains display elevated spontaneous mutation rates because of a deficiency in the process of postreplicative mismatch correction. As a consequence the mutational spectra reveal the nature of spontaneous DNA replication errors. The spectra consist of base substitutions (75%) and single base deletions (25%). Among the base substitutions, transitions (both A.T----G.C and G.C----A.T) are strongly favored over transversions (96% versus 4%). Large site-to-site differences are observed among identical base substitutions, presumably reflecting the modulating effects of neighboring bases. The single base-deletion spectrum is dominated by a large hotspot at a run of adjacent identical base pairs, implying a Streisinger-slippage mechanism. The data, when compared to a previously determined wild-type spectrum, also provide information on the specificity of the mismatch repair system. PMID- 3306674 TI - Individual variation in serum cholesterol levels. AB - The intraindividual variances in serum/plasma cholesterol levels from a variety of sources have been examined. It is apparent that these are very substantial with mean coefficients of variation usually between 5% and 10%, even when the diet is controlled in metabolic studies. Some subjects show extreme variability from one blood sample to the next. Thus, it is very difficult to assess the degree of risk of individuals according to the guidelines provided by the Consensus Conference on lowering blood cholesterol levels to prevent heart disease, and many individuals will be misclassified unless particular attention is paid to this problem. PMID- 3306673 TI - Confidence interval for the number of selectively neutral amino acid polymorphisms. AB - A statistical approach to the analysis of DNA sequences has been developed, which provides a confidence interval estimate for the proportion of naturally occurring amino acid polymorphisms that are selectively neutral. When applied to the gnd gene coding for 6-phosphogluconate dehydrogenase in a sample of seven natural isolates of Escherichia coli, the method indicates that the proportion of observed amino acid polymorphisms that are selectively neutral is unlikely to be greater than 49% (upper 95% confidence limit). On the other hand, the observations are also consistent with a model in which all of the observed amino acid substitutions are mildly deleterious with an average selection coefficient approximating 1.6 X 10(-7). Various models for the distribution of configurations at silent sites are also investigated. PMID- 3306675 TI - Extensive amino acid sequence homologies between animal lectins. AB - We have established the amino acid sequence of the beta-D-galactoside binding lectin from the electric eel and the sequences of several peptides from a similar lectin isolated from human placenta. These sequences were compared with the published sequences of peptides derived from the beta-D-galactoside binding lectin from human lung and with sequences deduced from cDNAs assigned to the beta D-galactoside binding lectins from chicken embryo skin and human hepatomas. Significant homologies were observed. One of the highly conserved regions that contains a tryptophan residue and two glutamic acid residues is probably part of the beta-D-galactoside binding site, which, on the basis of spectroscopic studies of the electric eel lectin, is expected to contain such residues. The similarity of the hydropathy profiles and the predicted secondary structure of the lectins from chicken skin and electric eel, in spite of differences in their amino acid sequences, strongly suggests that these proteins have maintained structural homologies during evolution and together with the other beta-D-galactoside binding lectins were derived from a common ancestor gene. PMID- 3306677 TI - A superactive insulin: [B10-aspartic acid]insulin(human). AB - The genetic basis for a case of familial hyperproinsulinemia has been elucidated recently. It involves a single point mutation in the proinsulin gene resulting in the substitution of aspartic acid for histidine-10 of the B chain of insulin. We have synthesized a human insulin analogue, [AspB10]insulin, corresponding to the mutant proinsulin and evaluated its biological activity. [AspB10]Insulin displayed a binding affinity to insulin receptors in rat liver plasma membranes that was 534 +/- 146% relative to the natural hormone. In lipogenesis assays, the synthetic analogue exhibited a potency that was 435 +/- 144% relative to insulin, which is statistically not different from its binding affinity. Reversed-phase HPLC indicated that the synthetic analogue is more apolar than natural insulin. We suggest that the observed properties reflect changes in the conformation of the analogue relative to natural insulin, which result in a stronger interaction with the insulin receptor. Thus, a single substitution of an amino acid residue of human insulin has resulted in a superactive hormone. PMID- 3306676 TI - Glucose transport and antilipolysis are differentially regulated by the polar head group of an insulin-sensitive glycophospholipid. AB - A glycophospholipid has been purified from rat liver membranes, which copurified with an insulin-sensitive glycophospholipid isolated from H35 hepatoma cells. The polar head group of this glycophospholipid, which is a phosphooligosaccharide, was generated by treatment with a phosphatidylinositol-specific phospholipase C from Staphylococcus aureus. There was an "insulin-like" inhibitory effect of this phosphooligosaccharide on isoproterenol-stimulated lipolysis in adipocytes, whereas there was no effect on glucose oxidation under conditions that measure glucose transport. The antilipolytic effect of this phosphooligosaccharide was demonstrated in intact adipocytes. There was a linear correlation between the concentration of phosphooligosaccharide and its antilipolytic effect, the magnitude and time course of which were similar to that obtained with physiological concentrations of insulin. Submaximal concentrations of insulin and phosphooligosaccharide produced an additive antilipolytic effect. The antilipolytic effect of the phosphooligosaccharide was demonstrated only after release of this compound from the precursor glycophospholipid with phosphatidylinositol-specific phospholipase C, and the activity of the phosphooligosaccharide was sensitive to alkali. It is proposed that this phosphooligosaccharide plays a role in mediating certain insulin actions. PMID- 3306678 TI - DNA sequence analysis suggests that expression of flagellar and chemotaxis genes in Escherichia coli and Salmonella typhimurium is controlled by an alternative sigma factor. AB - Biosynthesis of bacterial flagella involves the coordinated expression of 30 or more genes in several separate operons. We have recently shown that in Bacillus subtilis, the sigma 28 factor is essential for flagellar synthesis, suggesting that transcription of these genes is directly under the control of this alternative sigma factor. In enteric bacteria structural genes for flagellar, chemotaxis, and motility operons appear to be under coordinate control, however, the nature of the regulatory factors has not been determined. Sequence analysis of many such genes has failed to reveal plausible promoter sequences for the predominant bacterial RNA polymerase, and several such genes are not transcribed effectively in vitro by the Escherichia coli sigma 70 RNA polymerase. However, all of the sequenced flagellar, chemotaxis, and motility operons from the enteric bacteria are preceded by DNA sequences highly homologous to B. subtilis sigma 28 promoters. We propose that an alternative sigma factor controls expression of the flagellar regulon in both B. subtilis and in the enteric bacteria. PMID- 3306679 TI - Structure of the reaction center from Rhodobacter sphaeroides R-26: membrane protein interactions. AB - The energetics of membrane-protein interactions are analyzed with the three dimensional model of the photosynthetic reaction center (RC) from Rhodobacter sphaeroides. The position of the RC in the membrane and the thickness of the membrane were obtained by minimizing the hydrophobic energy with the energy function of Eisenberg and McLachlan. The 2-fold symmetry axis that relates the L and M subunits is, within the accuracy of 5 degrees, parallel to the normal of the membrane. The thickness of the membrane is estimated to be 40-45 A. Residues that are exposed to the membrane are relatively poorly conserved in the sequences of homologous RC proteins. The surface area of the RC is comparable to the surface areas of water-soluble proteins of similar molecular weight. The volumes of interior atoms in the RC are also similar to those of water-soluble proteins, indicating the same compact packing for both types of proteins. The electrostatic potential of the cofactors was calculated. The results show an asymmetry in the potential between the two possible pathways of electron transfer, with the A branch being preferred electrostatically. PMID- 3306680 TI - Endogenous lectins from cultured cells: nuclear localization of carbohydrate binding protein 35 in proliferating 3T3 fibroblasts. AB - Proliferating 3T3 mouse fibroblasts contain higher levels of the lectin carbohydrate-binding protein 35 (CBP35) than do quiescent cultures of the same cells. An immunofluorescence study was carried out with a rabbit antiserum directed against CBP35 to map the cellular fluorescence distribution in a large population of cells under different growth conditions. This cytometric analysis showed that the lectin is predominantly localized in the nucleus of the proliferating cells. In quiescent 3T3 cultures, the majority of the cells lost their nuclear staining and underwent a general decrease in the overall fluorescence intensity. Stimulation of serum-starved quiescent 3T3 cells by the addition of serum resulted in an increase in the level of CBP35. The percentage of cells showing distinct punctate intranuclear staining reached a maximum at about the same time as the onset of the first S-phase of the cell cycle. All of these results suggest that CBP35 may be a protein whose presence in the nucleus, in discrete punctate distribution, is coordinated with the proliferation state of the cell. PMID- 3306681 TI - Intramolecular recombination between partially homologous sequences in Escherichia coli and Xenopus laevis oocytes. AB - We describe a system to analyze the individual contribution of a single physical DNA end on intramolecular recombination between partially homologous sequences. We took advantage of this partial sequence divergence to measure the distance separating the DNA end from the final recombination event. We show that a single physical DNA end stimulates recombination when located in a region of homology. Recombination frequency decreases gradually with the distance from the DNA end. A recombinational hot spot is found at the end of the region of homology. A large insertion of unrelated DNA interferes asymmetrically with this process, suggesting that a recombinogenic signal propagates along the region of homology. PMID- 3306682 TI - Expression of abnormal von Willebrand factor by endothelial cells from a patient with type IIA von Willebrand disease. AB - Studies were conducted to characterize the biosynthesis of von Willebrand factor (vWf) by cultured endothelial cells (EC) derived from the umbilical vein of a patient with type IIA von Willebrand disease. The patient's EC, compared with those from normal individuals, produced vWf that had decreased amounts of large multimers and an increase in rapidly migrating satellite species, features characteristic of plasma vWf from patients with type IIA von Willebrand disease. The type IIA EC did produce a full spectrum of vWf multimers in both cell lysates and postculture medium, although the relative amounts of the largest species were decreased. The large multimers were degraded in conjunction with the appearance of rapidly migrating satellites that contained approximately equal to 170-kDa proteolytic fragments, suggesting that this patient's functional defect is due to abnormal proteolysis and not to a primary failure of vWf subunit oligomerization. Moreover, the observed degradation appears to result from an abnormal vWf molecule and not elevated protease levels. These results suggest that this patient's von Willebrand disease phenotype is caused by increased proteolytic sensitivity of his vWf protein. PMID- 3306684 TI - Nutrition and puberty in the female. PMID- 3306683 TI - Evidence that endogenous beta nerve growth factor is responsible for the collateral sprouting, but not the regeneration, of nociceptive axons in adult rats. AB - A key role has not yet been identified for beta nerve growth factor (NGF) in the growth responses that continue to be expressed in the sensory neurons of adult animals. We have now examined the effects of daily administration to adult rats (and in a few experiments, mice) of antiserum to NGF on (i) the collateral sprouting of undamaged nociceptive nerves that occurs into denervated adjacent skin and (ii) the regeneration of cutaneous sensory axons that occurs after they are damaged. The results were unexpected. All collateral sprouting was prevented and that already in progress was halted; sprouting resumed when treatment was discontinued. In contrast, the reestablishment, and even enlargement, of cutaneous nerve fields by regenerating axons was unaffected by anti-NGF treatment, even after dorsal rhizotomy was done to eliminate any central trophic support. In denervated skin, regenerating and collaterally sprouting axons utilized the same cellular pathways to establish functionally identical fields, thus displaying apparently identical growth behaviors, yet anti-NGF treatment clearly distinguished between them. We suggest that endogenous NGF is responsible for the collateral sprouting of nociceptive axons, probably reflecting an ongoing function of NGF in the regulation of their fields. This demonstration in the adult sensory system of a defined role for NGF in nerve growth could apply to nerve growth factors generally in the adult nervous system. The regeneration, however, of nociceptive axons (and nonnociceptive one) is not dependent on NGF. PMID- 3306685 TI - Voluntary food intake and reproduction. PMID- 3306687 TI - Nutritional interactions with reproduction in birds. PMID- 3306686 TI - Nutritional effects on puberty and lactational infertility in mammals: some interspecies considerations. PMID- 3306688 TI - Nutritionally induced congenital defects. PMID- 3306689 TI - Obesity and reproduction. PMID- 3306690 TI - Nutritional effects on the fetus and mammary gland during pregnancy. PMID- 3306691 TI - Placental transfer of calcium to the ovine fetus and its regulation. PMID- 3306692 TI - Suppressed in vitro blastogenic responsiveness of rat spleen cells after continuous infusion of endotoxin by an implanted osmotic pump. AB - Continuous infusion of a gram-negative bacterial endotoxin in relatively small doses into rats by means of an implanted osmotic pump was studied. The model system was designed to examine the effects of endotoxin on the blastogenic response of spleen cells to the endotoxin itself and to a nonspecific T-cell mitogen, concanavalin A (Con A). Rats were implanted with an osmotic pump which delivered saline for the first 42 hr to provide postsurgical recovery before the onset of endotoxin infusion. Previous studies had shown that during the first 1-4 days after administration of endotoxin marked alterations of metabolism and some changes in physiologic parameters such as blood pressure and in vitro myocardial performance occurred. In the present study the blastogenic responsiveness of spleen cells to endotoxin itself as well as to the nonspecific T-cell mitogen Con A was markedly decreased after several days of continuous administration of endotoxin. Control animals receiving only saline for the same period of time showed a similar depression of blastogenic responsiveness to the lipopolysaccharide (LPS), as well as to Con A, however, with a delay of 2-4 days before comparable levels of suppression became evident. These results indicate that marked alterations of immune competence as measured by blastogenesis of spleen cells to Escherichia coli LPS and to a mitogen such as Con A may occur after implantation of an osmotic pump, with or without continuous infusion of endotoxin. Further studies seem warranted to determine the role of the foreign body reaction to the osmotic pump as well as to the endotoxin administered by the pump. PMID- 3306693 TI - Smoked drum pharmacology: alive and well and living in the west. PMID- 3306694 TI - The effects of D1 and D2 receptor antagonists on pain sensitivity and morphine analgesia in the rat. PMID- 3306695 TI - Precision cut tissue slices in culture: a new tool in pharmacology. PMID- 3306696 TI - A comparison of bioassay and binding assay derived kinetic parameters for angiotensin II analogues in the rat uterus: the effect of GTP gamma S. PMID- 3306697 TI - Advances in chronobiology. Part B. Proceedings of the XVIIth International Conference of the International Society for Chronobiology. Little Rock, Arkansas, November 3-6, 1985. Dedicated to Professor Franz Halberg. PMID- 3306698 TI - Diagnostic information provided by ambulatory blood pressure monitoring. AB - Ambulatory blood pressure monitoring allows one to evaluate the blood pressure profile over a 24-hr period. It has been demonstrated that an average of daily pressure readings is more predictive of cardiovascular complications of hypertension than casual monitoring of blood pressure. On the other hand, there is no conclusive evidence that the higher degree of blood pressure variability found in hypertensive patients is related to increased hypertensive morbidity. The absence of a physiological decrease in arterial pressure during sleep is associated with complications of hypertension such as atherosclerosis and left ventricular hypertrophy as well as with impairments of the autonomic nervous system. PMID- 3306699 TI - Aspects of chronopharmacology and chronotherapy in pediatrics. AB - Pediatric chronopharmacological findings until now have been limited to circadian changes in children from ages 6 to 15 years. This means that data in newborns and even in infants of 1 year are not available and other bioperiodicities with periods of about-1-year (infradian rhythms) have not been explored in older children. Biologic time-related changes have been documented for phenytoin and theophylline with regard to pharmacokinetics, for orciprenaline with regard to bronchodilation, and for corticosteroids as well as anticancer agents with regard to their effectiveness. Despite the limited number of experiments performed to date, it is already possible to state that a chronopharmacological approach provides better precision in pharmacologic study than the conventional approach not using time-related data and better therapeutics can be achieved with the help of chronopharmacological facts since appropriate timing in administration of medicine usually enhances its desired and/or reduces its undesired effects. PMID- 3306700 TI - Antidepressants and food restriction cycles: evidence for multiple pacemakers in rodents. AB - Studies involving the suprachiasmatic nuclei (SCN) provide insufficient evidence to support the SCN as master pacemaker(s) in the rodent circadian system. Restricted feeding (RF) cycles act as strong zeitgebers for activity and corticosterone rhythms and provide support for the existence of important secondary pacemakers. These proposed pacemakers show anticipatory behavior, a limited range of entertainment for RF cycles, and prolonged free runs under certain circumstances. Additional evidence supporting a multiple pacemaker model of rodent circadian organization comes from studies involving antidepressants. Lithium treatment lengthens the free-running tau of rat activity rhythms and shifts the range of entrainment towards longer zeitgeber cycles. Lithium also phase delays many rodent rhythms but does not appear to affect the SCN-pineal axis. These data are difficult to explain without involving more than one pacemaker. Models of the rodent system can be developed incorporating multiple pacemakers. To test these models, a multivariate approach will be required. Combining the labeled 2-deoxyglucose method for metabolic mapping and the procedures of fractional desynchronization with antidepressant psychopharmacology and RF cycles may prove to be an important multivariate approach. PMID- 3306701 TI - Electron microscopy of hepatitis delta antigen (HDAg) in liver. PMID- 3306703 TI - Experimental hepatitis delta virus infection in the chimpanzee. PMID- 3306702 TI - Autoantibodies to thymic epithelial cells in HDV infection. PMID- 3306704 TI - Autonomous and helper-dependent small pathogenic RNAs of plants: viroids and satellites. PMID- 3306705 TI - Delta reinfection in human liver transplantation: report of two cases. PMID- 3306706 TI - Delta hepatitis in the Americas: an overview. PMID- 3306707 TI - Epidemiology of the hepatitis delta virus (HDV) in Brazil. PMID- 3306708 TI - Antimutagenic potency of the cytotoxic and anti-psoriatic compound anthralin (cignolin). AB - The anti-psoriatic compound anthralin (cignolin) was determined to exhibit a strong cytostatic activity on HeLa-Koln cells; an ED50 concentration of 1.2 microM are cytotoxic for the cells. These growth-inhibition data were confirmed by thymidine-uptake experiments. The drug anthralin was determined to be neither direct a mutagen nor a premutagen in the Ames test using Salmonella typhimurium strain TA 100 (anthralin-concentration = 5 microM). Moreover, this compound was a strong inhibitor of benzo(a)pyrene monooxygenase, an enzyme which causes the metabolic conversion of premutagens to mutagens. These data demonstrate anthralin to be an anti-psoriatic compound devoid of mutagenic property in vitro with regard to base-pair substitutions and provided at least with some antimutagenic potential. PMID- 3306709 TI - Seventieth birthday: Prof. Albrecht Fleckenstein. PMID- 3306710 TI - Mechanisms of monooxygenase induction and inhibition. AB - The mechanisms of monooxygenase induction and inhibition have been discussed from the standpoint of historic development, from the current concepts about the molecular mechanism of enzyme induction, and from the various possibilities by which inhibitors can interact with the complex cytochrome P-450 monooxygenase system. In detail the main features and phenomena of induction and of the induced new enzyme protein are briefly described, whereby general principles are emphasized. The current knowledge on the mechanism of induction is exemplified by a description of the inducing action of TCDD on mouse hepatoma cells. A special example of increase in the molecular activity towards 7-ethoxycoumarin-0 deethylation is given by the action of sulmazole on mouse liver cytochrome P-450. It possesses properties similar to that of cobaltous chloride in that it decreases the amount of cytochrome P-450 in the microsomal protein but at the same time increases the molecular activity to about a four-fold level. The mechanisms of inhibition of the microsomal monooxygenase are explained in general terms by outlining the various modes of inhibitory action that lead to a decrease in enzyme activity. PMID- 3306711 TI - In vivo methods to study enzyme induction and enzyme inhibition. PMID- 3306712 TI - Human drug metabolism polymorphisms: use of recombinant DNA techniques. PMID- 3306713 TI - Environmental factors of enzyme induction and inhibition. PMID- 3306714 TI - Ethanol as enzyme inducer and inhibitor. PMID- 3306715 TI - Clinical implications of hepatic microsomal enzyme induction by antiepileptic drugs. PMID- 3306716 TI - Importance of the glutathione cycle in drug metabolism. PMID- 3306717 TI - Developmental aspects of enzyme induction and inhibition. PMID- 3306718 TI - Reversible inhibition and activation of hepatic GSH S-transferases by ethylene dibromide. PMID- 3306719 TI - Induction and its influence of human cancer. PMID- 3306720 TI - Enzyme induction in humans. Clinical aspects--an overview. PMID- 3306721 TI - The passive electrical properties of biological systems: their significance in physiology, biophysics and biotechnology. PMID- 3306723 TI - Wavelength-dependence of the photoreactivable response of dark-repair-deficient phr mutants of Escherichia coli K-12. PMID- 3306724 TI - Spectroscopy of reversed micelles. PMID- 3306722 TI - Endonucleolytic incision of UVB-irradiated DNA. PMID- 3306725 TI - Mechanisms of drug photosensitization. PMID- 3306726 TI - A review of some topics concerning mutagenesis by ultraviolet light. PMID- 3306727 TI - UV-inducible SOS response in Escherichia coli. PMID- 3306728 TI - Structure of rhodopsin and bacteriorhodopsin. PMID- 3306729 TI - An action spectrum for lethal photosensitization of Candida albicans by 8-MOP after low-dose broad-band UV-A irradiation; an action spectrum for 8-MOP 4',5' monoadducts. PMID- 3306730 TI - Thirst and fluid intake following graded hypohydration levels in humans. AB - The relationship among changes in thirst sensations, blood variables, and differential fluid intake in hypohydrated humans was examined. Seven subjects were hypohydrated by 0%, 3%, 5%, and 7% of their body weight on four separate trials which were systematically randomized between subjects. Hypohydration levels were achieved with a regimen of restricted food and fluid intake and moderate heat-exercise stress. Statistically significant linear and quadratic trends were found for the intensity of several sensations with progressive hypohydration levels. In general, plasma osmolality and renin activity increased and plasma volume decreased with increasing hypohydration levels. During a one hour period of ad lib drinking, all subjects consumed insufficient fluid to rehydrate back to baseline body weights. Using regression analyses, fluid intake was predicted by the magnitude of subjective and physiological indices of hypohydration. Results demonstrate that both hypovolemia and plasma osmolality contribute significantly to fluid intake in hypohydrated humans. The results also indicate that thirst sensations make a substantial contribution to differential fluid intake in humans. PMID- 3306731 TI - Decreased binding to hypothalamic insulin receptors in young genetically obese rats. AB - [125I]insulin binding to partially purified hypothalamic membranes is reduced during prolonged starvation, and changes in hypothalamic insulin binding capacity correlate well with spontaneous variations in energy balance in ground squirrels. To determine whether an insulin binding impairment in the central nervous system can be observed during the early expression of genetic obesity, both obese (fa/fa) and phenotypically lean (Fal-) Zucker rats were studied at 6 weeks of age. Hypothalamic tissue from fa/fa rats bound significantly less hormone than that from the lean animals, but binding was not changed in tissue from cerebral cortex. It is concluded that a defect in insulin binding to hypothalamic receptors in Zucker fatty rats may contribute to the development of weight gain in these animals. PMID- 3306733 TI - A new IncQ plasmid R89S: properties and genetic organization. AB - The new small (8.18 kb) streptomycin-resistant multicopy plasmid R89S of the Q group incompatibility is described. In contrast to other IncQ plasmids, replication of R89S is dependent on DNA polymerase 1 and proceeds in the absence of de novo protein synthesis. According to our data up to now, the host spectrum of the plasmid R89S is limited to Enterobacteriaceae. A genetic map of the plasmid R89S has been prepared through the construction of deletion and insertion derivatives. Phenotypic analysis of these derivatives has identified the location of genes encoding resistance to streptomycin, and the region essential for mobilization of R89S. The origin of vegetative replication has been located within a 0.7-kb fragment. Another region highly homologous to oriV of the plasmid RSF1010, but not functioning as an origin of replication, was localized. Two regions involved in the expression of incompatibility have also been identified. The data from the restriction analyses, DNA-DNA hybridization, and genetic experiments enable us to assume that the plasmid R89S is a naturally occurring recombinant between part of an IncQ plasmid and another narrow host range replicon of unknown incompatibility group. PMID- 3306732 TI - Corticosterone inhibition of the intracerebroventricular effect of 2-deoxy-D glucose on brown adipose tissue thermogenesis. AB - The effects on food intake, blood glucose and the binding of guanosine 5 diphosphate (GDP) to mitochondria from interscapular brown adipose tissue (IBAT) were examined following the injection of 2-deoxy-D-glucose (2-DOG) into the third ventricle of the brain. Microinjections of 2-DOG increased food intake and blood glucose within 30 to 60 min, but binding of GDP to mitochondria from IBAT, on the other hand, was reduced. The order of sensitivity to 2-DOG was IBAT--feeding- hyperglycemia. Implantation of a 50 mg pellet of corticosterone inhibited the stimulatory effect of 2-DOG on feeding and hyperglycemia and prevented the inhibition of GDP binding to mitochondria from IBAT. These data are consistent with the hypothesis that glucocorticoid may inhibit glucose metabolism at multiple sites in the hypothalamus. PMID- 3306734 TI - finO sequences on conjugally repressed and derepressed F-like plasmids. AB - DNA-DNA hybridization studies have demonstrated the physical relatedness of the fertility inhibition gene, finO, among both FinO+ and FinO- F-like conjugative plasmids, viz. ColV2-K94, R100-1,R1drd19,R1,R6-5, UCR123, R386, p307, R453, R773, and pIP162-1. Furthermore, the data indicate that finO sequences on the FinO- plasmid ColV2-K94 map downstream of the transfer region, within 93.6-95.3 ColV2 K94. PMID- 3306735 TI - Kinetic and segregational analysis of mitochondrial DNA recombination in yeast. AB - A pair of yeast strains of opposite mating type was constructed to contain polymorphisms at three loci on the mitochondrial genome--the 21 S rRNA gene, var1, and cob--such that parental and recombinant forms of these genes could be easily detected by Southern blot analysis. These polymorphisms were used to measure in a single cross gene conversions at the 21 S rRNA and var1 loci and a reciprocal recombination at cob. For all three loci, recombination initiates at about the same time, 4 to 6 h after mixing cells, and increases with similar kinetics over a 24-h period. The segregation of parental and recombinant forms of these genes was then followed by pedigree analysis. The results, which show a high variance in the distribution of parental and recombinant forms of all three genes in cells derived from both the first bud and the mother zygote, are consistent with the segregation of a small number of mitochondrial DNA molecules from the zygote to diploid buds. Based on these results and previous experiments of this type, a limited "zone of mixing" of parental mitochondrial DNA molecules probably exists in the zygote. The extent of sampling from this zone, together with the intrinsic properties of the recombination events themselves, is likely to determine the observed pattern of recombination of mitochondrial DNA sequences at the population level. PMID- 3306736 TI - Cloning and overexpression of the colicin E1 immunity gene. AB - A DNA fragment containing only the putative immunity gene-coding sequence was cloned under the control of the trp and lambda PL promoters, generating pRKA11 and pIPL, respectively. Escherichia coli hosts containing either construction were immune to colicin E1. Cells harboring both pIPL and pNT204, which encodes a temperature-sensitive cI repressor, were sensitive to colicin E1 at 30 degrees C, but became immune after 0.5 h of incubation at 42 degrees C. In addition, pRKA11 directed the synthesis of a 14.5-kDA protein in maxicells, identical to that found with the wild-type immunity gene. This evidence identifies unequivocally the coding sequence of the immunity gene as that extending from bases 1214 to 1552 [OKA, A., et al., Mol. Gen. Genet. 172, 151-159 (1979)]. The entire immunity gene operon was also cloned under the control of the tac promoter, generating pTCU2, which, upon induction with isopropyl beta-D-thiogalactopyranoside, produced the imm gene product in amounts sufficient to be visualized by autoradiography. PMID- 3306737 TI - Recent developments in our knowledge of steroids. PMID- 3306738 TI - Nasal tip projection: counterpoint. AB - The achievement of tip projection in rhinoplasty has been overemphasized in recent programs and publications. The normal spring support of the tip by the medial crura will ordinarily give adequate tip projection in a well-executed rhinoplasty. If additional tip projection is required, the simplest procedures are advancement of the columella and tip upward on the end of the septum and similar advancement of the alar cartilages toward the bridge. For additional support, a cartilage strut is inserted between the medial crura. Retrusion of the distal nasal complex requires maxillary advancement or support beneath the base of the alae and columella. If a tip graft is required, one achieves a more natural tip by a posterior conchal graft, utilizing its natural curve, rather than by a building-block support. PMID- 3306739 TI - Guidelines for pharyngostome closure. AB - The reconstructive procedure for pharyngostome closure includes single-stage restoration in three steps: lining, intermediate layer, and covering. The lining repair is the key factor to the successful outcome of the operation. Three clinical situations may be distinguished. First, the mucosa is sufficient to restore a new gullet. In this case, it is widely undermined and sutured along the midline without any tension. Second, the mucosa is only partially sufficient. The same procedure as above is adopted to close the lower two-thirds of the pharyngostome, while an advancement flap is outlined from the base of the tongue to restore the upper third. Third, the mucosa is not sufficient. A musculocutaneous flap solves the problem. Reconstruction of the intermediate layer involves rotation of one (or both) sternomastoid muscle(s), if present. The possibilities for coverage include a submandibular flap, a thoracoacromial flap, and/or musculocutaneous flaps. By following these guidelines, the authors have successfully closed 37 pharyngostomes. PMID- 3306740 TI - A method of reconstructing a pendulous breast utilizing the tissue expander. AB - It is possible to reconstruct a breast mound of almost any size by utilizing tissue expansion. In order to produce a pendulous breast which is also ptotic, the tissue-expansion technique has been combined with two other procedures. A new technique is being introduced. It is that of elevating the lower third of the mature breast capsule surrounding the tissue expander at the time the permanent prosthesis is to be exchanged for the expander. The established techniques of inframammary fold reconstruction of Pennisi and Ryan are used to provide pedicle skin coverage for the undersurface of the breast and the bed of the elevated capsule. Internal and external surgical approaches are described, and two examples of each are illustrated. Breasts reconstructed in this manner have remained pendulous structures. Some loss of the initial degree of ptosis has been noted in some cases. PMID- 3306741 TI - Immediate Z-plasty for semicircular wounds. AB - Simple layered repair of semicircular and curved lacerations frequently results in elevation of the central area following contraction of the scar. Traditionally, immediate tissue rearrangement at the time of the injury has been discouraged. We performed single or multiple Z-plasties at the time of the initial repair on five consecutive patients with curved and semicircular lacerations of the face. None of the wounds formed the typical trapdoor deformity. Use of immediate Z-plasties in the acute management of semicircular flaplike lacerations seems to prevent the formation of the trapdoor deformity. PMID- 3306742 TI - Ear replantation. AB - The authors' tactical and technical contribution to this type of microsurgical replantation can be summarized in three main points: (1) direct sutures to the superficial temporal vessels, when these are undamaged, which simplifies the operation and makes it safer; (2) use of Kunlin's technique to make up for the great difference in diameter between the arterial vessels; and (3) deepithelialization of the posterior auricular skin to allow for creation of venous drainage channels during the first postoperative days and the enlargement of the area of contact with the recipient bed, which also helps to better immobilize the amputated part. PMID- 3306743 TI - A case of supernumerary nostril. AB - A very rare case of supernumerary nostril is reported. This case is different from previously reported cases, because this accessory nostril was located nearer the nasal septum than the natural nostril and its opening was on the same level as the natural one. Although its cause and development are only speculative due to the small number of reported cases, a new hypothesis is proposed and discussed, since our findings are contradictory to previous literature. PMID- 3306744 TI - Survival of a nonadhering skin graft. PMID- 3306745 TI - Nasal competitions. PMID- 3306746 TI - [Contribution of E. W. Schmidt to the development of Soviet neurology and its international relations]. AB - A short retrospect, occasioned by the death on July 13, 1985, of E. W. Schmidt, of his career as director of the Neurological Research Institute at the Academy of Medical Sciences of the USSR, and his influence as scientist, medical man, and humanist on the development of neurology in the Soviet Union and its representation on the international scene. PMID- 3306747 TI - Psychiatric deinstitutionalization: the possibilities and the reality. AB - There is a substantial research data base which indicates that the majority of the chronically mentally ill can function outside of institutional settings. A number of community support programs have been implemented and positively evaluated. However, despite this evidence, large-scale deinstitutionalization of these patients has not occurred. Instead, patients have been relocated to new institutional placements such as nursing homes and single-room only hotels (SRO's). The role of Medicaid and Supplemental Security Income (SSI) in mental health care appears to have contributed to limited placement options. In addition, deinstitutionalization has created ambiguity around the degree of dependence and social role status of these patients. Recommendations are made to provide the deinstitutionalized mentally ill with a viable social role using existing financial resources. PMID- 3306748 TI - Plasma adenosine levels: measurement in humans and relationship to the anxiogenic effects of caffeine. AB - The effects of caffeine on plasma adenosine were examined in eight healthy normal volunteers. Subjects were randomly administered on 4 separate days, in a double blind fashion, either placebo or three different doses of caffeine (240, 480, and 720 mg). Adenosine concentrations, measured by high performance liquid chromatography, were in the micromolar range when samples were drawn into tubes containing dipyridamole to prevent adenosine reuptake by red blood cells. Plasma adenosine levels did not change after caffeine administration. The effects of caffeine on anxiety were related to changes in plasma caffeine but not plasma adenosine levels. The potential interest of caffeine as a chemical model of anxiety is discussed. PMID- 3306749 TI - Is case-ascertainment of Alzheimer's disease in field surveys practicable? PMID- 3306751 TI - Contributions to the history of psychology: XLIII. A tribute to Princess Marie Bonaparte. PMID- 3306750 TI - Desperate remedies: a Gothic tale of madness and modern medicine. AB - The theory that many diseases were produced by focal infection or chronic sepsis enjoyed a brief vogue in general medicine in the first quarter of the twentieth century. This paper explores its practical applications in psychiatry, which extended well into the 1930s. The analysis focuses particularly closely on the activities of Henry A. Cotton at the Trenton State Hospital in New Jersey. PMID- 3306752 TI - The mind-body problem from a medical perspective. AB - Classical philosophical ideas on the mind-body problem were interpreted in the light of contemporary theories. There are two mind-body theories that are suspect for a natural scientist, namely, parallelism and panpsychism. There are three further theories that are considered radical and not supported by current research: epiphenomenalism, central-state materialism and behaviorism. That leaves us with the two most prevalent theories, namely, interactionism and neural identity. The authors discuss the evidence for and against each theory. PMID- 3306753 TI - Self-regulation method: psychological, physiological and clinical considerations. An overview. AB - Body-oriented therapies as relaxation training and certain forms of meditation are gaining popularity in the treatment and prevention of psychosomatic disorders. In this paper, a new method of self-control called self-regulation method (SRM), derived from autogenic training and Zen meditation, is presented. The technique of SRM is introduced. Secondly, physiological studies on SRM using skin temperature, galvanic skin response, and cortical evoked potentials are presented. Thirdly, the results of psychological tests conducted on SRM are presented. These psycho-physiological studies suggest that SRM may elicit a state of 'relaxed alertness'. Fourthly, clinical applications of SRM are discussed, and 3 cases are presented. Finally, SRM is discussed in relation to the psychology and physiology of 'relaxed alertness'. PMID- 3306754 TI - Periodic disease, recurrent polyserositis, familial Mediterranean fever, or simply 'FMF'. PMID- 3306755 TI - Familial Mediterranean fever (recurrent hereditary polyserositis) in Arabs--a study of 175 patients and review of the literature. AB - Recurrent hereditary polyserositis (RHP) or familial Mediterranean fever (FMF) is a chronic inherited illness of obscure aetiology. The disease is characterised by paroxysmal attacks of fever, peritonitis, pleuritis or arthritis, and predominantly affects Sephardic Jews, Arabs, Turks and Armenians. In this study, we report our 11-year experience of 175 Arab patients with this disease. As with other ethnic groups, the most common manifestation (93.7 per cent) was peritonitis. Arthritis (33.7 per cent) and pleurisy (32 per cent) were next in frequency. Adult patients in this series unlike those in other ethnic groups, rarely presented with arthritis. Similarly rare were amyloidosis, rashes, splenomegaly, hepatomegaly or lymphadenopathy. The aetiology of this disease is not clear but we suspect that abnormalities in catecholamine metabolism may be a factor in the pathogenesis. PMID- 3306756 TI - Clinical characteristics and aetiological classification of insulin-dependent diabetes in the elderly. AB - In a prospective study of 195 newly-diagnosed diabetic patients aged 65 years or over, 80 (41.0 per cent) were treated initially by diet, 89 (45.6 per cent) by diet and oral hypoglycaemic agents, and 26 (13.3 per cent) by diet and insulin. Fifteen patients (7.7 per cent) died within a year of diagnosis. Of 26 patients treated with insulin, six died in the first year, 14 were successfully transferred to diet and oral agent treatment and six continued on insulin--two of whom failed to a trial of oral agents, two showed only a temporary response and two received no trial. A further nine patients were taking insulin 12 months after diagnosis because of no response (eight patients) or a transient response (one patient) only to oral agents. Age, percentage ideal body weight, history of acute onset, blood glucose, glycosylated haemoglobin, and random C-peptide concentration at diagnosis did not discriminate between patients requiring insulin at 12 months and those successfully treated without insulin. Patients who were insulin-dependent 12 months after diagnosis had an increased frequency of ketonuria at diagnosis and a previous medical history of endocrine disease. In insulin-dependent patients there was an increased frequency of HLA DR3 but not DR4 and an increased frequency of thyroid microsomal and gastric parietal cell antibodies but not islet cell antibodies. It is concluded that elderly newly diagnosed diabetic patients who are treated at diagnosis with insulin are not necessarily insulin dependent and can be given a trial of oral agents with safety.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306758 TI - Nuclear magnetic resonance--from molecules to man. PMID- 3306757 TI - Pathogenesis of pulmonary emphysema. PMID- 3306759 TI - Protein structure by solid-state NMR spectroscopy. PMID- 3306760 TI - Potentially lethal damage repair is due to the difference of DNA double-strand break repair under immediate and delayed plating conditions. AB - Cells plated immediately after irradiation on nutrient agar (immediate plating) exhibit a lower survival than cells which are kept under nongrowth conditions before plating (delayed plating). The difference between the survival curves obtained after immediate plating and delayed plating is considered to exhibit the cell's capacity to repair potentially lethal damage. In yeast evidence has been presented previously for the DNA double-strand break (DSB) as the molecular lesion involved in the repair of potentially lethal damage observed at the cellular level. Radiation-induced DSB are repaired in cells plated on nutrient agar, i.e., under growth conditions, as well as in cells kept under nongrowth conditions. In this paper DSB repair under growth and nongrowth conditions is studied with the help of the yeast mutant rad54-3 which is temperature conditional for DSB repair. It is shown that the extent of repair of potentially lethal damage can be varied by shifting the relative fractions of repair of DSB under growth conditions versus nongrowth conditions. Repair of DSB in cells plated on nutrient agar is promoted when glucose is substituted by Na-succinate as an energy source. As a result the immediate plating survival curve approaches the delayed plating survival curve, thus reducing the operationally defined repair of potentially lethal damage. We show that this reduced potentially lethal damage repair is caused, however, by a higher amount of DSB repair in cells immediately plated on succinate agar as compared to glucose agar. PMID- 3306762 TI - [Effect of the dose rate on the synergism of combined ionizing radiation and hyperthermia]. AB - In experiments with yeast cells it was shown that the synergistic effect of a combination of ionizing radiation and hyperthermia is a function of dose rate. It was demonstrated that the temperature at which radiation is delivered should be elevated to obtain the maximum synergistic effect with the increasing dose rate. PMID- 3306761 TI - [Survival and repair of single-stranded DNA breaks after gamma-irradiation of Escherichia coli cells depending on the presence of plasmids pKN101 and COIIB P9]. AB - Plasmids, pKM101 and ColIb-P9, present in an autonomous state in E. coli AB 1157, JC5519, and P3478 cells at the stationary and logarithmic phases of growth, somewhat sensitize the cells to the lethal effect of gamma-radiation and do not influence the radiosensitivity of B/r, Bs-1 gamma R, Bs-1, and W3110 cells. The efficiency of repair of gamma-ray-induced DNA single-strand breaks in AB1157 and P3478 cells containing plasmids is somewhat lower than that in the same non plasmid strains. PMID- 3306763 TI - [Protective effects of cysteamine and anoxia in Escherichia coli mutants]. AB - The values of the oxygen effect (m) and maximum radioprotective effect of cysteamine (DMF*) have been determined for the following Escherichia coli strains: AB1157 (the wild type), AB1886 (uvrA), AB2463 (recA), and p3478 (polA). Three mechanisms are shown to be responsible for the protective effect of cysteamine, they are: (1) anoxia, (2) diminution of the indirect effect, (3) an increased efficiency of enzyme repair. Anoxia is the main contributor to the protective effect in all the strains under study while mechanism (3) is only effective in the wild type strain. PMID- 3306764 TI - [Morphological changes in the lungs after single whole-body irradiation in rabbits]. AB - Morphological changes in rabbit lungs were studied after whole-body nonuniform irradiation (24 Gy) the head and the abdomen being shielded. Acute pneumonitis was shown to develop between the 17th and the 24th day after irradiation. No pulmonary fibrosis was registered 60 days following irradiation. Embolised megakaryocytes were found in the lung capillaries between the 8th and the 24th day after irradiation. PMID- 3306765 TI - Patient care and communication as a science. PMID- 3306766 TI - Imaging of the coronary arteries using digital grey-scale angiography. PMID- 3306767 TI - Improved localisation for radical treatment of breast carcinoma using CT and ultrasound. PMID- 3306768 TI - Breast sonography. PMID- 3306769 TI - Aspects of patient care: the consumer's view of ultrasound in pregnancy. PMID- 3306770 TI - Atherosclerosis of the lower limb. AB - Atherosclerosis is a disease of the arteries which is characterised by the formation of yellowish plaques of atheroma in the inner lining of the arteries. It chiefly affects the cerebral arteries, the coronary arteries and the arteries supplying the lower limb. This presentation will concentrate on the latter. PMID- 3306771 TI - Low-cost mass screening with mammography as a means of reducing overall mortality from breast cancer. AB - Screening mammography has made major contributions in the earlier detection of breast cancer. It is the only reliable means of identifying non-palpable cancers, and can detect many "minimal" breast cancers when they appear to be curable. Low cost, high-quality mass screening mammography is indeed feasible and can be expected to reduce overall mortality from breast cancer. Recognition of the need and desire to provide the service are essential initial motivating factors. PMID- 3306773 TI - Recent advances in screen-film mammography. AB - Today there are many dedicated mammographic x-ray units available that are capable of providing high-quality screen-film mammograms. Likewise, screen-film combinations designed for mammography are capable of providing images with appropriate contrast, resolution, and noise levels. Proper film processing is most important in order to obtain the appropriate film speed and contrast. A higher-speed screen-film combination designed for mammography can provide mammograms with significantly lower radiation dose, especially for grid and magnification techniques. Designing x-ray units and techniques as well as screen film combinations with the singular goal of reducing radiation dose will always involve compromises and trade-offs. The key is to always consider optimizing all of the factors that affect image quality: (1) appropriate beam quality, (2) breast compression, (3) consideration of the use of grids, (4) good geometry, (5) selection of an appropriate screen-film combination, and (6) proper film processing. Optimization of all appropriate imaging factors will produce high quality mammograms at the lowest radiation dose to the patient. PMID- 3306772 TI - Mammography equipment: principles, features, selection. AB - 1. Three-phase and constant potential generators may offer advantages over single phase generators. These include shorter exposure times with less chance for motion unsharpenss, more adequate exposure and possible lower dose, and longer tube life. 2. Control of tube voltage in increments of 1 kVp are desirable for screen-film mammography and 2 kVp for xeromammography. 3. Tube loading limitations should be capable of allowing an adequate mA and mAs output. A mammography unit with a lower mA output may require longer exposure times with consequent motion unsharpness and/or higher dose. The maximum mA output is limited by the power rating of the tube and not by the power rating of the generator, which is usually much higher. Thus, tube rating charts rather than generator power rating should be used to compare the mA output of different mammography units. 4. Phototimer capability can reduce exam time, facilitate proper exposure, and reduce radiation dose. Units with a greater number of density steps and three or more photocell locations, one of which is near the edge of the film holder, provide better phototimer results. 5. A molybdenum target, beryllium window tube with 0.03 mm molybdenum added filtration is presently preferred for screen-film mammography. A tungsten target tube with 1 to 2 mm added aluminum filtration is advised for xeromammography. 6. Effective local spot size for contact mammography should be in the range of 0.2 to 0.5 mm. However, high resolution also requires sufficiently long source-to-image-receptor distances. Using measured focal spot size and source-to-image-receptor distance, it has been shown that some mammography units do not fully utilize the resolution capabilities of some available screen-film systems. On the other hand, a focal spot that is too small may limit the field size and lead to uneven energy distribution in the x-ray field. 7. In order to perform standard and supplementary mammographic projections, the C arm assembly must be capable of being located at multiple positions within a 180 degrees rotation. Greater degrees of rotation are not required. 8. The heat dissipation capability should be adequate to accommodate the anticipated work-load in terms of number of patients and patient scheduling. A mammographic unit with an anode heat capacity of 90,000 heat units or more should be adequate for most practices. A mammography unit with a heat capacity of 20,000 heat units or less may require waiting time between exposures or studies in a high-volume mammography practice. 9. The compression plate should be made of plastic, usually 1 to 4 mm thick.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306774 TI - History and recent developments in xeroradiography of the breast. AB - The article deals in very broad terms with the development of xeroradiography. The imaging process is a by-product of the search by Chester Carlson for a method to copy documents. The early experimental work was done at Battelle Memorial Institute, Columbus, Ohio. Clinical trials followed the fabrication of a machine by the Xerox Corporation. The machine as we know it today was introduced to the market in 1970-1971. PMID- 3306775 TI - Imaging features and management of characteristically benign and probably benign breast lesions. AB - While only a few benign lesions in the breast have a characteristic appearance, many others have a high probability of being benign. In those situations, follow up by palpation and mammography is a reasonable alternative to excisional biopsy. The appearance of characteristically benign lesions of the breast and an approach to the management of probably benign lesions is presented. PMID- 3306776 TI - Nonmammographic breast imaging techniques: current status and future developments. AB - X-ray mammography is the only breast imaging technique with proven efficacy for screening. Ultrasound is useful for cyst/solid differentiation and to guide the aspiration and localization of selected lesions. All other modalities should be considered experimental with no demonstrated efficacy for detection or diagnosis. PMID- 3306777 TI - The control of breast cancer through mammography screening. What is the evidence? AB - There are few forms of cancer that can be effectively controlled. Now that there is sufficient evidence demonstrating that mortality from breast cancer can be reduced with the help of mammography screening, we are faced with the challenge of applying this method on a large scale. What are the major practical problems? The medical profession and decision makers must be made familiar with nature of the recent achievements and with their practical implications. The personnel who will be responsible for undertaking screening have to be adequately trained before screening gets under way. Women should understand the benefits that they can gain from mammography screening so that they will be sufficiently motivated to attend. This can be achieved by sincere, periodic information through the mass media. It is important that every woman eligible for screening understand that her risk of dying from breast cancer will be half as much if she participates in screening as it would be if she fails to participate. She should also be aware that the smaller cancers detected at screening can often be removed by breast conserving surgery without the need for mastectomy. Because mammography does not prevent breast cancer, women must be aware of the fact that mammography has to be repeated at regular intervals if the benefits of screening are to be maintained. Additionally, breast self-examination should be practiced in the interval between screens. Finally, decision makers will have to realize that screening with mammography can, in the long run, lead to reduction of health service costs. It is obvious that the expenses involved in taking care of a patient with advanced breast carcinoma can be very high. As it has been clearly demonstrated that properly performed screening will significantly decrease the number of advanced, costly breast carcinomas, a large proportion of these expenses will be saved in the population invited to screening. Because screening itself drains economic resources, the costs of screening outweigh the savings until the number of advanced cancers decreases; however, after this occurs the expenses of screening will be far less than the savings. The savings arise from the smaller number of advanced, costly cases. The results to date are convincing enough to justify recommending large-scale mammographic screening. The Swedish government has recommended screening with mammography for all women aged 40-74. This recommendation repeatedly emphasizes the necessity of high quality examinations interpreted by well-trained radiologists. PMID- 3306778 TI - Urinary tract infection in children: putting radiology in its place. AB - Bacterial infection of the child's urinary tract can be viewed as a phenomenon in which bacterial virulence factors outweigh host resistance mechanisms. Structural abnormalities that compromise the host account for only a small part of the picture, but it is important to discover these abnormalities, and uroradiologic examinations can do this superbly. There are many ways to image the kidneys and the lower urinary tract, but more important than debating which of these tests to use is deciding who should be studied, why, and when, and what it means when an abnormality is discovered. PMID- 3306779 TI - Automated and hand-held breast US: effect on patient management. AB - Breast ultrasound (US) was performed, with either an automated or a hand-held unit or both, on 1,212 patients. Of 612 asymptomatic patients, 118 (19.3%) had solitary cysts; ten (1.6%), multiple cysts; and 29 (4.7%), benign masses; however, US depicted only one (0.2%) nonpalpable mammographically undetected carcinoma. In 513 patients with palpable masses (n = 396) and with mammographically detected masses (n = 117), US was useful in avoiding an unnecessary biopsy in 113 (22.0%), leading to aspiration of a cyst in 26 (5.1%), monitoring multiple cysts in 31 (6.0%), avoiding aspiration of a solid mass in 65 (12.7%), supporting biopsy of an equivocal solid mass in 91 (17.7%), and demonstrating a nonpalpable mammographically detected carcinoma in six (1.2%). In 224 patients with either palpable or mammographically visible masses who underwent both methods of US, the 4.5-MHz or 3.9-MHz automated unit depicted the abnormality in 119 (53.1%) and the 7.5-MHz hand-held unit, in 171 (76.3%). Of 18 cancers evaluated with both methods, all were detected with the hand-held unit and only 12 were seen with the automated unit. PMID- 3306780 TI - Exogenous lung surfactant: effect on radiographic appearance in premature infants. AB - At birth, premature infants of 25-29 weeks gestation, at high risk for development of neonatal respiratory distress syndrome (RDS), were given a single dose (90 mg) of calf lung surfactant extract (CLSE) by intratracheal instillation. The frequency and severity of RDS were assessed with use of a simple radiographic scoring system in which pulmonary parenchymal densities and the prominence of the air-bronchogram effect were used as indicators of widespread atelectasis. Radiographs were obtained in surfactant-treated and control infants within the first 90 minutes of life as part of an initial evaluation of their pulmonary status. Subsequent examinations were performed at less than 24 hours and less than 48 hours of age. Radiographic assessment of lung disease compared consistently with coordinated data on oxygen and mean airway pressure requirements of the infants. Both indicated a significantly decreased frequency and severity of RDS in the infants treated with surfactant. The results provide supporting evidence of the effectiveness of exogenous lung surfactant replacement in mitigating RDS in very premature infants. PMID- 3306781 TI - Contrast venography of the leg: diagnostic efficacy, tolerance, and complication rates with ionic and nonionic contrast media. AB - A prospective, three-center study of two contrast agents for leg venography was performed to evaluate both the relative frequency of adverse effects and whether low-osmolality agents provided significant advantages for this procedure. Fifty four patients were studied with the standard preparation (iothalamate meglumine) and 57 with a nonionic agent (iopamidol). Both were used at an iodine concentration of 200 mg/mL, and there were no differences in volume of contrast material, duration of infusion, percentage of positive studies, or overall diagnostic adequacy. Patient discomfort was less with iopamidol than with iothalamate (18% vs. 44%), although discomfort was generally mild in both groups. By objective follow-up studies, the frequency of postvenographic thrombosis was not significantly different in the two groups (8% vs. 9%). Contrast venography, then, had a low frequency of complications when either a dilute conventional or a low-osmolality agent was employed. Although the frequency of postvenographic thrombosis was low with both agents, patient discomfort was less with the low osmolality formulation. PMID- 3306782 TI - Acute unilateral pulmonary nonventilation due to mucous plugs. AB - Acute bronchial obstruction by mucous plugs may be manifested clinically by dyspnea, hypoxemia, and respiratory alkalosis mimicking pulmonary thromboembolism. In eight cases with complete interruption of ventilation to an entire lung, chest radiography failed to reveal the extent of the obstruction. Perfusion was substantially less affected than ventilation. Routine ventilation perfusion scintigraphy with technetium-99m DTPA aerosol aids in the diagnosis of acute major bronchial obstruction in patients with suspected pulmonary thromboembolism. PMID- 3306783 TI - Normal and abnormal pancreas in children: US studies. AB - The real-time ultrasound images of the pancreas in 273 children without pancreatic disease were prospectively analyzed to determine the normal appearance of the pancreas. The dimensions of the head, body, and tail of the pancreas were correlated with patient age, weight, height, and body surface area. Correlation between pancreatic dimensions and patient age was as good as or better than that obtained with the other physical parameters. In general, the normal pancreas had a similar sized head and tail with a thinner body as compared with the abnormal pancreas, and an echogenicity that was equal to or slightly greater than that of the liver. Analysis of the images of 13 patients with pancreatitis showed that the presence of a dilated main pancreatic duct was the most useful feature in suggesting an abnormality. Evaluation of pancreatic size, configuration, and echogenicity was not reliable in the differentiation of the normal from the abnormal pancreas. PMID- 3306784 TI - Parathyroid variants: US evaluation. AB - High-resolution (10-MHz) ultrasonography was performed in 181 patients with primary or secondary hyperparathyroidism during a 4-year period and evaluated retrospectively. Thirty-seven unusual-appearing parathyroid tumors were found among 235 parathyroid glands identified as abnormal. There was pathologic correlation in 36. The typical appearance of parathyroid adenoma was that of an oval hypoechoic or anechoic lesion in the neck, aligned in a craniocaudal direction and often posterior to the thyroid. Morphologic variations from the norm included giant size (n = 11) (4.6%), cystic changes in a solid tumor (n = 9) (3.8%), calcified glands (n = 6[in three patients]) (2.5%), a multilobulated configuration (n = 5) (2.1%), an inhomogeneous pattern (n = 5) (2.1%), and a parathyroid cyst (n = 1) (0.4%). Recognizing the abnormal parathyroid variants can increase the diagnostic accuracy of sonographic examination. PMID- 3306786 TI - Clinicians' appraisal of sonography. AB - The perceived efficacy of sonography in making diagnostic and management decisions in clinical practice was determined through a questionnaire survey of physicians who had recently referred patients to a university radiology department. Of 2,178 questionnaires sent, 1,611 were returned (74%). Sensitivity and specificity of sonography, corrected for verification bias, were 72% and 84%. Referring physicians considered the studies to be of value in arriving at the final diagnosis and in the clinical management of patients in approximately two thirds of the cases. Results were considered of no value and misleading in 4% of the cases. Sonography was more accurate and was reported to be valuable by approximately 10% more physicians when a specific indication for an examination could be identified rather than when indications were vague and when sonographic findings were abnormal rather than normal (P less than .005). In general, sonography was of equal value to both specialists and nonspecialists. The results of this study suggest that sonography is, and is perceived by clinicians to be, an accurate and valuable clinical diagnostic modality. PMID- 3306785 TI - Lymphomatous superficial lymph nodes: US detection. AB - Superficial adenopathy is the most frequent clinical manifestation of lymphoma, both at initial workup and later when disease recurs. Data obtained by means of physical examination and ultrasonography (US) of the cervicosupraclavicular, axillary, and inguinal regions were compared for 120 patients, 60 at the time of initial staging and 60 during follow-up for a previously treated lymphoma. Twenty nine in the second group had recurrent disease, as confirmed with histologic examination. For all 120 patients, US revealed clinically impalpable lesions in an average of 10.8% of cases for the cervicosupraclavicular region, 17.9% for the axillary region, and 4.1% for the inguinal region. Eight of the 29 relapses were not detected at physical examination, and three were demonstrated solely with US. These findings emphasize the value of US exploration of the superficial node bearing regions in patients with lymphoma, during both initial staging and follow up. PMID- 3306787 TI - Surgical portosystemic shunts in children: assessment with duplex Doppler US. Work in progress. AB - The patency of 12 surgical portosystemic shunts in 11 children with portal hypertension was assessed with duplex Doppler ultrasonography. Results were compared with surgical, angiographic, and clinical findings. Seven of nine patent shunts were directly seen, and flow in them was assessed. One proximal splenorenal and one mesentericocaval shunt were not directly seen because of intestinal meteorism. The obstructed shunts were not seen, and no flow could be detected at their site. The presence and direction of flow in the splanchnic venous system were determined in all children, obviating the need for further angiographic studies. PMID- 3306788 TI - A prudent approach to Doppler US. PMID- 3306789 TI - Mucin-hypersecreting carcinoma of the pancreas. AB - Five cases of prominent, diffuse dilatation of the main pancreatic duct caused by mucin-hypersecreting carcinoma are reported. Adenocarcinoma was noted mainly within one markedly dilated main pancreatic duct. On endoscopic retrograde pancreatograms, dilated main pancreatic ducts with amorphous or well-defined filling defects resulting from mucin (five patients) or tumor (one patient) were noted. The proximal portion of the main pancreatic duct alone was delineated in three cases because of reflux of contrast material as a result of the presence of excessive mucin and a patulous orifice of the papilla of Vater (major duodenal papilla). Diffuse dilatation of the main pancreatic duct was demonstrated or suggested on computed tomographic (CT) and ultrasound scans. Four patients who underwent operations are alive and free from carcinoma (mean, 50 months after diagnosis). Whenever prominent, diffuse dilatation of the main pancreatic duct is encountered on CT or ultrasound scans, endoscopic retrograde pancreatography is mandatory to permit confirmation or ruling out of mucin-hypersecreting carcinoma of the pancreas. PMID- 3306790 TI - The periportal collar: a CT sign of liver transplant rejection. AB - A low-attenuation region around the peripheral portal tracts (periportal collar) was noted on 13 of 43 computed tomographic studies obtained in 17 patients who had undergone 20 orthotopic liver transplantations. This region was then correlated with acute liver transplant rejection. The periportal collar as a sign of rejection has a sensitivity of 1.0, a specificity of 0.86, a negative predictive value of 1.0, and a positive predictive value of 0.62. This sign corresponds histopathologically with the lymphocytic portal infiltration that occurs during acute liver transplant rejection. Though viral hepatitis and nonspecific portal triad edema can also result in a periportal collar, acute liver rejection is strongly suggested when this sign is seen after liver transplantation. Early diagnosis and confirmation of rejection permit faster and more appropriate clinical intervention. PMID- 3306791 TI - Complicated first-trimester pregnancies: evaluation with endovaginal US versus transabdominal technique. AB - Endovaginal ultrasound (US) was performed in 38 pregnant women at 5-12 menstrual weeks, when the initial transabdominal sonograms had been considered inconclusive or equivocal. Clinical follow-up disclosed 32 intrauterine pregnancies (12 living, 18 spontaneous incomplete abortions, and two embryonic demises) and six ectopic pregnancies. In the 32 intrauterine pregnancies (normal and abnormal), the correct diagnosis was made in all cases with endovaginal US. The endovaginal images demonstrated the intrauterine embryo, its heart motion, and the yolk sac more clearly and more often when these structures were not apparent on the transabdominal scans. Abnormal gestational sacs were better resolved. In the six cases of ectopic pregnancy, while an extrauterine ectopic sac was visualized in only three, absence of an intrauterine gestational sac was confirmed in all cases with endovaginal scanning. No endovaginal study yielded less information than its transabdominal counterpart. Endovaginal sonography is likely to be diagnostic when transabdominal images fail to yield a definitive diagnosis in early pregnancies. PMID- 3306792 TI - Staghorn calculi: endourologic management in 120 patients. AB - Symptomatic staghorn renal calculi were removed from 106 of 124 kidneys (85%) with percutaneous ultrasonic lithotripsy. All remaining fragments were less than 5 mm in greatest diameter, small enough to pass spontaneously. Use of two or more access routes was necessary in 91 kidneys (73%), and 29 patients (24%) required multistage nephrolithotripsy for complete stone removal. The total operative time averaged 162 minutes per patient. The average hospitalization period was 12.5 days, and the average convalescence time after discharge was 15 days. The most common adverse effect was bleeding necessitating transfusion (57%). Infection occurred in 27% of patients and may be intrinsic to removal of these infected stones. There was one death in the study group: a patient with multiple medical problems died of myocardial infarction. Successful stone extraction requires a clear understanding of renal anatomic features, properly placed access routes, and radiologic-urologic expertise. It is concluded that staghorn calculi can be safely and effectively treated with the use of percutaneous techniques. PMID- 3306793 TI - Evidence for myogenic vasomotor activity in the coronary circulation. PMID- 3306794 TI - Cerebellar astrocytomas in children. PMID- 3306795 TI - Spinal cord astrocytomas of childhood. PMID- 3306796 TI - Immunocytochemical characterization of long-term medulloblastoma cultures: preliminary report. PMID- 3306797 TI - Immunopathology of leptomeningeal dissemination of brain tumors. PMID- 3306798 TI - Pineal region tumors. PMID- 3306799 TI - Proliferative potential of pediatric brain tumors. PMID- 3306800 TI - Clinical application of monoclonal antibodies against glioma-associated antigens. PMID- 3306801 TI - Anti-nutritive factors in animal feedstuffs and their effects on livestock. AB - This review deals with compounds -mainly organic-which when present in the diet, may affect the health of livestock or interfere with normal feed utilization. The anti-nutrients occur as natural constituents of plants and animal feeds, as artificial factors added during processing, or as contaminants of the ecosystem. Their mode of action, metabolism in the living body, and detoxification mechanisms, are described briefly. It is stressed that ruminants and monogastric species frequently differ in susceptibility to the same toxicant, mainly due to the action of rumen microorganisms. The toxicants described are classified as follows: proteins depressing digestion (protease inhibitors and lectins); glucosides; phenolic substances; other toxicants occurring in plants; substances interfering with the utilization of vitamins; mycotoxins; pesticides and industrial chemicals. PMID- 3306802 TI - Nutritional and endocrinological influences on the composition of animal growth. AB - Several domesticated species of mammals are raised to provide protein for human consumption. The goal of producers is to generate a product, lean meat, efficiently. Much of the weight gain of animals is fat, a large portion of which is not needed by the animal and unwanted by the human consumer. Thus, improvement in efficiency of animal growth must consider not only rate of weight gain and use of feed to support the gain but also the composition of the gain. One method to improve efficiency of growth, including body composition is to lower the energy intake of animals; feeding less than ad libitum is particularly effective for some species. There are three types of endocrines, anabolic steroids, growth hormone and adrenergic agonists, that have demonstrated ability to change mammalian growth and body composition. Exogenous anabolic steroids increase weight gain, improve efficiency of feed utilization and change body composition toward more muscle and less fat. They are especially effective in ruminant species and are used in beef cattle. Exogenous growth hormone has the same effects as anabolic steroids but is effective in nonruminant species as well. Exogenous adrenergic agonists, analogs of norepinephrine, have marginal effects on weight gain and feed efficiency but favorably change body composition in all species. As more is understood about the control of endocrine secretion, the possibility arises for animal manipulation by administration of exogenous releasing factors or release-inhibiting factors or by changing central nervous system neurotransmitter control of the hypothalamic production and release of these factors. It is also possible to use selective immunization to modify endogenous hormones. Thus, biological knowledge coupled with modern technology continues to open many frontiers to favorably change animal growth and composition. Some of these approaches are in use, several are in experimental use and others await experimental demonstration of utility. PMID- 3306803 TI - Zinc and the central nervous system. AB - The effect of zinc nutriture and metabolism on brain function has been reviewed. Zinc nutriture and its effect on the concentration and metabolism of essential elements (e.g. zinc, copper, manganese, magnesium, sodium, potassium and calcium) and on the concentration and metabolism of toxic elements (e.g. aluminum and lead) are discussed in relationship to brain function. In addition, possible interrelationships between zinc nutriture and metabolism and its effect on a number of diseases including acrodermatitis enteropathica, Pick's disease, Alzheimer's disease, schizophrenia, fifth day fits, and epilepsy are discussed. Descriptions and comparisons of methods to measure brain zinc are presented. Behavioral changes and the altered brain morphology which have been associated with zinc deficiency are reviewed. Some possible mechanisms for the association of anorexia with zinc deficiency are outlined. Perinatal brain damage produced by early zinc deficiency followed by rehabilitation with adequate zinc appears to be long term, maybe permanent. Interrelationships between zinc nutriture and aspects of neurochemistry are outlined. Some of the neurochemistries discussed include nucleic acid and protein synthesis, cytoskeletal proteins, neurotransmitters (e.g. catecholamines, indoleamines, glutamate, gamma-aminobutyric acid, and neuropeptides), neurotransmitter receptors, 7S nerve growth factor and zinc binding proteins. Recent evidence linking zinc and neurotransmission is discussed. PMID- 3306804 TI - Computerized EEG correlates of depression and antidepressant treatment. AB - Quantitative EEG was used to examine: differences between non-medicated depressives and normal controls; chronic effects of antidepressant drug treatment. Spectral analysis of cortical EEG activity revealed: significant group differences in slow and fast wave activity and significant differences in hemispheric asymmetry; limited effects of antidepressants which were restricted to slow wave activity. Group differences are supportive of cortical disactivation of the right-hemisphere in depressive disorders and the limited drug-EEG effects in depressives argue for additional studies on multi-lead oriented pharmaco-EEG profiles in psychiatric populations. PMID- 3306805 TI - [Role and mechanism of lipoprotein lipase activity in lipoprotein metabolism]. PMID- 3306806 TI - [Clinical trial of epirubicin in patients with cardiologic contraindications for the use of doxorubicin]. PMID- 3306807 TI - Malignant lymphoma of the salivary gland: case reports and review of the literature. AB - Six cases of malignant lymphoma with unusual presentation in the salivary gland are reported here. In all subjects (except one), the lesion was located in the parotid gland. After further investigation and in accordance with the Ann Arbor staging system, patients' disease stages were I (1), II (3), III (1), and IV (1). Following the establishment of diagnosis through either tumor biopsy or resection, radiotherapy was given for early (I-II) and chemotherapy for more advanced (III-IV) stages of malignancy. With an average follow-up period of 27 months, overall 33% (2/6) survival and 67% (4/6) local control rates were observed. The literature is reviewed with consideration of clinicopathologic features and results of applied treatment. PMID- 3306808 TI - Which RBE for iodine 125 in clinical applications? AB - The problem of the selection of a RBE value for 125I is discussed for clinical applications in interstitial therapy. Microdosimetric studies indicate that the emission of the 125I has a y spectra similar to X-rays of 12-140 keV (conventional X-rays), but differs from 60Co, 137Cs gamma-rays and high energy X rays. The radiobiological data available show RBE values ranging from 1 to 2.4 for 125I (reference beam 60Co). Although obtained with different biological systems and endpoints, RBE values of 1.15-1.20 are in general observed for high doses and high dose rates. On the other hand, higher RBE values (up to 2) are observed at low doses or low dose rates, which is consistent with theoretical and microdosimetric data. PMID- 3306809 TI - Thermal enhancement of radiation response: a growth delay study on superficial human tumour metastases. AB - In a quantitative study of 96 nodules in 10 patients, an enhancement of radiation response has been demonstrated following the addition of a single heat treatment 3-4 h after a single dose of radiation. Thermal enhancement ratios ranging from greater than 1.6 to 4.2 have been derived from growth-delay curves obtained by ultrasonic and caliper tumour volume measurements. Nodules subjected to heat and radiation regress more rapidly than those receiving radiation alone, with median tumour volume halving times of 15.5 and 70 days, respectively. The total volume reduction was greater in heated nodules and the nadir values were observed later compared with nodules receiving radiation alone. PMID- 3306810 TI - A comparison of Doppler examination and digital subtraction angiography with surgery in carotid disease. PMID- 3306811 TI - Digital angiography in children. PMID- 3306812 TI - Percutaneous needle biopsy guided by ultrasound in the diagnosis of intraabdominal masses. PMID- 3306813 TI - Sonography for space-occupying lesions in the liver. PMID- 3306814 TI - Tumors of the nasopharynx: review of 132 cases. PMID- 3306815 TI - Renal function during bovine neurotensin infusion in man. AB - The peptide hormone neurotensin (NT) is found mainly in gut endocrine cells of the ileum, but has also been identified as a putative neurotransmitter in the central and peripheral nervous systems. It may have a dual role as a circulating gastrointestinal hormone and peripheral neurotransmitter. Its predominant effects are to reduce oesophageal sphincter tone, inhibit gastric secretion and emptying and inhibit intestinal motility, but stimulate intestinal and pancreatic exocrine secretion; NT-like immunoreactivity has been found in kidney and therefore NT may influence renal function. When infused i.v. in rabbits it causes antinatriuresis. We have studied its renal effects in 11 healthy males by i.v. infusion under conditions of altered dietary sodium. Postprandial circulating neurotensin levels were reproduced by infusion. There were no consistent systemic or renal haemodynamic effects. Plasma electrolytes and renin did not change. Only renal chloride excretion changed significantly, falling by ca. 30%, and recovering after infusion. There is no evidence for a specific renal tubular chloride transport mechanism, but coupled cotransport, Na+:K+:2CI-, may be hormonally regulated. NT might stimulate this process and contribute to the renal response to changes in dietary composition, especially sodium intake. PMID- 3306817 TI - Kashin-Beck disease. AB - Kashin-Beck disease is the most frequent rheumatologic problem of children in China. Although it is acquired environmentally and frequently leads to life-long crippling, the etiology remains an enigma. PMID- 3306816 TI - Occurrence of VIP and peptide HM in human pancreas and their influence on pancreatic endocrine secretion in man. AB - By immunohistochemistry it was found that VIP- and peptide HI/peptide HM (PHI/PHM)-like immunoreactivity occurred in autonomic neurons in the human pancreas. Antisera against both VIP and PHI/PHM reacted with neuronal cells in local ganglia and these ganglia also contained PHI/PHM- and VIP-immunoreactive fibre plexuses. VIP- and PHI/PHM-positive fibres were also seen close to the Langerhans' islets. In addition, PHI/PHM- but not VIP-like immunoreactivity was observed in the endocrine cells often located in the periphery of the islets. The nature of these PHI/PHM-positive cells remains to be established. I.v. infusion of VIP at constant rates of 300 and 900 pmol/kg X h for 30 min in 6 healthy volunteers resulted in plateau values of 102 +/- 26 and 291 +/- 25 pM, respectively. These levels of VIP which are above those found in the circulation under physiological conditions stimulated secretion of insulin, C-peptide and pancreatic glucagon dose-dependently. On the contrary prolonged (60 min) infusion of PHM in doses resulting in plasma levels up to 1340 +/- 405 pM had no effect on pancreatic hormone secretion. These findings suggest that VIP is a likely neurotransmitter in the control of endocrine pancreatic secretion while PHM has a less prominent role, if any. PMID- 3306818 TI - Responding to the needs of children with chronic illness. The Title V approach. AB - We have established an approach through Title V which involves 1) the Title V state system; 2) the tertiary level in universities, children's hospitals, and other major institutions; and 3) the community level, with local physicians, school staff, and community health, mental health, and social service providers for building a system of care for specific groups of chronically ill and disabled children using all available resources--public, private, and voluntary. The challenge in the 1990s as we move to the twenty-first century is to use that experience to support a generic system of care; each disease may have medically different consequences but all chronic illnesses share important characteristics for the child and family. The nation will be better served by programs that address children with special health needs as a class than by programs that are duplicated 200 times or more. The system developed cannot be a rigidly controlled or structured system. We live in a free pluralistic society where services to children are provided by public, private, and voluntary resources and by many different agencies and professionals. But it can be a more rational and better developed approach to long-term care based on the experience and knowledge we have gained in the past 50 years. PMID- 3306819 TI - Chronically ill children in schools: programmatic and policy directions for the future. AB - Children with arthritic diseases and other chronic illnesses will need some form of "special" consideration by the educational system at some point in their school careers. There is great variability among schools, school systems, and states in how the problems of educating chronically ill children are handled and how the state and federal special education laws and health codes are implemented. This paper reviews current practices and makes recommendations for improvements in school-based services to children with chronic illnesses. PMID- 3306820 TI - Health status assessment in pediatric rheumatology. AB - Major issues in the conceptualization and measurement of health status in pediatric rheumatology are considered. Recent work on the Arthritis Impact Measurement Scales (AIMS) questionnaire for adults provides a framework for the discussion. PMID- 3306821 TI - The history of pediatric rheumatology in the United States. AB - Children were afflicted uncommonly by the rheumatic diseases so that one physician's experience was obviously limited. In the latter half of the nineteenth century a few physicians began to study several of the diseases systematically in hospitals. Slow progress continued in the twentieth century but was accelerated by the grants in the 1950s which made possible the establishment of well-staffed centers for the treatment of these patients and their long-term clinical and laboratory study. Teaching of medical students and resident staffs was improved. A serious medical problem was getting the attention it deserved. PMID- 3306822 TI - Current knowledge of the etiology and pathogenesis of chronic uveitis accompanying juvenile rheumatoid arthritis. AB - Inflammation of ocular and articular tissues occurs together with high frequency. In children with juvenile rheumatoid arthritis, uveitis not only is a frequent occurrence but constitutes the most serious complication of the most common type of chronic inflammatory arthritis of childhood. PMID- 3306824 TI - Studies of immunosuppressive drugs in the treatment of lupus nephritis. AB - Long-term, controlled trials to evaluate the efficacy and toxicities of immunosuppressive drug therapies compared to treatment with corticosteroids alone in the management of patients with lupus nephritis have been performed. The studies demonstrate that immunosuppressive drug regimens, particularly intravenous cyclophosphamide, reduce the likelihood of end-stage renal failure. However, toxicities such as herpes zoster and ovarian failure were found to be increased in patients with cyclophosphamide. PMID- 3306823 TI - Patterns of autoimmunity to nucleoproteins in patients with systemic lupus erythematosus. AB - The ANAs described above can be accounted for on the basis of an immune response to just three nucleoprotein structures--the nucleosome, the U1 snRNP, and the Ro particle. When these nucleoproteins are looked at in turn, the following picture emerges. The nucleosome is identified by both anti-histone and anti-DNA antibodies. Anti-histone H1 and anti-histone H2B antibodies predominate and tend to occur together. They, as well as the anti-DNA antibodies with which they appear to be linked, recognize external features of the intact nucleosome. The U1 snRNP is recognized by both anti-U1 RNP and anti-Sm antibodies. Most so-called anti-U1 RNP antisera actually contain several linked sets of different antibodies that are directed against various polypeptides (68K, A, and C) found on the U1 snRNP. Anti-Sm antibodies are linked to the occurrence of anti-U1 RNP antibodies. The Ro particle is recognized by both anti-La and anti-Ro antibodies, and almost all sera that contain anti-La antibodies also contain anti-Ro antibodies. Thus, it appears that these three nucleoprotein particles become direct focal points for autoimmune responses in SLE. It is difficult to explain such focused responses on the basis of a general defect in immune regulation or spontaneous B lymphocyte hyperactivity. Rather it appears that these nucleoproteins themselves are directly involved in determining which B-lymphocyte clones become activated. Thus, the simplest rationalization for the patterns with which these autoantibodies occur is to invoke the possibility that the particles themselves are directly triggering autoimmune responses. PMID- 3306825 TI - Radiological approaches in the evaluation of joint disease in children. AB - In summary, the newer technologies in radiology have allowed us to visualize more clearly the manifestation of joint disease in children. The presence of small erosions and cartilage damage can be seen much better with magnetic resonance imaging than with any other modality short of arthrography, a much more invasive examination. Joint effusion, although sometimes visualized with conventional radiography, is probably best recognized with ultrasound or magnetic resonance imaging, although it can be detected with computed tomography as well. For the evaluation of avascular necrosis that can be associated with steroid use in joint disease, bone scintigraphy is a simple, sensitive method. Magnetic resonance may be as or more sensitive and gives additional information as well. In the detection of change with time, conventional radiography probably will remain the standard as it is still the simplest, least expensive examination; however, it has many limitations in specific cases. Bone scintigraphy may be of value in selected cases. Although we have still not had enough experience with magnetic resonance imaging to use it as a way of evaluating progress of joint disease, it promises to be the most sensitive radiologic measure of evaluating progress as small anatomical changes can be detected within the cartilage, which cannot be done easily with other means. PMID- 3306826 TI - Morphology and biochemistry of the growth plate. AB - The structure and function of the growth plate are discussed in detail by Dr. Brighton. Specifically, the blood supply, histology and histochemistry, biochemistry, and ultrastructure of the various zones of cartilagenous portion of the growth plate, as well as the bony and fibrous portions of the growth plate, are described. PMID- 3306828 TI - A consumer report on stock trays for dental arches. PMID- 3306827 TI - A moulding technique for the construction of porcelain crowns. PMID- 3306829 TI - Maryland bridgework using restored posterior abutment teeth. PMID- 3306830 TI - [Values of various immunologic parameters in kidney transplants]. PMID- 3306831 TI - [Acute hepatitis and gallbladder]. PMID- 3306832 TI - [Eikenella corrodens pleuropulmonary infections]. PMID- 3306833 TI - [Substitutes for a heterologous pericardium: a call to attention]. PMID- 3306834 TI - [Comparative study of the diagnostic efficacy of percutaneous transcutaneous cholangiography and echography in the patient with cholestasis]. PMID- 3306835 TI - [Results of gastroplasty in the treatment of cancer of the esophagus. Review of the last 5 years]. PMID- 3306836 TI - [Toxic megacolon caused by Salmonella enteritidis]. PMID- 3306838 TI - Genetics of steroid 21-hydroxylase deficiency. PMID- 3306837 TI - Biological actions of prolactin in human breast cancer. PMID- 3306839 TI - Mullerian inhibiting substance: gene structure and mechanism of action of a fetal regressor. PMID- 3306840 TI - Developmental and hormonal regulation of neuroendocrine gene transcription. PMID- 3306841 TI - The mammalian GnRH gene and its pivotal role in reproduction. PMID- 3306843 TI - [The renin-angiotensin-aldosterone system in obesity associated with essential arterial hypertension]. PMID- 3306842 TI - Cachectin: a pluripotent hormone released during the host response to invasion. PMID- 3306844 TI - [[Effects of salizole on the antihypertensive activity of captopril. Comparison with indomethacin]. PMID- 3306845 TI - [Arterial hypertension: new frontiers in dynamic blood pressure monitoring and chronobiometry]. PMID- 3306846 TI - [Regulation of receptors and mechanism of action of growth hormone]. AB - The initial step in the action of growth hormone (GH) is interaction with specific sites localized in target cell membranes. Growth hormone receptors have been demonstrated in different tissues and have been extensively studied in the liver. 125I-human growth hormone injected IV in the intact male rat is internalized in the hepatocytes by a receptor-mediated process; the radioactive material is sequentially associated with plasma membranes, endocytic structures and lysosomes. A dramatic decrease in the number of hepatic growth hormone receptors has been demonstrated in several situations of growth defect in the rat. GH, insulin and estrogens play a role in the regulation of hepatic growth hormone receptors, but their mechanism of action is not clear. GH receptors have been partially purified; the binding subunit has an approximate MW of 110,000 in rat hepatocytes and adipocytes and in IM-9 lymphocytes, a MV of 50 to 70,000 in rabbit liver. Monoclonal antibodies raised against the GH receptor will facilitate studies of receptor structure and function. The postreceptor events in growth hormone action are unknown. No second messenger or mediator has been demonstrated. Elucidation of the early events that follow activation of the growth hormone receptor is a priority. PMID- 3306847 TI - [22K and 20K growth hormone: correlation of receptor binding and the biological effect on rat adipocytes]. AB - The 20K variant of native (22K) hGH is a full agonist for the growth promoting and lactogenic properties of the hormone in vivo, but has been reported to have reduced or no insulin-like properties. To explore whether these differences could be explained at the receptor level, we compared the binding of 22K and 20K hGH to receptors in isolated rat adipocytes, a target for the insulin-like effects of the hormone. We compared then the biological insulin-like effects of both hormones using a sensitive assay based on the stimulation of lipogenesis in isolated rat adipocytes. The 20K variant was only 3% as potent as 22K hGH for binding and bioactivity, demonstrating that rat adipocyte receptors are different from those promoting the growth effect. PMID- 3306848 TI - Insulin-like growth factor (IGF) binding in hypophysectomized rat liver microsomes: alteration by a soluble binding moiety. AB - In this study, we compared the binding of IGF-I and IGF-II to liver microsomes of normal and hypophysectomized (Hypox) rats. The binding of [125I]-IGF-II, measured by centrifugation of membrane-bound ligand, was lower in hypox than in normal rats (15 +/- 2 vs 26 +/- 1%, p less than 0.001) but binding was increased (46 +/- 1.5 vs 31 +/- 1%, p less than 0.001) when bound and free hormones were separated using polyethyleneglycol (PEG) precipitation. This was due to the presence of soluble binding activity which dissociated from membranes to compete for IGF binding. When soluble binding activity was first removed from microsomal membranes by a washing procedure no difference was found in [125I]-IGF-II binding to microsomes of Hypox and normal animals (33 +/- 1 s 32 +/- 1%). However, in the microsomal washing supernatant from Hypox (containing soluble binding activity) IGF-II binding was much higher than in that from normals (17 +/- 2 vs 6 +/- 0.5%, p less than 0.001). The binding of [125I]-IGF-I was lower than that of [125I]-IGF II but was comparably changed. By contrast, [125I]-insulin binding was similar in Hypox and normal rats and was not influenced by PEG precipitation or prewashing of the membranes. Inhibition dose-response curves showed a paradoxical increase in [125I]-IGF-II binding to unwashed microsomes of Hypox rats in the range of 0.5 5 ng/ml cold IGF-II. In normal animals [125I]-IGF-II binding to microscomes was progressively inhibited by IGF-II in a range of 0.5-500 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306850 TI - Serodiagnosis of Babesia motasi (Wales), Theileria recondita (Wales) and Cytoecetes phagocytophila infection in sheep. AB - The indirect fluorescent antibody test (IFAT) was used to diagnose some tick borne infections of sheep, Babesia motasi (Wales), Theileria recondita (Wales) and Cytoecetes phagocytophila. Antigen was prepared from blood derived from splenectomised sheep except for C phagocytophila which was derived from a normal animal. A field survey was made to assess the prevalence of B motasi and T recondita in North Wales and a comparison made between the titres using the B motasi (Wales) antigen with those previously reported. IFA titres reported in the homologous system were consistently lower than those described previously. The results of the field survey suggested that B motasi (Wales) infection is more widespread than was originally thought and more widespread than the known distribution of its vector Haemaphysalis punctata. No serological cross reactions occurred between B motasi (Wales), T recondita (Wales), C phagocytophila, B divergens, Sarcocystis ovicanis and Toxoplasma gondii. PMID- 3306849 TI - Investigations on the possible involvement of the dopaminergic system in the modulation of the growth and steroidogenic capacity of the rat adrenal zona glomerulosa: a coupled morphometric and biochemical study. AB - The effects of metoclopramide (MTC) and bromocriptine (BRC) (two drugs which act as antagonist and agonist of DOPA-receptors, respectively) on the zona glomerulosa of dexamethasone/ACTH-treated rats were investigated by coupled biochemical and morphometric techniques. Short-term (1-h) MTC administration significantly increased the plasma concentration of aldosterone, while long-term (7-day) MTC administration, as well as short- and long-term treatment with BRC did not cause any apparent change. Long-term MTC administration was found to significantly potentiate both the rise in the plasma level of aldosterone and the hypertrophy of the zona glomerulosa and its parenchymal cells induced by a prolonged treatment with angiotensin II (AII), but not those evoked by a chronic sodium deprivation alone or combined with AII infusion. Long-term BRC administration notably counteracted the effects of sodium restriction (coupled or not with AII infusion), but not those induced by the administration of AII alone. Long-term MTC administration partially reversed both the lowering of the plasma concentration of aldosterone and the atrophy of the zona glomerulosa and its parenchymal cells caused by a prolonged sodium-loading (combined or not with captopril infusion), but not those produced by the administration of captopril alone. On the other hand, long-term BRC treatment induced a further significant reduction in the blood level of aldosterone and the volume of zona glomerulosa and its cells only in captopril-treated animals. These findings are consistent with the view that the dopaminergic system exerts a maximal tonic inhibitory effect not only on the secretory activity, but also on the growth and steroidogenic capacity of the rat zona glomerulosa. Furthermore, they suggest that the activity of the dopaminergic system is in turn controlled by the sodium balance, being almost completely suppressed by a prolonged sodium deprivation. PMID- 3306851 TI - Haemagglutination patterns of the different variants of Escherichia coli K88 antigen with porcine, bovine, guinea pig, chicken, ovine and equine erythrocytes. AB - Determination of the porcine adhesive phenotype was not achieved by haemagglutination (HA) of porcine erythrocytes, which in all cases were agglutinated by K88ab and K88ad, independent of the adhesive phenotype as determined by the brush border adhesion test. K88ac always gave negative HA results with porcine red cells. However, HA appeared to offer a method of differentiating between the K88 variants without monospecific antisera. K88ab agglutinated porcine, guinea pig and chicken erythrocytes; K88ac agglutinated only guinea pig red cells and K88ad produced haemagglutination with porcine and guinea pig erythrocytes. PMID- 3306852 TI - Oral dosing of mice with Clostridium botulinum type C cultures and culture filtrates. AB - In two of 14 tests in which adult mice were dosed per os, whole broth culture of Clostridium botulinum type C was more lethal than culture sterilised by membrane filtration. The results indicated that occasionally--though not usually- significant bacterial multiplication and toxigenesis occurred in the gut. PMID- 3306853 TI - Type-A behavior and central serous chorioretinopathy. AB - A consecutive series of newly-diagnosed patients with central serous chorioretinopathy (CSC) was compared to two independent control groups chosen from the same patient population for the presence of a Type A behavioral pattern based on the Jenkins Activity Survey. The patients selected as matched controls had painless, reduced central vision and other chorioretinal diseases (Group I), or non-chorioretinal ocular conditions (Group II). The Type A behavior was significantly more frequent in study patients than in either Control Group I (X2 = 6.1 and P less than 0.025) or Control Group II patients (X2 = 17.7 and P less than 0.001). When both control groups were combined for comparison to the CSP patients, there was also a highly significant difference with regard to Type A behavior (X2 = 14.1 and P less than 0.001). A comparison of Control Group I with Control Group II revealed no significant difference in Type A behavior. Subfactor analysis of the Type A behavior pattern was also studied. The results of this clinical study were used in conjunction with experimental evidence linking catecholamines with CSP in developing a multifactorial etiologic hypothesis. The hypothesis suggests that the eyes as an organ system, and the macula as an ultimate target area, can be intermittently or continuously stimulated adversely by Type A behavior and its physiological consequences, most notably a sympathetic discharge. The multifactorial concept alludes to other potential risk factors such as age, race, sex, refractive state, or unknown tissue susceptabilities. The pathogenesis implies an inter-relationship between finely balanced components of a complex biopsychological system involving an individual's genetic endowment, his environment, and his behavioral pattern. The concept also offers new possible lines of investigation for the treatment of CSP, utilizing pharmacological regulators and for its prevention through early identification of CSP-prone individuals. A review of the pertinent cardiovasculature literature linking the Type A behavior with coronary artery disease and the significant papers in the ophthalmic literature on central serous pigment epitheliopathy are included in the discussion. PMID- 3306854 TI - [Oxygen transport and its parameters]. PMID- 3306855 TI - [Indications of chromic oxygen therapy]. PMID- 3306857 TI - [Evaluation of left ventricular volume and wall motion by digital intravenous subtraction angiography: comparison with conventional left ventriculography]. PMID- 3306856 TI - [Diagnosis of the mitral valve prolapse]. PMID- 3306858 TI - [Transference and resistance to serum in gram-negative strains multiresistant to antimicrobial drugs]. PMID- 3306859 TI - Etiologic factors in renal cell adenocarcinoma. PMID- 3306860 TI - Biological aspects of renal cell carcinoma. PMID- 3306861 TI - Paraneoplastic syndromes in hypernephroma. AB - It is noted that while a wide variety of syndromes have been associated with hypernephroma in the clinical literature, there is clear understanding of the pathophysiology of these effects only in the cases of the endocrine disorders where direct tumor production of hormone can be demonstrated in vitro. Furthermore, this knowledge has done little to alter the care of patients with the disease, except for indications that indomethacin might be of benefit in some patients with hypercalcemia and that one might consider the use of converting enzyme inhibitors in patients with hypernephroma and hypertension. The overall approach to the disease is still surgical. Resection of the tumor also removes the paraneoplastic syndrome. Persistence or recurrence of a syndrome suggests the continued presence of the neoplasm, with the considerations for prognosis which that fact entails. To that degree, at least, these conditions are useful as tumor markers, but such use is limited because they are inconsistent. Further studies of pathophysiology of paraneoplastic syndromes will lead to better understanding of processes of cell differentiation and regulation, and possibly better ways to manage the patients in which they occur. PMID- 3306862 TI - The natural history and clinical features of renal carcinoma. PMID- 3306863 TI - Treatment strategies in renal carcinoma. PMID- 3306864 TI - Future trends in research, prevention, and treatment of renal cell carcinoma. PMID- 3306865 TI - Effects of weight training on risk factors for coronary artery disease. PMID- 3306869 TI - [Richard von Krafft-Ebing's "Psychopathia sexualis". Pornography or professional literature?]. PMID- 3306870 TI - [Pharmacology and toxicity of local anesthetics]. PMID- 3306867 TI - Standard anaerobic exercise tests. AB - Anaerobic tests are divided into tests measuring anaerobic power and anaerobic capacity. Anaerobic power tests include force-velocity tests, vertical jump tests, staircase tests, and cycle ergometer tests. The values of maximal anaerobic power obtained with these different protocols are different but generally well correlated. Differences between tests include factors such as whether average power or instantaneous power is measured, active muscle mass is the same in all the protocols, the legs act simultaneously or successively, maximal power is measured at the very beginning of exercise or after several seconds, inertia of the devices and body segments are taken into account. Force velocity tests have the advantage of enabling the estimation of the force and velocity components of power, which is not possible with tests such as a staircase test, a vertical jump, the Wingate test and other long-duration cycle ergometer protocols. Maximal anaerobic capacity tests are subdivided into maximal oxygen debt test, ergometric tests (all-out tests and constant load tests), measurement of oxygen deficit during a constant load test and measurement of peak blood lactate. The measurement of the maximal oxygen debt is not valid and reliable enough to be used as an anaerobic capacity test. The aerobic metabolism involvement during anaerobic capacity tests, and the ignorance of the mechanical efficiency, limit the validity of the ergometric tests which are only based on the measurement of work. The amount of work performed during the Wingate test depends probably on glycolytic and aerobic power as well as anaerobic capacity. The fatigue index (power decrease) of the all-out tests is not reliable and depends probably on aerobic power as well as the fast-twich fibre percentage. Reliability of the constant load tests has seldom been studied and has been found to be rather low. In theory, the measure of the oxygen deficit during a constant load test is more valid than the other tests but its reliability is unknown. The validity and reliability of postexercise blood lactate as a test of maximal anaerobic capacity are probably not better than that of the current erogmetric tests. The choice of an anaerobic test depends on the aims and subjects of a study and its practicability within a testing session. PMID- 3306871 TI - [Treatment of disorders of esophageal motility with calcium antagonists]. PMID- 3306868 TI - Diuretic therapy and exercise performance. AB - Drugs that induce an increased urine flow are used both legitimately (treatment of hypertension and oedema) and otherwise (rapid weight loss) in sports and exercise. There are 5 major categories of diuretic drugs based on their mechanisms and loci of action. Common to all classes is hypohydration, which has been shown to have an array of adverse effects on performance, including impaired strength, power and endurance. Postural hypotension can be particularly troublesome in the elderly. Also common to all diuretics, except those interfering with the aldosterone mechanism in the distal nephron, is hypokalaemia. Severe symptomatic hypokalaemia (serum K+ concentration less than 3.0 mmol/L) is rare except in clinical situations in which additional hypokalaemic factors are present. Moderate levels of hypokalaemia (serum K+ concentration 3.0 to 3.5 mmol/L) can increase the risk of adverse reactions as has been shown in a variety of prospective clinical studies. Hypokalaemia has effects on cardiac rhythm, muscle function and integrity, local blood flow, carbohydrate metabolism, and the blood lipid profile. Performance studies generally show diminished exercise tolerance in direct proportion to the degree of hypohydration induced. This is not the case, however, in a clinical setting of compromised cardiopulmonary function, in which diuresis has direct and indirect inotropic effects which augment exercise tolerance and decrease symptoms. The ability of the carbonic anhydrase inhibitor, acetazolamide, to induce a hyperventilatory response to the obligatory metabolic acidosis is taken advantage of in mountaineering to prevent or ameliorate the symptoms of acute mountain sickness, thereby improving exercise performance at high altitude. It is suggested that in clinical situations in which the use of a diuretic is considered appropriate, every effort be made to maintain or restore the serum concentration and the total body store of potassium to normal. To some degree this can be accomplished through diet, although potassium chloride supplements or potassium-sparing diuretics or diuretic combinations may be necessary. PMID- 3306866 TI - Effect of exercise on serum enzyme activities in humans. AB - Increased serum enzyme activity after exercise was first reported in 1958; subsequent studies have established that many factors determine the degree to which the serum activities of a variety of enzymes increase during and after exercise. The serum activities of those enzymes found especially in muscle, particularly creatine kinase, increase in proportion to the intensity and duration of the preceding exercise, peaking 24 hours after exercise; the effect of duration is dominant, so that the highest postexercise serum enzyme activities are found after very prolonged competitive exercise such as ultradistance marathon running or triathlon events. Weight-bearing exercises which include eccentric muscular contractions such as bench stepping and downhill running induce the greatest increases in serum enzyme activities; serum enzyme activities increase very little even after prolonged participation in those non-weight bearing activities such as swimming and cycling which do not include eccentric muscular contractions. Prolonged (greater than 2 hours) daily training or competition in weight-bearing activities produces chronically elevated serum enzyme activities. Serum enzyme activities increase more with exercise in males, Blacks and the untrained than they do in females, Whites and the trained, respectively; age does not appear to influence the degree to which serum enzyme activities increase with exercise. There is a remarkable individual variability in the degree to which serum enzyme activities increase with exercise; a 50-fold difference in post-race serum creatine kinase activities has been found in healthy and equally trained athletes completing the same 90km ultramarathon footrace. The biochemical explanation for this degree of individual variability is not currently understood; possibly persons who show abnormally large increases in serum enzyme activities with exercise may have as yet unrecognised subclinical myopathies. No circadian rhythms have been identified for serum enzyme activities; activities rise during the day because of increased physical activity. The rise in serum enzyme activities is greater after exercise at altitude or in the heat than after equivalent exercise at sea level or in the cold. The most likely explanation for the increased serum enzyme activities that follow prolonged weight-bearing activities that also cause marked muscle soreness, is myofibrillar damage in particular sarcomeric Z-disk disruption.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3306872 TI - [Historical notes on retinoblastoma: apropos of 2 ancient terracotta figures]. PMID- 3306873 TI - [2 centuries of controlling epidemics]. PMID- 3306875 TI - Abnormal expression of lysosomal cysteine proteinases in muscle wasting diseases. PMID- 3306874 TI - Sleep research in affective illness: state of the art circa 1987. AB - Future sleep research in affective illness will probably continue the current evolution beyond cross-sectional to longitudinal studies, and beyond a largely descriptive emphasis to the testing of specific hypotheses and predictions derived from models of the pathophysiology of depression. These models are and will be variously neurochemical, chronobiological, genetic, and developmental in nature. Adequate testing of these models and predictions from them will require the use of pharmacologic and naturalistic probes and the use of sophisticated CNS imaging techniques. These probes will help further characterize the physiology of depression under conditions of disequilibrium or perturbation, such as following sleep deprivation, REM deprivation, phase advancement of the major sleep period, or the administration of antidepressant drugs with specific monoaminergic activity. Concurrently, if one is to understand further whether the sleep abnormalities of depression are part of a larger circadian rhythm disturbance, investigations will necessarily include 24-h measures of sleep-wake activity, psychomotor activity, and probably core body temperature rhythm under constant routine conditions. A complementary point of view would suggest that more intensive investigative efforts be focused on the first 100 min of sleep at night, since it is the first NREM-REM cycle that seems to show the greatest and most specific deviation in depressed patients from normal controls. Efforts to characterize further this part of the 24-h cycle, with respect to age- and gender related variance as well as responses to physiologic, hormonal, pharmacologic, and naturalistic probes, are strongly warranted. PMID- 3306876 TI - Biological activities of complement-derived peptides. PMID- 3306878 TI - Approaches to visual cortical function. PMID- 3306877 TI - Hereditary disorders of the urea cycle in man: biochemical and molecular approaches. PMID- 3306880 TI - [Continuing education. Updating knowledge, recycling]. PMID- 3306879 TI - [The past, present and future of surgery of the pancreas]. PMID- 3306881 TI - Prevalence of anti-P. falciparum sporozoite antibodies in adults in the Amapa region of Brazil. PMID- 3306882 TI - Legal consultations continue: focus on marking place of origin on imported appliances. PMID- 3306883 TI - Custom light-cured maxillary prosthetic premolars opposing natural dentition. PMID- 3306884 TI - Microwave cooking hits the denture market. PMID- 3306885 TI - The immune system and lymphoma. (A commentary on the role of the immune system in experimental lymphomagenesis). AB - Normal immune responsiveness is compared with four main types of experimental lymphomagenesis. In these types of lymphoma, the proximal cause of lymphomagenesis can be identified as a specific class of the immunoregulatory defect. The adaptive differentiation of normal immunocytes to immunocompetence permits the specific activation by antigenic determinants through the requirement for cognate recognition of such epitopes in the presence of an actively maintained self-tolerant state. Defective control of immune responsiveness in lymphomagenesis permits lymphocyte activation by stimuli resulting from the acquisition of alterations or defects in the expression of normally invariant molecules present during adaptive differentiation. Target antigens include class I and II MHC, env glycoproteins, and framework determinants of T cell receptor or immunoglobulin idiotype. Features common to both normal immune responsiveness and to lymphomagenesis are immunocompetence of the cognate recognition process and specificity of the target immunocyte for the permitted immunogenic or lymphomagenic stimulus. PMID- 3306886 TI - Leishmania infecting man and wild animals in Saudi Arabia. 3. Leishmaniasis in Psammomys obesus Cretzschmar in Al-Ahsa oasis. AB - Zoonotic cutaneous leishmaniasis (ZCL) is hyperenzootic in Psammomys obesus in Al Ahsa oasis in Saudi Arabia: 93% of 202 specimens of this rodent examined had signs of the infection. Leishmania major and L. arabica were isolated from both normal ear skin as well as from ears with slight to severe lesions. L. major was the predominant species and gave rise to characteristic lesions that consisted of swelling, rounding of the edges, hyperpigmentation, ulceration, necrosis and, in advanced cases, sloughing and loss of ear tissue. PMID- 3306887 TI - [The First National Congress of Public Health (Madrid, 1934) as validation of medico-social professionalization in Spain]. PMID- 3306888 TI - Transmission electron microscopy of early microbial colonization of human enamel and root surfaces in vivo. AB - This study describes the early microbial colonization of teeth by the use of light- and transmission electron microscopy. Six dental students carried a total of 60 test pieces of unerupted enamel and root surface in intraoral acrylic appliances for 4, 8, 12, 24 and 48 h, during which periods oral hygiene was abandoned. Pronounced variations were recorded in structure and thickness of the pellicle across the individual surfaces of both dental tissues. Bacterial single cell colonization increased the electron density of the adjoining pellicle. Micro colonies of bacteria were observed in relation to enamel surface irregularities such as perikymata, while the distribution on root surfaces appeared incidental. Root surfaces were generally colonized by thicker deposits than homologous enamel surfaces although the structural composition of the microbiota was similar. Gram positive bacteria with thick cell walls appeared in coccoid or rod-shaped configurations depending on the age of the bacterial deposit. These bacteria were further characterized by selective invasion between collagen fibers. After 48 h the complexity of the microbiota was increased by the establishment of new bacterial species in the superficial layer. It is concluded that the pattern and composition of the early microbiota on teeth is more complex and variable than hitherto assumed. PMID- 3306889 TI - No evidence of hypersensitivity to dental restorative metals in oral lichen planus. AB - Twelve patients with oral lichen planus (OLP) suspected of dental restorative metal allergy were examined. All patients were patch tested with several metals including six different mercury compounds. One (8%) patient showed a positive patch test to two mercury compounds whereas no mercury allergy was found in a reference group of 17 patients suspected of dental restorative material allergy but without OLP lesions. The mercury allergic OLP patient was further tested on palatal mucosa but no reactions developed. Moreover, the energy dispersive X-ray microanalysis failed to show any contaminating metals in his OLP lesion. Mucosal biopsies were taken in close contact with amalgam fillings from nine OLP patients but these disclosed no evidence of lichenoid or dysplastic alterations. In OLP lesions, the immunofluorescence findings showed fibrinogen deposition, altered basement membrane and elastic fiber staining and intense Ulex europeaus I lectin fluorescence through all epithelial cell layers. Therefore, the present patch tests did not reveal increased frequency of mercury or other metal allergy in OLP patients and the mucosal biopsies failed to show any histologic or immunofluorescence alterations deviating from idiopathic OLP lesions. PMID- 3306890 TI - Thickening of the gallbladder wall in alcoholic hepatitis verified by ultrasonographic examination. Its clinical implications. AB - In 14 patients with alcoholic hepatitis an echographic study of the gallbladder was carried out. Nine subjects showed gallbladder wall thickening (thickness greater than 4 mm) and two a 'scanty content gallbladder'. These findings did not correlate with the serum albumin levels. The authors point out the similarity of these ultrasonographic findings with those described in patients with acute cholecystitis. Since the clinical characteristics of the two conditions may also be similar, the differentiation between them cannot be exclusively based on the gallbladder echographic appearance. PMID- 3306891 TI - Does sucralfate reduce acetylsalicylic-acid-induced gastric mucosal bleeding? AB - We studied the possible protection of sucralfate with regard to acetylsalicylic acid (ASA)-induced gastric mucosal bleeding as measured by a radiochromium assay of faecal blood loss in a double-blind crossover study involving 16 healthy male volunteers. Medication was given in two combinations during the 2nd and 5th week of the study: 1 g ASA and 1 g sucralfate four times daily, or 1 g ASA four times daily and placebo tablets. Mean faecal blood loss (+/- SEM) was 0.38 +/- 0.04 ml/day in the 1st week (no drugs administered), 7.17 +/- 1.60 ml/day during treatment with ASA + sucralfate, and 9.59 +/- 1.76 ml/day during treatment with ASA + placebo, the difference being not statistically significant. Individual bleeding values registered during sucralfate treatment correlated with those measured in the placebo period. However, three persons with pronounced bleeding after ASA + placebo had minimal bleeding after ASA + sucralfate. Sucralfate may have a protective potential by reducing ASA-induced gastric mucosal bleeding, but further studies are required to evaluate its protective mechanisms and to identify the groups of patients that could benefit from this. PMID- 3306892 TI - Screening for Campylobacter pyloridis in patients with upper dyspepsia and the relation to inflammation of the human gastric antrum. AB - Campylobacter pyloridis, a recently detected microorganism, was isolated from gastric antral mucosa in 58% of 119 consecutive patients with upper dyspepsia. There was a highly significant correlation between the presence of Campylobacter pyloridis and antral inflammation and a close relation to prepyloric and duodenal ulcer. There was no significant correlation with the severity or type of inflammation. This microorganism, which seems to be as common in Denmark as in other parts of the world, is considered a possible cause of gastroduodenal disease. PMID- 3306894 TI - Taking a calculated risk: predictive scoring systems in dyspepsia. AB - The derivation of a predictive index is illustrated using 14 simple questions to assess the chance of the presence of an ulcer. The evaluation and use of such a 'calculated-risk' is briefly described. PMID- 3306893 TI - Reflux esophagitis: assessment of therapy effects and observer variation by video documentation of endoscopy findings. AB - Twenty-eight patients with endoscopically confirmed erosive or ulcerative esophagitis completed an 8-week placebo-controlled trial evaluating the symptomatic and endoscopic improvement obtained with ranitidine, 150 mg twice daily. Twice daily the patients recorded the number of episodes of retrosternal pain, regurgitation, and pyrosis on a diary card during a trial period of 1 week and during the 1st and 5th study week. Video documentation of endoscopy findings was undertaken before and at the end of the trial. The symptomatic relief obtained with ranitidine was significantly better than that obtained with placebo. The videotapes were assessed blindly and independently by three experienced fiberoptic endoscopists. The tapes were also recoded and reassessed by the same endoscopist. No systematic difference between different observers, either before or after treatment, could be detected. The interobserver variation, expressed as Kendall's tau b correlation coefficient, was 0.44 to 0.74. This coefficient was higher in intra-observer variation (0.63 to 0.91). Corresponding kappa-values for inter- and intra-observer variations were 0.12 to 0.30 and 0.27 to 0.85, respectively. The esophagitis, as judged by all observers, improved more in the ranitidine group than in the placebo group, but the difference did not reach statistical significance. PMID- 3306895 TI - Transferability of a probabilistic algorithm in differential diagnosis of jaundice. PMID- 3306896 TI - Use of a computer system for diagnosing acute abdominal pain in a small hospital. PMID- 3306897 TI - Computer-aided diagnosis of 233 acute abdominal cases at Nacka Hospital Sweden. PMID- 3306898 TI - Computer aided diagnosis of jaundice. A comparison of two data bases. AB - A computer system for probabilistic diagnosis of jaundice was tested on a patient sample from a geographical area different from that for which it was first constructed. 144 consecutive patients with jaundice seen in two Stockholm hospitals were interviewed and examined to record a total of 82 indicants from history, demographic details, physical findings and laboratory tests. Data were compared with those of 319 jaundiced patients previously interviewed and examined at different London hospitals. It was found that disease incidences were different in the two patient samples. There were more patients with acute viral hepatitis, chronic active hepatitis and primary biliary cirrhosis in the London data base whereas the Stockholm data base included significantly more patients with Gilbert's syndrome and alcoholic cirrhosis. Indicant frequencies, standardised for disease incidence, differed with respect to age (Stockholm patients were on average six years older), time from onset of first symptom to hospital admission (Stockholm patients had on average a two-week shorter history of disease) and a number of symptoms such as nausea, vomiting, anorexia, weight loss, itching, pale stools and dark urine which were more frequent among the London patients. Differences in hospital admission policy was regarded as an important reason for the differences in indicant frequency. The results of probabilistic diagnosis were poor. Only 49% of the cases were correctly classified into twelve diagnostic groups. In particular the computer model was poor at separating different causes of malignant bile duct obstruction and at differentiating between malignant and benign bile duct obstruction. However, all cases of acute viral hepatitis were correctly classified and the computer model was 87% accurate in differentiating between medical and surgical jaundice. Reclassification of the 144 patients on their own data showed the computer system to be well calibrated and 97% of the cases were correctly classified according to this procedure. In conclusion, the computer system could not be directly transferred for use in a Swedish hospital but the results of reclassification were sufficiently encouraging to warrant prospective studies. PMID- 3306899 TI - Transferability of a computer system for medical history taking and decision support in dyspepsia. A comparison of indicants for peptic ulcer disease. AB - The transferability of a British data base for differential diagnosis of dyspepsia using data obtained by computer interrogation was tested in 467 Swedish patients. The diagnostic value for peptic ulcer disease of symptoms such as frequent night pain relieved by food or antacids, smoking, family history of ulcer, food relief pain, male sex, and episodic pain was shown to be reproducible. However, for a number of symptoms their value for the diagnosis of peptic ulcer disease could not be reproduced in Swedish patients. The combined value of indicants was tested using a computer based algorithm for calculating diagnostic probabilities. The performance of this algorithm was poor when British data were applied to Swedish patients but reclassification of the Swedish patients on their own data base showed promising results. Crean and colleagues in Glasgow have developed a computer system for automated interrogation of patients with dyspepsia. The system utilises a large number of questions to obtain information regarding a maximum of 160 diagnostic indicants. The symptoms elicited from a patient can be compared with those of a large number of previously examined patients and the probabilities of ten different diagnoses can be calculated. The calculation of diagnostic probabilities is based on scores reflecting the diagnostic value of different symptoms in different diseases. After careful translation of questions the system has been transferred for use in Sweden. The present report is based on data from patients seen during the first two years with the system at a Swedish hospital.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3306900 TI - Enhancement of mucosal defence by prostaglandins. Rationale and clinical experience in ulcer disease. PMID- 3306901 TI - The gastric mucosal epithelial barrier: role of mucus and fibrin. AB - A continuous layer of insoluble mucus gel is adherent to the luminal surface of the gastric epithelium. The true thickness of the gel and its continuity can only be observed on unfixed sections of mucosa since histological fixatives cause dehydration and denaturation of mucus. The mucus:bicarbonate barrier can protect the undamaged epithelium from the endogenous luminal aggressors acid and pepsin but does not appear to offer much protection against exogenous damaging agents such as topical alcohol. Following acute ethanol injury, damaged epithelium is replaced by cells migrating from the gastric pits. In rat gastric mucosa this process of re-epithelialisation is protected by a gelatinous coat ten times thicker than the normal adherent mucus layer. Our studies now show this coat to be a fibrin gel with mucus and necrotic cells. Evidence suggests that the existing mucus layer can act as a template for the fibrinogen--fibrin conversion. These results demonstrate that a fibrin based gelatinous coat, quite distinct from the adherent mucus layer and with considerable protective potential, can be formed over the repairing damaged gastric mucosa. PMID- 3306902 TI - Mixed-linked beta-(1----3), (1----4)-D-glucans in the cell walls of barley and oats--chemistry and nutrition. PMID- 3306903 TI - Loperamide in treatment of irritable bowel syndrome--a double-blind placebo controlled study. AB - The effects of loperamide in patients with IBS (all had diarrhoea as a main symptom) were studied in a double-blind placebo controlled trial. Subjective overall response stool consistency and six individual symptoms (urgency, pain, frequency, flatulence, borborygmi and painful propulsions) were studied over a 13 week long treatment period. Twenty-one patients out of 25 completed the trial, 11 in the loperamide group and 10 in the placebo group. A significant advantage for loperamide was found for stool consistency (p less than 0.001), pain (p less than 0.02) and urgency (p less than 0.05). Subjective overall response was also significantly better in the loperamide group (p less than 0.03). Self-titration of dose and administration in a single nightly dose was safe and efficient. PMID- 3306904 TI - Loperamide treatment of the irritable bowel syndrome. AB - The effect of loperamide was investigated in a double-blind, placebo-controlled study in 60 patients with irritable bowel syndrome (IBS). Active treatment was given in low dosage (4 mg nocte). The effect of treatment was assessed in clinical subgroups. In a group of patients with painless diarrhoea (n = 16) there was a highly significant improvement in stool frequency and consistency. In a group with alternating bowel habits and abdominal pain (n = 21) there was also a statistically significant improvement in stool frequency and consistency as well as significantly fewer painful days during loperamide treatment. Patients with alternating bowel habits and no pain (n = 12) experienced no symptomatic improvement, and patients with constipation (n = 9) generally felt worse on loperamide. No side effects were encountered. It is concluded that loperamide can be considered an alternative symptomatic treatment in some IBS patients whose main symptoms are painless diarrhoea or alternating bowel habits associated with abdominal pain. PMID- 3306905 TI - The localization of antigen in lymph node follicles of congenitally athymic nude rats. AB - We have examined the postulated dependence on T cells of follicular retention of antigen by studying antigen retention in the draining lymph nodes of congenitally athymic, nude rats after local injections of horseradish peroxidase (HRP). The lymphoid tissues of these rats contained germinal centres and follicular dendritic cells (FDC) that were ultrastructurally identical to those seen in euthymic rats and expressed the differentiation antigen MRC OX2. Nude rat FDC captured and retained locally injected antigen on their surfaces, but as with euthymic rats, only in the presence of previously injected anti-HRP antibody. This demonstrates that the FDC mature both morphologically and functionally in the absence of a thymus or T cells. However, in contrast to euthymic rats, there was no detectable antigen retention in nude rats that had been actively immunized by repeated intraperitoneal injections with HRP for 3 months. The lower number of germinal centres observed in athymic animals compared with their euthymic littermates could thus be explained by deficient production of specific antibody of the isotype necessary for follicular localization of environmental antigens. PMID- 3306906 TI - Immunopurification of radiolabelled antigens of Mycobacterium leprae and Mycobacterium bovis (bacillus Calmette-Guerin) with monoclonal antibodies. AB - Radiolabelled sonicate of Mycobacterium leprae when examined by SDS-PAGE and two dimensional gel electrophoresis (2-DE) contained fewer antigens than the comparable sonicate from M. Bovis (bacillus Calmette-Guerin) (BCG). A solid-phase immunopurification assay with anti-M. leprae monoclonal antibodies (MoAb) was used to characterize four of these antigens. Three of the MoAb were M. leprae specific and with them antigens with apparent molecular weights (Mr) of 12,000 (12K), 18K, and 35K were isolated. On 2-DE, the heavily labelled 12K antigen was heterogeneous with a range in pI of 4.8-5.2. The 35K antigen, which was identified by a conformational determinant, and the 18K antigen were also acidic proteins with pI of 5.4 and 5.1. The fourth antigen was purified from both M. leprae and BCG sonicates and had an Mr of 70K and a pI of 5.1. MoAb reacting with the cell wall protein of M. leprae resulted in separation of multiple bands ranging in Mr from 12K to 65K, rather than the dominant 65K protein seen in immunoblots. A similar pattern was obtained with MoAb that reacted with two cell wall polysaccharide antigens, and these antibodies may have co-precipitated the radiolabelled cell wall proteins. Immunoprecipitates of the M. leprae sonicate with human lepromatous leprosy sera, when analysed by 2-DE, were also found to contain the dominant 12K band and the 35K band. Furthermore, half the radiolabelled BCG antigens were precipitated by the same sera. PMID- 3306907 TI - Process-reactive dimension and outcome for narrow concepts of schizophrenia. AB - The data presented by the authors suggest a more successful prediction of outcome by the process-reactive dimension when it is applied to schizophrenic patients defined according to broad concepts of schizophrenia (e.g., DSM-II) than to narrow concepts of schizophrenia (e.g., DSM-III). Research indicates that the DSM III is more likely than the DSM-II diagnosis to be composed of "poor prognosis" schizophrenia, as defined by the classical prognostic indicators. In general, the overall results could support the views of Herron and others that the process reactive dimension is more valuable as a predictor for a schizophrenia spectrum than for modern, narrow concepts of schizophrenia. However, while recent data of the authors indicate that DSM-III schizophrenic patients show poorer outcome than DSM-II schizophrenic patients, they also indicate that (1) DSM-III schizophrenic patients still show heterogeneity in prehospital functioning and outcome, and (2) other prognostic indexes, such as the Zigler-Phillips Scale and the Vaillant Stephens Scale, have some efficacy in predicting course and outcome among DSM-III schizophrenic patients. Data on prehospital functioning and outcome are discussed in terms of two contrasting models--a developmental model and a natural history model of the course of schizophrenia. PMID- 3306908 TI - Genetic principles and methods in high-risk studies of schizophrenia. AB - Recent advances in genetic epidemiology present excellent opportunities for future high-risk studies of schizophrenia. Improved methods are now available for specifying the natural boundaries of the schizophrenia spectrum and evaluating the mode of inheritance of schizophrenia and its biosocial risk factors. Path analytic techniques permit the derivation of multifactor indices of both biological and social antecedents of schizophrenia. Powerful advances have been made in segregation analysis of pedigree data and in the power of linkage tests with DNA markers to confirm the presence of putative major loci that influence susceptibility to complex phenotypes like schizophrenia. The yield of information from high-risk samples is greatly increased when both longitudinal and pedigree analyses are combined. PMID- 3306909 TI - Methodological issues facing the interpretation of high-risk studies: biological heterogeneity. AB - High-risk studies provide a unique opportunity to examine the interaction of biological vulnerability and psychosocial factors in the development of the major psychiatric illnesses. To parcel out the effects of psychosocial variables, high risk populations need to be separated into offspring who are and who are not biologically/genetically vulnerable, since psychosocial modifiers will be interactive only in the biologically vulnerable offspring. Criteria are suggested for the use of "biological markers" to detect subjects at genetic/biological risk within high-risk cohorts. Presently, only the d' statistic of the continuous performance test (CPT) appears to satisfy the criteria for identification of such biologically vulnerable offspring. PMID- 3306910 TI - [Nickel: elements in the aquatic environment. I. Biotic and abiotic systems]. PMID- 3306911 TI - Macrophage-like cells of the pannus area in rheumatoid arthritic joints. AB - Frozen sections of pannus tissue taken from the joints of patients with rheumatoid arthritis have been investigated using immunohistological methods to determine the distribution of subsets of macrophage-like cells in this area. A panel of monoclonal antibodies including reagents specific in normal tissue for interdigitating cells (RFD1), macrophages (RFD7), epithelioid cells, (RFD9), monocytes (UCHMI), and osteoclasts (263C), were used. Indirect immunoperoxidase and combination indirect immunofluorescence procedures revealed the phenotypes of macrophage-like cells in four histologically distinct areas of the tissue: the synovial lining layers, the deeper stroma, areas of perivascular infiltration, and the articular cartilage junction where degeneration was occurring. It was discovered that 80% of the lining cells and a majority of macrophage-like cells of the stroma, express the phenotype RFD1+ RFD7+ UCHMI+. Cells with a typical 'dendritic cell' phenotype (RFD1+ RFD7-) were only present in the perivascular infiltrates, while 'classic macrophages' (RFD7+ RFD1-) were the cells accumulating at the cartilage junction. No significant numbers of RFD9+ epithelioid cells were seen. 263C+ osteoclasts were present in small numbers distributed throughout the stroma but did not appear to be involved in areas of cartilage degradation. This cellular distribution in the pannus is compared with previous studies on the rheumatoid synovium proper. It is concluded that a distinct inflammatory reaction occurs in the pannus and that classic activated macrophages are the cells involved in cartilage degradation. PMID- 3306912 TI - [Literature review of the diseases of the exocrine pancreas of the cat]. PMID- 3306913 TI - Low dose heparin for prevention of deep vein thrombosis and pulmonary embolism in medical patients. PMID- 3306914 TI - Yersinia pseudotuberculosis with inflammation of the appendix: a case report. AB - Human enteric infection with Yersinia enterocolitica or Yersinia pseudotuberculosis may masquerade clinically as acute appendicitis but it is unusual for the appendix to be histologically inflamed. We report a case of Yersinia pseudotuberculosis infection in which acute appendicitis was present in the absence of terminal ileitis. PMID- 3306915 TI - New questions in Strobel case. PMID- 3306916 TI - The nerve growth factor 35 years later. PMID- 3306917 TI - Transcriptional regulation in the yeast life cycle. AB - The transition from haploid to diploid in homothallic yeast involves a defined sequence of events which are regulated at the level of transcription. Transcription factors encoded by SWI genes activate the HO endonuclease gene at a precise stage in the cell cycle of mother cells. The HO endonuclease initiates a transposition event which activates genes of the opposite mating type by causing them to move away from a silencer element. The activated mating type genes then regulate genes involved in cell signaling such as the mating type-specific pheromones and their receptors. Since HO is only activated in one of the sister cells after division (the mother), adjacent cells of opposite mating type are generated which respond to each others' secreted pheromones by inducing genes involved in conjugation. This leads to the formation of a diploid in which many of the genes involved in mating and mating-type switching become repressed due to the heterozygosity of the mating-type locus. This article summarizes what is known about these transcriptional controls and discusses possible parallels in higher eukaryotes. PMID- 3306918 TI - Tumor necrosis factor (cachectin) as an essential mediator in murine cerebral malaria. AB - Tumor necrosis factor, or cachectin (TNF-alpha), a protein with a wide range of biological activities, is produced mainly by macrophages and may be important in inflammatory processes. The role of TNF-alpha in the pathogenesis of cerebral malaria was investigated in a murine model. Most CBA mice infected with Plasmodium berghei anka die between days 6 and 14 with acute neurological manifestations unrelated to the level of parasitemia, whereas mice of some other strains have malaria of the same severity that ends in death after 3 to 4 weeks without neurological manifestations. The activity of serum TNF-alpha was considerably increased in CBA/Ca mice with cerebral malaria but not in Plasmodium berghei-infected mice that did not develop this complication. One injection of rabbit antibody to TNF-alpha on day 4 or 7 fully protected infected mice from cerebral malaria without modifying the parasitemia, whereas immunoglobulins from normal rabbit had no effect. In mice with cerebral malaria, the cerebral vessels showed focal accumulations of packed macrophages often containing infected erythrocytes; this lesion was not seen in mice treated with antibody to TNF-alpha or in untreated mice without cerebral malaria. These findings indicate that TNF alpha has an important role in the pathogenesis of cerebral malaria in this murine model and suggest that local accumulation and activation of macrophages may lead to the predominance of lesions in the central nervous system. PMID- 3306920 TI - Meeting on AIDS drugs turns into open forum. PMID- 3306919 TI - Neurosteroids: cytochrome P-450scc in rat brain. AB - The steroid hormones corticosterone and testosterone are supplied to the central nervous system by endocrine glands, the adrenals and gonads. In contrast, the 3 beta-hydroxy-delta 5-derivatives of cholesterol, pregnenolone and dehydroepiandrosterone, accumulate in the rat brain through mechanisms independent of peripheral sources. Immunohistochemical studies have been performed with specific antibodies to bovine adrenal cytochrome P-450scc, which is involved in cholesterol side-chain cleavage and pregnenolone formation. The enzyme was localized in the white matter throughout the brain. Scarce clusters of cell bodies were also stained in the entorhinal and cingulate cortex and in the olfactory bulb. These observations strongly support the existence of "neurosteroids," which have been posited on the basis of biochemical, physiological, and behavioral studies. PMID- 3306921 TI - Choppin takes reins at Howard Hughes. PMID- 3306922 TI - Saccharomyces cerevisiae has a U1-like small nuclear RNA with unexpected properties. AB - Previous experiments indicated that only a small subset of the approximately equal to 24 small nuclear RNAs (snRNAs) in Saccharomyces cerevisiae have binding sites for the Sm antigen, a hallmark of metazoan small nuclear ribonucleoproteins (snRNPs) involved in pre-messenger RNA splicing. Antibodies from human serum to Sm proteins were used to show that four snRNAs (snR7, snR14, snR19, and snR20) can be immunoprecipitated from yeast extracts. Three of these four, snR7, snR14, and snR20, have been shown to be analogs of mammalian U5, U4, and U2, respectively. Several regions of significant homology to U1 (164 nucleotides) have now been found in cloned and sequenced snR19 (568 nucleotides). These include ten out of ten matches to the 5' end of U1, the site known to interact with the 5' splice site of mammalian introns. Surprisingly, the precise conservation of this sequence precludes perfect complementarity between snR19 and the invariant yeast 5' junction (GTATGT), which differs from the mammalian consensus at the fourth position (GTPuAGT). PMID- 3306923 TI - An in vitro neurite-promoting antigen functions in axonal regeneration in vivo. AB - The function of the neurite growth-promoting antigen INO has been tested in an in vivo neurite regeneration system, the rat iris. The sympathetic innervation of the irides was removed by a single systemic injection of 6-hydroxydopamine. The subsequent regeneration of sympathetic axons into the iris of one eye bathed by the INO antibody, which inhibits neurite growth in vitro, was compared with the regrowth of sympathetic axons into the iris of the animal's other eye, which contained control antibody. Antibodies were released within the eye by implanted hybridoma cells. Neurite regeneration was measured by assaying [3H]norepinephrine uptake into freshly explained irides. The blockage of the function of the INO antigen by the antibody resulted in a decreased rate of axonal regeneration, thus suggesting the involvement of the INO antigen in the process of neurite regeneration in vivo. PMID- 3306924 TI - Evidence for dispensable sequences inserted into a nucleotide fold. AB - Previous experimental results along with the structural modeling presented indicate that a nucleotide fold starts in the amino-terminal part of Escherichia coli isoleucyl-transfer RNA synthetase, a single chain polypeptide of 939 amino acids. Internal deletions were created in the region of the nucleotide fold. A set of deletions that collectively span 145 contiguous amino acids yielded active enzymes. Further extensions of the deletions yielded inactive or unstable proteins. The three-dimensional structure of an evidently homologous protein suggests that the active deletions lack portions of a segment that connects two parts of the nucleotide fold. Therefore, the results imply that removal of major sections of the polypeptide that connects these two parts of the fold does not result in major perturbation of the nucleotide binding site. PMID- 3306925 TI - Direct demonstration of macula densa-mediated renin secretion. AB - An in vitro method has been used to examine whether secretion of renin from the juxtaglomerular apparatus is affected by changes in the sodium chloride concentration of the tubular fluid at the macula densa. Single juxtaglomerular apparatuses were microdissected from rabbits and the tubule segment containing the macula densa was perfused, while simultaneously the entire juxtaglomerular apparatus was superfused, and the fluid was collected for renin measurement. In this preparation, in which influences from renal nerves and local hemodynamic effects are eliminated, a decrease in the tubular sodium chloride concentration at the macula densa results in a prompt stimulation of the renin release rate. PMID- 3306927 TI - Controversies of different regimens of thrombolytic therapy in acute pulmonary embolism. PMID- 3306926 TI - Acyl enzymes for thrombolytic therapy. PMID- 3306928 TI - Deep vein thrombosis of inferior limbs: are thrombolytic agents superior to heparin? PMID- 3306929 TI - The infectious etiology of chronic rheumatic diseases. PMID- 3306930 TI - Immunomodulatory treatment in patients with rheumatic diseases: mechanisms of action. PMID- 3306931 TI - Adult onset Still's disease: experience in 23 patients and literature review with emphasis on organ failure. PMID- 3306932 TI - The endocrinologic associations of the autoimmune rheumatic diseases. AB - Having seen five patients with both SLE and thyroid disease (case reports available on request) in a short period of time, we have undertaken a survey of the association between the ARD and endocrine disorders. On the basis of a literature review and our own reported study, it is apparent that an association between these major groups of disorders is well established with some individual diseases, though much more dubious in others (Table 3). The possibility of coexistent endocrine disease in a patient with a multisystem ARD should be carefully considered throughout the course of the patient's follow-up. PMID- 3306933 TI - The cellular pharmacology of auranofin. PMID- 3306934 TI - Adrenal cortical carcinoma. PMID- 3306936 TI - Papillary thyroid carcinoma: factors influencing prognosis and current therapy. PMID- 3306935 TI - Pheochromocytoma. PMID- 3306937 TI - Lymphoma of the thyroid and related disorders. PMID- 3306938 TI - Primary leiomyosarcoma of bone. A clinical, radiographic, pathologic-anatomic, and prognostic study of 16 cases. AB - Sixteen cases of primary leiomyosarcoma of bone are described. The patients, 11 males and 5 females, ranged in age from 9 to 74 years. The annual incidence of this tumor in Sweden was calculated to be 0.09 cases per million. This figure was obtained by reviewing a Swedish series of spindle cell sarcomas of bone of which one quarter (11/44) were diagnosed by us as primary leiomyosarcoma. The diagnosis was based on light- and electron-microscopic examinations using the same criteria as for leiomyosarcoma of soft tissues. Thirteen tumors were located in a long bone of an extremity (nine close to the knee joint) and three in the central skeleton. Radiographically, all the tumors presented as a purely osteolytic lesion, and three patients had sustained a pathologic fracture. In four of six cases angiography suggested malignancy by revealing hypervascularity, irregular tortuous vessels, and diffuse contrast opacification. Contrast-enhanced computed tomography, performed in two cases, showed hypervascular areas within the tumors. Scintigraphy showed a marked increase in radionuclide uptake in all five cases studied. The clinical behavior indicates that primary leiomyosarcoma of bone is highly malignant. Eight patients had died of the tumor and, of the eight patients who were alive at follow-up, two had metastases, and one had been operated on three times for a cutaneous metastasis, which had recurred locally twice. The remaining five patients had been continuously free of disease for 6.5 to 12.3 years. PMID- 3306939 TI - Metastatic tumours of bones of the hand and foot. A comparative review and report of 43 additional cases. AB - Metastases in the bones of the hands and feet are rare. The literature relating to these tumours has been reviewed, and 43 new cases are reported. In the cumulative total of cases, metastases to the hand outnumber those to the foot 2:1 (196 cases as against 94). Bronchial carcinoma is the most common neoplasm metastasising to the hand. Subdiaphragmatic neoplasms such as gastrointestinal, vesical, renal and uterine malignancies, metastasize more frequently to the foot. A possible explanation for this latter finding is the retrograde spread of tumour emboli from the vertebral venous plexus down incompetent leg veins. PMID- 3306940 TI - Traditional Chinese medicine: some historical and epistemological reflections. AB - So-called Chinese medicine is practiced widely in the U.S.A. and Europe, and traditional Chinese medical concepts are presented, and advocated, through a vast body of secondary literature in European languages, as alternatives to current western interpretations of illness and disease. The present paper analyses some of the values determining the reception of traditional Chinese medicine in the west, and it demonstrates how the cognitive aesthetics of European culture and western science have influenced the selection of specific concepts from a heterogeneous pool of traditional Chinese conceptual systems of health care by western authors in recent years. A comparison of different approaches to health care in traditional Chinese as well as traditional European and modern western medicine suggests that the differences between Chinese and western medicine may not be as clear-cut as they have been portrayed in western secondary literature of the past years. One of the more fundamental dividing lines appears to be the handling of cognitive disagreements, and, possibly related to this, the ubiquitous phenomenon of patterned knowledge in Chinese medicine and culture. PMID- 3306941 TI - Lay theory of healing in northwestern New Spain. AB - Northwestern New Spain experienced not only a territorial and a spiritual conquest, but a medical conquest. This medical conquest came from a tradition, established after the conquest of central New Spain, that had fused classical medicine of the Old World with medicine of indigenous groups, in the writings of European doctors and scientists as well as graduates of Mexican colleges. The medical conquest of Sonora was accomplished by laymen, explorers and missionaries who carried the theory of healing resulting from these syncretic processes into the northern lands, adding new materials that they learned from indigenous peoples there. When the Indians were ill with epidemic disease or injuries, they were cared for by missionaries brought up on European domestic medicine. The theory of illness and its cure held by the lay healers became predominantly that of the conquest culture. The conquerers', missionaries' and colonists' interpretations of native plant, animal and mineral remedies that they learned from northwestern native medicine were colored by their own concepts of disease and healing, resulting in an epistemology which continues to guide lay or domestic medicine not only in Sonora but also in the rest of the American Mexican west today. PMID- 3306942 TI - The Kur in West Germany as an interface between naturopathic and allopathic ideologies. AB - In countries where biomedicine developed from earlier medical knowledge, medical pluralism provides unusual cultural parameters and perspectives on biomedical epistemologies. Past therapy traditions, which are still salient in the biomedical system of West Germany today, are examined historically and ethnomedically. The Kur, now part of a complex system of rehabilitation medicine utilizing medical bathing and environmental stimuli, illustrates divergent ideologies in the contemporary German health care system. The influence of cultural, social, and political-economic factors on therapeutic eclecticism and directions are discussed as cultural dynamics of the biomedical system in general. PMID- 3306943 TI - Moxalactam versus clindamycin plus tobramycin for the treatment of puerperal infections. AB - Sixty women with the diagnosis of puerperal endometritis were randomized to receive either moxalactam (n = 29) or the combination of clindamycin and tobramycin (n = 31) as therapy for their infection. Endometrial bacteriology consisted of mixed flora, both aerobic and anaerobic gram-positive and gram negative organisms. Clinical cure was achieved in 27 (93%) of the moxalactam treated patients and 28 (90%) of those given combination therapy. The two failures of moxalactam therapy were associated with enterococcal infection. Failures of clindamycin/tobramycin therapy were due to enterococcal infection, abscess formation, and moderately severe diarrhea. This study indicates that moxalactam is as effective and safe as the combination of clindamycin/tobramycin for the treatment of postpartum endometritis. PMID- 3306944 TI - Serial sonograms to detect pancreatitis in children receiving L-asparaginase. AB - The clinical, laboratory, and ultrasonographic findings in children receiving L asparaginase therapy were retrospectively reviewed and correlated to determine the diagnostic reliability and clinical usefulness of serial pancreatic sonograms in detecting L-asparaginase-induced pancreatitis. A total of 217 sonograms were obtained in 92 patients. Six of the 92 (6.5%) had L-asparaginase-induced pancreatitis. The diagnosis of pancreatitis was based solely on clinical symptoms in three patients, on clinical and laboratory findings in two, and on sonographic and laboratory findings in one. No confirmed cases of pancreatitis were detected solely by ultrasonography before clinical or laboratory evidence was obtained. Sonograms were useful only in confirming clinical and/or laboratory evidence of pancreatitis, but were of no value in making the early or preclinical diagnosis of drug-induced pancreatitis. We have discontinued the practice of obtaining routine serial pancreatic sonograms in children receiving L-asparaginase at our institution. PMID- 3306945 TI - Sinusitis and asthma. AB - Knowledge of the diagnosis and treatment of sinusitis is essential to the care of the patient with asthma. Interest in the association of this disease and bronchial asthma has been renewed during the past decade, although it had been recognized for years. Sinusitis is more common in subjects with asthma, especially those with the aspirin triad (aspirin intolerance, asthma, and nasal polyps). Proper treatment by medical and/or surgical means will frequently result in significant improvement of asthma. PMID- 3306946 TI - Local and regional recurrence of breast cancer: a perspective on detection and treatment in relation to reconstruction. PMID- 3306947 TI - Henry Hill Hickman (1800-1830): country doctor and discoverer of inhalation anesthesia. PMID- 3306948 TI - Captopril-induced liver dysfunction. AB - We have described a patient with captopril-induced cholestatic jaundice. Captopril was confirmed as the causative agent, because jaundice occurred after administration of captopril and resolved quickly after administration was stopped. PMID- 3306949 TI - Pleural aspergillosis diagnosed by computerized tomography. AB - As shown by the case we have reported, patients with a chronic pneumothorax and nodular, thickened pleura may have pleural aspergillosis. We recommend that when such patients have CT of the chest, the examiner use the alternate dependent position to look for mobile pleural debris. PMID- 3306950 TI - [Medical history aspect of the study of the role of schools of science in the development of medical science]. PMID- 3306951 TI - [The history of Caucasian mineral waters]. PMID- 3306952 TI - [The Moscow physician Kh. F. Oppel' and his role in the establishment of Soviet paramedical education]. PMID- 3306953 TI - [Operations of the Communist Party of the Soviet Union in public health administration during World War II (1941-1945)]. PMID- 3306954 TI - [Epidemic control work of military physicians in liberated areas during World War II]. PMID- 3306955 TI - [History of social-hygienic studies of students]. PMID- 3306956 TI - [Preventive therapy prescriptions in early Russian literature]. PMID- 3306957 TI - [Contribution of Abu-1-Kasima az-Zakhravi to medicine]. PMID- 3306958 TI - [Training of physicians at the Kazan Admiralty Naval Hospital]. PMID- 3306959 TI - [Instruction in the history of medicine in light of the resolutions of the 27th Congress of the CPSU]. PMID- 3306960 TI - [Surgical treatment of bullous emphysema of the lungs]. PMID- 3306961 TI - [Hereditary hemochromatosis]. PMID- 3306962 TI - [Data processing modeling in the preventive medical examinations of women]. PMID- 3306963 TI - [The 50th anniversary of the journal "Sovetskaia Meditsina"]. PMID- 3306964 TI - [Clinico-immunologic indices in pseudotuberculosis (yersiniosis)]. PMID- 3306966 TI - [Radiodiagnosis of recurrences and metastases of colorectal tumors]. PMID- 3306965 TI - Scoliosis induced by medullary damage: an experimental study in rabbits. AB - To date, there have been no reports of experiments designed to induce scoliosis by direct damage of different areas of the spinal cord. In a series of rabbits with medullary damage, the authors attempted selectively to interrupt the pathways that mediate proprioceptive input. Unilateral lesion of the dorsal column and posterior horn of the spinal cord was performed using three different techniques: coagulation with laser, stereotaxic microcoagulation, and longitudinal electrocoagulation. Of 32 operated rabbits, 17 developed scoliosis, exhibiting clear pathologic damage of the spinal cord. Electrophysiologic study, including EMG and analysis of the tonic -- vibratory reflex, was performed on 10 rabbits with medullary damage (scoliotic and non-scoliotic) and 12 matched controls. The data suggest disturbance of the sensory afferences that control the postural tone and consequent muscular imbalance, expressed as reduced activity in the muscles of the convex side. This work supports the view that loss of proprioceptive neural impulses caused by medullary damage can induce scoliosis. PMID- 3306967 TI - [Malignant liver tumors due to Thorotrast exposure: comparison of ultrasound, computed tomography and nuclear magnetic resonance]. PMID- 3306968 TI - Occupational cancer and carcinogenesis. PMID- 3306969 TI - Chemical carcinogenesis: tumor initiation and promotion. PMID- 3306970 TI - Occupational cancers of the gastrointestinal tract. I. Colon, stomach, and esophagus. PMID- 3306971 TI - Occupational cancers of the gastrointestinal tract. II. Pancreas, liver, and biliary tract. PMID- 3306972 TI - Occupational cancers of the brain and bone. PMID- 3306973 TI - Occupational skin cancers. PMID- 3306974 TI - Occupational leukemia. PMID- 3306975 TI - Regulators and workplace carcinogens. PMID- 3306977 TI - In vitro testing for carcinogens and mutagens. AB - A large number of in vitro assays for chemical carcinogenicity and mutagenicity have been developed. They have been validated to various extents with the use of known carcinogens and noncarcinogens. When applied to chemicals of unknown carcinogenicity, they must be used in a battery or a tiered testing protocol. This is necessary since false negatives may occur with any one assay. The size of the battery should depend upon the potential risk to humans. A chemical with high human exposure (e.g., food additives) should be tested with a larger number of assays than one with more limited human exposure. The tests should complement one another and detect different events. Thus bacterial or mammalian mutation, cell transformation, DNA repair and chromosome assays should all be included in a test battery. Results form in vitro assay can be utilized to determine whether the chemical should also be tested in an animal bioassay. While negative results in all tests may indicate low risk, a chemical with widespread human exposure may still be worth evaluating in a long-term animal bioassay. It is impossible to prove a chemical safe and without risk. Short-term assays do, however, provide a means for quickly obtaining reasonable information about the genotoxic potential of large numbers of chemicals. PMID- 3306976 TI - Oncogenes and oncogene proteins. PMID- 3306978 TI - Animal testing of carcinogens. PMID- 3306979 TI - Occupational cancer epidemiology. PMID- 3306980 TI - Occupational cancers of the respiratory tract. PMID- 3306981 TI - Occupational cancer of the urinary tract. PMID- 3306982 TI - Health in the health care industries? PMID- 3306983 TI - Health problems of health care workers. PMID- 3306984 TI - Transmission of human immunodeficiency virus within the health care setting. PMID- 3306985 TI - Prevention of hepatitis in health care workers. PMID- 3306986 TI - Hazard control of infectious agents. PMID- 3306987 TI - Health hazards to personnel handling antineoplastic agents. PMID- 3306988 TI - Allergy to laboratory animals in health care personnel. AB - Lab animal allergy is a frequent affliction of health care and research personnel whose work involves contact with lab animals. It affects up to 30% of those who are exposed directly and even some workers exposed indirectly, often unwittingly. The consequences of LAA may be severe, including disabling asthma and loss or attenuation of a career. Although recognized for many years, the working-out of the fine details about animals antigens, extracts, and diagnosis and treatment regimens is still far from finished. Not one prospective study longer than one year has been reported, although at least three are underway. It is hoped that information from these studies will contribute to the knowledge about the true incidence of LAA, exposure dose-response, and sensitivity, specificity, and positive predictive value of possible contributory factors such as atopy. The consesus of opinion is that, until the full significance of possible predictive factors is known, judgments concerning employment based on these factors should be avoided. Finally, there is a great need for increased emphasis on the development and objective evaluation of preventive measures. PMID- 3306989 TI - Indoor air quality in health care facilities. PMID- 3306990 TI - Chemical dependency in health care professionals. PMID- 3306991 TI - Stress in health care workers. PMID- 3306992 TI - Organization and conduct of a hospital occupational health service. PMID- 3306993 TI - Actuarial status of the HI (hospital insurance) and SMI (supplementary medical insurance) Trust Funds. AB - This article is adapted from the 1987 Annual Reports of the Medicare Board of Trustees. It presents a summary of the current financial and actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds. The Board found that the present financing schedule for the HI program is sufficient to ensure the payment of benefits over the next 12-14 years if the intermediate (II-A and II-B) assumptions underlying the estimates are realized. Although steps have been undertaken to reduce the rate of growth in payments to hospitals, the Board urges Congress to take remedial measures to bring future HI program costs and financing into balance. The Board found the SMI program to be actuarially sound but recommends that Congress take action to curtail the rapid growth in that part of Medicare. PMID- 3306994 TI - Piperacillin and a combination of clindamycin and gentamicin for the treatment of hospital and community acquired acute pelvic infections including pelvic abscess. AB - Therapy for acute polymicrobial pelvic infections is empiric and must include predictable anaerobic coverage. Single agent therapy, if effective, is advantageous for the patient, nurses, pharmacy and hospital. Piperacillin sodium was compared with a combination of clindamycin and gentamicin as therapy for 63 female patients who were hospitalized with acute pelvic infections including pelvic abscess complicating community acquired salpingitis. Over-all clinical efficacy with piperacillin was 96.8 per cent and 90.3 per cent for clindamycin and gentamicin. Fewer bacteria demonstrated in vitro resistance to piperacillin (p = 0.008) and the cost of treatment for these infections was significantly less with piperacillin (p less than 0.05). Serious adverse reactions were not observed with either regimen. Piperacillin provides effective, cost-efficient therapy for women with acute polymicrobial pelvic infections. PMID- 3306995 TI - The central venous anatomy in infants. AB - A study of 21 consecutive autopsy specimens of infants less than one year of age and weighing less than 6 kilograms was performed to determine the topographic anatomy and regional relationships of the central venous anatomy. This anatomy was compared with 14 additional autopsies performed upon older children. There was no significant difference in diameter between the internal jugular and subclavian venous system, on either the right or left side. In the infant, the right and left subclavian veins entered the central system at an acute angle. The left innominate vein joined the right innominate vein at a right angle. These angulations become less acute after one year of age. This adult configuration may account for the relative ease of central venous cannulation through the percutaneous subclavian approach in the older patient. In contrast, the external and internal jugular veins entered centrally in almost a straight line even in the infant. The findings of this study suggest that the internal and external jugular veins should be considered as safe and reliable portals for percutaneous entry into the central venous system in infants. In the infant less than one year of age, the difficult patient (for example, those with thrombocytopenia or severe pulmonary failure) or when the surgeon is less familiar with the infraclavicular approach, the veins of the neck may, in fact, be the site of choice. Additionally, we believe that a surgeon should not hesitate to switch to the internal or external jugular site after unsuccessful attempts at percutaneous entry into the subclavian vein. PMID- 3306996 TI - Leo Davidoff. PMID- 3306998 TI - Stereotactic operation for brain abscess. AB - Stereotactic management of brain abscess (stereotactic aspiration with external drainage) was performed in 14 patients. Fifteen abscesses in 14 patients were successfully aspirated by this method. After aspiration of the abscess, all patients underwent external drainage for an average of 14.5 days. No complications during aspiration or during external drainage (such as bleeding or infection, respectively) were encountered in our series. Ten out of 14 patients (71.4%) showed excellent prognosis, and 3 of 14 (21.4%) showed good outcome. Only one patient died after the operation, but this was due to lung cancer. Our operative results are quite satisfactory in comparison with operative results reported by other authors. PMID- 3306999 TI - A perspective of the 1940s. PMID- 3306997 TI - Estrophilin immunoreactivity versus estrogen receptor binding activity in meningiomas: evidence for multiple estrogen binding sites. AB - The existence of estrogen receptors in human meningiomas has long been a controversial issue. This may be explained, in part, by apparent heterogeneity of estrogen binding sites in meningioma tissue. In this study, estrogen receptors were determined in 58 meningiomas with an enzyme immunoassay using monoclonal antibodies against human estrogen receptor protein (estrophilin) and with a sensitive radioligand binding assay using 125I-labeled estradiol (125I-estradiol) as radioligand. Low levels of estrophilin immunoreactivity were found in tumors from 62% of patients, whereas radioligand binding activity was demonstrated in about 46% of the meningiomas examined. In eight (14%) tissue samples multiple binding sites for estradiol were observed. The immunoreactive binding sites correspond to the classical, high affinity estrogen receptors: the Kd for 125I estradiol binding to the receptor was approximately 0.2 nM and the binding was specific for estrogens. The second, low affinity class of binding sites considerably influenced measurement of the classical receptor even at low ligand concentrations. The epidemiological and clinical data from patients with meningiomas, and the existence of specific estrogen receptors confirmed by immunochemical detection, may be important factors in a theory of oncogenesis. PMID- 3307000 TI - [Diagnosis of malignancies in the head and neck area: impasse or progress? From the viewpoint of the otorhinolaryngologist]. AB - The article describes the role of sonography in the diagnostic of head and neck tumors, comparing the advantages and disadvantages in regard to other methods. The suprasonic procedure permits the detection of the dimension, type, borderlines and relations of tumors to neighbour tissues. The method has a special value for preoperative staging and surgical planning strategy. But also in long time controls sonographic diagnostic takes a definitive place. The ultrasound controlled biopsy is regarded as an important progress. PMID- 3307001 TI - [Diagnosis of malignancies in the head and neck area: impasse or progress? From the viewpoint of the radio-oncologist]. AB - Magnetic resonance imaging is a new imaging method with growing importance in diagnostics, therapy planning and follow-up of ORL tumors. The method has multiple benefits compared to other examination methods such as ultrasonography or computed tomography. These benefits are demonstrated for different anatomic structures as examples. PMID- 3307002 TI - [Carcinoma of the nasopharynx: remarks on its etiology, diagnosis and prognosis]. AB - In Germany the yearly incidence rate of nasopharyngeal carcinoma (NPC) is about 0.2 to 0.4. Most of them are carcinomas and lymphoepitheliomas of Schmincke Regaud type (anaplastic or poorly differentiated). Etiologically important are genetic and environmental factors as well as Epstein-Barr virus (EBV) infection. Beside the usual clinical and radiological examination EBV serology therefore is of great importance for the diagnosis of NPC. The level of VCA-IgA and VCA-IgG as well as EA-titers is significant for the differential diagnosis, the early therapeutic success and the long term follow-up especially in case of lymphoepithelioma. Present five-year survival rates range from 10 to 20% (squamous cell carcinoma) to 40 to 50% (lymphoepithelioma). These aspects will be critically discussed in summary with regard to the own results and those from the literature. PMID- 3307003 TI - [Electrophoretic studies on the effect of different types of radiation (60Co, electrons, x-ray, photons, UV) on low-molecular ribonucleic acids]. AB - Electron irradiation (45 MeV) with the chosen doses modifies the molecule composition of isolated dry yeast RNA. High-energy irradiation will crack the RNA which then forms new chains of macromolecular nucleic acids. Other radiation types (60Co, photons, X-rays) do not modify dry RNA, but when irradiated in aqueous solution, these macromolecular bands will be built, too. After UV irradiation with 254 nm delivered over 24 hours these macromolecular bands disappear completely in the electrophoretic diagram. This wavelength corresponds to the absorption maximum of purines, thus stimulating them and reducing their stability. PMID- 3307004 TI - Experience with 3, 6, and 24 hours' hypothermic storage of the canine pancreas before islet cell preparation and transplantation. AB - Canine pancreases underwent cold storage in Collins' solution (CS) or in silica gel-filtered plasma (SGF) for 3, 6, and 24 hours before collagenase digestion and autotransplantation of dispersed pancreatic tissue that contained islet cells to the spleens of totally pancreatectomized dogs. The functional outcome in these animals was compared with animals that received intrasplenically autotransplanted pancreatic islet cell preparations from unstored pancreases. Normoglycemia was restored in 15 of 20 (75%) dogs that received freshly prepared islets. Two of five dogs (40%) whose pancreases were stored in CS for 3 hours became normoglycemic, as did 2 of 5 dogs (40%) whose pancreases were stored for 3 hours in SGF. When 6-hour storage was used only 1 of 5 dogs (20%) whose pancreases were stored in CS and 1 of 5 dogs (20%) in whom SGF was used for storage became normoglycemic. Normoglycemia occurred in only 2 of 16 dogs (12.5%) whose pancreases were stored for 24 hours (one in SGF and one in CS). The results indicate that islet cell preparation should be performed immediately after pancreatectomy. The failure thus far of clinical islet allotransplantation may be due, at least in part, to functional deterioration during preservation of the donor pancrease before isolation of islet cells. PMID- 3307005 TI - Neutrophil activation after burn injury: contributions of the classic complement pathway and of endotoxin. AB - We attempt to elucidate the mechanisms of neutrophil (PMN) activation after burn injury. We previously reported prolonged elevations of PMN cell surface complement (C) opsonin receptor levels after burn trauma with a corresponding period of depressed PMN chemotaxis to C5a, which suggests that the C product, C5a, was responsible for PMN activation. However, a lack of direct correlation of C activation with C receptor levels soon after injury raised the possibility of a second PMN-activating substance. We therefore investigated the effect of endotoxin (LPS) on the expression of the C receptors (CR1 and CR3) by normal human PMNs. Concentrations from 0 to 50 ng/ml of LPS 026:B6 caused a dose response increase in the PMN surface expression of CR1 and CR3 as assessed by monoclonal antibody binding and indirect immunofluorescence. The relative CR1 dependent fluorescence rose from a mean of 50 to 385 and CR3 from 50 to 300. Chelation by ethylenediaminetetra acetic acid (EDTA) did not influence this dose response, thus ruling out the possibility of C activation by LPS--an inference supported by the lack of complement activation observed with these concentrations of LPS in normal serum. A similar dose response was obtained in the absence of other cell types or serum, which implies a direct effect that mimicked that of C5a. To determine the mechanism of the later, prolonged C activation after burn injury, we next examined C activation products in 22 patients with burn injuries. Elevations of plasma C3a desArg were present and persisted for 50 days. Elevations were at maximum levels on days 9 through 13 postburn (mean +/- standard error of mean [SEM], 496 +/- 47 ng/ml versus normal 113 +/- 32; p less than 0.01). These were accompanied by elevations of C4a desArg (917 +/- 154 ng/ml versus normal 424 +/- 50; p less than 0.01), which are indicative of classic pathway activation. Finally, we examined PMN function, phagocytosis and percentage killing of Staphylococcus aureus, and found PMN function to be unaltered in the 22 patients. Thus PMN activation after burn injury appears to be caused by LPS soon after injury and by C5a later after injury and affects only selected PMN functions. PMID- 3307007 TI - [These are my best memories. Recollections from the East, Middle and West]. PMID- 3307006 TI - [Living past: Deaconess House in Kaiserwerth]. PMID- 3307008 TI - [Children's health. 17. Pedagogy and childhood are carved into the school's features]. PMID- 3307009 TI - [Children's health. 18. The poorest pupils are stamped with the visit of lice]. PMID- 3307010 TI - [A case of a long-term course of Brill-Symmers disease without active antineoplastic therapy]. AB - The paper is concerned with a case of Brill-Symmers' disease started with the thrombocytopenic syndrome relating to hypersplenism. After splenectomy the first benign stage of disease without eradication therapy lasted over 10 years. Signs of immunological incompetence (signs of secondary infection) and recurring immune thrombocytopenia were noted in that period. A regular use of glucocorticoids and antibiotics resulted in the improved condition. The development of the second stage of disease (malignant diffuse lymphoma with the involvement of the internal organs) was fast resulting in the patient's death. PMID- 3307012 TI - [Effectiveness of platidiam in the chemotherapy of lymphogranulomatosis and lymphosarcoma]. PMID- 3307011 TI - [A case of successful transplantation of allogeneic bone marrow in a patient with myelocytic leukemia]. AB - Allogenic bone marrow transplantation was performed in a patient with chronic myelocytic leukemia (Ph+) in a stable phase. A 1,5-year recurrence-free period since the time of transplantation was observed. Transplantation features were as follows: incompatibility of the recipient and donor by ABO-antigens, the development of acute graft versus host disease and transient Ph-positivity. PMID- 3307013 TI - A tier system for developmental toxicity evaluations based on considerations of exposure and effect relationships. AB - The backlog of untested chemicals and the rate at which new substances enter the marketplace exceed our capacity for developmental effects testing by standard in vivo methods. However, conservative use of two observations in a manner consistent with present day understanding of abnormal developmental biology can more accurately focus attention and resources on those agents in greatest need of complex testing for effects on in utero development. These two observations are 1) most chemicals are no more toxic to embryonic development than they are to adult homeostasis and 2) most human exposure to chemicals is de minimus, i.e., so small that it is inconsequential. Recently devised in vitro assays to quantitatively rank chemicals according to their developmental hazard index, when used in conjunction with more conventional in vivo methods and appropriate considerations of exposure, permit evaluation of a significantly larger number of chemicals than is currently achieved. The methods described apply a tier approach to establish testing priorities that markedly reduce the time, cost, and number of laboratory animals needed for evaluation of developmental toxicity. PMID- 3307014 TI - Loss of the activity of human coagulation factor XII by a chymotrypsin-like protease activated in rat mast cells during degranulation with compound 48/80. AB - Mediator release from mast cells is an initial step in the immediate-type hypersensitivity. Thus, the interaction of neutral proteases released from mast cells with plasma kallikrein-kinin system was investigated. Two proteases, chymotrypsin-like (CHY) and trypsin-like (TRY) proteases, were activated in purified rat mast cells after degranulation with compound 48/80. Three fourths of the CHY activity remained in the cell residue, and the activity was inhibited by chymostatin, whereas most of the TRY activity was released in the medium and was inhibited by leupeptin. The incubation of rat or human plasma with degranulated mast cell (DMC) suspension did not cause the activation of plasma prekallikrein, but did cause a loss in the activity of coagulation factor XII, as ascertained by the lack of activation of prekallikrein in either the DMC-treated plasma by glass powder or in the incubation of DMC-treated human plasma with factor XII deficient plasma activated by kaolin. The prekallikrein and high-molecular-weight kininogen levels were sufficient for activation of factor XII. PMID- 3307016 TI - Who really discovered anesthesia? PMID- 3307015 TI - Enhanced release of von Willebrand factor by human endothelial cells in culture in the presence of phorbol myristate acetate and interleukin 1. AB - Human umbilical vein endothelial cells (EC) were cultured in the presence of 4 beta-phorbol 12-myristate 13-acetate (PMA), interleukin 1 (IL-1) and interleukin 2 (IL-2), and secretion of von Willebrand factor activity (vWF, Ristocetin Co factor) and von Willebrand factor antigen (vWFAg) measured at intervals. The levels of both vWF and vWFAg in cultures containing IL-1 were significantly higher than those in control cultures after longer than 5-6 days growth. Similarly, the levels of vWF and vWFAg were significantly increased in cultures containing PMA, but in these instances the rate of cell growth appeared to be enhanced, and confluence was observed after 6 days compared to 9-10 days in control cultures. vWF and vWFAg also increased significantly in the supernatant of confluent control EC incubated further with IL-1. Moreover, the immuno fluorescence pattern of vWFAg in these treated cells was markedly less granular than that of control cells. Immuno-fluorescence of PMA-treated cells suggested that vWFAg might be less granular than in control EC but the mean levels of vWF and vWFAg in the supernatant of cells incubated with PMA were not significantly different from control values. The results of all assays in the presence of IL-2 were not significantly different from those of control cells. In all instances no morphological evidence of endothelial injury was observed, and more than 90% of cells remained viable at the termination of cultures. The results indicated that the synthesis and release of vWF were increased in the presence of PMA, and secretion of vWF was stimulated by IL-1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307018 TI - [Ultrasound guided fine-needle aspiration biopsy in cytological diagnosis]. PMID- 3307017 TI - Dental miracle drug. PMID- 3307019 TI - [Ultrasonic diagnosis of ileocolic intussusception]. PMID- 3307020 TI - Immunochemical comparison of peptide angiogenic factors. AB - A panel of 40 monoclonal antibodies was constructed in response to cationic endothelial cell growth factor (c-ECGF), the cationic peptide mitogen isolated from endothelial mitogen. The monoclonal antibodies were assayed by dot blot for immunoreactivity to various other peptide angiogenic factors. The panel of monoclonal antibodies to c-ECGF exhibited complete cross-reactivity with pituitary fibroblast growth factor and sarcoma-derived growth factor. A group of 28 monoclonal antibodies was found to exhibit reactivity to anionic endothelial mitogen (a-ECGF), brain fibroblast growth factor, endothelial cell growth factor, and retina-derived growth factor. None of the monoclonal antibodies was found to react with epidermal growth factor or platelet-derived growth factor. These data provide an immunological basis for grouping heparin-binding endothelial cell growth factors into anionic and cationic groups. PMID- 3307021 TI - Monoclonal antibodies as probes for processing of the mosquito yolk protein; a high-resolution immunolocalization of secretory and accumulative pathways. AB - A library of monoclonal antibodies (mAB) directed against yolk polypeptides of the mosquito Aedes aegypti was utilized to visualize the secretory pathway of these polypeptides in the fat body and their accumulative pathway in developing oocytes. Single and double immunolabelling using mABs and colloidal gold of different sizes confirmed biochemical observation that 200 +/- 5 and 65 +/- 3 kDa polypeptides represent subunits of the yolk protein. This immunocytochemical analysis showed that, in trophocytes of the fat body, both the subunits of the yolk protein were routed simultaneously through the Golgi complex into secretory granules and were subsequently secreted. The yolk protein subunits were also directed together through all the steps of the accumulative pathway in the oocyte. Double immunogold labelling revealed that the subunits were present together during their binding to the oocyte membrane, transportation into and accumulation in the transitional yolk body, and, finally, crystallization in the mature yolk body. Electron microscopical immunocytochemistry also confirmed immunofluorescent data and showed that mABs directed against different steps in the biosynthetic processing of the yolk protein in the fat body, as well as in its accumulative pathway in oocytes. PMID- 3307022 TI - Endotoxin inactivation by the humoral components in the tolerant rat serum. AB - A rapid inactivation of endotoxin has shown to occur following its incubation in serum obtained from endotoxin-tolerant rats with the aid of the limulus amebocyte lysate (LAL) assay. The tolerant rat had large quantities of lipopolysaccharide inhibitor (LPSI) activity, which does not appear to be complement. Heating tolerant rat serum for 60 min at 56 degrees C or the addition of lead acetate to the tolerant serum both resulted in the loss of LPSI activity. This paper focuses on the most unique properties of LPSI, namely it's alteration of activity after heating or the addition of lead acetate, compared with those properties of inhibitors for endotoxin which have been previously demonstrated by a number of investigators. PMID- 3307023 TI - A comparative study, with 40 chemicals, of the efficiency of the Salmonella assay and the SOS chromotest (kit procedure). AB - A comparison was made, for 40 compounds belonging to different chemical classes, of the mutagenicity as measured by the Salmonella assay and of the SOS-inducing potency as measured by the SOS chromotest kit procedure. It was found that most (78%) of the chemicals described as mutagens/carcinogens (14 compounds) were detected with a simplified Ames test procedure, using 3 strains (TA 97, TA 98, TA 100) and 3 concentrations of the tested material. The SOS chromotest, carried out following the recommendations of the commercially available kits, revealed that only 4 Ames test-positive compounds were mutagenic towards E. coli strain PQ 37. PMID- 3307025 TI - Mid 19th century Cape Town dental advertising ephemera. PMID- 3307024 TI - 2-(N-nitroso-N-methylamino)propiophenone, a direct acting bacterial mutagen found in nitrosated Ephedra altissima tea. AB - A new N-nitroso compound identified in a nitrosated tea extract made from the plant Ephedra altissima and shown to be formed under in vivo conditions was identified as 2-(N-nitroso-N-methylamino)propiophenone (NMAP). N-Nitrosoephedrine (NEP), another N-nitroso compound detected in nitrosated Ephedra altissima tea and NMAP are shown to exert mutagenic activity in the Salmonella/mammalian microsome mutagenicity (Ames) test. Base-pair substitution mutation-detecting strains (TA100 and TA1535) showed both compounds to be weak direct-acting mutagens without the addition of S9-mix. The identification, synthesis and mutagenicity of NMAP are discussed. PMID- 3307026 TI - An inexpensive apparatus for automatic continuous dehydration. AB - An apparatus is described for automatic dehydration of material using the principle of continuous dilution. Specimens may be dehydrated, in a period chosen by the operator, for as little as 30 min to as much as 16 hr (overnight). The apparatus is inexpensive both to construct and to run. PMID- 3307027 TI - Method for histological preparation of bone sections containing titanium implants. AB - A thin sectioning technique involving hand grinding has been developed to produce 20-40-microns-thick sections of bone-titanium implant sites. Components include: 1) surface staining of sections prior to mounting on slides so bone labels (oxytetracycline-HCl and 2,4-bis(N,N-dicarbomethyl)aminomethylfluorescein (DCAF] can be seen in sections viewed with transmitted light, 2) a pneumatic sample press for bonding sections to slides with a thin, uniform glue line and without trapped air bubbles, and 3) bonding methyl methacrylate embedded sections to clear acrylic slides with methyl methacrylate monomer to provide enhanced bond strength and grinding properties compared to those obtainable with glass slides. Sample cracking and distortion is minimized and the tissue-implant interface can be kept intact. The expense of start-up equipment for this technique is minimal. PMID- 3307029 TI - Film coating on single-slot grids for high voltage electron microscopy of serial thick sections. PMID- 3307028 TI - Decalcification end point determination by X-rays and flame photometry to obtain superior quality pulpal sections. AB - Radiography and flame photometry have been compared as means of determining the end point of decalcification in relation to minimizing pulp-dentin separation in histological sections of teeth. Eighteen homologous pairs of vervet monkey incisor teeth were decalcified in a formic-citric acid mixture. At 24 hr intervals decalcification was monitored in half of the teeth by radiography and in the other half by flame photometry. When decalcification was complete as determined by the respective methods, histological specimens were prepared and separation at the pulp-dentin interface evaluated in hematoxylin and eosin stained step serial sections. The median separation was determined for the combined group and the median test applied. There was significantly less separation in the flame photometry group and within each group significantly less separation on the side where the knife cut from dentin to pulp. PMID- 3307030 TI - A rapid fluorescence method for observing phloem regeneration in Coleus blumei. PMID- 3307031 TI - A method of retaining phloroglucinol proof of lignin. PMID- 3307032 TI - A simple method for exact alignment of small paraffin embedded specimens to the cutting plane. PMID- 3307033 TI - Carotid and lower extremity arterial disease in elderly adults with isolated systolic hypertension. AB - The prevalence of carotid and lower extremity arterial disease was assessed in a healthy population of 56 elderly adults with isolated systolic hypertension. Duplex scans were performed to determine the extent of carotid disease, and postexercise ratios of ankle to arm systolic blood pressure were measured to assess lower extremity arterial disease. Internal carotid stenosis was found in 38% (21 of 56) of subjects and lower extremity arterial disease in 42% (23 of 55). The strongest predictor of internal carotid stenosis was lower extremity arterial disease. Independent risk factors for lower extremity arterial disease were smoking, internal carotid stenosis, and age. A measure of extent of carotid plaque was found to correlate with age, carotid stenosis, male sex, history of smoking, and total cholesterol. The high prevalence of peripheral vascular disease in this population may be related to their age and blood pressure. The high correlation between carotid stenosis and lower extremity arterial disease suggests that persons with peripheral vascular disease should be assessed and treated for atherosclerotic disease in general. PMID- 3307035 TI - Bone marrow transplantation. PMID- 3307034 TI - Duplex ultrasound and Doppler analysis in evaluating carotid artery disease. PMID- 3307036 TI - A solid-phase antiglobulin test. AB - A solid-phase test (SPT), a machine-readable adaptation of the indirect anti human globulin test (IAHG), is described. The SPT level of sensitivity was comparable to that of the manual IAHG test for the detection of IgG antibodies and was compared with manual pretransfusion compatibility tests. The average difference from the mean of duplicate SPT results was 5.94 percent of the optical density value. The data also demonstrated a linear and overlapping relationship between the scores of manual IAHG tests and SPT optical density values. The accuracy of the SPT declined slightly as the concentration of red cell samples increased; the optimum concentration of immunoglobulin used in the preparation of the solid phase was about 275 mg per l. The 97.5th percentile of negative tests occurred at the same optical density (0.13) when serums from either healthy donors or hospitalized patients were tested. Compatibility tests completed on 1304 blood samples from donors and 437 serum samples from hospitalized patients showed that 1.38 percent of results were SPT-positive and manual IAHG-negative, and 5.37 percent were SPT-negative and manual IAHG-positive. The lowest possible score in the manual test was allocated to 97.14 percent of the latter group, indicating good correlation between the two techniques. PMID- 3307038 TI - Bone marrow collection from a 9.4-kg donor avoiding allogeneic blood transfusion. PMID- 3307037 TI - ABO and Lewis blood group antigens of donor origin in the bile of patients after liver transplantation. AB - The authors prospectively studied the expression of blood group antigens and their corresponding glycosyltransferases in the bile of 11 patients who received orthotopic liver transplants. In six patients, the donor was of the same ABO/Lewis/secretor as the recipient, and the expected blood group antigens were found in the postoperative bile. Five patients who received transplants from donors discordant for either ABO, Lewis, or secretor status continued to produce blood group antigens of donor origin. This study provides evidence that the expression of soluble blood group antigens is under autonomous end-organ control. PMID- 3307040 TI - P-31 nuclear magnetic resonance spectroscopic evaluation of heterotopic cardiac allograft rejection in the rat. AB - P-31 nuclear magnetic resonance (NMR) spectroscopy was used to evaluate heterotropic cardiac allograft rejection in the rat. To enable optimal application of NMR spectroscopy for the in vivo study of myocardial metabolism in the transplanted organ, an accessory heart transplantation to groin in the rat was used. The allografts were studied in a 1.89 Tesla horizontal bore magnet. Each spectrum was obtained by Fourier transform of 512 scans using 60-degree pulses with 2-sec delays. Changes in phosphocreatine (PCr), adenosine 5 triphosphate (ATP), and inorganic phosphate (Pi) and intracellular pH as determined by P-31 NMR were compared with rejection process as judged by histological studies. Allografts treated with cyclosporine (CsA) did not show any rejection (NR) and had relatively high levels of PCr, and low levels of Pi. Allografts that did not receive any CsA revealed both vascular and cellular rejection. These rejected allografts (R) had relatively low levels of PCr and high levels of Pi. It is concluded that P-31 NMR spectroscopy may have potential application to the clinical diagnosis of cardiac allograft rejection. PMID- 3307039 TI - Extension of survival of rat parathyroid allografts by depletion of Ia donor cells plus preoperative cyclosporine. AB - Methods that avoid chronic immunosuppression of transplant recipients must be developed to eliminate the various risk factors associated with such treatment (e.g., increased infections and malignancies). Pretransplant treatment of the graft with anti-Ia serum plus complement to eliminate "passenger cells" is one such method. An alternative approach is short-term treatment of the recipients with cyclosporine (CsA). In this study, parathyroid glands from Lewis X Brown Norway rats were cultured for one week at 37 degrees C and treated with anti-Ia and complement. Treated glands were transplanted into parathyroidectomized, hypocalcemic Wistar-Furth recipients that had received 30 mg/kg of CsA once a day for the three days prior to transplant. At 1 year posttransplant, 67% of the recipients had functional parathyroid allografts. Control rats (no CsA; fresh, untreated glands) rejected their grafts within 28 days. Controls given three days of CsA and transplanted with fresh, untreated glands all had functional grafts for greater than 56 days (median survival: 80.5 days). Prolongation of allograft survival with short-term, preoperative CsA demonstrates the efficacy of immunosuppression given only at the time of antigen presentation. This course of CsA allowed for indefinite graft survival when the recipient received a graft previously cultured and treated with Ia antiserum. These results are encouraging and should be evaluated further to determine whether similar approaches will be useful in human transplants. PMID- 3307041 TI - Immunologic, morphologic, and functional evaluation of long-term-surviving beagle lung allograft recipients treated with lethal total-body irradiation, autologous bone marrow, and methotrexate. AB - Immunologic, morphologic, and functional evaluations were performed in beagle dogs with single lung allografts surviving 3-13 years after transplantation. Immunosuppressive treatment included lethal total-body irradiation, autologous bone marrow reconstitution, and three doses of methotrexate. Three beagle recipients with full DLA-haplotype-matched grafts and five recipients with one haplotype-mismatched grafts were studied. Evidence of rejection--i.e., infiltrates on chest roentgenograms, hypoperfusion on radionuclide lung scans, and histopathologic changes--were absent in the matched recipients and in three of the five mismatched recipients. Two of the mismatched recipients had decreased perfusion to their allografted lungs, and open-lung biopsy specimens revealed diffuse fibrotic blood vessels with narrowed lumina but no other abnormalities. Decreased fractional blood flow to the lung allograft of the five one-haplotype mismatched recipients was correlated (r = -0.92) with the level of donor-specific cytolytic lymphocyte activity generated in mixed lymphocyte cultures (MLC). In contrast, the level of proliferative activity in donor-specific MLC did not correlate well with graft function. These findings suggest that the mechanism of tolerance to these lung allografts (with particular regard to vascular integrity) involves attenuation of the response against major histocompatibility complex (MHC) class I alloantigen since the induction of cytolytic T lymphocytes in MLC is directed primarily against these molecules. Though all of the mismatched recipients had the ability to react against MHC class II alloantigens in vitro (as demonstrated by proliferative responses in MLC), in vivo responses to class II gene products may not occur because of the lack of expression of these molecules on long-term surviving grafts. PMID- 3307042 TI - Preoperative preparation of high-risk, specifically hyperimmunized canine renal allograft recipients with total-lymphoid irradiation and cyclosporine. AB - Hyperimmunized subjects are a particularly high-risk and rapidly growing group in the patient population awaiting renal transplantation. In a search for methods designed to ameliorate the prognosis in such cases, dogs of defined DLA genotype were sensitized with DLA incompatible skin allografts and injections of buffy coat. Each recipient was challenged with a renal allograft bearing the same DLA incompatibilities. Five dogs received kidney transplants, without any other treatment, and rejected their transplants at 2.5, 4, 5, 6, and 6.5 days, respectively. Another four dogs were given a 9-11-week course (1760 +/- 35 cGy) of total-lymphoid irradiation (TLI), followed by rabbit antithymocyte globulin (ATG); these animals rejected their renal allografts at 7, 8, 14, and 17 days, respectively. Five other dogs were treated with TLI and received cyclosporine (CsA) and methylprednisolone (MPd) daily until graft rejection. Their renal allografts survived for 7.5, 8.5, 20, 62, and 227 days, respectively. Renal allografts placed in normal recipients under the same conditions of donor recipient DLA incompatibility had a mean survival time of 12.4 days (range: 10-18 days). At the time of transplantation, the specific anti-DLA antibody titers in the recipients were 81 to 243 in the untreated dogs; 27 to 81 in the TLI-ATG treated group, and 3 to 243 in the TLI-CsA/MPd-treated group. The titers fell within 24-48 hr after renal transplantation, to 3 to 81 in the untreated sensitized dogs; they were 3 to 9 in the TLI-ATG-treated group, and were 9 to 243 in the TLI-CsA/MPd treated group. The cytotoxic antibody titers reached postoperative peaks of 6500 to 200,000 in the untreated dogs; 729 to 6500 in the TLI-ATG-treated dogs, and 243 to 6500 in the TLI-CsA/MPd-treated recipients. The combined use of TLI and CsA/MPd can significantly inhibit the capacity of immunized recipients to muster a secondary humoral response to the DLA antigen(s) used in the sensitization process; such treatment also abrogates the ability of the recipients to reject renal allografts bearing the same DLA specificities in accelerated fashion. This effect of TLI and cyclosporine may be of relevance to current severe problems in high-risk hyperimmunized human renal transplant candidates. PMID- 3307043 TI - Expression of class II major histocompatibility complex antigens by bronchial epithelium in rat lung allografts. AB - Variations in expression of class II major histocompatibility complex antigens on bronchial epithelial cells and vascular endothelium were investigated in normal rat lungs and allografted lungs during acute rejection and after cyclosporine (CsA) treatment. BN (RT1n) left lungs were transplanted into LEW (RT1l) recipients. Lungs were excised during acute rejection in untreated rats on postoperative days 1 through 5, and after CsA treatment (25 mg/kg on days 2 and 3) on days 5 and 100. Cryostat sections were examined for class II antigen expression with an immunoperoxidase technique, using various monoclonal antibodies. In the normal lung, class II antigens were not expressed by epithelial or endothelial cells. In the allografts, induction of class II antigens closely correlated with the rejection process: on day 2, the ciliated bronchial epithelium was locally positive; it became uniformly positive with increasing cellular peribronchial infiltration on days 3 and 4. CsA treatment prevented class II antigen expression to a certain extent, leaving the bronchial epithelium weakly positive at 100 days. Endothelial cells were invariably negative for class II antigens in all allografted lungs. The class II antigens expressed on the bronchial epithelial cells were of graft origin, except for recipient-type class II molecules found on the ciliated surface in CsA-treated animals. We conclude that expression of class II antigens by bronchial epithelium is the result of a bronchus-directed rejection process, and hypothesize that such a rejection process may have caused bronchiolitis obliterans in several of the patients with combined heart-lung transplants. Important is the observation that class II molecules can be present on the membranes of cells that do not themselves produce these antigens. PMID- 3307044 TI - Precise specificity of induced tubular HLA-class II antigens in renal allografts. AB - HLA-class II antigen expression is induced in the tubules of renal allografts, but it is unclear whether all three class II products--HLA-DR, DQ, and DP--are induced, and whether the induced product is of donor origin. A pretransplant (n = 14) and serial transplant biopsies (n = 45) were obtained from 14 transplant recipients in whom induced HLA-class II antigen was detected after transplantation with a monoclonal antibody reactive with HLA-DR, DP, and possibly DQ antigens. Cryostat sections were stained with locus-specific or polymorphic monoclonal antibodies in an indirect immunoperoxidase assay. In pretransplant biopsies intracellular HLA-DR antigen was expressed on proximal tubules, whereas all tubules were negative for HLA-DQ and DP products. After transplantation grafts with induced tubular HLA-class II antigen had induced HLA-DR, DQ and DP antigens expressed both within the cytoplasm and on the cell membranes. The donor or recipient origin of induced HLA-class II expression was determined using polymorphic antibodies specific for either donor or recipient antigens. This approach demonstrated that the induced class II antigen is of donor origin--and, furthermore, that the renal parenchyma remains of donor HLA-type, even one year after transplantation, and thus remains a source of antigenic stimulus to the recipient. PMID- 3307045 TI - Fulminant hepatitis in renal transplant recipients. The role of the delta agent. AB - In a series of about 300 renal transplant patients followed from 1972 to 1983, 3 cases of fulminant hepatitis were observed in HBs Ag-positive patients. In the liver biopsies of 2/3 of them, the delta antigen was detected by direct immunofluorescence with a specific anti-delta serum. This result demonstrates the responsibility of the delta agent for the development of fulminant hepatitis, and emphasizes the possibility of delta infection in HBs Ag-positive transplant patients with severe hepatitis. PMID- 3307046 TI - Needle biopsy evaluation of class II major histocompatibility complex antigen expression for the differential diagnosis of cyclosporine nephrotoxicity from kidney graft rejection. AB - Twenty needle biopsies from 14 patients were taken at times of renal dysfunction, and frozen sections were stained for class I and class II major histocompatibility complex (MHC) antigen expression using the immunoperoxidase technique and monomorphic mouse monoclonal antibodies. Eight of the 9 biopsies taken during periods of dysfunction attributed to cyclosporine toxicity had normal levels of class II expression. In contrast, 9 of the 10 biopsies taken during episodes of rejection had easily recognized increases in class II expression. In the one case where no definite clinical diagnosis was possible, no class II induction was present. Class I levels were less definitive but tended to be markedly raised in the cases of rejection, and only mildly raised in the cases of nephrotoxicity. Biopsy results can be available within 1 1/2-2 hr. The test is therefore likely to be of value in the correct diagnosis of the cause of renal dysfunction and thereby improve the management of cyclosporine-treated renal transplant patients. PMID- 3307047 TI - Close association between antibodies to cytoskeletal intermediate filaments, and chronic graft-versus-host disease. AB - Chronic graft-versus-host disease can mimic various autoimmune disorders, although autoantibodies are rarely detected in the sera of affected patients. Antibodies to cytoskeleton are a frequent finding in patients affected by autoimmune disorders. In all the sera of 16 patients who were submitted to allogeneic bone marrow transplantation, we have found antibodies against cytoskeletal intermediate filaments. Moreover, the titer of such antibodies is quite elevated when compared with those reported in autoimmune disorders. A statistically significant difference between the titers found in patients without and with cGVHD (median 1:40 vs. 1:256, P less than 0.05) has been found. This would suggest that such antibodies might be relevant in monitoring clinical course. Furthermore, since certain cytoskeleton antigens have been shown to be expressed also on cell membrane, antibodies against intermediate filaments might also play a more important role by interfering with such surface structures. PMID- 3307048 TI - Epithelial class II antigen expression in cutaneous graft-versus-host disease. AB - Induced class II histocompatibility antigens have been observed in the target tissues of rodents and humans with acute graft-versus-host disease (GVHD). Possibly this expression triggers the target tissue phase, through antigen presentation, lymphocyte recruitment, or additional antigenic stimulus. We have tested whether the induced expression is required for cutaneous GVHD in human marrow recipients. Ninety-two skin biopsies from 37 allogeneic marrow recipients at the Johns Hopkins Bone Marrow Transplant Unit were stained for HLA-DR, OKT6 (Langerhans cells), and for surface markers of lymphocyte and monocytes. Of 22 biopsies taken at the onset of GVHD, 12 did not have detectable HLA-DR antigen, and 10 had patchy-to-diffuse expression. The biopsies with HLA-DR- GVHD consisted primarily of epithelial infiltrates of cytotoxic/suppressor cells (CD8+), while those with HLA-DR+ GVHD had a mixed infiltrate with more helper/inducer/class-II reactive cells (CD4+) in the epidermis and dermis and more monocytes in the dermis. Eight of 9 patients with HLA-DR- GVHD had follow-up biopsies that later expressed epithelial DR antigen, but the epidermal and dermal infiltrates showed no significant changes. Most of those receiving cyclosporine (CsA) prophylaxis (7/9) developed HLA-DR- GVHD, while those receiving cyclophosphamide were split between the two groups (8 of 13 were HLA-DR+). HLA-DR antigen expression was evident in some biopsies with no GVHD or minimal GVHD but did not appear to predict the development of GVHD or the type of GVHD. HLA-DR antigen expression was not evident in 2 of 3 initial biopsies of lichenoid-type chronic GVHD. Class II antigen induction is clearly not necessary for the target phase in most patients of this study. PMID- 3307049 TI - Effect of immunization with Escherichia coli J5 on graft-versus-host disease induced by minor histocompatibility antigens in mice. AB - We have used a cell-wall-deficient mutant of Escherichia coli (E coli J5) to study the effect of active and passive immunization against bacterial endotoxin (ET) in a murine model of acute graft-versus-host disease (GVHD) induced by minor histocompatibility antigens. C57BL/B6 (H-2b) mice were irradiated and grafted with 1 X 10(7) anti-Thy-1.2 and complement-treated bone marrow cells and 5 X 10(7) spleen cells from LP/J (H-2b) donors. Groups of mice were immunized against J5--either actively immunized with killed J5 cells or pure J5 lipopolysaccharide or passively immunized with rabbit anti-J5 antiserum (R alpha J5). Controls included irradiation controls, negative controls (conventional mice grafted with depleted bone marrow only), positive controls (conventional mice grafted with bone marrow and spleen cells), and mice passively immunized with normal rabbit serum (NRS). Positive control mice developed GVHD and all died by day +77. Active immunization partially protected against the rapid weight loss due to GVHD (P less than 0.05) but mice had an earlier onset of GVHD (P less than 0.05) and a shortened survival after onset (P less than 0.05). Median survival time (MST) and overall survival were unchanged. Passive immunization with R alpha J5 delayed death (P less than 0.01), increased MST (P = 0.01), increased overall survival (P less than 0.01), and protected against weight loss (P = 0.01). NRS had no beneficial effect. PMID- 3307050 TI - Graft-versus-host reactions in the beige mouse. An investigation of the role of host and donor natural killer cells in the pathogenesis of graft-versus-host disease. AB - To investigate the role of natural killer (NK) cells in the induction and pathogenesis of graft-versus-host (GVH) disease, +/beige (+/bg; normal NK cell activity) and beige/beige (bg/bg; deficient NK cell activity) parental C57BL/6 (B6) lymphoid cells were used to induce GVH reactions in either B6 X C3H/Hej +/bg (+/bgF1) or B6 X C3H/HeJF1 bg/bg (bg/bg F1) hybrid mice. When B6 bg/bg parental lymphoid cells (PLC) were injected into bg/bg F1 mice, early splenomegaly, early severe suppression of the plaque-forming cell (PFC) response to sheep red blood cell (SRBC), and only partial suppression of T cell mitogen responses to concanavalin A (Con A) and phytohemagglutin (PHA) were observed on day 12 after GVH induction. In the same GVH combination, slightly augmented NK cytotoxic activity was induced and no GVH-induced moderate-to-severe pathological alterations in the liver and pancreas were observed. When bg/bg PLC were injected into +/bg F1 mice, early splenomegaly and pronounced immunosuppression of the PFC response to SRBC and partial suppression of Con A and PHA responses were observed on day 12 after GVH induction. In this combination (bg/bg----+/bg F1), significant NK cell activity was induced, but no moderate-to-severe histopathological alterations were observed. In contrast, when B6 +/bg PLC were injected into either +/bg F1 or bg/bg F1 hybrids, early splenomegaly, and severe immunosuppression of both the PFC response to SRBC and the T cell mitogen responses to Con A and PHA were observed by day 12--which persisted until day 30 after GVH induction. Furthermore, high NK cell activity was recorded and moderate to-severe histopathological alterations appeared in both +/bg F1 and bg/bg F1 recipients. These results show that the bg/bg PLC can induce GVH-associated early splenomegaly and immunosuppression of the PFC response to SRBC in both the bg/bg F1 and +/bg F1 hybrids, but that it failed to induce moderate-to-severe histopathological alterations, even though NK cell activity of host origin was activated during GVH reactions. Conversely, when +/bg donor cells were used to induce the GVH reaction, splenomegaly and immunosuppression, as well as moderate to-severe histopathological lesions were induced. These results suggest that donor NK cells rather than host NK cells play an active role in GVH-associated tissue damage, which in turn contributes to the long-term suppression. PMID- 3307051 TI - Hyperthermia for treatment of human split-thickness skin. Differential effects on HLA-DR-expressing cells and keratinocytes. AB - Human split-thickness skin was hyperthermia-treated and then the tissue was trypsinized to obtain dispersed cell suspensions. Cells consisting mainly of keratinocytes, obtained from the treated epidermis, retained their capacity to grow in vitro. By contrast, HLA-DR-expressing cells, dispersed from the epidermis as well as the dermis, lost their capacity to stimulate allogeneic peripheral blood mononuclear leukocytes after heat treatment (1.5 hr at 45 degrees C). The heat-treated epidermal cells did not release a factor that inhibited allogeneic lymphocyte proliferation. Even though the cells expressing HLA-DR antigen were no longer capable of stimulating allogeneic lymphocytes after hyperthermia, they still expressed HLA-DR antigen on their surface up to 72 hr after exposure to heat. The inhibition of stimulation of allogeneic lymphocytes by heat treatment was at least partially reversed by the addition of exogenous interleukin-2, but not interleukin-1. Thus, functions of the various cell types present in split thickness skin were differentially sensitive to heat, a characteristic of skin cells that may be useful in skin transplantation. PMID- 3307052 TI - Drug-induced tolerance to allografts in mice. XII. The relationships between tolerance, chimerism, and graft-versus-host disease. AB - When AKR/J Sea (AKR, H-2k) mice were primed i.v. with 1 X 10(8) viable spleen cells from naive C3H/He Slc (C3H, H-2k) mice and treated i.p. with 200 mg/kg cyclophosphamide (CP) 2 days later, a minimal degree of mixed chimerism associated with tolerance to C3H skin was established without graft-versus-host disease (GVHD) and maintained for at least one month. When AKR mice were primed i.v. with 1 X 10(8) viable spleen cells from C3H mice preimmunized i.v. 7 days earlier with 5 X 10(7) viable AKR spleen cells, and treated with 200 mg/kg CP, chimerism became exclusive, but lethal GVHD occurred in the AKR mice. Moreover, most of normal AKR mice primed with the preimmunized C3H spleen cells without CP died of GVHD. In contrast, in a major histocompatibility complex (MHC) incompatible combination of AKR (H-2k)-C57BL/6 Cr Slc (B6, H-2b), mixed chimerism, tolerance to skin allografts, and GVHD were not observed, whether or not the mice had been treated with naive or preimmunized B6 spleen cells with or without CP. PMID- 3307053 TI - Retransplantation with HLA-identical living-related allografts in children. PMID- 3307054 TI - Prevalence of hyperlipidemia in heart transplant recipients. PMID- 3307056 TI - Replacement of donor cells after liver transplantation. PMID- 3307055 TI - Effects of coadministration of cyclosporine and acyclovir on renal function of renal allograft recipients. PMID- 3307058 TI - Prolongation of segmental and pancreaticoduodenal allografts in the primate with total-lymphoid irradiation and cyclosporine. AB - The prolongation of segmental and pancreaticoduodenal allografts (PDA) by total lymphoid irradiation (TLI) and in combination with cyclosporine (CsA) was assessed in a well established total pancreatectomy, diabetic, primate transplantation model. Pancreatic transplantation was performed in 119 pancreatectomized baboons (Papio ursinus). Of a total of 109 allografts performed, 71 were segmental allografts (open duct drainage) and 38 PDA. Of 119 graft recipients, 10 received segmental pancreatic autografts. TLI and CsA administered separately to segmental allograft recipients resulted in modest allograft survival and indefinite graft survival was not observed. 8 of 17 (47%) segmental allograft recipients that received TLI and CsA had graft survival beyond 100 days, indicating highly significant pancreatic allograft survival. All long-term segmental allograft recipients were rendered normoglycemic (plasma glucose less than 8 mmol/L) by this immunosuppressive regimen. In contrast, poor results were observed in PDA recipients treated with TLI and CsA. Mean survival in 18 treated PDA recipients was 23.8 days, 8 survived longer than 20 days (44.4%), and 1 greater than 100 days (5.5%). Despite treatment, early rejection of the duodenum in PDA recipients frequently resulted in necrosis and perforation and contributed to a high morbidity and mortality. This study indicates that, in contrast to the significant prolongation of segmental allografts by TLI and CsA, poor immunosuppression was achieved by this regimen in PDA recipients and was associated with a high morbidity and mortality caused by early rejection of the duodenum. PMID- 3307057 TI - Engraftment of DLA-nonidentical bone marrow facilitated by recipient treatment with anti-class II monoclonal antibody and methotrexate. AB - Marrow transplants were carried out between unrelated DLA-nonidentical dogs. Recipients were prepared for transplantation by 9.2 Gy single-dose total-body irradiation (TBI) administered at 7 cGy/min. All recipient dogs received marrow, 4 X 10(8) cells/kg, and no buffy coat cells. In addition to TBI, 19 dogs were given anti-class II monoclonal antibody (mAb) 7.2, either alone or combined with a second anti-class II mAb, HB10a, at doses of 0.2 or 0.4 mg/kg/day on days -5 to 0 or -1 to +3. Seven had hemopoietic engraftment. Ten dogs were given, in addition to TBI, methotrexate (MTX), 0.4 mg/kg/day on days 1, 3, 6, and 11 after grafting, and six had engraftment. Ten dogs were given a combination of mAb 7.2 pregrafting and MTX after grafting, and 9 had evidence of engraftment. Among 7 dogs treated with the irrelevant mAb 31E6.4, only one had engraftment. Thus the administration of anti-class II mAb pregrafting and MTX postgrafting had a beneficial effect in overcoming resistance to histoincompatible marrow grafts. Possibly this effect is more pronounced when both approaches are combined. PMID- 3307059 TI - Allogeneic bone marrow transplantation in irradiated adult rabbits. AB - In an effort to produce stable, long-term, complete hematopoietic chimerism in unrelated RLA-matched adult rabbits, the maximum dose of total-body irradiation (TBI) tolerated both with and without autologous marrow support was defined, and it was then determined whether the maximum tolerated dose was sufficiently immunosuppressive and myeloablative to allow engraftment of allogeneic marrow. Forty rabbits received TBI at 4.8 cGy/min at doses from 525-925 cGy. All rabbits receiving 525, 625, 725 and 825 cGy survived without marrow transplantation. At 875 cGy 50% of animals died and at 925 cGy all animals died within 96 hr of TBI. Survival was not changed with autologous marrow support, with all animals receiving 825 cGy surviving, while 50% survived at 875 cGy, and none at 925 cGy. Two RLA-matched, sex and immunoglobulin allotype-mismatched pairs were transplanted following 825 cGy and were given posttransplant cyclosporine. Both recipients survived beyond 200 days posttransplant, with cytogenetic and immunoglobulin allotype evidence of complete, or nearly complete, hematopoietic engraftment. Thus, stable, long-term complete chimerism can be achieved in adult RLA-matched unrelated rabbits prepared by TBI, and this animal model can be used for bone marrow transplantation studies. PMID- 3307060 TI - The effect of verapamil in reducing the severity of acute tubular necrosis in canine renal autotransplants. AB - Calcium channel blockade has been shown to prevent warm renal ischemic damage. The ability of verapamil to decrease the severity of acute tubular necrosis (ATN) after 24-hr cold storage and autotransplantation was studied in a randomized paired study of 12 dogs. Experimental animals pretreated with intraarterial verapamil and flushing of the harvested kidney with cold intracellular solution containing verapamil demonstrated significantly (P less than .05) greater renal function preservation over their matched controls. A subsequent nonpaired study of 6 dogs treated only with flushing of the harvested kidney with perfusate containing verapamil demonstrated no significant preservation advantage over controls. We conclude that verapamil, administered prior to the ischemic event, can enhance the protective effect of hypothermia and decrease the severity of ATN in ischemically injured kidneys. PMID- 3307061 TI - The impact of cyclosporine and combination immunosuppression on the incidence of posttransplant diabetes in renal allograft recipients. AB - The incidence of posttransplant diabetes mellitus (PTDM) was compared in three groups of renal transplant recipients: nondiabetic patients who had been randomized between 1980 and 1983 to receive antilymphoblast globulin (ALG), azathioprine (AZA), and prednisone (P) (group 1) or cyclosporine (CsA) plus prednisone (group 2). Group 3 consisted of a more recent (1984-85) cohort who were given a combination of azathioprine, cyclosporine, and prednisone (+/- ALG). PTDM developed in 20 of 173 previously nondiabetic 18-55-year-old patients. Three of 47 patients (6.4%) in group 1, 4 of 58 patients (6.9%) in group 2, and 13 of 68 patients in group 3 (19.1%) developed PTDM. Thus in the two groups composing the concurrent prospective randomized trial (groups 1 and 2) the incidence of PTDM did not differ. The subsequent patients who were given a combination of ALG, azathioprine, cyclosporine, and prednisone developed a significantly greater incidence of PTDM even though the total dose of cyclosporine and prednisone were lower than in groups 1 and 2. PTDM usually occurred within two months of transplantation, and 11 of 17 patients who initially required insulin are still dependent upon exogenous insulin. The incidence of PTDM was not significantly affected by sex of the recipient, HLA-type, primary renal disease, rejection episodes, primary vs. secondary transplant, or prior splenectomy. The incidence of PTDM is greater in patients older than 45 (34.2% vs. 5.2%), and heavier than 70 kg (21.1% vs. 5.1%); in recipients of cadaveric allografts (15.7% vs. 4.6%); and in patients who were hospitalized for infections (22.4% vs. 4.7%). CsA levels tended to be higher in the group 2 and 3 patients who developed PTDM than in those who remained nondiabetic. One-year actuarial patient survival in those with PTDM was 83.3% vs. 98% (P less than .01) in the nondiabetic and graft survival was 77.1% vs. 87.1% (NS). The combination of Minnesota ALG, azathioprine, cyclosporine, and prednisone appears to predispose older, heavier recipients of cadaver allografts to the development of PTDM. The risk of PTDM must be weighed against the more usual results of improved patient and graft survival using this combination of immunosuppression. PMID- 3307062 TI - Who should be converted from cyclosporine to conventional immunosuppression in kidney transplantation, and why. AB - Twenty-three cadaveric renal allograft recipients with stable but compromised kidney function were electively converted from cyclosporine to azathioprine one year after transplantation. Within a few weeks glomerular filtration rate (GFR) rose by 40% and serum creatinine fell from 171 +/- 12 (mean +/- SEM) to 129 +/- 7 mumol/L. The increase in GFR was due to an increase in effective renal plasma flow of 21%. This suggests that one year of continuous cyclosporine (CsA) therapy does not result in irreversible structural renal damage. Although antihypertensive treatment was not changed, blood pressure fell from 142 +/- 4/90 +/- 3 to 123 +/- 3/77 +/- 2 mmHg. In addition a significant drop in serum cholesterol and triglycerides and an improvement in glucose tolerance were found. The beneficial effects on renal function, blood pressure, and metabolic indices were, however, outweighed by a high incidence of postconversion rejection in recipients of a second allograft. For these patients conversion from CsA to azathioprine seems therefore contraindicated. Recipients of a first kidney allograft can be converted safely, as long-term CsA administration in these patients induced a solid engraftment. The sequelae of the mode of treatment- impaired renal function, hypertension, and metabolic disturbances--are reversible even after late conversion. PMID- 3307063 TI - Accidental transplantation of malignant tumor from a donor to multiple recipients. PMID- 3307064 TI - Pancreas autotransplantation--unsuitability of the swine as a model. PMID- 3307065 TI - Effect of retinoid therapy on rat cardiac allograft survival. PMID- 3307067 TI - Ureteropyelostomy with a monofilament absorbable suture. PMID- 3307066 TI - Self-limited Toxoplasma parasitemia after liver transplantation. PMID- 3307069 TI - Autoimmune hyperthyroidism associated with chronic graft-versus-host disease. PMID- 3307068 TI - Natural killer cell activity in cardiac transplant recipients. PMID- 3307070 TI - One-stage urethroplasty for stricture. PMID- 3307071 TI - Fatal P. falciparum malaria mimicking Babesia infection. PMID- 3307072 TI - Experience with ultrasound on a medical ward in Papua New Guinea. PMID- 3307074 TI - [Changes in the karyotype and surface properties of L cells during the adaptation of a suspension culture to monolayer growth]. AB - Distribution of cells (L929, LS, LSM) in the two-phase polymer system was studied in addition to characterization of their karyotypes. In the course of LSM cell passages, the increased ratio of cells with a reduced number of chromosomes was found. The results obtained show that in the process of adaptation of the suspension cell culture to the growth as monolayer (the culture of LSM cells) the changes of the cell surface do not dependent on the chromosome number. PMID- 3307073 TI - [Estimation of the randomness of the overlapping of cellular structures]. AB - Methods for estimation of randomness of mutual overlaps of cells, their parts, and intracellular structures are developed. Two methods are proposed: a "method of areas" based on the estimation of the area of overlaps of randomly located figures, and a "method of contours" based on the evaluation of the number of intersections of linear structures located randomly. Examples are given as applied to cells and cellular nuclei, in particular during contact inhibition of cellular movement. PMID- 3307075 TI - [Lines of transformed murine thymus cells. I. Production of the lines]. AB - Supernatant of activated cells of human T-leucosis line "Jurkat" enriched with interleukin-2 (IL-2) was injected to Balb/c mice. After a number of injections the animals were sacrificed and the thymus cells were cultured in vitro. Transformed cell clones were formed on days 3-4. Two stable T-cell strains of the reproduced primary cells were obtained (TC.SC-1/1.1. and TC.SC-1/2.0). The strains corresponded to the transitional stage of pre-T-lymphocytes and consisted of tumour cells. A possible mechanism of malignant transformation of these cells is discussed. PMID- 3307076 TI - [Postreplication DNA repair in Escherichia coli cells. III. Repair independent of the presence of pKM101 and COLIb-P9 plasmids]. AB - The presence of pKM101 or ColIb-P9 plasmids in E. coli leads to the increase in the survival of UV-irradiated cells of wild type and of polAI, recB21 recC22 and dnaGts mutants; it does not change the survival of recA13 and lex3 mutants and does not influence kinetics and efficiency of postreplication repair (PRR) of DNA in cells of all the strains examined (with the exception of PG3 dnaGts mutant whose PRR of DNA in the presence of pKM101 plasmid is somewhat lower). The survival of both plasmid-containing and plasmid-free bacteria treated with chloramphenicol decreases in the same degree, but the survival of chloramphenicol treated recA13, lex3 recB21 rec C22 mutants does not change. The pKM101 plasmid does not lend the dnaGts mutant a new capacity of repairing postreplication gaps with the participation of inducible component of PRR; the chloramphenicol sensitive component of PRR is absent in this mutant. Plasmid and plasmid-free E. coli strains of wild type and of the polA1 mutant do not differ by the kinetics and level of inducible chloramphenicol-sensitive component of PRR of DNA. PMID- 3307077 TI - [Redistribution of bone marrow cells according to mitotic cycle phases after the action of agents altering the intracellular concentration of cyclic nucleotides]. AB - The method of flow cytofluorometry was used to determine the distribution of murine bone marrow cells along the phases of the cell cycle in normal mice (CBA X C57Bl) F1 after the whole body equal X-ray irradiation, after irradiation in combination with burn, after administration of imidazole, insulin and caffeine, and after the treatment of cells by acetylcholine. In non-irradiated mice insulin and caffeine induced an increased ratio of bone marrow cells in G0 and G1 and a reduced one in S phase. Imidazole increased the number of G2- and M-cells by 1.5 times only in regenerating bone marrow of irradiated mice. After X-ray irradiation of mice at a dose of 2.3 Gy, reducing the percentage of cells in S and increasing it in G2 and M phases, insulin, acetylcholine and caffeine were found to decrease the number of cells in G2 and M phases: besides, caffeine and acetylcholine increased the percentage of S-phase cells. The data obtained are discussed in terms of possibility of normalization of bone marrow cell proliferation broken after exposure to physical stress-factors. PMID- 3307079 TI - [Liposomes as carriers of polyfunctional immunogens]. AB - Liposomes are promising carriers for construction of the up-to-date chemical vaccinal preparations. The immunogenic and immunomodulating properties of liposomes may be varied by incorporation of the natural or synthetic immunomodulators into the inner water volume or into the lipid bilayer parallel with antigens as well as by introduction of the receptor-specific vector to definite types of immunocompetent cells into liposomes. The pronounced immunobiological properties of the liposomal carrier are shown in studies of liposomes conjugated with haptens or model protein antigens. The application of liposomes as carriers of bacterial antigens induces a delayed catabolism of the antigen and formation of its depot. The immunomodulating properties of antigen containing liposomes rise after introduction of such immunomodulators as lipid A, muramyldipeptide or interleukin-1 into the liposome composition. PMID- 3307081 TI - The value of ultrasound in the initial assessment of gynecological patients. PMID- 3307078 TI - Control of Brucella melitensis infection in sheep and goats--a review. PMID- 3307080 TI - [Peptide hydrolase activity in brain tissues during the early stages of post hypothermia period]. AB - The acid peptidohydrolase activity in the homogenate, dissoluble and mitochondrial-lysosomal fractions of brain tissues of rats who have endured deep hypothermia was determined after their "active" warming for an hour and on the 1st, 2nd, 3d and 7th days after their self-warming. The "active" warming of rats who have endured deep hypothermia (19-20 degrees C) brings about the restoration of the acid peptidohydrolase activity in the subcellular brain tissue fractions. After self-warming the examined enzyme activity restores 7 days later. In the dynamics of the posthypothermic period a change in the acid peptide hydrolase distribution in fractions occurs on the 2nd-3d days. PMID- 3307082 TI - Bibliography of biomedical ultrasound. No. 67. PMID- 3307083 TI - Facial baroparesis: a review. AB - If impaired eustachian tube function causes an overpressure to remain in the middle ear after ascent in diving or aviation in a subject with a defect in the wall of the facial canal, an ischemic neurapraxia of the seventh cranial nerve may occur. This type of facial palsy is designated facial baroparesis, baroparesis facialis, or alternobaric facial palsy. If the middle ear pressure is asymmetric the subject may also have alternobaric vertigo. A causative relationship between middle ear overpressure and facial palsy is supported by the palsy's rapid onset following a reduction in ambient pressure and by its quick disappearance after either an increase in ambient pressure or release of the middle ear overpressure. Transient compression-induced ischemic neurapraxia of the facial nerve is also demonstrated in animal experiments. A similar palsy, ischemic neurapraxia of the fifth cranial nerve due to compression in the maxillary sinus, has been reported in divers. Although it is under-reported, facial baroparesis occurs infrequently, with 23 subjects mentioned in the available literature. Nevertheless, it is important to be aware of its existence, because misdiagnosis as type II DCS or air embolism results in unnecessarily long recompression treatments and pointless delay of resumption of diving. In the worst case, a misdiagnosis might cause a diving license to be revoked. PMID- 3307084 TI - Priestley lecture 1986. On the science of deep-sea diving--observations on the respiration of different kinds of air. PMID- 3307085 TI - Absence of circulating PGI2 response to bubble-provoking decompression. PMID- 3307086 TI - Development of androgen-independent tumor cells and their implication for the treatment of prostatic cancer. AB - Development of androgen-independent prostatic cancer cells from androgen responsive cells can occur by a variety of mechanisms (e.g., environmental adaptation, multifocal origin, or genetic instability). Regardless of the mechanism of development, however, once androgen-independent cancer cells become present within prostatic cancer, the tumor is no longer homogeneous but is now heterogeneous. Once a prostatic cancer is heterogeneously composed of both androgen-dependent and -independent cancer cells, androgen withdrawal therapy, no matter how complete, cannot be curative. In order to produce cures of such heterogeneous prostatic cancers, hormonal therapy must be combined simultaneously with chemotherapy early in the course of the disease so that all the cancer populations (i.e., androgen-dependent and -independent) can be simultaneously affected within an individual patient. PMID- 3307087 TI - Hormone-independent, non-alkylating mechanism of cytotoxicity for estramustine. AB - Over two decades, experience with estramustine has provided limited data which support an estrogenic mechanism of action and no data which indicate the nitrogen mustard involvement in the cytotoxic properties of the drug. Consideration of the carbamate-ester portion of estramustine supports the pharmacokinetic evidence that estramustine has a long half life since enzymatic hydrolysis of the carbamate is an uncommon event. Using a variety of immunocytochemical and cellular morphology procedures, estramustine per se has been found to express anti-cytoskeletal properties through non-covalent binding to microtubule associated proteins (MAP's). In both fish erythrophores and in dividing human prostatic carcinoma cells, estramustine exerts an antimicrotubule effect at micromolar concentrations. Thus, estramustine possesses unique pharmacology and protein binding specificity. As such, it should not be classified as an alkylating agent. The estrogenic effects, while possibly of relevance to clinical administration, are not the primary mechanism by which the drug exerts cytotoxicity. PMID- 3307088 TI - Carbohydrate residues in non-malignant prostatic epithelium as revealed by lectins. AB - Non-neoplastic prostatic epithelium from 39 patients obtained at transurethral resection for outflow tract obstruction and 5 normal prostates from men under 35 years of age obtained at postmortem were formalin-fixed and paraffin-embedded. The distribution of 8 lectin receptors were studied using a peroxidase anti peroxidase method and an avidin-biotin method. Con A, WGA, and PNA bound to most epithelial cells. Con A and WGA also showed major stromal binding. Approximately 5% to 10% of cells bound UEA1, GS1, DBA, SBA and BPA. No major differences in lectin receptor expression were observed between normal and hyperplastic epithelium with either of the immunohistochemical techniques except that hyperplastic cells stained more strongly than normal epithelium. PMID- 3307089 TI - [Ureter replacement operations]. AB - Reviewing the recent literature and own clinical experiences, the possibilities of replacement of the ureter by isolated bowel segments, alloplastic prostheses and xenoplastic or autoplastic transplants are shown and evaluated. Although used only in single cases, the interposition of the appendix vermiformis into larger defects of the ureter seems to render the best results. The interposition of bowel segments in the urinary tract has been applied more often, the results, however, have been variable. Numerous modifications have been proposed. The use of alloplastic prostheses and free autologic transplants have--up to now--led to no satisfying long-term results. Only human deep frozen umbilical veins as xenotransplants seem to be suitable as ureter replacements. PMID- 3307090 TI - [Plastic surgical correction of megaureter]. AB - Between 1967 and 1986 185 children (246 renoureteral units) and 21 adults (25 renoureteral units) with megaureters have been treated surgically in our department. 85 of the children had primary obstructive megaureters, 77 children showed secondary megaureters, whereas 23 others showed either a gross ureteral dilatation due to an ureterocele or gross reflux. All of the adult patients presented with primary obstructive megaureters. 122 children (65.9%) and 15 adults (71.4%) underwent ureterocystoneostomy (UCN) using various techniques, the Psoas Hitch technique being exclusively the method of choice since 1977 with markedly better results. The indication for ureteral tapering was considered extremely conservatively. In the rest of the patients the elimination of the infravesical obstruction alone was sufficient or a nephrectomy/nephroureterectomy had to be performed due to a non-functioning kidney. The percentage of UCN in primary obstructive megaureters throughout the years (79% in 1967-1971 and 63% in 1977-1986) and its significant decrease in secondary megaureters from 71% to 39% during the same time period displays the conceptional changes in the therapy regimen. The majority of children and adults with primary obstructive megaureters can be treated conservatively. UCN should be indicated for cases with synchronous reflux and/or recurrent febrile urinary tract infections. The indication for ureteral tapering should be considered very carefully. Especially in secondary megaureters the indication for ureteral tapering and reimplantation is rare since the adequate relief of the infravesical obstruction may be sufficient alone in many of the cases. PMID- 3307092 TI - [The S-bladder--a complete continent antireflux functional replacement of the bladder sphincter muscle function]. AB - The S-bladder, developed on the basis of the Parks S-pouch, is a continent ileourethrostomy with antireflux implantation of the ureters via a nipple valve. It provides a low-pressure reservoir with a large capacity and allows voiding in the natural way by means of abdominal straining. Reflux is reliably prevented by use of the antireflux nipple valve already familiar from the Kock pouch. If continence during day and night cannot be achieved with the distal sphincter mechanism alone an artificial sphincter can be implanted at the bulbous urethra in men and around the urethral stump in women. Since 1986 16 patients have received S bladders following cystectomy, and implantation of an artificial urinary sphincter has been necessary in 7. All patients are continent by both day and night. The overall complication rate has been low. For 15 patients it is possible to empty the bladder solely by abdominal straining, while in 4 cases additional self-catheterization is necessary. In most cases the urine remains sterile, and gross electrolyte disturbances and acidosis have never been observed. Our indications were: bladder carcinoma in men (T1-2NoMo) with carcinoma-free prostatic urethra, nonfunctional neurogenic bladder, and shrunken bladder following infection or radiation. Psychological acceptance of the procedure, which allows natural voiding with no kind of abdominal wall stoma even after cystectomy, has been excellent. PMID- 3307091 TI - [Gil-Vernet transvesical antirefluxplasty. Initial clinical experiences]. AB - Our results in 18 cases with the Gil-Vernet technique of surgical correction of vesicoureteral reflux are presented. The ureteral orifices are advanced across the trigone by means of a single submucosal mattress suture in order to increase the intramural length of each distal ureter. The new procedure offers some advantages to the more widely applied techniques. It is rapid and simple to perform and the intrinsic and extrinsic musculature of the terminal ureters is preserved. This technique can be used indiscriminately in cases of primary unilateral or bilateral reflux, including grades II to IV. PMID- 3307093 TI - Human chorionic gonadotropin treatment of nonorganic erectile failure and lack of sexual desire: a double-blind study. AB - Forty-five cases of nonorganic failure (n = 39) or lack of sexual desire (LSD, n = 6) were treated for one month, either with human chorionic gonadotropins (HCG, 5,000 IU I.M. twice per week) or with placebo using a double-blind method. HCG gave better results than placebo (47% vs 12%, p less than 0.05) and improved a higher number of sexual parameters (6/7) than placebo (2/7). HCG effect on sexual behavior did not correlate with the increase in plasma testosterone level: it seems HCG is a useful option in sexologic treatment of erectile failure and LSD. PMID- 3307094 TI - Octoson imaging in pediatric urology. AB - Ultrasonic imaging of infants and children using an automated transducer water path delay scanning system (Octoson) overcomes many of the technical difficulties of contact B mode ultrasound imaging and computed tomography. These disadvantages relate to small patient size, motion artifacts, hypothermia, and lack of patient cooperation. Sedation may be required for either conventional study. The automated water-path system is soothing to small children, maintains the body temperature of infants, and avoids direct transducer contact. Sedation is not necessary. Excellent resolution, shorter scan time than computed tomography, and greater flexibility of patient and transducer positioning allows much more complete imaging information. In addition, the panoramic view obtained using this modality serves to demonstrate the complete lesion and its relationship to surrounding structures. PMID- 3307095 TI - Paraneoplastic syndrome in squamous cell carcinoma of urinary bladder. AB - Hypercalcemia with metastatic tumor is a common clinical entity, but without metastasis, hypercalcemia as a manifestation of squamous cell carcinoma of the bladder is rare. We present a case demonstrating immunoreactive parathyroid hormone-like activity in a nonmetastasizing tumor. Hypercalcemia subsided after ablative surgery. PMID- 3307096 TI - Digital subtraction angiography for renal donor evaluation. AB - A consecutive series of 52 living related renal donors were evaluated preoperatively by angiography. The preoperative angiographic interpretation was compared with the anatomy found at donor nephrectomy. Standard selective renal arteriography was found to be 100 per cent accurate in defining single (25) or multiple (1) renal arteries. Digital subtraction angiography (DSA) alone performed with an intra-arterial injection of contrast material was found to be 82 per cent accurate in determining the number of renal arteries. In five kidneys with multiple renal arteries, only two had the correct number of vessels identified. The errors are inherent in the DSA technology. DSA at the present time is not accurate enough to replace the standard arteriogram in the evaluation of the donor nephrectomy patient. PMID- 3307097 TI - Kelfiprim versus co-trimoxazole in recurrent and persistent urinary tract infections: multicenter double-blind trial. AB - Kelfiprim (KP) is a new bactericidal agent containing trimethoprim (T) and sulfametopyrazine (S), a long-acting sulfonamide (ratio 5:4). The posology is one capsule (T 250 mg + S 200 mg) daily, after a loading dose of two capsules on the first day. To evaluate the clinical value of Kelfiprim (KP) vs co-trimoxazole (CO) in urinary tract infection (UTI) a controlled multicenter double-blind trial (MDBT) was carried out in 76 patients suffering from persistent and recurrent UTIs. About 90 per cent response rate (sterile urine at the end of treatment) was obtained for KP and about 85 per cent for CO in recurrent UTI. In persistent UTI the rate of recovery was 66.8 per cent and 53 per cent for KP and CO, respectively. Safety of treatments was excellent in 97 per cent of patients treated with Kelfiprim and 87 per cent treated with co-trimoxazole. Two patients, one in each group, were dropped from the study because of adverse reactions. PMID- 3307098 TI - [Clinical trial of the use of the preparation Healon in surgery of the anterior segment of the eye]. PMID- 3307100 TI - [Improved operation for reinforcing the sclera in myopia]. PMID- 3307099 TI - [Autoscleroplasty in retinal detachment]. PMID- 3307101 TI - [Simplified method of contact-free droplet echography of the eye]. PMID- 3307102 TI - [Use of solcoseryl jelly as the contact medium for gonioscopy, contact biomicroscopy and echoscopy]. PMID- 3307103 TI - [Harmful effect of alcohol on the eye]. PMID- 3307104 TI - [Informative value of suprathreshold tonal and ultrasonic studies in the diagnosis of the neurosensory component of mixed hearing loss in patients with tympanosclerosis]. PMID- 3307106 TI - [Nuclear magnetic resonance tomography in the diagnosis of diseases of the ENT organs]. PMID- 3307105 TI - [Cervical nystagmus: research technics, methods of evaluation, clinical significance]. PMID- 3307107 TI - [Errors and complications in external drainage of the common bile duct]. AB - Errors and complications taking place in external drainage of the common bile duct were analyzed in 484 patients. They appear due to choice of a wrong drainage tube. The authors describe their method of fixation the drain when draining through the stump of the bladder duct. In the postoperative period it is necessary to perform intracholedochal therapy with antibiotics for treatment of purulent cholangitis and for preventing a secondary infection of the bile ducts. Time of the removal of the drain depends on the state of the pancreas and on the data of transdrainage cholangiography. PMID- 3307108 TI - [Multiple organ failure in severe surgical pathology]. PMID- 3307110 TI - [Extremity amputation in patients with acute arterial obstruction]. PMID- 3307109 TI - [Comparative evaluation of methods for determining blood loss in the prehospital stage]. PMID- 3307111 TI - [Means for decreasing the incidence of postoperative tubular necrosis in kidney transplants]. AB - An analysis of the work on transplanting 264 cadaver kidneys has shown a considerable decrease of delayed functions of the transplants due to an adequate anti-ischemic defense in the donor's organism and during operation in the recipient's organism. An exact scheme of medicamentous management of the potential donors and the corresponding transfusion therapy during transplantation of the kidney has reduced the percentage of delayed functions in renal transplants from 54.4 to 25.8%. PMID- 3307112 TI - Ovarian response to PMSG and GnRH in ewes immunised against oestradiol-17 beta. AB - Forty-six adult merino ewes were immunised against oestradiol-17 beta-6 carbomethyloxime:human serum albumin and 48 comparable ewes were used as controls in an experiment to study the effects of gonadotrophin releasing hormone (GnRH) on ovulatory responses after treatment with pregnant mare's serum gonadotrophin (PMSG). All the ewes were treated with progestogen sponges for 14 days and received 1500 iu PMSG on the 12th day. Twenty-four control and 24 immunised ewes received 25 micrograms GnRH 21.5 hours and 23 hours after the sponges were withdrawn. Plasma samples were collected between 17 and 50 hours after the sponges were withdrawn and assayed for luteinising hormone (LH). Immunisation reduced the proportion of ewes which ovulated and their rate of ovulation. Injection of GnRH increased the proportion of immunised ewes ovulating (P less than 0.0005) and their rate of ovulation (P less than 0.0001). More unovulated follicles were observed in immunised ewes regardless of GnRH treatment (P less than 0.0001). The rate of recovery of eggs was reduced after immunisation. Treatment with GnRH produced a surge of LH of equal magnitude in the control and immunised ewes although not as many immunised ewes ovulated. PMID- 3307113 TI - Caffeine--the potential for its abuse in the racing greyhound. AB - The effects of caffeine and its availability as a drug or constituent of beverages is described. The literature concerning the effect of caffeine in greyhounds is reviewed and deductions are made and tested by experimental work. Thus conclusions are drawn as to how caffeine affects greyhound racing carried out under the National Greyhound Racing Club (NGRC) rules. PMID- 3307114 TI - Radiographic examination of the canine spine. AB - Radiography plays an essential part in the diagnosis of spinal disease in the dog. Careful positioning of the patient and attention to technique are important in obtaining diagnostic films and sedation or general anaesthesia is usually required, especially if the animal is in pain or muscle spasm. Additional information may be obtained by myelography, a technique in which a water-soluble iodine-containing contrast medium is injected into the subarachnoid space via the cisterna magna, under general anaesthesia. The advent of two new contrast media, iopamidol and iohexol, has rendered this a relatively safe procedure which may be carried out in practice. The radiological features of a variety of canine spinal conditions are discussed, including congenital and developmental abnormalities, infective, nutritional and degenerative conditions and trauma and neoplasia. PMID- 3307116 TI - Serological classification of Pasteurella multocida. PMID- 3307115 TI - Retarded growth rate and delayed onset of egg production associated with spirochaete infection in pullets. AB - Retarded growth rates and delayed onset of egg production were recorded in 22 week-old pullets reared on deep litter and with indirect contact with pigs. Birds reared in cages or transferred to cages were unaffected. Spirochaetes were isolated and identified from the intestines of the pullets reared on deep litter but not from those reared in cages. Birds kept solely on deep litter were more severely affected, with 24 per cent immature birds and 10 per cent mortality compared with those transferred from deep litter to cages where no mortality was recorded but 15 to 22 per cent were found to be immature. The histopathological changes are described and the significance of the findings is discussed. PMID- 3307117 TI - Assessment of pregnancy in sheep by analysis of plasma progesterone using an amplified enzyme immunoassay technique. AB - An amplified enzyme immunoassay kit for progesterone analysis was used to diagnose pregnancy in a flock of 130 mule ewes. An accuracy of 100 per cent was obtained after the analysis of progesterone in plasma samples taken 15 to 16 days after mating. In mule ewes a plasma progesterone level greater than 5.9 nmol/litre was indicative of pregnancy. In the validation of the technique, duplicate ewe plasma samples and progesterone standards were compared with a radio immunoassay technique; the regression coefficient between the two techniques was r = 0.82. PMID- 3307118 TI - Prospects for molecular vaccines in veterinary parasitology. AB - Despite the profound developments in recombinant DNA technology there is only one marketed recombinant vaccine (for human viral hepatitis B). The development of others proceeds with great difficulty. Molecular vaccines against veterinary parasites are at the utmost pole of complexity in the spectrum of potential vaccines since these parasites are complex eukaryotic organisms, often dwelling at mucosal surfaces where anamnestic responses are problematic, where the immunogenicity of the parasite components is poorly understood and where the effector mechanisms of immunity are unresolved. Cloning a "protective" gene is only the first step, and perhaps the easiest, in a long process which will be necessary to develop vaccines against parasites. Additional steps will involve comprehensive analyses of the immunological responses to ensure that vaccine antigens contain the correct epitopes to induce appropriate immune effector mechanisms for parasite elimination and immunological memory and that these responses are not genetically restricted. The great expectations for recombinant vaccinia-based vaccines must be modified substantially in the light of recent evidence indicating immunological and other constraints on this approach. The use of anti-idiotype vaccines is an underexplored opportunity for practical parasite vaccines since they have several potentially important advantages. The need to include T cell antigenic peptides in peptide vaccines to extend the range of genetic responsiveness and to induce anamnestic responses is now clear. New algorithms for the prediction of such sites exist and these can be tested experimentally with synthetic peptides. There are no major technical obstacles to the development of vaccines for parasites which cannot be overcome. However substantial long term basic research is needed over a range of disciplines to achieve this worthwhile objective. PMID- 3307119 TI - New approaches in the development and management of drugs used in ectoparasite control. AB - This review examines the present trend in ectoparasite control towards application techniques designed to give prolonged persistence and efficacy. The consequences of this approach for resistance management and current developments in relation to the resistance problem are considered. Likely leads and new concepts in the search for alternative drugs are discussed. In particular the role of molecular biology in advancing knowledge and providing new techniques in this field is explored. PMID- 3307120 TI - Parasite defense mechanisms for evasion of host attack; a review. AB - This review covers some of the basic mechanisms whereby parasites evade host responses. These mechanisms include; antigenic variation, repeated antigenic determinants, induction of suppressor cells, acquisition of host proteins or molecular mimicry, proteinase destruction of host effector molecules, proteinase inhibitor-mediated inhibition of humoral and cellular immune effector arms and immunosuppressive products of parasite arachidonic acid metabolism. Vet. Parasitol. PMID- 3307121 TI - Host effector mechanisms against parasites. AB - The first part of this presentation considers some of the complexities of parasitic infections and parasite-specific effector mechanisms which have hampered the development of practical methods of immunisation against parasitic diseases. In the second part, an outline is given of the effector mechanisms involved in immunity of cattle to the protozoan parasite Theileria parva. Parasites are antigenically complex organisms which often have distinct developmental stages, sometimes with different predilection sites within the host. Antigenic polymorphism between strains is a common feature of parasites and sometimes results in strain-specific immunity. Certain parasites have also evolved mechanisms of modulating surface antigens which allow them to escape host effector mechanism. Effector mechanisms which control parasitic infections may operate by preventing establishment of the parasites, by eliminating the parasites once they have established or by affecting growth or fecundity of the parasites. In addition to specific antibody and cell-mediated immune responses, inflammatory or physiological responses play an important role in the control of some parasites. Current evidence suggests that effector mechanisms against T.parva parasites operate at two levels. First, antibodies produced against the infective stage of the parasite, the sporozoite, can, by neutralising infectivity, reduce the numbers of organisms which establish in the host. Second, cytotoxic T cells directed against parasitised lymphoblasts cause destruction of parasites following their establishment in the host. Moreover, in situations where immunity is parasite strain-specific, the cytotoxic T cell responses have also been found to be strain-specific. The elucidation of these effector mechanisms has indicated potential new strategies of immunisation against T.parva. PMID- 3307122 TI - Anthelmintic resistance and the future for roundworm control. AB - Anthelmintic resistance has emerged as the most important problem confronting the successful control of nematode parasites of grazing animals. Although the significance of the problem varies between, and within, countries and farming enterprises, there is little likelihood that it will disappear of its own accord. On the contrary, it is reasonable to assume that it will increase if there is no change in traditional methods of parasite control. Although progress is being made in non-chemotherapeutic methods of control, these are unlikely to provide any practical alternatives in the short-term future. Nor can the pharmaceutical industry be expected to solve the problem because of the long period and the exceedingly high costs involved in bringing a completely new class of drug on to the market. The answer must lie in carefully husbanding the currently available anthelmintics, by providing farmers with programs which give good levels of parasite control and maintain high productivity in animals with fewer anthelmintic treatments. To be enthusiastically adopted by farmers, the programs require a commitment by both research and advisory workers. Such success can be achieved, as exemplified by the "Drenchplan" and "Wormkill" programs in Australia. It behoves workers in all countries which have a significant grazing livestock industry, not only those with an existing resistance problem, to consider how such schemes could be implemented. PMID- 3307123 TI - The history of scabies in veterinary and human medicine from biblical to modern times. AB - For many centuries a host of naturalists, savants, physicians and veterinarians have tried to unravel the etiology of scabies in humans and animals and to discover effective remedies to control it. After many attempts, success was achieved in the discovery of the parasitic etiology of the disease in the 15th century. Also, major advances with regard to the treatment of the disease were made during the 19th and 20th centuries. Today the prevalence of epidemic scabies in humans has diminished; on the other hand, good progress in the control of mange of livestock has been made only in a few countries including Australia, New Zealand and the U.S.A. PMID- 3307124 TI - Improvements in the serodiagnosis of helminthic zoonoses. AB - Remarkable progress has been achieved in developing improved serodiagnostic assays for a group of diseases for which other diagnostic methods are often lacking. Toxocariasis, trichinellosis, dirofilariasis, Taenia solium cysticercosis and the cystic and alveolar forms of hydatid disease are occult infections in humans and sometimes in lower animal hosts. Although Strongyloides stercoralis achieves patency in humans, parasitologic diagnosis is often very difficult. Efforts to develop reliable immunodiagnostic methods have spanned several decades but progress had been slow until recently. The complexity and nonspecificity of helminth antigens were major problems which prevented the full realization of the benefits of the highly sensitive assay systems now available. Modern immunologic methods including hybridoma technology, immunoaffinity chromatography and immunoblotting, however, have yielded improved reagents and the means to characterize their nature and function. The outcome of this research has been more sensitive and specific serologic tests based on measurement of both circulating antigens and antibodies as well as improved understanding of the nature of host-parasite interactions. Although much remains to be done, many improved immunodiagnostic procedures are already being applied in clinical diagnosis, epidemiologic studies and control programs directed against the helminthic zoonoses. PMID- 3307126 TI - Enteric infections caused by non-enterotoxigenic Escherichia coli in animals: occurrence and pathogenicity mechanisms. A review. AB - Not all E. coli that cause diarrhoea in farm animals act by elaborating the classical heat-labile or heat-stable enterotoxins. These newly recognised animal enteropathogenic E. coli (EPEC) attach to and efface the microvilli of the gut epithelium and resemble the well known human EPEC. In rabbits, only this type of E. coli enteritis is known to be important and a similar disease has been shown to occur in cattle also. There is no doubt that adherence factors are important in the pathogenesis of animal EPEC, but they are not well understood when compared with the adhesion of human EPEC, or to the adhesion of animal ETEC. The enteropathogenic effect is probably due to Shiga-like toxin, a cytotoxin that is active on Vero cells and has also been called Verotoxin. A different type of Verotoxin is produced by most serotypes that are associated with post-weaning diarrhoea and oedema disease in pigs. This toxin is suspected to play a role in the pathogenesis of the latter. PMID- 3307125 TI - Cytopathogenic effect of African swine fever virus for pig monocytes: characterization and use in microassay. AB - A microculture assay is described for the titration of African swine fever virus (ASFV) using swine monocytes contained in mononuclear leucocyte (MNL) microcultures. Titration endpoints were determined by observing cytopathogenic effects (CPE) of ASFV infected monocytes with an inverted microscope at 40 X magnification. CPE was a late event following the detection of ASFV antigens in monocytes by radioimmune assay, immunofluorescence and hemadsorption. It began with the detachment, enlargement and rounding of monocytes which progressively formed into grape-like clusters of 3-20 or more cells which eventually lysed. The characteristic CPE was produced in monocyte microcultures by virulent, moderately virulent, Vero cell adapted, and nonhemadsorbing ASFV strains. The sensitivity and reproducibility of the CPE microassay was similar to that of the hemadsorption microassay. PMID- 3307127 TI - Proteolytic zymograms of Staphylococcus hyicus subsp. hyicus isolated from pigs, chickens and cows. AB - The extracellular proteases of Staphylococcus hyicus subsp. hyicus were assayed by a zymogram showing caseinolysis and gelatinolysis. Four bands were associated with caseinolysis or with gelatinolysis. The patterns shown by strains isolated from pigs, chickens and cows were compared; isolates from pigs differed from those isolated from chickens or cows but strains isolated from diseased and healthy pigs could not be differentiated. PMID- 3307128 TI - [Diagnostic potentials of neurosonography with premature infants]. PMID- 3307129 TI - [Experience in using the Soviet echotomoscope in prophylactic examinations of children]. PMID- 3307130 TI - A simple hemolytic assay for bovine complement component C3. AB - A simple, one-step, alternative pathway (AP) hemolytic assay for bovine C3 has been developed. Methylamine was used to prepare a bovine serum reagent, R3, functionally depleted of C3. The addition of purified bovine C3 to the R3 reconstituted, in a dose-dependent manner, the hemolytic activity for unsensitized heterologous erythrocytes. The assay was used to determine relative levels of C3 in different bovine serum samples. Human C3 and bovine C3 were interchangeable in the assay. Reconstitution of bovine and human R3 reagents with homologous or heterologous C3, in the presence of different species of erythrocytes, provided evidence that cell surface regulation of the homologous hemolytic AP may not be limited to the assembly and activity of the C3 convertase. The AP assay was more sensitive and less complex to perform than a standard classical pathway assay for bovine C3. PMID- 3307131 TI - Organophosphorus compounds. I. Toxicity in domestic animals. AB - Organophosphorus compounds with various aspects of their modes of action, toxicity and antidotal treatment have been briefly reviewed. Their clinical, pathological and biochemical effects on different species of domestic animals are also described. PMID- 3307132 TI - Bovine pododermatitis aseptica diffusa (laminitis) aetiology, pathogenesis, treatment and control. AB - Pododermatitis aseptica diffusa (laminitis) is a major cause of lameness and discomfort to cattle with resultant economic losses. The disease is a result of multifactorial aetiology most of which is not clearly understood. Feeding readily fermentable carbohydrates to unaccustomed cattle predisposes to the disease. Histamine, lactic acid and endotoxins are believed to be involved. Systemic acidosis, histaminosis and endotoxaemia are thought to produce the pathophysiological characteristics of laminitis. The diagnosis is primarily based on the observation of symmetrical and bilateral lesions in hooves and characteristic lameness affecting all feet. Gross lesions include concavity of the dorsal wall, discolorations in the sole and rotation of the pedal bone. Degenerative changes and arteriosclerosis are constant histological findings in the corium, with chronic thrombi and chronic granulation tissue. The disease may be treated conservatively and by application of cyclo-oxygenase inhibiting non steroidal anti-inflammatory drugs and prevented or controlled by proper feeding and management practices. PMID- 3307133 TI - [Cultivation and demonstration of the classic swine fever virus]. AB - Experiments were carried out for the cultivation and indication of the swine pestivirus in several continuous and in primary cell lines, using lapinized and field strains of the virus. It was demonstrated that in the various cell cultures the strains used showed varying rates of growth. In PK-15 and pig embryonic kidney cell lines, the field strains and the virulent Vratsa strain replicated with no preliminary adaptation, forming numerous large fluorescent plaques at the 16th to 18th hour. In the same cultures the lapinized strains K and Hudson had more delayed growth, forming double plaques not until the 36th hour. In rabbit kidney primary cultures the virulent K strain only exhibited growth, and up to the 4th hour at that. All results obtained were in agreement with the results from biologic experiments with pigs and rabbits. Experiments were also carried out for the indication of the swine pestivirus in infected lamellae of the cell cultures used, which were subject to additional treatment for 5 min following primary handling with the specific marked serum with the 1:40,000 solution of Evans blue. The infected cells treated by this method showed light green fluorescence of the protoplasm, with a dark nucleus, while the intact cells had tile-red cytoplasm. PMID- 3307134 TI - [Lyophilization of live CA-80 vaccine against coli enteritis in pigs]. AB - A live vaccine against coli enteritis in pigs, CA-80, with a protection medium of 5 per cent hemodex, was successfully freeze-dried in ampoules or vials at the rate of 5 to 10 vaccinal doses each, the titer ranging from 10(9) to 10(10) live bacteria per cu. cm, of a 12-month shelf-life period. The vaccine was found to be innocuous for pigs, and was intended for active immunoprophylaxis on both infected and menaced farms and complexes, applying it to sows in the last third of the gestation period. PMID- 3307135 TI - [Cultivation of cells in a medium with blood hydrolysate]. AB - Use was made of fresh blood of swine, diluted with an equal amount of distilled water to produce a protein hydrolysate. Enzyme hydrolysis was effected through extracellular alkaline protease produced by stain DI of Bacillus subtilis. The cell lines BHK-21, PK-15 and spzv were cultured in a nutrient medium containing 0.180-0.200 mg/cm3 alpha-amine nitrogen and relevant growth factors of nonprotein character. It was found that the cells cultured in this medium showed no differences with regard both to morphology and karyology as against the control cells which were treated with the classic medium of Eagle. It was also found that the medium could successfully be used instead of the imported nutrient media. PMID- 3307136 TI - [Microbial decontamination by aerobic purification of liquid manure from swine breeding farm complexes]. AB - Studied was the microbial decontamination of swine mature with the employment of a laboratory model of an aerobic lagoon as well as in a purification station, having a mechanical step, two biologic steps, and a facultative lagoon. It was found under modelled conditions that a substantial decontaminating effect was produced with regard to coli bacteria and Salmonella organisms. The effect was less with regard to the microbial count. The studies carried out in stations showed the effectiveness of the individual steps in reducing the microbial content of manure. PMID- 3307137 TI - [Assessment of hypokinesia in ischemic heart disease patients and its correction by the methods of therapeutic physical exercise]. PMID- 3307138 TI - [Deficiencies and errors in the research and use of drug electrophoresis]. PMID- 3307139 TI - [Platelets--the object of a study of enzymopathies in blood diseases (review of the literature)]. PMID- 3307140 TI - [Review of dissertations dealing with the application of ultrasonic diagnosis in clinical oncology, 1981-1985]. PMID- 3307141 TI - [Cancer and diabetes mellitus based on autopsy data]. AB - A clinico-anatomical evaluation of the evidence on 3436 autopsies (1091 cases of cancer included) was carried out. The levels of glucagon-producing A- and insulin producing B-cells were studied in pancreatic islands from 148 autopsied cases (33 cases of cancer included). Diabetes mellitus incidence in non-tumor cases was thrice (13.73%) that in cancer patients older than 54 years (4.15%). However, pancreatic islands' A-cell levels were higher than those of B-cells in both groups, such prevalence being generally regarded as a causative factor of diabetes mellitus development. The study was concerned with incidence of diabetes mellitus in cases of different primary cancers, the significance of cachexia, corticosteroid production by cancers of the adrenal cortex and some other factors which influence clinical manifestations of diabetes mellitus, particularly, those related to age-linked changes in A/B-cells ratios in pancreatic islands. PMID- 3307142 TI - [Activation of oncogenes as a mechanism of chemical carcinogenesis]. PMID- 3307143 TI - [Methods of evaluating the effectiveness of treatment of patients with malignant neoplasms]. AB - The advantages offered by application of combined and complex treatment make the case for perfecting procedures of optimal choice, combination and adequate evaluation of the efficacy of methods of malignant tumor treatment. The report deals with a retrospective analysis of procedures of evaluation of cancer patients treatment. Treatment modalities, concurrent monitoring and alternative study group selection are discussed. Emphasis is placed on the role and significance of cooperative prospective and retrospective randomization studies. PMID- 3307145 TI - [Methods of determining mercury in food products]. PMID- 3307144 TI - [Role of the State Control Vitamin Station of the Ministry of Public Health of the USSR during World War II]. PMID- 3307146 TI - [Experience with the training of nurses in Odessa]. PMID- 3307147 TI - [Effect of alcohol on the initiation and development of endocrine disorders (review of the literature)]. PMID- 3307148 TI - [Drug correction of blood rheological disorders in patients with chronic cor pulmonale (a review of the literature)]. PMID- 3307149 TI - [Ultrasonic study in the diagnosis of increased dimensions of the liver]. PMID- 3307151 TI - [Contact thermometry in examining patients with viral hepatitis A and acute intestinal infections]. PMID- 3307150 TI - [Immunomorphological aspects of myocardial infarct]. PMID- 3307153 TI - [Current antifungal drugs from the group of imidazole derivatives]. PMID- 3307152 TI - [Remarks with regard to the treatment of toxoplasmosis]. PMID- 3307155 TI - [Initial 2-year results of the treatment of patients after kidney transplantation at the Szczecin center]. PMID- 3307154 TI - [Changes in the organs of mastication in patients with diabetes mellitus]. PMID- 3307156 TI - [Thrombolytic therapy of myocardial infarction]. PMID- 3307157 TI - [Glucocorticosteroids in the treatment of brain edema]. PMID- 3307158 TI - [The earliest information on acupuncture and moxibustion in Europe]. PMID- 3307159 TI - [Comparative biochemical studies on the pathogenic and non-pathogenic amebae of the genus Naegleria]. PMID- 3307160 TI - [Parasites of domestic animals in the work of Columella "De re rustica". II. Ectoparasites]. PMID- 3307161 TI - [Studies of ticks (Acari: Ixodida) in Poland]. PMID- 3307162 TI - [Melanoma precursors--risk nevi]. PMID- 3307163 TI - [Diagnosis of Chlamydia infections]. AB - Tissue culture for Chlamydiae requires facilities that are not generally available, are costly and require 3 to 7 days for completion. With the introduction of specific monoclonal antibodies Chlamydia trachomatis can be recognized within 30 minutes. Therefore the direct specimen test should be performed as the method of choice. In complicated, ascending forms of the disease requiring special methods for sample collection (e.g. laparoscopy), serology may aid in the diagnosis of a Chlamydia trachomatis infection. PMID- 3307164 TI - [Clinical research studies from the ethical and legal point of view]. AB - Relevant cases that had come to public knowledge and critical analysis of medical research on human beings prompted the USA to introduce the provision of approval by a committee and other forms of administrative control. In the 70's, ethics commissions were set up in Central Europe in compliance with the recommendations of the revised Helsinki-Tokyo Declaration. In Austria, the guiding principles are now legally safeguarded by the Pharmaceuticals Act, whereby general principles of research on human beings such as benefit-risk calculation and consent of the test person are laid down by statute. The risks involved in a novel method of treatment must nowadays be shared by the patient, which presupposes that the patient must be adequately informed. Notwithstanding the patient's consent, however, the risk must be socially acceptable, meaning that the experiment must be scientifically relevant and carried out in compliance with accepted methods and rules. The concept of cumulative justification is demanded today; it consists of the scientist's freedom of research, the test person's right to self determination and the benefit-risk calculation. Ethics commissions composed of researchers themselves are invaluable consultant bodies for the scientist when soberly viewing his own particular project and who must himself undertake to observe the generally accepted principles regulating research on human beings. Only positive control by the medical profession itself will, in the long run, be able to effectively stave off an ever increasing encroachment of legislative and state control upon medical research. PMID- 3307165 TI - [Pathophysiology of autoimmune thrombocytopenia]. AB - Current knowledge of the pathomechanism of autoimmune thrombocytopenias is discussed on the basis of our own experimental and clinical experience. Of particular interest is the role of the target antigen(s) involved. Autoantibody binding to certain antigens may result either in premature sequestration or in functional impairment of platelets, or in both. The mechanisms by which autoantibodies are formed are still poorly understood. Serological methods have increased our knowledge of the pathomechanisms of immune thrombocytopenias and studies with 111Indium labelled platelets provided detailed information on platelet kinetics. The importance of the reticuloendothelial system and the therapeutic consequences derived from experimental and clinical observations are discussed. PMID- 3307166 TI - [Wound healing models for studying the formation of granulation tissue]. AB - In this report models of granulation tissue formation during wound healing are reviewed. As suggested by Kovac and Rudas a distinction is made between inflammatory, foreign body and reparative granulation tissue formation. The advantages and disadvantages of the different models are discussed. While the older studies mainly compared qualitative evaluation of granulation tissue, in recent experiments models involving predominantly quantitative histological and biochemical methods are of increasing importance. One of these is a spongiosa implant model designed by our group which is briefly discussed. PMID- 3307167 TI - [Determination of non-organ specific autoantibodies. Their relevance for the differentiation of autoimmune diseases]. AB - The determination of non-organ-specific autoantibodies is a major tool in the serological diagnosis of rheumatic disorders. Antinuclear antibodies (ANA) are routinely determined by indirect immunofluorescence (IFL) testing on cryostat sections, but the use of cultured cell lines now allows to detect new antibody specificities that are obscured on tissue sections. Titres and IFL patterns of antibodies add further information to the interpretation of results. Homogeneous or perimembranous patterns point to systemic lupus erythematosus (SLE) which is better characterized by the presence of antibodies to double-stranded DNA or to the Smith-antigen (Sm-antigen) detected by other methods. Antibodies to extractable nuclear antigens (ENA) are strongly correlated with connective tissue disease, the main representatives of which may now be identified serologically by the presence of marker anti-ENA antibodies. PMID- 3307168 TI - [Non-organ specific anticytoplasmic autoantibodies. Immunoserologic detection and diagnostic relevance]. AB - The detection of circulating serum antibodies that react with various nuclear or cytoplasmic antigens of cell substrates has become an established investigation in the diagnosis of autoimmune diseases. Antinuclear antibodies as well as some non-organ-specific anticytoplasmic autoantibodies might be of diagnostic significance. Some examples are anti-mitochondrial antibodies in autoimmune liver diseases, anti-cytoskeletal antibodies in chronic active hepatitis, polymyositis and infectious diseases and microsomal antibodies in juvenile cryptogenic liver cirrhosis. New techniques and methods such as indirect immunofluorescence on tissue culture substrates, enzymelinked immunoassays and immunoblotting tests now form the basis of further studies. These tests allow a more sensitive and specific assay for lysosomal and Golgi apparatus antigens. It may be possible to more precisely associate particular anti-cytoplasmic antibodies that react with autoimmune diseases. PMID- 3307169 TI - Preoperative radiotherapy in rectal cancer. PMID- 3307170 TI - Rationale and indications for limited surgery in breast cancer: current data. PMID- 3307172 TI - State Medical Society of Wisconsin. 1987 Membership Directory as of June 19, 1987. PMID- 3307171 TI - Arterial bullet embolism with radiologic demonstration of vessel entrance site. PMID- 3307173 TI - Clinical trial of a calcium channel blocker in patients with aneurysmal subarachnoid hemorrhage--prevention of delayed ischemic deficits. PMID- 3307174 TI - Isolation, purification and characterization of keratinolytic proteinase from Microsporum canis. PMID- 3307175 TI - Results of subhepatic fluid collection after cholecystectomy; a serial sonographic study. PMID- 3307176 TI - Pulmonary nocardiosis in a renal transplant patient. PMID- 3307177 TI - In vitro study of nonspecific cellular immunity in rheumatoid arthritis. PMID- 3307178 TI - [Screening in the early detection of malignant neoplasms--scientific principles, methods of evaluating success and practical consequences]. PMID- 3307179 TI - [Thyroid hormones and bones--a review]. PMID- 3307180 TI - [Cesarean section for rare indications]. PMID- 3307181 TI - [Synopsis of the medical literature on terminal care appearing in recent years in East Germany]. PMID- 3307182 TI - [Dedicated to continuing education--Hans Kehr on the 125th anniversary of his birth]. PMID- 3307185 TI - [Carl Flugge's contribution to the development of environmental health]. PMID- 3307183 TI - Human vitamin C requirements. AB - The importance of vitamin C is reflected in its multifunctional roles which include participation in collagen and carnitine syntheses, promotion of iron absorption and the more recently discovered participation in noradrenaline synthesis, inactivation of free radical chain reactions, prevention of N-nitroso compound formation and more. Given the many extra-antiscorbutic functions of the vitamin, the Recommended Dietary Allowances (RDA) should not just prevent deficiency disease but should aim at providing sufficient amounts for all vitamin C-dependent functions to operate at full capacity. The concept of vitamin C tissue saturation is best able to meet this demand. The use of kinetic models has shown that the body pool is saturated with a daily intake of 100 mg vitamin C in non-smokers and 140 mg in smokers, amounts that may be regarded as optimal RDA values. Certain disease states may be accompanied by still higher vitamin C requirements but the exact amounts are not yet known. PMID- 3307184 TI - [Public health education in Russia in the 18th century]. PMID- 3307186 TI - [Friedrich Kraus--originator of functional diagnosis and electrocardiography in Germany]. AB - The 50th anniversary of the death of Friedrich Kraus (31 May 1858 to 1 March 1936) was the occasion to remind of the merits of this internist for the development of the functional diagnostics and the spreading of the electrocardiography in Germany. After the first professorship in Graz (foundation of the constitution research) he was appointed director of the 2nd Medical Clinic of the Charite in Berlin 1902, where he worked up to his discharge from the active service in 1927. From 1906 he dealt with electrocardiological problems, mainly together with G.F. Nicolai (1874-1955). In 1910 the first monography on "The Electrocardiogram of the Healthy and Ill Man" was published. After World War I Kraus dealt with the "Special Pathology and Therapy of Internal Diseases" and the "General and Special Pathology of the Person". In the theory of the depth person, being ahead of the time, psychosomatic connections were explained. A selective bibliography of the most important works of Kraus is added to the paper. PMID- 3307188 TI - [Morphology and function of Ito cells of the liver]. AB - An actual review about Ito cells of the liver is presented from the viewpoint of history, morphology and cytogenesis. Much attention is given to examinations elucidating the relationship between Ito cells and liver fibrogenesis. Latest ultrastructural immunological and enzyme histochemical results using animal and human liver tissue are explained. PMID- 3307187 TI - [Problems of instituting insulin therapy in advanced age]. AB - The population of diabetics of a district was analysed concerning the age structure, the proportion of the insulin-dependent patients as well as the insulin-dependent diabetics older than 60 years were analysed with regard to the degree of the realization of insulinisation. 13.8% of all diabetics with an age older than 60 years are insulin-dependent. In 71.5% of them the insulinisation is realized. Only in 43% of all insulin-dependent older diabetics an autoinjection of insulin is possible. The results are discussed and propositions for changing the situation are submitted. PMID- 3307189 TI - [A physician and polyhistorian: on the 300th birthday of Johann Heinrich Schulze (1687-1744)]. AB - The 300th anniversary of the birthday of Johann Heinrich Schulze gives rise to the remembrance of life and work of a polyhistorian who is riveted by particular attainments in medicine and several other special branches (orientalistics, graecistics, archaeology, numismatics). The medical historiography considers him one of the outstanding representatives of the 18th century, chemistry calls him the ancestor of photography. The University of Halle honours him as one of the most eminent scientists of its period of foundation. PMID- 3307190 TI - [Ultrasound-controlled percutaneous puncture of pancreatic pseudocysts]. AB - The puncture of pancreatic pseudocysts with the help of ultrasound is an attempt of treatment without putting too much strain on the patient. In a number of cases a definitive emptying of cysts is successful so that a surgical intervention with application of an interior drainage can be avoided. Of 4 male patients of medium age treated 2 were successfully to be treated. The casuistics of one of the patients is reported. Under the point of view that a sonographically assisted intervention increases the security of the puncture therapy the complex of problems is outlined. PMID- 3307192 TI - [Does the anesthesia method modify the results of dermatologic surgery of the nose?]. AB - Since dermatosurgery has become a generally acknowledged subsection of dermatology, it seems strange that we have got so little account regarding the influences of anesthesia on the results of plastic surgery in the antrofacial region. A long-term follow-up of 139 patients, who had received regional flaps or free grafts because of tumors of the nose, revealed that the functional and esthetic results of operations carried out in local anesthesia were perfectly comparable with those in general anesthesia. We recommend local anesthesia because of its easy handling and little complications even in elderly polymorbid patients. PMID- 3307191 TI - [Co-occurrence of plane and verrucous leukoplakia evolving into an invasive squamous cell carcinoma]. AB - A 40-year old female patient showed extended areas of homogeneous and verrucous leukoplakias on the floor of her mouth. In addition, we found leukoplakia of the speckled type on her right lower alveolar ridge. Histological examination of specimens taken from this region revealed squamous cell carcinoma with invasion into the mandibular bone. Heavy smoking as well as chronic irritation caused by a poorly fitted denture were considered predisposing factors. We carried out radical excision of the carcinoma and the verrucous leukoplakias including partial bone resection. During a follow-up period of two years, we did not observe any recurrences of the carcinoma. PMID- 3307193 TI - [Immunohistologic characterization of stasis dermatitis transformed skin of the lower leg]. AB - Antibodies against human T-lymphocytes and their subpopulations were applied to frozen sections obtained from skin affected with stasis dermatitis of the lower leg from 13 patients suffering from chronic venous insufficiency. In all cases, we observed an intense staining reaction with HLA-DR antibodies, i.e. mainly monocytes, macrophages, fibroblasts, and endothelial cells. Control sections of clinically normal skin taken from patients without stasis dermatitis showed only staining of endothelial cells and of dendritic epidermal cells with HLA-DR antigens. The dermal infiltrate in stasis dermatitis displayed only moderate staining with antigens directed against T-helper and T-suppressor cells. Our findings of large quantities of HLA-DR positive cells in skin affected with stasis dermatitis points to their possible role with regard to the induction and persistence of contact allergies so frequently encountered in this group of patients. PMID- 3307194 TI - [Zinc--a new therapeutic principle in dermatology?]. AB - Zinc, a metal enzyme, is essential for the metabolism, it is mainly found in moulting tissue. Success or failure of systemic treatment with zinc of acne vulgaris, alopecia areata, or leg ulcer may be explained by understanding the metabolism of zinc in the organism interpreted as a feedback mechanism: treatment with zinc is only successful if zinc is not available in a sufficient amount for the organism, i.e. in case of primary zinc deficiency. This concept of therapy is illustrated by the case of a female patient suffering from leg ulcer, who developed an epithelization rate of 2.31 cm2 per day during treatment with zinc. PMID- 3307196 TI - [The history of the German Society of Gerontology]. PMID- 3307195 TI - [Budd-Chiari syndrome as a late complication following closure of an atrial septal defect]. AB - A case of a Budd-Chiari syndrome in a 19-year-old female patient is reported who had undergone surgical closure of a secundum atrial septal defect 13 years before. 8 months before the development of the Budd-Chiari syndrome she started to take oral contraceptives. The clinical picture of the Budd-Chiari syndrome developed within several days. The inferior vena cava did not fill with contrast dye when an angiography was performed using the right vena iliaca approach. The contrast dye disappeared through collateral veins (vena azygos, vena hemiazygos). After 4 days of treatment with systemic streptokinase she underwent open-heart surgery. The orifice of the inferior vena cava was occluded to a diameter of 6 mm. No thrombi were found. The lesion was corrected with two patches, one in the right atrium and the other in the inferior vena cava. This case report demonstrates that a Budd-Chiari syndrome is a possible late complication after closure of an atrial septal defect which should be treated by surgery. PMID- 3307197 TI - [Critical assessment of the methods of binding and degradation studies in modern hormone research exemplified by the study of glucagon metabolism of human erythrocytes and rat hepatocytes]. PMID- 3307198 TI - [In memory of Prof. Ivan Stanek. A contribution on the commemoration of his 70th birthday]. PMID- 3307199 TI - [The history of the German Society of Lymphology from its foundation to the present]. PMID- 3307200 TI - [4 generations of different deliveries--only women around greatgrandmother]. PMID- 3307201 TI - [It was not better in the old days...]. PMID- 3307202 TI - [Role of the ideas of V. V. Parin in the development of space medicine]. PMID- 3307203 TI - [Man in prolonged space flight]. PMID- 3307204 TI - [Radioimmunologic study of the endo- and exocrine functions of the pancreas in patients with atopic dermatitis]. PMID- 3307205 TI - [D.K. Zabolotnyi (on the 120th anniversary of his birth and the 80th anniversary of the founding of the first syphilis laboratory in Russia)]. PMID- 3307206 TI - New detection method for uropepsinogen (PGA) using isoelectric focusing and immunoblotting techniques. AB - Uropepsinogen (PGA) was isolated and purified from human urine using a column chromatography series. The purified PGA was injected into a rabbit and a PGA specific antibody was obtained. PGA isozymogen in human urine could be detected reproducibly by immunoblotting using this antibody after isoelectric focusing electrophoresis (IEF) on polyacrylamide gels. This technique may prove to be useful in the genetic study of PGA polymorphism. PMID- 3307207 TI - A comparative study of immuno-blotting techniques for the detection of Gc subtypes after isoelectric focusing on agarose and polyacrylamide gels. AB - A comparison of separation and detection techniques has been carried out to determine the most suitable combination for use in Gc-subtyping. The best results (i.e., high sensitivity, distinct bands, especially with reference to the 1S and 1F separation) were achieved using isoelectric focusing in polyacrylamide gel (pH 4.5-5.4) followed by transfer to nitrocellulose membrane by electroblotting and finally detection with enzyme-linked antibody complex. PMID- 3307209 TI - [New possibilities in the detection and surgical therapy of synovitis of the hip joint]. AB - Missing pathognomonic clinical and radiological signs, an early diagnosis of hip joint synovitis is often impossible. Ultrasonography and arthroscopy of the hip joint are useful methods to accomplish recognition and exact description of chronic inflammatory hip joint diseases. These new diagnostic methods enable an early adequate treatment. Until today synovectomy of the hip joint is still a rare surgical procedure. Reasons are the difficulties in diagnosis of the synovitis and the insufficient radicality of synovectomy if the femoral head is not luxated temporarily. The semi-arthroscopic synovectomy of the hip joint allows a radical removal of the synovial membrane even in the fossa acetabuli, avoiding the inherent risks of a luxation of the femoral head. PMID- 3307208 TI - [Morphologic studies of reactive changes in the joint cartilage in experimental erysipelas arthritis]. AB - In experimentally Erysipelothrix rhusiopathiae-induced polyarthritis of pigs, important pathomechanisms of bacterial invasion of the articular cartilage matrix were studied. Furthermore, observations were made concerning inflammatory cartilage changes in the transitional zone of the distal femur condyle. The morphological changes were a loss of proteoglycans, proliferation and transformation of cartilage cells, compensatory formation of collagenous fibers progressing to cartilage fibrosis and pannus formation. As histology only represents a static picture, different methods are necessary to finally verify the dynamics of this process. It appears likely, that cartilage and pannus combined, and synergistically after fibroblastic transformation, produce a reparative scar in the area of cartilage alteration. PMID- 3307210 TI - [The history of psychotherapy of torticollis. A historical review]. AB - Beginning with a historical introduction the author gives an overview over the different forms of psychotherapy used for torticollis. A special reference is given to psychoanalytic concepts. The different etiological concepts of this disease imply corresponding heterogeneous forms of therapy. PMID- 3307211 TI - [20 years' experience with kidney transplantation in Stockholm]. AB - Renal transplantations have now been carried out at our hospital for just over 20 years. The results have gradually improved and are now very satisfactory. There are many explanations for this development, but the improvement in immunosuppression has probably been the most crucial development. Renal transplantation is cheaper and it provides greater wellbeing for the patient than does chronic dialysis treatment. The indications have been widened and the number of patients waiting for a new kidney is increasing. An improved retrieval of cadaveric kidneys will be necessary for the required expansion of kidney transplantation programmes. PMID- 3307212 TI - [Kidney autotransplantation]. AB - Five cases are presented in which an autotransplantation of the kidney was performed. Four patients had a renovascular hypertension and one an extended injury of the ureter. In one case postoperatively appeared an arterial thrombosis which led to nephrectomy. PMID- 3307213 TI - [Does CAPD have a future?]. AB - Five decades were between the first clinical use of the peritoneal dialysis and the introduction of the continuous ambulant peritoneal dialysis (CAPD)-five decades with many problems and little acceptance of this technique by patients and physicians. Greater week clearances in the CAPD led to a significant increase of the effectiveness in comparison to intermittent therapeutic forms, so that the popularity of this method of treatment rapidly increased. A simple technical handling and the patient's independence of the machine essentially contribute to the popularity of the CAPD. Significant results in the combat against peritonitis, the main problem of the CAPD, made the CAPD a recognized method of treatment for the terminal renal insufficiency. Should not unforeseeable innovations decisively improve the technique of haemodialysis, the CAPD will maintain its position beside the haemodialysis also in the following decade. PMID- 3307214 TI - [Oral galactose loading in characterizing the elimination and metabolizing performance of the liver in chronic renal failure]. AB - For characterising the elimination and metabolisation performance of the liver in chronic renal insufficiency the galactose load test was carried out. 9 children with healthy liver and kidneys, 35 children with chronic renal insufficiency (15 were conservatively treated = group 1, 20 were in the chronic haemodialysis programme = group 2) as well as 5 children after kidney transplantation were examined. In group 1 a normal blood galactose concentration was present. Patients of the 2nd group showed increased concentrations of galactose in the blood which might refer to a decreased redox potential in the liver caused by the uraemic intoxication. In the group of patients who underwent a kidney transplantation in the patients with azathioprine therapy a disturbed use of galactose was present. Children with cyclosporin-A had a normal galactose concentration. PMID- 3307216 TI - [Affinity-histochemical labeling methods using colloidal gold. Overview of developments in the past 15 years]. AB - A survey is given of the development of affinity-histochemical labelling methods using colloidal gold for electron and light microscopy. Historical aspects and trends are discussed and principle methodologic variations are illustrated. A comprehensive compilation of previously published data provides a concise overview of technical variations and applications of the colloidal gold method. PMID- 3307215 TI - [Modification by cyclophosphamide of the effect of autovaccination in chronic pyelonephritis in an animal experiment]. AB - In an existing chronic pyelonephritis the influence of cyclophosphamide on the efficacy of an immunisation with autopathogenic antigens and the surface antigen of an E. coli rough strain was tested in an animal experiment. After an existence of the infection of about five weeks a decisive decrease of the antibody production by cyclophosphamide was not to be observed. The animals treated with cyclophosphamide did not show any improved elimination of germs. The histological findings of the kidneys documented the cytotoxical effect of the cyclophosphamide on the renal tissues and the epithelium of the urinary tract. The immunisation of animals with chronic pyelonephritis with various autopathogenic antigens altogether led to a statistically significant decrease of inflammatorily changed kidneys. PMID- 3307217 TI - [Problems in the classification of disease--historical and current aspects]. AB - Based on the general principles for classifying objects and its significance for science, and analysis of the current most important principles of classification in pathological anatomy is undertaken. In this context 6 groups of signs are presented which seem useful for the classification of diseases. The tendency to change from an artificial to a more natural mode of classification is described. A combination of these two aspects seems to best satisfy the actual needs. Special attention should be concentrated on general etiology and its relation to dialectic determinism. Of great importance is to consider new knowledge on the significance of DNA for the classification of diseases. The idea of disorders of metabolism is outdated and the chapter on disturbances of growth and differentiation must be divided according to the underlying defect. PMID- 3307218 TI - [Role of pathologists in the besieged city of Leningrad (1941-1943)]. AB - The siege of Leningrad by fascist German troops (1941-1942) resulted in an acute food shortage which lead to severe malnutrition in the population and amongst military personnel. In the face of severe nutritional deficiency the majority of illnesses demonstrated a completely atypical clinical course and were thus difficult to diagnose. The results of autopsy first revealed the true underlying cause of death in many cases of bacterial dysentery, atypical pneumonia, generalized tuberculosis and vitamin deficiency in severely emaciated patients. As a result of the work of the Leningrad pathologists, many of whom themselves fell victim to starvation and illness, it was possible to improve the diagnosis and therapy of many disease with atypical courses. Moreover it was possible to institute preventive measures against the spread of epidemics. The overriding lesson from the bitter experience of the Leningrad pathologists is that keeping the peace must be the highest priority of all peoples and for every physician. PMID- 3307219 TI - [Ultrasound diagnosis in ileus]. AB - Unspecific clinical symptoms and negative general X-ray findings from the abdominal region have often been characteristic of early ileus stages and have caused delay in prognosis-enhancing surgery. These early stages can be more reliably identified by means of abdominal sonography. Ileus was detected by means of general abdominal sonography from three of 14 of the authors' own patients from whom negative findings had been recorded by X-ray examinations. Their ileus was eliminated by immediate surgical intervention. PMID- 3307220 TI - [Use of highly evacuated Redon drainage following gynecologic operations]. AB - A highly evacuated wound drainage system according to Redon (980 mbar) was applied to 100 women who had undergone laparotomy. No change of bottles was necessary up to removal of the system in 96 cases. Bacteriological tests were applied to various points of the Redon system and revealed only minimum colonisation with pathogenic germs. No relationship was recordable between the rate of wound healing disorders and bacteria detected in the Redon system. PMID- 3307221 TI - [Our surgical heritage. Hans Kehr and Ernst Unger]. PMID- 3307222 TI - [Symptomless gallstone disease--when to treat surgically?]. AB - The cholecystolithiasis is the symptom of a disease. Recent radiological procedures, above all sonography, can be helpful not only in more frequent detection of gallstones, but they can also provide information, even without clinical symptoms, on pathological changes to gallbladder and biliary tracts. However, early diagnosis of carcinoma of the gallbladder still is rare. Mortality of gallbladder carcinoma has remained unchanged in the Federal Republic of Germany over the past ten years, whereas mortality following cholecystolithiasis has been lowered due to progress in medicine. The surgical risk rises along with age and is low up before 60 years. Indication for cholecystectomy continues to be a highly individual decision which should be considered with particular caution in cases of "asymptomatic" gallstones. PMID- 3307223 TI - [Ultrasonic measurement of the uterus in juvenile diabetic patients and possible corrections between genital development and diabetes mellitus. 2]. AB - The sonographically determined length of uterus in 100 insulin-dependent diabetic girls of the age-classes 1964 to 1974 are considered in relation to diabetes mellitus. In order to recognise the possibility of a disturbed development of the inner genitals during puberty of juvenile diabetics, the uterus development is considered in relation to ossification age, duration of diabetes, and to the period before or after the 10th year of age as well as before respectively after menarche. Before the 16th year of age the growth curves of the uterus in all metabolism groups show non-significant delays, which are difficult to interpret. Up to the 18th year the course of the curves reach a similar standard of development--that is an average of 60 mm. In order to determine the precise moment of the diagnostic and therapeutic activity in delayed puberty development, it seems to us appropriate to use the sonographic measurement of the uterus length in addition to the definition of ossification age. PMID- 3307224 TI - [Correlation of sonomorphologic placental maturity with the L/S ratio and creatinine level in the amniotic fluid]. AB - With 184 L/S-ratio determinations and 132 creatinine determinations in amniotic fluid we tried to show a connection between these parameters and sonographically provable changes of placental structures. We found no relationship between placental grading and fetal lung and renal maturity by statistical processing of the results, considering gestational age. There is between L/S-ratio and creatinine determinations no statistical relationship, too. PMID- 3307225 TI - [Spermiologic aspects of in vitro fertilization]. AB - Some publications of the last three years, which deal with the influence of the spermatozoa on the success rates of the in vitro fertilization (ivf) were analysed: 1. Semen samples with 10(7) spermatozoa per ml and more than 30% motile and normally configurated sperm cells are regarded as the lower limit of the usability. 2. Microbiological investigations, determination of the concentration of white blood cells, assessment of the motility during an in vitro incubation, evaluation of the acrosomal enzymes, the resistance of the spermatozoa to osmotic stress and the ability of the penetration of pre-ovulatory mucus represent additional criteria for the selection of semen samples. 3. The correlation between the results of the penetration test of the zona pellucida-free hamster oocytes and of the ivf is discussed. A lower limit of the conventional semen parameters concerning a success of the ivf is not detectable by this test. 4. The applied method of the separation of the spermatozoa should depend on the sperm quality. "Swim up"-method led to the best rates of fertilization. 5. Improvement of the male conditions for the ivf is possible. 6. The infertility caused by antisperm-antibodies is an accepted indication of ivf in contrast to oligozoospermia. 7. The fertilization of the oocyte by the spermatozoon prerequisites several spermatozoal alterations (capacitation, acrosome reaction), which are presented in this article in parts. PMID- 3307226 TI - [Immunology of fetomaternal interaction: HLA antigens]. AB - The histocompatibility complex is an essential part of the immunology of the fetomaternal interactions. HLA antigen haplotyps are present on fetal lymphocytes. HLA antigens are also localized in the chorion. The paternal HLA antigenicity is decreased by different mechanism. In multiparae HLA antibodies are detectable in 20 to 30 per cent without injuries of the fetal tissues or wellbeing respectively. The placenta possesses the ability of the immunoadsorption of maternal lymphocytotoxic antibodies. In cases of increased compatibility of materno-paternal HLA antigens habitual abortions are more frequent according to some authors. Therapeutic leucocyte transfusion can be used regarding to prevention of recurrent abortions. PMID- 3307228 TI - [Comparison of the effectiveness of Partusisten and ethanol tocolysis. II. Short term tocolysis with Partusisten or ethanol]. AB - A prospectively randomised study for treatment of premature labor either by Partusisten or ethanol short term tocolysis was done in the years 1981 to 1983. The tocolysis was successful in 54 per cent (Partusisten) respectively 50 per cent (ethanol) by reaching a birth weight 2,500 g. 36 per cent respectively 37 per cent pregnant women reached 37th gestational week. Prolongation index 21 or more allows to predict a birth weight of 2,500 g or more. Success score 12 is not identical with corresponding birth weight. Ethanol tocolysis is an alternative to Partusisten treatment. PMID- 3307227 TI - [Incidence of B streptococcal diseases and colonization--a clinico epidemiological study]. AB - The incidence of newborn infections caused by group B streptococci (GBS) has risen significantly in recent years. In 1983 and 1984 ten GBS diseases of the newborns were registered in the Department of Neonatology of the University Hospital (Charite). This is a morbidity of 1.2 per 1,000 live births. Eight infants showed an early onset and 2 a late onset type. Three of the neonates died. These were term infants with a birth weight of more than 2,500 g. The isolated types in these cases were Ia, Ia/c and III. In 1983 and 1984 430 nonselected women between the 34th and 40th weeks of gestation were examined for GBS colonization. One rectal, vaginal and cervical swab was collected from each women and cultured both in a selective broth medium and a selective blood agar plate. The colonization rate was 11.4% in pregnant women. The most frequent colonized region was the rectum, followed by vagina and cervix. Cultures from infants were obtained from throat, left and right ear. 2.7% of the newborns were positive for GBS. The most frequent isolated types are III/R and Ia. In all cases, positive for maternal and neonatal colonization, the isolated types were identical. PMID- 3307229 TI - Coagulase-negative staphylococci. PMID- 3307230 TI - Microcalorimetric assessment of liquid culture media. AB - Microcalorimetry constitutes an analytic tool to register the heat effects produced by the metabolic processes taking place in a bacterial culture. Since these depend on the nutrients supplied in the media, microcalorimetry allows conclusions to be drawn about the nature and quality of the culture medium when using a standard germ. Taking Columbia Broth as an example, we showed that faulty weighing of the dry substrate, incorrect pH or overheating during the dissolving or autoclaving procedures could be detected by the use of the microcalorimetry. A microcalorimetric assessment to compare media of the same name produced by different manufacturers was carried out and significant differences were observed. We consider this microcalorimetric technique to be a valuable tool in the assessment of liquid culture media. PMID- 3307231 TI - Antibiotic residues and R-plasmid selection: are in vitro methods good models? AB - Three clones of E. coli, one of which was harbouring a tetracycline resistance plasmid were inoculated together into the stomach of axenic mice. Without antibiotic selective pressure, the R-Plasmid bearing strain became dominant in the faeces of mice, while the R-plasmid free strain was eliminated. When the R plasmid bearing strain was given to mice 4 days after the inoculation with the R plasmid free strain, it was repressed and remained at the stable level of 10(4.5) organisms per g of faeces. But a rapid spread of the R-plasmid was observed, tetracycline resistant bacteria become dominant within one day, and replace the tetracycline sensitive E. coli. The tetracycline resistance plasmid did not disadvantage the mediating strain in the gut, even in the absence of antibiotic pressure. In contrast Lebek and Egger (1983), studying the same strains in vitro, found that in a chemostat the plasmid bearing strain was overgrown by the plasmid free strain. These results strongly suggest that in vitro interactions between E. coli strains cannot be directly extrapolated to in vivo conditions. For the determination of the no-effect level of antibiotic residue on the selection of R factor in the gut, studies should be made in vivo. PMID- 3307232 TI - [Comparison of two ELISA kits for the demonstration of antibodies against LAV/HTLV-III]. AB - Eight hundred sera from a non-risk group and thousand sera from people at risk for acquiring AIDS were tested for the presence of LAV/HTLV-III specific antibodies by ELISA test kits manufactured by Du Pont and Organon. Western Blot analysis was used as a confirmatory test. All Western Blot positive sera were also positive in the Du Pont ELISA which in addition revealed a very low rate of false positive results (0.44%). In the Organon ELISA negative results were obtained with one positive and one questionable positive serum, as determined by Western Blot. The possible problem of test sensitivity being too low has been taken into account by the manufacturer by changing the calculation of cut-off values. PMID- 3307234 TI - Rapid in vivo assay method for type G botulinal toxin. AB - The survival time (ST) dose-response curve for Clostridium botulinum type G toxin was determined in mice and evaluated as a rapid assay method. As it occurs with other botulinal toxin types, the results showed a linear relationship between the logarithm of the injected dose and the logarithm of ST. The slope of the ST dose response curve for type G toxin differed significantly from those for type A or subtype Af toxins. This parameter was altered when trypsin-activated type G toxin was used. The ST dose-response curve was rather stable. This in vivo assay method could be applied for the estimation of the potency of G toxin preparations in a short time using only some few mice. PMID- 3307233 TI - Detection of Shiga-like (SL) toxins of enteropathogenic Escherichia coli (EPEC) of human, porcine, calf, and lamb origin on Vero and HeLa S3 cells: a comparative study. AB - One hundred and forty eight strains of human, porcine, calf and lamb origin belonging to different enteropathogenic O:H serotypes isolated in 13 countries in four continents were tested for production of Shiga, Shiga-like (SL) and other cytotoxins on Vero cells and HeLa (S3 subline) cells in tissue cultures. Altogether, 45% human strains and 89% porcine strains were defined as strong toxin producers (toxin titre greater than or equal to 1:100) on Vero or HeLa S3 cells while 31% of human and 9% porcine strains were regarded as moderate to weak toxin producers (toxin titre less than 1:100). Twenty three percent of human and 1.5% of porcine strains were negative for Shiga or SL-toxin. Polymyxin release of Shiga or SL toxins from bacterial colonies of blood agar grown cultures is recommended as it is simple and effective method facilitating the detection of even low levels of toxins in EPEC or non-EPEC strains. Of the ten strains from calves and lambs, only four were strong toxin producers when cell-free culture supernatants were tested while a polymyxin release method showed that 8 strains were strong toxin producers. One strain was negative by both methods. The high proportion of Shiga/SL toxin negative strains in all O:H serotypes of human origin (but not of porcine origin, especially O 139 serogroup) suggests that systematic studies should continue to look for new toxins in freshly isolated strains grown under in vivo like conditions, e.g. in iron depleted culture media. PMID- 3307235 TI - [Local immunity and microbial IgA proteases]. PMID- 3307236 TI - [Role of the lipid peroxidation system of Escherichia coli cells in maintaining their viability in air]. AB - The study of 6 E. coli strains differing in their capacity for survival in the air has revealed that the physicochemical characteristics of lipids in microbial cells, such as antioxidizing activity, the concentration of peroxidation products, the content of lipids and their capacity for oxidation, are interrelated, which confirms the existence of the system regulating the peroxidation of lipids in prokaryotic cells, similar to the system regulating lipid peroxidation in eukaryotic cells. The capacity of cells for survival in the air has been shown to depend on the physicochemical state of lipids in cellular membranes. PMID- 3307237 TI - [Use of a new method for restoring the type properties of atypical Vibrio cholerae]. AB - Subcultures with a number of signs characteristic of epidemically significant strains have been isolated from cholera vibrios, nonpathogenic and atypical in a number of properties, by a new in vitro method developed by the authors. This method makes it possible to increase the virulence of poorly agglutinating cultures of V. cholerae O1 and their agglutinability with cholera antisera. PMID- 3307238 TI - [Combinations of pathogenicity factors in Escherichia coli isolated from children and domestic animals]. AB - The study has shown that in E. coli strains isolated from children aged up to 1 year with acute intestinal diseases of unknown etiology different combinations of pathogenicity factors (Ent. K88, K99, Vir, CFAI, CFAII, HIy, ColV, ColI) can be detected in 47.1 +/- 3.8% of cases, while in E. coli strains isolated from practically healthy children of the same age combined carriership of these factors does not exceed 5.8 +/- 2.5%. In E. coli strains isolated from swine and cattle with diarrhea the combined carriership of pathogenicity factors is 68.5 +/ 2.8% and 58.4 +/- 4.9% respectively. PMID- 3307239 TI - [Immunological effectiveness of secondary revaccination against tetanus performed at prolonged intervals]. AB - After primary immunization with adsorbed DPT vaccine antitetanus immunity was retained for 9-10 years in 90.6-98.4% of children covered by this study. The second booster immunization of children against tetanus with adsorbed DT toxoid with reduced antigen content, made at an interval prolonged to 7-10 years under the conditions of lower antitoxic immunity, ensured a high level of intense antitetanus immunity. These data point to the possibility of prolonging the interval between booster immunizations to 9-10 years and reducing the number of injections and antigenic load. PMID- 3307240 TI - [Early detection and rapid identification of Streptococcus pneumoniae and Haemophilus influenzae in acute pneumonias]. AB - The comparative study of the diagnostic value of the enzyme immunoassay (EIA), indirect immunofluorescence (IF) and countercurrent immunoelectrophoresis (CIE) was made. The serological identification of the isolated and reference pneumococci (19) and H. influenzae (38) strains revealed the possibility of using all three microanalytical methods for this purpose. The study of pneumococcal and H. influenzae antigens in native sputum obtained from 74 patients with acute pneumonia showed that EIA and indirect IF were highly sensitive, their sensitivity considerably exceeding that of the bacteriological analysis. Pneumococcal antigens were detected in 66.2% of patients by EIA and in 54.0% of patients by indirect IF, while H. influenzae antigens were detected in 58.1% of patients by EIA and in 67.6% of patients by indirect IF. The sensitivity of CIE proved to be considerably lower; in the detection of pneumococcal antigens it was level with the sensitivity of the bacteriological analysis (23.0%) and H. influenzae antigens could be detected only in 27.0% of patients. PMID- 3307241 TI - [Biological properties of plasmid-free strains of Salmonella typhimurium and S. dublin]. AB - The study of Salmonella virulent strains has revealed that the characteristic feature of such strains is the presence of plasmids with a molecular weight of 90.2-91.5 kb for S. typhimurium and 77.2-78.5 kb for S. dublin. From Salmonella strains harboring only a single plasmid, variants with no plasmid at all have been obtained. These variants possess lower virulence for mice infected through enteral and intraperitoneal routes; besides, they lose their capacity for penetration into epithelial cells of HeLa line. S. typhimurium and S. dublin have shown decreased multiplication rate in vivo in comparison with the parent strains, while the multiplication rates in vitro were similar. These results suggest that the products of plasmid genes are either responsible for the virulent properties of salmonellae, or they have regulatory functions, thus controlling the work of chromosomal genes. PMID- 3307242 TI - [Determination of the cytotoxic action of cell fractions of Streptococcus group A on continuous human heart cells]. AB - The work deals with the study of the cytotoxic action of the fractions of group A streptococcal cells, type 1, on human heart cells in continuous cell cultures, carried out by the method of J. L. Middlebrook and R. B. Dorland based on the determination of the protein content in the surviving monolayer cells. The addition of crude cytoplasm and the supernatant of sonicated streptococcal cell walls to human heart cell culture has made it possible to obtain a statistically significant decrease in the protein content of the remaining monolayer cells. The action of purified cytoplasm has resulted in faint statistically insignificant suppression of cell growth, thus decreasing the content of cell protein. This method of studying the cytotoxicity of streptococcal cell fractions is simple, convenient and can be used in research work. PMID- 3307243 TI - [The function of Salmonella typhi at different stages in the pathogenesis of typhoid infection]. AB - The complex study of the adhesive, colicinogenic and antigenic properties of S. typhi of different origin has revealed that adhesive properties can be observed more frequently in the strains isolated from the blood and bile and are completely absent in the strains isolated from feces. S. typhi strains of various origin do not essentially differ in their sensitivity to colicins and in the capacity for their production. Among the strains isolated from feces and bile, agents in the W-form occur more frequently than among the strains isolated from the blood. Escherichia coli, isolated from typhoid patients and carriers at the moment of the persistence of S. typhi in the body, are characterized by faintly pronounced antagonistic properties, enhanced sensitivity to colicins and rather pronounced hemagglutinating activity. PMID- 3307244 TI - [Forerunners of influenza epidemics and their practical use]. PMID- 3307245 TI - [Current aspects of the biology and immunology of Streptococcus mutans]. PMID- 3307246 TI - [The use of lectins in microbiology]. PMID- 3307247 TI - [Treatment of status epilepticus in children with short-acting barbiturates]. AB - The results of the multiple-modality treatment of epilepsy in 56 children of different age with the use of thiopental-sodium are presented. It has been shown that its early administration to children with a true status epilepticus makes it possible to faster bring the patient out of the pathologic condition as compared to the conventional methods of treatment. In patients with a symptomatic epistatus and in children with marked residual-organic cerebral insufficiency associated with the development of convulsions anticonvulsive therapy should be combined with the treatment of the underlying disease aimed at the correction of extra- and intracranial homeostasis. PMID- 3307248 TI - [Prevalence of the major mental illnesses (review)]. PMID- 3307249 TI - [Prediction of the outcome of craniocerebral injuries in the acute period]. AB - Unified clinical findings in 302 patients were analysed to prognosticate the outcomes of severe craniocerebral trauma in the acute phase. The patients condition in the acute stage was evaluated in points according to four types of outcome: fatal, with coarse and moderate neurological disorders, and with a satisfactory compensation of the condition. In a condition rated 20-30 points the probability of a favourable or a fatal outcome was equal. In a condition rated less than 20 points the probability of a fatal outcome increases, in one-rated above 30 points the probability of a favourable outcome grew. PMID- 3307251 TI - [Electrosubcorticography and impedance in the computer tomographic biopsy of brain tumors]. AB - During 15 stereotaxic biopsies of brain tumors along 26 trajectories of introduction of the bioptic cannula, the brain tissue impedance was measured many times together with the recording of an electrosubcorticogram from the same points. Electrophysiological examination yields mutually complementing and authentic information concerning the boundaries of the pathological process and the condition of the perifocal brain matter, which improves the results of stereotaxic biopsy by increasing its informativeness. The impedance contours on the whole reflect the changes of the brain matter X-ray density, but there may be a discrepancy between these data in some cases since impedance is a more dynamic characteristic. PMID- 3307250 TI - [Stereotaxic removal of intracranial hematomas]. AB - The high lethality and frequent postoperative complications in surgical treatment of intracerebral hemorrhages stimulate the search for new methods of their management. The introduction of computer tomography into clinical practice provided the grounds for elaborating a stereotaxic method for sparing removal of intracerebral hematomas. Experience in the clinical use of the method (54 operations on 51 patients) allows its results to be considered encouraging. Lethal outcomes amounted to 24%, while the possibilities of functional restoration were higher than in the other types of surgical and nonoperative treatment. PMID- 3307252 TI - [Method of measuring the length of the intracerebral microcirculatory bed (the Blinkov-Moiseev technic)]. AB - Experiments on a "caprone-thread" model demonstrated that the method suggested by S. M. Blinkov and G. D. Moiseev produced adequate results of measurement of firm linear structures in all series of sections 10 to 60 microns thick with 95% level of reliability. The integration method produces an error of 300 to 600% which depends on the thickness of the section. PMID- 3307253 TI - [Current concepts on the treatment of tumors of the pituitary gland (review of the foreign literature)]. PMID- 3307254 TI - Parathyroid localization. Clinical review. AB - Recent advances in the techniques of preoperative parathyroid localization include ultrasonography, computed tomography, thallium-technetium subtraction scanning, magnetic resonance imaging, digital subtraction angiography with selective venous catheterization for PTH measurement, and ultrasound or CT-guided needle aspiration biopsy for cytological examination or PTH assay. These techniques are helpful for patients with hyperparathyroidism undergoing the initial operation, and essential for patients with persistent or recurrent hyperparathyroidism undergoing reoperation. Noninvasive procedures should be performed first, and the combination of any two positive studies localizes the tumor with near certainty. Invasive procedures have a higher risk of complications and are recommended only in selected patients before reoperation. PMID- 3307255 TI - Effect of antibiotics on gram-negative sepsis in the rat. Lack of endotoxin burst. AB - Endotoxin and monocyte thromboplastin activity were evaluated in rats with gram negative septicaemia induced by caecal perforation or intravenous Escherichia coli challenge and treated with antibiotics or placebo. Endotoxin burst was not detected in either form of septicaemia during antibiotic treatment. Thromboplastin synthesis in monocytes is known to be stimulated by endotoxin, but the rats showed no increase of monocyte thromboplastin activity after antibiotic treatment, which constituted further evidence against the concept of massive endotoxin liberation during antibiotic therapy for gram-negative septicaemia. PMID- 3307256 TI - Splenectomy in the rat. Immediate and late effects on clearance of gram-negative bacteria and on monocyte activation as expressed by thromboplastin synthesis. AB - Young rats (weight 190-200 g) were subjected to splenectomy or sham laparotomy and gram-negative bacteraemia was induced by caecal perforation or by injection of viable Escherichia coli intraperitoneally (10(9) bacteria) or intravenously (2 X 10(8]. Clearance of bacteria was significantly less in the splenectomized than in the sham-laparotomized rats, irrespective of the mode of microbial inoculation. Monocyte thromboplastin activity, shown to be a sensitive indicator of gram-negative bacterial presence, was heightened in the asplenic rats. When the infectious challenge was made 15 weeks postoperatively, however, no significant difference in bacterial clearance or in monocyte thromboplastin values was found between splenectomized rats and controls. Nor was increased susceptibility to gram-negative bacteria found in asplenic rats when both operation (splenectomy vs. sham laparotomy) and bacterial challenge were performed at a late age (weight 530-580 g). The postsplenectomy clearance of gram negative bacteria thus seemed to be age-dependent. PMID- 3307257 TI - Stomach cancer: a prospective study of anastomotic failure following total gastrectomy. AB - The incidence and cause of esophagojejunal anastomotic leakage were prospectively studied in 350 patients following total gastrectomy for stomach cancer. Anastomotic leak was demonstrated in 30 patients (8.6%), ten of whom underwent reoperation. Nine of the 30 patients died. Statistical analysis revealed that the outcome was better for patients with stapled esophagojejunostomy than when the anastomosis was hand-sutured. The odds for leakage were 2.37 times higher in patients with hand-sutured, than in those with stapled anastomosis. Antibiotic prophylaxis may be significant in preventing leakage. No association was found between anastomotic leakage and type of hospital, patient age or sex, preoperative weight loss, concomitant splenectomy or residual tumor in the resection margin. PMID- 3307259 TI - Continuous subcutaneous insulin infusion (CSII) in the management of diabetic lipodystrophy: a case report. AB - A case of diabetic lipodystrophy which showed an improvement after continuous subcutaneous insulin infusion into lipodystrophic areas is reported. The authors feel that this therapeutic regimen could be useful when conventional treatments (the injection of regular purified insulin or dexamethasone-insulin mixtures in the area of the lesion) have failed to obtain good results. PMID- 3307258 TI - Mechanism of hyperglycemia induced by extensive wounds and generalized surgical infection. AB - Significant differences were revealed in the mechanism of hyperglycemia in extensive wounds and generalized surgical infection. Hyperglycemia in extensive burn injuries is caused by the inhibition of insulin formation, decreased insulin binding to cellular receptors, which leads to decreased sensitivity of tissues to insulin. Hyperglycemia developing in generalized infection is a result of insufficient blood insulin levels consequent to inhibition of its secretion (while insulin biosynthesis is elevated) under the effects of hyperproduction of prostaglandins, and is also mediated by defects in insulin-receptor interaction. Correction of carbohydrate metabolism disorders in these surgical pathologies in spite of the different pathogenetic mechanisms might be achieved by exogenous insulin administration, and also by insulin administration together with indomethacin, a nonsteroid anti-inflammatory agent, inhibiting prostaglandin production. PMID- 3307260 TI - Pre-diabetes in the spontaneously diabetic BB/E rat: pancreatic infiltration and islet cell proliferation. AB - A cohort of BB/E rats derived from litters with a high and low incidence of IDDM was studied prospectively to examine the relationship between circulating autoantibodies, islet insulin secretion, pancreatic infiltration, and islet cell replication during the pre-diabetic period. Although a higher incidence of islet cell surface (ICSA) and insulin autoantibodies (IAA) was detected in the diabetes prone than in the low diabetic-incidence BB/E rats there was no correlation between the two antibodies in individual animals. Moreover, ICSA, but not IAA, were associated with loss of first phase islet insulin release. Between 75 and 105 days of age the number of diabetes-prone rats with ICSA and impaired islet insulin secretory function increased. Over the same period, there was a concomitant increase in the proportion of diabetes-prone animals with pancreatic infiltration, and increased islet endocrine cell proliferation. All these interrelated phenomena were observed in diabetes-prone BB/E rats at a time when the animals were normoglycaemic. PMID- 3307261 TI - Experiences with different techniques of chorionic villi sampling for first trimester diagnosis. PMID- 3307262 TI - Induction of ovulation in normo-androgenic women, affected by primary hypothalamic amenorrhea, with chronic pulsatile administration of GnRH, using an automatic portable pump (Zyklomat). AB - Pulsatile administration of GnRH appears to be the most rational and physiological treatment of infertility in patients affected by hypothalamic amenorrhea. The authors conclude that the results obtained with this method of treatment in patients with severe hypothalamic amenorrhea suggest that the choice of pulsatile GnRH therapy is an effective and practical method for induction of ovulation. PMID- 3307263 TI - Recurrent spontaneous abortion: state of the art and new horizon. AB - Spontaneous abortion is the commonest complication of pregnancy and its frequency has been estimated to be between 15 and 20% of all clinical pregnancies. A comprehensive classification of etiologic factors that may cause repeated abortions is made and the importance of a precise program of the necessary diagnostic steps is underlined. PMID- 3307264 TI - [Cytochemical study of macrophages in sarcoidosis patients in skin window exudates]. AB - The development of skin-window macrophages was studied in four untreated patients suffering from sarcoidosis by cytochemical assessment of the acid phosphatase activity. The results obtained in these patients were compared with those of healthy volunteers. Appearance of the focal acid phosphatase-activity in the Golgi area was delayed in patients with sarcoidosis. A decreased amount of activity in mature macrophages was also demonstrated depending on the clinical activity of the disease. Patients with hypothyroidism showed the same cytochemical pattern. In contrast to these results, no significant difference in the development of acid phosphatase activity was found in patients with tuberculosis as compared to healthy volunteers. Our observations confirm the hypothesis that the functional disorder of monocytes is, at least, a partial pathogenetic mechanism of sarcoidosis. PMID- 3307265 TI - Thoracic and abdominal lymph drainage in relation to mechanical ventilation and PEEP. AB - Thoracic and abdominal lymph flow have been studied in 25 dogs. Thoracic lymph flow (TLF) was found to be (mean +/- s.e. mean) 6.1 +/- 1.4 ml/h before, and 29 +/- 4.6 ml/h after the induction of lung damage with oleic acid. TLF was depressed by 50% both before and after lung damage, when a positive end expiratory pressure (PEEP) of 1.0 kPa (10 cmH2O) was applied. This suggests impeded drainage of the lung tissue. Spontaneous breathing, compared to mechanical ventilation, significantly increased TLF by approximately 70%. Abdominal lymph flow increased from 61 +/- 5.3 ml/h to 111 +/- 12.6 ml/h, when a PEEP of 1.0 kPa was applied. These findings demonstrate that PEEP may contribute to oedema in a surgical area. It is concluded that increased intrathoracic pressure reduces TLF, and spontaneous breathing increases TLF, as compared to mechanical ventilation without PEEP. PMID- 3307266 TI - Gas exchange in low-compression HFPPV is maintained at low distending pressures in the pig. AB - The fact that collateral ventilation normally occurs in the human lung has led to the suggestion that it might contribute to the successful clinical effects of low compression high-frequency positive-pressure ventilation (HFPPV). As the pig has poor collateral ventilation, pulmonary vasoconstriction has to be part of the regulatory mechanisms matching ventilation-perfusion. A study was made on nine pigs anesthetized with ketamine hydrochloride intravenously to elucidate the maintenance of ventilation-perfusion balance during mechanical ventilation. Comparisons were made between the ventilatory patterns provided by a conventional ventilator (Servo-Ventilator 900C) and an improved prototype of a low-compression system for volume-controlled ventilation (system H). A ventilatory frequency of 20 breaths per min (bpm) with SV-900C (SV-20) and system H (H-20) and of 60 bpm with system H (H-60) was used. The experimental conditions were otherwise identical. Positive end-expiratory pressures (PEEP) were applied to maintain the same mean airway pressure with the three systems. The tidal volume required for normoventilation differed significantly between the three ventilatory patterns, but there were no differences in circulatory and oxygen-transport variables. By measurements of airway pressure and intrapleural liquid surface pressure, it was demonstrated that the distending pressure (at end-inspiration) was significantly lower with a low-compression system (H-20 versus SV-20), especially at a high ventilatory frequency (H-60 versus H-20). Consequently, although the mean airway pressure was set at the same level for the three different ventilatory modalities, the distending pressures required for the same alveolar ventilation and arterial oxygenation differed significantly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307267 TI - Dose-related effects of isoflurane on superior mesenteric vasoconstriction induced by endotoxemia in the rat. AB - To investigate the interplay between endotoxin-induced circulatory shock and the cardiovascular effects of different doses of isoflurane, mean aortic pressure (MAP), central venous pressure (CVP), mean pulmonary arterial pressure (MPAP), heart rate (HR), cardiac output and superior mesenteric artery flow (SMAF), were monitored in rats anesthetized with either 1.4% or 2.0% isoflurane in oxygen. Cardiac index (Cl), total peripheral vascular resistance (TPR) and superior mesenteric vascular resistance (SMVR) were derived. During continuous administration of isoflurane, endotoxin (LD90, 40 mg X kg-1 iv) was given after a 30-min baseline period, and data were collected for an additional 2-h period. Sham-challenged (saline) animals served as controls. The response to endotoxin in the systemic circulation showed a decrease in Cl and MAP, while HR and TPR increased. MPAP and CVP were essentially unchanged. There were no significant differences in the systemic circulation variables between endotoxin groups, apart from a more pronounced HR increase during 1.4% isoflurane. Regionally, however, SMAF was lower and SMVR was higher in the 2.0% versus the 1.4% isoflurane group following endotoxin. To conclude, the degree of mesenteric vasoconstriction during endotoxemia was dependent on the dose of isoflurane. This dose-related effect seems to be mediated through interaction with intrinsic vascular control, a higher dose allowing a more pronounced local blood flow reduction. PMID- 3307269 TI - Effects of salbutamol and hyperventilation on the rise in serum potassium after succinylcholine administration. AB - It is known that circulating catecholamines stimulating beta 2-receptors and the acid-base balance play important roles in the regulation of serum potassium (K+). The present study was undertaken to investigate the effect of salbutamol (SB), a highly selective beta 2 agonist, and hyperventilation (HV)-induced alkalosis on the change in serum K+ after succinylcholine (SCh) administration in dogs. Pretreatment with SB (0.4 microgram.kg-1.min-1 for 30 min) produced sustained decreases in serum K+ and mean arterial pressure, and transient increases in cardiac output and serum insulin concentration. Maintaining respiratory alkalosis with HV (PaCO2 = 2.6-3.3 kPa) produced sustained decreases in serum K+ and cardiac output. Although both pretreatment with SB and HV-induced alkalosis significantly reduced the absolute increases in serum K+ after SCh, the effect of SB was more remarkable than that of HV. These results suggest that the degree of beta 2-receptor activity can strongly modulate the change in serum K+ after SCh administration. PMID- 3307270 TI - Extreme metabolic acidosis. Case report. AB - A 42-year-old male patient, who suffered from insulin-dependent diabetes mellitus (IDDM) and intolerance of lactose, presented with extreme metabolic acidosis (lactic acidosis). On arrival, an arterial blood sample showed: pH 6.79, PO2 18.8 kPa, PCO2 0.9 kPa, base excess-33 mmol l-1, blood glucose 38 mmol l-1 and oesophageal temperature 30 degrees C. Apart from the uncontrolled hyperglycaemia, a fluid balance disorder elicited by diarrhoea and disturbed tissue perfusion were possible aetiological factors. The patient was treated with a low-dose insulin regimen and infusion of isotonic sodium bicarbonate with a satisfactory result. PMID- 3307268 TI - Central haemodynamics and regional blood flows during thoracic epidural analgesia combined with positive pressure ventilation. An experimental study in the pig. AB - Cardiac output, central haemodynamics and regional blood flows were studied in pigs. The microsphere technique was used for blood flow determinations. Measurements were made during spontaneous breathing (SB) and during intermittent positive pressure ventilation with 0.8 kPa (8 cmH2O) positive end-expiratory pressure (8 PEEP) before and during thoracic epidural analgesia (TEA). TEA in the pig caused reduced cardiac output due to reduced heart rate with maintained stroke volume. During TEA there was also a reduction of mean arterial blood pressure which ran almost parallel to the decrease in cardiac output with maintained systemic vascular resistance during SB and at 8 PEEP. The distribution of cardiac output was basically the same during SB and at 8 PEEP as it was before TEA. However, myocardial blood flow and relative perfusion decreased during TEA, both during SB and at 8 PEEP. TEA also reduced spinal cord blood flow within the thoracic region during SB and at 8 PEEP. PMID- 3307271 TI - Immunohistochemical studies on GABAergic neurons in the rat locus coeruleus, with special reference to their relationship to astrocytes. AB - Purified antisera against GABA were prepared. A few small GABAergic neurons in the rat locus coeruleus were immunohistochemically demonstrated by both the unlabeled peroxidase-antiperoxidase method and the avidin-biotin peroxidase complex method using affinity-purified GABA antibodies. The glial fibrillary acidic protein immunoreactivity in this nucleus was localized by the latter method in the astrocytal framework encircling medium-sized and small neurons as well as in straight processes. Astrocytes may play a role as energy donors to these neurons. PMID- 3307272 TI - Desertomycin: a potentially interesting antibiotic. PMID- 3307273 TI - The effect of bacterial endotoxin of phagocytosis of Tetrahymena and serotonin induced imprinting. AB - Endotoxin inhibited the phagocytosis of Tetrahymena pyriformis after a short exposure and, to a lesser degree, after repeated treatments during one week (about 35 generations). Endotoxin also prevented the development of serotonin imprinting. Detoxified endotoxin (Tolerin) affected the phagocytosis of Tetrahymena much less, indicating that the lipid-A part of the molecule may account for the membrane-toxic effect. PMID- 3307274 TI - Comparison of adjuvanticity and autoantibody inducing capacity of endotoxin and radio-detoxified endotoxin in mice. AB - Endotoxin (LPS) and radio-detoxified endotoxin (RD-LPS: 150 kGy 60Co-gamma irradiated) preparations were compared in mice (C57Bl X CBA: F1/Rapo) for capacity to enhance the immune response against sheep red blood cells and to induce the production of antibody against autologous (bromelain-treated) erythrocytes. As RD-LPS retains its capacity to stimulate immune response against heterologous antigen, it may be used as an immuno-adjuvant. The LPS preparation gave rise to a significant increase of autoreactive cells. However, RD-LPS activated the autoantibody forming cells only to a very small degree. PMID- 3307275 TI - ELISA detectable virulence marker antigen of enteroinvasive Escherichia coli is coded by a 140 megadalton plasmid. AB - The ELISA reactive virulence marker antigen, characteristic of enteroinvasive Escherichia coli and virulent Shigella, expressed in an E. coli K-12 recipient after the 140 Md plasmid of an enteroinvasive E. coli strain had been introduced into it. Similarly to the epithelial cell penetration and Congo red binding capacities--known to be coded by the above plasmid--the virulence marker antigen expressed also only at 37 degrees C but not at 30 degrees C. These data suggest the plasmid coded nature of the virulence marker antigen. PMID- 3307276 TI - Stability of the Hungarian National BCG Reference Preparations. Trend of viability during 4-7 years storage at +4 degrees C. AB - The stability of the viability of the Hungarian BCG Reference Preparations (Vaccine Bch. Nos: 265, 456, 505) was tested according to the recommendation of the World Health Organization. The BCG viable units of the vaccines were estimated from the colony counts determined on solid medium. The control data of the BCG viable units expressing the stability in 10(6)/ml values were analysed up to 7 years in a three-step statistical model applying unbiased parameter estimates, valid hypothesis test and multiple comparison. The presented model verifying the stability of the reference preparations ensures the reliability of the assays to accept or reject the viability at controlling routine BCG vaccines in comparison with the reference preparations. PMID- 3307278 TI - Experimental meningitis in the rabbit. II. Cerebral energy metabolism in relation to increased cerebrospinal fluid concentrations of lactate. AB - We have analyzed cerebral energy metabolism in rabbits with Streptococcus pneumoniae or Escherichia coli meningitis aiming at an increased understanding of the cerebrospinal fluid (CSF) lactacidosis observed in this disease. After intracisternal inoculation of bacteria the lactate concentration in the CSF increased to 9.7 +/- 0.7 (mean +/- SE) mmol/l compared to control values of 3.2 +/- 0.2 mmol/l. Simultaneously sampled brain tissue from parietal cortex, caudate nucleus, and thalamus showed no increase in lactate concentrations. The high energy phosphate content decreased only marginally, phosphocreatine levels by 11 17% in the cortex and in the caudate nucleus, and adenosine triphosphate concentrations by 15%, but only in the caudate nucleus. Our results indicate that the CSF lactate increase in bacterial meningitis is not primarily linked to cerebral lactacidosis. The decreased concentrations of high-energy phosphates in diseased animals need further study but may be due to increased intracranial pressure and reduced capillary blood flow. PMID- 3307277 TI - Virulence factors of Escherichia coli. IV. Association in Escherichia coli of LD50 with haemolysin production, haemagglutinating capacity, antigens K1, K5 colicinogenicity and pathogenicity. AB - Haemolysin production (HLY), mannose resistant haemagglutinating activity (MRA), presence of antigens K1 and K5 and colicinogenicity (Col) were compared with LD50 for mice in 663 Escherichia coli strains, including 281 faecal, 129 urinary and 253 other extraintestinal isolates. Those isolates that LD50 value fell into less than or equal to 10(6) LD50 category were arbitrarily termed highly virulent (HV) and those which belonged to greater than or equal to 10(7) LD50 category were considered avirulent (AV). HV isolates occurred significantly more frequently (58%) among strains from different extraintestinal samples than from faeces (14%) or urine (16%). The incidence of HV strains was significantly higher in patients with sepsis (43%) or meningitis (100%) than in patients with enteritis (20%), urinary tract infections (UTI, 16%) or in healthy subjects (28%). The incidence of HV strains in the most frequent (O1, O2, O4, O6, O7, O18, O75) serogroups was significantly higher (60%) than in others (10%). Strains with different virulence markers (HLY, MRA, K1, K5, Col) belonged significantly more frequently to the HV group than those which failed to have these markers (44 vs 27%, 51 vs 25%, 83 vs 17%, 78 vs 27%, 52 vs 16%, respectively). Important role of antigen K1 playing in pathomechanism of meningitis was confirmed by data of analysis according to which significant difference was revealed in the incidence of HV strains between groups of isolates with MRA+K1+ (71%) and MRA+K1- (44%, p less than 0.02), or between groups of isolates with MRA+K1- and MRA-K1+ (91%, p less than 0.001). Moreover there were significant differences in the incidences of HV strains in K1+Col- (73%) and K1-Col+ (29%, p less than 0.001), and in K1+Col+ (86%) and K1-Col+ (29%, p less than 0.001) groups. Further evidence was given by those data that there were no significant differences between groups of HV strains with MRA+K1+ and MRA-K1+ (p greater than 0.05) or with K1+Col+ and K1+Col- (p greater than 0.1) properties. Isolates that possessed simultaneously two of MRA, HLY, Col markers were more pathogenic in LD50 assay than those that had one or the other of these markers alone. Strains in serogroup O18 killed mice significantly more frequently than those of other serogroups independently of having any virulence factor, suggesting that bacteria in serogroups O18 must have some special virulence other than K1, Col, MRA or K5. MRA+HLY+ HV strains occurred frequently in extraintestinal diseases (42%) supporting the preconception that these properties play an important role also in the pathomechanism of extraintestinal infections other than UTI.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3307279 TI - Neutral protease in cerebrospinal fluid from patients with multiple sclerosis and other neurological diseases. AB - Neutral protease activity was significantly elevated in the cerebro-spinal fluid of patients with multiple sclerosis (MS) in exacerbation and in the acute phase of acute viral meningoencephalitis (AME) compared with that of MS in remission, amyotrophic lateral sclerosis or psychosomatic disease. Since in each relapse of MS, protease activity was higher in exacerbation than in remission, this activity may be one good marker of disease activity in MS. One hundred micro molar of FOY305, synthetic protease inhibitor, inhibited in vitro increased neutral protease activity in MS in exacerbation, which suggests the possibility of a clinical application of this protease inhibitor for MS. PMID- 3307280 TI - [Cervantes, Don Quixote and the teeth]. PMID- 3307281 TI - [Scanning electron microscopy study of the border area of human dental pulp]. PMID- 3307282 TI - Fixation of displaced femoral neck fractures. A comparison between sliding screw plate and four cancellous bone screws. AB - In a prospective, randomized trial, 104 consecutive patients with displaced femoral neck fractures were allocated either to fixation with a sliding screw plate or 4 ASIF cancellous bone screws. The patients were reexamined at fixed intervals to determine the time of union. The 2-year-cumulated rate of union was 64 per cent in the plate group and 84 per cent in the screw group. PMID- 3307283 TI - Hyperextension injuries of the PIP finger joint. Comparison of early motion and immobilization. AB - In a prospective study of traumatic lesions of the volar fibrocartilage of the PIP joint, 56 patients were randomized to treatment by immobilization for 3 weeks and 56 patients, to purely analgetic treatment without immobilization. Seventy eight patients were reexamined 6 months later and 77 patients, in a follow-up study 2-3 years after the injury. No difference was found between the two groups with respect to subjective complaints or objective signs. PMID- 3307285 TI - Prediction of symptomatic patent ductus arteriosus in preterm infants using Doppler and M-mode echocardiography. AB - To investigate whether the development of symptomatic patent ductus arteriosus could be predicted, 26 preterm infants dependent on mechanical ventilation were examined daily with Doppler and M-mode echocardiography until 3 days after birth. The presence or absence of a hemodynamically significant ductus shunt, as judged from echocardiographic criteria, was tested for predictive power in terms of sensitivity, specificity and total error rate. Out of the 26 infants 13 developed symptomatic patent ductus arteriosus at a median age of 5 days (range 2-8). These 13 infants developed echocardiographic evidence of a large shunt at a median age of 2 days (range 1-3). The sensitivity of prediction was 18, 46 and 100% at 1, 2 and 3 days after birth. The specificity was 80, 92 and 85% and the total error rate was 52, 32 and 8%. Thus, accurate prediction was possible 3 days after birth. PMID- 3307284 TI - The cartilaginous fracture callus in rats. AB - The right tibia was broken manually in 56 rats weighing 100 g; the fracture was stabilized with an intramedullary steel wire. Groups of rats were killed after 3 30 days. The fracture with its surrounding musculature was dissected out and immediately frozen to -70 degrees C. Cryostat sections of the fracture region were stained with hematoxylin/eosin, toluidine blue, and immunoenzymatically with collagen II antibodies. Another series of 30 fractured rats were killed after 1 15 days, and the fractures were examined histologically after decalcification with EDTA. Two types of callus were observed. The periosteal-endosteal callus started as proliferation of pre-osteoblasts without inflammatory cells on Day 1 and developed bone trabeculae from Day 3 until Days 8-10, but not thereafter. The cartilaginous callus was formed by condensation of fibroblast-like mesenchymal cells mixed with inflammatory cells outside the periosteal callus and started on Day 5 at the fracture fragments denuded of periosteum. The cells differentiating to cartilage seemed to migrate from the surrounding musculature and its newly formed vessels. The enchondral bone formation started close to the periosteal callus from which vessels were piercing into the then hypertrophic and mineralized chondrocytes on Day 11. We conclude that the bridging callus is formed by fundamentals of periosteal callus derived from predetermined cells and the bridge of enchondrally formed bone trabeculae by cells migrating from outside. PMID- 3307286 TI - Simplified immunoglobulin treatment of idiopathic thrombocytopenic purpura. AB - The recommended dose of intravenous IgG for idiopathic thrombocytopenic purpura has been 0.4 g/kg on 5 consecutive days. A simplified approach, giving a single infusion of 0.8-1.0 g/kg over 8 hours, has been tried in a series of 11 children with newly diagnosed disease. In 8 cases the infusion produced a prompt platelet response culminating at 128-502 X 10(9)/l after 3-13 days, and 4 of these cases required no further treatment while 2 needed a booster infusion due to an early relapse and 2 followed a chronic course. In 3 cases platelet responses were poor in spite of supplementary doses to a total of 1.4-2.0 g/kg: 2 infants failed to achieve normal platelet counts and 1 case with fulminant bleeding manifestations proved completely resistant. Significant side effects were not observed. These results indicate that IgG-therapy practically may be initiated with a single infusion, the resulting platelet response indicating the need for further infusions. PMID- 3307287 TI - Histological changes of bile duct in experimental graft-versus-host disease across minor histocompatibility barriers. I. Light microscopic and immunocytochemical observations. AB - Graft-versus-host disease (GVHD) across minor histocompatibility antigens was developed in mice and the bile duct lesions were surveyed for up to 7.5 months after spleen and bone marrow cell transplantation. Lymphoid cell infiltration was evident by day 3, reached maximum at 2 weeks, then reduced gradually and persisted during the observation period. Fibrous expansion of the portal tracts paralleled with the time after transplantation, but none of the cases progressed into liver cirrhosis. The infiltrates abutted the interlobular and septal bile ducts and distorted their appearance with a frequent infiltration of mononuclear lymphoid cells into the duct epithelial layer. The duct epithelium showed a variety of degenerative and hyperplastic changes, including nuclear enlargement with anisonucleosis, nuclear pyknosis, cytoplasmic and nuclear darkness, cytoplasmic vacuolization, focal epithelial dropout, formation of apoptotic bodies, and micropapillary infolding. Disappearance of the bile ducts and formation of granuloma around the bile ducts were not seen. Immunocytochemical study revealed the exclusive preponderance of helper/inducer T cells in the portal infiltrates and marked expression of I-A antigen on the bile duct epithelium in GVHD mice. These results suggest that immunological mechanisms by helper/inducer T cells against minor histocompatibility antigen on bile duct epithelium in association with class II molecules of MHC are important in the pathogenesis of the bile duct lesions. A putative role of such lymphocytes is discussed. PMID- 3307288 TI - Malignant granular cell tumor of the esophagus. A case report with light and electron microscopic, histochemical, and immunohistochemical study. AB - Malignant granular cell tumor of the esophagus found in a 70-year-old female was reported. Microscopically, the tumor showed a variety of the histology from compact proliferation of polygonal granular cells in pseudo-epitheliomatous pattern to plexiform proliferation of elongated granular and fibroblastic cells in neurofibromatous pattern, and the tumor cells frequently contained eosinophilic globules in the cytoplasm. Histochemically, argyrophilic neurofibrils in the stroma and argyrophilic cytoplasmic processes or grains were seen. Immunohistochemically, the tumor cells showed positive reaction with S-100 protein (S-100), but all reactions with myoglobin (MG), desmin (DM), fibronectin (FN), creatinine phosphokinase-mm (CPK), factor 8th-related antigen (F8RA), alpha 1-antitrypsin (A1AT), alpha-1-antichymotrypsin (A1ACT), keratin (KN), and carcinoembryonic antigen (CEA) were negative. Electron microscopy revealed that the tumor cells had typical lysosomal granules filled with proteinaceous electron dense materials and fine membrane-bound particles sized 15 to 45 nm resembling virus or neurosecretory granule. PMID- 3307289 TI - So-called "papillary and cystic neoplasm of the pancreas." An immunohistochemical and ultrastructural study. AB - A case of so-called "papillary and cystic neoplasm of the pancreas" (PCNP) was reported and investigated immunohistochemically and ultrastructurally. A tumor of the pancreatic head in a 21-year-old female was curatively resected. The tumor was cystic and histologically consisted of uniform cells in papillary and solid structure. Although there was no immunoreactivity for pancreaticogut hormones or secretory products of the pancreas in the tumor cells, most of the tumor cells were diffusely immunoreactive for neuron-specific enolase (NSE). Some neurosecretory granules were detected in the tumor cells ultrastructurally. Both facts suggested endocrine cell character of the tumor. Certain cases of PCNP might show a differentiation to endocrine cells. PMID- 3307290 TI - Anaplastic carcinoma of the thyroid with osteoclast-like giant cells. An ultrastructural and immunohistochemical study. AB - An unusual anaplastic thyroid carcinoma with osteoclast-like giant cells is reported in a 72-year-old woman. Monotonous proliferation of variously sized mononuclear tumor cells interspersed with numerous osteoclast-like multinucleated giant cells was dominant. A small area of papillary carcinoma merging with the anaplastic carcinoma was disclosed. Immunohistochemically, tumor cells forming papillary pattern were positive for both thyroglobulin and keratin. Cells and cell clusters positive for keratin were found in anaplastic carcinoma. Electron microscopically, the anaplastic carcinoma cells displayed prominent mitochondria, a rough endoplasmic reticulum, and intermediate cell junctions. The cell clusters formed irregular lumina into which numerous microvilli were extended and which contained colloid-like material. Occasionally incomplete basal laminae were present. Cell clusters showing transitional pictures from cell clusters to multinucleated giant cells and multinucleated giant cells engulfing mononuclear tumor cells were observed by both light and electron microscopy. Findings from this study support the conclusion that anaplastic tumor cells arise in preexisting differentiated thyroid cancer and that associated multinucleated giant cells are formed by the fusion of carcinoma cells. PMID- 3307291 TI - Merkel cell tumor. AB - A Merkel cell tumor appeared on the left cheek of an 83-year-old female was reported. The tumor was located mainly in the dermis and infiltrated to the subcutaneous adipose tissue with an involvement of the blood vessels and lymphatics at the periphery. Electron-microscopically, few of the dense-cored granules and the single globular aggregates of intermediate filaments at the nuclear indentations were observed. Electron-microscopic uranaffin reaction proved positive reaction on the dense-cored granules. Half of the cytoplasmic border was smooth, while the rest had short projections. Desmosomes or junctional complexes were not detected among the tumor cells. Immunohistochemically, the cytoplasm of tumor cell showed positive reaction to both neuron-specific enolase (NSE) and keratin. The single globular positive spots of the latter were localized in accordance with the aggregates of intermediate filaments. These findings suggested a neurogenic origin with double differentiation, epithelial and neuroendocrine, of the Merkel cell tumor. PMID- 3307292 TI - Dermatopathic lymphadenopathy. Electronmicroscopic, enzyme-histochemical and immunohistochemical study. AB - Dermatopathic lymphadenopathy (DPL) is characterized by lymph node enlargement with reactive process and is generally caused by chronic inflammatory skin disease. Interdigitating reticulum cells (IDCs) with broad cytoplasm, innumerable cytoplasmic interdigitation, and bizarre shaped nuclei are the most striking cell type in DPL. According to the shape of the nucleus, arrangement of the tubulovesicular complexes (TVC) and amount of melanin granules, these cells fall into two types: type I has a marked indented nucleus, innumerable TVC and some desmosomal junctions and fewer melanin granules, while type II has a large amount of melanin granules. On the other hand, LCs contain a few loose melanin granules. It appears that IDCs and Langerhans cells (LCs), surrounded by T-lymphocytes, are similar in morphology and function, but both of them can be characterized by the positive of S-100 protein and Leu 6, absence of lysozymes and CEA by PAP method, and positive of ATP-ase and ACP-ase, and they differ only by having or not having Birbeck granules. The mechanism of the proliferation of IDCs in DPL and delineation of the functional relationship between the accessory cells and the T lymphocytes remains to be investigated. PMID- 3307293 TI - Immunohistochemical and ultrastructural studies on histiocytosis in children. AB - Thirty-four cases of eosinophilic granulomas, 18 cases of diffuse histiocytosis X, 2 cases of Letterer-Siwe-like syndrome with immunodeficiency, 4 cases of malignant histiocytosis and virus associated hemophagocytic syndrome were studied. On paraffin section, S100 protein, lysozyme, alpha-1-anti-trypsin, alpha 1-antichymotrypsin, alpha-2-macroglobulin, Transferrin, Ferritin, peanuts agglutinin, Concanavalin-A, and dolichos biflorus associated antigen were stained by the immunoperoxidase method. In a few fresh materials, T-cell subpopulation by use of monoclonal antibodies (OKT-3, 4, 6, and OK-M1) was examined by the immunoperoxidase method. Two types of Langerhans' cells were found, one is positive for Ferritin and alpha-2-macroglobulin in diffuse histiocytosis-X cells, and another is negative for them in both eosinophilic granulomas. Diffuse histiocytosis-X cell resembled the transformed type of Langerhans cell more than eosinophilic granuloma cells in cellular differentiation. It seemed that the term prolangerhans' cell proliferation disorder might be responsible for it. PMID- 3307294 TI - Spindle cell carcinoma of the uterus. AB - A case of spindle cell carcinoma of the uterus in a 56-year-old woman is reported. Microscopically, it showed an intimate admixture of epithelial and sarcomatous elements. The epithelial nature, especially the squamous cell nature, in sarcomatous areas was indicated by immunoreactivity for keratin and ultrastructural characters, such as bundles of tonofilaments and some cell junctions, while the tumor cells in these areas were also vimentin-positive. Furthermore, ultrastructural study and immunostaining for actin demonstrated myofilaments in tumor cells in both tumor nests and sarcomatous areas. This may impart the high degree of invasiveness of spindle cell carcinoma. PMID- 3307295 TI - Circulating IgG from patients with primary Sjogren's syndrome deposited in the epidermis of normal human skin transplanted to athymic nude mice. AB - Sera from 7 patients with primary Sjogren's syndrome and from two control persons were administered intraperitoneally to athymic nude mice transplanted with normal human skin. Seven days after transfer of serum from 5 of the patients, intra epidermal IgG1 and IgG3 deposits were demonstrated in the skin grafts by immunofluorescence. The deposits closely resembled in vivo deposits found in the skin of these patients. No correlation was found between the presence of epidermal deposits and levels of IgG1 and IgG3 in serum. No IgG deposits were found in skin grafts on animals given control serum, and neither could human IgG be detected in mouse skin adjacent to the grafts. Epidermal deposits of human IgM, -IgA, -fibrinogen, -C3c and mouse-Ig were not demonstrated in biopsies from grafts or mouse skin. The results support the hypothesis that epidermal in vivo deposits of IgG in patients with primary Sjogren's syndrome are the result of Fc receptor-mediated binding to epidermal cells. PMID- 3307296 TI - Immunohistochemical characterization of intraepidermal in vivo IgG deposits in patients with primary Sjogren's syndrome. AB - 68% of patients with primary Sjogren's syndrome have previously been found to have intra-epidermal in vivo IgG deposits in clinically unaffected skin. In this investigation, we examined immunohistologically skin biopsies from 5 patients with primary Sjogren's syndrome and from 5 normal controls in order to characterize further the intra-epidermal IgG deposits. Employing direct immunofluorescence and peroxidase-antiperoxidase (PAP) techniques, IgG was localized to epidermal cell surfaces. Double-labelling immunofluorescence experiments showed IgG to be bound to OKT6-positive Langerhans cells, and to some degree also to keratinocytes. Only IgG1, IgG3 and in one patient IgA were deposited, whereas IgG2, IgG4, IgM, IgD, IgE, C1q, C3c, C3d, C4, beta-2 microglobulin, albumin, fibrinogen and C-reactive protein were not found deposited in the intra-epidermal area. The epidermal IgG deposits were reactive with anti-Fc-fragment antibodies and with staphylococcal protein-A. These results are compatible with, although not definitive proofs of, the hypothesis that the in vivo deposited IgG is found in the form of IgG-containing immune complexes. PMID- 3307297 TI - Gynecomastia. Immunohistochemical demonstration of estrogen receptors. AB - Immunohistochemical estrogen receptor (ER) analysis using a monoclonal ER antibody was performed on a total of 30 specimens from 26 patients with gynecomastia. Twenty-six specimens were ER-positive, 3 were ER-negative, and the analysis failed in one case. Immunohistochemical analysis proved more sensitive than biochemical ER analysis in a group of 20 patients, and in a group of 6 patients, the immunohistochemical analysis correlated well with in vitro hormonal sensitivity of the gynecomastic tissue. Semi-quantified ER content was inversely correlated with patient age. There was no relationship between ER content and either histopathologic features or hormonal status. In conclusion, this study demonstrates that the intracellular ER responsible for estrogenic stimulation is present in most gynecomastic tissue specimens, supporting the general assumption that estrogen can be one of the hormones responsible for the development of gynecomastia. PMID- 3307298 TI - The prevalence of renal amyloidosis of the AA-type in a series of 1,158 consecutive autopsies. AB - To determine the prevalence of renal amyloidosis of the AA-type in a defined population, formalin-fixed specimens from the kidneys of all the cases autopsied in 1983 at The General Hospital of Malmo, Sweden, were investigated using immunohistochemical techniques. Amyloid deposits of protein AA were found in 10 of 1,158 investigated cases and the calculated prevalence was 0.86 per cent. The mean age at death of the individuals with the AA-type of amyloidosis was 79 years. Six of the cases with amyloidosis had rheumatoid arthritis. The avidin biotin-peroxidase complex technique was found to be superior to the immunofluorescence method and a high sensitivity and specificity was achieved when sequence-specific antibodies against a synthetized nonapeptide corresponding to a hydrophilic segment of the polypeptide chain of protein AA were used in the assay. Nine cases with other types of amyloid deposits in the kidneys were also detected. None of these cases showed any AA immunoreactivity but all of them demonstrated Congophilic deposits which were immunohistochemically stained by antibodies against the amyloid P-component. The prevalence of renal amyloidosis comprising all types of amyloid protein deposits was 1.64 per cent. PMID- 3307299 TI - A simple and exact two-point interpolation method for determination of haemolytic activity in microtiter plates. AB - A new haemolytic test based on direct reading of the optical density of unlysed erythrocytes was developed and adapted for use with microtiter plates and an appropriate reader. The relationship between the concentration of erythrocytes and the optical density was not strictly linear, but a high reproducibility of the curve was noted. There was a linear relation between the optical density of unlysed erythrocytes and -log2 of the haemolysin dilution in a wide range. The correlation coefficient was higher than 0.99. Because of this strong linearity, only two points of the two-fold dilution series, representing the dilutions before and after 50% lysis, were used to interpolate the exact haemolysin titer. These calculations were preferably performed automatically by a connected personal computer. The titers obtained by this method were identical with those obtained by the traditional tube test based on measurement of the absorbance of released haemoglobin. The standard deviations obtained for different haemolysin preparations were found to be 3.7-8%. PMID- 3307300 TI - Effects of endotoxins from Bacteroides intermedius and Escherichia coli on cytotoxic and lysosomal activity in peritoneal macrophages from endotoxin responder and low responder mouse strains. AB - Peritoneal macrophages from normal mice strains (C3H/Tif and C57BL/6J) and from the endotoxin (lipopolysaccharide, LPS) low responder strain (C3H/Hej were exposed to two structurally different endotoxins from Bacteroides intermedius and Escherichia coli in vitro. Intracellular activity of a lysosomal enzyme (acid phosphatase) and macrophage mediated cytotoxic activity against a tumor cell line (L929) were tested. Both endotoxins caused increased levels of acid phosphatase activity in normal mice macrophages. No change was obtained in the C3H/Hej macrophages exposed to E. coli LPS; however, the B. intermedius LPS was able to strongly elevate intracellular enzyme level in the C3H/Hej low responder macrophages. Cytotoxic activities were investigated in macrophage supernatants and in co-cultures of stimulated macrophages and target cells. Cytotoxic activity evaluated by measuring release of radioactivity from 14C-thymidine labelled tumor cells was increased with both endotoxins in normal mouse macrophages, but not in non-responder macrophages. When macrophage-mediated effects on tumor cells were tested by counting target cells left per culture, a reduction in target cell number was observed in endotoxin-treated low responder macrophage as well as in normal strain macrophage cultures more pronounced, however, in the normal strain. Cell contact between cytotoxic macrophages and target cells was verified by scanning electron microscopy. The results suggest that LPS effects on macrophages are dependent upon the functional parameters studied, and that the chemical composition of a particular LPS is important for its selective effects on macrophage functions. PMID- 3307301 TI - The role of prostanoids in the feline intestinal vascular and central haemodynamic responses to i.v. infusion of live E. coli. AB - Bacterial infusion in the cat, causing experimental septic shock, induces an early vascular response mainly characterized by pulmonary hypertension and intestinal vasoconstriction. Prostanoids are held to be important mediators of the pulmonary vascular reaction. This study was performed to explore the involvement of prostanoids in the central haemodynamics and the small intestinal vascular reactions in experimental septic shock. Aortic blood pressure was continuously monitored, as were aortic blood flow, the pressure in a. pulmonalis and the small intestinal venous outflow. All cats (n = 24) were given live E. coli (10(10) ml-1) as a continuous intravenous infusion. One series was pretreated with indomethacin, another with UK-38,485, a specific thromboxane A2 synthetase inhibitor, and a third series served as untreated control. The pulmonary hypertensive response was clearly attenuated in the two pretreated series, in fact abolished in the one given UK-38,485. The early intestinal vasoconstriction was eliminated in the two pretreated series. Later during bacteraemia, when untreated and indomethacin-pretreated cats showed intestinal vasoconstriction, UK-38-485-pretreated animals kept intestinal blood flow within the preseptic range. These data suggest that in the cat, thromboxane A2 is the prostanoid mediating the vascular reactions, not only in the lung but also in the small intestine. PMID- 3307302 TI - Nervous control of tracheal blood flow in the cat measured by the laser Doppler technique. AB - The tracheal blood flow as determined by the laser Doppler technique was continuously monitored in anaesthetized cats. Electrical stimulation of the right superior laryngeal nerve caused an atropine-resistant increase in blood flow of the upper trachea. Unilateral vagal nerve stimulation at the cervical level in the presence of atropine induced a frequency-dependent increase in blood flow of the lower trachea. Intermittent stimulation with bursts of impulses at a high frequency resulted in a considerably larger blood flow increase than a continuous low frequency stimulation giving the same total number of impulses. The ganglionic blocking agent chlorisondamine abolished most of the vagally induced increase in tracheal blood flow when using low threshold parameters (2 V, 0.2 ms) presumably activating preganglionic nerves. High threshold stimulation (10 V, 5 ms) however, still resulted in an increased blood flow suggesting antidromic activation of sensory C fibres. Local mechanical irritation or chemical irritation by capsaicin also increased tracheal blood flow. Furthermore, local application of calcitonin gene-related peptide on to the mucosa caused a slowly developing, long-lasting increase in blood flow. Electrical stimulation of the cervical sympathetic trunk and local application of adrenaline reduced tracheal blood flow. In conclusion, vagal nerve stimulation induces an atropine-resistant increase in tracheal blood flow probably mainly by activating preganglionic parasympathetic nerves and possibly also by antidromic stimulation of C-fibre afferents. PMID- 3307303 TI - Renal degradation and distribution between urinary and venous output of prostaglandins E2 and I2. AB - To examine renal degradation and distribution between urine and renal venous blood, prostaglandins E2 and I2 (PGE2 and PGI2), and a metabolite of PGI2, 6-keto PGF1 alpha, were infused into the suprarenal aorta of anaesthetized dogs after blocking prostaglandin synthesis by indomethacin, 10 mg kg-1 body wt iv. During one passage through the kidney 80% of PGE2 and only 25% of PGI2 and 6-keto-PGF1 alpha were metabolized. Prostaglandin degradation and arterial input were proportional (r greater than 0.90). To stimulate the intrarenal prostaglandin synthesis in unblocked kidneys, arachidonic acid was infused at rates ranging from 24 to 160 micrograms min-1 kg-1 body wt. During arachidonic acid and PGE2 infusion the urinary excretion of PGE2 was about 20% of the renal venous output over a wide range of infusion rates. During arachidonic acid and PGI2 infusion urinary excretion of 6-keto-PGF1 alpha was about 10% of total renal output, but failed to increase further when total renal output exceeded 70 pmol min-1. Further increase in output occurred only in the renal vein. In contrast, during 6 keto-PGF1 alpha infusion the urinary excretion and the renal venous output of this metabolite were related as 1:2 over a wide range of infusion rates. Thus, PGI2 is much less degraded by renal tissue than PGE2, and the distribution patterns differ. Similar distributions between urine and renal venous blood during aortic infusion and stimulated intrarenal synthesis suggest a pre glomerular vascular origin of both prostaglandins. PMID- 3307304 TI - The influence of cardiopulmonary receptors on long-term blood pressure control and plasma renin activity in conscious dogs. AB - The isolated and combined influence of cardiopulmonary and arterial baroreceptor denervation on long-term blood pressure (MAP), heart rate (HR), plasma volume (PV) and plasma renin activity (PRA) was studied in 10 conscious, chronically instrumented foxhounds receiving a normal sodium diet. Cardiopulmonary denervation was achieved by surgically stripping both thoracic vagi. Near complete arterial baroreceptor denervation, leaving most cardiopulmonary fibres intact, was made by left vagal deafferentiation which has been shown to eliminate most aortic baroreceptor afferents, and a carotid sinus denervation. Five groups were studied: (I) control (n = 9), (II) cardiopulmonary denervation (n = 5), (III) aortic baroreceptor denervation (n = 5), (IV) arterial baroreceptor denervation (n = 4) and (V) total denervation (n = 6). No changes in PV were observed. Only group V revealed significantly higher levels of MAP (119.5 +/- 5.4 vs. 100.1 +/- 1.6 mmHg; P less than 0.05), HR (118.1 +/- 4.4 vs. 87.8 +/- 3.7 beats min-1; P less than 0.001) and PRA (3.0 +/- 0.8 vs. 0.9 +/- 0.2 ng AI m-1 h 1; P less than 0.05). It is suggested that the isolated function of either cardiopulmonary or arterial baroreceptors is sufficient to maintain these variables at a normal level. Contrary to the results of other reports the cardiopulmonary receptors do not seem to regulate MAP at a level about which the arterial baroreceptors operate. When both groups of afferents were interrupted MAP, HR and PRA rose to significantly higher levels, implying that cardiopulmonary and arterial baroreceptor afferents interact in a sense of a non additive attenuation. PMID- 3307305 TI - Blood flow in skin, subcutaneous adipose tissue and skeletal muscle in the forearm of normal man during an oral glucose load. AB - Blood flow to the forearm, and the subcutaneous tissue and skin in the forearm were measured by strain gauge plethysmography, 133Xe-elimination and Laser Doppler flowmetry during an oral glucose load (I g glucose kg-1 lean body mass) and during control conditions. The forearm blood flow remained constant during both experiments. Glucose induced a two-fold vasodilatation in subcutaneous tissue. In skin, glucose induced a relative vasodilatation and later a relative vasoconstriction compared with control experiments. When estimated from forearm blood flow and subcutaneous and skin blood flows, muscle blood flow decreased about 20-30% during both experiments. Proximal nervous blockade did not abolish the glucose-induced vasodilatation in subcutaneous tissue. In the glucose experiment, arterial glucose concentration increased to 7.8 +/- 1.17 mmol l-1 30 min after the load was given and then decreased to 4.5 +/- 0.34 mmol l-1 at the end of the experiment. In the control experiments glucose concentration was constant. Arterial noradrenaline concentration increased significantly from 1.0 +/- 0.13 to about 1.5 +/- 0.3 nmol l-1 120 min after glucose and remained at this level during the experiment. Similarly adrenaline increased from 0.16 +/- 0.11 to about 0.4 +/- 0.16 nmol l-1 180 min after glucose. It is hypothesized that the vasodilating effect of glucose in subcutaneous tissue is secondary to metabolic events connected to glucose uptake and energy deposition in adipose tissue. PMID- 3307306 TI - Experiences of duplex ultrasonography of carotid arteries performed by clinicians -correlation to angiography. AB - One hundred and eleven carotid vessels in 56 patients were analysed by high resolution duplex ultrasound. Vessels were graded as normal, 25, 50 or 75% stenotic and 100% occluded and the results were compared with similarly graded biplanar angiograms. There was absolute agreement in 68.5% of the vessels, agreement within one grade of severity of disease in 27.0%, while poor correlation was obtained in 4.5%. The results of ultrasound and angiography were also related to the surgical specimens obtained after thrombendarterectomy of 23 vessels in 20 patients. Good agreement was obtained between the three methods in 20/23 vessels. In one case ultrasound was better than angiography, in another case the reverse was true and in a third case both methods overdiagnosed a plaque. It is concluded that duplex ultrasound will work in the hands of a clinician and is a reliable non-invasive screening method for carotid artery disease leading to a more optimal selection of candidates for angiography. PMID- 3307307 TI - Dietary calcium intake and blood pressure in normotensive subjects. AB - Epidemiological and prospective studies in man and animals have indicated an inverse relationship between calcium intake and cardiovascular mortality and blood pressure (BP). We have therefore studied the effect of dietary calcium on blood pressure in two groups of women. In a cross-sectional study 103 early postmenopausal women were stratified into three groups according to daily calcium intake calculated from a questionnaire. Both diastolic and systolic blood pressures were identical in the three groups. We thereafter conducted a prospective placebo-controlled trial on the effect of calcium supplementation. Twenty-eight healthy women were randomized to placebo treatment (n = 14) or calcium supplementation 2,000 mg daily (n = 14) for one year. In both groups BP remained at initial levels throughout the study and was identical in the two groups at measurements every three months. We thus conclude that calcium supplementation has no effect on BP in normotensive subjects on a high calcium diet. PMID- 3307308 TI - Effects of metoprolol on the counter-regulation and recognition of prolonged hypoglycemia in insulin-dependent diabetics. AB - The effect of metoprolol on the counter-regulation of prolonged hypoglycemia was studied in eight insulin-dependent diabetics. Insulin was given as an i.v. infusion of 2.4 U/h over 180 min alone, or together with metoprolol (3.0 mg i.v. bolus followed by an i.v. infusion of 4.8 mg/h) in random order. Blood glucose, counter-regulatory hormones, hypoglycemic symptoms and the cardiovascular responses were assayed over 240 min. Metoprolol did not significantly modify the blood glucose levels. The plasma levels of free insulin, however, were elevated by approximately 20% (p less than 0.01) by metoprolol during hypoglycemia and the plasma concentrations of epinephrine, norepinephrine, growth hormone and cortisol were enhanced by the drug. Sweating was increased by metoprolol, while other symptoms were unaltered. We conclude that metoprolol administered acutely does not aggravate prolonged hypoglycemia in diabetics with blunted response of glucagon. Moreover, exaggerated responses of counter-regulatory hormones, provoked by metoprolol, may compensate for the inhibitory effect of this drug on insulin clearance. PMID- 3307309 TI - Clinical outcome of using insulin at 40 IU/ml and 100 IU/ml in pump treatment. Results of a controlled multi-center trial. AB - In three different diabetes centers the use of insulin at a strength of 40 IU/ml (U40) and 100 IU/ml (U100) in continuous subcutaneous insulin infusion (CSII) treatment of insulin dependent (Type I) diabetic patients was compared in a randomized cross-over design. Forty-six Type I diabetic patients, all previously treated with CSII for at least one year, completed consecutively two 13-week periods of treatment with U40 and U100. Body weight and insulin requirements were identical at the end of the two periods. Slightly higher levels of glycemia were recorded during U40 when compared to U100 treatment: mean blood glucose was 142 +/- 34 (SD) vs. 133 +/- 34 mg/dl (2 p less than 0.01). The same tendency was observed in the mean glycosylated hemoglobin value (6.84 +/- 1.35 vs. 6.65 +/- 1.13%, 2 p greater than 0.1). There were no significant differences between U40 and U100 in the number of catheters used and the number of catheter blockages reported, while the development of subcutaneous nodules at the insertion sites was significantly more frequent during U40 treatment. It is concluded that the implementation of insulin in the strength of 100 IU/ml is as effective as the use of insulin in the strength of 40 IU/ml for CSII therapy, and might even be associated with slightly improved glycemic control and less subcutaneous side effects. PMID- 3307310 TI - Insulin action--biochemical and clinical aspects. PMID- 3307311 TI - Glucose intolerance and insulin resistance accompany immobilization. AB - Physical activity is known to increase glucose tolerance and insulin sensitivity. To examine the influence of physical inactivity on insulin sensitivity, we measured oral glucose tolerance (OGTT) and insulin response to glucose in 18 patients immobilized to bed for six weeks after acute spine fracture. The results were compared to those of nine chronically immobilized spinal cord injury patients and to eight healthy mobile controls. During the first week after trauma both glucose and insulin responses in the OGTT were two- to three-fold above normal (p less than 0.01). The index of insulin resistance (glucose area X insulin area) was seven-fold greater than in healthy controls (p less than 0.001). After three weeks' immobilization insulin resistance had declined by 30 35% (p less than 0.05) being then at the level observed in chronically immobilized subjects. After remobilization the insulin resistance was further decreased but remained still 2.3 times higher than in controls. Thus, trauma causes a manifold increase in insulin resistance, which is reduced but not normalized during the subsequent immobilization and remobilization. PMID- 3307312 TI - Psychological therapy of pain. PMID- 3307313 TI - Neuronal mechanisms of pain with special emphasis on visceral and deep somatic pain. AB - Pain has several dimensions: the sensory-discriminative, the motivational affective, the cognitive and the motor and autonomic dimension. Each dimension can be roughly identified with certain brain areas. The sensory-discriminative dimension is also called the "nociceptive dimension" or, briefly, "nociception". 1. Noxious stimuli applied to the skin appear to be encoded quite specifically by certain types of nociceptive afferent units with group III (A) and IV (C) fibers. The impulse activity of these cutaneous primary afferents converges on spinal "nociceptive-specific" neurones, most of which seem to be located in lamina I of the dorsal horn, and together with the nonnociceptive information from the skin on "wide-dynamic range" (multisensory) neurones in the grey matter, most of which are situated in lamina V, but some also in adjacent laminae and lamina I. 2. Many of these "nociceptive-specific" and "wide-dynamic range" neurones project with their axons through the anterolateral tract to the nucleus ventralis posterolateralis (VPL) of the thalamus and also to other thalamic nuclei, to the mesencephalon and to the reticular formation of the brain stem. In the VPL of the thalamus, most neurones with nociceptive input have a wide-dynamic range property, very few are nociceptive-specific. 3. Noxious events leading to deep somatic pain are encoded by thin myelinated (A delta) and unmyelinated afferent fibers (e.g., from skeletal muscle, tendon and joint capsule). Besides these deep somatic "nociceptive" afferent units, other nonnociceptive deep somatic afferent units with fine afferents have been claimed to exist and it is believed that these are involved in functions other than nociception. The specificity of responses of these afferents, with respect to the natural stimuli, is only relative. 4. For the viscera nociceptive spinal visceral afferents, which are only activated when injurious or potentially injurious events in the visceral domain (which may lead to pain) occur, cannot be unambiguously shown to exist. It seems more likely that the activity in the same population of spinal visceral afferents is involved in nociceptive as well as in nonnociceptive sensory functions, in the regulation of visceral organs and in various types of reflexes. 5. No neurones in the spinal grey matter have been found which specifically transmit and process information from fine deep somatic and spinal visceral afferents. This information seems to converge not only on many "wide-dynamic range" (multisensory) spinal neurones but also on some "nociceptive-specific" neurones.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3307314 TI - Cultural-historical aspects of pain. PMID- 3307315 TI - Non solum gloria. The foundings of academies in history. PMID- 3307316 TI - Evaluation of antinociceptive, reinforcing and aversive properties of psychotropic agents and analgesics in animals: models for prediction of their analgesic activity and dependence liability. PMID- 3307318 TI - Acupuncture analgesia. PMID- 3307317 TI - Central and peripheral electrical stimulation of the nervous system in the treatment of chronic pain. PMID- 3307319 TI - Neurosurgical treatments of pain--a general survey. AB - Various ablative procedures for the relief of intractable pain have been briefly described in the previous sections. In Table 5, common types of pain and the procedures which the author thinks indicated for those types are listed. For the relief of cancer pain, if it is unilateral and involving the trunk and extremities, percutaneous cordotomy may be the procedure of choice. If cancer involves the head and neck or the body bilaterally, stereotaxic mesencephalotomy or stereotaxic posteromedial hypothalamotomy may be indicated. For deafferentation pain, dorsal root entry zone lesion, or if it involves the face, trigeminal spinal nucleotomy may be most suitable. Thalamic pain is difficult to treat. Stereotaxic thalamolaminotomy and/or vim-tomy may be worthwhile trying. Other central pain may be treated by thalamolaminotomy. Trigeminal neuralgia is best treated by microvascular decompression. If the patient's condition does not permit this rather major procedure, it can be treated by percutaneous thermocoagulation of the Gasserian ganglion or glycerol injection into the trigeminal cistern. Glossopharyngeal neuralgia is also effectively treated by microvascular decompression or by percutaneous thermocoagulation of the petrous ganlion. The neurosurgeon should always bear in mind that effects of ablative procedures may be temporary, and must adopt the best possible procedure for the patient according to his general conditions and his disease. PMID- 3307320 TI - Antitumor anthracyclines produced by Streptomyces peucetius. PMID- 3307321 TI - Micellar liquid chromatography. PMID- 3307322 TI - Derivatization in liquid chromatography. PMID- 3307323 TI - Analytical high-performance affinity chromatography. PMID- 3307324 TI - HPLC in endocrinology. PMID- 3307325 TI - Nonenzymatically glycosylated proteins. AB - Nonenzymatic glycosylation takes place in all proteins with a free-reacting lysine or valine in the presence of glucose. The formation of glycosylated plasma albumin, hemoglobin (Hb A1c), and skin collagen provides a diagnostic index of short- to long-term time-concentration of glucose in vivo. A wide range of assay methods are available, with affinity chromatographic, isoelectric focusing, and spectrophotometric methods providing the best accuracy and versatility. Glycosylated hemoglobin assays indicate glucose pressure over the previous 2 to 3 months and are of diagnostic value in general diabetic control, while glycosylated plasma albumin determinations are preferable in acute episodes in the life of a diabetic (e.g., pregnancy, infection, stress, trauma, surgery), since they provide an overview of changing blood glucose values of the previous 2 to 4 weeks. Glycosylated collagen estimations reflect tissue aging and are relevant in healing processes. Glycosylation alters the biologic activity of proteins, and these may relate to the manifold complications concomitant on the lifelong elevation of blood and tissue glucose in the diabetic (C6a). Assays for glycosylated hemoglobin have been routinely performed in clinical chemistry laboratories for a decade, and convenient determination for other nonenzymatically glycosylated proteins is proceeding apace. PMID- 3307326 TI - Clinical and metabolic aspects of sulfohydrolases in man. PMID- 3307327 TI - Thymic physiology and biochemistry. PMID- 3307328 TI - The physiology and biochemistry of normal and diseased lung. PMID- 3307329 TI - Variation in body stockiness among and within ethnic groups at ages from birth to adulthood. PMID- 3307330 TI - Content knowledge: its role, representation, and restructuring in memory development. PMID- 3307331 TI - The Dimelys IUD. AB - The Dimelys is a new lily-shaped copper-bearing IUD of French origin of which the first clinical results are reported here. This device was inserted at interval in 348 women and 8975 woman-months of experience were accumulated at 3 years. Though only moderately effective (pregnancy rates 2.8 and 5.7 at 1 and 3 years, respectively) the Dimelys is well retained by the uterus (expulsion rates 1.5 and 2.5 at 1 and 3 years, respectively). Clinical efficacy was found to be influenced by the recipient's age, and expulsion rates were significantly higher when inserted by unskilled operators. PMID- 3307333 TI - Genital actinomycosis and Actinomyces israelii in the female genital tract. PMID- 3307332 TI - IUD perforation leading to obstructive nephropathy necessitating nephrectomy: a rare complication. AB - A rare case of uterine perforation leading to ureter obstruction and ultimately to nephrectomy is presented to emphasize the importance of a careful IUD insertion technique and follow-up of IUD patients. Complications of this kind can be avoided by prompt localization of 'missing' IUDs by ultrasonography of X-ray. PMID- 3307334 TI - Sexually transmitted disease, infertility, IUDs and epidemiology. PMID- 3307335 TI - The role of spermatozoa in the development of pelvic inflammatory disease in the woman. PMID- 3307337 TI - A medical "first": Ely's operation to correct protruding ears. PMID- 3307336 TI - Toxicity of antimony and its compounds. AB - Experimental and clinical experience with compounds containing antimony have shown that the trivalent compounds are generally more toxic than the pentavalent ones. APT can cause severe pain and tissue necrosis and is therefore not given by intramuscular or subcutaneous injection. APT has the actions and uses of AST, but it is less soluble and more irritating than the sodium salt which is therefore more suitable for intravenous use. Trivalent antimony compounds are toxic when used topically. Adverse effects are similar for all trivalent compounds, and include nausea, vomiting, weakness and myalgia, abdominal colic, diarrhoea, and skin rashes, including pustular eruptions. Hypersensitivity reactions also occur. Respiratory symptoms include cough, dyspnoea, and chronic lung changes. Cardiotoxicity is the most important and may produce arrhythmias, myocardial depression and damage, Stokes-Adams attacks, heart failure, and cardiac arrest. Hepatic damage and necrosis, as well as blood dyscrasias, may occur. Toxic effects on the kidney may follow chronic use. Continuous treatment with small doses of antimony may give rise to symptoms of subacute poisoning, similar to those of chronic arsenic poisoning, due to accumulation of antimony in the body, especially if trivalent compounds are used, because of their long biological half lives. Reproductive disorders and chromosome damage have been reported; antimony compounds are, therefore, potentially toxic to reproduction and have mutagenic, and oncogenic potential. Antimony compounds should, therefore, not be used during pregnancy or in the presence of hepatic, renal, or heart disease. Pentavalent antimony preparations especially the organic compounds, together with non metallic synthetic preparations, such as the diamidines, have now replaced APT for use in leishmaniasis. Because of the toxicity of antimony compounds, investigations have been undertaken to reduce their adverse effects by combining them with chelating agents. These preparations appear to have reduced the toxic effects of antimony without affecting the efficacy of the preparations. Liposome encapsulated antimony products have, more recently, been shown to be much less toxic because of the reduced dose of the antimony compound required for effective therapy. The historical uses of antimony were based on the belief that the topical and systemic adverse effects, for example, skin eruptions and diarrhoea and vomiting, were signs that the condition being treated was responding by being brought to the surface to relieve congestion at the diseased area. There is no evidence in topical use, but there is evidence that such use can cause severe reactions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3307338 TI - A classic reprint: An operation for prominence of the auricles (with two wood cuts). By Edward T. Ely. 1881. PMID- 3307339 TI - William Harvey's report on Old Parr's autopsy. PMID- 3307340 TI - Modulation by endothelium of the vascular effects of angiotensin II. AB - Modulation by vascular endothelium of the effects of AII was studied in the isolated rabbit aortic and superior mesenteric artery strips. The contractile effect of AII was enhanced in rubbed aortic strips. Similar enhancement was obtained in hydroquinone pretreated unrubbed strips. The relaxing effect of acetylcholine in AII--induced precontracted aortic strips was abolished after rubbing and hydroquinone pretreatment. However, no significant changes were observed in the contractile response to AII on aspirin and nicotine pretreated strips. In the isolated mesenteric artery strips AII produced a biphasic responses. The contractile effect of AII was enhanced in rubbed strips. Similar potentiation was also obtained in hydroquinone, aspirin and nicotine pretreated unrubbed strips. The relaxation phase of AII response was completely abolished in rubbed strips but partially inhibited in hydroquinone, aspirin and nicotine pretreated unrubbed strips. From these results it was concluded that EDRF is the main endothelial humoral factor which modulates the effect of AII in the rabbit aorta while both EDRF and PGI2 are involved for the modulation of the effects of octapeptide in the mesenteric artery. PMID- 3307341 TI - Cyclosporin A-induced nephrotoxicity in the rat: relationship to increased plasma renin activity. AB - Cyclosporin A (CsA; 50, 100 or 150 mg/kg) was administered by gavage, daily for 4 days, to groups of normotensive rats. An additional group of animals received the drug vehicle. CsA-induced nephrotoxicity, characterized by reduced glomerular filtration rate (GFR) and urinary sodium flow, enzymuria and proximal tubular cell damage was accompanied by elevated plasma renin activity (PRA). These changes were dose-related at 50 and 100 mg/kg CsA, but were not increased by administration of 150 mg/kg. Circulating trough drug levels were related to dosage. Four days after CsA withdrawal in animals given 50 mg/kg, there was reduced nephrotoxicity and PRA had returned to normal, even though circulating CsA levels had not diminished. Rats given 100 and 150 mg/kg, however, showed no reduction in nephrotoxicity or in PRA. Hyperglycaemia was evident at 4 days in animals given 100 and 150 mg/kg CsA and persisted 4 days after drug withdrawal. There were no accompanying abnormalities in islet cell structure. Continuous administration of CsA (50 mg/kg) to rats for 14 days caused elevated PRA on day 4 but a return to normal levels by day 7. In contrast, significant GFR impairment was evident by day 7 whilst enzymuria was significantly increased from day 4 onwards. CsA nephrotoxicity in the rat is clearly associated with activation of the renin-angiotensin-aldosterone system. Possible mechanisms leading to increased renin release are discussed. PMID- 3307343 TI - [The hazards of biopsy in oral medicine]. PMID- 3307344 TI - Strategies for induction of protective immunity against schistosomes. PMID- 3307342 TI - Hyposmotic swelling leads to the expression of trypsin-like activity by rat peritoneal fluid mast cells. AB - Rat peritoneal fluid mast cell present parallel increases in cell area (swelling), and in hydrolytic activity on the trypsin substrate p-tosyl arginine methyl ester (TAME), when placed in Tris buffers of concentrations between 0.15 and 0.03 M. Under these conditions, cells do not degranulate and preserve their trypsin-like enzyme activity after low speed centrifugation. Exposure to more dilute Tris buffers, between 0.015 and 0.003 M, leads to cell rupture accompanied by progressive degranulation and loss of activity on TAME. Protamine, a heparin antagonist prevented this loss when added to mast cells prior to hyposmotic lysis, or lysis by sonication or repeated periods of freezing and thawing. Enzyme activity released in the presence of protamine was fully recovered in supernates of cell lysates submitted to low speed centrifugation. Controlled swelling of mast cells propitiates the expression of trypsin-like activity, possibly by facilitating enzyme-substrate interaction. Cell lysis on the contrary, leads to inactivation of such activity, possibly by enzyme binding to heparin in exposed mast cell granules. PMID- 3307345 TI - Prospects for immunological intervention in human schistosomiasis. Historical perspectives. PMID- 3307346 TI - Vaccinia virus recombinants: potential vaccines. PMID- 3307347 TI - Immunopotentiating complexes. PMID- 3307348 TI - Intravascular contrast media: adverse reactions. PMID- 3307349 TI - Thrombosis of upper extremity thoracic inlet veins: diagnosis with duplex Doppler sonography. AB - Duplex Doppler sonography of the axillary, subclavian, internal jugular, and brachiocephalic veins was performed in 20 normal volunteers and in a series of 22 consecutive patients with suspected venous thrombosis. When normal, these vessels had hypoechoic or anechoic lumina, sharply echogenic walls, and characteristic Doppler flow patterns that varied with changes in intrathoracic pressure. Most thrombosed vessels had poorly defined walls and echogenic lumina. All had absent flow on Doppler analysis. Duplex Doppler sonography was positive in all 10 patients subsequently shown to have venous thrombosis by venography or CT. One false-positive result occurred in a technically limited study. Sonography has the advantages of portability, ease of performance, and high patient acceptance. Duplex Doppler has advantages over either continuous-wave Doppler or imaging sonography alone. Our experience suggests that duplex Doppler sonography should be the initial diagnostic study in evaluating suspected thrombosis of the upper extremity thoracic inlet veins. PMID- 3307350 TI - Hemodynamic changes in portal circulation after portosystemic shunts: use of duplex sonography in 43 patients. AB - Forty-five patients with 46 surgical portosystemic shunts were examined by duplex Doppler sonography, and the results were compared with those of esophageal endoscopy, angiography, surgery, and clinical follow-up. Thirty-eight shunts were patent, and in 33 of these, the shunt was directly visualized and flow was observed with Doppler sonography. Eight shunts were obstructed. After a successful portosystemic shunt procedure, flow in the shunted splanchnic vein was directed toward the shunt and the systemic vein. We studied the intrahepatic portal venous circulation in all of the patients; we found that in the presence of patent portosystemic shunt, portal flow is hepatofugal. This reversal of blood flow occurred in all but four patients. In the end-to-side portacaval shunt, where the portal vein is ligated, blood in intrahepatic portal branches presumably reaches the shunt through perihepatic collaterals. In the presence of a thrombosed shunt, intrahepatic portal venous flow was hepatopetal. To our knowledge, this is the first noninvasive in vivo study of intrahepatic portal circulation after portosystemic shunt surgery. The duplex Doppler evaluation of portosystemic shunts appears to be reliable and should be the method of choice for shunt patency assessment in patients with recurrent signs of portal hypertension. In addition to demonstrating flow at the site of the anastomosis, the Doppler study may yield an easy and reliable sign of shunt patency: reversed flow (hepatofugal flow) in the intrahepatic portal veins probably signals a patent shunt, even if the site of the anastomosis cannot be visualized directly by sonography. PMID- 3307351 TI - Mesoatrial shunt for the treatment of Budd-Chiari syndrome: radiologic evaluation in eight patients. AB - The construction of a mesoatrial shunt for portal decompression is one of the surgical procedures used for the treatment of Budd-Chiari syndrome. The results of the imaging procedures performed in eight patients treated in this fashion were retrospectively analyzed. All of the patients had angiography; seven had MR imaging and two had Doppler sonography. The demonstration of shunt patency, stenosis, or occlusion by MR and Doppler sonography was confirmed by angiography in all cases. We conclude that MR imaging may serve as an accurate screening method to assess shunt patency and to determine which patients require angiography to obtain hemodynamic data. Doppler sonography may also be a useful screening method, but additional data must be obtained to assess its role in evaluation of shunt patency. PMID- 3307352 TI - Intrahepatic portosystemic venous shunt: occurrence in patients with and without liver cirrhosis. AB - Portosystemic venous shunt within the hepatic parenchyma is rare, and its cause is disputed. Only 12 cases have been reported in the literature. Four new patients are presented here, all of whom had cerebral manifestations due to elevated blood-ammonia levels. One patient, initially misdiagnosed as having a psychiatric disorder, had multiple small portohepatic venous shunts in the peripheral hepatic parenchyma that were believed to be congenital in origin. The other three patients with clinical evidence of cirrhosis and portal hypertension had large tubular shunts between the posterior branch of the portal vein and the inferior vena cava. Shunts of this type were considered to be the collateral pathways developed in the hepatic parenchyma as a result of portal hypertension. The diagnosis of intrahepatic portosystemic venous shunts was established by angiography in all four patients. Sonography and CT failed to show the multiple small shunts, but did provide diagnostic information concerning the large tubular shunts. Intrahepatic portosystemic venous shunt can be the cause of hepatic encephalopathy. One should be familiar with the typical radiographic manifestations of this condition to prevent misdiagnosis as a psychiatric or neurologic disorder. PMID- 3307353 TI - Sonographic diagnosis of neutropenic typhlitis. AB - Five immunosuppressed patients with neutropenic typhlitis were studied with sonography. In four, sonography was the imaging technique that first suggested the diagnosis. In each case, sonography showed thickening of the right colon wall (1-2.5 cm) with low- or high-level echoes. Serial sonograms were used to monitor the daily progress of the disease in two patients. Sonography appears to be a useful tool not only to detect typhlitis in patients with symptoms suggestive of the disease, but also to follow their clinical course. PMID- 3307354 TI - Subchorionic hemorrhage: sonographic diagnosis and clinical significance. AB - Twenty-one pregnancies with sonographic evidence of subchorionic hemorrhage were evaluated clinically and sonographically. Clinical evaluation included maternal age, gravidity, parity, gestational age, presence of pain, presence and amount of bleeding, and pregnancy outcome. Sonographic evaluation included the relative and absolute size of the hematoma, its echogenicity and location in relation to the placenta, the presence of marginal placental abruption, and progress on follow-up examinations. The outcome of these pregnancies was unfavorable in 15 cases (71%) and correlated well with the relative and absolute size of the hematoma, severity of vaginal bleeding, change in hematoma size on follow-up examination, and presence of pain. There was no significant correlation between the outcome and the echogenicity of the hematoma, presence of placental margin elevation, gestational and maternal age, gravidity, or parity. All hematomas extended to the margin of the placenta. Subchorionic hemorrhage is a frequent cause of first and second trimester bleeding and has a grave prognosis. Familiarity with the varied sonographic appearances and meticulous sonographic examination with special attention to the placental margins can be helpful in the diagnosis. PMID- 3307355 TI - Radiographic evaluation of joints resurfaced with osteochondral shell allografts. AB - The radiographic features of 41 cadaveric osteochondral shell (low ratio of subchondral bone to articular cartilage) allografts placed in 24 patients for articular resurfacing as an alternative to arthroplasty are presented. Underlying causes of joint disease included ischemic necrosis (20 grafts), osteochondritis dissecans (nine), chondromalacia patellae (10), and posttraumatic osteochondral fracture with degenerative disease (two). Congruity with the adjacent native articular surface and the opposite side of the joint was evident on immediate postoperative radiographs in all patients, and proved to be critical to the ultimate success of the procedure. On follow-up radiographs over a period of 2-28 months, successful incorporation of the allograft was characterized by progressive loss of the relative increased density of the graft, in association with diminished lucency related to new bone formation at the graft-native bone interface, as well as maintained alignment. Graft failure was associated with positional changes including collapse, persistent increased density, and poorly defined fragmentation that occasionally simulated infection radiographically and resulted in intraarticular bodies. Resurfacing of diseased articulations with osteochondral shell allografts constitutes a potentially desirable alternative to total joint arthroplasty, particularly among younger patients. Consequently, an awareness of the expected radiographic alterations associated with graft incorporation and failure is important. PMID- 3307357 TI - The biophysical basis of tissue contrast in extracranial MR imaging. AB - So that radiologists can understand better the differences between tissues that determine MR image contrast, the biophysical basis of proton-MR tissue contrast is reviewed. Differences in the molecular sizes of water, fat, and protein macromolecules affect the rate of molecular motion, which in turn influences relaxation times. Differences in the physical state of water within tissues determine the extent to which the motion of water is restricted by binding to hydrophilic macromolecules (e.g., protein), which in turn causes variable amounts of T1 and T2 shortening. Understanding these concepts and knowing the location in the body of free water, cellular tissues, fat, collagen, bone, and tissue iron improve the radiologist's ability to extract useful information from MR images. PMID- 3307356 TI - Sonography of thigh abscess: detection, diagnosis, and drainage. AB - Sonographic characteristics and percutaneous catheter drainage of thigh abscesses in 18 patients are described. Most of these patients had underlying diseases including osteomyelitis, trauma, diabetes mellitus, rheumatoid arthritis, leukemia, lymphoma, sepsis, bleeding dyscrasia, and autoimmune disease. Previous procedures on these thigh collections included seven operations and 12 nondiagnostic ward aspirations. All collections were shown by sonography to be either anterior or anterolateral. Two cases referred for drainage were posteromedial; sonography showed these to be mycotic pseudoaneurysms. The abscesses were either anechoic or hypoechoic, and occasionally had debris and septations. Abscesses associated with underlying osteomyelitis abutted the femur; those related to other causes generally were more superficial within muscle or fascial layers. Sonographically guided catheter drainage successfully cured all patients, even those in whom ward aspiration or formal surgery had been unsuccessful. Sonography is a simple and inexpensive method of imaging and guiding the drainage of thigh abscesses. Percutaneous catheter drainage is the treatment of choice in cases in which simple emergency room or ward incision and drainage are inadequate. PMID- 3307358 TI - Sonographic diagnosis of foreign bodies of the distal extremities. PMID- 3307359 TI - Rate and extent of recovery of left ventricular function in patients following acute myocardial infarction. AB - To determine the rate and extent of recovery of left ventricular (LV) performance following acute myocardial infarction (MI), peak aortic blood acceleration was measured serially in 26 patients and in 11 normal volunteers with a continuous wave Doppler placed suprasternally. In patients, Doppler measurements were made 20 +/- 2 hours after the acute onset of chest discomfort and were repeated daily for 6 consecutive days. Infarction patients were divided into two groups. Group I consisted of 15 patients who did not have a previous MI and whose present course was not complicated by congestive heart failure (CHF). Group II consisted of 11 patients who had either a previous MI or developed CHF during the present admission. Peak acceleration in the normal volunteers showed minimal daily variations over a period of 6 days. Peak acceleration in the entire group of 26 MI patients increased from 13 +/- 3 m/sec/sec on the day of admission (day 1) to 18 +/- 6 m/sec/sec on day 6 (p less than 0.001). In group I, peak acceleration increased from 13 +/- 4 to 20 +/- 6 m/sec/sec between day 1 and day 6 (p less than 0.001). In group II, however, peak acceleration was 12 +/- 2 m/sec/sec on day 1 and increased to only 15 +/- 4 m/sec/sec on day 6 (NS). These results indicate that LV performance, based upon peak acceleration of blood in the ascending aorta, improves markedly within 6 days in patients suffering their first MI uncomplicated by CHF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307360 TI - Successful left ventricular opacification following peripheral venous injection of sonicated contrast agent: an experimental evaluation. AB - A new agent for use in contrast echocardiography that is capable of passing through the pulmonary circulation and opacifying the left ventricular cavity after intravenous injection was evaluated in a canine model. Air-filled albumin microbubbles were produced by sonication. A Coulter counter was used to size and count the resultant microbubbles in vitro. The microbubbles had diameters sufficiently small (less than 9 micron) to permit transpulmonary passage. A total of 72 injections were made into the forepaw vein of five closed-chest dogs. Simultaneous two-dimensional echocardiographic images of the right ventricle and the left ventricle were recorded and digitized on an off-line computer. Of the 72 injections, 59 (82%) were suitable for digitization. Forty of the 59 digitized injections (68%) demonstrated left ventricular contrast enhancement. Indicator dilution curves were generated from plots of intraventricular gray level VS time, and the curve widths and areas under the curves were determined. The ratio of total indicator curve area for left to right ventricular cavity was 0.39 for the 40 successful injections, indicating transpulmonary transmission of 39% of the contrast effect. Injection of bubbles with mean size less than 6 microns resulted in a larger median left ventricular curve area than those with bubbles averaging from 6 to 9 microns. Injections demonstrating successful left ventricular contrast opacification had larger right ventricular curve areas than those that were not successful. Blood pressure, heart rate, and arterial blood gases were not significantly altered by repeated intravascular contrast injections. Postmortem examination of hearts, lungs, livers, and kidneys revealed no histologic changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307361 TI - Electrophysiologic study in the management of cardiac arrest survivors: a critical review. AB - This review discusses the value and limitations of EPS in the management of cardiac arrest survivors. Uncertainties associated with EPS include a lack of consensus with respect to stimulation protocol, end points for VT suppression during drug testing, significance of induced polymorphic VT or VF, and timing of EPS after myocardial infarction. Despite methodologic shortcomings in most clinical studies, a useful body of knowledge has emerged. In cardiac arrest survivors, incidence of inducible sustained VT ranged from 35% to 75%. Where induced VT (sustained or nonsustained) was successfully suppressed, recurrent arrhythmic events occurred in 0% to 33% of patients over a 1- to 5-year follow-up period. Failed regimens correlated with a high risk of arrhythmic recurrence. EPS also helps to select patients for the implantable defibrillator or electrocardiac surgery. In conclusion, EPS appears empirically useful in the management of cardiac arrest survivors with coronary artery disease; its value in other disease entities is uncertain. PMID- 3307362 TI - Silent myocardial ischemia: II. Prognosis and implications for the clinical assessment of patients with coronary artery disease. AB - Myocardial ischemia is known to be a strong independent predictor of cardiac events. New data suggest that the presence of silent ischemia, like symptomatic ischemia, is indicative of an increased risk of future cardiac events. Ordinarily, patients with suspected or known coronary artery disease are evaluated first for the presence of myocardial ischemia by performing exercise ECG, used as a test of both diagnosis and prognosis. In those patients who have an "intermediate" probability of cardiac event after exercise ECG, prognostic assessment may be enhanced, by using either radionuclide stress testing, to assess the extent and severity of potentially inducible ischemia, or ambulatory ECG, to assess the frequency and duration of spontaneously occurring ischemia. The indications for testing and type of test to be used are highly dependent on a number of clinical factors, not the least of which are the nature of the population to be evaluated and the exercise ECG response. We have proposed an overall approach for prognostic testing that considers the potential strengths and limitations of each form of testing. This potential approach now requires prospective evaluation. PMID- 3307363 TI - Accelerated hypertension complicated by myocardial infarction after use of a local anesthetic/vasoconstrictor preparation. PMID- 3307364 TI - Mistaking catheter-induced coronary arterial dissection for coronary spasm. PMID- 3307365 TI - Efficacy and safety of oral nadolol for exercise-induced ventricular arrhythmias. AB - Sixty-four patients with reproducible exercise-induced ventricular arrhythmias were enrolled in an open-label, multicenter study to assess the efficacy and safety of oral nadolol therapy. There were 53 men and 11 women ranging in age from 19 to 75 years (mean 53.9). The severity of arrhythmias varied from frequent ventricular premature beats to nonsustained and sustained ventricular tachycardias. Using serial treadmill exercise tests, patients underwent dose titration for 1 month and were followed up for 3 to 6 months. Depending on drug tolerance and response to treadmill exercise testing, the single daily required dose of oral nadolol ranged from 20 to 240 mg (average 66). Twenty-three (36%) of the patients experienced a total of 30 adverse effects of nadolol therapy; however, only 9 (14%) patients had to be withdrawn from the study. The adverse effects observed were those commonly associated with beta-adrenergic blocking agents, and all were dose-dependent and reversible. At the last patient visit, the severity of exercise-induced ventricular arrhythmias was significantly decreased compared with pretreatment in 36 (75%) of 48 evaluable patients. Eighteen (38%) of the patients demonstrated total suppression of arrhythmias. This was accompanied by significant increases from pretreatment in both the mean duration of symptom-limited exercise (+1.02 +/- 0.41 minutes, p less than 0.05) and the mean time of exercise required for arrhythmia induction (+1.80 +/- 0.66 minutes, p less than 0.01), a significant decrease from pretreatment in the mean peak exercise double-product (-4,775, p less than 0.001) and a decrease in the incidence of exercise-induced ST-segment depression (-33%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307366 TI - Comparative effects of nadolol-digoxin combination therapy and digoxin monotherapy for chronic atrial fibrillation. AB - In some patients with chronic atrial fibrillation, treatment with digitalis alone may fail to produce a satisfactory decrease in heart rate at rest or during exercise or emotional stress. Findings of a few clinical studies suggest that beta blockade in combination with digitalis therapy may be of benefit in these patients. In a randomized, double-blind, placebo-controlled, parallel-group, 8 week study of 32 patients with chronic atrial fibrillation, the effects of digoxin therapy alone were compared with a combination of digoxin and nadolol. Criteria for entry into the study included ventricular rate at rest greater than or equal to 80/min or greater than or equal to 120/min with exercise, and serum digoxin levels within the therapeutic range. After digoxin dose titration to produce therapeutic levels, digoxin dosage remained constant throughout the balance of the study. After a 2-week, single-blind placebo lead-in period, patients were randomized to receive either digoxin plus placebo or a combination of digoxin and nadolol. The dose of nadolol/placebo was titrated from 20 to 120 mg daily as tolerated. Twenty-four hour ambulatory electrocardiographic (Holter) recordings, symptom-limited exercise treadmill tests and serum digoxin and nadolol levels were obtained at the end of the single and double-blind treatment periods. Comparing endpoint with baseline, results from Holter recordings showed that patients treated with a combination of digoxin and nadolol had significant (p less than 0.001) decreases in 24 hour average (78 +/- 4 to 63 +/- 3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307367 TI - Effects of early high-dose streptokinase intravenously on left ventricular function in acute myocardial infarction. AB - One hundred seven patients who recently had acute myocardial infarction were randomly assigned either to standard heparin therapy or to intravenous streptokinase within 5 hours after the onset of symptoms in 7 hospitals without catheterization facilities. In the third week, the patients were referred to a university hospital, where the patency rate of the infarct-related artery was studied by selective coronary arteriography and left ventricular function by radionuclide angiography. Fifty-five patients received heparin and 52 streptokinase within a mean period of 190 minutes after the onset of symptoms. Seven patients in the heparin group and 4 in the streptokinase group died in hospital. The patency rate of the infarct-related artery was identical in both groups (69% in the heparin group vs 68% in the streptokinase group). Left ventricular ejection fraction was not statistically different (0.44 +/- 0.13 in the heparin group vs 0.45 +/- 0.12 in the streptokinase group). Left ventricular ejection fraction was significantly higher in patients with a patent infarct related artery than in patients with an obstructed infarct-related artery (0.49 +/- 0.12 vs 0.41 +/- 0.15, p less than 0.01). In patients with inferior wall infarction, left ventricular ejection fraction was identical (0.50 +/- 0.10 in the heparin group vs 0.52 +/- 0.09, in the streptokinase group). In patients with anterior wall infarction, left ventricular ejection fraction was significantly higher in the streptokinase group than in heparin group (0.40 +/- 0.10 vs 0.33 +/ 0.09, p less than 0.05). Analysis of regional wall motion revealed that improvement occurred in the lateral wall of the left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307368 TI - Comparison of exercise-positive with recovery-positive treadmill graded exercise tests. AB - A treadmill exercise test response may become positive because a diagnostic electrocardiographic ST-segment shift occurred during exercise, or, less often, because it occurred only during the recovery period after exercise had been completed. Factors that may be related to these 2 different responses in subjects enrolled in the Program of Surgical Control of Hyperlipidemia were investigated. No differences were found with regard to age, sex, level or location of Minnesota electrocardiographic Q-QS codes, number of narrowed coronary arteries, presence of collateral coronary artery circulation, ejection fraction, number of abnormally moving left ventricular wall segments, heart rate, systolic and diastolic blood pressure, double product, total exercise time, exercise-induced angina, or maximally achieved exercise heart rate or double product. Thus, the same significance should be attributed to a recovery-positive as to an exercise positive treadmill test, and electrocardiographic, hemodynamic and angiocardiographic variables do not distinguish between subjects who exhibit these 2 different responses. PMID- 3307369 TI - Imbalance among T-cell subsets in patients with coronary arterial aneurysms in Kawasaki disease. AB - The populations of T cells were studied in 46 patients with Kawasaki disease, separated into 2 groups: group I--11 patients with coronary aneurysms; and group II--35 patients with normal coronary arteries. Patients from both groups with early acute illness, before day 5, had a significant reduction in the population of OKT3+ (p less than 0.001), OKT4+ (p less than 0.02) and OKT8+ cells (p less than 0.002), but normal OKT4/OKT8 ratios compared with age-matched control subjects. These abnormal values quickly returned to normal levels during week 2 in patients with normal coronary arteries. In contrast, patients in whom coronary aneurysms developed within 3 weeks of the onset had an imbalance between OKT4 and OKT8 during week 2, characterized by a decrease in the number of OKT8+ cells and an increase in the number of OKT4+ cells, resulting in a high OKT4/OKT8 ratio (p less than 0.01). Three patients in whom large coronary aneurysms developed had ratios higher than 4.50. Follow-up analysis of T-cell subsets from individual patients with coronary aneurysms showed that the OKT4/OKT8 ratio during the acute stage was reduced during the convalescent stage (p less than 0.005). In contrast, the ratio in patients with normal coronary arteries was normal during the course of the illness. These observations suggest that an immune regulatory process operating in coronary aneurysm formation is present. PMID- 3307370 TI - Special issue in honor of James A. Miller, Jr. PMID- 3307371 TI - The 1986 Herman award lecture. Nutrition science as a continually unfolding story: the folate and vitamin B-12 paradigm. PMID- 3307372 TI - Relation of body fat distribution to hyperinsulinemia in children and adolescents: the Bogalusa Heart Study. AB - The relation of body fat distribution to plasma levels of glucose and insulin during an oral glucose tolerance test was examined in 355 Black and White school age children. Both central and peripheral fat were similarly related to fasting, 30-min, and 1-h glucose. Unlike peripheral fat, central body fat was more strongly related to the 1-h insulin response (r = 0.35 vs 0.26); this association remained significant for central fat independent of peripheral fat (r = 0.18). The strong relation of central fat to insulin response was noted in both races and sexes but not in either sexually immature or relatively thin children. These findings indicate that, even in early life, a central body fat pattern relates positively to insulin response to glucose load. Thus, knowledge of body fat localization may help identify persons most susceptible to hyperinsulinemia in early life. PMID- 3307373 TI - Effect of protein dose on serum glucose and insulin response to sugars. AB - To clarify the effects of protein on insulin and glucose response to sugars, 14 healthy normal-weight males and females were fed test meals containing 0, 15.8, 25.1, 33.6, and 49.9 g protein along with approximately 58 g carbohydrate. Serum samples were obtained at fasting time zero and 15, 30, 60, and 120 min postprandial. Mean areas of the glucose curves above fasting decreased with increasing protein dose. Protein-containing meals produced significantly lower (p less than 0.01) areas than the protein-free meal and the relationship between blood glucose area and protein dose was significant (p less than 0.001). Protein containing meals produced significantly greater (p less than 0.01) insulin areas compared with the protein-free meal. However, no differences in insulin areas among the protein-containing meals were observed. These data support previous studies showing a blood glucose moderating and insulin-enhancing effect of protein ingestion. PMID- 3307374 TI - Follicular lymphoma mimicking progressive transformation of germinal centers. AB - Three cases of a morphologically distinctive "floral" variant of follicular large cell lymphoma are presented. In each instance, the diagnosis of theoretically "florid" progressive transformation of germinal centers (PTGC) was made or considered. The features that separate this pattern of lymphoma from reactive follicular hyperplasia with PTGC include involvement of all nodules without the presence of any reactive germinal centers, a homogeneous proliferation of large transformed lymphocytes with a markedly decreased or absent population of phagocytic histiocytes, and extension by abnormal cells into the perinodal adipose tissue. If the desirability of frozen section tissue immunophenotyping is anticipated, these lymphomas would be distinguished from PTGC by monotypic staining for light chains. PMID- 3307375 TI - Beta 2-microglobulin amyloidosis (AB2M) in patients undergoing long-term hemodialysis. A new type of amyloid. AB - Amyloidosis has been increasingly recognized in association with renal failure and chronic hemodialysis. This report describes three patients who had long-term hemodialysis (between 7-18 years), in whom deposits developed of a new type of amyloid of beta 2-microglobulin origin. Beta 2-microglobulin amyloid (AB2M) was found in multiple organs, i.e., bone, subendocardium, gastrointestinal blood vessels, tongue, and carpal tunnel connective tissue. AB2M displayed characteristic amyloid features on conventional light and polarized microscopic examination after congo red staining. However immunostaining with anti-amyloid A protein, kappa, and lambda antisera were negative. The studied material reacted positively with beta 2-microglobulin antisera, identifying AB2M in all three cases. Ultrastructural study revealed an unusual curvi-linear fibrillar configuration. AB2M appears to be a new subtype of systemic amyloidosis secondary to renal failure and long-term hemodialysis. PMID- 3307376 TI - Evaluation of BCDE, a microcomputer program to analyze automated blood counts and differentials. AB - A microcomputer program (BCDE) has been developed to analyze automated blood cell counts and differentials' similarity to normal values or to 36 disease categories. In 50 normal subjects, the analytic program listed the correct diagnosis as the first diagnosis in 49 cases (the only diagnosis in 44) and second of two diagnoses in one case. In 182 subjects with known hematologic disorders, the correct diagnosis was listed first in 134 and second or third in an additional 40. Subjects with iron deficiency, heterozygous thalassemia, immune thrombocytopenia, anemia of chronic disease, reactive thrombocytosis, acute infection, and chronic leukemia had the disorder identified as the most likely one by the analytic program with both sensitivity greater than 80% and specificity greater than 98%. Subjects with acute leukemia, folate deficiency, sickle cell anemia, cytotoxic chemotherapy, and chronic liver disease had the disorder identified as most likely by the program with a sensitivity less than 80%. In a different 11 cases with known hematologic status, a panel of 37 physicians identified the disorder(s) or normality only 72% of the time, whereas the analytic program listed the correct diagnosis first in 10 of 11 (91%). The analytic program appears useful for both triage of normal from abnormal data and for the initial differential analysis of abnormal data. PMID- 3307377 TI - The effect of centrifugation on the rapid detection of adenovirus in shell vials. AB - Monoclonal antibody, specific for the adenovirus group-reactive hexon antigen, was used for the detection of this agent by immunofluorescence 24 and 48 hours after inoculation of HEp-2 cell monolayers in 1-dram shell vials after low-speed centrifugation (700 X g, 30 minutes). Of 31 adenovirus isolates, 16 (sensitivity, 52%) and 30 (sensitivity, 97%) were detected after incubation for 24 hours and 48 hours, respectively. All adenovirus strains were detected in conventional tube cell cultures but required an average of four days incubation. The shell vial assay is rapid, sensitive, and specific and can be easily implemented in laboratories with cell culture experience. PMID- 3307378 TI - In memoriam James N. Patterson, M.D. (1902-1986). PMID- 3307379 TI - Tensile bond strengths of orthodontic bonding resins and attachments to etched enamel. AB - The purpose of this in vitro study was to determine the tensile bond strengths (TBS) of several orthodontic bonding systems and orthodontic brackets to enamel surfaces exposed to different etching procedures. The TBS of four bonding systems were determined by a test method developed by Kemper and Kilian. Twelve test specimens were prepared for each procedure. The test system was modified to determine the TBS of orthodontic brackets bonded to enamel surfaces by six bonding procedures and the TBS were evaluated 15 minutes and 24 hours after specimen preparation. The specimens were loaded to failure in an Instron machine operated at a crosshead speed of 0.02 inch/min. The TBS were expressed in MN.m-2. The TBS of the four bonding systems to etched enamel were not significantly different (P = 0.2528). The TBS of bonded brackets determined 24 hours after specimen preparation were not significantly different than the TBS recorded after 15 minutes except for brackets bonded with Lee Cleanse and Bond I to enamel surfaces etched with 15% H3PO4 for 30 seconds. The TBS of brackets to enamel etched with 15% H3PO4 for 30 seconds were not significantly different from the TBS to enamel surfaces etched with 5% H3PO4 for 15 seconds except for brackets bonded with Lee Cleanse and Bond II and tested 24 hours after bonding. PMID- 3307381 TI - In defense of RME. PMID- 3307382 TI - Abraham Jacobi lecture. The study of tuberculosis in childhood. The evolution of pediatric pulmonology in North America. PMID- 3307380 TI - Effect of timing on long-term clinical success of alveolar cleft bone grafts. AB - Despite the almost universal agreement on the desirability of bone grafting in the cleft alveolar process, there are little long-term data to support preference for grafting at one time versus another. Investigation was undertaken to compare the clinical success of grafts placed at three distinct developmental stages: the "primary" group consisting of 20 rib grafts placed at less than 1 year of age; the "secondary" group consisting of 19 iliac crest grafts placed when the permanent canine was one fourth to one half formed; and the "delayed" group consisting of 18 iliac crest grafts placed after eruption of the permanent canines. Patients were a minimum of 15 years of age at time of final evaluation. Records were made a minimum of 5 years postsurgery. Biometric data and periapical x-ray films were evaluated. There was a trend for the delayed group to have a decreased incidence of successful bony bridging of the graft site compared with the other treatment groups. The primary group exhibited significantly (P less than 0.001) greater ridge height and increased bone attachment than the secondary and delayed groups. There were significantly fewer teeth lost adjacent to the cleft for the primary group compared with the secondary and delayed groups. Before orthodontic treatment, there were no significant differences among groups in incidence of anterior crossbite; posterior crossbites were seen more frequently in the secondary and delayed graft groups than in the primary group (P less than 0.001). At final evaluation, there were significantly fewer anterior and posterior crossbites in the primary group than in the secondary and delayed groups (P less than 0.002).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307384 TI - Postnatal overestimation of gestational age in preterm infants. AB - In a study involving 25 preterm infants, obstetric clinical age (standard gestational age) was determined by history, physical examination, and ultrasonographic evaluation. Postnatally, these infants were then evaluated using the Dubowitz Scoring System (DSS) for gestational age assessment. The DSS, as administered by us, significantly overestimated gestational age compared with the standard gestational age (mean +/- 1 SD: 34.2 +/- 2.9 vs 32.5 +/- 3.9 weeks, respectively) in preterm infants. To illustrate, the gestational ages of 13 newborns (52%) in the total study group were each overestimated by more than two weeks. This percentage increased to 75% among the 16 infants whose gestational ages were less than 34 weeks (by standard gestational age). When the standard gestational age was underestimated by the DSS, this difference never exceeded two weeks. These findings suggest that the present system of postnatal assessment of gestational age in preterm infants needs further investigation. PMID- 3307383 TI - Pancreatic endocrine insufficiency in posttransplant cystinosis. AB - Nephropathic cystinosis causes renal death by approximately age 10 years. With increased life span due to kidney transplantation, ten to 25 years of cystine accumulation has resulted in pancreatic complications in individuals with cystinosis. We noted severe hyperglycemia in five posttransplant patients, three of whom remained insulin-dependent diabetics several years after transplant. The clinical findings were not consistent with steroid-dependent or insulin-resistant diabetes. Pancreatic cystine deposition was detected histologically and biochemically on post-mortem examination of two other patients. We conclude that hyperglycemia may be anticipated in the immediate posttransplant period in cystinotic patients and that some patients will require insulin therapy years later. The use of cystine-depleting agents should be considered in posttransplant cystinosis as an attempt to prevent potential damage to the pancreas and other organs from cystine deposition. PMID- 3307385 TI - Surreptitious insulin administration: is it an iatrogenic syndrome? PMID- 3307386 TI - A clinical trial of a monocomponent pertussis toxoid vaccine. AB - We compared a monocomponent pertussis toxoid vaccine preparation (JNIH-7) in a double-blind, randomized study with another component vaccine (JNIH-6) containing pertussis toxoid and filamentous hemagglutinin in equal proportions. Monocomponent pertussis toxoid vaccines have not been tested previously in children. This trial comprised 255 previously nonimmunized children 6 to 10 months old who were given two 0.5-mL subcutaneous injections of either vaccine four to five weeks apart. Prevaccination and postvaccination serum samples from 235 infants showed an antitoxin seroconversion rate of 100% in both groups. Adverse reactions were few and mild, with local reactions occurring more often after administration of the second dose and among recipients of the two-component vaccine (P less than .05). PMID- 3307387 TI - Neonatal lupus syndrome. AB - Neonatal lupus erythematosus is a rare syndrome occurring in the first six months of life. It is characterized by the presence of Ro antibodies in the mother and affected infant, and at least one clinical manifestation--cardiac, hematologic, or dermatologic. If present, congenital heart block is irreversible and may be life-threatening in the neonatal period. Mothers of infants with neonatal lupus erythematosus may be asymptomatic when the affected infant is born but may later develop connective-tissue disease. The affected infants are at risk to develop systemic lupus erythematosus during adolescence or adulthood. PMID- 3307389 TI - Complications of endoscopic injection sclerotherapy: a review. AB - As endoscopic injection sclerotherapy becomes more widely applied to the treatment of bleeding esophageal varices, an increasing number of complications are being reported. Dysphagia, chest pain, and fever are usually transient and incosequential but may herald more serious life-threatening sequelae. Mortality commonly results from the major complications of recurrent bleeding, perforation, sepsis, and respiratory disorders. We carried out a review of sclerotherapy complications to understand their basis and to determine what measures can be taken to prevent or manage them. PMID- 3307388 TI - Suppression of plasma renin activity in a boy with chronic hyperkalemia. AB - Chronic hyperkalemia (6.8 mmol/L [6.8 mEq/L]) was discovered in a boy, aged 13 years 7 months, with short stature, delayed puberty, and normal blood pressure. Additional studies revealed hyperchloremic metabolic acidosis (serum values: sodium ion, 139 mmol/L [139 mEq/L]; chloride, 113 mmol/L [113 mEq/L]; bicarbonate, 18 mmol/L [18 mEq/L]), a normal glomerular filtration rate, a subnormal renal threshold for bicarbonate reabsorption, and normal serum thyroxine, growth hormone, and cortisol values. Renal excretion of potassium ion was subnormal for the prevailing serum concentration of potassium ion but was increased normally by infusion of sodium sulfate. The serum aldosterone concentration was appropriate for a normokalemic subject, despite marked suppression of plasma renin activity (PRA) (supine/upright: aldosterone, 140/580 pmol/L [5/21 ng/dL]; PRA, 0.0/0.03 ng/L X s [0.0/0.1 ng/mL/h]). Treatment with chlorothiazide and sodium chloride resulted in correction of the abnormal electrolyte concentrations and an increase in linear growth velocity. Serum aldosterone concentrations did not change significantly during treatment, even though the PRA had increased (supine/upright: aldosterone, 110/920 pmol/L [4/33 ng/dL]; PRA, 0.89/2.17 ng/L X s [3.2/7.8 ng/mL/h]). In this patient, we conclude that (1) hyperkalemia was due to inadequate renal excretion of potassium ion; (2) the serum potassium ion concentration was the major stimulus to aldosterone secretion before treatment; (3) suppression of PRA was more likely due to hyperkalemia than to extracellular volume expansion. PMID- 3307390 TI - A prospective randomized clinical trial of peripheral amino acid-glucose supplementation in acute alcoholic hepatitis. AB - Twenty-eight patients with biopsy or clinical acute alcoholic hepatitis were prospectively randomized to 21 days of conventional therapy (14 control patients) or, in addition, to 2 L/day of a peripheral iv infusion of a 900 mosmol amino acid-glucose solution (14 patients). Cirrhosis was present in 64% of controls and in 54% of infused patients. There were three deaths in controls and one in the infused group. There were no significant intergroup differences in mortality, clinical findings, liver tests, or functional mass by the galactose elimination capacity either at entry or after completion of the study. In controls, there was intragroup improvement in serum bilirubin (p = 0.033) and AST (p = 0.008) but not in other "liver tests" or in functional hepatic mass by galactose elimination capacity. In infused patients there was improvement in bilirubin (p = 0.001), AST (p = 0.008), and serum albumin (p = 0.016). Improvement in functional mass by galactose elimination capacity was significant at the p = 0.052 level. Hyaline was initially present in six of eight pairs of biopsies in both groups. After treatment, five of six pairs in controls but only one of six pairs in the infused group still had hyaline (p = 0.03). This latter finding, if confirmed in larger groups, may be of considerable clinical importance. It is suggested that 3- to 4 wk trials of such protocols may require a longer duration of follow-up in greater numbers of patients to detect important advantages of amino acid-glucose infusions which are only implicit in these findings. PMID- 3307391 TI - Sex hormones, insulin, lipids, and prevalent ischemic heart disease. AB - The relations between estradiol, testosterone, insulin, lipids, and prevalent ischemic heart disease were examined using the cross-sectional data from the Caerphilly Heart Disease Study, a cohort of 2,512 men (aged 45-59 years) surveyed between 1978 and 1982. Endogenous levels of estradiol were associated directly with high density lipoprotein (HDL) cholesterol (r = 0.106, p less than 0.001), but this relation was removed after adjustment for testosterone and insulin levels. Estradiol was not associated with prevalent ischemic heart disease. Endogenous levels of testosterone were associated directly with HDL cholesterol (r = 0.148, p less than 0.001) and inversely with triglyceride (r = -0.217, p less than 0.001). Persons with prevalent ischemic heart disease had significantly lower testosterone levels than persons without ischemic heart disease (mean levels 20.9 vs. 22.0 nmol/liter, p less than 0.01). These relations were confounded by associations with insulin. The associations between testosterone and the lipids persist after adjusting for body mass index, age, and insulin. The association between testosterone and prevalent ischemic heart disease was reduced after adjusting for insulin and/or triglyceride levels. The results suggest that insulin and testosterone may have an interdependent regulatory effect on lipid metabolism. The effect of testosterone on ischemic heart disease appears to be primarily mediated through its association with insulin. Future work on sex hormones and ischemic heart disease will need to account for the effects of insulin. PMID- 3307392 TI - Acetylcholinesterase in red blood cells. PMID- 3307393 TI - Proceedings from the symposium on Progress in Renal Diseases in honor of Dr Jacob Churg's 75th birthday. New York, New York, May 23rd, 1986. PMID- 3307394 TI - The nephrotic syndrome and its complications. AB - Modern views of the pathogenesis and natural history of nephrotic syndrome have changed substantially since the early studies by Cotugno and Bright. Contrary to beliefs held 20 years ago, we do not possess a unique satisfying explanation for the induction, maintenance, and resolution of nephrotic edema, and many concepts firmly established as "classic" are now being revised or reconsidered. These include the relationship between urinary protein losses and hypoalbuminemia, which is complicated by several factors such as daily protein intake, albumin catabolism, and the possible role of albumin loss at extrarenal sites. The influence of lowered plasma albumin on the decrease in plasma volume is also quite complex, due to technical difficulties in measuring plasma volume and turnover of radio-labeled albumin. The most contentious areas are how sodium and water retention are initiated and maintained and the relationship between hypoalbuminemia, plasma oncotic pressure, and edema. While aldosterone excretion and plasma concentrations are elevated in nephrotic patients, data on the renin angiotensin system are controversial and the renal handling of sodium is related to a host of factors including glomerular filtration rate, altered proximal tubular reabsorption, and the role of vasodilators or vasoconstrictors. The complications of nephrotic syndrome are protean and relatively common. Among those are acute renal failure, thrombosis, infections, and hyperlipidemia. Since the introduction of percutaneous biopsy, the spectrum of lesions underlying nephrotic syndrome has widened considerably, the most common being minimal change, especially in children. There are very few prognostic indicators by which response to treatment may be predicted and these include persistent microscopic hematuria. PMID- 3307395 TI - Hypertension and renal diseases. AB - Experimental data are summarized that provide evidence that enhanced transmission of systemic hypertension to the glomerulus occurs in the setting of reduced renal mass. It is proposed that similar adaptive glomerular hemodynamic alterations occur in parenchymal renal disease in humans, favoring the development of intraorgan hypertension. Accelerated vascular and glomerular damage and functional deterioration result. Treatment of systemic hypertension with agents that reduce glomerular capillary pressure has been shown to ameliorate the manifestations of experimental glomerular disease. The importance of preventing hemodynamic injury to the arterioles and glomerular capillaries in the management of human renal disease is stressed. PMID- 3307396 TI - Glomerular lesions in the transplanted kidney in children. AB - The glomerular pathology of 634 transplant specimens (526 biopsies and 108 transplantectomies) from 410 children was studied. Three types of glomerulopathies were observed: (1) recurrent glomerulonephritis (GN) (40 of 142 patients with glomerular nephropathy), (2) de novo GN (52 grafts), and (3) transplant glomerulopathy (29 grafts). The study of recurrent GN is considered of great interest because of the possible insight into the nature of the original disease and the opportunity to observe the evolution of the disease in sequential biopsies of the transplant. The two major forms of de novo GN were membranous GN and IgG linear deposits along glomerular and tubular basement membranes. Transplant glomerulopathy, although distinctive morphologically, may resemble membranoproliferative GN (MPGN) or thrombotic microangiopathy. PMID- 3307398 TI - Prudent and sensible advertising policies. PMID- 3307397 TI - Compatibility of premixed theophylline and methylprednisolone sodium succinate intravenous admixtures. AB - The stability of theophylline supplied as a premixed injection and of methylprednisolone sodium succinate in admixtures containing both drugs was studied. Solutions containing theophylline in concentrations of 4.0 mg/mL and 0.4 mg/mL were used. Methylprednisolone sodium succinate was added to each solution to produce a final concentration of 0.5 mg/mL and 2.0 mg/mL of methylprednisolone alcohol, a pharmacologically active form of methylprednisolone sodium succinate. Each admixture was prepared in triplicate, and samples were kept at room temperature in glass containers. Immediately after admixture and at 3, 6, 12, and 24 hours, samples were visually inspected, tested for pH, filtered, and assayed in duplicate by high-performance liquid chromatography for theophylline concentration and for both methylprednisolone sodium succinate and methylprednisolone alcohol content. Control solutions containing only one of the two drugs were also tested. No visual changes were observed. The addition of theophylline in 5% dextrose injection to the methylprednisolone sodium succinate solutions resulted in decreased pH values for all solutions, which did not vary significantly throughout the study period. Theophylline concentrations did not change significantly compared with baseline. In solutions containing theophylline 0.4 mg/mL with either 2.0 or 0.5 mg/mL of methylprednisolone sodium succinate, less than 90% of the initial methylprednisolone sodium succinate concentrations remained at 24 hours. However, within three hours after admixture preparation, methylprednisolone alcohol was detected in those solutions in increasing concentrations. A commercial preparation of premixed theophylline in 5% dextrose injection in a concentration of 4 mg/mL or less can be mixed with methylprednisolone sodium succinate in a final concentration of 2 mg/mL or less and administered intravenously within 24 hours after mixing. PMID- 3307399 TI - Mail-order pharmaceuticals. PMID- 3307401 TI - Review of clinical studies of thrombolytic agents in acute myocardial infarction. AB - Much of the current work in the field of thrombolytic therapy in acute myocardial infarction involves short-term, high-dose infusions of lytic agents. From 1983 to 1986, there were five major trials of these agents in acute myocardial infarction: the Western Washington Intracoronary Streptokinase Trial, the Dutch Interuniversity Group Trial, the Italian Group for the Study of Streptokinase in Myocardial Infarction Trial, the Thrombolysis in Myocardial Infarction Trial, and the Intravenous Streptokinase in Acute Myocardial Infarction Trial. This review considers each of these randomized, prospective trials in terms of design, mean time to therapy, lysis rate, reocclusion and in-hospital reinfarction, bleeding complications, in-hospital mortality, late survival, left ventricular function, and post-infarction morbidity. Findings from these trials indicate that thrombolytic therapy, if given less than four to six hours after onset of symptoms, improves the mortality rate and reduces post-infarction morbidity. Bleeding, a major cause of morbidity, can be managed by careful patient selection and clinical observation. PMID- 3307400 TI - Historical overview of antithrombotic and thrombolytic therapy. AB - Early attempts to treat thromboembolic disorders focused on the prevention of thrombus formation, along with the prevention of extension and/or embolization of an existing thrombus. Antithrombotic therapy for these conditions included intravenous and oral anticoagulants and later antiplatelet agents, all of which remain in use today. Subsequent research sought a thrombolytic agent that could lyse a clot directly. Intravenously administered streptokinase and urokinase were found to act on the inactive proenzyme plasminogen to produce the active enzyme plasmin that could safely and effectively lyse fresh fibrin clots. These agents have proved effective for the treatment of myocardial infarction and pulmonary embolism, as well as peripheral arterial and venous thromboembolic conditions. Recent efforts have been directed toward a search for clot-specific agents that would avoid the systemic lytic state associated with the use of urokinase and streptokinase. Three clot-specific plasminogen activators are currently being evaluated: recombinant tissue-specific plasminogen activator, anisoylated streptokinase plasminogen activator complex, and pro-urokinase. PMID- 3307402 TI - Conversion from low-dose insulin therapy to glipizide in patients with non insulin-dependent diabetes mellitus. AB - This study examines the effect of glipizide therapy in patients with non-insulin dependent diabetes mellitus (NIDDM) previously treated with a low-dose insulin regimen. To determine the comparative safety and efficacy of these two treatment regimens, 135 patients with NIDDM who received low-dose insulin (40 units per day or less) were enrolled in a prospective, multicenter trial. After a four-week period of continued insulin therapy, therapy was converted to the second generation oral sulfonylurea, glipizide. This report includes efficacy data on 79 patients with NIDDM who completed an eight- to 10-week course of glipizide therapy. A majority of these patients were obese (more than 120 percent of ideal body weight), with a mean age of 61.4 years, and a mean duration of diabetes of 10.0 years. Conversion from low-dose insulin resulted in no deterioration in overall glycemic control as reflected by an unchanged glycosylated hemoglobin at 16 weeks. Seventy patients (89 percent) attained fair glucose control and continued an additional 12 weeks of glipizide maintenance therapy. Subgroup analysis by fasting plasma glucose criteria demonstrated that 44 percent of these patients had statistically significant improvements in glucose control with glipizide as compared with insulin therapy. As this study showed, many patients with NIDDM currently receiving treatment with low-dose insulin can have maintained and some even improved glucose and lipid parameters when therapy is converted to glipizide. The rate of hypoglycemic adverse reactions corrected for duration of treatment in all 135 patients was 0.32 event per patient-month of therapy with insulin as compared with 0.12 event per patient-month of therapy with glipizide. When issues of efficacy, safety, and convenience are considered, it might be more appropriate to administer an oral sulfonylurea to patients with NIDDM rather than proceeding to therapy with insulin. PMID- 3307403 TI - Effects of short-term insulin therapy upon therapeutic response to glipizide. AB - The effect of glipizide alone and glipizide preceded by a short course of insulin therapy (10 weeks) was studied in 69 patients with non-insulin-dependent diabetes mellitus (NIDDM) in a 10-month study. The patients were obese, had poor glycemic control, and, in all patients, first-generation sulfonylurea therapy had failed. The majority were Mexican-Americans, an ethnic population with a high incidence of NIDDM and insulin resistance. Plasma glucose levels were monitored using the eight-point [Saarstedt] series. In the group receiving glipizide alone, mean fasting plasma glucose levels decreased from 255.9 mg/dl at baseline to 228.7 mg/dl at the end of the study; two-hour postprandial glucose levels decreased from 280.1 to 260.5 mg/dl; glycosylated hemoglobin decreased from 9.1 to 7.4 percent; and post-Sustacal C-peptide levels increased from 0.7 to 1.0 pmol/ml. In the group receiving insulin/glipizide, mean fasting plasma glucose levels decreased from 241.1 mg/dl at baseline to 217.0 mg/dl; two-hour postprandial glucose levels increased from 267.2 to 279.0 mg/dl; glycosylated hemoglobin decreased from 9.1 to 7.5 percent; and post-Sustacal C-peptide levels increased from 0.6 to 1.0 pmol/ml. At the end of 10 weeks, insulin administration was associated with a more rapid decrease in the levels of fasting plasma glucose, two-hour postprandial glucose, and glycosylated hemoglobin, but there was no significant difference between the two therapies by the end of the study. Both regimens had a positive influence on reducing the total cholesterol/high-density lipoprotein ratio. More patients in the group receiving insulin/glipizide withdrew from the study, which may have been due to difficulties associated with insulin administration. In conclusion, there does not appear to be a prolonged effect of insulin treatment on the post-receptor defect. Some patients in whom first-generation oral agents fail may not have to be given permanent insulin therapy, especially those with fasting plasma glucose levels of less than 200 mg/dl. There was no overall difference between these treatments with respect to glycemic control or lipoprotein profiles. In the interests of simplifying both therapy and monitoring, enhancing patient compliance, and achieving cost reductions, therapy with glipizide alone ultimately may be sufficient for cases in which immediate control is unnecessary (for example, patients with asymptomatic hyperglycemia, and in the absence of hyperlipidemia and vascular disease). PMID- 3307405 TI - Abnormal lipoprotein metabolism in non-insulin-dependent diabetes mellitus. Pathogenesis and treatment. AB - Although diabetes mellitus is by definition a state of abnormal carbohydrate metabolism, defects in lipoprotein metabolism are a prominent feature of the diabetic syndrome. This is particularly true of patients with non-insulin dependent diabetes mellitus (NIDDM), and it is quite likely that the abnormal lipid metabolism contributes significantly to the increased morbidity and mortality from coronary artery disease that characterizes NIDDM. In this presentation, an attempt is made to develop a coherent picture as to the pathogenesis of the defects in lipoprotein metabolism seen in patients with NIDDM, as well as to discuss therapeutic approaches to the treatment of these abnormalities. PMID- 3307404 TI - Achieving therapeutic goals in insulin-using diabetic patients with non-insulin dependent diabetes mellitus. A weight reduction-exercise-oral agent approach. AB - Non-insulin-dependent diabetes mellitus (NIDDM) is the most common form of diabetes in the civilized world. Its consequences include microvascular and macrovascular disease, both of which appear to evolve from a common background of obesity and physical inactivity. The current study was undertaken in obese patients with NIDDM to see whether improvements could be made in glycemic control as well as in many cardiovascular risk factors (obesity, hypertension, lipid abnormalities, and physical inactivity) that are typical of this condition. Fifteen obese insulin-using patients with NIDDM (average body mass index, 34.0) were treated with a 500-calorie formula diet for eight to 12 weeks. Administration of insulin and diuretics was discontinued at the onset of the study. A eucaloric diet was begun at eight to 12 weeks and maintained until Week 24. A behaviorally oriented nutrition-exercise program was instituted at the beginning of the study. Glipizide or placebo was added (randomized) at Week 15 if the fasting plasma glucose level in patients exceeded 115 mg/dl. Patients lost an average of 22 pounds over the course of 24 weeks. Frequency and duration of physical activity increased significantly from baseline, as did the maximal oxygen consumption rate. Glycemic control by 15 weeks (without insulin) was similar to baseline (with insulin). With the addition of glipizide at Week 15, both fasting plasma glucose and glucose tolerance improved significantly. This improvement was not observed with placebo. In addition, both systolic and diastolic blood pressure decreased by about 10 mm Hg. There were no significant changes in the levels of serum lipids or glycosylated hemoglobin. In conclusion, a multifaceted intervention program, employing weight reduction, exercise, diet, and glipizide therapy, can be instituted in insulin-using patients with NIDDM, with improvement in glycemic control and in certain risk factors (hypertension, obesity, physical inactivity) for cardiovascular disease. PMID- 3307406 TI - Southern Society for Pediatric Research. Presidential address: What is causing diabetes in children? AB - Insulin-dependent diabetes mellitus (IDDM) is caused by the destruction of the beta cells of the pancreas. This process is associated with the presence of islet cell antibodies (ICA). The risk for developing IDDM is associated closely with the presence of the HLA type DR3 and/or DR4. The risk is greatest for those with both DR3 and DR4. Recent evidence indicates that the DR antigens are only expressed in the beta cells of individuals who are developing IDDM. Activation of the DR antigen in beta cells apparently plays a role in the pathogenesis of IDDM. A process that turns off the expression of the DR antigen may stop the destruction of the beta cells. Preliminary evidence indicates that total suppression of beta cell function with an artificial pancreas (Biostator) significantly prolongs beta cell function well beyond that reported for immunosuppressive drugs. The Biostator may work by total suppression of beta cell function, which turns off the expression of the DR antigen with a resultant cessation of beta cell destruction. PMID- 3307407 TI - Bone marrow transplantation for immunodeficiency diseases. AB - Allogeneic bone marrow transplantation (BMT) was applied in 1968 to treat severe combined immunodeficiency disease (SCID). Almost simultaneously, marrow from an MHC-matched donor corrected the immunological deficiency of a patient with Wiscott-Aldrich Syndrome (WAS). In the first successful treatment of X-linked SCID the match was imperfect and, although SCID was cured, a graft vs. host reaction caused pancytopenia. A second BMT from the same donor successfully treated a complicating aplastic anemia. Subsequently, it has been possible to cure most patients with SCID who are in reasonably good condition at the time of BMT without other manipulation if a matched sibling donor is available. Successes are reported from Holland, France, Italy, England, Scandinavia, Japan, Germany, and from many centers in the United States. Similarly, BMT is used to correct SCID due to adenosine deaminase (ADA) deficiency or nucleoside phosphorylase (NP) deficiency, which underlie two forms of SCID. Bone marrow transplantation using HLA-matched sibling donors can now treat, successfully, at least eight genetically separable forms of SCID. Highly lethal defects of phagocytic function (including LFA-1, MO-1, CR-3 deficiencies, IL-2 and IL-1 receptor deficiencies), defects of killing after phagocytosis (as in chronic granulomatous disease, WAS, and Kostmann's Syndrome), and certain inborn errors of metabolism can be cured by BMT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307408 TI - Marrow transplantation for malignant disease. AB - The results of high-dose chemoradiotherapy and marrow transplantation from an HLA identical sibling for various stages and types of leukemia and lymphoma are summarized. It has been shown that marrow transplantation can be carried out successfully using partially matched family members or matched unrelated donors. Some of the complications of marrow transplantation are discussed. PMID- 3307409 TI - Prevention of deterioration in metachromatic leukodystrophy by bone marrow transplantation. AB - The first girl in a family was affected with late infantile metachromatic leukodystrophy (MLD) and had the expected characteristic central nervous system progressive deterioration, which resulted in decerebration and death. The second girl (propositus) demonstrated similar symptoms and signs at the same age. Both girls had characteristically low arylsulfatase A levels. The propositus underwent allogeneic bone marrow transplantation (BMT) from a normal histocompatible sibling. Two and a half years later, the propositus has not developed the intellectual and neurologic impairment demonstrated by the first sibling, although nerve conduction has continued to worsen. These results suggest that the induction of normal enzyme levels by BMT may be retarding or inhibiting CNS deterioration. These results, confirming earlier results of others, are sufficiently promising to warrant a larger scale critical trial of BMT early in the course of MLD. PMID- 3307410 TI - Clinical presentation as a guide to therapy for travelers' diarrhea. AB - To better define the role of antimicrobial therapy among U.S. travelers in Mexico, clinical and nonculture laboratory parameters were compared for 56 patients with shigellosis and 204 others with diarrhea of other causes. The presence of fever, stool mucus and blood, and fecal leukocytes were significantly more common among patients with shigellosis (p less than 0.001) who also tended not to present with mild diarrhea (p less than 0.05). However, clinical and laboratory parameters were either too insensitive or too nonspecific to be useful in identifying most cases of shigellosis or in excluding the likelihood of its presence. Patients with mild clinical presentations, regardless of etiology, experienced resolution of disease sooner than those with moderate to severe presentations (p less than 0.01), but withholding therapy from patients with mild presentations resulted in 48% of these patients remaining ill at the end of 48 hours. Based on these findings, the authors advise empiric use of antimicrobial agents in travelers with diarrhea associated with fever, bloody stools, or fecal leukocytes, and for all travelers with moderate and severe diarrhea. If therapy is withheld from patients with initially mild presentations, a proportion might still require therapy, possibly an antimicrobial agent, for optimal control of symptoms. PMID- 3307411 TI - Microcephaly: genetic counselling and antenatal diagnosis after the birth of an affected child. AB - We describe the clinical and genetic details of a series of microcephalic patients who were referred to the Genetic Counselling Service for the West of Scotland. There were 29 isolated cases of microcephaly and 9 families with recurrent microcephaly. The sib recurrence risk was 19%, which reflects the high incidence of autosomal recessive microcephaly in this series. There was evidence for several varieties of recessive microcephaly. The most frequent, affecting 5 sib pairs, was associated with spastic quadriplegia, seizures, and profound mental handicap. In 15 families with one microcephalic child, prenatal diagnosis by serial ultrasound scans was undertaken in 21 subsequent pregnancies. Four recurrences of microcephaly were detected in the third trimester and one recurrence was missed because no scans were performed after 24 wk gestation when the ultrasound measurements indicated satisfactory head growth. The main reason for late diagnosis of affected fetuses was that head growth did not slow appreciably until the last trimester. The high recurrence risk in this prospective series emphasizes the contribution of autosomal recessive inheritance of microcephaly amongst patients of our Genetic Counselling Service. PMID- 3307412 TI - Craniolacunia as the result of compression and decompression of the fetal skull. PMID- 3307413 TI - Low-output left ventricular failure in end-stage renal disease. AB - To determine the factors associated with low-output left ventricular failure (LVF) in endstage renal disease (ESRD), we performed echocardiography and gated cardiac scan on 217 nondiabetic dialysis and transplant patients. The prevalence of low-output LVF (ejection fraction less than 55% and left ventricular end diastolic diameter greater than or equal to 5.5 cm) in dialysis patients was 18% and in transplant patients 2%. The 26 patients with LVF were compared to 52 controls without LVF, matched by age, sex and year of starting treatment for ESRD, but not for current ESRD therapy. Mean age was 55 +/- (SEM) 14 years; 73% of the patients in both groups were males. Duration of treatment for ESRD was 5.6 +/- 4.3 years in patients, compared to 5.1 +/- 4.1 years in controls. Significant differences between LVF patients and controls included current treatment (73% of cases were on hemodialysis and 8% were transplanted, compared to 48 and 42%; chi 2 = 9.9, p less than 0.01), high serum creatinine, smoking and high serum alkaline phosphatase. There were no differences for current blood pressure, proportion on treatment for hypertension, left ventricular wall thickness, symptomatic ischemic heart disease, proportion with functioning vascular access, degree of weight gain between dialyses, hemoglobin level or high transfusion requirement. Multiple logistic regression demonstrated the most significant and independent variables associated with LVF were high alkaline phosphatase (suggestive of hyperparathyroidism), smoking and high serum creatinine levels (reflecting degree of uremia). Dialysis patients with LVF (n = 23) were compared to dialysis patients who had normal echocardiograms (n = 29).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307414 TI - Diclofenac, a nonsteroidal anti-inflammatory drug, decreases proteinuria in some glomerular diseases: a controlled study. AB - Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) was first used in glomerulonephritis (GN) in 1966 but its efficiency is still debated. We studied the antiproteinuric effect of such a treatment in a double-blind study. 29 GN patients with normal renal function (17 membranoproliferative GN, 12 IgA GN) were randomly assigned to receive 100 mg/day of diclofenac or placebo for at least 2 months. There was a significant antiproteinuric effect of diclofenac versus placebo with a fall of 70% in the diclofenac group versus 6% in the placebo group (p less than 0.001 with the Mann-Whitney test). The median was 3 mg/min at onset and 2.45 mg/min after 2 months treatment with the placebo. In the diclofenac group, it was 2.2 and 0.95 mg/min, respectively (p less than 0.01). Diclofenac did not significantly increase creatinine levels. Gastric irritation was noted only once. This study establishes the short-term antiproteinuric action of diclofenac. Whether this action affects the final outcome is not yet determined. PMID- 3307415 TI - Polycythaemia following renal transplantation: an association with azathioprine dosage? AB - Patients from a renal transplantation unit with an unusually high incidence of polycythaemia were divided into polycythaemic and control groups. The rate of rise of haemoglobin concentration was not significantly different in the two groups. The polycythaemic group received a significantly lower dose of azathioprine (p less than 0.005) and included more patients with polycystic disease than the control group (p less than 0.05). An effect of azathioprine on bone marrow function was suggested by the polycythaemic group also having a higher mean white cell count (p less than 0.02). Azathioprine dosage correlated negatively with post-transplantation polycythaemia regardless of the original cause of renal failure. PMID- 3307417 TI - Strategic planning in home care. PMID- 3307416 TI - Renal tubular vacuolization in a cyclosporine-A-treated renal transplant patient without evidence of cyclosporine A nephrotoxicity. PMID- 3307418 TI - Coping with nights. PMID- 3307419 TI - Responsibility, obligation, and duty. Presidential address. PMID- 3307420 TI - Careful surgical technique can reduce infectious morbidity after cesarean section. AB - A total of 635 consecutive cesarean sections performed in private practices during the past 20 years are reviewed. In the course of this 20 year period, we have tried to alter gradually our surgical technique used for this procedure to conform to the principles of surgery developed by Halsted. The study is divided into three periods of time to examine the results of changes in technique. With the use of the standard definition of febrile morbidity (temperature of greater than or equal to 100.4 degrees F during any two 24-hour periods after the first postoperative 24 hours) the postoperative morbidity rate was 15% during 1967 to 1973, 5.4% during 1974 to 1979, and 0.7% during the period 1980 through 1986. Prophylactic antibiotics were used with decreasing frequency. It was clear that the reduction in morbidity was the result of the modifications in surgical technique. PMID- 3307422 TI - Fetal cerebellar growth unaffected by intrauterine growth retardation: a new parameter for prenatal diagnosis. AB - Nineteen pregnant women with a clinical suspicion of intrauterine growth retardation and with gestational age confirmed by early ultrasound examination were referred to our departments for sonographic evaluations. Multiple biometric parameters were obtained, including the transverse cerebellar diameter by use of the electronic calipers of the machine. A prenatal diagnosis of intrauterine growth retardation was made in all cases based on: (1) the transverse cerebellar diameter being consistently correlated with gestational age as predicted by the last menstrual period, whereas most of the other measurements were consistently discrepant with the transverse cerebellar diameter by more than 2.5 weeks (i.e., more than 2 SD above the mean), and (2) the estimated fetal weight of all fetuses being equal to or less than the tenth percentile for gestational age. Neonatal examination confirmed all fetuses to be growth retarded with birth weights at or below the tenth percentile for gestational age. These findings indicate that growth of the transverse cerebellar diameter is unaffected by intrauterine growth retardation; thus this sonographic measurement may serve as an independent and reliable correlate of gestational age against which potential deviations of growth may be compared. PMID- 3307421 TI - Simultaneous objective and subjective evaluation of meclofenamate sodium in the treatment of primary dysmenorrhea. AB - Eighteen patients participated in a double-blind, placebo-controlled, single dose, crossover study of meclofenamate sodium in women with primary dysmenorrhea. Simultaneous evaluations of pain intensity and pain relief, sampling of continuous intrauterine pressure recording, and monitoring of blood meclofenamate levels were carried out. Improvements in pain intensity and pain relief were observed at 45 minutes and reached statistical significance at and beyond 1 hour 45 minutes after meclofenamate therapy. Ten of 14 uterine pressure parameters showed statistically significant responses after drug therapy and 12 of the 14 parameters showed statistically significant differences in time-response patterns. Statistically significant changes were noted as early as 45 minutes after meclofenamate therapy. Statistically significant correlations were found between and among the parameters of blood drug level and the subjective and objective measures. No drug-related adverse effects were found. PMID- 3307423 TI - A prospective random trial of home uterine activity monitoring in pregnancies at increased risk of preterm labor. AB - In a prospective trial we enrolled 157 women at increased risk of preterm birth, randomly assigning women in a ratio of 1:2 to receive either frequent (greater than or equal to 5 days/wk) nursing contact, education in preterm labor symptoms, and self-palpation of uterine activity (group E, n = 50), or daily nursing contact, preterm labor education, and the Term Guard home uterine activity monitor (group EM, n = 107). Comparison of the rate of preterm birth, the incidence of preterm labor and successful tocolysis, and the mean birth weight and gestational age revealed no significant differences and suggested that beneficial effects previously attributed to monitored contraction data may in fact be the result of frequent (five or more times per week) nursing contact and careful attention to preterm labor symptoms and perceived contractions. PMID- 3307424 TI - Ultrasound evaluation of tachycardia-induced hydrops in the fetal lamb. AB - Nonimmune hydrops was induced in six fetal lambs at 120 days' gestation by right atrial pacing at 300 beats/min. Biochemical, hemodynamic, and Doppler parameters were observed and monitored by real-time ultrasound during the creation (18 to 42 hours) and resolution of hydrops. The significant changes seen were hypoproteinemia (34.3 to 29.0 mg/100 ml), venous hypertension (24.6 to 31.3 mm Hg), decreases in thoracic aorta flow, and decreases in systolic/diastolic ratios in the aorta and umbilical artery. These changes were reversed with the discontinuation of pacing and the resolution of fetal hydrops. PMID- 3307425 TI - Gestational diabetes: insulin requirements in pregnancy. AB - A prospective study of 57 women with gestational diabetes mellitus was undertaken to determine actual insulin requirements throughout pregnancy. Women were placed on a multiple injection, mixed insulin regimen and monitored their blood glucose level 6.5 +/- 1 times per day using a memory-based reflectance meter to obtain verified data. A significant (p less than 0.01) increase in total insulin dose was found during the initial treatment period (7 +/- 2 days) until the target glucose range was achieved. Insulin requirements continued to significantly (p less than 0.01) rise until 30 +/- 1 gestational weeks, despite a stabilization of glucose level. Thereafter, there was no significant change (3%) in insulin requirement. A correlation of r = 0.58 (p less than 0.001) for the relationship between insulin dose at the 24 and 32 weeks' gestation, and an r = 0.99 (p less than 0.0001) for the relationship between insulin dose at 32 and 39 weeks' gestation was found. We concluded that an emphasis on ambulatory blood glucose control and insulin adjustments should occur in the early treatment phase of gestational diabetes. PMID- 3307426 TI - The nonpredictive value of fetal urinary electrolytes: preliminary report of outcomes and correlations with pathologic diagnosis. AB - Fetal urine was sampled 12 times in nine fetuses with sonographically diagnosed urinary tract obstruction to assess renal function. By previously proposed criteria, four fetuses were predicted to have poor renal function. Two of these fetuses were found to have renal dysplasia on autopsy after elective termination. The other two died in the neonatal period but only one of these had histologic evidence of renal dysplasia. Five fetuses were predicted to have good renal function. Three of these developed renal failure after birth, one was found to have renal dysplasia on autopsy after elective termination, and one is alive and well. We conclude that fetal urine electrolytes are not necessarily an accurate predictor of neonatal renal function. PMID- 3307427 TI - Early third-trimester ultrasound screening in gestational diabetes to determine the risk of macrosomia and labor dystocia at term. AB - The purpose of this study was to determine whether an early third-trimester fetal abdominal circumference measurement can be used in patients with gestational diabetes to predict the presence or absence of macrosomia and labor dystocia at term. The predictive accuracy of a 30- to 33-week abdominal circumference measurement was tested, using the ninetieth percentile as the discriminant point. The study consisted of 201 patients with gestational diabetes who maintained weekly fasting glucose levels less than 100 mg/dl and 2-hour postprandial glucose levels less than 120 mg/dl with dietary management alone. The predictive accuracy of a 30- to 33-week fetal abdominal circumference measurement was 96.4% for ruling out macrosomia and 56.3% for predicting macrosomia. Patients with fetal abdominal circumference measurements greater than the ninetieth percentile at 30 to 33 weeks had a significantly increased incidence of cesarean section for failure to progress, shoulder dystocia, and birth trauma, whereas patients with abdominal circumference measurements less than or equal to the ninetieth percentile were at no greater risk than the general population. These results suggest that patients with non-insulin-dependent gestational diabetes with fetal abdominal circumference measurements less than or equal to the ninetieth percentile at 30 to 33 weeks are not at increased risk for macrosomia, cesarean section, or birth trauma at term, as long as their weekly glucose testing remains within normal limits. Efforts to decrease the incidence of macrosomia and its attendant risks should focus on those gestational diabetic patients whose fetal abdominal circumference greater than the ninetieth percentile at 30 to 33 weeks. PMID- 3307428 TI - Umbilical cord size and amniotic fluid volume in prolonged pregnancy. AB - Expectant management of prolonged pregnancy is predicated on reassuring biophysical testing. However, even the combination of a reactive nonstress test and normal amniotic fluid volume may not prevent subsequent morbidity. To test the hypothesis that diminished cord Wharton's jelly incurs risk of peripartum cord compression in addition to decreased amniotic fluid, 68 patients with confirmed gestational age greater than or equal to 41 weeks were evaluated prospectively with semiweekly nonstress tests and weekly ultrasound examinations. Amniotic fluid volume was assessed, and umbilical cord diameter was measured and then correlated with the quantity of Wharton's jelly at delivery, determined by cord circumference. A significant correlation between cord circumference and umbilical cord diameter was observed, even in those patients with decreased amniotic fluid volume. Either an amniotic fluid volume less than 3.8 cm or an umbilical cord diameter less than 1.6 cm was associated with significant cord compression patterns. Peripartum morbidity was greatest in the presence of a smaller cord and decreased fluid, suggesting a synergism between these two factors for the risk of cord compression in prolonged pregnancy. PMID- 3307429 TI - The presence or absence of fetal breathing movements as a predictor of outcome in preterm labor. AB - The presence or absence of fetal breathing movements may be helpful in differentiating between true and false preterm labor. We attempted to demonstrate the clinical utility of this simple ultrasonic observation in predicting short term delivery outcome during suspected preterm labor. A total of 50 pregnancies between 26 and 34 weeks' gestation with presumed preterm labor were observed in a prospective manner. During 20 minutes of observation with real-time ultrasound at the time of admission, fetal breathing movements were observed in 33 patients and considered absent in the remaining 17 patients. In those pregnancies with absent fetal breathing movements, true labor with subsequent delivery occurred in 16 patients. Of the 33 pregnancies with fetal breathing movements present, 29 continued for greater than 48 hours. It appears that the absence of fetal breathing movement is a reliable indicator of imminent preterm delivery, irrespective of fetal membrane status (p less than 0.0001). The observed mean sensitivity and specificity of this phenomenon in predicting short-term delivery outcome are 96.6% +/- 3.3% (mean +/- SD) and 80.0% +/- 8.9%, respectively. A multivariant statistical model based on the frequency of contractions, white blood cell counts, initial cervical examination results, and premature rupture of membranes could successfully predict delivery outcome in 40% to 75% of cases. The addition of fetal breathing movement analysis to the model allowed for the correct prediction of outcome in 90% of the cases. PMID- 3307430 TI - Ultrasonic ratio of fetal thoracic to abdominal circumference: an association with fetal pulmonary hypoplasia. AB - Real time ultrasound was used in pregnant women who were considered to be at risk for development of pulmonary hypoplasia (n = 26). The population consisted of women who had either premature rupture of membranes (n = 16) or oligohydramnios (n = 10). The ratio calculated by comparing the fetal thoracic circumference to abdominal circumference was obtained in all cases within 10 days of delivery. This ratio correlated strongly with neonatal outcome. Multivariate regression models of neonatal outcome were developed to analyze the relationship of gestational age at which premature membrane rupture occurred, the duration of premature rupture, date of birth, and prenatal diagnosis. The addition of the thoracic circumference to the abdominal circumference ratio increased significantly the proportion of explained variability. Application of this ratio should be considered in evaluating fetal status in oligohydramnios and in the expectant management of premature rupture of membranes. PMID- 3307431 TI - Effects of alterations of zinc-to-phosphorus ratios and meconium content on group B Streptococcus growth in human amniotic fluid in vitro. AB - Several authors have described the bacterial growth-altering properties of amniotic fluid. We examined Group B Streptococcus growth in aseptically obtained amniotic fluid in vitro after altering its zinc, phosphorus, and meconium contents. Zinc and phosphorus levels were calculated in amniotic fluid and in meconium. Separate solutions of zinc and phosphorus were added to yield concentrations of 0.7, 7.0, 70, and 700 mumol. The solutions were incubated with Group B Streptococcus III 893 and Escherichia coli C5 strains, and 24-hour growth curves were plotted. Meconium, 0.5 mg/ml, was added to each amniotic fluid + zinc and amniotic fluid + phosphorus solution, and growth curves were plotted. The rate of proliferation of Group B Streptococcus varied directly with the zinc concentration (700 = 70 greater than 7 greater than 0.7 mumol) and inversely with the phosphorus content (700 less than 70 less than 7 = 0.7 mumol). Meconium enhanced the proliferative effect of zinc and hindered the inhibitory effect of phosphorus. Thus one possible mechanism whereby meconium enhances bacterial growth in amniotic fluid may be by alteration of zinc-to-phosphorus ratios. PMID- 3307432 TI - Assessment of success and complications of triple procedure surgery. AB - In an effort to quantify both the success and complications of triple procedure surgery, we studied a consecutive series of 166 patients who underwent this procedure. The average length of follow-up was 17 months. Of 166 patients, 138 (83%) achieved a visual acuity of 20/40 or better after surgery; in the most recent 52 patients, 26 (50%) achieved this within two months. The most frequent complications during the postoperative period were glaucoma (40 patients, 24%), endothelial graft rejection episodes (two-year cumulative risk, 16%), and astigmatism (mean keratometric cylinder, 4.97 D). Additional surgical interventions were required in 27 patients (16%). PMID- 3307433 TI - Hepatitis B surface antigen in corneal donors. AB - Using an enzyme immunoassay, we detected hepatitis B surface antigen in washings of ocular tissue from two of three corneal donors who had positive serum assays for hepatitis B surface antigen. Hepatitis B surface antigen was identified in emulsified corneal tissue from one of two donors from whom corneal tissue was available for study. PMID- 3307434 TI - Medical and surgical treatment of Acanthamoeba keratitis. PMID- 3307435 TI - The nationwide study of epikeratophakia for myopia. PMID- 3307436 TI - Efficacy of vision therapy in amblyopia: a literature review. AB - In this paper the major optometric, ophthalmologic, and orthoptic literature on the efficacy of vision therapy for amblyopia has been surveyed. Over the past four decades there are many examples of the successful treatment of amblyopia in the form of well documented individual case reports or large sample studies. Although occlusion of the dominant eye has been applied universally, there are some instances of the successful use of minimal occlusion combined with extensive visual-motor therapy. Overall, the results of the literature review strongly support the use of active vision therapy as an integral part of the clinical treatment of amblyopia. PMID- 3307437 TI - Efficacy of vision therapy for nonstrabismic vergence anomalies. AB - A review of the literature published in the past 15 years was carried out to determine the effect of visual training on vergence measurements for nonstrabismic patients. Results of cited studies are summarized. PMID- 3307438 TI - Management of binocular anomalies: efficacy of vision therapy in the treatment of accommodative deficiencies. AB - This paper is a review of the literature supporting vision therapy as an effective treatment mode for accommodative deficiencies. Vision therapy procedures have been shown to improve accommodative function effectively and eliminate or reduce associated symptoms. In addition, the actual physiological accommodative response variables modified by the therapy have been identified, eliminating the possibility of Hawthorne or placebo effects accounting for treatment success. Finally, the improved accommodative function appears to be fairly durable after treatment. PMID- 3307439 TI - Management of binocular anomalies: efficacy of vision therapy, exotropia. AB - This paper presents a survey of the literature on management of the various forms of exotropia. Criteria for success of treatment are examined. A table summarizing the results of 11 studies is given. PMID- 3307440 TI - Houston Myopia Control Study: a randomized clinical trial. Part II. Final report by the patient care team. AB - In a randomized clinical trial designed to test the efficacy of bifocal lenses for the control of juvenile myopia, each of 207 children between the ages of 6 and 15 years wore single vision lenses, +1.00 D add bifocals, or +2.00 D add bifocals for a period of 3 years. For the 124 subjects who completed the study, the mean changes in refraction were found to be -0.34 D per year for subjects wearing single vision lenses, -0.36 D per year for those wearing +1.00 D add bifocals, and -0.34 D per year for those wearing +2.00 D add bifocals. These differences were not statistically significant. When subjects in all three treatment groups were combined, it was found that the rate of progression tended to be the most rapid for subjects who entered the study at an early age with a large amount of myopia, and tended to be the least rapid for subjects who entered the study at a later age with a small amount of myopia. It was also found that subjects having with-the-rule astigmatism progressed more slowly than those having no astigmatism or against-the-rule astigmatism. PMID- 3307441 TI - A review and a suggested classification system for myopia on the basis of age related prevalence and age of onset. AB - Systems for the classification of myopia are usually based on etiological dichotomies such as hereditary vs. environmental, physiological vs. pathological, structural vs. functional, or axial vs. refractive. The purpose of this paper is to propose a system for the classification of myopia based not on assumed etiological factors but on readily available and easily verifiable information, including age-related prevalence and age of onset. The proposed system classifies myopia into four categories: congenital, youth-onset, early adult-onset, and late adult-onset. Paradoxically, such a classification, being devoid of etiological assumptions, may help to make possible a better understanding of the etiology of the various categories of myopia. PMID- 3307442 TI - Tumor cell growth fraction in Hodgkin's disease. AB - The growth fraction of tumor cells was studied in 45 cases of Hodgkin's disease by means of a recently developed double immunostaining technique using monoclonal antibody Ki-1, which reacts selectively with Hodgkin and Reed-Sternberg cells in tissues affected by Hodgkin's disease, and antibody Ki-67, which recognizes a cell proliferation-associated nuclear antigen. The medians of the growth fractions of the tumor cells in all histologic subtypes of Hodgkin's disease varied between 78% and 83%. In none of the cases investigated did we find a growth fraction below 50%. Furthermore, mononucleated Hodgkin cells as well as multi-nucleated Reed-Sternberg cells showed a similar Ki-67 labeling index, indicating that both tumor cell types belong to the proliferating pool of this malignancy. PMID- 3307443 TI - Human spleen contains phenotypic subsets of macrophages and dendritic cells that occupy discrete microanatomic locations. AB - Macrophages (M phi s) are an important component of the immune response and mediate numerous other functions. Phenotypic and functional subsets of circulating monocytes have been described, but few similar studies have analyzed M phi s in human tissues. By use of immunohistochemical techniques and a large number of monoclonal antibodies, the presence and distribution of phenotypic subpopulations of M phi s and dendritic cells in human spleen were assessed. The results of this study show that different subsets of M phi s and dendritic cells are present in the spleen and that some of these occupy discrete microanatomic locations. In the red pulp (RP) certain groups of antigens are expressed by different proportions of uniformly distributed M phi s in the cords. On the other hand, some antigens are present on M phi s that form clusters of variable size within the red pulp. M phi s in the splenic marginal zone (MZ) share some antigens with red pulp M phi s, but in addition express CR3, Mo-2, 61D3, and 63D3. These antigens are found on only a few RP M phi s. MZ cells expressing one antigen shared with RP M phi s (Leu-3a,b) and one present largely on the MZ cells (63D3) form clusters around small vessels; these structures resemble the so called splenic ellipsoids that may play a role in the trapping of circulating antigens. Phagocytic M phi s (tingible body M phi s) of the white pulp follicular germinal centers were also shown to differ from RP and MZ cels with respect to the expression of the antigens detected by anti-FcR, Leu-M3, Mo-2, 25F9, and anti CR3. The unique topographical and surface antigenic features of dendritic cells were confirmed by this study. Furthermore, these cells were found to share a number of antigens with RP, MZ, and white pulp M phi s, which suggests that they may be derived from a common progenitor. The presence of phenotypic subpopulations and variation in distribution among human splenic phagocytic cells and dendritic cells may be indicative of functional specialization. PMID- 3307444 TI - Perinatal hemochromatosis. Clinical, morphologic, and quantitative iron studies. AB - Three sibling and two isolated-case perinates (4 newborn, 1 stillborn) died with siderotic cirrhosis and widespread parenchymal siderosis, the latter similar to that seen in both hereditary and secondary hemochromatosis. Reticuloendothelial siderosis was absent, as occurs in primary hemochromatosis. Studies of iron metabolism were performed antemortem in two of the siblings and ante-, post- and internatally in their mother, who showed hyperferremia antenatally. The only finding in the affected family suggestive of hereditary hemochromatosis was the commonly associated HLA haplotype (A3, B7) in the mother and an infant. Liver morphology, including immunocytochemistry and ultrastructure, was similar in the 5 infants and suggested that liver disease commenced as massive necrosis in midfetal life. Histologic grading and chemical assays for iron and copper on liver and spleen of the 5 index cases were compared with 26 controls; placentas were compared with 12 control placentas. Hepatic iron concentration, but not hepatic copper concentration, was significantly increased in index cases, compared with controls. Hepatic iron to copper ratio was significantly increased in index cases, compared with controls, but this ratio was unaltered in spleen and placenta. Total hepatic iron, but not total hepatic copper, was significantly increased in index cases, compared with a subgroup of 11 controls of low gestational age, similar to the fetal stage when liver disease commenced in utero. The results suggest that, irrespective of the fetal liver disease being genetic or acquired, hepatic iron overload was directly involved in pathogenesis. PMID- 3307445 TI - Analysis of changes in rat prostate carcinoma following hormone deprivation. AB - The R3327-H model of prostatic adenocarcinoma was employed for the study of the cellular changes that occur during induction, regression, and recurrence of prostate cancer after endocrine therapy. The present study was designed to compare the glandular and stromal elements of the relapse phase with the histologically distinct early and intermediate phases of tumor progression. Morphometric analysis revealed significant differences between all three groups in the percentages of total tumor occupied by the epithelial component. At all three time periods, high-power inspection of autoradiograms prepared after incubation of the tissues with radioactive dihydrotestosterone revealed large cells in the stroma, especially in the intermediate phase. Immunohistochemistry further revealed evidence of invasion across the prostatic acinar basement membranes by similar cells. These studies lead the authors to postulate a mechanism by which hormone-independent cells in the epithelium repopulate the stroma, causing a recapitulation of the original morphology of the tumor in the postremission period. They propose that prostate tumor response to estrogen therapy can be operationally defined in three phases: involution, rebound, and relapse. They infer that further knowledge of the timing of these phases may permit early selective use of specific therapeutic strategies which will be able to balance the clinical risk with the known behavior of the neoplasm during progression of the disease. PMID- 3307447 TI - Overview of inner ear disease. PMID- 3307448 TI - The UCSF/Storz cochlear implant: patient performance. AB - Clinical trials of the UCSF/Storz multichannel cochlear implant were initiated in February 1985, under the sponsorship of Storz Instrument Company. This four channel device uses simultaneous bipolar, radial stimulation and a vocoder-based speech processing scheme. To date, eighteen patients have been implanted with the UCSF/Storz implant at four clinical centers in the United States. Based on data accumulated through June 1986, fifteen of these patients had received their speech processors and were given at least an initial evaluation of their performance with the implant. Results have been very encouraging, with all but two of these patients obtaining some degree of open-set auditory-only speech recognition. Most patients have demonstrated improvement over time without extensive rehabilitative intervention and all patients have attained an enhancement in lip-reading ability, as measured with a tracking procedure. According to a self-rated performance scale, all patients have experienced improvement in general communicative function since receiving the implant. PMID- 3307449 TI - The Prosper Meniere Society Gold Medal Honor Award banquet in honor of William F. House, M.D. PMID- 3307446 TI - DNA aneuploidy in Hodgkin's disease. A multiparameter flow-cytometric analysis with cytologic correlation. AB - In 15 cases of Hodgkin's disease, the authors studied the DNA content of isolated nuclei from deparaffinized tissue by using multiparameter flow cytometry. An antinucleolar antibody preparation was employed as well as a secondary antibody that had been conjugated with fluorescein isothiocyanate. By simultaneously quantitating nucleolar fluorescence and DNA content, rare but distinct aneuploid populations were detected among the nuclei with brightly stained nucleoli. DNA aneuploidy was found in each case when this multiparameter analysis was used, but was detected in only 1 case when DNA content was analyzed alone. With the multiparameter analysis, two to four aneuploid populations were found in each case. These populations exhibited incremental duplications of DNA content that suggested endopolyploidy, ie, replication of DNA without accompanying nuclear division. The aneuploid stem line was hypodiploid or hypotetraploid in 6 cases, hyperdiploid in 7 cases, and near-triploid in 2 cases. These various abnormalities in ploidy showed only some correlation with histologic subtypes. Cell sorting showed that some nuclei with more than four or nearly eight times normal DNA content resembled nuclei of typical Reed-Sternberg cells. Many nuclei with an intermediate aneuploid DNA content resembled nuclei of mononuclear Reed Sternberg cells. The near-diploid and near-triploid nuclei corresponded to nuclei of cells which were not readily recognizable as neoplastic in histologic sections. It is concluded that multiparameter analysis of DNA content can provide further insights into the neoplastic cells in Hodgkin's disease and may offer an objective basis for studying heterogeneity in this disorder. PMID- 3307450 TI - A distal nephron glycoprotein that has different cell surface distributions on MDCK cell sublines. AB - Monoclonal antibodies that recognize three distinct epitopes of a 23-kDa glycoprotein (gp23) on the plasma membrane of MDCK cells were used to study cell surface polarity. Immunofluorescence microscopy of MDCK cells obtained from the American Type Culture Collection demonstrated that gp23 was nonpolarized in approximately 50% of the cells (on both apical and basolateral membranes), whereas, in the remaining cells, gp23 had a polarized distribution (basolateral only). This heterogeneous gp23 cell-surface staining was not observed in a variety of other MDCK sublines. Instead, gp23 was found to have a nonpolarized distribution on MDCK cells that produced monolayers with low transepithelial electrical resistances (less than 220 omega X cm2) and was localized only to the basolateral membrane of MDCK cell lines capable of generating considerably higher transepithelial electrical resistances (770-2,220 omega X cm2). Immunofluorescence and immunoelectron microscopy of dog, rat, and rabbit kidney demonstrated that gp23 is a nephron segment-specific glycoprotein localized only to the distal and collecting tubules. These observations provide further evidence for the heterogeneity of the MDCK cell line. They also support a proposal that the origin of MDCK cells is the renal distal nephron. PMID- 3307451 TI - Reversible MM-creatine kinase binding to cardiac myofibrils. AB - Skinned rat papillary muscles and purified preparations of rat cardiac myofibrils were used to study the nature of the interaction of creatine kinase with cardiac myofibrils. High activity of creatine kinase (2 IU/mg protein in fibers and 0.9 IU/mg in purified myofibrils) was due mostly to reversibly bound enzyme. This activity could be removed and rebound. The process of creatine kinase rebinding was characterized by apparent Km value of 0.14 mg/ml (approximately equal to 2 X 10(6) M). Rebinding of creatine kinase to cardiac myofibrils restored the phenomenon of functional compartmentation of adenine nucleotides in myofibrillar space and restored the ability of phosphocreatine to decrease the rigor tension in the presence of MgADP. The physiological experiments with quick length changes showed that rebinding of creatine kinase to skinned papillary muscle also restored Ca sensitivity, increased maximal tension development, decreased stiffness, and restored the tension recovery after quick length changes in muscle under condition of inhibition of endogenous creatine kinase by 1-fluoro-2,4 dinitrobenzene. It is concluded that creatine kinase reversibly bound to cardiac myofibrils is involved in the energy supply for cardiac contraction. PMID- 3307452 TI - Dissociation of in vitro sensitivities of glucose transport and antilipolysis to insulin in NIDDM. AB - It is unclear from previous studies whether qualitative or only quantitative differences exist in insulin action in adipocytes obtained from obese subjects with non-insulin-dependent diabetes mellitus (NIDDM) when compared with equally obese nondiabetic subjects. In addition, the role of changes in insulin binding as a cause of insulin resistance in NIDDM is still controversial. We compared the sensitivities of glucose transport and antilipolysis to insulin and measured insulin binding in abdominal adipocytes obtained from 45 obese nondiabetic (% fat, 41 +/- 1), 25 obese diabetic (% fat, 40 +/- 1), and 15 nonobese (% fat, 30 +/- 1) female southwestern American Indians. Compared with the nonobese group, the sensitivities of glucose transport and antilipolysis were reduced in both the obese nondiabetic and obese diabetic groups. Compared with the obese nondiabetic subjects, the ED50 for stimulation of glucose transport was higher in the obese patients with NIDDM (171 +/- 38 vs. 92 +/- 10 pM, P less than 0.005). In contrast, the ED50s for antilipolysis were similar in obese diabetic patients (32 +/- 6 pM) and obese nondiabetic subjects (27 +/- 3 pM). No difference was found in insulin binding in patients with NIDDM when compared with the equally obese nondiabetic subjects. These data indicate 1) the mechanism of insulin resistance differs in NIDDM and obesity, and 2) the selective loss of insulin sensitivity in NIDDM precludes changes in insulin binding as a cause of insulin resistance in this disorder. PMID- 3307453 TI - Muscle glycogen repletion during active postexercise recovery. AB - High-intensity intermittent bicycle exercise was used to deplete muscle glycogen levels by 70% and elevate blood lactate levels to greater than 13.0 mmol/l. Thereafter subjects either cycled with one leg for 45 min followed by 45 min of passive recovery (partially active recovery) or rested for 90 min (passive recovery). During the first 45 min of partially active recovery 1) blood lactate (P less than 0.05) and pH levels (P less than 0.05) returned more rapidly to preexercise values than during passive recovery, 2) the rate of net glycogen resynthesis (0.28 mumol . g-1 . min-1) was the same in both legs, and 3) muscle lactate levels were significantly lower (P less than 0.05) in the passive than in the active leg. Thereafter the rate of net muscle glycogen resynthesis was unchanged (0.26 mumol . g-1 . min-1) and lactate removal could theoretically account for only 18% of the glycogen resynthesized. Overall, the rate of muscle glycogen resynthesis and muscle lactate removal was not different from that measured during passive recovery. After high-intensity exercise 1) glycogen repletion is not impeded by light exercise, and 2) blood glucose is an important substrate for glycogen resynthesis. PMID- 3307454 TI - Differences between in vitro and in vivo degradation of LHRH by rat brain and other organs. AB - Homogenates of brain, pituitary, liver, lung, ovary, and testes were incubated with [pyro Glu1-3,4-3H]luteinizing hormone-releasing hormone ([3H]LHRH), and the profiles of metabolites generated as a function of time were determined. After 5 min of incubation, 5 was the predominant metabolite in most homogenates. Although the profiles of metabolites varied at different time intervals, metabolites 2, 3, 4, and 5, and in some instances 7 and 9, appeared to form simultaneously and were detectable at 10 min. Neither metabolite 6 nor other larger metabolites formed initially as dominant degradation products. The findings suggest cleavage of LHRH by the simultaneous action of several endopeptidases. After a single vascular transit of [3H]LHRH, metabolites were determined in the venous blood of liver, lung, and brain of rats in vivo. There were no metabolites of [3H]LHRH in venous blood of liver and lung; however, metabolites 2-4 were present in venous blood of the brain. Incubation of rat anterior pituitary cells with [3H]LHRH yielded metabolites 1-4 but not metabolites 5 or 9 as in homogenates. Incubation of [3H]LHRH with porcine follicular granulosa cells resulted in the generation of metabolites 2-7 and 9, similar to the profile in homogenates. Thus, since homogenates contain enzymes of disrupted cells, they do not always reflect mechanisms for in vivo hydrolysis of circulating LHRH. Brain degraded 12.1% of LHRH during a single vascular transit and may account for substantial degradation of the circulating hormone. PMID- 3307455 TI - Segmental synthesis and actions of prostaglandins along the nephron. AB - The sites of synthesis and action of prostaglandins (PGs) along the renal tubule are examined. We focused our attention on experiments performed on well-defined nephron segments, using direct quantitative measurements of prostaglandin synthesis by radio- or enzyme-immunoassay. On the other hand, we selected, among the described effects of PGs, those obtained on precisely defined tubular segments. Among PGs, PGE2 synthesis is largely predominant all along the tubule. Its main sites of synthesis are the medullary collecting tubule and, to a lesser extent, the cortical collecting tubule and the thin limb of Henle's loop. Synthesis of PGE2 is amplified approximately tenfold in the presence of an excess exogenous substrate, arachidonic acid, compared with values measured without addition of substrate. Other eicosanoids have roughly the same distribution along the tubule as PGE2. Their rate of synthesis is, however, much less than that of PGE2, approximately 20-fold lower for PGF2 alpha and 6-keto-PGF1 alpha, and 100 fold lower for thromboxane B2 (TxB2). This contrasts with glomerular PG synthesis, where the difference between the production of PGE2 and other eicosanoids is much less marked. Most studies agree that antidiuretic hormone (ADH) and kinins augment PGE2 synthesis, whereas corticosteroids decrease it, at least in the collecting tubule. Direct effects of PGE2 have been described mainly in the medullary thick ascending limb and collecting tubule. They generally consist of a decrease in transepithelial potential difference and reabsorptive rates of water and solutes, in particular sodium and chloride. However, whatever the solute or tubular segment concerned, some studies failed to find such effects. The bulk of evidence suggests that ADH and PGs interact in kidney tubular cells. It is generally accepted that PGs antagonize the hydrosmotic effects of ADH in the collecting tubule. The mechanisms underlying these complex interactions are still under discussion: they probably involve several types of receptors and pathways for ADH action, which intervene in the modulation of both PG synthesis and cyclic nucleotides, and several types of PG receptors, either stimulatory or inhibitory to adenylate cyclase. PMID- 3307456 TI - Use of ultrasound for noninvasive study of blood vessel responsiveness. AB - To provide a noninvasive means for studying individual macroscopic blood vessels, an ultrasound scanner was modified to provide a recording of blood vessel diameter. The instrument has A- and B-modes of signal display. The B-mode is used to position the probe and the A-mode to measure vessel diameter. The A-mode has two electronic gates for tracking the echo from each of two structures, i.e., near and far wall of vessel. The front gate was modified to pick up the falling rather than rising edge of a peak generated by the vessel wall. An analog signal proportional to the distance between gates was derived for recording with a strip chart recorder. Probe holders were constructed to optimize positioning and holding of probe. Stability was excellent (reading varied 0.05 mm over 1 h). Axial resolution was between 0.3 and 0.73 mm. Discrepancy of measurements of plastic tubing made by ocular and ultrasound varied from 1.1 to 4.6%. Discrepancy with lightly fixed vessels was 2.7-8.2%. Ex vivo measurements on vessels with viable smooth muscle were more variable, perhaps because of actual change during measurements. Changes in vessel diameter induced by change in hydrostatic pressure and exposure to histamine were recorded. PMID- 3307457 TI - Why do total-body decay curves of iodine-labeled proteins begin with a delay? AB - The initial delay that occurs in total-body radiation curves reaching their single-exponential slopes was analyzed from 106 experiments involving several mammalian species (guinea pig, mouse, rabbit, and rat) and plasma proteins (alpha 1-acid glycoprotein, antithrombin III, fibrinogen, immunoglobulin G, and transferrin) in 14 different combinations. The time interval (Td) between injection and the intercept of the slope with the full-dose value was adopted as a measure of curve nonideality. The overall mean Td was 6.6 h, but individual values showed a significant correlation to protein half-lives, whereby proteins of unequal metabolic properties exhibited different mean Td values. Targeting protein to the liver abolished delay. Choice of the isotope (125I or 131I) and size of the labeled protein had no influence on the magnitude of delay. Whole body radiation curves of animals that received [125I]iodotyrosines, Na131I, or 131I-polyvinylpyrrolidone exhibited no initial delays. These results do not support the earlier notion that delay is caused by a redistribution of the labeled protein in the body to radiometrically more favorable sites. However, they are compatible with the assumption that delayed passage of a protein dose through the extracellular matrix and/or retarded transfer of proteolytic products from extravascular catabolic sites to plasma may be responsible for the phenomenon. PMID- 3307458 TI - Behavioral and metabolic effects of sucrose-supplemented feeding in hyperactive rats. AB - Two hyperactive rat strains [spontaneously hypertensive rats (SHR) and SHR-Wistar Kyoto cross (WK-HA)] and their nonhyperactive genetic control strain (Wistar Kyoto) were fed ad libitum sucrose-supplemented rat chow, or chow alone in controls, to determine the effects of dietary sugar on behavior. The diets were given either overnight (acute sugar) or for 14-18 days (chronic sugar), and testing was carried out on the morning after each of the dietary schedules. The metabolic studies revealed significant strain, sex, and age differences in appetite for sucrose, caloric intake, postprandial plasma levels of glucose and insulin, and weight gain after sucrose feeding. The findings indicate that sugar feeding led to increased plasma glucose and insulin levels; however, total caloric intake was decreased, and less weight gain was observed than in chow-fed controls, particularly among the hyperactive strains. In behavioral tests, sugar feeding did not alter spontaneous activity levels in any of the strains after either acute or chronic diets. There were also no significant effects of sucrose consumption on spatial learning and memory in a plus-shaped maze as determined by use of a shock-avoidance paradigm. The only significant behavioral effects of sucrose observed were an impairment in habituation and distractibility among the WK-HA females, the most hyperactive group among these strains. PMID- 3307459 TI - Glucose-induced norepinephrine levels and obesity resistance. AB - The value of glucose-stimulated sympathetic activation in differentiating rats that would subsequently resist or develop diet-induced obesity (DIO) when chronically fed a high-calorie diet (CM) enriched in fat and sucrose was tested in 3-mo-old male Sprague-Dawley rats. While the rats were on chow the areas under the curve for plasma glucose, insulin, and norepinephrine (NE) levels were measured for 60 min after an intravenous glucose load (1 g/kg). Half of the rats then switched to the CM diet for 14 wk developed DIO with 54% more weight gain and 205% heavier retroperitoneal fat pads; half [diet resistant (DR)] had weight gain and pad weights comparable to chow-fed controls. Caloric intake was comparable in all animals. NE areas after intravenous glucose loads were 54% lower in DR than DIO rats, and there was a positive correlation (r = 0.63) between these NE areas and subsequent weight gain on the CM diet. Areas under the insulin curve correlated with subsequent weight gain on chow (r = 0.71) but not the CM diet. These results suggest that rats predisposed to become DR on the CM diet have dampened sympathetic activation after a glucose load, possibly because of heightened end-organ responsiveness to NE. PMID- 3307460 TI - Dynamic and static phases of obesity following lesions in PVN and VMH. AB - The effect of electrolytic lesions in the ventromedial hypothalamus (VMH) and the paraventricular nucleus (PVN) has been compared during both the dynamic and static phase of weight gain. Hyperphagia and weight gain were greater in the VMH lesioned rats than in the PVN-lesioned rats. Food intake increased at night after both lesions but increased in the daytime only in VMH-lesioned rats. During the dynamic phase of rapid weight gain, the diurnal pattern of corticosterone was blunted to a similar degree in both lesioned groups. The morning insulin concentrations were higher in both lesioned groups than in the sham-operated controls, but in the static phase only the VMH-lesioned rats had higher insulin levels. In the afternoon the insulin was higher in the VMH-lesioned rats than in either the sham-operated or PVN-lesioned rats. In the dynamic phase the weight of interscapular brown adipose tissue was significantly increased in the VMH lesioned rats, but the specific GDP binding was depressed both in the morning and afternoon when compared with either the sham-operated or PVN-lesioned groups. In both the dynamic and static phases GDP binding was similar in sham-operated and PVN-lesioned animals. The differences in concentration of corticosterone in morning and afternoon were smaller in the lesioned groups than in the controls. These data are consistent with the hypothesis that animals with PVN lesions do not show the disturbances in food intake or in the autonomic nervous system that characterize the VMH-lesioned rats. PMID- 3307461 TI - Alterations in immunocompetence during stress, bereavement, and depression: focus on neuroendocrine regulation. AB - There is now clear evidence that stress, bereavement, and depression can compromise specific components of the immunologic apparatus. The first part of this paper gives an overview of fundamental immunology and is followed by a review of the patterns, possible causes, and potential clinical implications of abnormal immunoregulation. After a discussion of the immunomodulating properties of glucocorticoids, the authors conclude with an overview of the many factors that mediate the complex interdependence between immunologic function, the brain, and neuroendocrine regulation. PMID- 3307462 TI - Current status and future directions of research on the American Indian child. AB - American Indians are the most severely disadvantaged of any population within the United States. By adolescence, Indian children show higher rates of suicide, alcoholism, drug abuse, delinquency, and out-of-home placement. School achievement is severely compromised, and many youths drop out before graduation from high school. The Indian child understands the environment through intuitive, visual, and pictorial means, but success in the Anglo school is largely dependent on auditory processing, abstract conceptualization, and language skills. This difference compounds existing problems of poverty, dislocation, alienation, depression and intergenerational conflict and can partially account for the higher rate of emotional and behavioral problems among Indian adolescents. PMID- 3307463 TI - Amyloid tumor of the spleen. AB - An unusual case of amyloid tumor of the spleen that developed in a patient with malignant lymphoma is reported. A splenectomy performed for a persistent splenic lesion after an otherwise complete response to chemotherapy revealed the amyloid tumor. To our knowledge, amyloid tumor has not been previously described in the spleen. PMID- 3307464 TI - Diagnostic criteria for liver allograft rejection. PMID- 3307465 TI - Reminiscences and ruminations: vascular surgery then and now. PMID- 3307466 TI - Use of ultrasonic venography in the evaluation of venous valve function. AB - Forty healthy limbs and 31 limbs with suspected deep venous insufficiency were imaged with real-time B-mode ultrasound to determine valve location, anatomic characteristics, and function. Valve function was evaluated by comparison with Doppler ultrasonographic techniques, and the data clearly indicated that ultrasonic venography accurately localized and determined the extent of deep venous reflux. Ascending contrast venography was performed in 15 postphlebitic limbs for assessment of valve location. The results indicate that ultrasonic venography is a more accurate method for visualization of valves in this group of patients. Therefore, ultrasonographic imaging is a valuable technique for evaluating limbs with chronic venous insufficiency. PMID- 3307467 TI - Use of the short saphenous vein in situ for popliteal-to-distal artery bypass. AB - In the absence of a usable greater saphenous vein, the short saphenous vein has been relatively ignored for use as an arterial bypass conduit. In 36 patients, duplex ultrasound scanning was used for preoperative assessment of the short saphenous vein. The internal diameter of the vein ranged from 2.8 to 4.2 mm. The short saphenous vein was harvested for a free vein graft in 31 patients. In the remaining five patients, the short saphenous vein was used in situ for popliteal to-distal artery bypass. In four patients, the distal anastomosis was performed to the distal anterior tibial artery and in one patient, to the distal posterior tibial artery. Valves were excised with valvulotomes and deep fistulas were easily ligated. A medial incision for vein exposure was the preferred approach. We suggest that the short saphenous vein be considered more often for use as an arterial bypass conduit when the greater saphenous vein is not available, before submitting to nonautogenous bypass or primary amputation. PMID- 3307468 TI - Evolution of the in situ bypass. AB - The origins of the in situ vein bypass in Montreal, Canada and in London, England, are described. The subsequent evolution of the original techniques in Europe and the United States are followed. The condemnation of the procedure in the United States in 1969 is noted. The persistence of Cartier in Montreal and Hall in Norway and the revival of interest in the procedure by Leather and Karmody in Albany, New York, is recounted. The pathophysiologic basis for the complications of the method are analyzed and the measures by which they are currently remedied are shown. The method's present superiority is reported. The initial rejection and slow acceptance of this method is explained in terms of the special conditions attendant on its introduction and the attitudes of surgeons to new procedures. PMID- 3307469 TI - Technique for intraoperative localization of urinary leakage. AB - Urinary leakage is an uncommon complication of renal transplantation with a near equal division occurring between ureteral and bladder origins. The diagnosis is usually entertained from a characteristic clinical course and confirmed by preoperative contrast cystography or radionuclide scanning. A technique for precise intraoperative localization of the site of urine extravasation using intracystic instillation of Intralipid has been described. It allows easy recognition without damaging or staining surrounding tissues. In addition, this technique may be applied in other situations to confirm anastomotic or hollow viscus closures. PMID- 3307470 TI - The letters of William Stewart Halsted and John Chalmers DaCosta. AB - William Stewart Halsted and John Chalmers DaCosta are two of the most distinguished surgeons in the history of medicine in the United States. Although their personalities were completely opposite, they enjoyed a long and devoted friendship. During their relationship, a fairly continuous correspondence was maintained. This essay has examined their friendship through an analysis of their personal letters, which are published herein for the first time. PMID- 3307471 TI - Pleural fluid pH: diagnostic, therapeutic, and prognostic value. AB - Measurement of pleural fluid pH has diagnostic, therapeutic, and prognostic implications in exudative pleural effusions (Table II). A parapneumonic effusion with a pleural fluid pH below 7.2 indicates an empyema is forming which necessitates chest tube drainage in all patients, whereas a pleural fluid pH over 7.3 does not require drainage. If the pH of a parapneumonic effusion is 7.2 to 7.3, serial pleural fluid pH measurements with clinical observation will help to determine the need for chest tube drainage. A pleural fluid glucose level of below 60 mg/dl and a lactic dehydrogenase level over 1,000 IU/dl in conjunction with a pleural fluid pH of 7.2 to 7.3 indicate an impending empyema. These findings are consistent with our clinical experience in patients with parapneumonic effusion. Tuberculous pleural effusions had a pleural fluid pH below 7.4 in all reported patients. This pH may be of value in distinguishing tuberculous pleural effusions from recent malignant effusions, which tend to have a higher pleural fluid pH, particularly if used in conjunction with other pleural fluid values, cell counts, and other clinical parameters. In patients with malignant pleural effusions, a pH of less than 7.3 is usually seen in those effusions present for several months and is associated with a lower glucose level and a higher white cell count and lactic dehydrogenase level. Results of cytologic study of the pleural fluid and pleural biopsy are often positive, there is poor response to sclerosing agents, and the prognosis is poor. A rheumatoid pleural effusion most often has a pleural fluid pH below 7.3. A pleural fluid pH below 6 is seen almost exclusively in esophageal rupture but rarely with empyemas, whereas a pleural fluid pH below 7 occurs in esophageal rupture, empyema, and rheumatoid pleural effusions. In pleural effusions secondary to congestive heart failure, the pH is almost always greater than 7.4 unless systemic acidemia coexists, in which case the pleural fluid pH is within 0.04 units of the simultaneous arterial pH. The major value of pleural fluid pH is to determine the need for chest tube drainage in parapneumonic effusions and to determine the response to sclerosing agents in patients with malignant pleural effusions. As with all diagnostic tests, the results should be interpreted in the context of other diagnostic tests of the pleural fluid and clinical aspects before diagnostic or therapeutic decisions are made. PMID- 3307472 TI - The physician's role in physical activity, physical fitness and health. PMID- 3307473 TI - History of medicine in Alaska. Vernon A. Cates, M.D. PMID- 3307474 TI - Nelson Paul Anderson (1899-1957). PMID- 3307475 TI - Medical mumbo jumbo in the comedies of Moliere. PMID- 3307476 TI - The man behind the eponym. Paul Langerhans. Life and work. Part III: Scientific research, marriage, and death. PMID- 3307477 TI - The man behind the eponym. Paul Langerhans. Life and work. Part IV: Publications. PMID- 3307478 TI - Evaluation of a method for controlled tissue embedding for histologic evaluation of tumor margins. AB - Controlled tissue embedding is a method which facilitates the histologic search of margins of excised skin and subcutaneous tissue for evidence of tumor extensions. Used on frozen unfixed specimens, data obtained from a study of 141 sections made from 32 excised tumors show that controlled embedding allows for adequate assessment of surgical margins in less time and with less tissue cutting as compared to conventional methods. PMID- 3307479 TI - Epidermolysis bullosa acquisita. Direct immunofluorescence and ultrastructural studies. AB - A case of epidermolysis bullosa acquisita (EBA), associated with inflammatory bowel disease in which cicatricial alopecia was present, was studied by electron microscopy and direct immunofluorescence microscopy. Direct immunofluorescence studies were performed on both clinically normal and perilesional skin, with and without previous separation of the epidermis from the dermis by incubation with 1 M sodium chloride. We propose the use of this separation technique to identify the level of antibody deposition in patients with EBA in whom circulating antibodies are lacking. This technique may be particularly beneficial in delineating between EBA and the clinically similar scarring localized forms of bullous pemphigoid in which circulating antibodies are often absent. PMID- 3307480 TI - Immunofluorescence of the nail bed in pemphigoid. AB - A case of pemphigoid is described which is complicated by ulcerative colitis and a cicatrizing nail dystrophy. A longitudinal nail biopsy revealed linear deposits of C3 and IgM at the basement membrane zone. The relevance of these findings is discussed. PMID- 3307482 TI - The sculptured sponge technique: a simple method for orienting specimens during histological processing. PMID- 3307481 TI - Reminiscences and caricatures of American dermatopathologists. PMID- 3307483 TI - Conjunction of biomedical and behavioral sciences: can research on alcoholism show the way? PMID- 3307484 TI - Neuroglial and neuroblastoma cell lines are capable of metabolizing ethanol via an alcohol-dehydrogenase-independent pathway. AB - Two neuroglial cell lines (U-251 MG and C6) had a substantial capacity to convert ethanol to acetate in vitro largely by an alcohol dehydrogenase (ADH)-independent mechanism and three neuroblastoma cell lines (IMR-32, NB41A3, and Neuro-2a) had a lesser but significant ethanol-metabolizing capacity which was also either partly or largely ADH-independent. The ADH-independent pathway of ethanol metabolism by neural cells appeared to be dependent on one or more isoenzymes of cytochrome P 450. The data emphasize the possibility that the neurotoxicity of ethanol may be related to a relatively high ethanol-metabolizing capability of neural tissue and particularly of neuroglial cells. PMID- 3307485 TI - Effects of alpha-methylparatyrosine on voluntary consumption of ethanol, water, and solid food in UChA and UChB rats. AB - The effect of daily doses of 80 mg/kg (intraperitoneal) of alpha methylparatyrosine, AMPT (inhibitor of tyrosine hydroxylase) on the voluntary consumption of ethanol, water, and solid food was studied in rats of both sexes belonging to the UChA (lower ethanol consumer) and UChB (high ethanol consumer) strains. The consumptions during the treatment period were compared to those of the preceding one (basic). Decrease of ethanol and solid food intake and increase of that of water in UChB rats and only a decrease of solid food intake in UChA rats were observed. These effects cannot be ascribed to blocking of dopaminergic or noradrenergic synapses, since this dose of AMPT inhibits the in vivo synthesis of both catecholamines. PMID- 3307486 TI - Two generations of maternal alcohol consumption in mice: effect on pregnancy outcome. AB - This study investigated whether female offspring of alcohol-treated mothers are, themselves, more or less susceptible than control offspring to the deleterious effects of alcohol on the outcome of their own pregnancy. One group of pregnant C57BL mice was fed a liquid diet containing 25% ethanol-derived calories (EDC) and another group was pair-fed an isocaloric (0% EDC) control diet. A third group was fed lab chow ad libitum (LC). The female offspring resulting from those matings were subsequently mated upon reaching 90 days of age. These pregnant mice were then separated into three prenatal treatments (25% EDC, 0% EDC, and LC). On gestation-day 19, second generation fetuses were removed by cesarean section, weighed, and sexed. Results indicated that number of implants, live births, and percent prenatal mortality did not differ between groups. However, fetal weight was lower in groups prenatally exposed to ethanol than in controls, regardless of the prenatal history of the mothers, themselves. More importantly, the data suggest that offspring of alcohol-treated mothers who do not consume alcohol themselves during their own pregnancy may still have a tendency to have offspring of lower birth weight. On the other hand, if mothers prenatally exposed to alcohol do consume alcohol during their own pregnancy, the impact of fetal weight suppression is even greater than expected for in utero alcohol exposure alone. These effects may be due to the fact that mothers who were prenatally exposed to alcohol weighed less than controls at the time of becoming pregnant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307487 TI - Effect of acute alcohol on attention and the processing of hierarchical patterns. AB - Subjects received 100-msec exposures of hierarchical patterns consisting of a large "global" letter composed of several smaller "local" letters. Subjects were to respond whether a target letter was present at the global or at the local level. In the Neutral Bias condition target letters occurred randomly and equally often at the global and local levels. In the Global Bias condition, 79% of the targets occurred at the global and 21% at the local level. In the Local Bias condition, 79% of the targets occurred at the local and 21% at the global level. Subjects indicated by pressing a key which of two target letters had appeared on that trial. Subjects received either a placebo drink, a drink containing 0.7 ml of Alcohol per kg body weight, or a drink containing 1 ml of Alcohol per kg body weight. Placebo subjects were better at detecting letters at the global than at the local level in the Global Bias condition, better at local than global in the Local Bias condition, and about equally good at both levels in the Neutral Bias condition. Alcohol had no effect on detection of letters at the local level in any of the bias conditions but reduced detection of letters at the global level except when subjects were biased globally. The data suggest that alcohol does not affect attentional capacity. Instead, alcohol seems to affect either how attentional capacity is allocated or the global processing mechanism itself. PMID- 3307488 TI - Ethanol vapor above skin: determination by a gas sensor instrument and relationship with plasma concentration. AB - Studies with a new instrument show that blood ethanol concentrations in rats and humans can be estimated by measurement of ethanol vapor above the skin. After intravenous bolus administration of ethanol (1 g/kg) to rats a novel device based on the Figaro sensor was placed above the animal's abdomen. Plasma and skin vapor ethanol concentrations, analyzed by gas chromatography and sensor, respectively, declined in parallel (r = 0.96). In healthy human subjects, plasma and skin vapor concentrations, measured on the palm, also declined in parallel after intravenous ethanol infusion (1 hr, 0.5 g/kg), r = 0.99. In 10 alcoholic liver disease outpatients attending clinic in whom plasma ethanol concentrations ranged from 32 304 mg/dl, the correlation of plasma ethanol determined directly by gas chromatography and indirectly by skin vapor analysis was slope = 0.93, intercept = 1.8, r = 0.94. In controlled studies, skin vapor measurements are comparable with breathalyzer determinations; they may be performed in situations where breathalyzer measurements are inconvenient or where continuous monitoring is desirable. PMID- 3307489 TI - Prenatal ethanol exposure affects temperature responses of adult rats to pentobarbital and diazepam alone and in combination with ethanol. AB - Long-term effects of prenatal alcohol exposure on body temperature responses to pentobarbital and diazepam and to either drug in combination with ethanol were studied in adult rats who were the offspring of dams fed a 5.0% w/v ethanol containing liquid diet during the last 2 weeks of gestation. Adult offspring of pair-fed and chow-fed dams served as nutritional and normal controls, respectively. Pentobarbital (6.25-25.0 mg/kg) and diazepam (2.5-10.0 mg/kg) produced significantly greater dose-related hypothermic responses in females than males. Following either pentobarbital or diazepam administration female prenatally ethanol-exposed (E) rats responded with a greater fall in body temperature than the controls. Significantly greater hypothermia occurred in both male and female E rats than in controls when ethanol (1.5 g/kg) was administered together with pentobarbital or diazepam. However, the drug combinations did not produce additive effects on body temperature in any prenatal treatment group. Pentobarbital produced acute cross-tolerance to ethanol while diazepam potentiated ethanol's effect. These studies confirm and extend our previous findings of enhanced hypothermic responses to ethanol in adult rats exposed to ethanol in utero and indicate that maternal alcohol consumption produces long term effects on the central thermoregulatory systems of offspring. PMID- 3307490 TI - Surfactant deficiency with decreased opsonic activity in a guinea pig model of alcoholism. AB - Chronic alcoholism was induced in guinea pigs to quantitate the effect of alcohol on lung surfactant. Animals were studied after 6 weeks of treatment with either ethanol (ETH) or isocaloric dextrose saline (DEX) injections. The amount of surfactant retrieved by bronchoalveolar lavage (BAL) was evaluated by measuring the quantity of phosphatidylcholine (PC) and disaturated phosphatidylcholine (DSPC) in the fluid. The amount of DSPC recovered from the ETH animals (40.9 +/- 10.4 micrograms/ml of BAL fluid, mean +/- SD) was significantly lower than from the DEX animals (82.7 +/- 18.6 micrograms/ml of BAL fluid, p less than 0.001). This decrease in surfactant was associated with impairment of the opsonic activity from BAL fluid in the ETH versus DEX animals using a standard assay of bacterial (Staphylococcus aureus) killing with normal polymorphonuclear leukocytes and BAL fluid as an opsonin. We conclude that in the guinea pig model of alcoholism, surfactant deficiency occurs and has physiologic importance in reduced bacterial killing. PMID- 3307491 TI - Ascorbic acid and elevated SGOT levels after an acute dose of ethanol in the guinea pig. AB - Male guinea pigs were maintained on a vitamin C-deficient chow diet and supplemented with either 0.05 or 2.0 mg of ascorbic acid/ml drinking water for 3 weeks prior to receiving an intraperitoneal injection of 4.0 g of ethanol/kg body weight. The following biochemical parameters were measured prior to, and hourly for 12 hours after, ethanol administration: serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvate transaminase (SGPT), serum triglycerides, and blood ethanol clearance. The animals were killed 12 hours after ethanol administration and liver weight to body weight ratios and hepatic ascorbic acid concentrations determined. Acute ethanol administration resulted in a 12-fold increase in SGOT levels in animals with hepatic ascorbic acid concentrations at or below 16 mg/100 g of liver. A marked reduction, 60%, in this increase was observed in animals that had concentrations of hepatic ascorbic acid above 16 mg/100 g of liver. No effect of hepatic ascorbic acid concentration was observed on elevated levels of SGPT, serum triglycerides, or blood ethanol clearance. PMID- 3307492 TI - Discriminant analysis of the Self-Administered Alcoholism Screening Test. AB - For a sample of 1156 patients (520 alcoholics and 636 nonalcoholics), discriminant function analyses were performed on the total score, a nine-item version, and a two-item version of the Self-Administered Alcoholism Screening Test (SAAST). With sensitivities set at 90 and 95%, specificities for the total score and nine-item versions ranged from 96.4 to 99.4%. Cross-validation of the nine-item version with the "jackknife" procedure resulted in only one additional misclassification of the 1156 subjects. Separate analyses of the male and female samples revealed that more items entered the discriminant function for women than for men and resulted in a higher, although clinically nonsignificant, percentage of correct classification for women. The results strongly support the use of either the total score or the nine-item version of the SAAST in large-scale screening for alcoholism in a medical patient population. PMID- 3307493 TI - Alcohol-induced changes in pituitary-adrenal activity during pregnancy. AB - This study examined the interactive effects of ethanol and nutritional status on pituitary-adrenal function of pregnant females consuming high doses of ethanol throughout gestation. Three liquid diets were formulated ranging in protein content from suboptimal to supraoptimal (18%, 25%, or 32% of total calories) in terms of pregnancy requirements, while ethanol was held constant at high levels (36% of total calories). In addition to the alcohol group (A), both pair-fed (PF) and ad libitum-fed control (C) groups were included in each diet regimen. Basal levels of corticosterone and the adrenocortical response to stress were measured in dams on days 11, 16, or 21 of gestation. Plasma levels of corticosterone binding globulin (CBG) were also measured on gestation days 16 and 21. Maternal adrenal weights, basal corticosterone levels, the adrenocortical response to stress, and the corticoid stress increment were all significantly increased in A compared to both PF and C females. Plasma CBG levels of A females were similar to or less than those of PF and C females. Thus alcohol consumption significantly increased maternal pituitary-adrenal activity as early as day 11 of gestation and these effects on hormonal function increased as gestation progressed. This adrenocortical hyperactivity was relatively unaffected by maternal nutritional status and thus appears specific to alcohol. PMID- 3307494 TI - Developmental changes in alcohol pharmacokinetics in rats. AB - Developmental changes in the pharmacokinetics of alcohol could influence the outcome of alcohol exposure during different periods of postnatal development. Hence, the development of the ability to absorb and metabolize alcohol in the rat was examined by administering an acute dose (2.5 g/kg) of ethanol in milk formula by intragastric intubation to rats of 1, 2, 4, 6, 8, 10, 15, 21, 30, and 60 days of age. Each animal in a particular litter was assigned a different time point following intubation when its blood alcohol concentration (BAC) was determined from a tail blood sample. At all ages tested, maximum BACs occurred between 1.25 and 1.5 hr following intubation. However, maximum BACs decreased with age from 155 mg/dl in 1-day-old rats to 111 mg/dl in 60-day-old rats. Furthermore, the rate of alcohol clearance was slower in the younger rats. By linear regression analysis, the elimination rate of alcohol in 1-day-old rats was estimated to be 7.5 mg/dl/hr which increased to 42.2 mg/dl/hr in 60-day-old-rats. By 8 hr following intubation, rats that were 21 days of age and older had completely cleared the alcohol, whereas the younger rats (1-15 days of age) had not. No consistent sex differences were seen in either the maximum BAC or clearance rate. Since developmental changes in the ability to clear alcohol occur throughout the first 60 postnatal days in the rat, controlling for these changes is essential when looking for critical periods of an organ's vulnerability to damage by alcohol. PMID- 3307495 TI - Serum procollagen type III N-terminal peptides and laminin P1 peptide in alcoholic liver disease. AB - The appearance of perivenular fibrosis on liver biopsy reflects the beginning of the fibrotic process that ultimately results in liver cirrhosis. To examine whether the fibrogenic activity can be detected by blood tests, we evaluated whole antibody radioimmunoassay (RIA) of procollagen type III N-terminal peptides (P-III-P), RIA of these peptides using Fab fragments (Fab-P-III-P), and RIA of the laminin P1 peptide in alcoholics within 1 week of alcohol abstinence. The Fab P-III-P levels in subjects with perivenular fibrosis were significantly higher than those in patients with simple fatty liver. Values in 63% of subjects with perivenular fibrosis exceeded the upper limit of the fatty liver group. Patients with simple fatty liver had significantly lower values than nonalcoholic controls. Serum levels of P-III-P and laminin were elevated in patients with alcoholic hepatitis and correlated well with the degree of inflammation. With abstinence, Fab-P-III-P levels increased in all alcoholics. P-III-P values increased in patients with normal P-III-P values on admission. By contrast, the values of laminin decreased during abstinence. Therefore, to interpret serum levels of Fab-P-III-P, P-III-P, and laminin, the duration of abstinence must be taken into consideration. P-III-P, Fab-P-III-P and laminin measurements in the serum within 1 week of abstinence can contribute to the detection of alcoholic liver disease and the determination of its stage. PMID- 3307496 TI - Acupuncture treatment of alcoholic recidivism: a pilot study. AB - We performed a randomized trial of acupuncture on a group of 54 hardcore alcoholic recidivists to determine if sobriety could be achieved and episodes of drinking and/or Detox Center admissions be decreased by this mode of therapy. Patients in the treatment group received acupuncture points specific for the treatment of substance abuse; control patients received nonspecific points. Significant differences in the two groups were noted at the end of the study. Patients in the treatment group expressed less need for alcohol (p less than 0.003), and had fewer drinking episodes (p less than 0.0076) and admissions to the Detox Center (p less than 0.03) during the study than did control patients. The majority of treated patients felt that acupuncture had a definite impact on their desire to drink, whereas only a few control patients noted this effect (p less than 0.015). The results of this study suggest that acupuncture may be able to interdict the cycle of alcoholic recidivism. Further investigation is needed to define the role of acupuncture in the treatment of alcoholism more precisely. PMID- 3307497 TI - Neuroendocrine, psychophysiological and subjective reactivity to an alcohol placebo in male alcoholic patients. AB - Alteration in neuroendocrine activity associated with the regulation of energy metabolism and food intake may play a role in characterizing the alcohol dependent state. Alcoholics, when compared to controls, demonstrated significantly larger and more rapid glucose and insulin responses following the consumption of a placebo beer, which they believed contained alcohol. The existence of significant correlations between peak neuroendocrine responses and desire to drink, anxiety, as well as psychophysiological responses in alcoholics suggests the potential multivariate nature of the biological/behavioral state associated with alcohol dependence. PMID- 3307498 TI - Liver toxicity encountered in the Veterans Administration trial of disulfiram in alcoholics. AB - Alcoholic subjects (453) were randomly assigned to disulfiram or placebo therapy and followed for up to 12 months for drinking. Drinking status was determined from interviews of the subject and a household contact each 2 months and from the analysis of eight blood samples or 39 urines submitted at intervals during the year. Liver status was monitored each 2 months by obtaining serum alkaline phosphatase, bilirubin, and AST. Sensitive criteria were arbitrarily selected to identify about 1/5 of the patients with episodic elevations of liver tests. There was no relationship of liver test elevations to disulfiram treatment. However, the elevated AST related significantly to drinking status (p = 0.004) as did elevated bilirubin (p = 0.044), but not elevated alkaline phosphatase (p = 0.146). Two hundred one patients had liver test elevations at least one time and were continued on drug, four were dropped. One hundred seventy-nine of these patients were drinking, 22 were abstinent, and four were indeterminant. It is concluded that patients on disulfiram with minor liver test abnormalities are usually drinking. PMID- 3307499 TI - Evaluation of an oral solution to accelerate alcoholism detoxification. AB - Twenty-five newly admitted patients were randomly assigned to supplemental treatment with an oral fructose mineral drink or a placebo solution. Nine pints were given in a double-blinded study during the first 3 days. Observations of tremor, chlordiazepoxide requirements, patients perceptions, and observer perceptions of common withdrawal symptoms and signs and the serum levels of Zn, Mg, and potassium were made initially and after the treatment. Although the patients improved over the 4 days of observations by many of the criteria, there were no differences between those receiving active solution and placebo. PMID- 3307501 TI - Alcohol-induced hepatocyte enlargement: transfer of susceptibility to offspring. PMID- 3307500 TI - Chronic alcohol consumption reduces the cortical layer volumes and the number of neurons of the rat cerebellar cortex. AB - Past work showed that chronic alcohol consumption induces massive degeneration in the rat cerebellar cortex. In order to provide details of these effects, the cortical cell numbers and the cerebellar layer volumes were studied in adult rats fed alcohol for 1, 3, 6, 12, and 18 months and compared with respective age matched controls. Significant decreases of granular and molecular layer volumes were found after 3 and 6 months of alcohol feeding, respectively. No significant differences were found in the Purkinje cell layer volume. Neuron countings showed that granule cells and molecular layer interneurons were the earliest and most severely affected populations. A decrease in the number of Purkinje cells was observed only after 18 months of alcohol consumption and Golgi cells were not significantly reduced. Thus, we concluded that cerebellar neurons have a selective vulnerability to alcohol which might alter the balance between excitatory and inhibitory limbs of the cerebellar circuitry. PMID- 3307502 TI - Effect of ethanol on regional myocardial blood flow and hemodynamics, before and after coronary artery ligation in dogs. AB - The effects on regional myocardial blood flows (RMBF) and hemodynamics due to ethanol administered before and after acute coronary artery ligation (CAL) in 18 anesthetized dogs were studied. Ethanol was administered to seven dogs (group I) prior to CAL and to six dogs (group II) after CAL; five dogs (group III, control) received only saline before and after CAL. Uniform blood ethanol levels (180 +/- 30 mg/dl) were maintained in groups I and II after initial ethanol administration. In these groups the heart rate and rate-pressure product (which reflects myocardial oxygen consumption) remained stable, but pulmonary arterial pressures were elevated. Other hemodynamic parameters remained stable in all groups. Ethanol caused a significant transmural increase of RMBF (p less than 0.001) in both groups I and II. In group II the increase was significant in both nonischemic and ischemic tissues, with no apparent redistribution of flow among the myocardial layers. The percentage increase of RMBF due to ethanol was highest in group II nonischemic tissue (95-107%) compared to the corresponding ischemic tissue (57-60%) and the group I myocardial tissue (36-47%) prior to CAL (p less than 0.001). The observed differences between ethanol pre- and posttreatments suggest different interactions between ethanol and catecholamines. The results also confirm that vasodilatory reserve is present in the acutely ischemic myocardium and that the local availability of ethanol is important for coronary vasodilatation. PMID- 3307503 TI - Family history of alcoholism does not predict neuropsychological performance in alcoholics. AB - We examined the relationship of history of alcoholism in first-degree relatives to neuropsychological performance of alcoholics abstinent from several weeks to several years. Eighty-four men were assigned to four groups based on "strength" of family history of alcoholism. The groups were: (1) "strong history," a parent plus another first-degree relative positive; (2) "moderate," parent only positive; (3) "weak," nonparent first-degree relative only positive; and (4) "negative," no first-degree relative positive. There were no significant between group differences in NP performance. In other analyses there were no NP differences between alcoholics classified positive or negative purely on basis of paternal alcoholism, and no differences between subjects who had multigenerational versus unigenerational versus negative familial histories of alcoholism. It is concluded that genetic loading for alcoholism does not significantly affect the NP status of abstinent alcoholic groups equated for education, drinking history, and medical risk. PMID- 3307504 TI - Static ataxia as a psychobiological marker for alcoholism. AB - Sons and daughters of male alcoholics were compared with the sons and daughters of controls on two measures of static ataxia. Increased sway was seen in the children of the alcoholic fathers who had an average of 3.7 first- and second degree relatives meeting criteria for alcoholism. The possibility that static ataxia may be a psychobiological marker for the more genetically mediated variant of alcoholism is discussed. PMID- 3307505 TI - Genetic influences on use and abuse of alcohol: a study of 5638 adult Finnish twin brothers. AB - To evaluate genetic influences on the use and abuse of alcohol, we compared questionnaire measures of the frequency, quantity, and density of social drinking, and the frequency of alcohol-induced passouts self-reported by 879 monozygotic (MZ) and 1940 dizygotic (DZ) pairs of twin brothers, aged 24-49 yr. The measures of frequency, quantity, and density (heavy drinking once or more a month) significantly intercorrelate, and the self-reported alcohol consumption by this sample is satisfactorily stable and consistent with nationwide sales figures. None of the drinking measures was associated with twin type (zygosity), and only density correlated with age. Similarity of drinking habits among twin brothers was evaluated as a function of their genetic resemblance and age, the frequency of their social contact with one another, and the interactions of these terms. The effects were estimated from hierarchical linear regressions of a double-entry data matrix from which each twin's drinking was predicted from that of his twin brother, and that pair's age, zygosity, cohabitation status, and frequency of social contact. Significant genetic variance was found for each of the drinking measures with heritability estimates ranging from 0.36 to 0.40. Co twins in more frequent social contact with one another reported greater similarity in their use of alcohol, but heritable variance remained after the effects of age and social contact were removed from both mean levels and co-twin resemblance. Reported frequency of passouts yielded significant, but equivalent, correlations in both MZ and DZ twins and no evidence of genetic influence. PMID- 3307506 TI - Expression of prostaglandin protective functions in gastric mucosa cells cultured in the presence of ethanol: effects on the synthesis, retention, secretion, and structure of mucus glycoprotein. AB - The magnitude of prostaglandin [16,16-dimethylprostaglandin E2 (DMPGE2)] protection against ethanol action has been evaluated by studying the intracellular events leading to synthesis, modification, intracellular retention, and secretion of mucus glycoprotein in the rat gastric mucosal cell culture. When metabolic activity of the cultured cells was expressed as the amount of radioactive tracer in purified mucus glycoprotein, it was found that ethanol at low concentration (0.1 M) caused an 8- to 9-fold increase in proline and a 5- to 6-fold increase in palmitic acid incorporation into mucus glycoprotein; however, at 1.5 M ethanol, the synthetic processes ceased to function. In the presence of DMPGE2 (10 ng/ml), a 2-fold increase in proline and a 3-fold increase in palmitic acid incorporation into mucus glycoprotein were observed. A simultaneous addition of DMPGE2 (10 ng/ml) and ethanol (0.1-1.5 M), or pretreatment with DMPGE2 (10 ng/ml) for 20 min followed by the addition of ethanol (0.1-1.5 M), resulted in the stabilization of glycoprotein synthesis and secretion, and in restoration of the function at the level observed with DMPGE2 alone. The addition of 10 ng/ml of DMPGE2 caused a 32% increase in mucus glycoprotein secretion and an 11% increase in the intracellular content of the glycoprotein. The amount of mucus apoprotein precursor rose by 18%, and the fatty acylation of the synthesized peptides was up by 38%. Addition of DMPGE2, together with ethanol, prevented depletion of the intracellular glycoprotein stores. As observed with ethanol alone, the secretion was elevated by 16-27%, whereas the intracellular glycoprotein stores remained similar to those of controls. The synthesis of the mucus apoprotein precursor was highly sensitive to ethanol, and addition of DMPGE2 only partially prevented its inhibitory action. Pretreatment with DMPGE2, however, eliminated ethanol toxicity, and the precursor pool level remained elevated (28-30%) at all concentrations of ethanol tested. The fatty acylation, although positively affected by DMPGE2, decreased steadily with increments of ethanol concentration. The results show that DMPGE2 stabilizes the cellular membrane processes and thus imposes control over mucus glycoprotein synthesis, secretion, and its intracellular retention. PMID- 3307507 TI - History of chronic alcohol abuse is associated with increased nighttime hypoxemia in older men. AB - The all-night blood oxygen saturations (SaO2) of 19 older abstaining male alcoholics and 19 healthy age-matched controls were recorded. The alcohol group had significantly lower nighttime mean and minimum oxygen saturations, significantly greater absolute (mean-minimum) SaO2 desaturations, and significantly more desaturations below 90% compared with the control group. Additionally, the alcohol group had significantly more individuals with nighttime SaO2 means below 95% and nighttime SaO2 minimums below 90%. Finally, within the alcohol group, alcohol history was found to significantly correlate with nighttime mean and minimum SaO2 and absolute SaO2 desaturation. This preliminary study finds evidence that chronic alcohol abuse may predispose an individual to nighttime hypoxemia, and, inferentially, to sleep apnea. However, the effect is modest and it will need to be confirmed in larger, more carefully controlled studies. PMID- 3307508 TI - Alcoholic cerebellar degeneration is not a dose-dependent phenomenon. AB - Eleven alcoholics with cerebellar degeneration (eight with computerized tomography confirmation of cerebellar atrophy) were matched with nonataxic alcoholics and nonalcoholics. There were no laboratory or physiological markers for ataxia, including hemoglobin A1a + b, red blood cell transketolase, liver function enzymes, and measures of reaction time and hand-eye coordination. Acetaldehyde-modified hemoglobin levels (as hemoglobin A1a + b) did not, as previously reported, distinguish between alcoholics and nonalcoholics. There was 24% less annual alcohol consumption in ataxic alcoholics compared with nonataxic alcoholics, 9% less lifetime consumption in ataxic alcoholics, and 33% less maximal daily intake. The finding that ataxic alcoholics do not have higher alcohol consumption than nonataxic alcoholics suggests that alcoholic cerebellar degeneration is not a dose-dependent phenomenon, and that alcoholics with cerebellar degeneration may have an idiosyncratic sensitivity to the neuronal effects of alcohol. PMID- 3307509 TI - Cognitive dysfunction and aging among male alcoholics and social drinkers. AB - The relationship between aging and various drinking styles was examined. Four age groups (25-34, 35-44, 45-54, and 55-65 years) and four drinking styles (nondrinkers, social drinkers, alcoholics, and abstinent alcoholics) were compared. A battery of eight neuropsychological tests was administered to 322 men; 72 nondrinkers, 100 social drinkers, 58 abstinent alcoholics, and 92 alcoholics. Cognitive dysfunction related to aging was found to be a more significant factor than decline with alcohol use. Cognitive dysfunction associated with alcohol use was significant for three Wechsler Adult Intelligence Scale subtests; Vocabulary, Digit Symbol and Block Design. Alcohol-related differences in intellectual functioning tended to diminish with increasing subject age. PMID- 3307510 TI - Pyridoxine deficiency and ethanol-induced liver injury. AB - It has been suggested that pyridoxine deficiency may potentiate ethanol-induced liver injury. Our purpose was to clarify the effect of pyridoxine deficiency on ethanol-associated liver injury by comparing liver histology, serum liver enzymes, and the viability of cultured hepatocytes from pyridoxine-deficient and pyridoxine-sufficient rats that had been chronically fed ethanol-enriched diets. Our data fail to substantiate that pyridoxine-deficient animals are more susceptible to the hepatotoxic effects of ethanol than pair-fed pyridoxine sufficient controls. Furthermore, the addition of pyridoxine to hepatocyte cultures fails to prevent in vitro cytotoxicity of added ethanol. Pyridoxine deficiency may augment ethanol-induced enhancement of hepatic urea synthesis. These data suggest that pyridoxine deficiency may contribute to the abnormal plasma amino acid profiles and nitrogen balance of chronic alcoholics, but that it does not potentiate ethanol-induced liver injury. PMID- 3307511 TI - Influence of family alcoholism history on alcohol metabolism, sensitivity, and tolerance. AB - As part of the Colorado Alcohol Research on Twins and Adoptees (CARTA), 35 subjects who reported having an alcoholic parent or sibling [family alcoholism history positive (FHP)] were matched with 35 controls [family alcoholism history negative (FHN)]. All subjects were tested three times on a battery of physiological, motor, and cognitive performance tasks before the ingestion of alcohol, then were tested three more times over a 3-hr period during which their blood alcohol concentration (BAC) was brought up to and maintained at about 0.10 g/dl by an initial large dose of ethanol and subsequent topping doses. FHP subjects scored significantly lower than FHN subjects on the Raven's Progressive Matrices and on some of the cognitive tasks before alcohol ingestion. FHP and FHN subjects, however, did not significantly differ in absorption and clearance of alcohol or in sensitivity and acute tolerance scores calculated on the repeated measures. Contrary to expectations, FHP subjects perceived themselves as being more impaired by alcohol than FHN subjects, and there was little evidence to suggest that they were less sensitive to variations in BAC. PMID- 3307512 TI - Biologically active phytoestrogens are present in bourbon. AB - The nonethanol congeners of bourbon have been found to possess estrogenic activity when tested using an in vivo oophorectomized rat bioassay, as well as an in vivo estrogen receptor assay system. The phytoestrogen, biochanin A, as well as the plant sterol, beta-sitosterol, were identified in the bourbon preparation using gas chromatography/mass spectrometry. These findings, using three methodological approaches, demonstrate that bourbon contains at least one biologically active phytoestrogen and suggest that the effects of alcoholic beverage use or abuse, particularly as they relate to endocrine systems, should not be viewed as resulting solely from exposure to ethanol. PMID- 3307513 TI - Brain impairment in social drinkers? No cause for concern. AB - Correlations between measures of alcohol consumption and cognitive test scores have been interpreted to reflect a chronic toxic effect of ethanol on brain function in light to moderate social drinkers. However, the data indicate that there is little support across research groups for any specific relationship and, at best, the effect of alcohol consumption accounts for only a small proportion of variance. Consideration of test validity suggests that the principal measure of ability used in this research is not capable of elucidating cerebral deficit. Further, the pattern of observed correlations is not consistent with the assumption that the putative effects of social drinking involve deficits less severe but similar in type to those seen in chronic alcoholics. Instead, an association between innate ability, demographic variables, and drinking behavior in the general population is the most parsimonious explanation of all the data. PMID- 3307514 TI - A specific antagonist of ethanol: clinical implications. PMID- 3307515 TI - The role of the eosinophil in the pathogenesis of asthma. PMID- 3307516 TI - Release of antigens and allergens during shake-culture of Aspergillus fumigatus. AB - The appearance of IgG and IgE binding components in the medium of shake cultures of Aspergillus fumigatus has been studied. Cultures were grown in synthetic asparagine medium at 35 degrees C and flasks harvested in duplicate 1, 2, 3, 4, 7 and 14 days after inoculation. The pH of the medium dropped from its initial value of 5.5 to pH 3, and then after 4 days gradually increased up to pH 7.5 in the 14-day medium. The weight of mycelium, after an initial peak followed by a slight decline, increased as the pH of the medium increased. Components able to bind IgG and IgE from pooled ABPA sera were detected by crossed immunoelectrophoresis/self-crossed radioimmunoelectrophoresis within 24 h of growth, but maximal release of both antigens and allergens coincided with the increase in pH of the medium and was seen in the 14-day culture filtrate. Two recognised "major" antigens, Ag 7 and Ag 13, detected using the relevant monospecific antisera, were present in the culture medium after 14 days of growth and similarly for Ag 3, the major allergen, although another allergen, Ag 1, was identified in the 1-day extract. None of the culture filtrates was found to contain the "C-substance" polysaccharide. PMID- 3307517 TI - [Atropine in intraoperative isorhythmic AV dissociation]. AB - 40 patients of the ASA groups I and II in whom intra-operatively an isorhythmic AV dissociation occurred under inhalation narcosis with halothane or enflurane, were examined in a randomized study. Within an observation period of 15 minutes the spontaneous rate of return to the sinus rhythm was 20 per cent (group A, n = 20). Intravenous administration of 0.01 mg/kg atropine sulphate produced a significantly higher rate of return of 80% within the same period. On the whole, no influence on arterial blood pressure was noted. Atropine increases the heart rate by 32%, and this is considered to be an important drawback. The possibility of influencing the AV dissociation via atropine points to the pathogenetic importance of the vagus in so far as it acts as a depressant on the sinus node. PMID- 3307519 TI - Total collapse of lung and CPAP. PMID- 3307518 TI - The morphine sparing effect of ketorolac tromethamine. A study of a new, parenteral non-steroidal anti-inflammatory agent after abdominal surgery. AB - A randomised, double-blind study of patients after upper abdominal surgery was undertaken to assess the analgesic efficacy of ketorolac tromethamine, a new, parenteral non-steroidal anti-inflammatory agent. Postoperatively, patients received a 24-hour intramuscular infusion of either saline (n = 20), ketorolac 1.5 mg/hour (n = 21) or ketorolac 3.0 mg/hour (n = 20). Cumulative morphine requirements were measured using a patient-controlled analgesia system which delivered intravenous increments of morphine on demand. Pain was assessed by visual analogue scores. Arterial blood gas analyses were performed pre operatively and on the first postoperative day. Patients who received low and high dose ketorolac infusions required less morphine than the control group (p less than 0.05 and p = 0.06, respectively). This was associated with significantly lower pain scores. Patients who received the higher ketorolac dose had significantly less postoperative increase in arterial carbon dioxide tensions than controls. This study suggests that ketorolac tromethamine is a useful analgesic drug with significant morphine sparing properties. PMID- 3307520 TI - [Midazolam (Dormicum) as oral premedication for local anesthesia]. AB - Good physician-patient rapport and an anxiolytic, sedative, and amnesic premedication are necessary for comfortable, stress-free surgery under local anesthesia. Sufficient experience exists with the intramuscular and intravenous administration of the new benzodiazepine midazolam (Dormicum), while knowledge relating to its oral administration is still scant. Therefore, in a randomized double-blind study midazolam was investigated for oral premedication prior to local anesthesia: two dosages of midazolam were studied and compared with diazepam and placebo. One hour prior to ophthalmic surgery under local anesthesia, four randomized groups of 30 patients each, received a tablet of 7.5 or 15 mg midazolam, 10 mg diazepam, or a placebo. Following this medication, the anxiolytic, sedative, amnesic, and side-effects were determined at defined points of time during the day of surgery and the 1st postoperative day. Anxiolysis was determined using the "state-trait anxiety inventory (STAI)" of Spielberger et al.; sedation was assessed according to Pandit et al.; amnesia was determined by recall of picture cards which had been presented to the patients 50 min after premedication; and patients were asked about 13 side-effects typical of benzodiazepines in a standardized way. Anxiety increased little following the placebo; it decreased significantly following 10 mg diazepam and more markedly following 7.5 and 15 mg midazolam. Sedation increased little following the placebo; it increased more and similarly 50 min after the benzodiazepines; after 90 min the sedative effect was most marked for 15 mg midazolam. However, sedation was of shorter duration after midazolam than after diazepam.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307522 TI - [Anesthesia in bronchial asthma]. AB - Between 2% and 5% of the population suffer from bronchial asthma. The disease is characterized by bronchial hyperreactivity to physical, chemical, pharmacological, and/or immunological irritants. The incidence of perioperative complications is higher in asthmatics than in non-asthmatics. Careful pre- and postoperative care can reduce complications in these patients. Successful management of an asthmatic patient undergoing anesthesia starts with the identification of patients with asthma, the preoperative assessment, and evaluation of the pulmonary function. No elective surgery should be performed in patients suffering from unstable asthma or an acute attack. Thorough knowledge of the effects and interactions of broncholytic therapy with anesthesia is mandatory. Preanesthetic management must take into consideration the etiology of the disease; intraoperatively, attention must be paid to the pathophysiology. Appropriate perioperative monitoring can help to prevent complications. No one type of anesthesia is associated with lower postoperative complications. The skill of the anesthesiologist, early recovery from general anesthesia, and good postoperative care greatly reduce the incidence of complications. Besides the changes in pulmonary function that occur following anesthesia and surgery, asthmatics may suffer from abnormalities in control of ventilation and mucociliary function postoperatively. The patient with a history of asthma needs close supervision during the postoperative period: many sudden deaths from asthma and many episodes of ventilatory arrest occur during the night and in the early morning. PMID- 3307521 TI - [Comparative clinical studies of the hemodynamic parameters by anesthesia combination with Nalbuphin (Nubain) and Fentanyl]. AB - The narcotic agonist-antagonist nalbuphine is reported to act as a strong analgesic with only minor respiratory depressant side-effects. Even in the postoperative period, the pain-relieving properties of analgesic drugs are reported to continue if the respiratory side-effects are being antagonized by administering nalbuphine. It was the aim of this study to investigate the analgesic properties of nalbuphine as compared to those of fentanyl, in suppressing the hemodynamic responses due to endotracheal intubation and skin incision. Furthermore, we are interested in studying postoperative analgesia and respiratory depression after using the two drugs during anesthesia. PATIENTS AND METHODS: Forty-one patients undergoing general surgical procedures were randomly assigned to two groups in a double-blind study. The patients were between 18 and 70 years old and belonged to ASA classes I-III. Patients with chronic obstructive pulmonary disease, cerebral vascular disorders, hepatic or renal failure, or those treated with monoamine oxidase inhibitors and tricyclic antidepressants were excluded from the study, as were patients with a drug dependency. All patients were premedicated with 25-50 mg each promethazine and pethidine. Anesthesia was induced with either 60-70 mg nalbuphine or 0.3-0.35 mg fentanyl, 2 mg alcuronium, 0.01 mg/kg flunitrazepam, and 1-2 mg/kg thiopental. All patients were intubated following 1-2 mg/kg succinylcholine. Five minutes following intubation they received another 30-40 mg nalbuphine or 0.15-0.2 mg fentanyl intravenously. Anesthesia was maintained with N2O:O2 2:1, alcuronium, and either nalbuphine or fentanyl and enflurane up to 1 vol.% or halothane up to 0.5 vol.%. Blood pressure, pulse rate, and arterial blood gases were measured at certain intervals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307523 TI - Morphological aspects and observations about the permeability of the rat mesentery to the osmium-amine. AB - In a previous work we felt that many authors were interested in observing the permeability and structure of the mesentery employing many techniques and analysing the material from different points of view. Our collaboration, at that time, was limited to the study of the permeability of the mesentery to the lanthanum nitrate and we came to a final conclusion that the penetration of the heavy salt is impeded by the presence of a basement membrane, localized between the mesothelial and connective tissue layers and that it was continuous to the basal lamina, located between neighbouring mesothelial cells; we could then observe that the lanthanum traveled through the cytoplasm and not in between mesothelial cells. In this paper we analyze the behavior of the mesentery in relation to the osmium-amine and we compare it to the observations made in our previous work. Generally speaking, we were unable to observe any reaction in any of the structures of the mesentery, except for some special cases. In those not very common cases, employing special techniques, we came to the conclusion that the osmium-amine reacts in the periphery (outer surface) of the mesentery and also penetrates, sometimes with no visible reaction, all the way to the elastic layer, where a reaction can be detected. PMID- 3307524 TI - Cytology and immunocytochemistry of the nucleus extrolateralis anterior of the mormyrid brain: possible role of GABAergic synapses in temporal analysis. AB - Mormyrid fish use their electrosensory/electromotor system for both electrolocation and electrocommunication. One type of electroreceptor, the knollenorgan, has a low threshold and is used strictly for detecting a conspecific's electric organ discharge. Knollenorgan afferents terminate with mixed synapses (gap junctions and asymmetric chemical synapses) on neurons of the nucleus of the lateral line lobe (nLLL), which in turn projects to a midbrain nucleus--the nucleus extrolateralis anterior (ELa). ELa contains numerous granule cells, which are adendritic, and scattered larger neurons, here termed interstitial cells, which possess several branched dendrites. Because of the overall paucity of dendrites, the neuropil of ELa is scarcely developed and myelinated fibers predominate in between the cell bodies. Axons presumed to originate in nLLL make mixed synapses on both the interstitial and the granule cells. The interstitial neurons are immunoreactive for glutamic acid decarboxylase (GAD), the synthetic enzyme for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), while the granule cells are GAD-negative. Many GAD-positive synapses are found on each granule cell soma; at smaller densities, GAD-positive boutons also synapse on the cell bodies and dendrites of interstitial cells. The GAD-positive boutons have pleomorphic vesicles and make symmetric synapses. Such boutons presumably originate from a plexus of interstitial cell axons. Mormyrid fish use their knollenorgan afferents for precise temporal discriminations, and this information is needed for electrocommunication. The ELa, with its relatively simple neuronal circuitry, is the most likely site for precise temporal analysis in the knollenorgan afferent pathway, and we propose that the GABAergic synapses on the granule cells may be essential for accurate detection of specific time intervals. PMID- 3307526 TI - Special issue for Carl Schirren's 65th birthday. PMID- 3307525 TI - Morphologic characterization of cultured smooth muscle cells isolated from the tracheas of adult dogs. AB - The goals of our study were to isolate smooth muscle cells from the trachealis muscle of adult dogs and to characterize the cells morphologically when they were maintained in primary culture. Enzymatic digestion of the muscle yielded 4.8 +/- 1.8 X 10(6) viable smooth muscle cells per gram of tissue. When placed in culture, these cells rapidly proliferated until confluence was reached. The proliferating cells in culture differed from the cells in the intact tissue in that they stained less intensely for smooth muscle myosin, developed immunofluorescent staining for the intermediate filament protein vimentin, and lost many of the ultrastructural properties of the intact muscle. Only within nodules of cells in the confluent cultures were these ultrastructural properties preserved. Cultures of canine tracheal fibroblasts differed from these smooth muscle cell cultures in that the fibroblasts did not stain for smooth muscle myosin and did not form nodules at confluence. We concluded that adult canine airway smooth muscle cells may be maintained in primary culture, that the confluent cultures contain nodules of cells with many morphologic characteristics of the intact muscle, and that these preparations may be distinguished from cultured canine tracheal fibroblasts on specific morphologic grounds. PMID- 3307528 TI - Use of a double-lumen endotracheal tube with independent lung ventilation for treatment of refractory atelectasis. PMID- 3307527 TI - [Practicality of ultrasound diagnosis in veterinary andrology]. AB - It is possible to use the ultrasound technique in the veterinary andrology. Important results of that method may increase the evidence of the clinical examination of the male genital organs. To make sure that no harm may effect the sperm cells, ejaculates of bulls and boars were exposed to pulsed ultrasound (5 MHz/0,140 mW) up to 120 minutes. It was confirmed that this technique has no influence on sperm cell motility and morphology. PMID- 3307529 TI - Inappropriate attachment of PEEP valve causing total obstruction of ventilation bag. PMID- 3307531 TI - Electroconvulsive therapy--1987. AB - The noncontroversial fact regarding ECT seems to be that controversy exists in almost every area of its use, its art, and its science. The nature of the treatment itself, its history of abuse, unfavorable media presentations, special attention by the legal system, uneven distribution of use among facilities and practitioners, and lack of certified standards for psychiatric training in ECT have tended, in the past 2 decades, to swing the pendulum towards the use of tricyclic and other antidepressant agents for the treatment of severe depression. Despite recommendations for continual review of data and of clinical and research experience, few pertinent reports by anesthesiologists have appeared. Guidelines for the anesthesiologist have not been established. Due to the pervading presence in earlier studies of hypoxia, hypercarbia, and acidosis, it is futile to compare findings of unmodified ECT to modified ECT. More recent studies relating especially to cardiovascular abnormalities have also been difficult to evaluate because of widely varying formats, use of different agents and dosages, continuance or discontinuance of psychotropic drugs, and variability of ventilation and concentrations of oxygen. ECT is a modality that has not outlived its usefulness. With proper pretreatment, selection and evaluation of patients, use of appropriate modification techniques, and careful clinical management and monitoring during treatment, ECT can be both safe and effective, even in relatively high-risk patients. ECT provides an exciting challenge for concerned physicians to explore the role of brain function and behavior, and the effects of seizures on neuroendocrine mechanisms, neurohumoral mechanisms, cerebral metabolism, the blood-brain barrier, and ion transport systems. It may lead to further understanding of the action of general anesthetics, CNS depressant drugs, and the effects of stimulation of the central autonomic nervous system and the endocrine systems. A close interaction between basic and clinically oriented researchers holds the key to designing studies that can answer these critical questions, rather than continuation of studies that merely generate more data. PMID- 3307530 TI - Hepatic circulation during surgical stress and anesthesia with halothane, isoflurane, or fentanyl. AB - Hepatic blood flow and the oxygen supply/uptake relation were studied in 19 miniature pigs using labeled microspheres. Changes in hepatic arterial blood flow and portal blood flow, as well as total hepatic blood flow during halothane anesthesia were more closely associated with changes in mean arterial pressure (MAP) and cardiac output than during anesthesia with isoflurane or fentanyl. Halothane or isoflurane administered in concentrations that decreased MAP by approximately 30% were accompanied by decreases in hepatic oxygen delivery (DO2th) averaging 46% during halothane and 31% during isoflurane anesthesia and parallel decreases in hepatic blood flow. In concentrations that decreased MAP by 50%, halothane and isoflurane decreased DO2th 61 and 37%, respectively. DO2th was maintained (statistically insignificant, 23% increase) during both doses of fentanyl administered (20 micrograms/kg followed by 0.17 microgram . kg-1 . min 1, and 50 micrograms/kg followed by 0.42 microgram . kg-1 . min-1). Hepatic oxygen uptake increased 50% during fentanyl and was maintained at baseline levels during both doses of halothane and isoflurane anesthesia. Oxygen content in hepatic venous blood was maintained at baseline levels during fentanyl and isoflurane administration and was decreased by both concentrations of halothane anesthesia. The hepatic oxygen supply demand ratio was maintained at baseline levels after both doses of fentanyl and during isoflurane administered in a concentration that decreased blood pressure 30%; the ratio decreased during isoflurane administered in a concentration decreasing blood pressure by 50% and during both doses of halothane anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307532 TI - Topical analgesia for relief of post-circumcision pain. PMID- 3307533 TI - Post-circumcision analgesia--a prospective evaluation of subcutaneous ring block of the penis. PMID- 3307534 TI - Percutaneous inguinal block for the outpatient management of post-herniorrhaphy pain in children. PMID- 3307535 TI - Epinephrine prolongs lidocaine spinal: pain in the operative site the most accurate method of determining local anesthetic duration. PMID- 3307536 TI - Correlation of endotracheal tube size with sore throat and hoarseness following general anesthesia. PMID- 3307537 TI - General or spinal anesthesia: which is better in the elderly? PMID- 3307538 TI - Glucose concentrations for routine intravenous infusion in pediatric outpatient surgery. PMID- 3307539 TI - Propofol versus thiopental for outpatient anesthesia. PMID- 3307540 TI - [Pulmonary gas exchange and hemodynamics during intermittent positive ventilation of the lungs with positive end-expiratory pressure]. PMID- 3307541 TI - [Anesthesia for patients with concomitant diabetes mellitus]. PMID- 3307542 TI - [Current status of the problem of halothane hepatotoxicity]. PMID- 3307543 TI - [Venous localization, dissection and cannulation facilitated by ultrasound]. PMID- 3307544 TI - Infection control and the autopsy of persons with human immunodeficiency virus. PMID- 3307545 TI - Hemorheology in surgery--a review. AB - The rheological behavior of blood and its components under physiologic and pathophysiologic conditions is reviewed, with a focus on the type and extent of pathohemorheological changes in surgical patients during hospitalization and thereafter, as well as their clinical consequences with regard to thromboembolic complications. During the operation and the postoperative period various hemorheological and hemostasiological alterations acquire clinical significance: 1. hyperreagibility of platelets with increased aggregation and adhesion tendency 2. changes in fibrinogen, albumin, and globulin concentrations, which affect viscosity and red cell aggregation 3. impairment of red cell deformability 4. increase in clotting factors 5. disturbance of fibrinolysis characterized by diminution of plasmatic plasmin and increase in antiplasmin activity In addition, anesthetic techniques have also been shown to affect hemorheological and hemostasiological parameters. The complex pattern of pathohemorheological and hemostasiological changes shows that thromboembolism in the course of surgical interventions is provoked by multifactorial disorders. Thrombosis prevention should, therefore, counteract both hemorheological and hemostasiological disturbances. Since pathohemorheological and pathohemostasiological changes are already detectable before, and increase during operation, preventive measures should start before the surgical intervention to obtain maximum benefit. Therapeutic possibilities for the avoidance of these multifactorial disturbances are discussed with particular reference to pentoxifylline, which satisfies the complex requirements of a hemorheologically and hemostasiologically active therapeutic agent. PMID- 3307546 TI - Correlation between Seralyzer reflectance photometer theophylline assay and an Emit assay. AB - Recently a method for theophylline assay on the Ames Seralyzer was introduced. We compared the interday variability of this method to the established interday variability of an enzyme multiplied immunoassay (Emit) technique used in the service laboratory of a hospital. Control sera and calibrator prepared to known concentrations (10, 15, and 25 micrograms/mL) were assayed singly daily for ten days with the Seralyzer machine. Assays were done singly to simulate the in office use of the machine. Their respective coefficients of variations (CVs) were 6.96%, 5.50%, and 5.23%, which compared favorably with the established CVs for the Emit of 6.7%, 5.8%, and 6.1% respectively at comparable test concentrations. Two hundred and fifty-one sera were assayed in parallel on both machines in eight batches. Linear regression analysis of these data showed a slope of 0.995, intercept of 0.468, and a correlation coefficient of 0.945. These data suggest that the Seralyzer values compared favorably with the Emit values. PMID- 3307547 TI - The effect of oral zindotrine (MDL-257), a bronchial smooth muscle relaxant, on histamine airways responsiveness in asymptomatic asthmatics. AB - We evaluated the efficacy of an oral dosage form of the investigational smooth muscle relaxant, zindotrine, a novel pyridazine derivative, in counteracting histamine-induced bronchospasm in a group of 12 non-medicated asymptomatic asthmatics. Histamine inhalation challenges were performed before (control) and 45, 150, and 300 minutes after zindotrine (200 and 300 mg), or the corresponding dose of placebo was administered orally in a randomized, double-blind crossover fashion. When compared to the control state, the 300-mg zindotrine dose markedly lowered histamine airway responsiveness as indicated by a significant (P less than .01) increase in the inhaled histamine dose necessary to provoke a 20% decrease in the forced expired volume in one second (PD20FEV1) 45 minutes after drug administration. The PD20FEV1 then decreased linearly over time but remained higher than the control PD20FEV1 value (P less than .05) during the entire observation period. The 200-mg zindotrine dose failed to affect the PD20FEV1. Our data indicate that orally administered zindotrine lowers airways responsiveness to inhaled histamine in asymptomatic asthmatics in a dose-dependent and time dependent fashion. PMID- 3307548 TI - [Comparison of propanidid with propofol for dental surgery of short or medium duration]. AB - The properties of propofol in emulsion given by continuous intravenous infusion to spontaneously breathing patients have been well studied. Thirty randomized voluntary premedicated patients undergoing dental extraction were anaesthetized with propofol (2.5 mg X kg-1 IVD, and 9 mg X kg-1 X h-1) or with propanidid (9 mg X kg-1 IVD, and 60 mg X kg-1 X h-1), supplemented with nitrous oxide in oxygen and fentanyl. Induction, maintenance and recovery times had the same characteristics. Highly significant differences occurred between the two groups regarding the increase in heart rate, apnoea and recovery time. This study showed that propofol was an eminently suitable agent for continuous intravenous anaesthesia in spontaneously breathing patients for dental surgery. PMID- 3307549 TI - [Propofol versus methohexital in the surgery of the spinal canal]. AB - The aim of this study was to compare the quality of postanaesthetic recovery after anaesthesia with methohexitone (M) or with propofol (P). Thirty patients undergoing spinal surgery were randomly assigned to either group. The induction dose was 2 mg . kg-1 for both M and P. Anaesthesia was maintained by continuous infusion. The rate was 0.15 mg . kg-1 . min-1 for P and 0.07 mg . kg-1 . min-1 for M. Analgesia was obtained with fentanyl with the same doses in both groups. The maintenance doses were subsequently decreased by 50 and 75% of the initial values. This work compared the quality induction and the criteria of recovery (Aldrete score, Newman test). In two patients in each group, sensory evoked potentials (SEP) were recorded to monitor neurological integrity. The quality of induction was similar in both groups. Awakening was significantly more rapid in group P. The SEP were much decreased in group P, whilst there were few changes in group M. Monitoring of medullar integrity is mandatory in spinal surgery, requiring a rapid recovery. This objective was obtained with shorter delays in patients anaesthetized with propofol than in those who had received methohexitone. However, the former, at the doses used, seemed to depress the SEP. PMID- 3307550 TI - [Comparative trial of propofol and ketamine in anesthesia for the baths of severely burnt patients]. AB - Ketamine was the normal anaesthetic drug for carrying out the baths of severely burnt patients. It was compared with propofol in a study of 50 patients (greater than 50 UBS) randomly assigned to two groups: 2.5 mg . kg-1 propofol and 2 mg . kg-1 ketamine. The speed of induction was the same for both groups, surgery beginning within the same time intervals. In the propofol group, however, apnoea was seen more often and lasted longer (p less than 0.05) than in the ketamine group. The times between repeat injections were short (about 5 min) and constant with propofol, whereas they were larger and irregular with ketamine; this was due to the shorter distribution half-life and lack of accumulation of propofol. During anaesthesia with propofol, haemodynamic parameters remained steady after an initial period of cardiovascular depression. Respiratory rate increased, because of the lack of analgesia. Recovery was very quick, complete and with no bothersome adverse effects in the propofol group. These hypercatabolic patients could therefore be fed early postoperatively; also, there was no deleterious psychological interference in these deeply disturbed patients. PMID- 3307551 TI - A theoretical discourse on the pharmacology of toxic marine ingestions. AB - The known and theoretical pharmacology of poisons involved in toxic marine ingestions has assisted in the development of specific therapeutics for these afflictions. The clinical manifestations of several toxic marine ingestions have suggested toxins/cogeners that may be involved in the poisoning process, providing direction for the development of diagnostic laboratory tests, including those for cyclic ethers. Future investigations should involve utilization of acetaminophen and indomethacin for chronic ciguatera fish poisoning, and the evaluation of the role of polycyclic ethers in the temperature sensation reversal phenomenon of both ciguatera and neurotropic shellfish poisoning. PMID- 3307552 TI - Biotoxicology of sea snake venoms. AB - Sea snakes are the most abundant venomous reptiles, found throughout the Indian and Pacific Oceans. Divided into two subfamilies, Laticaudinae and Hydrophiinae, all sea snakes are poisonous. Venoms are highly toxic, as indicated by low LD50 values in test animals. Toxic compounds include presynaptic and postsynaptic neurotoxins. Similarities in phylogeny are reflected in immunodiffusion patterns, immunoelectrophoresis, cross-neutralization by antivenin against heterologous venoms, and amino acid composition. The clinical syndrome following a bite is largely neurotoxic and myotoxic, with rare hepatotoxicity and nephrotoxicity. Proper emergency field therapy and timely administration of antivenin can be lifesaving. Hemodialysis may be useful when antivenin is not available. PMID- 3307553 TI - Enzymatic frostbite eschar debridement by bromelain. AB - Bromelain is a plant proteinase derived from the stem of the pineapple plant that has been used successfully to debride the eschar from third-degree burn injuries. Its applicability to frostbite eschar removal was extrapolated and investigated. Third-degree frostbite lesions were produced on swine using supercooled air as the freezing media, and the resulting eschars were treated with a bromelain preparation. In the initial trial, no debridement other than that of the superficial layers of the eschar was noted. The experiment then was repeated with the introduction of third-degree burn injuries as a control to validate the efficacy of the enzyme preparation. Although the burn injuries debrided to a graftable bed after two applications of the enzyme, the frostbite injuries remained unaffected. It was concluded that the patent vasculature, resulting tissue edema, and lack of coagulation of proteins found in the freeze injury are sufficient to inactivate the bromelain enzyme before tissue digestion and dissection can be effected. PMID- 3307554 TI - Present tests for detection of snake venom: clinical applications. AB - Immunologic tests for detection of snake venom and venom antibodies have important clinical applications. Enzyme-linked immunoassay (ELISA) and radioimmunoassay (RIA) provide adequate specificity and sensitivity. The former is much more widely used because it is inexpensive, relatively easy to perform, and uses stable reagents. Some ELISA systems will detect 0.5 ng of venom; however, a sensitivity of 10 to 100 ng is more usual. Minimum running time is 30 to 45 minutes; with longer times, greater sensitivity can be attained. Wound aspirate, serum, and urine are the most suitable materials for venom detection. ELISA has been used for clinical diagnosis of snakebite, to monitor antivenom dose, to study clinical syndromes associated with envenomation, to detect venom in forensic cases, and to evaluate first aid techniques. The indirect ELISA usually is used for detecting and titrating venom antibody. This is potentially useful in epidemiological studies of snakebite incidence, in evaluating potency and paraspecific activity of antivenoms, and in studying response to venom immunogens. Current ELISA systems involving snake venoms have low specificity, and most cannot reliably differentiate venoms of related snakes. Venom antibody detection assays are less satisfactory than those for venom; nonspecific reactions and cross-reactivity are unacceptably high. Methods for improvement of snake venom immunodiagnosis are discussed. PMID- 3307555 TI - Plant-induced dermatitis. AB - Patients with plant-induced dermatitis frequently present to the emergency department. The range of responses varies from irritant to allergic to photo or granulomatous. To a certain extent the clinical presentations will vary; it is important to determine causation because appropriate emergency therapy treatment also will vary. This review considers the most common forms of plant dermatitis and emphasizes advances in the understanding of pathomechanisms and recommended therapy for each type. PMID- 3307557 TI - Immune suppression at high altitude. AB - This paper is a review and interpretation of prior studies that have investigated the effects of hypoxia on immune function. A summary of current methods used to assess immune effector cell function in human beings is presented using in vitro models of mononuclear cell activation. Animal studies indicate that impaired host defenses against bacterial pathogens may be compromised, but that resistance to virus infections may remain intact. Data from human studies and animal models indicate that active immunization and B cell function are unimpaired, whereas T cell function is blunted following exposure to hypoxia. Mechanisms that may be responsible for alterations in normal immunoregulation are presented. The implications of altered immune function in subjects exposed to high altitude are discussed. PMID- 3307556 TI - Altitude-aggravated illness: examples from pregnancy and prenatal life. AB - Nearly 40 million persons worldwide live permanently at elevation above 8,000 ft (2,439 m) and perhaps as great a number visit high-altitude regions annually. Health effects include the well-recognized altitude-specific syndromes of acute mountain sickness and high-altitude pulmonary edema. Emphasis is placed in this article on altitude-aggravated illness or those preexisting conditions that may be adversely affected by reduced O2 availability at high altitude. Examples from studies of pregnant women and their infants at high altitude are reviewed to demonstrate the effect of high altitude on maternal and fetal well-being. Increased maternal ventilation and ventilatory response to hypoxia during pregnancy at 10,200 ft (3,110 m) and 14,200 ft (4,329 m) raised arterial O2 saturation, helped to preserve arterial O2 content at levels present when nonpregnant, and correlated positively with the offspring's birth weight. Fetal growth retardation and an increased incidence of the complications of pre eclampsia and neonatal hyperbilirubinemia at high altitude suggested that altitude may aggravate complications of pregnancy and prenatal life. Other conditions that may be aggravated at high altitude are reviewed. Virtually all studies on altitude-aggravated illness have been conducted on permanent residents. Future studies should seek to determine whether high altitude aggravates pre-existing conditions among the large and growing number of high altitude visitors. PMID- 3307558 TI - Medical therapy of altitude illness. AB - Acute mountain sickness (AMS) and high-altitude pulmonary edema (HAPE) continue to cause significant morbidity and occasional deaths among mountain recreationists and residents. Descent to lower altitude is still considered the treatment of choice, but an increased role for medical therapy is emerging. Acetazolamide is currently the drug of choice for prevention of AMS, and probably HAPE as well. Numerous studies have demonstrated the drug's effectiveness when it is started 12 to 24 hours before ascent. Suggestions for indications, dosage, and regimen vary with different authors. Lower dosage offers adequate protection with fewer side effects. Acetazolamide has still not been adequately studied for treatment of altitude illness. Oxygen effectively treats HAPE and mild AMS, but is not as useful for cerebral edema. Dexamethasone recently was found effective for treatment of AMS, including early cerebral edema, but not for advanced cerebral edema. Side effects limit its use for prophylaxis, but dexamethasone offers an alternative to acetazolamide for those with sulfa intolerance. PMID- 3307559 TI - High-altitude pulmonary edema: pathophysiology and clinical review. AB - High-altitude pulmonary edema (HAPE) affects young, healthy climbers in an unpredictable fashion. It is potentially fatal, and its underlying pathophysiology is not thoroughly understood. The history and clinical presentation of HAPE, as well as the known underlying pathophysiology, are reviewed. For instance, in HAPE there is an association with blunted respiratory drives to hypoxia and accentuated hypoxic pulmonary vasoconstriction. Recent data show that HAPE is a high permeability leak of protein into the alveolar space associated with an influx of alveolar macrophages. These data have been obtained recently by fiberoptic bronchoscopy in the field setting of Mt McKinley at 4,400 m. The approach to recognition and treatment that involves primarily descent and/or oxygen is discussed. PMID- 3307560 TI - Equine endotoxemia: cardiovascular, eicosanoid, hematologic, blood chemical, and plasma enzyme alterations. AB - Ponies with electromagnetic blood flow transducers implanted around the main pulmonary and left main coronary arteries, were used to evaluate effects of chronic sublethal endotoxin on cardiac output (CO), stroke volume, and left coronary blood flow (LCBF). Plasma thromboxane (TX), as indicated by TXB2, prostacyclin as indicated by 6-keto-prostaglandin (PG) F1 alpha, and hematologic and blood chemical values also were evaluated. Over 24 hours, 2 groups of ponies were given progressively increasing IV and intraperitoneal doses of Escherichia coli lipopolysaccharide (LPS) at 0, 6, 12, and 18 hours. Group 1 was not treated and group 2 was treated with flunixin meglumine, before each LPS insult. Initial LPS inoculation in group 1 led to 10-fold increases in TXB2 and 6-keto-PGF1 alpha values by 30 and 90 minutes, respectively. These eicosanoid values returned to base line by 6 hours after each insult. Although repeated LPS injections stimulated recurring high plasma concentrations of 6-keto-PGF1 alpha, TXB2 production became less with each successive LPS insult. Cardiac output decreased to 55% to 60% of base-line values in association with increased 6-keto-PGF1 alpha values. Left coronary blood flow could not be evaluated accurately. Severe lactic acidosis developed in group 1. Group-2 ponies remained clinically normal, indicating protection of cardiovascular function and peripheral perfusion with flunixin meglumine. Seemingly, flunixin meglumine helped to maintain acceptable cardiovascular function and tissue perfusion during endotoxemia. Flunixin meglumine given to healthy ponies had no effect on cardiovascular function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307561 TI - Induction of bovine plaque-forming cells in vitro. AB - A culture system was developed for the in vitro inoculation of bovine splenic lymphocytes with sheep RBC and trinitrophenylated proteins. The addition of pokeweed mitogen to the cultures was necessary for the induction of plaque forming cells to the antigen. This culture system required the use of autologous serum and the addition of mitogen. PMID- 3307562 TI - Immunologic memory responses induced in BALB/c mice by cross-linked outer membrane extracts of four Salmonella serotypes. AB - Outer membrane proteins (OMP), extracted from Salmonella enteritidis, S anatum, S typhimurium, and S infantis, were cross-linked to form a large immunogen (4-OMP lipopolysaccharide [LPS]). Vaccinations with 4-OMP-LPS dissolved in phosphate buffered saline solution and 4-OMP-LPS emulsified with muramyl dipeptide were capable of eliciting specific and sustained primary IgM and IgG responses in BALB/c mice, as well as inducing immunologic memory for 130 days. In addition to 4-OMP-LPS-specific responses, substantial IgM and IgG responses specific for each live homologous organism were detected over the 130-day trial. In comparison with vaccination with 4-OMP-LPS dissolved in phosphate-buffered saline solution, responses specific for the antigen or the homologous Salmonella were not markedly increased in mice vaccinated with 4-OMP-LPS emulsified with muramyl dipeptide. Seemingly, cross-linked OMP, without the inclusion of muramyl dipeptide, may have potential as vaccine components and may induce immunologic memory. PMID- 3307563 TI - Comparison of methods used to collect canine intestinal tissues for histologic examination. AB - Five commonly used methods of collecting canine intestinal tissues for histologic examination were compared by analysis of the histologic artifact frequency, types, and severity, using a double-blind study design. Tissue samples from the duodenum, jejunum, ileum, and colon from 12 dogs were collected, using the following methods: method 1, longitudinally incising the intestine along the antimesenteric border and stapling the free ends of the intestine to a wooden tongue depressor; method 2, ligating the ends of an unopened length of intestine and injecting the lumen with formalin; method 3, longitudinally incising the intestine along the antimesenteric border and laying the opened intestine on a dry paper towel with the serosal surface down; method 4, placing a segment of unopened and uninjected intestine directly into formalin; and method 5, longitudinally incising the intestine along the antimesenteric border. All tissues were fixed by immersion in neutral-buffered 10% formalin and were processed, using routine histologic techniques. Two of these dogs were perfused IV with formalin before tissues were collected. Samples of intestinal tissue were examined by scanning electron microscopy to confirm the histologic findings. Method 2 resulted in significantly fewer and less severe artifacts (P less than 0.02) than did the other methods. Method 4 resulted in significantly more artifacts of greater severity (P less than 0.02) than did the other methods. The number of artifacts and the severity of artifacts induced by methods 1, 3, and 5 were not significantly different. Significantly (P less than 0.05) more artifacts and artifacts of greater severity occurred in the duodenum and jejunum than occurred in the ileum and colon, regardless of the method used. PMID- 3307564 TI - Effect of intramammary devices on the outcome of induced Escherichia coli infection of bovine mammary quarters. AB - Eighteen Holstein cows, free of intramammary infection, were fitted with smooth (n = 9) or abraded (n = 9) intramammary devices (IMD) in 2 diagonally opposed quarters within 4 weeks after calving. The 2 other quarters of each cow were used as controls. Three to 6 weeks after IMD insertion, depending on when milk somatic cell counts returned to a base-line value of less than 4 X 10(5)/ml, all cows were subjected to bacterial challenge exposure in the front or rear quarters by intracisternal injection of about 30 colony-forming units of Escherichia coli/quarter. Challenge exposure was done immediately after milking. Three weeks after the initial bacterial exposure, the other quarter pairs were similarly challenge exposed. Quarter bacteriologic status, concentration of milk somatic cells, and clinical observations (rectal temperature, milk appearance, udder palpation, and general condition of the cow) were monitored. Infection developed in 14 of 16 (88%) quarters with smooth IMD vs 16 of 16 (100%) control quarters and in 7 of 17 (41%) quarters with abraded IMD vs 17 of 17 (100%) control quarters. The difference in infection frequency between quarters with smooth IMD and quarters with abraded IMD was significant (P less than 0.05). Protection against establishment of infection was associated with somatic cell counts greater than 8.0 X 10(5)/ml in milk collected immediately after milking (7 of 12 quarters) or 4 hours later (11 of 12 quarters). In 10 quarters (59%) of cows fitted with abraded IMD, secretory abnormalities appeared before bacterial challenge inoculation. Abnormal milk or visible blood was observed over periods varying from 2 weeks after insertion through the entire lactation. PMID- 3307566 TI - Synergy of lung biology and medicine: the NHLBI from the perspective of the pulmonary community. PMID- 3307565 TI - Pulmonary research: where have we come and what does the future hold? PMID- 3307567 TI - Intranasally and orally administered antihistamine treatment of experimental rhinovirus colds. AB - Although antihistamines are widely used for symptomatic treatment of seasonal (allergic) rhinitis, the role of histamines in the pathogenesis of infectious rhinitis is not clear. Two antihistamines, orally administered chlorpheniramine maleate (CM) and diphenhydramine hydrochloride (DH) administered by intranasal spray, were used under double-blinded, randomized, placebo-controlled conditions to assess both tolerance and efficacy in volunteers with experimental rhinovirus (RV) colds. In the initial trial, CM (4.0 mg per treatment) was ingested 4 times daily for 4 days beginning 24 h after intranasal inoculation of RV type 29 in susceptible volunteers. In the second trial, DH was sprayed intranasally 4 times daily (2 mg per treatment) for 5 days beginning 24 h after inoculation of RV type 39. Clinical colds occurred in 60% of the CM group (n = 13) and 73% of the placebo (n = 15) in the first study, and in 66% of the DH group (n = 12) compared with 81% in the placebo group (n = 11) in the second. Both CM and DH were well tolerated but had no significant effects on nasal symptoms or nasal mucus production. The findings provide additional evidence against an important role for histamine in the pathogenesis of nasal symptomatology in rhinovirus colds. PMID- 3307568 TI - Changes in pharyngeal cross-sectional area with posture and application of continuous positive airway pressure in patients with obstructive sleep apnea. AB - In an attempt to elucidate whether changes in posture (from sitting to supine) result in reduction in pharyngeal area, thus promoting pharyngeal occlusion during sleep in so predisposed persons, we studied 12 snoring apneic patients and 6 snoring nonapneic control subjects. in all subjects, we employed acoustic reflection technique to measure pharyngeal area at FRC sitting and supine. We also examined changes in pharyngeal area resulting from the application of positive intrapharyngeal pressure in sitting and supine posture. We found that (1) pharyngeal cross-sectional area at FRC was similar in both groups, (2) decrease in pharyngeal area with assumption of supine posture was also similar in both groups (21 +/- 11% in patients with OSA versus 15 +/- 13% in nonapneic control subjects), and (3) pharyngeal distensibility was significantly higher in apneic snorers than in nonapneic control subjects (0.090 +/- 0.039 cm H2O-1 in apneic snorers versus 0.032 +/- 0.027 cm H2O-1 in nonapneic control subjects; p less than 0.005). We conclude that changes in posture alone are not sufficient to convert a snorer into a patient with OSA; however, when physiologic abnormalities ("floppy" pharynx) are superimposed on postural reduction in pharyngeal area, airway occlusion results. PMID- 3307570 TI - A prospective study of lung water measurements during patient management in an intensive care unit. AB - We prospectively evaluated a protocol that included extravascular thermal volume (ETV) as a measure of extravascular lung water (EVLW) instead of pulmonary artery wedge pressure (Ppaw) measurements to guide the hemodynamic management of 48 critically ill patients. Patients were randomized to either a protocol management (PM), or to a routine management (RM) group. In the RM group, EVLW measurements were unknown to the primary care physicians. The 2 groups were similar with respect to age, gender, and severity of illness. In patients with initially high EVLW, EVLW fell to a greater extent in PM than in RM patients (18 +/- 5 versus 4 +/- 8% decrease, p less than 0.05). This difference was even greater in patients with heart failure. No adverse effects on oxygenation or renal function occurred in following the protocol. Mortality for the groups as a whole was similar, but was significantly better (p less than 0.05) for PM patients with initially high EVLW and normal Ppaw (predominantly patients with sepsis or the adult respiratory distress syndrome). For both groups, patients with an initial EVLW greater than 14 ml/kg had a significantly greater mortality than did those with a lesser amount of EVLW: 13 of 15 (87%) versus 13 of 32 (41%), p less than 0.05. We conclude that management based on a protocol using EVLW measurements is safe, may hasten the resolution of pulmonary edema, and may lead to improved outcome in some critically ill patients. PMID- 3307569 TI - Lung function in prematurely delivered rabbits treated with a synthetic surfactant. AB - We treated prematurely delivered rabbit pups with the synthetic surfactant that has been named Exosurf. By weight, Exosurf is 61.8% dipalmitoylphosphatidylcholine, 6.8% hexadecanol, 4.6% tyloxapol, and 26.7% NaCl. This simple mixture, suspended at 15 mg lipid X ml-1 water, has appropriate in vitro characteristics for a lung surfactant substitute. As determined by static pressure volume relationships performed after 30 min ventilation, lungs treated with Exosurf accepted significantly more gas at maximal inflation (36 versus 15 ml X kg-1 body weight) and had significantly greater volumes during deflation that did saline-treated control lungs; lungs treated with natural rabbit surfactant (SAM) had significantly larger volumes at maximal inflation (65 versus 35 ml X kg-1) and during deflation than did the Exosurf-treated lungs. After 30 min of ventilation with oxygen and fixation at 10 cm H2O pressure, the ratio of air space to tissue space was determined by a point-counting technique, and mean linear intercepts were measured for air spaces. Exosurf-treated lungs were intermediate between SAM and saline-treated lungs in both measurements. With positive pressure ventilation to maintain a tidal volume of 6.5 to 7.5 ml X kg-1, total compliance was significantly greater and inspiratory pressure significantly lower in both SAM- and Exosurf-treated animals than in saline-treated control animals, although the lungs of the SAM-treated animals were more compliant than the lungs of animals treated with Exosurf. During the first minute of positive pressure ventilation, lungs treated with SAM or Exosurf expanded equally rapidly, both expanding more rapidly than the saline-treated lungs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307571 TI - Oxygen toxicity in the premature baboon with hyaline membrane disease. AB - Immaturity, pulmonary barotrauma, and oxygen toxicity have been implicated in the pathogenesis of bronchopulmonary dysplasia (BPD). Although the physiologic and biochemical consequences of oxygen toxicity have been described in newborn and adult animals, there have been no controlled observations in prematures. We compared the physiologic and morphologic effects of prolonged hyperoxia with those of clinically appropriate oxygen in premature baboons with hyaline membrane disease (HMD) supported with conventional positive pressure ventilation and continuous distending airway pressure (PPV/PEEP). Twenty-one premature baboons were delivered at 140 days gestation, intubated and resuscitated, and supported with PPV/PEEP and standard NICU techniques for 11 days. The FIO2, PaO2, PaCO2, pHa, ventilator and airway pressures, and blood pressure were intermittently measured and recorded. The physiologic observations could be divided into 3 distinct phases. During Phase 1 (0 to 42 h) there were no significant intergroup differences, and (a/A)PO2 and IO2 (oxygenation index; (a/A)PO2/Paw) remained stable. In Phase 2 (43 to 96 h) there was a rapid improvement in (a/A)PO2 and IO2 in both groups, but the response in the hyperoxic animals was significantly dampened. During Phase 3 (97 to 264 h) there was continued improvement in the "prn" animals, which contrasted with progressive deterioration in those exposed to FIO2 1.0. Five of 11 "prn" and 3 of 10 FIO2 1.0 baboons developed air leaks during Phase 1 or early Phase 2. Four of 10 of the hyperoxic animals died after the late onset of air leak. Pathologic changes of BPD were found in all FIO2 1.0 animals surviving more than 6 days but in none of the "prn" long-term survivors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307572 TI - Pressure-volume curve of total respiratory system in acute respiratory failure. Computed tomographic scan study. AB - To investigate the relationship between lung anatomy and pulmonary mechanics in acute respiratory failure (ARF), 20 patients with ARF underwent computerized tomography (CT) at 3 levels of positive end-expiratory pressure (PEEP) (5, 10, and 15 cm H2O). The static pressure-volume curve of the total respiratory system and the lung volumes (helium dilution method) were also measured. By knowing the lung volumes and analyzing the CT number frequency distribution, a quantitative estimate of normally aerated, poorly aerated, and nonaerated lung tissue was obtained at each level of PEEP. The recruitment was defined as the percent increase of normally aerated tissue from 5 to 15 cm H2O. We found that the different compliances (starting compliance, inflation compliance, and deflation compliance) were correlated only with the amount of normally aerated tissue present in the range of pressures explored by a given compliance (5 cm H2O for starting compliance and 15 cm H2O for inflation and deflation compliances). No relationship was found between the compliances and the poorly aerated and nonaerated tissue. The specific compliance was in the normal range, whereas the amount of recruitment was related to the ratio of inflation compliance to starting compliance. Our data suggest that (1) the pressure-volume curve parameters in ARF investigate only the residual healthy zones of the lung and do not directly estimate the "amount" of disease (poorly or nonaerated tissue), (2) the pressure-volume curve may allow an estimate of the anatomic recruitment, and (3) the residual normally aerated zones of the ARF lung seem to maintain a normal intrinsic elasticity. PMID- 3307573 TI - Inflammation and models of chronic pulmonary hypertension. PMID- 3307574 TI - Modification of pulmonary hypertension secondary to congenital heart disease by prostacyclin therapy. AB - We have shown that PGI2 is a powerful but not selective pulmonary vasodilator, and we believe that there is a role for PGI2 in pulmonary vascular disease secondary to congenital heart disease, but much work remains to be done, including comparisons of PGI2 with other vasodilators. The role of PGI2 in altering the cellular and chemical events producing pulmonary vascular disease secondary to congenital heart disease, and any role in long-term treatment, is largely unexplored. PMID- 3307575 TI - Prostacyclin and PGE1 treatment of pulmonary hypertension. AB - Prostacyclin and PGE1 show promise in treatment of many forms of pulmonary hypertension. Their clinical use can be expected to increase as their pulmonary vasodilating effects become better known. There is as yet no unequivocal reason to choose one agent over the other, but several observations suggest that prostacyclin will eventually be preferred. First, prostacyclin appears to have a shorter half-life (1 to 2 min), which means that any drug-induced adverse effects will disappear more quickly. Although it is commonly said that up to 80% of PGE1 is metabolized with one passage through the lungs, in one study 34% of intravenously administered radiolabeled PGE1 remained in the bloodstream 20 min after administration. Second, prostacyclin causes less severe and less prolonged rebound platelet activation after discontinuation. Third, prostacyclin has been shown to reduce resting pulmonary vascular tone and hypoxic pulmonary vasoconstriction in virtually every published study in every species tested at every stage of development (fetal, newborn, and adult life); results with PGE1, although very impressive, have been less consistent. Nevertheless, there is little doubt that PGE1 is a powerful pulmonary vasodilator in most clinical situations complicated by pulmonary hypertension. Further, PGE1 is available for clinical use, while prostacyclin remains an investigational drug. Thus, it is likely that PGE1 will become the "nitroprusside" of the lesser circuit for intensive care use, a position PGE1 will hold alone at least until prostacyclin becomes available. Chronic infusions of prostacyclin may prove particularly useful in patients with primary pulmonary hypertension awaiting heart-lung transplantation. Eventually, orally available prostacyclin and PGE1 analogs will offer a new therapeutic avenue in many diseases complicated by chronic pulmonary hypertension. PMID- 3307576 TI - The place of prostacyclin in the clinical management of primary pulmonary hypertension. AB - Primary pulmonary hypertension (PPH), in which no cause for a rise in pulmonary artery pressure can be found, is characterized by a "restriction" of the peripheral pulmonary vascular bed. Treatment is directed at the consequences of this, namely, the low cardiac output. Oral anticoagulants appear to improve prognosis, as in other low cardiac output states, by preventing intravascular coagulation. Oral vasodilators are not uniformly successful in improving cardiac output. Acute intravenous infusion of prostacyclin (PGI2) lowers both pulmonary and systemic vascular resistance in normal subjects and patients with PPH. Long term infusion in patients with a poor prognosis, that is, with a PA saturation O2 less than 63%, has, in an uncontrolled study, improved symptoms and rate of maximal oxygen consumption (V max O2) during progressive exercise testing. Its more general use in PPH awaits controlled studies, but there is a possibility that, in addition to its vasodilator properties and the ability to impede platelet aggregation and adherence, PGI2 long term may influence the progressive nature of PPH. PMID- 3307577 TI - Nocturnal positive pressure ventilation via a nasal mask. PMID- 3307579 TI - Role of immediate versus delayed nephrectomy for failed renal transplants. AB - The role of timing of transplant nephrectomy after renal transplantation has not been well defined. This report compares the morbidity, mortality, and hospitalization costs of 37 patients undergoing transplant nephrectomy within 14 days after graft failure and return to dialysis, with 31 patients undergoing delayed transplant nephrectomy (less than 14 days after graft failure and return to dialysis). This analysis revealed that there were no significant (P greater than .05) differences in patient morbidity and mortality between these groups. There was, however, a substantial increase (P less than .05) in the cost of hospitalization in the delayed nephrectomy group. For this reason, we recommend early nephrectomy after renal transplant failure in order to minimize the cost of health care for these patients undergoing failed cadaver donor transplant nephrectomy. PMID- 3307578 TI - Shouldice hernia repair: results at a teaching institution. AB - Authors with wide experience report that the Shouldice technique for repair of inguinal hernia is very effective. The technique has not gained widespread acceptance or notoriety. For example, the 13th edition of Textbook of Surgery, edited by Sabiston, devotes only one paragraph to this type of herniorrhaphy. Because of the excellent results reported by the Shouldice Clinic, this technique was adopted at the Augusta Veterans Administration Hospital, a teaching hospital of the Medical College of Georgia. Since 1976, a total of 604 Shouldice repairs have been performed by supervised house staff; 468 patients have been followed for up to 8 years and a recurrence rate of 1.3 per cent is reported. Although the follow-up is brief, the Shouldice hernia repair is widely applicable and good results are not dependent on wide experience alone. PMID- 3307580 TI - Management of exocrine secretions in pancreatic transplantation: a new technique. AB - The management of exocrine secretions in pancreatic transplants remains an obstacle to success. This report describes an alternative approach for handling this problem. The technique includes a pancreaticocystostomy and occlusion of the accessory pancreatic duct prior to transplantation of the pancreatic graft. Thus far, acceptable results have been obtained by using this method in two whole pancreas transplant cases. PMID- 3307581 TI - [Atresia of the bile ducts. Current status]. PMID- 3307583 TI - Seronegative secondary syphilis in a patient infected with the human immunodeficiency virus (HIV) with Kaposi sarcoma. A diagnostic dilemma. AB - Reagin and treponemal antibody tests are highly reliable in diagnosing secondary syphilis. However, patients infected with the human immunodeficiency virus (HIV) respond abnormally to antigenic stimulation and may fail to develop typical serologic responses to infections. We report the case of an HIV-infected man with Kaposi sarcoma and secondary syphilis whose VDRL test and fluorescent treponemal antibody-absorbed test were repeatedly nonreactive. Correct diagnosis required biopsy of a skin lesion with silver staining to show spirochetes. Clinicians treating HIV-infected patients should be aware of the problems of serologic diagnosis of syphilis in these patients. Biopsy samples of appropriate tissues and staining for spirochetes may be needed to arrive at the correct diagnosis. PMID- 3307582 TI - Adjusted subcutaneous heparin or continuous intravenous heparin in patients with acute deep vein thrombosis. A randomized trial. AB - STUDY OBJECTIVE: To determine the efficacy and safety of adjusted subcutaneous calcium heparin compared with continuous intravenous calcium heparin as the initial treatment for acute deep vein thrombosis. DESIGN: Randomized control trial. SETTING: University-affiliated general hospital. PATIENTS: Of 111 consecutive patients considered, 103 had acute proximal or calf vein thrombosis confirmed by ascending venography and met all other eligibility criteria. INTERVENTIONS: PATIENTS were randomly assigned to receive subcutaneous or intravenous heparin. The subcutaneous regimen consisted of an initial dose of 15,000 U, adjusted thereafter to prolong the activated partial thromboplastin time to 50 to 70 seconds. The continuous intravenous regimen was begun as a bolus injection of 5000 U, followed by an infusion of 1250 U/h, adjusted to maintain the activated partial thromboplastin time at 50 to 70 seconds. MEASUREMENTS AND MAIN RESULTS: There was no significant difference in the rate of new pulmonary embolism between the two groups, as defined by new high-probability defect on repeat ventilation-perfusion scintigrams of the lung in 96 (93%) of the patients after 7 to 10 days of treatment. Five of forty-seven patients in the subcutaneous group and 5 of 49 in the intravenous group developed pulmonary embolism (95% confidence interval [CI] for the difference, -13.1% to 12.2%). Similarly, there was no significant difference in the frequency of hemorrhagic complications. Five of fifty-one patients in the subcutaneous group and 5 of 52 in the intravenous group had hemorrhagic complications (95% CI for the difference, -11.2% to 11.6%). CONCLUSION: Adjusted subcutaneous calcium heparin may be an effective and safe alternative to continuous intravenous calcium heparin in the initial treatment of acute proximal deep vein thrombosis. PMID- 3307584 TI - Biosynthetic human insulin improves postprandial glucose excursions in type I diabetics. AB - To determine if the more rapid absorption of subcutaneously administered human insulin, as compared with animal insulin, would result in an improved postprandial metabolic response, ten persons with type I diabetes mellitus were studied during a fixed meal. Plasma glucose and insulin concentrations were compared after subcutaneous injections of 0.2 U/kg body weight of regular biosynthetic human insulin or regular purified pork insulin in a double-blind randomized crossover trial. Meal glycemic excursions improved after the administration of biosynthetic human insulin, when compared with purified pork insulin (p less than 0.05 at 150, 180, and 210 minutes postprandially). Serum free immunoreactive insulin concentrations were significantly higher after injections of biosynthetic human insulin, and the rate of incremental rise during the first 30 minutes was also greater. Insulin antibody studies showed a strong negative correlation between peak insulin levels and the association constant for the high-affinity-binding insulin antibodies. We conclude that biosynthetic human insulin is more rapidly absorbed after subcutaneous injection than is purified pork insulin, a characteristic that results in improved postprandial metabolic control. PMID- 3307585 TI - Oxygen radicals and human disease. AB - Toxic oxygen free radicals have been implicated as important pathologic mediators in many clinical disorders. We discuss the chemistry of oxygen radical production and the roles of iron and of various antioxidants as well as the diseases that have received active attention in oxy-radical research. Particular attention is focused on cigarette smoke oxidants, ischemia-reperfusion-induced radical production, carcinogenesis, and aging. Such research may well provide a firm foundation for therapeutic breakthroughs. PMID- 3307586 TI - Ethical dilemmas in providing health care to workers. AB - The internist, expected to play an increasing role in occupational medicine, is likely to encounter ethical dilemmas in treating working patients, including those involving loyalty, confidentiality, reporting known or suspected occupational hazards and diseases, and maintaining awareness about occupational health factors. Many of these dilemmas become realized when the internist integrates occupational health services into general internal medicine practice, particularly when these services are important to employment decisions, such as the preemployment and periodic examinations. Appropriate responses to these dilemmas and the situations from which they arise can be formulated, based on accepted ethical and legal principles. PMID- 3307587 TI - Screening for coronary artery disease. PMID- 3307588 TI - [Cystic lymphangioma of the lesser epiploon (on a case brought to our attention)]. PMID- 3307589 TI - [Value of computed medical imaging in the surveillance of neo-adjuvant chemotherapy of osteogenic osteosarcoma in children and adolescents. 51 patients seen from 1984 to 1986]. AB - The value of quantitative bone scintigraphy, digitised angiography, CT scanning and magnetic resonance imaging in the follow-up of neo-adjuvant chemotherapy for osteogenic osteosarcoma was assessed in 51 patients between 1984 and 1986. Bone scintigraphy was a very sensitive method of detecting bone metastases but of limited value in assessing the response to preoperative chemotherapy. CT scanning was very useful in small and medium sized tumours with predominantly non-calcific involvement of the soft tissue. At present, digitised angiography seems to be the best investigation for following up these patients as shown by the close histo angiographical correlations. However, magnetic resonance imaging is a very promising method and may in future replace the more invasive aforementioned techniques in this indication. PMID- 3307590 TI - [Infarction of the right ventricle: from physiopathological mechanisms to therapeutic strategy]. PMID- 3307592 TI - [Recurring spontaneous abortion: rational basis of immunotherapy. Bibliographic review]. PMID- 3307591 TI - Prednisolone acetate-gentamicin combination following cataract surgery. AB - One-hundred-eleven patients participated in a 21-day, open-label study to evaluate the therapeutic efficacy and safety of a prednisolone acetate 1% gentamicin 0.3% ophthalmic suspension to control inflammation and prevent infection after cataract surgery. Beginning the day after surgery, the medication was instilled qid for the next 21 days. No postoperative infection was noted, and postoperative inflammation, which was mild immediately after surgery, decreased steadily during follow-up. The results of this study suggest that a prednisolone acetate-gentamicin combination used for three weeks after cataract surgery is safe and has a positive therapeutic effect on postoperative inflammation and infection. PMID- 3307593 TI - [On the physiopathology of erythema annulare centrifugum]. PMID- 3307594 TI - [Vitiligo. Recent bibliographical data]. PMID- 3307595 TI - Music Rx: physiological and emotional responses to taped music programs of preoperative patients awaiting plastic surgery. AB - This study investigated the physiological and emotional responses of patients awaiting an elective plastic surgery procedure to a 30-minute taped music program. The study replicated in part the research study of Bonny entitled "Music Rx." Values for the physiological variables of systolic blood pressure, diastolic blood pressure, pulse rate, mean arterial pressure (MAP), and double product index (DPI) were obtained before and after the music listening. These data were analyzed via a repeated measures t-test using each subject as her or his own control. The convenience sample of 10 was nonrandomized. Emotional responses were evaluated by means of an open-ended, nondirective questionnaire developed around 5 categories of depression, sadness, and despair; psychological isolation and defensiveness; anxiety; difficulty of medical management; and preoccupation with pain. Process recordings and documented verbal and body language were used before and after the music to identify themes and mood states expressed by patients. Every physiological variable decreased in value at the less than .001 level of significance. The most significant emotional effect appeared to be an experienced shift in patients' awareness toward a more relaxed, calm state. The most critical conclusion is that music listening appeared to effect desirable pattern shifts in physiological and emotional states in the presurgical setting for those patients studied. PMID- 3307597 TI - How to harvest skin graft from the avulsed flap in degloving injuries. AB - A new and simple way of harvesting skin graft from a degloved flap is presented. This technique allows precise harvesting and does not require assistance. The split-thickness skin excision is also a reliable diagnostic tool for determining degloved flap avascularity. PMID- 3307596 TI - The plantar digital web space island flap for reconstruction of the distal sole. AB - A neurovascular flap of interdigital web space skin based on the plantar circulation is described. The flap is useful for reconstructing distal plantar defects that do not have an adequate surface for skin grafting. It leaves a donor defect in a non-weight-bearing area and does not disrupt the structural integrity of the foot. The surgical anatomy and operative approach are detailed. The key to the approach is to preserve the fat pad around the neurovascular bundle during the dissection. Six patients have successfully undergone this procedure and have been followed for at least 2 years postoperatively. The plantar island flap is a reliable flap for repairing plantar defects overlying the metatarsal heads. PMID- 3307598 TI - Chronobiochemistry: an overview of circadian rhythms and some applications to clinical medicine and biochemistry. PMID- 3307600 TI - Clinical trials in disseminated malignant melanoma. AB - At present the available treatment modalities are not therapeutic for disseminated stage III- and IV melanoma. The management of these patients therefore concentrates primarily on effective palliation taking care to improve the quality of life. As an exception from this rule, patients with regional or solitary metastases may be treated vigorously to improve survival: However, (a) regional tumor resection with or without radiotherapy; (b) regional perfusion of tumor-bearing extremities, and (c) indicator chemotherapy, followed by the resection of solitary metastases and sometimes secondary adjuvant treatment with the same cytostatic regimen, will cure only about 20% of these patients. Systemic treatment with cytostatic agents given alone or in combination fail to reproducibly reach an objective remission rate of more than 20% or a gain in median survival of more than 6 months. The addition of biomodulators may even worsen these results and endocrine treatments are rarely helpful. Current research therefore concentrates on defining a well selected patient population with skin-, soft tissues-, and lung-metastases, who will benefit from systemic treatment, as well as on the development of drug derivatives with fewer side effects. Another small step forward may be expected from sophisticated techniques such as linking cytotoxins to monoclonal antibodies for selective cell killing, or rendering tumor cell membranes vulnerable to endogenous and/or exogenous attacks by altering their structure with the help of biomodulators (Interferons, DNCB etc.), or priming lymphokine-activated killer cells for specific lysis of vital tumor-associated antigens. Melanoma remains the cornerstone for testing the efficiency of medical oncology in general. PMID- 3307599 TI - Activity and inhibition by cytotoxic and antimetastatic drugs of cathepsin B-like cysteine proteinase in transplantable leukemias in mice. AB - The cellular levels of cathepsin B-like cysteine proteinases have been determined in a panel of transplantable mouse leukemias possessing a different potential to metastatize to the liver after i.p. implantation. The higher enzymatic activity observed in L1210 leukemic cells matches their higher capacity for hepatic infiltration. No significant difference is observed for TLX5 lymphoma and P388 leukemia, in spite of their different liver invasiveness, and their enzymatic levels do not significantly differ from that of the non-invasive Ehrlich ascitic carcinoma. The in vivo administration of the antimetastatic drugs ICRF159 and DM COOK, or of the cytotoxic drugs cyclophosphamide, cisplatin, CCNU and GANU, does not cause a pattern of enzyme inhibition matching the tumor metastatic potential and the increase in life-span of the treated tumor bearing mice, indicating that the inhibition of cathepsin B-like cysteine proteinase is not involved in either their cytotoxic or their antimetastatic action. PMID- 3307601 TI - A phase III of cisplatinum versus cisplatinum-etoposide for previously untreated squamous cell carcinoma of the head and neck. AB - 136 patients with previously untreated stage III or IV squamous cell carcinoma of the head and neck entered a prospective randomized trial to compare the efficacy and toxicity of DDP vs DDP-VP 16 213 (Etoposide). 69 patients (group A) were given three courses of DDP 100 mg/m2 administered on day 1, while 67 patients (group B) were given three courses of a combination of Etoposide 100 mg/m2 per os administered on days 1 to 5 and DDP 100 mg/m2 on day 4. Objective response rate appeared to be low in both groups: in group A (60 evaluated patients) CR = 1, PR = 9; CR + PR = 14.5%, and in group B (57 evaluated patients) CR = 3, PR = 8; CR + PR = 16.4% (p greater than 0.4). One drug-related death occurred in each group. There was no difference in toxicity between the two treatments with regard to leukopenia, thrombopenia, vomiting and nephrotoxicity. Thus this schedule of oral Etoposide does not seem to increase either the efficacy or the toxicity of DDP. PMID- 3307602 TI - Unexpected normal serum beta-microglobulin (B2M) levels in multiple myeloma. AB - Measuring serum beta-2-microglobulin (B2M) in 90 patients with multiple myeloma (MM) from diagnosis to death (83 cases), or to the terminal phase of their disease (7 cases), we have obtained evidence that 9% of them retained normal serum B2M levels during the whole of their follow-up. This was observed in 6 IgA MM, in one light chain MM only and in one non-secretory MM. These data suggest a lack of B2M production and/or secretion by some myeloma tumors. This could limit the use of B2M as clinical marker in MM. PMID- 3307603 TI - Age-related shrinkage of cortically projecting cholinergic neurons: a selective effect. AB - The number and size of basal forebrain neurons that provide the cholinergic innervation for the cerebral cortex, amygdala, and hippocampus were studied in young and aged mice. The results showed that these neurons became substantially smaller with increasing age. This effect was relatively selective, since the immediately adjacent cholinergic neurons in the striatum did not show a change of similar magnitude. The shrinkage of these basal forebrain neurons may account for the decline of cholinergic innervation that occurs with age. In the material that we examined, aging did not influence the number of cholinergic neurons in the basal forebrain, only their size. It seems, therefore, that the age-related changes in cholinergic function (and their putative behavioral consequences) are not associated with a substantial component of irreversible cell death. PMID- 3307604 TI - [Isolation and analysis of human leukocyte interferons synthesized by bacterial producer strains]. AB - Rapid and sensitive methods for immunochemical estimation of bacterially-made human leukocytic interferons were developed. A large number of strains producing such interferons was analyzed with these methods and optimal ones capable of synthesizing up to 10(10), 10(8), 10(9) and 10(9) IU/l of interferons alpha A, alpha N, alpha F and alpha I1 respectively were selected. The proteins were isolated in homogenous state and their main physico-chemical parameters were characterized. Interferon oligomers were detected. Their formation was partially due to intermolecular disulphide exchange. The effect on interferon alpha A of retinal (vitamin A) and its derivatives efficiently interacting with this protein was studied. PMID- 3307605 TI - [Optimization of the gene expression for human alpha F- and beta 1-interferons in Escherichia coli cells]. AB - The basic results of the studies on expression of the genes of human alpha F- and beta 1-interferons in E. coli cells are presented. To synthesize the fibroblast interferon, the respective fragment of the human chromosome was cloned, the complete nucleotide sequence of the structural moiety of mature beta-interferon was determined and the genes of "hybrid (interferon-like) proteins" and "hybrid sites of ribosome binding" were constructed with control of the beta-interferon gene by the prokaryotic regulatory areas. Synthesis of beta-interferon was achieved (1.10(7)-5.10(7) IU per 1 l of the bacterial culture) with the use of the tryptophan operon promoter. A new procedure for optimization of allogenic genetic information in E. coli cells: constructing of "hybrid operons with partially overlapping genes" or artificial "overlappons" was developed following the example of the alpha F-interferon gene cloned in the Laboratory headed by E. D. Sverdlov at the Institute of Bioorganic Chemistry of the USSR Academy of Sciences. The use of this procedure enabled production of up to 5.10(7) IU/l of alpha F-interferon under the control of the lacUV5-promoter. On the basis of the newly constructed vector molecules expression of the genes of alpha F- and beta 1 interferons was amplified with the "overlappon" procedure. PMID- 3307606 TI - [Molecular-genetic structure and incompatibility of the nonconjugative enterobacterial R plasmids pKMR281 and pKMR285]. AB - Physical maps of Enterobacteriaceae nonconjugative plasmids pKMR281 (Sm, Su, molecular weight of 6 kb) and pKMR285 (Sm, Su Tc, molecular weight of 9 kb) were constructed for endonucleases EcoRI, PstI, EcoRV, SmaI, BglII, SalI and PvuII. The genes controlling production of aminoglycoside-3''-phosphotransferase and dihydropteroate synthetase of type II and the genetic tetracycline resistance determinant of class A were localized on the plasmids. Heteroduplex analysis of plasmids pKMR281 and pKMR285 showed that plasmid pKMR281 was completely homologous to plasmid pKMR285. The site of plasmid pKMR285 nonhomology with respect to plasmid pKMR281 corresponded to the area containing the tetracycline resistance determinant. Plasmids pKMR281 and pKMR285 were compatible with the tester plasmids of 25 incompatibility groups of Enterobacteriaceae and probably constitute a new incompatibility group. It was shown that pKMR281 and pKMR285 type plasmids were widely distributed in clinical strains of E. coli and Shigella spp. isolated in the Krasnodar Region. PMID- 3307607 TI - [Solid-phase immunoenzyme analysis of insulin using Bacillus licheniformis 749/c beta-lactamase and horseradish peroxidase as markers]. AB - Two modifications of solid phase enzyme immunoassay (EIAA) for insulin with the use of beta-lactamase from B. licheniformis 749/c and horse radish peroxidase as the markers were developed. beta-Lactamase and peroxidase conjugates with insulin were prepared with the glutaric aldehyde and periodate methods respectively. Both the conjugates were stable and preserved high immunospecific and enzymatic activity. Sensitivity of EIAA with the use of the beta-lactamase or peroxidase as the markers was the same and amounted to 15 ng/ml of insulin. However, with the use of the beta-lactamase in EIAA not only spectrophotometric recording but also visual registration of the results was possible. PMID- 3307608 TI - [Action of a yeast dsRNA preparation on the humoral immune response and the delayed hypersensitivity reaction]. AB - The studies showed that yeast dsRNA in a dose of 2.5 mg/kg had a stimulating effect on the humoral immune response. When the preparation was administered soon after sensitization of experimental animals by the thymus-dependent antigen (sheep red blood cells, SRBC), there were observed a more than two-fold increase in the AFC count in the spleen and increased titers of hemolysins in blood serum. With the use of higher doses of the preparation (up to 10 mg/kg) the level of the immunostimulating effect remained unchanged. The efficacy of the preparation in CBA and C57BL/6 mice with high and low reactivity to the antigen was the same. Delayed-type hypersensitivity in the animals sensitized by SRBC was inhibited by yeast dsRNA in a dose of 10 mg/kg. PMID- 3307609 TI - [Mechanism of action of beta-lactam antibiotics and the resistance of microorganisms]. PMID- 3307610 TI - [Metabolism of amino acids and their use in creating blood-correcting preparations]. PMID- 3307611 TI - [Directed transport of anticancer antibiotics into tumor cells]. PMID- 3307612 TI - [Current aspects of the regulation of the biosynthesis of beta-lactam antibiotics]. PMID- 3307613 TI - [Cloning of the regulator gene of Erwinia carotovora repressing pectate lyase ptlA gene expression]. AB - Pectate lyase synthesis in the cells of Erwinia carotovora ELA 49 is induced by polypectate. This suggested that the Erwinia chromosomes carried a regulator gene responsible for negative regulation of the pectate lyase gene expression. In the present study the regulator gene controlling expression of one of the pectate lyase structural genes was cloned and designated as ptlA gene. For this purpose a genetic system with the tester plasmid pPc624 as the main element was constructed. The tester plasmid contained cat gene (resistance to chloramphenicol) controlled by the promotor of the ptlA gene cloned on vector pPD620. Plasmid pPC624 was maintained in the E. coli cells in a number of 1-2 copies and transferred resistance to chloramphenicol in concentrations up to 100 micrograms/ml to the cells. The E. carotovora cells containing pPC624 were sensitive to chloramphenicol in media containing no inductor (sodium polypectate). In media with the inductor they were resistant to chloramphenicol. Therefore, plasmid pPC624 proved to be a suitable system for testing the regulator gene product. The E. coli cells containing plasmid pPC624 were transformed by the hybrid Ptl+ plasmids identified in the clonotheque of the Erwinia DNA EcoRI fragments. The E. coli cotransformants were characterized by chloramphenicol sensitivity which provided a conclusion that the regulator ptlR gene controlling the ptlA gene expression was localized on the DNA EcoRI fragment (7.3 kb) containing the pectate lyase ptlA and ptlB genes. Deletion analysis showed that the investigated genes were localized in the EcoRI fragment (7.3 kb) of the E. carotovora chromosomal DNA in the following order: ptlA--ptlB- ptlR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307614 TI - [Characteristics of the oleandomycin producer inoculum at various levels of antibiotic biosynthesis]. AB - Parameters of the oleandomycin-producing organism metabolism were studied at the stage of inoculum when intensity of the antibiotic biosynthesis was increased by treating the spores with a surface active substance (twin-21). It was shown that the inoculum producing later at the stage of fermentation higher quantities of the antibiotic was characterized by certain peculiarities. In particular, there were observed a shorter lag phase, a higher specific growth rate and a higher rate of accumulating the medium components at lower pyruvate levels in the exponential phase, higher activity of succinate dehydrogenase and higher levels of ATP in the mycelium during this period. PMID- 3307615 TI - [Microbiological transformation of beta-lactam antibiotics]. PMID- 3307616 TI - Recent analytical methods for cephalosporins in biological fluids. AB - Since 1980, RP chromatography has been the principal analytical technique used for cephalosporins. This technology offers selectivity, accuracy, and ease of use. Most of the methods rely on protein precipitation and, to a lesser extent, solid-phase isolation or extraction procedures. The proper selection of a method depends on the analytical constraints imposed by the overall objective of the study. For example, pharmacokinetic datum interpretation mandates that the method be validated and provide specific and accurate results. LC is the preferred technique, since it not only meets these specifications but may also distinguish between the drug and metabolites. Those chromatographic methods which quantify several different cephalosporins are not desirable for pharmacokinetic datum interpretation, since accuracy and precision are usually compromised in order that many different drugs may be quantified in a single analysis. The proper selection of sample preparation method is dependent on the presence of potential interferences and the acceptable lower limit of quantitation. Protein precipitation methods offer ease of sample preparation but may suffer from nonselectivity. Solid-phase isolation and extraction procedures may increase selectivity and improve the limit of quantitation. Although LC provides specific and accurate results, clinical laboratories may prefer to use the less specific methods for therapeutic drug monitoring. In this case, microbiological, enzymatic, and fluorimetric methods offer improved sample throughput but less specificity. However, these methods should not be used for drugs that may have a low margin of safety or if the patient is on multiple-antibiotic therapy. Future methods may involve incorporating solid-phase isolation columns to enhance the specificity of chromatographic, microbiological, enzymatic, and fluorescence methods. Advancements in microbore column technology may allow improvements in the selectivity and sensitivity of LC methods. Many investigators prefer to use simple protein precipitation procedures for sample preparation because of sample throughput constraints. However, advances in robotic sample preparation may allow the more cumbersome solid-phase isolation or extraction techniques to be used to improved sample throughput and specificity. PMID- 3307617 TI - Response of Streptococcus pyogenes to therapy with amoxicillin or amoxicillin clavulanic acid in a mouse model of mixed infection caused by Staphylococcus aureus and Streptococcus pyogenes. AB - The response of Streptococcus pyogenes to amoxicillin or amoxicillin-clavulanic acid (Augmentin; Beecham Group) therapy of a mixed streptococcal-staphylococcal infection was studied in a surgical wound in mice. A superficial wound was produced on the backs of anesthetized mice, and a suture infected with S. pyogenes, Staphylococcus aureus, or a mixed inoculum of both organisms was inserted. Oral therapy was started 4 h after infection and continued for 3 days. Both amoxicillin and amoxicillin-clavulanic acid were effective in eliminating the streptococci from the pure wound infection. In contrast, amoxicillin failed to eliminate the streptococci from a mixed infection in which a beta-lactamase producing strain of S. aureus was also present, wound counts reaching 10(7) streptococci per wound by 80 h, whereas amoxicillin-clavulanic acid reduced the count to less than 33 streptococci per wound by 24 h. Numbers of S. aureus were also reduced by amoxicillin-clavulanic acid therapy, controlling the infection, whereas amoxicillin was ineffective. Also of significance was the fact that successful therapy was achieved with blood and tissue concentrations of amoxicillin and clavulanic acid of the same order as those measured in humans. These results show that amoxicillin therapy failed to eliminate S. pyogenes from a wound infection in the presence of a beta-lactamase-producing strain of S. aureus and suggest the potential of amoxicillin-clavulanic acid in the treatment of mixed bacterial skin infections involving beta-lactamase-producing organisms. PMID- 3307618 TI - Inhibitory effects of antiviral compounds on respiratory syncytial virus replication in vitro. AB - We examined the inhibitory effect of 20 antiviral compounds, including ribavirin, on the replication of respiratory syncytial virus in HeLa and HEp-2 cell cultures. Of the compounds studied, pyrazofurin and 3-deazaguanine emerged as more potent inhibitors of respiratory syncytial virus than ribavirin. Based on their inhibitory effect on the cytopathogenicity of respiratory syncytial virus in HeLa cells, the average 50% effective dose of pyrazofurin and 3-deazaguanine for eight strains was 0.07 and 1.65 micrograms/ml, respectively; that of ribavirin was 5.82 micrograms/ml. The cytotoxicity of these compounds for HeLa cells was examined by monitoring the incorporation of radiolabeled uridine into cellular RNA. The selectivity indexes of pyrazofurin and 3-deazaguanine exceeded that of ribavirin by 70- and 11-fold, respectively. Pyrazofurin, 3-deazaguanine, and ribavirin inhibited both viral antigen expression and syncytium formation in HeLa cell cultures, as assessed by an indirect immunofluorescence assay. In these assays, pyrazofurin and 3-deazaguanine again proved more potent than ribavirin. 2,5-Diamidinoindole and carbodine were less potent than ribavirin. Various other compounds, i.e., 3-adenin-9-yl-2-hydroxypropanoic acid isobutyl ester, 3 deazauridine, 3'-C-methyluridine, 5'-deoxy-5-fluorouridine, 5-cyanoimidazole-4 carboxamide, and its ribofuranosyl derivative, did not inhibit the cytopathic effect of the Long strain of respiratory syncytial virus at concentrations greater than or equal to 125 micrograms/ml. Tubercidin, 5-chlorotubercidin, xylotubercidin, neplanocin A, thiosemicarbazone R, and 3-methylquercetine were too toxic to HeLa cells for their inhibitory effects on respiratory syncytial virus to be examined. PMID- 3307619 TI - Antimicrobial substance from a human Lactobacillus strain. AB - Lactobacillus sp. strain GG, which was isolated from the feces of a normal person, produced a substance with potent inhibitory activity against a wide range of bacterial species. It inhibited anaerobic bacteria (Clostridium spp., Bacteroides spp., Bifidobacterium spp.), members of the family Enterobacteriaceae, Pseudomonas spp. Staphylococcus spp., and Streptococcus spp., as demonstrated by a microbiological assay; however, it did not inhibit other lactobacilli. The inhibitory activity occurred between pH 3 and 5 and was heat stable. Bactericidal activity against Escherichia coli was demonstrated at a dilution of 1:128. The inhibitory substance was distinct from lactic and acetic acids. It had a low molecular weight (less than 1,000) and was soluble in acetone water (10:1). Because of these characteristics, the inhibitory material could not be considered a bacteriocin; it most closely resembled a microcin, which has been associated previously with members of the family Enterobacteriaceae. PMID- 3307620 TI - Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults. AB - Effervescent lozenges containing 10 mg of zinc acetate were evaluated as a treatment of upper respiratory tract infections in a double-blind randomized trial by using a placebo which was indistinguishable to most observers in taste and appearance from the active material. Of the 70 treatment courses used by 55 individuals in 34 families, 63 (33 zinc and 30 placebo) were considered evaluable, in that the volunteer used the medication at least four times daily for at least 3 days, the average utilization being 5.4 days at an average dose of six lozenges daily. Six users of zinc reported nausea (versus no placebo users), and eight reported an unpleasant taste or aftertaste (versus one placebo user). No benefit was observed among the users of zinc acetate. The mean duration of symptoms in users of the zinc was 12.1 days, compared with 7.7 days in those who used the placebo. Nor was any beneficial effect of zinc evident among the four zinc-treated versus the two placebo-treated individuals from whom rhinovirus was grown. PMID- 3307621 TI - Improved sensitivity in assays for binding of novel beta-lactam antibiotics to penicillin-binding proteins of Escherichia coli. AB - Tigemonam and temocillin, but not aztreonam, bound to penicillin-binding proteins (PBPs) 1a and 3 of Escherichia coli with apparent improved affinity when challenged with benzylpenicillin at lowered temperatures. Half times for deacylation of the tigemonam-PBP complexes were shorter than were those of the corresponding aztreonam-PBP complexes. The implications of the routine testing of PBP affinities are discussed. PMID- 3307622 TI - Detection of a second mechanism of resistance to gentamicin in animal strains of Escherichia coli. AB - One mechanism of plasmid-mediated resistance to gentamicin in Escherichia coli strains isolated from animals is due to the synthesis of the aminoglycoside 3-N acetyltransferase type IV. A second mechanism of plasmid-mediated resistance to gentamicin was detected in animal strains of E. coli in France and is due to the production of the aminoglycoside 3-N-acetyltransferase type II. The molecular relationships among plasmids encoding this enzyme were studied. PMID- 3307624 TI - Vascularized bone grafts. Treating pseudarthrosis of the tibia. PMID- 3307623 TI - Oral ribavirin treatment of influenza A and B. AB - A loading dose and short-term administration of oral ribavirin significantly improved symptoms and signs of influenza type A or B infection in 25 patients. The antiviral effect was not significant. No adverse clinical effects or significant laboratory values were observed. Oral treatment of patients with influenza A or B infection might be possible with ribavirin. PMID- 3307625 TI - Drainage systems. Their role in wound healing. AB - In recent years, studies have demonstrated that the risk of wound infection can be reduced by careful wound management and adequate wound drainage. Evidence indicates that if a wound is not allowed to drain freely, blood, body fluids, pus, and necrotic material will collect in the wound, providing a growth medium for microorganisms. Surgical wound drainage is recognized as a key element in facilitating the healing process. Wound drainage systems are designed to allow enough moisture to remain in tissues to promote regeneration and lessen inflammation, while removing excess exudate or material that may hamper the healing process. Regardless of the system selected, it must be able to apply enough negative pressure to maintain surface apposition in the healing wound. This requires careful nursing assessment to ensure constancy of vacuum pressure. As the cost of treating preventable infections increases, infection control is becoming a high priority. Health care workers have therefore become increasingly interested in any product or system that contributes to the prevention of costly surgical wound infections. PMID- 3307626 TI - Holistic nursing. An approach to patient and self-care. AB - The re-emergence of the holistic health care paradigm has begun to revolutionize the health care system. New modes of nursing intervention, including therapeutic massage, therapeutic touch, imagery, and music can now be implemented by the perioperative nurse. All nurses must recognize the need for self-care and healthful behavior patterns in their own lives. When nurses achieve wellness, not only will they feel and function better, but they will be able to deliver high quality care. PMID- 3307627 TI - Food-induced changes in brain serotonin synthesis: is there a relationship to appetite for specific macronutrients? PMID- 3307628 TI - Nutrition, serotonin and appetite: case study in the evolution of a scientific idea. PMID- 3307629 TI - Central dietary "feedback onto nutrient selection": not even a scientific hypothesis. PMID- 3307630 TI - Effect of beta-hydroxybutyrate and acetoacetate on insulin and glucagon secretion from perfused rat pancreas. AB - To elucidate the physiological significance of ketone bodies on insulin and glucagon secretion, the direct effects of beta-hydroxybutyrate (BOHB) and acetoacetate (AcAc) infusion on insulin and glucagon release from perfused rat pancreas were investigated. The BOHB or AcAc was administered at concentrations of 10, 1, or 0.1 mM for 30 min at 4.0 ml/min. High-concentration infusions of BOHB and AcAc (10 mM) produced significant increases in insulin release in the presence of 4.4 mM glucose, but low-concentration infusions of BOHB and AcAc (1 and 0.1 mM) caused no significant changes in insulin secretion from perfused rat pancreas. BOHB (10, 1, and 0.1 mM) and AcAc (10 and 1 mM) infusion significantly inhibited glucagon secretion from perfused rat pancreas. These results suggest that physiological concentrations of ketone bodies have no direct effect on insulin release but have a direct inhibitory effect on glucagon secretion from perfused rat pancreas. PMID- 3307631 TI - Possible processing of mitochondria-bindable hexokinase to the nonbindable form by a lysosomal protease in rat liver. AB - As a possible mechanism for the absence of mitochondria-bindable hexokinase in the liver, the presence of a protease similar in action to chymotrypsin, which specifically eliminates the binding ability of the bindable hexokinase without changing its catalytic properties, was investigated in rat liver. The lysosomal fraction prepared from the liver converted the bindable hexokinase prepared from rat brain to the nonbindable form with little change in catalytic activity. The activity of such a "processing protease" was much lower in rat brain, where the bindable form is predominant. The processing activity cosedimented with lysosomal marker enzyme activities in the subcellular fractionation of livers from normal and Triton WR-1339-injected rats. A fair portion of the activity was detected in the lysosomes without disruption. The activity was maximal at pH 6.0-7.0, inactivated almost completely by tosylphenylalanine chloromethyl ketone, tosyllysine chloromethyl ketone, leupeptin, antipain, and chymostatin, and dependent on dithiothreitol and mercaptoethanol. These results suggest that a protease, properties of which are fairly similar to those of cathepsin M, may be involved in the post-translational processing of original bindable hexokinase to the nonbindable form in rat liver. PMID- 3307632 TI - [Phase II study of chlorambucil in patients with hematological malignancies]. AB - Eight patients with various hematological malignancies were treated with chlorambucil, an analogue of nitrogen mustard. Five patients with CLL, 2 patients with malignant lymphoma, and one each with pseudolymphoma of the lung and primary macroglobulinemia were given 4-6 mg of chlorambucil per day for 1-2 weeks at 2-4 week intervals or a daily dose of 6 mg continuously. Two cases of CLL and one each of follicular lymphoma and pseudolymphoma achieved partial remission. Side effects included myelosuppression, especially leukopenia. Chlorambucil can be used orally without severe toxicity for longer periods and the major indication for this drug seems to be CLL and favorable type of malignant lymphoma. PMID- 3307633 TI - [Antitumor activity of cisplatin and carboplatin against human tumor xenografts serially transplanted into nude mice--with special reference to gastric carcinomas]. AB - Experimental chemotherapy with cisplatin and carboplatin was performed against nine human tumor xenografts serially transplanted into nude mice. Tumors used for the experiment were seven gastric (St-4, St-15, St-40, H-111, SC-2-JCK, SC-6-JCK and Exp-4), one breast (MX-1) and one colon (Co-4) carcinomas. Cisplatin 9 mg/kg and carboplatin 100 mg/kg were administered intraperitoneally (ip). Carboplatin 25 mg/kg was also given ip 4 times every 4 days. The efficacy rates of cisplatin and carboplatin by bolus injection were 77.8% and 66.7% respectively with no statistically significant differences. However, carboplatin was found more effective when given by bolus. The antitumor spectra of both drugs were similar. From these results, these two platinum compounds seemed to be effective against human gastric carcinomas. PMID- 3307634 TI - [The Su-polysaccharide skin test in lung cancer]. AB - Skin testing with intradermally injected Su-Polysaccharide (extracted from Su strain Streptococcus bacteria) was performed in 41 cases of lung cancer. Su polysaccharide skin test results were correlated, to some extent, with the patient's age, clinical stage and performance status and showed a similar trend to the simultaneously performed PPD skin test. These results suggested the potential usefulness of Su-Polysaccharide skin test results as one of the parameters of immunological status of patients with lung cancer. It was also demonstrated that skin reaction to Su-Polysaccharide was increased specifically after OK-432 immunotherapy and was well correlated with the prognosis of the disease. The Su-Polysaccharide skin test was thus considered to be a useful parameter for monitoring the immune response to OK-432 immunotherapy in lung cancer and also one of the parameters of prognostic value. PMID- 3307635 TI - [Clinical results of a randomized controlled trial on the effect of adjuvant immunochemotherapy using Esquinon and Krestin in patients with curatively resected gastric cancer--7-year survival--Cooperative Study Group for Cancer Immunochemotherapy, Tokai Gastrointestinal Oncology Group]. AB - A randomized controlled study was carried out on curatively resected gastric cancer patients in a cooperative study involving 16 institutions in order to evaluate the effect of an alternative long-term adjuvant immunochemotherapy using Esquinon (CQ) and Krestin (PSK). One week after surgery, CQ was given at a dose of 2mg/m2 once a week for 3 weeks and this was repeated every 6 weeks. CQ was administered intravenously in the 1st course and thereafter orally up to 9 courses. Three postoperative week, immunotherapy was then started in which PSK was given orally in 3 divided doses of 2g/m2/day from the day when CQ therapy ended for 4 consecutive weeks, and this performed for every course. Estimated survival rate and cumulative survival curves were compared utilizing the data up to 7 years after surgery in the chemotherapy group given CQ alone and in the immunochemotherapy group given CQ + PSK. The survival curve in all cases showed a favorable form in the CQ + PSK group for up to 36 months, and thereafter it crossed with that of the CQ group for up to 68 months. Both curves twisted at 68 months and then deviated from each other, showing that the effect in the CQ + PSK group beneficial. The curve showed a twisting configuration throughout the treatment period. There was no statistically significant difference between the survival curves of the two groups. Retrospective survival analysis was then performed on separate subgroups classified into the category of S1, S2, N1, and N2. The CQ + PSK group was better than the CQ alone group in its survival rate for the S1 + S2 (N1-2) group, the percentage being 11.5%, and a statistically significant difference was observed between the two groups (p = 0.089). PMID- 3307636 TI - Treatment of alopecia areata with squaric acid dibutylester. AB - Fourteen of 18 patients with extensive alopecia areata completed a course of weekly treatments with the topical allergen squaric acid dibutylester in acetone. The concentration of squaric acid was varied as needed to maintain a moderate dermatitis. Only one area of alopecia was treated in each patient until marked hair growth occurred. The remainder of the scalp was then treated. Four patients (28.5%) had complete regrowth of hair during treatment; one of these patients had recurrent alopecia after stopping treatment. Ten patients (71.4%) were treatment failures. Of these ten failures, seven developed a moderate dermatitis and hair regrowth but experienced recurrent alopecia with continued treatment. One patient failed to maintain an adequate persistent dermatitis, and two failed to grow any hair despite the presence of dermatitis. Successful results in these patients correlated with (1) a duration of alopecia of less than two years, (2) the development of a moderate dermatitis within three weeks of starting treatment, (3) persistent hair growth within two months of developing dermatitis, and (4) an age of 16 years or older. PMID- 3307637 TI - Intercellular IgA dermatosis with clinical features of subcorneal pustular dermatosis. AB - In a patient whose clinical features resembled subcorneal pustular dermatosis, IgA deposits in the intercellular space of the upper epidermis were found on direct immunofluorescence study. Furthermore, by indirect immunofluorescence, IgA autoantibodies against the same area of the epidermis were demonstrated in the patient's serum. PMID- 3307638 TI - Acute bullous dermatosis and onycholysis due to high-dose methotrexate and leucovorin calcium. PMID- 3307639 TI - Reticulin and endomysial antibodies in bullous diseases. Comparison of specificity and sensitivity. AB - Reticulin antibodies of IgG- and IgA-class and endomysial antibodies, which are of the IgA class, were studied by indirect immunofluorescence in 30 normal subjects, and in 45 patients with dermatitis herpetiformis (DH), 31 with pemphigoid, and 30 with pemphigus. Endomysial antibodies were present in 65% of patients with DH maintained on a normal diet and were absent in those on a gluten free diet and in those with other diseases and in normal controls. Reticulin antibodies of the IgA class were disease specific for DH and occurred in only 25% of such patients. IgG-class reticulin antibodies, on the other hand, were not specific for DH, as they occurred in similar frequencies in patients with pemphigoid and pemphigus and in normal subjects. IgA-class reticulin antibodies occurred primarily in those patients with DH who had high titers of endomysial antibodies. None of the 20 such patients who were negative for endomysial antibodies had IgA-class reticulin antibodies. These studies indicate the high degree of specificity and sensitivity of endomysial antibodies. PMID- 3307640 TI - Acquired cutis laxa concomitant with nephrotic syndrome. AB - A 41-year-old woman developed laxity and wrinkling of the skin. This process spread slowly to involve the skin of almost the entire body, without any previous inflammatory skin disorder. The skin of her face, neck, and trunk hung in loose folds, leading to a prematurely aged appearance. One year later she noticed edema on her face and legs. Laboratory studies disclosed low C3 and CH50 serum levels and proteinuria. Skin biopsy specimens revealed extensive loss and fragmentation of dermal elastic fibers. A renal biopsy specimen showed membranoproliferative glomerulonephritis (type 2), and an immunofluorescent study disclosed C3 and IgG deposition in the mesangial matrix and along the glomerular basement membrane. We propose that, in this case, cutis laxa may be related to an abnormal immune response. PMID- 3307641 TI - Crusted papules on the arm and trunk. Walkman dermatosis, or adapter dermatosis. PMID- 3307642 TI - Endotracheal resuscitation of preterm infants at birth. AB - The adequacy of initial ventilation in 21 preterm babies (25-36 weeks' gestation), who required endotracheal intubation and positive pressure ventilation, were studied. Pressure and flow were measured at the proximal end of the endotracheal intubation tube and expiratory volume calculated from the flow trace. The results were compared with those from a group of 26 term infants who also required resuscitation. Five of 21 preterm babies (24%) had adequate tidal ventilation with the first inflation. This rose to seven of 21 (33%) by the third inflation. This was significantly less than the results in the term infants (chi 2 = 4.38 p less than 0.05). Respiratory reflex responses to resuscitation were seen in 41% of inflations in preterm and 56% of inflations in term infants. There was a significant correlation between reflex activity and adequate ventilation in the preterm group (chi 2 = 11.83, p less than 0.001) but not in the term group (chi 2 = 0.212, p = NS). No correlation was seen between initial ventilation and outcome. PMID- 3307643 TI - Comparison of intranasal and oral desmopressin for nocturnal enuresis. AB - A single blind dose response study of the effects of treatment with tablets containing 50-400 micrograms of desmopressin was conducted in 15 children with primary nocturnal enuresis. A dose response effect was seen, with the 100, 200, and 400 micrograms doses resulting in significantly more dry nights than when a placebo was used. The response after 200 micrograms was significantly different from that after 100 micrograms (p less than 0.02) but not from that after 400 micrograms. A randomised, double blind, double dummy, cross over study was then carried out in 30 children to compare the effects of a 20 micrograms dose given through a nasal pipette, a 200 micrograms tablet, and a placebo. The numbers of dry nights were significantly greater during both periods of treatment with desmopressin when compared with that using placebo, but there were no differences between the methods of taking the drug. After oral and nasal treatment 41% and 52%, respectively, of the patients improved by more than 50%. Nine children (31%) remained completely dry after treatment. PMID- 3307645 TI - [Induction of long-term tolerance by cyclosporine in orthotopic kidney allografts in rats]. PMID- 3307644 TI - Five year prospective study of plasma renin activity and blood pressure in patients with longstanding reflux nephropathy. AB - Eight of 100 normotensive children who had pyelonephritic scarring secondary to urinary infection and vesicoureteric reflux were found in an earlier study to have increased plasma renin activity (PRA). Because the risk of these patients becoming hypertensive is between 10% and 20% and because renin activity may play a part in the pathogenesis of the hypertension, PRA and blood pressure were studied in 98 of the original group after five years of follow up. Two patients could not be traced, and other factors that might influence blood pressure or PRA led us to exclude 13 others, 10 of whom were girls taking oral hormonal contraceptives. Increased PRA was found in 11 of the remaining 85 patients but not in five of the eight patients with increased PRA in the first study. Of eight children identified as hypertensive in the follow up study, only three had had increased PRA five years previously. In normal children PRA decreases with age. In the initial study this tendency was less pronounced in children with renal scars, and in the follow up study it was reversed. This was also confirmed by PRA standard deviation scores, which showed a significant increase in PRA during the five years. PRA tends to rise in patients with pyelonephritic scars as they grow older. There was no direct correlation between blood pressure and PRA, plasma creatinine concentration, or degree of scarring. Analysis of blood pressure standard deviation scores, however, suggested an excessive rise in blood pressure during the five years. PMID- 3307646 TI - [Immunotherapy use of keyhole-limpet hemocyanin in the treatment of bladder cancer. Preliminary study]. PMID- 3307648 TI - Improving nursing's public image and impact. PMID- 3307647 TI - [Immunohistochemistry of tumors of the nervous system]. PMID- 3307649 TI - [Effect of chemoprophylaxis or chemotherapy with chloroquine on the acquisition of antimalarial fluorescent antibodies in the savannah area]. PMID- 3307650 TI - In vivo chloroquine sensitivity of Plasmodium falciparum in South West Niger. PMID- 3307651 TI - [Human listeriosis]. PMID- 3307652 TI - A computer aided teaching program in epidemiology and biostatistics. PMID- 3307653 TI - Shunt surgery versus endoscopic sclerotherapy for long-term treatment of variceal bleeding. Early results of a randomized trial. AB - In September 1982, a prospective randomized trial comparing shunt surgery and endoscopic sclerotherapy for the elective management of variceal hemorrhage in patients with cirrhosis was initiated. Twenty-seven patients have received shunts (distal splenorenal = 23, nonselective = 4) and 30 patients have had chronic sclerotherapy. Eighty-six per cent of patients had alcoholic cirrhosis and 33% were Child's class C. After a mean follow-up of 25 months, 19% of shunt and 57% of sclerotherapy patients have had rebleeding (p = 0.003). Kaplan-Meier survival analysis reveals similar 2-year survival rates for shunt (65%) and sclerotherapy (61%) groups. Only two of 10 sclerotherapy failures have been salvaged by surgery. Posttherapy quantitative hepatic function, frequency of encephalopathy, and cumulative medical costs were similar for both groups. Hepatic portal perfusion and portal pressure at 1 year were better maintained by sclerotherapy than by distal splenorenal shunt. In conclusion, endoscopic sclerotherapy and shunt surgery provide similar results with respect to survival, hepatic function, frequency of encephalopathy, and costs. Sclerotherapy is an acceptable, but not superior, alternative to shunt surgery for treatment of variceal hemorrhage. PMID- 3307654 TI - Blood flow in colonic anastomoses. Effect of stapling and suturing. AB - Sutureline blood flow was measured with laser Doppler velocimetry in colonic anastomoses created with the stapler, manual suturing, or a combination. Blood flow was always reduced in the sutureline compared with normal mucosa. Of all the anastomoses studied, tight stapling reduced sutureline blood flow the most, whereas the two-layered manual anastomosis or stapling reinforced with sutures were somewhat less ischemic. Stapling adjusted to bowel wall thickness impaired flow only moderately. It was possible with practice to outperform the stapler by single-layered manual anastomosis using fine sutures. In humans, stapled ileocolostomy had a higher sutureline blood flow than the two-layered manual anastomosis. In view of the existing clinical experience of safe stapling without adjustment for bowel wall thickness, a low sutureline blood flow is probably tolerated to a considerable degree in humans. However, this study clearly shows that tight stapling can reduce sutureline blood flow unduly, whereas superior blood supply can be attained by attention to staple closure height relative to bowel wall thickness. PMID- 3307655 TI - The chemotherapy of rodent malaria, XL. The action of artemisinin and related sesquiterpenes. AB - Artemisinin (Qinghaosu), a poorly soluble sesquiterpene lactone derived from the plant Artemisia annua Linn., and a number of more soluble, semi-synthetic derivatives are rapidly-acting blood schizontocides against Plasmodium berghei and P. yoelii nigeriensis. An oily suspension of artemisinin given s.c. is more effective than aqueous suspensions. The activity is retained against lines resistant to primaquine, cycloguanil, pyrimethamine, sulphonamides, mefloquine and menoctone, but a highly chloroquine-resistant line is much less sensitive. Artemisinin has no causal prophylactic, gametocytocidal or sporontocidal action. Dihydroartemisinin causes the pigment of P. berghei to clump, but in a different fashion from the pigment changes induced by chloroquine or quinine, reflecting a different mode of action of the sesquiterpenes from that of these other antimalarials. PMID- 3307656 TI - Comparative study of the virulence of two Leishmania donovani isolates of different origin. AB - The virulence of two isolates of Leishmania donovani (LMU-6 isolated from a human case in Ethiopia and LMU-16 isolated from an asymptomatic dog in the south-east of Spain) in BALB/c and C57Bl/6 mice and in hamsters was observed over a period of 14 weeks. Regular measurements of the liver parasite burdens and observations of external signs of infection were made, and the humoral and delayed type hypersensitivity responses were tested. No major differences were observed in the infection patterns produced by the two isolates in mice, except for a slightly stronger humoral and lower delayed type hypersensitivity response detected in C57Bl/6 mice infected with LMU-16. However, LMU-16 showed a higher virulence in hamsters than did LMU-6. PMID- 3307657 TI - Albendazole in children with hookworm infection. PMID- 3307659 TI - Acute traumatic rupture of the aorta: repair by simple aortic cross-clamping. AB - This report describes the techniques used in 16 patients for repair of acute traumatic rupture of the aorta. Direct aortic cross-clamping (13 to 27 minutes) was used without additional methods of spinal cord protection. Direct suture was possible in (56%) of the 9 patients with partial rupture of the aorta but in only 1 (14%) of the 7 patients with complete disruption. In the remaining patients, the repair was carried out by interposing Gore-Tex patches (4 patients) or open tubular grafts (6 patients) using a simplified method, which is described. The 2 deaths, 1 intraoperative and 1 postoperative, were unrelated to the technique. There were no additional perioperative complications. Direct aortic cross clamping and repair by direct suture or open tubular graft, as described, greatly simplify the correction of acute traumatic rupture of the aorta, and their use is strongly recommended. PMID- 3307658 TI - HLA compatibility and cardiac transplant recipient survival. AB - Although the major histocompatibility complex has been linked with the control and expression of immune response in mammalian species, its importance for heart transplantation has not been demonstrated. The relationship of patient survival to human lymphocyte antigen (HLA) (A and B loci) compatibility was studied in 164 consecutive cyclosporine-treated patients who underwent orthotopic heart transplantation between 1980 and 1986 at Stanford University Medical Center. All patients receiving a transplant within this time frame were included except those for whom HLA typing was unavailable. A mismatched antigen was defined as an antigen present in the donor but not in the recipient. The actuarial four-year survival (Cutler-Ederer) for the 19 patients with 0 or 1 mismatch was 88 +/- 8%; for the 39 patients with 2 mismatches, 70 +/- 12%; for the 73 patients with 3 mismatches, 59 +/- 7%; and for the 33 patients with 4 mismatches, 54 +/- 14%. Both actuarial and linear rate analyses revealed no significant correlation between HLA mismatching and rejection rate, likelihood of death from rejection, or length of time to first episode of rejection. Patients with 3 or 4 mismatches had significantly (p less than 0.05) more infections than those with fewer mismatches. By actuarial analysis, a trend toward a higher number of deaths from rejection and infection was observed in the groups with 3 and 4 mismatches, but it did not achieve statistical significance. The data demonstrate that well matched HLA grafts are associated with better long-term survival and fewer infections in cardiac transplant patients. PMID- 3307660 TI - Coarctation of the aorta with arch hypoplasia: improvements on a new technique. AB - The association between coarctation and arch hypoplasia can be difficult to manage surgically. Several complex techniques have been designed for its management (e.g., resection of coarctation with either retrograde subclavian flap or carotid subclavian angioplasty). However, residual gradients are frequent. Recently, a new technique of extensive end-to-end anastomosis was described that has the advantages of leaving the left subclavian artery intact and resulting in a wide anastomosis. The present report details a modification of this technique, which more extensively dissects the arch branches and clamps the aortic arch almost 50% of the way across the innominate branch. The descending aorta is mobilized to the diaphragm. Anastomosis is completed with 7-0 PDS or polypropylene sutures. This type of repair has been performed in 7 patients, with a maximum residual gradient at the end of the procedure of 5 mm Hg. These modifications represent an excellent option to the surgeon in the management of this difficult clinical entity. PMID- 3307661 TI - Classics in thoracic surgery. The Waterston shunt: a commentary. PMID- 3307662 TI - Myocardial protection. PMID- 3307663 TI - Interdisciplinary andrology. STDs. AIDS research. AB - Multidisciplinary andrology deals with clinical application and modern technology for the evaluation and differential diagnosis of male infertility with emphasis on morphological, anatomical, biochemical, immunological, hereditary, and microbiological parameters. Little is known about the effects of diet, disease, stress, environmental, and drugs on male-related unexplained infertility of couples. Regional, national, and international centers of multidisciplinary andrology should provide (1) extensive and unique clinical services; (2) a computerized "patient referral center," (3) self-learning packages (slides/tape programs) for patients; and (4) a computer link to the National Library of Medicine and the Drug Information Center. Specialized laboratories and clinics can be served by expert consultants, visiting professors, bilingual and well trained clinicians, nurses, laboratory technologists, computer operators, and related allied health personnel. Patient education pamphlets, updated every few years, can be distributed during training workshops when an extensive network of remote teleprinters can be utilized. Qualified client location may install a printer to allow on-site printing of reports in the shortest possible time. Special mailing containers are provided to clients who wish to mail their laboratory specimens. Other clinical services may include the following: 1. Central source of communication and information in andrology; 2. International roster of multidisciplinary andrology centers; 3. Patient referral to centers and consultations for developing countries; 4. Screening of husbands and wives for in vitro fertilization/embryo transfer (IVF/ET); 5. Screening of couples with unexplained infertility for sexually transmitted diseases (STDs) including AIDS; 6. Exchange of research material and methodology; 7. Coordination of multicenter research; 8. Organizing training workshops for clinicians, nurses, and laboratory technicians; 9. Establishing a repository of films, video tapes, slides, catalogs, instrumentation, books, SEM photos, and atlases; 10. Publication and editorial assistance; 11. Consultation for the appropriate selection, purchase, and quality control of instrumentation (all on one computer system); 12. Evaluation of new diagnostic tools for idiopathic infertility and fertility regulation; 13.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3307664 TI - Glucose intolerance and insulin resistance with aging--studies on insulin receptors and post-receptor events. AB - The oral glucose tolerance test and immune reactive insulin level determination were performed on 100 non-obese healthy elderly and 40 young and middle-aged non obese healthy subjects. In about 60% of the elderly an altered glucose tolerance test was found, but the insulin level was increased in the whole group of elderly subjects. This means an insulin-resistant state with aging. Further investigations were carried out to determine some possible causes of this insulin resistance. The chromium level in sera and granulocytes of elderly was significantly decreased as well as the insulin receptor numbers and the affinity to erythrocytes. In contrast, when the cyclic nucleotide levels were investigated in granulocytes under in vitro stimulation, an age-dependent increase of cAMP level was found and an unresponsiveness of cGMP, which ranged between mild and severe degrees. Concomitantly, all these changes found could contribute to the insulin resistance at the receptor and post-receptor levels with aging. PMID- 3307665 TI - Problems of evaluation in gerontology--a short review. AB - Problems of health evaluation are summarized under three headings covering theoretical, technical, and practical aspects, in physical mental, and social fields. Methods used and instruments applied in gerontology are briefly commented. The heterogeneity of elderly populations is stressed considering group and individual features. Guidelines for comprehensive evaluation, in which psychological variables have an important role, are suggested for assessing the elderly. PMID- 3307667 TI - Effect of gangliosides on nerve conduction velocity during diabetic neuropathy in the rat. AB - Diabetic neuropathy was induced in male inbred rats by a single injection of streptozotocin. The diabetic state of the animals was prevented from detoriation by daily injections of small amounts of insulin. Before as well as 4 and 8 weeks after induction of diabetes compound action potentials evoked by electrical stimulation were repeatedly recorded from muscle and tail nerves of the same 55 animals. The motor nerve as well as the maximal proximal and distal nerve conduction velocity were determined. The neuropathy was established by comparing the increase in conduction velocity in a nondiabetic control group with the marked decrease in a group of diabetic animals receiving daily placebo injections. In a second group of diabetic animals daily injections of gangliosides (Cronassial) significantly counteracted the slowing of nerve conduction in comparison to that observed in the diabetic placebo group during the development of the neuropathy. This effect is discussed in terms of an increase of Na+-K+-ATPase or neuronal sprouting, possibly induced by the daily ganglioside application, and its usefulness in ameliorating human diabetic neuropathy. PMID- 3307666 TI - [Homage to Charles Nicolle. Birth, eclipse and resurgence of the concept and diseases caused by autoimmunization]. PMID- 3307668 TI - The persistent problem of poor blood pressure control. AB - Despite improvements in the control of hypertension in the United States, there is evidence that considerable numbers of people still have uncontrolled high blood pressure (BP). Because mortality and morbidity are reduced in proportion to BP reduction, it is important to identify the major causes of failure to control hypertension. This article summarizes the results of various studies of BP control: population surveys, assessments of usual practice, worksite programs, large-scale special projects, and quality assurance programs. The evidence suggests that patient characteristics and behaviors explain much of the poor BP control in patients under care. The most important of these patient factors is compliance. However, other factors associated with poor BP control are excessive alcohol intake, life stress, lower income, younger age, black race, male sex, and unmarried state. In evaluating BP control, the clinician and researcher must also be aware of various measurement effects that may lead to erroneously high BP readings. PMID- 3307669 TI - Amiodarone in the management of refractory atrial fibrillation. AB - Thirty-eight patients were studied to evaluate amiodarone hydrochloride in the treatment of refractory atrial fibrillation. Among them were 25 with sustained atrial fibrillation and 13 with paroxysmal atrial fibrillation. All patients were symptomatic and refractory to therapeutic doses of at least two conventional drug trials, and patients with atrial fibrillation had relapsed from electroversion. Amiodarone hydrochloride was administered in doses of 5 mg/kg intravenously, then 600 to 800 mg/d for seven to ten days, followed by 200 to 400 mg/d. Holter recordings were obtained every one to three months. The effect of amiodarone on the ventricular rate during sustained atrial fibrillation was evaluated in 18 patients and decreased from 99/min (range, 72/min to 143/min) at baseline to 75/min (range, 60/min to 102/min) at follow-up before conversion. Conversion to normal sinus rhythm occurred in 19 patients (76%), including 11 with and eight without direct-current cardioversion. During long-term treatment, sinus rhythm was sustained on an average of 16 months (range, three to 27 months) in 20 patients (53%). This included 11 of 25 patients with sustained atrial fibrillation and nine of 13 patients with paroxysmal atrial fibrillation, with only four of these patients relapsing. Four patients (11%) developed intolerable side effects, but no serious toxic effects were encountered, perhaps because of the relatively low doses of amiodarone hydrochloride that were used (average, 232 +/- 80 mg/d). Amiodarone is a safe and effective alternative to standard therapy in patients with refractory sustained or paroxysmal atrial fibrillation. PMID- 3307670 TI - Ranitidine therapy for gastroesophageal reflux disease. Results of a large double blind trial. AB - In a multicenter, double-blind trial, 284 patients with gastroesophageal reflux disease were evaluated before, during, and after six weeks of treatment with either placebo or ranitidine (150 mg twice daily). Randomization resulted in two comparable patient groups. Ranitidine treatment was significantly more effective than placebo treatment in decreasing the frequency and the severity of heartburn during both daytime and nighttime assessment periods. There was a significant correlation between improvement in heartburn symptoms and decrease in antacid consumption; hence, patients receiving ranitidine consumed significantly fewer antacid tablets. Among patients with endoscopic esophagitis at baseline, the overall change in endoscopic classification after six weeks of therapy was significantly better for the ranitidine-treated patients. The ranitidine-treated group had less evidence of erosions and ulcerations as well as greater healing. There were no differences between the groups with respect to changes in esophageal mucosal sensitivity to acid perfusion or changes in histologic grading of esophageal mucosal biopsy specimens. The ranitidine safety profile was similar to that of previous studies. We conclude that, in patients with gastroesophageal reflux disease, ranitidine therapy, 150 mg twice daily, markedly reduced the heartburn symptoms of reflux disease and significantly improved the endoscopic appearance of the esophageal mucosa. PMID- 3307671 TI - Who still prefers aggressive surgery for breast cancer? Implications for the clinical applications of clinical trials. AB - Conservative breast surgery and modified radical mastectomy may, according to recent reports, yield equivalent survival. Analysis of a 1985 Canada-wide study (N = 228) compared surgeons and oncologists still recommending modified radical mastectomy (30%) with those recommending less aggressive surgery (69%) for a hypothetical stage I patient. The groups did not differ significantly in most physician characteristics, estimated survival and cure probabilities, importance of most treatment goals, uncertainty about treatment choice, or most attitudinal responses. Although equally involved with and cognizant of the value of clinical trials, the modified radical group expressed more skepticism about the ability of trial results to be transferred to practice and to take sufficient account of patient uniqueness, indicating greater focus on variation than mean results. Trial results might be more readily adopted if they are reported in accessible data-bases, incorporating patient characteristics potentially relevant to treatment choice. This would allow clinicians to individualize treatment by analyzing patient subsets of their own choosing. PMID- 3307673 TI - Gentamicin resistance among gram-negative bacillary blood isolates in a hospital with long-term use of gentamicin. AB - Between 1977 and 1985, gentamicin was the only formulary aminoglycoside at the Buffalo Veterans Administration Medical Center. During this time, there was a significant increase in the amount of gentamicin purchased. Amikacin represented 11% or less of the total aminoglycoside purchased in the same period, but purchases of this agent also significantly increased. Because of this long-term use of gentamicin, a retrospective analysis of gentamicin resistance among gram negative bacillary blood isolates was performed. The results of this review revealed no significant change in the overall incidence of gram-negative bacteremia; approximately 75% of these bacteremic episodes were hospital acquired. The mean yearly gentamicin-resistance rate of gram-negative blood isolates was 13.2% (range, 6% to 18%) with no significant change in the rate for the period reviewed. However, for certain strains there were fluctuations in the percentage of resistance from year to year, suggesting that clusters of infections due to these organisms had occurred. Bacteremic infection due to resistant organisms was a major contributor to the overall level of gentamicin resistance among blood isolates. Amikacin resistance among gram-negative blood isolates was rare. In conclusion, despite the predominant use of gentamicin there was no change in the gentamicin resistance rate among gram-negative bacillary blood isolates during a nine-year period. The rate of gentamicin resistance among blood isolates appeared to be related to outbreaks/clusters of infections due to resistant strains rather than the frequency of use of gentamicin. PMID- 3307672 TI - Psychiatric complications of long-term interferon alfa therapy. AB - Ten (17%) of 58 patients with chronic viral hepatitis treated with a four- to 12 month course of recombinant human interferon alfa developed psychiatric side effects. The psychiatric side effects fell into three categories: an organic personality syndrome characterized by irritability and short temper; an organic affective syndrome marked by extreme emotional lability, depression, and tearfulness; and a delirium marked by clouding of consciousness, agitation, paranoia, and suicidal potential. These psychiatric side effects appeared after one to three months of therapy, usually improved within three to four days of decreasing the dose of interferon alfa, and invariably resolved once therapy was stopped. The organic personality and affective syndromes tended to occur in patients who received the highest dose of interferon alfa, who had relatively mild hepatitis, and who lost weight during interferon treatment. Delirium tended to occur in patients with severe hepatitis who had previous evidence of organic brain injury or dysfunction or previous drug and alcohol abuse. Failure to recognize these side effects quickly and to treat them with supportive therapy and modification of the dose of interferon alfa could result in limitation of therapy and serious personal and interpersonal consequences. PMID- 3307674 TI - Yersinia enterocolitica infection complicated by intestinal perforation. AB - Yersinia enterocolitica causes primarily ileocolitis in human beings, and is manifested by abdominal pain, diarrhea, and fever. Usually, it is a self-limiting disease. Local or systemic complications are rare. A 71-year-old man with Y enterocolitica colitis complicated by perforation and abscess formation is described. This complication is very rare, and the four other cases that have been reported in the literature are reviewed. PMID- 3307675 TI - Studies on the mechanism of "hypoglycemic" effect of nopal (Opuntia sp.). PMID- 3307676 TI - [Homicides in the federal city of Ulm in the first 5 decades following the 30 years' war]. AB - Reports about homicidal crimes after the end of the Thirty Years War from 1648 to 1699 were investigated with respect to the way and frequency of homicide, the social milieu and the consequences of the crime. Original sources from the municipal archives of Ulm were evaluated. Thirty six crimes of manslaughter were officially documented, out of these 30 crimes could be investigated. Most frequent was murder by puncture (11 cases) followed by striking dead (7 cases). Sixteen delinquents were arrested, 8 were executed and 3 absolved. In 9 cases the statements of a doctor or a barber were taken into account for judgement. Only in two cases of infanticide comments about the social background could be found. Delinquents as well as victims of the crimes belonged to various social classes. In the present view the years after several decades of war do not appear as a time of increased violence or legal insecurity. PMID- 3307677 TI - An improved method for protoplast formation and its application in the fusion of Rhodotorula rubra with Saccharomyces cerevisiae. AB - Protoplasts from various strains of red-pigmented yeasts were generated at high frequency using improved procedures. The use of sulphur-containing amino acids and 2-deoxyglucose in growth media led to impaired cell wall synthesis and rendered cells very susceptible to treatment with mercapto-ethanol and various lytic enzymes. Use of individual lytic enzymes separately resulted in relatively low frequencies of protoplasts from most of the red yeasts examined, whilst use of beta-glucuronidase, Novozyme and Zymolyase in series markedly increased stable protoplast formation. The latter effects were shown to be strain specific. The ability to generate large numbers of red yeast protoplasts prompted the attempt to examine intergeneric fusion between auxotrophs of a strain of Saccharomyces cerevisiae and Rhodotorula rubra. Putative hybrids were selected as variously pigmented prototrophic colonies growing on minimal medium and stabilised by subculturing on the latter medium. Unusual cream, orange and yellow hybrid colonies were generated, composed of cells of varying morphologies (chains, multibudded). The majority of stable hybrids contained one nucleus, although several heterokaryons were also observed. Some hybrids possessed the phenotypes of both parents: fusant wcat41 grew as rapidly as the S. cerevisiae parent but also contained an inducible phenylalanine ammonia-lyase (PAL) which appeared to be more active than that of the Rhodotorula parent. PMID- 3307678 TI - Interaction of lysosomal enzymes and their natural inhibitors in bronchoalveolar lavage fluid and serum in atopic bronchial asthma. AB - To evaluate the role of proteolytic balance in atopic bronchial asthma, the activity of lysosomal enzymes and the concentration of their natural inhibitors were determined in bronchoalveolar lavage fluid and serum in 28 patients with asthma. The results were statistically analyzed. A significant increase of lysosomal enzyme activities as compared with healthy volunteers was detected mainly in bronchoalveolar lavage fluid. Similarly, a selective increase in the concentration of the natural inhibitors of proteolytic enzymes, especially alpha 2-macroglobulin, was noted. Moreover, the concentrations of alpha-1-antitrypsin and the activities of neutral protease, alpha-1-antitrypsin, alpha-2 macroglobulin and acid protease were correlated. These findings suggest the participation of lysosomal enzymes and their natural inhibitors in immune response during atopic bronchial asthma. The protease antiprotease balance control may be used in prognostic and therapeutic procedure in diseases of the respiratory tract. PMID- 3307680 TI - Identification of cells producing anti-treponemal lymphotoxin (ATL). AB - Identification of cells producing ATL was carried out on suspensions of cells enriched with lymphocytes T, B and macrophages. The cells were isolated from the spleen of syphilitic rabbits and from their testes when the rabbits were infected intratesticularly. The isolation of lymphocytes and macrophages was performed on different days after infection. It has been found that all examined cells are able to produce ATL but most active are T lymphocytes. These cells isolated from the testes were able to produce ATL already 6 days after infection, whereas lymphocytes B and macrophages acquired this capability not before day 10-13. The ability of cells to produce ATL was followed by marked reduction of treponemes from testes. The isolated treponemes were also immobilized and destroyed. Dependence between capability of cells to produce ATL and disappearance of treponemes from infected organ indicated that ATL kills treponemes also in vivo. PMID- 3307679 TI - Enzyme-linked immunosorbent assay (ELISA) of penicillin amidases. AB - Non-competitive, sandwich enzyme immunoassay for both penicillin amidases from Escherichia coli is described. The assay involves the use of monospecific antibodies and their conjugates. The amidases inactivated by heating and by acid- or alkali-treatment cannot be assayed. Reproducible results for each amidase were achieved within 5-6 hours in the range of 3-500 ng/ml (0.25-40 mU/ml) and coefficient of variation was 13%. PMID- 3307681 TI - Bone marrow transplantation in Polish conditions. A modified method of marrow collection and preparation for transplantation. AB - Marrow is collected from posterior iliac crests using specially developed "Wiktor's" needles and from other sites using commercially available sternal needles into heparinized syringes. Then it is directly injected into collecting flasks through specially designed bone marrow filters. This assures single cell nature of marrow cell suspension which then may be either directly infused into the recipient or processed for red cell or T cell depletion. During collection marrow cell suspension is mixed using magnetic stirrers. The described method allows collection of sufficient number of marrow cells for engraftment at the expense of acceptable risk for the donor. Data for 10 consecutive marrow collections are reported. PMID- 3307682 TI - The challenges of ionized calcium. Cardiovascular management and critical limits. PMID- 3307683 TI - Ionized calcium monitoring during liver transplantation. AB - Ionized calcium concentration was measured in five patients undergoing liver transplantation. Varying degrees of decreased ionized calcium were observed in all cases and can be attributed to the chelation of calcium by the citrate added during blood transfusions, the inability of the patient to metabolize citrate by the liver during the anahepatic phase of the transplant, and hemodilution of the blood volume with the perfusion prime during venovenous bypass. Calcium chloride was administered when necessary as guided by ionized calcium measurements to restore concentrations to levels that maintain adequate cardiac output. Because of the serious hemodynamic consequences of severe hypocalcemia, regular monitoring of ionized calcium concentration is necessary during this procedure. Total calcium levels are not reliable for this because they do not reflect the extent of anion binding. PMID- 3307684 TI - Coronary artery atherosclerosis revisited in Korean war combat casualties. AB - To confirm earlier studies of a high prevalence of coronary atherosclerosis in combat casualties of the Korean and Vietnam wars, we examined previously uncut coronary arteries from the hearts of 94 American male combat casualties (mean age, 20.5 years) from the Korean War using computerized planimetry and microscopic evaluation. Six (6.4%) men had severe atherosclerosis (75% to 90% cross-sectional area luminal narrowing) in one or more coronary arteries; five of the six had fibrous plaques, and one had a complicated plaque. Our prevalence is similar to that reported previously (5%). Therefore, to determine whether the decrease in the incidence of severe coronary atherosclerosis today is the result of decreased plaque formation in the young, we will need to examine at least 772 men to detect a 50% decline with 85% to 90% confidence. PMID- 3307686 TI - Whole-heart decalcification for better coronary artery study. AB - This article presents a new approach for a more thorough study of the coronary arteries at postmortem examination involving whole-heart fixation followed by decalcification prior to examination and sampling. This allows preservation of the integrity of the entire specimen and avoids artifacts and other shortcomings usually associated with the other procedures. PMID- 3307685 TI - Causes of death in renal transplant recipients. A review of autopsy findings from 1966 through 1985. AB - From 1966 through 1985, a total of 640 patients received 739 renal transplants at a single center transplantation program. Of 245 total deaths, a slide and chart review of all 116 autopsied cases (47%) identified the major causes of death as pneumonia (n = 43), sepsis (n = 32), hemorrhage (n = 15), peritonitis (n = 11), meningitis (n = 7), and pulmonary embolism (n = 5). Eighty-five (73.3%) of these patients died of complications directly associated with immunosuppression, almost all (n = 82) as a result of infection. Organisms most frequently identified at death were gram-negative bacilli (n = 72), Candida species (n = 23), cytomegalovirus (n = 17), enterococcus (n = 14), Staphylococcus aureus (n = 11), Aspergillus species (n = 10), Pneumocystis carinii (n = 5), and mycobacteria (n = 5). Significant associations were found between bolus steroid antirejection therapy and infection with Aspergillus cytomegalovirus. Diabetics had a higher incidence of fungal infections and bowel perforation than nondiabetics. During this 20-year period, overall one-year actual patient survival rates for the four respective five-year intervals increased dramatically (69.9%, 68.2%, 83.3%, and 91.8%), but the normalized death rate showed a smaller decrease for infectious vs noninfectious causes. PMID- 3307688 TI - Serum protein distribution in hydatidiform mole. An immunohistochemical study. AB - In normal placentas during the first trimester of pregnancy, the syncytiotrophoblast appeared to be immunoreactive to alpha-antitrypsin (alpha 1 AT), alpha 1-antichymotrypsin, albumin, IgG, and transferrin. The underlying cytotrophoblast was negative for these same serum proteins. In the hydatidiform mole, these findings were profoundly different. The syncytiotrophoblast lost its immunoreactivity to albumin, IgG, transferrin, and, less frequently, to alpha 1 AT. Furthermore, the underlying cytotrophoblast became immunoreactive to albumin, alpha 1-AT, IgG, transferrin, ferritin, orosomucoid, and, sometimes, to alpha 1 antichymotrypsin. This altered immunohistochemical pattern suggested a notable change in the pinocytotic activity of the trophoblast in the placenta during molar degeneration. The absence of pinocytosis in the syncytiotrophoblast for several proteins can be explained by the partial loss of specific membrane receptors. The contemporaneous appearance of numerous serum proteins in the cytotrophoblast could indicate an activation, not only proliferative, but also functional, in the germinative cytotrophoblast. Diagnostically, this histochemical finding in the hydatidiform mole, which was quite different from that seen in normal placentas during the first trimester of pregnancy, could provide additional evidence concerning trophoblastic abnormalities in the chorionic villi during molar degeneration. PMID- 3307689 TI - Filariasis of the breast. AB - Filariasis of the breast is usually seen in endemic areas. Involvement may, however, present years after leaving an endemic area and be associated with circulating microfilariae. We describe the findings in a woman who developed a breast mass three years after a visit to her native India. PMID- 3307687 TI - Urinary cannabinoids in monitoring abstinence in a drug abuse treatment program. AB - Urine specimens from 162 adolescents entering a drug treatment program were tested for cannabinoids using a photometric immunoassay (EMITst) and thin-layer chromatography (TLC). The EMITst has a cutoff point of detection 25 ng/mL or less of 9-carboxy-tetrahydrocannabinol. When reported as positive, both tests appeared to be reliable. There were two false-positive EMITst results and three false positive TLC results in the 67 urine specimens that did not contain cannabinoids. When reported as negative, however, the EMITst with its 100 ng/mL cutoff failed to detect almost 40% of all cannabinoid-positive specimens. Of the 65 chronic marijuana smokers in the present study who stated that they had smoked within two days of their admission into the treatment facility, 17 (26%) went undetected by the 100 ng/mL cutoff used by the EMITst method. In clinical settings such as drug treatment programs, tests for urinary cannabinoids should use a detection threshold at 20 ng/mL or less. PMID- 3307690 TI - Fibrosarcoma of the urinary bladder. Study of a case showing extensive chondroid differentiation. AB - A case of primary fibrosarcoma of the urinary bladder showing extensive chondroid differentiation was studied by light microscopy and immunofluorescent microscopy using tissue-specific antibodies against intermediate filaments. The tumor cells were uniformly and positively labeled with vimentin antibodies and were negative for desmin and keratin, thus confirming the nonmuscle mesenchymal origin of the neoplasm. The value of intermediate filament typing in the differential diagnosis of spindle cell tumors of the urinary bladder is discussed, and a review of the literature on the subject is presented. It is postulated that the retained capacity for continued differentiation displayed by this tumor may account for the relatively better prognosis observed for this patient. PMID- 3307691 TI - Brain heterotopia and anencephaly. AB - This report describes the finding of nodular collections of heterotopic brain tissue in the lungs of a stillborn anencephalic infant. Immunoperoxidase staining was performed on the nodules and on the neural tissue found at the infant's cranial defect, for neuron-specific enolase, glial-fibrillary acidic protein, carcinoembryonic antigen, and epithelial membrane antigen. The nodules were shown to consist of neurons and neuroglia. Epithelium-lined channels within the nodules were shown to have the same staining characteristics as bronchi and bronchioles in the lung, and to be different from ependyma. To our knowledge, ours is the first report of immunoperoxidase techniques being used to objectively characterize the makeup of the lesions in a case of brain heterotopia. PMID- 3307693 TI - [Pierre Robin syndrome]. PMID- 3307692 TI - The forearm flap as a free neurovascular flap for treatment of an extensive bone/soft-tissue defect in the calcaneal part of the foot. AB - A discussion is presented on the case of a 28-year-old motorcyclist who had an accident and got caught in the spoked wheel of her vehicle. The result was an extensive soft-tissue injury of the metatarsus and calcaneal part of the foot, a defect fracture of the calcaneus, an osseous disinsertion of the Achilles tendon, a lateral malleolus Weber type-A fracture, and a fracture of the second metatarsal bone. The primary treatment consisted in extensive debridement of the strongly contaminated soft parts and refixation of the Achilles tendon on the calcaneus with two osteosynthesis screws. The bruised skin flaps remaining were adapted in a tension-free manner. However, this was possible only in a considerable talipes equinus position. In the further course, the patient developed an extensive skin and soft-tissue necrosis over the calcaneal part of the foot. A neurovascularly pedicled forearm flap was freely grafted in order to maintain the load capacity of the calcaneal part of the foot, to prevent osteitis of the calcaneus, to correct the talipes eqinus position, and to achieve a resensibilization in the load zone of the sole. The healing result was good, and it was possible to achieve extensive correction of the talipes equinus position as well as prevention of calcaneus osteitis; the function of the Achilles tendon was also maintained. Moreover, there was satisfactory resensibilization of the calcaneal part of the foot, so that the patient can now walk in ready-made shoes with a fully molded arch support. PMID- 3307694 TI - [Sarcoidosis and its oral manifestations (I)]. PMID- 3307695 TI - [Sarcoidosis and its oral manifestations (II)]. PMID- 3307696 TI - [Cortical congenital hyperostosis]. PMID- 3307697 TI - Giants before their time. PMID- 3307698 TI - Recent experience with the asymptomatic cervical bruit. AB - To document our recent experience with asymptomatic cervical bruit, we reviewed the records of 418 patients referred to the noninvasive vascular laboratory. Mean follow-up of 23.7 months was obtained for 370 patients by record review or telephone. In a group of 313 patients not operated on, transient ischemic attacks occurred in 14 and stroke in seven (6.7%). The risk of neurologic morbidity was highest in patients with advanced carotid stenosis. Carotid endarterectomy was performed 62 times in 57 patients, with one stroke (1.6%). If carotid endarterectomy is performed with low morbidity, identification of selected surgical candidates with advanced carotid stenosis is reasonable. PMID- 3307699 TI - In vivo determination of modulated migration of radiolabeled leukocytes. AB - A method to determine migration of phagocytic cells in vivo has been evaluated. It was used to analyze leukocyte migration during ischemia, peritonitis, and after pretreatment with methylprednisolone. Phagocytic cells were labeled in vitro with 150 megabecquerel (4.05 mCi) of technetium Tc 99m colloid and reinfused. Saline 0.03 mg and 3.0 mg of endotoxin per kilogram per rat were injected subcutaneously in duplicate. Four hours later, a standardized amount of skin and subcutaneous tissue from the area of injection was removed and weighed. A dose-related accumulation of radiolabeled leukocytes to endotoxin was found in healthy controls but not in animals with hypoperfusion or peritonitis or those pretreated with methylprednisolone. This in vivo method to calculate leukocyte migration will give reproducible results with a mean difference between duplicate samples of less than 6%. PMID- 3307700 TI - Surgical therapy of radiation-induced small-bowel lesions. Report of 34 cases with a high share of patients with combined chemotherapy. AB - Operations on irradiation-injured bowel are rare, bear a high postoperative mortality, and the procedure of choice (resection vs bypass) is still controversial. Thirty-seven operations on small bowel for late effects of irradiation in 16 years were analyzed retrospectively. Fifty-one percent of the operations were performed in the last four years. Ovarian cancer treated by a combination of radiotherapy and chemotherapy was the most frequent underlying disease of 20 patients (58%) followed by carcinoma of the cervix (eight [24%] of the patients). The median latent period between irradiation and surgery was eight months after the combined radiotherapy/chemotherapy, and 12 months after radiotherapy alone. Thirty operations (81%) were done for small-bowel stricture, four for fistula, and three for perforation. Bypass was performed in 17 patients and resection in 16. Complications (fistula, peritonitis, perforation) occurred after 13 operations (35%). All three patients who developed peritonitis died (mortality, 8.1%): two after resection and one after bypass. Suture-associated complications occurred in three (23%) of 13 cases after single-layer and in three (35%) of 17 cases after two-layer anastomoses. Ten patients are still alive two to 76 months (median, 32 months) after operation, six of them free of tumor. All are underweight and suffer from diarrhea (four to 12 stools per day). Pernicious anemia developed in all six patients surviving more than two years. PMID- 3307701 TI - MEDIS library system. PMID- 3307702 TI - Estimation of exposure of man to substances reacting covalently with macromolecules. PMID- 3307703 TI - Classical absorption theory and the development of gastric mucosal damage associated with the non-steroidal anti-inflammatory drugs. AB - Evidence has accumulated during the last decade to support the view that the pharmacokinetic behaviour of non-steroidal anti-inflammatory drugs (NSAIDs) contributes not only decisively to their therapeutic effects but also to the type and incidence of their side effects. It has been shown that NSAIDs reach particularly high concentrations in those compartments in which they cause effects and side effects. Specifically, the data reviewed herein indicate that the accumulation of NSAID within gastric mucosal cells a priori is a principal factor associated with the intervention of intracellular biochemical events and resultant gastric mucosal damage. To a large extent this behaviour is according to the precepts of classical absorption theory; in this respect the limitations of such theory are examined. Our survey further indicates that the failure of certain NSAIDs to significantly reduce gastric mucosal levels of prostaglandins (PG) in vivo may reflect pharmacokinetic differences between NSAIDs rather than tissue-specific differences in their potency as inhibitors of cyclo-oxygenase. PMID- 3307704 TI - The detection of chemical impurities by high pressure liquid chromatography and the genetic activity of medical grades of pyrvinium pamoate in Saccharomyces cerevisiae and Salmonella typhimurium. AB - The genetic activity of several medical grades of the anthelmintic drug pyrvinium pamoate, which is a dipyrvinium salt, was studied in a diploid mitotic recombination and gene conversion assay (strain D5 of Saccharomyces cerevisiae), and in several haploid yeast reversion assays (strains XV185-14C, XY718-1A, and 7854-1A). All of the samples were recombinogenic in strain D5 and mutagenic in the haploid strains, however, the degree of genetic activity varied considerably among the medical grades of pyrvinium pamoate that were tested. Similarly, these samples varied in degree of mutagenicity when they were tested in strains TA97, TA98, TA100, and TA102 of Salmonella typhimurium, but some of the medical grades of pyrvinium pamoate were mutagenic both in the presence and in the absence of the metabolic transformation system, whereas other medical grades of the drug required such activation to be mutagenic. In addition, the medical grades and dosage forms of several brands of pyrvinium pamoate were examined for purity by fluorescence high pressure liquid chromatography (HPLC) using a methanol:water (90:10) solvent system. The HPLC data indicate that monopyrvinium salts are the major contaminants in these pharmaceuticals. In general, there is a correlation between the degree of genetic activity and toxicity, and the number and relative quantity of impurities found in each sample. PMID- 3307705 TI - Elevation of urinary trehalase activity in patients of itai-itai disease. AB - The elevation of urinary trehalase activity in patients of itai-itai disease was examined. Urinary trehalase was correlated with tubular reabsorption of phosphorus (%TRP): the lower the trehalase activity, the worse was %TRP. Furthermore, this activity was inversely correlated with urinary glucose and urinary total protein. In itai-itai disease, the excretion of beta 2 microglobulin seems to be maximal, and urinary trehalase activity was low in the latter stages of the disease. It is inferred that itai-itai disease produces extremely severe tubular damage as well as glomerular dysfunction. PMID- 3307706 TI - Mutagenic activity of the feces of rats following oral administration of tartrazine. AB - After oral administration of the azo dye tartrazine, bile and feces of treated rats were investigated for mutagenicity using the Ames test with Salmonella typhimurium strains TA 98 and TA 100 with and without metabolic activation. In the presence of S 9-mix fecal extracts developed a weak but reproducible dose related response in strain TA 100. In bile no metabolites exerting mutagenic activity were found. PMID- 3307708 TI - [Effect of glucocorticoids on the endocrine system of the pancreas of the pigeon and rat after a food load]. AB - The level of 35S-methionine incorporation (in 15, 30 min, 1, 2, 3, 6, 12, 24 h) has been investigated in A- and B-cells of the pigeon and rat pancreatic islets against the background of excessive injection of hydrocortisone. The pigeon and rat A- and B-endocrinocytes respond in a similar was to the excess of hydrocortisone. An accelerated elimination of the isotope from the pigeon A- and B-endocrinocytes is noted, while in the rat the effect of the excessive hydrocortisone is opposite. PMID- 3307707 TI - Teratogenicity testing in vitro: status of validation studies. PMID- 3307709 TI - [Use of lectins in light-microscopic histochemistry (methodologic aspects)]. PMID- 3307710 TI - Clinical neuroepidemiology. I. Diagnosis. PMID- 3307711 TI - Failure of oblique needle insertion to prevent post-lumbar puncture headache. PMID- 3307712 TI - Anti-Purkinje cell antibody producing B-cell lines from a patient with paraneoplastic cerebellar degeneration. AB - Two patients with paraneoplastic cerebellar degeneration with anti-Purkinje cell antibodies are described. Using an avidin-biotin peroxidase complex method, serum anti-Purkinje cell antibody titers of these patients were 1:32,000 and 1:64,000, and the cerebrospinal fluid titers were 1:40 and 1:320, respectively. After extensive plasmapheresis together with radiation therapy and chemotherapy, the cerebellar symptoms of one patient ameliorated concomitantly with a reduced serum anti-Purkinje cell antibody titer. Four B-cell lines producing anti-Purkinje cell antibodies were established from one patient by Epstein-Barr virus transformation of peripheral lymphocytes. None of these antibodies reacted with peripheral T cells, although the serum anti-Purkinje cell activity of the patient was markedly reduced after absorption with purified human T cells. Thus, anti-Purkinje cell antibodies are apparently directed both to antigens unique to the cerebellar tissue and those shared by T cells. PMID- 3307713 TI - Effects of chlorhexidine gluconate in drinking water on dental caries and oral microorganisms in the Syrian hamster. AB - Hamsters infected with Streptococcus sobrinus (formerly Streptococcus mutans) strain 6715-1119 were given high-sucrose diet 2000. After 5 days, they were presented with 0.05 or 0.1 per cent w/v chlorhexidine gluconate (CHX) continuously in their drinking water, which was well-tolerated. Compared to infected but untreated controls, their caries scores were less by 84 and 97 per cent respectively after 42 days. Coronal dental plaque deposits were reduced in a dose-related fashion. Culture plates of oral swabs showed reductions in Strep. sobrinus and total streptococci after 10 and 35 days of CHX. Hamster oral streptococci were more sensitive to CHX than were lactobacilli but neither was completely eliminated. The incidence of stained tooth deposits after 0.1 per cent CHX was slightly but not significantly greater than in controls. PMID- 3307714 TI - Simplified monocanalicular silicone intubation. Case report. PMID- 3307715 TI - Intraocular Echinococcus multilocularis. AB - Alveolar hydatid disease, caused by the organism Echinococcus multilocularis, is a potentially lethal helminthic infection. After initial hepatic infestation, the organism may spread locally and hematogenously to distant sites. Death occurs secondary to hepatic failure, local extension into vital structures, or metastasis to the brain or lungs. A 67-year-old male Alaskan Eskimo developed decreased visual acuity secondary to a choroidal mass in the right eye eight years after an initial diagnosis of alveolar hydatid disease and four years before the development of symptomatic cerebral metastasis. A pathologic examination disclosed characteristic parasitic membranes involving the posterior pole of the right eye. To our knowledge, this is the first report of ocular involvement in alveolar hydatid disease. PMID- 3307716 TI - The safety and efficacy of topical 1% ALO 2145 (p-aminoclonidine hydrochloride) in normal volunteers. AB - We prospectively evaluated the efficacy and safety of the twice-daily application of 1% ALO 2145 (p-aminoclonidine hydrochloride, a topical alpha 2-agonist) in 21 normal volunteers for one month. Criteria measured included intraocular pressure (IOP), basal tear secretion, pupillary size, corneal sensitivity, heart rate, and blood pressure; urinalysis and blood chemistry studies were also performed. The mean (+/- SD) IOP fell 38.7%, from 17.5 +/- 3.9 mm Hg to 10.7 +/- 3.4 mm Hg, in five hours. The mean IOP remained between 23% and 30% below the pretreatment level when checked 12 hours after the last drop's instillation from day 8 through day 28 of the study. No clinically significant changes in mean systolic blood pressure, blood chemistry values, urinalysis results, basal tear secretion, or corneal sensitivity were noted. The mean heart rate and diastolic blood pressure were each significantly decreased at only one of nine time intervals. Dry mouth was noted at some time in 52% of volunteers. ALO 2145 seems to be effective in lowering IOP in normal volunteers, without marked cardiovascular effects. PMID- 3307718 TI - Metastatic tumors to the eye and orbit. Patient survival and clinical characteristics. AB - A review of the charts of 112 patients (141 eyes) presenting with a metastasis to the eye or orbit revealed that breast cancer was the most common primary tumor (49.1%). The median survival time (MST) following choroidal metastasis for all stages of breast cancer was 314 days. The MST after choroidal metastasis in patients thought to have stage I or II breast cancer, prior to diagnosis of the metastasis, was longer than that of patients with stage III or IV cancer (873 vs 139 days, respectively). Lung cancer metastasized to the eye and orbit earlier than did breast cancer (276 vs 1266 days, respectively) and had a shorter MST following this metastasis (188 vs 666 days, respectively). When age was considered as a continuous variable, the data indicated that older patients with breast metastases survived longer than did younger patients. Echography demonstrated that choroidal metastases from breast tumors were thicker than those from lung tumors (3.70 vs 2.59 mm, respectively). PMID- 3307717 TI - Effects of topical ALO 2145 (p-aminoclonidine hydrochloride) on the acute intraocular pressure rise after argon laser iridotomy. AB - A prospective, randomized, double-masked pilot study compared topical 1% ALO 2145 (p-aminoclonidine hydrochloride, a topical alpha 2-agonist) with a placebo to determine its ability to minimize any acute postoperative intraocular pressure (IOP) increase after argon laser iridotomy. Twenty-eight eyes (21 patients) with chronic narrow angle glaucoma underwent argon laser iridotomy. Fourteen eyes were treated with ALO 2145; the remainder received a placebo. All eyes received one drop of the appropriate medication one hour before and following the iridotomy. Six eyes (43%) treated with the placebo and no eyes treated with ALO 2145 experienced an IOP increase greater than 10 mm Hg over baseline. The mean IOPs and mean IOP changes from baseline were significantly lower during the first three postoperative hours in the eyes treated with ALO 2145. No significant difference was noted in the ease of iridotomy formation, rate of iridotomy closure, visual acuity, anterior segment inflammation, or mean heart rate. PMID- 3307719 TI - Contrast sensitivity after penetrating keratoplasty. AB - Contrast sensitivity testing in the corneal transplant patient may enhance our assessment of visual performance, which is traditionally evaluated using Snellen acuity only. To evaluate contrast sensitivity function after penetrating keratoplasty, we studied 29 patients with anatomically successful corneal grafts and a best corrected visual acuity of 20/50 or better. Graft patients were compared with an age-matched control group including persons with comparable visual acuities without ocular disease. In addition to a complete ophthalmic examination, all subjects underwent contrast sensitivity testing using a computer generated sinusoidal grating system as well as a commercially available contrast sensitivity wall chart. Data indicate that, despite comparable Snellen visual acuity, the contrast sensitivity curves for graft patients were depressed overall compared with those of normal subjects except at the lowest spatial frequency. However, comparison of grafted eyes to contralateral eyes with corneal disease in a small subset of patients with bilateral disease shows a trend toward higher contrast sensitivity values in the eyes that had been operated on. These data suggest that despite an improvement in contrast sensitivity with penetrating keratoplasty, an eye with a corneal transplant is not entirely normal from a visual standpoint. Nonacuity parameters may be important indexes for assessing real-world visual function in the graft patient, although the clinical role of these tests is not yet completely defined. PMID- 3307720 TI - Impression cytology for detection of vitamin A deficiency. AB - Vitamin A (retinol) deficiency causes blindness, increased morbidity, and mortality among preschool children in many developing nations. Previous studies suggest that impression cytology may represent the first simple, reliable test to detect mild xerophthalmia in young children. We used impression cytology to evaluate and follow up 75 Indonesian preschool children with mild xerophthalmia and an equal number of age-matched, clinically normal neighborhood controls. Results of impression cytology, which were closely correlated with baseline serum vitamin A levels, documented histologic improvement following treatment with vitamin A. Furthermore, results of impression cytology, where abnormal, improved to normal following vitamin A treatment in a significant percentage (23%) of otherwise clinically normal children. Impression cytology appears to detect clinical and physiologically significant preclinical vitamin A deficiency. PMID- 3307721 TI - Standardized A-scan echography in optic nerve disease. AB - This study documents the results of standardized A-scan examinations performed in 59 cases of optic nerve lesions (15 perioptic meningiomas, four gliomas, 15 acute neuritides, ten optic atrophies, five ischemic optic neuropathies, five acute central retinal vein occlusions, five traumatic optic neuropathies), as compared with 73 normal optic nerves. Analysis included the assessment of reflectivity (spike height) and nerve width (maximal diameter) with the patient fixating in primary gaze and 30 degrees of eccentric gaze; measurements were obtained from the anterior one third and posterior one third of the optic nerves. Increased nerve diameters could be distinguished as noncompressible (a negative 30 degrees test) when due to tumor, or compressible (a positive 30 degrees test) when due to increased subarachnoid fluid, as exemplified by inflammatory optic neuritis or traumatic neuropathy. Moreover, reflectivity patterns regularly differentiated meningioma (medium reflectivity) from optic glioma (low reflectivity). Neither ischemic neuropathy nor vein occlusion altered optic nerve diameter. These results indicate that echographically defined optic nerve diameter, compressibility in eccentric gaze, and reflectivity patterns can be used to effectively distinguish among causes of chronic optic atrophy (tumor vs remote neuropathy) and disc edema (tumor vs neuritis vs ischemic neuropathy). PMID- 3307722 TI - Calcific band keratopathy after intraocular chondroitin sulfate. AB - A patient developed an acute onset of pseudophakic bullous keratopathy and a diffuse, gray, subepithelial corneal deposit ten days following surgery during which sodium chondroitin sulfate was used. The deposit, identified histologically as calcium, was noted throughout Bowman's layer. The absence of chronic pathologic features in the posterior cornea eliminated Fuchs' endothelial dystrophy as the cause of the acute corneal decompensation. This histopathologic confirmation of calcium deposition with one formulation of chondroitin sulfate, combined with similar conclusions from previous case reports, stimulated the reformulation of the product, which has been shown to be useful in clinical practice. PMID- 3307724 TI - Pre-operative sonographic assessment of lower genital tract anomalies. PMID- 3307723 TI - Recessive dystrophic epidermolysis bullosa. AB - Recessive epidermolysis bullosa dystrophica (REBD), a bullous disorder of the skin and mucous membranes, is frequently associated with ocular complications. A 40-year-old woman presented with lid ulcerations, chronic conjunctivitis, diffuse subepithelial corneal scarring, corneal ulceration, and cataracts. Management with intensive lubricant therapy, soft-bandage contact lenses, and cataract extraction successfully restored her sight. Histologic examination via light and electron microscopy revealed blister formation and scarring beneath the epithelial basement membrane of both the skin and cornea, confirming the diagnosis of REBD. The ultrastructure of the skin and cornea and the ocular complications of the major forms of epidermolysis are described herein. To our knowledge, successful ocular management of a confirmed case of REBD with complete ocular histopathologic features has not been documented. PMID- 3307725 TI - Immunocytochemical study of the placenta of a twin pregnancy with a retained dead fetus. PMID- 3307726 TI - Acquisition of skills required for use of Doppler ultrasound and the assessment of varicose veins. AB - Doppler ultrasound is a useful adjunct to clinical examination for varicose veins. A simple study demonstrated that someone inexperienced in the use of a Doppler ultrasound can rapidly acquire sufficient expertise to use the instrument effectively. PMID- 3307727 TI - A double-blind comparison of the relative efficacy, side effects and cost of buprenorphine and morphine in patients after cardiac surgery. AB - The analgesic efficacy, side effects and cost of administration of regimens of intravenous buprenorphine and intravenous morphine were compared in a randomized double-blind trial performed during the first 24 h after cardiac surgery. Seven patients received buprenorphine by intermittent intravenous injection and six received morphine by continuous infusion. Both these regimens provided good analgesia for the entire 24 h period, with only mild pain at rest and moderate pain on vigorous coughing. Both regimens also produced mild respiratory depression but this was not of clinical importance: the mean arterial PCO2 in both groups was less than 45 mmHg after extubation. The major difference between drugs in the clinical setting was the ease of administration. Buprenorphine had no narcotic code restriction and could be given by intermittent intravenous injection, whereas morphine required checking and handling as a restricted drug and administration by continuous intravenous infusion. When labour and material costs were computed, over the first 24 postoperative hours, it cost $19.76 per patient to administer morphine, but only $3.16 to administer buprenorphine. Thus the use of buprenorphine injections for the first 24 h after cardiac surgery produced pain relief and respiratory depression comparable to that produced by a morphine infusion, but with a significant cost saving in terms of labour and materials. PMID- 3307728 TI - Efficacy and safety of continuous morphine infusion for postoperative analgesia in the paediatric surgical ward. AB - This study determines the efficacy and safety of continuous infusion of morphine following major surgery in non-ventilated children being nursed in general paediatric surgical wards. Pain and analgesia were assessed by a linear analogue scale. Assessment of pain by nursing staff was similar to that made by the patient and parent. Continuous infusions were easy to institute, well accepted by staff and patients alike and resulted in few side effects. The safety and efficacy of morphine infusions allow for wider adoption as a routine method of analgesia for children following major surgery. PMID- 3307729 TI - Multicystic peritoneal mesothelioma in a 29 year old male. AB - A case of multicystic peritoneal mesothelioma in a 29 year old white male is reported. This is the second reported case of cystic peritoneal mesothelioma in a male and the first case of cystic mesothelioma reported in Australia. Clinical, histopathologic and ultrastructural findings are discussed together with a review of previous cases. PMID- 3307730 TI - Differentiated thyroid carcinoma, intermediate type. AB - A thyroid carcinoma showing histological and histochemical features of both follicular and parafollicular cell carcinoma was diagnosed in a 56 year old male. Previously the two cell types have been considered to be derived from embryologically distinct and separate precursors. The unusual combination of the two cell types in this tumour suggests the possibility that the cell lines may be derived from a common stem cell with the potential of differentiating into both follicular and parafollicular cells. The tumour was aggressively invasive and had metastasized widely to lymph nodes at the time of presentation. It represents an example of the recently described entity of differentiated thyroid carcinoma of intermediate type. PMID- 3307731 TI - Cycad (zamia) poisoning in Australia. AB - The Cycads belong to an ancient family of plants and were the cause of the first well documented plant poisoning in Australia when Captain Cook's men and their pigs were affected by eating them. Subsequent reports particularly by early explorers refer to toxicity of the seeds to man. One reason for this was the evidence that the natives ate them. Subsequent reports and experimental work established the toxicity to sheep and cattle. In sheep and cattle 2 syndromes occur, ataxia and liver damage. In cattle the former is the better known, the spinal cord lesion being mainly a demyelination of the sensory pathways. The liver damage is necrosis and fibrosis. PMID- 3307732 TI - Assessment of an enzyme linked immunosorbent assay for the detection of cattle infected with Mycobacterium bovis. AB - An indirect enzyme linked immunosorbent assay (ELISA) using an unpurified antigen was assessed for its accuracy in detecting Mycobacterium bovis infected cattle. The ELISA test recorded sensitivities of 88.7% and 63%, respectively, for infected cattle tuberculin tested positive and for infected cattle never tuberculin tested. Specificity was determined at 52.6% for cattle from confirmed free herds which had never been tuberculin tested. Significant differences in the mean ELISA values were recorded between the 3 groups. No evidence was found for long term effects of tuberculin testing upon the titre of antibodies detected by the ELISA in unaffected cattle. The indirect ELISA using the unpurified antigen of this assay was considered to be unsuitable as an alternative to tuberculin testing for the detection of M. bovis infected animals. PMID- 3307734 TI - Agenesis of the corpus callosum in the foetus, neonate and infant. PMID- 3307733 TI - Veterinary education in China. AB - A brief history of the development of veterinary knowledge and education in China and a short account of present-day veterinary education are presented. In dealing with the latter, information on the number and structure of schools, the undergraduate curriculum, graduate numbers and employment on graduation are considered. Information on the staffing of veterinary teaching departments, academic staff salaries and pensions is also added. PMID- 3307735 TI - Initial detection of gastrointestinal disease during routine real-time, abdominal ultrasound in adults. PMID- 3307736 TI - The radiological diagnosis of mass lesions in the liver. PMID- 3307737 TI - The radiological, ultrasound and computed tomographic findings in a case of renal malacoplakia. PMID- 3307739 TI - Directory of members: Aerospace Medical Association. PMID- 3307738 TI - The Macy reports: Combat fatigue in World War II fliers. AB - Having supported psychiatric investigation into the psychosomatic aspects of "war neurosis" since 1931, the Josiah Macy, Jr., Foundation published five volumes on combat fatigue and its prophylaxis, recognition, treatment, and administrative aspects during World War II. The five volumes were as follows: "War Neuroses in North Africa," by R. R. Grinker and J. P. Spiegel (1943); "Psychiatric Experiences of the Eighth Air Force," by D. W. Hasting, D. G. Wright, and B. G. Glueck (1944); "How Can the Flight Surgeon Better Treat Anxiety?" by D. D. Bond, and "Notes on Men and Groups Under Stress of Combat," by D. G. Wright (a single volume, 1945); "Personality Disturbances in Combat Fliers," by N. A. Levy (1945); and "Observations on Combat Flying Personnel," by D. G. Wright (1945). The author corresponded with Drs. Spiegel, Grinker, Glueck, and Levy about the circumstances leading to these monographs, and has combined their reminiscences and observations with a brief historical view of psychiatric practice in the U.S. Army Air Force during the war. This review contrasts two therapeutic philosophies concerning combat fatigue, and comments on the lack of more modern psychiatric data about combat flying. PMID- 3307740 TI - Memory improvement by glucose, fructose, and two glucose analogs: a possible effect on peripheral glucose transport. AB - The memory-improving action of post-training, noncontingent injections of glucose was investigated in a series of experiments which examined the effects of several substances that interact with glucose metabolism on the retention of a conditioned emotional response and on blood glucose levels in male hooded rats. Although post-training glucose injections of 1, 2, and 3 g/kg all produced similar increases in blood glucose, only 2 g/kg improved retention, suggesting that attainment of a particular blood glucose level is not critical for memory improvement. Post-training injections of a range of insulin doses (0.25-4 IU/kg) failed to affect retention. Post-training injection of fructose (the same doses as were used for glucose) had no effect on blood glucose levels and, as with glucose, only the 2 g/kg dose improved retention. This finding suggests that blood glucose levels are not critical for the memory-improving effect, that glucose and fructose may act on the same substrate and, because fructose does not act directly on the brain, it raises the possibility that both substances act peripherally. Post-training injections of 2-deoxyglucose and 3-O-methylglucose both improved retention. The fact that these mostly nonmetabolized glucose analogs were effective suggests that the memory-improving action of glucose may depend on the activation of a membrane glucose transport mechanism. The implications of the possible action of glucose on peripheral transport mechanisms for understanding the effect of reinforcers on memory are discussed. PMID- 3307741 TI - The human T cell receptor for antigen: structure, ontogeny and gene expression. AB - T cell receptor molecules are now well characterized as well as the genes encoding alpha and beta chains of this molecular complex. The genome organisation of alpha and beta chain genes is similar to the genomic organisation of immunoglobulin genes. In T cell differentiation immature precursor cells move into the human thymus, where they mature and subsequently are released into the periphery as immuno-competent T cells with a variety of different functions. The processes at work in thymic ontogeny are understood, only in part, and await further study. One aspect of T cell differentiation is the acquisition of immunocompetence by T cells in thymic ontogeny. This process is associated with T cell receptor gene rearrangements and T cell receptor gene expression. The mechanisms leading to gene expression have been studied in many systems and basic principles are now emerging. The enzyme RNA polymerase II, which synthesizes m RNA requires additional factors for its activity, and these factors have, at least in part, been identified as proteins. Experiments aimed at identifying DNA protein interactions at the V beta upstream regulatory region are discussed. PMID- 3307742 TI - Ronald S. Wilson (1933-1986). PMID- 3307743 TI - Three cheers for behavior genetics: winning the war and losing our identity. PMID- 3307744 TI - The interest of actin immunocytochemistry in diagnostic histopathology. AB - The immunohistochemical detection of different isoforms of actin provides useful data in the histopathological diagnosis of human tumours. The marked resistance of this protein to fixation and embedding procedures makes it a practical alternative to the ultrastructural search of microfilaments in routine tissue sections. Staining with monoclonal antibodies against alpha smooth muscle actin is helpful in the diagnosis of benign and malignant smooth muscle tumours and allows the differentiation of various types of spindle cell sarcomas. These antibodies are also useful in tracing the myoepithelial cells in normal and various pathological conditions of the breast and salivary glands. Skeletal muscle actin is a reliable marker in the diagnosis of rhabdomyosarcomas. Its use should be combined and complemented with other markers (i.e. desmin; foetal, slow and fast myosins; myoglobin) to monitor the degree of rhabdomyoblastic differentiation of the neoplastic cells in single cases, a parameter of potential prognostic value. PMID- 3307745 TI - Evidence for basement membranes in rat tail tendon sheaths. AB - The presence of anti-laminin antibodies and a basement membrane-like thin electrondense lamina has been demonstrated in the peritendineum of the rat tail tendon by indirect immunofluorescence and electron microscopy. PMID- 3307748 TI - [From eugenics to reproduction medicine]. PMID- 3307747 TI - [Double anchoring of the acetabulum prosthesis in protrusio acetabuli]. PMID- 3307746 TI - [August Blencke--promotor of gymnastics training in Magdeburg]. PMID- 3307750 TI - [Current status of reproductive medicine]. PMID- 3307749 TI - [Homosexuality as a topic of sexual science in national socialism]. PMID- 3307752 TI - [Prevention and therapy of coccidiosis in poultry]. PMID- 3307751 TI - [Active immunization of poultry against botulism]. PMID- 3307753 TI - Professional collaboration in high blood pressure control. PMID- 3307755 TI - Exercise testing and subsequent casual blood pressure measurements. A longitudinal study. PMID- 3307754 TI - Twenty-four-hour blood pressure monitoring in the evaluation of once daily treatment of essential hypertension. PMID- 3307756 TI - Verapamil SR 240 mg as a contribution to compliance in long-term treatment of hypertension. PMID- 3307757 TI - Non-invasive monitoring of ambulatory blood pressure and its variability in elderly hypertensive patients: effect of guanfacine. PMID- 3307758 TI - Mild hypertension--a therapeutic dilemma. The results of the MRC trial in Britain. PMID- 3307759 TI - Effect of a structured health education program on reducing morbidity and mortality from high blood pressure. PMID- 3307761 TI - The stimulation by salts of hexose phosphate uptake by Escherichia coli. AB - Hexose phosphate uptake in Escherichia coli is stimulated by salts. KCl and MgCl2 stimulate to about the same extent, but Mg2+ is effective at a tenth the concentration of K+. At higher concentrations, both salts inhibit. The stimulation by a series of salts correlates strongly with the hydrated radius of the cation, with small ions more effective than large. There are effects by the anion, but they do not correlate with any simple property. Cells accumulate glucose 6-phosphate to a higher concentration in the presence of KCl than in its absence. The maximum velocity of glucose 6-phosphate uptake is stimulated by KCl, as is the ratio V/Km. PMID- 3307762 TI - Effects of pressure overload and insulin on protein turnover in the perfused rat heart. Prostaglandins are not involved although their synthesis is stimulated by insulin. AB - A modified anterogradely perfused rat heart preparation is described in which all the cardiac output passes through the coronary circulation. Such a preparation develops hypertensive aortic pressures. Hypertensive aortic pressures or insulin stimulate the rate of cardiac protein synthesis and inhibit the rate of protein degradation. Aortic pressure and insulin may be important in the regulation of cardiac nitrogen balance in vivo. By abolishing cardiac prostaglandin synthesis with 4-biphenylacetate, we were able to investigate the possible involvement of prostaglandins in the modulation of protein turnover by pressure overload or insulin. There was no evidence of any involvement. However, insulin stimulated and cycloheximide inhibited cardiac prostaglandin synthesis. These findings are consonant with an enzyme involved in prostaglandin synthesis being short-lived and prostaglandin synthesis being rapidly influenced by activators and inhibitors of protein synthesis and degradation. PMID- 3307763 TI - Regulation of hepatic very-low-density lipoprotein secretion in rats fed on a diet high in unsaturated fat. AB - Rats were fed ad libitum on either a standard, high-carbohydrate, chow diet or a similar diet supplemented with 15% unsaturated fat (corn oil). Hepatocytes were prepared either during the dark phase (D6-hepatocytes) or during the light phase (L2-hepatocytes) of the diurnal cycle. In hepatocytes from rats fed on the unsaturated-fat-containing diet, secretion of very-low-density lipoprotein (VLDL) triacylglycerol was inhibited to a greater extent in the D6- than in the L2 hepatocytes. Plasma non-esterified fatty acid concentrations were elevated to the same extent at both D6 and L2 in the unsaturated-fat-fed animals. The secretion of VLDL esterified and non-esterified cholesterol was relatively insensitive to changes in the unsaturated-fat content of the diet. This resulted in proportionate increases in the content of these lipid constituents compared with that of triacylglycerol in the nascent VLDL. There was also an increase in the ratio of esterified to non-esterified cholesterol in the nascent VLDL produced by hepatocytes of the unsaturated-fat-fed animals. In the D6-hepatocytes from the unsaturated-fat-fed animals, the decrease in the secretion of VLDL triacylglycerol could not be reversed by addition of exogenous oleate (0.7 mM) to the incubation medium. In contrast, addition of a mixture of lactate (10 mM) and pyruvate (1 mM) stimulated both fatty acid synthesis de novo and the rate of VLDL triacylglycerol secretion. Secretion of esterified and non-esterified cholesterol also increased under these conditions. Insulin suppressed the secretion of VLDL triacylglycerol and cholesteryl ester under a wide range of conditions in all types of hepatocyte preparations. Non-esterified cholesterol secretion was unaffected. In hepatocytes prepared from the fat-fed animals, these effects of insulin were more pronounced at D6 than at L2. Glucagon also inhibited VLDL lipid secretion in all types of hepatocyte preparations. The decrease in cholesterol secretion was due equally to decreases in the rates of secretion of both esterified and non-esterified cholesterol. PMID- 3307765 TI - The K1 beta-lactamase of Klebsiella pneumoniae. AB - beta-Lactamase K1 was purified from Klebsiella pneumoniae SC10436. It is very similar to the enzyme produced by Klebsiella aerogenes 1082E and described by Emanuel, Gagnon & Waley [Biochem. J. (1986) 234, 343-347]. An active-site peptide was isolated after labelling of the enzyme with tritiated beta-iodopenicillanate. A cysteine residue was found just before the active-site serine residue. This result could explain the properties of the enzyme after modification by thiol blocking reagents. The sequence of the active-site peptide clearly established the enzyme as a class A beta-lactamase. PMID- 3307767 TI - Purification of trypsin and bacterial proteinases by column chromatography on coffee grain particles. AB - Trypsin and extracellular proteinases produced by Bacillus sp. were purified by column chromatography on coffee grain particles. The ballast proteins were eluted with water, while the adsorbed proteinases were eluted with 1 M sodium chloride solution. The capacity is approximately 2 mg of trypsin per ml of the packed sorbent. PMID- 3307764 TI - Resolution and analysis of 'native' and 'activated' properdin. AB - A rapid and reproducible procedure for the resolution of 'native' and 'activated' forms of properdin (a component of the alternative activation pathway of complement), by gel filtration on the polyvinyl matrix Fractogel TSK HW-55(S), is reported. This fractionation permitted effective screening of samples for conditions that cause activation. Only 'native' properdin was detected in serum, even after activation of the alternative pathway by yeast cell walls. Transformation of 'native' into 'activated' properdin in vitro was produced by freeze-thawing of the protein, but not upon binding to and dissociation from the C3 convertase, C3bBb. Electron microscopy showed that only the 'native' population contained the discrete cyclic structures described previously by Smith, Pangburn, Vogel & Muller-Eberhard [(1984) J. Biol. Chem. 259, 4582-4588]. 'Activated' properdin, which was eluted from the gel-filtration column close to the breakthrough peak, was mainly composed of large amorphous aggregates. We therefore conclude that properdin 'activation' is not a physiological event that occurs in serum on complement activation, but is an artifact of isolation. Fractionation of properdin on Fractogel TSK HW-55(S) has, however, enabled detailed analysis of functional heterogeneity within the 'native' population. PMID- 3307766 TI - Regulation of rat foetal lipogenesis in brown adipose tissue in vivo and in isolated brown adipocytes during the last day of, and after prolonged, gestation. AB - Rates of lipogenesis in foetal isolated brown adipocytes from 22-day-pregnant rats were significantly increased by lactate plus pyruvate as major substrates in the incubation medium, in comparison with the endogenous rates. Insulin stimulated foetal brown-adipocyte lipogenesis, and adrenaline or noradrenaline and isoprenaline decreased lipogenesis. Glucagon had no effect on the lipogenic rate in brown adipocytes. Progesterone administration to the mother significantly increased the rates of lipogenesis in brown adipose tissue and in isolated brown adipocytes from 22-day foetuses. Prolongation of gestation by progesterone to day 23 decreased the rates of brown-adipose-tissue lipogenesis in vivo and in isolated cells in the post-mature foetuses. PMID- 3307770 TI - Oncogenes and cell cycle genes. PMID- 3307760 TI - Human cancer and cellular oncogenes. PMID- 3307768 TI - Antifertility factors of mammalian seminal fluid. PMID- 3307769 TI - The origin, development and regulation of osteoclasts. PMID- 3307771 TI - Molecular analysis of Duchenne and Becker muscular dystrophy. PMID- 3307772 TI - Selective elevation of c-myc transcript levels in the liver of the aging Fischer 344 rat. AB - The expression of several proto-oncogenes involved in normal cell growth was examined as a function of age in male Fischer-344 rats aged 3, 6-9, 12 and 21-23 months. Northern blot analysis using RNA isolated from pooled livers or brains showed that the transcript levels of c-myc, but not c-sis or c-src-related genes, were markedly elevated in the liver with age. In contrast, there was no substantial change in transcript levels of any of these genes in aging brain. When c-myc expression was analyzed in livers from individual rats ranging in age from 4 to 22 months, a significant (p less than 0.01) 5-fold increase in c-myc transcript levels in relation to age was detected. The results indicate that expression of c-myc in rat liver is modulated during aging and more generally, that aging in rats is associated with organ-specific changes in the transcript levels of particular genes. PMID- 3307773 TI - Effects of gluconeogenic hormones on insulin binding in intact human red blood cells. AB - The effects of gluconeogenic hormones, adrenaline and cortisol, on insulin binding were studied in intact human red blood cells. Insulin binding was significantly decreased when red blood cells were preincubated with 1.0 microgram . ml-1 adrenaline or cortisol respectively. The Scatchard plot suggested that this was due to a decrease in surface receptor concentration. Furthermore, it showed that adrenaline also increased insulin receptor affinity. The negative co operativity affinity profile demonstrated that adrenaline caused a rise in only the upper limit average affinity, Ki, of the insulin receptor. PMID- 3307775 TI - Purification and characterization of recombinant human interleukin-1 beta produced in Escherichia coli. AB - Recombinant human interleukin-1 beta (rIL-1 beta) produced in Escherichia coli was purified to homogeneity by a combination of mass ion exchange column chromatography, ion exchange and gel filtration high performance liquid chromatography. The purified rIL-1 beta had a molecular weight of 18 kD on SDS polyacrylamide gel electrophoresis and an isoelectric point of 6.9 on analytical isoelectric focusing. These values were almost same as those of natural interleukin-1 beta. The amino acid composition and amino acid sequence of the amino terminal region were consistent with those deduced from the cDNA sequence. In addition, the primary structure was confirmed by peptide mapping with lysyl endopeptidase on reverse phase HPLC. Besides rIL-1 beta with amino terminal Ala, two molecular species, [Met0] rIL-1 beta and [desAla1] rIL-1 beta, were also obtained. Biological and physicochemical properties of the three species of rIL-1 beta were compared. PMID- 3307774 TI - The actions of arginine and glucose on glucagon secretion are mediated by opposite effects on cytoplasmic Ca2+. AB - Cytoplasmic Ca2+ (Ca2+i) was monitored in single guinea-pig pancreatic alpha 2 cells exposed to modulators of glucagon release. The stimulatory amino acid arginine raised Ca2+i from 62 to 160 nM, whereas the inhibitor glucose reduced both the latter concentration and basal Ca2+i by 30%. Epinephrine which potentiates arginine-stimulated secretion by increasing cAMP, does so without affecting Ca2+i. The results indicate that glucagon secretion is positively modulated by Ca2+i. It is suggested that glucose-induced lowering of Ca2+i is a fundamental effect in cells where the sugar is readily metabolized. PMID- 3307777 TI - The insulin-receptor interaction: is the kinetic approach for inferring negative cooperative site-site interactions valid? AB - The dissociation of insulin from its receptor is reportedly enhanced when the dissociation is induced by dilution in the presence of insulin. This experiment is frequently conducted when curvilinear Scatchard plots of insulin binding are observed in order to infer negative cooperative site-site interactions amongst insulin receptors. However, when insulin binding to purified liver plasma membranes was measured at 15 degrees C in 50 mM Tris, pH 7.5 containing 0.1% bovine serum albumin and 100 U/ml bacitracin, the insulin binding data was characterised by a linear Scatchard plot and a Hill plot with a slope equal to unity. Thus, under the conditions of this binding assay, insulin apparently bound to a single non-interacting class of homogeneous binding sites. But, despite the apparent absence of cooperative interactions under these specific conditions, the dissociation of receptor-bound insulin was still enhanced when the dissociation of insulin from its receptor was induced by dilution in the presence of insulin. This result cast serious doubt on the validity of inferring negative-cooperative site-site interactions amongst insulin receptors based solely on the observation that the dissociation of receptor-bound insulin is enhanced by dilution in the presence of insulin. PMID- 3307776 TI - Investigation of conformational changes in yeast enolase using dynamic fluorescence and steady-state quenching measurements. AB - Conformational changes in yeast enolase were investigated using steady state quenching and dynamic (fluorescence decay and fluorescence anisotropy decay) measurements. The tryptophan fluorescence rotational correlation time increases from 24 to 38 ns on subunit association. The acrylamide quenching constant decreases two-fold when the subunits associate. The conformational metal ion effect suggests a more compact molecule. Under conditions of catalysis, the correlation time decreases 25%, though the sedimentation constant does not change (Holleman, 1973). The enzyme may undergo a hinge-bending motion during catalysis. PMID- 3307778 TI - Nuclear transition protein 2 (TP2) of mammalian spermatids has a very basic carboxyl terminal domain. AB - Nuclear transition protein 2 (TP2) along with TP1 are major basic chromosomal proteins of rat spermatids during the period of transition from histone associated to protamine-associated DNA. TP2 isolated by reversed phase high pressure liquid chromatography was cleaved with S. aureus V8 protease to yield two fragments. The complete amino acid sequence of the 27 residue peptide assigned to the carboxyl terminus was established. It contains most of the basic residues of the protein and is likely to be a major site of DNA binding. Thus, TP2 is differentiated from core histones in having its basic domain at the carboxyl rather than amino terminal end. PMID- 3307779 TI - Purification of decidual prolactin-releasing factor, a placental protein that stimulates prolactin release from human decidual tissue. AB - Decidual prolactin-releasing factor (PRL-RF), a placental protein that stimulates the release of prolactin from human decidual tissue, has been purified from conditioned medium of human placental explants. The purification scheme consisted of ethanol extraction, anion exchange chromatography on DEAE-cellulose, size exclusion chromatography on Spherogel TSK-3000, and either a) immunoaffinity chromatography using an antiserum to a partially purified PRL-RF preparation or b) acetic acid-urea/SDS 2-dimensional PAGE. The apparent molecular weight of the purified releasing factor, estimated by SDS-PAGE, was 23,500 Da; and the half maximal dose for the acute stimulation of prolactin release from human decidual cells was 0.05-0.1 ug/ml (2.2-4.4 nM). PMID- 3307782 TI - Pyridoxal 5'phosphate binding site of Escherichia coli beta cystathionase and cystathionine gamma synthase comparison of their sequences. AB - The phosphopyridoxyl peptides of beta cystathionase and cystathionine gamma synthase of Escherichia Coli were identified after reduction, carboxymethylation and proteolysis of the holoenzymes. Their comparison with those obtained from rat liver gamma cystathionase (Fearon, C.W., Rodkey, J.A. and Abeles R.H. 1982. Biochemistry 21 3790-3794.) showed a high degree of homology between the three PLP binding sites with the presence of the tripeptide sequence: Thr-Lys(Pxy)-Tyr in their structure. This homology suggests that these enzymes of methionine metabolism have probably the same origin. PMID- 3307781 TI - In vitro assay of squalene epoxidase of Saccharomyces cerevisiae. AB - We describe a simple assay for measuring squalene epoxidase specific activity in Saccharomyces cerevisiae cell-free extracts, by using [14C] farnesyl pyrophosphate as substrate. Cofactor requirements for activity are FAD and NADPH or NADH, NADPH being the preferred reduced pyridine nucleotide. Squalene epoxidase activity is localized in microsomal fraction and no supernatant soluble factor is required for maximum activity. Microsomal fraction converted farnesyl pyrophosphate into squalene, squalene 2,3-epoxide and lanosterol, showing that squalene 2,3-epoxide-lanosterol cyclase is also a microsome-bound enzyme. We show also that squalene epoxidase activity is not inhibited by ergosterol or lanosterol, but that enzyme synthesis is induced by oxygen. PMID- 3307780 TI - The soluble metalloendoprotease required in myoblast fusion remains intracellular. AB - The fusion of myoblasts to myotubes requires an endogenous soluble metalloendoprotease. To determine whether this protease is released by fusing myoblasts, or stays within the cell, we examined the effects of membrane impermeant and a membrane-permeant metalloendoprotease inhibitors. Membrane permeant 1,10-phenanthroline, and membrane-impermeant bathophenanthroline disulfonic acid both inhibited soluble metalloendoprotease activity in homogenized myoblasts with equal potency. However, while 1,10-phenanthroline inhibited fusion, bathophenanthroline disulfonic acid had no effect. In addition, metalloendoprotease activity could not be detected in the media of fusing myoblasts, but was in the cells. These observations support the conclusion that the soluble metalloendoprotease required in fusion remains within the myoblast. PMID- 3307783 TI - Identification of A chain cleavage sites in intact insulin produced by insulin protease and isolated hepatocytes. AB - The degradation of insulin by the enzyme insulin protease and by isolated hepatocytes results in proteolytic cleavages in both the A and B chains of intact insulin. Previous studies have shown that one of the A chain cleavages is between A13 leucine and A14 tyrosine and that a second cleavage occurs carboxyl to the A14 residue. In the present study we have used insulin specifically iodinated on the A19 tyrosine and examined the A chain cleavages by the enzyme and by hepatocytes. Insulin degradation products were purified by HPLC and sequenced by automated Edman degradation. Only two A chain cleavage sites were identified, one the previously reported A13-A14 and the other between A14 tyrosine and A15 glutamine. These data thus identify the second A chain cleavage site and further support the role of insulin protease in hepatic metabolism of insulin. PMID- 3307784 TI - A phospho-oligosaccharide mimics insulin action on glycogen phosphorylase and pyruvate kinase activities in isolated rat hepatocytes. AB - A phospho-oligosaccharide which is the polar head group of a novel insulin sensitive glycophospholipid has recently been involved in insulin action. We have investigated the insulin-like effects of this phospho-oligosaccharide on both glycogen phosphorylase a and pyruvate kinase activities of hepatocytes incubated in the presence of glucagon (0.1 nM). Similarly to insulin, the phospho oligosaccharide antagonized glucagon-dependent activation of glycogen phosphorylase, as well as the inactivation of pyruvate kinase caused by this hormone. The antagonistic action of the phospho-oligosaccharide on glucagon effects was dose-dependent. Furthermore, it partially antagonized glucagon stimulated cyclic AMP levels. These results support the hypothesis that this phospho-oligosaccharide mediates at least some insulin actions in hepatocytes. PMID- 3307785 TI - Characterization of a cytochrome P450 deficient mutant of Candida albicans. AB - A previously described Candida albicans nystatin resistant mutant blocked in 14 alpha-demethylation of lanosterol was shown to also lack all traces of cytochrome P450 as determined by carbon monoxide difference spectra. This strain does not require ergosterol for growth and reverted to an ergosterol producing, cytochrome P450 containing strain indicating no other lesions. Cytochrome P450 mutants described in Saccharomyces cerevisiae are auxotrophic for ergosterol or contain a second mutation in 5,6 desaturation of the sterol B ring. These results suggest that a cytochrome P450 lesion in these yeasts have different phenotypes and may reflect different sterol requirements for the two organisms. PMID- 3307786 TI - Ten to fourteen residue peptides of Alzheimer's disease protein are sufficient for amyloid fibril formation and its characteristic x-ray diffraction pattern. AB - The molecular basis of fibril formation in Alzheimers disease was explored by electron micrographic and x-ray diffraction analysis of a series of synthetic peptides corresponding to portions of the amino acid sequence of beta protein and that of its putative precursor. A minimum 14 residue peptide was identified that formed typical amyloid fibrils under physiological conditions. Of these 14 residues, 10 were sufficient to give an identical 4.76 A and 10.6 A diffraction pattern as that recently described for isolated neurofibrillary tangles, amyloid plaque cores and leptomeningeal amyloid fibrils. PMID- 3307787 TI - Enzymatic transformation of mercapturic acids derived from halogenated alkenes to reactive and mutagenic intermediates. AB - The metabolism of the mercapturic acids S-pentachlorobutadienyl-N-acetylcysteine (N-Ac-PCBC), S-trichlorovinyl-N-acetylcysteine (N-Ac-TCVC) and S-dichlorovinyl-N acetylcysteine (N-Ac-DCVC) by subcellular fractions from male rat liver and kidney homogenates was studied. As a model compound, N-Ac-PCBC, 14C labelled, was synthesised. It was intensively metabolised by cytosolic but not by microsomal enzymes from rat liver and kidney. The major metabolite identified by GC/MS was pentachlorobutadienylcysteine, the amount produced being highest in kidney cytosol. Metabolic conversion of 14C-N-Ac-PCBC by kidney and liver cytosol resulted in covalent binding of radioactivity to protein, binding was strongly inhibited by the beta-lyase inhibitor aminooxyacetic acid (AOAA). N-Ac-TCVC and N Ac-DCVC were also transformed by cytosolic enzymes to the corresponding cysteine conjugates (trichlorovinylcysteine and dichlorovinylcysteine). The three mercapturic acids tested were strong mutagens in the Ames-test after addition of rat kidney cytosol. In the absence of cytosol, N-Ac-TCVC and N-Ac-DCVC were weakly but definitely mutagenic, whereas N-Ac-PCBC was not. In contrast to N-Ac PCBC, the "direct" mutagens N-Ac-TCVC and N-Ac-DCVC were both transformed to pyruvate by bacterial (S. typhimurium TA100) homogenate 100,000 g supernatants. It is concluded that mercapturic acids are deacetylated to the corresponding cysteine conjugates by cytosolic (N-Ac-PCBC, N-Ac-TCVC and N-Ac-DCVC) and bacterial enzymes (N-Ac-TCVC and N-Ac-DCVC) and further cleaved to reactive and mutagenic intermediates by mammalian and/or bacterial beta-lyase. The observed activation mechanisms for the mercapturic acids, whose formation from hexachlorobutadiene, tetrachloroethylene and trichloroethylene has been proven, might contribute to the nephrotoxicity and nephrocarcinogenicity of the parent alkenes. PMID- 3307788 TI - Islet cell growth and function. A reappraisal of the role of progesterone and prednisolone. AB - The mechanism of the inhibitory effect of steroid hormones, progesterone and prednisolone on the incorporation of [3H]-thymidine into pancreatic islet cell DNA was investigated. Treatment with either hormone had no effect on the incorporation of 32P-orthophosphate into islet cell DNA. Both prednisolone (10 microM) and progesterone (3 microM) markedly stimulated the activity of the enzyme thymidylate synthetase of islet cells possibly leading to increased synthesis of endogenous thymidine which resulted in dilution of the [3H] thymidine added to the islets in tissue culture. Prednisolone (10 microM) significantly increased both insulin biosynthesis and release, while at 5 microM it was effective in increasing only insulin release. In contrast, progesterone at the two concentrations employed did not affect insulin biosynthesis or release. The smaller doses of both hormones markedly stimulated the total protein biosynthesis. PMID- 3307789 TI - Decreased hepatic elimination of pyrimethamine during malaria infection. Studies in the isolated perfused rat liver. AB - The elimination of the antimalarial drug pyrimethamine was studied in isolated liver preparations from young rats (80-100 g) infected with merozoites of Plasmodium berghei two weeks earlier. Perfusate half-life of pyrimethamine was increased in livers from M.I. rats (t1/2 beta control group = 56 +/- 11 min vs M.I. group = 101 +/- 12, P less than 0.01), reflecting a decrease in hepatic clearance (3.6 +/- 1.1 ml/min vs 1.9 +/- 0.5 ml/min, P less than 0.01). There was no significant difference in volume of distribution between livers from M.I. and control groups. Intrahepatic concentration of unchanged drug at 3 hr was 4-5-fold greater in livers from infected rats (control group = 4725 +/- 2287 ng/ml vs M.I. group = 22,324 +/- 6824 ng/ml), while liver: perfusate concentration ratios were not significantly different (control group = 30.8 +/- 24.1 vs M.I. group = 35.6 +/- 20.3). We conclude that the hepatic elimination of pyrimethamine is substantially impaired in the malaria-infected rat. PMID- 3307790 TI - Phosphorolytic cleavage of 2-fluoroadenine from 9-beta-D-arabinofuranosyl-2 fluoroadenine by Escherichia coli. A pathway for 2-fluoro-ATP production. AB - 2-Fluoroadenine (F-Ade) is a metabolite of 9-beta-D-arabinofuranosyl-2 fluoroadenine (F-ara-A) that may be involved in the development of toxic side effects from this anticancer drug. The liberation of F-Ade from F-ara-A has been examined in different biological systems. Extracts of Escherichia coli but not mammalian cells or tissues catalyzed the conversion of F-ara-A to F-Ade with apparent Km and Vmax values of 1350 microM and 7.7 nmol/min/mg protein respectively. This reaction depended on the presence of phosphate and was inhibited by purine nucleosides in a competitive manner, indicating that the enzyme responsible for the conversion is purine nucleoside phosphorylase. After incubation of intact bacteria with 100 microM [3H]F-ara-A, [3H]F-Ade was the same percentage of cellular radioactivity as in the medium, but it was only one-tenth the concentration of F-ara-A in the cells. In contrast, the cellular concentration of 2-fluoro-ATP was 20-fold greater than that of F-ara-A-5' triphosphate. These results suggest that F-ara-A entered the bacteria intact and was phosphorolytically cleaved to liberate F-Ade, which would have been either anabolized to the toxic triphosphate or excreted. The latter pathway would provide a route by which F-Ade might be absorbed into the host circulation. PMID- 3307791 TI - Novel immunosensors. AB - The development of practical immunosensors is an important topic for biosensor research. Recently the authors have demonstrated novel immunosensors called, respectively, the reactor-type enzyme immunosensor, the potentiometric sensing system for pathogenic microbes, the piezo-immunosensor, the pulse immunoassay, the bio-image sensor and the photofluctuation immunosensor. These six types of immunosensors based on novel principles are described. PMID- 3307792 TI - Evidence of immune deposits and of basement membrane alterations in dermal vessels of normal skin of patients with essential mixed cryoglobulinemia. AB - To gain insight into the pathogenic mechanisms of immune complex-mediated vasculitis, clinically normal skin specimens from the forearms of 12 patients with essential mixed cryoglobulinemia were investigated by light microscopy, immunofluorescence microscopy, and electron microscopy. Basement membrane alterations were documented in 9 patients. Eleven patients had deposits in vessel walls, but only in 1 was there evidence of inflammation. The same immunoglobulins of the cryoproteins could be demonstrated in the tissue deposits by immunofluorescence analysis and by immunoelectron microscopy. These findings suggest that, in essential mixed cryoglobulinemia, immune reactants in dermal vessels of normal skin are more common than is evidenced by clinical examination. Moreover, it seems that cryoglobulins, as such, are not sufficient to trigger an inflammatory process: Additional local or plasma factors are required. Deposits were absent in 7 patients with cryoglobulinemia that was associated with a primary disorder. This could be ascribed to the lower cryocrit levels documented in this group of patients, or to the shorter duration of their disease. PMID- 3307793 TI - Computer-based patient education for older persons with osteoarthritis. AB - A program of 8 lessons on various aspects of osteoarthritis (OA), its treatment, and patient self-care was prepared on an Apple IIc computer. The courses were then field-tested and evaluated by 72 older (age range 52-88) OA patients in community centers for senior citizens. Statistical analysis of the findings showed significant increases in knowledge and significant self-reported, beneficial behavior changes, including increased exercise, use of heat, and rest. Our findings demonstrate that older persons can use the computer to learn to cope with OA when a thoughtfully planned program is made available in a community setting. PMID- 3307794 TI - Hypertension and atherosclerosis in cholesterol-fed rabbits. II. One-kidney, one clip Goldblatt hypertension treated with nifedipine. AB - Eight groups of New Zealand white rabbits were used to study the effects of moderate chronic one-kidney, one clip hypertension (HT) and long-term nifedipine therapy on atherogenesis. Four groups were fed a normal diet (ND) over an 8-month study period; two groups, one of which was given nifedipine, remained normotensive (NT) throughout the study. Of the two HT groups, one remained hypertensive for 7 months; the blood pressure of the other group was normalized after 2 months with nifedipine. The other four groups of animals were similarly constructed except that they were fed a 0.1% cholesterol diet (CD). The results showed that: although scattered fibromuscular vascular lesions were present in the aortas of normal-diet, HT animals no atheroma was observed; neither moderate chronic HT nor abrupt, short-term HT exacerbated atherogenesis in the CD-animals; nifedipine therapy had no suppressive effect on either fibromuscular lesions or atherogenesis; nifedipine therapy reduced the aorta weight of the normotensive ND and CD groups; the aortic triglyceride content of both dietary groups was reduced by nifedipine; cholesterol content was unaffected; left ventricular hypertrophy was evident only in HT-untreated groups; and only the weight of the left ventricle of the ND-NT-treated group was significantly reduced, but the mitochondria volume per unit volume of left ventricle myocardial cells was reduced only in the NT-CD group treated with nifedipine. It is concluded that an antihypertensive dosage of nifedipine administered to animals with atherosclerosis does not suppress subsequent atherogenesis. PMID- 3307795 TI - A two year randomized exercise trial in older women: effects on HDL-cholesterol. AB - Most of the research on the level of high density lipoprotein cholesterol (HDL-C) and physical activity (PA) has been cross-sectional and thus self-selection of the exercisers may occur. In the current research, 229 white postmenopausal women, mean age 57.7 years, were randomized into either a walking or a control group. Of these 229 women, 204 women had blood samples available for lipid determinations. PA was measured subjectively by the Paffenbarger Survey and objectively with activity monitors. At baseline, there were no differences in PA, total HDL-C (HDL-TC), HDL-2C or HDL-3C between the two randomized groups. After two years, the PA of the walking group was significantly higher than the PA of the control group. This increase in PA was not accompanied by changes in any of the lipids or lipoproteins. Examination of the lipid changes in the walking group by compliance status and actual activity changes revealed little difference between groups. These results suggest that it is possible to increase physical activity in older women. However, the long-term effects of the increased activity on HDL-C were not apparent despite an observed strong cross-sectional relationship between PA and HDL-C. PMID- 3307796 TI - Malotilate: the new hope for a clinically effective agent for the treatment of liver disease. PMID- 3307797 TI - Relationship between peri-intraventricular hemorrhage and neonatal hyperbilirubinemia in very low-birthweight infants. AB - The incidence of hyperbilirubinemia (serum bilirubin values greater than 205 mumol/l) in two groups of preterm infants (birthweight less than 1500 gm) with and without peri-intraventricular hemorrhage (PIVH) was studied. In the first 10 days of life, 16 (39%) of the 41 infants with PIVH vs. 22 (46.8%) of those without PIVH (n = 47) had high bilirubin levels. No difference in peak serum bilirubin concentrations nor a need for phototherapy was noted between the two groups (P greater than 0.07). Forty-one infants had PIVH: 30 had PIVH grade I or II and 11 had grade III or IV. No statistically significant correlation was found between degree of PIVH and hyperbilirubinemia. Moreover, at 12 months corrected age, major and minor handicaps were equally distributed between the two groups. The neurologic outcome appeared to relate, in largest part, to the severity of the PIVH, and to not be influenced by the hyperbilirubinemia. We conclude that there is no positive relationship between incidence and extension of PIVH, plasma bilirubin levels, and outcome in very low-birth weight infants. PMID- 3307798 TI - Prepartum diagnosis of limb-shortening defects with associated hydramnios. AB - Two cases of skeletal dysplasia with limb-shortening abnormalities are presented. In association with the skeletal abnormalities, gross hydramnios was noted. A review of the existing literature reveals that coexistent fetal skeletal dysplasia and hydramnios have an extremely poor prognosis, especially in the nonachondroplastic patient with singleton fetus. The two cases presented here and the accompanying review emphasize the importance of recognizing this association in providing appropriate counseling to parents. PMID- 3307799 TI - Prenatal sonographic diagnosis and management of a twin pregnancy with placenta previa and hemicardia. AB - The sonographic diagnosis of a twin pregnancy complicated by acardius anceps of one fetus, total placenta previa, uterine overdistension, and preterm labor is presented and management is discussed. Attempted selective fetocide is described, but was not successful. Clinical management of severe discordant sonographic dysmorphology is discussed, and diagnostic criteria for sonographic diagnosis of acardia are presented. PMID- 3307800 TI - Acute pyelonephritis in pregnancy. AB - There were 107 episodes of pyelonephritis associated with pregnancy or the early puerperium occurring in 103 gravidas investigated retrospectively for information concerning prematurity, low birthweight, and antibiotic susceptibility patterns in the recovered microorganisms. No difference was found in the incidence of prematurity on low birthweight between that group and a control group of gravidas from the same population. Members of the Enterobacteriaceae genus were the most common bacterial isolates from the urine, with a large portion of E. coli being resistant to both ampicillin (33%) and cephalothin (13%). Treated pyelonephritis associated with pregnancy does not appear to predispose to prematurity or low birthweight in this population. Also, initial therapy with a first-generation cephalosporin may no longer be appropriate, because a significant number of isolates (11%) were resistant to cephalothin. PMID- 3307801 TI - Evaluating the effectiveness of neonatal intensive care. What can the literature tell us? AB - This article reviews the characteristics of 69 clinical research studies of the effectiveness of neonatal intensive care (NIC). Emphasis is on the availability of important information in the studies, and on their scientific quality. The analysis suggests that these studies cannot answer several of the most important questions about the usefulness of NIC, because of poor study design or implementation. Guidelines for assessing the usefulness of existing studies and suggestions for future research are provided. PMID- 3307802 TI - Evolution of complete heart block in a fetus and its perinatal management. AB - The antepartum course of a patient with a fetus showing heart block and complex congenital heart disease was followed closely using serial nonstress tests, ultrasonograms, and echocardiograms. Internal fetal heart rate and capillary pH monitoring during labor were useful in guiding the successful vaginal delivery. PMID- 3307803 TI - Do blood and meconium affect the detection of endotoxin in amniotic fluid with the limulus amebocyte gel clot assay? AB - The limulus amebocyte lysate (LAL), assay is the most sensitive technique for the detection of endotoxin in biological fluids. Because endotoxin is a component of gram-negative bacteria, the assay has been employed in the detection of gram negative bacterial contamination of biological fluids. The LAL assay is rapid, inexpensive, easy to perform, and requires little laboratory expertise. When used in conjunction with the gram stain examination of amniotic fluid, it improves the detection of intra-amniotic infection before the availability of culture results. However, the usefulness of the LAL assay in the detection of endotoxin in other body fluids is limited by the presence of an inhibitor to the gelation of the assay. The studies reported in this communication were undertaken to establish if amniotic fluid contains such an inhibitor. Sterile amniotic fluid (AF) samples obtained from 93 patients by transabdominal amniocentesis before labor were used to determine the ED 50 dose of endotoxin necessary for a positive LAL result. The ED 50 dose of endotoxin required for gelation was significantly higher when AF- rather than pyrogen-free saline--was used as the diluent, implying that inhibitors are in fact present (ED 50 = 58.3 pgm/ml). The presence of blood or meconium in the AF did not enhance inhibition significantly: ED 50 doses were 58.3 pgm/ml and 56.2 pgm/ml, respectively. This is not significantly different from the ED 50 of clear amniotic fluid. PMID- 3307804 TI - Failure of endotoxin to cross the chorioamniotic membranes in vitro. AB - We have previously reported the detection of endotoxin in the amniotic fluid of patients with gram-negative intra-amniotic infection. Endotoxin or lipopolysaccharide (LPS) is a potent biologic product capable of inducing prostaglandin release from several cell types, and therefore may be involved in the onset of human parturition in the setting of intra-amniotic infection. The experiments outlined in this report were designed to determine whether endotoxin crosses chorioamniotic membranes in vitro. Chorioamniotic membranes obtained at the time of elective cesarean section were placed in Ussing chambers used for transport experiments. Endotoxin was placed in one chamber, and serial timed samples were taken from both chambers for endotoxin quantification, which was performed with the limulus amebocyte gel clot assay. Blue dextran was used to exclude the presence of large defects. Bromophenol blue was used to demonstrate membrane permeability to low-molecular weight substances. Endotoxin failed to cross the chorioamniotic membranes in all experiments (n = 11). PMID- 3307805 TI - [30 years of halothane--30 years of halothane hepatitis]. PMID- 3307806 TI - [Intragastric spread of respiratory gas in CPAP breathing]. PMID- 3307807 TI - [Highlights from the history of intensive therapy]. PMID- 3307808 TI - [Physical growth]. PMID- 3307809 TI - [Administration of insulin by sublingual route in children with insulin-dependent diabetes mellitus]. PMID- 3307810 TI - [Escherichia coli: pathogenic mechanisms and enterohemorrhagic strains]. PMID- 3307811 TI - [Relation between the isolation of strains of Escherichia coli O157:H7 and the presence of hemorrhagic colitis in children]. PMID- 3307812 TI - [Current antimicrobial resistance of Salmonella typhi, Salmonella enteritidis and Shigella sp]. PMID- 3307813 TI - ["I'm fat!" and the teeth will become thin]. PMID- 3307814 TI - [The transradicular implant]. PMID- 3307815 TI - [Occlusal re-equilibration for esthetic harmony]. PMID- 3307816 TI - [Functional and dynamic analysis of prosthetically reconstructed occlusal relations (II). Experimental gnathologic reconstruction]. PMID- 3307818 TI - [The onlay step by step]. PMID- 3307819 TI - [Prosthesis. Impact on esthetics and periodontal function. Morphology of dental elements]. PMID- 3307817 TI - [Functional and dynamic analysis of prosthetically reconstructed occlusal relations (III). An electronic study of function]. PMID- 3307820 TI - [Technic for the construction of a complete denture. It is better in 2 phases]. PMID- 3307821 TI - [Prosthesis. The morphology of the teeth and its effect on esthetics and periodontal function. II. The lower elements]. PMID- 3307822 TI - [Dentures without soldering]. PMID- 3307823 TI - [Relining, rebasing, remaking of a previous removable complete denture--1. Fundamental principles of construction]. PMID- 3307824 TI - [Relining, rebasing, remaking of a previous removable complete denture--2. Relining? Better than not]. PMID- 3307825 TI - [Relining, rebasing, remaking of a previous removable denture--3. 6 conditions for rebasing]. PMID- 3307826 TI - [Crowns in Cerestore]. PMID- 3307827 TI - [Inlay on inlay]. PMID- 3307828 TI - [Functional and dynamic analysis of prosthetically reconstructed occlusal relations (I). Gnathological reconstructive principles]. PMID- 3307829 TI - [Possibilities and limits in preprosthetic therapy. When the orthodontist is helpful]. PMID- 3307830 TI - [Balanced bilateral occlusion]. PMID- 3307831 TI - [Rapid expansion of the palate]. PMID- 3307833 TI - RU-41740 (K. pneumoniae glycoprotein) enhances resistance to experimental candidiasis and stimulates phagocytic functions. AB - RU-41740, a purified glycoprotein extract from Klebsiella pneumoniae, (which is an efficient non-specific immune activator in a broad spectrum of in vitro and in vivo reactions) was administered either orally or parenterally in the mouse. It enhanced the resistance of mice to candidiasis, both in terms of survival rate and a decrease in viable yeast cell recovery in kidneys. The drug administered at 0.1 mg or 1 mg/kg augmented 4-fold the mean survival time (MST) of animals infected with 1 to 2 X 10(6) Candida albicans, both by the intraperitoneal and the intravenous route. The effect of the orally administered drug was less striking but nonetheless present. At 10 mg/kg, the MST of infected animals increased about 2-fold. In vitro, in the presence or absence of zymosan, the drug at 10 or 100 micrograms/ml was able to stimulate the phagocytic process of elicited mouse peritoneal cells (65% polymorphonuclear cells, 35% macrophages) and human peripheral blood cells (95% polymorphonuclear cells, 5% monocytes) in terms of activated oxygen species production. The involvement of polymorphonuclear cells in the mechanisms of natural resistance to C. albicans infection led us to discuss the role of these cells as targets for the drug. PMID- 3307832 TI - Changes in recognition of Plasmodium falciparum antigens by human sera depending on previous malaria exposure. AB - Naturally acquired immunity against Plasmodium falciparum malaria was analysed by immunoprecipitation and electrophoretic analysis of FUP-1 strain antigens by sera from individuals with different histories of exposure to malaria. Sera from individuals in the process of either acquiring natural resistance (from different age groups in a village of Upper Volta) or losing acquired resistance (adults travelling from hyperendemic areas of Africa to France) were compared. From electrophoretic patterns, it was apparent that two parasite peptides of MW 96 and 100 Kd were preferentially recognized by putatively resistant individuals. Analysis of the reactivity of adult sera from different parts of the world with FUP-1 antigens showed that there were no major geographically restricted antibody specificities. In particular, antibodies reactive with these two peptides were identified in sera of diverse geographic origins. These 96- and 100-Kd peptides of P. falciparum may therefore be antigens related to naturally acquired immune resistance and common to P. falciparum strains of different geographic origin. PMID- 3307834 TI - The structure and regulation of the human prointerleukin-1 beta gene. PMID- 3307835 TI - Contradictory action of interleukin-1: cell growth and tumour cell killing. PMID- 3307837 TI - [Imaging diagnosis in the study of abnormal abdominal masses]. PMID- 3307836 TI - [In vitro and in vivo recovery of marrow progenitor cells after cryopreservation and autotransplantation of the bone marrow]. PMID- 3307838 TI - [Infection with the hepatitis B virus (HBV), the human T-lymphotropic retrovirus (HIV) and Treponema pallidum in jailed minors]. PMID- 3307839 TI - [Distribution in the human pancreas of cell elements expressing class I and class II surface histocompatibility antigens]. PMID- 3307840 TI - [Semi-automatic computerized analysis of ocular movements and caloric vestibular nystagmus]. PMID- 3307841 TI - Preliminary data of insulin "cephalic" secretory. PMID- 3307842 TI - Incidence of infectious symptoms after radiation therapy for breast cancer. Long term effects. AB - The incidence of symptoms generally associated with infectious disease was assessed by a questionnaire sent out to 519 disease-free breast cancer patients 7 to 12 years after primary treatment. All patients were treated in the context of a randomized trial where pre- and postoperative radiation (45 Gy) was evaluated versus surgery only. The results indicate a significantly higher morbidity among patients treated with preoperative irradiation compared with those irradiated postoperative (p less than 0.05). This increased morbidity mainly seemed to be caused by symptoms usually associated with respiratory tract infection (p less than 0.05). Although statistically not significant the preoperatively irradiated patients also had a higher morbidity than those treated with surgery alone. There was no difference between postoperatively irradiated patients and patients treated with surgery only. A significantly higher integral dose (absorbed energy within the body) of the pre- compared with the postoperative group (p less than 0.025) is associated with the differences in morbidity between the two irradiated groups. An explanation for the increased morbidity seems to be that the volume of lung tissue, encompassed within the full-dose target volume, is the crucial factor. This volume was considerable in the preoperatively treated patients but kept at a minimum in the postoperative group. PMID- 3307844 TI - Radioprotection of peripheral blood cells with a combination of hydroxytryptophan and a thiol compound in mice. AB - Radiation induced changes in peripheral blood cells were studied in male Swiss albino mice after 4 Gy and 10 Gy whole body gamma irradiation with and without pretreatment with 2-amino-ethylisothiuronium bromide hydrobromide (AET) or with a combination of 5-hydroxy-L-tryptophan (5-HTP) and AET. Combination of 5-HTP with AET or AET alone in a high dose achieved excellent protection against both 4 Gy and 10 Gy whole body irradiation as regards peripheral blood cell counts. PMID- 3307845 TI - Effects of microwaves on the colony-forming capacity of haemopoietic stem cells in mice. AB - A suspension of bone marrow cells from femurs of female (CBA X C57Bl)F1 mice was exposed to 2450 MHz CW microwaves in a specially designed waveguide exposure system. The temperature of the suspension rose, during exposure to microwaves, from 20 degrees C to 45 degrees C, and at an interval within 20 degrees C to 45 degrees C the number of haemopoietic stem cells (CFUs) was determined by the spleen exocolony method. The time of exposure of bone marrow cells to each temperature studied was 20 s. Control suspensions of bone marrow cells were exposed to a water bath temperature. There were no significant effects of the CFUs with the water bath temperature, while after exposure to microwaves the number of spleen colonies was elevated with a nadir at the temperature of 37 degrees C. With a microwave-induced increase of the temperature above 41 degrees C the number of CFUs in the bone marrow suspension decreased. The increase in the number of colonies was related to the rise in the seeding rate of the CFUs as well as to a rise in their proliferative activity, while the drop in the number of colonies was influenced also by heat-killing of the CFUs by microwave exposure. PMID- 3307843 TI - Elevation of blood levels of zinc protoporphyrin by radiomimetic drugs and Friend leukemia virus. AB - Sublethal doses of whole-body irradiation induced the elevation of zinc protoporphyrin (ZPP). Experiments were conducted to determine if recovery from radiomimetic drugs also resulted in elevation of ZPP. Daily injections with hydroxyurea and other cytotoxic drugs for 10 days caused ZPP elevation and a dose of radiation too low to cause ZPP elevation by itself caused ZPP elevation when hydroxyurea was administered prior to irradiation. Friend leukemia virus also brought about an elevation of ZPP. However, not all factors that increased erythropoiesis brought about ZPP elevation. The elevated erythropoiesis in response to hypoxia and the enhanced erythropoiesis that followed administration of folic acid to folic acid-deficient mice was not accompanied by ZPP elevation. PMID- 3307846 TI - Ultrastructural renal findings in allografted kidneys of patients treated with ciclosporin A. AB - 22 renal biopsies of 22 patients with 6-month-old transplants have been examined at the light- and electron-microscopic level to demonstrate the toxic effects induced by ciclosporin A (CS). These patients presented stable renal function and were exempt from acute rejection symptoms or nephrotoxicity. Interstitial fibrosis, tubular atrophy and interstitial lymphocytic infiltration were the lesions most often observed by light microscopy. In a single case an arteriolar lesion suggestive of arteriolopathy due to Cs was seen. Ultrastructural observations of renal tubular cells showed a tendency of rough and smooth endoplasmic reticulum to microdilate and microvacuolize. In 4 out of 22 cases there were mitochondrial alterations with giant mitochondria. In only 1 case, clusters of cilia were seen. Clinical histological correlations show that interstitial fibrosis is directly proportional to CS blood level. CS higher blood levels suggest a higher risk of nephrotoxicity. PMID- 3307847 TI - Ultrastructural glomerular findings in cryoglobulinemic glomerulonephritis. AB - Thirty-three renal biopsies of patients affected by cryoglobulinemic glomerulonephritis (CRYGN) were investigated by electron microscopy, paying particular attention to the nature of cells responsible of glomerular hypercellularity, the presence and site of electron-dense deposits and their ultrastructural characteristics. Personal as well as literature data suggest (a) diffuse glomerular hypercellularity found in most cases of CRYGN is mainly due to polymorphonuclear leukocytes and even more to monocyte exudation; (b) the interposition of the latter cell type in the glomerular capillary wall is the main responsible cause of the frequent occurrence of the membranoproliferative pattern in CRYGN, and (c) peculiar structures found in the electron dense deposits are characteristic of CRYGN and related to cryoglobulin composition. Electron microscopy therefore seems to be a valuable diagnostic procedure for this type of glomerulonephritis. PMID- 3307848 TI - Renal amyloidosis in children: an ultrastructural study. AB - Eleven renal biopsy specimens from 10 children affected with systemic amyloidosis were studied by electron microscopy. Focal parietal deposits of amyloid fibrils and detachment of podocytes were observed in the 9 patients having marked proteinuria. Adjacent capillary loops were normal with intact podocyte foot processes. In the 2 renal biopsies obtained after treatment of the underlying disease a double layer of subendothelial and subepithelial basement membrane material enclosed the parietal amyloid deposits and separated them from adjacent cells. PMID- 3307849 TI - Transplant glomerulopathy. AB - Transplant glomerulopathy is the most common glomerular lesion noted in long standing renal allografts and isografts. Morphologic examination of 328 specimens taken from 177 patients because of decreasing function revealed transplant glomerulopathy in 55, rejection glomerulonephritis in 39, de novo glomerulonephritis in 20, and recurrent glomerulonephritis in 9 patients. The most important microscopic finding is a finely lamellar thickening of the glomerular basement membrane. Endothelial swelling and mesangial proliferation are minor. Immunofluorescence is weekly positive and electron-dense deposits are missing. There is, however, subendothelial electron-lucent thickening of the lamina rara interna comparable to the lesions seen in thrombotic microangiopathy. Transplant glomerulopathy can be superimposed on other glomerular transplant lesions and is typically associated with chronic rejection; in fact it can been considered to be the glomerular equivalent of chronic vascular rejection. PMID- 3307851 TI - Renal lesions in ciclosporin A-treated kidney transplant patients. AB - Ninety renal biopsies (RB) in 73 out of 152 ciclosporin A (CsA)-treated allograft patients were studied by light and electron microscopy; they were grouped according to the clinical setting: (1) prolonged posttransplant anuria (9 RB), (2) early graft function deterioration (14 RB), (3) late graft function deterioration (15 RB) and (4) control biopsies (52 RB) at least 6 months after Tx. Glomerular, tubular abnormalities, interstitial cellular infiltrate and fibrosis, peritubular capillary mononuclear cell congestion (PCC), vascular changes and erythrocyte extravasation were evaluated and the following morphologic patterns were identified alone or in combination: acute (AR) and acute on chronic rejection (ACR), toxic tubulopathy (TT), interstitial stripe fibrosis (ISF), CsA-associated arteriolopathy (CsAA). AR was observed in 95% of RB in group 1 and 2, and in 26% in group 3, never in group 4; PCC and TT were only observed concomitantly with AR; ACR was found in 26% of group 3; ISF in 53% of group 3, sometimes linked to CsAA and, of moderate entity, in 70% of group 4. CsAA was noted in 10% of all RB, mainly in group 3 (26%), although in some RB of group 2 (13%) as well. PMID- 3307850 TI - Recurrent and de novo glomerulonephritis in allografted kidneys: aspects of ultrastructural diagnosis. AB - Allograft glomerulonephritis (GN) is a noteworthy alternative in the differential diagnosis of renal graft dysfunction. The true frequency of allograft GN is unknown; a rough estimate is 5-15%. The highest rates of recurrence (100-20%) have been reported, in decreasing order of frequency, in mesangiocapillary GN (MCGN) type 2, IgA nephropathy, MCGN type 1, and focal segmental glomerulosclerosis (FSGS). In addition, in about 2% of allografts membranous GN (MGN) occurs as a de novo lesion. Electron microscopy has proved valuable in detecting early or mild MGN, MCGN type 2 and FSGS, and in differentiating between MCGN type 1 and allograft (rejection) glomerulopathy. Even with the aid of electron microscopy, however, the demarcation between MCGN type 1 and allograft glomerulopathy may prove impossible. The finding of prominent mesangial deposits (in an otherwise normal allograft), is highly suggestive of recurrent IgA nephropathy. PMID- 3307852 TI - Methods of reducing bacterial contamination of the atmosphere arising from use of an air-polisher. PMID- 3307853 TI - Badges of the dental profession. American Dental Society of Europe. PMID- 3307854 TI - Professional education for dentistry before 1859. PMID- 3307855 TI - Selective mechanical ventilation of dependent lung regions in the anaesthetized horse in dorsal recumbency. AB - The effect of selective mechanical ventilation of dependent lung regions were studied in anaesthetized horses (mean weight 486 kg) in dorsal recumbency. Blood gas measurements were performed with the horse in the lateral position during spontaneous breathing (before selective intubation) and in dorsal recumbency during spontaneous breathing, general mechanical ventilation, and spontaneous breathing + selective mechanical ventilation. Arterial oxygen tension (PaO2) was 32.3 kPa in the lateral position during spontaneous breathing with a high inspired oxygen fraction (FlO2 greater than 92%). In dorsal recumbency PaO2 decreased to 10.9 kPa during spontaneous breathing and was not significantly affected by general mechanical ventilation (PaO2 12.6 kPa). The institution of selective mechanical ventilation with a selective positive end-expiratory pressure (PEEP) of 20 cm H2O caused a marked increase in PaO2 to an average of 35.3 kPa. It is concluded that selective intubation of dependent regions in the diaphragmatic lobes is a feasible procedure and that selective mechanical ventilation with PEEP markedly improves arterial oxygenation in the anaesthetized horse in dorsal recumbency. PMID- 3307856 TI - Otosclerosis: its modern surgical management. PMID- 3307857 TI - General practice trials: a reappraisal in the light of the findings of a general practice study of Oruvail. PMID- 3307858 TI - Randomised double-blind trial of quinine sulphate for nocturnal leg cramp. PMID- 3307859 TI - A comparison of the analgesic efficacy of flurbiprofen, diclofenac, dihydrocodeine/paracetamol and placebo following oral surgery. PMID- 3307860 TI - Controlled trials of acemetacin versus piroxicam in osteoarthritis. PMID- 3307861 TI - Efficacy and safety of an ibuprofen and dextropropoxyphene combination (Ibudex) in medical practice. PMID- 3307862 TI - Comparative effects of nicardipine hydrochloride and hydrochlorothiazide in the treatment of mild to moderate hypertension: a double-blind parallel study. PMID- 3307863 TI - Mefenamic acid versus ibuprofen in osteoarthritis--a double-blind cross-over study. PMID- 3307864 TI - Vitamin B6 in the treatment of pre-menstrual mastalgia. PMID- 3307865 TI - Radiation and cancer: a two-edged sword. PMID- 3307866 TI - Biological consequences of strand breaks in plasmid and viral DNA. AB - Some biological consequences of strand breakage in biologically active single- and double-stranded plasmid and viral DNA are examined. A double-strand break in DNA produced by restriction-endonucleases in aqueous solution is not a 100% lethal damage. The survival depends strongly on the structure of the end groups. Evidence is presented that survival is the result of a balance between degradation and repair. The enzymatically produced double-strand break (dsb) is a potentially lethal damage similar to the irradiation-produced dsb in cells. Results with double-stranded biologically active DNA treated either with gamma rays, heat, pancrease nuclease or UV-light in aqueous solution suggest that a single-strand damage is also a potentially lethal damage. Mechanisms for conversion of single-strand damage to lethal events are discussed. PMID- 3307867 TI - Cellular radiation biology in consolidation and transition. AB - Cellular radiation biology currently is undergoing changes common to all science in which the understanding in one area is becoming solidified while in another area conclusion of the classical phase is being engendered by the needs of modern thought. Aspects of these changing circumstances are discussed here from the standpoint of the roles played by direct and indirect action in cell death and the position that promulgation of the correct explanations of the radiosensitivities of mammalian cells can be facilitated if use of such classical operational definitions as sublethal and potentially lethal damage is discontinued. The latter consideration will be supported by a summary of the responses of synchronous populations of the L5178Y S/S murine leukaemic lymphoblast to 20Ne, 28Si, 40Ar, 56Fe and 93Nb ions of energies broadly in the region of 500 MeV/u. PMID- 3307868 TI - Lipid antioxidants: how they may act in biological systems. AB - Chain breaking antioxidants scavenge the chain carrying oxygen radicals and suppress the peroxidation of liposomal and biological membranes in aqueous dispersions. Vitamin E scavenges peroxyl radicals rapidly and its lateral diffusion is suggested to be fast, but its antioxidant efficiency in the liposomal and bio-membranes appears to be considerably smaller than in homogeneous solution. Water soluble chain breaking antioxidants, such as uric acid, cysteine, glutathione, and vitamin C, scavenge radicals in the aqueous region and suppress the peroxidation. However, they cannot scavenge the peroxyl radicals within the lipid region of the membranes. Nevertheless, vitamin C can interact with vitamin E radical, probably at membrane-water interface, and regenerate vitamin E. PMID- 3307869 TI - Redox properties and rate constants in free-radical mediated damage. AB - The interpretation of quantitative relationships between chemical properties and biological effects requires great caution if erroneous conclusions are to be avoided. A knowledge of intracellular concentrations is especially desirable. Since many chemical properties are themselves interrelated, reliable identification of critical reactions may be difficult. Free radicals often react by electron transfer or radical addition, and there are quantitative redox dependencies characteristic of both reaction types. Absolute rate constants, and equilibrium constants, of electron transfer reactions may vary greatly according to the dielectric properties of the reaction environment. PMID- 3307870 TI - Cigarette smoke and the involvement of free radical reactions in chemical carcinogenesis. PMID- 3307871 TI - Are single or multiple mechanisms involved in radiation-induced mammalian cell killing? AB - The survival curve of repair-competent mammalian cells exposed to X- or to gamma rays has a shoulder usually followed by a region of exponential survival. A curve of this shape results from the accumulation of subeffective damage in the shoulder region. This damage has been called sublethal [Elkind & Sutton (1959), Nature, 184, 1293], a designation the basis for which has been questioned by Alper [(1977), Brit. J. Radiol., 50, 459] who noted that if the shoulder results from the progressive reduction of a repair capacity, then the damage would be potentially lethal. A series of experiments is analyzed to show that requiring an equivalence between sublethal and potentially lethal damage has limited usefulness because as many questions are raised as are answered. Moreover, the sector of repair corresponding to the shoulder region is small compared to the sector of damage which must be repaired if only a minority of the lesions in DNA are effective. It is concluded that multiple mechanism may be involved in cell killing and, in addition, that the processes connected with the shoulder region of the survival curve amount to only the tip of an iceberg whose size and properties are yet to be fully appreciated. PMID- 3307872 TI - Free radicals, membrane damage and cell-mediated cytolysis. PMID- 3307873 TI - Free radicals and tissue injury: fact and fiction. PMID- 3307874 TI - Are reduced quinones necessarily involved in the antitumour activity of quinone drugs? AB - Several studies have shown that the antitumour quinones, adriamycin, mitomycin C, mitozantrone and 3,6-diaziridinyl-2,5-bis (carboethoxyamino)-1,4-benzoquinone (AZQ) can form semiquinone radicals in vitro. The biophysical chemistry data for these reactions and the properties of the radical quinones are presented together with the proposed mechanisms for cytotoxicity. An attempt has been made to correlate the available in vitro data for the quinones with each other and with the available in vivo data. As a consequence of these correlations a number of conclusions have been proposed regarding the techniques of investigation and the evidence for the role of reduced quinones in antitumour activity. PMID- 3307875 TI - Protein fluorescence and its relationship to free radical activity. AB - Evidence for free radical involvement in pathological processes is often indirect and frequently depends upon the detection of characteristic changes in tissue constituents, particularly polyunsaturated lipids. Free radical attack on protein leads to specific oxidative changes in their constituent amino acids, principally cysteine, tryptophan and tyrosine. This is associated with the induction of characteristic fluorescence (excitation 360 nm, emission 454 nm) and protein aggregation. This observation leads to a suitable assay for studying protein oxidation, and such fluorescent proteins may be relevant in the pathogenesis of diabetic microangiopathy and rheumatoid arthritis. PMID- 3307876 TI - Free radical-mediated reperfusion injury: a selective review. AB - Tissue damage as a consequence of ischemia is a major medical problem in an industrialized society. Whereas the conventional view has attributed this injury process to ischemia itself, recent studies have found that a variable, but often substantial proportion of the injury is caused by toxic oxygen metabolites that are generated from xanthine oxidase at the time of reperfusion. This mechanism was first identified and characterized in a model of moderately mild partial vascular occlusion in the feline small intestine. Strikingly similar mechanisms have been subsequently confirmed as the basis for ischemia/reperfusion injury in the stomach, pancreas, liver, skin, skeletal muscle, heart, lung, kidney and central nervous system. The potential for clinical application of this concept is related primarily to that proportion of the total post-ischemic injury that is due to this reperfusion mechanism, set against the proportion due to ischemia itself. Ironically, in clinical cases of intestinal ischemia the reperfusion component appears to be proportionately small, and the potential for treatment of ischemic bowel disease is correspondingly limited. On the other hand, there is reason to expect that the ablation of free radical-mediated reperfusion injury, something that can be readily achieved through non-toxic means, may provide substantial benefit for the treatment of ischemic renal disease, myocardial infarction, stroke, cardiac arrest, and of organs preserved for transplantation. PMID- 3307877 TI - Radiation and chemically induced transformation: free radicals, antioxidants and cancer. PMID- 3307878 TI - Role of superoxide dismutase in modification of radiation injury. AB - The effects of superoxide dismutase on radiobiological end-points are discussed in terms of the time scale of primary radiation chemical reactions and later cellular and physiological processes. The effectiveness of SOD on responsive subpopulations of bone marrow progenitor cells is shown to be temperature- and dose-dependent. Under certain conditions, the protective actions of superoxide dismutase and catalase complement each other in a sequential fashion. Finally, cellular levels of endogenous superoxide dismutase in atomic radiation workers are compared with those in a control population. PMID- 3307880 TI - Problems in the diagnosis of occupational asthma. PMID- 3307879 TI - The role of glutathione in radiation and drug induced cytotoxicity. AB - The cellular response to radiation and various chemotherapy drugs, whose mechanism in part includes production of free radicals or DNA damage, may be altered by modification of cellular thiols. The recent introduction of agents which either inhibit glutathione (GSH) biosynthesis (buthionine sulfoximine, BSO) or stimulate GSH synthesis (oxothiazolidine-4-carboxylate, OTZ) has enabled detailed studies assessing the role of GSH in the radiation and chemotherapy response. GSH depletion by BSO has resulted in radiosensitization of both aerobic and hypoxic cells, with some discrepancy among laboratories as to the extent of sensitization of hypoxic cells. GSH elevation (by approximately 200% of control) has resulted in modest protection of aerobic and hypoxic cells. GSH has been shown to play an important role in the radiosensitization of hypoxic cells using nitroimidazoles. The extent of nitroimidazole hypoxic radiosensitization has recently been shown to depend on intracellular GSH levels. Recent findings that some human tumour cell lines, as opposed to rodent cell lines, are high in cellular GSH have prompted a need to evaluate in vivo, GSH levels in human tumours. Possible roles of GSH in the chemotherapy response include: (1) detoxification of H2O2 and/or organoperoxides through GSH peroxidase, (2) non catalyzed nucleophilic reaction of GSH and drug, (3) binding of the drug with GSH catalyzed by GSH transferase, and (4) activation of certain drugs to toxic species by GSH. The role of GSH as it relates to the various topics mentioned above is discussed with emphasis on direction for future studies. PMID- 3307881 TI - A comparison of inhaled budesonide and beclomethasone dipropionate in childhood asthma. AB - The objective of this study was to compare the clinical effects of beclomethasone dipropionate (BDP) and budesonide in asthmatic children using two common ways of administration. Twenty-one children, aged 4-14 years, who regularly used inhaled corticosteroids for their control of asthma were included in the study. The drugs were studied by using a double-blind randomized cross-over design trial with a single-blind placebo period at the end. Each period lasted 3 weeks. The dosage was 100 micrograms b.i.d. for both drugs. Budesonide was administered via a spacer inhaler (Inhalet), and beclomethasone dipropionate via a standard actuator. Compared with placebo, both drugs significantly improved PEFR values for morning (20% for budesonide and 14% for BDP) and evening (14% for budesonide and 9% for BDP). Both morning and/or evening peak flows were significantly higher during the budesonide treatment as compared with the BDP treatment. In comparison with the placebo period, FEV1.0 was significantly improved with budesonide but not with BDP. Plasma cortisol, WBC counts, differential and eosinophilia counts in blood were determined at the beginning and the end of each period. All of the values except for the eosinophil counts were within normal ranges. Candida was looked for but not found in any case. No other adverse effects were registered. For most of the children, a deterioration of the state of their asthma and increased need for concomitant therapy during the placebo period confirmed their steroid dependence. The number of administrations with concomitant anti-asthmatic therapy increased during placebo by 61% as compared with the budesonide therapy, and by 40% compared with the BDP therapy. PMID- 3307882 TI - EMG biofeedback and relaxation in the treatment of hyperfunctional dysphonia. PMID- 3307883 TI - Isolation and culture of intrahepatic bile ducts and its application in assessing putative inducers of biliary epithelial cell hyperplasia. AB - A method for the isolation and culture of intact intrahepatic bile ducts from normal rats, and its use in studying putative inducers of biliary epithelial cell (BEC) hyperplasia was developed. Ducts were isolated by sequential perfusion of the liver with EGTA and collagenase-hyaluronidase followed by mild mechanical agitation. The resultant fraction, consisting of numerous small bile ducts within a connective tissue framework, was collected and embedded in a collagen gel and cultured on a raft assembly in Medium 199 supplemented with 15% newborn calf serum and antibiotics. Following 10-15 days in culture, the tissue consisted of dilated bile ducts lined by large cuboidal to elongated BEC. At day 15, the BEC 3H-thymidine-labelling index was 5.56 +/- 0.66% (mean +/- s.e.m.) which is nine times that observed in normal rat BEC in situ and similar to the rate of cell division of BEC lining hyperplastic ductules following bile duct ligation in the rat. Putative cholangiotrophic factors, proline, lithocholic acid and extracts of liver and small intestinal mucosa from normal rats and rats after 3 weeks' total biliary obstruction (TBO), were added to the culture medium for the last 5 days of a 15-day culture. With the exception of the extract of liver following TBO which had a growth inhibitory effect and lithocholic acid which was toxic, these treatments did not result in any alteration in the rate of BEC replication. PMID- 3307885 TI - An animal model for chronic infection of the unobstructed urinary tract. AB - Chronic cystitis due to Escherichia coli is frequently associated with anatomical or functional abnormalities of the lower urinary tract, but there is no satisfactory animal model available to help resolve biological and management problems. We have induced chronic infection of the unobstructed urinary tract in the rat by implanting a small polyurethane sponge into the dome of the bladder, 14 days before bacterial challenge. This manipulation provides a focus of infected urine and leads to the establishment of a chronic cystitis. Both the predisposing factor and the pathological details mimic important features of the disease in man. PMID- 3307884 TI - Electron microscopic studies on the location of bacterial proliferation in the liver in murine salmonellosis. AB - Highly susceptible inbred male C57BL/6 mice were infected with 2 X 10(7) virulent Salmonella typhimurium by intraperitoneal inoculation. Samples of the liver were removed 2 or 3 days post-infection for examination by electron microscopy. Rapid infiltration of polymorphs and macrophages was observed in the site of infection. Visual evidence is presented to confirm the destruction of salmonellae within these inflammatory phagocytes as previously reported. The proliferation of the pathogens occurred in the extracellular locations of sinusoids and early lesions, and within hepatocytes. PMID- 3307887 TI - An appraisal of ultraviolet lamps used for the phototherapy of psoriasis. PMID- 3307886 TI - Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. AB - In a double-blind trial patients with atopic eczema received either oral evening primrose oil (EPO) (n = 14) or placebo (n = 11) for 12 weeks. In the EPO group a statistically significant improvement was observed in the overall severity and grade of inflammation and in the percentage of the body surface involved by eczema as well as in dryness and itch. Patients in the placebo group showed a significant reduction in inflammation. The patients receiving EPO showed a significantly greater reduction in inflammation than those receiving placebo. Evening primrose oil caused a significant rise in the amount of dihomogammalinolenic acid in the plasma phospholipid fatty acids. Plasma levels of TXB2, 6-keto-PGF1 alpha and PGE1, and the amount of TXB2 released into serum during clotting were not altered by evening primrose oil. PMID- 3307888 TI - Comparison of Grenz rays versus placebo in the treatment of chronic hand eczema. AB - A double-blind trial was performed on 30 patients with bilateral symmetrical constitutional hand eczema, resistant to previous treatment. There was no difference in efficacy between Grenz rays in a total dose of 900 rad (9 Gy) given in three equal doses at 21-day intervals, and placebo therapy given in a similar treatment schedule. PMID- 3307889 TI - A double-blind study of Grenz ray therapy in chronic eczema of the hands. AB - The effect of Grenz ray therapy as an adjunct to topical therapy in chronic symmetrical eczema of the hands was assessed in 24 patients by randomly allocating active treatment to one hand while the other, which received simulated therapy, served as a control. Three Gy of Grenz rays were applied on six occasions at intervals of 1 week. There was a significantly better response to active treatment 5 and 10 weeks after the start of treatment compared with the untreated control. PMID- 3307890 TI - Cimetidine and chlorpheniramine in the treatment of chronic idiopathic urticaria: a multi-centre randomized double-blind study. AB - One hundred and twenty patients with chronic idiopathic urticaria, who entered a study at five centres (Sheffield, London, Bristol, Cardiff and Leeds) were treated with therapeutic doses of the H1 antagonist chlorpheniramine for 6 weeks. Histamine H1 non-responders (40 patients) were entered into a double-blind study and received chlorpheniramine plus cimetidine 400 mg q.d.s. (21 patients) or chlorpheniramine plus placebo (19 patients) for a further 8 weeks. The most important response measure was the change from baseline of the total symptom score: an assessment of the number and duration of new weals and degree of itching. There was a statistically significant difference between the average response in the two treatment groups in favour of chlorpheniramine plus cimetidine after 4 and 8 weeks' treatment (P less than 0.05 and P less than 0.01, respectively). No significant side-effects related to treatment were noted. PMID- 3307891 TI - Melanocytic naevi and melanoma: an epidemiological perspective. AB - There is growing evidence that individuals at high risk of cutaneous melanoma can be identified by the use of simple measures of benign melanocytic naevi--raised risk occurring in persons who have large numbers of naevi, or naevi with atypical clinical features. Very high risk of melanoma appears to exist in two rare groups: persons with dysplastic naevi whose families include at least two individuals who have had melanoma, and persons with giant congenital naevi. Risks of melanoma in other individuals with dysplastic naevi and in persons with small congenital naevi have not yet been quantified. Much of the published work on risk of melanoma in relation to naevi has been based on clinical series or assemblage of case reports, with great potential for bias. In such studies, naevi have often been classified into dichotomies or syndromes originally defined for pathological or clinical purposes, frequently using poorly reproducible criteria. Case-control and cohort studies of the relationship of naevi to melanoma are needed, which use reproducible criteria and designs minimizing bias, and which examine risk in relation to graded clinical and histological measures of naevi. PMID- 3307892 TI - Herpes gestationis factor reacts with the amniotic epithelial basement membrane. AB - Sera from five patients with clinically and immunopathologically proven herpes gestationis were studied by complement fixing immunofluorescence and complement fixing immuno-electron microscopy using specimens of skin, amniochorion and placenta. The results demonstrated that the complement fixation antibody (herpes gestationis factor) could bind to the basement membrane zone of skin, amnion and chorion laeve but not to that of the placental syncytiotrophoblast. These data suggest that the herpes gestationis factor may be induced by the basement membrane zone antigens of extra-villous cytotrophoblasts. PMID- 3307893 TI - The distribution of p29 protein in normal human skin. AB - In order to identify specific oestrogen-sensitive structures, normal human skin was examined for the binding of the ER D5 antibody which is associated with p29, a 29 kilodalton protein found in the cytoplasm of normal oestrogen-sensitive cells. Strong and specific staining was seen in the epidermis, with a gradient showing the most intense staining in the granular layer. Similar positive staining was seen in the hair follicles and sebaceous glands. Variable staining was seen in the eccrine glands and vessels. These findings demonstrate p29 to be present in these structures, and hence that oestrogens may exert a specific effect on these tissues. PMID- 3307894 TI - Nifedipine in the treatment of Raynaud's phenomenon in patients with systemic sclerosis. AB - A double-blind, placebo-controlled, cross-over trial of nifedipine 10 mg three times daily for 6 weeks, in 10 patients with Raynaud's phenomenon secondary to systemic sclerosis, is reported. A significant reduction in the duration of attacks of Raynaud's phenomenon was observed. Nifedipine therapy also reduced the number and severity of attacks of Raynaud's phenomenon and the development of new digital ulcers, and increased the digital blood flow, but none of these changes was statistically significant. No alteration in red blood cell deformability or leukocyte chemiluminescence was observed during nifedipine treatment. PMID- 3307895 TI - Pharmacogenetic perspectives on susceptibility to toxic industrial chemicals. PMID- 3307896 TI - Occupational hazards in hospitals: accidents, radiation, exposure to noxious chemicals, drug addiction and psychic problems, and assault. AB - Except for infectious diseases all the main occupational hazards affecting health workers are reviewed: accidents (explosions, fires, electrical accidents, and other sources of injury); radiation (stochastic and non-stochastic effects, protective measures, and personnel most at risk); exposure to noxious chemicals, whose effects may be either local (allergic eczema) or generalised (cancer, mutations), particular attention being paid to the hazards presented by formol, ethylene oxide, cytostatics, and anaesthetic gases; drug addiction (which is more common among health workers than the general population) and psychic problems associated with promotion, shift work, and emotional stress; and assault (various types of assault suffered by health workers, its causes, and the characterisation of the most aggressive patients). PMID- 3307897 TI - A comparison of Goldmann and Humphrey automated perimetry in patients with glaucoma. AB - Humphrey automated threshold perimetry (Program 30-2) was performed on 42 eyes of 25 patients with glaucoma to determine both the sensitivity and specificity of automated perimetry in detecting glaucomatous visual field defects. Automated perimetry sensitivity was 90.38%, while automated perimetry specificity was 91%. Fifty-two patients and a technician took part in a survey to determine their preference for either test. Patients generally preferred having Goldmann perimetry. The technician favoured Humphrey automated perimetry. Program 30-2 on the automated perimeter took 25% longer to perform than Goldmann perimetry. PMID- 3307898 TI - Acanthamoeba keratitis. AB - We report on four patients seen during the past two years who had acanthamoeba keratitis. One is described in detail. We believe that acanthamoebic eye infection is not rare. An immunofluorescent technique for localisation of amoebae and cysts is described. Our patients' response to propamidine and dibromopropamidine therapy was complicated by problems of toxicity. PMID- 3307899 TI - Disseminated aspergillosis in a patient with ocular reticulum cell sarcoma. AB - A 75-year-old healthy woman developed uveitis and chorioretinal infiltrates OD compatible with reticulum cell sarcoma. She was admitted to hospital 18 months later with somnolence and confusion. Examination revealed diffuse white matter hypodensity on computed tomography and a persistent cerebrospinal fluid pleocytosis. At necropsy reticulum cell sarcoma was found in the right globe and Aspergillus fumigatus was present in almost every other organ, including the brain. PMID- 3307900 TI - Attenuation of ocular and systemic responses to tracheal intubation by intravenous lignocaine. AB - This study was undertaken to determine whether intravenous lignocaine could mitigate or prevent the ocular reactions and especially the acute increase in intraocular pressure associated with laryngoscopy and tracheal intubation. Two groups of children undergoing minor eye surgery under nitrous oxide-oxygen halothane anaesthesia were examined. The experimental group (n = 17) received 2 mg/kg lignocaine and the controls (n = 18) an equivalent volume of saline. The incidence of local laryngeal and ocular reflexes was much lower in the lignocaine group. Pulse acceleration was significantly lower in the lignocaine group (p less than 0.025), and the maximal mean intraocular pressure was significantly less than in the control group (p less than 0.005). Other ocular reactions were recorded, and all were attenuated after lignocaine administration. The beneficial effects of lignocaine, a suppressant of autonomic reflexes, suggest that intraocular pressure, like the heart rate, rises after intubation as a result of autonomic stimulation. The use of intravenous lignocaine is thus recommended for children at risk, such as those needing an urgent operation because of lacerated eye injury under rapid sequence induction of anaesthesia. PMID- 3307901 TI - Epithelial metabolism of the corneal graft is abnormal. AB - Both eyes of 16 patients who had undergone unilateral penetrating keratoplasty were examined in this study. The mean corneal oxygen uptake rate in the centre of the graft was 3.88 (SD 0.55) mmHg/s and in the control eye was 4.29 (SD 0.62) mmHg/s. In the temporal host periphery the results for the grafted and control eyes were 4.52 (SD 0.54) mmHg/s and 4.26 (SD 0.52) mmHg/s respectively. The differences in the oxygen uptake rate between the centre of the graft cornea and the contralateral control eye and between the centre and periphery of the graft eye were statistically significant (p less than 0.01). The central corneal touch threshold of the graft eye showed good recovery in four patients, while the remaining 12 had no or minimal recovery. The central and temporal epithelial and corneal thicknesses of the graft and the control eyes were not significantly different. The central endothelial cell density was 1383 cells/mm2 in the graft and 3053 cells/mm2 in the control eye. As corneal oxygen uptake reflects changes in aerobic epithelial metabolism, it is possible that there is a link between loss of neural integrity of graft epithelium and lowered epithelial aerobic metabolism following penetrating keratoplasty. PMID- 3307902 TI - Regulation of deoxyribotide synthesis. PMID- 3307903 TI - Salt-dependent binding of Escherichia coli RNA polymerase to DNA and specific transcription by the core enzyme and holoenzyme. AB - The interaction of the Escherichia coli RNA polymerase with several forms of DNA has been studied by difference absorption spectroscopy, protection against endonucleases, and limited, specific initiation. The core enzyme is able to open duplex poly[d(A-T)] in 10 mM KCl. The core enzyme binds to promoters in linear DNA in a salt-dependent manner, but it does not bind to the same promoters in supercoiled DNA. The binding of the core enzyme is not as tight as that of the holoenzyme. The holoenzyme initiates specific transcription from promoters in a salt-dependent manner. The core enzyme also initiates specific transcription from the same promoters at approximately one-fifth the level of the holoenzyme with a different salt dependence. The profile of the salt dependence of specific transcription initiation varies with the promoter. The origin of differences between holoenzyme-DNA and core enzyme-DNA interactions and the mechanism whereby sigma improves transcriptional specificity are discussed in light of these data. PMID- 3307904 TI - Yeast and horse liver alcohol dehydrogenases: potential problems in target size analysis and evidence for a monomer active unit. AB - Yeast and horse alcohol dehydrogenases are commonly used as standards for radiation inactivation analysis of proteins, usually assuming that the minimal functional unit corresponds to the physical size in solution, a tetramer (Mr = 148,000) and a dimer (Mr = 80,000), respectively. Results described in this paper demonstrate that molecular weight overestimates may be obtained for the yeast protein as a result of its unusual sensitivity to secondary radiation products. Irradiation in the presence of sulfhydryl reagents results in a smaller functional size estimate (67,000 +/- 3000) than that obtained in their absence (128,000 +/- 5000), indicating that some sulfhydryl groups in the enzyme may be particularly susceptible to attack by radiolytic species. Analysis of the horse liver enzyme reveals that although it has structural and functional similarities to the yeast protein, it is not as prone to secondary radiation damage and gives a minimal functional size estimate (33,000 +/- 1000) that most closely corresponds to a monomer. Quantitation of disappearance of the protein from a sodium dodecyl sulfate gel as a function of radiation dose also gives a target size (48,000 +/- 3000) in reasonable agreement with the monomer molecular weight. These results indicate that the individual subunits of horse liver alcohol dehydrogenase have independent catalytic capacity and imply that the same may be true for the yeast enzyme. PMID- 3307905 TI - Optically detected magnetic resonance of tryptophan residues in complexes formed between a bacterial single-stranded DNA binding protein and heavy atom modified poly(uridylic acid). AB - Optically detected magnetic resonance (ODMR) methods were employed to study three single-stranded DNA binding (SSB) proteins encoded by plasmids of enteric bacteria: pIP71a, R64, and F. Equilibrium binding isotherms obtained by fluorescence titrations reveal that the complexes of the plasmid SSB proteins with heavy atom modified polynucleotides are readily disrupted by salt. Since all the plasmid SSB proteins show limited solubility at low ionic strength (pIP71a greater than R64 greater than F), we were able to bind only the pIP71a protein to mercurated poly(uridylic acid) [poly(5-HgU)] and brominated poly(uridylic acid) [poly(5-BrU)]. ODMR results reveal the existence of at least one heavy atom perturbed, red-shifted, stacked Trp residue in these complexes. Amplitude modulated phosphorescence microwave double resonance spectra display selectively the phosphorescence associated with Hg-perturbed Trp residue(s) in the pIP71a SSB protein-poly(5-HgU) complex, which has a broad, red-shifted 0,0-band. Our results suggest that Trp-135 in Escherichia coli SSB, which is absent in the plasmid encoded SSB proteins, is located in a polar environment and is not involved in stacking interactions with the nucleotide bases. Phosphorescence spectra and lifetime measurements of the pIP71a SSB protein-poly (5-BrU) complex show that at least one Trp residue in the complex does not undergo stacking. This sets a higher limit of two stacking interactions of Trp residues with nucleotide bases in complexes of pIP71a SSB with single-stranded polynucleotides. PMID- 3307906 TI - Kinetic mechanism of histidinol dehydrogenase: histidinol binding and exchange reactions. AB - Salmonella typhimurium histidinol dehydrogenase produces histidine from the amino alcohol histidinol by two sequential NAD-linked oxidations which form and oxidize a stable enzyme-bound histidinaldehyde intermediate. The enzyme was found to catalyze the exchange of 3H between histidinol and [4(R)-3H]NADH and between NAD and [4(S)-3H]NADH. The latter reaction proceeded at rates greater than kcat for the net reaction and was about 3-fold faster than the former. Histidine did not support an NAD/NADH exchange, demonstrating kinetic irreversibility in the second half-reaction. Specific activity measurements on [3H]histidinol produced during the histidinol/NADH exchange reaction showed that only a single hydrogen was exchanged between the two reactants, demonstrating that under the conditions employed this exchange reaction arises only from the reversal of the alcohol dehydrogenase step and not the aldehyde dehydrogenase reaction. The kinetics of the NAD/NADH exchange reaction demonstrated a hyperbolic dependence on the concentration of NAD and NADH when the two were present in a 1:2 molar ratio. The histidinol/NADH exchange showed severe inhibition by high NAD and NADH under the same conditions, indicating that histidinol cannot dissociate directly from the ternary enzyme-NAD-histidinol complex; in other words, the binding of substrate is ordered with histidinol leading. Binding studies indicated that [3H]histidinol bound to 1.7 sites on the dimeric enzyme (0.85 site/monomer) with a KD of 10 microM. No binding of [3H]NAD or [3H]NADH was detected. The nucleotides could, however, displace histidinol dehydrogenase from Cibacron Blue-agarose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307907 TI - Products of the inactivation of ribonucleoside diphosphate reductase from Escherichia coli with 2'-azido-2'-deoxyuridine 5'-diphosphate. AB - Ribonucleoside diphosphate reductase (RDPR) from Escherichia coli was completely inactivated by 1 equiv of the mechanism-based inhibitor 2'-azido-2'-deoxyuridine 5'-diphosphate (N3UDP). Incubation of RDPR with [3'-3H]N3UDP resulted in 0.2 mol of 3H released to solvent per mole of enzyme inactivated, indicating that cleavage of the 3' carbon-hydrogen bond occurred in the reaction. Incubation of RDPR with [beta-32P]N3UDP resulted in stoichiometric production of inorganic pyrophosphate. One equivalent of uracil was eliminated from N3UDP, but no azide release was detected. Analysis of the reaction of RDPR with [15N3]N3UDP by mass spectrometry revealed that the azide moiety was converted to 0.9 mol of nitrogen gas per mole of enzyme inactivated. The tyrosyl radical of the B2 subunit was destroyed during the inactivation by N3UDP as reported previously [Sjoberg, B. M., Graslund, A., & Eckstein, F. (1983) J. Biol. Chem. 258, 8060-8067], while the specific activity of the B1 subunit was reduced by half. Incubation of [5' 3H]N3UDP with RDPR resulted in stoichiometric covalent radiolabeling of the enzyme. Separation of the enzyme's subunits by chromatofocusing revealed that the modification was specific for the B1 subunit. PMID- 3307908 TI - Pyridine coenzyme analogues. Synthesis and characterization of alpha- and beta nicotinamide arabinoside adenine dinucleotides. AB - The synthesis and characterization of a new pyridine coenzyme analogue containing a nicotinamide arabinonucleotide moiety are reported. The redox potentials are 339 mV for beta-oxidized nicotinamide arabinoside adenine dinucleotide and -319 mV for alpha-oxidized nicotinamide adenine dinucleotide, and the lambda max is 346 and 338 nm for beta- and alpha-reduced nicotinamide arabinoside adenine dinucleotides (araNADH), respectively. Anomerization of the reduced analogues leads to a 5:1 ratio of alpha-araNADH to beta-araNADH at 90 degrees C. These results establish that the relative configuration of the 2'-hydroxyl to the base is the primary determinant for the configuration-dependent changes in lambda max, the redox potential of the pyridine nucleotides, and the preferred anomeric configuration of the reduced coenzymes. Comparison of the 1H and 31P NMR spectral data of the analogues with those for the ribo coenzymes is reported and the conformational analysis discussed. The coenzyme properties of the arabino analogues have been evaluated with yeast and horse liver alcohol dehydrogenases. Both the alpha- and beta-anomers are found to serve as coenzymes, and the stereochemistry of hydride transfer is identical for both anomers. PMID- 3307909 TI - Amino acid sequence of guinea pig prostate kallikrein. AB - The primary structure of the major arginine esteropeptidase from guinea pig prostate has been deduced from automated Edman degradation of peptides generated by clostripain, cyanogen bromide, endoproteinase Lys-C, and Staphylococcus aureus V8 protease digestion of the protein. The esteropeptidase is a single polypeptide chain comprised of 239 amino acids and contains 2 apparent sites of carbohydrate attachment, Asn-78 and Asn-169. Both occur in consensus sequences for N-linked glycosylation sites. The esteropeptidase exhibits approximately 35% homology with trypsin including conservation of the catalytic residues and the aspartic acid which confers specificity toward basic amino acids. The sequence identity, however, extends to greater than 60% with the kallikrein family of serine proteases. In addition to the overall homology, the guinea pig enzyme displays a number of features characteristic of kallikreins including 10 conserved half cystine residues, a C-terminal proline, and the "kallikrein loop". On the basis of this structural relatedness, the enzyme has been designed as guinea pig prostate kallikrein. In contrast to many of the kallikreins of other species and tissues, this enzyme does not contain any sites within the kallikrein loop sensitive to proteases that result in internal breaks in the polypeptide chain. PMID- 3307910 TI - Structural comparison of acyl carrier protein in acylated and sulfhydryl forms by two-dimensional 1H NMR spectroscopy. AB - Sequence-specific assignments of 1H NMR resonances are obtained for the backbone protons of Escherichia coli acyl carrier protein, acylated with an eight-carbon chain covalently attached to the prosthetic group thiol (octanoyl-ACP). Comparison of 1H-1H sequential connectivities in the NOESY spectra of octanoyl ACP and the unacylated protein (ACPSH) indicates that secondary structure is largely conserved on acylation. Changes in resonance positions observed for certain groups of residues are interpreted in terms of a model that describes the spatial reorientation of secondary structural elements in the protein resulting from introduction of the acyl chain. PMID- 3307911 TI - Evidence for the existence of three or more slow phases in the refolding of ribonuclease A and some characteristics of the phases. AB - The slow refolding kinetics of RNase A have been analyzed, by using a nonlinear least-squares program for deconvoluting the kinetic phases and applying statistical tests for quality of fit. It is found that a minimum of three slow phases are required to fit the kinetic data properly, and this is true whether the method of detection is absorbance of fluorescence. Since the number of phases and the relaxation times for each phase are independent of the method of detection, it is concluded that the same three rate-limiting processes are seen by absorbance and fluorescence. These phases correspond to the XY, CT, and ct phases described in our earlier studies. The fact that fluorescence-detected kinetics are somewhat slower than absorbance-detected kinetics is a trivial effect due not to differences in relaxation times but to the fact that the amplitude of the CT phase is enhanced in fluorescence measurements, at the expense of the faster XY phase, because of intrinsic fluorescence changes associated with the isomerization of proline-93. By use of a new double-jump technique [Schmid, F.X., Grafl, R., Wrba, A., & Beintema, J.J. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 872], it is shown that proline-93 isomerizes as the rate limiting step in only one of the three phases, the CT phase, and that this phase involves only 25-30% of the RNase molecules. There is still no indication as to the molecular events that occur in the large, ammonium sulfate dependent XY phase, which is the pathway for formation of the nativelike intermediate. PMID- 3307912 TI - Backbone dynamics of a model membrane protein: assignment of the carbonyl carbon 13C NMR resonances in detergent-solubilized M13 coat protein. AB - The major coat protein of the filamentous bacteriophage M13 is a 50-residue amphiphilic polypeptide which is inserted, as an integral membrane-spanning protein, in the inner membrane of the Escherichia coli host during infection. 13C was incorporated biosynthetically into a total of 23 of the peptide carbonyls using labeled amino acids (alanine, glycine, lysine, phenylalanine, and proline). The structure and dynamics of carbonyl-labeled M13 coat protein were monitored by 13C nuclear magnetic resonance (NMR) spectroscopy. Assignment of many resonances was achieved by using protease digestion, pH titration, or labeling of the peptide bond with both 13C and 15N. The carbonyl region of the natural-abundance 13C NMR spectrum of M13 coat protein in sodium dodecyl sulfate solution shows approximately eight backbone carbonyl resonances with line widths much narrower than the rest. Three of these more mobile residues correspond to assigned peaks (glycine-3, lysine-48, and alanine-49) in the individual amino acid spectra, and another almost certainly arises from glutamic acid-2. A ninth residue, alanine-1, also gives rise to a very narrow carbonyl resonance if the pH is well above or below the pKa of the terminal amino group. These data suggest that only about four residues at either end of the protein experience large-amplitude spatial fluctuations; the rest of the molecule is essentially rigid on the time scale of the overall rotational tumbling of the protein-detergent complex. The relative exposure of different regions of detergent-bound protein was monitored by limited digestion with proteinase K.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307913 TI - Backbone dynamics of a model membrane protein: measurement of individual amide hydrogen-exchange rates in detergent-solubilized M13 coat protein using 13C NMR hydrogen/deuterium isotope shifts. AB - Hydrogen-exchange rates have been measured for individual assigned amide protons in M13 coat protein, a 50-residue integral membrane protein, using a 13C nuclear magnetic resonance (NMR) equilibrium isotope shift technique. The locations of the more rapidly exchanging amides have been determined. In D2O solutions, a peptide carbonyl resonance undergoes a small upfield isotope shift (0.08-0.09 ppm) from its position in H2O solutions; in 1:1 H2O/D2O mixtures, the carbonyl line shape is determined by the exchange rate at the adjacent nitrogen atom. M13 coat protein was labeled biosynthetically with 13C at the peptide carbonyls of alanine, glycine, phenylalanine, proline, and lysine, and the exchange rates of 12 assigned amide protons in the hydrophilic regions were measured as a function of pH by using the isotope shift method. This equilibrium technique is sensitive to the more rapidly exchanging protons which are difficult to measure by classical exchange-out experiments. In proteins, structural factors, notably H bonding, can decrease the exchange rate of an amide proton by many orders of magnitude from that observed in the freely exposed amides of model peptides such as poly(DL-alanine). With corrections for sequence-related inductive effects [Molday, R. S., Englander, S. W., & Kallen, R. G. (1972) Biochemistry 11, 150 158], the retardation of amide exchange in sodium dodecyl sulfate solubilized coat protein has been calculated with respect to poly(DL-alanine). The most rapidly exchanging protons, which are retarded very little or not at all, are shown to occur at the N- and C-termini of the molecule.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3307914 TI - Prostatic growth factor: purification and structural relationship to basic fibroblast growth factor. AB - Prostatic growth factor (PrGF) was purified from alkaline homogenates of human benign prostatic hyperplastic tissue by a combination of ammonium sulfate precipitation, heparin affinity chromatography, and cation-exchange chromatography. The 17,600-dalton, basic (pI 10.2) PrGF is related to basic fibroblast growth factor (bFGF) since antisera raised against synthetic peptides with sequence homologies corresponding to an internal peptide and amino- and carboxyl-terminal peptides of bFGF react with the growth factor. The growth factor appears larger than bFGF, suggesting that additional amino-terminal sequences may be present as a result of alkaline extraction in the presence of protease inhibitors. PMID- 3307915 TI - Purification and properties of Escherichia coli 4'-phosphopantothenoylcysteine decarboxylase: presence of covalently bound pyruvate. AB - 4'-Phosphopantothenoylcysteine decarboxylase was purified 900-fold from Escherichia coli B with an overall yield of 6%. The enzyme migrates as a single band with a molecular weight of 35,000 +/- 3000 in 10% polyacrylamide gel electrophoresis under denaturing conditions. The native enzyme has an apparent molecular weight of 146,000 +/- 9000 as determined by a gel exclusion column. At pH 7.6 and 25 degrees C, Km = 0.9 mM and Vmax = 600 nmol/(min X mg of protein). The pH optimum for Vmax is between 7.5 and 7.7. Hydroxylamine, phenylhydrazine, potassium cyanide, and sodium borohydride as well as pyridoxal phosphate and pyridoxal inactivated the enzyme. The enzyme contains covalently bound pyruvate as suggested by the isolation of [3H]lactate and pyruvate from [3H]NaBH4-reduced enzyme and native enzyme, respectively. One mole of [3H]lactate was isolated per 39,000 g of [3H]NaBH4-reduced and completely inactivated enzyme, and 1 mol of pyruvate was isolated per 31,000 +/- 4000 g of native enzyme. Mild base treatment released lactate and pyruvate from the reduced and the native enzymes, respectively, suggesting the pyruvate is attached to the enzyme by an ester bond. These findings are in accord with similar results obtained with the horse liver enzyme (R. Scandurra, personal communication). The presence of covalently bound pyruvate in the bacterial and mammalian enzymes suggests that pyruvate plays a major role in the mechanism of action. PMID- 3307916 TI - Construction and evaluation of the kinetic scheme associated with dihydrofolate reductase from Escherichia coli. AB - A kinetic scheme is presented for Escherichia coli dihydrofolate reductase that predicts steady-state kinetic parameters and full time course kinetics under a variety of substrate concentrations and pHs. This scheme was derived from measuring association and dissociation rate constants and pre-steady-state transients by using stopped-flow fluorescence and absorbance spectroscopy. The binding kinetics suggest that during steady-state turnover product dissociation follows a specific, preferred pathway in which tetrahydrofolate (H4F) dissociation occurs after NADPH replaces NADP+ in the ternary complex. This step, H4F dissociation from the E X NADPH X H4F ternary complex, is proposed to be the rate-limiting step for steady-state turnover at low pH because koff = VM. The rate constant for hydride transfer from NADPH to dihydrofolate (H2F), measured by pre-steady-state transients, has a deuterium isotope effect of 3 and is rapid, khyd = 950 s-1, essentially irreversible, Keq = 1700, and pH dependent, pKa = 6.5, reflecting ionization of a single group in the active site. This scheme accounts for the apparent pKa = 8.4 observed in the steady state as due to a change in the rate-determining step from product release at low pH to hydride transfer above pH 8.4. This kinetic scheme is a necessary background to analyze the effects of single amino acid substitutions on individual rate constants. PMID- 3307918 TI - Biomembrane fusion: a new concept derived from model studies using two interacting planar lipid bilayers. PMID- 3307917 TI - Probing the functional role of phenylalanine-31 of Escherichia coli dihydrofolate reductase by site-directed mutagenesis. AB - The role of Phe-31 of Escherichia coli dihydrofolate reductase in binding and catalysis was probed by amino acid substitution. Phe-31, a strictly conserved residue located in a hydrophobic pocket and interacting with the pteroyl moiety of dihydrofolate (H2F), was replaced by Tyr and Val. The kinetic behavior of the mutant enzymes in general is similar to that of the wild type. The rate-limiting step for both mutant enzymes is the release of tetrahydrofolate (H4F) from the E X NADPH X H4F ternary complex as determined for the wild type. The 2-fold increase in V for the two mutant enzymes arises from faster dissociation of H4F from the enzyme-product complex. The quantitative effect of these mutations is to decrease the rate of hydride transfer, although not to the extent that this step becomes partially rate limiting, but to accelerate the dissociation rates of tetrahydrofolate from product complexes so that the opposing effects are nearly compensating. PMID- 3307919 TI - Lipid intermolecular hydrogen bonding: influence on structural organization and membrane function. AB - The great variety of different lipids in membranes, with modifications to the hydrocarbon chains, polar groups and backbone structure suggests that many of these lipids may have unique roles in membrane structure and function. Acidic groups on lipids are clearly important, since they allow interaction with basic groups on proteins and with divalent cations. Another important property of certain lipids is their ability to interact intermolecularly with other lipids via hydrogen bonds. This interaction occurs through acidic and basic moieties in the polar head groups of phospholipids, and the amide moiety and hydroxyl groups on the acyl chain, sphingosine base and sugar groups of sphingo- and glycolipids. The putative ability of different classes of lipids to interact by intermolecular hydrogen bonding, the molecular groups which may participate and the effect of these interactions on some of their physical properties are summarized in Table IX. It is frequently questioned whether intermolecular hydrogen bonding could occur between lipids in the presence of water. Correlations of their properties with their molecular structures, however, suggest that it can. Participation in intermolecular hydrogen bonding increases the lipid phase transition temperature by approx. 8-16 Cdeg relative to the electrostatically shielded state and by 20 30 Cdeg relative to the repulsively charged state, while having variable effects on the enthalpy. It increases the packing density in monolayers, possibly also in the liquid-crystalline phase in bilayers, and decreases the lipid hydration. These effects can probably be accounted for by transient, fluctuating hydrogen bonds involving only a small percentage of the lipid at any one time. Thus, rotational and lateral diffusion of the lipids may take place but at a slower rate, and the lateral expansion is limited. Intermolecular hydrogen bonding between lipids in bilayers may be significantly stabilized, despite the presence of water, by the fact that the lipids are already intermolecularly associated as a result of the hydrophobic effect and the Van der Waals' interactions between their chains. The tendency of certain lipids to self-associate, their asymmetric distribution in SUVs, their preferential association with cholesterol in non cocrystallizing mixtures, their temperature-induced transitions to the hexagonal phase and their inhibitory effect on penetration of hydrophobic residues of proteins partway into the bilayer can all be explained by their participation in intermolecular hydrogen bonding interactions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3307920 TI - Subcellular organization of glycosylation in mammalian cells. PMID- 3307921 TI - Ion transport by the placenta: a review of membrane transport systems. PMID- 3307922 TI - Insulin-membrane interactions and membrane fluidity changes. PMID- 3307923 TI - E. coli minichromosome replication in vitro and in vivo: comparative analyses of replication intermediates. AB - The process of replication of Escherichia coli minichromosomes was examined by following the intermediates formed in vitro and in vivo. Replication initiated on a supercoiled closed circular (CC) monomer, proceeded rapidly to a late but incomplete stage in polymerization (the LC form) in both systems, passed more slowly through a series of open and closed circular catenated dimers with varying extents of intertwining between the monomer units, and then yielded, after decatenation, the supercoiled CC monomer. The replication patterns of two different minichromosomes were similar, although the LC form and the multiply intertwined dimers were much more evident in the smaller pAL4 than in pAL2. The same basic replication scheme was seen in vitro and in vivo but completion of polymerization and processing of the dimers were slower in vitro. Some radioactivity was detected in OC monomer early during replication, consistent with occasional decatenation of LC structures to produce OC molecules which then completed replication to form CC molecules. However, progression to CC catenated dimers prior to formation of CC monomers represented the major replication pathway. PMID- 3307924 TI - Cloning and sequencing of a carp beta s-crystallin cDNA. AB - The mRNAs were extracted from common carp (Cyprinus carpio) lenses, purified, reverse transcribed, dC tailed and cloned into Escherichia coli with pBR322 as vector. The cloning efficiency was around 1 X 10(7) colonies per micrograms of mRNA. A clone (pC20) was found by hybrid-arrested to contain the cDNA related to carp crystallins. However, comparison of the derived amino-acid sequence with bovine gamma-II and beta s-crystallins indicates that this carp crystallin sequence resembles closely the bovine beta s-crystallin and should be better classified as such except that this fish sequence does not contain the N-terminal 'arm' of four amino-acid residues present in bovine beta s-crystallin. PMID- 3307925 TI - Structural and spectroscopic comparison of manganese-containing superoxide dismutases. AB - Predicted secondary structures and optical properties of four manganese containing superoxide dismutases isolated from Saccharomyces cerevisiae, Bacillus stearothermophilus, Escherichia coli and human liver are compared. The structural predictions are further compared with the known crystal structure of the manganese-containing superoxide dismutase from Thermus thermophilus HB8. The secondary structures of the four dismutases are predicted by the methods of Chou and Fasman (Adv. Enzymol. 47 (1978) 45-148), Garnier et al. (J. Mol. Biol. 120 (1978) 97-120) and Lim (J. Mol. Biol. 88 (1974) 873-894). The three models show satisfactory agreement and predict that the enzymes have a mixed alpha-helix and beta-sheet structure, and that they have homologous structures. The former conclusion is also reached from an analysis of the hydrophobic character of the amino-acid sequences of the four proteins according to Kyte and Doolittle (J. Mol. Biol. 157 (1982) 105-132). The calculation of the secondary structure based on the 185-260 nm circular dichroism spectrum of manganese-containing superoxide dismutase from S. cerevisiae reveals that the enzyme consists of 61% alpha-helix, 13% beta-sheet, 11% turn and 8% random coil conformations, which is in good accordance with the prediction based on the amino-acid sequences. Comparison of the 400-700 nm circular dichroism spectra of manganese-containing superoxide dismutase from S. cerevisiae, E. coli and T. thermophilus demonstrates that manganese atoms have homologous coordination in the three enzymes. This investigation based on primary structures and spectral properties indicates that the four dismutases have the same overall structure. Since the structural predictions are in good agreement with the structure found for the manganese containing superoxide dismutase from T. thermophilus HB8, it can be concluded that this structure is representative for the four enzymes and probably for manganese-containing superoxide dismutases in general. PMID- 3307926 TI - The presence of functional arginine residues in phosphoenolpyruvate carboxykinase from Saccharomyces cerevisiae. AB - Saccharomyces cerevisiae phosphoenolpyruvate carboxykinase (ATP:oxaloacetate carboxy-lyase (transphosphorylating), EC 4.1.1.49) is completely inactivated by phenylglyoxal and 2,3-butanedione in borate buffer at pH 8.4, with pseudo-first order kinetics and a second-order rate constant of 144 min-1 X M-1 and 21.6 min-1 X M-1, respectively. Phosphoenolpyruvate, ADP and Mn2+ (alone or in combination) protect the enzyme against inactivation, suggesting that the modification occurs at or near to the substrate-binding site. Almost complete restoration of activity was obtained when a sample of 2,3-butanedione-inactivated enzyme was freed of excess modifier and borate ions, suggesting that only arginyl groups are modified. The changes in the rate of inactivation in the presence of substrates and Mn2+ were used to determine the dissociation constants for enzyme-ligand complexes, and values of 23 +/- 3 microM, 168 +/- 44 microM and 244 +/- 54 microM were found for the dissociation constants for the enzyme-Mn2+, enzyme-ADP and enzyme-phosphoenolpyruvate complexes, respectively. Based on kinetic data, it is shown that 1 mol of reagent must combine per enzyme active unit in order to inactivate the enzyme. Complete inactivation of the carboxykinase can be correlated with the incorporation of 3-4 mol [7-14C]phenylglyoxal per mol of enzyme subunit. Assuming a stoichiometry of 1:1 between phenylglyoxal incorporation and arginine modification, our results suggest that the modification of only two of the three to four reactive arginine residues per phosphoenolpyruvate carboxykinase subunit is responsible for inactivation. PMID- 3307927 TI - Affinity and stability modifications of immobilized alcohol dehydrogenase through multipoint copolymerization. AB - Yeast alcohol dehydrogenase (alcohol:NAD+ oxidoreductase, EC 1.1.1.1), a potentially useful enzyme for cofactor regeneration processes, was covalently immobilized in a multipoint fashion by activation with acryloyl chloride and subsequent copolymerization in a polyacrylamide gel. Several properties such as the activity and stability were systematically studied for the free enzyme, the acryloate-enzyme and the immobilized enzyme. The activation energy was significantly lowered upon immobilization. The thermal stability of the immobilized enzyme was, however, greatly increased. But its maximum activity was observed at a lower temperature. These results suggest an important effect of the diffusional restrictions and of the mode of activation and immobilization on the activity and the stability of the enzyme. PMID- 3307929 TI - Developmental expression and modification of genes. AB - Differentiating tissue is characterized by a specific repertoire of proteins out of which some are developmentally controlled. This review describes modifications in the structure of genes which encode developmentally regulated proteins. Evidence is provided for changes in chromatin conformation and DNA methylation of specific genes-either change can be observed in various stages of some vertebrates. The involvement of hormones in regulating DNA modifications is suggested, and interrelationships between DNA modifications and gene expression are discussed. PMID- 3307928 TI - Relationship between intracellular sterol content and sterol esterification and hydrolysis in Saccharomyces cerevisiae. AB - The relationship between the supply of free sterol and the synthesis of steryl esters by an auxotroph of Saccharomyces cerevisiae has been examined in order to understand the role of cellular free sterol content in the regulatory interactions of sterol esterification. Our results show that the yeast cells must maintain an essential, low level of free sterol that is critical for growth. An additional, expandable pool of free sterol is maintained by the cells, provided there is adequate available sterol. As the quantity of sterol in the expandable pool increases, there is a progressively increasing rate of sterol esterification, which is consistent with the results from in vitro assays of acyl Co A:ergosterol acyltransferase. Some increases in acyltransferase activity were insensitive to the protein synthetic inhibitor, cycloheximide. The data support the conclusion that sterol interconversion between the free and esterified forms is directed toward maintaining the essential amount of free sterol and that the activity of the relevant sterol enzymes in this organism are modulated in response to intracellular sterol content. PMID- 3307930 TI - "Resonances" in the dielectric absorption of DNA? AB - An attempt was made to confirm previous reports of resonant-like dielectric absorption of plasmid DNA in aqueous solutions at 1-10 GHz. The dielectric properties of the sample were measured using an automatic network analyzer with two different techniques. One technique used an open-ended coaxial probe immersed in the sample; the other employed a coaxial transmission line. No resonances were observed that could be attributed to the sample; however, resonance-type artifacts were prominent in the probe measurements. The coaxial line technique appears to be less susceptible to such artifacts. We note two important sources of error in the calibration of the automatic network analyzer using the probe technique. PMID- 3307931 TI - Twenty-five years in medical genetics and experimental mammalian genetics with particular reference to the gene map of mouse and man. PMID- 3307932 TI - Retroviral DNA content of the mouse genome. AB - Mice, like many other vertebrate species, carry multiple copies of retrovirus related sequences as part of their normal genetic complement. These endogenous retroviral DNA sequences are, in general, structurally and functionally similar to proviruses formed via exogenous virus infection. They behave as relatively stable genetic entities, are transmitted in a normal mendelian manner, and can be expressed by normal cellular mechanisms. Chromosome mapping studies have shown that these virus-related sequences are dispersed throughout the mouse genome, in most cases were acquired after speciation but before inbreeding, and occasionally cause mutations as a result of integrating within the mouse genome. PMID- 3307934 TI - Structure and organization of mammalian chromosomes: normal and abnormal. PMID- 3307933 TI - Maternal genes: mitochondrial diseases. PMID- 3307935 TI - The sources of molecular evolution: an outsider's view. PMID- 3307938 TI - The press week: a sidebar to the short course. PMID- 3307936 TI - Mouse models of genetic diseases. PMID- 3307937 TI - Prospects for gene replacement therapy. PMID- 3307939 TI - Chromosome mapping using DNA probes: a case study (chromosome 11) and future possibilities. AB - Recombinant DNA technology has greatly facilitated the mapping of human chromosomes. Somatic cell hybrid analysis, in situ hybridization, and linkage analysis are the major methods of gene mapping. Restriction endonuclease analysis and DNA hybridization techniques create new potentials for old methods, and the human gene map is becoming more dense with mapped loci at an ever quickening pace. The major usefulness of the saturation of the gene map with DNA polymorphic markers is that one can localize and study unknown genes responsible for common genetic disorders. PMID- 3307940 TI - Proceedings of the Sixth International Congress of Biorheology. Vancouver, B.C., Canada, 27 July-1 August 1986. Dedicated to Yuan-Cheng Bert Fung. PMID- 3307941 TI - Poiseuille Gold Medal award ceremony. Laudatio: Poiseuille Awardee Yuan-Cheng Fung. PMID- 3307942 TI - Transport in living plants. AB - This paper provides a general over-view to introduce the subsequent papers on particular topics of plant transport. A revised statement is given of the transport processes reviewed in Ann. Rev. Fluid Mech., 9, 275 (1977), outlining the tissue and cell structures of the plant body which carry out the long distance movements of water, mineral nutrients, and organic material. Some of the questions posed in that review are now better understood, e.g. the breaking of xylem water columns under tension, the loading of sugars into phloem in leaves, and the dissemination of water in leaf veins. Intractable questions remain to which there are no agreed answers, especially the organisation within phloem sieve tubes and the relative roles of the apoplast and symplast in the uptake of water and mineral ions by roots. New techniques are available for tracing water soluble substances at high resolution in microscopic preparations which may lead to the resolving of some of these questions. PMID- 3307943 TI - Blood rheology in myocardial infarction and hypertension. AB - Blood rheology was studied in patients with acute myocardial infarction (AMI) and essential hypertension (EH), and the results were correlated with in vivo hemodynamic functions. Blood viscosity (eta B) was elevated as a result of sequential changes of a number of parameters, including increases in hematocrit, plasma fibrinogen and alpha 2-globulin, an enhancement of red cell aggregation and a reduction of red cell filterability in plasma. Total peripheral resistance (TPR) was elevated upon admission, due to increases in both the vascular hindrance (ZS) and eta B. During recovery, the eta B became normalized; alterations in eta B were accompanied by parallel changes in TPR and an inverse change in plasma volume (PV). In EH patients, the increase in eta B showed a correlation with arterial pressure. For both established and borderline hypertensives, the rheological changes were most prominent in the high renin subgroups. In mild EH, the elevation of eta B was compensated by a decrease in ZS (vasodilation), keeping the TPR essentially normal. In EH with higher arterial pressure, the elevation of eta B was accompanied by a normal ZS without compensatory vasodilation, and hence TPR rose to exacerbate the hypertension. These results suggest that the elevation of eta B may be an early event in the development of EH and that its role must be considered with concurrent cardiovascular functions. In EH there is a significant correlation between left ventricular mass and eta B. Experimental manipulations of the hematocrit level in spontaneously hypertensive rats led to a corresponding variation of arterial pressure. The available data implicate a significant role of eta B in the pathophysiology of AMI and EH. Further interdisciplinary, longitudinal studies are needed tin order to unravel the complicated pathophysiological changes in myocardial infarction and hypertension. PMID- 3307944 TI - Biochemical aspects of cellular migration and invasion. PMID- 3307945 TI - A two-color flow cytometry assay for detection of hairy cells using monoclonal antibodies. AB - We have developed a simple two-color immunofluorescence assay equally suited for microscopy and flow cytometry detecting hairy cells (HCs) in single cell suspensions, based on the concomitant reactivities with the B cell-specific monoclonal antibody B1 (CD20) and the monocyte/HC-associated antibody SHCL-3 (CD11c). Thus, HCs can be demonstrated in peripheral blood, bone marrow, and spleen specimens from hairy cell leukemia (HCL) patients even when they constitute less than 1% of the cell suspension. Likewise, admixture experiments with normal mononuclear cells and the MOLT-4 T-acute lymphocytic leukemia (ALL) cell line demonstrated that HCs could be detected in amounts as low as 1%. The validity of this assay has been ascertained by the lack of double marker positivity in cell suspensions from B-chronic lymphocytic leukemia (CLL) and acute myelogenous leukemia (AML) patients that only expressed B1 or SHCL-3, respectively. Furthermore, other malignant blood diseases, including malignant lymphomas, acute leukemias, and chronic leukemias disclosed no double marker positive cells. In a clinical setting, this assay was used for purifying HCs (by flow cytometry) from the peripheral blood from patients with no apparent morphological evidence of circulating HC infiltration and for monitoring the effect of interferon therapy. In conclusion, this assay should be of value for both diagnosis and monitoring patients with HCL. PMID- 3307946 TI - Recurrence of acute lymphoblastic leukemia in donor cells after allogeneic marrow transplantation associated with a deletion of the long arm of chromosome 6. AB - This report concerns a woman who experienced a relapse of acute lymphoblastic leukemia (ALL) associated with an interstitial deletion of the long arm of chromosome 6 in donor cells more than 4 years after allogeneic bone marrow transplantation (BMT). Direct bone marrow preparations revealed the presence of two leukemic clones 46,XY,del(6)(q23q25) and 45,X,-4,del(6)(q23q25),+8,-15, 21,+i(21q), +mar, the former clearly indicating that male donor cells were involved in the malignant process. Relapse as evidenced by these chromosome anomalies was confined to metaphases from directly prepared marrow cells and phytohemagglutinin (PHA)-stimulated peripheral blood cells. Cytogenetic analyses of T cell colonies gave predominantly normal donor karyotypes (65 of 69 mitoses) along with three host mitoses and a single donor metaphase carrying the 6q- anomaly. The marrow stroma, as represented by first-passage adherent layer cells from long-term marrow cultures, showed 17 of 19 host metaphases. One of two donor cells found within the stromal elements exhibited a 6q- chromosome. In the subsequent remission mitoses derived from myeloid and lymphoid cells were exclusively of donor origin, and chromosomal abnormalities could no longer be detected. Stromal elements remained host-derived (14 of 16 mitoses). PMID- 3307948 TI - The effect of lithium on growth factor production in long-term bone marrow cultures. AB - We have previously reported that lithium chloride (LiCl) stimulates the production of granulocyte-macrophage colony-forming cells (GM-CFC), pluripotent stem cells (CFU-S), and differentiated granulocytes, macrophages and megakaryocytes in murine Dexter marrow cultures and that this effect appears to be mediated indirectly by a radioresistant adherent marrow cell. In this study we have established that exposure of murine Dexter cultures to LiCl (4 mEq/L) causes an increase of colony-forming cell megakaryocytes (CFU-meg) over 1 to 6 weeks of culture in both supernatant (188% to 611%) and stromal phases (123% to 246%). Moreover, we have shown that lithium treatment of either irradiated (1,100 rad) or unirradiated stromal cells increased production of activities stimulating formation of megakaryocyte, granulocyte, macrophage, and mixed lineage colonies and proliferation of the factor-dependent cell line, FDC-P1. This FDC-P1 stimulatory activity was completely blocked by an antibody to purified recombinant granulocyte-macrophage colony stimulating factor (rGM-CSF). The baseline or lithium-induced--stromal-derived bone marrow colony stimulating activity was partially blocked by the antibody to rGM-CSF and by an antibody to purified colony stimulating factor I (CSF-1); the two antibodies combined resulted in greater than 90% inhibition of the lithium-induced marrow stimulatory activity. In addition, radioimmunoassay (RIA) showed that although CSF-1 was detectable in supernatants of these cultures, exposure to lithium did not increase CSF-1 levels. These data indicate that Dexter stromal cells produce CSF 1 and GM-CSF and that lithium appears to exert its stimulatory effects on in vitro myelopoiesis by inducing production of GM-CSF. PMID- 3307947 TI - Immunohistochemical characterization of a 183 KD myeloid-specific-DNA-binding protein in B5 fixed, paraffin-embedded tissues, and bone marrow aspirates by monoclonal antibody BM-1. AB - A monoclonal antibody, designated BM-1, which is reactive in B5 formalin-fixed, paraffin-embedded tissues, has been generated against a cytoplasmic and nuclear antigen expressed in human myeloid precursor cells and derived leukemias. Using the avidin-biotin-complex immunoperoxidase procedure, BM-1 was found to stain selectively myeloid precursor cells in normal bone marrow and mature granulocytes in the blood. In a screen of 26 normal adult and fetal human organs fixed in B5 formalin, BM-1 was negative in all nonhematopoietic tissues with the exception of tissue granulocytes and scattered cells in the peripheral cortex of the thymus. Likewise a screen of 30 solid tumor cell lines including a spectrum of carcinomas, sarcomas, and neural-derived tumors was negative. BM-1 was also negative with 21 T and B cell lymphomas and 11 Hodgkin's disease tumors. A preliminary study of tumors of the hematopoietic system revealed that BM-1 was reactive with M2 and M3 acute myelogenous leukemias (AML), chronic myelogenous leukemias (CML) and myelomonocytic leukemias, and granulocytic sarcomas. M1, M4, M5, and M6 AML clot preparations were negative in this study, indicating that BM 1 may have a role in the histopathologic diagnosis of myelogenous leukemia. Myeloid leukemic cell lines HL-60, ML-2, KG1, and TPH-1-O showed BM-1 nuclear and/or cytoplasmic reactivity in a subpopulation of cells, but erythroid and lymphoid leukemias and all lymphoma cell lines were negative. Immunoperoxidase studies of a panel of fetal tissues showed BM-1 positive cells in the peripheral cortex of the thymus and portal myelopoietic regions of the liver at 18 weeks gestation. Finally, DNA-cellulose and solid phase radioimmunoassay (RIA) techniques developed in our laboratory demonstrate that the BM-1 antigenic domain is reactive only after binding to eukaryotic but not prokaryotic single- or double-stranded DNA. Immunoblot techniques using a DNA-cellulose purified protein sample revealed that BM-1 recognizes a 183 kD protein. These studies indicate that BM-1 is recognizing a myeloid-specific antigen that, because of its DNA binding characteristics, may have an important role in the differentiation of myeloid cells at the molecular level. PMID- 3307949 TI - HL-T, a new cell line derived from HL-60 promyelocytic leukemia cell cultures expressing terminal transferase and secreting suppressor activity. AB - A cell line with immature blast cell morphology was isolated from HL-60 promyelocytic leukemia cell cultures and designated HL-T. This new cell type is biphenotypic, expressing terminal transferase (TdT) together with myelomonocytoid immunologic features. TdT enzymatic activity, undetectable in HL-60, was determined to be 140 to 180 units/10(8) HL-T cells by the dGTP-assay, approximately 20% of the activity found in lymphoblastoid cell lines. HL-T predominantly synthesize the known 58-kDa TdT-protein plus a minor 54/56-kDa doublet. The 58-kDa steady state form is nonglycosylated and is phosphorylated. Precursor antigens S3.13 and MY-10, absent on HL-60, are expressed by HL-T; however, the cells are negative for HLA-Dr. Southern blot analysis by hybridization with immunoglobulin heavy chain (JH) and T cell-receptor chain gene (T beta) probes shows JH to be in the germ-line configuration in both cell lines and the T beta gene to be in germ-line in HL-60 but to be rearranged in HL-T. Truncation of the gene encoding the granulocyte-macrophage-colony-stimulating factor (GM-CSF), as found in HL-60, is not observed in HL-T. HL-T are resistant to differentiation-induction by retinoic acid and 1,25-dihydroxyvitamin D3. Cytogenetically HL-T share with HL-60 a deletion of the short arm of chromosome 9 at breakpoint p13, an aberration frequently found in patients with T cell leukemia. In addition, HL-T display t(8;9)(p11;p24) and trisomy 20. Tetraploidy is observed in 80% of HL-T metaphases with aberrations identical to those in the diploid karyotype. Like HL-60, the new line shows some surface-antigenic-T cell characteristics. Despite an antigenic pattern most consistent with that of helper inducer T cells (T4+, D44+/-, 4B4+, 2H4-, TQ1+/-), HL-T cells and their conditioned culture medium suppress antigen, mitogen, and mixed-leukocyte-culture mediated lymphocyte proliferation. PMID- 3307950 TI - Progenitor cell assays predict hematopoietic reconstitution after syngeneic transplantation in mice. AB - Hematopoietic reconstitution following syngeneic bone marrow transplantation with graded doses of untreated and drug-treated bone marrow was studied in B6D2F1 mice. Granulocyte-macrophage colony-forming units (CFU-GM) and spleen colony forming units (CFU-S) showed similar in vitro drug sensitivities. Both the speed of hematologic recovery and survival of mice transplanted with untreated or drug treated bone marrow were directly related to the number of CFU-GM or CFU-S transplanted. Similar hematologic recovery was seen for untreated marrow transplants and treated transplants that had similar CFU-GM or CFU-S content. There is a minimum number of transplanted CFU-GM or CFU-S that allows survival of lethally irradiated mice. This number is present in a marrow transplant containing the equivalent of 5 X 10(3) untreated cells or producing one to two spleen colonies. There also exists a maximum value for the number of hematopoietic progenitors in a marrow graft, above which the rate of hematologic recovery following transplantation is rapid and no detectable increase in the rate is seen with increasing CFU-GM or CFU-S content. The presence of this maximum value for transplanted progenitors and variations in culture techniques are probably the reasons previous studies have not always shown a correlation between CFU-GM content and hematologic recovery after bone marrow transplantation. PMID- 3307951 TI - von Willebrand factor and von Willebrand disease. AB - Progress has occurred in the past several years in the understanding of the structure and function of von Willebrand factor (vWF). This multimeric glycoprotein exhibits a dual role, that of mediating platelet adhesion and aggregation onto thrombogenic surfaces, and that of functioning as carrier in plasma for the factor VIII procoagulant protein. New insights into the nature of the several functional domains of vWF have led to the identification of the regions of the molecule that interact with factor VIII, heparin, the glycoprotein lb of platelets, and collagen. Alterations of vWF are the cause of von Willebrand disease (vWD), a congenital bleeding disorder. In the majority of patients, the plasma levels of vWF are decreased, but there is no demonstrable structural or functional alteration of the protein. In other patients, however, the structure of vWF is abnormal. This review summarizes the current knowledge on vWF and vWD. PMID- 3307952 TI - Cloning and nucleotide sequence of a mouse erythrocyte beta-spectrin cDNA. AB - A rabbit monospecific antibody for mouse beta-spectrin was used to screen a mouse anemic spleen cDNA expression library. A mouse beta-spectrin cDNA clone was isolated and identified by its ability to make mouse beta-spectrin-like antigens in Escherichia coli. This clone was used to probe total RNA from various mouse tissues. Anemic spleen RNA showed two strongly hybridizing RNA species of approximately 6 and 8 kb. Two very faintly hybridizing bands of about 6 kb and 10 kb could also be seen in total mouse brain RNA. All of these bands could be detected after hybridization under both stringent and nonstringent conditions. This suggests that erythroid beta-spectrin may also be expressed in the brain. No bands could be detected in kidney, liver, or spleen RNA. Southern blot analysis of mouse genomic DNA showed a single hybridizing band after digestion with several restriction endonucleases even under nonstringent conditions. Nucleotide sequencing of the cDNA insert revealed almost complete identity between the N terminus of the deduced amino acid sequence of the cDNA clone and the C-terminal 15 amino acids of a peptide derived from the beta-8 repeat unit of human erythrocyte beta-spectrin. The deduced amino acid sequence contained most of the conserved amino acids characteristic of the 106 amino acid repeat unit first found in human alpha-spectrin and thus provides the first evidence for a complete 106 amino acid repeat unit structure in beta-spectrin. PMID- 3307953 TI - Clinical and biologic hallmarks of the Philadelphia chromosome in childhood acute lymphoblastic leukemia. AB - Of 366 children with acute lymphoblastic leukemia (ALL) in whose bone marrow cells complete G-banding of chromosomes was successful, translocations were present at diagnosis in 141 (38.5%). The Philadelphia (Ph) chromosome was identified in 18 of these cases (4.9%). Features closely associated with the presence of the Ph chromosome were older age (median, 7.9 years), high leukocyte count (median, 47.3 X 10(9)/L), French-American-British L1 blast cell morphology, high incidence of CNS leukemia at diagnosis, and the common ALL immunophenotype. All patients were treated according to modern chemotherapeutic regimens for ALL used at our institution. Complete remissions were successfully induced in only 13 (72%) of the 18 patients with Ph + ALL, and only six remain free of leukemia for periods of 7+, 9+, 10+, 13+, 49+, and 70+ months. Our findings confirm the association of the Ph chromosome with classic high-risk features of ALL in children and suggest that this abnormality confers a very poor prognosis that has not yet been improved by modifications in established therapeutic regimens. PMID- 3307954 TI - Retarded recovery of functional T cell frequencies in T cell-depleted bone marrow transplant recipients. AB - We have studied the effect of removing donor T cells by treatment with the monoclonal antibody Leu-1 and complement before marrow transplantation on the regeneration of functionally competent T lymphocytes in the blood at selected times after transplant. Using sensitive limiting-dilution methods that allow us to enumerate helper, cytotoxic, and proliferating T lymphocyte precursors, we report that regeneration of a functional T cell compartment is more severely impaired for the first 180 days after transplantation in those patients given T cell-depleted bone marrow than in recipients of untreated marrow. After this first 6 months, however, patients given T cell-depleted bone marrow had blood T cell frequencies comparable to those observed in patients given untreated marrow. Diminished frequencies of reactive T cells in recipients of depleted marrow could leave them more susceptible to infection or to the recurrence of neoplastic cells. PMID- 3307955 TI - Correspondence between the development of hemopoietic tissue and the time of colony formation by colony-forming cells. AB - The development of a haemopoietic tissue and the time when colony-forming cells in it formed detectable colonies were studied with in vivo spleen colony-forming units (CFUs) and in vitro high-proliferation-potential colony-forming cells (HPP CFC). Cells that form colonies first are developmentally more mature than those doing so later. Marrow containing mature spleen colony-forming cells formed fewer cells in the femora of recipients than that which contained early colony-forming cells. The growth curve of developmentally early high-proliferation potential colony-forming cells was steeper than that of later cells. The time period before colony-formation occurs is a property of the colony-forming cell and is not due to regulatory mechanisms in the animal or to regulatory cells in the haemopoietic stroma. PMID- 3307956 TI - A comparative study of Trypanosoma cruzi enzyme polymorphism in South America. AB - 1. The electrophoretic patterns of 13 loci were used to compare the three main T. cruzi zymodemes (Z) circulating in North/Northeastern Brazil (Br 1 through 3) with the four principal zymodemes present in Southeastern (BrA through D) Brazil. 2. Nei's standard genetic distances (D) obtained by paired comparison of the Brazilian zymodemes indicate the presence of four divergent groups, separated by D = 1.18. Zymodemes BrB and BrD presented heterozygous patterns for six and three loci, respectively, for alleles coding for isoenzymes of the BrA/Br 2 and BrC zymodemes. 3. The 7 principal Brazilian zymodemes were in turn compared with the 11 other zymodemes thus far identified in South America (Colombia, Bolivia, Paraguay and Chile). Numerical taxonomy demonstrated the presence of three main infraspecific categories ('groups') separated by D greater than 1.08. Each of these 'groups' could be divided into 2 or 3 subgroups at D greater than or equal to 0.50. 4. The wide range of zymodemes within a group separated by a genetic distance ranging from 0 to 0.95, the presence of zymodemes with variable numbers of heterozygous patterns (1 to 6), the detection of two homozygous zymodemes circulating sympatrically with their corresponding heterozygous zymodemes, and the circumstantial evidence that the majority of zymodemes carrying heterozygous profiles are found in the domestic sector of subtropical regions and always associated with Triatoma infestans, indicates that genetic recombination can also occur presently under certain conditions. PMID- 3307957 TI - Distribution of proline endopeptidase activity in sub-synaptosomal fractions of rat hypothalamus. AB - 1. Proline endopeptidase (E.C.3.4.21.26) is an enzyme which cleaves several peptides at the carboxyl side of proline residues. Because brain contains relatively large amounts of this enzyme and because of its specificity it has been suggested that it plays a role in the metabolism of neuropeptides, acting both on their processing and their degradation. 2. Since the final steps of neuropeptide processing occur in the synaptic vesicles and the degradation of most of these peptides is believed to occur in the synaptic cleft, we studied the distribution of proline endopeptidase activity in sub-fractions of rat hypothalamus. 3. Proline endopeptidase activity is present in synaptosomal fractions and is released by hypo-osmotic shock. Its specific activity is higher in the synaptoplasma than in synaptic membranes or vesicles (7.98 vs 0.18 and 0.24 nmol min-1 mg protein-1 carbobenzoxy-glycyl-prolyl-sulfamethoxazole hydrolysis). 4. Inhibitory avoidance training, a situation which releases hypothalamic vasopressin and beta-endorphin, both in vitro substrates, did not affect the specific or total activity of proline endopeptidase in synaptosomal plasma membranes. PMID- 3307958 TI - Monocyte procoagulant activity induced by concanavalin A is decreased in a population of chronic chagasic patients. AB - 1. The ability of peripheral blood mononuclear cells (PBMC) from Chagas' disease patients to induce monocyte procoagulant activity (PCA) in response to concanavalin A (Con A) and to a Con A induced lymphokine was studied. 2. In spite of the variability of PCA levels among both chagasic patients and normal controls, statistical analysis of the data permitted us to draw the following general conclusions. 3. The Con A-induced monocyte PCA measured in 17 assays of 15 chagasic patients was significantly lower than the PCA response of 18 normal controls or of 11 patients with non-chagasic myocardiopathies. 4. The response of PBMC from chagasic patients to lymphokine was also lower than that observed for normal controls. 5. These results suggest that monocytes from chagasic patients are deficient for the generation of PCA which is an in vitro correlate of the delayed-type hypersensitivity reaction. PMID- 3307959 TI - Carbohydrate metabolism of rats with chronic renal failure. AB - 1. Various aspects of carbohydrate metabolism were evaluated in rats exhibiting chronic uremia induced by the surgical removal of 5/6 of the kidneys (NX group). Operated rats developed moderate uremia and maintained a nutritional status similar to that of a sham-operated control group (C rats). 2. After a 12-h fast, the NX group showed a 32% decrease in plasma glucose vs 20% for the C group. 3. After intravenous glucose administration (75 mg/100 mg body weight), plasma glucose and insulin levels were similar in both NX and C rat groups. 4. The decrease in plasma glucose after insulin administration (0.025 U/100 g body weight) was larger in the NX group than in controls. 5. No significant difference was found between the hepatic glycogen levels of NX and C animals although diaphragm muscle glycogen levels in the NX group were nearly twice that of controls. 6. Carcass fatty acid levels in the NX group were 42% lower than in the C group, while total liver lipids were similar for both. 7. These findings suggest that nephrectomized rats exhibit increased sensitivity to exogenous insulin, are not intolerant to intravenous glucose and after a 12-h fast show hypoglycemia that could be related to higher glucose utilization by muscle tissue. PMID- 3307960 TI - Embryology of the vitreous. Congenital and developmental abnormalities. PMID- 3307961 TI - Degenerative conditions of the vitreous. PMID- 3307963 TI - Vitreous changes in retinopathy of prematurity. PMID- 3307962 TI - Vitreous changes in vascular diseases. PMID- 3307964 TI - The vitreous in ocular trauma. PMID- 3307965 TI - Effect of aphakia upon the vitreous. PMID- 3307966 TI - Vitreous degeneration in myopia and retinitis pigmentosa. PMID- 3307967 TI - Hereditary vitreoretinal diseases. PMID- 3307968 TI - Vitreous substitutes and vitreous surgery. PMID- 3307969 TI - Structure, function, and age-related changes of the human vitreous. PMID- 3307970 TI - The vitreous and vitreoretinal interface. Historical introduction. PMID- 3307971 TI - Biochemistry of the vitreous. PMID- 3307972 TI - Clinical methods of vitreous examination. PMID- 3307973 TI - Abdominal actinomycosis: a forgotten disease? PMID- 3307974 TI - Overcoming the problems of lung transplantation. PMID- 3307975 TI - Assessment of suicide risk. PMID- 3307977 TI - The effect of sulpiride on negative symptoms of schizophrenia. PMID- 3307976 TI - Tiapride in the long-term management of alcoholics of anxious or depressive temperament. AB - Thirty-two chemically dependent alcoholics with significant levels of anxiety or depression were admitted to a double-blind randomised study in which the effect of the substituted benzamide tiapride was compared with that of placebo over a 6 month period. Twenty patients completed the study. Assessments included relevant biochemical and haematological tests, drinking levels and associated behaviour, expressed satisfaction with various areas of life, the Crown-Crisp Experimental Index of neurotic symptoms and questionnaires on self-esteem and alcohol dependence. The results indicated that in comparison with the placebo group, patients treated with tiapride drank less and had longer periods of abstinence. This was associated with improvements in laboratory tests, reduction in neurotic symptoms, gains in self-esteem and increased levels of expressed satisfaction with life situation. The drug was well tolerated and no deleterious effects were noted, suggesting its potential usefulness for this patient group. PMID- 3307979 TI - Behavioural psychotherapy in general psychiatry. Helping patients to help themselves. PMID- 3307980 TI - Prevalence studies in schizophrenia. AB - Over 70 prevalence studies of schizophrenia published since 1948 are reviewed. Despite problems of method, the studies suggest that there may be significant differences in prevalence among different populations and that prevalence may change over time. Further research is needed on how much differences in diagnosis or the course of schizophrenia contribute to the variable prevalence rates. The paper suggests the following as areas for additional enquiry: a possible north south gradient, special populations (e.g. American Hutterites, northern Swedes, western Irish, castes in India) and ongoing case registers in areas of suspected high and low prevalence. PMID- 3307978 TI - Is there really a split in schizophrenia? The genetic evidence. AB - Although the clinical presentation and course of schizophrenia is highly variable, it is unclear whether this reflects heterogeneity at an aetiological level. The genetic evidence is reviewed concerning 'traditional' clinical subtypes as more novel categories derived from multivariate statistical methods and Crow's type I-type II classification. Recent data based on a twin series and re-analysis of older published family material suggest that attempts to divide up schizophrenia have resulted in splits between two or more categories of disorder which occupy different positions on the same continuum of liability. Thus, apparent heterogeneity is more likely to be due to quantitative difference in familial-genetic loading rather than qualitative differences. Similarly, the hypothesis that schizophrenia can be broadly divided into two groups, one genetic and the other non-genetic has little to support it. It seems improbable that any further useful and genetically relevant subdivision of schizophrenia can be effected on purely clinical grounds. Further progress awaits developments in the discovery of endophenotypes and the application of molecular genetic marker strategies. PMID- 3307981 TI - Hostility and deliberate self-poisoning: the role of depression. AB - The evidence for an association between hostility and deliberate self-poisoning is reviewed. Although the concept of hostility is poorly defined and different measuring instruments may not measure the same entity, self-poisoning subjects as a group appear to have very high levels of hostility. However, depression is also associated with hostility and when studies have taken into account the psychiatric diagnosis of overdose patients it is outwardly-directed hostility which distinguishes these individuals from other psychiatric patients or normals. A model is proposed to show the inter-relationships of hostility, depression and self-poisoning. PMID- 3307982 TI - A comparative trial of a new antidepressant, fluoxetine. AB - This clinical trial of a new antidepressant, fluoxetine, shows it to be as effective as a standard tricyclic drug, imipramine. It is effective as a single daily dose and is free of any significant side-effects. It is less sedative and appears to cause fewer problems of weight increase. The three scales used to assess efficacy showed a very positive correlation. PMID- 3307984 TI - The neuroleptic malignant syndrome, so-called. A survey of the world literature. AB - Because of its rarity, the neuroleptic malignant syndrome has been studied in a survey of the world literature. Similar conditions which occurred before the advent of neuroleptics have also been included, as they may indicate that the drugs are not totally to blame. It is also apparent that with modern treatments, the condition is not usually lethal. The implications of this for theories of dopaminergic disturbances underlying the mental illnesses involved are considered. An overall picture of the syndrome, its treatment and outcome, is presented from over 200 published references. The spread of recognition of the condition throughout the world and especially across linguistic barriers has been followed. PMID- 3307983 TI - Depressive disorder in primary care. AB - Since the pioneering study of psychiatric morbidity in primary care by Shepherd et al in 1966, it has become increasingly apparent that a substantial proportion (between 20% and 25%) of patients consulting their GP are suffering from some form of psychiatric disturbance (Goldberg & Blackwell, 1970; Hoeper et al, 1979). The composition of this psychiatric morbidity has been shown to be almost wholly affective in nature and largely mild in degree. In their important review Jenkins & Shepherd (1983) recently summarised the now extensive findings relating to overall minor psychiatric morbidity in primary care. However, recent collaborative studies between psychiatrists and GPs have identified that within this dilute pool of minor disorders, lurks a significant but poorly served population of patients suffering from depressive disorders which are by no means minor in degree. A number of crucial issues regarding this depression in primary care emerge which the present paper aims to review. In particular, how common is it, and how severe? How does it present and what, if any, are its special characteristics? What is the precise relationship between depressive symptoms and depressive illness presenting to the GP and what is the relationship between physical illness and depression? And finally, what is the course and outcome of depression in this setting and what are the indications for and effect of treatment? PMID- 3307985 TI - Biological and neuropsychological approaches to childhood autism. AB - There is growing conviction that childhood autism is a biologically based disorder. The evidence that has accrued in a variety of areas pertaining to biological abnormality in autism suggests that, with the possible exception of genetic factors, very few data are available that illuminate the autistic disorder specifically. Neurological models which might be useful in guiding further research are discussed and reasons for the slow progress in this important aspect of the study of autism are identified. PMID- 3307986 TI - Range of mental illness among the elderly in the community. Prevalence in Liverpool using the GMS-AGECAT package. AB - A sample of 1070 elderly persons aged over 65 living in the Liverpool community was interviewed using the community version of the Geriatric Mental State (GMS) and the findings processed to provide a computerised diagnosis by AGECAT. Levels of organic disorder, probably dementia, reached 5.2%, intermediate between those of London and New York derived from previous studies. Levels for depressive illness overall were below those of other studies at 11.3% while levels for neurotic disorder were much the same at 2.4%. The rise in the prevalence of dementia with age was further confirmed. The GMS AGECAT Package provides a method for standardising both the collection of data and the diagnostic process for comparative epidemiological studies and other research. PMID- 3307987 TI - Psychiatric disorder in the community and the General Health Questionnaire. AB - Goodchild & Duncan-Jones (1985) have proposed a new scoring method for Goldberg's General Health Questionnaire (GHQ) in which increased weight is given to item responses considered to indicate current (but chronic) affective disorders. This report examines both their revised and the conventional scoring of the GHQ in the context of a longitudinal general population study of psychiatric disorder among women. Sensitivity estimates based upon advised cut-points were found to be higher for the revised than for the conventional scoring scheme, and this difference remained when allowance was made for the duration for which disorders had been present prior to assessment with the GHQ. However, Relative Operating Characteristic (ROC) analysis revealed that while both forms of scoring the GHQ discriminated affective conditions (with or without allowance for their duration) there was no significant difference in their ability to do so. The justification therefore for the post-hoc interpretation of certain item responses as indicators of enduring affective states remains controversial and an issue for future research. PMID- 3307988 TI - Bereavement and reactions to job loss: a comparative review. AB - An assessment is made of the applicability of the grief framework for understanding reactions to job loss. Jahoda's 'deprivation view' of unemployment is introduced as a statement of what is lost, with the grief model describing the process of adjustment to loss. The main features of grief are described: it is an active process, changing over time, consisting of a number of episodic components combined with a background of chronic emotional disturbance. Parkes' concept of psychosocial transitions is then outlined; this provides a theoretical link between grieving and reactions to other forms of loss, including job loss. An assessment is made of how the grief process has been applied to job loss in existing research. Evidence for most of the components of the grief process is apparent in accounts of reactions to unemployment, but there is little evidence on their frequency, changes over time or their relationship to one another. Variables which are likely to affect the occurrence, extent and precise course of any grief-like process are examined by comparing reactions to bereavement and job loss. The family and social contexts of reactions to loss are then considered in relation to both grief and unemployment. Finally, the advantages and limitations of the grief model are briefly discussed. PMID- 3307989 TI - Venous anatomy of the lower oesophagus: a new perspective on varices. PMID- 3307990 TI - Surgical treatment of chronic pancreatitis: an overview. AB - The correct management of chronic pancreatitis remains undecided. The aims of surgical treatment are to relieve pain, treat complications and preserve pancreatic function. The appropriate surgical procedure to achieve these ends must be carefully chosen. PMID- 3307992 TI - Fascia closure after midline laparotomy: results of a randomized trial. AB - Four techniques to close the fascia after midline laparotomy were compared in a prospective randomized multicentre trial. The four techniques were: interrupted closure with polyglactin; continuous closure with polyglactin; continuous closure with polydioxanone-s, and continuous closure with nylon. The early postoperative results in 1491 patients revealed an incidence of wound infection of 8.6 per cent and of wound dehiscence of 2.3 per cent with no statistically significant differences between the four techniques. We reviewed 1156 patients after 1 year. Wound pain was present in 9.7 per cent of the patients, statistically significantly more in the group closed with nylon (16.7 per cent). Suture sinuses developed in 3.5 per cent of the patients, statistically significantly more frequently in the nylon group (7.7 per cent). The total number of incisional hernias detected 1 year postoperatively was high (15.2 per cent) (interrupted polyglactin 16.9 per cent, continuous polyglactin 20.6 per cent, continuous polydioxanone 13.2 per cent and continuous nylon 10.3 per cent). The difference between nylon and continuous polyglactin is statistically significant. The results of this trial indicate that although nylon has the lowest incidence of incisional hernia it also is associated with more wound pain and suture sinuses. PMID- 3307991 TI - Lateral paramedian incision. AB - Prospective randomization of 360 patients undergoing abdominal surgery determined whether a standard lateral paramedian incision was made (group A) or one of two modifications in which the anterior sheath was incised medially and posterior sheath incised laterally (group B) or vice versa (group C), in order to determine the necessity for incising both layers laterally to provide the shutter mechanism which is held responsible for the integrity of this wound. Medial incision of the anterior rectus sheath significantly reduced the time required to perform the incision (P less than 0.02) and tended to reduce wound sepsis rate. However, this was achieved at the cost of a higher incisional hernia rate (0 per cent, 2.9 per cent and 4.6 per cent in groups A, B and C respectively, P less than 0.02). We conclude that lateral incision of both anterior and posterior rectus sheath is necessary to obviate the risk of wound hernia with the lateral paramedian incision. PMID- 3307993 TI - Natural history and surgical management of radiation enteritis. AB - Radiation enteritis is an increasing problem. The effect of ionizing radiation is due to a direct effect on proliferating cells and due to a progressive obliterative vasculitis. Predisposing factors include the dose of radiation, combination with chemotherapy, previous operations and vascular disease. Management is related to the stage of disease at presentation, and tailored to the clinical problem. Surgical management must take into account the poor healing associated with irradiated intestine. PMID- 3307994 TI - The hormonal regulation of extracellular calcium. PMID- 3307995 TI - Intracellular calcium homeostasis. PMID- 3307996 TI - Intracellular calcium receptor mechanisms. PMID- 3307997 TI - Calcium and the cytoskeleton. PMID- 3307998 TI - Exocytosis: control by calcium and other factors. PMID- 3307999 TI - Calcium and cell proliferation. PMID- 3308000 TI - Cellular interactions between lead and calcium. PMID- 3308001 TI - Calcium in mineralized tissues and pathological calcification. PMID- 3308002 TI - Insulin receptors and insulin action in dissociated brain cells. AB - The present study was conducted to characterize insulin receptors and insulin action in rat brain cells. Binding of [125I]insulin to cells obtained by mechanically dissociating rat brains was 86% specific, time-dependent and reached equilibrium within 90 min. The t1/2 of association was 14 min and t1/2 of dissociation was 8 min. Scatchard analysis demonstrated the typical curvilinear plot providing high affinity (0.03 nM) and low affinity (6.6 nM) binding sites. The total number of binding sites were 0.15 pmol/mg protein. Crosslinking of [125I]insulin to its receptors on dissociated brain cells followed by SDS-PAGE and autoradiography showed that the alpha-subunit of the receptor had a molecular weight of 122,000. This was in contrast with a molecular weight of 134,000 for the liver alpha-subunit. Incubation of dissociated brain cells with insulin resulted in a concentration-dependent inhibition of total [3H]norepinephrine (NE) uptake. This inhibitory effect of insulin on [3H]NE uptake was sodium ion dependent suggesting that 80-90% of the sodium ion-dependent uptake was insulin sensitive. Incubation of lectin-purified insulin receptors with insulin resulted in a time- and concentration-dependent stimulation of phosphorylation of the tyrosine residue of an exogenous substrate poly (Glu, Tyr) (4:1). In addition, insulin also stimulated the autophosphorylation of the beta-subunit of the insulin receptors. These observations corroborate our contention that insulin exerts neuromodulatory effects mediated by the specific insulin receptors in the brain. PMID- 3308003 TI - Terminal nerve damage impairs the mating behavior of the male hamster. AB - We examined the effects of bilateral terminal nerve (TN) transections (TNx) on the sexual behavior of male hamsters. These lesions produced a decrease in mating frequency and/or an increase in the number of intromissions required to reach ejaculation. Damage to the olfactory bulbs or rostral forebrain did not account for these effects. No amelioration of the behavioral impairments occurred over the mating sessions. Basal testosterone levels in the blood of male hamsters were not altered by TN damage. Hamsters with TNx retained their ability to detect odors, but demonstrated reduced attraction to vaginal odors as compared with unoperated animals. The reduced attraction to vaginal odors was most pronounced in sporadically mating TNx animals. These data suggest that the TN may facilitate odor-induced sexual excitation in the male hamster. PMID- 3308004 TI - GABA-like immunoreactivity in the squirrel monkey vestibular endorgans. AB - The localization of gamma-aminobutyric acid (GABA)-like immunoreactivity in the squirrel monkey vestibular endorgans was investigated using an antiserum against GABA coupled with glutaraldehyde to bovine serum albumin. GABA-like immunoreactivity was found in nerve fibers and bouton-type terminals, both in the cristae ampullares and the maculae. The location of positive staining corresponded better with known efferent than afferent components of the vestibular periphery. PMID- 3308005 TI - Interaction of monoclonal antibodies with a neurite outgrowth factor from chicken gizzard extract. AB - A neurite outgrowth factor (NOF), which promotes neurite outgrowth of cultured peripheral neurons, was purified to homogeneity from chicken gizzard extract and used as an immunogen for generating monoclonal antibodies. From 603 hybridoma clones, 55 positive hybridoma cell lines were detected. Four of them (IgG1 (kappa chain) producers designated as 5-10A, M1-2G, 4-2C and 1-4D) were selected for further characterization. These antibodies immunoprecipitated 125I-labelled gizzard NOF molecules, whereas they did not inhibit the biological activity of NOF (or NOF-like molecules) derived from the tissues tested. The subcellular distribution of NOF in chick embryonal tissues was investigated using monoclonal antibody 4-2C. Both ciliary ganglionic (CG) neurons and gizzard muscle tissues were stained. The NOF content of embryonic CG, measured by an immunoblot assay, increased about 20-fold during embryogenesis from 6 to 15 days, whereas the sensitivity of neurons to NOF reciprocally decreased. At least two different sizes of NOFs (700 and 800 kDa) were found in CG of various ages, with the 800/700 kDa ratio gradually increasing with age. A mixture of these 4 monoclonal antibodies was used for immunoaffinity purification of NOF from chicken gizzard muscles. PMID- 3308006 TI - Evidence for dopaminergic innervation on kitten retinal ganglion cells. AB - Effects of iontophoretically applied dopamine and its receptor antagonists on physiologically identified retinal ganglion cells were studied in the optically intact eye of pentobarbitone anaesthetised kittens (7-9 weeks of age) and the results were compared with the effects obtained from adult cats (18-22 weeks of age). In both the adult and the kitten, dopamine had an inhibitory effect on visually evoked and spontaneous activity of the retinal ganglion cells, irrespective of cell type. However, unlike in the adult, the effects of dopamine in kittens were variable and not dependent on retinal eccentricity. In adult cells, only L-sulpiride (a potent D2 receptor antagonist) reduced the inhibitory effect of exogenous dopamine, whereas in kitten cells, both alpha-flupenthixol (a potent D1 receptor antagonist) and L-sulpiride did so. When applied alone, neither alpha-flupenthixol nor affected the activity of ganglion cells in adults, but in kittens both antagonists produced an excitatory effect in some cells. Physiologically active dopaminergic innervation seemed, therefore, to be present on the immature ganglion cells, but was subsequently 'eliminated' during the course of postnatal development. Furthermore, in immature cells, both D1 and D2 type receptors are present but only D2 receptors remain in adult. Therefore, there is a mismatch between dopamine receptors and dopamine in the adult retina and this mismatch may be the consequence of a developmental event. PMID- 3308007 TI - Presence and development of ependymal cells in primary tissue cultures derived from embryonic rat cerebral cortex. AB - Using indirect immunohistochemistry, a secondary antibody was detected in a commercial preparation of antiserum against vasoactive intestinal polypeptide. The secondary antibody selectively stained ependymal cells during the first 3 weeks in vitro in cultures of dissociated cerebral cortical tissue from rat. This staining provided a convenient mechanism for investigating the development and properties of these cells in cultures. The overall level of immunofluorescent staining during the initial 3-week time period appeared to directly reflect the proliferation and development of ependymal cells. Fluorescent staining was initially detected in cells which appeared to correspond to matrix cells or progenitor cells from the ependyma. These cells underwent rapid cell division, as evidenced by distinct morphological stages, to yield daughter cells which were the precursors of mature ependymal cells. Three different morphological classes of mature ependymal cells were observed in the cortical cultures. These classes corresponded to the cuboidal, tanycyte and secretory ependymal cell types described in vivo. Direct counting of stained cells showed that these morphological classes were represented in the cultures in roughly the same proportions seen in vivo (cuboidal 75%, tanycyte 19% and secretory 6%). The temporal aspects of ependyma development permitted the staining of developmental stages corresponding to the various morphological classes or types. The morphological sequence of development of the cuboidal cell and tanycyte from the precursor cell or matrix cell--daughter cell was determined. These two cell types displayed marked differences in their developmental sequence. The developmental sequence of the secretory cell could not be resolved; however, what appeared to be multiple morphological subtypes of this cell class were encountered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308009 TI - [In vitro study of the secretory capability of organ cultures of the pancreas with atrophy of the excretory portion]. PMID- 3308008 TI - Identification of microglia in primary cultures of mixed cerebral cortical cells. AB - Microglia were investigated in tissue cultures of dissociated cerebral cortex from embryonic rat. Three different forms of microglia were identified in relatively mature cultures on the basis of morphological criteria, esterase histochemistry, and immunohistochemical staining for Fc receptors. Two of these forms corresponded to the amoeboid and ramified microglia; the amoeboid form stained intensely for esterase activity and ramified cells possessed Fc receptors. The third microglial cell form was distinguished by its morphological properties and was characterized by the presence of numerous filopodial processes. This morphological form occasionally possessed esterase staining and was the predominate type of microglia observed in the cultures. The identification of these cell types supports the potential use of this culture system to investigate functional aspects of microglia and their interaction with other brain cells. PMID- 3308010 TI - [Bernardo Alberto Houssay (1187-1971)]. PMID- 3308011 TI - [Relationship between calcium metabolism and carbohydrate metabolism]. PMID- 3308012 TI - [Meeting devoted to the commemoration of the bicentennial of the birth of Mateo Orfila (1787-1853)]. PMID- 3308013 TI - [A biography of Orfila 1787-1853]. PMID- 3308014 TI - [Orfila, the founder of toxicology]. PMID- 3308015 TI - [Mathieu Orfila and forensic medicine]. PMID- 3308016 TI - [Orfila and the organization of medical studies]. PMID- 3308017 TI - Bone marrow Ig-secreting cells in patients with malignant lymphoma. AB - Bone marrow immunoglobulin (Ig)-secreting cells of three major Ig classes were quantitated in patients with malignant lymphoma with or without definite bone marrow invasion, using a protein A hemolytic plaque assay. The mean percentage of each class of Ig-secreting cells in patients without bone marrow invasion was 77% for IgG, 17% for IgA, and 6% for IgM, whereas it was 86% for IgG, 6% for IgA, and 8% for IgM in patients with definite bone marrow invasion. An increase in bone marrow Ig-secreting cells of the same Ig class that is detected on the surface of lymphoma cells and that is consistent with the concentration of the same serum monoclonal Ig is considered to indicate the presence of metastatic lymphoma cells in the bone marrow. A decrease in the percentage of bone marrow IgA-secreting cells was a consistent feature in patients with definite bone marrow invasion. PMID- 3308018 TI - Time dependency of endotoxin-induced resistance to transplantable tumors in mice. AB - A single injection of bacterial endotoxin induced cyclic changes of enhanced or reduced host reactivities, as determined in some measurements of the beneficial effects of endotoxin, such as immune potentiation or protection against lethal irradiation. The results described here show that endotoxin-induced resistance to subsequent challenge with transplantable tumors such as Lewis lung carcinoma or L1210 murine leukemia is similarly time dependent. While certain time intervals between endotoxin treatment and tumor challenge will provide significant protection, others will render the recipients highly susceptible to the same tumor. It was also observed that L1210-bearing mice have a lower resistance to endotoxin injections than tumor-free mice of the same strain. PMID- 3308019 TI - Is radiation therapy in conjunction with mastectomy indicated for the treatment of operable breast cancer? PMID- 3308021 TI - [Anesthesia and resuscitation of patients with spinal cord injuries in the post injury period]. PMID- 3308022 TI - Norman Ainsworth. PMID- 3308020 TI - [Brain death: diagnosis, physiopathology and management]. PMID- 3308023 TI - Dental implants. Periodontal considerations. PMID- 3308024 TI - Non-invasive therapy for proximal enamel caries. An expanded role for bitewing radiography. PMID- 3308025 TI - Bleeding and hemostasis. PMID- 3308026 TI - Myofascial headache. Exacerbation of symptoms due to diflunisal and ranitidine therapy. A case report. PMID- 3308027 TI - Standardization. PMID- 3308028 TI - Tax Reform highlights. PMID- 3308029 TI - Clinical evaluation of light-cured and auto-cured composite resin restorations. PMID- 3308030 TI - The use of a cast etch bridge in a diastema situation. PMID- 3308031 TI - Factors influencing dental professionals' uptake of new preventive clinical procedures and materials. PMID- 3308032 TI - [The mechanism of pain and the treatment of cervical dentin sensitivity]. PMID- 3308034 TI - Computer assisted care in nursing. Computers at the bedside. PMID- 3308033 TI - Evaluation research in computer-based instruction. Dilemmas and directions. PMID- 3308035 TI - A critical review of studies on the dentist-patient relationship. PMID- 3308036 TI - Epidemiological study of the relationship between Congo red binding Escherichia coli and avian colisepticemia. AB - An epidemiological prospective (longitudinal) study design was used to evaluate the association of Congo red positive Escherichia coli and avian colisepticemia. High and low risk exposure groups of chickens were identified at hatching, and placed in separate identical houses on the same farm. Approximately 14,000 birds were placed in each house for the seven week grow-out period, during which all birds which died were necropsied and cultured, together with a representative sample of birds which were culled weekly. The findings implicated Escherichia coli as the etiological agent of avian colisepticemia. A relative risk of 6.5 and attributable risk of 73.5% supported the hypothesis that the Congo red medium identifies a virulent form of Escherichia coli which causes airsacculitis colisepticemia in poultry. PMID- 3308038 TI - Transmission of human immunodeficiency virus: ethical considerations and practical recommendations. PMID- 3308039 TI - This business of medicine. PMID- 3308040 TI - "The Open Arms": Osler's Oxford home needs your help. PMID- 3308037 TI - The health of children of low-income families. AB - Childhood poverty is common in Canada: 1,114,000 children under 16 years of age live below the poverty line. The incidence is highest among children of single mothers, unemployed parents, Canadian native peoples and recent immigrants, particularly refugees. Compared with the national average, the infant mortality rate is twice as high, deaths from infectious diseases are 2.5 times more common and accidental deaths are twice as common among children of low-income families. Other problems associated with poverty are iron deficiency anemia, dental caries, chronic ear infections, mental retardation, learning disabilities, poor school performance and increased suicide rates. Health care professionals can help address the poor physical and mental health associated with poverty in children by promoting a broad range of public policies. PMID- 3308041 TI - Relationship of cancer and aging. AB - The major risk factor for cancer is progressive age. Molecular advances in our understanding of carcinogenesis and the aging process are helping to clarify this relationship. The magnitude of cancer in the elderly warrants institution of an active prevention program by clinicians caring for this population. PMID- 3308042 TI - Perspectives in cancer screening in the elderly. AB - The concern is whether physicians and the health care system make cancer screening available to the elderly. This question has special meaning in this population as it is apparent that problems in screening for cancer have not been addressed. First, primary care physicians do not emphasize cancer prevention and early diagnosis in the elderly. Second, there is a need to educate the American population about cancer prevention, methods of early diagnosis, and the problems and realities surrounding cancer. The elderly are less aware of and use significantly fewer of the available screening resources. When this is coupled with a health system that does not provide funding for preventive and screening services (Medicare, Medicaid, and most third-party insurance carriers), the potential to deal with this problem becomes extremely difficult. High-quality primary care is the key to cancer screening in the elderly. The physician must take responsibility for health promotion while concentrating on screening. Two good rules of thumb are 1) to screen all patients for cancer and other diseases on a routine basis based upon screening recommendations in the current literature; and 2) to evaluate a normal patient who comes to the physician with a complaint (to assure early diagnosis). It is difficult to decide when an aggressive work-up is needed since older patients are at risk of complications from diagnostic procedures. The elderly are singularly under-represented in most studies of screening and prevention. We are therefore left with the reality that, no matter what set of recommendations is put forward, the physician is acting from incomplete information. The published guidelines are not directed at the elderly. Omission of the elderly from these studies leaves unknown the risks, benefits, and even the actual ability to screen. There is a need for better screening methods. There is evidence in the literature that both the physician and the patient need to be educated. The need for research in screening efficacy is coupled with a need to define methodologies to educate the provider and the patient and to determine how to reach high-risk populations. In the interim, the implementation of the guidelines discussed, with consideration of the current literature, is recommended to the physician as a rational approach. PMID- 3308043 TI - Quantitative approaches to clinical diagnosis of cancer in elderly patients. AB - Recommendations for cancer detection in the elderly are based on even less evidence of efficacy than are recommendations for the general adult population. In this article, we present some quantitative measures of test performance- operating characteristics, effectiveness and cost effectiveness/cost benefit--and show examples of how to use these measures to adjust diagnostic strategies for factors especially relevant to the elderly. PMID- 3308044 TI - Perioperative care in cancer surgery. AB - This article reviews the current data on mortality rates of elderly patients undergoing major thoracic and abdominal surgery, those procedures most applicable to cancer surgery. The major morbidity of surgery is discussed in relation to normal aging physiology of the heart, lungs, and kidneys. Preoperative risk assessment is discussed in relation to clinical assessment, laboratory and radiologic assessment, and the use of indexes developed to estimate surgical risk. General recommendations important in the perioperative period are given as well as specific recommendations for patients with cardiac disease, cerebrovascular disease, hypertension, thromboembolic disease, diabetes mellitus, and renal disease. PMID- 3308045 TI - Radiation therapy of the elderly. AB - Approximately 50 per cent of cancer patients will receive radiation treatment during the course of their illness. Similar benefits from palliative and curative treatments are seen in the elderly. Considerations for incorporating radiation treatment into the cancer management of older patients are discussed. The basis of and strategies for improved patient tolerance are reviewed. PMID- 3308046 TI - Cancer, clinical pharmacology, and aging. AB - The changes in the pharmacology of cancer chemotherapeutic agents related to age remain largely unexplored. Certain physiologic changes are well documented and dictate changes in therapy such as the decrease in CCNU and methotrexate dosage. Other toxicities are also shown to correlate with age, such as bleomycin toxicity. However, in several retrospective studies of combination therapy, arbitrary dose reductions have probably impacted negatively on survival. Further prospective investigation will be required in order to develop more rational approaches to cancer chemotherapy in the elderly. There is an urgent need to systematically examine the impact of age on the pharmacology of antineoplastic agents. Trials and clinical treatments uniquely designed for older cancer patients are essential in order to develop rational approaches to management. PMID- 3308047 TI - Supportive care of the patient with cancer. AB - In assessing the needs of the elderly patient with cancer, we need first to determine the extent of cancer, its complications, and the type of comorbid physical and psychologic conditions. The next step is to determine the goals of our care and specifically the extent to which supportive care is needed to deal with problems. For supportive care to be truly effective, the specific underlying condition producing a complaint must be investigated. It is also important not to underestimate the significance of a symptom such as constipation. Furthermore, nutritional support requires as much planning as, for example, the control of pain. Some problems (eg, nausea, vomiting, pain, and constipation) are best managed with preventive measures; others (eg, anemia, granulocytopenia, and coagulopathies) have very specific indications for intervention. Considerable progress has been made toward understanding the mechanisms of clinical problems such as nausea and vomiting, and a more rational approach to supportive therapy is now possible. However, it is usually not possible to recommend any one intervention for a particular problem: no one intervention is uniformly effective or safe. Aggressive supportive care in elderly cancer patients can improve their ability to tolerate anti-cancer therapies and, more importantly, provide palliation of distressing symptoms. PMID- 3308048 TI - Nursing care of elderly persons throughout the cancer experience. A quality of life framework. AB - The geriatric oncology nurse integrating a sound theoretical knowledge base with the dimensions of time, an ethical framework, and an affirmative approach to aging reinforces older adults' constellation of personal strengths and coping resources and sustains the self-determination and integrity of patients throughout the cancer experience. Assisting older adults to accomplish life tasks while balancing illness demands with coping resources requires patience, flexibility, and sensitivity. Strategies are planned and implemented to assist older adults in achieving with equanimity biologic and psychosocial life tasks and maintaining a comfortable level of functioning consistent with the limitations imposed by the illness and aging processes. It is challenging for nurses to provide the best possible control of troublesome symptoms in an evolving illness with frequently changing needs and concerns. Adequate symptom management requires astute observation skills and coordination of care among other disciplines to achieve patient comfort and dignity. The patient's frame of reference regarding well-being and life quality is the major determinant in planning care. In this era of technological and scientific innovations, it is a nursing responsibility to explore quality of life as a realistic outcome variable for older adults throughout the cancer experience, including the time when death is imminent. PMID- 3308049 TI - Ethical and legal issues in the care of the elderly cancer patient. AB - Contemporary cancer care is complex. Although its purpose is to cure, treatment of elderly patients requires recognition that incompetence and death may occur in the near future. The best way to honor the wishes of elderly patients is to construct a treatment decision status contract with them in advance. Through dialogue about probable outcomes of interventions, both patients and physicians can explore fundamental values to be respected in the course of treatment. In this way, physicians can preserve their traditional role of championing the value of life while respecting the considered judgments of elderly patients about their care. PMID- 3308050 TI - Skeletal disorders in malignant disease. AB - When the elderly are afflicted by malignancy, chances are good that at some point in the course of their illness the skeleton will be involved. Bone metastases, hypercalcemia, and other paraneoplastic syndromes are commonly encountered and require definitive diagnosis and management. In general, the therapy for the elderly patient with these disorders is the same as that for younger individuals. The diagnostic and therapeutic approach must often be tempered, however, by coexistent chronic disease, which may also affect the skeleton. PMID- 3308051 TI - Approach to oncologic emergencies in the elderly. AB - Until now there has not been a treatise summarizing the management of oncologic emergencies in the aged. All of the well-described acute complications of malignancy occur in the elderly. Such clinical events are best labeled urgent rather than emergent, and some may be less well tolerated in the older patient because of normal physiologic changes of aging. However, all should be recognized as early as possible and can be treated, when it is appropriate to do so, as has been detailed for 14 problems discussed in this article. The authors also address two important topics, the quality of life and the use of intensive care units, both germane to the difficult question of whom and when to treat. PMID- 3308052 TI - A clinical trial of buspirone and diazepam in the treatment of generalized anxiety disorder. AB - In double-blind trials with hundreds of patients, buspirone has proven to be as effective an anxiolytic as the benzodiazepines. It causes less sedation and motor impairment than diazepam, and may be particularly useful in geriatric patients. We conducted a 4 week double-blind, randomized trial of buspirone versus diazepam and placebo in thirty adult outpatients with generalized anxiety disorder. Maximum doses were 40 mg of diazepam or buspirone or eight placebo tablets a day. There were no significant differences in outcome between the three groups on any physician or subject measures. Some implications of this finding are discussed. PMID- 3308053 TI - Hypofrontality in schizophrenia: a review of the evidence. AB - This paper reviews the possible role of frontal lobe dysfunction in the pathophysiology of schizophrenia. Pathological, computerized axial tomography (CAT) scan and magnetic resonance imaging (MRI) studies have indicated that a substantial number of schizophrenic patients show structural abnormalities in the frontal lobe areas and other parts of the brain. In some cases, these changes can be correlated with negative symptoms. Attempts to study frontal lobe function with neuropsychological tests, topographic EEG, cerebral blood flow (CBF) and positron emission tomography (PET) scans have also indicated that a substantial number of schizophrenics show abnormalities compared to normal controls. However, these abnormalities can be seen to some degree in other conditions. As well, patients early in the course of their illness tend not to show frontal lobe functional abnormalities. The implications of these findings for current theories of schizophrenia are discussed. PMID- 3308054 TI - Non-Hodgkin's lymphoma of the pleural cavity developing from long-standing pyothorax. AB - Malignant lymphomas developing in tissue affected by a long-standing severe inflammatory process of nonautoimmune nature are presented. Two men and a woman aged 50, 58, and 73 years, were admitted after 22 to 30 year histories of pyothorax resulting from artificial pneumothorax for the treatment of pulmonary tuberculosis or tuberculous pleuritis. The diagnoses at admission were chronic pyothorax associated with a lung mass. Microscopically, tumors diffusely or locally proliferated with thickened pleura were present. A histologic examination showed that all the tumors were diffuse non-Hodgkin's lymphomas (NHL) of immunoblastic type with (one case) or without (two cases) plasmacytoid differentiation. Immunohistochemistry on paraffin sections revealed restricted expression of immunoglobulin light chains in one case showing plasmacytoid differentiation. A review of the literature showed that malignant lymphomas of this type have been reported exclusively from Japan but never from Western countries. PMID- 3308055 TI - Lymph nodes as sites of metastases from sarcomas of soft tissue. AB - Records of 323 patients with TNM Stage M0 sarcoma of soft tissue treated by the Radiation Medicine Service of the Massachusetts General Hospital over a 14-year period were reviewed to study the incidence and the implication of regional lymph node involvement. Nineteen patients (5.9%) had evidence of sarcoma metastatic to draining lymph nodes, zero of 63 (0%) were Grade 1 sarcomas, two of 118 (2%) were Grade 2, and 17 of 142 (12%) were Grade 3 sarcomas. Among patients with Grade 3 sarcomas, rhabdomyosarcoma (five of 14), vascular sarcoma (two of five), and epithelioid sarcoma (four of five) were associated with a higher incidence of lymph node involvement than synovial sarcomas (zero of four), fibrosarcomas (zero of 16), malignant fibrohistiocytomas (one of 29), neurofibrosarcomas (one of eight), liposarcomas (one of 14), and leiomyosarcomas (one of ten). From the 19 patients who had evidence of metastatic nodes, six (32%) were alive more than 58 months after the treatment of the nodes; four of six patients were without further tumor. The data of this study are compared with those cited in a review of the literature. PMID- 3308056 TI - Gastric adenocarcinoma after gastric lymphoma. AB - Three men and one woman developed intestinal-type moderately or poorly differentiated gastric adenocarcinoma 4 to 15 years after the diagnosis of gastric lymphoma. Treatment of the lymphomas had included partial gastrectomy and follow-up radiotherapy and/or chemotherapy. Review of the literature reveals an additional 12 patients who developed adenocarcinoma 3.5 to 34 years (median, 14.5 years) after diagnosis of gastric lymphoma. In the total series of 16 patients, only four were women, who tended to be younger (median age, 36.5 years) than the men (median, 48.5 years) when lymphoma was diagnosed. Patients with gastric lymphoma seem to have an increased incidence of gastric adenocarcinoma. Carcinoma after gastric lymphoma often arises in the distal stomach and appears to occur irrespective of the type of therapy for the lymphoma. PMID- 3308057 TI - The evaluation of trends in soft tissue sarcoma according to diagnostic criteria and consumption of phenoxy herbicides. AB - The possible association between exposure to phenoxy herbicides and development of soft tissue sarcomas has been studied in both case-control and cohort studies. In these studies soft tissue sarcoma cases have been identified from either deaths with malignant neoplasms of the connective tissue (ICD-8 171) as the underlying cause of death, from incident cancer cases with the same topography code, or from incident cases of extraskeletal sarcomas, excluding lympho and reticulosarcomas. The current study shows that the choice of source material has a considerable influence on the registered occurrence of soft tissue sarcomas in a well defined population. In 1978 to 1982 an annual number of 33 deaths from ICD 8 171 was registered in Denmark, whereas the annual number of diagnosed extraskeletal sarcomas was 231. The distribution over histologic types differed between tumours coded to the connective tissue and extraskeletal sarcomas coded to specific organs. Furthermore, during the period 1943 to 1982 the mortality from ICD-8 171 increased slightly, whereas the incidence from all extraskeletal sarcomas decreased slightly, except for males since 1970. Time trends based on any of the three source materials should, however, be interpreted with caution. PMID- 3308059 TI - Preventive strategies for cancer in women. AB - It is estimated that 480,000 types of cancer will occur in women during 1987, the most frequent being breast (27%), colon and rectum (16%), lung (11%), and uterus (10%). Of cancer deaths, lung (20%), breast (18%), and colorectal (14%) are most common. Uterine cancer is now the sixth cause of cancer death, after ovary and pancreas, due to the application of cancer detection. with an aging US population, cancer will become an even more significant health issue for women. Cancer in women aged 65 years and older occurs twice as frequently as in those aged 45 to 64 years. Melanoma is becoming an increasingly important public health problem because of its rising incidence during the last 20 years. Preventive strategies can be widely promoted to women in order to lower their cancer risk and to find cancer before symptoms appear. Smoking control, safe sun exposure, and simple recommendations for diet and nutrition can assist women in taking control of their lifestyles to reduce cancer risk. Early cancer detection, as outlined in the American Cancer Society's Cancer Related Checkup Guidelines, can be expected to find breast, colorectal, uterine, and other forms of cancer in asymptomatic women. PMID- 3308058 TI - Patient response to sigmoidoscopy. A randomized, controlled trial of rigid and flexible sigmoidoscopy. AB - Sigmoidoscopy could aid in the control of large bowel cancer by early detection of the 55% of colorectal cancers that develop in the rectosigmoid and by the identification and eradication of significant rectosigmoid adenomas. Rigid sigmoidoscopy has had poor patient acceptance and therefore has not been successful. The present study is a prospective randomized trial to evaluate patient response to flexible as compared with rigid sigmoidoscopy. Patients reported significantly less discomfort (10.1% versus 29.7%), anxiety (9.8% versus 27.6%) and embarrassment (5.2% versus 12.8%) during flexible as compared with rigid sigmoidoscopy. Flexible sigmoidoscopy appears to have better patient acceptance than rigid sigmoidoscopy (P less than 0.01). This could enhance its value as a cancer-control instrument. This article addresses the feasibility of sigmoidoscopy. Its validity also needs to be addressed within the framework of a long-term trial, evaluating mortality for rectosigmoid cancer. PMID- 3308060 TI - Replacement estrogens and risk of gynecologic cancers and breast cancer. AB - The two cancers specific to women for which substantial research on their relationship to exogenous estrogens has been reported are endometrial cancer and breast cancer. With the former, the link to estrogen use is well established. The estrogen use patterns associated with increased risk of endometrial cancer are characteristic of a promotional agent. The example serves as a prototype model for the study of an adverse health effect subsequent to a prescribed medication. However, modification in estrogen prescribing patterns have lowered significantly the endometrial cancer risk for patients. A relationship between estrogen replacement therapy and breast cancer is difficult to assess. Despite biologic plausibility, large epidemiologic studies have shown no association between estrogen use and breast cancer occurrence. Those studies suggesting a relationship find it concentrated in the high dose estrogen products and possibly among women who have had a prior bilateral oophorectomy. A convincing resolution to the current uncertainty is likely to require new approaches in laboratory, clinical, and epidemiologic research. Larger studies investigating more refined hypotheses within the same conceptual confines are unlikely to be productive. PMID- 3308061 TI - The use and abuse of imaging in gynecologic cancer. AB - The radiologic detection in staging of gynecologic malignancies comprises a variety of noninvasive and invasive procedures. In the last few years, the emergence of the cross-sectional imaging techniques such as ultrasonography (US), computerized tomography (CT), and more recently, magnetic resonance imaging (MRI) have enabled the radiologist to determine more accurately the entire degree and extent of pathologic processes both within the pelvis and spread of disease outside the pelvis. The radiologist has also become more involved in invasive procedures such as percutaneous biopsies, aspirations of fluid collections, and transcatheter intraarterial infusion and occlusions. Although the newer imaging modalities will be emphasized, an attempt will be made to point out both their strengths and weaknesses relative to the older modalities. The discussion will concentrate on ovarian and cervical cancers while the other cancers of the female genital tract will be superficially discussed. The thrust of the presentation will emphasize the workup of gynecologic patients, that the workup may be quick, thorough, and as practical as possible. PMID- 3308062 TI - Surgical staging of gynecologic malignancies. AB - The role of surgical staging in gynecologic malignancies has not been precisely defined at this time despite the conventional employment of this modality in the initial staging of ovarian neoplasms. Major discrepancies have been documented between clinical and surgical estimates of disease extent in cervical, endometrial, and vulvar carcinomas. We recently reviewed our experience with patients who were found to have positive periaortic nodes after surgical exploration for clinical Stage IB and Stage IIA cervical cancer. Postoperative extended field radiotherapy was employed with minimum complications and the 5 year actuarial survival rate was 50% with a median survival time of 29 months. In order to justify the utilization of surgical staging for gynecologic neoplasms, it is necessary to demonstrate a survival advantage in patients where the precise extent of disease has been established and subsequent therapy tailored accordingly. In addition, it must be shown that surgical staging does not increase complications or decrease the efficacy of subsequent therapeutic interventions. PMID- 3308063 TI - The case against the surgical concept of en bloc dissection for certain malignancies of the reproductive tract. AB - The en bloc dissection approach to many cancers of the reproductive tract needs re-evaluation in light of recent data. The mechanisms by which one or more malignant cells leaves the primary lesion and are then deposited as a viable focus at distant sites, is also in need of study. The hypothesis is put forth that metastases to regional lymph nodes occurs from the primary lesion as an embolic event leaving the intervening normal tissue bridge at low risk for disease. Indeed, these viable cells, which have the potential for becoming a metastatic focus, may fall victim to the patient's host defense mechanisms. In light of this, recent clinical experience with cancer of the cervix, vulva, and breast, is outlined with particular emphasis on more conservative surgical techniques and their success. A plea is made for individualization of surgical therapy, especially with early lesions affording ample opportunities for preservation of function, body image, and improved quality of life. PMID- 3308064 TI - Initial therapy for early ovarian carcinoma. AB - Approximately 33% of women with invasive ovarian tumors present with what appears to be early epithelial ovarian cancer (FIGO Stages I and II) accounting for approximately 6000 new ovarian cancer cases each year in the United States. A better understanding of the natural history and patterns of spread of this disease has led to an increased awareness of the importance of thorough operative staging, cytoreductive surgery, and accurate determination of the extent of residual disease. These staging studies have documented frequent understaging of such patients. Results from such surgical staging studies indicate that only about 25% of women operated on in the United States have an initial surgical incision adequate to allow evaluation of the entire pelvis and abdominal cavity. As a result about 33% of patients thought to be free of disease at initial surgery have residual disease and in 75% the disease has spread intraabdominally. These studies have important implications for the design of future adjuvant trials. Fortunately, these accurate staging studies have defined groups of patients who require adjuvant treatment as well as those who do not. It is now apparent that certain groups of patients with Stage II and high-risk Stage I disease are at risk for failure throughout the abdominal cavity. Any form of adjuvant therapy, if it is to succeed, must obviously encompass this entire area. With this in mind, several prospective clinical trials have tested a variety of adjuvant approaches. Present evidence would suggest that systemic chemotherapy, intraperitoneal radioisotopes (32P) or whole abdominal irradiation have the potential to eradicate micrometastases throughout the area at risk. The need for adjuvant therapy is dependent upon the accuracy of initial surgical staging. If initial surgical evaluation was incomplete, the five year survival rates for Stage I (70%) and Stage II (40% to 50%) disease are poor enough that most investigators would advocate some sort of adjuvant therapy. However, comprehensive and accurate surgical staging will define subsets of ovarian cancer patients with such good prognoses (five year survival of 90% to 95%) that no adjuvant treatment is required. With the known risk of late second malignancies in ovarian cancer patients treated with long-term adjuvant chemotherapy, the identification of patients who do not require further treatment represents an advance. Accurate surgical staging coupled with proper adjuvant therapy designed to treat areas of high risk have improved the survival rate of patients with early ovarian cancer. PMID- 3308065 TI - Selecting initial therapy for invasive breast cancer. AB - The correct choice of therapy for localized breast cancer is controversial. A great many published clinical experiences, some of considerable size, have tended on the one hand to provide apparently contradictory information, and on the other hand to polarize views. A detailed consideration of the many clinical, pathologic, biochemical and kinetic prognostic variables which may bias such clinical experiences will be discussed. These may contribute to differing results from institutions apparently employing a single treatment plan. The prospectively randomized trials which have helped to establish the limits of acceptable therapy for localized breast cancer will also be reviewed together with comments on their limitations. Particular attention will be paid to National Surgical Adjuvant Breast Project (NSABP) trial B-06; the Milan Cancer Institute trial; and current National Cancer Institute (NCI) investigations. A thorough consideration of these issues should permit a more rational choice of primary treatment for patients with Stage I and Stage II breast cancer. PMID- 3308066 TI - Clinical applications of monoclonal antibodies in gynecologic oncology. AB - The advances of both murine and human monoclonal antibody (MoAb) technology have allowed the development of several antibodies against gynecologic tumors. The goals are to produce effective and specific reagents for both immunodiagnosis and therapy. However, despite an extensive research effort, a clear demonstration of specific cancer-associated antigens in gynecologic malignancies, or of specific immune responses to such antigens has been elusive. Currently, most antibodies found are cross reactive with either oncofetal antigens or some normal adult tissues. Clinical usefulness of these MoAbs as a screening test in radioimaging or in immunotherapy remains to be proven. However, the use of MoAb technology in defined antigens/tumor markers such as beta-human chorionic gonadotropin, and alpha fetal proteins has provided convenient, reproducible and highly specific reagents. More recently, promising antibodies have been shown to detect tumor antigens in serum of patients with ovarian cancer. PMID- 3308067 TI - Multidrug resistance in ovarian cancer. AB - The development of acquired resistance has limited the effectiveness of chemotherapy in the treatment of ovarian cancer. Experimental model systems were developed to study the mechanisms associated with primary resistance to chemotherapeutic agents and broad cross-resistance (multidrug resistance) which is characteristic of human ovarian cancer. Doxorubicin-resistant cell lines developed in vitro by exposure of a sensitive cell line to increasing concentrations of doxorubicin develop resistance on the basis of a decrease in drug accumulation and have increased expression of the mdr-1 gene. This gene encodes for a membrane glycoprotein and leads to a decreased drug accumulation in drug resistant cell lines. Cell lines established from patients refractory to doxorubicin-containing combinations, however, do not demonstrate a decrease in drug accumulation. Studies are in progress on the measurement of mdr-1 levels in tumors of patients undergoing treatment to determine whether agents, such as verapamil may be useful in the treatment of drug resistant gynecologic cancers. Human ovarian cancer cell lines from drug resistant patients also has been demonstrated to increase levels of glutathione. Lowering of glutathione levels with buthionine sulfoximine (BSO), which irreversibly inhibits the enzyme gamma glutamyl cysteine synthetase, leads to a marked potentiation of the cytotoxicity of melphalan both in vitro and in vivo in a nude mouse model of human ovarian cancer. Based on those studies, BSO is undergoing toxicologic evaluation before initiation of clinical trials in drug resistant patients. Our studies demonstrate that drug resistance in human ovarian cancer is likely due to interaction of multiple factors. However, biochemical intervention in some of the key steps leading to drug resistance has been demonstrated experimentally feasible and indicates that pharmacologic reversal of drug resistance is a clinical possibility. PMID- 3308068 TI - Treatment of advanced and recurrent gynecologic cancer. AB - In 1986 73,400 new cases of invasive gynecologic cancer and 45,000 new cases of in situ carcinoma of the uterine cervix (about 9% of all cancers in women) were diagnosed in the US. A significant proportion of these patients die of local failure. In dealing with the wide variety of gynecologic cancers, extreme care must be used in choosing the appropriate treatment program for each problem. Therefore, the full extent of the disease at the time of initial presentation and recurrence must be determined. It is only with these data that appropriate treatment programs can be designed with the maximum potential for long-term control or cure and with the minimum in treatment complication. There are no groups of disease processes like those seen in advanced or recurrent gynecologic cancer that offer such a challenge to the clinical practitioner. PMID- 3308069 TI - Surgical approaches for advanced or recurrent cancer of the cervix. AB - The American Cancer Society estimates that in 1987 13,000 women in the United States will develop invasive cervical cancer, and 6800 women will die of this disease. Two groups of patients contribute significantly to mortality from cervical cancer. In the first group are patients who have an advanced stage of cervical cancer at the time of diagnosis. The second group consists of patients who have received unsuccessful primary treatment. Over the past decade the role of surgery in the management of patients with advanced disease has been studied with a view toward a more precise extent of disease evaluation prior to definitive therapy. The potential benefit of pretreatment surgical staging of cervical cancer is considered in this article. The role of pelvic exenteration in the treatment of recurrent cervical cancer has been established for more than 30 years. In this article recent advances in the application of these procedures including better criteria for patient selection, improvement in surgical techniques, and patient rehabilitation are discussed. PMID- 3308070 TI - Chemotherapy for advanced or recurrent gynecologic cancer. AB - Studies of chemotherapy in advanced or recurrent gynecologic cancer have focussed on ovarian, cervical, and endometrial carcinoma. For celomic epithelial carcinomas of the ovary, a large number of cytotoxic agents have been shown to be active. Dramatic improvement in frequency of response with lesser improvement in survival has been noted with the use of cisplatin-based combination chemotherapy as compared to single alkylating agents. More recent studies have evaluated alternative ways to employ cisplatin: higher dose schedules, intraperitoneal administration, and platinum compounds with a potentially better therapeutic index. None has yet been shown superior to a combination of relatively low-dose cisplatin plus an alkylating agent with or without doxorubicin. Cisplatin remains the best studied and most active single agent in patients with squamous cell carcinoma of the cervix. While a number of other agents have demonstrated moderate activity, no combination of drugs has as yet proved superior to single agent cisplatin. In endometrial carcinoma, progestins and doxorubicin are the most active agents. Tamoxifen, cisplatin, and hexamethylmelamine appear to have moderate activity. No combination has yet been shown to be superior to single agents. Information on chemotherapy for less common gynecologic malignancies is largely anecdotal. Two observations are of note. Cisplatin-based combination chemotherapy is highly active against germ-cell neoplasms of the ovary. Cisplatin also has definite activity against mixed mesodermal sarcoma of the uterus. PMID- 3308071 TI - Treatment-related cancers after gynecologic malignancy. AB - Second malignancies are one of the known complications of cancer treatment. Several recent studies which have quantified the risk of treatment-induced cancers following gynecologic malignancies are reviewed. After cervical cancer, there is a 9% excess risk of second cancers, of which only 5% could be attributed to radiation therapy. Most of the treatment-related malignancies after cervical or endometrial cancer are solid tumors occurring within the radiation field. Following both cervical and endometrial cancer, there is a small increased risk of leukemia associated with radiation therapy. In contrast, after ovarian cancer, there is significantly increased risk of leukemia related to treatment with alkylating agents, which varies by drug type and total dose. The cumulative risk of leukemia and preleukemia following single agent melphalan is 11.2% +/- 2.6% at ten years; the risk after cyclophosphamide is 5.4% +/- 3.2%. Overall, the risk of second malignancies following treatment of gynecologic cancers is small. PMID- 3308072 TI - Sexual functioning complications in women with gynecologic cancer. Outcomes and directions for prevention. AB - Since the 1980 conference on gynecologic cancer, there has been an energetic focus on the psychological and behavioral outcomes following gynecologic cancer diagnosis and treatment. Extensive descriptive data on the sexual outcomes following cervix cancer are available. Much less is known about the sexual outcomes for women with other disease sites such as the ovary or vulva or women receiving radical or combination treatments. New directions for research and the design of preventive treatments to reduce sexual complications are discussed. PMID- 3308073 TI - Genes for tumor markers are clustered with cellular proto-oncogenes on human chromosomes. AB - We have analyzed the relative mapping positions of genes for polypeptides expressed abnormally in tumors (tumor markers) and cellular proto-oncogenes and find a remarkable degree of co-mapping of tumor marker genes with oncogenes in the human karyotype. We propose that aberrant expression of marker genes in tumors may be related to their proximity in the human genome to oncogenes expressed during the development of malignancy, and we suggest ways to test this hypothesis of concerted abnormal gene expression in mammalian tumor cells. PMID- 3308074 TI - Alpha-acetoxy derivatives of methyl-2-oxopropylnitrosamine: synthesis, hydrolysis rate and bacterial mutagenicity. AB - N-Methyl-N-2-oxopropylnitrosamine (MOP) induces pancreatic tumors in hamsters. As models for the putative proximate carcinogenic alpha-hydroxy derivatives, we studied N-acetoxymethyl-N-2-oxopropylnitrosamine (AMOP) and N-methyl-N-(1-acetoxy 2-oxopropyl)nitrosamine (MAOP). AMOP was synthesized from aminoacetone by the method of Roller et al. [1975), Tetrahedron Lett., 25, 2065-2068) and MAOP was synthesized by acetoxylation of MOP with lead tetraacetate. The half-lives of AMOP, MAOP and acetoxymethylmethylnitrosamine (ADMN) in aqueous buffer decreased as the pH rose from 5 to 9, with values at pH 5 of 2.8 X 10(4) min for AMOP, 3.2 X 10(3) min for ADMN, and 23 min for MAOP. Mutagenicity was examined in Salmonella typhimurium TA1535, using a pre-incubation at pH 5 without microsomal activation. The mutagenic potency, expressed as revertants/mumole, was 56 for AMOP, 150 for ADMN, and 4.5 X 10(4) for MAOP. Hence, hydrolysis rates at pH 5 were probably important in determining the relative mutagenicity. PMID- 3308075 TI - Heat shock proteins in thermotolerance and other cellular processes. AB - Heat shock proteins appear to be causatively involved in the acquisition of thermotolerance in prokaryotes but not in eukaryotes. Further, the enhanced synthesis of hsps may be necessary for some cellular responses to stress but not others. In prokaryotic cells the development of thermotolerance, as measured by cell survival, is dependent upon protein synthesis. However, in eukaryotes, enhanced hsp synthesis following an inducing stress and prior to a subsequent heat shock is neither necessary nor sufficient for the development of thermotolerance as measured by colony-forming assays. The enhanced expression of hsps may be required for some mammalian cellular stress responses, such as the ability to reform both actin microfilament bundles and nucleolar morphology. These latter two thermotolerant responses have not been correlated with colony forming ability. Future work should address the relationships between these various physiological responses to stress and determine if hsps function in some repair mode with regard to colony formation responses. Evidence is accumulating that hsps or their cognates may function in growth and differentiation in some manner as yet to be fully explained. Recent studies indicate that genes controlling cell division in E. coli may be linked to those of several stress regulons, and it would not be surprising to find a similar relationship in eukaryotes. At this time, it is important that studies investigating the role of hsps in stress and other cellular responses such as growth and differentiation define the specific gene (including its regulatory sequences) that encodes the protein being investigated, in order to avoid apparently contradictory and confusing reports of hsps expression. PMID- 3308076 TI - Prognostic significance of the expression of a ras protein with a molecular weight of 21,000 by human breast cancer. AB - Expression of the cellular ras Mr 21,000 protein (p21) has been measured in tumors from breast cancer patients who at time of presentation had no evidence of metastatic disease. Western blotting analysis revealed that 37 of 54 (69%) tumors contained p21 levels 2- to 10-fold greater than those of control breast tissues. An excessive increase of p21 (5- to 10-fold over the control value) occurred more frequently in tumors of T3 and T4 stages [15 of 25 (60%)] than in tumors at T2 stage [6 of 29 (21%)], suggesting a correlation between advancement of disease and high p21 levels. p21 levels were positively related to the involvement of axillary lymph nodes at the time of primary treatment. As no correlations were detected between p21 levels and a gross pathological parameter, tumor grade, it is possible that p21 levels may reflect the degree of cellular malignancy. This is supported by data on tumor recurrence; 13 of 16 patients (81%) with tumors expressing low p21 levels were disease free for greater than or equal to 4 years after primary treatment, whereas only 5 of 9 patients (56%) with high p21 tumors remained disease free. These results suggested that a quantitative enhancement of p21 oncogene protein is associated with both the progression and prognosis of breast cancer. PMID- 3308077 TI - Relationship of carbohydrate antigen 19-9 and Lewis antigens in pancreatic cancer. AB - Carbohydrate antigen (CA) 19-9 identified by a murine monoclonal antibody against a colorectal carcinoma antigen is thought to be a sialylated Lewis (Le)a blood group antigen and occurs in high concentration in serum of patients with pancreatic carcinoma. This study was designed to identify the relationship between Lewis antigens and CA 19-9 in patients with pancreatic cancer. The following analyses were performed in 20 pancreatic cancer patients: Lea and Leb antigen phenotype in saliva (modified enzyme-linked immunosorbent assay) or on red cells (hemagglutination); CA 19-9 levels (radioimmunoassay) in serum; and CA 19-9 and Lea and Leb expression (immunoperoxidase assay) on tumor tissue. Lea-b- patients based on salivary phenotype failed to express CA 19-9 in tumor tissue and had normal or low levels of CA 19-9 (less than 37 units/ml) in serum (P = 0.0011, versus Lea+b- and Lea-b+ patients). Eighty-eight % of Lea+b- and Lea-b+ patients had elevated serum CA 19-9 levels (greater than 37 units/ml). All Lea+b- and Lea-b+ patients expressed both Lea and Leb antigens in tumor tissue. These results support the view that Lea-b- pancreatic cancer patients cannot manufacture CA 19-9. Surprisingly, Lea-positive patients express Leb antigen in tumor tissue; in this subgroup, Leb antigen may be a tumor-specific biomarker. PMID- 3308078 TI - Gallium nitrate in prostatic cancer: evaluation of antitumor activity and effects on bone turnover. AB - Gallium nitrate, an agent known to inhibit bone resorption, was evaluated in patients with bidimensionally measurable hormone-refractory prostatic cancer. The starting dose was 200 mg/m2 iv by continuous infusion over 7 days. Two patients (10%; 95% confidence limits, 0%-22%) achieved short partial remissions of 1 and 6+ months, while seven of 23 (30%; 95% confidence limits, 14%-52%) showed a diminution of bone pain. Serial indices of bone turnover including serum calcium, phosphorus, and urinary hydroxyproline excretion showed a significant decrease at the completion of the infusion which returned to baseline prior to the next cycle. The data suggest the effect on bone was too short to produce consistent improvement. Reasons for the dissociation of pain relief and antitumor activity are discussed. PMID- 3308079 TI - Phase II trial of a combination of doxorubicin and mitoxantrone in metastatic breast cancer. AB - To exploit possible different non-cross-resistant mechanisms of cytotoxicity, 25 patients with advanced breast cancer were given combination chemotherapy consisting of iv mitoxantrone (7 mg/m2) and doxorubicin (30 mg/m2) every 3-4 weeks. The patients had predominantly visceral disease and received a median of six (range, one to 12) cycles of therapy. There were no complete responders, but 13 patients (52%) achieved partial remission lasting a median of 8 months (range, 4-21+). Three patients (12%) had disease stabilization and nine (36%) had disease progression. Hematologic toxicity was generally mild, with median wbc count and platelet count nadirs of 1900/mm3 (range, 700-3100) and 160,000/mm3 (range, 49,000-406,000), respectively. One patient may have died from treatment-related sepsis (pneumonia), but lymphangitic lung disease was not excluded. Hair loss progressing to severe alopecia over several treatment cycles was relatively common, affecting seven of 16 evaluable patients (44%). Vomiting was mild or absent in 17 (71%) of 24 evaluable patients. Three of 15 patients in whom serial measurements of left ventricular ejection fraction were performed developed significant reductions compatible with anthracycline-induced cardiotoxicity. Two of these patients also had pericardial effusions and one developed congestive heart failure. In conclusion, mitoxantrone and doxorubicin is an active, well tolerated drug combination for the treatment of advanced breast cancer but may have appreciable cardiotoxicity. PMID- 3308080 TI - Phase II trial of recombinant beta interferon in advanced colorectal cancer. AB - Betaseron is a genetically altered recombinant beta interferon with in vitro properties equivalent to those of native beta interferon. Nineteen patients with measurable advanced colorectal carcinoma who had no previous chemotherapy were given 30 X 10(6) IU Betaseron by iv push on Days 1-5 and 8-12 of each 28-day cycle. One of 17 evaluable patients had a complete response after nine courses of treatment which has been sustained greater than 9 months. The overall response rate was 6% (95% confidence limits, 0%-18%). Treatment was well tolerated with toxic effects consisting of fever, flu-like symptoms, nausea and vomiting, and transient mild granulocytopenia and liver function abnormalities. All toxic effects were World Health Organization (WHO) grade less than or equal to 2. No interferon neutralizing antibody activity was detected. Phase I and preclinical data support further investigation of Betaseron with dose escalation to tolerance for individual patients, as well as investigation of concomitant therapy with 5 fluorouracil, in an attempt to improve the observed response rate in colorectal cancer. PMID- 3308081 TI - Phase I trial of procarbazine as a 5-day continuous infusion in children with central nervous system tumors. AB - Seven children with previously treated brain tumors were enrolled in a phase I trial of 5-day continuous-infusion procarbazine at 360, 480, and 638 mg/m2/day. Vitamin B6 levels were monitored. Myelosuppression was moderate though occasionally delayed, and nausea and vomiting were mild. At the highest dose level, a patient experienced severe psychosis that persisted for several weeks. From that dose-limiting toxicity and the degree of myelosuppression, the recommended dose for phase II trials in children is the same as for adults, 450 mg/m2/day. PMID- 3308082 TI - Continuous-infusion cisplatin and bolus 5-fluorouracil in colorectal carcinoma. AB - Twenty-one evaluable patients with metastatic colorectal carcinoma were treated with a combination of continuous-infusion cisplatin (25 mg/m2/day X 3 days) and bolus 5-fluorouracil (400 mg/m2/day X 3 days). Toxicity was minimal. Seven patients (33%) responded. All responses were observed among the 16 previously untreated patients (44%) and lasted a median of 30 weeks. The results indicate the need for phase III trials of this treatment. PMID- 3308084 TI - An awareness of tragedy. PMID- 3308083 TI - Open-label phase II trial of recombinant beta interferon (IFN-beta (ser)) in patients with colorectal cancer. PMID- 3308085 TI - Congestive heart failure secondary to cerebral arterio-venous fistula. AB - Arteriovenous fistula is a relatively rare cause of severe congestive heart failure in the newborn. An intracranial arteriovenous malformation associated with an aneurysm of the great vein of Galen is the most frequent of such malformations and, although well known, it remains a difficult diagnosis in the neonate because the clinical picture first presents with findings suggesting cardiac disease. The newborn with a vein of Galen aneurysm has volume and pressure overload on his myocardium; cyanosis is often present due to persistent fetal circulation; peripheral pulses are generally decreased in amplitude except in those arteries near the fistula where they are bounding, as an expression of a hyperdynamic status. A continuous murmur may be heard over the scalp, but this highly suggestive sign is often not present. The majority of newborns with intracranial arteriovenous fistula die very soon. Unfortunately, most of these infants are at first considered to have congenital heart disease and are, therefore, subjected to cardiac catheterization and angiography, with their well known risks, before a correct diagnosis is made. Cross-sectional echocardiography, by demonstrating normal intracardiac anatomy, eliminates the need for an invasive investigation in a very sick neonate. Ultrasonography of the head will then provide a rapid and accurate demonstration of the aneurysm of vein of Galen. Cerebral angiography will complete the diagnosis in those cases in which a neurosurgical intervention is contemplated. PMID- 3308086 TI - Periaqueductal tumor as a cause of late-onset aqueductal stenosis. AB - Localized periaqueductal tumors usually present as hydrocephalus, which is then thought to be late-onset congenital aqueductal narrowing. In the past, radiological investigations, including positive contrast ventriculography, pneumoencephalography and even contrast CT scanning, have frequently failed to show tumors in this region in the early stages. However, recent experience using MRI on patients with unexplained late-onset aqueductal stenosis has in some instances shown the presence of a localized periaqueductal tumor as the cause of obstruction of the aqueduct. Four patients are described with hydrocephalus secondary to presumed late-onset congenital aqueductal stenosis, all of whom were shown to have a periaqueductal tumor. One patient had been investigated with a pneumoencephalogram and positive contrast ventriculogram and CT with an early generation scanner, but the tumor was diagnosed only at the time of autopsy. In one patient, the tumor was diagnosed by CT and also confirmed with MRI; a histologic diagnosis has been obtained. In two other patients, CT with and without contrast enhancement was negative and in one of these, a positive contrast ventriculogram was also negative, but the tumor was easily identified on MRI scans. In both of these patients, a histologic diagnosis was obtained by stereotactic biopsy. Periaqueductal tumors must be considered in the differential diagnosis of patients who present with late onset aqueductal occlusion and in such patients, MRI would appear to be the investigation of choice. PMID- 3308087 TI - Extrusion of peritoneal catheter through the anus. AB - Two cases of spontaneous extrusion of the abdominal portion of a ventriculoperitoneal shunt through the anus are reported. PMID- 3308089 TI - Haemodynamics at rest and during isometric exercise under long-term treatment with captopril in dilated and ischaemic cardiomyopathy. AB - In the present study 12 patients with severe chronic heart failure (7 with dilated cardiomyopathy and 5 with ischaemic heart disease) underwent right heart catheterization at rest and during isometric exercise by handgrip before and 6 months after treatment with captopril (mean dose 2 X 39.6 mg/day) while concomitant digitalis and diuretics were unchanged. After 6 months resting haemodynamics changed as follows: decrease in heart rate, mean arterial pressure, pulmonary capillary pressure and total vascular resistance; increase in stroke volume index and stroke work index. During handgrip the following changes were observed after captopril: decrease in total vascular resistance; increase in stroke volume index and stroke work index. Before captopril 11 patients showed no increase or even a decrease in stroke work index during isometric exercise, whereas after captopril 5 out of the 12 patients showed an increase in stroke work index. The results demonstrate that in patients with severe chronic heart failure long-term treatment with captopril lowers preload and afterload, which is accompanied by a significant improvement in left ventricular performance at rest. Furthermore, during isometric exercise after captopril an improvement in left ventricular function was found in 5 out of 12 patients. PMID- 3308088 TI - DL-apiose substituted with stable isotopes: synthesis, n.m.r.-spectral analysis, and furanose anomerization. AB - The branched-chain pentose DL-apiose has been synthesized in good yield by a new and simple chemical method that can be adapted to prepare (1-13C)-, (2-13C)-, (1 2H)- and/or (2-2H)-enriched derivatives. N.m.r. spectra (1H- and 13C-) have been interpreted with the aid of selective (13C)- and (2H)-enrichment, and 2D and 13C[13C]-n.m.r. spectra. The solution composition of DL-(1-13C)apiose in 2H2O, determined by 13C-n.m.r. spectroscopy, has been found to differ from that determined previously by 1H-n.m.r. spectroscopy. Several 13C-1H and 13C-13C couplings have been measured and interpreted in terms of apiofuranose ring conformation. Ring-opening rate-constants of the four apiofuranoses [3-C (hydroxymethyl)-alpha- and -beta-D-erythrofuranose, and 3-C-(hydroxymethyl)-alpha and -beta-L-threofuranose] have been determined by 13C-saturation-transfer n.m.r. spectroscopy, and compared to those obtained previously for the structurally related tetrofuranoses. PMID- 3308090 TI - Role of digitalis in chronic congestive heart failure and sinus rhythm. AB - Whereas the use of digitalis in atrial fibrillation is universally accepted, its administration in patients in sinus rhythm for its inotropic properties has recently been questioned. The risk of digitalis administration is high and may be unavoidable because of the occurrence of changes in sensitivity to digitalis. Benefits of digitalis are poorly defined. Hemodynamically digitalis is a weak inotropic agent. Clinical improvement is difficult to detect; furthermore, the role of long-term maintenance digitalis therapy appears questionable, inasmuch as several studies failed to show deterioration after digitalis therapy has been discontinued. PMID- 3308092 TI - First Vienna Symposium on New Trends in HTX. Progress in immunosuppression and diagnostics after heart transplantation. September 18-19, 1987, Vienna (Austria). Abstracts. PMID- 3308091 TI - Digitalis: is it useful in congestive heart failure in patients in normal sinus rhythm? AB - The value of digoxin in the patient in normal sinus rhythm with chronic congestive heart failure continues to be controversial. Although many patients taking digoxin have no clinical deterioration after its discontinuance, there is a subgroup of patients (up to 30% of the total group) who demonstrate clinical deterioration on digoxin withdrawal. Patients with an S3 gallop and an enlarged left ventricle are especially likely to benefit from digoxin therapy. Furthermore, there is good evidence in patients with congestive heart failure that there is a persistent, chronic, positive inotropic effect with digoxin. Since digitalis is the only presently available, chronic, oral positive inotropic drug capable of increasing stroke volume at any given filling pressure, it should be used in patients with congestive heart failure. PMID- 3308093 TI - Reduction of left ventricular mass in normal rats by captopril. AB - To assess the influence of captopril on left ventricular mass in 24 normal Sprague-Dawley rats, 12 were given high sodium (group 1) and 12 low sodium (group 2) diets. Half the rats given each diet were treated with 30 mg.kg-1/day captopril by gavage, the others were given placebo. Mean(SEM) arterial pressure was significantly reduced in group 2 treated rats (102.3(2.0) vs 123.4(1.5) mmHg, p less than 0.0002) but not in group 1 treated rats (113.8(2.5) vs 123.7(2.9)mmHg, NS). Blood pressure response to a 200 ng.kg-1 iv dose of angiotensin I was blocked in both group 2 (8.3(2.1) increase vs 29.7(3.6) mmHg increase for controls) and group 1 treated rats (7.8(2.8) increase vs 36.5(4.0) mmHg increase for controls). In group 2 treated rats the left ventricular to body weight ratio (X 10(-3)) was reduced compared with control (2.1(0.05) vs 2.4(0.08), p = 0.026), whereas in group 1 rats this ratio was not significantly different in the treated and control groups (2.3(0.06) vs 2.5(0.18), NS), suggesting that the reduction in left ventricular mass resulted from the influence of captopril on blood pressure. It is concluded that captopril causes a reduction in left ventricular mass in normal rats as a result of a reduction in blood pressure, independent of the effects of angiotensin I converting enzyme. This supports the concept that left ventricular mass is determined primarily by wall stress and is capable of both upward and downward regulation. PMID- 3308094 TI - Methodological aspects of the use of heart rate stratified RR interval histograms in the analysis of atrioventricular conduction during atrial fibrillation. AB - A new computer assisted method for analysing RR interval histograms was devised in 32 patients with sustained atrial fibrillation. Twenty four hour ECG recordings were divided consecutively into periods with 64 heart beats and mean heart rates calculated for each period. Using increments of 10 beats.min-1 serial heart rate stratified histograms with 5120 RR intervals were constructed according to the calculated heart rate. In all histograms the RR intervals were sorted into 20 ms wide subgroups between 180 and 2100 ms. The analysis showed a bimodal RR distribution in 26 patients. Several indices were chosen to characterise a given RR interval peak in the histogram analysis. The rate dependence of peak was calculated for each individual peak. In the presence of two or more peaks a peak dominance change value was defined. Furthermore, differences and ratios between peak values at peak dominance change value (peak gap and peak value ratio) were calculated. A contour index was used to describe the smoothness of the appearance of the histogram. Comparisons were made between the histograms with periods composed of different numbers of heart beats (8, 16, 32, 64) for the mean heart rate calculation and between the histograms constructed with different numbers of RR intervals (512, 1024, 2560, 5120, 10,240, pooled data) in six patients. A significant finding was that greater than 5000 RR intervals should be used for the construction of a heart rate stratified histogram. Comparison was also made between the repeated histograms with a mean time interval of 137 days (7-413 days) in eight patients. The findings showed a high reproducibility of the heart rate stratified histogram. PMID- 3308095 TI - Streptococcus mutans, lactobacilli and Streptococcus sanguis in plaque from abutment teeth of cemented and of loose retainers. PMID- 3308097 TI - [2 centuries of the Brno Hospital (1786-1986)]. PMID- 3308098 TI - [The dopaminergic system and the regulation of body weight]. PMID- 3308099 TI - [The First Internal Medicine Clinic at the Medical School of Charles University between two wars. I. What it was like at Hynek's clinic]. PMID- 3308100 TI - [My memories of Prof. Josef Pelnar]. PMID- 3308102 TI - [Salmonella infections in patients after kidney transplantation]. PMID- 3308101 TI - [The history of 6 viral diseases. I]. PMID- 3308103 TI - [The First Internal Medicine Clinic at the Medical School of Charles University in Prague between two wars. II. What it was like at Hynek's clinic]. PMID- 3308096 TI - Pontogeniculooccipital waves: spontaneous visual system activity during rapid eye movement sleep. AB - 1. Pontogeniculooccipital (PGO) waves are recorded during rapid eye movement (REM) sleep from the pontine reticular formation, lateral geniculate bodies, and occipital cortex of many species. 2. PGO waves are associated with increased visual system excitability but arise spontaneously and not via stimulation of the primary visual afferents. Both auditory and somatosensory stimuli influence PGO wave activity. 3. Studies using a variety of techniques suggest that the pontine brain stem is the site of PGO wave generation. Immediately prior to the appearance of PGO waves, neurons located in the region of the brachium conjunctivum exhibit bursts of increased firing, while neurons in the dorsal raphe nuclei show a cessation of firing. 4. The administration of pharmacological agents antagonizing noradrenergic or serotonergic neurotransmission increases the occurrence of PGO waves independent of REM sleep. Cholinomimetic administration increases the occurrence of both PGO waves and other components of REM sleep. 5. Regarding function, the PGO wave-generating network has been postulated to inform the visual system about eye movements, to promote brain development, and to facilitate the response to novel environmental stimuli. PMID- 3308104 TI - [The history of 6 viral diseases. II]. PMID- 3308106 TI - [100 years since the birth of Academician Arnold Jirasek]. PMID- 3308105 TI - [Therapy of complicated urinary infections using ceftazidime]. PMID- 3308107 TI - [Modern developments in cataract surgery]. PMID- 3308108 TI - [Questions regarding the wounding and death of A.S. Pushkin. On the 150th anniversary of the poet's death]. PMID- 3308109 TI - Presence of glycoconjugates in prolactin granules of male rats. AB - Prolactin granules in the anterior pituitary glands of male rats contain densely stained materials at the periphery of the matrix. These occur in both small spherical and large polymorphic types of granules. The presence of densely stained materials around secretory granules may be a useful criterion for identification of prolactin cells since the dense structure was observed in 95% of these cells after conventional staining by uranyl acetate and lead citrate. The localization of glycoconjugates in the prolactin granules was examined by applying concanavalin A (Con A) on the ultrathin sections. HRP-Con A or ferritin conjugated Con A bound specifically to the densely stained materials in the peripheral region of the prolactin granule matrix, indicating that this densely stained matrix contains glycoconjugates; the significance thereof is discussed with reference to the concentration and packaging of secretory product. PMID- 3308113 TI - [ELISA detection of the malaria antibody: related problems]. PMID- 3308110 TI - The 180-kD component of the neural cell adhesion molecule N-CAM is involved in cell-cell contacts and cytoskeleton-membrane interactions. AB - N-CAM180, the molecular form of the three neural cell adhesion molecules (N-CAM) with the largest cytoplasmic domain, is accumulated at sites of cell-cell contact (cell bodies, neurites, growth cones) in cultures of neuroblastoma and cerebellum. At these sites the cytoskeleton-membrane linker protein brain spectrin and actin are also accumulated. Brain spectrin copurifies with N-CAM180 by immunoaffinity chromatography and binds specifically to N-CAM180 but not to N CAM140 or N-CAM120 in a solid-phase binding test. These observations indicate an association of N-CAM180 with the cytoskeleton in vivo. This association may underlie the reduced lateral mobility of N-CAM180 in the surface membrane compared to N-CAM140 (Pollerberg et al. 1986). Together with the fact that N CAM180 is only expressed after termination of neuron migration in vivo (Persohn and Schachner, unpublished) these results suggest a role for N-CAM180 in stabilization of cell contacts. PMID- 3308112 TI - [The investigation and evaluation of a new kind of paper disk for rapid identification of E. coli groups]. PMID- 3308111 TI - Failure of luteinizing hormone-releasing hormone (LHRH) to affect the differentiation of LH cells in the rat hypophysial primordium in serum-free culture. AB - The aims of this study were to investigate the differentiating capacity of adenohypophysial LH cells in a serum-free culture medium and to test whether cytogenesis is affected by synthetic LHRH. The adenohypophysial primordia of fetal rats were isolated on days 11.5 and 12.5 of gestation and cultured without serum for 10 and 9 days, respectively, in synthetic Medium 199 or alpha MEM. Immunohistochemical examination using the PAP method revealed that most culture explants, apart from a few degenerate ones, contained LH cells. In comparison with Medium 199, which has been widely used as a culture medium for hypophysial explants, alpha MEM gave far better results and the primordia cultured in this medium showed better tissue growth and contained a greater number of LH cells. Administration of synthetic LHRH (10 ng/ml) on the first day of culturing had no effect on the number of LH cells, no matter whether or not the culture medium was supplemented with insulin, transferrin or thyroxine. These results suggest that at the early developmental stage LHRH is not essential for the differentiation and/or proliferation of LH cells. PMID- 3308114 TI - [Present status and prospects of diphtheria control]. PMID- 3308115 TI - Chronic paroxysmal hemicrania: recent developments. PMID- 3308116 TI - Yeast mitochondrial RNA polymerase is homologous to those encoded by bacteriophages T3 and T7. AB - Analysis of the nucleotide sequence of the genetic locus for yeast mitochondrial RNA polymerase (RPO41) reveals a continuous open reading frame with the coding potential for a polypeptide of 1351 amino acids, a size consistent with the electrophoretic mobility of this enzymatic activity. The transcription product from this gene spans the singular reading frame. In vivo transcript abundance reflects codon usage and growth under stringent conditions for mitochondrial biogenesis and function results in a several fold higher level of gene expression than growth under glucose repression. A comparison of the yeast mitochondrial RNA polymerase amino acid sequence to those of E. coli RNA polymerase subunits failed to demonstrate any regions of homology. Interestingly, the mitochondrial enzyme is highly homologous to the DNA-directed RNA polymerases of bacteriophages T3 and T7, especially in regions most highly conserved between the T3 and T7 enzymes themselves. PMID- 3308117 TI - Induction of S-100b (beta beta) protein in human teratocarcinoma cells. AB - Human teratocarcinoma NT2/D1 cells undergo differentiation into a variety of cell types, including neurons, treated with retinoic acid. In the present study, the concentrations of alpha S-100 and beta S-100 proteins (alpha and beta subunits of S-100 proteins), and three subunits (alpha, beta and gamma) of enolase in NT2/D1 cells were measured using the sensitive enzyme immunoassay method. The concentration of beta S-100 was markedly increased in the cells after treatment with retinoic acid, whereas the concentration of alpha S-100 was undetectably low, indicating that the S-100b (beta beta) protein was induced by retinoic acid. On the other hand, the concentrations of the three forms of enolase isozymes did not change in the same culture. The induction of S-100b protein was not observed in the NT2/D1 cells after treatment with forskolin, dibutyryl cyclic AMP or cholera toxin. The indirect double-labeled immunofluorescence, using antibodies specific to beta S-100 and monoclonal antibodies specific to neurofilaments, revealed that both the S-100b protein and the neurofilaments were induced in the same subpopulation of cells which underwent neuronal differentiation. PMID- 3308118 TI - The study of mammalian organogenesis by mosaic pattern analysis. AB - Chimeras are animals derived from more than one zygote and composed of two cell lineages which are distinguishable in some way at the cellular level. Spontaneous mosaic animals are also composed of distinguishable cell lineages but are monozygotic. The tissues of both mono- and multizygotic animals of this type are mosaic arrays in which aggregates of like cells form patches, the size and distribution of which can be useful in the analysis of diverse problems in developmental biology. Both biochemical and in situ methods have been applied to the elucidation of mosaic pattern. Both forms of mosaicism have proven useful in establishing theoretic constructs of the formation and maintenance of mammalian organs. A number of these constructs are discussed: cell fusion as related to myotube formation; mechanisms of coat pigmentation and the cellular origin of melanocytes; and pattern analyses of the retinal pigmented epithelium, the intestine, liver, adrenal cortex and thymus. Pathologic alterations in such animals have also been studied utilizing mosaic pattern analysis. In particular, neoplastic tumors and their associated preneoplastic lesions have been shown to be clonal. PMID- 3308119 TI - Somite chondrogenesis: the role of the microenvironment. PMID- 3308120 TI - An immunofluorescence study of chondrogenesis in murine mandibular ectomesenchyme. AB - The temporal and spatial distribution of type I collagen, type II collagen, cartilage-specific proteoglycan (CSPG) and fibronectin in mouse mandible is described. CD-1 mouse embryos of 12-, 15-, and 18-day gestation were used, and matrix molecules were localized using indirect immunofluorescence. On day 12, accumulation of type II collagen, CSPG, and fibronectin within regions of condensed mesenchyme was noted. On day 15, intense staining for type II collagen and CSPG occurred. Fibronectin was less brilliant with its greatest concentration near the perichondrium. On day 18, the cartilage matrix was undergoing osseous replacement concurrent with loss of type II collagen and CSPG. Type I collagen was seen in the perichondrium, membranous bone and sub-basement membrane region in specimens of all ages. Synthesis and expression of extracellular matrix molecules reflect patterns of differentiation in mandibular mesenchyme. PMID- 3308121 TI - Simultaneous development of antibody-dependent cellular cytotoxicity (ADCC) and natural killer (NK) activity in irradiated mice reconstituted with bone marrow cells. AB - Spleen cells from irradiated, bone marrow-reconstituted mice were tested for their ability to mediate antibody-dependent cellular cytotoxicity against P815 target (ADCC-P815), ADCC against sheep red blood cells (ADCC-SRBC), and natural killer (NK) activity judged as YAC-1 lysis at different times after bone marrow reconstitution. Donor-derived ADCC-P815 effectors were found to appear in the spleens 10-12 days after bone marrow reconstitution simultaneously with the appearance of donor-derived NK cells. NK cells recently derived from bone marrow are known to express the Thy-1 antigen; the phenotype of the "early" ADCC-P815 effectors was found to be the same as that of NK cells, i.e., Thy-1+, asialo GM1+. These data suggest that ADCC-P815 effector cells belong to the NK cell population. ADCC-SRBC, in contrast to ADCC-P815 and NK activity, was already high on Day 7 after bone marrow reconstitution. However, it was mediated partly by recipient-derived effectors. ADCC-SRBC effectors were characterized to be different from ADCC-P815 effectors. PMID- 3308122 TI - Bioassays for the detection of a cytokine that enhances the development of cytolytic T lymphocytes. AB - Interleukin 2 (IL-2) is an important growth factor for cytolytic T lymphocytes (CTL). Other factors here termed cytolytic differentiation factor(s) (CDF) may be required for CTL responses, but it has been difficult to identify suitable bioassays. We report a polyclonal assay in which lytic activity develops after 2 days of culture with lectin and lymphokines. CDF is required for the development of Thy-1+, CD8+, CD4- CTL in this assay. The responsive T cells are thymocytes from certain strains of mice (A, Swiss NCS, B6.H-2k) or peripheral T cells cultured in the presence of high doses of hydrocortisone acetate. If these precautions are taken, little or no lytic activity develops in the presence of rIL-2 alone. CDF is present in the media of mitogen-stimulated mouse spleen or human blood mononuclear cells, but not in the conditioned media of a number of mouse and human cell lines. It is immunologically distinct from IL-2, but only acts in concert with IL-2 to induce CTL. A large panel of available mouse and human cytokines do not synergize with Il-2 in the bioassay. These include interferons, colony-stimulating factors, lymphotoxin/tumor necrosis factor, and IL-1, -3, and -4. Therefore a distinct CDF(s) seems essential for the induction of at least some CTL. The assays described here should be useful in purifying the molecule responsible for this biological activity. PMID- 3308123 TI - Electronic anesthesia. Electricity in dentistry. PMID- 3308124 TI - Efficient export of secretory proteins through a vacuolized Golgi complex. AB - The transport of the secretory proteins fibronectin (FN) and procollagen (PC) was studied in cells infected with the temperature-sensitive mutant ts 12 of Uukuniemi virus. Using pulse-labeling followed by immunoprecipitation and SDS PAGE (FN), or by determination of radioactivity incorporated into hydroxyproline (PC) at different time points we could show that the secretion rates for these proteins were normal although the Golgi complex had become vacuolized as a result of infection with the virus. We conclude that such a morphologically altered Golgi can still carry out effective transport of secretory proteins. PMID- 3308125 TI - Protein phosphorylation and dynamics of cytoskeletal structures associated with basal bodies in Paramecium. AB - The presence of phosphorylated proteins associated with microtubule organizing centers in tissue culture cells during mitosis has been demonstrated by the use of monoclonal antibodies raised against mitotic HeLa cells [Vandre et al., Proc. Natl. Acad. Sci. U.S.A. 81:4439-4443, 1984]. We report here that in Paramecium two of the mitosis specific antibodies, MPM-1 and MPM-2, decorate throughout the cell cycle all the microtubule organizing centers (MTOCs) located in the cortex and in the oral apparatus (gullet). Immuno-electron microscopy showed that these antibodies labeled the electron-dense material surrounding basal bodies from which several microtubule networks as well as kinetodesmal fibers originate. During mitosis, these antibodies also stained other cortical cytoskeletal structures, the kinetodesmal fibers (MPM-1 and MPM-2) and the epiplasm (MPM-1). Among the different polypeptides recognized by the antibodies on immunoblots, three major ones of 60, 63, and 116 kDa were found to be common to the cortex (where several thousand ciliary basal bodies are anchored) and the oral apparatus (which comprises several hundred basal bodies around which various arrays of cytoplasmic microtubules are organized). Alkaline phosphatase treatment abolished the immunoreactivity of the polypeptides and the labeling observed by immunofluorescence. These results demonstrate that phosphorylated proteins are associated with all the known active microtubule organizing centers present in the cortex throughout the cell cycle of Paramecium. Furthermore they indicate that in Paramecium phosphorylation of proteins could also be involved in the cell cycle dependent dynamics of cortical cytoskeletal structures other than microtubules. PMID- 3308126 TI - Characterization of the intermediate filament apparatus in skin fibroblasts from patients with giant axonal neuropathy: effect of trypsin. AB - Skin fibroblasts from two siblings with giant axonal neuropathy (GAN) were examined by both biochemical and immunocytochemical studies. The presence of intermediate filaments (IF) characteristic of these cells was affected by the growth conditions. Immediately after plating and during the following 24 hours the majority of the cells contained an IF "bundle"; however, after 4-6 days in culture only a minority of the cells retained this structure. We present evidence that trypsinization but not serum concentration is likely to influence the formation of the "bundle." The results indicate that the formation of the "bundle" may result from a defective association or relationship between the cytoskeleton and the plasma membrane. PMID- 3308127 TI - Platelet intermediate filaments: detection of a vimentinlike protein in human and bovine platelets. AB - Human and bovine platelets contain a 58,000-dalton vimentinlike protein that cross-reacts with antivimentin antibody. Sodium dodecyl sulfate polyacrylamide gel electrophoresis and Western blots indicate that this protein is present in whole platelet lysates and triton insoluble cytoskeletons. Transmission electron microscopy of platelets reveals an isotropic network of individual intermediate filaments distributed throughout the platelets. High salt, triton extracted, glutaraldehyde and tannic acid fixed platelets reveal 10-nm filaments that can be seen to form a peripheral ring, as well as an isotropic network in the body of the cells. Indirect immunofluorescence of resting and spread platelets demonstrates a circumferential staining pattern close to the cell membrane, with additional fibrillar staining throughout the platelets. Our data suggest that the 58,000-dalton vimentinlike protein may be associated with the microtubule coil and the plasma membrane, and may thus help to maintain the resting platelet's discoid shape. PMID- 3308128 TI - [Determination of fibrinogen in plasma using immunochemical methods]. PMID- 3308129 TI - [Ovulation induction using pulsatile administration of LH-RH]. PMID- 3308130 TI - [Beta 2 microglobulin in women with sperm antibodies]. PMID- 3308132 TI - [Surgical procedures in severe epistaxis]. PMID- 3308131 TI - [Effect of drugs on tissue proteolytic enzyme activity]. PMID- 3308133 TI - [Palatine tonsils and immunoglobulins]. PMID- 3308134 TI - [The beginnings of the first pediatric otolaryngologic facility in Bratislava]. PMID- 3308135 TI - [History of the Otolaryngology Department at the Pediatric Hospital of the Medical School in Bratislava 1951-1986]. PMID- 3308137 TI - [Electrophysiologic study of the influence of the cerebellar dentate nucleus on brain activity in epilepsy]. PMID- 3308136 TI - [The effect of cerebellar stimulation on spasticity in man]. PMID- 3308138 TI - [The Czech Pediatric Clinic of the Prague Home for Foundlings in my memory and during my life. II]. PMID- 3308139 TI - [Are we neglecting historiography of the Institutes of National Health?]. PMID- 3308140 TI - [Digital subtraction angiography. Basic technical principles, their advantages and disadvantages]. PMID- 3308141 TI - [Personal experience with digital subtraction angiography]. PMID- 3308142 TI - [Initial experience in the examination of the carotid circulation in cardiac surgery patients in our department]. PMID- 3308143 TI - [Ultrasonic examination of the lower urinary tract in children]. PMID- 3308144 TI - [The effect of Cholestil on the quality of ultrasonic imaging of the gallbladder and biliary tract]. PMID- 3308145 TI - [Modern diagnosis of a cystic duct stump]. PMID- 3308146 TI - Effect of subinhibitory concentrations of ampicillin on the R plasmid transfer in Escherichia coli. AB - The effects of subinhibitory concentrations (sub-MICs) of ampicillin on R plasmid transfer in Escherichia coli were studied. Each donor strain culture was separated into two parts; one was mixed with a recipient strain culture for mating, the other was treated with the sub-MIC of ampicillin and then mixed with the recipient strain culture. In both cases the R plasmid transfer frequency was determined at 30, 60, 90 and 120 min of mating. Results showed that there exists a general decrease in the transfer frequencies under sub-MIC treatment (two plasmids did not transfer at all). The proportion of aggregates and the number of cells that compose them were not affected by the sub-MIC of ampicillin. Our study supports the idea that the changes induced in E. coli by sub-MICs of ampicillin did not affect the function of the surface structures responsible for aggregation but did affect the proteins implicated in DNA transfer, situated on the cell surface. PMID- 3308147 TI - Acute bronchopulmonary infections: treatment with i.v. spiramycin. AB - This paper reports the results of an open study to assess the efficacy (433 patients) and tolerance (453 patients) of spiramycin adipate given by slow intravenous infusion to treat severe acute bronchopulmonary infections in adults. Efficacy was good in 80.4% of patients. More specifically, high efficacy was obtained in 76.5% of 85 pneumococcal respiratory infections, 72% of 50 Haemophilus influenzae and H. parainfluenzae infections, 100% of 18 Mycoplasma infections, 100% of 16 Chlamydia infections and 93% of 14 Legionella infections. Tolerance was good in 83.5% of patients, moderate in 15.4% and poor in 6%. Venous irritation was the most frequent complication, observed in 16.3% of patients. No serious complication or sequel was observed. The authors conclude that spiramycin adipate constitutes an appropriate first-line treatment of acute bronchial and/or pulmonary infections in adults. While inferior to benzylpenicillin against Mycoplasma, Chlamydia and Legionella, spiramycin is as active as, and better tolerated than, erythromycin. PMID- 3308148 TI - Single-dose treatment of lower urinary tract infections with fosfomycin trometamol: preliminary experiences. AB - In recent years many clinical trials were carried out in order to evaluate the efficacy of single dose therapy in lower urinary tract infections (UTIs). In this trial we treated 26 patients (5 M and 21 F) suffering from lower UTI with an single oral dose of 3 g of fosfomycin trometamol, a new phosphonic acid derivative. The overall cure rate four weeks after treatment was 77% (20 out of 26 patients). A cure rate of 89% (16 out of 18 patients) was observed in adult females with uncomplicated UTI. No patients complained of side effects due to fosfomycin trometamol. PMID- 3308150 TI - Conformational analysis of a diene analog of isocarbacyclin and prostacyclin. PMID- 3308149 TI - Detoxication of aliphatic epoxides by diol formation and glutathione conjugation. AB - The Ames procedure with Salmonella typhimurium strain TA100 was used to follow the detoxication by rat liver fractions of two series of aliphatic epoxides. The epoxides employed were 3-chloro-, 3,3-dichloro- and 3,3,3-trichloropropylene oxides and also p-methoxyphenyl-, phenyl- and p-nitrophenylglycidyl ethers. In our procedure with preincubation of the epoxides with rat liver fractions prior to the Ames tests, there was more detoxication of both systems by glutathione conjugation (non-enzymatic and transferase promoted) than by the hydrolase pathways. Non-enzymatic reaction with glutathione was more pronounced for the chloro series than for the glycidyl ethers. An HPLC system was developed which was capable of quantitative measurements of the phenylglycidyl ethers together with their diol and glutathione conjugate products. A comparison of the HPLC and Ames test results indicates that the glutathione transferase reported to be present in Salmonella could be playing a role in detoxication by the Ames test. Diols were measured more readily by HPLC than by use of the Ames test in the microsomal fraction and were detected in the cytosol with the glycidyl ethers while they were not by the Ames procedure. However, all three epoxides were converted to a greater extent to their glutathione conjugates than to their diols. Thus, while literature references question the availability of the glutathione detoxication system for epoxides produced by membrane-bound enzymes, such detoxication would be of primary importance where direct-acting environmental epoxides come into contact with the cytosolic enzymes prior to possible reaction with bionucleophiles. PMID- 3308152 TI - [Care of kidney transplant patients using different immunosuppressive drugs]. PMID- 3308151 TI - An enzyme immunoassay system with a monoclonal antibody for the determination of 11-deoxycortisol. PMID- 3308153 TI - [Postoperative hypothyroidism]. AB - The author consider the problem of hypothyroidism after thyroid surgery for Basedow's disease and multinodular, toxic and nontoxic, goitre. In the behavior of such surgical complication, in addition to thyroid remnant size and technique employed many others biological factors, whose nature up to today is not well defined, are the cause. This multifactorials genesis makes very unforeseeable, in each case, the long term result of surgery in the form of hypothyroidism. However, the hypothyroidism after surgery may be the consequence of a phase of functional adjustment, and then to start substitution therapy immediately after surgery may have opposite effect. PMID- 3308154 TI - [Biliary pathology in chronic pancreatitis]. AB - The authors expose in a very accurate discussion the biliary pathology during chronic pancreatitis. They divide the biliary lesions into associated with pancreatitis and secondary to chronic pancreatitis. They emphasize the necessity to practise a detailed study of the biliary tract in all patients affected by chronic pancreatitis and the good results showed by a very simple surgical act. PMID- 3308156 TI - [Astigmatism after keratoplasty and the Hana trepan: initial results]. PMID- 3308155 TI - [Malignant neoplastic pathology in patients given a kidney transplant]. AB - The incidence of malignant neoplasms in patients subjected to pharmacological immunosuppression following kidney transplantation is higher than that observed in the control population at large. In our unit, in a study population of 451 patients undergoing a total of 462 kidney transplants over the period from 1968 to 1986, four malignant neoplasms (0.9%) were observed in 3/369 (0.8%) patients treated with azathioprine (1 ovarian papilliferous cystoadenoma, 1 embryonal carcinoma of the testicle and 1 Kaposi's sarcoma) and in 1/93 (1.1%) patients treated with cyclosporin (1 Kaposi's sarcoma). The neoplasm was successfully controlled only in the first case after bilateral extended adnexectomy. PMID- 3308157 TI - Affinity purification of antibodies specific for 1,4-dihydropyridine Ca2+ channel blockers. AB - High-affinity antibodies specific for the 1,4-dihydropyridine Ca2+ channel blockers have been produced in sheep and affinity purified using a dihydropyridine-Sepharose affinity column. Dihydropyridine-Sepharose affinity matrix was synthesized by reaction of aminohexyl-Sepharose with an affinity analogue of nifedipine, dimethyl 1,4-dihydro-2,6-dimethyl-4-(2 isothiocyanatophenyl)-3,5-pyridine-dicarbo xylate. Residual amine groups were then blocked by carbodiimide-catalyzed acetylation. [3H]Nitrendipine-binding activity in serum was specifically absorbed by the dihydropyridine-Sepharose affinity column. The bound antibody was eluted with diethylamine (pH 11.5) in 10% dioxane or with a low-affinity dihydropyridine ligand (diethyl 1,4-dihydro-2,4,6 trimethyl-3,5-pyridinedicarboxylate), pH 7.4. Thirty-six milligrams of highly pure IgG antibody, as demonstrated by sodium dodecyl sulfate-gel electrophoresis, was isolated from 50 ml hyperimmune sheep serum. The affinity-purified anti dihydropyridine antibodies have been shown to have high affinity (Kd approximately 0.1 nM) and specificity for the 1,4-dihydropyridine Ca2+ channel blockers and, therefore, exhibit dihydropyridine-binding properties similar to the membrane receptor for the 1,4-dihydropyridine Ca2+ channel blockers. Immunoblot staining of an azidopine-bovine serum albumin conjugate with affinity purified antidihydropyridine antibodies demonstrated that the anti dihydropyridine antibodies recognize the 1,4-dihydropyridine Ca2+ channel blockers when covalently coupled to protein and, therefore, should be useful in the identification and purification of receptors covalently labelled with 1,4 dihydropyridine Ca2+ channel blockers. PMID- 3308158 TI - [Establishment of the FCC102/JS strain of Plasmodium falciparum]. PMID- 3308159 TI - [Field application of the indirect fluorescent antibody test in malaria control]. PMID- 3308160 TI - [Indirect fluorescent antibody test with 2 different antigens in a repeated cross sectional survey of malaria]. PMID- 3308161 TI - [Longitudinal surveillance in areas with bancroftian filariasis virtually eradicated in Guizhou]. PMID- 3308162 TI - [Estimation of some entomological parameters in relation to the transmission of bancroftian filariasis]. PMID- 3308163 TI - [Studies on indirect fluorescent antibody test for the diagnosis and epidemiological investigation of filariasis]. PMID- 3308164 TI - The long-term effect of oral and percutaneous estradiol on plasma renin substrate and blood pressure. AB - The long-term effect of percutaneous and oral estrogen replacement therapy on blood pressure, plasma renin substrate, and serum estrogens was examined in a 2 year placebo-controlled study with 110 early postmenopausal women. The women were allocated to four treatment groups: (1) oral cyclical combination of 2 mg estradiol valerate and cyproterone acetate, (2) oral placebo, (3) percutaneous 17 beta-estradiol, supplemented by 200 mg oral progesterone during the second year, or (4) percutaneous placebo cream. Systolic and diastolic blood pressure remained unchanged in both hormone treatment groups, whereas the diastolic blood pressure tended to increase in both placebo groups. Plasma renin substrate increased during oral treatment with estradiol, but remained unchanged with percutaneous estradiol. No correlation was found between blood pressure and plasma renin substrate. During percutaneous administration of estradiol, the serum concentrations of estrone and estradiol continued to rise after 3 months and reached a plateau at 6 months of therapy. Serum estrone but not estradiol showed the same pattern during oral estradiol therapy. No further changes in any of the measured variables were observed in the women treated with percutaneous estradiol after addition of cyclical oral progesterone. We conclude that both oral and percutaneous treatment with estradiol may provide protection against the age related increase in diastolic blood pressure observed in early postmenopausal women, and that the metabolic steady state is not attained until after 3 months of estradiol therapy. PMID- 3308165 TI - Time course of resolution of pulmonary hypertension and right ventricular remodeling after orthotopic cardiac transplantation. AB - Most patients with severe congestive heart failure have secondary pulmonary hypertension (PHT). Elevation of pulmonary vascular resistance (PVR) to greater than 480 dynes.sec.cm-5 (6 Wood units) is currently the principle hemodynamic contraindication to orthotopic cardiac transplantation. We performed serial two dimensional Doppler echocardiographic examinations and right heart catheterizations in 24 recipients (21 men, 14-58 years old) of orthotopic cardiac transplants to determine the time course of resolution of PHT and the concomitant remodeling of the donor right ventricle. Right and left heart filling pressures declined in parallel and reached the upper normal range at 2 weeks after the transplant procedure and remained unchanged at 1 year follow-up. Mean pulmonary arterial pressure (mm Hg) decreased from 38 +/- 9 preoperatively to 22 +/- 5 at 2 weeks and was 19 +/- 5 at 1 year after the transplantation procedure. At 1 year after surgery, PVR had decreased from 202 +/- 89 dynes.sec.cm-5 preoperatively to 99 +/- 36 dynes.sec.cm-5 (p less than .001), while cardiac output increased from 3.7 +/- 1.2 to 6.3 +/- 1.5 liters/min (p less than .001). Echocardiographic analysis showed that transplant recipients had an enlarged right ventricle on day 1 after surgery, and a volume overload contraction pattern and tricuspid regurgitation was present in the majority. This increase in right ventricular size was maintained at 1 year follow-up while the incidence of tricuspid regurgitation decreased. We conclude that there is rapid resolution of moderately elevated pulmonary arterial pressures after cardiac transplantation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308166 TI - Development of coronary artery disease in cardiac transplant patients receiving immunosuppressive therapy with cyclosporine and prednisone. AB - Coronary artery disease (CAD) has been shown in previous uncontrolled studies to be a limiting factor to long-term survival in patients undergoing cardiac transplantation and who were taking conventional immunosuppressive agents. To study the development of CAD after cardiac transplantation in patients taking the newer immunosuppressive agent cyclosporine, we prospectively performed yearly coronary arteriography on all eligible transplantation patients (first year, 57 patients; second year, 30 patients; third year, 14 patients). The prevalence of CAD by life table analysis was 18% at 1 year, 27% at 2 years, and 44% at 3 years. The occurrence of two or more major rejection episodes was associated (p less than .005) with the development of CAD. In two patients who died of CAD, coronary artery histology revealed subintimal inflammatory cellular infiltration in some lesions. These data demonstrate that the prevalence of CAD rises progressively over time and immunologic factors may be important in its development. PMID- 3308168 TI - Guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Coronary Angiography). PMID- 3308167 TI - New guidelines for the treatment of high blood cholesterol in adults from the National Cholesterol Education Program. From controversy to consensus. PMID- 3308169 TI - Medical approaches to the treatment of acute focal cerebral ischemia. PMID- 3308170 TI - Fatal ethylene glycol intoxication. Report of a case and review of the literature. PMID- 3308171 TI - Extracardiac mass causing cardiac tamponade in a patient with disseminated lymphoma. PMID- 3308172 TI - Differentiation between AIDS-related and non-AIDS-related Kaposi's sarcoma. PMID- 3308173 TI - Methotrexate in the treatment of arthritis and connective tissue diseases. PMID- 3308174 TI - Cleveland Clinic: the supporting cast 1940-1960. PMID- 3308175 TI - Cleveland Clinic: the supporting cast 1920-1940. PMID- 3308176 TI - Maternal phenylketonuria (PKU)--a review. AB - This review points out the very high incidence of damage to the fetus in untreated maternal phenylketonuria (PKU). In classical cases, 92% of the offspring are mentally retarded, 73% have microcephaly, 40% are growth retarded at birth, and 12% have congenital anomalies. Less severe types of PKU and its variants and patients treated with a low phenylalanine diet during pregnancy have a much lower incidence of these defects in their offspring. Very promising results have been obtained in a small number of preconception and early first trimester treated patients under very strict dietary control. Nutrition of the mother and fetus is a major concern during the application of this restrictive diet and must be monitored closely to avoid fetal damage from malnutrition. A 7 year collaborative study of maternal PKU began in November 1984 in the US and Canada, but even in this well publicized study, many patients are presenting late for treatment. It is suggested that premarital and/or prenatal screening for maternal PKU should be initiated for the next generation. PMID- 3308177 TI - Pitfalls in the initial diagnosis of tyrosinemia: three case reports and a review of the literature. AB - The tyrosinemias are a complex and heterogeneous group of disorders in tyrosine catabolism that embrace a wide spectrum of clinical conditions, ranging from the benign neonatal variety to the severe hepatorenal form. Readily available diagnostic tests are too insensitive to distinguish between these variants, and more definitive but technically difficult tests can be performed rapidly in only a few centres. Effective management may therefore be compromised, due to the inability of obtaining a working diagnosis quickly. This report describes difficulties encountered with conventional testing in three patients. Analysis of whole blood delta-aminolevulinic acid dehydratase activity and determination of urinary inhibition activity against the enzyme were found to be rapid and reliable screening tests for hepatorenal or type I hereditary tyrosinemia. These procedures are recommended in the initial evaluation of undifferentiated tyrosinemic states. PMID- 3308178 TI - Incidence of cleft lip, cleft palate, and cleft lip and palate among races: a review. AB - A review of the literature pertaining to the incidence of cleft lip, cleft palate, and cleft lip and palate in different races is presented. The studies have been evaluated according to the method used to record the incidence rate. Half of the studies include in their base population livebirths, stillbirths, and abortions, or livebirths and stillbirths to record the incidence rate. In addition, in most of the studies, clefts with associated malformations and possible syndromes are included in the reported incidence. There is evidence, however, to suggest that the risk of developing clefts in stillbirths and abortions is three times as frequent as in livebirths and that clefts with associated malformations behave differently epidemiologically from clefts without associated malformations. It is suggested, therefore, that the incidence of cleft lip, cleft palate, and cleft lip and palate should be studied separately for each group, namely for livebirths, stillbirths, and abortions and should be reported separately for clefts without associated malformations, clefts with associated malformations, and syndromes. More research is needed to study the risk of developing clefts among the various groups that exhibit different epidemiologic behavior for each race. PMID- 3308179 TI - Thyroid function in leukaemia patients after allogeneic bone marrow transplantation. AB - The thyroid function of 29 patients who underwent allogeneic bone marrow transplantation preceded by total body irradiation was followed closely during four weeks after transplantation. Twenty patients showed a marked decrease of T3 and TSH levels, whereas T4 fluctuated. Long-term follow up from three to five years of the surviving 16 patients revealed a restoration of the T3 levels to normal, a slight increase in T4 levels and a doubling of the TSH levels. This indicates the necessity of a higher pituitary drive to maintain euthyroidism. One patient developed hypothyroidism. PMID- 3308180 TI - Determination of polyamines and metabolites in cerebrospinal fluid by isotope dilution mass fragmentography, and a clinical application. AB - Capillary gas chromatography and mass fragmentography was used to determine simultaneously 1,3-diaminopropane, putrescine, cadaverine, spermidine, spermine, isoputreanine and putreanine in cerebrospinal fluid. After addition of deuterium labelled analogs and acid hydrolysis, the compounds were isolated by adsorption onto silica and converted into their N-heptafluorobutyryl-methylesters. Quality control data and an application of the method are given. A patient harbouring an astrocytoma was monitored during chemotherapeutic treatment. PMID- 3308181 TI - Assay of oestrogen and progestin receptors in human meningioma cytosols using immunological methods. AB - Oestrogen (ER) and progestin receptors (PR) were assayed in human meningioma cytosol by radioligand binding assay with Scatchard plot analysis and by monoclonal antibody based enzyme immunoassays. For comparison, human breast cancer tissues were used. Results of both assays agreed very well. For human breast cancer, receptor levels assayed with both methods showed a highly significant (ER: r = 0.96; n = 74 and PR: r = 0.95; n = 19). Also for meningioma cytosols a good agreement was observed between the result of both assays. Thus, most meningiomas were devoid of ER but contained significant concentrations of PR. PR levels in meningioma determined with the enzyme immunoassay correlated well with those found by Scatchard plot analysis. After logarithmic transformation of the data the regression line was; PR(EIA) = 0.83 X PR(Scatchard) + 0.36 (r = 0.917; n = 24). The recognition of the progestin binder in meningioma by a monoclonal antibody against the progestin receptor is a further indication that progestin binding in meningioma occurs to a true receptor. PMID- 3308182 TI - Complement component C9 in Graves' disease. AB - C9, the terminal component of complement, is the key part of the membrane attack complex formed as a result of complement activation; it has also been reported to be an acute phase protein. Its potential role in Graves' disease has been studied by measuring plasma C9 concentrations using an automated two-site immunoradiometric assay employing monoclonal antibodies, whose binding to thyroid tissue has also been investigated. The plasma C9 concentration in patients with hyperthyroid Graves' disease (86.3 +/- 21.6 mg/l, mean +/- SD; n = 49) was significantly increased (P less than 0.001) compared with normal subjects (60.4 +/- 13.4 mg/l; n = 48). In contrast, the plasma concentration of C-reactive protein, a marker of the acute phase response, was not significantly different between the two groups. The plasma C9 concentration in patients with hyperthyroid Graves' disease decreased significantly (P less than 0.01) after treatment with antithyroid drugs (carbimazole or methimazole; n = 14), but not after radioactive iodine (131I) treatment (n = 18). Immunohistochemical staining demonstrated that monoclonal antibody to C9 bound to the basement membranes of thyroid follicular cells of Graves' thyroid tissue but not to normal thyroid tissue. Radiolabelled monoclonal antibody to C9 bound to membrane fragments prepared from thyroid glands from two patients with Graves' disease. We conclude that C9, and by implication the membrane attack complex, may be involved in the pathogenesis of Graves' disease. PMID- 3308183 TI - Calcitonin gene-related peptide and calcitonin in medullary thyroid carcinoma. AB - We have investigated the levels of serum calcitonin and calcitonin-gene related peptide (CGRP) in 35 patients with well-documented medullary thyroid carcinoma (MTC). Immunohistochemical investigations for calcitonin and CGRP have been performed on tumour tissue from 9 patients to clarify the cellular pattern of production. In four patients with aggressive disease, serum calcitonin and CGRP values have been monitored in relation to progression of disease after surgery. All 35 patients with MTC have elevated calcitonin and 26 elevated CGRP levels. Generally calcitonin values were found to be higher than those of CGRP, although the ratio of the two peptides varied from patient to patient. The immunohistochemical investigations corresponded with these findings, generally showing diffuse staining for calcitonin in MTC tumour-cells and only a small number of CGRP positive cells. Calcitonin and CGRP are produced by alternative processing of the common precursor gene transcript. Our results suggest that absolute values of either calcitonin or CGRP in serum have no direct relationship to aggressiveness of disease. Thus whilst serum CGRP measurements appear to be a useful additional marker for the disease, they can be considered to be only a useful adjunct to serum calcitonin as a marker for tumour progression. PMID- 3308184 TI - Determinants of thyroid volume as measured by ultrasonography in healthy adults in a non-iodine deficient area. AB - Thyroid volume was measured by ultrasonography in 50 healthy adults (25 males, 25 females, age 20-70 years) living in the non-iodine deficient area of Amsterdam. Thyroid volume was 10.7 +/- 4.6 ml (mean +/- SD, range 2.7-20.4 ml). No relation was found between thyroid volume and any of the following parameters: plasma TSH, T4, T3, thyroglobulin (Tg), urinary iodine excretion, tobacco and alcohol consumption. Thyroid volume in males (12.7 +/- 4.4 ml) was greater than in females (8.7 +/- 3.9 ml, p = 0.0014), but no sex difference was observed in the ratio of thyroid volume to body weight (males, 0.16 +/- 0.05 ml/kg; females 0.13 +/- 0.06 ml/kg; NS). Thyroid volume was positively related to body weight, but not to age. We conclude that the sex difference in thyroid volume is due to the difference in body weight between males and females. Lean body mass is presumably the most important physiological determinant of thyroid size in subjects living in a non-iodine deficient area. PMID- 3308185 TI - Gonadotrophin responses to GnRH pulses in hypogonadotrophic hypogonadism: LH responsiveness is maintained in the presence of luteal phase concentrations of oestrogen and progesterone. AB - LH pulse secretion changes during the menstrual cycle from a rapid regular pattern in the follicular phase to a slower and irregular pattern in the luteal phase. To determine whether the irregular LH pulse pattern in the luteal phase reflects altered GnRH secretion or altered pituitary responsiveness to GnRH, we gave low dose GnRH pulses (25 ng/kg i.v.) every 2 h or every hour for 10 or 12 d to three women with isolated GnRH deficiency. After 4 d of GnRH alone, oestradiol (E2) was given and after 6 d progesterone (P) was added to mimic the hormonal milieu of the luteal phase. LH and FSH were measured every 4 h throughout and also every 20 min for 6 or 12 h, before and after GnRH alone (day 0 and day 4), after E2 (day 6), and after E2 + P (day 10 and day 12). Both GnRH pulse frequencies resulted in a rapid increase in plasma FSH to peaks on day 4 (every 2 h) and day 2 and 3 (every hour). FSH concentrations then declined as plasma E2 rose to 50-80 pg/ml reflecting the selective inhibitory effect of E2 on FSH release. Plasma LH was also increased after the hourly GnRH injections and this regimen was associated with a more rapid rise in E2 reflecting follicular maturation. In contrast to the differences in mean hormone concentrations, administration of GnRH at both frequencies resulted in sustained one-on-one responsiveness of LH that was maintained in the presence of both oestrogen and progesterone at mid-luteal phase concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308186 TI - CV 205-502: a new long-acting drug for inhibition of prolactin hypersecretion. AB - CV 205-502, an octahydrobenzo(g)quinoline, is a new non-ergot long-acting prolactin inhibitor. The substance was given to 24 hyperprolactinaemic women for 7 d. The women were randomized to one of three dose regimens, 0.01 mg, 0.03 mg or 0.06 mg daily. Two patients in each group were given placebo. Frequent blood samples were obtained during days 1, 7 and 8. The prolactin levels in serum were depressed dose-dependently in all patients given active substance. In group 1 (0.01 mg) the dose was insufficient to induce normal serum prolactin levels except in one woman, while two women in group 2 (0.03 mg) and four in group 3 (0.06 mg) became normoprolactinaemic. The depressant effect on prolactin secretion lasted for 24 h in group 2 and 3. Side-effects were mild and transient. No change in blood pressure was observed. CV 205-502 was an effective and long acting drug for treatment of patients with hyperprolactinaemia in this short-term study and this new drug deserves investigation of its usefulness in long-term treatment. PMID- 3308188 TI - Gonadotrophin releasing hormone: from physiology to pharmacology. PMID- 3308187 TI - The plasma arginine vasopressin response to insulin-induced hypoglycaemia in children with short stature is related to age and the onset of puberty. AB - The plasma arginine vasopressin (AVP) response to insulin-induced hypoglycaemia was investigated in 27 children with short stature. None had diabetes insipidus. Six patients were excluded from further analysis because of hypothalamo-pituitary dysfunction. Of the remainder, 14 were prepubertal (Tanner 1) and seven were pubertal (Tanner 2-4). Both groups had similar height velocity retardation. There was a significant rise of AVP of 3.4 +/- 1.3 pmol/l at 30 min in the pubertal group (P less than 0.05) but no significant change in prepubertal patients. There was a significant relationship between chronological age and AVP response 30 min after insulin (r = 0.45, P less than 0.05) and a closer correlation between bone age and AVP response (r = 0.62, P less than 0.01). The data suggest that insulin induced hypoglycaemia does not reliably stimulate AVP secretion in children and that this response is related to age and pubertal stage. PMID- 3308189 TI - Evaluation of diagnostic criteria for Leydig cell tumours in adult men revealed by gynaecomastia. AB - Gynaecomastia caused by Leydig cell tumours (LCT) in adult men may appear a long time before clinical evidence of testicular swelling. To evaluate the diagnostic criteria for LCT, hormonal status was studied in 14 cases and compared with results of a control group (CG) and 10 men with idiopathic gynaecomastia (IG). The mean plasma T level was significantly (P less than 0.005) lower in LCT (16.7 +/- 1.7 SEM nmol/l) than in CG (23.0 +/- 1.3 nmol/l). However, individual plasma T levels were in the normal range in 9/14 LCT. The mean plasma E2 level was significantly (P less than 0.001) higher in LCT (204.9 +/- 27.6 pmol/l) than in CG (87.9 +/- 7.7 pmol/l). However, individual plasma E2 levels were in the normal range in 5/14 LCT. In LCT, neither means of basal gonadotrophin levels nor the gonadotrophin responses to LHRH were different from CG. The mean of the plasma T responses to hCG did not differ between LTC, CG and IG. However the mean of E2 peak responses appeared significantly (P less than 0.005) higher in LCT (735.3 +/ 103.4 pmol/l) than in CG (420.5 +/- 40.4 pmol/l). The mean of the E2 peak responses was significantly (P less than 0.001) lower in IG (196.5 +/- 33.4 pmol/l) than in CG. Likewise the mean of plasma E2 levels, measured on day three following hCG administration, remained significantly (P less than 0.001) higher in LCT (662 +/- 94 pmol/l) than either in CG (228 +/- 14 pmol/l) or in IG (158 +/ 25 pmol/l). On day 3 following hCG administration, there was no overlap in individual plasma E2 levels between either LCT and CG or LCT and IG. In all LCT, plasma beta-hCG levels were in the normal range. A testicular echogram, performed in 12 LCT, confirmed the presence of a palpable tumour in 10 and revealed an occult tumour in two cases. We conclude that normal plasma beta-hCG levels, a prolonged plasma E2 response to hCG and testicular echogram appear to be the best criteria for early diagnosis of LCT responsible for gynaecomastia in adult men. PMID- 3308190 TI - Acromegaly. AB - A personal series of 256 cases of acromegaly/gigantism seen over a 20-year period from 1963 is described. The insidious nature of the condition resulted in delay in diagnosis which was often made by a doctor when seeing the patient for an unrelated problem. Other features which commonly led to the diagnosis being made were headache, change in appearance, carpal tunnel syndrome, amenorrhoea and diabetes. The Hardy system for grading the radiological appearance of the pituitary tumour was used. Widely invasive tumours were not common but tended to occur in patients with younger age of onset and high GH levels. The occurrence of various symptoms and clinical features was noted and the changes resulting from reducing the GH level to normal. The incidence of hypertension, but not of coronary artery disease, is increased and the blood pressure may be reduced following successful treatment. The effects on the upper and lower respiratory tract are reported as well as sleep apnoea and problems associated with anaesthesia. Skin manifestations included sweating, pigmented skin tags, acanthosis nigricans and cutis verticis gyrata. In the skeletal system the incidence of kyphoscoliosis and osteoarthritis especially of the hip is reported: the question of hip replacement is discussed. Diabetes mellitus disappeared in most cases if the acromegaly was cured. In men but not in women the incidence of colloid nodular goitre was increased as was hyperthyroidism in middle-aged women. In two patients a parathyroid adenoma was present: hypercalcaemia was present in five additional patients, but the cause was not determined. The common occurrence of amenorrhoea in the younger women was noted, it was not always associated with hyperprolactinaemia, and often responded to successful treatment of the acromegaly. The association of acromegaly with hirsutism and galactorrhoea is confirmed. The incidence of impotence and loss of libid in the men is discussed: in a proportion of those in whom the acromegaly was cured, potency returned, but in a number depression occurred and what was believed to be psychogenic impotence persisted. Hyperprolactinaemia was found in 49 out of 151 patients with active acromegaly in whom the prolactin level was measured. Previous reports have indicated a doubling of death rates in acromegalics. In this series there were 47 deaths observed compared to 37.2 expected. The increased death rate was in women of all ages and in men under the age of 55, The increased deaths in the women were from cardiovascular and cerebrovascular causes and from breast cancer.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3308191 TI - Clinical usefulness of a highly sensitive enzyme-immunoassay of TSH. AB - Using a recently developed sensitive enzyme immunoassay (EIA) for TSH, serum TSH levels in normal subjects and patients with various thyroid disorders were measured. The minimum detectable concentration was less than 0.005 mU/l. An excellent correlation was observed between TSH values measured by EIA and by sensitive radioimmunoassay (r = 0.932). In 26 normal subjects, serum TSH ranged from 0.30 to 2.65 mU/l (geometric mean 0.97 mU/l). In 27 untreated hyperthyroid Graves' patients, serum TSH was detected in all but one, ranging from 0.005 to 0.19 mU/l (geometric mean 0.040). These values were proved to be specific for human TSH by absorption, recovery, cross-reactivity and dilution studies; non specific serum effects were also ruled out. In 10 patients with destructive thyroiditis, similar TSH values (0.005-0.20 mU/l, mean 0.032) were observed. However, no significant correlations between TSH and circulating thyroid hormone levels were observed in these thyrotoxic conditions. Furthermore, 9 untreated Graves' patients did not respond to a single i.v. injection of TRH. In 13 hypothyroid patients with hypothalamo-pituitary disorders, 10 had basal TSH levels of less than 0.4 mU/l, and TRH tests in five gave peak TSH values of more than 0.8 mU/l, which were associated with significant increases in serum T3. In three patients with Sheehan's syndrome, elevated basal TSH levels were observed. Two of them responded to TRH, but these TSH elevations were not associated with T3 increases. In conclusion, this sensitive EIA could measure TSH levels in most patients with thyrotoxicosis and central hypothyroidism. However, the true significance of these measured values needs to be elucidated by future studies. PMID- 3308192 TI - Orbital cobalt irradiation combined with retrobulbar or systemic corticosteroids for Graves' ophthalmopathy: a comparative study. AB - Combined therapy with systemic corticosteroids and orbital cobalt radiotherapy has been shown to be an effective treatment of severe Graves' ophthalmopathy. The potentially serious side-effects of large doses of systemic corticosteroids prompted us to evaluate the use of retrobulbar corticosteroids instead of systemic corticosteroids. Forty-four patients with active Graves' ophthalmopathy were given orbital cobalt irradiation (total dose 2000 rads) and retrobulbar methylprednisolone acetate (14 bilateral injections at 20-30 d intervals). The degree of ocular involvement and responses to treatment were evaluated by numerical scoring (ophthalmopathy index, OI) and clinical assessment. Excellent or good responses were observed in 11 out of 44 patients (25%), 24 (55%) showed slight responses, and no change was found in 9 patients (20%). The initial OI mean score was 5.9; the final score was 3.2, with a change of -2.7 (P less than 0.001). Regression or partial improvement was observed in most cases (35/44, 80%) with soft tissue changes, and in all 9 cases with sight loss due to optic neuropathy. Proptosis, corneal lesions and extra-ocular muscle involvement were less responsive, since regression or partial improvement was observed in 39% (12/31), 50% (8/16) and 31% (13/42), respectively. No major side-effects were observed. The effects of this type of therapy and those obtained by combined therapy with systemic corticosteroids and orbital radiotherapy were compared in two groups of 30 patients each, randomly assigned to either treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308193 TI - Modification of the interaction of human renin with different substrates by monoclonal antibodies. AB - The mechanism by which anti-renin antibody inhibits renin activity was studied by following the kinetics of the reaction with angiotensinogen or a low molecular weight synthetic substrate, tetradecapeptide (TDP). Two monoclonal antibodies (70 pM) inhibited the production of angiotensin I from angiotensinogen but they differed when hog TDP was used as a substrate. R3-47-10 partially and non competitively inhibited, whereas R3-36-16 stimulated the activity of renin. This is in contrast to the effects of the synthetic renin inhibitor, CGP 29 287, which competitively inhibits the enzyme activity with both substrates. These antibodies probably bind to the renin molecule on the flap which protects the active cleft. Angiotensinogen may be prevented from entering the cleft due to steric hindrance from bound antibody. However TDP, because of its smaller size may still be able to reach the catalytic site. In addition R3-36-16 might freeze the flap in an open position allowing a greater turnover of TDP whereas R3-47-10 may prevent the flap from fully opening and thereby hinder the reaction of TDP with the active site. PMID- 3308194 TI - Measurement of active renin by the 4G1 anti-human renin monoclonal antibody. AB - Three monoclonal human renin antibodies have been selected to settle two immunoradiometric assays of human plasma renin (IRMA). The first pair of antibodies 3E8-4G1 recognizes exclusively active renin (AR), as demonstrated by the lack of increase either of the number of AR molecules or the renin enzymatic activity, when plasma is set free of inactive renin (IR) by immunoaffinity chromatography with human renin prosegment monoclonal antibody. The second pair of monoclonal antibodies 4E1-3E8 gives results which are very significantly correlated to those obtained with the 3E8-4G1 pair after trypsin activation. The standardization of renin measurements with use of monoclonal antibodies, and the standardization of renin will allow the exchange of comparable informations between the various laboratories involved in the investigation of the renin angiotensin system in humans. PMID- 3308195 TI - Renal vein immunoreactive renin in patients with renal artery stenosis and essential hypertension. AB - In 36 patients with unilateral renal artery stenosis and in 24 with essential hypertension the plasma levels of total immunoreactive renin, and enzymatically active renin were measured in both renal veins (V) and in the aorta (A) by direct RIA by using monoclonal renin antibodies. Active renin and trypsin-activatable inactive renin were also measured by indirect RIA with angiotensin-I antibodies. The V/A ratio for the different forms of renin calculated from the results of direct and indirect RIA were not different. The V/A ratio of active renin for the kidney with the stenotic artery was 3.04 +/- 0.28 (mean +/- sem) with direct and 3.02 +/- 0.25 with indirect RIA. The contralateral ratio was 1.04 +/- 0.02 with the direct and 1.05 +/- 0.02 with the indirect RIA. In essential hypertension it was 1.28 +/- 0.04 with direct RIA and 1.28 +/- 0.04 with indirect RIA. Chronic treatment with captopril had no influence on this ratio in both patients groups. The V/A ratio of total immunoreactive renin was lower than that of active renin and this ratio had lost discriminative power for lateralization. This ratio was significantly greater than one on the affected side in renal artery stenosis but not contralaterally and in essential hypertension. This study shows that renin activity after trypsin-activation of plasma is an accurate measure of the total renin concentration, i.e. active renin plus prorenin. It also shows that a kidney with a stenotic artery secretes inactive renin, which is immunologically related to active renin and is likely to be prorenin. Direct RIA for measuring active renin is technically more simple than indirect RIA. Direct RIA however is somewhat less sensitive. For measuring the V/A ratio for active renin in patients with renal artery stenosis this can be overcome by stimulating the renin angiotensin system for instance by captopril. PMID- 3308196 TI - Comparative measurements of immunoreactive renin, plasma renin activity and angiotensin II in human plasma. AB - In human plasma samples we compared the values of renin activity, determined with a conventional enzymatic assay, with those of immunoreactive renin, determined with a new, direct immunoradiometric assay which employs highly specific monoclonal antibodies, and with those of angiotensin II; the comparative measurements of renin were carried out also in trypsin activated samples of nephric and anephric subjects. We found that, overall, there was a close relationship between renin activity and immunoreactive renin; however, this relationship was absent when the statistical analysis was restricted to plasmas with low or very low renin. We also found that, within a rather wide range of values, angiotensin II was more closely correlated with immunoreactive renin than with renin activity. Trypsin activation increased to a similar extent immunoreactive renin and renin activity in plasma of nephric and anephric subjects and, overall, the values of total renin obtained with the two assays were significantly correlated. The results of these comparative determinations indicate that, in general, the measurement of immunoreactive renin represents a valid alternative to that of renin activity and a reliable index of the activity of the renin-angiotensin system. In addition, studies with trypsin activation suggest that even in the anephric state human plasma contains an inactive enzyme convertible into an active form which has immunological properties similar to those of active renin. PMID- 3308197 TI - Immunoradiometric assay of active renin in human plasma: comparison with plasma renin activity. AB - The direct measurement of active renin with monoclonal antibodies (IRMA) in plasma from hypertensive patients was compared with the traditional PRA method. Two monoclonal antibodies were used: 3E8 and 4G1. The first was coupled to magnetizable beads and was used to trap both active and inactive renin from plasma. The second antibody, 4G1, was iodinated and used to detect active renin trapped by 3E8. The correlation coefficient between the two methods was very high (r = 0.98, p less than 0.001) in plasma samples whose PRA values were higher than 2 ng/ml/h; in low renin samples (PRA lower than 2 ng/ml/h) no significant correlation was found (r = 0.12 n.s.). When PRA and IRMA were performed before and after trypsin activation of inactive renin, the percentage of inactive over total renin was 86.8% and 84% as calculated with PRA and IRMA respectively. The direct monoclonal antibodies method for measuring active renin can be usefully adopted, in conjunction with the traditional PRA procedure, in studying both clinical and pathophysiological aspects of the renin-angiotensin system. PMID- 3308198 TI - A highly sensitive and reproducible immunoradiometric assay for total human renin using monoclonal antibodies, iodogen labelling and polystyrene star tubes. AB - A two-site immunoradiometric assay for total renin concentration in human plasma is described. A new type of polystyrene tubes with a special bottom geometry, so called Star Tubes were used. The lower limit of detection was 2 microIU per ml and the working range from 2 to 2000 microIU per ml. The variation for duplicate determinations on standards and plasma samples was 2.7% and the day to day variation was 4.8%. No significant interferences or cross reactivities were identified. EDTA-plasma was analyzed after dilution with a phosphate buffer. Plasma samples from different patient categories were analyzed. The results were compared with those obtained by our substrate enrichment method after acid activation of the samples had taken place. A linear correlation (r = 0.990) between the results obtained with the two methods was found. PMID- 3308199 TI - Potential functions of plasma prorenin; regional activation and tissue extraction. AB - The fate of circulating inactive prorenin was examined in patients and volunteers. Prorenin was activated either by acid-dialysis with warming at pH 3.3 or with trypsin. The results were similar but omission of warming reduced the value by 13%. In 6 volunteers, 20 min forearm venous occlusion raised regional total (T) and inactive (I) plasma renin concentration (PRC) by 51% and 48% without change of active (A) renin. During intense forearm exercise the ratio APRC: IPRC did not change in muscle or skin venous blood. Body anaerobic exercise increased APRC 3.7-fold without change in IPRC. These procedures activate plasminogen but are without effect on prorenin. In 18 patient with stable angina, TPRC was lower in coronary sinus than arterial blood (p less than 0.001) but APRC was not affected. A-V differences were not detected across the leg. Prorenin is apparently stable in the circulation but extracted by the heart. PMID- 3308200 TI - Ovarian prorenin. AB - We review here recent evidence that the ovaries synthesize and secrete prorenin and we explore the possible reasons why prorenin, and not active renin, is formed almost exclusively in this extra-renal site. Very high concentrations of prorenin are present in the human ovary in the fluid inside mature follicles. This ovarian prorenin appears to be secreted into the circulation since plasma prorenin increases in normal women for two to three days at mid-menstrual cycle, at the time of ovulation. No change in plasma active renin occurs at this time. Plasma prorenin increases much more at mid-cycle in women whose ovaries have been hyperstimulated with gonadotropins. Their mid-cycle increment in plasma prorenin (after hCG) is directly related to the number of ovarian follicles. Plasma prorenin also increases markedly (10-fold) in pregnant women within two weeks after conception, in parallel with the rise in endogenous hCG. The ovaries are the apparent source of the increase in plasma prorenin during pregnancy since no such increase occurred in a woman with ovarian failure who conceived after receiving a donor egg. These results suggest that the ovaries synthesize and secrete prorenin in response to stimulation by gonadotropic hormones. Future studies will investigate the potential role of ovarian prorenin in human reproductive function. We postulate the existence of a prorenin receptor which activates prorenin and, in consequence, activates a local renin-angiotensin system. The functioning of this system may be regulated by changes in prorenin and its receptor. PMID- 3308201 TI - Direct determination of plasma renin concentration during pregnancy: comparison with renin enzymatic activities. AB - A solid phase sandwich assay for human renin was used to determine the total renin concentration in plasma throughout the course of a normal pregnancy. These values were compared with the enzymatic activity of renin, with and without trypsin treatment. Plasma concentration of immunoreactive renin rapidly increased four fold from 214 +/- 33 pg/ml (in non-pregnant subjects) within a few weeks after conception and remained high up to the third trimester. Total renin concentration, estimated by trypsin-activated enzyme activity showed similar changes, both qualitatively and quantitatively. A positive correlation (r = 0.63, p less than 0.001) between immunoreactive renin concentration and its enzymatic activity was noted whereas the active renin concentration did not positively correlate with the immunoreactive renin concentration. These data indicate that solid phase sandwich assay for human renin should be a pertinent tool to elucidate the role of the renin-angiotensin system in pregnancy. PMID- 3308202 TI - Effects of chronic administration of a monoclonal antibody against human renin in the marmoset. AB - In this study, the hypotensive efficacy of R-3-36-16, a monoclonal antibody against human kidney renin, was investigated during chronic administration to a primate. R-3-36-16 was given by continuous intraperitoneal infusion with osmotic minipumps to normotensive marmosets fed a low-sodium diet in doses of 30 or 300 micrograms/kg/day for 14 days. The lower dose had no effect on blood pressure (BP) or plasma renin activity (PRA). After two days of treatment, the higher dose reduced PRA by 57% and lowered BP by 13 +/- 7 mm Hg. Although the hypotensive response persisted after 14 days of treatment (-17 +/- 2 mm Hg), PRA had recovered to pretreatment levels. BP gradually returned to pretreatment values in the week after stopping the treatment. There was no evidence of an immune reaction when an acute challenge dose of R-3-36-16 was given 7 weeks after stopping the chronic treatment. Thus, R-3-36-16 appears to be an effective and well-tolerated hypotensive agent during chronic administration to sodium-depleted primates. The hypotensive response does not seem to be directly related to the inhibition of renin in the plasma. PMID- 3308203 TI - Harold Wordsworth Barber. PMID- 3308204 TI - Memories of working with Howard Whittle 1946-1953. PMID- 3308205 TI - Multiple injection abscesses in a diabetic caused by Mycobacterium chelonei. PMID- 3308206 TI - Autoimmune sera recognize a 100 kD nuclear protein antigen (sp-100). AB - Autoimmune sera from patients suffering from undifferentiated connective tissue diseases (UCTD), Sjogren's syndrome (SS), primary biliary cirrhosis (PBC) and other disorders were found to contain antibodies that produce a distinctive nuclear spot pattern with HEp-2 cells in immunofluorescence studies. These spots which vary in size and number, are spread over the whole nucleus with the exception of the nucleoli. This pattern is easily distinguishable from the staining patterns of anti-centromere, anti-RNP, anti-nucleolar and anti-Scl-70 antibodies. In cells of non-human origin this pattern is discerned only at high serum concentrations. Immunoblotting experiments with a soluble protein fraction from HeLa nuclei revealed that the antigenic target common to all sera is a polypeptide of 100 kD with a pI value of about 5.2. The correlation between immunofluorescence and immunoblotting data was confirmed by affinity-purification of sp-100 specific autoantibodies followed by immunofluorescence experiments. PMID- 3308207 TI - Experimental autoimmune myositis in SJL/J mice. AB - Experimental autoimmune myositis (EAM), was produced in SJL/J mice by injection of an emulsion of crude syngeneic muscle homogenate and complete Freund's adjuvant (CFA). Nearly all injected SJL/J mice showed necrotic muscle fibres associated with infiltrating mononuclear cells, both within the necrotic fibres and in surrounding endomysial connective tissue. The disease in SJL/J mice was confined to skeletal muscle. Eight other mouse strains of different major histocompatibility types, similarly injected, failed to develop EAM. Direct immunofluorescence staining revealed prominent IgG deposition at the muscle cell membrane and in perimysial and endomysial connective tissue. This staining was present in both involved muscle of immunized SJL/J mice as well as in undamaged muscle from other immunized strains. Circulating anti-muscle antibodies as detected by indirect immunofluorescence staining of normal muscle were also present in both SJL/J mice and non-susceptible strains. An enzyme-linked immunosorbent assay (ELISA) was also developed for detection of serum anti-muscle antibody activity. Three strains of mice, including SJL/J, failed to develop significantly elevated anti-muscle antibody activity after injection of muscle and CFA, whereas six other strains that did not demonstrate histological myositis developed a 10- to 20-fold elevation of anti-muscle antibody activity. These results suggest that the ability to produce anti-muscle antibodies after immunization does not determine susceptibility to histological disease. Although EAM has been previously induced in other species, there have not been previous descriptions of this experimental disease in mice. This murine model may provide new insight into the immunopathogenesis of human inflammatory myopathies. PMID- 3308208 TI - Opsonization of yeast by human serum IgA anti-mannan antibodies and phagocytosis by human polymorphonuclear leucocytes. AB - The ability of sera from 72 patients with liver disease to opsonize yeast for phagocytosis by normal polymorphonuclear leucocytes has been studied. Seven showed defective opsonization. The opsonic activity of all but two sera was decreased markedly by heating at 56 degrees C for 1 h. When the two sera with heat stable opsonic activity were fractionated by gel filtration and by ion exchange chromatography, the activity copurified with IgA, not with IgG. The purified IgA, radiolabelled with 125I was shown to bind in a saturable manner to the yeast. Both sera had high levels of anti-yeast mannan IgA detected by an ELISA. In one case most of the anti-mannan activity was due to monomeric IgA, in the other it was dimeric. This was consistent with the observation of an apparent molecular weight of the opsonin of approximately 180 kD in one serum and 300-400 kD in the other. PMID- 3308209 TI - Transfer of maternal specific cell-mediated immunity to the fetus. AB - The extent of specific cell-mediated immunity was measured in 67 consecutive newborns and their mothers. The stimulation index of blast transformation of the infants' lymphocytes in the presence of purified protein derivative, Candida extract and streptokinase was greater than 2.0 in 54%, 18% and 23% respectively. This was seen only in infants whose mothers' index was also greater than 2.0 to the same antigen. Leucocyte inhibition factor generated from lymphocytes of four babies in the presence of purified protein derivative inhibited migration of indicator cells over 50%; their stimulation index with purified protein derivative was greater than 2.0. Newborns have cell mediated immunity to the same antigens as their mothers, and this wanes during the first few months of life. PMID- 3308210 TI - Suppression of delayed hypersensitivity skin reactions to tuberculin by M. leprae antigens in patients with lepromatous and tuberculoid leprosy. AB - Delayed hypersensitivity skin reactions to tuberculin when injected alone or in mixture with antigens of M. leprae were examined in leprosy patients and in healthy controls. The tuberculin reaction was significantly inhibited in more than one half of both LL and BT patients by the soluble extract of M. leprae (leprosin), the leprosin derived 12 kD protein or leprosin depleted of the 12 kD antigen. However, suppression was not found in healthy controls from a leprosy endemic region. These results suggest that multiple M. leprae-specific antigens have an immunoregulatory function. Since suppression was demonstrable not only in LL (leprosin-anergic), but also in BT (leprosin-responder) patients it is of interest that the 'mixed' skin test can discriminate the immune status of at least certain BT patients from that of the infected but self-healing healthy controls. Corollary lymphocyte cultures failed to show any suppression by leprosing of the lymphoproliferative responses to tuberculin. PMID- 3308212 TI - Monoclonal antibodies distinguish macrophages and epithelioid cells in sarcoidosis and leprosy. AB - Existing anti-macrophage monoclonal antibodies are unable to differentiate between macrophages and epithelioid cells. In search of more precise reagents, we have applied recently developed antibodies to lesions of sarcoidosis and leprosy. UCHM1 and Leu-M3 stained both granulomas and surrounding histiocytes. However, in lesions with epithelioid granulomas there was a clear distinction between cells identified by RFD9 (epithelioid and giant cells) and RFD7 (macrophages in the surrounding mantle and normal tissue), whereas macrophages in the non hypersensitivity granulomas of lepromatous leprosy were labelled by both the latter antibodies. In lung biopsies, alveolar macrophages were also labelled by both RFD7 and RFD9. These reagents may be useful for studying pathogenic mechanisms in granuloma formation. PMID- 3308211 TI - Immunological aspects of chronic active hepatitis. PMID- 3308213 TI - Regulation of the immune response in Plasmodium falciparum malaria: IV. T cell dependent production of immunoglobulin and anti-P. falciparum antibodies in vitro. AB - T cells from patients with acute Plasmodium falciparum malaria were investigated for induction of immunoglobulin- or anti-malaria antibody secretion in vitro. Stimulation of autologous T/B cell mixtures (2T:1B) with low concentrations of P. falciparum antigen and cultured for 12 days gave rise to a T-dependent IgG secretion which was significantly elevated over that in medium controls. This was achieved with both a crude P. falciparum antigen and a partially purified preparation enriched in Pf 155, a merozoite-derived antigen deposited in the red cell membrane at invasion (Perlmann et al., 1984). Control antigen (RBC ghosts) induced IgG secretion only when added at high concentrations (greater than 10 micrograms/ml). Neither of the antigens induced IgG secretion at concentrations of less than or equal to 10 micrograms/ml in control cultures of lymphocytes from patients with P. vivax malaria. Supernatants from cultures of P. falciparum patients frequently contained anti-P. falciparum antibodies when nanogram quantities (10-100 ng/ml) of either one of the two malaria antigen preparations was used for stimulation. No anti-P. falciparum antibodies were induced by the control antigen at any concentration. The induced anti-P. falciparum antibodies were directed to intracellular parasites and. at lower frequencies, to Pf 155 as detected on the surface of infected erythrocytes. The induction in vitro of anti P. falciparum antibodies appeared to be correlated with the presence of such antibodies in the sera of the lymphocyte donors. The lymphocytes of only one out of eight P. vivax patients responded to antigen stimulation by secreting anti-P. falciparum antibodies. However, this donor (but not any of the others), was also P. falciparum seropositive. Taken together, these results indicate that the induction of anti-P. falciparum antibody secretion reflects a secondary response in vitro of cells primed in vivo. The present experimental system should be well suited to map parasite antigen for their capacity to induce T cell dependent responses in P. falciparum malaria. PMID- 3308215 TI - Role of the pineal gland in immunity: II. Melatonin enhances the antibody response via an opiatergic mechanism. AB - The pineal gland constitutes a major neuroendocrine organ in the brain. It transduces exogenous signals such as circadian and seasonal variations of light and temperature into proper hormonal changes which adjust and adapt internal endocrine functions. These pineal activities seem to be exerted via circadian synthesis and release of the indoleamine melatonin, a neurohormone secreted by the pineal itself. Alteration of circadian rhythms have been associated with affective disorders, psychosomatic diseases, cancer and many other pathologies. We have reported that functional and pharmacologic inhibition of melatonin synthesis results in depressed immune functions in vivo and that exogenous, evening administration of melatonin enhances antibody formation via an antigen activated process and also antagonizes the immunosuppressive effects of corticosterone. We communicate here findings demonstrating that (a) three different inbred strains of mice possess a clear-cut cycle of melatonin levels in serum, (b) that melatonin administered in the evening enhances primary antibody response (IgM and IgG immunoglobulins) in vivo according to a dose-response behaviour and that (c) the opioid receptors blocker naltrexone antagonizes the immunostimulatory effect of melatonin. These findings point to a fundamental immunoregulatory role of circadian melatonin and to an activity of the neurohormone via opioid peptides. PMID- 3308214 TI - HLA-DR antigen expression on T cells from cerebrospinal fluid in multiple sclerosis and aseptic meningo-encephalitis. AB - HLA-DR expression on T lymphocytes in cerebrospinal fluid (CSF) from patients with multiple sclerosis (MS) and acute aseptic meningo-encephalitis (AM), and from blood only from healthy controls was examined by a new double immunofluorescence labelling assay using species-specific second layers on prefixed cell samples. Thirteen of 16 patients with AM (81%) had an elevated percentage of DR positive T cells in CSF against only two of 20 patients with MS (10%). Our data indicate that AM, an acute infection of the central nervous system (CNS), is accompanied by accumulation in CSF of activated, DR positive T cells as a reflection of actively involved cellular immunity within the CNS, while this accumulation of DR positive T cells is not seen in MS, a chronic inflammatory CNS disease, despite some of the patients being examined during clinical exacerbations. PMID- 3308216 TI - Dupuytren's contracture studied with monoclonal antibodies to connective tissue differentiation antigens. AB - Seventeen patients with Dupuytren's contracture underwent partial fasciectomy, and frozen tissue sections from the involved palmar fascia were prepared for binding studies with hybridoma-derived murine monoclonal antibodies (MoAb) recognizing connective tissue differentiation antigens. The two MoAb used were both generated using human sarcomas as immunizing agents, 23H7 known to bind to an antigen shared by selected sarcomas and carcinomas but not normal adult tissues except a subset of granulocytes, and 12C9 shown to recognize a common fibroblastic marker. MoAb 23H7 was discovered to bind to a subset of fibroblasts within the lesions of six of 17 patients with Dupuytren's disease. Occasionally it immunostained a single cell population associated with tissue granulocytes dispersed in the surroundings of the lesions. MoAb 12C9 was found to be expressed in only 12 of 17 specimens prepared from involved lesions from Dupuytren's disease. It is suggested that fibroblasts from selected patients with Dupuytren's contracture express a novel antigen, defined by MoAb 23H7, previously shown to be associated with human sarcomas and other neoplasia. The other fibroblast marker which is defined by MoAb 12C9 and known to be a common connective tissue antigen, is only occasionally expressed in lesions involved with this disease. Though additional markers associated with Dupuytren's contracture remain to be defined, the MoAb, capable of defining connective tissue differentiation markers, reported in this study may serve as new immunological probes for immunodissecting this syndrome into subsets of diseases which may better define the variety of clinical patterns presented by patients. PMID- 3308217 TI - Limiting dilution analysis of the human T cell response to mycobacterial antigens from BCG vaccinated individuals and leprosy patients. AB - The number of peripheral blood T lymphocytes responding to soluble mycobacterial antigens from Mycobacterium tuberculosis purified protein derivative (PPD) and M. leprae (MLS) was estimated by limiting dilution analysis. Antigen-induced lymphocyte activation was measured by means of [3H]TdR incorporation on day 10 of culture in the presence of suboptimal concentrations of interleukin 2 (IL-2). In the peripheral blood of BCG-vaccinated individuals from the UK, the frequency of T lymphocytes responding to PPD was 1.5 to 4 times greater than to MLS. Frequencies between 1/1970 and 1/13, 982 were observed in response to PPD and between 1/4097 and 1/24, 717 in response to MLS. A proportion of cells in the peripheral blood were also observed to respond to IL-2 only. The frequency of cells observed in limiting dilution analysis for PPD and MLS reflected the relative amounts of proliferation to these two antigens in bulk culture lymphocyte transformation tests. Use of PPD-specific T cell lines suggested that the responsiveness observed to M. leprae antigens in BCG-vaccinated individuals was due to cross-reactivity with antigens shared with M. bovis BCG. In tuberculoid leprosy, the frequency of peripheral blood T lymphocytes responding to M. leprae antigens was either greater than or similar to the frequency of T cells responding to PPD. In contrast, limiting dilution analysis of T lymphocytes from the peripheral blood of lepromatous leprosy patients revealed the complex regulatory heterogeneity of this group. In some patients M. leprae responsive T cells were detected in the presence of exogenous IL-2. PMID- 3308218 TI - Precipitating antibodies to rabbit thymus extractable antigens in chronic liver disease: relationship with anti-actin antibodies. AB - Using counterimmunoelectrophoresis (CIE), serum antibodies to rabbit thymus extractable antigens were detected in 15% (38/259) of patients with chronic liver disease (CLD) of various aetiologies and 33% (41/124) of patients with miscellaneous connective tissue diseases (CTD). A remarkable diversity of precipitating systems was apparent among cases with the two classes of disorders. All the five systems found in CLD (XR, XR2, SS-B, XR3, XR4) were associated mostly with immunological hepatic disorders. In the 52 autoimmune hepatitis cases, XR was mainly detected (29%), whereas in the 82 primary biliary cirrhosis patients the whole spectrum of reactivities was represented (XR: 11%, XR2: 10%, SS-B and XR3: 2% each, XR4: 1%). XR proved to be closely associated with smooth muscle antibodies (SMA, detected by indirect immunofluorescence on rat kidney sections) both qualitatively and quantitatively. Since all SMA positive sera with anti-actin specificity (SMAT, SMAG) were XR positive and purified actin could absorb out XR CIE reactivity, the hypothesis is made that a cross-reaction occurs between XR antigen and actin epitope(s). PMID- 3308219 TI - HLA-DR antigens on colonic epithelial cells in inflammatory bowel disease: I. Relation to the state of activation of lamina propria lymphocytes and to the epithelial expression of other surface markers. AB - The colonic epithelial expression of HLA-DR molecules and of other markers of cell membrane perturbation was investigated by immunofluorescence in biopsy specimens from patients with ulcerative colitis and Crohn's disease. It was found that in virtually all specimens from either groups showing active inflammation there was a diffuse epithelial expression of HLA-DR molecules. There was no relation between the grading of active inflammation and the epithelial expression of HLA-DR antigens. The epithelium of virtually all specimens from the macro and microscopically uninvolved areas of patients with active colitis and from patients with histologically quiescent colitis showed no detectable expression of HLA-DR molecules. The counts of isolated lamina propria lymphocytes expressing the transferrin receptor and the interleukin 2 receptor were higher in specimens with HLA-DR+ epithelium than in those with a HLA-DR- epithelium. Twenty-nine of the 35 (83%) HLA-DR positive specimens proved to express the 4F2 antigen on their epithelium and 19 (54%) were positive for the transferrin receptor. All sections positive for either the 4F2 antigen or the transferrin receptor were also HLA-DR positive while all HLA-DR negative sections were also negative for either of the two other markers. Data in this study suggest that in active IBD the epithelial participation in active inflammation is associated with a sequence of cell membrane rearrangements, and that the expression of HLA-DR molecules is a part of this sequence. PMID- 3308220 TI - CD5-positive B cells after T cell depleted bone marrow transplantation. AB - CD5 is an antigen normally found on T cells and on a minority subpopulation of B cells in fetal spleen and tonsil and on the majority of cells in B-chronic lymphocytic leukaemia. Recent reports described the occurrence of large numbers of CD5-positive B cells in the peripheral blood after bone marrow transplantation (BMT). We examined the peripheral blood for CD5-positive B cells in 21 patients who underwent allogeneic BMT for leukaemia with marrow first depleted of T cells using anti-T monoclonal antibodies and complement mediated lysis. Twenty-six samples were obtained from patients 24-644 days after BMT and examined for the existence of blood-borne CD5-positive B cells by immunofluorescence analysis microscopically and by flow cytometry. The number of CD5-positive B cells was consistently lower than 2%. The absence of CD5-positive B cells in this series may be due to the method of T cell depletion of the marrow or to methodological differences in the analysis of the cells. PMID- 3308221 TI - Origin of human mast cells studied by dual immunofluorescence. AB - Previous reports have suggested that mast cells derive either directly from basophils or mononuclear phagocytes, or from a common myeloid precursor. We have used monoclonal antibodies to investigate expression by normal human tissue mast cells of antigens characteristic of other haemopoietic lineages. We find that mast cells express panhaemopoietic markers, but not antigens typical of either myeloid or lymphoid cells. We propose, therefore, that mast cells form a distinct lineage, only distantly-related to other haemopoietic cells. PMID- 3308223 TI - The synovial membrane of healthy individuals--immunohistochemical overlap with synovitis. AB - The synovial membrane of healthy volunteers was analysed by immunohistochemical staining of biopsies sampled under direct vision at arthroscopy or obtained blindly by needle. Infiltrating Leu-4+ T lymphocytes were found scattered in all biopsies but frequently also perivascularly accumulated. A majority of the synovial lining cells expressed either the OKM1 monocyte/macrophage marker or HLA DR antigens. Some OKM1- HLA-DR+ lining cells also expressed the Leu-3a T 'helper' cell marker. In the sublining tissue non-lymphoid cells with varying morphology including macrophage- and fibrocyte-like cells were found expressing either HLA DR, or Leu-3a, or both antigens simultaneously, whereas OKM1+ macrophage-like sublining cells were rare. The perivascular T lymphocyte accumulation as well as the phenotypic heterogeneity of infiltrating and residing cells, previously thought indicative of synovitis, were thus also found in the synovial membrane of healthy individuals. PMID- 3308222 TI - Progress in the immunology of the mycobacterioses. PMID- 3308224 TI - Humoral response in Treponema pallidum-infected guinea pigs: I. Antibody specificity. AB - Young male inbred strain 2 guinea pigs were infected intradermally with 8 X 10(7) Treponema pallidum extracted from a rabbit orchitis, and 5 months later reinfected with 10(7) T. pallidum. Ninety percent of the animals developed symptomatic lesions after initial infection but none on challenge. Immunoblotting of sera obtained at intervals after infection or reinfection showed antibodies against T. pallidum antigen (TP), nonpathogenic treponemes--T. phagedenis biotype Reiter (TR), T. refringens strain Noguchi (TN), and T. vincentii (TV)--as well as normal rabbit serum (NRS) and normal rabbit testes extract (NRT). Antibodies reacting with TP were detected as early as 17 days (five polypeptides) and steadily rose (at 3 months 17 polypeptides were seen). Cross-reacting antibodies to TR, TN, TV, or rabbit proteins decreased within 3 to 5 months. After reinfection, the antibodies to NRS increased more sharply than the anti treponemal antibodies. Adsorption with TR and NRS of sera obtained after infection or reinfection produced a reduction of antibodies to TP by 75-87%. PMID- 3308225 TI - Malaria specific human T cell clones: crossreactivity with various plasmodia species. AB - Peripheral blood mononuclear cells (PBMC) from donors with or without previous exposure to malaria in vivo were cultivated for 4 to 7 days in the presence of different malaria antigen (M.Ag) preparations: Plasmodium falciparum (P.f.Ag), P. berghei (P.b.Ag) and P. gallinaceum (P.g.Ag). All preparations induced a proliferative response in PBMC from donors with or without previous exposure to malaria. PBMC from both groups of donors were then primed with each of the three M.Ag and cloned in presence of autologous irradiated PBMC and M.Ag. All 152 clones recovered had the T4+ phenotype and required autologous antigen presenting cells (APC) in addition to M.Ag for proliferation. Species specific and crossreactive T cell clones (T cell clones proliferating in the presence of the three M.Ag preparations) were recovered following priming with each of the three M.Ag. Species specific and crossreactive T cell clones were recovered in similar percentages (approximately 50%) using PBMC from donors with or without previous exposure to malaria. These data are discussed in the context of crossreactivity at the T cell level among various plasmodia species and in relation to epitope recognition of malaria native, synthetic and fusion polypeptides. PMID- 3308226 TI - Insulin autoantibodies, islet cell surface antibodies and the development of spontaneous diabetes in the BB/Edinburgh rat. AB - The presence of insulin autoantibodies (IAA) and islet cell surface antibodies (ICSA) was sought in two longitudinal studies, involving BB/Edinburgh rats of high (BB/E/H, n = 157) and low (BB/E/L, n = 61) susceptibility to diabetes development. Both studies were designed to correlate pancreatic morphology with cellular and humoral immunity. In Study I, groups of eight male and eight female non-diabetic rats of the BB/E/H line were killed at 15 day intervals from 30-105 days and plasma samples were obtained by cardiac puncture. In study II, 61 BB/E/H and 41 BB/E/L rats underwent pancreatic biopsy 1-3 times from 30 days of age until onset of diabetes or 150 days, plasma samples being taken from the tail vein at biopsy. Both studies revealed a higher prevalence for ICSA than IAA in BB/E rats. Whereas a highly significant association of ICSA with diabetes development was observed in study II (chi 2 = 8.30, P less than 0.005), IAA were associated with diabetes development only weakly (P less than 0.03, Mann-Witney U rank test). No correlation between the presence of ICSA and IAA in individual rats was observed and IAA were not significantly associated with BB/E/H in preference to BB/E/L rats, although positive IAA values were significantly elevated in the former compared with the latter (P less than 0.01). These observations support the concept that IAA form part of a background of heightened autoimmunity against which frank diabetes develops in some animals. PMID- 3308227 TI - Autoantibodies against cytoplasmic structures of neutrophil granulocytes in Wegener's granulomatosis. AB - Autoantibodies against cytoplasmic components of neutrophil granulocytes (ACPA) were detected in 18 of 32 patients with Wegener's granulomatosis (WG), but in none of the controls (n = 900), including patients with glomerulonephritis, sarcoidosis, tuberculosis, polyarteritis nodosa, and connective tissue diseases, and healthy blood donors. The presence and, to a lesser extent, the titre of ACPA correlated with the severity and activity of the disease. ACPA could be detected in only three of 11 patients with the limited form of the disease and in none in complete remission. In contrast, in all patients with active extensive disease, ACPA were present in a higher titre, and in most of the patients in partial remission (eight of 12) antibodies were demonstrable, especially in those with frequent relapses. Furthermore, the antibody titre correlated significantly with the C-reactive protein concentration (P less than 0.05), but with none of the other laboratory parameters. In conclusion, ACPA have proven to be a highly specific disease marker of great clinical significance that provides us with a useful tool to confirm, or even establish. the diagnosis of WG. PMID- 3308228 TI - Expression of MHC class I determinants on erythrocytes of SLE patients. AB - Strong expression of MHC Class I determinants had been observed on the erythrocytes of three genetically C4 deficient patients who all had SLE. In a study of 35 other SLE patients who were not C4 deficient, 30 showed a marked increase in the expression of MHC Class I on their erythrocytes. There was a correlation between the expression of erythrocyte Class I and disease activity. The polymorphic HLA determinants were detected by haemagglutination with human cytotoxic antisera from untransfused pregnant women. A shared monomorphic epitope of HLA-A, -B and -C, and beta 2-microglobulin were detected by haemagglutination with monoclonal antibodies. A monoclonal antibody for a monomorphic epitope on MHC Class II alpha and beta chains did not react. Erythrocytes from a group of RA patients and a group of normal controls had moderate and low expression respectively. We suggest that MHC Class I may be induced on erythrocytes maturing in a milieu containing mediators derived from activated cells of the immune system. Aberrant tissue expression of MHC antigens may be more widespread than has been previously recognized in diseases mediated by immune mechanisms. PMID- 3308229 TI - A monoclonal antibody to the surface membrane of human platelets which inhibits ristocetin- and collagen-induced platelet aggregation reacts with H1 histones of cell nuclei. AB - A murine monoclonal antibody HuPIA3, produced by immunization with human platelet membranes, reacted by radioimmunoassay with platelets, and inhibited ristocetin- and collagen-induced platelet aggregation and release of 14C-serotonin. The antibody also inhibited ristocetin-induced aggregation of washed, formaldehyde fixed platelets by von Willebrand factor. On cultures of human and rodent fibroblasts, and on frozen sections of rabbit liver and rat kidney, the antibody gave a diffuse, homogenous immunofluorescence staining of cell nuclei which could be abolished by treatment with 0.1 M HC1 or 2 M NaCl and restored by reconstitution with histones, suggesting a reaction with nuclear histones. Absorption of the antibody with histones abolished nuclear staining and abrogated the inhibitory effect of the antibody on ristocetin- and collagen-induced platelet aggregation and 14C-serotonin release. Conversely, absorption with platelets removed antibody reactivity for platelets and for cell nuclei. In addition, the antibody reacted with H1 histones by radioimmunoassay, and immunoblotting studies showed that the antibody reacted with a protein of 199,000 daltons on platelets and with H1 histones (31,000 dalton and 32,000 dalton). These observations suggest that the antibody recognizes epitopes found on surface molecules of platelets as well as on H1 histones of cell nuclei. PMID- 3308231 TI - Membranous glomerulonephritis and pregnancy. AB - The clinical courses of 33 pregnancies in 24 patients with biopsy proven membranous glomerulonephritis have been analyzed. Twenty-four percent (8) of pregnancies resulted in fetal loss, 43% (14) in premature delivery and 33% (11) in a live birth after 36 weeks gestation. Maternal renal function declined during pregnancy in 9% (3) of the pregnancies and in 46% (15) hypertension developed. In 55% (18) proteinuria increased significantly during pregnancy. In 30% (10) nephrotic range proteinuria was recorded in the first trimester. Presence of nephrotic range proteinuria during the first trimester correlated with both poor fetal and poor maternal outcome (p less than 0.0004 and p less than 0.0002, respectively). It is concluded that pregnancy in patients with membranous glomerulonephritis is associated with increased fetal loss and, in some instances, a worsening in maternal renal function. The literature on this topic is reviewed in relation to these findings. PMID- 3308232 TI - Renal response to volume expansion in heart-transplant and kidney-transplant recipients. AB - The renal excretion of an intravenous sodium load by ten heart-transplant recipients with (five patients) or without (five patients) moderate renal failure was compared with the results obtained in two matched control groups of ten kidney-transplant recipients with similar renal function. All patients were treated with prednisone and cyclosporine except, for the latter treatment, the kidney-transplant recipients without renal failure. A supplementary control group of five healthy subjects who did not receive any treatment was also included in the study. Fractional sodium and osmolal clearances were greater in heart transplant than in kidney-transplant recipients for both the patients with and the patients without renal failure. These two parameters were also greater in heart-transplant recipients without renal failure than in healthy subjects. Free water clearance was smaller in the heart-transplant recipients than in the corresponding control patients. Fractional potassium clearance was not different from group to group. These results demonstrate that heart-transplant recipients excrete a greater fraction of the filtered sodium load than their controls. This increased fractional excretion of sodium cannot be attributed to the cyclosporine treatment or the moderate chronic renal failure which both have been taken into account in the comparisons. The unchanged blood pressure during the saline load and the high or normal plasma renin activity levels in the heart-transplant recipients make it also unlikely that the exaggerated natriuresis was the consequence of the higher blood pressure observed in these patients. The chronic cardiac denervation which is the consequence of surgery in these patients could play a role in the mechanism of the saline diuresis. PMID- 3308230 TI - Splenic regulation of the murine pulmonary lymph node response. AB - Exposure to intratracheal immunization and aerosolization with soluble antigen plus murmayl-dipeptide (MDP) induces the development of plaque-forming cells in the pulmonary draining lymph nodes of two of three inbred mouse strains. Splenectomy before immunization led to a heightened plaque-forming cell response in the two responder mouse strains. Adoptive transfer of spleen cells from one strain exposed to sperm whale myoglobin via the respiratory tract revealed the presence of antigen-specific suppressor cells. These observations suggest that the spleen may play a role in the down-regulation of an immune response elicited in the pulmonary draining lymph nodes by exposure of the respiratory tract to soluble antigens plus MDP. PMID- 3308233 TI - Relation between biological IgA abnormalities and mesangial IgA deposits in isolated hematuria in childhood. AB - Indications for renal biopsies in isolated hematuria in childhood remain difficult to define. Their limitation to patients presenting with either a macroscopic or a familial hematuria [Trachtman et al. 1984] bears the potential risk of missing the diagnosis of IgA-associated nephropathies (Berger disease and Henoch-Schonlein nephritis) which may manifest themselves by microscopic hematuria only. In order to reevaluate the association between biological IgA abnormalities and mesangial IgA deposits, iterative and concomitant determinations of IgA plasma levels, of IgA immune complexes and of IgA production by lymphocytes in vitro have been performed over a one-year period in two groups of hematuric children presenting with mesangial IgA deposits (14 cases) or not (13 cases). The incidence of positivity of each test was significantly higher in the former group of patients than in the latter. However, the best discrimination between both groups was observed when the three tests were repeated and/or considered together (97% vs 15% of positivity). In Berger disease and Henoch-Schonlein nephritis, IgA immune complexes were the only IgA abnormality more frequently detected in patients presenting with hematuria than in patients presenting with no hematuria at the time of testing. It is proposed to add IgA abnormalities to macroscopic or familial hematuria as indications for renal biopsies in isolated hematuria in childhood. PMID- 3308234 TI - Asymptomatic low molecular weight proteinuria: studies in five patients. AB - Asymptomatic low molecular weight proteinuria, a disease recently reported by Suzuki et al. [1985], was found in five boys, two pairs of brothers and a sporadic patient aged 3 to 11 years. Their urinary proteins contained 56% to 67% of proteins of less than 40,000 mol wt, defined as low molecular weight proteins by Suzuki et al. [1985], an indication that proximal tubular reabsorption of these proteins is impaired in these patients. Their glomerular function tests and intravenous urography were normal. An attempt was made to identify urinary low molecular weight proteins in these patients, using Western blotting analysis of the protein bands separated by sodium dodecylsulfate polyacrylamide gel electrophoresis. All five proteins tested were detected: alpha 1-acid glycoprotein (mol wt 44,000), alpha 1-microglobulin (mol wt 33,000), retinol binding protein (mol wt 21,000), lysozyme (mol wt 14,000), and beta 2 microglobulin (mol wt 11,800). The latter two proteins had been identified in the disease by other means by Suzuki et al. [1985], while the other three were newly identified. Light microscopic studies of renal biopsy specimens from these patients revealed in three of four patients tested focal global or segmental glomerular sclerosis with scattered intratubular casts and focal tubular atrophy. Immunofluorescence staining of the renal biopsy specimens for the five proteins revealed some in the lumens of the proximal tubules and in the casts in the distal or collecting tubules, while only retinol-binding protein was found in the epithelial cytoplasm of the proximal tubules. PMID- 3308235 TI - Suspected infectious agent and host environment interactions in spondyloarthropathies. PMID- 3308236 TI - Do bacterial antigens persist in reactive arthritis? PMID- 3308238 TI - Position may reduce or stop pneumothorax formation in dogs receiving mechanical ventilation. AB - We have previously shown that in dogs with normal lungs, dependent placement of the puncture site reduced and/or stopped pneumothorax formation while breathing spontaneously. This experiment is now repeated in an acute injury model in dogs receiving either intermittent positive pressure ventilation (IPPV) or continuous positive pressure ventilation (CPPV). Pneumothorax was induced by percutaneous transthoracic insertion of a 20-gauge needle into the right lung. After a constant rate of pneumothorax formation was established (measured by evacuation of right pleural gas by chest tube), the dogs were alternated between 3 min with the puncture site up (left decubitus) or down (right decubitus). Only when the puncture was placed down did the rate of pneumothorax formation decrease (in every case), and this maneuver caused the leak to seal in 21 and 30% of the times with IPPV and CPPV, respectively. These results are consistent with the hypothesis that dependent placement of the puncture site allows reduction of both the alveolar size and alveolar to pleural pressure difference in the region surrounding the leak, thereby reducing and possibly stopping pneumothorax formation. PMID- 3308237 TI - Enhancement of lung colony formation by admixing irradiated with viable tumor cells: dependence on host status. AB - The study was designed to determine whether whole-body irradiation or stimulation of the reticuloendothelial system of mice influences the ability of heavily irradiated tumor cells to enhance formation of artificial metastases when given simultaneously with viable tumor cells. Experiments were performed with a nonimmunogenic sarcoma syngeneic to C3Hf/Kam mice. Whole-body irradiation augmented and stimulation of the reticuloendothelial system abolished the metastasis-enhancing effect of tumor cells. Another observation was that heavily irradiated tumor cells can enhance formation of metastases if given i.v. within several hours before or after i.v. injection of tumor cells. PMID- 3308239 TI - Hexose transport regulation in cultured fibroblasts derived from normal and type II diabetic patients. AB - The kinetics of saturable and nonsaturable sugar transport were studied in normal and Type II diabetic cultured skin fibroblasts under fast or slowly growing conditions. The Km of hexose transport for fast and slow-growing normal fibroblasts was 1.38 +/- 0.3 and 0.88 +/- 0.12 mM, respectively, while those of the diabetic fibroblasts were 1.57 +/- 0.29 and 0.8 +/- 0.19 mM, respectively. The respective transport Vmax for normal and diabetic fast-growing cells was 13.9 +/- 0.8 and 12.95 +/- 2.4 nmoles 2-DG/mg protein/min. For slowly growing cells of both groups, a transport Vmax of 11.5 +/- 2.4 and 11.3 +/- 1.7 nmoles 2-DG/mg protein/min was obtained. No significant differences were observed in the Km or Vmax of hexose transport under these various growth conditions between normal and diabetic cell cultures. Nonsaturable sugar uptake as determined by L-glucose or cytochalasin B inhibited 2-DG uptake was variable, but no significant differences were observed between the normal and Type II diabetic cells. The activation energies for saturable and nonsaturable sugar uptake were not different among the two donor groups. Insulin stimulation of hexose transport was studied in the presence and absence of dexamethasone (5 X 10(-6) M) at varying insulin concentrations. No difference was observed in the amount of insulin necessary to obtain a maximum stimulatory response (approximately 33 nM insulin in both groups). Also, the insulin concentration required to achieve a one-half maximal response was not significantly different in the donor groups (i.e., 3.53 +/- 0.6 nM for normals and 3.98 +/- 1.1 nM for diabetics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308240 TI - Inactive renin and aldosterone in Bartter's syndrome. AB - Studies of plasma samples of 3 subjects with Bartter's syndrome were compared to 8 subjects with other conditions. Despite high levels of active renin initially, with low levels of inactive renin, addition of either human nephrectomized plasma or sheep substrate not only increased active renin (by at least 3-fold) but also led to the appearance of large quantities of inactive renin (10-20 times the concentration originally present, much greater than the small increase seen with other plasmas). The activated inactive renin after substrate addition possibly had a larger and more variable molecular size (42,000-48,000) than normal inactive renin (42,500-44,500). Renin substrate in Bartter's plasma was present in similar amounts and had a normal or supranormal angiotensin generation rate with exogenous human renin. Bartter's substrate had a similar molecular weight (55,000) to that found in normal human plasma. The agent in the exogenous substrate preparations causing the increase in apparent active and inactive renin was not ultrafiltrable. However, an acidification procedure that destroyed exogenous substrate also removed the renin-increasing effect. Captopril increased renin but not aldosterone, while amiloride increased aldosterone but not renin. Neither agent improved serum potassium significantly in these patients on indomethacin. PMID- 3308242 TI - Prepared childbirth. PMID- 3308241 TI - Double blind randomized prospective trial of levamisole/placebo in stage I cutaneous malignant melanoma. AB - One hundred and fifty-six Stage I, Clark's Level III, IV, and V cutaneous malignant melanoma patients were randomized, 83 to Levamisole and 73 to placebo. One hundred and thirty-seven patients were evaluable. Their median follow-up time was 5 years. The 2 groups were comparable in terms of patient characteristics, except for a slightly higher percentage of Clark's level III in the placebo group (57.8 vs 52%). Severe toxicity leading to discontinuation of the medication occurred in 32 patients in the Levamisole arm, versus 10 in the placebo arm. Thirty per cent of patients receiving Levamisole have recurred in comparison with 26% of those on placebo treatment, and despite a trend in the delay of appearance of distant metastasis in the patients receiving Levamisole (30 months versus 9 months in the placebo patients), this drug does not appear to be effective in altering the disease-free survival or the survival of Stage I patients in the dosage schedule utilized in this study. PMID- 3308243 TI - Selection and use of local anesthetics. PMID- 3308244 TI - Epidural analgesia for labor and vaginal delivery. PMID- 3308246 TI - Anesthesia for cesarean delivery. AB - The available options for cesarean section anesthesia are spinal, epidural, and general anesthesia. Each method has been enhanced over the years to provide better operating conditions and increased maternal and fetal safety. The choice is made primarily by the requirements of the situation as each can be provided with nearly equivalent safety by today's obstetric anesthesiologist. PMID- 3308245 TI - Regional anesthesia, other than epidural, for labor and vaginal delivery. PMID- 3308247 TI - Invasive hemodynamic monitoring in the obstetric patient. AB - The pulmonary artery catheter, although initially used by internists and anesthesiologists, has recently entered the armamentarium of the maternal/fetal medicine specialist. Expertise in gaining central venous access and correct placement of the catheter is required. The physician should be familiar with the indications for its use in the obstetric patient, as well as the potential complications. With correct interpretation of the parameters obtained, the pulmonary artery catheter can be an invaluable aid in the management of the critically ill obstetric patient. PMID- 3308248 TI - Anesthesia for the parturient with pregnancy-induced hypertension. AB - The parturient with PIH presents several anesthetic challenges. The evaluation of each major organ system is necessary in formulating an anesthetic plan for each patient such that a healthy mother and baby is the end result. PMID- 3308249 TI - Anesthesia for the obstetric patient with cardiac disease. PMID- 3308250 TI - Resuscitation of the newborn. AB - The simple mnemonic ABCDE summarizes the five key principles of neonatal resuscitation: 1. Airway 2. Breathing 3. Circulation 4. Drugs 5. Evaluation of concurrent and causative problems and maintenance of a neutral thermal Environment. PMID- 3308251 TI - Anesthesia for nonobstetric surgery during pregnancy. PMID- 3308252 TI - Neuroendocrine processes relevant to the childhood years. PMID- 3308253 TI - Approach to evaluation of premenarchal child with a gynecologic problem. PMID- 3308254 TI - Bleeding and vulvovaginitis in the pediatric age group. AB - Vaginal bleeding and vulvovaginitis are common clinical problems in the pediatric patient. Careful attention to historical and physical findings usually can resolve the problem at the initial visit. Knowledge of the differential diagnoses -including bacterial, nonspecific origins, dermatologic, traumatic, foreign bodies, neoplastic, urologic, precocious pubertal, or exogenous steroid ingestion -allows the clinician to include all significant causes of vaginal bleeding in this age group. PMID- 3308255 TI - Benign and malignant tumors. PMID- 3308256 TI - Use of Y DNA probes to identify children at risk for dysgenetic gonadal tumors. PMID- 3308258 TI - Abnormalities of sexual differentiation: evaluation and management. AB - Normal male and female sexual differentiation begins with gametogenesis. Both male and female sexual differentiation follow a timetable of events with predictable development of the gonads, internal genital ducts, and the external genitalia. Completed sexual maturation occurs during the pubertal years. Abnormalities of sexual differentiation may occur at any step along the way. The abnormalities may result in abnormal differentiation of the gonads, the internal genital ducts, or the external genitalia. The end result of these abnormalities produces predictable clinical syndromes. While many of these defects of sexual differentiation are evident at birth, others will not be identified until puberty at which time the patient may manifest aberrant external maturation or may remain sexually infantile. Genital ambiguity in a newborn represents a true medical emergency. Early and expedient diagnosis is essential to avoid life-threatening crises, to determine sex-of-rearing, to provide for appropriate immediate and long-term treatment, and to assure that the family is provided adequate genetic counseling. Medical and surgical treatment should begin during the birth hospitalization and the child should leave the hospital with his or her external genitalia concordant with sex-of-rearing. Finally, the emotional well-being of the family unit requires appropriate education and ongoing counseling. PMID- 3308257 TI - Genital anomalies in childhood. PMID- 3308259 TI - Precocious puberty. PMID- 3308260 TI - The role of sonography in pediatric gynecology. AB - Sonography has a major role in the evaluation of children with gynecologic disorders. The size, consistency, and origin of pelvic masses and the status of the internal genitalia can be evaluated. Sonography is useful in evaluation of children with precocious puberty because it can demonstrate adult-size ovaries in true precocious puberty, which distinguishes this from premature thelarche and adrenarche. Specific causes of precocious sexual development such as adrenal and ovarian tumors and cysts also can be diagnosed. PMID- 3308261 TI - Androgen overproduction in the prepubertal female. PMID- 3308263 TI - Application of molecular genetics to pediatric gynecology. PMID- 3308262 TI - Rape, incest, trauma: the molested child. PMID- 3308264 TI - Primary malignant histiocytosis of the brain: a clinical, radiological and morphological study with cytological and immunohistochemical demonstration of atypical histiocytes. AB - Clinical, radiological and morphological findings in the case of a 79-year-old patient with a primary malignant histiocytosis of the brain are reported. The tumor was exclusively situated in the brain as proven by autopsy and was spreading on the inside of the lateral ventricles. The demonstration of atypical histiocytic cells in the CSF and the immunohistochemical demonstration of lysozyme, alpha 1-antitrypsin and alpha 1-antichymotrypsin which are typical for histiocytes, underline the histiocytic origin of the tumor. PMID- 3308265 TI - Microcystic meningiomas. AB - Four patients (two male and two female) underwent surgery for the removal of tumors with clinical and radiographic features typical of a meningioma. Despite an incorrect intraoperative frozen section diagnosis in two cases, the tumors were totally resected because the surgeon was convinced of the meningiomatous nature of the lesion. Subsequent histology revealed features of a microcystic meningioma and careful scrutiny of paraffin sections showed that each of the tumors contained occasional typical meningothelial cellular whorls which were a helpful diagnostic clue. Ultrastructural examination and the absence of GFAP confirmed the diagnosis. Close liaison with the neurosurgeon, on the part of the pathologist and an awareness of this unusual variant of meningioma should prevent misdiagnosis and inappropriate treatment of a potentially curable tumor. PMID- 3308266 TI - Cerebellar hemangioblastoma with prominent stromal astrocytosis: diagnostic and histogenetic considerations. AB - A cerebellar hemangioblastoma with atypical radiologic and morphologic features is reported. On computed tomography this tumor presented as a single ring enhancing mass in the right cerebellar hemisphere without adjacent cyst formation. It was radiologically indistinguishable from an abscess or malignant neoplasm. Postmortem examination demonstrated a circumscribed, cystic neoplasm arising in the pia at the base of a sulcus. Microscopically, the tumor contained a prominent astrocytic component that mimicked the appearance of a highly vascular astrocytoma. Hemangioblastomas with this degree of astrocytosis are unusual. They must be distinguished pathologically from both cystic astrocytoma and mixed hemangioblastoma-glioma (angioglioma). PMID- 3308267 TI - Congenital ependymoblastoma presenting as a sacrococcygeal mass in a newborn: an immunohistochemical, light and electron microscopic study. AB - We describe a case of congenital ependymoblastoma presenting as a subcutaneous mass in the sacrococcygeal area of a newborn male. The tumor was composed of primitive cells disposed in compact sheets and cords and exhibiting focal ependymal differentiation. No other line of cellular differentiation was identified by either immunohistochemistry or ultrastructural study. Elevated serum alpha-fetoprotein was found, which decreased following surgical extirpation of the tumor. We propose that this tumor had its origin in the ependymal medullary vestige, similar to other sacrococcygeal ependymomas. PMID- 3308268 TI - Polymethylmethacrylate fixation of osteochondral fragments in dog knees. AB - The usefulness of polymethylmethacrylate (PMMA) to secure small osteochondral fragments was investigated in canine knees. Small osteochondral free fragments were osteotomized from the medial femoral condyle of 16 dog knees. The fragments were then bonded back in place with various amounts of PMMA. After 13 months, the animals were killed and each knee was examined for healing and arthritis. All of the fragments revascularized and healed. Poor reduction and PMMA extending to the articular surface universally led to arthritis. Small localized spot bonds of PMMA seemed to yield better results than large amounts of surface attachments. PMID- 3308269 TI - Displaced proximal humeral fractures. Part I. Classification and evaluation. By Charles S. Neer, I, 1970. PMID- 3308270 TI - Evaluation and classification of shoulder instability. With special reference to examination under anesthesia. AB - Increasing knowledge of instability in the shoulder has created a more complex evaluation sequence. The history continues to be important. Many physical examination maneuvers are available to further define the problem. Routine roentgenographic examination has been extended to include views specifically designed to demonstrate subtle bony changes. Complex radiographic contrast studies, especially computed arthrotomography, can confirm most anatomic lesions. When surgical treatment is under consideration, reexamination under anesthesia is increasingly being recognized as an important, essential procedure. Arthroscopy will effectively identify pathologic lesions within the joint and confirm uncertain diagnoses. An organized sequence of examinations is necessary for a thorough clinical investigation. After the investigation is complete, a classification of the shoulder instability can be made that relates to the results of treatment. The classification includes the elements of etiology, volition, direction of instability, and degree of instability. PMID- 3308271 TI - Internal fixation techniques for proximal humeral fractures. AB - Operative treatment of proximal humeral fractures is performed with a variety of fixation techniques. Selection of the optimum device for fixation is dependent on anatomic considerations, fracture characteristics, surgical exposure, and biomechanical features of fixation devices. Fixation objectives are evaluated in light of Neer's four segment classification. An extended deltopectoral approach with release of anterior deltoid distal insertion as well as the proximal pectoralis major raphe provides a wide exposure. The approach heals rapidly and allows rapid rehabilitation. The shoulder fracture fragments are adaptable to tension band wiring. With loss of bone stock, tension band wiring becomes increasingly important because compression or shearing forces can be expended in the tendinous insertion of the fragments. Fixation principles are applied according to specific fracture patterns. Whatever the choice of fixation method, a protracted and vigorous rehabilitation program is essential to achieve maximal functional recovery. PMID- 3308272 TI - Management of tumors of the shoulder girdle. AB - The differential diagnosis of all painful shoulders includes tumors of a wide variety. Evaluation of a shoulder tumor has several areas in common with other musculoskeletal neoplasms, but the function of the rotator cuff is a key consideration in treatment goals. Thorough evaluation of patients with persistent pain requires not only routine radiography, but also radionuclide imaging, computed tomographic (CT) scanning, magnetic resonance imaging, and angiography. As with all tumors, the importance of the biopsy cannot be overemphasized. A poorly executed biopsy can make limb salvage impossible. Surgical treatment of shoulder tumors will depend on age, type of tumor, extent of tumor, and neoplasm aggressiveness. Though in some instances limb sparing is not possible, a variety of reconstructive options exists that will salvage the distal limb and obtain satisfactory surgical margins. PMID- 3308273 TI - Spontaneous regression of cardiac rhabdomyoma in tuberous sclerosis. AB - Life-threatening cardiac rhabdomyoma in a newborn infant regressed spontaneously within a 5 month period. Since cardiac surgery for rhabdomyoma is dangerous in infancy, medical management should be considered if symptomatology is not severe. When a fetal arrhythmia is diagnosed, antenatal ultrasound examination for presence of cardiac tumors is warranted. PMID- 3308274 TI - Ascites as a presenting sign of peritonitis in chronic granulomatous disease of childhood. PMID- 3308275 TI - Art, love, and facial beauty. AB - The author discusses female facial beauty through reference to works of art by Praxiteles, Rubens, and Rossetti. PMID- 3308276 TI - Neck contour deformities. The art, engineering, anatomic diagnosis, architectural planning, and aesthetics of surgical correction. AB - The best quality long-lasting results require attention to the diagnosis of the precise anatomic problems followed by the architectural planning--the art of making beautiful highlights, shadows, and curves where indicated to produce a result that is aesthetically pleasing. Attention to the details of the surgical planning, execution of surgery, and postoperative care are essential to minimize untoward results and problems and produce a happy patient and pleased surgeon. PMID- 3308277 TI - Surgical anatomy of the eyelids. AB - The key to precision surgery of the eyelids and orbital area is a complete knowledge of surgical anatomy. The author reviews the form and function of individual anatomic constructs as they pertain to surgery. PMID- 3308278 TI - The art of eyelid and orbital aesthetics: multiracial surgical considerations. AB - Contemporary philosophy on eyelid surgery mandates a totally new approach to orbital aesthetics and aesthetic surgery of the orbital region. This demands, first of all, that the aesthetics be defined and that the surgeon understand its ingredients, the potential for repair, and the close relationship between optimal function and optimal aesthetics. This revised approach results in enhancement of the quality of the operative repair and of patient satisfaction. PMID- 3308279 TI - Anatomy of aesthetic surgery of the nose. AB - The nose is divided anatomically into its component aesthetic parts. The preoperative examination of each of these parts, as well as techniques to modify them, have been reviewed. It is stressed that the nose is aesthetically more than the sum of its parts. No component may be completely ignored, because the result we strive for must take into account the effect of each upon its counterparts. PMID- 3308280 TI - Aesthetic anatomy of the non-Caucasian nose. AB - Aesthetic rhinoplasty in the non-Caucasian patient is a challenging operation, even to the experienced rhinoplastic surgeon used to operating on Caucasians. Only by thoroughly understanding the anatomic differences between the Caucasian and non-Caucasian nose can the plastic surgeon effectively manipulate the various structures to obtain an aesthetically gratifying result. The major differences in the internal and external anatomy of the Caucasian versus the non-Caucasian nose are described. PMID- 3308281 TI - Soft-tissue manifestations of aesthetic defects of the jaws: diagnosis and treatment. AB - Treatment planning for patients with dentofacial deformities should include a skeletal and a soft-tissue analysis. This article collates and summarizes several different soft-tissue analyses. In addition, it correlates the anticipated soft tissue profile changes with various skeletal and soft-tissue surgical procedures. PMID- 3308282 TI - Evidence for a direct action of exogenous insulin on the pancreatic islets of diabetic mice: II. Prolonged insulin therapy before islet isolation and perifusion. AB - 24 week old diabetic mice of the C57Bl/Ks (db/db) strain were treated with subcutaneous injections of Ultratard M.C. insulin at a dose of 40 mU/animal rising to 100 mU/animal after 12 weeks. The mean plasma insulin value was 146 +/- 20 microU/ml (n = 6). During this time, the mean body weight of the animals rose significantly (p less than 0.05) and the mean blood glucose concentration fell significantly (p less than 0.005) until a value 2-3 times normal was reached, the insulin dose was then adjusted empirically to maintain hyperglycaemia at this level. Pancreatic islets from these animals, untreated diabetic mice and normal (+/+) mice were isolated by collagenase digest and perifused with a modified Krebs-Ringer medium containing either 3 mmol/L or 15 mmol/L glucose. During glucose challenge, normal islets demonstrated the usual biphasic insulin response, but high glucose levels elicited no response from islets of untreated diabetic mice. Previous treatment of diabetic mice with insulin led to a restoration of the first phase of glucose mediated insulin secretion on perifusion and a significant increase (p less than 0.05) in the second phase. Such an improvement in beta-cell function in the face of prevailing hyperglycaemia, even allowing for the possible mediating effect of a 30% fall in blood glucose, was taken as further evidence for a direct action of exogenous insulin on the islets of diabetic mice. PMID- 3308283 TI - The effect of trauma and surgery on interorgan fluxes of amino acids in man. PMID- 3308284 TI - Acute effect of a thromboxane synthetase inhibitor on renal function in unanaesthetized sheep. AB - 1. Eleven healthy, unanaesthetized sheep were given either a single intravenous bolus infusion of U63,577A (Upjohn), a selective thromboxane synthetase inhibitor, at a dose of 30 mg/kg (group 1, n = 6), or vehicle alone (group 2, n = 5). Animals were maintained in metabolic cages during the study, and received 150 ml of water/h and 7.5 mmol of sodium/h as Ringers lactate by intravenous infusion for 24 h before and during the study. During two 1 h control urine collections via bladder catheter, urine volume and sodium excretion closely paralleled these infusion rates. 2. In the first hour after injection of U63,577A, there were significant two- to three-fold increases in urine volume, urinary sodium excretion and fractional sodium excretion, compared with the control collections. During the subsequent 4 h, urine volume, urinary sodium excretion, and fractional sodium excretion fell to values significantly lower than in the control period. Creatinine clearance was reduced 1, 2 and 4 h post injection and returned to control values at 5 h. Urinary excretion of thromboxane B2 was significantly reduced compared with control values during the 5 h after injection of U63,577A. Excretion of 6-keto-prostaglandin F1 alpha did not change. Plasma renin activity was significantly increased 1, 3 and 5 h after injection of U63,577A. Vehicle controls showed no change in any of the above parameters. 3. The results indicate that in healthy conscious sheep, sodium and water replete, U63,577A has a transient but significant diuretic and natriuretic effect, followed by sodium and water retention and increased plasma renin activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308285 TI - Erythrocyte cation fluxes during the menstrual cycle in normal female subjects. AB - 1. Studies of erythrocyte cation transport mechanisms in vitro were performed on eight normotensive, premenopausal female subjects at the mid-points of the follicular and luteal phases of their menstrual cycles. Concurrent plasma concentrations of 17 beta-oestradiol, progesterone, aldosterone and renin activity were measured. 2. Ouabain-resistant, frusemide-resistant rubidium influx (an index of passive potassium diffusion) was significantly lower in the luteal than the follicular phase. 3. In further studies in four of the eight subjects, the mean rate constant of the rubidium influx measurement was also lower in the luteal than in the follicular phase. 4. There were no changes in Na+-K+ co transport, sodium pump activity or intracellular cation concentrations throughout the cycle. 5. There was a tenfold fall in the mean plasma 17 beta oestradiol/progesterone ratio, as well as increases in plasma aldosterone concentration and renin activity between the mid-follicular and mid-luteal phases. 6. We conclude that changes in plasma oestrogen/progesterone ratio during the menstrual cycle may be associated with alterations in passive potassium diffusion. PMID- 3308286 TI - Enhanced diurnal variation of blood pressure in the renal hypertensive rat: effect of angiotensin II suppression. AB - 1. Chronic two-kidney, one-clip hypertensive rats were infused with captopril for 5 days and the daily variability of blood pressure compared with that for both hypertensive rats infused with glucose and normotensive animals. 2. Blood pressure was measured continuously using a computer data collecting system. 3. Normotensive animals showed a stable level of arterial pressure throughout each 24 h period with troughs occurring when they slept during the daytime. 4. Hypertensive animals given glucose had an enhanced diurnal rhythm of blood pressure compared with normotensive rats, with peaks occurring during periods of activity at night as well as troughs when they slept during the day. 5. Hypertensive rats given captopril retained this enhanced pressure variability, in spite of the fact that blood pressure was significantly lower and angiotensin II was suppressed. 6. These results suggest that angiotensin II is not involved in the increased blood pressure variability of renal hypertension and that some other irreversible mechanism is responsible. PMID- 3308287 TI - Decreased systemic formation of prostaglandin E and prostacyclin, and unchanged thromboxane formation, in alcoholics during withdrawal as estimated from metabolites in urine. AB - 1. The rates of secretion into the circulation of prostaglandin E, prostacyclin, and thromboxane A2 were estimated in male alcoholics on the third day of withdrawal and in control subjects by measuring appropriate metabolites in urine. 2. Urinary levels of tetranor-5,11-diketo-7 alpha-hydroxyprostane-1,16-dioic acid (the major urinary metabolite of prostaglandins E1 and E2), of 2,3-dinor-6-keto prostaglandin F1 alpha (the major urinary metabolite of prostacyclin) and of 6 keto-prostaglandin F1 alpha (the stable hydrolysis product of prostacyclin) were significantly different from the normal subjects in the alcoholic group. In contrast, 2,3-dinor-thromboxane B2 (the major urinary metabolite of thromboxane A2) and thromboxane B2 (the stable hydrolysis product of thromboxane A2) were not significantly different between the groups. 3. These data suggest that the ratio of the vasodilator prostanoids prostaglandin E and prostacyclin and the vasoconstrictor prostanoid thromboxane A2 is lower than in normal subjects, in alcoholics during withdrawal. This may be one causal factor for the higher incidence of hypertension observed in withdrawing alcoholics compared with control subjects. PMID- 3308288 TI - Bronchial hyper-responsiveness after human cardiopulmonary transplantation. AB - 1. Bronchial responsiveness to inhaled methacholine was studied in ten heart-lung transplant (HLT) recipients a mean 10.6 months (range 1.5-28 months) post-HLT and in ten normal subjects. 2. The mean provocation dose of methacholine producing a 20% fall in FEV1 (PD20 FEV1) was significantly lower in the HLT recipients (1.70 +/- 3.96 mg vs 11.55 +/- 3.79 mg; P less than 0.001), as was the mean provocation dose of methacholine producing a 50% fall in specific airway conductance (PD50 sGAW) (0.08 +/- 0.08 mg vs 5.13 +/- 5.47 mg; P less than 0.005). 3. These results establish the presence of significant bronchial hyper-responsiveness to inhaled cholinergic agonists in the transplanted lung. PMID- 3308289 TI - Practical application of monoclonal antibodies to the diagnosis and classification of acute leukaemias. PMID- 3308290 TI - Comparison of immunofluorescence and immunoperoxidase techniques for demonstration of phenotype and monoclonality in lymphoproliferative disorders. AB - To determine whether a simple immunoperoxidase (IP) technique could replace the traditional immunofluorescence (IF) technique (by fluorescence microscopy) for determination of phenotype and monoclonality in cell suspensions from patients with lymphoproliferative disorders, we tested samples from 48 cases by both methods, using small panels of antibodies designed to determine proportions of B cells, T-cells and cells bearing immunoglobulin light chains. There were 27 cases of chronic lymphocytic leukaemia (CLL), 6 of prolymphocytic leukaemia (ProLL), and 15 of non-Hodgkin's lymphoma (NHL). We found that IP was at least as reliable as IF in all cases. In the 47 B-cell cases, the mean proportion of cells apparently belonging to the malignant clone was higher by IP than by IF; conversely, the proportion of B-cells displaying the non-malignant light chain marker and the proportion of residual T-cells was apparently lower by IP. We conclude that IP is a useful and reliable technique for determining phenotype and monoclonality in lymphoproliferative disorders; because it is tolerant of delays to samples in transit and requires only simple facilities, it may be particularly suitable for small laboratories. PMID- 3308291 TI - Antimicrobial susceptibility tests and their role in therapeutic drug monitoring. AB - Principles and techniques of routine and special in vitro antimicrobial susceptibility testing of bacteria are reviewed with emphasis on the advantages, limitations, and potential problems of each method. The utilities of MBC testing and of serum bactericidal titer determination are discussed in the clinical context. The use of testing for possible antibiotic interactions is examined in light of potential benefits and risks of combination antimicrobial therapy. PMID- 3308292 TI - Monitoring aminoglycoside therapy. AB - The aminoglycoside antibiotics are indispensible therapeutic agents; however, a high incidence of toxic effects mandates that they be used with caution. In many patients, careful monitoring of serum concentrations is required. Because of their chemical characteristics, aminoglycosides are given parenterally except in certain well-defined clinical situations such as bowel preparation prior to surgery. The drugs act by interfering with microbial protein synthesis and are uniformly bactericidal. Plasmid-mediated resistance remains a problem, particularly in the hospital environment. Aminoglycosides find their most frequent use in infections caused by aerobic gram-negative bacilli. The pharmacokinetics have been well characterized, and an appropriate dosage regimen can be selected to achieve peak bactericidal levels while maintaining trough concentrations low enough to minimize toxicity. Monitoring of serum aminoglycoside concentrations is essential in many types of patients, such as those having compromised renal function, those receiving a maximum dose of the drug, the obese, the elderly, and patients with cystic fibrosis. Close cooperation between the clinical laboratory and all groups involved in the patient's care is necessary to make maximum clinical use of drug monitoring information. PMID- 3308293 TI - Chloramphenicol and vancomycin. AB - These two antibiotics have been important agents in the treatment of serious infections. Chloramphenicol use is decreasing owing to the potentially fatal toxicities associated with its use. Vancomycin use, on the other hand, is increasing owing to the emergence of methicillin-resistant staphylococci. It is important to routinely monitor serum concentrations of these drugs. An overview of the pharmacology and methods of analysis for each drug is presented in this review. PMID- 3308294 TI - Flucytosine (5-fluorocytosine). AB - Monitoring of flucytosine (5-FC) concentration in serum is of great importance. It may be anticipated that demand for this service will increase in the near future, because this drug is used in situations involving immunocompromised patients, including those afflicted with AIDS. PMID- 3308295 TI - Lithium monitoring. AB - Lithium is the drug of choice for treatment of mania and for long-term maintenance to prevent both depressive and manic episodes in bipolar disorders. A thorough knowledge of lithium is necessary for its safe and effective use. It must be used with caution owing to its narrow therapeutic range and significant toxicities. Patients should be screened prior to initiating lithium therapy. The drug-drug interactions must be appreciated, and it is recommended that the lithium concentration, thyroid function, and renal function be monitored in addition to the clinical progress. Blood samples for lithium monitoring should be obtained 12 hours after the evening dose. PMID- 3308296 TI - Monitoring cyclic antidepressants. AB - Therapeutic drug monitoring of antidepressants can ensure that a reasonable amount of drug reached the circulation, can aid in dosage adjustments for treating endogenous depression, can avoid toxicity, and aid in the diagnosis of drug-induced delirium. This article reviews the justification for antidepressant monitoring, discusses sample collection procedures, and presents guidelines for the interpretation of data. PMID- 3308297 TI - Newer cardiac agents: antiarrhythmics and antianginal agents. AB - This article has briefly summarized the physiologic effects, pharmacokinetics, adverse effects, drug interactions, and methods of analysis for the newer cardiac agents. Methods of analysis for these newer agents are primarily chromatographic types, such as gas-liquid or high-pressure liquid chromatography. Conspicuously absent from methods of analysis for these agents are the newer immunologic methods such as RIA or enzyme-linked assays. This deficiency in methodology is due to several factors. Cross-reactivity between metabolites and parent compounds is often a problem with antibody-based assays, and several of these agents have metabolites that reach concentrations equivalent to that of the parent drug. Several of the newer antiarrhythmics are structurally related not only to each other but also to older agents such as lidocaine. Overcoming this cross reactivity would be necessary before these assays could be used in patients being converted from intravenous lidocaine to the newer oral preparations. With the development of monoclonal antibody techniques, the need for close therapeutic monitoring of several of the drugs, and the increased emphasis on restraining costs in the clinical laboratory, the newer immunologic methods may soon be introduced in the United States. PMID- 3308299 TI - Antineoplastic drug monitoring. AB - The ability to monitor biologically significant levels of antineoplastic drugs in patients' plasma is rapidly expanding. The expanded application of therapeutic drug monitoring to the clinical practice of oncology will require a better understanding of the relationship between drug levels, toxicity, and therapeutic benefit in particular patient populations. PMID- 3308298 TI - Cardiac glycosides. AB - Despite continuous controversy associated with a variety of aspects of the pharmacology of the cardiac glycosides, it appears that these agents will continue to be widely used in the future. Current methods for the measurement of digoxin are unreliable and allow measurement of both cardioinactive metabolites of digoxin and endogenous digoxin-like substances. As a result, the therapeutic monitoring of digoxin concentrations should, for the most part, be limited to an assessment of patient compliance and confirmation of a clinical impression of drug toxicity. PMID- 3308300 TI - Laboratory detection of cannabinoids. AB - Cannabis, or marijuana, has been known and used as a drug for many thousands of years. Recent interest in drug abuse and detection has spurred the development of several methodologies for cannabinoid detection. These methods include immunoassays and chromatography. Laboratories routinely performing cannabinoid testing use two or more methodologies; the accepted method is to screen with one methodology and confirm by a second. These methodologies vary widely in sensitivity, specificity, and time required for analysis. Although therapeutic applications of cannabis constituents often produce undesirable side effects, two cannabinoids, delta 9-THC and nabilone, have been approved for use as antiemetics in chemotherapy. Further investigations of cannabinoid pharmacology and structure activity relationships may result in the development of promising new therapeutic agents. PMID- 3308301 TI - Detection of androgenic anabolic steroids in urine. AB - Virtually all professional and amateur sporting organizations forbid the use of androgenic anabolic steroids (AAS). The International Olympic Committee, United States Olympic Committee, and more recently the National Collegiate Athletic Association enforce the regulations by conducting urine testing. Over the past 3 years we have conducted about 8000 tests for AAS in urine and discovered several hundred positive cases. AAS when present in urine can be detected by screening and confirmatory tests using gas chromatography-mass spectrometry. PMID- 3308302 TI - Cyclosporine controversies. AB - Cyclosporine is a potent immunosuppressant with low myelotoxicity. It is approved for use to prevent rejection of kidney, liver, and heart transplants, and is being investigated for possible use for suppression of graft-versus-host disease in patients who have received bone marrow transplants. Although cyclosporine is generally thought of as an immunosuppressive agent for use in conjunction with transplantation, there are investigations underway that could result in wider applications. PMID- 3308303 TI - Monitoring of anti-inflammatory drugs. AB - Advances in analytic technology have allowed clinical laboratories to accurately measure plasma levels of NSAIDs. With the exception of salicylate, however, there is no relationship, or only a weak one, between plasma NSAID levels and clinical responses. Therefore, therapeutic drug monitoring of NSAIDs other than salicylate is of little value to clinicians in their management of patients with rheumatoid arthritis. On occasion, however, it may be helpful to monitor specific patients suspected of noncompliance by measuring plasma drug levels. Routine therapeutic drug monitoring of these NSAIDs must await further work on the refinement of quantitating clinical response and the possible relationship between free drug level and drug effects. PMID- 3308304 TI - Application of pooled monoclonal antibodies for 1-hr detection of respiratory syncytial virus antigen in clinical specimens. AB - A fluorescein isothiocyanate-conjugated pool of monoclonal antibodies (MoAb) to respiratory syncytial virus (RSV) was prospectively evaluated for its utility as a direct, 1-hr test for the diagnosis of RSV infection. Direct nasopharyngeal swab smears collected from 109 infants and children with acute respiratory illnesses were studied and compared with results obtained by indirect immunofluorescence using bovine polyclonal anti-RSV antibody on eluted cells derived from pooled nasopharyngeal and throat swab specimens (a 2.5-3 hr procedure), and culture. The MoAb-direct smear method was at least 86%-89% sensitive and 95%-100% specific compared with either of the other procedures. Additional prospective evaluations, as well as retrospective studies on a selected bank of slides stored from the preceding year, established that this MoAb could also be used with confidence in testing where direct smears are not employed. PMID- 3308305 TI - Disseminated Mycobacterium bovis infection in an elderly patient. AB - We report a fatal case of disseminated infection due to Mycobacterium bovis occurring in an elderly patient. The greatest incidence of tuberculosis is in the aged, who were likely to have been infected in childhood when the disease was more prevalent. However, the clinical or radiographic presentation of tuberculosis in the older patient may be atypical or nonspecific, contributing to delay in diagnosis, and greater morbidity and mortality. PMID- 3308306 TI - Haemophilus paraphrophilus brain abscess. AB - The clinical course of a patient with brain abscess due to Haemophilus paraphrophilus is described. The organism was recovered in pure culture from purulent material collected at surgery. The role of this organism as a human pathogen is reviewed. PMID- 3308307 TI - Evaluation of the Strep-A-Chek technique for presumptive identification of group A beta-hemolytic streptococci and group D enterococci. AB - Strep-A-Check (E-Y Laboratories, San Mateo, CA) is a 15-min chromogenic test for a species-specific aminopeptidase that could replace testing bacitracin susceptibility for presumptive identification of group A streptococci as well as 6.5% NaCl agar tolerance for presumptive identification of enterococcal streptococci, with a time savings of 24 hr. Recent clinical streptococcal isolates (n = 341), identified by conventional biochemical and serologic techniques, were used to evaluate the 15-min Strep-A-Chek test. Among the beta hemolytic streptococci (176 group A, 43 group B, 8 group C, 9 group F, and 9 group G), Strep-A-Chek was 100% accurate. Among the non-beta-hemolytic streptococci, 100% of 52 group D enterococci, 100% of 30 viridans streptococci, and 100% of 14 group D nonenterococci were correctly identified by Strep-A-Chek. Strep-A-Chek is an extremely rapid and reliable test for presumptive identification of group A and enterococcal streptococci. PMID- 3308309 TI - Comparative psychology--past, present, and future. PMID- 3308308 TI - Presumptive identification of group B streptococci by rapid detection of CAMP factor and pigment production. AB - Modified rapid versions of CAMP and pigment tests were developed for the identification of group B streptococci using the supernatant and cell deposit of organisms grown for 4 hr in a modified Todd-Hewitt broth. All but one of 203 group B streptococci were reliably differentiated from 148 nongroup B strains. PMID- 3308310 TI - Personality and epilepsy: new evidence for a relationship? A review. PMID- 3308311 TI - Contact dermatitis to a carotidian Doppler gel. PMID- 3308312 TI - Ultrasound for assessment of allergic and irritant patch test reactions. AB - The oedema formation of patch test reactions was quantified by high-frequency ultrasound measurement of skin thickness. Patch testing with nickel sulphate, nickel chloride and sodium lauryl sulphate 1, 2, 5 and 10% was performed in 12 individuals with known nickel allergy. Oedema was greater in allergic than in irritant reactions similar in strength according to the clinical reading. In allergic reactions, the oedema appeared more transcutaneous, while in irritant reactions, more superficial. For differentiation of the 2 types of reaction, application of substances for a 24-h period with measurements the following day is preferable. For rating of allergic and irritant reactions, 48 h of application is preferable with measurements performed on the day patches are removed. PMID- 3308313 TI - Development of metabolic alkalosis after massive transfusion during orthotopic liver transplantation. AB - Five patients undergoing orthotopic liver transplantation were investigated for changes in acid-base homeostasis secondary to large volume transfusions. All patients developed a transient acidemia during the operative period, followed by alkalemia which persisted into the early postoperative period. The patients received an estimated mean of 750 mEq of citrate, which appeared to cause metabolic alkalosis. The biochemical basis underlying the regulation of citrate metabolism that may have led to the timing, extent, and duration of the subsequent metabolic alkalosis is presented. Finally, the time course for the development of metabolic alkalosis may be a potentially sensitive indicator of early allograft function. PMID- 3308314 TI - A continuous flow intermittent mandatory ventilation with continuous positive airway pressure circuit with high-compliance reservoir bag. AB - Unstable inspiratory pressure may reduce the benefits of intermittent mandatory ventilation and impose a greater work of breathing than some patients can tolerate. The authors evaluated a continuous flow intermittent mandatory ventilation with continuous positive airway pressure apparatus provided with a 10 L high compliance reservoir bag, separated from the ventilator circuit by a one way valve. A pulmonary simulator was tested to generate a wide range of inspiratory peak flow rates. Pressures and flow rates were examined in different sections of the system, using PEEP levels up to 15 mm Hg and different fresh gas flow rates. The circuit offers many advantages, particularly considering the low inspiratory pressure drop and the low fresh gas flow rates needed for optimal function. PMID- 3308315 TI - Recent advances in pulmonary edema. PMID- 3308316 TI - Conventional and rapid methods for yeast identification. AB - Identification of yeasts depends on data obtained from morphological features and physiological characteristics. This article reviews the commonly used conventional methods for the identification of yeast to set the stage for a critical review of rapid systems for yeast identification. Comparative analyses of percentage agreement of API 20C, Uni-Yeast Tek, Minitek, Mycotube, Micro-Drop, Auxodisk, Iatron, Autobac 1, AMS, Abbott MS-2, and Abbott Quantum 11 against the conventional method and, in some cases, against each other are tabulated. Gas liquid chromatography method, enzyme method, MUG, and the Fung's mini-system are also mentioned as possible rapid methods for yeast identification. The purpose of this review is to update the rapidly expanding information concerning diagnostic kits and systems for yeast identification and analyze some of the advantages, disadvantages and potential uses of rapid systems of yeast identification. PMID- 3308317 TI - Pediococci and biotechnology. AB - Nomenclature changes of pediococci postdate the publication of Bergey's Manual. Pediococci possess both a "group" and a "type" antigen. They are gram positive, asporogenous, nonmotile, generally catalase negative, but may possess catalase like activity. The pediococci may have either a cytochrome or a flavoprotein enzyme system. Anaerobically they are homofermentative using the PEP:PTS and the EMP pathway. Catalase positive strains utilize glucose aerobically and anaerobically while lactose and glycerol are only used aerobically. Some pentoses are fermented to lactate and acetate. Absolute requirement for folinic acid and nearly all amino acids is observed. Pediococci grow luxuriously in All Purpose Tween (APT) broth and are isolated on Rogosa SL agar. Detection can be done by electrical impedance and fluorescent antibody techniques. The Arrhenius concept was utilized in selecting metabolically efficient strains. Antibiotics, antioxidants, some chloride salts and some spices are detrimental to the pediococci. On the other hand, some chloride salts, manganese, and some spices are stimulant. Dialysis-fermentation and immobilization of pediococcal cells were recorded. Some strains decarboxylate histidine to histamine. The resting cell metabolism and the production of bacteriocin have been utilized in antibiosis. An intra and intergeneric genetic transfer system of plasmids from pediococci was by a conjugation-like mechanism. Formation of bacteriocin and fermentation of carbohydrates were linked to plasmids. Lytic bacteriophages to pediococci have not yet been identified. Industrial cultures are mainly frozen concentrates. Linear equations were developed to model the fermentative activity of pediococci and the effects of environmental factors. PMID- 3308318 TI - Mechanisms of halotolerance in microorganisms. AB - Microorganisms have the ability to adapt to a wide range of NaCl concentrations. In general the NaCl tolerance shown by microbes far exceeds the salt tolerance of any other organism, procryote or eukaryote. There are at least three mechanisms available for adaptation to different salt concentrations. The first would be a passive one in which the cytoplasmic ion content would always equal that in the medium. A second mechanism which is used by many organisms involves concentrating compatible solutes to create an osmotic balance between the cytoplasm and the external environment. The third mechanism involves changing the cell physiology to control the movement of water allowing the cell to exist with an ionically dilute cytoplasm. This article will review the major developments and discuss the implications of increasing knowledge about salt tolerance in microorganisms. PMID- 3308319 TI - Vitrification of human islets of Langerhans. AB - Cryopreservation of human islets of Langerhans by vitrification was studied. Isolated islets were divided into four groups: (1) control islets which were cultured for 6 days, (2) islets which were vitrified after 2 days of culture, (3) control islets which were cultured for 10-13 days, and (4) islets which were vitrified after 6-9 days of culture. After warming, islets from groups 2 and 4 were cultured for 4 days. The thus treated islets were investigated with respect to insulin secretion in the presence of 2.5 or 25 mM glucose, capacity to survive during postwarming culture, and morphology. The insulin secretion in islets from all groups could be stimulated by an increase of the concentration of glucose from 2.5 to 25 mM. No significant differences were observed between the insulin secretions of the vitrified and control islets or between the islets vitrified after 2 and 6-9 days of culture. It is concluded that human islets of Langerhans cryopreserved by vitrification are functional in vitro. PMID- 3308320 TI - Gelling agents. AB - The characteristic physical properties of food gels result from the ability of certain proteins and polysaccharides to form continuous three-dimensional molecular networks. Development of new products based on gels, and improvements to existing ones, require a basic understanding of the intermolecular forces by which network cross-linkages are formed and stabilized. In this review new methods for studying food gels are described. The mechanisms by which molecular networks are formed by the gelling agents most frequently used by the food industry are discussed, with emphasis on the role of the solvent (water) and added solutes such as salts and sugars. More complex mixed gelling systems are discussed in some detail because of their practical importance and recent significant developments in this area. PMID- 3308321 TI - The chemistry and biological significance of saponins in foods and feedingstuffs. AB - Saponins occur widely in plant species and exhibit a range of biological properties, both beneficial and deleterious. This review, which covers the literature to mid 1986, is concerned with their occurrence in plants and their effects when consumed by animals and man. After a short discussion on the nature, occurrence, and biosynthesis of saponins, during which the distinction between steroidal and triterpenoid saponins is made, the structures of saponins which have been identified in a variety of plants used as human foods, animal feedingstuffs, herbs, and flavorings are described. Many of these compounds have been characterized only during the last 2 decades, and modern techniques of isolation, purification, and structural elucidation are discussed. Particular consideration is given to mild chemical and enzymatic methods of hydrolysis and to recent developments in the application of NMR and soft ionization MS techniques to structural elucidation. Methods currently used for the quantitative analysis of saponins, sapogenols, and glycoalkaloids are critically considered; advances in the use of newer methods being emphasized. The levels of saponins in a variety of foods and food plants are discussed in the context of the methods used and factors affecting these levels, including genetic origin, agronomic, and processing variables, are indicated. Critical consideration is given to the biological effects of saponins in food which are very varied and dependent upon both the amount and chemical structure of the individual compounds. The properties considered include membranolytic effects, toxic and fungitoxic effects, adverse effects on animal growth and performance, and the important hypocholesterolemic effect. A final section deals briefly with the pharmacological effects of saponins from ginseng, since use of this plant is increasing in certain sections of western society as well as being traditional in the Orient. PMID- 3308322 TI - Experimental induction of renal tumors. AB - Renal tumors have been reported to be induced by natural products, chemical carcinogens, viruses, or radiation. Species or strain specificity and sex also appear to play significant roles in their development. In man, it is also likely that the heredity existence of other diseases, smoking, food habits, and irradiation may be etiological factors. It also appears that hormonal, chemical, and other environmental factors can play a role. Nephrotoxin modifies two-stage chemical carcinogenesis in rat kidney. Some nephrotoxins without carcinogenicity promote the development of renal tumors in rats pretreated with subcarcinogenic doses of chemical carcinogens. The importance of nephrotoxin in development of renal adenocarcinomas needs elucidation. Preneoplastic lesions in the kidneys can be recognized by histochemical methods with specific antibodies. It is hoped that further research will be continued, so that data obtained from experimental work will provide a better understanding of the etiology and induction of renal cancer in man. PMID- 3308323 TI - Maternal toxicity of drugs and metabolic disorders--a possible etiologic factor in the intrauterine death and congenital malformation: a critique on human data. AB - Human data were searched to determine whether an association of metabolically or drug-induced maternal toxicity with congenital malformations and intrauterine death would be valid for the human species. Intrauterine death was found to occur in association with maternal homeostatic alterations resulting from phenylketonuria and diabetes, and with maternal toxicity from toxemia of pregnancy, leukemia, burns, alcohol, aminopterin, isotretinoin, and possibly trimethadione. A pattern of anomalies found similar (except for minor differences) and thus suggestive of a possible common cause, was observed among anomalies to phenylketonuria, diabetes mellitus, aminopterin, alcohol, warfarin, phenytoin, phenobarbital, trimethadione, valproic acid, and isotretinoin. The pattern usually consisted of deficiencies in pre- and postnatal development, mid facial hypoplasia, cleft palate, atrial or ventricular septal defects, patent ductus arteriosus, hypospadias, hernias, and other less frequent anomalies. The pattern is tentatively associated with alterations in maternal physiology resulting from phenylketonuria and diabetes; maternal toxicity of aminopterin, alcohol, and diverse factors co-occurring with warfarin use; and therapeutic doses (generally toxic in adults) of phenytoin, phenobarbital, trimethadione, and valproic acid. Whether these fetal malformations and intrauterine deaths would occur at nonmaterno-toxic levels of the above teratogenic agents, and, consequently, the strength of the associations could not be estimated for lack of data. However, human data seem to provide some, though weak, support and not to contradict the previous assumption formulated from animal studies that maternal toxicity may be causally related to fetal malformations and embryo-fetal mortality. PMID- 3308324 TI - Cell patterning in vertebrate development: models and model systems. PMID- 3308325 TI - Changes in intermediate filament composition during neurogenesis. PMID- 3308326 TI - Plasmalemmal properties of the sprouting neuron. PMID- 3308328 TI - Synapse formation in retina is influenced by molecules that identify cell position. AB - Molecules that identify cell type and position in the nervous system were detected by monoclonal antibodies. One molecule, TOP, is distributed in a 35-fold topographic gradient from the dorsoposterior margin to the ventroanterior margin of avian retina. The gradient is present in young embryos, increases with retinal growth, and persists in the adult. TOP molecules are present on most or all cells of retina. The number of TOP molecules detected per cell varies continuously along the axis of the antigen gradient. Thus, TOP can be used to identify position in the plane of retina along that axis. Other antigens that identify cell type and position across the thickness of retina also were detected. Molecules that mark such cellular organization may represent a neuronal recognition system. Antibodies were used to examine the role of markers of cell position in development of the nervous system. Antibody to TOP from hybridoma cells that were injected into in vivo embryo eyes diffused into the retina and bound in a topographic gradient of Ab.TOP complexes. Synapse formation in retina was inhibited in the presence of anti-TOP antibody. This suggests that TOP is involved in synapse formation and that recognition of position by neurons is necessary for normal synapse formation. PMID- 3308327 TI - Monoclonal antibody approaches to neurogenesis. PMID- 3308329 TI - Axon-target cell interactions in the developing auditory system. PMID- 3308330 TI - Position-dependent cell interactions and commitments in the formation of the leech nervous system. PMID- 3308331 TI - Neural reorganization and its endocrine control during insect metamorphosis. PMID- 3308332 TI - Development of the noradrenergic, serotonergic, and dopaminergic innervation of neocortex. PMID- 3308333 TI - Roles of cell lineage in the developing mammalian brain. PMID- 3308334 TI - The insect nervous system as a model system for the study of neuronal death. PMID- 3308335 TI - Self-induced trauma to the nails. AB - Both frequent and rare deformities of the nails have been reported that are due to self-inflicted damage. Some of these disorders may be confused with common diseases such as psoriasis, lichen planus, onychomycosis, or industrial injury. Awareness of the common patterns, inspection of the periungual tissues, observation of the patient's attitude toward his or her nail disorder, and inclusion of self-trauma in the differential diagnosis will lower the incidence of ineffective treatments and unnecessary laboratory tests. PMID- 3308336 TI - The treatment of alopecia areata. AB - Alopecia areata has an unpredictable course that is not easily altered by treatment. Different treatments will provoke regrowth of terminal hair to a variable extent but may not prevent further hair loss. Corticosteroids are the most popular form of treatment and can be given topically, intralesionally, or, in rare cases, systemically; they work best by intralesional injection of long acting steroid suspensions. Minoxidil has had limited success in stimulating hair regrowth without altering the course of alopecia areata. Short-contact anthralin therapy has also showed promise, especially in children. Other forms of treatment described herein include contact sensitizers, phototherapy, and immunomodulators such as inosiplex, cyclosporine, and nitrogen mustard. PMID- 3308338 TI - [Effect of injuries on the development of the stomatognathic system in children and adolescents--a review of the literature]. PMID- 3308337 TI - [Effect of an adhesive gel toothpaste Solcoseryl on wound healing after periodontal surgery. Multicenter comparative study on the adhesive gel toothpaste Solcoseryl and the Peripac preparation]. PMID- 3308339 TI - [Prosthetic appliances used by individuals over 50 years of age in the province of Lublin]. PMID- 3308340 TI - [Is augmentation of the alveolar portion of the mandible with a rib transplant still a good method of preprosthetic surgery?]. PMID- 3308341 TI - [Trials of use of xylitol in the prevention of caries and periodontal disease]. PMID- 3308342 TI - [Pages from the history of dentistry]. PMID- 3308343 TI - A controlled trial of ambroxol in chronic bronchitis. AB - Ambroxol is a mucolytic agent which is widely used in chronic bronchitis in Europe. We conducted a double-blind randomized controlled trial of ambroxol vs matched placebo in 90 patients with chronic bronchitis and difficulty clearing secretions. It was concluded that there was no advantage to taking ambroxol. PMID- 3308344 TI - Nasal continuous positive airway pressure in atelectasis. AB - Nasal continuous positive airway pressure (CPAP) has been widely and safely used in the treatment of sleep disorders but has not been previously utilized for therapy of pulmonary atelectasis in adults. We observed three patients with significant atelectasis which was refractory to conventional chest physiotherapy. Bronchoscopy was not a viable therapeutic option in any patient. Therapy with continuous nasal CPAP was initiated at 10 to 15 cm H2O. The patients tolerated the therapy well and had prompt resolution of atelectasis. Nasal CPAP may be an effective modality for therapy of pulmonary atelectasis in spontaneously breathing patients, particularly when conventional therapies are not tolerated or are ineffectual. PMID- 3308345 TI - Amiodarone-associated pulmonary fibrosis. Evidence of an immunologically mediated mechanism. AB - A case of pulmonary fibrosis attributed to amiodarone was studied immunologically and morphologically. A specific antibody of the IgG class was identified in the serum of this patient which reacted with the patient's own lung tissue. The immunoglobulin did not react with normal lung tissue nor was there evidence of reaction with lung tissue from patients with pulmonary fibrosis but without a history of amiodarone therapy. The patient probably developed a humoral antibody response to a lung-amiodarone complex with the amiodarone acting as a hapten which bound in vivo to the lung tissue. The subsequent antibody-antigen reaction stimulated a proliferation of pulmonary fibroblasts and probably enhanced the fibro-collagen deposition in the lung. PMID- 3308346 TI - Combined therapy with dobutamine and amrinone in severe heart failure. Improved hemodynamics and increased activation of the renin-angiotensin system with combined intravenous therapy. AB - The hemodynamic and hormonal responses to dobutamine alone and with the addition of amrinone were studied in ten patients with severe heart failure. Dobutamine significantly increased heart rate, cardiac index, and stroke volume index and significantly decreased mean right atrial and systemic arterial pressures and systemic and pulmonary vascular resistance. The addition of amrinone further decreased significantly mean right atrial, pulmonary arterial, and pulmonary arterial wedge pressures and systemic vascular resistance, while heart rate rose. The response of the cardiac index was variable, increasing in seven and decreasing in three patients. Plasma renin activity rose significantly with dobutamine and further increased with amrinone. We conclude that in most patients with severe heart failure, amrinone, when combined with dobutamine, improves hemodynamics. The further increase in heart rate, variable effects on the cardiac index, and marked activation of the renin-angiotensin system suggest caution and potential limitations in the use of this combination. PMID- 3308348 TI - Pulmonary cryptococcosis in AIDS. AB - Cryptococcus neoformans is emerging as an important etiologic agent of disseminated infection in patients with the acquired immunodeficiency syndrome (AIDS). Little attention has been placed on the pulmonary expression of this systemic infection. We report five patients with AIDS and cryptococcosis with primary pulmonary involvement. Patients usually presented with fever, cough, dyspnea, and pleuritic chest pain. Chest x-ray findings varied from localized and diffuse infiltration to lymphadenopathy and pleural effusions. All patients developed disseminated disease despite antifungal therapy. Pulmonary cryptococcosis is a frequent presentation of this infection in patients with AIDS. PMID- 3308347 TI - Preliminary observation of speech disorder in obstructive and mixed sleep apnea. AB - Clinical observation suggested that speech disorder seemed to be associated with sleep apnea. We recorded a standard speech sample from 39 matched subjects in three groups, 13 sleep apnea individuals, 13 subjects with COPD, and 13 subjects without sleep apnea or COPD. Three speech pathologists in a single blind listening task of the recorded samples judged whether or not speech disorder was present. Eight of the sleep apnea subjects were judged to have disordered speech compared to three of the COPD group and one of the non-sleep apnea, non-COPD (normal) group. These results were statistically significant. This supports a clinical impression that speech disorder is more common in sleep apnea than expected. There may be common anatomic and physiologic disturbances present between the two conditions, and perhaps disordered speech is a sign of sleep apnea. PMID- 3308349 TI - [Surgery of the trachea and bronchi]. PMID- 3308350 TI - [Interventions on the lung and mediastinum]. PMID- 3308351 TI - [Primary infrapapillary leiomyosarcoma of the duodenum]. AB - The primary infrapapillary leiomyosarcoma of the duodenum is very rare. In spite of the rarity and often uncharacteristical symptomatology of these tumors the knowledge of the clinical symptoms and diagnostical possibilities is for all the greater importance, because a radical operation with good late results is possible at early recognition. PMID- 3308352 TI - [Tissue expander in breast reconstruction. Experiences and results with more than 300 expanders]. PMID- 3308353 TI - [Technics and pitfalls of the endorectal echography in rectal tumors]. PMID- 3308354 TI - [A 100 years of appendectomies (1887-1987)]. PMID- 3308355 TI - [Prophylactic uses of antibiotics after gynecologic surgery]. PMID- 3308356 TI - [Effects of low-dose aspirin on platelet aggregation and the biosynthesis of PGI2 and TXA2 in patients with coronary heart disease]. PMID- 3308357 TI - [Advances in Doppler echocardiography]. PMID- 3308358 TI - [Pulmonary arterial hypertension in portal hypertension]. PMID- 3308359 TI - [Myelodysplastic syndromes]. PMID- 3308360 TI - [Recent advances in research on cryptosporidiosis]. PMID- 3308361 TI - [Watershed infarcts in the brain]. PMID- 3308362 TI - [Epidemiological features of residual infection foci of filariasis in controlled areas and purifying measures]. PMID- 3308363 TI - [Radioactivity of cigarette smoke and lung cancer]. PMID- 3308365 TI - [Ultrasonography in the diagnosis of hepatic metastases]. PMID- 3308364 TI - [Clinical significance of the measurement of the portal venous system by ultrasonography]. PMID- 3308367 TI - [An evaluation of traumatic renal lesions with ultrasonography]. PMID- 3308366 TI - [Use of ultrasonography in the diagnosis of thyroid nodules]. PMID- 3308368 TI - A randomized study on hemorrhoidectomy combined with anal dilatation. AB - Forty patients with third-degree hemorrhoids were randomized in two groups. Seventeen patients had a Milligan hemorrhoidectomy combined with anal dilatation and 23 had hemorrhoidectomy only. Anal manometry was carried out preoperatively at three, six, and 12 months postoperatively. Maximum resting pressure decreased significantly in both groups after surgery, although a small increase in maximum resting pressure was noticed after six months. A significant decrease in anal pressure was measured in both groups after one year. After one year, three patients in the dilatation group had minor degrees of incontinence compared to none in the nondilated group. In both groups three patients complained of recurrent symptoms of hemorrhoids. It is concluded that the combination of hemorrhoidectomy and anal dilatation does not improve cure rate compared to hemorrhoidectomy alone, but may increase the risk of continence disturbances. PMID- 3308369 TI - Peutz-Jeghers polyposis associated with carcinoma of the digestive organs. Report of three cases and review of the literature. AB - Three cases of Peutz-Jeghers polyposis with carcinoma of the digestive organs are studied. Although mucocutaneous pigmentation was not present in two of the three patients, the features of intestinal polyposis are consistent with those of Peutz Jeghers syndrome. One patient had a carcinoma of the pancreas and the other two had carcinomas with colonic Peutz-Jeghers polyps. Previous reports on carcinomas associated with Peutz-Jeghers syndrome are reviewed. An unusual location in the gastrointestinal tract, together with occurrence at an early age, characterize the carcinoma in Peutz-Jeghers syndrome. In Japanese patients, the large bowel is the site of the greatest number of carcinomas. On the other hand, Western patients showed a relatively even distribution. A possible surveillance protocol for early detection of gastrointestinal carcinoma in patients with Peutz-Jeghers syndrome is discussed. PMID- 3308370 TI - Mesenteric panniculitis of the sigmoid colon. Report of two cases. AB - Mesenteric panniculitis is an extremely rare disease in which the normal fatty architecture of the mesentery is replaced by fibrosis, necrosis, and calcification. Grossly, the mesentery is massively thickened and rubbery, with irregular areas of reddish-brown to pale yellow foci resembling fat necrosis scattered throughout. Microscopically, inflammatory involvement of the fibroadipose tissue shows round cells, foam cells, and giant cells. Macrophages that have ingested fat, also called lipophages, are the hallmark of the diagnosis. One hundred twenty-two cases of mesenteric panniculitis have been described in the literature; only three of these involved the large-bowel mesentery. This paper presents a review of the literature and two new cases that involve exclusively the mesentery of the sigmoid colon. PMID- 3308371 TI - Innocuous pneumatosis intestinalis of the right colon in renal transplant recipients. Report of three cases. AB - Three cases of innocuous pneumatosis intestinalis (IPI) of the right colon occurred in a series of 218 renal transplant recipients over a five-year period. Each of the three transplants was in the right iliac fossa. Clinically, these patients had little or no gastrointestinal symptoms and had normal physical examinations of the abdomen. One of the patients had a generalized herpes simplex type 2 (HSV II) infection. Cystic or linear lucencies were present within the bowel wall, associated with varying degrees of localized colonic distention. The condition (IPI) did not warrant surgical intervention or reduction of immunosuppressive therapy. The pneumatosis resolved over a period of several weeks without sequelae or recurrence. PMID- 3308372 TI - Cecal diverticulitis. A review of the American experience. AB - The etiology of cecal diverticulitis remains unclear. The majority of diverticula are solitary and probably false and may be the result of the same degenerative process seen in the more common left-sided diverticulosis. A minority are true diverticula and may be of congenital origin. Cecal diverticulitis is clinically indistinguishable from acute appendicitis although patients with cecal diverticulitis tend to be older (average age, 40 years), have a longer duration of symptoms, and present less often with nausea and vomiting. In patients with previous appendectomy and in those with more indolent symptoms, barium enema may be helpful in making the diagnosis. If nonoperative treatment is chosen, careful follow-up with air contrast barium enema and colonoscopy should be carried out. The majority of patients require surgery and two types of cecal diverticulitis are encountered at laparotomy. The usual type, accounting for two thirds of cases, is easy to recognize, has an inflamed projection from the cecal wall, and is dealt with by a limited local diverticulectomy. Some authors advocate nonsurgical treatment for this first group of patients. Incidental appendectomy is advocated to avoid confusion should symptoms occur postoperatively. The hidden variant presents as a large, indurated phlegmon and is difficult to distinguish from a perforated cecal carcinoma. With the hidden variant, right hemicolectomy is the surgical treatment of choice and carries a 1.4 percent mortality. PMID- 3308373 TI - Sonographic imaging of the pancreatic duct. New diagnostic possibilities using secretin stimulation. AB - The pancreatic duct or at least parts of this structure can be demonstrated today by sonography in 75-85% of all persons examined. In 84 persons we have now measured the caliber of the sonographically visualized pancreatic duct in the region of the proximal body of the pancreas with special attention to dependence on age. The diameter of Wirsung's duct ranged from 1 to 3 mm (mean 1.9 mm) and increased significantly from the fifth decade of life onwards. After intravenous injection of the hormone secretin, healthy persons usually show a distinct duct enlargement, which also depends on age. Nine persons aged 19 through 35 (median 28) years showed a dilatation of the main pancreatic duct by about 110% following secretion injection. Nine further probands, 50-74 (median 58) years old, had a dilatation of about 70%. Eighteen patients with confirmed chronic pancreatitis and a pancreatic duct diameter not exceeding 4 mm generally showed no duct enlargement after secretin stimulation. We believe that periductal fibrosis, which is common in chronic pancreatitis, is the most important reason for these results. The use of the sonographic secretin test in the diagnosis of chronic pancreatitis should be considered. PMID- 3308374 TI - Pancreatic abscess and infected pancreatic necrosis. Different local septic complications in acute pancreatitis. AB - Local septic complications in acute pancreatitis need to be exactly characterized and defined in order to develop improved concepts for their prevention, early diagnosis, and therapy. While up to now all local septic complications have been termed abscesses, the present study for the first time delineates the morphologic, clinical, and laboratory criteria needed to distinguish between two separate clinical entities: the infected necrosis (IN) and the pancreatic abscess (PA). IN is defined as a diffuse bacterial inflammation of necrotic pancreatic and peripancreatic tissue, but without any significant pus collections. On the other hand, the morphologic substrate of PA is a localized collection of pus surrounded by a more or less distinct capsula. IN becomes clinically evident during the early phase of acute pancreatitis (AP). The patients with IN present both the signs of sepsis and the laboratory findings of AP. Thus in these patients the most fulminant course of AP is observed; 51.8% and 35.7% of them have pulmonary or renal insufficiency, respectively. The mortality of the patients with IN is high and amounts to 32.1%. Pancreatic abscess, on the other hand, does not develop before the fifth week after onset of symptoms and after subsidence of the acute phase of pancreatitis. In these patients laboratory signs of AP-like amylasemia, hypocalcemia, hyperglycemia, and rise of LDH are rarely observed. Corresponding to the lack of pathophysiologic effects of AP per se, pulmonary and renal insufficiencies occur in only 33.3% and 16.7%, respectively, and mortality in these patients is 22.2%. While an abscess may readily be identified by computed tomography, the differentiation between IN and non-IN can be very difficult.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308375 TI - An analysis of imaging studies and liver function tests to detect hepatic neoplasia. AB - A retrospective study was conducted to determine the sensitivity, specificity, and accuracy of scintigraphy, ultrasound, and CT scanning in conjunction with biochemical tests in the detection of liver neoplasia. Sixty-three patients with metastatic liver disease and 45 patients with nonmalignant liver disease received a total of 46 liver/spleen scans, 61 ultrasounds, and 49 CT scans. The sensitivities of liver/spleen scan, ultrasound, and CT scan were 72, 73, and 81%, respectively; the specificities were 86, 94, and 83%, respectively; and, the accuracies were 78, 84, and 82%, respectively. No statistically significant difference in specificity, sensitivity, or accuracy was seen between the three imaging studies. The serum alkaline phosphatase was significantly more accurate than total bilirubin and SGOT in detecting liver metastasis. However, 19 and 13% of the malignant and nonmalignant groups, respectively, had normal biochemical tests. The sensitivity, specificity, and accuracy of the imaging studies in the presence of an abnormal alkaline phosphatase, SGOT, or total bilirubin were not significantly different than in the presence of normal biochemical tests. These results suggest that other factors such as cost, reproducibility, and availability of skilled interpreters should be considered in the selection of imaging studies for the detection of neoplastic liver disease. PMID- 3308377 TI - Primate research: relevance to human learning and development. AB - The monkey has proved an extremely useful model with which to examine the effects of developmental exposure to neurotoxic agents such as lead. Like humans, monkeys have a long period of gestation, infancy and sexual immaturity during which they continue to develop. This long period of vulnerability allows investigation of critical variables concerning sensitive periods of exposure. The nervous system of the monkey is very similar to humans and often responds to toxic insult like the human system. The behavioral repertoire of the monkey is also more like the human than is that of other laboratory species. Monkeys were exposed from birth with doses of lead that resulted in blood lead concentrations observed routinely in the population of children, and which are presently considered safe. Behavioral impairment was observed consistently in those monkeys on measures of activity, attention and memory, distractibility, adaptability and learning ability. Impairment persisted into adulthood. PMID- 3308376 TI - Insulin resistance is the main determinant of impaired glucose tolerance in patients with liver cirrhosis. AB - To clarify the pathogenesis of impaired glucose tolerance in patients with cirrhosis, several factors possibly affecting carbohydrate metabolism were studied in 12 cirrhotic patients with different blood glucose responses to an oral glucose tolerance test. Glucose levels, 120 min after the load, were inversely and significantly related to insulin sensitivity, measured by means of the euglycemic "glucose clamp" technique (r = -0.746). Basal and glucose-induced insulin secretion (insulin and C-peptide levels) only slightly correlated with glucose tolerance, which was not related to functional liver cell mass (galactose elimination), portal-systemic shunting (degree of varices at endoscopy), or maximal glucose-independent insulin secretion (peak C-peptide levels after a glucagon test). Multiple regression analysis identified insulin sensitivity and liver cell mass as the independent variables able to explain most of the variance of 120-min blood glucose (about 84%), and both of them contributed considerably to the regression. While reduced insulin sensitivity is probably the main cause of impaired glucose tolerance, the reduced hepatocellular mass only appears to modulate the degree, and therefore the clinical relevance, of this defect. PMID- 3308378 TI - Effect of teratogenic exposure on the developing brain: research strategies and possible mechanisms. AB - Some of the problems associated with human behavioral teratology are reviewed and research strategies necessary for the elucidation of the possible prenatal bases for the later occurrence of Learning Disabilities (LD) are suggested. An animal model for LD was created by exposure of female rats during pregnancy or during lactation to diazepam, monosodium glutamate, caffeine, or maternal stress. The gestation period most sensitive to these prenatal insults was established, and some of the neurochemical and histological correlates of the resulting discrimination learning deficits were investigated. PMID- 3308380 TI - Neurotoxicology in regulation and risk assessment. AB - It is well recognized that a wide variety of chemicals exert toxic effects on the structure and function of the nervous system. Regulatory agencies, charged with the protection of human health from toxicant exposures, should therefore consider neurotoxicological evaluations in the risk assessment process. Over the last decade, several expert panels have recommended testing schemes for evaluating neurobehavioral toxicity. In general, these panels have recommended behavioral measures performed in tandem with neuropathological evaluations. In keeping with these recommendations, the Environmental Protection Agency has developed seven neurotoxicity test guidelines for use in evaluating new and existing chemicals. Further refinement and extension of these test guidelines will flow from a better understanding of the cellular/molecular events which underly neurotoxicant induced functional alterations. PMID- 3308379 TI - Environmental contaminants and behavior disorders. AB - The discipline of behavioral toxicology is an acknowledgement that behavioral assessments should play a role in judging the safety of chemicals. Such a role is emphasized by the toxicological history of many different classes of substances. These include metals, insecticides, volatile organic solvents, and even food additives. For all of these, incipient toxicity often takes the form of subjective complaints that are later followed by overt impairments. The fetus and young child seem to be at special risk for substances such as methylmercury and synthetic food colors, a susceptibility not fully recognized. PMID- 3308381 TI - Mitral valve prolapse. AB - Mitral valve prolapse is a common mitral valve disorder manifested clinically as a midsystolic click and/or a late systolic murmur (the click-murmur syndrome) and pathologically as billowing or prolapsing mitral leaflets (the floppy valve syndrome). Not only is it one of the two most common congenital heart diseases and the most common valve disorder diagnosed in the United States, but it is also prevalent throughout the world. Mitral valve prolapse may be associated with a variety of other conditions or diseases. Diagnosis of mitral valve prolapse should be made on clinical grounds and, if necessary, supported by echocardiography. The majority of patients with mitral valve prolapse suffer no serious sequelae. However, major complications such as disabling angina-like chest pains, progressive mitral regurgitation, infective endocarditis, thromboembolism, serious arrhythmias, and sudden death may occur. Unless these serious complications occur, most of the patients with mitral valve prolapse need no treatment other than reassurance, including those with atypical chest pain or palpitation unconfirmed by objective data. Therapy with a beta-blocker for disabling chest pain and/or arrhythmias and antiplatelet therapy for cerebral embolic events may be indicated. In occasional patients with significant mitral regurgitation surgery may be necessary. PMID- 3308382 TI - The yeast tRNA(Phe) gene family: structures and transcriptional activities reveal member differences not explained by intragenic promoters. AB - Several cloned members of the yeast tRNA(Phe) gene family were transcribed in vitro using a HeLa extract and a yeast extract. The optimum DNA concentration was determined and kinetic experiments were performed for each clone to compare transcription levels. Both extract systems were able to splice the intervening sequence, but only the yeast extract produced the mature product. Some genes were not transcribed with the homologous system while they were transcribed with the HeLa extract, suggesting a control mechanism that is not operating in the heterologous system. Competition experiments demonstrated that the intragenic promoters of the inactive genes were able to bind transcription factor(s), but not as efficiently as active genes. This binding was not so strong when using linear DNA and was dependent on the presence of the 3' intragenic control region. DNA sequencing and computer analysis indicated the presence of short conserved sequences upstream from the genes. These sequences, which are not related to the intragenic promoters, are direct repeats of part of the 3' coding region in those genes that are transcribed in the homologous system. The relevance of these sequences on homologous transcription in vitro remains to be established. PMID- 3308383 TI - [Localization of oncoprotein P21ras in the human liver cancer]. AB - Using the human liver cancer DNA transfected NIH/3T3 cell line, the human N-ras oncogene and the over expression of the oncoprotein P21ras was demonstrated, BALB/C mice were immunized. The spleen cells from the immunized mice were fused with SP2/0 myeloma cells. After the HAT medium selection and screening, two hybridoma cell lines, SCI-Oncogema 1 and 2, were established. In the immunoprecipitation test, the molecular weight of the protein reacting to Oncogema 1 was 21,000. This M.W 21,000 protein possessed the capability to bind with GTP, i.e. the character of P21ras. These data indicate that the Oncogema 1 is the monoclonal antibody against P21ras. Using Oncogema 1, specimens from 6 liver cancer patients were studied by immunopathology. With ABC stain, it was observed that the malignant cells in all the samples showed dark staining; the P21ras revealed over expression. Although the staining was heterogeneous, it implied that the ras oncogene was involved in the carcinogenesis of these six samples. No over expression was seen in the normal liver cells even in those around the cancerous lesion. However, dysplastic cells were moderately stained which means that the ras oncogene was activated and P21ras over expressed in these cells. The results suggest that the ras oncogene and P21ras play an important role in the early stage of liver cancer carcinogenesis. PMID- 3308384 TI - [Gastric cancer-associated antigen P42]. AB - The corresponding antigen to monoclonal antibody PCI against gastric cancer cells was demonstrated as a protein sensitive to heating and easily degraded by proteinase. By western blotting, it was shown that the molecular weight of the antigen was 42 KD and the antigen was named P42. P42 could be shed into serum free culture medium of the target cells and its activity be assayed in sera of the gastric cancer patients. Using inhibition test, the levels of P42-like substance in sera were measured. The results indicated that this level in the gastric cancer patients (26.53 +/- 23.11) was markedly higher than that in patients with benign gastric diseases (4.66 +/- 2.67) and controls (2.57 +/- 2.67). It is suggested that P42, a novel gastric cancer-associated antigen, be useful in the mass screening and supplementary in diagnosing gastric cancer. PMID- 3308385 TI - [The effect of low-intensity laser irradiation on non-stationary metabolic processes in Escherichia coli cells]. PMID- 3308386 TI - [Isolation of the recombinant antigen of HTLV-III virus surface protein from Escherichia coli cells and its use in the immunodiagnosis of AIDS]. PMID- 3308387 TI - Antitumor activity of new N-substituted daunorubicin derivatives. AB - The biological properties of two new structural groups of modification products of daunorubicin, the N-glycosyl and enamino derivatives, were investigated. The activities of the compounds were characterized in vitro (yeasts and leukaemia cells) and in vivo (L1210 leukaemia in mice). Among the compounds studied DR-19, N-(1-carboethoxypropen-1-yl)daunorubicin, exhibited activity comparable with that of the parent antibiotic. The correlation coefficients calculated showed good correlation between in vitro tests. In vitro activity and potency (reciprocal of optimal dose) in mice leukaemia were also correlated. However, no correlation between the in vitro activity and activity in mice leukaemia (increase of life span) was observed. PMID- 3308389 TI - Headache in association with sleep disorders in children: a psychodiagnostic evaluation and controlled clinical study--L-5-HTP versus placebo. AB - Forty-eight elementary and junior high school students presenting the association of recurring headache and sleep disorders were selected for this study on the basis of a questionnaire filled out by the entire school population. The selected students had normal intellectual capacity but often showed inadequate progress in school, attentive-mnemonic deficiencies, and psychopathological elements of a depressive nature. The clinical characteristics predicted that this group would be responsive to treatment with L-5-hydroxytryptophan. The results of a double blind, cross-over trial with placebo confirmed these expectations for headache and some sleep disorders, in particular frequent awakenings and some parasomnias. PMID- 3308388 TI - L-acetylcarnitine in depressed elderly subjects. A cross-over study vs placebo. AB - An open, cross-over study was performed on a population of 24 geriatric patients hospitalized because of depressive syndrome. They were subdivided, according to Hamilton's Scale as modified for the aged, into low- and high-score subgroups. The study period covered 2 months. Half the patients received acetylcarnitine for 1 month and placebo thereafter (Group A); the other half received placebo and acetyl-carnitine thereafter (Group B). Statistical evaluation was twofold: parametrical analysis of variance was carried out on 4 subgroups (A1, A2, B1 and B2) and analysis of the score percentage modifications before and after treatment was performed on Groups A and B. The experimental results showed that acetylcarnitine treatment was highly effective and statistically significant in subgroups A1/B1, A2/B2, A1, B1 and B2. In particular, it should be noted that depressive tendencies were significantly modified in most groups, whereas general somatic symptoms as well as anxiety, asthenia and sleep disturbances proved to be little affected. Clinical evaluation, carried out by calculation of modifications in pre- and post-treatment score percentages, provided clear evidence that acetylcarnitine was particularly effective in patients showing more serious clinical symptoms. The drug caused no side-effects at the doses and regimens used. PMID- 3308390 TI - Minaprine and imipramine in the treatment of major depressive disorders. A comparative double-blind study. AB - Minaprine dihydrochloride is an aminopyridazine derivative which is chemically unrelated to other known psychotropic drugs. In rodents minaprine is active in most models of depression and is thought to exert this activity by enhancing serotonergic and dopaminergic transmission. In humans minaprine has been shown to be more effective than placebo in the treatment of major depressive episodes as defined by the DSM-III. In the present study, the efficacy and safety of minaprine (100 mg b.i.d.) in the treatment of major depressive disorders (DSM III) were compared with those of imipramine (50 b.i.d.) in 104 patients, in a 4 week randomized, double-blind, multicentre trial. The two drugs were comparable in efficacy as judged by the Hamilton Depression Rating Scale, a Clinical Global impression and a Zung Self-Rating Scale. The onset of activity appeared to be significantly more rapid with minaprine. The incidence and intensity of unwanted effects was significantly higher in the imipramine treatment group. PMID- 3308391 TI - Bismuth subsalicylate in the treatment and prevention of diarrheal disease. AB - Bismuth subsalicylate (BSS) has been used for more than 80 years to treat gastrointestinal symptoms although little clinical evidence was available until recently to substantiate its value and possible mechanisms of action. BSS 4.2 g given over 3 1/2 hours was shown to reduce the number of stools passed and favorably alter subjective symptoms in patients with traveler's diarrhea. BSS has also been shown to have beneficial effects on chronic infantile diarrhea. A small but discernible effect has been shown on selected symptoms associated with Norwalk virus-induced gastroenteritis. A liquid preparation, in a dose of 60 ml qid (4.2 g/d), was 62 percent effective in preventing traveler's diarrhea during a three-week period of risk and a tablet formulation (BSS 600 mg qid) was 76 percent effective in preventing experimentally induced enterotoxigenic Escherichia coli diarrhea in volunteers. A tablet formulation (2.1 g/d) was recently shown to be 65 percent effective in preventing traveler's diarrhea during a three-week clinical trial in Mexico. Preliminary evidence suggests that the salicylate moiety exerts antisecretory effects in patients with diarrhea and the bismuth and intestinal hydrolysis products of BSS have direct antimicrobial effects. PMID- 3308392 TI - Infectious diseases in day-care centers: transmission and approaches to prevention. AB - Child day care is used increasingly by both single-parent and two-parent families. With the growth in numbers of children receiving day care outside the home comes a greater awareness of the potential for disease transmission. Epidemiologic patterns of spread of such diseases as Hemophilus influenzae type b, hepatitis A, diarrheal diseases, and cytomegalovirus are changing with respect to attendance at a day-care center. Not only is this a problem for the staff and children who attend a center, but it also may be a public health concern as these diseases could spread to households and the community at large. This review will identify those transmissible infectious agents frequently found in children who attend day-care centers with an emphasis on approaches to prevention and methods for decreasing secondary spread. PMID- 3308393 TI - The contribution of epidemiology to the study of drugs. AB - Epidemiology is concerned with the distribution of disease and health in human populations. Drugs are one of the factors that influence such a distribution. Pharmacoepidemiology can be defined as the application of epidemiologic knowledge, methods, and reasoning to the study of the effects (beneficial and adverse) and uses of drugs in human populations. Pharmacoepidemiology aims to describe, explain, control, and predict the effects and uses of pharmacologic treatment modalities in a defined time, space, and population. The present article is an introduction to the contributions of epidemiology to the study of drugs. PMID- 3308394 TI - Cancer chemotherapy: carboplatin v cisplatin. PMID- 3308395 TI - Ciprofloxacin--an important new antimicrobial. PMID- 3308397 TI - [Pneumocystosis-- Pneumocystis carinii pneumonitis. Pulmonary complications of the acquired immunodeficiency syndrome]. PMID- 3308396 TI - [Therapy of sleep apnea syndrome]. PMID- 3308398 TI - The assembly and positioning of cytoskeletal elements in Tetrahymena. AB - The oral skeleton of Tetrahymena is a precisely arranged assemblage of basal bodies, microtubule bundles and connecting filaments found associated with the feeding structure in this cell type. Tubulin and filament proteins have been isolated but no actin has been recovered. The conditional mutant NP1 of Tetrahymena thermophila forms a normal oral skeleton at the permissive temperature (28 degrees C), but forms an abnormal one at the restrictive temperature (37 degrees C). Antibodies against tubulin and oral filament protein OF1 were used to visualize the abnormal oral skeleton and stages in its development, and ultrastructural comparisons of abnormal and wild-type oral skeletons were made. It was found that the overall pattern of organization was altered in the mutant, whereas the substructure appeared everywhere to be normal. Studies of cells in which the mutant phenotype was coming to expression revealed that normal basal bodies in the oral skeleton failed to move from the disordered state characteristic of early stages of development into the correct pattern of four organized clusters characteristic of later stages. Together, these results suggest that the lesion in NP1 does not affect cytoskeleton assembly per se, but instead affects a discrete mechanism responsible for the positioning of cytoskeletal elements with respect to each other after they have been formed (meta-assembly). Reasons for suspecting the involvement of the membrane skeleton are presented. PMID- 3308399 TI - Cytoarchitecture of the Xenopus thymus following gamma-irradiation. AB - This paper describes in vitro and in vivo attempts to deplete the 4- to 8-month old Xenopus laevis (J strain) thymus of its lymphocyte compartment. Gamma irradiation (2-3000 rad) of the excised thymus, followed by two weeks in organ culture, is effective in removing lymphocytes, but causes drastic reduction in size and loss of normal architecture. In contrast, in vivo whole-body irradiation (3000 rad) and subsequent in situ residence for 8-14 days proves successful in providing a lymphocyte-depleted froglet thymus without loss of cortical and medullary zones. In vivo-irradiated thymuses are about half normal size, lack cortical lymphocytes, but still retain some medullary thymocytes; they show no signs of lymphocyte regeneration when subsequently organ cultured for 2 weeks. Light microscopy of 1 micron, plastic-embedded sections and electron microscopy reveal that a range of thymic stromal cell types are retained and that increased numbers of cysts, mucous and myoid cells are found in the thymus following whole body irradiation. In vivo-irradiated thymuses are therefore suitable for implantation studies exploring the role of thymic stromal cells in tolerance induction of differentiating T lymphocytes. PMID- 3308400 TI - Segmentally repeated pattern of expression of a cell surface glycoprotein in Drosophila embryos. AB - We report here that a previously described cell surface antigen (Brower, Smith & Wilcox, 1980) is expressed in a segmentally repeating pattern of stripes in the epidermis and nervous system of segmented Drosophila embryos. We also report that the antigenic activity is found on two closely related cell surface glycoproteins. The pattern of expression of this antigen is reminiscent of the expression of some segmentation genes and is affected by mutation of at least two of these genes, fushi tarazu and paired. Thus these glycoproteins are candidates for cell surface molecules involved in carrying out the patterning processes controlled by segmentation genes. PMID- 3308401 TI - Vasculogenesis in the early quail blastodisc as studied with a monoclonal antibody recognizing endothelial cells. AB - QH1, a monoclonal antibody that recognizes quail endothelial and haemopoietic cells, was applied to quail blastodiscs in toto, in order to analyse by immunofluorescence the emergence of the vascular tree. The first endothelial cells were detected in the area opaca at the headfold stage and in the area pellucida at the 1-somite stage. Single cells then interconnected progressively, especially in the anterior intestinal portal and along the somites building up the linings of the heart and dorsal aortas. This study demonstrates that endothelial cells differentiate as single entities 4 h earlier in development than hitherto detected and that the vascular network forms secondarily. The horseshoe shape of the extraembryonic area vasculosa is also a secondary acquisition. A nonvascularized area persists until later (at least the 14-somite stage) in the region of the regressing primitive streak. PMID- 3308402 TI - Preparation and properties of monoclonal and polyclonal antibodies to mouse epidermal growth factor (EGF) receptors: evidence for cryptic EGF receptors in embryonal carcinoma cells. AB - Monoclonal antibodies to mouse epidermal growth factor (EGF) receptor were prepared by the immunization of rats with receptor glycoprotein purified from mouse liver by affinity chromatography on immobilized EGF. Purified mouse EGF receptor retained EGF-inducible autophosphorylating activity and was antigenic in rats and rabbits. The monoclonal antibodies cross react very poorly with human EGF receptor, while polyclonal rabbit antibodies immunoprecipitate human, rat and mouse EGF receptor equally well. The rabbit antibody blocks EGF binding to mouse fibroblast cells and, at 20-fold higher concentrations, stimulates uptake of tritiated thymidine into DNA. This indicates that antibodies bind at or close to the EGF-binding site and can mimic the effects of the growth factor. None of the monoclonals bind at the EGF site of the receptor. Immunoprecipitation, immunoblotting, 125I-EGF cross linking, 125I-surface labelling, immunohistochemistry and autophosphorylation techniques were used to delineate the basis for the induction of EGF receptors when OC15 embryonal carcinoma (EC) cells differentiate into endodermal derivatives (END). EGF-stimulated autophosphorylation of a 170 X 10(3) Mr protein in solubilized OC15 EC cells is readily detectable, although intact EC cells do not bind or respond to EGF by all other tests. The results suggest that cryptic EGF receptors are present in EC stem cells, a finding with implications in development. PMID- 3308403 TI - Genetics of cell and axon migrations in Caenorhabditis elegans. AB - The Caenorhabditis elegans epidermis comprises 78 cells which cover the external surface of the embryo as a single cell layer. These cells secrete the cuticle from their exterior faces and support the body wall muscles and most of the nervous system on their interior faces. The epidermal cells arise by autonomous embryonic cell lineages but show regulative interactions after their assembly into an epithelium. It is believed that the various epidermal cells express different kinds or amounts of surface molecules that govern their mutual assembly and also guide the attachments and migrations of the underlying body muscles and neurones. The first muscles and neurones may in turn express new surface molecules that refine later cell movements. Mutations in some 30 known genes disrupt the movements of cells or axons along the body wall. PMID- 3308404 TI - Biology of mammary fat pad in fetal mouse: capacity to support development of various fetal epithelia in vivo. AB - Epithelia from the lobular part of submandibular salivary gland, glandular stomach, intestine and colon of 14-day C3H/HeN fetuses, and from pituitary gland and pancreas of 12-day fetuses were recombined with 14-day mammary fat pad precursor tissue and syngrafted under the kidney capsule. The normal organogenetic development typical of the epithelium occurred. The same epithelia taken from earlier stage fetuses did not develop normally. Thus, 14-day fetal mouse mammary fat pad precursor tissue has the capacity to support normal organogenesis of various fetal epithelia of developmentally advanced stages. This supportive capacity is decreased in the fat pad precursor tissue of 17- to 18-day fetal mice and is entirely lost postnatally. PMID- 3308406 TI - Immunochemical demonstration of the clonal organization of chimaeric mouse epidermis. AB - The clonal organization of chimaeric mouse epidermis was demonstrated by in situ staining of whole-mount preparations using monoclonal antibodies directed against H-2k and H-2b antigens. A striking pattern of transversely oriented stripes or patches was found which extended from mid-dorsum to the flank region. The orientation of these patches indicates a preferred directional expansion of clones during the development of dorsal/lateral epidermis. The clonal pattern of the belly region differed in that stripes were not found, but a marked ventral midline boundary was observed. This demarcation line may be due to a physical effect, i.e. isolation of the left and right ventral halves of the epidermis during early embryogenesis with relatively little cell mingling following closure of the abdominal wall. The obvious nonhomogenous distribution of chimaeric components in dorsal/lateral and ventral epidermis contradicts assumptions of homogenous, fine-grained patchiness derived from electrophoretic analysis of tissue samples and used in studies of skin carcinogenesis. The observation that hair follicles may contain cells of both parental genotypes implies a polyclonal origin. Epidermal proliferative units as described by Potten (1974) were not revealed by the pattern of mosaicism at the cellular level in these chimaeric tissue sheets. This indicates that the proliferative compartment of each putative epidermal unit is polyclonal. PMID- 3308405 TI - Autonomy of differentiation in avian branchial somites and the influence of adjacent tissues. AB - This study investigates the differentiative abilities of avian brachial somites at stages of development before, during and after the migration of somitic cells into the wing primordium. These somites are the source of cells that migrate into the forelimbs and there give rise exclusively, and totally, to the skeletal muscle lineage of the wing and yet show no morphological evidence of commitment to that fate when they leave the somites. The aim of the study was to see if the brachial somitic cells are committed to particular developmental pathways at these stages. The brachial somites were isolated from HH stage-12, -15 and -18 chick embryos, either by microdissection or enzymatic dissociation, and grown in organ culture, in explant culture on different substrata or on the chorioallantoic membrane (CAM) of host chicks, either alone or in combination with adjacent tissues. Myogenesis and chondrogenesis occurred in all stage-18 enzymatically separated somites, regardless of the growth environment. Myogenesis was reduced in stage-15 somites and unobservable in stage-12 somites; however, recombination of stage-12 somites with epithelium or neural tube increased the incidence of myogenesis at this stage. The incidence of chondrogenesis was also less in the younger explants. Unlike its effect on myogenic expression, recombination with epithelium resulted in a dramatic decrease in chondrogenesis in both stage-12 and -15 somites. The recombination experiments suggest that conditions that maintain the normal spatial relationships within isolated somites permit expression of a preexisting specification to a particular fate. They also show that the overlying epithelium can inhibit chondrogenesis in these somites. Overall, the results suggest that by the time migration of somitic cells into wing regions is finishing, brachial somitic cells have become stabilized in their ability to undergo both myogenesis and chondrogenesis for they will do so under a variety of growth conditions and independently of adjacent tissues. However, immediately before (stage 12) and shortly after (stage 15) the onset of migration, both myogenic and chondrogenic expression by brachial somitic cells are still under the influence of interactions with adjacent tissues. PMID- 3308407 TI - The midblastula cell cycle transition and the character of mesoderm in u.v. induced nonaxial Xenopus development. AB - Xenopus embryos (UV embryos) resulting from u.v. (254 nm) irradiation to the vegetal egg hemisphere and thus developing little or no axial pattern (UV5-Scharf & Gerhart, 1983), have been compared histologically with synchronous normal siblings at each of three stages. In addition, the relative amounts of blood forming tissue produced in normal and in UV embryos have been studied by Western blotting total protein from larval stages and by immunofluorescence on sections. The observations on midblastulae (around 5000 cells) were aimed at detecting any systematic retardation, due to u.v., of the slowing of the cell cycle that normally commences at the 2-4000 cell stage and makes possible zygotic transcription and the preparation for gastrulation. No such retardation was apparent. Observations on postgastrular stages gave an assessment of the size and character of the population of mesoderm founder cells, in relation to the control, for embryos visibly undergoing entirely nonaxial development. Little deficit in total mesodermal cell number was found, though the entire mesoderm adopted the histological character proper to only some 40% of that in the normal pattern i.e. trunk lateral plate. Blood-forming capacity appears to be enhanced out of all proportion to the size of the mesoderm as a whole. The results are discussed in terms of the probable nature of the primary positional system for axial pattern and the later mechanisms of mesodermal patterning. PMID- 3308408 TI - Embryonic induction--molecular prospects. PMID- 3308410 TI - Optimum management of nausea and vomiting in cancer chemotherapy. AB - Nausea and vomiting continue to be critical problems in cancer chemotherapy, although considerable progress has been made toward understanding the neuropharmacological mechanisms of vomiting and how chemotherapeutic agents and antiemetics affect these mechanisms. The principles of behavioural psychology have also been applied in an effort to understand and effectively manage these complications which have potentially serious consequences. For example, there is now some degree of rationality to our use of metoclopramide for cisplatin-induced nausea and vomiting, the use of combination antiemetic regimens, and use of lorazepam for the prevention (albeit unproven) of anticipatory nausea and vomiting. It must be admitted, however, that our approach is for the most part still empirical. Selecting an antiemetic programme is not a simple task. The emetogenic potential of the chemotherapy being used, the presence of coexisting diseases, the potential toxicity of the antiemetic drug and whether antiemetic therapy is to take place in the hospital or in an outpatient setting, the familiarity of the clinician with the various antiemetic therapies, and cost are all factors which need to be considered. Although phenothiazines remain the standard treatment, they are of little value against chemotherapy programmes that produce moderate or severe problems. Newer pharmacological approaches including butyrophenones, cannabinoids, metoclopramide, high-dose corticosteroids, and benzodiazepines have shown increased antiemetic efficacy, as have combinations of these agents which are directed against multiple sites of emetogenic activity. The role of behavioural therapies, which have been shown to be effective particularly in children and in anticipatory nausea and vomiting, needs to be more firmly established. Rather than recommending a given antiemetic programme for any particular chemotherapy, it is preferable to think in terms of initial approaches and how they can be modified. No one antiemetic programme is effective or safe in all situations. PMID- 3308409 TI - l-Carnitine. A preliminary review of its pharmacokinetics, and its therapeutic use in ischaemic cardiac disease and primary and secondary carnitine deficiencies in relationship to its role in fatty acid metabolism. AB - l-Carnitine occurs naturally as an essential cofactor of fatty acid metabolism which is synthesised endogenously or obtained from dietary sources. In patients with primary carnitine deficiencies, which may be life-threatening, and some secondary deficiencies such as organic acidurias, the exogenously administered compound is clearly beneficial: by abolishing hypotonia, motor skills are improved, as are muscle weakness and wasting. In preliminary clinical trials in patients with ischaemic cardiac disease, therapy with l-carnitine has shown beneficial effects on myocardial function and metabolism and has improved exercise tolerance in patients with angina pectoris-findings which require further substantiation in larger controlled studies. Moreover, while some interesting evidence suggests that l-carnitine may find potential use in such diverse conditions as carnitine deficiencies secondary to prolonged total parenteral nutrition supplementation or chronic haemodialysis, hyperlipidaemias and the prevention of toxicity induced by anthracyclines and valproate, such findings must be regarded as preliminary. Exogenously administered l-carnitine is very well tolerated. Thus, while its role in primary deficiencies is established, with its profile of negligible toxicity l-carnitine is worthy of further investigation to more clearly define its therapeutic applications in a variety of conditions which may be indirectly related to alterations in fatty acid metabolism. PMID- 3308411 TI - Anisoylated plasminogen streptokinase activator complex (APSAC). A review of its mechanism of action, clinical pharmacology and therapeutic use in acute myocardial infarction. AB - APSAC is a new thrombolytic agent with advantages over conventional therapy such as streptokinase. In particular, it is suitable for intravenous administration over 4 to 5 minutes, in contrast with the prolonged infusion required with intravenous streptokinase, thus facilitating treatment of acute myocardial infarction outside a coronary care unit. Additionally, its fibrinolytic action is theoretically selective for fibrin associated with thrombi, which should minimise systemic fibrinolysis. However, in practice, systemic fibrinolysis does occur to some extent in most patients, but clinically significant haemorrhagic complications are rare. At the recommended dose of 30U injected intravenously over a period of 4 to 5 minutes in patients with acute myocardial infarction of less than 6 hours' duration, reperfusion of occluded coronary arteries occurs in about 72% of patients (range 53 to 91% in individual studies). Subsequent reocclusion has been reported in 0 to 20% of patients in most studies, with an average reocclusion rate of around 10%. The reperfusion rate compares favourably with that reported for intracoronary streptokinase and has tended to be superior to that with intravenous streptokinase. Thus, APSAC is an important advance in thrombolytic therapy for patients with acute myocardial infarction. Of particular importance is its relative ease of administration, reducing the dependence on coronary care units with catheterisation facilities, and the associated costs and delays in implementing treatment. APSAC should result in effective thrombolytic therapy being rapidly introduced after acute myocardial infarction in a wider proportion of patients than was previously feasible. PMID- 3308414 TI - [The social sciences in the health field in Brazil: notes for its history]. AB - In this work the author reviews, along general lines, the origins and development of the social sciences in the health field in Brazil, with emphasis on the part played by the departments of preventive and social medicine, which extended the scope of undergraduate medical school instruction in the sixties to embrace social issues, and introduced the first subjects and disciplines of the social sciences. He also describes graduate instruction and makes general remarks on social science research in the health field. Originally presented at a Seminar on "The Social Scientist in the Health Field," where participants had to relate their personal experiences, the work tries to evaluate some aspects of the author's experience. PMID- 3308416 TI - Auditory evoked potentials during deviations from homeostasis: theoretical and clinical implications. AB - Evoked responses of various modalities are being used for sensory and neurological clinical assessment. An additional application is their use in studying the functional activity of several sensory pathways and many brain regions during induced deviations from homeostasis in the intact animal. The auditory nerve-brain-stem evoked response (ABR) has been studied during hypoxia, hypercapnia, acidosis, hypoglycemia, systemic hypotension, intracranial hypertension and decreased cerebral perfusion pressure. In many such experiments the following were also recorded: EEG, cortical evoked potential (EP), somatosensory EP (including peripheral nerve, brain-stem and cortical components), visual and vestibular EP. Even though the EEG was already isoelectric, the ABR and many of the other EPs were not affected by relatively severe deviations in homeostasis, several of which have been shown to induce brain lesions and severe perturbations of energy metabolism. The ability of these brain pathways to produce electrical activity in such conditions may be due to the generation of such EP by oligosynaptic pathways and to compensatory mechanisms such as increased local cerebral blood flow. Clinically, these findings point out the usefulness of ABR recordings in the diagnosis of brain death and to the possibility that when ABR is continuously monitored in the intensive care patient, alterations in the ABR may indicate the need for immediate intervention. PMID- 3308415 TI - Electrophysiological monitoring in the intensive care unit. AB - Spontaneous electrical activity (EEG) and event-related computer averaged brain electrical potentials (EPs) are becoming an integral part of CNS function monitoring in neurological intensive care patients. EEG monitoring using the compressed spectral array (CSA) computer analysis offers continuous information about cerebral electrical activity, permitting an accurate definition of the severity of brain injury, forecasting patient's course, and early detection of secondary intracranial changes. It offers more precise indications for treatment and prognosis. Combining EEG with multimodality EPs permits a finer diagnosis of the location and extent of CNS damage and contributes information, not otherwise obtainable, on the integrity of CNS pathways. Changes is electrophysiological patterns are often related to changes in other physiological parameters or events affecting the patient. Consequently, it appears advantageous to monitor simultaneously other CNS and body functions and record, process and display the data obtained in the patient care area. To make this comprehensive monitoring system reliable and useful, a wise application of advanced computer technology and a high degree of understanding of intracranial dynamics are required. PMID- 3308417 TI - Sleep/wake disturbances in working life. AB - This paper reviews the effects of shift work on sleep, alertness and well-being. It is seen that shift work causes disturbed sleep and increased fatigue. These effects are mainly due to sleep being displaced to the rising phase of the circadian rhythm, at which interference with sleep is at its maximum. Similarly, wakefulness is displaced to the circadian trough where the sleep-promoting properties of the circadian rhythm are at their maximum. The review concludes with a discussion of possible countermeasures. PMID- 3308418 TI - Effects of noise on the nervous system. PMID- 3308419 TI - Use of clinical neurophysiological methods in ergonomic studies of heavy industrial work. PMID- 3308420 TI - New EMG methods to study the motor unit. AB - This short review of different EMG techniques has indicated their values in studies of the microphysiology and anatomy of the normal and abnormal motor unit (Table I). It has also pointed to the fact that the combination of techniques gives more information than each of them alone. The techniques can be used in the study of normal motor units and also help in diagnosis and in understanding the pathophysiological processes which occur in neuromuscular disorders. PMID- 3308412 TI - Pentoxifylline. A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic efficacy. AB - Pentoxifylline (oxpentifylline) is an orally active haemorheological agent for the treatment of peripheral vascular disease, cerebrovascular disease and a number of other conditions involving a defective regional microcirculation. Pentoxifylline acts primarily by increasing red blood cell deformability, by reducing blood viscosity and by decreasing the potential for platelet aggregation and thrombus formation. Extensive open and placebo-controlled studies have shown that pentoxifylline 600 to 1200 mg/day for at least 6 weeks is associated with subjective and objective improvements in 60 to 100% of patients with peripheral vascular disease. The most commonly assessed clinical parameter, walking distance, is usually improved by about 100%, although much greater improvements have also been documented. Other parameters which have been clearly improved include lower limb rest pain, paraesthesia, muscle blood flow, cramps and leg ulcers. Pentoxifylline has produced consistently better results than placebo, and in those studies using comparative drugs, better results than nylidrin, adenosine and naftidrofuryl. In patients with cerebrovascular disorders, open studies with pentoxifylline, usually at a dosage of 600 to 1200 mg/day (300 to 600 mg/day in Japan), have shown marked overall clinical improvements in about 85% of patients. Symptomatic improvements in rehabilitation psychometric tests, neuromotor and speech deficits and other subjective symptoms have accompanied increased cerebral blood flow, particularly to ischaemic areas. Pentoxifylline would appear to be useful in most types of cerebrovascular disease including transient ischaemic attacks, sequelae of cerebral thrombosis and haemorrhage, and chronic ischaemic disorders. In patients with chronic cerebrovascular disease pentoxifylline 600 to 1200 mg/day conferred significant clinical benefit compared with placebo and in isolated studies proved to be superior to drugs such as co-dergocrine mesylate, adenosine and pyrithioxine. Preliminary studies indicate that pentoxifylline may also prove useful in vaso-occlusive crises of sickle cell disease, some hearing disorders, disorders of eye circulation, high altitude sickness and asthenozoospermia. Pentoxifylline is usually well tolerated when administered as the conventional controlled release formulation, gastrointestinal symptoms (about 3%) being the most common complaint, although these and other adverse effects have not occurred to a significantly greater extent than with placebo. Thus, pentoxifylline offers a well-tolerated and effective alternative to the treatment options available for patients with peripheral vascular disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3308422 TI - Electrophysiological evidence for central inhibitory deficits in old age. PMID- 3308421 TI - Brain metabolism and blood flow during aging. AB - Recent studies of cerebral metabolism have suggested that although cerebral blood flow is reduced during rest in the healthy aged brain, there is little or no decline in resting glucose consumption. Intercorrelations between resting regional cerebral rates for glucose (rCMRglc), as determined by positron emission tomography using [18F]fluorodeoxyglucose, were shown to provide a measure of the functional associativity of brain regions. Partial correlation coefficients, controlling for whole brain glucose metabolism, were used in the analysis. Dividing the brain into 59 regions, we found, for 40 healthy males (21-83 years in age) in a state of reduced sensory input, that the strongest correlations generally were between bilaterally symmetric brain regions, and that there were many statistically significant correlations (P less than 0.01) among frontal and parietal lobe regions and also among temporal and occipital lobe areas, but few significant correlations between these two domains. The correlation analysis then was applied to two groups (15 healthy males each) of young (20-32 years old) and elderly (64-83 years old) subjects in the same resting state. Compared with the young group, we found that the elderly subjects have fewer statistically significant (P less than 0.01) correlations, with the most noteworthy reductions being between parietal and frontal lobe regions, and among parietal lobe areas. These findings indicated that cerebral functional interactions were reduced in the healthy elderly. The same analysis, applied to 21 mainly mildly-to-moderately impaired presumed Alzheimer subjects (and 21 age-matched controls), revealed fewer significant correlations between homologous brain regions which correspond to metabolic asymmetries linked to neuropsychological deficiencies. PMID- 3308423 TI - Effects of age on the late positive and slow wave components of the evoked potential: implications for clinical application. PMID- 3308424 TI - Diagnostic modalities in gynecologic and obstetric emergencies. AB - Gynecologic emergencies are an integral part of the practice of an emergency physician. In fact, the occurrence of one of these, ectopic pregnancy, has increased dramatically in recent years. Fortunately, the diagnostic modalities available to emergency physicians, particularly serologic pregnancy testing and ultrasonography, have kept pace by undergoing tremendous technologic improvements that allow more rapid and accurate diagnosis of these potential life threats. Armed with the still valuable procedure of culdocentesis as well, the emergency physician has never been in a better position to cope with the distressed gynecological patient. PMID- 3308413 TI - New intravenous anaesthetics and neuromuscular blocking drugs. A review of their properties and clinical use. AB - The newer neuromuscular blocking drugs include vecuronium and atracurium. Vecuronium is a competitive neuromuscular blocking drug with a steroid nucleus. A dose of 0.1 mg/kg has an onset time of 2 minutes and provides surgical paralysis for 20 minutes. Recovery to 90% twitch height occurs in 40 to 50 minutes. Vecuronium has few adverse effects and its use is associated with cardiovascular stability. Atracurium is a competitive neuromuscular blocking drug which undergoes Hofmann degradation and ester hydrolysis in plasma. A dose of 0.6 mg/kg has an onset time of around 2 minutes and provides surgical paralysis for 20 to 30 minutes. Recovery to 90% twitch height occurs in 60 to 80 minutes. Histamine release, usually only localised, has been reported in association with the use of atracurium. The organ-independent metabolism of atracurium allows its use in standard dosage in patients with renal or hepatic disease. Edrophonium, although not a new drug, has recently been re-evaluated for reversal of neuromuscular blockade. In a dose of 0.5 mg/kg it has been shown to be as effective as neostigmine at reversing neuromuscular blockade after recovery has started (greater than 25% twitch height recovery). However, if blockade is profound (less than 10% recovery), edrophonium is less effective. Among the newer intravenous anaesthetics are propofol (disoprofol) and midazolam. In a dose of 1.5 to 2.5 mg/kg, propofol produces sleep rapidly with a prompt recovery in 4 to 6 minutes. Induction of anaesthesia may be associated with a transient apnoea and a fall in systolic pressure. The rapid recovery has led to its use for maintenance of anaesthesia. Midazolam is a water-soluble benzodiazepine which has been used as an anaesthetic agent. The dose needed to induce sleep varies widely (0.15 to 0.5 mg/kg); onset is slow (1.5 to 5 minutes), and recovery may be prolonged. Midazolam is also used in lower doses as a sedative. Ketamine, an intravenous induction agent, has recently been used intrathecally and extradurally to provide analgesia. PMID- 3308426 TI - Ectopic pregnancy. AB - Ectopic pregnancy is a potentially lethal disorder that is often difficult to diagnose clinically. More than 70,000 ectopic pregnancies are reported annually in the United States, and the incidence is rising. A thorough knowledge of predisposing factors, clinical presentation, common misdiagnoses, and recent advances in diagnostic modalities should help the Emergency Department physician avoid the pitfalls that lead to misdiagnosis with resulting morbidity and, occasionally, mortality. PMID- 3308425 TI - Management of genital infections. AB - The scope of this article includes disorders ranging from simple vaginitis to a perspective on acquired immunodeficiency syndrome. Gynecologic infections are an extremely common cause of visits to the Emergency Department, especially those in large inner cities. Pelvic inflammatory disease is the most serious of the infectious presentations. Vulvovaginitis, although not as serious, can be quite debilitating and is extremely common. Acquired immunodeficiency syndrome (HIV), although not necessarily a gynecologic infection, is included herein because of its sexually transmitted disease potential, and a perspective on protection for the Emergency Department worker is given. PMID- 3308427 TI - Hypertensive disorders of pregnancy. AB - Pre-eclampsia/eclampsia, or pregnancy-induced hypertension, is an uncommon but life-threatening complication of pregnancy associated with significant perinatal morbidity. When superimposed on underlying chronic hypertension, its impact on the fetus becomes even greater. Although the pathophysiology of the disease has not been fully defined, vasospasm appears to be the principal, underlying, etiologic mechanism. Therapy of the disease is principally aimed at controlling convulsions with magnesium sulfate and controlling hypertension with the antihypertensive agent hydralazine. Because development of the disease depends on the presence of trophoblastic tissue, the only true cure for pre eclampsia/eclampsia is removal of the trophoblast through delivery of the infant. The timing and type of delivery is dependent on the severity of the disease and gestational age of the infant. PMID- 3308428 TI - Medical disorders in pregnancy. AB - Although there is still controversy regarding the management of these patients, the therapy and testing that is now available enables us to formulate a reasonable individualized management plan. The maternal platelet count should be monitored carefully during pregnancy and treated according to the prior information. In addition, platelet antibodies may assist in predicting more effectively the potentially affected fetuses. In these cases, deliveries by cesarean section should be considered. If a fetal scalp platelet count is possible at the onset of labor, this should be performed, and if the count is less than 50,000 per mm3, the fetus should be delivered by immediate cesarean section. Clearly, it is necessary to have facilities available for immediate cesarean section prior to performing the platelet count. The use of steroid therapy near term appears to have a beneficial effect on the neonatal platelet count and should be strongly considered. Further information relating to the neonatal effects of high-dose intravenous immunoglobulin therapy may indicate this as a preferential prophylactic form of fetal therapy that may be available prior to delivery. PMID- 3308429 TI - Neonatal resuscitation. AB - Three decades of ongoing research and obstetric and pediatric education have seen neonatal resuscitation develop into a well-organized delivery room procedure. Because neonatal resuscitation does not occur frequently in the Emergency Department, few are well prepared. A designated site in the Emergency Department, trained personnel, appropriate equipment and well defined procedures are necessary. These recommendations for the organization of the resuscitation site, procedures, therapeutic drugs, and required equipment must be individualized to each Emergency Department. PMID- 3308430 TI - The evaluation and treatment of the sexually assaulted patient. AB - There are several significant problems encountered in treating the assault victim in the Emergency Department setting. In a busy Emergency Department, the patient who has been assaulted may be prioritized behind other patients with more significant life-threatening illnesses or injuries. The delay in treatment that ensues may aggravate the emotional trauma already experienced. Additionally, the legal and technical aspects involved in the evaluation and subsequent testimony may erect a psychological barrier on the part of the physician or nurse. This article provides guidelines and handling all of the above problems with regard to the sexually assaulted patient. PMID- 3308431 TI - Trauma in pregnancy. AB - Care of the pregnant trauma patient requires knowledge of the mechanism of injury, understanding the physiological changes of pregnancy, assessing fetal maturity and stability, and close teamwork among emergency, trauma, obstetric and pediatric services. PMID- 3308432 TI - Antilipolytic effect of prostaglandin E2 in perifused rat adipocytes. AB - Previously, the antilipolytic effect of prostaglandin E2 (PGE2) has been investigated in conventional adipocyte incubations. To define the effect of PGE2 on lipolysis more clearly, isolated epididymal adipocytes were studied with the perifusion system. PGE2 inhibited isoproterenol (100 nM)- and theophylline (1 mM) stimulated lipolysis in a concentration-dependent manner in both the perifusion system and conventional incubations. However, the half-maximally inhibitory concentration (ED50) of PGE2 on isoproterenol-induced lipolysis was about 0.4 nM in the perifusion system, whereas the ED50 was 8 nM in the static adipocyte incubations. The ED50 values of PGE2 on theophylline-induced lipolysis were 0.8 nM (perifusion) and 5 nM (incubation), respectively. Thus, the sensitivity of stimulated lipolysis to PGE2 was about 10 times higher in the perifusion system than in conventional adipocyte incubations. In addition, the maximal antilipolytic effect of PGE2 was greater in the perifusion system. At a concentration of 100 nM PGE2 inhibited theophylline-induced lipolysis by 82 +/- 5% in adipocyte incubations, whereas lipolysis was inhibited by 100 +/- 3.5% in the perifusion system (P less than 0.05). When lipolysis was stimulated by isoproterenol the maximal antilipolytic effect of PGE2 was an inhibition of 90 +/ 2.5% in the perifusion system and 55 +/- 5% in adipocyte incubations (P less than 0.05). Moreover, the maximal antilipolytic effect was obtained at a PGE2 concentration of 20 nM in the perifusion system, but at a concentration of 100 nM in static incubations. The release of immunoreactive PGE2 from adipocytes was measured by RIA. In the perifusion system no PGE2 could be detected in the effluent under basal conditions; however, during exposure to 100 nM isoproterenol a small amount of PGE2 was detected (3-4.5 pg/10(6) cells X min). Exogenous PGE2 was almost totally (90%) recovered in the effluent. In adipocyte incubations basal PGE2 production was 103 +/- 22 pg/10(6) cells X 60 min, whereas both isoproterenol and theophylline increased these amounts of PGE2 2-fold (P less than 0.01). It is concluded that exogenous PGE2 has pronounced antilipolytic properties at very low concentrations (subnanomolar) in perifused adipocytes. The reduced sensitivity and maximal responsiveness of PGE2 in static incubations may be related to accumulation of FFA and endogenous PGs, which may partially obscure the interaction of exogenous PGE2 with the adenylate cyclase complex. PMID- 3308433 TI - Positive interaction between insulin and phorbol esters on the regulation of a specific messenger ribonucleic acid in rat hepatoma cells. AB - With Northern blot analysis, we demonstrate that phorbol 12-myristate 13-acetate (PMA) stimulated P-33 messenger RNA (mRNA)-accumulation in rat hepatoma cells in a time- and concentration-dependent manner similar to insulin and plant lectins. No effect of PMA on P-33 mRNA half-life was detected when mRNA synthesis was inhibited with either actinomycin D or 5.6-dichloro-1-beta-D-ribofuranosyl benzimidazole. The effects of insulin and PMA were additive at submaximal concentrations and no additivity was observed under these conditions at maximal concentrations. Thus PMA has a marked insulin-like effect on the accumulation of P-33 mRNA in rat hepatoma cells. PMID- 3308434 TI - Cation-dependent and cation-independent stages in regulation of the vascular angiotensin receptor after alteration of sodium balance in the rat. AB - The role of cations in vascular angiotensin receptor regulation has been investigated by radioligand receptor assay using a cell membrane fraction derived from mesenteric arterial muscle of the rat. In arterial membrane fractions from normal rats, the apparent receptor density varied with the ambient [Ca++] over the range, 0-10 mM. Receptor densities of 50 +/- 4, 102 +/- 4, and 156 +/- 5 fmol/mg membrane protein were obtained in low (0 mM), normal (4.8 mM), and high (25 mM) [Ca++], respectively. After 2 days of sodium loading, sodium depletion, and converting enzyme blockade altered receptor densities were detected in normal assay but not in high [Ca++] or low [Ca++], indicating changes in the relationship between [Ca++] and apparent receptor density. Similar results were obtained after 12 days of sodium loading or converting enzyme blockade. After 12 days of sodium depletion, there was no difference in receptor density between normal and high [Ca++] (44 +/- 5 fmol/mg protein) and the value obtained in low [Ca++] (27 +/- 2 fmol/mg protein) was significantly below that for all other groups. No change in receptor affinity was observed. These results suggest that there are two stages in vascular angiotensin receptor regulation; an initial masking-unmasking process which involves Ca++, and with prolonged agonist occupancy, an actual loss of receptors. PMID- 3308435 TI - Sex difference in the effect of mating on the pulsatile secretion of luteinizing hormone in a reflex ovulator, the ferret. AB - Sex differences in the pulsatile secretion of LH were examined in male and female ferrets after mating. Female ferrets which were either gonadally intact and in estrus or gonadectomized and maintained on a pulsed regimen of daily estradiol (E2) injections exhibited a prolonged rise in plasma LH, characterized by an elevation in mean LH levels and an increase in the number of LH pulses after receiving an intromission from a stud male. By contrast, no such increase in LH secretion occurred in males which achieved an intromission with a female, regardless of whether they were gonadally intact and in breeding condition or gonadectomized and given pulsed estrogen. In fact, intact breeding males which achieved an intromission had significantly fewer LH pulses 1-5 h later than unmated males bled serially over the same time period. This decrease in LH pulse frequency was followed by a significant rise in mean plasma levels of androgen 5 12 h later. When a sexually dimorphic LH response to intromission was observed in gonadectomized E2-treated ferrets, we asked whether this could reflect a sex difference in pituitary responsiveness to the endogenous release of GnRH. Thus, plasma LH levels were measured in gonadectomized and gonadectomized E2-treated ferrets for 2 h after iv injection of GnRH. In the absence of gonadal steroids, ferrets exhibited a sex-specific difference in LH responsiveness to GnRH; however, no sex difference was apparent under the influence of E2. These findings demonstrate that ferrets' sexually dimorphic LH responses to intromission probably reflect a sex difference in the processing of somatosensory inputs from the genitalia or in the neural control of GnRH release into the pituitary portal vessels. PMID- 3308436 TI - Alpha-transforming growth factor in the bovine anterior pituitary gland: secretion by dispersed cells and immunohistochemical localization. AB - A growth factor secreted by bovine calf anterior pituitary cells in culture was purified, and its N-terminal amino acid sequence was determined. This sequence shows near-identity with human and rat alpha-transforming growth factor (alpha TGF). With the use of an anti-alpha TGF monoclonal antibody generated against a C terminal rat alpha TGF synthetic peptide, alpha TGF-like material was localized by immunohistochemical techniques in the cytoplasm of normal bovine adenohypophysial cells. The antibody staining was immunospecific because it could be completely inhibited by saturating concentrations of the synthetic peptide to which it was raised. There was no immunoreactivity in cells of the intermediate and posterior lobes. Some of the cells containing alpha TGF immunoreactivity also contained PRL; alpha TGF immunoreactivity was not demonstrated in cells containing ACTH, TSH, FSH, and LH. This is the first report documenting the secretion of alpha TGF by nonneoplastic adult cells and the presence of alpha TGF immunoreactivity in the corresponding normal adult tissue. PMID- 3308437 TI - Inhibitory effects of interleukin 1 on insulin secretion, insulin biosynthesis, and oxidative metabolism of isolated rat pancreatic islets. AB - Recent observations suggest a role for interleukin 1 (IL-1), a macrophage-derived cytokine, in the autoimmune B cell destruction, which is observed in type 1 diabetes. In the present study we have investigated the effects of IL-1 and two other cytokines, namely tumor necrosis factor (TNF) and interferon-gamma (IFN gamma) on the pancreatic B cell paying particular attention to insulin production and glucose metabolism. Rat pancreatic islets were isolated and kept in tissue culture for 5 days. The islets were subsequently transferred to media containing medium RPMI 1640 plus 0.5% human serum with or without additions of human recombinant preparations of either IL-1 (25 U/ml), TNF (1000 U/ml), or IFN-gamma (500 U/ml), and cultured for another 48 h. After the culture period the islets were subjected to light microscope examination and different functional tests in short-term incubations in the absence of cytokines. IL-1 was found to reduce insulin release in culture and totally inhibit glucose-stimulated insulin release in short-term incubations. Islet (pro)insulin biosynthesis, glucose oxidation, and oxygen uptake at 16.7 mM glucose were partially inhibited by IL-1. The DNA content of islets cultured with IL-1 was decreased and may partly explain these latter findings. However, inhibition of glucose oxidation could not be seen in islets exposed to IL-1 in short-term experiments only. By light microscopy there were marked signs of degeneration in IL-1 treated islets. TNF and IFN-gamma were essentially without effect on islet morphology or function. The results of this study indicate that IL-1 may be cytotoxic to islet B cells. The primary toxic action of IL-1 seems to involve factors other than an impaired islet glucose metabolism. PMID- 3308438 TI - Prolactin (in vitro) decreases the glucose stimulation threshold, enhances insulin secretion, and increases dye coupling among islet B cells. AB - The purpose of this study was to determine the in vitro effect of ovine PRL (oPRL) on the dynamics of insulin secretion and dye coupling among islet B cells. The effect of oPRL (2 micrograms/ml) on insulin secretion was time dependent and reached a maximum on day 4 when there was a 2.4-fold increase in insulin secretion from cultured neonatal rat islets (n = 6, P less than 0.001). When islets cultured in the presence of oPRL for 4 days were perifused, 300 mg/dl glucose stimulation resulted in insulin release of 131 +/- 20 microU/ml.100 micrograms islet tissue as compared to control islets 94 +/- 20 microU/ml.100 micrograms islet tissue (n = 7, P less than 0.02). Stimulation of the islets with a linear 30-250 mg/dl glucose gradient resulted in a threshold for glucose stimulated insulin secretion of 73 +/- 6 mg/dl glucose for the oPRL treated islets (n = 7) as compared to a threshold of 123 +/- 6 mg/dl glucose for control islets (n = 7, P less than 0.001). Mean islet volume was unchanged after 4 days of oPRL treatment but was 34% greater after 8 days (n = 6, P less than 0.001). Dye coupling among central islet B cells was also increased after in vitro treatment with oPRL for 4 days. The mean projected area of dye spread was 2-fold greater in the oPRL treated islets (n = 33) in comparison to the control islets (n = 33, P less than 0.05). These results indicate that in vitro lactogen treatment, in the form of oPRL, alters insulin secretory behavior and B cell junctional communication and supports our hypothesis that lactogen, insulin secretion, and junctional communication among B cells are related. PMID- 3308439 TI - Insulin and insulin-like growth factor I both stimulate metabolism, growth, and differentiation in the postneurula chick embryo. AB - Chick embryos after 48 h of development (day 2) maintained in ovo provide an adequate model to study hormonal influences in early organogenesis in vertebrates. In previous studies at this (prepancreatic) stage of chick embryogenesis we demonstrated not only the presence of an insulin-related material but also insulin receptors and insulin-like growth factor I (IGF-I) receptors. Further, when embryos developed in the presence of antiinsulin antibodies, we showed retardation in both morphological and biochemical events which strongly suggested a physiological requirement for insulin in normal embryogenesis. In the present study we have evaluated the effects of insulin, proinsulin, desoctapeptide insulin, and IGF-I when applied to day 2 chick embryos. At day 4 of development biochemical indices were compared in treated vs. control groups. Insulin (10-100 ng/embryo) increased the content of protein, total creatine kinase, creatine kinase MB isozyme, triglycerides, cholesterol, phospholipids, DNA, and RNA, in a dose-dependent fashion. IGF-I had a lower potency than insulin in stimulating both metabolic and growth indices and was nearly equipotent in stimulating the creatine kinase MB content (marker of muscle differentiation). The high relative potency of insulin together with the effects of proinsulin (less than 15%) and desoctapeptide insulin (less than 10%) compared to insulin on the chick embryo, led us to infer that at low doses (nanograms per embryo) insulin stimulates developmental processes mainly through the insulin receptor, with the possible exception of muscle differentiation. The broad range of metabolic, growth, and differentiation indices stimulated by insulin and IGF-I in chick embryos, at a stage when specific receptors for both peptides are present, suggests that insulin and IGF-I may have a regulatory, complementary, or overlapping role in normal chick embryo early development. PMID- 3308440 TI - Stimulation of luteinizing hormone-releasing hormone release from perifused hypothalamic fragments by phospholipase A2. AB - LHRH release is dependent on the availability of calcium, and prostaglandin E2 is a potent releaser of LHRH. Therefore, we investigated the role of phospholipase A2 (PLA2) on the release of LHRH from the hypothalamus. Four rat hypothalami were perifused with Krebs-Ringer buffer, and after a 60-min preincubation period, PLA2 was applied during 10 min. The LHRH response was determined by RIA of 10-min fractions collected for the next 60 min. PLA2 induced LHRH release in a dose related manner at amounts of 2, 10, and 50 U. Omission of Ca++ from the medium using EGTA eliminated the PLA2 effect. Indomethacin treatment increased rather than diminished the PLA2 stimulation. Perifusion with melittin, an activator of PLA2, also increased LHRH release. These results are interpreted as a demonstration that PLA2 has a role in the release of LHRH and that a different route of the cyclooxygenase may be involved besides the well known mediation of prostaglandin E2. PMID- 3308441 TI - Insulin resistance of adjuvant-induced granuloma pouch formation in genetically diabetic KK-CAy mice. AB - The characteristics of adjuvant-induced pouch granuloma in genetically diabetic KK-CAy mice with hyperinsulinemia were investigated. Both the dose-response relationship and the time-course experiments showed that the wet weight of pouch granuloma in diabetic KK-CAy mice was lower than in ddY normal mice. Insulin treatment enhanced granuloma formation in KK-CAy mice, and it restored the suppressed DNA content in the granuloma tissue to the level in ddY mice. Although the DNA content was dose-dependently increased by insulin, the ratio of DNA content to granuloma weight was constant. In severely diabetic mice, the granuloma weight was not different from that in normoglycemic mice, despite significantly higher blood insulin levels and greater body weight. Insulin stimulated granuloma formation in severely diabetic KK-CAy mice only when higher doses (1 mg/kg) were given. This evidence suggests that suppression of granuloma formation in diabetic KK-CAy mice is due to insulin resistance and that restoration requires pharmacological doses of insulin. PMID- 3308442 TI - Postprandial changes in plasma ketone body and carnitine levels in normal and non insulin-dependent diabetic subjects. AB - We have examined changes in plasma ketone bodies and their related metabolites after the ingestion of a mixed meal in normal and NIDDM (non-insulin-dependent diabetes mellitus) using a highly sensitive colorimetric method. In normal subjects, fasting plasma acetoacetic acid (AcAc) and 3-beta-hydroxybutyric acid (3-OHB) concentrations were 40.2 +/- 2.9 and 21.3 +/- 4.0 microM, respectively. The total carnitine level in fasting plasma was 48.2 +/- 3.2 microM and acyl/free was 0.34 +/- 0.12. These values did not change significantly after the meal. In diabetic subjects, fasting AcAc and 3-OHB levels were 57.9 +/- 3.5 and 97.9 +/- 14.7 microM, respectively and these values especially 3-OHB, decreased almost to the normal level by 4 h after the meal. The total carnitine level in the fasting plasma of diabetics was 48.7 +/- 2.8 microM and acyl/free was 0.58 +/- 0.09. Such characteristics were observed when their plasma glucose had been completely normal for more than 10 days. In patients treated with sulfonylurea, the fasting ketone body level, especially 3-OHB, was significantly lower than that of diabetics treated with insulin or diet alone, whereas the fasting plasma glucose level and its postprandial increase were higher than those of the others. These results demonstrate that measurement of the plasma ketone body (especially 3-OHB) level is a sensitive tool for monitoring the metabolic status of NIDDM. PMID- 3308443 TI - The insulin receptor: molecular biology and transmembrane signaling. PMID- 3308444 TI - Neuropeptide regulation of appetite and weight. PMID- 3308445 TI - Advances in our understanding of thyroid hormone action at the cellular level. PMID- 3308446 TI - The endocrinology and developmental biology of the prostate. PMID- 3308447 TI - Nerve growth factor-induced changes in neural cell adhesion molecule (N-CAM) in PC12 cells. AB - The effects of nerve growth factor (NGF) on the expression of neural cell adhesion molecule (N-CAM) in PC12 cells were determined. A quantitative immunoassay was used to show that NGF induces a 4- to 5-fold increase in relative N-CAM levels over a 3-day period. This increase could not be mimicked by cholera toxin suggesting that it is not a simple consequence of morphological differentiation. The changes in N-CAM levels induced by NGF were accompanied by changes in N-CAM molecular forms. The 140-kd N-CAM species is the major N-CAM expressed by naive PC12 cells, while NGF-treated cultures express N-CAM species of 180 kd and 140 kd. Northern analysis showed that naive cells express a 6.7-kd N-CAM mRNA species only, while NGF-treated cultures express both a 6.7-kb and a 7.2-kb transcript. As the 6.7-kb and 7.2-kb mRNAs are alternative spliced transcripts of a single gene, this result shows that NGF can activate a neuron specific splicing mechanism. This is the first description of control of N-CAM expression by a growth factor. PMID- 3308449 TI - Analysis of two benzo[a]pyrene-resistant mutants of the mouse hepatoma Hepa-1 P(1)450 gene via cDNA expression in yeast. AB - Two benzo[a]pyrene-resistant mutant clones (c1 and c37) of the mouse hepatoma Hepa-1 wild-type (wt) cell line were examined for their lack of P(1)450 [aryl hydrocarbon (benzo[a]pyrene) hydroxylase (AHH)] activity. From lambda gt11 cDNA libraries, the nearly full-length P(1)450 cDNAs of wt, c1 and c37 were isolated and sequenced. The c1 cDNA was found to have a single mutation leading to premature termination of the protein after Asn-414; a rapidly migrating band corresponding to this truncated protein was found on Western immunoblots. The c37 cDNA was found to have two point mutations, leading to Leu-118----Arg-118 and Arg 245----Pro-245, but otherwise to encode the normal (524-residue) protein; the mature protein was confirmed by Western blot analysis. P(1)450 cDNA from wt, c1 and c37 and chimeric cDNAs between wt and c37 were inserted into the expression vector pAAH5 and expressed in Saccharomyces cerevisiae strain 50.L4. The Leu-118- --Arg-118 mutation alone was found to have negligible effect on AHH activity, while the Arg-245----Pro-245 mutation alone leads to a 2- to 3-fold decrease in enzyme activity. The two mutations together totally abrogate AHH activity. The biologic mutant c37 provides the first evidence for the importance of Arg-245, and the complementary function of Leu-118, in normal P(1)450 enzymic function. This alteration in a single amino acid from arginine to proline might block electron flow directly, or change secondary structure of the protein, such that normal monooxygenation of benzo[a]pyrene cannot occur. PMID- 3308448 TI - A constitutive nucleolar protein identified as a member of the nucleoplasmin family. AB - Using monoclonal antibodies we have localized a polypeptide, appearing on gel electrophoresis with a Mr of approximately 38,000 and a pI of approximately 5.6, to the granular component of the nucleoli of Xenopus laevis oocytes and a broad range of cells from various species. The protein (NO38) also occurs in certain distinct nucleoplasmic particles but is not detected in ribosomes and other cytoplasmic components. During mitosis NO38-containing material dissociates from the nucleolar organizer region and distributes over the chromosomal surfaces and the perichromosomal cytoplasm; in telophase it re-populates the forming nucleoli. With these antibodies we have isolated from a X. laevis ovary lambda gt11 expression library a cDNA clone encoding a polypeptide which, on one- and two dimensional gel electrophoresis, co-migrates with authentic NO38. The amino acid sequence deduced from this clone defines a polypeptide of 299 amino acids of mol. wt 33,531 which is characterized by the presence of two domains exceptionally rich in aspartic and glutamic acid, one of them flanked by two putative karyophilic signal heptapeptides. Comparison with other protein sequences shows that NO38 is closely related to the histone-binding, karyophilic protein nucleoplasmin: the first 124 amino acids have 58 amino acid positions in common. Protein NO38 also shows striking homologies to the phosphopeptide region of rat nucleolar protein B23 and the carboxyterminal region of human B23. We propose that protein NO38, which forms distinct homo-oligomers of approximately 7S and Mr of approximately 230,000, is a member of a family of karyophilic proteins, the 'nucleoplasmin family'. It is characterized by its specific association with the nucleolus and might be involved in nuclear accumulation, nucleolar storage and pre-rRNA assembly of ribosomal proteins in a manner similar to that discussed for the role of nucleoplasmin in histone storage and chromatin assembly. PMID- 3308450 TI - Protein import into yeast mitochondria is inhibited by antibodies raised against 45-kd proteins of the outer membrane. AB - Import of several precursor proteins into isolated yeast mitochondria is inhibited by rabbit antiserum raised against the total mitochondrial outer membrane or against electrophoretically purified 45-kd outer membrane proteins. Antisera against other outer membrane proteins are only marginally active or inactive. Inhibition by the antiserum against 45-kd proteins is only weak with untreated mitochondria, but reaches 80-90% with mitochondria that had been pretreated with 0.1 mg/ml trypsin. This trypsin pretreatment by itself inhibits precursor import only slightly (30-50%). Selective inhibition of import does not correlate with binding of the various IgGs to the mitochondrial surface and is also observed with the corresponding Fab fragments. Inhibition by antibodies against 45-kd outer membrane proteins strongly suggests the existence of a mitochondrial surface protein mediating protein import and offers a means of isolating this protein. PMID- 3308451 TI - Disruption of the outer membrane restores protein import to trypsin-treated yeast mitochondria. AB - Treatment of isolated yeast mitochondria with high levels (1 mg/ml) of trypsin severely inhibits protein import but does not destroy the integrity of the outer membrane or abolish mitochondrial energy coupling. If the outer membrane of these trypsin-inactivated mitochondria is disrupted by osmotic shock, the resulting mitoplasts are again able to import proteins. Protein import into mitoplasts, like that into intact mitochondria, is energy-dependent; however, whereas import into mitochondria is inhibited by antibody against 45-kd proteins of the outer membrane [Ohba and Schatz, EMBO J., 6, 2109-2115 (1987)], import into mitoplasts not affected by this antibody. Protein import into mitoplasts appears to bypass one or more steps normally occurring at the mitochondrial surface. PMID- 3308452 TI - The yeast homologue of U3 snRNA. AB - snR17, one of the most abundant capped small nuclear RNAs of Saccharomyces cerevisiae, is equivalent to U3 snRNA of other eukaryotes. It is 328 nucleotides in length, 1.5 times as long as other U3 RNAs, but shares significant homology both in nucleotide sequence and in predicted secondary structure. Human scleroderma antiserum specific to nucleolar U3 RNP can enrich snR17 from sonicated yeast nuclear extracts. Unlike other yeast snRNAs which are encoded by single copy genes, snR17 is encoded by two genetically unlinked genes: SNR17A and SNR17B. The RNA snR17A is more abundant than snR17B. Deleting one or other of the genes has no obvious phenotypic effect, except that the steady-state level of snR17B is increased in snr17a- strains. Haploid strains with both genes deleted are inviable, therefore yeast U3 is essential. PMID- 3308453 TI - Maturation of vacuolar (lysosomal) enzymes in yeast: proteinase yscA and proteinase yscB are catalysts of the processing and activation event of carboxypeptidase yscY. AB - Studies were performed to unravel the activation and maturation mechanism of vacuolar (lysosomal) proteinases in Saccharomyces cerevisiae. In vivo and in vitro studies show that proteinase yscA and proteinase yscB are involved in the activation and processing event of pro-carboxypeptidase yscY. Processing and activation of pro-carboxypeptidase yscY by proteinase yscA depends on an additional factor contained in the vacuolar fraction. Comparable activation can be mimicked by sodium polyphosphate. Optimum pH for processing by this proteinase yscA-triggered event is 5. The proteinase yscA-triggered maturation process of pro-carboxypeptidase yscY leads to an intermediate mol. wt form of the enzyme which is, however, fully active. Proteinase yscB transfers the intermediate mol. wt form of the original precursor to the apparently authentic, mature and active carboxypeptidase yscY. An activation and maturation scheme is devised. PMID- 3308455 TI - Enhanced glucose availability for working muscles reduces exercise hyperthermia in dogs. AB - Body temperature and metabolic responses to 2 h treadmill exercise in dogs given glucose intravenously (25-30 mg.kg-1 X min-1 throughout the run) were compared with those measured in the same animals with elevated plasma FFA concentrations (soya bean oil ingestion + intravenous heparin) and in control experiments (24 h fasting). In comparison with control conditions enhanced glucose availability for the working muscles caused a reduction in the exercise-induced increases in both rectal (by 0.9 +/- 0.11 degree C) and muscle (by 0.9 +/- 0.16 degree C) temperatures, a lower rate of oxygen uptake (by 16%) and an elevated respiratory exchange ratio. A tendency towards enhanced body temperature responses to exercise, accompanied by increases in VO2 and cardiac frequency was noted in dogs with elevated plasma FFA concentrations as compared with the control animals. The estimated amount of heat effectively dissipated from the body, expressed as a fraction of heat load (thermoregulatory efficiency) was significantly higher in dogs infused with glucose (0.962 +/- 0.0035), than in the controls (0.947 +/- 0.0043) and those with elevated plasma FFA concentrations (0.931 +/- 0.0029). It is concluded that the increased contribution of carbohydrates to the energy yield during exercise results in a marked attenuation of hyperthermia, associated with a reduced metabolic rate and improved thermoregulatory efficiency. PMID- 3308454 TI - The first step in the functional inactivation of the Escherichia coli polynucleotide phosphorylase messenger is a ribonuclease III processing at the 5' end. AB - The transcripts covering pnp, the gene encoding polynucleotide phosphorylase, are processed by ribonuclease III. In this study, it is shown that the steady state level of the pnp mRNA increased 11-fold in a ribonuclease III-deficient strain. The synthesis rate of this messenger is only slightly affected in the mutant strain whereas the half-life, which is 1.5 min in the wild type, is considerably increased to more than 40 min. Moreover, polynucleotide phosphorylase is 10-fold over-expressed in the mutant strain, which shows that unprocessed pnp mRNA is functional. The position of the ribonuclease III-sensitive site suggests that the sequence involved in the stabilization of the pnp mRNA is located at the 5' end of the message and that the RNase III processing triggers the decay of the transcripts downstream. A similar function for ribonuclease III in the processing of the messenger for the beta beta' subunits of RNA polymerase is proposed. PMID- 3308456 TI - The effect of dietary carbohydrate intake on the metabolic response to prolonged walking on consecutive days. AB - Six healthy subjects walked 37 km per day for four consecutive days on two occasions one month apart; on one walk, subjects consumed a high carbohydrate (CHO) diet (85 +/- 1% CHO, Mean +/- SE) and on the other walk an isocaloric low CHO diet (2 +/- 0% CHO) was consumed. Subjects were fasted each day until after the completion of the walk. Blood samples were obtained at rest prior to exercise and after completion of each of three laps of 12.3 km. Exercise intensity corresponded to approximately 17% of VO2max. The first day of each walk demonstrated that the pattern of substrate mobilisation in response to this type of exercise is highly reproducible, there being no difference in any of the parameters measured between the two walks. Circulating glucose, lactate, insulin and triglyceride levels remained essentially unchanged; alanine fell progressively and glycerol, free fatty acid (FFA) and 3-hydroxybutyrate (BHB) rose progressively. After the first day there was a general tendency for the blood glucose concentration to decline as exercise progressed; by the end of the walk on Day 2, blood glucose was lower on the low CHO diet than on the high CHO diet. On Day 4 plasma insulin was higher (p less than 0.05) on the high CHO diet than on the low CHO diet and declined progressively on both diets. Blood lactate and alanine concentrations were generally higher at rest on the high CHO diet, but fell so that no differences existed by the end of exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308458 TI - Nucleotide sequence and comparative analysis of the frd operon encoding the fumarate reductase of Proteus vulgaris. Extensive sequence divergence of the membrane anchors and absence of an frd-linked ampC cephalosporinase gene. AB - The fumarate reductase of Escherichia coli is a bioenergetically important membrane-bound flavoenzyme consisting of four subunits. A and B comprise a membrane-extrinsic catalytic domain whereas C and D are hydrophobic polypeptides which link the catalytic centres to the electron-transport chain. The nucleotide sequence of the frd operon encoding the fumarate reductase of the distantly related bacterium, Proteus vulgaris has been determined and used to predict the primary structures of the respective subunits. Extensive amino acid sequence identity (greater than 80%) was found between the fumarate reductase A and B subunits of P. vulgaris and E. coli. In contrast, the primary structures of the P. vulgaris and E. coli C and D proteins are much less closely related (about 60% homology) although the overall hydrophobicity of their three membrane-spanning segments has been conserved. In most enteric bacteria, the frd operon is followed by genes, ampR and/or ampC, required for the genetic regulation and biosynthesis of a cephalosporinase. The corresponding region of the P. vulgaris genome is occupied by an operon (orf A'BCD) containing at least four genes which are clearly unrelated to the ampC system. Intriguingly the primary structures of the OrfA and OrfD proteins suggest that, like fumarate reductase, they may be components of a membrane-bound enzyme complex involved in energy metabolism. PMID- 3308457 TI - Lipopolysaccharide-sensitive serine-protease zymogen (factor C) of horseshoe crab hemocytes. Identification and alignment of proteolytic fragments produced during the activation show that it is a novel type of serine protease. AB - The horseshoe crab clotting factor, factor C, present in the hemocytes is a serine-protease zymogen activated with lipopolysaccharide. It is a two-chain glycoprotein (Mr = 123,000) composed of a heavy chain (Mr = 80,000) and a light chain (Mr = 43,000) [T. Nakamura et al. (1986) Eur. J. Biochem. 154, 511-521]. In our continued study of this zymogen, we have now also found a single-chain form of factor C (Mr = 123,000) in the hemocyte lysate. The heavy chain had the NH2 terminal sequence of Ser-Gly-Val-Asp-, consistent with that of the single-chain factor C, indicating that the heavy chain is derived from the NH2-terminal part of the molecule. The light chain had an NH2-terminal sequence of Ser-Ser-Gln-Pro . Incubation of the two-chain zymogen with lipopolysaccharide resulted in the cleavage of a Phe-Ile bond between residues 72 and 73 of the light chain. Concomitant with this cleavage, the A (72 amino acid residues) and B chains derived from the light chain were formed. The complete amino acid sequence of the A chain was determined by automated Edman degradation. The A chain contained a typical segment which is similar in sequence to a family of repeats in human beta 2-glycoprotein I, complement factors B, protein H, C4b-binding protein, and coagulation factor XIII b subunit. The NH2-terminal sequence of the B chain was Ile-Trp-Asn-Gly-. This chain contained the serine-active site sequence-Asp-Ala Cys-Ser-Gly-Asp-Ser-Gly-Gly-Pro-. These results indicate that horseshoe crab factor C exists in the hemocytes in a single-chain zymogen form and is converted to an active serine protease by hydrolysis of a specific Phe-Ile peptide bond. PMID- 3308459 TI - Frequency domain fluorescence studies of yeast phosphoglycerate kinase and its ternary complex. AB - A frequency domain fluorescence study of yeast phosphoglycerate kinase has been performed to observe the effect of substrates on the structure and dynamics of the enzyme. At 20 degrees C and pH 7.2, a biexponential decay is observed for tryptophanyl emission. The short fluorescence lifetime (0.4 ns) component is associated with a spectrum having a 329-nm maximum and a 18.4-kJ/mol activation energy, Ea, for thermal quenching. The long-lifetime (3.5 ns) component has a 338 nm maximum and an Ea of only 7.9 kJ/mol. Tentatively we assign the short and long lifetime components to Trp-333 and Trp-308. Binding of the substrates ATP and 3 phosphoglycerate leads to a significant increase in the fluorescence lifetime, the red shift of the emission spectrum and in the decrease in the Ea for both components. Acrylamide-quenching studies indicate that the two tryptophan residues have about the same degree of kinetic exposure to the quencher and that the binding of the substrates causes a very slight change in the quenching pattern. These fluorescence studies indicate that the binding of the substrates to phosphoglycerate kinase may influence the conformational dynamics around the two tryptophan residues located on one of the protein's domains. PMID- 3308460 TI - 1H-NMR studies on the gene-5-encoded single-stranded DNA binding protein of the filamentous bacteriophage IKe. General spectral and structural features. AB - Under physiological conditions and at concentrations needed for NMR studies, severe aggregation of the gene-5 protein of the filamentous phage IKe occurs. Conditions are described for which well-resolved 1H-NMR spectra of the protein can be obtained. The aromatic part of the spectrum is analyzed by means of two dimensional NMR techniques; a complete interpretation is presented. Oligonucleotide binding studies reveal that just one phenylalanyl residue and one tyrosyl residue are influenced by the binding of rAMP, (dA)2, (dA)3, (dA)4, (dA)6, d(pT)3 or (dT)4. Upon binding, the aromatic resonances of these amino acid residues are shifted upfield by about 0.4-0.5 ppm. NMR measurements at different pH values demonstrate that only one of the two histidyl residues is freely titratable. From CIDNP experiments it is concluded that three out of five tyrosyl residues are located at the surface of the protein. Measurements carried out as a function of protein concentration indicate the occurrence of specific protein protein interactions between dimeric gene-5-protein molecules. The data obtained are compared with those available for the gene-5 protein of M13. It follows from the comparison that these proteins mimic each other in almost every respect. PMID- 3308461 TI - Peroxisomal oxidation of L-2-hydroxyphytanic acid in rat kidney cortex. AB - A previously unreported metabolite of mammalian phytanic acid catabolism, 2 oxophytanic acid, was identified by gas chromatography/mass spectrometry analysis. The formation of 2-oxophytanic acid was demonstrated to result from the oxidation of L-2-hydroxyphytanic acid, a reaction catalysed by a rat-kidney cortex H2O2-generating oxidase. The pH optimum for the L-2-hydroxyphytanate oxidase activity was 8.5 and its apparent Km and Vm were about 0.15 mM and 0.35 mumol min-1 (g tissue)-1, respectively. L-2-Hydroxyisocaproate, a substrate of rat kidney L-alpha-hydroxyacid oxidase type B, inhibited the formation of 2 oxophytanate from L-2-hydroxyphytanic acid. Fractionation studies have indicated that 40% of L-2-hydroxyphytanate oxidase was associated with a particulate fraction and that the activity distribution of the oxidase closely paralleled that of catalase, a well known peroxisomal marker enzyme. PMID- 3308462 TI - The photochemical reaction center of Chloroflexus aurantiacus is composed of two structurally similar polypeptides. AB - A method has been devised which allowed the isolation of highly purified reaction center from the thermophilic green bacterium, Chloroflexus aurantiacus. The procedure consisted of three chromatography steps. The final step was fast protein liquid chromatography on Mono Q in the presence of nonanoyl-N methylglucamide (Mega-9). The purified reaction center complex was photochemically active and had an A280/A813 of 1.4 or less. Under non-denaturing conditions, a pigmented protein band having a Mr of 52,000-55,000 was observed in sodium dodecyl sulfate gels. When the isolated complex was heat-dissociated in the presence of sodium dodecyl sulfate, just two polypeptides having very similar Mr (24,000 and 24,500) were observed. Two protein bands were also observed in two dimensional isoelectric focusing/sodium-dodecyl-sulfate polyacrylamide gel electrophoresis; the PI values of the two polypeptides were 6.5 and 6.7. Partial peptide mapping of the two isolated subunits, using both enzymatic and chemical cleavage techniques, yielded almost identical patterns which indicated a high degree of sequence homology between the two polypeptides. The N-terminal amino acid sequences of the two polypeptides were identical and did not exhibit any homology to reaction center subunits of purple sulfur bacteria. The Chloroflexus reaction center is believed to be composed of one molecule of each polypeptide, the photoactive bacteriochlorophyll a dimer and, as accessory pigments, an additional bacteriochlorophyll a and three bacteriopheophytins. Hence, it appears to be the smallest photochemically active reaction center isolated to date. PMID- 3308463 TI - Gastric leiomyosarcoma. Comparative value of barium examinations, ultrasonography and CT scans. AB - The authors discuss four cases of gastric leiomyosarcoma explored by various imaging techniques (barium examinations, ultrasound, CT scans). Barium examinations were normal in two cases, abnormal but insufficient for diagnosis in one, and sufficient to allow topographic diagnosis in one. Ultrasonography gave abnormal findings insufficient for diagnosis in two cases and allowed topographic diagnosis in the other two cases. CT scans were abnormal but insufficient for diagnosis in one case, allowed topographic diagnosis in 3 cases, and in two of the cases permitted initial diagnosis of a connective tissue malignancy. Due to the frequently subserosal nature of leiomyosarcoma of the stomach and of the digestive tract in general, analysis by CT in mandatory. Analysis of tumor relations with the spleen, the left kidney and the pancreas is facilitated by ultrasonography. PMID- 3308464 TI - Pitfalls of digital angiography in the diagnosis of right aortic arch. AB - The authors describe the difficulties using intravenous digital subtraction angiography, in diagnosing on a left anterior oblique view a right aortic arch with aberrant left subclavian artery and left descending aorta. The proximal topography of the left common carotid artery ostium is a useful sign in the diagnosis of this kind of abnormality. PMID- 3308465 TI - Endocrine control and disturbances of calcium and phosphate metabolism in children. AB - Most disorders of extracellular calcium and phosphate metabolism in childhood can be attributed to primary increased or decreased secretion/action of 1,25 dihydroxyvitamin D3 and parathyroid hormone or primary increased or decreased urinary excretion of phosphate and calcium. Based on this pathogenetic classification the most important diseases related to calcium and phosphate metabolism will be discussed. PMID- 3308466 TI - Bacterial endophthalmitis in neonates. AB - Invasive bacterial eye infections in the neonate range from perforating keratitis to panophthalmitis. These infections have gained clinical and therapeutic importance since mortality rates are high and prognosis concerning preservation of vision is poor. Effective antibiotics against the infective agents are now available. Risk factors for developing invasive bacterial eye infections are mainly prematurity and colonisation with Pseudomonas aeruginosa. PMID- 3308467 TI - Partial ornithine transcarbamylase deficiency in females: diagnosis by an immunohistochemical method. AB - Females heterozygous for the X-linked urea cycle disorder, ornithine transcarbamylase (OTC) deficiency have a significant risk of developing hyperammonaemia. Diagnosis of this genetic defect in a proband is the essential starting point for family studies. By an immunohistochemical analysis of the liver specimens fixed in 10% formalin, we confirmed heterozygous status for OTC deficiency in two female patients, a 15-year-old girl and a 2-year-old girl, who died of hyperammonaemia. Since most affected males lack cross reactive materials (CRM), an immunochemical analysis should be useful for the diagnosis of most heterozygous females. PMID- 3308468 TI - Cold thyroid nodules in childhood: is surgery always necessary? AB - In children who present with a cold thyroid nodule the current recommendation is that surgery immediately be performed in view of the high probability of thyroid cancer. Because the incidence of thyroid cancer in children may be decreasing and because extensive experience has been gained in adults with thyroid echography and fine-needle aspiration cytology, we evaluated three consecutive children with cold thyroid nodules by means of these non-surgical techniques. The diagnoses were: thyroid cancer in one patient, thyroid abscess in one and haemorrhagic cyst of the thyroid in one. In the latter two patients, fine-needle aspiration was both diagnostic and therapeutic. We conclude that thyroid echography and fine needle aspiration of thyroid nodules deserve more extensive evaluation in the paediatric age group. PMID- 3308469 TI - Segmental auxiliary liver transplantation in dogs: a search for an ideal graft- illusion or reality? AB - Segmental auxiliary liver transplantation (SALT) has been carried out in 13 mongrel dogs to assess the possibility of a certain size of liver segment to accept without sequelae the total splanchnic and arterial blood normally diverted to the liver of the host. Prednisone (1 mg/daily) and azathioprine (2 mg/kg daily) were used as immunosuppression. Five dogs died during the first hours after the operation. Three because of technical failure and two of acute portal hypertension secondary to total portal and arterial blood diversion in dogs with liver segments of 195 +/- 49 g as a result of overloading of the graft. The remaining 8 dogs were divided into: 4 dogs into which a liver segment (195 +/- 49 g) was transplanted (group A) and 4 dogs in which a liver segment (385 +/- 85 g) was used (group B). Partial portal and total arterial blood diversion in group A dogs was not associated with portal hypertension but resulted in poor function of the graft and in poor survival. In contrast, the graft in group B dogs was able to cope with both total or partial portal blood and with a normal arterial blood diversion. Infection and graft rejection prohibited long-term survival (8-28 days). Data from this study support the view that the present technique of SALT with a graft corresponding to 300-400 g in mongrel dogs of about 30 kg is a potential alternative as temporary liver support in the diseased animal. PMID- 3308471 TI - Benign testicular tumors. AB - Testicular tumor is considered rare in Oriental people and benign testicular tumor has never been reported from this area. From 1969 to 1985 70 cases of intratesticular tumors were treated at Tri-Service General Hospital. 12 of them were benign in nature including 8 epidermoid cysts, 1 cavernous hemangioma, 1 foreign body granuloma with pseudocyst, 1 Sertoli cell tumor and 1 intratesticular simple cyst. A testis-sparing procedure was performed for 5 epidermoid cysts, the Sertoli cell tumor and the simple intratesticular cyst. The tumors were excised completely and the testes were preserved after careful and thorough frozen section pathological studies. One of the epidermoid cysts and the case of simple testicular cyst were diagnosed correctly before surgery by using scrotal ultrasound. PMID- 3308470 TI - Microvascular changes in the early stage of reflux pyelonephritis. An experimental study in the pig kidney. AB - Renal microvascular changes were studied in the pig kidney during the initial stage of reflux pyelonephritis. In 10 piglets vesicoureteric reflux was surgically induced. The animals were then infected with a strain of Escherichia coli and sacrificed 2 weeks following the initiation of infection. Following injection of the kidneys with Microfil, microvascular changes were investigated by a combined stereomicroscopic, microradiographic and histological technique. Renal microcirculation was found to be impaired in the areas involved in the acute inflammatory process, owing to the compression of glomeruli, small peritubular capillaries and vasa rectae by the ensuing interstitial oedema. These findings indicate that acute focal ischaemia caused by microvascular obstruction could be an important factor in the mechanism of renal damage in reflux pyelonephritis. PMID- 3308472 TI - Non-functioning tumor of the suprarenal gland. Compatible with metastasis from a melanoma. AB - A case of metastatic melanoma in the right suprarenal gland is presented. It manifested as a mass and paraneoplastic syndrome. We put forward a set of considerations on the differential diagnosis of suprarenal masses, and the diagnostic use of several tests taken in conjunction (echography, computer tomography, percutaneous punctures). PMID- 3308473 TI - Technical pitfalls, methodological improvements and quality control of steroid hormone receptor assays. PMID- 3308474 TI - Role of chemotherapy for localized non-Hodgkin's lymphoma? PMID- 3308475 TI - Hairy cell leukemia still an enigmatic disease. PMID- 3308476 TI - Do proteases play a role in cancer invasion and metastasis? AB - The main difference between a benign and malignant tumor is the ability of the malignant form to invade normal tissue and spread or metastasize to distant sites throughout the body. It is the ability to form metastasis which makes cancer such a difficult disease to treat. Evidence suggesting that proteolytic enzymes are involved in cancer spread is as follows: proteases are involved in normal destructive events and tissue remodelling, correlations exist between different protease activities and metastatic potential in model tumor systems, inhibitors and antibodies against proteases inhibit metastasis in model systems and the finding of highest levels of protease activity at the invading front in tumors. The most likely mechanism by which proteases could mediate metastasis is by catalyzing degradation of the extracellular matrix and basement membranes. It is concluded that if proteases could be proved to play a role in the spread of human cancers, inhibition of these enzymes could open up new therapeutic approaches for the control of malignancy. PMID- 3308477 TI - Double-blind controlled trial of the antiemetic efficacy and toxicity of methylprednisolone (MP), metoclopramide (MTC) and domperidone (DMP) in breast cancer patients treated with i.v. CMF. AB - Sixty-two patients treated for the first time with i.v. CMF were included in a double-blind comparative study aimed at evaluating the efficacy of 3 different drugs (methylprednisolone (MP), metoclopramide (MTC), and domperidone (DMP) in preventing chemotherapy-induced nausea and vomiting. Complete protection from vomiting/nausea was obtained in 85%/80% in the group treated with MP; in 60%/65% in the group treated with MTC and in 38%/42% in the group treated with DMP. Average number of vomiting episodes was 2.4 with MP, and 1.7 with MTC and 6.2 with DMP. Older patients seem to be a prognostically unfavorable subgroup. Side effects were mild and infrequent. We conclude that MP and MTC are probably equally efficacious antiemetic treatments in patients undergoing i.v. CMF chemotherapy, but due to the risk of extrapyramidal reactions with MTC, MP probably should be the treatment of choice in these patients. PMID- 3308478 TI - The effect of the immune status of the TAR mouse on the growth and metastasis of tumour xenografts. AB - Mice thymectomised at 3-4 weeks of age and subsequently given whole-body irradiation (9 Gy) under cytosine arabinoside cover (TAR mice) provide an alternative model to the athymic nude (nu+/nu+) mouse for studying the biological characteristics of tumour xenografts. In the present study we have evaluated the repopulation events in the bone marrow and spleen following whole body irradiation of TAR mice, and analysed immune competence up to 98 days following irradiation. Repopulation of both bone marrow and spleen was evident in the weeks following whole body irradiation, and an initial increase in the relative proportion of T-lymphocytes present in the spleen was followed by a decrease in the percentage of lymphocytes expressing T-cell markers, which remained below the level observed in control mouse spleen cell preparations. TAR mice exhibited a decreased ability to respond to a non-specific T-cell mitogen and to elicit a T cell dependent antibody response to influenza viral antigen. Both TAR and control mice possessed macrophages which could be activated to the tumouricidal state, and natural killer activity of TAR mice was enhanced greater than 3-fold above control values. The ability of TAR mice to accept tumour xenografts decreased with the increasing time interval between irradiation and subcutaneous implantation of tumour cells, and (in some instances) spontaneous regression was observed. In addition, a hamster tumour cell line possessing high metastatic potential in its syngeneic host was shown to metastasise to the regional lymph node, lungs, liver, kidneys and spleen of TAR mice from a cell inoculum implanted subcutaneously immediately after irradiation; however, with increasing time between irradiation and inoculation of tumour cells tumour metastasis decreased. The ability of TAR mice to support the growth and metastasis of tumour xenografts would appear to inversely correlate with the increase in natural killer cell activity following irradiation. PMID- 3308479 TI - The clinical value of serum CA125 levels in ovarian cancer patients receiving platinum therapy. AB - Serum CA125 concentrations are elevated in 60% (49/86) of patients, with histologically proven residual adenocarcinoma of the ovary, before chemotherapy. The frequency of elevated levels correlates with stage of disease and tumour size but not histological tumour type. Serial antigen determinations in 44 patients receiving monthly i.v. infusions of platinum therapy suggest that an elevated serum CA125 concentration after chemotherapy may identify the presence of residual tumour but a serum antigen level falling into the normal range does not always indicate the complete eradication of tumour. The role of this serum marker is limited by lack of sensitivity for small tumour masses. PMID- 3308480 TI - Value of CEA determination in biological fluids and tissues. PMID- 3308481 TI - Perspectives in the treatment of hairy cell leukemia. PMID- 3308482 TI - Preclinical toxicology of platinum analogues in dogs. AB - A toxicology study of cis-diamminedichloroplatinum (II) (CDDP), aqua(1,1-bis (aminomethyl)cyclohexane)sulfatoplatinum(II) (TNO-6), diammine(1,1 cyclobutanedicarboxylato)platinum(II) (CBDCA), cis-dichloro-trans-dihydroxo-cis bis(isopropylamine)platinum-(IV) (CHIP) and ethylenediaminemalonatoplatinum(II) (JM-40) was carried out in dogs. The main purpose of the study was to compare the results with those obtained earlier in mice and rats and with the toxicology data in humans. Each platinum compound was tested in three dogs. Each dog received three intravenous bolus injections at intervals of 3 weeks. The compounds were administered in dosages of 1.2, 1.0, 12, 10 (or 6) and 10 mg/kg, respectively. Toxic death occurred for two dogs (both on day 54) from haematotoxicity (10 mg/kg CHIP) and renal toxicity (TNO-6), respectively. Serum urea nitrogen and creatinine concentrations were variable after TNO-6 and remained within normal values after treatment with the other compounds. Severe proteinuria was observed in all three dogs treated with TNO-6. Values returned to normal within 16 days. JM-40 did not cause significant proteinuria. CDDP, CBDCA and CHIP caused short lasting and slight proteinuria. CHIP caused a severe reduction in the number of leukocytes and platelets, while the other drugs caused acceptable reductions. Except after the high dose CHIP regimen, haematotoxicity was of a transient nature. Vomiting in order of severity occurred after TNO-6, CHIP, CDDP and JM-40, while CBDCA did not cause any vomiting. The dogs were sacrificed 6 weeks after the last drug dose. Organs were fixed for histopathology to complete and support clinical-toxicological parameters. On the basis of the results from the single dose study in dogs and those obtained earlier in mice and rats it can be concluded that the gain from the use of the dog as a prognosticator for organ toxicity in man was disappointing and limited to the prediction of vomiting. PMID- 3308484 TI - In vitro depletion of clonogenic cells in adult acute lymphoblastic leukemia with a CD10 (anti-cALLA) monoclonal antibody. AB - A semi-solid medium colony assay was used in common acute lymphoblastic leukemia (cALL) to test growth inhibition of leukemic progenitors (CFU-L) after exposure to monoclonal antibodies (MoAbs) directed against CD10 and CD9 antigens. Peripheral or bone marrow cells from 15 patients were plated after exposure to various concentrations of ALB2, a CD10 cytotoxic MoAb, followed by complement lysis. CFU-L inhibition was complete (no residual colony) in 5 cases (33%), marked (greater than or equal to 95%) in 4 cases (27%), but only moderate (64% +/ 28) in 6 cases (40%). This inhibition was not related to the percentage of cALLA positive cells before exposure to MoAb. In addition, cells of 5 patients were exposed to BA1 (CD24) + complement. In these cases, the proportion of CFU-L inhibition was equal to or higher than with ALB2. In 3 cases, cells were exposed to an association of ALB2 and SB4 (CD19) MoAbs followed by complement lysis, with a marked inhibition (greater than or equal to 99%) in 2/3 cases. These observations give supplementary support to the use of several MoAbs directed against various antigens present at early stages of B differentiation. PMID- 3308483 TI - A randomized, prospective, comparative, multicentre trial of a single combination versus alternating combinations of antitumour drugs in advanced breast cancer. AB - A prospective, multicentre trial was conducted in 262 patients with advanced breast cancer randomized to receive every 3 weeks either: (i) a single five-drug combination of adriamycin (50 mg), vincristine (1.5 mg) and 5-fluorouracil (750 mg) given intravenously; with methotrexate (50 mg) intramuscularly and chlorambucil (10 mg) orally all at time zero, followed by three further doses of chlorambucil (10 mg) at 6-h intervals, or (ii) one course of two alternating three-drug combinations consisting of regimen A--vincristine (1.5 mg), adriamycin (70 mg) and methotrexate (50 mg) and regimen B--5-fluorouracil (750 mg) and vindesine (5 mg) intravenously with cyclophosphamide (50 mg) orally at time zero, followed by three further doses of cyclophosphamide (50 mg) at 6-h intervals. Results show that overall response rates to chemotherapy were comparable in the two arms of this study being 63% (83 of 131 patients) for the single combination and 64% (84 of 131 patients) for the alternating combinations. Response rates according to menopausal status indicate no significant difference for the two arms of this study. However overall, combining all patients treated with either the single or the alternating combinations, post-menopausal patients had a significantly lower response rate (57%) compared with pre-menopausal patients (76%), P less than 0.05. Overall serious side-effects were minimal and were similar in both treatment groups. Response durations and overall survival data, which are essentially similar for the two treatment groups, proved disappointing with a median response duration of only approx. 6 months and overall median survival only slightly in excess of 1 year. Alternative treatment approaches are needed to maintain the remissions initially achieved in metastatic breast cancer. PMID- 3308486 TI - Strategy training: a need for clarification. PMID- 3308485 TI - Establishment of human ovarian tumour lines in nude mice and their responses to platinum analogues. PMID- 3308487 TI - Disposition of moracizine (ethmozine) in healthy subjects after oral administration of radiolabelled drug. AB - Moracizine (ethmozine) is a phenothiazine derivative with demonstrated antiarrhythmic activity. To characterize the pharmacokinetics and material balance relationships in humans, we have given 14C-moracizine X HCl as a single oral dose of 500 mg (50 microCi) to six healthy men. Plasma, urine, and faecal samples were collected for 7 days after administration and the concentrations of total radioactivity and intact moracizine were determined by liquid scintillation counting and HPLC, respectively. Urine and faecal recovery accounted for 95% of the administered radioactivity. Most of this radioactivity was found in the faeces (59%). Only 0.05% of the dose was recovered from urine as intact moracizine. The Cmax and AUC for moracizine equivalents of total radioactivity were 4- and 18-fold higher, respectively, than the corresponding values for intact moracizine. Additionally, both the disappearance of total radioactivity from plasma and its excretion rate into urine were slower in comparison to intact drug. Terminal t1/2 values calculated from plasma concentration-time data were 85.2 and 3.5 h for total radioactivity and intact moracizine, respectively. However, based on urinary excretion rates, the t1/2 for total radioactivity was shorter (29.3 h) while the t1/2 for intact drug was comparable (2.7 h) to the results obtained from the plasma data. The oral plasma clearance of moracizine was relatively large (2.2 l X min-1), suggesting first-pass metabolism. The estimated oral systemic availability of moracizine was 34%. PMID- 3308488 TI - Cyclophilin binds to the region of cyclosporine involved in its immunosuppressive activity. AB - Although several cytosolic proteins including calmodulin and cyclophilin have been shown to bind cyclosporine, the direct involvement of these proteins in the immunosuppressive activity of cyclosporine remains to be established. In the present study, a quantitative immunoassay for cyclophilin was developed which made it possible to compare its relative affinity for cyclosporine and any of its analogues. The binding of cyclophilin to cyclosporine coated on a solid phase was revealed by anti-cyclophilin rabbit antiserum followed by antiglobulin-enzyme conjugate. This reaction could be inhibited by addition of free cyclosporine or certain cyclosporine analogues. By studying the binding of cyclophilin to more than fifty cyclosporine derivatives modified singly on each of the eleven amino acid residues, it could be shown that cyclophilin binds to the residues of cyclosporine known to be critical for its immunosuppressive activity. These data identify cyclophilin as a highly discriminating stereospecific binding protein for cyclosporine. PMID- 3308489 TI - Endothelial cell lysis induced by lymphokine-activated human peripheral blood mononuclear cells. AB - In vitro exposure of human peripheral blood mononuclear cells (PBMC) to interleukin 2 results in the generation of lymphokine-activated killer (LAK) cells. Such LAK cells exhibit cytotoxicity against a spectrum of tumor target cell lines whereas they apparently do not affect normal tissues. In this report we show that PBMC that have been activated with T cell growth factor lyse trypsinized human umbilical cord venous endothelial cells as well as endothelial cell monolayers in a dose-dependent manner. Microscopic analysis showed that during the 4-h incubation period cell clumps containing detached endothelial cells and LAK cells were formed. When these clumps were evaluated with trypan blue the endothelial cells stained positive whereas LAK cells excluded the dye. No lysis occurred when fresh PBMC were added to target endothelial cells. The endothelial cell kill could not be blocked with an anti-LFA-1 antibody nor with intact OKT3 or F(ab')2 fragments of WT32. We conclude that lymphokine-activated PBMC exhibit cell-mediated endothelial cell detachment and lysis. PMID- 3308490 TI - Anticonvulsant action and biochemical effects in DBA/2 mice of CPP (3-((+/-)-2 carboxypiperazin-4-yl)-propyl-1-phosphonate), a novel N-methyl-D-aspartate antagonist. AB - CPP has a potent anticonvulsant effect against sound-induced seizures in audiogenic DBA/2 mice. Pretreatment with CPP (0.01-10 nmol i.c.v., 45 min) protects against successive phases of sound-induced seizures in a dose-dependent fashion (ED50, tonic phase, 0.023 nmol; clonic phase, 0.039 nmol; wild running, 0.17 nmol). Systemic administration of CPP (0.001-0.1 mmol/kg i.p., 45 min) produces a similar protection (ED50, tonic phase, 0.0012 mmol/kg; clonic phase, 0.0026 mmol/kg; wild running, 0.021 mmol/kg). Following the administration of a fully anticonvulsant dose of CPP (0.1 mmol/kg i.p., 45 min) to adult DBA/2 mice regional brain glucose (cerebellum and striatum) levels are elevated and lactate (striatum and hippocampus) levels decrease. The CPP-induced changes in alanine, serine and glycine paralleled those of lactate. Aspartate levels are significantly decreased by CPP in the striatum (-21%) and the hippocampus (-23%). PMID- 3308491 TI - Chronic treatment with antidepressants decreases the number of [3H]SCH 23390 binding sites in the rat striatum and limbic system. AB - Binding of [3H]SCH 23390 to dopamine D-1 receptors and of [3H]spiperone to D-2 sites was measured in identical membrane preparations of the striatum and limbic system of rats treated chronically (twice daily, for two weeks) with antidepressants. Chronic administration of imipramine, amitriptyline, mianserin, citalopram, bupropion, iprindole and electroconvulsive shocks, but not benztropine or cyproheptadine (non-antidepressants) decreased the number of [3H]SCH 23390 binding sites, while no change in the parameters of [3H]spiperone binding was observed. The serotonin2 receptor antagonist ketanserin when added to the incubation medium had no effect on [3H]SCH 23390 binding to D-1 sites. The results suggest that D-1 receptor subsensitivity is a component of the therapeutic effect of antidepressants. PMID- 3308492 TI - Regulation of c-myc transcription and protein expression during activation of normal human B cells. AB - The close link between an actively expressed c-myc gene locus and cellular proliferation has been established in a variety of cell types. By using normal human peripheral blood B cells as a model for in vivo quiescence, we have assessed the expression pattern of the c-myc gene in terms of transcriptional activation and concurrent production of c-myc protein, following induction by antibodies directed against antigens on the cell membrane. Both the 1F5 monoclonal antibody, which reacts with the pan B cell antigen CD20, and the anti mu could promote transcriptional activation of the c-myc gene roughly corresponding to the increased levels of cytoplasmic c-myc mRNAs. In addition, more than 80% of the B cells could be induced to express c-myc protein by either stimulus. Since treatment only with polyclonal anti-mu renders the B cells competent to proliferate in the presence of BCGF, c-myc protein expression is not per se sufficient for cell cycle progression into S phase. PMID- 3308493 TI - Regulated arrest of cell proliferation mediated by yeast prt1 mutations. AB - Several temperature-sensitive cell-division-cycle (cdc) mutations differentially affect the regulatory step for cell proliferation in the yeast. Saccharomyces cerevisiae, including one mutation termed cdc63-1, which resides in a previously known gene called PRT1. Other mutations in the PRT1 gene have been shown by others to affect an initiation step in protein synthesis. Here we show that at the appropriate nonpermissive temperature each prt1 mutation can produce a uniform and concerted arrest of cell division; the prt1-1 mutation, like cdc63-1, is shown to arrest cells specifically at the regulatory step for cell proliferation. This response of cessation of cell division is different from the response of cells to an equivalent limitation of protein synthesis using cycloheximide or verrucarin A, which implies that the PRT1 gene product could separately influence both cellular growth via protein synthesis and events in the regulation of cell proliferation. PMID- 3308494 TI - The role of hormones and prostanoids in the in vitro proliferation and differentiation of human myoblasts. AB - Fetal human myoblasts have been employed to examine the role of hormonal factors in human myogenesis. The results show that human myoblast proliferation is stimulated by insulin, hydrocortisone, and prostaglandin F2 alpha (PGF2 alpha). Exposure of human myoblasts preparing to differentiate to either PGE2 or isoproterenol results in the precocious initiation of differentiation (i.e., cell fusion and increase in creatine kinase activity). Three antagonists of prostanoid synthesis, indomethacin, aspirin, and DL-6-chloro-alpha-methylcarbozole-2-acetic acid, inhibit cell number increase with complete inhibitions of proliferation at 5 X 10(-5) M indomethacin and 6 X 10(-4) M aspirin. Reversal of the indomethacin imposed block is achieved by prostaglandin F2 alpha. The same antagonists of prostanoid synthesis, when added to older cultures, depress prostaglandin E (PGE) levels and inhibit human myoblast differentiation. During differentiation, PGE is present in both the intracellular compartment (0.47 to 0.66 pmol/microgram DNA) and the culture medium (1.83 to 4.53 nmol PGE). The results suggest a role for prostanoids in the regulation of both human myoblast proliferation and differentiation. They also demonstrate that the active cyclooxygenase products are produced endogenously by the in vitro myogenic population. The findings are discussed within the context of what is known of the relationship between growth factor and prostanoid actions and the roles of these two categories of hormones in the regulation of myogenesis. PMID- 3308496 TI - A high molecular weight actin binding protein: its localization in the cortex of the sea urchin egg. AB - From the Triton-treated cortex fraction of sea urchin eggs, a high molecular weight actin binding protein (260K protein) was solubilized by a high salt solution and purified. A cosedimentation assay revealed that the 260K protein binds to actin filaments in a concentration-dependent manner. The low-shear viscosity of actin solutions largely increased in a concentration-dependent manner after addition of 260K protein. Electron microscopy showed that this protein induces the formation of large curled bundles of actin filaments. Different from fascin-induced actin bundles, no clear striations were observed within the actin bundles formed by the 260K protein. Antibodies against the 260K protein were raised in a rabbit and affinity purified. Immunoblotting analysis of Triton-solubilized cortex and various subcellular fractions showed that first only a single band reacted with the antibody and second that the 260K protein exclusively localized in the cortex fraction. Indirect immunofluorescence microscopy localized the protein in the cortex and the region of the cleavage furrow. After double staining, the fluorescence images for actin filaments and the 260K protein well correlate with each other. PMID- 3308495 TI - Similarities and differences in the regulation of N-myc and c-myc genes in murine embryonal carcinoma cells. AB - c-myc and N-myc are closely related genes coding for putative DNA-binding proteins. The protein products of both genes have been implicated in the regulation of growth of normal and neoplastic cells. We compared the regulation of N-myc and c-myc expression under different growth conditions as well as in vitro differentiation of the murine EC lines F9 and PCC7. N-myc and c-myc expression was found to be regulated by distinct mechanisms, although similarities exist. Differences were found both at the transcriptional and at the post-transcriptional level. The two myc genes were regulated by mainly post transcriptional mechanisms, but in PCC7 cells nuclear run-on assays indicated that c-myc was repressed at the level of transcription. N-myc and c-myc expression was negatively regulated at a post-transcriptional level in F9 and PCC7 cells during differentiation to visceral endoderm and nerve-like tissue, respectively. Serum stimulation of F9 cells for 4 h induced a sevenfold increase in c-myc transcripts but no significant elevation of N-myc transcripts. Mitogenic stimulation with insulin and transferrin also induced a marked elevation of c-myc but not of N-myc mRNA. In addition, the N-myc and c-myc genes differed in F9 cells with respect to (i) the kinetics of expression following induction of differentiation, c-myc undergoing quicker changes than N-myc; (ii) the response to cycloheximide inhibition of protein synthesis, indicating that c-myc but not N myc is down-regulated by a short-lived protein; and (iii) the half-lives of the transcripts, estimated to be approximately 40 min for c-myc and 130 min for N myc. PMID- 3308497 TI - Role of thrombin in the proliferative response of T-47D mammary tumor cells. Mitogenic action and pleiotropic modifications induced together with epidermal growth factor and insulin. AB - The growth of the human metastatic cell line (T-47D) in a chemically defined medium (DM) is shown to be dependent on the presence of three traditional growth factors: epidermal growth factor, insulin, and transferrin. The addition of thrombin further stimulates its growth. The mitogenic action on a human mammary tumor cell line from epithelial origin is a novel action of thrombin. Cells in the DM show striking morphological changes which are dramatically enhanced by the addition of thrombin. These observations are part of a pleiotropic response to the growth factors: the protein content of the cells increases in the defined medium; the 2DG gels of the 35S- and 32P-labeled proteins show important changes in spots, several of which are probably of cytoskeletal origin. It is also shown that cells in a semisolid growth factor-supplemented medium have growth advantages over their counterparts grown with serum. All the phenotypic changes mentioned above reveal the important role of growth factors in the growth and behavior of this mammary cell line. The results obtained with thrombin indicate a new site of action of this enzyme which may be important in the metastatic spread of human mammary tumor cells. PMID- 3308498 TI - Autonomic neurons supplying the rat eye and the intraorbital distribution of vasoactive intestinal polypeptide (VIP)-like immunoreactivity. AB - We traced the origin and path of autonomic nerves to the rat eye using, as an aid to dissection, a modified thiocholine method for the histochemical demonstration of cholinesterase. When applied to whole nerves and ganglia supplying the rat eye, this procedure is not specific for cholinergic neurons; instead it stains both sympathetic and parasympathetic nerves, many of which are otherwise too fine to identify in dissection. We found that nerves from the superior cervical and pterygopalatine ganglia form a plexus at the orbital apex corresponding to the retro-orbital plexus found in rabbit, monkey and man. In the rat, nerves from the retro-orbital plexus travel peripherally to the superior surface of the optic nerve sheath. Here, they fuse with long ciliary nerves and the post-ganglionic nerves from the ciliary ganglion to form another dense nerve-fiber plexus that ultimately supplies the eye. Importantly, the plexus on the optic nerve contains many isolated or aggregated ganglion cells. These are comparable in number to those in the ciliary ganglion itself and are assumed to be accessory ciliary neurons. Using immunohistochemistry, we also sought evidence for vasoactive intestinal polypeptide in these ganglia and nerves. As previously known, many pterygopalatine ganglion cells are immunoreactive for this peptide. Vasoactive intestinal polypeptide (VIP)-like immunoreactive nerve fibers are present in nerves from the retro-orbital plexus to the optic-nerve sheath plexus, in most nerves of the latter plexus, and in most nerves entering the eye. Furthermore, a small proportion of nerve cells in the main and accessory ciliary ganglia also are immunoreactive for VIP. We conclude that in addition to the pterygopalatine ganglion, the ciliary ganglion and its accessory ganglia are sources of VIP-like immunoreactive nerves in the rat eye. PMID- 3308499 TI - Acetylcholine as a neurotransmitter in the vertebrate retina. AB - The evidence for the existence of acetylcholine as a neurotransmitter in the vertebrate retina is reviewed. There is evidence for the existence of a cholinergic system in every retina studied to date; therefore, it appears that acetylcholine is both essential and ubiquitous at this level of the visual system. Particular attention is directed to descriptions of the possible functions of acetylcholine in the retina, and formation of testable models which will serve to elucidate some of the details of cholinergic neurotransmission in the retina. PMID- 3308500 TI - Comparison of collagen degradation and synthesis in the peripheral and central areas of experimental corneal grafts. AB - The distribution of collagen degradation and synthesis (turnover) between the central and peripheral areas of clear corneal allografts was determined, following transplantation of 6-mm [3H]proline-labelled corneal buttons from extensively pre-labelled, young rabbits into 13 nonradioactive mature rabbits. Control, contralateral 6-mm corneal buttons of each radioactive pair were frozen at -70 degrees C after being trephined into a central 3-mm button and a peripheral ring of cornea. The grafts were removed 10-100 days after the operation and trephined similarly to the paired controls. The central and peripheral areas of the graft and control corneal buttons were analysed separately for total hydroxyproline and radioactivity. A significant degradation of old collagen (as seen by the loss of total radioactivity) occurred early in both the central (19.4 +/- 6.1%) and peripheral (12.3 +/- 7.5%) areas of the grafted corneas, compared to the corresponding areas of the contralateral controls. A significant increase in new, non-radioactive collagen occurred in both the central (22.0 +/- 7.6%) and peripheral areas (30.6 +/- 6.1%); however, a significant net increase in total collagen occurred only in the peripheral area (18.3 +/- 11.4). Loss of original (old) collagen was significantly greater in the central area than in the peripheral area; whereas, the increase in new collagen was significantly greater in the peripheral area than the central area, accounting for a significant increase in total collagen. There was no correlation in collagen turnover with time after surgery. Collagen turnover occurs acutely throughout the clear corneal graft and thereafter is stable. PMID- 3308501 TI - Ontogeny of alpha A and alpha B crystallin polypeptides during Rana temporaria lens development. AB - The ontogeny and localization of alpha A and alpha B polypeptide chains of alpha crystallin were investigated in the developing lens of Rana temporaria, an anuran amphibian, using the indirect immunofluorescence staining method with heterologous antibodies directed against these two polypeptides. alpha A and alpha B crystallins are primary gene products and are translated by different mRNAs in mammals. Although they show about 6000 amino-acid sequence homology (Bloemendal, 1977), the alpha A cDNA of rat and mouse does not hybridize to alpha B mRNA (Dodemont et al., 1981; King and Piatigorsky, 1983). Antigenically too, alpha A and alpha B polypeptides have been shown to be different. These two polypeptides were isolated from mouse lens native alpha-crystallin by SDS-gel electrophoresis and were injected into young rabbits to raise antibodies. These antibodies were tested by immunoblotting against R. temporaria total lens soluble proteins before their use in the present investigation. Results presented here show that in the developing lens of R. temporaria, alpha A appears earlier than alpha B, suggesting a differential gene activation. In addition, these two polypeptides could not be detected either in the developing lens epithelium or in the epithelium of young froglets (2-3 weeks post-metamorphosis). PMID- 3308502 TI - Generation of murine hematopoietic precursor cells from macrophage high proliferative-potential colony-forming cells. AB - High-proliferative-potential colony-forming cells (HPP-CFC) have been described as primitive murine macrophage progenitors. We have previously demonstrated the existence of two populations of HPP-CFC: one population, termed HPP-CFC-1, is stimulated by the combination of macrophage colony-stimulating factor (CSF-1) plus haemopoietin-1 (H-1) and actively generates a second population of HPP-CFC, termed HPP-CFC-2. HPP-CFC-2 are stimulated by CSF-1 plus interleukin-3 and generate macrophage CFC that differentiate to form mature macrophages. In this study, we have demonstrated that HPP-CFC-1, when stimulated by CSF-1 plus H-1, generate colony-forming cells (CFC) for the megakaryocyte and granulocyte lineages in addition to HPP-CFC-2 and M-CFC. No CFC were detected with erythroid potential. In addition, HPP-CFC-1 generated cells that formed day-13 spleen colonies, cells that repopulated the bone marrow, cells with platelet repopulating ability, and cells with erythroid-repopulating ability in lethally irradiated mice. These data support previous data that the HPP-CFC-1 represent a primitive hemopoietic cell population and demonstrate the multipotentiality but not totipotentiality of these cells. PMID- 3308503 TI - In vitro responses of airways from an asthmatic patient. AB - Responses of isolated human airways, obtained from a single asthmatic patient at thoracotomy, were compared to responses of airways from 10 non-asthmatic subjects in vitro. Asthmatic bronchiolar strips exhibited increased contractile responses to histamine, methacholine and leukotriene (LT) C4, and relaxed normally in response to 1-isoprenaline and forskolin. The non-adrenergic inhibitory response to field stimulation was low, but was not significantly different from control values. These results suggest that increased airway smooth muscle contractility may contribute to the asthmatic airways hyperresponsiveness in this patient. PMID- 3308504 TI - Diagnostic levels of ultrasound may disrupt myelination. AB - Neonatal rats 3 to 5 days of age were exposed to the ultrasound beam from a medical ultrasound imaging system. Dorsal nerve roots were examined by electron microscopy. Comparison between exposed and sham-exposed controls revealed disruption of the nodes of Ranvier attributable to ultrasound. Morphologic changes ranged from vacuole formation in the paranodal region to frank demyelination and were still evident after 24 h of recovery. Rats of this age are at a stage of myelination similar to that of a human fetus 4 to 5 months. The ultrasound intensities used in this study are consistent with those used for human imaging (SPTA 0.135 mW/cm2, SATA 0.045 mW/cm2, SPTP 8.7 W/cm2, SPPA 1.9 W/cm2), but the relevance of these findings to clinical ultrasound will require further study. PMID- 3308505 TI - Plasmodium falciparum: fine structural changes in the cytoskeletons of infected erythrocytes. AB - Following parasitization by Plasmodium falciparum, numerous changes take place in the host erythrocyte membrane. In this study, we used the technique of whole cell mount electron microscopy to determine if the ultrastructure of the erythrocyte cytoskeleton changed following parasitization with knobby and knobless strains of P. falciparum. Using this technique, a network of spectrin filaments (3-10 X 45 120 nm) branching from electron dense junctions (15-25 nm in diameter), the presumed site of bands 4.1 and actin, were visualized. The overall architecture of normal and parasitized erythrocyte cytoskeletons was the same: however, additional patches (35 to 60 nm in size) and aggregates (30 X 150 nm) of electron dense material were present in parasitized skeletons. The ultrastructure of knobby and knobless cytoskeletons was similar, except knobless skeletons usually did not possess the larger aggregates of material. Antigens associated with the erythrocyte cytoskeleton of cells infected with knobby and knobless strains, but not uninfected cells, were demonstrated by indirect immunofluorescence. Results suggest that antigens, associated with the erythrocyte cytoskeleton, may contribute to perturbations in the host erythrocyte membrane. PMID- 3308506 TI - Plasmodium vivax: exoerythrocytic schizonts recognized by monoclonal antibodies against blood-stage schizonts. AB - Exoerythrocytic parasites of Plasmodium vivax grown in human hepatoma cells in vitro were probed with monoclonal antibodies raised against other stages of P. vivax. Monoclonal antibodies specific for four independent antigens on blood stage merozoites all reacted with exoerythrocytic schizonts and merozoites by immunostaining. The characteristic staining pattern of each monoclonal antibody was similar on both blood- and exoerythrocytic-stage parasites and appeared only in mature schizont segmenters. In contrast, a monoclonal antibody specific for the caveolar-vesicle complex of the infected host cell membrane and a second monoclonal antibody reacting with an unknown internal antigen did not appear to react with exoerythrocytic parasites. We confirm prior reports that monoclonal antibodies against the sporozoite immunodominant repeat antigen react with all exoerythrocytic-stage parasites, but note that as the exoerythrocytic parasite matures the immunostaining is concentrated in plaques reminiscent of germinal centers and apparently distinct from mature merozoites. These results indicate that mature merozoites from either exoerythrocytic or blood-stage parasites are antigenically very similar, but that stage-specific antigens may be found in specialized structures present only in a specific host cell type. PMID- 3308507 TI - Dirofilaria immitis: identification and partial characterization of parasite antigens in the serum of infected dogs. AB - We have recently developed a sensitive and specific immunodiagnostic test for canine Dirofilaria immitis infection based on detection of soluble parasite antigens in dog sera by monoclonal antibody-based enzyme immunoassay. In addition to their importance as markers of infection, these antigens may contribute to the pathogenesis of heartworm disease in dogs. In the present study, a variety of methods were used to identify and characterize circulating D. immitis antigens. Two antigens were identified in infected dog sera that formed lines of identity in rocket-line immunoelectrophoresis with soluble antigens extracted from adult D. immitis. Circulating D. immitis antigens were also demonstrated in infected dog sera by immunoblot analysis with polyclonal and monoclonal antibodies. These antigens had apparent molecular weights that ranged from 50 to 250 kDa. Most of the circulating D. immitis antigens contained the epitope defined by monoclonal antibody 1418BF2.1 which is used in our enzyme immunoassay for circulating D. immitis antigen. Studies of parasite antigens released during in vitro culture indicated that the circulating D. immitis antigens in dog sera that are detected by our enzyme immunoassay are primarily derived from adult female worms. PMID- 3308508 TI - Physicochemical aspects of the giant multinucleate cell formation. AB - Process of multinucleate cell formation was studied under two conditions: (1) during the perichondral ossification of the chick embryonal tibia, and (2) in foreign-body reaction against polyhydroxyethylmethacrylate (POLYHEMA) and copolymer of hydroxyethylmethacrylate and methacrylic acid (POLYHEMA-MA) subcutaneously implanted into the rat. Multinucleate cells covered a surface of the substrate with relatively low hydrophylia and with low or without acidic groups (mineralized bone and POLYHEMA). On the other hand, no (POLYHEMA-MA) or only exceptional (nonmineralized resorbed cartilage) multinucleate cells were visible on the substrate rich in water and acidic groups. This similarity is not surprising, since it is accepted that both cell types represent a specialized phagocytic element. These results demonstrate that precursor cells can fuse only under convenient conditions. Forces analogous to hydrophobic and electrostatic interactions probably participate in this process. PMID- 3308510 TI - The epidemiology of nosocomial epidemic Pseudomonas cepacia infections. AB - Pseudomonas cepacia has occasionally been identified as an epidemic and endemic nosocomial pathogen. In outbreaks, usually one clinical site predominates but many may be involved. Detailed investigations have usually implicated a contaminated liquid reservoir or moist environmental surface as the source. Liquid sources have included a number of different classes of antiseptics and disinfectants such as quaternary ammonium chlorides, biguanides, hexachlorophene, and iodophors. Environmental and patient isolates have had multiply resistant antimicrobial susceptibility patterns. The clinical distinction between colonization and infection may be difficult and may challenge the skills of the clinician. Expenditure of resources needed to solve epidemics is justified in view of the potential virulence of this organism and the high likelihood that an unrecognized but easily eliminated liquid environmental reservoir may be the source. PMID- 3308509 TI - Condyloma acuminatum: epidemiological, clinical and therapeutic aspects. AB - Condyloma acuminatum, CA or genital warts, are benign fibro-epithelial tumors with a predilection for moist environments, especially mucosal surfaces. This sexually transmitted disease (STD) is increasing rapidly in incidence. The lesions are associated with a number of human papillomavirus (HPV) types. Some HPV types are closely linked with genital (especially cervical) dysplasia and neoplasia. Treatment consists of such traditional modalities as podophyllin, cryotherapy or surgical excision and, more recently, administration of interferon (IFN). PMID- 3308511 TI - Computerized colonization-surveillance based on antimicrobial susceptibility patterns. AB - In order to estimate the occurrence of hospital-acquired colonizations, a specific program based on antimicrobial susceptibility tests was developed for the early recognition of clusters of colonized patients. This program allowed: (a) estimation of the endemic level of nosocomial colonization every three days within an intensive care unit; (b) detection of outbreak of hospital-acquired infections; (c) distinction between primary and secondary infections according to the dates of admission and collection; (d) provision of the latest profiles of susceptibility to antimicrobials for the 5 pathogens studied (Staphylococcus aureus, S. epidermidis, Serratia spp., Pseudomonas spp., Acinetobacter spp.). This study reported the experience of a two-year trial in colonization surveillance. PMID- 3308512 TI - Immunity to tetanus among Italians born between 1956 and 1963. AB - Systematic mandatory immunization of children against tetanus begun in Italy in 1968. Preceding birth cohorts, accounting for almost 80% of present Italian population, were poorly immune or totally non-immune; around 90% of cases of tetanus occurring in Italy in recent years are observed among them. In a national sample of 4770 young males born between 1956 and 1963, about one third was not protected. Prevalence of non-immune subjects was greater in the Southern Regions and the Islands, in rural areas, among the unemployed, among the older birth cohorts. PMID- 3308513 TI - A possible structure for alpha-crystallin. AB - alpha-Crystallin, the major protein of the mammalian eye lens, is found in vivo as a multimeric aggregate composed of two closely related subunits whose molar ratio is widely variable from species to species. Attempts to determine the arrangement of the subunits within the aggregate, or even to determine the size of the aggregate and the number of subunits composing it, have not resulted in general agreement. Because of the variability in alpha-crystallin particle size, the apparent dependence of this parameter on certain environmental factors (e.g. temperature), the absence of a specific requirement for either alpha-crystallin isoform in aggregation, and the sharp division in the amino acid sequence between a strong hydrophobic region and a sharply hydrophilic one, it is suggested that the alpha-crystallin aggregate has the properties of a protein micelle. This hypothesis is consistent with what is known of the alpha-crystallin molecule and aggregate, and can be tested experimentally. If this hypothesis is shown to be true, then alpha-crystallin will be the first example of a naturally occurring protein micelle. PMID- 3308514 TI - A yeast gene coding for a putative protein kinase homologous to cdc25 suppressing protein kinase. AB - A yeast gene termed YKR coding for a putative protein kinase was isolated by using the cloned cDNA for rabbit protein kinase C as a hybridization probe. The encoded protein (YKR), composed of 380 amino acid residues, shows extensive sequence homology to serine/threonine-specific protein kinases from various species in the approx. 320 C-terminal amino acid residues, strongly suggesting that YKR is endowed with a protein kinase activity. The observed homologies to the cdc25 suppressing protein kinase from yeast, the catalytic subunit of mammalian cAMP-dependent protein kinase, and mammalian protein kinase C were 76, 48 and 37%, respectively. Gene replacement experiments showed that YKR itself is not essential for cell proliferation. PMID- 3308515 TI - Pertussis toxin does not affect the time course of exocytosis in mast cells stimulated by intracellular application of GTP-gamma-S. AB - Exocytosis was studied in single rat peritoneal mast cells. Granule fusion was monitored by time-resolved capacitance measurements using the patch-clamp technique. Intracellular stimulation of mast cells with 20 microM GTP-gamma-S stimulates exocytosis with a calcium-dependent time course. Secretion in response to receptor-mediated stimulation with compound 48/80 was completely abolished by treatment with pertussis toxin (IAP) at 180 ng/ml for 4 h. The time course of exocytosis in response to GTP-gamma-S remained unaffected in IAP-treated cells supporting the involvement of a second GTP-binding protein in stimulus-secretion coupling. PMID- 3308516 TI - Tissue-specific binding of a nuclear factor to the insulin gene promoter. AB - Using a DNA-binding gel mobility shift assay, a protein-DNA complex was detected using the rat II insulin promoter and a nuclear extract from rat insulinoma cells. This complex was detected using extracts from other insulin-producing cell lines but was not found using nuclear extracts from non-insulin-producing pancreatic cell lines or other cell types. Binding of the tissue-specific protein to the labelled promoter fragment was effectively competed by both rat and human insulin genes but not by the SV40 TATA box. This protein DNA interaction may be involved in tissue-specific regulation of insulin gene expression. PMID- 3308518 TI - Surgical management of distal tubal obstruction--are we making progress? PMID- 3308517 TI - Vitamin K-dependent carboxylase. Possible role for thioredoxin in the reduction of vitamin K metabolites in liver. AB - In the liver vitamin K epoxide, which is produced during the posttranslational carboxylation of protein-bound glutamic acid residues, is recycled by the action of one or more dithiol-dependent reductases. In vitro synthetic dithiols may serve as a cofactor for these enzymes, but the physiological reductant has not yet been found. In this paper we report that in vitro the commercially available thioredoxin/thioredoxin reductase from E. coli can replace the synthetic dithiols during the various reactions of the vitamin K cycle. Based on the assumption that in vivo thioredoxin also plays a role in the regeneration of vitamin K hydroquinone from the epoxide, an extension of the generally accepted vitamin K cycle is proposed. PMID- 3308519 TI - What is efficacious infertility therapy? PMID- 3308520 TI - Comparison of techniques for the selection of bacteria-free sperm preparations. AB - The authors compared the three most commonly used sperm preparation techniques- swim-up, fall-down, and Percoll gradient--for their ability to recover highly motile sperm and minimize bacterial contamination. Eleven human semen samples collected by masturbation were used and run in parallel with the three methods. A semiquantitative bacterial analysis was performed in all samples and results expressed in colony-forming units per milliliter (CFU/ml). The Percoll gradient technique resulted in an average sperm concentration of 5.81 +/- 4.4 X 10(6) ml, and the average bacterial concentration dropped from 8.66 +/- 12.96 X 10(3) CFU/ml in semen to 0.01 +/- 0.03 X 10(3) CFU/ml. The bacterial count was not significantly different when the raw semen was compared with the swim-up or the fall-down preparations. The authors conclude that the Percoll gradient method yields an adequate sperm concentration, with high motility and improved morphology, while eliminating bacterial contamination. PMID- 3308521 TI - Pregnancies following in vitro fertilization and ultrasound-directed surgical embryo transfer by perurethral and transvaginal techniques. AB - Ultrasound-directed surgical ET is useful in patients with a history of difficult cervical (nonsurgical) transfer, and was performed without complications in the small group reported here. The technique is straightforward, and requires no greater expertise than that necessary for ultrasound-guided oocyte collection. However, further studies are necessary to assess its role in the routine transfer of embryos following IVF. PMID- 3308522 TI - [Results of saliva tests on pregnant diabetic women]. PMID- 3308523 TI - [Statistical characteristics of abutment numbers, pontic numbers and index of maximum abutments in fixed dentures]. PMID- 3308524 TI - Biological mechanisms of ageing. AB - In a short review of the theories or proposed biological mechanisms of ageing it is necessary to be very selective in the ideas which are included or rejected. Although many theories of ageing are advanced in the literature a high proportion can be considered to be special cases of a previous hypothesis. No one individual theory satisfactorily explains the biological mechanism of ageing, indeed elements of many theories may be required to understand such a complex phenomena. Such a view has been formally expressed by Wright and Davison who consider that all theories represent too simplistic an approach to the understanding of ageing, a biochemical complexity which can only be resolved using system analysis techniques. PMID- 3308525 TI - Structure, function and ageing of the collagens of the eye. PMID- 3308526 TI - Presbyopia: an animal model and experimental approaches for the study of the mechanism of accommodation and ocular ageing. AB - During the last hundred years, observations on normal and a few aniridic human eyes, together with population studies on the age-dependent decline in accommodative amplitude, resulted in the formulation of theories of human accommodation, and led to the concept that presbyopia is an inevitable consequence of ageing. However, such studies failed to substantiate these theories and concepts or to reveal the fundamental mechanisms of accommodation and its age-dependent loss. Detailed understanding of these mechanisms and the environmental, dietary, and behavioural factors that may influence the development of presbyopia will require controlled studies and, in some cases, invasive experimental manipulations that can only be achieved through the use of an animal model. This paper reviews some of the evidence indicating that the rhesus monkey is a highly suitable primary animal model for such studies, as well as for studies on other aspects of ocular ageing, and reviews some of the techniques and experimental approaches that have already been adapted or developed for such studies. PMID- 3308527 TI - The objective assessment of cataract. AB - The objective assessment of cataract is central to any epidemiological or therapeutic study of cataract. The objective methods consist of: 1: A resolution target projection ophthalmoscope (Acuity scope) for the estimation of potential visual acuity. 2: The Oxford Clinical Cataract Classification and Grading System, which records and quantifies the features of the lens that are visible at the slit-lamp microscope. This system is essential since photographic methods cannot define the morphology of cataract. 3: Two photographic methods; slit-lamp photography and retro-illumination photography are needed to give a comprehensive statement about the amount of cataract. The negatives are measured by computerised image analysis systems. PMID- 3308529 TI - Age-related cellular proliferation at the vitreoretinal juncture. AB - Clinical and pathological features of non-vascularised epiretinal membranes are reviewed with special attention to focal epimacular tractional lesions in the elderly. The role of immunohistochemistry in elucidating the nature of component cells of complex epiretinal membranes is emphasised. Clinicopathological correlation establishes the 'fibroglial membrane' as the causative lesion of age related epimacular traction. The pathogenesis of this process is discussed, including relevant animal models, and chronic inflammation and ischaemia (rather than acute posterior vitreous detachment) are implicated. Vitrectomy and epimacular membrane peeling results in significant visual improvement in most patients. PMID- 3308528 TI - Ageing of the vitreous. AB - Changes that occur in the vitreous during ageing contribute to a variety of vitreo-retinal disorders. These age-related changes are rheologic, biochemical, and structural in nature. Our current knowledge of these ageing changes is reviewed. Hypotheses for the mechanisms of liquefaction (synchisis senilis) and posterior vitreous detachment are proposed. PMID- 3308530 TI - Light and macular degeneration: a biophysical and clinical perspective. AB - The evidence linking photic retinopathy to ageing macular degeneration (AMD) is compelling but circumstantial. The biophysical foundations of ageing theory are presented, in addition to an analysis of retinal senescence and the potential contributory role of photochemical retinal damage. Although there is pressure to implement clinical therapy for AMD based on laboratory studies of photic retinopathy, there is no evidence at this time that any such therapy is effective. Nonetheless, until the relationship between photic retinopathy and AMD is better understood, it is appropriate for individuals to use ultraviolet and deep blue protective sunglasses in bright environments, particularly if they have reduced ocular pigmentation or if they are aphakes or pseudophakes without an ultraviolet-protective intraocular lens. PMID- 3308531 TI - The visual status of diabetics on renal replacement therapy (RRT). AB - The visual status of 48 patients with end-stage diabetic nephropathy who were undergoing treatment either by dialysis or transplantation was assessed. At the time of starting dialysis, the vision was good in 27 (56 per cent), impaired in 7 (15 per cent) and of navigating standard only in 12 (25 per cent) while the remaining 2 (4 per cent) had no useful vision. During the time on dialysis and/or following transplantation, vision improved in 6 patients (12 per cent), deteriorated in 9 (19 per cent) and remained unchanged in 33 (69 per cent). Changes in the degree of retinopathy in the 96 eyes resulting either from treatment of the renal failure or laser therapy were noted. The reasons for any changes in vision and the effect of ophthalmic treatment will be discussed. PMID- 3308533 TI - [Esthetics: a new dimension in dentistry]. PMID- 3308532 TI - Fine binocular control in dyslexic children. AB - Dyslexic children often complain that letters seem to move around. The hypothesis advanced here is that this is a symptom of immature vergence control which leads to an unstable sense of visual direction. Evidence is presented that (1) sixty seven per cent of dyslexic children exhibit poor dynamic control of vergence movements in response to a small fusion stimulus, (2) most good readers have good vergence control, (3) children with poor vergence control have reduced stereoacuity, (4) six months monocular occlusion for reading and close work assisted 51 per cent of dyslexics with unstable vergence control to improve; thereafter their reading improved rapidly also. It is concluded that defective vergence control is an important, though not the only, cause of dyslexics' problems. PMID- 3308534 TI - [Reconstruction of the teeth with preprosthetic aspects]. PMID- 3308535 TI - [Periodontology and reconstructive dentistry: analysis of the dimension of biological width]. PMID- 3308536 TI - [Ceramic fractures: prevention and repair]. PMID- 3308537 TI - [Magnetic dentures: presentation of 2 clinical cases]. PMID- 3308539 TI - [The intermediate element of the bridge]. PMID- 3308538 TI - [Gingival hypertrophy: presentation of 3 clinical cases]. PMID- 3308540 TI - [Prosthetic solution following destruction of the oro-naso-sinus diaphragm]. PMID- 3308541 TI - [Clinical significance of endomysium autoantibodies of the IgA type in dermatology]. PMID- 3308542 TI - [History of the Society for Medical Mycology of East Germany]. PMID- 3308543 TI - A retrospective study of the inpatient treatment of psoriasis with dithranol. AB - This study reports the results of the Ingram dithranol regimen for the treatment of psoriasis in 275 inpatients. The median duration of hospitalization until clearance was 25 days and the medians of the interval until a next treatment or hospitalization was needed were 11 and 8.5 months, respectively. PMID- 3308544 TI - Epidermal allografts in humans: an unattainable dream? PMID- 3308545 TI - Ophthalmological surgery 1966-1986, as reflected by the IOMSG (International Ophthalmic Microsurgery Study Group). PMID- 3308547 TI - Rings and wrinkles in the transplanted human cornea. PMID- 3308548 TI - Corneal regrafts. AB - Report on the clarity of 45 corneal regrafts with a minimum follow-up time of 1 year. The results of regrafts in keratoconus are good. In herpetic disease with corneal vascularization and frequent secondary glaucoma the results are poor. In patients with failed grafts for corneal dystrophies or degenerations the regrafts can be beneficial. PMID- 3308546 TI - Minnesota corneal storage system: 1986 update. PMID- 3308549 TI - Visual gold from refractive straw: the correction of post-operative graft astigmatism. PMID- 3308550 TI - Triple procedure. PMID- 3308551 TI - Early results of epikeratophakia. AB - One hundred and seven patients underwent epikeratophakia for either adult or pediatric aphakia, keratoconus or myopia at the Ohio State University. Minimum follow-up was 3 months. There were four graft removals. Objective postoperative refractions revealed that an average of 70, 72, and 54% of all patients achieved at least 20/40 acuity in adult aphakia, keratoconus and myopia, respectively. In pediatric aphakia, postoperative refraction revealed that an average of 31% of patients achieved at least 20/50 acuity. These results are presented and complications necessitating graft removal are discussed. PMID- 3308552 TI - The Zeiss surgical keratometer in cataract surgery. AB - The Zeiss keratometer is easy to use with simple and fast reading. The preoperative keratometry principle is satisfactory by allowing theorically a better control of surgical factors of postoperative astigmatism after cataract surgery. Its major interest appears in surgical training, when one wants to compensate a preoperative astigmatism or when one wishes to avoid secondary suture removal. However, its interest is very variable according to surgical experience. PMID- 3308553 TI - Penetrating keratoplasty, glaucoma and silicone drainage tubing. PMID- 3308554 TI - A modified technique of pupillary stretching. AB - In eyes undergoing vitreoretinal surgery up to now dilatation of a miotic pupil by the pupillary stretching technique could be performed only in aphakic eyes. Now a new needle with a tiny eye at its tip has been developed. With the help of this needle, 4 iris loop sutures can be led around the iris only passing the anterior chamber. This permits pupillary stretching also in phakic eyes. The modified technique was used on 3 phakic and 2 aphakic eyes. PMID- 3308555 TI - Hyperinsulinemia as a possible risk factor of macrovascular disease in diabetes mellitus. Proceedings of an international workshop. Saint-Paul-de-Vence, Nice, France, January 29-30, 1987. PMID- 3308556 TI - Hyperinsulinaemia as a possible risk factor of macrovascular disease in diabetes mellitus. An overview. PMID- 3308557 TI - The blood vessel wall as an insulin target tissue. AB - Study of the effects of insulin and insulin-like growth factors on blood vessel walls has been expedited by the ability to isolate and grow components of large and small blood vessels in pure culture. This paper summarizes current knowledge about the effects of insulin and related molecules on blood vessel derived cells, with an emphasis on: (1) peptide receptors, their regulation, and transport and processing of molecules through the endothelium; (2) metabolic and (3) mitogenic effects of insulin and related peptides on the blood vessel wall, with a discussion of major differences between large and small vessel endothelia; and (4) interactions of insulin with barrier endothelia, for example cerebral microvascular endothelium, site of the blood-brain barrier. PMID- 3308558 TI - Effects of insulin and hydrostatic forces on the metabolism of the aorta. AB - To better understand the putative association between insulin and atherosclerosis many experimental studies have explored the metabolic effects of insulin upon the arterial intima-media (which is essentially made up of smooth muscle cells). This tissue appears to be insulin-sensitive in vivo but not in vitro, suggesting that the actions of insulin on arterial metabolism are probably indirect. Yet, cultured arterial smooth muscle cells do increase their anabolism when physiological concentrations of insulin (10-250 microU/ml) are added to the medium. To account for these discrepancies we have proposed a haemodynamic explanation : hydrostatic forces present in vivo but absent in vitro, would be necessary for insulin to reach the cells of the media and act upon them. We demonstrated such an effect using an isolated rat aorta perfused under variable pressure. But only highly unphysiological concentrations of insulin (0.1 mU/ml) could stimulate the metabolism of intima-media significantly. The insulin sensitivity of the target tissue for atherosclerosis remains an enigma. We speculate that the variable phenotype of arterial smooth muscle cells (either contractile or synthetic) might be an interesting clue to this problem. PMID- 3308559 TI - Vascular growth factors and the development of macrovascular disease in diabetes mellitus. AB - The pathogenesis of macrovascular disease in diabetes mellitus is still incompletely understood. Within the various pathomechanisms abnormal growth of vascular cells is well established as an intrinsic part of the angiopathic process. In this regard, there are different groups of vascular growth factors that are of potential relevance for the development of macrovascular disease in diabetes : hormones, locally released growth factors of platelet and of arterial wall cell origin. The following hormones whose blood levels could increase under various conditions in diabetes have to be considered : growth hormone, insulin like growth factor I and II and insulin. Human platelets contain at least eight growth peptides or proteins that all stimulate in vitro growth of arterial wall cells : platelet-derived-, epidermal-, fibroblast-, diabetic serum-, endothelial- and transforming growth factor, vascular endothelial cell proliferation factor and platelet-derived endothelial cell mitogen. In serum and plasma from type II diabetics only the diabetic serum growth factor has been shown to be increased. Platelets from type I and II diabetic patients contain increased growth stimulating activity. This increased growth activity returned to normal levels in both types of diabetes after strict metabolic control. Arterial endothelial and smooth muscle cells, fibroblasts and monocyte/macrophages of different species release at least in culture a variety of growth factors that could participate in an autocrine or paracrine manner in the growth regulation of the arterial wall. Diabetes may affect the release of these factors, but direct evidence to which degree this would contribute to the development of macrovascular disease is lacking.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308560 TI - Insulin as a growth regulator of arterial smooth muscle cells: effect of insulin of I.G.F.I. AB - The proliferation of smooth muscle cells in the vessel wall plays an important role in the development of an atherosclerosis. The insulin-like growth factor I (I.G.F.I) is an important growth factor for cultivated arterial smooth muscle cells. The plasma I.G.F.I level is controlled by growth hormone and insulin--both factors seem to be important for the development of a diabetic macroangiopathy. In order to evaluate whether I.G.F.I is associated with the development of a macroangiopathy we measured the serum I.G.F.I level in type 2 diabetics with and without macroangiopathy and in non diabetic patients with atherosclerosis and in healthy controls. The range of the individual I.G.F.I levels was wide and the I.G.F.I level between the various groups was not statistically significant. However, our studies with cultured cells show that modulation of the cellular responsiveness to I.G.F.I is as important in the growth control as are changes in the plasma I.G.F.I level. We observed that cultured smooth muscle cells were able to produce an I.G.F.I-like factor. The synthesis and secretion of this factor was dependent on insulin. These findings explain one mechanism by which insulin may influence the growth of smooth muscle cells in the vessel wall. PMID- 3308561 TI - Hyperinsulinemia as a possible etiology for the high prevalence of non insulin dependent diabetes in Mexican Americans. AB - The prevalence of non-insulin dependent diabetes mellitus (NIDDM) is higher in Mexican Americans (MAs) than in non-Hispanic whites (NHWs) even after adjustment for the former's greater overall and more centralized adiposity. We previously have shown that MAs are more hyperinsulinemic than NHWs even after adjustment for body mass index (BMI), waist-to-hip ratio (WHR), subscapular-to-triceps skinfold ratio, and glucose tolerance. We now confirm these findings in much larger population (n = 1,182). Since hepatic extraction of insulin may be decreased with upper body adiposity, we also measured fasting and 2-hour C-peptides in a subset of subjects (n = 70). C-peptide concentrations were higher in MAs than in NHWs indicating that MAs have higher insulin secretion. We examined whether the increased insulin concentrations in MAs may be associated with a bimodal distribution of insulin concentrations in which the second or higher mode might represent pre-diabetics. No evidence of bimodality, however, was apparent. The effect of overall adiposity (BMI) and upper body adiposity was similar in both Mexican Americans (a high risk population for NIDDM) and non-Hispanic whites (a low risk population for NIDDM). These data indicate that, like other populations at high risk for NIDDM such as Pima Indians in the U.S. Southwest and Micronesians in the South Pacific, Mexican Americans have more hyperinsulinemia than can be accounted for by their adiposity and body fat distribution. Prolonged insulin secretion (secondary to increased insulin resistance), is one possible explanation for this phenomenon which could lead to islet cells decomposition and eventual clinical diabetes. PMID- 3308562 TI - Macrovascular complications in relation to hyperinsulinaemia in non-insulin dependent diabetes mellitus. AB - Despite suggestive evidence from studies on experimental pathology and cell biology of the arterial wall and from clinical and epidemiological studies on non diabetic subjects indicating that hyperinsulinaemia might be associated with an increased risk of atherosclerotic vascular disease (ASVD) information concerning the role of hyperinsulinaemia as a risk factor of ASVD in diabetic patients still is circumstantial. A few cross-sectional and still fewer prospective studies in patients with non-insulin-dependent diabetes (NIDDM), including two ongoing studies carried out by our own research group, have shown associations between hyperinsulinaemia and the occurrence of ASVD, but these data still are far from consistent and conclusive. Further studies applying combined clinical and epidemiological approach, building upon the results of experimental research concerning possible mechanisms, are needed for better clarification of the role of hyperinsulinaemia as a risk factor of ASVD in NIDDM. PMID- 3308563 TI - Diabetes, hyperglycaemia, hyperinsulinaemia and atherosclerosis: epidemiological data. AB - Beside arterial hypertension, hypercholesterolaemia and smoking habits, diabetes is considered as a risk factor of coronary heart disease (CHD). However, the role of impaired glucose tolerance (IGT) has not been demonstrated in the different epidemiological studies in the world which are summarized here; hyperinsulinaemia was also suspected and its independent role--investigated in only three prospective surveys--was demonstrated. The recent data of the Paris Prospective Study, where normoglycaemic, IGT and diabetic patients were analysed together, show that hyperinsulinaemia may be the first and genuine marker of the carbohydrate metabolism disturbance connected to the clinical manifestations of atherosclerosis. PMID- 3308566 TI - Is insulin the key factor to explain the associations between body mass, blood pressure and glucose? AB - The relationships between body mass index (BMI), fasting plasma glucose and insulin and blood pressure level have been investigated in a group of 2,144 healthy middle-aged men. The associations between BMI and blood pressure are largely independent of plasma glucose and insulin. Plasma glucose is strongly related to blood pressure in non-obese subjects. Plasma insulin is not associated with blood pressure independently of BMI and plasma glucose, although the simultaneous elevation of BMI, plasma glucose and insulin is strongly associated with blood pressure. PMID- 3308565 TI - Daily insulin dose as a predictor of macrovascular disease in insulin treated non insulin-dependent diabetics. AB - In the longitudinal Schwabing study, unselected insulin-treated diabetic patients were followed for major vascular complication (MVC) (stroke, myocardial infarction, gangrene) and asymptomatic, early detectable peripheral vascular disease (PVD). In the group of insulin-treated NIDDM multiple logistic regression analysis revealed the number of daily injected insulin units as a significant predictor for MVC and PVD (t = 1.98; p less than 0.04; x +/- S.D.: PVD yes 57.6 +/- 21.4 U/d; PVD no 44.3 +/- 17.7; age-adjusted univariate p less than 0.001). Daily insulin dose correlated highly significantly with serum triglycerides (r = 0.40, p less than 0.001) as well as with blood glucose (r = 0.33, p less than 0.001). These data suggest that insulin resistance is characteristic for atherosclerotic disease in NIDDM and the hyperinsulinemia-hypertriglyceridemia syndrome might be a powerful cardiovascular risk factor in diabetes mellitus. PMID- 3308564 TI - Serum insulin concentrations and anticipatory factors of cardiomyopathy in NIDDM. AB - To summarise from some preliminary analyses, a high early insulin: obesity (BMI) ratio remains an associate of later development of ECG change in this diabetic population, and there are reasons to suggest that this may be involved particularly through mechanisms of relative insensitivity to the hypoglycaemic effect of insulin. PMID- 3308567 TI - Hyperinsulinemia and hypertension in patients with newly diagnosed non-insulin dependent diabetes. AB - An increased occurrence of hypertension was observed in a group of patients (N = 133) with newly diagnosed non-insulin-dependent diabetes as compared to non diabetic control subjects (N = 144). In men the excessive occurrence of hypertension in diabetics seemed to be mainly confined to obese subjects, whereas in women it occurred both in obese and non-obese subjects. Fasting or postglucose serum insulin levels showed a positive correlation with blood pressure levels in non-diabetic men and in diabetic and non-diabetic women even after adjustment of insulin for obesity. PMID- 3308569 TI - Adipose tissue distribution, plasma insulin, and cardiovascular disease. AB - Hyperinsulinaemia is of great importance, being a primary risk factor for cardiovascular disease and non-insulin dependent diabetes (NIDDM). Furthermore, unwanted effects of increased exposure of tissues to insulin are known. Hyperinsulinaemia may, in principle, be caused by primary hypersecretion, or be a secondary consequence of diminished effectiveness of insulin in the periphery. Obesity is the commonest condition characterized by insulin resistance, which is seen most frequently when excess adipose tissue is localized to the abdominal region. Insulin resistance in obesity is found in several tissues, however, with liver and muscle being quantitative the most important. Muscle insulin sensitivity is regulated by genetic factors, hormonal effects, and the influence of free fatty acids, as well as the state of physical activity. There is evidence for the action of each of these factors in obesity. The pathogenetic mechanisms linking hyperinsulinaemia with cardiovascular disease and NIDDM are unknown. Comparisons between development of NIDDM in experimental animal models and in humans in prospective studies however, provide useful hypotheses for further studies. PMID- 3308568 TI - Hyperinsulinemia--a link between glucose intolerance, obesity, hypertension, dyslipoproteinemia, elevated serum uric acid and internal cation imbalance. AB - A representative sample (n = 1211) of the Jewish population in Israel age 40-70 (excluding known diabetics), underwent a glucose tolerance test. Insulin response was found to be independently and positively associated with the GOH conditions- glucose intolerance (p less than 0.001), obesity (p less than 0.001), and hypertension (p less than 0.01) and with elevated serum uric acid (p less than 0.001) after accounting for the effects of sex, age, serum creatinine and use of antihypertensive medications. In a representative subgroup of 542 individuals, total VLDL and LDL fractions were estimated by standardized values (based on the reference group--individuals free of the GOH conditions), of their cholesterol and triglyceride components. Hyperinsulinemia was characterized by jointly elevated VLDL and LDL with reduced HDL. The risk ratio for this pattern (adjusted for the effects of age, sex, smoking and presence of any of the GOH conditions) was 3.4 (p less than 0.001). There was no further association of this disturbed lipoprotein profile with the GOH conditions. Cation concentrations were determined in a stratified subsample (n = 89) of the study group. The subsample comprised 30 individuals in the reference group, and 59 representing each of the seven possible combinations of abnormal glucose tolerance, obesity and hypertension (GOH group). Rate of cation imbalance defined as presence of at least one of three cation concentration--red blood cell sodium greater than or equal to 7.0 mEq/l, red blood cell potassium less than 92.5 mEd/l or plasma potassium greater than or equal to 4.5 mEq/l was 88.1% in the GOH, compared to 40.0% in the reference group (p greater than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308570 TI - Insulin and HDL-cholesterol metabolism. AB - Insulin is essential to the physiological regulation of high density lipoprotein (HDL) cholesterol metabolism. It acts directly at the hepatic level by favouring HDL2 to HDL3 conversion (by its action on hepatic lipase). In the peripheral circulation, it induces HDL2 formation by allowing triglyceride-rich lipoprotein catabolism by lipoprotein lipase (LPL) and free cholesterol esterification by lecithin acyl cholesterol transferase (LCAT). In the case of insulin deficiency or peripheral insulin resistance, there is a reduction of HDL cholesterol related to HDL2 decrease, partly due to LPL deficiency. In the case of endogenous hyperinsulinism, there is an intrahepatic disturbance of HDL metabolism partly related to excessive synthesis of VLDL-TG and leading to the decrease of HDL2/HDL3 and enhanced formation of HDL2 TG. When hepatic hyperinsulinism is associated with peripheral insulin resistance, HDL cholesterol decrease is the consequence of both intrahepatic action of insulin and diminution of its peripheric action. Optimized insulin therapy can normalize HDL cholesterol in case of true insulin deficiency. When there is preservation of insulin secretion, HDL cholesterol remains lower than controls. Insulinopenia as well as hyperinsulinism can favour atherogenic lipoprotein disturbances. PMID- 3308572 TI - Primary ovarian pregnancy with intrauterine device in situ. AB - A case of primary ovarian pregnancy associated with an intrauterine device in a multipara taking thyroglobulin is reported. The clinical signs and symptoms were identical to those of any ectopic pregnancy with tubal rupture and hemoperitoneum. The final diagnosis was based on the histopathological findings. The literature is reviewed and the association between IUD and ovarian pregnancy is discussed. PMID- 3308571 TI - Single- versus three-dose cefoxitin prophylaxis in caesarean section: a randomized clinical trial. AB - The present study was undertaken to determine the minimal effective antibiotic dosage in caesarean section prophylaxis. The study was conducted at the Academisch Ziekenhuis der Vrije Universiteit in Amsterdam (Amsterdam Free University Hospital) to compare the efficacy of one dose of cefoxitin (2 g) with three administrations of 2, 1 and 1 g respectively. In this prospective and double-blind study, 66 patients were given one dose and 72 patients received three doses. In terms of febrile morbidity, endometritis, wound infection, urinary tract infection and need for postoperative antibiotic therapy, the three dose group showed fewer postoperative infections: as to wound infections (p less than 0.05) and therapeutic antibiotic use (p less than 0.025) these differences were statistically significant. The numbers of days of hospitalization after the caesarean section also showed differences: 10.6 +/- 2.6 versus 9.8 +/- 1.5 days in the one- and three-dose groups respectively (p less than 0.05). It is concluded that, contrary to several reports in the literature, prophylaxis consisting of three administrations of cefoxitin is to be preferred. No significant allergic or adverse reactions were observed in our patients. PMID- 3308573 TI - Acute abdomen due to placenta percreta. AB - Placenta percreta is a rare but serious complication of pregnancy, usually presenting itself in the third trimester. The incidence of fetal death and maternal mortality is high. We report a case presenting as an acute abdomen, due to haemoperitoneum at 33 weeks of pregnancy. Incidence, etiology, diagnosis and treatment are discussed, and the literature is reviewed. PMID- 3308574 TI - Effects of castration, exogenous testosterone and estrogen on endotoxin response in male rats. AB - Using an experimental model of continuous endotoxin infusion, the effects of castration, testosterone and estrogen substitution on disseminated intravascular coagulation in male rats were investigated. Male rats which are not pretreated react in the same way to an endotoxin infusion as female animals, with an increase in free plasma hemoglobin, decrease of fibrinogen level, decrease of hematocrit and platelets and glomerular fibrin depositions. Different experimental groups of testectomized rats were pretreated with (i) 0.3 micrograms (pregnancy-conserving dose) or (ii) 30 micrograms ethinylestradiol (ovulation suppression dose) or (iii) 250 mg testosterone. They were then compared to groups of animals treated with sesame oil as well as untreated group of rats. The pretreatment with testosterone and estrogens in the small-dose group had only an insignificant effect on the shock sequence. Only those animals which were treated with a high dose of estrogens showed a dramatic enhancement of their endotoxin sensitivity. It was also shown that in male animals an increased estrogen level might mediate a state of 'preparation', but testosterone does not 'prepare' castrated rats for the generalized Schwartzman reaction. The possible significance of enhancement of endotoxin toxicity by estrogens in explaining some pathophysiological characteristics of disseminated intravascular coagulation in pregnancy is discussed. PMID- 3308575 TI - Regulation of estrogen biosynthesis by human adipose cells in vitro. PMID- 3308576 TI - Ligand-induced changes in the subcellular distribution of insulin receptors in rat liver: effects of colchicine. AB - The in vivo effects of colchicine on the subcellular distribution of insulin receptors have been studied in insulin-injected rats and in control animals. Colchicine (0.1 mg/100 g or 10 mg/100 g body weight, i.v.) did not affect the ability of plasma membranes and Golgi fractions of control rats to bind insulin. As previously reported (Desbuquois et al., 1982), the injection of native insulin (8 nmol, i.v.) caused a 50% decrease in the insulin binding activity of plasma membranes and a concomitant 50% increase in insulin binding to Golgi fractions. These changes occurred at 4 and 40 min after insulin injection but were no longer detectable at 3 h. Colchicine treatment did not affect the initial changes in the distribution of insulin receptors induced by insulin; however, in rats treated with the low dose of colchicine, insulin binding to plasma membranes at 3 h was not fully restored. Colchicine treatment did not alter the amount of acid extractable insulin associated with Golgi fractions of insulin-injected rats. The time course of uptake of 125I-insulin was similar in plasma membranes, microsomal fraction and Golgi fractions of colchicine-treated (0.1 mg/100 g) and of untreated rats. These results suggest that colchicine does not interfere with the endocytosis of insulin receptors induced by their ligand and has little effect, if any, on the reinsertion of internalized receptors in the plasma membrane. PMID- 3308577 TI - Actions of insulin on MCF-7 cells that are synchronized with hydroxyurea. AB - The role of insulin in stimulating metabolic processes in MCF-7 cells was studied in cells synchronized at the G1:S interphase of the cell cycle using hydroxyurea. Cells released from the hydroxyurea block progressed through one S-phase of the cell cycle when insulin was absent from the medium. When free insulin was present the cells continued through more than one S-phase. Since cells accumulate at G0 in serum- and hormone-free conditions it is apparent that insulin has an essential action in the MCF-7 cells between the G0 and S-phase of the cell cycle. Insulin is also known to stimulate the incorporation of [3H]leucine into a pH 4.6 precipitable phosphoprotein fraction in the MCF-7 cells. Insulin was shown to express this action, even when the cells were maintained at the G1:S interphase with hydroxyurea. Insulin is thus able to effect a differentiative action, i.e. a stimulation of phosphoprotein synthesis, under conditions where insulin's effect on [3H]thymidine incorporation into DNA is prevented. PMID- 3308578 TI - Ontogeny of insulin receptors in the rat hemochorial placenta. AB - Binding of 125I-insulin to rat placental membranes was time and protein concentration dependent, reversible, and specific. Unlabeled porcine insulin competed for 125I-insulin binding with an IC50 of 65 nM, while IGF-I was much less potent with an IC50 of 2.12 mM. Specific binding of 125I-insulin decreased during the second half of gestation from Days 11 to 19. Scatchard analysis of the binding data for membranes prepared from Gestation Days 11 and 19 yielded typical curvilinear plots which showed a marked decrease in the number of binding sites in late gestation placenta. Beginning on Day 14, insulin binding was characterized with isolated labyrinth and basal zone portions of the hemochorial placenta. There was no evidence for differences in Kd values or the number of binding sites in these two functionally distinct portions of the rat placenta. Crosslinking of 125I-insulin followed by SDS-PAGE showed a single protein with a molecular weight of 130,000 from placental tissues on Gestation Days 11 and 19 and confirmed a gestational decrease in the number of insulin receptors. In solubilized, lectin-purified preparations from placenta and liver membranes, insulin stimulated the phosphorylation of a Mr 95,000 protein. 32P-incorporation into this 95,000 protein was stimulated fivefold by insulin in Day 11 placenta receptor, whereas no detectable 32P-incorporation was found in Day 19 placenta. Thus, while the alpha- and beta-subunits of insulin receptors in mid and late gestation placenta have molecular weights which are similar to receptors in maternal liver, data indicate the presence of a functional difference in insulin stimulated kinase activities. PMID- 3308579 TI - Buffy coat transfusions in early type I diabetes. AB - Fresh whole-blood buffy coats from American Red Cross volunteers were used to treat early type I diabetes. Attempts were made to adapt to human diabetic patients a protocol successfully used in prediabetic BB rats. Twenty-two type I diabetic patients (duration of disease less than 4 wk) were randomized to treatment or control groups; the treatment patients were given one buffy coat (approximately 0.6 X 10(9) T-lymphocytes) weekly for 5 wk. Plasma C-peptide (stimulated and unstimulated), insulin dose, and hemoglobin A1c were measured before and periodically after the treatment for 24 wk. The control group underwent the same studies. Although there were no significant differences for the parameters studied between the two groups, 2 of 12 patients in the treatment group underwent three complete (normal glycemia without insulin) temporary remissions. One of these patients was given a second course of transfusions after relapse from the first remission and developed a second complete remission that lasted 2 mo. No control patient had remissions during the 24-wk study. Although the future of adoptive immunotherapy in the treatment or prevention of diabetes is not known, several probable limitations of the current protocol, as discussed here, can explain the differences in results between this trial and the rodent studies. PMID- 3308580 TI - Prolactin enhances cell-to-cell communication among beta-cells in pancreatic islets. AB - To determine the role of prolactin in increasing junctional communication among islet beta-cells, we studied dye coupling in pancreatic islets exposed to elevated levels of prolactin in vivo and in vitro. Islets were isolated from rats immediately after lactation or from rats bearing mammosomatotropic tumors (MtTW15), conditions involving high levels of prolactin (either 5-fold or 1000 fold control levels, respectively). When beta-cells were microinjected with the gap junction permeant dye Lucifer yellow CH, the mean number of dye-coupled cells per injection was approximately 10-fold greater than in islets from virgin control rats. As a more direct test of the effects of prolactin on beta-cell coupling, islets isolated from virgin rats were treated for 90 min with 500 ng/ml rat prolactin in the presence of low glucose (2.8 mM) and were microinjected with dye. The mean number of dye-coupled cells per injection increased by 6.7-fold over controls with low glucose, demonstrating a direct effect of prolactin on beta-cell coupling. In vitro treatment with high glucose (16.7 mM) resulted in a 2.7-fold increase in dye-coupled cells per injection. We discuss the possible relationship between the effects of glucose and of prolactin on coupling. PMID- 3308581 TI - Spontaneously diabetic BB rats have age-dependent islet beta-cell-specific surface antibodies at clinical onset. AB - Diabetes-prone BB rats were examined before, during, and after clinical onset of diabetes for the occurrence of circulating islet cell surface antibodies (ICSAs) with a specific binding to islet beta-cells. The presence of ICSA was assessed by incubating serum immunoglobulin fractions with normal Wistar rat islet cells and identifying cell-bound immunoglobulins by indirect immunofluorescence and by a complement-induced cell toxicity reaction. Under the selected experimental conditions, none of the diabetes-resistant rats were ICSA positive over the entire study period (45-120 days of age). In two diabetes-prone BB rat strains, 19 animals developed diabetes with onset between 50 and 120 days. At day 45, none of these animals was positive for ICSA. In rats developing diabetes between 50 and 85 days of age, 7 of 9 animals presented ICSA at clinical onset, determined by either the immunofluorescence or cytotoxicity test. The antibodies bound to insulin-containing beta-cells but not to other islet cell types, and binding was not eliminated by absorption with liver powder. In animals developing diabetes between 85 and 120 days, only 1 of 10 was positive for beta-cell-specific surface antibodies at onset of the disease. After 30 days of insulin treatment, beta-cell specific antibodies were detectable in 3 of 4 animals of age 50-85 days, whereas only 3 of 12 older rats presented ICSAs that were, in addition, of low titer or affinity. Our data confirm that ICSAs develop in diabetic BB rats and indicate that these antibodies can bind specifically to islet beta-cells compared with other islet cell types.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308582 TI - Adoptive transfer of insulitis and diabetes in neonates of diabetes-prone and resistant rats. Tissue localization of injected blasts. AB - Intravenous transfusion of concanavalin A-activated splenic cells from acutely diabetic BB or diabetic BB/hooded hybrid donor rats into 6- to 36-h-old neonate recipients of diabetes-prone and -resistant rat lines induced insulitis and in some severe diabetes. These effects were observed 10-20 days after the injection of the blasts. Focal lesions of insulitis were absent in neonates killed 1 and 3 days after the blast injection but were observed in neonates killed on the 5th and 8th day. As determined by autoradiography after the injection of [3H]thymidine-labeled blasts, numerous blast cells migrated and settled in various immature lymph nodes and in the spleen within 24 h after injection. Focal mononuclear infiltrations in the islets containing labeled and unlabeled cells were again observed on the 5th and 8th day but not on the 1st and 3rd day after injection. These experiments indicate that target-specific blasts undergo a short phase of proliferation and maturation in lymphoid organs of the recipients, before initiating the autoimmune process in the pancreatic islets. They further suggest that specific immune cells rather than humoral anti-islet antibodies are more likely to play the major role in this autoimmune animal model of diabetes. PMID- 3308583 TI - Identification and characterization of insulin receptors in basolateral membranes of dog intestinal mucosa. AB - Little is known about hormonal regulation of substrate transport and metabolism in the mucosal lining of the small intestine. Because insulin regulates these functions in other tissues by binding to its receptor, we have investigated the presence of insulin receptors in canine small intestinal mucosa with basolateral membranes (BLM) and brush border membranes (BBM) prepared by sorbitol density centrifugation. A14-[125I]iodoinsulin was used to study binding and structural characteristics of specific insulin receptors in BLM. Analysis of receptors in BLM identified binding sites with high affinity (Kd 88 pM) and low capacity (0.4 pmol/mg protein) as well as with low affinity (Kd 36 nM) and high capacity (4.7 pmol/mg protein). Binding was time, temperature, and pH dependent, and 125I labeled insulin dissociation was enhanced in the presence of unlabeled insulin. Cross-reactivity of these receptors to proinsulin, IGF-II, and IGF-I was 4, 1.8, and less than 1%, respectively. Covalent cross-linking of labeled insulin to BLM insulin receptors with disuccinimidyl suberate revealed a single 135,000-Mr band that was completely inhibited by unlabeled insulin. There was a 16-fold greater specific binding of insulin to BLM (39.0 +/- 2.4%) than to BBM (2.5 +/- 0.6%). These results demonstrate the presence of a highly specific receptor for insulin on the vascular, but not the luminal, surface of the small intestinal mucosa in dogs, and suggest that insulin may play an important role in the regulation of gastrointestinal physiology. PMID- 3308585 TI - Effect of IgG subclasses on in vivo bioavailability and metabolic fate of immune complexed insulin in Lewis rats. AB - The bioavailability, distribution, and metabolic fate of 125I-labeled insulin complexed to antibodies in guinea pig antiserum, purified guinea pig IgG1, IgG2, a mixture of IgG1 and IgG2, and homologous Lou/m rat antiserum were studied in inbred Lewis rats. 125I-insulin complexed to purified guinea pig IgG2 antibodies was rapidly cleared from the blood and sequestered in increasing amounts with time in the liver. Large amounts of the 125I-insulin complexed to guinea pig IgG1 antibodies remained in the blood for at least 30 min. The bioavailability of 125I insulin bound to IgG1 and IgG2 antibodies was inhibited for at least 30 min because significantly less was available for rapid binding to insulin receptors on hepatocytes and renal tubular cells and its subsequent rapid degradation. The bioavailability of 125I-insulin was further decreased when bound to antibodies in native guinea pig antiserum or a mixture of IgG1 and IgG2 antibodies compared with the 125I-insulin complexed to either purified IgG1 or IgG2 antibodies alone. The 125I-insulin bound to antibodies in native guinea pig antiserum or a mixture of IgG1 and IgG2 antibodies was distributed in vivo in a manner reflecting the relative concentrations of the IgG1 and IgG2 antibodies present. The bioavailability, distribution, and metabolic fate of 125I-insulin in immune complexes prepared with homologous Lou/m rat insulin antiserum was qualitatively similar to that observed with immune complexes prepared with guinea pig insulin antiserum. It appears that the Lewis rat can be used as an in vivo model to study the bioavailability,distribution,and metabolic fate of insulin bound to xenogenic or homologous insulin antibodies. PMID- 3308586 TI - Subunit structure, autophosphorylation, and tyrosine-specific protein kinase activity of hepatic insulin receptors in fetal, neonatal, and adult rats. AB - The ontogeny of the structural and functional characteristics of insulin receptors is determined by examining insulin binding, subunit structure, autophosphorylation, and tyrosine-specific protein kinase activity in partially purified solubilized liver receptors from fetal (approximately 21 days postconception), neonatal (1- and 7-day-old), and adult rats. Specific 125I labeled insulin binding to these receptor preparations in the presence of different insulin concentrations was higher in fetal and neonatal rats compared with that in the adult rats. The electrophoretic mobilities of the alpha- and beta-subunits on sodium dodecyl sulfate-polyacrylamide gel electrophoresis autoradiography were similar at different stages of development. Insulin stimulated autophosphorylation of insulin receptors was similar in the different groups. With fixed amounts of protein, the tyrosine-specific protein kinase activity in the presence of different insulin concentrations (1 X 10(-8) to 1 X 10(-6) M) was significantly higher in the fetal and neonatal rats than in adult rats. However, when expressed as a function of insulin-binding activity, the insulin-stimulated tyrosine-specific protein kinase activity in fetal and neonatal rats appears to be similar to that in adult rats because of decreased insulin binding in the latter group. These results demonstrate the structural and functional similarities of hepatic insulin receptors in fetal, neonatal, and adult rats. The relative differences in insulin-mediated biological functions in fetal and adult rat livers as reported previously are due to alterations in a step(s) distal to activation of insulin-receptor kinase. PMID- 3308584 TI - Effects of tolazamide and exogenous insulin on pattern of postprandial carbohydrate metabolism in patients with non-insulin-dependent diabetes mellitus. Results of randomized crossover trial. AB - To determine whether therapy with exogenous insulin or sulfonylureas results in a postprandial pattern of carbohydrate metabolism in patients with non-insulin dependent diabetes mellitus (NIDDM) that resembles that in nondiabetic individuals, we employed a dual-isotope technique combined with forearm catheterization to examine meal disposition in NIDDM patients, before and after 3 mo of therapy with tolazamide and after 3 mo of therapy with exogenous insulin, with a randomized crossover design. Results were compared with those observed in nondiabetic subjects. Although both forms of therapy improved chronic glycemic control (glycosylated hemoglobin concentration went from 9.6 +/- 0.7 to 7.6 +/- 0.5 and 7.1 +/- 0.2%, respectively, P less than .01), exogenous insulin resulted in a lower postprandial glycemic response than tolazamide (P less than .001). Both agents comparably increased (P less than .01) fasting and integrated postprandial insulin concentrations. However, the initial rate of postprandial increase was greater with exogenous insulin (P less than .05). Tolazamide (P less than .05) but not exogenous insulin increased postprandial C-peptide concentrations. However, tolazamide did not improve the deficient early insulin release. Both agents (P less than .05) lowered postabsorptive hepatic glucose release (from 2.8 +/- 0.3 to 2.3 +/- 0.2 mg . kg-1 . min-1), but not to normal rates (1.8 +/- 0.1 mg . kg-1 . min-1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308587 TI - Quantitative assay for human cytoplasmic islet cell antibodies. AB - An assay for human islet cell antibodies (ICAs) in serum yielding numerical values and amenable to statistical evaluation has been developed utilizing fluorescence spectrophotomicroscopy (FSPM). The results of the blinded trials by FSPM were compared with those by standard indirect immunofluorescence (IFL). No false-positive or false-negative readings were obtained in 258 observations when the results by FSPM were compared with those by IFL. The intra- and interassay variabilities encountered were not enough to misclassify a specimen. The presence of anti-thyroid, anti-adrenal, or anti-nuclear antibodies did not produce false positive readings. Twenty-eight additional specimens from diabetic children were also analyzed via three blood group type O pancreases. There was complete agreement concerning the presence or absence of ICA between IFL and FSPM analyses. Analysis of the three pancreases yielded different numbers of results positive for ICA (14/28 vs. 22/28 vs. 15/28, P = .008) in both assays. Thus, selection of pancreatic substrate may influence the outcome of assays for ICA. A matrix of fluorescent microspheres has been devised that allows calibration of the FSPM system. Now, reproducible and comparable readings for ICA values can be obtained from the various reporting laboratories. Should an international reference serum for ICA become available, the remaining problem in the ICA assay, that of substrate (pancreas) variability, should be resolved. PMID- 3308588 TI - Effects of fasting on plasma glucose and prolonged tracer measurement of hepatic glucose output in NIDDM. AB - We studied the measurement of hepatic glucose output (HGO) with prolonged [3 3H]glucose infusion in 14 patients with non-insulin-dependent diabetes mellitus (NIDDM). Over the course of 10.5 h, plasma glucose concentration fell with fasting by one-third, from 234 +/- 21 to 152 +/- 12 mg/dl, and HGO fell from 2.35 +/- 0.18 to 1.36 +/- 0.07 mg . kg-1 . min-1 (P less than .001). In the basal state, HGO and glucose were significantly correlated (r = 0.68, P = .03), and in individual patients, HGO and glucose were closely correlated as both fell with fasting (mean r = 0.79, P less than .01). Plasma [3-3H]glucose radioactivity approached a steady state only 5-6 h after initiation of the primed continuous infusion, and a 20% overestimate of HGO was demonstrated by not allowing sufficient time for tracer labeling of the glucose pool. Assumption of steady state instead of non-steady-state kinetics in using Steele's equations to calculate glucose turnover resulted in a 9-24% overestimate of HGO. Stimulation of glycogenolysis by glucagon injection demonstrated no incorporation of [3 3H]glucose in hepatic glycogen during the prolonged tracer infusion. In a separate study, plasma glucose was maintained at fasting levels (207 +/- 17 mg/dl) for 8 h with the glucose-clamp technique. Total glucose turnover rates remained constant during this prolonged tracer infusion. However, HGO fell to 30% of the basal value simply by maintaining fasting hyperglycemia in the presence of basal insulin levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308590 TI - Total denervation of the pancreas does not alter the pancreatic polypeptide response to food intake. AB - The secretion of pancreatic polypeptide (PP) seems to be controlled by vagal cholinergic mechanisms, since both vagotomy and atropine significantly inhibit the PP response to food intake, sham feeding or insulin hypoglycaemia. In the present study, we examined the PP response to a meal after orthotopic autotransplantation of the pancreas. Completeness of vagal pancreatic denervation was confirmed by the missing response of pancreatic protein and the PP response to insulin hypoglycaemia. Total vagal denervation of the pancreas did not alter the PP response to a meal (peak PP levels 402 +/- 41 pg/ml before transplantation compared to 510 +/- 98 pg/ml after operation). The secretion of PP after food intake seems not to be mediated by direct vagal innervation of the pancreas itself. Since pancreatic autotransplantation results in an interruption of gastropancreatic or enteropancreatic neural reflexes, our results confirm the findings of Debas et al. [Surgery 92:309-313, 1982] and strongly suggest that the PP response to nutrient stimuli is mediated by a humoral mechanism. PMID- 3308589 TI - Physiological role of cholecystokinin in meal-induced insulin secretion in conscious rats. Studies with L 364718, a specific inhibitor of CCK-receptor binding. AB - It has been suggested that the gut hormone cholecystokinin (CCK), by modulating insulin output from pancreatic beta-cells, plays an important role in the enteroinsular axis. To investigate this hypothesis, eight rats were studied on two different occasions: after injection of L 364718, a specific antagonist of CCK binding to its membrane receptor, and after vehicle injection. In both studies a mixture of casein (11%) and glucose (9%) was infused through a chronic indwelling intraduodenal catheter to evoke CCK secretion. Plasma was analyzed for insulin, glucose, glucagon, and tyrosine many times during the procedure. Prior administration of the CCK antagonist significantly attenuated the increase in plasma insulin and glucagon after casein infusion. These results support the concept that cholecystokinin plays an important physiologic role in the in vivo regulation of postprandial plasma insulin and glucagon concentrations after protein ingestion. PMID- 3308591 TI - Noise and public policy. PMID- 3308592 TI - Synergistic interactions of noise and other ototraumatic agents. AB - The following is a review of the literature on interaction of noise and other agents, both ototraumatic and nonototraumatic. A short description of the anatomical effects of exposure to intense sound previews the interaction literature. The effects of exposure to combinations of continuous and impulse noise are discussed. This is followed by a review of data on interactions of noise and ototoxic drugs and noise and whole-body vibration, including discussion of putative mechanisms of synergism. In addition, preliminary results of noise cisplatinum interaction are presented which suggest that if cisplatinum is presented during noise exposure in dose schedules simulating human chemotherapy schedules, hearing threshold shifts and histological damage is much greater than that caused by either agent in isolation. The clinical relevance of the interactions is discussed, along with potential synergistic interactions not yet investigated. PMID- 3308594 TI - Brief tone audiometry: a review. AB - This paper reviews a number of studies on temporal integration of acoustic power at threshold. A wide variety of results for normal-hearing individuals and for hearing-impaired patients is revealed. This variability limits the current clinical application of brief tone audiometry. PMID- 3308593 TI - Proceedings of a meeting in honor of Professor Jay Sanders. Nashville, July 26, 1986. PMID- 3308595 TI - Audiologic manifestations of tumors of the VIIIth nerve. PMID- 3308596 TI - Central auditory assessment: thirty years of challenge and change. AB - In this paper we discuss some of the major developments that have occurred in the field of central auditory assessment over the past 30 years. We discuss both the psychophysical and the electrophysiological procedures that have been used for either research and/or clinical purposes. Case illustrations from our own clinical experience are also provided. Finally, we conclude by suggesting directions for future research. PMID- 3308597 TI - The acoustic reflex in diagnostic audiology: from Metz to present. AB - In 1946, Metz described what was probably the first practical impedance bridge for measurement of the acoustic reflex. Over the next four decades, diagnostic use of the acoustic reflex progressed in parallel with instrumentation refinements. Today, acoustic reflex threshold and decay testing are a routine component of the diagnostic audiology test battery. Recent advances in the measurement of suprathreshold latency and amplitude have further enhanced the diagnostic value of acoustic reflex measurement. PMID- 3308598 TI - Diagnostic audiology: a golden anniversary, 1936-1986. PMID- 3308599 TI - Neurodiagnostic audiology: contemporary perspectives. AB - This paper reviews the principals of clinical epidemiology as they relate to diagnostic audiology including the problems associated with the test battery approach. The paper also presents a philosophical discussion as to the influence of disease prevalence on diagnostic testing protocols in different clinical environments. PMID- 3308600 TI - Assessing low frequency hearing using auditory evoked potentials. PMID- 3308601 TI - Diagnostic audiology: historical perspectives. AB - In summary, the modern era of diagnostic audiometry began with the era of loudness recruitment in the 1950s, followed closely by the era of acoustic impedance in the 1960s and 1970s and, most recently, the era of evoked potentials in the 1970s and early 1980s. Throughout this period, the era of speech audiometry has grown slowly but steadily. Jay Sanders has made important contributions in each of these areas, but his most important legacy will be the continuing contributions of his many dedicated and loyal students in the years to come. PMID- 3308603 TI - Insulin suppression of plasma-free fatty acid concentration in normal individuals and patients with type 2 (non-insulin-dependent) diabetes. AB - In order to define the effect of Type 2 (non-insulin-dependent) diabetes mellitus on the ability of insulin to regulate plasma-free fatty acid (FFA) concentrations, we determined the plasma FFA response to the intravenous infusion of various amounts of insulin. Plasma FFA concentrations were higher in patients with Type 2 diabetes (two way analysis of variance, p less than 0.001) over a plasma insulin concentration which ranged from approximately 5 to 55 mU/l of insulin. Although plasma FFA concentrations were higher in patients with Type 2 diabetes at any given insulin concentration, the relative ability of insulin to suppress plasma FFA concentration to half the initial value was comparable in normal individuals and patients with Type 2 diabetes, occurring at a plasma insulin concentration of approximately 20 mU/l. These data demonstrate that plasma FFA levels are regulated over a narrow range of plasma insulin concentrations in humans, and that plasma concentrations are higher than normal in patients with Type 2 diabetes throughout this range. PMID- 3308604 TI - Familial diabetes mellitus with variable B cell reserve; analysis of a pedigree. AB - Some patients do not fall neatly into the categories of Type 1 (insulin dependent), Type 2 (non-insulin-dependent) or maturity onset diabetes of young people diabetes. The pedigree and characteristics of the family reported here illustrate this problem. Nine cases of diabetes are known in 4 out of 5 generations, with onset between 17-70 years. Treatment was with insulin in 5 (onset 17-29 years), tablets in 3 (onset 32-70 years), and in one diabetes occurred before the insulin era. Plasma C-peptide was 0.04-0.52 nmol/l (fasting) and 0.35-1.33 nmol/l (peak stimulation with glucagon). HLA typing, available in 7 diabetic patients showed DR2 or DR7 in all, DR4 in 2 and DR3 in none. Pancreatic islet cell antibodies were absent at diagnosis in the most recently diagnosed patient. Diabetic complications remain absent in two insulin-treated patients (duration 28 and 24 years), but have occurred extensively in the remainder. The form of diabetes in this family is therefore characterised by (a) strong family history (possible autosomal dominant with variable penetrance), (b) widely variable age of onset, (c) a variable degree of B cell reserve (d) no association with HLA DR3/4 and the presence of DR2 or DR7 and (e) no protection from complications. PMID- 3308602 TI - Endothelial cell function in diabetic microangiopathy. PMID- 3308605 TI - The permissive effect of glucose, tolbutamide and high K+ on arginine stimulation of insulin release in isolated mouse islets. AB - Mouse islets were used to study how glucose modulates arginine stimulation of insulin release. At 3 mmol/l glucose, arginine (20 mmol/l) decreased the resting membrane potential of B cells by about 10 mV, but did not evoke electrical activity. This depolarisation was accompanied by a slight but rapid acceleration of 86Rb+ efflux and 45Ca2+ influx. However, 45Ca2+ efflux and insulin release increased only weakly and belatedly. When the membrane was depolarised by threshold (7 mmol/l) or stimulatory (10-15 mmol/l) concentrations of glucose, arginine rapidly induced or augmented electrical activity, markedly accelerated 86Rb+ efflux, 45Ca2+ influx and efflux, and triggered a strong and fast increase in insulin release. When glucose-induced depolarisation of the B-cell membrane was prevented by diazoxide, arginine lost all effects but those produced at low glucose. However, the delayed increase in release still exhibited some glucose dependency. In contrast, depolarisation by tolbutamide, at low glucose, largely mimicked the permissive effect of high glucose. Depolarisation by high K+ also amplified arginine stimulation of insulin release, but did not accelerate it as did glucose or tolbutamide. Omission of extracellular Ca2+ abolished the releasing effect of arginine under all conditions. The results thus show that the permissive action of glucose mainly results from its ability to depolarise the B cell membrane. It enables the small depolarisation by arginine itself to activate Ca channels more rapidly and efficiently. Changes in the metabolic state of B cells may also contribute to this permissive action by increasing the efficacy of the initiating signal triggered by arginine. PMID- 3308607 TI - [Vasculitis]. PMID- 3308606 TI - Effect of high sucrose diet on insulin secretion and insulin action. A study in rats with non-insulin-dependent diabetes induced by streptozotocin. AB - The effects of chronic high sucrose feeding for 1 month on in vivo and in vitro insulin secretion and on in vivo insulin action were studied in rats with non insulin-dependent diabetes. As compared to the standard diet, the high sucrose diet induced an increase of the in vivo insulin response to an intravenous load and deteriorated the glucose tolerance as attested by significantly lower rates of glucose disappearance (K values, p less than 0.001). The increased insulin secretion in response to glucose in vivo seems to be related to a slight increase of the pancreatic B-cell reactivity to glucose, since it was still observed in vitro with the isolated perfused pancreas preparation. By contrast, B cells of sucrose-fed rats exhibited in vitro a significantly lowered (p less than 0.01) response to acetylcholine and arginine. The insulin action in the sucrose-fed diabetic rats was quantified in vivo with the insulin-glucose clamp technique. The effects of different concentrations of insulin on glucose production and glucose utilisation were studied in anaesthetized rats while in the postabsorptive state. The basal glucose utilisation was found significantly higher (p less than 0.001) in sucrose-fed rats. During the clamp studies the glucose utilisation induced by submaximal (450 mU/l) insulin level was significantly less important (p less than 0.01) in the sucrose-fed rats than in the chow-fed rats. Following a maximal hyperinsulinaemia (5000 mU/l) the glucose utilisation was similar in both groups. This suggests that insulin-mediated glucose uptake is decreased over the range of submaximal plasma insulin levels in the sucrose-fed diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308609 TI - [Current knowledge on acquired immunodeficiency syndrome (AIDS)]. PMID- 3308608 TI - [Effects of thymopentin and recombinant interferon alpha 2A on the biochemiluminescence of neutrophil granulocytes in subjects with HIV infections]. PMID- 3308610 TI - Harland Wood--active at 80. PMID- 3308611 TI - The glomerular mesangial cell: an expanding role for a specialized pericyte. AB - The mesangial cell occupies a central position in the renal glomerulus. It has characteristics of a modified smooth muscle cell, but is also capable of a number of other functions. Among these are generation of prostaglandins (PGs) and mediators of inflammation; production and breakdown of basement membrane and other biomatrix material; synthesis of cytokines; and uptake of macromolecules, including immune complexes. In terms of its smooth muscle activity, the mesangial cell contracts or relaxes in response to a number of vasoactive agents. This ability allows the cells to modify glomerular filtration locally. The cellular mechanism of action of many agents influencing mesangial cells involves activation of phospholipase C for phosphatidylinositol 4,5-bisphosphate. This results in generation of inositol trisphosphate and release of intracellular calcium. Mesangial cell relaxation can be mediated by enhanced cAMP or cGMP generation. Many vasoactive substances also stimulate PG production by mesangial cells. This involves activation of both phospholipase C and A2, the latter being responsible for the release of arachidonic acid. Mesangial cells are also capable of endocytosis of macromolecules, including immune complexes. This is initiated by binding to a specific receptor, resulting in formation of PG, platelet activating factor, and reactive oxygen species. Mesangial cells can generate interleukin 1 and platelet-derived growth factor and respond to these in an autocrine manner. Thus, the mesangial cell not only can control glomerular filtration, but may also be involved in the response to local injury, including cell proliferation and basement membrane remodeling. PMID- 3308612 TI - [Role of Doppler echocardiography in the evaluation of left ventricular diastolic function]. PMID- 3308613 TI - [Architecture and medicine]. PMID- 3308614 TI - [An original method of bacteriological sampling for studying Campylobacter pylori in duodenal ulcer]. AB - The presence of Campylobacter pylori in duodenal ulcer was investigated in 26 patients. The method used was a sterile endoscopic sampling technique which forcasted and checked for contamination of the samples. A sterile catheter was introduced through the endoscope and then an infusion of saline was instituted. Once the catheter was in the intestinal lumen, the infused solution was aspirated for control of sterility. Semi-quantitative cultures of gastric and duodenal juices and of biopsies of the duodenal ulcer, the bulbar mucosa close to the ulcer and prepyloric antral mucosa were compared. Only two contaminations were detected with this method. C. pylori was isolated in one gastric and one duodenal sample only. It was isolated in 14 of 26 duodenal ulcers, 12 of 26 bulbar mucosa and 20 of 26 mucosal specimens. Our study established that the presence of C. pylori was very uncommon in gastric and duodenal juices even when the bacterium was present in the mucosal membrane in large quantities. PMID- 3308615 TI - [Nutritional and metabolic status of cancer patients]. PMID- 3308616 TI - [Treatment of primary biliary cirrhosis]. PMID- 3308617 TI - [Vidarabine treatment of chronic active hepatitis associated with hepatitis B virus multiplication. A randomized multicenter study]. AB - A randomized controlled study of one course of vidarabin was carried out in 30 patients with HBs Ag, HBe Ag, DNAp, positive chronic active hepatitis: 15 patients were treated with vidarabin given intravenously (15 mg/kg/day for 7 days then 7.5 mg/kg/day for 14 days); the other 15 patients received a placebo for 21 days. During treatment, DNA polymerase activity fell dramatically in 13 treated patients and in no controls (p less than 0.001). Six months after inclusion, ALT normalization was observed in 40 p. 100 of the treated patients and 6 p. 100 of the controls (p less than 0.05), a decrease in inflammatory activity on liver biopsies was observed in 70 p. 100 of the treated patients and 20 p. 100 of the controls (p less than 0.05), a permanent lost of DNA polymerase and of HBe Ag occurred in 33 p. 100 and 13 p. 100 of the treated patients and 20 p. 100 and 7 p. 100 of the controls, respectively. In addition, a second course of vidarabin was administered to the 12 patients who were still HBe Ag positive 6 months after the first course. During the next 6 months, 8 patients lost DNA polymerase and 4 lost HBe Ag. Altogether, the final score of durable inhibition of HBV replication was 11/15 (73 p. 100) within one year. The above results demonstrate that one course of vidarabin can significantly improve ALT and liver inflammatory activity but the effect upon HBV replication is only transient. A second course does however increase efficacy on HBV replication without additional side effects. PMID- 3308619 TI - [In vitro tests in the diagnosis of drug hepatitis]. PMID- 3308618 TI - [Criteria of imputation of acute hepatitis to a drug. Results of consensus meetings]. AB - The use of an official drug adverse reaction assessment procedure became compulsory in France in 1984. The method proposes various qualifications for chronologic and semiologic criteria but does not define them. Consensus meetings have been organized in order to define, in the main pathologic fields, the adverse reactions themselves and the various qualifications of the criteria. This paper reports the results of meetings attended by hepatologists from university hospitals, members of the National Network of pharmacovigilance and representatives of Roussel Uclaf Drug Monitoring Department for drug-induced acute hepatitis. Participants studied (a) the limits of the time interval between the appearance of the adverse reaction and the beginning or the end of the treatment with the suspected drug; (b) the interpretation of the course of disease with or without cessation of treatment; (c) the interpretation of a possible rechallenge; (d) the signs evoking a drug-induced origin and the risk factors, as well as the investigations to be performed in order to eliminate other possible causes. PMID- 3308620 TI - [Heterogenous hepatic steatosis: ultrasonic anomalies may be persistent]. PMID- 3308621 TI - [Value of real time in ultrasonography]. PMID- 3308622 TI - Fc receptors of liver sinusoidal endothelium in normal rats and humans. A histologic study with soluble immune complexes. AB - Fc receptors for immunoglobulin G in the liver sinusoidal wall were studied in the normal rat and in humans by applying peroxidase-antiperoxidase immunoglobulin G complexes to the frozen sections. Fc receptors were found to exist continuously along the sinusoidal lining. The receptors showed no zonal distribution in the rat, and they were generally scarce near the central veins and portal areas in humans. To characterize the sinusoidal cells, carbon or latex was given intravenously and endogenous peroxidase was demonstrated for the rat, whereas factor VIII-related antigen and endogenous peroxidase were demonstrated for the humans. In the rat, Fc receptors were detected on Kupffer cells, which were characterized by an intense endogenous peroxidase activity and ingestion of latex or quantities of carbon. They were also detected on sinusoidal endothelial cells, which were characterized by undetectable peroxidase activity and no ingestion of latex nor of a small quantity of carbon. In humans, Fc receptors were also present on Kupffer cells as well as sinusoidal endothelial cells, as identified by endogenous peroxidase and factor VIII-related antigen, respectively. PMID- 3308623 TI - Mucosal subclass distribution of immunoglobulin G-producing cells is different in ulcerative colitis and Crohn's disease of the colon. AB - As a marked local immunoglobulin G (IgG) response has previously been found to be the most prominent immunopathological feature of both ulcerative colitis and Crohn's disease, the subclass distribution of colonic IgG-producing immunocytes was examined. This study included tissue specimens from 10 patients with ulcerative colitis and 8 with Crohn's colitis. Paired immunofluorescence staining was performed with subclass-specific murine monoclonal antibodies combined with a rabbit antibody reagent of IgG; the proportion of cells belonging to each subclass could thereby be determined in relation to the total number of mucosal IgG immunocytes. A significantly higher median proportion of IgG1 immunocytes was found in ulcerative colitis (81.3%) than in Crohn's colitis (66.5%). Conversely, the median proportion of IgG2 immunocytes was significantly higher in Crohn's colitis (24.9%) than in ulcerative colitis (9.4%). This disparity in the local IgG subclass response might reflect dissimilar mucosal exposure to mitogenetic or antigenic stimuli or genetically determined immunoregulatory differences in the two categories of patients. PMID- 3308624 TI - [Significance of radiologic pelvic viscerography for rational therapy of female stress incontinence]. AB - The rational therapy of stress incontinence requires a knowledge of the pathologico-anatomical physiology of the urorectogenital tract of the female pelvis. The usual urethrocystography gives only very incomplete, and in the case of the chain method, misleading information. Viscerography (Wick - urethro-cysto colpo-rectoanography), however, informs about the possibilities and requirements of appropriate anatomical procedures in a complete and objective manner. The development, practice, interpretation and indication of the viscerography are thoroughly discussed and demonstrated by means of typical examples, on the basis of more than 2000 viscerograms. PMID- 3308625 TI - [Obstetric management in severe fetal growth retardation. Report of experiences based on 278 newborn infants with severe dystrophy 1970-1985]. AB - The article discusses and reviews the obstetrical modalities in confirmed severe growth retardation and the effects exercised by marked dystrophy of newborn (less than or equal to 3rd percentile of weight) at the Department of Gynaecology of the University of Cologne between 1970 and 1985 on perinatal mortality, rate of asphyxiation and neonatal complications. In view of the optimal diagnostic possibilities available during the past decade, the examinations were subdivided into two groups (1970-1975 and 1976-1985). In severe foetal growth retardation mainly confirmed sonographically-the proportion of primary Caesarean sections increased from 10% to 38%, whereas indication for inducing labour clearly dropped from 25% to 6%. The desired slight reduction in incidence of prenatally severely dystrophic newborn from 1.6% to 1.2% is regarded as the beginning of the effect of ultrasound screening during pregnancy. The higher perinatal mortality of the severely dystrophic newborn of the years 1976-1985 is explained by the increased incidence of dystrophic newborn who are considerably underweight (less than 1000 g) from 1.3% (1970-1985) to 10.4% (1976-1985). If perinatal mortality rate is corrected accordingly, perinatal mortality for both groups is about equal, namely, 3.3% and 3.2% respectively. Among the severely dystrophic newborn there were distinct differences on comparing the two groups in respect of the degree of maturity depending on the pregnancy period, and of the weight at birth. In 1970 75 85% of the dystrophic children were born after the 37th pregnancy week, i.e. mature-dystrophic, and only 15% showed in addition the signs of immaturity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308626 TI - [Double cerclage. Cervix insufficiency in the middle trimester and its treatment]. AB - The treatment of cervical insufficiency with prolapse of the amniotic sac by double cerclage-a procedure that augurs success-is illustrated on the basis of case descriptions. PMID- 3308627 TI - [Computer-assisted documentation and recording of findings of obstetrical ultrasound findings]. AB - Since 1976 on our department obstetrical reports are generated and stored by computer. This kind of documentation has been also introduced for obstetrical ultrasound investigations. One year ago the part of our database for storing and recording the results of obstetrical ultrasound examinations was changed according to new purposes. This system was designed to support diagnosis of pathological findings and to arrange the results more clearly. Immediately after the investigation the results are entered in a terminal (3278 IBM). Our database is a CICS (Customer Information Computer System) application of the WAMIS (Wiener Allgemeines Medizinisches Informationssystem) from the IMC (Institut fur Medizinische Computerdokumentation). The results of the investigation are printed after storage in the data base. The screen and the obtained print-out are divided into several sections according to medical purposes. Since the results of fetal measurement are displayed graphically, fetal growth and the change of normal or abnormal findings can be judged immediately. The new layout of the hardcopy of the results of our ultrasound investigations improves diagnosis of pathological findings. Each examinator is forced to visualize fetal organs, signs of fetal vitality and to perform standardized measurement. Therefore, the possibility to find pathological alteration is improved especially if the investigator is less experienced. PMID- 3308628 TI - Calcium antagonists, vasoconstrictors and the peripheral circulation. PMID- 3308629 TI - Effects of FUT-175, a novel synthetic protease inhibitor, on the development of adjuvant arthritis in rats and some biological reactions dependent on complement activation. AB - 1. The effects of FUT-175 on the development of adjuvant arthritis in rats were studied and compared with those of indomethacin. FUT-175 inhibited both primary and secondary paw lesions in the adjuvant arthritic rats when it was administered orally on a daily basis from the day before through 18th day after adjuvant injection. 2. In addition, FUT-175 inhibited the increase in hemolytic complement in adjuvant arthritic rats in a dose-dependent manner. 3. Indomethacin also showed an inhibitory effect on the development of arthritic lesion, but had no effect on the increase in hemolytic complement in the adjuvant arthritis in rats. 4. Furthermore, FUT-175 inhibited the activities of various proteases in vitro, and then strongly inhibited complement-mediated hemolysis via the classical and alternative pathways, while indomethacin had no effect on them. 5. These results suggest that the anti-inflammatory activity of FUT-175 may differ from indomethacin in the mechanisms of action and, at least in part, due to the anti complement activity. PMID- 3308630 TI - Effect of insulin on lipid bilayer viscoelasticity. AB - Changes in the Young elasticity modulus in perpendicular direction to the membrane surface E perpendicular, in the coefficient of dynamic viscosity eta, in the electric capacitance C, in the surface charge U1, in the conductivity g and in the coefficient of non-linearity beta of current-voltage characteristic caused by insulin were studied in bilayer lipid membranes (BLM) prepared from a mixture of egg lecithin and cholesterol (4:1, w/w) in n-heptane. Even relatively small concentrations of insulin in electrolyte (ci approximately 4.8 x 10(-11) mol/l) caused a diminution in parameters E perpendicular and eta. Negative surface charge emerged on the membrane due to the insulin absorption, and U1 gradually increased depending on the concentration of the hormone in the electrolyte. Addition of insulin was also followed by an increase in membrane conductivity and affected the value of the coefficient of non-linearity beta of current-voltage characteristic. The effect of insulin on the BLM structure was discussed on the basis of the results obtained. PMID- 3308631 TI - n-heptane and n-hexane enhance in a dose-dependent manner insulin binding to erythrocytes and its degradation. PMID- 3308632 TI - [Radiation-induced instability of yeast chimeric chromosomes]. AB - Instability of the I chimeric chromosome of the yeast Saccharomyces induced by gamma-irradiation has been studied. The chimeric chromosome analysed contained an integrated pYF91 plasmid. Cells of the integrant were irradiated and then mated with non-irradiated cells of the proper tester strain marked by ade1 mutation (red colour of colonies). We isolated 10 hybrids with pink colonies on selective medium. They displayed high degree of mitotic instability during growth on nonselective medium, segregating red colonies (15 to 90% of the total). Tetrad analysis showed that some of the unstable chromosomes exhibited lethal effect in haploids, while others were viable and could pass through meiosis retaining their instability. PMID- 3308633 TI - [Electrophoretic pseudopolymorphism: the role of modifications illustrated by proteolysis]. AB - The term "pseudopolymorphism" refers to a situation, where there is no simple correspondence between genotype and phenotype: a single genotype may be moulded into several phenotypes. It is known that broad substrate specificity of enzymes may be one of the causes for pseudopolymorphism. This article deals with the other cause for this phenomenon--a consequence of post-translation modifications, such as limited proteolysis. Variability of some enzymes of grass carp Ctenopharyngodon idella Val. (Pisces, Cyprinidae) was studied by gel electrophoresis. It was found that variability of isozyme patterns of lactate dehydrogenase (LDH), glucose-6-phosphate dehydrogenase (G-6-PDH), malic enzyme (ME) and esterase (EST) is connected with the differences in protease activity of grass carp liver homogenates. The fish isozyme patterns of high (and, partially, intermediate) proteinase activity had some anomalies: displacement of fractions, one or several additional fractions, decreased activity of single fractions or the whole spectrum. In some cases, this variability looked like a classical polymorphic system specified by two alleles of one locus. The effect of enzymes' and proteins' modifications on electrophoretical pseudopolymorphism is discussed. PMID- 3308635 TI - Tolerated variations in a genome: the case of closely related Bacillus phages PZA, phi 29 and phi 15--a review. AB - Restriction-site analysis was used to estimate the relationship of bacteriophages PZA, phi 29 and phi 15. Complete nucleotide sequences of PZA and luminal diameter 29 genomes were compared and tolerated variations were assessed. Most of the base pair changes are silent nucleotide substitutions in the third position of codons but amino acid changing substitutions are also observed. The terminal portions of the phage genomes diverged faster than their central parts. Gene mutations in phage PZA were induced by hydroxylamine and their frequency was compared with the evolutionary mutability. PMID- 3308634 TI - [Spontaneous mutation of the H-2b-haplotype in C57BL/10SnY mice]. AB - A new spontaneous mutation of the H-2b haplotype was found in skin graft tests with BC3 mice derived from B10.R111 (71NS) and C57BL/10SnY outcrossing. The mutation site localized in the F1 test in the H-2Kb gene is nonidentical to and noncomplementary with bm1, bm3, bm4 mutations. The novel mutation is maintained as B10.R111-H-2bm25 strain. PMID- 3308636 TI - Analysis of the regulatory region of the protease III (ptr) gene of Escherichia coli K-12. AB - The ptr gene of Escherichia coli encodes protease III (Mr 110,000) and a 50-kDa polypeptide, both of which are found in the periplasmic space. The gene is physically located between the recC and recB loci on the E. coli chromosome. The nucleotide sequence of a 1167-bp EcoRV-ClaI fragment of chromosomal DNA containing the promoter region and 885 bp of the ptr coding sequence has been determined. S1 nuclease mapping analysis showed that the major 5' end of the ptr mRNA was localized 127 bp upstream from the ATG start codon. The open reading frame (ORF), preceded by a Shine-Dalgarno sequence, extends to the end of the sequenced DNA. Downstream from the -35 and -10 regions is a sequence that strongly fits the consensus sequence of known nitrogen-regulated promoters. A signal peptide of 23 amino acids residues is present at the N terminus of the derived amino acid sequence. The cleavage site as well as the ORF were confirmed by sequencing the N terminus of mature protease III. PMID- 3308637 TI - Isolation of the lux genes from Photobacterium leiognathi and expression in Escherichia coli. AB - Genes necessary for luminescence (lux genes) in the marine bacterium Photobacterium leiognathi, strain PL721, were isolated and expressed in Escherichia coli. A 15-kb fragment obtained from a partial digestion of PL721 DNA with HindIII was cloned into the plasmid pACYC184, resulting in the hybrid plasmid pSD721. When pSD721 was transformed into E. coli ED8654, the resulting transformants were luminous with no additions to the cells, indicating that it contained the structural genes coding for the alpha and beta subunits of luciferase (luxA and luxB), and for components involved in aldehyde biosynthesis. Hybridization analysis with luxA and luxB 32P probes confirmed the location of these two genes on the 15-kb insert. When pSD721 was transformed into four different strains of E. coli, luminescence expression varied widely in amount and in pattern. In some strains, luminescence developed like an autoinducible system, and at maximum induction was very bright, even with no addition of aldehyde, while in others, luminescence was 100-fold less, and no induction was seen. In no case was luminescence affected by shifts in temperature, osmolarity, or iron concentration. These results indicate that, while the complete lux regulon is apparently contained on the 15-kb cloned fragment, the regulation of the lux regulon in pSD721 is subject to host controls by E. coli, controls which vary widely among different E. coli strains. PMID- 3308638 TI - A simple procedure for large-scale purification of plasmid DNA. AB - We report a simple, rapid and reliable procedure for large-scale purification of plasmid DNA from non-amplified bacterial cultures. It is a modification of the boiling method of Holmes and Quigley [Anal. Biochem. 114 (1981) 193-197] and involves gel-filtration chromatography using Sephacryl S-1000 for final purification of plasmid DNA. This method does not require CsCl gradients and the recovered plasmids are free of RNA and chromosomal DNA, are supercoiled, retain their biological activity, and are suitable for restriction analysis. PMID- 3308640 TI - Medicare-supported HMOs: should physicians give up on the frail elderly? PMID- 3308639 TI - Promoter selection by a bacterial enhancer-like activator element (BELE) in Escherichia coli. AB - The Escherichia coli glnA gene promoter glnAp2 is activated by an element able to act bidirectionally and at variable distance over the DNA. We demonstrate here that this activating element does not influence another promoter, 82p, adjacent to it, from which a gene is transcribed in opposite direction to glnA. Thus, although it displays a great flexibility, this element can activate selectively. The unresponsive promoter and glnAp2 are recognized by RNA polymerases complexed to two different sigma factors. Therefore, we argue that promoter selection by this element is dependent upon distinguishing the proper sigma factor. PMID- 3308641 TI - Clinical approach to the aged brain. AB - There are two main clinical manifestations of the aging brain, which appear to be independent of any disease process, namely adaptability and general slowing. Impaired adaptability depends in part on poor function of the homeostatic mechanisms. General slowing affects all levels of nervous activity and can be measured in various ways. Research relevant to the clinical problem is reviewed and evaluated. PMID- 3308642 TI - Pathophysiology of ageing brain. AB - Even in nonfamilial cases of dementia there is some evidence of a genetic factor. This may be linked to defective expression of neurofilament protein and also abnormal phosphorylation of cytoskeletal proteins. In this respect there may be a link with accumulation of tangles and amyloid which have some degree of homology. It may be speculated that neurons containing tangles or undergoing granulovacuolar degeneration would not be able to release trophic factors and that transneuronal degeneration would result. However, the environmental or aetiological factors associated with Alzheimer's disease are not known. Although there has been a failure to transmit Alzheimer's disease to primates, it is possible that as in postencephalitic Parkinson's disease virus may be implicated at some stage in the pathogenesis. Finally, free radical formation has been considered as an alternative mechanism for death of large neurons within the CNS. Although tangles are found in several other dementing conditions (e.g. dementia puglistica, Parkinson-dementia complex of Guam), Alzheimer-type plaques and tangles are not invariably found in cases of cognitive deficit. For example, in dementia of Parkinson's disease there is a low neuritic plaque count and normal population of tangles. In addition, memory loss is not necessarily associated with defects in the cholinergic system and/or loss of nucleus basalis nerve cells. We have proposed that damage to or loss of cortical cells may be a more general finding in dementing illness. PMID- 3308643 TI - Macromolecular turnover in brain during aging. AB - During aging there are several structural, functional and biochemical alterations, including changes in macromolecular composition and turnover. Regulation of gene expression, DNA and RNA synthesis, total poly(A)+ and poly(A)- RNA contents, qualitative and quantitative changes of synaptosomal plasma membrane proteins, diminished plasticity, loss of synapses, lower rate of axoplasmic transport, impairment of antioxidant and bioenergetic systems seem to be involved in the aging process of nervous system. PMID- 3308644 TI - Patterns of lipid changes in membranes of the aged brain. AB - The lipid composition of cell plasma membranes reflects a steady-state between accumulation of serum lipids, predominantly cholesterol, and intracellular lipid synthesis and degradation. In the aging tissue this subtle balance is impaired with a net accumulation of cholesterol and other rigidifying lipids such as sphingomyelin in the membrane. As a consequence, most membrane processes, including ion transports in neuronal tissues, are slowed down. In principle, it is possible to rectify such adversative processes in vivo by increasing the level of specific phospholipids and glycerides in the serum. PMID- 3308645 TI - Reparative processes in aged brain. AB - Endogenous neurotrophic factors have been proposed to play an important role in degenerative diseases and aging. In aged rats, neurotrophic activity induced by partial lesion of nigro-striatal pathways seems to be lower compared to young rats when assayed in vitro on cultured mesencephalic dissociated neuronal cells. In parallel experiments, we could also observe an age-dependent delay in spontaneous recovery of striatal tyrosine hydroxylase activity after lesion. Both experimental evidences suggest a low-potential neuroplasticity in aged rats. Nevertheless, the aging brain seems to be responsive to pharmacological manipulation. Long-term phosphatidylserine treatment has been shown to maintain the integrity of neuronal structures altered by the aging process. Putative mechanisms of action underlying these effects are presented. PMID- 3308646 TI - Present state of hemorheology. AB - Hemorheological disturbances are present in more than 50% of cerebrovascular disease (CVD). An inverse relationship between cerebral blood flow (CBF) and viscosity has been established. There also exists an interaction of vessel wall changes, whole blood viscosity, and plasma fibrinogen. The acute ischemic episode is associated with hyperaggregability of the blood platelets, increased blood viscosity, hyperaggregability of the red cells and an increase in plasma fibrinogen. Hemorheological changes to a certain extend may occur not only in CVD but also in senile dementia of Alzheimer type (SDAT) and certain cases of Parkinson's disease. This fact allows to differentiate between idiopathic parkinsonism and Parkinson's disease with high hemodynamic risk. PMID- 3308647 TI - Gas tamponade as a single technique in the treatment of retinal detachment: is vitrectomy needed? A comparative study of 120 cases. AB - Internal gas tamponade is employed with no episcleral buckle and can be combined with or without a vitrectomy for the surgical treatment of some forms of retinal detachment. These techniques are for forms of retinal detachment with no proliferative vitreoretinopathy that are being operated upon for the first time and have one or several breaks located on the superior half of the retina. We compare these two techniques, their anatomical results, and their complications. PMID- 3308648 TI - [Biophysical evaluation of the fetal condition]. PMID- 3308650 TI - Tripotassium dicitrato bismuthate (TDB) versus two different dosages of cimetidine in the treatment of resistant duodenal ulcers. AB - The use of tripotassium dicitrato bismuthate (TDB) has been suggested recently for cimetidine resistant duodenal ulcers. This study compares the efficacy of TDB with two different cimetidine dosages in the treatment of duodenal ulcer patients who failed to respond to an eight week therapy with H2-blockers. Fifty two patients (40 men, 12 women) were randomly allocated to one of the following three oral regimens: (1) TDB 120 mg quid, (2) cimetidine 400 mg tid, (3) cimetidine 400 mg with meals plus 800 mg at bedtime. Endoscopy was carried out after four weeks; if the ulcer had not healed patients continued with the same treatment for a further four week period when they were endoscopically reassessed. After four weeks similar percentages of ulcer healing were registered in the two cimetidine schedules (39% with 1.2 g and 44% with 2 g), whereas TDB resulted in a significantly higher healing rate (82%) compared with cimetidine 1.2 g (p = 0.01) and with cimetidine 2 g (p = 0.025). After eight weeks the cumulative percentages of healing were 65% on cimetidine 1.2 g, 75% on cimetidine 2 g, and 94% on TDB (TDB v cimetidine 1.2 p = 0.042). These results confirm previous data that resistant duodenal ulcers are more responsive to an agent which strengthens the mucosal defences than to antisecretory compounds. PMID- 3308651 TI - IgA protease-producing bacteria in patients with ulcerative colitis. PMID- 3308649 TI - Anastomotic recurrence of colorectal cancer--a biological phenomenon or an avoidable calamity? PMID- 3308653 TI - Primary leiomyosarcoma of the ovary: a histological and immunocytochemical study. AB - A case of primary leiomyosarcoma of the ovary in a 35-year-old woman is presented. The tumor was investigated histologically and by histochemistry. Desmin was demonstrated in neoplastic cells. Pertinent literature is reviewed and histogenesis is discussed. PMID- 3308652 TI - Endoluminal ultrasonic scanning in the staging of cervical carcinomas. AB - A new method in the staging of cervical carcinomas using endoluminal rectal ultrasound scanning is demonstrated in the different staging. PMID- 3308654 TI - Gastrointestinal surgery in gynecologic oncology: evaluation of surgical techniques. AB - In recent years, the use of surgical staples has become popular in all subspecialties of surgery. The advantages proposed have been a decrease in operative time and morbidity. This paper reviews the University of Miami/Jackson Memorial Medical Center, Division of Gynecologic Oncology experience with the use of surgical staples in gastrointestinal surgery on patients with a diagnosis of a gynecologic malignancy. Between January 1, 1979 and July 1, 1985, a total of 152 procedures were done, 81 by stapler and 71 by suture anastomosis. Ninety-one patients had received previous radiation or chemotherapy. The average age of the patients was 52 years. The results show a decrease in operating time, blood loss, and postoperative hospital stay in those patients where the stapler anastomosis was used. The postoperative morbidity and mortality were not increased. Twenty seven total pelvic exenterations were performed during the period of study and they were evaluated separately. The hospital stay and blood loss as well as the operative time were significantly less using staplers. This report includes a detailed evaluation of the results. From this study, we concluded that surgical staples are a safe alternative in gastrointestinal surgery in patients with a gynecologic malignancy. PMID- 3308655 TI - [Sonographic diagnosis of extrauterine pregnancy]. PMID- 3308656 TI - [Acyclovir in pregnancy]. PMID- 3308657 TI - Ultrasonographic assessment of fetal adrenal gland and placenta: correlation with estrogen in maternal urine. AB - Forty-eight ultrasonographic examinations done to assess growth of the fetal adrenal gland and placental aging were performed on 17 normal fetuses and 7 fetuses with intrauterine growth retardation (IUGR). Gestational age ranged from 30 to 40 weeks. High correlations of the area of fetal adrenal gland (FAGA) with gestational age were noted in the normal fetuses (r = 0.96, p less than 0.001) and IUGR (r = 0.93, p less than 0.001), respectively. FAGA correlated well with the level of estrogens in the maternal urine (r = 0.65, p less than 0.001). When the value of FAGA was 300 mm2 and over, the level of estrogens in the maternal urine was 20 mg/day and over, and all were normal fetuses. In cases of grade I and II placentas, the mean values of FAGA in normal fetuses were larger than those in IUGR, respectively (p less than 0.001). In the case of IUGR with placental infarction and hematoma associated with severe toxemia of pregnancy, the FAGA was significantly small. PMID- 3308658 TI - Platelet reactions in acute Plasmodium berghei infection in Swiss albino mice. AB - Swiss albino mice were infected by the intraperitoneal route with P. berghei berghei malaria parasite, and platelets, white cell counts and some coagulation parameters were monitored in order to find out whether changes reported in man also occurred in the mice. Parasitaemia developed form the 2nd post-infection day and reached significant levels by the 4th-6th day. Reduced circulating platelets which reached severe thrombocytopenic levels were observed. parallel with the increasing degree of parasitaemia. Anaemia which progressed to severe degree was also observed as was a slight leucocytosis attributed to the presence of normal mouse erythrocytes in the peritoneal space. All untreated animals died by the 6th day of infection. Intramuscular chloroquine sulphate (20 micrograms/g body wt.) given for 7 days completely cured the malaria, and white cell and platelet counts were restored to preinfection levels in each animal about 2 weeks after treatment had ceased. Platelet hypersensitivity to exogenous ADP was observed within 48 hours of infection and persisted with the parasitaemia. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged while clottable fibrinogen concentration was reduced. PMID- 3308659 TI - [Immunopharmacological approach to the modulation of IgE antibody formation]. AB - Soluble factors released by both T and B cells are involved in the class-specific regulation of IgE antibody formation; some factors have affinity for IgE, whereas others do not. The induction phase of the primary and secondary IgE antibody response is highly sensitive to treatment with such factors or some drugs. In contrast, persistent IgE antibody formation is mostly insensitive to the same treatments, indicating that this phase differs apparently from the induction phase. Thus, it is very important to note the marked differences between the regulatory mechanisms of these two phases when drugs responsible for the suppression of IgE antibody response are developed. In the present review, the recent advances pertaining to the regulation of IgE antibody formation in animals and humans are described in view of immunopharmacology. PMID- 3308660 TI - Synthesis, structure-activity relationships and a reaction mechanism for mutagenic N-nitroso derivatives of glycosylamines and Amadori compounds--model substances for N-nitrosated early Maillard reaction products. AB - A series of nine glycosylamines and an Amadori compound were synthesized, together with their N-nitroso derivatives. Their structures were established by physico-chemical and spectroscopic data and elemental analyses. The N-nitroso compounds were further characterized by denitrosation with hydrogen bromide acetic acid, followed by detection of the liberated NO by a chemiluminescence detector. N-Nitroso derivatives of N-p-nitrophenyl/p-methylphenyl/p-carboxyphenyl pentopyranosylamines, N-p-methylphenyl-1-deoxy-D-fructosylamine (the Amadori compound) and N-3-ethylindole-D-xylopyranosylamine were shown to be direct-acting mutagens in Salmonella typhimurium TA100. The activity of some of the compounds was similar to that of N-ethyl-N-nitrosourea. Their mutagenic activity was shown to depend on the structure of the amine and the sugar moieties and to require the presence of free hydroxyl groups in the sugar. The mutagenicity of N nitrosoglycosylamines was attributed to their hydrolysis to arenediazonium cations. The formation of these compounds was detected by azo-coupling with N ethyl-1-naphthylamine, using spectrophotometric and mass spectrometric analyses. These data implicate arene(alkyl)diazonium cations as the ultimate mutagens of N nitrosoglycosylamines (and possibly of N-nitroso Amadori compounds), a little explored class of N-nitroso compounds that may be formed in vivo. PMID- 3308661 TI - [Sonographic emergency diagnosis. 1: Ileus, perforation, pancreatitis, cholecystitis]. PMID- 3308662 TI - [Significance of hormonal contraceptives for coronary heart disease]. AB - Oral contraceptives represent the most commonly employed means of contraception in the Federal Republic; they are used in 25% of all women in child-bearing age. The risk of myocardial infarction or cardiovascular death while taking oral contraceptives is determined primarily by three factors: the age of the user, the type and concentrations of estrogen and gestagen administered as well as the concomitant risk factors for coronary artery disease. With currently-used low dose hormonal contraceptives, in young women (less than 30 years of age) who do not smoke and do not have other risk factors for coronary artery disease, there is no clear increase in the normally low risk of developing coronary artery disease or myocardial infarction. With increasing age and concomitant risk factors, users of hormonal contraceptives have an increased risk of myocardial infarction and cardiovascular death, where smoking has assumed a particularly important role. In general, the risk of cardiovascular death in users of oral contraceptives is approximately four-fold higher than in women who have never used oral contraception. A statistically-significant higher mortality has been documented in oral contraceptive users older than 35 years who smoke. In nonsmoking oral contraceptive users, the relative risk of myocardial infarction is 4.5. This increases to 23-fold for women who smoke more than 24 cigarettes daily. 75% of young women with myocardial infarction (under the age of 50 years) who use oral contraceptives, are smokers. Overall, the manifestation age of myocardial infarction is advanced four years through smoking alone, ten years through oral contraception alone and 13 years through the combination of smoking and oral contraception. The relevance of the duration of oral contraceptive use on the risk of infarction remains controversial. The number of young women with myocardial infarction and no or single-vessel coronary artery disease is significantly higher at 60% in women who have used oral contraceptives than in women of comparable age without oral contraceptive use (30%). The pathophysiological mechanism primarily responsible for myocardial infarction in oral contraceptive users and smokers appears to be thrombosis. PMID- 3308663 TI - Mary Reynolds: a post-traumatic reinterpretation of a classic case of multiple personality disorder. AB - In 1811 Mary Reynolds, a somber Pennsylvania spinster, awoke from a prolonged sleep as a new personality. Family memoirs describing her 18 years of shifts between two personalities shaped nineteenth century thinking about multiple personality disorder. As in other early case histories, no mention was made of childhood trauma, a factor found in 97% of contemporary cases. This discussion reviews genealogical and historical documents which suggest that Mary Reynolds did experience early trauma as a victim of religious persecution, which finally forced her family to leave Birmingham, England, when Mary was eight. Review of her illness indicates it may have functioned to eradicate memories of traumatic early experiences. PMID- 3308664 TI - The association of hepatic glycogen depletion with hyperammonemia in cirrhosis. AB - Hyperammonemia is a well-recognized metabolic abnormality which occurs in cirrhotic patients with advanced liver dysfunction. We recently documented that hyperglucagonemia that occurs as a result of hepatic glycogen depletion may be responsible for this hyperammonemia by promoting gluconeogenesis to provide glucose as a fuel for functioning of several organ systems. Thus, hepatic glycogen depletion may be the initial process responsible for hyperammonemia. Since the glucose rise following intravenous glucagon administration is a reflection of hepatic glycogen breakdown, we studied the effect of glucagon (1 mg) injection on plasma glucose, insulin and ammonia levels after an overnight fast in cirrhotic patients and normal subjects. Glucose rise was significantly stunted, and ammonia rise was significantly greater in patients with advanced liver dysfunction as compared to normal subjects. Furthermore, the smaller the glucose increment, the earlier the ammonia rise. The smallest glucose responses were seen in the patients with the highest basal plasma ammonia levels. Finally, significant negative relationships were noted between the glucose response to glucagon administration (delta glucose) and the degree of liver dysfunction as reflected by Composite Clinical Laboratory Index, as well as basal ammonia and ammonia responses (delta ammonia) on the other. Therefore, this study suggests that hepatic glycogen depletion may be the initial event leading to elevated plasma ammonia concentrations in hepatic cirrhosis. PMID- 3308665 TI - Lack of hepatic transferrin receptor expression in hemochromatosis. AB - The major part of hepatocellular iron is derived from uptake of transferrin-bound iron by means of nonspecific fluid-phase endocytosis and specific, saturable binding on high-affinity transferrin receptors. We investigated the expression of transferrin receptors on hepatocytes in liver biopsies of 22 cases of hemochromatosis (21 primary hemochromatosis and 1 secondary hemochromatosis), using immunohistochemical demonstration of the human transferrin receptor with the specific monoclonal antibody OKT9. Fifty liver biopsies (normal and pathological) without demonstrable iron storage (Perls' stain negative) served as controls. In the controls, membranous and/or cytoplasmic transferrin receptor expression was always present on hepatocytes, albeit in variable numbers and patterns without obvious relation to the underlying liver disease. In 19 of 22 hemochromatosis cases with severe iron overload, OKT9 immunoreactivity on hepatocytes was completely absent. Three hemochromatosis cases showed few hepatocytes positive for OKT9. One showed mild iron overload, while the second, a successfully treated case, was free of iron. The remaining hemochromatosis case was a known alcoholic with severe iron overload. Since OKT9 binding to the transferrin receptor is not blocked by previous binding of transferrin, the findings show that in advanced hemochromatosis hepatocytes do not express transferrin receptors. This finding is in keeping with the inverse relation between transferrin receptor expression and exogenous iron supply in various cell cultures. These results indicate that in hemochromatosis,apparently as a result of progressive iron overload,transferrin receptor expression on hepatocytes disappears.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308666 TI - Sinusoidal endothelial cells from guinea pig liver synthesize and secrete cellular fibronectin in vitro. AB - Endothelial liver cells were obtained from guinea pig by enzymatic digestion and centrifugal elutriation. Cells were cultured on gelatin and fibronectin pretreated culture vessels. Endothelial cells were characterized by phase contrast microscopy, electron microscopy and the presence of Factor VIII-related antigen. Fibronectin secretion was determined in cell-free supernatants by a sensitive and specific ELISA and localized on fixed cultured cells by immunofluorescence. [35S]Methionine endogeneously labeled fibronectin was immunoprecipitated from supernatants and cellular lysates and displayed on sodium dodecyl sulfate polyacrylamide slab gel electrophoresis. After attachment to the culture vessel, one day after plating, endothelial cells start to produce fibronectin as measured by ELISA and demonstrated by immunoprecipitation and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Secretion of fibronectin increases as cells proliferate to form a confluent monolayer. By immunofluorescence, fibronectin is visualized inside permeabilized cells and as a fibrillar network on the cell surface. Underneath the cell bodies, fibronectin positive material is present as short strands. From supernatants and cellular lysates, fibronectin is immunoprecipitated with an apparent Mr of about 235,000 obviously larger than plasma fibronectin with an Mr of 220,000, which behaves electrophoretically like fibronectin isolated from early hepatocyte cultures. As endothelial cells incorporate [3H]fucose in fibronectin, whereas hepatocytes do not, we conclude that endothelial cells in contrast to hepatocytes produce cellular fibronectin. Endothelial cells, therefore, are probably the cellular source of the fibronectin present in the space of Disse. The significance of this finding with respect to fibrotic liver disease is discussed. PMID- 3308667 TI - Pancreatic hormones and amino acid levels following liver transplantation. AB - Glucose intolerance, hyperinsulinemia, peripheral insulin resistance and hyperglucagonemia are common in patients with advanced liver disease. These abnormalities in the plasma levels of the pancreatic hormones, insulin and glucagon have been thought to be responsible, at least in part, for the abnormal plasma ratio of branched-chain amino acids to aromatic amino acids. To evaluate this issue, plasma levels of glucose, insulin, glucagon, C-peptide and the branched-chain and aromatic amino acids were measured before and serially after orthotopic liver transplantation in 9 humans and 5 dogs. The abnormal plasma amino acid levels rapidly improved and achieved normal levels following orthotopic liver transplantation. Insulin levels also became normal following orthotopic liver transplantation, despite enhanced insulin secretion documented by an even further increased level of C-peptide. In contrast, the baseline abnormal plasma glucagon levels which are commonly seen in cirrhotics became even more abnormal following orthotopic liver transplantation. Despite this progressive increase in the abnormally elevated plasma glucagon levels, plasma amino acid levels, both branched-chain and aromatic, became normal. These data demonstrate that before and after orthotopic liver transplantation, there is: (i) no relationship between the changes in the plasma levels of glucagon and changes observed in the plasma level of amino acids; and (ii) plasma insulin and amino acid levels change in the same direction. In addition, these changes in plasma insulin and amino acid levels following orthotopic liver transplantation occur despite enhanced secretion of insulin evidenced by the progressive increase in plasma levels of C-peptide. PMID- 3308668 TI - Highlights of the meeting on prevention of gallstones. PMID- 3308669 TI - Conceptual review of the hepatic vascular bed. PMID- 3308670 TI - Variceal sclerotherapy: the combination of thrombosclerosis and the intentional removal of the distal esophageal mucosa to treat variceal bleeding and prevent variceal recurrence. PMID- 3308672 TI - Congress freezes PPS prices in budget battle. PMID- 3308671 TI - Acute leukemia with coexpression of lymphoid and myeloid phenotypes. AB - A multiparameter analysis of 706 cases of acute leukemia (AL) over a two-year period revealed only six cases (0.86 per cent) with coexpression of lymphoid and myeloid phenotypes. In three cases, expression of both lymphoid and myeloid markers by the majority of the blast cells suggested a 'biphenotypic' pattern while in the remaining three cases, the lymphoid and myeloid phenotypes were segregated into two morphologically distinct populations of blast cells indicating a 'biclonal' distribution. The poor response to anti-acute lymphoblastic leukemia therapy in five of these six cases underlines the bad prognostic significance of coexpression of lymphoid and myeloid phenotypes in AL. The incidence of 'mixed lineage' phenotype in the present series appears very low. PMID- 3308673 TI - Substance-abuse treatment facilities brace for PPS change. PMID- 3308674 TI - ProPAC analysis: 10% revenue per case under PPS. PMID- 3308675 TI - AZ Medicaid HMO quits the business. PMID- 3308676 TI - Physician payment reform: HCFA's next surgery. PMID- 3308677 TI - PRRB caseload down in FY 1987. PMID- 3308678 TI - More physicians are assigning Medicare claims. PMID- 3308679 TI - Invasive aspergillosis diagnosed by immunohistochemistry with monoclonal and polyclonal reagents. AB - Therapies differ for invasive infection due to the various filamentous fungi. However, histopathologic identification of Aspergillus, Pseudallescheria, Fusarium, Trichosporon, dematiacious Hyphomycetes, Candida, and Zygomycetes may be confused, and microbiologic isolation is often delayed. To improve diagnosis, we examined the utility of polyclonal and monoclonal antibodies to identify Aspergillus organisms by peroxidase immunohistochemical techniques. Tissues obtained from 68 infected patients were examined. Fungal antigen was detected in all 26 cases of aspergillosis by the monoclonal immunohistochemical test. Hyphae of Aspergillus organisms exhibited strong intracellular and cell wall staining, and extracellular localization was also observed. In contrast, negative tests were observed in tissues from five cases of infection with Pseudallescheria boydii, three with Trichosporon, three with Zygomycetes, six with Candida species, and one with Curvularia, from as well as 20 cases of nonfungal pneumonia. However, cross-reactivity to Coccidioides immitis spherules was noted in three cases. Staining of Candida was observed with the polyclonal antibody but not the monoclonal reagent. This is the first immunohistochemical demonstration of aspergillus antigen with a monoclonal reagent. The study indicates that the monoclonal immunohistochemical technique can distinguish Aspergillus species from other filamentous fungi and may facilitate the clinical diagnosis of invasive aspergillosis. PMID- 3308680 TI - Distribution of basement membrane in squamous cell carcinoma of the head and neck. AB - The immunohistologic distribution of the basement membrane components, type IV collagen and laminin, was evaluated in 57 alcohol-fixed, paraffin-embedded tissue sections which demonstrated immunostaining patterns with antigen preservation similar to that of frozen tissue sections. Normal and hyperplastic squamous mucosa, a spectrum of intraepithelial neoplasia, and invasive squamous cell carcinomas of the upper aerodigestive tract were evaluated by this technique. Prominent and continuous basement membrane staining characterized normal and reactive hyperplastic squamous mucosa. The basement membrane varied greatly with epithelial dysplasia and was usually prominent and continuous in mild to moderate dysplasias. In severe dysplasia/carcinoma in situ, the basement membrane was often thinned and occasionally discontinuous. The distribution of basement membrane in invasive carcinomas was also varied. Basement membrane was usually present in invasive tumors with well-defined tumor host borders and cohesive patterns of stromal invasion which were interpreted as foci of histologic differentiation. In contrast, invasive carcinomas with irregular cords or single tumor cells distributed through the host stroma invariably lacked basement membrane at the tumor-stromal interface; this was interpreted as a decreased expression of histologic differentiation. We conclude that 1) severe intraepithelial neoplasia is often associated with irregularities of basement membrane and that the absence of basement membrane does not necessarily define invasive cancer; 2) immunolocalization of basement membrane in invasive carcinomas is common in areas displaying histologic differentiation; and 3) the association of basement membrane distribution and histologic pattern of tumor invasion suggests that squamous cell carcinomas are capable of undergoing focal histologic differentiation after invasion has occurred. PMID- 3308681 TI - A systematic approach to the immunohistologic classification of lymphoproliferative disorders. AB - From the study of over 3,000 immunologically well characterized cases, we have developed a systematic approach for the immunohistologic evaluation of lymphoproliferative disorders (LPD). By using a basic screening panel of antibodies on fresh-frozen sections, LPD can be reliably immunophenotyped. Fourteen patterns of immunoreactivity have been identified that can be used in differential diagnosis and the establishment of the correct diagnosis. A comprehensive table has been developed for systematically recording for each case the results of immunohistologic evaluation of fresh-frozen sections. The information recorded is easily computerized for later studies of large numbers of cases. We also propose a strategy for the further characterization of rare cases that are not easily defined with the basic screening panel of immunologic reagents. The proposed systematic approach allows the rapid recognition of the predominant immunologic pattern, the determination of the differential diagnoses, and the establishment of the correct diagnosis. In many cases, the final diagnosis can be predicted on the basis of patterns of immunoreactivity in the fresh-frozen section prior to the evaluation of the paraffin-embedded histologic material. Moreover, this systematic approach may provide an additional method to classify LPD more precisely and reproducibly. PMID- 3308683 TI - Split hand, obstructive urinary anomalies and spina bifida or diaphragmatic defect syndrome with autosomal dominant inheritance. AB - Three members of a nuclear family were affected by split hands and feet or syndactyly, obstructive urinary anomalies and spina bifida or diaphragmatic defect. PMID- 3308682 TI - Hyperphenylalaninemia due to deficiency of 6-pyruvoyl tetrahydropterin synthase. Unusual gene dosage effect in heterozygotes. AB - We have identified deficient biopterin synthesis in four probands and one sib with persistent postnatal hyperphenylalaninemia. The metabolic findings were associated with a benign clinical presentation and normal biopterin level in cerebrospinal fluid in the newborn period, indicating the peripheral (hepatic) form of this autosomal recessive phenotype. Impaired development was apparent at 3 months in one proband not treated early. Treatment with oral tetrahydropterin restored adequate phenylalanine hydroxylase activity; it also maintained or improved CNS function. The deficient enzyme in these subjects is 6-pyruvoyl tetrahydropterin synthase (PTS). Erythrocyte activity of PTS in homozygotes (or compound heterozygotes) is less than 10% of normal. Heterozygotes have 20%-50% of normal PTS activity (enzyme phenotype), a finding compatible with a range of gene dosage effects, some abnormal. The metabolic phenotype in heterozygotes (urine biopterin excretion) did not correlate with erythrocyte PTS activity. The complex relationship between erythrocyte PTS activity, and biopterin synthesis in these families indicates genetic heterogeneity at the PTS locus. PMID- 3308685 TI - A computerized system for measuring cerebral metabolism. PMID- 3308684 TI - Alveolar permeability in HIV antibody positive patients with Pneumocystis carinii pneumonia. AB - Pulmonary permeability was assessed using the technique of 99mTc (technetium-99m) diethylene triamene pentacetic acid (DTPA) aerosol transfer in 10 patients who had antibodies to human immunodeficiency virus (HIV) and were non-smokers and in 20 HIV antibody positive smokers. Five patients had Pneumocystis carinii pneumonia (PCP) proved by transbronchial lung biopsy; four were non-smokers and one a smoker. Two findings emerged: patients with PCP had greater epithelial permeability than non-smokers and smokers; and the permeability curves were monophasic in smokers and non-smokers, but biphasic in patients with PCP. The biphasic curve observed is indicative of diffuse alveolar damage and might be useful to predict PCP in patients with antibodies to HIV who have normal chest radiographs. As the study was of only five patients with PCP, however, further studies are necessary to confirm this observation. PMID- 3308687 TI - Quantitative considerations of T-cell activation and self tolerance. AB - We have reviewed evidence for the hypothesis that T-cell activation by antigen is an all or none process which is triggered when signal strength exceeds a certain threshold. Signal is generated by multivalent interaction between T-cell antigen receptors (TCR) and antigenic epitopes on the surface of antigen-presenting cells (APC) or target cells. Therefore total signal strength (Stot) will depend upon the concentration of TCR (and other accessory molecules that bind to cell surface ligands, e.g. CD4 and CD8) on T cells, the concentration of antigen on APC or targets and the affinity of interaction between receptors (a broad term incorporating TCR plus CD4 and CD8) and antigen. This hypothesis means that T cell self tolerance is quantitatively determined by self-antigen concentrations on cell surfaces. Implications for a variety of immunological phenomenona are reviewed. PMID- 3308686 TI - The interaction between protein-derived immunogenic peptides and Ia. PMID- 3308688 TI - Metastatic melanoma of bladder with occult primary presenting as haematuria--a case report and review of literature. PMID- 3308691 TI - A reason for the cytolytic inefficiency of murine serum. AB - Murine serum exhibits very poor haemolytic and bactericidal activity. We report that this is due, at least in part, to the presence of a potent, naturally occurring plasma inhibitor of the terminal complement sequence. The inhibitor is a heat-stable euglobulin. It is highly effective in suppressing haemolysis following complement activation on target erythrocytes with heterologous serum. It also inhibits C3-independent reactive haemolysis of guinea-pig erythrocytes with human C5b-9. Current evidence indicates that the inhibitory factor acts at the C5b-7 stage by preventing binding of the terminal complement complex to cells undergoing complement attack. In this respect, the inhibitor differs from the previously recognized regulators of the terminal complement sequence including plasma S-protein. The inhibitor does not protect C5b-7-laden cells from the action of C8 and C9, and also does not suppress formation of haemolytically inactive SC5b-9 in the fluid phase. The action of murine inhibitory factor is not confined to the red cell, and its presence can totally abolish the bactericidal activity of human serum on a sensitive, rough E. coli K12 strain. PMID- 3308690 TI - Ontogeny of ovine lymphocytes. III. An immunohistological study on the development of T lymphocytes in sheep fetal lymph nodes. AB - The development of T lymphocytes in ovine fetal lymph nodes was studied immunohistologically using a panel of monoclonal antibodies. T lymphocyte subsets appeared within the ovine fetal lymph node in a specific sequence. SBU-T1- and SBU-T8-positive lymphocytes were seen at Day 47 of gestation. LCA, sIg, MHC I, MHC II, SBU-T6 and 46.66 antigens were also seen within the lymph node at this time. The first SBU-T4-positive cells were seen within the fetal lymph node at Day 50 of gestation, along with the first 20.96-, 25.69- and 38.38-positive cells. SBU-T19 lymphocytes appeared later in gestation, being present in fetal lymph nodes from Day 69 of gestation. The appearance and distribution of T and B cells in the developing lymph nodes of the ovine fetus is described and compared with the ontogeny of lymphocytes in the fetal thymus and spleen. PMID- 3308689 TI - Ontogeny of ovine lymphocytes. II. An immunohistological study on the development of T lymphocytes in the sheep fetal spleen. AB - The development of T and B lymphocytes in the ovine fetal spleen was studied immunohistologically using a panel of monoclonal antibodies. A specific sequence of appearance of lymphocyte markers on cells was observed. At 43-44 days of gestation, SBU-T1- and SBU-T8-positive lymphocytes were present in low numbers. However, no SBU-T4, 20.96-, 25.69-, 38.38-, or 46.66-positive lymphocytes were seen until 50-55 days of gestation. Surface immunoglobulin (sIg) was first detected on fetal spleen cells at 45-50 days of gestation. SBU-T19 lymphocytes appeared later in gestation, being observed in fetal spleens at 57 days gestational age (g.a.). The distribution of T cells, B cells and MHC antigens in the developing spleen of the ovine fetus is described. PMID- 3308692 TI - Ontogeny of ovine lymphocytes. I. An immunohistological study on the development of T lymphocytes in the sheep embryo and fetal thymus. AB - The time of appearance of lymphocytes expressing T-cell markers and the subsequent development of the fetal thymus were studied in ovine embryos using a panel of monoclonal antibodies. Leucocyte common antigen (LCA) and major histocompatibility complex class I (MHCI) antigens were seen on a small number of cells within the ovine embryo at Day 19 of gestation. SBU-T6 (CD1)-positive cells were found at Day 22 of gestation, while major histocompatibility complex class II (MHC II) antigens were first observed at Day 25 of gestation. Large basophilic cells, weakly staining for SBU-T1 (CD5), were present in the mesenchyme of the neck and in the dorsal mediastinum and mesentery of embryonic sheep of 33 days gestational age (g.a.); however, no SBU-T1-positive cells were detected in the thymus at this time. No SBU-T4 (CD4)- or SBU-T8 (CD8)-positive cells were detected in any organs of embryos of this age. SBU-T4- and SBU-T8-positive cells were first seen in fetal thymi, and elsewhere within the fetus, at 35-38 days g.a. SBU-T19-positive cells were first seen within the fetal thymus at 50-58 days g.a. PMID- 3308693 TI - Studies on the possible mutagenic action of metronidazole. PMID- 3308694 TI - Monoclonal antibodies for the diagnosis of infectious diseases. PMID- 3308697 TI - D-penicillamine in the therapy of Indian childhood cirrhosis. PMID- 3308696 TI - Foodborne diseases in India. PMID- 3308699 TI - Directory of on-going research in cancer epidemiology. 1987. PMID- 3308695 TI - Infections and malnutrition among poor children. PMID- 3308698 TI - Proteus mirabilis pneumonia with giant pneumatocele. PMID- 3308700 TI - Inhibition of hypertension and salt intake by oral taurine treatment in hypertensive rats. AB - Effects of oral treatment with taurine on fluid intakes produced by renin were assessed in spontaneously hypertensive rats of the Okamoto strain (SHR). Renin injected into the preoptic area increased water intake and evoked salt (2.7% NaCl solution) intake, and angiotensin II injected into this area increased water intake, but not salt intake, in both SHR and control normotensive Wistar-Kyoto rats (WKY). The salt intake elicited by renin, but not water intake produced by renin or angiotensin II, was potentiated in SHR. These effects of renin and angiotensin II on fluid intakes were antagonized by previous administration of taurine or gamma-aminobutyric acid into the cerebral ventricles in both strains. When SHR received water containing 3% taurine from 32 to 105 days of age, development of hypertension was inhibited. Renin administered into the preoptic area at 105 days of age caused an increase in salt intake, but the increase was markedly inhibited by the oral administration of taurine as well. These results show that salt appetite produced by centrally administered renin is exaggerated in SHR and that development of hypertension as well as renin-induced salt appetite in SHR is inhibited by dietary taurine. PMID- 3308701 TI - Renin suppression by saline is blunted in nonmodulating essential hypertension. AB - We have reported that 50% of subjects with normal renin essential hypertension have both delayed suppression of the renin-angiotensin-aldosterone axis following sodium infusion and a delayed rate of excretion of an acute salt load. In another study we have also described a subset of patients with essential hypertension (called nonmodulators) who have several abnormalities, including a pressor response to salt loading. To evaluate whether the abnormalities described in these different groups of patients actually occur in the same patient, we assessed the renin-angiotensin-aldosterone axis response to short-term saline loading in 38 hypertensive patients. Their ability to modulate was determined by their renal vascular response to infused angiotensin II on a high salt diet (200 mEq Na). In response to a 3-hour infusion of saline, 75 mEq/hr, the reduction in plasma renin activity at both 60 and 120 minutes was significantly greater (p less than 0.008) in patients with normal modulation than in the nonmodulators. Plasma aldosterone levels were also significantly lower (p less than 0.001) in those with intact modulation. Thus, nonmodulating essential hypertensive patients have abnormalities in several systems that influence sodium homeostasis, including altered adrenal and renal vascular response to angiotensin II, altered renal blood flow response to salt loading, and a delayed suppression of the renin angiotensin-aldosterone system with short-term saline infusion. PMID- 3308702 TI - Effect of dietary fats and carbohydrate on blood pressure of mildly hypertensive patients. AB - The effect on blood pressure (BP) of replacing dietary saturated fat with either polyunsaturated fat (linoleic acid) or carbohydrate was studied in 21 untreated mildly hypertensive patients. In a randomized, double-blind, crossover protocol, all subjects received dietary supplements of cream, safflower oil, and carbohydrate in random sequence, each prepared in flavored yogurt or milk. Each supplement was administered for 6 weeks and followed by a 4-week washout period of no supplementation. Dietary linoleic acid increased from 4.6 to 13% of energy intake when the safflower oil replaced cream, while saturated fat decreased from 16 to 10%. Total fat intake was 37 to 38% during the cream and safflower oil periods but was 28% during the carbohydrate period. Compliance with the diets was demonstrated by significant changes in fasting plasma fatty acid measurements. Mean clinic BP was 135 +/- 9/93 +/- 6 mm Hg at baseline. There were no significant differences in BP measured in the clinic or at home among the three dietary periods. The protocol had more than 80% power to detect a mean effect of diet of 3 mm Hg systolic or 2 mm Hg diastolic BP. Therefore, replacing dietary saturated fat with carbohydrate or with linoleic acid does not affect BP in subjects with mild hypertension. PMID- 3308704 TI - Comparative analysis of the localization of lipoteichoic acid in Streptococcus agalactiae and Streptococcus pyogenes. AB - The cellular locations of deacylated lipoteichoic acid (dLTA) and lipoteichoic acid (LTA) were examined in late-exponential-phase cells of a serotype III strain of Streptococcus agalactiae (group B streptococci [GBS]) isolated from an infant with late-onset meningitis and compared with a fresh clinical isolate of Streptococcus pyogenes (group A streptococci [GAS]). LTA and dLTA were found to be associated with the protoplast membranes of both organisms, with only dLTA found in mutanolysin cell wall digests. Both organisms released dLTA during growth, but only the GAS released substantial levels of LTA into the culture medium. However, penicillin treatment (5 micrograms/ml for 60 min) of GBS resulted in the recovery of LTA in cell wall digests as well as in the culture medium. These results suggest that under normal growth conditions, the hydrophobic region (glycolipid) of LTA remains associated with the cytoplasmic membrane of GBS and unavailable for hydrophobic interactions at the cell surface with epithelial cells. In contrast, release of LTA into the environment by the GAS allows the fatty acid moieties to interact with hydrophobic domains on the surface of epithelial cells. These results may help explain the marked differences in the specificity of binding between these two major streptococcal pathogens for human fetal and adult epithelial cells. PMID- 3308703 TI - Identification and characterization of the Pasteurella haemolytica leukotoxin. AB - The identification and chromatographic characterization of the leukotoxin of Pasteurella haemolytica is described. The toxin, which has an apparent native molecular weight of greater than 400,000 as judged by gel exclusion chromatography, has a 105-kilodalton (105K) polypeptide as its major protein component. The proteolytic degradation of the 105K polypeptide could be correlated with the loss of toxin activity in aging cultures of P. haemolytica. Antisera raised against purified 105K polypeptide neutralized toxin activity. A 3.9-kilobase-pair fragment of the P. haemolytica genome cloned into a plasmid vector resulted in the production of intracellular toxin in Escherichia coli host cells. The restriction map of this clone shows significant overlap with the map of a previously reported leukotoxin clone (R. Y. C. Lo, P. E. Shewen, C. A. Strathdee, and C. N. Greer, Infect. Immun. 50:667-671, 1985). Finally, antisera raised against the 105K species labeled the P. haemolytica cell surface in a nonuniform, punctate manner. PMID- 3308705 TI - Characterization of the Cryptosporidium antigens from sporulated oocysts of Cryptosporidium parvum. AB - The antigenic constituents of sporulated Cryptosporidium parvum oocyst antigens were characterized with antisera from mice immunized against C. parvum. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by silver staining defined the major proteins. Six of seven lectins used recognized as many as 15 bands. The lectins concanavalin A, Dolichos biflorus, and wheat germ agglutinin showed strong activity against the same eight bands with molecular weights ranging from 72,000 to greater than 100,000. An enzyme-linked immunosorbent assay was used to detect antibody to C. parvum. Antibody binding was significantly decreased by heat and enzymatic treatment with trypsin, protease, and mixed glycosidases. C. parvum antigens were further defined by the reactivity of immune sera with a C. parvum sonicate preparation separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis and electrophoretically transferred to nitrocellulose paper. Antisera from orally infected mice consistently recognized four antigens with molecular weights ranging from 72,000 to greater than 100,000. These antigens also bound concanavalin A. Treatment of the antigen preparation with mixed glycosidases reduced the reactivity of antisera with most antigens with molecular weights greater than 60,000. The data suggest that the antigenic composition of C. parvum is complex and that carbohydrates alone or in association with lipids or proteins may be important in the immune response to C. parvum. PMID- 3308706 TI - Physiology of the potentiation of lethal endotoxin shock by streptococcal pyrogenic exotoxin in rabbits. AB - Streptococcal pyrogenic exotoxin (SPE) dramatically potentiates the lethal shock induced by gram-negative bacterial endotoxin. To provide further understanding of the mechanism underlying the potentiating effect, the physiological basis for the toxic synergism of the two toxins was investigated. Pretreatment of rabbits with an intravenous (i.v.) dose (10 micrograms/kg of body weight) of SPE greatly enhanced the endotoxin lethality and reduced the 50% lethal dose to less than 5 micrograms of endotoxin per kg. The SPE pretreatment dose caused severe pathophysiological changes in combination with a small i.v. dose of endotoxin (1 microgram/kg). These changes included transient hyperglycemia followed by profound hypoglycemia, elevation of the blood lipoperoxide level, and an acute increase in plasma beta-glucuronidase activity. These changes were comparable with those in animals given a large i.v. dose of endotoxin (100 micrograms/kg) alone. An injection of SPE alone did not alter any of the parameters described above. These results suggest that SPE renders rabbits more sensitive to extensive pathophysiologic effects of endotoxin, and the potentiating effect on endotoxin lethality may thus involve a general potentiation of physiologic failures. The SPE pretreatment depressed the vascular clearance of a large dose of endotoxin (100 micrograms/kg) but failed to affect that of a small dose of endotoxin (1 microgram/kg). The data suggest that the potentiating effect is not readily explained solely on the basis of the decreased clearance of endotoxin. PMID- 3308707 TI - Lipid X ameliorates pulmonary hypertension and protects sheep from death due to endotoxin. AB - Lipid X (2,3-diacylglucosamine-1-phosphate) is a novel monosaccharide precursor of lipid A that has some of the physiologic activities of endotoxin but little toxicity. To determine whether lipid X would interfere with the toxic effects of endotoxin, we pretreated sheep with either 100 or 200 micrograms of lipid X per kg of body weight and then challenged them with a potentially fatal dose of Escherichia coli endotoxin (20 micrograms/kg). Twenty-one sheep underwent pulmonary artery catheterization and were monitored for changes in pulmonary artery pressure, temperature, pH, partial O2 pressure, partial CO2 pressure, blood pressure, and cell counts over 7 h. Overall mortality for control animals was 37% versus 5.3% for pretreated animals. None of the 13 animals pretreated with 100 micrograms of lipid X per kg died. These differences in survival were significant (P less than 0.05). Animals pretreated with 100 micrograms of lipid X per kg had significantly lower pulmonary artery pressure during both phases 1 and 2 of endotoxin-induced pulmonary artery hypertension. A higher dose of lipid X, 200 micrograms/kg, produced pulmonary hypertension. Perhaps because lipid X is a subunit of lipid A, lipid X shows a partial pyrogenic effect while also decreasing the pyrogenic activity of complete lipopolysaccharide (LPS). Lipid X did not prevent endotoxin-induced neutropenia or moderate hypotension in response to LPS. Lipid X is a potential prototype compound for a new type of chemotherapy directed at blocking the harmful effects of LPS during bacterial septicemia. PMID- 3308708 TI - Fate of Legionella pneumophila Philadelphia-1 strain in resident, elicited, activated, and immune peritoneal macrophages of guinea pigs. AB - Legionella pneumophila is known to grow intracellularly in resident peritoneal macrophages of guinea pigs. The present study was done to determine what kinds of macrophage stimulants are able to activate guinea pig macrophages to inhibit intracellular growth of the organism. Peritoneal macrophages were harvested from healthy guinea pigs, from guinea pigs injected intraperitoneally with proteose peptone (PP) or thioglycolate medium, from guinea pigs injected intraperitoneally with live Mycobacterium bovis BCG or killed Propionibacterium acnes (Corynebacterium parvum), and from guinea pigs surviving infection with live L. pneumophila. After in vitro phagocytosis, the L. pneumophila CFU in each well were counted on charcoal-yeast extract agar plates. In the macrophages elicited by PP or thioglycolate medium, the organism grew as well as it did in resident macrophages. In BCG-activated and immune macrophages, growth was inhibited almost completely. In P. acnes-activated macrophages, the initial growth of L. pneumophila was inhibited to some extent, but its growth reached the same level as in the resident and PP-induced macrophages after 3 or 4 days of culture. In the lethal challenge experiments in vivo, the superior protection provided by BCG over P. acnes was ascertained and the importance of macrophages in resistance to L. pneumophila was confirmed. Difference of activation by BCG and P. acnes in relation to the inhibition of intracellular growth of L. pneumophila in guinea pig macrophages is discussed. PMID- 3308710 TI - Lung cancer from passive smoking: hypothesis or convincing evidence? AB - The epidemiological literature on passive smoking and lung cancer is reviewed and the well-known criteria for establishing a causal relationship are applied in order to determine what level of causal evidence currently exists. Three cohort studies and 12 case control studies are analysed. Of the prospective cohort studies, one contributes very little to our knowledge, one shows no risk increase and one results in a moderate risk increase of 1.74 for women married to heavy smokers. The last is the only study which has to be taken seriously, even when other considerations show that its results might be caused by chance, bias or confounding. None of the six case control studies yielding a positive relationship was conducted according to the state of art of epidemiological research, giving reasonable and sound evidence which cannot be explained by chance, bias, confounding or misclassification. Two studies contribute nothing to the evidence. None of the four case control studies yielding no risk change or a risk decrease can exclude the possibility that a causal relation exists. The epidemiological and toxicological evidence is discussed in the light of recent findings. The volume of accumulated data is conflicting and inconclusive. The observations on nonsmokers that have been made so far are compatible with either an increased risk from passive smoking or an absence of risk. Applying the criteria proposed by IARC there is a state of inadequate evidence. The available studies, while showing some evidence of association, do not exclude chance, bias or confounding. They provide, however, a serious hypothesis. Further studies are needed, if one wants to come to an adequate and scientifically sound conclusion concerning the question as to whether passive smoking causes lung cancer in man. PMID- 3308709 TI - Adoptive transfer of immunity to Treponema pallidum Nichols infection in inbred strain 2 and C4D guinea pigs. AB - T lymphocytes purified from lymph nodes and spleens of chancre-immune, inbred strain 2 guinea pigs, when infused into syngeneic guinea pigs, conferred protection against challenge with Treponema pallidum subsp. pallidum Nichols. No protection was conferred by similar injections of cell suspensions from normal guinea pigs or guinea pigs immunized with T. phagedenis biotype Reiter or T. pallidum-free testis supernatants from infected rabbits. Similar results were obtained with homozygous C4D guinea pigs. After several months of infection, 2 of 11 strain 2 and 1 of 8 strain C4D recipients of T. pallidum-immune cells developed an erythematous reaction of short duration at the injection site; 2 of these recipients were positive for T. pallidum. Throughout the experimental period the humoral response to treponemal antigens was substantially lower in the adoptively immune guinea pigs than in various unprotected control groups. Passive immunity to infection with T. pallidum, however, seems to be dose related, since asymptomatic infection persisted for as long as 3 months after challenge in strain 2 guinea pigs transfused with 10(8) T. pallidum-immune lymphocytes, but not in C4D recipients of twice as many immune cells. PMID- 3308712 TI - Medical applications of computers: an overview. AB - In this review computer applications in medicine are discussed from the point of view of the levels of information processing as suggested by van Bemmel. Applications are presented and research directions indicated. The purpose of this review article is to give an overview of the field of medical informatics. A structural approach is followed in discussing the subjects of communication, databases, complex calculations (including signal analysis and image analysis techniques), pattern recognition and expert systems. The role the computer system plays in relation to the physician is discussed. It is stressed that computers cannot replace the physician, because computer systems use programs, that are of a scientific nature. This means that only certain aspects are taken into account and that one abstracts from individuality. Therefore, computers are unable to give advice about individual patients regarding their future. PMID- 3308713 TI - Effect of sampling frequencies on the velocity of slow and fast phases of nystagmus. AB - A computer analysis of slow and fast phase of velocity of nystagmus is presented. Several methodological factors are known to affect the computation of velocities, such as sampling frequencies, cutoff frequencies of the differentiation method, and resolution in bits of analog-digital conversion. A simulated signal without noise was first applied in nystagmus data in order to study maximum velocities at the theoretical level. Electro-oculographic postrotational nystagmus movements were then examined to test theoretical results. It was shown that the sampling frequency ought to be 400 Hz at least, the cutoff frequency about 70 Hz, and the resolution of analog-digital conversion 12 bits or higher. PMID- 3308711 TI - A specific enzyme-linked immunosorbent assay for definition of the IgG antibody response to disulphide-conjugated D-penicillamine in the rabbit. AB - An enzyme-linked immunosorbent assay (ELISA) has been developed for unambiguous detection of antibodies against the sulphydryl drug D-penicillamine (PA) and its disulphide-conjugated metabolites. Disulphide-linked PA human serum albumin (PA HSA) conjugates for use as coating antigens were prepared by a range of procedures employing oxidation with either potassium ferricyanide (0.1 M) or cupric sulphate (5 ppm). A satisfactory degree of conjugation was achieved by both oxidative procedures. Hapten density and antigenicity were increased when urea-denatured rather than non-denatured HSA was used. In 2 out of 3 rabbits, a specific IgG anti-PA response was detected following monthly injection of PA keyhole limpet haemocyanin (PA-KLH) in Freund's complete adjuvant. In the third rabbit, any anti-PA activity was obscured by a high level of binding to HSA. The anti-PA response was slow to develop in the 2 responder rabbits (requiring four injections) and was of low intensity (antibody titres less than 6,000). In contrast, the IgG antibody response to the structurally related drug captopril (CP), administered under identical conditions, was rapid in onset and of greater intensity (titres greater than 6,000 after one injection of CP-KLH). The hapten specificity of the IgG anti-PA-HSA antisera was defined by ELISA inhibition assays. Binding of IgG to PA-HSA was inhibited by PA, PA disulphide, PA cysteine and disulphide-linked PA-HSA conjugates, but not by PA acetone (thiazolidine ring linked PA), CP, or unconjugated HSA. The inhibitory preparations were inactive in unrelated ELISAs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308715 TI - Captopril in treatment of infant heart failure: a preliminary report. AB - We have studied retrospectively 18 infants who have received captopril for treatment of severe heart failure due to left-to-right shunts with pulmonary hypertension. Captopril has been administered in doses of up to 3.5 mg/kg/day (mean 2.47 mg/kg/day). Maintenance treatment with digoxin and frusemide was continued but potassium-sparing diuretics were stopped in most patients. The mean period of assessment was 19 days before and 27 days after commencing captopril. The mean daily weight gain before captopril was -7 g and after its introduction was + 13 g (P less than 0.001). There were statistically significant (P less than 0.05) falls in mean heart rate and respiratory rate and rises in plasma sodium concentration and feeding score. Plasma urea concentration fell but this did not reach statistical significance. Two patients suffered hypotension after increments in captopril dosage and subsequently had a rise in plasma urea and creatinine values. This adverse reaction may be linked to the presence of hyponatraemia. This preliminary report shows captopril may be useful in the control of severe heart failure in infancy. PMID- 3308714 TI - Effect of myocardial contraction on systolic coronary resistance in conscious dogs. AB - We studied the effect of cardiac contraction on systolic coronary resistance under the conditions of maximally dilated coronary resistance vessels in six conscious dogs. Subendocardial segment length in areas supplied by the left circumflex coronary artery, left ventricular pressure and left circumflex coronary artery flow were simultaneously measured. At 5 sec after release of the first 2 min of left circumflex coronary artery occlusion, diastolic coronary blood flow revealed its peak value in association with markedly depressed regional contractile function. With collateral development induced by repeated 2 min left circumflex coronary artery occlusions, segmental dysfunction during occlusion and early reperfusion was progressively attenuated. Before and after collateral development, diastolic coronary resistance at 5 sec of reperfusion remained unchanged, but systolic coronary resistance increased by 41% secondary to restoration of regional myocardial shortening. In each animal, normalized regional shortening correlated well with changes in systolic coronary resistance. The fraction of systolic coronary resistance due to active regional myocardial contraction was 52%. These studies demonstrate that when coronary vasomotor tone is abolished, regional myocardial contraction impedes the coronary systolic flow in proportion to the extent of shortening. PMID- 3308716 TI - Very early presentation of Pompe's disease and its cross-sectional echocardiographic features. AB - Pompe's disease was diagnosed in a 23-day-old female infant with congestive cardiac failure and hypotonia. The cross-sectional echocardiographic features of this case are described. The possible implications of this extremely early presentation are discussed. PMID- 3308718 TI - A preliminary pharmacokinetic study of cyclosporine A in 10 Japanese renal transplant patients. AB - A pharmacokinetic study of cyclosporine A (CyA) was performed in ten Japanese renal transplant patients. The peak blood CyA concentration appeared at about 2.5 h after oral administration of CyA 180-360 mg, and the mean peak CyA concentration was 582 +/- 238 (SD) ng/ml. The apparent clearance was 39.9 +/- 16.9 (SD) ml/min/kg which is almost the same as reported in European transplant patients. The apparent distribution volume was 5.34 +/- 3.05 (SD) l/kg. The wide variations observed both in the apparent clearance and in the apparent distribution volume are ascribed to the wide variation of the area under the curve (AUC). No correlation was found between the oral dose per body weight and peak blood CyA level or AUC in the 10 subjects. However, a linearity was ascertained between blood CyA concentrations and oral CyA doses (250 mg and 500 mg), though in one patient. Especially, in one patient, blood CyA level was under the lower detection limit of our assay method, 50 ng/ml, over 20 h after oral administration of CyA. This study strongly supports the need of the blood monitoring in the CyA therapy after renal transplantation. PMID- 3308717 TI - Renal tuberculosis and accelerated hypertension: the use of renal vein renin sampling to predict the outcome after nephrectomy. AB - This case report records the rare presentation of accelerated hypertension secondary to long-standing renal tuberculosis and the subsequent beneficial response to surgery predicted by lateralisation of renin levels within the renal veins. The patient's hypertension proved difficult to control medically and he was therefore assessed for possible surgical management. Renin sampling revealed clear lateralisation within the renal veins indicating possible benefits from surgery. Nephro-ureterectomy was performed and, post-operatively, the patient's hypertension, while not completely resolved, was easily controlled with monotherapy. Patients with unilateral renal tuberculosis and hypertension which prove difficult to control should have measurement bilaterally of renal venous renin which may indicate potential benefits from surgery. PMID- 3308719 TI - Multicenter double-blind randomized clinical trial of imidazole salicylate versus ibuprofen in patients with rheumatoid arthritis. AB - In a 24-week multicenter double-blind clinical trial, efficacy and safety of the novel nonsteroidal anti-inflammatory drug imidazole salicylate (750 mg t.i.d. per os) and ibuprofen (600 mg t.i.d. per os) were compared in 60 patients with classical or definite rheumatoid arthritis, randomly assigned to one of the two treatment groups. The patients improved significantly with both treatments in all the clinical parameters examined such as the duration of morning stiffness, grip strength of both hands, Ritchie's articular index and severity of joint pain. The systemic tolerability, assessed by hematological, liver and kidney function tests was excellent with both treatments. The incidence of side effects was overall fairly low with both drugs, and lower in the group treated with imidazole salicylate (23% vs. 33%). PMID- 3308720 TI - Early indicators of nephrotoxicity: comparison of two antibiotics. AB - The aim of the study was the evaluation of the clinical efficacy and the kidney tolerance of ceftazidime in comparison with netilmicin in pediatric patients. Forty subjects, ranging from six months to ten years of age were randomly allocated in two groups and treated either with ceftazidime (80-100 mg/kg/day) or netilmicin (6 mg/kg/day). A control group of twenty subjects was selected in order to establish the normal values of beta 2-microglobulin and urinary enzymes excretion. beta 2-microglobulin, enzymuria, cylindruria and urinary osmolability were estimated, as well as hematological parameters. Ceftazidime was as efficacious as netilmicin in the clinical outcome and in addition it did not cause any pathological change in early markers of tubular damage. PMID- 3308721 TI - Generalized pustular psoriasis. PMID- 3308722 TI - Scleroderma-polymyositis overlap syndrome. Clinical and serologic aspects. PMID- 3308723 TI - Retrovirus (HIV). Transfer, potential vectors, and biomedical concerns. PMID- 3308724 TI - Pediatric dermatology: chronologic excursions into the literature. Part IV. Pediatric dermatology texts. PMID- 3308725 TI - Immunological and biological characterization of Plasmodium falciparum exoantigens. PMID- 3308726 TI - Endocrine effects of a single infection with Ostertagia ostertagi in the calf. PMID- 3308727 TI - Lactoferrin effects on the interaction of blood forms of Trypanosoma cruzi with mononuclear phagocytes. PMID- 3308729 TI - Effect of varied protein intake on the nephropathy of the diabetic mouse (C57BL/s J db/db). AB - Protein intake has been suggested to influence progression of renal disease by affecting intraglomerular pressures and flows. The renal disease of the diabetic mouse (C57BL/Ks/db/db) has been proposed as a suitable model of human diabetic nephropathy. Ten diabetic mice and ten non-diabetic controls were placed on 1 of 3 protein intakes, 4%, 27% and 50%, and serial functional measurements were made at 2 to 3 week intervals until week 20. All diabetic animals showed similar degrees of hyperglycemia. The creatinine clearances were generally higher in the diabetic mice than the controls, except the 4% protein intake diabetic group, until week 20 when the 27% db/db mice showed a significant decline (p less than 0.05) compared to the control mice. Albumin excretion was significantly higher in the 27% and 50% protein intake db/db mice than the controls. Again the 4% group showed albuminuria not different from the control animals. Histologic studies at 20 weeks showed minimal abnormalities in the normal and 4% protein intake diabetic group. The 27% and 50% intake diabetic mice showed a progressive increase in severity of mesangial matrix expansion with segmental sclerosis. Electron microscopy confirmed these findings. Immunofluorescence microscopy showed a marked increase in mesangial immunoglobulin G and M. With similar degree of hyperglycemia, higher protein intake was associated with more severe histologic changes, greater albuminuria and early decline in GFR. Thus protein intake can markedly affect the progression of renal disease in the diabetic mouse. PMID- 3308728 TI - Randomized clinical trial of intraocular silicone vs. gas in the management of complicated retinal detachment and vitreous hemorrhage. AB - We performed a prospective randomized clinical study to compare intravitreal silicone oil vs. gas (20% C3F8 or 30% C4F8) in the management of complicated retinal detachments and vitreous hemorrhage. Despite similar anatomic and visual results, the gas-treated group had significantly more instances of vitreous hemorrhage, late elevated intraocular pressure, and localized retinal detachment as postoperative complications than those receiving oil injections (P less than .05). Silicone oil injections containing less than 3.0 ml contributed significantly to postoperative detachments (P less than .05). PMID- 3308730 TI - Seizures and blindness following intravenous pulse methylprednisolone in a renal transplant patient. AB - Seizures in renal transplant recipients may be due to a variety of causes. Although intravenous pulse methylprednisolone used to treat acute rejection episodes has been reported to be associated with acute central nervous system (CNS) manifestations in adult renal transplant patients, this complication has not previously been described in pediatric patients. We report a 12 year old renal transplant recipient who developed transient blindness and focal seizures 72 hours following intravenous pulse methylprednisolone. Serum creatinine and urea nitrogen were 1.5 and 31 mg/dl respectively; serum electrolytes, calcium, magnesium, phosphate, and glucose were normal. Although usually due to other etiologies, seizures in the pediatric transplant recipient may be secondary to acute CNS toxicity resulting from intravenous glucocorticoid infusion. PMID- 3308732 TI - Clonidine in neuropsychiatric disorders: a review. AB - We describe the basic pharmacological principles underlying the activity of the alpha 2-adrenergic receptor agonist clonidine, including its interactions with the cholinergic, histaminergic, serotoninergic, endorphinergic and possibly dopaminergic systems. The use of clonidine for the therapy of various neuropsychiatric indications in which it appears to be beneficial is described. These conditions include migraine, Korsakoff's psychosis, Tourette's syndrome, withdrawal states, tardive dyskinesia, essential tremor, neuroleptic-induced akathisia, neurogenic bladder, idiopathic orthostatic hypotension, paroxysmal localised hyperhydrosis, diabetic neuropathy and stiff-man syndrome. The need for long term evaluation of this agent in some of these diseases is stressed. PMID- 3308731 TI - The effect of buflomedil in diabetic retinopathy estimated by ocular fluorophotometry. AB - Tissue hypoxia is thought to be one of the possible factors involved in the etiology of diabetic retinopathy. Buflomedil has been reported to improve microvascular perfusion with a secondary increase in tissue oxygen pressure and may therefore be of interest in the study of diabetic retinopathy. We investigated 10 males with insulin-dependent diabetes and non-proliferative retinopathy, aged 24-46 with a duration of diabetes of 5-31 years. Buflomedil, 600 mg daily, or placebo was given for 4 weeks in a randomized, double-blind cross-over design, with a one-week washout in between. Patients were studied initially and at the end of each of the three periods. Ocular fluorophotometry was performed at each visit and a penetration index (PI) calculated by dividing the ocular measurements with the preceding average free fluorescein concentration. There was a slight, but significant decrease in the PI of the posterior vitreous while on buflomedil, from 10.6 +/- 13.4 (mean +/- SD) to 8.8 +/- 9.6 10(-4), p less than 0.05. No measurable changes were found in metabolic control as estimated by HbA1, and no side effects were observed. That the drug may act by increasing blood flow, was illustrated by measurements on capillary blood, where pH increased (7.43 +/- 0.01 to 7.45 +/- 0.01, p less than 0.05) and pCO2 decreased (5.48 +/- 0.4 to 5.15 +/- 0.24 kPa, p less than 0.05). Buflomedil may reduce the permeability of the posterior ocular barriers in diabetic retinopathy. PMID- 3308733 TI - Neuropsychological development of cognitive abilities: a new research strategy and some preliminary evidence for a sexual orientation model. AB - The organizing action that prenatal sex hormones exert on the brain has been implicated in the aetiology of sex differences in cognitive abilities and cerebral asymmetries. Prenatal sex hormones are known to determine neuroendocrine responses and subsequent adult sexual behaviour in nonhuman animals and these hormones may also influence human sexual orientation. To unify these observations, we elaborate a sexual orientation model of neuropsychological development which predicts that sex differences in neuroendocrine responses, cerebral asymmetries, and cognitive abilities are related to sexual orientation rather than to sex per se. A common problem in the study of sex differences is that biological and sociocultural explanations are confounded. The sexual orientation model suggests a new research strategy, the comparison of homosexual and heterosexual groups, for which explanations in terms of sociocultural factors would be more difficult to sustain. The available evidence supports the model: In terms of a neuroendocrine response, cerebral asymmetry, and cognitive abilities, homosexual males resemble heterosexual females rather than heterosexual males. Our conclusions lead to questions that further research in this area should address, and to a consideration of problems which such research may have to face. PMID- 3308734 TI - Probing the temporal world of the elderly. AB - This paper reviews the literature on subjective time experience, especially as it relates to the elderly; comments on the problems associated with measuring such experience; describes a study to explore temporality in older women; provides speculations concerning the meaning and impact of time on the life and health of the aged; and notes nursing implications. Findings from the study of elderly women suggest that successful aging may be linked to a feeling of timelessness, and furthermore, that a search for the meaning of temporality in old age may add to an understanding of physical and mental health, well-being and longevity. PMID- 3308735 TI - The placebo in the practice of medicine. PMID- 3308736 TI - Sophrology. PMID- 3308737 TI - Calcium and magnesium status in pregnant women. A comparison between treatment with calcium and vitamin C in pregnant women with leg cramps. AB - 60 pregnant women underwent a double blind trial with calcium or ascorbic acid (1 g twice daily) as treatment for leg cramps. There was no significant difference between the two treatment groups with respect to clinical improvement. In 14 out of 60 patients the symptoms were totally abolished and in another 27 patients the symptoms were significantly decreased by the treatment (irrespective of drug used). In 17 patients the symptoms were unaffected while only two patients experienced an increase in frequency of their leg cramps during therapy. Serum total and ionized calcium concentrations, serum total magnesium and albumin concentrations were determined and were not significantly changed throughout therapy in any of the groups. No biochemical differences were found between the different treatment regimens or between those patients relieved or not relieved of their symptoms. Serum magnesium concentrations were at or just below the lower normal limit (for non pregnant women) in treated women and pregnant controls. PMID- 3308738 TI - Nocardia. AB - N asteroides is an aerobic, gram-positive, partially acid-fast, branching rod. Cell-mediated immunity via both macrophage activation and direct cytotoxicity represents the main host defense. While clinical infection most commonly occurs in immunocompromised hosts, Nocardia can infect and exist as a saprophyte in normal hosts. Diligence on the part of the treating physician is necessary to confirm the diagnosis. A combination of trimethoprim and sulfamethoxazole is the mainstay of treatment. With an aggressive approach to diagnosis and therapy, the prognosis in patients with nocardiosis appears to be dependent on their underlying disease process. PMID- 3308739 TI - Flash sterilization: carefully measured haste. PMID- 3308741 TI - Candida (Torulopsis) glabrata. AB - Candida (Torulopsis) glabrata is usually a nonpathogenic fungus living saprophytically with normal flora. However, under special circumstances, the organism can become locally invasive and potentially disseminate. Laboratory identification is based on colonial appearance, absence of hyphae, and characteristic biochemical reactions. Treatment usually consists of amphotericin B with occasional reports of 5-fluorocytosine usefulness. It is apparent that Torulopsis represents yet another "evolving" disease with which the clinician must be familiar because successful treatment rests on successful diagnosis. PMID- 3308742 TI - Hospital infection control in Sweden. PMID- 3308740 TI - The importance of surveillance stool cultures during periods of severe neutropenia. AB - The correlation of fecal gram-negative bacilli (GNB), neutropenia, and bacteremia was studied in 45 bone marrow transplant recipients. Weekly stool cultures were prospectively monitored for GNB resistant to routine prophylactic and empiric antimicrobial agents. Seven cases of GNB bacteremia occurred in 45 patients described as follows. Twenty-three patients had no fecal or blood GNB. Fifteen patients had fecal GNB and no blood GNB; three of these latter patients had less than or equal to 50/mm3 circulating white blood cells (WBC) at the time of isolation of fecal GNB but two of the three were concurrently receiving appropriate empiric antibiotics. Two patients had blood GNB but no fecal GNB: one patient had a trimethoprim/sulfamethoxazole (TMP-SMZ)-sensitive isolate that would not be detectable in the feces by our methodology and one patient had feces analyzed only after the bacteremic event. Five patients had fecal GNB and blood GNB: one of these patients did not have a fecal sample analyzed prior to bacteremia but the remaining four patients had the same species/antibiogram of GNB isolated from the feces two to three days prior to the detection of bacteremia. Thus, the fecal GNB could have been used to predict the antibiogram of the subsequent blood GNB. In addition, all four of these latter bacteremic patients had less than or equal to 50/mm3 circulating WBC at the time of documented fecal GNB. Thus, bone marrow transplant recipients with fecal GNB coupled with severe neutropenia (less than or equal to 50/mm3 circulating WBC) were more likely to develop bacteremia (P less than 0.02) than were those with fecal GNB and greater than 50/mm3 circulating WBC. PMID- 3308743 TI - Agents for the treatment of Pseudomonas aeruginosa infections. PMID- 3308744 TI - Preoperative visual acuity evaluation. PMID- 3308745 TI - Specular microscopy of the cataract patient. PMID- 3308746 TI - Evaluation of cataractous eyes with opaque media. PMID- 3308747 TI - Techniques of irrigation and aspiration. PMID- 3308748 TI - YAG lasers in cataract surgery. PMID- 3308749 TI - Complications of intraocular lenses. PMID- 3308750 TI - Medical and surgical treatment of aphakic cystoid macular edema. PMID- 3308751 TI - [Punctures and biopsies. Structure and function]. PMID- 3308752 TI - [Morphologic diagnosis. Methodologic principles from the viewpoint of the pathologist]. PMID- 3308753 TI - [Biopsy procedures in pneumology]. PMID- 3308754 TI - [Diagnosis by biopsy in the gastrointestinal tract]. PMID- 3308755 TI - [Kidney biopsy]. PMID- 3308756 TI - [Aspiration cytology of the thyroid gland]. PMID- 3308757 TI - [Morphologic bone marrow study. Sternal puncture or iliac crest biopsy]. PMID- 3308758 TI - Biosynthetic responses of the rabbit cornea to a keratectomy wound. AB - Following a corneal wound involving removal of the epithelium and basement membrane, the epithelium must migrate across bare stroma. To examine the effect of the removal of the basement membrane on epithelial migration and on protein and glycoprotein synthesis in both the epithelium and stroma, we performed superficial keratectomies on rabbits and allowed the corneas to heal in organ culture. We then analyzed the following parameters: (1) rate of epithelial wound closure; (2) proteins synthesized during epithelial wound closure in both the epithelium and stroma using SDS-PAGE; and (3) presence of fibronectin in the epithelium and stroma using immunodot blots and immunofluorescence. We found that: (1) a 7 mm keratectomy wound heals in 66 hr with a maximal rate of epithelial migration of 0.83 mm2/hr; (2) four proteins, 400+K, 220K, 70K, and 58K, are present in the epithelium migrating to close the wound that are not seen in the control epithelium; (3) a 220K band is seen in the wounded stroma but not in control stroma; and (4) fibronectin represents 2% of the total protein in the stroma 66 hr post-keratectomy but less than 0.02% in wounded epithelium, unwounded epithelium, and unwounded stroma. PMID- 3308759 TI - Macular corneal dystrophy: immunochemical characterization using monoclonal antibodies. AB - Macular corneal dystrophy is an inherited corneal disease characterized by corneal opacities resulting from intra- and extracellular deposits within the corneal stroma. Several monoclonal antibodies developed against antigens of corneal fibroblasts were screened for their reactivity with these abnormal deposits in corneas with macular dystrophy using an indirect peroxidase conjugated immunostaining technique. One of these monoclonal antibodies (designated 8F1-3) reacted very strongly with these abnormal deposits. Although the antigen recognized by this monoclonal antibody was present in the normal corneal stromal and endothelial cells, its concentration in the cells in the corneas with macular dystrophy appeared to be considerably higher, based on the intensity of the immunostaining reaction. Corneal fibroblasts grown in tissue culture were employed for further characterization of the antigen. After fixing with paraformaldehyde and permeabilizing with Triton X-100, immunofluorescent staining of the corneal fibroblasts using these monoclonal antibodies revealed a filamentous pattern of staining which resembled that seen for vimentin filaments. On treatment of corneal fibroblasts with colchicine, the filaments recognized by this antibody were withdrawn from their cytoplasmic array to form a perinuclear cap as also observed for vimentin-containing intermediate filaments. Immunoelectron microscopic studies using colloidal gold-conjugated antimouse IgG indicated that this monoclonal antibody recognized an antigen associated with intermediate-type filament. However, antivimentin antibody did not react with the abnormal deposits in the corneas with macular dystrophy, indicating that the antigen identified in the present study, although associated with intermediate filaments, was not vimentin. Analyses of cytoskeletal antigens by the immunoblotting technique further revealed that this monoclonal antibody recognized two polypeptides with Mr48,000 and 45,000, while antivimentin antibody reacted with 58,000 Mr polypeptide (vimentin). PMID- 3308760 TI - Attempted oral immunization with chlamydial lipopolysaccharide subunit vaccine. AB - The effects of oral immunization with a recombinant vaccine expressing chlamydial lipopolysaccharide (LPS) on subsequent ocular challenge with Chlamydia trachomatis were studied in cynomolgus monkeys. Groups of four or five monkeys were given an oral vaccine containing 5 X 10(8) parent or recombinant Escherichia coli on days 0, 14, and 35 and were challenged with either 2 X 10(3) or 5 X 10(3) inclusion forming units of viable purified elementary bodies on day 42. On clinical and microbiologic grounds, oral immunization failed to protect monkeys against subsequent ocular challenge. Antichlamydial IgG or IgA antibodies were not induced by oral vaccination, and the antibody response following ocular challenge was similar in vaccinated and nonvaccinated animals. Paradoxically, however, while nonvaccinated control animals developed antibodies against chlamydial LPS detectable by immunoblotting after chlamydial challenge, the LPS vaccinated animals did not. This study demonstrates that the oral recombinant vaccine expressing chlamydial LPS was ineffective in protecting against chlamydial eye infection and strongly suggests that chlamydial LPS may not be an important antigen for protective immunity against chlamydia. PMID- 3308761 TI - Parasympathetic denervation hypersensitivity of the iris in ocular hypertension. AB - Seventy-eight ocular hypertensive patients and 47 age-and sex-matched control subjects were assessed for parasympathetic denervation hypersensitivity of the iris using topical application of 2.5% methacholine chloride solution. Constriction of the pupil in response to methacholine stimulation of the sphincter pupillae was significantly greater in the ocular hypertensive patients than the control group (P less than 0.001). The implications are discussed, with particular reference to the association between autonomic neuropathy and the primary glaucomas. PMID- 3308762 TI - Merbarone: an antitumor agent entering clinical trials. AB - Merbarone was developed to clinical trial stage on the basis of its 'curative' activity against P388 and L1210 leukemias and moderate activity against B16 melanoma and M5076 sarcoma. Its activity appears to be schedule-dependent favoring a longer duration of administration. The mechanism of action of merbarone is not yet established but it does induce single strand breaks in DNA apparently without binding to DNA. The pharmacokinetic data in the dog indicate that clearance mechanisms may be saturable. Merbarone is hydroxylated at the 4' position in the rat, mouse and dog, and glucuronidated in the dog. Parent drug and the hydroxy metabolite are excreted in the urine. If saturable clearance mechanisms also pertain to man, this will mean that infusion rate (and therefore steady state concentrations reached) may be a significant factor in determining acute toxicity. Preclinical toxicology studies revealed that major target tissues are in the lymphoid organs, bone marrow, gastrointestinal tract and kidney. Some behavioral signs of reversible central nervous system toxicity were observed. Phase I trials have commenced using only a 5-day continuous intravenous infusion schedule based on the preclinical data. The pharmacokinetic information from these trials will be crucial for further clinical development of the compound, including selection of the optimal schedule(s) for phase II/III evaluation. PMID- 3308763 TI - The Carmichael School of Medicine. PMID- 3308764 TI - The health services in Ireland: a perspective on origins. PMID- 3308765 TI - Oestrogens for women: the risk/benefit ratio. PMID- 3308766 TI - Declining rate of neural tube defects in three eastern counties of Ireland: 1979 1984. PMID- 3308767 TI - Aspects of medicine in Hibernia Magna. PMID- 3308769 TI - The platelet and migraine: a nonspecific association. PMID- 3308768 TI - Atenolol in migraine prophylaxis a double-blind cross-over multicentre study. PMID- 3308770 TI - A comparison of naproxen sodium, acetaminophen and placebo in the treatment of muscle contraction headache. PMID- 3308771 TI - [Psoriasis and bullous pemphigoid]. AB - The coexistence of psoriasis and bullous pemphigoid in 44 patients has been described in the literature. In the majority of cases no causative agent was found for the development of bullous pemphigoid, but in many cases the bullous eruption was related to antipsoriatic treatment such as PUVA, anthralin, tar and salicylic acid. A 46-year-old man with a 20-year history of psoriasis who developed bullous pemphigoid without any previous therapy is described. After clearing, a later exacerbation of both psoriasis and bullous pemphigoid indicated that there is a pathogenetic relationship between the diseases. Among 72 patients with bullous pemphigoid no others suffered from psoriasis. PMID- 3308772 TI - [Autographs from Albert Neisser's library]. AB - Preserved letters from Filipp Josef Pick, Moriz Kaposi, Martha Kaposi, and Eduard Jacobi to Albert Neisser are reported and reproduced. A collection of books is also presented of authors who have written dedications to Albert Neisser: for instance, Ernst Bumm, Keizo Dohi, William Auguste Dubreuilh, Raymond Sabouraud, and James Clarke White. PMID- 3308773 TI - [Pemphigus vegetans of the Hallopeau type. Detection of pemphigus antibodies with direct and indirect immunofluorescence]. AB - We report the case of a 25-year-old woman with bullous lesions diagnosed as the rare pustular type of pemphigus described by Hallopeau. Direct immunofluorescence studies revealed deposits of IgG and C3 in the intercellular spaces of the epidermis; the indirect immunofluorescence technique revealed circulating antiepithelial IgG antibodies. The skin lesions cleared completely following treatment with systemic corticosteroids and azathioprine. These findings indicate the disease first described by Hallopeau as "pyodermite vegetante" does indeed belong to the pemphigus group, being a rare type of pemphigus vegetans. PMID- 3308774 TI - [Carcinogenic risks of phototherapy and photochemotherapy]. AB - The data in the literature regarding the carcinogenic risks involved in both UVB phototherapy and 8-methoxypsoralen plus UVA photochemotherapy are discussed. Both modes of treatment can be mutagenic and can induce immunosuppression. Which of the two factors (the initiator or the promoter effect) is more responsible for the carcinogenic risks involved in phototherapy or photochemotherapy is a subject of much controversy. In addition to discussing the theoretical background, the present article also takes into consideration the long-term clinical studies that have been performed. Practical guidelines are given on how to apply phototherapy and photochemotherapy as safely as possible. PMID- 3308775 TI - [Moulages from the Wurzburger University Dermatologic Clinic as an example of a German collection--historical development and didactic value]. AB - Dermatological wax moulages were often used as clinical teaching models well into the 1930s. Their didactic possibilities and their historical development in the German-speaking area are described. The extensive collection of such moulages in Wurzburg is currently being reviewed and is presented here as an example of a moulage collection typical for those formerly used in this country. Several moulages by wax modellers whose work is represented in the collection are illustrated in detail. PMID- 3308776 TI - [Immunohistochemical classification of cutaneous lymphomas and pseudolymphomas]. AB - We investigated 46 cases of cutaneous lymphoma and pseudolymphoma by immunohistochemical methods using a panel of monoclonal antibodies. Of the cutaneous T cell lymphomas, 2 did not show the classic helper phenotype but revealed a predominance of suppressor cells in one case and of immature thymocytes in the other. Cutaneous B cell lymphomas of low-grade malignancy were characterized by the presence of completely developed T zones between the B cell areas. B cell lymphomas of high-grade malignancy revealed an immunohistologically homogeneous infiltrate. Cutaneous pseudolymphomas can be classified in T cell pseudolymphomas (lymphocytic infiltration, lymphomatoid papulosis) and B cell pseudolymphomas. Lymphadenosis cutis benigna with germinal center cell differentiation was clearly distinguishable from other B cell pseudolymphomas, which are considered to comprise mainly peripheral B lymphocytes. Immunohistological methods are obviously useful in the classification of lymphoproliferative diseases of the skin and can make a contribution to increasing our understanding of them. PMID- 3308777 TI - Living with asthma: replications and extensions. AB - This article reviews replications and extensions of Living with Asthma, a self management system developed and tested at the National Asthma Center in Denver between 1977 and 1980. Research on the system since the latter date has been conducted within the conceptual framework provided by the social or cognitive learning model. This approach has switched experimenter effort away from developing and evaluating the acquisition of self-management skills toward assessing their performance by patients. Efforts to insure these skills are used effectively by patients to control their asthma, focusing particularly on the assessment of performance variables, are described. PMID- 3308778 TI - Near drowning: consensus and controversies in pulmonary and cerebral resuscitation. AB - By consensus, the most clinically important consequence of near drowning is hypoxemia. Whether it is due to physiologic shunting induced by diffuse alveolar flooding from saltwater aspiration or to diffuse atelectasis induced by surfactant inactivation from freshwater aspiration, both physiologic disturbances can be reversed with the institution of positive-pressure breathing in the form of PEEP or CPAP, which should be the mainstay of pulmonary management of respiratory insufficiency in these patients. The use of prophylactic antibiotics or corticosteroids as an adjunct in the management of pulmonary insufficiency resulting from near drowning is not warranted, may be detrimental, and remains controversial. The most crucial clinical consequence of the hypoxemia resulting from near drowning is cerebral injury and the consequent neurologic sequelae. The general consensus supported by large clinical studies is that near-drowning victims who, after initial resuscitation, are spontaneously breathing and are not comatose have a uniformly benign neurologic outcome. A significant subset of comatose near-drowning victims survive with eventually normal neurologic recovery when routine aggressive supportive intensive care is administered. Uncontrolled studies reporting improved outcomes with the institution of complex cerebral salvage techniques, such as induction of hypothermia, intracerebral pressure monitoring, induction of barbiturate coma, and the use of corticosteroids and osmotic diuretics, remain controversial. It is now clear that neither induced hypothermia nor barbiturate coma improves survival or neurologic outcome in these patients and may be detrimental.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308780 TI - Importance of accurate placement of precordial leads in the 12-lead electrocardiogram. PMID- 3308779 TI - Normal saline instillation as part of the suctioning procedure: effects on PaO2 and amount of secretions. PMID- 3308781 TI - Kingella kingae endocarditis: report of a case and review of the literature. PMID- 3308782 TI - Hormone dependence of breast tissue estradiol and progesterone interaction. PMID- 3308783 TI - Growth factors: general review. PMID- 3308784 TI - Transforming growth factor-beta: potential common mechanisms mediating its effects on embryogenesis, inflammation-repair, and carcinogenesis. AB - In conclusion, we have demonstrated that a single growth factor, TGF-beta, can act in either an autocrine or paracrine mode to bring about, either directly or indirectly, all of the complex events which together lead to the formation of granulation tissue and tumor stroma. All of the participating cell types, lymphocytes, macrophages, endothelial cells, and fibroblasts have receptors for TGF-beta and many of them secrete TGF-beta as well. Although other growth factors such as platelet-derived growth factor and fibroblast growth factor clearly also participate in these processes, we have shown that TGF-beta, alone, is sufficient to initiate the cascade of events, probably through its ability to chemoattract and to activate macrophages and fibroblasts. Without question, neovascularization and appropriately timed matrix synthesis and degradation are central to embryogenesis as well. Fibronectin, in particular, has been shown to promote cell adhesion and cell migration throughout embryogenesis (Hynes and Yamada, 1982; Rovasio et al., 1983). We propose that TGF-beta will be found to be an important mediator of embryonic development, not only by control of angiogenesis and matrix synthesis, but also by exerting direct local effects on cellular growth and differentiation (reviewed in Roberts and Sporn, 1987). PMID- 3308786 TI - [Radiologic diagnosis and localization of foci of infection]. PMID- 3308785 TI - [So-called Secretan hard edema of the back of the hand]. PMID- 3308787 TI - Variants of the alpha chain. International Hemoglobin Information Center. PMID- 3308788 TI - Bilateral renal cell carcinoma and its treatment. PMID- 3308789 TI - Improved techniques for orthotopic liver transplantation in pigs: a preliminary study. PMID- 3308790 TI - Immunohistochemical localization of a novel, human plasma protein, tetranectin, in human endocrine tissues. AB - A monospecific antibody to a plasminogen kringle 4-binding tetramer protein of human blood, tetranectin, was applied to various human endocrine tissues employing the peroxidase-antiperoxidase staining technique. Endocrine cells with a known protein or glycoprotein hormonal production such as chromophils (pituitary), follicular and parafollicular cells (thyroid), chief cells (parathyroid), hepatocytes (liver), islet cells (pancreas) and ganglion cells of the adrenal medulla displayed a convincing, positive staining reaction for tetranectin, which varied from cell to cell within the different tissues. The liver showed a distinct and universal reaction within almost all hepatocytes, thus raising suspicion of producing the bulk of tetranectin to the blood. Tetranectin has recently been characterized as a lectin-like protein with amino acid sequence homology to the core protein of a rat chondrosarcoma proteoglycan. Proteoglycans have been demonstrated in secretory granules of rat pituitary and pancreatic islet cells, where they probably serve as modulators in hormonal production. The granular, cytoplasmic immunohistochemical localization of tetranectin demonstrated in this study combined with the fact that tetranectin is known to attach to plasminogen and promote plasminogen activation catalysed by tissue plasminogen activator suggests that this protein might have a dual function, serving both as a regulator in the secretion of certain hormones and as a participant in the regulation of the limited proteolysis, which is considered important for the activation of prohormones. PMID- 3308791 TI - Vasoactive-intestinal-polypeptide (VIP)-like immunoreactive cells in the skull base of rats. A combined study using acetylcholinesterase histochemistry. AB - We investigated the distribution of vasoactive intestinal polypeptide (VIP)-like immunoreactive cell bodies in relation to the major cerebral and internal carotid arteries at the skull base in rats. Acetylcholinesterase (AChE) histochemistry was also applied to investigate the localization of this enzyme. VIP staining revealed a few positive cell bodies in nerves close to the internal carotid artery at the base of the skull as well as in the cerebral arterial wall. Ganglion-like cell bodies were detectable within the greater superficial petrosal (GSP) nerve. AChE activity was observed in VIP-like immunoreactive cell bodies along the whole of the GSP nerve. These cell bodies in the GSP nerve may give rise to at least some of the perivascular VIP- and AChE-containing nerves of the internal carotid arteries at the base of the skull. PMID- 3308792 TI - Distribution of microtubules and microfilaments in exocrine (ventral prostatic epithelial cells and pancreatic exocrine cells) and endocrine cells (cells of the adenohypophysis and islets of Langerhans). The relationship between cytoskeletons and epithelial-cell polarity. AB - We investigated the distribution of microtubules and microfilaments in some exocrine and endocrine cells in rats. Microtubules were stained by applying an immunofluorescent technique using antibodies against beta-tubulin, while microfilaments were stained with rhodamine-phalloidin, which binds selectively to polymerized actin filaments. In the cytoplasm of some exocrine cells (pancreatic acinar cells and ventral prostatic epithelial cells), the microtubules were distributed longitudinally from the apical region to the basal region, but no microtubules were found in the nuclear region. In exocrine cells, most of the microfilaments were localized beneath the apical plasma membrane. In some endocrine cells (those of the adenohypophysis and the islets of Langerhans), the microtubules exhibited a radial or reticular distribution in the cytoplasm, and intense fluorescence was observed in the perinuclear region. The immunofluorescence produced by the antibodies against beta-tubulin was more intense in endocrine cells than in exocrine cells. The microfilaments observed in the endocrine cells studied were homogenously distributed beneath the plasma membrane. Dot-like rhodamine-phalloidin staining was often observed in the cytoplasm of both the exocrine and endocrine cells. The present study clearly demonstrated marked differences in the distribution of cytoskeletal elements in exocrine and endocrine cells, and these may reflect differences in the secretory direction of such cells as well as in epithelial-cell polarity. PMID- 3308793 TI - Comparison of the effects of a preliminary hepatic washing and of saponin on the intracellular penetration of peroxidase-labeled anti-rat albumin antibodies in hepatocytes. AB - The effect of a preliminary hepatic washing with saline before liver fixation either by perfusion or immersion was compared to the effect of saponin, a membrane-permeabilizing agent, in order to ascertain which procedure is best to obtain a homogeneous distribution of albumin-containing hepatocytes in the hepatic lobule. Albumin was located in the hepatocytes by peroxidase-labeled antibodies using light and electron microscopy. The efficacy of the two procedures on the intracellular penetration of labeled antibodies in liver sections was judged by preparing transverse ultrathin sections. Both procedures yielded similar results. Liver fixation by perfusion with saponin and without a preliminary washing, however, distributes albumin-containing hepatocytes more homogeneously in the hepatic lobule and enables labeled antibodies to penetrate more satisfactorily. In contrast, when the liver is fixed by immersion, the preliminary washing is the only way to obtain an even distribution of albumin containing hepatocytes, as saponin is not effective under these conditions. In conclusion, the localization of albumin in the hepatocytes must be adapted according to the technique used to fix the liver. PMID- 3308794 TI - [Retrospect and perspective in rhinologic allergology]. AB - The first classical description of allergic rhinitis was given by John Bostock in 1819, and Blackley demonstrated the etiology in 1873. In 1906 Clemens von Pirquet discussed a relationship between hypersensitivity and immunity: he called it allergy. In 1922 Prausnitz and Kustner described the transfer of the immediate type hypersensitivity by serum. Coca and Cooke called the factor atopic reagin. The breakthrough in 1967 was due to Ishizaka and Ishizaka who discovered the IgE antibodies, and proved that these are identical with the postulated reaginic antibodies. The knowledge of the new IgE-antibody class allowed the incorporation of nasal allergy in clinical immunology. PMID- 3308795 TI - Bubonic plague. PMID- 3308796 TI - Ultrasonographic diagnosis of portacaval shunts in young dogs. AB - Ultrasonography was performed on 21 young dogs with portacaval shunts. Initial ultrasonography revealed a small hypovascular liver in all dogs. Eight portacaval shunts (4 intrahepatic, 4 extrahepatic) were detected. Supplementary ultrasonography of dogs under general anesthesia and subjected to positive pressure ventilation identified 6 additional intrahepatic portacaval shunts. PMID- 3308797 TI - Cutaneous vasculitis in horses: 19 cases (1978-1985). AB - The medical records of 19 horses with cutaneous vasculitis were reviewed. Most (73.7%) affected horses were between 3 and 10 years old, and there were significantly more mares (14) than stallions or geldings (5) (P less than 0.01). Subcutaneous edema of the limbs, body, and/or head was the predominant clinical sign (18/19 horses; 94.7%). The single most prevalent laboratory abnormality was neutrophilia (greater than 7,000 neutrophils/microliter), which was detected in 10 horses (52.6%). Leukocytoclastic vasculitis was evident in skin biopsy specimens from 12 of 14 horses (85.7%). All horses were treated with corticosteroids and supportive care, and the overall survival rate was 63.1% (12/19). The mean duration of treatment with corticosteroids in surviving horses was 14 (+/- 5.3) days. Of the 7 horses that died, 5 failed to respond to treatment (4 were euthanatized, 1 died), and 2 others had persistent debilitating sequelae (euthanatized). The only significant clinical or laboratory abnormality predictive of poor prognosis was fever (odds ratio, 17.81; P less than 0.05). Seven horses had history of, or were exposed to horses with, abscessed peripheral lymph nodes and likely were suffering from equine purpura hemorrhagica. In spite of histopathologic evidence of hypersensitivity-vasculitis and/or the clinical suspicion that the cause for vasculitis was immune mediated, 7 of 19 horses (36.8%) had no history of bacterial or viral infection nor a history of current drug administration. PMID- 3308798 TI - Immunohistochemistry of secretory proteins in the bull seminal vesicle. AB - Antibodies against several proteins isolated from bovine seminal fluid (ribonucleases, bull seminal proteinase inhibitor BUSI II, seminal antimicrobial protein SAP) were used to identify the secretion sites of the respective proteins within the genital tract of the bull. Consistent positive immunoreactions were achieved with most of the antisera in the seminal vesicle epithelium, while only weak or dispersed immunoreactions were found in the epididymis, ductus deferens or the prostate. Comparison of serial sections of bull seminal vesicle stained with different antisera gave incongruous distribution patterns of positively reacting cells. This was interpreted as a sign of either a differential secretion cycle for different proteins in these cells or, more likely, a fixation or processing artifact. There was no clear cut evidence for secretion of seminal antimicrobial protein by seminal vesicle epithelium, but rather a resorption of intraluminally concentrated SAP. The secretion site of this important protein remains obscure, unless cRNA probes for in situ hybridisation studies are available. PMID- 3308800 TI - The evolution and growth of the Anatomical Society of Great Britain and Ireland, 1887-1987. PMID- 3308799 TI - Age-related changes in the role of matrix vesicles in the mandibular condylar cartilage. AB - A combined approach of light microscopy, immunofluorescence, transmission electron microscopy and electron energy loss spectroscopy (EELS) was used to study age-related changes in the condylar cartilage in mice. Chondrocalcin, a cartilage matrix calcium-binding protein, was demonstrated by indirect immunofluorescence microscopy using monospecific antibodies. In one week old animals the most intense staining was observed in the matrix around the hypertrophic cells in the mineralising zone, to a lesser degree around the cells in the zone of chondroblasts, while no staining was noted in the zone of chondroprogenitor cells and in the matrix around the early hypertrophic cells. In the mineralisation zone the distribution of chondrocalcin correlated with that of mineral deposits as revealed by the von Kossa stain. The matrix between the early hypertrophic cells as shown by transmission electron microscopy revealed the presence of matrix vesicles and demonstrated a gradual accumulation of hydroxyapatite in the mineralising zone. In one month old animals chondrocalcin localisation was mainly confined to the lower hypertrophic zone which also demonstrated positive von Kossa staining was seen along the articular surface. In older animals multiple electron-dense structure that resembled matrix vesicles were observed in the non-mineralising portions of the condylar cartilage. Use of the EELS method confirmed the almost complete lack of calcium ions in these structures. In contrast, with the use of the same method, detectable amounts of calcium were recorded in vesicles in the mineralising zones of all age groups. Hence what appear ultrastructurally as structures similar to matrix vesicles represent atypical vesicles that might characterise an ageing and degenerative articular cartilage and are not necessarily associated with the mineralisation process. PMID- 3308802 TI - Isolation and culture of auditory cells from the goldfish (Carassius auratus). AB - Large numbers of hair cells and VIIIth nerve ganglion cells are obtained from the inner ears of adult goldfish by a combination of enzymatic and mechanical dissociation. Centrifugation of the dissociated tissue through a discontinuous density gradient produces one fraction enriched in hair cells and another enriched in nerve cells. The fraction of cells enriched in neurons can be put into cell culture and kept for a period of weeks. During that period, the neurons send out processes that can extend for millimeters. The morphology of these cultured neurons is similar to that of the goldfish auditory neurons in histological material. PMID- 3308801 TI - Further characterisation of the extracellular matrix in the mandibular condyle in neonatal mice. AB - This study provides newer information concerning the extracellular matrix of neonatal condylar cartilage--a genuine representative of a secondary type of cartilage. In addition, the data presented hereby indicate that the condylar cartilage contains a population of progenitor cells that synthesise Type I collagen rather than Type II. Under normal conditions in vivo local biomechanical factors influence the progenitor cells to differentiate into cartilage cells and thereby to shift their synthetic pathway from Type I collagen to Type II collagen -the typical collagen of cartilage extracellular matrix. In the absence of such biomechanical effects the condylar progenitor cells seem to proceed with their inherent differentiation pathway and express an osteogenic phenotype (Fig. 21). PMID- 3308803 TI - Presumptive diagnosis of pulmonary nocardiosis: value of sputum microscopy. AB - Three hundred samples of sputum from patients suffering from various forms of pulmonary disorders were homogenized by pancreatic digestion, examined microscopically and cultured on brain heart infusion agar, trypticase soy agar, in brain heart infusion broth, trypticase soy broth and McClung's carbon-free broth. Several elements of varying morphological forms, believed to be from aerobic actinomycetes or nocardias, were observed in 16 cases. Six strains of Nocardia asteroides, one N. brasiliensis, eight of Rhodococcus species and one Micromonospora were isolated and studied at various stages of growth. Several nocardial and rhodococcal elements closely resembling those observed in the Gram stained sputa were found. It is suggested that some of those in the sputum were from nocardias and that their appearance in sputum, as seen from the Gram-stained slide, when combined with clinical symptoms can serve for a presumptive diagnosis of pulmonary nocardiosis pending a more definitive identification by a specialized laboratory. PMID- 3308804 TI - On the statistical evaluation of adherence assays. AB - Parametric (unpaired t-test) and non-parametric (Mann-Whitney U-test) methods have been used in the evaluation of adherence assays on the non-antibiotic antimicrobial agent, Taurolin. In all but one case, where the anti-adherence effect was known to be marginal, both statistical methods gave similar results although there were some minor differences in the levels of significance achieved. The effect of the agent on the deviation of adherence data from normality was quantified by calculation of the skewness coefficient for each data set. A significant anti-adherence effect appears to result in a decrease in the skewness of the adherence assay data. It was concluded that either parametric or non-parametric statistical evaluation of adherence assay data is valid for large numbers of observations. In future studies of this type it is suggested that attention should also be given to the effect of the anti-adherence agent on the deviation of adherence data from normality as denoted by the skewness coefficient. PMID- 3308805 TI - Factors influencing deactivation of yeast cells exposed to ethanol. AB - The lyotropic series discovered in 1888 by Hofmeister describes the effect of solutes on the structure and physical chemistry of the aqueous phase. Chaotropic members of the lyotropic series destructure the aqueous phase while antichaotropic solutes act to enhance the structuredness of the aqueous phase. This alteration of the aqueous phase affects the physical structure or physicochemical state of any other phase exposed to the aqueous phase, such as the plasma membrane of any cell. Solute lyotropy is therefore, via its ability to alter the physicochemical state of the plasma membrane, able to modify the processes of yeast cell deactivation (i.e. the processes leading to loss of ability to replicate and to eventual cell death) in the presence of toxic solutes such as ethanol. In this study the effect of a variety of salts and non-ionic solutes upon cell deactivation in the presence of 16% w/v ethanol is explained in terms of the lyotropic series. Chaotropic salts protect against ethanol-induced deactivation and antichaotropic salts enhance the rate of this process. It is proposed that the mechanism by which chaotropic solutes exert their protective effect involves a reduction in the activity coefficient of the ethanol, thereby reducing the concentration of ethanol within the plasma membrane. PMID- 3308806 TI - The isolation of salmonellas and campylobacters. PMID- 3308807 TI - Head-down tilt and restraint on renal function and glomerular dynamics in the rat. AB - A model utilizing 25 degree head-down tilt (HDT) and incorporated with chronic catheterization and renal micropuncture techniques in rats was employed to study alterations in renal function induced by HDT. Renal function and extracellular volume measurements were performed after 24 h, 4 days, and 7 days of HDT in conscious rats and compared with their own control measurements and to nontilted but similarly restrained rats. After 24 h HDT, glomerular filtration rate (GFR) increased 19 +/- 8% and renal plasma flow (RPF) increased 18 +/- 8% with increases in urine flow rate, Na+, and K+ excretion in conscious rats. These increases after 24 h were associated with an increase in extracellular volume of 16 +/- 3% (P less than 0.01). In the nontilted controls, there was a decrease in extracellular volume after 24 h of suspension. After 7 days of HDT, GFR was decreased by 7 +/- 1% (P less than 0.01), but RPF and extracellular fluid volume were not different from control values. However, RPF and GFR increased in the nontilted rats after 7 days. After 7 days of HDT renal micropuncture studies demonstrated that single-nephron filtration rate was also decreased from 43 +/- 2 to 31 +/- 3 nl/min (P less than 0.05) due solely to reductions in the glomerular ultrafiltration coefficient (0.11 +/- 0.01 to 0.07 +/- 0.01 nl.s-1 X mmHg-1, P less than 0.05). There was a dissociation between GFR and water and Na+ excretion at days 4 and 7 of HDT not observed in the nontilt restraint controls. PMID- 3308808 TI - Circulating vasoactive substances and hemodynamic adjustments at birth in lambs. AB - Circulating vasoactive substances and hemodynamics were examined in chronically instrumented unanesthetized lambs before, during, and after cesarean section (spontaneous respiration). One of three infusions were started 20 min before birth: saline control (n = 10), saralasin (n = 5), or captopril (n = 6). Control lambs exhibited peak (means +/- SE) increases above fetal base line at 5 min after birth in plasma renin activity (5.0 +/- 1.1 to 11.0 +/- 3.4 ng.ml-1.h-1), angiotensin II (ANG II, 37 +/- 6 to 141 +/- 45 pg/ml) and total catecholamines (318 +/- 35 to 3,821 +/- 580 pg/ml). Mean systemic arterial pressure (Psa) and arterial O2 partial pressure (PaO2) increased more rapidly and to a greater extent by 1 h after birth in control lambs (Psa, 65 +/- 1 Torr; PaO2, 45 +/- 3 Torr) compared with the captopril group (Psa, 53 +/- 2 Torr; PaO2, 31 +/- 4 Torr) and the saralasin group (Psa, 56 +/- 2 Torr; PaO2, 27 +/- 3 Torr). Intravenous infusions of ANG II in control lambs, 2 h after birth resulted in a preferential systemic vs. pulmonary pressor response. The results demonstrate that at birth ANG II formation fosters the postnatal rise in Psa and PaO2, and high levels of circulating catecholamines may support postnatal cardiac output and Psa. PMID- 3308809 TI - Altitude acclimatization attenuates plasma ammonia accumulation during submaximal exercise. AB - This study examined the effects of acclimatization to 4,300 m altitude on changes in plasma ammonia concentrations with 30 min of submaximal [75% maximal O2 uptake (VO2max)] cycle exercise. Human test subjects were divided into a sedentary (n = 6) and active group (n = 5). Maximal uptake (VO2max) was determined at sea level and at high altitude (HA; 4,300 m) after acute (t less than 24 h) and chronic (t = 13 days) exposure. The VO2max of both groups decreased 32% with acute HA when compared with sea level. In the sedentary group, VO2max decreased an additional 16% after 13 days of continuous residence at 4,300 m, whereas VO2max in the active group showed no further change. In both sedentary and active subjects, plasma ammonia concentrations were increased (P less than 0.05) over resting levels immediately after submaximal exercise at sea level as well as during acute HA exposure. With chronic HA exposure, the active group showed no increase in plasma ammonia immediately after submaximal exercise, whereas the postexercise ammonia in the sedentary group was elevated but to a lesser extent than at sea level or with acute HA exposure. Thus postexercise plasma ammonia concentration was decreased with altitude acclimatization when compared with ammonia concentrations following exercise performed at the same relative intensity at sea level or acute HA. This decrease in ammonia accumulation may contribute to enhanced endurance performance and altered substrate utilization with exercise following acclimatization to altitude. PMID- 3308810 TI - Pulmonary arterial transit times. AB - To begin to characterize the pulmonary arterial transport function we rapidly injected a bolus containing a radiopaque dye and a fluorescence dye into the right atrium of anesthetized dogs. The concentrations of the dye indicators were measured in the main pulmonary artery (fluoroscopically) and in a subpleural pulmonary arteriole (by fluorescence microscopy). The resulting concentration vs. time curves were subjected to numerical deconvolution and moment analysis to determine how the bolus was dispersed as it traveled through the arteriole stream tube from the main pulmonary artery to the arteriole. The mean transit time and standard deviation of the transport function from the main pulmonary artery to the arterioles studied averaged 1.94 and 1.23 s, respectively, and the relative dispersion (ratio of standard deviation to mean transit time) was approximately 64%. This relative dispersion is at least as large as those reported for the whole dog lung, indicating that relative to their respective mean transit times the dispersion upstream from the arterioles is comparable to that taking place in capillaries and/or veins. The standard deviations of the transport functions were proportional to their mean transit times. Thus the relative dispersion from the main pulmonary artery to the various arterioles studied was fairly consistent. However, there were variations in mean transit time even between closely adjacent arterioles, suggesting that variations in mean transit times between arteriole stream tubes also contribute to the dispersion in the pulmonary arterial tree. PMID- 3308811 TI - Alveolar vessel behavior in the zone 2 lung inferred from indicator-dilution data. AB - To gain insight into the changes occurring in alveolar vessels when alveolar pressure exceeds venous pressure at the downstream end of the alveolar vessels (zone 2), we compared the uptake of serotonin and the extravascular volume accessible to 3HOH (Qev) under zone 2 and 3 conditions in isolated dog lung lobes. We also examined the influence of occluding some of the small pulmonary arteries with 58- to 548-micron-diam beads on the serotonin uptake and Qev. We found that, with the bead embolization, both the serotonin uptake and the Qev were reduced, whereas the change from zone 3 to 2 reduced serotonin uptake but did not change Qev. A plausible explanation for these observations is that the beads occluded vessels that were relatively large compared with those in which significant transvascular 3HOH exchange and serotonin uptake take place. Perfusion ceased in the collection of capillaries normally served by the obstructed arteries. Thus the extravascular water and the serotonin uptake sites downstream from the obstructions were not accessible to the indicators during the short time interval of the indicator passage through the lung. On the other hand, the change from zone 3 to zone 2 resulted in the collapse of small individual capillary segments within the alveolar vessel bed. Since the serotonin does not readily diffuse from the vessels through the tissue, it could not reach the endothelial cells of the collapsed capillaries. However, since the distances for diffusion between collapsed capillaries and neighboring perfused capillaries were small, the more highly diffusible 3HOH had access to the same Qev under both zone 2 and 3 conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308812 TI - In vivo functional antagonism between isoproterenol and bronchoconstrictants in the dog. AB - The functional antagonism between isoproterenol and methacholine, histamine and serotonin, as described in vitro in respiratory smooth muscle was explored in vivo in a canine model. Infusions of isoproterenol were administered during brief peaks of bronchospasm produced by aerosolized methacholine and histamine, or during sustained bronchospasm produced by infused serotonin. In eight mongrel dogs anesthetized with pentobarbital sodium, the mean protection by infused isoproterenol against methacholine challenge decreased from 60.6 to 29.1% as the mean lung resistance (RL) was increased from 78 to 232% over base line by a fourfold increase in methacholine (P less than 0.002). In six dogs, the mean protection by isoproterenol against histamine decreased from 55.5 to 26.9% as the opposing RL increased from 80 to 182% over base line with a fourfold increase in histamine (P less than 0.02). However, with serotonin infusions there was only a small 18% mean decrease in protection (P = 0.05), associated with a correspondingly small 37% mean increase in dose of serotonin despite a 269% mean increase in resistance (P = 0.02). In all cases, the loss of protection correlated more closely with the dose of constrictant than the resistance increase over base line. These findings demonstrate in vivo functional antagonism between isoproterenol and the dose of bronchoconstrictant but not necessarily resistance increase per se. PMID- 3308813 TI - Effects of endotoxemia on pulmonary vascular resistances in unanesthetized sheep. AB - Ten experiments were conducted on nine sheep to determine the effects of endotoxemia (1.0 microgram/kg iv over 15 min) on the vascular resistances of two segments of the pulmonary circulation. The first segment (S1) was from the main pulmonary artery to the site in the pulmonary veins corresponding to the pressure measured with a deflated and wedged 7-Fr Swan-Ganz catheter. The second segment (S2) was from the wedge pressure measurement site to the left atrium. Endotoxemia caused both pulmonary arterial pressure and pulmonary arterial wedge pressure to increase significantly during early (phase 1) and late (phase 2) periods of response; left atrial pressure was significantly decreased during both phases. Normalized cardiac output decreased significantly at 35 and 180 min but not at 240 min after starting endotoxin infusion. The calculated resistance of S1 significantly increased from a base-line value of 3.03 +/- 0.31 (cmH2O.1-1.min) to 7.60 +/- 0.71, 6.34 +/- 1.22, and 6.66 +/- 1.35 at 35, 180, and 240 min, respectively. Calculated resistance of S2 was 1.32 +/- 0.14 at base line and increased significantly to 11.43 +/- 1.66 at 35 min, 4.45 +/- 0.47 at 180 min, and 3.32 +/- 0.61 at 240 min. The calculated percent of total pulmonary resistance in S2 increased significantly from approximately 31 to 59% during phase 1 and remained significantly increased at 41% from 90 to 180 min after endotoxin. Hematocrit increased by 40% at 35 min, whereas plasma total protein concentration increased by only 8% at 35 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308814 TI - Effect of hormonal and substrate backgrounds on cell membrane function in normal males. AB - Hormonal and substrate influences on in vivo cellular membrane function were evaluated in 15 healthy male volunteers. Each subject underwent serial evaluations of membrane function in the anterior tibialis muscle, as assessed by transcutaneous measurement of resting membrane potential (Em). Group A subjects (n = 9) underwent measurement of resting Em in the basal state and again during the 10th day of intravenous feeding (IVF). Group B subjects (n = 6) underwent measurement of resting Em in the basal state during epinephrine infusion and again during epinephrine infusion on the 7th day of IVF. Percutaneous needle biopsy of the vastus lateralis muscle permitted calculation of transmembrane electrolyte distribution from the Nernst equation, using the measured Em and the chloride space method. Hospitalization with intake of a defined-formula enteral diet for 3 days resulted in depolarization (P less than 0.05) of resting Em ( 75.3 +/- 1.6 mV) compared with normal (-79.8 +/- 0.9 mV). Despite 10 days of subsequent IVF, further depolarization (P less than 0.05) of resting Em (-71.2 +/ 1.2 mV) was observed. In the dual presence of IVF and exogenous epinephrine infusion, there was an increase (P less than 0.05) in intracellular potassium concentration and repolarization of resting Em (-80.6 +/- 0.8 mV) to normal levels. These data indicate that hormonal background and substrate availability contribute to the in vivo modulation of cellular membrane function in human skeletal muscle, possibly through facilitation of sodium-dependent amino acid transport across the cell membrane. PMID- 3308815 TI - Pulmonary lymphatic clearance of 99mTc-DTPA from air spaces during lung inflation and lung injury. AB - A total of 22 sheep with lymphatic cannulas were used to determine if 99mTc labeled diethylenetriaminepentaacetic acid (DTPA) clears directly from the air spaces of the lungs into the lymph vessels. Each sheep was anesthetized and ventilated with an aerosol of the DTPA for 2-5 min, and the DTPA activities in the lymph and plasma were measured every 15 min for 2 h. After the first 45 min, the average ratio of the DTPA in the lymph to that in the plasma (L/P) was 1.03 +/- 0.06 (SD) in the six control experiments and 1.11 +/- 0.05 in the six experiments in which the lungs were inflated with a positive end-expired pressure of 10 cmH2O throughout the study. Direct movement of the DTPA from the air spaces into the lymph was not necessary to account for the DTPA clearance in these experiments because the L/P ratio was not significantly different from 1.0. Eight additional sheep received intravenous infusions of air at 0.2 ml.kg-1.min-1 for 2 h to induce lung injury before depositing the DTPA. In these sheep L/P was 1.53 +/- 0.28, which was significantly higher than the value measured in the control group (P less than 0.01). We considered the possibility that the increased L/P ratio in these sheep could be due to alterations in the distribution of the blood flow to the tissue, but the L/P ratio in four sheep whose distribution of blood flow was altered by inflation of a balloon in the right pulmonary artery was 1.05 +/- 0.10, the same as the control value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308816 TI - Effect of N-methyl-D-aspartate applied to the ventral surface of the medulla on the trachea. AB - Structures located near the ventral surface of the medulla (VMS) affect both cardiovascular tone and respiratory activity. In addition cooling the intermediate area of the VMS blocks the increases in parasympathetic activity and tracheal tone resulting from ventilation with hypercapnic or hypoxic gas mixtures, or due to stimulation of mechanoreceptors within the lung. Since cooling the surface of the VMS may affect fibers of passage as well as cell bodies, we performed studies in which pledgets containing N-methyl-D-aspartic acid (NMDA), a synthetic excitatory amino acid, were applied to intermediate area of the VMS. The studies were performed in chloralose-anesthetized, artificially ventilated cats. Application of pledgets containing NMDA (10(-7) mol at 10(-3) M) caused increases in tracheal pressure and the onset of phasic phrenic activity, but application of 10(-8) mol at 10(-4) M of NMDA could produce tracheal constriction without the appearance of phasic phrenic activity. Applying to the entire VMS either 2-amino-5-phosphonovalerate (2-APV, 10(-6) M), a specific antagonist to NMDA, or lidocaine (2%), a local anesthetic, 60 s before the application of pledgets containing NMDA, prevented the increase in tracheal tone and phasic phrenic activity. Intravenous administration of atropine methyl nitrate 0.5 mg/kg, a cholinergic antagonist, blocked tracheal responses to local application of pledgets containing NMDA but did not affect the increase in phasic phrenic nerve activity. These findings suggest that when stimulated, neurons near the surface of the VMS in the vicinity of the intermediate area increase the activity of parasympathetic fibers to the airway. PMID- 3308817 TI - Adrenal hormones enhance glycogenolysis in nonexercising muscle during exercise. AB - The purpose of this study was to investigate whether epinephrine exerts an effect on glycogen metabolism in nonexercising (Non-Ex) as well as in exercising (Ex) skeletal muscle. Rats ran (15 m/min; 8% grade) on their forelimbs while their hindlimbs (Non-Ex) were suspended above the treadmill. Electromyographic records confirmed the lack of significant contractile activity in muscles during suspension. Plasma epinephrine levels were manipulated in three experimental groups (n = 20 for each group): adrenalectomized (ADX), intact adrenals (IA), and IA + epinephrine injection (+Ep). Another group of rats performed normal exercise on all four limbs (15 m/min; 8% grade). Muscle glycogen levels were measured in selected hindlimb muscles at t = 0 and after 90 min exercise (15 m/min; 8% grade) or suspended rest. In the absence of epinephrine (ADX), no glycogen loss was found (P greater than 0.05) in Non-Ex muscles during the exercise period. In the IA group (epinephrine levels elevated sixfold above basal at t = 90 min), glycogen levels in the nonexercising soleus, plantaris, and red and white gastrocnemius were significantly (P less than 0.05) depleted to 62 +/- 6, 67 +/- 6, 58 +/- 5, and 67 +/- 9% of control values, respectively. Similar decrements occurred in these muscles when exercise was performed on all four limbs (P greater than 0.05). We conclude that glycogenolysis occurs in nonexercising skeletal muscle independent of contractile activity, probably due to the effect of epinephrine. Furthermore, the present data strongly suggest that glycogen depletion patterns in muscles during exercise cannot be used as an index of motor unit recruitment. PMID- 3308818 TI - Automated computation of relative flow resistance using a pulsed Doppler flowmeter. AB - Use of a pulsed Doppler flowmeter to assess changes in blood flow resistance often requires a laborious series of calculations, and full characterization of resistance changes frequently necessitates replotting of calculated data. To facilitate the interpretation of pulsed Doppler flowmetry data, a simple, inexpensive device was constructed that computes the signal ratio of mean arterial pressure (MAP) to directional pulsed Doppler outputs. With this device, relative flow resistance can be recorded and quantitatively assessed at a glance in three vascular beds in real time. This computer-like device was designed around the Burr-Brown DIV100HP integrated circuit. C741G OpAmps provide input buffering, zeroing, and ranging adjustments enabling the user to accurately follow resistance over a very broad range of changes without exceeding the device's operating limits. A LM339 quad comparator monitors the input of each DIV100 and indicates when operating limits are exceeded via a channel-specific LED indicator and an audible alarm. No significant attenuation of the input signals occurs over the range of direct current to 50 kHz, and the output is without significant phase shift. Comparisons with calculated changes in resistance derived from the MAP and pulsed Doppler flowmetry in unanesthetized, unrestrained rats confirmed that resistance changes can be measured with precision and accuracy. PMID- 3308820 TI - Hematologic manifestations of bacterial and fungal infections. AB - Bacterial and fungal infections have a varied and often profound effect on the cellular elements of the blood and the hemostatic system. These infections may increase or decrease numbers of circulating erythrocytes, leukocytes, and platelets or may induce qualitative changes in these elements, some of which affect their function. Bacterial and fungal infections may also produce thrombosis or hemorrhage. They exert these effects through mechanisms that involve specific microbial virulence factors or host defenses mobilized against the infectious agents. This article focuses on the diverse hematologic manifestations of bacterial and fungal infections in the context of these mechanistic considerations. PMID- 3308821 TI - Hematologic manifestations of gastrointestinal disease. AB - A diverse number of hematologic abnormalities may occur in association with gastrointestinal disease. For example, deficiencies of iron, folate, and vitamin B12 often accompany and may be the first clue to diseases such as colon cancer, celiac sprue, and chronic gastritis, respectively. A compilation of the hematologic disorders associated with diseases of the gastrointestinal tract, liver, and pancreas is provided. PMID- 3308819 TI - Stimulation of the caudal ventrolateral medulla decreases total lung resistance in dogs. AB - Although the role played by the caudal ventrolateral medulla in the regulation of the cardiovascular system has been extensively investigated, little is known about the role played by this area in the regulation of airway caliber. Therefore, in alpha-chloralose-anesthetized dogs, we used both electrical and chemical means to stimulate the caudal ventrolateral medulla while we monitored changes in total lung resistance breath by breath. We found that electrical stimulation (25 microA) of 26 sites in this area significantly decreased total lung resistance from 7.1 +/- 0.4 to 5.7 +/- 0.3 cmH2O.1-1.s (P less than 0.001). The bronchodilation evoked by electrical stimulation was unaffected by beta adrenergic blockade but was abolished by cholinergic blockade. In addition, chemical stimulation of seven sites in the caudal ventrolateral medulla with microinjections of DL-homocysteic acid (0.2 M; 66 nl), which stimulates cell bodies but not fibers of passage, also decreased total lung resistance from 8.3 +/- 1.1 to 6.5 +/- 0.8 cmH2O.l-1.s (P less than 0.01). In contrast, microinjections of DL-homocysteic acid into the nucleus ambiguus (n = 6) increased total lung resistance from 7.5 +/- 0.5 to 9.2 +/- 0.4 cmH2O.l-1.s (P less than 0.05). We conclude that the caudal ventrolateral medulla contains a pool of cell bodies whose excitation causes bronchodilation by withdrawing cholinergic input to airway smooth muscle. PMID- 3308822 TI - Hematologic abnormalities in patients with renal diseases. AB - Renal diseases are associated with a host of hematologic abnormalities affecting erythropoiesis, thrombopoiesis, platelet function, coagulation, fibrinolysis, and immune function. Many of the abnormalities described in acute or chronic renal failure appear to be directly related to accumulation of uremic toxins, particularly those in the middle molecular range and may respond to dialysis treatment. The recent availability of recombinant human erythropoietin facilitated the demonstration that anemia in renal failure is predominantly due to inadequate production of erythropoietin, and evolution in the management of anemia in these patients is now likely. Renal cell carcinoma is associated with a variety of unusual hematologic manifestations that may be confused with other diseases, but when recognized provide an early clue to the presence of a renal tumor and result in successful therapy. PMID- 3308823 TI - Hematologic abnormalities in patients with endocrine and metabolic disorders. AB - A wide variety of endocrine disorders can be associated with hematologic dysfunction. Usually the hematologic manifestations of endocrine disease are mild to moderate and self-limited. Correction of the endocrinopathy should result in clearing of the hematologic disturbance. Whereas it is prudent to recognize the impact of endocrinology on red cell, leukocyte, platelet, and coagulation physiology, serious hematologic disorders are usually not solely the result of endocrinopathies but are instead associated or coincident abnormalities. There are some situations (e.g., the coagulopathies associated with Cushing's syndrome, oral contraceptive use, or hypothyroidism) in which an appreciation of the attendant hematologic abnormalities may prompt preventative actions. PMID- 3308824 TI - Hematologic abnormalities in patients with nonhematologic malignancies. AB - Hematologic abnormalities are not uncommon in patients with nonhematologic malignancies and may contribute significantly to morbidity and even to mortality. An appreciation for the spectrum of severity and etiology will allow the physician to anticipate and perhaps ameliorate some of these complications. This understanding will also provide sufficient information to decide when intervention is unnecessary. PMID- 3308825 TI - Hematologic effects of acute and chronic alcohol abuse. AB - Alcoholism affects 3 to 10 per cent of the American population. Alcohol is toxic to all organ systems. This article summarizes current information about the hematologic sequelae of alcohol abuse. A brief summary of ethanol-related metabolic events is followed by discussion of specific disorders of erythrocytes, leukocytes, platelets, and the immune apparatus. PMID- 3308826 TI - Hematologic aspects of toxicology. AB - Exposure to a number of toxins may result in a variety of hematologic abnormalities. Derangements of the synthesis of cellular elements, a shortened red cell half life, abnormalities of coagulation, and interference in oxygen carrying capacity are some of the pathologic effects. Pharmacologic agents, heavy metals, and animal and insect venoms are among the toxins implicated in the production of hematologic abnormalities. This article focuses on some of these issues. PMID- 3308828 TI - Colocalization of laminin and fibronectin in bovine lens epithelial cells in vitro. AB - The distribution and organization of the extracellular matrix (ECM) proteins laminin, fibronectin, entactin, and type IV collagen were investigated in primary colonies and secondary cultures of bovine lens epithelial cells using species specific antisera and indirect immunofluorescence microscopy. Primary cell colonies fixed in formaldehyde and permeabilized with Triton X-100 displayed diffuse intracellular patterns for type IV collagen and entactin, observed to a similar degree throughout the colonies. In contrast, thick bundles of laminin and fibronectin were located on the basal cell surfaces and in between cells in the densely packed center of the colonies, and as "adhesive plaques" and fine extracellular matrix cords in the sparsely populated (migratory) outer edge of the colonies. The distribution of ECM proteins observed in secondary lens epithelial cell cultures was similar to that observed at the periphery of the primary colony. Extraction of the secondary cell cultures with sodium deoxycholate confirmed that laminin and fibronectin were deposited on the basal cell surface. Indeed, the patterns of laminin and fibronectin deposition suggested that these proteins codistribute. These results establish that lens epithelial cells in culture can be used as a model system to study the synthesis and extracellular deposition of the basement membrane proteins, laminin and fibronectin. PMID- 3308827 TI - Genetic predisposition to cancer with special reference to mutagen sensitivity. AB - From studies on cancer genetics, available information suggests the following tentative conclusions: 1. Cancer starts with a genetic change (or changes) from a normal somatic cell, but the changes (mutational events) must be specific in a target tissue cell. In a number of cases, genetic changes can be detected at the chromosome level. 2. Hereditary cancers usually have one genetic lesion already existing prezygotically; therefore only one additional mutational event is required in the homologous gene to complete the process of neoplastic transformation. In nonhereditary neoplasms, both mutations must occur postzygotically. 3. Individuals with high spontaneous mutation rates (monitored by chromosome breakage rates) are more liable to acquire specific genetic lesions than those with low mutation rates; therefore they are at higher risk to develop neoplasms. 4. Individuals with genetic defects in response to damage induced by mutagens (carcinogens) are more liable to accumulate genetic lesions than those who are more resistant; therefore, they are more liable to develop cancers. Mutagen sensitivity or resistance is probably genetic expression of DNA repair capabilities. 5. An effective assay method for sensitivity or resistance to mutagens can be developed to analyze the human population to identify the at-risk fraction. PMID- 3308829 TI - Effects of fenfluramine on autistic individuals residing in a state developmental center. AB - The effects of fenfluramine on 21 maladaptive behaviors in 20 autistic individuals were examined over a 9-month period utilizing a double-blind, cross over, placebo-controlled design. Raters carried out time-sampled observations in the school and residence. In addition, videotaped data were collected in controlled settings and assessed by the raters at the conclusion of the study. Some individuals displayed negative side effects such as tension, agitation, insomnia, and sweating during the 16-week period they received fenfluramine. The results demonstrated that fenfluramine caused no significant reductions in maladaptive behaviors. The lack of any significant positive results from this medication and the side effects observed strongly indicate the need for caution in the use of fenfluramine with autistic persons. PMID- 3308830 TI - Fragile-X syndrome: variability of phenotypic expression. PMID- 3308831 TI - Communicative intent: a framework for understanding social-communicative behavior in autism. PMID- 3308832 TI - Children in medieval Europe. PMID- 3308833 TI - Estimation of total and individual kidney GFR with 99m technetium DTPA. PMID- 3308834 TI - Cardiac evaluation of patients for non-cardiac surgery. PMID- 3308835 TI - Filarial chyluria: an immunological and renal function study. PMID- 3308836 TI - A trial of low dose steroid in renal transplantation. PMID- 3308837 TI - A randomised double blind cross over trial of atenolol and propranolol in mild to moderate hypertension. PMID- 3308838 TI - Renin profile in primary hypertension. PMID- 3308839 TI - [Inguinoscrotal pathology in newborn infants: role of ultrasonic tomography]. PMID- 3308840 TI - [Echography and epidemiology of hydatid cyst in children in Tunisia]. PMID- 3308841 TI - Pseudoaneurysm in a pancreatic pseudocyst: diagnostic modalities. PMID- 3308842 TI - Regulation of H2 oxidation activity and hydrogenase protein levels by H2, O2, and carbon substrates in Alcaligenes latus. AB - Regulation of H2 oxidation activity and hydrogenase protein levels in the free living hydrogen bacterium Alcaligenes latus was investigated. Hydrogenase activity was induced when heterotrophically grown cells were transferred to chemolithoautotrophic conditions, i.e., in the presence of H2 and absence of carbon sources, with NH4Cl as the N source. Under these conditions, H2 oxidation activity was detectable after 30 min of incubation and reached near-maximal levels by 12 h. The levels of hydrogenase protein, as measured by a Western blot (immunoblot) assay of the hydrogenase large subunit, increased in parallel with activity. This increase suggested that the increased H2 oxidation activity was due to de novo synthesis of hydrogenase protein. H2 oxidation activity was controlled over a surprisingly wide range of H2 concentrations, between 0.001 and 30% in the gas phase. H2 oxidation activity was induced to high levels between 2 and 12.5% O2, and above 12.5% O2, H2 oxidation activity was inhibited. Almost all organic carbon sources studied inhibited the expression of hydrogenase, although none repressed hydrogenase synthesis completely. In all cases examined, hydrogenase protein, as detected by Western blot, paralleled the level of H2 oxidation activity, suggesting that control of hydrogenase activity was mediated through changes in hydrogenase protein levels. PMID- 3308843 TI - Changes in the linking number of supercoiled DNA accompany growth transitions in Escherichia coli. AB - The supercoiling levels of plasmid DNA were determined from Escherichia coli which was grown in ways that are known to alter global patterns of gene expression and metabolism. Changes in DNA supercoiling were shown to occur during several types of these nutrient upshifts and downshifts. The most dramatic change in supercoiling was seen in starved cells, in which two populations of differentially relaxed plasmids were shown to coexist. Thus, some changes in the external nutritional environment that cause the cells to reorganize their global metabolism also cause accompanying changes in DNA supercoiling. Results of experiments with dinitrophenol suggested that the observed relaxations were probably not due to reduced pools of ATP. When rifampin was used to release supercoils restrained by RNA polymerase, the cellular topoisomerases responded by removing these new, unrestrained supercoils. We interpret these results as implying that the cellular topological machinery maintains a constant superhelical energy in the DNA except during certain growth transitions, when changes in metabolism and gene expression are accompanied by changes in DNA supercoiling. PMID- 3308845 TI - Role of DNA polymerase I in postreplication repair: a reexamination with Escherichia coli delta polA. AB - Using strains of Escherichia coli K-12 that are deleted for the polA gene, we have reexamined the role of DNA polymerase I (encoded by polA) in postreplication repair after UV irradiation. The polA deletion (in contrast to the polA1 mutation) made uvrA cells very sensitive to UV radiation; the UV radiation sensitivity of a uvrA delta polA strain was about the same as that of a uvrA recF strain, a strain known to be grossly deficient in postreplication repair. The delta polA mutation interacted synergistically with a recF mutation in UV radiation sensitization, suggesting that the polA gene functions in pathways of postreplication repair that are largely independent of the recF gene. When compared to a uvrA strain, a uvrA delta polA strain was deficient in the repair of DNA daughter strand gaps, but not as deficient as a uvrA recF strain. Introduction of the delta polA mutation into uvrA recF cells made them deficient in the repair of DNA double-strand breaks after UV irradiation. The UV radiation sensitivity of a uvrA polA546(Ts) strain (defective in the 5'----3' exonuclease of DNA polymerase I) determined at the restrictive temperature was very close to that of a uvrA delta polA strain. These results suggest a major role for the 5'-- -3' exonuclease activity of DNA polymerase I in postreplication repair, in the repair of both DNA daughter strand gaps and double-strand breaks. PMID- 3308844 TI - Expression, purification, and characterization of an exo-beta-D-fructosidase of Streptococcus mutans. AB - A genetic library of Streptococcus mutans GS-5, constructed in an Escherichia coli plasmid vector, was screened for cells which could utilize sucrose as the sole carbon and energy source. The recombinant plasmid pFRU1, containing a 4.2 kilobase pair insert of S. mutans DNA, was shown to confer this phenotype. Further characterization of the gene product encoded by pFRU1 revealed that the enzyme was a beta-D-fructosidase with the highest specificity for the beta (2--- 6)-linked fructan polymer levan. The enzyme could also hydrolyze inulin [beta (2- --1)-linked fructan], sucrose, and raffinose with 34, 21, and 12%, respectively, of the activity observed for levan. The gene (designated fruA) appeared to be expressed under its own control in E. coli, as judged by the lack of influence on gene product activity of induction or repression of the beta-galactosidase promoter adjacent to the insertion site on the cloning vector. The protein was purified to homogeneity, as judged by silver staining of purified protein in denaturing and reducing conditions in polyacrylamide gels, from sonic lysate of E. coli, as well as from culture supernatants of S. mutans GS-5 grown in a chemostat at low dilution rate with fructose as the sole carbohydrate source. Both purified proteins had an apparent molecular mass of 140,000 daltons in sodium dodecyl sulfate-polyacrylamide gel electrophoresis, were immunologically related and comigrated in sodium dodecyl sulfate-polyacrylamide gel electrophoresis as determined by Western blotting with antisera raised against the cloned gene product, and were identical in all physical and biochemical properties tested. The pH optimum of the enzyme acting on fructan polymers was 5.5, with a significant amount of activity remaining at pH 4.0. The optimum pH for sucrose degradation was broader and lower, with a peak at approximately 4.5. Enzyme activity was inhibited almost completely by Hg2+ and Ag2+, inhibited partially by Cu2+, not inhibited by fluoride ion or Tris, and slightly stimulated by Mn2+ and Co2+. Fructan polymers were attacked exohydrolytically by the enzyme, fructose being the only product released. With sufficient time, both levan and inulin were degraded to completion, with no evidence of product inhibition. PMID- 3308847 TI - Effects of genes exerting growth inhibition and plasmid stability on plasmid maintenance. AB - Plasmid stabilization mediated by the parA+ and parB+ genes of the R1 plasmid and the ccd+ and sop+ genes of the F plasmid was tested on a mini-R1 plasmid and a pBR322 plasmid derivative. The mini-R1 plasmid is thought to be unstably inherited owing to a low copy number and to random segregation of the plasmid at cell division, whereas cells harboring the pBR322 derivative used in this work are lost through competition with plasmid-free cells, mainly as a result of the shorter generation time of cells without plasmids. The pBR322 derivative carries a fusion between part of the atp operon of Escherichia coli and the bacteriophage lambda pR promoter, and the cI857 repressor gene. The insertion of sop+ from the F plasmid or parB+ from the R1 plasmid reduced the loss frequency by a factor of 10(3) for the pBR322 derivative and by at least a factor of 10(2) for the mini-R1 plasmid. Insertion of parA+ from the R1 plasmid decreased the loss frequency of the pBR322 derivative by a factor of 10 and that of the mini-R1 plasmid by a factor of 50. When ccd+ from the F plasmid was inserted, the loss frequency of the pBR322 derivative was decreased by a factor of 10, but it had only a marginal effect on the stability of the mini-R1 plasmid. In no case was any significant structural instability of the plasmids observed. PMID- 3308846 TI - Promoter region of the nar operon of Escherichia coli: nucleotide sequence and transcription initiation signals. AB - The nar operon, which encodes the three subunits of nitrate reductase in Escherichia coli, is fully induced under anaerobic conditions with nitrate. Two distinct regulatory domains have been delineated in the 5' region of the operon which respond respectively to positive induction by the fnr gene product under anaerobic conditions and to positive induction by the narL gene product in the presence of nitrate (S.F. Li, T. Rabi, and J.A. DeMoss, J. Bacteriol. 164:25-32). To characterize these two regulatory regions, we determined the DNA sequence for a 500-base-pair (bp) region extending upstream from the first structural gene of the nar operon. Analysis of subsequent subclones of the operon established that the 5' limit of the nar operon lies between 215 and 260 bp upstream from the translational start site of the first structural gene. The region required for induction by the fnr gene product is located within 160 bp from the translation start site, while the region responding to induction by nitrate extends an additional 100 bp upstream. Protein fusions of lacZ with the N-terminal sequence of the narG gene were constructed so that beta-galactosidase formation was under the control of the nar promoter and one or both regulatory domains. Analysis of strains bearing these fusion plasmids indicated that the expression of the hybrid proteins paralleled that of nitrate reductase by the parent plasmids, demonstrating that the regulatory signals did not extend significantly into the first structural gene. The transcriptional start site and the level of the transcription were determined by the S1 mapping procedure. One major transcript was identified which initiated -50 bp from the translational start site of the first structural gene. The synthesis of the transcript was repressed aerobically, was fully induced by nitrate anaerobically, and was greatly reduced in an Fnr- mutant. Possible regulatory sequences were identified in the 200-bp regulatory region extending upstream from the transcription start site. PMID- 3308848 TI - Involvement of a low-molecular-weight substance in in vitro activation of the molybdoenzyme respiratory nitrate reductase from a chlB mutant of Escherichia coli. AB - The soluble subcellular fraction of a chlB mutant contains an inactive precursor form of the molybdoenzyme nitrate reductase, which can be activated by the addition to the soluble fraction of protein FA, which is thought to be the active product of the chlB locus. Dialysis or desalting of the chlB soluble fraction leads to the loss of nitrate reductase activation, indicating that some low molecular-weight material is required for the activation. The protein FA dependent activation of nitrate reductase can be restored to the desalted chlB soluble fraction by the addition of a clarified extract obtained after heating the chlB soluble fraction at 100 degrees C for 8 min. The heat-stable substance present in this preparation has a molecular weight of approximately 1,000. This substance is distinct from the active molybdenum cofactor since its activity is unimpaired in heat-treated extracts prepared from the organism grown in the presence of tungstate, which leads to loss of cofactor activity. Mutations at the chlA or chlE locus, which are required for molybdenum cofactor biosynthesis, similarly do not affect the activity of the heat-treated extract in the in vitro activation process. Moreover, the active material can be separated from the molybdenum cofactor activity by gel filtration. None of the other known pleiotropic chlorate resistance loci (chlD, chlG) are required for the expression of its activity. Magnesium ATP appears to have a role in the formation of the active substance. We conclude that a low-molecular-weight substance, distinct from the active molybdenum cofactor, is required to bestow activity on the molybdoenzyme nitrate reductase during its biosynthesis. PMID- 3308849 TI - Signal sequence mutations that alter coupling of secretion and translation of an Escherichia coli outer membrane protein. AB - The lamB701-708 signal sequence mutation reduces expression of LamB, an outer membrane protein of Escherichia coli. To investigate the possibility that synthesis and export of LamB are coupled, as suggested by the expression defect of the lamB701-708 mutation, we isolated intragenic suppressors of the lamB701 708 mutation. The expression defect imposed by the lamB701-708 mutation is suppressed by an export-defective signal sequence mutation, suggesting that translation and export are coupled. The additional observation that not all export-defective signal sequence mutations suppressed the lamB701-708 expression defect suggests that translational arrest can be uncoupled from export. PMID- 3308850 TI - Purification and properties of formylglutamate amidohydrolase from Pseudomonas putida. AB - Formylglutamate amidohydrolase (FGase) catalyzes the terminal reaction in the five-step pathway for histidine utilization in Pseudomonas putida. By this action, N-formyl-L-glutamate (FG) is hydrolyzed to produce L-glutamate plus formate. Urocanate, the first product in the pathway, induced all five enzymes, but FG was able to induce FGase alone, although less efficiently than urocanate did. This induction by FG resulted in the formation of an FGase with electrophoretic mobility identical to that of the FGase induced by urocanate. A 9.6-kilobase-pair HindIII DNA fragment containing the P. putida FGase gene was cloned into the corresponding site on plasmid pBEU1 maintained in Escherichia coli. Insertion of the fragment in either orientation on the vector resulted in expression, but a higher level was noted in one direction, suggesting that the FGase gene can be expressed from either of two vector promoters with different efficiencies or from a single vector promoter in addition to a less efficient Pseudomonas promoter. FGase was purified 1,110-fold from the higher-expression clone in a yield of 10% through six steps. Divalent metal ions stimulated activity, and among those tested (Co, Fe, Zn, Ca, Ni, Cd, Mn, and Mg), Co(II) was the best activator, followed by Fe(II). FGase exhibited a Km of 14 mM for FG and a specific activity of 100 mumol/min per mg of protein in the presence of 5 mM substrate and 0.8 mM CoCl2 at 30 degrees C. The enzyme was maximally active in the range of pH 7 to 8. FGase was found to be a monomer of molecular weight 50,000. N-Acetyl-L-glutamate was not a substrate for the enzyme, but both it and N-formyl-L-aspartate were competitive inhibitors of formylglutamate hydrolysis, exhibiting Ki values of 6 and 9 mM, respectively. The absence of FGase activity as an integral part of histidine breakdown in most other organisms and the somewhat uncoordinated regulation of FGase synthesis with that of the other hut enzymes in Pseudomonas suggest that the gene encoding its synthesis may have evolved separately from the remaining hut genes. PMID- 3308851 TI - Molecular analysis of the regulatory region of the Escherichia coli K-12 tyrB gene. AB - The tyrB gene from Escherichia coli K-12 was cloned and sequenced, and the transcriptional start point of tyrB was determined by primer extension. By using a fusion plasmid in which the lacZ structural gene is transcribed from the tyrB promoter, it was shown that the expression of tyrB is controlled at the transcriptional level by the TyrR protein, with tyrosine as corepressor. The fusion plasmid was used to isolate mutants in which the repression of tyrB had been abolished. The tyrB promoter-operator region of these mutants was sequenced, and the tyrB operator was identified. A comparison between the tyrB operator and those of the other genes belonging to the tyrR regulon is presented. PMID- 3308852 TI - Transverse membrane topography of the B875 light-harvesting polypeptides of wild type Rhodobacter sphaeroides. AB - Purified B875 light-harvesting complex, chromatophores, and spheroplast-derived vesicles from wild-type Rhodobacter sphaeroides were treated with proteinase K or trypsin, and the alpha and beta polypeptides were analyzed by electrophoretic, immunochemical, and protein-sequencing methods. With the purified complex, proteinase K digested both polypeptides and completely eliminated the A875 peak. Trypsin digested the alpha polypeptide and reduced the A875 by 50%. Proteinase K cleaved the beta polypeptide of chromatophores and the alpha polypeptide of spheroplast-derived vesicles. Sequence analyses of polypeptides extracted from proteinase K-treated chromatophores revealed that the beta polypeptide was cleaved between amino acids 4 and 5 from the N terminus. The N terminus of the alpha polypeptide was intact. We concluded that the N terminus of the beta polypeptide is exposed on the cytoplasmic membrane surface, and the difference in the digestion patterns between the spheroplast-derived vesicles and chromatophores suggested that the C terminus of the alpha polypeptide is exposed on the periplasmic surface. PMID- 3308853 TI - Iron regulation of Shiga-like toxin expression in Escherichia coli is mediated by the fur locus. AB - Shiga-like toxin is an iron-regulated cytotoxin quite similar to Shiga toxin from Shigella dysenteriae 1. The structural genes for Shiga-like toxin in Escherichia coli (sltA and sltB) appear to be transcribed as an operon from a promoter upstream of sltA. We used a gene fusion between the promoter and proximal portion of sltA with the gene for bacterial alkaline phosphatase to assess the regulation of toxin expression. Growth in low-iron conditions resulted in a 13- to 16-fold increase in alkaline phosphatase activity. In the presence of a null mutation in the fur locus, however, alkaline phosphatase activity was constitutively high regardless of the iron concentration. These data indicate negative regulation of the slt operon by the fur gene product. We used deletion analysis of the region upstream of the gene fusion to localize the promoter of the slt operon and to show that a region of DNA between the -35 and -10 boxes is necessary for iron regulation of slt expression. In this region, there is a 21-base-pair dyad repeat that is homologous to similar dyads in the promoter regions of three other fur regulated genes. This region of dyad symmetry may represent an operator binding site for the Fur protein in the presence of iron. PMID- 3308854 TI - Membrane topography of anaerobic carbon monoxide oxidation in Rhodocyclus gelatinosus. AB - Rhodocyclus gelatinosus 1 grows anaerobically in the dark at the expense of carbon monoxide. Topographical studies with methyl viologen as the membrane probe indicated that CO oxidation and H2 production sites were on the cytoplasmic side of the cell membrane. Membrane-associated hydrogen gas production appeared to be a unidirectional reaction. In the dark, strain 1 whole cells oxidized CO and incorporated about 306 pmol of 32Pi into ATP per min per mg of protein. With CO as the sole energy-yielding substrate, cells grew with a low growth yield coefficient of 3.7 g (dry weight) of cells per mg of CO oxidized. PMID- 3308855 TI - Pheromone induction of agglutination in Saccharomyces cerevisiae a cells. AB - a-Agglutinin, the cell surface sexual agglutinin of yeast a cells, was assayed by its ability to bind its complementary agglutinin, alpha-agglutinin. The specific binding of 125I-alpha-agglutinin to a cells treated with the sex pheromone alpha factor was 2 to 2.5 times that of binding to a cells not treated with alpha factor. Competition with unlabeled alpha-agglutinin revealed that the increased binding was due to increased cell surface expression of a-agglutinin, with no apparent change in the binding constant. The increase in site number was similar to the increase in cellular agglutinability. Increased expression of a-agglutinin followed the same kinetics as the increase in cellular agglutinability, with a 10 min lag followed by a 15- to 20-min response time. Induction kinetics were similar in cells in phases G1 and G2 of the cell cycle. Maximal expression levels were similar in cells treated with excess pheromone and in cells exposed to pheromone after destruction of constitutively expressed a-agglutinin. PMID- 3308856 TI - recA gene of Escherichia coli complements defects in DNA repair and mutagenesis in Streptomyces fradiae JS6 (mcr-6). AB - Streptomyces fradiae JS6 (mcr-6) is a mutant which is defective in repair of DNA damage induced by a variety of chemical mutagens and UV light. JS6 is also defective in error-prone (mutagenic) DNA repair (J. Stonesifer and R. H. Baltz, Proc. Natl. Acad. Sci. USA 82:1180-1183, 1985). The recA gene of Escherichia coli, cloned in a bifunctional vector that replicates in E. coli and Streptomyces spp., complemented the mutation in S. fradiae JS6, indicating that E. coli and S. fradiae express similar SOS responses and that the mcr+ gene product of S. fradiae is functionally analogous to the protein encoded by the recA gene of E. coli. PMID- 3308857 TI - Mutations in the recD gene of Escherichia coli that raise the copy number of certain plasmids. AB - Chromosomal mutants were isolated in which, for several small plasmids, there was an increased amount of either covalently closed circular plasmid DNA or total plasmid DNA or both. The mutations were mapped to recD, which has been shown to affect exonuclease V activity and a variety of plasmid maintenance and replication functions. Our results suggest that rolling-circle plasmid replication can occur in recD mutants and that site-specific recombination can resolve the resulting linear multimers into covalently closed circular plasmid forms. PMID- 3308858 TI - Dimethylthetin can substitute for glycine betaine as an osmoprotectant molecule for Escherichia coli. AB - Glycine betaine is believed to be the most active naturally occurring osmoprotectant molecule for Escherichia coli and other bacteria. It is a dipolar ion possessing a quaternary ammonimum group and a carboxylic acid group. To examine the molecular requirements for osmoprotective activity, dimethylthetin was compared with glycine betaine. Dimethylthetin is identical to glycine betaine except for substitution of dimethyl sulfonium for the quaternary nitrogen group. Dimethylthetin was found to be about equally as effective as glycine betaine in permitting E. coli to grow in hypertonic NaCl, and both compounds were recovered almost completely from bacterial cells grown in the presence of hypertonic NaCl. 3-Dimethylsulfonioproprionate, an analog of dimethylthetin observed in marine algae, and 3-Dimethylsulfonio-2-methylproprionate were found to be less active. Dimethylthetin may prove useful as a molecular probe to study betaine metabolism and as a model for the development of antibacterial agents. PMID- 3308859 TI - Genetic separability of the chorismate mutase and prephenate dehydrogenase components of the Escherichia coli tyrA gene product. AB - Fragments of the tyrA gene of Escherichia coli, when suitably engineered, can express either the chorismate mutase activity or the prephenate dehydrogenase activity without the other. PMID- 3308860 TI - Spontaneous missense mutations in the rplX gene for ribosomal protein L24 from Escherichia coli. AB - Temperature-resistant pseudorevertants of the temperature-sensitive Escherichia coli mutant KNS19, harboring a mutation in rplX, the gene for ribosomal protein L24, were isolated, cloned, and sequenced. The codon GAC for the amino acid Asp in the temperature-sensitive mutant corresponding to position 84 in the protein chain mutated either back to the wild type (Gly) or to codons for the amino acids Tyr and Glu. Furthermore, rplX genes from two other mutants with an altered protein L24 were cloned and sequenced. The mutations were localized at position 56 (Gly to Asp) and at position 62 (Glu to Lys) in the rplX gene. The latter two mutants lacked a conditional lethal phenotype. The results suggest that the amino acid Gly at positions 56 and 84 in the protein might be involved in loop formations. PMID- 3308861 TI - A thermostable Gm-methylase recognizes the tertiary structure of tRNA. AB - The efficiency of methylation of tRNA by a thermostable tRNA(guanosine-2') methyltransferase (Gm-methylase) was examined at various temperatures using several species of tRNA isolated from Escherichia coli, yeast and Bacillus subtilis, each possessing different thermal properties. The optimal temperature for the methylation reaction was ca. 20 degrees C lower than the melting temperature of the tRNA in each case. Arrhenius plots of the methylation reactions with various tRNAs gave straight lines below the optimal temperatures in all cases, with similar activation energies of between 10 and 14 kcal/mol. Above the optimal temperatures, the methyl acceptor activity decreased as the incubation temperature was raised to 80 degrees C, at which point the methylase was still active. A correlation was observed between the remaining methyl acceptor activity and the hyperchromicity of tRNA. These results suggest that Gm methylase recognizes the tertiary structure of tRNA, and it is not the substrate tRNA but the enzyme which is activated by heat. PMID- 3308862 TI - Characterization of E. coli-derived recombinant human interferon-beta as compared with fibroblast human interferon-beta. AB - Homogeneous E. coli-derived recombinant human interferon-beta (E. coli-rHuIFN beta) was characterized in order to elucidate its physicochemical properties, as compared with those of fibroblast human interferon-beta (fibroblast HuIFN-beta). Purified E. coli-rHuIFN-beta and fibroblast HuIFN-beta exhibited a single band of Mr 19,000 and 23,000, respectively, on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The primary structure of E. coli-rHuIFN-beta was identical to the prediction from the cDNA sequence. Furthermore, both the circular dichroism (CD) spectra and the 1H nuclear magnetic resonance (NMR) spectra of E. coli-rHuIFN-beta and fibroblast HuIFN-beta at pH 6.8 were closely similar to each other. On the other hand, on reverse-phase high-performance liquid chromatography (HPLC) using a C18 column, the retention time of E. coli rHuIFN-beta was longer than that of fibroblast HuIFN-beta. Moreover, although the isoelectric point of E. coli-rHuIFN-beta was pH 8.9, purified fibroblast HuIFN beta exhibited multiple isoelectric points, probably due to heterogeneity of the carbohydrate moiety. These results indicate that the E. coli-rHuIFN-beta polypeptide folds similarly to fibroblast HuIFN-beta, and the carbohydrate moiety of natural HuIFN-beta has little influence on higher-order structure but does influence the hydrophobic and the electrostatic properties of the molecule. PMID- 3308863 TI - Direct expression of a synthetic somatomedin C gene in Escherichia coli by use of a two-cistron system. AB - Direct expression of a growth-promoting peptide hormone, somatomedin C/insulin like growth factor I, which is quite difficult due to the instability of somatomedin C itself in Escherichia coli, has been achieved by the use of a two cistron system. Assuming that basic somatomedin C might be stabilized by forming a complex with an acidic polypeptide, we constructed synthetic genes consisting of two cistrons; an acidic 93-amino-acid polypeptide was coded in the first cistron followed by a synthetic somatomedin C gene in the second cistron. The chain termination codon for the first polypeptide overlapped the initiation codon for the second polypeptide in the intercistronic region, as occurs in the polycistronic E. coli tryptophan operon, whose products are associated in multi subunit enzyme complexes. In the expression of the resulting genetic system, recombinant somatomedin C associated with the acidic polypeptide was accumulated to high levels in the cells. After treatment of the product with acetic acid to dissociate the two components, the recombinant somatomedin C was isolated in a yield of 4.0 mg from a liter of culture broth at A600 = 1.6. It was determined to be Met-somatomedin C by chymotryptic mapping as well as amino-terminal analysis. PMID- 3308864 TI - Purification and amino acid sequence of Kunitz-type protease inhibitor found in the hemocytes of horseshoe crab (Tachypleus tridentatus). AB - A low molecular weight protein protease inhibitor was purified from Japanese horseshoe crab (Tachypleus tridentatus) hemocytes. It consisted of a single polypeptide with a total of 61 amino acid residues. This protease inhibitor inhibited stoichiometrically the amidase activity of trypsin (Ki = 4.60 X 10(-10) M), and also had inhibitory effects on alpha-chymotrypsin (Ki = 5.54 X 10(-9) M), elastase (Ki = 7.20 X 10(-8) M), plasmin, and plasma kallikrein. However, it had no effect on T. tridentatus clotting enzyme and factor C, mammalian blood coagulation factors (activated protein C, factor Xa and alpha-thrombin), papain, and thermolysin. The complete amino acid sequence of this inhibitor was determined and its sequence was compared with those of bovine pancreatic trypsin inhibitor (BPTI) and other Kunitz-type inhibitors. It was found that the amino acid sequence of this inhibitor has a high homology of 47 and 43% with those of sea anemone inhibitor 5-II and BPTI, respectively. Thus, this protease inhibitor appeared to be one of the typical Kunitz-type protease inhibitors. PMID- 3308865 TI - Structural and functional studies of the amino terminus of yeast metallothionein. AB - Purified yeast copper-metallothionein lacks 8 amino-terminal residues that are predicted from the DNA sequence of its gene. The removed sequence is unusual for metallothionein in its high content of hydrophobic and aromatic residues and its similarity to mitochondrial leader sequences. To study the significance of this amino-terminal cleavage, several mutations were introduced into the metallothionein coding gene, CUP1. One mutant, which deletes amino acid residues 2-8, had a minor effect on the ability of the molecule to confer copper resistance to yeast but did not affect CUP1 gene regulation. A second mutation, which changes two amino acids adjacent to the cleavage site, blocked removal of the extension peptide but had no effect on copper detoxification or gene regulation. Immunofluorescence studies showed that both the wild-type and these two mutant proteins are predominantly cytoplasmic with no evidence for mitochondrial localization. The cleavage site mutation allowed isolation and structural characterization of a full length metallothionein polypeptide. The copper content and luminescent properties of this molecule were identical to those of the truncated wild-type protein indicating a homologous cluster structure. Moreover, the amino-terminal peptide was selectively removed by various endopeptidases and an exopeptidase suggesting that it does not participate in the tertiary fold. These results argue that the amino-terminal peptide is not required for either the structural integrity or biological function of yeast metallothionein. PMID- 3308866 TI - Tertiary structure of histidine-containing protein of the phosphoenolpyruvate:sugar phosphotransferase system of Escherichia coli. AB - The tertiary structure of the histidine-containing phosphocarrier protein (HPr) of the Escherichia coli phosphoenolpyruvate:sugar phosphotransferase system has been determined by x-ray diffraction at 2.8-A resolution. Initially, a partial structure was fitted to the multiple isomorphous replacement map and then least squares refined by the Konnert/Hendrickson restrained parameter method (Konnert, J. H., and Hendrickson, W. A. (1980) Acta Crystallogr. A36, 344-350) and finally, a subsequent map was computed by use of the phase combination method of Read (Read, R. J. (1986) Acta Crystallogr. A42, 140-149). More of the protein structure was located in the latter map. The procedure of model building, least squares refinement, and electron density map recalculation was repeated until the tertiary structure of HPr was obtained. The overall structure of HPr consists of four beta-strands, three helical regions, and four beta-turns. At the active center, the His15 imidazole interacts with one oxygen atom of the alpha-carboxyl C terminus of the polypeptide chain; the conserved Arg17 side chain interacts with the other oxygen atom of the alpha-carboxyl C terminus as well as with the side chain of Glu85. This is the first x-ray analysis of a protein of the phosphoenolpyruvate:sugar phosphotransferase system. Furthermore, this work represents a protein structure which has been solved by starting with a model that represented only one-third of the scattering matter. PMID- 3308867 TI - The conformation of T4 bacteriophage dihydrofolate reductase from circular dichroism. AB - The secondary and tertiary structure of T4 bacteriophage dihydrofolate reductase is investigated by vacuum ultraviolet circular dichroism (CD) spectroscopy and probability analysis of the primary amino acid sequence. The far ultraviolet CD spectrum of the enzyme in the range of 260-178 nm is analyzed by the generalized inverse and variable selection methods developed by our laboratory. Variable selection yields an average content of 26% alpha-helix, 21% antiparallel beta sheet, 10% parallel beta-sheet, 20% beta-turns, and 32% "other" structures within the T4 protein. The characteristic peaks of the CD spectrum indicate that the enzyme has a lot of antiparallel beta-sheet, which is typical of the alpha + beta tertiary class of globular proteins. The secondary structure of the protein is also analyzed by using four statistical methods on the amino acid sequence. Although the secondary structures predicted by each individual statistical method vary to a considerable extent, the fractions of each structure jointly predicted by a majority of the methods are in excellent agreement with our CD analysis. The alternating arrangement for some segments of alpha-helix and beta-sheet predicted from primary structure to be within the enzyme is characteristic of proteins containing parallel beta-sheet. This supports our conclusion that the protein contains both parallel and antiparallel beta-sheet structures, but finding both types of beta-sheet also means that the protein may have the variation on alpha/beta tertiary structure recently found in EcoRI endonuclease and thymidylate synthase. These observations, in conjunction with other physical properties of the T4 reductase, suggest that the enzyme perhaps shares an evolution in common with the dihydrofolate reductases derived from type I R plasmids rather than with the host-cell protein. PMID- 3308868 TI - Construction of a lethal mutation in the synthesis of the major acidic phospholipids of Escherichia coli. AB - In order to determine if the major acidic phospholipids of Escherichia coli are essential to the organism, we constructed a null allele (pgsA30) of the pgsA gene thus rendering the organism incapable of synthesizing phosphatidylglycerol or cardiolipin. In strains carrying the pgsA30 allele cell viability, synthesis of gene product and the ability to synthesize the two major acidic phospholipids were dependent on the presence of a functional copy of the pgsA gene carried on a plasmid which was temperature-sensitive for replication. Growth ceased at the temperature restrictive for plasmid replication when the acidic phospholipid content dropped to about 10% of wild type levels which is slightly higher than the level reported in cells carrying the pgsA3 allele in a genetic background derived from strain SD12; the latter cells, which are capable of synthesizing low levels of acidic phospholipids, were previously shown to have no abnormal growth phenotype (Miyazaki, C., Kuroda, M., Ohta, A., and Shibuya, I. (1985) Proc. Natl. Acad. Sci. U. S. A. 82, 7530-7534). The pgsA30 allele, unlike the pgsA3 allele, could not support growth in strain SD12. Neither allele could support growth in two other independently derived strains of E. coli. Therefore, there is a direct dependence of cell viability on a functional pgsA gene product. Strain SD12 appears to contain a suppressor which allows cells with a reduced capability to synthesize acidic phospholipid (pgsA3 allele) to grow, but cannot support growth in cells with a complete lack of synthetic capability (pgsA30 allele). PMID- 3308869 TI - A mutation that alters the nucleotide specificity of elongation factor Tu, a GTP regulatory protein. AB - A single amino acid substitution (Asp to Asn) at position 138 of Escherichia coli elongation factor Tu (EF-Tu) was introduced in the tufA gene clone by oligonucleotide site-directed mutagenesis. The mutated tufA gene was then expressed in maxicells. The properties of [35S]methionine-labeled mutant and wild type EF-Tu were compared by in vitro assays. The Asn-138 mutation greatly reduced the protein's affinity for GDP; however, this mutation dramatically increased the protein's affinity for xanthosine 5'-diphosphate. The mutant protein forms a stable complex with Phe-tRNA and xanthosine 5'-triphosphate, which binds to ribosomes, whereas it does not form a complex with Phe-tRNA and GTP (10 microM). These results suggest that in EF-Tu.nucleoside diphosphate complexes, amino acid residue 138 must interact with the substituent on C-2 of the purine ring. Thus, in wild type EF-Tu, Asp-138 would hydrogen bond to the 2-amino group of GDP, and in the mutant EF-Tu, Asn-138 would form an equivalent hydrogen bond with the 2 carbonyl group of xanthosine 5'-diphosphate. Aspartic acid 138 is conserved in the homologous sequences of all GTP regulatory proteins. This mutation would allow one to specifically alter the nucleotide specificity of other GTP regulatory proteins. PMID- 3308870 TI - Fluorescence resonance energy transfer studies on the proximity relationship between the intrinsic metal ion and substrate binding sites of Escherichia coli RNA polymerase. AB - DNA-dependent RNA polymerase from Escherichia coli contains 2 mol of zinc/mol of holoenzyme (alpha 2 beta beta' sigma) with one zinc each in the beta and beta' subunits. A new method to substitute selectively the zinc in the beta subunit was developed by the inactivation of RNA polymerase with 0.25 M NaNO3, 1 M NaCl, 1 mM diaminocyclohexane tetraacetic acid, and 0.1 mM dithiothreitol followed by reconstitution with Co(II), Cd(II), or Cu(II). The hybrid Co-Zn, Cd-Zn, or Cu-Zn RNA polymerase thus obtained retains, respectively, 91, 88, and 50% enzyme activity of the reconstituted Zn-Zn RNA polymerase. Co-Zn RNA polymerase exhibits absorption maxima at 395 and 465 nm, and Cu-Zn RNA polymerase at 637 nm (epsilon = 815 M-1 cm-1). 1-Aminonaphthalene-5-sulfonic acid (AmNS) derivatives of ATP, UTP, and dinucleoside monophosphates (diNMPs), UpA or ApU, were synthesized with AmNS attached to NTP via a gamma-phosphoamidate bond or to diNMPs via a 5' secondary amine linkage. Since the fluorescence emission maxima of (5'-AmNS)UpA, (gamma-AmNS)ATP, and (gamma-AmNS)UTP at 445, 464, and 464 nm, respectively, when excited at 340 nm, overlap the 465-nm absorption band of Co-Zn RNA polymerase, the spatial relationship between fluorescence substrate analogs and the intrinsic Co(II) in Co-Zn RNA polymerase was studied by fluorescence resonance energy transfer technique. The fluorescence of the initiator, (5'-AmNS)UpA, and elongator, (gamma-AmNS)UTP, of the RNA chain, was quenched 20.3 and 7.1%, by the addition of saturation concentration of Zn-Zn RNA polymerase, and 21.3 and 14.7%, respectively, by the addition of template, poly(dA-dT). The fluorescence of (5' AmNS)UpA and (gamma-AmNS)UTP was quenched 81.8 and 80.6%, respectively, by the addition of the saturation concentration of Co-Zn RNA polymerase in the absence of template, and 82.7 and 82.9% in the presence of template. On the basis of respective Ro values of 21.3 and 21.9 A for the (5'-AmNS)UpA-Co and (gamma AmNS)UTP-Co pairs, the distances from Co(II) to the initiation site and to the elongation site were calculated to be 17.4 and 17.5 A, respectively, in the absence and 17.2 and 17.4 A in the presence of template. PMID- 3308871 TI - DNase I footprint of ABC excinuclease. AB - The incision and excision steps of nucleotide excision repair in Escherichia coli are mediated by ABC excinuclease, a multisubunit enzyme composed of three proteins, UvrA, UvrB, and UvrC. To determine the DNA contact sites and the binding affinity of ABC excinuclease for damaged DNA, it is necessary to engineer a DNA fragment uniquely modified at one nucleotide. We have recently reported the construction of a 40 base pair (bp) DNA fragment containing a psoralen adduct at a central TpA sequence (Van Houten, B., Gamper, H., Hearst, J. E., and Sancar, A. (1986a) J. Biol. Chem. 261, 14135-14141). Using similar methodology a 137-bp fragment containing a psoralen-thymine adduct was synthesized, and this substrate was used in DNase I-footprinting experiments with the subunits of ABC excinuclease. It was found that the UvrA subunit binds specifically to the psoralen modified 137-bp fragment with an apparent equilibrium constant of K8 = 0.7 - 1.5 X 10(8) M-1, while protecting a 33-bp region surrounding the DNA adduct. The equilibrium constant for the nonspecific binding of UvrA was Kns = 0.7 - 2.9 X 10(5) M-1 (bp). In the presence of the UvrB subunit, the binding affinity of UvrA for the damaged substrate increased to K8 = 1.2 - 6.7 X 10(8) M 1 while the footprint shrunk to 19 bp. In addition the binding of the UvrA and UvrB subunits to the damaged substrate caused the 11th phosphodiester bond 5' to the psoralen-modified thymine to become hypersensitive to DNase I cleavage. These observations provide evidence of an alteration in the DNA conformation which occurs during the formation of the ternary UvrA.UvrB.DNA complex. The addition of the UvrC subunit to the UvrA.UvrB.DNA complex resulted in incisions on both sides of the adduct but did not cause any detectable change in the footprint. Experiments with shorter psoralen-modified DNA fragments (20-40 bp) indicated that ABC excinuclease is capable of incising a DNA fragment extending either 3 or 1 bp beyond the normal 5' or 3' incision sites, respectively. These results suggest that the DNA beyond the incision sites, while contributing to ABC excinuclease-DNA complex formation, is not essential for cleavage to occur. PMID- 3308872 TI - Mechanism of damage recognition by Escherichia coli DNA photolyase. AB - Escherichia coli DNA photolyase binds to DNA containing pyrimidine dimers with high affinity and then breaks the cyclobutane ring joining the two pyrimidines of the dimer in a light- (300-500 nm) dependent reaction. In order to determine the structural features important for this level of specificity, we have constructed a 43 base pair (bp) long DNA substrate that contains a thymine dimer at a unique location and studied its interaction with photolyase. We find that the enzyme protects a 12-16-bp region around the dimer from DNase I digestion and only a 6 bp region from methidium propyl-EDTA-Fe (II) digestion. Chemical footprinting experiments reveal that photolyase contacts the phosphodiester bond immediately 5' and the 3 phosphodiester bonds immediately 3' to the dimer but not the phosphodiester bond between the two thymines that make up the dimer. Methylation protection and interference experiments indicate that the enzyme makes major groove contacts with the first base 5' and the second base 3' to the dimer. These data are consistent with photolyase binding in the major groove over a 4-6-bp region. However, major groove contacts cannot be of major significance in substrate recognition as the enzyme binds equally well to a thymine dimer in a 44 base long single strand DNA and protects a 10-nucleotide long region around the dimer from DNase I digestion. It is therefore concluded that the unique configuration of the phosphodiester backbone in the strand containing the pyrimidine dimer, as well as the cyclobutane ring of the dimer itself are the important structural determinants of the substrate for recognition by photolyase. PMID- 3308873 TI - Phosphorylation and modulation of the enzymic activity of native and protease cleaved purified hepatic 3-hydroxy-3-methylglutaryl-coenzyme A reductase by a calcium/calmodulin-dependent protein kinase. AB - A Ca2+/calmodulin-dependent kinase has been purified which catalyzed the phosphorylation and concomitant inactivation of both the microsomal native (100,000 Da) and protease-cleaved purified 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase) (53,000 Da) fragments. This low molecular weight brain cytosolic Ca2+/calmodulin-dependent kinase phosphorylates histone H1, synapsin I, and purified HMG-CoA reductase as major substrates. The kinase, purified by sequential chromatography on DEAE-cellulose, calmodulin affinity resin, and high performance liquid chromatography (TSKG 3000 SW) is an electrophoretically homogeneous protein of approximately 110,000 Da. The molecular weight of the holoenzyme, substrate specificity, subunit protein composition, subunit autophosphorylation, subunit isoelectric points, and subunit phosphopeptide analysis suggest that this kinase of Mr 110,000 may be different from other previously reported Ca2+/calmodulin-dependent kinases. Maximal phosphorylation by the low molecular form of Ca2+/calmodulin-dependent kinase of purified HMG-CoA reductase revealed a stoichiometry of approximately 0.5 mol of phosphate/mol of 53,000-Da enzyme. Dephosphorylation of phosphorylated and inactivated native and purified HMG-CoA reductase revealed a time-dependent loss of 32P-bound radioactivity and reactivation of enzyme activity. Based on the results reported here, we propose that HMG-CoA reductase activity may be modulated by yet another kinase system involving covalent phosphorylation. The elucidation of a Ca2+/calmodulin-dependent HMG-CoA reductase kinase-mediated modulation of HMG-CoA reductase activity involving reversible phosphorylation may provide new insights into the molecular mechanisms involved in the regulation of cholesterol biosynthesis. PMID- 3308874 TI - The internal signal sequence of Escherichia coli leader peptidase is necessary, but not sufficient, for its rapid membrane assembly. AB - Leader peptidase of Escherichia coli, a protein of 323 residues, has three hydrophobic domains. The first, residues 1-22, is the most apolar and is followed by a polar region (23-61) which faces the cytoplasm. The second hydrophobic domain (residues 62-76) spans the membrane. The third hydrophobic domain, which has a minimal apolar character, and the polar, carboxyl-terminal two-thirds of the protein are exposed to the periplasm. Deletion of either the amino terminus (residues 4-50) or the third hydrophobic region (residues 83-98) has almost no effect on the rate of leader peptidase membrane assembly, while the second hydrophobic domain is essential for insertion (Dalbey, R., and Wickner, W. (1987) Science 235, 783-787). To further define the roles of these domains, we have replaced the normal, cleaved leader sequence of pro-OmpA and M13 procoat with regions containing either the first or second apolar domain of leader peptidase. The second apolar domain supports the translocation of OmpA or coat protein across the plasma membrane, establishing its identity as an internal, uncleaved signal sequence. In addition to this sequence, we now find that leader peptidase needs either the amino-terminal domain or the third hydrophobic domain to permit its rapid membrane assembly. These results show that, although a signal sequence is necessary for rapid membrane assembly of leader peptidase, it is not sufficient. PMID- 3308875 TI - Probing the structure of gal operator-repressor complexes. Conformation change in DNA. AB - The gal operon is regulated by binding of Gal repressor to two operator loci, OE and OI, which are separated by 114 base pairs (bp). We have probed the actual operator DNA segments with and without Gal repressor occupation by characterizing the regions protected by repressor from DNase I digestion and dimethyl sulfate methylation. The segments which are protected from DNase I digestion in both OE and OI are about 22 bp long and seem to include 2-3 extra bp on either side of a 16-bp similar sequence containing an approximate dyad symmetry, with a consensus half-symmetry sequence GTG(G/T)AA-C. Repressor occupation hinders the reactivity of the consensus guanines in the four half-symmetry sequences, as shown by retardation of methylation at the N-7 positions by dimethyl sulfate owing to repressor binding. The protected guanines are symmetrically located. Since a dimeric Gal repressor affects symmetrically located bases, it is consistent with the notion that each half-operator is occupied by a repressor subunit. Because the N-7 positions of methylation of guanines lie in the major grooves and the protected guanines are located at positions 1, 3, 8 and the rotational 1', 3', and 8' in the 16-bp dyad symmetry, we suggest that Gal repressor establishes direct contacts with bases at 1, 3, 1', and 3' through two major grooves lying on one face of an operator helix and prevents reactivity of the guanines at 8 and 8' of a third major groove on the opposite face by changing the DNA helical structure at this position. Contacts at other positions are also discussed. PMID- 3308876 TI - Low binding capacity and altered O-linked glycosylation of low density lipoprotein receptor in a monensin-resistant mutant of Chinese hamster ovary cells. AB - We have studied function and structure of the low density lipoprotein (LDL) receptors in a monensin-resistant (Monr-31) mutant isolated from Chinese hamster ovary (CHO) cells. To assay the ability of the receptor to bind LDL, we employed three methods, 125I-LDL binding to the cells at 4 degrees C, 125I-LDL binding to the receptor-phospholipid complex (Schneider, W.J., Goldstein, J.L., and Brown, M.S. (1980) J. Biol. Chem. 255, 11442-11447), and ligand blotting (Daniel, T.O., Schneider, W.J., Goldstein, J.L., and Brown, M.S. (1983) J. Biol. Chem. 258, 4606 4611). The LDL receptor number was similar in both CHO and Monr-31, but the binding affinity was reduced in the mutant. The semi-quantitative immunoblotting assay with an antibody directed against the COOH-terminal 14 amino acids and the ligand-blotting assay with LDL also showed that the relative steady-state level of the receptor in Monr-31 was comparable to that in CHO, whereas the binding capacity of the receptor in Monr-31 was lower than that in CHO. The precursor and degradation forms of the LDL receptors produced in the mutant cells were similar in size to those in the parental cells, but the apparent molecular mass of the mature receptor protein in sodium dodecyl sulfate-polyacrylamide gels was reduced about 5000 daltons in the mutant. These results suggest a structural change at the NH2-terminal LDL binding domain. Tests of the effects of tunicamycin, endo alpha-N-acetylgalactosaminidase (O-glycanase), and sialidase (neuraminidase) on the molecular size of the mature receptors indicated that the reduced size of the receptor in the mutant cells resulted from altered oligosaccharide chain(s) linked to serine/threonine residues in the binding domain. We compared the molecular sizes and binding activity of human LDL receptors in several clones derived from CHO and Monr-31 cells which were transfected with human LDL receptor cDNA. The human LDL receptors produced in the transfected clones of Monr-31 were also smaller in molecular size and lower in binding capacity than those produced in the transfected clones of CHO. These results suggest that both structural and functional alteration of the LDL receptor of Monr-31 is not caused by a mutation in the structural gene of the LDL receptor but by altered processing or maturation of the receptor. The correlation of the decrease in molecular size and reduced binding capacity of the LDL receptor is discussed. PMID- 3308877 TI - Chlorophyll-proteins of the photosystem II antenna system. AB - The chlorophyll-protein complexes of purified maize photosystem II membranes were separated by a new mild gel electrophoresis system under conditions which maintained all of the major chlorophyll a/b-protein complex (LHCII) in the oligomeric form. This enabled the resolution of three chlorophyll a/b-proteins in the 26-31-kDa region which are normally obscured by monomeric LHCII. All chlorophyll a/b-proteins had unique polypeptide compositions and characteristic spectral properties. One of them (CP26) has not previously been described, and another (CP24) appeared to be identical to the connecting antenna of photosystem I (LHCI-680). Both CP24 and CP29 from maize had at least one epitope in common with the light-harvesting antennae of photosystem I, as shown by cross-reactivity with a monoclonal antibody raised against LHCI from barley thylakoids. A complex designated Chla.P2, which was capable of electron transport from diphenylcarbazide to 2,6-dichlorophenolindophenol, was isolated by nondenaturing gel electrophoresis. It lacked CP43, which therefore can be excluded as an essential component of the photosystem II reaction center core. Fractionation of octyl glucoside-solubilized photosystem II membranes in the presence and absence of Mg2+ enabled the isolation of the Chla . P2 complex and revealed the existence of a light-harvesting complex consisting of CP29, CP26, and CP24. This complex and the major light-harvesting system (LHCII) are postulated to transfer excitation energy independently to the photosystem II reaction center via CP43. PMID- 3308878 TI - Study of the kinetic and physical properties of the orotidine-5'-monophosphate decarboxylase domain from mouse UMP synthase produced in Saccharomyces cerevisiae. AB - In mammals, the bifunctional protein UMP synthase contains the final two enzymatic activities, orotate phosphoribosyltransferase and orotidine-5' monophosphate decarboxylase (ODCase), for de novo biosynthesis of UMP. The plasmid pMEJ contains a cDNA for the ODCase domain of mouse Ehrlich ascites UMP synthase. The cDNA from pMEJ was joined to the Saccharomyces cerevisiae iso-1 cytochrome c (CYC1) promoter and the first four CYC1 coding nucleotides in the plasmid pODCcyc. ODCase-deficient yeast cells (HF200x1) transformed with pODCcyc expressed an active ODCase domain with a specific activity of 20 nmol/min/mg in cell extracts. The expressed ODCase domain has a lower affinity for the substrate orotidine 5'-monophosphate and the inhibitor 6-azauridine 5'-monophosphate than intact UMP synthase or an ODCase domain isolated after proteolysis of homogenous UMP synthase. Sucrose density gradient sedimentation experiments showed that the expressed ODCase domain forms a dimer in the presence of ligands which bind at the catalytic site. These studies support the existence of an ODCase structural domain which contains the ODCase catalytic site and a dimerization surface of UMP synthase, but the domain may not have the regulatory site required to form the altered dimer form. PMID- 3308879 TI - Potentiation by glucose metabolites of inositol trisphosphate-induced calcium mobilization in permeabilized rat pancreatic islets. AB - Saponin-permeabilized rat pancreatic islets degraded exogenously added inositol 1,4,5-trisphosphate (IP3), and degradation was inhibited in the presence of either fructose 1,6-bisphosphate or diphosphoglycerate. The addition of either fructose-1,6-P2 or diphosphoglycerate to 45Ca2+-labeled permeabilized islets potentiated 45Ca2+ release caused by IP3 (by either exogenously added IP3 or IP3 generated endogenously in the presence of carbachol or guanosine 5'-3-O (thio)triphosphate (GTP gamma S). The effect of diphosphoglycerate and fructose 1,6-P2 on 45Ca2+ release correlated well with the effects of these agents on the recovery of radioactivity in IP3. These results further support our previous proposal that in pancreatic islets intracellular calcium mobilization may be sustained in part via the inhibition of IP3 degradation by metabolites produced during stimulation with insulinotropic concentrations of glucose (Rana, R.S., Sekar, M.C., Hokin, L.E., and MacDonald, M.J. (1986) J. Biol. Chem. 261, 5237 5240). PMID- 3308880 TI - The 0 degree C closed complexes between Escherichia coli RNA polymerase and two promoters, T7-A3 and lacUV5. AB - The promoter-specific binding of Escherichia coli RNA polymerase to the T7-A3 and the lacUV5 promoters at 0 degrees C was analyzed by DNase I footprinting. At 37 degrees C, the footprint from RNA polymerase bound to the A3 promoter is essentially the same as that reported by Galas, D.J., and Schmitz, A., (1978) Nucleic Acids Res. 5, 3157-3170 for the lacUV5 promoter. At 0 degrees C, the footprint for the A3 promoter is well defined but reduced in size. The principal difference between the 0 and 37 degrees C footprints is a region from -2 to +18 which is protected by polymerase at the higher but not at the lower temperature. In contrast, the 0 degree C footprint for the lacUV5 promoter differs substantially in character from the footprint for A3 at 0 degree C. The footprint is similar to the pattern of DNase I digestion of DNA bound to a surface; alternating regions of sensitive and protected DNA are spaced at intervals of about 10 base pairs. This region of DNase I-sensitive and -resistant DNA has the same boundaries as the 0 degree C footprint on T7-A3. Temperature shift experiments confirmed the sequence specificity of the RNA polymerase interaction with UV5 at 0 degree C. These results indicate that RNA polymerase binds specifically to each promoter sequence in a closed complex. The increased time and amounts of RNA polymerase required to form the 0 degree C footprint on the lacUV5 promoter indicate that it binds RNA polymerase more weakly than does the T7-A3 promoter. Therefore there is a correlation between the binding constant for closed complex formation estimated from kinetic measurements and the formation of the 0 degree C footprint. The -35 region of the promoter may be more important in establishing the 0 degree C footprint because the T7-A3 promoter is a better match to the consensus sequence. Conversely, the -10 region seems less important because lacUV5 is a perfect match to the consensus, whereas the T7-A3 promoter matches at only five out of seven positions. The 0 degree C footprints encompass both regions along with the spacer; the combination of these regions rather than an individual region may determine the character of the footprint and the magnitude of the binding constant. PMID- 3308882 TI - Electrostatic and hydrophobic interactions of the intermediate filament protein vimentin and its amino terminus with lipid bilayers. AB - Immunofluorescence and electron microscopical studies on the intracellular distribution of intermediate filaments (IFs) have demonstrated a close proximity of these cytoskeletal structures to cellular membranes. Moreover, nonepithelial IF (protein)s have been shown to exhibit high affinities for lipids, especially for negatively charged and nonpolar lipids. Here, using hydrophobic labeling with the photoactivatable phosphatidylcholine analogue [3H]1-palmitoyl-2-[11-[4 (trifluoromethyldiazirinyl]undecanoyl+ ++]-sn- glycero-3-phosphorylcholine or with 1-azidopyrene at low and physiological ionic strength, it is demonstrated that the IF subunit protein vimentin can interact with the hydrophobic core of lipid bilayers, in addition to strong ionic relationships between both reactants. Whereas the presence of acidic phospholipids in the lipid vesicles was absolutely essential for efficient vimentin labeling, cholesterol played a synergistic role in this reaction. Proteolytic degradation of photolabeled vimentin localized the derivatization exclusively to the non-alpha-helical, highly positively charged N terminal domain of the filament protein. Furthermore, circular dichroism studies performed on the isolated N terminus of vimentin revealed a significant increase in the alpha-helical content of the polypeptide upon its interaction with vesicles containing negatively charged phospholipids. These results indicate an amphiphilic character of the N terminus and suggest that the cationic arginine residues of the N-terminal domain react with the negatively charged head groups of acidic phospholipids prior or parallel to interaction of the polypeptide with hydrophobic regions of the lipid bilayer. PMID- 3308881 TI - In vitro characterization of the yeast mitochondrial promoter using single-base substitution mutants. AB - A short DNA sequence, 5'ATATAAGTA(+1)3', extending from -8 to +1 nucleotides has been shown to function as a promoter in the yeast mitochondrial genome. A complete set of single site mutations of this nonanucleotide promoter sequence has been constructed, cloned, and used to promote specific in vitro transcription using a highly purified mitochondrial RNA polymerase. Each deviation from the natural promoter sequence results in a reduction or abolition of specific transcription depending on the nucleotide substituent. The nucleotide at -8 is not considered as a component of the promoter. Any nucleotide at position +1 is compatible with correct transcriptional initiation. The consensus sequence that exists in vivo is the strongest promoter since only down mutations are seen among the substitutions. The mutant analyses indicate that a very short octanucleotide sequence comprised of 5'TAT/aAA/g/cGT/a/cN(+1)3' is the minimal sequence necessary to direct accurate initiation by mitochondrial RNA polymerase. PMID- 3308883 TI - Characterization of rat cellular retinol-binding protein II expressed in Escherichia coli. AB - Rat cellular retinol-binding protein II (CRBP II) is a small (15.6 kDa) intracellular protein that binds all-trans-retinol. In the adult rat, expression of the CRBP II gene is essentially limited to the small intestinal lining cells (enterocytes), suggesting that CRBP II may be uniquely adapted for intestinal metabolism of newly absorbed retinol. Functional and structural analysis of this protein has been hampered by difficulties in freeing rat intestinal CRBP II from its ligand without denaturation. To circumvent this problem, we have obtained efficient expression of rat apoCRBP II in Escherichia coli. The purified E. coli derived apoprotein, when complexed with all-trans-retinol, demonstrates fluorescence excitation-emission spectra and absorption spectra indistinguishable from that of CRBP II-retinol isolated from rat intestine. Quantitative ligand binding studies were performed by monitoring either the fluorescence of bound retinol or the quenching of protein fluorescence. They revealed that E. coli derived CRBP II binds retinol tightly (the apparent dissociation constant is estimated to be 10(-7)-10(-8) M), with a stoichiometry of 1:1. Fluorescence quenching studies used acrylamide as a probe for the exposure of the 4 tryptophan residues to solvent. The results indicate that although there is heterogeneity in the exposure of these 4 tryptophan residues to solvent, they are situated in a relatively nonpolar environment. These studies suggest that E. coli-derived apoCRBP II will serve as a useful model for studying retinol-protein interactions. PMID- 3308884 TI - Modulation of yeast 5 S rRNA synthesis in vitro by ribosomal protein YL3. A possible regulatory loop. AB - Synthesis of yeast 5 S rRNA in a homologous cell-free system has previously been shown to be inhibited by exogenous yeast 5 S rRNA. This inhibition is diminished when 5 S rDNA is first incubated with the cell-free system, implying the presence of a transcription factor IIIA analog in yeast, and is dependent on the nucleotide sequence of the 5 S rRNA added. A two-dimensional gel electrophoresis method was used to demonstrate assembly of newly synthesized 5 S rRNA into a ribonucleoprotein complex containing ribosomal protein YL3. Immunodepletion of the cell-free system with anti-YL3 IgG was found to increase the sensitivity of 5 S rRNA synthesis to inhibition by 5 S rRNA. We propose a model for the regulation of yeast 5 S rRNA synthesis in which YL3 competes with the presumptive transcription factor IIIA analog for binding of 5 S rRNA. PMID- 3308885 TI - In vitro transcripts of a yeast variant 5 S rRNA gene exhibit alterations in 3' end processing and protein binding. AB - When a yeast 5 S rRNA gene with a variant 3'-terminal nucleotide sequence was transcribed in a homologous cell-free system, primary transcripts that were shorter, more heterogeneous in length and much more resistant to processing than pre-5 S rRNA from the major "repeat" 5 S rRNA gene were produced. After 3'-end processing, variant 5 S rRNA was one nucleotide shorter than mature repeat 5 S rRNA and was bound much less strongly to ribosomal protein YL3. The stable variant pre-5 S rRNA appeared to bind another, unidentified protein. The formation of this presumptive ribonucleoprotein complex was disrupted by (Up)4UOH, suggesting that it may contain a yeast analog of the mammalian La protein. PMID- 3308886 TI - Involvement of lactaldehyde dehydrogenase in several metabolic pathways of Escherichia coli K12. AB - Lactaldehyde dehydrogenase (E.C. 1.2.1.22) of Escherichia coli has been purified to homogeneity. It has four apparently equal subunits (molecular weight 55,000 each) and four NAD binding sites per molecule of native enzyme. The enzyme is inducible, only under aerobic conditions, by at least three different types of molecules, the sugars fucose and rhamnose, the diol ethylene glycol and the amino acid glutamate. The enzyme catalyzes the irreversible oxidation of several aldehydes with a Km in the micromolar range for alpha-hydroxyaldehydes (lactaldehyde, glyceraldehyde, or glycolaldehyde) and a higher Km, in the millimolar range, for the alpha-ketoaldehyde methylglyoxal. It displays substrate inhibition with all these substrates. NAD is the preferential cofactor. The functional and structural features of the enzyme indicate that it is not an isozyme of other E. coli aldehyde dehydrogenases such as glyceraldehyde phosphate dehydrogenase, glycolaldehyde dehydrogenase, or acetaldehyde dehydrogenase. The enzyme, previously described as specific for lactaldehyde, is thus identified as a dehydrogenase with a fairly general role in aldehyde oxidation, and it is probably involved in several metabolic pathways. PMID- 3308887 TI - Promoter search by Escherichia coli RNA polymerase on a circular DNA template. AB - Using the rapid-mixing/photocross-linking technique developed in our laboratory, we have investigated the kinetics of interaction between Escherichia coli RNA polymerase and pAR1319, a recombinant plasmid DNA containing the bacteriophage T7 A2 early promoter. By monitoring the time-dependent density of bound RNA polymerase along the relaxed circular DNA molecule using this technique, we have been able to demonstrate kinetic evidence for linear diffusion of RNA polymerase along DNA in a different system from that previously described (Park, C. S., Hillel, Z., and Wu, C.-W. (1982) J. Biol. Chem. 251, 6950-6956). The nonspecific association rate constant kon was measured to be 7.7 x 10(4) M-1 s-1 at a DNA chain concentration of 22.4 nM. By taking advantage of the fact that rapid mixing displaces bound protein molecules from DNA, but leaves them within the domain of the DNA, the rate of intradomain binding of RNA polymerase to pAR1319 DNA was determined to be 8.2 s-1. Since the plasmid is described by a radius of gyration of 0.22 microns, the intradomain concentration of base pairs could be calculated. Using this concentration (180 microM), the rate constant for intradomain nonspecific association of RNA polymerase to pAR1319 DNA was estimated to be 4.6 x 10(4) M-1 s-1. In addition, a mathematical model has been used to fit the other two important rate constants to the experimental data: koff, which describes the dissociation of RNA polymerase from nonspecific binding sites, and D1, the one dimensional diffusion coefficient of the enzyme along the DNA molecule. In this model, the circular DNA molecule is described as a ring of interconnected binding sites which together comprise a DNA "domain." RNA polymerase, which enters the domain via three-dimensional diffusion and binds to each site, is allowed to diffuse linearly between adjacent sites and three-dimensionally on and off the DNA molecule. The rate equations for the time-dependent occupancy of each site by RNA polymerase could be written, based on general principles. By solving the resulting family of differential equations, koff and D1 were determined to be 0.3 s-1 and 1.5 x 10(-9) cm2 s-1, respectively. PMID- 3308889 TI - Responses to insulin by two forms of rat hepatic microsomal cytochrome P-450 that undergo major (RLM6) and minor (RLM5b) elevations in diabetes. AB - Total cytochrome P-450 levels rise in diabetic rats. Two specific forms of cytochrome P-450 that are elevated have been isolated from liver microsomes of streptozotocin-induced idabetic male rats. One enzyme, termed RLM6, metabolizes aniline and acetol, but not testosterone, in a reconstituted system with NADPH cytochrome P-450 reductase. RLM6 is isolated as a high spin cytochrome with a minimum molecular weight of 53,500. It has a unique amino-terminal amino acid sequence lacking methionine at the amino-terminal position. Polyclonal antibodies to RLM6 recognized most other forms of cytochrome P-450 in Western blots, but could be made monospecific by adsorption to cross-reacting proteins coupled to Sepharose 4B. Using the monospecific antibodies, RLM6 was estimated to be present in microsomes of untreated male rats at 0.04 nmol/mg protein (5% of total P-450). In chronically diabetic rats this level rose to 0.35 nmol/mg protein and 24% of the P-450 content. Immunoreactive protein of molecular weight identical to RLM6 was elevated in microsomes of non-diabetic rats treated with ethanol, acetone, or isoniazid as well as in rats starved for 48 h. Insulin treatment of diabetic rats for 1 week lowered the immunologically detectable levels of RLM6 to levels found in the untreated rat. The other form of cytochrome P-450, RLM5b, does not metabolize aniline and only poorly metabolizes acetol and testosterone. This 52.5 kDa protein is isolated as a predominantly (60%) high spin enzyme. It has a unique NH2-terminal amino acid sequence with methionine as the terminal residue, and is present in untreated male rat liver microsomes at 0.16 nmol/mg protein. It is elevated in diabetes, like RLM6, but treatment with insulin for 1 week does not completely restore the microsomal content to that of the non-diabetic rat. PMID- 3308888 TI - Spontaneous fragmentation of several proteins in Drosophila pupae. AB - Autoproteolysis is an essential activity in the expression of the entire genomes of a number of viruses. That is, new viruses can be produced only after large polyprotein products translated from the genome or from subgenomic mRNA degrade themselves to the polypeptides necessary for RNA replication or for the construction of new virus particles. We have recently shown that the major heat shock protein of Drosophila and a mouse cell line (70 kDa) also undergoes autoproteolysis with the production of specific patterns of smaller polypeptides. We show now that many other proteins in eucaryotic tissues also have a potential for self-degradation. We suggest that special coding regions in many genes may have important roles in both protein turnover and in the production of regulatory peptides. PMID- 3308890 TI - The primary structure of rat ribosomal protein S12. The relationship of rat S12 to other ribosomal proteins and a correlation of the amino acid sequences of rat and yeast ribosomal proteins. AB - The covalent structure of the rat 40 S ribosomal subunit protein S12 was determined from the sequence of amino acids in tryptic, chymotryptic, thermolytic, and cyanogen bromide peptides and inferred from the sequence of nucleotides in a recombinant cDNA. Rat ribosomal protein S12 contains 129 amino acids and has a molecular weight of 14,120. The amino acid sequences of a number of ribosomal proteins appear to be related to rat S12. These include spinach chloroplast L7, Escherichia coli S5, Nicotiana tabacum chloroplast S18, and Bacillus stearothermophilus S12, and perhaps others. In addition, there are two sequences, 26 and 18 amino acids in length, in rat S12 that may be related to segments of the same number of residues in ribosomal proteins from a number of species. These, and other results, reinforce the suggestion that ribosomal proteins form an extended family. PMID- 3308891 TI - The use of ultrasound in vivo to determine acute change in the mechanical properties of bone following intense physical activity. AB - The velocity of ultrasound was measured transcutaneously across the patella and tibia in 98 volunteers both before and after running the 26 mile Boston Marathon. Absolute sound velocities were 2.9% higher in those runners finishing before 3 h when compared to runners finishing after 3 h. Tibial velocities in males were 8.8% higher than in female runners. The mean velocity across the patella of three wheelchair racers was 28% lower than the mean combined patella velocity measured in all runners. These data suggest that 'faster' velocities are associated with bone that is better suited for high functional demands. Surprisingly, when pre- and post-race velocities were compared in each runner, there was a 1.6% increase in ultrasonic velocity across the tibia, and a 3.5% increase across the patella. An increase in ultrasonic velocity following extreme physical activity suggests that adaptive mechanisms exist in healthy bone to withstand, or possibly avoid, the microdamage which might be caused by repetitive cyclic loading. PMID- 3308893 TI - Orthopaedic complications of Raynaud syndrome. A case report. PMID- 3308892 TI - The mechanism of 2-deoxy-glucose-induced insulin secretion in the mouse. AB - 1 Intravenous injection of 2-deoxy-glucose (3 mmol/kg) increases plasma levels of insulin and glucose in the mouse. This study investigated the contribution of various autonomic receptors to the plasma insulin response. 2 Pretreatment with the cholinergic antagonist methylatropine abolished the response completely. 3 Pretreatment with the alpha-adrenoceptor antagonist phentolamine caused a potentiated response, whereas the beta-adrenoceptor antagonist L-propranolol had no effect. 4 Pretreatment with methylatropine and phentolamine combined caused a small insulin response, which was inhibited by propranolol. 5 Pretreatment with the nicotonic antagonist hexamethonium abolished the response. 6 It is concluded that 2-deoxy-glucose induces a stimulation of insulin secretion in vivo in the mouse predominantly by a cholinergic mechanism. 7 2-Deoxy-glucose also activates alpha-adrenergic mechanisms which affect the size of the insulin secretory response. beta-Adrenoceptor and non-adrenergic, non-cholinergic mechanisms seem to be less important. PMID- 3308894 TI - Lower limb-length discrepancy. PMID- 3308895 TI - Bridging large defects in bone by demineralized bone matrix in the form of a powder. A radiographic, histological, and radioisotope-uptake study in rats. AB - Demineralized bone powder was used as an osteoinductive substance to bridge very large defects (more than 50 per cent of the total length of the bone) in one radius of each of thirty-three rats. An identical defect was produced in the contralateral radius of each animal for use as a control. The defect on the control side was left unbridged or was bridged by large chips of autologous bone or an autologous inlay graft. All rats showed formation of new bone throughout the length of the radial defect only on the side in which the demineralized bone powder had been implanted. The control side, in which an autologous graft in the form of chips or inlay had been implanted, showed resorption of the graft. The maximum rate of formation of bone occurred fifteen to twenty-one days after implantation of the demineralized bone powder. At thirty-five days, the experimental defect was fully bridged, forming solid bone, in 71 per cent of the rats, and the remaining 29 per cent showed bridging of 95.8 per cent of the length of the defect, with union on one side. Analysis of the sequential radiographs, technetium-99m scans, and histological findings showed that the formation of bone and bridging of the defect were superior on the side in which the demineralized bone powder had been implanted compared with the side in which pieces of autologous bone or an autologous inlay graft had been used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3308896 TI - Hypnotherapy as a treatment for pain in patients with burns: research and clinical considerations. AB - Hypnotherapy has increasingly been included in the management of burn patients, particularly in the area of acute pain. To better understand such issues as (1) overall efficacy of hypnotherapy to alleviate acute burn pain, (2) instances in which hypnotherapy is contraindicated, (3) interaction of hypnotherapy with medication, (4) standard induction techniques to use with various age groups, (5) role of nursing and other staff in facilitating hypnotic effects, and (6) future methodological directions, we examined the clinical and methodological merits of recent studies of hypnoanalgesia. Through a computer search of the medical literature and cross-referencing recent bibliographies, we were able to find 17 studies in which hypnotherapy was applied to the management of burns. The literature generally supports the efficacy of this approach to reduce burn pain; however, little else can be concluded from these studies. Several recent studies have applied hypnotherapy to aspects of burn care other than pain using excellent experimental designs. It is suggested that future studies of acute pain management follow suit. PMID- 3308897 TI - Arterial assessment before carotid endarterectomy: current practice in Great Britain and Ireland. AB - A survey of the management of patients with putative carotid artery disease by 245 vascular and neurosurgeons in Great Britain and Ireland was conducted with a 96 per cent response. Ninety-six (41%) surgeons performed at least one carotid endarterectomy in 1984 and a total of 1374 such operations were carried out in that year. Of the 40 surgeons who performed more than ten operations in 1984, 95 per cent generally employed a screening technique which was less invasive than conventional angiography in their management. Techniques based on ultrasonography were more popular than those based on digital subtraction angiography (DSA) in this respect. If carotid endarterectomy were to be undertaken, 63 per cent of surgeons required pre-operative conventional angiograms. Of the 38 per cent who did not routinely use conventional angiography, all but one used digital subtraction angiography. Ultrasonography and DSA have had a significant impact on the management of carotid artery disease in Great Britain and Ireland and their individual places in such management are becoming clear. PMID- 3308898 TI - Failure of patent aorto-renal grafts to cure hypertension in renin positive patients. AB - Correction of renal artery stenosis in a hypertensive patient does not always result in cure of the hypertension. In a follow-up on 127 patients operated on for renovascular hypertension over a 24-year period 32 patients with favourable preoperative factors, unilateral disease, normal renal parenchyma and a positive renal vein renin ratio were studied. 20/32 were regarded as cured with a BP of less than 140/90 and 12/32 were regarded as unsuccessful with a BP, although lessened, higher than 140/90. Hypotensive medication was required in 10/12 in the latter group and was still required in 8/20 of the former. The cure rate of less than 2/3rd is lower than most reports in the literature. The possible causes of the discrepancy are discussed. PMID- 3308899 TI - Salmonella endarteritis, about two cases and their management. AB - Mycotic aneurysms due to Salmonella are a classical but uncommon complication of Salmonella infections. We report two cases of such aneurysms, the first one having developed two successive aneurysms of the iliac arteries due to Salmonella typhimurium. The literature on Salmonella endarteritis is briefly reviewed. The importance of an aggressive surgical approach of the mycotic aneurysm, with removal of all infected material and extra-anatomic bypass through contaminated tissue is emphasized. The role of antibiotic treatment is also discussed. PMID- 3308900 TI - Evaluation of double aortic arch and aortic coarctation by intravenous digital subtraction angiography (IV DSA). AB - Eleven pediatric patients with congenital aortic anomalies were evaluated using intravenous digital subtraction angiography (IV DSA). Excellent correlation was found between IV DSA, other imaging studies, and operative findings. Ten of 11 patients studied (90.9%) were correctly diagnosed using this technique. Intravenous DSA may be the procedure of choice in assessing aortic arch anomalies in selected patients. PMID- 3308902 TI - Monoclonal antibodies that recognize transcription unit proteins on newt lampbrush chromosomes. AB - We prepared hybridoma cell lines from mice injected with newt germinal vesicle proteins. We tested culture supernates from these cell lines for antibodies that bound to specific morphological structures in lampbrush chromosome preparations (nucleoli, loops, chromomeres, etc.). Four mAbs that recognize antigens on the lateral transcription loops are described here. We suggest that these antigens are proteins associated with nascent RNA transcripts, although they are not among the 30-40-kD "core" heterogeneous nuclear ribonucleoproteins. PMID- 3308901 TI - Some recent advances in the chemistry and biology of transforming growth factor beta. PMID- 3308903 TI - The coordinated regulation of fibrinogen gene transcription by hepatocyte stimulating factor and dexamethasone. AB - Glucocorticoids and hepatocyte-stimulating factor (HSF; a monocyte/macrophage derived polypeptide) are potent regulators of fibrinogen biosynthesis. Using primary rat hepatocytes and a rat hepatoma cell line (FAZA) we have determined, more precisely, the interaction between these two molecules in the control of fibrinogen production. When dexamethasone (DEX) or HSF is added to the cells, there is a substantial increase in fibrinogen production (1.5-3-fold). However, if both agents are administered simultaneously the response is much greater with a 15-20-fold rise in synthesis. Quantitative RNA analysis demonstrates that when the factors are present individually only HSF elevates fibrinogen mRNA levels, but the effect is much enhanced in the presence of DEX. This pattern is also seen in the results of the in vitro transcription assays which allow quantitation of mRNA synthesis in isolated nuclei. Cycloheximide does not significantly interfere with the increased transcription brought about by HSF in either cell type. However, the DEX enhancement is blocked by cycloheximide in FAZA cells, thus indicating that in the transformed cell protein synthesis is required for maximal transcription to occur. Data presented here demonstrates the requirement for two types of regulator molecules in the control of fibrinogen gene expression; a polypeptide hormone (HSF) that increases transcription and a steroid (DEX) that enhances the action of the polypeptide. PMID- 3308904 TI - Basic proteins of the perinuclear theca of mammalian spermatozoa and spermatids: a novel class of cytoskeletal elements. AB - The nuclei of bovine spermatids and spermatozoa are surrounded by dense cytoplasmic webs sandwiched between the nuclear envelope and the acrosome and plasma membrane, respectively, filling most of the cytoplasmic space of the sperm head. This web contains a complex structure, the perinuclear theca, which is characterized by resistance to extractions in nondenaturing detergents and high salt buffers, and can be divided into two major subcomponents, the subacrosomal layer and the postacrosomal calyx. Using calyces isolated from bull and rat spermatozoa we have identified two kinds of basic proteins as major constituents of the thecal structure and have localized them by specific antibodies at the light and electron microscopic level. These are an Mr 60,000 protein, termed calicin, localized almost exclusively to the calyx, and a group of multiple-band polypeptides (MBP; Mr 56,000-74,000), which occur in both the calyx and the subacrosomal layer. The polypeptides of the MBP group are immunologically related to each other, but unrelated, by antibody reactions and peptide maps, to calicin. We show that these basic cytoskeletal proteins are first detectable in the round spermatid stage. As we have not detected any intermediate filament proteins and proteins related to nuclear lamins of somatic cells in sperm heads, we conclude that the perinuclear theca and its constituents, calicin and MBP proteins, are the predominant cytoskeletal elements of the sperm head. Immunologically cross reacting polypeptides with similar properties have been identified in the heads of rat and human spermatozoa. We speculate that these insoluble basic proteins contribute, during spermiogenesis, to the formation of the perinuclear theca as an architectural element involved in the shape changes and the intimate association of the nucleus with the acrosome and the plasma membrane. PMID- 3308905 TI - Characterization of a monoclonal antibody that induces the acrosome reaction of sea urchin sperm. AB - A monoclonal antibody, J18/29, induces the acrosome reaction (AR) in spermatozoa of the sea urchin Strongylocentrotus purpuratus. J18/29 induces increases in both intracellular Ca2+ and intracellular pH similar to those occurring upon induction of the AR by the natural inducer, the fucose sulfate-rich glycoconjugate of egg jelly. Lowering the Ca2+ concentration or the pH of the seawater inhibits the J18/29-induced AR, as does treatment with Co2+, an inhibitor of Ca2+ channels. The J18/29-induced AR is also inhibited by verapamil, tetraethylammonium chloride, and elevated K+. All these treatments cause similar inhibition of the egg jelly-induced AR. J18/29 reacts with a group of membrane proteins ranging in molecular mass from 340 to 25 kD, as shown by immunoprecipitation of lysates of 125I-labeled sperm and Western blots. The most prominent reacting proteins are of molecular masses of 320, 240, 170, and 58 kD. The basis of the multiple reactivity appears to reside in the polypeptide chains of these proteins, as J18/29 binding is sensitive to protease digestion but resistant to periodate oxidation. There are approximately 570,000 sites per cell for J18/29 binding. J18/29 is the only reagent of known binding specificity that induces the AR; it identifies a subset of sperm membrane proteins whose individual characterization may lead to the isolation of the receptors involved in the triggering of the AR at fertilization. PMID- 3308907 TI - Generation of osteoclasts in cultures of rabbit bone marrow and spleen cells. AB - The primary and specific function of the osteoclast is the resorption of bone. We have applied this criterion, and a monoclonal antibody that binds specifically to osteoclasts, to cultures of tissues that may contain osteoclastic precursors. Bone marrow and spleen cells were incubated for up to 4 weeks in the presence or absence of parathyroid hormone, interleukin 1, or 1,25(OH)2 vitamin D3, on plastic coverslips or slices of devitalised bone. Osteoclasts (as judged by the presence of resorption cavities and the appearance of monoclonal antibody positive cells) did not develop in cultures incubated without added hormones, nor in cultures containing parathyroid hormone or interleukin 1, but were regularly observed when bone marrow cells were incubated with 1,25(OH)2 vitamin D3. Although multinucleate giant cells were common after incubation, especially in the presence 1,25(OH)2 vitamin D3, monoclonal antibody bound not to these cells but to a minor and distinctive population of mononuclear cells and cells of low multinuclearity. We found no excavations and no monoclonal antibody-positive cells after incubation of peritoneal macrophages with 1,25(OH)2D3. These results provide direct evidence of osteoclastic function arising in cultures of haemopoietic tissues. PMID- 3308906 TI - Translocation and clustering of endosomes and lysosomes depends on microtubules. AB - Indirect immunofluorescence labeling of normal rat kidney (NRK) cells with antibodies recognizing a lysosomal glycoprotein (LGP 120; Lewis, V., S.A. Green, M. Marsh, P. Vihko, A. Helenius, and I. Mellman, 1985, J. Cell Biol., 100:1839 1847) reveals that lysosomes accumulate in the region around the microtubule organizing center (MTOC). This clustering of lysosomes depends on microtubules. When the interphase microtubules are depolymerized by treatment of the cells with nocodazole or during mitosis, the lysosomes disperse throughout the cytoplasm. Lysosomes recluster rapidly (within 30-60 min) in the region of the centrosomes either upon removal of the drug, or, in telophase, when repolymerization of interphase microtubules has occurred. During this translocation process the lysosomes can be found aligned along centrosomal microtubules. Endosomes and lysosomes can be visualized by incubating living cells with acridine orange. We have analyzed the movement of these labeled endocytic organelles in vivo by video enhanced fluorescence microscopy. Translocation of endosomes and lysosomes occurs along linear tracks (up to 10 microns long) by discontinuous saltations (with velocities of up to 2.5 microns/s). Organelles move bidirectionally with respect to the MTOC. This movement ceases when microtubules are depolymerized by treatment of the cells with nocodazole. After nocodazole washout and microtubule repolymerization, the translocation and reclustering of fluorescent organelles predominantly occurs in a unidirectional manner towards the area of the MTOC. Organelle movement remains unaffected when cells are treated with cytochalasin D, or when the collapse of intermediate filaments is induced by microinjected monoclonal antivimentin antibodies. It can be concluded that translocation of endosomes and lysosomes occurs along microtubules and is independent of the intermediate filament and microfilament networks. PMID- 3308908 TI - Cell-cycle-dependent expression of human ornithine decarboxylase. AB - A human ornithine decarboxylase (ODC) gene probe has been isolated from a Jurkat T-cell cDNA expression library, sequenced, and used to analyze ODC mRNA levels in untransformed human lymphocytes and fibroblasts stimulated to proliferate by various mitogens. The partial cDNA sequence is 86% homologous to the mouse ODC cDNA, and Northern blots indicate that the human and mouse mRNA species are similar in size. ODC mRNA is barely detectable in quiescent human T lymphocytes and undetectable in density-arrested W138 fibroblasts. Following stimulation of T lymphocyte proliferation with phytohemagglutinin, the ODC mRNA level rises to a peak around mid G1 phase and decreases as the cells enter S phase. Serum stimulation of density-arrested fibroblasts results in an elevation of the ODC mRNA level which persists throughout the cell cycle. Epidermal growth factor (20 ng/ml) but not insulin (10 mg/ml) or dexamethasone (55 ng/ml) stimulates ODC expression in quiescent W138 fibroblasts. Southern blots suggest that human cells have a single copy of the ODC gene. PMID- 3308909 TI - Joint physiology, cartilage metabolism, and the etiology of osteoarthritis. AB - Articular cartilage is hypocellular, avascular, aneural, and alymphatic. Nutrition derives predominantly from the synovial fluid. The cartilage matrix is hyperhydrated. Water represents 80 per cent of the total weight. The water is very important in joint lubrication and wear resistance. The dry weight consists mainly of proteoglycan and type II collagen. Osteoarthritis is not the result of a diminution in metabolic activity but is a very active catabolic process. Matrix synthesis and cell replication proceed at greater rates in damaged than in normal cartilage. Lysosomal enzymes that degrade cartilage are released. Proteoglycan content diminishes in proportion to the disease severity. Despite the heightened synthetic activity, the chondrocyte's capacity is eventually exceeded by the rate of matrix degradation and the cartilage becomes eroded. A multitude of hypotheses have been suggested to explain the etiopathogenesis of osteoarthritis. These hypotheses fall into two categories: those that point to excessive stresses imposed upon normal tissue and those that emphasize the inadequacy of the chondrocyte response. The factors that initiate the process are not fully known. Trauma, aging, joint laxity, diet, hormones, crystal deposition, bone microfractures, and immunologic factors have all been implicated. PMID- 3308911 TI - Degenerative diseases of the metacarpophalangeal joints. AB - Degenerative arthritis of the finger metacarpophalangeal joints is uncommon and, when seen, a specific etiology should be sought. MP joint arthritis in the absence of a history of trauma may signal an underlying systemic disease. The clinical and radiographic findings may be subtle. Once degenerative changes occur, the usual treatment is arthroplasty using a flexible silicone rubber (Swanson) finger joint implant that should provide a relatively stable and painless joint with a functional range of motion. Degenerative arthritis of the thumb MP joint is more common following injuries that damage the ligaments on the ulnar or radial side of the MP joint and which result in lateral instability of the joint. Arthritis of the MP joint also may occur following infection or direct joint injury. Secondary MP arthritis may result from thumb CMC joint disease and must be attended to at the time CMC joint reconstruction is performed. Degenerative disease of the thumb sesamoid bones must be considered in patients with persistent MP joint pain after either trauma or MP joint fusion. PMID- 3308910 TI - Clinical and radiologic features of primary osteoarthritis of the hand. AB - An appreciation of the salient clinical and radiologic presentations of osteoarthritis, as well as associated tenosynovial problems (stenosing tenosynovitis and carpal tunnel syndrome), is necessary for effective diagnosis. The treatment of osteoarthritis is predicated upon an understanding of the anatomy and pathomechanics of the disease process. Relevant features of the anatomy of the joints of the hand have been reviewed. The correlation of pathologic abnormalities with their radiologic findings has been presented. The degenerative joint disease termed osteoarthritis affects primarily cartilagenous and osseous tissues, while synovial changes are less pronounced. The characteristics of osteoarthritis of the interphalangeal, carpometacarpal joint of the thumb, and metacarpophalangeal joints of the hand have been reviewed. PMID- 3308912 TI - Visualization of the living cytoskeleton by video-enhanced microscopy and digital image processing. AB - Two steps led to our present-day view of the cytoskeleton as a highly dynamic structure that is actively involved in force generation for various kinds of cell motility and, as a result, is itself often actively moving. The first step was the introduction of video microscopy, especially of the Allen Video Enhanced Contrast-Differential Interference Contrast Microscopy (AVEC-DIC), which allows the visualization of cellular structures in the light microscope that are up to 10 times smaller than the limit of resolution. This enables one to see images of unfixed, unstained, native or purified microtubules and actin bundles, and their interaction with membrane-bound organelles. The second step was the discovery of a system exceptionally well-suited to study microtubule and organelle movements, namely, the extruded axoplasm of the squid giant axon. From this axon the cytoplasm can be extruded free from surrounding plasma membrane, and individual microtubules and organelles can be separated from the bulk axoplasm. The study of these native microtubules by AVEC-DIC microscopy yielded a great number of quite unexpected details of the dynamic behaviour of both the microtubules themselves and the motility associated with them. PMID- 3308913 TI - Analysis of pseudopodial structure and assembly with viral projections. AB - The mechanisms by which cells extend motile pseudopodial projections are still poorly understood. Several fundamental mechanisms have been proposed on the basis of hydrostatic pressure, membrane addition and microfilament reorganization. A common focus of all such mechanisms is the growing tip of a pseudopodium. Yet some basic questions about the nature of the tip in natural pseudopodia remain obscure. However, one class of structure, the virus-tipped projections, often contains a well-defined particle, both morphologically and biochemically, and therefore provides a useful model system for the examination of the tips of cellular projections. In P815 cells the virus-tipped projections are long, thin structures closely resembling filopodia in other cells. The apical virus particle is a retrovirus particle produced by the chronic infection existing in this cell line. In demembranated filopodia, the virus particle retains a tight association with a single actin microfilament. Biochemical analyses indicate that the major retroviral structural polypeptide Pr65 is an actin-binding protein that could provide the anchorage site for the actin filament. The existence of a solid virus particle tethered by an actin filament to the cytoskeleton makes it very unlikely that these projections grow by membrane addition at the tip. The major positive implication is that the apex of a projection does not relinquish its interaction with the submembranous cytoskeleton during growth. Such an arrangement would be compatible with either a hydrostatic-pressure-driven or a cytoskeleton-driven mechanism of filopodial growth. PMID- 3308915 TI - The cytoskeleton of the early Drosophila embryo. AB - The organization and roles of the cytoskeleton are described for a complex developing system (the early Drosophila embryo) at a time when the basic embryonic plan is mapped out. This type of embryo shows a separation of mitosis from cytokinesis during the early stages of development. Most cells are only formed when a syncytium of approximately 6000 nuclei are present. The functions of the cytoskeleton are considered for the process of nuclear migration (pre blastoderm), which distributes the nuclei throughout the embryo and brings most of them close to the surface. They are also described for the subsequent mitoses of the syncytial blastoderm where the cortex and its well-developed cytoskeleton is reorganized into cell-like surface protrusions known as 'caps' or 'buds'. A comparison is made of the very different cytoskeletal organization present during the cleavages that form the two cell types of early development (pole cell and blastoderm cell), together with information from mutations that affect various aspects of these cleavages via factors laid down during oogenesis. PMID- 3308914 TI - Supracellular microtubule alignments in cell layers associated with the secretion of certain fish scales. AB - Intercellularly aligned microtubule arrays are present in cell layers associated with the growth and secretion of scales in the zebra fish Brachydanio rerio and the neon tetra fish Hyphessobrycon innesi. The layers in question are: the osteoblast layer that covers the ossified outer surface of a scale, and the layer of fibroblasts that is situated immediately underneath the inner collagenous surface of a scale's fibrillary plate. In certain osteoblasts, the proximal portions of microtubules (with respect to centrosomes) run closely alongside the anterior margin of each cell where it flanks one of a scale's ridge-shaped circuli. These osteoblasts and microtubule portions are arranged in aligned rows that are parallel to circuli. However, the distal portions of the microtubules curve into an orientation that is approximately at right angles to circuli and they are aligned with each other and similar microtubule portions in adjacent osteoblasts. Such microtubule alignments only occur in osteoblasts that are associated with circuli. In Hyphessobrycon osteoblasts situated elsewhere on a scale's surface, microtubules radiate from cell centres but their distal portions curve into alignment with each other and are oriented alongside cell margins. The proximal portions of fibroblast microtubules radiate from centrally positioned centrosomes but the distal portions curve into alignment with each other and distal microtubule portions in neighbouring fibroblasts. The overall pattern of microtubule alignment is similar to that of collagen fibres, which these fibroblasts are secreting onto the fibrillary plate. The immunofluorescence protocol that was used to demonstrate the microtubule alignments described above did not reveal such alignments in the osteoblast and fibroblast layers associated with scales of the brown trout Salmo trutta fario. These findings are assessed in terms of intra-and inter-cellular control of microtubule alignment, and decentralized reorientation of microtubules at distances of several micrometres from centrosomal microtubule-organizing centres. The functional significance of the relationships between microtubule alignment and supracellular patterns of alignment that take place as collagen deposition and ossification proceed during scale formation is also considered. PMID- 3308916 TI - Cytoskeletal changes during oogenesis and early development of Xenopus laevis. AB - The frog oocyte is well known for studies on the control of gene expression, but has been used much less in studies on the cytoskeleton. However, frog oocytes are very large single cells, whose cytoplasmic movements and asymmetries are fundamental to the correct development of the subsequent embryo. One particular example of asymmetrically distributed cytoplasm is germ plasm, thought to be important in the formation of the germ line. Data are presented that show that germ plasm is highly concentrated mass of cytoskeletal elements, which include tubulin, and an intermediate filament protein of molecular weight 55 X 10(3). The distribution of these molecules has been studied during oogenesis and during early post-fertilization development. The implications of these findings are discussed. PMID- 3308917 TI - Myosin distribution and actin organization in different areas of antibody labelled quick-frozen fibroblasts. AB - In cortical and subcortical areas of motile non-muscle cells myosin is found only on linear actin filament bundles that are aligned with the cell's long axis. Myosin is absent from actin filaments perpendicular to these bundles and from areas of cortical and subcortical actin, which has a complex geometrical array. These data suggest that in the non-muscle cell myosin exerts force in a unidirectional manner only, as it does in muscle. The presence of myosin up to the ends of cell processes suggests that, even in the cortex, this force transduction takes place over short-range distances. The absence of myosin rods in vivo but the presence of structures corresponding to single myosin molecules suggests that the force-generating unit for actomyosin-based movement in non muscle cells is either a myosin dimer/small oligomer or single myosin molecule, attached to actin by their tail regions. PMID- 3308918 TI - Studies of tektin filaments from flagellar microtubules by immunoelectron microscopy. AB - Chemically resistant 2-3 nm filaments with a high alpha-helical content, isolated from sea-urchin sperm flagellar doublet microtubules, consist of proteins that have been named tektins. Polyclonal affinity-purified antibodies to tektins labelled sperm tails all along their lengths, as shown by indirect immunofluorescence microscopy, provided the specimens were not too well fixed. Results obtained for unfixed specimens studied by immunoelectron microscopy suggested the tektins are normally masked by tubulin. A monoclonal anti-tektin antibody labelled bare tektin filaments at longitudinal intervals of approximately 48 nm, which fits in well with the 96 nm longitudinal repeat of axonemes. We discuss a possible scheme for the regular interaction of tubulin monomers with an alpha-helical coiled coil. PMID- 3308919 TI - Intermediate filament networks: organization and possible functions of a diverse group of cytoskeletal elements. AB - Immunofluorescence and electron microscopic observations demonstrate that intermediate filaments (IF) form cytoplasmic networks between the nucleus and cell surface in several types of cultured cells. Intermediate filaments interact with the nuclear surface, where they appear to terminate at the level of the nuclear envelope. From this region, they radiate towards the cell surface where they are closely associated with the plasma membrane. On the basis of these patterns of IF organization, we suggest that IF represent a cytoskeletal system interconnecting the cell surface with the nucleus. Furthermore, IF also appear to interact with other cytoskeletal components including microtubules and microfilaments. In the former case microtubule-IF interactions are seen in cytoplasmic regions between the nucleus and the cell membrane, whereas microfilament-IF interactions occur in the cortical cytoplasm. IF also appear to be cross-linked to each other; especially in the case of the IF bundles that occur in epithelial cells. In order to determine the molecular and biochemical bases of the organizational state of IF we have developed procedures for obtaining IF-enriched 'cytoskeletons' of cultured cells. In these preparations IF nuclear and IF-cell surface associations are retained. Thus, these preparations have enabled us to begin to study various IF-associated structures (e.g. desmosomes) and associated proteins (IFAPs) using biochemical and immunological methodologies. To date, the results support the idea that IF and their associated proteins may comprise the cell type specific molecular infrastructure that is involved in transmitting and distributing information amongst the major cellular domains; the cell surface/extracellular matrix, the cytoplasm and the nuclear surface/nuclear matrix. PMID- 3308920 TI - Excision repair in the yeast, Saccharomyces cerevisiae. AB - cdc9 mutants of yeast lack detectable DNA ligase activity at restrictive temperatures. They also appear to be more sensitive than wild-type cells to ultraviolet (u.v.) radiation and it has been assumed that this is because the CDC9 ligase is needed for the final ligation step in excision repair. The fact that single-strand breaks have been demonstrated in u.v.-irradiated cdc9 mutants has been regarded as evidence for this interpretation. However, the kinetics of appearance of nicks in the DNA do not support this since maximal levels of strand breaks appear almost immediately after exposure to u.v. light and not progressively as repair events are initiated. We believe, therefore, that these strand breaks are connected with a u.v.-dependent preincision event, possibly connected with reorganization of chromatin. PMID- 3308921 TI - Toxicity, mutagenesis and stress responses induced in Escherichia coli by hydrogen peroxide. AB - Two modes of killing of Escherichia coli by hydrogen peroxide can be distinguished. Mode-one killing is maximal at 1-2 mM; at higher concentrations the killing rate is approximately half-maximal and is independent of H2O2 concentration but first order with respect to exposure time. Mutagenesis and induction of a phage lambda lysogen are similarly affected by H2O2 concentration, with reduced levels of response above 1-2 mM-H2O2. Mutagenesis is not affected by inactivation of umuC. Mode-one killing requires active metabolism during the H2O2 challenge and it results in sfiA-independent filamentation of both cells that survive and those that are killed by the challenge. This mode of killing is enhanced in xth, polA, recA and recB strains; however, it is unaffected by mutations in the nth, uvrA, uvrB, uvrC, uvrD, rep, gyrA, htpR and rel loci. Mode one killing is normal in strains totally lacking catalase activity (katE, katG), glutathione reductase (gor) or glutathione synthetase (gshB), but enhanced in a strain lacking NADH dehydrogenase (ndh). Mode-one killing is accelerated by the presence of CN- or by an unidentified function that is induced by anoxic growth and is under the control of the fnr locus. A strain carrying both xth and recA mutations and certain polA mutants appear to undergo spontaneous mode-one killing only under aerobic conditions. Taken together, these observations imply that mode one killing results from DNA damage that normally occurs at a low, non-lethal level during aerobic growth. Models for the resistance to mode-one killing at dose above 1-2 mM-H2O2 will be discussed. Mode-two killing occurs at high concentrations of H2O2 and longer times. It does not require active metabolism, and cells that are killed do not filament, although survivors demonstrate a dose dependent growth lag followed by a period of filamentation. Mode-two killing is accompanied by enhanced mutagenesis, but strains with DNA repair defects were not observed to be especially sensitive to this mode of killing. PMID- 3308922 TI - Plasmid genes affecting DNA repair and mutation. AB - Many bacterial plasmids have the effect of increasing the ultraviolet (u.v.) resistance of host cells that harbour them, apparently by an error-prone repair mechanism that leads to a high level of mutation amongst the survivors. These plasmid systems are apparently analogues of the Escherichia coli umuD/C operon, which is absolutely required in this organism for mutation induced by u.v. light and by many chemical mutagens. This article reviews the extensive and sometimes conflicting literature relating to this phenomenon, and describes the further characterization of one such plasmid system, the imp (I group mutation and protection) operon of the I1 group plasmid TP110. It is demonstrated that each of the protection mutation systems well characterized to date shows a similar genetic arrangement, and that significant homology can be detected at the amino acid level between the proteins encoded by these different systems. PMID- 3308923 TI - The role of O6-methylguanine in human cell killing, sister chromatid exchange induction and mutagenesis: a review. AB - O6-methylguanine (O6mG) produced in DNA by such SN1 methylating agents as N methyl-N-nitrosourea and N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) has been suggested by some to be the lesion that leads to certain biological endpoints in mammalian cells: cell killing, sister chromatid exchange (SCE) production, mutagenesis and cellular transformation. Other evidence is interpreted as inconsistent with this point of view. The finding of Karran & Williams (1985) that O6mG delivered to cells in culture resulted in the depletion of the activity of the protein responsible for repair of O6mG in DNA (O6mG-DNA methyltransferase, O6MT) provided a tool for the assessment of the role of O6mG in producing biological endpoints. In this paper we review much of the literature on human cells pertinent to this question. In addition we present our survival data obtained using the depletion technique of Karran & Williams as well as data supporting a model invoking a mismatch and excision response to O6mG proposed by Sklar & Strauss (1980). Although data linking O6mG to causation are inconclusive, it is premature to conclude that O6mG is not a lesion lethal to certain cultured cells. PMID- 3308924 TI - A genetic and molecular analysis of DNA repair in Drosophila. PMID- 3308925 TI - DNA repair mutants in higher eukaryotes. AB - Over the past ten years or so, we have seen a proliferation of reports of new cell lines of various vertebrate species, showing hypersensitivity to killing by DNA damaging agents. Regrettably, but predictably, there is no standard terminology to describe the mutants, and as a result the literature is liberally scattered with fragments of individualistic nomenclature. There is no way of imposing order at this stage, but it may be helpful to bring together in this chapter as much information as possible on the mutants now available. As well as being an aid for reference, this should serve as a pointer towards further investigation--either in characterizing the mutants we have, or in developing new ones to fill gaps in our knowledge. PMID- 3308926 TI - Invasive behaviour of mouse primordial germ cells in vitro. AB - We have isolated migrating primordial germ cells (PGCs) from 10.5-day mouse embryos and studied their behaviour when cultured on a mouse embryo fibroblast (STO) cell line. Living and fixed PGCs were identified by fluorescent labelling with a monoclonal antibody specific for PGCs in the culture system used. The behaviour of the cells was studied using interference reflexion microscopy (IRM) and time-lapse video cinematography. The IRM pattern displayed by PGCs is typical of highly motile cell types, the cells lack focal contacts and possess large areas of close contacts indicative of weak membrane to substrate interaction. The PGCs exhibit relatively high rates of translocation and lack contact inhibition. They were observed to underlap STO cells in subconfluent monolayers and to penetrate between the cells of confluent monolayers, becoming located between the monolayer and its substrate. These observations support the hypothesis that migrating mouse PGCs are inherently motile and are able transiently to disrupt the adhesion of surrounding cells. These results suggest that PGCs actively migrate to the developing gonad in vivo. PMID- 3308927 TI - Proteins of the membrane skeleton in rat Sertoli cells. AB - Analogues of the alpha, beta and gamma subunits of human spectrin and erythroid protein 4.1 have been detected in rat Sertoli cell primary cultures. Immunofluorescence of permeabilized cells showed that erythroid type spectrin, protein 4.1 and actin co-distribute within the cells as filamentous structures. Fodrin-like molecules were distributed in a diffuse manner, mostly associated with the plasma membrane. Immunoprecipitation and immunoblotting experiments indicated that the polypeptides present in rat Sertoli cells are immunologically related and display molecular weights similar to their analogues in the human erythroid and non-erythroid membrane skeleton. PMID- 3308928 TI - Endoplasmic reticulum contains a common, abundant calcium-binding glycoprotein, endoplasmin. AB - The most abundant protein in microsomal membrane preparations from mammalian cells has been identified as a 100 X 10(3) Mr concanavalin A-binding glycoprotein. The glycosyl moiety of the glycoprotein is completely sensitive to endoglycosidase H, suggesting a predominantly endoplasmic reticulum localization in the cell. Using a monospecific antibody it was shown by binding and immunofluorescence studies that the glycoprotein is intracellular. Immunoelectron microscopy showed that the glycoprotein was at least 100 times more concentrated in the endoplasmic reticulum than in any other cellular organelle. It was found to be substantially overexpressed in cells and tissues rich in endoplasmic reticulum. Since it is the major common protein component associated with the endoplasmic reticulum we refer to it as endoplasmin. Calcium-binding studies show that endoplasmin is a major calcium-binding protein in cells, suggesting that at least one of its roles might be in the calcium-storage function of the endoplasmic reticulum. The amino-terminal sequence of endoplasmin is identical to that of a 100 X 10(3) Mr stress-related protein. PMID- 3308929 TI - Characterization of a spontaneously transformed pulmonary embryonic rat (PER) epithelial cell line. AB - A spontaneously transformed pulmonary embryonic rat epithelial cell line (PER) is described in terms of growth, tumorigenicity, growth factor responsiveness and biosynthetic capacity. At low-passage subcultures, PER cells grew as a monolayer and did not form colonies in soft agar. After long-term subcultivation, they lost contact inhibition, became anchorage-independent and formed tumours in nude mice. Low concentrations of foetal calf serum permit the maximum growth rate. The multiplication and metabolic activity, assessed by 2-deoxy-D-glucose uptake, was significantly stimulated by growth factors. PER cells synthesized collagen types I, III, IV and V, laminin and fibronectin, and organized a pericellular matrix made up of only basement membrane components (type IV collagen and laminin) and fibronectin. These data enabled us to define PER cells as a transformed epithelial cell line evolving towards malignancy with long-term subcultivation. These cells appeared to be a valuable tool in studies of tumour cell-matrix interactions and regulation of growth factor receptors in tumorigenesis. PMID- 3308930 TI - Conditional absence of mitosis-specific antigens in a temperature-sensitive embryonic-arrest mutant of Caenorhabditis elegans. AB - A monoclonal antibody, specific to phosphoproteins in mitotic HeLa cells was found to crossreact with a similar set of proteins in embryos of the nematode, Caenorhabditis elegans. In C. elegans, as in mammalian cells, the highly conserved antigenic epitope is associated with a family of high molecular weight polypeptides. The antigenic reactivity of these multiple proteins also depends on their phosphorylation, since antibody binding is reduced after alkaline phosphatase treatment. The antigens are detected at the centrosomes, and in the nuclear region and surrounding cytoplasm of mitotic cells. The significance of these antigens is emphasized by their absence at restrictive temperature in embryos of the temperature-sensitive embryonic-arrest mutant, emb-29V. Furthermore, temperature shift-down experiments suggest that the emb-29 mutation defines a cell division cycle function that affects an essential activity required for progression into M phase. PMID- 3308931 TI - Association of calmodulin with lysosomes. AB - We examined the subcellular localization of calmodulin in several cultured cells (primary thyroid follicular cells, thyroid C-cell tumour cells (TT), kidney cells (PtK2-L23) and peritoneal macrophages) by indirect immunofluorescence using affinity-purified antibody to calmodulin. When cells were fixed with 3% formaldehyde for 15 min prior to lysis with 0.5% Triton X-100, spindle fibres in mitotic cells were fluorescent and a diffuse cytoplasmic localization of calmodulin was observed in resting cells. However, when cells were lysed with 0.5% Triton X-100 for 90s prior to fixation for 30 min with 3% formaldehyde, three effects were observed. One: there was little diffuse cytoplasmic staining. Two: discrete vesicles were stained. Three: spindle fibres in mitotic cells were fluorescent. The stained vesicles were phase-dense and ranged from 0.1 to 0.5 micron in primary thyroid follicular cells but were smaller in PtK2 and TT cells. The thyroid follicular cells retained vesicular staining after exposure to thyrotropin and isobutylmethylxanthine, but the number of labelled vesicles decreased by almost 80%. Phase-dense vesicles were identified as lysosomes or other acidic vesicles by vital staining with Acridine Orange. After differential centrifugation of thyroid homogenates, calmodulin was measured by radioimmunoassay (RIA) and found in both cytosolic (89%) and membrane vesicle fractions (11%). The vesicular calmodulin was not eluted by washing with 5 mM EGTA. The thyroid fractions were subjected to SDS-polyacrylamide gel electrophoresis and the gels incubated with 125I-labelled calmodulin to reveal calmodulin acceptor proteins (CAPs). The vesicle fraction contained quantitatively major CAPs with Mr of 200,000, 140,000, 89,000, 38,000 and 34,000, and minor CAPs of 60,000 and 50,000. Washing the pellet with 5 mM-EGTA did not reduce the content of CAPs. Thus, calmodulin and CAPs are present both in the cytoplasm and in a membrane vesicle fraction. The lysosomal locale of calmodulin and the effect of thyrotropin on vesicle number suggest a role for calcium in the regulation of lysosome function. PMID- 3308932 TI - Reticuloplasmins: a novel group of proteins in the endoplasmic reticulum. PMID- 3308933 TI - Visualization of the intact endoplasmic reticulum by immunofluorescence with antibodies to the major ER glycoprotein, endoplasmin. AB - Antibodies to endoplasmin were used to examine the morphology of the endoplasmic reticulum (ER) by immunofluorescence on permeabilized plasmacytoma and fibroblastoid cells. In unfixed cells, permeabilization led to a pronounced vesiculation of the ER. Therefore cells were first fixed lightly prior to permeabilization with detergent. Fibroblastoid cells gave a characteristic reticular pattern surrounding the nucleus with clear staining of the nuclear membrane. Plasmacytoma cells, in the conventional fluorescence microscope, gave a cisternae-like pattern. Optical sectioning with a confocal scanning laser microscope gave a distinct pattern of concentric cisternae similar to those obtained with transmission electron microscopy on cell sections. The overall morphology of the ER in such cells could be revealed by serial optical sectioning. Evidence was obtained that the ER does not undergo extensive vesiculation during mitosis in plasmacytoma cells. Using anti-endoplasmin immunofluorescence monitoring, conditions were developed for the retention of ER morphology in unfixed, permeabilized cells. These studies illustrate the value of endoplasmin as a general marker for the analysis of ER morphology in different types of cells by immunofluorescence microscopy. PMID- 3308934 TI - The assessment of "clumsy" children: old and new approaches. PMID- 3308935 TI - Hallucinations in children and teenagers admitted to Bethlem Royal Hospital in the nineteenth century and their possible relevance to the incidence of schizophrenia. AB - The case notes of 1069 children and teenagers admitted to Bethlem Royal Hospital, ("Bedlam"), in the nineteenth century were analysed with particular reference to the frequencies and types of hallucinations. There was a significant increase (P less than 0.001) in the frequencies of auditory and visual hallucination from 1830 to the end of the century. The presence of auditory hallucinations of people, when they occurred in males, significantly worsened the prognosis (P less than 0.025) compared to females. The findings are considered with special reference to the incidence and aetiology of schizophrenia in the last century. PMID- 3308936 TI - Rapid dual-column chromatographic assay for recombinant leukocyte interferon alpha-2. AB - A rapid dual-column chromatographic assay for determining recombinant leukocyte interferon alpha-2 in complex mixtures is described. The assay relies on the use of a high-performance monoclonal antibody affinity column connected in tandem with a reversed-phase column. The high specificity and selectivity of these columns permits the quantitation of subcomponent species, such as interferon oligomers that may be present in assay samples. The assay has a limit of sensitivity equal to 1 microgram/g over a range of 1-20 micrograms/g. The precision of the assay was estimated to be about 5%. PMID- 3308937 TI - Purification of allergens by high-performance liquid chromatography. III. Purification of fungal allergens. PMID- 3308938 TI - Gas chromatographic determination of hippuric acid and a furancarboxylic acid in plasma of patients with kidney diseases. PMID- 3308939 TI - Use of pentafluorobenzyl and pentafluoropropionyl-pentafluorobenzyl esters of bacterial fatty acids for gas chromatographic analysis with electron-capture detection. PMID- 3308940 TI - Immunohistochemical localization of aromatase cytochrome P-450 and estradiol dehydrogenase in the syncytiotrophoblast of the human placenta. AB - Immunohistochemistry employing immunoglobulin G fractions raised against aromatase cytochrome P-450 and antiserum against 17 beta-estradiol dehydrogenase was used to localize these two steroid-converting enzymes in the human placenta. Immunostaining for both enzymes was found exclusively in the syncytiotrophoblast, while the underlying cytotrophoblast and the villus core did not stain. Ultrastructural examination of aromatase cytochrome P-450- and 17 beta-estradiol dehydrogenase-labeled sections disclosed immunoreactive product in the membranes of the endoplasmic reticulum; the nucleus, mitochondria, Golgi apparatus, and secretory granules were free of staining. These findings suggest that the syncytiotrophoblast is actively involved in the synthesis and metabolism of estrogens and in their role in placental endocrine function. PMID- 3308941 TI - Sparing of cognitive function in mild hypoglycemia: dissociation from the neuroendocrine response. AB - Central nervous system function during insulin-induced reductions in plasma glucose was studied by measuring plasma epinephrine concentrations and testing cognitive function. Mild glucose reduction [mean plasma glucose, 62 +/- 3 (+/- SEM) mg/dL (3.4 +/- 0.2 mmol/L)] was induced with an iv insulin infusion at the rate of 40 mU/kg.h for 180 min in 7 normal subjects. Despite a marked increase in mean plasma epinephrine concentrations, which peaked at 426 +/- 68 pm/mL (2325 +/ 371 pmol/mL; P less than 0.001), no significant differences in cognitive function occurred as determined by a series of trail-making tests compared with the results of serial tests in a group of 17 control subjects. In contrast, when hypoglycemia was induced (plasma glucose, less than 42 mg/dL; 2.3 mmol/L) by bolus injection of insulin in 4 normal subjects, cognitive function was impaired in every subject, as demonstrated by a delay in completion of the trail-making test. The mean completion time was prolonged to 107 +/- 16% of the baseline at the time of hypoglycemia vs. 74 +/- 4% in control subjects (P less than 0.01). These findings suggest that cognitive function may be spared during mild plasma glucose reductions and is dissociated from the neuroendocrine adrenergic response that is activated under these conditions. This dissociation may be part of a homeostatic process in which overall brain function is maintained during glucoprivation, although counterregulation has already been triggered to prevent a further decrease in plasma glucose. PMID- 3308944 TI - A clinical look at early post-implantation pregnancy failure. PMID- 3308942 TI - B-cell stimulatory factors (BSFs): molecular structure, biological function, and regulation of expression. PMID- 3308943 TI - Assessment of the antigenic response in humans to a recombinant mutant interferon beta. AB - Cancer patients were given a recombinant mutant interferon beta by alternating IM and IV injections with weekly escalation of doses from 0.1 to 400 million U. Antibodies specific to the interferon of the IgG class were detected in 24 of 30 patients using an indirect enzyme-linked immunosorbent assay. Serum from only 1 of the 30 patients had detectable ability to neutralize interferon biological activity. The in vivo interferon serum level, assayed as antiviral activity immediately after IV injection, was not lower than levels seen in the absence of antibodies. Antibodies did not alter the kinetics of clearance of interferon from the serum after IV administration. Antibody levels progressively decreased when interferon administration was discontinued. In most patients antibody levels decreased during a maintenance period when interferon was being administered only by the IV route. In a subsequent trial interferon was given IV, and antibody developed in only 2 of 36 patients. In contrast, in a trial in which interferon was given IM, 20 of 25 patients developed antibody. No antibody-related clinical sequelae could be detected in any of these patients. PMID- 3308945 TI - Comparative analysis of two rapid automated methods and a semiautomated version of the urease method for determining aminoglycoside concentrations in serum. AB - The Syva EMIT Autolab 6000 and the Abbott TDX automated methods for measuring serum aminoglycoside concentrations were compared with each other and with a new semiautomated version of the urease technique. Each was evaluated for accuracy, reproducibility, cost, and ease of use. All three methods gave satisfactory results, although the Abbott TDX was the most accurate. Both automated methods gave results within minutes, whereas the new urease method, which involved more initial manipulation, took 1.25 h to complete (mainly incubation time). There was no difference in accuracy of performance between experienced and inexperienced operators. The new urease method was much cheaper in terms of initial capital expenditure and in cost per test and needed no provision of manufacturer's back up maintenance services. This could prove invaluable in situations where financial resources are at a premium. Otherwise, the Abbott TDX is currently our method of choice, and reasons for its preference to the EMIT system are listed. PMID- 3308946 TI - Comparative study of tissue culture and mouse inoculation methods for demonstration of Toxoplasma gondii. AB - Two methods for the isolation of Toxoplasma gondii were analyzed and compared. Bradyzoites or tachyzoites of three strains of T. gondii were injected into mice and introduced in parallel onto MRC5 fibroblasts cultured on cover slips. In the cultures, the parasites were more readily identified by an indirect immunofluorescence assay than by examination of unstained or Giemsa-stained cultures. With the RH strain, the tachyzoites replicated actively, and large foci of parasites were observed in 24 h. The bradyzoites or tachyzoites of the other strains could also be cultivated, but grew rather slowly; 2 days after inoculation, early stages of multiplication could be observed: from day +4, Toxoplasma clusters or foci were easily identified at a x100 magnification. The course of infection in mice was greatly dependent on the virulence of the strain and on the parasitic stage inoculated. In the chronically infected mice, evidence of Toxoplasma infection was only detected 45 days after inoculation through the demonstration of cysts in the brain or the presence of specific antibodies in the serum. The mean ratio of infected mice and positive cultures was compared in relation to the inoculum size. The tissue culture method was found to be at least as sensitive as mouse inoculation. Since Toxoplasma organisms may be isolated within a few days in tissue culture, it is proposed that this method should be used when early isolation of the parasite is crucial for the diagnosis of toxoplasmosis. PMID- 3308947 TI - Comparison of Du Pont Isolator and Roche Septi-Chek for detection of fungemia. AB - The rapid detection of fungemia in hospitalized patients is imperative, particularly for those who are immunocompromised. Our laboratory compared the Roche Septi-Chek with the Du Pont Isolator for the recovery of fungi from blood. Of 23,586 matched pairs of blood cultures, 199 were positive. The Isolator detected 178 (89.4%) and the Septi-Chek detected 119 (59.7%) of all positive isolates. The mean recovery time for the Isolator and Septi-Chek was 2.2 and 4.9 days, respectively. The Isolator detected fungemia earlier than the Septi-Chek did and was the only culture system positive in 83% of 53 patients, whereas the Septi-Chek system yielded the same results in only 13% of the patients. The Isolator provides a more rapid and sensitive method for the recovery of fungi from blood. PMID- 3308948 TI - Production of monoclonal antibodies to Naegleria fowleri, agent of primary amebic meningoencephalitis. AB - Monoclonal antibodies (MAbs) to Naegleria fowleri, the etiologic agent of primary amebic meningoencephalitis (PAM), have been produced and used as probes to identify N. fowleri amebae in brain sections of patients who died of that disease. These MAbs were characterized for their specificity by the indirect immunofluorescence assay (IIF), dot immunobinding assay (DIBA), and enzyme-linked immunotransfer blot technique (EITB). The MAbs reacted intensely with all strains of N. fowleri tested originating from different geographic areas in the IIF and DIBA tests, but showed no reactivity with four other species of Naegleria, N. gruberi, N. jadini, N. lovaniensis, and N. australiensis, or a strain of Acanthamoeba castellanii. In the EITB assay the MAbs reacted with the antigens of N. fowleri and produced intensely staining bands at the 160-, 104-, 93-, and 66 kilodalton (kDa) regions and several minor bands at the 30- and 50-kDa regions. The MAbs also reacted with the antigens of N. lovaniensis and produced a darkly staining band at 160 kDa and a diffusely staining band at 116 kDa, indicating that these antigens were shared by the two species. The MAbs, however, showed no reactivity with N. jadini and N. gruberi in the EITB assay. PMID- 3308949 TI - Detection of culture-derived Babesia bovis exoantigen using a two-site enzyme immunoassay. AB - Soluble exoantigens in the supernatants of Babesia bovis cultures have been shown to be efficient immunogens against bovine babesiosis. We used a two-site enzyme immunoassay to monitor the release of these antigens during in vitro cultivation. Bovine immunoglobulin G was isolated from serum of an adult cow previously immunized with culture-derived B. bovis exoantigens and challenged via needle with virulent parasites. The specific immunoglobulin G was used as a capture antibody and as an enzyme-conjugated recognizing antibody. The optimal protein concentration of capture antibody was 10 micrograms/ml. The 24-h cultures showed the greatest antigen concentration. The test was sensitive for detection of differences in species-specific antigenic activity among B. bovis isolates, for determining loss of antigenicity during storage and formalinization, and for monitoring the kinetics of exoantigen release during in vitro cultivation. Antigens cross-reactive with the other major Babesia species of cattle, Babesia bigemina, were also detected with this assay. The high specificity, sensitivity, and reproducibility of this technique should facilitate detection and quantitation of Babesia antigens during purification and in standardization of candidate immunogens. PMID- 3308950 TI - Reaction of fungal products with amebocyte lysates of the Japanese horseshoe crab, Tachypleus tridentatus. AB - A commercially available endotoxin assay (CS-TAL) employing a chromogenic peptide and an amebocyte lysate from the Japanese horseshoe crab, Tachypleus tridentatus, gave a positive result with aqueous extracts of all 15 strains of Candida albicans and 1 strain each of Candida tropicalis, Cryptococcus neoformans, and a Mucor species that we tested. Purified glucans prepared from the Candida strains gave the same results. Reconstruction experiments showed that the positive results were not due to contaminating endotoxin. By contrast, assays employing amebocyte lysates of the American horseshoe crab, Limulus polyphemus, were inconsistent. Japanese workers have presented evidence that glucans activate the Tachypleus amebocyte lysate system by acting on an enzyme different from that on which endotoxin acts. Using a Tachypleus lysate preparation (Endospecy; Seikagaku Kogyo, Tokyo, Japan) from which this enzyme was excluded, we demonstrated a 5- to 10-fold drop in reactivity to the aqueous Candida extracts and glucans, whereas reactivity to endotoxin was unchanged. Normal human plasma was shown to decrease the effect of fungal extracts on CS-TAL. This inhibition was completely removed by heating the plasma. Our results suggest that Tachypleus systems may be of use clinically in distinguishing bacterial from fungal infections. PMID- 3308951 TI - Enzyme-linked immunosorbent assay for detection of antibodies to the venereal disease research laboratory (VDRL) antigen in syphilis. AB - An enzyme-linked immunosorbent assay (ELISA) for detection of immunoglobulin G (IgG) and IgM to cardiolipin, lecithin, and cholesterol (VDRL [Venereal Disease Research Laboratory] ELISA) is described. The specificity of the VDRL ELISA for IgG and IgM was 99.6 and 99.5%, respectively, with sera from 1,008 persons without syphilis. For a group of patients with false-positive results in traditional nontreponemal tests and for patients with autoimmune diseases, the VDRL ELISA for IgG had a higher specificity than the VDRL ELISA for IgM. The sensitivity for IgG and IgM with 118 sera from patients with untreated syphilis was 96.6 and 94.9%, respectively, which was equivalent to the sensitivities of the traditional nontreponemal tests. The performance of the VDRL ELISA was compared with that of an ELISA that uses cardiolipin as the antigen (cardiolipin ELISA). The VDRL ELISA was significantly more sensitive (P less than or equal to 0.01) than the cardiolipin ELISA with 25 sera from syphilis patients but was less sensitive (P less than or equal to 0.01) with 53 sera from patients with autoimmune diseases. The antibody reactivity in the VDRL ELISA could not be absorbed out by lecithin and cholesterol, and the sera from patients with syphilis did not react in an ELISA that uses cholesterol and lecithin as the antigen. This indicates that cholesterol and lecithin, although not antigenic by themselves, may change the structural form of the epitope on cardiolipin so that it becomes more recognizable for antibodies in syphilis and less recognizable for antibodies in autoimmune diseases. The results of the VDRL ELISA were expressed in percentages of the absorbance value of a positive control. The VDRL ELISA gave, without titration of sera, quantitative results that correlated with the quantitative results of the traditional nontreponemal tests obtained by titration. The VDRL ELISA will be well suited for large-scale testing for syphilis and may replace other nontreponemal tests. PMID- 3308952 TI - Comparison of a new, rapid enzyme immunoassay with a latex agglutination test for qualitative detection of rubella antibodies. AB - A total of 450 sera were tested for rubella virus antibodies by using a new, rapid enzyme immunoassay, SUDS Rubella. The results were compared with those obtained by using the Rubascan test, a well-established latex agglutination method. The sensitivity of the SUDS Rubella was 99.5%, and the specificity was 100%, when compared with Rubascan. The SUDS Rubella test can be performed in 10 min and provides an accurate screening test for the detection of rubella antibodies. PMID- 3308954 TI - Test-of-cure analysis by direct immunofluorescence for Chlamydia trachomatis after antimicrobial therapy. AB - The direct immunofluorescence assay (DFA) was compared with culture for test-of cure analysis for Chlamydia trachomatis in patients 7 to 10 days after antimicrobial therapy was given. DFA test-of-cure results correlated with culture results in 79.5% of 39 patients. Of DFA-negative patients, 97% had negative cultures. Six of seven patients with borderline DFA results had negative culture results. PMID- 3308953 TI - Detection of antibodies to human immunodeficiency virus by latex agglutination with recombinant antigen. AB - Recombinant human immunodeficiency virus (HIV) env antigen was attached to polystyrene particles, and these complexes were used to develop the first latex agglutination assay for antibodies to HIV. A total of 95 positive and 116 negative human serum samples were assayed for antibodies to HIV by latex agglutination, and results were compared with those of a commercial enzyme immunoassay. Latex agglutination was also compared with, and found to be completely concordant with, Western blot (immunoblot) analysis with virion antigens. PMID- 3308955 TI - Gastroenteritis, sepsis, and osteomyelitis caused by Plesiomonas shigelloides in an immunocompetent host: case report and review of the literature. AB - We report the 11th human case of bloodstream infection with Plesiomonas shigelloides. This was the first case without any apparent underlying immunocompromising disease, and the patient was the first adult to survive the infection. We review all the extraintestinal cases associated with this organism, giving special attention to the clinical characteristics of the bloodstream infections reported previously. PMID- 3308956 TI - Effect of chronic hyperglycemia on in vivo insulin secretion in partially pancreatectomized rats. AB - We have examined the effect of chronic (4 wk) hyperglycemia on insulin secretion in vivo in an awake, unstressed rat model. Three groups of animals were examined: control, partial (90%) pancreatectomy, and partial pancreatectomy plus phlorizin, in order to normalize plasma glucose levels. Insulin secretion in response to arginine (2 mM), hyperglycemia (+100 mg/dl), and arginine plus hyperglycemia was evaluated. In diabetic compared with control animals three specific alterations were observed: (a) a deficient insulin response, in both first and second phases, to hyperglycemia; (b) an augmented insulin response to the potentiating effect of arginine under basal glycemic conditions; and (c) an inability of hyperglycemia to augment the potentiating effect of arginine above that observed under basal glycemic conditions. Normalization of the plasma glucose profile by phlorizin treatment in diabetic rats completely corrected all three beta cell abnormalities. These results indicate that chronic hyperglycemia can lead to a defect in in vivo insulin secretion which is reversible when normoglycemia is restored. PMID- 3308957 TI - Effects of angiotensin-converting enzyme inhibition on altered renal hemodynamics induced by low protein diet in the rat. AB - We assessed the role of angiotensin II in mediating the alterations in renal hemodynamics known to result from low protein feeding to normal rats by examining the effect of the angiotensin-converting enzyme (ACE) inhibitor captopril. 2 wk of low protein (6% casein) diet resulted in decreased glomerular filtration rate (normal protein [NP], 1.82 +/- 0.17 vs. low protein [LP], 0.76 +/- 0.01 ml/min; P less than 0.05) and renal plasma flow (NP, 6.7 +/- 0.2 vs. LP, 3.3 +/- 0.3 ml/min; P less than 0.05); renal vascular resistance rose (NP, 8.7 +/- 0.4 vs. LP, 19.8 +/- 1.4 dyn . s per cm5; P less than 0.05). These changes were accompanied by a significant decrease in plasma renin activity (NP, 7.0 +/- 0.7 vs. LP, 4.4 +/- 0.8 ng A I/ml per h; P less than 0.05), plasma aldosterone concentration (NP, 7.0 +/- 0.6 vs. LP, 4.1 +/- 0.7 ng/dl; P less than 0.05), and urinary PGE2 excretion (NP, 3,120 +/- 511 vs. LP, 648 +/- 95 pg/mgCr; P less than 0.05); by contrast renal renin content was significantly increased (NP, 2,587 +/- 273 vs. LP, 7,032 +/- 654 ng A I/mg protein; P less than 0.05). Treatment with captopril (30 mg/kg per d) raised glomerular filtration rate (GFR; LP + capt, 1.6 +/- 0.2 ml/min) and renal plasma flow (RPF; LP + capt, 6.7 +/- 0.7 ml/min), and reduced renal vascular resistance (LP + capt, 9.2 +/- 0.5 dyn/s per cm5) in low protein-fed animals. These values were not different from those measured in untreated and captopril-treated rats fed a normal (23%) protein diet. There were no changes in systemic mean arterial pressure in any group of rats. These data provide evidence that intrarenal angiotensin II mediates the changes in intrarenal hemodynamics induced by protein deprivation. The effects of low protein feeding may be partly potentiated by the reduction in PGE2 synthesis. However, the normalization of GFR and RPF in view of only modest increases in PGE2 excretion after captopril (LP, 648 +/- 95 vs. LP + capt, 1,131 +/- 82 pg/mgCr; P less than 0.05) suggests that if PGE2 is involved in these changes, it plays a permissive but not essential role in the increased renovascular resistance. PMID- 3308959 TI - Falciparum malaria parasites invade erythrocytes that lack glycophorin A and B (MkMk). Strain differences indicate receptor heterogeneity and two pathways for invasion. AB - To determine the ligands on erythrocytes for invasion by Plasmodium falciparum, we tested invasion into MkMk erythrocytes that lack glycophorins A and B and enzyme-treated erythrocytes by parasites that differ in their requirement for erythrocyte sialic acid. The 7G8 strain invaded MkMk erythrocytes and neuraminidase-treated normal erythrocytes with greater than 50% the efficiency of normal erythrocytes. In contrast, the Camp strain invaded MkMk erythrocytes at 20% of control and neuraminidase-treated normal erythrocytes at only 1.8% of control. Invasion of MkMk erythrocytes by 7G8 parasites was unaffected by treatment with neuraminidase but was markedly reduced by treatment with trypsin. In contrast, invasion of MkMk cells by Camp parasites was markedly reduced by neuraminidase but was unaffected by trypsin. We conclude that the 7G8 and Camp strains differ in ligand requirements for invasion and that 7G8 requires a trypsin sensitive ligand distinct from glycophorins A and B. PMID- 3308958 TI - Long-term effect of insulin on glucose transport and insulin binding in cultured adipocytes from normal and obese humans with and without non-insulin-dependent diabetes. AB - We have tested the hypothesis that in vitro exposure of insulin-resistant adipocytes with insulin results in improved insulin action. A primary culture system of adipocytes from obese subjects with or without non-insulin-dependent diabetes mellitus (NIDDM) and nonobese control subjects has been developed. The adipocytes when cultured in serum-free medium do not lose their original characteristics in regard to insulin binding and glucose transport. The adipocytes from three groups were incubated with insulin (0, 10(-10) M, and 10( 7) M) for 24 h at 37 degrees C, receptor-bound insulin was dissociated, and basal and insulin (1 X 10(-11)-10(-7) M)-stimulated glucose transport and 125I-insulin binding were determined. The 24-h insulin exposure of adipocytes from control subjects decreased basal and insulin-stimulated glucose transport. The effects of 1 X 10(-7) M insulin were more pronounced than 1 X 10(-10) M insulin. Similarly, insulin exposure decreased insulin sensitivity and responsiveness of cultured adipocytes from obese and NIDDM patients. The insulin-induced reduction in insulin sensitivity and responsiveness for glucose transport in three groups were due to alterations at insulin binding and postbinding levels. In conclusion, insulin induces insulin resistance in control adipocytes and further worsens the insulin resistance of adipocytes from obese and NIDDM subjects. For insulin to improve the insulin resistance of adipocytes from NIDDM patients, either more prolonged in vitro insulin exposure and/or other hormonal factors might be required. PMID- 3308960 TI - In vitro activity of nicotinamide adenine dinucleotide- and nicotinamide adenine dinucleotide phosphate-linked 15-hydroxyprostaglandin dehydrogenases in placentas from normotensive and preeclamptic/eclamptic pregnancies. AB - Concentrations of prostaglandins E2 and I2 may be decreased in preeclamptic and eclamptic pregnancies. Because these prostaglandins produce vasodilation and inhibit platelet aggregation it has been suggested that a reduction in their biosynthesis might play an important role in the pathogenesis of the hypertension and coagulation abnormalities associated with preeclampsia. Placental tissue is an extremely rich source of several enzymes that catalyze the catabolism of prostaglandins. The present study was initiated to determine whether one of these catabolic enzymes might be increased in preeclamptic/eclamptic pregnancies. The activities of the NAD- and the NADP-linked 15-hydroxyprostaglandin dehydrogenases were measured in 16 preeclamptics (mean diastolic pressure, 108 +/- 13 mmHg) and compared with 16 normotensive controls matched for age (20.8 +/- 5.43 vs. 20.6 +/ 5.16) and gestational week of delivery (34.6 +/- 5.40 vs. 35.0 +/- 5.06). These results indicate that the activity of the placental NAD-linked 15 hydroxyprostaglandin dehydrogenase is elevated in preeclampsia (40.1 +/- 31.3 vs. 14.9 +/- 8.30 mU/g tissue, P less than 0.01). If this increase were also expressed in vivo, its effect on prostaglandin metabolism could be mistaken for impaired prostacyclin biosynthesis unless both the 6-keto- and 6,15-diketo metabolites of prostacyclin were measured. PMID- 3308961 TI - Weight reduction increases adipose tissue lipoprotein lipase responsiveness in obese women. AB - Lipoprotein lipase was measured in gluteal adipose tissue from nine obese (90.6 +/- 2.7 kg) women fasting and after the intravenous infusion of insulin and glucose before, immediately after, and 3 mo subsequent to a 14.0 +/- 1.8% (mean +/- SEM) weight reduction. Fasting adipose tissue lipoprotein lipase activity (ATLPL) decreased from 5.3 to 2.3 nEq FFA/10(6) cells per min (P less than 0.02) immediately after weight reduction, yet after weight maintenance, higher levels were again found (6.1 nEq FFA/10(6) cells per min). Although responsiveness of ATLPL to 40 mU/m2 per min of insulin infusion over 6 h was absent before weight loss, increases were seen immediately after weight loss (delta 0.8, P = 0.05) and more so (delta 7.7, P less than 0.01) after 3 mo. Moreover, whereas before weight loss the ATLPL response to ingested mixed meals (delta 0.9) was minimal, in the maintained reduced-obese state a marked increase was seen (delta 12.6, P = 0.02). Thus, because ATLPL is important to lipid filling in adipose tissue, the maintenance of high levels of fasting ATLPL and the increase in enzyme responsiveness in the reduced-obese state could play an important role in the resumption of the obese state, which so commonly follows weight reduction. PMID- 3308963 TI - Demonstration of lymphoid antigens in decalcified bone marrow trephines. AB - A panel of antibodies recognising lymphoid and epithelial antigens in formalin fixed, paraffin embedded sections was applied to a series of 54 bone marrow trephines decalcified by formic or edetic acids. Normal trephines and cases infiltrated by myeloid, lymphoid, and epithelial tumours were included. Patterns of reactivity were distinct and allowed the different diseases to be distinguished. All lymphoid tumours expressed leucocyte common antigen, with B cell tumours staining with MB1 and MB2, and T cell tumours staining with MT1 and UCHL1. T cell acute lymphoblastic leukaemia (ALL)/lymphoblastic lymphoma all stained with MT1, but some were negative with UCHL1. B cell ALL/lymphoblastic lymphoma also stained with MT1, but could be distinguished by its reactivity with MB1 and MB2. Reed-Sternberg cells did not stain with any reagent. Normal and neoplastic myeloid cells stained with MT1. Carcinomas stained with CAM 5.2 but were negative for lymphoid markers except MB2 staining in some cases. A case of neuroblastoma could be distinguished from ALL/lymphoblastic lymphoma by its lack of reactivity with all antileucocyte antibodies and its staining with antineurone specific enolase. Although not ideal, if used together, this panel of reagents may usefully be applied to routinely fixed and processed, decalcified bone marrow trephines. PMID- 3308962 TI - Simple method of monitoring colonising microbial load in chronic bronchial sepsis: pilot comparison of reduction in colonising microbial load with antibiotics given intermittently and continuously. AB - Aerobic and anaerobic culture of sputum on selective bacteriological media, combined with a new method of plating and plate reading, permitted rapid identification and quantitation of three genera of bacteria commonly associated with chronic bronchial sepsis (Haemophilus spp, Pseudomonas aeruginosa, and Staphylococcus aureus) and avoided time consuming serial dilution of sputum and subculture of organisms. The accuracy of this new technique was assessed in patients with chronic bronchial sepsis and was used to detect changes in the colonising microbial load of Haemophilus spp and Ps aeruginosa in patients with bronchiectasis receiving one of three different antibiotic regimens: intermittent seven day courses of amoxycillin for exacerbations; or a six month course of continuous oral or nebulised amoxycillin. The colonising microbial load of Haemophilus spp was reduced only temporarily (+++ to ++) after each intermittent course of antibiotic, but a sustained and greater reduction in the colonising microbial load of both Haemophilus spp (+++ to +) and antibiotic resistant P aeruginosa (+++ to +) was seen during both continuous treatments. Sputum purulence decreased in parallel with colonising microbial load, reflecting a reduction in host inflammatory response to the colonising microbial load. PMID- 3308964 TI - Immunocytochemical analysis of HLA class II (DR) antigens in liver disease in man. AB - The in situ distribution of the major histocompatibility (HLA) class II (DR) antigens was studied in 113 liver biopsy specimens and five livers obtained at necropsy, using monoclonal antibody CR3/43. In 20 normal livers HLA-DR antigens were not detected in bile duct epithelium, hepatocytes, or portal vein endothelium. Normal arteriolar, sinusoidal and central venous endothelium often expressed HLA-DR. Kupffer cells always expressed these antigens. HLA-DR positive spindle cells were identified in the connective tissue of portal tracts, large hepatic veins, and liver capsule: most shared antigens common to all leucocytes and reacted with the histiocytic maker EBM11. Bile duct epithelium expresses HLA DR in primary biliary cirrhosis, large duct obstruction, and drug induced cholestasis, indicating that HLA-DR positive spindle cells are phenotypically similar to histiocytes. PMID- 3308965 TI - Leucocyte populations in ectopic tubal pregnancy. AB - Leucocytes at the ectopic implantation site in 10 cases of early tubal pregnancy were characterised with a series of monoclonal antibodies using an indirect immunoperoxidase technique on cryostat sections. Most were HLA-DR positive macrophages, and there were a small number of mature T lymphocytes (UCHT1 and Dako-T1 positive cells). These results were compared with those reported in normal first trimester intrauterine pregnancies, and the contributions of the various leucocyte types to successful implantation at both the ectopic and intrauterine sites were assessed. PMID- 3308966 TI - Incidence of cysteine dependent Escherichia coli in a general practice population. PMID- 3308967 TI - Method for preparing large specimens obtained by disarticulation or amputation for histological examination. PMID- 3308968 TI - Maintenance care for treated periodontitis patients. AB - This paper is a review of current literature combined with clinical observations. Well-controlled maintenance care is a key consideration in the long-term prognosis of treated periodontitis patients. Periodic professional tooth cleaning every 3 to 4 months often is recommended. Furthermore, recent studies indicate a potential need for selected retreatment in problem areas, since minute residual accretions may be left behind during active therapy--even with "open" surgery. While efficient plaque control is essential for optimal results during the healing phase of periodontal therapy, periodic prophylaxis may prevent loss of clinical attachment over long periods of time even for patients with less than perfect oral hygiene. PMID- 3308969 TI - 4 modalities of periodontal treatment compared over 5 years. AB - The purpose of the present study was to assess in a clinical trial over 5 years the results following 4 different modalities of periodontal therapy (pocket elimination or reduction surgery, modified Widman flap surgery, subgingival curettage, and scaling and rool planing). 90 patients were treated. The treatment methods were applied on a random basis to each of the 4 quadrants of the dentition. The patients were given professional tooth cleaning and oral hygiene instructions every 3 months. Pocket depth and attachment levels were scored once a year. 72 patients completed the 5 years of observation. Both patient means for pocket depth and attachment level as well as % distribution of sites with loss of attachment greater than or equal to 2 mm and greater than or equal to 3 mm were compared. For 1-3 mm probing depth, scaling and root planing, as well as subgingival curettage led to significantly less attachment loss than pocket elimination and modified Widman flap surgery. For 4-6 mm pockets, scaling and root planing and curettage had better attachment results than pocket elimination surgery. For the 7-12 mm pockets, there was no statistically significant difference among the results following the various procedures. PMID- 3308970 TI - The influence of a dentifrice containing a zinc salt and a nonionic antimicrobial agent on the maintenance of gingival health. AB - The purpose of the present investigation was to test the concept that a dentifrice containing zinc citrate and Triclosan could maintain gingival health. The gingival health of 101 young predominately female student nurses in Oslo was brought to a high level by professional cleaning supported by oral hygiene instruction. The criterion of gingival health was less than or equal to 5 elicited bleeding sites from a full mouth assessment. The mean bleeding value attained for the whole group was 3.5. 2 balanced groups were formed, based on the initial number of elicited bleeding sites and plaque values. One group used the test dentifrice and the other group the placebo for 6 months, with an intermediate assessment after 3 months. The placebo group failed to maintain the standard of oral hygiene and gingival health that had been achieved by professional care. In contrast, the group using the test dentifrice for 6 months exhibited similar levels of plaque and gingival health to that observed at baseline following oral hygiene instruction. After 6 months, less than 7% of the subjects in the placebo group possessed healthy gingivae in contrast to 60% of the test group. Thus a dentifrice containing a zinc salt and nonionic germicide had successfully maintained gingival health in a group of young adults. PMID- 3308971 TI - The presence of methanobacteria in human subgingival plaque. AB - Through a procedure of setting up a strictly anaerobic chain from sampling subgingival plaque to incubation in an anaerobic cabinet (O2 less than 10 ppm), it was possible to, for the first time, isolate methanobacteria from human subgingival plaque. PMID- 3308972 TI - Gingival attachment level measurements with an automated periodontal probe. AB - The accurate and reproducible measurement of gingival attachment level is essential for studying the progression of periodontitis in human populations. An automated periodontal probe has been developed which measures gingival attachment level using the occlusal or incisal surface of the tooth as a fixed landmark and which transfers data directly to a computer. The probing force is adjustable and is regulated by changing the air pressure. A mercury level switch maintains uniform probe angulation during measurements. The reproducibility of measurements obtained with the automated periodontal probe was examined by making duplicate gingival attachment level measurements at 784 sites in 9 patients 1 week apart and comparing the difference between the paired values. A probing force of 0.30 N was used. There was no significant difference in the frequency distributions of measurement differences between either maxillary versus mandibular teeth or anterior versus posterior teeth. The data demonstrate that this device can be used to measure gingival attachment level without the need for stents or estimation of the level of the cementoenamel junction and that reproducible data can be obtained and automatically stored in a computer for subsequent analysis. PMID- 3308973 TI - The Swiss drug review and approval process. PMID- 3308974 TI - Renal excretion. PMID- 3308975 TI - Intravenous pinacidil in the acute treatment of hypertension. AB - Pinacidil (N''-cyano-N-4-pyridyls-N'-1,2,2-trimethyl-propyl guanidine, monohydrate), a recently developed direct-acting vasodilator, was given intravenously in a dosage of 0.1-0.2 mg/kg body weight to ten untreated hypertensive patients. Pinacidil caused a fall of blood pressure from 170/108 +/- 6/3 to 156/80 +/- 5/4 mm Hg (mean +/- SE). The proportional decrease of mean arterial pressure (MAP) was 13.7 +/- 1.6%. Together with the decrease of blood pressure an increase of heart rate by 29.7 +/- 6.2% occurred. The heart rate increased by 13.6 beats/min per 10 mm Hg decrease of MAP. Pinacidil also caused significant rise of plasma noradrenaline and plasma renin activity, whereas plasma adrenaline and aldosterone remained unchanged. The serum concentrations of pinacidil and its major metabolite pinacidil-N-oxide were within the expected limits. The authors conclude that intravenously administered pinacidil causes a rapid decrease of blood pressure, but at the cost of a considerable increase of heart rate, and thus does not offer advantages over other vasodilators. PMID- 3308976 TI - Biliary excretion. PMID- 3308977 TI - Bromocriptine-desipramine protocol in treatment of cocaine addiction. AB - Thirty-six male cocaine abusers, in withdrawal, were studied for 99 days in a double-blind design. Treatment with bromocriptine was significantly more effective than placebo in alleviating withdrawal symptoms. Adding desipramine to the bromocriptine regimen was significantly more effective than either placebo or bromocriptine alone. The authors hypothesize that these results support a model of dopamine depletion and receptor supersensitivity in cocaine withdrawal. PMID- 3308978 TI - Antifungal agents in dermatology. AB - Development of new antifungal agents has increased significantly over the past two decades, with recent advances reflecting interest in synthetic agents as opposed to antibiotics. We review the various antifungal medications in use or under development, beginning with a discussion of over-the-counter agents, antibiotics, and older azole compounds and ending with an evaluation of newer azoles and the new class of antifungals, the allylamines. PMID- 3308979 TI - Large speckle-like thready and thready antinuclear antibody patterns as markers for different clinical presentations in lupus erythematosus. AB - Fifty-one patients with lupus erythematosus were studied retrospectively. They were chosen on the basis of their antinuclear antibody (ANA) immunofluorescent pattern. Only those with the thready or the large speckle-like thready patterns were studied. Autoantibody profiles consisting of ANA, anti-single-stranded deoxyribonucleic acid (ssDNA) antibody, and anti-extractable nuclear antigen (ENA) antibody determinations were obtained. The patients with the thready ANA pattern and anti-ENA (Sm) antibodies had a significantly higher incidence of pulmonary, joint, and renal involvement than the anti-ENA negative patients with the large speckle-like thready pattern. There was also a significantly higher incidence of Raynaud's phenomenon in patients with the thready pattern than in those with the large speckle-like thready pattern. Photosensitivity was seen significantly more frequently in the patients with the large speckle-like thready pattern than in those with the thready pattern. PMID- 3308981 TI - Localized scleroderma (morphea) and antibody to Borrelia burgdorferi. AB - Enzyme-linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA) were performed in 25 and 32 cases of morphea, respectively. The more sensitive and specific ELISA was positive in only 1 of 25 cases and the mean value was lower in cases of morphea than in controls. IFA showed minimally reactive titers in 6 (19%) of 32 cases. There were an additional six cases with borderline titers. These data indicate that there is no specific association between Borrelia burgdorferi infection and morphea but that patients with morphea tend to have circulating antibodies that are cross-reactive. PMID- 3308980 TI - Amikacin alone and in combination with trimethoprim-sulfamethoxazole in the treatment of actinomycotic mycetoma. AB - We report the excellent therapeutic response obtained with amikacin alone and in combination with trimethoprim-sulfamethoxazole in the treatment of 15 patients with actinomycotic mycetoma who had a poor response to the traditional pharmacologic agents and/or in whom important organs such as lungs, spinal cord, and bone were involved. We evaluated the results by clinical, radiologic, and laboratory tests. No important side effects were detected during or after the therapy. PMID- 3308982 TI - Cryptococcal cellulitis in renal transplant recipients. AB - We report three cases of cryptococcal cellulitis in renal transplant recipients and review five other cases in the literature. Seven cases of cryptococcal cellulitis occurring in other immunocompromised states are also reviewed and compared with the renal transplant group. Cryptococcal cellulitis in renal transplant recipients affects the skin of the extremities and is seen along with erythema, induration, tenderness, and superficial ulcerations of varying extent. Histopathologic examination shows either a variable lymphohistiocytic infiltration of the reticular dermis and subcutaneous fat or an acute panniculitis. Organisms may be difficult to find on routine sections, and special stains are recommended. Culture of tissue aspirate is an excellent method of diagnosis. PMID- 3308983 TI - Insulin lipodystrophy, lipohypertrophic type. PMID- 3308984 TI - Therapy versus placebo for alopecia areata. PMID- 3308985 TI - CT demonstration of giant choledochal cysts in adults. AB - The initial diagnosis for three adult patients with giant choledochal cysts was confused because of the enormous size of the cysts. Jaundice in association with marked upper gastrointestinal displacement was the dominant feature in two of our cases. Intrahepatic ductal dilatation is common when choledochal cysts present in the adult. The malignant potential of choledochal cysts is discussed. PMID- 3308986 TI - Acalculous inflammatory disease of the biliary tree in acquired immunodeficiency syndrome: CT demonstration. AB - Acalculous inflammatory disease of the biliary tree is a recently recognized complication of acquired immunodeficiency syndrome (AIDS). Two men with AIDS and elevated serum alkaline phosphatase levels are reported. Computed tomography and cholangiography demonstrated biliary disease resembling sclerosing cholangitis. PMID- 3308987 TI - Cine-CT measurement of cortical renal blood flow. AB - A modified indicator-dilution technique using radiographic contrast material and a cine-CT scanner was used to measure blood flow in the renal cortex of dogs. To validate this technique, CT measurements were correlated with simultaneous measurements of flow determined by radioactive microspheres. Measurements were taken during euvolemic conditions and after hemorrhage. Thirty-nine measurements were compared, covering a flow range from 1 to 7 ml min-1 g-1, and a good correlation was found between the cine-CT and microsphere results (r = 0.93; p less than 0.001). Additionally, cine-CT measurements were made of the mean transit time (MTT) of contrast material through the renal cortex, and the reciprocal of these MTT values was also well correlated to microsphere determined flow (r = 0.94; p less than 0.001). Thus, cine-CT appears to be a promising new technique for measuring renal blood flow. PMID- 3308988 TI - CT findings in hepatosplenic and renal candidiasis. AB - Fourteen patients with the diagnosis of leukemia and one with lymphoma developed systemic candidiasis. Involvement of the liver (15 patients), spleen (nine patients), and kidney (five patients) was diagnosed by clinical, CT, and pathologic findings. The CT findings ranged from low-density lesions (11 livers, nine spleens, and five kidneys) to hepatomegaly or hepatosplenomegaly. All livers and three kidneys had positive biopsy findings for Candida. Two patients with diffuse splenic lesions underwent splenectomy and were proven to have candidiasis. During a 1 year follow-up, two patients developed hepatic calcifications and one developed renal calcifications. In proper clinical setting, CT should be done for simultaneous evaluation of the liver, spleen, and kidneys. These studies, when positive, are useful to guide percutaneous or open biopsy and to follow the results of therapy. However, regardless of the hepatic CT finding, biopsy should be obtained to establish the diagnosis and begin proper treatment. PMID- 3308989 TI - Recent studies on nucleotide sequences encoding the caseins. PMID- 3308990 TI - Influence of cardiac output on thermal-dye extravascular lung water (EVLW) in cardiac patients. AB - The influence of varying cardiac output (CO) on thermal-dye extravascular lung water (EVLW) was investigated in a total of 40 cardiac surgery patients before the onset of the operation. EVLW was measured by means of the double indicator dilution technique with indocyanine green as the non-diffusible indicator and a microprocessed lung water computer 15 min and 30 min after change of CO. CO was varied from -45% to +70% of the baseline value by nifedipine infusion (CO increases, n = 20) or halothane application (CO decreases, n = 20), respectively. CO was measured from the femoral artery instream thermistor tipped lung water catheter and, simultaneously, from the pulmonary artery. In spite of a highly significant decrease (-45%) and increase (+70%) in CO no change in EVLW could be observed. CO estimation was comparable for both methods used. Regression analysis revealed no relationship between CO and EVLW as well as between EVLW and various hemodynamic parameters. We conclude that thermal-dye technique for estimation of EVLW may be accurate in spite of changing cardiac output over a wide range. PMID- 3308991 TI - Use of total inspiratory pressure-volume curves for determination of appropriate positive end-expiratory pressure in newborns with hyaline membrane disease. AB - Thirty newborns with hyaline membrane disease were treated by mechanical ventilation with individualized appropriate positive end-expiratory pressure (APEEP) from inspiratory pressure-volume curves of the total respiratory system. APEEP was started before H24 in group 1 (19 patients), and after H24 in group 2 (11 patients). Until APEEP, the 2 groups had classical PEEP levels (lower than 0.8 kPa) either without or with incomplete improvement in arterial hypoxia. The mean APEEP of each group was greater than classical PEEP (p less than 0.001). In group 1 the time of exposure to FiO2 greater than 0.4 was shorter (23.8 +/- 13.7 h) than in group 2 (88.6 +/- 56.9 h) (p less than 0.001) and rapid improvement in blood gas exchanges was seen in group 1 compared to group 2 that was independent of the severity of the disease. Tolerance was excellent. APEEP ventilation started before H24 is of special interest in the management of newborns with severe alveolar injury. PMID- 3308992 TI - Nursing management of postoperative pain: use of relaxation techniques with female cholecystectomy patients. AB - The purpose of this study was to assess the effectiveness of two different relaxation techniques in the management of postoperative pain. The sample consisted of 40 women between the ages of 21 and 65 years who were undergoing elective cholecystectomy. Using an experimental design, participants were randomly assigned to four groups: an experimental group who received a taped recording of a rhythmic breathing exercise (RB); an experimental group who received a taped recording of Benson's Relaxation Technique (BRT); an attention distraction control group (CA) who received a taped recording of a history of the hospital; and a standard control (CB) group who had only the routine perioperative care which all groups received. Data were collected on postoperative sensation and distress at five time points during the first 72 postoperative hours, number of doses of analgesic medication during the same time period, and number of postoperative hospital days. Data were analysed using multivariate and univariate analyses of variance. The BRT group was significantly different from the CA group on a combined sensation and distress factor (P = 0.011). No significant differences were found among groups for doses of analgesics (P = 0.068) or postoperative hospital days (P = 0.56). PMID- 3308994 TI - Gies Award Outstanding Editorial for 1986. "Telling it like it is". PMID- 3308993 TI - Towards a coexistence of paradigms in nursing knowledge development. AB - During the last 35 years, nursing knowledge has known a surge in its development. Following the evolution of the scientific world, nursing first embraced the logical empiricist perspective of discovering and knowing. Historicism and, more recently, critical social theory have been explored as alternative ways of making knowledge in nursing. This paper discusses the evolution of nursing knowledge, considering its past and present activities. The authors suggest that a cooperative attitude amongst nurses, and a coexistence of various paradigms of knowledge development characterize the future of nursing. Nursing knowledge should be understood as a stage in its evolution and growth. The result of this process will never be a final static body of knowledge. Knowledge expansion will be encouraged through a process of integrating components from different research traditions, such that a multidimensional understanding of phenomena will be realised. PMID- 3308995 TI - Gies Award Honorable Mention Editorial for 1986. The positive side. PMID- 3308996 TI - Gies Award Honorable Mention Editorial for 1986. Advocates of destruction. PMID- 3308997 TI - The Presidents. Hubert A. McGuirl 1968-1969. PMID- 3308998 TI - AIDS update: oral findings, diagnosis, and precautions. AB - The dimensions of AIDS continue to increase. The number of people infected with the AIDS virus (HIV) grows and no effective vaccine or curative treatment is expected in the near future. This article describes the oral findings of AIDS and AIDS-related complex (ARC). It will help dentists in recognition, diagnosis, consultation, and office precautions. These oral findings are important considerations in treatment planning and staging for patients with AIDS and ARC. PMID- 3308999 TI - Suction cups on maxillary dentures: report of case. AB - A report of case is presented in which a maxillary denture was fitted with a suction cup causing a round, depressed area of inflammation on the center of the palate. Awareness of existing prosthodontic practices is important to recognize and manage such a case for the restoration of tissue health and prevention of further tissue damage. PMID- 3309000 TI - Wear of composite resins in permanent posterior teeth. AB - Although improvements in wear resistance have accompanied the development of newer materials, the routine use of composite resins in permanent posterior teeth cannot be justified. Clinical studies have not yet proved the long-term wear resistance of these materials. However, they may be used if case selection and material selection are kept within certain guidelines. In terms of case selection, a composite resin might be used in areas of esthetic concern, or where minimal cavity preparation is possible. Resins might also be used in areas of low functional stress, and in premolars instead of molars. In selecting a material, the conventional resins should never be used for posterior teeth. Instead, a material with smaller, softer filler particles should be used. Also, light-cured materials are preferred to the self-cured types. Long-term clinical evaluation of the posterior composite resins is required before they can be accepted as a substitute for amalgam. If the problem of wear cannot be eliminated, but only reduced, then the effects of wear in terms of occlusal stability and function must be determined. PMID- 3309001 TI - Periodontics in general practice: perspectives on nonsurgical therapy. AB - Clinical studies have shown that nonsurgical treatment is a highly effective method of periodontal therapy. It can be instituted in both shallow and deep pockets; however, an objective evaluation of post-scaling soft tissue changes should be recorded to determine the response to therapy. Closed scaling and root planing has limitations as a definitive procedure for the removal of calculus from deep pockets and surgical treatment may be indicated for nonresponding sites. The condition of the tissue, not the probing depth, should dictate the course of action. During maintenance therapy all practitioners should recognize unsuccessfully treated or recurrent periodontitis and provide interceptive treatment to avoid a case of "supervised neglect." Periodontal treatments should be provided by the general practitioner. This can result in improved oral health for the patients and constitute a professionally rewarding part of dental practice. PMID- 3309002 TI - Comparison of outcome after valve replacement with a bioprosthesis versus a mechanical prosthesis: initial 5 year results of a randomized trial. AB - The Veterans Administration Cooperative Study on Valvular Heart Disease was organized to compare survival and incidence of valve-related complications between patients receiving a bioprosthesis (the Hancock porcine heterograft) and a mechanical prosthesis (the Bjork-Shiley spherical disc valve). Five hundred seventy-five patients undergoing single aortic or mitral valve replacement were randomized at surgery to one of the two valve types. At an average follow-up of 5 years (range 3 to 8) there are no statistically significant differences in survival between patients with the two valve types in the aortic valve replacement group. There is a statistically nonsignificant trend toward improved survival in patients undergoing mitral valve replacement with a bioprosthesis compared with a mechanical prosthesis (5 year survival probability was 0.70 +/- 0.05 and 0.58 +/- 0.06, respectively). Fatal and nonfatal valve-related complications occurred significantly less frequently in patients with a bioprosthesis compared with a mechanical prosthesis for both mitral and aortic valve replacement. Five year complication-free probability was 0.67 +/- 0.05 and 0.45 +/- 0.06, respectively, for patients with mitral valve replacement and 0.63 +/- 0.04 and 0.53 +/- 0.04, respectively, for those with aortic valve replacement. The difference in overall complication rates was largely due to the increased number of clinically significant but nonfatal bleeding episodes in patients receiving a mechanical prosthesis. Adjustment for differences in baseline characteristics between patients receiving a mitral mechanical prosthesis and a mitral bioprosthesis reduced the statistical significance of the difference in both mortality and complications. PMID- 3309003 TI - Computer-assisted versus unassisted analysis of the exercise electrocardiogram in patients without myocardial infarction. AB - Computer-assisted interpretation of the exercise electrocardiogram has been advocated to improve the accuracy of diagnosing coronary artery disease. Its accuracy was compared with a blinded visual interpretation of exercise-induced ST depression in 271 consecutive subjects without prior myocardial infarction who were referred for coronary angiography. The sensitivity of the visual and computer readings was 0.51 and 0.51, respectively, at a specificity of 0.87. Receiver operating characteristic curves were generated for the visual and computer ST depression in lead V5. Analysis of the areas under these curves showed no significant difference between them, indicating that computer-assisted analysis was not superior to unmodified visual analysis. A similar analysis was applied to two other computer indexes reported to be superior to visual assessments (treadmill exercise score and ST index). These computer indexes were not superior to a conventional visual analysis of leads I, II, V2, V4 and V5 in predicting severe disease (greater than 50% luminal narrowing). These results suggest that computer-assisted interpretation does not improve the accuracy of exercise electrocardiography in diagnosing coronary artery disease in subjects without prior myocardial infarction. PMID- 3309004 TI - Dependence of enhanced maximal exercise performance on increased peak skeletal muscle perfusion during long-term captopril therapy in heart failure. AB - Maximal oxygen uptake (VO2), skeletal muscle blood flow by xenon-133 washout technique and femoral vein arteriovenous oxygen difference and lactate were measured at rest and during maximal bicycle exercise in eight patients with severe congestive heart failure before and after 8 weeks of therapy with captopril. During therapy, skeletal muscle blood flow at rest increased significantly from 1.5 +/- 0.6 to 2.6 +/- 1.0 ml/100 g per min (p less than 0.05), with a concomitant decrease in the femoral arteriovenous oxygen difference from 10.0 +/- 1.7 to 8.3 +/- 1.9 ml/100 ml (p less than 0.05). Maximal VO2 increased significantly from 13.4 +/- 3.0 to 15.5 +/- 4.1 ml/kg per min (p less than 0.05). In four patients, the increase in maximal VO2 averaged 3.7 ml/kg per min (range 2.7 to 4.9), whereas in the remaining four patients, it was less than 1 ml/kg per min. Overall, peak skeletal muscle blood flow attained during exercise did not change significantly during long-term therapy with captopril (19.6 +/- 6.2 versus 27.6 +/- 14.3 ml/100 g per min, p = NS). However, the four patients with a significant increase in maximal VO2 experienced substantial increases in peak skeletal muscle blood flow and the latter changes were linearly correlated with changes in maximal VO2 (r = 0.95, p less than 0.001). Femoral arteriovenous oxygen difference at peak exercise was unchanged (12.6 +/- 2.6 versus 12.6 +/- 2.4 ml/100 ml). Thus, improvement in maximal VO2 produced by long term therapy with captopril is associated with an increased peripheral vasodilatory response to exercise, and this improvement only occurs when the peak blood flow is augmented.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309005 TI - Doppler and echocardiographic features of normal and dysfunctioning bioprosthetic valves. AB - Echocardiographic and Doppler studies were performed on 183 clinically normal and 58 severely dysfunctioning bioprosthetic mitral, aortic and tricuspid valves. The valve dysfunction resulted from spontaneous cusp degeneration in 49 instances and from paravalvular regurgitation in 9. The pulsed Doppler study demonstrated regurgitant flow in 36 (92%) of 39 regurgitant valves and 8 (90%) of 9 paravalvular regurgitant valves. Diagnostic echocardiographic features were present in only 51 and 10% of the patients, respectively. Although the Doppler regurgitant jet was peripheral in seven of the nine patients with paravalvular regurgitation, it was not possible to differentiate these patients from those who had valve degeneration and cusp tear at the periphery of the valve ring. Eight patients presented with a musical holosystolic murmur of mitral insufficiency. In all eight there was a characteristic honking intonation on the audio signal and a striated shuddering appearance on the video Doppler signal. Ten stenotic mitral bioprosthetic valves (less than or equal to 1.1 cm2 valve orifice) were identified by Doppler study. Diagnostic echocardiographic features were present in only two of these patients. The Doppler-derived valve orifice dimension correlated well (r = 0.83) with cardiac catheterization values. Fourteen asymptomatic or minimally symptomatic patients had echocardiographically thickened mitral cusps (greater than or equal to 3 mm). These patients had a significantly (p less than 0.0001) smaller valve area as compared with normal control valves, and during 4 to 24 months of follow-up, five of these patients developed severe valve regurgitation or stenosis. Doppler ultrasound is more sensitive than echocardiography in diagnosing bioprosthetic valve stenosis and regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309006 TI - Advances in the hemodynamic assessment of stenotic cardiac valves. AB - In 1951 Gorlin and Gorlin (Am Heart J 1951;41:1-29) published their formula for calculating the area of a stenotic cardiac valve from hemodynamic data. The important concept implicit in this formula is that the hemodynamic evaluation of a stenotic valve requires that the pressure gradient across that valve be examined in light of the cardiac output passing through the orifice. The concept asserts that if an accurately obtained pressure gradient can be related to an accurate cardiac output by an accurate formula, valve area can be determined. However, recent studies have demonstrated flaws in current practices for obtaining transvalvular gradients and cardiac outputs. Further, new data are available regarding the validation and possible changes in the Gorlin formula, validation and changes that the Gorlins noted might be necessary to make. These new data concerning the three basic requirements of an accurate valve area determination are the subject of this review. PMID- 3309007 TI - Doppler mitral pressure half-time: a clinical tool in search of theoretical justification. AB - The Doppler determination of the mitral pressure half-time has gained widespread acceptance as a reliable estimate for mitral valve area, despite little theoretical basis for its "independence" of other hemodynamic variables. A simple model of the left atrium and mitral valve has been developed and a governing equation derived from fluid dynamics fundamentals. Solution of this equation indicates that the pressure half-time should vary inversely with mitral valve area, but also proportionally to net left atrial and ventricular compliance and to the square root of the peak transmitral gradient. This complex relation is apparently masked in the typical clinical situation because pressure and compliance tend to change in opposite directions, thereby partly offsetting each other. In several clinical settings, such as balloon mitral valvotomy, left ventricular hypertrophy and aortic regurgitation, changes in initial pressure and compliance may be large enough to alter the relation between mitral area and pressure half-time. This study reviews the development of the pressure half-time concept, presents an overall method for studying mitral valve flow using mathematical modeling and describes the effects of factors other than mitral valve area on pressure half-time. PMID- 3309008 TI - Clarence Agress pioneers experimental thrombolysis of the coronary artery in 1952. AB - In 1952, Clarence Agress performed an experiment on dogs to demonstrate his idea that a thrombus in a coronary artery could be dissolved without harm to the myocardium. Although this landmark in cardiology has been forgotten, credit to Agress is deserved. PMID- 3309009 TI - Update from the Thrombolysis in Myocardial Infarction Trial. PMID- 3309010 TI - Dietary sugars and carbohydrate metabolism in type II diabetes. AB - Diabetes, the most common metabolic disease, is responsible for the deaths of over 300,000 Americans annually. The incidence of the disease increases with age and since the U.S. population is graying, prevalence is also increasing. Obesity and family history are strong predictors of diabetes. The etiology of Type II diabetes is heterogeneous. The hyperglycemia of Type II diabetes can result from a variety of metabolic defects including impaired beta cell secretion, receptor deficiencies, or abnormal hepatic production or uptake of glucose. Other glucoregulatory hormones such as glucagon, growth hormone, cortisol, thyroid hormones, somatostatin, and gastric inhibitory polypeptide may contribute to the aberrations of carbohydrate metabolism. Environmental factors including stress, diet, and exercise may also contribute to the disease. Since most diabetics are obese, weight loss should be the first priority in improving status. A variety of diet and exercise regimens may help achieve this goal or even improve glucose control without weight loss. Due to the heterogeneity of the disease individualized treatment must be used to improve status of patients with the various metabolic defects of Type II diabetes. PMID- 3309011 TI - Food and nutrition services in bone marrow transplant centers. AB - Nutrition care for bone marrow transplant recipients is recognized as vital for a successful transplant, yet little research has been done to determine the most effective foodservice methods. Many decisions regarding methods for the oral feeding of bone marrow transplant patients are based on tradition and/or individual judgments. This study surveyed marrow transplant centers to identify existing food and nutrition services that could be used as a basis for developing a foodservice protocol. A survey instrument was developed and sent to all chief dietitians (no. = 35) affiliated with transplantation centers in the United States. Four of the 30 respondents reported changing from the traditional sterile diet to either a low-bacteria or a modified house diet. Problems of limited availability of single-serve sterile foods, lack of standardization of recipes, and low patient acceptance of autoclaved sterile foods were reported as reasons for the move toward less stringent dietary procedures. The responses clearly indicate the need for additional research before a foodservice model can be established. PMID- 3309012 TI - Predigested formula for infants with cystic fibrosis. AB - The object of this study was to assess the growth rates of patients with cystic fibrosis fed various diets and test the hypothesis that the weight of infants could be normalized by 1 year of age if they were placed on predigested formula before age 6 months. A group of 19 newly diagnosed patients placed on Pregestimil were compared with a group who were fed standard formula. At 1 year of age, the Pregestimil group showed significantly greater length and weight and a twofold higher average weight percentile. Growth velocity determined for the period between diagnosis and 12 months of age was better (p less than .001) for babies raised on Pregestimil (556 compared with 423 gm/month). Using weight percentile as the major growth index and values less than the fifth percentile as abnormal at age 12 months, we found that all 19 babies were normal in the group fed Pregestimil, whereas nine were below the fifth percentile in the group fed regular formula (p = .0006). PMID- 3309013 TI - Bone marrow transplantation: dietitians' experience and perspective. PMID- 3309014 TI - Hyperimmune bovine colostrum inefficacious as multiple sclerosis therapy in double-blind study. PMID- 3309015 TI - A role of mixed-function oxidation reactions in the accumulation of altered enzyme forms during aging. PMID- 3309016 TI - The future of Medicare. PMID- 3309017 TI - Neonatal seizures: a commentary on selected aspects. AB - Despite the immaturity of the newborn brain, the neonatal period is reported to have a very high frequency of seizures. This review concludes that many of the neonatal events that are called seizures probably originate from subcortical structures, have little in common with cortical seizures seen in older individuals, and may not benefit from conventional anticonvulsant treatment. Many studies of anticonvulsants in the newborn have important methodologic problems, compounded by the fact that the seizures tend to spontaneously remit with the resolution of the acute hypoxic-ischemic encephalopathy that is most often the cause. Randomized trials of anticonvulsants in this setting have not been carried out. Even in many of these seizures do not originate in the cortex, they still imply profound cortical disturbance and are associated with high mortality and morbidity. It is unknown if the type and duration of treatment influence the long term, overall outcome. The seizures usually stop in the newborn period, and anticonvulsants beyond hospital discharge seem unwarranted because they are unlikely to prevent subsequent epilepsy. Newer investigations, including video EEG and nuclear magnetic resonance studies, may clarify the real significance of neonatal seizures. PMID- 3309018 TI - Dermofasciectomy and full-thickness grafts in the treatment of Dupuytren's contracture. AB - We report a 16-year experience with full-thickness grafts to resurface defects created by releasing contractures of Dupuytren's disease. This technique was used in 68 patients with Dupuytren's contracture from 1970 to 1985. Follow-up of 36 hands of 24 patients averaged 3.9 years postoperatively. There was no recurrent disease in the palms and digits that were covered with the full-thickness grafts. The incidence of extension outside the grafts was 8%. The area of full-thickness grafting covered most of the width of the palm, an extension of Gonzalez's technique, which was presented in 1970. PMID- 3309019 TI - Lateral arm composite tissue transfer to ipsilateral hand defects. AB - Different applications in the use of the ipsilateral lateral arm free flap in 29 patients treated in our unit from November 1983 to December 1984 are described. The flap was used in both elective and emergency reconstruction with a success rate of 96.5%. This flap is elevated from the same limb as the injured hand, permitting the entire operative procedure to be performed with the patient under a single regional block anesthesia, both flap and recipient sites being prepared synchronously in a bloodless field. PMID- 3309020 TI - Carpal tunnel syndrome, pyridoxine, and the work place. AB - Carpal tunnel syndrome has become a major source of work-related impairment. Recent studies have suggested pyridoxine deficiency may be a cause of carpal tunnel syndrome, but all studies on this relationship have been flawed by lack of scientific design. Given the available evidence, pyridoxine is not likely to be a significant cause of carpal tunnel syndrome in the work place. Ergonomic measures are more likely to be effective than pyridoxine in reducing the incidence and cost of carpal tunnel syndrome in the work place. PMID- 3309021 TI - Psychological group counseling for the prevention of ulcer relapses. A controlled randomized trial in duodenal and prepyloric ulcer disease. AB - The effect of psychological counseling on 1-year ulcer relapse rate of recurrent duodenal and prepyloric ulcer disease was evaluated in 148 patients randomly allocated into three treatment groups; psychological counseling group, maintenance cimetidine (400 mg at bedtime), and placebo cimetidine at bedtime. Ulcer relapses were monitored by endoscopy at 6 and 12 months after inclusion and at symptomatic recurrence. The estimated proportion of relapse-free patients after 12 months follow-up in the psychological counseling group (0.43 +/- 0.08) did not differ significantly from the placebo group (0.47 +/- 0.07), whereas the corresponding value for the cimetidine group (0.70 +/- 0.07) was significantly higher (p less than 0.01). The effect of cimetidine on ulcer recurrence, however, was confined to smokers; relapse risk among nonsmokers did not differ significantly between the treatment groups. The negative outcome of psychological counseling raises doubts as to whether duodenal or prepyloric ulcer recurrences can be prevented by such a therapeutic approach. PMID- 3309022 TI - Drunks, livers, and values. Should social value judgments enter into liver transplant decisions? AB - The idea that social value judgments should enter into the distribution of scarce resources has been debated for many years. The question of transplanting livers into alcoholic patients, even if they do not constitute a technically worse group than do nonalcoholics, is used to examine this issue. The paper concludes that (a) "social worth," as a criterion for distribution of scarce resources, is morally precluded in allocations directly involving the patient-physician relationship; (b) social worth criteria may be useful in macroallocation decisions prior to resorting to a lottery approach or to a market approach; (c) social worth criteria may be more legitimately applied when it comes to transplanting organs than in the distribution of other resources. Social worth criteria constitute an expression of communal value and are prone to the evolution of communal sensitivities and to growth. PMID- 3309023 TI - Barium appendicitis: fact or fancy? Report of a case and review of the literature. AB - Whether barium retained in the appendix can be a cause of acute appendicitis is debatable. We describe a 40-year-old man who developed nonspecific right abdominal pain 7 weeks after a barium enema, which proved to be normal. On abdominal film a distended appendix containing barium was seen, and at laparotomy acute appendicitis was present. Thus far, 26 cases of "barium appendicitis" have been reported. On the basis of the relevant literature and the cases collected, it is appropriate to draw the following conclusions: 1) With present knowledge it is not possible to state whether retained barium plays any etiologic role in the development of subsequent uncomplicated acute appendicitis. 2) If a later appendicitis does supervene, it carries a high risk of being complicated; barium seems to be responsible for the complication. 3) The longer the interval between the barium study and the subsequent appearance of acute appendicitis, the higher will be the risk of complications. PMID- 3309024 TI - Adrenal insufficiency. A rare initial sign of metastatic colon carcinoma. AB - A 75-year-old woman evaluated for "drop attacks" 3 years after anterior resection for colo-rectal cancer developed hyponatremia associated with a morning cortisol of 5.7 micrograms/dl, a plasma adrenocorticotropic hormone level of 319 pg/ml, and an inadequate response to cosyntropin. Computed tomography scan demonstrated bilateral adrenal masses. Fine needle aspiration biopsy of the adrenals revealed adenocarcinoma, histologically similar to her previous colon carcinoma. Addison's disease secondary to isolated colon cancer metastases to the adrenals is rare. Our report represents the first antemortem histologically confirmed diagnosis of this entity. A review of the available literature is presented. PMID- 3309025 TI - Pepsinogen. Prolate ellipsoid or unrecognized pathogen? AB - Pepsin is a potent proteolytic enzyme stored and secreted by chief cells in an inactive precursor form, pepsinogen. Its secretion is modulated by both cAMP and calcium-dependent mechanisms. Abnormalities in levels of pepsinogen and its various isozymogens have been linked clinically, epidemiologically, and experimentally to peptic ulcer disease and gastric carcinoma. The ulcerogenesis of pepsin stems from its ability to breach gastroduodenal mucosal barriers. Furthermore, certain isozymogens seems abundant and hyperactive in patients with peptic ulcer disease. The etiology and significance of low pepsinogen levels with disproportionate elevations of pepsinogen II and pepsin 5 in gastric cancer and its precursors is less clear. Further exploration of the patho-physiologic role of pepsin is likely to be of considerable importance in initiating further advances in the understanding and treatment of upper gastrointestinal disease. PMID- 3309026 TI - Relevance of species specific filarial antigens for diagnosis. PMID- 3309027 TI - Genetically determined variation in immune response to filarial infections. PMID- 3309028 TI - Immunological features of onchocerciasis in Sudan. PMID- 3309029 TI - Immunological approaches to the detection of prepatent onchocerciasis. PMID- 3309030 TI - Detection and diagnostic utility of in vitro and in vivo released antigens in bancroftian filariasis. PMID- 3309031 TI - Relative impact of integrated vector control strategy vis-a-vis conventional control strategy on bancroftian filariasis in Pondicherry. PMID- 3309032 TI - Control of filariasis in India. PMID- 3309033 TI - Control of bancroftian filariasis in rural areas through selected treatment with diethylcarbamazine. PMID- 3309034 TI - A filariasis survey among the migratory labourers at Alwar, Rajasthan. PMID- 3309035 TI - In vitro maintenance and development of Wuchereria bancrofti microfilariae. PMID- 3309036 TI - Lymphatic filariasis: lymphocyte sub-populations in Wuchereria bancrofti infection. PMID- 3309037 TI - Epidemiological study on lymphatic filariasis in an endemic zone of Orissa. PMID- 3309038 TI - Studies on some biochemical aspects of filarial parasites. PMID- 3309040 TI - Effectiveness of membrane feeding method in relation to development of filarial infective larvae in Culex quinquefasciatus. PMID- 3309039 TI - Filaria specific monoclonal antibodies for diagnosis. PMID- 3309041 TI - Factor influencing acceptance and non-acceptance to DEC in a bancroftian endemic area. PMID- 3309042 TI - Trace elements and the liver. PMID- 3309043 TI - The early years: Indiana University School of Medicine. PMID- 3309044 TI - Neonatology: new modalities of treatment. PMID- 3309045 TI - Identification of tissue histiocytes on paraffin sections by a new monoclonal antibody. AB - A mouse monoclonal antibody (MAC 387) with specificity for monocytes and tissue histiocytes was produced by immunization of a BALB/c mouse with peripheral blood monocyte components derived by affinity chromatography of detergent-solubilized monocyte material on Sepharose 4B coupled to rabbit anti-monocyte antibodies. MAC 387 strongly stained the cytoplasm of cells of the monocyte/macrophage series on paraffin sections after controlled trypsinization of sections. The antibody showed broad reactivity for a variety of tissue histiocytes, including infiltrating and reactive histiocytes, alveolar macrophages, Kupffer cells, follicle-center macrophages, splenic red pulp macrophages, tumor-infiltrating macrophages, sinus histiocytes, epithelioid giant cells (variably), and cases of histiocytosis X and dermatopathic lymphadenopathy. Molecular weight data obtained by Western blotting, immunoprecipitation, and immunoaffinity-purification revealed that the antigen was present in different forms in the monocyte and granulocyte. In the granulocyte, free alpha (Mr 12 KD) and beta (Mr 14 KD) chains expressing the MAC 387 epitope were found together with associations of one alpha and one beta chain linked by disulfide bonds to yield a heterodimer of Mr 26 KD. In the monocyte, free alpha and beta chains are not found, but instead the heterodimer and associations of two (Mr 56 KD) and four (Mr 112 KD) heterodimers are disulfide-linked together. This new monoclonal reagent should have particular value for identification of tissue histiocytes in routine paraffin sections and particularly for demonstration of histiocytes in malignant lymphomas. PMID- 3309046 TI - First visualization of dopaminergic neurons with a monoclonal antibody to dopamine: a light and electron microscopic study. AB - A monoclonal antibody recently synthesized against dopamine (DA) was tested in rat and mouse brain sections after further treatment by PAP immunocytochemistry at the light and electron microscopic levels. Distribution of DA-immunoreactive cell bodies was examined in the substantia nigra (sn), the ventral tegmental area (vta), and the raphe nuclei. DA-immunoreactive fibers were investigated in two DA projection systems, the striatum and the septum. Many dopaminergic cell bodies were found in the sn and the vta. Some scattered DA neurons were encountered in the pars reticulata of the sn. The dorsal raphe and linearis raphe nuclei displayed sparse immunoreactive neurons and a dense plexus of DA fibers. Immunoreactive fibers were observed in the entire striatum, more dense in the ventral part. In the septum, immunonegative neurons were outlined by thin DA fibers in synaptic contact with their somata or dendrites. According to our observations, this DA monoclonal antibody seems to be a selective and sensitive tool for studying the dopaminergic neuronal circuitry at both histological and ultrastructural level. PMID- 3309047 TI - Histological distribution of the 35-KD protein substrate of the epidermal growth factor receptor/kinase in thymus. AB - Rat thymus has been identified as a tissue comparatively enriched in a 35-KD substrate of the epidermal growth factor receptor/kinase (lipocortin-1) (J Biol Chem 261:13784, 1986). A polyclonal antiserum prepared against the 35-KD protein was used to determine histological distribution of the protein in thymus. Frozen sections of rat thymus were examined after indirect labeling of the 35-KD protein with a rhodamine conjugate of secondary antibody. The antigen was localized primarily in the reticular network of the thymic epithelium, with no detectable labeling of resident thymocytes. Immunoblotting (Western blots) of cytosol extracts also demonstrated that thymocytes did not contain detectable amounts of the antigen. Cultured thymic epithelial cells (TEC), however, contained an abundance of two immunologically related protein bands with molecular weights similar but not identical to the antigen from the parental cell line (human A-431 carcinoma). Paraffin sections of rat and human thymus were subjected to an immunoperoxidase staining procedure, and it was observed that Hassall's corpuscles (keratinized epithelial cells) and other cortical and medullary TECs were intensely stained. The demonstration that the antigen is primarily associated with TEC in thymus, in conjunction with its distribution in other tissues, will aid in deducing its physiological role. PMID- 3309048 TI - Fixation, processing, and immunochemical reagent effects on preservation of T lymphocyte surface membrane antigens in paraffin-embedded tissue. AB - Fixatives, fixation additives, paraffin processing reagents, and immunochemical reagents were investigated for effects on preservation of T-lymphocyte surface membrane antigens CD3, CD4, and CD8 in human tonsil. Individual reagent effects were assessed in frozen sections by use of monoclonal antibodies and this information was used to optimize T-cell immunostaining in paraffin sections. Harmful factors were fixation delay, fixation at acid pH, fixation and processing at temperatures above 4 degrees C, hot paraffin wax, proteolytic enzymes, methanolic hydrogen peroxide, Triton X-100, and prolonged iodine treatment. Optimal T-cell demonstration in paraffin sections followed tissue fixation in periodate-lysine-paraformaldehyde dichromate at 4 degrees C, pH 7.5; processing through isopropanol, then xylene or chloroform, at 4 degrees C; and embedding in low melting point wax at 45-50 degrees C. Graded antigen stability occurred: CD3 most stable, CD8 least, and CD4 intermediate. CD4 and CD8 antigen preservation in paraffin sections required critical optimal tissue handling. CD3 was more stable and was also demonstrated in tissue fixed in commercial formalin, glutaraldehyde, and Bouin's fluid when fixation and processing conditions were optimized for pH and temperature. Of the fixation additives studied, polyethylene glycol and several potassium and magnesium salts enhanced immunostaining, whereas calcium chloride and lidocaine were deleterious. PMID- 3309049 TI - Immunohistochemical localization of a low molecular weight surfactant-associated protein in human lung. AB - We used an antiserum to a hydrophobic 6 KD surfactant-associated protein to localize this protein in human lung tissue. This antiserum does not crossreact with the 35 KD surfactant-associated protein. By light microscopy using the indirect immunoperoxidase technique, the protein appears to be localized within Type II alveolar epithelial cells. Staining is also detectable in alveolar macrophages and occasionally within the lumina of alveoli and bronchioles. No staining was detected within the alveolar septa or in association with blood vessels. An identical distribution is seen for the 35 KD surfactant-associated protein using an antiserum specific for that protein. PMID- 3309050 TI - The preoperative use of the relaxation response with ambulatory surgery patients. AB - The efficacy of the regular elicitation of the relaxation response in reducing surgical anxiety and pain in an ambulatory surgery setting was studied in a population of patients scheduled for the surgical removal of a skin cancer. Forty nine patients with skin cancer were enrolled in the study immediately after being informed of the ned for surgery; 21 of these patients elicited the relaxation response 20 minutes per day until the day of surgery, 21 read for 20 minutes per day, and 7 were noncompliant and were excluded from the study. Contrary to expectations, neither group of patients showed any increase in anxiety immediately before or after surgery on either psychological or physiological measures. Thus, there were no differences between the two groups on any of the psychological or physiological measures of anxiety, nor were there any differences in pain perception. There were statistically significant subjective differences; the experimental patients stated that the relaxation-response technique had reduced their anxiety several days before surgery and reportedly experienced their highest levels of anxiety prior to entering the study, while the controls experienced their highest levels of anxiety during and after surgery. This suggests that (1) minor outpatient surgery does not lead to detectable increased anxiety levels on the day of surgery and (2) regular elicitation of the relaxation response can alter subjective reports of distress associated with surgery. PMID- 3309051 TI - Clonal analysis of B cell growth and differentiation activities induced from T lymphocytes upon triggering of T3-Ti and T11 pathways. PMID- 3309052 TI - Leucyl-leucine methyl ester treatment of donor cells permits establishment of immunocompetent parent----F1 chimeras that are selectively tolerant of host alloantigens. AB - Treatment of murine lymphocytes with L-leucyl-L-leucine methyl ester (Leu-Leu OMe) selectively removes natural killer cells, cytotoxic T lymphocyte precursors, and the capacity to cause lethal graft-vs-host disease, whereas bone marrow stem cell function and alloantigen-induced L3T4+ T helper function remains intact. The present studies assess the immunocompetence of allogeneic bone marrow chimeras established by reconstituting irradiated (C57BL/6 X DBA/2)F1 (B6D2F1) mice with Leu-Leu-OMe-treated C57BL/6 (B6) bone marrow and spleen cells. Spleen cells from such chimeras were found to have normal B and T cell mitogenic responses. Furthermore, levels of natural-killer cell function were comparable to those observed in B6----B6 syngeneic radiation chimeras established without Leu-Leu-OMe treatment of donor cells. Spleen cells from B6----B6D2F1 mice were identical with B6----B6 or B6 mice in allostimulatory capacity and thus contained no discernible cells of non-H-2b phenotype. Whereas B6----B6D2F1 spleen cells demonstrated alloproliferative and allocytotoxic responses toward H-2k bearing spleen cells, no H-2d specific proliferative or cytotoxic responses could be elicited. B6--- B6D2F1 spleen cells did not suppress the generation of anti-H-2d or anti-H-2k proliferative or cytotoxic responses from control B6 spleen cells. Furthermore, addition of rat concanavalin A supernatants did not reconstitute anti-H-2d responses of B6----B6D2F1 chimeric spleen cells. Thus, Leu-Leu-OMe treatment of B6 donor cells not only prevents lethal graft-vs-host disease, but also permits establishment of long-lived parent----F1 chimeras that are selectively tolerant of host H-2 disparate alloantigens, but fully immunocompetent with respect to natural killer cell function, B and T cell mitogenesis, and anti-third party alloresponsiveness. PMID- 3309053 TI - Acquisition of an anti-idiotypic cytotoxic T lymphocyte repertoire in B cell transferred or tetraparental bone marrow chimeric mice. AB - In previous studies we showed that major histocompatibility complex-restricted cytotoxic T lymphocytes (CTL) specific for the cross-reactive idiotype (CRI) of MOPC-104E myeloma protein could only be induced in BALB/c or BAB-14 mice which have the ability to produce the CRI, but not in C.AL-20 or C.B-20 mice which have no ability to produce the CRI. The strong correlation between CRI-specific CTL responder strains and CRI producers supports the idea that the VH gene products are intrinsic primary antigenic stimuli for the generation of the anti-idiotypic CTL. To investigate the role of B lymphocytes in the selection of T lymphocyte repertoire, the purified B cells of CRI producer strains were repeatedly injected into anti-CRI CTL nonresponder neonatal mice. CRI-specific CTL activity was successfully induced in the CRI nonproducer mice only when they were exposed to CRI producer strain B lymphocytes from neonatal life. When the CTL nonresponder adult mice received CRI producer B lymphocytes, the nonresponder phenotype was not changed into the responder phenotype. Inducibility of CRI-specific CTL was also analyzed in tetraparental bone marrow chimeras. When CRI nonproducer bone marrow cells repopulated along with CRI producer bone marrow cells, the anti-CRI CTL of CRI nonproducer origin were generated. Adaptive differentiation of haplotype preference was also observed. When these observations are taken collectively, we see that the anti-idiotypic T lymphocyte repertoire is not a genetically determined one, but rather that the repertoire of T lymphocytes strongly depends on the postnatal selection process through the intrinsic idiotypic repertoire of B lymphocytes, i.e., internal images. PMID- 3309055 TI - Anti-NOR 90. A new autoantibody in scleroderma that recognizes a 90-kDa component of the nucleolus-organizing region of chromatin. AB - We identified a patient (CAG) with scleroderma whose serum contained a high titer of IgG class antibodies that stained nucleoli in a pattern of independent tiny spots. When tested on isolated chromosomes, these antibodies selectively stained the nucleolus-organizing regions (NOR) of chromosomes 13, 14, 15, 21, and 22. These staining patterns were not altered when substrate cells and chromosomes were treated with RNase, 0.1 M HC1, or 4 M urea, but they were abolished by treatment with DNase and trypsin. Immunoblots performed with serum CAG on isolated nucleolar substrates identified a protein antigen of approximately 90 kDa. Antibodies affinity-purified from this protein selectively stained nucleoli and NOR chromosomal regions. Therefore, this protein is the antigen that accounts for the ability of serum CAG to recognize the NOR. In a search for the NOR 90-kDa specificity among 254 patients with various rheumatic diseases, we found nine additional patients whose sera stained metaphase chromosomes selectively at the NOR. Sera from five of them (three with scleroderma, two of unknown diagnosis) recognized a protein that electrophoretically co-migrated with the CAG antigen. Thus, scleroderma is present in at least four of six who appear to have this specificity. We conclude that autoantibodies to the NOR 90-kDa antigen have an association with scleroderma and may be useful diagnostically and as a probe for further studies of the biology of the cell nucleolus. PMID- 3309054 TI - Rejection of fetal neocortical neural transplants by H-2 incompatible mice. AB - In order to examine questions concerning immunologic privilege of the central nervous system, we placed neocortical transplants into cerebral ventricles of mice. We compared the fates of transplants between fully H-2 compatible (isografts) and H-2 incompatible (allografts) animals. Histologic evaluation comparing animals from iso- and allograft groups revealed significant differences in the number of inflammatory cells and in the degree of necrosis within the grafts. Response to allografted tissue within the brain mimics that seen in several immune-mediated diseases of the nervous system in that neurons appear to be selectively spared. Only upon subsequent stimulation of the host's immune system with an orthotopic skin graft bearing the major histocompatibility complex antigens of the neural graft are neurons destroyed. Immunohistochemical evaluation revealed that the inflammatory cell infiltrates in and around the allografts were composed of Lyt-2+, L3T4+, and Mac-1+ cells. In addition, Ia+ endothelial cells as well as Ia+ parenchymal CNS cells were found in both donor and host tissue of allografted animals. Hence, H-2 incompatible neural tissue transplanted to the CNS is recognized and rejected by the immune system of the recipient animal. The cellular infiltrates seen within the first weeks to months following transplantation of allogeneic CNS tissue resemble those seen in other allografts undergoing rejection. We conclude that the CNS is not unconditionally privileged as either a transplant site or as a source of transplanted tissue. PMID- 3309056 TI - Rosetting of human T lymphocytes with sheep and human erythrocytes. Comparison of human and sheep ligand binding using purified E receptor. AB - Previous studies have shown that the purified T lymphocyte glycoprotein, cluster differentiation 2 (CD2) (also known as T11, lymphocyte function-associated antigen (LFA)-2, and the erythrocyte (E) rosette receptor) interacts with the LFA 3 molecule on human E. We have examined the interaction of the purified CD2 molecule with the T11 target structure (T11TS) molecule on sheep E, and compared the two interactions. Purified, 125I-labeled CD2 bound to sheep E and the binding was inhibited by anti-T11TS monoclonal antibody (mAb). Reciprocally, the binding of T11TS mAb to sheep E was inhibited by pretreatment of sheep E with purified CD2. High concentrations of purified CD2 aggregated sheep E, possibly by inserting into the membrane, and the aggregation was inhibited by T11TS mAb. The affinity and number of binding sites for purified CD2 on sheep and human E was found to be similar, with Ka of 9 X 10(7)/M and 6 X 10(7)/M and 9800 and 8300 CD2 binding sites/E, respectively. Thus, the human T lymphocyte CD2 molecule is a receptor that cross-reacts between LFA-3 on human E and T11TS on sheep E, suggesting that LFA-3 and T11TS are functionally homologous ligands. As measured by saturation mAb binding, there are 8100 and 3900 ligand molecules/sheep and human E, respectively. Human and sheep E have surface areas of 145 and 54 micron 2, respectively. The 3.2- to 5.6-fold higher ligand density on sheep E appears to account for the ability of sheep but not human E to rosette with certain types of human T lymphocytes. PMID- 3309057 TI - Modulation of the murine immune response to streptococcal group A carbohydrate by immunization with monoclonal anti-idiotope. AB - Using monoclonal anti-idiotopes with previously defined specificities for the variable (V) domain of HGAC 39, a monoclonal antibody against streptococcal group A carbohydrate (GAC), we have studied the effect of anti-idiotope on an anticarbohydrate immune response. Anti-IdI-3a and anti-IdI-3b are anti-idiotopes which recognize binding site-associated determinants, whereas anti-IdX recognizes a framework-associated determinant on the HGAC 39 V kappa domain. Each of three anti-idiotopes elicited a specific idiotope response, as measured by inhibition radioimmunoassay, in A/J and C57BL/6J mice. A single immunization with conjugated anti-IdI-3a elicited an idiotope(+), GAC-binding(+) response in C57BL/6J and (BALB/c X CBA/N)F1 male mice, but not in A/J or (CBA/N X BALB/c)F1 male, X-linked immunodeficient mice. When C57BL/6J mice immunized initially with anti-idiotope were further treated with group A vaccine, those receiving anti-IdX had the greatest increase in anti-GAC activity. Stimulation of an anticarbohydrate response with anti-idiotope may therefore be enhanced by selecting anti-idiotopes against both binding site- and framework-associated determinants. PMID- 3309059 TI - IgG antibody subclasses in human filariasis. Differential subclass recognition of parasite antigens correlates with different clinical manifestations of infection. AB - The four subclasses of IgG are distinct in structure, function, and degree of participation in the antibody response to complex antigens. Looking for differential responsiveness of potential pathogenetic significance, we have analyzed both quantitatively and qualitatively the filaria-specific IgG subclass responses of 20 patients with lymphatic filariasis presenting either with chronic lymphatic obstructive pathology and elephantiasis (CP) or with asymptomatic microfilaremia (MF). Subclass-specific monoclonal antibodies were used in an enzyme-linked immunosorbent assay to study IgG filarial antibodies quantitatively and in immunoblot analyses to determine qualitatively the subclass antibody specificities. Quantitatively, the most significant differences among patient groups were in levels of IgG4, which were more than 17 times higher in MF patients (geometric mean, 64.7 micrograms/ml) than in those with CP (mean, 3.7 micrograms/ml). When qualitative analyses were done on the same sera, major differences were noted, particularly in the recognition profiles of the IgG1, IgG3, and IgG4 responses. IgG1 and IgG3 responses to antigens were seen especially to antigens with m.w. greater than 68,000 in all patients with elephantiasis, whereas MF patients showed most of their reactivity to antigens less than 68,000. For IgG4, the MF patients showed prominent recognition of antigens throughout the entire range of m.w., whereas those with CP had very little IgG4 recognition of antigens of any m.w. Interestingly, this relationship was essentially reversed in the IgG3 antibody responses (especially to antigens greater than 68,000) and, to a lesser extent, the IgG1 responses. These findings demonstrate correlations of potential cause/effect significance between IgG4 antibody responsiveness and the immunomodulated asymptomatic MF form of clinical filariasis and between IgG3/IgG1 antibody responsiveness and the clinical presentation of CP. PMID- 3309058 TI - Monoclonal antibody characterization of Plasmodium falciparum antigens in immune complexes formed when schizonts rupture in the presence of immune serum. AB - When Plasmodium falciparum parasites are cultured with some immune sera, merozoites are agglutinated by antibodies to form immune clusters of merozoites and prevent their invasion into erythrocytes. Within these immune clusters of merozoites, several antigens that are normally found in the soluble fraction after detergent extraction accumulate in relatively insoluble immune complexes. From mice immunized with these immune complexes, we obtained hybridomas secreting monoclonal antibodies (mAb) that react with various immune clusters of merozoites antigens, including mAb 3D5, which recognizes a 101-kDa antigen (p101) and mAb, 5E3, which recognizes a 113-kDa antigen (p113). Both mAb reacted with antigens at the surface of schizonts, in the vacuolar space, and at the surface of merozoites before their release from schizont-infected cells. Both p101 and p113 were synthesized by mature trophozoites and young schizonts. In pulse-chase experiments, p113 was processed to 100-, 70-, 55-, and 50-kDa products. Both p101 and p113 appeared in the culture medium when schizont rupture occurred in normal culture medium but were found in immune complexes when schizont rupture occurred in the presence of immune serum. Antibodies in immune complexes, when dissociated with acid and used to probe immunoblots, reacted with affinity-purified p101 and p113. Antigens such as these, which are accessible at the parasite surface and react with antibodies present in immune serum that inhibits parasite invasion, are logical candidates to study in the search for a vaccine against the erythrocytic stages of malaria. PMID- 3309060 TI - Genetic analysis of the H-2D region using a new intra-D-region recombinant mouse strain. AB - A rare D-region recombination event which gave rise to the B10.RQDB major histocompatibility complex haplotype has been examined to ascertain the nature of the crossover and to determine which class I genes are present in the new alignment of D-region genes. Serologic analysis have shown that the B10 . RQDB major histocompatibility complex recombinant mouse inherited the H-2Dd gene from the B10.T(6R) parental line and the H-2Db gene from the B10.A(2R) parental line, representing the first example of an intra-D-region crossover resulting from an intercross. Previous molecular genetic analyses of the d and b haplotypes revealed structural diversity in the organization of their D-region gene clusters. Hence, the D region is comprised of five class I genes in the d haplotype and only one in the b haplotype. Because allelic relationships among the various D-region genes are not defined, either a homologous or nonhomologous alignment of genes has generated the RQDB crossover. Therefore, the possibility that all three D-region antigen-presenting molecules (Dd, Ld, and Db) might be encoded by the RQDB haplotype was examined. Fluorescence-activated cell sorter and cytotoxic T lymphocyte analyses revealed no detectable levels of H-2Ld cell surface expression, confirming earlier studies with antibody-mediated cytotoxicity and immunoprecipitation. Southern blot analysis localized the recombination point to within a 1-kb region at the centromeric end of the H-2Ld gene on the B10 . T(6R) chromosome in a region of high homology to the H-2Db gene on the B10 . A(2R) chromosome. Together, these studies define the D region of the RQDB haplotype as containing the five class I genes: Dd, D2d, D3d, D4d, and Db. In addition to providing insight into rare recombination events in the D region, the B10.RQDB mouse should be a useful tool for exploring the function of D-region genes. PMID- 3309061 TI - A highly sensitive microtitre plate enzyme immunoassay for oestradiol-17 beta. AB - A specific and sensitive solid-phase microtitre plate enzyme-linked immunosorbent assay for oestradiol-17 beta (E2) is described. After coating with an IgG anti-E2 fraction, we used E2-6-carboxymethyl-oxime-beta-galactosidase in a competitive binding assay and revealed the bound activity with a fluorogenic substrate. Two methods for the competitive binding assay were tested: (1) a classical one (method A) defined as a 'two-step competition' because the E2 sample was first incubated alone, and then E2-beta-galactosidase conjugate was added; (2) and a new one (method B) also performed in two steps but in which the E2 sample was evaporated to dryness. The detection limit of method A was 100 pg/ml (9 pg/well). Method B was more sensitive since 1 pg/ml (0.3 pg/well) was statistically different from 0 pg/ml. Specificity was equivalent with both methods while precision was better in B. Thus, this new method may be able to measure very low levels of oestradiol-17 beta in, for example, the blood of domestic mammals. PMID- 3309062 TI - A rapid immunological spot test for the identification of proteins in covalently linked protein-nucleic acid complexes. AB - A method is described for the rapid immunological identification of proteins in studies of multicomponent systems. In this case the system is the E. coli ribosome, and the ribosomal proteins to be identified are covalently attached to fragments of labelled ribosomal RNA as a result of chemical cross-linking procedures. Antisera raised against the individual ribosomal proteins are spotted onto a nitrocellulose sheet, and an aliquot of the covalent complex under test is added to each antibody spot. After suitable washing procedures, a positive reaction with one or other of the antisera is visualized by autoradiography of the labelled RNA moiety attached to the antibody via the ribosomal protein. Amounts of protein as low as 10 pg can readily be detected. PMID- 3309063 TI - Limitations of a hemolytic plaque assay for IgG-anti-IgG rheumatoid factor producing cells. AB - An attempt has been made to develop a hemolytic plaque assay capable of detecting homophile IgG rheumatoid factor (RF)-producing cells. Anti-immunoglobulin allotype-developing reagents were used to distinguish between target and effector IgG. The hemolytic assay has been used to demonstrate an apparently high level of homophile IgM and IgG RF-producing cells in the spleens and lymph nodes of mice stimulated by LPS. However, it appears that a large proportion of the plaques obtained in these assays are due to an artefact resulting from cross-linking of target and effector molecules by the developing reagents. In the case of IgM RF the artefact depends on the presence of a small contamination of the target IgG by IgM, allowing cross-linking of target and effector IgM by the anti-mu-specific developing reagent. With the IgG RF, cross-reactivity of the rabbit anti-Ighb allotype-developing serum for the 'wrong' (Igha) allotype, normally undetectable, becomes sufficient to be biologically relevant when the developing antibody is complexed by being bound to its target (Ighb) allotype. Nevertheless anti allotype reagents may afford an accurate means of detecting homophile IgG RF producing cells using other assay systems. PMID- 3309065 TI - Polyethylene glycol enzyme immunoassay for screening anti-haptoglobin monoclonal antibodies. AB - An enzyme immunoassay for the screening of anti-haptoglobin activities in supernatants of hybridoma cell cultures is described. The sandwich technique was greatly improved by the addition of 2% polyethylene glycol 6000 to all the reagents. It allowed a six-fold shortening in the incubation time compared with the standard method without sacrificing either sensitivity or accuracy. PMID- 3309064 TI - An enzyme immunoassay for synthetic thymulin. AB - Thymulin, a metallononapeptide with the following aminoacid sequence: pyroGlu-Ala Lys-Ser-Gln-Gly-Gly-Ser-AsnOH is a thymic hormone involved in T cell differentiation requiring zinc to express biological activity as measured by the rosette assay. We established an enzyme immunoassay (EIA) for synthetic zinc-free thymulin with a thymulin-acetylcholinesterase conjugate as tracer and specific polyclonal rabbit antithymulin antibodies. The assay is performed as a classical competition assay in microtiter plates previously coated with mouse monoclonal IgG to rabbit IgG. A quantitative thymulin assay more sensitive than radioimmunoassays (RIAs) previously described was obtained with a sensitivity (IC50) of 32.5 +/- 5 pg/ml and a detection limit of 5 pg/ml. Analysis in the EIA of synthetic thymulin analogs showed that the minimal peptidic structure necessary for enzymatic tracer competition is the C-terminal part Lys3 to Asn9. It was also shown that the biologically active form of thymulin (zinc-bound) has the same immunoreactivity as zinc-free thymulin and that other thymic hormones, thymosin alpha 1 and thymopoietin II (or TP5) and unrelated short peptides do not cross-react with thymulin. These data demonstrate the specificity of this EIA for thymulin and show its suitability for application in biological fluids. PMID- 3309066 TI - Antibodies against synthetic carboxy-terminal peptides distinguish H-ras and K ras oncogene products p21. AB - Synthetic peptides corresponding to the carboxy-terminal region of H-ras, K-ras, and N-ras oncogene product p21 proteins are used to obtain antibodies specific to each ras oncogene product. The synthetic peptides of 32 amino acids are immunogenic in rabbits without being coupled to carriers. Specific antibodies are purified by absorption of the antisera with the other peptides coupled to CH Sepharose 4B, and antibodies reacting with all three peptides are obtained by affinity chromatography. These findings imply that antibodies specific to each peptide recognize the variable carboxy-terminal region while antibodies reacting with all three peptides recognize the constant region of the carboxy-terminal amino acid sequence of p21 proteins. The affinity-purified antibodies against H ras and K-ras peptides are shown to react specifically with c-H-ras and v-K-ras p21 proteins expressed in E. coli and eukaryotic cells, respectively. These antibodies may be useful tools to study the functional roles of p21 carboxy terminal domain and to detect differential expression of the family of ras oncogenes in cancerous tissues. The affinity-purified anti-N-ras peptide antibody, however, fails to react with N-ras p21 in spite of its positive reactivity with the N-ras peptide. PMID- 3309067 TI - A simple and rapid immunological technique for visualising chromosome-mediated gene transfer (CMGT). AB - A method is described for visualising chromosome-mediated gene transfer (CMGT) by detecting chromosomes labelled with bromodeoxyuridine (BrdU) using a monoclonal antibody to BrdU. In this experiment, the CCRF-CEM T cell line was grown in the presence of BrdU and the labelled chromosomes were isolated and transfected into human embryonic fibroblasts. Uptake and retention of chromosomes were compared for transfection with either PEG or DMSO treatments. Following transfection the labelled chromosomes could be visualised in recipient cells using a monoclonal antibody to BrdU, followed by immunoperoxidase staining. Chromosome uptake into cells was similar for both DMSO and PEG treatments and was a relatively frequent event; about 1 in 5 recipient cells had labelled material present. This technique can be used to assess the technical aspects of the earliest stages of chromosome mediated gene transfer. PMID- 3309069 TI - Sexually transmitted diseases in female. PMID- 3309068 TI - A colorimetric liquid culture assay of a growth factor for primitive murine macrophage progenitor cells. AB - Synergistic factors from media conditioned (CM) by human placentas or the 5637 human bladder carcinoma cell line (SFH-HPCM and SFH-5637 respectively) have the ability to stimulate early progenitor cells in mouse bone marrow to form large colonies in agar cultures after 12-14 days, in the presence of CSF-1. Culture conditions have been examined and a quicker and more convenient liquid culture assay has been developed for this factor, using a tetrazolium salt to quantitate cell proliferation. The use of flat-bottomed vessels, high cell density, supra optimal doses of CSF-1 or the addition of WEHI-3-CM to these cultures, all resulted in a decrease in the required incubation time. In combination, these modifications reduced the assay time to 4 days. PMID- 3309070 TI - Infectious Diseases Society of America. Report from the Antimicrobial Agents Committee. PMID- 3309071 TI - Implications of endotoxin contamination in the evaluation of antibodies to lipopolysaccharides in a murine model of gram-negative sepsis. AB - The pharmacological factors involved in lipopolysaccharide (LPS)-induced host resistance against infection were investigated in relation to the problem of endotoxin contamination of preparations of monoclonal antibody to the common structure of endotoxin. When administered prophylactically, purified LPS (as low as 4 ng/kg of mouse body weight) or antibody preparations contaminated with endotoxin (assayed by Limulus amoebocyte lysate test) were protective against lethal challenge with a clinical isolate of Escherichia coli (P less than .01). Antibodies that were nonreactive to LPS were similarly protective (P less than .001) when spiked with low doses of LPS (100 ng/mg of protein) but, as with LPS, were without effect when administered after infection. Endotoxin contamination of core-reactive antibody to LPS is mostly a problem associated with the large-scale production, purification, and concentration of the monoclonal antibody. The efficacy (as reported in studies in animal models of gram-negative bacterial sepsis) of antibody to LPS core is controversial. We suggest that endotoxin contamination is a likely factor in this controversy. PMID- 3309072 TI - Children with trimethoprim- and ampicillin-resistant fecal Escherichia coli in day care centers. AB - We conducted a cross-sectional study of 79 children attending seven day care centers in Houston, Texas, to detect fecal gram-negative bacilli resistant to trimethoprim (TMPr) and ampicillin (AMPr). Fifteen children (19%) were colonized with TMPr Escherichia coli; all but one strain were also resistant to sulfonamides. Most of the children with TMPr E. coli were clustered in center A, where 11 (37%) of 30 children were colonized; only four (8%) of 49 children in the other six centers were colonized with TMPr E. coli (P less than .005). The TMPr E. coli isolates from 10 of the 11 children in Center A had a similar antibiogram, which included resistance to sulfonamides, ampicillin, and streptomycin; eight had a similar total plasmid pattern, an observation suggesting spread within the day care center. Children colonized with AMPr E. coli were present in all centers, although a higher percentage of children in center A were colonized than in the other centers combined (70% vs. 35%; P less than .01). PMID- 3309073 TI - Evidence for a correlation between proteinase secretion and vulvovaginal candidosis. AB - Candida albicans isolates from nondiabetic, nonpregnant outpatients with vaginitis were compared for in vitro proteinase secretion with isolates from women without specific candidal vaginitis symptomatology (carriers). Proteinase production was assayed in medium containing bovine hemoglobin (BH-P; 39 isolates in 69 independent determinations) or bovine serum albumin (BSA-P; 39 isolates in a single determination each). All isolates had measurable, consistent BH-P secretion, and most also showed detectable BSA-P activity. However, isolates from patients were more proteolytic than those from carriers, with the difference being statistically highly significant. When the patients with vaginitis were categorized according to signs and symptoms, the highest BH-P values were recorded for those with full symptomatology, whereas the only BSA-P-negative isolates were from the group without vaginitis. Isolates from the patient and carrier groups did not differ as a whole in their growth potential in vitro, and all were germ tube responders in serum, independent of their source. PMID- 3309075 TI - Human immunodeficiency virus isolated from a serum sample collected in 1976 in Central Africa. PMID- 3309074 TI - Induction of prostaglandin synthesis as the mechanism responsible for the chills and fever produced by infusing amphotericin B. AB - Amphotericin B produces chills and fever in a significant proportion of patients who receive this drug. The mechanism for this adverse effect is unknown. Amphotericin B suspension at a concentration of 1.0 microgram/ml was demonstrated to be a potent inducer of prostaglandin E2 synthesis by human and murine mononuclear cells in vitro. A double-blind, placebo-controlled clinical trial demonstrated that ibuprofen (10 mg/kg), a potent inhibitor of prostaglandin synthesis, administered 30 min before amphotericin B administration reduced the incidence of chilling from 87% to 49% (P = .01); the incidence of chilling reactions considered severe was reduced from 69% to 15% (P = .008). We postulate that the chills and fever produced by an infusion of amphotericin B are mediated through prostaglandin E2 synthesis. Ibuprofen is therapeutically useful in ameliorating the chills and fever caused by amphotericin B. PMID- 3309076 TI - Comparison of saline agglutination, antibody to human gammaglobulin, and immunofluorescence tests in the routine serological diagnosis of yersiniosis. PMID- 3309077 TI - Systemic candidiasis in Spanish heroin addicts: a possible source of infection. PMID- 3309078 TI - Apical hypertrophic cardiomyopathy: a view from the U. S. A. PMID- 3309079 TI - Synchrotron radiation at the Photon Factory for non-invasive coronary angiography: experimental studies. AB - Synchrotron radiation available at the Photon Factory, National Laboratory for High Energy Physics, provides a new X-ray source which is highly suitable for K edge subtraction. This is due to its high intensity, its parallelism and its monochromaticity, available in a monochromator system. Experiments were performed using wiggler synchrotron radiation. Since the beam size is relatively-small for in-vivo imaging, a phantom coupled with a detector was moved horizontally using a scanning table. K-edge subtraction was successfully applied both to the coronary artery phantom filled with barium sulphate, and to rat angiography using iodine contrast material. The potential use and value of energy subtraction was successfully demonstrated. PMID- 3309080 TI - [Left ventricular asynergy detected by cardiac blood pool emission computed tomography using the subtraction method]. AB - To evaluate left ventricular regional wall motion, ECG dual-gated cardiac blood pool ECT was performed for 25 patients with ischemic heart disease, including 19 cases of myocardial infarction, five cases of angina pectoris, and one case of post A-C bypass surgery. There were six normal controls. Following SPECT obtained using 32 views (180 degrees), the vertical and horizontal long axes were reconstructed from transaxial images. Then, regional wall motion was evaluated from subtraction images; (end-diastolic)-(end-systolic) and (end-systolic)-(end diastolic) images. SPECT images were compared with left ventriculography (LVG); vertical long-axial ECT images with segments 1-5 of LVG by the AHA classification, and horizontal ECT long-axial images with segments 6 and 7 of LVG, respectively. The subtraction images from ECG dual-gated cardiac blood pool ECT corresponded with left ventriculography in 79.4% of 175 segments in 25 patients with ischemic heart disease (sensitivity 92.6%, specificity 68.0%, and accuracy 79.4%). When wall motion was classified as normal, hypokinesis, akinesis, and aneurysmal, good agreement was observed between the two methods in 68% of these segments. The locations of asynergy as obtained by this method were closely in accord with those of perfusion defects by Tl-201 myocardial SPECT in 74.4% of segments. Left ventricular aneurysms were detected using subtraction image; (end-systolic)-(end-diastolic). We conclude that this subtraction method is useful for evaluating left ventricular asynergy. PMID- 3309081 TI - Clinical applications of recent advances in immunology of leprosy. PMID- 3309082 TI - Vaccines in leprosy. PMID- 3309083 TI - Genesis of leprosy lesions. PMID- 3309084 TI - Multi-drug therapy in leprosy. PMID- 3309085 TI - Metabolic studies on mycobacteria. III. Demonstration of key enzymes of TCA cycle in M. leprae. AB - Cell free extracts of armadillo derived M. leprae, M. phlei, M. smegmatis and normal armadillo liver were analysed for the two key enzymes of TCA cycle. Aconitase activity was assayed in the presence of inhibitor fluorocitrate and it was observed that cell free extracts from cultivable mycobacteria as well as aramadillo derived M. leprae had this enzyme activity and 66-82% of this activity was inhibited by 0.1 mM fluorocitrate. 74% of M. leprae derived enzyme activity was inhibited by fluorocitrate in contrast with armadillo derived enzyme which was only 29% inhibited by fluorocitrate. PAGE separation of cell free extracts and staining for Isocitrate dehydrogenase (ICD) activity showed that an additional bond of ICD activity was demonstrable in the cell free extracts of armadillo derived M. leprae and this was NADP dependent. The mobility (ef) of this band of activity was in the same range as ICD from cultivable mycobacteria and much lower than ICD from normal armadillo liver. From this study and from the previously reported work, it is concluded that like other mycobacteria TCA cycle is operative in M. leprae. PMID- 3309086 TI - Metabolic studies on mycobacteria. V. A preliminary report on the ATP synthesis by mycobacteria including M. leprae by using different substrates. AB - By deletion and addition of various substrates in Sauton's and Dubos media, an experimental system has been standardised in which the role of various nutrients in the energy synthesis of mycobacteria can be determined. By using this system with cultivable mycobacteria it was observed that glycerol and asparagine are the important ingredients for ATP synthesis by mycobacteria. Glucose further enhanced the ATP synthesis and growth of these mycobacteria. In the media containing asparagine or glycerol, there was marginal increase in the ATP in the M. leprae suspensions initially but this was not sustained and there was no progressive increase in biomass or multiplication. When M. leprae was incubated in the media from which both these substrates were deleted, there was progressive decline in ATP levels right from the beginning. From these preliminary results, it appears that asparagine and glycerol may be useful as substrates for ATP synthesis by M. leprae and need to be investigated further. In depth studies are necessary to find out the factors which results in the inability of M. leprae to utilise these and other substrates in a substrained manner for its multiplication and growth in artificial media. PMID- 3309087 TI - [Total circular annuloplasty with absorbable suture of the repair of mitral regurgitation of endocardial cushion defect in growing children]. PMID- 3309088 TI - Treatment of chronic erythema nodosum leprosum with cyclosporine A produces clinical and immunohistologic remission. AB - We have treated three leprosy patients suffering from chronic, steroid-dependent erythema nodosum leprosum (ENL) with cyclosporine A (CsA). Excellent results were obtained in two patients. Extra-cutaneous manifestations of the reactional state were completely suppressed, and the development of new skin lesions was sharply curtailed. Immunohistologic abnormalities characteristic of active ENL were corrected. Lymphocyte subpopulations and anti-mycobacterial antibody levels in peripheral blood were unaffected. The third patient showed only a partial response to CsA, but satisfactory blood levels were never obtained in this individual because of dose-related gastrointestinal toxicity. The effectiveness of CsA in the treatment of ENL is consistent with the hypothesis that aberrant activation of a subset of T-helper cells is involved in the pathogenesis of this reaction. CsA may have a role in the treatment of chronic ENL that has failed to respond to conventional therapeutic modalities. PMID- 3309089 TI - Primary visceral virchowian (lepromatous) hanseniasis. AB - A case of primary visceral virchowian hanseniasis is presented. The onset and symptoms of the disease made one think that it was a lymphoma because of the severe enlargement of the liver, spleen, and lymph nodes. Biopsies of the liver, lymph nodes, and bone marrow revealed virchowian infiltration with acid-fast bacilli and globi. The skin was free of lesions and negative to bacilli, and there were no neural symptoms. PMID- 3309090 TI - An ultrastructural study of dermal nerves in early human leprosy. AB - Skin biopsies from the cutaneous lesions of seven patients with indeterminate, BT, BL, and LL leprosy of less than 1 year's duration were examined by light and electron microscopy. Inflammatory cells, which marked the location of Mycobacterium leprae in bacilliferous cases (BL and LL) were most frequently and consistently found in relation to dermal blood vessels, neurovascular bundles, nerves, arrector pili muscles, and skin adnexa. The number of bacilli and inflammatory cells in the epineurium was in great excess of those in the perineurium and endoneurium. Perineurial infiltration by lymphocytes and bacillated macrophages was seen to occur through gaps between the constituent cells of a loosened and sometimes proliferated perineurium. Bacillation of Schwann cells and associated inflammation in the endoneurium was minimal. M. leprae were identified in endothelial cells, arrector pili muscles, macrophages and Schwann cells. At this stage, inflammatory destruction of nerve fibers was not encountered. It is concluded that M. leprae which are extruded from the circulation into the epineurium (or perineurium) may be carried in inflammatory cells across the perineurium which is loosened and rendered permeable to inflammatory cells as a consequence of chronic inflammation in the adjacent epineurium. This is suggested as a very probable route for M. leprae to enter nerves. PMID- 3309092 TI - Investigations into cultivation of M. leprae in a nasal mucus medium: a preliminary report. PMID- 3309091 TI - The search for animal models of leprosy. PMID- 3309093 TI - Schwann cells and M. leprae. PMID- 3309094 TI - Microbe dependence of Mycobacterium leprae: a possible intracellular relationship with protozoa. PMID- 3309095 TI - [Physiopathology and treatment of spondylolisthesis (spondylolytic and degenerative spondylolisthesis)]. PMID- 3309096 TI - [Essential hypertension and multiple renal arteries]. PMID- 3309097 TI - [A case of 48,XXYY syndrome with recurrent foot ulcers and renal hypouricemia. Effective treatment of ulcer by autologous skin transplantation]. PMID- 3309098 TI - Pulse oximetry: historical review and Ohmeda functional analysis. AB - Oximetry relies on the detection of the spectral properties of oxygenated and reduced hemoglobin. In vitro bench analysis capabilities have spurred the desire to accomplish accurate in vivo measurement through various techniques. The 1930 40s were a particularly active period for oximetry culminating in the development of pulse oximeters in the 1970s. Ohmeda pulse oximeters deal with the dynamics of this technology in several unique ways. Microprocessor controlled sequencing, signal processing and data validation schemes form the framework for accurate and stable readings. Arterial oxygen saturation readings are derived from the ratio of pulse-added signals of red and infrared light energy passed through tissue. Data manipulation that includes empirically derived constants produces numerical data that is clinically useful. A photo-plethysmographic waveform display of actual oximeter signal closes the loop between man and machine. PMID- 3309100 TI - Treatment of rectal prolapse by Delorme's operation. AB - Rectopexy in the sacral hollow or to the promontory with synthetic material is the most efficient method of reducing and fixing a complete rectal prolapse. However, this distressing condition occurs frequently in elderly patients, often with high operative risk. In these some surgeons have advocated a perineal approach. Eighteen female patients (mean age 74 years) with complete rectal prolapse have been treated by a modified Delorme's procedure which involves a mucosal stripping of the prolapse and longitudinal plication of the muscular wall of the rectum. There was no postoperative mortality or morbidity. After a mean follow-up of 18 months, two complete recurrences occurred. These were treated by the same technique with a good result at 3 years. One other patient presented a partial and intermittent recurrence. Incontinence has improved in four patients and was not made worse in the others. Our results and those previously published show that this procedure is safe in elderly high risk patients considered too unfit for transabdominal surgery. PMID- 3309099 TI - Staging of colorectal cancer. PMID- 3309102 TI - [A clinical study on the distribution and the bond failure of etched Maryland bridge (I). A preliminary report of 135 cases]. PMID- 3309101 TI - The surgical anatomy of the rectum--a review with particular relevance to the hazards of rectal mobilisation. AB - The major complications of rectal surgery that are wholly or partially avoidable by the use of an anatomically based dissection are haemorrhage from presacral veins, perforation of the rectum, damage to pelvic autonomic nerves and inadequate clearance of a rectal cancer. Important technical points in minimising the incidence of these complications are: (1) posterior dissection in the presacral space; (2) entry to this space by sharp dissection immediately posterior to the superior rectal artery; (3) deliberate incision of the rectosacral fascia; (4) anterior dissection posterior to Denonvilliers fascia in benign disease; (5) removal of the entire mesorectum for low rectal cancer. Other anatomical points not widely appreciated are: 1. The middle rectal artery does not run in the lateral ligaments of the rectum, but below them, on levator ani. It reaches the rectum by penetrating Denonvilliers' fascia. 2. The lateral ligaments may contain an accessory middle rectal artery in 25% of cases. 3. The pelvic autonomic nerves are buried in endopelvic fascia on the pelvic side wall, but come to lie close to the anterior aspect of the rectum at the level of the prostate or upper vagina. PMID- 3309103 TI - Induction of mouse monocyte-macrophage replication by a mesangial cell-derived factor. AB - Conditioned media of cultured mouse mesangial cells (possessing microfilaments) were shown to contain a factor that stimulated splenic monocytes-macrophages and blood monocytes to replicate. Replicated cells were shown to express MAC-1 antigen as demonstrated by immunofluorescence with anti-MAC 1 and to possess Fc receptors as evidenced by their capacity to ingest sensitized erythrocytes. Preliminary characterization revealed the following characteristics: by Amicon ultrafiltration, fractions greater than 100,000 daltons were shown to have biologic activity; chromatofocusing of these active fractions revealed a peak of activity associated with fractions having pH 4; heating to 100 degrees C for 10 minutes abolished almost all activity, whereas trypsin treatment was without effect. The observations suggest a mechanism by which mesangial cells may modulate the proliferation of monocytes-macrophages that infiltrate the glomerulus in glomerulonephritis. PMID- 3309105 TI - Microcomputer courseware production and evaluation guidelines for students with learning disabilities. PMID- 3309104 TI - Preservation of neck dissection for histological study. AB - Dissection of lymphatic nodes in the neck--whether radical or partial, functional or prophylactic--forms an integral part of the surgical management of cancer of the head and neck. Accurate orientation and fixation of the surgical specimen is a prerequisite for correct histopathological study of the extent of the disease and for a complete clinicopathological interpretation, which is of significant therapeutic and prognostic importance. PMID- 3309107 TI - Mechanisms of intervertebral joint fixation: a literature review. AB - The cause of restricted intervertebral mobility, or joint fixation, has generated much speculation. A number of etiologies have been proposed in the literature by authors addressing this question. The four possible theories that merit further investigation include meniscoid entrapment, displaced intervertebral disc fragments, segmental or intersegmental muscle spasm and periarticular connective tissue adhesions. The two questions to be addressed for each theory are how does each mechanism acutely restrict intervertebral joint movement and how does a high velocity manipulation restore movement and relieve symptoms? The pros and cons of each theory are presented, citing the relevant literature. In addition, research possibilities to further investigate each mechanism are presented. PMID- 3309106 TI - Cholesterol synthesis in the perfused liver of pregnant hamsters. AB - Pregnancy is a risk factor for the development of cholesterol gallstones. In pregnant women, biliary cholesterol saturation and secretion are increased. To investigate whether this was due to increased cholesterol synthesis, we studied hepatic cholesterol synthesis in Syrian Golden hamsters. Female controls and animals 10- to 14-days pregnant were studied. The studies were performed in the in situ perfused hamster liver. Cholesterol synthesis was determined by measuring the incorporation of 3H2O added to the perfusate into hepatic, perfusate, and bile cholesterol during a 90-min period. In both pregnant groups, bile flow decreased significantly, but biliary cholesterol concentration increased only in the 14-day pregnant group. The cholesterol synthesis rate averaged (mean +/- SD) 172 +/- 27, 127 +/- 37, and 552 +/- 79 nmol X hr-1 X g liver-1 in controls, 10 day, and 14-day pregnant animals, respectively. The 14-day pregnant animals secreted a markedly higher fraction (47.3 +/- 11.3 vs. 11.1 +/- 13.4%; P less than 0.01) of newly synthesized cholesterol into bile but not into perfusate. Chenodeoxycholate, but not cholate, synthesis rate was decreased in both pregnant groups. We conclude from our studies that hepatic cholesterol synthesis increases towards the end of pregnancy in the hamster and that more newly synthesized cholesterol is secreted into bile at that time. This could at least partially explain the increased biliary cholesterol saturation and secretion observed in women in the third trimenon, and explain pregnancy as a risk factor in the development of cholesterol gallstones. PMID- 3309108 TI - A concept in search of fulfillment. PMID- 3309110 TI - Two-dimensional echocardiographic diagnosis of aortic dissection: report of a case and review of echocardiographic criteria. PMID- 3309111 TI - Mathematical modeling of electrical activity of the heart. AB - This paper reviews the literature on mathematical models of cardiac activation and evaluates these approaches against an analytical approach that includes both structure and membrane properties. The advantages and disadvantages of each methodology are described and directions for future research suggested. PMID- 3309109 TI - Adenocarcinoma arising in a duplication of the rectum: a case report and review of the literature. PMID- 3309112 TI - Asystole with syncope following strenuous exercise in a man without organic heart disease. AB - A 29-year-old man without organic heart disease who had a history of six episodes of syncope following sudden cessation of strenuous exercise over the last 18 years was reported. Resting electrocardiogram and 24-hour electrocardiographic monitoring did not show any rhythm disturbance or ischemic changes. Sinus node recovery time, sinoatrial conduction time and A-V conduction were normal on electrophysiologic study. Asystole with syncope occurred immediately following sudden cessation of strenuous exercise and following release of intrathoracic pressure during Valsalva's maneuver performed after subcutaneous administration of 0.5 mg of epinephrine. However, Master's single two-step test and Valsalva's maneuver performed without epinephrine could not evoke asystole. It was assumed from these results that transient overactivity of the autonomic nervous system and sympathetic-parasympathetic interactions were the underlying factors responsible for the occurrence of asystole following sudden cessation of strenuous exercise in the present case. PMID- 3309113 TI - The use of reversed-phase high-performance liquid chromatography to detect proteolytic activity from human pancreas in a radioimmunoassay for corticotrophin releasing factor. AB - Degradation of tracer during a radioimmunoassay (RIA) can result in false positive concentrations of immunoreactivity being reported in a biological sample. A technique has been developed using reversed-phase high-performance liquid chromatography (HPLC) to detect proteolytic degradation of corticotrophin releasing factor-41 (CRF-41) during incubation with tissue extracts under RIA conditions. Human pancreatic tissue was extracted in HCl or urea and incubated with 125I-labelled CRF-41 at neutral pH for 18 h. When samples were analysed by HPLC and fractions counted for radioactivity, tracer was extensively degraded. Heating extracts at 85 degrees C or adding lima bean trypsin inhibitor to the medium prevented degradation. Pancreatic tissue extracted in HCl was analysed by gel filtration and HPLC, and fractions were subjected to RIA for CRF-41. A peak of immunoreactivity was detected by both chromatographic methods. However, when this material was incubated with tracer and analysed by HPLC, the tracer was degraded, indicating that proteolytic activity remained after acid extraction and two forms of chromatography. PMID- 3309114 TI - Plasma Met-enkephalin and catecholamine responses to insulin-induced hypoglycaemia in greyhounds. AB - The involvement of endogenous opioid peptides in the stress response was investigated by measuring plasma concentrations of Met-enkephalin-like immunoreactivity (MLI), adrenaline and noradrenaline during insulin-induced hypoglycaemia in conscious greyhounds. Moreover, the molecular forms of circulating MLI were characterized using gel filtration chromatography. In the first group of animals, i.v. administration of insulin (0.3 units/kg) provoked marked hypoglycaemia (blood glucose concentrations fell from 4.4 +/- 0.1 to 1.5 +/- 0.2 mmol/l; mean +/- S.E.M.) which was associated with significant (P less than 0.001) rises in plasma MLI concentrations from a basal concentration of 45 +/- 8 to a peak of 189 +/- 39 ng/l. A within-subject study comparing five different insulin doses ranging from 0.004 to 0.3 units/kg showed dose-related effects on blood glucose with nadir concentrations of 4.1 +/- 0.6 mmol/l (after the smallest dose of insulin) and 0.8 +/- 0.1 mmol/l (after the largest dose of insulin). This was associated with dose-related rises in plasma MLI with peak concentrations of 56 +/- 17 and 558 +/- 35 ng/l, plasma adrenaline with peak concentrations of 0.45 +/- 0.06 and 15.76 +/- 1.33 nmol/l and plasma noradrenaline with peak concentrations of 0.49 +/- 0.07 and 2.27 +/- 0.45 nmol/l following the smallest and largest doses of insulin respectively. These results are the first demonstration of raised plasma MLI concentrations following hypoglycaemia. Moreover, they show that the hormonal responses vary with the degree of hypoglycaemia achieved. Together with reports by other investigators these findings might suggest opioid modulation of the responses of the sympathoadrenal system to hypoglycaemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309115 TI - Insulin-modulated interleukin-2 production by murine splenocytes and a T-cell hybridoma. AB - Murine interleukin-2 (IL-2)-producing AOFS 21 T-cell hybridoma cells and normal murine splenocytes were stimulated in serum-free media by 16 potential mitogens/growth factors. Only insulin, concanavalin A (Con A), peptidoglycan monomer and a tumour-derived insulinoid stimulated [3H]thymidine incorporation by AOFS 21 cells and splenocytes. Supernatants of these stimulated cultures were tested for IL-2 activity which generally followed the pattern of growth stimulation. Both the mitogenicity and stimulation of IL-2 secretion by insulin were second only to the effects of Con A. PMID- 3309116 TI - Lack of glucose-induced priming of insulin release in the perfused mouse pancreas. AB - Perfusion of the mouse or rat pancreas with 20 mmol D-glucose/l caused a biphasic release of insulin. The second phase was nearly constant in the mouse but rose in the rat. Repeated pulses of 8, 20 or 30 mmol D-glucose/l did not potentiate subsequent insulin responses in the mouse, whereas repeated pulses of 20 mmol/l did in the rat. When 20 mmol D-glucose/l was introduced through the mesenteric artery or aorta of the mouse, the pattern of insulin release was the same as when it was introduced through the coeliac artery. Thus, insulin secretion in mice differs from that in rats both in not showing an increasing second phase in response to continuous stimulation with glucose and also in not showing successive enhancement in the insulin response to repeated pulses of glucose. PMID- 3309117 TI - Measures of social class based on education for use in health studies in developing countries. AB - In this paper we consider the appropriateness of education, compared to occupation and income, as a measure of social class for use in health-related studies in developing societies in transition. Three evaluation criteria were used, namely, the feasibility of constructing the measure, its sensitivity in reflecting relevant social class life conditions, and its ability to produce a family-level measure of social class. We used two data sets from community health surveys in areas of Amman city, Jordan, and in Beirut city, Lebanon, to define a family-based average educational score. We then proceeded, using the Beirut data, to test the score's ability to discriminate social class effects on family health, compared to a more standard representation based on the educational level of the head of the family. It was found that the performance of the average educational score was often better than, but not consistently superior to, the educational level of the head of the family. PMID- 3309118 TI - Does G6PD deficiency protect against cancer? A critical review. AB - Previous observations on the lower mortality for cancer experienced in populations with a higher frequency of G6PD deficiency support biochemical studies on the role of G6PD during cell proliferation. The general agreement among experimental studies prevented a deeper analysis of the sources of what has been called "epidemiological evidence of the protective role of G6PD deficiency against cancer". This review analyses the methods and findings in those papers, stressing their limitations and emphasising that no final conclusions can be drawn from them. Preliminary results of ongoing epidemiological studies of G6PD deficiency and cancer are presented, although they do not prove or disprove the hypothesis that G6PD deficiency protects against cancer. PMID- 3309119 TI - The menopause and breast cancer. PMID- 3309120 TI - The effect of replacing different regions of limb skin with head skin on regeneration in the axolotl. AB - Head skin was used to replace different halves of limb skin from the upper and lower arms of axolotls. Replacement of upper arm posterior skin caused the regeneration of a high proportion of single-digit limbs while replacement of dorsal, ventral or anterior skin caused only minor defects to the normal skeletal pattern. When dorsal or ventral skin was replaced, however, regenerates often lacked dorsal or ventral muscle. Results from the lower arm were different in that replacement of any half of limb skin failed to cause defects either in the skeletal or muscular pattern. These results are used in conjunction with previous work (Wigmore & Holder, 1985; Wigmore, 1986) to suggest that posterior skin is essential for regeneration of the anteroposterior axis and dorsal and ventral skin is necessary for the differentiation of the muscle pattern in regenerates from the upper arm. In the lower arm no localized region of skin appears to be essential for regeneration of the normal pattern and the patterning mechanism may have a different spatial organization. PMID- 3309121 TI - The relationship between emerging neural crest cells and basement membranes in the trunk of the mouse embryo: a TEM and immunocytochemical study. AB - The earliest stage of neural crest cell (NCC) migration is characterized by an epitheliomesenchymal transformation, as the cells leave the neural tube. There is evidence that in a number of cell systems this transformation is accompanied by alteration or depletion of associated basement membranes. This study examines the ultrastructural relationship between mouse NCCs and adjacent basement membranes during the earliest stages of migration from the neural tube. Basement membranes were identified by transmission electron microscopy (TEM) and immunofluorescence using antibodies to type-IV collagen. The ultrastructural features of NCCs and their relationship with surrounding tissues were also examined using TEM. In the dorsal region of the neural tube, from which NCCs originate, the basement membrane was depleted or absent, and with the immunofluorescence technique it was shown that this pattern was reflected in a deficit of type-IV collagen. TEM observations indicated that ultrastructurally NCCs differ from their neuroepithelial neighbours only in overall cell shape and their relationship to other cells and the extracellular matrix. PMID- 3309122 TI - An in vitro assay for neural crest cell migration through the somites. AB - Neural crest cells in the trunk of the avian embryo come into contact with the somites and neural tube during the course of their migration. However, the relationship between the somites and the early migratory routes followed by these cells is not yet completely understood. Here, we use a tissue culture assay to examine if avian neural crest cells migrate through the somites. Cultures of quail somites were prepared from four adjacent regions along the neural axis in the trunk. Each region had four pairs of consecutive somites with region I being most anterior and region IV containing the last four segments. Within each region, the somites were separated from other tissues by enzymatic digestion and plated onto collagen-coated dishes. Immunocytochemical techniques were used to confirm that no neural crest cells, recognized by the HNK-1 antibody, were present on the surface of the somites at the time of explanation. After several days in culture, the explanted somites were screened to identify pigment cells. Because neural crest cells give rise to all of the melanocytes in the trunk, the presence of pigment cells indicated that neural crest precursors were contained within the initial explant. After 5-11 days in vitro, the percentage of somite cultures containing pigment cells in regions I through IV, respectively, was 36%, 51%, 31% and 1%. These results suggest that neural crest cells migrate through the somitic mesenchyme and first enter the somites between 5 to 9 segments rostral to the most recently formed somite. PMID- 3309123 TI - Deficiency of lymphocyte function-associated antigen 3 (LFA-3) in paroxysmal nocturnal hemoglobinuria. Functional correlates and evidence for a phosphatidylinositol membrane anchor. AB - Lymphocyte function-associated antigen 3 (LFA-3) is a widely distributed cell surface glycoprotein that binds to the T lymphocyte CD2 surface glycoprotein. This interaction mediates CTL-target cell conjugate formation and adhesion of thymocytes to thymic epithelial cells. CD2 is also the E rosette receptor of T lymphocytes and mediates rosetting with autologous E by binding to LFA-3. We describe deficient expression of LFA-3 on E from paroxysmal nocturnal hemoglobinuria (PNH) patients. PNH is an acquired defect affecting phosphatidylinositol-anchored membrane proteins, of which decay-accelerating factor (DAF) is most important in the clinical symptoms of PNH. LFA-3-negative, weakly positive, and positive populations were found among PNH E. There was a good correlation with DAF deficiency. PNH E exhibited decreased binding of 125I CD2 and rosetting with a human T lymphoma cell line. PNH E readily incorporated purified LFA-3, restoring LFA-3 expression and the CD2 binding and rosetting activity to normal levels. The expression of DAF was not restored after the incorporation of purified LFA-3 into PNH E, showing that LFA-3 and DAF are different molecules. Phosphatidylinositol-specific phospholipase C (PIPLC) treatment of a B lymphoma cell line released 35% of the cell surface LFA-3 and 62% of DAF. LFA-3 on E was resistant to PIPLC. However, when LFA-3 purified from human E was reconstituted in sheep E or human E and subjected to PIPLC treatment, 40-50% of LFA-3 was released from the cell membrane. The results show that LFA-3 is attached to the cell membrane by a phosphatidylinositol glycolipid moiety, and confirm previous findings (37-41) that LFA-3 is a cell adhesion molecule that mediates adhesion by interacting with CD2 antigen. PMID- 3309124 TI - Raised serum levels of cachectin/tumor necrosis factor alpha in renal allograft rejection. AB - A sensitive radioimmunoassay was used for monitoring serum levels of endogenous cachectin/tumor necrosis factor alpha (TNF) in 10 renal transplant recipients. Acute allograft rejections were associated with marked elevations of circulating TNF. The peak levels of TNF (median 140 pg/ml) were in the same concentration range as previously reported in parasitic infections. The results show that the release of TNF into circulation is an early event in renal allograft rejection and that raised levels of TNF in man can also be induced by noninfectious stimuli. PMID- 3309125 TI - Murine macrophages and pancreatic beta cells. Chemotactic properties of insulin and beta-cytostatic action of interleukin 1. AB - This study has used in vitro techniques to investigate the potential interactions between mouse pancreatic islet cells and syngeneic macrophages (M phi). Islets strongly stimulated M phi migration from agarose microdroplets; insulin was the only one of four islet cell hormones tested that was effective individually. Chronic exposure of islet monolayers to recombinant mouse IL-1, an M phi secretory product, was not cytolytic, but inhibited insulin secretion, reduced intracellular insulin content, and produced beta cell-specific degranulation. These effects were unique to IL-1; another monokine, tumor necrosis factor, as well as the lymphokine IL-2, and lymphotoxin were all without effect on insulin secretion or monolayer viability at the concentrations tested. The potential pathological consequences of the chemoattractive action of insulin on M phi, and the inhibitory effect of IL-1 on insulin secretion, are discussed. PMID- 3309126 TI - Syngeneic transfer of autoimmune diabetes from diabetic NOD mice to healthy neonates. Requirement for both L3T4+ and Lyt-2+ T cells. AB - We have developed a model of syngeneic adoptive transfer for type I diabetes mellitus of NOD mice. This model consists in injecting spleen cells from diabetic adult mice into newborn NOD recipients. 50% of recipients inoculated with 20 X 10(6) cells develop diabetes within the first 10 wk of life, at a time when none of the control littermates have yet become diabetic. The earliest successful transfers are observed at 3 wk of age, at a time when controls do not even exhibit histological changes in their pancreas. In addition we have shown that: (a) both males and females can be adoptively transferred, despite the fact that males rarely develop spontaneous diabetes in our colony; (b) diabetes transfer is a dose-dependent phenomenon that provides an in vivo assay for comparing the autoimmune potential of spleen cells from mice at various stages of their natural history; (c) the susceptibility of the recipients to the transfer is limited in time and declines after 3 wk; and (d) both L3T4+ and Lyt-2+ T cell subsets are necessary for the successful transfer. The neonatal syngeneic transfer provides an effective model for studies of the cellular events involved at regulatory and effector stages of autoimmune type I diabetes. PMID- 3309127 TI - Primary structure of lymphocyte function-associated antigen 3 (LFA-3). The ligand of the T lymphocyte CD2 glycoprotein. AB - We have isolated the cDNA for human lymphocyte function-associated antigen 3 (LFA 3), the ligand of the T lymphocyte CD2 molecule. The identity of the clones was established by comparison of the deduced amino acid sequence to the LFA-3 NH2 terminal and tryptic peptide sequences. The cDNA defines a mature protein of 222 amino acids that structurally resembles typical membrane-anchored proteins. An extracellular domain with six N-linked glycosylation sites is followed by a hydrophobic putative transmembrane region and a short cytoplasmic domain. The mature glycoprotein is estimated to be 44-68% carbohydrate. Southern blots of human genomic DNA indicate that only one gene codes for human LFA-3. Northern blot analysis demonstrates that the LFA-3 mRNA of 1.3 kb is widely distributed in human tissues and cell lines. PMID- 3309128 TI - Inhibition of phagosome-lysosome fusion in macrophages by certain mycobacteria can be explained by inhibition of lysosomal movements observed after phagocytosis. AB - We have investigated the mechanism of the inhibition of phagosome-lysosome (P-L) fusion in macrophages known to occur after infection by Mycobacterium tuberculosis and by the mouse pathogen Mycobacterium microti. We have used an M. microti infection and have studied, first, the saltatory movements of periphagosomal secondary lysosomes by means of visual phase-contrast microscopy (a similar use of the method having been previously supported by computer analyses). The movements became slow or static after ingestion of live but not of heat-killed M. microti. They were unaffected by a fusiogenic mycobacterium M. lepraemurium. Second, we studied the behavior of a normally fusiogenic unrelated organism, Saccharomyces cerevisiae, after its phagocytosis by cells already containing live M. microti ingested 18 h previously. We observed, using a fluorescent assay of fusion, that many of these yeast phagosomes now also failed to fuse with the lysosomes; in contrast, when the host M. microti had been heat killed the yeast phagosomes fused normally. These observations were extended by ultrastructural quantitative analyses of P-L fusion, which confirmed the nonfusion of phagosomes of live M. microti and, more particularly, the change to nonfusion from the normal fusion behavior of the separate phagosomes of accompanying yeasts. Third, we have assembled evidence against the likelihood that these M. microti-induced phenomena are nonspecific, i.e., secondary to a general depression of activity of heavily infected host cells. The evidence includes the feasibility of adjusting the degree of infection so as to facilitate visual assessment of organelle movements without the presence of detectable damage to the cells studied; the absence of lysosomal stasis after comparable infection with another mycobacterium of comparable virulence (M. lepraemurium); and the reversibility of the stasis. We conclude that inhibition of lysosome saltatory movements (and consequently its secondary effect on the associated yeasts) is a significant, specifically induced phenomenon. From these observations and considerations, therefore, in conjunction with the analogous inhibition of lysosomal movements in normal macrophages by some chemical inhibitors of P-L fusion, and our suggestion that this association is causally related, we now suggest that M. microti-induced focal lysosomal stasis is also the main means by which the inhibition of P-L fusion is brought about by this organism. This concept is strengthened by the observations on S. cerevisiae, which provide strong evidence that stasis can cause suppression of fusion. PMID- 3309130 TI - Strategies for treating sore throat in adults. PMID- 3309129 TI - Effector cells in allelic H-2 class I-incompatible skin graft rejection. AB - The cellular mechanisms of skin graft rejection with allelic H-2 class I differences were studied by examining the effect on graft survival of in vivo administration of anti-Lyt-2.2 mAb, anti-L3T4 mAb, or both to recipient mice. The injections of anti-Lyt-2.2 mAb and anti-L3T4 mAb caused selective depletions of Lyt-2+ cells and L3T4+ cells, respectively. Injection of anti-Lyt-2.2 mAb significantly prolonged graft survival in 7 of 12 combinations of H-2D-end difference, but did not prolong graft survival in 5 other combinations of H-2D end difference, or in 2 combinations of H-2K-end difference. Injection of anti L3T4 mAb did not prolong graft survival in any combinations with class I difference tested. Injection of anti-L3T4 mAb plus anti-Lyt-2.2 mAb markedly prolonged graft survival in the combinations with class I difference in which anti-Lyt-2.2 mAb had no effect and overcame the effect of anti-Lyt-2.2 mAb in those in which anti-Lyt-2.2 mAb had an effect in prolonging graft survival. These results indicated that in combinations in which anti-Lyt-2.2 mAb did not prolong graft survival, class I antigen stimulated L3T4+ effector cells when Lyt-2+ cells were blocked and Lyt-2+ effector cells when L3T4+ cells were blocked. On the other hand, in the combinations in which anti-Lyt-2.2 mAb prolong graft survival, these antigens initially caused preferential stimulation of Lyt-2+ but not L3T4+ effector cells, although delayed activation of L3T4+ effector cells occurred when Lyt-2+ cells were blocked. Furthermore, a significant correlation was found between the effect of anti-Lyt-2.2 mAb in prolonging graft survival and the failure of recipient mice to produce H-2 antibody. These results can be taken as evidence that L3T4+ effector cells are not involved in the initial phase of graft rejection in these combinations. PMID- 3309132 TI - Transcript analysis of the citrate synthase and succinate dehydrogenase genes of Escherichia coli K12. AB - A transcript analysis of the citrate synthase and succinate dehydrogenase genes (gltA-sdhCDAB) of Escherichia coli was done by nuclease S1 mapping. Evidence was obtained for two monocistronic gltA transcripts extending anti-clockwise, to a common terminus, from independent promoters with start points 196 bp (major) and 299 bp (minor) upstream of the gltA coding region. Evidence was also obtained for two polycistronic sdh transcripts, sdhCDAB (minor) and sdhDAB (major), extending clockwise, from sites 219 bp upstream of sdhC and 1455 bp upstream of sdhD (i.e. within sdhC), to a common terminus. The synthesis of all of the transcripts was repressed by growth in the presence of glucose, and this is consistent with the well-established fact that both enzymes are subject to catabolite repression. Sequences resembling known binding sites for the cAMP-CRP (cyclic AMP-cyclicAMP receptor protein) complex occur in the vicinity of each promoter suggesting that they are activated by the cAMP-CRP complex. PMID- 3309131 TI - Effects of antihypertensive medications on vitality and well-being. AB - The effects of captopril, methyldopa, and propranolol were assessed for sense of well-being and vitality among 626 men with mild to moderate hypertension in a multicenter, randomized, double-blind clinical trial. After a 24-week treatment period, patients taking captopril, compared with patients taking methyldopa and propranolol, scored significantly higher on measures of well-being and vitality. In addition, patients on captopril had more favorable results in being able to keep up with their work and in not feeling tired or sleepy at work. The effects of each of the drugs manifested themselves at different periods. For example, the negative effects of methyldopa on vitality were evident by week 8, whereas the negative effects did not become manifest for propranolol until week 24. On the other hand, a steady progressive improvement in vitality scores was evident at week 8 and at week 24 for patients on captopril. The findings of the study also suggest that the effects of the treatment drugs were most marked in patients who had had previous antihypertensive medications and who were on single-drug therapy during the course of the clinical trial. Further, the differences between patients taking captopril and those on methyldopa and propranolol appear to be obscured by the addition of a diuretic. The findings of the study may guide the physician in orienting his or her patient and in planning and implementing a therapeutic regimen. PMID- 3309133 TI - Microcin-E492-insensitive mutants of Escherichia coli K12. AB - Mutations in three Escherichia coli K12 genes, tonB, exbB and the newly discovered semA, reduce sensitivity to the low Mr polypeptide antibiotic microcin E492. The products of the tonB and exbB genes were previously shown to be involved in the uptake of siderophore-complexed iron and in the action of a number of colicins. Strains mutated at or close to semA (collectively referred to as sem mutations) remained fully sensitive to these colicins, and grew as well as wild-type strains under conditions of iron starvation. Expression of a number of sem-lacZ operon fusions was not affected by iron limitation, and sem mutations did not affect the production of iron-regulated outer membrane proteins which are known or thought to be involved in iron uptake. Hfr conjugation and P1 phage transduction experiments indicated that semA is located close to pabB at 40 min on the E. coli K12 chromosome. This places semA close to the mng locus, wherein mutations result in decreased manganese sensitivity. However, strains carrying the semA mutation exhibited increased manganese sensitivity. PMID- 3309134 TI - Effect of R-plasmid RP1 on surface hydrophobicity of Proteus mirabilis. AB - The presence of R-plasmid RP1, as well as the conditions of growth, affected the surface hydrophobicity of a clinical isolate of Proteus mirabilis. However, results depended upon the method of assessment. Stationary phase plasmid containing cells appeared to be less hydrophobic than plasmid-free cells when hydrophobicity was measured by the contact angle method, but more hydrophobic when measured by bacterial adherence to hydrocarbons or hydrophobic interaction chromatography. Cells growing in a chemostat differed in hydrophobicity from stationary phase cells and results varied with the growth rate. Plasmid-mediated effects were greatest in iron-depleted cells, and differences between plasmid containing and plasmid-free cells were virtually eliminated by pre-treatment with antiserum. PMID- 3309135 TI - Catabolite repressive effects of 5-thio-D-glucose on Saccharomyces cerevisiae. AB - The effect of the glucose analogue 5-thio-D-glucose (5TG) on the yeast Saccharomyces cerevisiae was studied. Derepression of mitochondrial respiratory chain cytochromes, alcohol dehydrogenase (isoenzyme II), NADH dehydrogenase and maltase was inhibited by 0.5-2 mM-5TG. Growth rate was only slightly affected. Ethanol was efficiently produced with 2 mM-5TG in medium initially containing 0.25% glucose. Mutants resistant to the growth inhibitory effects of 5TG on glycerol medium showed resistance to the catabolite repressing effects of glucose. Other mutants, known to be catabolite repression resistant, showed resistance to 5TG. The analogue seems to inhibit derepression of glucose repressible enzymes with greater potency than glucose itself. PMID- 3309136 TI - Pyrolysis gas chromatography-mass spectrometry of mycobacterial mycolic acid methyl esters and its application to the identification of Mycobacterium leprae. AB - Pyrolysis gas chromatography-mass spectrometry of methyl mycolates from 32 species of mycobacteria, including Mycobacterium leprae, was carried out. The mycobacteria could be classified into four groups in respect of the fatty acid ester patterns detected within the range C20 to C26. The applicability of this pyrolysis-gas chromatographic method for identifying M. leprae is discussed. PMID- 3309137 TI - Mechanism of inactivation of hexokinase PII of Saccharomyces cerevisiae by D xylose. AB - The mechanism of inactivation of hexokinase PII of Saccharomyces cerevisiae by D xylose was characterized. Inactivation was dependent on the presence of MgATP and was irreversible. Inactivation involved phosphorylation of the protein. Observation of the carbon catabolite repression of selected enzymes showed that invertase and maltase synthesis were not repressed when hexokinase PII was phosphorylated. PMID- 3309138 TI - Physiological role of glutaminase activity in Saccharomyces cerevisiae. AB - The participation of glutaminase activity in glutamine degradation was studied in a wild-type strain (S288C) of Saccharomyces cerevisiae. Evidence is presented that this strain has two glutaminase activities, a readily extractable form (glutaminase B) and a membrane-bound enzyme (glutaminase A). Glutaminase A and B activities could also be distinguished by their thermostability, pyruvate sensitivity and pH optimum. Glutaminase B activity was negatively modulated by some 2-oxo acids, and in vivo pyruvate accumulation inhibited this activity. A mutant strain (CN10) with an altered glutaminase B activity was isolated and partially characterized. Its glutaminase B activity was more sensitive to inhibition by pyruvate and 2-oxoglutarate than the wild type, thus resulting in inactivation of this enzyme in vivo. The physiological role of glutaminase activity is discussed with regard to the phenotype shown by the mutant strain. PMID- 3309139 TI - Expression and stability of a recombinant plasmid in Zymomonas mobilis and Escherichia coli. AB - A recombinant plasmid was constructed by ligating EcoRI digests of the plasmid cloning vector pBR325 and pZMO2, one of the natural plasmids of Zymomonas mobilis ATCC 10988. This vector, named pDS212 (total size 7.9 kb), which was able to transform Escherichia coli efficiently, was also transferred to Z. mobilis hosts by mobilization during conjugation using the helper plasmid pRK2013. pDS212 was inherited stably in both E. coli and Z. mobilis hosts and could be recovered intact from them. Markers of pBR325 and pRK2013 were also transferred in Z. mobilis but at very low frequencies. Neither pBR325 nor pRK2013 could be recovered intact from the Z. mobilis hosts. It is proposed that expression and stability of pDS212 in Z. mobilis is due to the origin of replication of pZMO2 that it carries, and that it may be used for developing a gene transfer system in Z. mobilis. PMID- 3309140 TI - The cdc30 mutation in Saccharomyces cerevisiae results in a temperature-sensitive isoenzyme of phosphoglucose isomerase. AB - The cdc30 mutation in the yeast Saccharomyces cerevisiae causes cell cycle arrest late in nuclear division when cells are shifted from the permissive temperature of 25 degrees C to the restrictive temperature of 36.5 degrees C. Cell cycle arrest at 36.5 degrees C is dependent upon the carbon source used: a shift-up in glucose containing media results in cell cycle blockade, whereas a shift-up in ethanol, fructose, glycerol, glycerol plus ethanol, or mannose does not. Metabolite analyses showed accumulation of glucose 6-phosphate in a cdc30-bearing strain after a temperature shift-up in glucose-containing medium. Thermal denaturation studies and kinetic measurements indicate the existence of two isoenzymes of phosphoglucose isomerase (EC 5.3.1.9); one of which is apparently altered in the temperature-sensitive cell cycle mutant. We propose that the gene products of both the CDC30 and PG11 genes are required for cell cycle progression in glucose media and that the PGI1 gene product has a regulatory function over the CDC30 gene product. PMID- 3309141 TI - Identification of the outer membrane proteins of Campylobacter pyloridis and antigenic cross-reactivity between C. pyloridis and C. jejuni. AB - The outer membrane and surface exposed proteins of four strains of the gastric Campylobacter-like organism Campylobacter pyloridis were identified by SDS-PAGE of Sarkosyl-insoluble membranous material and 125I-surface-labelled whole bacteria. Although constant outer membrane proteins (molecular mass 61, 54 and 31 kDa) were observed in these strains, several variable 125I-labelled surface proteins were detected. C. pyloridis does not appear to express a single surface exposed major outer membrane protein like that of C. jejuni and C. coli. Putative flagella proteins were identified from isolated flagella and acid-extractable surface material and by immunoblotting with anti-flagella antibodies. Several major protein antigens were observed by immunoblotting with anti-C. pyloridis antisera. At least two of these antigens cross-reacted with anti-C. jejuni antiserum. This cross-reaction appears to be caused primarily by flagellar antigens. However, one major protein antigen (61 kDa) was not cross-reactive with C. jejuni and may, therefore, be useful in serological tests for the specific diagnosis of C. pyloridis infections. PMID- 3309142 TI - Immunochemical characterization of a polysaccharide antigen of Bacteroides fragilis with an IgM monoclonal antibody. AB - An IgM mouse monoclonal antibody (McAb) Bf4 was produced to a surface polysaccharide of Bacteroides fragilis NCTC 9343. Immunoblotting showed that McAb Bf4 reacted strongly with a high molecular mass structure which was sensitive to oxidation with periodate but resisted protease treatment. An inhibition enzyme linked immunosorbent assay (ELISA) indicated that McAb Bf4 did not cross react with the sixteen Bacteroides species and strains tested. Cells of B. fragilis NCTC 9343 recovered from the various interfaces of a Percoll discontinuous density gradient were tested in the inhibition ELISA. Bacteria from the 0-20%, 20 40% and 40-60% interfaces inhibited the ELISA; however, cells from the 60-80% interface did not. Electron microscopy with immunogold labelling showed that McAb Bf4 did not react with the extracellular fibrous network on bacteria recovered from the 0-20% interface, or the extracellular electron dense layer on cells from the 60-80% interface; however, it was associated with a surface structure on cells from the 20-40% interface. Growth in vivo did not enrich for bacteria with this structure. PMID- 3309143 TI - Electrophoretic analysis of proteins from Mycoplasma hominis strains detected by SDS-PAGE, two-dimensional gel electrophoresis and immunoblotting. AB - The proteins of 14 strains of Mycoplasma hominis were compared by SDS-PAGE in gradient gels, by two-dimensional (2D) gel electrophoresis of extracts of 35S labelled cells and by immunoblot analysis of cell proteins. The strains examined included the M. hominis type strain PG21 and 13 others isolated variously from genital tract, mouth, blood, upper urinary tract and a wound. These 14 strains shared 76-99% of proteins in SDS-gradient gel analysis and 41-72% in the 2D gels. As expected, the immunoblot analysis likewise revealed the existence of an extensive common protein pattern in M. hominis, in addition to a number of antigens shared only by some strains. PMID- 3309144 TI - Exochelin-mediated iron acquisition by the leprosy bacillus, Mycobacterium leprae. AB - Exochelins, water-soluble siderophores of mycobacteria, were isolated and partially purified from culture filtrates of iron-deficiently grown cultures of Mycobacterium neoaurum NCTC 10439 and an armadillo-derived Mycobacterium (ADM 8563). Two biologically active fractions mediating iron uptake were isolated from each bacterium which not only were able to transport iron into the producing organism but also into suspensions of Mycobacterium leprae isolated from armadillo liver. The rate of exochelin-mediated iron uptake into M. leprae was about 1.5% of the rate observed into the producing organisms. The process of iron uptake appears to be by facilitated diffusion as it was not inhibited by HgCl2, NaN3, KCN, dinitrophenol or carbonyl cyanide m-chlorophenylhydrazone. Since no uptake of iron occurred into iron-sufficient ADM cells, this may indicate that M. leprae, as recovered from an animal tissue, had been growing iron-deficiently in order for iron uptake to have been demonstrated in vitro. PMID- 3309145 TI - Detection of trehalose monomycolate in Mycobacterium leprae grown in armadillo tissues. AB - Trehalose-6-monomycolate (TMM) was isolated from the lipids of armadillo-derived Mycobacterium leprae. Only meagre amounts of this glycolipid were recovered, but its structure was unequivocally established. Only alpha-mycolates were detected in the TMM by 252Cf plasma desorption mass spectrometry. Electron impact mass spectrometry showed the alpha branch to be principally C20. Trehalose dimycolate (cord factor) was not detectable. Since we have also found TMM in M. lepraemurium and in every Mycobacterium species so far examined, we suggest that this glycolipid is truly ubiquitous amongst mycobacteria. PMID- 3309146 TI - Glutamine degradation through the omega-amidase pathway in Saccharomyces cerevisiae. AB - A glutamine transaminase activity has been identified in Saccharomyces cerevisiae, and the existence of the omega-amidase activity previously described in this yeast has been confirmed. The glutamine transaminase utilizes different 2 oxo acids as substrates, including pyruvate and glyoxylate, and is regulated by the available nitrogen source. The glutamine transaminase activity decreases when lysine or glycine is added to the medium; the inhibition by lysine diminishes under microaerophilic culture conditions. PMID- 3309147 TI - Lack of pleiotropic compensation in extracellular protein production by hypoproducing variants of Staphylococcus simulans biovar staphylolyticus. AB - The changes in bacterial density, total extracellular protein and activities of three extracellular enzymes were monitored during growth of wild-type Staphylococcus simulans biovar staphylolyticus, a representative pleiotropic variant that produced decreased levels of the three extracellular enzymes, and a variant that produced only 5 of the 14 extracellular proteins secreted by the wild-type organism. Both variants produced less total extracellular protein than did the parental organism. SDS-PAGE of the proteins secreted by these hypoproducing variants showed that all of the extracellular proteins were produced in decreased amounts. No pleiotropic compensation in extracellular protein production was observed for these hypoproducing variants of S. simulans biovar staphylolyticus. PMID- 3309148 TI - The osmotically regulated proU locus of Salmonella typhimurium encodes a periplasmic betaine-binding protein. AB - The proU locus of Salmonella typhimurium encodes an osmotically induced betaine transport system. We have identified a 31 kDa periplasmic protein, encoded by proU, whose synthesis is induced by osmotic stress. A specific betaine-binding activity with a KD of about 1 microM is also present in the periplasm of osmotically induced cells. This activity is absent in those proU mutants which lack the 31 kDa periplasmic protein. Thus, ProU is a periplasmic binding-protein dependent transport system. PMID- 3309149 TI - Cloning, characterization and expression in Escherichia coli of a leucine biosynthetic gene from Streptomyces rochei. AB - Leucine and histidine biosynthetic genes from Streptomyces rochei HP1 that complemented auxotrophic mutations in S. lividans TK54 were cloned in pIJ61. DNA from one leucine recombinant plasmid was subcloned into pBR322. From the latter, a recombinant plasmid was obtained that complemented the leuA mutation in Escherichia coli CV512 but not other leucine markers in E. coli. Analysis of this and several subclones, including mutant plasmids constructed in vitro, established that the cloned S. rochei gene was expressed in E. coli from the tetracycline promoter of pBR322 to produce a polypeptide of 67 kDa; the corresponding coding region was shown to be within a 1.7 kbp DNA fragment. Blot hybridization revealed corresponding homologous genes in several other streptomycetes. PMID- 3309151 TI - Location and function of fruC, a gene involved in the regulation of fructose utilization by Escherichia coli. AB - Procedures are described for the selection of Escherichia coli mutants that constitutively take up and phosphorylate fructose, and convert it to fructose 1,6 bisphosphate. The phenotype of such mutants is described. The altered regulatory gene, fruC, is highly co-transducible with leu and other markers located at min 2 on the genome. In merozygotes, fruC+ is dominant to fruC. Mutants can be readily isolated that are fruC at 42 degrees C but fruC+ at 30 degrees C; moreover, the integration of a Tn10 transposon in the genome at min 2 converts fruC+ strains to fruC. It is therefore likely that the fruC+ regulatory gene specifies a repressor protein. PMID- 3309150 TI - Isolation from Klebsiella and characterization of two rcs genes that activate colanic acid capsular biosynthesis in Escherichia coli. AB - Two genes, designated rcsA (regulation of capsule synthesis) and rcsB, that had been cloned from the chromosome of Klebsiella aerogenes (K. pneumoniae) capsular serotype K21 were capable of activating expression of colanic acid capsular polysaccharide in Escherichia coli K12. The Klebsiella rcsA gene encoded a polypeptide of 23 kDa that was required for the induction of a mucoid phenotype at less than or equal to 30 degrees C but not at greater than or equal to 37 C. The Klebsiella rcsB locus encoded no apparent polypeptides and was not capable by itself of causing the overproduction of colanic acid. However, when present in the same cell with rcsA, either in cis or in trans, rcsB caused expression of mucoidy in E. coli at all growth temperatures. These findings are best explained if the Klebsiella rcsA gene product acts as a positive regulator of colanic acid biosynthesis in E. coli and that activity of this protein is in turn subject to regulation by Lon protease. The Klebsiella rcsB locus may exert its effect by preferentially binding a negative regulator of capsular biosynthesis, possibly Lon itself. DNA sequences homologous to the Klebsiella K21b rcsA and rcsB genes were found in the genomes of all other capsular serotypes of klebsiellae examined, including K2, K12, K36 and K43. However, there was no homology between such genes and the chromosome of E. coli. The ability of these rcs genes to induce a mucoid phenotype explains the apparent conjugative transfer from klebsiellae to E. coli of the ability to produce K21 or other Klebsiella capsular polysaccharides that are structurally and antigenically related to colanic acid. PMID- 3309152 TI - 2-Phenylethylamine catabolism by Escherichia coli K12. AB - Escherichia coli K12 grows on 2-phenylethylamine as sole carbon and energy source by converting it, via phenylacetaldehyde, to phenylacetic acid. Phenylacetaldehyde was formed by the action of an inducible amine oxidase and catalase activity was increased sixfold, presumably to ensure removal of the H2O2 that was expected to be a product of the amine oxidation. The phenylacetaldehyde was oxidized to phenylacetic acid by an inducible NAD+-dependent dehydrogenase. Mutants defective in phenylacetaldehyde dehydrogenase cannot grow on 2 phenylethylamine as carbon and energy source but can still use it as a nitrogen source. PMID- 3309153 TI - Co-adaptation of Escherichia coli and coliphage lambda vir in continuous culture. AB - Populations of the bacterium Escherichia coli and of its phage lambda vir appeared to equilibrate in continuous cultures. The bacterial end-populations were heterogeneous in respect of their resistance to lambda vir and their ability to utilize maltose. The most competitive of the selected bacteria were mutants which had a reduced rate of synthesis of lambda-receptor so as to become highly, but not totally, resistant to the phage. The coexisting phage had an increased affinity for the receptor and an altered antigenic specificity, suggesting adaptation of its adsorption site in response to the evolution of resistance in the bacteria. PMID- 3309154 TI - The influence of ammonium permease activity and carbon source on the uptake of ammonium from simple defined media by Saccharomyces cerevisiae. AB - When growing under defined conditions, cells of the yeast Saccharomyces cerevisiae absorbed ammonium more rapidly with glucose as carbon source than with maltose. Ammonium pool sizes and permease activity were also higher in the glucose-grown cells and the relationship implies that firstly, the sugar is a primary determinant of ammonium permease activity and, secondly, the activity of the permease largely determines both the rate of ammonium uptake and ammonium pool size in the first part of the fermentation. PMID- 3309155 TI - The role of glucose in the pH regulation of germ-tube formation in Candida albicans. AB - It has been reported that Candida albicans can form germ-tubes only in the narrow pH range of 6-8, and that by changing only the pH one can regulate germ-tube formation. We found that the pH minimum for germ-tube formation could be dramatically lowered by eliminating the glucose present in many induction solutions. Lee's medium lacking glucose, ethanol, N-acetyl-D-glucosamine, and proline induced germ-tubes at pH values as low as 3 under most conditions. The presence of as little as 1 mM-glucose in these induction solutions was sufficient to cause the cells to grow either as yeasts with multiple buds or as pseudohyphae when the pH was 3.7. However, when C. albicans was grown in any of the above induction solutions (with the exception of ethanol), containing 200 mM-glucose buffered at pH 5.8, not only were germ-tubes formed, but their rate of formation and length were also increased. Preincubation of the cells in a solution buffered at pH 3.7 and containing 200 mM-glucose, before exposure to induction solutions lacking glucose at pH 3.7 or at pH 5.8, did not inhibit germ-tube formation. Likewise, addition of glucose after 45 min exposure to an induction solution was without effect. Theophylline and dibutyryl cAMP did not counteract the action of glucose. Other sugars which suppressed germ-tube formation at low pH were fructose, galactose, mannose, xylose, gluconic acid and the nonmetabolizable sugar 3-O-methylglucose. These results indicate that pH does not directly regulate dimorphism in C. albicans, and that glucose or its metabolites may play an important role. PMID- 3309156 TI - Electrophoretic karyotypes and chromosome numbers in Candida species. AB - The electrophoretic karyotypes of five Candida albicans isolates and of five other Candida species have been determined, using orthogonal field alternating gel electrophoresis (OFAGE). None of the C. albicans isolates had the same electrophoretic karyotype. By comparing all five strains, we arrived at a chromosome number of nine to ten, but since the organism is diploid, we cannot distinguish genetically different chromosomes from homologues which resolve. We determined minimal chromosome numbers of 9 for Candida stellatoidea, 10 for C. glabrata and 6 for C. guilliermondii. PMID- 3309157 TI - Establishment of the steady state in glucose-limited chemostat cultures of Klebsiella pneumoniae. AB - To investigate the relationship between growth rate and concentration of the nutrient that limits growth, 'Klebsiella aerogenes' NCTC 418 (K. pneumoniae) was grown in a glucose-limited chemostat. The actual time required to establish a steady-state glucose concentration exceeded that expected theoretically. Apparently, there is a long-term adaptation of the cells to nutrient limitation. As yet, it is not clear whether this has a phenotypic or genetic origin. In the final steady state, the dependence of the growth rate on glucose concentration could be mathematically described equally well by a hyperbolic and by a logarithmic function. PMID- 3309158 TI - L-cysteine biosynthesis in Escherichia coli: nucleotide sequence and expression of the serine acetyltransferase (cysE) gene from the wild-type and a cysteine excreting mutant. AB - Serine acetyltransferase (SAT) from Escherichia coli is subject to feedback inhibition by L-cysteine. A mutant was isolated which excretes L-cysteine because of a lesion in cysE, the structural gene for SAT, rendering the enzyme less feedback sensitive. To analyse the structural basis for this mutation the cysE genes both from wild-type E. coli and the mutant strain were cloned and their nucleotide sequences determined. The cysE gene contained an open reading frame consisting of 819 bp, equivalent to a protein of 273 amino acids. The mutant gene showed a single base change in position 767 resulting in a methionine to isoleucine substitution. A causal connection between this SAT sequence alteration, feedback insensitivity and L-cysteine excretion was demonstrated. The SAT from the wild-type strain was purified. It was composed of a single polypeptide chain migrating in SDS gels according to an Mr of 34,000. As in Salmonella typhimurium, the enzyme was associated in a bifunctional complex with O-acetylserine (thiol)-lyase. PMID- 3309159 TI - Morphology, growth and reversion in a stable L-form of Escherichia coli K12. AB - An L-form isolated from Escherichia coli K12 by sequential treatment with N methyl-N'-nitro-N-nitrosoguanidine and lysozyme was adapted to grow in hyperosmolar liquid cultures. It was stable in the absence of antibiotic when cultured in brain heart infusion (BHI) broth containing NaCl and CaCl2, the optimal concentrations being 0.34 M and 1 mM, respectively. No growth of the L form was observed when CaCl2 was not added to BHI medium containing 0.34 M-NaCl. On the other hand, when KCl replaced NaCl as the osmotic stabilizer, growth of the L-form was repressed in the presence of CaCl2. Electron microscopy of the L form confirmed the absence of a cell wall. A revertant strain derived from the L form grew as a stable bacillary form in BHI medium without osmotic stabilizer. The growth characteristics of the revertant strain resembled those of the parent strain. The revertant strain produced L-forms in the presence of NaCl. PMID- 3309160 TI - Characterization of binding of human fibrinogen to the surface of germ-tubes and mycelium of candida albicans. AB - The binding of human fibrinogen to germ-tubes and mycelium of Candida albicans, forms usually found in infected tissues, was studied in vitro by an immunofluorescence assay. Binding was quantified by using 125I-labelled fibrinogen. The degree of binding differed according to the morphological form of the fungus. Binding relative to that of the yeast form was greater for mycelium (12-fold) than for germ-tube (7.7-fold). Pretreatment of yeasts with fragments D and E (terminal degradation products of fibrinogen) before fibrinogen binding showed that fragment D possessed a higher affinity for C. albicans than fragment E. Binding of fibrinogen was diminished when C. albicans was pretreated with 2 mercaptoethanol alone or in combination with pronase, or pretreated with alpha mannosidase or trypsin. Binding was not decreased by pretreatment with pronase alone or chitinase. Inhibition experiments using C. albicans dialysed culture filtrate, C. albicans mannan, chitin, sugars or amino sugars were done by preabsorbing the fibrinogen with each of the above mentioned compounds. C. albicans dialysed culture filtrate inhibited the binding more strongly than C. albicans mannan. However, fibrinogen binding to C. albicans was not significantly reduced by mannose, several other sugars or chitin. These studies demonstrate the existence of a fibrinogen-binding factor (FBF) strongly associated with the surface of germ-tube and filamentous forms of C. albicans, and indicate a possible role for FBF in the pathogenicity of C. albicans. PMID- 3309161 TI - Nucleotide sequence of bglC, the gene specifying enzymeIIbgl of the PEP:sugar phosphotransferase system in Escherichia coli K12, and overexpression of the gene product. AB - The EnzymeIIbgl of the phosphoenolpyruvate- (PEP-) dependent phosphotransferase system catalyses the uptake and concomitant phosphorylation of beta-glucosides by Escherichia coli; it is specified by the gene bglC. The nucleotide sequence of a 3.6 kb HindIII restriction fragment spanning bglC, cloned on a plasmid, was determined. DNA analysis strongly suggests that the published order of this and other genes involved in beta-glucoside utilization, bgl C, S, B, is incorrect, and that the regulatory gene bglS may be located upstream of the structural genes bglC and bglB. From the deduced amino acid sequence it is predicted that the membrane protein specified by bglC consists of 625 amino acid residues (66.48 kDa). The protein has the hydropathic profile expected of an integral membrane protein (average hydropathy = 0.62). Comparisons between the amino acid sequences deduced for the EnzymeIIbgl and for the mannitol-specific EnzymeIImtl show that these proteins are related, and a little direct homology is apparent. A 2.3 kb AluI fragment spanning bglC was subcloned into an expression vector which carries the lambda PL promoter and then transformed into a host strain which produces thermolabile cI857 repressor and the anti-terminator N; thermoinduction resulted in the overproduction of a membrane protein and the appearance of Bgl activity. PMID- 3309163 TI - Isolation and partial characterization of an adhesin from Candida albicans. AB - Candida albicans produces extracellular polymeric material (EP) which contains a mannoprotein adhesin. EP isolated from culture supernatants of C. albicans GDH 2346 consisted of a mixture of glycoprotein components and inhibited yeast adhesion to buccal epithelial cells by up to 60%. Partial purification of the adhesin was achieved by a two-step procedure involving chromatography of EP on concanavalin A-Sepharose and DEAE-cellulose. The purified adhesin inhibited adhesion to buccal cells 30 times more efficiently (on a weight basis) than unfractionated EP. Pretreatment of EP with heat, dithiothreitol or proteolytic enzymes either partially or completely destroyed its ability to inhibit adhesion, whereas pretreatment with sodium periodate or alpha-mannosidase had little or no effect. These results suggest that the protein portion of the mannoprotein adhesin is more important than the carbohydrate moiety in mediating yeast attachment to buccal epithelial cells. PMID- 3309162 TI - Cloning and expression of treponema pallidum common antigen (Tp-4) in Escherichia coli K12. AB - A library of Treponema pallidum DNA was constructed using a cosmid cloning system. Sixteen hundred Escherichia coli recombinant clones were generated covering the T. pallidum genome with a probability of 99%. Three hundred of the clones were screened for expression of T. pallidum antigens by a modified rocket immunoelectrophoresis technique using a polyspecific antiserum to T. pallidum. One clone was identified which produced the 'common antigen' (CA) of T. pallidum (Tp-4). CA shares epitopes with antigens present in more than 50 different bacterial species, but nothing is known about its structure, function and localization. The recombinant E. coli clone will be of value for a structural analysis of the CA gene. PMID- 3309164 TI - Role of glycosides as epithelial cell receptors for Candida albicans. AB - The effect of various lectins and sugars on adhesion of five strains of Candida albicans to buccal and vaginal epithelial cells in vitro was investigated. Adhesion of C. albicans GDH 2346 was inhibited primarily by L-fucose and winged pea lectin, whereas adhesion of strain GDH 2023 was inhibited by N-acetyl-D glucosamine, or D-glucosamine, and wheat-germ agglutinin. Three other strains of C. albicans (MRL 3153, GRI 681 and GRI 682) gave results similar to those obtained with strain GDH 2346. Extracellular polymeric material (EP) isolated from strain GDH 2346 inhibited adhesion of strains MRL 3153, GRI 681 and GRI 682 by more than 50%, but that of strain GDH 2023 by only 30%. EP from strain GDH 2023 had little or no effect on the adhesion of any other yeast strain. Lectin like proteins with affinities for L-fucose, N-acetyl-D-glucosamine and D-mannose were detected in EP from all five strains in different amounts. These results indicate that there are at least two types of adhesion mechanism and that glycosides containing L-fucose or N-acetyl-D-glucosamine can function as epithelial cell receptors for C. albicans. PMID- 3309165 TI - Isolation and characterization of Escherichia coli mutants lacking inducible cyanase. AB - To determine the physiological role of cyanate aminohydrolase (cyanase, EC 3.5.5.3) in bacteria, mutants of Escherichia coli K12 devoid of this inducible activity were isolated and their properties investigated. Five independent mutations were localized next to lac; three of them lay between lacY and codA. Thus cyanase activity could depend on the integrity of one gene or set of clustered genes; we propose for this locus the symbol cnt. Growth of the mutant stains was more sensitive to cyanate than growth of wild-type strains. This difference was noticeable in synthetic medium in the presence of low concentrations of cyanate (less than or equal to 1 mM). Higher concentrations inhibited growth of both wild-type and mutant strains. Urea in aqueous solutions dissociates slowly into ammonium cyanate. Accordingly wild-type strains were able to grow on a synthetic medium containing 0.5 M-urea whereas mutants lacking cyanase were not. We conclude that cyanase could play a role in destroying exogenous cyanate originating from the dissociation of carbamoyl compounds such as urea; alternatively cyanate might constitute a convenient nitrogen source for bacteria able to synthesize cyanase in an inducible way. PMID- 3309166 TI - Cyanate specifically inhibits arginine biosynthesis in Escherichia coli K12: a case of by-product inhibition? AB - Growth of Escherichia coli K12 cultivated in minimal medium was strongly inhibited by 2 mM-cyanate. This inhibition could be specifically reversed by arginine. Citrulline (but not ornithine, N-alpha-acetylornithine or N acetylglutamate) could also restore a normal growth rate. Since growth inhibition by cyanate was followed by an accumulation of ornithine within the cell it was concluded that cyanate specifically inhibits the formation of citrulline from ornithine. The effect of cyanate on the growth of defined strains was consistent with a specific inhibition of carbamoylphosphate synthase. A kinetic study of carbamoylphosphate synthase and ornithine carbamoyltransferase in vitro supported this conclusion. Since carbamoylphosphate is probably the only source of endogenous cyanate it is postulated that carbamoylphosphate synthase activity can be regulated by cyanate resulting from the dissociation of carbamoylphosphate in metabolic circumstances leading to its overproduction. PMID- 3309167 TI - Effects of moenomycin on Escherichia coli. AB - The antibiotic moenomycin is a valuable biochemical tool for studying the metabolism of peptidoglycan and the autolytic system in Escherichia coli, since as a specific inhibitor of peptidoglycan polymerases it can efficiently promote cell lysis. In liquid media the bacteriolytic effect on E. coli K12 was dependent on the concentration of moenomycin, on growth phase and on growth rate. Before lysis cells underwent major morphological alterations. In sucrose-containing medium complete transformation to osmotically sensitive spheroplasts was easily achieved by addition of moenomycin. The minimum inhibitory concentration of the antibiotic varied with the strain of E. coli and was highly dependent on the growth medium. A tritiated derivative of moenomycin, [3H]decahydromoenomycin A, was prepared and found to have the same inhibiting efficiency. Its binding to E. coli membranes and membrane proteins was investigated. The absence of irreversible binding suggested that moenomycin might be a competitive inhibitor of the peptidoglycan polymerases. Spontaneous moenomycin resistant variants were isolated at a frequency of about 10(-9). PMID- 3309168 TI - Cloning of the galactokinase gene (galK) from Streptomyces coelicolor A3(2). AB - Streptomyces coelicolor A3(2) and Streptomyces lividans 66 strains were shown to be sensitive to the galactose analogue 2-deoxy-D-galactose. Spontaneous resistant mutants were isolated that were Gal- and lacked the enzyme galactokinase. The galK gene (structural gene for galactokinase) from S. coelicolor was cloned into S. lividans using the low copy number vector pIJ922. The resulting plasmid (pMT650), which contained a 14 kb insert, complemented gal mutations in both species. The presence of the galK gene on a 2.8 kb EcoRI fragment was confirmed by expressing it in Escherichia coli where it complemented a well characterized galK mutation. PMID- 3309169 TI - Interaction of non-lytic beta-lactams with penicillin-binding proteins in Streptococcus pneumoniae. AB - The monobactam aztreonam and the cephalosporin ceftazidime, beta-lactam antibiotics that possess the same side chain R1, showed unusual effects on exponentially growing pneumococci compared to other beta-lactams. Both antibiotics did not induce lysis even at concentrations up to 2 mg ml-1, values well above the respective MICs. However, morphological alterations and growth inhibition of the cells were observed at much lower concentrations. Binding to penicillin-binding proteins (PBPs) in vitro could be monitored directly by using anti-aztreonam antiserum and the Western blot technique. Both antibiotics showed high affinity for PBP 3, but had an extremely low affinity for PBP 2b. It is suggested that the failure to bind to PBP 2b is responsible for the failure to induce lysis in pneumococci. PMID- 3309170 TI - Isolation from urine of two Serratia marcescens strains excreting a diffusible yellow pigment. AB - Two bacterial strains excreting a yellow pigment were isolated from human urine and identified as Serratia marcescens. The pigment was produced in the late exponential and early stationary phases of growth. Minimal media supplemented with tyrosine, phenylalanine, 3,4-dihydroxyphenylacetate or tryptophan, as well as complex media, induced pigment production. UV-visible spectra of the extracted pigment had peaks characteristic of 2-hydroxy-5-carboxymethylmuconate semialdehyde, produced from meta-cleavage of 3,4-dihydroxyphenylacetate by the enzyme 3,4-dihydroxyphenylacetate 2,3-dioxygenase (EC 1.13.11.15). This enzyme was active when the bacteria were grown under conditions promoting pigment production. The kinetics and factors affecting pigment production are also reported. PMID- 3309171 TI - Flagellation of Salmonella typhimurium treated with nalidixic acid. AB - Filamentous cells of Salmonella typhimurium, obtained after treatment with nalidixic acid in the exponential phase of growth, elongated up to 10 micron, corresponding to 4 unit cell lengths, per nucleoid. During elongation, division of nucleoids and septum formation did not occur, but de novo formation of flagella continued. Most of the filamentous cells were motile, and flagella were evenly distributed on their surface. PMID- 3309172 TI - Differentiation of Shigella by esterase electrophoretic polymorphism. AB - The electrophoretic mobilities of four esterases (A, B, C, and I) of 182 strains of Shigella dysenteriae, S. flexneri, S. boydii and S. sonnei were compared to those of 636 strains of Escherichia coli from various origins, including the Alkalescens Dispar group and enteroinvasive strains. Discriminant analysis of the distribution of esterases among the strains revealed that Shigella could be distinguished from E. coli by differences in the distribution of allozymes of esterases C and I. Principal components analysis distinguished four major clusters of Shigella strains corresponding to the following: S. dysenteriae serotype 1; S. flexneri serotypes 1 to 5; S. flexneri serotype 6 and S. boydii serotypes 2 and 4; and S. sonnei. The last three were characterized by distinct electrophoretic variants of carboxylesterase B, as judged by the two-dimensional electrophoretic profile and titration curves. The distinct esterase pattern obtained for the strains of S. boydii serotype 13 substantiates the view that this serotype may constitute a new species. PMID- 3309173 TI - Cytochrome P-450 accumulation and loss as controlled by growth phase of Saccharomyces cerevisiae: relationship to oxygen, glucose and ethanol concentrations. AB - Ethanol induced small amounts of cytochrome P-450 in Saccharomyces cerevisiae NCYC 754 under conditions in which it is not normally detectable. Moreover, in non-growing yeast the existing cytochrome P-450 content was increased by 50% at a limited range of glucose concentrations (8-12% in 0.1 M-potassium phosphate buffer, pH 7.0), in which ethanol is produced by fermentation, possibly at an optimum concentration for induction of cytochrome P-450. Added alkanols, other than ethanol, caused rapid degradation of cytochrome P-450 in non-growing yeast; the rate of loss was directly related to the lipid solubility of the alkanol. Ethanol therefore favoured the accumulation of cytochrome P-450 in yeast; this may be related to an important putative role of one of the isoenzymes in ethanol tolerance of the yeast, by the oxidative removal of ethanol from the endoplasmic reticulum of the cell. It is the accumulation of dissolved oxygen, rather than ethanol, that occurs on cessation of yeast growth that is likely to trigger the rapid disappearance of cytochrome P-450 observed at this time. PMID- 3309174 TI - Molecular cloning and nucleotide sequence of the 3-isopropylmalate dehydrogenase gene of Candida utilis. AB - A 3-isopropylmalate dehydrogenase (3-IMDH, EC 1.1.1.85) gene was cloned from a gene library of Candida utilis. One of the plasmids, pYKL30, could complement Escherichia coli leuB and Saccharomyces cerevisiae leu2 auxotrophs; a 2.2 kb HindIII fragment subcloned in pBR322 could still complement the leuB mutation. Southern hybridization confirmed that this fragment was derived from C. utilis. An open reading frame of 1089 bp that corresponded to a polypeptide of 363 amino acids, one residue shorter than the 3-IMDH of S. cerevisiae, was found in the cloned fragment. The homology between the 3-IMDHs of C. utilis and S. cerevisiae was 76.2% in nucleotides and 85.4% in amino acids. In contrast, the homology between the 3-IMDHs of C. utilis and Thermus thermophilus was much smaller and was restricted to some regions of the gene. PMID- 3309175 TI - Incidence of the aerobactin iron uptake system among Escherichia coli isolates from infections of farm animals. AB - To assess the importance of aerobactin-mediated iron uptake as a bacterial virulence determinant in animal infections, a total of 576 strains of Escherichia coli isolated from cattle, chickens, sheep and pigs were screened by colony hybridization to determine the presence of the aerobactin genetic determinants, and by a bioassay to detect aerobactin secretion in iron-limited conditions. Results obtained by the two complementary methods correlated well. The incidence of the aerobactin system was very high among septicaemia isolates, particularly those from cattle and chickens, an observation that strongly suggests an important role for this mechanism of iron assimilation in pathogenesis. On the other hand, the incidence of the aerobactin system among mastitis strains was not significantly higher than among faecal isolates from healthy animals. No classical enterotoxigenic E. coli strains tested carried the aerobactin genetic determinants. Although most strains that produced aerobactin were also able to make colicin V, the fact that the two characteristics existed separately in a significant minority of isolates suggested that colicin testing alone could not be reliably used to determine the presence of the aerobactin system. PMID- 3309176 TI - Changes in 45Ca and 109Cd uptake, membrane potential and cell pH in Saccharomyces cerevisiae provoked by Cd2+. AB - The effect of Cd2+ poisoning of Saccharomyces cerevisiae on 45Ca, 109Cd and [14C]tetraphenylphosphonium (TPP) uptake and cell pH was examined. At Cd2+ concentrations that produced substantial K+ efflux the rates of uptake of 45Ca, 109Cd and [14C]TPP increased progressively during incubation of the cells with Cd2+, and the cell pH was lowered concomitantly. The initial rates of uptake of the divalent cations and of TPP were increased in cells pre-loaded with Cd2+, which shows that stimulation of the ion fluxes was exerted by the Cd2+ that accumulated in the cells. The distribution ratio of TPP between cells and medium, however, was decreased by Cd2+. Although hyperpolarization of the cell membrane by Cd2+ cannot be excluded, it is argued that Cd2+ primarily stimulated divalent cation uptake by increasing the cation permeability of the cell membrane allowing the cations to enter the cells more easily. PMID- 3309177 TI - The control of experimental Escherichia coli diarrhoea in calves by means of bacteriophages. AB - Seven phages highly active in vitro and in vivo against one or other of seven bovine enteropathogenic strains of Escherichia coli belonging to six different serotypes were isolated from sewage. Severe experimentally induced E. coli diarrhoea in calves could be cured by a single dose of 10(5) phage organisms. It could be prevented by doses as low as 10(2), by spraying the litter in the calf rooms with aqueous phage suspensions or simply by keeping the calves in uncleaned rooms previously occupied by calves whose E. coli infections had been treated with phage. Microbiological examinations of calves used in these experiments revealed that the phage organisms multiplied rapidly and profusely after gaining entry to the E. coli-infected small intestine, quickly reducing the E. coli to numbers that were virtually harmless. The only phage-resistant E. coli that emerged in the studies on calves infected with one or other of the seven E. coli strains were K-. These organisms were much less virulent than the K+ organisms from which they were derived and did not present a serious problem in calves given adequate amounts of colostrum. Infections produced by oral inoculation of a mixture of six strains of the E. coli could be controlled by administration of a pool of the six phages that were active against them but, in general, the control was less complete than that observed in the single-strain infections. K+ phage resistant bacteria emerged in some of the calves used in these mixed infections and they were as virulent as their parent organisms; evidence from in vitro studies suggested that they might have arisen by genetic transfer between organisms of the different infecting strains. Infections produced by these K+ mutants and their parents could be controlled by the use of mutant phages derived from phages that were active on their parents. During the experiments with mixed E. coli infection, an extraneous phage active against one of the six E. coli strains suddenly appeared in calves kept in the same rooms. Microbiological examinations revealed that this phage was effectively controlling the multiplication of organisms of that particular strain of E. coli in the small intestines of the calves. PMID- 3309178 TI - Factors influencing the survival and multiplication of bacteriophages in calves and in their environment. AB - Seven phages were fairly susceptible in vitro to the lethal effect of acidified whey, more so than the enteropathogenic Escherichia coli strains on which they were active. The low acidity that prevailed in the abomasum contents of calves shortly after a milk feed had little harmful effect on orally administered organisms of these phages; they flooded into the small intestine. The high acidity that prevailed later was lethal to orally administered phage organisms; few entered the small intestine. The lethal effect could be counteracted by giving CaCO3 in the feed. Low concentrations of phage-neutralizing antibodies were found in some serum samples from human beings, cattle and pigs. Antibodies to one of the seven phages were common in the human samples and antibodies to another, phage B44/1, were common in the cattle and pig samples and in bovine colostrum. Phage B44/1 antibodies in a sample of colostral whey were destroyed at pH 3.25 or less. Giving colostrum containing phage B44/1 antibodies with CaCO3 to a calf greatly reduced the numbers of orally administered phage B44/1 organisms in its alimentary tract. Antibodies to another phage were induced in the serum of a calf suffering from E. coli diarrhoea by treating it with that phage. The phages were as susceptible as the E. coli strains to the lethal action of formaldehyde and sodium hypochlorite. In contrast to the E. coli strains, they were almost completely resistant to phenol and chloroxylenol. The in vitro virulence of 21 phages varied according to the temperature at which tests were performed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309179 TI - Molecular analysis of regulatory and structural xyl genes of the TOL plasmid pWW53-4. AB - pWW53-4 is a cointegrate between RP4 and the catabolic plasmid pWW53 from Pseudomonas putida MT53, which contains 36 kbp of pWW53 DNA inserted close to the oriV gene of RP4; it encodes the ability to grow on toluene and the xylenes, characteristic of pWW53, as well as resistance to tetracycline, kanamycin and carbenicillin, characteristic of RP4. A physical map of the 36 kbp insert of pWW53 DNA for 11 restriction enzymes is presented, showing that the relative positions of the two xyl operons are different from those on the archetypal TOL plasmid pWW0. The location of the genes for 4-oxalocrotonate decarboxylase (xylI) and 4-oxalocrotonate tautomerase (xylH) were shown by subcloning and enzyme assay to lie at the distal end of the meta pathway operon. Although 2-oxopent-4-enoate hydratase (xylJ) and 4-hydroxy-2-oxovalerate aldolase (xylK) could be detected on a large cloned HindIII fragment, they could not be accurately located on smaller subcloned DNA, but the only credible position for them is between xylF and xylI. The gene order in the meta pathway operon is therefore xylDLEGF(J,K)IH. The regulatory genes xylS and xylR were located close to and downstream of the meta pathway operon, and the restriction map of the DNA in this region, as has previously been shown for the two operons carrying the structural genes, shows similarities with the corresponding region on pWW0. Evidence is also presented for the existence of two promoters, termed P3 and P4, internal to the meta pathway operon which support low constitutive expression of the structural genes downstream in Pseudomonas hosts but not in E. coli. PMID- 3309180 TI - Peptidoglycan and arabinogalactan of Mycobacterium leprae. AB - The arabinogalactan and peptidoglycan of armadillo-grown Mycobacterium leprae were examined. Within the limits defined by the small amount of material available, the resemblance of these polymers to those of other mycobacteria was confirmed. The polymers were linked by a highly acid-labile bond and the arabinogalactan was itself acid-labile; free arabinose and a variety of oligosaccharides containing both arabinose and galactose, as well as polysaccharide and peptidoglycan, were released by dilute acid. The resonances from anomeric protons in the proton NMR spectrum of the arabinogalactan were similar to those from the arabinogalactan of M. tuberculosis. The composition and structure of the peptidoglycan resembled those of other mycobacteria. The only major difference was the specific replacement of L-alanine by glycine in the peptide of the peptidoglycan. PMID- 3309181 TI - Molecular cloning of Clostridium thermocellum DNA and the expression of further novel endo-beta-1,4-glucanase genes in Escherichia coli. AB - Sau3A fragments of Clostridium thermocellum (NCIB 10682) DNA were ligated into the BamHI site of pBR322 and expressed in Escherichia coli HB101 and a Lac- mutant thereof. Twenty-eight clones with carboxymethylcellulase (CMCase) activity were selected from two libraries by means of the Congo Red plate assay. Restriction enzyme analysis indicated that the CMCase+ clones contained a total of 13 unique DNA inserts. Hybridization of recombinant plasmids with chromosomal DNA confirmed the physical maps in all but one case and was further used to demonstrate the absence of homology between the HindIII restriction fragments of similar size which occurred in many of the clones. Without exception, CMCase+ E. coli clones expressed endoglucanase activity, but differed with respect to the amount and nature of the enzyme activity produced; additionally, some clones had exoglucanase activity which, in at least one case, was not attributable to the production of a second enzyme. For a few selected clones, the partially purified CMCase was analysed by electrophoresis. A temperature profile characteristic of a thermostable enzyme was demonstrated for the endoglucanase of one of the most active clones. Based on the evidence presented here, it is probable that the 13 unique DNA fragments described do not contain any of the C. thermocellum endoglucanase genes previously cloned. PMID- 3309182 TI - An endogenous inducer of sexual development in Aspergillus nidulans. AB - During development of the homothallic ascomycete Aspergillus nidulans, asexual sporulation is followed by sexual sporulation. We report here the detection of a solvent-extractable activity which inhibits asexual sporulation and stimulates premature sexual sporulation. This activity, called precocious sexual inducer (psi), is overproduced by certain mutants that are blocked in both modes of sporulation. Using partially purified preparations of psi, biological response could be elicited with as little as 50 ng of material. We suggest that psi is a hormone-precursor which is converted to a hormone by normal sporulating strains that respond to psi, but not by the asporogenous mutants that overproduce psi. The stability of psi activity gives promise that the compound can be purified and identified. PMID- 3309183 TI - Localization of an arenavirus protein in the nuclei of infected cells. AB - Host cell nuclear involvement in an arenavirus infection was examined by immunofluorescence. Both polyclonal antisera and monoclonal antibodies specific for the major nucleocapsid (N) polypeptide revealed virus-specific nuclear inclusions in Pichinde virus-infected Vero cells. Immunoprecipitation of infected cell extracts with the anti-N monoclonal antibodies and subsequent analysis by SDS-PAGE, identified two N-related proteins with mol. wt. of 36,000 (p36) and 28,000 (p28) in addition to the N polypeptide. Only those monoclonal antibodies which precipitated p28 as well as N and p36 were found to produce nuclear as well as cytoplasmic fluorescence. These findings suggest that either the p28 protein itself or a conformational variant of N was the nuclear antigen detected. PMID- 3309184 TI - [Renal hypoplasia, polydactyly, cardiopathy: a new syndrome?]. AB - The occurrence of a polymalformation pattern associated with a polydactyly indicates a mendelian inheritance. We report a case with renal hypoplasia, polydactyly, congenital heart defects. A large literature review makes the differential diagnosis and brings this case nearer to an anterior observation of the literature. We discuss an eventual new syndrome with autosomal recessive inheritance. PMID- 3309185 TI - Is panic disorder a distinct diagnostic entity? A critical review of the borders of a syndrome. AB - The evidence supporting the existence of panic disorder as a distinct clinical entity is critically examined, as are the current criteria for panic disorder in DSM-III. It is argued that the current definition of a panic attack is imprecise and that the borders and overlap of panic disorder with other psychiatric disorders raise broader questions as to what is meant by a distinct psychiatric disorder. DSM-III "panic disorder" defines an ideal type that may be more relevant for research purposes than clinical. In defining fairly homogeneous "pure" cases, it overlooks the prevalence and importance of atypical "mixed" and subsyndromal cases. PMID- 3309186 TI - Agoraphobics 5 years after imipramine and exposure. Outcome and predictors. AB - Five years after treatment in a controlled trial, in which all had received self exposure homework, a group of 40 agoraphobic outpatients retained marked improvement in agoraphobia, mood, and free-floating anxiety. Frequency of spontaneous panics decreased as much in those who had placebo and self-exposure as in those who received imipramine and self-exposure. Few patients, however, were completely well at 5 years and over half had received further treatment for agoraphobia during the follow-up. Patients who were still highly phobic at the end of the clinical trial were more often prescribed psychotropic medication during follow-up and remained phobic at 5 years. Phobic improvement had generalized more in those patients with very low than in those with moderate pretreatment Hamilton depression scores. Frequency of initial spontaneous panics did not predict outcome. Improvement in agoraphobia was associated with improved marital adjustment. Those who began with the best marital, work, and social adjustment were more improved in their phobias 5 years later. PMID- 3309188 TI - Insulin-like activity of chromium-binding fractions from brewer's yeast. AB - 51CrCl3 was added to the incubation medium of Saccharomyces cerevisiae for up to 48 hr. After repeated freezing and thawing, lysing in 9 M urea with 1% NP-40 detergent, and dialysis against water, the lower molecular weight (Mr less than 3500) dialysate was retained on a SE53 cationic exchange column, eluted with 0.25 M NH4OH and fractionated on a Bio-gel P-2 column. The insulin-like biological activity of the fractions was measured by the 14C-glucose oxidation in isolated rat adipocytes. The biological activity that was found in two of nine fractions did not correspond to their chromium content. Moreover, identical findings were obtained when chromium was added not to the live yeast but to the yeast extract, which showed that its binding was a chemical process not requiring cellular activity. No fraction demonstrated insulin-potentiating activity on rat adipocytes. PMID- 3309187 TI - A novel serotonin-immunoreactive neuron in the antennal lobe of the sphinx moth Manduca sexta persists throughout postembryonic life. AB - A single serotonin-immunoreactive neuron in the antennal lobe (AL) of the brain of the sphinx moth Manduca sexta is present in larval, pupal, and adult stages. This neuron has a neurite that extends to the contralateral AL, where it forms sparse arborizations in each glomerulus. Other neurites from this neuron project into the ipsilateral and contralateral protocerebrum. This cell is morphologically very different from other neurons previously characterized in the adult AL. The neuron maintains the same basic profile in the adult as in the larva, although fine processes such as the arborizations within the AL neuropil appear to be restructured to conform to the larger, more anatomically differentiated regions of the adult brain. PMID- 3309190 TI - Six decades of the Society of British Neurological Surgeons. PMID- 3309189 TI - Neoplastic angioendotheliosis: a case of subacute dementia with unusual cerebral CT appearances and a review of the literature. AB - A 62 year old woman presented with subacute dementia and hemiparesis which progressed to death with terminal seizures over 5 months. A cerebral biopsy specimen and necropsy showed the features of neoplastic angioendotheliosis which proved to be lymphomatous. Cerebral CT showed multiple low density areas in the white matter with striking enhancement after high-dose intravenous contrast administration. There was temporary clinical improvement with prednisolone therapy. The clinical features, cerebral CT appearances and partial response to treatment are discussed, with a review of the relevant literature. PMID- 3309191 TI - GFA protein reactivity in nerve sheath tumors: a polyvalent and monoclonal antibody study. AB - We studied glial fibrillary acidic (GFA) protein immunoreactivity in 30 schwannomas, including two intracerebral examples, 26 neurofibromas and 12 neuromas using the immunoperoxidase method with a polyvalent antiserum (PVAS) and three well-characterized monoclonal antibody (MAb) preparations. Twelve of the schwannomas, including both intracerebral tumors, two of the neurofibromas and none of the neuromas immunostained with PVAS. Except for one schwannoma, all the PVAS-positive tumors were positive with two of the MAb preparations. While both of the intracerebral schwannomas were positive with the third MAb, none of the extracerebral tumors were. Our results suggest that: 1) human nerve sheath tumors contain cells having polypeptides that share epitopes with GFA protein, but 2) these polypeptides differ from astrocytic GFA protein by at least one epitope, and 3) the location of the tumors in relation to the central nervous system may influence GFA protein immunoreactivity. PMID- 3309192 TI - Subacute leucoencephalopathy induced by carmofur, a 5-fluorouracil derivative. AB - Three cases of leucoencephalopathy induced by carmofur (1-hexylcarbamoyl-5 fluorouracil), an antineoplastic derivative of 5-fluorouracil are reported and the literature is reviewed. Initial symptoms were unsteady gait and dementia developing several weeks or months after carmofur had been started. Symptoms increased gradually even after stopping the drug. Severe encephalopathy with confusion, delirium or coma appeared frequently. Symptoms were usually reversible but death occasionally occurred. The EEG showed marked slowing. Computed tomography of the brains of severely intoxicated patients showed marked hypodensity of the entire cerebral white matter. Carmofur must be discontinued immediately if any psychomotor symptoms develop. PMID- 3309193 TI - Stenosis and occlusion of the subclavian artery: ultrasonographic and clinical findings. AB - Continuous-wave (CW) Doppler sonography has proved to be a reliable tool both to detect subclavian stenosis or occlusion and to detect reversal of blood flow in the vertebral artery. This method is entirely atraumatic and in contrast to angiography allows investigation of asymptomatic patients and provides more representative data for epidemiological studies. The incidence of subclavian stenosis or occlusion was 1.15% among the 23,500 patients examined in our department between 1978 and 1985. Of the 272 patients with unilateral or bilateral subclavian stenosis or occlusion, 54% were asymptomatic with no subjective complaints and were normal upon neurological examination; 29% reported vertebrobasilar transient ischaemic attacks (TIAs), with or without concomitant TIAs or infarction in the vascular territory of the carotid arteries; and 17% complained of symptoms exclusively referring to the region of carotid blood supply. Reversal of blood flow in the ipsilateral vertebral artery was detected in 152 patients (56%). The incidence of neurological symptoms within this group was double that found in patients without steal. None of the patients suffered from permanent vertebrobasilar damage. In most cases, subclavian artery disease was due to atherosclerosis. For 13 patients an inflammatory, iatrogenic, traumatic, or congenital aetiology could be assumed. The marked preponderance of left-sided subclavian stenosis or occlusion, reported by others, could be confirmed among our patients, but was less pronounced for tight stenoses than for occlusions. Mild-to-moderate subclavian stenoses were about equally distributed on each side. PMID- 3309194 TI - Guillain-Barre syndrome after varicella-zoster infection. Report of two cases. AB - Two patients developed Guillain-Barre syndrome after varicella-zoster infection; a 4-year-old boy after chickenpox and a 74-year-old man after shingles. Both had decreased CD8-positive lymphocytes in the blood during the course of their illness. These cases and others reported in the literature suggest that varicella zoster infection is a significant but rare trigger factor of Guillain-Barre syndrome. An alteration in the balance of helper and suppressor lymphocytes may be an important pathogenetic mechanism. PMID- 3309195 TI - CAF in metastatic breast cancer: standard therapy or another effective regimen? PMID- 3309196 TI - The 5-year results of a randomized trial of adjuvant radiation therapy after chemotherapy in breast cancer patients treated with mastectomy. AB - The use of adjuvant radiation therapy in breast cancer patients treated with mastectomy and adjuvant chemotherapy has been controversial. In order to assess the necessity and effectiveness of adjuvant radiation therapy in this setting, we reviewed the results in 510 patients with T1-T3 tumors and pathologically positive nodes or tumors larger than 5 cm and negative nodes who were treated with adjuvant chemotherapy. Patients with four or more positive nodes or at least one positive apical node were randomized to receive either five or ten cycles of cyclophosphamide/Adriamycin (Adria Laboratories, Columbus, OH) (CA) and patients with one to three positive nodes or operable tumors larger than 5 cm and pathologically negative nodes were randomized to receive eight cycles of either cyclophosphamide, methotrexate, and 5-fluorouracil (5-FU) (CMF) or methotrexate and 5-FU (MF) chemotherapy. Two hundred six of these patients were subsequently rerandomized to receive either no further treatment or adjuvant radiotherapy. Thirty-five patients withdrew after randomization, including 34 who declined to receive radiotherapy. Radiation therapy consisted of 4,500 cGy in 5 weeks to the chest wall and appropriate draining lymph nodes. Median follow-up from chemotherapy randomization is 45 months for patients in the CA arm and 53 months for those in the CMF/MF arm. The crude rate of local failure (chest wall or draining lymph node areas) as first site of failure for patients randomized to receive chemotherapy only was 14%; for those randomized to receive both chemotherapy and radiotherapy it was 5% (P = .03). For patients in the CMF/MF arm, the rate of local failure as the first site of failure was nearly the same for patients randomized to chemotherapy only as for those randomized to adjuvant radiotherapy as well (5% v 2%). For patients in the CA arm, the crude rate of local failure was 20% for patients randomized to receive chemotherapy only, and 6% for those randomized to both types of adjuvant treatment (P = .03). Among the 43 patients treated with CA who actually received radiotherapy, there was only one local failure, compared with 12 local failures among the 59 patients (20%) who actually did not receive radiotherapy (P = .007). No significant difference was seen in disease-free survival or overall survival in either the CA or the CMF/MF arm between patients randomized to receive radiation therapy and those randomized to no further treatment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3309197 TI - Phase I trial of escalating doses of cisplatin in hypertonic saline. AB - A phase I trial of escalating doses of cisplatin (CDDP) in 3% sodium chloride was conducted to evaluate the toxicity of this method of administration. The maximally tolerated dose (MTD) was 40 mg/m2/d X 5 (200 mg/m2) in previously untreated patients, with dose-limiting leukopenia occurring on day 24 (median; range, 19 to 28). Nephrotoxicity was minimal. Ototoxicity was dose limiting in two patients. Peripheral neuropathy was observed in only one patient, but few patients received multiple courses of therapy. Six partial responses (PR) were observed in 47 patients, including two patients with refractory breast cancer and four with squamous cell carcinoma of head and neck origin. Two of the four patients with head and neck cancer had been previously treated with conventional doses of CDDP, suggesting a possible dose-response phenomenon in this disease. The saline infusion was well tolerated by older patients, suggesting that this method of administration can be safely used in those CDDP-sensitive malignancies that occur in older patients. PMID- 3309198 TI - Long-term evaluation of a CNS prophylaxis trial--treatment comparisons and outcome after CNS relapse in childhood ALL: a report from the Childrens Cancer Study Group. AB - The current status of children with acute lymphoblastic leukemia (ALL) who had developed CNS disease while being treated on protocol CCG-101 was investigated. Seven hundred thirty-six eligible patients were entered into the study between June 1972 and July 1974. All children who were greater than 18 months of age were eligible for randomization to a CNS prophylaxis trial for which one regimen gave only a short course of intrathecal methotrexate (IT MTX) as prophylaxis. All other regimens included radiation therapy as prophylaxis. Current follow-up (median, greater than 10 years) shows no significant difference by standard life table analysis for ultimate survival, although a substantial excess of CNS episodes occurred on the IT MTX regimen. Of the 675 patients who completed induction therapy and achieved remission in the study, 100 (14.8%) developed CNS disease as the first evidence of relapse. Fifty-five of these 100 had no subsequent CNS episodes. Only 17 of these 55 patients are surviving without further relapses since the CNS episode. The median time to isolated CNS relapse was 457 days. Time to the initial CNS relapse was found to be the most important factor for predicting outcome. Thirty-five of the 55 patients with isolated relapse subsequently relapsed in the bone marrow, and of these, 32 have died. Twenty patients of the 100 with CNS disease as the first evidence of relapse developed two episodes of CNS involvement and 17 of these 20 patients subsequently relapsed in the bone marrow; only one patient survived. Twenty-five patients of the 100 have shown a pattern of chronic CNS disease with multiple CNS relapses. The overall disease-free survival for the 100 patients who developed one or more relapse was only 16%. These data demonstrate that the occurrence of a CNS relapse is an indicator of poor subsequent outcome. Comparison of results of groups receiving different CNS prophylaxis required careful consideration of the entire pattern of relapses and mortality. PMID- 3309199 TI - A prospective randomized trial of single-agent versus combination chemotherapy in meningeal carcinomatosis. AB - Forty-four patients with documented meningeal carcinomatosis (small-cell lung carcinoma [SCLC], 29%; breast carcinoma, 25%) were treated in a prospective randomized trial with intrathecal methotrexate (MTX) 15 mg or MTX plus cytosine arabinoside (Ara-C) 50 mg/m2. Most patients received intrathecal hydrocortisone (HC) each treatment to minimize arachnoiditis. Overall response was 55%. Seven patients achieved complete response. Response to MTX was superior to combined MTX/Ara-C, but not significantly so (61% v 45%; P greater than .10). Response was more frequent if drugs were administered via Ommaya reservoir than by lumbar puncture (65% v 48%; P greater than .10). Concurrent radiotherapy to the CNS was associated with significantly better response (73% v 35%; P less than .05). Small cell lung carcinoma patients showed the best response (69%). Overall median survival for the whole group was 8 weeks, but responders fared better than nonresponders (median survival, 18 v 7 weeks; P less than .05). Nausea and vomiting were the most common toxicities encountered (45%), but rarely proved limiting. An unusual, previously undocumented reaction to intrathecal HC was noted. MTX is moderately effective in nonleukemic meningeal carcinomatosis, but the addition of Ara-C does not appear to improve results. Pretreatment factors did not predict outcome in this trial. PMID- 3309200 TI - Flow cytometry, cellular DNA content, and prognosis in human malignancy. AB - The use of flow cytometry to analyze the cellular DNA content of human malignancies has become increasingly commonplace. The relationship between abnormalities in DNA content or proliferative characteristics and prognosis is becoming clear for a variety of malignancies in part through new techniques that permit analysis of archival material. High- and low-risk groups of patients with early breast and bladder carcinomas, non-small-cell lung cancer, and colorectal, ovarian, and cervical carcinoma can be distinguished on the basis of abnormal stemline DNA content. In several hematologic and common pediatric malignancies, the prognostic relevance of DNA content flow cytometry has been similarly established. Though the interpretation of tumor cell cycle analyses is less certain, this characteristic may also be prognostically important. However, generalizations cannot be made when applying flow cytometric DNA analysis to clinical decision making. The prognostic importance of an abnormal DNA histogram for an individual patient must be assessed on the basis of the relevant data base for that particular tumor type. The current extent of this data base for various malignancies is reviewed. PMID- 3309201 TI - Severe life-threatening toxicities observed in study using leucovorin with 5 fluorouracil. PMID- 3309202 TI - Intra-axial tumors of the cervicomedullary junction. AB - The authors present their experience with the operative management of 20 intra axial tumors of the cervicomedullary junction. There were two distinct modes of clinical presentation: lower cranial nerve dysfunction and spinal cord dysfunction. Both groups of patients had indolent courses: in 75% of the patients the symptoms had been present for 6 months to 2 years. Radical excision was carried out in all patients. There was no surgical mortality. Postoperative neurological recovery was directly related to the preoperative status; one patient had a significant new deficit. The authors conclude that intrinsic gliomas of the cervicomedullary junction are amenable to radical excision and that an aggressive surgical approach offers the potential for both neurological recovery and long-term survival. The neuroradiological evaluation and operative technique are discussed. PMID- 3309203 TI - Magnetic resonance imaging and computerized tomography scanning of herpes simplex encephalitis. Report of two cases. AB - The authors present two cases of herpes simplex encephalitis (HSE) in which computerized tomography (CT) scanning and magnetic resonance imaging (MRI) were performed. They also review the literature on the use of these imaging modalities in cases of HSE. The striking changes noted in these cases on T2-weighted magnetic resonance images in comparison to the CT findings suggest that MRI will help speed recognition of nonhemorrhagic HSE abnormalities. PMID- 3309204 TI - Congenital fourth ventricular midline outlet obstruction. Report of two cases. AB - Obstruction of the foramen of Magendie unrelated to illness or trauma is rare in adults. Two cases of congenital membranous occlusion of the foramen of Magendie in adults are presented. Analysis of the reported cases of fourth ventricular outlet obstruction disclosed only three similar cases. PMID- 3309205 TI - Tethered cervical spinal cord. Case report. AB - A case of congenital tethered cervical spinal cord is presented in a young adult. Metrizamide computerized tomography was the most useful imaging technique for identifying the tethered spinal cord. Intraoperative somatosensory evoked potentials correlated well with clinical improvement following surgery. PMID- 3309206 TI - Georg de Hevesy Nuclear Medicine Pioneer Award Citation--1986. Rosalyn S. Yalow and Solomon A. Berson. PMID- 3309207 TI - Carnitine deficiency revisited. PMID- 3309209 TI - Environmental tobacco smoke and indoor air quality in modern office work environments. PMID- 3309208 TI - Effects of changes in dietary zinc, copper and selenium supply and of endotoxin administration on metallothionein I concentrations in blood cells and urine in the rat. AB - These studies were designed to investigate the effects of low dietary zinc, copper or selenium intake of certain types of stress and of injection of zinc, copper or cadmium on metallothionein I (MT-I) concentrations in the blood and urine of rats. The aim was to establish whether such measurements could be of value in the diagnosis of zinc deficiency. Marginal zinc deficiency rapidly caused a major decrease in MT-I levels in the blood cells and to a lesser extent in urine. Injection of zinc and also of cadmium and copper had the opposite effect and increased MT-I concentrations in both samples, although the effects of zinc on blood cells and urine were relatively transient. The MT-I in the blood cells was associated mainly with the erythrocytes. No changes in blood or urine MT-I levels were found in copper- and selenium-deficient rats. Neither cold stress nor restriction of food intake for 24 h had any significant effect on MT-I levels in the blood cells or urine. Endotoxin injection increased urinary MT-I excretion in both zinc-adequate and zinc-deficient rats but did not affect blood cell MT-I levels in either group of animals. It appears therefore that assay of erythrocyte MT levels could be of particular value in the diagnosis of zinc deficiency, especially when it is accompanied by stress or infection. PMID- 3309211 TI - Vascular renin-angiotensin system: the unanswered questions. AB - Study of the vascular renin-angiotensin system can be approached in a number of ways. The capacity of the blood vessel to generate angiotensin II, when exposed to angiotensinogen, immunocytochemical demonstration of renin, the presence of renin mRNA and functional changes attributable to local generation of angiotensin have all been used. Although each of these techniques requires careful and critical examination from the standpoint of specificity and sensitivity, there is now strong evidence for a functionally important system in the arterial wall. The relative importance of uptake and local synthesis and the physiological role of this system, as distinct from the renal renin system, still remains to be elucidated. PMID- 3309210 TI - Therapeutic aspects of the clinical encounter. PMID- 3309212 TI - Possible prorenin activating mechanisms in the blood vessel wall. AB - The blood-vessel wall has the potential for activating circulating prorenin by several mechanisms. Prorenin may be taken up by the blood vessel and activated by enzyme(s) localized on the vascular cells. We do not know whether this mechanism is usually operative or is only activated under certain conditions. This local activation system can increase the vascular-wall renin concentration and may be involved with the regulation of local vascular tone and regional blood flow. Circulating blood cells may release enzymes which can activate prorenin. At the inflammatory site, a neutrophil-dependent prorenin activating mechanism may be important for the increased production of angiotensin II which modulates vascular permeability and tone. In addition, at sites of vascular injury where platelets aggregate, prorenin may be activated locally and may play a role in the genesis of vasospasm. PMID- 3309213 TI - Detection of renin messenger RNA in rat tissues: increased sensitivity using an RNAse protection technique. AB - Total cellular RNA and poly A+ RNA isolated from various tissues of Wistar-Kyoto (WKY) rats were screened for renin-specific messenger RNA by Northern blotting and RNAse protection. Northern blot analysis, carried out with a copy DNA (cDNA) probe of mouse submandibular gland renin, demonstrated a single RNA species of 1.8 kb in the kidneys of WKY rats. Other tissues screened by this technique were negative. With the more sensitive RNAse protection technique, our initial results indicate more widespread expression of renin, messenger RNA (mRNA) being detected in aorta, adrenal, heart, lung and spleen. PMID- 3309214 TI - Arteriolar vasculitis on endomyocardial biopsy: a histologic predictor of poor outcome in cyclosporine-treated heart transplant recipients. AB - The histologic pattern of severe, potentially lethal cardiac rejection in transplant recipients who are treated with cyclosporine may be difficult to distinguish from mild or moderate rejection. The purpose of this study was to determine whether specific histologic abnormalities seen on endomyocardial biopsy could identify which histologic patterns of rejection are associated with progression to graft dysfunction or graft failure. We performed a blinded, retrospective analysis of endomyocardial biopsies from our initial 19 transplant recipients. Group 1 was composed of five patients who developed graft failure or dysfunction after transplantation. Group 2 was composed of the remaining 14 patients with normal hemodynamics and function at heart catheterization 1 year after transplantation. Seventeen histologic parameters were semiquantitatively graded, and comparisons between the two groups were made with the Student's t test. Of the 17 parameters, only arteriolar vasculitis was significantly increased in group 1 versus group 2 biopsies (p = 0.002). Arteriolar vasculitis was identified in four of five patients in group 1 and was unique to group 1. Of 53 group 1 biopsies, eight patients had foci of arteriolar vasculitis and were seen up to 88 days before graft failure. Therefore the finding of arteriolar vasculitis on endomyocardial biopsy may identify high risk rejection episodes in transplant recipients who are treated with cyclosporine. PMID- 3309215 TI - Combined heart failure transplant program: advantages in assessing medical compliance. AB - Compliance, motivation, and strong family support have been identified as important factors to the success of heart transplantation. Approaches to psychosocial evaluations determining suitability of candidates vary among transplant centers. Although testing, interviewing, and retrospective analyses of patient profiles are valuable, they do not allow for longitudinal evaluation of patients who have been denied transplantation under these standard methods of assessment. The Utah Cardiac Transplant Program (UCTP) combines heart failure and transplant services to provide maximum conventional and experimental therapy to patients with end-stage cardiac dysfunction. A single medical team provides care to all patients. From March 8, 1985 to November 1, 1986, UCTP evaluated 170 patients, assigning 57 to conventional medication therapy, 72 to experimental medication therapy, and 41 directly to heart transplantation. Of the 72 patients assigned to experimental therapy, 21 were subsequently assigned to heart transplantation. In the initial evaluation of four patients, it was determined that they did not have adequate family support or emotional stability to undergo transplantation. After monitoring these four patients through a drug study, it was found that the initial evaluation was incorrect, as the patients demonstrated the ability to adhere to a complex regimen involving multiple diagnostic tests, clinic visits, and medication therapy. Three of these patients subsequently underwent successful transplantations and are alive with a mean follow-up time of 212 days. In conclusion, combining all modalities of treatment for end-stage heart disease into one unified program has definite advantages that include longitudinal evaluation of patients previously denied transplantation. PMID- 3309217 TI - Mechanical circulatory assistance after heart transplantation. AB - Results with mechanical circulatory assistance for the treatment of profound cardiopulmonary failure after conventional heart surgery have been encouraging. Its usefulness after heart transplantation is not known. Since August 1982, eight patients (of 59 transplant patients) have required support 0 to 48 hours (mean, 19.5 hours) after transplantation. The ages of the patients ranged from 7 days to 52 years (mean, 28.4 years). Underlying recipient heart disease was ischemic in three patients, congenital in two, cardiomyopathic in two, and rheumatic in one patient. Preoperative North American Transplant Coordinators Organization (NATCO) classification was status 9 in one patient (on extracorporeal membrane oxygenation [ECMO]), status 1 in five patients, and status 3 in two patients. Reasons for graft failure, although usually multifactorial, were primarily pulmonary hypertension with right ventricular failure in five patients and pneumonia, hyperacute rejection, and fat embolus in one patient each. In three patients, there was a mismatch in graft size (too small in two adults and too large in one neonate). Graft ischemic times ranged from 75 to 229 minutes (mean, 171 minutes). Two patients received mechanical support with an intra-aortic balloon (IAB), three with ECMO, and three with a right ventricular assist device (RVAD). One of the patients on ECMO and two of the patients with an RVAD also had IABs. Duration of support ranged from 4 hours to 8 days (mean, 3.2 days). Initial hemodynamic stability was achieved in all patients. Complications were common, including sepsis in seven patients and kidney failure in five patients. Only three patients were weaned. One patient with pulmonary hypertension, who was treated with ECMO, died 36 hours after being weaned.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309216 TI - Impact of protection isolation on the incidence of infection after heart transplantation. AB - Infection is a major cause of morbidity and mortality in heart transplantation. Therefore protective isolation has been an inherent part of our postoperative regimen. For retrospective review we selected patients before and after modification of protective isolation. The intensity of protective isolation appeared to have no impact on incidence, morbidity, or mortality resulting from infection in these study groups. PMID- 3309218 TI - Effect of prostacyclin analog on pulmonary edema in isolated heart-lung autoperfusion model. AB - Pulmonary edema and impaired gas exchange function are worrisome early complications of heart-lung transplantation. The present study was designed to determine the effect of a new prostacyclin analog, OP-41483, on these complications with the use of a heart-lung autoperfusion model. Twenty-four mongrel puppies (4 to 6 kg) were evenly divided into four groups according to the oxygen content of inspired air (group 1, 95%; group 2, 60%) and the use of an intravenous drip of OP-41483 (0.1 microgram/kg/min) (group 3, 95% + OP; group 4, 60% + OP). During the course of these experiments, systolic pressure and cardiac output were maintained constant at 100 mm Hg and 40 ml/kg/min, respectively. Pulmonary arterial pressure was almost constant in each group throughout the experiment. Arterial oxygen tension (Pao2) was significantly decreased in groups 1 (410 +/- 49 to 237 +/- 38 mm Hg, p less than 0.01) and 2 (368 +/- 44 to 243 +/- 26 mm Hg, p less than 0.01) over the 5-hour autoperfusion period but was maintained at a high level in groups 3 (488 +/- 70 to 447 +/- 39 mm Hg) and 4 (431 +/- 33 to 430 +/- 35 mm Hg). Pathologic findings (perivascular edema and capillary dilatation) were significant in group 1 but less marked in group 2. However, no abnormal pathologic changes were observed in groups 3 or 4. These data demonstrated that OP-41483 was effective in preventing functional and pathologic pulmonary disturbances at a dosage (0.1 microgram/kg/min) that is reported to induce no undesirable hemodynamic effect. PMID- 3309219 TI - Limitations of esophageal electrocardiography in recording atrial rhythms after orthotopic heart transplantation. AB - Esophageal electrocardiography is a commonly used tool for the differential diagnosis of arrhythmias. A 39-year-old man who underwent orthotopic heart transplantation developed a narrow complex tachycardia. Esophageal electrocardiography showed a junctional tachycardia (recording native atrial activity alone), whereas atrial intracavitary electrograms showed the correct diagnosis of atrial flutter. Esophageal recording in patients who undergo orthotopic heart transplantation is a useful technique for recording native atrial activity. For arrhythmia diagnosis in these patients it is frequently necessary to record donor atrial activity with intracavitary electrograms. The limitations of esophageal electrocardiography should be recognized by physicians who care for these patients. PMID- 3309220 TI - Gallium-67 imaging in human heart transplantation: correlation with endomyocardial biopsy. AB - Endomyocardial biopsy seems to be the most accurate method to use for diagnosis and follow-up of acute rejection of the transplanted heart. This investigation compared a noninvasive procedure, gallium-67 imaging, with endomyocardial biopsy in the detection of acute rejection in heart transplantation. Seven male patients (aged 41 to 54 years) sequentially had 46 gallium-67 scintigrams and 46 endomyocardial biopsies between 1 week and 8 months after transplantation. Both studies were obtained in the same day, 48 hours after the administration of an intravenous injection of gallium-67 citrate. Cardiac uptake was graded as negative, mild, moderate, and marked according to an increasing count ratio with rib and sternal uptakes. Histologic findings were graded as negative, mild acute rejection, moderate acute rejection, severe acute rejection, resolving rejection, and nonspecific reaction. Negative biopsies were not found with moderate uptake, and neither moderate nor severe acute rejection were found with negative scintigrams. Imaging sensitivity was 83% with 17% false negatives and 9% false positives. Of seven studies with moderate uptake, five showed moderate acute rejection, and the patients had specific therapy with a decline in uptake, which correlated with resolving rejection. It is conceivable that in the future this technique may be used as a screening procedure for sequential endomyocardial biopsies in the follow-up of heart transplant patients. PMID- 3309221 TI - Septic arthritis by Salmonella enteritidis after heart transplantation. AB - A 13-year-old boy underwent orthotopic heart transplantation for end-stage idiopathic dilated cardiomyopathy. Immunosuppressive therapy consisted of cyclosporine, azathioprine, prednisone, and antithymocyte globulin. Endomyocardial biopsies revealed persistent moderate rejection, which was treated aggressively. In the sixth week, septic arthritis by Salmonella enteritidis developed. We discuss our management of this exceptional complication and the poor results obtained because of superimposed cytomegalovirus infection. PMID- 3309223 TI - Donor site for alveolar cleft bone grafts. PMID- 3309222 TI - Effects of cyclosporine on the transplanted human heart. AB - The possible short-term effects of cyclosporine on the heart were studied in 42 endomyocardial biopsies taken at the time of high levels of cyclosporine in the blood, in 20 biopsies at low blood cyclosporine levels, and in 44 biopsies taken from patients on a conventional (before cyclosporine) regimen of azathioprine and steroids after heart transplantation. More long-term effects were studied in postmortem heart sections from 11 liver transplant patients, six of whom had received cyclosporine immunosuppression therapy. The weight of transplanted hearts at necropsy and at retransplantation were analyzed, and in each of the groups of rejectors and nonrejectors, the hearts treated with cyclosporine were significantly heavier than the hearts treated with azathioprine and steroids. Cyclosporine is associated with a higher incidence of interstitial edema and fibrosis than other forms of immunosuppression therapy, and these changes are probably aggravated by rejection. PMID- 3309224 TI - Ultrasonography of inflammatory soft tissue swellings of the head and neck. AB - Experience with 107 B-scan sonographs of inflammatory soft tissue swellings of the head and neck is described, and an echomorphologic classification is proposed which consists of the following five types: edema, infiltrate, preabscess, echo poor, and echo-free abscess. Because the clinical course of the symptoms differs significantly between the last three types, it was concluded that they represent different stages of abscess formation. A comparison of all the physical and sonographic diagnoses showed only slightly higher sensitivity for sonography. However, with regard to the specific diagnosis of abscess, the sonographic examination seemed to be superior to the clinical diagnosis. PMID- 3309225 TI - The application of decision analysis to evaluate the need for extraction of asymptomatic third molars. AB - A theoretical model using a decision tree is used to compare three alternative strategies: extract all third molars prior to complete root formation; extract only those third molars that become impacted; and extract only those impacted third molars that develop some associated pathology. The model used to determine the expected value of these alternative strategies depends on the probability of eruption, the type of impaction, and likelihood of developing preoperative pathology. The decision tree can be used to identify a preferred strategy either for an individual patient or for a policy recommendation under a variety of clinical conditions. PMID- 3309226 TI - Use of cricothyroidostomy in oral and maxillofacial surgery. AB - Surgical entry into the upper airway is not only important in emergency situations but also in the treatment of certain elective maxillofacial procedures. The procedure of choice by which surgical access is gained has traditionally been a tracheostomy. Although a cricothyroidostomy is easier and quicker to perform, with a higher degree of safety, it has generally been relegated to only emergency situations. The purpose of this paper is to present the anatomy, indications, and surgical technique of cricothyroidostomy. It is concluded that cricothyroidostomy, and not tracheostomy, is the preferred procedure for surgical establishment of an upper airway, either in elective maxillofacial surgical procedures, or in an emergency situation. PMID- 3309227 TI - Congenital infiltrating lipomatosis of the face: report of cases and review of the literature. AB - Three cases of infiltrating congenital lipomatosis of the face are presented. These lesions shared the following morphologic criteria: 1) nonencapsulated congenital fatty tumor; 2) infiltration of adjacent muscle and soft tissue; 3) absence of lipoblast and malignant characteristics; 4) presence of fibrous elements with numerous nerve bundles and vessels; and 5) hypertrophy of subjacent bone. Although these tumors are benign, all three recurred after surgical excision. Extensive specimen sampling is advisable to exclude infiltrating lipoma, diffuse angiomatosis, infiltrating angiolipoma, and well-differentiated liposarcoma. Relationship with lipoblastomatosis and histogenesis of infiltrating congenital lipomatosis of the face are discussed. PMID- 3309228 TI - Leiomyosarcoma of gingiva: report of a case and review of the literature. AB - Leiomyosarcoma of the oral region has rarely been reported. A review of the literature yield only 24 cases. The histopathology with special reference to ultrastructural findings and immunohistochemical examination of an additional case of leiomyosarcoma of mandibular gingiva has been presented. The manifestation and symptoms, treatment and prognosis, and the origin of this tumor are discussed. Because of the high rate of local recurrence and metastases, extensive surgical excision and long-term follow-up are mandatory. PMID- 3309229 TI - C. L. Oakley lecture (1987). The pathogenesis of beta cell destruction in type I (insulin-dependent) diabetes mellitus. AB - In a study of pancreases from 75 patients who died at presentation of Type I diabetes there was selective destruction of beta cells associated with islet inflammation (insulitis). According to a recent hypothesis, aberrant expression of Class II major histocompatibility complex (MHC) products on a target cell may allow presentation of organ specific surface antigen(s) to potentially autoreactive T helper lymphocytes and thus lead to autoimmunity. Aberrant expression of Class II MHC was demonstrated immunohistochemically on beta cells in 21 out of 23 patients with recent onset diabetes. No such expression was seen on the other pancreatic endocrine cells. Ninety-four per cent of insulin containing islets in these patients had marked hyperexpressions of Class I MHC affecting all endocrine cells in these islets. Insulin deficient islets were not thus affected. Both these abnormalities of MHC expression appeared to precede insulitis within a given islet and appeared to be unique to Type I diabetes, being absent in pancreases of patients with Type II diabetes, chronic pancreatitis, cystic fibrosis, graft-versus-host disease and Coxsackie B viral pancreatitis. The development of autoimmunity to beta cells in Type I diabetes may be a 'multistep' process in which abnormalities of MHC expression are crucial events. PMID- 3309230 TI - Helix pomatia and Ulex europeus lectin binding in human breast carcinoma. AB - Formalin fixed, paraffin embedded tissue from 100 consecutive cases of breast carcinoma were studied for binding with Helix pomatia (HPA) and Ulex Europeus (UEA1) lectins. Serial sections were pretreated with trypsin or neuraminidase to determine the effect of these enzymes on lectin binding. The lectins were visualized by the peroxidase antiperoxidase technique and the cell staining proportion assessed in a semi-quantitative manner under the light microscope. Correlating staining with prognostic factors and patient follow-up details showed that UEA1 related to disease-free interval and survival, and HPA to lymph node stage, time to loco regional recurrence and to survival. Relationships with both lectins were abolished by pretreatment with neuraminidase. The study demonstrates that a simple assessment of lectin binding can provide prognostic information in breast cancer. This may be useful particularly when conservational surgical practice restricts the amount of nodal tissue for staging. PMID- 3309231 TI - Pancreatic venous stasis and endotoxaemia as aetiologic factors in acute haemorrhagic pancreatitis. AB - The present study was undertaken to assess the possible significance of endotoxaemia and venous stasis of the pancreas in the pathogenesis of acute haemorrhagic pancreatitis. Complete obstruction of the venous drainage of the pancreas in rats induced acute haemorrhagic pancreatic necrosis. Partial venous obstruction caused only oedema and haemorrhage in the interstitium. Systemic endotoxaemia produced slight superficial pancreatic necrosis and fat necrosis, but not oedema or haemorrhage. The administration of endotoxin to the rats with partial obstruction of pancreatic venous outflow caused severe haemorrhagic pancreatic necrosis and a large number of fibrin thrombi in the capillaries and venules in and around the necrotic areas, although the severity of the lesions was less severe when compared with those induced by complete obstruction of pancreatic venous drainage. These findings suggest that acute haemorrhagic pancreatitis can be induced by the coexistence of endotoxaemia and partial venous obstruction of the pancreas. The mechanism may be that the endotoxin-induced capillary and venous fibrin thrombi superimposed upon the venous stasis lead to obstruction of venous drainage of the pancreas severe enough to produce haemorrhagic pancreatic necrosis. PMID- 3309232 TI - Choosing a pediatric recipient for orthotopic liver transplantation. AB - Between March 3, 1981, and June 1, 1984, 216 children were evaluated for orthotopic liver transplantation. Of the 216 patients, 117 (55%) had received at least one liver transplant by June 1, 1985. Fifty-five (25%) died before transplantation. The 117 patients who received transplants were grouped according to severity of disease and degree of general decompensation at the time of transplantation. The severity of a patient's medical condition with the possible exception of deep hepatic coma, did not predict outcome following orthotopic liver transplantation. Seventy variables were assessed at the time of the evaluation. Twenty-three of the 70 variables were found to have prognostic significance with regard to death from progressive liver disease before transplantation. These 23 variables were incorporated into a multivariate model to provide a means of determining the relative risk of death among pediatric patients with end-stage liver disease. This information may allow more informed selection of candidates awaiting liver transplantation. PMID- 3309234 TI - Low-dose oral clonidine: effective growth hormone releasing agent in children but not in adolescents. PMID- 3309233 TI - Taurine supplementation, fat absorption, and growth in cystic fibrosis. AB - The effect of taurine supplementation (30 to 40 mg/kg/24 hr) on fat absorption and related measurements was examined in 21 preadolescent children with cystic fibrosis (CF) using a 12-month double-blind crossover technique. The mean coefficient of fat absorption was unchanged by taurine both in the unselected study group (without taurine, mean +/- SD 84.0% +/- 11.9%; with taurine, 84.4% +/ 11.8%, n = 20) and in a subgroup of seven children with moderately severe fat malabsorption (without taurine, 75.6% +/- 15.6%; with taurine, 74.8% +/- 14.6%). The mean fecal split fat/total fat ratio, which generally reflects bile acid related fat malabsorption, was also unchanged. Linoleic and arachidonic acid deficiencies noted in plasma before supplementation showed no significant improvement with taurine supplementation. Likewise, plasma/serum vitamin A, E, and D levels were unchanged. Standard scores for height and weight were not affected significantly. This study does not support the use of taurine supplementation in the nutritional management of CF. PMID- 3309235 TI - Prolongation of normoglycemia in patients with type I glycogen storage disease. PMID- 3309236 TI - Efficacy of inhaled amikacin as adjunct to intravenous combination therapy (ceftazidime and amikacin) in cystic fibrosis. AB - Eighty-seven patients with cystic fibrosis were admitted to hospital with an acute exacerbation of pulmonary symptoms associated with isolation of Pseudomonas aeruginosa from sputum. The patients were randomly allocated to receive intravenously administered ceftazidime (250 mg/kg/day) and amikacin (33 mg/kg/day) alone or with inhaled amikacin (100 mg twice a day). Other aspects of the 2-week treatment were constant. The two therapy groups were comparable in all aspects. At the completion of therapy, the addition of aerosolized amikacin produced temporary eradication of P. aeruginosa in 70% of the patients, compared with 41% in the intravenous therapy only group (P less than 0.02). Suppression of P. aeruginosa in sputum cultures was correlated with the amikacin sputum concentrations. However, both regimens resulted in similar improvements in clinical, radiologic, laboratory, and pulmonary function measurements, and within 4 to 6 weeks most patients were recolonized with P. aeruginosa. There was no serious toxicity or adverse effect. In patients with cystic fibrosis, the addition of aerosol aminoglycoside to systemic antipseudomonal combination therapy is not clinically beneficial. PMID- 3309238 TI - On Trypanosoma (Megatrypanum) talpe from Talpa europaea: method of division and evidence of haemogamasinae as vectors. PMID- 3309237 TI - Chlamydia trachomatis in suburban adolescents. PMID- 3309239 TI - Monoclonal antibodies to parasite antigens: a rapid immunization protocol requiring small numbers of parasites. PMID- 3309240 TI - The infectivity and purification of cultured Plasmodium berghei ookinetes. AB - Plasmodium berghei ookinetes were cultured from hamster blood as described previously (Kurtti and Munderloh, 1986). An average of 7.3 X 10(6) ookinetes was harvested from each ml of blood. Ookinetes were purified by centrifugation on first a 40% and then a 36% Percoll gradient. The final preparation comprised 32.8% of the ookinetes initially obtained, and contained 3.3 other parasite stages or blood cells per ookinete. Unpurified and purified ookinetes were resuspended in hamster blood and fed to Anopheles stephensi. There was a strong linear correlation between the concentration of purified or unpurified ookinetes and the number of oocysts formed. With unpurified ookinetes, a maximum was reached when preparations containing 1 X 10(7) ookinetes/ml were fed, and feeding preparations containing a higher concentration did not produce more oocysts. Sporozoites were found in the salivary glands of mosquitoes fed ookinetes by days 14 (unpurified) or 15 (purified) PI. Approximately 5 times as many purified as unpurified ookinetes were required to produce each oocyst. PMID- 3309241 TI - Chesson strain Plasmodium vivax in Saimiri sciureus boliviensis monkeys. AB - Nine Saimiri sciureus boliviensis monkeys were inoculated with sporozoites of Plasmodium vivax (Chesson strain) dissected from Anopheles stephensi mosquitoes infected by feeding on blood from infected chimpanzees. The animals were splenectomized 7 days after inoculation. Seven animals developed infections with prepatent periods ranging from 12 to 43 days (mean of 19.6 days). Parasitemias were low during the first 50 days. Maximum parasitemias in 5 animals in which the strain adapted ranged from 10,000 to 46,800 per mm3. Anopheles freeborni mosquitoes were infected by feeding on 4 of the monkeys. PMID- 3309242 TI - Enhanced resistance of highly susceptible Balb/c mice to infection with Trypanosoma congolense after infection and cure. AB - Balb/c and C57Bl/6 mice were cured with Berenil after infection with cloned organisms of Trypanosoma congolense and challenged with homologous or heterologous variants. The mice were fully protected against infection with 10(3) but not 10(5) organisms of the homologous variant. Normal Balb/c mice infected with 10(5) organisms developed uncontrolled parasitemia and had a mean survival time of 8.4 days. Challenge of drug-cured Balb/c mice with 10(5) organisms of the homologous variant established an infection associated with prolonged prepatent period, control of the first peak of parasitemia, and prolonged survival time (36 days). Indirect immunofluorescent and agglutination tests on live trypanosomes revealed that the "delayed" population of the first peak of parasitemia consisted of variants other than that used for challenge. No protection of drug-cured Balb/c mice was obtained following challenge with 10(1)-10(5) organisms of a heterologous variant. Passive transfer of variant-specific antiserum protected mice against infection with 10(3) organisms. Against infection with 10(5) organisms, it resulted in a prolonged prepatent period but had no effect on severity of parasitemia or duration of survival. There was no evidence for persistence of Berenil, which potentially could affect resistance. It was concluded that enhanced immunity in drug-cured Balb/c mice was due to (a) antibody to the variant surface glycoprotein and (b) another, yet unidentified, synergistically acting immune response to the parasite. Possible mechanisms are discussed. PMID- 3309243 TI - Taenia taeniaeformis: early inflammatory response around developing metacestodes in the liver of resistant and susceptible mice I. Identification of leukocyte response with monoclonal antibodies. AB - Female BALB/cJ (resistant), C3H/HeJ (intermediate resistant), and C3H/HeDub (susceptible) inbred mice, 4-5 wk old, were infected with Taenia taeniaeformis. Liver sections were stained by an immunoperoxidase technique (avidin-biotin complex, ABC) for the differentiation antigens Lyt-1, Lyt-2, Mac-1, Mac-2, Mac-3, and B220. Binding of ABC to the cytoplasm of hepatocytes around the developing parasite was observed at 4 days postinfection (PI) in all 3 strains of mice, persisting in BALB/cJ and C3H/HeJ liver sections at 5 and 6 days PI, suggesting the presence of high concentrations of biotin, a fatty acid synthesis mediator. Two cell populations were labeled with B220 monoclonal antibodies: lymphocytes and polymorphonuclear (PMN) cells. At 4 days PI the number of labeled PMN cells peaked in infected C3H/HeJ and BALB/cJ mice; however a low number of PMN cells were labeled in infected C3H/HeDub mice. Few lymphocytes bound the B220 antibody in either BALB/cJ, C3H/HeJ, or C3H/HeDub infected mice. The number of Mac-1+ cells detected in infected C3H/HeJ and BALB/cJ liver sections were similar whereas fewer Mac-1+ cells were present in infected C3H/HeDub mice. Mac-2+ cells appeared in high numbers around the growing parasite at 5 and 6 days PI in the liver of C3H/HeDub mice, but not in the liver of BALB/cJ mice. Mac-3+ cells followed a similar pattern to that of the cell population defined by Mac-2. Few Lyt-1+ and Lyt-2+ cells were detected around the parasite site in the 3 strains of mice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309244 TI - Orthotopic liver transplantation in children. AB - Ten children, aged 3 to 16 years, were part of a group of 61 patients who received liver transplants at University Hospital in London, Canada between November 1982 and April 1986. All of the children received cyclosporine in combination with other agents for immunosuppression. Two children died of rejection, one child died from a lymphoma, and one child died from a hypoxic brain injury sustained during a respiratory arrest. Six children are currently alive from 4 months to 2 1/2 years following transplantation. All of the survivors have returned to a normal life style. With current surgical techniques and modern immunosuppression, hepatic transplantation has become the treatment of choice for patients with endstage irreversible liver disease. The extreme shortage of donor organs is now the major factor limiting the application of liver transplantation in children. PMID- 3309245 TI - The anal sphincter force in health and disease. AB - The measurement of the strength of the anal sphincters has heretofore involved voluntary cooperation by the patient. In some children one cannot count on the maximum squeeze pressure being generated and in others the child is too young to understand what is required. We have devised an objective method of measuring the anal sphincter force (ASF) and have collected data derived from over 256 children over the course of 24 months. These include patients with Hirschsprung's disease, constipation, postoperative incontinence, spina bifida, and normal children both conscious and anesthetized. The results are presented and the value of the test and its applications are discussed. PMID- 3309246 TI - An alternative to an interposition procedure in esophageal atresia. AB - The suture fistula technique for long gap esophageal atresia with tracheoesophageal fistula (TEF) was described by Shafer and David in 1974. Schullinger in 1982 reported five cases with fistulization occurring in four cases. In the past 2 years, we have used this technique in four infants who ranged from 1,200 to 1,700 g and in one infant who weighed 2,900 g. Successful luminal continuity was established in four of the cases and a temporary fistula in the fifth, but this closed. The latter did require a repeat thoracotomy with resection and end-to-end suture 28 days after the original suture-fistula technique. She is well. In a recent full-term infant this technique was used successfully too. All procedures were done transpleurally. We have found that fistulization usually occurs about the eighth or ninth day. This is apparent when milk, given by gastrostomy, appears in the mouth. To date, one of our children (K.C.) has required an antereflux procedure. PMID- 3309247 TI - Invasive techniques for prenatal diagnosis and therapy. PMID- 3309248 TI - Combined electronic fetal heart rate and fetal movement monitor--a preliminary report. AB - We have tested a new Doppler ultrasound apparatus which registers both fetal movements and fetal heart rate with a single transducer. To evaluate the reliability of the recognition of movements we also observed them simultaneously by real time ultrasound. In 20 patients with normal pregnancies between the 30th and 42nd week of gestation, taking the real time ultrasound as reference the positive predictive value was 0.93 and the sensitivity 0.94. Maternal hiccups or coughing were recorded as fetal movements. Neither gestational age, the amount of amniotic fluid or the position of the placenta influenced the recognition of movement; nor did fetal breathing, maternal breathing, speaking or laughing. PMID- 3309249 TI - Watchful waiting of a fetus with zone III amniotic fluid values. AB - A case of Rh negative, sensitized patient was observed while her amniotic fluid values climbed through zone III of Liley's graph. The fetus was monitored weekly with ultrasound and delivered when it had a mature lung profile. It is not always necessary to proceed with immediate fetal therapy whenever amniotic fluid values are in zone III. PMID- 3309250 TI - The use of blade implants in a selected population of partially edentulous adults. A 15-year report. AB - In order to provide longitudinal data for endosteal bladevent implants, a continuing study is being conducted from an original group of 49 implants in 32 patients placed 15 years ago. The present work evaluated 26 of these bladevent implants in 18 patients. Three basic patterns were observed 15 years postoperatively: (1) In 13 of 26 implants, there was clinical and radiographic evidence of health; (2) in 13 of 26 implants, there was a radiolucency 2- to 3-mm square around the neck and shoulder of the implants, along with sulcular depths capable of being probed and evidence of bleeding on probing; and (3) two implants showed evidence of settling deeper into the bone. These results indicate that bladevent endosteal implants can be maintained in the mouth for up to 15 years, and 50% can be free from periodontal disease. PMID- 3309251 TI - The role of adjunctive Rodogyl therapy in the treatment of advanced periodontal disease. A longitudinal clinical and microbiologic study. AB - Several studies have indicated that the combination of metronidazole and spiramycin is synergistic against anaerobic bacteria and may be effective against oral infections. The present study sought to determine the efficacy and safety of a commercial preparation of these two antibiotics (Rodogyl) when used adjunctively in the treatment of advanced periodontal disease. In a double-blind parallel randomized trial, 56 patients (mean age = 44 years) with advanced periodontitis (50 of whom completed the study) were assigned to either the Rodogyl or placebo group. Both groups were thoroughly scaled and root planned for approximately 6 hours, with one group receiving Rodogyl for 2 weeks and the other a placebo. No other therapy was received during the study period. Two sites in each patient with probing depths of at least 7 mm were selected for study. Plaque level (P1I), gingival inflammation (GI), probing depth (PD), and attachment level (AL) were measured at baseline, 14 days, 1 month, and then at monthly intervals up to 6 months. Subgingival bacteria were monitored with dark-field microscopy. The development of resistant bacteria, as well as side effects to the medications, was also monitored. The Rodogyl group exhibited a greater gain in AL (0.67 mm) from the 2-month interval until the end of the study. Although this difference was statistically significant (P less than 0.05), it was not necessarily of biologic significance. There was a significantly greater decline in the proportion of spirochetes in the Rodogyl group at the 14-day interval, and this difference remained significant (P less than 0.05) at all study intervals. No difference in the proportion of motile organisms was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309252 TI - Lysosomal and cytoplasmic enzyme activity, crevicular fluid volume, and clinical parameters characterizing gingival sites with shallow to intermediate probing depths. AB - The biochemical analysis of gingival crevicular fluid (GCF) may offer a sensitive means of determining periodontal disease activity, including the transition of gingivitis to periodontitis. To continue our evaluation of the relationship between clinical and GCF parameters, 552 sites with shallow to intermediate (2.0 5.0 mm) probing depths (PD) were examined. The data were collected at baseline from 33 periodontitis patients participating in a longitudinal trial examining the relationship of changes in GCF biochemistry to attachment loss. Mesiobuccal sites were scored for dichotomous measures of bleeding on probing, gingival redness, suppuration, and plaque accumulation. In addition, GCF was collected using filter paper strips inserted into the sulcus for 30 seconds, eluted in buffer and assayed for activity of the enzymes beta-glucuronidase (BG), arylsulfatase (AS), and lactate dehydrogenase (LDH), markers for ground substance degradation and cellular necrosis, respectively. Clinical and GCF parameters were evaluated by increasing PD. Plaque accumulation and bleeding on probing increased with increasing PD, although there was considerable overlap across groups. Suppuration was present in only a very small number of sites and the proportion of sites displaying gingival redness was not related to PD. GCF volume was grouped in 0.25-microliter increments, revealing a progressive shift with increasing PD toward a normal distribution around the median range of 0.51 to 0.75 microliter at 5.0 mm. Mean enzyme activities of BG, and to a lesser extent AS and LDH increased sharply from 2.0 to 3.0 mm, were relatively stable from 3.5 to 4.5 mm, and were significantly higher in 5.0 mm than 4.5 mm sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309253 TI - [Intestinal absorption and the mechanism of ionized drugs]. PMID- 3309254 TI - [Proteases in different membrane fractions of Acinetobacter calcoaceticus]. AB - Distinct protease activities were found in membrane fractions from Acinetobacter calcoaceticus grown on acetate-NH4+ medium until early stationary phase. Mechanical or enzymatic cell disintegration followed by membrane fractionation through sucrose gradient revealed higher activities in the outer membrane than in the cytoplasmic membrane. Using azocasein and synthetic p-nitroanilides as substrates we found very low proteinase activities in intracytoplasmic membrane fractions. However, these fractions contained a significant aminopeptidase activity which was absent from cell envelope membranes. Peptidolytic activities in intracytoplasmic membranes of gram-negative bacteria have not been described before. PMID- 3309257 TI - [Morphometric study of healing of experimental inflammatory gingival disease in man, at an early stage]. PMID- 3309256 TI - Studies on curcumin and curcuminoids. IX: Investigation of the photobiological activity of curcumin using bacterial indicator systems. AB - The dye curcumin is a natural, nontoxic food constituent. On irradiation with visible light, curcumin proves to be phototoxic for Salmonella typhimurium and Escherichia coli, even at very low concentrations. The observed phototoxicity makes curcumin a potential photosensitizing drug which might find application in the phototherapy of, for example, psoriasis, cancer, and bacterial and viral diseases. PMID- 3309255 TI - Effects of sodium taurodihydrofusidate on nasal absorption of insulin in sheep. AB - To investigate the utility of a novel adjuvant, sodium taurodihydrofusidate (STDHF), as an enhancer of mucosal permeation of drugs, experiments involving intranasal insulin:STDHF administration in sheep were performed. Rabbit erythrocyte lysis assays were employed to assess the relative membrane lytic activity of STDHF, as well as that of its glycine-conjugated analogue, compared with a nonionic detergent and a common bile salt. Equivalent weight concentrations of the fusidates were found to be 5- to 10-fold less lytic than the bile salt and at least 100-fold less lytic than the nonionic detergent laureth-9. Provided the concentration of STDHF was greater than its critical micellar concentration, formulations of insulin with STDHF greatly enhanced intranasal insulin absorption. Optimal nasal insulin absorption was attained at a molar ratio of STDHF to insulin of 5:1. In addition, intranasal absorption was linearly related to insulin dose. Compared with intravenous administration, the mean bioavailability of intranasal insulin was 16.4%. Interovine variability was low, with a coefficient of variation of 14% for 12 animals. It was found that intranasal absorption of sodium insulin was not significantly different from that of zinc insulin. However, formulations of both crystalline insulin preparations were absorbed more efficiently than a formulation prepared using commercially available solutions of U-500 insulin. The results taken together indicate that STDHF is an excellent enhancer of insulin absorption from the nasal mucosa. PMID- 3309258 TI - [Periodontitis and immune response]. PMID- 3309259 TI - [Focus on conservative and surgical treatment]. PMID- 3309260 TI - Passive cable properties and morphological correlates of neurones in the lateral geniculate nucleus of the cat. AB - 1. We used an in vivo preparation of the cat to study the passive cable properties of sixteen X and twelve Y cells in the lateral geniculate nucleus. Cells were modelled as equivalent cylinders according to Rall's formulations (Rall, 1959a, 1969, 1977). We injected intracellular current pulses into these geniculate neurones, and we analysed the resulting voltage transients to obtain the cable parameters of these cells. In addition, fifty-four physiologically characterized neurones were labelled with horseradish peroxidase (HRP) and analysed morphologically. 2. Analysis of HRP-labelled geniculate neurones showed that the dendritic branching pattern of these cells adheres closely to the 3/2 power rule. That is, at each branch point, the diameter of the parent branch raised to the 3/2 power equals the sum of the diameters of the daughter dendrites after each is raised to the 3/2 power. Furthermore, preliminary data indicate that the dendritic terminations emanating from each primary dendrite occur at the same electrotonic distance from the soma. These observations suggest that both X and Y cells meet the geometric constraints necessary for reduction of their dendritic arbors into equivalent cylinders. 3. We found a strong linear relationship between the diameter of each primary dendrite and the membrane surface area of the arbor emanating from it. We used this relationship to derive an algorithm for determining the total somatic and dendritic membrane surface area of an X and Y cell simply from knowledge of the diameters of its soma and primary dendrites. 4. Both geniculate X and Y cells display current-voltage relationships that were linear within +/- 20 mV of the resting membrane potential. This meant that we could easily remain within the linear voltage range during the voltage transient analyses. 5. X and Y cells clearly differ in terms of many of their electrical properties, including input resistance, membrane time constant and electrotonic length. The difference in input resistance between X and Y cells cannot be attributed solely to the smaller average size of X cells, but it also reflects a higher specific membrane resistance (Rm) of the X cells. Furthermore, X cells exhibit electrotonic lengths slightly larger than those of Y cells, but both neuronal types display electrotonic lengths of roughly 1. This indicates that even the most distally located innervation to these cells should have considerable influence on their somatic and axonal responses.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3309261 TI - The organization and post-natal development of area 18 of the cat's visual cortex. AB - 1. We made extracellular recordings from 1176 single units in area 18 of adult cats and kittens aged between 7 days and 10 weeks, and from 137 single units in area 17 in kittens aged between 12 days and 10 weeks. 2. All cells examined in area 18 of adult cats were visually responsive, 84% being orientation selective, 9% orientation biased and 7% non-oriented. Orientation columns and ocular dominance columns were identified. There was an over-all bias towards horizontal and vertical in the distribution of preferred orientations in the rostral part of area 18, where we were recording. 3. In area 18 of 7-day-old, visually inexperienced kittens the majority of cells (60%) were visually unresponsive; the remainder were either non-oriented (25%) or orientation biased (15%), and no orientation-selective units were found. Nevertheless there seemed to be a rudimentary columnar system, even in the youngest animals, in that orientation biased cells tended to occur in clusters with neighboring neurones having similar orientation preferences. In normal animals of 3 weeks and younger we found that the distribution of preferred orientations of a sample of neurones in area 18 with receptive fields scattered over much of the left lower quadrant of the visual hemifield was biased to oblique orientations. 4. As in adult cats, most cells in area 18 in young kittens were binocularly driven, and periodic alternation of dominance along oblique penetrations, characteristic of ocular dominance columns, was sometimes seen, even at the earliest ages. 5. Many of the developmental changes that we observed in area 18 occurred during the first 4 post-natal weeks. Orientation selectivity, orientation tuning, directionality and responsiveness of neurones matured rapidly over this period. The proportions of simple and complex cells were similar in kittens aged 4 weeks or more to those in adult cats, whereas prior to this most neurones that displayed an orientation preference appeared to be immature simple cells. 6. A laminar analysis revealed that very few units in the superficial layers (I, II and III) in area 18 are visually responsive in kittens during their first and second weeks, but orientation selectivity rapidly develops during the third week. By contrast, even in very young, visually inexperienced kittens, the majority of neurones found in deeper laminae (IV, V and VI) are visually responsive and a few of them already show an orientation preference; however, the subsequent appearance of larger proportions of orientation-selective cells in these lower layers is a more prolonged process than in upper laminae.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3309262 TI - The effect of glucose on insulin release and ion movements in isolated pancreatic islets of rats in old age. AB - 1. The effect of glucose on 86Rb+ efflux, 45Ca2+ net uptake and insulin secretion of pancreatic islets from 3- and 24-month-old rats was studied. 2. Raising the glucose concentration from 3 to 5.6 and 16.7 mM had no effect on 86Rb+ efflux from islets of 24-month-old male rats whereas that from 24-month-old female rats was decreased. 3. At 16.7 mM-glucose, net uptake of 45Ca2+ was significantly diminished in islets of 24-month-old rats compared to islets of 3-month-old rats. 4. In the presence of 16.7 mM-glucose, islets of 24-month-old rats exhibited only 60-70% of the insulin release obtained with islets from 3-month-old rats. 5. Neither net uptake of 45Ca2+ nor insulin secretion appear to differ between the sexes. 6. These data suggest that the decreased insulin secretory response to glucose during old age is due, at least in part, to inadequate inhibition of K+ efflux and diminished net uptake of Ca2+. PMID- 3309263 TI - Baclofen reduces post-synaptic potentials of rat cortical neurones by an action other than its hyperpolarizing action. AB - 1. Intracellular recordings were obtained from neurones in layers 2 and 3 of the rat frontal neocortex in an in vitro slice preparation. Three distinct types of stimulation-evoked post-synaptic potentials were recorded in these neurones: excitatory post-synaptic potentials (e.p.s.p.s); bicuculline-sensitive, chloride dependent inhibitory post-synaptic potentials (i.p.s.p.s) with times to peak of 20-25 ms (fast(f)-i.p.s.p.s); bicuculline-insensitive, potassium-dependent i.p.s.p.s with bicuculline-insensitive, potassium-dependent i.p.s.p.s with times to peak of 150-250 ms (long(l)-i.p.s.p.s). 2. The effects of baclofen were investigated on seventy-one neurones. Baclofen was applied by ionophoresis or pressure ejection from micropipettes or was added to the superfusion medium. 3. Baclofen depressed stimulation-evoked e.p.s.p.s in fifty-seven of the sixty neurones tested. This effect was associated with an increase in the stimulation intensity required to produce a synaptically evoked action potential for thirty nine of forty-four neurones. 4. Baclofen depressed f-i.p.s.p.s in thirty-seven of the thirty-nine neurones tested and l-i.p.s.p.s in each one of the seventeen neurones tested. Reversal potential values for each type of i.p.s.p. were not changed by baclofen and its depressions of each were independent of membrane potential (Em). Baclofen reduced the magnitude and the duration of the conductance increases that were associated with f- and l-i.p.s.p.s. 5. Baclofen hyperpolarized forty of seventy-one neurones and produced outward currents in three of four neurones recorded in voltage clamp at holding potentials between 55 and -65 mV. These actions were associated with 10-58% reductions of neuronal input resistance (RN) and 10-20% increases in neuronal input conductance (gN), respectively. Baclofen decreased the direct excitability of twenty-three of twenty-seven neurones tested. Determinations of the reversal potential for baclofen-induced changes of Em indicate that baclofen increases the conductance of rat neocortical neurones to potassium ions. 6. The EC50 for each action of DL baclofen was approximately 1 microM. L-Baclofen was greater than 100 times more potent than D-baclofen. 7. Concentrations of bicuculline that blocked f-i.p.s.p.s and responses to ionophoretically applied gamma-aminobutyric acid (GABA) had no effect on the depressions of e.p.s.p.s or the hyperpolarizations and decreases in RN that baclofen produced. 8. Baclofen did not reduce the duration of action potentials that were prolonged with intracellular injections of caesium ions or by superfusions with medium that contained 10 mM-tetraethylammonium (TEA).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3309264 TI - The ventral and dorsal lateral geniculate nucleus of the rat: intracellular recordings in vitro. AB - 1. The membrane properties and the electrotonic structure of neurones in the ventral and dorsal lateral geniculate nucleus (l.g.n.) of the rat were studied using an in vitro slice preparation. 2. Following electrophysiological characterization, horseradish peroxidase (HRP) was injected intrasomatically and the morphological features of impaled cells were characteristic of principal neurones of the rat ventral and dorsal l.g.n. 3. Neurones in the ventral l.g.n. had a higher input resistance but similar membrane time constants (tau o) and resting potentials than cells in the dorsal l.g.n. 4. Using a simple neuronal model, the electrotonic length (L) and the dendritic to somatic conductance ratio (rho) were calculated and found to be similar for cells in both divisions of the l.g.n. The mean value of L (0.7) and rho (1.5) suggest that both groups of neurones are electrotonically compact. 5. The width and after-hyperpolarization of directly evoked action potentials, but not their threshold or their amplitude, were different between cells of the ventral and dorsal l.g.n. 6. At potentials more negative than -55 mV, a slow rising and falling potential could be evoked in each neurone (n = 310) of the dorsal l.g.n. but only in three cells of the ventral l.g.n. (n = 94). The electrophysiological and pharmacological properties of this potential were identical with those of the low-threshold Ca2+-dependent potential observed in other thalamic nuclei. 7. These results indicate that some of the passive and active membrane properties of ventral and dorsal l.g.n. neurones are different. The implications of these findings for the control of the integrative capability and the response of l.g.n. neurones to visual stimulation are discussed. PMID- 3309267 TI - New observations on first-generation merogony of Eimeria tuskegeensis in Sigmodon hispidus. AB - First-generation development of Eimeria tuskegeensis was evaluated using light microscopy. Sporozoite-shaped meronts containing a prominent refractile body were observed in small intestinal cells of an experimentally infected cotton rat at 24 h post inoculation (PI). Mature spherical or subspherical meronts containing crescent-shaped merozoites were observed at 36 h PI. Refractile bodies were observed in some of these merozoites. Sporozoite-shaped meronts that were isolated from host intestinal cells and inoculated onto human fetal lung cell cultures penetrated the cultured cells by 2 h PI. A mature, subspherical, first generation meront containing seven merozoites was observed at 9 h PI in cell culture, indicating that sporozoite-shaped meronts isolated from the host retained their infectivity. PMID- 3309266 TI - Relationship between mitochondria and oxygen consumption in isolated cat muscles. AB - 1. Oxygen consumption, mitochondrial content and composition, intracellular lipid stores and fibre size were studied in isolated cat muscles: predominantly glycolytic gracilis, purely oxidative soleus and gracilis transformed into an oxidative muscle by chronic low-frequency (10 Hz) electrical stimulation. 2. Oxygen consumption in control gracilis at rest (0.303 +/- 0.050 ml O2 min-1 100 g 1; mean +/- S.E. of mean) was three to five times lower than in either stimulated gracilis (1.16 +/- 0.40) or soleus (1.57 +/- 0.56); it was about two times lower during maximal contractions in control gracilis (5.15 +/- 0.24) than in either stimulated gracilis (11.6 +/- 2.0) or soleus (9.34 +/- 0.78). 3. The volume density of mitochondria in control gracilis (2.75 +/- 0.12%) was half that of soleus (6.23 +/- 0.76) and only one-third that of stimulated gracilis (8.35 +/- 0.71). Subsarcolemmal mitochondria represented a significantly smaller fraction of the total mitochondrial volume in control gracilis than in either soleus or stimulated gracilis. 4. The surface area of inner and outer mitochondrial membranes per unit volume of mitochondria ranged from 23.4 to 26.1 and from 14.0 to 16.5 m2 cm-3, respectively. Mean values of these variables were not significantly different among experimental groups. 5. The volume density of the intracellular lipid stores in control gracilis (0.232 +/- 0.041%) was one-fourth of that in stimulated gracilis (0.860 +/- 0.12) and one-fifth of that in soleus (1.17 +/- 0.27). 6. The fibre cross-sectional area was 1670 +/- 260 micron 2 in control gracilis, 2250 +/- 280 in stimulated gracilis and 2390 +/- 110 in soleus. The difference was statistically significant only between control gracilis and soleus. 7. There was a significant correlation between the volume density of mitochondria and maximal oxygen consumption for all three muscles combined. 8. It was found that mitochondrial structure was similar in muscles with different oxidative capacities and that equal amounts of mitochondria consumed equal amounts of oxygen under limiting conditions of maximal in vivo respiration. PMID- 3309265 TI - Supraspinal morphine and descending inhibitions acting on the dorsal horn of the rat. AB - 1. Recordings were made from thirty-nine convergent neurones in the lumbar enlargement of the rat spinal cord. These neurones were activated by both innocuous and noxious stimuli applied to their excitatory receptive fields located on the extremity of the ipsilateral hind paw. Transcutaneous application of suprathreshold 2 ms square-wave pulses to the centre of the receptive field resulted in responses to A- and C-fibre activation being observed; a mean of 18.8 +/- 1.8 C-fibre latency spikes was evoked per stimulus. This type of response was inhibited by applying noxious conditioning stimuli to heterotopic body areas; immersing the tail in a 52 degrees C water-bath caused a mean 54.5 +/- 2.3% inhibition of the C-fibre-evoked response; such inhibitory processes have been termed diffuse noxious inhibitory controls (d.n.i.c.). 2. The effects of microinjections of morphine (5 micrograms; 0.2 microliter) on both the unconditioned C-fibre-evoked response and inhibitory processes triggered from the tail were investigated in an attempt to answer two questions: (a) does morphine increase tonic descending inhibitory processes and (b) what are the effects of morphine on descending inhibitory processes triggered by noxious stimuli? 3. The predominant effect of periaqueductal grey matter (p.a.g.) morphine on the C-fibre evoked responses was a facilitation: 51% of cells had their C-fibre-evoked responses increased by morphine (by roughly 50%); 31% of cells were not influenced while the remaining 18% of units were depressed; however the cells classified as depressed were only marginally so. No clear relationships were found either between the microinjection sites in the p.a.g. and their corresponding effects or between the number of C-fibre-spikes evoked in the control sequences and the subsequent effect of morphine. 4. While d.n.i.c. was not altered by morphine in 56% of cases, it was clearly reduced in the remaining cells. The effects were immediate but peaked at 40 min following the microinjection (a mean 77% reduction) and then returned towards control values. All but three of the corresponding microinjection sites were such as to include the medio-ventral p.a.g. including the nucleus raphe dorsalis. In contrast none of the cases where d.n.i.c. was unaltered included microinjection sites in this region. 5. No relationship was found between the changes in d.n.i.c. and the number of spikes evoked in the control sequences, or the changes in the C-fibre responses. 6. Autoradiographic controls using [3H]morphine showed a large diffusion of the drug within an area of about 0.75 mm around the tip of the cannula.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3309268 TI - Ultrastructure of the erythrocytic stages of Plasmodium malariae. AB - This report describes the fine structure of the erythrocytic stages of Plasmodium malariae. Erythrocytic parasites from a naturally acquired human infection and an experimentally infected chimpanzee were morphologically indistinguishable and structurally similar to other primate malarias. New findings included observations of highly structured arrays of merozoite surface coat proteins in the cytoplasm of early schizonts and on the surface of budding merozoites and the presence of knobs in the membranes of Maurer's clefts. Morphological evidence is presented suggesting that proteins are transported between the erythrocyte surface and intracellular parasites via two routes: one associated with Maurer's clefts for transport of membrane-associated knob material and a second associated with caveolae in the host cell membrane for the import or export of host- or parasite-derived substances through the erythrocyte cytoplasm. PMID- 3309269 TI - Extracellular killing of Trypanosoma cruzi amastigotes by human eosinophils. AB - Granules released from human eosinophils upon interaction with Trypanosoma cruzi amastigotes in vitro were seen attached to the surface of non-internalized parasites by electron microscopy. Amastigote damage was preceded by the binding of eosinophil granule material to its membrane, and eosinophil granule major basic protein (MBP) bound to the parasite surface was readily detectable. Additional evidence of eosinophil cytotoxicity for extracellular amastigotes was the observation that amastigotes trapped between two eosinophils, without being ingested by either one, were destroyed at the interface. Amastigotes isolated from the spleens of infected mice or grown in culture were similarly sensitive to the lytic effects of purified MBP. These results demonstrate the ability of human eosinophils to lyse T. cruzi amastigotes extracellularly in the absence of antibody and suggest that MBP may be involved in the effect. Thus, eosinophils, known to be capable of destroying phagocytosed amastigotes, could also contribute to the clearance of these parasites through extracellular killing. PMID- 3309270 TI - Serology of Naegleria fowleri and Naegleria lovaniensis in a hospital survey. AB - An avidin-biotin horseradish peroxidase method was used to detect antibodies to Naegleria fowleri and N. lovaniensis in human serum samples. Antibodies were detected in 101 specimens from 115 hospital patients ranging in age from 15 to 98 years. Class-specific anti-immunoglobulins identified antibodies as IgG and IgM. IgG antibody titers to both species ranged from 1:20 to 1:640. Seven of 15 serum samples collected from newborn infants also demonstrated IgG antibodies to these organisms with a titer range of 1:20 to 1:80. The immunoperoxidase test and Western blot analysis of selected serum samples demonstrated a close similarity in serological results between N. fowleri and N. lovaniensis. PMID- 3309271 TI - Antigenic relationship between Plasmodium falciparum and Babesia bovis: reactivity with antibodies to culture-derived soluble exoantigens. AB - Antigenic similarities between Plasmodium and Babesia parasites of the phylum Apicomplexa have been previously demonstrated primarily by the serological cross reactivity observed in the indirect fluorescent antibody (IFA) test. We have now studied the antigenic relationship between the human malaria parasite, Plasmodium falciparum, and the hemoparasitic agent of cattle, Babesia bovis, using rabbit monospecific antibodies produced against individual culture-derived P. falciparum polypeptides and bovine polyspecific antibodies to B. bovis exoantigens. These respective antibodies were found to be distinctly cross reactive in the IFA test using infected erythrocytes (squirrel monkey--P. falciparum; bovine--B. bovis) as antigen substrates. Immunofluorescence was shown to be highly specific for parasite surfaces. Additionally, the degree of reactivity with soluble exoantigens contained in Plasmodium and Babesia culture supernatants was monitored by a two-site enzyme immunoassay employing the cross-reactive antibodies. Further evidence for antigenic cross reactivity between P. falciparum and B. bovis parasites was shown with the in vitro inhibition assay. Antibodies to P. falciparum and B. bovis were found to be highly inhibitory for the in vitro growth of P. falciparum in human erythrocytes. PMID- 3309272 TI - Understanding ECT. PMID- 3309273 TI - Small bowel decompression in paediatric surgery. PMID- 3309274 TI - Laser-assisted end-to-side anastomosis. AB - The milliwatt CO2 laser was used to anastomose rat carotid arteries in an end-to side fashion, and this technique was compared to the standard suture technique. Vessels were studied at two to six weeks. All anastomosis were patient and overall, there was a 78.6 percent rate of aneurysm formation in the laser cohort, compared with 7.1 percent with suture (p less than 0.001 Fisher exact). Vessels and aneurysm histology were similar to those previously reported for the end-to end technique. PMID- 3309275 TI - A comparison of vascularized and nonvascularized bone transfer in rabbits: a roentgenographic, scintigraphic, and histologic evaluation. AB - Extensive bone defects caused by bone tumor resection, osteomyelitis, congenital pseudoarthrosis, post-traumatic bone loss, or femoral head necrosis, require large bone grafts. Such large defects usually are not amenable to conventional, nonvascularized cancellous grafts. By using vascularized bone grafts that do not undergo creeping substitution, that heal rapidly and are not depending on the surrounding tissue, better, safer, and faster results can be obtained. To compare recoveries after vascularized grafts with those after conventional, nonvascularized grafts, experiments were carried out in a rabbit model. They demonstrated good viability and better and faster healing of the microvascular grafts, using radiography, scintigraphy, light microscopy of bone osteocytes and vessels, and tetracycline double-labeling evaluation techniques. PMID- 3309277 TI - Induction of precocious puberty in ewe lambs by pulsatile administration of GnRH. AB - Circhoral administration (250 ng/h, i.v.) of GnRH induced a preovulatory-like surge of LH and subsequent luteal function in 4 of 4 ewe lambs 1 month before expected date of puberty. Within 12h of the start of pulsatile delivery of GnRH, mean concentrations of immunoactive and bioactive LH increased significantly (P less than 0.05) and the LH surge occurred by 1.8 +/- 0.6 days of treatment. Mean concentrations of serum progesterone were elevated significantly (P less than 0.001) 3 days after the surge. The biopotency of LH (bioactive LH/immunoactive LH) before the GnRH-induced surge of LH did not differ from LH biopotency in ewe lambs receiving circhoral delivery of saline (0.41 +/- 0.05 and 0.46 +/- 0.04, respectively). Biopotency of LH declined markedly at the GnRH-induced LH surge (0.25 +/- 0.04), but biopotency of serum LH was significantly augmented (P less than 0.05) during the period of luteal activity (0.70 +/- 0.07). Regular oestrous cycles were observed in 3 of 4 ewe lambs after the 10-day GnRH treatment period. These results indicate that pulsatile delivery of GnRH is effective in inducing precocious puberty in ewe lambs. Increase in LH biopotency does not appear to be required in the pubertal transition to reproductive cyclicity in this species. Augmented LH biopotency may be important in support of luteal function after first ovulation. PMID- 3309276 TI - Ways of influencing the behaviour of general practitioners. AB - What evidence is there for the success or failure of the different methods used to influence the behaviour of general practitioners, whether in their work with patients, or in the organization of a practice?This preliminary exploration of the literature suggests that, although change is always occurring, its deliberate inducement is usually slow and laborious. Doubt is cast on the efficacy of existing financial incentives, and of unsolicited feedback about performance. There is little evidence for the influence of audit on behaviour but personal contact with doctors, nurses and other colleagues, and to a lesser extent with patients, is relatively effective, both in influencing the teamwork of a practice and in more formal education. However, it is combinations of different methods which most successfully influence general practitioners. PMID- 3309278 TI - Immunohistochemical demonstration of prostaglandin E-2 in preimplantation mouse embryos. AB - An antiserum to prostaglandin (PG) E-2 and indirect immunofluorescence were used to demonstrate immunohistochemically the presence of PGE-2 in preimplantation mouse embryos. Fluorescence was observed in the cytoplasm of unfertilized 1-cell embryos to the blastocyst stage. The strongest fluorescence was detected at the 8 cell and morula stages. In embryos cultured from the 2-cell stage on, the fluorescence was observed in the cytoplasm of 4-cell embryos to the blastocyst stage. No differences were observed in the intensity and the distribution of the fluorescence between embryos in vivo and those in vitro. However, when blastocysts were cultured in a medium containing 100 microM-indomethacin, the fluorescence was diminished markedly. We therefore suggest that preimplanted mouse embryos contain PGE-2 during their early developmental stages and that the embryos synthesize the PGE-2. PMID- 3309280 TI - Fertilization in vitro of rat oocytes undergoing maturation in response to a GnRH analogue. AB - Oocytes were exposed to GnRHa to induce their maturation both in vivo, by administration of the hormone to hypophysectomized rats, and in vitro, in cultures of intact ovarian follicles. Mature oocytes obtained under both these conditions were then exposed in vitro to a sperm suspension for fertilization. Fertilization of control groups of oocytes, isolated from intact or hypophysectomized PMSG-primed hCG-induced ovulators, was 88.3 +/- 3.3% (n = 331) and 90.0 +/- 2.8% (n = 427), respectively, as compared to 82.8 +/- 3.2% (n = 413) for oocytes isolated from hypophysectomized PMSG-primed GnRHa-induced ovulators. Fertilization rate in oocytes treated by GnRHa in vitro was 78.5 +/- 3.1% (n = 247) as compared to 79.3 +/- 4.1% (n = 261) in LH-treated oocytes. These results demonstrate that fertilizability of oocytes undergoing maturation in response to GnRHa is similar to that of oocytes induced to mature by LH. No differences could be detected in the proportions of abnormal oocytes (polyspermic, fragmented and dead) and the zygotes obtained after fertilization of GnRHa- or LH-treated oocytes showed similar ability to cleave. PMID- 3309279 TI - Immunocytochemical study of anti-Mullerian hormone in sheep ovarian follicles during fetal and post-natal development. AB - Anti-Mullerian hormone (AMH) was detected in perinatal and postnatal sheep ovaries, using avidin-biotin immunohistochemistry with a monoclonal antibody specific for ruminant AMH. Immunoreactivity was limited to granulosa cells, and was influenced both by the degree of follicular development, and by the age of the animal. In the fetus, only the most advanced follicles exhibited a faint immunoreactivity at 120 days gestation, and no reaction was observed in younger animals. Immediately before and after birth, primordial follicles were still negative, but a faint reaction was elicited in young growing follicles, increasing with follicle size. Strong immunoreactivity was visible in antral follicles, especially in the innermost granulosa cell layers, close to the oocyte and lining the antral cavity. PMID- 3309281 TI - Lateral diffusion of a human sperm-head antigen during incubation in a capacitation medium and induction of the acrosome reaction in vitro. AB - An integral component of human spermatozoa, a glycoprotein of Mr 143,000 (two subunits of Mr 76,000 and 67,000) was recognized by the a-HS 1A.1 monoclonal antibody. The antigen was localized on the plasma membrane over the sperm head, as demonstrated by transmission electron microscopy. The antigen-antibody binding on gametes during changes in their functional state was followed by an indirect immunofluorescence assay of live human spermatozoa. In freshly ejaculated spermatozoa the antibody binding pattern revealed a patchwork quilt-like topography of the plasma membrane over the acrosome; the percentage of positive cells varied from 20 to 78% with a mean of 50% (n = 82). Incubation in a capacitation medium could increase this percentage up to 98%, revealing new epitopes in an energy-dependent and temperature-independent manner; concomitantly, a part of the antigen migrated in energy-independent and temperature-dependent manner and accumulated in a ring over the postacrosome. When an acrosome reaction was induced in vitro in the presence of Ca2+ with either A23187, ionomycin or human follicular fluid, the HS 1A.1 antigen migrated until immobilization in a well defined pattern around the equatorial segment (single band) or around the equatorial and postacrosomal segments (2 or, seldom, 3 bands). The new antigen localization resulted from a lateral diffusion of pre existing molecules, occurred in only a few minutes, did not require energy and was temperature-dependent. At the same time, the well outlined large patch burst into a multitude of small spots before vanishing. this veil-like labelling was often observed in spermatozoa kept in the seminal plasma or treated with a metabolic poison. The HS 1A.1 antigen localization reflects surface changes induced by the incubation in a capacitation medium and the acrosome reaction. Apart from the regional heterogeneity of the plasma membrane of a single cell, as noted above, there were differences in the plasma membrane changes in individual spermatozoa from the same ejaculate as well as in semen samples from different donors. The new antibody binding pattern was often alike in successive ejaculates of the same donor. In patients consulting for infertility the percentage of positive cells was often low and migration of the antigen was slight or absent. PMID- 3309282 TI - Induction of ovulation, mating, and conception in androgen-treated immature rats. AB - Attempts were made to induce pregnancy in androgen-treated immature rats. Treatment with PMSG alone, which causes ovulation in normal immature rats, failed to cause ovulation in androgenized rats. However, treatment with PMSG plus LHRH was effective in causing ovulation. After ovulation, some of the normal and androgenized rats mated. Normal mated rats became pregnant but androgenized mated rats did not. However, when a pituitary gland was transplanted from a normal rat into the kidney capsule of an androgenized rat to maintain functional corpora lutea, implantation occurred in some of the mated animals. The positive decidual reaction in the uteri of such androgenized rats was similar to that observed in normal rats. These results suggest that the uterine sensitivity to blastocyst implantation of androgenized immature rats may be normal. PMID- 3309283 TI - An enzyme-linked immunosorbent assay (ELISA) for bovine LH capable of monitoring fluctuations in baseline concentrations. AB - Using a Fab'-horseradish peroxidase conjugate, an ELISA for bovine LH was developed and validated. It had good specificity (less than or equal to 0.2% cross-reactivity with FSH or TSH), was not susceptible to interference from plasma components and exhibited very low non-specific binding. It was carried out on microtitre plates and had incubation times totalling 4 or 18 h, not including the initial antibody coating step. The longer incubations gave a lower detection limit (10 pg, 300 amol) and were used when fluctuations in baseline concentrations were being monitored. The values determined were independent of the plasma volume employed, standard added to plasma samples was accurately determined and the results obtained from the analysis of plasma samples correlated closely with those obtained by radioimmunoassay. The assay was applied to the analysis of plasma samples taken from heifers with normal ovarian activity or treated in a number of ways, and in every case the results obtained were similar to those determined by radioimmunoassay and reported in the literature. PMID- 3309284 TI - Monoclonal antibody against a sperm antigen Mr 95,000 inhibits attachment of human spermatozoa to the zona pellucida. AB - A murine monoclonal antibody raised against hamster spermatozoa was found to cross-react with human spermatozoa. By immunofluorescence, the antigen was visualized over the equatorial segment of human sperm heads. In the presence of antibody, sperm binding to the zona pellucida of salt-stored human oocytes was significantly inhibited (P less than or equal to 0.005) compared with other antibodies or control preparations. Using SDS-PAGE of whole spermatozoa and membrane preparations followed by Western blot analysis, the antigen was identified as a determinant with a relative molecular weight of 95,000. PMID- 3309285 TI - Differences in immunogenicity indicating polymorphism of sperm antigens from mice of different inbred strains. AB - Polymorphism of mouse sperm was investigated by analysis of immune sera generated in BALB/c female mice against sperm from 6 inbred strains. The immune sera were analyzed by immunofluorescence and Western blot techniques against sperm antigens from the 6 immunizing strains. Immunofluorescence revealed no differences in reactivity patterns or titers. However, several different reaction patterns were detected by Western blot technique which indicated that both the sperm extracts and the antisperm immune sera contained different components. Syngeneic (anti BALB/c sperm) antisera showed far fewer reactive antibody species than allogeneic immune sera. The anti-BALB/c sera recognized an antigen of 23 kDa in sperm extracts from DBA/2J and C57BL/6 mice, and failed to react with an antigen of the same molecular weight when applied to sperm from A/J and 129/J mice, indicating antigenic differences between sperm from these inbred strains. Anti-C57BL/6 sera contained a unique antibody which reacted with an antigen of 80 kDa in all of the 6 sperm extracts, whereas others antisera did not detect this antigen. These findings indicate antigenic and immunogenic polymorphism in sperm from different inbred strains of mice. PMID- 3309286 TI - A monoclonal antibody reacting with the zona pellucida of the oviductal egg but not with that of the ovarian egg of the golden hamster. AB - A monoclonal antibody (mAb) designated AZPO-8 was produced by hybridizing a mouse myeloma with spleen cells from BALB/c mice immunized with materials obtained from the hamster oviduct. With an immunofluorescence test, AZPO-8 reacted with the zona pellucida (ZP) of ovulated eggs in the oviduct (ZP-OVI) but not with the zona pellucida of eggs in the ovary (ZP-OVA). Using indirect enzyme immunostaining, this mAb reacted with epithelial cells of the oviduct, the uterus (especially the cervical epithelium) and the gastric mucosa, but not with other hamster tissues examined. The reactivity of antigen-positive tissues was abrogated by pretreatment of the tissues with periodic acid. Western blotting analysis revealed that AZPO-8 reacted with substances of broad molecular weight range, and the strongest reactivity was detected at a molecular weight of approximately 200,000 in both cases when extract of ZP-OVI or the hamster oviduct was applied on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE) gel. AZPO-8 showed strong hemagglutination activity only to group A human red blood cells. These results indicated that (1) ZP-OVI had an antigen that was not detected on ZP-OVA, (2) ZP-OVI and the oviduct shared the same antigenicity, and (3) the antigenic determinant reactive with the mAb might be carbohydrate in nature. A possible role of this antigen in fertilization was discussed. PMID- 3309287 TI - Fetal biophysical testing. The effects of prolonged maternal fasting and the oral glucose tolerance test. AB - Fetal biophysical testing incorporates observations of the fetal heart rate (FHR), fetal breathing movements (FBMs) and fetal trunkal movements (FTMs). These parameters were examined during maternal fasting and glucose loading. Thirty normal term gravidas were studied during a 210-minute session, of which the first 30 minutes served as a fasting control period, following which 20 (group G) received 100 g oral glucose, while 10 (group F) continued fasting. Serum glucose levels in both groups were determined every 30 minutes. FHR, FBMs and FTMs were recorded concurrently using abdominal electrocardiography and real-time ultrasonography and entered on line into a microcomputer. Offline data analysis provided mean 30-minute baseline FHRs, acceleration counts, FBM incidences, FBM rates and FTM incidences. Both groups were similar for gestational age, birth weight and perinatal outcomes. Mean 30-minute FHR baseline was unchanged and similar in both groups. Mean 30-minute FHR acceleration counts and FTM incidences were significantly higher in group F, while FBM incidences and rates were significantly higher in group G. While biophysical testing can be conducted under either set of maternal conditions, different normal standards must be employed, test length must be sufficient to account for normal biologic variations, and biophysical parameters must be monitored concurrently. PMID- 3309288 TI - Four-quadrant assessment of amniotic fluid volume. Interobserver and intraobserver variation. AB - While the use of the four-quadrant technique, or the amniotic fluid index (AFI), for amniotic fluid volume assessment has been shown to correlate with perinatal outcome, one concern among clinicians is the reliability of a single AFI measurement. The purpose of this investigation was to ascertain the margin of error using this technique among 23 term and postterm women. The AFI was obtained using linear array real-time B-scan ultrasound to measure the vertical diameter of the largest amniotic fluid pocket in each of the four quadrants. The sum of these measurements was expressed as the AFI. Eight women underwent ten consecutive AFI measurements by the same sonographer to determine intraobserver variation. Interobserver variation between five sonographers was measured by assessing the AFI in 15 additional patients. With the amniotic fluid volume in the low or normal range, our results demonstrated the intraobserver and interobserver variations in AFI to average 1.0 and 2.0 cm, respectively. With an above-normal amniotic fluid volume, a 2.5- to 3-fold greater variation was observed. A relatively small margin of error appears to exist between observers using the four-quadrant technique to assess amniotic fluid volume. PMID- 3309289 TI - Outcome of fetal meningomyelocele after vaginal delivery. AB - Eight neonates with meningomyelocele were delivered vaginally. Diagnosis of meningomyelocele was made by ultrasonography during the latter half of pregnancy in three patients. The remaining five did not have ultrasound examination during the antenatal period. None of the meningomyelocele sacs (less than or equal to 4 cm in diameter) was ruptured at the time of delivery. Cesarean section may not be necessary for all fetuses with meningomyelocele. PMID- 3309290 TI - Amniotic fluid index measurements during pregnancy. AB - Amniotic fluid volume assessment has become an important part of antepartum fetal surveillance. The amniotic fluid index (AFI), or four-quadrant technique, has been suggested for this purpose. While previous reports have outlined this technique and correlated the results with pregnancy outcome, none have reviewed the changes in AFI throughout pregnancy. We studied AFI changes from 11 through 43 weeks' gestation. As part of the entry criteria, only patients with good dates were evaluated. The AFI was determined by the summation of the vertical diameter of the largest pocket in each of the four quadrants. All amniotic fluid studies were conducted using real-time linear array B-scan. During the study period, 197 patients with good dates confirmed clinically and sonographically underwent 262 AFI assessments. From 11 to 26 weeks the AFI rose progressively. Thereafter until term, the AFI remained approximately 16.2 +/- 5.3 cm. After 38 weeks the AFI appeared to gradually decline. Data obtained from this study population corroborate previously defined normal amniotic fluid volumes. These results also suggest that serial measurements of the AFI may be an effective means of assessing fetal status throughout pregnancy. PMID- 3309291 TI - Current status of total joint arthroplasty: observations and projections. AB - The 10-20 year results and complications of the first generation of total hip arthroplasties suggest that early problems such as infection, component breakage, and early loosening have been controlled, but that late aseptic loosening is now the major problem. Newer approaches will bring with them a new set of complications which must be carefully monitored. A standardized rating scheme and computerized information bank will allow more rapid analysis of trends and problems. A number of joint preserving alternatives to total replacement are available but intervention must be early, before a salvage situation exists. PMID- 3309292 TI - The biotechnology of hand and wrist implant surgery and rehabilitation. AB - The earliest successful implants for restoration, alignment and function of finger joints and the wrist were made of organic silicones. In spite of initial improvement, the longterm complications of fracture, loosening and silicone synovitis have led to a search for better methods. Techniques currently under study are perichondrial grafting, the use of processed carbon implants and continuous passive motion rehabilitation. PMID- 3309293 TI - Advances in orthotics for the patient with rheumatoid arthritis. AB - Orthotics are externally applied devices which support a joint or enhance its function. In arthritis orthotics are prescribed to stabilize joints, provide better positioning, reduce pain, prevent deformity and improve function. Splints are used primarily for the upper extremity. Specially designed shoes can control foot and ankle pain and instability. Continuous passive motion devices are becoming widely used for early postoperative rehabilitation after arthroplasty. Unfortunately, few controlled studies have been performed to determine the utility of orthoses in patients with arthritis. Some of the most important questions on this subject are posed and available data discussed as well as the need for additional information. PMID- 3309294 TI - Rehabilitation research in neuromuscular diseases: current research activities and future research needs. AB - Rehabilitation management of individuals with neuromuscular disorders has been based primarily on clinical observation. Most investigations of treatment failed to follow sound clinical research techniques and were retrospective. In addition to using appropriate clinical research methodology, 2 parallel categories of research are desirable: investigations of the natural course of each disease, and studies of treatment outcomes. Prospective studies are needed of treatment interventions designed to include an adequate treatment group sample, control subjects matched for duration or severity of disease, supervised therapy sessions, an appropriate objective, valid and reliable measurement criterion against which to assess outcomes, and a double blind system. PMID- 3309295 TI - Muscle atrophy in rheumatoid arthritis. AB - The purpose of this paper is to describe some research opportunities in the area of muscle atrophy secondary to arthritis. Future research should utilize quantitative methods of evaluating muscle atrophy such as computerized tomography or ultrasonography. The gross muscle atrophy should be further characterized by muscle fiber type measurements. These techniques as well as biochemical determinations should be utilized to identify mechanisms of muscle atrophy as well as determine ideal methods for reversing muscle atrophy and weakness. PMID- 3309296 TI - New drugs for mental disorders? PMID- 3309297 TI - New drugs for mental diseases? New diseases for old drugs? PMID- 3309299 TI - Building or extending a hospital department: radiology. A path through the planning minefield (7). PMID- 3309298 TI - Experience with nalbuphine, a new opioid analgesic, in acute myocardial infarction. AB - A total of 141 patients admitted to hospital with a diagnosis of suspected myocardial infarction were randomized to treatment with intravenous diamorphine (71) or nalbuphine (70). Myocardial infarction was subsequently confirmed in 109 patients. Both drugs provided good analgesia. Heart rate, blood pressure, respiratory rate, peak flow and minute volume were measured over a three-hour study period. Except for a slight fall in systolic blood pressure in the nalbuphine-treated group, there were no statistically significant differences between the groups. The nalbuphine-treated group had higher levels of aspartate aminotransferase and hydroxybutyric acid dehydrogenase but not creatine phosphokinase. The haemodynamic outcome and mortality at three months of the two groups were similar. It is concluded that nalbuphine provides effective analgesia coupled with few adverse circulatory or respiratory effects. PMID- 3309300 TI - Intractable functional abdominal pain: Sir Clifford Allbutt and Sir Robert Hutchison remembered. PMID- 3309301 TI - Polycythaemia following renal transplantation. AB - Polycythaemia has developed in 10 of 59 regularly reviewed patients with renal transplants surviving more than three months. The pathology of the raised haemoglobin level was heterogeneous. Three patients had a picture characterized by a normal red cell mass and reduced plasma volume. Seven patients had a raised red cell mass; in 3 of these this was associated with a period of abnormal liver function and fitted with the state of raised red cell mass in association with hepatic transaminitis. The remaining 4 patients form a unique, previously undefined group with no features to explain the underlying aetiology of the polycythaemia. The patients had a trouble-free post-transplant course with early establishment of graft function. It is proposed, from the data obtained from in vitro culture studies, that the early return of good renal function allows the erythroid compartment to expand in response to circulating erythropoietin. The establishment of an erythron of increased size allows for a persistently raised haemoglobin in the presence of normal erythropoietin levels. PMID- 3309302 TI - Parathyroid carcinoma: a review. PMID- 3309304 TI - Building or extending a hospital department: radiology. A path through the planning minefield (8). PMID- 3309303 TI - A. Charles King: a unique contribution to anaesthesia. PMID- 3309305 TI - Acute renal failure and acute hydronephrosis in pregnancy: use of the double-J stent. PMID- 3309307 TI - Biblical ills and remedies. PMID- 3309306 TI - Fatal Streptococcus pyogenes pneumonia. PMID- 3309308 TI - Laboratory measurement of nutrition in cystic fibrosis. PMID- 3309309 TI - Management of the chest in cystic fibrosis. PMID- 3309310 TI - The chest radiograph in cystic fibrosis in children and the role of other radiological techniques. PMID- 3309311 TI - The difficulties of treating cystic fibrosis in adults. PMID- 3309312 TI - Synthesis and biological properties of N3-(4-methoxyfumaroyl)-L-2,3 diaminopropanoic acid dipeptides, a novel group of antimicrobial agents. AB - A series of dipeptides with N3-(4-methoxyfumaroyl)-L-2,3-diaminopropanoic acid (FMDP), the irreversible inhibitor of glucosamine-6-phosphate synthetase from bacteria and fungi, have been synthesized and their antibacterial and antifungal properties in vitro evaluated. The results demonstrate that these peptides inhibit the growth of a number of the tested microorganisms, especially pathogenic fungus Candida albicans. The results of competitive antagonism studies indicate specific peptide transport of the peptides via peptide permeases as drug delivery system and gives evidence for the high selectivity of the action upon the cells, as a result of the inhibition of generation of glucosamine. PMID- 3309314 TI - Synthesis and biological studies of iodinated (127/125I) derivatives of rhodamine 123. AB - Rhodamine 123, a mitochondrial stain that preferentially accumulates in certain cancer cells, has been reduced and iodinated by using NaI in the presence of N chlorosuccinimide. The various mono-, di-, and triiodo derivatives have been isolated and characterized. These nonfluorescent compounds are taken up by mammalian cells, become fluorescent within the cytoplasm (presumably following oxidation), and show the same pattern of localization as the parent compound. Iodination with no-carrier-added Na125I yields the same mixture of compounds. All 125I derivatives accumulate preferentially in PC3 adenocarcinoma cells compared with V79 lung fibroblasts, with the differential being greatest for the monoiodo compound, followed by the di- and triiodo derivatives. PMID- 3309313 TI - Renin inhibitors. Dipeptide analogues of angiotensinogen incorporating transition state, nonpeptidic replacements at the scissile bond. AB - A series of dipeptide analogues of angiotensinogen have been prepared and evaluated for their ability to inhibit the aspartic proteinase renin. The compounds were derived from the renin substrate by replacing the scissile amide bond with a transition-state mimic and by incorporating bioisosteric replacements for the Val-10 amide bond. Analogue 21a exhibited an IC50 of 7.6 nM against purified human renin, showed high specificity for this enzyme, and produced a hypotensive response in anesthetized, salt-depleted cynomolgus monkeys. PMID- 3309315 TI - alpha,alpha-Difluoro-beta-aminodeoxystatine-containing renin inhibitory peptides. AB - The preparations of sodium 4(S)-[(tert-butyloxycarbonyl)amino]-2,2-difluoro-3(S)- and -3(R)-[(4-methoxyphenyl)amino]-6-methylheptanoates (7a and 7b) from sodium 4(S)-[(tert-butyloxycarbonyl)amino]-2,2-difluoro-3(R)- and -3(S)-hydroxy-6 methylheptanoates (1a and 1b) are described. The key step involves the stereospecific intramolecular displacement via a Mitsunobu reaction for the conversion of a beta-hydroxy hydroxamate to a beta-lactam ring. Compounds 7a and 7b are useful as synthetic intermediates for the preparation of enzyme inhibitors that contain 3(S),4(S)- and 3(R),4(S)-diamino-2,2-difluoro-6-methylheptanoic acid inserts. Angiotensinogen analogues VII and VIII that contain these novel amino analogues of difluorostatine were shown to be inhibitors of the enzyme renin. The alpha,alpha-difluoro-beta-aminodeoxystatine-containing compounds were shown to be weaker inhibitors than the corresponding difluorostatine-containing congeners. PMID- 3309316 TI - Renin inhibitors. Statine-containing tetrapeptides with varied hydrophobic carboxy termini. AB - A series of statine-containing tetrapeptides, systematically modified at the carboxy terminus with various hydrophobic aromatic groups, is described. These compounds were tested in vitro for their ability to inhibit porcine, human plasma, and purified human kidney renins. These analogues help to define optimal binding aspects in a region of the enzyme that appears to be specific for spatial arrangement of aromatic groups. Replacement of the metabolically labile Phe amide with nonpeptidal groups proved possible while achieving inhibitory potency in the nanomolar range vs. porcine kidney renin. For the compounds 6i, 6m, and 6o, a large discrepancy in potency between the human plasma and the purified human kidney renin assays was observed. This disparity does not appear to be a consequence of a previously proposed plasma binding component. PMID- 3309317 TI - Effect of beta-alkyl substitution on D-1 dopamine agonist activity: absolute configuration of beta-methyldopamine. AB - beta-Methyldopamine and its enantiomers and racemic beta-phenyldopamine were synthesized and evaluated for dopamine D-1 agonist activity. In the dopamine sensitive adenylate cyclase assay, beta-phenyldopamine had about one-sixth the activity of dopamine. Racemic beta-methyldopamine was less potent. The absolute configuration of beta-methyldopamine was determined to be R-(+) and S-(-). Evaluation of (R)-(+)- and (S)-(-)-beta-methyldopamine revealed no enantioselectivity for stimulation of adenylate cyclase. PMID- 3309318 TI - Detection of centromeric regions of chromosomes by immunofluorescence: procedure and application. PMID- 3309319 TI - Increased sensitivity to erythromycin in Escherichia coli associated with the presence of the ColV,I-K94 virulence plasmid. AB - Introduction of the virulence plasmid, ColV,I-K94, into Escherichia coli strains led to increased sensitivity to erythromycin. This was the result of increased passage of antibiotic into ColV,I-K94+ organisms because the plasmid effect was abolished in bacteria which had been made permeable by chemical treatment. Full sensitivity in ColV+ strains appears to depend on the simultaneous presence of transfer and colicin components. Increased erythromycin sensitivity associated with the plasmid was demonstrated in organisms grown at 37 degrees C; the sensitivity of ColV,I-K94+ organisms grown at 25 degrees C was similar to that of the parent strain. Added Mg++ or Ca++ ions reversed erythromycin inhibition in strains with the basal level of sensitivity (i.e., the Col- parent grown at 25 degrees C or 37 degrees C or the ColV,I-K94+ derivative grown at 25 degrees C) and in those with the plasmid-associated increase in sensitivity. Addition of phosphate or EDTA to broth increased erythromycin sensitivity in Col- and ColV,I K94+ strains although the latter was affected most. Erythromycin was more inhibitory at pH 8.5 than at pH 7.4. This enhanced activity was more marked against the ColV,I-K94+ strain than against the Col- strain. The effects of growth in phosphate-containing medium and at alkaline pH were partially additive. We suggest that ColV,I-K94+ strains may be sensitive to erythromycin because ColV specified proteins are extruded by a process of "self-promoted transfer" and that the effects of these proteins on the lipopolysaccharide component of the outer membrane facilitates antibiotic influx. PMID- 3309321 TI - Difficulties in the serodiagnosis of infection with the fragilis group of Bacteroides. AB - Bacteroides antibodies were studied in sera from 74 patients infected with the fragilis group of Bacteroides and 74 healthy control persons, by immunofluorescence of 26 different serotypes of the fragilis group. Antibodies were present at titres of 10-320 in 65 (88%) patients and 50 (68%) controls (p less than 0.01). Titres of greater than or equal to 80 were demonstrated in sera of 38 (51%) patients and 5 (7%) controls (p less than 0.01). Specific IgM antibodies were detected in sera of 42 (57%) patients at a geometric mean titre (GMT) of 30, and 8 (11%) controls at a GMT of 11 (p less than 0.01). High antibody titres as well as specific IgM were found in 32 (43%) patients, while none of the controls showed such a combination (p less than 0.01). The majority of positive patients' sera (57%) reacted with five or more serotypes, whereas most positive control sera (51%) reacted against only one or two serotypes (p less than 0.01). A selected combination of serotypes not reacting with the control sera showed positive reactions with 52 (70%) patients' sera. These findings may be useful in devising schemes for the serodiagnosis of infection caused by the fragilis group of Bacteroides. However, there are indications of geographic variation in prevalence of serotypes, which may prevent the development of a single universal scheme. PMID- 3309320 TI - Effect of Bacteroides fragilis cellular components on chemotactic activity of polymorphonuclear leukocytes towards Escherichia coli. AB - Chemotaxis of polymorphonuclear leukocytes (PMNL) in response to cell components of Bacteroides fragilis alone or in combination with Escherichia coli was evaluated. E. coli produced much more powerful chemotactic factors than B. fragilis. The culture filtrate (CF), outer membrane (OM) preparation, and lipopolysaccharide (LPS) of B. fragilis slightly stimulated chemotactic activity of PMNL. The culture filtrate and OM preparation were capable of inhibiting the chemotaxis of PMNL in response to the chemotactic factors of E. coli but LPS of B. fragilis was not able to do so. Reduction by B. fragilis of PMNL chemotaxis in response to E. coli was not specific for B. fragilis but also occurred in the presence of facultative bacteria. In parallel with chemotaxis, lysozyme release, but not beta-glucuronidase release, by PMNL was significantly stimulated by E. coli but not by B. fragilis. PMID- 3309322 TI - Studies on cell adhesion and concanavalin A-induced agglutination of Candida albicans after mannan extraction. AB - Candida albicans cells were treated with alkali and acid to extract preferentially the cell wall alpha-mannan. Cells were recovered at three stages, as extraction proceeded from mild to more extensive: Alk-1, Alk-2 and Alk + Acid. Yeast adhesion to human epithelial cells was then examined with an in-vitro adherence assay. Yeasts from all three stages of extraction adhered in significantly lower numbers to buccal mucosal cells than did unextracted yeasts. Adhesion was as low for Alk-1 cells as for those submitted to more complete mannan extraction. When yeast cells from all three stages were treated with Concanavalin A (Con A), a lectin probe with strong affinity for yeast alpha mannans, and then subjected to the adherence assay, there was no significant change in adhesion. When yeast agglutinability by Con A was examined in tests with treated and untreated yeast cells, abundant agglutination occurred only with the untreated cells. However, Alk-1 cells, though lacking in adhesive capacity towards mucosal cells, showed significant agglutination. The results suggest that candidal adhesion is mediated by an alkali-soluble, mannan-containing moiety(ies) which appears to be lost early in the extraction process. Blockage of this moiety by Con A inhibits the adhesion of unextracted cells. Extracted cells lack this moiety but still possess enough structural mannan for Con A recognition and agglutination. PMID- 3309324 TI - A morphological study of the action of equine anti-lipopolysaccharide plasma on gram-negative bacteria. AB - Three strains of gram-negative bacteria--one each of Escherichia coli, Klebsiella pneumoniae and Enterobacter sp.--were treated with anti-lipopolysaccharide hyperimmune equine plasma (anti-LPS) or non-immune control plasma and examined by scanning electronmicroscopy. Within a few minutes of treatment with anti-LPS, bacteria were agglutinated. Evidence of cell membrane destruction was observed shortly thereafter and total cell disintegration and disruption occurred within 1 2 h. In contrast, non-immune plasma had no effect on cell morphology. This confirms the findings in previous microbiological studies that specific antibodies in anti-LPS bind to lipopolysaccharide (LPS endotoxin), and thereby initiate the destruction of gram-negative bacteria. PMID- 3309323 TI - Variations in affinity to Candida albicans in vitro among human buccal epithelial cells. AB - Using an in-vitro adherence assay it was observed that the number of Candida albicans cells that attached to individual buccal mucosal cells varied greatly. Three mucosal-cell characteristics--state of aggregation, size and viability- that might influence yeast adhesion in vitro were studied. The number of attached yeast cells per mucosal cell varied from 0 to 32. The majority of buccal cells (88%) had none or very few yeasts attached, whereas a minority of cells (12%) bound more than one half of all the attached yeasts. In donors whose buccal cells had large numbers of attached yeasts this percentage increased and the number of cells with no attached yeast cells fell. Cells of an intermediate size (36-70 micron) had a greater affinity for yeasts than did cells of other sizes. Buccal cell viability appeared not to be necessary for adhesion of yeasts. No significant differences were observed in the number of yeast cells attached to single buccal cells compared with attachment to buccal cells within sheets. It would appear, therefore, that there are distinct subpopulations of epithelial cells with high and low affinity for attachment by C. albicans in vitro. Mucosal cell size or viability might influence this affinity. PMID- 3309325 TI - Proteus mirabilis strains of diverse type have IgA protease activity. AB - A strain of Proteus mirabilis associated with chronic urinary tract infection was found to produce an EDTA-sensitive IgA protease that cleaved the IgA heavy chain into two fragments at sites different from those attacked by other microbial IgA1 proteases. Another 14 P. mirabilis strains of diverse type and from various clinical conditions also produced a similar IgA protease. This enzyme may be a virulence determinant of P. mirabilis. PMID- 3309326 TI - Defect in excision repair alters the mutational specificity of PUVA treatment in the lacI gene of Escherichia coli. AB - The sequences of 152 lacI- mutations obtained following exposure of Escherichia coli UvrB- strain NR3951 to ultraviolet light in the presence of 8 methoxypsoralen (PUVA treatment) were compared to the spectrum of mutation induced by PUVA treatment in a Uvr+ strain, NR3835. Mutations recovered following PUVA treatment of the UvrB- strain were quite different from those recovered in the Uvr+ strain. In addition, they occurred at a restricted number of unique sites. For example, A.T----T.A base substitutions at position 141, minus G frameshifts at positions 586/587/588 and deletions of 15 base-pairs from position 78 to 92 accounted for 50% or more of mutations recovered in each of the above mutational classes. This altered mutational specificity was accompanied by a failure to recover mutations frequently identified following PUVA treatment of the Uvr+ strain. These mutations include spontaneous-hotspot frameshifts involving the gain or loss of a tetramer 5'-CTGG-3' repeated three times at position 620 to 631; and minus A.T base-pair frameshifts recovered at potential T T crosslink sites. These results indicate that while crosslinks may play a substantial role in the induction of mutation in the Uvr+ strain, they do not contribute substantially to mutagenesis in the UvrB- strain. In addition, the data also suggest that excision repair may not always occur in an error-free manner. PMID- 3309327 TI - Effects of overproduction of single-stranded DNA-binding protein on RecA protein dependent processes in Escherichia coli. AB - Overproduction of single-stranded DNA-binding protein (SSB) in Escherichia coli led to a decrease in the basal level of repressor LexA. Expression of the LexA controlled genes was increased differentially, depending on the affinity of the LexA repressor for each promoter: expression of the recA and sfiA genes was increased 5-fold and 1.5-fold, respectively. Despite only a slight effect on expression of sfiA, which codes for an inhibitor of cell division, bacteria overproducing SSB produced elongated cells. In fact, the effect on cell shape appeared to be essentially independent of the expression of the sfiA and recA genes. Bacteria overproducing SSB were therefore phenotypically similar to bacteria partially starved of thymine, in which filamentation results from both sfiA-dependent and sfiA-recA-independent pathways. These data indicate that excess SSB acts primarily by perturbing DNA replication, thereby favoring gratuitous activation of RecA protein to promote cleavage of LexA protein. When bacteria overproducing SSB were exposed to a DNA-damaging agent such as ultraviolet light or mitomycin C, the recA and sfiA genes were fully induced. Induction of the sfiA gene occurred, however, at higher doses in bacteria overproducing SSB protein than in bacteria with normal levels of SSB. Whereas the efficiency of excision repair was apparently increased by excess SSB, the efficiency of post-replication recombinational repair was reduced as judged by a decrease in the recombination proficiency between a prophage and ultraviolet irradiated heteroimmune infecting phage. Following induction of ssb+ bacteria with mitomycin C, the cellular content of SSB was slightly increased. These results provide evidence that SSB modulates RecA protein-dependent activities in vivo. It is proposed that SSB favors the formation of short complexes of RecA protein and single-stranded DNA that mediate cleavage of the LexA and lambda repressors, while it delays the formation of long nucleoprotein filaments, thereby slowing down RecA-promoted recombinational events in uninduced as well as in induced bacteria. PMID- 3309328 TI - Asymmetric segregation of heat-shock proteins upon cell division in Caulobacter crescentus. AB - Three Caulobacter crescentus heat-shock proteins were shown to be immunologically related to the Escherichia coli heat-shock proteins GroEL, Lon and DnaK. A fourth heat-shock protein was detected with antibody to the C. crescentus RNA polymerase. This 37,000 Mr heat-shock protein might be related to the E. coli 32,000 Mr heat-shock sigma subunit. The synthesis of the major C. crescentus RNA polymerase sigma factor was not induced by heat shock. The E. coli GroEL protein and the related protein from C. crescentus were also induced by treatment with hydrogen peroxide. Like some of the proteins in the heat-shock protein families of Drosophila and yeast, the four heat-shock proteins in C. crescentus were found to be regulated developmentally under normal conditions. All four proteins were synthesized in the predivisional cell, but the progeny showed cell type-specific bias in the level of enhanced synthesis after heat shock. The 92,000 Mr Lon homolog and the 37,000 Mr RNA polymerase subunit were preferentially synthesized in the stalked cell, whereas the synthesis of the 62,000 Mr GroEL homolog was enhanced in the progeny swarmer cell. Furthermore, the four heat-shock proteins synthesized in the predivisional cell were partitioned in a specific manner upon cell division. The stalked cell, which initiates chromosome replication immediately upon division, received the Lon homolog, the DnaK homolog and the 37,000 Mr RNA polymerase subunit. The GroEL homolog, however, was distributed equally to both the stalked cell and the swarmer cell. These results provide access to the functions of C. crescentus heat-shock proteins under both normal and stress conditions. They also allow an investigation of the regulatory signals that modulate the asymmetric distribution of proteins and their subsequent cell type-specific expression in the initial stages of a developmental program. PMID- 3309329 TI - Silent and functional changes in the periplasmic maltose-binding protein of Escherichia coli K12. II. Chemotaxis towards maltose. AB - We examined the chemotactic behavior of ten Escherichia coli mutants able to synthesize a modified periplasmic maltose-binding protein (MBP) retaining high affinity for maltose. Eight were able to grow on maltose (Mal+), two were not (Mal-). In the capillary assay six out of eight of the Mal+ strains showed an optimal response at the same concentration of maltose as the wild-type strain; the amplitude of the response was strongly reduced in two Mal+ mutants and partially affected in one. The amplitude of the chemotactic response of the two Mal- strains was at least equal to that of the wild type, so that the chemotactic and transport functions of MBP were dissociated in these two cases. We define two regions of the protein (residues 297 to 303 and 364 to 369), that are important both for the chemotactic response and for transport, and one region (residues 207 to 220) that is essential for transport but dispensable for chemotaxis. Interestingly, some regions that were found to be inessential for transport are also dispensable for chemotaxis. PMID- 3309330 TI - Three-dimensional crystals of the light-harvesting chlorophyll a/b protein complex from pea chloroplasts. AB - Two forms of three-dimensional crystals of the light-harvesting chlorophyll a/b protein complex from pea have been obtained. Crystals of one form grew as hexagonal plates measuring up to 150 micron across and 2 to 3 micron in thickness. Electron diffraction patterns of thin hexagonal plates showed sharp reflections to a resolution of 3.7 A on a hexagonal reciprocal lattice. The unit cell in projection (a = 127.0 A) and the symmetry of the diffraction pattern (6 mm) suggested that the hexagonal plates were highly ordered stacks of two dimensional crystals suitable for structure analysis by electron microscopy and image processing. Crystals of a second form grew as dark green octahedra measuring roughly 0.5 mm across. Low-resolution X-ray diffraction patterns suggested a large cubic unit cell (a = 390 A). SDS/polyacrylamide gel electrophoresis of single octahedral crystals showed the same polypeptide composition as the starting solution, one major band at 24,000 apparent molecular weight and two satellite bands of 23,000 and 23,500 apparent molecular weight. PMID- 3309331 TI - Structure and expression of an alcohol dehydrogenase 1 gene from Pisum sativum (cv. "Greenfeast"). AB - Three genomic clones for anaerobically inducible alcohol dehydrogenase (Adh) have been isolated from Pisum sativum cv. "Greenfeast" via cDNA cloning. One of these contains a complete gene, has exon sequences corresponding to one of the cDNA sequences and is likely to be an expressed gene. This gene has a structure similar to the Adh genes of maize, with introns in the same positions in the coding sequence but differing in their lengths and nucleotide sequences. At the nucleotide level the coding sequence is 75% homologous to both maize Adh1 and Adh2 and 80% homologous to the Adh gene from Arabidopsis, but has an extra coding triplet in exon 1 that is not found in the other plant Adh genes. The non translated regions of all the gene transcripts are widely divergent between species. A short segment of the pea Adh promoter region (-290 to +57) was fused to a reporter gene and introduced into protoplasts of Nicotiana plumbaginifolia by electroporation. Transient expression of the introduced gene increased markedly when the transfected protoplasts were incubated under anaerobic conditions, showing that cis-acting regulatory signals necessary for anaerobic control of expression reside in the -290 to +57 segment. Sequence comparisons between this region and the corresponding regions of maize and Arabidopsis Adh genes have identified short sequences that may be involved in the anaerobic regulation of plant Adh genes. PMID- 3309333 TI - All three elements of the lac ps promoter mediate its transcriptional response to DNA supercoiling. AB - The supercoiling response of four closely related promoters was examined in vitro. It was found that changes in all three elements of the lac ps promoter, i.e. the -10 sequence, the -35 sequence, and the spacer length, alter the transcriptional response to DNA supercoiling. Thus, the promoter as a whole, not just the melted region, mediates the supercoiling response. It is proposed that DNA supercoiling changes the structure of the promoter DNA to a form that can be recognized by RNA polymerase and then easily melted. All four promoter variants tested show the same qualitative response to the introduction of DNA supercoiling; that is, transcription is increased compared to relaxed DNA. However, for three of the four promoters, the rate peaked at intermediate levels of supercoiling and declined at higher superhelicities. Each mutation was found to alter both the extent of stimulation that can be achieved and the amount of superhelicity associated with maximal stimulation. The trend is that the stronger promoters are stimulated less, and this maximal stimulation occurs on templates containing fewer superhelical turns. At the level of supercoiling that may pertain in vivo, changes in superhelicity would result in considerable differential changes in the strengths of these promoters. PMID- 3309332 TI - Comparison of the tertiary structure of yeast tRNA(Asp) and tRNA(Phe) in solution. Chemical modification study of the bases. AB - A comparative study of the solution structures of yeast tRNA(Asp) and tRNA(Phe) was undertaken with chemical reagents as structural probes. The reactivity of N-7 positions in guanine and adenine residues was assayed with dimethylsulphate and diethyl-pyrocarbonate, respectively, and that of the N-3 position in cytosine residues with dimethylsulphate. Experiments involved statistical modifications of end-labelled tRNAs, followed by splitting at modified positions. The resulting end-labelled oligonucleotides were resolved on polyacrylamide sequencing gels and analysed by autoradiography. Three different experimental conditions were used to follow the progressive denaturation of the two tRNAs. Experiments were done in parallel on tRNA(Asp) and tRNA(Phe) to enable comparison between the two solution structures and to correlate the results with the crystalline conformations of both molecules. Structural differences were detected for G4, G45, G71 and A21: G4 and A21 are reactive in tRNA(Asp) and protected in tRNA(Phe), while G45 and G71 are protected in tRNA(Asp) and reactive in tRNA(Phe). For the N-7 atom of A21, the different reactivity is correlated with the variable variable loop structures in the two tRNAs; in the case of G45 the results are explained by a different stacking of A9 between G45 and residue 46. For G4 and G71, the differential reactivities are linked to a different stacking in both tRNAs. This observation is of general significance for helical stems. If the previous results could be fully explained by the crystal structures, unexpected similarities in solution were found for N-3 alkylation of C56 in the T-loop, which according to crystallography should be reactive in tRNA(Asp). The apparent discrepancy is due to conformational differences between crystalline and solution tRNA(Asp) at the level of the D and T-loop contacts, linked to long-distance effects induced by the quasi-self-complementary anticodon GUC, which favour duplex formation within the crystal, contrarily to solution conditions where the tRNA is essentially in its free state. PMID- 3309334 TI - Regulation of mini-F plasmid DNA replication. A quantitative model for control of plasmid mini-F replication in the bacterial cell division cycle. AB - A quantitative model for the regulation of replication of plasmid mini-F in the Escherichia coli cell division cycle has been developed. The essential repE gene of mini-F encodes a polypeptide that serves both as a positive replication initiation protein and as a regulatory repressor protein. The mini-F regulatory processes include the interaction of repressor with an operator site in the autogenous control of transcription of the repE gene, and the binding of initiator to repeated DNA sequences located both downstream from the repE gene and at the replication origin. A statistical thermodynamic model was used to predict probable configurations of the regulatory processes in a single growing cell. These probabilities were coupled by a kinetic model to events of the cell cycle such as mRNA transcription and protein translation, and the initiation of plasmid DNA replication. Parameter values were chosen so that the simulated values for plasmid copy number and repressor and initiator protein concentrations of the model agreed with experimentally determined estimates for mini-F. Simulations of deviations from regular segregation of plasmid copies at cell division and of premature or delayed initiation of plasmid replication suggest that mini-F replication control responds rapidly and precisely to these perturbations. The simulations also accurately mimic the response of plasmid mini F to various plasmid copy number mutations and to various mini-F regulatory elements provided in trans. These simulations predict a stable pattern of inheritance for plasmid mini-F despite its low plasmid copy number, in agreement with experimental observation. PMID- 3309335 TI - Structural comparison of the yeast cell division cycle gene CDC4 and a related pseudogene. AB - The function of the cell division cycle gene, CDC4, is required in Saccharomyces cerevisiae for progression beyond the G1 phase of the cell cycle. The wild-type gene was isolated from a plasmid library by selection for complementation of a recessive, temperature-sensitive allele. Hybridization of genomic sequences with the cloned gene revealed the presence of a duplicated sequence. Both CDC4 and the duplicated sequence were subjected to DNA sequence analysis. These analyses revealed (1) that CDC4 contains a large open reading frame encoding a protein of 779 amino acids, and (2) that the duplicated sequence bears strong homology with the carboxy-terminal segment of this open reading frame. Presence of a nonsense codon within the duplicated sequence suggested that it does not encode a functional product. Disruption of the duplicated sequence within the yeast genome provided a more critical test for function. The absence of any detectable phenotype for this disruption confirms that the sequence should be considered a pseudogene. The marker inserted to disrupt the sequence also served to map the duplication and to establish that it is not genetically linked to CDC4. The structural features determined suggest evolutionary relationships between these genes as well as between the CDC4 product and other proteins. PMID- 3309336 TI - Bacteriophage P4 DNA replication. Nucleotide sequence of the P4 replication gene and the cis replication region. AB - A 3100 base piece of DNA from the 11,500 base genome of bacteriophage P4 was analyzed for its nucleotide sequence. This segment of DNA contains two open reading frames of 106 and 777 amino acid residues; the latter of which is the coding sequence for the Mr 84,841 alpha protein, which is necessary for P4 DNA replication and is thought to act as a P4-specific DNA primase. A region of about 300 base-pairs localized just beyond the alpha gene and about 4500 bases from the origin of replication (ori), was defined as the locus for P4's cis replication region (crr). This region is required for replication both in vivo and in vitro, and consists of two directly repeated sequences of 120 base-pairs that match one another at 98 positions. These directly repeated sequences are separated by 60 base-pairs, which are not necessary for replication. Each repeat in crr contains three copies of the octamer TGTTCACC that is found six times in ori. Either of the 120 base-pair repeat sequences in crr is sufficient for replication, and the entire crr can function in an inverted orientation. crr is also active at a distance of 1800 bases from the P4 origin of replication. PMID- 3309337 TI - Affinities of tight-binding lactose repressors for wild-type and pseudo operators. AB - Five tight-binding (Itb) mutants of the Escherichia coli lactose (lac) repressor have been characterized with regard to their non-specific affinity for DNA and their specific affinity for the wild-type operator and several sequence-altered (pseudo-) operators. Repressor-operator association rates were determined in the presence or absence of competitor DNA, dissociation rates of repressor from various DNA fragments were measured, and equilibrium competition for repressor binding was examined for several pseudo-operator DNAs. The mutant repressors exhibited increased non-specific affinity for DNA, and variable increases in affinity for sequence-altered operators. The known positions of amino acid substitutions for three of these Itb repressors support suggestions that residues 51 to 64 are important for operator recognition in addition to residues 1 to 50. PMID- 3309338 TI - Structure of the C-terminal domain of the ribosomal protein L7/L12 from Escherichia coli at 1.7 A. AB - The structure of a C-terminal fragment of the ribosomal protein L7/L12 from Escherichia coli has been refined using crystallographic data to 1.7 A resolution. The R-value is 17.4%. Six residues at the N terminus are too disordered in the structure to be localized. These residues are probably part of a hinge in the complete L7/L12 molecule. The possibility that a 2-fold crystallographic axis is a molecular 2-fold axis is discussed. A patch of invariant residues on the surface of the dimer is probably involved in functional interactions with elongation factors. PMID- 3309339 TI - Three-dimensional structure of the frozen-hydrated flagellar filament. The left handed filament of Salmonella typhimurium. AB - Electron micrographs of frozen-hydrated preparations of flagellar filaments of Salmonella typhimurium were used to obtain a three-dimensional reconstruction of the structure. The filaments were obtained from the mutant SJW1660, which produces straight, left-handed filaments. The subunits in this filament are thought to be all in the L-state. The structure consists of a set of 11 longitudinal segmented rods of density that lie at a radius of 70 A. The outermost feature of the filament is a set of knobs of density that project outward from the rods. The interior of the filaments consists of arms that extend inward radially from the segmented rods. The 11 segmented rods and their interconnections are noteworthy because current theories regarding filament structure involve switching of subunits between the L and R states co-operatively along the directions of the rods. PMID- 3309340 TI - Binding of Escherichia coli RNA polymerase to a promoter carrying mutations that stop transcription initiation. AB - The gal P2 promoter can be inactivated by point mutations located in the -10 hexamer sequence or immediately upstream from it. Mutations at either site reduce expression in vivo and prevent the formation, in vitro, of tight complexes with RNA polymerase that give a strong footprint and can initiate transcription. However, with a mutation upstream from the -10 region, RNA polymerase could still make a specific contact with gal promoter DNA as judged by interference with cleavage by restriction enzyme SfaNI at a site within the promoter. In contrast, with a mutation in the -10 hexamer sequence, RNA polymerase could not make this contact and does not interfere with restriction by SfaNI. PMID- 3309342 TI - Novel rpoA mutation that interferes with the function of OmpR and EnvZ, positive regulators of the ompF and ompC genes that code for outer-membrane proteins in Escherichia coli K12. AB - The expression of the ompF and ompC genes that code for major outer-membrane proteins of Escherichia coli is positively regulated by the products of the ompR and envZ genes. Recently, we isolated the ompR77 mutation, which suppresses the envZ11 mutation. In this work, a novel mutation that interferes with the suppression of the envZ11 mutation by ompR77 was isolated. The mutation was located in the rpoA gene that codes for the alpha subunit of DNA-dependent RNA polymerase. These results suggest that an interaction between the positive regulators and RNA polymerase is involved in the initiation of transcription of the ompF and ompC genes. In addition, the results suggest that during transcription the RNA polymerase migrates along DNA strands with the alpha subunit facing backward and the beta beta' subunits facing forward. PMID- 3309341 TI - Topological unwinding of strong and weak promoters by RNA polymerase. A comparison between the lac wild-type and the UV5 sites of Escherichia coli. AB - Two Escherichia coli control regions have been compared in their ability to be unwound by RNA polymerase during formation of the transcriptionally active ("open") complex: the wild-type control region, consisting of two overlapping binding sites P1 and P2, both weakly transcribed, and an "up" P1 mutant, the strong lac L8UV5 promoter. The final complexes were characterized by their topological unwinding, by DNase I and orthophenanthroline footprints, as well as by methylation of unpaired cytosine residues. At the wild-type control region, the RNA polymerase footprint is weak, and single-strand formation is incomplete and slow. The same signals are strong, complete and quickly established at lac L8UV5; yet the final complexes were found to be equally unwound (by 1.7 turns) in the absence of nucleotide substrates as well as during an abortive initiation cycle. At the lac wild-type region, open complex formation occurs slowly enough to permit the measurement of the extent of a single-stranded region and of topological unwinding during the latency period. Not all the final species are active and unwinding appears to precede, in time, full open-complex formation. At the lac UV5 promoter the same conclusion was reached by a different method involving those changes in the various parameters that characterize open-complex formation monitored by an abortive initiation assay, conducted at increasing levels of template superhelicity. From both approaches we conclude that, at these promoters, the formation of the single-stranded region occurs at the expense of a negative change in linking number, initially stored in a closed intermediate, perhaps as negative writhing. Furthermore, abortive transcription assays indicate that the specific initiation efficiency of the species stored at both promoters, P1 and P2, on the wild-type template is increased as a whole with increasing superhelicity (conversion of inactive species to active ones, increased efficiency of active ones). We conclude that negative supercoiling is not an extra-regulatory element of the lactose system, allowing modulation of expression of the wild-type promoter to the profit of P1. Instead, P2 and P1, in the absence of active catabolite receptor protein (CRP-cAMP), appear to be equally weak and to be equally affected by negative supercoiling in the range of superhelical densities examined. The physiological importance of the P1-P2 competition in the regulation of expression in this region is thus questioned. The major effect of CRP-cAMP stimulation appears to be the direct activation at the P1 promoter. PMID- 3309343 TI - Cloning and expression of the filamentous bacteriophage Pf1 major coat protein gene in Escherichia coli. Membrane protein processing and virus assembly. AB - A restriction fragment carrying the major coat protein gene (gene VIII) was excised from the replicative form (RF) DNA of the class II filamentous bacteriophage Pf1, which infects Pseudomonas aeruginosa. This fragment was cloned into the expression plasmid pKK223-3, where it came under the control of the tac promoter. In transformed Escherichia coli JM101 cells, in the presence of the inducer isopropyl-beta-D-thiogalactoside, the bacteriophage Pf1 gene was strongly expressed. The bacteriophage Pf1 coat protein displays the same pattern of negatively charged N-terminal region, hydrophobic middle region and positively charged C-terminal region as that of its counterpart in the class I bacteriophage fd, which infects E. coli, but otherwise the two proteins have no sequence homology. However, the Pf1 procoat protein was found to undergo processing and insertion into the E. coli cell inner membrane, like its fd counterpart, demonstrating that this part of the assembly process is the same for these different bacteriophages. The complete transcriptional unit, incorporating the tac promoter and rrnB transcription terminators flanking the Pf1 coat protein gene, was excised from the expression plasmid and cloned into the intergenic space of bacteriophage R252, an fd bacteriophage that carries an amber mutation in its own major coat protein gene. The Pf1 coat protein gene was again well expressed in infected E. coli cells but the chimeric bacteriophage had growth properties identical to those of the parent bacteriophage R252 on suppressor and non-suppressor strains of E. coli. The class I bacteriophage Pf1 coat protein evidently cannot be recognized by the class I bacteriophage assembly complex at or in the E. coli cell inner membrane, either at the point of initiation of assembly or during the elongation process. PMID- 3309344 TI - Limited co-operativity in protein-nucleic acid interactions. A thermodynamic model for the interactions of Escherichia coli single strand binding protein with single-stranded nucleic acids in the "beaded", (SSB)65 mode. AB - We present a statistical thermodynamic model ("tetramer/octamer" model) that describes the equilibrium binding of the Escherichia coli single strand binding (SSB) protein to single-stranded nucleic acids in its "beaded" binding mode, which seems to be equivalent to the high site size, (SSB)65 binding mode. The method of sequence-generating functions is used to derive the model, which accounts for the observation that clustering of bound SSB tetramers is limited to the formation of octamers, which have been observed as "beads" in the electron microscope. The model also accounts for the overlap of potential protein binding sites on the nucleic acid. The "tetramer/octamer" model is fully described by only three parameters: the site size, n; the intrinsic equilibrium constant, K; and the co-operativity parameter, omega, and we obtain exact, closed form expressions for the binding isotherm as well as the distribution of DNA-bound SSB tetramers and octamers. The closed form expressions allow one to calculate easily average binding properties and analyze experimental binding isotherms to obtain estimates of K and omega. In order to test the tetramer/octamer model, we have determined the equilibrium binding isotherm for the E. coli SSB protein-poly(U) interaction in 0.2 M-NaCl over a wide range of binding densities. These are conditions in which the low co-operativity (SSB)65 binding mode solely exists. The tetramer/octamer model provides a much better description of the experimental isotherm over the entire binding density range than a model that assumes the formation of clusters of unlimited size. A co-operativity parameter of omega = 420 +/- 80 provides a good fit to data for SSB binding to poly(dA) and poly(U), corresponding to an interaction free energy of -3.6 kcal/mol of SSB octamer formed. On the basis of this moderate value of omega, the tetramer/octamer model predicts that at low to intermediate binding densities, a significant fraction of bound SSB exists in the form of tetramers co-existing with octamers. In the case of E. coli SSB protein binding in the "beaded", (SSB)65 mode this model provides a significant improvement over previous treatments which assume unlimited nearest neighbor interactions, since the binding parameters, K and omega, represent physically meaningful interaction constants rather than fitting parameters. PMID- 3309345 TI - Ribosomal proteins EL11 from Escherichia coli and L15 from Saccharomyces cerevisiae bind to the same site in both yeast 26 S and mouse 28 S rRNA. AB - The heterologous interaction of Escherichia coli ribosomal protein EL11 with yeast 26 S and mouse 28 S rRNA was studied by analysing the ability of this protein to form a specific complex with various synthetic rRNA fragments that span the structural equivalent of the EL11 binding site present in these eukaryotic rRNAs. The fragments were obtained by SP6 polymerase-directed in-vitro run-off transcription of parts of the yeast or mouse large rRNA gene cloned behind the SP6 promoter. EL11 was found to protect an oligonucleotide fragment of 63 nucleotides from both the yeast and mouse transcripts against digestion by RNase T1. In both cases, the position of this fragment in the L-rRNA sequence coincides almost exactly with that of the fragment previously found to be protected by EL11 in E. coli 23 S rRNA. Moreover, the protected yeast fragment was shown to be able to re-bind to EL11 by a nitrocellulose filter binding assay. A ribosomal protein preparation from Saccharomyces cerevisiae containing L15 (YL23) as well as the acidic proteins L44', L44 and L45 protects exactly the same oligonucleotide fragment as does EL11 in both the yeast and mouse transcripts. Evidence is provided that L15, which is known to be structurally and functionally equivalent to EL11, is the rRNA-binding protein in this preparation. Thus the structural equivalent of the EL11 binding site present in yeast 26 S rRNA constitutes the second example of functional conservation of a ribosomal protein binding site on rRNA between prokaryotes and eukaryotes. PMID- 3309347 TI - Crystallization, preliminary X-ray study and crystal activity of the hydrogenase from Desulfovibrio gigas. AB - Hydrogenase (EC 1.12) from Desulfovibrio gigas is a dimeric enzyme (26 and 62 (X 10(3) Mr) that catalyzes the reversible oxidation of molecular hydrogen. Single crystals of hydrogenase have been produced using the hanging drop method, with either PEG (polyethylene glycol) 6000 or ammonium sulfate as precipitants at pH 6.5. X-ray examination of the crystals indicates that those obtained with ammonium sulfate are suitable for structure determination to at least 3.0 A resolution when synchrotron radiation Sources are used (1 A = 0.1 nm). The crystals are monoclinic, with space group C2, and cell dimensions a = 257.0 A, b = 184.7 A, c = 148.3 A and beta = 101.3 degrees, and contain between four and ten molecules per asymmetric unit. The enzyme can be reactivated within the crystals under reducing conditions without crystal damage. PMID- 3309346 TI - A set of positively regulated flagellar gene promoters in Caulobacter crescentus with sequence homology to the nif gene promoters of Klebsiella pneumoniae. AB - The study reported here describes nuclease S1 mapping of the in-vivo transcription start sites of transcription units I and III of the hook gene cluster of Caulobacter crescentus. We show that transcription units I and II of this flagellar (fla) gene cluster, which have divergent promoters with transcription start sites separated by 218 nucleotides, are under positive transcriptional control by genes in transcription unit III. The promoters of transcription units I, II, and III were compared with flagellin gene promoters P25, P27 and P29 recently identified in C. crescentus. Promoters PII, P25, and P27, which are under positive regulation by transcription units III to V have strongly conserved sequence elements at -13 and -24 with the consensus sequence (C/T)TGGC(C/G)C-N5-TTGC. The -13, -24 sequence elements are not well conserved in promoter PI, but the promoter does contain a copy of the -13 and -24 consensus sequence 23 base-pairs upstream (PI). The C. crescentus fla gene promoters are not homologous to the canonical Escherichia coli -10, -35 promoter sequence, but they are very similar to the -12, -24 nif gene promoter sequence reported for Klebsiella pneumoniae and Rhizobium sp. The four positively regulated fla gene promoters examined here also share a third conserved element designated II-1, with the consensus sequence C-C-CGGC--AAA--GC-G, located at approximately -100. We speculate that the conserved sequence elements mapping at -13, -24 and -100 are cis-acting regulatory elements required for the transcription and periodic regulation of these fla genes in the C. crescentus cell cycle. PMID- 3309348 TI - Structure of the rat L-type pyruvate kinase gene. AB - The total sequence of a 13,021 base-pair (bp) genomic fragment containing the rat L-type pyruvate kinase (L-PK) gene was determined by "shot gun" sequencing. This fragment includes 8360 bp of the L-PK gene, plus 3193 bp of the 5'-flanking and 1468 bp of the 3'-flanking regions. Like the chicken PK-M1 gene, the rat L-PK gene exhibits a fully conserved exon-intron structure, with 11 exons and 10 introns. In the chicken M1 gene, the coding sequences are well conserved (about 70%), in particular at the level of the exons implicated in the formation of PK active sites, exons that are also partially homologous to the corresponding sequences of the yeast gene. Various types of repetitive sequences exist in the L PK gene, especially two ID (identifier) sequences located in the second intron and the 11th exon. Elements very similar to the "cyclic AMP-dependent regulatory element" recently described in the phosphoenolpyruvate carboxykinase and somatostatin genes are found in the sequenced fragment, but far upstream (-2338) and downstream (+5788) from the cap site. Various sequences homologous to described regulatory elements (glucocorticoid regulatory elements, enhancers, potential Z-DNA) are also observed 5' and 3' of the cap site. A comparison of the 5'-flanking region of the L-PK gene with the same regions of liver-specific or non-specific, cyclic-AMP-responsive or non-responsive genes was also made. It revealed various potentially interesting features that will be used to guide a further functional study. The cap site was determined by primer extension and nuclease S1 mapping using either mature mRNA or precursor RNA as templates. With both templates the start site of transcription appeared to be microheterogeneous, 19 to 14 bp before the ATG translation initiation codon. PMID- 3309350 TI - Isolation and properties of transcribing ternary complexes of Escherichia coli RNA polymerase positioned at a single template base. AB - We have studied the conditions needed for the formation of stable ternary complexes by Escherichia coli RNA polymerase using a procedure in which elongation by the majority of active enzyme molecules is halted at a specific template base. Stable complexes of this sort, containing RNA chains as short as 15 nucleotides, have been formed from three different promoter sites (T7 A1, lambda PL, and E. coli rrnB P1) using di- and trinucleotides as primers in reactions limited by the presence of only three of the nucleoside triphosphate substrates. The resulting ternary complexes can be stored for at least five days without loss in activity, and provide useful reagents and substrates for studies of the properties of RNA polymerases engaged in chain elongation and termination. At all three promoter sites abortive initiation, leading to synthesis and release of oligomers up to ten nucleotides, competes with productive initiation, leading to the formation of stable elongating complexes. Thus the relative instability of ternary RNA polymerase complexes bearing transcripts shorter than ten nucleotides may be a general feature of the transcription initiation reaction. PMID- 3309349 TI - Analysis of side-chain orientations in homologous proteins. AB - The side-chain conformations of topologically equivalent residues in seven pairs of proteins ranging in sequence homology from 16% to 60% are compared. Both identical and mutated residues are included. For proteins with greater than 40% homology, it is found that at least 80% of the side-chain orientations of identical residues and 75% or more of the mutated residues in each pair of proteins have matching gamma atom dihedral angles (+/- 40 degrees); the comparison is not based strictly on chi 1 angles. Further, if a match is obtained at the gamma position, there is a high probability of matching for the delta atom(s) of the side-chain. For proteins with less than 25% homology the percentages are somewhat lower. Trends observed for conservative substitutions are essentially the same as those noted for mutated residues in general. Side chain accessibility does not affect the probability of matches of identical residues; however, less accessible pairs of mutated residues have 10 to 20% higher matching probabilities than do exposed residues. Mismatches can frequently be related to large B-factors, certain types of amino acid substitutions, or the appearance of multiple minima on the side-chain potential energy surfaces and are most likely to occur for certain small residues (Ser, Thr, Val). Analysis of all the results makes possible the formulation of a set of rules for side-chain positioning in the modeling of homologous proteins. PMID- 3309351 TI - Regulation of alpha operon gene expression in Escherichia coli. A novel form of translational coupling. AB - The alpha operon of Escherichia coli contains the genes for ribosomal proteins S13, S11, S4, RNA polymerase subunit alpha, and r-protein L17, in this order. Previous studies have shown that translation of all four ribosomal proteins is regulated by S4, and that binding of S4 to the mRNA at the start site for S13 translation is probably responsible for the regulation of translation of S13, S11 and S4. The alpha gene is "unique" in that it is located between the genes for two ribosomal proteins (S4 and L17) and yet appears to be regulated independently of them. In the present studies, we have measured the synthesis rates of all the alpha operon proteins under a variety of physiological conditions. Our results confirm that alpha gene expression is regulated independently of the co transcribed ribosomal protein genes and is relatively insensitive to translational feedback repression by S4. S1 nuclease analysis of alpha operon mRNA failed to reveal the presence of any unique transcription start or mRNA cleavage that leads to separation of the alpha cistron from preceding ribosomal protein cistrons. Therefore, it appears that differential regulation of alpha synthesis takes place at the level of mRNA translation. We have also carried out a deletion analysis of the alpha operon leader and identified a region of the alpha operon leader mRNA that is required for regulation by S4. Furthermore, deletion of this region results in increased synthesis of L17 together with S13, S11 and S4, whereas alpha synthesis did not increase significantly. Therefore, we conclude that interaction of S4 with this single target site results in translational repression of not only the proximal three cistrons for S13, S11 and S4 but also that of the last cistron, L17, without affecting the intervening alpha cistron. PMID- 3309352 TI - Insulin production following injury and sepsis. AB - It is known that alterations in insulin metabolism following injury and infection result in depression of insulin levels and the development of insulin resistance. In order to further study insulin during septic and traumatic stress, we estimated insulin production in control (Group 1, n = 6), postoperative (Group 2, n = 5), and postoperative-septic (Group 3, n = 8) human subjects by measuring the 24-hour urinary C-peptide excretion. In addition, basal and peak glucose and insulin levels in response to a standard (0.5 gm/kg) intravenous glucose stimulus were measured immediately thereafter to determine if insulin levels reflected insulin production. Basal insulin for Groups 1, 2, and 3 (16 +/- 8.4, 10 +/- 3.4, 9.5 +/- 4.4 microU/ml +/- SD, respectively) were not substantially different. Peak insulin response to glucose infusion declined from Groups 1 to 3 (51 +/- 14, 42.4 +/- 31, 20.4 +/- 6.8 microU/ml, respectively) with Group 3 exhibiting a significantly decreased mean peak level compared to the other groups. Corresponding C-peptide excretion rates increased from Groups 1 to 3 (28.3 +/- 15.3, 63.7 +/- 27.6, 121.3 +/- 95.2 micrograms/day, respectively) with Group 3 exhibiting a significantly (p less than 0.05) higher level than Group 1. These data suggest that low insulin levels which may be evident in injured or septic patients not in shock reflect increased clearance and not decreased production.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309353 TI - Clearing the cervical spine: initial radiologic evaluation. AB - The identification of unstable cervical spine injury (UCSI) in blunt high-energy transfer injury (BHETI) patients is critical to management. In a prospective study of BHETI patients identified to be at high risk for UCSI, the use of lateral cervical spine view (LCV), three-view cervical spine series (FCS), and limited computerized tomography (CT) in the initial evaluation of these patients was analyzed. Thirteen of 204 patients sustained UCSI. Sensitivity of the LCV alone was 0.85 and the predictive value of the negative test was 0.97. Sensitivity and predictive value of a negative study were maximized by the use of FCS combined with CT when plain X-rays were inadequate. We conclude that technically adequate, normal FCS can be safely used to eliminate the presence of UCSI. If these studies are technically inadequate, the addition of a limited CT can be used to "clear" the spine. PMID- 3309354 TI - Immunohistochemical localization of fibronectin and laminin in murine liver using protein A-gold technique at light microscopic level--a methodological study. PMID- 3309356 TI - An approach to stridor in infants and children. AB - Stridor is a clinical sign, common to many disease entities which may compromise the airway. Although stridor may herald a life-threatening condition, most patients have a minor self-limiting condition. Diagnosis based on the character of the stridor alone is tenuous, and consideration of presentation other than the stridor is discussed in the management of these infants. PMID- 3309355 TI - Distribution of group B streptococcal serotypes in Malaysia. AB - A total of 350 strains of group B streptococci (308 from adults and 42 from neonates) were serotyped. The majority of the isolates from adult patients were from the genito-urinary tract and most of the neonatal isolates were from babies less than 10 days old. Serotype III was the predominant type among all groups of patients and accounted for 50.9% of all serotypes. The second and third most frequently occurring serotypes were II and Ic respectively. Together with type III they made up 87% of the isolates. PMID- 3309357 TI - Management of the cleft palate child. AB - The rehabilitation of the child with cleft lip and cleft palate is a complex process requiring the interaction of many health professionals. Utilizing the team approach, a good cosmetic and functional result may be obtained, allowing the child to participate normally in society. PMID- 3309358 TI - Otitis media, 1987. AB - This paper summarizes current concepts in otitis media for the clinician. Otitis media with effusion appears to be a disease spectrum which follows one of four recognizable patterns in children. Recognition of such patterns assists the otolaryngologist in selecting appropriate medical or surgical treatment for the individual child. PMID- 3309359 TI - Research in pediatric otolaryngology: an overview. AB - Pediatric otolaryngology research, most of the time, relies on basic research in animals. This is especially evident when looking at the neonatal period on which this paper is mainly focused. Most of perinatal hearing pathologies are related to the existence of sensitive periods during development. Major improvements of evoked potential techniques have permitted early recognition of hearing losses. This paper also deals with problems involving secretory otitis media, laryngeal stenosis and drooling in crippled children. Finally, there is brief mention of future research domains: immunology and vestibular pathology. PMID- 3309360 TI - Inverted papillomas of the nose and paranasal sinuses in children. AB - Inverted papillomas are uncommon lesions in the nose and paranasal sinuses, especially in the pediatric age group. We report the occurrence of one case in a 13-year-old Chinese female. Review of the literature and conclusions about management of these lesions in children are provided. PMID- 3309361 TI - Button battery ingestion: a case report and review of the literature. AB - Disc batteries represent a distinct type of pediatric foreign body because of their potential for severe morbidity and mortality. We present the case of an 18 month-old boy who ingested a lithium battery and, despite a delay in diagnosis, had a favorable outcome. Button batteries are being used with increasing frequency in a variety of devices including hearing aids, watches and calculators. Most contain a heavy metal such as mercury, and an alkaline electrolyte. Esophageal impaction results in a corrosive esophagitis leading to perforation with the attendant sequelae. Injury may occur by four mechanisms: (1) electrolyte leakage from batteries; (2) alkali produced from external currents; (3) mercury toxicity, and (4) pressure necrosis. Early diagnosis and urgent removal are required for esophageal impaction. More distal sites can be managed conservatively with spontaneous passage occurring in the majority of cases. Prevention should be directed at placing the cells out of reach and child proofing battery-powered appliances. PMID- 3309362 TI - The biochemistry of African trypanosomes and its significance for chemotherapy. PMID- 3309363 TI - Flutamide eliminates the risk of disease flare in prostatic cancer patients treated with a luteinizing hormone-releasing hormone agonist. AB - Although chronic treatment with luteinizing hormone-releasing hormone agonists achieves castration levels without side effects other than those related to hypoandrogenism, a limitation to their use alone for the treatment of prostatic cancer is the transient increase in serum androgens that lasts for 5 to 8 days at the start of treatment with the risk of disease flare. Our data show that the concomitant administration of the pure antiandrogen flutamide in association with the luteinizing hormone-releasing hormone agonist (D-Trp6) luteinizing hormone releasing hormone ethylamide caused a 64 to 78 per cent decrease in serum prostatic acid phosphatase on days 3 and 7 after the start of treatment in 70 patients with previously untreated stage D2 prostatic cancer. Pain, which was present in 41 patients at the start of treatment, did not increase in any patient, it decreased in 7 at 1 week and it disappeared or decreased in 27 at 2 weeks. Performance, which originally was abnormal in 34 patients, became normal in 7 within 1 week and in 20 within 1 month (59 per cent). These data show that the addition of flutamide completely eliminates the risks of disease flare associated with the use of the otherwise exceptionally well tolerated luteinizing hormone-releasing hormone agonists in patients treated for prostatic cancer. PMID- 3309364 TI - Hypertension induced by occult renal tissue. AB - Hypertension was noted in 2 children thought to have a solitary kidney after multiple radiological studies. Aggressive diagnostic evaluation allowed for detection of occult contralateral renal tissue. Surgical removal of this parenchyma resulted in a return to normal blood pressure. PMID- 3309365 TI - Ileocecocystoplasty bladder augmentation and renal transplantation. AB - In 4 patients with a small contracted bladder and end stage renal failure ileocecocystoplasty bladder augmentation was done in conjunction with renal transplantation. All 4 patients have stable renal and bladder function 13 to 46 months after transplantation. In carefully selected patients bladder augmentation may be an alternative to urinary diversion. PMID- 3309366 TI - Ultrasound of polyorchidism: case report and literature review. AB - We report a case of polyorchidism that was suggested preoperatively by scrotal sonography. A review of the literature on this rare anomaly discloses a previously underemphasized association with malignancy. PMID- 3309367 TI - Monocyte cytolytic factor in promoting monocyte-mediated lysis of bladder cancer cells by bacillus Calmette-Guerin. PMID- 3309368 TI - Immunohistochemical localization of a prostatic secretory protein of 94 amino acids in normal prostatic tissue, in primary prostatic tumors and in their metastases. AB - Using the immunoperoxidase technique, we have studied in normal, hyperplastic and adenocarcinomatous prostates the tissue localization of an abundant 94 amino acid protein secreted by prostatic epithelial cells. In normal and hyperplastic prostates, strong immunoreactivity was found exclusively in glandular epithelial cells. No reaction was observed over the stroma. In well differentiated adenocarcinoma, the acinar cells were generally stained less intensely than in benign prostatic hyperplasia while in poorly differentiated tissue, strongly positive immunoperoxidase staining was found in some cancer cells scattered in the stroma. All prostatic cancer tissues examined (N = 21), with the exception of one, exhibited at least a few positive immunoreactive areas for the 94 amino acid secretory protein. In addition, immunoperoxidase staining was observed in lung and bone marrow metastases respectively in two patients with prostatic carcinoma. All other normal tissues and non-prostatic cancers studied to date were negative. These results suggest that this new marker could be a useful addition to prostatic acid phosphatase and prostate specific antigen. PMID- 3309369 TI - Antisperm antibodies bind with different patterns to sperm of different men. AB - Immunologic infertility is an important area of current clinical research. The immunobead test is a laboratory method that identifies the classes of antisperm antibodies and their binding sites on the sperm surface. In this study we have investigated the variability in the pattern of antibody binding to spermatozoa after passive transfer from blood serum. Serum from a single donor containing antisperm antibodies of the IgG class was used in all experiments. The spermatozoa from 27 semen donors were found to differ significantly in the degree and location of immunobead binding after exposure to this serum. There was substantial day-to-day variability in the results for individual semen donors and the overall variability in test results was significantly greater when a number of semen donors was used rather than a single donor. These data suggest that details of antisperm antibody binding after passive transfer from body fluids may depend on the sperm donor. The design of research studies involving antibody transfer must take this source of variability into account. PMID- 3309370 TI - F. Douglas Stephens: a pioneer in pathoembryology. PMID- 3309371 TI - Neonatal renomegaly. AB - A retrospective clinical review was done to study the value of ultrasound and renography in the investigation of 100 neonates with renomegaly. Abnormalities in 73 patients were detected antenatally with ultrasonography. Of the neonates 47 had lower urinary tract pathological conditions and ultrasound was more than 90 per cent accurate in identifying the accompanying ureteral dilatation. A total of 53 neonates had upper tract anomalies (ureteropelvic junction obstruction or cystic dysplasia). With ultrasonography the degree of pyelocaliectasis in patients with ureteropelvic junction obstruction was classified as mild (22 units), moderate (13) or severe (7). Initial treatment and followup were reviewed to study the clinical course of neonates with mild to moderate degrees of pyelocaliectasis followed nonoperatively, and to determine whether the diuretic renogram had a predictive role in identifying which kidneys were most likely to deteriorate. PMID- 3309372 TI - In-office ultrasonography to image the kidneys and bladder of children. AB - We present the first experience with in-office ultrasonography to further the office evaluation of children with urological problems. Since February 1986 we imaged prospectively the kidneys and bladders of 172 children (100 boys and 72 girls, mean age 6 years) who presented for office evaluation using a portable 5 MHz. real-time linear array scanner. Initially, we gained familiarity with in office ultrasonography by examining 38 children who presented for evaluation of problems not recognized to be associated with renal malformations (that is undescended testis). In-office ultrasonography showed hydronephrosis in 1 boy with a buried penis that was found later to be owing to ureteropelvic junction obstruction requiring pyeloplasty. Then, in-office ultrasonography was used to supplement the office evaluation of children with a history of urine infection, voiding problems or known malformations of the kidney and/or bladder. The test showed that 12 of 24 children (50 per cent) with a history of urine infection had a thickened detrusor, large bladder capacity with or without residual urine or reduced sensation to void. In-office ultrasonography also showed that 24 of 74 children (32 per cent) with voiding problems had a thickened detrusor, large bladder capacity with or without residual urine, fecal impaction, suspected bladder neck obstruction (which later required internal urethrotomy) or small bladder capacity. In 35 children with known malformations of the urinary tract in office ultrasonography was useful to assess the progress of hydronephrosis (29) or to clarify the etiology of the hydronephrosis (4). The diagnostic value of this test was evaluated in 98 children in whom enough data were available to compare the results to those of subsequent urography or clinical outcome. In office ultrasonography had a 98 per cent sensitivity and an 82 per cent specificity rate. We conclude that in-office ultrasonography is a reliable means to identify incomplete bladder emptying in children with urine infection related to dysfunctional voiding, identify detrusor thickening related to the unstable bladder and indicate the likely etiology of hydronephrosis. PMID- 3309373 TI - Bilateral neonatal torsion. AB - Extravaginal neonatal torsion of the spermatic cord, although rare, is being recognized with increasing frequency. Bilateral neonatal torsion is even more uncommon. Only 1 previous case of asynchronous neonatal torsion has been reported. Controversy exists concerning the urgency of exploration as well as the need for contralateral orchiopexy, since some reports suggest that the contralateral testicle is not at risk for torsion. We present 4 consecutive cases of bilateral neonatal torsion seen between 1966 and 1986. Two cases were asynchronous, 1 of which with a previously normal-appearing contralateral gonad was rendered anorchid. In the other patient a testicle was salvaged by prompt intervention. We have adopted a policy of prompt exploration with contralateral orchiopexy in all cases of unilateral neonatal torsion. Treatment of the ipsilateral testicle is determined by operative findings. PMID- 3309374 TI - Renal dysgenesis and cystic disease of the kidney: a report of the Committee on Terminology, Nomenclature and Classification, Section on Urology, American Academy of Pediatrics. AB - We believe that the confusion regarding abnormal renal development could be reduced by more precise terminology. Therefore, we suggest precise definitions for dysgenesis, hypoplasia, dysplasia, hypodysplasia, aplasia and agenesis of the kidney. We suggest the term reflux nephropathy be a generic label for any instance of abnormal renal morphology (gross or microscopic) associated with vesicoureteral reflux. Hypoplasia and hypodysplasia can be subclassified on the basis of associated urological criteria. There have been many previous attempts to classify cystic disease of the kidney but none has been accepted collectively by pathologists, urologists, nephrologists and radiologists. On the basis of known patterns of inheritance, a classification is outlined in which renal cystic disease is divided into 2 major groups: genetic and nongenetic. Each entity is discussed. PMID- 3309375 TI - The use of bladder mucosa and combined bladder mucosa/preputial skin grafts for urethral reconstruction. AB - Autologous bladder mucosa was used as a free graft for urethral reconstruction in 47 patients. However, in some cases the graft extended to the tip of the penis and became exposed to air. The resultant columnar metaplasia and hypertrophic changes in the mucosa produced stickiness and occlusion of the meatus. As a result a combined graft has superceded the simple mucosal graft for urethral substitution extending to the tip of the penis. The terminal few millimeters of such a graft are fashioned from preputial or penile skin, and they prevent exposure of the bladder mucosa to air. Our initial results are encouraging, although followup is short. PMID- 3309376 TI - Epididymitis in infants and boys: underlying urogenital anomalies and efficacy of imaging modalities. AB - Of 47 children diagnosed as having epididymitis between 1975 and 1985, 8 of 17 prepubertal patients (47 per cent, or 17 per cent of the total group), including 3 of 4 infants (75 per cent), had an underlying urogenital anomaly. Thus, patients with epididymitis secondary to an underlying anomaly present at an earlier age. The common finding in patients with underlying anomalies was a pathological connection between the urinary tract and the genital duct system or bowel. Coliform urinary infections predominated in patients with underlying anomalies (4 of 6). Although a positive urine culture suggested an underlying anomaly (positive predictive value 0.60), a negative culture virtually ruled out an anomaly (negative predictive value 1.00). Of the 8 patients with underlying anomalies 6 underwent voiding cystourethrography and 6 underwent excretory urography, and the diagnosis was established in 6 (100 per cent) and 4 (67 per cent), respectively. Thus, voiding cystourethrography has the greatest diagnostic yield. Any prepubertal patient with epididymitis merits a complete urological evaluation, including a urine culture, voiding cystourethrography and excretory urography to rule out an underlying urogenital anomaly, which often is amenable to an operation. Surgery often involves severance of the pathological urogenital or urinary-fecal connection and it was successful in 7 of our 8 patients. PMID- 3309377 TI - Inhibition of protein glycosylation causes renal dysplasia in the chick embryo. AB - The pathogenesis of renal dysplasia, a common congenital renal malformation, remains poorly understood. However, the disease is believed to represent failure of normal renal morphogenesis. Recently, it has been demonstrated that a shift in the composition of the extracellular matrix from an interstitial type to a basement membrane type heralds induction of the renal mesenchyme. In addition, 2 agents that inhibit glycosylation of extracellular matrix glycoconjugates, 6 diazo-5-oxonorleucine and tunicamycin, prevent induction of tubules in vitro. To investigate the relationship between failure of tubulogenesis and renal dysplasia experimentally, we used these inhibitors as potential teratogens and examined the resultant effects of the renal distribution of 2 extracellular matrix constituents: laminin, a basement membrane glycoprotein, and fibronectin, an interstitial glycoprotein. We documented the normal shift in the distribution of laminin and fibronectin during tubulogenesis. Fibronectin, prominent in undifferentiated mesenchyme, tended to disappear during development, while laminin appeared in increasing amounts within differentiating tubules. Renal rudiments (7 to 9 days of incubation) were exposed to tunicamycin, 6-diazo-5-oxo norleucine or control media in vitro and then they were permitted to develop further as grafts in ovo. In 127 surviving grafts those treated at 8 days of incubation for 48 hours most often were dysplastic: 12 of 18 (67 per cent) tunicamycin versus 3 of 16 (19 per cent) control media (p less than 0.025) and 8 of 13 (62 per cent) 6-diazo-5-oxo-norleucine versus 2 of 16 (12 per cent) control media (p less than 0.025). Most rudiments exposed to 6-diazo-5-oxo-norleucine or tunicamycin for only 24 hours at 8 days of incubation or at 7 or 9 days of incubation were not dysplastic. Finally, 4 chick kidneys with induced dysplasia and 2 fresh surgical specimens with dysplasia were stained for laminin and fibronectin with indirect immunofluorescence and all showed abnormal distributions of both glycoproteins. These results support existing theories that dysplasia is the result of a disruption in normal epithelial-mesenchymal interaction during the induction of renal tubules. PMID- 3309378 TI - An operation to create a continent catheterizable urinary sphincter from a short intestinal segment: experimental observations. AB - We describe a new operation to create a continent, catheterizable urinary sphincter from a short segment of ileum. The sphincter has provided continence over a wide range of bladder pressures in dogs and it may be adapted to a variety of clinical continence requirements. PMID- 3309380 TI - Aortoesophageal fistula: case report and literature review. AB - Fistulous communication between the aorta and esophagus is a rare but usually fatal disorder. Esophageal foreign bodies have been reported to cause aortoesophageal fistula rarely. Spontaneous aortoesophageal fistula as a result of atherosclerotic disease of the aorta has not been reported. This article describes a case of aortoesophageal fistula caused by an ulcerated atherosclerotic plaque, which we believe is the first case report implicating such an etiologic factor. PMID- 3309379 TI - Recurrent carotid stenosis after autologous tissue patching. AB - This study was carried out to evaluate two techniques of widening the carotid bifurcation with autologous material after endarterectomy to determine whether the incidence of recurrent stenosis could be reduced. As a control, a similar series was performed without patching. Autologous saphenous vein was used as a patch in one group of patients, whereas in another, the bifurcation was widened by suturing the external carotid to the internal carotid artery, advancing the bifurcation by several centimeters, a technique we termed bifurcation advancement. All three groups were studied at least 1 year after operation by means of Doppler ultrasonography. We found no difference in either of the patched techniques compared with unpatched controls. Significant recurrent stenosis (greater than 50% diameter reduction) was found in 12.5% of reconstructions with a vein patch, 12.5% of those with bifurcation advancement, and 16.6% of those with simple closure. The overall incidence of significant recurrent stenosis was 13.8%, with symptoms occurring in 2.7%. PMID- 3309381 TI - Fungal graft infections: case report and review of the literature. AB - Fungal intravascular graft infections are rare. In addition to our case, which forms the basis of this article, only 13 documented instances could be found in the literature in the 20-year period from 1966 to 1986. Three of these cases (21%) had both fungus and bacteria grown in culture. Candida and Aspergillus species constituted most of the infecting organisms (79%). There was no obvious difference in the clinical presentations between fungal and bacterial infections. In two cases (14%), there was a strong predisposition toward fungal infection: one in a patient with pulmonary histoplasmosis and one in a patient with leukemia. Appropriate intervention appears to be graft excision and extra anatomic bypass with concomitant therapy with amphotericin B. Survival with this approach was 84%, whereas other methods yielded a survival rate of 20%. PMID- 3309382 TI - Chylous ascites after abdominal aortic aneurysmectomy: successful management with a peritoneovenous shunt. AB - Postoperative chylous ascites is a rare complication of aortic aneurysmectomy. Although increasing numbers of abdominal aortic aneurysms are being resected annually, there have been only eight previously reported cases of chylous ascites after this operation. This article describes the ninth case of postoperative chylous ascites after abdominal aortic aneurysm resection and emphasizes the value of management with peritoneovenous shunting. PMID- 3309383 TI - Aortic thrombosis with paraplegia: an unusual consequence of blunt abdominal trauma. AB - Aortic thrombosis occurring after blunt abdominal trauma is a rare but recognized event. Most of these patients present with progressive and profound neurologic compromise. Successful management requires early diagnosis, maintenance of hemodynamic stability, and prompt revascularization. Despite appropriate management a large percentage of these patients (unprotected by heparin or collateral vessels) will remain paraplegic. PMID- 3309384 TI - Primary aortoduodenal fistula caused by Salmonella aortitis. AB - We report the management and follow-up of two cases of primary aortoduodenal fistulas caused by Salmonella aortitis. The origin, presentation, diagnosis, and results of operative therapy for patients with primary aortoduodenal fistulas, especially patients with positive aortic wall cultures, are reviewed. Successful therapeutic principles included early intervention, primary duodenal repair, aneurysm resection, aortic reconstruction with an in situ Dacron graft, and prolonged courses of bactericidal antibiotics. PMID- 3309385 TI - Can carotid duplex scanning supplant arteriography in patients with focal carotid territory symptoms? PMID- 3309388 TI - Alprazolam abuse and methadone maintenance. PMID- 3309386 TI - Physicians, AIDS, and occupational risk. Historic traditions and ethical obligations. AB - The profound reluctance of some physicians to care for patients with acquired immunodeficiency syndrome prompted us to review medical responses to other historic plagues. No consistent professional tradition emerged. Many physicians, including Galen and Sydenham, fled from patients with contagious epidemic diseases. Many of their colleagues, at considerable personal risk, remained behind to care for plague victims. This inconsistency suggests that an ethic stressing traditional professional duties may not be ideal for defining the optimal relation of the medical profession to patients with acquired immunodeficiency syndrome. A new professional ethic to guide physicians in the acquired immunodeficiency syndrome pandemic is needed. This ethic cannot be entirely derived from these patients' right to health care, which is primarily a claim against society rather than individual practitioners. Civil and professional proscriptions against negligence or abandonment apply only to therapeutic relationships after they are contracted. However, a professional duty to treat human immunodeficiency virus-infected persons could be based on the understanding of medicine as a moral enterprise. In this context, treating human immunodeficiency virus-infected persons is a virtuous act, which meets both patients' and society's health needs and affirms the moral mission of health care. PMID- 3309387 TI - The consequences of uncertainty. An empirical approach to medical decision making in neonatal intensive care. PMID- 3309389 TI - Tobacco, alcohol, and cancer. PMID- 3309390 TI - Issues in employee drug testing. Council on Scientific Affairs. PMID- 3309391 TI - Intradermal bullous dermatitis due to candidiasis in an immunocompromised patient. PMID- 3309392 TI - Transfusion medicine. The evolution of a new discipline. PMID- 3309393 TI - It sounds glamorous, but TV celebrity status offers physician little respite. PMID- 3309394 TI - Newspapers' physician-reporters focus on finding facts, not offering own professional advice. PMID- 3309395 TI - Gerald Weissmann: belletrist in the laboratory. PMID- 3309397 TI - [Thermodynamic interpretation of molecular mechanism of anesthesia]. PMID- 3309396 TI - It doesn't always require a medical degree to report medicine's story to the public. PMID- 3309399 TI - [Clinical evaluation of sevoflurane vs enflurane--a multi-center well-controlled study]. PMID- 3309398 TI - [Clinical evaluation of sevoflurane--a multi-center clinical trial]. PMID- 3309400 TI - [The effects of prostaglandin I2 on coronary circulation in experimental canine ischemic heart during isoflurane anesthesia]. PMID- 3309401 TI - [Intravenous digital subtraction angiography in occlusive arterial diseases: comparison with conventional angiography]. PMID- 3309403 TI - [Learning from practice and progress achieved by midwives in the past (4). Interviews with midwives who were active during the Taisho period and the first half of the Showa period]. PMID- 3309402 TI - [Use of stereo DSA in assessing the abdominopelvic region]. PMID- 3309405 TI - [Midwifery technics practiced by Ainu (5): Prevention of urethral prolapse and safe delivery]. PMID- 3309404 TI - [Transition in the midwifery profession. 25. The prewar birth control movement and the concept of eugenics]. PMID- 3309406 TI - Immunopathological correlations of circulating immune complexes and anti-DNA antibodies to glomerular lesions in systemic lupus erythematosus. PMID- 3309407 TI - Altered intraglomerular localization of immune complex induced by daunomycin administration in murine serum sickness. PMID- 3309408 TI - Chronic thyroiditis complicated by nephrotic syndrome and marked hydroureteronephrosis. PMID- 3309409 TI - Case report of atypical type 2 membranoproliferative glomerulonephritis. PMID- 3309410 TI - [Information on self-help groups: the "directory" available in England]. PMID- 3309411 TI - [History of nursing in Japan. 1. Introduction]. PMID- 3309412 TI - [Life in the primitive period and nursing (1). Life and health maintenance during the Jomon period (from 8000 B. C. to 200 B. C]. PMID- 3309413 TI - [Life in the primitive period and nursing (2). Life and health during the Yayoi (period from 200 B. C. to A. D. 200)]. PMID- 3309414 TI - Effects of adrenergic drugs on isolated and perfused hearts of streptozotocin induced diabetic rats. AB - To examine the myocardial contractile response of the diabetic heart, effects of isoproterenol (ISO) and norepinephrine (NE) on perfused hearts isolated from streptozotocin (STZ)-induced diabetic rats and insulin-treated diabetic rats were evaluated. Male Sprague-Dawley rats, weighing 200-260 g, were divided into the control (C)-group, diabetes mellitus (DM)-group and diabetes mellitus treated with insulin (DMI)-group. The C group was injected with buffered vehicle. DM and DMI groups were injected intravenously with 60 mg/kg STZ on the first day. Three days after STZ injection, the DMI group was subsequently treated with 4 U of Lente insulin subcutaneously every day. At 45 days after injection of STZ, experiments were performed using a Langendorff perfused heart preparation. The heart was paced at 300 beats/min, and myocardial developed tension (T) was measured isometrically. Plasma glucose values (mg/dl) were 142.4 +/- 8.7 in C, 499.3 +/- 15.6 in DM and 370.6 +/- 27.6 in DMI group. The order of percent increase in T induced by ISO (3 X 10(-9) - 3 X 10(-8) g) was C = DMI much greater than DM, and that by NE (10(-7) - 10(-6) g) was C greater than DMI greater than DM. On the other hand, the percent increase in T induced by CaCl2 (1.1 X 10(-4) - 2.2 X 10(-3) g) and aminophylline (AMI, 0.31 X 10(-3) - 5.00 X 10(-3) g) was not significantly different among three groups. These results indicate that adrenergic receptor-mediated contractile response was significantly depressed in the diabetic heart. PMID- 3309415 TI - [Bronchial responsiveness to methacholine in patients with sarcoidosis]. PMID- 3309416 TI - [Usefulness of ultrasonic-guided needle biopsy in the diagnosis of mediastinal lesions]. PMID- 3309417 TI - [Usefulness of ultrasonography in lung cancer with atelectasis]. PMID- 3309418 TI - [Clinical assessment of myocardial protection utilizing crystalloid cardioplegia in neonates and infants--analysis with myocardial ultrastructures]. PMID- 3309419 TI - [A study on tissue characterization using the ultrasonic attenuation ion coefficient in vivo]. PMID- 3309420 TI - [The restoration of the prostate after subcapsular prostatectomy by means of transrectal ultrasonotomography]. PMID- 3309421 TI - Cancer incidence and mortality trends among whites in the United States, 1947-84. AB - Cancer incidence trends from the late 1940s to 1983-84 were assessed among white residents of five geographic areas (Atlanta, Connecticut, Detroit, Iowa, San Francisco-Oakland) by means of data derived from several National Cancer Institute surveys, the Connecticut Tumor Registry, and the Surveillance, Epidemiology, and End Results Program. Incidence trends were compared with mortality trends for the entire United States and for the same five study areas. This study documented rising incidence and mortality rates for four cancers: lung cancer, melanoma of the skin, multiple myeloma, and non-Hodgkin's lymphomas. Increases in lung cancer continued through the early 1980s, but the rate of increase has been moderating during recent years, particularly among males and at younger ages for whom recent declines are evident. Overall, lung cancer incidence rates increased more than 220 and 400% among males and females, respectively. Although much rarer than lung cancer, melanoma of the skin and multiple myeloma increased greatly until the early 1980s among both males and females. The overall rate of increase in melanoma incidence among males was greater than that for lung cancer, and the rate of increase in multiple myeloma mortality among females was exceeded only by that for lung cancer. Increases of 70-120% were observed for non Hodgkin's lymphomas. Increases in incidence and mortality rates for pancreatic cancer were apparent during the early years but less conspicuous in recent years. Laryngeal and kidney cancer rates generally increased substantially, although the changes were not remarkable for laryngeal cancer mortality among males and kidney cancer mortality among females. The rates for cancers of the mouth and pharynx increased among females but not males. Prostate, colon, and bladder cancer incidence rates increased more than 65% among males, whereas mortality rates changed only moderately. The incidence of thyroid cancer increased more than 75% among both sexes until the late 1970s, but mortality rates have declined during the period of study. Breast cancer incidence increased 30%, whereas mortality rates remained remarkably constant. The incidence of corpus uteri cancer increased dramatically during the mid-1970s and decreased substantially thereafter; these changes were not reflected in the mortality rates, which continually declined during the entire time period. The incidence of testicular cancer increased more than 90% and that of Hodgkin's disease did not change greatly; however, mortality rates for both cancers declined more than 50% since the late 1960s and early 1970s.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3309422 TI - State League for Nursing Education organizes. PMID- 3309423 TI - [Problem of the diagnosis of dissecting aortic aneurysm]. PMID- 3309424 TI - [Use of the dye dilution curve for indirect evaluation of the hemodynamic efficiency of various types of mitral valve prosthesis]. PMID- 3309425 TI - [Treatment of patients with chronic nonspecific lung diseases complicated by cor pulmonale]. PMID- 3309426 TI - [Ultrasonic study of the liver, spleen and their large veins in patients with chronic post-infarct aneurysm of the left ventricle]. AB - Computerized echotomography demonstrated abnormal structure or size of the liver, the spleen or major hepatic and splenic veins in all patients with left ventricular chronic postinfarction aneurysm. Notably, congestion of the greater circulation can be detected instrumentally at a preclinical level. Flow impairment in the vena cava inferior affects acoustic properties of blood which can be detected by ultrasound. PMID- 3309428 TI - [Mutual activation of the sympathetic-adrenal and renin-angiotensin systems in the acute period of macrofocal myocardial infarction]. PMID- 3309427 TI - [Effect of the anti-arrhythmia compounds etmozin and ethacizine on the contractile activity of myocardial preparations from heart defect patients]. AB - Changes in contraction amplitudes, contraction peak time and relaxation time were evaluated at 50% and 80% of contraction peak, with adrenaline or strophanthin acting on the myocardium pretreated with antiarrhythmic substances, using atrial specimens from patients with acquired heart diseases and septal defects. Etmozin and ethacizine were shown to have a negative inotropic effect, reducing contraction intensity by about 50%. Adrenaline and strophanthin are capable of restoring myocardial contractility in the presence of antiarrhythmic effects without actually inducing spontaneous auto-arrhythmic activity. Causes of the recovery of myocardial mechanical activity, effectuated by adrenaline or strophanthin in the presence of antiarrhythmic agents are discussed. It is suggested that a combination of effective antiarrhythmic properties and negative inotropic effect of phenothiazines is significant for cases of arrhythmias with and without signs of heart failure. PMID- 3309429 TI - [Evaluation of the principles of distribution of electrocardiographic R-R intervals for elaboration of methods of automated diagnosis of cardiac rhythm disorders]. AB - A statistical analysis of prolonged ECG records has been carried out in patients with various heart rhythm and conductivity disorders. The distribution of absolute R-R duration values and relationships between adjacent intervals have been examined. A two-step algorithm has been constructed that excludes anomalous and "suspicious" intervals from a sample of consecutively recorded R-R intervals, until only the intervals between contractions of veritably sinus origin remain in the sample. The algorithm has been developed into a programme for microcomputer Electronica NC-80. It operates reliably even in cases of complex combined rhythm and conductivity disorders. PMID- 3309430 TI - [Effect of beta-adrenoreceptor blockade on gas exchange in patients with angina pectoris during physical load]. AB - Changes in ventilation, gas exchange and hemodynamic parameters were examined in 16 anginal patients, exposed to stepwise stress in the presence of beta-block. Physical stress of 30-60-90 W was associated with less pronounced hemodynamic response, as compared to a control bicycle-ergometric test, in anginal patients. Propranolol reduced ventilation, oxygen consumption and carbon dioxide expiration during a 30-60 W exercise. When stress was increased to 90 W following beta block, oxygen consumption decreased further, while the increment of ventilation and the respiratory coefficient was more marked, as compared to the controls. The pattern of ventilation and gas exchange variation was dependent on the magnitude of stress and related to hemodynamic shifts due to the beta-block. PMID- 3309431 TI - Role of peritoneal cavity lymphatic absorption in peritoneal dialysis. PMID- 3309432 TI - HUS and TTP: variable expression of a single entity. PMID- 3309433 TI - [Clinical significance of cardiac arrhythmias in newborn infants and infants in the 1st half-year. 2: General pathophysiological prerequisites and conditions]. PMID- 3309434 TI - [Diagnosis of lesions of the brachiocephalic trunk in patients with chronic occlusion of the aorta and arteries of the lower extremities]. PMID- 3309435 TI - [Microsurgical autotransplantation of a flap from the scapular region]. PMID- 3309436 TI - [A method of protecting vascular anastomosis from wound infection]. PMID- 3309437 TI - [Modification of continuous vascular sutures]. PMID- 3309438 TI - [Drainage in abdominal surgery (review of the literature)]. PMID- 3309439 TI - [Surgical rehabilitation of patients after resection of the large intestine with formation of an ileostomy (review of the literature)]. PMID- 3309440 TI - [Possibilities of current imaging diagnosis of cancer of the gallbladder]. PMID- 3309441 TI - [Completion of choledochotomy in acute cholecystitis in middle-aged and elderly patients]. PMID- 3309442 TI - [Ultrasonic examination in occlusive lesions of the abdominal aorta]. PMID- 3309443 TI - [A new operation to strengthen the sclera in high myopia and its results]. AB - The present paper communicates the technique and results of a simple operation, involving little risk of trauma, for strengthening the sclera in highly myopic children and adults. The posterior lateral part of the sclera, which offers the least resistance to deformation, is strengthened. The progression of myopia was halted in 97% of the cases thus treated, with postoperative complications occurring in only one case. PMID- 3309444 TI - [Comparison of the effectiveness of acyclovir and vidarabine in superficial herpes keratitis]. AB - In a double-blind clinical trial 28 patients with primary and recurrent herpetic corneal ulcerations were treated either with 3% Acyclovir eye ointment or 3% Adenosine Arabinoside eye ointment. In 11 out of 14 (78%) patients treated with Acyclovir and 8 out of 14 (57%) patients treated with Adenosine Arabinoside the ulcerations healed within a treatment period of 6.5 days and 8 days respectively (no statistical significance). However, the results revealed that Acyclovir was more effective. Both drugs were well tolerated. PMID- 3309445 TI - [Attempt at preoperative differentiation of malignant melanoma of the choroid. A comparison of nuclear magnetic resonance tomography, ultrasound echography and histopathology]. AB - In a large choroidal melanoma (prominence 12 mm, volume approx. 1,900 mm3) diagnostic sonography revealed an unusual compartmentation, corresponding to the internal reflectivity of the tumor. When NMR imaging was performed, marked differences in signal behavior were seen between the tumor's center and its periphery. Histopathology revealed a highly pigmented spindle B melanoma containing an amelanotic island with signs of necrosis. The ultrasound pattern was explained on the basis of well known physical phenomena, whereas the NMR signals are still not fully understood. PMID- 3309446 TI - [Digital dacryocystography]. AB - The technique of conventional dacryocystography has recently been improved and extended by utilizing new technological developments. Digital dacryocystography, performed with computer-controlled X-ray equipment with a C-arc, and coupled to an image intensifier-TV system, enables the passage of the contrast medium to be observed, the image to be enlarged to any desired size, and also offers the advantages of digital subtraction angiography. A great deal of diagnostic information is thus obtained, making precise localization of stenoses of the lacrimal pathways possible. The method is especially useful for localizing stenoses of the lacrimal pathways, presaccal, intrasaccal and postsaccal stenoses which are difficult to demonstrate by conventional methods; and combined stenoses of the efferent lacrimal pathways. Exact localization is an essential prerequisite for choosing an appropriate surgical procedure. PMID- 3309447 TI - [1987--a jubilee year]. PMID- 3309448 TI - [Effect of bencyclane on the visual field in glaucoma]. PMID- 3309449 TI - [Introduction to the 15th Retinology Symposium]. PMID- 3309450 TI - [Clinical trials of using Cavinton in the form of intravenous infusion in the treatment of macular degeneration]. PMID- 3309451 TI - [Treatment of retinal vein thrombosis]. PMID- 3309452 TI - [Clinical aspects of the disordered androgen effect (the androgen resistance syndrome)]. AB - The genetic, biochemical, clinical and endocrinological features of four distinct syndromes are described in which defective virilization in genetic and gondal men appears to result from resistance to androgen action. The clinical appearance of these forms of intersexuality covers the whole spectrum of phenotypical female patients to phenotypically normal appearing men with infertility. Based on studies with cultured genital skin fibroblasts three defects on the level of the androgen target organ can be differentiated in these syndromes: 1. Defective testosterone metabolism, 2. Anomalies of the androgen receptor and a 3. Postreceptor defect. PMID- 3309453 TI - [Hormonal findings in obese children. A review]. AB - Serum thyroid hormones in childhood obesity are not altered but caloric intake affects monoiodination of T4 to T3 and rT3. Plasma cortisol and urinary free cortisol concentrations are normal. Increase in cortisol production and secretion rate is reflected in increased values of urinary 17-hydroxycorticosteroids. Elevated urinary 17-ketosteroids are caused by increased androgen synthesis accounting for the increased height velocity in obese preadolescents and for the accelerated skeletal maturation. In both sexes earlier onset of puberty is noticed without remarkable alterations in gonadal steroids. Whether altered prolactin concentrations reflect neuroendocrine abnormalities remains unclear. Impairment of growth hormone release in face of normal or high somatomedins is not of clinical significance. Basal and stimulated insulin concentrations are high. Insulin resistance exists because glucose tolerance is simultaneously impaired. This is due to reduction in insulin receptor numbers and post-receptor defects in insulin action. Weight loss is effective in normalizing the above mentioned hormonal defects. PMID- 3309454 TI - [Stereotaxic diagnosis of brain tumors in childhood as a principle for therapy planning]. AB - Brain tumors of the various histologic types and topographical localization may occur in children. The incidence of brain tumors under the age of 15 years is 2.4 6.5/100,000. Due to the profound physiopathological differences between the various types of cerebral tumors can the choice of the adequate method of treatment not accurately be made without the exact knowledge of the histologic nature. Modern imaging techniques facilitate the visualization of cerebral lesions, do not furnish however a histologic diagnosis. Stereotactic biopsy allows by a direct approach to the lesion--without removal or retraction of healthy brain tissue, as well in the supra--as in the infratentorial space, to establish the histologic diagnosis. This is, together with the topographical localization and the volume, an essential factor for the choice between open surgery, external irradiation (teletherapy), stereotactic interstitial radiation therapy (brachytherapy), stereotactic endocavitary treatment or conservative management. PMID- 3309455 TI - High neuron-specific enolase level of cerebrospinal fluid in the early stage of Creutzfeldt-Jakob disease. AB - The measurement of neuron-specific enolase level in serum and cerebrospinal fluid was conducted time-sequentially in an autopsy confirmed patient with Creutzfeld Jakob disease. The level was markedly high in the early stage of the disease at which time the brain CT showed no or minimal abnormalities, while falling into the normal range in the advanced stage. This is the first report of the elevated level of neuron-specific enolase in Creutzfeldt-Jakob disease. PMID- 3309457 TI - Adipose tissue development: the role of precursor cells and adipogenic factors. Part II: The regulation of the adipogenic conversion by hormones and serum factors. AB - Cell culture systems have proven to be valuable models for the study of the processes involved in the formation of new fat cells. Two separate steps may be distinguished in adipocyte development. First, the determination of a mesenchymal stem cell into a preadipocyte, second, its conversion into a mature fat cell. In cloned cell lines adipose conversion depends on at least one postconfluent mitosis possibly induced by insulin-like growth factors or by as yet unknown mitogens. In addition growth hormone, glucocorticoids, and insulin are needed for conversion to take place. The adipose conversion of preadipocytes originating from the stromal vascular fraction of adipose tissue does not depend on postconfluent mitoses and needs only insulin and glucocorticoid hormones in physiological concentrations. However, the ability to undergo adipose conversion is not stable in these cells, but gets lost after repeated subcultures or seeding at low densities. In addition to stimulating hormones an increasing number of factors inhibiting the conversion process have also been detected, the physiological function of which remains unclear at the moment. PMID- 3309459 TI - [Case study of bone marrow transplantation in an aplastic anemia patient]. PMID- 3309460 TI - Pleural effusion examination by ultrasound. PMID- 3309456 TI - Adipose tissue development: the role of precursor cells and adipogenic factors. Part I: Adipose tissue development and the role of precursor cells. AB - Obesity is regarded as a heterogeneous syndrome, which may appear in different forms. Various causes have been found to contribute to its pathogenesis. During recent years investigations of adipose tissue cellularity and its dynamic changes have gained growing interest. An important progress was the discovery of adipose tissue precursor cells. These cells have not yet been precisely identified by morphological and biochemical methods in intact tissue. However, due to methodological developments such precursor cells can be cultured both as primary cultures and as established cell lines. These culture systems have proven to be valuable models for the study of the processes involved in the formation of new fat cells. PMID- 3309461 TI - Computer diagnosis of acid base disorders in a paediatric intensive care unit. PMID- 3309458 TI - Failure to reduce cholesterol as explanation for the limited efficacy of antihypertensive treatment in the reduction of CHD. Examination of the evidence from six hypertension intervention trials. AB - Over the past 6 years, major hypertension intervention studies in Europe, Australia, and the USA have shown disappointing results in the prevention of coronary heart disease (CHD) in spite of adequate treatment and good compliance. Recently, it has become increasingly clear that hypertensives with or without treatment display higher cholesterol levels than normotensive persons. The present review examines cholesterol levels in six intervention studies, none of which offered dietary or drug therapy for hypercholesterolemic patients. The Oslo study and the British MRC Trial reported very high average cholesterol levels and both showed no protection from CHD through intensive therapy in comparison to control patients. The Australian and the American MRFIT studies produced evidence for reduced coronary mortality among hypertensives with low in contrast to those with high cholesterol levels. The European Working Party showed indirectly that patients with marked reduction in blood pressure and cholesterol had a significantly lower cardiac mortality compared to placebo-treated patients. The IPPPSH study found that increasing cholesterol levels in hypertensives under beta blocker or diuretic therapy increased the risk of myocardial infarction. Failure to reduce cholesterol in hypertensive patients apparently is a major reason for the limited efficacy of antihypertensive treatment in the reduction of CHD. PMID- 3309462 TI - Oral rehydration therapy in acute gastroenteritis--a clinical trial with 3 electrolyte solutions. PMID- 3309463 TI - Methods for the metabolic quantification of regional myocardial ischemia. AB - An adequate balance between oxygen supply and demand is a basic requirement for normal cardiac function. When oxygen supply does not meet the demand, progressive cellular damage occurs leading to cardiac dysfunction and, ultimately, tissue death. While traditionally "ischemia" has been defined as decreased oxygen supply secondary to a decrease in blood flow, and "hypoxia" as decreased oxygen supply secondary to a decrease in oxygen tension, this review defines ischemia in its broader sense, namely as a pathophysiologic state in which there is a lack of oxygen relative to the demand for it. In a large number of experimental studies involving the heart, there is need to promptly recognize the ischemic state, to monitor its course in vivo, and to quantify it. Because of cardiac autoregulatory mechanisms, research methods which attempt to quantify supply (e.g., measurement of myocardial blood flow) and/or demand (e.g., measurement of myocardial oxygen consumption) do not necessarily reflect the status of the balance between supply and demand. An imbalance between myocardial supply and demand is more likely to be reflected by metabolic fluxes and by the accumulation of products specific to the ischemic state. Thus, the purpose of this review is to summarize the various methods available to the cardiac surgical investigator today for the metabolic quantification of myocardial ischemia. Due to the complexity of the heart and its inherent regional differences, myocardial ischemic changes are frequently regional in nature. Thus, this review will address metabolic methods for the regional quantification of myocardial ischemia. PMID- 3309464 TI - Tuberculous peritonitis. Case report and review of the literature. PMID- 3309465 TI - Vanderbilt medical internship and residency--past and present. PMID- 3309466 TI - On epidemics. PMID- 3309468 TI - Alcohol as a risk factor for injury or death resulting from accidental falls: a review of the literature. AB - An examination of the English language literature published from 1950 to 1985 on the subject of alcohol consumption and falls yielded 21 studies. Those identified represented four types. Type I studies examined alcohol exposure among fall cases. The percentage of fatal falls related to alcohol exposure ranged from 21 to 77%; for nonfatal falls the range was 17-53%. Among Type II studies comparing fatal falls among alcoholics to the standard population, ratios of observed to expected deaths ranged from 2.9 to 16. Type III studies compared blood alcohol levels (BALs) of fall patients and disease patients treated medically. Those studies yielded odds ratios from 2.5 to 10. In the single Type IV study comparing BALs of fall subjects with nonfall controls relative risks were 1 (BALs, 50-100 mg/dl), 3 (BALs, 100-150 mg/dl) and 60 (BALs, greater than 160 mg/dl). We conclude that there is substantial evidence that alcohol increases risks for falls, but that more case-control studies (Type IV) are required to evaluate the exact magnitude of this risk and intervention studies are needed to assess methods to reduce the risk. PMID- 3309467 TI - Robert A. Hingson, M.D., Sc. D.: former Memphis anesthesiologist receives presidential award. PMID- 3309469 TI - Primary adenocarcinoma of the appendix: report of five cases and review of the literature. AB - Five patients with primary adenocarcinoma of the appendix are reported. All patients presented with symptoms resembling those of acute appendicitis or periappendicular abscess. In none of them was malignancy suspected prior to operation. It is advisable that every patient above 50 years of age presenting with symptoms of appendicitis undergo laparotomy, thus enabling a better exploration of the cecal region. If an appendiceal mass is present and frozen section shows malignancy, a right hemicolectomy should be performed. The prognosis of adenocarcinoma of the appendix is dismal as most patients present with an advanced stage of the disease. PMID- 3309470 TI - Mucoepidermoid carcinoma arising from a preexisting cyst of the liver. AB - A case of mucoepidermoid carcinoma of the liver of a 46-year-old female is described. The resected mass from the left lobe of the liver measured 3 X 3 X 2 cm. The cut surface showed a well demarcated white, round shape, and a cystic formation measuring 1.8 X 1.4 cm was present in the center of the mass. Microscopically, the mass showed high-grade-type mucoepidermoid carcinoma, which consisted of squamous cells, mucus-producing cells, and glandular cells. The cystic wall was lined with apparently benign glandular, mucus-producing cells, squamous metaplastic cells, and tumor cells. The tumor was intimately contiguous with the cyst and gradual transition between tumor cells and cystic lining cells was recognized. It is suggested that the mucoepidermoid carcinoma of the liver in the present case was derived from malignant transformation of a preexisting cyst of the liver. PMID- 3309472 TI - The basis of synchronization by repetitive dilution of a growing culture. AB - Cultures of Escherichia coli have been synchronized by periodic dilution with fresh growth medium in the laboratory of Francois Kepes. When diluted by a large factor into complete test medium, the treated cultures undergo up to 12 synchronous divisions. This long term synchrony must result from an adjustment process during the periodic dilution procedure so that all cells have nearly identical biochemical properties. Robert Pritchard (University of Leicester, personal communication) suggested that this phasing would happen if the uptake of a critical nutrient was limited by the surface area of the cell during a portion of the dilution cycle. If his suggestion is valid, a general method for synchronization of almost any organism that grows exponentially and divides by binary fission into equal sized daughters should be achievable. A computer program was devised to simulate the growth of an initially asynchronous culture under periodic dilution with medium containing a single limiting nutrient. Various models of cell shape and growth were tested along with various models for the growth-limiting substrate uptake. PMID- 3309471 TI - Primate endocrine function after pancreatico-duodenal-splenic allotransplantation. AB - In this study the endocrine function following intraperitoneal hetero- and orthotopic pancreatico-duodenal-splenic allotransplantation (PDS) in hemipancreatectomized, non-immune-suppressed chacma baboons was assessed. Significantly reduced K-values and insulin release together with glucose intolerance during IVGTT were observed in hemipancreatectomized recipients (HPS) without grafts. Orthotopic and heterotopic PDS transplantation improved the glucose intolerance of HPS recipients; orthotopically sited grafts rendering the best curves. Normal glucose tolerance was not achieved. Both orthotopic and heterotopic PDS transplantation rendered suboptimal insulin release during IVGTT; heterotopically draining grafts released significantly more insulin than orthotopic grafts. Hyperglucagonaemia during IVGTT was a constant feature in both groups, heterotopic grafts releasing the most glucagon during stimulation. C peptide release was significantly lower in orthotopic grafts compared to normal animals or heterotopically drained insulin. It is concluded that glucose tolerance was not directly related to insulin or glucagon release in this study as orthotopic grafts rendered near-normal IVGTT curves in the presence of hypoinsulinaemia, hyperglucagonaemia, and reduced C-peptide values. The hormonal response after PDS transplantation was variable and the advantages of portal vs systemic insulin drainage remain to be defined. PMID- 3309473 TI - Co-operativity in monomeric enzymes. AB - It has been known for at least 20 years that monomeric enzymes can in principle show kinetic behaviour similar in appearance to the binding of ligands to oligomeric proteins in which there are co-operative interactions between multiple binding sites. However, the initial lack of experimental examples of kinetic co operativity suggested that in nature co-operativity always arose from interactions between binding sites. Now, however, several examples are known, most of which cannot be explained in terms of multiple binding sites on one polypeptide chain. All current theoretical models for monomeric co-operativity postulate that it arises from the presence in the mechanism of parallel pathways for substrate binding that are slow compared with the possible rate of the catalytic reaction. Rapid removal of the intermediates produced in the slow steps prevents them from approaching equilibrium and allows the appearance of kinetic properties that would not be possible in systems at equilibrium. PMID- 3309474 TI - How the slot machine led biologists astray. AB - An extensive search, in the literature, for experiments in which a new enzyme did evolve, produced only two: the first by Campbell et al. in 1973; the second by Hall & Hartl in 1974. Since the experiments provide the only means of gaining a first hand view of how new enzymes evolve, they were scrutinized, minutely, with the objective of ascertaining whether the mutations involved were random or non random. We report here that they were non-random. Further, with the benefit of hindsight, we highlight the weakness in the insights and the reasoning which produced the belief that new enzymes evolve purely by chance. PMID- 3309475 TI - Theoretical modelling of protein synthesis. AB - This article provides an overview of the use of mathematical and computer modelling in furthering the understanding of protein synthesis. In particular, we discuss issues such as the nature of the rate limiting step(s), error rates, tRNA codon adaptation, codon bias, attenuation control, and problems of selection and error corrections, focussing on their theoretical treatment. PMID- 3309476 TI - Mathematical models for a G0 phase in Saccharomyces cerevisiae. AB - Three models for the cell cycle of the budding yeast, Saccharomyces cerevisiae, which include a reversible G0 phase during proliferation, are presented. The analysis gives estimates for various quantities of biological interest, such as the probability of entry to and rate of exit from the G0 phase, the average duration of a cell in the G0 phase, the cycle time of cycling daughters and the population doubling time of cycling cells, none of which is easily measurable. PMID- 3309477 TI - Mass transfer limitations in gel beads containing growing immobilized cells. AB - Immobilized-cell aggregates have traditionally been approximated as effective continua within which the catalytic activity of the cells is homogeneously distributed. Chang & Park (1985), however, recently modelled the immobilized cells as discrete inclusions within a support matrix. With some modification, this theory is applicable to the analysis of microbial colonies growing within gel beads, and indicates that predictions obtained using the traditional approach may be significantly in error. PMID- 3309478 TI - What is the status of reaction-diffusion theory thirty-four years after turing? AB - Physicochemical explanations of phenomena are divisible into three classes: structure, equilibrium and kinetics. For the phenomena of biological development, many physical scientists have the preconception that the explanations must turn out to be principally kinetic. In this class of theory, reaction-diffusion is by far the most extensively developed, and is worthy of attention both for its own sake and because many of its features well exemplify the nature of the broader field of kinetic theory. Reaction-diffusion should be thought of as a class, rather than a species, of theory. This review addresses three aspects: first, the general nature of the two-morphogen interaction as first proposed by Turing and incorporated in many later models; second, the specifics of these later models and their probable relative scope; third, the current state of attempts to identify the chemical nature of morphogens. It is concluded that reaction diffusion in particular, and kinetic theory in general, are now slowly emerging from the almost total neglect by biologists which reaction-diffusion suffered for its first 20 years. PMID- 3309479 TI - Comparison of two protocols for heparin neutralization by protamine after cardiopulmonary bypass. AB - Twenty patients undergoing cardiac operations were randomly assigned to two protocols for heparin neutralization by protamine after cardiopulmonary bypass. In all patients protamine chloride was given at a ratio of 1 unit of protamine to 1 unit of injected heparin. In Group I (10 patients) all protamine was infused within 10 minutes after termination of cardiopulmonary bypass. Group II (10 patients) received 75% of the calculated protamine dose within 10 minutes after termination of bypass and the remainder after transfusion of all blood in the heart-lung machine. Plasma heparin levels were significantly lower in Group II 5 minutes after transfusion of all blood in the heart-lung machine and were 0.13 units/ml (standard deviation 0.04) in Group I and 0.06 units/ml (standard deviation 0.05) in Group II (p less than 0.001) 60 minutes after bypass. Activated partial thromboplastin time mirrored the changes in plasma heparin, whereas activated clotting time (Hemochron) was too insensitive to detect these low plasma heparin levels. We conclude that the two-dose protocol resulted in more complete heparin neutralization than the one-dose protocol. PMID- 3309481 TI - Improved technique for closure of median sternotomy incision. Mersilene tapes versus standard wire closure. AB - A continuous series of 2,135 cardiac surgical procedures performed with a median sternotomy is reviewed. Standard closure with steel wire was used in 1,650 patients, and a new technique with Mersilene tape was used with 485. The rate of sternal dehiscence was 2.4% among those having wire closure, and there were no instances of dehiscence among the 485 patients with Mersilene tape closure (a statistically significant difference at p less than 0.005). The method was quick and easy to perform and highly effective in establishing firm and permanent approximation of the sternum. Presence of factors associated with increased risk of postoperative sternal dehiscence did not affect the outcome when Mersilene tape was used. We highly recommend this technique in all median sternotomy incisions. PMID- 3309480 TI - Atrial activity during cardioplegia and postoperative arrhythmias. AB - Cardioplegia provides excellent protection for the left ventricle, but the right atrium may be poorly protected. Myocardial temperatures, right atrial electrical activity, and postoperative arrhythmias were assessed in 103 patients participating in two consecutive randomized trials comparing blood cardioplegia (n = 36), crystalloid cardioplegia (n = 38), and diltiazem crystalloid cardioplegia (n = 29). Both right atrial and right ventricular temperatures were significantly warmer (p less than 0.05) during delivery of the blood cardioplegic solution than during delivery of either the crystalloid or the diltiazem crystalloid cardioplegic solutions; the aortic root temperatures were 9 degrees +/- 2 degrees C with blood cardioplegia and 5 degrees + 1 degrees C with both crystalloid and diltiazem crystalloid cardioplegia. Atrial activity during cardioplegic arrest was greatest with blood cardioplegia (12 +/- 3 beats/min), lower with crystalloid cardioplegia (10 +/- 2 beats/min), and minimal with diltiazem crystalloid cardioplegia (5 +/- 1 beats/min, p less than 0.05). Perioperative ischemic injury (by creatine kinase MB isoenzyme analysis) was greatest with crystalloid cardioplegia (p less than 0.05). Postoperative supraventricular arrhythmias (both treated and untreated) were more frequent after crystalloid cardioplegia (crystalloid, 63%; blood, 40%; diltiazem, 47%; p less than 0.05). Patients in whom supraventricular arrhythmias developed had significantly more postoperative ischemic injury (by creatinine kinase MB isoenzyme analysis, p less than 0.05). Blood cardioplegia reduced supraventricular arrhythmias by reducing ischemic injury despite warmer intraoperative temperatures and more right atrial activity. Diltiazem crystalloid cardioplegia reduced postoperative arrhythmias by improving intraoperative myocardial protection and suppressing intraoperative and postoperative atrial activity. Crystalloid cardioplegia cooled but did not arrest the right atrium intraoperatively, resulted in the most perioperative ischemic injury, and yielded the highest incidence of postoperative supraventricular arrhythmias. PMID- 3309482 TI - New developments for reconstruction of the tricuspid valve. AB - Four patients with multivalvular disease underwent tricuspid valve repair by a new technique. The anterior and posterior leaflets adjacent to the incompetent commissure were separated from the anulus to allow coaptation of the three leaflets in the middle. In conjunction with the commissure, half of the isolated anulus was then excluded with a continuous 3-0 Ti-Cron suture. A 5-0 Prolene suture was then used to readapt the cut edges of the leaflets to the shortened anulus. In this way it was possible to reduce the circumference of the anulus selectively, without reducing the active area of the leaflets. All patients survived. A significant decrease in the mean right atrial pressure without evidence of regurgitation could be recorded in all patients. Postoperative morphometric echocardiographic evaluation of the tricuspid valve showed a maximal anulus diameter even larger than in normal hearts. No inflow obstruction was present. The systolic shortening of the anulus ranged within normal limits. The opening amplitude of the leaflet as well as the slope of the ejection fraction were not decreased. No significant regurgitation was evidenced by contrast echocardiograms. One to 3 months postoperatively, no annuloplasty dehiscence has occurred. PMID- 3309483 TI - Preparation of immunoperoxidase-labelled wholemounts of invertebrate brains. AB - An immunoperoxidase method is described for the immunocytochemical labelling of whole cerebral ganglia of the crayfish to reveal serotonin-containing neurons. Careful desheathing, unusually long immersion in antibody reagents, the inclusion of blocking reagent in every incubation and extensive washing produce immunolabelled wholemount preparations with very low background. The entire neurotransmitter system is consistently labelled and single identifiable neurons can be repeatedly recognized. PMID- 3309484 TI - Montage: a system for three-dimensional reconstruction by personal computer. AB - This paper describes a simplified system for serial section three-dimensional (3 D) reconstruction. A set of 9 software programs runs on a standard personal computer and produces camera-ready illustrations suitable for publication. The user enters trace points on a digitizing tablet from sections that have been already aligned. A 3-D view of the reconstructed object is generated which can be displayed with hidden lines removed. Analysis of volume, surface area and autoradiographic grain density are performed automatically. A relational database query language allows display and analysis of a selected subset of the data. The system runs under the UNIX operating system which allows the programs to be easily transported to new hardware or modified for other purposes. PMID- 3309485 TI - A new double labelling immunofluorescence technique for the determination of proliferation of human astrocytes in culture. AB - We describe a method that can positively identify proliferating human astrocytes in culture. The procedure is an indirect double immunofluorescence staining technique that uses bromodeoxyuridine together with specific antibodies directed against it and glial fibrillary acidic protein. The method is simple, rapid, reproducible, and promises to decrease many of the limitations inherent in other previously used methods. Using this technique, we observed that mitosis occurred in 57 and 11% of human astrocytes that have been in culture for 11 days and 16 weeks, respectively. PMID- 3309487 TI - Hydrotherapy (Kneippism). PMID- 3309486 TI - The ISL(International Society of Lymphology): past, present, and future. PMID- 3309488 TI - Arterial fibromuscular dysplasia. AB - Fibromuscular dysplasia is a nonatherosclerotic, noninflammatory vascular disease that involves primarily the renal and internal carotid arteries and less often the vertebral, iliac, subclavian, and visceral arteries. Although its pathogenesis is not completely understood, humoral, mechanical, and genetic factors as well as mural ischemia may play a role. The natural history is relatively benign, with progression occurring in only a minority of the patients. Typical clinical manifestations are renovascular hypertension, stroke, subarachnoid hemorrhage, abdominal angina, or claudication of the legs or arms. In patients with symptoms, percutaneous transluminal angioplasty has emerged as the treatment of choice in most involved vascular beds. PMID- 3309489 TI - Monoamines in autism: an update of neurochemical research on a pervasive developmental disorder. AB - Recent neurochemical studies of norepinephrine (NE), dopamine (DA), and serotonin (5HT) in autism are reviewed. Most studies of the catecholamines, their metabolites, and associated enzymes have not found differences between autistic and normal subjects. However, a robust increase in platelet 5HT has been well replicated and characterized. Studies on the possible causes of the increased platelet 5HT in autism suggest that an alteration in platelet physiology is the cause of the increase. Future directions for research on the platelet are discussed as are other potentially fruitful methods for examining monoamine functioning in autism. PMID- 3309490 TI - Recent progress in the research of Alzheimer's disease. AB - The purpose of this review is to survey some of the recent advances made in the understanding of the basic mechanisms underlying cognitive functions and dysfunctions in Alzheimer's disease (AD). Cholinergic projections from the nucleus basalis of Meynert (nbM), which are involved in AD, have been related to certain memory functions. Information processing, attention or arousal may, however, be influenced by nbM neurons more than primary memory mechanisms. Perforant pathway and subiculum projections, which presumably use glutamate as a neurotransmitter, are involved in AD leading to the disconnection of the hippocampus from the neocortical areas. The hippocampus and entorhinal cortex seem to play an important role in learning and memory. The hippocampus can be regarded as a relay station for the processing of recent episodic memory, but information is bound to memory storage in the cortical association areas. An important finding has been the plasticity changes in the hippocampus seen after the destruction of entorhinal cortex. Antemortem markers of AD have been under extensive study. Alz-50 antigen may be one of the most promising findings in this area, but no definite biological marker of AD currently exists. A medication for treatment of AD is also under development. PMID- 3309491 TI - Biogenic amines in the regulation of wakefulness and sleep. AB - Neurophysiological, neurochemical and neuropharmacological evidence indicates that cerebral monoamines are important regulators of wakefulness and sleep besides cerebral amino acid-ergic and peptidergic systems. The cerebral monoamines noradrenaline, dopamine and acetylcholine are positively involved in electroencephalographic aspects of waking and paradoxical or REM sleep. A high level of noradrenergic transmission facilitates waking, and a lower, moderate level facilitates REM sleep. Serotonin is involved in the regulation of synthesis, storage and release of sleep inducing factors, and in the gating mechanisms of REM sleep. Histamine neurons play a role in the regulation of vigilance during waking state. These neurotransmitter systems are important targets for drug actions. PMID- 3309492 TI - Selection of perturbation parameters for identification of the posture-control system. PMID- 3309493 TI - Insulin dosage adjustment using manual methods and computer algorithms: a comparative study. PMID- 3309494 TI - Online measurement of cardiac indices from frequency transformed TAV Doppler ultrasound signals. PMID- 3309495 TI - Regurgitant flow through heart valves: a hydraulic model applicable to ultrasound Doppler measurements. PMID- 3309498 TI - [Infantile acropustulosis. Considerations on 11 cases]. AB - Eleven patients with infantile acropustulosis, 10 from Mendoza and one from Buenos Aires, are presented. Remarkably was a blood eosinophilia in 4 cases and the prompt improvement with dapsone in 2 cases. The differential diagnosis with other dermatosis, specially with scabies, are discussed. PMID- 3309496 TI - [Advances and perspectives in American cutaneous leishmaniasis]. AB - The advances and perspectives in American (mucocutaneous) leishmaniasis are presented under the following topics: 1. Epidemiology in Latin America, particularly in Brazil. 2. Parameters for taxonomic identification of species and subspecies of the genus leishmania, which belong to L. mexicana and L. braziliensis complexes: biologic behaviour in hamster, in culture, in animal reservoir, clinical aspects, vectors, electronic microscopy, electrophoretic mobility of isoenzymes, radiorespirometry, DNA characterization, monoclonal antibodies, other immunological aspects and genetics. 3. Diagnosis by intradermal test, indirect immunofluorescence, ELISA, culture and animal inoculation. 4. Therapeutics and prevention by vaccination. PMID- 3309497 TI - [Prolonged and severe photodermatitis, an early manifestation of ataxia telangiectasia]. AB - We report two new cases of ataxia-telangiectasia (A-T) in two child brothers. The first symptom of the disease was a serious and prolonged pellagra-like photodermatitis. This rare manifestation of the has not be reported before and it could be explain by a defect in DNA repair. PMID- 3309499 TI - [Angiolymphoid hyperplasia with eosinophilia. Apropos of a case of peculiar development: importance of its correct diagnosis and treatment]. AB - We present the case of a patient thirty seven years old who has angiolymphoid hyperplasia with eosinophilia, diagnosis confirmed by histopathological examination, localized in ear's pavilion, ear's outer duct and beyond the ear. She has received intralesional injections of corticoid (because of a possible misdiagnosis). This provoked the appearance of a pyogenous process with a profuse, purulent and fetid secretion (Staphylococcus aureus) resistant to many antibiotics which was finally controlled with trimethoprim-sulfamethoxazole. We controlled the disease with radiotherapy applications and afterwards partial cryosurgery. PMID- 3309500 TI - [Leishmaniasis of the genital organs]. AB - Five cases of leishmaniasis in genital organs are exposed. The patients are males, farmers, with less than 30 years old (except one), residents of high leishmaniasis incidence zones. The majority of lesions were in penis, and of scabies ulcer type, destructive, painless and of slow evolution. In this cases generally, the clinic diagnosis was difficult to corroborate by the habitual laboratory methods and we insist that the principal differential diagnosis are the neoplastic process of the zone. The suspicion high index is important even to proceed to the therapeutic test and solve this kind of problems. PMID- 3309501 TI - [Clinico-pathological evaluation of keloids treated with intralesional injections of corticoid]. AB - 37 keloid patients were treated with triamcinolone intralesionally every 15 days, in all 6 inoculations. Histologically after the treatment we observed alterations in dermal vascularization, in morphology, in color characteristics and in the arrangement of the collagen bundles. The disappearance of mucin and the presence of palisade granulomas was observed in some cases probably because of the corticoid deposited. There was regression of pruritus and pain in all the patients. We believe that the intralesionally infiltration of corticoid is even today one of the best methods of treatment, and it may also be effected together with other technics. PMID- 3309502 TI - [Pitted keratolysis of hyperkeratotic form and isolation of the etiologic agent: Corynebacterium sp]. AB - Two cases of "pitted keratolysis" with a very accentuated plantar hyperkeratosis, and the isolation on chocolate thelurite agar of the presumptive etiologic agent, Corynebacterium sp., is presented. In order to keep permanently in mind, for a proper diagnosis, the original description of the disease as "keratoma plantare sulcatum" (Castellani, 1910), we are proposing to distinguish two different clinical forms: The hyperkeratotic one and the common or usual form of "pitted keratolysis" with keratolysis as the main sign. The prosecution of our biochemical studies with a significant number of strains isolated from both "pitted keratolysis" and from classical erythrasma cases, will surely permit us to definitively determine if all of them should or not be assimilated to Corynebacterium minutissimum. PMID- 3309503 TI - [Micaceous and pseudoepitheliomatous balanitis]. PMID- 3309504 TI - [Dermatophytoses in the Murcia region. Changes in the frequency of isolations in the last 22 years]. AB - Different clinical forms of dermatophyte infections were studied in 136 patients, T. mentagrophytes being the most frequently isolated species. Our results are similar to those of other authors of South-Eastern Spain, though differing from those in more distant, parts of the country. In our area, the rabbit is considered the most important dermatophytic animal reservoir. PMID- 3309505 TI - [Kaposi's sarcoma as the first manifestation of AIDS]. AB - We report herein a case of Acquired Immunodeficiency Syndrome in a 38 years old man with Kaposi's sarcoma, which evolution was fulminant in some months. The clinical, pathological and pathogenic characteristics of Kaposi's sarcoma in this syndrome are discussed. PMID- 3309506 TI - Indexes of molecular shape from chemical graphs. PMID- 3309507 TI - The thymidylate synthesis cycle and anticancer drugs. PMID- 3309508 TI - The biofunctional chemistry of 5-deazaflavins and related compounds. PMID- 3309510 TI - Angiotensin-converting enzyme inhibition with quinapril (CI-906) and captopril in spontaneously hypertensive rats with suppressed renin-angiotensin system. AB - Renin- and nonrenin-mediated antihypertensive actions of angiotensin-converting enzyme (ACE) inhibitors were investigated in young spontaneously hypertensive rats (SHR). Renin was suppressed either by removal of 2/3 of the renal mass, deoxycorticosterone (DOC) treatment, or 1% of NaCl in drinking water. Blood pressure responses to the nonsulfhydryl ACE inhibitor quinapril (CI-906) and the sulfhydryl inhibitor captopril, given orally for 2 days each, were examined by the tail cuff method. The marked depressor responses observed in control SHR were attenuated by the different manipulations in a manner clearly related to suppression of plasma renin activity (PRA). The decrease in blood pressure falls and in PRA was smallest in partially nephrectomized SHR. The mineralocorticoid (DOC) administration or 1% NaCl reduced PRA and the responses to ACE inhibitors markedly, though not completely. In a further experiment, severe salt retention induced by DOC and NaCl in uninephrectomized SHR suppressed PRA to an unmeasurable level and prevented the depressor action of a large dose of captopril. The results suggest that in SHR the acute blood pressure-lowering effect of ACE inhibitors is completely dependent on the renin-angiotensin system. The experiments also show that this system clearly participates in the support of rapidly increasing blood pressure in young SHR. PMID- 3309509 TI - Isolation of sarcolemmal membrane, membrane orientation, and lipid asymmetry. PMID- 3309511 TI - [Islet cell antibodies in children with diabetes in Sweden--a preliminary report]. PMID- 3309512 TI - [Classification and definition of smell and taste disorders]. AB - The smell and taste disorders are defined in terms due to two principles - the type and site of lesion. The quantitative dysosmias (anosmia, hyposmia, hyperosmia) correspond to the quantitative dysgeusias (ageusia, hypogeusia, hypergeusia) and the qualitative dysosmias (parosmia, pseudo-osmia, phantosmia, agnosmia) correspond to the qualitative dysgeusias (parageusia, pseudogeusia, phantogeusia, agnogeusia). Due to the site of lesion we can differentiate between respiratory, epithelial, combined, neural, and central dysosmias as well as epithelial, neural, and central dysgeusias. Typical examples are demonstrated, denying other classifications and terms as not precisely enough or negligible ones. PMID- 3309513 TI - Current clinical and pathological features of round window diseases. AB - The round window niche and membrane can be involved in clinical problems including perilymphatic fistulas, sensorineural hearing loss in otitis media, and a variety of others. The background of these problems is documented by a review of the literature and recent experimental evidence on round window grafting and tracer studies. Clinical pathological correlates including recent clinical experience are discussed for perilymphatic fistulas (sudden deafness, chronic progressive fluctuating sensorineural hearing loss, and association with Meniere's disease), sensorineural hearing loss in acute and chronic otitis media, and findings in round window membrane including absent round window reflex in cases of exploratory tympanotomy and otosclerosis. In addition, a new syndrome termed perilymphatic hypertension is described as seen in a subset of patients with sudden sensorineural hearing loss. PMID- 3309514 TI - Implantation of human keloid into athymic mice. AB - In the interest of developing an animal model for keloids, human keloid dermis was implanted in the subcutaneous tissues of athymic (nude) mice. Subsequent growth resulted in a lesion with histology similar to the original keloid. Fibroblasts were cultured from keloid dermis. When the fibroblasts alone were implanted in the subcutaneous tissues of nude mice, growth of a visible lesion was again produced. The fibroblasts had proliferated and deposited collagen in an abnormal fashion with the histology resembling the parent keloid. Further research could develop this into a reliable animal model to allow in vivo experimentation. PMID- 3309515 TI - [Controlled prospective study of chemotherapy in advanced ovarian cancer- cyclophosphamide monochemotherapy versus polychemotherapy with adriamycin, cyclophosphamide, 5-fluorouracil and methotrexate]. PMID- 3309516 TI - [Respiratory syncytial viruses]. PMID- 3309517 TI - Stereochemical effect in the mutagenicity of the aflatoxicols toward Salmonella typhimurium. AB - The mutagenicities of [1R] and [1S] aflatoxicol were measured using the Salmonella microsome test. In strain TA100 the [1R] form (unnatural aflatoxicol, aflatoxicol B) had a mutagenic potency approximately four times that of the [1S] epimer (natural aflatoxicol, aflatoxicol A, Ro) in the presence of S-9 liver microsomal fraction. The order in mutagenic potency compared to some other toxicologically important aflatoxins was as follows: B1 greater than [1R] approximately equal to G1 much greater than [1S] much much greater than B2. Thus, the trans relationship between the vinyl ether and hydroxyl groups leads to greater mutagenicity than the cis relationship. This may be important in the elucidation of stereochemical structure-activity relationships for the aflatoxins. PMID- 3309519 TI - Simultaneous elevation of plasma insulin and catecholamines during endotoxicosis in the conscious and anesthetized rat. AB - Plasma levels of glucose, insulin and catecholamines were assessed during the early phase of sub-lethal endotoxicosis in fasted male rats which were either conscious or continuously anesthetized with sodium pentobarbital. Exogenous glucose challenge was administered during endotoxicosis to probe insulin release at a time when plasma catecholamines were elevated. An endogenous hyperglycemia occurred following endotoxin but was moderated by continuous pentobarbital anesthesia. Plasma insulin was elevated in the conscious but not anesthetized rats during endogenous hyperglycemia following endotoxin. Hyperglycemia with exogenous glucose elevated plasma insulin levels in both conscious and anesthetized groups and occurred in the presence of elevated levels of norepinephrine, epinephrine and dopamine. Simultaneous elevation of plasma catecholamine and insulin levels during endotoxicosis suggests that glucose utilization may be promoted at the same time that glucose is mobilized through adrenergic mechanisms. These events may contribute to the rapid depletion of carbohydrate stores leading to the hypoglycemia of the agonal stage of endotoxic shock. PMID- 3309518 TI - A possible explanation of genetic hypertension in the spontaneously hypertensive rat. AB - Converting enzyme inhibitors prevent the development of hypertension and normalize arterial blood pressure in spontaneously hypertensive rats (SHR), suggesting a critical role for angiotensin II in genetic hypertension. We hypothesized that the SHR is hyperresponsive to the slow-pressor effect of angiotensin II. To test this hypothesis, 14 SHR and 14 normotensive Wistar Kyoto rats (WKY) were treated chronically with captopril (100 mg X kg-1 X day-1 in drinking water) beginning at 5 weeks of age. At 9 weeks of age, either angiotensin II (125 ng/min; 7 SHR and 7 WKY) or vehicle (7 SHR and 7 WKY) was infused for 2 weeks via an osmotic minipump implanted into the peritoneal cavity. Captopril treatment was maintained and systolic blood pressure was monitored 3 times weekly. Although systolic blood pressure was similar in SHR and WKY infused with vehicle (101 +/- 2 versus 103 +/- 5 mmHg, respectively during the second week), systolic blood pressure in SHR treated with angiotensin II was much greater than systolic blood pressure in WKY treated with angiotensin II (193 +/- 9 versus 132 +/- 11 mmHg, respectively during the second week, p less than 0.001). These results indicate that compared to WKY, SHR are remarkably more sensitive to the slow-pressor effect of chronic, low-dose infusions of angiotensin II. Our results support the hypothesis that the critical genetic defect in SHR is a change in the sensitivity to the slow-pressor effect of angiotensin II. PMID- 3309520 TI - Renin secretion in intact dogs following incubation of epinephrine in blood in vivo. AB - Previous experiments have shown that epinephrine-induced renin secretion in vivo apparently is initiated by activation of extrarenal adrenoceptors. However the location of these receptors has not been determined despite considerable search. The present experiments were designed to evaluate the hypothesis that epinephrine induced renin secretion is initiated by a change in blood composition, independent of the passage of the blood through any organ. Accordingly, the left kidneys of anesthetized dogs were perfused with femoral arterial blood via an extracorporeal circuit. The circuit consisted of large-bore Tygon tubing (157 ml volume) with an infusion port and a mixing chamber near the femoral arterial origin, and a blood sampling and pressure-monitoring site near the renal artery. A roller pump was used to maintain renal perfusion pressure approximately equal to femoral arterial pressure, and renal blood flow was measured with an electromagnetic flowmeter. Transit time (of a dye) in the extracorporeal circuit was approximately 40 seconds. Intravenous infusion of epinephrine at 25 ng X kg-1 X min-1 increased renin secretion significantly. However, infusion of epinephrine into the extracorporeal circuit at a rate of 5 ng X kg-1 X min-1 did not alter renin secretion, even though epinephrine concentration in the renal perfusate was higher than during intravenous infusion. The data do not support the hypothesis that epinephrine-induced renin secretion is initiated by a direct effect of epinephrine on blood composition, independent of the passage of blood through any organ. PMID- 3309521 TI - The Baby Fae case. PMID- 3309522 TI - AIDS: the legal aspects of a disease. PMID- 3309523 TI - A comparative view of the roles of motive and consent in the response of the criminal justice system to active euthanasia. PMID- 3309524 TI - Measurement of retinol-binding protein in the assessment of renal allograft function. PMID- 3309525 TI - Errors in bacteriological techniques: results from the United Kingdom national external quality assessment scheme for microbiology. PMID- 3309526 TI - Lectins in diagnostic histopathology: a review. PMID- 3309527 TI - Laboratory management of the haemolytic uraemic syndrome. PMID- 3309528 TI - Survival of Legionella pneumophila. PMID- 3309529 TI - Storage of mycobacteria at -20 degrees C. PMID- 3309530 TI - Antibacterial activity in urine examined for urinary tract infection. PMID- 3309531 TI - Microscopy to select urine specimens that will not yield significant growth. PMID- 3309532 TI - A semi-automated method for the culture, identification and susceptibility testing of bacteria direct from urine specimens. PMID- 3309533 TI - The new fluoroquinolones: a review. PMID- 3309534 TI - Harnessing the red cell for immunoassays. PMID- 3309535 TI - Detection of anti-HTLV III: modification of a commercial enzyme immunoassay. PMID- 3309536 TI - [Pages from the history of roentgenology and radiology in Latvia]. AB - The author discusses the history of roentgenology in Latvia singling out 3 periods in its development: 1) from the discovery of x-rays up to the Great October Socialist Revolution and the establishment of Soviet power in Latvia; 2) the bourgeois period in Latvia (1920-1940); 3) from the beginning of the Great Patriotic War to the present period. The paper is devoted to an analysis of the main historical events and facts pertaining to the formation and further development of roentgenology and radiology in Latvia. The role and importance of the roentgenology and radiology chair and the Republican roentgenoradiological center in the development of roentgenoradiology as independent clinical branches, training of specialists, the development and clinical application of present-day methods of radiation therapy are considered. The chief advances of Latvian radiologists and their contacts with leading specialists are marked. PMID- 3309537 TI - [Research Institute of Medical Radiology of the USSR Academy of Medical Sciences- a quarter of a century]. PMID- 3309538 TI - Clinical ultrasound imaging. PMID- 3309539 TI - Grateful Med. PMID- 3309540 TI - [History of the Moscow Foundling Hospital]. PMID- 3309541 TI - [50th anniversary of a school (the Mogilev-Podol'skii Medical School)]. PMID- 3309542 TI - Phosphorus nuclear magnetic resonance: a non-invasive technique for the study of muscle bioenergetics during exercise. AB - Phosphorus nuclear magnetic resonance (31P NMR) spectroscopy is a non-destructive analytical laboratory technique that, due to recent technical advances, has become applicable to the study of high-energy phosphate metabolism in both animal and human extremity muscles (in vivo). 31P NMR can assay cellular phosphocreatine, ATP, inorganic phosphate, the phosphorylated glycolytic intermediates, and intra-cellular pH in either resting or exercising muscle, in a non-invasive manner. NMR uses non-perturbing levels of radio-frequency energy as its biophysical probe and can therefore safely study intact muscle in a repeated fashion while exerting no artifactual influence on ongoing metabolic processes. Compared with standard tissue biopsy and biochemical assay techniques, NMR possesses the advantages of being non-invasive, allowing serial in situ studies of the same tissue sample, and providing measurements of only active (unbound) metabolites. NMR studies of exercising muscle have yielded information regarding fatigue mechanisms at the cellular level and are helping resolve long-standing questions regarding the metabolic control of glycolysis, oxidative phosphorylation, and post-exercise phosphocreatine re-synthesis. NMR is also being utilized to measure enzymatic reaction rates in vivo. In the near future, other forms of NMR spectroscopy may also permit the non-invasive measurement of tissue glycogen and lactate content. PMID- 3309543 TI - A general treatment of NMR imaging with chemical shifts and motion. AB - A general treatment of nuclear magnetic resonance imaging (MRI) and spectroscopic imaging (MRSI), which takes into account the effects of chemical shift, motion, field inhomogeneity, and relaxation times, is presented. A graphical representation based on the k trajectory formalism which includes these effects is then developed for MRI and MRSI acquisition processes. These considerations should be useful in the study and design of flow-sensitive MRI and MRSI methods and the accurate prediction of motion artifacts in conventional MRI and MRSI techniques. We conclude by presenting examples illustrating applications of the general theory to specific MRSI and flow imaging methods. PMID- 3309544 TI - Brain lipoprotein lipase is responsive to nutritional and hormonal modulation. AB - Functional lipoprotein lipase activity was recently described in rat brain. The present study was performed to further characterize the biologic significance of brain lipoprotein lipase (heparin releasable component) and elucidate regulatory factors. Comparative studies were performed on tissue (brain, adipose, and heart) heparin releasable lipoprotein lipase in the fasted and diabetic (streptozotocin 100 mg/kg BW IP) rat. Both fasting (96 hours) and diabetes (ten days) significantly decreased brain (cortical) (P less than .05) and adipose (epididymal fat pad) (P less than .001) lipoprotein lipase activity. In contrast, heart muscle enzyme activity was significantly increased (P less than .001) in response to fasting and diabetes. Refeeding (Purina chow 96 hours) and insulin replacement (96 hours) reversed these changes in tissue lipoprotein lipase consequent to fasting and diabetes, respectively. There was a positive correlation between the changes in serum insulin concentration and adipose lipoprotein lipase, but there was no correlation between this parameter and brain or heart lipoprotein lipase. In addition, although T3 therapy normalized the low T3 state associated with both fasting and diabetes, it had no effect on the enzyme activity in the studied tissues. However, subsequent studies demonstrated that hypothyroidism (2 weeks post thyroidectomy) significantly decreased brain lipoprotein lipase activity (P less than .001) and increased both the adipose (P less than .025) and heart (P less than .025) enzyme activity. T3 replacement (0.8 micrograms/100 BW/d for 1 week) reversed the effects of hypothyroidism. However, the relationship between brain enzyme activity and serum T3 was nonlinear as hyperthyroidism tended to reduce brain LPL activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309545 TI - Impaired glucose handling in active rheumatoid arthritis: relationship to the secretion of insulin and counter-regulatory hormones. AB - An intravenous glucose tolerance test was performed in 45 untreated patients with active inflammatory rheumatoid arthritis and in age- and sex-matched healthy subjects. The mean k value in the patients, which correlated to the inflammatory activity, was 1.0 +/- 0.05 (SEM), which was significantly lower (P less than .001) than in the controls (1.8 +/- 0.09). The basal serum insulin concentration and the maximum insulin response to glucose loading were significantly higher (P less than .001 and P less than .01, respectively) in the patient group. The patients had a normal basal concentration of growth hormone in the serum, but during glucose infusion the concentration increased. The plasma glucagon level was significantly lower than in the controls (P less than .001). The urinary output of cortisol and catecholamines was normal. It is concluded that impaired glucose handling in active chronic inflammatory disease cannot be explained as a stress reaction but may be due to peripheral insulin resistance mediated by the inflammatory process. A paradoxical increase in growth hormone secretion during glucose infusion may suggest that this hormone is one factor that influences glucose handling in chronic inflammation. The pathophysiologic relevance of altered glucose metabolism and enhanced insulin secretion is uncertain but may reflect a possible link with the proposedly increased risk of atherosclerotic cardiovascular disease in rheumatoid arthritis. PMID- 3309547 TI - Metabolic control and B cell function in patients with insulin-dependent diabetes mellitus secondary to chronic pancreatitis. AB - Among 88 unselected patients with chronic pancreatitis 35% (95% confidence limits 25 to 46) had insulin-dependent diabetes, 31% (21% to 41%) had non-insulin dependent diabetes or impaired glucose tolerance (by intravenous glucose tolerance test), and 34% (24% to 45%) had normal glucose tolerance. B cell function measured by C-peptide concentration after 1 mg glucagon IV correlated with the pancreatic enzyme secretion (meal stimulated duodenal lipase content). B cell function was preserved to a greater extent (P less than .01), and glycosylated hemoglobin and fasting level of glucose were lower (P less than .01 to .05) in the 31 patients with pancreatogenic diabetes than than in 35 otherwise comparable patients with type I (insulin-dependent) diabetes, yet daily insulin dose was similar in the two groups. Glucagon stimulated C-peptide was inversely correlated to glycosylated hemoglobin in insulin-dependent patients with pancreatogenic diabetes and in type I diabetes. Since body mass indices were identical in the two groups, better glucoregulation was not due to reduced food intake or malabsorption in pancreatogenic diabetes. Rather residual B cell function and/or different secretion of other pancreatic hormones in pancreatogenic diabetes may account for different metabolic control in type I IDDM compared with insulin-dependent pancreatogenic diabetes. PMID- 3309546 TI - Impaired glucose handling in active rheumatoid arthritis: effects of corticosteroids and antirheumatic treatment. AB - Forty-two patients with active rheumatoid arthritis were studied serially with respect to glucose metabolism after the institution of different anti inflammatory and antirheumatic therapies. Sixteen patients received 20 mg of prednisolone daily. After 1 week of treatment the mean k value in glucose tolerance tests increased from 1.0 +/- 0.1 (SEM) to 1.6 +/- 0.1 (P less than .001). The corticosteroid therapy thus restored the glucose tolerance to normal and significantly enhanced the insulin response (P less than .01). Corticosteroids also normalized the growth hormone response to glucose infusion but had no effect on plasma glucagon. Treatment with nonsteroidal anti inflammatory drugs did not affect the k values nor the hormonal pattern either after short-term treatment or after three months of therapy, except for causing a minor increase in the plasma glucagon levels both before and after glucose infusion. The long-term effects of treatment with penicillamine (n = 4), chloroquine (n = 7), and immunosuppressive agents [corticosteroids combined with azathioprine or cyclophosphamide (n = 7)], were an improvement of the clinical state, a reduction of the inflammatory activity, and a reversal of the glucose handling to normal. PMID- 3309548 TI - Effects of intraduodenal nutrient infusion on insulin response to subsequent intravenous glucose in rats. AB - To elucidate the so-called incretin effect, the effects of intraduodenal bolus injection of glucose, 0.9% NaCl (saline), amino acids, and triglyceride on insulin response to subsequent intravenous injection of glucose (0.5 g/kg in 10% solution) was investigated in rats. Portal and femoral venous insulin and glucose concentration were simultaneously measured. Significantly higher portal insulin and lower femoral glucose values were observed in intraduodenal glucose or saline injection rats compared with controls (nothing was infused into the duodenum). Peripheral removal of insulin in these rats was not decreased. In the rats with intraduodenal injection of amino acids or triglyceride, slightly higher portal insulin and lower femoral glucose values were observed, but they were not significantly different from controls. These results indicate that incretin effect is provoked by intraduodenal infusion of glucose and saline, and may have some important physiologic role on glucose metabolism in rats in vivo. PMID- 3309549 TI - Cystine: binding protein assay. PMID- 3309550 TI - Hypotaurine aminotransferase assay: [2-3H]hypotaurine. PMID- 3309551 TI - S-adenosylmethionine and its sulfur metabolites. PMID- 3309552 TI - Trimethylselenonium ion. PMID- 3309553 TI - Sulfotransferase assays. PMID- 3309554 TI - Cysteine S-conjugates. PMID- 3309555 TI - Electrochemical reduction of disulfides. PMID- 3309556 TI - Sulfinic acids from disulfides: L-[35S]cysteinesulfinic acid. PMID- 3309557 TI - Intracellular delivery of cysteine. PMID- 3309558 TI - Thiosulfate reductase. PMID- 3309559 TI - Mammalian sulfur amino acid metabolism: an overview. PMID- 3309560 TI - Cysteinesulfinate decarboxylase. PMID- 3309561 TI - Microbial sulfur amino acids: an overview. PMID- 3309562 TI - O-acetyl-L-serine-O-acetyl-L-homoserine sulfhydrylase from Saccharomyces cerevisiae. PMID- 3309563 TI - Second-strand cDNA synthesis: mRNA fragments as primers. PMID- 3309564 TI - Homopolymeric tailing. PMID- 3309565 TI - Adaptors, linkers, and methylation. PMID- 3309566 TI - Directional cDNA cloning in plasmid vectors by sequential addition of oligonucleotide linkers. PMID- 3309567 TI - Selection of clones from libraries: overview. PMID- 3309568 TI - Amplification, storage, and replication of libraries. PMID- 3309569 TI - Oligonucleotide probes for the screening of recombinant DNA libraries. PMID- 3309570 TI - Interaction of protein with DNA in vitro. PMID- 3309571 TI - Endocrinology of breast cancer. AB - Oestrogen predominance over progesterone may cause hyperproliferation of mammary epithelium and thus promote breast carcinogenesis. In patients with a hormone dependent tumour, oestrogens may also accelerate cancer growth. Conversely, they may inhibit tumour growth in patients with an oestrogen receptor-negative carcinoma which has grown in an oestrogen-poor environment. Progesterone opposes oestrogen-induced epithelial proliferation and causes cellular differentiation with decreased mitosis, thus reducing the risk of breast cancer. Prolactin brings about mammary epithelial differentiation for secretory function; in the lactation state, epithelial proliferation is minimal. The role of androgens, melatonin, thymosin, metabolic hormones (growth hormone, thyroid hormone(s), insulin, glucocorticosteroids) and prostaglandins in the pathobiology of breast cancer is poorly understood. A breast cancer population consists of individuals in whom more than 20 different tumour subsets may be present, i.e. patients with different individual tumour pathobiology and endocrinology patterns and therefore different prognoses. Progress in the endocrinology of breast cancer seems possible through prospective studies in which hormones are determined in normal breast tissue (ductal fluid, cyst fluid) and then related to the corresponding concentrations in the plasma and urine of patients who develop breast cancer and those who do not. In addition, genetic and nonhormonal risk factors for breast cancer must be taken into consideration to define the endocrinological aspects involved. PMID- 3309572 TI - Hormone replacement therapy and breast cancer. AB - Numerous studies on oestrogen replacement therapy have failed to incriminate the use of exogenous oestrogen as a cause of breast cancer in post-menopausal women. Since so many variables influence breast cancer risk, it has not been possible for any single study to evaluate every potential risk factor included in the epidemiological and clinical reports on hormone use and carcinoma of the breast. The relative risk (RR) for breast cancer in oestrogen users has been found to vary from 0.4 to 3.4, with the vast majority of investigators reporting an RR very close to 1.0, or no increased risk at all. There is growing evidence that progesterone deficiency may increase the risk for breast cancer in some women. At least three studies have indicated that the addition of progestogen to oestrogen replacement therapy may significantly decrease the risk for carcinoma of the breast. It was observed that the RR of breast cancer varied from 0.47 to 0.89 in these studies when oestrogen-progestogen users were compared with unopposed oestrogen users. However, it is pointed out that progestogens are not added to oestrogen replacement therapy to negate an increased risk of breast cancer from unopposed oestrogens, since oestrogen therapy does not increase the risk. Combination oestrogen-progestogen therapy is recommended for hormone replacement treatment, even in women who have had a hysterectomy, because it will reduce the risk for breast cancer in some women. PMID- 3309573 TI - Risk factors as an indicator for breast cancer screening in asymptomatic patients. AB - A review of breast carcinoma risk factors has established that age and sex are dominant variables. Additional epidemiological factors include family history, past medical history, menstrual status, age at birth of first child, demographic factors and reproductive history, which are of established importance as major or minor risk determinants for breast cancer. Taking into account the various epidemiological correlations and the multifactorial aetiology of this type of carcinoma, there is only a small probability that the identification of known risk factors will enable conclusive identification or prevention of the disease. Nevertheless the recognition of known risk factors may enhance screening efforts through surveillance, more selective biopsies and interval xeromammography. Total ductoglandular mastectomy may possibly be considered a beneficial approach to the management of the high-risk patient in whom preinvasive disease is detected. The identification of the high-risk patient is of paramount importance for prophylaxis. Prospective clinical trials using diagnostic approaches may include the study of genetic markers, hormones and steroid metabolites, mammographic parenchymal patterns and the analysis of genetic pedigree or other undetermined risk markers. While screening and detection programmes for breast carcinoma are not cost-effective, these intensive surveillance procedures do allow the early identification of high-risk individuals with the disease. The formulation of screening programmes which incorporate major and minor risk determinants may enhance the effectiveness of efforts to achieve diagnosis at a prognostically favourable stage of disease. Established diagnoses of stage 0 or stage I disease will translate as direct benefits to survival and reductions in economic morbidity. PMID- 3309574 TI - Analysis of fatty acid composition of Candida species by gas-liquid chromatography using a polar column. AB - The fatty acid composition of representative Candida species was examined by gas liquid chromatography (GLC) using a polar column. The major fatty acids were C14:0, C16:0, C18:0 saturated, C16:1 and C18:1 monoenoic series, with or without C18 polyunsaturated acids (C18:2 and C18:3). In Torulopsis glabrata and Saccharomyces cerevisiae the C18:2 and C18:3 acids were not found, but the C10:0 and C12:0 acids were detected in S. cerevisiae. These results indicated that the Candida genus could be distinguished from Torulopsis and Saccharomyces genera by GLC analysis of fatty acids. Quantitative differences in the fatty acid composition between cells grown at high temperature (37 degrees C) and low temperature (25 degrees C) were found generally in Candida species, and the amounts of C18 polyunsaturated acids (C18:2 and C18:3) increased in the cells grown at 25 degrees C. Each Candida species showed a characteristic profile in fatty acid composition. Determination of the cellular fatty acid composition in Candida species is likely to be useful for the grouping or chemotaxonomy of newer isolates of Candida species. PMID- 3309575 TI - Incidence and transfer of R-plasmids at a hospital in Saudi Arabia. AB - One hundred and fifty Gram-negative bacteria isolated from patient specimens at King Faisal Specialist Hospital were examined for their ability to transfer antibiotic resistance plasmids to a sensitive Escherichia coli recipient in conjugation and transformation experiments. Agarose gel electrophoresis was used to enumerate and size the R-plasmids found, and Southern DNA hybridization was used to assess similarities between antibiotic resistance plasmids from different bacteria and sources. Of the bacterial isolates tested 65% contained plasmids, 70% of these transferred antibiotic resistance to E. coli, and 40% transferred multiple, linked resistances on R-plasmids. DNA hybridization of these R-plasmids demonstrated widespread similarities between plasmids from different bacterial genera and from different hospital locations. In particular, a gene encoding ampicillin resistance appeared especially widespread, indicating that a transposon may be mediating transmission of this resistance. PMID- 3309576 TI - Changes in regional plasma extravasation in rats following endotoxin infusion. AB - Regional differences in plasma extravasation during endotoxin shock in rats and a possible relationship with changes in regional blood flow were studied with radioactive isotopes (125I-HSA, 51Cr-labeled red blood cells, microspheres) in anesthetized rats (pentobarbital). Shock was induced by intravenous infusion of endotoxin (Eschericia coli; 10 mg X kg-1) for 60 min (starting at t = 0); at t = 120 min, the experiments were terminated. These rats (n = 8) were compared with time-matched control rats (n = 8). A third group (rats killed 7.5 min after injection of 125I-HSA, i.e., no extravasation; n = 8) served as baseline. The amount of plasma extravasated in 2 hr of endotoxin shock was significantly increased over control values in skin (by 67%), colon (88%), skeletal muscle (105%), stomach (230%), pancreas (300%), and diaphragm (1300%). Losses of 125I HSA into intestinal lumen and peritoneal cavity had also increased over control values by 146 and 380%, respectively. Blood flow was compromised in most organs except heart and diaphragm. Extravasation when normalized for total plasma supply was correlated with total blood supply; the more the blood supply decreased, the higher the normalized extravasation. In the diaphragm, however, blood supply and plasma leakage increased together. Decreased blood supply and plasma extravasation may be related but they could also be simultaneously occurring independent phenomena with a common origin. PMID- 3309577 TI - The response of arterioles in skeletal muscle grafts to vasoactive agents. AB - Arteriolar responses to the vasodilator adenosine and to the vasoconstrictor norepinephrine (NE) were examined in small bundles of extensor digitorum longus muscle grafted onto the cheek pouches of hamsters. Responses of arterioles to topically applied adenosine or NE were measured from 30 to 180 days after grafting and compared with the response of arterioles in control cheek pouches. Verapamil and potassium chloride (KCl) were applied to 120- and 180-day grafts to determine the response of arterioles to vasoactive agents not mediated by receptors. Arterioles in grafted muscle did not respond to adenosine until 60 days. The response increased with time but was significantly less than the control value even after 180 days. Arterioles in grafts did not respond to NE until 90 days. At both 90 and 120 days the degree of constriction in response to NE was not uniform along the length of a given arteriole (punctate response). By 180 days, the response of a given arteriole to NE was uniform but significantly less than the control value. In 120- and 180-day grafts the responses of arterioles to verapamil and KCl were similar to the responses of arterioles to adenosine and NE, respectively. We conclude that the diminished response of arterioles in small EDL muscle grafts to vasoactive agents may be caused by either a structural or a functional impairment in the smooth muscle layer of arterioles. PMID- 3309578 TI - Evaluation of the experimental pathogenicity of some Cryptococcus species in normal and cyclophosphamide-immunodepressed mice. AB - The pathogenic potential of distinct Cryptococcus species has been evaluated in mice rendered leukopenic by one or two injections of the potent immunosuppressive drug cyclophosphamide (Cy). Pathogenicity assessment included enumeration of viable cryptococcal cells in animal organs and histopathological observations. It was found that putatively non-pathogenic species of Cryptococcus, in particular C. cereanus and C. albidus, showed significant lethality for Cy-treated mice. In Cy-immunodepressed mice, challenged with the infectious cryptococcal cells two days after pharmacological treatment, a significant decrease of LD50 (equivalent to at least one order of magnitude) was observed for all Cryptococcus species. However, the pathogenicity enhancement due to Cy immunodepression was greater with C. neoformans. In all cases, brain and kidney were the most invaded tissues as also evidenced by histopathological examination, which showed the typical cystic lesion. All the observations made point to the conclusion that the pathogenic potential, for the immunomodulated host, of Cryptococci other than C. neoformans is significant being quantitatively and not qualitatively different from that of C. neoformans, as evidenced by a similar organotropism and similar type of histological lesions in the target organs (brain and kidney). PMID- 3309580 TI - Watch midwife: aid for the deaf, pregnant woman. PMID- 3309579 TI - Effects of a new antibiotic, isohematinic acid, on the resistance of mice to experimental infections. AB - Isohematinic acid, an antibiotic newly isolated from the culture broth of Actinoplanes philippinensis SANK 61681, was assessed for its ability to enhance nonspecific resistance to bacterial infections against Escherichia coli and Pseudomonas aeruginosa in mice. This agent, as well as BM 12,531 (Azimexon), was found to prolong the survival of normal mice infected with E. coli and also of compromised mice infected with either E. coli or P. aeruginosa, whose defense system had been deteriorated by treatment with carboquone, an alkylating agent. Like BM 12,531, isohematinic acid administered to normal mice significantly increased the nitroblue tetrazolium reducing potency of polymorphonuclear leucocytes (PMN), indicating that the microbicidal activity of PMN was enhanced by these agents. In addition, in the compromised mice these agents were able to restore the number of peripheral blood leucocytes, which had been reduced to about 30% of the normal level by carboquone. These results suggest that isohematinic acid, like BM 12,531, enhances nonspecific resistance to these bacterial infections by stimulating the microbicidal activity of PMN and inducing leucocytosis. PMID- 3309582 TI - [Results of the storage of freeze dried microbial cultures for 25 years]. AB - Saprophytic microorganisms belonging to different physiological groups (Azotobacter, acetic, ammonifying, lactic and nodule bacteria, a phototrophous purple bacterium of the Chromatium genus, bacteria of the Micrococcus and Pseudomonas genera, and a yeast of the Candida genus) were stored at 3-6 degrees C for 25 years in the freeze-dried state. All of the strains were found to be viable after the storage. The number of viable cells decreased for some bacteria, but to a far less degree than when the cultures were kept immediately after the freeze-drying for a year at 30 degrees C. PMID- 3309581 TI - [The effect of low-intensity light from the red and far red regions of the spectrum on Escherichia coli]. AB - The effect of red and far red light having a low intensity on Escherichia coli growth was studied. The growth accelerated when the culture was irradiated with the light at a dose of 1--4 X 10(3) J/m2. When the light of the two spectral regions was used together, the effect depended on the dose and order of the irradiation. It is possible that receptors for red light and for far red light interact in E. coli cells. PMID- 3309583 TI - [Neonatal group B colonization and maternal urogenital and anorectal system carriage]. AB - In pregnant women, the main reservoirs of group B streptococci (GBS) are rectum and urethra. The mother's birth canal and the newborn infant easily contract the organisms from these sites. We studied 100 women and their newborn babies to determine the relation between the maternal carriage and the neonatal group B streptococcal colonization. Vaginal, urethral and rectal swabs obtained from all pregnant women during labor. Within a few minutes after birth and on day 4 of life swab specimens were also taken from the external auditory canal, throat and umbilicus of the infants. The overall maternal carriage rate was found to be 7.00 percent. The frequency of transmission to the neonates was found to be 57.14 percent among maternal carriers. In early neonatal period, the colonization rate of GBS was found to be % 4.0 percent and the infection rate of GBS was found to be 2.0 percent among the newborn population. PMID- 3309584 TI - [Throat culture isolation and Haemophilus influenzae cross reactions of Escherichia coli serotypes]. AB - 73 strains of Escherichia coli were isolated from throat cultures of patients examined in the clinics of Children's Hospital of Hacettepe Medical Faculty. 11 of them were serotype 075:Kq5:H5, 8, 07:K1:05 and 1, 07:K1:H--. These 20 strains were tested for the presence of cross-reacting antigens with the Haemophilus influenzae type b. 6 strains gave precipitation zones in the agar and found to be positive. 4 of them were 07:K1:H--, 1, 075:Kq5:H5 and 1, 07:K1:H5. PMID- 3309586 TI - Suicide in young persons. PMID- 3309585 TI - [Serological tests for the diagnosis of toxoplasmosis]. AB - There are number of tests that can be used in diagnosis of Toxoplasmosis. The clinical findings should always be supported by serological tests for a definitive diagnosis. A four fold use in the titre, or a titre of over 1:32 for IgM should be sought for the diagnosis of acute toxoplasmosis. In this article the validity of the IgG and IgM antibody titres in diagnosis of acute toxoplasmosis and congenital toxoplasmosis are discussed. PMID- 3309587 TI - Drugs of abuse in pregnancy--an overview. PMID- 3309588 TI - The detection of early breast cancer: three-year results from a diagnostic breast clinic. AB - The initial results from a diagnostic breast clinic in which clinical examination, x-ray mammography and ultrasound are used to establish a diagnosis during a single patient-visit are described. In 3461 patient-visits, 82 histologically-proven breast cancers were detected. Fifty-two per cent of these cancers were 2 cm or less in diameter and 61% had no axillary lymph-node metastases. Fifteen cancers were impalpable lesions which were detected by mammography alone. The over-all malignant-to-benign biopsy ratio was 1:2.7; for impalpable tumours, this ratio was 1:3.9. The role of such a diagnostic breast clinic is discussed, and attention is drawn to a relatively low attendance of women in the "high-risk" age group of over 50 years of age. PMID- 3309590 TI - Liver transplantation in Australia. PMID- 3309589 TI - Autonomic neuropathy after rubella infection. AB - A woman with autonomic neuropathy after rubella infection is described. She had features of both sympathetic and parasympathetic impairment, the major problems being postural hypotension, abdominal and parotid pain, and fatigue. Autonomic dysfunction persisted 38 months after the rubella infection with minimal response to treatment. The literature relating to autonomic neuropathy is reviewed, and the similarities of this patient's condition to the Guillain-Barre syndrome are discussed. PMID- 3309591 TI - Surgery for gallstones--when? PMID- 3309593 TI - The Queensland Liver Transplant Programme: the first two years. AB - Orthotopic liver transplantation began in Brisbane in January 1985. During the first two years of the programme an assessment committee evaluated 55 patients (38 adults, 17 children). Patients were either accepted for transplantation, rejected as unsuitable or deferred for elective reassessment. All of the 10 adults who were rejected for transplantation because they had "too advanced" disease died within four months of assessment. Six children who were accepted for transplantation died before a suitable donor liver could be found. In the first two years, 21 orthotopic liver transplantations were performed on 18 patients (adults, 13 patients; children, five patients). Fifteen of 21 grafts were procured from within Queensland. Twelve (67%) patients are alive at three to 23 months and all have been discharged from hospital. Deaths in adults were due to sepsis (three patients), aspiration pneumonitis (one patient), rejection and hepatic artery thrombosis (one patient) and the recurrence of a hepatocellular carcinoma five months after discharge from hospital (one patient). Two patients underwent a second transplantation procedure because of chronic rejection at four months and at 11 months, respectively, after the initial operation. One patient received a second transplant for primary graft failure at four days after the operation. A scoring system which considered the presence of pre-operative patient factors, such as coma, ascites, malnutrition and previous abdominal surgery, partly predicted the operative blood loss and patient survival. In conclusion, orthotopic liver transplantation is being performed in Australia with survival rates that are comparable with those of established overseas units. PMID- 3309592 TI - Initial report of the Australian National Pilot Liver Transplantation Programme. AB - Our group began a National Pilot Liver Transplantation Programme in January, 1986, for which this report documents the results of the first 15 months' work. Seventy potential recipients (55 adults, 15 children) were referred for consideration for liver transplantation either directly or by state selection committees that had been established in most Australian states. The most common conditions for referral of adults were chronic active hepatitis, primary sclerosing cholangitis and primary biliary cirrhosis; 11 patients had fulminant hepatic failure. In children, the most common condition for referral was biliary atresia. Twenty-nine (41%) patients were considered unsuitable candidates for liver transplantation, 25 patients (21 adults and four children) were accepted for transplantation at a later time, and 16 patients (11 adults and five children) were selected for immediate transplantation. Of these 16 patients, three patients died before a donor could be found. Of the 13 patients to receive transplants (one patient received two transplants), 10 patients (seven of nine adults; three of four children) are alive and well; nine patients have good liver function and one patient has impaired liver function. The additional costs of the Programme to the hospitals were estimated at approximately $2 million a year. It is concluded that for those persons who require liver transplantation in Australia, worthwhile survival after this procedure can be obtained. PMID- 3309594 TI - Third International Conference on the acquired immunodeficiency syndrome. PMID- 3309595 TI - Digoxin in the 1980s. PMID- 3309596 TI - [Teratogenic damage caused by alcohol]. PMID- 3309598 TI - Brain stem death--the evolution of a concept. PMID- 3309597 TI - [Malaria--chemotherapeutic agents and immunoprevention]. PMID- 3309599 TI - Enterotoxigenic Escherichia coli O153:H45 from an outbreak of diarrhoea in Spain. AB - Enterotoxigenic Escherichia coli (ETEC) strains belonging to a characteristic serobiotype, O153:H45 ST+, were isolated from an outbreak of neonatal diarrhoea in Valencia, Spain. The restriction of the geographical location of this clone to South America and Spain is discussed. PMID- 3309600 TI - Neuroblastoma overview--1986. AB - Understanding of the biology of neuroblastoma has advanced dramatically in the last several decades. Misunderstood and misdiagnosed in the early years of this century, neuroblastoma is now the prototypic model for research in the molecular biology and genetics of the transformed cell. It is through these advances in knowledge of the malignant process, and of neuroblastoma itself, that exquisitely targeted therapies will shortly evolve. These include not only immunologic approaches through monoclonal antibodies, but also the exploitation of metabolic pathways. Radioactive meta-iodobenzylguanidine (MIBG) is among the most promising of the latter methods. It is deservedly undergoing clinical tests for its diagnostic and therapeutic applications in the management of neuroblastoma patients. PMID- 3309601 TI - Update on basic research and clinical experience with metaiodobenzylguanidine. AB - I 131-metaiodobenzylguanidine (MIBG) is an aralkylguanidine with certain structural similarities to norepinephrine (NE). It is concentrated, stored, and released from chromaffin granules in a manner almost identical with that of NE. It will image the enlarged adrenal medullae of adrenal medullary hyperplasia when the CAT and NMR scans are normal. It is more sensitive in detecting extra-adrenal pheochromocytomas than CAT and NMR imaging. Because 46% of our 176 patients with histopathologically proved "benign" pheochromocytomas (pheos) have developed demonstrable metastases, with or without elevated plasma and urinary catecholamines, we now image all patients with "benign" pheos yearly. As of January 22, 1986 we had treated 28 patients with malignant pheos 71 times with MIBG. As of July 24, 1986, we had given 34 neuroblastoma patients 55 tracer doses. In some cases MIBG demonstrates more neuroblastoma than all other imaging modalities and this is helpful in staging. We have had 30-50% objective regressions in neuroblastoma tumor mass in 3 out of the first 12 patients treated. These three patients had slower-growing tumors and a lower body burden than the nonresponders. We also record the sensitivity of MIBG imaging of neuroendocrine tumors other than pheos and neuroblastomas. PMID- 3309602 TI - Radiochemistry, biochemistry, and kinetics of 131I-metaiodobenzylguanidine (MIBG) and 123I-MIBG: clinical implications of the use of 123I-MIBG. AB - Metaiodobenzylguanidine (MIBG) is actively concentrated in adrenergic neuroendocrine tissues and tumors by an active, energy- and sodium-dependent, high-affinity, saturable mechanism. This has proved successful, when labeled with 131-I or 123-I, in scintigraphically depicting pheochromocytomas and neuroblastomas. For imaging purposes 123-I has multiple advantages over 131-I; the gamma ray energy is ideal for modern instruments, the decay by electron capture limits the particulate emissions, and the short half-life reduces the radiation burden. It is thus possible to use doses of 123-I-MIBG 20 times as large as doses of 131-I-MIBG with equivalent absorbed radiation doses. Disadvantages of 123-I include the cost and difficulties in the regular delivery of this short-lived radionuclide. For most imaging purposes 123-I-MIBG is the optimal agent if logistical problems in its supply can be overcome. PMID- 3309603 TI - Metaiodobenzylguanidine (MIBG) labeled with 123I/131I in neuroblastoma diagnosis and follow-up treatment with a review of the diagnostic results of the International Workshop of Pediatric Oncology held in Rome, September 1986. AB - Our experience in scintigraphic diagnosis using 123I/131I-metaiodobenzylguanidine (MIBG) on 37 children with neuroblastomas stage III-IV is reported and discussed, together with the results obtained by other authors on MIBG diagnosis at the International Workshop of Pediatric Oncology held in Rome in September 1986. In our own investigation, 49 examinations were undertaken with 123I-MIBG and 66 with 131I-MIBG partly under therapy conditions with high-activity doses of 131I-MIBG. There were 29 neuroblastomas, 3 ganglioneuromas, and 3 ganglioneuroblastomas. The localization of all primary tumors was over 90%; for neuroblastomas with a high level of catecholamine excretion, over 95%. The specificity was about 100%. The sensitivity with respect to tumor relapse and all localization of metastasis and bone-marrow tumor infiltration in the follow-up-phase approaches was 70% during or after therapy. What emerges from the experience of most investigators is that 123I-MIBG is the agent best suited to detect tumor relapse and metastasis, especially in the bone marrow. MIBG examinations are of great value in follow-up studies for detecting tumor relapse and bone marrow infiltrations, especially before the onset of clinical symptoms and other indications. PMID- 3309604 TI - Treatment of neuroblastoma with metaiodobenzylguanidine: results and side effects. AB - Between April 1984 and December 1985 we treated ten children suffering from neuroblastoma in a total of 25 metaiodobenzylguanidine (MIBG) courses. Five had had a relapse of neuroblastoma stage III or IV, three had never achieved a remission in spite of intensive chemotherapy, and two were treated with an unstable remission. The children were each administered from 1 to 5 courses with a dosage per course of between 1,295 and 9,065 MBq. The sum of the single doses during the whole course of therapy ranged between 3,145 and 21,904 MBq per child. Five of five children suffering from bone pain and fever became free of complaints during the first three treatment days. Six of eight children with manifest tumor at onset of therapy responded well to the treatment: response extended from transitory decrease in elevated catecholamine levels in serum and urine to complete disappearance of large abdominal tumor masses. We also observed a decrease in bone marrow involvement and a stabilization of osteolytic lesions. Seven of these eight children died in spite of a good response from 55 to 350 days after the first MIBG treatment course. The only side effect we witnessed was a reversible bone marrow depression. In three children we combined the MIBG therapy with bone marrow transplantation. PMID- 3309605 TI - High-dose melphalan, vincristine, and total-body irradiation with autologous bone marrow transplantation in children with relapsed neuroblastoma: a phase II study. AB - Seven children with neuroblastoma who had relapsed on or after conventional therapy (3 originally stage IV, 3 stage III, 1 stage II) were entered on a study of "massive therapy" with purged autologous bone marrow rescue. In 5 patients attempts were made to reinduce remission with alternative chemotherapy, and a partial or complete response was achieved in 3. The massive therapy regimen comprised melphalan, vincristine, and total-body irradiation. Of 6 patients with measurable disease, all showed objective response to high-dose therapy (5 partial, 1 complete remission), but the median duration of remission was only 5 months (range 1/2 to 10). One patient remains disease-free at 18 months post graft. This patient was the only one treated in second complete remission. These data confirm the high response rate achieved by high-dose melphalan, total-body irradiation regimens, but it appears unlikely that a single high-dose chemoradiotherapy procedure will cure patients after relapse, particularly if they are unresponsive to conventional salvage regimens. Such protocols may, however, have a role as consolidation in first remission. The use of double autograft procedures is an alternative that warrants further investigation in patients with relapsed neuroblastoma. PMID- 3309607 TI - [Epidemiology of Hodgkin's disease: familial occurrence. Exogenous factors?]. PMID- 3309606 TI - Long-term sequelae of cancer treatment on the central nervous system in childhood. AB - Increasing numbers of children with cancer, including those with acute lymphocytic leukemia and medulloblastoma, are experiencing long-term disease control. As survival increases, so does the recognition that the treatment used to prolong survival may have significant detrimental effects on the central nervous system (CNS). Because of the slow replication rate of most constituents of the CNS, these effects tend to be delayed. Radiotherapy, and to a lesser extent, chemotherapy (primarily methotrexate) have been implicated in the causation of such sequelae. The pathogenesis of CNS damage is only partially understood and evidence suggests that direct effects on intracranial endothelial cells and brain white matter and immunologic mechanism play a role. A spectrum of clinical syndromes may occur, including radionecrosis, necrotizing leukoencephalopathy, mineralizing microangiopathy with dystrophic calcification, cerebellar sclerosis and spinal cord dysfunction. The two most common forms of sequelae are neuropsychological and neuroendocrinologic damage. The frequency, degree of and etiology of neurocognitive dysfunction is less than completely elucidated. Radiotherapy has been implicated as the major cause of damage, but the relationship between radiotherapy and the type of damage caused and the volume and dose of radiotherapy and degree of cognitive damage is unclear. Cognitive deficits are progressive in nature. Younger children are more likely to suffer the severest damage; but no patient of any age is free of risk of damage. Growth hormone impairment is the most common form of neuroendocrinologic dysfunction. There is increasing evidence that children with cancer who are long term survivors are at increased risk for the development of secondary CNS tumors; possibly due, in part, to previous treatment. Much work needs to be done to characterize the sequelae which may occur, develop means of earlier detection, investigate ways to ameliorate sequelae and devise less toxic treatment. PMID- 3309608 TI - [Diagnostic value and functional damage of fiber optic bronchoscopy]. PMID- 3309609 TI - [Echographic characteristics of the polycystic ovary syndrome]. PMID- 3309611 TI - Perforation of the esophagus by chicken bones. A report of two cases and a review of the literature. PMID- 3309610 TI - Ultrasonic calling in rodents: a new experimental approach in behavioural toxicology. AB - Ultrasonic calls are emitted by many species of rodents in a variety of situations. In particular, infants commonly emit such calls when removed from the nest; the rate and intensity of calling are related to the degree of development of homoiothermy. The relevant biological significance of these signals is documented by their capability to promote parental behaviour, such as maternal retrieval. There is recent evidence that ultrasonic vocalization in rodent pups could be valuable as a bioassay in Behavioural Toxicology. In particular, the results of our recent studies together with those of other authors suggest that ultrasonic calls emitted by infant rats could be considered a useful test in detecting subtle effects of adverse treatment during development. PMID- 3309612 TI - Hepatic manifestations of rheumatic disorders. PMID- 3309614 TI - [Conformation of oligonucleotides in solution from data of the nuclear Overhauser effect]. AB - In this review the results of studies of oligonucleotides conformation in solution by 1D and 2D NOE over the last four years are presented. Theoretical basis of 2D NOE and other 2D techniques are briefly considered. The few attempts of determination of oligonucleotides structures in solution on the half quantitative level and the perspectives of using 2D NOE for quantitative structure resolution are discussed. PMID- 3309613 TI - [Enzymatic transamination: the history of its discovery and milestones in the study of its mechanism and biological role (on the 50th anniversary of its discovery)]. AB - The history of discovery of enzymic transamination is described. A survey presents the crucial steps of the investigations of the catalytic mechanisms and metabolic functions of transaminases. PMID- 3309615 TI - [Experimental study of DNA hydratation]. AB - The present article as a review of experimental investigations of water-DNA interaction in solutions, films, fibres, and crystals. The discussion of the experimental data is directed to the analysis of the sizes of the hydration shells of the DNA atomic groups, the distances at which atomic groups of DNA affect the hydration of each other; the structural, thermodynamic and kinetic characteristics of the water in the DNA hydration shell and their relations with DNA structure. The modern views on the mechanisms by means of which the water affects the physico-chemical properties of DNA are discussed. PMID- 3309616 TI - [Molecular biology, darwinism and nomogenesis]. AB - The theory of nomogenesis put forward by L. S. Berg in 1922 is discussed. It is shown that side by side with some erroneous anti-darwinian ideas the theory contains a series of important suggestions which anticipate the further development of the synthetic theory of evolution. Berg has foreseen the development of molecular biology. Thus he was the fore-teller of our branch of science. The theory of nomogenesis emphasized the limitations of natural selection which determine the directionality of evolution. Berg treated the speciation as a kind of phase transition. Even the most conscientious critics of Berg have misrepresented the real sense of his works. It is totally groundless to treat nomogenesis as an idealistic of Lamarkian theory. Berg was superior to his critics. However the enthusiasm about nomogenesis in our time shows the inability to separate "the grains from weeds". PMID- 3309617 TI - [Regulation of expression of the htpR gene in Escherichia coli]. AB - The hybrid operon htpR: ATP was obtained, in which the expression of the aminoglycoside phosphotransferase gene is controlled by the promoter of the htpR gene of Escherichia coli. It was shown that the transcription of the htpR gene is not induced during the "heat shock". The basal level of the htpR gene transcription in htpR mutants was found to be two times higher than that in the strains of the "wild type". These findings suggested that the expression of the htpR gene is autoregulated. Hybridization experiments demonstrated that the genome of Pseudomonas bacteria contains the htpR-like gene. PMID- 3309618 TI - [Effectiveness of the promoter Ptac' in vitro and in mini-cells]. AB - The efficiency of hybrid promotor Ptac', comprising a synthetic trp-promoter and lacUV5 "-10" sequence, was studied. By means of electrophoresis and hybridization of RNA-products obtained in vitro and in minicells, with promotor-containing plasmids; the hybrid promotor was found to be 6 times and 3-4 times as efficient as trp and lacUV5 promoters, respectively. PMID- 3309619 TI - [RNA M1 and other catalytically active polyribonucleotides]. AB - A review of data on the RNA components of RNAase P which proved to be the catalytic subunits of the enzyme is given. The properties of the polyribonucleotides, the comparison of their structure and the principles of their action, suggested at the time being, are discussed. PMID- 3309620 TI - [Genome-linked proteins in DNA and RNA viruses]. AB - General principles of the organization of viral nucleic acid--protein covalent complexes are formulated. Participation of the genome-linked proteins in the initiation of viral nucleic acid replication is discussed. PMID- 3309621 TI - [Mechanism of enzymatic catalysis. Quantum chemistry study of models of serine proteases]. AB - The results of molecular orbital calculations for reactions in the active site of serine proteases are outlined. The agreement and disagreement between these results and the theories of enzyme catalysis are discussed. PMID- 3309622 TI - [Primary structure of mRNA and translation strategy of eukaryotes]. AB - The diversity of primary structures of cellular and virus mRNAs was considered from the standpoint of their functioning at the initial stops of translation. The number and reciprocal localization of the open translational frames along the mRNAs, and also the number, localization and nucleotides surroundings the initiation codons were analysed. The structural organizations of the polycistronic and other non-canonical forms of native mRNAs, translated in eukaryotic cells, were considered and classified. The possible mechanisms of translation initiation by different forms of mRNAs are discussed. PMID- 3309623 TI - [Affinity modification of Escherichia coli ribosomes by 4-[(N-2-chloroethyl)N methylamino]benzyl-5'-phosphamide hexauridylate in a complex stabilized by codon anticodon interactions on P and A sites]. AB - Affinity labeling of E. coli ribosomes with 4-[(N-2-chloroethyl)-N-methylamino] benzyl-5'-phosphamide of hexauridylate was studied within the complex containing tRNAPhe at P site and Phe-tRNAPhe at A site directed by EF-Tu and GTP. Ribosomal proteins as well as rRNA both in 30S and 50S subunits were found to be labelled within the complex. Labeled proteins were identified as S3, S9 and L2. Selectivity of affinity labeling with mRNA analogs was shown to depend on the functional state of the ribosomes. Modification was more selective within the complex stabilized by codon-anticodon interaction both at A and P-sites than within the complex in which this interaction takes place preferentially at P site. PMID- 3309624 TI - Activation of human serum complement by bacterial lipopolysaccharides: structural requirements for antibody independent activation of the classical and alternative pathways. AB - A variety of bacterial lipopolysaccharide (LPS) preparations with highly defined primary polysaccharide chemical structure and/or aggregate macromolecular composition have been employed to examine the molecular requirements for activation of the classical and alternative pathways of human serum complement. Evidence is presented for two independent modes of polysaccharide dependent activation of the APC by LPS. One mechanism is dependent upon specific O-antigen polysaccharides and the second is defined by a specific L-glycero-D mannoheptose/glucose region of the core oligosaccharide. LPS O-antigen polysaccharide but not core oligosaccharide determinants can convert sheep erythrocytes to cells capable of initiating the APC. The data presented provide convincing evidence that the tertiary assembly of individual LPS subunits into an aggregate macromolecule is a critical determinant in the expression of APC activity by LPS. The results of these studies provide strong evidence that CPC activation by LPS is restricted to the Re-chemotype and isolated lipid A. LPS isolated from other R-chemotypes as well as native wild type LPS preparations do not activate the CPC, in spite of the fact that the former LPS preparations contain more lipid A than polysaccharide on a percentage by wt basis. The presence of core polysaccharide L-glycero-D-mannoheptose, which provides a critical recognition role for activation of the APC, appears to negatively regulate CPC activation in a similar inverse relationship. In addition, the presence of polysaccharide containing LPS subunits in synthetic mixed LPS micellar aggregates can also restrict CPC activation by Re LPS subunits, most probably by steric hindrance at the LPS macromolecular surface. Our data are consistent with the hypothesis that activation of either pathway of human serum complement by a given LPS preparation is a mutually exclusive event dictated by the presence or absence of L-glycero-D-mannoheptose. PMID- 3309625 TI - A natural auto-inhibitory factor of the terminal complement pathway in serum of Ctenodactylus gondi. AB - The serum of Ctenodactylus gondi, a Tunisian rodent, contains a unique inhibitor of the terminal complement pathway. The auto-inhibitor has been partially characterized as a heat-stable euglobulin that is slightly retarded on a DEAE-ion exchange column at pH 7 and elutes as a symmetrical peak on Sephacryl S-300 in the mol. wt region of approximately 200,000. The inhibitor acts by preventing attachment of cytolytic C5b-9 complexes to natural target cells. It does not appear to affect formation and function of C3-convertase, does not exert inhibitory effects at stages later than C5b-7 formation, and also does not prevent formation of SC5b-9 in serum. That the factor prevents attachment of C5b 7/C5b-9 to cells has been demonstrated in hemolysis model systems using sheep EA + human serum, and in the C3-independent reactive lysis system with the use of ELISA methods and quantitative assays with radioiodinated C8. Addition of partially purified inhibitory factor to human sera or to sera of other animal species abolishes the hemolytic activities of these sera. The inhibitory factor of Gondi serum is the first inhibitor of the terminal pathway which has been shown to be capable of preventing cytolysis of cells undergoing complement attack under physiological conditions. The presence of this factor is probably partially responsible for the remarkable susceptibility of C. gondi towards bacterial and parasitic infections. PMID- 3309627 TI - [Current aspects of the endocrinology of female puberty]. AB - Some important aspects of current knowledge on female pubertal development are reviewed specially regarding hormonal events. Pulsatile hypothalamic (LHRH-) activity occurs early in childhood and shows a specific development after the onset of puberty, resulting in progressive enhancement of gonadal estrogen and gestagen secretion finally until the menstrual cycle is established by specially characterized hormonal controls. In the ovary an "internal metabolic milieu" is necessary for normal adult function. Some pathophysiological problems and clinical syndromes leading to functional or systemic developmental failure are discussed shortly. PMID- 3309626 TI - Biotinylation: an alternative to radioiodination for the identification of cell surface antigens in immunoprecipitates. AB - A method has been developed in which the conventional radioiodine label is replaced by non-radioactive biotin in studies involving the immunoprecipitation and analysis of cell surface antigens. The labelling reagent, d-biotinyl-N hydroxysulfosuccinimide ester (NHSS-biotin), reacts preferentially with lysine residues in polypeptides and possibly also with free amino-groups on carbohydrates and lipids. The reagent can be used as a cell surface label, does not interfere with antigen-antibody interactions and allows labelled molecules to be detected with high sensitivity using streptavidin-peroxidase conjugates. The target antigens of a range of monoclonal antibodies to human cell surface components have been identified using this procedure. PMID- 3309628 TI - [Clinical and prognostic aspects of congenital hydrocephalus]. AB - Clinical data of 24 patients with congenital hydrocephalus are presented. 13 children died within the first 7 months of life; the average period of survival was 2 months. Associated malformations of the CNS or other organs, severely raised intracranial pressure in utero, and postnatal complications involving the CNS indicated a poor prognosis. The follow-up of the 11 surviving children showed severe neurologic sequelae and drug resistent epilepsy in 2 of them. Three others had neural tube defects and associated paraplegia. The 6 remaining children had mild or moderate cerebral palsy or were moderately mentally retarded. If possible, birth should not be induced before 36 weeks of gestation, and the hydrocephalus should be shunted soon after birth. Satisfactory results can be obtained in about one half of surviving patients by early shunting of congenital hydrocephalus. PMID- 3309629 TI - [Cystic hygroma of the neck and non-immunologic hydrops fetalis]. AB - Fetal cystic hygromas are a manifestation of early lymphatic obstruction. They are mostly associated with nonimmune hydrops fetalis. They often occur in a number of chromosome abnormalities (Turner syndrome and Down syndrome). We report on a prenatally detected case with nuchal cystic hygroma and nonimmune hydrops fetalis without chromosome aberration and without further major malformations. Postnatally hygroma and hydrops regressed. PMID- 3309630 TI - Neural control of the exocrine pancreas: an analysis of the cholinergic, adrenergic, and peptidergic pathways and their positive and negative components. 1: Neural mechanisms. PMID- 3309631 TI - Protease-antiprotease balance in serum and pancreatic tissue in acute experimental pancreatitis in rats. PMID- 3309632 TI - Recovery of pancreatic function after distal resection for chronic pancreatitis: regeneration or merely functional amelioration? PMID- 3309633 TI - Lymphoma of the pancreas. PMID- 3309634 TI - Crohn's disease of the duodenum associated with pancreatitis: a case report and review of the literature. PMID- 3309635 TI - Enteric tuberculosis: literature review. PMID- 3309636 TI - omega-Hydroxyemodin, a major hepatic metabolite of emodin in various animals and its mutagenic activity. AB - The hepatic microsomes derived from various animal species transformed emodin (1,3,8-trihydroxy-6-methylanthraquinone), an anthraquinoid pigment present in fungal metabolites and a constituent of plant medicines, into an unidentified anthraquinone h, along with 2-hydroxy-, 4-hydroxy- and 7-hydroxyemodins. TLC, UV, MS and NMR clarified this unidentified major metabolite as omega-hydroxy-emodin (1,3,8-trihydroxy-6-hydroxymethylanthraquinone). Among 7 animal species, the highest activity to produce this omega-hydroxyemodin was observed in the hepatic microsomes of guinea pig and rat, followed by mouse and rabbit. The microsomal activity to convert emodin into omega-hydroxyemodin was accelerated by the pretreatment of animals with phenobarbital, and inhibited by SKF 525A. The microsomal hydroxylation reactions of the methyl residue and the anthraquinoid nucleus of emodin were presumed to be catalyzed regiospecifically by multiple forms of cytochrome P-450. omega-Hydroxyemodin was not mutagenic to Salmonella typhimurium in the absence of S9, but exhibited mutagenicity in the presence of an activating system. This genotoxic potential was comparable to 2-hydroxyemodin, a direct-acting mutagen. PMID- 3309637 TI - Inter-laboratory variability in Ames assay results. AB - The Ames test is widely used in the screening of chemicals and compounds for potential carcinogenic effect. There is, however, considerable inter-laboratory variability in results from this assay. Using data from the RTI Collaborative Study of the EPA Ames Test Protocol, we show that their reported standard errors of estimates of mutagenicity fall far short of capturing day-to-day or laboratory to-laboratory variation. We estimate the factors by which the standard errors must be inflated to account for these sources of variation. The laboratory protocol and previous studies suggest that much of this variation may be caused by factors that are relatively constant within days (e.g. technician, incubation temperature, S9 liver homogenate preparation) but vary over days and across laboratories. Therefore, such variation might be reduced through use of a reference compound tested on the same day and under the same conditions as the test chemical. This conjecture was, however, not supported by analyses that considered the positive control compound and a pure chemical as possible reference assays. PMID- 3309638 TI - Comparative activation of 3,3'-dichlorobenzidine and related benzidines to mutagens in the Salmonella typhimurium assay by hepatic S9 and microsomes from rats pretreated with different inducers of cytochrome P-450. AB - The metabolic basis of the differential activation of 4 benzidines--3,3' dichlorobenzidine (DCB), benzidine (BZ), o-tolidine (TOL) and o-dianisidine (DIN) -to mutagens was examined in the Ames test, using Salmonella typhimurium TA98. For each benzidine congener, the comparative activation by 3 rat liver enzyme systems--(i) postmitochondrial supernatant (S9), (ii) S9 + acetylcoenzyme A (S9 Ac) and (iii) microsomes--and the effect thereon of animal pretreatment with 3 cytochrome P-450 inducers--DCB, 3-methylcholanthrene (MC) and phenobarbital (PB)- were examined. DCB was the most activated of the benzidines, with activation by the 3 systems being in the order: S9 = S9-Ac greater than microsomes, whereas dianisidine and tolidine were the least activated. Benzidine was activated only in the S9 systems but the S9-catalyzed activation of benzidine, unlike that of DCB, was enhanced by added acetylcoenzyme A. Pretreatment with either DCB, MC or PB enhanced the activation of DCB, decreased that of benzidine, and had no effect on that of tolidine or dianisidine. The enhanced DCB activation was most pronounced with DCB pretreatment and was 2.5-fold, 2-fold, and 3-fold, in S9-Ac, S9, and microsomes, respectively. The microsomal-catalyzed DCB activation was inhibited by the cytochrome P-450 inhibitors 2,4-dichloro-6 phenylphenoxyethylamine and alpha-naphthoflavone by 93% and 48%, respectively. DCB, but not its congeners, elicited NADPH-dependent metabolite complex formation with microsomal cytochrome P-450. The results show that DCB is the most mutagenic of the 4 benzidines under conditions of cytochrome-P-450-catalyzed activation and suggest that the DCB activation may be catalyzed most effectively by cytochrome P 450 species induced specifically by the compound itself. PMID- 3309639 TI - Incidence of chromosome aberrations in mammalian sperm stained with Hoechst 33342 and UV-laser irradiated during flow sorting. AB - The separation of two sperm populations is possible using the technique of flow sorting, provided that a significant difference exists in the DNA content of X- and Y-bearing sperm. In order to ascertain whether or not chromosome damage was induced in sorted sperm, chromosome preparations were made from isolated sperm that had been microinjected into hamster eggs. While egg chromosomes exhibited a low frequency of chromosome aberrations, ranging from 4 to 7%, a large proportion of sperm cells exhibited chromosome damage. Between 29% of unstained and unsorted sperm and 38% of stained and unsorted sperm exhibited some type of chromosomal abnormality and this proportion increased to 50% in sorted sperm. If only damaged sperm nuclei are considered, the two unsorted sperm groups had a mean of 0.6 breaks, 0.8 triradial exchanges, and 0.2 quadriradial exchanges per nucleus. However, sorted sperm, which were stained with a fluorochrome and exposed to UV laser irradiation, exhibited a mean of 2.9 breaks, 2.6 triradial, and 1.9 quadriradial exchanges per nucleus in which damage occurred. These observations indicate that the treatments and manipulations to which sperm nuclei are subjected during flow sorting cause chromosomal aberrations, and that exposure of the cells to UV-laser irradiation contributes substantially to the chromosome damage observed. PMID- 3309640 TI - Guide for the Salmonella typhimurium/mammalian microsome tests for bacterial mutagenicity. AB - Since its development by Dr. Bruce Ames and his coworkers, the Salmonella typhimurium/mammalian microsome mutagenicity assay has been used widely throughout the world. Many authors have suggested various modifications and made recommendations in regards to this assay. Although the recommendations of a panel of experts was published in 1979 by de Serres and Shelby, a committee of members of the Environmental Mutagen Society (EMS) initiated this effort in response to the encouragement by the American Society of Testing and Materials (Committee E47.09.01) and because of new developments within the field of microbial mutagenesis testing. Its purpose is to provide a guide for people who perform or evaluate microbial mutagenesis tests, but it is not intended for these recommendations to replace or diminish the usefulness of presently available protocols and procedures. PMID- 3309641 TI - Mutagenicity of nitrofurans in Salmonella typhimurium TA98, TA98NR and TA98/1,8 DNP6. AB - 8 representative 2-substituted 5-nitrofurans were assayed for mutagenicity in Salmonella typhimurium strains TA98, TA98NR and TA98/1,8-DNP6. The tested compounds were: 5-nitro-2-furanacrylic N-(5-nitro-2-furfurylidene)hydrazide (1); furazolidone (2); 5-nitro-2-furanacrolein (3); 5-nitro-2-furaldehyde semicarbazone (4); 5-nitro-2-furaldehyde (5); nitrofurantoin (6); 5-nitro-2 furaldehyde diacetate (7); and 5-nitro-2-furoic acid (8). These compounds exhibited markedly different mutagenic activities in TA98, and these mutagenicities were similar both in the presence and the absence of rat-liver hepatic S9 activation enzymes. The mutagenic responses ranged from potent (90-300 revertants/nmole, compounds 1-3), to medium (about 10 revertants/nmole, compounds 4 and 6), to weak (0-4 revertants/nmole, compounds 5, 7 and 8). The mutagenicity of 3 was similar in all 3 tester strains, while compound 8 was essentially inactive. The mutagenicities of 1, 4, 5 and 7 were decreased 30-75% in TA98NR, while 2 and 6 showed an even greater depression of activity in this strain. Compound 6 with S9 was about equally mutagenic in TA98 and TA98/1,8-DNP6, while the activities of 6 without S9 and 2 and 7 both with and without S9 were 50-75% lower in TA98/1,8-DNP6. Compounds 1, 4 and 5 were only about 5-10% as mutagenic in TA98/1,8-DNP6 as in TA98. These results suggest that: (i) nitrofurans and their S9-mediated metabolites have similar mutagenic potencies; (ii) with the possible exception of No. 3, nitroreduction is the major route of mutagenic activation for these nitrofurans; and (iii) for compounds 2, 6 and 7, both the presumed N-hydroxy and N,O-ester derivatives of the corresponding aminofuran metabolites appear to lead to mutations. PMID- 3309642 TI - The characterization of the mutagenic activity of soil. AB - The solvent extracts of non-agricultural soil were shown to cause a potent mutagenic response to Salmonella bacteria. The extract of soil from local sites had activities of 100,000-250,000 TA98 revertants per kg with S9 activation and 44,000-83,000 revertants per kg to TA100 with activation. The soil is mutagenic to both strains without S9, but at lower levels. Nitroreductase-deficient bacterial strains show that the soil extract may have mutagenic compound(s) containing a nitro group. The revertant numbers per gram of soil are lowest at the surface, increase at 4-10 cm and decrease in a linear fashion to a depth of 0.5 meter. HPLC fractionation shows that there is more than one separable component responsible for the mutagenicity of the soil. The source and consequences of the high levels of mutagenicity in 'ordinary soil' are unknown. Soil mutagens can be a significant complicating factor to those using the Ames/Salmonella assay for environmental sampling. PMID- 3309643 TI - Mutagenicity modulating effect of quercetin on aromatic amines and acetamides. AB - The effect of quercetin on the mutagenicity of 32 kinds of aromatic amines and their acetamides were investigated using Salmonella typhimurium TA98 with a mammalian metabolic activation system (S9 mix). Quercetin enhanced the mutagenicity of the tricyclic aromatic amines (aminofluorene, aminoanthracene and aminophenanthrene) and their acetamides by 1.2-5.9-fold. Whereas, quercetin depressed the mutagenicity of aniline derivatives, biphenyl derivatives, and bi- and tetra-cyclic amino derivatives. The modulation of mutagenicity of Trp-P-1, Trp-P-2, Glu-P-1 and Glu-P-2 (heterocyclic amines) by quercetin were liable to be affected by the content of S9 in the S9 mix. It seems that quercetin does not have the same effect as norharman, because quercetin did not enhance the mutagenicity of aniline. It is suggested that the modulation of the mutagenicity of aromatic amines and acetamides is caused by the modulation of the balance between the mutagenic activation and inactivation in the metabolism of these amines and acetamides in the presence of quercetin. In this modulation, quercetin may participate through its effects on the promotion of N-hydroxylation and the inhibition of arylhydroxylation and transacylation. The presence of tricyclic aromatic rings of amines and acetamides is a structural requirement for the mutagenicity enhancement by quercetin. PMID- 3309644 TI - Ingestion of parsley inhibits the mutagenicity of male human urine following consumption of fried salmon. AB - The urinary mutagenicity of 3 nonsmoking, healthy men was investigated after strictly defined meals by means of the Ames Salmonella/microsome test. When the subjects ate 150 g of fried salmon at one meal, a potent mutagenicity of almost 5000 revertants of TA98 strain was present in all 6-h urine samples. On the other hand, less than 2500 revertants was present in the urine when the subjects simultaneously consumed 70 g of parsley and 150 g of fried salmon. Thus, the protection against mutagenicity affected by parsley warrants further attention. PMID- 3309646 TI - Micronuclei in exfoliated urothelial cells and urine mutagenicity in smokers. PMID- 3309645 TI - Induction of the SOS response by hydroxyurea in Escherichia coli K12. AB - Hydroxyurea at concentrations higher than 10(-2) M induced the recA and sfiA genes of E. coli as well as the lambda prophage by a pathway independent of the recBC genes. In addition, the hydroxyurea-mediated induction of the SOS response is accompanied by a recA-dependent decrease on the cellular ATP pool. The presence of the multicopy plasmid pPS2, harboring the nrdAB genes (encoding the ribonucleoside reductase enzyme), abolished the hydroxyurea-induced expression of the recA gene. These data lead us to suggest that induction of the SOS response by hydroxyurea is due to the blocking of DNA replication by the inhibition of the ribonucleoside reductase complex activity. PMID- 3309647 TI - Mutagenicity of N-nitrosodiethanolamine in the Salmonella/microsome test. AB - Mutagenicity of a commercially available N-nitrosodiethanolamine (NDELA) and purified NDELA was examined, using Salmonella typhimurium TA100 as a tester strain. Purified NDELA was positive in the presence of liver activation system from either rats or hamsters, but the mutagenicity was completely lost when dimethyl sulfoxide (DMSO) was used as a solvent. In contrast, the commercial NDELA which was chemically of 93.8% purity showed positive mutagenicity without metabolic activation, and the liver activation system and DMSO had no effect on the direct mutagenic activity. These results indicate that an apparent discrepancy among previous findings of several investigators with the mutagenic response of NDELA might be due to an impurity in NDELA samples and the solvent, DMSO. PMID- 3309648 TI - Antimutagenic effect of p-aminobenzoic acid on the mutagenicity of N-methyl-N' nitro-N-nitrosoguanidine in Salmonella typhimurium. AB - p-Aminobenzoic acid (PABA) exhibited antimutagenic activity toward N-methyl-N' nitro-N-nitrosoguanidine(MNNG)-induced mutagenicity in the Ames assay in Salmonella typhimurium. The antimutagenic effects were associated with an increased rate of decomposition of MNNG in the presence of PABA. The participation of other mechanisms, such as the alteration of cellular processes by PABA, however, cannot be excluded. PMID- 3309649 TI - Effect of bacterial growth-inhibiting ingredients on the Ames mutagenicity of medicinal herbs. AB - A solvent fractionation method was introduced to screen for mutagenicity in 10 medicinal herbs being consumed in Korea. The Ames mutagenicity test result of Scutellariae and Rhei was significantly increased by eliminating growth inhibiting substances through solvent fractionation of the crude extract. It is suggested that a physicochemical pretreatment should reduce the false-negative results which are caused by the presence of growth-inhibiting substances in complex mixtures. PMID- 3309650 TI - Hormonal control of muscle growth. AB - In muscle of whole animals, pituitary growth hormone, the thyroid hormones, and insulin are major growth-promoting hormones, and the glucocorticoids have significant catabolic actions. At the cellular level the primary anabolic hormones for cultured myoblasts are the somatomedins (insulin-like growth factors) and fibroblast growth factor. In these cells physiological concentrations of growth hormone, thyroid hormones, and insulin have no growth promoting effect; some of the reported actions of insulin probably result from cross-reaction with the somatomedin receptor. Results with purified proteins do not support the view that mitogens block myoblast differentiation; transforming growth factor-beta and interferon are nonmitogenic proteins that inhibit differentiation, insulin-like growth factors are mitogens that stimulate differentiation, and fibroblast growth factor is the only purified mitogen that inhibits differentiation. At least six serum-free media have now been devised for the growth of various kinds of muscle cells under closely defined conditions. PMID- 3309651 TI - AAEE minimonograph #27: differential diagnosis of myotonic syndromes. AB - Recent advances in neuromuscular diseases have also widened the diagnostic spectrum of myotonic disorders. Treatment, prognosis, and genetic aspects are different in the various syndromes and mandate a correct diagnosis. The combination of neurologic examination, standard EMG, exercise test, cold exposure, potassium loading, eye examination, and pedigree analysis allows correct classification of nearly all patients with myotonic disorders. In this review emphasis is placed on clinical features and electrophysiologic evaluation. PMID- 3309652 TI - Causes and control of dental caries. PMID- 3309653 TI - "Salt-sensitive" essential hypertension in men. Is the sodium ion alone important? AB - We investigated whether the anionic component of an orally administered sodium salt can influence the salt's capacity to increase blood pressure. In five men with essential hypertension in whom blood pressure was normal with restriction of dietary sodium chloride to 10 mmol per day (0.23 g of sodium per day), oral administration of sodium chloride for seven days, 240 mmol per day (5.52 g of sodium per day), induced significant increases in systolic and diastolic blood pressures, of 16 +/- 2 and 8 +/- 2 mm Hg (mean +/- SEM), respectively (P less than 0.05). An equimolar amount of sodium given as sodium citrate induced no change in blood pressure. Replacing supplemental sodium chloride with an equimolar amount of sodium as sodium citrate abolished the increase in blood pressure induced by sodium chloride. Both salts induced substantial and comparable sodium retention, weight gain, and suppression of plasma renin activity and plasma aldosterone, but supplemental sodium chloride increased plasma volume and urinary excretion of calcium, whereas sodium citrate did not. These preliminary findings demonstrate that the anionic component of an orally administered sodium salt can influence the ability of that salt to increase blood pressure, possibly by determining whether the salt induces an increase in plasma volume. Our observations in a small group of men with salt-sensitive hypertension will require confirmation in larger numbers of patients of both sexes. PMID- 3309654 TI - Aortic dissection. PMID- 3309655 TI - Regulation of insulin-gene expression. Implications for gene therapy. PMID- 3309657 TI - T lymphocytes: ontogeny, function, and relevance to clinical disorders. PMID- 3309656 TI - Transmission of the human immunodeficiency virus. PMID- 3309658 TI - Antibiotic administration to treat possible occult bacteremia in febrile children. AB - We performed a prospective, randomized, placebo-controlled, double-blind clinical trial of antibiotic administration to treat possible occult bacteremia in febrile children. A total of 955 children aged 3 to 36 months with temperatures greater than or equal to 39.0 degrees C and no focal bacterial infection were enrolled at the emergency departments of two children's hospitals from January 1982 until July 1984. Blood samples for culture were obtained, and the children were randomly assigned to receive either oral amoxicillin or placebo and were restudied approximately 48 hours after enrollment. Data were also collected on 228 children who could not be randomly assigned. Twenty-seven of the randomly assigned children (2.8 percent) had bacteremic infections with pathogenic organisms (Streptococcus pneumoniae, Haemophilus influenzae, and salmonella). There were no differences in the incidence of major infectious morbidity associated with bacteremia between the antibiotic and placebo groups--2 of 19 patients (10.5 percent) in the antibiotic group and 1 of 8 (12.5 percent) in the placebo group--although the power for this comparison was low. Antibiotics reduced fever (P less than 0.005) and improved the clinical appearance (P = 0.07) in the children with bacteremia but not in those without bacteremia. Although there were no statistically significant differences in the incidence of side effects, diarrhea tended to occur more often in the patients treated with amoxicillin (15 vs. 11 percent, P less than 0.10). We conclude that our data do not support the routine use of standard oral doses of amoxicillin in febrile children who do not have evidence of focal bacterial disease. PMID- 3309659 TI - Treatment of symptomatic hyponatremia and its relation to brain damage. A prospective study. AB - We studied the effects of replacement therapy in two groups of patients with symptomatic hyponatremia. Thirty-three patients, who were studied prospectively, had no evidence of cerebral demyelinating lesions. Their hyponatremia (mean serum sodium concentration [+/- SE], 108 +/- 1 mmol per liter) was increased to 126 +/- 1 mmol per liter with hypertonic saline (856 mM) delivered at a rate of 1.3 +/- 0.2 mmol per liter per hour. The serum sodium concentration did not rise to normal or hypernatremic levels in the first 48 hours of therapy, and none of these patients had a respiratory arrest or other hypoxic episode. Twelve patients, evaluated retrospectively, had evidence of cerebral demyelinating lesions at autopsy or on computerized axial tomography. The rate of correction of hyponatremia (1 +/- 0.2 mmol per liter per hour) was similar to the rate in the patients in Group I. However, at least one of four characteristics was present: an increase in serum sodium to normal or hypernatremic levels in the first 48 hours, a change in the serum sodium concentration of more than 25 mmol per liter in the first 48 hours, a hypoxic-anoxic episode, and an elevation of serum sodium to hypernatremic levels in patients with hepatic encephalopathy. Although these four features were associated with demyelination, our observations suggest that this complication does not depend on the rate of correction of hyponatremia. PMID- 3309660 TI - Ethics and human experimentation. Henry Beecher revisited. PMID- 3309661 TI - Zollinger-Ellison syndrome. Current concepts in diagnosis and management. AB - The Zollinger-Ellison syndrome, although uncommon, is not rare, and most patients with the disorder present with clinical manifestations similar to those of patients with common peptic ulcer. Early studies emphasized death due to complications of massive gastric acid hypersecretion. However, with the availability of potent antisecretory agents to control acid secretion, death is now more frequently associated with the metastatic potential of slowly growing but malignant gastrinomas. Therefore, physicians should maintain a high degree of suspicion of the Zollinger-Ellison syndrome in assessing patients with either chronic peptic ulcer or unexplained secretory diarrhea. An evaluation aimed at early diagnosis of the Zollinger-Ellison syndrome should be instituted in such patients and should begin with a determination of the fasting serum gastrin level. At least 50 percent of patients with gastrinoma will have nondiagnostic serum gastrin concentrations and will therefore require provocative testing to establish the correct diagnosis. After the presence of the syndrome is established, patients should be treated with a potent antisecretory agent in doses sufficient to reduce basal acid output to less than 10 mmol in the hour preceding administration of the next dose. Although some patients may be maintained satisfactorily in this manner for extended periods, an approach aimed at tumor localization and extirpation is recommended in most patients. Preoperative evaluation should begin with CT scanning with intravenous contrast material. Selective angiography, and occasionally, portal venous sampling for gastrin, should be performed if the location and extent of tumor remain in question. If metastatic disease is demonstrated, or if MEN-I is present, surgery aimed at tumor resection, although it is occasionally effective, will probably be unsuccessful. Because of the considerable morbidity and mortality associated with pancreatoduodenectomy, it should not be performed for unresectable tumor in the head of the pancreas. In other patients with the Zollinger-Ellison syndrome, exploratory surgery should be performed; this should include a careful search for, and resection of, all pancreatic and extrapancreatic gastrinomas. With this approach, it is likely that at least 20 percent of all patients with the Zollinger-Ellison syndrome can be cured. PMID- 3309662 TI - The new opportunistic fungal infection: diagnosis, isolation, identification and impact on mycology. Fear of fungi. PMID- 3309663 TI - Mycotic morbidity--an occupational risk for mycologists. AB - Classical mycologists may be at a greater risk for infection with organisms under investigation than medical mycologists. The methods of infection of human beings by systemic mycotic pathogens is known. These principles can be used to develop good laboratory practices for classical mycological investigators. Newly recognized fungal pathogens and a more susceptible population may cause more laboratory infections. Minimal safety practices to prevent mycotic morbidity are described. PMID- 3309665 TI - Overview of gastrointestinal microecology. AB - In germ-free life many characteristics are not the consequence of living bacteria's metabolic activities but of bacteria acting as antigens. On the other hand, merely some bacteria species are able to activate the immune system. Noteworthy experimental results relate to inhibitory effects of dietary lactobacilli on intestinal carcinomas. Besides bacteria other components play a role within the very complex man-microbe ecosystem. Thus, protozoa, fungi, and viruses may be generally concerned with diseases in monogastric animals. PMID- 3309664 TI - Uncommon yeastlike zoopathogens and commercial systems for their identification. AB - Opportunistic infections caused by yeasts or yeastlike fungi have increased in incidence in recent years as a result of clinical and therapeutic factors. Several formerly uncommon yeastlike zoopathogens--Candida lusitaniae, Candida paratropicalis (sucrose-negative variant of Candida tropicalis), Trichosporon beigelii, Blastoschizomyces capitatus, and Rhodotorula species--have been isolated from patients with invasive infections. The increased isolation of such opportunistic pathogens from a variety of clinical specimens has created a demand for simple, rapid, reliable, and accurate commercial systems to assist laboratorians in identification. Here we summarize the manual and automated systems currently available and present detailed descriptions of three representative commercial products, i.e., API 20C, Abbott Quantum II, and API Yeast-Ident. PMID- 3309666 TI - Microorganisms associated with epithelial surfaces and stability of the indigenous gastrointestinal microflora. AB - Indigenous microorganisms of many genera and species associate with mucosal epithelia in the gastrointestinal tracts of animals and humans. These mechanisms may involve a high degree of specificity for host and surface habitat. They may include a capacity of the microorganisms to adhere to the membranes of substratum epithelial cells, to colonize and utilize as a source of nutrients the mucus overlying epithelial cells, and to be motile and attracted into the mucous layer by chemotaxis. The microbes must be able as well to thrive in the nutritional and environmental conditions prevailing on the epithelial surfaces. Microbial communities associated with epithelial surfaces are critical for maintaining a microflora in areas of the tract (i.e., stomach, small intestine) where the lumenal content moves at a rate exceeding the maximum rates at which indigenous microorganisms can multiply. Such communities even may be important in areas (i.e., the cecum and colon) where the content moves at rates below those at which the microbes can multiply. In such areas, microorganisms colonizing mucus on the epithelium and in the crypts of Lieberkuhn may provide a stable inoculum for the lumenal content which may be altered in composition in times of dietary change. Microorganisms associated with gastric and intestinal surfaces undoubtedly serve in a major way to stabilize the composition of the indigenous gastrointestinal microflora. At the molecular level, however, little is known about the mechanisms stabilizing the composition or the biochemical and genetic activities of the microflora. Such mechanisms are important subjects for research in the future. PMID- 3309668 TI - Treatment of gastrointestinal infections in infants by oral administration of colostral antibodies. AB - Passive immunization used for treatment of gastrointestinal infections represents a safe and effective method in premature and full-term newborns, avoiding the use of oral antibiotics. PMID- 3309667 TI - [Changes within Lactobacillus and Bifidobacterium species]. AB - Laboratory rats with a gut flora unambiguous free from Bifidobacterium revealed three days after an application of a lactose-rich food a dominating Lactobacillus plantarum flora. Up from this date, Bifidobacterium could be detected for the first time. At the beginning, there was to be observed merely B. adolescentis and B. pseudolongum, at the 5th to the 10th day B. bifidum supervened. Finally this species together with B. infantis was dominating. With in vitro experiments, by a systematic modifying of the medium changes from Bifidobacterium species typical to faeces from infants to such species only to meet in faeces from adults could be observed only after a long time of cultivation. PMID- 3309669 TI - [Tests for anaerobes in patients with hemoblastosis]. AB - A simplified control programme for the selective decontamination is proposed. Before the beginning of the attendance a microbial "large scale programme" is applicated in order to determine the quantitative and qualitative composition of the small intestinal and of the large intestinal flora on aerobic and anaerobic cultural conditions. During the attendance a "short-time programme" is applicated. At this on the basis of an aerobic cultural method and by the help of a direct microscopic numeration the flora is determined in its quantitative composition. At the end of an attendance the microbial "large-scale programme" is repeated. PMID- 3309670 TI - The minipig as a model in gnotobiology. AB - Due to its close physiological and morphological resemblance to man, the pig occupies an important position in biomedical research. The minipig lends itself particularly well to germfree research. It is easy to deliver, maintain, and utilize in isolators. The colostrum-free, newborn germfree piglet lacking passively obtained antibodies is of an exclusive use if distinguishing the factors of natural and adaptive immunity is needed. It fits also well in studies investigating the earliest mechanisms of antibody synthesis. Under germfree conditions, the pig has been proved an excellent model for testing the action of ionizing radiation as well as of selected bacterial strains when monoassociated. Recently, conventional pigs have been used also for studies in total or selective decontamination of the intestinal tract by antibiotics and strict isolation. PMID- 3309671 TI - Intermediate filaments. Looking for a function. PMID- 3309673 TI - The art of the soluble. PMID- 3309672 TI - p53 and DNA polymerase alpha compete for binding to SV40 T antigen. AB - The large T antigen (T) of simian virus 40 is a multifunctional protein required for both viral DNA replication and cellular transformation. T antigen forms specific protein complexes with the host protein p53 in both virus-infected and transformed cells. p53 has recently been shown to be an oncogene, but its normal function is not clear. We previously established a radioimmunoassay to study the newly described complex between T antigen and DNA polymerase alpha, and have noted a similarity between the antigenic changes induced in T by the binding of both p53 and polymerase. We now extend this analysis to a larger collection of anti-T antibodies and formally establish that p53 and DNA polymerase alpha can compete for binding to the SV40 T antigen. At a critical concentration of the three components it is possible to detect a trimeric complex of T, p53 and DNA polymerase alpha. Our observations have important implications for the control by these nuclear oncogenes of viral and cellular DNA synthesis and viral host range in both normal and transformed cells. We present a model for the action of p53 in growth control. PMID- 3309674 TI - Untimely death of Soviet virologist after hostile letters. PMID- 3309675 TI - At the heart of the nucleolus. PMID- 3309676 TI - MHC antigen expression in the pancreas. PMID- 3309678 TI - Nobel prize for Japanese immunologist. PMID- 3309677 TI - Structure of the human class I histocompatibility antigen, HLA-A2. AB - The class I histocompatibility antigen from human cell membranes has two structural motifs: the membrane-proximal end of the glycoprotein contains two domains with immunoglobulin-folds that are paired in a novel manner, and the region distal from the membrane is a platform of eight antiparallel beta-strands topped by alpha-helices. A large groove between the alpha-helices provides a binding site for processed foreign antigens. An unknown 'antigen' is found in this site in crystals of purified HLA-A2. PMID- 3309679 TI - Yeast the model. PMID- 3309680 TI - HLA-DQ beta gene contributes to susceptibility and resistance to insulin dependent diabetes mellitus. AB - Over half of the inherited predisposition to insulin-dependent diabetes mellitus maps to the region of chromosome 6 that contains the highly polymorphic HLA class II genes which determine immune responsiveness. Analysis of DNA sequences from diabetics indicates that alleles of HLA-DQ beta determine both disease susceptibility and resistance, and that the structure of the DQ molecule, in particular residue 57 of the beta-chain, specifies the autoimmune response against the insulin-producing islet cells. PMID- 3309681 TI - [50 years of phalloidine: its discovery, characterization and current and future applications in cell research]. AB - Phalloidin, like the later-detected phallotoxins, consists of a cyclic heptapeptide backbone, the ring being crosslinked by a 2'-indolylthioether moiety (tryptathionine). After intraperitoneal administration--not per os--it will, after a short time, damage the liver specifically, presumably in consequence of its very tight binding to F-actin preventing its dissociation. This affinity can be utilized for a sensitive visual identification of F-actin by using fluorescent derivatives. PMID- 3309683 TI - Costing out nursing services: an annotated bibliography. PMID- 3309682 TI - [Cytostatic non-platinum metal complexes: new perspectives for the treatment of cancer?]. AB - Non-platinum-group metal antitumor agents are represented by inorganic and organometallic compounds which contain either main-group metals such as gallium, germanium, and tin, or transition metals such as titanium, vanadium, iron, copper, and gold. Their antiproliferative properties have been detected during the past years, the spectrum of antitumor activity not being identical with that of cytostatic platinum complexes. In the case of germanium complexes, the antitumor activity is obviously not based on direct cytotoxic effects, but on host-mediated immunopotentiating mechanisms. The toxic properties of most non platinum-group metal antitumor agents differ fundamentally from those of platinum compounds. Thus, non-platinum-group metal antitumor agents may open new perspectives for the clinical therapy of human malignancies. PMID- 3309684 TI - [The prevalence of Chlamydia trachomatis infections in a general hospital in Amsterdam]. PMID- 3309685 TI - [Characteristics of neuronal background activity in the reticular nucleus of the thalamus of the human brain]. AB - Background activity of 240 units of n. reticularis thalami (Rt) was investigated by microelectrodes in awake dyskinetic patients during 37 stereotaxic operations. It was shown that Rt can be represented by three types of neurons: units with irregular unitary discharges (A-type, 40%); burst units fired in short 10 divided by 20 ms bursts with unstable rhythmic (2-5 Hz) pattern (B-type, 49%); burst units fired aperiodically in prolonged 0.1 divided by 2 s discharges with constant 80 divided by 150 ms interburst inhibitions (C-type, 11%). Invariant activity-patterns of A-, B- and C-neurons characterized by instability due to functional stimulation were revealed. The unit activity dynamics was described during short-term anaesthesia showing an inhibition of the A-unit activity parallel to stabilization and synchronization of rhythmic bursts of B-neurons. An invariance of the cell type representation of Rt in the dorso-ventral plane was observed, although a number of dynamic activity characteristics of A and B-units increased reliably toward the ventral part of Rt (frequency, variation of rhythm). In addition to the absence of any relationship between rhythmic bursts and parkinsonian tremor, a parameter correlation between them was found. The data show an indirect increase of the firing level and frequency stabilization of the B-unit rhythm parallel to the stage of trembling. The regular burst phenomena in discharges of B and C-neurons are discussed. PMID- 3309686 TI - [The cytoskeleton of nerve cells during their differentiation]. AB - Ultrastructural and cytochemical characteristics of cytoskeletal elements of the cell (microtubules, microfilaments and neurofilaments), their state and proportion in a mature neuron and at definite stages of its differentiation are analyzed. Structural and functional properties of microtubule-associated proteins are described with their distribution in different parts of the neuron and quantitative changes in the course of differentiation. Data from literature concerning functional significance of cytoskeletal elements of the neuron, their connections with electrically excitable surface membrane and participation of the cytoskeleton in pathological states of the nervous system are discussed. PMID- 3309687 TI - Supplementary characteristics of anti-MHC class II monoclonal antibodies elicited by an ALL cell line: immunofluorescence cytofluorometry, C-dependent cytotoxicity, two-dimensional analysis of antigen. AB - Monoclonal antibodies directed to MHC class II antigen(s), elicited by a non-T, non-B ALL cell line, were characterized by immunofluorescence flow cytofluorometry and ELISA immunofiltration measurements of their immunoreactivity with selected neoplastic hemopoietic cell lines, determination of their complement-dependent cytotoxic activity against isolated peripheral blood B and T lymphocytes and by two-dimensional electrophoretic analysis (isoelectric focusing, SDS-PAGE) of radiolabeled, immunoprecipitated by these antibodies cell surface antigens. Patterns of these immunological reactivities, as well as two dimensional radioimmunoprecipitation patterns (acidic heavy chain p35 and basic light chain p30) of antigens recognized by these antibodies confirm their anti MHC class II specificity. One of these antibodies (braFB6; IgG2b) displayed identical pattern of expression on cell lines and cell types as the typical anti MHC class II antibodies, but immunoprecipitated only a single chain p30 radioiodinated cell surface protein (with two-dimensional pattern close to the beta-chain of MHC class II DR antigen). These properties indicate the ability of braFB6 monoclonal antibody to recognize a nonpolymorphic determinant of DP-MHC class II antigen. PMID- 3309688 TI - [Bulimia nervosa--the disease picture and problem of nosologic classification]. PMID- 3309690 TI - [The pediatric and adolescent psychiatric day clinic]. PMID- 3309689 TI - [Event-related brain potentials and psychopathology]. PMID- 3309691 TI - [Psychiatric vulnerability--Canstatt 1841. On the history of the concept of vulnerability, predisposition and psychosis in the 1st half of the 19th century]. PMID- 3309692 TI - Coffee and the human cardiovascular system. PMID- 3309693 TI - Low dose guanfacine and methyldopa in mild essential hypertension. A multiple centre study. PMID- 3309694 TI - Ultrasonic detection of occult Leydig cell tumours in two patients with gynaecomastia. PMID- 3309695 TI - Transplantation of marrow from donors other than genotypically HLA-identical siblings. PMID- 3309696 TI - A renin-secreting tumor. AB - A 23-year-old white male was referred for hypertension resistant to triple antihypertensive treatment, with hypokalemia, hyperaldosteronism and elevated levels of circulating plasma renin activity (PRA). Renal angiography and echoscans put in evidence an avascular solid mass at the midlower level of the right kidney. Renal vein catheterization with sampling of blood from the lower branches of the right renal vein showed lateralization of renin secretion from that side. After surgical exeresis, the mass (1.0 cm) was diagnosed as a renal hemangiopericytoma on the basis of light and electron microscopy. Tumor exeresis was followed by a prompt normalization of blood pressure and plasma potassium, with a decrease in PRA and aldosterone. Two months after surgery the patient was still normotensive. Circulating levels of inactive (trypsin-activable) renin were around 60% of the total pool of plasma renin, i.e. much lower than those reported in other cases of renin-secreting tumors. After surgery, inactive and active renin fell in parallel, implying that both were secreted by the tumor. Tumoral PRA responded to postural stimulation, but was unresponsive to acute converting enzyme inhibition, suggesting that sympathetic stimuli were still operative, but the negative feedback inhibition by angiotensin II on renin secretion was lost. Acute converting enzyme inhibition by captopril dropped blood pressure; however, during long-term treatment, the drug (3 X 50 mg/day) was ineffective in terms of either blood pressure normalization or relief of secondary hyperaldosteronism. Acute calcium entry blockade by nifedipine (10 mg p.o.) caused an evident blood pressure drop. PMID- 3309697 TI - Central nervous system disease in renal transplant recipients. PMID- 3309698 TI - Prevalence of asymptomatic internal carotid artery stenosis. AB - The prevalence of internal carotid artery stenosis was studied with continuous wave Doppler and Duplex scanning in 526 subjects aged 45-84 years of age. They were devoid of any cerebrovascular symptoms or signs and were not referred to us because of risk factors or manifestations of atherosclerosis. The prevalence of stenosis, whatever the grade, was low in both sexes aged under 65 years: 2.4% in males aged 55-64 years. It increased sharply with age, reaching 30.3% for stenosis of less than 50% and 6.1% for stenosis of greater than 50% in males aged 75-84 years. The prevalence of minimal lesion (plaque with less than 15% diameter reduction) was high: 32.1% in males aged 45-54 years and 48.5% in the 75- to 84 year age range. PMID- 3309699 TI - [Use of monoclonal antibodies for the prevention of graft-versus-host and host versus-graft reaction in allogenic bone marrow grafts]. AB - The graft-versus-host (GvH) reaction remains one of the major complications in allogeneic bone-marrow (BM) grafting, in spite of prophylactic treatments such as methotrexate and Cyclosporine-A. It is admitted that T lymphocytes of graft origin become the effector cells reacting against the host tissues. It is possible to deplete the vast majority of T cells from the BM inoculum using monoclonal antibodies (MoAb) of the anti-pan T specificity. The two most currently used methods are the complement-dependent cytolysis and the use of immunotoxins (MoAb combined to ricin). The T cell depletion is the most effective procedure for the prevention of GvH (less than 10% versus 40 to 60% in the historical series). However, this mode of prevention can induce resistance phenomena towards the graft acceptance (15 to 20% of cases). This complication can be prevented by the in vivo use of MoAb specific for the host's radioresistant cells. Another alternative way consists in the reinforcement of conditioning aiming both at the elimination of residual immunocompetent cells and at a more efficient action upon the imperceptible tumoral mass. The absence of GvH can indeed be accompanied by an increase of recurrent diseases due to the absence of a graft-versus-leukemia (GvL) reaction. PMID- 3309701 TI - Development of chronic renal cyclosporin-A toxicity. AB - Treatment with cyclosporine in renal transplantation causes an increased incidence of interstitial fibrosis. The degree of interstitial fibrosis seems to be correlated with high cyclosporine consumption and episodes of acute CyA nephrotoxicity. The cause of acute CyA nephrotoxicity seems to be hemodynamic alterations. Whether this is the cause for the chronic nephrotoxicity has still not been shown. PMID- 3309700 TI - [Results, over a 3-year, period of a triple combination: cyclosporin, azathioprine, prednisolone in high-risk kidney transplants]. AB - A prospective study was conducted on 57 high-risk patients having received cadaver renal transplants between January 1983 and May 1984, and submitted to the triple combination: cyclosporine, azathioprine, and steroids. 23 patients of Group I including 12 pre-sensitized and poorly matched recipients were treated from the Day 1 post-transplant. 34 patients of Group II received the triple combination following a steroid-ALG resistant rejection. Actuarial graft survival in the whole group was 74%, 64%, and 64% at 1, 2, and 3 years respectively. Patient survival was 100% in the Group I, vs 85% at 1 year, and 82% at 2 years in the group II (p less than 0.02). The incidence of infectious complications and infectious deaths was significantly higher in patients of Group II. Our results suggest the effectiveness of a triple low-doses combination in high-risk renal transplantation, but the delayed use of this combination following a treatment with high-doses of steroids and ALG fails to reverse the rejection, with an obvious overimmunosuppression risk. PMID- 3309702 TI - [In vivo use of OKT3 monoclonal antibodies in recipients of renal allografts]. AB - The OKT3 monoclonal antibody, that is specific for all mature human T lymphocytes represents a potent immunosuppressant when injected in vivo. The OKT3 antibody has been administered to more than 500 renal allograft recipients either to treat or prevent acute rejection episodes. OKT3 exerts its immunosuppressive effect by inducing rapid and important T cell depletion following the first injection. Then, OKT3 mediates the antigenic modulation of its T cell target antigen a phenomenon that is also related to the immunosuppressive effect exerted by the monoclonal antibody. The principal side effect observed following OKT3 administration, particularly if the antibody is injected alone, is the xenosensitisation against the foreign protein. Essentially, two sorts of anti OKT3 antibodies are produced that respectively recognize the isotypic and the idiotypic determinants of the antibody molecule. The different strategies that may be envisaged to overcome this important side effect, that may totally neutralize the therapeutic effectiveness of OKT3 are discussed in detail. PMID- 3309703 TI - [Principles of the treatment of epilepsy at the developmental age]. PMID- 3309704 TI - [Treatment of myotonia. Mechanism of action of antimyotonic drugs]. PMID- 3309705 TI - [Use of drugs inhibiting blood platelet activity in the treatment of cerebral ischemia]. PMID- 3309706 TI - Activation of luteinizing hormone-releasing hormone release advances the onset of female puberty. AB - The juvenile-peripubertal transition period in the female rat is associated with an ovarian-independent afternoon increase in the amplitude of plasma luteinizing hormone (LH) pulses. To determine if the immature pituitary could be activated to cause precocious puberty juvenile female rats were subjected for 4 days to a microprocessor-driven pulsatile intravenous administration of LH-releasing hormone (LHRH) at a dose that produced a peripubertal pattern of LH release. To determine if the LHRH neurons themselves could be prematurely activated to induce such a pattern of plasma LH, and hence lead to precocious puberty, the neuroexcitatory amino acid analog N-methyl-DL-aspartic acid (NMA) was similarly administered. The time of puberty (vaginal opening and first ovulation) was advanced by both the LHRH and NMA treatments, by 5 and 7 days, respectively. Ovarian weight and incidence of corpora lutea at first diestrus were similar in all animals regardless of treatment, but a juvenile body weight was retained by the animals that underwent precocious puberty. Therefore, just as the adenohypophysis can be driven by exogenous LHRH to initiate puberty, the LHRH neuronal system can be precociously activated by the episodic administration of an excitatory amino acid analog that is known to interact with specific brain receptors. It is likely, therefore, that sexual maturation is limited by factors that lie further upstream in the hypothalamo-pituitary axis (e.g., the neuronal circuits that impinge upon LHRH-producing neurons). PMID- 3309707 TI - Central dopamine-peptide interactions: electrophysiological studies. AB - A variety of peptides have been shown to have physiological activity, either pre- or post-synaptically in DA systems. Significantly, this has not been true of all the peptides tested and physiological activity has for the most part, correlated with anatomical evidence for the presence of that peptide in the same area as DA and with the presence of specific receptors for the active peptide. In the main, biochemical and behavioral studies of the effects of peptides on the function of DA systems also correlate well with the effects of the various peptides on the activity of DA neurons. However, despite this growing body of knowledge we still know very little about the physiological relevance of most peptides to animal behavior or the interaction between these peptides and DA systems. This is due, in part, to the fact that the functioning of peptide systems is still relatively difficult to study in terms of synthesis, release, metabolism and turnover. The fact that there are very few selective non-peptide antagonists for many of these substances has also hampered the study of their function in the brain. Nevertheless, their proven interaction with midbrain DA systems, regardless of whatever else they may do in the brain, makes them of great potential clinical interest. Given the number of neurological and mental disorders in which malfunction of the DA system is presumed to be involved, any endogenous substance that can modulate activity of the DA cells and thus provide a new mechanism for controlling the functioning of central DA systems may have potential therapeutic value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309708 TI - Stress, prolactin and hypothalamic dopaminergic neurons. AB - Most of what is known about dopamine (DA)-containing neurons in the brain has been learned from studies on the nigrostriatal system, although it is misleading to consider a neuron in this system as a "model" for other DA neurons in the brain. In this presentation the properties of nigrostriatal DA neurons are compared with those hypothalamic DA neurons that comprise the tuberoinfundibular system. These latter neurons, which have cell bodies in the arcuate nucleus and short axons which terminate in the median eminence, function to inhibit the release of prolactin from the anterior pituitary. The activities of the nigrostriatal and tuberoinfundibular DA neurons were estimated biochemically by measuring the rates of synthesis (accumulation of DOPA after the administration of a decarboxylase inhibitor, NSD 1015), turnover (decline of DA after the administration of a tyrosine hydroxylase inhibitor, alpha-methyltyrosine) and metabolism (concentrations of dihydroxyphenylacetic acid) of DA in regions of the brain that contain the terminals of these neurons (striatum and median eminence, respectively). Tuberoinfundibular DA neurons differ from nigrostriatal DA neurons in that the former neurons: (1) are not directly regulated by DA receptor mediated mechanisms, (2) are stimulated by prolactin, (3) exhibit a sexual difference with activity being 2-3 times greater in females and (4) are inhibited by afferent neuronal circuits that are activated by suckling and restraint stress. PMID- 3309709 TI - Quinpirole hydrochloride, a potential anti-parkinsonism drug. AB - Quinpirole hydrochloride, a putative dopamine agonist, was investigated in animal models of central dopaminergic activity, to evaluate its possible role in the treatment of Parkinson's disease. The drug induced stereotyped sniffing in rats but, unlike apomorphine, did not produce a maximal behavioural response (stereotyped gnawing). Pretreatment with neuroleptics blocked the stereotypy induced by quinpirole. Quinpirole reversed the effects of reserpine and alpha methyl-paratyrosine, caused dose-dependent contralateral rotations in rats with unilateral lesions of the substantia nigra induced by 6-hydroxydopamine and induced vomiting in dogs. Small doses of quinpirole decreased locomotor activity, an effect presumably mediated by pre-synaptic autoreceptors. Quinpirole bound to D2 dopamine receptors in the striatum of the rat. The chronic injection of both subthreshold and suprathreshold doses, failed to induce behavioral supersensitivity. These data indicate that quinpirole can stimulate central dopaminergic receptors, and that it is a partial agonist with direct-acting properties. Quinpirole differs from other dopaminergic drugs and may be useful for the therapy of Parkinson's disease. PMID- 3309710 TI - Harvey Cushing's Guillain-Barre syndrome: an historical diagnosis. AB - Harvey Cushing developed an illness in the last months of World War I that made it impossible for him to operate and forced him to bed for over a month. The features of Cushing's malady included symmetrical weakness, numbness, and paresthesias of the hands and feet, areflexia, bilateral facial paresis, diplopia, and fever. Neither Cushing nor his physicians were able to make a diagnosis. John Fulton, Cushing's biographer, misdiagnosed the condition as a "vascular polyneuritis," and Harry Zimmerman, who performed Cushing's autopsy, incorrectly attributed his symptoms to occlusion of the abdominal aorta. Based on extensive notes in Cushing's war diary describing the illness, it is readily recognized today as Guillain-Barre syndrome. PMID- 3309711 TI - Spinal cord proliferative sparganosis in Taiwan: a case report. AB - A 43-year-old woman suffered from low back pain and bilateral footdrop. A cisternal myelogram unexpected revealed multiple filing defects in the spinal canal extending from the lower cervical region to the caudal equina. Diagnostic exploration revealed numerous cystic organisms adhering to the spinal cord and nerve roots. Histopathological examination showed these organisms to be proliferative sparganum cestode larvae. Although these cestode larval infections have been reported a dozen times in humans from various parts of the world, this is probably the first reported case of spinal cord infection. PMID- 3309712 TI - Association of a ganglioneuroma with an arteriovenous malformation: case report. AB - The unusual concurrence of a brain tumor and an arteriovenous malformation (AVM) is discussed in this case report. A 12-year-old child presented with a severe headache, and an intracerebral mass was found on neuroradiological study. At operation, we encountered a superficial AVM, not shown on the computed tomogram or arteriogram. At a second procedure, a ganglioneuroma was removed. The literature on the concurrence of these two entities is reviewed; comments are made on the pathology of ganglion cell tumors. PMID- 3309713 TI - Multiple sclerosis plaque simulating cerebral tumor: case report and review of the literature. AB - Multiple sclerosis rarely may present as a focal cerebral mass with clinical features and computed tomographic scan appearances of cerebral tumor. Distinguishing between these can be difficult or impossible. We report a case of a multiple sclerosis plaque involving the parietal lobe with mass effect; clinical and radiological features had led to a diagnosis of cerebral tumor. PMID- 3309714 TI - Malignant recurrence of childhood cerebellar astrocytoma: case report. AB - A 15-year-old boy developed a glioblastoma in a cerebellar hemisphere 7 years after surgical excision and local irradiation of a pilocytic astrocytoma in the cerebellar vermis. Clinical and histopathological details are presented, and the literature on late malignant recurrence of childhood cerebellar astrocytoma is reviewed. PMID- 3309715 TI - Intragastric migration of a ventriculoperitoneal shunt catheter. AB - A child developed bacterial meningitis and shunt dysfunction 2 years after the insertion of a ventriculoperitoneal shunt for posttraumatic hydrocephalus. The distal end of the shunt catheter had penetrated the gastric wall. We found no other report of intragastric shunt catheter migration with successful treatment. PMID- 3309716 TI - Intrahepatic migration of a peritoneal shunt catheter: case report. AB - The intrahepatic migration of a peritoneal shunt tube of a ventriculoperitoneal shunt system (low pressure Pudenz valve and low pressure Pudenz peritoneal catheter) is reported. This is a rare complication of ventriculoperitoneal shunting and was diagnosed by metrizamide shuntography and abdominal computed tomography. To our knowledge, this is the second case complicated with migration of a peritoneal shunt tube into the liver. PMID- 3309718 TI - Neurosurgical training in Japan. PMID- 3309717 TI - Peroral extrusion of a ventriculoperitoneal shunt catheter. AB - A case of retrograde migration and peroral extrusion of a ventriculoperitoneal catheter is reported. A patient population at risk is defined, and preventive measures are discussed. PMID- 3309719 TI - Richard Jung (1911-1986). PMID- 3309720 TI - Dopaminergic mechanisms in hemiparkinsonian monkeys. AB - The motor effects of direct agonists which act selectively on certain dopamine receptors were studied in monkeys rendered hemiparkinsonian by unilateral intracarotid injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). The D-2 dopamine agonist, LY 171555, but not the D-1 agonist, SKF 38393, reduced parkinsonian signs and induced rotation away from the side of the nigral lesion. When administered together, SKF 38393 diminished the LY 171555-induced turning in a dose-dependent manner. A selective D-1 antagonist, SCH 23390, induced mild and brief rotation when administered alone. These results suggest that D-2 receptor stimulation is necessary to ameliorate parkinsonism, but that pharmacologic manipulation of both D-1 and D-2 receptors may be required for an optimal therapeutic response. PMID- 3309721 TI - Biochemical and immunologic studies in a case of congenital myopathy with unusual morphologic features. AB - Mitochondria and myosin were isolated from a muscle biopsy of a 9-year-old boy with an unusual congenital myopathy characterized by type I fiber uniformity, jagged Z-line, and transverse network hypertrophy of mitochondria. Biochemical examination of isolated mitochondria showed that only citrate synthase activity was significantly reduced. Electrophoresis of myosin heavy chains and immunoenzymatic analysis of myosin heavy and light chains with antibodies specific to either fast or slow myosins showed that only the slow-type isoform of myosin was detectable. Indirect immunofluorescence of muscle biopsy showed that all muscle fibers homogeneously expressed only the slow type of myosin. PMID- 3309722 TI - Chronic relapsing demyelinating polyneuropathy associated with hepatitis B infection. AB - We studied a patient with chronic relapsing polyneuropathy associated with immune complexes of hepatitis B virus. There were cycles of remission and exacerbation in parallel with liver dysfunction. Immunofluorescent deposits of hepatitis B antigen, immunoglobulin, and C3 component were detected in the vasa nervorum. Ultrastructural study revealed electron-dense deposits that might have been immune complexes composed of hepatitis B virus, both around the endoneural capillary and in the endoneurium. Immune complexes composed of hepatitis B virus may play a role in the pathogenesis of chronic relapsing polyneuropathy. PMID- 3309723 TI - Alban G. Smith and the beginnings of spinal surgery. PMID- 3309724 TI - [Effect of prostacyclin PGI2 and indomethacin on ischemic damage of sector CA1 of Ammon's horn in the Mongolian gerbil]. PMID- 3309726 TI - [Use of CPAP under mask in status asthmaticus in patients with COPD]. PMID- 3309725 TI - [Clinical usefulness of captopril in the treatment of severe myocardial insufficiency in childhood]. PMID- 3309727 TI - [Hospital infections in an emergency surgery ward]. AB - A study was conducted on hospital infections in an emergency surgery ward. The survey lasted one year and confirmed the higher incidence of infections after contaminated and dirty operations. Rates of infection were also high after clean operations due to the large number of subjects at risk among the group examined. The most commonly encountered micro-organisms in the infections of surgical wounds were, in order, E. coli, Str. faecalis and Staph. aureus, the latter being only minimally responsive to the standard antibiotics. Several proposals are advanced for prophylaxis in the attempt to halt the circulation of strains with a multiple resistance to antibiotics. PMID- 3309728 TI - [Gardner's syndrome associated with periampullar carcinoma. Description of a case and review of the literature]. AB - The Authors report a case of a 49 year old female patient with Gardner's Syndrome and adenocarcinoma of the Ampulla of Vater. In this case, adenocarcinoma of the Ampulla of Vater was associated with duodenal polyp (adenoma), which suggests that adenocarcinoma is the consequence of malignant of duodenal polyps. The world medical literature was reviewed and 29 cases of periampullary carcinoma complicating familial polyposis or Gardner's Syndrome were analyzed. PMID- 3309729 TI - Electron microscopic study on S-100 protein-immunoreactive cells in the guinea pig duodenum, with special reference to the interstitial cells of Cajal. AB - S-100 protein-immunoreactive cells were studied in the nervous system of the guinea pig duodenum by pre-embedding immunoelectron microscopic cytochemistry. Immunoreactivity of S-100 protein was found diffusely in the cytoplasm of enteroglial cells in the ganglia, nerve strands and autonomic ground plexus. There were fibroblast-like cells containing no S-100 protein immunoreactivity around the ganglia and nerve bundles. Relationship between the fibroblast-like cells and the interstitial cells of Cajal was discussed. PMID- 3309731 TI - Ontogenesis of prolyl endopeptidase in the chick retina. AB - The time course of prolyl endopeptidase (PE) activity, measured using 7-(N succinyl-Gly-Pro)-4-methyl-coumarinamide as substrate, was determined in the developing chick retina, and in monolayer and aggregate culture of embryonic retinal cells. PE activity/retina increased 12.5-fold between embryonic days 7 and 12 and remained constant from the 12th embryonic day until the 3rd post hatched day. PE activity/retina decreased 2.3-fold from the 3rd to the 9th post hatched day. The levels of PE specific activity in aggregates and in retina were similar, whereas they were 44-81% higher in monolayer than in aggregate cultures between 3 and 13 days in culture. The data suggest that the development of PE activity and of plexiform layers occurs in parallel during chick retina ontogenesis, and that the chick retina can be an adequate in vivo and in vitro model to study PE development. PMID- 3309730 TI - Peptide histidine-isoleucine (PHI)-immunoreactive amacrine cells in the retina of the rat. AB - Peptide histidine-isoleucine (PHI) immunoreactivity was located in amacrine-like cells in adult rat retina by use of immunohistochemical techniques. Immunoreactive somata were found in the proximal part of the inner nuclear layer. From these somata, processes could be followed into the inner plexiform layer. The terminals of these processes were mainly found in the sublayers, 1, 2, and 3, but a few terminals were also present in the other inner plexiform sublaminae. The distribution of PHI-immunoreactive somata and processes corresponds with the cellular distribution of vasoactive intestinal peptide (VIP) and indicates a possible co-localization with this peptide. PMID- 3309732 TI - Spigelian hernia: problem in diagnosis and management. PMID- 3309733 TI - The biological effects of iodine deficiency and their public health significance. PMID- 3309734 TI - Zinc deficiency and the developing embryo. PMID- 3309735 TI - Effects of zinc deficiency on prenatal and postnatal development. PMID- 3309737 TI - Management of common parasitic infections encountered in primary care. AB - Ascaris lumbricoides, Enterobius vermicularis, Strongyloides stercoralis and Giardia lamblia are among the most frequently diagnosed human pathogenic parasites in the United States. Primary care practitioners need to be aware of the overt and covert signs and symptoms of these parasitic infections. This article focuses on the diagnosis and management of these common parasites. PMID- 3309736 TI - The physiopathologic significance of manganese in brain: its relation to schizophrenia and neurodegenerative disorders. PMID- 3309738 TI - Nurses' guide to home health care. PMID- 3309739 TI - Home care. PMID- 3309740 TI - Group B streptococcal infection in 1987. PMID- 3309741 TI - Arthur Donaldson Smith, MD. Physician, explorer, naturalist, and diplomat--Part V. PMID- 3309742 TI - Group B streptococcal osteomyelitis in an adult. PMID- 3309743 TI - Life and death of the tooth worm theory or when I believe it, I will see it. PMID- 3309744 TI - "Dentures in, dentures out" commentary. PMID- 3309745 TI - Malpractice and the temporomandibular pain dysfunction syndrome. PMID- 3309746 TI - Intraperitoneal chemotherapy as treatment of ovarian carcinoma: why, how, and when? PMID- 3309747 TI - Ovarian prorenin-renin-angiotensin system. AB - Renin is classically considered to be an enzyme that is synthesized by the kidneys and secreted into the circulation where it affects angiotensin production. We review here recent evidence that suggests the existence of an extra-renal renin system, the ovarian prorenin-renin-angiotensin system, which may be linked to reproductive function. Prorenin, the inactive form of the enzyme renin, is present in the fluid of mature human ovarian follicles in extremely high concentrations; however, only 1 per cent of the renin in follicular fluid is in the active form. Plasma prorenin increases about 2-fold at midmenstrual cycle at the time of the LH surge, and the peak of prorenin is sustained for about 2 days. No change in plasma active renin levels occurs at this time. Administration of hCG to women whose ovaries have been stimulated with gonadotropins results in much higher plasma prorenin levels and the height of prorenin response is directly related to the number of mature follicles. Plasma prorenin also increases 10-fold during the early stages of pregnancy. It begins to rise on days 8 to 12 after embryo transfer, in parallel with the rise in endogenous hCG. The ovaries are the apparent source of the increase in plasma prorenin in early pregnancy since no such increase in prorenin occurred in a woman with ovarian failure who conceived after receiving a donor egg. These results suggest that prorenin is synthesized and secreted by the mature ovarian follicle and by the corpus luteum in response to LH/hCG. They also suggest that an ovarian renin system exists that is regulated by changes in prorenin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309748 TI - The psychological impact of diagnostic ultrasound. AB - The psychological impact of ultrasound scanning in pregnancy was examined in low- and high-risk pregnancies. Women in each category were assigned consecutively to a condition of either low or high feedback. In the latter condition, the women received extensive verbal and visual feedback, whereas in the former, subjects were denied visual access to the monitor. Psychological changes were measured using the State Anxiety Inventory and the Subjective Stress Scale. When a male partner attended, he was included in the assessment. The emotional impact of ultrasound was influenced by the level of feedback provided, with those in the high-feedback condition indicating significantly less anxiety and more positive emotional experiences during the scan, compared with those who received less feedback. PMID- 3309749 TI - Prediction of discordant twins using ultrasound measurement of biparietal diameter and abdominal perimeter. AB - Prediction of twin birth weight discordancy was tested in 116 gestations using sonographic measurements of biparietal diameter (BPD) and abdominal perimeter. Abdominal perimeter measurement differences of 20 mm or greater were more sensitive and specific than BPD difference in detecting twins with dissimilar birth weights. PMID- 3309750 TI - Ultrasound assessment of fetal intestinal development in the evaluation of gestational age. AB - A prospective ultrasound study was conducted in 289 uncomplicated pregnancies with gestational ages ranging from 16-40 weeks. Biometric measurements obtained included biparietal diameter (BPD), head and abdominal circumferences, measurements of long bones, and maximal transverse colon diameter. The pattern of small intestinal peristalsis, presence of colonic haustra, and progressive changes in the colon's intraluminal echogenicity were also evaluated. A high degree of correlation was found between gestational age and transverse colon diameter (in millimeters) (R2 = 0.859; P less than .0001), increasing colonic intraluminal echogenicity (R2 = 0.741; P less than .0001), and the appearance and progressive increase in small intestinal peristalsis (R2 = 0.726; P less than .0001). Colonic haustra were visualized in 87.5% after 30 weeks (specificity 100%, sensitivity 77.4%). A high degree of correlation with gestational age was also found if echogenicity and peristalsis were combined (R2 = 0.873; P less than .0001), and proved superior to that found with measurement of BPD (R2 = 0.655; P less than .0001) or femur length (R2 = 0.805; P less than .0001) after 28 weeks. Observations of progressive changes in small intestinal peristalsis and colonic intraluminal echogenicity, together with the development of colonic haustra and progressive increase in transverse colon diameter, allow one to estimate gestational age independent of standard biometry. This approach has particular utility in the third trimester, when sonographic estimation of gestational age is least accurate. PMID- 3309751 TI - Oxytocin during labor after previous cesarean section: results of a multicenter study. AB - The use of oxytocin for labor induction or augmentation in patients with previous cesarean delivery is controversial. This paper presents a series of 1776 patients allowed to labor after a previous cesarean section, of whom 485 (27%) were treated with oxytocin. When the patients who received oxytocin were compared with those who did not, no significant differences were found with respect to uterine rupture, maternal morbidity, fetal morbidity, or fetal mortality. We conclude that the judicious use of oxytocin is safe in the patient with a previous low transverse cesarean section. PMID- 3309752 TI - The dynamics of nonsteroidal anti-inflammatory therapy for primary dysmenorrhea. AB - The dynamics of drug therapy are generally discussed in terms of absorption, excretion, and blood levels. These established methods of analyzing the pharmacodynamics frequently fail to determine the more critical tissue concentrations necessary for ultimate drug action. The use of intrauterine pressures to objectively measure uterine response to drug therapy may be used to demonstrate the onset and magnitude of drug action in nonsteroidal anti inflammatory drug therapy for patients with primary dysmenorrhea. When continuous intrauterine pressure data is combined with plasma drug level sampling, a reflection of the dynamics of these drugs may be possible. Data were studied from 18 patients who participated in a double-blind, placebo-controlled, single-dose crossover study of subjective and objective responses to meclofenamate. The responses in these patients indicated a clear parallel in time response curves between plasma drug level and alterations in uterine contractile activity. The slight time delay between the changes in blood drug level and the onset of changes in uterine activity is hypothesized to represent the time necessary to establish effective tissue levels. Examples of time response curves are illustrated. PMID- 3309753 TI - Thyroid disease and reproductive dysfunction: a review. AB - Thyroid disorders are often ubiquitous and insidious in their presentation. They have been implicated in a broad spectrum of reproductive disorders ranging from abnormal sexual development to menstrual irregularities and infertility. If pregnancy occurs in a patient with thyroid disease, the physician must ensure that therapeutic measures instituted to restore the health of the mother do not adversely affect the developing fetus. This review examines the role of thyroid disease in disorders confronting the obstetrician/gynecologist and provides a theoretical framework upon which to base practical management decisions. PMID- 3309754 TI - Indirect blood pressure monitoring in the postpartum patient. AB - Direct intra-arterial blood pressure (BP) measurements were compared with simultaneous standard cuff sphygmomanometry and automated inflatable cuff manometry in 12 postpartum patients. An adjustable arterial damping device was used to correct overestimations of systolic values due to distorted pressure waveforms. No significant differences in diastolic pressure with and without arterial damping were noted between noninvasive techniques and direct intra arterial values. The systolic readings obtained with the standard cuff were significantly lower than the intra-arterial values with or without the arterial damping device (P less than .001 in both cases). However, mean systolic BP by automated cuff did not differ significantly from intra-arterial readings in the presence of the damping device (P = .10, not significant). We recommend indirect BP monitoring by automated cuff manometry in nonobese critically ill patients requiring frequent BP readings, and arterial catheter in situations requiring frequent arterial blood samples or oxygenation assessment. PMID- 3309756 TI - Medicare payments and profits. PMID- 3309755 TI - A new technique to overcome failed second-trimester amniocentesis due to membrane tenting. AB - Membrane tenting during amniocentesis is a significant cause of dry taps, leading to immediate procedure failure or multiple needle insertions. Because of the increased risk of fetal loss and other minor complications reported with multiple taps, a means of accomplishing fluid retrieval on a single pass is desirable. We describe a new single-pass technique that involves further needle penetration into the posterior myometrium, under ultrasound guidance, physically displacing the obstructing membranes down the shaft away from the tip. PMID- 3309757 TI - [Effect of thymostimulin on chemotherapy-induced changes in lymphocyte subset distribution. A longitudinal study in patients with primary inoperable oropharyngeal cancers]. AB - 20 patients with primarily inoperable squamous cell carcinoma of the head and neck were treated with 2 cycles of chemotherapy prior to surgical treatment. The lymphocyte subsets were determined prior to chemotherapy, as well as directly after and 3 weeks after start of each chemotherapy cycle. For this, 2 different flow cytometric techniques were used in parallel. After the second cycle of chemotherapy 10 patients were additionally treated with thymostimulin for 2 weeks. The remaining ten patients received no additional immunotherapy and served as control group. Three patients (one in the control group and two in the verum group) had to be excluded from the study because the immunological examination could not be performed in accordance with the protocol. In addition another patient had a local skin reaction so that thymostimulin therapy could not be started as allergy to bovine proteins was suspected. Prior to the first chemotherapy treatment, there is no detectable defect in the distribution of lymphocyte subsets. Under chemotherapy treatment the absolute number of Pan-T cells, T-helper cells, T-suppressor cells and Leu-10 positive B-cells decreased. In contrast, additional treatment with thymostimulin directly after the chemotherapeutic regimen resulted in a marked increase of all T-lymphocytes as well as the Leu-10-positive cells. The results measured with two different flow cytometric techniques were comparable. PMID- 3309758 TI - Assay of the cell-mediated immunity in patients with malignant and non-malignant diseases. AB - The depression of cell-mediated immunity (CMI) was determined in patients with ovarian and breast carcinomas by lymphokine production under Con-A-stimulation (migration inhibitory factor), T-lymphocyte-transformation test under PHA stimulation and with a skin reactivity test with a viscum album extract (Plenosol, Dr. Madaus, Cologne, FRG). The results show a good correlation between the different types of CMI function tests. The cytostatics have a depressive effect on CMI more through a cumulative effect than through the actual concentration. Some of the patients with chronic rheumatism who were not treated were anergic, and that also had an influence on the therapy. PMID- 3309759 TI - Immunomodulation with Viscum album and Echinacea purpurea extracts. AB - Extracts of Viscum album (Plenosol) and Echinacea purpurea (Echinacin) are used clinically for their non-specific action on cell-mediated immunity. In vitro we could prove that these two extracts have a stimulating effect on the production of lymphokines by lymphocytes and in the transformation test. A toxic effect on cells was produced only with very high, clinically irrelevant concentrations. Clinical application of these extracts can produce a stimulation of cell-mediated immunity (one therapeutic administration followed by a free interval of one week) or can have a depressive action (daily administrations of higher doses). These observations were confirmed by lymphokine production and assay, 3H-thymidine incorporation and a skin test with recall antigens (Multitest Merieux). PMID- 3309760 TI - [Immunostimulation using a plant combination preparation]. PMID- 3309761 TI - [Cellular immunity using skin tests in children with malignant diseases at the time of diagnosis and after therapy]. AB - Patients with cancer often have disturbances of cellular immunity. Changes of cellular immunity are frequently associated with tumor progression or an increased risk of a relapse. Cellular immunity is studied with an in vivo test system using 7 different recall antigens. We studied the cutaneous reaction of 80 children with various malignant diseases at time of diagnosis, at the end of the chemotherapy or prior to a relapse of the disease using the multitest Merieux. Before starting treatment patients with systemic diseases showed only a little response to the recall antigens. Patients with solid tumors had normal responses. No prognostic meaning of the multitest results were seen, if it was done before starting the treatment. At time of a relapse, these patients mostly had negative skin reactions using the multitest. It has to be studied if these results show a new systemic disease or if they are expression of an ongoing disturbance of cellular immunity of these patients. PMID- 3309762 TI - [Supportive therapy with xenogenous peptides in patients with metastatic breast cancer undergoing aggressive chemotherapy (modified AC-protocol): a prospective, randomized double-blind study]. PMID- 3309763 TI - [In vivo testing of cell-mediated immunity in urology]. AB - The new disposable plastic device, called Multitest, presents 7 standardized microbial antigens. In this way 558 urological patients and healthy subjects were skin-tested. We obtained a statistically decrease in generalization of tumor disease and in perioperative complications. So the test battery may be of interest for monitoring cancer patients and to define high-risk patients. PMID- 3309764 TI - [New data on nuclear transplantation in mammals]. AB - The results of studies on nuclear transplantation in mammals published in 1986 allow to suppose the causes of failure in experiments on mice and outline ways of overcoming these difficulties. PMID- 3309765 TI - Treatment of Mooren's and Mooren's-like ulcer by lamellar keratectomy: report of six eyes and literature review. AB - Three cases of Mooren's ulcer (four eyes) and one case of marginal corneal ulcer associated with relapsing polychondritis (two eyes) are presented with decrease in ocular inflammation following extensive lamellar keratectomy or lamellar keratoplasty. Tissue adhesive was needed in two cases to maintain ocular integrity. The procedure may work by the removal of a corneal antigenic stimulus to a self-perpetrating auto-immune phenomenon that causes corneal melting. More cases are needed to evaluate the therapeutic efficacy of lamellar keratectomy for Mooren's and Mooren's-like corneal ulcers. PMID- 3309766 TI - Cornea fistula. AB - We report a case of corneal fistulization which developed following acute hydrops in a patient with keratoconus. Treatment with thermokeratoplasty yielded good visual results. Corneal rupture and fistulization occurring after acute hydrops has been unreported. This case illustrates the need to be alert to these complications. PMID- 3309767 TI - Prediction of aphakic refractive error in children. AB - Formulas created to predict the optical requirements of the aphakic eye have been tested mainly in adult eyes. The accuracy of these formulas in shorter pediatric aphakic eyes was examined using retrospective analysis of 17 aphakic pediatric patients. The Sanders-Retzlaff-Kraff contact lens formula, used previously to predict required lens powers for epikeratophakia, consistently underestimated the required aphakic correction in the shorter eyes, which may have been responsible in part for the large undercorrections obtained previously in patients under one year of age. The Hoffer-Colenbrander and Binkhorst theoretical formulas, Donzis Kastl-Gordon percentage change formula, and a linear regression formula derived from the present data (LIN), were significantly more accurate. The differences between these formulas were not significant. The use of one of these formulas should facilitate prediction of required epikeratophakia lenticule power or intraocular lens power in young children. PMID- 3309768 TI - Scanning electron microscopic study of an anterior chamber intraocular lens: latent endophthalmitis. AB - Two years after intracapsular cataract extraction and intraocular lens implantation, an anterior chamber lens was removed. The lens was studied by scanning electron microscope which demonstrated the presence of colonies of cocci, a thin acellular membrane covering part of the lens and some modifications of the lens surface. PMID- 3309769 TI - Coloboma and microphthalmos in chromosomal aberrations. Chromosomal aberrations and neural crest cell developmental field. AB - A survey of more than 500 reports on patients with autosomal chromosomal aberrations associated with microphthalmos and/or coloboma shows that these anomalies are unspecific. Anterior chamber anomalies were common as were abnormal ears, preauricular pits and tags, cleft lip-palate, micrognathia, urogenital malformations, congenital heart disease, atresia of the anus and minor malformations of the hands and feet. It is proposed that the chromosomal aberrations induce faulty development of neural crest cells and rostral neural plate derivatives. PMID- 3309770 TI - Ten years after the Diabetic Retinopathy Study. AB - The Diabetic Retinopathy Study (DRS) demonstrated that prompt argon laser photocoagulation, in comparison to indefinite delay in treatment, could reduce by more than 50% the risk of severe visual loss from proliferative diabetic retinopathy. The DRS also enlightened two generations of ophthalmologists about the value of the randomized controlled clinical trial as a way of assessing new and existing treatments for unsolved therapeutic problems. After the example of the DRS, laser treatment was shown to be effective in reducing vision loss in selected patients with branch retinal vein occlusion, age-related macular degeneration, ocular histoplasmosis, and diabetic macular edema. Existing trials, supported by the National Eye Institute, are seeking to determine the appropriate treatment for selected patients with newly diagnosed glaucoma, vascularized corneas, retinopathy of prematurity, proliferative vitreoretinopathy and complicated retinal detachment, and choroidal melanoma. Clinical practice has benefited enormously from these studies all of which owe their existence, at least in part, to the prototypical clinical trial, the DRS. This symposium discusses the DRS and places it in today's perspective, with a look to the past as well. PMID- 3309771 TI - Glaucoma associated with penetrating keratoplasty. AB - The occurrence of chronic postoperative glaucoma in 502 consecutive penetrating keratoplasty cases performed in 421 patients during 1978 through 1986 was 18% (91 cases). Immediate postoperative glaucoma occurred in 9% (44 cases) and progressive angle closure occurred in 2% (13 cases) of keratoplasties. Statistically significant risk factors for development of glaucoma were preexisting glaucoma and aphakia. The type of cataract extraction, use of an intraocular lens, or performance of vitrectomy did not pose significant risk of glaucoma. Surgical therapy of glaucoma was required in 24% of those with glaucoma and was most effective as cyclodestructive surgery especially in patients with progressive angle-closure glaucoma. PMID- 3309772 TI - Cell density and sex chromatin in lens epithelium of human cataracts. Quantitative studies in flat preparation. AB - The lens epithelium of the human eye obviously plays a crucial role in the pathogenesis of primary and secondary cataracts. Four hundred nine flat preparations of human lens epithelium attached to the anterior capsule, obtained during surgical extracapsular cataract extraction (ECCE), were studied. Of these, 197 proved to be suitable for quantitative cell density determination and 93 for counting of the Barr bodies (sex chromatin). Barr bodies are, on the average, found in 54% of the lens epithelial cell nuclei of female patients and in 8% of male patients (P less than 0.001). The median for the cell density of all preparations was 4382 epithelial cells/mm2. Lens epithelium of patients exceeding 50 years of age showed a lower cell density than epithelium of younger patients (P less than 0.05), and, surprisingly, epithelium of females showed a significantly higher density than that of male patients (P less than 0.01). With increasing cortex involvement of the cataracts, a tendency towards a decrease of epithelial cells was noted. PMID- 3309773 TI - Clinical results with a ceramic keratoprosthesis placed through the eyelid. AB - The authors placed a ceramic keratoprosthesis through the eyelids of 11 consecutive patients: six with alkali injury, four with cicatricial pemphigoid, and one with Stevens-Johnson syndrome. The surgery was technically successful in ten patients. One patient experienced an intraoperative, expulsive choroidal hemorrhage, and the keratoprosthesis was not implanted. Six patients were followed for 21 to 56 months; three, who had no postoperative potential for visual improvement were followed for 2 to 6 months; and one patient died 14 months after surgery. Six patients achieved 20/20 to 20/100 corrected visual acuity at some point after surgery. At last examination, only three eyes (27%) saw 20/200 or better. Complications included eyelid cellulitis, extrusions, aqueous leaks, retroprosthetic membranes, endophthalmitis, and progressive glaucoma. The authors think mechanical torque by movement of eyelid and globe destabilizes the keratoprosthesis, producing many of the complications. PMID- 3309774 TI - Epikeratoplasty. The surgical correction of aphakia, myopia, and keratoconus. AB - Thirty-five patients have had 39 consecutive epikeratoplasty procedures (12 adult aphakic, 9 pediatric aphakic, 12 myopic, and 6 keratoconic eyes) by the same surgeon, using commercially prepared lenticules. The lenticule remained totally clear in 85% of eyes. Two lenticules were removed due to infection and scarring; four lenticules had minimal scarring and did not require removal. Spectacle corrected acuity was worse than one line from the preoperative spectacle corrected acuity in 58% of the adult aphakic eyes; however, 75% were 20/50 or better postoperatively. Fifty percent were within 2 diopters (D) of emmetropia and 92% within 3 D. All pediatric aphakic patients showed an improvement in best corrected acuity, and 83% of eyes at 6 months were within 2 D of emmetropia; by 1 year a 3.4-D average myopic shift had occurred. Two of the six eyes (33%) using the original myopia technique were within 2 D of emmetropia, whereas five of the six eyes (83%) with the current technique are within this range. Spectacle corrected acuity in the entire current myopia group has either improved by one or more lines or has remained unchanged. Five of the six keratoconic eyes had 20/40 or better spectacle-corrected and 20/25 contact lens-corrected acuity postoperatively; average corneal flattening was 6 D. Persistent epithelial defect and irregular astigmatism were the principal factors in delay in visual recovery. PMID- 3309775 TI - Penetrating keratoplasty for herpes simplex keratitis and keratoconus. Allograft rejection and survival. AB - To determine the relationship between corneal allograft rejection and failure, we studied patients who underwent penetrating keratoplasty for herpes simplex keratitis (n = 82) and keratoconus (n = 345), two frequent indications for keratoplasty in young patients, using survival analysis. For first grafts for herpes, the probability of survival was significantly less than it was for keratoconus (P less than 0.0001). For second grafts, this difference was less pronounced, and for three or more grafts, the difference in survival was not significant. The incidence of rejection episodes was similar in first grafts for herpes (16.6%) and keratoconus (18.5%) (P greater than 0.05). However, the incidence of rejection episodes in regrafts for herpes was significantly greater than in keratoconus (23.7 versus 17%, P less than 0.01). The incidence of failure after rejection episodes (first grafts and regrafts combined) was significantly greater in grafts for herpes (52.4 versus 16.2%, P less than 0.001). Because survival after multiple regrafts in both groups is poor, additional measures, such as tissue matching, may be necessary to improve the likelihood of success in these high-risk cases. PMID- 3309776 TI - Tear and serum IgE concentrations by Tandem-R IgE immunoradiometric assay in allergic patients. AB - The authors studied a population of 39 allergic and 15 nonallergic patients, and determined their tear and serum IgE concentrations. Samples of tear and serum were tested for IgE by the Tandem-R immunoradiometric assay, which uses monoclonal antibody to produce a specific assay for IgE. The serum IgE levels in the study group showed a range from 23,280 to 16 IU/ml compared with controls of 72 to 2 IU/ml. Tear IgE in the study group varied from 159 IU/ml to less than 1 IU/ml compared with controls of 8 IU/ml to less than 1 IU/ml. A statistically significant correlation between tear and serum IgE exists in the allergic patients with eye symptoms. It also exists when serum IgE was greater than 100 IU/ml, the tear IgE greater than 4 IU/ml, or when both the serum IgE was greater than 100 IU/ml and the tear IgE greater than 4 IU/ml. PMID- 3309777 TI - Autologous versus homologous bone grafting in osteotomies, secondary cleft repairs and ridge augmentations: a clinical study. AB - To compare the clinical results, complications and morbidity of osteotomies, secondary cleft repairs and ridge augmentations in which frozen femoral head homologous bone or autologous bone was used, a series of 61 patients with follow up periods of 1 to 6 years has been reviewed. Long-term clinical observation shows that, with a correct indication and surgical technique, frozen homologous bone is a good alternative to autologous bone in clinical grafting procedures. PMID- 3309778 TI - The use of allogeneic bone for alveolar cleft grafting. AB - Freeze-dried bone marrow has been used for grafting alveolar clefts. In all instances in which canines were present, they erupted through the grafted allogeneic bone. The ability to avoid donor site morbidity, coupled with successful eruption of canines through the grafted allogeneic bone, represents an additional technique for treating alveolar clefts. PMID- 3309779 TI - Involucrin as a diagnostic marker in oral lichenoid lesions. AB - Thirty-eight biopsy specimens were examined for involucrin reactivity by an immunoperoxidase technique. The sampling consisted of specimens diagnosed as normal oral mucosa, reactive epithelial hyperplasia, lichen planus (LP), nonspecific lichenoid stomatitis (NLS), lichenoid dysplasia (LD), carcinoma in situ, and squamous cell carcinoma (SCCa) on routine hematoxylin and eosin examination. Findings were consistent with prior observations of involucrin reactivity in skin and cervical-vaginal mucosa. Specifically, conditions characterized by predominance of mature squamous epithelial cells (superficial layers of normal and hyperplastic oral epithelium, NLS, and LP) exhibited strong involucrin reactivity in such areas. In contrast, atypical or dysplastic lichenoid lesions (LD), as well as carcinoma in situ, despite squamoid differentiation, demonstrated irregular distribution of involucrin, suggesting disturbances in terminal differentiation. Invasive components of SCCa revealed markedly diminished involucrin expression. These findings support prior evidence that LP and LD are biologically distinct lesions. Clinically and microscopically, both may be morphologically similar. However, involucrin reactivity should be helpful in distinguishing difficult cases. Accordingly, we suggest that the use of involucrin immunoreactivity may prove to be a valuable adjunct in the separation of similar lichenoid oral conditions. PMID- 3309780 TI - Sinus histiocytosis with massive lymphadenopathy (Destombes-Rosai-Dorfman syndrome) occurring as a single enlarged submandibular lymph node: a light and immunohistochemical study with review of the literature. AB - Sinus histiocytosis with massive lymphadenopathy (SHML) is primarily a disease of children and young adults in which there is a pronounced and persistent cervical lymph node enlargement that usually is bilateral and is accompanied by fever. The histology, which varies according to the stage of the disease, is characterized by an exuberant intrasinusoidal histiocytic proliferation. The present case involves a 4-year-old girl who had several episodes of upper respiratory infection and otitis media; subsequently, a walnut-sized enlargement developed in the left anterior portion of the neck. Results of a physical examination were essentially normal. A laboratory work-up was noncontributory. Serologic tests for toxoplasmosis, infectious mononucleosis, and cat-scratch disease were negative. Immunoelectrophoresis disclosed normal values for IgG, IgM, IgA, and IgE. The histopathology was characteristic of SHML. The lymph node demonstrated pericapsular and capsular fibrosis and widely dilated subcapsular, trabecular, and medullary sinuses packed with histiocytes and plasma cells. "Lymphophagocytosis" and large atypical histiocytes resembling Reed-Sternberg cells were noted. Immunohistochemistry demonstrated a polyclonal population of plasma cells mostly stained with rabbit anti-human igG. The cytoplasm of the histiocytes, having ingested lymphocytes, was positively stained for IgG. Other groups of lymph nodes were affected during the next several months. The patient's condition has now been followed for 2 years, and the lymphadenopathy has almost completely regressed. The site distribution of the head and neck extranodal manifestations of SHML was analyzed in 54 cases. PMID- 3309781 TI - Butorphanol/diazepam compared to meperidine/diazepam for sedation in oral maxillofacial surgery: a double-blind evaluation. AB - Butorphanol and meperidine, each combined with titrated diazepam, 10 to 20 mg, were compared in a randomized, double-blind trial for their sedative-analgesic effects. The fifty patients underwent multiple dental extractions under local anesthesia and sedation in an outpatient clinic. Butorphanol was significantly superior to meperidine with respect to the diazepam dose required to achieve the target level of sedation, the total diazepam dose administered, the clinical level of sedation, the surgeon's overall evaluations of effectiveness and of sedation level, and several patient evaluation parameters measured at discharge from the recovery room and at follow-up interview. All study drugs were well tolerated. Butorphanol offers clinical advantages over meperidine when combined with diazepam for sedation analgesia in outpatient oral surgery. PMID- 3309782 TI - [The outcome of microsurgical operations in nerve injuries]. PMID- 3309784 TI - [Our experience with preserving the extremity in severe open fractures of the forearm]. PMID- 3309783 TI - [Diagnosis and treatment of injuries of the nerves of the upper extremity in children and adolescents]. PMID- 3309785 TI - [Alloplastic tenodesis of the distal interphalangeal joint]. PMID- 3309786 TI - [Textbook-writing activities of Mihaly Lenhossek Jr]. PMID- 3309787 TI - [Life, works and example of the two Toltenyis]. PMID- 3309788 TI - [Experience with percutaneous kidney stone removal based on 150 cases]. PMID- 3309789 TI - [From the past of Hungarian-Finnish medical relations]. PMID- 3309790 TI - [Floor insulation by using ceramic pots in an old dwelling of a physician in Edeleny]. PMID- 3309791 TI - [Pelvic bone defects in alloarthroplasty]. AB - Loss of acetabular bone renders secure fixation of an artificial cup difficult. Loss of pelvic bone mainly results from repeated revision of failed THR, tumor resection within the acetabular region and trauma. The main criteria for the method of treatment to be applied are the biomechanical condition of acetabular defects, the bacteriological situation, and the patient himself. In aseptic cases we regard bony reconstruction with homografts as the method of choice. From 1982 to 1986 about 1000 bony reconstructions were performed using more or less extensive facilities for support, i.e. screws, baskets, plates. In septic cases defects are closed using antibiotic-loaded acrylic cement in combination with screws. In the extreme case of bone destruction we recommend the saddle prosthesis as an alternative measure. This type of prosthesis was used in 76 cases from 1979 to 1984. Other methods of treatment, such as resection arthroplasty, arthrodesis, and partial pelvic replacement may be considered. PMID- 3309792 TI - [Patellectomy as a salvage operation]. AB - One hundred seven patients were examined who had undergone patellectomies between 1965 and 1983 (113 patellectomies). The mean follow-up time was 10.5 years (3 17.5 years) and the average age of the patients 42.6 years. There were three distinct groups of operative techniques: (1) the purse-string technique in 40 patellectomies; (2) the vastus medialis technique in 24 patellectomies; (3) other techniques in 49 patellectomies. The indications for patellectomy were: chondromalacia, 56 cases; comminuted patellar fractures, 32 cases; arthritis, 17 cases; recurrent patellar dislocations, 8 cases. The patients were examined for pain, rage of motion, giving way, swelling, quadriceps strength, activity and cosmetic results (interview, physical examination, Cybex and radiographic study). In the purse-string technique group, 81% of the cases ended up with good or excellent results; in the vastus medialis group there were 79% and in the third group only 73% good or excellent results. Among the patellectomies for comminuted fractures, 75% had excellent results. The clinical outcome of patelletomy for arthritis is fair, for recurrent dislocation favorable, and for chondromalacia variable and not predictable. PMID- 3309793 TI - W. S. Stiles and the variation in directional sensitivity of the retina. PMID- 3309794 TI - [Prof. Aleksander Zakrzewski. Obituary notice]. PMID- 3309795 TI - Transplant patient has no more doubts. PMID- 3309796 TI - [Sonographic study of upper abdominal organs in children and adolescents with cystic fibrosis]. PMID- 3309797 TI - [Interdisciplinary meeting on anti-infection chemotherapy. 4 December 1986, Paris. Proceedings]. PMID- 3309798 TI - [Quality control of multicenter evaluation studies of the in vitro activity of antibiotics]. AB - The estimation of the in vitro activity of an antibiotic, by different laboratories, requires the measurement, in standardized conditions, of the inhibition zone diameters versus a series of strains distributed to these laboratories (kits). Using the studies realized with two antibiotics, denoted by A and B, we observed an important variability between the different laboratories for a given strain and a less but still significant variability within the laboratories. Variance analysis revealed a significant interaction between strains and experimental laboratories. These results prevent the establishment of a standard diameter for a given strain but permit the quality control of the measurements and the improvement of the experimental design for future studies. PMID- 3309799 TI - [Computerized data storage of antibiograms obtained by various methods (automatic reading by 2 different systems or manual processing by the disk method) and retrieval of antibiograms and cytobacteriological data using microcomputers]. AB - This software is composed of different programmes. It works on Apple IIe computers. It enables to capture all the data information concerning bacteriological tests to store them and to edit either personnel reports or global lists made out according to different criteria and to study them under both the statistical or the epidemiological aspects. The results of the antibiotic sensitivity test are notified either by an automatic reader (ABAC or API system) when carried out in a liquid environment or by an original computerized device (compass or enlarger) when manually carried out by the disc method. The informations are directly transmitted to the computer. It's possible to make up a common data file that can be exploited as a whole. PMID- 3309800 TI - [Direct determination of clavulanic acid in biological fluids using HPLC]. AB - The so far described HPLC methods for clavulanic acid (CA) monitoring needed post column derivatization with imidazole, resulting in poorly practicable methods. We propose here a direct determination of CA in human biological fluids with a ion pairing technology using the bathochromic shift of tetrabutylammonium bromide (TBAB). The separation is performed on a reversed phase analytical column (250 X 4.6 mm) with the following mobile phase: 10% acetonitrile in 1 mM TAB and 20 mM ammonium acetate (pH = 5). The U.V. detection is at 214 nm. Serum and bile are prepared with acetonitrile and methylene chloride, and urines are diluted 1/10 prior the analysis. Retention time of CA is 8.4 min. Detection limit for bile and serum is 0.1 mg/l and 5 mg/l for urines. Within and between-day reproducibility is respectively 5.4% and 7.2% for serum and bile, and 4.7% and 6.8% for urine. This method may be suitable for clinical routine analysis and pharmacokinetic studies. PMID- 3309801 TI - [Course of the diffusion of cefotiam in infected ascitic fluid]. AB - The cefotiam (CFT) penetration in infected ascitic fluid was investigated in 12 cirrhotic patients. CFT (1 g every 8 h) was given intravenously and measured by HPLC in plasmatic and ascitic samples. The mean ascitic concentrations (+/- SEM), 1 h, 3 h and 8 h after the first injection (J1) were 14.6 +/- 4.6, 11.8 +/- 3 and 8.4 +/- 2.9 micrograms/ml respectively. These values were 38, 62 and 88% of the corresponding mean plasmatic concentrations and higher than the MIC's for the organisms most commonly involved. The mean plasmatic and ascitic concentrations, a few days later (4.5 or 6 days) (Jn) were not significantly different from the corresponding values at J1. A significant decrease of polymorphonuclear cell count was observed between J1 and Jn. These results suggest that CFT diffusion into ascitic fluid is independent of inflammation and CFT is an adequate antibiotic in cirrhotic patients with infected ascitic fluid. PMID- 3309802 TI - [Determination of blood ceftriaxone. Comparison of microbiological and HPLC methods]. AB - 108 serum samples in 27 patients were collected after the first, before the second, after and before the fifth dose of 2 g every 24 h and assayed for ceftriaxone by microbiological method and high pressure liquid chromatography (HPLC). The statistical analysis of the results show a correlation coefficient equal to 0.95. The protein binding doesn't affect the microbiological method. The two methods are convenient for clinical use. PMID- 3309803 TI - [Pharmacokinetics of ceftriaxone in hemodialysis]. AB - The influence of hemodialysis on the pharmacokinetics of ceftriaxone was studied in 5 patients with chronic renal failure, with a glomerular filtration rate of less than 5 ml/min, and treated by regular hemodialysis. A single dose of 2 g ceftriaxone was administered IV at the end of a hemodialysis, and venous samples were drawn 12 and 24 h thereafter. Two hemodialysis were performed at the 44th (HD1) and the 92nd (HD2) hour, and blood samples were drawn simultaneously on arterial and venous sides of the dialyzer at the onset of HD1 and at the end of HD2. Plasma ceftriaxone concentrations were measured on each sample by both microbiological and chromatographic (HPLC) methods. In these patients, ceftriaxone kinetics are considerably longer than in normal subjects, with an elimination half-life of 16 h, an apparent distribution volume of 800 ml/kg, but without decrease of plasma clearance, except in one patient who had hepatic cytolysis at the time of injection. Plasma concentrations on both sides of dialyzers, or before and after hemodialysis, are not significantly different, and the mean hemodialysis clearance ranges between 26 and 30 ml/min/m2 dialyzer area. According to these data, the dose-interval between successive administrations of ceftriaxone 2 g IV should be 48 h in patients with chronic renal failure, and supplemental doses do not appear necessary after hemodialysis. PMID- 3309804 TI - [Diffusion of ceftriaxone in bronchial secretions for 24 hours after a single injection]. AB - The authors have determined the bronchi concentration 1 h, 3 h, 6 h and 24 h after a single muscular injection of ceftriaxone in a series a 13 patient with tracheostomy that received ceftriaxone for prophylaxis. In spite of a large inter individual variability the result is a good mean ceftriaxone concentration during the first 24 h. Theses results confirms the value or a single daily injection in the treatment of pulmonary injection whose germ is sensitive to the drug. PMID- 3309805 TI - [Diffusion of ceftriaxone in the renal parenchyma]. AB - Diffusion of ceftriaxone in renal parenchyma after IV injection (2 g) was studied in six patients with normal renal function, undergoing nephrectomy. Cortex and medulla of the kidney were studied. Blood samples, tissular fragments and urine were studied for drug concentration using HPLC and microbiologic assay 1, 12 and 24 h after injection. Both methods led to similar results. No difference in drug concentration was found between cortex and medulla. Tissular concentration of ceftriaxone remain higher than MIC for most Enterobacteriaceae strains until 24 h. PMID- 3309806 TI - [Pharmacokinetics of habekacin in patients with chronic renal insufficiency]. AB - Pharmacokinetics of habekacin, a new semisynthetic aminoglycoside antibiotic were investigated in six healthy subjects and twenty-five uraemic patients (six of whom were on hemodialysis) after a single 3 mg/kg Im or IV administration. After the IM injection, the peak serum levels were higher and the times to peak levels were longer in patients with renal impairment than in healthy subjects. Elimination serum half-life increased in relation to the degree of renal impairment, from 2 h in normal subjects to 32 h in patients with creatinine clearance below 10 ml/min. Renal impairment did not significantly modify the apparent volume of distribution. After a single 3 mg/kg dose as one hour-IV infusion in six hemodialysis patients, elimination half-life averaged 48 h and 5 h, out of and on a 4 to 5 hour-hemodialysis session, respectively. Habekacin pharmacokinetic parameters appeared to be similar to those of the other available aminoglycoside antibiotics. PMID- 3309807 TI - [Antipneumococcal activity of erythromycin and spiramycin in 2 experimental models in mice]. AB - Macrolides often remain the first intention treatment in many chest infections caused by S. pneumoniae. Antipneumococcal activities of spiramycin and erythromycin have then been tested in a septicaemia model and in a pulmonary infection model in mice. In the septicaemia model, spiramycin has been found 5 to 15 times more active than erythromycin by subcutaneous route and 1.5 to 6 times by oral route. In the pneumonia model, spiramycin has been found as active (one strain) to 5 times more active than erythromycin (three strains) by both subcutaneous and oral route. These data might indicate that better tissular penetration of spiramycin is responsible for better in vivo activity. These facts also support the statement that MIC should not be the only choice standard of infectious chemotherapy. PMID- 3309808 TI - [Effects of rifampicin on the pharmacokinetics of doxycycline]. AB - Because of the potential of doxycycline-rifampicin for oral therapy of infectious diseases with intracellular bacteria, specially brucellosis and the well known cytochrome P450 enzyme system inductive activity of rifampicin, we may speculate that this antibiotic can altered the serum concentration-time profile of doxycycline when given in combination. So, the main pharmacokinetic parameters of doxycycline (200 mg/day orally) in seven patients before and after rifampicin association (10 mg/kg/day). According to the results two groups may be individualized: the first (n = 3) showed no variation in the doxycycline++ pharmacokinetic; the second (n = 4) had significant differences (p less than 0.05) for all pharmacokinetic parameters (AUC, T1/2, Cl, Cmax) after association with rifampicin (AUC were half reduced). Moreover, as regard doxycycline half life, a difference was observed between these two groups before rifampicin treatment: in one case T1/2 was of 17.9 + 6.6 hours, while in the other it was of 9.2 + 2.3 hours. The group with obvious enzyme induction had the longer half life. This suggests that the inductive rifampicin effect would be essentially observed in patients considered as "poor metabolizers". The pharmacokinetic modifications observed are likely of clinical significance on account of the doxycycline serum concentrations decrease under the MIC of most agents of intracellular infections. PMID- 3309809 TI - [Comparative pharmacokinetics of fosfomycin in the neonate: 2 modes of administration]. AB - In newborn, fosfomycin-cefotaxime in combination is more and more commonly used for the treatment of nosocomial infections. A pharmacokinetic study was conducted in ten newborns in the aim of suggesting a therapeutic schedule of the fosfomycin. Each newborn received 200 mg/kg, intravenously twice a day. Two groups have been formed according to the time of perfusion: 2 h or 30 min. The study of pharmacokinetic parameters do not demonstrated significant difference between the two populations. In addition, residual serum concentrations, twelve hours after the administration, are greater than the minimal inhibitory concentrations of most common pathogens causing nosocomial infections in neonates. PMID- 3309810 TI - [Fosfomycin-trometamol (monuril): pharmacokinetics and food-drug interactions]. AB - A new water soluble monobasic salt of fosfomycin with trometamol has been recently developed for oral administration. The objective of this study was to evaluate the pharmacokinetics of trometamol-fosfomycin (monuril) in serum and urine in 10 healthy volunteers after oral administration of one single dose (50 mg/kg). In the volunteers, the concentrations of fosfomycin were measured before and after food absorption in serum and urine samples taken at t = 0, 2, 4, 6, 8, 24 h after the dose (plus 0.5 hand 1 h for serum samples). The measurement of fosfomycin levels was carried out by means of a microbiological procedure using Proteus mirabilis ATCC 21100 as test organism. The results indicated at 2 h after oral administration of the antibiotic, a mean serum peak level of 21.04 +/- 6.88 micrograms/ml. The urine concentrations reached 2,000 to 2,750 micrograms/ml at the 2nd hour, with high levels (mean: 1,876 +/- 709 micrograms/ml) till the 8th hour and persistence of noticeable concentrations at 24 h (334 +/- 210 micrograms/ml). The influence of food absorption, even variable, decreased significantly the rate of absorption with lower serum and urine levels. Taking into account this factor influencing the bioavailability and the distribution of the drug, the results of the study confirm that a high proportion of the oral dose of trometamine salt of fosfomycin is well absorbed; the extremely high urinary recovery of the drug could certainly allow short course therapy in the treatment of uncomplicated urinary tract infection. PMID- 3309811 TI - [In vitro antibacterial activity of 2 new quinolones: A 56619 (difloxacin) and A 56620. Comparison with pefloxacin, ofloxacin and ciprofloxacin]. AB - Minimal inhibitory concentration (MIC) of two new quinolones, A 56619 (difloxacin) and A 56620 were evaluated by agar dilution for 511 bacterial strains, in comparison with pefloxacin (PEF), ofloxacin (OFL) and ciprofloxacin (CIP). For Enterobacteriaceae, A 56620 (MIC 50 and 90 p. 100: 0,12 and 2 micrograms/ml) was less active than CIP (0,03 and 1) and more active than OFL (0,12 and 4) whereas A 56619 (1 and 16) appeared slightly inferior to PEF (0,25 and 8); the same range of activity was observed for Pseudomonas aeruginosa: CIP: 0,12-0,5; A 56620: 0,5-2; OFL and PEF: 1-4; A 56619: 1-8. For the majority of Acinetobacter (mode MIC: 0,5-1), Haemophilus (0,008-0,016), Meningococci (less than or equal to 0,008), Gonococci (0,06 a 0,25) and Legionella (0,12), activity of the two new compounds appeared very similar to those of the three other quinolones. A 56619 and A 56620 had a good activity (mode MIC: 0,25-0,5 micrograms/ml), similar to those of the three other quinolones, on Staphylococci sensitive strains whereas they were inactive on resistant strains. For Streptococci, A 56620 is about two times superior to A 56619; its activity is similar to that of PEF for Enterococci (mode MIC: 4) and to that of CIP on Streptococci A and Pneumococci (mode MIC: 0,5-1). For anaerobes, the two compounds had about the same activity similar to that of OFL and CIP (C. perfringens: 0,25-0,5 and B. fragilis: 4 micrograms/ml). PMID- 3309812 TI - [Diffusion of fluoroquinolones in the aqueous humor and crystalline lens]. AB - In 53 patients undergoing cataract extraction, the authors measured pefloxacin and ofloxacin penetration in aqueous humour and lens. Cataract removal was performed at varying times after either the end of one-hour infusion of pefloxacin, ofloxacin per os in one time, or pefloxacin per os during 3 days. In the two first schemes, acme concentrations in aqueous humour are 1.45 mg/l for pefloxacin, 1.14 mg/l for ofloxacin. These concentrations reach the MIC90 of most bacteria usually involved in endophthalmia. The steady state concentrations of pefloxacin are between 6 and 7 mg/l during the first 12 h: they reach the MIC of 80% of Streptococci. There is no evidence of accumulation of pefloxacin in lens; lenticular concentrations of ofloxacin are very low and rapidly decrease. PMID- 3309813 TI - [Intraocular penetration of pefloxacin in man and rabbit. The aqueous humor and vitreous body]. AB - Intraocular distribution of pefloxacin was evaluated in 64 patients undergoing ocular surgery and in 4 rabbits after experimental infection of one eye by Staphylococcus aureus. Patients were perfused during one hour either with 800 or 400 mg of pefloxacin. Samples (serum, aqueous humor, vitreous fluid) were collected 0, 1, 2, 3, 4, 5 or 12 h after the end of antibiotic administration. Antibiotic levels were measured using a standard microbiological assay. The aqueous humor levels remained stables until 12 h, but were higher with a posology of 800 mg (mean level: 2.66 mg/l) than with a posology of 400 mg (mean level: 0.66 mg/l). The ratio between vitreous and serum concentrations ranged from 8 at 12% with 400 mg and from 2 to 36% with perfusion of 800 mg. The efficacy of pefloxacin treatment is demonstrated in the experimental infection of rabbits eyes. PMID- 3309814 TI - [Pharmacokinetics of pefloxacin in burn patients]. AB - The aim of this study was to evaluate pharmacokinetics of pefloxacin (PFL) in burn patients (n = 11), compared with 5 non burned subjects. The role of the extent of the burn and the delay after initial thermal trauma were also evaluated. Our results suggest that neither the extent of the burn, nor the delay of the study play a role. Compared with non-burned subjects, burn patients exhibit a shorter elimination half-life, but modifications in dosage regimen are not required. PMID- 3309815 TI - [Diffusion, in the bronchial mucus, of enoxacin administered by oral route in man]. AB - The diffusion of Enoxacin into the bronchial mucus was studied in 34 patients admitted because of an acute infectious episode over chronic bronchopathy. They received via the oral route 400 mg of Enoxacin twice daily. The antibiotic concentrations were measured in sputum and serum by microbiological assay and HPLC. The patients were divided into 5 groups according with the timing of sampling: 1, 3, 6, 12 hours after dosing at day 3 (group I, II, III, IV), 3 hours after dosing at day 1, 2 and 3 (group V). Serum concentrations of Enoxacin were low (2.46 mg/l at 3rd hour). Bronchial concentrations exceed blood levels (mean 3.06 mg/l at 3rd hour). The bronchial levels of Enoxacin were above the mean MIC of many respiratory bacterial pathogens. PMID- 3309816 TI - [Modulation by quinolones of the in vitro proliferative response of splenic cells of the mouse and IL 1 production]. AB - Besides their antibacterial activity, antibiotics can modulate immune response. In this work, we studied the effects of 6 quinolones (nalidixic and pipemidic acid, pefloxacin, norfloxacin, ofloxacin, ciprofloxacin) on Con A or LPS induced mitogenic response in mice. Data presented here show that pefloxacin and ofloxacin enhanced Con A (1 microgram/ml) induced proliferative response when used at low concentrations (0.1 microgram/ml and 1 microgram/ml). In the same conditions LPS induced response was not modified. When used at high concentrations (greater than 25 micrograms/ml), inhibition of both LPS and Con A induced responses was observed. Con A induced response needs interaction between macrophages and T lymphocytes. So, we investigated whether quinolones could act on interleukin 1 (IL 1) production by macrophages. Our results showed that pefloxacin and ofloxacin, used at low concentrations, enhanced LPS induced IL 1 production by macrophages. PMID- 3309817 TI - [Effects of beta-lactamases on the antibacterial activity of carumonam and aztreonam against Klebsiella sp. in comparison with 4 other beta-lactams]. AB - Carumonam and aztreonam are two similar monocyclic beta lactam antibiotics. We have studied their antibacterial activities on Klebsiella, in comparison with cefotaxime, cefoxitin, cefotetan and imipenem. In the case of K. pneumoniae (53 strains) the antibacterial activities of the two monobactams are very similar. On the contrary, with K. oxytoca (22 strains) carumonam is significantly more active. This situation seems to be justified by an improved stability of carumonam to beta lactamases. In addition, the antibacterial activities of imipenem and of cephamycins remain quite constant within all the strains. Then the antibacterial activity of cefotaxime is fluctuant, which is in relation with a clear susceptibility to the Klebsiella beta lactamases. PMID- 3309818 TI - [Comparative activity of ticarcillin-clavulanic acid and various beta-lactams against Pseudomonas maltophilia]. AB - An increase is observed in the isolation of P. maltophilia as a casual agent of nosocomial infection, particularly in hospitalized immunocompromised patients. These infections are associated with the acute problem of their treatment as most of the P. maltophilia strains are generally resistant to many of the commonly used antimicrobial agents, including those active against Pseudomonas aeruginosa: beta lactams, aminoglycosides and imipenem. This resistance is correlated with two inducible beta lactamases (L1, pI = 6.9; L2, pI = 8.4). Azlocillin, piperacillin, cefoperazone, ceftazidime, latamoxef, ticarcillin, ticarcillin and clavulanic acid in combination were tested against 93 P. maltophilia isolates by disk diffusion testing and agar dilution technique. The association of clavulanic acid with ticarcillin resulted in better MIC values for ticarcillin (MIC 50 = 32, MIC 90 = 128). 96% of strains were sensible to the breakpoint of 128 mg/l. Other beta lactam antibiotics showed a loss of activity except for latamoxef (67% of strains susceptible to 4 mg/l) which is a potent inhibitor of both beta lactamases. According to these results, the combination of clavulanic acid with ticarcillin may be useful in the treatment of P. maltophilia acquired hospital infections. PMID- 3309820 TI - [Cytomorphological study of the action of ornidazole against Bacteroides fragilis]. AB - The action of ornidazole on Bacteroides fragilis at the following concentrations, 4 MIC--MIC--MIC/2--MIC/4, is observed by electron microscopy, transmission and scanning, for 18 to 48 hours. The primary effect on ultrastructure was characterized by a distinct change in the morphology with filament formations and abnormal forms. Secondary effects were significant change in the distribution of ribosomes and abnormal cell division. No significant alterations in the peripheral cell wall were observed. PMID- 3309819 TI - [Susceptibility of Campylobacter pyloridis to antibiotics]. AB - In vitro antibacterial activity of 32 antimicrobials was studied on 20 strains of Campylobacter pyloridis (CP). CP is susceptible to beta lactams, cyclins, chloramphenicol, rifampicin, macrolides, aminoglycosides, sometimes to colistin, nalidixic acid, metronidazole, never to vancomycin, trimethoprim, co-trimoxazole. PMID- 3309821 TI - [Fatal septicemias: factors of mortality. Analysis of 72 fatal cases in the series of 462 case reports collected by the Septicemia Expert System group in 1985]. AB - During the year 1985, 462 cases of septicemia were collected by SES group; 417 observations could be exploited. 73 patients died (17.3%). The statistical analysis of epidemiological and clinical data argued to factors correlated with high mortality rate: a shock, an acute respiratory distress syndrome, a pulmonary portal of entry lead to a high mortality rate. The fatal outcome increased with the age of the patients. A documented immunodeficiency (granulopenia, cytotoxic chemotherapy...), a previous broncho-pulmonary, neurologic or cardiovascular disease were factors of risk. The pulmonary or cutaneous localisations occurring within a septicemic phase were significantly related to death. Among fatal cases of bacteremia, 25% were Staphylococci, 25% Enterobacteria, 20% Pneumococci, 7% Pseudomonas. Pseudomonas, then Pneumococcus, then Staphylococcus bacteremias looks to have a worse prognosis. The more serious cases were prescribed several antibiotics, significantly much more than the mild cases. These results are compared with the results of former series; the main prognosis factors of actual septicemia are elicited in here. PMID- 3309822 TI - [Septic localizations in septicemias]. AB - Seventeen university hospitals have joined their observations of septicemias through an informatics system. 461 septicemias have been collected in 1985. 407 are septic localizations, 299 primitives and 108 secondary. The frequent localisations are urologic (20.4%), pulmonary (20.15%), cutaneous (10.56%), abdominal (10.56%), cardiac and neurologic (9.58%). In 51.8%, the organisms are Gram positive cocci (Staphylococcus 23.9%, Streptococcus 27.9%). In 46.9% septic localizations are due to Gram negative bacilli with Escherichia coli (50.2%). The origin of septicemia is urologic (18%), abdominal (15.8%), cutaneous (8.7%), pulmonary (8.7%), stomatologic (7.2%), venous (4.3%). Gram positive cocci infections have more septic localizations than Gram negative bacilli infections. The mortality is more increased in pulmonary localizations (35%) than in the others localizations: venous (20%), cutaneous (19%), urologic (11%) and stomatologic (10%). Septic localizations which required the most of an antibiotics association are osseous (81.5%) and cardiac (80.5%), where as all septicemias require two antibiotics in 51%. PMID- 3309823 TI - [Epidemiology, clinical aspects and treatment of nosocomial septicemias]. AB - One hundred one nosocomial septicemias (NS) were studied among 461 cases of septicemias (22%) collected by French Septicemia Expert System Group during 1985. The mean-age of the patients was 58 +/- 23 years while it was 56 +/- 23 years in the 360 community acquired septicemias (CAS). The source of septicemia was found more frequently in NS than in CAS (79/101 versus 223/360; p less than 0.002): mainly urinary tract and intravenous therapy in NS, urinary tract, gastrointestinal and biliary origin in CAS. Invasive procedures (except surgical procedures) were more frequent in NS than in CAS (13/101 vs 14/360; p less than 0.0001). Underlying diseases were more often associated with NS than with CAS (96/101 vs 276/360; p less than 0.0001). Many pathogens were involved in these NS but the frequency of S. aureus meti-S and meti-R, S. epidermidis, Enterobacter, Klebsiella, Serratia, Proteus indol + and Pseudomonas carbeni-R was significantly greater in NS than in CAS. There was no significant difference between NS and CAS for septic localizations, respiratory distress syndrome and septic shock. Two antibiotics (and possibly 3 antibiotics for polymicrobial septicemias) were more often used in NS than in CAS (61/101 vs 135/360; p = 0.002). If the duration of hospitalization was not significantly greater in NS than in CAS (26 +/- 29 days vs 23 +/- 33 days), the overall mortality was significantly more important (25.6% vs 14.9%; p less than 0.05). PMID- 3309824 TI - [Septicemia of urinary origin. Epidemiology and initial antibiotic treatment]. AB - The SES group was formed by the "Ligue Francaise pour la Prevention des Maladies Infectieuses" to create a diagnostic and therapeutic expert system on septicemia. 461 cases of septicemia were thus collected from january 1 to december 31, 1985. 83 out of these septicemias had an urinary tract portal of entry, 21 were contracted in hospital. The mean age was 65 +/- 21 years (57 +/- 20 years for the 461 cases NS). There were 46 women and 37 men, i.e., a sex-ratio apposite to that of the overall population of septicemias (p less than 0.001). Au urinary lesion was found in 27 patients (p less than 0.001), a neurological disease in 22 (p less than 0.05), a cardiac disease in 24 (NS). 94 bacteria were isolated (11 polymicrobic septicemias) from the blood cultures: 56 E. coli, 7 Klebsiella, 6 Proteus, 7 Gram positive Cocci. 57 out of the 81 patients whose antibiotherapy was known received single-drug treatment (74%, vs 49% for the whole group, p less than 0.001). The evolution was known in 75 patients, uncomplicated in 57 (fatality rate: 11%). Prognosis did not appear to be influenced by the type of pathogen, or the existence of an urinary abnormality. PMID- 3309825 TI - [Treatment of post-traumatic and post-neurosurgical bacterial meningitis with ceftriaxone alone or in combination with fosfomycin]. AB - From 1984 to 1986, 13 patients (10 adults, 3 children) with bacterial meningitis following neurosurgery or traumatism were given ceftriaxone alone 6 times at a dose of 40 mg/kg one IV injection per day, or in association 7 times with fosfomycin at a dose of 200 mg/kg/day, 3 IV perfusions every 4 h. The bacteriological diagnosis was confirmed in 9 cases (3 Staphylococcus aureus, 4 Streptococcus pneumoniae, 1 Klebsiella, 1 Peptococcus). In vitro neither synergy nor antagonism were observed between the two antimicrobial agents. The acute infections episode resolved in all patients except on who died with a negative CSF culture. One superinfection meningitis with Achromobacter was seen. CSF concentrations of ceftriaxone were assayed and found to be comparable with those reported by most authors. Tolerance was excellent for all our patients. PMID- 3309826 TI - [Penicillin G in the treatment of pneumococcal meningitis. Its real importance at the present time]. AB - The authors carried out this work with the purpose both of verifying the present importance of penicillin G for the treatment of pneumococcal meningitis and of comparing it with the clinical effectiveness of other medicines presently available for the same purpose. They have studied 27 patients with clinical and laboratory diagnosis of pneumococcal meningitis and which were admitted in the "Servico de Infecto-Contagiosos" of Santa Maria Hospital, Lisbon, for the period from 1.1.81 until 31.05.86. Of these patients 18 were males and 9 females, ranging from 8 to 80 years old. All of them were treated exclusively with penicillin G, the medium dose being 400,000 IU/kg per day and for a medium period of 15 days. The final results accounted for: 23 patients healed (85.2%), 2 decreased (7.4%) and the remaining 2 (7.4%) with neurological sequels by the time of discharge from the hospital. These, in our opinion, are values for the minimum equivalent to those in other series of the same pathology and under treatment by the different medicines presently available in alternative. Bearing in mind these results and considering it is more expensive to use these new antibiotics, the authors think they may state that penicillin G keeps ahead for the treatment of pneumococcal meningitis, except for cases of hypersensitivity to this medicine or penicillin-resistance. PMID- 3309827 TI - [Comparison of 3 antibiotics, cefaclor, josamycin and penicillin V in the treatment of acute throat infections. A multicenter study: 581 cases]. AB - Five hundred and eighty one patients, both adults and children, of either sex, with acute throat infections, with or without associated pharyngitis, were randomized into three groups comparable as to age, general condition and temperature before treatment, previous infectious episodes, history of allergy and underlying conditions. Cefaclor was administered to the first group (C), josamycin to the second group (J) and penicillin V to the third group (V); duration of therapy was practically the same, respectively 8.41, 8.20 and 8.14 days. Concurrent administration of paracetamol was allowed and was comparable for all three groups. Response was assessed on the basis of clinical criteria only, including onset of apyrexia in particular. In group C apyrexia was obtained within 48 hours or less in 54.4% of the patients versus 35.7% only in Group J (p less than 0.001) and 41.5% in group V (p less than 0.02). Onset of overall clinical improvement was 3 days or less in 69.5% of the patients receiving C versus 50.3% for those receiving J (p less than 0.001) and 57.2% for those receiving V (p less than 0.02). Adverse reactions were significantly more frequent in the josamycin group (p less than 0.001) and penicillin group (p less than 0.05) than in the cefaclor group. The most common type of adverse reactions was gastrointestinal upsets in the josamycin (43/49) and the cefaclor group (9/10) and skin reactions in the penicillin group (9/20). PMID- 3309828 TI - [Comparison of the efficacy of a single daily injection versus fractionated injections of ceftriaxone in the treatment of acute experimental pyelonephritis]. AB - Unilateral acute pyelonephritis were produced in rabbits by injecting E. coli, using the retrograde route and after a temporary ureteral obstruction. Animals were treated with ceftriaxone IM at a dose of 50 mg/kg/d and 100 mg/kg/d (corresponding to 1 g/d and 2 g/d in humans) either by a single daily injection or by two daily injections at 12th intervals. Sacrifices were performed at day 5 and 7 of therapy. Analysis of bacteriological, morphological and histological data obtained in infected kidneys demonstrates that the single daily injection of ceftriaxone is more effective than the same dose divided in two injections at 12 h intervals. These results are observed as well with low and high doses of ceftriaxone. PMID- 3309829 TI - [Prevention of postoperative infections in non-endoscopic urologic surgery by a single dose of cefotiam]. AB - We report on the results of a randomized study of 1 g cefotiam flash pre operative antibioprophylaxis to prevent post-operatory infection complications in non-endoscopic urologic surgery. Thirty-seven patients (17 controls and 20 treated) have had a prostatic adenomectomy: treatment has lead to decrease the number of post-operatory wall complications (47% vs 20%) and hospitalisation staying (p less than 0.03). Seventy-eight patients have had a urologic surgery with lumbar or abdominal incision (37 treated and 41 controls). In this group, there was not gain on post-operatory infections complications nor on hospital staying, since this surgery has a little number of infections complications. During the study, we have not noted an abnormal part of cefotiam resistant germs. PMID- 3309830 TI - [Erythromycin and latamoxef in the initial treatment of diffuse peritonitis with visceral failure]. AB - In a thirty months prospective study, 61 patients treated in an Intensive Care Unit received erythromycin (E) (3 g/24 h) and latamoxef (L) (2 g/24 h) as soon as acute peritonitis was surgically confirmed. Five days later, E + L were stopped and nitro-imidazol (NI) was prescribed while searching for a possible infection. The severity of the illness was assessed by clinical study of organ failures and by use of the Simplified Acute Physiology Score (SAPS). 21 patients died (34%): among them 8 of the 19 with postoperative peritonitis. Average SAPS was 17.8 (+/- 4.1) while it was 13 in 631 ICU treated patients (mortality: 22%). Every patient needed mechanical ventilation; pre or per-operative shock has been noted in 41 (67%) and 27 had developed acute renal failure (44%). During E + L, 6 patients died because of an irreversible shock and twice the treatment was not efficient on the isolated bacteria (Pseudomonas aeruginosa, Staphylococcus). No more shock developed post-operatively. During NI, 11 secondary infections (20%) were diagnosed (bacteremia = 6, urinary tractus infection = 4, reactivated arthritis = 1). The bacteria were Streptococcus (n = 6) with Enterococcus (n = 5), Staphylococcus (n = 3) and Pseudomonas aeruginosa (n = 2): they were still respectively sensitive to ampicillin, methicillin and ticarcillin. The association E + L was clinically and biologically well tolerated. PMID- 3309831 TI - [Doxycycline treatment of experimental legionellosis in guinea pigs infected by aerosol]. AB - The efficacy of curative and preventive treatment by doxycyclin was studied with the same experimental model as during the study of erythromycin [14]. The infectious aerosol was done with a strain of Legionella pneumophila serogroup 1, Philadelphia (ATCC 33152). Male albinos Dunkin-Hartley guinea-pigs were exposed for 30 min to an aerosol dose of 1, 10 or 100 LD 50 (10(3), 10(4) or 10(5) viable organisms). After preliminary assays to find out the efficient posology, doxycyclin was administered intraperitoneally (IP) 18 h after the infection at a dosage of 60 mg/kg/day for 5 days in the animals infected with 1 LD 50, and 75 mg/kg/day in the animals with 10 and 100 LD 50. The preventive treatment (75 mg/kg/day) administered one day before and the day of the infection was tested with animals infected with 10 LD 50. The guinea-pigs were observed 8 days (weight, rectal temperature) and watched over 3 weeks after the end of treatment; serological and bacteriological tests (cardiac blood, lungs, spleen) were performed in every animal; doxycyclin assays (serum, lungs) during treatment were performed by high performance liquid chromatography (HPLC). The treatment of guinea-pigs infected by 1, 10 and 100 LD 50 gave a survival rate of 100%, 75% and 50% respectively. On the other hand the animals which received preventive treatment were all survivors. Seroconversions with antibody titres from 64 to 512 were observed for all the survivors. Bacteriological tests were all negative. The mean doxycyclin concentrations in serum (microgram/ml) and lung (microgram/g) were 1.66 and 11.42 after 24 h of treatment and 5.71 and 18.93 after 7 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309832 TI - [Present status of nitroxoline]. AB - Nitroxoline (8-hydroxy-5-nitroquinoline) has been used since 1962 in the treatment of urinary tract infections especially those due to gram negative bacilli (E. coli). The current renewal of the drug is in relation to the recently shown activity of nitroxoline against fungi (Candida, Torulopsis), Mycoplasma and U. urealyticum, as well as Trichomonas. In order to update the knowledge of the drug, the aim of this study was a pharmacokinetic study in serum and urines collected after administration of one single dose (2 X 100 mg) and after multiple doses (200 mg X 3). Eight healthy volunteers were included in the study. The assays were carried out by means of the microbiological procedure and HPLC comparatively in the same samples. From the results several comments should be made: 1) In all subjects, serum levels were measurable 15 to 30 min. after administration, suggesting a rapid absorption. 2) Despite individual variations due to oral administration, pharmacokinetic parameters could be calculated: Tmax: 1.75 +/- 1.04 h; Cmax: 5.59 +/- 3.15 mg/l; t 1/2 beta: 2.63 +/- 2.66 h. 3) The hepatic metabolization of the drug into conjugated derivatives occurs early as shown by early levels of conjugated nitroxoline as measured by means of HPLC; the metabolization seems to be variable according to the subjects quantitatively and as for its kinetics. 4) The urinary elimination of nitroxoline is extremely rapid, and high levels of free drug and conjugated derivatives were measured at the 1st hour after the administration. Persistent high levels were measured at the 10th and 24th hours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309833 TI - [In vitro antifungal activity of nitroxoline. Preliminary clinical results]. AB - Nitroxoline is an oxyquinoline derivative with a large antifungical activity. The fungistatic activity of nitroxoline is greater against Candida albicans than against Torulopsis glabrata, Candida tropicalis and Candida krusei. The MIC are compatible with urinary concentrations of nitroxoline. These preliminary clinical results favor the use of nitroxoline in the management of fungal urinary tract infections. PMID- 3309834 TI - [Antifungal spectrum of epicarin. In vitro study]. AB - Epicarine, 3-(2 hydroxy-1-naphthylmethyl) salicylic acid, has been used for a long time for the topical treatment of different dermatological diseases. We studied the in vitro antifungal activity of epicarine and its sodium salt by the dilution method in solid medium (221 pathogenic strains belonging to 23 different species). The results show that the acid is two or three fold more potent than the salt and that dermatophytes (MIC 20 to 1,000 micrograms/ml are more sensitive than yeasts and moulds (MIC 500 to 2,000 micrograms/ml). Because of the usual concentrations in topical applications (2 to 10%) and the absence of toxicity of this molecule, these results seem to show that the therapeutic use of this product is perfectly legitimate. PMID- 3309835 TI - [Value of a standard exudate in the in vitro study of antiseptics]. AB - Bactericidal activity of antiseptics is generally determined in France according the AFNOR norms the principles of which have recently been reconsidered by the Pharmacopoeias. These norms preconize the use of either hard water (12 Ca++ milliequivalents) or a mixture of proteins (albumin-yeast extract) to appreciate any loss of activity by interference. However these two interfering substances are very different from exudates on wounds or burns. This is why we have prepared a standard exudate composed of dried bovine albumin (Cohn fraction V for bacteriology) 4% m/V; Ca++ 0.01% m/V and Mg++ 0.003% m/V. These protein and ion concentrations correspond to the percentage of these elements in plasma. A first sequence of assays on two antiseptics, one with a chlorhexidine base, the second with a iodine polyvidon base allowed us to study individually the interference of proteins, of ions, and that of the standard exudate. The first results showed that for the iodine polyvidon the effect of ions was slight compared with the effect of proteins whereas for chlorhexidine the effect of ions was a strong as that of proteins. Therefore we have used this standard exudate in the study of other antiseptics according to the protocol of the norms NF T 72-170. Results showed that the standard exudate strongly inhibits the bactericidal activity of antiseptics. We propose that its use be generalised in the in vitro study of antiseptics destined for cutaneous or mucous lesions. PMID- 3309836 TI - [Use of the MS2 automated system in the determination of the activity of 5 antiseptic drugs: quality control]. AB - The study of growth curves of Klebsiella pneumoniae and Staphylococcus aureus in presence of five antiseptics, established using a MS2 Abbott system is presented. From our results, the advantages of automation after the adaptation of the method for the determination of bactericidal properties are examined. This technique may be proposed for the quality control of such drugs. PMID- 3309837 TI - [A computer program for examining pathomorphology, individually creating a set of questions]. PMID- 3309838 TI - [Ovarian carcinoid tumors--review of the literature and case reports]. PMID- 3309839 TI - Pavlov as a psychologist. A reappraisal. AB - American psychologists are informed on Pavlov's work on conditional reflexes but not on the full development of his theory of higher nervous activity. This article shows that Pavlov's theory of higher nervous activity dealt with concepts that concerned contemporary psychologists. Pavlov used the conditioning of the salivary reflex for methodological purposes. Pavlov's theory of higher nervous activity encompassed overt behavior, neural processes, and the conscious experience. The strong Darwinian element of Pavlov's theory, with its stress on the higher organisms' adaptation, is described. With regard to learning, Pavlov, at the end of his scholarly career, proposed that although all learning involves the formation of associations, the organism's adaptation to the environment is established through conditioning, but the accumulation of knowledge is established by trial and error. PMID- 3309840 TI - Early Pavlovian studies on the effects of starvation. A contribution to the history of neurodietetics. AB - This communication is based on the pioneering studies performed by I. P. Pavlov's associates, Yu. P. Frolov (in 1918) and I. S. Rozental' (in 1918/1919) at the Institute of Experimental Medicine, in Petrograd. The changes in the "independent variable"--the dogs' diet--were not planned but were the consequences of severe shortages of food for man and beast. The principal generalization concerns the order in which different forms of "complex nervous activity" were impaired: the order is opposite to the order in which they emerge in the process of ontogenesis. First to suffer was "internal inhibition," as documented by the failure of stimulus differentiation. This was followed by the decrease in the magnitude of well-established conditional responses (CRs). As a result of a more severe impairment of the excitatory processes, it became difficult or impossible to establish new CRs. In time, previously established CRs to artificial stimuli, visual and acoustic, disappeared totally. The CRs to natural conditional stimuli (CSs) were maintained fairly well but, eventually, they too decreased markedly. In the terminal phase of starvation, the unconditional salivary reflexes continued to function, although their magnitude was depressed. PMID- 3309841 TI - Historical aspects of cardiac diagnosis and management. PMID- 3309842 TI - Ambulatory electrocardiographic monitoring. PMID- 3309843 TI - Pediatric exercise testing. PMID- 3309844 TI - Digital subtraction angiography. PMID- 3309845 TI - Doppler echocardiography. AB - The advancements in Doppler methodology in the past decade have dramatically changed the way we assess children with heart disease. Techniques to determine pressures, gradients, shunt flows, and regurgitant lesions have shifted the noninvasive studies into areas that were strictly the venue of catheterization a decade ago. The more recent color Doppler developments take the 2DE image one step further by providing some of the flow visualization previously available only through angiography. When applied to appropriate clinical settings Doppler methodology will continue to provide us with increasingly sophisticated and precise definitions of intracardiac physiology. PMID- 3309846 TI - Etiology and pathogenesis of insulin dependent diabetes mellitus. PMID- 3309847 TI - Why control blood glucose? Influence on chronic complications of diabetes. PMID- 3309848 TI - Urodynamics. AB - Urologic problems constitute a very significant percentage of all clinical problems in pediatrics. Incorporation of urodynamic evaluation and followup is important in achieving optimal results in a significant number of these entities. In terms of cost effectiveness, it is particularly efficient in this age of extremely high-priced technology. PMID- 3309850 TI - Renal transplantation in children. AB - The application of the principles underlying successful renal transplantation in children has led us to increasing success in achieving our goals, which involve more than simple renal function replacement and include effective growth in stature, skeletal and central nervous system development, as well as social development. To succeed in these diverse areas, all modalities of therapy for ESRD may be needed at various times in some patients. Pretransplant therapy must be judiciously selected, and post-transplant protocols often modified to reflect individualized needs. PMID- 3309849 TI - Incontinence and enuresis. AB - Most children with incontinence not associated with known neurologic impairment will have either functional immaturity of the nervous system or inflammatory conditions of the lower urinary tract as the etiology for incontinence. By using the criteria outlined in this article, one can manage selective urologic evaluation of the diurnally incontinent and enuretic child, saving most patients the cost and stress of more in-depth diagnostic evaluations. PMID- 3309852 TI - Reflux uropathy. AB - Although much remains to be learned, most pediatric nephrologists and urologists are now in comfortable agreement with the following assumptions: (1) Most reflux (primary reflux) is due to a congenital anatomic abnormality of the bladder trigone. (2) In many instances this anomaly improves with growth and development of the child so that the reflux may cease spontaneously. In low-grade (I-II) reflux with undilated ureters, approximately 75 to 85 per cent will stop refluxing. In higher grades (III-V) with dilated ureters, the cessation rate is in the range of only 25-30 per cent. (3) Although radiologic grading is helpful in predicting the likelihood of spontaneous cessation, it is possible to improve that predictability by cystoscopic evaluation of the size, configuration, and position of the ureteral orifice plus the length of the submucosal tunnel. (4) Reflux in combination with bacteriuria can and does lead to renal scarring. (5) Renal scarring probably does not occur in patients with primary reflux and normal voiding pressures in the absence of bacteriuria. (6) Renal growth may proceed normally despite sterile reflux. (7) A few refluxing patients, perhaps 10 per cent, will have bacteriuria despite continuous antimicrobials, and these "breakthrough" infections may cause renal scars. (8) Other patients prove either unwilling or unable to comply with continuous medications and are also vulnerable to scars. (9) A successful antireflux operation may not change the recurrence rate of urinary tract infections per se, but it almost eliminates the likelihood of pyelonephritic episodes and the necessity for further continuous antibiotics. Unfortunately, in patients with intermediate grades of reflux, it is not presently known whether an early surgical correction might be more effective in allowing normal renal growth, in avoiding renal scars, and in preventing eventual hypertension, which is present as a late complication in almost 20 per cent of the patients. The data to answer this important question should ultimately be forthcoming from the current International Collaborative Reflux Study. PMID- 3309851 TI - Upper urinary tract obstruction in children: current controversies in diagnosis. AB - Our approach to the evaluation and treatment of children with upper urinary tract obstruction is shown in Figure 10. The following guiding principles should be remembered: 1. Intravenous urography and renal ultrasonography are usually insufficient to establish the diagnosis of obstruction in an asymptomatic patient. 2. Diuresis-enhanced renography is diagnostic in nonobstructed systems (spontaneous excretion of the radioisotope before the injection of furosemide) or unequivocally obstructed systems (no excretion of the radioisotope after injection of furosemide). 3. If the results of diuresis-enhanced renography are equivocal, a patient should be evaluated by pressure flow studies before surgical correction is undertaken or a diagnosis of no obstruction. 4. Diuresis-enhanced renography is extremely useful in followup and in evaluating surgical results. PMID- 3309853 TI - Antenatal diagnosis and management of urinary abnormalities. AB - Although much time, effort, and money have been expended in the area of fetal surgery and even though considerable unfortunate media publicity has resulted, the actual clinical problem is not one of great magnitude. Currently all those interested in this area agree that consideration of any intrauterine manipulation or surgery should be reserved for a fetus who has bilateral involvement that is progressive, destructive, and associated with oligohydramnios. Except for rare instances, this eliminates all fetuses except those with some type of urethral obstruction. Significant urethral obstruction accounts for approximately 10 per cent of all patients who have a prenatal diagnosis of a urologic abnormality. Of this 10 per cent, some will not be progressive, some will not be destructive, some will not involve both kidneys, and some will not develop oligohydramnios. Some of these patients will be diagnosed early enough in pregnancy to allow termination of the pregnancy if the involvement is significant and if termination is acceptable to the family. Some will be diagnosed late enough in pregnancy so that if the lungs are mature or can be stimulated to mature, early delivery and postnatal management can be elected. Some will have other associated lethal anomalies that can be diagnosed and would preclude any consideration of intrauterine manipulation or therapy. Some will have irreversible renal failure. Occasionally, the mother may refuse any proposed intrauterine therapy. Thus we are probably considering, on a theoretic basis, well under 1 per cent of all fetuses who have a prenatal diagnosis of urologic abnormalities. There may be some unusual situations that justify intrauterine manipulation. One that we encountered involved a fetus with an abdominal mass so large that a cesarean section was deemed necessary (Figs. 12 and 13). Aspiration of the mass just before delivery was performed to allow a vaginal delivery. Another case involved a pregnant woman who developed severe toxemia. The fetus was found to have a solitary renal cyst. Repeated aspirations of the cyst resulted in resolution of the toxemia, which promptly recurred when fluid reaccumulated in the fetal renal cyst. Insertion of a double-universe catheter from the cyst into the amniotic cavity allowed completion of the pregnancy, with the delivery of an otherwise normal fetus without recurrence of the toxemia. A recent report on fetal surgery from the International Fetal Surgery Registry, coauthored by the strongest advocate of intrauterine intervention, reached these conclusions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3309854 TI - Asthma: a pediatric pulmonary disease and a changing concept. PMID- 3309855 TI - Nonimmunoglobulin fraction of human milk inhibits the adherence of certain enterotoxigenic Escherichia coli strains to guinea pig intestinal tract. AB - The protecting effect of human milk against intestinal infections has been well documented, but its mechanism not completely understood. We have examined the effect of the nonimmunoglobulin fraction (NIgF) of human milk and colostrum on bacterial adherence to the intestinal tract. The NIgF was prepared by passing the milk through an immunosorbent column containing rabbit antihuman gamma-globulin (IgG and IgA). The effluent fraction did not contain gamma-globulins as shown by immunodiffusion on agarose and by using rabbit antihuman Ig, that was then detected with fluorescently-labeled goat antirabbit Ig. The effect of the NIgF of human milk on the adherence of enterotoxigenic Escherichia coli strains to guinea pig intestinal tract was quantitatively determined using radiolabeled bacteria which were incubated with suspensions of viable intestinal cells. Thirteen to 17 bacteria adhered per intestinal cell. NIgF of human milk and colostrum (300 microliter, 6.7 mg) caused about 50% inhibition of the adherence of enterotoxigenic E. coli strains whose attachment was mediated by colonization factor antigen I and II. No inhibition was noted on the adherence of enterotoxigenic E. coli strains containing type I pili. The inhibitory activity resisted boiling and proteolytic digestion with trypsin, but was completely abolished by periodate treatment, indicating that carbohydrate residues were probably involved. Examination of the effect of NIgF of human milk on bacterial adherence to intact intestinal surfaces revealed comparable results. Observations with scanning electron microscopy confirmed, morphologically, the attachment of the bacteria and the inhibitory effect of human milk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309856 TI - Effect of insulin on the distribution of cardiac output in the fetal lamb. AB - Three to five measurements of fetal cardiac output and its distribution were made using radiolabeled microspheres in each of 12 sheep fetuses in whom fetal plasma insulin concentration was varied by exogenous infusion of insulin to the fetus. Blood concentrations of oxygen and glucose as well as blood gases, pH, hematocrit, and plasma insulin concentrations were also measured. Both fetal arterial oxygen content and whole blood glucose concentration fell as fetal insulin concentration rose. Fetal cardiac output rose as insulin concentration increased and was accompanied by an increase in fetal heart rate. Increased insulin concentration was associated with increased flow to the heart, stomach, placenta, and carcass while blood flow to the fetal brain, lungs, liver, kidneys, spleen, and intestines was not affected. As plasma insulin concentration rose, the percentage of the cardiac output distributed to the fetal heart and upper carcass increased; that distributed to the fetal brain, lungs, liver, stomach, intestines, and lower carcass remained unchanged; while that distributed to the kidneys, spleen, and placenta decreased. When expressed as a fraction of cardiac output, an additional 7% (from 39 to 46%) of the cardiac output was distributed to carcass over the range of insulin concentrations studied. Most of the increased portion of the fetal cardiac output distributed to the fetal carcass during hyperinsulinemia was accounted for by a decrease in the percentage of fetal cardiac output perfusing the placenta. PMID- 3309857 TI - Identification of somatomedin/insulin-like growth factor immunoreactive cells in the human fetus. AB - Somatomedins/insulin-like growth factors (Sm/IGFs) are present in blood and in extracts from multiple tissues of the human fetus and induce the proliferation of cultured human fetal cells. To identify the cellular location of immunoreactive Sm/IGF in human fetal tissues, we have performed immunocytochemistry in tissues from prostaglandin-induced human fetal abortuses of 12 to 20 wk in gestation. Every tissue studied except the cerebral cortex contains Sm/IGF immunoreactive cells. Cells staining positively include hepatocytes, hepatic hemopoietic cells, columnar epithelia of the pulmonary airways, intestine and kidney tubules, adrenal cortical cells, dermal cells, skeletal and cardiac muscle fibers, and pancreatic islet and acinar cells. Immunostaining was specific for Sm/IGFs, but because of the cross-reactivity of the antibodies it was not possible to determine whether the immunoreactivity represented Sm-C/IGF I, IGF II, or both. Liver contained the greatest proportion of immunoreactive cells, while the thymus and spleen had only a few immunostained cells. With the possible exception of dermal and some adrenal cortical cells, the immunoreactive cells do not appear to be the primary sites of Sm/IGF synthesis, because parallel in situ hybridization histochemical studies using Sm/IGF oligodeoxyribonucleotide probes show that Sm/IGF mRNAs are localized predominantly to fibroblasts and mesenchymal cells. Therefore the immunoreactive cells identified in this study may define sites of action of Sm/IGFs. PMID- 3309858 TI - Murine responses to immunization with pertussis toxin and bovine serum albumin: I. Mortality observed after bovine albumin challenge is due to an anaphylactic reaction. AB - It has been suggested that pertussis toxin (Ptx) is involved in the pathogenesis of the adverse neurologic reactions that can occur in infants and children after pertussis immunization. One group of investigators has recently reported that a clinical syndrome with pathological features very similar to post-pertussis vaccination encephalopathy can be induced in specific strains of mice after their immunization with bovine serum albumin (BSA) and Ptx. The aim of this investigation was to further characterize the immunologic mechanisms operative in this murine model. Studies were undertaken to determine whether the role played by Ptx in this condition required the A-protomer of the toxin to enter a cell and ADP-ribosylate a nucleotide binding protein (a Class I activity) or was dependent upon the binding of the B-oligomer of the toxin to the surface of target cells (a Class II activity). The results of our experiments have established that the disease induced by coimmunizing mice with Ptx and BSA is due to an immediate type hypersensitivity reaction rather than an encephalopathy and that the mechanism of action of Ptx in this system seems to be dependent upon a Class II activity of the toxin and independent of its ADP-ribosyl transferase activity. PMID- 3309860 TI - Achondrogenesis type II, abnormalities of extracellular matrix. AB - Immune and lectin histochemical and microchemical methods were employed to study growth cartilage from seven cases of achondrogenesis type II (Langer-Saldino). The normal architecture of the epiphyseal and growth plate cartilage was replaced by a morphologically heterogeneous tissue. Some areas were comprised of vascular canals surrounded by extensive fibrous tissue and enlarged cells that had the appearance and histochemical characteristics of hypertrophic chondrocytes. Other areas contained a mixture of cells ranging from small to the enlarged chondrocytes. The extracellular matrix in the latter areas was more abundant and had characteristics of both precartilage mesenchymal matrix and typical cartilage matrix; it contained types I and II collagen, cartilage proteoglycan, fibronectin, and peanut agglutinin binding glycoconjugate(s). Peptide mapping of cyanogen bromide cartilage collagen peptides revealed the presence of types I and II collagen. These observations could be explained by a defect in the biosynthesis of type II collagen or in chondrocyte differentiation. PMID- 3309859 TI - Leprechaunism: in vitro insulin action despite genetic insulin resistance. AB - We recently identified a female leprechaun infant with marked hyperinsulinemia [as high as 10,975 microU/ml (78,746 pmol/liter)], presumably secondary to insulin resistance. She had two physical findings suggestive of possible insulin action: cystic ovarian enlargement with gonadotropin-independent steroid secretion and persistent, severe myocardial hypertrophy. To examine the pathophysiology of this disorder we measured the in vitro sensitivity to insulin and other growth factors of erythroid progenitors and a T-lymphoblast cell line derived from her peripheral blood. Resistance to insulin was demonstrated by failure of her circulating erythroid progenitor cells to augment proliferation in response to physiologic concentrations of insulin (1-10 ng/ml). An immortalized T lymphoblast cell line was established by transforming the cells with the human retrovirus human T cell leukemia virus II. This cell line showed little or no response to physiologic concentrations of insulin contrary to consistently observed stimulation of colony formation by cell lines similarly derived from normals. The patient's T lymphoblasts, however, showed normal sensitivity to insulin-like growth factor I. In response to supraphysiologic insulin concentrations (25-1000 ng/ml), leprechaun T lymphoblasts showed significant augmentation of colony formation (peak 189% above baseline at 50 ng/ml); normal T lymphoblasts also showed responsiveness at these high insulin concentrations. Preincubation with a monoclonal antibody against the insulin-like growth factor I receptor (alpha IR-3 at 5000 ng/ml) blocked the in vitro effect of physiologic concentrations of insulin-like growth factor and supraphysiologic concentrations of insulin on leprechaun and control T lymphoblast colony formation, but had no clear effect upon the response to physiologic insulin concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309862 TI - [Baron de Lenval Institute of Child Hygiene. History, objectives, organization and progress report. Historical outline. I]. PMID- 3309861 TI - Piriprost: a putative leukotriene synthesis inhibitor increases pulmonary blood flow in fetal lambs. AB - Leukotrienes may control fetal pulmonary vascular tone since infusions of putative leukotriene receptor antagonists markedly increase pulmonary blood flow and decrease pulmonary vascular resistance in fetal lambs. This hypothesis would be strengthened if inhibition of leukotriene synthesis also produced similar hemodynamic changes. We therefore studied the effects of piriprost (U 60257), a putative leukotriene synthesis inhibitor, on thirteen fetal lambs at 137 to 140 days gestation. In preliminary studies in four fetal lambs, doses of U 60257 greater than 20 mg/kg increased pulmonary blood flow. In the nine other fetal lambs, U 60257 (31.7 +/- 4.1 mg/kg) increased pulmonary blood flow by 502% (p less than 0.05) and decreased pulmonary vascular resistance by 87% (p less than 0.05). Pulmonary arterial and left atrial pressures were unchanged. Descending aortic pressure was increased (p less than 0.05) and heart rate was decreased (p less than 0.05). The abilities of both putative leukotriene synthesis inhibitors and leukotriene receptor antagonists to similarly increase fetal pulmonary blood flow and decrease pulmonary vascular resistance are consistent with the hypothesis that leukotrienes play a role in regulating fetal pulmonary vascular tone. PMID- 3309863 TI - Familial apple peel jejunal atresia: surgical, genetic, and radiographic aspects. AB - Fifty-seven cases of apple peel jejunal atresia have been reported in the English literature. Patients with this anomaly have a high incidence of prematurity (70%), malrotation (54%), short gut syndrome (74%), multiple atresias (15%), complications (63%), and mortality (54%). Mortality has decreased from 63% to 47% since 1970. We report three new cases of apple peel jejunal atresia, including two from one family. Radiographic evidence of high small bowel obstruction and a malrotated microcolon on preoperative roentgenogram with barium enema should suggest this diagnosis. Five families, including ours, have been reported in which more than one child was affected, and it has been suggested that this disorder is transmitted by an autosomal recessive gene. However, the occurrence of conventional intestinal atresia in other siblings, the association with multiple atresias, and discordance in a set of apparently monozygotic twins indicate that there may be a more complex spectrum of genetic transmission. Subsequent siblings are at increased risk for apple peel atresia or related malformations. Prenatal ultrasound can facilitate early diagnosis and treatment. PMID- 3309864 TI - Orthotopic liver transplantation in patients with cystic fibrosis. AB - An 11-year-old boy who had cystic fibrosis underwent an orthotopic liver transplantation. His immediate postoperative course was not unusually complicated when compared with other liver transplant recipients. Transplantation did not correct abnormalities in the sweat test or the respiratory disease. Cholestasis due to obstruction of the recipient duct with tenacious bile was cleared by instilling N-acetylcysteine into the duct. On the 48th day after the transplantation, he died of an intraventricular and intracerebral hemorrhage caused by an Aspergillus brain abscess. We conclude that certain patients with cystic fibrosis may be appropriate candidates for liver transplantation, but their pre- and post-operative management may need to differ from other liver transplant recipients. PMID- 3309866 TI - Heart transplantation. PMID- 3309865 TI - Children as witnesses in child sexual abuse trials. AB - When alleged child sexual abusers are prosecuted and brought to trial, child witnesses are often exposed to procedural requirements of the criminal justice system that may cause further psychologic trauma. These procedures are driven by the dual interests of pursuing the truth and protecting the constitutional rights of the accused to a fair trial with a presumption of innocence. Proposals for judicial reforms designed to balance both interests while shielding children from potential adverse effects of the process are discussed. PMID- 3309867 TI - [Use of vitamin E in children with diabetic ophthalmopathies]. PMID- 3309868 TI - [Ribonuclease treatment of infectious mononucleosis in children]. PMID- 3309869 TI - [Post-mumps orchitis: sequelae, treatment and prevention]. PMID- 3309870 TI - [Neuroblastoma in 1987 (1)]. AB - Neuroblastoma is a rare tumour, yet the most frequent one in children below the age of five years. It can be considered as a model in several regards. It is a unique clinical modal with a particular form in infants below one year of age, who present a better prognosis, whereas the disseminated form in children over one year of age has been almost always fatal until recently. It shows the necessity of the interdisciplinary approach in paediatric oncology and some of its recent progress. It is a unique biological model to study the problems of spontaneous maturation, immunological control of tumours, the impact of genetics and of techniques which may completely change cancer therapy ten years from now. Finally, neuroblastoma is a model concerning possible screening and prevention of a childhood malignancy, which involves the cost/efficacy aspect. PMID- 3309871 TI - [Ultrasonic and x-ray computed tomographic diagnosis of isolated traumatic hematomas of the adrenal glands in children. Apropos of 2 cases]. AB - A Hematoma of the right adrenal gland was found by computed tomography and ultrasonography in two 4 year-old boys following a mild traumatism. Such traumatic adrenal hematomas appear to be very rare in children. Their pathogenicity is discussed. PMID- 3309873 TI - [Endoscopic treatment of vesico-ureteral reflux by injection of Teflon in children. Preliminary results]. AB - Twenty-three infants and children with primary or secondary vesico-ureteric reflux (representing a total of 38 reflux) were treated by endoscopic injection of Polytef paste with 86% complete corrections of the reflux after the first injection, and 92% after the two injections. These results are comparable to those published so far in the literature. There were no secondary stenosis. There is, however, a need for a more prolonged delay to correctly evaluate its long term efficiency. This technique appears safe and efficient. Furthermore, it has an interesting economical aspect since it requires a maximum of two days of hospitalisation. PMID- 3309874 TI - W S Stiles memorial issue. PMID- 3309872 TI - [Intraventricular hemorrhage in the newborn infant at term: thalamic origin]. AB - Four observations of intraventricular hemorrhage in full term neonates without perinatal asphyxia are reported. The clinical pictures were remarkably similar in the four infants: neurological symptoms developed several days after birth with sunsetting and eye deviation and symptoms of cranial hypertension. Ultrasonography and CT scan showed a thalamic hemorrhage. PMID- 3309875 TI - Walter Stanley Stiles 1901-1985. PMID- 3309876 TI - Reflections on the past and comments on the present. PMID- 3309877 TI - The pi mechanisms of W S Stiles: an historical review. AB - The origins, development, and status of the pi mechanism theory are reviewed. The paper is divided into four sections. In the first section Stiles's general ideas about 'color mechanisms' are examined, and it is concluded that foremost amongst these is a mathematical theory that specifies certain formal rules or laws that should govern a certain class of observations. In the case of pi mechanisms, the class of observations is that of two-color thresholds, and the defining laws are the two well-known displacement laws. Five other laws that two-color increment threshold observations should obey, if the latter are governed by ideal pi mechanisms, are abstracted from Stiles's writings. In the second section literature pertinent to the testing of the seven Stilesian laws is reviewed, and it is asked whether or not the seven pi mechanisms of Stiles do in fact obey the laws. In the third section the relation of the pi mechanism concept to physiological concepts is examined, and its relation to the 'cone fundamental' is discussed; the evidence pertinent to the question: "Are any of the pi mechanisms of the single-fundamental type?" is then reviewed. The last section is devoted to the evolution of Stiles's ideas in the period after 1959 when Stiles's own investigations and those of others propelled him to reject the initial (1953) pi mechanism theory as an adequate characterization of the data of the two-color threshold. PMID- 3309878 TI - Therapeutic strategies to combat pneumococcal disease: repeated failure of physicians to adopt pneumococcal vaccine, 1900-1945. PMID- 3309879 TI - Hypothesis: where the depleted plasma amino acids go in phenylketonuria, and why. PMID- 3309880 TI - Eugene O'Neill and Addison's disease. AB - A detailed review of hospital records, physician's notes, diaries, letters, and autopsy reports offers sufficient clinical grounds to establish that Eugene O'Neill developed adrenal insufficiency, secondary to tuberculosis, in later life -a fact hitherto unknown--the condition not becoming manifest until after he had abdominal surgery in 1936. PMID- 3309881 TI - The playwright, the practitioner, the politician, the President, and the pathologist: a guide to the 1900 Senate Document titled "Vivisection". PMID- 3309882 TI - Antimicrobial activities of essential oils. A 1976-1986 literature review on possible applications. AB - The testing of essential oils for antimicrobial activities is reviewed with respect to various possible applications. Consideration is given to the screening for antimicrobially active oils or constituents, for disinfecting or antiseptic properties and for food conserving properties. The role of essential oils in biological interactions and their potential as therapeutic agents are also discussed. PMID- 3309883 TI - The value of stump split skin grafting following amputation for trauma in adult upper and lower limb amputees. AB - One hundred and twenty adult patients were reviewed in whom split skin grafts were applied to the stump following traumatic amputation of the upper limb (44 amputees) or lower limb (76 amputees). The average follow-up period was seven and a half years after initial amputation. There was delay in prosthetic fitting in all patients. Approximately one third of patients complained of occasional minor ulceration, controlled by removing the prosthesis for a few days or modification of the prosthesis. Further revision surgery, including excision of the grafted skin often combined with proximal bone resection, but not removal of the proximal joint, was necessary in 29% of below-elbow amputees and approximately 50% of below and above-knee amputees. At the above-elbow level, use of skin grafts allowed prosthetic fitting because of preservation of sufficient length of the stump. Despite the fact that revision surgery may often be necessary, split skin grafting has a definite place in the early management of the stump following traumatic limb amputation in the adult. Preservation of stump length with the knee or elbow joint allows easier rehabilitation and lower energy expenditure when using the prosthesis. Partial foot amputation, when combined with skin grafting usually requires subsequent revision to a more proximal level to obtain a satisfactory result. PMID- 3309885 TI - [MR image synthesis using multiple spin echoes]. PMID- 3309884 TI - [Stereotaxic radiotherapy instrument applicable to X-ray CT and MRI. 1. Effect of the material on the X-ray CT and MRI image]. PMID- 3309886 TI - [Low dose IADSA of the foot]. PMID- 3309887 TI - Random cloning of bent DNA segments from Escherichia coli chromosome and primary characterization of their structures. AB - A simple method for the selective detection of DNA segments containing a sequence directed static bend was developed. Two-dimensional polyacrylamide gel electrophoresis performed at two different temperatures (60 degrees C and 10 degrees C) can effectively separate a bent DNA from a mixture of normal DNA. Using this method, a bank of plasmids carrying bent DNA inserts from the E. coli total chromosome was constructed. The primary characterization of a set of bent DNA segments randomly cloned from E. coli was presented. PMID- 3309889 TI - The UAS of the yeast PGK gene contains functionally distinct domains. AB - The upstream activation site (UAS) of the yeast phosphoglycerate kinase gene (PGK) has been localised by deletion analysis (1). Here we show that the UASPGK contains two functionally distinct domains. These two domains, designated activator (A) and modulator (M), appear to be located within bases -460 to -402 and -531 to -461, respectively, relative to the initiating ATG; although it is possible that part of the M domain resides within the A domain. They have been shown, using a heterologous assay promoter, to have distinct transcriptional functions. Domain A is responsible for activation of transcription whilst domain M is required for carbon source dependent regulation of transcription. Protein DNA binding studies have demonstrated that the DNA fragment containing domain M has high affinity for at least one specific DNA-binding protein, whilst domain A does not appear to interact strongly in protein-binding assays under the same conditions. The domain M binding activity is dependent on the carbon source in the growth medium and may be functional in the carbon source control of PGK expression. PMID- 3309888 TI - The effects of covalent additions of a psoralen on transcription by E. coli RNA polymerase. AB - Synthetic DNA substrates containing a site-specifically engineered psoralen monoadduct or diadduct were used to characterize the response of the E. coli RNA polymerase elongation complex to these lesions. The psoralen derivative HMT (4' hydroxymethyl-4,5', 8-trimethylpsoralen) was site specifically placed into two synthetic double-stranded DNA fragments each of which contained an E. coli RNA polymerase promoter at one end. The HMT molecule was attached to the middle of the DNA fragments as either a furan-side monoadduct or an interstrand diadduct. Transcription off the HMT crosslinked DNA templates showed that E. coli RNA polymerase terminated at the HMT diadduct site, i. e., one nucleotide before the modified thymidine residue on the template strand. The furan-side monoadduct when on the template strand also blocked transcription by the polymerase. However, no effect on transcription was observed when the monoadduct was located on the non template strand. PMID- 3309890 TI - A homogeneous nucleic acid hybridization assay based on strand displacement. AB - A homogeneous nucleic acid hybridization assay which is conducted in solution and requires no separation steps is described. The assay is based on the concept of strand displacement. In the strand displacement assay, an RNA "signal strand" is hybridized within a larger DNA strand termed the "probe strand", which is, in turn, complementary to the target nucleic acid of interest. Hybridization of the target nucleic acid with the probe strand ultimately results in displacement of the RNA signal strand. Strand displacement, therefore, causes conversion of the RNA from double to single-stranded form. The single-strand specificity of polynucleotide phosphorylase (EC 2.7.7.8) allows discrimination between double helical and single-stranded forms of the RNA signal strand. As displacement proceeds, free RNA signal strands are preferentially phosphorolyzed to component nucleoside diphosphates, including adenosine diphosphate. The latter nucleotide is converted to ATP by pyruvate kinase(EC 2.7.1.40). Luciferase catalyzed bioluminescence is employed to measure the ATP generated as a result of strand displacement. PMID- 3309891 TI - DNA sequence within the Mu C operon. PMID- 3309892 TI - A single intronless action gene in the fission yeast Schizosaccharomyces pombe: nucleotide sequence and transcripts formed in homologous and heterologous yeast. AB - The actin gene of the fission yeast Schizosaccharomyces pombe has been isolated by using as a hybridization probe cloned actin DNA from the budding yeast Saccharomyces cerevisiae. In contrast to most actin genes studied from diverse eukaryotic species, the S. pombe gene is not interrupted by introns. The protein sequence deduced from the nucleotide sequence of the gene shows that the S. pombe actin is more closely related to the mammalian gamma-actin than to the actin of S. cerevisiae. Three transcripts of 1240, 1650 and 1850 nucleotides having the same 5' end but differing in the length of their 3' untranslated region are generated in the fission yeast. Only one messenger RNA of 1330 nucleotides is formed from the S. pombe actin gene in S. cerevisiae. Contrary to the observation made with other S. pombe genes transcribed in the budding yeast, the heterologous actin gene transcript is initiated 39 nucleotides upstream of the initiation start site used in the homologous yeast. The mRNA termination (or 3' processing) mechanism in the two ascomycetes also differs as the 3'end of the S. pombe actin gene transcript in S. cerevisiae does not coincide with either of the three 3'ends mapped in the fission yeast. PMID- 3309893 TI - Transcription initiation and RNA processing of a yeast mitochondrial tRNA gene cluster. AB - Expression of 5 yeast mitochondrial tRNA genes (Ala, Ile, Tyr, Asn and Metm), localized upstream from the oxil gene has been analyzed by in vitro capping using guanylyltransferase, northern hybridization and S1 nuclease mapping in the wild type and a rho-strain. The 5 tRNA sequences belong to the same transcriptional unit which is initiated 133 bp upstream from the tRNA(Ala) gene at a promoter sequence TTATAAGTA. Furthermore, a truncated tRNA(Tyr) transcript, 2 nucleotides shorter than mature tRNA(Tyr) has been found, only in the rho-strain. This minor transcript may result from secondary transcription initiation at a variant nonanucleotide sequence, ATATAAGGA, which overlaps the tRNA(Tyr) coding sequence by 3 nucleotides. The polycistronic precursor has proven to be useful in investigation of the mechanisms of tRNA processing. Maturation of this primary transcript proceeds exclusively by precise endonucleolytic cleavages at the 5' and 3'-ends of tRNA sequences. PMID- 3309895 TI - Nucleotide sequence of rat beta 2-microglobulin cDNA. PMID- 3309894 TI - Nucleotide sequence of the transcriptional repressor gene korB which plays a key role in regulation of the copy number of broad host range plasmid RK2. AB - The product of the korB gene of broad host range plasmid RK2 is one of at least two proteins which repress transcription of the essential replication gene trfA. We report here the nucleotide sequence of korB and the properties of its predicted polypeptide product KorB which has a molecular weight of 39,011 Da. KorB is likely to be a soluble protein with an overall net negative charge. However, consistent with a role in transcriptional regulation, there is a region with extensive homology to the alpha helix-turn-alpha helix motif of many DNA binding proteins. This region shows no significant homology to equivalent regions of the TrfB protein which is the primary transcriptional repressor of RK2 and which binds to an operator whose half sites show considerable homology to the half sites of the korB operator. PMID- 3309897 TI - Tumor markers: relevance to clinical practice. PMID- 3309896 TI - Nursing's forgotten hero (Henry C. Burdett). PMID- 3309898 TI - [Current theories on calcium metabolism disorders in patients with sarcoidosis]. PMID- 3309899 TI - [Accidents in childhood. From epidemiology to prevention]. AB - Accidents are still the first cause of death in childhood with the exception of the first year of life. Perhaps the most important barrier in their prevention is in the term "accident" itself: the concept that an accident is an unpredictable and so unpreventable event, not an injury with a specific epidemiology that can be watched, studied, solved. The pediatrician plays, a key-role in accident's prevention: as epidemiologist, expert of growth and development, child's advocate, teacher and promoter of researchers, educational campaigns, policies. So he can no more say: "Accidents are not a medical problem"; on the contrary it is the time to know accident's epidemiology, apply the "safety equations" in the real life and be finally "accidentologists". PMID- 3309900 TI - [A case of neurogenic bladder caused by spinal cord traction in childhood. Diagnostic and therapeutic aspects]. AB - The diagnostic and therapeutic aspects of a pediatric case of tethered cord syndrome are described. The urological symptoms were of primary importance; bladder dysfunction was confirmed urodynamically; voiding cystourethrography showed trabeculation and elongation of bladder with distal sphincter obstruction and left vesicoureteral reflux. The bladder dysfunction was managed satisfactorily with pharmacological therapy and clean intermittent self catheterization. Nuclear magnetic resonance demonstrated a tethered spinal cord with lipoma of cauda equina. The importance of neuroradiology is emphasized in order to establish an early and precise diagnosis. Early neurosurgery is justified by the need to avoid any progressive and severe lower extremity deficit and by the high frequency of urological improvement in cases treated with spinal operation. However, in this case, clinical and pathological findings suggested to defer any surgical intervention. PMID- 3309901 TI - Ineffectiveness of ceruletide to reduce food intake and body weight in obese women hospitalized for weight reduction and treated with a restricted diet. A double-blind study. AB - Ceruletide is a synthetic decapeptide closely resembling the 8-carboxy-terminal peptide of cholecystokinin (CCK-8) with which it shares several biological properties. In a double-blind study versus placebo, we evaluated the effects of ceruletide on self-rated hunger and food intake at lunch time, as well as on body weight in 14 obese women hospitalized for weight reduction and on a restricted diet. During two 6-day courses of treatment with ceruletide or placebo, ceruletide 0.3 microgram/kg b.wt. or an equivalent volume of its diluent were injected IM at 11.30 a.m., i.e., 30 min before lunch. Feelings of hunger were quantitated, using a visual analogue self-rating scale, prior to the injection of ceruletide or placebo and 30 min thereafter, i.e., just prior to the start of meal ingestion, as well as 2 hr after the start of the meal. Duration and caloric content of food ingested at lunch, as well as morning body weight, were recorded daily. Ceruletide, compared to placebo, did not significantly influence any of the above variables. However, in the first three experimental days, the increase in self-rated hunger from values before the injection to 30 min thereafter was less marked, though not significantly so (0.05 less than p less than 0.1), with ceruletide than with placebo. Thus, it appears that ceruletide, under the experimental conditions of the present study, was not effective in enhancing the patients' motivation to lose weight and to further restrict their food intake at lunch time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3309902 TI - Photosensitive psoriasis--an immunohistochemical study after light provocation with UVA and UVB. AB - To gain further insight into the pathogenesis of photosensitive psoriasis, i.e. worsening of psoriasis lesions after sun exposure, 21 patients with this condition were studied following provocation with high doses of UVA and UVB. Thirteen of the patients had a history of polymorphous light eruption (PMLE). Here, a PMLE reaction could be induced by UV provocation. In 7 cases this developed further into psoriasis. In 8 of the 21 patients, psoriatic lesions developed subsequent to provocation with no preceding PMLE reaction. The test areas were periodically biopsied, and processed with a two-stage immunoperoxidase technique using monoclonal antibodies to immunophenotype the cell infiltrate. The dermal infiltrate consisted mainly of Leu-4+ cells (PAN-T). Leu-3+ cells (T helper/inducer phenotype) dominated, with a smaller proportion of Leu-2+ cells (T cytotoxic/suppressor phenotype), except in a few cases where these were prominent. This pattern was seen in all the groups investigated, including a control group of non-psoriatic PMLE patients. Exocytosis, with mainly Leu-2+ cells in the epidermis, was seen in most patients after psoriasis had developed. OKT-6+ (Langerhans) cells in the dermis were sparse, except in a few patients in all groups where a considerable number were observed. Leu-M1+ cells in the dermis (monocytes, granulocytes) were also sparse, but increased in most patients after psoriasis had developed. No B1+ cells (B lymphocytes) were seen, and very few Leu 7+ cells (NK). The only significant differences in the reaction pattern between the different clinical groups were the increased number of Leu-M1+ cells and the exocytosis of Leu-2+ cells after psoriasis had developed. PMID- 3309903 TI - Retinoic acid and photocarcinogenesis--a controversy. AB - There is considerable evidence that retinoids, including retinoic acid, prevent or normalize many malignant transformations. Contrary reports are few in number and are often problematic in design or interpretation. The mechanism of action of retinoids in differentiation and in neoplasia is not understood. The effects, however, are multifarious, and may be exerted directly on normal tumor cells, or indirectly via cytotoxic mechanisms and the immune system. After extensive testing and after almost 25 years of use on human skin, retinoic acid has not been found to be a carcinogen. When applied topically to non-irradiated mouse skin for up to 18 months it does not produce tumors (130). It was also negative in the Ames test. Moreover, the role of retinoic acid in normal differentiation of skin and mucous membranes appears to make it a physiologic necessity. Since UV radiation apparently destroys epidermal vitamin A (127, 128), its metabolite, retinoic acid, may need to be replenished continuously. The extreme vulnerability of the hairless mouse to UV radiation makes it a valuable animal for many photobiologic studies, including studies of carcinogenesis. However, this same extraordinary vulnerability means that we must be cautious in making casual extrapolations to humans. This problem is compounded when active topical agents are added, especially when application is made to the entire dorsum of the mouse, in contrast to limited areas of human skin. In most cases, animal studies have to be interpreted very carefully. The final judgment must rest on the human experience. PMID- 3309904 TI - Immunoscintigraphic evaluation of lymph node involvement in prostatic carcinoma. AB - Five patients who were candidates for radical prostatectomy were investigated. One milligram of diethylene triamine pentaacetic acid derivatives of purified F(ab')2 fragments of monoclonal antibodies against prostatic acid phosphatase, labeled with 99mTc, were bilaterally injected into the periprostatic space. The amount of radioactivity injected varied between 3 and 7 mCi. Imaging took place dynamically for the first hour following injection, then at 6 and 24 hr. In one patient, lymph node metastases were detected in the left paraaortic, iliac, and obturator lymph nodes by this technique. The lesions incorporating radioactivity were confirmed to be metastases of prostatic cancer following staging pelvic lymphadenectomy. Immunolabeling electron microscopy studies revealed internalized antibody in prostatic cancer cells. In the four other patients, radioimaging did not show any lymph node metastases, and this negative finding was confirmed at surgery. These early data indicate the possibility of preoperative staging of prostatic cancer using radiolabeled derivatives of monoclonal antibodies raised against prostatic acid phosphatase and injected into the periprostatic area. PMID- 3309905 TI - Sclerema neonatorum and subcutaneous fat necrosis of the newborn. AB - Sclerema neonatorum and subcutaneous fat necrosis are rare disorders affecting the panniculus of the newborn. This review attempts to put into perspective their similarities and differences in light of historical, biochemical, pathologic, and etiologic considerations. Recent therapeutic modalities and the prognosis are discussed. PMID- 3309906 TI - Eosinophil fluorescence: a cause of false positive slide tests for herpes simplex virus. AB - Two neonates who had different vesicular eruptions were erroneously diagnosed as having herpes simplex infections because of false positive results of herpes simplex fluorescent antibody slide tests. The infants, who proved to have incontinentia pigmenti and histiocytosis X, respectively, had multiple vesicular lesions containing numerous eosinophils. Eosinophils are known to show nonspecific fluorescence in immunofluorescent techniques because the fluorescein isothiocyanate label of the antiserum binds with the basic proteins in the eosinophilic granules. Clinicians should be aware that nonspecific eosinophil fluorescence may result in false positive results of immunofluorescent slide tests. PMID- 3309907 TI - Pediatric human immunodeficiency virus infection and its cutaneous manifestations. AB - Acquired immunodeficiency syndrome was first observed in children in 1982. Human immunodeficiency virus (HIV) is now known to be the etiologic agent of this disease complex. Children acquire the viral infection in utero or perinatally, or by receiving contaminated blood products. The cutaneous manifestations include persistent oral thrush, herpes simplex, herpes zoster, molluscum contagiosum, and a variety of fungal and bacterial skin infections. Vasculitis, unusual drug eruptions, and cutaneous manifestations of nutritional deficiencies are also seen. PMID- 3309908 TI - Kawasaki disease and its diagnosis. AB - Mucocutaneous lymph node syndrome, or Kawasaki disease, is a febrile, exanthematous disease of children that has potentially fatal complications. The most important complication is the development of aneurysms in the coronary arteries, which may thrombose or occasionally, rupture and cause severe morbidity or death. Criteria for the diagnosis of Kawasaki disease have been developed that may help the clinician make the diagnosis and prevent complications. The major criteria include fever, skin eruption, ocular changes, oral changes, changes in the extremities, and lymphadenopathy. Prognosis may be evaluated by the clinical picture and cardiac work-up with echocardiogram. PMID- 3309909 TI - Neurobrucellosis. PMID- 3309910 TI - Anticardiolipin antibodies--clinical associations. PMID- 3309911 TI - Assessment of neutrophil function--II. Laboratory tests of neutrophil function. PMID- 3309912 TI - Urography prior to prostatectomy. AB - As part of the pre-operative assessment for prostatectomy, the routine intravenous urogram continues to be requested by many practitioners. One hundred and ten patients being considered for prostatectomy underwent, prospectively, intravenous urography and trans-abdominal ultrasound. This paper specifically examines the respective contribution to management of these investigations. In 34% of patients, management was influenced in some way. This could have been achieved by ultrasound and plain abdominal radiograph alone. Additional intravenous urography would not have affected the clinical management of any patient. PMID- 3309913 TI - The association of non-Hodgkin's lymphoma with glomerulonephritis. AB - Paraneoplastic glomerulonephritis is an infrequent complication in the course of non-Hodgkin's lymphoma (21 cases to date). We report a modality not previously described: mesangioproliferative glomerulonephritis and mixed lymphocytic lymphoma, and review the literature on the subject. The onset of the two processes was simultaneous. Antitumour treatment induced simultaneous remission of the lymphoma and glomerulonephritis. PMID- 3309914 TI - Ultrasound diagnosis of portal vein thrombosis following splenectomy. AB - We present a case of clinically unsuspected portal vein thrombosis occurring soon after splenectomy in a patient with chronic lymphocytic leukaemia. Ultrasound provided a means of easy and accurate diagnosis and allowed frequent reassessment of the thrombus during the period of its resolution under conservative management. PMID- 3309915 TI - Pitfalls in the ultrasonographic diagnosis of gallbladder diseases. AB - Ultrasonography is rapidly replacing radiological techniques of gallbladder investigation. While ultrasonography is highly accurate, there are technical, anatomical and diagnostic pitfalls which will trap the unwary. This presentation highlights the pitfalls which we have encountered, reviews the literature in this area and suggests techniques whereby these pitfalls may be avoided. PMID- 3309916 TI - Campylobacter pyloridis: a new organism to explain an old problem? PMID- 3309917 TI - Dystrophia myotonica and pregnancy--an instructive case. AB - Two cases of dystrophia myotonica, a mother and her newborn child, are reported. The diagnosis in the mother was only made after seven years and two eventful deliveries. The obstetrical and anaesthetic complications, as well as the neonatal form of dystrophia myotonica, are reviewed. PMID- 3309918 TI - Systemic lupus erythematosus and primary cerebral lymphoma. AB - A woman with a 21 year old history of systemic lupus erythematosus (SLE) is presented. During a period of low connective tissue disease activity she developed sudden difficulty in walking and after much investigation was found to have a primary lymphoma of the brain. She died 6 months after this diagnosis from meningeal spread, despite radiotherapy to the tumour. The association between SLE and lymphoma is discussed. PMID- 3309920 TI - Trimethoprim versus amoxycillin for upper respiratory tract infection. PMID- 3309919 TI - Epstein's syndrome: case report and survey of the literature. AB - A diagnosis of Epstein's syndrome was made in a young female with congenital macrothrombopathic thrombocytopenia, a nephropathy and mild sensorineural deafness. Previous case reports of this rare disorder are briefly reviewed and attention is drawn to the frequent association between inherited thrombocytopenia and renal disease. PMID- 3309921 TI - Some memories of early public health nursing in North Dakota. PMID- 3309922 TI - [Prosthetic after-care of patients with clefts in the northern Moravian region]. PMID- 3309923 TI - [Bronchial asthma in childhood--a current review]. PMID- 3309924 TI - [Inflammatory pseudotumor of the lung--case report and review of the literature]. PMID- 3309925 TI - [Significance of the oscillation method in the diagnosis of respiratory function]. PMID- 3309926 TI - [Development of a hemangiosarcoma at the site of a polyamide thoracic implant]. PMID- 3309927 TI - [Sexual abuse of children]. PMID- 3309928 TI - Pierre Robin sequence associated with amniotic band syndrome ultrasonographic diagnosis and pathogenesis. AB - A case of prenatal diagnosis of the Pierre Robin sequence is reported in which hydramnios and amniotic bands are present. The possible pathogenesis is discussed. PMID- 3309929 TI - Interpretation of syncytial sprouts and bridges in the human placenta. AB - Human placental villi from normal and pathological material from the eighth to the 40th week of gestation were examined by light, scanning and transmission electron microscopy. Trophoblastic specializations--such as syncytial sprouts of early and late pregnancy, syncytial knots and syncytial bridges--were classified into proliferative and degenerative processes or artefacts caused by tangential sectioning. In early pregnancy and in diabetes mellitus most syncytial sprouts represent the initial phases in the development of villi. In late pregnancy, in particular in pre-eclampsia, most syncytial knots, sprouts and bridges are histological artefacts, caused by tangential sectioning of the trophoblastic surface. The chance of producing such artefacts is increased with increasing section thickness and with increasing branching and tortuosity of the villi. However, a small proportion of the syncytial knots, sprouts and bridges in the last-trimester placenta, those containing coarse pyknotic nuclei, are trophoblastic specializations of a probably degenerative character. PMID- 3309930 TI - Demonstration of immunoreactive eosinophil granule major basic protein in the plasma and placentae of non-human primates. AB - A protein immunologically identical to the major basic protein (MBP) of eosinophil granules is present in the plasma of pregnant women and has been localized to human placental X cells using immunofluorescence. This study demonstrates the presence of similar immunoreactive molecules in the placental X cells from several non-human primates. We also describe the presence of increased plasma levels of MBP in the pregnant gorilla and in pregnant cynomolgus and rhesus monkeys as compared to non-pregnant counterparts. Such findings suggest that non-human primates are a suitable animal model for the study of the X cell function and in particular the physiological importance of MBP in pregnancy. PMID- 3309931 TI - [Behavior of the large fragment of DNA polymerase I (the Klenow fragment) during fractionation of a cell-free extract of E. coli MRE-600]. AB - Distribution of the DNA polymerase I large fragment (Klenow fragment) was studied during fractionation of the E. coli MRE-600 cell-free extract with polyethylenimine. On the basis of the results obtained a simple procedure is proposed that enables the Klenow fragment to be obtained as a coproduct of DNA polymerase I, RNA polymerase, polynucleotide phosphorylase, nucleotide kinases with acetokinase and nucleoside deoxy-ribosyltransferase in the framework of a combined technological scheme. PMID- 3309932 TI - [Effects of insulin in vitro in the fatty tissue of rats with alloxan diabetes after insulin treatment or administration of insulin-like growth factors from human serum]. AB - Insulin insufficiency in rats caused by alloxan, results in a decrease in the sensitivity of the fatty tissue to insulin determined by glucose oxidation and synthesis of lipids manifested in a decrease in a maximum response of the tissue to insulin. Multiple injection of insulin as well as of partially purified total fraction of insulinoid growth factors causes an increase in a maximum response of the fatty tissue to insulin and a right-hand shift of dose-response curves. The total effect of the injection of insulin or partially purified growth factors is expressed in elevated sensitivity of the fatty tissue to insulin. PMID- 3309933 TI - [Effect of hyperbaric oxygenation on residual insulin secretion in patients with diabetes mellitus type 1]. AB - The paper is concerned with the results of a study of the C-peptide concentration in blood serum of 45 patients with type I diabetes mellitus prior to and during therapy with hyperbaric oxygenation (HBO). Each patient was given 10-12 HBO sessions. A HBO therapeutic course was shown to stimulate residual insulin secretion in type I diabetes mellitus with a period of disease not more than 3 years, a daily dose of insulin not more than 60 units, in the absence of excess body mass over 10%, and retinopathy over stage I. Prognostic criteria make it possible to take into account clinical factors in the course of diabetes mellitus preventing the normalization or stimulation of residual basal insulin secretion which can be used for the determination of indications for HBO therapy aimed at the stimulation of insulin secretion. PMID- 3309935 TI - [Effect of a number of cryoprotective agents on the structure and function of cultured pancreatic islet cells of newborn piglets]. AB - The paper is concerned with the results of a direct effect of widely used cryoprotectors on the structure and function of cell culture in pancreatic islet cells. It has been concluded that PEO-400 (polyethylene oxide) concentration up to 10% and DMSO (dimethyl silfoxide) concentration up to 7.5% do not influence the toxic effect of morphofunctional features of pancreatic cells. PMID- 3309934 TI - [Effect of physical exercise conducted at various times of the day on the regulation of carbohydrate metabolism in patients with diabetes mellitus]. AB - A study was made of the levels of glucose, IRI, STH, ACTH and cortisol in the blood serum (plasma) of 39 patients with diabetes mellitus prior to and after physical exercise testing. 25 patients performed physical exercises on an empty stomach in the morning (8-9 a.m.) 14 patients in the daytime (4-5 p.m.). Exercise therapy in the morning hours resulted in the readjustment of hormonal regulation characterized by the predominance of the activity of the counterinsular systems over the insular one. In the daytime the IRI level in patients with diabetes mellitus increased and the activity of the hypophyseoadrenal system before and after physical exercise testing decreased as compared to morning indices producing a beneficial effect on the carbohydrate metabolic status. Daytime hours seem optimum for exercise therapy of patients with diabetes mellitus of both types. PMID- 3309936 TI - [The heart in diabetes mellitus]. PMID- 3309937 TI - [Pancreatic polypeptide]. PMID- 3309938 TI - [Myoplasty in thoracic surgery]. PMID- 3309939 TI - [Role of the respiratory muscles in the pathogenesis of obstructive lung diseases and means of their therapeutic correction]. PMID- 3309941 TI - Colonization of the rectum of Triatoma infestans by Trypanosoma cruzi studied by scanning electron microscopy: influence of blood uptake by the bug. AB - The colonization of the different regions of the rectum of Triatoma infestans by Trypanosoma cruzi was studied in unfed larvae, during and after feeding of the bug by scanning electron microscopy. The rectal pads always possessed the highest population densities, but in some bugs the main rectal sac and the region around the anus were also covered by a "carpet" of flagellates. Such high densities were never observed at the midgut/rectal junction. A slight decrease in this region might be caused by blood ingestion and the resulting excretion of urine. However, the flagellates in this region cannot be responsible for a phenomenon described by other authors, namely that the percentage of metacyclics is low in the first drop of faeces and increases in the following drops of deposited urine. Our observations indicate that metacyclics lying on the "carpet" of flagellates in bugs before and right after the start of feeding might later become loosened. In all dissections, numerous metacyclics were attached to the rectal wall. Further studies are necessary to clarify the exact origin of metacyclics in the urine. PMID- 3309942 TI - Identification and characterisation of proteins associated with the rhoptry organelles of Plasmodium falciparum merozoites. AB - We describe antigens of Plasmodium falciparum recognised by murine monoclonal antibodies which by immunofluorescence react with the rhoptry organelles of the extracellular merozoite stage. Immunoblotting shows that the antibodies recognise two major parasite antigens of Mr 82 and 65 kilodaltons (kDa). Immunoprecipitations from detergent extracts of [35S]-methionine-labelled parasites show that the 82-kDa and 65-kDa antigens are parasite proteins. Pulse chase experiments on synchronous parasite cultures show that the 82-kDa protein is synthesised during early schizogony and is later processed into the 65-kDa antigen in segmenting schizonts. In Nonidet P-40, these antigens are non covalently associated with two other proteins of 40 kDa and 42 kDa. The 40/42-kDa doublet is synthesised in parallel with the 82 kDa antigen and persists, apparently unchanged, till the end of the cell cycle. PMID- 3309944 TI - A comparative study on the effect of chloroquine and ammonium chloride on feeding process of Plasmodium falciparum in vitro. PMID- 3309943 TI - Isolation and characterization of the 80,000 dalton Plasmodium falciparum merozoite surface antigen. AB - The 80,000 dalton merozoite surface protein, derived from the 185,000-195,000 dalton schizont precursor, was isolated from detergent extracts of naturally released merozoites using chromatographic procedures. A rabbit antiserum raised against this antigen was used for characterizing the 80,000 dalton fragment. The antiserum did not inhibit merozoite invasion or parasite growth in vitro, suggesting that this merozoite surface antigen is not directly involved in the invasion process of the merozoite into the host erythrocyte. PMID- 3309940 TI - Heterologous antagonistic and synergistic interactions between helminths and between helminths and protozoans in concurrent experimental infection of mammalian hosts. AB - Experimental concurrent infection with two or more parasite species in mammalian host models may result in heterologous antagonistic and synergistic interactions ranging in magnitude from reduced/enhanced growth and fecundity to blockage/enhancement of establishment/expulsion. With some exceptions only, there is a reasonable correlation between the levels of interaction monitored by parasitological and by clinico-pathological parameters. Heterologous antagonistic interactions mediated by functional and specific immunological cross-reactivity occur between closely related parasite species exhibiting a marked immunobiological similarity. In contrast, antagonistic interactions between antigenetically more remote species of helminths, protozoan-induced resistance to helminth infection and helminth-induced suppression of concurrent protozoan infection generally appear mediated by immunologically non-specific factors like macrophage activation and inflammatory reactions. Synergistic heterologous interactions between helminths, helminth-induced enhancement of concurrent protozoan infection and interference with the development and maintenance of resistance to helminth infection in response to concurrent protozoan infection are generally thought to be mediated by non-specific parasite-induced immunosuppression. Concurrent experimental infection is very complex. There are problems and limitations in extrapolating from experimental studies on concurrent infection in laboratory animals to natural polyparasitism. This fact, coupled with the complex influence of ecological factors on the pattern and frequency of concurrent natural infection means that major consequences of natural concurrent parasite infection have not been definitively demonstrated. Appropriately planned and controlled field studies and further laboratory experiments on primate and domestic animal models are imperative for elucidation of the importance of heterologous interactions in concurrent parasite infection for the disease pattern in man and domestic stock. Experimental studies hitherto conducted on concurrent parasite infection pointing to natural heterologous interactions may be a valuable starting point for further studies. PMID- 3309945 TI - Loss of (2'-5')oligoadenylate synthetase activity by production of antisense RNA results in lack of protection by interferon from viral infections. PMID- 3309946 TI - Recovery from ultraviolet light-induced inhibition of DNA synthesis requires umuDC gene products in recA718 mutant strains but not in recA+ strains of Escherichia coli. AB - Ultraviolet light (UV) inhibits DNA replication in Eschericia coli and induces the SOS response, a set of survival-enhancing phenotypes due to derepression of DNA damage-inducible genes, including recA and umuDC. Recovery of DNA synthesis after UV irradiation ("induced replisome reactivation," or IRR) is an SOS function requiring RecA protein and postirradiation synthesis of additional protein(s), but this recovery does not require UmuDC protein [Khidhir, M. A., Casaregola, S. & Holland, I. B. (1985) Mol. Gen. Genet. 199, 133-140]. IRR occurs in strains carrying either recA718 (which does not reduce recombination, SOS inducibility, or UV mutagenesis) or umuC36 (which eliminates UV mutability), but not in recA718 umuC36 double mutants. In recA430 mutant strains, IRR does not occur whether or not functional UmuDC protein is present. IRR occurs in lexA-(Ind ) (SOS noninducible) strains if they carry an operator-constitutive recA allele and are allowed to synthesize proteins after irradiation. We conclude the following: (i) that UmuDC protein corrects or complements a defect in the ability of RecA718 protein (but not of RecA430 protein) to promote IRR and (ii) that in lexA(Ind-) mutant strains, IRR requires amplification of RecA+ protein (but not of any other LexA-repressed protein) plus post-UV synthesis of at least one other protein not controlled by LexA protein. We discuss the results in relation to the essential, but unidentified, roles of RecA and UmuDC proteins in UV mutagenesis. PMID- 3309947 TI - Construction of a yeast strain devoid of mitochondrial introns and its use to screen nuclear genes involved in mitochondrial splicing. AB - We have constructed a respiring yeast strain devoid of mitochondrial introns to screen nuclear pet- mutants for those that play a direct role in mitochondrial intron excision. Intron-less mitochondria are introduced by cytoduction into pet- strains that have been made rho0; cytoductants therefrom recover respiratory competency if the original pet- mutation is required only for mitochondrial splicing. By this means, we have identified 11 complementation groups of such genes. Their total number may be estimated as about 18. PMID- 3309948 TI - Expression of a set of synthetic suppressor tRNA(Phe) genes in Saccharomyces cerevisiae. AB - Synthetic ochre and amber tRNA suppressor genes derived from the yeast tRNA(PheGAA) sequence have been constructed. They were efficiently transcribed in vitro and expressed in vivo via a synthetic expression cassette. tRNA(PheUUA) and tRNA(PheUUA) delta IVS (IVS = intervening sequence) are relatively inefficient ochre suppressors. They are toxic to the cell when expressed on a multicopy plasmid, and they do not suppress at all when present as single copies. The intron does not seem to have any effect on suppression. In contrast, the amber suppressor tRNA(PheCUA) delta IVS is efficient when expressed from a single-copy plasmid, while its efficiency is reduced on a multicopy vector. PMID- 3309950 TI - Isolation and characterization of a T-lymphocyte somatic mutant with altered signal transduction by the antigen receptor. AB - We have developed an approach for deriving and characterizing antigen-receptor (CD3/Ti) signal-transduction mutants. This strategy combines receptor-mediated growth inhibition and fluorescence-activated cell sorting with the Ca2+-indicator indo-1. Despite the expression of structurally normal CD3/Ti complexes, one such mutant (J.CaM1) fails to exhibit inositolphospholipid metabolism or Ca2+ mobilization in response to anti-CD3 or anti-Ti monoclonal antibodies and fails to produce lymphokines in response to these antibodies. Surprisingly, anti-Ti antibody retains its effectiveness as a stimulus for the down-regulation of CD3/Ti surface expression. These cells remain responsive to AIF-4, at least one anti-CD3 antibody, and some combinations of nonagonist anti-Ti and anti-CD3 antibodies. The mutation in J.CaM1 appears to lie in a proximal component of the signal-transduction apparatus. PMID- 3309951 TI - New concepts in studying the control of normal and cancer growth of the prostate. PMID- 3309949 TI - Direct evidence for a receptor-ligand interaction between the T-cell surface antigen CD2 and lymphocyte-function-associated antigen 3. AB - The recognition of foreign antigen by T lymphocytes requires direct contact with cells expressing the antigen. It has recently become clear that T lymphocytes can form conjugates with other cells in the absence of foreign antigen expression. Studies using monoclonal antibodies (mAbs) to inhibit conjugate formation have suggested that a portion of the antigen-dependent adhesion is mediated by T lymphocytes interacting with cells expressing lymphocyte-function-associated antigen 3 (LFA-3), a widely distributed cell surface protein. We have investigated antigen-independent adhesion by incorporating affinity-purified LFA 3 into the lipid membrane of an artificial target cell (ATC; a nylon-matrix vesicle with a lipid membrane). These vesicles are similar in size and density to intact cells, so that conjugates between cells and ATCs may be seen by light microscopy. ATCs expressing a density of LFA-3 similar to that on intact cells were found to form conjugates with T cells, but only if the T cells expressed the sheep erythrocyte receptor, CD2 (T11; LFA-2). Previous studies using mAbs have implicated the CD2 molecule in both adhesion and T-cell activation. ATCs prepared without surface protein or with purified HLA class I protein failed to interact with the CD2-positive T cells, indicating that the adhesion found was mediated by the LFA-3 molecule. Furthermore, mAb against LFA-3 or CD2 was able to block the LFA-3-mediated vesicle-cell interaction, whereas mAb against LFA-1 or HLA failed to inhibit the interaction. These results provide direct evidence that LFA-3 functions as an adhesion molecule by serving as a ligand for the CD2 molecule on T cells. PMID- 3309952 TI - Regulation of c-sis expression in tumors of the male reproductive tract. PMID- 3309954 TI - A critical evaluation of the use of androgen receptor assays to predict the androgen responsiveness of prostatic cancer. PMID- 3309953 TI - Androgen regulated prostate genes: structural analysis and regulation. PMID- 3309955 TI - Acceptor sites: genomic sites for androgenic regulation of prostatic growth. PMID- 3309956 TI - Growth factors in the prostate. PMID- 3309957 TI - Stromal-epithelial interactions in normal and abnormal prostatic development. PMID- 3309958 TI - Mesenchymal-epithelial interactions: technical considerations. PMID- 3309959 TI - Protease inhibitors: possible preventive agents of various types of cancer and their mechanisms of action. PMID- 3309960 TI - Mechanisms of metastasis: prostate cancer. PMID- 3309961 TI - The endocrinology and treatment of prostate tumor progression. PMID- 3309962 TI - Replicative cultures of human prostatic epithelial cells. PMID- 3309963 TI - Development and characteristics of the available animal model systems for the study of prostatic cancer. PMID- 3309964 TI - Current diagnostic and staging practices. PMID- 3309965 TI - Detection, staging, and monitoring of prostatic cancer: clinical overview and opportunities for research. PMID- 3309966 TI - The application of flow cytometry to the study of prostate cancer. PMID- 3309967 TI - Oncogene expression. PMID- 3309969 TI - Uses and limitations of hormone, receptor and enzyme assays in prostate cancer. PMID- 3309970 TI - New concepts on the androgen sensitivity of prostate cancer. PMID- 3309968 TI - A critical review of the concept of total androgen ablation in the treatment of prostate cancer. PMID- 3309971 TI - Development of androgen resistance in prostatic cancer. PMID- 3309972 TI - Current status of the LHRH immunization approach. PMID- 3309973 TI - Anandron (RU 23908) associated to surgical castration in previously untreated stage D prostate cancer: a multicenter comparative study of two doses of the drug and of a placebo. PMID- 3309974 TI - Progress in pathology of carcinoma of prostate. PMID- 3309975 TI - Prostate metabolism of steroids following castration. PMID- 3309976 TI - Steroid receptor and biochemical profiles in prostatic cancer: correlation with response to hormonal treatment. PMID- 3309977 TI - Diagnostic value of transrectal ultrasonography in prostatic cancer. AB - The high frequency endocavitary sectorial probe developed by the authors has been used for the evaluation of transrectal ultrasonography as a diagnostic method for prostatic cancer. A double-blind study was conducted with retrospective interpretation of the ultrasonographic documents obtained from a series of 213 patients. Histological control was available in 132 patients, including 42 patients with cancer. The specificity for the diagnosis of cancer (number of true negatives/number of patients without cancer) was 79%, while the sensitivity (number of true positives/number of cancers) was only 48%. In the second phase of the study, ultrasound guided prostatic needle biopsy was performed in a series of 72 patients with either prostatic induration without a nodule (47 cases) or with a prostatic nodule (25 cases). The histological material was of good quality and no complications were recorded. However, the ten cancers diagnosed (5 from each group) could not be clearly distinguished ultrasonographically from other examinations of adenoma, prostatitis or normal prostate. PMID- 3309978 TI - Ultrasonography and prostatic cancer: improving diagnosis by the suprapubic study of seminal vesicles. Based on 175 cases. PMID- 3309979 TI - Monitoring of prostate volume by ultrasound in hormonally treated prostate cancer. PMID- 3309980 TI - Place of transperineal and suprapubic ultrasonography in the diagnosis of prostatic cancer. PMID- 3309981 TI - Estracyt--mode of action and clinical experience. PMID- 3309982 TI - A current review of the clinical experience with Estracyt. PMID- 3309983 TI - French multicenter study on the use of estramustine phosphate versus diethylstilbestrol. PMID- 3309984 TI - To what degree is chemotherapy useful in the treatment of prostatic cancer. PMID- 3309985 TI - Transperineal prostatic biopsy guided by transrectal ultrasonography. PMID- 3309986 TI - Is it justified to neglect the role of chemotherapy in the treatment of prostatic cancer? PMID- 3309987 TI - The use of transrectal echography for screening on prostate cancer. Results and evaluation. PMID- 3309988 TI - Management of stage A-2 prostate cancer. PMID- 3309989 TI - The role of radical prostatectomy in the management of stage B adenocarcinoma of the prostate. PMID- 3309990 TI - The role of surgery in stage B-2 malignancy. PMID- 3309991 TI - Ultrasound monitoring of prostatic cancer in treatment. PMID- 3309992 TI - The management of stage C prostate cancer. PMID- 3309993 TI - Echoguides biopsy in low stage prostatic carcinoma. PMID- 3309994 TI - Management of primary stage D prostatic cancer. AB - Androgen withdrawal rarely if ever results in a cure of prostatic carcinoma. Thus, if the object of therapy is to cure rather than palliate, it is necessary for us to alter our strategem so as to trick the prostatic cancer cells into dying while sparing the host. Data has been presented that suggest that tumor cell heterogeneity and the preexistence of populations of cells resistant to androgen withdrawal are responsible for the failure of hormonal therapy. Additionally, the use of androgen withdrawal as a single mode of therapy may actually induce a more rapid emergence of cells resistant to chemotherapeutic intervention by increasing the genetic instability of the tumor population. Assuming that a tumor is composed of a heterogeneous population of cells and the institution of unimodal therapy will exert a destabilizing influence on the tumor, the logical therapy for disseminated disease would be multimodal therapy. Animal models suggest that the most effective therapy for disseminated disease would be a combination of androgen withdrawal and cytotoxic chemotherapy instituted as early as possible when the number of cells capable of division, stem cells, is at minimum. Whether or not early, sequential withdrawal, repletion, withdrawal of hormones to synchronize the tumor cell cycle and increase the growth fraction of the tumor will have any beneficial effects remains to be determined. This form of androgen priming should be safer than in patients with hormonally refractive disease since LHRH initially stimulates testosterone production without any significant irreversible sequelae. Although the above therapeutic logarithms may prove to have no therapeutic advantage over androgen withdrawal alone, it certainly seems a good starting point for a change in our therapeutic concepts. Only by adopting new approaches based upon what we know about tumor biology can we hope to impact on the current dismal prognosis. PMID- 3309996 TI - Ultrasound guided implantation of radioactive seeds. PMID- 3309995 TI - Is there still place for estrogens in the treatment of advanced prostatic carcinoma? PMID- 3309997 TI - Specificity of T cell responses to murine chemically-induced tumor antigens. PMID- 3309998 TI - Expansion of tumor-infiltrating lymphocytes from human solid tumors in interleukin-2. PMID- 3310000 TI - Graft-vs-leukemia following bone marrow transplantation: a model of immunotherapy in man. AB - Considerable data in animals suggest an antileukemia reaction associated with transplantation of allogeneic bone marrow cells. In some instances, this graft-vs leukemia (GVL) reaction may be distinct from graft-vs-host-disease (GVHD). Data in humans also support the concept of a GVL effect associated with bone marrow transplantation. These observations include an increased risk of leukemia relapse in identical twin transplants and in recipients of T-cell depleted allogeneic transplants, and a decreased risk of leukemia relapse in individuals who develop acute or chronic GVHD. Although indirect, these findings are among the most convincing evidence that the immune system plays a role against cancer in man. It may be possible to exploit this effect in other settings and with other cancers. PMID- 3309999 TI - Overview: cellular immunotherapy of cancer. PMID- 3310001 TI - Graft-versus-leukemia in man: relationship of acute and chronic graft-versus-host disease to relapse of acute leukemia following allogeneic bone marrow transplantation. AB - To study the effect of acute and chronic graft-versus-host disease (GVHD) on recurrent leukemia, we analysed data on patients with acute leukemia receiving allogeneic marrow transplants in Seattle between 1970 and 1986. Four hundred fifty-four patients survived in remission 150 days after HLA-identical transplant and 114 currently survive five to fifteen years after marrow grafting. At the time of transplant, 252 patients had acute nonlymphocytic leukemia in remission or relapse and 202 had acute lymphocytic leukemia in remission or relapse. According to Kaplan-Meier estimates, recurrence of leukemia following transplantation was observed in 28% of patients developing moderate to severe (grade II-IV) acute GVHD and 48% of patients with no or mild (grade O-I) acute GVHD (p = 0.0028). Relapse was observed in 34% of patients developing clinical extensive chronic GVHD and 45% of patients free of chronic GVHD (p = 0.0001). The incidence of recurrent leukemia was 28% in recipients developing both acute and chronic GVHD and 52% in patients free of both acute and chronic GVHD (p = 0.0001). These data confirm an apparent graft-versus-leukemia effect in patients developing GVHD after allogeneic marrow grafting. Current studies are aimed at determining the influence of such apparent adoptive immunotherapy within the different categories of leukemia and methods to manipulate and augment the clinical benefit of this observation. PMID- 3310002 TI - Graft versus leukemia effect in man: the relapse rate of acute leukemia is lower after allogeneic than after syngeneic marrow transplantation. AB - To determine whether allogeneic bone marrow transplantation (BMT) is associated with a graft vs leukemia (GVL) effect in man, the relapse rate of acute leukemia after allogeneic BMT was compared with that occurring after syngeneic (genetically identical twin) BMT. The patients had ALL or ANL in second or subsequent complete remission (CR) or in relapse. The allogeneic and syngeneic marrow recipients were comparable in diagnosis, age, and interval from diagnosis to BMT and received comparable chemoradiotherapy regimens. Allogeneic marrow recipients, however, received, in addition, GVH disease prophylaxis, most often methotrexate and, more recently, cyclosporine or both. All patients treated by the Seattle team from 1970-1986 are included. Leukemic recurrence was observed in 62% of 785 allogeneic recipients and 75% of 53 syngeneic recipients (p less than 0.0001). The results confirm the circumstantial evidence for a GVL effect exerted by allogeneic marrow. Analyses are in progress to determine whether a GVL effect exists in subsets of patients as a function of their particular diagnosis or status at the time of BMT. PMID- 3310003 TI - Manipulation of T-cell content in transplanted human bone marrow: effect on GVH and GVL reactions. PMID- 3310005 TI - The immunogenetics of chronic graft versus host disease and its relevance for the graft versus leukemia effect. PMID- 3310006 TI - Mechanistic aspects of successful immunotherapy of established pulmonary metastases by the systemic administration of high-dose recombinant interleukin-2. PMID- 3310007 TI - Lineage establishment in hemopoiesis: problems and opportunities. PMID- 3310004 TI - Phenotype and functional characterization of NK and LAK cells following T depleted bone marrow transplantation. PMID- 3310008 TI - Immunoregulatory T cells and immunodeficiency. PMID- 3310010 TI - Chromosomal translocations in B-cell derived tumors. PMID- 3310009 TI - Molecular structure of chromosome 21. PMID- 3310011 TI - Fatty acid metabolism of isolated mammalian cells. AB - It is now clear that a wide variety of differentiated cells in culture exhibit essentially the full spectrum of mammalian fatty acid metabolism. These cells readily incorporate free fatty acids into membrane phosphoglycerides, modify exogenous fatty acids by desaturation and elongation, and store excess fatty acyl groups, primarily as triacylglycerols. Similarly, many different types of cells synthesize cyclooxygenase and lipoxygenase derivatives of long chain polyunsaturated fatty acids. Furthermore, although the fatty acid composition of cellular phospholipids can be modified by medium supplementation, cells in culture exhibit definite fatty acyl specificities for the various steps of fatty acid activation, transesterification and release. As the extensive repertoire of fatty acid metabolism in mammalian cells has been elucidated, and as the ability to grow differentiated cells in culture has increased, new questions have arisen. There is still much to be learned about the enzymes involved in synthesizing and maintaining the unique fatty acid composition of the different cellular phospholipids and the processes which regulate the desaturation, elongation and retroconversion of polyunsaturated fatty acids. Other areas of great current interest are the mechanisms by which certain long chain polyunsaturated fatty acids are made available for conversion to oxygenated, biologically-active derivatives, the metabolic interactions between different polyunsaturated fatty acids, particularly n-3 and n-6 fatty acids, the cellular roles of the C22 polyunsaturated fatty acids, and the functions of particular molecular species of phospholipids in membrane-mediated events. Further research in these areas will contribute to unravelling the role of fatty acids and fatty acid derivatives in the physiological processes of mammalian cells. PMID- 3310012 TI - Taurine and icosanoids in the heart. AB - Experiments were carried out on non-working isolated rabbit hearts perfused by Tyrode solution: the effects of Taurine introduced into the coronary circulation were studied on the biosynthesis of the anti-thromboxane synthetase factor ("FATS") and on the TXA2 and PGI2 synthetase activities of cardiac tissue. The effects of Taurine were simultaneously studied on the biosynthesis of TXA2 and PGI2 in vitro. Experiments performed under the adopted conditions have shown that in vitro Taurine did not significantly modify the biosynthesis of TXA2 and PGI2; ex vivo Taurine did not change the biosynthesis of "FATS" but inhibited both TXA2 and PGI2 synthetase activities of the cardiac tissue: Taurine was more active on the TXA2 synthetase activity than on the PGI2 one. Thus Taurine promoted the formation of vasodilator and antiaggregating PGI2 at the expenses of vasoconstrictor and proaggregating TXA2. This could at least partly explain the beneficial effects of Taurine in the physiopathology of the heart. PMID- 3310013 TI - Prostaglandin and thromboxane levels during endotoxin-induced respiratory failure in pigs. AB - Arterial plasma concentrations of thromboxane B2 (TxB2), prostaglandin F2 alpha (PGF2 alpha) and 6-keto-prostaglandin F1 alpha (PGF1 alpha) were measured during endotoxin-induced acute respiratory failure (ARF) in anesthetized 10-12 wk old pigs. A 4.5 hour (hr) infusion of endotoxin resulted in a biphasic pattern of ARF. Phase 1 (0-2 hr) was characterized by increased pulmonary artery pressure, pulmonary vascular resistance (PVR), and alveolar-arterial O2 gradient (delta A aO2), and decreased cardiac index (CI) and lung dynamic compliance (LDC). Following a return of PVR and CI values towards baseline, a second phase (2-4.5 hr) of deteriorating function occurred and was characterized by additional increases in PVR and delta A-aO2 and decreases in CI and LDC. Baseline (i.e., 0 hr) plasma TxB2 concentrations were 241 +/- 24 pg/ml; these values peaked at 0.5 hr (3228 +/- 712 pg/ml) and declined to 1635 +/- 453 pg/ml at 4.5 hr. Plasma concentrations of PGF2 alpha slowly increased from a baseline value of 154 +/- 32 pg/ml to 2355 +/- 738 pg/ml at 4.5 hr, while PGF1 alpha values increased from 54 +/- 2 pg/ml at 0 hr to 503 +/- 172 pg/ml at 4.5 hr. Time-matched control pigs showed no changes in pulmonary hemodynamics or in plasma TxB2, PGF2 alpha or PGF1 alpha levels. These results indicate that cyclooxygenase products are increased during both phases of endotoxin-induced ARF in pigs. PMID- 3310014 TI - Stimulation of prostacyclin synthesis in rats treated with phenobarbital. AB - The effect of phenobarbital treatment on the synthesis of prostacyclin in coronary vascular microsomes was studied in Sprague Dawley rats. It was found that the treatment increased the synthesis of prostacyclin by nearly 100%. The treatment also resulted in an increase in HDL and a decrease in LDL in the serum. In vitro effects of HDL and LDL on the microsomal synthesis of prostacyclin showed that the synthesis was stimulated by HDL and inhibited by LDL. Hence it appears that the increase in prostacyclin synthesis resulting from phenobarbital treatment was at least partly due to increased level of HDL and decreased level of LDL in the serum. PMID- 3310015 TI - [The development of bioactive structures. Systems testing]. PMID- 3310016 TI - Fendiline: a review of its basic pharmacological and clinical properties. AB - Fendiline is an anti-anginal agent for the treatment of coronary heart disease. Together with other diphenylalkylamines it is sub-classified in the group of lipophilic calcium antagonists. It binds to the calcium channel and to calmodulin with rather similar affinities. Pharmaco-dynamically, it exerts the typical calcium as well as calmodulin antagonistic actions: inhibition of the transmembrane calcium current, smooth muscle relaxation, negative inotropism, cardioprotection, inhibition of calmodulin-activated myosin light-chain kinase and phosphodiesterase. Pharmacokinetics reveal slow onset of action and a long half-life. The anti-anginal and anti-ischaemic efficacy of fendiline has been proven in several placebo-controlled, double-blind trials. It does not interfere with digoxin therapy. Direct comparison with other calcium antagonists by means of controlled studies revealed that its potency is at least equal to that of nifedipine but, in contrast to nifedipine, verapamil, and diltiazem, its anti anginal action increases during chronic therapy, reaching a steady state of action after 2 to 3 weeks. In addition, the anti-ischaemic and anti-anginal potency is about equal to that of isosorbide dinitrate but fendiline has the advantage of lacking tolerance development. Nevertheless, the data presented indicate that a combination of fendiline with low doses of ISDN may be beneficial. Adverse cardiac and haemodynamic actions, such as increase or decrease in heart rate, disturbance of AV nodal conduction, impairment of cardiac contractile performance or considerable decrease in arterial pressure in hypotensives and normotensives, are lacking. PMID- 3310017 TI - Intra-articular treatment with sodium hyaluronate in gonarthrosis: a controlled clinical trial versus placebo. AB - A double-blind, placebo-controlled study was carried out in 34 patients suffering from osteo-arthritis of the knee. A total of 40 joints was treated at random with 3 intra-articular injections, at 1 week intervals, of either 20 mg sodium hyaluronate or placebo. Clinical examinations, including assessments of spontaneous pain intensity, pain on touch, under load and while walking, were made before each injection and repeated 7 days after the last one and again at 60 days after the start of the trial. The results showed a significant difference between treatments for all the variables assessed. In the sodium hyaluronate group, pain relief was not only rapid but also long lasting. Local tolerance was very good for both treatments. PMID- 3310019 TI - Cardiovascular effects of garlic (Allium sativum): a review. AB - Garlic (Allium sativum) has been used medicinally for centuries and still is included in the traditional medicine of most cultures. Recently, there has been renewed interest in its role in the treatment of cardiovascular diseases and its effectiveness in offsetting the risks of such conditions. The results of numerous studies are reviewed; they show that garlic can bring about plasma lipids normalization, enhancement of fibrinolytic activity, inhibition of platelet aggregation, and reductions in blood pressure and blood glucose. It is concluded that garlic has potential in the prevention and control of cardiovascular disorders. PMID- 3310018 TI - A double-blind comparative study of alprazolam and dothiepin hydrochloride in the treatment of anxiety associated with depression. AB - One hundred patients with mixed symptoms of anxiety and depression were enrolled into a prospective, multi-centre, randomized, double-blind study comparing the response to, and the side-effects of, alprazolam and dothiepin hydrochloride over 4 weeks of treatment. Mean daily doses were 2.33 mg alprazolam and 115 mg dothiepin. Data on 96 patients were evaluated for tolerance, and data for 85 patients were analyzed for therapeutic response. In each case, the groups were similar in numbers, mean ages and sex ratios. Both groups experienced satisfactory responses to therapy, with highly statistically significant changes (p less than 0.001) in the means of all efficacy measures within each group. No statistical difference was demonstrated in favour of either treatment group. Both dothiepin and alprazolam exhibited a similar profile of mild minor side-effects, but more patients suffered moderate to severe reactions to dothiepin, leading to a greater drop-out rate in the dothiepin-treated group. It is concluded that, as both treatments produced equally satisfactory responses in this study, alprazolam should be considered for the treatment of anxiety associated with depression in patients for whom tricyclic antidepressant drugs are either contra-indicated or poorly tolerated. PMID- 3310020 TI - A 6-month, double-blind study comparing nabumetone to naproxen in the treatment of osteoarthritis. AB - A 6-month, double-blind, controlled, randomized, parallel study was performed to compare the efficacy and tolerance of nabumetone (1000 mg at bedtime) with naproxen (250 mg twice daily) in the treatment of osteoarthritis. Five efficacy parameters were evaluated: patient's assessment of overall osteoarthritis activity and pain, physician's assessment of overall osteoarthritis activity and pain, and physician's assessment of pain with respect to a defined activity. All 40 patients entered (20 in each group) were available for evaluation of tolerance and 36 patients for efficacy analysis (18 in each group). The efficacy results revealed significant improvement in all five parameters for each medication except measurement of pain with respect to a defined activity for naproxen (p less than 0.07). The frequency of possible or probable drug-related adverse experiences was high for both drugs. However, only 1 patient left the study because of a probable drug-related adverse experience (abdominal pain in a nabumetone patient). Six nabumetone and 4 naproxen patients dropped out of the study because of lack of efficacy. The results indicate that nabumetone and naproxen have comparable efficacy and tolerance at the dosage used, and suggest that a single night-time dosage of nabumetone may be a convenient and useful treatment for osteoarthritis. PMID- 3310021 TI - Characterization of motor activity patterns induced by N-methyl-D-aspartate antagonists in gerbils. AB - A computerized motor activity data collection and analysis system is described. An example of the utilization of the Digiscan system is provided, in which motor activity patterns induced by three N-methyl-D-aspartate (NMDA) antagonists and the dissociative anesthetic, ketamine, are compared. All of these compounds produce a distinct pattern of motor activity characterized by an increase in distance traveled, movement time, speed and perimeter walking, with a decrease in vertical activity. Recently described links between NMDA and phencyclidine (PCP) binding sites may account for these findings. The utility of computerized motor activity apparatus is clearly demonstrated. PMID- 3310022 TI - Norepinephrine release from PVN and lateral hypothalamus during perfusion with 2 DG or insulin in the sated and fasted rat. AB - Both insulin and 2-deoxy-D-glucose (2-DG) when given systemically to the rat modify the activity of noradrenergic systems in different regions of the animal's hypothalamus. The purpose of the present investigation was to ascertain whether the nutritional status of the animal would serve to influence the pattern of efflux of norepinephrine (NE) from sites in the hypothalamus perfused with either 2-DG or insulin. Permanent guide cannulae were first implanted stereotaxically above the paraventricular nucleus (PVN) or lateral hypothalamus (LH). Following recovery from surgery, each rat was either satiated with food or deprived of food for 20-22 hr with water always freely available. Then 0.1 microCi of [3H]-NE was micro-injected into the intended site of perfusion in a volume of 1.0 microliter. After 15 min had elapsed, the site was perfused repeatedly with an artificial CSF at a rate of 20 microliters/min. At the mid-point of successive 5.0 min perfusions, either 10 micrograms/microliter 2-DG or 4.0 mU/microliters porcine insulin was incorporated into the CSF perfusate. Thereafter, an additional set of 3-4 samples of perfusate was collected. When perfused in the PVN of the satiated rat, 2-DG significantly enhanced the efflux of [3H]-NE, whereas in the fasted animal insulin tended to suppress the output of the catecholamine. Conversely, at sites of perfusion in the LH, insulin evoked the release of [3H]-NE when the rat was fasted, whereas 2-DG tended to induce mixed effects on the release of [3H]-NE under both sated and fasted conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310023 TI - Barrel rotation in rats induced by intracerebroventricular bradykinin antagonists. AB - Intracerebroventricular (ICV) administration of bradykinin (BK) analogs containing the substitution DPhe7 produced extreme postural distortions within 2 4 min after injection, eventually causing rats to spin repeatedly around their longitudinal axis. This behavior, called barrel rotation, has been previously reported following ICV administration of several other neuropeptides. Episodes lasted 5-20 min; two deaths occurred at high doses, but no other long-term effects were observed. The quantal ED50 of the prototype compound B4162 (DArg0, Thi5,8 DPhe7BK), was 14.9 nmole; all seven other DPhe7 analogs tested elicited a positive response at 20 nmole. Among analogs not containing DPhe7, only BK elicited any activity (20% response rate), and only at 100 nmoles. Structure activity considerations indicate that this behavior is not mediated by classical kinin receptors. The response rate to 20 nmole B4162 (81%) did not significantly change after pretreatment with ICV BK (100 nmoles), or IP atropine, haloperidol or phenytoin; whereas pretreatment with ICV captopril and muscimol and IP naloxone, diazepam and phenobarbital all significantly inhibited the response. A GABAergic mechanism may be involved in this peptide behavior. PMID- 3310024 TI - Phenylpropanolamine decreases food intake in rats made hyperphagic by various stimuli. AB - Phenylpropanolamine (PPA, d,l-norephedrine), found in many over-the-counter appetite suppressants and nasal decongestants, induces anorexia by a yet unidentified mechanism. The present study evaluates the effects of PPA on different types of non-drug- and drug-induced hyperphagias (i.e., food deprivation, 2-deoxy glucose, ketocyclazocine and insulin). Phenylpropanolamine (15, 25 and 35 mg/kg IP) significantly reduced food intake in a dose-related fashion at the 1 hr and 3 hr time intervals in the food deprivation-, insulin- and 2-deoxy glucose-induced hyperphagic models. Phenylpropanolamine produced a non-dose-related 99% reduction of food intake in the ketocyclazocine-induced model at the 1 and 3 hr measurement, which was most likely due to a combination of the appetite suppressant activity of PPA and the sedation produced by ketocyclazocine in combination with PPA. We conclude that PPA is capable of suppressing appetite in rats made hyperphagic by various stimuli. PMID- 3310025 TI - Vegetable proteins as drugs. PMID- 3310026 TI - Atherosclerosis risk factors. PMID- 3310027 TI - Metabolism of the arterial wall--influence of atherosclerosis and drugs. PMID- 3310028 TI - Photoaffinity labeling of muscarinic receptors. PMID- 3310029 TI - Ranitidine drug interactions--a literature review. PMID- 3310030 TI - Pharmacology of new tropan derivatives. PMID- 3310031 TI - Photoaffinity labelling of nucleoside transporter polypeptides. PMID- 3310032 TI - Oxytocin and vasopressin: photoaffinity labeling of neurophysins, secretory granule hormone-binding proteins. PMID- 3310033 TI - Inhibitors of protein glycosylation and glycoprotein processing in viral systems. PMID- 3310034 TI - Photoaffinity labelling of the adenosine nucleotide transporter of cholinergic vesicles. PMID- 3310035 TI - Selenium effects on drug and foreign compound toxicity. PMID- 3310036 TI - Photoaffinity labeling of thyroid hormone receptors. AB - Photoaffinity label probes of iodothyronines can interact with nuclear receptors in intact cells and in solubilized receptor preparations. These probes have certain advantages over a chemical affinity label in analyzing receptor structure. First, a photoaffinity label probe covalently cross-links only after photoactivation. Therefore, it is possible to demonstrate with appropriate competitive inhibition studies that the photoaffinity label probe associates with the receptor in question. Secondly, since cross-linking only occurs after photolysis, it is possible to adjust the concentration of the photoaffinity label to maximize association with "specific" binding sites relative to "non-specific" associations prior to covalent linkage by photoactivation. The different [125I]iodothyronine-PAL analogues may be useful as probes of the thyroid hormone receptor binding domain since PAL compounds with different affinities for receptor may photocouple to different receptor residues within or proximate to the hormone binding region. These probes may also be useful as an adjunct to receptor purification and in probing the organization of the receptor in chromatin. Lastly, they may provide insights into possible alterations of receptor structure in patients with partial end organ resistance to thyroid hormone (Refetoff et al., 1967; Eil et al., 1982). PMID- 3310037 TI - Photoaffinity labelling of N-formyl peptide receptors. PMID- 3310038 TI - Photoaffinity labelling of angiotensin receptors: functional studies on responding tissues. PMID- 3310039 TI - Clinical pharmacology of non-steroidal anti-inflammatory drugs. PMID- 3310040 TI - Ethanol and minerals. PMID- 3310041 TI - Occurrence and treatment of solvent abuse in children and adolescents. PMID- 3310042 TI - Metabolism of hydrazine anti-cancer agents. PMID- 3310043 TI - Drug metabolism in pregnancy, infancy and childhood. PMID- 3310044 TI - Ethanol metabolism. AB - Alcohol is metabolized by two pathways in humans: the ADH pathway which accounts for the bulk of the metabolism, and the MEOS pathway which contributes to the increased rate of ethanol elimination at high blood alcohol levels. The increased rate of elimination which results from chronic alcohol consumption is due to an increase in MEOS activity. The activities of these pathways are influenced by environmental factors such as smoking, diet, and endocrine factors. In addition, individuals inherit different types of ADH isoenzymes which have different kinetic properties. Individuals with different phenotypic variants, e.g. the beta 1 vs beta 2 isoenzymes, appear to have different rates of ethanol elimination. The cloning of the ADH genes and the availability of molecular hybridization methods now make it possible to genotype individuals and to correlate the genotype with both alcohol elimination rates and with the risk of developing medical complications of alcoholism or even of developing alcoholism itself. PMID- 3310046 TI - Serum enzymes of drug metabolism. PMID- 3310047 TI - Peter Irving (1771-1828): physician, litterateur, and Burrite polemist. PMID- 3310045 TI - Psoralens and related compounds in the treatment of psoriasis. AB - PUVA therapy has radically altered the management of severe psoriasis. It is of greatest benefit in those patients with extensive involvement, and in those unresponsive to conventional therapy. The long term side effects of PUVA currently limit its use to patients with disabling disease. The full extent of long term side effects has yet to be defined. In order to reduce the toxicity and improve the efficacy of PUVA, a better understanding of the molecular aspects of psoralen-DNA interaction, DNA repair, and mutagenesis is required. The action spectrum of PUVA in clearing psoriasis has yet to be defined. By limiting the spectrum of UVA exposure it may be possible to reduce some of the toxic effects of PUVA. The recent advances in the formulation of 8-MOP preparations has yielded a drug with more predictable pharmacokinetics and clinical response. Further research with newer psoralens may produce more effective and less toxic compounds. In the last ten years, PUVA has been both a valuable addition to dermatologists' clinical armamentarium and a useful tool in increasing our understanding of cellular biology and the interaction between ultraviolet radiation and biologic systems. PMID- 3310048 TI - The summer of '44: experiences with the Twelfth General Hospital (U.S.). PMID- 3310049 TI - A lesson on ephemeral nodes and equanimity. PMID- 3310050 TI - A history of lobotomy in the United States. PMID- 3310051 TI - Use of high voltage pulsed galvanic stimulation for patients with levator ani syndrome. AB - Levator ani syndrome is characterized by brief, intermittent pain and discomfort in the perirectal or rectal region that can be aggravated by sitting. Physical therapists are beginning to receive referrals for pain reduction in this patient population. The purpose of the study was to examine the use of high voltage pulsed galvanic stimulation (HVPGS) for reducing symptoms in patients with levator ani syndrome. A descriptive research design was used. Treatment consisted of one hour of HVPGS at a frequency of 120 Hz and at an intensity to the patient's maximum tolerance applied through a rectal probe. Results on 28 patients indicate that 50% had pain or symptom relief, or both, after an average of eight treatments. Those patients who were unresponsive to treatment had a primary diagnosis of irritable colon or were postsurgical. We are continuing to examine this treatment and will conduct follow-up examinations on those patients who obtained pain relief. Based on these preliminary results, we believe that HVPGS is an effective treatment for selected patients in this population. PMID- 3310052 TI - Diabetic plantar ulcers treated by total contact casting. A clinical report. AB - The purpose of this clinical report is to describe the healing times of plantar ulcers treated by total contact casting (TCC) in nondiabetic and diabetic patients with and without evidence of severe peripheral vascular disease. Thirty patients with 33 chronic plantar ulcers were treated by applying total contact walking casts. Results demonstrate that 27 of 33 ulcers (81.8%) healed in an average time of 43.6 days. Healing times of patients with severe peripheral vascular disease secondary to diabetes mellitus are similar to those of patients without evidence of vascular disease. These results indicate that TCC is an effective and rapid treatment for chronic plantar ulcers in patients with or without vascular compromise secondary to diabetes mellitus. In addition, the results suggest that pressure reduction on the insensitive foot should be considered in treatment. PMID- 3310053 TI - Removal of the vomeronasal organ disrupts the activation of reproduction in female voles. AB - The reproductive system of female prairie voles remains quiescent in the absence of stimulation from males; however, chemosignals from males are capable of at least partially activating female reproduction. In other species, the vomeronasal system mediates some of the reproductive responses of females to males. We found that surgical removal of the vomeronasal organ (VNX) from adult female prairie voles impeded reproductive activation in response to pairing with stud males: ovarian and uterine weights of VNX females paired with stud males for 24 or 60 hours were significantly less than those of normal (NORMAL) or sham-operated (SHAM) females. Furthermore, 8 of 9 NORMAL, 10 of 13 SHAM, but only 4 of 9 VNX females paired with stud males for 60 hours mated. VNX females, however, were still able to use chemosensory cues to locate food. Behavioral observations of females encountering stud males were similar for VNX, SHAM and NORMAL females. We conclude that vomeronasal chemoreception may be a primary component of reproductive activation in female prairie voles, presumably by mediating neuroendocrine responses to chemosignals. PMID- 3310055 TI - Composite autologous-allogeneic skin replacement: development and clinical application. AB - A major unsolved problem in skin restoration in severe burns is replacement of lost dermis. We report the development and clinical application of a composite grafting technique in which allogeneic skin is the source of dermis, and cultured autologous keratinocytes generate epidermis. Excised burn wounds are resurfaced with unmatched allograft. Immunosuppression from the burn and reduced immunoreactivity of the allograft permit successful allograft engraftment. Keratinocyte cultures are initiated from the patient. Allogeneic epidermis is removed, and the dermal bed is resurfaced with keratinocyte cultures. The allogeneic dermis promotes rapid (less than 7 days) stratification, maturation, and integration of the cultures and the synthesis of anchoring fibrils. One case followed 11 months has shown no evidence of rejection. We reason that removal of the epidermis from allograft eliminates the majority of cells constitutively expressing alloclass II antigens, leaving behind a viable allogeneic dermal bed that serves as an ideal substrate for engraftment and integration of keratinocyte cultures but does not initiate rejection. PMID- 3310054 TI - Effects of restraint and water-immersion stress and insulin on gastric acid secretion in rats. AB - Effects of restraint and water-immersion stress (RWIS) and of insulin injection on gastric acid secretion were investigated in relation to blood glucose levels and to brain glucose uptake in rats. Venous blood glucose levels (VBG) were significantly increased while arterial blood glucose level (ABG) was slightly increased by RWIS. In contrast, ABG and VBG were significantly decreased by administration of insulin; the decrease in ABG was greater than that in VBG. Glucose uptake into the brain, calculated from the ABG-VBG, was significantly decreased both by RWIS loading and by insulin administration. The uptake of [14C] 2-deoxy-D-glucose [( 14C]-2DG) into the brain was also significantly decreased in RWIS-loaded or insulin-treated rats. Gastric acid output was significantly increased both by RWIS loading and by insulin administration. The increased acid output paralleled the decrease of glucose uptake into the brain in RWIS-loaded and insulin-treated rats. Results suggest that RWIS-induced gastric acid secretion is regulated by brain glucose uptake and that this gastric acid secretion is a hypothalamic neuron-mediated event as is insulin-stimulated gastric acid secretion. PMID- 3310056 TI - Skin grafting of pyoderma gangrenosum lesions. PMID- 3310057 TI - Skin marking for the forehead flap. PMID- 3310059 TI - Parental alcoholism and childhood psychopathology. PMID- 3310058 TI - Treatment of antisocial behavior in children: current status and future directions. PMID- 3310060 TI - Carbohydrates, tryptophan, and behavior: a methodological review. PMID- 3310061 TI - The dexamethasone suppression test in healthy controls. AB - We have summarized the results of 53 studies which examined the dexamethasone suppression test in normal controls. Only 3.6% of 687 0800 hr postdexamethasone cortisol levels were above 5 micrograms/dl. Corresponding figures for 1600 hr and 2300 hr cortisol levels were 7.4% (85/1144) and 6.3% (28/434), respectively. Neither the type of assay (competitive protein binding or radioimmunoassay) nor mean/median age of the subjects was associated with non-suppression rates. PMID- 3310062 TI - [Metaphors of medical psychology]. PMID- 3310063 TI - Hypothalamic-pituitary-adrenocortical suppression and recovery in renal transplant patients returning to maintenance dialysis. AB - Sixty-six per cent of a group of 21 renal transplant recipients with chronic renal failure were shown to have adrenal suppression due to glucocorticoid treatment. Gradual withdrawal of steroids in these patients returning to maintenance dialysis therapy was achieved with few symptoms of hypoadrenalism. Adrenal recovery occurred in 52 per cent of patients after three months and 71 per cent after six months. However, the plasma cortisol response to insulin induced hypoglycaemia, studied in patients in whom adrenal recovery had been demonstrated, was impaired in 46 per cent of cases. These results indicate that corticosteroids in renal transplant recipients induce profound hypothalamic pituitary-adrenal suppression which is slow to recover. Such patients returning to maintenance dialysis are at risk of acute adrenocortical insufficiency for several months. Although withdrawal of steroids can be achieved safely, cover during periods of stress should be given until the hypothalamic-pituitary-adrenal axis has been shown to respond normally. PMID- 3310064 TI - Biliary cholesterol--friend or foe? AB - It has hitherto been assumed that the cholesterol in bile simply represents an excretory mechanism for cholesterol surplus to bodily requirements. However, recent evidence suggests that this is not the case and that biliary cholesterol has other functions. The functions consist of a mucosal protective effect against the toxic action of bile-salts and also a role in regulating dietary cholesterol absorption. Biliary cholesterol is clearly more than just an excretory substance and serves other important physiological roles. PMID- 3310065 TI - Diet, obesity and hypertension: an hypothesis involving insulin, the sympathetic nervous system, and adaptive thermogenesis. PMID- 3310066 TI - Plasmodium falciparum infection: problems in prophylaxis and treatment in 1986. PMID- 3310067 TI - Outcome of pregnancy in insulin-dependent (type 1) diabetic women between 1971 and 1984. AB - We have looked at the outcome of pregnancy in women with type 1 (insulin dependent) diabetes mellitus who were confined at Glasgow Royal Maternity Hospital between 1971 and 1984. Of 134 pregnancies, 123 proceeded beyond 28 weeks' gestation and yielded 125 live infants. The perinatal mortality rate was 16/1000, due solely to congenital foetal malformation. Malformations were not related either to the severity of maternal diabetes (as graded by the White classification) or the glycaemic control in the first trimester (as judged by maternal glycosylated haemoglobin concentration). Over the period of study, there has been a marked reduction in the frequency of ketoacidosis during pregnancy and in the delivery of small-for-dates babies; more mature lecithin:sphingomyelin ratios have been obtained by amniocentesis; and better Apgar scores have been demonstrated in the infants at delivery. The Caesarean section rate has fallen from 83 to 30 per cent, and babies now spend less time separated from their mothers in paediatric units. These improvements largely reflect better diabetic treatment (improved insulin regimens and glycaemic control) and closer obstetric assessment. Foetal malformation occurred overall in 11.4 per cent of pregnancies and did not become less frequent over the period of study. Further major improvement in the outcome of diabetic pregnancy will only come from a reduction in the congenital malformation rate, which implies better diabetic control at and around the time of conception. PMID- 3310068 TI - Amiodarone and the thyroid. PMID- 3310069 TI - Evidence that lowering serum lipids favourably influences coronary heart disease. PMID- 3310070 TI - Asbestos-induced diseases: clinical perspectives. PMID- 3310071 TI - The changing face of asthma. PMID- 3310072 TI - The haemolytic uraemic syndrome: a review. PMID- 3310073 TI - Pathogenesis of acute porphyria. AB - The pathogenesis of the clinical manifestations of acute porphyria has been considered in the light of their pathological changes and their aberrations of the haem biosynthetic pathway. These manifestations may be explained almost entirely upon a neurogenic basis. A number of hypotheses have been considered to explain the clinical, pathological and biochemical features. Of these hypotheses two seem more impressive: (i) the neurological manifestations may be explained by a deficiency of haem in neural tissues; (ii) the porphyrin precursor 5 aminolaevulinic acid (ALA) may have in addition specific pharmacological activity. PMID- 3310074 TI - An analysis of community and hospital-acquired bacteraemia in a large teaching hospital in the United Kingdom. AB - A total of 875 episodes of bacteraemia and fungaemia were analysed in patients admitted to University Hospital, Nottingham, and three smaller hospitals over a four-year period. In 814 episodes (93 per cent) a single organism was isolated, most commonly Escherichia coli (27.4 per cent), other enterobacteria (14.4 per cent), Staphylococcus aureus (11.2 per cent), Streptococcus pneumoniae (9.0 per cent), or Haemophilus influenzae (6.4 per cent). In 61 cases (7.0 per cent) bacteraemia was due to two or more species. In almost 60 per cent of cases, bacteraemia was considered to be community-acquired. The most common sources were the urinary (26.9 per cent), respiratory (14.6 per cent), gastrointestinal (11.6 per cent) and biliary (9.5 per cent) tracts, but in almost 10 per cent of cases the focus of infection was unknown. Polymicrobial bacteraemia was common when the biliary tract was the focus of infection. Shock was recorded in 19.5 per cent of cases, and was commoner in polymicrobial (42.9 per cent) than in monomicrobial (17.4 per cent) episodes. In monomicrobial episodes haemolytic streptococci were associated with the highest incidence of shock (30.0 per cent). Mortality directly related to bacteraemia (19.5 per cent) was higher with Gram-positive (23.5 per cent) than with Gram-negative (15.8 per cent) organisms; in polymicrobial (31.1 per cent) than in monomicrobial episodes (18.7 per cent); and in those who had multiple episodes (34.7 per cent) than in those who had a single episode of bacteraemia (20.3 per cent). Other factors influencing mortality included shock, failure to mount an adequate febrile response, leucopenia or granulocytopenia, and underlying disease. Mortality was markedly reduced by appropriate treatment; a single antimicrobial agent was as effective as combination therapy in bacteraemia caused by Gram-negative bacilli. PMID- 3310075 TI - Continuous ambulatory peritoneal dialysis (CAPD)--ten years on. PMID- 3310077 TI - Distance geometry and related methods for protein structure determination from NMR data. AB - Computational tools have been developed in the last few years, to allow a direct determination of protein structures from NMR data. Numerical calculations with simulated and experimental NMR constraints for distances and torsional angles show that data sets available with present NMR techniques carry enough information to determine reliably the global fold of a small protein. The maximum size of a protein for which the direct method can be applied is not limited by the computational tools but rather by the resolution of the two-dimensional spectra. A general estimate of the maximum size would be a molecular weight of about 10,000 (Markley et al. 1984), but parts of larger proteins might be accessible with the method. Effort for improvement of the NMR structures should be concentrated more on the local conformation rather than the global features. The r.m.s. D values for variations of the polypeptide backbone fold are on the order of 1.5-2 A for several of the studied proteins, indicating that the global structure is well determined by the present NMR data and their interpretation. The local structures are sometimes rather poor, with standard deviations for the backbone torsion angles of about 50 degrees. Possible improvements would be stereospecific resonance assignments of individual methylene protons and individual assignments of the methyl groups of the branched side-chains. Accurate estimates of the short-range NOE distance constraints by calibrating the distance constraints, including segmental flexibility effects, and combined use of distance geometry, energy minimization and molecular dynamics calculations, are further tools for improving the structures. PMID- 3310076 TI - Hepatic sarcoidosis with portal hypertension. A report of seven cases with a review of the literature. AB - We have reviewed the clinical, histological and hemodynamic features of sarcoidosis complicated by portal hypertension in seven patients and in 40 previously reported cases. Young black patients of either sex and white females over 40 years were selectively affected. In 12 of these 47 patients, portal hypertension appeared to be a consequence of cirrhosis due to longstanding intrahepatic cholestasis; in white patients, this condition was clinically, histologically, and serologically indistinguishable from primary biliary cirrhosis. In most of the other patients, portal hypertension was the predominant and often the presenting symptom of hepatic sarcoidosis; in these patients portal hypertension was due to a presinusoidal block probably determined by portal granulomas, with or without superimposed sinusoidal block determined by fibrosis. Corticosteroids did not prevent the development of portal hypertension. PMID- 3310078 TI - NMR studies of kinetics in cells and tissues. PMID- 3310079 TI - Methodology of magnetic resonance imaging. PMID- 3310080 TI - Medical applications of nuclear magnetic resonance imaging. PMID- 3310081 TI - [Possible applications and results of studies of probe technics in coronary disease]. PMID- 3310082 TI - [Radiocardiographic probe technics in the hemodynamic follow-up of long-term antihypertensive therapy]. PMID- 3310083 TI - [Hyperfractionated radiotherapy of early vocal cord cancer--adverse radiogenic reactions]. PMID- 3310085 TI - [Value of noninvasive diagnostic procedures in the classification of penile plastic induration]. PMID- 3310086 TI - [Clinical staging of malignant tumors by the TNM system. Contribution of modern imaging procedures in patients with testicular tumors]. AB - For classification of testicular tumors in the TNM-System several modern imaging methods are available: sonography, conventional radiography, lymphography, computer-tomography, nuclear magnetic resonance and scintigraphy. Sonography- usually the first method to be used for reasonable classification--is significantly inferior to lymphography and CT for N and M staging. It remains to be seen if the NMR-methods will reach the good informative standard of CT. Only in the case of extensive lymphatic metastasis (bulky disease) are i.v. pyelogram and cavography still used to verify displacement of the ureter or infiltration of the tumor into the cava. In the nuclear medical field bone scintigraphy plays the main role for testicular tumor metastases. PMID- 3310087 TI - [Clinical staging of malignant tumors of the head and neck region by the TNM system: contribution of modern imaging procedures]. AB - Currently, the method of choice for evaluation of head and neck cancers is CT, because in many respects it is superior to the other imaging modalities except for MR. For parotid tumors, however, histological grading is of major importance. The staging of tumors of the hypopharynx and larynx can be done just as reliably by CT and microlaryngoscopy; the latter has the advantage of including biopsy. Ultrasound is of primary value in providing information on metastases to the cervical lymph nodes. If CT is used for staging of the primary tumor or planning radiation therapy, then it also can be utilized for the detection of lymphatic spread. PMID- 3310084 TI - [Intestinal invagination and ultrasound tomography]. PMID- 3310088 TI - [Clinical staging of malignant tumors of the digestive system by the TNM system]. AB - Computed tomography has decisively improved the determination of the clinical stage of tumors of the esophagus- and rectum. This method enables tumors to be diagnosed and localized as well as the extend of tumor spread to adjacent organs and metastatic lymph node involvement to be evaluated in most cases without additional invasive imaging procedures. CT is rarely used for tumors of the stomach, small bowel and colon. PMID- 3310089 TI - [Clinical staging of malignant lung and bronchial tumors]. AB - The use of computed tomography for staging lung cancer is still under discussion. With reference to the literature, a comparison is made between the established conventional X-ray examinations, computed tomography and mediastinoscopy. Computed tomography is a useful non-invasive staging method for pretreatment classification of the primary tumour, the regional lymph node, and distant metastasis. The limitations of this method for staging lung cancer are outlined. PMID- 3310090 TI - [Clinical staging of malignant lymphoma]. AB - The clinical staging of malignant lymphomas not only includes histopathological classification but also non-invasive methods for assessing the stage and prognosis. In contrast to the TNM system of staging malignant epithelial tumors, in lymphomas the size is unimportant. Comparison is made between the invasive methods of staging Hodgkin's disease and Non-Hodgkin's lymphomas (splenectomy, laparotomy) and the non-invasive clinical radiological investigations (conventional X-rays, lymphography, sonography, CT, MR) and their statistical reliability. Whereas positive results in clinical staging are diagnostic, a negative result requires further correlation. A phased program for clinical staging is offered. PMID- 3310091 TI - Mammographic dual-screen-dual-emulsion-film combination: visibility of simulated microcalcifications and effect on image contrast. AB - Three test objects simulating different mammographic problems were imaged with a new low-dose dual-screen-dual-emulsion-film combination and a standard screen film combination, with and without a moving grid, at 28 and 32 kVp, and with 0.3- and 0.5-mm focal spots. The new combination reduced exposure by 50%, but it failed to equal the other combination in the depiction of simulated microcalcifications, even when a different brand of film-processing chemicals was used. Compared with the standard screen-film combination exposed without a grid, the new combination exposed with a grid resulted in a superior image of dense parenchyma without an increase in dose. Furthermore, when the exposure time was decreased by 25% (rather than 50%), dense breasts were imaged with greater penetration by the new combination. A clinical trial of the new combination in 200 patients showed prominent quantum mottle and reduced contrast in regions of dense parenchyma. In addition, the skin and subcutaneous tissue were often poorly depicted with both standard and high-intensity illumination. PMID- 3310092 TI - Nonsurgical repositioning of central venous catheters. AB - Long-term central venous catheters are placed for total parenteral nutrition and/or chemotherapy. These catheters are placed surgically and fixed to the subcutaneous tissues. Complications include infection, venous thrombosis, and mechanical problems. The authors developed a method to percutaneously reposition displaced central venous catheters. The procedure is performed with fluoroscopy and modified angiographic techniques. Fifteen patients underwent a total of 17 procedures. The initial success rate was 76%; the final success rate was 88%. Many central venous catheters can be salvaged with this low-morbidity procedure, which negates the need for surgical intervention. PMID- 3310093 TI - The Radiological Society of North America: the early years. PMID- 3310094 TI - Hepatic metastases: randomized, controlled comparison of detection with MR imaging and CT. AB - To determine the accuracy of magnetic resonance (MR) imaging relative to computed tomography (CT) in the diagnosis of liver metastases, a randomized, controlled study was conducted of 135 subjects, including 57 with cancer metastatic to the liver, 27 with benign cysts or hemangiomas, and 51 without focal liver disease. The sensitivity of MR imaging for detecting individual metastatic deposits was 64%, significantly greater than 51% for CT (P less than .001); the difference in sensitivity for identifying patients with one or more hepatic metastases was less (82% for MR imaging vs. 80% for CT). In patients without hepatic metastases, the specificity of MR imaging was 99% versus 94% for CT. Significant differences were found between individual MR pulse sequences in detection of individual lesions. The sensitivity of both T1-weighted spin-echo (SE) (64%) and inversion-recovery (IR) (65%) pulse sequences was significantly (P less than .001) greater than either the TE (echo time) 60 msec (43%) or TE 120 msec (43%) T2-weighted pulse sequences. Overall, the accuracy of a single T1-weighted (10-minute) pulse sequence was superior to that of contrast-enhanced CT. PMID- 3310095 TI - Retained surgical sponges: CT and US appearance. AB - The computed tomographic (CT) and ultrasonographic (US) appearances of retained surgical sponges are described. In each case, the presence of a sponge was confirmed at repeat operation. CT examinations were performed in nine patients. In six cases, a low-density mass was demonstrated; in two cases, a complex mass with areas of both low and medium density was seen. The remaining case was a high density mass. After intravenous administration of contrast material, dense and prolonged enhancement of the rim of the mass was noted in five of eight cases. Calcification was found in four cases, and spongiform gas in one. US performed in six patients revealed an echogenic area with strong acoustic shadowing in three cases and a complex mass, a hypoechoic mass, and a cystic mass with irregular internal echoes in one case each. Granuloma caused by a retained surgical sponge should be considered as a cause of an abdominal mass in patients with a history of prior abdominal surgery. PMID- 3310096 TI - Cirrhosis: US images with narrow band filtering. AB - A new type of ultrasound (US) image was created by first recording unfiltered, backscattered ultrasonic amplitudes to a standard dynamic range prior to narrow band digital filtration of the ultrasonic signal and mapping of the resultant filtered ultrasonic envelope amplitudes. Unlike unfiltered images, those created by narrow band digital filtration permit differentiation between phantoms with different scattering characteristics and normal from cirrhotic human liver in vivo. Significantly different image statistics for normal and cirrhotic liver (P less than .002) were demonstrated in preliminary clinical trials. PMID- 3310097 TI - The role of radiology in extracorporeal shock wave therapy. AB - Extracorporeal shock wave lithotripsy was used for the treatment of 1,252 kidneys and ureters with calculi during a 10-month period at the authors' medical center. Before lithotripsy was performed, excretory urography, radiography, renography, computed tomography, and ultrasound studies were done, when necessary, to locate the calculi. Nine calculi in five kidneys could not be fragmented with lithotripsy. Of 895 patients with calculi less than 2.5 cm in diameter, only 13 (1.5%) required interventional procedures to clear the calculi, whereas of 161 patients with calculi greater than or equal to 2.5 cm, 36 (22.4%) required nephrostomies. A column of calculous debris in the mid and distal portions of the ureter (steinstrasse) was seen in 171 instances (13.6%) after lithotripsy; 62% required interventions. The most common intervention required for successful lithotripsy was retrograde ureteral catheterization. Evaluation and treatment of patients with urolithiasis were largely dependent on radiography and excretory urography. PMID- 3310098 TI - Twin gestations: monitoring of complications and anomalies with US. AB - An evaluation of 227 consecutive twin gestations was undertaken to assess the role of ultrasound (US) in the diagnosis of major obstetric complications and congenital anomalies. US accurately depicted the growth and development of fetuses in 65 patients with underlying maternal disorders that produced additional risks to the pregnancy. Complications such as malpresentations (104 cases), polyhydramnios (15 cases), oligohydramnios (five cases), and uterine myomas (seven of 11 cases) were demonstrated prenatally with US. Fetal anomalies included anencephaly (two cases), hydrocephalus (two cases), conjoined twins (three cases), twin-twin transfusion syndrome (five cases), and acardiac monsters (two cases). Demise of one twin in 20 gestations and demise of both twins in 18 gestations (overall mortality of 17%) were correctly identified with US. These 38 gestations included intrauterine demise in 12, spontaneous abortion in 13, and neonatal deaths in 13. Therefore, when multiple gestations are suspected clinically, serial real-time US scans should be obtained beginning in the first trimester. PMID- 3310100 TI - Second-trimester polyhydramnios: evaluation with US. AB - The sonograms of 40 patients with second-trimester polyhydramnios were reviewed to determine (a) whether fetal and maternal conditions occur as often during second-trimester polyhydramnios as during third-trimester polyhydramnios, (b) the frequency of persistence of polyhydramnios into the third trimester, and (c) how sonography can help in maternal and fetal management. Second-trimester polyhydramnios often (62%) persisted into the third trimester. The frequencies of maternal (25%) and fetal (12%) conditions were similar to those previously reported for third-trimester polyhydramnios. Fetal anomalies were always identified on the sonogram that initially demonstrated polyhydramnios. Fetal outcome was excellent in the nondiabetic patient with polyhydramnios in whom no fetal abnormalities were detected on sonograms. In polyhydramnios associated with maternal diabetes mellitus, however, the pregnancy was often (71%) complicated by premature labor or macrosomia. In such patients serial sonographic follow-up is indicated. PMID- 3310099 TI - Use of furosemide in pregnancies complicated by oligohydramnios. AB - To differentiate pregnancies complicated by oligohydramnios due to intrauterine growth retardation from those due to renal agenesis, the authors administered furosemide intravenously to eight pregnant women (19-25 weeks gestation) with oligohydramnios. The fetal abdomen was scanned with ultrasound to demonstrate the fetal urinary bladder. In six fetuses, sonography failed to demonstrate the bladder: two fetuses had growth retardation with normal kidneys and bladder, and four had renal anomalies. It is concluded that administration of furosemide to the mother fails to induce diuresis in growth-retarded fetuses of 19-23 weeks gestation and that failure to see the fetal bladder after furosemide administration does not necessarily indicate absent fetal kidneys. PMID- 3310101 TI - Low-level echogenicity in intraventricular hemorrhage versus ventriculitis. AB - Serial cranial sonograms of 55 neonates with large perinatal intraventricular/intraparenchymal hemorrhages and moderate-to-severe posthemorrhagic hydrocephalus were reviewed. In all 55 patients, the ventricles were initially enlarged and filled with anechoic cerebrospinal fluid, which contained discrete hyperechoic fragments of hematoma. Between 7 and 25 days after the initial hemorrhagic episode, however, diffuse, low-level echogenicity appeared in the ventricles of 34 patients. The low-level echogenicity was transient and persisted for 7-59 days (average, 18 days). In 32 patients, low level echogenicity was a benign finding associated with prior intraventricular hemorrhage. In two patients, the low-level echogenicity was associated with ventriculitis. Low-level echogenicity appeared, increased, then cleared, but reappeared with the onset of ventriculitis in these two patients. Thickening of the ependyma and abnormal periventricular echogenicity, signs of inflammation, were also present. Although low-level echogenicity may commonly be a benign finding, the possibility of ventriculitis should not be ignored. PMID- 3310102 TI - Isoforms of contractile proteins. PMID- 3310104 TI - Research and potential clinical applications of retroviral vectors. PMID- 3310103 TI - Computer studies of interactions between macromolecules. PMID- 3310105 TI - The host response to African swine fever virus. PMID- 3310106 TI - Live attenuated influenza vaccines. PMID- 3310107 TI - Recent progress in the development of new antidepressant drugs. PMID- 3310108 TI - Chemical and biological aspects of sparsomycin, an antibiotic from Streptomyces. PMID- 3310110 TI - [Genes encoding T cell antigen receptor]. PMID- 3310109 TI - [Antigen recognition by T cell]. PMID- 3310111 TI - [Tumor necrosis factor]. PMID- 3310112 TI - [An unusual translation pattern of genetic codes: the context effect on nonsense codon expression]. PMID- 3310113 TI - [Transcriptional regulation by the nuclear oncogene products]. PMID- 3310114 TI - [A high molecular weight-multifunctional protease]. PMID- 3310115 TI - [Detection of target gene, or its transcript using oligodeoxynucleotide hybridization probes]. PMID- 3310116 TI - [Tissue compliance measuring device]. PMID- 3310117 TI - [Clinical evaluation of the therapeutic results after framework denture use]. PMID- 3310118 TI - [Comparative studies of the effect of various temperatures during heating of cast dies on the structure and elasticity of chromium-cobalt alloys]. PMID- 3310119 TI - [Analysis of the posterior seal of complete upper denture]. PMID- 3310120 TI - [Prognosis of prosthetic treatment in relation to the anatomical-physiological conditions of the edentulous mouth]. PMID- 3310121 TI - [Factors affecting pronunciation in patients treated with complete dentures]. PMID- 3310122 TI - [The height of posterior seal borders formed on upper complete dentures by impression materials of varying plasticity]. PMID- 3310123 TI - [Our modification of a technic of preparing crown-root inlays]. PMID- 3310125 TI - [Comparison of the results of ultrasonographic examination and cholecystography and changes found during the surgical treatment of cholelithiasis]. PMID- 3310126 TI - [Mechanisms activating and inhibiting the fibrinolysis system]. PMID- 3310124 TI - [A trial of analysis of the bone remains of the temporomandibular joint of humans living near Tarnobrzeg 3000 years ago]. PMID- 3310127 TI - [Pathogenesis of drug-induced collagenosis-like syndrome]. PMID- 3310128 TI - Discrete peritoneal and pericardial implants of non-Hodgkin lymphoma--CT findings and review of the literature. AB - Peritoneal spread of non-Hodgkin lymphoma is rare: fewer than three percent of persons afflicted with this disease develop peritoneal spread. Pericardial involvement by non-Hodgkin lymphoma is equally rare. We report an instance of peritoneal and pericardial spread in a patient with non-Hodgkin lymphoma that was detected only by CT scan. The peritoneal lesions were not visible by ultrasound examination. A pertinent review of the literature is presented. PMID- 3310129 TI - Thiosemicarbazones: inhibition of the growth of pox viruses and requirement for the growth of an isatin-beta-thiosemicarbazone dependent mutant. PMID- 3310130 TI - A matrical approach to the basic and clinical pharmacology of antiarrhythmic drugs. AB - In summary, the lethal cardiac arrhythmias remain a major public health problem and their treatment is a major challenge to the clinician. We possess rapidly increasing knowledge of the electrophysiologic events which underly arrhythmogenesis and the antiarrhythmic as well as the proarrhythmic actions of drugs. Much of this electrophysiologic knowledge is irrelevant to the practicing physician. While complex, we believe that the matrical approach provides the clinician with a useful intellectual framework within which to consider the actions of arrhythmogenic influences and antiarrhythmic drugs. The matrical approach is scientifically sound, reflects clinical realities, and serves as a rational guide to the treatment of cardiac arrhythmias. The traditional classifications of antiarrhythmic drugs have served a useful purpose, but they are clearly outmoded. PMID- 3310131 TI - Synaptic pharmacology of the hippocampus. AB - There is a wealth of information available regarding the complex synaptic pharmacology of the mammalian hippocampus. It is clear that many neurotransmitters are present in the hippocampus. Fig. 3 is an attempt to summarize in a schematic manner some of the synaptic connections of this structure and the neurotransmitters involved. The pyramidal cell and its inputs are shown and how various neurotransmitters modify its action in an excitatory (+) and inhibitory (-) manner. The hippocampus is an excellent model system for studying not only normal brain physiology, but also pathologic processes such as seizures, aging, etc. In view of the important role of the hippocampus in learning and memory and other brain functions, it is essential that the detailed synaptic mechanisms of the hippocampus be thoroughly understood. The present review is an attempt to integrate our knowledge of this structure into a rational basis for understanding how it functions and how it can be modified by pharmacological agents. PMID- 3310132 TI - Membrane effects of ethanol in excitable cells. AB - Ethanol has a wide range of biochemical and behavioral effects. Many of these can be explained by the ability of ethanol to reduce the amount of order, or increase the fluidity, in biological membranes. During chronic ethanol administration, membrane fluidity in the absence of ethanol and the sensitivity of membrane fluidity to added ethanol are decreased. Changes in membrane lipid composition that are consistent with decreased fluidity or with resistance to ethanol including increases in membrane cholesterol, reductions in the double bond index of phospholipid acyl chains, and increases in anionic phospholipids, have been reported during ethanol treatment. These changes are not found uniformly, however, and membrane tolerance and resistance have been reported in their absence. A variety of changes in lipid metabolism have been reported; their possible relevance to these adaptive changes is discussed. Ethanol treatment affects several transport systems in membranes; Na+, K+-ATPase, Ca++-ATPase, and other Ca++ transport systems all appear to undergo adaptive changes during ethanol treatment. Alterations in these systems may account for some of the effects of ethanol on activity-dependent energy metabolism and neurotransmitter release. Paradoxes in the membrane actions of ethanol remain to be resolved, including the weakness of membrane fluidization by ethanol in vitro compared to the evidence that it occurs in vivo, and the consistency with which adaptive changes in membrane fluidity and in Na+, K+-ATPase are observed compared to the inconsistency in changes in membrane composition. PMID- 3310133 TI - [Determination of bone density of the macerated human radius. Comparison of diverse densitometry methods: computerized axial tomography and single photon ray densitometry]. AB - Bone mineral content (BMC) assays are widely used in clinical practice. The most common techniques in vivo are computed axial tomography (CT) and single photon ray densitometry (SPA). The two techniques were compared in studies of macerated bone (16 macerated radii of both sexes). The BMC was measured first by SPA that provides information on both the trabecular and the cortical bone tissue. CT densitometry was then performed on the cortical bone in the same sites at the SPA. Bone sections were then taken and the area of the depth of the cortical bone calculated on their radiographic images using a semiautomatic image analyser. The results show that data obtained by SPA correlate better with the CT data (r1 = 0.861) than with the figures for the area of the thickness of the cortical bone (r2 = 0.786). This suggests that the BMC of the radius as measured by SPA may depend more on the density than the thickness of the cortical bone. PMID- 3310134 TI - [Current role of echography in the study of thoracic pathology]. AB - Echotomographic examinations were performed in 64 patients suffering from thoracic wall, pleural, pulmonary and mediastinal diseases, after preliminary examinations using standard radiographic techniques. The value of echography in the detection and evaluation of the location and extent of the lesion is assessed. Particular stress is placed on the physical difficulties involved in the detection and correct evaluation of the relationship with the adjacent organs. The importance of echography in detecting the type of the lesion is under lined and the semeiological criteria for its correct location are given. PMID- 3310135 TI - [Ultrasound and CT evaluation of non-lymphomatous splenic focal lesions]. AB - Differential diagnosis problems are caused by the increased, at time occasional, detection of benign and malignant spleen focal lesions in routine superior abdomen ultrasound (US). The following pathologic conditions were reported in 29 patients with focal lesions (excepted systemic diseases): 6 plain cysts, 1 cystic lymphangioma, 3 echinococcus cysts, 3 abscesses, 7 hematomas and 9 metastases. US examination and clinical data together have permitted the differentiation of cysts from solid nodules but has limits in the characterisation of lesions and in the diagnosis of abscesses. Metastases did non present specific US or CT aspects and have been correctly characterized only with aid of anamnestical data and for the coexistence of hepatic lesions. CT has proven superior specificity, compared to US, only in the diagnosis of abscesses and should thus be utilized only in selected cases. PMID- 3310136 TI - [Computerized instruction. Preliminary analysis of the experience at the Institute of Radiological Sciences of the University of Milan]. AB - Computerised instruction means teaching by computer using a program that alternates information with self-checking multiple choice questions. This system was used to create a fully computerized lesson on the diagnosis and treatment of breast cancer which was then tested on a small group of medical students attending the Radiology School of the Milan University Institute of Radiological Sciences. At the end of the test, the students were asked to complete a questionnaire which was then analysed. The computer lesson consisted of 66 text messages and 21 self-checking questions. It aroused considerable interest, though the most common reason was curiosity about a novel system. The degree of fatigue caused was modest despite the fact that the computer lesson was at least as demanding as a traditional lesion, if not more so. The level of learning was considered high and optimised by the use of self-checking questions that were considered an essential element. However no student agreed to sit an official examination, even interactively, using the computer. PMID- 3310137 TI - [Renal extravasation caused by spontaneous rupture of the pelvis. A conservatively treated case]. PMID- 3310138 TI - [Echography in biliary ileus. 2 case reports]. PMID- 3310139 TI - Maternal phenylketonuria: cause for concern among women with PKU. AB - The literature on maternal phenylketonuria (MPKU) is reviewed in terms of its identification, description, and treatment. A number of professionals have projected a rebound in the frequency of mental retardation associated with PKU since the discovery of MPKU. The lack of knowledge of the exact causal mechanism of the phenomenon and the absence of a consistently effective treatment are emphasized. Evidence gathered regarding the effectiveness of the low phenylalanine diet in the prevention of MPKU is presented, and the implications of this evidence are discussed. Issues surrounding both the phenomenon and possible preventive measures are also discussed. Finally, some questions and responsibilities to be considered by physicians, mental retardation professionals, and policy makers are presented. PMID- 3310140 TI - Evaluation of multiple component relaxation training with developmentally disabled persons. AB - Prior studies evaluating the response of developmentally disabled persons to relaxation training procedures are largely limited to case study reports. Most often relaxation training procedures are vaguely described in these studies, and limited outcome measures are employed. In the present comparative group outcome study a specific progressive muscle relaxation training procedure was combined with auditory electromyographic (EMG) biofeedback, modeling, and reinforcement procedures in an attempt to teach relaxation skills to mentally retarded persons (N = 32) who functioned in the profound to mild range. The procedure was effective in reducing experimental group subjects' EMG levels, F (1,28) = 6.39, p less than .05, and activity level as measured with an interval recording behavior rating procedure, F (1,28) = 58.05, p less than .05. No effect was found on peripheral skin temperature. Additionally, no significant difference between the response of low functioning and high functioning subjects was seen indicating that intellectual level and adaptive behavior level failed to predict success in treatment. Scoring on a simple behavioral assessment designed to measure receptive language skills and modeling abilities thought to relate to relaxation training success also failed to correlate with outcome measures. The need to develop other predictors of relaxation training success with a mentally retarded population is discussed. PMID- 3310141 TI - [Paralysis of the serratus anterior muscle. Results of treatment of 12 cases including 9 surgically treated and a general review of the literature]. AB - An analysis of the results of treatment in twelve cases of serratus anterior paralysis, nine of which were treated operatively, and a review of the literature has shown that, in lesions that fail with conservative treatment by physiotherapy, surgical treatment rapidly restores normal strength and function. Long follow-up, between 3 and 23 years, confirms the effectiveness and reliability of muscle transfers, particularly of pectoralis major. PMID- 3310142 TI - [Treatment of chondrosarcoma of the tibia by cryosurgery. Apropos of 2 cases]. AB - Two grade II central tibial chondrosarcomata of have been treated by extensive curettage and cryotherapy as described by Marcove. No recurrences or metastases were present after a follow-up of six and eight-and-a-half years respectively. A review of the treatment of these tumours was made and the advantages and disadvantages of liquid nitrogen considered. The indications for cryosurgery are described. The frequency and time of onset of recurrences and metastases is discussed in the light of published papers. PMID- 3310143 TI - [Zinc acexamate in gastric ulcer]. PMID- 3310144 TI - [The dermal-epidermal junction and immunologic bullous diseases of the junction]. PMID- 3310145 TI - [Continuous epidural anesthesia for renal transplants. Prospective study on 30 patients]. PMID- 3310146 TI - [Isoflurane: bibliographic update]. PMID- 3310148 TI - [Our experience in mechanical sutures with the EEA stapler]. PMID- 3310147 TI - [Embolization of the disk in a Bjork-Shiley mitral prosthesis: echocardiographic findings with a bidimensional technic]. PMID- 3310149 TI - [Current controversies on hepatic rejection: clinical, immunologic and anatomopathologic aspects]. PMID- 3310150 TI - Insulin-receptor interactions. Possible involvement of metals. AB - Addition of Zn2+ or Cu2+ ions to plasma membrane preparations or to purified insulin receptors from rat liver resulted in an increase of specific insulin binding; no effect was observed with the addition of Fe3+, Ca2+ or Na+. Dialysis of membrane preparations, or of purified receptors, against chelating agents such as zincon (2-carboxy-2'-hydroxy-5'-sulfoformazyl-benzene) or 1,10-phenantroline resulted in a decrease in specific binding of insulin. With the readdition of Zn2+ or Cu2+ to the medium an increase in specific binding was observed, and values much higher than those of the original preparations were obtained; the addition of Ca2+, Fe3+ or Na+ to dialyzed preparations did not cause any effect on the specific binding. Dialysis of purified receptors against chelating agents resulted in a decrease in the content of Zn2+ and Cu2+. Zincon has been found to be a competitive inhibitor of insulin interfering with the specific binding to the receptor, and noncompetitive with the nonspecific binding. These results suggest the possible involvement of a metal ion present in the receptor in the formation of the insulin-receptor complex. PMID- 3310151 TI - [Emergent infections]. PMID- 3310152 TI - [Profile of a new antibiotic: the combination sulbactam/ampicillin]. PMID- 3310154 TI - [Enteritis caused by Rotavirus in children]. PMID- 3310153 TI - [Pseudomembranous colitis and diarrhea caused by antibiotics]. PMID- 3310155 TI - [Microcomputer and rehabilitation of cognitive cerebral performance disorders]. AB - Clinical neuropsychology has so far mostly been concerned with theoretical aspects of the brain-behavior relationship, as well as the diagnosis of cognitive deficits after brain damage. Only very recently has cognitive rehabilitation of the brain injured patient become a major area of interest in neuropsychology, and computer-assisted therapy of higher cortical functions is playing an increasing role especially in the United States. A survey found that 73% of the rehabilitation centers included were using computers in delivering their cognitive rehabilitation therapy, major areas of computer-assisted therapy being deficits of eye-hand coordination, attention, concentration, orientation, visual spatial processing, memory, discrimination, problem solving, and concept formation. Treatment of speech disorders using computers is so far limited but will improve when more efficient language analyzers and synthesizers become available. More powerful microcomputers will lead to both computer-assisted and computer-managed cognitive programs, which allow for maximum flexibility and individualization of treatment. Computer use in cognitive rehabilitation should be subject to supervision by a therapist, and the following requirements should be met: 1) detailed diagnostic analysis of the differential cognitive performance pattern of a patient; 2) individual adaptation of computer peripherals to achieve optimum patient-computer-interaction; 3) selection and adaptation of therapy software to match the individual cognitive performance profile of a patient. Cognitive computer therapy appears to be most profitable in the rehabilitation phase and in post-rehabilitation treatment. PMID- 3310156 TI - [Secretion of steroids by embryonic gonads in the bird]. PMID- 3310157 TI - Quantitative determination of cyclosporin A in whole blood and plasma by high performance liquid chromatography. AB - A simple, specific and sensitive method for monitoring therapeutic levels of the immunosuppressive agent cyclosporin A (CyA) in whole blood and plasma has been developed which uses a high performance liquid chromatography and involves a simple liquid-liquid extraction procedure. Samples were delipolysed with 0.1 mM dextran sulfate sodium salt, extracted with n-hexane, and chromatographed on a Lichrosorb Si-60 column with UV detection at 215 nm. Each of CyA and internal standard (cyclosporin D) is resoluted clearly as a single peak and no interfering peaks are observed on the chromatograms. The detection limit is 5 ng/ml in whole blood and plasma. The reproducibility assessed by repeated analysis is satisfactory, that is to say, each coefficient of variation of the within-run and between-run precision is below 4%. The analytical recovery of added CyA is almost complete. This method is sensitive enough for monitoring whole blood and plasma levels of CyA in renal transplant patients in the therapeutic dose range, and is also applicable to the study on the distribution of CyA between plasma and non plasma fractions of blood in patients with renal allografts. PMID- 3310158 TI - Effect of two doses of inhaled diltiazem on exercise-induced asthma. AB - Seven asthmatic children with moderately to severely increased bronchial responsiveness to methacholine took part in a double-blind placebo-controlled study to assess the effect of a calcium channel blocker, diltiazem, on exercise induced asthma (EIA), and its duration. On the control day, bronchial response to exercise was found to be highly reproducible when performed 2 h apart (intraclass correlation coefficient 0.92). Normal saline and diltiazem at concentrations of 1.75 and 3.50 mg/ml (estimated nebulized doses 5 and 10 mg, respectively) were given in random order before exercise on a bicycle ergometer. Exercise challenge was performed 20 min and 2 h after each treatment, and bronchial response was expressed as percent fall in the forced expiratory volume in 1 s. In the overall group, diltiazem did not significantly change resting bronchial tone and produced no significant (p = 0.18) attenuation of EIA. An almost complete protection was detected only in two subjects 20 min after diltiazem 10 mg. This limited effect waned 2 h after the administration. PMID- 3310161 TI - [Pathology of hypertrophied and dilated heart]. PMID- 3310159 TI - Protective effect of methylxanthines against carbachol-induced bronchoconstriction in normal subjects. AB - The bronchoprotective effect of bioequivalent doses of theophylline (TH; 234 mg) and a combination of TH, proxyphylline (PPH) and diprophylline (DPH) in the proportion 2:3:3 (Neo-Biphyllin, NB; 600 mg) against carbachol-induced bronchoconstriction was studied in 10 healthy non-smokers in a randomised controlled double-blind cross-over trial. The subjects were on a methylxanthine free diet 4 days prior to and during each study day. Bronchial provocation tests were conducted in the morning and afternoon of the three separate study days- control and two medication days--using a standardised technique. On the control day, the dose of carbachol required to reduce the partial expiratory flow volume at 25% of vital capacity (V25p) by at least 25% was established. A significant protective effect was achieved with both TH (p less than 0.05) and NB (p less than 0.001) as measured by V25p. Bronchoprotection was achieved with low maintenance serum levels of TH. PMID- 3310160 TI - Pulmonary involvement in progressive systemic sclerosis: a multidisciplinary approach. AB - In an attempt to define the early features and the natural evolution of lung involvement in progressive systemic sclerosis (PSS), we planned a multidisciplinary study of these patients using radiological, scintigraphic and functional methods. As yet we have studied 21 subjects, all affected by PSS according to the American Rheumatism Association criteria. A well-defined restrictive functional pattern was present only in 10 patients out of 21; an increased elastic recoil may be present before a significant decrease of the transfer test for carbon monoxide; an increased alveolar-capillary permeability assessed by the 99mTc-diethylene-triamine-pentacetic acid (99mTc-DTPA) clearance rate has been detected in almost all the patients (13 out of 14) in at least one lung field; no significant correlation has been found between the radiological lung involvement and the 99mTc-DTPA clearance rate. We think that these preliminary results are consistent with an alveolar and interstitial inflammation rather than with a vasculitic process. PMID- 3310162 TI - Lung epithelial permeability in sarcoidosis. AB - Sarcoidosis is a multisystem disease with a 90% prevalence of lung involvement. It is now accepted that lymphocytes play a major modulatory role in the pathogenesis of this disease. However it has become evident in recent years that a number of other inflammatory cells capable of releasing mediators which can cause lung injury are involved as well. Although sarcoidosis is a relatively benign disease, it is well recognized that about 25% of the patients, perhaps those with unresolved injury, experience a relentless course and ultimately die from the disease. The rate of absorption from the lung of 99m Tc-DTPA is influenced by the integrity of the pulmonary epithelium, which might be altered as a result of injury to the lung. Several groups have measured 99m Tc-DTPA absorption in patients with sarcoidosis and have shown that it was increased in more than 50% of the patients studied. This abnormality seemed to prevail in patients with more advanced disease and in those who did not show a benign course. Whether a persistent increase in the rate of absorption of 99m Tc-DTPA reflects current or unresolved lung injury is unclear. The possibility of this technique being useful in monitoring the course of sarcoidosis deserves attention and should be further explored. PMID- 3310163 TI - Disseminated sarcoidosis. AB - A patient with sarcoidosis manifested by skeletal and cutaneous involvement had a normal chest x-ray and gallium scan of the lungs. The absence of pulmonic disease in spite of the extrapulmonic manifestations of sarcoidosis is rare. A normal chest x-ray does not exclude the diagnosis of sarcoidosis. PMID- 3310164 TI - Italy's medical heritage. PMID- 3310165 TI - [Inhibition of prostaglandin synthesis suppresses the renal functional reserve in patients with lupus nephropathy]. PMID- 3310166 TI - [Prospective study of the immunologic classification of 128 cases of acute lymphoblastic leukemia in the city of Puebla, Mexico]. PMID- 3310167 TI - [Cytogenetic findings in malignant hematologic disorders]. PMID- 3310168 TI - [The vacuum technic and its possible application in odonto-periodontal prophylaxis]. PMID- 3310171 TI - [Acquired immunodeficiency syndrome (AIDS). II]. PMID- 3310169 TI - [Where were the first radiographies made in Romania?]. PMID- 3310170 TI - [A manuscript of recipes for homemade medicine from the 18th century]. PMID- 3310172 TI - Effect of ureteral obstruction on renal hemodynamics. PMID- 3310173 TI - Effect of pathologic processes and pharmacologic interventions on ureteral function. PMID- 3310174 TI - Postobstructive renal function. AB - In summary, a natriuresis and diuresis following the relief of BUO is common. This is frequently associated with the reversal of hypertension and other signs of salt and water retention. The need for replacement therapy is best determined from clinical assessment of salt and water status. Only rarely will a prolonged salt-losing state ensue, but the physician must be aware of this possibility, since long-term replacement of water and electrolytes may be required. Recovery of function occurs in two phases, an early tubular phase and a later glomerular phase. The tubular phase appears to be quantitatively more important. There is some disparity between the improvement in creatinine clearance and that in 99mTc DTPA and iohexol clearance, and we would postulate that the initial improvement in creatinine clearance is due to secretion of creatinine during the predominantly tubular phase of recovery. It follows that when assessing renal functional recovery after insertion of a nephrostomy tube or other form of decompression of an obstructed upper urinary tract, these different phases must be borne in mind. Following the relief of UUO, changes in water and electrolyte excretion do occur, but they are rarely of clinical significance. PMID- 3310175 TI - Indwelling ureteral stents. PMID- 3310176 TI - [Hepatic encephalopathy: clinical presentation, psychometric tests and differential diagnosis]. PMID- 3310177 TI - [Advances in anorectal surgery]. PMID- 3310178 TI - ["Die Gewissheit der Chirurgie": bases of clinical therapeutic evaluation around 1750]. PMID- 3310179 TI - [Can malaria be eradicated by vaccination?]. PMID- 3310180 TI - [Definition of the case method from its historical development in the medical schools of Europe]. PMID- 3310181 TI - Mucin histochemistry in colonic polyps and cancer. AB - Mucins are the predominant glycoproteins found in gastrointestinal epithelia, and their structures differ according to the location in the GI tract and the state of cellular differentiation. Different forms of mucin are secreted in colonic polyps and cancers compared to those found in the normal colon. This paper reviews the methods available to probe mucin structure and the state of knowledge regarding the structures of neoplasia-associated mucins. Many of the assumptions made in the interpretation of classical histochemical stains on tissue sections have recently been questioned, and new insight into mucin structure has been gained from the development of newer methodologies such as lectin histochemistry and immunocytochemistry that use well-defined monoclonal antibodies. PMID- 3310183 TI - [Epilepsy and Canon Law]. AB - The Canon Law (Codex Iuris Canonici), promulgated in 1917, was a classification of laws and jurisprudence which ruled the early Church, governed the ecclesiastical condition of Roman Church until its reorganisation in 1983. It forbade to be ordained or to exercise orders already received to "those who are or were epileptics either not quite in their right mind or possessed by the Evil One". All the context and in particular the paragraph which treated of bodily lacks, indicated that between these three conditions, there was juxtaposition and no confusion. The texts specified the foundations of these dispositions, not in a malefic view of epilepsy inherited from Morbus Sacer of Antiquity, but in decency and on account of risk incured by Eucharist in case of fit. Some derogations could attenuate the severity of these dispositions--as jurisprudence had taken progresses of Epileptology and therapeutics into consideration. In the new Code of Canon Law (1983) physical disabilities were removed from the text and also possessed evil and epilepsy, the only impediment being "insanity or other psychic defect" appreciation of which is done by experts. Concerning poorly controlled epilepsies, we believe that experts will be allowed to express their opinion and a new jurisprudence will make up for the silence of the law. PMID- 3310182 TI - Role of chemotherapy in the treatment of colorectal carcinoma. AB - Large bowel cancer afflicts more patients in the United States than any other malignancy excluding skin cancer. Fifty percent of patients who undergo resection of colorectal carcinoma have positive lymph nodes, and approximately 18% have liver metastases at initial presentation. To improve survival, more effective treatment than surgical resection of the primary must be developed. The most active single agent in the treatment of colorectal carcinoma is 5-fluorouracil (5 FU). To increase the response rate obtained with this agent, work has been done on the modulation of 5-FU by other agents, using drugs that are synergistic with 5-FU and manipulating the method of 5-FU administration. Combination chemotherapy has improved response rates in some situations, though generally it has not been shown to improve survival. Studies using direct hepatic infusion clearly demonstrate an increase in response rates, but again, it is too early to say whether this type of treatment increases survival. Early adjuvant chemotherapy trials used inadequate doses of chemotherapy for short periods of time and demonstrated no added efficacy to surgery alone. Later studies with more aggressive therapy suggested some benefit to treating patients with rectal carcinoma; however, there is still little evidence that adjuvant chemotherapy improves survival in patients with colon carcinoma. To compare and understand the various chemotherapy trials, more stringent reporting of baseline laboratory values, performance status, and estimation of tumor involvement are needed. PMID- 3310185 TI - Diagnosis, significance, and treatment of neonatal seizures. PMID- 3310184 TI - [Pro-opiomelanocortin neuronal systems]. AB - Proopiomelanocortin (POMC) is a glycoprotein which serves as a multihormonal precursor for corticotropin (ACTH), lipotropins (beta and gamma-LPH), melanotropins (alpha, beta- and gamma-MSH) and endorphins (alpha-, beta- and gamma-endorphins). This precursor protein is primarily synthesized in corticotrophs of the anterior lobe and in melanotrophs of the intermediate lobe of the pituitary, as well as in other organs or tissues such as the genitourinary tract, the gastrointestinal tract and leukocytes. POMC is also present in the central nervous system (CNS) and numerous studies have been conducted to determine the localization, biosynthesis and functions of POMC-derived peptides. The identification of POMC-neuronal systems has been achieved by combining immuno histochemical studies, biochemical analysis, bioassays and radioimmunoassays. Three groups of perikarya containing various POMC-related peptides have been identified. One of these is located in the arcuate nucleus in the basal hypothalamus and projects towards the septum, thalamus and telencephalon. Some fibers originating from the arcuate nucleus terminate in the nucleus of the solitary tract in the brainstem where a second group of POMC-containing nerve cells are located. The latter innervates both the mesencephalon, the brainstem and the spinal cord. A third group of neurons, which contain alpha-MSH but not other POMC-derivates, has been identified in the zona incerta in the dorso lateral hypothalamus. Processing of POMC in the cell bodies of the arcuate nucleus follows a similar pattern as in the pituitary intermediate lobe. Endopeptidases called "acid-thiol-arginyl-proteases" cleave the prohormone at paired basic amino acids. The basic residues remaining on the resulting peptides are subsequently eliminated by the joint action of the less specific B-type carboxypeptidases and B-type aminopeptidases. alpha-MSH and beta-endorphin are among the major end products. Enzymatic modifications including N-alpha acetylation by opiomelanotropin-acetyltransferase (OMAT) and/or C-terminal amidation by peptidyl-glycine alpha-amidating monooxygenase (PAM) occur after proteolytic processing. However, the rate of acetylation observed in hypothalamic POMC neurons is much lower than in the melanotrophs of the pars intermedia. Acetylation of MSH and endorphin is crucial in determining the biological potency of these peptides. Desacetyl alpha-MSH is far less active than alpha-MSH (monoacetyl alpha-MSH), whereas acetylated beta-endorphin has no opiate activity. The mechanisms regulating the activity of POMC-containing neurons are still unknown.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3310186 TI - Cautions to young persons concerning health, in a public lecture delivered Nov. 20, 1804 by Benjamin Waterhouse. PMID- 3310188 TI - RN at 50: half a century of service to nurses. PMID- 3310187 TI - [Examination of the breast: the 1st link in the prevention of cancer]. PMID- 3310189 TI - [Complications of intravenous digital subtraction angiography--results in 500 patients]. AB - 500 patients were studied respectively for complications of intravenous digital subtraction angiography (IV-DSA) performed with non-ionic contrast media, using a central venous injection technique. In 21 patients (4.2%) during or shortly after the procedure 23 systemic, 1 neurologic, and 7 local complications occurred. In addition 1 patient developed acute renal failure 26 hours after the IV-DSA, whereas 4 patients later showed on thromboses of the catheterised vein. No permanent neurologic or systemic complications and severe allergic reactions were seen. PMID- 3310190 TI - [Sonographic findings in 133 malignant breast tumors in relation to their connective tissue content]. AB - The sonographic results of 133 histologically proven breast malignancies are reviewed retrospectively and compared with the physical, mammographic and histopathologic findings. All tumours are classified in three groups according to their cell-fibrous tissue relation. The ultrasound features that are typical of each category are demonstrated and discussed. A close relationship is found between the sonographic findings and the amount of connective tissue in breast carcinomas. Tumours with a predominance of fibrous tissue show sonographic characteristics regarded as typical of malignancy, such as irregular form, hazy contours, heterogeneous internal echos, and dorsal acoustic middle shadow. In contrast, ultrasound findings suggestive of benign lesions--regular form, smooth contours, increased dorsal echos--prevail in carcinomas with little connective tissue. Because of its superior accuracy in detection of carcinoma in radiodense breasts, sonography is a useful complementary method to mammography. On the other hand, echography cannot replace mammography as a screening method, since its sensitivity in detecting non-invasive and small carcinomas is distinctly lower. PMID- 3310191 TI - [Palpebral wounds and lacerations]. PMID- 3310192 TI - [Male contraception in 1987]. PMID- 3310194 TI - A methodological study of discontinuous Percoll-gradient separation of pancreatic islets from rats. AB - A discontinuous Percoll gradient was used to separate pancreatic islets from rats. Adjusting the osmolality to 315 mosmol kg-1 H2O, working at 4 degrees C and filtration of the pancreatic digest prior to gradient separation were vital for securing an optimal separation. The gradient design was also critical. Thus, optimal results were obtained with gradient centrifugation at 800 g, and using a bottom gradient that maintained the tissue evenly distributed prior to centrifugation. No significant difference was observed in the insulin release from islets isolated manually and islets isolated on Percoll gradients. Neither was there any significant differences in the insulin release from Percoll separated islets stimulated in solutions containing 25 mmol l-1 NaHCO3 and islets stimulated in solutions containing only 4.2 mmol l-1 NaHCO3. In conclusion, discontinuous-Percoll gradients can be used for isolation of pancreatic islets from rats. PMID- 3310193 TI - [The effect of fractionated irradiation on hormones and saccharides in laboratory rats]. PMID- 3310195 TI - The effect of dexamethasone on the enteroinsular axis. AB - In order to examine whether hyperinsulinaemia induced glucocorticoid therapy involves alterations of the enteroinsular axis glucose, insulin, C-peptide, glucagon and GIP responses to a test meal with and without prior intake of dexamethasone (2 + 2 mg) in 13 healthy subjects were measured. Dexamethasone caused impaired glucose tolerance, which was associated with an exaggerated insulin (0.61 +/- 0.05 vs. 0.38 +/- 0.05 nmol/l; p less than 0.001). C-peptide (0.97 +/- 0.08 vs. 0.71 +/- 0.06 nmol/l; p less than 0.001) and glucagon response to a test meal. In contrast, the GIP response to the test meal was blunted after dexamethasone (126 +/- 17 vs. 177 +/- 23 pmol/l; p less than 0.001). It therefore follows that alterations in the enteroinsular axis, that is, GIP secretion, cannot be responsible for the enhancement of insulin secretion observed after dexamethasone. The mechanism(s) for the decreased GIP response after dexamethasone could involve (1) a direct inhibitory effect on GIP secretion by dexamethasone, and/or (2) a negative feedback of elevated glucose and insulin levels on GIP secretion. PMID- 3310196 TI - Long-term survivors after variceal haemorrhage. Follow-up of a controlled study of endoscopic sclerotherapy versus conservative management. AB - In a prospective controlled trial of conservative therapy (vasopressin/balloon tamponade (control group] versus endoscopic sclerotherapy (ST) for the acute bleeding and at rebleeding, 107 cirrhotic patients with major variceal haemorrhage were studied from 1979 to 1983. The prospective follow-up study is now presented of the 51 patients surviving for more than 1 year. The present ST group (30 patients) was followed for a median of 5 years (range, 1-7.5 years), and the controls for 4 years (3-5.5 years). Variceal eradication was obtained in 22 ST patients in the 1st year after a median of 6 months and 5 ST sessions, and in 7 ST patients after 21 months and 9 ST sessions. The delay was due to alcoholic abuse. Eleven ST patients and 11 controls (NS) rebled on 30 and 45 occasions during a total follow-up time of 1364 and 696 months and 0.0220 and 0.0647 bleeds per patient-month, respectively (p = 0.098). Eight ST patients experienced 12 variceal bleeds, 11 controls had 39 haemorrhages with variceal aetiology, 0.0088 and 0.0560 bleeds per patient-month (p = 0.016), respectively. Five ST patients had recurrent varices on nine occasions with five episodes of bleeding a median of 13 months after completion of the initial serial ST. Reelimination was achieved with a median of three ST sessions during 3 months, but three patients had a second variceal recurrence 14-24 months later, successfully treated with one ST session in two of them. There was no difference in survival.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310197 TI - The effects of omeprazole on gastro-oesophageal sphincter pressure, intragastric pH, and the migrating motor complex in fasting healthy subjects. AB - Placebo and omeprazole (80 mg) were administered by intravenous injection in a random, double-blind, cross-over manner. Phase I and phase II of the MMC were divided into segments, and phase III constituted a single segment. The highest and lowest sphincter pressures were recorded in each segment. In the placebo group only one of the lowest values was significantly different from phase I,1. Among the highest values all means from phase II,1 to phase III were significantly higher. In the omeprazole group all means from phase II,4 to phase III in the upper demarcation were significantly higher. When the pressure profiles of placebo and omeprazole in each segment were compared, no differences were found. An unchanged pressure profile in all segments of the MMC in connection with a substantial reduction of acid secretion indicates that omeprazole shows great promise for use in patients with oesophagitis. PMID- 3310198 TI - Insulin-induced gastric ulcers in the rat. AB - Low doses of insulin (less than 1.25 IU/kg body weight) stimulate gastric acid secretion in the rat, whereas higher doses (greater than 2.5 IU/kg) release gastrin and cause gastric ulcers but do not increase acid secretion. In this study we have characterized the ulcerogenic properties of insulin in the rat. A dose of 5 IU/kg subcutaneously proved to be maximally effective. Ulcer formation was rapid, and the maximum 90% incidence was reached after 5 h. Both glucose administration and food intake protected against the ulcerogenic effects of insulin. The effects of anti-ulcer drugs and of vagotomy on insulin-induced ulcers were also studied. Animals were divided into seven groups: 1) saline, 2) omeprazole, 3) ranitidine, 4) sucralfate, 5) bilateral vagotomy, 6) unilateral vagotomy, and 7) antrectomy. Medical treatment was continued for 6 days before insulin administration, operations having been performed 6-8 weeks earlier. Insulin was injected subcutaneously in a dose of 5 IU/kg. Five hours later stomachs were inspected for ulcers. Neither the antrectomized rats nor those treated with omeprazole or ranitidine had ulcers. In the saline- and the sucralfate-treated groups the gastric ulcer incidence was 83% and 80%, respectively, with a mean of six and seven ulcers per rat. Ulcers were evenly distributed between the two sides of the stomach. Rats that had undergone bilateral vagotomy (which abolishes gastric acid secretion and causes hypergastrinemia) responded to insulin with an ulcer incidence of 5%. In the unilaterally vagotomized rats there were only 2 ulcers on the denervated compared with 37 on the innervated side.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310199 TI - Ulcer pain mechanisms. The clinical features of active peptic ulcer disease and implications for therapy. AB - Pain is commonly the initial symptom in peptic ulcer, but the mechanism is controversial. Chemical irritation by hydrochloric acid (HCl) and disordered motor activity have been implicated. Questions have been raised as to whether pain is a good indicator of an active ulcer. We have studied the mechanism of ulcer pain, using intragastric administration of 0.1 N HCl, study of X-ray alterations, measurement of intraluminal pressures, and measurement of gastric acidity along with fluorocinematography. Ulcer pain was accompanied by a synchronous increase in motor activity; gastric emptying was rapid with duodenal ulcer and delayed with gastric ulcer; relief of pain occurred with emptying. Ulcer pain is not a good indicator of activity. Relief of ulcer pain before endoscopic healing with famotidine is due to the inhibition of HCl below the threshold required to initiate disturbances of motor activity. Recurrent 'silent' ulcer with complications occurs in 40% of patients. PMID- 3310201 TI - [Metals as possible chemical carcinogens]. PMID- 3310200 TI - Famotidine: proven once-a-day treatment for gastric ulcer. AB - An 8-week, double-blind, randomized, placebo-controlled, multinational (n = 14), multicenter (n = 44) trial was conducted to determine whether famotidine speeds healing and relief of symptoms in patients with benign gastric ulcer. Of the 336 patients who entered the trial, 167 received 40 mg of famotidine in the evening, and 169 received placebo. At 4, 6, and 8 weeks after entry, ulcers had healed in a significantly (P less than 0.01) higher percentage of famotidine-treated patients than in those treated with placebo (47%, 65%, 80% versus 31%, 46%, 54%, respectively). Famotidine was also superior to placebo in relieving ulcer symptoms; the proportion of patients receiving additional antacid therapy was significantly lower in the famotidine group. The findings show that the new H2 receptor antagonist famotidine, administered as a single evening dose, significantly speeds the healing of benign gastric ulcers and that it is a safe and highly effective treatment of gastric ulceration. The convenient dosage regimen of famotidine (one tablet in the evening) should improve patient compliance, which, in turn, may result in faster healing of ulcers and a lower incidence of ulcer complications. PMID- 3310203 TI - The use of scanning electron microscopy in studying enamel caries. AB - SEM studies related to carious change in dental enamel are reviewed, and their contribution to understanding the mechanism of formation of the early enamel lesion and of its repair evaluated. SEM has contributed significantly to understanding the mechanism of enamel dissolution at the level of the single crystal. Etching studies have yielded useful information on the effect of enamel structure on the pattern of acid dissolution at the microscopic level and have highlighted the importance of re-precipitation phenomena in modifying the pattern of mineral loss. High-resolution studies have provided interesting quantitative data on changes in crystal size, and also information on changes in crystal shape and orientation, during lesion formation and remineralization. However, further work is required in this area to clarify uncertainties about sampling bias and to relate the observed changes more precisely to the larger-scale structure of the tissue. Numerous observations on the surface morphology and internal structure of carious lesions have been made but preparation techniques used to date introduce artifact to a greater or lesser extent and interpretation of some of these results is therefore handicapped. We propose the use of a methacrylate replication technique as the method of choice for studying pore distribution in carious enamel and present preliminary results using this technique. PMID- 3310202 TI - Is there a calcification factor common to all calcifying matrices? AB - This paper reviews the principal morphological findings pertinent to the early phases of the calcification process and explores the possibility that there may be a calcification factor common to all calcifying matrices. Three structures have a main role in calcification: collagen fibrils, matrix vesicles, and crystal ghosts. Only crystal ghosts are present in all calcified tissues, so that only they can be taken into consideration as a common calcification factor. They are organic molecules which have the same morphology as that of the inorganic structures present in the calcified matrix, which means that they can be considered as templates for those structures. Early calcification might be initiated by the binding of calcium and phosphate ions to the unmasked reactive groups of the crystal ghosts which are probably contained not only in the matrix, but also in the "holes" of the collagen fibrils and in matrix vesicles. The available data suggest that crystal ghosts share many of the properties of "crystal bound proteins". The involvement of alkaline phosphatase in their composition may account for their calcium- and phosphate-binding activity. PMID- 3310205 TI - Scanning electron microscopy in oral mucosal research: a review. AB - This review paper highlights some aspects of the contribution of SEM in the field of oral mucosa research. These include 1) different preparative techniques, 2) structure of the oral mucosa and its role in normal function, 3) advances in oral microbiology, 4) development of the oral mucosal epithelium, 5) pathological diagnosis and 6) morphometry. There are four main ways to study the oral mucosa with SEM; biopsy (autopsy) samples, smears, replica technique, and cell culture techniques. The structural studies can be divided as studies of the surface structure of the superficial cells of the oral mucosa and studies of the interactions between epithelium and connective tissue. Colonization and the morphology of micro-organisms are easy to see with SEM. Morphometric techniques have been used to determine the density of connective tissue papillae and to analyse surface structures of epithelial cells. In this paper, computerized image analysis systems for use in SEM research are presented. PMID- 3310204 TI - X-ray microanalysis of growth cartilage after rapid freezing, low temperature freeze drying and embedding in resin. AB - This paper reviews the work undertaken on the X-ray microanalysis of growth cartilage particularly in relation to matrix calcification. Attention is focused on the methodology available to accurately localize and retain the elements of interest. A method is described which involves rapid freezing, low temperature freeze drying in a custom built device, and embedding in Spurr resin. The results show that little tissue damage occurs and that elements of physiological interest are accurately localized at the sub-cellular level. Where damage occurs to chondrocytes as a result of freezing, however, dense intra mitochondrial granules are seen suggesting a phase transformation takes place resulting in the precipitation of calcium phosphate. Further improvements may be made in retaining the more labile elements such as K by using resins which polymerize at low temperature. PMID- 3310206 TI - Ultrastructural analysis of dynamic cellular processes: a survey of current problems, pitfalls and perspectives. AB - Dynamic phenomena in cells that can be analyzed on the ultrastructural level comprise so different aspects as ion shifts, conformational changes of macromolecules, membrane particle rearrangements, lipid phase transitions, protein-protein interactions (notably ligand-receptor interactions, including their sorting and sequestration), reversible membrane-to-membrane contacts, membrane fusions, transcellular transport phenomena, restructuring of cytoskeletal elements, ciliary and flagellar beat, cell shape changes, etc. Only some of these phenomena can be analyzed under stationary conditions, while others are unidirectional and sometimes very rapid. Therefore, the methodical approaches to be used (primary methods and follow-up procedures) might be widely different. Quite different methods are available, such as fast freezing, specific labeling, low temperature processing and/or analysis, x-ray-microanalysis, etc. Only occasionally are there alternative non-ultrastructural control methods available. This survey paper tries to analyze the degree of reliability (or uncertainty) of current methods and to pinpoint the goals and eventually also new methodical perspectives for an integrative approach to analyze dynamic cellular processes with the high temporal and spatial resolution provided by the electron microscope. PMID- 3310207 TI - Rapid freezing techniques and cryoprotection of biomedical specimens. AB - It has been realized almost from the start of biological electron microscopy that the use of low temperature in specimen preparation might alleviate the problems associated with conventional chemical fixation and plastic embedding. In practice it has been very difficult to realize any benefits, owing to the problems encountered in trying to prepare samples with the water transformed to ice, yet without the sample itself hopelessly distorted by ice crystals. The difficulty is caused by the poor diffusibility of heat through water, the main constituent of almost all biological samples. Even with a maximal temperature gradient between the sample surface and the coolant, and a perfect contact between the two, heat diffusibility through the sample quickly becomes the limiting parameter affecting cooling rate. Unless the cooling rate is as high as 10(2) or even 10(3) degrees C.msec.-1, the ice formed will be crystalline. Such high cooling rates can only be attained in the first few micrometers of even very small samples: therefore, for bulk samples one must either accept the use of a 'suitable' cryoprotectant, or else accept the presence of ice crystals. Theoretical and practical considerations for freezing samples using liquid and solid coolants will be reviewed. Special consideration will be given to the present status of cryoprotection and the indications and contra-indications for its use. PMID- 3310209 TI - Preservation of in vivo morphology of blood vessels for morphometric studies. AB - Preservation of in vivo morphology of the blood vessels is important for morphometric studies. With each fixation method (e.g., immersion fixation, perfusion fixation), there are inherent pitfalls which can easily distort vessel wall morphology, thereby creating artifacts. Alteration of the vessel wall cell volume due to tissue preparation is another common source for errors. Selection of proper morphometric protocols for comparative studies is crucial. Lack of attention in these areas is a cause of confusion and contradiction in the literature. In this review, the merits of various commonly used methods for vessel wall preparation and measurements are discussed. PMID- 3310208 TI - Low temperature techniques in biomedical microanalysis. AB - Many diseases are associated with a change in the distribution of diffusible ions at the cell or tissue level. These diseases can profitably be studied by X-ray microanalysis. This technique for the study of ion distribution requires the use of cryoprepared specimens. Analysis at low or medium resolution can be carried out on thick or semi-thick cryosections, or on frozen-hydrated or freeze-dried embedded bulk samples. Such analyses are particularly useful in the initial stages of an investigation, or when many data from a large number of samples have to be acquired. Quantitative analysis is then usually carried out with the peak to-local background method: by taking the background in the same energy range as the characteristic peak, an intrinsic correction for absorption of X-rays within the sample is made. X-ray microanalysis of cultured cells prepared by freeze drying can also be carried out in this way. Analysis at high resolution has to be carried out on thin sections: cryosections, or sections of freeze-substituted or freeze-dried embedded tissue. For the latter type of specimens, the use of low temperature embedding methods may have important advantages. Quantitative analysis of thin sections is carried out by the established continuum method. PMID- 3310210 TI - Exposure of vascular smooth muscle cells for analysis with the scanning electron microscope. AB - There has been interest in using the scanning electron microscope (SEM) to study the structure of tissues obscured by other cellular or non-cellular elements almost since the SEM was first used to examine biological tissues. Such interest includes the vessel wall and, in particular, the vascular smooth muscle cells. This paper presents a review of the three basic methodologies that have been employed to allow examination of the vascular smooth muscle, 1) blunt dissection, 2) digestion and 3) microdissection. Discussion of other perivascular elements was not a focus of this review. Also presented is the application of these different methodologies to different pathophysiologic conditions. PMID- 3310211 TI - [Focal nodular hyperplasia of the liver]. AB - The differential diagnosis of focal nodular hyperplasia of the liver (FNH) encompasses a variety of hepatic mass lesions with differing prognosis and therapy. Ten patients with FNH confirmed by histology form the basis of this review of the pathogenesis, the clinical features and of diagnostic and therapeutic aspects. - FNH is usually diagnosed fortuitously in women of childbearing age. It is considered to be a reactive process rather than a true neoplasia, and its biological behaviour seems to be modified by female sex steroids. In contrast to liver cell adenoma, rupture and bleeding are exceptional. For the diagnosis of FNH a combination of dynamic computed tomography and 99mTc sulphur colloid liver scintigraphy is most reliable, whereas ultrasonography lacks specificity. Once the diagnosis of FNH is established, surgery usually is unnecessary. PMID- 3310213 TI - [Oxygen free radicals and reperfusion-induced arrhythmias]. PMID- 3310212 TI - [Diagnosis of glomerular and non-glomerular erythrocyturia using phase contrast microscopy of the urine sediment]. AB - Recently the appearance of deformed polymorphous erythrocytes in the urinary sediment has been described as characteristic of glomerular bleeding. We studied 30 patients with histologically confirmed glomerular disorders and 25 patients with urological diseases and with hematuria. In the sediment of 10 ml urine 200 erythrocytes were counted under phase-contrast microscopy and evaluated relative to their morphology. The number of glomerular erythrocytes was expressed as a percentage. In all groups of glomerular disorders (mesangial-proliferative, membranous and membrano-proliferative glomerulonephritis, focal segmental glomerulosclerosis, glomerulonephritis of systemic disease, thinning of the glomerular basement membrane) the percentage of glomerular erythrocytes varied widely between 2 and 100%. In 7 cases less than 10% of glomerular erythrocytes were found. There was no correlation between the percentage of glomerular erythrocytes and the degree of renal insufficiency, hematuria or proteinuria. On the other hand, in patients with hematuria from the lower urinary tract, erythrocytes were uniformly non-glomerular in shape (95-100%). We conclude that 10-20% or more of glomerular erythrocytes in the urinary sediment are a good indicator of glomerular disease, whereas lower figures do not definitely rule out a glomerular origin for hematuria. PMID- 3310214 TI - [Phrenic motor neurons]. PMID- 3310215 TI - [Recent advances in research on sleep-promoting substances]. PMID- 3310216 TI - [Free radicals and myocardial ischemia]. PMID- 3310217 TI - [Progress in studies on fetal liver hematopoiesis]. PMID- 3310218 TI - [Activation of platelets in pathological processes]. PMID- 3310220 TI - [Relation between the action of oncogenes and the metastasis of tumors]. PMID- 3310219 TI - [Effect of neuropeptide Y on the cardiovascular system]. PMID- 3310221 TI - [Sonography of the rotator cuff]. PMID- 3310222 TI - [Sonographic diagnosis of bile duct calculi. Results of a prospective study of 222 cases of choledocholithiasis]. AB - To evaluate sonographic accuracy in the diagnosis of choledochal calculi 490 patients with cholestasis were examined prospectively with real-time scanner before ERCP or surgery. Ultrasound detected duct stones in 177 of 222 patients (sensibility 80%) and their absence in 242 of 268 (specificity 90%). Dilated extrahepatic bile ducts were demonstrated via ultrasound in 84% of cases with choledocholithiasis, dilated intrahepatic bile ducts in 57%. Intestinal gas obscuring the distal common duct was the most important factor limiting the ability of ultrasound to detect duct stones. PMID- 3310223 TI - [10 years of sonographic diagnosis of gallstones--what do surgical statistics tell us about its reliability?]. AB - The efficiency of sonographic gallstone diagnosis was checked retrospectively by examining a group of surgical patients. In 724 patients examined preoperatively during 1974 to 1981, cholecystectomy was performed four times on the basis of a false positive sonographic diagnosis. False negative findings were more frequent (n = 33); in one-half of the total number of these false negative cases the reason for overlooking the gallstones had been the presence of hydrops of the gallbladder (hydrocholecystis) in the acute stage. Nevertheless, sonographical diagnosis for performing cholecystectomy was easy to make in cases with hydrops of the gallbladder. No assessment of the gallbladder was possible in 6 cases only out a total of 724 cases (0.8%). Sensitivity of sonographic diagnosis was about 95.9%; after introduction of modern linear-array and sector scanners in 1983 the sensitivity increased to 98.4%. At that time radiological examination was hardly conducted preoperatively. On the whole, no statistically significant differences were seen in comparison to radiological examination methods when introducing sonography. PMID- 3310224 TI - [Results of sonographic diagnosis of ureteral calculi]. AB - In a retrospective study in 61 cases of sonographically, roentgenologically and clinically diagnosed calculi in the ureter, the sensitivity was found to be 64%. During the observation period of 2 years this increased from 69% to 84% with experienced investigators. Investigators with less than one year's experience achieved a level of 14%. Diagnosis of calculi in the ureter requires a special examination method using sector scanners. The results are additionally influenced by ureteral width, filling of the urinary bladder, meteorism and adiposity. If sonographic diagnosis is skillfully handled, it becomes possible to restrict the use of the I.V. pyelogram to a few instances and indications only. PMID- 3310225 TI - [Sonographic diagnosis of gallstone ileus]. AB - We report on the early diagnosis of gallstone ileus by sonography. The usually principal x-ray sign was missing in the pneumocholangiogram or pneumocholecystogram. The size and position of the stone were easy to determine by ultrasound. While character of pain and x-ray results are often misleading in gallstone ileus sonography offers another way to diagnosis and may so avoid the heavy mortality of the disease. PMID- 3310226 TI - [Ultrasonic morphology of acute pancreatitis taking into consideration the degree of severity]. AB - The ultrasonic findings of 37 patients with acute pancreatitis were related to the severity of the disease according to the Ranson criteria (RK). Pathologic findings of the pancreas were found in every case of severe pancreatitis (oedema, necrosis, conglomerate tumour), whereas in the large group of mild pancreatitis (0-2 RK, n = 26) only 17 patients showed an oedematous swelling of the organ. In 5 patients with mild pancreatitis a tryptic exudation was observed in the peripancreatic area, which must be considered as necrosis in 4 cases because of its long-lasting persistence in follow-up. Five patients in this group showed a rapid reversible ascites representing an effusion due to peritoneal irritation. In the group of severe pancreatitis, peripancreatic exudations were seen in 10 of 11 patients; the higher the severity of disease, the higher was the incidence of ascites, pleural effusions and sonographic signs of ileus. PMID- 3310227 TI - [Sonographic determination of gastric emptying]. AB - A reproducible method for the measurement of gastric emptying by real-time ultrasound is described. Gastric emptying was assessed by determining the decrease of the stomach area of the ultra-sound images during 55 min after fluid uptake. For the purpose of "validation", the gastric emptying time of 3 liquid test meals with different effects on gastric motility were measured. PMID- 3310228 TI - [Ultrasonic diagnosis of echinococcal cholangitis]. AB - The role of sonographic examination in echinococcal cholangitis is stressed based on a clinical case. Due to perforation of the hepatic hydatid cyst into the bile ducts the clinical picture of acute cholangitis occurred, this being difficult to differentiate from that of choledochal stones. The correct diagnosis was made by sonographic examination and was confirmed intraoperatively. The importance of emergency sonographic examination in severely ill patients is stressed. PMID- 3310229 TI - [Ultrasonic-guided percutaneous renal biopsy in patients with renal insufficiency]. AB - 64 percutaneous renal biopsies were done on 60 patients with renal impairment (serum creatinine level more than 1.5 mg%) under sonographic guidance. In 62 biopsies (96.8%), more than 3 glomeruli were seen, in 45 biopsies (70.3%) the amount of at least 10 glomeruli could be obtained, this being the amount desirable for a good histological diagnosis; 8 cases (12.5%) presented with minor complications after the biopsies. All of them resolved spontaneously. Ultrasound guided percutaneous renal biopsy is a safe procedure for rapid diagnosis and induction of a specific therapy in patients with renal impairment. PMID- 3310230 TI - The inheritance of epigenetic defects. AB - Evidence from many sources shows that the control of gene expression in higher organisms is related to the methylation of cytosine in DNA, and that the pattern of methylation is inherited. Loss of methylation, which can result from DNA damage, will lead to heritable abnormalities in gene expression, and these may be important in oncogenesis and aging. Transformed permanent lines often lose gene activity through de novo methylation. It is proposed that epigenetic defects in germline cells due to loss of methylation can be repaired by recombination at meiosis but that some are transmitted to offspring. PMID- 3310231 TI - "On the shelf" AIDS drug in clinical trial. PMID- 3310232 TI - Time-resolved x-ray diffraction of biological materials. AB - Instrumental and specimen considerations pertinent to performing time-resolved x ray diffraction on biological materials are discussed. Existing synchrotron x-ray sources, in conjunction with integrating x-ray detectors, have made millisecond diffraction experiments feasible; exposure times several orders of magnitude shorter than this will be possible with synchrotron sources now on the drawing boards. Experience gained from time-resolved studies together with order-of magnitude estimates of specimen requirements can be used to determine the instrumental capabilities needed for various time-resolved experiments. Existing instrumental capabilities and methods of dealing with time-resolved specimens are reviewed. PMID- 3310233 TI - The role of protein structure in chromatographic behavior. AB - Chromatographic retention is determined by a relatively small number of amino acids located in a chromatographic contact region on the surface of a polypeptide. This region is determined by the mode of separation and the amino acid distribution within the polypeptide. The contact area may be as small as a few hundred square angstroms in bioaffinity chromatography. In contrast, the contact region in ion exchange, reversed phase, hydrophobic interaction and the other nonbioaffinity separation modes is much broader, ranging from one side to the whole external surface of a polypeptide. Furthermore, structural changes that alter the chromatographic contact region will alter chromatographic properties. Thus, although immunosorbents can be very useful in purifying proteins of similar primary structure, they will be ineffective in discriminating between small, random variations within a structure. Nonbioaffinity columns complement affinity columns in probing a much larger portion of solute surface and being able to discriminate between protein variants. PMID- 3310234 TI - Magnetoencephalography and epilepsy research. AB - Magnetoencephalography is the detection of the magnetic field distribution across the surface of the head, which is generated by a neuronal discharge within the brain. Magnetoencephalography is used in clinical epilepsy to localize the epileptogenic region prior to its surgical removal. A discussion of the instrumentation based on the superconducting quantum interference device that is used for detecting the magnetic field distribution, the analytical techniques, current research, and future directions of magnetoencephalography in epilepsy research is presented. PMID- 3310235 TI - Antibody research garners Nobel Prize. PMID- 3310236 TI - Computer-aided molecular design. AB - Theoretical chemistry, as implemented on fast computers, is beginning to yield accurate predictions of the thermodynamic and kinetic properties of large molecular assemblies. In addition to providing detailed insights into the origins of molecular activity, theoretical calculations can be used to design new molecules with specific properties. This article describes two types of calculations that show special promise as design tools, the thermodynamic cycle perturbation method and the Brownian reactive dynamics method. These methods can be applied to calculate equilibrium and rate constants that describe many aspects of molecular recognition, stability, and reactivity. PMID- 3310237 TI - Helix geometry, hydration, and G.A mismatch in a B-DNA decamer. AB - The DNA double helix is not a regular, featureless barberpole molecule. Different base sequences have their own special signature, in the way that they influence groove width, helical twist, bending, and mechanical rigidity or resistance to bending. These special features probably help other molecules such as repressors to read and recognize one base sequence in preference to another. Single crystal x-ray structure analysis is beginning to show us the various structures possible in the B-DNA family. The DNA decamer C-C-A-A-G-A-T-T-G-G appears to be a better model for mixed-sequence B-DNA than was the earlier C-G-C-G-A-A-T-T-C-G-C-G, which is more akin to regions of poly(dA).poly(dT). The G.A mismatch base pairs at the center of the decamer are in the anti-anti conformation about their bonds from base to sugar, in agreement with nuclear magnetic resonance evidence on this and other sequences, and in contrast to the anti-syn geometry reported for G.A pairs in C-G-C-G-A-A-T-T-A-G-C-G. The ordered spine of hydration seen earlier in the narrow-grooved dodecamer has its counterpart, in this wide-grooved decamer, in two strings of water molecules lining the walls of the minor groove, bridging from purine N3 or pyrimidine O2, to the following sugar O4'. The same strings of hydration are present in the phosphorothioate analog of G-C-G-C-G-C. Unlike the spine, which is broken up by the intrusion of amine groups at guanines, these water strings are found in general, mixed-sequence DNA because they can pass by unimpeded to either side of a guanine N2 amine. The spine and strings are perceived as two extremes of a general pattern of hydration of the minor groove, which probably is the dominant factor in making B-DNA the preferred form at high hydration. PMID- 3310238 TI - [Osteogenesis by demineralized allogeneic bone in experiments and clinical medicine]. PMID- 3310239 TI - [Effect of etofenamate on early scald-induced edema. An experimental ultrasound study]. PMID- 3310240 TI - The hemolytic uremic syndrome of childhood and its variants. PMID- 3310241 TI - Thrombotic microangiopathy in the cancer patient including those induced by chemotherapeutic agents. PMID- 3310242 TI - The treatment of thrombotic thrombocytopenic purpura with exchange transfusions, plasma infusions, and plasma exchange. PMID- 3310243 TI - The role of bone marrow transplantation for nuclear accidents: implications of the Chernobyl disaster. PMID- 3310244 TI - AIDS-related Kaposi's sarcoma: therapeutic modalities. PMID- 3310245 TI - Sickle cell disease: an overview. PMID- 3310246 TI - [Biochemical and immunofluorescent identification of the tubulin in nervous system of shrimp (Penaeus orientalis)]. PMID- 3310248 TI - Essential arterial hypertension: plasma and urinary aldosterone alterations. AB - We studied 52 patients with mild to severe essential arterial hypertension and ranging in age from 30 to 60 years (average, 44). Various biochemical and endocrinologic parameters were studied, with special emphasis on plasma aldosterone and urinary aldosterone. At the same time, a control group of 30 normal subjects (nonhypertensive) were studied under the same conditions. Both groups were carefully selected. Results indicated that the hypertensive group demonstrated a marked increase in plasma aldosterone levels (P less than .01) and an increase in the coefficient of plasma aldosterone/plasma renin activity (P less than .01). This indicates inadequate secretion of plasma aldosterone. There were no significant changes in the urinary aldosterone. Statistically significant changes were found in plasma renin activity (P less than .001) and plasma aldosterone (P less than .001) when the hypertensive patients were divided into two age groups, those under 45 and those over 45. These changes were not found in the normal subjects in the same age groups, indicating that age is an important influence on the renin-aldosterone system in hypertensive patients, and leads to variations in this hormonal axis similar to those observed in normal elderly subjects. PMID- 3310247 TI - Imaging studies of the cadaver hand using transmission ultrasound. AB - Ultrasonic transmission imaging has already demonstrated potential for evaluating structures in the hand. In this study, a cadaver hand was imaged using a transmission scanner with improved imaging capability. The hand was then frozen and serially sectioned and comparisons were made between the sectional anatomy and the corresponding image. Bone (in silhouette), muscle, cartilage, and tendon were visualized with high resolution. PMID- 3310249 TI - Obesity: is it really a risk factor in thrombophlebitis? AB - Obesity is assumed to be a risk factor in the occurrence of thrombophlebitis. We studied 168 consecutive patients retrospectively; 33 were men and 135 women, with an average age of 34 (range 27 to 41) years. All patients had a gastric bypass because of obesity, with a minimum of 100 lb over normal weight. The mean weight was 279.2 lb (range 191 to 500). Only three patients had a history of deep vein thrombophlebitis, with no thromboembolism. Eighty-four of the patients were studied preoperatively by noninvasive means (Doppler, impedance plethysmography [IPG], phleborheography [PRG]); 12 had evidence of old disease, and two had a history of treated deep vein thrombophlebitis. No patient had prophylactic therapy. The incidence of clinical deep vein thrombophlebitis was zero; noninvasive evaluation in 64 patients demonstrated no abnormality. Postoperative thromboembolism, which occurred in three of 168 (1.8%) patients, was confirmed by ventilation-perfusion scan and pulmonary angiogram. The mortality from thromboembolism was less than 1% (1/168 patients). Extreme obesity may not necessarily constitute a major risk factor in the occurrence of postoperative deep vein thrombophlebitis and thromboembolism. Prophylactic medications and therapy may add inappropriate risk, undue cost, and unnecessary discomfort, and must be weighed against a mortality of less than 1%. PMID- 3310250 TI - Thrombocytopenia and cancer: use of the Kim-Ray Greenfield filter to prevent thromboembolism. AB - The association of hypercoagulation and cancer, a well established pattern of disease, often leads to pulmonary emboli in an already compromised patient. Anticoagulation therapy in these patients is occasionally complicated by several factors including thrombocytopenia, which may result in a life-threatening situation of hemorrhage versus pulmonary emboli. Mechanical intervention may prevent pulmonary emboli from reaching the lungs, thereby negating the use of anticoagulants in the patient with thrombocytopenia. In this clinical trial, ten patients with cancer and thrombocytopenia complicated by recurrent pulmonary emboli received the Kim-Ray Greenfield filter. There were four men (two with colon carcinoma and two with chronic lymphocytic leukemia) and six women (four with breast carcinoma, one with colon carcinoma, and one with chronic lymphocytic leukemia). Pulmonary emboli were documented in all patients by comparative ventilation/perfusion lung scans, arterial blood gas determinations, and chest x ray films. In each case anticoagulation was begun, but in six of the ten patients hemorrhage developed and anticoagulation had to be discontinued. The Kim-Ray Greenfield filter was subsequently placed in all ten patients in the infrarenal inferior vena cava (eight via a jugular approach and two via the femoral vein) without complication, and anticoagulation was discontinued. All patients had follow-up to time of death, ranging from six to 26 months (mean 11 months). In no patient was recurrent pulmonary emboli detectable based on clinical evidence, nor in autopsy reports in three of the ten patients. There should be increased usage of the Kim-Ray Greenfield filter in patients with malignancy, thrombocytopenia, and pulmonary emboli. PMID- 3310251 TI - Pulmonary embolism: complications of therapy. PMID- 3310252 TI - Combination insulin-sulfonylurea therapy in type II diabetes mellitus. PMID- 3310253 TI - Subcapsular hepatic abscess: a rare complication of ventriculoperitoneal shunt. AB - Abdominal complications of ventriculoperitoneal shunts include fluid collections and migration of the peritoneal end of the shunt tube, producing a wide spectrum of symptoms and signs. Cross-sectional imaging methods have proved to be very useful in the early diagnosis of these complications. I have described the diagnosis and management of an unusual case of intrahepatic abscess from migration of a ventriculoperitoneal shunt. PMID- 3310254 TI - Surgical maggots. PMID- 3310255 TI - Quinine resistant falciparum malaria in Vanuatu? A case report. PMID- 3310256 TI - Superoxide dismutase and catalase activities in spleen of mice infected with Plasmodium berghei. PMID- 3310257 TI - Controlled trial of initial slow intravenous quinine vs conventional quinine infusion in the treatment of highly parasitized falciparum malaria in adult patients. AB - A total of 10 patients (adults) with highly parasitized falciparum malaria were treated initially with intravenous quinine (10 mg per kg quinine diluted in 20 ml normal saline injected very slowly with a syringe taking not less than 20 minutes). Six control patients were treated with quinine infusion standard method (quinine 10 mg/kg diluted in 500 ml of normal saline given as slow drip taking 4 hours for the drug to enter the patient's body). Both two groups of patients were followed by oral quinine 10 mg/kg three times a day for 7 days. PMID- 3310258 TI - Torulopsis glabrata vertebral osteomyelitis. Case report and review of the literature. PMID- 3310260 TI - Horizontal fracture of the anterior arch of the atlas. Report of two cases and review of the literature. PMID- 3310259 TI - Thoracic vertebrostenosis combined with thoracic disc herniation. Case report and review of the literature. PMID- 3310261 TI - Spinal stenosis in acromegaly. PMID- 3310262 TI - [Sero-epidemiologic study of malaria in Puerto Madero, Chiapas, 1985]. PMID- 3310264 TI - DNA base sequence changes induced by ethyl methanesulfonate in a chromosomally integrated shuttle vector gene in mouse cells. AB - We have analyzed the specificity of mutations induced by ethyl methanesulfonate (EtMes) in mouse cells carrying a selectable bacterial gene. The target gene was the Escherichia coli gpt gene contained within a retroviral shuttle vector integrated into mouse chromosomal DNA. Following mutagenesis by EtMes, cells with mutations in the gpt gene were selected as resistant to 6-thioguanine. Shuttle vector sequences were recovered from the mutant cell lines following fusion with monkey COS cells and introduced into bacteria as part of a bacterial plasmid. The DNA base sequences of the mutant genes were directly determined from plasmid DNA. All of the EtMes-induced mutations involving single base changes were found to be G:C to A:T transitions. PMID- 3310263 TI - [Search for indicators for training intermediaries in the management of MEDLARS (Medical Literature Analysis and Retrieval System)]. PMID- 3310265 TI - [Imaging diagnosis in femur head necroses]. PMID- 3310266 TI - [Hip ultrasound in newborn infants in the diagnosis of hip dysplasia- classification and results of a screening program]. PMID- 3310267 TI - [Sonography of the thyroid gland in childhood]. PMID- 3310268 TI - [Emission computed tomography (ECT). 1. Principles and single photon ECT]. PMID- 3310269 TI - [Duplex sonography of the carotid artery following thrombendarterectomy and dilatation plasty]. PMID- 3310270 TI - [Emission computed tomography (ECT). 2. Positron ECT]. PMID- 3310271 TI - [Electronic data processing in x-ray diagnosis]. PMID- 3310272 TI - [Experience with orthotopic heart transplantation]. PMID- 3310273 TI - [Transplantation of the the pancreas: experimental part]. PMID- 3310274 TI - [Personal experience with the use of Duratexol--a dura mater substitute]. PMID- 3310275 TI - [Stereotaxic surgical treatment of hypertensive cerebral hemorrhage guided by computer tomography]. PMID- 3310276 TI - [Aging changes in connective tissues]. PMID- 3310277 TI - [The role of Ca2+ in metabolisms and functions of neutrophils]. PMID- 3310279 TI - [Peroxidase of human mastocytes. I. Ultrastructural characterization]. PMID- 3310278 TI - Detection of Treponema pallidum by a fluorescent monoclonal antibody test. AB - Definitive diagnosis of early syphilis currently requires dark-field microscopy and/or a newly reactive serologic test for syphilis. The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microscopist. Serologic diagnosis may be affected by the delay between the appearance of the primary chancre and the onset of serologic reactivity. We used a pathogen specific fluorescein-conjugated monoclonal antibody to examine lesion exudates from 128 consecutive patients and compared these data with results of dark-field microscopy, the rapid plasma reagin (RPR) test, and the fluorescent treponemal antibody-absorbed (FTA-Abs) test. The monoclonal antibody test demonstrated Treponema pallidum in 48 (73%) of 66 patients with infectious syphilis, while dark-field microscopy was positive for 52 (79%) of 66 patients. None of 62 patients without syphilis was positive by either test. The FTA-Abs test was reactive for 61 patients (92%) of the 66 with infectious syphilis. Thus the fluorescent monoclonal antibody test for detection of T. pallidum in direct smears is as sensitive and specific as dark-field microscopy for the diagnosis of infectious syphilis. It has the potential to provide a convenient, accurate means for definitive diagnosis of genital ulcer disease by health care personnel without ready access to dark-field microscopy. PMID- 3310280 TI - [Peroxidase of human mast cells. II. Comparison with other types of human peroxidases. Relation to mast cell function]. PMID- 3310281 TI - [Does the transitional basophil/mastocyte cell exist?]. PMID- 3310282 TI - Antibiotics in infections of the biliary tract. AB - The combination of a penicillin and an aminoglycoside has been recommended as the initial treatment of choice for patients with infections of the biliary tract. However, elderly, septic, patients with jaundice have a high incidence of renal problems. For this reason, amingolycoside treatment of these patients must be reevaluated as newer less nephrotoxic agents become available. We, therefore, performed a prospective, randomized trial of ampicillin plus tobramycin, cefoperazone and piperacillin in patients with biliary tract infections. During a 20 month period, 106 patients with acute cholecystitis (53) or cholangitis (53), or both, received one of these antibiotic regimens for a minimum of five days. In patients with acute cholecystitis, ampicillin plus tobramycin, cefoperazone and piperacillin had clinical cure rates of 85, 95 and 95 per cent, respectively. In patients with cholangitis, however, cure rates for the three regimens were 85, 56 (p less than 0.05 versus ampicillin plus tobramycin) and 60 per cent (not significant versus ampicillin plus tobramycin), respectively. Moreover, 13 per cent of the patients receiving cefoperazone had an increased prothrombin time and three of 39 patients receiving this antibiotic had clinical problems with bleeding. Nephrotoxicity was greatest in patients with cholangitis receiving ampicillin plus tobramycin, 10 per cent, as compared with 3 per cent in those who did not receive an aminoglycoside. This difference, however, was not statistically significant. It was concluded that piperacillin should be considered for antibiotic management of patients with acute cholecystitis and that further studies are necessary in patients with cholangitis to determine whether or not newer agents should replace penicillin and aminoglycoside combinations. PMID- 3310283 TI - Management options for penetrating injuries to the great veins of the neck and superior mediastinum. AB - Between January 1984 and January 1986, 74 patients were treated for stab or gunshot injury to the great veins in the neck and superior mediastinum. Veins involved in the neck were the subclavian and internal jugular and in the mediastinum, the brachiocephalic and subclavian vein and the superior vena cava. Most patients presented in a state of shock. Twenty-nine were bleeding too rapidly to resuscitate adequately and required emergency operation while in a moribund state. Twenty-five had arteriovenous fistulas and were hemodynamically stable. Direct venous repair was attempted if simple lateral suture or end to end anastomosis could be rapidly done. If complex repairs were required, ligation was performed. Fifty-five veins were ligated on this basis, including 14 brachiocephalic trunks, nine proximal subclavian veins and one superior vena cava cephalad to the azygos. Nineteen were repaired. Two patients died after ligation and one patient after repair, all as a result of the effects of massive hypovolemia. Edema of the upper limb developed in two patients in each treatment group in whom the distal part of the subclavian vein had been involved. The edema resolved within five to seven days. Chronic venous stasis problems did not develop in any patient during the two to 26 month follow-up period. PMID- 3310284 TI - Morbidity and recurrence rates after surgical treatment of malignant melanoma by scalpel versus CO2 laser beam. AB - A retrospective study was carried out on 219 patients who underwent surgical treatment of a malignant melanoma. A scalpel was used in 96 patients in group 1 and CO2 laser beam was used in 123 patients in group 2. The average length of hospitalization for group 2 was longer (16.3 versus 12.8 days for group 1). This was due to failure of the skin graft; 32.5 per cent in group 2 versus 15.6 per cent in group 1 (p = 0.005). The accumulative rate of recurrence for both groups was almost the same although there were significant differences according to the various parameters. Male patients in group 2 had a significantly higher rate of recurrence as compared with female patients in the same group (p less than 0.001) and male patients in group 1 (p = 0.002). In both groups, there was a significantly higher rate of recurrence for ulcerated primary lesions and those lesions more than 1.6 millimeters thick (p = 0.05). Patients in group 2, with lesions more than 3 millimeters in thickness, had a higher rate of recurrence than those in group 1 (54.6 versus 40.6 per cent). In both groups, patients who underwent elective regional dissection of lymph nodes had a lower rate of recurrence (19.4 per cent) than those patients who did not undergo dissection (53.6 per cent) (p = 0.001). It is suggested that thermal damage to the blood and lymph vessels incurred during laser excision may be more extensive than has been reported. These damaged walls may cause the higher rate of distal metastases of malignant melanoma from a primary lesion more than 1.6 millimeters in thickness; primarily in male patients. PMID- 3310285 TI - An improved technique for multiple organ harvesting. AB - A rapid technique for multiple organ harvesting is described which allows removal of all the major organs within 30 to 60 minutes after beginning the donor operation. No preliminary dissection of the liver or kidneys is required or necessary since these organs are cooled by infusion of cold solutions in situ and with subsequent rapid dissection in a bloodless field. The incidence of well functioning kidneys, livers and hearts has been better than with the previous methods. The acceptance of this procedure by other personnel has been almost universal. PMID- 3310286 TI - The Austin Flints and their contribution to medicine and hepatology. PMID- 3310287 TI - Radiation enteritis. AB - Acute radiation enteritis is almost inevitable in the curative treatment of malignant tumors of the abdomen and pelvic area. It is frequently a self-limiting disorder of intestinal function associated with reversible mucosal changes of the intestine. The prevalence of chronic radiation enteritis has been underestimated in most surgical series and the majority of patients with symptoms probably do not seek medical advice until a serious complication occurs. Although associated with specific histologic features, the mechanism of chronic radiation injury is poorly understood. The prevalence, pathogenesis, diagnosis and approaches to the treatment and prevention of acute and chronic radiation enteritis are discussed herein. Recent investigative techniques should lead to a better understanding of the physiopathologic characteristics of radiation enteritis and, thereby, provide a more rational basis for treatment which, at the present time, is unsatisfactory. Attempts to reduce the prevalence of radiation enteritis should be directed toward careful patient selection for radiation treatment of the pelvis and to minimize injury to the small intestine, by reducing the volume of small intestine in the radiation area and providing more individualized dosimetry. PMID- 3310288 TI - About the Nobel Prize in Medicine. PMID- 3310289 TI - Stereotactic localization of small subcortical brain tumors for open surgery. AB - A noninvasive, computed tomography (CT) stereoadapter was used for stereotactic localization of small brain tumors in 16 patients scheduled for open surgery. The stereotactic CT study was carried out 1 day to 3 months before surgery. On the day of surgery, the adapter was remounted on the patient's head. The tumor in relation to the adapter, as shown on the CT study, was drawn on the scalp of the patient. The tumor could be found and removed through a small bone opening and a minimal cortical incision. PMID- 3310290 TI - Spontaneous cervical epidural hematoma. AB - The authors report a case of spontaneous cervical epidural hematoma in a 13-year old boy who exhibited hematoma recurrence 3 years after the first incidence. A review of the literature indicates very few reports of the recurrence of spinal epidural hematoma. PMID- 3310291 TI - Normal reference values in TCD. PMID- 3310292 TI - [Standardized setup and dosimetry in total body irradiation using 3-dimensional compensators]. AB - In order to obtain a homogenous dose distribution in total body irradiation, a compensator is inserted into the ray path. The different thickness and density of the patient is so compensated near the focus by a water equivalent metal layer. The faults arising in the calculation of the compensator are investigated. Furthermore a regulation technique is presented which allows a simple, rapid, and exact adjustment of patient, compensator, and measuring probes for dosimetry. PMID- 3310293 TI - Optic nerve hypoplasia. AB - Optic nerve hypoplasia is an easily overlooked, nonprogressive developmental anomaly which results in a wide range of visual deficits. It is frequently associated with clinically significant central nervous system and endocrine abnormalities. Maternal substance abuse is increasingly recognized in many cases. A supranormal regression of optic nerve axons in utero, rather than a primary failure of differentiation, is proposed as the pathogenesis. PMID- 3310294 TI - Acquired dyschromatopsias. AB - Theories of color vision have been founded on behavioral observations of how the human eye distinguishes colors and mixtures of colors. Studies of congenital dyschromatopsias (inherited disorders of color vision) have been important to the development of these theories. Subsequent studies of acquired dyschromatopsias (disorders of color vision caused by disease) were understandably influenced by these concepts. Theories to explain the patterns of color vision impairment found in acquired diseases (for example, preferential hue discrimination defects) have stressed the likelihood of selective damage to specific components of the afferent visual system (photoreceptors, ganglion cells, synaptic elements, axons etc.). More recent evidence suggests, however, that impairment of color vision by diseases of the retina and optic nerve is commonly nonspecific, and not the result of selective impairment of individual neural mechanisms responsible for mediating color vision. Rather, the patterns of acquired dyschromatopsias often appear to be related to a physiologically heterogeneous distribution of color vision in the foveal and perifoveal visual field, coupled with a tendency for the visual field defects caused by acquired diseases to be unevenly distributed in these same areas. PMID- 3310295 TI - Anatomy of the optic nerve head and glaucomatous optic neuropathy. AB - The mechanism of axon damage in eyes with glaucomatous optic neuropathy remains undefined. Interestingly, it has been observed that, although the entire nerve cross-section may be involved by the nerve damage, in many instances, the superior and inferior axon bundles are preferentially affected by the pressure insult. Thus, recent studies by many investigators have stressed a re-examination of the optic nerve head anatomy, including the nerve head microcirculation, the glial and connective tissue elements within the nerve head, and the morphology of the axons themselves. Any correlation between regional differences in this anatomy and the preferential involvement by specific axon bundles within the nerve head by the pressure insult may suggest some further insight into the mechanisms underlying the pressure-induced axon loss in glaucomatous eyes. PMID- 3310296 TI - Frick's Treatise on the Diseases of the Eye. AB - George Frick, generally regarded as the first American physician to limit his practice to ophthalmology, was also the first American to author a textbook on the eye. In this historical article, the author describes Frick's education under his two great mentors, Philip Syng Physick and George Joseph Beer, and reviews Frick's book: A Treatise on the Diseases of the Eye; Including the Doctrines and Practice of the Most Eminent Modern Surgeons, and Particularly Those of Professor Beer. PMID- 3310298 TI - A comparative study of cytologic smears and frozen-tissue sections in the determination of sex steroid receptor status of breast carcinomas. AB - The estrogen receptor (ER) status of breast cancer is important as an indicator of prognosis and in the selection of patients for endocrine therapy. Biochemical techniques (estrogen receptor analysis [ERA]) are conventionally used to determine ER; however, they have limitations and disadvantages. In this study a monoclonal antibody to ER (estrogen receptor-immunochemical assay [ERICA]) was used to detect the presence of ER on cytologic and frozen tissue specimens of breast cancers and was compared with the dextran-coated charcoal assay. One hundred two breast cancers were studied. Ninety-four specimens were studied by ERA and ERICA; in eight patients in whom tissue was insufficient for ERA, ERICA alone was performed. ERICA correlated remarkably well with ERA: 94% sensitivity, 89% specificity, and 93% accuracy. In the eight patients in whom ERA could not be performed, ERICA was successfully applied to obtain information regarding receptor status. There was uniform agreement between frozen-sectioned tissues and cytologic smears. The results suggest that immunocytochemical determination of ER is a valuable adjunct and/or alternative to the biochemical method for determination of the ER status of breast cancers. PMID- 3310297 TI - Recurrence patterns in a prospective study of patients with stage II breast cancer treated with endocrine-chemotherapy. AB - Local-regional versus distant recurrence patterns were investigated for 311 patients with stage II node-positive breast cancer who were part of an endocrine chemotherapy adjuvant breast cancer trial. After mastectomy patients were randomized to receive either cytoxan, methotrexate, and 5-fluorouracil (CMF) (1 year) or CMF with tamoxifen (1 year) with or without bacillus Calmette-Guerin (BCG). With a median follow-up of 92.1 months, 55.3% of the patients had recurrences. The first site of recurrence was local-regional for 31.4% of patients and distant for 68.6%. This pattern of first recurrence was not associated with treatment groups, menopausal status, race, estrogen receptor value, number of positive lymph nodes, or tumour diameter. Although patients with a first local-regional recurrence had a better overall prognosis compared with those with a first distant recurrence, 52.2% of those patients with an initial local-regional recurrence developed a distant recurrence within 12 months. Among patients who had a recurrence, 48.3% had a local-regional recurrence at some time during their follow-up. Conclusions from this study are (1) patterns of recurrence were not affected by the addition of antiestrogen therapy to chemotherapy; (2) for the variables tested, including number of positive nodes and tumor diameter, no association with recurrence patterns was found; and (3) most patients (52.2%) with a first local-regional recurrence will develop a distant recurrence within 1 year. PMID- 3310299 TI - Pancreas transplantation with pancreaticocystostomy and quadruple immunosuppression. AB - Forty-three whole-pancreas transplantations with pancreaticocystostomy were performed. Eighteen patients received pancreas transplants after previously receiving living-related kidney transplants, 18 patients received simultaneous kidney and pancreas transplants, and seven patients received pancreas transplants after previously receiving cadaver kidney transplants. All patients were immunosuppressed with quadruple immunosuppression including antilymphocyte globulin, prednisone, cyclosporine, and azathioprine. Overall graft survival for pancreas transplants is 73.1%. In the group with pancreas after living-related kidney, 1-year graft survival was 50% for the pancreas and 95.4% for the kidney. In the pancreas after cadaver kidney group, pancreas and kidney survival rates were 100% at 1 year, and in the simultaneous pancreas and kidney group, pancreas 1-year graft survival was 87.5% and kidney transplant survival was 93.8%. Overall patient survival at 1-year is 95.6%. Technical complications occurred in 21 patients. These included wound infections, intra-abdominal abscess formation, bleeding, and disruption of the pancreaticocystostomy. We believe that pancreas transplantation can now be performed with acceptable graft and patient survival. PMID- 3310300 TI - Pancreas transplant results according to the technique of duct management: bladder versus enteric drainage. AB - Between July 1978 and February 1987, 177 pancreas transplants were performed. The 1-year patient and graft survival rates for the first 100 transplants up to October 1984 were 88% and 27%, respectively. Since November 1984, duct drainage has been used for 74 of 77 transplants, bladder (BD) in 36 and enteric (ED) in 38, with 1-year patient survival rates of 89% and 92%, respectively, and graft survival rates of 58% and 42%. The technical failure rate was similar in both groups (31%). Immunosuppression was with antilymphocyte globulin, cyclosporine, azathioprine, and prednisone. Most recipients were nonuremic, without kidney transplants, and 1-year graft survival rates were 69% for BD (n = 21) and 42% for ED (n = 29). The diagnosis of rejection was based on a decline in urine amylase activity in the BD and on an increase in plasma glucose alone in the ED group. For technically successful (TS) grafts, the number of rejection episodes reversed per number diagnosed was 23 of 26 (18 patients) in BD (88%) and six of 15 (14 patients) (40%) in ED (p less than 0.05). The advantage of BD with monitoring of urine amylase activity is seen in TS cases; 1-year cadaveric graft survival rates were 90% for BD (n = 23) versus 47% for ED (n = 15) (p = 0.05). In recipients of segmental transplants with ED from living-related donors, 1-year graft survival rates were 57% overall (n = 18) and 88% for TS cases (n = 12), which is identical to cadaveric BD cases. A disadvantage of BD was metabolic acidosis induced by chronic bicarbonate loss in the urine from the pancreas graft. Nevertheless, we conclude that BD is the preferred technique for pancreas transplants from cadaver donors because of the ability to monitor exocrine and endocrine function continuously, thus leading to early diagnosis and treatment of rejection episodes. PMID- 3310301 TI - Pediatric renal transplantation with an emphasis on the prognosis of patients with chronic renal insufficiency since infancy. AB - In this report recent experience with renal transplantation in 43 children who were 17 days to 16 years old was reviewed. One-year patient survival rate was 98%, and overall one-year graft survival rate was 68%. One-year graft survival rate was 73% for cyclosporine-treated patients and 78% for recipients of related donor kidneys. A subpopulation of patients affected with renal insufficiency since infancy was analyzed separately to evaluate the prognosis of these patients, who have previously been reported to be a high risk for permanent neurologic, developmental, and growth retardation. All 16 such patients underwent transplantation. Gross motor delay that was noted in 31% of patients before surgery resolved in all patients after transplantation. No evidence of severe developmental delay was noted after transplant and seven of 11 patients with successful transplants had evidence of catch-up growth. Overall renal transplantation is a safe and effective procedure for children with renal failure, and even the patients at highest risk for growth and developmental failure caused by renal insufficiency show potential for rehabilitation after transplantation. PMID- 3310302 TI - Duplex scanning versus conventional arteriography for the evaluation of carotid artery plaque morphology. AB - Examinations that are performed for the evaluation of the extracranial cerebrovascular system need to supply accurate information regarding the luminal surface of the carotid artery as well as the morphologic characteristics of the plaque. To compare conventional carotid artery angiography and Duplex scanning, 32 consecutive patients underwent both evaluations, the results of which were compared, in a blinded manner, to the plaque characteristics noted on direct examination by the attending surgeon and pathologist. The following observations were made: angiographic and Duplex scanning evaluations concurred with direct specimen examination for luminal narrowing in 31 of 32 patients (97%) and 30 of 32 patients (94%), respectively, whereas Duplex scanning was more accurate for diagnosing ulcerative lesions, 13 of 14 patients (93%), than angiography, five of 14 patients (36%) (p less than 0.0001). Luminal surface irregularity was accurately described by Duplex scanning in 20 of 23 patients (87%) and by angiography in 11 of 23 patients (48%) (p less than 0.005), whereas plaque morphology or consistency was not commented on with angiography but was accurately described with Duplex scanning in 12 of 12 patients (100%). This series clearly demonstrates that both angiography and Duplex scanning are extremely accurate for determining the reduction in the diameter of the carotid artery, whereas Duplex scanning is more accurate for detecting important plaque characteristics such as irregularity, ulceration, and composition. PMID- 3310303 TI - The microbiology of explanted vascular prostheses. AB - The incidence of bacterial colonization and the microflora of prosthetic vascular graft material explanted from 44 patients undergoing graft revision was determined. Graft material for culture was obtained from aortofemoral or femoropopliteal vascular prostheses without signs of infection but requiring revision for femoral anastomotic aneurysm (n = 21) or thrombosis (n = 26). Explanted graft material was placed in tryptic soy broth and ultrasonically oscillated to disrupt the adherent graft surface biofilm, which is a technique that increases the recovery of microorganisms compared with standard microbiologic culture methods. Microorganisms were isolated from 90% (19/21) of grafts associated with anastomotic aneurysms and 69% (18/26) of thrombosed grafts. Staphylococcus epidermidis was the prevalent organism recovered and accounted for 69% of the isolates. Slime production, a growth characteristic of S. epidermidis associated with prosthetic device infection in humans, was demonstrated by 87% (13/15) of strains isolated from grafts with pseudoaneurysms compared with 33% (4/12) of strains isolated from occluded grafts (p less than 0.01). Despite the high incidence (79%) of colonization of vascular prostheses, no patient developed wound or graft infection after graft replacement and perioperative antibiotic administration. Low-virulent microorganisms, such as S. epidermidis, can colonize vascular prostheses and not provoke signs of graft infection. The high recovery rate of slime-producing S. epidermidis strains from grafts with anastomotic aneurysms and the adherence-mediated growth of these bacteria on biomaterials suggest this late graft complication is the sequelae of a bacteria-laden biofilm infection. PMID- 3310305 TI - Body of knowledge and the ontology of the body. PMID- 3310304 TI - [Anniversary. "Marry and get fired" our "law" 50 years ago]. PMID- 3310306 TI - Medicine and the Cartesian image of man. PMID- 3310308 TI - Salmonella typhimurium and rupture of the thoracic aorta. PMID- 3310307 TI - The K veim response: still useful, still a puzzle. PMID- 3310310 TI - Unexpected pulmonary nocardiosis in a non-immunocompromised patient. PMID- 3310311 TI - Hypertrophic osteoarthropathy: four early reports by British authors (1889-97). PMID- 3310309 TI - Resistance of spores of Aspergillus fumigatus to ingestion by phagocytic cells. AB - Phagocytic cells are believed to have an important role in the eradication of fungal spores from the lung. The ability of human and mouse cells to phagocytose the opportunistic fungus Aspergillus fumigatus has been examined, spores of the non-pathogenic fungus Penicillium ochrochloron being used for comparison. Most spores became associated with cells. Those of A fumigatus appeared to remain bound to the surface of the phagocyte rather than being ingested; in contrast, P ochrochloron spores appeared to be phagocytosed more readily, although they also were seen, in small numbers, o n the cell surface. In view of the subjective nature of these observations, the effects of spore diffusates on phagocytosis were examined. Diffusates from spores of A fumigatus were shown to inhibit phagocytosis of antibody coated radiolabelled sheep red blood cells by primed mouse phagocytic cells. Diffusates of spores of P ochrochloron had no such effect. These results suggest that when spores of A fumigatus become bound to the surface of phagocytes they are able to release a substance that inhibits their ingestion while having little or no effect on surface binding. PMID- 3310312 TI - Rapid diagnosis of an outbreak of Legionnaires' disease at Glasgow Royal Infirmary. AB - In the last three months of 1985 there was an outbreak of legionnaires' disease at Glasgow Royal Infirmary affecting 15 patients and one surgeon; five patients died. Legionnaires' disease was first suspected when a second case of severe nosocomial pneumonia occurred in a high dependency unit. The application of the direct fluorescent antibody test to specimens obtained at bronchoscopy was responsible for the rapid diagnosis of legionnaires' disease, which led to the prescription of appropriate antibiotic treatment and the shutting down of the contaminated cooling tower, thereby containing the outbreak. It also led to a search for further cases. It is suggested that these diagnostic techniques should be included in the investigation of affected patients in an outbreak of pneumonia. PMID- 3310313 TI - Anatomical distribution of bronchoalveolar lavage fluid as assessed by digital subtraction radiography. AB - A digital subtraction imaging technique was used to visualise directly the anatomical distribution of 3 X 60 ml aliquots of saline containing a low concentration of radio-opaque dye, introduced sequentially into a segment of the middle lobe. It was possible to estimate the relative movement of fluid within the segment during the sequential aspiration of each of these aliquots. The first 60 ml aliquot introduced stayed close to the bronchoscope and probably sampled only the proximal airways. With the introduction of cumulative volumes of 120 ml or more, the fluid filled the segment more evenly. Aspiration then moved fluid back from the periphery, implying that the aspirate had also lavaged both distal airways and alveoli. PMID- 3310314 TI - Benign thymic cysts in Hodgkin's disease: report of a case and review of published cases. PMID- 3310315 TI - Use of a flexible choledochoscope for pericardioscopy and drainage of a loculated pericardial effusion. PMID- 3310317 TI - [Arterial hypertension in the elderly. Double-blind multicenter comparative study of labetalol and clonidine]. PMID- 3310316 TI - [Cyclosporin-nicardipine interaction in the kidney-transplant patient]. PMID- 3310318 TI - Metformin decreases the high plasminogen activator inhibition capacity, plasma insulin and triglyceride levels in non-diabetic obese subjects. AB - We have previously observed a positive correlation between Plasminogen Activator Inhibition capacity (PA Inhibition), Body Mass Index (BMI) and plasma insulin levels in a population of non diabetic subjects. The anti diabetic biguanide Metformin which decreases insulin resistance has been reported to increase the blood fibrinolytic activity. Therefore we have studied the effect of Metformin on PA Inhibition levels in obese subjects with normal glucose tolerance. Eighteen obese women (O) (BMI: 31.4 +/- 1.13, m +/- S.E.M.) were compared to age matched controls (C) (BMI: 20.2 +/- 0.8) and randomized to a 15 days treatment by Metformin (M) (1.7 g/day) or placebo (P) in a double blind study while on a weight maintaining diet. O compared to C had higher levels (m +/- S.E.M.) of PA Inhibition (9 +/- 1.8 IU/ml, versus 2.88 +/- 0.29 p less than 0.01), lower euglobulin fibrinolytic activity (EFA) (4.95 +/- 1.17 mm versus 9 +/- 0.29 p less than 0.05), higher plasma insulin (24.1 +/- 2.1. uU/ml), versus 12 +/- 1 p less than 0.01) and triglyceride (1.32 +/- 0.16 mmol/l, versus 0.8 +/- 0.08 p less than 0.05). After 15 days of treatment, in group M a significant decrease in PA Inhibition (5.51 +/- 1.4, versus 9.48 +/- 2.1 p less than 0.05) in plasma insulin (18.5 +/- 0.1, versus 24.5 +/- 3.5, p less than 0.05) and plasma triglyceride (1.08 +/- 0.1, versus 1.47 +/- 0.3 p less than 0.05) and an increase in EFA (6.50 +/- 0.28, versus 5.25 +/- 0.35 p less than 0.05) were observed. No significant variation was observed in group P. PMID- 3310320 TI - Anticardiolipin antibodies and prostacyclin synthesis. PMID- 3310319 TI - Platelet procoagulant properties studied with snake venom prothrombin activators. AB - Purified snake venom prothrombin activators were used to probe the procoagulant properties of platelet membranes. Human platelets were able to stimulate prothrombin activation by the venom activators from Oxyuranus scutellatus and Notechis scutatus, while the prothrombin activator from Echis carinatus was not affected by the presence of platelets. The prothrombin-converting activity of platelets was further studied with the venom activator from Oxyuranus scutellatus and with the factor Xa-Va complex as prothrombin activating enzymes. Stimulation of platelets with collagen, collagen plus thrombin or with the Ca-ionophore A23187 resulted in a considerable increase of platelet prothrombin converting activity probed with the factor Xa-Va complex as well as with the prothrombin activator from Oxyuranus scutellatus. The stimulatory effect of activated platelets on the rates of prothrombin activation by Oxyuranus scutellatus was similar to that determined for factor Xa-Va-catalyzed prothrombin activation. Compared to non-stimulated platelets, platelets stimulated with thrombin plus collagen exposed 20-times more procoagulant sites for as well the factor Xa-Va complex, as for the venom activator from Oxyuranus scutellatus. The actual number of procoagulant sites per platelet determined with the factor Xa-Va complex was in close agreement with the number of sites determined with the venom activator. Also the time course of appearance of procoagulant activity during platelet stimulation by collagen plus thrombin was comparable for both activator complexes. Phospholipase A2 treatment of stimulated platelets resulted in an almost complete loss of their ability to stimulate prothrombin activation by the enzyme from Oxyuranus scutellatus or by factor Xa-Va complex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310321 TI - Dr. Mario Baldini (January 15, 1917-August 4, 1986). PMID- 3310322 TI - Electroimmunoassay of vWF:Ag: increased sensitivity with enzyme enhancement. PMID- 3310323 TI - Effect of prostacyclin derivatives on platelet factor 3 availability. PMID- 3310324 TI - Anthony P. Fletcher (1919-1987). PMID- 3310325 TI - Role of A alpha chain of fibrinogen in coagulation and platelet interaction investigated with a monoclonal antibody. AB - A murine monoclonal antibody (anti-C2G7), reactive with fibrinogen, was used to analyse the structure and function of the fibrinogen epitope C2G7. Anti-C2G7 was found to be reactive with fibrinogen but not with fibronectin, Factor VIII-von Willebrand Factor (FVIII-vWF), beta-thromboglobulin (beta TG), platelet factor 4 (PF4) nor with a range of normal cells and cell lines. Biochemical and plasmin digestion studies of fibrinogen revealed that C2G7 is present on the carboxy terminal end of the alpha chain on a fragment with a Mr approximately 30-40 K. Functional studies, on the role of fibrinogen in coagulation and platelet function, demonstrated the importance of C2G7 (or a closely associated region) for thrombin-associated fibrin polymerization and collagen induced fibrinogen binding to platelets. PMID- 3310326 TI - Studies on the steric relationship between HLA antigens, beta 2-microglobulin and the Fc receptor on human platelets. AB - Normal human platelets were investigated by immunofluorescent staining methods for the steric relationship between HLA class I antigens, beta 2-microglobulin and the Fc receptor. IgG antibody to human class I antigens or beta 2 microglobulin, but not their F(ab')2 fragments, blocked the binding of human IgG Fc fragments to the platelet Fc-receptor. The receptor binding of human IgG-Fc fragments did not prevent the binding of any of the antibodies. This was observed in incubation studies performed both at 4 degrees C, 20 degrees C and 37 degrees C. The results provide evidence that HLA class I antigens and their associated beta 2-microglobulin are in close proximity to the Fc-receptor on human platelets. It is suggested that inhibition of the platelet Fc-receptor was due to binding between the Fc part of surface-bound antibody molecules and the Fc receptors. PMID- 3310327 TI - Binding of heparin to human endothelial cell monolayer and extracellular matrix in culture. AB - Endothelial binding of heparin contributes to its local antithrombotic action and catabolism. However, it is uncertain whether heparin may be bound to a damaged or even de-endothelialized vessel surface. Therefore, the binding of 3H-heparin to cultured endothelial cell monolayer and extracellular matrix was studied. The binding reached equilibrium after 4 h. 3H-heparin bound to endothelium could be displaced by unlabelled heparin which competed for about 80% of binding. The binding became saturable when the concentration of heparin exceeded 30-times the therapeutical value. Approximately 6 X 10(11) binding sites for heparin per cm2 of endothelium were calculated. Heparin was bound not only to endothelial cells but also to extracellular matrix, even when it was exposed in the absence of cells. About 40% of binding sites were localized in the extracellular matrix fraction. A similar affinity of binding of 3H-heparin to complete endothelium, endothelial cells and extracellular matrix was estimated /Kd of almost 1 microM/. The binding of heparin to extracellular matrix should be considered in the interpretation of heparin interaction with endothelium. PMID- 3310328 TI - [Ovulation induction with gonadotropin-releasing hormone]. PMID- 3310329 TI - [Baron von Munchhausen. A person of current interest in Norwegian medicine?]. PMID- 3310331 TI - [Colibacillosis in calves, especially enterotoxic E. coli infections]. AB - Developments in the knowledge of colibacillosis are reviewed in the series of 'Papers in the Past and Present.' The starting-point of this paper is provided by the paper by H. Veenstra:' A Note on Diseases of Young Breeding Calves in the Province of Friesland' (1894) but particularly, by the study by J. Poels: 'Report on Calf Disease in the Netherlands' which appeared in 1899. A historical review of bacteriological features in the pathogenesis of neonatal diarrhoea in calves and their significance in diagnosis, particularly that of enterotoxigenic Escherichia coli infection (ETEC), is followed by data on the incidence of ETEC infection in the Netherlands and a discussion of the possibilities of prevention in ETEC infections, which, is so far as farm management is concerned, could still fall back on the advice given by Poels towards the close of the last century. PMID- 3310330 TI - [Diseases of young breeding calves in Friesland. By H. Veenstra, 1894]. PMID- 3310332 TI - [Maternal immunity]. AB - After a short introduction concerning immune system function, the physiological and pathophysiological aspects of the foeto maternal relationship are discussed. Ontogeny of the immune system, the foetus as an in utero 'foreign body', and maternal immune competence during pregnancy and lactation are all considered. The process of presentation of maternal antibodies to the foetus/neonate is then presented. The phenomenon of pinocytosis is also discussed. The article concludes with a discussion of the problem of neonatal infections. PMID- 3310333 TI - [Genetic aspects of disease resistance in farm animals]. AB - Improved hygiene, management and vaccinations have led to reduced natural selection, which means that breeding farms have less information on the disease resistance status of their breeding stock. Knowledge concerning the mechanisms of resistance (immunology) has increased enormously. In diseases for which preventive measures are not available, genetic resistance may be of importance. This requires knowledge of parameters involved in disease resistance, and their genetic background. This article discusses the genetic resistance of specific diseases, and general disease resistance, in poultry, pigs and cattle. PMID- 3310334 TI - Separation of biologically active chromium complex from cow colostrum. AB - By a procedure based on ion-exchange chromatography, five chromium-containing fractions were separated from the ethanol extract (50-90%) of cows' colostrum which should provide infant with all or most of the chromium needed in available form. Three of the fractions are anionic (A-1, A-2 and A-3) and two are cationic (C-1 and C-2). Two major fractions, A-1 and A-3, comprise together about 77% of the total chromium recovered in the effluent after ion-exchange chromatography and C-1 and C-2 comprise together only about 21%. Approximate molecular weight was determined by the Sephadex gel chromatography to be 1,500 for A-1 and C-2 and 2,000 for C-1. A-3 was eluted from the Sephadex gel column at the elution position corresponding to that of inorganic trivalent chromium. Among five fractions, A-1 shows glucose tolerance factor (GTF) activity as measured by the stimulation of [U-14C] glucose oxidation to 14CO2 in rat epididymal adipocytes. A 1 stimulates glucose oxidation at chromium concentration as low as 100 pg/ml only when it is incubated with insulin. These findings suggest that A-1 fraction separated from cow milk contains a low-molecular-weight, chromium complex which plays a role in glucose metabolism in close relation with the action of insulin. PMID- 3310335 TI - Effect of insulin on motilin release in man. AB - The effect of insulin on motilin release was investigated by use of the euglycemic glucose clamp technique. By use of this technique plasma glucose concentration was maintained constant at 80-90 mg/100 ml, and plasma insulin immunoreactivity (IRI) was increased from 15 +/- 6 microU/ml to 171 +/- 22 microU/ml in 10 min, and remained at this level for 2 hr. Plasma motilin like immunoreactivity (MLI) concentration decreased within 10 min from 199 +/- 36 pg/ml to 120 +/- 28 pg/ml and remained low during the course of study. A significant negative correlation between MLI and IRI concentrations (r = -0.72, p less than 0.01) was observed. The present results indicate that the suppressive effect of insulin on motilin release is a direct action of insulin and is not mediated by glucose. PMID- 3310336 TI - Reduced estradiol production by a substituted triazole results in delayed ovulation in rats. AB - Ovulation in the rat is delayed by a single administration of the substituted triazole R151885 (1,1-di(4-fluorophenyl)-2-(1,2,4-triazol-1-yl)-ethanol). This delay results from a 24-hr shift in the preovulatory luteinizing hormone (LH) surge since administration of chorionic gonadotrophin on proestrus restores ovulation. Plasma levels of estradiol are markedly reduced (42-45%) 6-12 hr after administration of R151885. The restoration of ovulation in R151885-pretreated rats, by administration of exogenous estradiol benzoate, indicates that the reduced estradiol levels play a pivotal role in the delay of ovulation. Granulosa cells isolated from rat ovaries produce estradiol and progesterone in vitro in the presence of both follicle-stimulating hormone and testosterone. The addition of R151885 to such cultures results in a dose-dependent inhibition of estradiol production (69% by 1 microM) without a significant effect on progesterone production. This inhibition occurs at concentrations of R151885 similar to those measured in vivo. R151885 is a competitive inhibitor of human placental aromatase (apparent Ki with androstenedione substrate of 410 nM) and produces a type II spectral perturbation of cytochrome P-450 from placental microsomes. Pituitaries isolated from R151885-treated rats have reduced LH output in response to gonadotrophin-releasing hormone stimulation compared with those of controls. It is proposed that R151885 competitively inhibits aromatase activity in developing ovarian follicles. The resultant temporary reduction of plasma estradiol levels at a critical time in the estrous cycle, and consequent inadequate pituitary sensitization, produces a 24-hr delay in the preovulatory LH surge and hence ovulation is delayed by 24 hr. PMID- 3310338 TI - The effect of solvent and extraction methods on the bacterial mutagenicity of sidestream cigarette smoke. AB - The mutagenic activity of sidestream cigarette smoke particles was estimated by testing sidestream cigarette smoke particles which had been collected under controlled burning conditions in the laboratory. Two different extraction methods (Soxhlet and ultrasonic agitation) and 3 different solvents (dichloromethane, methanol, and acetone) were compared for their efficiencies in the extraction of compounds from sidestream cigarette smoke particles which are mutagenic in the Ames test. The mutagenic activity of the sidestream smoke particles was estimated to be 15,000-20,000 revertants per cigarette in TA98 with metabolic activation and 12,000-17,000 revertants per cigarette in TA100 without metabolic activation. Only weak mutagenic activity was detected in TA98 without activation and in TA100 with activation. Under test conditions used, ultrasonic agitation produced the most consistent results and acetone extraction produced the highest levels of mutagenic activity. PMID- 3310337 TI - Cisplatin nephrotoxicity: in vitro studies with precision-cut rabbit renal cortical slices. AB - Severe nephrotoxic side effects limit the use of cisplatin, a potent anticancer drug. In this study, precision-cut renal cortical slices from rabbits were evaluated as a cisplatin nephrotoxicity model. Cortical slices accumulated approximately 180 ppm (195 ppm Pt = 10(-3) M) of platinum(II) after 18 hr of incubation in medium containing 10(-3) M cisplatin. Dose- and time-dependent toxic responses for clinically relevant concentrations of cisplatin (10(-3)-10( 5) M) were apparent using leakage of intracellular K+, ATP, and lactate dehydrogenase (LDH) to determine cell damage. Histopathologic changes were also produced. Intracellular ATP levels dropped significantly after 6 hr of incubation in 10(-3) M cisplatin, and after 12 hr with 10(-4) M cisplatin. Similarly, intracellular K+ levels decreased significantly by 6 hr of incubation with 10(-3) M cisplatin but remained at control levels for 18 hr in the presence of 10(-4) M cisplatin. Decrements in intracellular LDH levels were not seen until after 12 hr of incubation in 10(-3) M cisplatin. The noncytotoxic isomer transplatin at 10( 3) M was not accumulated by slices; however, intracellular ATP levels were depressed. Of the viability parameters evaluated, intracellular K+ and ATP were found to be optimal indicators. Other active platinum analogs, carboplatin and iproplatin, also caused dose- and time-dependent leakage of intracellular K+ and ATP from renal cortical slices. The ranking of nephrotoxicity of the platinate compounds within this system at concentrations adjusted to approximate equivalent therapeutic activity was similar to that observed in vivo (cisplatin = iproplatin greater than carboplatin greater than transplatin). These results suggest that precision-cut renal cortical slices comprise a viable in vitro model for platinum induced nephrotoxicity studies. PMID- 3310339 TI - The Lang lecture 1986. The enigma of primary open-angle glaucoma. AB - An account is given of the Moorfields prospective surgical v medical trial in primary open angle glaucoma. The intra-ocular pressure, visual fields calculated on a percentage basis and the visual acuity were measured in 52 subjects at 3 monthly intervals for up to 18 years. Fifty per cent of the patients underwent surgery by random selection and an attempt was made to determine whether the surgical or the medical cases fared better. Even after this extended period little correlation between visual field and the level of intra-ocular pressure could be found. The results appeared to favour the possibility that surgery was of some benefit in terms of visual field whereas medical therapy was probably better for visual acuity: but in neither case was convincing proof obtained. The final conclusion was that more research is needed but in the meantime too frequent and too elaborate surveillance of open angle glaucoma is not particularly beneficial to the patients. PMID- 3310340 TI - Reduction of astigmatism following cataract surgery. AB - This study documents the induced corneal astigmatism following cataract surgery. All patients developed significant astigmatism with the rule which decreased with time and following division of sutures. Corneal incision induced a significantly higher degree of astigmatism than limbal incision, but this difference was negated by suture division. There were no cases of wound dehiscence following division of sutures. Suture division is therefore recommended as a method of reducing astigmatism following cataract surgery. PMID- 3310341 TI - Control of chronic simple glaucoma with primary medical, surgical and laser treatment. AB - This prospective clinical study comparing laser trabeculoplasty, medical therapy and surgery as the primary therapy for 168 patients with untreated chronic simple glaucoma, showed that the surgical group resulted in the lowest mean intraocular pressures, and was most effective in controlling the diurnal swing of intraocular pressures. Laser trabeculoplasty resulted in a lesser degree of pressure reduction but these patients were more frequently subject to high pressure spikes. Medical therapy was the least effective in lowering pressure. PMID- 3310342 TI - Retinal pigment epithelial detachments in the elderly. PMID- 3310343 TI - Techniques of strabismus surgery: adjustable suture and posterior fixation suture. AB - The author's technique of adjustable suture and posterior fixation suture operations (Faden operation) are described. A short review of other techniques is given. Detailed indications for these procedures are not discussed. PMID- 3310344 TI - Pathophysiology of peptic ulcer. PMID- 3310346 TI - Unexpected findings amongst the skin test responses to mycobacteria of BCG vaccinated Kuwaiti school children. AB - A multiple skin test survey was carried out in Kuwait on 1200 school children aged 8-11 years, and on 1228 children aged 12-16 years. With only 15 exceptions, all these children had received vaccination with Japanese BCG just before they started school, 5 years and 9 years earlier respectively. Tuberculin positivity was almost 90% in both groups, with a mean response size of 8.7 mm. This was associated with remarkably high responsiveness to many of the other mycobacterial species investigated. Since this high reactivity was also to Mycobacterium ulcerans, a species most unlikely to be present in Kuwait, it is proposed that this might be due to responsiveness to group ii antigen which is present in all slow growing species. Only M. flavescens and M. rhodesiae amongst the fast growing species, were absent as sensitising organisms. After correction for the supposed reactivity to group ii antigen, M. avium B, M. gordonae, M. ulcerans and M. xenopi amongst the slow growing species, also appeared to be absent from the Kuwait environment. The species most commonly encountered were M. leprae, M. chitae, M. neoaurum, M. diernhoferi, and M. vaccae in this order. This was a remarkable finding for a country assumed to be poor in contact with environmental species, and known to have a very low prevalence of leprosy. As previously reported from Iran, but not confirmed in other places, there was a 95% correlation between responsiveness to Leprosin A and Vaccin. Amongst the slow growing species M. avium A, M. intracellulare, and M. kansasii appear to be frequent sensitising agents, in common with many other places. PMID- 3310345 TI - Pre-S proteins--a new marker for the hepatitis-B virus. PMID- 3310347 TI - The immune response in two populations of wild badgers naturally infected with bovine tubercle bacilli. AB - This study describes the immune responses of two defined badger populations; one from East Sussex and another from Staffordshire. The mean in vitro lymphoproliferative response, of all infected badgers from both areas, to Glaxo BCG, was significantly greater than that of healthy animals. The infected badgers had significantly higher antibody levels against mycobacterial antigens, especially New Tuberculin, than did the healthy animals. All the healthy and tuberculous badgers from the Staffordshire area were invariably unreactive to the various preparations used for skin-testing. However, in the East Sussex area, positive reactions were obtained in 10 out of 37 healthy and 7 out of 10 infected animals. This is the first account of positive skin tests in free living badgers. These results support the concept that badgers infected with bovine tubercle bacilli pass through an immunological spectrum throughout much of which they are unlikely to be important sources of infection. In the early stages, tubercle bacilli are excreted from infected wounds, whereas in the later stages, failure of cell-mediated immunity results in excretion of tubercle bacilli from other sites and the badger becomes a potent source of infection. PMID- 3310348 TI - Adenosine deaminase activity in tuberculous pleural effusions: a diagnostic test. AB - The activity of adenosine deaminase (ADA) was investigated in pleural effusions from 10 patients with tuberculous pleurisy and 76 patients with pleural effusions of other aetiology. The ADA activity in the tuberculous patients was significantly higher than in the other groups, with the exception of those with empyema. Specificity (87%) and sensitivity (100%) of this test for tuberculosis is high when a reference limit of more than 53 U/l is taken. PMID- 3310350 TI - Inflammatory pseudotumor of the liver: report of two cases. AB - Inflammatory pseudotumor of the liver is a rare benign lesion which clinically and grossly is often interpreted as a neoplastic condition. It usually arises in children or young adults. Only 11 cases have been described in the literature, and its etiology is still uncertain. Two new cases of inflammatory pseudotumor in adult male patients are reported here. Morphologically, these cases summarize all the features seen in the other cases described previously. They showed fibrous bands delimiting microabscesses made up of granulocytes, mononuclear elements and foamy macrophages. These lesions have in common the symptomatology which is amenable to infectious disease. The purpose of this paper is to draw attention to the existence of a lesion that clinically simulates a neoplastic condition of the liver. This lesion should be histologically recognized to avoid excessive surgical treatment. PMID- 3310349 TI - Secondary acute non lymphoid leukemia in patients treated for non Hodgkin's lymphoma: no risk of therapy-related ANLL after PROVECIP schedule. AB - The present study was undertaken to evaluate the frequency, characteristics and actuarial risk of secondary acute non lymphoid leukemia (s-ANLL) in 141 patients treated for non Hodgkin's lymphoma with different modalities. One hundred and twenty-four patients received chemotherapy according to PROVECIP protocol. Of these, 15 also received as induction treatment a local nodal irradiation and 33 an extended field radiotherapy. Seventeen out of 141 were treated by total body irradiation. Of these, 15 relapsed and received salvage chemotherapy. Sixteen of the 124 patients treated with PROVECIP also underwent different chemotherapeutic programs as salvage treatment. Of the entire population studied, 2 patients developed an s-ANLL, 45 and 63 months after diagnosis of NHL. The type of treatment significantly affected the occurrence of s-ANLL, since both leukemias occurred in patients treated with total body irradiation, given alone or followed by chemotherapy. The actuarial risk at 8 years was 5.24% in the whole group, whereas it greatly increased in the group of patients treated with total body irradiation (24%). Conversely, no risk was found in the group treated with PROVECIP, alone, with additional chemotherapy, or with associated local or extended field radiotherapy. PMID- 3310351 TI - Metastases to the submaxillary gland from breast cancer: case report. AB - A case of metastases to the submaxillary gland from breast carcinoma is reported. The patient, a 68-year-old female, had been operated for a stage II N+ breast carcinoma 4 years before. She then received six courses of CMF adjuvant program. A literature review is presented concerning the 8 well-documented cases reported. PMID- 3310353 TI - In vivo biomicroscopy with ultrasound. AB - We propose the use of inverse scattering theory methods to analyse high frequency ultrasound reflection data to provide high resolution images of living tissue. Conventional ultrasound imaging uses the pulse-echo method which can only resolve structures which are large compared to the wavelength of the ultrasound. Inverse scattering analysis, on the other hand, can image details as small as a quarter wavelength. This makes possible a significant improvement in resolution and has many potential applications in the detection and study of disease. We report here results obtained using this method to produce images of the retina, where we were able to resolve details as small as 50 micron in a 300 micron layer. PMID- 3310352 TI - Limitations of ultrasound imaging and image restoration. AB - The definition of medical ultrasound images is strongly limited by the need for low examination frequencies which is imposed by the high attenuation of acoustic waves in tissues. The filtering effect of imaging systems is described and quantified for echography, transmission tomography and reflection tomography. Improvement of image definition is demonstrated to be the result of a numerical restoration of the received echoes implemented, in the present case, by a simplified Kalman filter. The improvement in definition obtained is emphasized on simulated data and tissue images. The comparison between the results obtained from the three techniques shows that: if only echography provides a real-time acquisition of signals, tomographic methods lead to faster processing associated with a better signal-to-noise ratio on the reconstructed images, and reflection tomography offers the best definition. PMID- 3310354 TI - A review of the ultrasonic bioeffects of microsonation, gas-body activation, and related cavitation-like phenomena. AB - Ultrasonic exposures localized to regions smaller than a wavelength minimize the thermal mechanism, but promote nonthermal mechanisms of ultrasonic bioeffects. Microsonation experiments with vibrating needles or wires exploit this situation for the study of nonthermal mechanisms such as acoustic microstreaming flow. Shear stress in microstreaming flow, which is in excess of critical values for biomembranes, leads to cell lysis. Plane wave exposure of small bodies of gas also yields localized exposure, with further amplification of nonthermal mechanisms by resonance activation of oscillation. Gas body activation in vitro causes gathering of suspended cells by radiation forces, aggregation, cellular effects and lysis by microstreaming. When suitable gas bodies are present, these effects may occur at levels below the threshold for ultrasonic cavitation. In vivo, gas body activation generates intracellular microstreaming in Elodea leaves and disrupts the cells for super-critical shear stress levels. Similar phenomena seem to account for cell death, growth and mitotic index reductions in other plant tissues, and developmental abnormalities and delayed death in fruit flies. Only fragmentary and equivocal evidence presently exists on the medically relevant question of whether such subthreshold cavitation-like activity and bioeffects occur in vertebrates. PMID- 3310355 TI - The use of acoustic microscopy for biological tissue characterization. AB - A system of transmission raster acoustic microscope with an ultrasound frequency of 450 MHz has been designed to investigate biological tissues and comparative analysis of their optical and acoustic images. The possibility of obtaining the contrast acoustic images of nonfixed, nonstained biological tissues and viscoelasticity measurements in microscale was demonstrated. PMID- 3310356 TI - Bibliography of biomedical ultrasound. No. 68. PMID- 3310357 TI - Cryopreservation of mouse pancreatic islets: effects of human serum on islet survival. AB - The aim of this study was to compare the survival of cryopreserved mouse pancreatic islets frozen in the presence of either a simple salt solution (Hanks' balanced salt solution) or a complete tissue culture medium (RPMI 1640). Moreover, the addition of 10% human serum to the freezing solutions was evaluated. Collagenase isolated islets were kept in culture for three days, before being cooled at a rate of 5 degrees C/min or 25 degrees C/min to -70 degrees C, at which temperature the islets were transferred to liquid nitrogen. All freezing media were supplemented with 2 M dimethylsulphoxide as cryoprotectant. The islets were rapidly thawed at 37 degrees C and subsequently cultured for another three days. The recovery of islets was higher when the more rapid cooling rate was used and the addition of serum further improved the recovery. Compared to non-frozen cultured islets there was a loss of cells in all groups of cryopreserved islets, as measured by their DNA content, and this was accompanied by a lowered insulin content. All groups of frozen-thawed islets responded to a high glucose stimulus in vitro with a 5-9 fold increase in insulin secretion. There was no obvious advantage of using a complete tissue culture medium for islet cryopreservation, but the addition of serum had some beneficial effects. Data obtained from non-frozen control islets suggest that human serum slightly impairs the function of mouse pancreatic B-cells. PMID- 3310358 TI - A role for crinophagy in pancreatic islet B-cells. Minireview based on a doctoral thesis. PMID- 3310359 TI - [Surgical treatment of the concealed penis in children]. PMID- 3310360 TI - [Choice of the method of urine evacuation in traumatic spinal cord disease]. PMID- 3310361 TI - [Characteristics of disorders of insulin and C-peptide secretion in chronic glomerulonephritis patients]. PMID- 3310362 TI - [Physician, scientist, patriot (on the centenary of the birth of Prof. D. A. Vvedenskii)]. PMID- 3310363 TI - [Malignant neoplasms in uremia patients]. PMID- 3310364 TI - Percutaneous management of retroperitoneal abscesses. AB - Retroperitoneal abscesses have been a difficult diagnostic and therapeutic challenge in the past. With the advent of precise noninvasive imaging modalities, they now are defined more easily. Percutaneous guided catheter drainage has changed our therapeutic approach to this disease and enabled rapid and complete drainage to be performed in the majority of cases. Although the literature is replete with documentation of the percutaneous management of intra-abdominal abscesses, series dealing with retroperitoneal abscesses exclusively are surprisingly infrequent. We report on the percutaneous treatment of 31 retroperitoneal abscesses and the combined percutaneous and surgical management of 4 additional cases. PMID- 3310365 TI - Renal transplantation for end-stage polycystic kidney disease. AB - From 1963 to 1984, 56 renal transplants were performed in 51 patients with end stage renal failure due to autosomal dominant polycystic kidney disease (ADPKD). There were 49 cadaver and 7 living-related transplants. Overall patient and graft survival was 88 per cent and 66 per cent at one year, 59 per cent and 49 per cent at five years, respectively. There was no significant difference in patient or graft outcome with cadaver versus living-related donor kidneys. One-year graft success with and without pretransplant bilateral nephrectomy (BN) was 78 per cent versus 58 per cent, respectively (n.s.). Patient survival after return to dialysis after graft loss was not compromised by the earlier performance of BN. In patients who did not undergo pretransplant BN, there were no complications from the retained native kidneys after transplantation. In cadaver recipients, the two-year graft success rate with and without preliminary blood transfusions was 54 per cent versus 61 per cent, respectively (n.s.). Cadaver graft survival with and without adjunctive antilymphocyte globulin (ALG), excluding 3 recipients managed with cyclosporine, was 88 per cent versus 50 per cent at one year, and 70 per cent versus 32 per cent at five years, respectively (p less than 0.05). This beneficial effect of ALG was still evident when only transfused cadaver recipients were analyzed and was achieved with no resulting compromise in patient survival. Follow-up computerized tomography (CT) scanning of the transplant kidney in 10 recipients with a long-term (1-9 years) functioning allograft showed no evidence of recurrent ADKPKD. PMID- 3310366 TI - Flow cytometric analysis of relative mean DNA content of urogenital cancer cells in fresh and paraffin-embedded materials. AB - The relative mean DNA content calculation was performed by flow cytometry on single cell suspensions prepared from fresh and paraffin-embedded specimens of 10 patients with surgically resected urogenital cancer. Samples were processed by a modified method of Hedley et al. including two hours of pepsinizing time, ribonuclease digestion, and propidium iodide staining. The mean DNA content which is a quantitative description of flow cytometric characteristics was significantly correlated between the fresh and paraffin-embedded materials (n = 10, r = 0.869, p less than 0.01). This method allows for the objective, retrospective analysis of DNA content in relation to diagnosis and prognosis of urogenital cancer. PMID- 3310367 TI - Ultrasonography in evaluation of mechanical problems of inflatable penile prosthesis. AB - A simple noninvasive and relatively inexpensive new technique utilizing real time sector ultrasonography for evaluation of mechanical failure in inflatable penile prosthesis is presented. PMID- 3310369 TI - Phenylpropanolamine in treatment of female stress urinary incontinence. Double blind placebo controlled study in 24 patients. AB - Twenty-four women with stress urinary incontinence of slight to moderate grade were treated with phenylpropanolamine (PPA), po 50 mg twice daily, and placebo for periods of two weeks according to randomized double-blind cross-over schedule. A significant increase in maximum urethral closure pressure (MUCP) was found after treatment with PPA compared to placebo, but functional urethral length was unchanged. Number of leakage episodes were significantly reduced during PPA treatment, but micturition frequency was unchanged. Fourteen women preferred PPA, 4 preferred placebo, and 6 considered PPA and placebo to be ineffective. The scored improvements obtained by PPA were highly significant when tested against the scored placebo effect. There was a significant correlation between subjective assessment and improvement in number of leakage episodes and increase of MUCP. Plasma-PPA levels showed no significant correlation with any of the effect variables. Adverse reactions were few and negligible. PMID- 3310368 TI - Chlamydia trachomatis epididymitis diagnosed by fluorescent monoclonal antibody. AB - Two cases are described of atypical presentation of epididymitis requiring surgical exploration to rule out the presence of testicular tumor. In each case epididymal biopsy confirmed the diagnosis of epididymitis, and the causative organism, Chlamydia trachomatis was identified by fluorescent monoclonal antibody technique. PMID- 3310370 TI - Diseases of pigeons. AB - This article contains the most common bacterial, viral, protozoan, mycotic, and parasitic diseases of pigeons encountered by the practicing veterinarian. Emphasis is placed on etiology, transmission, clinical signs, postmortem lesions, treatment, and control to aid the veterinarian in assessing clinical conditions. PMID- 3310371 TI - Diseases of quail. AB - An increasing number and variety of quail are being kept for food production, experimental use, release on hunting preserves, preservation of endangered species, zoological display, and as companion birds. Quail are susceptible to a variety of noninfectious, infectious, and parasitic diseases. Because they are related to chickens and turkeys, many of the diseases in quail are similar to those in poultry. In this article, the diagnostic characteristics of diseases affecting quail are presented along with information on their prevention, control, and treatment. PMID- 3310372 TI - Biology and medicine of the ferret. AB - There is still much more to be learned about ferret behavior, nutrition, and physiologic responses associated with aging, disease, and environmental stimuli. The many similarities in the clinical disorders of ferrets and other small companion animals should emphasize the importance of using the same diagnostic methods developed for common companion animals in examinations of ferrets. There is still very little known of the efficacy of a wide spectrum of drugs in ferrets, and judicious use of pharmacodynamic agents that are safe for cats would be a reasonable approach to drug therapy. PMID- 3310373 TI - Anesthesia and surgery of laboratory animals. AB - This article reviews anesthetics and anesthetic techniques applicable to small laboratory animals. Anesthetic and analgesic dosage tables are presented for each species to guide the practitioner. The actions of the various agents are reviewed in the text, and key references are presented. Surgical considerations are also reviewed. PMID- 3310374 TI - Real-time ultrasonic scanning in sheep: the results of the first year of its application on farms in south-west Scotland. AB - After a two-day period of instruction in the use of a linear real-time ultrasonic scanning machine the results obtained by three operators scanning a variety of types of ewe under different conditions were recorded and compared with the actual lambing results. In the first season an overall accuracy of 95 per cent was achieved for the diagnosis of barren ewes and ewes carrying either one or two or more lambs. However, monitoring the accuracy achieved for the diagnosis of zero, one, two, three or four lambs demonstrated an improvement in expertise with time, the accuracy increasing from below 70 per cent to over 90 per cent. A particular improvement was observed after a comparative session with an experienced operator. Analysis of the figures of accuracy for zero, one, two, three and four lambs highlighted the differences between operators which were less evident if only the results for zero, one or two or more lambs were analysed. These analyses showed that 'newly trained' operators were not at first able to scan successfully. However, after a period of acquaintance with the technique (approximately 500 ewes) and an 'appraisal session' with an expert the accuracy of the operators improved sufficiently to be of commercial value to hill flocks and possibly to low-ground flocks with limited housing. PMID- 3310375 TI - Use of transrectal B-mode ultrasound imaging in bovine pregnancy diagnosis. AB - A 3 MHz ultrasonic transducer was used to make pregnancy diagnoses in 320 milk and beef cows and heifers, on average 41 days after the last insemination. The ultrasound diagnostic findings were systematically confirmed by rectal palpation. Signs of pregnancy were detected as early as the 25th day after insemination. Discounting 16 doubtful results, the accuracy of positive diagnosis (94 per cent) was better than negative diagnosis (89.7 per cent). Ultrasound scanning could be used for the study of embryo mortality or for the determination of fetal age. PMID- 3310376 TI - Cross-reactive antibody in immunity to colisepticemia in calves. AB - Cattle were immunized with a uridine diphosphate galactose epimerase deficient mutant of Escherichia coli to prepare antiserum cross-reactive with different serotypes of E. coli. Hypogammaglobulinemic calves were given bovine anti-J5 serum before oral challenge with virulent E. coli derived from a septicemic calf. Passively immunized calves had delayed and decreased bacteremia compared with calves given saline before challenge. Calves given antiserum also lived longer than control calves. A second experiment using ampicillin and antibody to treat colisepticemia also showed increased survival in anti-serum-treated calves. Decreased bacteremia was probably not due to the killing of the challenge strain by antibody and complement, as the strain was serum-resistant. However, anti-J5 serum did increase phagocytosis of the challenge strain of E. coli (JL9) by bovine neutrophils. Thus, partial protection by antiserum was probably due to increased clearance of bacteria as well as neutralization of endotoxin. PMID- 3310377 TI - Inhibition of virus replication in the tonsils of pigs previously vaccinated with a Chinese strain vaccine and challenged oronasally with a virulent strain of classical swine fever virus. AB - After an oronasal (O.N.) infection with classical swine fever (C.S.F.) virus, virus multiplication can be detected in the tonsils from Day 2 post infection (p.i.) till death. The course of viral replication during the first 10 days after O.N. challenge exposure of pigs, previously vaccinated with a Chinese strain vaccine in the presence or absence of maternal antibodies, was studied using direct immunofluorescence techniques on cryostat sections and virus isolations. When piglets were challenged O.N. in the presence of maternal antibodies, virus replication in the tonsils still occurred. The multiplication period and the localization of the virus, however, were directly correlated to the maternal antibody levels. The maternal antibody level also seems responsible for the efficacy of the vaccination to prevent challenge virus replication in the tonsils: vaccination in the presence of low maternal antibody titers completely inhibited virus replication; vaccination in the presence of high maternal antibody titers only reduced the multiplication period of the O.N.-administered virulent virus. In both cases, animals were challenged 1 week post vaccination. Vaccination of seronegative animals resulted in an almost complete inhibition of the virus replication in the tonsils during a full fattening period: cryostat sections revealed a limited virus replication in three out of 20 animals. In one of these animals, virus replication was probably so negligible that virus isolation remained negative. PMID- 3310378 TI - [Simultaneous detection by immunofluorescence of several viral infections and Mycoplasma, Chlamydia and Rickettsia burneti infections localized at the level of the conjunctival, nasal and pharyngeal mucosae of patients with recurring chronic keratoconjunctivitis]. AB - A study was conducted of the viral and inframicrobial populations present in the conjunctival, nasal and pharyngeal mucous membranes by immunofluorescence techniques, using a twelve hyperimmune serum kit, in 120 patients with chronic, relapsing keratoconjunctivitis. Qualitative and quantitative differences were noted in the antigen levels in the three investigated mucous membranes. The number of antigens in the conjunctival and nasal epithelial cells was higher than in the pharyngeal ones: 117 and 113 positive IF tests for the first two against 95 for the third. Incidence of each of the individual antigens was two or three times higher in the conjunctival and nasal mucous membranes, excepting, however, the parainfluenza viruses which were equally frequent in all the three mucous membranes. PMID- 3310379 TI - [The circulation of influenza virus in human communities subjected to the action of noxious chemical substances]. AB - Investigations were conducted during 1985 and 1986 years on the effect of some noxious chemicals on the influenza virus circulation in an industrial enterprise community. The presence of influenza virus type A (H1N1), A (H3N2) and B was revealed by immunofluorescence in exfoliated cells collected from nasopharynx. The kinetic of type specific hemagglutination inhibiting antibodies was followed monthly. Chick embryos were used to isolate influenza virus strains. Meaning of the results is discussed from an epidemiological point of view. PMID- 3310380 TI - [Multiple sclerosis. Risk factors]. AB - Hypothetical risk factors in multiple sclerosis are reviewed. So far accumulated data how that the most probable of the risk factors is represented by the morbillivirus group. PMID- 3310381 TI - Synthesis and cellular location of the ten influenza polypeptides individually expressed by recombinant vaccinia viruses. AB - A complete set of recombinant vaccinia viruses that express each of the influenza virus polypeptides has been constructed. PB1, PB2, PA, HA, NP, M1, and NS1 genes were derived from influenza virus A/PR/8/34, NA from influenza virus A/Cam/46, and M2 and NS2 genes from influenza virus A/Udorn/72. Cells infected with these recombinant viruses synthesize influenza polypeptides that are precipitable with specific antisera and that have electrophoretic mobilities similar to the corresponding influenza virus polypeptides. Indirect immunofluorescence studies have shown that HA, NA, and MS2 proteins migrate to the cell surface; PB2, PB1, PA, NP, and NS1 proteins migrate to the cell nucleus; and M1 and NS2 are distributed throughout the cell, although NS2 accumulates preferentially in nuclei. These transport processes occurred independently of other influenza polypeptides and are therefore attributable to the intrinsic properties of the influenza polypeptides themselves. PMID- 3310382 TI - Immunological analysis of 140-kDa adenovirus-encoded DNA polymerase in adenovirus type 2-infected HeLa cells using antibodies raised against the protein expressed in Escherichia coli. AB - The E2B region of adenovirus genome contains a long open reading frame (ORF) extending from 24 to 14.2 map units which encodes most of the 140-kDa DNA polymerase. It was cloned at the polylinker region of pUC18 vector with Escherichia coli JM109 as the host. A clone was serendipitously isolated that expressed in E. coli a protein of approximately 120 kDa in size at high levels. DNA sequence analysis of this clone showed the presence of an in-frame fusion of a region, encoding 13 amino acids located upstream, to the first ATG of the ORF. Polyclonal antibodies raised against this protein purified from E. coli were used for immunological analysis. The antibodies were able to detect a 140- and a 66 kDa polypeptide from the adenovirus type 2-infected HeLa cells on Western blots. In addition, the antibodies showed evidence of cross-reactivity with partially purified DNA polymerase alpha from uninfected HeLa cells. The subcellular localization of the viral polymerase in the infected HeLa cells by using indirect immunofluorescence showed that the viral protein is associated with globular structures in the nucleus. The replicating viral DNA and the polymerase were colocalized in these globular sites. Furthermore, HeLa cells infected with Ad5ts149, a temperature-sensitive mutant defective in DNA replication, showed the presence of these globular sites only at the permissive temperature, suggesting that these sites are probably involved in viral DNA replication. PMID- 3310383 TI - Temperature sensitivity of the multiplication of bacteriophage T4 amber mutants on nonpermissive host: characterization of the phenomenon. AB - The existence of temperature sensitivity of the multiplication of amber mutants on a nonpermissive host has been established for a considerable number of mutants in tail and head genes and for mutants in some other T4 genes as well. Temperature sensitivity of multiplication appears to be gene specific, and is typical of amber mutants in genes the products of which are not numerous per phage or which play the role of catalytic factor. Moreover, in most cases temperature sensitivity is characteristic of amber mutants in definite gene clusters. PMID- 3310384 TI - [Postoperative problems in liver transplantation]. PMID- 3310386 TI - [General principles of intensified conventional insulin therapy of type I diabetes]. PMID- 3310385 TI - [Pyruvate kinase activity as a marker of erythrocyte age increases the reliability of the method of determining insulin binding to membrane receptors]. PMID- 3310387 TI - [An attempt to remove red blood cells from a bone marrow suspension]. PMID- 3310388 TI - [Echinococcal liver cysts in Algeria]. PMID- 3310389 TI - [Levels of glucose, insulin and somatotropin hormone in patients with hyperbilirubinemia during the oral glucose tolerance test]. PMID- 3310390 TI - [Carbohydrates and blood pressure]. PMID- 3310391 TI - [Modern concepts of cytomedins and the problems of bioregulating therapy]. PMID- 3310392 TI - [New data on the acquired immunodeficiency syndrome (a review of the literature)]. PMID- 3310393 TI - [Konstantin Mikhailovich Figurnov (on the centenary of his birth)]. PMID- 3310394 TI - [Public health problems in the programs of the Communist Party of the Soviet Union]. PMID- 3310395 TI - [The role of lipoprotein modification in atherogenesis (review)]. AB - Structural stability and interaction of modified blood serum lipoproteins with cells and the components of intercellular matrix are reviewed. Modified lipoproteins might possess more distinct atherogenic properties as compared with the native lipoproteins. Existence of modified lipoproteins in vivo is considered. PMID- 3310396 TI - [Antithrombin III. Functional role and methods of determination (review)]. AB - Antithrombin III (AT III) is the most important inhibitor of thrombin and other serine proteinases in the system of blood coagulation. AT III not only removes the excess of thrombin from blood but it inhibits the enzyme synthesis. AT III became functionally active in presence of heparin, which operates as a catalyst and accelerates significantly the formation of inactive complexes between AT III and proteinases, which usually developed slowly in absence of the activator. AT III and heparin cofactor are synonyms and designate the same substance. Modern procedures for estimation of AT III in blood plasma are reviewed. PMID- 3310398 TI - [The use of antiemetics during chemotherapy in cancer patients]. PMID- 3310397 TI - [Malignant skin melanoma in Estonia: incidence and survival]. AB - The paper discusses changes in age-standardized indexes of incidence of skin malignant melanoma in male and female population of Estonia observed within 1963 1982. In 1968-1982, the average annual increase in the tumor incidence was 6.0% for males and 7.2% for females, being the highest for melanoma of the lower limbs. The 1, 5, 10 and 14-year relative survival rates in patients with skin malignant melanoma diagnosed within 1968-1982 were 71.6, 33.2, 35.3 and 16.4% for males and 84.2, 55.6, 43.2 and 42.0% for female patients, respectively. PMID- 3310399 TI - [Butylhydroxytoluene inhibition of the mutagenic activity of carcinogenic nitroso compounds and cyclophosphamide: the role of the glutathione conjugation reaction]. AB - Mutagenic effect of diethylnitrosamine, nitrosomorpholine and cyclophosphamide were studied on Salmonella typhimurium in the Ames test using S9, microsomal and cytosolic subfractions of Wistar male rats. Pretreatment with butylhydroxytoluene (BHT) was followed by a 50-60% decrease in metabolic activation of the said promutagens by liver subfractions. This was matched by an increase in cytosolic and microsomal glutathione-S-transferase activity and glutathione level in rat liver. The addition of glutathione to the incubation medium in the Ames test using liver subfractions of BHT-treated rats brought on a complete inhibition of mutagenic effect of the agents studied. It is suggested that BHT-induced decrease in production of active metabolites and increase in their inactivation in reactions of glutathione enzymatic conjugation account for the inhibition of mutagenicity of the promutagens under study. PMID- 3310400 TI - Detection of early anti-p24 HIV responses in EIA- and immunoblot-negative individuals. Implications for confirmatory testing. AB - A sensitive and specific radioimmunoprecipitation assay was developed for the detection and analysis of anti-HIV antibody response in human sera with the use of 125I-labelled purified HIV proteins with subsequent sodium-dodecylsulfate gel electrophoresis (125I-RIPA). The 125I-RIPA was shown to be as specific but at least 1 log more sensitive with respect to the detection of gp41env and p24gag than the immunoblot analysis as tested in serum samples from several risk groups. Sequential sera were obtained from 9 individuals who seroconverted for HIV antibodies. In 4 individuals, antibody to p24gag was detected in earlier serum samples by the 125I-RIPA than by EIA or immunoblot; in the other 5 individuals, the detection of p24gag concorded in enzyme-linked immunosorbent assay (EIA), immunoblot and 125I-RIPA. Moreover, in one of 78 randomly chosen EIA-negative sera from individuals at high risk, antibodies to p24gag could be detected by the 125I-RIPA. This early seroconversion was confirmed 3 months later by means of immunoblotting and EIA. The specificity of the 125I-RIPA was further demonstrated by analyzing sequential EIA-negative serum samples from 10 individuals at risk for AIDS, collected during 2 years at 3-monthly intervals. All 80 serum samples were found to be negative in the 125I-RIPA and the individuals revealed no signs of HIV infection. The 125I-RIPA technique may be a valuable confirmatory assay in the serology of HIV infections. The sensitivity of this test provides a reliable measure of effective sensitivity when new-generation screening tests are evaluated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310402 TI - New approaches to treating systemic lupus erythematosus. AB - These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Drs Homer A. Boushey, Associate Professor of Medicine, and David G. Warnock, Associate Professor of Medicine, under the direction of Dr Lloyd H. Smith, Jr, Professor of Medicine and Associate Dean in the School of Medicine. Requests for reprints should be sent to the Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143. PMID- 3310403 TI - Medicare-funded cardiac transplants. PMID- 3310401 TI - Pathogenesis of sarcoidosis. AB - Sarcoidosis is a multisystem granulomatous disease of unknown etiology. The organs that are involved by sarcoidosis include the lungs in which the granuloma is seen in more than 90% of patients to the pituitary, which is only rarely affected. There are many hypotheses as to the cause of sarcoidosis. Some of them rely on the similarities seen between sarcoidosis and the other granuloma-forming diseases such as tuberculosis, berylliosis, pine pollen inhalation and acute and chronic bacterial and viral infections, while others find similarities between sarcoidosis and immune reactions observed in autoimmune disorders. Still other explanations implicate a genetic predisposition or a still-unknown agent as the underlying cause of the granuloma formation. PMID- 3310404 TI - Clinical significance and interpretation of antinuclear antibodies. PMID- 3310405 TI - [Measurement of arterial blood pressure in children]. PMID- 3310406 TI - [Cytological examination of urinary sediment in the diagnosis of neoplasms of the urinary tract]. PMID- 3310408 TI - [Unusual dislocation of a fragment of Kirschner wire after fixation of the sternoclavicular joint]. PMID- 3310407 TI - [Current methods of early detection of breast cancer]. PMID- 3310409 TI - [Aleksander Fabian and the first Poland description of pneumoconiosis]. PMID- 3310410 TI - [Conducting medical congresses 100 years ago]. PMID- 3310411 TI - [Effect of selected bacterial pathogens of man on ticks (Acari, Ixodidae)]. PMID- 3310412 TI - [Practical evaluation of insecticides and their use]. PMID- 3310413 TI - [Hemolytic graft versus host reaction cause by immune "auto"-anti A1 formation in an A1 recipient following transplantation of an O kidney. With a review of studies up to now from the literature]. AB - The serological data are given of a patient with acquired haemolytic anaemia due to "auto"-antibodies of Anti A1 specificity induced by a group O kidney graft in an A1 recipient as a Graft-versus-Host (GvH) reaction. The gamma-globulin markers Gm (a,x,f) were tested for differentiation between auto- or alloantibody character of the patients "Auto"-Anti A1. The possibility of in vivo neutralization of the Immune-Anti A1 by blood group substance A in the plasma of the patient could not be proven, though initially presumed. The disadvantages of using ABO compatible, but not identical organ donors is pointed out, firstly the possibility of giving rise to ABO induced GvH reactions and, secondly, the reduced chance of group O recipients on the waiting list getting group O graft. A search of the literature revealed 46 similar cases, which are reviewed and their characteristics are discussed. PMID- 3310414 TI - [In vivo degradation of immune complexes in the kidney by orally administered enzymes]. AB - Preformed immune complexes were deposited in kidney glomeruli of rabbits after i.v. injection. In vivo disintegration of these complexes by orally administered enzymes was investigated. 3 rabbits were given labelled trypsin and papain and the radioactivity and enzyme activity determined in the blood. The radioactive fraction showed an active enzyme concentration of 3-5 mg%. 13 experimental rabbits and 3 control animals received three i.v. injections of 5 ml preformed soluble immune complexes at 12-hour intervals. 24 hours after the last injection the experimental animals were fed 1600 mg enzyme mixture. All animals were sacrificed 4 hours later and the glomeruli of the kidney were investigated by immunofluorescence. All control animals showed large amounts of immune complexes in the glomeruli. Experimental animals, which had all received oral enzymes showed no immune complexes any more, or only residual immune complexes in some glomeruli. This observation pointed to in vivo disintegration of immune complexes by orally-administered enzymes as providing the basis for the treatment of immune complex diseases. PMID- 3310416 TI - [Detection and quantification of erythrocyte-associated immunoglobulins using immunoenzyme technic--enzyme immunometric assay (EIMA)]. AB - A new technique is described for the quantification of erythrocyte-associated immunoglobulin G (EAIgG). Enzyme immunometric assay (EIMA) measures the consumption of enzyme-labelled anti-human globulin. Thus, the release of cellular enzymes is avoided and, thereby also falsification of the results owing to the antigen-antibody reaction taking place in media of differing molarity and ionic strength (as is inevitable in red cell lysis assays). This consumption technique is more sensitive than simple "sandwich" procedures. The measurement of minimal amounts of physiologically bound EAIgG is, moreover, possible. PMID- 3310415 TI - [HIV (HTLV III/LAV) serology: experiences based on more than 42,000 tests]. AB - 1,032 sera of diverse origin (AIDS risk groups, prostitutes, inpatients, blood donors) exhibiting a positive HIV (HTLV III/LAV) ELISA result (Organon and/or Abbott) were investigated with different HIV confirmation assays (Western blot, WB; immunofluorescence, IF; competitive enzyme immunoassay against cloned gp41- and p24-antigen). Sera were finally evaluated as positive if at least two confirmation assays turned out positive (IF and WB; IF and p24, gp41; WB and p24, gp41; IF and WB and p24, gp41). Test results were considered false if the respective finding (IF or WB or p24, gp41) differed from two other confirmatory assays. 1,001 out of 1,032 sera (97%) yielded corresponding results in IF and WB. The remaining 3% of the investigated sera showed false positive, false negative, non-interpretable IF results and non-interpretable WB findings. The present study demonstrates that a positive HIV test should be confirmed by at least two confirmatory tests, one of which should be the WB. Non-corresponding results in confirmatory tests necessitate a third test system. PMID- 3310417 TI - [On the problem of post-traumatic headache]. AB - Posttraumatic headache is a general term for pain localized in the head or neck, occurring after head trauma and of varied aetiology and pathogenesis. In many cases one only finds a time-dependent relation to trauma, but no causal one. There is no uniform, typical "posttraumatic headache". The headaches are commonly caused by injury to scalp, cervical spine and intracranial structures. A reciprocal influence exists between these functionally disturbed structures and a relation to psychogenic factors, which are essential co-factors. Usually it is difficult to decide whether posttraumatic headaches are exclusively caused by organic or psychogenic factors. Probably both factors are involved to an individually different degree. PMID- 3310418 TI - [Hyaluronidase in the therapy of malignant diseases]. AB - 260 patients with malignant disease received intravenous, intramuscular or intravesical hyaluronidase (H.) (Permease by Sanabo), 7,000 to 25,500 IU (10 to 30, 750 IU vials) or 200,000 IU (1 vial of H.) in addition to systemic or intravesical chemotherapy. Treatment was well tolerated except for 20 transient allergic episodes, 2 of which consisted in local symptoms at the injection site. Results are presented for 103 patients not responding to previous chemotherapy, 53 patients with primary and secondary brain tumours, and 51 patients with superficial bladder cancer. Adjuvant hyaluronidase was found to restore responsiveness in a large percentage of non-responders. The remaining systemically treated patients received H. together with their initial chemotherapy or with a modified cytostatic regimen. Intravesical H. in combination with mitomycin C was well tolerated and did not enhance mitomycin C plasma levels. In a randomized trial 5 of 23 patients with superficial bladder cancer receiving adjuvant intravesical mitomycin C alone developed tumour regrowth versus 1 of 21 patients receiving additional H. Adjuvant H. decreased 5 FU plasma saturation rates during arterial perfusion in colorectal cancer with metastatic spread to the liver, probably reflecting enhanced 5-FU extraction. Colorectal cancer stem cell assays with 5-FU showed a significant reduction of colony counts in the presence of H. Action mechanismus of hyaluronidase in malignant diseases are discussed, experimental data suggesting an effect of H. on immunologic events in malignant disease are presented. PMID- 3310419 TI - Alfred Spring Evans, M.D. A tribute. PMID- 3310420 TI - A symposium in honor of Alfred S. Evans, M.D., M.P.H. Fifth annual meeting of the American College of Epidemiology. September 25, 1986. Proceedings. PMID- 3310421 TI - A brief perspective on the early history of American infectious disease epidemiology. AB - The early history of epidemiology is closely linked to the history of infectious diseases and can be divided into three distinct periods. The earliest period, which can be traced to the writings of Hippocrates in the third and fourth centuries B.C., was that of clinical description of diseases with little investigation into their specific characteristics and etiologies. The second period, spanning the eighteenth and nineteenth centuries, may be distinguished by the rejection of early Hippocratic and Galenic doctrines and the more systematic description of morbid conditions. The third period, which was marked by the discovery of specific microbial causes of disease, spurred an extraordinary growth of knowledge and scientific exploration. This period will be the main focus of the paper, as it had the greatest influence on the development of American infectious disease epidemiology. PMID- 3310422 TI - [Prevention of hepatitis in dialysis centers. 1]. PMID- 3310423 TI - [Carl Friedlander (1847-1887) and the discovery of the Pneumococcus--in memory of the centenary of his death]. PMID- 3310424 TI - [Relation of aerobic and anaerobic bacterial counts in human saliva to dental parameters]. PMID- 3310425 TI - [Effect of water immersion on plasma renin activity, vasopressin and aldosterone level in diabetics]. AB - In 83 diabetic patients (23 of them were insulin-dependent) and 34 healthy subjects the influence of water immersion (WI) for 2 hrs on plasma renin activity (PRA), plasma aldosterone and vasopressin (AVP) level was examined. In both examined groups WI exerted a suppressive effect on PRA, plasma aldosterone and AVP level. In this respect only quantitative but not qualitative differences between diabetics and normals were observed. Presence of moderately advanced diabetic nephropathy and autonomic neuropathy influenced only slightly WI induced alterations of the renin-aldosterone system and AVP secretion. In all diabetic patients a defective volumetric mechanism of both the renin-aldosterone system and AVP secretion was stated. In addition in diabetic patients with late diabetic complications a defective osmotic mechanism of AVP secretion was observed. These findings suggest participation also of factors other than hypervolemia and decrease of the plasma osmolality in the mechanism of the observed WI induced suppression of the renin-angiotensin system and AVP secretion in diabetic patients. PMID- 3310426 TI - [Status of regional chemotherapy of the liver]. AB - The review of the literature and of own results show, that the local chemotherapy of hepatic only metastasis from colorectal or breast cancer and of primary liver carcinoma may result in a prolongation of life of six to eight months. There are no statistical advantages of different treatment modalities. Metastases from colorectal primaries show complete remission in about 10%. Other tumors are not suitable or need further interest. The advantage of the shown patients has to be bought by additional surgery and occasional local toxicity. The method still can not be seen as standard treatment, but should further be examined and developed by specialized centers. There is no more doubt that the surgical resection of localized tumors is of great value. PMID- 3310427 TI - [Regulation of gastric acid secretion: new aspects]. AB - The purpose of this short review is to reveal new aspects of regulation of gastric acid secretion. The complex interactions between humoral, paracrine, neurocrine, neuroendocrine, vagal and sympathetic mechanisms will be emphasized. The finding that stimulation of the vagus nerves releases bombesin from peptidergic nerve fibers, which causes release of gastrin from endocrine cells in the stomach, demonstrates the complex interaction between nerves and hormones. The target organ, the parietal cell, has receptors for gastrin, acetylcholine and histamine, which potentiate each other regarding stimulation of acid secretion. New findings about the pathophysiology of acid secretion in duodenal ulcer patients are emphasized. PMID- 3310428 TI - [Campylobacter pylori in duodenal ulcer--a concomitant phenomenon or causal association?]. AB - The rediscovery of spiral bacteria in gastric mucosa in recent years has given raise to new speculations concerning the pathogenesis of peptic ulcer disease. Due to the features and localisation of this bacterium it was named campylobacter pylori. Findings pointing to a pathogenetic role of this bacterium are few and not definitely settled. The frequency of campylobacter on the gastroduodenal mucosa, its short term survival in acidic environment, its extraordinary mobility and content of specific enzymes makes it likely that this bacterium exerts a noxious effect on the gastroduodenal mucosa. Moreover a local and systemic immune response caused by campylobacter has been reported. We performed ultrastructural investigations on duodenal mucosa in patients with active peptic ulcer disease. An ultrastructural localization of the bacterium in duodenal mucosa of these patients was possible in 40%. Campylobacter pylori is localized preferentially on metaplastic cells of the antrum type, is seen penetrating in the intercellular spaces and is found also included in vacuoles of epithelial cells. These findings raise the hypothesis that campylobacter pylori infection can lead to direct damage of duodenal mucosa. PMID- 3310429 TI - [Significance of the gallbladder in the regulation of duodenogastric reflux]. AB - Interdigestive motility of the gallbladder the duodenum and the antrum is coordinated by cyclic motor activity or the interdigestive myoelectric complex. Cholecystokinin and parasympathetic stimulation are regulating digestive and interdigestive contractility of the gallbladder. Duodenogastric reflux often can be found in patients with disturbances of gallbladder motility, e.g. cholecystolithiasis, post cholecystectomy and in patients with patholoc cyclic motor activity e.g. ulcer of the stomach or the duodenum. A strong correlation is not yet proven between duodenogastric reflux and gastritis or ulcer. PMID- 3310430 TI - [Cytotoxicity of bile acids and lysolecithin--a factor in the pathogenesis of stomach ulcer?]. AB - The role of bile acids and lysolecithin in the pathogenesis of peptic ulcer is as yet not unequivocally defined. Based on the physiochemical properties of bile acids and animal experiments they have damaging potential on the mucosal cell. However, the majority of results reported in patients do not favour a significant role of bile acids in the pathogenesis of peptic ulcer. With regard to lysolecithin a sufficient data base is missing. Based on the damaging potential in animal experiments and the few reported patient studies a role in pathogenesis is more probable than for bile acids. Studies on concentrations and effects of both, bile acids and lysolecithin over prolonged periods of time in patients with ulcer disease are necessary to further clarify their role in pathogenesis of ulcer disease. PMID- 3310431 TI - [Effects of nicotine, alcohol and caffeine on the incidence, healing and recurrence rate of peptic ulcer]. AB - A causal relationship exists between the incidence of peptic ulcer and smoking: smoking is significantly associated with a higher prevalence of gastric duodenal ulcer. Either type of peptic ulcer demonstrates a lower healing rate in smokers as compared to non-smokers and impaired spontaneous and drug-induced healing. Smoking is a major factor for rapidity of duodenal ulcer recurrence. Incidence, healing rate, and recurrence rate correlate with the number of cigarettes smoked. Beyond this, smoking increases the likelihood of ulcer perforation. The normal life expectancy is reduced in smokers after gastric surgery for peptic ulcer disease. Moderate alcohol and caffeine consumption presumably have no effect on the incidence of peptic ulcer. However, continuous alcohol abuse seems to increase the prevalence of duodenal ulcer. In ulcer disease, it seems unwarranted to exclusively interdict caffeine-containing or alcoholic beverages while permitting other equally potent stimulants of gastric acid secretion like milk. PMID- 3310432 TI - [Gastroduodenal lesions caused by drugs]. AB - Nonsteroidal analgetics (NSA), in particular, can cause acute gastroduodenal erosions. Acid NSA, especially acetylsalicylic acid (ASA), damage gastric epithelium and mucosal capillary endothelium directly. In addition, gastric mucosa is made more prone to attack by aggressive factors like acid, when prostaglandin biosynthesis is inhibited by NSA. Useful studies on the relationship between these acute lesions and peptic ulceration are rare. For the greatest offender, unbuffered ASA, an increased risk for gastric ulceration is documented after prolonged use of higher doses. Major bleeding from peptic ulcers and erosions seems likewise to be fostered. With newer NSA, the damaging potency is, in general, smaller. PMID- 3310433 TI - [Role of glycoproteins in the pathogenesis of peptic ulcer]. AB - Glycoproteins are major constituents of the two-component mucous barrier: glycoproteins of the mucin-type rich in carbohydrate groups form the viscoelastic mucous gel of the mucosa, oligosaccharides of glycoproteins and glycosphingolipids embedded into the plasma membrane form the glycocalyx of the epithelial cell surface. Both structures are thought to play major roles in protecting gastric mucosa against luminal acid and proteases. This assumption is supported by experimental evidence for mucus glycoproteins, however is largely hypothetical for cell surface glycoproteins. Reports that biosynthesis of mucus glycoproteins is decreased during gastric ulceration, while breakdown is enhanced indicate that disorders of glycoprotein biosynthesis and degradation may contribute to the pathogenesis of peptic ulcer disease. The molecular mechanisms responsible for the observed alterations, however, are unknown. Possible alterations of glycoprotein metabolism that may occur at different stages of biosynthesis and degradation are discussed. PMID- 3310434 TI - [The central nervous system and stomach as target organ: the diencephalic-gastric axis]. AB - Gastric functions are controlled by local and hormonal mediators as well as by viscero-afferent nerve fibers and by efferents from the central nervous system. Experiments using lesions of specific brain regions and electrical stimulation demonstrated that distinct brain areas like parts of the hypothalamus, the amygdala and the nucleus ambiguous regulate gastric functions. Apart from classic neurotransmitters, in recent years, neuropeptides have been initially identified in the gastrointestinal tract and subsequently in the brain that act within the central nervous system to modulate functions of various peripheral organ systems including the stomach. These central nervous system effects elicited by neuropeptides are predominantly mediated by the autonomic nervous system. This paper reports on the central nervous system regulation of gastric acid secretion, gastric mucus production, gastric blood flow and gastric emptying by neuropeptides. PMID- 3310435 TI - [Prenatal diagnosis of disorders of fetal kidney function--a critical analysis of 95 cases]. AB - Ninety-five gravidae were examined at Dusseldorf University Gynecological Clinic for assessment of the fetal renal system. Suspected disorders were ruled out in 33 cases by sonography. Urogenital malformations without major loss of function were diagnosed in 25 fetuses. The prognosis was unfavorable in 15, and 22 fetuses had other disorders. In 5 out of 22 infants on whom autopsy was performed, the kidneys were found to be normally developed, contrary to the sonographic diagnosis. However, all five of these infants had anomalies of the umbilical artery. It is well known that cases of anhydramnios in the first half of pregnancy have a poor prognosis. In order to assess such cases better, the authors consider the following examination procedure appropriate: 1) filling with amniotic fluid; 2) Lasix provocation test; 3) thorough sonographic examination of the fetus; 4) karyotyping; and 5) identification of maternal infections. It is at present impossible to say whether there is a statistical relationship between changes in the umbilical cord and disorders of renal function. PMID- 3310436 TI - [Pathologic psychosomatic reaction pattern in aging patients: epidemiologic, diagnostic, preventive and therapeutic remarks]. AB - Somatic, psychic, and social factors influence the Pathological Psychosomatic Reaction Pattern (PPSRP) in the elderly. Some administrative epidemiological, and differential-diagnostical data of the Viennese Psychosomatic Department comment on and extend previous findings. Because of the specificity of PPSRP in the elderly, specific preventive and therapeutic strategies are proposed. PMID- 3310437 TI - [Electroencephalotoposcopy and brain function]. PMID- 3310438 TI - [Reflections on the status and function of the human brain in the structures of intercentral relationships based on data from EEG spectral-correlational analysis]. PMID- 3310439 TI - [Spatial synchronization and functional stratification: the systems aspect of brain activity]. PMID- 3310440 TI - [Neurophysiological aspects of the brain]. PMID- 3310442 TI - [Spatial-phase structure of the biopotential field of the brain and the functional state of man]. PMID- 3310441 TI - [The neurophysiological aspect of research on the systems organization of brain activities]. PMID- 3310443 TI - [The significance of the concept of spatial synchronization of the electrical processes of the brain for psychophysiological research]. PMID- 3310444 TI - Basic criteria for clinical diagnosis and genetic counselling in von Hippel Lindau syndrome. PMID- 3310445 TI - Physical exercise for peripheral vascular disease--a review. PMID- 3310446 TI - The value of hyoscine butylbromide in aorto-iliac intravenous digital subtraction angiography. PMID- 3310447 TI - [Mathematical analysis of the turbidostat cultivation of microorganisms]. PMID- 3310448 TI - [Immunohistochemical study of the pattern of distribution of ABO blood group substances in male genitalia]. AB - The distribution of the ABH antigens was investigated in 11 different sections of the male genitalia in 53 autopsy cases; the peroxidase-antiperoxidase technique was used. Specific staining of the epithelia differed considerably among and between individuals. Nonsecretors showed a tendency toward less staining in the epithelia, whereas in the endothelia there was no difference. A2 cases could be recognized, as the endothelia were marked almost completely with anti-H. In A2B nonsecretor epithelia and endothelia, there was only a minimal reaction with anti A and anti-H. Spermatozoa were irregularly stained in the ampulla of the vas deferens, whereas in the testis and epididymis no reaction could be found. PMID- 3310449 TI - [Our urologic heritage: James Israel (1848-1926)]. AB - Life and work of the Berlin urological surgeon James Israel, one of the most outstanding representatives of renal surgery, which developed in the second half of the 19th century in Germany, is described. Coming out from surgery, Israel developed himself the most outstanding renal surgeon of his time, who by his work essentially contributed to the formation of urology in Germany. PMID- 3310450 TI - [Immune depression as a reaction to surgical operations--its significance for postoperative infection]. AB - Injuries, burns, and surgical intervention may lead to temporary depression of immune defence. Today, life-threatening infections may be caused by bacteria, such as pseudomonas, bacteroids, serratia as well as by viruses, including cytomegaly virus, and yeasts. Severe infections of that kind may be countered by adequate nutrition, planned application of antibiotics or, in the future, by possible active substances against depression of the immunity system, such as interferone, interleucine, and prostaglandins. More attention should be given in surgery to control of immunological defence as well as to knowledge about immunological defence mechanisms. Immune defence has proved to play an important role not only in transplantation surgery but also in other major surgical interventions and in intensive therapy. PMID- 3310451 TI - [Postoperative endotoxin determination and immunoglobulin therapy of infected patients in the intensive care unit]. AB - Seventy-four patients with septic postoperative complications were prospectively listed. Plasma-borne endotoxin was daily determined in all of them by means of the limulus-amoebocyte-lysate test. Maximum sensitivity of the test amounted to 64 per cent, related to days of illness due to severe septicaemia. The conclusion is drawn that additional parameters should be used in future studies to define sepsis, including determination of sepsis score. Endotoxin titres declined in response to immunoglobulin therapy. Lethality went down, as well. PMID- 3310452 TI - [Current status of perioperative preventive use of antibiotics in colorectal surgery]. AB - The rate of postoperative wound infections following colorectal surgery can be considerably reduced by rational perioperative short-time antibiotic prophylaxis. The anaerobic and aerobic microflora of the colon as well as the half-life of the medicaments used have to be taken into due consideration for good choice of antibiotics. Persistent orthograde intestinal flushing, using physiological electrolyte solution without any addition of antibiotics, on the eve of surgery as well as perioperative antibiotic prophylaxis "en flash", using slow-drop intravenous infusion of 1 g Ornidazole and 2 g Mezlocilline along with introduction of anaesthesia, made for a good approach to reducing wound infections following colorectal surgery to two per cent. Twice as much antibiotics were administered for 24 to 28 hours in emergency cases in which preoperative intestinal flushing was not possible. This helped to reduce the rate of postoperative infections from 32 to six per cent. PMID- 3310453 TI - [Clinically silent suture insufficiency in colorectal surgery]. AB - The courses of 140 colorectal resections were evaluated from among the authors' own patients. Regular postoperative radiological control and follow-up of anastomoses have shown that nearly half of all suture insufficiencies remain without any clinical symptoms. No direct relationship appeared to exist between expansion of suturing leaks and their clinical relevance. This seems to underline the importance of contrast media to follow up colorectal resections. PMID- 3310455 TI - Evaluation of fetal development and well-being with ultrasonic Doppler fetal actocardiogram. AB - A new ultrasonic technique for objective, continuous and simple recordings method of fetal movements on CTG chart has been introduced. Fetal activity and heart rate will be correlated. This allows a differentiation of fetal active and resting states. The duration of the first one was 24 to 150 minutes, that of the last one 10 to 36 minutes. Fetal actogram is useful in the prediction of imminent fetal distress. PMID- 3310454 TI - [Transplantation antigen specific rosette test and its inhibition with autologous serum--a new immunologic method for predicting rejection crisis following allogeneic organ transplantation]. AB - A combination of transplantation-antigen-specific rosette test with inhibition of rosette formation, using autologous serum, was used in postoperative follow-up checks on patients who had undergone allogeneic kidney transplantation and proved successful in early diagnosis or prediction of rejection episodes even before clinical manifestation. The numbers of antigen-detecting and antigen-binding cells differed considerably from each other, depending on patients who had undergone kidney transplantation. Almost complete inhibition of antigen detection was generally achieved by addition of patient serum. If sensitization to alloantigen in excess of the limit value (30 RBZ/10(3) KHZ) is accompanied by rosette formation with autologous serum addition in excess of about 18 RBZ/10(3) KHZ, clinically relevant rejection can be expected to occur after another two or three days and will have to be treated by immunosuppressives. Such partial or even complete elimination of rosette inhibition is usually only of short length (one day) and has rarely been observed to last longer. No rejection calling for treatment will develop, on the other hand, as long as blocking serum factors provide for high-stability inhibition of any bond of transplantation antigen (rosette formation). Constantly low rosette formation with serum addition and without was exhibited by control persons (blood donors, patients with cerebrocranial trauma) in daily examinations. Limit values of 18 or 30 RBZ/10(3) KHZ were not surpassed. PMID- 3310456 TI - Genus-specific antigens in Leptospira revealed by immunoblotting. AB - Immunoblotting of leptospiral sonicates with heterologous rabbit antisera revealed a distinct cross-reactive pattern which differed with respect to the pathogenic and non-pathogenic leptospiral serovars, and that all serovars tested from Leptospira interrogans, L. biflexa and L. illini contained a common 35 kilodalton (Kd) band. A leptospiral genus-specific antigen preparation produced by ethanol fractionation of L. biflexa serovar patoc reacted by enzyme immunoassay (EIA) with all heterologous serovars tested. Further purification using Sephacryl S-300 gel filtration revealed one major cross-reactive peak and several homologous peaks detectable by EIA. Gel electrophoresis of this peak revealed 3 major protein bands of 35, 34 and 29 Kd by Coomassie blue staining. This peak was further fractionated by high pressure liquid chromatography (HPLC), yielding 7 fractions, one of which cross-reacted. Rabbit antisera to this S 300/HPLC fraction reacted with all serovars tested. Immunoblotting revealed 2 distinct groups of cross-reactive antigens, a 33-35 Kd group that was proteinase K sensitive but not reduced by periodate oxidation, and a 14.4-26.5 Kd group whose activity was reduced by periodate but not proteinase K, indicating the presence of both protein and carbohydrate genus antigens. Immunoblotting L. interrogans serovar pomona flagella with S-300/HPLC antiserum suggested that the 35 Kd band found in all serovars tested was a flagellar component. PMID- 3310457 TI - Suppression of antibody responses by Toxoplasma infection in mice. AB - The immunosuppression elicited by Toxoplasma infection was proved to be due to suppressor macrophages. The induction of the suppressor macrophages are regulated by both H-2-linked and -nonlinked genes. The suppressor macrophages affect the proliferating step of lymphocytes, inhibiting them to reduce helper T cells, plasma cells and memory T- and B cells. The suppressive effect is via close contact of suppressor macrophages with lymphocytes, and not mediated by prostaglandins or H2O2. The more suppressive strain of mouse had heavier parasite burden than non-suppressive mouse strain. The patterns of induction of suppressor cells by various parasitic infections were compared and discussed. PMID- 3310458 TI - An alternative approach to malaria vaccine with a permanent attenuated mutant from a high virulence Plasmodium berghei strain. AB - An alternative approach to malaria vaccine with the use of Plasmodium berghei NK65XAT (XAT) is reviewed. XAT is a permanent low virulence strain derived from high virulence P. berghei NK65 (NK65) by irradiation. Although one organism of parent NK65 could kill one mouse, as many as 10(7) XAT parasites caused modest self limiting parasitaemia in immuno-competent mice. In the mice recovered from XAT infection, long lasting immunity to challenge not only by parent NK65, but also by ANKA so far as different species of rodent Plasmodia was seen. The XAT parasites invaded selectively into immature erythrocytes. Because of this feature, the attenuated parasite might induce potent and long-lasting immunity presumably with the background of MHC antigen expression on infected cells. Immunopathologic reactions in mice infected with XAT were modest comparing to those seen in mice with parent NK65 infection. Attenuation was also tested using P. yoelii nigeriensis with which cyclical transmission with A. stephensi was established. Although similar attenuation occurred by X-ray irradiation, produced parasites eventually reverted to virulence after several animal passages. Irradiation was also attempted to induce attenuated P. falciparum mutant and a parasite of a slow multiplication feature was obtained in an experiment. We would propose an alternative approach in the study of malaria vaccine using attenuated live organisms which confers potent and long lasting immunity to the host. PMID- 3310459 TI - Malaria studies in Indonesia. PMID- 3310460 TI - Goats as natural intermediate hosts of Hammondia hammondi. AB - The infectivity of Hammondia hammondi (the G-8 strain) to goats was studied to determine the origin of this strain, because it was originally isolated from feces of a cat fed goat muscles. No clinical signs except fever were observed in kids after oocyst inoculation. When cat fed muscles of these kids, the cats excreted oocysts. The prepatent period was 7 to 9 days and the patent period was 6 to 12 days. From these experiments it became clear that the G-8 strain was infectious to goats. The origin of this strain is very probably the goat, which thus is one of the natural intermediate hosts of H. hammondi. PMID- 3310461 TI - Detection of circulating antigens of Pneumocystis carinii in human sera by a sandwich enzyme-immunoassay. AB - A countercurrent immunoelectrophoresis test has been used for detection of circulating antigens of Pneumocystis carinii in humans; however, this study describes another experiment by sandwich enzyme-immunoassay. Antiserum was prepared by immunizing rabbits with P. carinii cysts which had been propagated in athymic nude rats. Profiles of time course in patients with the positive antigenemia show that P. carinii antigens are detectable prior to an onset of acute pneumonia. Since the sandwich enzyme-immunoassay has an ability of comparing serially monitored levels of the antigen in a quantitative value, the method is to be widely used as a clinical laboratory examination. PMID- 3310462 TI - Comparison of virulent trypomastigotes with low-virulent ones derived from a single strain of Trypanosoma cruzi: infectivity to new fibroblasts from various organs of the mouse. AB - Previous experiments have shown that the infectivity of virulent trypomastigotes in L-cell culture was much more intensive not only for macrophages but also for newly cultured fibroblasts from the mouse heart as compared to low-virulent trypomastigotes in L-cell culture which had been derived from the same strain. On the other hand, the infectivity of virulent trypomastigotes for L-cells was less intensive. In the present work, new fibroblasts derived from muscles, skin, heart and kidney of newborn mice and established fibroblasts from mouse muscles were examined in terms of their susceptibility to trypomastigotes of different virulence. A slight difference of susceptibility to virulent trypomastigotes among new fibroblasts from different sources was found, i.e. fibroblasts derived from muscles and skin were more susceptible than those from heart and kidney. Growth of low-virulent trypomastigotes was suppressed in all new fibroblasts. This suppression was explained by the result that amastigote proliferation of a low-virulent strain was much slower in new fibroblasts from mouse muscles in spite of a similar penetrative ability of both kinds of trypomastigotes. Furthermore, a slight decrease in the susceptibility of new fibroblasts to virulent trypomastigotes was found depending on the length of time fibroblasts had been maintained. PMID- 3310463 TI - Modulator effect of Toxoplasma lysate antigen in mice experimentally infected with Plasmodium berghei. AB - Normal mice were pretreated twice at an interval of 2 weeks with an emulsion of TLA (Toxoplasma lysate antigen), PLA (Plasmodium lysate antigen) or both in LMO (light mineral oil) or with a combination of the emulsion and Obioactin or Tp-LKs (Toxoplasma lymphokines) as an immunopotentiator. They were then given Obioactin or Tp-LKs 3 and 25 days after the first treatment and were further given parasitized erythrocytes with 1 X 10(2)-10(4) P. berghei 2 weeks after the second treatment. Thirty (3/10, number of survival/number of examined) per cent of mice treated with TLA, 50 (5/10)% of those treated with a combination of TLA and Tp LKs and 60 (6/10)% of those treated with a combination of TLA and Obioactin survived as long as 20 days postinfection while none of untreated controls survived more than 15 days postinfection. Only 18.2 (2/11)% of mice treated with PLA or TLA + PLA survived and 20 (2/10), 18.2 (2/11) and 60 (6/10)% of those treated with TLA + Obioactin, PLA + Obioactin or TLA + PLA + Obioactin survived throughout the experiment, respectively while none of controls survived more than 13 days postinfection. Five mice of each group were killed right before infection, and 5, 10 and 15 days postinfection. In mice treated with TLA + Obioactin, more macrophage phagocytosis and macrophage migration inhibition induced by sensitized T-cells were observed than in those treated otherwise. No appreciable differences were noted according to the method of treatment in blood examination values. Cross immunities between Toxoplasma and Plasmodium antigens were tested by counter-immunoelectrophoresis and indirect fluorescent antibody technique. By using counter-immunoelectrophoresis, a specific precipitin line was observed between TLA and anti-PLA which was absorbed by mouse erythrocytes, leucocytes and liver powder. By the indirect fluorescent antibody technique, anti Plasmodium IgM and IgG titers were detected in sera from mice treated with TLA or TLA-Obioactin before infection. PMID- 3310464 TI - With time changes of T-lymphocytes after Babesia infection in mice pretreated with Toxoplasma lysate antigen. AB - Adult female mice of the ICR/JCL strain were injected intraperitoneally with an emulsion of Toxoplasma lysate antigen (TLA; 100 micrograms per head) in light mineral oil (LMO) twice at 2 weeks' interval. Each mouse was inoculated intraperitoneally with 10(2) erythrocytes infected with Babesia rodhaini 2 weeks after the second injection of the emulsion. The rates of decrease in the erythrocyte count, hemoglobin concentration, and hematocrit value 10 days after inoculation, as compared with the counterparts determined 1 day before inoculation, were distinctly lower in these treated mice than in untreated control mice. In the course of Babesia inoculations, substantial reduction in size and weight of the thymus became higher in untreated control than in TLA treated mice as the infection progressed. In untreated controls, the number of Thy-1 positive (Thy-1 (+) ) cells was about 91.9% of the normal value being 3.7 X 10(7) cells in the whole thymus 1 day before inoculation while those in TLA treated mice were 6.5 X 10(7) and 0.9 X 10(7) cells 1 day before inoculation and 10 days after inoculation, respectively. The size and weight of the spleen increased in both groups by day 10 after inoculation. The total number of Thy-1 (+) cells in the spleen was 3.9 X 10(7) and 11.7 X 10(7) 1 day before and 10 days after inoculations, respectively in untreated and 12.9 X 10(7) and 15.6 X 10(7), respectively in TLA-treated mice. The number of Thy-1 (+) cells in the liver was 0.5 X 10(7) and 1.2 X 10(7) 1 day before and 10 days after inoculations, respectively in untreated and 0.3 X 10(7) and 3.4 X 10(7), respectively, showing a rate increase of 1033.3% in TLA-treated mice. The rate of increase in count of Thy-1 (+) cells contained in the peripheral blood was 61.4% in the former and 64.1% in the latter. In untreated mice, degeneration and destruction of lymphocytes in the thymus and spleen follicles and aggregation of lymphocytes, which were not found in Thy-1 (+) staining, around pericapillary ducts in the liver were seen histopathologically 10 days after inoculation. In TLA-treated mice, however, perivascular infiltration by Thy-1 (+) lymphocytes and activation of Kupffer cells in the liver and activation of spleen follicles were observed locally 10 days after inoculation. PMID- 3310465 TI - Plasmodium berghei: a study of globinolytic enzyme in erythrocytic parasite. AB - An acid protease of Plasmodium berghei (NK 65) was extracted from parasite lysate and purified by means of gel filtration followed by DEAE-sephadex column chromatography. The enzyme showed especially high activity to degrade hemoglobin. The pH optimum of the purified enzyme was 3.2, Km value was 0.012 mM. Molecular weight of the enzyme was estimated by gel chromatography as being 18,000-20,000. The enzyme activity was specifically inhibited by pepstatin, one of the peptide aldehyde protease inhibitors. These features of the enzyme were similar to those of acid protease taken from Dirofilaria immitis which also metabolizes hemoglobin as the major nutrient source. PMID- 3310466 TI - The role of thymocytes and IgG antibody in protection against malaria in nude rats. AB - Congenitally athymic nude (rnu/rnu) rats developed a high level of parasitemia and died with severe anemia after infection with Plasmodium berghei, while heterozygous littermates (rnu/+) showed a self-limiting infection and resisted further challenge. Transfer of normal thymocytes failed to protect rnu/rnu rats from the subsequent infection. Transfer of immune IgG fraction conferred resistance to malaria on rnu/+ but not on rnu/rnu rats. When both normal thymocyts and immune IgG were administered, rnu/rnu rats showed a self-limiting infection pattern, and a strong protective effect was demonstrated in the spleen after recovery. These results suggested that both T-cells and antibody were essential in developing protective immunity to malaria in this model. PMID- 3310467 TI - Plasmodium berghei: long lasting immunity induced by a permanent attenuated mutant. AB - A long-lasting immunity against challenge with highly virulent Plasmodium berghei (NK65) was observed in Balb/c mice immunized with a permanently attenuated parasite (XAT), a derivative (XAT) of the NK65 strain. Mice infected with living XAT parasites showed an extremely low self-resolving type of parasitaemia followed by a strong immunity against a challenge with the lethal parent NK65 strain. This immunity lasted for nearly one year. Cross immunity was also observed in the immune mice after challenges with P. berghei ANKA, P. yoelii 17XL, P. vinckei, and P. chabaudi. In addition stage specific immunity was found after P. yoelii nigeriensis sporozoites were inoculated into immune mice. Late radical treatment of immunized mice had little effect on the immunity. Both IgG and IgM anti-Plasmodium titers did not correlate with the degree of immunity. Immune suppression was not observed in the test mice as far as responsiveness of spleen cells to several mitogens is concerned. PMID- 3310468 TI - Clinical evaluation of antimalarial regimens in Japan. AB - The actual situation of the treatment of malaria for the past 10 years in Japan was investigated and analyzed. As a result, it was revealed that there were not a few cases which had been treated improperly probably because of the difficulty of getting antimalarial agents. Moreover, it was made clear that the death rate on falciparum malaria was constantly high, 8.7%, as expected and the relapse rate of vivax malaria was still as high as 18.0%. There was the recrudescence of falciparum malaria at 8.1%, maybe because of the influence of the prevalence of the drug-resistant strains of Plasmodium falciparum. The trouble in getting antimalarial agents has been overcome since 1980. Study Group on Pharmacotherapy of Imported Tropical Diseases was organized by the Ministry of Health and Welfare in 1980, and antimalarial agents have been supplied free of charge through the Study Group for the treatment of the disease. The number of cases of imported malaria has increased in our country. There are a lot of problems to be solved quickly to cope with the situation: people who travel abroad should be enlightened on the danger of the infection of malaria and take prophylactics for the disease and physicians should get familiar with the disease being supplied with information about it. PMID- 3310469 TI - Injuries of ureteral lower segment and the bladder during surgery. AB - The injuries of the lower ureteral segment and the bladder are relatively frequent during gynaecological and surgical interventions in the small pelvis. The cases of 25 ureteral injuries observed in the period between 1976 and 1985 are now evaluated. The majority of them are complications arising due to gynaecological operations. Attention is drawn to the rise in the number of ureteral lesions connected with the progress of colic and vascular surgery. The aim of reconstructive surgical solutions is to restitute function and to attempt to find the organ-saving possibilities. Bladder injuries occur most often during transurethral operations (TUR). The nature of artifactual injuries associated with TUR and the ways they are inflicted were analysed on the basis of a study of about 1000 cases. PMID- 3310471 TI - Uroandrology. I. Andrological importance of epididymal functions and diseases. AB - The evaluation, from the andrological point of view, of epididymal functions is made with an emphasis on the necessity of incorporating new knowledge into practical andrology. The andrological importance of the most common epididymal diseases and the more important modes of their correction are reviewed. PMID- 3310470 TI - Percutaneous technique in the diagnostics and therapy of renal diseases. AB - Based on the literature and of their own experience, authors deal with the possibility of the percutaneous approach of renal diseases. Of the diagnostic and therapeutic interventions, they report their experience regarding percutaneous nephrolithotomic investigative methods employed in the differential diagnosis of renal masses. During a period of one-and-a-half years, percutaneous nephrostomy was performed in 130 cases, of them in 64 for removing stones. In 48 cases of renal tumours revealed to be cystous structures by ultrasonography, puncture controlled by ultrasound was made. Based on the cytological and chemical analyses of the samples obtained by puncture, exploration was made in 6 cases for suspicion of malignancy. The requirements of the application of the percutaneous technique is discussed. PMID- 3310472 TI - The echographic examination of urological homogeneous masses based on 15 years of experience. AB - Based on his 15 years' experience, the author described the ultrasound diagnostics of urological homogeneous masses. He stresses that, of the diagnostic examinations, always the less inconvenient intervention imposing the least strain on the patients should be selected. The reliability of ultrasonic diagnosis is verified by the authors' own results. PMID- 3310473 TI - Hypertrophic cardiomyopathy caused by hyperparathyroidism. Report of a case and review of the literature. AB - Hyperparathyroidism is a rare, recently recognized cause of hypertrophic cardiomyopathy. Elevated serum levels of parathyroid hormone, rather than a rise in the extracellular calcium concentration, appear to be associated with left ventricular hypertrophy. This report describes the history of a patient who developed left ventricular hypertrophy during a 17 years lasting period of recurrent nephrocalcinosis, prior to the diagnosis of hyperparathyroidism. Cardiac function tests remained unchanged fifteen years after parathyroidectomy, suggesting that the latter intervention did not reverse the pathological process but only prevented further cardiac deterioration. PMID- 3310475 TI - Colostomy closure: still a hazardous procedure. AB - Seventy nine patients with closure of a loop (51 patients) or a terminal (28 patients) colostomy were reviewed retrospectively. Operative mortality was 2.5%. Wound infection in 19% and anastomotic breakdown in 7.7% were the most important postoperative complications. Restoring continuity after a Hartmann intervention, closure of left sided colostomies and early closure (before 12 weeks) all accounted for a statistically significant higher complication rate, while age and sex, the underlying disease, bowel preparation and the method of closure had no influence on the operative outcome. PMID- 3310474 TI - Haemodynamic steady state via combined infusion of dobutamine and dopamine in the pretransplant phase. AB - The course of a critically ill patient suffering endstage dilated cardiomyopathy is reported focusing on the use of inotropic support. A steady state haemodynamic condition was achieved using continuous low-dose infusion of dobutamine in combination with dopamine for several days. Thus as a candidate for heart transplantation he was made transportable to a foreign country. PMID- 3310476 TI - Is venous patch grafting after carotid endarterectomy able to reduce the rate of restenosis? Prospective randomized pilot study with stratification. AB - Many studies have already demonstrated that the restenosis rate after carotid endarterectomy is greater as expected since ultrasound examination has become a routine procedure after endarterectomy. The purpose of our randomized study is to compare the rates of restenosis with two methods of carotid endarterectomy- direct suturing and autologous vein grafting. Sofar restenosis are found after endarterectomy and direct suturing. Different possible causes for restenosis are discussed. We hope to inform soon if patching with the autologous vein is the best method in order to prevent early restenosis after CEA. PMID- 3310477 TI - [Autogeneic and allogeneic bone transplantation: indication, technic and results]. AB - Autograft and allograft bone transplantation is frequently performed to achieve sufficient stability in the primary or secondary treatment of fractures with cortical defects. The ingrowth of bone in his new environment develops in three consecutive periods: the revascularisation, the osteogenic regeneration and the functional adaptation. There is an important histomorphologic difference between the autografts and allografts in the first period of their development. Therefore there are different indications for the performance of autograft or allograft bone transplantation. An autograft bone transplantation implies an adjuvant surgical procedure with possible complications, otherwise after allograft bone transplantation a higher infection risk exists. At the University Clinic of Essen we performed 374 autograft bone transplantations with a complication rate of 2.7% at the donor site and only 0.6% at the receptor site. Infection rate after allograft bone transplantation was 5.7%. PMID- 3310478 TI - [The protocol for examining and preparing the recipient for kidney transplantation]. PMID- 3310479 TI - [The biomechanics of bone and the skeleton. I. (Analysis of Wolff's law on bone transformation from the year 1892)]. PMID- 3310480 TI - [Modern views on transplantation of bone tissue and bone derivatives. I]. PMID- 3310482 TI - [Sonographic examination of the hip joint in children]. PMID- 3310481 TI - [The significance of magnesium in orthopedics. III. Disorders of metabolism and their clinical significance]. PMID- 3310483 TI - [Modern views on transplantation of bone tissue and bone derivatives. II. Derivatives of bone tissue]. PMID- 3310484 TI - [Vascularized bone grafts in the anterior spinal fusion technic]. PMID- 3310485 TI - [Multisegmental subtotal somatectomy in the treatment of cervical myelopathy]. PMID- 3310486 TI - On the pathophysiology of intestinal ischemic injury. Clinical review. AB - Intestinal ischemia induces a spectrum of injury from relatively subtle changes in mucosal capillary permeability to gross transmural infarction depending on severity and duration. There is basically two events that can induce intestinal tissue injury in ischemic states, namely hypoxia during the ischemic period and generation of oxygen free radicals following ischemia at reperfusion. In this paper we review data indicating that there is a continuum of injury from the least to the most severe, and by approaching the problem from this perspective we have, in addition, tentatively defined the roles of the two mechanisms in the development of various degrees of intestinal ischemic tissue injury. PMID- 3310487 TI - Pre- and perioperative angiography and clinical physiological measurements. PMID- 3310488 TI - Management of graft dilation and non-infected anastomotic aneurysms. PMID- 3310489 TI - Campylobacter pyloridis. PMID- 3310490 TI - Insulinotropic effect of different formula of very low calorie protein supplemented diets in obesity. PMID- 3310491 TI - Graft versus host reactions. Pathogenic mechanisms of an immunological disorder. PMID- 3310492 TI - Effects of substrates for aromatic L-amino acid decarboxylase on insulin secretion. AB - It has been shown that substrates for aromatic L-amino acid decarboxylase potentiate glucose-induced insulin release. Microdissected islets of obese hyperglycemic mice (Umea ob/ob) have now been used in a study of the effects of decarboxylase substrates on insulin release induced by secretagogues other than glucose. L-5-hydroxytryptophan (L-5-HTP) at 4 mmol/l potentiated the effect of 1 mumol/l glibenclamide, 20 mmol/l D,L-glyceraldehyde or 20 mmol/l K+, but not that of 50 mumol/l chloromercuribenzene-p-sulphonic acid. The potentiating effect of 4 mmol/l L-5-HTP, 4 mmol/l D,L-m-tyrosine, or 4 mmol/l D,L-o-tyrosine on insulin release induced by 20 mmol/l L-leucine was inhibited by 0.1 mmol/l benserazide. Benserazide did not reduce the effect of 10 mmol/l L-glutamine on L-leucine induced insulin release. L-dihydroxyphenylalanine inhibited glucose-induced insulin secretion at 0.1 mmol/l with a tendency towards a reduction also at lower concentrations. The findings support the hypothesis that increased activity of aromatic L-amino acid decarboxylase can stimulate islet B cell function. PMID- 3310493 TI - Thyroid hormone binding and deiodination by pancreatic islets: relationship with the in vitro effect upon insulin secretion. AB - Thyroxine dehalogenation by rat pancreatic islets was studied incubating isolated islets with labelled T4. [125I]T4 added to the incubation medium was deiodinated by the islets with the consequent production of T3, rT3 and iodide. This deiodination process showed a clear glucose-dependence, being significantly increased in the presence of 16.6 mmol/l glucose. The existence of high and low affinity binding sites for T3 was also demonstrated incubating [125I]T3 with islets under different experimental conditions. The properties of these binding sites were greatly influenced by the extracellular concentration of glucose. Addition of T3 to the incubation medium, significantly modified the insulin release, but its effect varied according to the glucose concentration in the medium, i.e. it enhanced the insulin release at a glucose concentration between 2 to 8 mmol/l; it has no effect at 12 mmol/glucose, and significantly inhibited the secretion of insulin in the presence of 16.6 mmol/l glucose. Our results suggest that thyroid hormones might play a direct regulatory effect on insulin secretion, probably mediated by its deiodination and interaction with specific receptors in the islet cell. PMID- 3310494 TI - Effect of GnRH-associated peptide on prolactin secretion from human lactotrope adenoma cells in culture. AB - The effect of GnRH-associated peptide on PRL secretion by human pituitary lactotropes in culture was studied. Pituitary adenomas obtained at selective transsphenoidal adenomectomy from a patient with prolactinoma, and two patients with mixed GH- and PRL-secreting pituitary adenomas were cultured in monolayer. When cells were incubated with dopamine (10 nmol/l), a significant inhibition in PRL secretion was observed in all the experiments, which was blocked by co incubation with haloperidol. In mixed GH- and PRL-secreting adenoma cells, dopamine likewise decreased GH secretion. Incubation of cells with synthetic GnRH associated peptide at concentrations up to 100 nmol/l, on the other hand, failed to affect both PRL and GH secretion. These results suggest that synthetic GnRH associated peptide has no inhibitory effect on PRL secretion in human pituitary lactotropes. PMID- 3310495 TI - Alterations in the gastric mucosal immunoglobulin-producing cell population in the presence of Campylobacter-like organisms. PMID- 3310496 TI - Importance of effective pain control. AB - Although the scientific study of pain in the modern sense was initiated 150 years ago, and a number of theories were subsequently proposed, until two decades ago pain research remained conceptually stagnant and the meager amount done was not commensurate with the magnitude and clinical importance of pain. Consequently, pain treatment remained somewhat empirical and ineffective. Moreover, the knowledge and effective therapeutic modalities that were available were not properly applied, primarily because medical students and physicians were not taught the basic principles of pain management. Fortunately, during the past 20 years significant advances have been made in our knowledge of basic mechanisms of acute pain and about some chronic pain syndromes, and a variety of new therapeutic modalities have been introduced and old ones have been refined. Among the most important advances of the past decade have been the discovery of opiate receptors, the extensive pharmacokinetic and pharmacodynamic studies of narcotics, the development of very sensitive analytic techniques and mathematic knowledge and many other advances which have prompted the development of new drugs, novel drug preparations and novel methods of administration, of which intraspinal narcotic therapy is the most important and widely used. PMID- 3310497 TI - Intraspinal analgesia: an historical overview. AB - The application of opioids in the proximity of the spinal cord is a recent addition to the forms of treatment available for pain relief. During the last 20 years we have learned more about the intimate mechanisms of the action of opiates then we had in the preceding 5 millennia. Opium, in fact, has been used for medical purposes from prehistoric times. On the basis of the newly acquired knowledge, we are now applying opioids in more effective ways and providing more patients with long overdue relief of their pain. PMID- 3310499 TI - Immuno-electron-microscopic application of antiserum against elastin. AB - The antiserum against insoluble elastin from human aorta was applied to immuno electron microscopy. In the preembedding method, only the outer surface of the amorphous component (elastin) of elastic fibers showed a positive reaction. A major problem encountered with the preembedding method is associated with the penetration of either the primary antiserum or the secondary antibody into the tissue and, in particular, into elastin. On the contrary, a positive reaction was observed inner zones of elastin in the postembedding method. While the postembedding method employed here has limitations with nonspecific binding to the embedding medium, the postembedding method offers a decided advantage over the preembedding method. PMID- 3310500 TI - Immunoperoxidase localization of actin in Tomes' processes of ameloblasts of rat incisor. AB - Actin has been localized in Tomes' processes of the ameloblasts by the immunoperoxidase method using antiserum against purified rat actin. The zone of initial mineralization in dentin also gave a positive reaction. The possibility exists that actin may have a role in local accumulation of calcium during mineralization of various calcified tissues. PMID- 3310498 TI - Intraspinal morphine for cancer pain. AB - From a survey of the recent literature on chronic intraspinal morphine administration for cancer pain concerning 412 cases, the present authors observe that: 1. data regarding follow-up on pain relief and complications are lacking; 2. continuous administration by closed systems shows more efficacy in long-term pain relief; 3. tolerance, although not reported by all authors, is present and becomes remarkable in prolonged administration; 4. serious side-effects are less frequent with the epidural administration technique. These data are confirmed by the present authors' clinical experience of 22 patients treated with epidural morphine administration and 53 patients treated with intrathecal morphine. The widespread use of these methods is limited not only by technical complications but also by the existence of certain types of pain which do not respond to morphine and which may develop, as part of the evolution of the neoplastic disease, even during treatment with intraspinal morphine. PMID- 3310502 TI - A distinctive distribution of reactive astroglia in the precentral cortex in amyotrophic lateral sclerosis. AB - Morphological changes in astrocytes have been studied in the primary motor cortex of persons dying with or without amyotrophic lateral sclerosis (ALS). Glial fibrillary acidic protein (GFAP) and S-100 protein were used as immunohistochemical markers for reactive astroglia. In 12 brains of individuals without neurological disease glial cells showing moderate immunoreactivity for both GFAP and S-100 protein were uniformly distributed in the primary motor cortex in the upper regions of layer I and layer II. In 8 of 11 ALS cases, intensely immunoreactive cells were additionally found to occur and were scattered irregularly, mostly in layers II and III, but occasionally in layers IV and V. Clusters of these intensely positive cells occurred in patches about 200 400 micron in diameter, each containing about 6 to greater than 20 such cells. GFAP-positive astrocytes were seen in some of the 36 brains from persons with neurological problems other than ALS but the pattern was different. The abnormal appearance of clusters of positive astrocytes of the primary motor cortex may be intimately associated with the ALS disease process. PMID- 3310501 TI - Glial filaments in the subcutaneous tumors of mouse glioma clones differently expressing glial fibrillary acidic protein. An immunohistochemical and ultrastructural study. AB - Glial filaments contain vimentin and glial fibrillary acidic protein (GFAP). The question of how glial filaments change morphologically according to the expression of vimentin and/or GFAP has remained unclear. In this study, immunohistochemical and ultrastructural examinations were performed on the subcutaneously transplanted tumors of two clones (F6B3 and G10A10) derived from a mouse glioma. F6B3 tumor expressed GFAP and vimentin in large quantities. G10A10 tumor expressed plenty of vimentin but only a little of GFAP. Ultrastructurally, F6B3 tumor contained abundant cytoprocesses in most of which numerous intermediate filaments (IFs) were arranged in a parallel array. On the other hand, only a small number of the processes were seen in G10A10 tumor, which showed a few IFs arranged either randomly or sparsely in the processes. Both tumors commonly had the IFs accompanied by visible sidearms, but there was a difference in that the smooth and firm IFs were confined to part of F6B3 tumor. Thus, the comparison made between the two models presented differences in the content, arrangement and morphology of IFs, as well as in the manner of GFAP expression, suggesting correlation between these differences. PMID- 3310503 TI - Small for dates: evaluation of different diagnostic methods. AB - Ninety-four high-risk pregnancies were studied weekly in a prospective and longitudinal study. Uterine height, biparietal diameter (BPD), cranial perimeter (CrP) and abdominal perimeter (AbP) were measured. Amniotic fluid volume (AFV) was assessed. Of the sample selected, 58 neonates were appropriate for gestational age and 36 were small-for-date (17 symmetrical and 19 asymmetrical). The sensitivity values in diagnosis of small-for-dates were: 67% for BPD, 42% for CrP, 94% for AbP, 56% for Uterine Height and 28% for AFV. The specificity for the five variables ranged from about 91% to 100%. If we consider symmetrical and asymmetrical retardation separately, the sensitivity values for the former were: 94%, 77%, 100%, 77% and 24% for BPD, CrP, AbP, Uterine Height and AFV respectively. For symmetrical retardation, the sensitivity values were: 43%, 11%, 90%, 37% and 32% for BPD, CrP, AbP, Uterine Height and AFV respectively. The fetal cranial measurements were the only ones to demonstrate a different pattern of evolution in symmetrical and asymmetrical small-for-dates. This is therefore a useful measurement in making a differential diagnosis between both retardations. The earliest diagnoses were made in the symmetrical small-for-date group. PMID- 3310504 TI - Effects of intrapartum intravenous infusion of 5% dextrose or Hartmann's solution on maternal and cord blood glucose. AB - The effects of intrapartum infusion of dextrose or Hartmann's solution on maternal and cord blood glucose were studied. Patients with and without infusion of intravenous fluids during labor were randomly selected and allocated to one of three groups. Group I received 5% dextrose solution as a vehicle for oxytocin (dextrose group), group II received Hartmann's solution (Hartmann group) and group III did not receive any intravenous infusion (control group). Each group consisted of 16 patients. Routine labor ward procedures were followed. Maternal and cord blood samples were taken at delivery. Maternal blood glucose concentrations were significantly lower in the Hartmann group than in the dextrose and control groups, showing a dilution effect of Hartmann's solution. Cord blood glucose concentrations did not differ significantly between the three groups, indicating that maternal infusion of dextrose or Hartmann's solution in routine intrapartum management would have no adverse effects on fetal blood glucose. PMID- 3310505 TI - Measurement of acute response to draught in the eye. AB - In order to assess the sensitivity to draught of 7 different tests, 41 volunteer subjects were exposed experimentally: 18 to 1.0 m/s and 9 to 0.5 m/s in a climate chamber: 14 to an average of 0.67 m/s in an air-conditioned car. All exposures were at 21-22 degrees C. Exposures were for 30 min indoors, 45 min in the car. Break-up Time (BUT) of the pre-corneal film after a blink was observed before and after exposure in the laboratory. There was a significant decrease after exposure to 1.0 m/s (P less than 0.01) but not to 0.5 m/s. The variance of the observed BUT increased after exposure to 0.5 m/s (P less than 0.05). The Norn Lacrimal Dilution test showed increased tear flow after the climate-chamber exposures (P less than 0.05). Self-reported BUT(S) was always several times longer than BUT. There was a significant correlation between these measures (P less than 0.05) before exposure, but not after. BUT(S), like BUT, decreased after exposure to 1.0 m/s (P less than 0.01), but not after 0.05 m/s. However, the variance of BUT(S) did not increase significantly after 0.5 m/s; it decreased significantly after 1.0 m/s (P less than 0.01). A significantly improved mucus ferning pattern was observed after draught exposure (P less than 0.005), presumably due in part to increased lacrimal flow. There was no significant effect of draught on the albumin content of tear samples taken before and after exposure. Lissamine Green staining performed before and after exposure revealed no effect on micro-damage to the conjunctival epithelium. PMID- 3310507 TI - Visualization of ouabain binding in bovine cornea. AB - In these experiments, the binding of ouabain, a specific inhibitor of NA,K-ATPase is visualized in bovine cornea using an immunohistochemical method. Due to cross reactivity between ouabain and digitoxin antiserum, the ouabain binding is demonstrated after an immunological labelling with fluorescein. As shown in the corneal tissue sections and in the epithelial and endothelial cell preparations, a bright fluorescence of the endothelial cell membranes is observed in corneae incubated in 10(-5)-10(-3) mol/l ouabain. In the epithelium, only a weak binding of the ouabain is observed at the basolateral membrane after incubation in 10(-3) mol/l ouabain. PMID- 3310506 TI - Comparison of sodium hyaluronate and methylcellulose in extracapsular cataract extraction. AB - Extracapsular cataract surgery with posterior chamber lens implantation was performed in a total of 30 patients. These were randomly divided into two groups. In one group sodium hyaluronate 1% (Healon) was used as a tool in surgery, in the other group methylcellulose 2% was used. The viscous substances were irrigated out of the eyes at the conclusion of surgery. Central corneal thickness, intraocular pressure, and aqueous flare were recorded until one month post operatively. There was no difference in corneal thickness between the two groups. The mean intraocular pressure was lower than pre-operatively in both groups with a lower pressure in the methylcellulose group compared to the sodium hyaluronate group during the first part of the observation period. PMID- 3310508 TI - Post mortem HLA-DR typing of donor corneas using DNA-hybridization technique. AB - With donor material kept under banking conditions, corneal grafting is today an elective routine surgical procedure. Increasing evidence suggests that the clinical results may be improved by HLA matching. However, serological tests require that a blood sample be taken while the donor is still alive or shortly post mortem. We report HLA-DR donor typing with a DNA hybridization technique using DNA isolated from the donor eye more than 24 h post mortem. The practical implications of this procedure are briefly discussed. PMID- 3310509 TI - The triple procedure. Penetrating keratoplasty, extracapsular cataract extraction and posterior chamber lens implantation. A clinical and specular microscopic study. AB - The combination of penetrating keratoplasty, cataract extraction and intraocular lens implantation, the triple procedure, is the surgical choice for the patients with corneal disease and cataract. The success of the corneal graft depends chiefly on the endothelium of the transplanted cornea. Preservation, donor age, cadaver time, histocompatibility and operation itself affect endothelial cells. We present clinical results including endothelial evaluation of 20 patients who have undergone the triple procedure during the years 1984-1986. Mean age was 73 years. The follow-up time varied from 1 to 30 months. The visual recovery was very good. Every patient had better visual acuity post-operatively than pre operatively. We had no operative complications. Three patients had rejection episodes which all were cured with cortisone. No re-transplantations were needed. The mean endothelial cell density was 1723 cells/mm2. The possible factors affecting the outcome are discussed. PMID- 3310510 TI - Diabetic myopia--is it lens-induced? An oculometric study comprising ultrasound measurements. AB - An oculometric study has been performed to evaluate features possibly being responsible for a (permanent) shift towards myopia in eyes of diabetics, a trend apparent from previous clinical investigations. Having excluded cases of transient refractive change associated with poor metabolic control, we are dealing with adult subjects with stable refractive levels, also including cases of adult-onset myopia. Out of 62 diabetic and 48 non-diabetic eyes (age 17-23, diabetes duration 2-38 years) a careful matching according to age, sex and refraction provided 26 eye-pairs from 52 subjects for analysis. In 23 matched pairs there was low myopia. The lenses of diabetics appeared significantly thicker than in non-diabetics (mean difference 0.2 mm), and a higher lens power came close to significance. Corneal curvature, anterior chamber depth and axial length did not differ. A subsequent analysis of degree of lens thickness increase in diabetics revealed a positive correlation with diabetes duration. A thicker lens does not of necessity imply a higher lens power, but from the present data this is the most likely explanation of diabetic myopia in adults. PMID- 3310511 TI - Localization of motoneurons innervating the Eustachian tube muscles in cat. AB - The localizations of the motoneurons supplying the tensor tympani muscle (TTM), tensor veli palatini muscle (TVPM) and levator veli palatini muscle (LVPM) were determined by retrograde transport of horseradish peroxidase (HRP) in the cat. TTM motoneurons were found ipsilaterally outside the trigeminal motor nucleus in an area just ventral to it. TVPM motoneurons were distributed mainly in the ventral part of the ipsilateral trigeminal motor nucleus. They were more compactly distributed in the rostral part of the nucleus than in the caudal part. LVPM motoneurons were found in the ipsilateral nucleus ambiguus. There were no HRP-labelled cells in the contralateral nucleus ambiguus. PMID- 3310512 TI - Survival of the cortical bone columella in ear surgery. AB - Twenty-six partial and twenty-four ossicular replacement grafts were removed from patients because of hearing problems, cholesteatoma or re-perforation. The ossicles had been inserted in the middle ear between 7 and 121 months. The removed grafts were analysed with histology, enzyme histochemistry and, in 5 cases, tetracycline labelling. The results demonstrated that the majority (78%) of the grafts consisted at the time of removal of a mixture of living and dead bone. In 13% of the cases there were no indications of bone survival, while 9% of the removed grafts were found to consist of mainly vital bone. It is concluded that the fate of ossicular replacement grafts resembles that previously described for cortical bone grafts used in orthopaedic surgery. PMID- 3310513 TI - Comparison of different rates of artificial ventilation in preterm neonates with respiratory distress syndrome. AB - The effectiveness of three different ventilator rates of artificial ventilation (30, 60 and 120/min) was studied in 32 preterm infants, all of whom were suffering from the Respiratory Distress Syndrome (16 were paralysed). Ventilator pressures, I:E ratio and MAP were kept constant at each rate. Increase in rate from 30 to 60 and to 120/min was well tolerated and not associated with episodes of hypotension. The only significant improvement in oxygenation was amongst the non-paralysed infants and at a rate of 120/min (p less than 0.01) this was associated with synchronous respiration. Two different ventilators were used in the study and a significant change in PaCO2 (reduction) occurred only in non paralysed infants ventilated at a rate of 120/min by Sechrist ventilators (p less than 0.05). This difference may be a direct reflection of differences in ventilator performance at fast rates. PMID- 3310514 TI - Synchronous respiration: which ventilator rate is best? AB - Twenty-four infants were ventilated through a series of rates (30, 60 and 120/min), to determine which rate was most successful in provoking synchronous respiration. Their spontaneous respiratory rate was also documented during a temporary disconnection from the ventilator: respiratory rate and gestational age were significantly correlated (r = -0.85). Seventeen infants showed synchronous respiration at a ventilator rate of 120/min and 4 at 60/min. Of the remaining 3 infants, 2 only showed synchrony if ventilated at their own spontaneous respiratory frequency (between 60-75/min) and 1 infant was asynchronous at all rates including her own spontaneous respiratory frequency. The 17 infants synchronous at a ventilator rate of 120/min were significantly less mature (p less than 0.01) and had a faster spontaneous respiratory rate (p less than 0.01) than the 6 infants synchronous at ventilator rates of 60-75/min. PMID- 3310515 TI - Plasmid profiles of multi-resistant Staphylococcus aureus at a children's hospital. AB - Twenty-six strains of multi-resistant Staphylococcus aureus (MRSA) recovered from November 1985 to February 1986 were screened for their plasmid profiles. Among them, 11 strains were recovered from 8 patients with definite nosocomial infections. The results showed that one MRSA strain carrying 5 plasmids with molecular weight ranging from 1.75 X 10(6) to 5 X 10(6) daltons was epidemic in our hospital while 3 other distinct strains caused cross infections in both the burn ward and the medical wards. The epidemic strain and two other hospital acquired strains were found in identical form in the community, suggesting that the pattern of nosocomial MRSA can be affected by strains outside hospital. The plasmid profile analysis was employed to differentiate the epidemic isolates from the coisolates and to study the relation between clinical isolates. The method is apparently superior to antibiogram. PMID- 3310516 TI - Necrotizing lymphadenitis. Electron microscopical and immunohistochemical study. AB - Seven cases of necrotizing lymphadenitis (NEL) including a pair of male siblings, a female suffering from non-bacterial meningitis, and two cases with the proliferation of monocytes and/or macrophages in the bone marrow are reported. This disease is clinically documented by the occurrence in young adults usually accompanied by painful cervical lymphadenopathy with fever and leukopenia (below 4,000/mm3). Morphological features were characterized by nuclear debris from degenerated lymphocytes and the appearance of blastoid cells and/or immunoblasts and macrophages. Ultrastructurally, tubular inclusions with a close relation to the endoplasmic reticulum were observed in various kinds of cells in the lesion. Immunohistochemical studies revealed that the ratio of helper/suppressor T lymphocytes became low at the active stage and returned to normal range at the recovery stage. By immuno-histochemical study it was confirmed that suppressor cells mainly corresponded to large transformed lymphocytes and/or immunoblasts and helper cells were degenerated by an unknown agent. Though the pathogenesis of NEL is still uncertain, it is suggested that T-lymphocytes are mainly involved during the course of the disease and lymphocytes show cellular debris or blastoid transformation. PMID- 3310517 TI - [Effects of berberine on blood glucose regulation of normal mice]. PMID- 3310518 TI - [Structure-activity relationships of the inhibition of Escherichia coli dihydrofolate reductase (MB1428) by 5-(substituted phenyl) thio and 5 (substituted phenyl) seleno-2,4-diaminopyrimidines]. PMID- 3310519 TI - The central consequences of the application of capsaicin to one peripheral nerve in adult rat. AB - This paper reviews the central consequences of local application of capsaicin to one nerve in adult animals. 1) Marked chemical changes occur in the central terminals of C fibres. These include depletion of the enzyme FRAP and the peptides SP, CCK, somatostatin, CGRP and an increase of VIP. Maximal depletions occur if the nerve is soaked with capsaicin solutions with a concentration higher than 3 mM. The depletion begins by 7 days and is complete by 11. Recovery begins at about 110 days and is largely complete by 200. Our studies have concentrated on the effects of 40 mM capsaicin examined 14 days after the application. 2) Capsaicin treatment of a peripheral nerve decreased the ability of C fibres in that nerve to excite or to inhibit spinal cord cells. It produces a marked expansion of receptive fields of some cells in the dorsal horn which respond to A fibre stimulation. It is proposed that this change is not due to anatomical changes but to disinhibition. A further example of receptive field expansion is seen after treatment of the mouse infraorbital nerve which defocuses the normally precise projection of individual whiskers onto single cells in the barrel field of the somatosensory cortex. 3) Behavioural consequences follow the treatment of one adult nerve with capsaicin. In the area subserved by the treated nerve, there is a raised threshold to response to chemical and thermal stimuli, no change in the response to mechanical stimuli and an increase of autotomy following nerve section. 4) The aim of the experiments was to determine the role of C fibres in producing the changes seen in spinal cord following peripheral nerve section. Capsaicin treatment of nerve imitates the central effect of complete nerve section in certain important ways. Both result in a marked expansion of the receptive field of some cells. The effect is produced by a change of chemical transport. The results show that C fibres influence the connection of A fibres onto spinal cord cells. PMID- 3310520 TI - Neurotoxic effect of capsaicin in mammals. AB - Capsaicin is now widely used to explore and/or prove the role of peptide containing primary afferent neurones in different somato- and viscerosensory functions. The present paper deals with the morphological effects of capsaicin administered according to currently used experimental paradigms. As it has been repeatedly confirmed in the recent literature, administration of capsaicin to newborn mammals results in a highly selective degeneration of a particular population of small sized, B-type primary afferent neurones located in spinal and cranial sensory ganglia. Chemosensitive i.e. capsaicin sensitive primary sensory neurones (CPSNs) correspond to primary sensory ganglion cells which contain neuropeptides. The permanent functional impairments and the decrease in the peptide contents of the sensory neurones observed after neonatal capsaicin treatment may be accounted for an irreversible loss of CPSNs. Direct application of capsaicin to peripheral nerves results in an apparently irreversible functional impairment of unmyelinated afferent fibres implicated in nociceptive, viscerosensory and neurogenic inflammatory mechanisms. Morphological observations indicate that perineural treatment with capsaicin initiates a selective but delayed degeneration process of unmyelinated afferent nerve fibres presumably due to an inhibition of intraneuronal transport mechanisms. In contrast with perineural capsaicin treatment affecting the chemistry and function of the whole sensory neurone, injection of capsaicin into the subarachnoid space results in an irreversible abolition of the "afferent" but not the "efferent" function of CPSNs. Accordingly, noxious thermal or chemical stimuli applied to the peripheral innervation areas of the trigeminal nucleus caudalis or the affected segments of the spinal cord fail to induce nociceptive reflexes because of the degeneration of the central terminals of CPSNs. However, in these same skin areas, application of chemical irritants invariably evoked the neurogenic inflammatory response, indicating that CPSNs deprived of their central terminals maintain their capacity to synthesize and release the peptide(s) responsible for the initiation of that response. In contrast with previous findings, our recent studies furnished evidence for a selective neurodegenerative action of systemically injected capsaicin in adult mammals, as well. Therefore, some of the irreversible functional impairments produced by capsaicin in adult animals may result from the degeneration of a particular subpopulation of CPSNs.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3310521 TI - The morphological consequences of neonatal treatment with capsaicin on primary afferent neurones in adult rats. AB - A comparison was made using our work and that reported in the literature of the losses of myelinated and unmyelinated fibres in a variety of nerves and also of losses of nerve cells in dorsal root ganglia, after treatment of neonatal rats with capsaicin. In L3 and L4 dorsal roots 85-93% of unmyelinated fibres and 9-33% of myelinated fibres were lost after 50-100 mg/kg capsaicin neonatally. In rats treated with 85 mg/kg capsaicin, percentage losses of unmyelinated (89%) and myelinated (36%) fibres of L4 dorsal roots were remarkably similar to the calculated losses of small dark (92%) and large light (34%) neurones respectively in these ganglia. Studies with monoclonal antibody RT97 which labels the large light neurones only, confirmed that some RT97 negative cells (i.e. small dark neurones) remain after capsaicin treatment. At present no evidence exists to suggest that the cell death of small dark neurones or C fibres after neonatal capsaicin treatment is completely selective for subgroups of these neurones, either in relation to sensory modality, or in relation to immunocytochemical cell markers and peptide content. However much more data is required to establish whether this cell death is really nonselective as regards immunocytochemical markers. PMID- 3310522 TI - Involvement of capsaicin-sensitive sensory neurons in gastrointestinal function. AB - There is both morphological and functional evidence that capsaicin-sensitive sensory neurons innervate the digestive tract. The possible function of these neurons in gastric ulceration and gastrointestinal motility was investigated in rats which had been systemically pretreated with capsaicin (50-125 mg/kg). It was found that capsaicin-sensitive afferent neurons do not participate in the physiologic control of gastrointestinal propulsion. However, the inhibition of gastrointestinal transit due to surgical trauma or peritoneal irritation with iodine was reduced in capsaicin-treated rats. It was concluded that capsaicin sensitive sensory neurons may be involved in sympathetic reflex inhibition of gastrointestinal propulsion. Gastric ulceration induced by the intraperitoneal injection of indomethacin or intragastric administration of ethanol was greatly aggravated in capsaicin-treated rats. Since an involvement of the autonomic nervous system as well as of histamine and prostaglandins in this effect of capsaicin treatment could be ruled out, further support was lent to the previously proposed hypothesis that sensory nerve endings can protect the gastric mucosa against ulceration by the local release of vasodilator substances. PMID- 3310523 TI - The organization of capsaicin-sensitive visceral afferent systems. AB - It has become clear that a number of neuropeptides are found in sensory nerves, some of which have been identified in visceral afferents. The best studied peptide is substance P, which has been localized in a population of capsaicin sensitive visceral afferents. It has been established that there are a varied proportion of substance P-containing afferents in different visceral structures. In general, the peripheral termination of these nerves is around blood vessels. The central terminations of visceral afferents are in laminae I and V in the dorsal horn of the spinal cord. Substance P has been localized in these laminae and appears to be capsaicin-sensitive and therefore of sensory origin. Recently, substance K, which is derived from the same gene as substance P, has been found in visceral structures. Calcitonin gene-related peptide has been found in certain viscera to be contained in capsaicin-sensitive nerves. The contribution that other peptides make to visceral afferent innervation is not known. PMID- 3310524 TI - Serum antibodies to Escherichia coli in breast-fed and bottle-fed infants. AB - Titers of antibody against Escherichia coli in human milk and in the sera of 11 breast-fed infants, 6 bottle-fed infants and 9 infants in the post-weaning period were measured by the passive hemagglutination method. High antibody titers were observed in human milk in the first 4 days after parturition, but the titer decreased rapidly thereafter. None of the healthy, breast-fed infants had detectable serum antibodies, while a breast-fed infant with a perianal E. coli abscess had antibodies. On the other hand, 4 of the 6 bottle-fed infants and all of the 9 infants in the post-weaning period had antibodies. The significance of these results was discussed. PMID- 3310525 TI - [Malignant pleural mesotheliomas]. PMID- 3310526 TI - [Bulimia today]. PMID- 3310527 TI - [Primary leiomyosarcoma of the ureter]. PMID- 3310528 TI - [Pneumaturia and emphysematous cystitis. Contribution of a new case with echographic images]. PMID- 3310529 TI - Restricted environmental stimulation therapy of smoking: a parametric study. AB - Restricted environmental stimulation therapy (REST) has been shown in several studies to be an effective technique in smoking intervention. The most common procedure has been 24 hours in a dark, silent chamber; in several cases, messages designed to facilitate smoking cessation have been presented every few hours over an intercom. This study parametrically varied 12 versus 24 hour chamber REST sessions and four message presentation schedules (massed, distributed, or self demand presentation of five messages, and a no message condition). A ninth group of volunteer subjects spent five one hour sessions in a flotation REST tank. In this condition, no message was presented during the first session; one message was given during each of the next three sessions; and two messages were given in the last session. Previous findings of therapeutic efficacy were confirmed for chamber REST, with 3- and 12-month follow-ups showing means of 51% and 35% reduction, and 34% and 21% abstinence, respectively. The 24-hour distributed message group, representing the modal technique, showed a mean reduction rate of 51% and an abstinence rate of 36% one year after treatment. There were no significant differences as a function of the two main factors nor the interaction. Most chamber REST groups showed significant smoking reductions on both follow-ups. Flotation REST led to a significant decrease three months after the treatment, but not at one year. The data have theoretical as well as practical implications for future uses of REST. PMID- 3310530 TI - Immediate versus delayed feedback on urinalyses reports for methadone maintenance patients. PMID- 3310531 TI - Glycosaminoglycan degradation. PMID- 3310532 TI - P-450 cytochromes: structure and function. PMID- 3310533 TI - Glycolipid and glycoprotein degradation. PMID- 3310534 TI - Cold-promoted activation of factor VII and shortening of the prothrombin time. PMID- 3310535 TI - Immunologic aspects of vessel injury and thrombosis. AB - A large and rapidly growing quantity of information gained from both clinical and experimental observation strongly indicate that perturbations of the immune system can contribute to the pathogenesis of vessel injury and thrombosis. This is, in part, because the immune system functions to amplify and diversify the host response to a given stimulus often resulting in activation of associated pathways such as the hemostatic system and modulation of endothelial cell function. Studying the pathogenesis of arteriosclerosis and its complications, as well as other vascular disease, from an immunologic or immunopathologic perspective may provide a better understanding of why some some individuals appear to be at greater risk of cardiovascular disease than others, a more precise identification of the mechanisms leading to the expression of increased risk, and because of the structural specificity implicit in immunologic reactions, identification of those environmental factors responsible for inciting such immunologic perturbation. It is conceivable that identification of at least some of the risk factors associated with the 50% of deaths from heart attack that are not associated with known risk factors may be achieved through a consideration of the role of immunologic mechanisms in the pathogenesis cardiovascular disease. PMID- 3310536 TI - Venous thromboembolism in moderate risk patients. PMID- 3310537 TI - Prevention of venous thromboembolism in high-risk patients by prophylactic administration of oral anticoagulants. PMID- 3310539 TI - Treatment of first episode of venous thrombosis. PMID- 3310538 TI - Warfarin and the biochemistry of the vitamin K dependent proteins. AB - We have reviewed the biochemistry of the normal and warfarinized vitamin K dependent coagulation proteins, both individually and as members of their respective macromolecular enzyme complexes. Much has been learned in the past 10 15 years about the molecular mechanisms of coagulation. However, we have only scratched the surface and are beset by a number of interesting challenges. Clearly, we must begin to dissect the other vitamin K-dependent macromolecular enzyme complexes as has been done for prothrombinase. Prothrombin differs in fundamental ways from the other vitamin K-dependent proteins and we can anticipate significant differences as well as similarities in the other complexes. The presence of potentially functional domains in the non-catalytic portions of the vitamin K-dependent proteins and their similarities within this family of proteins should prove a fruitful area of future research. Finally, the evaluation of warfarinized vitamin K-dependent proteins, both in fundamental studies with purified systems and using uniquely engineered immunoassays, should shed light on basic molecular mechanisms and modes of monitoring warfarin therapy. PMID- 3310540 TI - Management of recurrent venous thromboembolism. AB - We have described our current criteria for selecting those patients with acute V T-E who merit long-term protection, for accomplishing the acute to long-term transition efficiently and for deciding when such protection can be interrupted. Naturally, in individual patients, special circumstances may exist which alter these decisions. Also, it is evident that additional studies are needed so that this sequence of decision-making can be improved. Our current approach contains a number of rather arbitrary components. Furthermore, if effective thrombolytic therapy does become available, we will need to reevaluate current criteria for long-term protection from recurrence. PMID- 3310542 TI - Clinical trials in myocardial infarction and coronary heart disease. PMID- 3310541 TI - Warfarin metabolism and drug-drug interactions. PMID- 3310543 TI - Anticoagulants in acute myocardial infarction. PMID- 3310544 TI - Following coronary thrombolysis. PMID- 3310545 TI - Cardiac embolic stroke: anticoagulating the elderly. PMID- 3310546 TI - Anticoagulants for the treatment of transient ischemic attacks. PMID- 3310547 TI - The biochemical basis of warfarin therapy. AB - Vitamin K is required for a liver microsomal enzyme that catalyzes the posttranslational conversion of specific glutamyl residues in precursors of the vitamin K-dependent clotting factors to gamma-carboxyglutamyl residues in the plasma form of these proteins. A second product of this carboxylation reaction is the 2,3-epoxide of the vitamin. The anticoagulant warfarin blocks the enzyme which reduces this epoxide to vitamin K quinone, and also blocks one of the microsomal pathways which converts the quinone to the active coenzyme form of the vitamin, the hydroquinone. Warfarin anticoagulation therefore reduces the activity of the vitamin K-dependent carboxylase and results in the secretion of vitamin K-dependent clotting factors that are under carboxylated. The presence of gamma-carboxyglutamyl residues is essential for the normal Ca++/phospholipid mediated activation of prothrombin, and the des-gamma-carboxy forms of prothrombin secreted by patients receiving warfarin therapy lack biological activity and have a reduced thrombotic potential. PMID- 3310548 TI - Tissue factor and the initiation of blood coagulation. PMID- 3310549 TI - Studies on the association between alcohol and high density lipoprotein cholesterol: possible benefits and risks. AB - The weight of the evidence suggests a positive relationship between alcohol consumption and HDLc. The relationship showed a linear dose response relationship with HDLc over the range of alcohol consumption from non-drinkers to alcoholics. The effect appears to be reversible since changes in alcohol intake result in changes in HDLc. Preliminary evidence has suggested that in alcoholics, the effect may primarily be on the HDL-2 subfraction, while in the general population, it may primarily raise the HDL-3 subfraction. Limited research has shown a positive relationship between alcohol consumption and apo A-I levels. The exact underlying mechanisms for this relationship is not known. It remains to be determined if alcohol also exerts an effect on Coronary Heart Disease that is independent of its effect on HDLc. It is important to further evaluate these important leads both because it may provide a better understanding of the relationship between HDL, lipoprotein metabolism and coronary artery disease and the role of alcohol in the genesis of heart disease. A public health recommendation to increase alcohol consumption to reduce risk of heart attack is not indicated. Cessation of moderate alcohol consumption, however, should also not be part of the current recommendation to improve lipoprotein profiles. PMID- 3310550 TI - Epidemiology of alcohol and hypertension. AB - An association between alcohol consumption, blood pressure levels and the prevalence of hypertension has been described in close to twenty population studies. The relationship is independent of ethnic group, gender, type of alcohol, cigarette smoking and obesity, but additive to effects of obesity and oral contraceptive use. Several studies show a progressive rise in blood pressure throughout the entire range of alcohol consumption. Reports indicating a threshold for the effect at around 30 g ethanol per day (three standard drinks) may be artefactual due to underreporting of drinking levels. Drinkers consuming an average of 3 or more glasses per day have three to four times the prevalence of "hypertension" compared with teetotallers. A randomized, controlled trial of moderating alcohol consumption in normotensives has confirmed a direct pressor action of alcohol and is supported by studies in hypertensives. These observations have important implications for the prevention and management of essential hypertension in most communities. PMID- 3310551 TI - [Historical development of infant mortality]. PMID- 3310552 TI - [Study of exopeptidase and leucine enkephalin-like substances in the cataractous human lens]. PMID- 3310554 TI - [The value of transrectal echography in the early diagnosis of prostatic cancer]. PMID- 3310553 TI - [Bladder complication of hernia repair using a prosthesis]. PMID- 3310555 TI - [Influences of percutaneous nephrolithotomy on renal function, an observation using the NAG-index and beta 2-microglobulin as indices]. AB - To examine the influence of percutaneous nephrolithotomy (PNL) on renal function, we measured the activity of urinary N-acetyl-beta-D-glucosaminidase (NAG) and beta 2-microglobulin (beta 2MG) in patients with nephrolithiasis, before and 3, 5, 7, 14 days and 1 month after PNL. With PNL, renal function was recovered within one month, and PNL was thought to be a more protective method than pyelolithotomy. Recovery of renal function was delayed in the cases in which PNL had been attempted over three times. In the patients with preoperative high-grade hydronephrosis, the excretion of NAG and beta 2MG in the urine was delayed. NAG index was considered to be a more sensitive parameter than beta 2MG to evaluate renal function. The NAG-index and beta 2MG values of bladder urine were in good correlation with those of nephrostomy urine 5 days or more postoperatively. Measurement of the urinary NAG-index 3, 7, 14, 30 days after PNL operation was considered valuable for determining changes in renal function. PMID- 3310556 TI - [Review of ureteral carcinoma as seen in mapping of the cystectomized bladder]. AB - The incidence of unexpected ureteral carcinoma on mapping and recurrence of upper urinary tract urothelial cancer was examined in 160 patients who had undergone total cystectomy for vesical cancer and complete mapping of the specimens between May, 1978 and June, 1986 at our Center. Unexpected carcinoma in the ureteral stump was found in 5 patients (3.1%) and recurrent cancer in the upper urinary tract developed in 2 (1.3%) of the 160 patients. The incidence was higher in the recurrent bladder cancer cases, and also higher in patients with non-visible, high grade and superficial tumors of the bladders. PMID- 3310557 TI - [A case of renal angiomyolipoma treated with partial nephrectomy. Diagnostic value of ultrasonography and computed tomography]. AB - A 62-year-old woman with renal angiomyolipoma is reported. Ultrasonogram revealed a hyperechoic renal mass and computed tomography showed a fatty density area in the tumor. Preoperative diagnosis of renal angiomyolipoma was made and was confirmed by frozen section during the operation. Partial nephrectomy was performed subsequently. Renal angiomyolipoma is known by its fat content causing high echogenicity in the ultrasonogram and fatty density area in computed tomography. Renal angiomyolipoma, therefore, could be suspected by this combination of findings and conservative surgery should be planned preoperatively. PMID- 3310559 TI - 200 years of veterinary education in Hungary. PMID- 3310560 TI - History of the departments (other science-related units) and disciplines. PMID- 3310558 TI - [A papillary adenocarcinoma of the kidney--a case report]. AB - A 57-year-old man was admitted to our hospital complaining of nausea, vomiting and fever of 38.7 degrees C. He was diagnosed as having acute cholecystitis with gallstones. Abdominal CT, however, incidentally revealed a space-occupying solid mass lesion at the upper pole of the left kidney. The feature of the lesion on ultrasonography was similar to that of renal simple cyst. The renal angiography showed that the tumor was avascular. Aspiration biopsy was done. Cytologically, small tumor cells forming cell clusters had scanty granular cytoplasms and small round or oval shaped nuclei sized 13-15 mu. The chromatin was diffusely distributed and increasing its density. Nucleoli were not so evident and if existing, usually small. Fatty stain was positive at granules in the cytoplasms. Radical nephrectomy was performed on August 28, 1984. Pathological examination revealed that almost all components of the tumor consisted of typical papillary renal adenocarcinoma, and staging was pT2, pN0, pV0, M0, INF alpha. Alpha-type interferon to a total doze of 11,700 X 10(4) units was administered intramuscularly daily for a month after the operation. By January 11, 1986, no evidence of tumor recurrence was noted. PMID- 3310561 TI - Hungarian University of Veterinary Science. Directory. PMID- 3310562 TI - History of the Budapest veterinary school. PMID- 3310563 TI - Five-year mortality rate in relation to enzyme-estimated infarct size in acute myocardial infarction. AB - In 727 patients with acute myocardial infarction, different enzyme variables reflecting infarct size were related to the 5-year mortality rate. The maximum activity of serum heat-stable lactate dehydrogenase (LD), analyzed every 12 hours for 48 to 108 hours, was significantly associated with the 5-year mortality rate when patients with a first myocardial infarction were evaluated (p less than 0.001), and similarly (p less than 0.001) when patients with a previous myocardial infarction were included in the analyses. Very similar results were found when the maximum activity of aspartate aminotransferase (ASAT) analyzed once daily for 3 days was related to the mortality rate over 5 years, whereas the maximum activity of creatine kinase (CK) and CK subunit B analyzed every 6 hours for 48 hours in a subset of patients did not predict the outcome to the same extent. The results from LD and ASAT analyses clearly indicated that the association between infarct size and 5-year mortality rate was caused by the much higher mortality rate in patients with larger infarcts during the first year after onset of infarction, whereas after the first year, incidence of death appeared to be independent of the original infarct size. Thus we conclude that although a highly significant relationship between infarct size and overall 5 year survival was found, the mortality rate seemed to be higher in patients with larger infarcts, particularly during the first year after infarction. PMID- 3310564 TI - Oncocytic cardiomyopathy of infancy with Wolff-Parkinson-White syndrome and ectopic foci causing tachydysrhythmias in children. AB - Two female infants, ages 6 months and 13 months, were first seen in the newborn period with supraventricular tachycardia associated with Wolff-Parkinson-White syndrome. One infant had echocardiographic and angiographic evidence of diffuse cardiomyopathy and died suddenly at home. The other infant was seen initially at 13 months of age with refractory ventricular tachycardia and died following surgical resection of arrhythmogenic foci on the left and right ventricles. Autopsy showed diffuse patchy oncocytic cardiomyopathy in both instances. Serial histologic sections of the cardiac conduction system showed oncocytic involvement of the atrioventricular (AV) node, His bundle, and bundle branches. Both infants had interruption of the anulus fibrosus by oncocytic cells at several sites, resulting in multiple accessory AV and nodoventricular connections. Additionally, patient No. 1 had an accessory AV connection by oncocytic cells in the fatty fibrous tissue of the left AV sulcus. To our knowledge, this is the first report of multiple accessory AV connections of oncocytic cells seen during histologic study. In addition, both infants had oncocytic involvement of the exocrine and endocrine glands. This report discusses the clinicopathologic correlations in these two patients, the literature on oncocytic cardiomyopathy, and the types of dysrhythmias found in these patients and their management. PMID- 3310565 TI - Acute and chronic hemodynamic effects of nicardipine hydrochloride in patients with heart failure. AB - Acute and chronic hemodynamic effects at rest and during exercise of a new dihydropyridine calcium antagonist, nicardipine hydrochloride, were studied in 10 patients with chronic heart failure. Acute intravenous administration of nicardipine resulted in a significant decrease in arterial blood pressure, systemic vascular resistance, and pulmonary capillary wedge pressure. There was a significant increase in cardiac index, stroke volume index, and the left ventricular stroke work index. Cardiac index measured at peak exercise increased significantly when compared with the cardiac index obtained at peak exercise before the infusion. After 9 days of continuous therapy with nicardipine, 30 mg three times a day, a significant decrease in arterial blood pressure and systemic vascular resistance and a significant increase in the cardiac index, stroke volume index, and left ventricular stroke work index at rest were observed in response to a single oral dose of 30 mg nicardipine. Data at peak exercise were also obtained before and 2 hours after the oral administration of nicardipine. With this comparison there was a significant increase in cardiac index, stroke work index, and exercise duration. It is concluded that in this group of patients with severe chronic heart failure, nicardipine enhanced myocardial performance during rest and exercise and this enhancement is sustained after 9 days of oral therapy. PMID- 3310566 TI - Piroximone (MDL 19,205) in the treatment of unstable and stable chronic cardiac failure. AB - The hemodynamic and clinical response to oral and intravenous piroximone was examined in 25 patients with chronic cardiac failure secondary to ischemic or myopathic heart disease: 14 with severe failure, who were clinically unstable (group I), and 11 with stable failure of mild to moderate severity (group II) in whom maximal O2 uptake (VO2 max) to treadmill exercise could be monitored serially. Intravenous (0.5 to 1.0 mg/kg) and oral (0.7 to 4.9 mg/kg) piroximone significantly (p less than 0.05) improved right and left ventricular pump function in both groups while causing an insignificant rise in heart rate and reduction in arterial pressure. Myocardial O2 uptake was not altered acutely or subacutely after piroximone, and myocardial lactate production was not observed. The salutary hemodynamic response to oral piroximone was sustained for 5 hours and there was no evidence of tolerance to the third and fourth doses. In group II, VO2 max was increased (p less than 0.05) at 4, 8, 12, 24, and 48 weeks of oral piroximone therapy. Adverse gastrointestinal effects were observed in two patients and a supraventricular tachycardia in another. Thus, piroximone may prove useful in the long-term management of chronic cardiac failure. Controlled clinical trials should be undertaken to determine the ultimate efficacy and safety of piroximone in these patients. PMID- 3310567 TI - Thallium imaging with single photon emission computed tomography. AB - Evaluation of myocardial perfusion with thallium-201 SPECT has advantages over planar images. These advantages are related to better contrast of the images, lack of superimposition of normal and abnormal areas, and a three-dimensional representation of the site and extent of perfusion abnormalities (ischemia, scar, or both). For this reason, rotational tomography is superior to planar imaging in assessing the extent of coronary artery disease, in the detection of small infarcts, and for quantitative measurements. Several techniques have provided accurate quantitative data for infarct sizing both in animals and men. The ability to quantitate infarct size (or ischemia) will be extremely important in studies of myocardial salvage, risk stratification, and longitudinal studies to evaluate the effects of medical and surgical interventions. PMID- 3310568 TI - Exercise and ventricular ectopy: relationship to coronary artery disease. PMID- 3310569 TI - Double-blind trial of the long-term effects of acebutolol and propranolol on serum lipoproteins in patients with stable angina pectoris. AB - In order to evaluate the long-term effects of propranolol and acebutolol on serum lipoprotein lipids, a double-blind clinical trial was carried out. Fifteen patients with stable angina pectoris, aged 32 to 79 years (mean = 53), were randomized to propranolol (80 to 160 mg/day) or acebutolol (400 mg/day) treatment groups, and followed for approximately 1 year (mean = 371 days). Blood was collected on the day treatment was begun, after approximately 5 months (mean = 158 days), and on completion of the trial. Very low-density lipoproteins (VLDL) (alpha less than 1.006), low-density lipoproteins (LDL) (1.006 to 1.063), and high-density lipoproteins (HDL) (1.063 to 1.125 [HDL2] and 1.125 to 1.21 [HDL3]) were isolated by sequential preparative ultracentrifugation, and their cholesterol and triglyceride quantified by enzymic procedures. After 1 year propranolol had raised the mean VLDL triglyceride concentration by 79% (p less than 0.005) and had lowered total HDL cholesterol by 24% (p less than 0.005). As LDL cholesterol was unchanged, the LDL cholesterol/HDL cholesterol ratio was increased by 26% (p less than 0.005). Mean values at 5 months were intermediate between those at baseline and those at 1 year. In contrast to these changes, acebutolol had no significant effect on any measured lipoprotein lipid. PMID- 3310570 TI - Review of primary prevention trials. AB - The main threat to patients with mild to moderate hypertension is coronary heart disease (CHD), but controlled trials of antihypertensive drug therapy have given disappointing results: overall, the reduction in CHD mortality (11%) and morbidity (10%) were small and nonsignificant. Recent trials comparing a beta blocker with other antihypertensive drugs have not shown the "cardioprotection" expected from their pharmacologic actions and from their effectiveness after myocardial infarction; but two large trials have suggested some reduction in CHD among male nonsmokers. Relaxation with biofeedback possibly lowers CHD risk. Although the trials indicate that drugs generally do little to reduce CHD in hypertensive patients, control of smoking and serum cholesterol may be more effective. PMID- 3310571 TI - Hypertension and coronary risk: possible adverse effects of antihypertensive drugs. PMID- 3310573 TI - AIDS update. History, disease manifestations, and transmission. PMID- 3310572 TI - Cardiovascular outcomes of treating high blood pressure. AB - Because hypertension is a major risk factor for cardiovascular disease, it has been anticipated that therapeutic reduction of blood pressure would protect patients from serious complications. In fact, this has been shown for strokes, congestive heart failure, and renal insufficiency. But in large trials of hypertension treatment, patients receiving active medications experienced an incidence of coronary events that averaged only 7% lower than that in placebo treated patients. This report examines some of the reasons for this disappointing outcome. During therapeutic trials patients receiving placebo tended to have fewer cardiovascular events than predicted. However, patients on active therapy in large-scale studies may have suboptimal blood pressure control. They may also be exposed to the adverse effects of inappropriate therapy. Careful selection of modern drugs should allow blood pressure to be controlled in a safe manner, and possibly contribute directly to protection from coronary events and other cardiovascular complications. PMID- 3310574 TI - AIDS update. Current treatment approaches. PMID- 3310575 TI - Management of hypertension in the elderly. The role of diuretics. PMID- 3310577 TI - Strut fracture of a Starr-Edwards mitral valve prosthesis. PMID- 3310576 TI - Exercise capacity and hemodynamics in persons aged 20 to 50 years with systemic hypertension treated with diltiazem and atenolol. AB - Hemodynamic responses and exercise capacity were studied during maximal exercise in 25 young hypertensive persons (mean age 40 years) taking placebo, diltiazem (mean 216 mg/day) and atenolol (mean 80 mg/day). The study was a crossover, double-blind, randomized trial, each medication period lasting 2 months. Sitting blood pressure (BP) was 160 +/- 19/109 +/- 8 mm Hg after run-in. Both drugs decreased BP significantly, diltiazem by 10/ 11 mm Hg and atenolol by 16/14 mm Hg (difference not significant between drugs). During exercise there were no differences among patients taking placebo, diltiazem and atenolol in peak workload and rating of perceived exertion. Atenolol significantly attenuated the increase in heart rate, BP and heart rate-BP product at each workload. Diastolic BP during exercise was significantly lower (6 to 10 mm Hg) during diltiazem therapy than during placebo at each workload. Thus, both diltiazem and atenolol decrease rest BP significantly without impairing exercise capacity. PMID- 3310578 TI - Cardiorespiratory response to early exercise testing after orthotopic cardiac transplantation. PMID- 3310579 TI - A symposium: Ethmozine (moricizine HCl)--a new antiarrhythmic agent. April 20, 1985, Montreux, Switzerland. Proceedings. PMID- 3310580 TI - Current approaches to drug treatment of ventricular arrhythmias. AB - Ventricular arrhythmias are common and cause serious problems, ranging from symptom aggravation to sudden cardiac death. New knowledge about arrhythmias and new antiarrhythmic drugs provide greater opportunities for treatment choice and evaluations. A prognostic classification of ventricular arrhythmias helps to focus management. For benign ventricular arrhythmias, the objective of drug treatment is alleviation. The best management approach to potentially malignant ventricular arrhythmias, however, is not yet known, and data from ongoing clinical studies continue to accrue, developing the knowledge base needed to devise better regimens. Symptomatic patients can be managed either by symptom alleviation, as in benign arrhythmia, or more aggressively, as in malignant ventricular arrhythmia. Treatment is not mandatory for asymptomatic patients with potentially malignant ventricular arrhythmias, because there is no evidence that reducing arrhythmia prolongs life or effectively prevents symptomatic disease. Also, antiarrhythmic drugs have the potential for causing adverse effects, even lethal ones. For malignant ventricular arrhythmia, the objective of treatment is prevention of symptomatic ventricular arrhythmia and sudden cardiac death. Effective new methods predictive of successful drug treatment in individual patients are available; these methods remove much of the empiricism from management of patients with malignant ventricular arrhythmia. Treatment deemed effective by rigorous noninvasive evaluation or by electrophysiologic studies has a high probability of success in the long term. Drug management of malignant ventricular arrhythmia should become more effective in the future as a result of newly developing approaches to drug evaluation. PMID- 3310581 TI - Reflections on reentry and focal activity. AB - Initiation and maintenance of reentrant arrhythmias, such as ventricular tachycardia and fibrillation in the acute phase of myocardial ischemia, may be due to different mechanisms. The characteristics of circus movement reentry, both with and without involvement of an anatomic obstacle, are discussed. The concept of wavelength of a reentrant circuit as calculated by the product of refractory period and conduction velocity is emphasized. To maintain circus movement tachycardia in an acutely ischemic myocardium, the ischemic tissue mass must be larger than the wavelength. For maintenance of fibrillation, several independent reentrant wavelets must be simultaneously present. Agents that prolong wavelength (by lengthening refractory period, increasing conduction velocity or both) may prevent reentry. Experiments are described that show the effectiveness of lidocaine, which depresses action potentials of ischemic myocardial cells, in preventing ventricular fibrillation when administered before coronary artery occlusion in isolated pig hearts. Ventricular premature depolarizations or beats are usually necessary to initiate reentrant rhythms. They may be caused by reflection, a type of reentrant excitation involving slow conduction, or by electronic transmission over short segments of depressed or unexcitable tissue. An example of microreentry in a 4 mm segment of papillary muscle exposed to elevated extracellular K+ concentrations, resulting in a ventricular premature beat, is shown. Focal mechanisms, such as abnormal automaticity or triggered activity, may also be responsible for premature impulses. Agents that suppress premature depolarizations may be effective against reentrant arrhythmias, even when they do not affect the reentrant mechanism itself. Experiments are described, showing that moricizine HCl suppresses abnormal automaticity in isolated papillary muscle, partially depolarized by application of electric current. PMID- 3310582 TI - Electrophysiologic aspects of moricizine HCl. AB - Moricizine HCl, a phenothiazine derivative, is a new antiarrhythmic drug that has quinidine-like effects on the myocardium. Moricizine HCl, 1 X 10(-7) g/ml, significantly decreases Vmax of the transmembrane action potential of canine Purkinje fibers and reduces the duration of the action potential at 50% and 90% of repolarization, whereas resting potential is unchanged. The drug decreases the fast inward sodium current (lNa), as measured by the double sucrose gap technique in frog atrium trabeculae; the processes of activation, inactivation and reactivation of current did not change even when a high concentration of drug (5 X 10(-6) g/ml) was used. At the same dose, the slow inward calcium current (lCa) increased, but the total outward current did not change. Using the patch-clamp technique, it was shown that moricizine HCl, 1 X 10(-4) g/ml, did not alter single-channel conductance, but essentially decreased the mean open tonic and open-state probability of potassium channels either at positive or negative holding potentials. lNa measured in a single myocyte preparation decreased faster when drug was administered in the external bath compared with intracellular injection. Moricizine HCl action on lNa of the single cell and on Vmax of the action potential is frequency dependent. When lNa was recorded directly, there was a cumulative effect of drug. Similar to other quinidine-like agents, moricizine HCl enhanced arrhythmogenicity within the first few minutes after coronary artery occlusion, but prevented arrhythmias 24 hours after acute myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310583 TI - Pharmacokinetics of moricizine HCl. AB - Moricizine HCl is a phenothiazine derivative with antiarrhythmic properties. It was developed in the USSR and is now undergoing clinical evaluation. Although preliminary work has shown moricizine HCl to be effective in treating both atrial and ventricular arrhythmias, little is known of its pharmacokinetics. There is a 4-fold variability in range for its elimination half-life and in volumes of distribution and clearance. There is a linear relation for peak plasma levels and area under the plasma concentration/time curve with regard to single-dose administration of moricizine HCl. The bioavailability of moricizine HCl connotes extensive first-pass effect, or presystemic metabolism. Very little of moricizine is excreted unchanged; it is extensively metabolized to certain compounds that are present in plasma for extended periods. Moricizine is extensively (92% to 95%) bound to plasma protein. Its coadministration with cimetidine leads to additive systemic effects; however, there is no evidence of alterations in steady state levels when moricizine HCl is coadministered with digoxin. Because moricizine is a drug with active metabolites, its concentration/effect profile is complex; this poses a challenge for accurate dose titration. This may, however, be a helpful challenge in that the metabolites may one day prove useful in therapy. This surmise warrants further study. PMID- 3310584 TI - Clinical, electrophysiologic and antiarrhythmic efficacy of moricizine HCl. AB - The electrophysiologic effects and antiarrhythmic efficacy of moricizine HCl (1.5 to 2.0 mg/kg intravenously, and 600 to 800 mg orally/24 hours) were studied using electrophysiologic testing, ambulatory electrocardiographic monitoring, exercise stress testing and transesophageal stimulation of the left atrium. Moricizine HCl had no significant effects on the sinus node in patients with normal nodal function and did not depress sinoatrial conduction time even in patients with serious node dysfunction. Moricizine HCl significantly lengthened the following intervals: PA (32 +/- 5 to 40 +/- 5 ms), AH (82 +/- 13 to 92 +/- 12 ms), HV (45 +/- 12 to 50 +/- 12 ms), paced cycle length 1:1 atrioventricular node conduction (340 +/- 14 to 352 +/- 14 ms) and paced cycle length 1:1 ventriculoatrial conduction (300 +/- 14 to 400 +/- 13 ms). The refractory periods of atrium, atrioventricular node and ventricular myocardium did not change significantly, and there was no alteration of the QRS or QT intervals. The drug abolished anterograde and retrograde conduction over the accessory pathway and increased the refractory period of accessory pathway in all patients. Intravenous moricizine HCl terminated and prevented tachycardia in 72% and 68% of the patients, respectively. Oral moricizine HCl (600 to 800 mg/24 hours) prevented tachycardia in 40% of patients with a preexcitation syndrome. Intravenous moricizine HCl terminated atrioventricular nodal reentrant paroxysmal tachycardia in 66% of patients, whereas 40% responded to the oral drug. Moricizine HCl 600 to 800 mg/24 hours suppressed ventricular premature beats in 60% of patients. A similar drug, Ethacizine, had the same electrophysiologic effects as moricizine HCl but was more potent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310585 TI - Efficacy and tolerance of Ethmozine (moricizine HCl) in placebo-controlled trials. AB - To investigate the tolerance and efficacy of moricizine HCl, single-blind placebo controlled trials were conducted. The early protocols involved patients hospitalized for 14 days, and daily Holter monitoring was used to document efficacy and the degree of spontaneous variability of ventricular premature complexes (VPCs). Moricizine HCl was given orally from 2.9 to 15.3 mg/kg 3 times daily. Patients with lethal ventricular arrhythmias were excluded. Additional outpatient trials were conducted to define long-term efficacy and safety. A dose response relation between moricizine HCl and the percentage of reduction in frequency of benign or potentially lethal ventricular arrhythmias was documented. Eighty-five percent of patients achieved a reduction in VPCs greater than 75% with daily dosages ranging from 10.1 to 15 mg/kg. This corresponded to a 95% decrease in mean frequency of VPCs. Long-term studies demonstrated no evidence of compromise in left ventricular function, and the proarrhythmic rate was only 2%. Symptomatic side effects were mild and usually well tolerated. Nausea, the most common, occurred in 11% of patients and dizziness in 9%. These results indicate that moricizine HCl is an effective and well-tolerated antiarrhythmic agent. PMID- 3310586 TI - Antiarrhythmic efficacy of Ethmozine (moricizine HCl) compared with disopyramide and propranolol. AB - In the investigation of new antiarrhythmic drugs, comparative trials with clinically available antiarrhythmic agents provide a perspective from which to judge the new investigational agent. Two clinical investigations of moricizine HCl, each using a placebo-controlled, double-blind, crossover design, are summarized. In the first study, 18 patients with greater than or equal to 30 ventricular premature complexes (VPCs) per hour (mean 369 +/- 95) were given propranolol (120 mg daily) compared with moricizine HCl (816 +/- 103 mg daily). Propranolol suppressed 38% of VPCs in the study group, moricizine HCl, 81% of VPCs, and the combination of both drugs, 87%. Moricizine HCl was more effective than propranolol in suppressing VPCs at all individual levels greater than 70% (p less than 0.05, McNemar's test). The combination of moricizine HCl and propranolol was well tolerated. The second investigation used a placebo controlled, double-blind, crossover design to compare the efficacy of disopyramide (600 mg daily) and moricizine HCl (800 mg daily) in 27 patients. Patients had greater than or equal to 40 VPCs/hr on a 24-hour ambulatory electrocardiogram. During moricizine HCl administration, the mean VPC frequency decreased from 524 to 151 VPCs/hr (71.2% reduction). In contrast, disopyramide reduced VPC frequency from 535 to 253 VPCs/hr (52.8% reduction) and demonstrated significantly greater side effects (p less than 0.05). Moricizine HCl was more effective than disopyramide in suppressing VPCs at all individual percent reduction levels greater than 70% (p less than 0.05, McNemar's test). Moricizine HCl was more effective in suppressing VPCs than either disopyramide or propranolol, with significantly fewer side effects. PMID- 3310587 TI - Ethmozine (moricizine HCl) therapy for complex ventricular arrhythmias. AB - Moricizine HCl (Ethmozine), a new antiarrhythmic agent, was administered to 102 patients with refractory ventricular fibrillation (n = 31), sustained ventricular tachycardia (VT) (n = 46) or symptomatic nonsustained VT (n = 25). A noninvasive approach utilizing monitoring and exercise testing was used in 82 patients who had a high density of reproducible spontaneous arrhythmia, whereas 20 patients without such arrhythmia required invasive electrophysiologic testing. The dosage of moricizine HCl was 200 mg 3 times daily, and during 5 to 6 days was titrated up to a maximum of 400 mg 3 times daily or 15 mg/kg daily, based on arrhythmia suppression and occurrence of side effects. Criteria for efficacy were a greater than 90% reduction in repetitive ventricular premature beats (couplets and runs of VT) and a greater than 50% reduction in ventricular premature beats when noninvasive methods were used. When electrophysiologic testing was used, the drug was judged effective if it prevented the induction of greater than 2 repetitive responses. Of 75 patients completing noninvasive study, 30 (40%) responded to moricizine HCl therapy, whereas only 1 of 20 patients undergoing electrophysiologic testing responded. There was no difference in moricizine HCl blood levels between responders and nonresponders (0.41 microgram/ml vs 0.43 microgram/ml, difference not significant). Side effects occurred in 28 patients (27%). Most frequent were aggravation of arrhythmia (n = 12), nausea and vomiting (n = 5), central nervous system toxicity (n = 3) and anticholinergic side effects (n = 3). The response rate to moricizine HCl therapy was higher in patients with nonsustained VT (62%) compared with those with sustained VT (19%) or ventricular fibrillation (33%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310588 TI - Electrophysiology of Ethmozine (moricizine HCl) for ventricular tachycardia. AB - Moricizine HCl, an antiarrhythmic phenothiazine drug, was investigated for its efficacy against ventricular tachycardia (VT) in a group of 60 patients from 8 institutions using electrophysiologic testing before and after oral administration. Moricizine HCl significantly prolonged PR, QRS, AH and HV intervals and cycle length for atrioventricular nodal block, but had minimal or no effect on repolarization or cardiac refractory periods. Induction of sustained VT (in 33 patients) and nonsustained VT (in 14 patients) occurred at baseline. During moricizine HCl therapy, sustained VT was induced in 31 patients and nonsustained VT in 7 patients. In individual patients, suppression of VT induction was obtained in 18% of patients with sustained VT and in 27% of patients with nonsustained VT. Cycle length of induced VT was significantly prolonged by moricizine HCl therapy. During prospective follow-up of 37 patients, electrophysiologic study predicted recurrence of nonrecurrence of VT with a sensitivity value of 82% and specificity of 65%. PMID- 3310590 TI - Drug interactions with Ethmozine (moricizine HCl). AB - Moricizine HCl, a phenothiazine derivative synthesized in the USSR in 1964, has been shown to be an orally effective antiarrhythmic drug. Moricizine HCl has demonstrated a low incidence of generally mild and transient side effects. Studies of possible drug interaction between it and other drugs most likely to be administered to cardiovascular patients are currently being conducted in US drug trials. Possible interactions between moricizine HCl and cimetidine, and between moricizine HCl and digoxin, are reviewed. The coadministration of moricizine HCl had no effect on the pharmacokinetics of cimetidine; in contrast, cimetidine administration slowed the elimination of moricizine HCl. The implications of greater therapeutic and/or toxic effects of moricizine HCl must be considered for patients receiving cimetidine and moricizine HCl concomitantly. No significant interactions were observed when monitoring serum levels of moricizine HCl and digoxin in patients with normal renal function receiving digoxin therapy for congestive heart failure or atrial fibrillation. Moricizine HCl in therapeutic dosages (10 mg/kg daily) demonstrated antiarrhythmic efficacy without significant alterations in serum digoxin levels. PMID- 3310589 TI - Effects of Ethmozine (moricizine HCl) on ventricular function using echocardiographic, hemodynamic and radionuclide assessments. AB - Ventricular arrhythmias combined with left ventricular (LV) dysfunction in patients portend a poor prognosis. Most antiarrhythmic agents have not been sufficiently investigated to adequately describe detrimental effects on LV function; we report the effects of moricizine HCl on ventricular function in 4 trials highlighting patients with LV dysfunction. Quantitative 2-dimensional echocardiography was used to evaluate 81 patients pre- and posttreatment. There was no change in mean global LV ejection fraction (EF) during placebo compared with moricizine HCl therapy (47 +/- 15% vs 46 +/- 14%, p greater than 0.05). In a separate trial, radionuclide LVEF at rest and exercise tolerance testing were performed in 24 patients with life-threatening ventricular arrhythmias who had a mean control LVEF of 40 +/- 19%. No significant change during moricizine HCl therapy (38 +/- 19%, p greater than 0.05) was detected and exercise parameters were unchanged. Rest and exercise LV function was measured during right-sided heart catheterization in a placebo-controlled study of 20 patients with ventricular tachycardia. Moricizine HCl was well tolerated without hemodynamic deterioration in all but 3 patients, who could be identified by their inability to increase stroke volume index during exercise. Finally, the relation between initial LV function and resultant antiarrhythmic efficacy indicates that moricizine HCl controls arrhythmias best in patients with LVEF greater than 30%. PMID- 3310591 TI - Ethmozine (moricizine HCl): a promising drug for "automatic" atrial ectopic tachycardia. AB - Atrial ectopic tachycardia is an uncommon life-threatening supraventricular tachycardia in children and is resistant to usual antiarrhythmic drugs. Whereas the cellular mechanism of atrial ectopic tachycardia is unknown, atrial ectopic tachycardia may be due to a form of automaticity. Moricizine HCl has been used primarily for ventricular rhythm disturbances; the drug depresses abnormal automaticity and delayed after-depolarizations but has little effect on normal automaticity. Because of this property, we have used moricizine HCl in 4 patients with atrial ectopic tachycardia. As evidenced by continuous 24-hour Holter monitoring, moricizine HCl was successful in suppressing atrial ectopic tachycardia in each patient. During a limited follow-up (6 months) no side effects have occurred. Moricizine HCl is a promising primary drug for atrial ectopic tachycardia. PMID- 3310592 TI - Refining the criteria for pulsed Doppler diagnosis of mitral regurgitation by comparison with left ventricular angiography. AB - Doppler echocardiography is established as a useful method for detecting mitral regurgitation (MR). However, studies also show that Doppler echocardiography may be too sensitive for diagnosing pathologic MR. To determine whether the false positive or clinically insignificant diagnosis of MR can be eliminated by defining more specific diagnostic criteria, pulsed Doppler findings were compared with left ventricular angiographic findings in 81 patients. Using the conventional Doppler criterion of any systolic increased spectral dispersion detected in the left atrium, sensitivity was 100% and specificity was 76%. Using holosystolic increased spectral dispersion as the criterion, sensitivity was 100% and specificity was 92%. Using the combined criteria of holosystolic increased spectral dispersion plus peak regurgitant blood flow velocity of greater than 150 cm/s, sensitivity was 100% and specificity was 97%. Doppler studies in 20 clinically normal persons showed that the combined Doppler criteria were 100% specific. In conclusion, the presence of holosystolic increased spectral dispersion within the left atrium with a peak regurgitant flow velocity greater than 150 cm/s appears to be as sensitive as and more specific than the presence of any systolic Doppler increased spectral dispersion in identifying patients with MR. PMID- 3310593 TI - Two-dimensional echocardiographic findings in patients on hemodialysis for more than six months. PMID- 3310594 TI - Blood lipid levels and antihypertensive therapy. PMID- 3310595 TI - Actin localization in male germ cell intercellular bridges in the rat and ground squirrel and disruption of bridges by cytochalasin D. AB - Filaments about 6-7 nm in diameter were seen associated with germ cell intercellular bridges in detergent-permeabilized cells treated with tannic acid. Approximately 40-50 filaments were present subjacent to the bridge density. Filaments encircled the bridge channel in a manner similar to contractile ring actin filaments of dividing cells. NBD-phallacidin and myosin S-1 subfragments were employed to demonstrate that the filaments observed at intercellular bridges are actin. Intratesticular injection of a single dose of cytochalasin D, a specific inhibitor of actin filaments, caused certain intercellular bridges of spermatids to open within 3 hr after injection, leading to the production of symplasts. During bridge opening, remnants of bridge densities were gradually incorporated into the lateral aspect of the plasma membrane of the symplast. Thus actin, present in bridge structures, appeared to participate in maintaining certain intercellular bridges. A model of intercellular bridge structure is presented. PMID- 3310596 TI - Morphometry and cytochemistry of Leydig cells in experimental diabetes. AB - Leydig cell ultrastructure and function in diabetic rats were studied by concurrent cytochemistry, morphometry, and testosterone assay. The streptozotocin (Stz) model was modified to include nondiabetic Stz-injected rats, an insulin treated diabetic group, and semistarved animals in addition to controls and untreated diabetic rats. The separation of the effects of diabetes, Stz, semistarvation, and insulin treatments was achieved by application of orthogonal contrast statistics. After 3 months of treatments, testes were perfusion-fixed, incubated for delta 5,3 beta-hydroxysteroid dehydrogenase (HSD) activity, and processed for electron microscopy. Diabetes increased Leydig cell smooth endoplasmic reticulum (SER), increased mitochondrial and lipid content, decreased HSD staining, and decreased serum testosterone levels. Insulin treatment reduced SER and increased testosterone concentrations. Semistarvation also increased SER and reduced testosterone levels but did not alter HSD staining. Stz had no significant effect on these variables. The results suggested that the hypoandrogen state was due to a primary Leydig cell compromise and not solely to malnutrition and that it was correctable by insulin treatment. PMID- 3310597 TI - February Man revisited. PMID- 3310598 TI - Methods for the assessment of human body composition: traditional and new. AB - Renewed interest in the assessment of human body composition has stimulated the need for a balanced understanding of available methodologies of estimating fat free mass and percent body fat. This review summarizes the physical bases and assumptions, describes applications, and discusses the theoretical and practical limitations of currently available indirect methods. Although standard methods are discussed, recent modifications and adaptations are emphasized. PMID- 3310599 TI - Alpha-linolenic acid deficiency in man: effect of ethyl linolenate on plasma and erythrocyte fatty acid composition and biosynthesis of prostanoids. AB - Treatment of human alpha-linolenic acid deficiency (ALAD) with ethyl linolenate is reported. The patient's scaly dermatitis nearly disappeared after 5-d supplementation with 0.1 mL ethyl linolenate. Pretreatment content of various n-3 fatty acids in RBC was 0-15% of healthy controls. After 14 d of supplementation, cholesterol and triglycerides were reduced by 70% of pretreatment values, 22:5n-3 and 22:6n-3 increased three- to fourfold while 18:3n-3 and 20:5n-3 remained low, indicating a rapid elongation and desaturation of 18:3n-3 in ALAD. Urinary excretion of PGI2-M was approximately 10 times higher than in healthy control subjects, while PGI3-M excretion was low. Linolenate supplementation increased PGI2-M excretion twofold, while PGI3-M remained near detection limit. Platelet capacity to synthesize TXA2, and urinary excretion of TXB2+3-M were nearly unaffected by supplementation. The results confirm that the minimal daily requirement of alpha-linolenic acid is 0.2-0.3% of total energy. PMID- 3310600 TI - Newer concepts of the indispensable amino acids. AB - In healthy adult humans, eight amino acids (isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine) were shown classically by nitrogen balance studies to be indispensable. Subsequent studies classifying histidine as indispensable are reviewed in this article. We also review the evidence that in certain nutritional or disease states or in certain stages of development otherwise dispensable amino acids may become indispensable. Arginine, citrulline, ornithine, cysteine, and tyrosine thus may be considered as acquired indispensable amino acids. Evidence for the indispensability of taurine is also considered. We propose a classification of the indispensability of amino acids based on clinical and therapeutic considerations. PMID- 3310601 TI - Glycemic index of processed wheat products. AB - Our aim was to determine the in vivo glycemic and insulin responses and in vitro starch digestibility of seven processed wheat products (shortbread biscuits, custard, quick-cooking wheat, wholemeal bread, water biscuits, puffed wheat, and puffed crispbread). The degree of starch gelatinization in the foods was measured. Fifty-gram carbohydrate portions of the foods were fed to eight volunteers after an overnight fast. The calculated glycemic indices (GI) (mean +/ SEM) ranged from 43 +/- 10 for custard to 81 +/- 9 for puffed crispbread. Insulin responses paralleled the glycemic responses. The GI correlated positively with the percentage of starch digested in vitro (p less than 0.05). The degree of starch gelatinization ranged from 0.4 to 60% and correlated positively with the percentage starch digested in vitro (p less than 0.05). Differences in the glycemic and insulin responses to wheat products may be explained in part by the extent of processing and the degree of gelatinization achieved. PMID- 3310602 TI - Glycemic responses to carbohydrates. PMID- 3310603 TI - Comparison of different trials of adjuvant chemotherapy in stage II breast cancer using a natural history data base. AB - Prognostic factors and treatment were analyzed for 2,578 patients to assess the impact of various forms of adjuvant chemotherapy on the natural history of operable stage II (node-positive) breast cancer. The outcome after surgery alone (or with radiotherapy) was determined in 1,014 patients in the natural history data base (NHDB). Adjuvant chemotherapy consisted of L-phenylalanine mustard (L PAM; 130 patients); cyclophosphamide, methotrexate, and 5-fluorouracil (CMF; 645 patients); doxorubicin and cyclophosphamide (AC; 241 patients); CMF plus vincristine and prednisone (CMFVP; 263 patients); and 5-fluorouracil plus AC (FAC; 285 patients). L-PAM had minimal effect on relapse-free survival (RFS) compared to the NHDB, but all combination chemotherapy programs significantly improved RFS and survival compared to the NHDB. In women with 1-3 positive nodes, all combination chemotherapy programs produced similar results. In women with 4-9 positive nodes, the FAC regimen appeared to be associated with superior RFS compared to other programs, but all were superior to the NHDB. In women with 10 or more positive nodes, FAC was the only regimen associated with improved RFS. The use of a NHDB and known pretreatment characteristics, such as nodal status and tumor size, permits comparison of patients at similar risk of recurrence of breast cancer who have received adjuvant chemotherapy and provides leads for evaluation in future prospective clinical trials. PMID- 3310604 TI - Development and use of a natural history data base of breast cancer studies. AB - Pretreatment information, type of treatment, and longitudinal follow-up on 1,971 patients with operable breast cancer were used to establish a breast cancer natural history data base (NHDB). Data were available for 957 patients with stage I (node-negative) breast cancer and 1,014 stage II (node-positive) patients. In women with negative nodes, information was available on 759 patients treated at the Milan National Cancer Institute and 188 patients treated at the Royal Marsden Hospital. After adjustment for differences in the distribution of patient prognostic factors, relapse-free survival and overall survival were not significantly different. Of the 1,014 node-positive patients, 540 were treated at the Milan National Cancer Institute, 258 at the Royal Marsden, and 216 at the M. D. Anderson Hospital. Relapse-free survival and overall survival did not significantly differ between Milan patients and those treated at the Royal Marsden Hospital. However, M. D. Anderson Hospital patients did have significantly better relapse-free and overall survival. In each institution, outcome was consistently most dependent on the number of involved axillary lymph nodes and tumor size. Also, similar patterns of survival were observed for each of the institutions. The development of an NHDB can be of value in the identification and evaluation of consistency of prognostic factors, permitting improved comparisons between clinical trials. The development of such a natural history data base (NHDB) provides a reference for assessing the impact of different adjuvant chemotherapy programs, and aids in the design of new protocols. PMID- 3310606 TI - Hepatitis B virus-related glomerulopathy in patients with systemic lupus erythematosus. AB - The clinical data and renal pathologic information from three patients with systemic lupus erythematosus (SLE), active glomerular disease, and hepatitis B virus (HBV) antigenemia are presented. All three patients fulfilled the American Rheumatism Association criteria for the diagnosis of SLE. However, the renal pathologic results excluded the diagnosis of lupus nephritis. The common findings shared by these patients included the following: presence of hepatitis B surface antigen (HBsAg) in both serum and glomeruli and of glomerular hepatitis B core antigen (HBcAg), and the absence of polyclonal immunoglobulins, C1q and C4, deposition in renal tissue. These common features and the renal pathologic results indicated that the glomerulopathy was associated with HBV antigenemia. The cases described here may represent a subset of patients with SLE in whom expression of lupus nephritis was altered by the concomitant HBV-related glomerulonephritis. PMID- 3310605 TI - Sequential administration of cyclophosphamide, methotrexate, 5-fluorouracil, and folinic acid as salvage treatment in metastatic breast cancer. AB - Experimental data show that sequencing methotrexate (MTX) and 5-fluorouracil (5 FU) may result in synergistic antitumor activity. Moreover, the effect of 5-FU is increased by folinic acid (FA), and finally, cyclophosphamide (CPA) produces an expansion of tumor growth fraction, suggesting an increased cytotoxic effect of cycle-specific drugs subsequently administered. Based on these premises, we have performed a Phase II study with CPA (600 mg/m2 i.v., day 1), MTX (200 mg/m2 1-h i.v. infusion, day 7), 5-FU (600 mg/m2 i.v., day 8), and FA (500 mg/m2 2-h i.v. infusion, day 8 plus 15 mg p.o. every 6 h on days 8 and 9) administered every 3 weeks. Thirty-six patients with metastatic breast cancer were admitted into the study. Median age was 52 years, and all but two patients were postmenopausal. Dominant sites of metastases were soft tissues in 10 patients, bones in 7 patients, and viscera in 19 patients. All patients were pretreated with chemo- and/or hormone therapy. Sixteen patients achieved an objective response (44.5%: 1 complete response and 15 partial responses), 8 had stable disease (SD) (22.2%), and 12 progressed (33.3%). Twenty-one patients had previously received conventional CMF in an adjuvant setting (15 patients) or for metastases (6 patients): 1 complete response (CR) and 7 partial responses (PR) were obtained in the first group and 1 in the second. Major toxic effects were hair loss (56.4%), nausea and vomiting (72%), mucositis (52.5%), and leukopenia (61%). A randomized study could be useful to assess the role of sequential CMF versus conventional CMF in metastatic breast cancer patients. PMID- 3310607 TI - Development of a coagglutination (COA) technic to detect Candida antigenemia. I. COA versus Candida isolation. AB - A coagglutination (COA) test to detect Candida antigenemia was developed using locally produced Candida antiserum and COA reagent. All 68 controls had normal results. Two patient groups were included in this study. In Group 1, consisting of eight patients, with definite systemic or deep candidiasis proved by repeat Candida isolation, COA detected antigenemia in 100% as against 50% by counterimmunoelectrophoresis (CIE). In Group 2, 9 of 19 patients had respiratory infection; 4 patients revealed antigenemia by COA, 2 of whom had no Candida isolation. In these 2 patients therapy was initiated based on COA results. Of another nine patients with hematologic and malignant diseases, five (56%) revealed antigenemia by COA, three of whom had no Candida isolation; two died and one was discharged against advice. Transient antigenemia was detected by COA in a single patient with ulcerative colitis with Candida isolation. Thus, the COA test was found to be rapid, sensitive, and specific for the detection of Candida antigenemia. Furthermore, it had early diagnostic (seven days) as well as prognostic value, as revealed by response to therapy and decrease in COA titer. Being highly cost effective, this test is recommended as a simple test within the reach of any routine diagnostic laboratory. PMID- 3310609 TI - The effect of melanin pigment removal on the peroxidase-antiperoxidase immunoperoxidase technic. AB - With the increasing use of immunoperoxidase technics, it may be difficult to differentiate between the dark staining of 3,3'-diaminobenzidine (DAB) compound reaction product and melanin pigment. The latter may be particularly observed in skin. Samples of both normal skin and melanotic malignant melanoma were treated for the removal of melanin by standard technics both before and after a peroxidase-antiperoxidase (PAP) immunohistologic sequence. Many methods for the removal of melanin pigment resulted in diminished DAB staining intensity. Some also caused cellular disruption. However, the method of choice was found to be treatment with 0.25 g/dL potassium permanganate and 1 g/dL oxalic acid before the immunoperoxidase sequence. PMID- 3310608 TI - Tumor-associated antigen expression of primary and metastatic colon carcinomas detected by monoclonal antibody 17-1A. AB - Murine monoclonal antibody (MAb) 17-1A has been used in radioimmunodetection and immunotherapy trials of intestinal adenocarcinoma in humans. Tumor heterogeneity of antigen expression has been recognized as a potential limiting factor in such studies. The authors report a study designed to evaluate the degree of heterogeneity of 17-1A antigen expression among primary and metastatic human colon carcinomas. All 141 specimens, including 74 primary or metastatic colonic adenocarcinomas, were evaluated with the use of an avidin-biotin complex immunoperoxidase technic on briefly fixed frozen tissue sections. All of these showed at least focal staining with MAb 17-1A. However, well- or moderately differentiated tumors generally showed diffuse cytoplasmic immunostaining, whereas poorly differentiated tumors showed minimal immunostaining with no detectable antigen in most areas. In 16 cases that had both primary and metastatic adenocarcinomas or multiple metastatic tumors, 17-1A antigen expression was similar among the tumor sites except for one case. This case showed variation in tumor differentiation and corresponding variation in 17-1A antigen expression. Of 36 additional malignant tumors that were not of colonic epithelial origin, adenocarcinomas of the stomach, duodenum, endometrium, ovary, and breast showed 17-1A antigen expression. PMID- 3310611 TI - Specificity and sensitivity of flow cytometry in analysis of lymphoid tissue by immunophenotyping: my experience has been different. PMID- 3310610 TI - Expression of the Leu-8 antigen by B-cell lymphomas. AB - The Leu-8 antigen is found on the surface of many hematologic cells, including many T- and B-lymphocytes. With the use of a frozen-section immunoperoxidase technic, 152 B-cell non-Hodgkin's lymphomas were examined for Leu-8 expression. Of these lymphomas, 53% expressed Leu-8. Subclassification of the lymphomas with the use of the International Working Formulation showed that most small lymphocytic, intermediate lymphocytic, and diffuse large cell lymphomas and about half of diffuse small cleaved, diffuse mixed, and follicular lymphomas expressed Leu-8. In contrast, all 17 cases of small noncleaved cell (Burkitt's) lymphoma and 9 of 10 cases of multiple myeloma/plasmacytoma were Leu-8 negative. These results indicate that Leu-8 is expressed on a wide variety of B-cell lymphomas and that differences in Leu-8 expression may be useful in the diagnostic separation of small lymphocytic lymphoma with plasmacytoid features from multiple myeloma/plasmacytoma, and diffuse large cell lymphoma from Burkitt's lymphoma. PMID- 3310612 TI - Lower premolar extraction/removable plastic Herbst treatment for mandibular retrognathia. AB - The patient was a 12-year-old girl with a Class I malocclusion characterized by maxillary arch width constriction, dental crowding, and mandibular retrognathia. Treatment goals related to the chief compliant were anterior mandibular repositioning, maxillary arch expansion, and dental alignment. Because the preexisting overjet was minimal and prevented adequate anterior repositioning of the mandible, lower first premolar extraction was recommended to increase the overjet and allow greater anterior repositioning. Treatment was divided into four stages: (1) extraction of mandibular first premolar teeth, alignment, space closure, and an increase in the overjet, (2) anterior mandibular repositioning with a removable plastic Herbst appliance, (3) arch alignment and detailing of the occlusion with full fixed appliances and a tooth positioner, and (4) retainers. At the end of treatment, the patient had an acceptable dental alignment with a Class III molar relationship and an improvement in facial appearance. PMID- 3310613 TI - Prevalence of gallstones in a Danish population. AB - A random sample of 4,807 men and women, aged 30, 40, 50, and 60 years, who lived in the western part of Copenhagen County, was drawn from the National Central Person Registry. A total of 226 subjects who were not of Danish origin were omitted. The response rate was 78.8% (3,608/4,581). Each person had his or her gallbladder examined by ultrasonography. The examinations took place between November 1982 and February 1984. The overall prevalence of gallstone disease (cases with stones and cholecystectomized cases) in males aged 30, 40, 50, and 60 years was 1.8%, 1.5%, 6.7%, and 12.9%, respectively. The corresponding prevalence in females was 4.8%, 6.1%, 14.4%, and 22.4%, respectively. Differences according to sex were significant in all age groups. Differences between the 40- and 50 year and 50- and 60-year age groups were significant in both sexes. Among subjects with gallstone disease, the disease was unknown to the proband in the majority of males and in the 30-year-old females, but only in half of the women aged 40, 50, and 60 years. The prevalence of clinically diagnosed gallstones was not significantly different between respondents and nonrespondents. PMID- 3310614 TI - High-dose chemoradiotherapy with syngeneic bone marrow transplantation for multiple myeloma: a case report and literature review. AB - We had the opportunity to treat a patient with progressive heavily pretreated multiple myeloma with high-dose chemoradiotherapy with hematopoietic rescue by syngeneic bone marrow transplantation. The patient was a 53-year-old male who had previously received melphalan, prednisone, 1,3-bis (2-chloroethyl)-l-nitrosourea (BCNU), vincristine, and standard radiation therapy. At the time of bone marrow transplantation, he had increasing bone pain, increasing M-protein (IgG kappa), and a bone marrow diagnostic of myeloma. The transplant regimen consisted of cyclophosphamide, 60 mg/kg intravenously for 2 days, and total body irradiation- 1,200 rads given as 200-rad fractions, twice daily for three days. The transplant course was complicated by confusion, herpes simplex mucositis, fever, and two episodes of idiopathic diffuse interstitial pneumonia. Over the next 2 years the patient did well and was in immunologic and bone marrow complete remission. Unfortunately, 3 years after treatment, the myeloma relapsed with detectable M protein. Three and one-half years after transplant, clinical relapse occurred with bone pain and lytic lesions necessitating additional radiation and chemotherapy. Salvage therapy has produced clinical improvement and the patient is alive almost 4 years from transplant and almost 7 years from diagnosis. Although intense chemoradiotherapy did not cure this patient, substantial control of a refractory tumor was observed. This case, together with other cases of intense therapy for myeloma which are reviewed in this paper, support the concept of high-dose therapy and should foster further investigation of high-dose therapy. PMID- 3310615 TI - Making sense of laboratory tests of folate status: folate requirements to sustain normality. PMID- 3310616 TI - Fetal surgery for obstructive uropathy: rational considerations. AB - The widespread use of high resolution dynamic ultrasound imaging methods in obstetrics now permits recognition of structural and/or functional developmental anomalies of fetal genitourinary tract with some considerable accuracy. Detection of congenital obstructive uropathy in the human fetus may occur as early as 16 weeks gestation. In the fetal lamb model, experimental occlusion of the outflow tract results in progressive hydronephrosis, pulmonary hypoplasia, and oligohydramnios. The renal parenchymal changes vary with the fetal age at obstruction ranging from simple hydronephrosis with later obstruction to dysgenesis with earlier obstruction. The pulmonary damage, and to some extent the renal damage, may be halted or even reversed with release of obstruction. These advances in diagnosis and an understanding of the pathophysiology have prompted attempts at chronic in utero diversion therapy in the human fetus with obstructive uropathy yielding encouraging, but as of yet, unproven success. In this report, the methods for such therapy, the rationale for the therapy, and the results of the therapy is reviewed. PMID- 3310617 TI - Renal involvement in essential mixed cryoglobulinemia. AB - Essential mixed cryoglobulinemia (EMC) is infrequently recognized in this country. We report studies performed in six patients with EMC evaluated by us over the last 6 years. Purpura was present in three patients and glomerulonephritis in all. Two patients had chronic hepatitis B infection. Positive cryoglobulins and C1q binding, hypocomplementemia (especially low C4), positive rheumatoid factor titer, and negative anti-DNA antibodies were characteristic laboratory findings. The cryoprecipitate had strongly positive rheumatoid factor activity and contained a monoclonal IgM, kappa type in one of the two patients evaluated. The predominant lesion by renal biopsy was mesangiocapillary glomerulonephritis type I; electron microscopy revealed typical fibrillar structures in four cases. The above-mentioned features help distinguish EMC from other forms of glomerulonephritis. PMID- 3310618 TI - Recurrent sickle cell nephropathy in a transplanted kidney. AB - Of patients who developed end-stage renal disease secondary to sickle cell anemia (SCA), some have undergone renal transplantation with reasonable success. We recently cared for a patient with SCA and a functioning, transplanted kidney who experienced a permanent decline in renal function three and one-half years following transplant. The evaluation of his renal dysfunction revealed multiple features to support recurrence of sickle cell nephropathy as the cause for the deterioration. PMID- 3310619 TI - Age-associated decline in cardiac allograft rejection. AB - The influence of age on cardiac allograft rejection was studied in 57 consecutive recipients. Twenty-one subjects were 54 years of age or older (mean, 57.7 +/- 0.6 years [+/- SEM]; range, 54 to 63 years) and 36 subjects were 52 years of age or younger (mean, 39.9 +/- 1.8 years; range, 16 to 52 years; p less than 0.001). The older recipients had fewer rejection episodes during the first four months following cardiac transplantation (0.24 +/- 0.05 episodes per month versus 0.72 +/- 0.09 episodes per month; p less than 0.001) and during the total duration of follow-up (0.20 +/- 0.03 episodes per month versus 0.40 +/- 0.07 episodes per month; p = 0.045), and experienced their first rejection episode later (50.4 +/- 4.0 days versus 27.7 +/- 8.5 days; p = 0.008). Younger age was found to add significantly as a predictor of rejection in a multivariate analysis that controlled for sex, immunosuppressive agents, cause of heart failure, and pretransplantation lymphocyte cross-match status (r = 0.64, p less than 0.05). Decreased rejection frequency occurred without a concomitant increase in the serious infection rate (67 percent in both groups). The 12-month actuarial survival was 100 percent in the older group and 94 percent in the younger group (p = NS). Decreased rejection in the older recipients is likely a manifestation of an age-associated decline in immune function and might represent an advantage in transplantation for carefully selected older patients. PMID- 3310620 TI - Hemodialysis without anticoagulation. One-year prospective trial in hospitalized patients at risk for bleeding. AB - This prospective study evaluated a protocol for hemodialysis without anticoagulation in a diverse group of hospitalized patients in unstable condition with relative contraindications to anticoagulation. Of 262 attempts at hemodialysis without anticoagulation in 49 patients, 239 hemodialysis treatments (91 percent) were successfully completed. Approximately 7 percent of the attempts required conversion to a low-dose heparin regimen because of clotting in the extracorporeal dialysis circuit. Fewer than 2 percent of the dialysis treatments resulted in clotting in the extracorporeal circuit sufficient to interrupt hemodialysis. Partial thromboplastin times and activated clotting times did not change during these hemodialysis treatments. Solute clearance, ultrafiltration rate, and decrements in arterial oxygen concentration and platelet count were not different from those in patients who underwent hemodialysis with anticoagulation. There were no episodes of accelerated bleeding associated with this dialysis method. This study indicates that hemodialysis without anticoagulation can be reliable and effective in closely monitored situations. PMID- 3310621 TI - Hemodialysis-associated amyloidosis and beta-2 microglobulin. Clinical and immunohistochemical study. AB - The beta-2 microglobulin type of amyloidosis was identified in articular and para articular tissues of 14 patients with non-amyloid nephropathies undergoing long term hemodialysis. Ten patients had carpal tunnel syndrome, 13 had juxta articular radiolucent cysts (complicated by spontaneous fractures of the femoral neck in three), and six had destructive arthropathies of the large joints of the limbs. Massive amyloid deposits were found in the synovium, capsule, ligaments, articular cartilage, and/or bone. They were characterized by Congo red-induced green birefringence that was sensitive to potassium permanganate treatment. They reacted with anti-beta-2 microglobulin antiserum, whereas they did not react with antibodies directed against AA protein, prealbumin, or immunoglobulins. These data suggest that the potentially disabling arthropathy of hemodialysis is due to amyloid lesions. The persistently elevated plasma beta-2 microglobulin levels may play a role in the pathogenesis of this recently recognized complication, and if so, this complication should be preventable. PMID- 3310623 TI - Diabetes mellitus in elderly patients. Is it different? PMID- 3310622 TI - Androgen therapy of hypogonadal men with transscrotal testosterone systems. AB - The need for improved controlled delivery of testosterone to hypogonadal men stimulated the development of a self-adherent transscrotal testosterone system to provide programmed testosterone delivery through the uniquely permeable scrotal skin. In this short- and long-term efficacy trial, the responses of testosterone and its metabolites to the application of transscrotal testosterone systems of varying testosterone content were compared with the response to 200 mg of testosterone enanthate. Daily transscrotal testosterone system administration resulted in a rapid increase of testosterone and bioavailable, non-sex hormone binding globulin-bound testosterone levels to normal, peaking at two hours, followed by a slow decline over 23 hours, resembling the diurnal variation of endogenous testosterone. One year of daily transscrotal testosterone system therapy demonstrated continued reliable absorption of testosterone and suppression to normal of the luteinizing hormone in two of three patients. There was a greatly disproportionate increase of serum dihydrotestosterone over testosterone, suggesting 5-alpha reduction at the scrotal site. The subjects reported marked subjective improvement. Thus, the transscrotal testosterone system is a novel, effective, and well-tolerated method of delivering testosterone to hypogonadal patients. PMID- 3310624 TI - Successful long-term catheter drainage in an immunocompromised patient with purulent pericarditis. AB - A case of extensive staphylococcal pericarditis following renal transplantation is described. Purulent pericarditis resolved after 18 days of continuous catheter drainage from the pericardium combined with antibiotic therapy. This case illustrates that life-threatening purulent staphylococcal pericarditis after renal transplantation in an immunocompromised patient may respond to medical therapy. PMID- 3310625 TI - Relapse rate of healed duodenal, prepyloric, and gastric ulcers treated either with sucralfate or cimetidine. AB - A multicenter double-blind study was designed to compare the relapse rates of peptic ulcers after initial healing with a cytoprotective agent and a histamine (H2)-receptor antagonist. Patients with endoscopically verified prepyloric or duodenal ulcers were treated with cimetidine 400 mg twice daily or sucralfate 1 g four times daily for a maximum of eight weeks; gastric ulcers were treated for up to 12 weeks. Patients with healed ulcers were followed up to 12 months, during which time anti-ulcer medication was not permitted. Control endoscopy was performed two to four and nine to 11 months after healing and at the time of symptomatic relapse. A total of 258 patients were followed for 12 months; of these, 143 had been previously treated with cimetidine and 115 had been treated with sucralfate. The relapse rates and the median time to relapse did not differ between the two groups. After 12 months, 71 percent of the previously cimetidine treated patients and 68 percent of the sucralfate-treated patients had experienced a relapse. Smoking significantly increased the relapse rate and shortened the time to relapse in the total study population and among cimetidine treated patients; it had no such effect in the sucralfate-treated group. PMID- 3310627 TI - Antibacterial activity of sucralfate in human gastric juice. AB - A series of experiments was conducted to determine the rate of bacterial growth in human gastric juice at various pH values in relation to the addition of sucralfate and antacid. Whereas the addition of antacid resulted in bacterial growth in gastric juice, sucralfate showed an antibacterial effect. This may account for the decreased rate of pneumonia among intensive-care patients who are receiving artificial ventilation and being treated with sucralfate for the prevention of stress-induced gastrointestinal bleeding compared with the rate in patients receiving conventional prophylaxis with histamine (H2)-antagonists or antacids. PMID- 3310626 TI - Risk of acute stress bleeding and nosocomial pneumonia in ventilated intensive care unit patients: sucralfate versus antacids. AB - In a prospective, controlled, randomized study of the prophylaxis of stress bleeding, 100 ventilated high-risk patients in a surgical intensive care unit received, on a daily basis, 1 g of sucralfate suspension (n = 50) every four hours, or an antacid (n = 50) every two hours. The mean duration of the treatment was about six days in both of the groups. Gastric pH was determined every eight hours. Bleeding was defined as macroscopically visible bleeding. The intragastric pH was less than 4 significantly more often in patients treated with sucralfate. In each group, one case of macroscopically visible bleeding occurred. Both of the patients had a very high risk of bleeding. None of the bleedings influenced the outcome of the patients. When patients with primary thoracic trauma or pneumonia were excluded, nosocomial pneumonia developed in significantly fewer (p less than 0.05) patients in the sucralfate group (three of 29) than in the antacid group (11 of 32). In four of the latter patients, pneumonia influenced the outcome of the patients. Sucralfate provides adequate protection against stress bleeding while also minimizing the danger of pneumonia caused by infection via the gastropulmonary route. PMID- 3310628 TI - Comparison of the effect of sucralfate and ranitidine in reflux esophagitis. AB - A total of 49 patients with primary reflux esophagitis were treated in a randomized controlled study at six trial centers. Treatment was given for eight weeks and consisted of daily doses of either 1 g of sucralfate suspension four times daily or one 150-mg ranitidine film-coated tablet twice daily. The evaluation of effect was based on data from 41 patients; 22 of these had received sucralfate, and 19 had received ranitidine. Reflux esophagitis was healed after eight weeks of treatment in 14 sucralfate-treated patients and in 13 ranitidine treated patients. Alterations in the esophageal mucosa were established by endoscopic examination; the severity of these alterations was expressed in degrees using the Savary-Miller method of classification. The greater the degree of severity as assessed before treatment, the lower were the chances of the condition being completely healed. The endoscopic findings after treatment did not show any difference in the effect of the sucralfate and ranitidine treatments (p greater than 0.05). Both forms of treatment were also found to have a similar positive effect on the subjective symptoms recorded. Overall tolerance of the two forms of treatment was good. One patient treated with ranitidine had to discontinue treatment because of an allergic rash. Based on these results, sucralfate seems to be an effective alternative for the treatment of reflux esophagitis. PMID- 3310629 TI - Sucralfate versus placebo in treatment of non-ulcer dyspepsia. AB - One hundred fifty-one patients with non-ulcer dyspepsia, defined as chronic epigastric pain without concomitant symptoms of the irritable bowel syndrome and with no evidence of any organic disease other than macroscopic or microscopic gastritis/duodenitis seen at endoscopy on entry into the trial, were randomly assigned to treatment for four weeks with sucralfate or a placebo, 1 g three times a day one-half hour before meals, according to a double-blind model. Seventy-nine patients received sucralfate and 72 patients received a placebo. According to patients' subjective assessment of their symptoms at four weeks, 61 patients (77 percent) in the sucralfate group and 40 patients (56 percent) in the placebo group had become symptom-free or showed improvement, whereas the condition of 18 (23 percent) in the former group compared with 32 (44 percent) in the latter group remained unchanged or deteriorated. The difference between the groups was significant (p less than 0.01). The best response to sucralfate treatment (84 percent or more symptom-free or improved) was achieved in patients with mild or moderate symptoms and without macroscopic or microscopic inflammation of their gastric mucosa--a typical patient with non-ulcer dyspepsia. Our results indicate that sucralfate is significantly more effective than placebo in the treatment of non-ulcer dyspepsia. PMID- 3310630 TI - Multicenter trial of sucralfate suspension for the treatment of reflux esophagitis. AB - The efficacy of sucralfate suspension in the treatment of reflux esophagitis was assessed in a multicenter, randomized, double-blind, placebo-controlled trial. Sixty-eight patients with symptomatic and endoscopic esophagitis received either sucralfate suspension (n = 31) or liquid placebo (n = 37) for eight weeks. The two groups were comparable at entry with the exception that despite randomization, a disproportionately high number of patients with esophageal ulcers were assigned to receive sucralfate. After four and eight weeks of treatment, both groups had reduced heartburn frequency and severity, but there was no difference in improvement between sucralfate and placebo (p greater than 0.05). Endoscopic results after eight weeks of sucralfate treatment revealed complete healing in 36 percent (placebo, 35 percent) and improvement in an additional 45 percent (placebo, 24 percent). Although neither of these differences was significant, the percent of patients in whom healing or improvement occurred with sucralfate (81 percent) was greater than with placebo (59 percent) (p = 0.07). These data fail to establish that eight weeks of treatment with sucralfate suspension improves symptoms or heals lesions in reflux esophagitis at a rate significantly greater than placebo. However, the unequal distribution of patients with ulcers and the trend toward endoscopic improvement indicate that a potential beneficial effect of sucralfate suspension for the treatment of reflux esophagitis cannot be excluded. PMID- 3310631 TI - Sucralfate treatment of nonsteroidal anti-inflammatory drug-induced gastrointestinal symptoms and mucosal damage. AB - In a randomized, double-blind trial, sucralfate therapy, 1 g four times daily, was compared with placebo in 143 symptomatic patients to assess the treatment of gastrointestinal symptoms and gastric mucosal damage associated with nonsteroidal anti-inflammatory drugs (NSAIDs). All patients followed a fixed regimen of NSAIDs, were assigned to one of two groups based on the presence or absence of gastric erosions at baseline endoscopy, and were then assigned randomly to receive sucralfate or placebo for four weeks. Patients were then followed for up to six months while receiving open-label sucralfate 1 g twice daily to up to 1 g four times daily. After four weeks of double-blind therapy, patients taking either nonsalicylate NSAIDs or long half-life NSAIDs and who were treated with sucralfate experienced a significant reduction in both peptic symptom frequency and intensity (p less than 0.03) as compared with patients receiving placebo. Sucralfate-treated patients with baseline endoscopic lesions showed a significant reduction in lesion scores (p less than 0.005) at four weeks as compared with baseline, whereas no improvement was observed in gastric mucosal lesions of patients given placebo. Long-term sucralfate therapy resulted in continued improvement in gastrointestinal symptoms and gastric lesion scores in patients receiving all types of NSAIDs. The results indicate that sucralfate used in conjunction with NSAIDs may allow patients to continue therapy by relieving gastrointestinal symptoms and mucosal damage associated with NSAID therapy. PMID- 3310632 TI - Comparison of two sucralfate dosages presented in tablet form in duodenal ulcer healing. AB - Two hundred twenty-two patients with endoscopically proven duodenal ulcers participated in a controlled trial to assess and compare the effects of two dosage regimens of sucralfate tablets on ulcer healing, i.e., 1 g four times daily (group A, n = 131) and 2 g twice daily (group B, n = 128). Healing was defined as complete re-epithelialization. Clinical and endoscopic assessments were performed after four weeks (Day 28) and, if complete healing was not achieved, after four more weeks (Day 56). After four weeks, in group A (n = 114: eight patients were lost and nine were withdrawn), the ulcers had healed in 90 patients (79 percent), and in group B (n = 108: six patients were lost and 14 were withdrawn), the ulcers had healed in 80 patients (74 percent). The cumulative healing rates after eight weeks were 94 percent in group A and 95 percent in group B. No serious adverse effect was observed in either group. These results suggest that sucralfate tablets in a dosage of 2 g twice daily are as effective as 1 g four times daily in the treatment of acute duodenal ulcers and could lead to better patient compliance. PMID- 3310633 TI - Nocturnal dosage regimen of sucralfate in maintenance treatment of gastric ulcer. AB - Sixty-six patients with recently healed gastric ulcers were entered into a double blind, placebo-controlled, six-month maintenance trial to determine whether sucralfate 2 g at night reduces the liability to recurrent ulceration. Thirty three patients were randomly assigned to treatment with sucralfate and 33 were assigned to placebo. Endoscopy was performed at the time of entry into the study and at 24 weeks, or earlier if clinical relapse occurred during this period. Of the patients available for analysis, endoscopic recurrences were found in eight of the 29 patients (28 percent) randomly assigned to sucralfate and in 15 of the 27 patients (56 percent) assigned to placebo. Eight of the recurrences noted at 24 weeks were asymptomatic and, of these, five were in the placebo-treated group. The cumulative relapse rate at 24 weeks was significantly lower in the sucralfate treated group (p less than 0.05), and the Cox-Mantel text showed a significant difference between the cumulative relapse curves of the two treatment groups over the 24-week period (p less than 0.05). The results indicate that a single maintenance dose of sucralfate 2 g at night reduces the relapse rate in patients with recently healed gastric ulceration. PMID- 3310634 TI - Sucralfate and cimetidine as maintenance treatment in the prevention of duodenal ulcer recurrence. AB - This multicenter trial investigated the ability of the cytoprotective agent sucralfate and the antisecretory agent cimetidine to prevent ulcer relapses. Seventy-one patients with recently healed duodenal ulcer were included, randomly assigned to one of the two treatment groups, and administered sucralfate 2 g per day or cimetidine 400 mg per day for six months; the treatment period was followed by another six months of follow-up without treatment. The response to therapy was evaluated by systematic single-blind endoscopy controls during the sixth and the 12th months. Quantitative (42 percent relapse rate with sucralfate and 52 percent with cimetidine) as well as qualitative (20 percent silent relapses with sucralfate and 47 percent with cimetidine) differences were observed, although these could not be demonstrated to be statistically significant. PMID- 3310635 TI - Pathophysiologic features of episodic gonadotropin secretion in man. AB - Endocrine glands typically signal their remote target tissues by an intermittent, rather than an invariant, pattern of hormone secretion. This pulsatile mode of hormone release is believed to convey significant information to the target cells. This review focuses on the luteinizing hormone pulse signal in man as a paradigm for endocrine glandular signaling in general. In particular, recent developments in our understanding of the pathophysiology of luteinizing hormone secretion in men and women is examined, and illustrate how specific disturbances in neuroendocrine physiology can result in altered reproductive states are illustrated. New models of pituitary-secretary dynamics that are likely to help clarify more subtle defects in fertility regulation in man and experimental animals are suggested. PMID- 3310636 TI - CAPD patients as renal transplant patients. AB - Most authors state that the continuous ambulatory peritoneal dialysis (CAPD) patient is not at increased risk when transplanted. These patients are always exposed to the risk of peritonitis, which may increase if patients are peritoneally dialyzed while immunosuppressed. The postoperative course of patients transplanted from our CAPD program from 1979 through August 1985 was evaluated. The transplant survival of patients dialyzed by CAPD, home hemodialysis, and at a free-standing dialysis facility were compared. Pretransplant dialysis modality did not influence long-term transplant success. Three of seven patients who required dialysis postoperatively developed peritonitis. The dialysis catheter was removed in two patients and one was treated by lavaging the peritoneal cavity with antibiotics. There was one instance of dialysate leaking through a drain in the transplant bed. This patient was converted to hemodialysis for subsequent dialysis. The dialysis catheters were removed at the time of discharge from hospital. Literature review confirmed this experience. Peritoneal dialysis post-transplant exposes the patient to a 10 33% risk of peritonitis and a 10% risk of a wound complication. Peritoneal dialysis patients are subject to risks unique to peritoneal dialysis. These complications do not translate into excessive morbidity or graft loss. PMID- 3310637 TI - Hypertrophic cardiomyopathy: current views on etiology, pathophysiology, and management. AB - Hypertrophic cardiomyopathy (HCM) is a primary myocardial disease of unknown cause that is characterized by a hypertrophied, nondilated, hypercontractile left ventricle. Its etiology and pathogenesis remain undefined but the three principal factors implicated are a genetic predisposition, a hypersensitivity to catecholamines, and an abnormal calcium metabolism. The hypertrophy typically involves the intraventricular septum to varying degrees, but may also involve the apex or free wall and even be concentric. The disease occurs in either an obstructive or a nonobstructive form depending on whether an intraventricular pressure gradient can be demonstrated at rest or on provocation. The gradient and obstruction to outflow is usually seen in patients with asymmetric septal hypertrophy (ASH) and anterior motion of the mitral valve during systole (SAM). Abnormal left ventricular diastolic function characterized by inadequate filling and impaired relaxation has been shown to be very important in both the obstructive and nonobstructive forms of the disease. In addition, inadequate coronary vasodilator reserve as a result of small vessel disease, microvascular spasm, and/or low capillary density per unit myocardial mass has been implicated as an important cause of ischemia in patients without coronary artery disease. HCM is a disease of young adulthood with relatively slow progression; young patients are often asymptomatic, whereas older patients are more limited by dyspnea, angina, dizziness, or syncope. Supraventricular tachyarrhythmias occur in 30% of patients, and high-grade ventricular arrhythmias occur in over 75%. The annual mortality is 3-5%. The common mode of demise is sudden cardiac death. Therefore, the primary objectives of treatment are the amelioration of symptoms, the control of arrhythmias, and the prevention of sudden death. Beta adrenoreceptor blocking agents decrease myocardial contractility and oxygen demands and increase ventricular volume; therefore, they are most useful in patients with the obstructive form of HCM. Calcium channel antagonists enhance left ventricular relaxation, relieve microvascular spasm, and improve coronary filling and therefore are the agents of choice in patients with diastolic dysfunction. The ability of the calcium channel antagonists to decrease contractility makes them valuable in patients with obstructive HCM. Arterial vasodilators, diuretics, nitrates, and inotropic agents should be avoided because they can increase the intraventricular gradient. Myomyectomy is reserved for those patients with the obstructive form of HCM whose symptoms are refractory to medical therapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3310638 TI - Kaposi's sarcoma in a renal transplant patient receiving cyclosporine. AB - A patient of Middle-Eastern descent developed Kaposi's sarcoma of the skin and lymph nodes after renal transplantation while receiving medical immunosuppression, including the use of cyclosporine. The clinical presentation of this patient resembled that of the HTLV-III-associated Kaposi's sarcoma. The tumors totally regressed seven weeks after cessation of immunotherapy. This case, along with other recently reported cases of Kaposi's sarcoma in postrenal transplant patients receiving cyclosporine, illustrates a rare complication of current immunosuppressive therapy. PMID- 3310639 TI - The inconsistent effects of calcium supplements upon blood pressure in primary hypertension. AB - The effects of 800 mg of elemental calcium per day (calcium carbonate or calcium citrate) on blood pressure were compared with a placebo in a controlled randomized, crossover, double-blinded trial involving 26 patients with uncomplicated primary hypertension. Each patient took two of the three forms of therapy orally for 8-week intervals with a 2-week washout period in between. Standing mean blood pressure rose an average of 5.7 mm Hg on placebo, rose an average of 0.5 mm Hg on calcium carbonate, and fell an average of 2.2 mm Hg on calcium citrate. Changes in sitting mean pressures averaged +1.9 mm Hg on placebo, -0.4 mm Hg on calcium carbonate, and -0.4 mm Hg on calcium citrate. Some patients had a fall, others had a rise in blood pressure on each form of calcium. Similarly, inconsistent responses were noted among the nine patients who took both forms of calcium. Neither initial nor post-treatment biochemical measures nor patient characteristics were predictive of the blood pressure response. Combinations of various measures and characteristics analyzed by the multiple regression technique explained only 30% of the overall variability in blood pressure. Therefore, until ways can be found to predict the response, calcium supplements should not be routinely prescribed for the treatment of hypertension and, if given for any indication, blood pressure should be monitored. PMID- 3310640 TI - The pharmacology of dobutamine. AB - Dobutamine is a sympathomimetic amine that was designed as an inotropic agent for use in congestive heart failure. Clinically, dobutamine increases cardiac output by selectively augmenting stroke volume, and this is associated with a decrease in total peripheral vascular resistance that is mediated, in part, by reflex withdrawal of sympathetic tone to the vasculature. This hemodynamic profile of dobutamine makes the drug of value in the management of low output cardiac failure. The inotropic activity of dobutamine has previously been attributed to selective stimulation of myocardial beta 1-adrenoceptors. However, recent studies from a number of laboratories indicate that the mechanism of action of dobutamine is substantially more complex. Dobutamine has the capacity to stimulate beta 1-, beta 2-, and alpha 1-adrenoceptors in the cardiovascular system at doses that approximate those used clinically. It has recently been suggested that the inotropic activity of dobutamine results from combined beta 1- and alpha 1 adrenoceptor stimulation in the myocardium, and that this activity could explain, at least in part, the inotropic selectivity of the compound. Furthermore, in the vasculature, the beta 2-adrenoceptor-mediated vasodilatory effect of dobutamine is exactly offset by the alpha 1-adrenoceptor-mediated vasoconstrictor activity, such that net changes in blood pressure are minimal following the administration of dobutamine. It is concluded, therefore, that the hemodynamic profile of dobutamine in patients with congestive heart failure is derived from a unique and complex series of interactions with alpha- and beta-adrenoceptors in the cardiovascular system. PMID- 3310641 TI - Drug fever: mechanisms, maxims and misconceptions. AB - Although drug fever is a clinical entity that has received considerable attention in textbooks and review articles, only recently have such writings been subjected to critical analysis. In the present review, mechanisms responsible for drug fever are examined. In addition, published characterizations of the syndrome are compared with the results of a recently published systematic analysis of 148 cases of drug fever. This comparison identified a number of important areas in which descriptions of the clinical entity in textbooks and review articles are at odds with the clinical profile exhibited by actual cases of drug fever. PMID- 3310642 TI - Detection of specific extracellular matrix molecules in drusen, Bruch's membrane, and ciliary body. AB - We used specific antibodies to localize a variety of extracellular matrix components by indirect immunofluorescence reactions on cryostat sections of drusen-bearing human donor eye tissue. These included collagen types I through V, fibronectin, laminin, heparan sulfate-containing basement membrane proteoglycan as well as antibodies to human IgG and IgM. The composition of drusen with respect to these specific molecules varied greatly, even within the same region of an eye. Hard or nodular drusen were more likely to show a discrete organized layer of specific basement membrane molecules over their apical surfaces than were diffuse type drusen. Diffuse but not nodular drusen generally contained fibronectin. Immunohistochemical reactivity of Bruch's membrane showed age related accumulation of type I collagen and localized changes associated with some drusen. PMID- 3310644 TI - Glaucoma treatment with once-daily levobunolol. PMID- 3310643 TI - Magnetic resonance imaging of metal loop intraocular lenses. PMID- 3310645 TI - Serologic markers after the transplantation of corneas from donors infected with human immunodeficiency virus. PMID- 3310646 TI - Prevention of myopic progress by glasses. Study design and the first-year results of a randomized trial among schoolchildren. AB - We report the design and first-year follow-up results of a randomized trial of three different types of corrective lenses: (1) minus lenses with full correction for continuous use (the reference group); (2) minus lenses with full correction for distant vision only; and (3) bifocal lenses. Two hundred and forty 9- to 11 year-old mildly myopic schoolchildren were randomly allocated to the three treatment groups to be followed up to 3 years. During the first year, 73% of the children were compliant with their treatment. Refraction values after the first year were obtained from all but one child. In the second group (spectacles for distant vision only) myopia had progressed somewhat more than in the reference group. In respect of other values (school achievement, reading habits, and accidents) there were no statistically significant differences between the groups. PMID- 3310647 TI - Biofeedback of accommodation to reduce myopia: a review. AB - Since the first report in 1970 of biofeedback to train voluntary control of accommodation, the use of biofeedback to train accommodation has progressed from basic research demonstrations to the clinical treatment of myopia. The initial reports showed that voluntary control of accommodation could be trained easily and accurately. The next series of investigations were into the efficacy of the technique for training low (less than 1.00 D), functional myopes. The research showed that functional myopia could be reduced with biofeedback training of accommodation. Finally, the technique has expanded into training for a wide range of myopes from children to senior citizens. The results demonstrate the effectiveness of biofeedback in reducing myopia by training voluntary control of accommodation. PMID- 3310648 TI - Distribution of airway contractile responses in major resistance airways of the dog. AB - The topographical distribution of airway contractile responses within major diameter bronchi was examined isometrically in vitro in 15 mongrel dogs. Responses were compared in the same animals among airway Generations 2-5. Concentration-response curves were generated in the same strips with methacholine (MCh) and potassium chloride (KCl) in vitro. Force of contraction was assessed as grams force (g) divided by tissue wet weight (g/g) and was normalized further for the proportion of smooth muscle in each airway by means of computerized morphometry (g/g smooth muscle mass; g/gM). Both techniques revealed substantial heterogeneity of response that was not dependent upon the mechanism of contraction. Maximal isometric contraction to MCh increased from 1911 +/- 245 (Generation 2) to 6693 +/- 850 g/gM (Generation 5) (P less than 0.005). Similarly, maximal contraction to KCl, an agonist causing contraction by a non receptor-mediated mechanism, was nearly three times greater in Generation 5 than in Generation 2 bronchi (P less than 0.005). It is concluded that the force of isometric contraction of bronchial smooth muscle increases through the first five generations of bronchi, even after normalization for smooth muscle mass. These differences are not agonist-dependent and do not depend upon the topographical distribution of receptors in the airways. PMID- 3310649 TI - Characterization of stromal cells with myoid features in lymph nodes and spleen in normal and pathologic conditions. AB - Stromal cells with myoid features were identified in rat or human lymph nodes and spleen in normal and pathologic conditions, using antibodies to desmin, alpha smooth muscle actin, and smooth muscle myosin. In normal lymph nodes, myoid cells (MCs) were present in the superficial and deep paracortex as well as in the medulla, and absent in lymphoid follicles. In the spleen, they were numerous in the red pulp, less abundant in periarteriolar lymphocyte sheaths of the white pulp, and absent in lymphoid follicles. On double immunostaining, alpha-smooth muscle actin and smooth muscle myosin were coexpressed with desmin only in the deep paracortex and parafollicular areas of the lymph nodes, as well as in the MCs of the periarteriolar lymphocyte sheaths and marginal zone of the spleen; the remaining MCs expressed only desmin. When examined by means of electron microscopy, MCs showed a dendritic shape and cytoplasmic bundles of microfilaments with dense bodies scattered between them. When compared with normal conditions, MCs showed changes of distribution and number in several pathologic situations. Additional findings were 1) staining of pericytes surrounding high endothelium venules of lymph nodes with alpha-smooth muscle actin antibodies in man and rat and with desmin antibodies in rats; 2) staining of endothelial cells in these venules with desmin antibodies in rats. It is concluded that a subset of reticular cells in lymph nodes and spleen, as well as pericytes and endothelial cells in high endothelium venules display cytoskeletal features suggesting a myoid differentiation and function. PMID- 3310650 TI - Immunophenotyping of non-Hodgkin's lymphoma. Lack of correlation between immunophenotype and cell morphology. AB - The establishment of Clusters of Differentiation for T- and B-lymphoid cells during International Workshops on Human Leukocyte Differentiation Antigens prompted the authors to evaluate the immunophenotypes in 160 cases of non Hodgkin's lymphoma (NHL). In this group, 130 were of B-lymphocyte lineage (117 by monotypic immunoglobulin expression), and 30 of T-cell lineage. In the B-NHL series the expression of immunoglobulin isotypes, B-cell maturation/differentiation antigens of CD9, CD10, CD19-24, CD37, and CD38 (OKT10), HLA-DR and peanut agglutinin binding showed no significant relationship with histopathologic diagnosis as defined by the Kiel classification. Of the T cell markers, CD5, CD6, and CD7 showed lineage promiscuity by their presence on some B-NHL. Conversely, the authors grouped the cases according to phenotypes (either CD antigens or immunoglobulin isotypes) which occur in distinct stages of (physiologic) B-cell maturation/differentiation. Eighty-six of the 130 cases could be fitted according to CD phenotype expression. This approach did not yield a significant relationship between phenotype and individual histopathologic categories either. The staging by CD phenotype and by immunoglobulin isotype yielded different results in this respect. Most B-NHL had an intermediate stage of B-cell maturation/differentiation. In the T-NHL series most cases showed a phenotype (CD1-CD8, CD38, TdT, and peanut agglutinin binding capacity) compatible with mature T-lymphocyte characteristics. The exceptions were lymphoblastic convoluted lymphomas, which exhibited an immature immunophenotype. It is concluded that NHL in distinct histopathologic categories are heterogeneous in immunologic phenotypes, and that the immunophenotype of lymphoma cells has no evident association with that of their presumed counterparts in physiologic cell maturation/differentiation. PMID- 3310651 TI - Immunophenotyping of non-Hodgkin's lymphomas using a panel of antibodies on paraffin-embedded tissues. AB - The use of monoclonal and polyclonal antibodies for the immunophenotyping of non Hodgkin's lymphomas in paraffin-embedded tissue has been limited by the fact that most antigens on lymphoid cells are denatured by histologic fixation, dehydration, and embedment. In this article the authors have analyzed a small panel of antibodies which represent exceptions to this rule, in that they identify denaturation-resistant determinants on leukocyte antigens in paraffin embedded tissue. Monoclonal antibodies L26 [corrected] and 4KB5 label preferentially B cells, monoclonal antibody UCHL1 stains predominantly T cells, and monoclonal antibody MAC 387 reacts with granulocytes and some macrophages. A polyclonal antiserum raised against purified CD3 (T3) antigen, a T-cell-specific molecule, was also employed. This antibody panel was used to immunophenotype routinely processed tissue biopsy specimens from 61 non-Hodgkin's lymphomas (all of which had been previously phenotyped in cryostat sections). The lineage of the neoplastic cells was correctly identified in 32 of 34 (94%) cases of B-cell lymphoma, in 19 of 19 (100%) cases of T-cell neoplasm, and in 2 of 4 (50%) cases of histiocytic malignancy. It is concluded that this combination of antibodies is helpful in immunophenotyping non-Hodgkin's lymphomas when only paraffin-embedded tissue sections are available, although additional reagents of higher specificity are required to improve the identification of lymphomas. PMID- 3310653 TI - Distribution of meprin in kidneys from mice with high- and low-meprin activity. AB - An inherited deficiency of a metalloendopeptidase (meprin) activity occurs in kidneys of many inbred mouse strains. To clarify whether meprin protein is present in low-activity strains and determine the distribution of meprin in kidneys of mice with high- and low-meprin activities, kidney slices were stained through the use of the indirect immunoperoxidase technique and examined by light and electron microscopy. Light microscopy at high dilutions of anti-meprin IgG confirmed the brush border localization of meprin in high-meprin activity strains and revealed no detectable cross-reactive material in low-meprin activity strains. However, light and electron microscopy studies that use lower dilutions of anti-meprin immunoglobulin G (IgG) revealed cross-reactivity in low-activity strains, also at the luminal surface of the proximal tubules. Studies at lower magnifications indicated that meprin is primarily associated with the juxtamedullary region of the kidney in both high- and low-activity strains. Western blots of urinary proteins showed significant amounts of meprin-like proteins, but only in the urine of mice with high-meprin activity. The low activity of meprin in some inbred mouse strains is not associated with the presence of the protein in compartments of kidney cells other than the brush border or with secretion of the protein into the urine. PMID- 3310654 TI - Control of late G0/G1 progression and protein modification by SmC/IGF I. AB - Somatomedin C/insulin-like growth factor I (SmC/IGF I) mediates traverse of late G0/G1 in density-arrested BALB/c-3T3 cells from a distinct growth arrest point in mid-G0/G1 (the V point) to the initiation of DNA synthesis. As a prelude to future studies aimed at defining the mechanism of action of SmC/IGF I, we investigated the level (e.g., transcriptional, translational) at which SmC/IGF I modulates V to S traverse. The post-V point progression of cells arrested at the V point by amino acid starvation and released into amino acid-replenished medium containing SmC/IGF I, insulin, or platelet-poor plasma (PPP) did not require either mRNA synthesis or an increase in the overall level of protein synthesis. Although two-dimensional gel analysis of proteins prepared from SmC/IGF I-treated cells did not reveal any preferentially synthesized proteins, several SmC/IGF I induced protein modifications, which result in an increase in isoelectric point (pI) and occur in the absence of mRNA synthesis, were evident. These findings suggest that SmC/IGF I modulates late G0/G1 progression by a posttranscriptional process that may involve protein modification. PMID- 3310652 TI - Epithelial hyperplasia in human polycystic kidney diseases. Its role in pathogenesis and risk of neoplasia. AB - The importance of tubular epithelial hyperplasia in polycystic kidney diseases has become apparent during the last decade. Micropapillary hyperplasia occurs in autosomal dominant polycystic kidney disease, in localized cystic disease, and in acquired cystic disease. Neoplastic or severely dysplastic epithelial hyperplasia occurs in von Hippel-Lindau disease. A histopathologically distinctive epithelial hyperplasia occurs in tuberous sclerosis. In each of these conditions, epithelial hyperplasia may be related to cyst formation and may also impose an increased risk of malignancy--a risk that seems to be highest in patients under treatment with long-term hemodialysis for end-stage kidney disease. Although hyperplasia in some of these diseases may share a common pathway of development, it is more probable that the histopathologic differences reflect different pathogenetic pathways that converge on a common endpoint. PMID- 3310656 TI - Effects of food restriction on lactate production from glucose by rat adipocytes. AB - We investigated the effects of acute food deprivation on the rates of glucose metabolism and lactate production by epididymal fat cells isolated from 2- and 8 mo-old Wistar rats in one of three nutritional states: fed ad libitum, restricted to 50% of ad libitum, or fasted for 48 h. Food restriction did not affect total rates of basal glucose metabolism but significantly altered its pattern. In small fat cells from 2-mo-old rats, donor's food restriction led to decreased basal and insulin-stimulated glucose oxidation and fatty acid synthesis but led to increased lactate production, which increased from 4% of total glucose metabolized by cells from fed rats to 62% by cells from fasted rats. In large fat cells from 8-mo-old rats, donor's food restriction produced minimal changes in basal glucose metabolism and lactate production (already elevated at 37% of total) but caused insulin-stimulated lactate production to increase. These findings indicate that adipose tissue can produce significant amounts of lactate (with adipocyte enlargement and/or food deprivation) and may play an important role in extrahepatic generation of triose intermediates and in the Cori cycle. PMID- 3310655 TI - Reversal of the exercise-induced increase in muscle permeability to glucose. AB - Exercise is associated with an increase in permeability of muscle to glucose that reverses slowly (h) in fasting rats during recovery. Previous studies showed that carbohydrate feeding speeds and carbohydrate restriction slows reversal of the exercise-induced increase in glucose uptake. This study was designed to evaluate the roles of glucose transport, glycogen synthesis, and protein synthesis in the reversal process in rat epitrochlearis muscle. In contrast to recovery in vivo, when muscles were incubated without insulin in vitro, the exercise-induced increase in muscle permeability to sugar reversed rapidly regardless of whether glucose transport or glycogen synthesis occurred. Inhibition of protein synthesis did not prevent the reversal. Addition of 33% rat serum or a low concentration of insulin to the incubation medium markedly slowed reversal in vitro. We conclude that 1) prolonged persistence of the increased permeability of mammalian muscle to glucose after exercise requires a low concentration of insulin, and 2) reversal of the increase in permeability does not require glucose transport, glycogen synthesis, or protein synthesis. PMID- 3310657 TI - Clenbuterol-induced muscle growth: investigation of possible mediation by insulin. AB - The role of insulin as a possible mediator of the beta-adrenergic agonist stimulation of muscle growth was investigated. To exclude possible action of the beta-agonist on the pancreatic release of insulin, diabetes was induced in rats by a streptozotocin injection (100 mg/kg). Insulin levels were almost not detectable in these rats. Feeding either normal diet or diet containing the beta adrenergic agonist clenbuterol (10 parts/million) did not alter plasma insulin concentrations. The effects of clenbuterol on muscle and weight gain were determined in diabetic rats given daily insulin replacement (D + I) and fed either a normal diet or clenbuterol-treated diet. Clenbuterol, fed for 1 wk, increased the wet weight of the gastrocnemius, soleus, and extensor digitorum longus muscles (15-23%) in both normal and D + I rats. Although clenbuterol increased body weight gain, it did not alter feed consumption and, therefore, feed efficiency (g gain/g food) was improved. Activities of cathepsin B and N acetyl-beta-glucosaminidase, but not cathepsin D, were elevated in the soleus muscles of clenbuterol-treated rats. The clenbuterol-induced increase in muscle growth in the insulin-replaced diabetic rats indicated that this beta-adrenergic agonist effect was not mediated by an alteration of circulating levels of insulin, secondary to beta-agonist action on pancreatic insulin release. PMID- 3310658 TI - Hyperglycemia stimulates carbohydrate oxidation in humans. AB - We examined whether hyperglycemia stimulates carbohydrate oxidation independent of insulin. Rates of total glucose disposal and substrate oxidation (indirect calorimetry) were measured at 4 insulin concentrations and at each level of insulin at 4 glucose concentrations in 88 separate studies in 22 normal volunteers. The insulin sensitivity of carbohydrate and lipid oxidation was independent of glycemia, but glucose, independent of insulin, increased the absolute rate of carbohydrate oxidation and decreased lipid oxidation. To compare the ability of glucose and insulin to stimulate carbohydrate oxidation, oxidation rates were examined at similar rates of total glucose disposal induced by hyperinsulinemia or hyperglycemia. At physiological matched rates of glucose disposal, insulin stimulated carbohydrate oxidation 2.4-fold more than glucose. The free fatty acids (FFA) were significantly lower in the presence of hyperinsulinemia than hyperglycemia. When compared at similar (supraphysiological) rates of total glucose disposal, where the FFA were completely suppressed, the rate of carbohydrate oxidation was related to the total rate of glucose disposal rather than the ambient glucose or insulin concentrations. We conclude that both glucose and insulin can increase carbohydrate oxidation in humans. We propose that the rate of carbohydrate oxidation is determined by FFA availability and by glucose availability independent of the FFA level in glucose-consuming tissues. Although FFA availability is almost solely determined by insulin, both glucose and insulin can increase carbohydrate oxidation by increasing glucose availability. PMID- 3310659 TI - Effect of superfused insulin on cerebral cortical glucose utilization in awake goats. AB - The effect on cortical cerebral glucose utilization (CMRglu) of intracerebral insulin administration in awake goats was studied. The insulin was superfused in a mock cerebrospinal fluid (CSF) solution employing chronically implanted cranial windows. Two windows were implanted bilaterally: one window over an equivalent portion of each parietal cortex. With one window used to deliver insulin/CSF and the other used to simultaneously deliver CSF alone (control), changes in CMRglu were assessed using a modification of a sequential 2-[3H]- then 2-[14C]deoxy-D glucose (2DG) technique originally described by Altenau and Agranoff (Brain Res. 153: 375-381, 1978). Initial experiments employing 125I-insulin demonstrated that the superfusion procedure increased insulin levels only in the outer 1 mm of cortical tissue exposed to insulin containing perfusate. Additional preliminary evaluations, using conditions known to alter CMRglu, generally established that present methods were adequate to induce and detect CMRglu changes. However, it was also shown experimentally and using a mathematical model that 2-[3H]DG test/control tissue ratios could be influenced by subsequent changes in CMRglu and the dephosphorylation rate. Thus 3H ratios could not be used to establish preexperimental test/control CMRglu relationships as the originally devised model assumed but could be employed to indicate changes in dephosphorylation. The mathematical model allowed for improved estimates of CMRglu changes from 2 [14C]DG/2-[3H]DG test over control tissue ratios. Even with these corrections, insulin was estimated to cause no more than an 8-15% increase in cortical CMRglu. A very limited role for insulin, at least in cerebral cortical metabolic regulation, is thus indicated. PMID- 3310660 TI - Role of the hepatic branch of the vagus nerve in liver regeneration in rats. AB - The role of the vagus nerve in liver regeneration after partial hepatectomy was examined by comparing the effects of hepatic vagotomy (sectioning of the hepatic branch of the vagus nerve) with those of subdiaphragmatic vagotomy in rats. Hepatic vagotomy delayed but did not suppress the increase in the rate of hepatic DNA synthesis and the activity of thymidine kinase after partial hepatectomy. On the other hand, subdiaphragmatic vagotomy delayed and suppressed these indices. The time courses of restoration of liver DNA content after partial hepatectomy were not affected by hepatic vagotomy. However, this index was both delayed and suppressed in subdiaphragmatic vagotomized rats. Hepatic vagotomy did not affect the daily food intake or the body weight increase after partial hepatectomy. However, subdiaphragmatic vagotomy caused considerably more loss of food intake and body weight. There were no differences in the plasma insulin levels after partial hepatectomy among three groups. We concluded that a vagal specific effect is evident in the delay but fails to suppress liver regeneration. PMID- 3310661 TI - Intestinal adaptations of rainbow trout to changes in dietary carbohydrate. AB - Although omnivores are able to alter the structure and functions of their digestive system in response to changes in dietary carbohydrate content, it is unclear whether carnivores are capable of such adaptive flexibility. Hence we recorded growth rates, intestinal morphometrics and histology, and nutrient uptake rates and concentrations of disaccharidases in the intestines of a carnivorous fish, the rainbow trout, fed different levels and types of carbohydrate. The trout is unable to adaptively regulate digestive system structure and function to increase glucose availability in response to increasing levels of dietary carbohydrates, even to easily digestible forms such as glucose. Paradoxically, a reduction in the concentrations of enzymes associated with carbohydrate digestion in response to elevated levels of easily digested carbohydrates suggests that carnivores may actually try to repress carbohydrate digestion when glucose is available in high quantities. Thus the lower levels of carbohydrate in the diet of trout throughout their evolution has resulted in a reduced ability to phenotypically regulate the digestion of carbohydrates. PMID- 3310662 TI - Roles and mechanisms of urinary buffer excretion. AB - Excretion of acid (or generation of bicarbonate) by the kidneys is necessary for acid-base homeostasis. Most of this acid is excreted in the form of ammonia and titratable acid, the latter representing the amount of acid required to titrate the urine buffers from the plasma pH to urine pH. The transport of ammonia in the kidney is now recognized to entail more than simple nonionic diffusion of NH3 and trapping of NH4+. NH4+ transport in the kidney probably occurs by passive diffusion and by transport on the Na+-H+ exchanger, the Na+-K+-2Cl- transporter and on Na+-K+-ATPase. NH3 diffusion is stimulated by an acid disequilibrium pH in various nephron segments. Also, diffusion equilibrium of NH3 in various regions of the kidney has now been disproved. These various mechanisms of ammonia transport are considered in terms of their possible changes with acid-base disturbances. Phosphate is the most predominant urine buffer; its urinary excretion increases with acidosis. The mechanisms probably involve a decrease in the preferentially transported species, HPO4(2-), and a direct effect of pH on proximal tubule apical phosphate transport. With chronic acidosis, changes in the activity of the apical Na+-phosphate transporter occur. These effects of systemic acid-base balance interact with parathyroid hormone and dietary phosphate status to alter phosphate reabsorption. Citrate transport in the kidney is analyzed because of its sensitivity to systemic pH and because of the possible influence on systemic acid-base status in certain circumstances. Alterations in citrate excretion with acid-base disturbances depend on changes in the concentration of the transported species, citrate2-, and on changes in renal metabolism. PMID- 3310663 TI - Release of renin and angiotensin II into plasma and lymph during hyperchloremia. AB - Renal vascular resistance (RVR) was related to intrarenal release of renin (RR) and angiotensin II (ANG II) during increases in plasma osmolality (Posmol) or chloride (PCl). Intrarenal infusions of 1.232 M solutions given to in situ kidneys increased Posmol by 7-18%. Hypertonic dextrose (n = 8) reduced RVR (P less than 0.005) but increased RR into plasma (P less than 0.01) and increased lymph renin (LR) (P less than 0.05). The response to hypertonic Na acetate (n = 5) was similar, but hypertonic NaCl (n = 9) increased RVR (P less than 0.02) without changing RR. During infusion of arachidonic acid (AA), hypertonic NaCl increased RVR (P less than 0.02) but decreased RR into plasma and decreased LR (P less than 0.05). Overall group mean changes in RVR were inversely related to LR (r = -0.96; P less than 0.01). An increase in PCl of 12 +/- 1 mmol/l was induced in denervated kidneys by changing an intrarenal 0.616 M infusion of Na acetate to NaCl. Hyperchloremia increased RVR from 14 +/- 2 to 19 +/- 2 mmHg . ml-1 . min-1 . kg-1 (P less than 0.01), reduced GFR from 1.4 +/- 0.1 to 1.1 +/- 0.1 ml . min-1 . kg-1 (P less than 0.01), and reduced ANG II (pg/ml) in renal venous plasma (55 +/- 6 to 35 +/- 6; P less than 0.05) and lymph (366 +/- 111 to 209 +/- 53; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310664 TI - Arterial pressure after chronic reductions in suprarenal aortic flow in fetal lambs. AB - Experiments were performed on 13 fetal lambs of 126 days gestational age. Seven days after surgery, suprarenal aortic blood flow was reduced to 70% of control with an inflatable occluder for a period of at least 4 days. This produced an almost constant aortic pressure difference of 35 mmHg across the occluder. Plasma renin activity (PRA) rose in the next hour from 6 to 42 ng.ml-1.h-1 (P less than 0.01) but decreased to a level that was statistically insignificantly above normal by the next day. PRA as a function of lower body arterial blood pressure showed rapid adaptation. Upper body arterial blood pressure was statistically significantly elevated by 5 mmHg within 5 min and continued to rise while plasma renin activity was falling. Femoral artery blood pressure dropped immediately but returned to near normal within 1 h and remained there. The long-term upper body hypertension was irreversible with a 30-min infusion of saralasin. Subrenal aortic flow reduction caused none of these changes. We conclude that the fetal kidneys can regulate arterial blood pressure upward but that the long-term effect does not depend solely on a direct vasoconstrictive action of angiotensin. PMID- 3310665 TI - Insulin does not influence muscle glycogenolysis in adrenodemedullated exercising rats. AB - Previous reports have indicated that adrenodemedullated (ADM) rats exhibit an impairment in muscle glycogenolysis and elevated plasma insulin during exercise. This study was designed to determine whether the impaired muscle glycogenolysis in ADM rats is due to absence of epinephrine or to the inappropriately elevated plasma insulin. Fasted ADM rats were infused with saline, with epinephrine (0.045 micrograms . 100 g-1 . min-1), or with epinephrine + insulin (1.6, 3.3, 6.6, and 8.3 ng . 100 g-1 . min-1) during a 30-min run on the treadmill (21 m/min, 10% grade). Soleus muscle glycogen decreased from 5.1 +/- 0.2 mg/g in resting ADM rats to 4.0 +/- 0.2, 0.8 +/- 0.1, and 0.8 +/- 0.1 mg/g in the exercising saline-, epinephrine-, and epinephrine + insulin (8.3 ng . 100 g-1 . min-1)-infused rats, respectively. Glycogen utilization in gastrocnemius and red and white quadriceps muscles during exercise was likewise unaffected by insulin infusion. Blood glucose concentrations were 3.75 +/- 0.08, 2.65 +/- 0.14, 3.93 +/- 0.20, and 2.03 +/- 0.09 mM in the same groups at the end of exercise. Blood lactate was 50% lower and the blood 3-hydroxybutyrate and plasma free fatty acid concentrations were significantly higher in the ADM + saline rats than the other exercising rats. We conclude that inappropriately elevated plasma insulin does not impair epinephrine-stimulated muscle glycogenolysis in fasted ADM rats during exercise. PMID- 3310666 TI - Effect of diltiazem on altered cellular calcium regulation during endotoxic shock. AB - Cellular free and exchangeable Ca2+ were quantitated in livers of rats injected with saline (control), Salmonella enteritidis endotoxin (20 mg/kg), or diltiazem (0.8-1.2 mg/kg) plus the endotoxin (20 mg/kg). Injection of endotoxin alone resulted in signs of endotoxic shock in animals 5 h later. All rats were killed 5 h postinjection, and their livers were excised. Hepatocytes were prepared for the measurement of cytosolic [Ca2+] under basal and hormone-stimulated (1 and 10 microM epinephrine) conditions by means of quin 2 fluorescence technique. Liver slices were labeled with 45Ca, and the radioactivity was washed out to determine cellular exchangeable Ca2+. The apparent basal level of cytosolic Ca2+ in endotoxic rat hepatocytes [525 +/- 92 (SE) nM] was significantly (P less than 0.05) higher than in controls (146 +/- 23). A significant increase in the basal [Ca2+] occurred after stimulation with epinephrine in controls but not in endotoxic rat hepatocytes. In the endotoxic rats receiving diltiazem, basal [Ca2+] was significantly lower than in rats given endotoxin alone, and a significant elevation of cytosolic [Ca2+] with epinephrine also occurred. The cellular exchangeable Ca2+ in endotoxic rats (564 +/- 27 nmol/g) was significantly higher than in controls (427 +/- 23). Diltiazem treatment of endotoxic rats restored the exchangeable Ca2+ level to that found in controls. The endotoxic accumulation of cellular Ca2+ and its restoration toward control levels by diltiazem could be due to catecholamine-mediated Ca2+ influx and its blockade by diltiazem. PMID- 3310667 TI - The dexamethasone suppression test: an overview of its current status in psychiatry. The APA Task Force on Laboratory Tests in Psychiatry. AB - The dexamethasone suppression test (DST) has had unprecedented evaluation among biological tests proposed for clinical use in psychiatry. It is hypothesized to reflect pathophysiologic changes at the CNS level. The sensitivity of the DST (rate of a positive outcome, or nonsuppression of cortisol) in major depression is modest (about 40%-50%) but is higher (about 60%-70%) in very severe, especially psychotic, affective disorders, including major depression with psychotic as well as melancholic features, mania, and schizoaffective disorder. The specificity (true negative outcome) of the DST in normal control subjects is above 90%, but it varies from less than 70% to more than 90% in psychiatric conditions that often need to be separated from major affective disorders. In dementia the specificity is even lower. In addition, a number of medical conditions, including severe weight loss and use of alcohol and certain other drugs (barbiturates, anticonvulsants, and others), can produce false positive results. Positive initial DST status in major depression does not add significantly to the likelihood of antidepressant response, and a negative test is not an indication for withholding antidepressant treatment. Some recent data suggest that DST-positive depressions (cortisol nonsuppression) are less likely than DST-negative cases (cortisol suppression) to respond to a placebo. If this is confirmed, it would increase the real magnitude of the difference in treatment response between DST-positive and DST-negative depressed patients. Failure to convert to normal suppression of cortisol with apparent recovery from depression suggests an increased risk for relapse into depression or suicidal behavior. Although the clinical utility of the DST as currently understood is limited, in certain specific situations its thoughtful use may aid clinical decision making. The association of an abnormal test result with major affective disorders encourages continued research on the DST. PMID- 3310668 TI - Clinical implications of adult developmental theory. AB - Multidisciplinary studies of adulthood have revolutionized thinking about developmental processes during the second half of life. These ideas are just beginning to be integrated with clinical theory and practice. The elaboration of the interface between the rapidly expanding developmental theory of normal adulthood and clinical intervention with older patients is a psychiatric frontier. Illustrating with clinical examples, the authors offer a rationale for using new diagnostic tools, suggest a revision of the theory of transference to include sources beyond childhood, and describe unique transference paradigms in older patients as well as equally phase-specific countertransference responses in their therapists. PMID- 3310669 TI - Morning versus midday phototherapy of seasonal affective disorder. AB - Sixteen depressed patients with seasonal affective disorder participated in a double-blind crossover study comparing the antidepressant effects of 2 hours of early morning and 2 hours of early afternoon therapy with bright light. They responded equally well to both treatments. These results suggest that the antidepressant effects of phototherapy in seasonal affective disorder do not depend on its capacity to extend day length (photoperiod) and are not likely to be due to a shift in the timing of circadian rhythms. These findings have practical implications for the administration of phototherapy in the treatment of seasonal affective disorder. PMID- 3310670 TI - Psychiatric complications of disulfiram treatment. AB - The authors studied psychiatric complications of disulfiram use in 605 alcoholic patients. The subjects were assigned to one of three treatment groups: a 250-mg disulfiram group (N = 202), a 1-mg disulfiram group (N = 204) to control for the fear of the alcohol-disulfiram reaction, and a no-disulfiram group (N = 199) to control for the effect of psychotherapy. No significant differences in the incidence of psychiatric complications were found among the three groups. The authors conclude that if psychiatric complications follow disulfiram use, the incidence must be very low with the doses of disulfiram used presently and in the absence of predisposing factors. PMID- 3310671 TI - Idiopathic cardiomyopathy and panic disorder: clinical association in cardiac transplant candidates. AB - Patients under evaluation for cardiac transplant surgery were seen for routine psychiatric diagnosis and treatment. Of 35 patients with idiopathic cardiomyopathy, 83% (N = 29) had definite or probable panic disorder. Of 25 patients with postinfarction cardiac failure, rheumatic heart disease, or congenital heart disease, only 16% (N = 4) had definite or probable panic disorder. The authors suggest that autonomic mechanisms may underlie the association of cardiomyopathy and panic disorder and that increased cardiac sympathetic tone or circulating catecholamines may cause myocarditis and cardiomyopathy. PMID- 3310672 TI - Antipsychotic effect of buprenorphine in schizophrenia. AB - The antipsychotic potency of the partial opiate agonist buprenorphine was evaluated in 10 neuroleptic-free schizophrenic patients suffering from frequent hallucinations, delusions, and severe formal thought disorders. Buprenorphine had a pronounced antipsychotic effect, which lasted about 4 hours, in patients with schizophreniform disorders (N = 4) and paranoid schizophrenia (N = 3). PMID- 3310673 TI - Fragmentation and reproductive freedom: federally subsidized family planning services, 1960-80. AB - This paper analyzes the evolution of the federal family planning program from 1960 to 1980. Political pressure to offer family planning raised the question how best to organize services. Long-standing providers preferred a categorical approach in order to maintain a diverse political coalition for an historically invisible service. In addition, categorical funding meant financial support for non-traditional providers. A compelling argument was also made for service integration. Given an expanded definition of health and the medicalization of contraceptive technology, the health delivery system presented itself as the appropriate service provider. Neither group prevailed. By 1980, federally supported family planning services were provided in autonomous clinics but also were integrated into existing maternal and child health programs. The debate continues but, under the Reagan Administration, terms and motivations differ from those of the past. PMID- 3310675 TI - Response of Plasmodium falciparum infections to pyrimethamine-sulfadoxine in Thailand. AB - The results of this study in Thailand indicate that the early response of falciparum infections to a single dose of pyrimethamine-sulfadoxine is influenced by the developmental stages of the parasite present at the time of treatment. Parasite clearance is slower when young rings predominate at the time of treatment. This should be taken into account when considering the clinical management of patients and the comparative efficacy of antimalarials in clearing parasites from the peripheral blood. The 36-48 hr delay in schizonticidal action observed after treatment of febrile infections and the associated decline in blood concentrations of pyrimethamine suggest that a single dose may not be the ideal way of administering this drug combination and may encourage the emergence of drug-resistant parasites. PMID- 3310674 TI - Flexor digitorum profundus avulsions with associated distal phalanx fractures. A report of four cases and review of the literature. AB - A review of the current literature reveals that avulsions of the flexor digitorum profundus tendon, with a separate and concomitant intraarticular fracture of the distal phalanx, is an uncommon and easily misdiagnosed injury that has been infrequently described. This report encompasses a review of four patients with such an injury, and includes treatment recommendations for this complex injurious pattern. A classification system for flexor digitorum profundus avulsions is reviewed and it is proposed that the avulsion of the flexor digitorum profundus tendon with concomitant and separate intraarticular fracture of the distal phalanx, be added to the classification as a Type IV injury. PMID- 3310677 TI - Age-specific prevalence of antibody to a synthetic peptide of the circumsporozoite protein of Plasmodium falciparum in children from three villages in Kenya. AB - The presence of antibody to the repeating epitope of the circumsporozoite protein of Plasmodium falciparum was determined in children 1 month to 10 years old from three villages in western Kenya using the synthetic peptide (PNAN)5 in an enzyme linked immunosorbent assay. The percentage of antibody-positive children increased with age and differed in the three villages. The village with the lowest percentage of antibody-positive children had the lowest percentage of infections as determined by detection of blood stage parasites. The villages also differed in the age at which antibody first appeared. In one village, only 12% of the children had antibody by the age of 5; while in the other two villages, 60% and 73% had antibody by 4 years of age. PMID- 3310676 TI - Plasmodium falciparum in Kinshasa, Zaire: in vitro drug susceptibility studies. AB - In June 1986, Plasmodium falciparum parasites were collected from 33 children presenting at the Mama Yemo Hospital in Kinshasa (Zaire) and were successfully tested in vitro by a 48-hr reinvasion test for their susceptibility to various antimalarial drugs. In vitro resistance to chloroquine was found in 82% of the isolates, a marked increase over findings obtained by the same technique 3 years ago in Kinshasa. In vitro chloroquine resistance was not associated with a history of previous drug intake. The inhibitory endpoints for quinine varied from 0.03 to 1 microM, and correlated with the chloroquine endpoints in the corresponding isolates (r = 0.64). Pyrimethamine resistance in vitro was demonstrated in 52% of the isolates tested. PMID- 3310678 TI - A radioimmunoassay for the diagnosis of malaria. AB - A newly developed radioimmunoassay for the diagnosis of malaria has been tested in South Africa. The radioimmunoassay is an antibody binding-inhibition assay, based on a monoclonal antibody (D5) cross-reacting with Plasmodium berghei and P. residual binding activity was tested on antigen-coated microtiter plates. A sample was considered positive if it inhibited binding of the antibodies to an extent exceeding that of the microscopically negative blood samples. Blood was collected on 3 separate occasions from a total of 530 individuals living in a malaria-endemic area and was examined by radioimmunoassay and microscopy. Group 1, consisting of 194 samples, yielded 12 samples positive by microscopy and 10 of these (83%) were also positive by radioimmunoassay. One sample in this group was "positive" in the radioimmunoassay but negative on microscopy (false positive). In the 320 samples of group 2, 13 were positive by microscopy and 6 (46%) by radioimmunoassay. Group 3, which included 16 samples preselected as positive by microscopic examination and 16 controls, was examined after 4 weeks storage at 20 degrees C. Twelve samples (75%) were positive by radioimmunoassay. Tests carried out to determine the effect of blood storage on the activity of the antigen indicated that activity was preserved with little loss over a 3-month period. PMID- 3310679 TI - Use of a DNA hybridization assay for the detection of Plasmodium falciparum in field trials. AB - A DNA probe consisting of 21 base pair repeats obtained from a Tanzanian isolate of Plasmodium falciparum, cloned in pBR322 and labeled with 32P by nick translation was used to detect malaria parasitemia in samples obtained during a malaria survey undertaken in The Gambia. In an initial trial the hybridization assay had a specificity for P. falciparum of 100% and a sensitivity of 68%. False negative results were obtained only on samples with low parasitemia. Assay of red cells collected during an earlier malaria survey which had been stored for 1 year at -20 degrees C gave a higher level of sensitivity (85%), suggesting a beneficial effect from freezing and thawing. This was confirmed by examining in the same assay red cells processed immediately after collection and after 2 weeks of storage at -20 degrees C. Freezing and thawing gave a 21% increase in positivity, and a sensitivity of 100% was achieved with the frozen samples. Quantitation of autoradiographs by visual inspection and by scintillation counting gave a reasonable correlation with parasite counts. The DNA hybridization assay has considerable promise as an epidemiological tool. PMID- 3310681 TI - Development of Plasmodium vivax in Anopheles superpictus under experimental conditions. AB - The susceptibility of Anopheles superpictus for Plasmodium vivax was described quantitatively under laboratory conditions. Of the 697 laboratory females studied in 16 groups, 513 (73.5%) females took a bloodmeal, of which 88.4% developed ookinetes on day 1, 56.1% oocysts between days 3 and 11, and 52.5% sporozoites in the salivary gland on days 15 to 63 post-infection. Sporogony was completed in 10 11 days post-infection. There was no difference in the longevity of uninfected and infected females. Infected females survived an average of 30 days (maximum 63 days). Sporozoites survived up to 50 days in the salivary glands without any observable changes in structure and motility. These data indicate that An. superpictus is an efficient laboratory vector of P. vivax and should not be ignored in future entomological field studies. PMID- 3310680 TI - Adaptation of the Panama II strain of Plasmodium falciparum to Panamanian owl monkeys. AB - The Panama II strain of Plasmodium falciparum, acquired at the second passage level in splenectomized Colombian owl monkeys, was adapted to owl monkeys of Panamanian origin. Patent infections were induced in 22 of 27 unaltered and 20 of 21 splenectomized recipients during 19 serial passages. The infections were significantly more virulent in splenectomized than normal Panamanian owl monkeys, however recrudescences in seven normal monkeys achieved peak parasitemias 48 times greater than in the primary attack. These results describe the first reproducible infections of indigenous falciparum malaria in Panamanian owl monkeys. PMID- 3310682 TI - Plasmodium falciparum: effect of infected erythrocytes on clotting time of plasma. AB - Procoagulant activity of erythrocytes infected with Plasmodium falciparum was determined by measuring the effect of infected erythrocytes on the clotting time of platelet-poor human plasma in the presence of Russell's viper venom. We found that erythrocytes infected with P. falciparum enhanced clotting. In the presence of the infected erythrocytes, clotting times were significantly shortened compared to clotting times in the presence of uninfected erythrocytes. Procoagulant activity of infected erythrocytes, especially at high parasitemia, may be a factor in the pathogenesis of disease in falciparum malaria. PMID- 3310683 TI - Shared polypeptides from various strains of Plasmodium falciparum recognized by Cameroon sera. AB - Sera collected from 176 individuals residing in three malaria-endemic regions of Cameroon, West Africa, were tested against Plasmodium falciparum isolates from different areas of the world by enzyme-linked immunosorbent assay (ELISA), growth inhibition studies, and immunoprecipitation assays. A wide range of parasite proteins with apparent molecular weights of 14 to 250 kilodaltons (Kd) were immunoprecipitated by the sera. Of these, two polypeptides of 41 and 96 Kd could be associated with parasite growth inhibition in vitro. PMID- 3310684 TI - Rapid detection of Leishmania amastigotes in fluid aspirates and biopsies of human tissues. AB - When using a genus-specific monoclonal antibody (83-J3D2) as the primary reagent in an indirect immunofluorescent antibody assay (IFA), intracellular amastigotes of Leishmania were easily identified in 9 of 9 biopsies and in 11 of 12 needle aspirates taken from human lesions. In contrast, only 5 of the biopsies and 4 of the aspirates yielded promastigotes upon culture in vitro. Similarly, all but 2 of the aspirates and one-half of the biopsies were reported as negative for parasites when stained with Wright's and hematoxylin-eosin, respectively. Serum antibody titers, ranging from 1:8 to 1:128, corroborated the results of the amastigote detection assays when histopathology and isolation were negative. These findings support the practicality of using the genus-specific monoclonal IFA in those field situations where it becomes necessary to differentiate leishmaniasis from other skin infections. PMID- 3310685 TI - Cross-reactivity among different Giardia lamblia isolates using immunofluorescent antibody and enzyme immunoassay techniques. AB - Rabbit antisera to 11 Giardia lamblia isolates were reacted with 8 G. lamblia isolates using single antibody ELISA and indirect immunofluorescent antibody techniques (IFA). Using living trophozoite organisms, IFA showed marked surface fluorescence with homologous antisera-organism pairs while heterologous pairs showed reduced or no reactivity. Using formalin-fixed trophozoites, the pattern of fluorescence changed to include diffuse internal fluorescence with both homologous and heterologous pairs. In contrast to the variability in surface fluorescence, similar reactivity was noted for homologous and heterologous antisera-isolate pairs with the ELISA. In addition, a double antibody enzyme immunoassay using rabbit antisera prepared to 2 G. lamblia isolates was performed with 8 different isolates as test antigen. All 8 were equally well detected. These data confirm previous findings that G. lamblia isolates have both different and common antigens. The different antigens appear to be on the surface of the organism while the common antigens appear to be internal or somatic. PMID- 3310686 TI - Three monoclonal antibodies with specific binding activity to the excretory system of Schistosoma mansoni: an immunoelectron microscopic study using the gold labeling technique. AB - This study describes three monoclonal antibodies against the excretory system of Schistosoma mansoni. Immunofluorescence revealed antigens forming part of the excretory system of cercariae, adult worms, and miracidia, which were located on the luminal membranes of flame and first tubule cells by immunoelectron microscopy. These antigens are either structural components of the membranes or they derive from excretory fluid and are absorbed during transport and ultrafiltration. Binding specificity of the monoclonal antibodies was tested by immunoelectrophoresis and competitive immunofluorescence; one or two antigens were recognized by each. Reactivity of the antigens after treatment with 7.5% trichloroacetic acid or Rossman's fixative demonstrates at least partial polysaccharide content. PMID- 3310687 TI - Dirofilaria ursi-like parasites acquired by humans in the northern United States and Canada: report of two cases and brief review. AB - Two cases of subcutaneous dirofilariasis acquired in Ontario and Vermont are reported. The parasites in these and eight cases previously reported from the northern United States and Canada are classified as resembling Dirofilaria ursi, a primarily subcutaneous parasite of bears, or D. subdermata of porcupines, in the same region. A distinguishing morphological feature of the D. ursi-like group is the presence of distinct longitudinal cuticular ridges regularly and widely spaced on the outer surface, and usually evident even when the worms are necrotic. In the 10 known cases, all patients were women, and the usual location of nodules containing the worms was the scalp or a covered part of the upper body where blackflies, the intermediate hosts of D. ursi, normally feed. PMID- 3310688 TI - In vitro cultivation of third stage larvae of Wuchereria bancrofti to the fourth stage. AB - Third stage larvae of Wuchereria bancrofti obtained from laboratory-infected mosquitoes grew and molted to the fourth stage in vitro. The culture medium which supported the best growth and development consisted of a 1:1 mixture (v/v) of two commercially available cell culture media, NCTC 135 and Iscove's modified Dulbecco's medium supplemented with 10% human serum or plasma and an antibacterial/antimycotic mixture. Cultures were incubated at 37 degrees C in an atmosphere of either 5% or 8% CO2 in air. After 35 days of culture, 65% to 100% of the larvae were fourth stage. They were motile and in excellent morphological condition with development of the reproductive system in males and females. This culture system will provide an important tool for biochemical and immunological studies. PMID- 3310689 TI - Experimental leprosy in African green monkeys (Cercopithecus aethiops): a model for polyneuritic leprosy. AB - Three African green monkeys (Cercopithecus aethiops) were inoculated intravenously and intracutaneously with Mycobacterium leprae derived from a naturally infected mangabey monkey. All developed cutaneous lesions at inoculation sites. One developed disseminated cutaneous lesions, while the cutaneous lesions in the other two regressed and eventually disappeared. The animals were examined at necropsy five years after inoculation. All three had active leprosy infection in peripheral nerves with extensive inflammation and fibrosis. The disease histologically resembled borderline-lepromatous leprosy. These findings add a new dimension to animal models of leprosy. PMID- 3310690 TI - In search of the first head and neck surgeon. PMID- 3310691 TI - Mandibular reconstruction using AO plates. AB - The AO plate represents an acceptable reconstructive choice for mandibular defects, with an 86.7 percent success rate demonstrated in this series. Because this method utilizes an alloplast which is precisely and quickly applied, virtually all patients requiring mandibular resection can be considered candidates for reconstruction. Adequate vascularized soft tissue coverage is essential to prevent plate extrusion and fistula formation. This is even more important for radiated patients. The pectoralis major myocutaneous flap provides muscle and skin for large anterior defects. Frequently, lateral defects can be closed primarily without using regional flaps. We suggest bone reconstruction to avoid potential plate fracture and to allow placement of functional dentures. Resections in elderly patients and for palliation will result in ideal cosmetic and functional results with the plate alone. If we exclude the four patients reconstructed with calcium hydroxyapatite and the AO plate, the morbidity rate is quite acceptable. With this group excluded, only four fistulas and eight plate exposures occurred. Only four plate removals were required to achieve wound closure. Evaluation of the titanium plate is in progress. It is hoped that better osseous and soft tissue integration will help to decrease wound complications. A large prospective review of postoperative radiotherapy patients using the new titanium plate has been designed to address this issue. The therapeutic choice between the AO plate and free vascularized bone graft reconstruction remains. The decision process is dependent on the technical skills of the surgeon, the treatment plan, the survival characteristics of the tumor, and the physiologic condition of the patient. PMID- 3310692 TI - Adaptive mechanisms of speech and swallowing after combined jaw and tongue reconstruction in long-term survivors. AB - Twelve patients have been studied for speech and swallowing function after major combined jaw and tongue reconstruction with the microvascular iliac bone and groin skin composite flap. Cinegraphic barium swallows demonstrated that for bolus propulsion, it is important to be able to occlude the palate with the flap. Glottic competence prevents aspiration. Speech studies show that although there is loss of certain speech sounds, approximate sounds are substituted. Speech is intelligible when soft-tissue contact to the palate can be accomplished. The adaptive mechanisms in these patients have been compared with the mechanisms used by a patient with uncorrected congenital aglossia and hypomandibulosis who developed excellent speech and swallowing. The mobility of this patient's mouth and pharynx was similar to that in the reconstructed cancer patients who were able to swallow and speak. This procedure has become our reconstruction method of choice for these major defects. PMID- 3310693 TI - Reconstruction in the head and neck regions with free radial forearm flaps and split-rib bone grafts. AB - Fifty patients with wound defects in the head and neck region underwent reconstruction with the free radial forearm flap. Mandible defects in 17 patients were reconstructed by split-rib bone grafts. Radiotherapy was administered to 44 patients preoperatively. The free flap was successful in 49 patients, and there was one case of partial flap necrosis. The free flap is soft, thin, and movable. The split-rib bone graft was successful in 15 patients, and there was one case of partial graft necrosis and one case of complete necrosis. Postoperative complications were decreased by 50 percent when compared with the complication rate when split ribs were covered by forehead flaps, deltopectoral flaps, or oral mucosa. Finally, the functional and cosmetic results were excellent. PMID- 3310694 TI - [Possibility of detecting cervical gonorrhea before voluntary abortion]. PMID- 3310695 TI - [Flash cefuroxime in the prevention of infection after implanting orthopedic prostheses]. PMID- 3310696 TI - [Peroperative antibioprevention with cefuroxime in cardiovascular surgery]. PMID- 3310697 TI - [Various problems of cesarean section]. PMID- 3310698 TI - [Current approach to the evaluation of postpartum uterine involution]. PMID- 3310699 TI - [Current achievements in echography in obstetrics and gynecology]. PMID- 3310700 TI - [Herpes gestationis]. PMID- 3310701 TI - Scanned projection digital radiography of the chest. A review of five years' experience. PMID- 3310702 TI - Cranial magnetic resonance imaging in multiple sclerosis. PMID- 3310703 TI - Venous thrombosis. Part II. Management. PMID- 3310704 TI - The history of the discovery of radioactive iodine and its relations to the atom bomb. PMID- 3310705 TI - Fever and altered mentation in a 29-year-old homosexual man. PMID- 3310706 TI - Pulmonary embolism. Part I. Incidence, pathophysiology, and diagnosis. PMID- 3310707 TI - The treatment of vascular headaches. PMID- 3310708 TI - Hyperlipoproteinemias and heart disease. A clinician's guide. PMID- 3310709 TI - Issues in the diagnosis and treatment of anorexia nervosa and bulimia. PMID- 3310710 TI - Osteoporosis and calcium: to supplement or not to supplement. PMID- 3310711 TI - Etiology, complications, and treatment of obesity. A clinician's guide. PMID- 3310712 TI - Eating by the book. PMID- 3310713 TI - Clinicopathological findings associated with agenesis of the corpus callosum. AB - Seven hundred five cases of agenesis of the corpus callosum (ACC) are reviewed from the literature (n = 660) and from our own observations (n = 45). The diagnosis was made or confirmed using neuroradiological techniques (n = 519) and necropsy or surgery (n = 231). Association with abnormalities often of chromosomes 8, 11, 13-15 and 18 suggests their involvement in abnormal corpus callosum (CC) morphogenesis. Four syndromes (e.g. Aicardi, acrocallosal, Andermann and Shapiro) are characterized by ACC, while others are only sporadically associated (e.g. fetal alcohol syndrome, Dandy-Walker syndrome, Leigh disease, Arnold-Chiari II syndrome). In non-Aicardi patients, the male-to female ratio was 3:2 and X-linked recessive inheritance is postulated to play a role in some cases. Common abnormalities in acallosal patients included: mental retardation (MR), 73% [corrected]; seizures, 42%; ocular anomalies, 42%; gyral abnormalities, 32%; hydrocephalus, 23%; other central nervous system (CNS) lesions, 29%; costovertebral defects, 24%. Developmental disabilities are not attributable to absence of the CC per se, but due to other CNS malformation or dysfunction, which may be genetic or non-genetic. Future research using recombinant DNA techniques will enable isolation and identification of specific chromosomal defects in those cases with a genetic abnormality. PMID- 3310714 TI - Immunotherapy with Hymenoptera venoms. Position paper of the Working Group on Immunotherapy of the European Academy of Allergy and Clinical Immunology. AB - Immunotherapy with Hymenoptera venoms is widely used throughout the world and is accepted as an effective treatment for most patients with Hymenoptera venom allergy. There are, however, still some unresolved problems with this form of treatment. At present there is no definite test which makes it possible to identify patients at risk - and thus candidates for immunotherapy - unequivocally. On the basis of prospective studies on the natural history of Hymenoptera allergy, venom immunotherapy is indicated in adults with severe systemic anaphylaxis. It is usually not necessary in patients with large local reactions only. Children with mild systemic reactions, e.g. urticaria, will need immunotherapy only in case of repeated reactions and/or a high risk of re exposure. The selection of venoms for immunotherapy may lead to some confusion owing to common antigenic determinants shared by venoms of various Hymenoptera species. Many different regimens for immunotherapy have been proposed. At present, the three main are: rush, stepwise or clustered and classical. The maintenance dose of 100 micrograms usually protects from life-threatening reactions. However, in some patients 200 micrograms are necessary for complete protection. The usual interval between maintenance injections is 4 to 6 weeks. In many patients a strong increase of venom specific serum IgG-antibodies usually parallels clinical protection induced by venom immunotherapy, although many exceptions have been reported. Allergic side effects of venom immunotherapy are not rare, especially with honey bee venom and during the initial phase of dose increase. The question of the duration of venom immunotherapy is handled differently: although some authors recommend treatment for life, most suggest treating patients until skin tests and RAST become negative. PMID- 3310715 TI - Endogenous antibodies to bovine lactoperoxidase in children and adolescents. AB - Sera from 146 children and adolescents (70 girls and 76 boys, median age 6 years; range 8 months - 18 years) were analysed for the presence of antibodies to bovine lactoperoxidase (LPO) using a solid-phase immunosorbent radioassay. LPO antibodies were present in all but one serum. The antibody titres varied from 1/5 to greater than 1/5000 (final dilutions). Most of the individuals had antibody titres between 1/50 to 1/5000. Because of the frequent occurrence of LPO antibodies in human beings, the presence of LPO antibodies in the serum must be regarded as a physiological phenomenon. PMID- 3310716 TI - Isolation and purification of a major allergen from Parietaria officinalis pollen. AB - A major allergen of Parietaria officinalis, a species responsible for a large number of respiratory allergies in Mediterranean areas, has been identified and characterized. This allergen (Pol) was found in the fraction which precipitates between 70 and 100% ammonium sulphate saturation. Pol showed a molecular weight of 15,000 daltons as determined by SDS-PAGE and HPLC. The pI of Pol was in the pH region 4-6, IEF showing four major bands. Two major bands were shown by CIE, CRIE and immunoblotting; major contaminants or aggregates were also revealed by the latter technique and by HPLC. Pol showed an allergic specific activity 2 times higher than the crude extract; moreover it was shown to be a major allergen since it inhibited 29 out of 30 sera from allergic patients sensitive to P. officinalis. PMID- 3310717 TI - High dose grass pollen tablets used for hyposensitization in hay fever patients. A one-year double blind placebo-controlled study. AB - Previous, placebo-controlled clinical trials with oral hyposensitization in grass pollinosis have been disappointing. Since the results possibly could be explained by too low doses of ingested allergens, the present study was initiated to evaluate the effect of high doses of allergens. Forty-two adults with symptoms in the grass pollen season and with grass pollen sensitivity demonstrated by skin prick test and conjunctival provocation test were included. Enterosoluble tablets were administered daily for 1 year. Twenty-two patients, who completed the study, received placebo and 17 mixed grass pollen allergens from rye grass, timothy grass, cultivated rye and velvet grass. Evaluated either by self-assessment or by symptom and medicine score before and after treatment, the group receiving pollens did not improve clinically compared the controls. During the study, conjunctival sensitivity decreased equally in the two groups, and changes in specific IgE, allergen-induced histamine release from blood cells and skin prick test were insignificant and with no difference between groups. Five patients, who received pollen allergens, had episodes of urticaria or angioedema, and a further three patients on the same treatment had slight gastrointestinal side effects. In conclusion, enterosoluble grass pollen allergens in contrast to birch pollens did not have any therapeutic effect, even in doses more than 4,000 times higher than those used for subcutaneous hypersensitization. The reason may be degradation of allergens before the immune system is reached. PMID- 3310718 TI - Leucocyte migration inhibition in diphtheria toxoid hypersensitivity. AB - A donor who was highly reactive to diphtheria toxoid (DT) in delayed hypersensitivity and in lymphocyte transformation showed scant evidence of antigen-induced inhibition in the direct leucocyte migration agarose test. Other donors, weak or negative to DT in skin test and transformation, did show evidence of inhibition. Although the migration test is useful in assessing cellular reactivity to tubercular antigen, these results question its suitability for DT. PMID- 3310719 TI - Grave anaphylactic-like reaction in the course of menstruation. A case report. AB - The case of a woman with a serious anaphylactic pattern during menstruation is described. The patient had a clinical picture of urticaria, angioedema and shock at each menstruation for a period of 2 years until hysterectomy was performed. The studies showed no hormonal or immunological change. The only relevant finding was the extraordinarily strong vasodilating action of the menstrual fluid in the patient, and not in the controls. The results of the study suggest the possibility of two mechanisms: 1) an IgE-mediated mechanism causing hypersensitivity to some metabolic substance in the menstrual fluid and 2) an excessive pharmacological vasodilatory action produced by the prostacyclin in the fluid itself. PMID- 3310720 TI - Comparison of conventional intermittent positive pressure ventilation with high frequency jet ventilation. Studies following aortocoronary bypass graft surgery. AB - This study was designed to compare the cardiorespiratory effects of high frequency jet ventilation at 150 breaths/minute with and without added positive and expiratory pressure, with conventional intermittent positive pressure ventilation in 20 patients following aortocoronary bypass graft surgery. On comparison with intermittent positive pressure ventilation, there was a decrease in peak airway pressure during high frequency jet ventilation when positive and expiratory pressure of 0 or 0.5 kPa was applied, but not with 1 kPa, and an increase in mean airway pressure with positive end expiratory pressures of 0.5 and 1 kPa. On changing from intermittent positive pressure to high frequency jet ventilation with no added end expiratory pressure, there was an acute decrease in arterial oxygen tension and increases in cardiac output and total tissue oxygen delivery. On changing from intermittent positive pressure ventilation to high frequency jet ventilation with 1 kPa of positive end expiratory pressure, there was an acute decrease in arterial oxygen tension, cardiac output and oxygen delivery, and increases in pulmonary arterial, right atrial and pulmonary capillary wedge pressures. The addition of positive end expiratory pressure did not prevent the acute decrease in arterial oxygen tension which occurred on transfer to high frequency jet ventilation. PMID- 3310721 TI - Bradycardia during intra-abdominal surgery. Modification by pre-operative anticholinergic agents. AB - The aim of the present study was to examine, in a double-blind, randomised manner, the effects of glycopyrronium 0.005 mg/kg, atropine 0.01 mg/kg or a placebo (normal saline) on the frequency of bradycardia in 92 patients scheduled for major abdominal or gynaecological surgery. All patients received fentanyl, halothane and vecuronium. The frequency of bradycardia in the group that received saline was 18%. No cases occurred in either anticholinergic group. Mean heart rates intra-operatively were not significantly different between the atropine and glycopyrronium groups. It is suggested that the routine use of pre-operative anticholinergic agents should be considered when a similar anaesthetic technique is employed. PMID- 3310722 TI - Controlled release morphine tablets: a double-blind trial in patients with advanced cancer. AB - Eighteen of 27 patients with pain due to advanced cancer, completed a randomised crossover comparison of 4-hourly aqueous morphine sulphate and twice daily controlled release morphine tablets. There was no difference between the two regimens in analgesic efficacy or adverse effects, but there was an apparent improvement in quality of sleep on the controlled release tablets. After completion of the study, 17 patients continued with the latter medication for periods that ranged from 2 days to 94 weeks (median 6.5 weeks). Controlled release morphine tablets given twice daily provide a simpler and more convenient treatment regimen than a 4-hourly opioid for patients with cancer pain, once they have been stabilised. PMID- 3310723 TI - [Is halothane obsolete? An illustration of measurement with two standards]. AB - In 1986 the discussion on the further use of halothane broke out anew, especially after the Bristol symposium and the European Congress of Anesthesiology in Vienna. Everywhere there is great uncertainty on whether or not halothane should continue to be used. A critical analysis of the literature shows that there are two standards applied to halothane. When judged by the same stringent criteria as halothane other anesthetic techniques are also dubious, e.g. neuroleptanesthesia or epidural block. Finally, experience with isoflurane, the strongest rival of halothane, is not adequate to warrant abandoning halothane, especially as long as the question of coronary steal is still open. At present there is no solid scientific basis for vanishing halothane. PMID- 3310724 TI - [Pathophysiologic principles, emergency medical aspects and anesthesiologic measures in severe brain trauma]. AB - In 60%-90% of cases head injury is a part of multisystem trauma and of very decisive importance for the post-traumatic prognosis. Hypoxia, hypercarbia, and hypotension increase the primary lesion and cause secondary brain damage. Therefore, emergency measures must be directed to the essentials of sustaining vital functions, i.e. intubation/ventilation/oxygenation and stabilization of the circulatory system. All trauma-specific measures should avoid additional increases in intracranial pressure or should decrease it if already elevated. Moderate hyperventilation not only causes cerebral vasoconstriction with a concomitant decrease in intracranial blood volume and intracranial pressure, but also partly restores the disturbed cerebral autoregulation, and is therefore an important part of the emergency care and anesthetic procedure in patients with severe head injuries. It is supplemented by analgesia and sedation to prevent intracranial pressure increases due to painful external stimuli. Elevation of the head and upper part of the body by 30 degrees causes a decrease in intracranial pressure by decreasing intracranial blood volume due to improved venous return from the brain; however, this measure is to be applied only in stable circulatory conditions. The head should be put in mid-position avoiding sideways rotation, flexion, and hyperextension. Osmotically active agents are only indicated in emergency situations when there are signs of clinical deterioration. High-dose barbiturate therapy is reserved as a "last resort", under intensive care conditions, for controlling an otherwise intractable intracranial pressure rise. Calcium antagonists have no indication in this context. Anesthesia in patients with severe head injury must involve only those techniques that do not further increase an already elevated intracranial pressure. As inhalational anesthetics, including nitrous oxide, elevate the intracranial pressure to varying extents due to cerebral vasodilation with a concomitant rise in intracranial blood volume, these substances have to be avoided whenever raised intracranial pressure cannot be excluded. Narcotics, benzodiazepines, small dosages of barbiturates, and long lasting muscle relaxants can be regarded as useful. PMID- 3310726 TI - [Anesthesia systems]. AB - A clear understanding of technical details is essential for safe handling of anesthetic machines. Following the ideas of E.A. Ernst, it is suggested that anesthesia systems be differentiated according to the underlying principles of construction into rebreathing systems, flow- and valve-controlled non-rebreathing systems, and systems without reservoirs. This classification seems much clearer than the usual differentiation into closed, semiclosed, semiopen, and open systems, which is based upon functional criteria. Anesthesia systems must be understood as technical parts (hardware) of anesthetic machines with variable function according to the chosen fresh gas flow (software). An unequivocal characterization of an anesthetic system will only be possible if its technical properties are described together with the fresh gas flow used. Most anesthetic machines currently in use are equipped with a circle system and sophisticated monitoring, which is designed for the rebreathing technique. This technique can only be used advantageously, however, if the rebreathing system is used in conjunction with substantially reduced fresh gas flows. PMID- 3310725 TI - [Nitrous oxide in combination anesthesia. Quantitative aspects of the effect of nitrous oxide]. AB - Minimal Alveolar Concentration (MAC) defines the anesthetic potency of nitrous oxide (N2O) combined with an inhalational anesthetic only for the moment of skin incision. For the complete operation, the proportional action of N2O is unknown. This prospective, randomized study reports the mean intraoperative concentration (MIC) of halothane with and without 70% N2O in combination with premedication, i.v. induction, and muscle relaxation for the duration of operation. METHODS: Forty ASA I-II patients scheduled for hysterectomies gave informed consent. All patients received atropine 0.5 mg, promethazine and pethidine 1 mg/kg i.m. 30-45 min prior to anesthesia, i.v. induction with thiopental, and neuromuscular blockade with alcuronium at the beginning of the operation. Post-induction, patients received randomized halothane in 30% O2/70% N2 (group 1, n = 20) or in 30% O2/70% N2O (group 2, n = 20). In the course of this observation (before induction and up to 15 min after extubation), the following parameters were measured (Table 1): arterial pressure (AP), heart rate (HR), plasma concentrations of growth hormone, prolactin, and cortisol in central venous blood, esophageal temperature, "train-of-four" ratio, and expiratory CO2 concentration. MIC had been computed from the integral of end-expiratory halothane concentration during the course of the operation. RESULTS: Biometric data and concomitant conditions were equivalent within the two groups (Table 2). MIC halothane was 0.72 +/- 0.014 vol% in group 1 (O2/N2) and 0.52 +/- 0.01 vol% in group 2 (O2/N2O).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310727 TI - [Comparative clinical study of nalbuphine and fentanyl. Effects and side effects with special reference to the induction phase]. AB - In a previous study concerning balanced anesthesia we realized that the adrenergic sympathetic reaction caused by intubation could not be suppressed by nalbuphine-HCl (NAL), a new narcotic agonist-antagonist in the same way as by fentanyl (FE). The aim of the study was to investigate whether the observed autonomic reaction could be overcome by: (a) varying the interval between injection of NAL and intubation or (b) increasing the induction-dose of NAL. MATERIALS and METHODS. After receiving institutional approval and the patients' written informed consent, a two-part randomized trial arrangement was made using two groups of 10 surgical patients each. During the first part the induction-dose of NAL was 1.5 mg/kg BW and that of FE was 0.005 mg/kg BW. Midazolam 0.15 mg/kg BW was the induction hypnotic. Orotracheal intubation was performed 15 min after NAL and 10 min after FE injection. During the second part, the NAL dosage was 2.5 mg/kg BW and intubation was carried out 10 min after opiate injection. Induction conditions in the FE group were unchanged. RESULTS. NAL causes adrenergic sympathetic hemodynamic and autonomic reactions immediately after injection (Figs. 1a + b, 2a + b). The rate-pressure product increase during intubation is significantly higher after NAL than after FE administration and cannot be suppressed by increasing the dosage or increasing the injection-intubation interval. In contrast, the postoperative period is characterized by long-lasting analgesia (114 min vs 82 min in the FE group) and sedation, especially after administration of 2.5 mg/kg BW NAL. CONCLUSION. These results may be explained by the agonist-antagonist activity of NAL at the opiate receptor sites. PMID- 3310729 TI - Cover photograph, August 1986. PMID- 3310728 TI - Early experience in the Queensland Orthotopic Liver Transplantation Programme. AB - The cases of the first nine patients to receive orthotopic liver transplants in the Queensland Liver Transplant Programme are reported. Problems peculiar to this type of operation are discussed generally and in the light of this experience. The anaesthetic technique employed is described. There were no deaths attributable to anaesthesia. PMID- 3310730 TI - Transformation of yeast spheroplasts without cell fusion. AB - The efficiency of genetic transformation of Saccharomyces cerevisiae spheroplasts has been increased 10- to 100-fold over previously published procedures. Optimal transformation frequencies for single-stranded and double-stranded replicating plasmids are 2 X 10(7) and 5 X 10(6) transformants/microgram, respectively. At saturating DNA concentrations, 12 and 3%, respectively, of the viable spheroplasts contain plasmid DNA. The percentage of transformants that have undergone nuclear fusion varies from 0.1 to 3%, indicating that fusion is not required for the uptake of DNA by yeast spheroplasts. PMID- 3310731 TI - Stable isotope dilution thermospray liquid chromatography/mass spectrometry method for determination of sugars and sugar alcohols in humans. PMID- 3310733 TI - [Silver impregnation of neurofibrils in paraffin sections]. AB - A method is described, which is based on an impregnation with a silver nitrate solution (pH = 5,0), and on a physical development. PMID- 3310732 TI - [Functional morphology of the maxillo-mandibular system in the mini-Lewe minipig. Structures of masticatory muscles in juvenile animals]. AB - The postnatal changes in the structures of the masticatory muscles are explained on the basis of the Sehnenspiegel. The jaw musculature of juvenile miniature pigs is similar in structure to that of adult animals. All Sehnenspiegel can be found in animals that are only 3 d old. Postnatal development of the masticatory musculature takes place on the basis of the pinnation existing prior to birth and consists in secondary pinnation. PMID- 3310734 TI - The "in situ" immune response in lymph nodes: a review. AB - For many years data on the development of specific antibody-forming cells in lymph nodes were incomplete, fragmentary, and even contradictory. A number of recent studies have been performed, concerning 1) their overall architecture; 2) migration of B-lymphocytes; 3) localization of accessory cells and T-lymphocytes which are believed to be involved in humoral immune responses; and 4) localization patterns of specific antibody-forming cells developing during thymus dependent and thymus independent immune responses. Comparison of these new results with those of earlier studies suggests a single route of migration followed by all cells which will differentiate into antibody-forming cells. During their differentiation into antibody-forming plasma cells, antigen reactive B-cells migrate along the required accessory cells and/or T-lymphocytes. PMID- 3310736 TI - The first reported oral intubation of the human trachea. PMID- 3310735 TI - The equatorial fibronectin band (EFB) on human spermatozoa--a diagnostic help for male fertility? AB - Spermatozoa were prepared by swim up technique in the same way as for in vitro fertilization of human eggs and incubated with antihuman fibronectin antibodies in the immunofluorescence technique. Fibronectin mediates adhesive interactions between cells. 69 p.c. of spermatozoa with a normal shape and only 17 p.c. of them exhibiting a pathological shape showed a positive fibronectin-fluorescent band on the equatorial segment, called equatorial fibronectin band (EFB). The cryopreservation of semen did not influence the EFB. The significance of EFB for the sperm-oocyte-binding is discussed in connection with the sperm morphology and epididymal function. PMID- 3310737 TI - Ketamine anesthesia in dogs undergoing liver transplantation. PMID- 3310738 TI - ASA Award: B. Raymond Fink. PMID- 3310739 TI - First pass uptake of fentanyl, meperidine, and morphine in the human lung. AB - The first pass uptake of fentanyl, meperidine, and morphine in human lung was studied in patients using a double indicator dilution technique. A bolus containing one of the drugs and indocyanine green dye (ICG) was rapidly injected into the central venous catheter of patients prior to anesthesia for surgery. Sequential arterial blood samples were collected at 1-s intervals for 45 s after injection. The total amount of drug taken up by the lung during the first pass and the instantaneous extraction of drug at each time point during the first pass were calculated from the differences in the arterial blood concentration versus time curves of the nondiffusible indicator (ICG) and the drug. The total uptake (mean +/- SE) during the first pass through the human lung for fentanyl and meperidine was 75.2 +/- 3.2% and 64.7 +/- 7.8% of the injected dose, respectively. The pulmonary uptake of morphine was very small, with 96.5 +/- 7.1% of the injected dose recovered in arterial blood after the first pass through the lung. The arterial blood concentration of drug and dye versus time showed a slight delay of the fentanyl and meperidine peaks compared to ICG. It was also observed that greater than 90% of these drugs were extracted from the blood in the early part of the first pass, but the extraction decreased with time during the first pass through the lung. These findings indicate that some of the drug taken up by the lung can diffuse back out into the blood.2+off PMID- 3310740 TI - Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. AB - Systolic pressure variation (SPV) is defined as the difference between the maximum and minimum values of systolic blood pressure following a single positive pressure breath. An increase in the SPV is known to occur clinically during hypovolemia. This study aims to quantify SPV during graded hemorrhage in ventilated dogs, and to compare its reliability relative to other hemodynamic indicators of hypovolemia. Ten anesthetized dogs were mechanically ventilated with a fixed tidal volume. A continuously inflated vest was applied around the chest to maintain the ratio of lung to chest wall compliance similar to that of humans (0.83 +/- 0.12). SPV was further divided into delta up and delta down components relative to apneic (5 s) systolic blood pressure. Dogs were bled 5, 10, 20, and 30% of their estimated blood volume. The measured parameters best correlated to the amount of bleeding were SPV (rs = 0.993), delta down (rs = 0.981), and cardiac output (rs = 0.976). The SPV and its delta down component correlated to the degree of hemorrhage as well as the CO and the pulmonary capillary wedge pressure, and significantly better than the central venous pressure and the mean systemic blood pressure. Thus, SPV and its delta down component are accurate indicators of hypovolemia in ventilated dogs subjected to hemorrhage. PMID- 3310741 TI - Unexpected migration of an esophageal foreign body. PMID- 3310742 TI - Cholesterol crystal embolization: a review of 221 cases in the English literature. AB - Cholesterol crystal embolization (CCE) frequently presents with nonspecific manifestations that mimic other systemic diseases. The authors reviewed 221 cases of histologically proven CCE in the English literature to define the clinical, laboratory, and pathologic characteristics of this disorder. CCE affected predominantly elderly males (mean age sixty-six) with a frequent history of hypertension (61%), atherosclerotic cardiovascular disease (44%), renal failure (34%), and aortic aneurysms (25%) at presentation. At least one possible predisposing factor was present in 31% and included operative and radiological vascular procedures and the use of anticoagulants. Cutaneous findings (34%) and renal failure (50%) were two of the most common clinical findings throughout the course of CCE. The nonspecific signs and symptoms included: fever (7%), weight loss (7%), myalgias (4%), and headache (3%). Premortem diagnoses were established in 31% of patients most commonly by biopsy of the muscle, skin, and kidney. Mortality was high (81%) and was most commonly due to multifactorial, cardiac, and renal etiologies. The authors conclude that CCE should be strongly considered in elderly patients with atherosclerotic vascular disease who have the onset of renal insufficiency and cutaneous manifestations. CCE may be confirmed by a skin or muscle biopsy. PMID- 3310743 TI - Deep venous thrombosis of the upper extremity--a case report. AB - This report describes a case of deep venous thrombosis (DVT) of the upper extremity following a routine blood donation by a regular donor. This cause of an upper limb DVT has not been previously reported. A review of the literature follows. PMID- 3310744 TI - Effects of pentoxifylline on severe intermittent claudication. AB - Pentoxifylline has been shown to improve treadmill walking distances under blinded, controlled conditions in patients with intermittent claudication. From the pooled data of a blinded, controlled, randomized, multicenter trial, the data from all enrolled patients with severe claudication (less than 70 m on treadmill at baseline) were evaluated. The treadmill data from these more severely ill patients were analyzed separately as a "severe subset" (placebo n = 17; pentoxifylline n = 21). No differences between the two treatment groups were observed in demography, history, or baseline treadmill walking distances. The initial claudication distance (ICD) improved 68% over baseline with pentoxifylline and 12% with placebo (p = .012) after twenty-four weeks of treatment. A new, derived efficacy variable was developed, "minimum distance walked," which tended to minimize psychological effects on treadmill performance. Over sixteen to twenty-four weeks of treatment, the pentoxifylline group improved 49% over baseline and the placebo group 3% (p = .019), when the "minimum distance walked" measurement was used. In this controlled trial the subset of patients with severe intermittent claudication benefited from pentoxifylline therapy. PMID- 3310745 TI - Changes in systemic and pulmonary vascular reactivity in hypertension following nifedipine and verapamil. AB - Excessive vascular tone and overresponsiveness to adrenergic stimuli characterize the hemodynamics of the greater and the lesser circulation in hypertension. We tested whether calcium entry blockade with verapamil (11 cases) or nifedipine (11 cases) may improve the vascular regulation in high blood pressure. Mental arithmetic and cold were used as adrenergic activators. The former stimulus produced obvious elevation of epinephrine plasma concentration, increase of cardiac output (CO), slight systemic vasodilatation, pulmonary vasoconstriction, and rise of blood pressure in both circuits. After calcium antagonists, the epinephrine reaction to the arithmetic test was significantly attenuated, variations in CO and systemic blood pressure were unchanged, pulmonary vasoconstriction was abolished, and the pressure rise in the lesser circuit was halved. The cold pressor test increased norepinephrine plasma concentration (NE pc), systemic and pulmonary blood pressure, and vascular resistance and did not alter CO. The attained NE pc during cold was unvaried after verapamil and significantly enhanced after nifedipine; pressure and resistance responses of the two circuits were almost unchanged after the former, whereas systemic and pulmonary vascular resistance rises were importantly attenuated after the latter compound, resulting in much lower pressure reactivity. A modulation of the sympathoadrenal reaction, per se, can explain changes in the systemic and in the pulmonary vasomotion with calcium blockade during arithmetic. It would seem that after verapamil the sympathetic system was still activated during cold to such an extent as to maintain the same vasoconstrictor potency. NE pc suggests that the sympathetic discharge was not reduced by nifedipine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310746 TI - Systemic noninflammatory vasculopathy with prominent CNS involvement--a case report. AB - This is a case report of a thirty-seven-year-old man with systemic noninflammatory vasculopathy who developed a slowly progressive dementia with multiple sites of stroke. Cerebral angiography revealed abnormal terminal vasculature with beading and occlusions. Brain biopsy confirmed a noninflammatory vascular pathology. We have also reviewed the world literature relevant to this clinicopathologic entity and have discussed its relationship to thromboangiitis obliterans cerebri. PMID- 3310747 TI - Rapid palatal expansion in adults with and without surgery. AB - A cemented palatal expansion appliance with a bite plane is used successfully in adults up to 43 years of age, augmented with lateral maxillary osteotomy in the older ages range. PMID- 3310749 TI - Grading severity and treatment requirements to control symptoms in asthmatic children and their relationship with airway hyperreactivity to methacholine. AB - Airway hyperreactivity has been proposed to be an important determinant of severity of asthma and medication needs to control symptoms in adults. In this study we tried to determine if this relationship existed in childhood asthma. One hundred and forty-five asthmatic children aged 6 to 19 years with a positive methacholine (MCH) challenge test and a baseline forced expiratory volume in one second (FEV1) of 56% to 118% predicted were studied. The MCH concentration required to decrease the FEV1 from baseline by 20% (PC20) ranged from 0.1 to 20 mg/mL (geometric mean = 1.85 mg/mL). Asthma symptoms in this population before the study ranged from 2 months to 14 years. They were followed for a mean of 10 months after the MCH challenge and then grouped into four groups according to overall severity of symptoms and treatment needed to control symptoms. The first grade was comprised of patients with intermittent symptoms only, with a respiratory tract infection (URTI), and no medication; grade 2 symptoms were severe enough to require intermittent bronchodilators (BD); grade 3 symptoms were severe enough to require daily BD; and grade 4 symptoms were severe enough to require daily BD and steroids. Geometric means PC20 were significantly different among the four groups when they were analyzed by ANOVA P less than .01. There was, however, marked overlap between the individual levels of PC20 among the four groups. There was no significant difference in mean FEV1, age, sex, or duration of symptoms among the four groups. There was no significant correlation between baseline FEV1 and the degree of airway hyperreactivity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310748 TI - Selected aspects of acute and chronic infectious mononucleosis and mononucleosis like illnesses for the practicing allergist. AB - The diagnosis of EBV-IM or a heterophil-negative mononucleosis-like syndrome is best approached by combining morphologic and serologic data. The minimal hematologic criteria should always be searched for before accepting a case as IM or an IM-like illness. If minimal morphologic data are not rigidly adhered to, the number of heterophil-negative cases included under the umbrella of IM or an IM-like illness will swell and include a variety of other illnesses where early diagnosis may be important for treatment purposes. When EBV studies are indicated, the entire profile (VCA-IgM, VCA-IgG, and anti-EBNA) should be performed. Anti-VCA-IgG titers alone, for example, are of very limited usefulness unless they are negative (less than 1:10), in which case the diagnosis of EBV-IM is excluded. The main problems connected with the diagnosis of the CMS center about the nonspecificity of both clinical and EBV serologic data. Thus, a significant effort must be made to rule out underlying disease, especially those chronic illnesses with immunosuppressive effects that are capable of reactivating the EBV latency state and producing EBV serology similar to that seen in CMS. Other dilemmas relate to diagnostic cut-off levels for particular EBV-related tests, including antibodies to EA and the relative unavailability of several tests for detection of subtle immunodeficiency or T-cell dysfunction in individual patients with suspected CMS. Future efforts will be directed to the diagnostic usefulness of antibody responses to well-defined recombinant fragments of the EBV genome (ie, anti-EBNA1 vs. -EBNA2 titers). PMID- 3310751 TI - [A computer program for recognition of normal and pathologic blood and bone marrow cells]. AB - A computer program to identify normal and pathological blood and marrow cells is presented. It requires an analysis of cellular morphology according to ten simple criteria. These criteria are treated by the Bayesian method; then the program offers, in decreasing order, the cells which are best classified. The responses are analyzed and discussed. This program seems to be well suitable to a computer assisted teaching (CAT) of cytology. It supplements effectively the traditional methods. PMID- 3310750 TI - Intravenous versus nebulized terbutaline in patients with acute severe asthma; a double-blind randomized study. AB - Twenty-three patients with acute severe asthma were treated in a randomized double-blind way by either intravenous terbutaline two times at an hour interval 6 micrograms/kg or inhaled terbutaline two times 0.1 mg/kg. Peak expiratory flow rate in percent of expected value rose from 89 L/min to 128 L/min (P less than .01) in the intravenous group and from 97 L/min to 122 L/min (P less than .02) in the inhalation group; this was comparable for both groups. PaO2 initially was 7.55 kPa in the intravenous group and rose by 1.4 after 60 minutes (P less than .02) and by 1.33 after 120 minutes (P less than .01). The mean PaO2 did not change in the inhalation group. The pulse rate and blood pressure did not vary significantly in either of the two groups. We conclude that both the intravenous and inhalational administration of terbutaline are effective in acute severe asthma, but that the intravenous route is possibly better for increasing PaO2. PMID- 3310753 TI - In vitro fertilization: past and future. AB - The current clinical status of in vitro fertilization is reviewed including ovarian stimulation, fertilization, implantation after replacement and luteal phase support. The evolution of singleton or multiple pregnancies after IVF is discussed; pregnancy loss can occur after ectopic pregnancy or abortion. Several new scientific advances are described: the cryopreservation of embryos, the studies on the metabolism of embryos by non-invasive methods and the use of fetal tissues to restore abnormal conditions in adults. The current ethical issues of IVF are discussed: freezing of embryos, oocyte and embryo donation, surrogate motherhood as well as the rights of an early embryo and the ethics of embryo research. PMID- 3310752 TI - [Macroenzymes in human plasma. 1: Macroamylase, macrocreatine kinase, macrolactate dehydrogenase]. AB - The authors propose here a general review of the main macroenzymes described until now. In this first part, informations will be given about the high molecular forms of alpha amylase, creatine kinase (CK) and lactate dehydrogenase (LDH) found in human plasma. Except macro CK type 2 which can be related to the mitochondrial CK, these macroenzymes are the result of the formation of enzyme immunoglobulin complexes; their specific immune character has been demonstrated in some cases. The formation of such immune complexes between the enzyme protein and plasma immunoglobulins seems a rather common phenomenon although neither the mechanism involved nor the physiopathological significance are known since they have been observed in patients and healthy individuals. Nevertheless, it is important to recognize these macromolecular forms because of the diagnostic uncertainties they may induce during isoenzyme studies and even total enzyme activity measurement. PMID- 3310754 TI - Somatic investigation of the infertile man. AB - The investigation of the male partner of an infertile couple is described. The medical history should include diseases, operations, traumata of the intrascrotal organs, exposure to X-rays, the use of drugs and any viral infection. The second part of the investigation is the physical examination. This should include: the accurate assessment of the body configuration, a varicocele examination, palpation of testis, epididymis and vas deferens, and rectal palpation of the prostate. PMID- 3310755 TI - Sperm analysis. AB - Human semen analysis is the first biological step of male fertility assessment. Its performance requires the use of standardized and objective procedures. The results of the tests may allow to conclude to a man's sterility when they reveal e.g. an azoospermia or an alteration of sperm morphology or motility incompatible with fertilization. More often however, it is difficult to precisely determine the relationships between the observed sperm anomalies and infertility. In a follow-up study of 520 infertile men over 3 years, the pregnancy rate was found to be significantly lower only in the cases where sperm concentration values were less than 5.10(6)/ml and unchanged for concentrations above this value. No threshold values were found for sperm motility and morphology, although the chances of conception were closely related to these two parameters for sperm concentration values above 5.10(6)/ml. Various tests have been described to evaluate the human sperm ability to migrate through the female genital tract and fertilize the oocyte. These tests and the human in vitro fertilization assay allow a better understanding of the structural and dynamical parameters mostly involved in sperm function. PMID- 3310756 TI - Immunological aspects of male infertility. AB - Some immunological aspects of male infertility are discussed, including the mechanism of induction of auto-antibodies to sperm-specific antigens. Tests to determine antispermatozoal antibodies in serum are discussed. Since there is no direct relation with infertility, more attention is focused on the presence of antispermatozoal antibodies in semen. These antibodies affect male fertility by reducing the capacity of the spermatozoa to penetrate cervical mucus. This penetration inhibition is caused by autoagglutination of the spermatozoa in the ejaculate and by the shaking phenomenon. The sperm-cervical mucus contact test, based on the shaking phenomenon is described. The use of the Mixed Antiglobulin Reaction tests, to detect IgG and IgA antibodies on spermatozoa is discussed. Finally, the effect of antispermatozoal antibodies on the fertilization process is reviewed. PMID- 3310757 TI - Role of ultrasound in infertility. AB - The use of ultrasound technology and its further prospects in an infertility clinic are described. First, the ultrasonic ovarian scanning during the follicular phase of stimulated cycles is discussed. With this technique the number and size of the follicles, and the thickness of the endometrium can be estimated. Second, three different routes for ultrasound guided follicle puncture are described, namely the transvesical, the transvaginal and the perurethral puncture. Finally, the ultrasound guided embryo transfer procedure is explained. PMID- 3310758 TI - Problems related to the laboratory part of treatment by in vitro fertilization and embryo transfer. AB - The successive stages leading to fertilization in mammals are reviewed in this article. Methods of human sperm preparation for IVF are described and the "ideal" delay between oocyte pick-up and insemination time is discussed, as well as methods to reduce the incidence of polyspermy. Different culture media and their supplementation are mentioned, as well as a semi-quantitative embryonic scoring system, defined by the IVF team of the Saint-Pierre Hospital in Brussels. Finally the optimal transfer time, and the handling of embryos at replacement are discussed. PMID- 3310759 TI - Geometric left-ventricular responses to interactions between the lung and left ventricle: positive pressure breathing. PMID- 3310760 TI - Left ventricular external constraint: relationship between pericardial, pleural and esophageal pressures during positive end-expiratory pressure and volume loading in dogs. AB - Left ventricular (LV) diastolic filling is limited by the constraining effects exerted by the pericardium (PE) and the lung/chest wall. The aim of the present study was to assess the validity of various estimates of external cardiac constraint, compared to pericardial surface pressure (Ppe) measured lateral to the LV myocardium. In nine anesthetized dogs we measured Ppe, pleural surface pressure (Ppt) (lateral to the pericardium) and esophageal pressure (Pes) under conditions of volume loading and positive end-expiratory pressure (PEEP). We measured Ppe and Ppl with flat, liquid-containing silastic rubber balloons and Pes with an air-containing cylindrical balloon. After instrumentation, the chest was resealed and continuous suction (-5 mm Hg, 1 mm Hg = 0.133 kPa) was maintained. Volume loading with incremental intravenous infusions of saline was used to increase LV end-diastolic pressure to 20-25 mm Hg. PEEP of 0, 10 and 20 mm Hg were applied at baseline and after each increment of volume loading. At low volume, increases in PEEP caused simultaneous increases in LV end-diastolic pressure (P less than 0.01) and in Ppe (P less than 0.0001) but a reduction in transmural LV pressure (P less than 0.0005). Ppl and Pes both increased with PEEP (P less than 0.001 and P less than 0.01, respectively). However, Ppe always exceeded Ppl, while Pes remained at only approximately 1/3 Ppl throughout. Volume loading caused a significant increase in Ppe (P less than 0.0001) and a smaller, but significant increase in Ppl (P less than 0.05). Pes remained unchanged during volume loading. Thus external cardiac constraint increased markedly during volume loading and PEEP as evidenced by a marked elevation of Ppe. Both Ppl and Pes markedly underestimated this increase. Therefore, calculation of transmural LV pressure by subtracting pleural or esophageal pressure from intracavitary pressure can lead to overestimation of LV preload. The decrease in cardiac output during PEEP occurs secondary to decreased preload, i.e. decreased transmural pressure and end-diastolic dimension. Analysis of performance using cardiac function curves does not suggest a change in contractility with PEEP. PMID- 3310761 TI - Model studies of the effects of the thoracic pressure on the circulation. AB - Two models of the cardiovascular system subjected to changes in intrathoracic pressure (ITP) are used to simulate the response to normal and positive pressure ventilation and the Mueller maneuver. The first model, based on our earlier model for cardiopulmonary resuscitation and cardiac assist by ITP variations, is based on lumped parameter representation of the cardiovascular system with two ventricles which function based on the time-varying elastance concept using their transmural pressures as the load. The ITP is assumed to be equally distributed in the thoracic cavity and equally affecting all cardiovascular structures within the chest. The model shows that a decrease in ITP is associated with an initial decrease in aortic pressure and flow and an increase in left ventricular end diastolic and end-systolic volumes. A transient decrease in left ventricular volume which was suggested to occur by a few studies cannot be predicted based on this model. Such a decrease in left ventricular volume can be only predicted when a pericardial constraint is included, as done in the second model. Positive pressure interventions are associated with decreased heart volumes and cardiac output which is primarily a "preload" effect. In general the model reasonably predicts the hemodynamics as a function of the ITP changes and may be used as a tool to investigate the response of the cardiovascular system to various ITP interventions. PMID- 3310762 TI - Popliteal cyst rupture and the pseudothrombophlebitis syndrome. AB - Fifteen patients presented during a four-year period with a pseudothrombophlebitis syndrome, subsequently confirmed arthrographically as being due to popliteal cyst rupture. Initially the majority of patients (73%) were erroneously diagnosed as having calf vein thrombosis, and were anticoagulated for periods of three to ten days. Clinical differentiation from venous thrombosis was usually impossible. Contrast arthrography was the definitive diagnostic investigation, revealing popliteal cysts in all patients, and an active synovial leak into the calf in 13 cases (87%). The mean delay in performing arthrography was 5.3 days, the procedure usually being performed after normal contrast venography. Doppler and isotope venography yielded misleading or equivocal results (42%) delaying diagnosis, and prolonging periods of potentially dangerous anticoagulation. We suggest that the marked overlap in the emergency presentation of popliteal cyst rupture and calf vein thrombosis mandates the aggressive use of arthrography combined with venography in all patients presenting with a painful swollen leg. PMID- 3310763 TI - Magnesium levels in cardiac arrest victims: relationship between magnesium levels and successful resuscitation. AB - Multivariate analysis was performed to evaluate significant differences between electrolytes, serum magnesium, and successful resuscitation in cardiac arrest victims in a prospective controlled study. Twenty-two cardiac arrest victims having ventricular fibrillation or tachycardia, electromechanical dissociation, or asystole were compared with 19 matched controls with no ventricular arrhythmias. Of the control group, one was hypermagnesemic (5%), 17 normomagnesemic (90%), and one hypomagnesemic (5%). In the arrest group, eight were hypermagnesemic (36%), nine normomagnesemic (41%), and five hypomagnesemic (23%). Thirteen of 22 cardiac arrest victims (59%) had an abnormal serum magnesium level. All hypermagnesemic and hypomagnesemic patients expired (100%). In the normomagnesemic group, four out of nine (44%) were successfully resuscitated. A positive correlation was identified between normomagnesemia and successful resuscitation (P less than .01). There was no correlation between other electrolytes and successful resuscitation (P greater than .05). PMID- 3310764 TI - Malignant hyperthermia. AB - Malignant hyperthermia is a hereditary trait characterized by hypercatabolic reactions induced by anesthetic drugs, or physical or emotional stress. Patients must be treated quickly and efficiently in order to prevent irreversible organ damage and death. PMID- 3310765 TI - Access to emergency medical care: emergency physicians and uncompensated care. American College of Emergency Physicians. PMID- 3310766 TI - Immunoperoxidase evaluation of pneumonic lesions induced by Pasteurella haemolytica in calves. AB - Calves inoculated with Pasteurella haemolytica serovar 1 developed lesions of coagulation necrosis in the lungs that were sharply demarcated by leukocytes. The P haemolytica antigen was detected in the area of coagulation necrosis in histologic sections, using an immunoperoxidase technique. In the central area of the necrotic tissue, the bacterial antigen was diffusely presented in the necrotic alveolar wall, fibrin, serous exudate, and degenerated leukocyte. The bacterial antigen also was found in some groups of degenerating leukocytes around the necrotic tissue. The bacterial colonies among these leukocytes had strong specific reactions against P haemolytica. The bacterial antigen was observed in the cytoplasm of macrophages in alveoli around the necrotic lesion. These findings confirmed that coagulation necrosis is an important lesion in calves with pneumonia caused by P haemolytica. PMID- 3310768 TI - Polymicrobial bacteremic pneumonia: report of three cases caused by Staphylococcus aureus and Streptococcus pneumoniae. AB - Three patients are reported with simultaneous bacteremia caused by Staphylococcus aureus and Streptococcus pneumoniae complicating community-acquired pneumonia. Polymicrobial bacteremia caused by pyogenic organisms has rarely been reported. Two of the patients had severe underlying hepatic disease, and the third had suffered a recent myocardial infarction. The infection ultimately proved fatal in each patient. The pathophysiologic aspects and clinical consequences of polymicrobial bacteremia arising from respiratory as well as from other sources is briefly reviewed. PMID- 3310767 TI - Ultrastructure of equine endothelial cells exposed to endotoxin and flunixin meglumine and equine neutrophils. AB - An in vitro system of cultured equine endothelial cells was evaluated as a model for endotoxin (ET) exposure in the horse. Primary cell lines from pulmonary vessels and aortas were cultured from tissues of 6 horses. Effects of ET alone with and without serum and in combination with the cyclo-oxygenase inhibitor flunixin meglumine and isolated equine neutrophils were evaluated by transmission electron microscopy. Cells plus serum were incubated with 10, 25, 50, or 100 micrograms of ET/ml of incubation medium for 1, 3, 8, or 24 hours. Cells without serum were cultured for 1 and 3 hours. Flunixin meglumine was used at a concentration of 20 micrograms/ml. Cells also were incubated in the presence of 1,000, 5,000, or 20,000 neutrophils/ml plus ET and in the presence of a combination of ET and flunixin meglumine for 1 or 3 hours. Endotoxin alone did not cause cell damage, and the only evidence of an effect was an increased number of secondary lysosomes at incubation hour 8. At incubation hour 24, cells appeared normal. Endotoxin plus neutrophils caused cells to become round and detach from the growth substrate. Cell pathologic changes included swollen and distorted mitochondria and cytoplasmic vacuolization. Response to the ET plus neutrophil combination was variable and ranged from 5% to 50% of the cells being affected. The variability appeared to have some correlation with cell age, as well as individual preparation of neutrophils. PMID- 3310769 TI - NHLBI workshop summary. Effects of tobacco smoke components on cellular and biochemical processes in the lung. PMID- 3310770 TI - Short-course chemotherapy of pulmonary tuberculosis in pneumoconiotic patients. AB - This is the first prospective clinical trial recorded to date of short-course chemotherapy in pulmonary tuberculosis complicated by pneumoconiosis. Forty-eight anthrasillicotic and 11 silicotic patients with previously untreated pulmonary tuberculosis completed 9-month, short-course chemotherapy regimens: 2 months of daily streptomycin, isoniazid, rifampicin, and pyrazinamide followed by daily isoniazid and rifampicin for 7 months (2SHRZ/7HR). There were 3 treatment failures (5%). The remaining 56 patients (95%) all had their sputum converted within 4 months (mean, 1.5 months). Bacteriologic relapses were noted in 3 patients (5%) after 18 to 40 months of follow-up (mean, 28.4 months). The relapses occurred within 7 months after chemotherapy was stopped. There were 2 deaths from nontuberculosis causes during the follow-up period. Fifty-one patients (90%) remained bacteriologically sterile for 28.4 +/- 6.1 months. These results suggest that the 2SHRZ/7HR regimen is satisfactory in treating anthrasilicotic or silicotic patients with pulmonary tuberculosis, though antituberculosis chemotherapy seemed less effective in patients with pneumoconiosis than in those without pneumoconiosis. PMID- 3310771 TI - The effects of angiotensin-converting enzyme inhibition on sodium handling in patients with advanced chronic obstructive pulmonary disease. AB - Ten clinically stable, hypercapneic patients with advanced chronic obstructive pulmonary disease were studied to assess the effect of angiotensin-converting enzyme blockade on their inability to excrete a sodium load. Renal, hormonal, and cardiovascular responses to sodium loading were determined during two 5.5-h studies: control day, placebo; and experimental day, captopril. At baseline, compared with control subjects, patients displayed a decrease in urinary sodium associated with low effective renal plasma flow and high plasma level of aldosterone. Captopril, given before sodium loading, produced a significant increase in urinary sodium without increasing effective renal plasma flow and without suppressing plasma aldosterone more than sodium loading alone. Thus, the mechanism by which angiotensin-converting enzyme inhibition induces an acute sodium diuresis in these patients remains to be elucidated. The blockade of angiotensin with captopril also affected the osmotic regulation of vasopressin: for a given increase in plasma osmolality, the increase in plasma vasopressin was subnormal, a finding consistent with the hypothesis that angiotensin II contributes to the regulation of vasopressin secretion. PMID- 3310772 TI - Evaluation of bronchodilator responsiveness in mechanically ventilated patients. AB - Airway pressure, flow, and volume were measured before and after administration of aerosolized metaproterenol during controlled mechanical inflation and stepwise deflation of the relaxed respiratory system in 13 mechanically ventilated patients. An increase in passive expiratory flow at constant respiratory system recoil pressure was considered evidence of bronchodilatation. In 10 patients, at a respiratory system recoil pressure of 6 cm H2O (VP6), expiratory flow increased 21 to 500% above prebronchodilator level. In these 10 dynamically hyperinflated patients, an increase in VP6 was associated with a decrease in peak inspiratory pressure (Ppeak) (mean delta = -4.7 cm H2O) and a decrease in intrinsic positive end-expiratory pressure (Peepi) (mean delta = -2.4 cm H2O). The elastance of the respiratory system was not affected by metaproterenol, and the delta Peepi corresponded to a mean decrease in end-expiratory lung volume of 0.20 L. The results are consistent with predictions based on a single-compartment model. When mean expiratory flow is determined only by the tidal volume and expiratory time, a decrease in airway resistance results in a decrease in lung volume at which patients are ventilated. Therefore, the decrease in Ppeak is caused not only by a decrease in the resistive pressure cost but also by a decrease in the elastic pressure cost of inflating the respiratory system. It is emphasized that Ppeak and Peepi provide valuable information about bronchodilator-induced changes in lung function during controlled mechanical ventilation. PMID- 3310773 TI - Hemodynamic effects of external continuous negative pressure ventilation compared with those of continuous positive pressure ventilation in dogs with acute lung injury. AB - Patients with noncardiogenic pulmonary edema requiring ventilatory assistance are usually supported with CPPV using positive end-expiratory pressure (PEEP), but CPPV requires endotracheal intubation and may decrease cardiac output (QT). The purpose of this study was to examine thoracoabdominal continuous negative pressure ventilation (CNPV) using external negative end-expiratory pressure (NEEP). The effects on gas exchange and hemodynamics were compared with those of CPPV with PEEP, with the premise that CNPV might sustain venous return and improve QT. In 6 supine, anesthetized and paralyzed dogs with oleic-acid-induced pulmonary edema, 30 min of CNPV was alternated twice with 30 min of CPPV. Positive and negative pressure ventilation were carefully matched for fractional inspired oxygen concentration (FIO2 = 0.56), breathing frequency, and tidal volume. In addition, we matched the increase in delta FRC obtained with the constant distending pressures produced by both modes of ventilation. An average of -9 cm H2O of NEEP produced the same delta FRC as 10.8 cm H2O of PEEP. Gas exchange did not differ significantly between the 2 modes. However, QT was 15.8% higher during CNPV than during CPPV (p less than 0.02). Mixed venous oxygen saturation also improved during CNPV compared with that during CPPV (58.3 versus 54.5%, p less than 0.01). Negative pressure ventilation using NEEP may be a viable alternative to positive pressure ventilation with PEEP in the management of critically ill patients with noncardiogenic pulmonary edema. It offers comparable improvement in gas exchange with the advantages of less cardiac depression and the possible avoidance of endotracheal intubation. PMID- 3310774 TI - High resolution computed tomography of inflation-fixed lungs. Pathologic radiologic correlation of centrilobular emphysema. AB - Centrilobular emphysema (CLE) is a disease defined pathologically. Assessment of the accuracy of high resolution computed tomography (CT) in the diagnosis of centrilobular emphysema has been hampered by a lack of pathologic correlation. We applied high resolution computed tomography to 20 postmortem lung specimens fixed by a method that allows for direct one-to-one pathologic-radiologic correlation. The degree of centrilobular emphysema was assessed radiologically on a visual grading system based on nonperipheral low-attenuation areas. The lungs were then sectioned along the plane of the CT image, and the degree of centrilobular emphysema was graded pathologically by scoring against a panel of standards. A significant correlation (r = 0.91, p less than 0.005) was found between the pathologic grade and the in vitro CT score. PMID- 3310775 TI - Maximal airway narrowing to inhaled leukotriene D4 in normal subjects. Comparison and interaction with methacholine. AB - We investigated whether or not leukotriene D4 can influence the maximal degree of airway narrowing in normal humans by comparing the maximal responses to inhaled methacholine and LTD4, and evaluating the interaction between both agonists. In 8 normal subjects, methacholine challenges were performed 24 h before and 24 and 72 h after a LTD4 challenge. Doubling doses of methacholine (1.3 to 655 mumol) or LTD4 (0.007 to 192 nmol) were inhaled by using a recently validated method. The highest dose of LTD4 was followed by the maximal dose of methacholine. The response was measured by FEV1 and volume history standardized partial expiratory flow-volume curves (V40p), and was expressed as percent fall from baseline. All subjects reached a maximal response plateau to both agonists. The maximal response plateau to LTD4 was systematically higher than to methacholine on the preceding day (mean difference, 13.4 and 12.7% fall for FEV1 and V40p, respectively) (p less than 0.01). Addition of methacholine on top of the LTD4 plateau caused a further increase in the response (mean, 6.6 and 4.8% fall, respectively) (p less than 0.005). The maximal responses to methacholine at 24 and 72 h after the LTD4 challenge were higher than at 24 h before (mean difference at 24 h, 4.0 and 8.5% fall for FEV1 and V40p, respectively, and at 72 h 5.7 and 9.3% fall) (p less than 0.05). However, the provocative dose of methacholine causing a 10% fall in FEV1 (PD10) or a 40% fall in V40p (PD40) was not altered by the previous LTD4 challenge test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310776 TI - Captopril-related (and -induced?) asthma. AB - A 51-yr-old nonsmoking male patient without any history of previous allergies, asthma, hay fever, or urticaria developed attacks of asthma when captopril was added to the nadolol and dyazide treatment for his high blood pressure. A double blind challenge with nadolol and captopril decreased FEV1 by 3 and 12%, respectively. This confirmed the history of captopril-related asthma. As angiotensin-converting enzyme seems to play a role in the genesis and metabolism of bronchomotor mediators, this rare form of drug-induced asthma is important for both clinicians and airways pharmacologists. PMID- 3310777 TI - Airway smooth muscle and disease workshop: structure and mechanical properties. PMID- 3310778 TI - Airway smooth muscle and disease workshop: histamine and prostanoids. PMID- 3310779 TI - Airway responses to platelet-activating factor. AB - Platelet-activating factor is a potent mediator, with numerous biologic activities. It is capable of inducing both acute bronchoconstrictor responses in the lung in addition to increasing airway responsiveness to non-specific factors. It is this latter property that is especially intriguing since no other mediator of immediate hypersensitivity has been demonstrated to have such striking properties. The recent demonstration of induction of persistent (as long as 2 wk) airway hyperresponsiveness in humans after aerosolized PAF is an exciting development in our understanding of potential mediators of this entity. Much remains to be defined regarding the role of PAF in bronchial asthma including the cellular source of its production, the dependence of its effect upon other cell types such as platelets and polymorphonuclear leukocytes, the secondary mediator or mediators released from recruited cells, which are involved in producing the final pathophysiologic picture, and the mechanism by which altered airway responsiveness occurs. PMID- 3310780 TI - Airway smooth muscle and disease workshop: epithelial mediators. AB - The bronchial epithelium has a number of mechanical functions including mucociliary clearance and protection against noxious agents. However, there is increasing evidence that it is a metabolically active tissue that may modulate the function of the underlying smooth muscle by metabolism and regulation of mediators and the production of relaxant, constrictor, or chemotactic factors. It is therefore possible that the epithelial abnormalities observed in asthmatics may lead, via several different mechanisms, to increased bronchial hyperresponsiveness (figure 2), which is a fundamental feature of asthma. However, it may not be necessary to invoke structural damage to explain derangement of epithelial function. It is possible that functional biochemical abnormalities may be present in epithelial cells, thereby producing bronchial hyperresponsiveness in the absence of histologic abnormalities. Further studies with bronchial epithelium, similar to those with vascular endothelium, are needed to clarify its role in the pathogenesis of asthma. PMID- 3310781 TI - Airway inflammation and hyperresponsiveness. PMID- 3310782 TI - Innervation of airway smooth muscle. PMID- 3310783 TI - Cholinergic control of airway smooth muscle. PMID- 3310784 TI - Presynaptic control of airway smooth muscle. PMID- 3310785 TI - In vivo versus in vitro human airway responsiveness to different pharmacologic stimuli. PMID- 3310786 TI - Site and mechanism of obstruction and hyperresponsiveness in asthma. PMID- 3310787 TI - Airway smooth muscle and disease workshop: theophylline. PMID- 3310788 TI - Electrophysiologic behavior of normal and sensitized airway smooth muscle. PMID- 3310789 TI - [Bone marrow transplantation in pediatrics]. PMID- 3310790 TI - [Malaria imported from Equatorial Guinea caused by Plasmodium falciparum probably resistant to chloroquine]. AB - The authors present the case of a 4 year old girl affected by malaria, the latter having been imported from Equatorial Guinea. The initial treatment of the disease with adequate administration and duration of chloroquine therapy, did not impede the recurrence of the disease, once the patient seemed apparently cured. Although due to the special evolutionary circumstances it was not possible to clinically confirm the chloroquine resistant of the parasite, it is considered, to best of our knowledge, to be the first pediatric case of probable chloroquine-resistant Plasmodium falciparum malaria imported into Spain from Western Africa. PMID- 3310791 TI - [Neonatal heart failure secondary to an aneurysm of the vein of Galen. Prenatal diagnosis apropos of a case]. PMID- 3310792 TI - Air-fluidized beds or conventional therapy for pressure sores. A randomized trial. AB - STUDY OBJECTIVE: To compare the effectiveness and adverse effects of air fluidized beds and conventional therapy for patients with pressure sores. DESIGN: Randomized trial with both masked and unmasked comparisons of outcome after a median follow-up of 13 days (range, 4 to 77 days). SETTING: Urban, academic referral, and primary care medical center. PATIENTS: Of 140 potentially eligible hospitalized patients with pressure sores, 72 consented to randomization; 65 (90%) completed the study. INTERVENTIONS: Thirty-one patients on air-fluidized beds (Clinitron Therapy, Support Systems International, Inc., Charleston, South Carolina) repositioned every 4 hours from 0700h to 2300h without use of other antipressure devices. Thirty-four patients on conventional therapy used an alternating air-mattress covered by a foam pad (Lapidus Air Float System, American Pharmaceal Company, Cincinnati, Ohio) on a regular hospital bed; were repositioned every 2 hours; and had elbow or heel pads as needed. Topical therapy was standardized for both groups. MEASUREMENTS AND MAIN RESULTS: Pressure sores showed a median decrease in total surface area (-1.2 cm2) on air-fluidized beds, but showed a median increase (+ 0.5 cm2) on conventional therapy; 95% confidence interval (CI) for the difference between medians, -9.2 to -0.6 cm2 (p = 0.01). Improvement, as assessed from serial color photographs by investigators masked to treatment group, occurred in 71% and 47%, respectively; 95% CI for the difference, 1% to 47% (p = 0.05). For pressure sores 7.8 cm2 or greater, outcome differences between air-fluidized beds and conventional therapy were greater: median total surface area change was -5.3 and +4.0 cm2, respectively; 95% CI for the difference, -42.2 to -3.2 cm2 (p = 0.01). Improvement rates were 62% and 29% respectively; 95% CI for difference, 1% to 65% (p = 0.05). After adjusting for other factors associated with sore outcome, the estimated relative odds of showing improvement with air-fluidized beds were 5.6-fold (95% CI, 1.4 to 21.7) greater than with conventional therapy (p = 0.01). No significant increase in adverse effects was seen with air-fluidized beds. CONCLUSIONS: Our findings suggest that air-fluidized beds are more effective than conventional therapy, particularly for large pressure sores. Studies are needed to determine the effectiveness of air-fluidized beds in long-term care settings. PMID- 3310793 TI - Risk factors for airflow obstruction in recipients of bone marrow transplants. AB - Obstructive lung disease is a complication of bone marrow transplantation. To identify risk factors we analyzed pulmonary function tests of 281 adult patients 1 year after marrow transplantation. The forced expiratory volume at 1 second divided by the forced vital capacity (FEV1/FVC) was used to measure airflow rates. Factors associated with a lower year-1 FEV1/FVC (%) included increased age (p less than 0.0001), male gender (p = 0.02), cigarette smoking (p = 0.01), lower FEV1/FVC before transplantation (p less than 0.0001), HLA-nonidentical grafts (p = 0.001), chronic graft-versus-host disease (p = 0.0002), and immunosuppressive therapy with methotrexate (p = 0.01). There was no significant association between the year-1 FEV1/FVC and underlying disease, dose of conditioning irradiation, or development of acute graft-versus-host disease. Linear multivariate regression analysis, after controlling for the FEV1/FVC before transplantation, shows both chronic graft-versus-host disease and administration of methotrexate independently associated with decrements in the year-1 FEV1/FVC. The combined occurrence of chronic graft-versus-host disease and methotrexate also was strongly associated with decreases in the year-1 FEV1/FVC, indicating an interaction of these risk factors. PMID- 3310794 TI - Autoimmune thrombocytopenia and primary biliary cirrhosis with hypoglycemia and insulin receptor autoantibodies. A case report. AB - A 43-year-old woman with spontaneous episodes of neuroglycopenic hypoglycemia was found to have immune-mediated thrombocytopenic purpura and primary biliary cirrhosis. Hypoglycemia along with hyperinsulinemia suggested insulinoma. Serum c peptide levels were disproportionately low, raising the possibility of factitious hypoglycemia. The patient's plasma contained circulating insulin receptor autoantibodies, thought to cause hypoglycemia by their insulin-like actions. With prednisone therapy, her other autoimmune features improved, and the hypoglycemia eventually resolved. Hypoglycemia mediated by insulin receptor autoantibodies should be considered in patients with fasting hypoglycemia and features suggesting an underlying autoimmune disorder before pursuing more invasive procedures. High-dose steroids may be life-saving in this disorder. PMID- 3310796 TI - Untangling causation issues in law and medicine: hazardous substance litigation. AB - Judges and juries are increasingly being asked to settle questions about disease caused by hazardous products. With the growth of litigation on toxic substances and unsafe products, more and more courts must wrestle with the complicated scientific proof of the relation between exposure and disease or injury. This proof frequently involves the use of probabilistic evidence in the form of statistical tests and epidemiologic studies. Anglo-American law relies on deductive notions of causation and is suspicious of probabilistic evidence of causation. As a result, court decisions of hazardous substance cases are sometimes based on a confused understanding of the critical causal connection. Physicians who testify in such cases, either as the treating doctor or as expert witnesses, must be aware of the court's difficulty with probabilistic evidence. In addition, physicians must state clearly the role of such evidence in the identification of a hazardous substance as the cause of a disease or injury. PMID- 3310795 TI - Sensor-triggered, rate-variable cardiac pacing. Current technologies and clinical implications. AB - Conventional implantable dual-chamber cardiac pacemakers adjust heart rate and maintain normal atrial and ventricular contraction by tracking "native" atrial electrical activity and pacing the ventricles after a predetermined programmable atrioventricular delay. However, in patients with symptomatic bradyarrhythmias, optimal function of "atrial-tracking" devices may be limited by concomitant sinoatrial disease. Provision of chronotropic response during physical exertion or emotional stress may be achieved by using physiologic sensors to alter pacing rate independently of atrial activity. Additional systems using sensor technologies are being developed. Future pacing systems will have dual-chamber pacing capability and may use several sensors coupled synergistically in order to take advantage of particular strengths of each. Physiologic sensor technology may be of diagnostic value in both antitachycardia devices and implantable cardioverter and defibrillator systems. PMID- 3310797 TI - Syndromes of acute nonlymphocytic leukemia. AB - The marriage of cytogenetics and molecular biology has resulted in major advances in our understanding of acute nonlymphocytic leukemia. These technologies reveal a number of clearly recognizable syndromes of acute nonlymphocytic leukemia. This review describes the salient features of several of these syndromes: acute myelomonocytic leukemia with abnormal eosinophils; acute nonlymphocytic leukemia with 11q abnormalities [biphenotypic leukemia with t(4;11); and acute monocytic leukemia with t(9;11)]; acute nonlymphocytic leukemia with t(8;21); acute promyelocytic leukemia; acute nonlymphocytic leukemia with normal or elevated platelet counts and rearranged 3q21 and 3q26; and acute nonlymphocytic leukemia with increased basophils and t(6;9). The pathogenesis of therapy-related leukemias is discussed also. PMID- 3310798 TI - The protease theory of emphysema. PMID- 3310799 TI - Flocculation of insulin preparations. PMID- 3310800 TI - The formation and inhibition of photochemical smog. AB - Photochemical smog is caused by a free-radical chain mechanism which converts NO to NO2. The NO2 further reacts to produce ozone, nitric acid, and peracylnitrates. This chain mechanism can be inhibited by suitable free-radical scavengers. The chemistry and toxicology of one such free-radical scavenger, diethylhydroxylamine, has been studied in depth. It has been shown to be effective, safe, and practical for use in urban atmospheres to prevent photochemical smog formation. PMID- 3310801 TI - Health aspects of low-level ionizing radiation. AB - Biological effects of small multiples of the natural ionizing radiation environment are addressed and attention paid to potential public health problems in nuclear technology. Implications for the employment of radiation in the healing arts are discussed. Formidable mathematical obstacles are noted due to the fact that health effects at low-level radiation doses are generally inferred from observations at much larger doses. Practical cost-effective decision-making consistent with sound radiologic health must take into account the breadth of current scientific uncertainties. PMID- 3310802 TI - Magnetic field exposure related to cancer subtypes. AB - Certain subtypes of cancer (notably nervous system cancer) showed an association with two indices of exposure to 60-Hz alternating magnetic fields (AMFs): Subtype similarities were seen in those people potentially exposed to AMFs by their occupations, and in those potentially exposed by high-current power lines near their homes. The incidence-age patterns observed in exposed and nonexposed groups suggest that prolonged AMF exposure may act as a cancer promoter. PMID- 3310803 TI - Influence of power frequency electric and magnetic fields on human health. AB - Several reports have appeared in the last ten years in which the authors suggest an association between cancer/leukemia and exposure to electric and magnetic fields in the workplace or in the vicinity of distribution lines from overhead transmission systems. Several of these reports are reviewed and critiqued. The reports of clinical effects of electric and/or magnetic fields among human populations present serious difficulties which stem from the many publications in which pertinent material is not presented, and the data are variable or internally inconsistent. The reports presented so far are not very probing. The numbers of subjects are small, the epidemiologic methodologies are often weak, measurements of intensity of field are absent, and the statistical analyses utilized are not always appropriate. Although suggestive associations of electric/magnetic fields and cancer or leukemia have been made, no one has established a causal relationship between these fields and cancer or leukemia. All the reports on human exposure have numerous deficiencies which include: lack of or imprecise measurements of electric or magnetic field intensities, questionable subject identification, lack of statistical significance, confounding with uncontrolled variables such as socioeconomic differences, smoking, X rays, drugs, population mobility, and the unreliability of occupational classification. Nevertheless the possibility of a link between leukemia and cancer and exposure to electric and magnetic fields has been raised and only responsible research can refute or confirm these reports. PMID- 3310804 TI - Intraepikeratophakia. AB - A refractive keratoplasty technique has been devised where the donor lenticule is placed between Bowman's membrane and the epithelial layer. We have termed this operation "intraepikeratophakia." The technique is based on the same principles as keratophakia. The epithelium is removed surgically and reapproximated over the transplanted lenticule. Twenty-two patients underwent conventional epikeratophakia, and ten underwent intraepikeratophakia. Of the 32 patients in this study, three required removal of the donor lenticule. All of these patients were in the epikeratophakia group, and all failures were secondary to poor reepithelialization of the lenticule. Of the ten patients who underwent intraepikeratophakia, nine had complete reepithelialization by the second postoperative day. On the average, these patients required 77% less time to reepithelialize completely compared with epikeratophakia patients. Patients in the intraepikeratophakia group were also more comfortable throughout their postoperative course probably as a result of the faster rate of reepithelialization. Intraepikeratophakia offers definite advantages over epikeratophakia and is a viable alternative to patients requiring refractive keratoplasty. PMID- 3310805 TI - Presence of retinal autoantigen in normal mice: absence in strains with retinal degeneration. AB - We examined the eyes of four strains of mice to determine if some or all contained an antigen which might cross-react with an antigen of guinea pig retina. To do this, we prepared guinea-pig antibody to guinea-pig retinal extract by immunizing Hartley guinea pigs with guinea-pig retinal extract in two different adjuvants. The retinal tissue of Balb/c and C57B1/6J mice stained well when we used the guinea-pig antibody to guinea-pig retinal extract. In contrast, the eyes of a subline, i.e., C57B1/6J-rd with retinal degeneration, did not stain. Likewise, the eyes of C3H/HeJ and SJL mice with abnormal retinas did not stain. The latter two strains are known to have retinal degeneration. The control studies were negative. This study shows that normal murine eyes have at least one antigen which cross-reacts with a guinea-pig retinal antigen. It also shows abnormal mouse retinas lack this antigen. PMID- 3310806 TI - [Features of mimicry in Plasmodium falciparum]. AB - In this study, we aim to show, by comparing the amino-acid sequences of several antigens of Plasmodium falciparum with those of some proteins manufactured by the host immune system, that the parasite appears to have a remarkable capacity for mimicry. This would help greatly to reduce the efficiency of the immune response during its asexual cycle. Indeed, the major sporozoite surface protein (CSP) has amino-acid sequences in common with interleukin 1; homologies between Pf 11, expressed at the trophozoite stage, and thymosin alpha 1 may be found. Lastly, RESA present at the schizont stage and protein S liberated when the parasitized erythrocyte is lysed, have sequences in common, respectively with thymosin alpha 1 and thymulin. PMID- 3310807 TI - [Collagen implants]. PMID- 3310808 TI - Direct anastomotic assessment for postoperative microvascular monitoring. AB - An experimental comparison of two techniques for direct monitoring of anastomoses postoperatively is presented. Arterial differential temperature measurements indicated arterial occlusion (n = 24) in island flaps by mean temperature decreases in the affected artery of 0.5 degrees = C, but temperature changes in cases of venous occlusion (n = 17) were small (mean, 0.2 degrees C), inconsistent, and not of predictive value. The technique did not distinguish success (n = 4) from failure (n = 2) in experimental free flaps, and occlusion of deep arteries produced little or no change in the arterial wall temperature. In contrast, an implanted ultrasound Doppler probe reliably indicated arterial and venous occlusion in island flaps (n = 10), because in both circumstances the mean arterial Doppler signal invariably decreased to 0. The two could be distinguished between by changes in Doppler sound and instantaneous signal. In experimental free flaps, success (n = 10) was clearly distinguished from failure (n = 3) by characteristic patterns of Doppler sound and signal. Arterial differential thermometry had serious limitations, but implanted ultrasound Doppler showed great potential as a postoperative monitor applicable to all microvascular procedures. PMID- 3310809 TI - Indications and long-term assessment of 10 cases of cross-leg free DCIA flaps. AB - Compound fractures of the lower limb with skin and bone loss are difficult repair problems, especially in multiple level injuries. With bone loss between 6 and 12 cms, the deep circumflex iliac artery (DCIA) flap is usually the flap of choice in reconstruction; the aim is to carry out microvascular anastomosis of the flap vessels to vessels on the damaged leg. However, this may be difficult or even impossible. Experience of 10 cross-leg DCIA flaps is outlined, with indications and surgical technique. The long-term bone healing is compared with 13 cases with anastomosis based on the same leg. There appears to be no difference in callus formation and remodelling of bone, indicating that despite subsequently dividing the original main vascular supply the bone in the DCIA flap remains vascularized and behaves as such. PMID- 3310810 TI - The complications of fasciocutaneous flaps. AB - We analyzed the complications in a series of 126 fasciocutaneous flaps. The overall complication rate was 40%, which included both early and late complications. The early complications were divided into major and minor groups. The main avoidable causes of major complications were poor design; the presence of orthopedic metal in the wound; and late referral of infected wounds, particularly of the lower leg. In all the cases in which partial necrosis occurred, the fascia had an adequate blood supply, either to allow the wound to heal with dressings or, if the necrosis was more extensive, to provide a good bed for a split-skin graft. PMID- 3310812 TI - A history of the repair of cleft lip and palate in Britain before World War II. AB - From Bald to Wardill in surgery, from Snow to Ayre in general anesthesia, from Van Praach to Morley in speech therapy, the contributions of the United Kingdom to the repair of cleft lip and palate have been of lasting importance. PMID- 3310811 TI - Infective cutaneous gangrene--urgency in diagnosis and treatment. AB - Many descriptions of infective cutaneous gangrene have been published under a variety of names. The classification adopted by Ledingham and Tehrani is illustrated by 4 cases seen in the Stoke Mandeville Hospital. Although the incidence is high in Eastern countries, infective cutaneous gangrene is uncommon in the Western hemisphere owing to a difference in geographic pathology. Early and delayed management is described, stressing that early diagnosis and aggressive treatment is required, ideally by a team consisting of a microbiologist and plastic and general surgeons. There is a substantial risk associated with the failure to diagnose and treat this condition. Mortality rates and prognosis are reviewed. PMID- 3310813 TI - Reconstruction of the pelvis using a composite island flap salvaged from the remaining leg. AB - The case of a patient who sustained horrific injuries resulting in the loss of his left leg and hemipelvis and damage to the right sacroiliac joint and leg is discussed. The remaining leg was paralyzed as a result of damage to the sacral plexus. As a salvage procedure, a right above-knee amputation was performed, preserving a large composite flap from the distal part of the limb. This flap, consisting of most of the skin and soft tissue of the lower leg, contained within it a 10 cm segment of tibia and fibula. By islanding the flap on a pedicle composed of the femoral vessels, saphenous, and sciatic nerves, it was possible to mobilize it sufficiently far proximally to reconstruct the bone and soft tissue defect of the contralateral hemipelvis. Seven years after this appalling injury, the patient has achieved a remarkable psychological and functional rehabilitation. He is independent and is successfully pursuing a professional career. This case report is a dramatic illustration of what can be achieved in reconstruction following trauma using salvage techniques. PMID- 3310815 TI - [Conservative treatment in splenic injuries in children. Apropos of 15 cases]. PMID- 3310814 TI - Desmoplastic fibroma of the mandible. AB - A desmoplastic fibroma of the mandible in an 11-year-old girl provided a difficult diagnosis because of its similarity, both clinically and histologically, to a low-grade fibrosarcoma following its rapid recurrence after primary local curettage. Immediate one-stage microvascular musculocutaneous reconstruction served to allow complete excision of the lesion and minimize the degree of psychological trauma. The differential diagnosis and the significance of cartilagenous elements present in the lesion are discussed. PMID- 3310816 TI - [Intrahepatic accessory gallbladder. Apropos of a case]. PMID- 3310817 TI - [Prevention of deep venous thrombosis in orthopedic surgery for total hip prosthesis. Randomized trial for determining optimal dosage]. PMID- 3310818 TI - [Evaluation of the emboligenic potential of carotid plaques. Apropos of 113 echographic and macroscopic comparisons]. AB - 113 cases of atheromatous plaques in carotid arteries (69 cases where symptoms were present and 44 were asymptomatic) surgically treated by endarterectomy, including an accurate description of gross lesions, were compared to findings obtained with echographic examination to determine if there are specific echographic criteria corresponding to exact anatomical lesions. The echographic criteria selected for this study were the echo-inducing structure of the plaques; the relationship of the plaque with the artery wall (presence of a lesion continuous with the wall); the regular configuration of the endoluminal edge of the plaque or not; and finally, the notion of a discrepancy between the extent of the carotid artery stenosis visualized by ultrasound and that observed with echography (E much less than U). The primary results of this study demonstrate that echo-inducing, uniform and regular (36 cases) atheromatous plaques corresponded to ordinary, fibrous or calcified plaques in 69.4% of cases, with regular endoluminal borders. Irregular and non-uniform plaques (31 cases) suggested irregular, friable and/or ulcerated substance in 64.4% of cases. Poor echo-conducting plaques (9 cases) suggested formation of a thrombus, basically, in 44.4% or of soft and friable plaques (33.3% of cases). Those plaques which were continuous with the wall do not correspond to a precise type of lesion but, rather, are characteristic (with poor echo-conducting plaques) of the embolic nature of the plaques (100%). The criteria echo much less than ultrasound is specific for a thrombus in 75% of cases. On the other hand, the thrombus may also assume very diverse echographic presentations. Finally, three negative echo ultrasound results were observed in this study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3310819 TI - [Latent congenital mitral insufficiency caused by an isolated mitral cleft. Diagnosis by two-dimensional echocardiography and pulsed Doppler]. AB - In this paper, the authors report the case of an 8-year-old boy with an isolated slit in his mitral valve, and who did not have a heart murmur detectable either by auscultation or by phonocardiography and who had no symptoms of heart failure. Two-dimensional echocardiography, with a left parasternal direction, in a transversal view revealed the presence of this abnormality of the endocardial leaflets accompanied by an accessory chorda tendina, and this procedure confirmed the absence of hemodynamic percussion. Doppler ultrasonography detected an abnormal turbulent systolic blood flow immediately behind the mitral valve, suggesting a minimal to moderate degree latent regurgitation. Two-dimensional echocardiography together with the Doppler ultrasound makes possible the diagnosis of an isolated slit of the mitral valve by non-invasive technique and the detection of concomitant latent mitral valve regurgitation, especially when the left atrium is not dilated and if the patient does not have low cardiac output. PMID- 3310820 TI - [Sub-adventitial rupture of the popliteal artery and recurrent ischemia: a diagnostic pitfall in young patients]. AB - In the absence of thromboembolic risk factors, signs of thrombosis in situ, or disorders of coagulation, two possible diagnoses must be envisaged when acute recurring ischemia is observed in a peripheral area of tissue: extrinsic compression or rupture of an arterial coat, especially when the subject is young and in good general health. The case of a 35 year old patient presenting with recurring ischemia in the popliteal artery of the right lower limb due to sub adventitial rupture of the popliteal artery suggests three comments: the period of latency (3 months) between initial trauma to the popliteal artery and the operation of reverse saphenous vein bypass, the necessity for dynamic manipulations together with angiographic and ultrasound examination, the probable underestimation of the traumatic or functional causes of this disorder (popliteal artery), and the surgical prognosis remains excellent. PMID- 3310821 TI - A giant unhomogenous leiomyoma simulating ovarian cancer. A case report. AB - We describe a case of a giant unhomogenous uterine leiomyoma that simulated ovarian cancer both clinically, roentgenologically (computerized tomography) and ultrasonically. As an incidental finding there was also a carcinoma in situ of the endometrium. The difficulties in the differential diagnosis of an abdomino pelvic mass are discussed, and the significance of laparotomy also as a diagnostic method is emphasized. PMID- 3310822 TI - Antibacterial capacity in amniotic fluid in normal and complicated pregnancies. AB - The antibacterial activity against Escherichia coli K 12 in 153 samples of amniotic fluid (AF) in 15 to 40 weeks of pregnancy were investigated by a new micromethod. Fifty-six mothers had an uncomplicated pregnancy while various complications (maternal diabetes, cholestasis of pregnancy, pregnancy induced hypertension, blood group isoimmunization and fetal growth retardation) were present in 97 cases. A significant (p less than 0.001) improvement of antibacterial activity was observed with advancing pregnancy. The highest antibacterial activity in AF was observed in cases with intrauterine growth retardation. In other respects the effect of various diseases was negligible. PMID- 3310824 TI - In honour of Lauri Rauramo on his 70th birthday. PMID- 3310823 TI - Lauri Rauramo--seventy years. PMID- 3310825 TI - Spironolactone in the treatment of hirsutism. AB - Clinical and laboratory studies were performed in 18 hirsute women for evaluation of the efficacy of spironolactone (S) therapy. Each patient received S 100 mg daily. The grade of hirsutism was assessed using a semiquantitative scale of Ferriman and Gallwey. Total testosterone, androstendione, dehydroepiandrosterone sulphate and sexhormone binding globulin were measured before initiation and after six months of therapy. A clinical response was seen in 12 women. The total score of hirsutism in the whole patient group was decreased from 14.1 +/- 6.3 (mean +/- S.D.) to 11.8 +/- 6.4 (p less than 0.01). No changes were found in the hormonal values. The findings of the present study confirm the efficacy of S in decreasing the hair growth by mainly a peripheral mode of action. PMID- 3310826 TI - Blood glucose, serum insulin, serum growth hormone and serum glycosylated proteins during two years' oral contraception with low-estrogen combinations. AB - Body weight, fasting blood glucose (GP) (BFG), serum immunoreactive insulin (IRI), serum growth hormone (GH) and serum glycosylated proteins were longitudinally followed in 2 groups of women during two years' oral contraception. One group (n = 10) received a combination of 0.030 mg ethinylestradiol and 0.150 mg levonorgestrel and the other (n = 10) a combination of 0.030 mg ethinylestradiol and 0.150 mg of desogestrel. There was a significant increase in BFG during the study and the values were still rising, when examined 2 months after discontinuation of the pill. Two subjects, reaching the level of 5.5 mmol/l showed normal pretreatment values, when investigated one year later. After 6 months' use of either preparation, GH significantly increased, remained on that level throughout the study and returned to the pretreatment level after discontinuation of the pill. Body weight, IRI and GPP did not change significantly during the study. PMID- 3310827 TI - Plasma renin activity, blood pressure and body weight during two years' oral contraception with two different low-estrogen combinations. AB - Body weight, systolic and diastolic blood pressure and plasma renin activity (PRA) were longitudinally followed in two groups of women during 2 years' oral contraception. One group (n = 10) received a combination of 0.150 mg levonorgestrel plus 0.030 mg ethinyloestradiol and the other (n = 10) a combination of 0.150 mg desogestrel plus 0.030 mg ethinyloestradiol. Three subjects discontinued the study due to relocation. No statistically significant changes occurred in any of the measured parameters. PMID- 3310828 TI - The treatment of perineal and perianal intraepidermal carcinoma with radical exstirpation and mesh skin graft. Case report. PMID- 3310829 TI - Pancreatic phospholipase A2 (PPLA2) during human pregnancy. AB - Pancreatic phospholipase A2 in human serum during pregnancy is within the normal range. In the amniotic fluid, the amount of immunoreactive pancreatic phospholipase A2 increases from 1.3 microgram/l at 16 weeks to 2.9 micrograms/l near term, but does not correlate with PLA2-activity. Meconium-stained amniotic fluid had highly elevated pancreatic, but not kinetic, PLA2. The fetal pancreas and its high PLA2-content may contribute to the progressive increase in uterine activity during human pregnancy. PMID- 3310830 TI - Interventional ultrasound in diagnosis and treatment of ovarian cysts. AB - In 46 patients, age 17-46 years, 48 simple ovarian cysts with the median diameter of 4-14 cm were punctured using ultrasonic quidance. The aspirate of cysts was examined cytologically. The punctured cysts were observed by ultrasonic examinations performed one month and three months after the punctures. The recurred cysts (n = 16) were punctured again. If the cyst recurred again, the patient was operated. The experience up to now indicates that the results of the puncture treatment are good. Out of 46 patients of the study, 14 (30%) had to be operated, while 32 (70%) did avoid from laparotomy due to the puncture. In cytological examinations no malignant cells were established. Besides one haematoma, no complications appeared. PMID- 3310831 TI - Aluminium in renal disease: current knowledge and future developments. PMID- 3310832 TI - A soluble-phase proinsulin radioimmunoassay and its use in diagnosis of hypoglycaemia. AB - A soluble-phase proinsulin assay has been developed which does not require solid phase antibody-binding. A human proinsulin standard curve is prepared in insulin free and proinsulin-free plasma for comparison with unknown plasma samples. Proinsulin and insulin are bound with excess anti-insulin antiserum, and free C peptide is removed by charcoal adsorption. The supernatant is then assayed using a routine C-peptide radioimmunoassay which utilises anti-C-peptide antiserum. The sensitivity of the assay (2 standard deviations above zero) is 9 pmol/L using 200 microL plasma sample. The assay is free from insulin cross-reactivity up to 100 mU/L and C-peptide up to 2000 pmol/L. Between-assay CV is 13% at 100 pmol/L. The assay has been used in subjects with hypoglycaemia of various aetiologies and has shown that a raised plasma proinsulin in the presence of hypoglycaemia can occur in sulphonylurea-induced and reactive hypoglycaemia as well as in insulinomas. After hyperglycaemic clamps at 7.5, 10 and 15 mmol/L glucose, type II diabetics both on and off sulphonylurea, were found to have lower proinsulin concentrations compared with normal subjects, commensurate with the diabetics' lower insulin responses. PMID- 3310833 TI - Growth hormone deficiency. PMID- 3310834 TI - What is happening to placental function tests? PMID- 3310835 TI - The effect of long-term metabolic control on free thyroid hormone levels in diabetics during insulin treatment. AB - Serum concentration of free T3 and, in female patients, FT4, were found to be lower in 20 asymptomatic, moderately-poor or well controlled, diabetics treated with insulin than in a group of non-diabetic subjects. Over a mean 3-month period of the study a significant fall occurred in HbA1 concentration in both groups of diabetics without change in free thyroid hormone levels. The mean capillary blood glucose, fasting free insulin and fasting lipid concentrations, other than high density lipoprotein (HDL) cholesterol, did not change. No correlations were found between the changes in HbA1 and free thyroid hormone concentrations. Improvement in long term metabolic control did not influence free thyroid hormone levels in well controlled and moderately-poor controlled diabetics, taking insulin. PMID- 3310837 TI - Cardiovascular stress and sleep. AB - This review summarizes briefly the present knowledge on sleep-related factors in ischaemic heart disease. A marked circadian rhythm in the frequency of onset of acute myocardial infarction has been found, but the exact mechanism is not known. The circadian variation is possibly explained by several mechanisms. The best documented is sleep apnoea syndrome, which seems to be a risk factor for ischaemic heart disease and stroke. Stressful REM-sleep seems to be potentially arrhythmogenic in patients with decreased cardiopulmonary function. The role of coronary spasm, increased thrombocyte aggregation and mental stress in sleep disorders is still poorly understood. PMID- 3310838 TI - Endocrine and immune adaptation in stress. AB - Several regulatory processes within the immune system have been clearly established. This complex autoregulation represents a self-monitoring system which protects the organism and maintains body homeostasis. There is, however, much evidence to suggest that the immune system is also under external regulation, especially by the endocrine and neural systems. These internal and neuroendocrine signals are thought to interact in both synergistic and antagonistic fashion, and are probably integrated in feedback circuits. Neuroendocrine and immune systems seem to act in parallel in many conditions, for example in their sensitivity to in vivo dexamethasone challenge. As a result of these interactions, the immune system will probably be kept in homeostatic balance, usually on a new and proper level. Animal studies suggest that there may be adrenal-dependent and adrenal-independent effects on immune function in stress situations. A significant and sustained deviation of the regulatory systems, such as increased and non-suppressible cortisol levels in endogenous depression, does not, however, induce such major changes in immune function. This elucidates the complex and counterregulatory functions of the other external adaptative systems. During diverse, stressful life events, such as bereavement and pathological grief situations, however, the interplay of these adaptative processes may be disturbed. This may lead to changes and abnormalities in immune functions and increase an organism's vulnerability to disease states. PMID- 3310836 TI - Pulsatile secretion of TSH in healthy subjects. AB - The physiological variations in serum TSH concentration have been investigated using an enzyme amplified immunoassay with improved sensitivity and precision. Blood samples were collected at regular intervals from 10 healthy volunteers during the period 1800 h to 0100 h. Spectral analysis followed by periodic regression analysis demonstrated significant serum TSH pulsatility with periodicities of 60 or 85-100 min. In addition, a significant (P less than 0.001) evening rise in serum TSH concentration was demonstrated in all subjects, with levels rising at around 21.30-22.00 h. PMID- 3310839 TI - [Role of growth factors and insulin during pregnancy]. AB - Growth factors represent different classes of polypeptides with insulin-like and mitogenic properties, known to stimulate cellular growth and metabolism. During pregnancy, insulin, insulin-like growth factors (IGFs), EGF, and PDGF are more specifically involved in the development of the fetoplacental unit. These peptides have specific receptors in the placenta and in various fetal tissues, which initiate metabolic and mitogenic effects. In addition, the placenta plays an active part in the regulation of IGFs secretion throughout pregnancy. Several lines of evidence suggest that growth-factors would be active to enhance the proliferative phase of feto-placental growth (14-24 semaines) while insulin would rather stimulate latter metabolic events (30-40 semaines). PMID- 3310840 TI - [Digestive hormones and the colon]. AB - The distribution of neuropeptides at the level of the colon is similar to that observed in other parts of the digestive tract, with, however, specific elements, such as the predominance of enteroglucagon and somatostatin cells. These substances regulate, on the one hand, the function of colonic absorption secretion, and, on the other hand, the motor function. The control exerted by these substances on sodium absorption and chloride secretion, is done through two metabolic systems depending on the AMPc level for one, and the intra-cellular calcium for the other. Neuro-hormonal peptides modulate the metabolic response through specific receptors and regulating proteins, activating and inhibiting. These same substances, acting either directly one smooth muscle, or indirectly through activating or inhibiting interneurons, share in the control of colon motility. PMID- 3310841 TI - Uncertainties in designation of age at menarche in the nineteenth century: revised mean for Denmark, 1835. AB - The earliest Danish study of mean age at menarche by Ravn (Fenger 1850) is analysed with special reference to age recordings and their subsequent groupings into age-classes. Uncertainties of interpretation of the age designations are discussed, and it is argued that, in all probability, mean age at menarche was 17 years in the samples of Danish women born around 1820, rather than below 16 years as believed previously. PMID- 3310842 TI - Failure of noncaloric sweet drinking to prevent the fasting-induced inhibition of insulin release. AB - Rats were fasted for 24 or 48 h, but given free access to either water or a sweet tasting solution of saccharin. Fasting caused a time-related decrease in body weight, plasma glucose and insulin concentrations, and insulin output from isolated pancreatic islets incubated at increasing concentrations of D-glucose. The concentration of the hexose causing half-maximal stimulation of insulin release was increased, in a time-related manner, in islets removed from fasted rats. Except for a somewhat lesser decrease in plasma glucose concentration, ingestion of the sweet drinking water failed to affect the fasting-induced changes in body weight, plasma insulin concentration and insulin output. PMID- 3310843 TI - Plasma glucose and insulin responses to carbohydrate food (rice) with different thermal processing. AB - The effects of thermal processing on plasma glucose and insulin responses in healthy subjects were examined. Fourteen volunteers, after being tested with a glucose load, were randomly administered a test meal, consisting of an amount of rice, calculated to yield the same quantity of glucose, used for the glucose tolerance test (70 g). Rice (90 g, raw) was cooked in two different manners: (a) boiled in salted water and (b) baked for 10 min at 160 degrees C after boiling as in the first test. A clear difference in viscosity and in in vitro hydrolytic rates between the two rice items could be established, whereas the plasma glucose and insulin responses in the volunteers differed to a smaller extent. In particular the 60-min incremental area for glucose was significantly lower in the case of baked rice, compared to boiled rice. These findings suggest that thermal processing of complex carbohydrates may differently affect glycemic responses in man. PMID- 3310844 TI - Influence of glucose, alcohol and glycerol on galactose tolerance in man. AB - Six volunteers were given 0.5 g galactose/kg body weight alone (A) or with 0.5 g glucose/kg (B) or with 0.5 g glycerol/kg body weight (C). Meals A and B were also given 15 min after ingestion of 300 mg ethanol/kg body weight. Glycerol did not influence the serum galactose response to galactose. Glucose reduced the serum galactose response as was expected. Administration of alcohol prior to a galactose test meal increased the mean area under the serum galactose response curve (p less than 0.01); when glucose was given with galactose after alcohol ingestion, the serum galactose response was significantly reduced (p less than 0.01) when compared to the serum galactose response to galactose after alcohol, but remained higher than after the galactose and glucose test meal. Glucose, therefore, can reduce the effect of alcohol on galactose levels but alcohol can abolish the effect of glucose on galactose metabolism. PMID- 3310846 TI - How valid is the concept of hormonal carcinogenesis in human neoplasias? AB - The associations of five tissue-specific steroidal disorders with five human neoplasias, as detected in our case-control studies, have been related to the genesis of each tumor. Information from epidemiology, experimental pathology and molecular biology is in support of the notion that a specified environment exerts its carcinogenic action on the target tissue through the mediating action of the steroid-generating system. The usefulness of the concept of hormonal carcinogenesis in the search for the etiology of human cancer is emphasized using information available both from our laboratory and from outside sources. PMID- 3310845 TI - Regulatory mechanisms in the expression of cell cycle dependent genes. AB - There are several prominent features of cell cycle dependent gene regulation which are apparent from the data reviewed here. First, almost all of the genes studied are regulated by a combination of transcriptional and post transcriptional mechanisms. Thus, the regulation of mRNA levels through the cell cycle is a complex process, with control at many different levels. This is not surprising, if we keep in mind that the modulation of these mRNAs at the proper times may be critical to cell division. Secondly, there does not appear to be a common theme in the regulation of the genes discussed here. It appears as if each gene will be regulated by its own specific mechanism. Table 3 shows the serum responsive sequences which have been identified so far, and they are all different; there does not appear to be a consensus sequence yet for a serum response element. The identification of more such sequences should be forthcoming, and should give us a better idea of the general and specific nature of growth factor regulation of gene expression. We know less about the regulation of genes at the posttranscriptional level than about their transcription. We still have very little information about the specific sequences in mRNA which render it susceptible to degradation. Elucidation of such sequences, such as the AU rich region in GM-CSF mRNA should help us to understand serum and growth factor gene regulation, since this means of control is as widespread, and probably as important as transcriptional control. We have only just begun to understand the mechanisms controlling the expression of CCD genes. The next few years should bring a great increase in our knowledge of these processes. PMID- 3310848 TI - The regulation of transcription of viral and cellular genes by herpesvirus immediate-early gene products (review). AB - The expression of viral genes during infection of tissue culture cells by herpesviruses can be divided into three broad classes termed Immediate-Early (IE), early and late. The IE polypeptides include trans-acting regulators of gene expression; prior expression of IE gene products is essential for the activation of transcription from early gene promoters. During the past five years, the use of modern gene manipulation techniques, short-term transfection assays and in vitro methods has resulted in a significant increase in our understanding of the IE polypeptides. This review concentrates on the genetic, physical and functional properties of herpesvirus IE gene products with particular emphasis on those of herpes simplex virus type 1. PMID- 3310847 TI - The c-Harvey-ras-1 oncogene in chromosome mediated gene transfer. AB - Transfection of DNA derived from a variety of tumours can induce morphological transformation of certain immortalised but normally contact-inhibited cell lines. This important technique has been instrumental in the identification and subsequent molecular cloning of a number of oncogenes, including Harvey-ras. We can extend this approach for studying neoplastic potential by performing chromosome-mediated, as distinct from DNA-mediated, gene transfer. This modification offers two potentially important advantages, both of which stem from the fact that sub-chromosomal lengths of DNA are transferred. Firstly, the expression of the oncogene can be studied in its normal chromosomal milieu; potential modifying effects of linked and unlinked sequences can be evaluated. Secondly, new chromatin segments with transforming potential but too large to be transferred as naked DNA may be revealed. Our experiments illustrate some of the new insights into the molecular basis of neoplastic change which can be gained by this technique. They also demonstrate the power of the technique as a genetic tool for the isolation and detailed molecular analysis of oncogene-associated, sub-chromosomal regions of the human genome. PMID- 3310849 TI - Embryogenesis and carcinogenesis: order and disorder. AB - Similarities and differences between embryogenesis and carcinogenesis are outlined. Recent advances on specific gene expression and developmental phenomena related to cancer are presented. PMID- 3310851 TI - Abnormal expression of interleukin-3 and leukaemia. AB - Autonomous production of a required growth factor is one mechanism by which a cell may become tumorigenic. Several leukaemias have been described which secrete growth factors which may be involved in autocrine stimulation of cell proliferation. One of these leukaemias is WEHI-3B, a myelomonocytic leukaemia that constitutively produces interleukin-3 (IL-3). Cloning of the IL-3 gene has enabled us to investigate possible genetic changes in this gene in WEHI-3B cells which may have resulted in autonomous production of growth factor. We have shown that one of the IL-3 genes in WEHI-3B has been rearranged, as a result of the insertion of a 5.1 kilobase intracisternal A-type particle genome head to head with the 5' end of the IL-3 gene, 215 bases upstream of the IL-3 TATA box. The rearranged gene, when cloned into a lambda EMBL3A vector, could readily be expressed in COS-1 monkey cells, whereas the normal gene, in the same vector, was silent. Thus the insertion of the endogenous retroviral element has resulted in abnormal expression of the IL-3 gene and is postulated to have been a key genetic change in the development of this leukaemia. In an attempt to experimentally construct IL-3 producing leukaemias, IL-3 responsive FDC-P1 and 32D cl-23 cells were transfected with a retroviral expression vector containing the IL-3 gene. This resulted in autonomous production of IL-3 and continuous proliferation of the transfected cells. As a result of transfection, the FDC-P1 and 32D cl-23 cells became leukemogenic demonstrating the oncogenic potential of abnormal expression of IL-3. The autocrine nature of the experimental leukaemias was demonstrated by blocking their proliferation with an IL-3 neutralising antiserum. Similarly treated cultures of normal bone marrow cells also produced IL-3 and could be maintained for several months after transfection but were not leukemogenic. The factor-dependent cell lines are unable to differentiate in the presence of known CSF's and presumably have undergone other genetic changes which allow them to become leukemogenic when autocrine-stimulated. In contrast, the transfected bone marrow cells could differentiate and form colonies containing mature granulocytes and macrophages. The non-tumorigenic behaviour of the transfected bone marrow cells is consistent with the concept that several other genetic changes which effectively block differentiation are required for development of tumorigenicity in these cells. PMID- 3310850 TI - The c-K-ras gene and human cancer (review). AB - A significant number of human tumors from diverse histological origins contain c K-ras oncogenes which have been activated by somatic point mutations resulting in single amino acids substitutions in the encoded p21 ras protein. In addition to these qualitative changes, other genetic alterations leading to increased expression of the c-K-ras gene, especially its mutated form, appear to be important in the activation of its oncogenic potential. These findings support the hypothesis that c-K-ras oncogenes are contributing in a dominant but dose dependent manner to the multistage process of human tumorigenesis. Activated c-K ras oncogenes have been detected in human tumors at different stages of progression, including premalignant neoplasms. These studies provide evidence for the involvement of somatic mutational activation of this ras gene in the early stages of tumor development in some types of human cancer. We discuss here the structural and functional features of the human c-K-ras gene and the involvement of its activated form in human cancer. PMID- 3310852 TI - [Ultrasound-guided percutaneous ureterostomy]. AB - The authors present a new technique for percutaneous insertion of a drain into the upper urinary tract, using the direct lumbar transureteric approach under ultrasonographic control. This ultrasound-guided percutaneous ureterostomy was performed in two patients to drain the upper urinary tract and to evaluate the adjacent renal parenchyma. In both cases, ureterostomy was preferred to nephrostomy because of the difficulties of performing the latter operation and because of the considerable dilatation of the ureter. PMID- 3310853 TI - Mendelian etiologies of stroke. AB - There are many genetic disorders associated with an increased risk for stroke that may easily be overlooked in the evaluation of both adult and pediatric acute stroke victims. The recognition of a genetic disorder as the cause of a stroke has important implications not only for the immediate care of the stroke victim, but often also for others in the patient's family who may be at risk for the same disease and for whom preventive measures sometimes can be taken. We present here a comprehensive review of genetic disorders associated with stroke in the nongeriatric age groups for which a causative role in the evolution of stroke has been recognized or is likely. For each disorder, the major clinical and biochemical characteristics as well as the probable pathogenetic mechanisms of stroke are discussed, together with the appropriate testing required to screen for and confirm the diagnosis. The great variety of genetic disorders and mechanisms causing stroke underscores the increasing importance of understanding genetic disease for appropriate diagnosis and treatment of a common clinical problem affecting both children and adults. PMID- 3310854 TI - Lambert-Eaton myasthenic syndrome: II. Immunoelectron microscopy localization of IgG at the mouse motor end-plate. AB - The autoimmune origin of the Lambert-Eaton myasthenic syndrome (LEMS) was documented by passive transfer of its electrophysiological features from humans to mice with IgG. Freeze-fracture electron microscopy has demonstrated a loss of active-zone particles in human LEMS and in its mouse passive transfer model. These data imply that the active zones are targets of the pathogenic LEMS autoantibodies. Immunolocalization of the antibodies has been hindered, however, by a paucity of active-zone particles (about 50/micron2 normally and still lower in LEMS) and by diffusion artifacts in the immunoperoxidase method. To obviate these problems, we employed sensitive avidin-biotin detection systems, both peroxidase and ferritin labels, and quantitative immunoelectron microscopy and end-plate morphometry. We compared mice treated with LEMS IgG, control IgG, and no IgG. In all mice, nonspecific background staining was found in the basal lamina covering the muscle fibers and Schwann cells. When a single 10-mg dose of IgG was injected intravenously, IgG samples from 12 patients produced significant immunostaining of the mouse active zones; from 7 patients they did not. Higher doses of intraperitoneally injected IgG (20 mg, three times a day for 2 days, or 10 mg/day for 15 days) from each of 4 patients (3 of whose IgG previously transferred LEMS to mice) caused significant immunostaining of mouse active zones: (1) the mean density (no./micron presynaptic membrane length) of positive active zones was 0.91 in the immunoferritin study and 0.72 in the immunoperoxidase study (control values, 0.12 and 0.02); and (2) 43% of the ferritin particles in the primary cleft were concentrated at the active zones and the rest were scattered randomly (control value, 5.3%). The findings indicate that LEMS IgG binds to the active zones of the presynaptic membrane. PMID- 3310856 TI - Therapy of Kaposi's sarcoma. PMID- 3310855 TI - [Paleodontologic study of skeletal findings at Takht-i Suleiman, West Iran]. AB - Within this paleodontological study 26 Achemenid and 8 Islamic skeletons from the excavations at Tahkt-i Suleiman (Western Iran) were investigated. The diagnosis of age and sex was done repeatedly according to various methods. The adult Achemenids reached an average age of 54.4 years (n = 16; SD = +/- 9.9 y), while the Islamic adult individuals reached a lifespan of 36.9 (n = 8; SD = +/- 11.0 y). The skeletons of the Achemenid children had an average of 6.8 years (n = 9; SD = +/- 3.3 y). In the specific dental investigations the teeth of all skeletons were checked for missing teeth or dental diseases or alterations of the jaws. For the whole series intravital loss of 19.3% of the teeth was found. 21.6% of the teeth were lost postmortally. The intravital loss of single teeth was 21.9% in the Achemenid teeth, disregarding the wisdom tooth and Dentes decidui; the respective value was 12% in the Islamic skeletons. The investigation for caries yielded a morbidity of 50% in the Achemenid skeletons, and 57% in the Islamic teeth. The frequency of caries was 6.2% in Achemenids and 9% in Islamic individuals. In the Dentes decidui the frequency of caries was found to be 3.6%. Dental tartar was present in 44.8% of the teeth, 42% of Achemenid teeth and 58% of Islamic teeth being affected. 33% of all teeth showed garlands of dental tartar. Signs of parodontolysis were investigated considering the health of the individual and the preservation of the skeleton. All adult teeth showed age dependent parodontolysis, the means of which were quantified. PMID- 3310857 TI - Role of the human immunodeficiency virus in the physiopathology of AIDS. PMID- 3310858 TI - Neuropsychological and psychosocial sequelae of AIDS. PMID- 3310859 TI - Anti-LAV/HTLV-III antibodies in high and low risk groups. PMID- 3310860 TI - Recombinant DNA-coded antigens: second-generation tests for the diagnosis of HTLV III infection. PMID- 3310861 TI - Antiviral and immunomodulator therapy of the acquired immune deficiency syndrome. PMID- 3310862 TI - AIDS surveillance in Europe. PMID- 3310863 TI - Some epidemiological and clinical characteristics of African AIDS. PMID- 3310864 TI - Pediatric AIDS. PMID- 3310865 TI - Epidemiology of AIDS in hemophiliacs and blood transfusion recipients. PMID- 3310866 TI - Malignant neoplasms associated with the HTLV-III/LAV infection. PMID- 3310867 TI - Interaction of (2,3)-methylenepenams with penicillin-binding proteins. AB - A series of (2,3)-methylenepenams were examined with respect to binding to essential penicillin-binding proteins (PBPs) in Escherichia coli and Staphylococcus aureus. The compounds were also examined with respect to their interaction with Streptomyces strain R61 DD-carboxypeptidase. The alpha isomer of (2,3)-methylene penicillin G bound to PBP 3 of E. coli and other enterobacteria at 0.1 to 10 micrograms/ml. The beta isomer bound to PBP 3 at 100 micrograms/ml. Either isomer bound to PBPs 1b and 2 of E. coli only at 100 micrograms/ml. The alpha, but not the beta, isomer also bound to PBP 2 of S. aureus at 0.1 micrograms/ml. Binding studies with radiolabeled compounds indicated the binding to be covalent and revealed no additional binding proteins. (2,3)-Methylenepenams active against E. coli bound to PBP 3 and induced filamentation. The compounds also inhibited Streptomyces strain R61 DD-carboxypeptidase with apparent 50% inhibitory concentrations as low as 10(-7) M. The two (2,3)-methylene penicillin G isomers bound to the enzyme covalently, most likely at the same site as penicillin G since partial proteolysis after binding radiolabeled compounds produced similar peptide patterns. The bound beta isomer was released with a half time similar to that of penicillin G (70 min at 30 degrees C), while the alpha isomer was released with a longer half-time (13 h at 30 degrees C). With either isomer, the major release product was phenylacetylglycine, suggesting C-5-C-6 cleavage. PMID- 3310868 TI - In vitro and in vivo antibacterial activities of CS-807, a new oral cephalosporin. AB - CS-807 is a new oral prodrug of R-3746, a cephalosporin derivative, with potent in vitro and in vivo antibacterial activity against both gram-positive and gram negative bacteria. The susceptibility of about 1,200 clinical isolates to R-3746 was determined by the agar dilution method. Ninety percent or more of pathogens such as Staphylococcus aureus, streptococci, Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, indole-positive and indole-negative Proteus spp., Providencia rettgeri, and Haemophilus influenzae were inhibited at concentrations ranging less than or equal to 0.01 to 1.56 micrograms/ml. Furthermore, at a concentration of 3.13 micrograms/ml, 50% or more of Staphylococcus epidermidis, Morganella morganii, Citrobacter freundii, and Serratia marcescens strains were also inhibited. Pseudomonas aeruginosa and Xanthomonas maltophilia were resistant to R-3746. The activity of R-3746 was scarcely influenced by several growth conditions. R-3746 was highly resistant to hydrolysis by beta-lactamases derived from various species of bacteria. Killing-curve studies demonstrated bactericidal activity of R-3746 at concentrations above the MIC. R-3746 showed high affinity for penicillin-binding proteins 1, 3, and 4 of Staphylococcus aureus and 1A, 1Bs, and 3 of Escherichia coli. Systemic infections in mice caused by various pathogens, including beta-lactamase-producing strains, responded well to therapy with oral doses of CS-807. PMID- 3310869 TI - Influence of beta-lactam antibiotics and ciprofloxacin on cell envelope of Escherichia coli. AB - The effects of subinhibitory concentrations of different beta-lactam antibiotics and one quinolone on the quantitative composition of the outer membrane (OM) of two strains of Escherichia coli, on lipid translocation into the OM, and on the production of capsular K1 polysaccharide were studied. The phospholipid/amino acid ratio was reduced in almost all OM preparations from antibiotic-treated bacteria. In one strain, antibiotic treatment increased the lipopolysaccharide/amino acid ratio. The amount of peptidoglycan fragments bound to the OM was increased by all the antibiotics. In pulse-chase experiments with a radioactive lipid precursor, ciprofloxacin, imipenem, and aztreonam inhibited phospholipid translocation into the OM. Furthermore, imipenem, cephaloridine, and ciprofloxacin induced a pronounced reduction of the production of capsular K1 polysaccharide. Thus, antibiotics seem to induce marked changes of the quantitative composition of the cell envelope of E. coli. Possible connections of these data with findings on the influence of antibiotics on functional parameters of the host-parasite relationship such as OM immunogenicity and serum resistance are discussed. PMID- 3310870 TI - Therapy of genital herpes with topically applied interferon. AB - Ninety-four patients with recurrences of genital herpes were randomized in a double-blind trial to receive topical therapy for 5 days with either alpha-2a interferon at 30 X 10(6) IU/ml or 10 X 10(6) IU/ml or placebo six times daily. No differences were noted between either interferon dose and placebo with respect to the duration of viral shedding, the time to crusting, or the time to healing of herpetic lesions. Aqueous solutions of alpha-2a interferon applied topically to unroofed vesicles do not appear to be clinically useful in the treatment of recurrences of genital herpes. PMID- 3310872 TI - When does sucrose increase appetite and adiposity? AB - Two methods of sucrose feeding have been employed in studies with rodents. In the nutritional method, part or all of the starch in a diet is replaced with sucrose. In the solution method, animals maintained on a nutritionally complete diet are given a sucrose solution to drink. The solution method is generally a more effective and reliable method of producing obesity except for weanling rodents. These two methods yield different results with regard to interactions with the fat and protein content of the diet, efficiency of weight gain, disaccharide effects and effects of meal feeding. It is suggested that for the nutritional method, sucrose alters food intake and adiposity via its effects on fat oxidation. For the solution method, the critical factor may be presenting a wet source of calories rather than sucrose per se. Differences in the way sucrose is fed do not account for all divergent results. Different investigators conducting similar experiments have often obtained different results. For these and other reasons, animal studies do not support the idea that sucrose intake causes obesity in humans. PMID- 3310871 TI - Empirical antibiotic therapy in the febrile neutropenic cancer patient: clinical efficacy and impact of monotherapy. PMID- 3310873 TI - Radiation-induced polymerization for the immobilization of penicillin acylase. AB - The immobilization of Escherichia coli penicillin acylase (EC 3.5.1.11) was investigated by radiation-induced polymerization of 2-hydroxyethyl methacrylate at low temperature. A leak-proof composite that does not swell in water was obtained by adding the cross-linking agent trimethylolpropane trimethacrylate to the monomer-aqueous enzyme mixture. Penicillin acylase, which was immobilized with greater than 70% yield, possessed a higher Km value toward the substrate 6 nitro-3-phenylacetamidobenzoic acid than the free enzyme form (Km = 1.7 X 10(-5) and 1 X 10(-5) M, respectively). The structural stability of immobilized penicillin acylase, as assessed by heat, guanidinium chloride, and pH denaturation profiles, was very similar to that of the free-enzyme form, thus suggesting that penicillin acylase was entrapped in its native state into aqueous free spaces of the polymer matrix. PMID- 3310874 TI - Enzyme-catalyzed, gas-phase reactions. AB - Dehydrated preparations of alcohol oxidase adsorbed on DEAE-cellulose vigorously catalyze a gas-phase oxidation of ethanol vapors with molecular oxygen. The gas phase reaction is strongly dependent on the water activity of the system. The enzymatic activity is severely inhibited by the product hydrogen peroxide. This inhibition can be alleviated, however, by an addition of catalase or peroxidase to the dry preparation. Such dehydrated, bienzymic catalysts afford a complete and selective conversion of the substrate to acetaldehyde. Dry alcohol oxidase is much more thermostable than in aqueous solution. The results of this work suggest that dehydrated enzymes have potential applications in the analysis of gaseous compounds and in the development of novel gas-solid bioreactors. PMID- 3310876 TI - Abstracts. 25th annual meeting of the Japanese Society for Stereotactic and Functional Neurosurgery. Tokyo, September 1986. PMID- 3310877 TI - Computerized tomography-guided stereotactic dentatotomy. AB - The CT stereotactic technique of dentatotomy is described and illustrated with two examples. With this combined technique, ventriculography or pneumencephalography is no longer needed to determine the target point. In addition, due to the direct representation of anatomic structures in the CT, abnormal positions of the dentate nucleus may be taken into consideration in the determination of the target point and approach for the coagulation probe. PMID- 3310875 TI - Immobilized bacterial luciferase and its applications. AB - This review discusses the properties of the bioluminescent bacterial system as well as the methods for immobilization of bacterial luciferases and for their co immobilization with other enzymes. The analytical systems using immobilized bacterial luciferases and their applications in analytical biochemistry and biotechnology have been described. PMID- 3310878 TI - Somatosensory evoked potentials in the ventrolateral thalamus. AB - Within the target area (VL) used for the stereotactic treatment of parkinsonian tremor and spasmodic torticollis, electrical stimulation as well as recording of somatosensory evoked potential (SEP) was performed. The effects of stimulation in the target area are facilitation of muscle tone showing some degree of somatotopic distribution. The recorded SEPs indicate a projection of an afferent system (probably of muscle afferents) to the target area. We assume that the target area is a relay station involved in the control of muscle tone. The interruption of muscle afferents in combination with the correct somatotopic localization of the lesion is important for the therapeutic efficacy in parkinsonian tremor and spasmodic torticollis. PMID- 3310879 TI - Reproducibility of repeated mountings of a noninvasive CT/MRI stereoadapter. AB - The reproducibility of a noninvasive computed tomography (CT)/magnetic resonance imaging stereoadapter was tested on 12 healthy volunteers. The adapter was easy to mount and detach without discomfort. Two repeated mountings of the adapter showed a good reproducibility in relation to the scalp. When extrapolated to a hypothetical target in the right thalamus, the mean differences between the two mountings were 0.07 mm in the lateral, 0.16 mm in the anteroposterior and 0.17 mm in the height coordinates. This high degree of reproducibility seems to permit a safe CT-guided functional stereotaxis, where the preoperative CT scanning can take place on one day and the surgery may be performed on any other suitable day. PMID- 3310880 TI - Plasmid stability in immobilized and free recombinant Escherichia coli JM105(pKK223-200): importance of oxygen diffusion, growth rate, and plasmid copy number. AB - Stability of the plasmid pKK223-200 in Escherichia coli JM105 was studied for both free and immobilized cells during continuous culture. The relationship between plasmid copy number, xylanase activity, which was coded for by the plasmid, and growth rate and culture conditions involved complex interactions which determined the plasmid stability. Generally, the plasmid stability was enhanced in cultured immobilized cells compared with free-cell cultures. This stability was associated with modified plasmid copy number, depending on the media used. Hypotheses are presented concerning the different plasmid instability kinetics observed in free-cell cultures which involve the antagonistic effects of plasmid copy number and plasmid presence on the plasmid-bearing/plasmid-free cell growth rate ratio. Both diffusional limitation in carrageenan gel beads, which is described in Theoretical Analysis of Immobilized-Cell Growth, and compartmentalized growth of immobilized cells are proposed to explain plasmid stability in immobilized cells. PMID- 3310882 TI - Degradation of the framework of the Chlamydomonas cell wall by proteases present in a commercially available alpha-amylase preparation. AB - A commercially available alpha-amylase derived from Bacillus licheniformis contained an enzymatic activity able to degrade the inner portion or framework of the cell wall of Chlamydomonas reinhardtii. Both the wall-degrading activity and the contaminating protease were destroyed by heating the alpha-amylase preparation at 90 degrees C for 30 min. Since the alpha-amylase activity was uneffected by heat treatment, we conclude that it was not the alpha-amylase but the contaminating protease in the preparation that was responsible for the cell wall-degrading activity. PMID- 3310881 TI - Small rodents and other mammals associated with mountain meadows as reservoirs of Giardia spp. and Campylobacter spp. AB - Sixty-five percent (469 of 722) of the fecal samples collected from small rodents in the central Washington Cascade mountains were positive for Giardia spp. Trapping studies showed that microtines of the genus Microtus were heavily infected with the parasite. Morphologically the cysts and trophozoites were of the Giardia duodenalis type. Small-rodent populations appear to maintain their infection throughout the year. Our data suggest that there is no difference in the percentage of positive animals in areas receiving a lot of human use as opposed to animals in those areas receiving very little or no human use. Giardia spp. were also found in elk and beaver fecal samples. Campylobacter spp. were recovered infrequently from the small rodents inhabiting alpine meadows. Of 551 specimens cultured, less than 1% were positive for the bacterium, and the isolates were identified as Campylobacter coli. Water voles were susceptible to a human isolate of Campylobacter jejuni and shed the bacterium for several weeks. C. jejuni was also isolated from a bear fecal sample collected from a protected watershed. Our studies indicate that microtines and possibly other small rodents inhabiting mountain meadows have a potential to act as a reservoir for both Giardia spp. and Campylobacter spp. Because these animals may carry human pathogens, they should be included in animal surveys designed to assess the health risks associated with mountain watersheds. PMID- 3310883 TI - Hydrogenase activity in aged, nonviable Desulfovibrio vulgaris cultures and its significance in anaerobic biocorrosion. AB - Batch cultures of Desulfovibrio vulgaris stored at 32 degrees C for 10 months have been found to retain 50% of the hydrogenase activity of a 1-day culture. The hydrogenase found in old cultures needs reducing conditions for its activation. Viable cell counts are negative after 6 months, showing that the hydrogenase activity does not depend on the presence of viable cells. These observations are of importance in the understanding of anaerobic biocorrosion of metals caused by depolarization phenomena. PMID- 3310884 TI - Marine bacteria which produce tetrodotoxin. AB - A number of type strains of marine bacteria, including members of the family Vibrionaceae, were cultured and examined for tetrodotoxin productivity by high performance liquid chromatography and gas chromatography-mass spectrometry. Most of the Vibrionaceae strains produced tetrodotoxin, anhydrotetrodotoxin, or both. PMID- 3310885 TI - Survival of Candida albicans in tropical marine and fresh waters. AB - A survey of Candida albicans indicated that the organism was present at all sites sampled in a rain forest stream and in near-shore coastal waters of Puerto Rico. In the rain forest watershed no relationship existed between densities of fecal coliforms and densities of C. albicans. At two pristine sites in the rain forest watershed both C. albicans and Escherichia coli survived in diffusion chambers for extended periods of time. In near-shore coastal waters C. albicans and E. coli survival times in diffusion chambers were enhanced by effluent from a rum distillery. The rum distillery effluent had a greater effect on E. coli than on C. albicans survival in the diffusion chambers. These studies show that neither E. coli nor C. albicans organisms are good indicators of recent fecal contamination in tropical waters. It further demonstrates that pristine freshwater environments and marine waters receiving organic loading in the tropics can support densities of C. albicans which may be a health hazard. PMID- 3310886 TI - Presence of Giardia spp. and absence of Salmonella spp. in New Jersey muskrats (Ondatra zibethicus). AB - Of 220 muskrat fecal specimens collected from 12 sites in southwestern New Jersey, 154 (70%) were found to contain cysts of the protozoan parasite Giardia spp. Cysts from selected muskrat fecal specimens infected Mongolian gerbils, but attempts to cultivate trophozoites removed from these gerbils were unsuccessful. Salmonella spp. were not detected in any of the muskrat fecal specimens. PMID- 3310887 TI - Isolation and characterization of mutants blocked in T-2 toxin biosynthesis. AB - Mutants of Fusarium sporotrichioides NRRL 3299 that were blocked or altered in the biosynthesis of the trichothecene T-2 toxin were generated by UV treatment and identified by a rapid screen in which monoclonal antibodies to T-2 were used. Three stable mutants were isolated and chemically characterized. Two mutants accumulated diacetoxyscirpenol, which suggests that they were defective in the step required for the addition of a hydroxyl group to the C-8 position in the trichothecene core structure. The third mutant appeared to be partially blocked at an early step or regulatory point in the pathway. This represents the first isolation of mutants in a trichothecene biosynthetic pathway. PMID- 3310888 TI - The action of sodium deoxycholate on Escherichia coli. AB - Sodium deoxycholate is used in a number of bacteriological media for the isolation and classification of gram-negative bacteria from food and the environment. Initial experiments to study the effect of deoxycholate on the growth parameters of Escherichia coli showed an increase in the lag time constant and generation time and a decrease in the growth rate constant and total cell yield of this microorganism. Cell fractionation studies indicated that sodium deoxycholate at levels used in bacteriological media interferes with the incorporation of [U-14C]glucose into the cold-trichloroacetic acid-soluble, ethanol-soluble, and trypsin-soluble cellular fractions of E. coli. Finally, sodium deoxycholate interfered with the flagellation and motility of Proteus mirabilis and E. coli. It would appear then that further improvement of the deoxycholate medium may be in order. PMID- 3310889 TI - Glucose-6-phosphate dehydrogenase alloenzymes and their relationship to pigmentation in Serratia marcescens. AB - A comparative study of environmental and clinical isolates of Serratia marcescens was undertaken with regard to glucose-6-phosphate dehydrogenase (G6PD) electrophoretic mobility and the production of prodigiosin. Two electromorphs of G6PD with electrophoretic mobilities of 0.22 and 0.30 were detected. G6PD electrophoretic type showed a good correlation with the ability to produce prodigiosin. PMID- 3310890 TI - Multiple proteases from Streptomyces moderatus. I. Isolation and purification of five extracellular proteases. AB - The presence of multiple proteases in the culture filtrate of Streptomyces moderatus was detected. After preliminary purification by ammonium sulfate precipitation and decolorization using DEAE-cellulose, the fractionation of various proteases was carried out using CM-trisacryl cation-exchange chromatography. By this procedure, four different protease fractions (Fr.) were separated (Fr. I, II, III, and IV). The first fraction was further separated into two different proteolytically active fractions (Fr. IA and Fr. Ib) by DEAE trisacryl anion-exchange chromatography. Fraction Ia was purified further by affinity chromatography on N-carbobenzoxy-D-phenylalanyl triethylenetetramine Sepharose 4B. The second fraction (Fr. Ib) was purified by gel filtration on Ultrogel AcA 44. For the purification of the other protease fractions (Fr. II, III, and IV) single-step affinity chromatography methods were employed. Protease fractions II and III were purified by epsilon-aminocaproyl-4-(4 aminophenylazo)phenylarsonic acid Sepharose 4B and protease fraction IV was purified on epsilon-aminocaproyl trialanine-Sepharose 4B. All five proteases purified were found to be apparently homogeneous by gel electrophoretic methods. PMID- 3310891 TI - Multiple proteases from Streptomyces moderatus. II. Physicochemical and enzymatic properties of the extracellular proteases. AB - The physicochemical and enzymatic properties of five different extracellular proteases of Streptomyces moderatus were studied. The first protease was found to be a metal chelator sensitive protease with a Mr of 21,000 +/- 1000 a and a pI of 4.6. The second enzyme was an anionic trypsin-like protease (Mr 19,000 +/- 1000; pI 3.8) with a Km value of 4.76 X 10(-4) M on N-benzoyl-L-arginine-p nitroanilide. A Km value of 1.52 X 10(-4) M was obtained when N-benzoyl-L arginine ethyl ester was used as the substrate. The other three enzymes were found to be serine alkaline proteases with Mr's of 22,000, 29,000, and 23,000 +/- 1000 and with respective pI's of 7.8, 8.4, and 9.2. All the proteases showed optimum activity in the alkaline pH range. One of the three proteases was found to possess chymotrypsin and elastase-like properties. All five proteases were found to be unstable at temperatures above 60 degrees C. Except the trypsin-like protease, which was stable only in acidic pH, all other enzymes were found to be stable over a wide range of pH. PMID- 3310892 TI - Induction and inactivation of catalase and superoxide dismutase of Escherichia coli by ozone. AB - Oxyradicals have been implicated in ozone (O3) toxicity and in other oxidant stress. In this study, we investigated the effects of O3 on the biosynthesis of the antioxidant enzymes catalase and superoxide dismutase in Escherichia coli to determine their role in the defense against ozone toxicity. Inhibition of growth and loss of viability were observed in cultures exposed to ozone. Results also showed an increase in the activities of catalase and superoxide dismutase in cultures exposed to ozone, which was shown to be due to true induction rather than activation of preexisting apoproteins. Cessation of O3 exposure resulted in 30 min of continual high rate of catalase biosynthesis followed by a gradual decrease in the level of the enzyme approaching that of control cultures. This decrease was attributed to a concomitant cessation of de novo enzyme synthesis and dilution of preexisting enzyme by cellular growth. Ozonation of cell-free extracts showed that superoxide dismutase and catalase are subject to oxidative inactivation by ozone. In vivo induction of these enzymes may represent an adaptive response evolved to protect cells against ozone toxicity. PMID- 3310893 TI - A single-step large-scale purification of pyruvate oxidase. AB - Pyruvate oxidase is an Escherichia coli peripheral membrane flavoprotein which catalyzes the oxidative decarboxylation of pyruvate to acetate and CO2. Pyruvate oxidase, like several other peripheral membrane enzymes, can be activated either by binding to lipid amphiphiles or by limited protease digestion. This paper reports a rapid and convenient method for effecting the large-scale purification of pyruvate oxidase from crude enzyme preparations using a Triton X-114 phase separation technique. It appears likely that this purification procedure can be used successfully with the family of enzymes which respond to both lipid and protease activation. PMID- 3310894 TI - 1H NMR studies of insulin: histidine residues, metal binding, and dissociation in alkaline solution. AB - The shifts of the H2 histidine B5 and B10 resonances of 2-Zn insulin hexamer were followed in 2H2O by 1H NMR spectroscopy at 270 MHz from pH 9.85 to 7. The two resonances present at high pH, previously assigned to H2 histidine B5 and B10 residues, moved slightly downfield and split into four resonances at pH 8.95 and also at pH 7. By use of a paramagnetic broadening probe (Mn2+) and the addition of Zn2+ to metal-free insulin, it was deduced that the four resonances arose from histidines B10 and B5 in two different magnetic environments, probably either bound to Zn2+ or not bound to Zn2+. The pK' values of the B5 and B10 histidines were determined in 60% 2H2O-40% dioxan, in which insulin was soluble throughout the pH range, to be 7.1 and 6.8, respectively at 37 degrees C. Studies at higher pH indicated that at a concentration level suitable for 1H NMR (approximately 1 mM) at 37 degrees C in 2H2O the 2-Zn hexamer was largely dissociated to dimer at pH 10.3 and to monomer at pH 10.8. Addition of paramagnetic shift probe Ni2+ to metal-free insulin caused changes to the spectrum similar to those produced on addition of diamagnetic Zn2+. Addition of Co2+ gave a different result, but there was no paramagnetic shift of the H2 histidine B10 resonance, probably because of rapid exchange at the binding site. Addition of Cd2+ and of Cd2+ and Ca2+ produced changes that were similar to each other but were different from those observed on addition of Zn2+, probably due to the binding of Cd2+ and Ca2+ at glutamate B13. PMID- 3310897 TI - The phosphoenolpyruvate carboxykinase of Trypanosoma (Schizotrypanum) cruzi epimastigotes: molecular, kinetic, and regulatory properties. AB - The phosphoenolpyruvate carboxykinase (ATP:oxaloacetate carboxy-lyase (transphosphorylating), EC 4.1.1.49) of the epimastigote form of Trypanosoma (Schizotrypanum) cruzi has been purified to homogeneity. The enzyme is composed of two apparently identical 42,000 +/- 500 subunits, is highly specific for adenine nucleotides, and has a strict requirement of Mn2+ ions for activity; the activation of the enzyme by ionic Mn2+ reveals that one Mn2+ ion required for each 42,000 subunit. Hyperbolic kinetics are observed for all substrates in the carboxylation reaction with Km (phosphoenolpyruvate) of 0.36 +/- 0.08 mM, Km (HCO 3) of 3.7 +/- 0.2 mM, and Km (Mg-ADP) of 39 +/- 1 microM. In the decarboxylation reaction the kinetics with respect to oxalacetic acid are also hyperbolic with a Km of 27 +/- 3 microM, but towards Mg-ATP there is a biphasic response: hyperbolic at low (less than 250 microM) concentrations with a Km of 39 +/- 1 microM, but at higher concentrations the nucleotide produces a strong inhibition of the enzyme activity. This inhibition is also observed with Mg-GTP and Mg-ITP which are not substrates of the reaction. The results are consistent with an important regulatory function of the enzyme in the amino-acid catabolism of T. cruzi. PMID- 3310895 TI - Distribution of chymoelastases and trypsin-like enzymes in five species of entomopathogenic deuteromycetes. AB - Nine isolates of the entomopathogenic deuteromycetes Metarhizium anisopliae, Beauveria bassiana, Verticillium lecanii, Nomuraea rileyi, and Aschersonia aleyrodis produced basic (pI greater than 7.0) chymoelastases that possessed extended binding sites, comprising at least four or five subsites, with preference for hydrophobic residues at the primary binding site. Most isolates also produced additional acidic enzymes with similar specificities against ester and amide substrates but which lacked activity against elastin. Both acidic and basic enzymes degraded high protein azure or locust cuticle and, as shown by inhibition studies, possessed essential serine and histidine residues in the active site. In spite of similarities in catalytic properties antibodies generated against a Metarhizium chymoelastase cross-reacted only with enzymes from two (out of four) Metarhizium isolates; enzymes from all other isolates did not cross-react. Two isolates of Metarhizium produced a third class of protease which degraded Bz-AA-AA-Arg-NA substrates (AA, various amino acids) and hide protein azure. Analogous peptidases were produced by other isolates but they were specific for Bz-Phe-Val-Arg-NA and showed less sensitivity to trypsin inhibitors. The possible significance to pathology of the presence of diverse yet similar protease forms in five genera of entomopathogens is discussed. PMID- 3310896 TI - Purification of microsomal epoxide hydrolase from liver of rhesus monkey: partial separation of cis- and trans-stilbene oxide hydrolase. AB - Solubilized rhesus monkey liver microsomes were used as the starting material for the purification of epoxide (cis-stilbene oxide) hydrolase. Successive chromatography over DEAE-Sephacel followed by CM-cellulose resulted in two peaks of activity, CM A and CM B. Passage of these two eluates over separate hydroxyapatite columns resulted in two peaks of activity from CM A, HA A1, and HA A2, and one peak from CM B and HA B, with respective recoveries of 1, 7, and 0.2% of cis-stilbene oxide hydrolase activities. A similar recovery was found for benzo[a]pyrene-4,5-oxide hydrolase, while trans-stilbene oxide hydrolase activity coeluted only in HA A2. Fraction HA A1 was homogeneous as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Immunoblots of the three eluates and solubilized microsomes incubated with anti-HA A1 demonstrated a single band at 49 kDa in each fraction. The three eluates were differentially affected by the inhibitors of epoxide hydrolase, trichloropropene oxide and 4 phenylchalcone oxide, and addition of Lubrol PX and phospholipid. Immunoprecipitation of HA A2 resulted in coprecipitation of cis- and trans stilbene oxide hydrolase activity. Upon immunoprecipitation of solubilized microsomes, all the cis-stilbene oxide and benzo[a]pyrene-4,5-oxide, but only 50 60% of trans-stilbene oxide hydrolase activity was precipitated. These studies support findings with other species that (i) an immunochemically distinct cytosolic-like epoxide hydrolase exists in microsomes, and (ii) microsomal epoxide hydrolase activity can be separated during ion-exchange chromatography giving proteins with similar molecular weights and immunochemical cross reactivity. The precipitation of cis- and trans-stilbene oxide hydrolase activity in eluate HA A2 provides convincing evidence that these isozymes are not structurally identical. PMID- 3310898 TI - Pectate lyase from Fusarium solani f. sp. pisi: purification, characterization, in vitro translation of the mRNA, and involvement in pathogenicity. AB - Since indirect experimental evidence suggested that penetration of Fusarium solani f. sp. pisi into its host (Pisum sativum) involved pectin-degrading enzymes (W. Koller, C. R. Allan, and P. E. Kolattukudy (1982) Physiol, Plant Pathol. 20, 47-60), direct tests were made for the production of such degradative enzymes by this pathogen. When the organism was grown on pectin, a pectate lyase (EC 4.2.2.2) was released into the media. This lyase was purified to apparent homogeneity from the culture filtrate by a two-step process involving passage through DEAE-Sephacel followed by hydrophobic interaction chromatography on octyl Sepharose. The enzyme cleaved polygalacturonate chains in an endo fashion. The molecular mass of the mature extracellular form of this enzyme was estimated to be 26 kDa. The isoelectric point of the enzyme was 8.3 and the optimum pH for activity was 9.4. Calcium was required for activity and evidence is presented that calcium probably interacts with the substrate rather than the enzyme. When antibodies prepared against this enzyme were used for Western blot analysis of the extracellular culture fluid, a single band was observed at 26 kDa. Following in vitro translation of poly(A)+ RNA, a 29-kDa precursor polypeptide was precipitated by the antibodies. Antibodies inhibited both the catalytic activity of the enzyme and the ability of the fungus to infect pea stems, strongly suggesting that this lyase is involved in pathogenesis. PMID- 3310899 TI - Reaction of 5-enol-pyruvoylshikimate-3-phosphate synthase with diethyl pyrocarbonate: evidence for an essential histidine residue. AB - 5-enol-Pyruvoylshikimate-3-phosphate synthase catalyzes the reversible condensation of phosphoenolpyruvate and shikimate 3-phosphate to yield 5-enol pyruvoylshikimate 3-phosphate and inorganic phosphate. The enzyme is a target for the nonselective herbicide glyphosate (N-phosphonomethylglycine). Diethyl pyrocarbonate inactivated this enzyme with a second-order rate constant of 220 M 1 min-1 at pH 7.0 and 0 degrees C. The rate of inactivation is pH dependent and the pH inactivation rate data show the involvement of a group with a pKa of 6.8. Almost all of the original activity was recovered by treatment of the inactivated enzyme with hydroxylamine. The difference spectrum of the inactivated and native enzyme reveals a single peak at 242 nm but no trough at around 278 nm is observed. Complete inactivation required the modification of four histidine residues per molecule of the enzyme. However, statistical analysis of the residual activity and the extent of modification shows that among the four modifiable residues, only one is critical for activity. Furthermore, this inactivation is prevented by the substrates of the enzyme. The above results indicated that one histidine is located within or very close to the active site and may play an important role in catalysis. PMID- 3310900 TI - Carbohydrate analysis of chicken heart glycolipids. AB - Neutral and acidic glycolipids were extracted from chicken hearts. The neutral and acidic compounds were separated by preparative thin-layer chromatography into eight and two fractions, respectively. Total hydrolysis by mineral acid, permethylation analysis, and sequential cleavage with exoglycosidases showed the presence of glycolipids that belong to the globo- and gala-oligosaccharide series, i.e., the monohexosylceramides Glc-Cer and Gal-Cer, the dihexosylceramides Gal beta 1-4Glc-Cer and Gal alpha 1-4Gal-Cer, the tetrahexosylceramides GalNAc beta 1-3Gal alpha 1-4Gal beta 1-4Glc-Cer and GalNAc alpha 1-3GalNAc beta 1-3Gal alpha 1-4Gal-Cer (III3GalNAc alpha-Ga3Cer) and four subfractions of the Forssman glycolipid GalNAc alpha 1-3GalNAc beta 1-3Gal alpha 1-4Gal beta 1-4Glc-Cer. With the notable exception of III3GalNAc alpha 1-Ga3Cer, all glycolipids with terminal GalNAc alpha 1-3GalNAc1 reacted on thin-layer chromatograms with a monoclonal anti-Forssman antibody. The major components of the acidic fraction glycolipids were characterized as the lactose-based gangliosides Glac1 (GM3) and Glac2 (GD3). PMID- 3310902 TI - Purification and characterization of ethanol-inducible human hepatic cytochrome P 450HLj. AB - Human hepatic cytochrome P-450HLj was purified in a catalytically active state from microsomes obtained from an ethanol-intoxicated man. The electrophoretically homogeneous preparation of HLj was compared to rat P-450j and found to have a slightly different apparent molecular mass (54 vs 51.5 kDa) but highly similar immunochemical, spectral, and catalytic properties. Purified HLj exhibited high activity toward N-nitro-sodimethylamine (NDMA) and aniline metabolism, low but measurable activity toward benzphetamine and 7-ethoxycoumarin, and no detectable activity toward benzo[a]pyrene, testosterone, and progesterone. Antibody against rat P-450j reacted with HLj in immunoblot analyses and, when added directly to HLj before reconstitution with NADPH-cytochrome P-450 reductase and lipid, the antibody inhibited (96%) NDMA metabolism by HLj almost completely. However, if HLj was reconstituted with the other components before the addition of the anti-P 450j IgG, the ability of the antibody to inhibit the metabolism of NDMA was greatly diminished. This suggests that the interactions between reductase and HLj are similar to those previously observed between rat P-450j and reductase, and appear to prevent the complete access of anti-P-450j. The addition of cytochrome b5 to reconstitution systems containing HLj resulted in a small increase in the Vmax from NDMA demethylation accompanied by a decrease in Km,app (1.3 to 0.3 mM) as has been observed in reconstitution systems with rat P-450j. Therefore, in reconstituted systems, cytochrome b5 appears to play an important role in the biotransformations mediated by HLj and P-450j. In conclusion, this study demonstrates that HLj is functionally related to ethanol-inducible rat P-450j and rabbit LM3a. PMID- 3310901 TI - Metabolism of monoterpenes: specificity of the dehydrogenases responsible for the biosynthesis of camphor, 3-thujone, and 3-isothujone. AB - Sage (Salvia officinalis) is shown to contain two electrophoretically distinct dehydrogenases for the respective oxidations of (+)-borneol to (+)-camphor, and of (+)-cis-sabinol to (+)-sabinone en route to (-)-3-isothujone. Similarly, tansy (Tanacetum vulgare) is shown to contain two electrophoretically distinct dehydrogenases for the respective oxidations of (-)-borneol to (-)-camphor and of (+)-cis-sabinol to (+)-sabinone en route to (+)-3-thujone. These results demonstrate that separate dehydrogenases are responsible for the biosynthesis of camphor from borneol and of the thujyl ketones via cis-sabinol, and they also indicate that the previously reported oxidations of various thujanols by the borneol dehydrogenases are only coincidental activities not relevant to the formation of 3-thujone and 3-isothujone. PMID- 3310903 TI - A multicatalytic high-molecular-weight neutral endopeptidase from human kidney. AB - A multicatalytic endopeptidase (ME) with three distinct activities, chymotrypsin like, cucumisin-like, and trypsin-like, occurred in all rat tissues examined with highest activities in kidney, testes, liver, and spleen; they were assayed with benzyloxycarbonyl-Gly-Gly-Leu-p-nitroanilide (Z-Gly-Gly-Leu-pNA), benzyloxycarbonyl-Leu-Leu-Glu-2-naphthylamide (Z-Leu-Leu-Glu-2NA), and benzyloxycarbonyl-Gly-Gly-Arg-2-naphthylamide (Z-Gly-Gly-Arg-2NA), respectively. All three activities were recovered from a single protein band on a polyacrylamide gel after electrophoresis of purified human kidney ME. The native enzyme had a Mr of 650,000, and it consisted of about 5,135 amino acid residues. After denaturation and electrophoresis on sodium dodecyl sulfate (SDS) polyacrylamide gels kidney ME dissociated into several low Mr components ranging from 23,000 to 33,000. Kidney ME had a pH optimum of 7.6-8.1 with Z-Gly-Gly-Leu pNA, 7.3 with Z-Leu-Leu-Glu-2NA, and 9.8 with Z-Gly-Gly-Arg-2NA. SDS enhanced chymotrypsin- and cucumisin-like activities by two to three times whereas trypsin like activity was not enhanced. The specificity constant (kappa cat/Km) of human kidney ME for Z-Gly-Gly-Leu-pNA was 6.7 X 10(3) M-1 S-1; Z-Gly-Gly-Leu-2NA was not hydrolyzed. The specificity constant for Z-Leu-Leu-Glu-2NA was similar to, and for Z-Gly-Gly-Arg-2NA was one half of that for Z-Gly-Gly-Leu-pNA. ME cleaves only the Phe5-Ser6 bond of bradykinin (BK); however, all three ME activities were inhibited by BK. Strong inhibition of ME by albumin suggests that ME is involved in cleavage of larger polypeptides. Antipain and leupeptin almost completely inactivated the trypsin-like activity whereas they had no significant effect on the other two activities. ME is not a metal-loenzyme nor is the serine residue essential for its activities; however, thiol groups are involved. Na+ and K+ inhibited all ME activities. Trypsin-like activity was more sensitive to divalent cations than the other two. PMID- 3310904 TI - [Antitumor drug screening at the National Cancer Institute, U.S.A]. AB - The development of suitable screening systems is one of the most important determinants for the successful discovery of new anti-tumor drugs. The National Cancer Institute, U.S.A. has been playing a major role in the discovery and development of new agents by using various animal tumor models since 1955. In this article, the historical overview of this effort, and the difficulties and problems of this approach was reviewed. Also the new "Disease-Oriented Screening System", which is now under development as a new screening system at the National Cancer Institute was also described. PMID- 3310905 TI - [A randomized controlled trial of acute and delayed cisplatin-induced emesis with metoclopramide, dexamethasone and prochlorperazine]. AB - Forty patients with advanced lung cancer who had received chemotherapy containing cisplatin (80 mg/m2) were accrued for a randomized controlled trial to evaluate the additional effect of prochlorperazine on the combination of high-dose metoclopramide and dexamethasone for the treatment of acute cisplatin-induced emesis. The effect of intravenous metoclopramide and dexamethasone in emesis occurring more than 24 hours after cisplatin administration was also evaluated. Excellent emetic control (no emesis during 24 hours after cisplatin administration) was achieved in 70% (14/20) and 76% (16/21) of the patients who received the combination of prochlorperazine, metoclopramide and dexamethasone and the combination of metoclopramide and dexamethasone, respectively. The overall toxicities associated with both regimens were not serious and were similar. Patients treated with metoclopramide and dexamethasone on days 2-7 experienced less delayed emesis, nausea and anorexia compared with those treated with a placebo (delayed emesis, 25% versus 50%, respectively, p = 0.105; more than 4 days of nausea, 10% versus 35%, respectively, p = 0.059; less than 3 days of anorexia, 80% versus 50%, respectively, p = 0.048). It was concluded that metoclopramide and dexamethasone showed an excellent antiemetic effect on acute drug-induced emesis, as well as on delayed emesis, induced by cisplatin. PMID- 3310906 TI - [The availability of digital subtraction angiography using continuous intra arterial infusion tubes founded various malignancy]. AB - DSA was employed using continuous intraarterial infusion tubes for various malignancies (73 cases) which were examined a total of 135 times. In head and neck malignancy (50 cases), the general position of the infusion tube had been determined beforehand by dye infusion, but DSA from the tube showed that the tubes in 24 cases (48%) were located in the wrong position, especially in tongue cancer (21 cases) where many tubes were discovered to be in an erroneous position (71%) such as the common carotid artery. We were unable to determine the effect of chemotherapy and radiation using DSA only. In 9 cases of breast cancer for which fixation of the tube was not attempted under X-ray fluoroscopy, 7 (78%) showed an unusual tube position such as the intraaortic arch. In 5 cases of abdominal malignancy, only the tube position for sigmoid colon cancer was unusual. We were able to observe the effect of chemotherapy by DSA in 2 cases. For DSA in one out of 3 hepatomas using a Port-A-Cath, we observed that infusion of anticancer drug with degradable starch microspheres caused a reduction in tumor size. However, in the two remaining cases, we were unable to observe any effect of infusion of these drugs by DSA for various mechanical reasons. DSA from an infusion tube revealed not only the location of the tube accurately and promptly, but also the effect of chemotherapy. PMID- 3310907 TI - [Clinical evaluation of tumor markers in breast cancer patients]. AB - During the past 4 years, the performances of various tumor markers such as CA15 3, CEA, ferritin, beta 2-microglobulin and TPA have been evaluated in 78 cases of mammary cancer. The results were categorised according to differences in stages, difference in values from patients with recurrent tumors, the incidence of abnormal values and differences in values before and after surgery. When the incidence of values higher than the cutoff value was determined for each of stage I, II and III + IV, the rates for CEA were 14.3%, 4.9% and 27.8%, respectively, whereas those for TPA were 25.0%, 22.2% and 26.7%, respectively. In addition, for CA15-3, the incidences were 0% in stage I, 5.0% in stage II and 57.1% for combined stages III + IV. The average values for patients with recurrent tumors were 3.2 ng/ml CEA, 194.5 ng/ml ferritin, 316.2 U/l TPA and 81.3 U/ml CA15-3. The rates of abnormal values were 40.0% for CEA, 40.0% for ferritin, 85.7% for TPA and 63.6% for CA15-3. Differences in the values after surgical removal of the tumor were observed with these tumor markers: the CEA value was reduced from 1.6 +/- 1.4 to 1.1 +/- 0.5 (p less than 0.01) and the CA15-3 value from 12.2 +/- 8.4 to 9.3 +/- 4.1 (p less than 0.05), respectively, whereas that for ferritin was conversely increased from 48.9 +/- 48.0 to 74.0 +/- 70.0 (p less than 0.01). However, the values for TPA, despite showing a tendency to decrease, did not show any statistically significant alteration. The fluctuations of these marker levels in patients with recurrent tumors reflects the progress of the disease, with a sudden elevation in values indicating imminent death. The diagnostic significance of these markers is not high, but they are considered to be useful in detecting the progress or condition of a recurrent tumor. PMID- 3310908 TI - True histiocytic lymphoma associated with dermatomyositis. PMID- 3310909 TI - Pitted keratolysis. The role of Micrococcus sedentarius. AB - Though pitted keratolysis of the foot is generally viewed to be caused by bacteria, there is confusion regarding the identity of the causative organism. Species of Corynebacterium, Actinomyces, Dermatophilus, and Micrococcus have been proposed by various investigators. We have studied eight cases of pitted keratolysis and have cultured an organism identified as Micrococcus sedentarius on the basis of colonial morphology, micromorphology, biochemical reactions, and chemical analysis of whole-cell components. Furthermore, pitted keratolysis was produced experimentally in a human volunteer by applying M sedentarius under an occlusive dressing onto the surface of the heel. PMID- 3310910 TI - Improvement of the appearance of full-thickness skin grafts with dermabrasion. AB - A series of 192 full-thickness skin grafts of the nose, periorbital area, and ear were examined, using age- and site-matched controls, to determine whether the appearance of the graft was improved by performing dermabrasion six to eight months after grafting. Dermabrasion is helpful in specific situations in adjusting the level of the skin graft to the level of the edge of the recipient site. The greatest improvement was obtained from dermabrasion of elevated grafts located on the nose; however, patients having elevated grafts in all locations were more likely to have resolution of the elevation following dermabrasion than the control subjects. Control subjects experienced most of their improvement six months after the operation, but 27% of the elevated grafts continued to improve between six and 18 months. Grafts that were depressed six months after the grafting procedure remained depressed at 18 and 24 months regardless of whether dermabrasion was performed. In the additional time the subjects were followed up, no further improvement was noted beyond that achieved 12 months after dermabrasion. The data presented in this report and the conclusions drawn from these data may allow physicians to more carefully select subjects who will benefit from dermabrasion after skin grafting. PMID- 3310911 TI - Side effects and long-term toxicity of synthetic retinoids. AB - The observation that vitamin A (retinol) has antikeratinizing properties has led to the development of synthetic retinol derivatives (retinoids) for the treatment of a variety of skin disorders characterized by abnormal keratinization. The goal of research in this area is the synthesis of retinoids that would have a more favorable therapeutic: toxic ratio than retinol itself. A limiting factor in the use of any vitamin A analogue is that, even with a more favorable therapeutic: toxic ratio, large pharmacologic doses are required that produce side effects related to the drug's action in most individuals. With few exceptions, all of the side effects are those seen from mega-vitamin A ingestion, primarily affecting the mucocutaneous, skeletal, and central nervous systems. Most of the side effects from excess vitamin A are reversible, with notable exceptions being those involving hepatic and osseous tissues. In terms of reversibility from synthetic retinoids, the experience to date has been incomplete, so there remains imprecise information as to the incidence and the persistence of toxic effects after drug withdrawal. PMID- 3310913 TI - Dermatologic signs in anorexia nervosa and bulimia nervosa. AB - The dermatologic changes in anorexia nervosa and bulimia nervosa may be the first signs to give the clinician a clue that an eating disorder is present, as many of these patients either deny their symptoms or secretly refuse to comply with treatment. The dermatologic signs are a result of (1) starvation or malnutrition, eg, lanugolike body hair, asteatotic skin, brittle hair and nails, and carotenodermia; (2) self-induced vomiting, eg, hand calluses, dental enamel erosion, gingivitis, and a Sjogrenlike syndrome; (3) use of laxatives, diuretics, or emetics and their dermatologic side effects; and (4) other concomitant psychiatric illness, eg, hand dermatitis from compulsive handwashing. Further, as most of the cutaneous signs are not specific to anorexia nervosa and bulimia nervosa, failure to include eating disorders in the differential diagnosis may lead to misdiagnosis of the cutaneous symptoms. PMID- 3310914 TI - James Spence Medallists, 1987. Professor John Lewis Emery, Dr Frederick J W Miller. PMID- 3310912 TI - Essential fatty acids and epidermal integrity. AB - The intercellular spaces of the stratum corneum contain multilamellar lipid sheets derived from the extruded contents of lamellar granules. In the absence of linoleic acid, lamellar granules appear empty, and only fragmentary extracellular sheets are found. This defective differentiation is attributable to substitution of oleate for linoleate in O-acylsphingolipids. Normally, linoleate is ester linked to 30- to 34-carbon omega-hydroxyacids, which, in turn, are amide-linked to sphingosine. Acylglucosylceramides, bearing a beta-D-glucosyl moiety on the sphingosine, may provide the driving force for lamellar granule assembly. The omega-hydroxyacyl chains are long enough to span a lipid bilayer, while the linoleate inserts into an adjacent bilayer. This interaction could promote assembly of lamellar granules. It has also been proposed that acylceramides may stabilize the extracellular sheets by a similar mechanism. In addition, the horny cell has been found to possess a covalently bound lipid envelope consisting principally of omega-hydroxyacylsphingosines derived from O-acylsphingolipids. PMID- 3310915 TI - United Kingdom multicentre clinical trial of somatrem. AB - In a multicentre clinical trial 54 children aged 4.0 to 17.3 years, who had growth hormone deficiency that had not previously been treated, were given biosynthetic methionyl growth hormone (somatrem) 4 units three times a week by subcutaneous or intramuscular injection for one year. Height was measured every three months for at least one year before and during treatment. Forty two patients responded to treatment with an increase in growth of greater than 1.5 cm/year. The remaining 12 who grew more slowly were less obviously short and had a higher pretreatment growth than those who responded. The three who responded and the one who did not had undergone therapeutic spinal irradiation before starting the drug. If a whole year's pretreatment growth rate of less than 5 cm/year had been used as a diagnostic criterion the prediction of those who responded would have slightly improved. About two thirds of the patients developed antibodies against growth hormone and Escherichia coli protein; these were, however, of low and fluctuating titre and binding capacity, and did not influence the response to treatment. No adverse side effects were encountered. We conclude that somatrem is a safe and effective alternative to pituitary growth hormone. PMID- 3310917 TI - Expiratory muscle activity in preterm babies. AB - The activity of the right external abdominal oblique muscle, in relation to respiration, in newborn babies from 25 to 34 weeks' gestation was studied, using surface electrodes. Babies without respiratory difficulties showed no activity associated with respiration in these muscles. Grunting babies with respiratory disease showed pronounced activity during expiration. This activity continued when the babies were endotracheally intubated; if the babies were ventilated it sometimes disturbed the tidal ventilation delivered by the machines. When the baby expired during a ventilator inflation, so that gas came up the endotracheal tube against the inflating pressure, the abdominal oblique muscles contracted in 98% of the breaths. PMID- 3310916 TI - Measurement of milk intake by deuterium dilution. AB - In 14 studies, each lasting seven days, on eight bottle fed infants milk intake was measured by deuterium dilution and by weighing the formula consumed and oral losses. Mean (SD) milk intake was 829 (108) g/day when measured by isotope dilution and 837 (98) g/day when measured by direct weighing, giving a mean difference between methods of 1.0 (5.0)%. Thus the stable isotope procedure is a potentially useful method for investigating lactation and nutritional problems. PMID- 3310919 TI - Otto Braun-Falco festschrift. On the occasion of his 65th birthday, 25 April 1987. PMID- 3310918 TI - Whole blood assay of theophylline concentrations using immunochromatographic stick at the bedside. AB - Blood was collected from 77 patients for estimation of theophylline concentration by whole blood assay using an immunochromatographic stick (Acculevel, Syva UK, Maidenhead, Berkshire). Results were validated by high performance liquid chromatography (HPLC). The stick method was rapid, reliable, required no technical expertise, and produced results equivalent to those obtained from assay from HPLC. PMID- 3310920 TI - Cryofibrinogenemic purpura. AB - A 50-year-old male patient had three episodes of acrally located purpura within 12 years without any other symptoms. The first two episodes which lasted several months coincided with the intake of beta-blockers; the third episode developed after a respiratory infection. A cryofibrinogenemia was found without any evidence of an underlying primary disease, especially not of a neoplasm. The clinical, histological, immunohistological, and electron microscopical findings, as well as the results obtained by intravital fluorescence videomicroscopy are presented. PMID- 3310921 TI - Vegetating cicatricial pemphigoid. A new subset of the cicatricial pemphigoid spectrum. AB - A case with widespread vegetating-pustular skin lesions, oral erosions, ulcerations and scarring, and conjunctival synechiae is reported. Clinically, histopathologically, and by immunofluorescence and electron microscopy this patient combined the features of pemphigoid vegetans, as described by Winkelmann and Su, and the mucocutaneous type of cicatricial pemphigoid. This observation suggests that a third subset of cicatricial pemphigoid can now be added to the two existing ones, the mucocutaneous and Brunsting-Perry types, and the designation vegetating cicatricial pemphigoid is proposed for this heretofore undescribed condition. PMID- 3310923 TI - Large cell lymphocytoma: follow-up, immunopathology studies, and comparison to cutaneous follicular and Crosti lymphoma. AB - Thirteen cases of large cell lymphocytoma are reviewed. All cases are alive or dead free of lymphoma. The histology and immunoreactivity of B cells. Peripheral or small central masses of T cells are present. The microscopic and clinical findings suggest that this tumor is a benign lymphadenoid proliferation which is readily treated by X-ray or surgery. PMID- 3310925 TI - Nonathymulin in rheumatoid arthritis: two double blind, placebo controlled trials. AB - Two randomised double blind, placebo controlled trials have been carried out to assess the effectiveness of nonathymulin, a synthetic thymic peptide hormone, in the treatment of rheumatoid arthritis (RA) and to compare three different dosage schedules (1, 5, and 10 mg/day). Nonathymulin 5 mg proved to be the most efficient dose, providing significant clinical improvement as evaluated by the global assessment of all patients who entered the trials (56% v 17% in the placebo group) (p less than 0.02) and by four objective parameters. This effect was accompanied with minimal adverse effects and was not associated with clear changes in immunological parameters. A significant correlation was observed, however, in clinical response to nonathymulin, and T cell subset imbalance was assessed using monoclonal anti-T cell antibodies and a functional suppressor T cell assay. PMID- 3310924 TI - An evaluation of respiratory effects following exposure to 2.0 ppm formaldehyde in asthmatics: lung function, symptoms, and airway reactivity. AB - Fifteen asthmatic volunteers were exposed in a double-blind, random manner to room air and 2.0 ppm formaldehyde for 40 min in an environmental chamber. These exposures were repeated on a separate day during moderate exercise (450 kpm/min) for 10 min. Ambient and dew point temperatures were 23.0 +/- 0.0 degrees C and 11.5 +/- 1.0 degrees C, respectively. No significant airway obstruction as measured by flow-volume parameters and airway resistance was noted in this group during or immediately after exposure. Furthermore, sequential measurements of peak flow for 24 hr following formaldehyde exposure revealed no delayed airway response. In contrast, in comparison to the baseline methacholine inhalation challenge (MIC) test on the screening day, 8 of 12 asthmatics demonstrated a lower threshold to MIC following 2.0 ppm exposure for 40 min; however, the mean and median decrements of threshold in methacholine concentration of 10.4 mg/ml and 24.3 mg/ml were not significant (p = .12). Bad odor, sore throat, and eye irritation were common during exposure but symptoms were infrequent afterward. PMID- 3310926 TI - Clinical picture of the amyloid arthropathy in patients with chronic renal failure maintained on haemodialysis using cellulose membranes. AB - The clinical picture of 15 patients (10 male, five female) with amyloid arthropathy secondary to chronic renal failure treated with haemodialysis has been studied. The average period of haemodialysis was 10.8 years. Joint symptoms appeared between three and 13 years after starting haemodialysis. No patient had renal amyloidosis. Early symptoms were varied and often overlapped: knee swelling (seven patients), painful and stiff shoulders (seven), and carpal tunnel syndrome (six) were the most prominent. Follow up showed extension to other joints. Joint effusions were generally of the non-inflammatory type. Radiologically, geodes and erosions of variable sizes were seen in the affected joints, which can develop into a destructive arthropathy. Amyloid was found in abdominal fat in three of the 12 patients on whom a needle aspiration was performed. Four of 12 patients showed changes compatible with amyloid infiltration in the echocardiogram. One patient had amyloid in the gastric muscular layer, another in the colon mucus, and two of four in rectal biopsy specimens. Amyloid deposits showed the presence of beta 2 microglobulin in 10 patients. The clinical and radiological picture was similar to the amyloid arthropathy associated with multiple myeloma. These patients can develop systemic amyloidosis. PMID- 3310927 TI - Chronic predominant interstitial nephritis in a patient with systemic lupus erythematosus: a follow up of three years and review of the literature. AB - Predominant interstitial nephritis is a rare manifestation of systemic lupus erythematosus. Only seven cases have been reported in the literature. Owing to the rarity of this entity, the natural history of predominant interstitial nephritis in lupus has not been adequately recorded and an appropriate therapeutic approach has yet to be defined. In this report we present the case of a 25 year old woman with active systemic lupus erythematosus complicated by kidney failure and renal tubular acidosis due to predominant interstitial nephritis. We describe the course of her disease over a three year period. Seven additional patients with systemic lupus erythematosus and predominant interstitial nephritis are reviewed. PMID- 3310928 TI - Wegener's granulomatosis: isolated involvement of the trachea and larynx. AB - A 26 year old man with subacute hoarseness and stridor was shown to have Wegener's granulomatosis isolated to the trachea and larynx. Although isolated laryngeal Wegener's is unusual, a review of the literature suggests that early treatment with cyclophosphamide is warranted. PMID- 3310929 TI - Synovial amyloid in chronic haemodialysis contains beta 2 microglobulin. AB - A case of amyloid arthropathy occurring in a patient receiving long term chronic haemodialysis treatment is reported. He was found to have raised serum beta 2 microglobulin (beta 2M). and beta 2M was detected in the synovial amyloid deposits. PMID- 3310930 TI - The first 100 liver transplants at UCLA. AB - A clinical program in liver transplantation was begun at UCLA in 1984 after a period of laboratory investigation. The first 100 orthotopic liver transplants (OLT) were performed in 83 patients (43 adults and 40 children) between February 1, 1984 and November 1, 1986. Donors and recipients were matched only for size and ABO blood group compatibility, with OLT performed across blood groups in 28 patients. Standard operative techniques were used, including venous-venous bypass in adults. Arterial reconstruction was performed using an aortic Carrel patch or "branch patch" in 65% of cases and by end-to-end or aortic conduit techniques in the remainder. The hepatic artery thrombosis rate was 5%. Biliary reconstruction was choledochocholedochostomy in 67 OLT and Roux-en-Y choledochojejunostomy in 33 (complication rate of 24% and 24%, respectively). Average lengths and ranges of donor liver ischemia, operating time, and blood replacement were 4 hours (range: 1-10 hours), 7.6 hours (range: 4-15 hours), and 17 units packed cells (range: 2 220 units). Immunosuppressive regimen was cyclosporine-steroid combination, with monoclonal anti-T-cell antibody (OKT3) used for refractory rejection. All patients had one or more complications: pulmonary (78%), infectious (51%), renal dialysis (25%), neurologic (22%). All patients had at least one episode of acute rejection, and 3.6% had chronic rejection. Retransplantation was needed in nine patients once and in four patients twice. The overall retransplant survival rate was 54%, and two of four patients who received a second retransplant are alive. Sixty-three of the 83 patients (76%) are alive (adults 72%, children 80%). The 1- and 2-year actuarial survival rate is 73% (adults 68%, children 78%). Thirty eight of 43 patients (88%) who had transplantation in the past year are alive. Of 14 perioperative variables assessed as predictors of early mortality, only postoperative dialysis (p less than 0.0005) and presence of severe rejection (p less than 0.01) had statistical significance. Seventy per cent of adults returned to work, and 84% of children had normal or accelerated growth. A new program in liver transplantation provides a dramatic option in patient care and an academic stimulus to the entire medical center. PMID- 3310932 TI - Delayed surgery and bone marrow transplantation for widespread neuroblastoma. AB - From 1983 to 1986, 21 patients with poor prognosis neuroblastoma were treated with bone marrow transplantation. This regimen included induction chemotherapy, delayed surgical resection, local irradiation, and intensive chemoradiotherapy followed by infusion of allogeneic or autologous marrow. This therapeutic approach resulted in a 57% long-term survival rate (follow-up: 14-48 months), which appears to be approximately three times superior to conventional chemotherapy in a comparable group of children. In addition, complete resection was possible in 11 of 17 patients operated on after induction therapy. Recurrence in the primary site after bone marrow transplantation occurred in only one of 18 evaluable patients. Thus, this approach almost always eradicates primary tumor in patients with neuroblastoma with advanced disease. PMID- 3310933 TI - Cardiovascular involvement in human and experimental leptospirosis: pathologic findings and immunohistochemical detection of leptospiral antigen. AB - Twenty hearts from patients dying of leptospirosis were studied. Interstitial myocarditis was found in 50% of the cases, and a significant statistical correlation was observed between myocarditis and the inflammatory involvement of the conduction tissue. Acute coronary arteritis, affecting the main branches of the coronary arteries, was observed in 70% of the cases, and this finding also correlates significantly with interstitial myocarditis. Aortitis was found in 57.8% of the cases. When serum against L. interrogans serovar icterohaemorrhagiae was used, focal IP antigen deposits were observed in the coronary arteries and in the aorta. Experimental data from 12 guinea-pigs inoculated with L. interrogans serovar icterohaemorrhagiae showed a focal myocarditis involving mainly the subendocardial and pericoronary heart tissue, with IP antigen deposits in the same sites. Leptospirosis might be visualized as a generalized illness resembling other infectious vasculitides. The heart and main vessels are involved during the septicaemic phase of the disease, and bacterial migration, toxin(s), enzymes and/or antigenic products liberated by bacterial lysis might account for the increased endothelial permeability with antigen deposits and inflammation. PMID- 3310931 TI - Prolongation of pig-to-dog renal xenograft survival by modification of the inflammatory mediator response. AB - The pathogenesis of hyperacute renal rejection consists of a nonspecific effector cascade that invokes most of the components of a typical acute inflammatory response. Platelet-activating factor (PAF) represents the most recent and perhaps the most significant mediator and promoting agent of this phenomenon. These studies evaluated SRI 63-441, a novel, synthetic, and the most potent PAF receptor antagonist available, alone and in combination with other prostanoids, for their ability to influence this response and to prolong renal xenograft survival and function in a model of pig-to-dog heterotransplantation. Inhibition of PAF by SRI 63-441 alone, at the dosage and schedule used in these experiments, did not significantly prolong xenograft survival or function. However, the combination of SRI 63-441 with either prostacyclin (PGI2) or prostaglandin E1 (PGE1) infusion demonstrated significant synergism, and resulted in a 6-9-fold increase in kidney survival and a 3-20-fold increase in urine output. Neither PGI2 nor PGE1 infusions alone significantly influenced this xenograft model. Electromagnetic flow studies demonstrated significantly delayed diminution in renal artery blood flow in the combination-treated animals. Serial and end-stage histologic examination of kidneys receiving combination therapy demonstrated a delayed onset of the pathologic deterioration and an overall amelioration of the entire process. These studies demonstrate that significant abrogation of a rapid and violent form of hyperacute rejection can be achieved solely by the pharmacologic manipulation of the inflammatory mediator response. PMID- 3310934 TI - Adjustable annuloplasty for tricuspid insufficiency. AB - De Vega described a technique for tricuspid annuloplasty using synthetic suture to reduce the size of the dilated annulus. We present our experience with an adjustable modification of de Vega's suture annuloplasty technique. The records of 12 patients followed for 15 to 30 months were reviewed. All 10 survivors had a significant drop in right-sided filling pressure (average, 39% decrease) and an associated improvement in clinical status. The 2 deaths in the series were not related to persistent tricuspid insufficiency. This technique represents a reliable, rapid, and readily teachable method for the surgical management of tricuspid insufficiency. PMID- 3310935 TI - Orthotopic cardiac transplantation in patients with large donor/recipient atrial size mismatch: surgical technique. AB - A successful surgical technique is described that overcomes the problem of severe size mismatch between the recipient's atrial remnants and the donor heart atria in patients undergoing orthotopic cardiac transplantation. The circumferences of the atria are reduced by plicating the atrial remnants until the appropriate sizes are obtained. PMID- 3310936 TI - An improved method of closure for saphenous vein donor sites. AB - In the modern surgical era, the functional result and aesthetics of wound closure have become important parts of any surgical procedure. The saphenous vein donor site for coronary artery bypass is often the most troublesome portion of a patient's postoperative course. Presented herein is a method for closure of saphenous vein donor sites that is aesthetically and functionally pleasing. PMID- 3310937 TI - The origins of pulmonary artery banding. PMID- 3310938 TI - Thrombotic and bleeding complications of prosthetic heart valves. AB - A review of articles published since 1979 indicates that thrombotic and bleeding complications account for about 50% of valve-related complications in patients with bioprosthetic aortic and mitral valves and for approximately 75% of the complications in patients with mechanical valves. Although compromised by lack of standard definitions and by variability in reporting and follow-up, the data suggest that the linearized rate of both thrombotic and bleeding complications in patients with aortic bioprostheses is approximately half that for aortic mechanical prostheses (2% versus 4%), but is approximately equal for both bioprostheses and mechanical valves in the mitral position (approximately 4%), and for mechanical and bioprosthetic aortic and mitral valves in combination. However, linearized rates for fatal thrombotic and bleeding events are two to four times higher in patients with mechanical prostheses. The adequacy of warfarin anticoagulation is the most important factor affecting thrombotic and bleeding complications in patients with mechanical valves and over shadows the dubious importance of other phenomena such as atrial fibrillation and left atrial thrombus. Short-term warfarin anticoagulation or the use of long-term platelet inhibitors, or both, do not appear to reduce the incidence of thrombotic complications in patients with aortic bioprostheses but increase bleeding. For mitral bioprostheses, the postoperative use of warfarin for three months or aspirin indefinitely is as effective in preventing thromboembolism as long-term warfarin. Acute prosthetic valve endocarditis is associated with a 13 to 40% incidence of thrombotic complications. Likewise, the recurrence rate of cerebral emboli is high (20-30%) in patients with prosthetic valves who are not anticoagulated. Bioprostheses are strongly preferred for women who wish to bear children; fetal wastage occurs in 25 to 30% of pregnant women with mechanical heart valves who receive either warfarin or heparin, or a combination of the two. Heparin, however, greatly increases the risk of maternal bleeding. In children, the efficacy of platelet inhibitors without warfarin anticoagulation is unproven; nearly all serious strokes occur when warfarin is omitted; and permanent disability from warfarin-related bleeding is rare. All prosthetic cardiac valves initiate coagulation and affect the dynamic equilibrium between activated procoagulants and endogenous anticoagulants. Warfarin is the only available oral exogenous anticoagulant.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3310939 TI - Supraventricular tachycardia. Mechanisms and therapy. AB - The insights into the mechanisms of supraventricular tachycardia provided by the techniques of intracardiac recording and programmed cardiac stimulation have had a major impact on our therapeutic approach to this common problem. These techniques have led to a more systematic analysis and precise interpretation of the standard surface electrocardiogram. An accurate diagnosis of the mechanism of supraventricular tachycardia can be made in the majority of patients using the electrocardiogram aided by special leads (eg, Lewis leads) and bedside maneuvers. Identification of the likely electrophysiologic mechanism allows for a more rational and effective approach to both acute and chronic therapy. PMID- 3310922 TI - Professor Dr. Dr. h. c. Otto Braun-Falco. PMID- 3310940 TI - Long-term effects of modest weight loss in type II diabetic patients. AB - Since most obese patients with type II diabetes are unable to achieve ideal body weight, this study examined whether more modest weight losses would provide a long-term benefit. Type II diabetic patients (N = 114) were treated in a behavioral weight control program and followed up for one year. Weight loss was significantly correlated with improvements in glycosylated hemoglobin values at posttreatment (r = .55) and one year (r = .51). Patients who lost more than 6.9 kg or had more than 5% reduction in body weight had significant improvements in glycosylated hemoglobin values at one year, while patients losing less weight had nonsignificant changes and those gaining weight had significant worsening. Thus, modest weight loss can have a long-term impact on glycemic control. However, the improvement in glycemic control for a given weight loss was greater initially than at one year, suggesting that energy restriction, in addition to weight loss, may contribute to initial improvement. Neither percent overweight nor diabetes treatment affected weight loss. PMID- 3310941 TI - A multicenter comparative trial of three-day norfloxacin vs ten-day sulfamethoxazole and trimethoprim for the treatment of uncomplicated urinary tract infections. AB - Two-hundred nine patients with symptoms of acute urinary tract infection and pyuria were randomized to 400 mg of administered norfloxacin twice daily for three days, or 800 mg of sulfamethoxazole and 160 mg of trimethoprim administered twice daily for ten days. Therapeutic outcome was assessed five to nine days and four to six weeks after treatment. The cure rates were 71/74 (96%) with norfloxacin and 81/81 (100%) with sulfamethoxazole and trimethoprim five to nine days after treatment. Only seven patients had a recurrence at the second follow up visit; four in the norfloxacin group and three in the sulfamethoxazole and trimethoprim group. No isolates were resistant to norfloxacin, but three Escherichia coli were resistant to sulfamethoxazole and trimethoprim. Fifteen patients in each group reported a side effect during treatment. Two patients in the norfloxacin group and four patients in the sulfamethoxazole and trimethoprim group discontinued therapy due to an adverse effect. In this multicenter study, a three-day course of norfloxacin was as effective and safe as a ten-day regimen of sulfamethoxazole and trimethoprim in the treatment of acute uncomplicated urinary tract infections. PMID- 3310942 TI - Cimetidine therapy in nonsteroidal anti-inflammatory drug gastropathy. Double blind long-term evaluation. AB - To assess the efficacy of cimetidine in treating and preventing gastric mucosal lesions associated with nonsteroidal anti-inflammatory drug (NSAID) therapy (NSAID gastropathy), we endoscopically studied 104 patients taking NSAIDs for a variety of rheumatic diseases. Fifty-six percent (22/43) of patients randomized to cimetidine 300 mg four times a day and 52% (22/42) of those randomized to placebo showed progression of endoscopic lesions during the eight-week short-term phase. Thirty-nine patients whose endoscopic lesions improved were then randomized to a ten-month maintenance regimen of either cimetidine 400 mg at bedtime or placebo. Fifty percent (7/14) of placebo-treated and 42% (5/12) of cimetidine-treated patients showed progression of lesions during the maintenance phase. The failure of cimetidine to offer any significant benefit under these protocol conditions reflects the fundamental difference in pathophysiologic features between classic acid-mediated ulcer disease and NSAID gastropathy. PMID- 3310943 TI - Atypical pulmonary and neurologic complications of amiodarone in the same patient. Report of a case and review of the literature. AB - Atypical manifestations of pulmonary toxicity and previously unreported autonomic nervous system dysfunction complicating amiodarone therapy were observed in a patient being treated for sustained ventricular tachycardia. Pulmonary and hepatic nodules on computed tomographic scan masquerading as metastatic carcinoma were initially noted. Focal infiltrates and a large left pleural effusion mimicking infection, malignant neoplasm, or collagen vascular disease became manifest at a later stage. Autonomic dysfunction presented as incapacitating orthostatic hypotension and persisted for six weeks after amiodarone withdrawal. The pleuropulmonary toxic effects were reversible on discontinuation of amiodarone therapy, and resolution was hastened by short-course steroid treatment. PMID- 3310944 TI - Inoculation of blood culture bottles with ascitic fluid: improved detection of spontaneous bacterial peritonitis. PMID- 3310945 TI - [Studies on the biology of the volcano mouse (Neotomodon alstoni). XI. Comparative study on the reproduction of wild females in the laboratory mated during 1 and 2 estrous cycles]. PMID- 3310947 TI - [History of porcine cysticercosis in Mexico]. PMID- 3310948 TI - Sensation and perception of pain: interdisciplinary neurophysiological, surgical and pharmacological approach. PMID- 3310946 TI - [Insulin cell receptors in diabetes caused by pancreatitis]. PMID- 3310949 TI - [Dismemberment and mutilation (1)]. PMID- 3310951 TI - [Psychosis and mental retardation]. PMID- 3310950 TI - Cell wall mannoproteins during the population growth phases in Saccharomyces cerevisiae. AB - Mannoproteins from cell walls of Saccharomyces cerevisiae synthesized at successive stages of the population growth cycle have been solubilized with Zymolyase and subsequently analyzed. The major change along the population cycle concerned a large size mannoprotein material; the size of the newly-synthesized molecules varied from 120,000-500,000 (mean of about 200,000) at early exponential phase to 250,000-350,000 (mean of about 300,000) at late exponential phase. These differences are due to modifications in the amount of N glycosidically linked mannose residues, since the size of the peptide moiety was 90,000-100,000 at all growth stages and the level of O-glycosylation changed only slightly. After incubation of the purified walls with concanavalin A-ferritin and subsequent analysis by electron microscopy, labelling was localized at the external and internal faces of the walls. The middle space of these was labelled after digestion of the glucan network with Zymolyase, which demonstrate the presence of mannoproteins in close contact with the structural glucan molecules throughout the wall. PMID- 3310952 TI - Alprazolam, diazepam, imipramine, and placebo in outpatients with major depression. AB - Two hundred forty-one outpatients with a DSM-III diagnosis of major depressive disorder participated in a six-week double-blind therapeutic trial of alprazolam, diazepam, imipramine hydrochloride, and placebo. Side effects were given as a major reason for attrition by patients taking the three active compounds and ineffectiveness was the reason given by patients taking placebo. Imipramine treated patients reported the most and placebo patients the least number of adverse effects. Imipramine and alprazolam, but not diazepam, produced significantly more improvement in depressed symptomatology than did placebo. Mean diazepam scores frequently assumed an intermediate position between those of imipramine or alprazolam and placebo. These treatment differences were found to be independent of initial severity levels of anxiety and depression. PMID- 3310953 TI - Age at onset in schizophrenia. A familial perspective. AB - We examined the impact of familial factors on age at onset in schizophrenia. Results from a literature review and from new analyses of two family studies and one twin study of schizophrenia support the following hypotheses: (1) no strong or consistent relationship exists between age at onset in schizophrenia and recurrence risk for schizophrenia in relatives; (2) age at onset in schizophrenia is not strongly related to the recurrence risk for other psychiatric disorders in relatives; and (3) in systematically ascertained pairs of affected siblings, the age at onset of schizophrenia is modestly correlated, whereas the correlation in age at onset in concordant monozygotic twin pairs is much higher. These results suggest that (1) from a familial perspective, early- and late-onset adult schizophrenia appear to be the same disorder, and (2) given that an individual will develop schizophrenia, familial factors, which may be genetic, influence the age at onset of the condition. PMID- 3310954 TI - Talk therapy vs drug therapy for depression. PMID- 3310955 TI - Blood vascular architecture of the rat cerebral hypophysis and hypothalamus. A dissection/scanning electron microscopy of vascular casts. AB - Complete casts of the hypophyseal and hypothalamic blood vascular beds of newborn, pubescent, adult and aged rats were produced by infusion of low viscosity methacrylate media, dissected under a binocular light microscope, and observed with a scanning electron microscope. The primary capillary plexus projected capillary loops into the median eminence and infundibular stalk. These loops were composed of anastomosing capillaries, being numerous in the central area of the anterior lip of the median eminence. The well developed long loops received their proper afferent arterioles from the arterial terminals in the primary plexus, and emitted their proper efferent venules continuous with the long portal vessels. The loops in newborn rats were poorly developed, appearing as simple ball-like protrusions of the capillaries of the primary plexus. Many branches of the anterior, middle and accessory middle hypophyseal arteries penetrated the primary plexus, and ascended as infundibular ascending arterioles in the median eminence and infundibular stalk. These infundibular ascending arterioles continued into the capillary bed of the hypothalamus, especially in its basilar and peri-ventricular areas. The subependymal capillary network was fairly independent, and located dorsal to the loops. This network received some of the infundibular ascending arterioles, and emitted infundibular descending venules continuous with the long portal vessels. The subependymal network also received the infundibular descending arterioles from the hypothalamic arteries, and emitted the infundibular ascending venules continuous with the hypothalamic veins. Thus, neither a feedback nor a retrograde portal route from the hypophyseal capillaries to the hypothalamic capillaries was noted. The capillary bed of the pars tuberalis was observed only in the adult and aged rats; it was a very coarse network which was derived from the primary capillary plexus and connected to the secondary capillary plexus. PMID- 3310956 TI - The serologic diagnosis of viral infection. An update. AB - The traditional basis for the serologic diagnosis of a viral infection is demonstration of seroconversion or a significant increase in circulating homologous viral antibody over the course of illness. Conventional methods include neutralization, complement fixation, hemagglutination-inhibition, indirect hemagglutination, and indirect immunofluorescence tests. Although these methods are reliable, each suffers from limitations that include procedural complexity, substantial "hands-on" time, need for titrating reagents and serially diluting specimens, occasional false-positive or false-negative results, and lack of interlaboratory standardization. Because of these problems, improved methods and new techniques for serologic diagnosis have been developed and investigated. Many appear to be superior to conventional methods in sensitivity, specificity, cost, time required for completion, and potential for automation. The advent of hybridoma technology has provided an exceptional opportunity to improve serologic reagents for the diagnosis of viral disease. In addition, IgM-specific antibody tests for rapid and early diagnosis of many viral infections are being reevaluated to eliminate the interfering effects of rheumatoid factor and antinuclear antibodies. Many of the new methodologies employ immunofluorescence assay or enzyme immunoassay for detection of specific IgM antibody, and latex agglutination, in addition to immunofluorescence and enzyme immunoassays, to detect specific IgG antibody. Simplified kits employing these methods are now becoming available commercially. PMID- 3310957 TI - Major histocompatibility antigen expression in the liver in acquired immunodeficiency syndrome. AB - Human leukocyte antigen (HLA) class I molecules are normally detected on most nucleated cells, but not on hepatocytes, while the expression of HLA class II antigens is mainly restricted to certain cell types of the immune system. This normal distribution pattern may be altered in human liver in a variety of disorders, particularly in infectious and immune diseases. In view of multiple infections and severe immune alterations in acquired immunodeficiency syndrome (AIDS), we studied the expression of HLA class I and class II antigens in liver obtained at autopsy from ten patients with AIDS and eight control patients, using a panel of monoclonal antibodies and the indirect immunofluorescence method. In spite of viral bacterial, and fungal infections, HLA class I antigens were detected on hepatocytes in only two patients with AIDS. Human leukocyte antigen class II antigens were found unexpectedly on bile duct epithelium in five of ten patients with AIDS and in one of eight control patients. The aberrant HLA class II antigen expression on bile ducts does not appear to be linked to bile duct damage or infection with cytomegalovirus or other agents, but may be related to immune alterations in patients with AIDS. PMID- 3310958 TI - Acquired brain damage and driving: a review. AB - Five issues in evaluating driving ability after brain damage were addressed through a review of the literature. Some preliminary conclusions were reached: (1) about half of all subjects studied still hold a valid driver's license; (2) brain-damaged drivers could not, in general, be seen as risky drivers, although some individuals show decreased driving skill and risky behavior in traffic; and (3) statistics show no increase in traffic violations or accidents in groups of neurologic patients with acquired brain lesions or diseases. Frequently noted problems of brain-damaged drivers include poor judgment of traffic situations, impulsivity, and visuospatial impairments. Traditional psychologic tests have insufficient predictive value regarding fitness to drive. It is suggested that new techniques be developed to enable more valid statements about the skills needed for safe traffic participation. These assessment techniques should emphasize the higher cognitive levels in driving, ie, the tactical and strategic levels. At the moment, driver training programs in rehabilitation focus mainly on the operational level, with emphasis on handling the car, use of controls and mirrors, and technical adaptation of the vehicle. PMID- 3310959 TI - Diagnostic ultrasound: its value in acute urinary tract infection in spinal cord injury. AB - Two cases of acute urinary tract infection in patients with spinal cord injury highlight the complications of calculus and perinephric abscess. Rather than waiting the customary 48 hours to assess response to antibiotics before evaluation for secondary complications, diagnostic ultrasound is advocated upon diagnosis of pyelonephritis. The potential benefits of early imaging seem to far outweigh the negligible risk and expense. PMID- 3310961 TI - Pylethrombosis. Serendipitous radiologic diagnosis. AB - Pylethrombosis is thrombosis of the portal vein or any of its branches. Five cases have been serendipitously detected, four by computed tomography and one by ultrasonography. Two patients had abdominal sepsis. A third patient had apparent acute cholecystitis with choledocholithiasis. The last two patients had a hypercoagulable state, mesenteric venous thrombosis, and enteric infarction that required resection. The newer diagnostic modalities of computed tomography and ultrasound may document unsuspected pylethrombosis. Surgery may be required because of signs of peritonitis, enteric ischemia, or unresolved sepsis. Anticoagulation is indicated for acute thrombosis of the portal or superior mesenteric veins to prevent further extension and enteric ischemia. PMID- 3310960 TI - Variables influencing the outcome following orthotopic liver transplantation. AB - Seventy-two patients who underwent orthotopic liver transplantation (OLT) were studied to identify perioperative variables that would predict survival and intraoperative blood loss. Survival and intraoperative blood loss were not affected by encephalopathy, length of donor liver ischemia, or any of the preoperative laboratory values studied. Survival was significantly decreased in patients requiring postoperative dialysis (41%) and in patients who had severe rejection requiring retransplantation (33%). Intraoperative blood loss was significantly greater in patients over 50 years of age (11.6 blood volumes) and patients with biliary atresia (8.7 blood volumes). These results may aid in choosing future recipients for orthotopic liver transplantation and in anticipating the postoperative support needed. PMID- 3310962 TI - A prospective study on the use of monoclonal anti-T3-cell antibody (OKT3) to treat steroid-resistant liver transplant rejection. AB - Conventional treatment of acute liver allograft rejection has included high doses of corticosteroids and antithymocyte globulin. Urgent retransplantation was the only option for patients who failed to respond. We report our initial experience with the use of monoclonal anti-T3-cell antibody (OKT3) in 25 patients with acute hepatic allograft rejection that was resistant to steroid and/or antithymocyte globulin therapy. Twenty-four of 25 patients had a response to OKT3, which was complete in 14 and partial in ten. With a mean follow-up of 8.2 months, allograft salvage has been 80% and patient survival 88%; two patients underwent successful retransplantation. Side effects have been mild and well tolerated. Repeated rejection has occurred in 40% of patients, but these episodes have responded to steroid therapy. We conclude that OKT3 is well tolerated and highly effective in reversing severe episodes of acute hepatic allograft rejection that is resistant to high-dose steroid therapy. PMID- 3310963 TI - Jejunogastric intussusception. A new diagnostic test. AB - Jejunogastric intussusception is a rare complication of gastrojejunal reconstruction of unknown cause. There are two types of jejunogastric intussusception: the acute type, presenting as a surgical emergency, and the chronic intermittent type, which is difficult to diagnose and is usually of mild symptomatology but which may progress to the acute type with the incarceration of the intussusceptum. With two case reports and a literature review, an endoscopic diagnostic maneuver is proposed, hinting at disordered motility with reversed peristalsis as a possible causative factor. Corrective surgical treatment to prevent recurrence and incarceration in chronic cases is advocated. Treatment should include dismantling of the efferent loop, which is the most frequent intussusceptum. PMID- 3310964 TI - Primary hepatic leiomyosarcoma. AB - We describe a case of primary hepatic leiomyosarcoma and review the previous reports on this entity. We stress the histologic differentiation of this tumor from similar neoplasms and point out the need for aggressive resection in operable cases. PMID- 3310965 TI - Duodenopancreatectomy for transplantation. AB - Forty duodenopancreatectomies for transplantation were performed. The technique focused on the maintenance of the cardiovascular hemodynamics of the donor during the procedure, the meticulous dissection and preservation of all vascular supplies to the duodenum and the pancreas, and the suppression of warm ischemia by in situ cooling. Recipient euglycemia was established within two hours of the revascularization in 37 of 38 pancreata transplanted. Only six of the 78 renal transplant recipients receiving more than one organ from the same donor required postoperative dialysis, for a 7.7% incidence of delayed graft function. Immediate function was observed in all six cardiac allograft recipients. PMID- 3310966 TI - [The evaluation of bronchial hyperresponsiveness in children with asthma--the significance of the parameters measured by methacholine inhalation challenge]. PMID- 3310967 TI - [Combination of immunodepression and disorders in nucleic acid metabolism of lymphoid tissue as a manifestation of a paraneoplastic syndrome]. AB - Several physiological, biochemical, and molecular biological approaches to the study of factors determining immunodepression in tumor-bearing animals are considered. Cancer cells release substances of nucleic and peptide nature that suppress the functional activity of macrophages and lymphocytes and stimulate cell proliferation in organs and tissues of the host. Suppressor T cells capable of inhibiting the function of helper T cells and impairing the differentiation of killer T cells are activated. The suppression of T- and B-cell-mediated immunity in the tumor host involves disturbances of nucleic acid metabolism in those cells as well as hypersecretion of glucocorticoids. The impairments of lymphocyte proliferation and differentiation that result in reduced immune responsiveness are attributable to drastic alterations in the metabolism of purine and pyrimidine nucleotides and to the damage sustained by the lymphocyte's DNA. PMID- 3310968 TI - [Septicemia against a background of immunodeficiency]. AB - Macroscopic diagnosis of septicemia at autopsy is extremely difficult to make in cases where relevant diagnostic cues, notably changes in the spleen characteristic for sepsis are lacking. Histologic, bacterioscopic, immunomorphologic, fluorescence electron-microscopic studies of autopsy material are described which, in combination, enabled the authors to establish pathologic diagnosis of septicemia, identify its etiology, and characterize the immune status. PMID- 3310969 TI - [Immunoperoxidase method of studying paraffin-embedded material and its use in the detection of early myocardial necrosis]. AB - Methodological approaches to the study of antigens in formalin-fixed and paraffin embedded sections are reviewed. Data on the proteolysis effected by various enzymes in such sections are included. It is shown that ischemic areas in the myocardium can be demonstrated by Regaud stain using an immunoperoxidase test. PMID- 3310970 TI - [I. F. Klein and the Moscow school of pathologists (on the 150th anniversary of his birth)]. PMID- 3310971 TI - [Parenchymatous-stromal interrelations in tumors and methods for their study]. AB - The major components of tumor stroma and parenchyma are described and their reciprocal influences are demonstrated. A scheme of parenchyma-stroma relationships is proposed. Knowledge of how the stromal and parenchymal components of a tumor relate to one another is of considerable diagnostic and prognostic value, for it leads to a better understanding of the nature of tumor growth and of the tumor-host relationships. PMID- 3310972 TI - [Morphological manifestations of the immune response in breast cancer as indices of disorders of immune homeostasis, adequacy of treatment and evaluation of prognosis]. AB - An analysis of the literature has shown that the relationship observed between the quantitative and qualitative characteristics of lymphocytic infiltration in the mammary cancer stroma, the stage of cancer, the degree of its histologic differentiation, and the patient's age reflect, as do the changes in regional lymph nodes, the alterations undergone by immune homeostasis in this disease. The quantitative and qualitative compositions of lymphocytes in the neoplastic tissue, regional lymph nodes, and peripheral blood must be thoroughly studied if the adequacy of treatment and the prognosis are to be assessed correctly. PMID- 3310973 TI - [Acute myocardial infarction. Study of 45 cases by means of computerized protocols]. PMID- 3310974 TI - [Right ventricle function]. PMID- 3310975 TI - Antibodies to a streptococcal antigen in gingival capillary and crevicular fluid washings, collected from man and non-human primates. AB - The local gingival antibody response was examined in actively-immunized rhesus monkeys and in human natural immunization to the cell-surface streptococcal antigen (SA I/II). A technique was developed to collect gingival capillary and crevicular fluid washings (GCCFW) from monkeys and human subjects with clinically normal gingiva. The thin crevicular epithelium and the adjacent capillary plexus are pierced with a probe and the resulting mixture of capillary blood, tissue fluid and crevicular fluid are collected by repeated washing of the gingival crevice. Antibodies measured by a solid-phase radioimmunoassay revealed that the IgG class of anti-SA I/II antibodies in GCCFW from the entire gingiva were positively correlated with the corresponding serum antibodies. Antibody levels from six defined dento-gingival units showed a progressive increase in the anti SA I/II antibody level from the incisor to the premolar and molar units. A significant negative correlation was found between the antibody level of the total GCCFW and past caries experience. A similar negative correlation was found between antibodies from the GCCFW and the DMFS index of the molar teeth. The results are consistent with the hypothesis that there is an independent local immune response in the dento-gingival unit, which is superimposed on the common circulating serum antibodies and sensitized lymphocytes. PMID- 3310976 TI - Quantification of the bacterium Bacteroides gingivalis in human dental plaque by detection of the trypsin-like protease activity of colonies imprinted on membrane filters. AB - Individual colonies of this organism in primary cultures of human dental plaque were distinguished from colonies of other species of black-pigmented Bacteroides by detection of their trypsin-like proteolytic activity using a specific chromogenic enzyme substrate. PMID- 3310977 TI - Quantitative analysis of the molar-size sequence in human prehistoric populations of the Canary Isles. AB - Percentage frequencies for molar-size sequence of first and second molars, as well as the statistical parameters for the individual differences between the measurements of these molars, were calculated in two human prehistoric aboriginal samples from Gran Canaria and Tenerife Islands using mesiodistal and buccolingual dimensions. Remarkable differences between the two populations, whose cultural and anthropological differences are well established, were observed. The findings support the hypothesis that quantitative analysis of molar size sequence can be useful in establishing phylogenetic relationships between populations. PMID- 3310978 TI - Determination of plasma catecholamines in dogs after experimental gingival retraction with epinephrine-impregnated cord. AB - Blood catecholamine levels were determined by high-performance liquid chromatography after placement of the cord around two teeth in a random sequence of the following treatments: (1) untreated cord to intact gingival crevice (C), (2) epinephrine cord to intact crevice (E1), and (3) epinephrine cord to a crevice disrupted with a tapered diamond bur to simulate a subgingival procedure such as in crown preparation (E2). Each cord was left in place for 30 min while blood was drawn from the external jugular vein at 0, 5, 10, 20 and 30 min, and at 10 and 30 min after removal of the cord. Catecholamine values were compared to baseline (time 0) measurements. Treatment C resulted in no significant change in blood catecholamines. Treatment E1 caused a significant increase (p less than 0.01) in blood epinephrine levels, reaching a 641 per cent increase at 30 min. Treatment E2 produced a highly significant increase (p less than 0.001) in blood epinephrine with a greater than 5000 per cent increase 10 min after cord removal. Norepinephrine and dopamine levels were not significantly altered by any of the treatments. PMID- 3310979 TI - The effect of smokeless-tobacco extracts on the growth of oral bacteria of the genus Streptococcus. AB - Aqueous tobacco extracts were used to supplement a basic salts solution (BSS) and a microbial medium. Thin-layer chromatography revealed sucrose in only one of four extracts. Discs saturated with extracts (0.1-50 mg/ml) failed to inhibit growth of any of the micro-organisms. Supplementation (10 mg/ml) of BSS with the tobaccos lacking sucrose resulted in augmented growth of Streptococcus mutans, Streptococcus salivarius and Streptococcus sanguis whereas the sucrose-containing brand augmented only Strep. sanguis growth. Thus extracts of these smokeless tobaccos would serve as a growth substrate for three species of oral streptococci which are frequently associated with human dental caries. PMID- 3310980 TI - Degradation of human secretory immunoglobulin A by protease isolated from the anaerobic periodontopathogenic bacterium, Bacteroides gingivalis. AB - This bacterium is implicated in periodontal diseases of human adult type. Secretory immunoglobulin A (IgA) purified from human colostrum (HC-IgA) was incubated with Bacteroides gingivalis cells or protease isolated from the culture supernatant of B. gingivalis; the digestion of IgA was determined by immunoelectrophoresis and sodium dodecyl sulphate-polyacrylamide gel electrophoresis. B. gingivalis cells almost completely degraded HC-IgA; protease isolated from the culture supernatant cleaved both HC-IgA and secretory IgA in human parotid saliva. Thus by degradation of IgA, the protease may mediate in part the periodontopathogenic role of B. gingivalis by decreasing the oral defence mechanism. PMID- 3310981 TI - Immunofluorescence localization of type I and type III collagen and fibronectin in mouse dental tissues in late development and during molar eruption. AB - Affinity-purified antibodies produced intense staining for type I collagen in alveolar bone matrix and predentine, and moderate staining in the dentine matrix, lamina propria, connective tissue invaginating into papillary layer of the enamel organ, dental sac and periodontal ligament. No staining occurred in oral epithelium, stellate reticulum, stratum intermedium, ameloblasts and odontoblasts. Fibronectin was distributed similarly except at the interface between the epithelial diaphragm and pre-odontoblasts where type I collagen was absent but fibronectin was present. In contrast, type III collagen showed strong staining in the periodontal ligament and lamina propria but no staining in bone matrix, predentine, dentine and at the interface between the epithelial diaphragm and pre-odontoblasts. The staining pattern for type III collagen was similar to that of type I and fibronectin in other tissues including endosteal reticular tissue, the connective tissue invaginating into papillary layer and the extracellular matrix of the pulp. PMID- 3310982 TI - The polyamines putrescine, spermidine and spermine in human gingival crevicular fluid. AB - In human periodontal disease, there may be periods of exacerbation and remission. Definition of the homeostatic mechanisms in the periodontium may therefore be important in understanding the natural history of this disorder. The polyamines are biologically active amines involved in the regulation of cell growth, regeneration of tissue and modulation of inflammation. Their occurrence was examined in gingival crevicular fluid (GCF). Fifteen sites were evaluated in four patients with moderately advanced periodontitis before and after root planing and scaling, and 15 sites were evaluated in four patients with mild inflammatory gingivitis and no attachment loss. Polyamine analysis was by high-performance liquid chromatography. GCF from untreated sites in periodontitis patients contained the highest concentration of putrescine (10(4) greater than serum). This polyamine was detected in all periodontitis samples and 12 of 15 gingivitis samples. Significant differences were seen when the amount of putrescine/30 s sample was compared: periodontitis sites before treatment 1005.7 +/- 106.1 pmol; periodontitis sites after treatment 504.7 +/- 89.2 pmol; gingivitis sites 186.7 +/- 40.1 pmol. In contrast, spermidine and spermine were detected only occasionally. Thus putrescine may play an important homeostatic role in the periodontium. PMID- 3310983 TI - Biochemical and immunochemical characteristics of the major protein of the murine parotid-granule membrane. AB - The membrane fraction (ParB) of the secretory granules of mouse parotid gland was isolated and characterized. The major phospholipids were phosphatidylcholine and sphingomyelin. The membranes contained one major protein, PMC, constituting at least 30 per cent of the total protein. PMC was purified: it is a small acidic protein with molecular weight of 12,000, containing one residue of phosphate per molecule. Using anti-PMC serum, PMC was detected only in the mouse parotid and saliva. Immunochemical characterization of organelle fractions indicated that PMC was mainly present in the secretory granule fraction; it was in part tightly bound to granule membranes. PMC was also present in both the 100,000 g parotid tissue supernatant and the water-extract of the ParB granules. This dual localization was corroborated by immunofluorescent studies with anti-PMC serum which demonstrated that PMC was distributed uniformly over the acinar cells. The major protein component of these membranes is absent from other exocrine organs, e.g. pancreas, submandibular and sublingual glands. PMID- 3310984 TI - Acanthamoeba keratitis masquerading as corneal homograft rejection. Case report. PMID- 3310985 TI - Desquamating endotheliopathy. An incipient iridocorneal endothelial syndrome? AB - Unilateral, noninfectious, nontraumatic corneal endotheliopathy was noted in a 34 year-old man who had had blurred vision for five years without evidence of iridic disease or glaucoma. Ultrastructural studies demonstrated focal necrosis of the corneal endothelial cells, with desquamation of the cells into the anterior chamber. The corneal endothelium appeared to expand beneath the dying endothelial cells, indicating reendothelialization of the cornea. There was no epithelialization of the endothelium, as evidenced by the lack of keratin production or desmosome formation. Descemet's membrane was thickened with edema, a posterior collagenous layer, and fibrous, long-spacing collagen. These alterations in Descemet's membrane were similar to those described for other corneal dystrophies. It is proposed that this unilateral desquamating endotheliopathy represents an incipient form or a forme fruste of the iridocorneal endothelial syndrome. PMID- 3310986 TI - Choroidal melanoma treatment with iodine 125 brachytherapy. AB - Twenty-six patients were treated for malignant melanoma of the choroid with iodine 125 episcleral plaques. Patients were followed up for at least two years, with a mean follow-up of 45 months. Tumor shrinkage was documented by A-scan ultrasonography in all but one patient. The average reduction in tumor thickness was 46%. Visual acuity remained within two Snellen lines of preoperative levels in 14 (54%) of the 26 patients. Of the 12 patients who lost more than two lines of central visual acuity, eight developed radiation changes affecting either the optic nerve or retina, and three developed cataracts; enucleation accounted for the loss of vision in the final patient. Enucleation was necessary in one other patient in this series because of tumor growth. The mean duration between treatment with iodine 125 and the development of radiation changes affecting the optic nerve or retina was 32 months. PMID- 3310987 TI - Effects of bacterial endotoxin on the ciliary activity in the in vitro eustachian tube. AB - We have used a tissue culture technique and a photoelectric method to examine the direct effect of lipopolysaccharide (LPS) on the ciliary activity present in the eustachian tube. Since LPS possesses the major part of the biological activity of endotoxin, our results show clearly that LPS deteriorates the ciliary activity in a dose-response fashion: LPS does not deteriorate the ciliary activity up to 168 h if its concentration is 1 ng/ml or less; 10 ng/ml LPS can cause deterioration of the ciliary activity with extended exposure (more than 96 h); LPS can cause dysfunction of the cilia rather quickly if the concentration is 100 ng/ml or more. Our results show that the ciliary activity in the eustachian tube under clinical conditions can be affected by endotoxin. PMID- 3310989 TI - Logical prescribing. A general practitioner's viewpoint. PMID- 3310988 TI - An approach to bladder and bowel management in children with spina bifida. PMID- 3310990 TI - Update on breast cancer. PMID- 3310991 TI - Genetic counselling and psychiatric illness. PMID- 3310992 TI - Local intra-arterial infusion of growth hormone into the mammary glands of sheep and goats: effects on milk yield and composition, plasma hormones and metabolites. AB - Lactating goats and sheep were fitted with catheters in the external pudendal arteries supplying both mammary glands. Saline was infused continuously into one artery whereas the other artery received continuous infusions, over successive 4 day periods, of either saline or growth hormone (GH)-doses increasing twofold between successive periods from 100 to 400 micrograms/day in goats and 400 to 3200 micrograms/day in sheep. Local infusion of GH at up to 1600 micrograms/day in sheep did not affect milk yield or composition nor peripheral plasma concentrations of GH, insulin, glucose, urea and non-esterified fatty acids (NEFA). Infusion of GH at 3200 micrograms/day in sheep increased peripheral plasma concentrations of GH, tended to increase milk yield and peripheral plasma NEFA but there were no changes in peripheral plasma insulin, glucose and urea. It is concluded that GH does not exert direct effects on the mammary glands of sheep and goats in situations where the hormone is administered over short periods. PMID- 3310993 TI - Effects of pituitary-derived bovine growth hormone on production parameters and biokinetics of key metabolites in lactating dairy cows at peak and mid-lactation. AB - Changes in production parameters and metabolite biokinetics induced by treatment with pituitary-derived bovine growth hormone (bGH) were monitored at peak (c. 40 days) and mid-lactation (c. 130 days) in dairy cows. During treatment with bGH milk production increased by 6 and 14% at peak and mid-lactation respectively. At peak lactation the content of milk fat tended to increase, whereas milk protein tended to decrease and milk lactose decreased significantly. Yield of milk fat increased, but there was no change in the yield of milk protein and lactose. The content of milk fat tended to increase at mid-lactation. Milk protein decreased and there was no change in milk lactose. Yields of milk fat and lactose but not protein increased. Growth hormone exerted metabolic effects which differed with stage of lactation. At peak lactation plasma glucose concentration and its irreversible loss increased, plasma urea and acetate were unchanged and their irreversible losses tended to increase. No change was measured for plasma non esterified fatty acids (NEFA) and the irreversible loss of NEFA decreased. At mid lactation plasma concentrations of glucose and NEFA were increased, plasma urea decreased and acetate and 3-hydroxybutyrate tended to increase. Irreversible losses of NEFA increased, urea tended to decrease and acetate and glucose remained essentially constant. The results show that exogenous pituitary bGH exerts metabolic effects which result in the supply of increased nutrients to support milk synthesis. The metabolic effects differ with the stage of lactation, reflecting differences in physiological and/or nutritional state. PMID- 3310995 TI - A novel compensating filter for resolution enhancement in ultrasonic imaging. PMID- 3310994 TI - An assessment of the Hewlett-Packard 4760 series pagewriter cardiograph with paediatric analysis program. PMID- 3310996 TI - Perinatal factors and the development of chronic lung disease in preterm infants: a case control study. AB - A case control study of neonates was performed to determine those factors contributing to the development of chronic lung disease (CLD). During the 5 years 1981-84 there were 487 neonatal survivors at gestations of 25-32 weeks; 391 of these developed respiratory failure (oxygen therapy required for more than 6 h). Fifty-six of the latter developed CLD (oxygen therapy required for more than 28 days and a coarse reticular pattern on chest X-ray). These neonates were predominantly of the shortest gestational ages, regardless of the initial chest X ray diagnosis. Forty-three of these infants with CLD were matched for gestation and initial chest X-ray appearance (respiratory distress syndrome, n = 20; normal, n = 15; non-specific, n = 8) with 42 control infants. The mean duration of oxygen therapy (P less than 0.001), maximum FiO2 (P less than 0.001), incidence (P less than 0.01) and duration of intermittent positive pressure respiration (IPPR; P less than 0.05) and peak IPPR (P less than 0.05) were significantly greater in the CLD group. Mean birthweight (P less than 0.001), arterial cord pH (P less than 0.05) and base excess (P less than 0.05) were significantly lower in the CLD group. Factors that were not statistically significant in the development of CLD included antenatal fetal heart rate abnormality, hypertensive disease of pregnancy, acute intrauterine infection (chorioamnionitis or umbilical vasculitis), administration of antenatal steroids, sex, patent ductus arteriosus and pneumothorax. The association between CLD and ventilator/oxygen therapy is confirmed. Contrary to other reports, male sex, clinical patent ductus arteriosus and pneumothorax were not associated with CLD. PMID- 3310997 TI - Artificial intelligence. Expert systems for clinical diagnosis: are they worth the effort? AB - Modeling the decision-making processes of human experts has been studied by scientists who call themselves psychologists and by scientists who say they are students of artificial intelligence (Al). The psychological research literature suggests that experts' decision-making processes can be adequately captured by simple mathematical models. On the other hand, those in Al who are preoccupied with human expertise maintain that complex computer models, in the form of expert systems, are required to do justice to those same processes. The resultant paradox of simple versus complex decision-making models is investigated here. The relevant literatures in psychology and Al are reviewed and, based on these findings, a resolution of the paradox is offered. PMID- 3310998 TI - Phospholipases of the myocardium. AB - The myocardium contains diverse cellular components and heterogeneous phospholipid-containing membranes. The major phospholipids are phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositnol, sphingomyelin and cardiolipin. The phospholipases capable of hydrolyzing these membrane lipids include phospholipase A, lysophospholipase, and phosphatidylnositol-specific phospholipase C. Early studies revealed that myocardial phospholipase A with an acid pH is localized to lysosomes; those with more alkaline and neutral activities are present in cytosol, microsomes, mitochondria and sarcolemma. Recently, we have identified phosphatidylinositol specific phospholipase C activity in bovine myocardium with molecular weights ranging from 40,000 to 271,000. Interestingly, forms I, II and III, had pH optima ranging from 4.5 to 5.5; form III also had significant activity at pH 7.0. All activities were stimulated by calcium, suggesting that they are different from calcium-independent phospholipases C found in liver and brain. The pathophysiological significance of these four cytosolic forms of phospholipase C remains to be determined. Thus, under injury-promoting conditions, phospholipase C appears capable of hydrolyzing membrane-associated phosphatidylinositol and the polyphosphoinositides, whereas phospholipases A and lysophospholiphases appear to prefer non-inositol containing phospholipids. Finally, very recent studies suggest "free radical-triggered lipolysis" by phospholipases as a possible mechanism for production of lysophospholipids in myocardial membranes. PMID- 3310999 TI - Uptake and transport of lipid substrates in the heart. AB - Between 1955-1960 it was realized that the fatty acids circulating in the blood, after transport into the cardiac cells, then beta-oxidation in the myocyte mitochondria, were the major source of energy behind the impressive hydraulic performance of the heart. Only albumin-bound fatty acids and, to a lesser extent, cholesterol ester and triglyceride fatty acids have access to the cardiac cells. Circulating phospholipid fatty acids are excluded. From experiments with isolated perfused hearts it was concluded that fatty acid uptake by the myocardium was essentially an energy independent process. An important question still pending in the literature concerns the mechanisms of fatty acid transport through the capillary endothelium, through the cardiac cell plasma membrane and then through the intracellular compartments. The most plausible model now emerging considers that specific fatty acid-binding proteins, sequentially disposed along this cascade of barriers, might facilitate and drive the flux of fatty acids entering the cardiac cells. PMID- 3311000 TI - Membrane phospholipid metabolism during myocardial ischaemia: past, present and future. AB - Alterations in myocardial membrane phospholipids may play an important role in the pathogenesis of ischaemic myocardial cell injury. Studies in canine myocardium, perfused rat heart, and cultured myocardial cells have demonstrated that the accumulation of free arachidonic acid correlates with the development of irreversible cell injury. Accumulation of other phospholipid hydrolysis products, including amphiphilic compounds such as lysophosphatidylcholine, has also been reported. The biochemical mechanisms which are responsible for phospholipid hydrolysis and arachidonic acid accumulation during ischaemia are unknown. This manuscript provides a synopsis of previous work in this field and suggests new directions for the field of myocardial phospholipid metabolism. PMID- 3311001 TI - Cholesterol and myocardial membrane function. AB - The incorporation of cholesterol into phospholipid membranes changes the physical properties of the membranes, such as their phase transition, fluidity and homogeneity. In cholesterol-containing phospholipid membranes, integral proteins are surrounded by "annular" phospholipids which exclude cholesterol. Cellular cholesterol is supplied by circulating low-density lipoproteins, and by intracellular de novo synthesis. Cholesterol removal is predominantly handled by circulating high-density lipoproteins. In cardiomyopathic hamsters, myocardial membranes (sarcolemma, mitochondria, sarcoplasmic reticulum) have an increased cholesterol content. In ischaemic myocardium, cholesterol content of sarcolemma fell and that of mitochondria rose. Apparently, cholesterol is redistributed within the ischaemic heart cell. Phospholipids are degraded in sarcolemma, mitochondria and sarcoplasmic reticulum of ischaemic heart cells, probably by activation of phospholipases present in these membrane systems. PMID- 3311002 TI - Lipid and carbohydrate metabolism in the ischaemic heart. AB - Ischaemia has profound effects on myocardial metabolism and cell function in general. High energy phosphate and glycogen stores are depleted. Lactate, inorganic phosphate and hydrogen ions accumulate, exerting negative effects on the initially accelerated glycolytic flux. Fatty acid oxidation is inhibited. The cellular content of lipid intermediates, such as hydroxy-fatty acids, acyl CoA and acylcarnitine, increases in low-flow ischaemia hearts. Non-esterified fatty acid (NEFA) accumulation occurs after 30-60 min ischaemia. Endogenous triacylglycerol and phosphoglyceride turnover is most likely impaired, ultimately resulting in accumulation of lipid droplets in the oxygen deprived cells and in degradation of myocardial membranes. Accumulated lipid substances such as NEFA, acyl CoA, acylcarnitine and lysophosphoglycerides, are likely to be involved in the mechanism underlying ischaemia-induced damage to myocardial cells. PMID- 3311003 TI - Accumulation of lipids and lipid-intermediates in the heart during ischaemia. AB - The content of non-esterified fatty acids (NEFA) and their CoA and carnitine esters is low in normoxic cardiac tissue. The majority of fatty acids is esterified in the triacylglycerol and phosphoglyceride pool. During myocardial ischaemia beta-oxidation of fatty acids is inhibited. In addition, turnover of the esterified fatty acid pools is most likely disturbed. Accumulation of hydroxy fatty acids, acylCoA and acylcarnitine rapidly occurs after the onset of ischaemia. The accumulation of NEFA is a slower process. In addition to extracellular sources, NEFA originate also from intracellular lipid pools, most likely from phosphoglycerides. Although it has been suggested that activation of phospholipase A2 occurs in ischaemic tissue, the mechanism underlying the enhanced degradation of phosphoglycerides ist still incompletely understood. PMID- 3311004 TI - Raised plasma non-esterified fatty acids (NEFA) during ischaemia: implications for arrhythmias. AB - Raised plasma non-esterified fatty acids (NEFA) have been directly implicated in the development of serious ventricular arrhythmias and death during acute myocardial infarction. Since this was first proposed by Oliver and Kurien in 1970, clinical and experimental evidence has been conflicting, but results of clinical studies with antilipolytic drugs suggested a reduction in ventricular tachycardia. Lowering of raised NEFA by antilipolytic therapy in dogs was effective, whilst raising NEFA, either by intravascular lipolysis or direct infusion, failed to precipitate VF. An alternative hypothesis is proposed, which suggests that a fatty acid--triglyceride energy wasting cycle operates at different rates within the ischaemic heart, and caused differential rates of K+ loss, leading to ventricular fibrillation. PMID- 3311005 TI - Synthesis, storage and degradation of myocardial triglycerides. AB - In the mammalian myocardium, an active triglyceride synthesis pathway is operating, (re)esterifying activated fatty acids from endogenous or exogenous sources, with the glycolytically derived three-carbon intermediates dihydroxyacetone-phosphate and glycerol-3-phosphate by the so-called Kennedy pathway. The seven enzymes of triglyceride synthesis are membrane bound and located at the sarcoplasmic reticulum. The first enzyme in the glycerol-3 phosphate pathway, glycerol-3-phosphate acyltransferase, is proposed to be rate limiting for triglyceride formation. This microsomal enzyme is regulated by phosphorylation (inactiycation)-dephosphorylation (activation) coupled to the beta-receptor--adenyl cyclase--protein kinase system. Additional regulatory steps in triglyceride formation are the reactions catalyzed by the microsomal phosphatidic acid phosphatase and diglyceride acyltransferase. Intracellular triglycerides occur as free floating cytosolic droplets, membrane-bound particles and lipid-filled lysosomes. No consensus exists about the metabolically active portion of myocardial triglycerides. Various lipases have been proposed to be involved in endogenous lipolysis: the lysosomal acid, microsomal and soluble neutral triglyceride, intracellular lipoprotein lipases and the microsomal di- and monoglyceridase. It has been acknowledged that the bulk of the intracellular neutral lipase represents the precursor of vascular lipoprotein lipase. The presence of a neutral lipase, as distinct from lipoprotein lipase, in the rat heart was recently advocated. Endogenous lipolysis is a hormone-sensitive process. Hormone-sensitivity may involve direct alteration of enzyme activity by protein phosphorylation-dephosphorylation but is also dependent on the removal rate of product fatty acids, since feedback inhibition is a common property of all lipases in the heart.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311006 TI - Lysophospholipids, long chain acylcarnitines and membrane dysfunction in the ischaemic heart. AB - Several findings suggest that the accumulation of ions and metabolites contribute to the electrophysiological alterations and associated malignant arrhythmias in the ischaemic heart. Our studies have focused on two amphipathic metabolites, lysophosphoglycerides (LPGs) and long-chain acylcarnitines (LCA). In an attempt to implicate any metabolite as contributing to the early electrophysiological alterations or subsequent development of irreversible cell injury in the ischaemic heart, several methodological and interpretative issues must be addressed, including the time course of accumulation and subcellular distribution. Current findings include: (1) both LPGs and LCA increase in ischaemic myocardium within 3 min, although the precise subcellular distributions have yet to be clarified, (2) electrophysiological alterations, analogous to those seen during ischaemia, are induced in vitro by both LPGs and LCA when as little as 1 mol% is incorporated into the sarcolemma (SL) based on EM autoradiography, (3) electrophysiological effects of LPGs are dependent on extracellular delivery, based on studies using intracellular pressure microinjection, (4) LPGs increase in both cardiac lymph and venular effluents in vivo within minutes to concentrations sufficient to induce electrophysiological alterations, (5) LCA increases in rat myocytes in vitro during hypoxia with a 5 fold increase in the SL determined by quantitative EM autoradiography. Inhibition of carnitine acyltransferase I (CAT-I) during hypoxia prevents not only the SL accumulation of LCA but also the associated electrophysiological alterations. Since the two major catabolic enzymes for LPGs are inhibited by LCA, studies are currently underway to assess the effects of inhibition of CAT-I during ischaemia in vivo, on both LCA and LPG accumulation and the influence on regional electrophysiological alterations and arrhythmogenesis. PMID- 3311007 TI - Dietary fatty acids and myocardial function. AB - It is widely recognized that dietary polyunsaturated fatty acids (PUFA's) and cholesterol can profoundly influence the development of atherosclerotic plaques in coronary vessels, which may lead to myocardial infarction. The possibility that dietary fatty acids may also directly influence cardiac function has received less attention. We therefore reviewed the evidence of the effects of dietary fatty acids, in particular n-3 and n-6 PUFA's, on myocardial phospholipid fatty acid composition and cardiovascular performance. Heart organelles appear to incorporate uncommon fatty acids like 22:1 and trans- 18:1. Diets enriched with 22:1 induce myocardial lipidosis. N-9, n-6 and n-3 families compete among membrane C20 and C22 acids. Several studies have dealt with the relation between diet-induced changes of cardiac membrane (sarcolemma, sarcoplasmic reticulum and mitochondria) phospholipids and membrane function. In view of the variety of diets used and of the membrane functions studied, the results do not permit equivocal interpretation. Several investigators have reported an altered stress response of the heart due to a change of PUFA's in the diet. In rats fed with a low 18:2n-6/18:3n-3 ratio combined with relatively low amounts of saturated fatty acids, a high incidence of myocardial lesions has been observed. Pigs are less sensitive but more susceptible to the development of vitamin E deficiency, when the dietary PUFA content is high. Increased contractility and coronary flow rate have been reported for Langendorff-perfused hearts of rats fed 18:2n-6-rich diets. The effects on coronary flow rate are possibly related to alterations in eicosanoid synthesis, which may also contribute to the reduction by n-6 or n-3 PUFA's in infarct size, magnitude of recovery of function and suppression of reperfusion arrhythmias following release of a coronary artery ligation. On the other hand, increased peroxidation of membrane lipids, due to their high content of n-3 PUFA, may be deleterious. PMID- 3311008 TI - Lipid peroxidation and myocardial ischaemic damage: cause or consequence? AB - Compelling evidence has been accumulated which indicates that myocardial tissue damage occurring during reperfusion after an ischaemic period may partly be due to the formation of oxygen free radicals and subsequent peroxidative processes. It has been well established that the actual toxicity of free radicals is dependent on the presence of free iron in the heart tissue. Based upon the hypothesis of McCord et al., proposing xanthine oxidase mediated formation of superoxide (O2-.) during the conversion of ATP-breakdown product(s) (hypo)xanthine to urate, we studied whether xanthine oxidase was able to mobilize free iron from the intra- and extracellular iron-binding proteins, ferritin and transferrin. It appeared that there was an O2-.-dependent and O2-.-independent mechanism by which xanthine oxidase could mobilize iron from ferritin while no iron mobilization from transferrin was detectable. The capacity of xanthine oxidase to mobilize iron from ferritin by an O2-.-independent mechanism implies that already during the anoxic/ischaemic period, iron may become available in the tissue which, upon the re-entrance of O2, catalyzes the formation of the very reactive OH radicals. The interaction between endothelial cells and cardiocytes in free radical homeostasis is discussed with the emphasis on the tissue localization of xanthine oxidase. The latter is located in endothelial cells implying an interaction between xanthine oxidase-induced endothelial cells initiated lipid peroxidation and the actual overall myocardial tissue damage. PMID- 3311009 TI - Myocardial carnitine transport. AB - In mammals, carnitine is synthesized from proteic trimethyllysine in the liver, brain and (in human) kidneys. The hydroxylase catalyzing the last step (deoxycarnitine----carnitine) is missing in the remaining tissues, which are thus entirely dependent on carnitine uptake from the blood. On the basis of experimental evidence, or reasonable assumptions, an interorgan transport of carnitine, carnitine precursors and derivatives is described. In particular, evidence demonstrating a bidirectional exchange between carnitine and deoxycarnitine across cardiac sarcolemma have been provided both in vitro and in vivo experiments. It has been demonstrated that in heart slices carnitine deoxycarnitine exchange, occurring in a close one to one ratio, is (i) insensitive to both glycolysis and oxidative phosphorylation inhibitors and (ii) sensitive to thiol reagents, such as NEM and Mersalyl. It is assumed that deoxycarnitine is released from muscles into the blood, taken up by the liver, or kidneys, to be hydroxylated to carnitine and the latter returned to the muscles. In vivo evidence for carnitine-deoxycarnitine exchange has been obtained by administering carnitine, or deoxycarnitine, to rats and measuring deoxycarnitine and carnitine, respectively, in different tissues and urine. The results clearly indicate that carnitine administration displaces endogenous deoxycarnitine from tissues and vice versa, thus further supporting the existence of a carnitine deoxycarnitine exchange process. PMID- 3311010 TI - The role of the carnitine system in myocardial fatty acid oxidation: carnitine deficiency, failing mitochondria and cardiomyopathy. AB - The carnitine system functions in the transport of activated acyl groups over the mitochondrial inner membrane, and is needed for oxidation of long-chain fatty acids by all mitochondria. The rate of cardiac fatty acid oxidation is determined by availability of fatty acids, oxygen and the activity of carnitine palmitoyltransferase I, which is regulated by a variety of factors. It is inhibited by malonyl-CoA, which in rat heart was found to be synthesized by acetyl-CoA carboxylase. It is also inhibited by long-chain acylcarnitine. Linoleoylcarnitine was found to be a better inhibitor than palmitoylcarnitine. The concentration of carnitine in human heart, muscle and other tissues is much higher than is needed for the optimal beta-oxidation rate. In contrast to controls, we found in several myopathic patients that extra carnitine (from 1/2 to 5 mM) caused a considerable increase in beta-oxidation rate of isolated muscle mitochondria. In some of these patients we detected medium-chain acyl-CoA dehydrogenase deficiency. Patients with primary carnitine deficiency caused by a renal carnitine leak often show cardiomyopathy, which completely disappears under carnitine therapy. Cardiomyopathy may also be the cause of secondary carnitine deficiency resulting from a mitochondrial defect in acyl-CoA metabolism, or by the mitochondrial defect itself, which may be induced by drugs or viral attack, or be the result of a genetic error. In cardiomyopathic patients with a (subclinical) myopathy, study of isolated mitochondria and homogenate from skeletal muscle may reveal a mitochondrial dysfunction, which, in some patients, is treatable by dietary measures and supplementation with vitamins, CoQ and/or carnitine. When the cause of cardiomyopathy is not known, determination of plasma carnitine and carnitine supplementation of hypocarnitinemic patients is of great therapeutic value. PMID- 3311011 TI - Physico-chemical properties and organization of lipids in membranes: their possible role in myocardial injury. AB - Lipids in biological membranes are organized in a bilayer configuration in order to form a semi-permeable barrier. The lipids are freely mobile in the bilayer, which is denoted as "fluid" or liquid-crystalline. For plasma membranes it is assumed that the lipids are not homogeneously distributed over the two leaflets or monolayers. This so-called lipid asymmetry is established for the erythrocyte membrane. There it was found that phosphatidylserine (PS) and phosphatidylethanolamine (PE) are present exclusively and predominantly in the cytoplasmic leaflet, respectively. It is shown that isolated PE at physiological conditions forms a non-bilayer configuration the so-called hexagonal HII phase. Moreover, isolated PS can undergo a transition from the fluid into the solid state upon addition of calcium. In mixtures of PS and PE, calcium is able to induce fusion events, possibly formation of the HII phase and phase separation of solid PS. The physico-chemical behaviour of these phospholipids will be discussed in the light of the structural changes of the sarcolemma of heart muscle cells observed by freeze-fracturing and thin section electron microscopy after ischaemia, ischaemia and reperfusion and the calcium paradox. The lateral phase separation of intramembranous particle aggregation is explained as isothermic phase separation by H+ and calcium. The disruption of the sarcolemma by the formation of blebs (liposomal structures) is interpreted as a destabilization of the bilayer configuration since PE prefers the HII phase and thus induces uncontrolled fusion events. This all leads to an irreversible disruption of the sarcolemma. PMID- 3311012 TI - Modulation of membrane protein function by bilayer lipids. AB - In many instances, the composition of fatty acyl groups of membrane phospholipids can be modified to achieve a range of fatty acyl unsaturation without any detectable change in bulk membrane fluidity. At the same time, the function of membrane proteins may be considerably altered, raising questions concerning the property of the lipids that brings about this altered protein function. There is some evidence that the lipids may be laterally distributed in a heterogeneous manner throughout the membrane, and changes in this distribution could be responsible for the effects on proteins. There is also increasing evidence for specific interactions between individual molecular species and membrane proteins that may also modulate membrane protein function. PMID- 3311013 TI - Serum factors which alter cell membranes. AB - Mammalian cell membranes are much more sensitive to changes in serum ion concentrations than they are to serum cholesterol. Because of this, arterial cells function normally only in a very narrow range of serum ion concentrations. Unfortunately, new introductions into the food supply have been made in the diet since 1920 which may perturb the delicate relationships between arterial cell membranes and the blood serum to which they are exposed. For example, powerful surface active agents are used to emulsify fats in a host of popular food items. None of them have been adequately tested for their possible role in changing phospholipid head group composition of arterial or myocardial cell membranes. Ocean salt has been replaced by refined table salt removing a rich source of magnesium from the diet of Northern Europeans and Americans. Excessive amounts of Vitamin D, which may calcify soft tissue, have been added to the diet as a means of preventing a disease that does not develop in babies exposed to sunshine. The introduction of hydrogenated vegetable oil to the diet has helped to stimulate per capita fat consumption to almost twice the level of 1920. How the introduction of such technology has changed arterial cell membrane structure or function has not been considered. It is now possible to consider the influence of this technology on the food supply by the application of modern genetic engineering methods. The application of this type of methodology in the study of cholesterol metabolism and its role in atherosclerosis may help to find means of preventing heart disease and strokes. PMID- 3311014 TI - Cardioprotection by anti-ischaemic and cytoprotective drugs. AB - Cardioprotective drugs are agents that prevent or moderate harmful consequences of impaired cardiac energetics, such as sudden coronary death (SCD) due to early post-occlusion ventricular fibrillation (EPVF), development of incapacitating myocardial necrosis. Cardioprotection may be due to anti-ischaemic action, correcting the imbalance between vascular supply and myocardial demand for blood, but also to cytoprotective effect, preserving cellular integrity in the presence of factors damaging structure and function of the cardiac cell membrane such as ischaemia, ionic imbalance and that of pH, etc. Neither anti-ischaemic nor cytoprotective effect alone, or in combination, are sufficient to warrant full cardioprotection, i.e. both prevention of SCD and limitation of infarct size. Thus the beta-blocker pindolol which is anti-ischaemic in its effect reducing myocardial O2 demand and protects from SCD and EVFP, failed to limit infarct size. Even interventions of a mainly cytoprotective type of action protecting from SCD and EPVF, such as the linoleic acid-rich diet, or lidocaine, were unable to limit infarct size, 7-oxoPGI2 (anti-ischaemic and cytoprotective) failed to protect from SCD, VF and did not limit infarct size. On the other hand the nonsteroidal anti-inflammatory drugs which, like salicylates or sulfinpyrazon, reduce myocardial O2 demand and protect from post-occlusion SCD and EPVF, effectively limiting infarct size. PMID- 3311015 TI - [Morphogenesis of hematogenously formed foreign body granulomas in lung parenchyma]. PMID- 3311017 TI - [Recent cases of scientific criminality in medicine]. PMID- 3311016 TI - [Nonspecific reactions in immunohistochemical determination of blood groups of human tissue]. PMID- 3311018 TI - [An early critic of nonmedical healing methods in Germany: Erwin Liek]. PMID- 3311019 TI - [Detection of poisons in living persons]. PMID- 3311020 TI - [Vital reaction of skeletal musculature]. PMID- 3311021 TI - Characterization and localization of the putative 'link' component in rat small intestinal mucin. AB - Rat intestinal mucin is polymerized by a putative 'link' component of Mr 118,000 that can be released from the native mucin by thiol reduction [Fahim, Forstner & Forstner (1983) Biochem. J. 209, 117-124]. To confirm that this component is an integral part of the mucin and independent of the mucin purification technique, rat mucin was purified in the present study by three independent techniques. In all cases, the 118,000-Mr component was released after reduction. The 118 kDa band was electroeluted from SDS/polyacrylamide gels and its composition shown to resemble closely that of the link component of human intestinal mucin [Mantle, Forstner & Forstner (1984) Biochem. J. 224, 345-354]. Carbohydrates were present, including significant (10 mol/100 mol) amounts of mannose, suggesting the presence of N-linked oligosaccharides. Monospecific antibodies prepared against the rat 118,000-Mr component established its tissue localization in intestinal goblet cells. Mucins subjected to SDS/polyacrylamide-gel electrophoresis and Western blots using the same antibody, established that the link components of rat and human intestinal mucin are similar antigenically. Brief exposure (10 min) of native rat mucin to trypsin or Pronase (enzyme/mucin protein, 1:500, w/w) also released a 118,000-Mr component that reacted with the monospecific antibody. Thus the 118,000-Mr component is an integral part of the mucin and, although linked to large glycopeptides by disulphide bonds, this component also has proteinase sensitive peptide bonds, presumably at terminal locations such that brief treatment with proteinases releases the molecule in a reasonably intact form. Under physiological conditions, therefore, one might expect that, after mucin is secreted into the intestinal lumen, luminal proteinases would rapidly remove the link component, thereby causing the mucin to depolymerize. PMID- 3311022 TI - Identification and characterization of a tissue kallikrein in rat skeletal muscles. AB - A tissue kallikrein was purified from rat skeletal muscle. Characterization of the enzyme showed that it has alpha-N-tosyl-L-arginine methylesterase activity and releases kinin from purified bovine low-Mr kininogen substrate. The pH optimum (9.0) of its esterase activity and the profile of inhibition by serine proteinase inhibitors are identical with those of purified RUK (rat urinary kallikrein). Skeletal-muscle kallikrein also behaved identically with urinary kallikrein in a radioimmunoassay using a polyclonal anti-RUK antiserum. On Western-blot analysis, rat muscle kallikrein was recognized by affinity-purified monoclonal anti-kallikrein antibody at a position similar to that of RUK (Mr 38,000). Immunoreactive-kallikrein levels were measured in skeletal muscles which have different fibre types. The soleus, a slow-contracting muscle with high mitochondrial oxidative-enzyme activity, had higher kallikrein content than did the extensor digitorum longus or gastrocnemius, both fast-contracting muscles with low oxidative-enzyme activity. Streptozotocin-induced diabetes reduced muscle weights, but did not alter the level of kallikrein (pg/mg of protein) in skeletal muscle, suggesting that insulin is not a regulator of kallikrein in this tissue. Although the role of kallikrein in skeletal muscle is unknown, its localization and activity in relation to muscle functions and disease can now be studied. PMID- 3311023 TI - Preparation and characterization of bovine growth hormones produced in recombinant Escherichia coli. AB - Two analogues of bovine growth hormone (BGH) have been produced in Escherichia coli by recombinant DNA techniques. In analogue Delta-1, the N-terminal alanine residue of the full-length bovine sequence is replaced by methionine. In analogue Delta-9, which is expressed at much higher levels than is Delta-1, the full length bovine sequence is truncated at the N-terminus by eight residues and there is a serine-for-glycine substitution in the first position of the truncated protein. Both analogues, which were characterized by isoelectric focusing (i.e.f.), polyacrylamide-gel electrophoresis in the presence of SDS (SDS/PAGE), amino acid analysis and N-terminal amino acid sequence determination using combined g.l.c.-m.s., are compared with BGH isolated from pituitaries. In contrast with pituitary-derived BGH, the recombinant-derived proteins are homogeneous on SDS/PAGE and on i.e.f. In a radioimmunoassay, a radioreceptor assay and a bioassay in vivo (rat tibia), Delta-9 BGH showed very similar characteristics to the pituitary-derived hormone. Similar results have also been obtained with the Delta-1 analogue. PMID- 3311024 TI - Proteolysis and deglycosylation of human C1 inhibitor. Effect on functional properties. AB - The effects of proteolysis and deglycosylation on C1 inhibitor (C1Inh) were tested with respect to both its ability to form complexes with C1s and its capacity to block C1 autoactivation. Limited proteolysis of C1Inh by Staphylococcus aureus V8 proteinase, proline-specific endopeptidase or elastase generated a major high-Mr (approximately 86,000) fragment. In contrast with the fragment produced by elastase, which was inactive, the fragments resulting from V8 proteinase and proline-specific endopeptidase treatment retained activity. Deglycosylation with N-glycanase or O-glycanase, or both, had no major effect on the functional activity of C1Inh. PMID- 3311025 TI - Kinetics of carbonyl reductase from human brain. AB - Initial-rate analysis of the carbonyl reductase-catalysed reduction of menadione by NADPH gave families of straight lines in double-reciprocal plots consistent with a sequential mechanism being obeyed. The fluorescence of NADPH was increased up to 7-fold with a concomitant shift of the emission maximum towards lower wavelength in the presence of carbonyl reductase, and both NADPH and NADP+ caused quenching of the enzyme fluorescence, indicating formation of a binary enzyme coenzyme complex. Deuterium isotope effects on the apparent V/Km values decreased with increasing concentrations of menadione but were independent of the NADPH concentration. The results, together with data from product inhibition studies, are consistent with carbonyl reductase obeying a compulsory-order mechanism, NADPH binding first and NADP+ leaving last. No significant differences in the kinetic properties of three molecular forms of carbonyl reductase were detectable. PMID- 3311026 TI - Control by insulin and insulin-related growth factor 1 of protein synthesis in a cell-free translational system from chick-embryo fibroblasts. AB - Insulin and insulin-related growth factor 1 (IGF-1) increase by 1.5-1.6-fold the rate of [3H]leucine incorporation into protein in primary monolayer cultures of chick-embryo fibroblasts (CEF); half-maximal hormone concentrations are 10 and 0.25 nM respectively. To investigate the mechanism of this effect, a rapid method is used to prepare a lysate from CEF which is active in protein synthesis. Lysate derived from cells treated for 30-150 min with insulin synthesized protein at 1.8 3.0-fold greater rate than did controls; the increased rate persisted for 20 min in vitro. Pactamycin (0.5 microM), an inhibitor of peptide-chain initiation, inhibited protein synthesis by 50% in lysates derived from insulin-treated and control cells. Thus insulin and IGF-1 cause an increase in the protein-synthesis rate in vivo, which persists in cell-free protein-synthesizing lysates of CEF. PMID- 3311028 TI - Regulation by insulin of liver carbamoyl-phosphate synthase II (glutamine hydrolysing). AB - Evidence is provided that insulin controls the amount and synthetic rate of liver carbamoyl-phosphate synthase II (EC 6.3.5.5) (synthase II) in rat. In 3- and 6 day starvation, with low plasma insulin, synthase II specific activity decreased to 47 and 30%, respectively, of normal; on re-feeding and with concurrent insulin injections, liver synthase II activity increased to 2.5 and 3 times that of starved rats respectively. Treatment with anti-insulin serum during re-feeding prevented the rise in synthase II activity. In diabetic rats, synthase II activity decreased to 28% of normal and was increased by insulin treatment for 2 and 7 days to 4.8- and 5.6-fold of the activity in diabetic liver; this rise in activity was blocked by actinomycin. Immunotitration demonstrated that alterations in synthase II activity were due to changes in the enzyme amount. In starvation, the relative synthesis rate of synthase II decreased to 44%, with an increase in catabolic rate to 122%; re-feeding returned these to control values. In diabetes the synthase II synthesis rate decreased to 52% and the degradative rate was accelerated to 180%; insulin treatment induced synthesis and returned degradation to the control range. Thus the integrative action of insulin in liver pyrimidine metabolism entails regulation of the amount and turnover of synthase II. PMID- 3311027 TI - Biochemistry of bile secretion. PMID- 3311029 TI - Bacterial killing by complement. C9-mediated killing in the absence of C5b-8. AB - The ability of serum complement to kill Gram-negative bacteria requires assembly of the membrane attack complex (MAC) on the cell surface. The molecular events that lead to cell killing after MAC assembly are unknown. We have investigated the effect of C9 on bacterial survival in the presence and absence of its receptor, the C5b-8 complex, on the outer membrane. A fluorescence assay of the membrane potential across the inner bacterial membrane revealed that addition of C9 to cells bearing the performed C5b-8 complex caused a rapid and complete dissipation of the membrane potential. No fluorescence change was observed in serum-resistant strains of Escherichia coli. Addition of trypsin, after C9 was bound to C5b-8, did not rescue the cells from the lethal effects of C9. Furthermore, assays of cell killing kinetics and C9 binding indicate that formation of tubular poly(C9) is not required for killing. When C9 was introduced into the periplasmic space in the absence of its receptor by means of an osmotic shock procedure, cell killing occurred. Other proteins, such as C8 or serum albumin, were not toxic, and C9 was ineffective against two resistant strains. The results presented here and previously [Dankert & Esser (1986) Biochemistry 25, 1094-1100], when considered together, indicate that the 'lethal unit' in complement killing of some Gram-negative bacteria is a C9-derived product that acts by dissipation of cellular energy. PMID- 3311031 TI - Nitrogenase of Klebsiella pneumoniae. Rhodanese-catalysed restoration of activity of the inactive 2Fe species of the Fe protein. AB - The inactive 2Fe species of the Fe protein of the nitrogenase of Klebsiella pneumoniae was generated by treating oxidized Fe protein (Kp2) with MgATP and chelator. Incubation of the 2Fe species of Kp2 with the sulphurtransferase rhodanese in the presence of thiosulphate, ferric citrate and reduced lipoate reproducibly restored activity. The extent of restoration of activity depended on the molar ratio of 2Fe Kp2 to rhodanese and was time-dependent. Re-activation did not occur in the reaction mixture lacking rhodanese. PMID- 3311030 TI - Biosynthesis of betagranin in pancreatic beta-cells. Identification of a chromogranin A-like precursor and its parallel processing with proinsulin. AB - The biosynthesis of insulin and betagranin, a 20-21 kDa co-secreted chromogranin A-related protein, were investigated in isolated insulinoma cells and islets. The insulinoma tissue processed proinsulin to insulin with kinetics similar to those reported in islet tissue. Unlike islets, however, the insulinoma released almost one-quarter of the newly synthesized proinsulin into the medium 10-40 min after its formation. Betagranin was initially immunoprecipitated as a 100 kDa precursor form, which was indistinguishable from chromogranin A in size and immunoreactivity and by peptide mapping. After an initial lag of 10-20 min, the precursor was converted progressively into betagranin, which appeared to be a stable end product. Formation of betagranin and insulin from their respective precursors followed a parallel course and could likewise be inhibited by NH4+, chloroquine and monensin, added either before labelling or at any point of time up to 15 min after labelling. As with proinsulin, approximately one-quarter of the betagranin precursor was released 10-40 min after synthesis. It is concluded that betagranin is produced by limited proteolysis from a chromogranin A precursor in pancreatic beta-cells by a cellular pathway indistinguishable from that of insulin from proinsulin. Chromogranin A is highly conserved in the N terminal region represented by betagranin, further suggesting that the biological activity of chromogranin A may reside in a derived peptide rather than in the parent molecule. PMID- 3311032 TI - Immunochemical evidence for multiple steroid-inducible hepatic cytochromes P-450 in the rat. AB - It has been established that there are glucocorticoid-inducible hepatic cytochromes P-450 in the rat (P-450p), the rabbit (LM3c) and man (HLp) which share extensive structural, functional and regulatory features. We prepared immunochemical probes to P-450p and identified a unique monoclonal antibody, 1G8, that recognizes purified P-450p, but neither purified LM3c nor HLp, on immunoblot analysis. The N-terminal amino acid sequence of purified samples of P-450p was identical with that previously reported for P-450PCN1 [Gonzalez, Nebert, Hardwick & Kasper (1985) J. Biol. Chem. 260, 7435-7441]. Immunoblot analyses of liver microsomes from untreated male rats revealed two 1G8-reactive proteins, whereas liver microsomes from untreated females contained none. Another monoclonal antibody, 13-7-10, reacted specifically with LM3c and HLp, but not with P-450p. A single 13-7-10-reactive microsomal protein was detected in untreated male and female rats, the latter protein exhibiting a greater apparent Mr. 1G8-reactive proteins were induced to the greatest extent by triacetyloleandomycin, followed by dexamethasone, chlordane, pregnenolone-16 alpha-carbonitrile and 2,4,2',4' tetrachlorobiphenyl. In contrast, 13-7-10-reactive proteins were most strongly induced by dexamethasone, only moderately by triacetyloleandomycin and pregnenolone-16 alpha-carbonitrile, weakly by chlordane and not at all by 2,4,2',4'-tetrachlorobiphenyl. We conclude that the P-450p family in rat liver consists of three or more proteins that are structurally related and yet appear to be under distinct regulatory control. PMID- 3311033 TI - Insulin receptor desensitization correlates with attenuation of tyrosine kinase activity, but not of receptor endocytosis. AB - A model of insulin-receptor down-regulation and desensitization has been developed and described. In this model, both insulin-receptor down-regulation and functional desensitization are induced in the human HepG2 cell line by a 16 h exposure of the cells to 0.1 microM-insulin. Insulin-receptor affinity is unchanged, but receptor number is decreased by 50%, as determined both by 125I insulin binding and by protein immunoblotting with an antibody to the beta subunit of the receptor. This down-regulation is accompanied by a disproportionate loss of insulin-stimulated glycogen synthesis, yielding a population of cell-surface insulin receptors which bind insulin normally but which are unable to mediate insulin-stimulated glycogen synthesis within the cell. Upon binding of insulin, the desensitized receptors are internalized rapidly, with characteristics indistinguishable from those of control cells. In contrast, this desensitization is accompanied by a loss of the insulin-sensitive tyrosine kinase activity of insulin receptors isolated from these cells. Receptors isolated from control cells show a 5-25-fold enhancement of autophosphorylation of the beta-subunit by insulin; this insulin-responsive autophosphorylation is severely attenuated after desensitization to a maximum of 0-2-fold stimulation by insulin. Likewise, the receptor-mediated phosphorylation of exogenous angiotensin II, which is stimulated 2-10-fold by insulin in receptors from control cells, is completely unresponsive to insulin in desensitized cells. These data provide evidence that the insulin-receptor tyrosine kinase activity correlates with insulin stimulation of an intracellular metabolic event. The data suggest that receptor endocytosis is not sufficient to mediate insulin's effects, and thereby argue for a role of the receptor tyrosine kinase activity in the mediation of insulin action. PMID- 3311034 TI - Cell-layer-associated proteolytic cleavage of the telopeptides of type I collagen in fibroblast culture. AB - In human skin fibroblast cultures a fraction of the procollagen that was processed to collagen and remained in the cell layer was further proteolytically modified by removal of both N- and C-terminal telopeptides. The proteolytic activity was associated with the cell layer, since secreted collagens were found always to contain intact telopeptides. The inclusion of neutral polymers, which caused the accumulation of the collagen in the cell layer [Bateman, Cole, Pillow & Ramshaw (1986) J. Biol. Chem. 261, 4198-4203], made the telopeptide cleavage more apparent in those cells which expressed the proteolytic activity. The extent of this cleavage was variable from cell culture to cell culture and between experiments with the same fibroblast line. The proteolytic activity was pH dependent; cleavage was greatest at a culture-medium pH of 7.5 and 8.0 and was completely inhibited at a culture-medium pH of 7.0 and 6.5. The activity was significantly inhibited by soybean trypsin inhibitor, an elastase-specific inhibitor (N-acetylalanylalanylprolylvalylchloromethane) and the thrombin inhibitor hirudin. This cell-associated proteolytic activity may play a role in collagen degradation by removing the telopeptides, which are the primary sites of collagen cross-linking, thus destabilizing the collagen matrix sufficiently to render it susceptible to further proteolytic breakdown. PMID- 3311035 TI - Glucose metabolism in isolated brown adipocytes under beta-adrenergic stimulation. Quantitative contribution of glucose to total thermogenesis. AB - To quantify the potential of brown adipose tissue as a target organ for glucose oxidation, O2 consumption and glucose metabolism in isolated rat brown adipocytes were measured in the presence and absence of insulin, by using the beta-agonists isoprenaline or Ro 16-8714 to stimulate thermogenesis. Basal metabolic rate (278 mumol of O2/h per g of lipid) was maximally stimulated with isoprenaline (20 nm) and Ro 16-8714 (20 microM) to 1633 and 1024 mumol of O2/h per g respectively, whereas insulin had no effect on O2 consumption. Total glucose uptake, derived from the sum of [U-14C]glucose incorporation into CO2 and total lipids and lactate release, was enhanced with insulin. Isoprenaline and Ro 16-8714 had no effect on insulin-induced glucose uptake, but promoted glucose oxidation while inhibiting insulin-dependent lipogenesis and lactate production. A maximal value for glucose oxidation was obtained under the combined action of Ro 16-8714 and insulin, which corresponded to an equivalent of 165 mumol of O2/h per g of lipid. This makes it clear that glucose is a minor substrate for isolated brown adipocytes, fuelling thermogenesis by a maximum of 16%. PMID- 3311036 TI - A glucagon-like peptide, structurally related to mammalian oxyntomodulin, from the pancreas of a holocephalan fish, Hydrolagus colliei. AB - The pancreatic islets of the holocephalan fishes contain, in addition to A-, B- and D-cells, X-cells, which are immunoreactive towards antisera directed against the N-terminal region of glucagon but not towards antisera directed against the C terminal region. A 36-amino-acid-residue peptide was isolated from the pancreas of a holocephalan fish, the Pacific ratfish (Hydrolagus colliei), that shows homology (69%) to mammalian glucagon in its N-terminal region and is reactive towards an N-terminally directed antiserum. Reactivity towards C-terminally directed antisera is prevented by the presence of a 7-residue C-terminal extension to the glucagon sequence that shows limited homology to the C-terminal region of glucagon-37 (oxyntomodulin). It is proposed that this peptide represents a major storage product of the islet X-cell. PMID- 3311037 TI - Purification and characterization of glutathione reductase encoded by a cloned and over-expressed gene in Escherichia coli. AB - An expression vector, pKGR, for the gor gene from Escherichia coli encoding glutathione reductase was constructed by subcloning of an AvaII fragment of the Clarke & Carbon bank plasmid pGR [Greer & Perham (1986) Biochemistry 25, 2736 2742] into the plasmid pKK223-3. The expression of glutathione reductase from the plasmid pKGR was found to have been successfully placed under the control of the tac promoter. Transformation of E. coli cells with this plasmid resulted in 100 200-fold increase in glutathione reductase activity in cell-free extracts. A rapid purification procedure for the enzyme, based on affinity chromatography on Procion Red HE-7B-CL-Sepharose 4B, was developed. The purified enzyme was homogeneous as judged by SDS/polyacrylamide-gel electrophoresis, and all its properties were consistent with the DNA sequence of the gene [Greer & Perham (1986) Biochemistry 25, 2736-2742] and with those previously reported for E. coli glutathione reductase [Mata, Pinto & Lopez-Barea (1984) Z. Naturforsch. C. Biosci. 39, 908-915]. These experiments have enabled an investigation of the protein chemical and mechanistic properties of the enzyme by site-directed mutagenesis. PMID- 3311038 TI - Glycogen phosphorylase isozyme pattern in rat liver and isolated non-parenchymal liver cells. AB - The isozyme distribution of glycogen phosphorylase (EC 2.4.1.1) was studied in adult rat liver and isolated non-parenchymal liver cells by means of immuno titration. In adult rat liver, the L-type of glycogen phosphorylase was found to dominate, whereas the heterogeneous non-parenchymal liver cell population apparently contains all three glycogen phosphorylase isozymes. PMID- 3311039 TI - [Ontogenetic changes in the circadian rhythm of plasma insulin and its correlation to food intake]. AB - In experiments with laboratory mice of different age (3, 9, 13, 18, 31 and 52 weeks old) directed changes of the daily pattern of plasma insulin concentration depending on the development stage of the animals could be quantified. The circadian acrophase undergoes a negative shift from the end of dark/beginning of light period in 3-weeks-old mice to the end of light/beginning of dark period in adults. The amplitude decreases up to an age of 9 weeks, whereas the amount of ultradian components is high, and increases during further development. Similar changes could be obtained for the daily pattern of feeding activity, occurring however some weeks earlier. The result is a temporary desynchronisation. In adult animals the phase correlations are relatively stable. The plasma insulin concentration reaches its maximal value before the maximum of feeding activity, thus stimulating a high food consumption and utilisation rate. PMID- 3311040 TI - Inhibition of macrophage migration by a factor from ascites fluids of ovarian cancer patients. III. Generation of monoclonal antibody specific for human MIF. AB - Migration inhibition activity from ascitic fluids of ovarian cancer patients (OC MIF) was used to develop monoclonal antibodies. The OC-MIF was purified about 10,000 fold by affinity chromatography on L-fucose-Sepharose 6B. Spleen cells from AB/Jena mice immunized with purified OC-MIF were hybridized with P3X63 Ag 8.653 myeloma cells. Supernatants of the hybridoma cultures were screened by solid-phase binding assay, direct neutralizing assay and solid-phase RIA. Several clones of these hybridomas secreted antibodies into the culture medium, which neutralized the biological activity of OC-MIF at dilutions as high as 10(-4) relative to the initial culture medium. After expansion and cloning one clone was selected for ascitic antibody production. This monoclonal antibody coupled to Sepharose 4B adsorbed OC-MIF. Most of the adsorbed biological activity could be eluted with 0.1 M acetic acid. PMID- 3311041 TI - Monoclonal antibodies against human hematopoietic survival and growth factor. AB - Mouse hybridoma clones were isolated, and found to constitutionally secrete monoclonal antibody (MoAb) immunoglobulins specific for human hematopoietic stem cell growth factor (SCGF). MoAbs were initially screened by dot-blotting and enzyme immunoassay (EIA), and their specificity was confirmed using western blotting and EIA. Protein A-purified MoAb IgG neutralized SCGF activity, namely, granulocyte-macrophage colony potentiating and erythroid burst-promoting activities. The availability of MoAb could extend its application to one-step immunoadsorbent affinity-purification of SCGF as well as analysis on its receptor. PMID- 3311042 TI - Bovine mitochondrial ribosomes: effect of cations and heterologous dissociation factors on subunit interactions. AB - The effects of cations and ribosome dissociation factors on the equilibrium between the bovine mitochondrial ribosome and its subunits has been investigated. As observed with other ribosomes, Mg2+ ions promote subunit association while monovalent cations promote subunit dissociation. E. coli IF-3 will prevent the reassociation of mitochondrial 28 S and 39 S subunits. However, at least 5-fold higher concentrations of IF-3 are required with mitochondrial subunits than are required with bacterial subunits. The cytoplasmic factor eIF-6, has no detectable activity in preventing mitochondrial ribosomal subunit association. PMID- 3311043 TI - The generation of the rifamycin binding site in the beta subunit of E. coli RNA polymerase through subunit interactions. AB - Spectral studies were performed using rifampicin quinone to investigate the generation of the rifamycin binding site in the beta subunit of E. coli RNA polymerase due to subunit interactions. The spectrum of rifampicin quinone is not significantly altered in the presence of the beta subunit. In the case of the alpha 2 beta subassembly, a negative difference spectral band at 330 nm is observed for rifampicin quinone, whereas in the presence of either the holoenzyme or core polymerase a positive band at 348 and a negative one at 318 are observed. In affinity labeling studies using 3-(2-bromo[1-14C]acetamidoethyl) thiorifamycin, it was demonstrated that the isolated beta subunit is nonspecifically modified by this reagent. However, in the case of both the alpha 2 beta subassembly and core polymerase, the beta subunit is specifically modified. PMID- 3311044 TI - Glutathione peroxidase in yeast. Presence of the enzyme and induction by oxidative conditions. AB - The presence of glutathione peroxidase activity is reported for the first time for a wild type strain of Saccharomyces cerevisiae. Both forms of enzyme, i.e. that specifically active toward H2O2 alone and that decomposing also organic peroxides, were found to be present. The H2O2 specific form disappeared when cells were grown in the absence of oxygen, while the other form was much increased under the same conditions. Addition of copper to the culture greatly increased both forms. The results show that glutathione peroxidase is to be included, as an important component that is also highly responsive to oxidative environments, in the enzyme defense system of yeast against oxidative damage. PMID- 3311045 TI - Role of kinase C in the insulin-like effects of human growth hormone in rat adipocytes. AB - Insulin and to a smaller extent, human growth hormone (hGH), both stimulate lipogenesis in isolated rat adipocytes preincubated 4 hours in the absence of hormone. The non-additivity of maximal doses suggested that hGH may share a subset of the metabolic pathways stimulated by insulin. We explored whether kinase C may be involved in the common lipogenic effect of both hormones. The stimulation of lipogenesis by phorbol ester 12-myristate 13-acetate (PMA) (an activator of kinase C) was not additive to the stimulation by either insulin or hGH. Downregulation of kinase C resulted in a marked decrease of the maximal insulin effect (44 +/- 9%) and even more of the hGH effect (64 +/- 14%). These data suggest that kinase C either mediates part of, or modulates, the effect of insulin and hGH on lipogenesis. PMID- 3311046 TI - Differential expression of multiple protein kinase C subspecies in rat central nervous tissue. AB - Protein kinase C from a number of areas of rat central nervous tissue was resolved into three distinct fractions upon hydroxyapatite column chromatography. One of the enzyme fractions, designated type II, could be further distinguished into two subspecies with polyclonal antisera, which were raised against synthetic peptides specific for the predicted amino acid sequences of two alternative cDNA clones encoding this enzyme type. Using a combination of these biochemical and immunological techniques, the relative activity of the multiple subspecies of protein kinase C was assessed for each brain area. A distinct regional pattern of expression was found, which per se may be an important factor in determining the response of different neuronal cell types to extracellular stimuli. PMID- 3311047 TI - Seleno-organic compounds and the therapy of hydroperoxide-linked pathological conditions. PMID- 3311048 TI - The effect of insulin on steroid metabolism in isolated rat hepatocytes. AB - Insulin administration has previously been shown to reverse the effects of chemically-induced and spontaneous diabetes on hepatic drug and steroid metabolism in the rat. The complex network of the intact hormonal system of the body and its physiological feedback mechanisms makes it difficult to ascribe the effects seen to any particular hormones. The present study investigated the effect of insulin on hepatic steroid metabolism in the absence of other hormonal influences by using isolated rat liver cells. Insulin (10(-9) M) produced two peaks of increased enzyme activity in the hepatocytes (at 1/2 hr and 24 hr). Dose response curves at 1/2 hr and 24 hr insulin preincubation suggest that these two peaks are probably generated by different mechanisms. The absence of any significant changes in cytochrome P-450 content after 1/2, 1 and 2 hr of insulin treatment indicates that the increase in steroid metabolizing enzyme activities is not due to an increase in de-novo enzyme synthesis. Our observations provide further evidence for the role played by insulin in the regulation of hepatic steroid and drug metabolism in the rat. PMID- 3311049 TI - Comparison of proteases from chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum. AB - An aminopeptidase and four hemoglobin-degrading acid proteases have been isolated from cloned strains of chloroquine-sensitive and chloroquine-resistant Plasmodium falciparum. Amino-peptidases from both strains showed similar properties including molecular weights of 63,000 and non-competitive inhibition by chloroquine; Ki = 535 and 410 microM for enzymes from the sensitive and resistant strains respectively. The acid proteases from the chloroquine-sensitive strain included a low molecular weight enzyme in the soluble fraction (protease S), an enzyme weakly associated with membrane (protease M2), and two enzymes strongly associated with membrane (proteases M3 and M4). The acid proteases from the chloroquine-resistant strain included protease S, protease M2, a second enzyme weakly associated with membrane (protease M1), and protease M3. All of the acid proteases were inhibited by ferriprotoporphyrin IX and by the chloroquine ferriprotoporphyrin IX complex, I50 = 5-25 microM. The data were consistent with a model for chloroquine action wherein chloroquine acts to divert ferriprotoporphyrin IX from sequestration into malarial pigment, leaving ferriprotoporphyrin IX (or its chloroquine complex) to interfere with digestion of host cytosol by inhibiting hemoglobin-degrading proteases. However, the similarities among the proteases from chloroquine-sensitive and chloroquine resistant strains of parasites suggest that chloroquine resistance does not result from changes in parasite proteases. PMID- 3311050 TI - A low molecular weight, heat-labile factor enhances neutrophil Fc receptor mediated lysosomal enzyme release and phagocytosis. AB - When exposed to solid-phase immune complexes, polymorphonuclear neutrophils (PMN) degranulate and release proteases capable of degrading the major structural macromolecules of the joint. Evidence indicates that the PMN response to such activators may be modified by factors present at the sites of inflammation. We have evaluated the effects of a low molecular weight factor present in synovial fluid from rheumatoid arthritis (RA) patients on Fc receptor-mediated PMN degranulation and phagocytosis. Synovial fluid samples from 11 RA patients were studied; 10 of them contained factor(s) which augmented phagocytosis and degranulation mediated through the Fc receptor. This factor(s) alone, however, did not initiate neutrophil degranulation: its MW is less than 10,000 daltons and it is unstable when heated to 56 degrees C. We also examined supernatants that were produced by coculturing adherent human mononuclear cells stimulated by IgG coated sheep red blood cells with autologous nonadherent mononuclear cells. A factor(s) with properties similar to those found in the synovial fluids (i.e., heat-labile at 56 degrees C and capable of augmenting Fc receptor-mediated degranulation and phagocytosis) was found in the stimulated human mononuclear cell culture supernatants. Filtration studies indicated that the MW of this factor(s) is between 2,000 and 10,000 daltons. No such activity was detected in culture supernatants of unstimulated mononuclear cells. Production of the cytokine was blocked by cycloheximide, indicating that protein synthesis was necessary. This factor(s), by enhancing PMN degranulation, may augment PMN mediated tissue destruction in diseases such as RA. PMID- 3311051 TI - Randomized, double-blind, placebo-controlled study of the treatment of the painful shoulder. AB - The effect of triamcinolone subacromial bursa injection versus naproxen therapy was compared in a randomized, double-blind, placebo-controlled study of 100 patients who had painful shoulders. Outcome was compared using degree of active abduction, pain, limitation of function, and a clinical index that combined equally weighted measures of all of these. In a time-adjusted analysis, triamcinolone was superior to placebo in all clinical variables. Naproxen was superior to placebo in all variables except pain. Triamcinolone was superior to naproxen in the relief of pain (P = 0.04) and the clinical index (P = 0.04). Multiple linear regression analysis showed that naproxen and triamcinolone treatment accounted for only 16% of the variation in outcome, compared with 44% accounted for by the clinical index prior to treatment. Thus, patients with a poor pretreatment clinical index (those with the most room for improvement) were least likely to improve. We conclude that both triamcinolone (P = 0.00005) and naproxen (P = 0.02) are superior to placebo in the treatment of the painful shoulder. PMID- 3311053 TI - Octahydroindolo[2,3-a]quinolizines and 3,4-dihydro-beta-carbolines as new inhibitors of human platelet aggregation. AB - Octahydroindolo[2,3-a]quinolizines and 3,4-dihydro-beta-carbolines proved to be powerful inhibitors of human platelet aggregation. They exhibited IC50 values two magnitudes lower than those of the commonly used cyclo-oxygenase inhibitors and no influence upon the routine parameters of blood coagulation was observed in vitro. Some of the compounds increased the vascular production of prostacyclin. PMID- 3311052 TI - Antimalarial and anticoccidial activity of 3-aryl-7-chloro-3,4-dihydroacridine 1,9-(2H,10H)-diones. 1-Imines, 1-amines, 1-oximes, 1-hydrazones and related compounds. AB - Out of more than 130 synthesized derivatives of floxacrine and of 10 deoxyfloxacrine, such as 3-(4-trifluoromethyl-phenyl) or 3-(4-chlorophenyl)-7 chloro-10-hydroxy- or -10-deoxy-3,4-dihydroacridine- 1,9(2H,10H)-dione 1-imines and 1-hydrazones, more than 45 showed an activity against asexual stages of Plasmodium berghei in the mouse which was comparable with or superior to that of floxacrine. More than 25 derivatives of the 3-(4-chlorophenyl)-floxacrine series and 3-(4-chlorophenyl)-10-deoxy-floxacrine series are more effective than floxacrine against Eimeria tenella infection in chickens. 1-Amino compounds of the various series proved of be generally inactive, as did fragments of the structure of and compounds related to floxacrine. Structure-activity relations are suggested on the basis of examples. PMID- 3311054 TI - Effect of bezafibrate and colestyramine in patients with primary hypercholesterolemia. AB - 40 patients with primary hypercholesterolemia were included in a randomized cross over trial comparing effects and tolerance of bezafibrate (Cedur) (200 mg t.i.d.) and colestyramine (4 g t.i.d.). Gastrointestinal side-effects led to the discontinuation of colestyramine in 11 patients. No adverse events were observed with bezafibrate. Both drugs had similar effects on total and low density lipoprotein cholesterol (bezafibrate: -15% and -12%, respectively; colestyramine: -10% and -11%, respectively). While the high density lipoprotein-increasing effect of bezafibrate was more marked (+20% vs. +14%), triglycerides and very low density lipoprotein cholesterol were lowered by bezafibrate (-22% and -27%, respectively) and tended to increase with colestyramine (+11% and +10%, respectively). In the light of results of a multicenter primary prevention trial bezafibrate also should have a protective effect on coronary heart disease. This, however, has to be proven in longterm prospective trials. PMID- 3311055 TI - The 1986-1987 Omnibus Survey: current information for sound planning. PMID- 3311056 TI - Some characteristics of career development in the speech-language-hearing profession. PMID- 3311057 TI - There is joy in Mudville. Career satisfaction. PMID- 3311058 TI - ASHA's retirees--important contributors. PMID- 3311059 TI - Alternative career selections of speech-language pathologists and audiologists: a retrospective and prospective approach. PMID- 3311060 TI - Skills. PMID- 3311061 TI - Recruiting students into the profession. PMID- 3311062 TI - Their chosen field: challenges, satisfactions, problems, rewards. PMID- 3311064 TI - Does advice to assume the knee-chest position reduce the incidence of breech presentation at delivery? A randomized clinical trial. PMID- 3311063 TI - Povidone-iodine solutions in traumatic wound preparation. PMID- 3311065 TI - Vaginal infections and prematurity. PMID- 3311066 TI - A quantitative method for the detection and localization of quantum-limited events from radionuclides in cells and tissue sections by computer-enhanced video microscopy. AB - Cellular dynamics often involve extremely low concentrations of biologically active substances, which can be radiolabeled and detected, localized and quantitated by autoradiography. The latter may require exposures from a few days to many months. The objective of this research was to demonstrate the feasibility of reducing this long period of data collection by one to two orders of magnitude, while maintaining or improving the spatial resolution and localization in tissues and the quantitative characteristics inherent in autoradiography. A mathematical model describing the complete system was generated using energy partition calculations to estimate photon production via scintillant per H3 beta particle emission and to estimate the subsequent photon capture based upon imaging system parameters and microscope geometry. Calculations showed that, typically, a single tritium beta particle produces a maximum of 5.8 X 10(3) photons. A photon-limited camera and microscope imaging system were selected and optimized in conjunction with a specially developed physical scintillation model. Results showed that the number of detected photoevents increases monotonically with both signal integration time and, independently, with the concentration of the radionuclide. Consequently, this work demonstrates that video microscopy imaging methods can spatially and temporally quantify very low concentrations of radiolabeled substances and can reduce data acquisition times. PMID- 3311067 TI - Analysis of object clustering. AB - Objects of a given type lie on a plane or in a thin layer. In the analysis of the arrangement of such objects, the question may arise as to whether these objects form clusters or whether they are randomly distributed. This question can be answered by the calculation of the coefficient of dispersion (CD) of the objects. Some statistical properties of this coefficient, i.e., its sensitivity and its chi-square approximation, are analyzed in this paper. The proposed approach for calculating sensitivity is a mathematical simulation that is not generally applicable but is valid in various biologic applications. Assuming that the objects are much smaller than the expected clusters and that no knowledge exists about interactions among the objects or between the objects and their surroundings, the objects can be assumed to be distributed randomly on the plane. Such situations may occur in various fields, i.e., biology, sociology, archaeology and ecology. The authors have applied this approach successfully in investigating the densities of T-cell lymphocytes in renal transplants treated with Cyclosporin A or conventional immunosuppressive therapy. PMID- 3311068 TI - Mass, volume and dimensional distributions in biology, with special reference to cells. AB - The positively skewed distribution of mass (weight) in biology was examined, and it was concluded all weight or masses can best be described by lognormal theory. Examples are given ranging in weight from viruses to humans. The accretion of mass proceeds as "more of the same" and primarily does not alter function. Immunologic properties must be carefully preserved. Small biologic entities can afford only small mass gains or losses while preserving their functionality; the larger the entity, the larger is the variability of mass functionally permitted. A well-established, convenient graphic method of analyzing a sample is described, with the advantages and pitfalls discussed. At the cellular level, volume and dimensions are lognormally distributed whenever the specific gravity (g/cu cm) is nearly homogenous among the particles or cells. In multicellular organisms, dimensions and forms (such as height and cranial circumference) are primarily the product of multifactorial genetic determinants and frequently appear as normal distributions. This paper discusses the meaning of the law of proportionate effects for small biologic objects, especially cells, and how an initial or "elementary" distribution may be conceived. PMID- 3311069 TI - Detection of diagnostic clues in statistical histometry. AB - Examples are given of the detection of diagnostic clues in quantitative cytology and histopathology by statistical testing, such as may be applied in image analytical procedures. Schematic and other examples are presented of the visual images analyzed by each procedure, whose limits are also discussed. The situations analyzed include increased cellularity, differences in nuclear placement patterns, uniformity of displacement, variance in nuclear diameters and chaincode variance of nuclear placement. A specific model is presented for describing or generating a series of dependent observations representing nuclear placement, based on the Box-Jenkins (ARIMA) models for decomposing a spatial or temporal series into several components. This model describes the statistical observations that are random samples from the series. Finally, one graphic example is given in which visual inspection more readily ascertains an alteration than does statistical analysis of a modest-sized sample. PMID- 3311070 TI - [Neonatal necrotizing enterocolitis]. PMID- 3311071 TI - Phenol-promoted structural transformation of insulin in solution. AB - Phenolic additives widely used for the preservation of insulin preparations can have a profound effect on the hormone's conformation in solution. m-Cresol, for instance, increases the circular dichroism in the far ultraviolet by 10-20%, corresponding to an increase in helix, and around 255 nm. The CD-spectral changes are strikingly similar to those brought about by halide ions which have been identified to reflect the 2 Zn----4 Zn insulin transition. Its most prominent element is the helix formation at the B-chain N-terminus. In both cases the changes fail to occur with dimeric insulin in the absence of Zn2 and with monomeric des-(B26-B30)-insulin. In the presence of Ni2 which is unable to replace Zn2 in 4 Zn insulin for coordinative reasons, the effect of m-cresol is impeded. m-Cresol thus induces a transition identical with or closely similar to the 2 Zn----4 Zn transformation. 2 Zn insulin crystals, when soaked in m-cresol containing solvents, are destroyed. Crystals grown in the presence of m-cresol, however, are monoclinic and containing symmetrical hexamers of, notably, 4 Zn conformation. Phenol, o- and p-cresol, m-nitrophenol, Nipagin M and benzene were further additives tested, all of them inducing largely the same spectral effects except for benzene. The results presented corroborate the close correspondence of insulin's structure in solution and in the crystal as well as insulin's capacity for structural variation. PMID- 3311072 TI - The N-terminal sequence of ribosomal protein L10 from the archaebacterium Halobacterium marismortui and its relationship to eubacterial protein L6 and other ribosomal proteins. AB - The amino-terminal sequence of ribosomal protein L10 from Halobacterium marismortui has been determined up to residue 54, using both a liquid- and a gas phase sequenator. The two sequences are in good agreement. The protein is clearly homologous to protein HcuL10 from the related strain Halobacterium cutirubrum. Furthermore, a weaker but distinct homology to ribosomal protein L6 from Escherichia coli and Bacillus stearothermophilus can be detected. In addition to 7 identical amino acids in the first 36 residues in all four sequences a number of conservative replacements occurs, of mainly hydrophobic amino acids. In this common region the pattern of conserved amino acids suggests the presence of a beta-alpha fold as it occurs in ribosomal proteins L12 and L30. Furthermore, several potential cases of homology to other ribosomal components of the three ur kingdoms have been found. PMID- 3311073 TI - Sex differences in the control of glucose-6-phosphate dehydrogenase and 6 phosphogluconate dehydrogenase. Interaction of estrogen, testosterone and insulin in the regulation of enzyme levels in vivo and in cultured hepatocytes. AB - Control of the activities of glucose-6-phosphate dehydrogenase, 6 phosphogluconate dehydrogenase, and malate dehydrogenase was investigated in intact rats and in hepatocyte cultures. 1) Adult females had 2-fold greater activities of hepatic glucose-6-phosphate- and 6-phosphogluconate dehydrogenases than adult males, but similar activities of malate dehydrogenase. Castrated males showed decreased activities of all three enzymes in comparison to age- and weight matched intact controls. In starved animals the activities of all three enzymes decreased significantly. After refeeding with nonpurified diet the activities returned to the prestarved levels in females, but increased to clearly higher values in intact and castrated males. 2) Estrogen levels were in the same range in immature and adult male and female rats. Testosterone levels were highest in adult males, clearly lower in adult females (1/8) and immature males (1/8), still lower in immature females (1/15) and lowest in castrated males (1/40). A simple correlation of the sex differences in these hormone levels to sex differences in glucose-6-phosphate- and 6-phosphogluconate dehydrogenase activities was not apparent. 3) In serum-free, dexamethasone-supplemented 48-h cultures of hepatocytes from both male and female rats the basal activities of glucose-6 phosphate dehydrogenase were the same; they were increased 2-3 fold by insulin alone, 1.5 fold by estrogen alone and 4-5 fold by insulin plus estrogen. Apparently sex differences did not persist in 48-h cell cultures. 4) In 48-h cultures of male hepatocytes, then used as the experimental model, insulin alone increased the activity not only of glucose-6-phosphate dehydrogenase but also of 6-phosphogluconate and malate dehydrogenases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311074 TI - Structure of the yeast isoleucyl-tRNA synthetase gene (ILS1). DNA-sequence, amino acid sequence of proteolytic peptides of the enzyme and comparison of the structure to those of other known aminoacyl-tRNA synthetases. AB - The ILS1 gene encoding for cytoplasmic isoleucyl-tRNA synthetase from Saccharomyces cerevisiae was subcloned from a 5.4-kb insert of the shuttle vector YEp13 to M13mp8 and M13mp9. Nucleotide sequence analysis of a 4.3-kb BamHI-HpaI fragment revealed a single open reading frame from which we deduced the amino acid sequence of the enzyme. Independently obtained amino-acid sequence information from ten tryptic peptides of the purified enzyme confirmed the gene derived structure. The enzyme is comprised of 1073 amino-acids consistent with earlier determinations of its molecular mass. The codon usage of ILS1 is typical of abundant yeast proteins. A significant homology to E. coli isoleucyl- and valyl-tRNA synthetases as well as to yeast valyl-tRNA synthetase was detected. The characteristic amino-acid residues of the aminoacyl-adenylate site and of the potential binding site of the 3'-end of tRNA found in other synthetases are present in the structure. PMID- 3311076 TI - Thermally modified azocasein--a new insoluble substrate for the determination of proteolytic activity. AB - An insoluble chromogenic substrate for the determination of proteolytic activity was prepared by heating azocasein in a thin layer at 200 degrees C for 4 h in a hot-air thermostat. The activity of an extracellular bacterial proteinase produced by Bacillus sp. was determined with this new substrate. PMID- 3311075 TI - The elastase inhibitory capacity and the alpha 1-proteinase inhibitor and bronchial inhibitor content of bronchoalveolar lavage fluids from healthy subjects. AB - Pulmonary emphysema is currently thought to be due to an elastase-antielastase imbalance with resultant destruction of alveolar structures. The present study was aimed at testing whether alpha 1-proteinase inhibitor (alpha 1 PI) is the major component of the antielastase screen of the lower respiratory tract of healthy subjects. Bronchoalveolar lavage was performed in 8 nonsmokers (27.8 +/- 3.8 years) and 9 smokers (25 +/- 0.96 years). The lavage fluids were tested for leukocyte and pancreatic elastase inhibitory capacity (LEIC and PEIC) and immunoreactive alpha 1 PI and bronchial inhibitor (brI) content. The mean +/- s.e.m. levels of LEIC, PEIC, alpha 1 PI and brI were 0.16 +/- 0.039, 0.042 +/- 0.006, 0.09 +/- 0.007 and 0.013 +/- 0.002 mol/mol albumin, respectively. Thus, on the average, the molar concentration of brI was about 14% that of alpha 1 PI. The difference between LEIC and alpha 1 PI did not reach statistical significance (P = 0.0503). The PEIC was however significantly lower than the alpha 1 PI levels (P less than 0.05), indicating that the lavage fluids contained both active and inactive alpha 1 PI. Nonsmokers and smokers did not differ in their LEIC, PEIC, alpha 1 PI and brI levels. When the data were examined on an individual basis, the subjects could be divided into 2 groups: group I (n = 9; 3 nonsmokers, 6 smokers) whose LEIC/alpha 1 PI molar ratios were higher than unity and group II (n = 8; 5 nonsmokers, 3 smokers) whose LEIC/alpha 1 PI molar ratios were equal or lower than unity. Group I subjects had significantly higher LEIC values (0.26 +/- 0.05 mol elastase inhibited/mol albumin) than group II individuals (0.055 +/- 0.006; P less than 0.001) but the two groups had similar levels of immunoreactive alpha 1 PI (0.09 and 0.08 mol alpha 1 PI/mol albumin for group I and II, respectively), functionally active alpha 1 PI (percentage of active alpha 1 PI: 53% and 37% for group I and II, respectively) and immunoreactive brI (0.016 and 0.010 mol brI/mol albumin for group I and II, respectively). These results suggested that the lavage fluids from group I contained significant amounts of undefined leukocyte elastase inhibitor(s). Gel filtration of a lavage fluid from group I showed that the undefined elastase inhibitor(s) co-eluted with brI. Most of the lavage fluids were still able to inhibit leukocyte elastase following removal of alpha 1 PI by perchloric acid precipitation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311077 TI - Analysis of IgA1 and IgA2 subclass distribution in IgA- containing circulating immune complexes in patients with diabetes mellitus. AB - Immune complexes (IC) containing IgA1 and IgA2 have been detected in diabetes mellitus. In particular IgA1 and IgA2-IC are equally distributed in type 2 diabetes. On the other hands IgA1-IC are prevailingly found in type 1 diabetes mellitus. IgA2-IC (immune complexes of "mucosal" origin?) seen to be of relevance in the pathogenesis of diabetic microangiopathy. PMID- 3311078 TI - Peripheral blood lymphocyte subpopulations after splenectomy for trauma. AB - Absolute and percent numbers of peripheral blood lymphocyte (PBL) subpopulations were evaluated using monoclonal antibodies in 20 subjects splenectomised for trauma. A significant increase was observed in the absolute counts of total PBL, B, null and Leu 7+ cells and in the percent counts of null and Leu 7+ lymphocytes. The percent numbers of OKT11+, OKT4+ and OKT8+ lymphocytes were significantly reduced, but the OKT4+/OKT8+ ratio was not statistically different from normal controls. The increase in B and killer/natural killer cells may provide a compensatory mechanism responsible for surveillance against infections and tumors in splenectomised patients, despite the numerous humoral and cellular abnormalities they commonly display. PMID- 3311079 TI - Analysis of serum immune complexes isolated from patients with essential mixed cryoglobulinemia. AB - The analysis of the molecular composition of serum immune complexes (IC) in autoimmune diseases has assumed growing importance in the evaluation of their clinical significance and possible pathogenetic role. Essential Mixed Cryoglobulinemia (EMC) is typically a disorder characterized by the presence of high levels of IC with pathogenic action, by reduced serum complement levels and by an antiglobulin activity of the cryoprecipitable IgM. In this report we refer on the preliminary results of a study on the molecular composition of the cryoprecipitable IC isolated from the serum of five patients with EMC. The methodology we adopted involves the solubilization at 37 degrees C of the washed cryoprecipitates and the purification of the IgG-containing IC by affinity chromatography through a Protein A-Sepharose CL4B column. The analysis of the molecular component was carried out by electrophoresis in polyacrylamide gel containing sodium-dodecyl-sulphate (SDS-PAGE) followed by Immun-Blot. Our results, although very preliminary, suggest that this kind of study appears really suitable for the detection of specific antibody or antigenic components in the IC molecules involved in the etiopathogenesis of essential mixed cryoglobulinemia. PMID- 3311081 TI - [Evaluation of the effects of the transition from animal insulin to biosynthetic human insulin]. PMID- 3311080 TI - Mitotic activity and chromosomal findings in lymph nodes from patients with carcinoma or non-Hodgkin's lymphoma. AB - We studied the chromosomal constitution of lymph node cells from two patients with non-Hodgkin's lymphoma, one patient with Crohn's disease, and four patients with carcinoma, using regional lymph nodes that microscopically did not contain metastatic tumor. No consistent chromosomal abnormalities were detected and normal metaphases were predominant. We also studied the mitotic activity of lymph node cell suspensions from six patients with carcinomas. Mitoses were always more abundant after 3-4 days in culture, and were consistently higher in cultures to which phytohemagglutinin had not been added. No mitotic activity was seen in lymph nodes that histologically were shown to contain metastatic carcinoma. Possible implications of these findings are discussed. PMID- 3311082 TI - [Evaluation of the long-term effects of the administration of gliquidone in subjects with diabetes type II]. PMID- 3311083 TI - [Intraerythrocytic sodium in dysmetabolic conditions]. PMID- 3311084 TI - [Natural alpha-interferon stimulates lymphocytes to release a neutrophil chemotactic factor]. PMID- 3311085 TI - [Regulation of the activity of adenylate cyclase in the superior cervical ganglion of the guinea pig: role of the Mg++ ions and guanine nucleotides]. PMID- 3311086 TI - Immunological comparison of major outer membrane proteins from different strains of Escherichia coli. AB - Rabbits were immunized with either the native trimer or the denatured monomer of OmpF porin of Escherichia coli. The specificity of the two antisera was checked by two different techniques. In liquid immunorecognition assays, the antisera detected the presence of common antigenic determinants at the surface of the monomer and trimer forms. A high response was observed between the two antisera and the native form of OmpF. Although cross-reactivity between the antiserum directed against the OmpF monomer and a denatured form of PhoE was obtained, this denatured porin was weakly recognized by the antiserum specific to the native protein. In immunoblotting experiments, though antiserum directed against the native porin detected the two forms of OmpF, antiserum specific to the monomer recognized only the denatured protein. These two antisera were used to check the immunological relationships of E. coli strains isolated from various contaminated waters. Proteins from several wild strains were compared to the immunoblotting patterns of E. coli reference strains. Porins from the majority of these wild strains were immunorelated to porins of the ML30 strain. In two strains, porins were related to the OmpC/OmpF of the K12 strain, and one strain contained a porin identical to the OmpF of the B strain. Thus, an immunological approach using polyclonal antibodies directed against a major outer membrane protein appears to be fruitful for an accurate classification of various E. coli strains. Moreover, the ecological habitat of a strain can also be investigated by this analysis. PMID- 3311088 TI - Animal source for human G6PD isozymes GdA and GdB. PMID- 3311087 TI - Whole-cell bacterial peroxidase test with isoproterenol as the hydrogen donor. AB - The beta-adrenergic compound isoproterenol was used as oxidizable reagent in a whole-cell assay for the detection of bacterial peroxidase activities. Isoproterenol has been shown to constitute a useful reagent for detecting peroxidase activities in enzymatic tests, utilizing standard purified enzymes, and in the microbiological application proposed. The procedure developed is simple and rapid to perform. In contrast to currently used whole-cell tests for bacterial peroxidases, the assay described here does not need preliminary permeabilization; moreover, the compound utilized does not have related toxicological problems. Therefore, the isoproterenol assay may represent a low cost safe additional peroxidase test in clinical bacteriology. PMID- 3311089 TI - Gastric mucosal calmodulin changes in different experimental ulcer models of rat. AB - It seems that the mucosal CaM content does not play a significant role in the pathomechanism or the regeneration of (experimental) gastric ulcers of rat. PMID- 3311090 TI - Interaction between insulin and thyroid hormones on the control of carbohydrate and lipid metabolism in rat adipose tissue. AB - Adipose tissue segments excised from normal rats and from rats rendered experimentally hypothyroid and hyperthyroid retained insulin responsiveness when studied in vitro. Basal rates of glucose oxidation to CO2, conversion into glyceride-glycerol, fatty acids, and total lipids, and the activities of pyruvate dehydrogenase and fatty acid synthetase were enhanced in fat pads from hyperthyroid rats when compared with values seen with tissue from euthyroid animals. The response of each of these parameters was further enhanced by treating tissue from hyperthyroid rats in vitro with insulin. Basal rates of glucose oxidation and the activities of pyruvate dehydrogenase and fatty acid synthetase were depressed as a result of hypothyroidism. However, all of these values could be restored to levels approaching the values seen in the basal state for euthyroid rats when tissue segments from hypothyroid rats were incubated in vitro with insulin. The basal rates for glucose conversion into glyceride glycerol, fatty acids, and total lipids were not changed by hypothyroidism but retained insulin responsiveness. These data suggest that the insulin-effector system in adipose tissue is not altered by thyroid status and that thyroid hormones may act independently with insulin to regulate glucose and lipid metabolism in this tissue at multiple intracellular metabolic sites. PMID- 3311091 TI - [Two neonatal cases of non-surgically treated epidural hematoma]. PMID- 3311092 TI - [Normal sonographic findings on the posterior cranial fossa in infants]. PMID- 3311093 TI - [Brain ultrasonographic findings in complications of bacterial meningitis]. PMID- 3311094 TI - [Digital subtraction angiography in neonates and children]. PMID- 3311095 TI - Hypertension. PMID- 3311096 TI - Congestive cardiac failure: central role of the arterial blood pressure. AB - A review of the history of our knowledge and understanding of the peripheral oedema of congestive cardiac failure points to the conclusion that an inability of the heart to maintain the arterial pressure is of central importance in this condition. Although the function of the circulation is to perfuse the tissues, the body monitors the adequacy of its perfusion, not not through metabolic messengers carried from the tissues in the blood stream, but by sensing the arterial pressure; and the mechanisms evoked act to maintain the arterial pressure. In the short term this is achieved by autonomic regulation of the heart and blood vessels; in the longer term the arterial pressure is maintained through an increase in the blood volume by a retention of salt and water by the kidney. To support the latter process, intrinsic renal mechanisms are successively magnified by the renin-angiotensin-aldosterone system and by the activities of the sympathetic system and vasopressin. The natriuretic influence mediated through volume receptors and the release of atrial peptide is overruled by the arterial baroreceptors, so that the body maintains the arterial pressure at the expense of an increase in blood volume. In these ways the syndrome of congestive cardiac failure may be regarded as one which arises when the heart becomes chronically unable to maintain an appropriate arterial pressure without support. PMID- 3311097 TI - Total body electrolyte composition in patients with heart failure: a comparison with normal subjects and patients with untreated hypertension. AB - Total body elemental composition was measured in 40 patients with well documented heart failure who were oedema-free on digoxin and diuretics. The results were compared with values for 20 patients with untreated essential hypertension matched for height, weight, age, and sex. Total body potassium alone was also measured in 20 normal subjects also matched for anthropomorphic measurements. Patients with hypertension had a very similar total body potassium content to that of normal subjects, but patients with heart failure had significantly reduced total body potassium. This could not be explained by muscle wasting because total body nitrogen, largely present in muscle tissue, was well maintained. When total body potassium was expressed as a ratio of potassium to nitrogen mass a consistent depletion of potassium was revealed in the group with heart failure. Potassium depletion was poorly related to diuretic dose, severity of heart failure, age, or renal function. Activation of the renin-angiotensin aldosterone system was, however, related to hypokalaemia and potassium depletion. Such patients also had significantly lower concentrations of serum sodium and blood pressure. Serum potassium was related directly to total body potassium. Despite the absence of clinically apparent oedema total body chlorine was not consistently increased in heart failure, but the calculated extracellular fluid volume remained expanded in the heart failure group. Total body sodium was significantly increased in patients with heart failure, but less than half of this increase could be accounted for by extracellular fluid volume expansion. Potassium depletion in heart failure may account in part for the high frequency of arrhythmias and sudden death in this condition. PMID- 3311099 TI - A British footnote to the life of Horace Wells. PMID- 3311098 TI - Brucella endocarditis. AB - Brucella endocarditis is an underdiagnosed, fatal complication of human brucellosis. Four successfully treated cases of Brucella endocarditis are reported. The development of a new valvar lesion and bulky vegetations seen on echocardiography helped to identify Brucella endocarditis occurring during systemic brucellosis. The aortic valve was affected in all four patients, and in one the mitral valve was also affected. Medical treatment did not cure the patients and all needed valve replacement--for haemodynamic deterioration in three and because a further embolism was feared in one. Antibiotics were continued for six to nine months after operation. There was no early or late mortality and no recurrence after a follow up of 15 months. PMID- 3311101 TI - Exercise dependence. PMID- 3311102 TI - Alcohol and alcohol problems research 15. Ireland. PMID- 3311100 TI - Prospective, multi-centre trial of mortality following general or spinal anaesthesia for hip fracture surgery in the elderly. AB - In a prospective randomized multi-centre study, the mortality following internal fixation surgery for fracture of the upper femur was investigated in 538 elderly patients allocated to receive subarachnoid blockade or general (narcotic relaxant) anaesthesia. The 28-day mortality was 6.6% with subarachnoid, and 5.9% with general, anaesthesia. The difference was not significant (95% confidence limits: -3.5 to +4.8). At 1 year following surgery, the mortality was 20.4%. Increasing age, ischaemic heart disease, cardiac failure, preoperative arrhythmias and poor ASA status were all associated with increases in early and long term mortality. A delay to surgery of more than 24 h from admission was also associated with an increased 28-day mortality. Senile dementia and admission other than from the patient's own home, were factors associated with a poorer long term outcome. From the point of view of mortality, subarachnoid anaesthesia did not appear to confer any advantages over general anaesthesia in non prosthetic surgery for hip fracture in the elderly. PMID- 3311103 TI - Acculturation and drinking patterns among U.S. Hispanics. PMID- 3311104 TI - Post marketing surveillance of captopril (for hypertension): a preliminary report. AB - 1 The methodology and interim results of a post marketing surveillance of captopril, the first orally active angiotensin converting enzyme inhibitor are presented. 2 Utilising viewdata technology, details of hypertensive patients were entered directly into a mainframe computer. This allowed day to day monitoring of events; a facility not available with paper-based methods. 3 The design of the study allowed analysis of results including some details of efficacy, concomitant therapy, any disease symptoms and reasons for withdrawal. These factors could be categorised according to sex and age. 4 This preliminary report is based on the first 13,295 patients entered from July 1983 with follow-up until January 1985. The results of the study confirm the safety of captopril in the patients studied. PMID- 3311105 TI - Lack of effect of topical indomethacin on psoriasis. AB - Topical 1% indomethacin had no effect on chronic stable plaque psoriasis in an open controlled study using subjective clinical scores nor in a randomised double blind inert base controlled study using both subjective and objective measurements of lesional response; nor did it initiate or affect the development of psoriasis after cold injury. Previous studies are reviewed and it is concluded that the evidence does not support the hypothesis which relates psoriasis to eicosanoids produced by lipoxygenase activity. PMID- 3311106 TI - Problems in assessing the possible disease-modifying effect of naproxen. PMID- 3311107 TI - A comparative study of conventional and long-acting formulations of propranolol in essential hypertension. PMID- 3311108 TI - Circulating lymphoma cells in patients with B & T non-Hodgkin's lymphoma detected by immunoglobulin and T-cell receptor gene rearrangement. AB - We studied peripheral blood mononuclear cells from 50 patients with active B- and T-cell non-Hodgkin's lymphoma by DNA hybridisation. Nineteen patients (38%) had circulating clones of cells detected by immunoglobulin gene rearrangement (17 patients) or T-cell receptor gene rearrangement (2 patients) with JH and J beta 2 probes. Lymphoma tissue and peripheral blood were studied simultaneously in 22 patients, 9 of which had a circulating clone of cells in peripheral blood. In 7 patients the gene rearrangement in lymphoma tissue and peripheral blood mononuclear cells was identical. However, in 2 patients both heavy chain and light chain gene rearrangements were different in tissue and peripheral blood. The incidence of peripheral blood involvement was commonest in advanced CSIII & IV disease (54%) compared to CSI & II disease (18%) (P less than 0.05), and in low grade (45%) compared to intermediate and high grade lymphoma (31%) (difference not statistically significant). Only 4 patients had definite lymphoma cells seen on peripheral blood smear. The presence of circulating lymphoma cells correlated with conventional assessment of bone marrow involvement although circulating clones were detected in 30% (12/40) of patients with apparently normal bone marrow. PMID- 3311109 TI - Evidence that 5-hydroxytryptamine3 receptors mediate cytotoxic drug and radiation evoked emesis. AB - The involvement of 5-hydroxytryptamine (5-HT) 5-HT3 receptors in the mechanisms of severe emesis evoked by cytotoxic drugs or by total body irradiation have been studied in ferrets. Anti-emetic compounds tested were domperidone (a dopamine antagonist), metoclopramide (a gastric motility stimulant and dopamine antagonist at conventional doses, a 5-HT3 receptor antagonist at higher doses) and BRL 24924 (a potent gastric motility stimulant and a 5-HT3 receptor antagonist). Domperidone or metoclopramide prevented apomorphine-evoked emesis, whereas BRL 24924 did not. Similar doses of domperidone did not prevent emesis evoked by cis platin or by total body irradiation, whereas metoclopramide or BRL 24924 greatly reduced or prevented these types of emesis. Metoclopramide and BRL 24924 also prevented emesis evoked by a combination of doxorubicin and cyclophosphamide. These results are discussed in terms of a fundamental role for 5-HT3 receptors in the mechanisms mediating severely emetogenic cancer treatment therapies. PMID- 3311111 TI - Comparative pO2 measurements in cell spheroids cultured with different techniques. PMID- 3311112 TI - Evaluation of desmin as a diagnostic and prognostic marker of childhood rhabdomyosarcomas and embryonal sarcomas. AB - The diagnostic and prognostic relevance of desmin expression in 80 rhabdomyosarcomas (RMS) and 5 embryonal sarcomas (ES) was examined using a peroxidase anti-peroxidase staining procedure. Fifty-nine RMS but only one ES stained for desmin (P less than 0.05). The maximum percentage of desmin containing cells was 49 in RMS compared with only 1% in ES. Desmin positivity correlated inversely with survival (P less than 0.02) in that RMS with high proportions of desmin positive cells were associated with poorer prognoses than those containing fewer desmin positive cells. If the degree of expression of desmin is related to myogenic differentiation, then our results indicate that poorly differentiated RMS tend to have a better prognosis than the well differentiated tumours. One possible explanation is that the poorly differentiated RMS respond better to chemotherapy than to well differentiated RMS. A multivariant analysis incorporating desmin staining, treatment, histology, age and gender revealed that the two most significant independent prognostic factors were treatment and histology. PMID- 3311113 TI - The history of the use of alcohol in the treatment of respiratory diseases. PMID- 3311114 TI - The difficult pneumothorax. PMID- 3311110 TI - The 1987 Walter Hubert lecture. Regulation and deficiencies in DNA repair. AB - A number of rare human inherited syndromes are associated with apparent defects in DNA repair and a greatly increased frequency of cancer. Cell lines derived from such individuals phenotypically resemble certain bacterial mutant strains that have increased sensitivity to radiation or chemical agents and well characterised repair defects. This analogy provides leads for unravelling the molecular alterations in such cancer-prone human cells. The inducibility of DNA repair enzymes is also reviewed. Exposure of bacteria to alkylating agents, or oxygen radicals, causes the overproduction of several novel and interesting repair activities, and the induced bacteria provide an abundant source of these proteins for purification and biological characterisation. Enzymes with the same defined specificities are often present in human cells, presumably serving the same functions as in microorganisms, but these activities are only constitutively expressed at low levels. PMID- 3311115 TI - Troublesome pleural fluid. PMID- 3311116 TI - Bronchoscopy in childhood. PMID- 3311117 TI - High dose salbutamol in chronic bronchitis: comparison of 400 micrograms, 1 mg, 1.6 mg, 2 mg and placebo delivered by Rotahaler. AB - Ten patients with chronic bronchitis (Medical Research Council definition) completed a double-blind placebo-controlled study comparing 400 micrograms, 1 mg, 1.6 mg and 2 mg salbutamol powder. Response was measured by spirometry, peak expiratory flow rate, heart rate and tremor at intervals up to 4 hours post inhalation. Pulmonary function results showed a trend towards higher doses producing improved response and a longer duration of action, with bronchodilatation following 2 mg significantly greater than 400 micrograms. Seven patients developed or had an increase in tremor following a single dose of 2 mg and in one this was considered to be severe. No adverse effects were recorded on ECG. PMID- 3311118 TI - A comparison of histamine and methacholine bronchial challenges using the DeVilbiss 646 nebulizer and the Rosenthal-French dosimeter. AB - We have compared bronchial challenge with both histamine and methacholine for the tidal breathing method and dosimeter method, using the DeVilbiss 646 nebulizer, in 18 patients with asthma. There was a significant difference between the PC20 FEV1 but not the PD20 FEV1 when either agonist was administered by the different techniques but not by the same method. PMID- 3311119 TI - Inhaled ceftazidime compared with gentamicin and carbenicillin in older patients with cystic fibrosis infected with Pseudomonas aeruginosa. AB - A randomized cross-over study was undertaken to compare nebulized (1) ceftazidime with (2) a combination of gentamicin and carbenicillin, and (3) saline, each given for 4 months, in patients with cystic fibrosis infected with Pseudomonas aeruginosa. Mean peak expiratory flow on ceftazidime, 299 litres/min, and on gentamicin and carbenicillin, 297 litres/min, were greater than on saline, 278 litres/min (P less than 0.02 and P less than 0.05 respectively). Similarly mean forced expiratory volume in 1 second on ceftazidime, 1.70 litres, and on gentamicin and carbenicillin, 1.70 litres, were greater than on saline, 1.48 litres (P less than 0.02 and P less than 0.01 respectively). Mean forced vital capacity on gentamicin and carbenicillin, 2.93 litres, was also greater than on saline (P less than 0.05). We were unable to demonstrate any difference in efficacy between the antibiotic regimens. The patients were admitted to hospital less frequently during the study year compared with the previous year (P less than 0.05). Sixty-nine per cent of patients had a clinically significant (20%) increase in forced expiratory volume in 1 second on an antibiotic regimen compared with that on entry to study, but a minority of patients appear not to respond to this form of treatment. PMID- 3311121 TI - Invasive pulmonary aspergillosis diagnosed by blood culture and successfully treated. AB - We present a case of invasive pulmonary aspergillosis when a blood culture isolate of Aspergillus fumigatus in an unusual medium was considered to be a genuine isolation. Early institution of appropriate therapy was successful. PMID- 3311122 TI - The Philadelphia chromosome: from cytogenetics to oncogenes. PMID- 3311120 TI - Effects of chronic administration of codeine and promethazine on breathlessness and exercise tolerance in patients with chronic airflow obstruction. AB - It has been reported that short-term treatment with relatively high doses of opiates or promethazine causes improvements in dyspnoea and exercise tolerance in patients with chronic airflow obstruction (CAO). This study was designed to determine whether initial benefits were sustained during chronic administration of codeine or promethazine and to compare the two drugs in terms of their efficacy and possible mechanisms of action. Eleven patients with stable CAO were entered into a double-blind, randomized cross-over trial in which codeine (30 mg four times daily) or promethazine (25 mg four times daily) were orally administered for 1-month periods. Treatment effects were assessed by spirometry, arterial blood gases, 12-minute walk distance and subjective dyspnoea ratings. A statistically significant increase from the baseline in mean arterial PCO2 at at 24 hours (P less than 0.01) and at 1 month (P less than 0.05) occurred with codeine administration. There was no significant change from baseline for any other measurement with either drug, and no differences were detected between the two treatment arms. Four of the eleven patients did not complete the study; three of the four experienced worsening of their CAO requiring hospitalization (two while receiving codeine, one while receiving promethazine). We conclude that chronic treatment with either codeine or promethazine provides uncertain benefits to patients with CAO which may not outweigh potential risks. PMID- 3311123 TI - Immunohistological diagnosis of a case of composite lymphoma. AB - A case of composite lymphoma consisting of Hodgkin's disease and B cell lymphocytic lymphoma is described. A diagnosis of lymphocyte predominant Hodgkin's disease was made initially by histology. The presence of a composite lymphoma was only appreciated once immunohistochemistry was available. The findings illustrate the importance of the use of immunological markers for the accurate diagnosis of lymphoma. PMID- 3311124 TI - Platelet glycoprotein IIb as a target antigen in two patients with chronic idiopathic thrombocytopenic purpura. AB - We have investigated the target antigens recognized by anti-platelet antibodies in patients with chronic idiopathic thrombocytopenic purpura (ITP) using an immunoblot procedure which could electrically separate the glycoprotein (GP) IIb/IIIa complex into GPIIb and GPIIIa. Various platelet proteins, having molecular weights of 167, 160, 145, 135, 124, 102, 92 and 80 kD, were recognized by circulating antibodies in 11 of 40 ITP patients. We identified the 145 kD antigen band, seen in two ITP patients, as GPIIb using thrombasthenic platelets as a source of target antigens. In one patient the anti-GPIIb antibody reacted with autologous GPIIb. These studies provide direct evidence for the presence of autoantibodies against GPIIb in some ITP patients. PMID- 3311125 TI - Annotations concerning the correlation of the immuno-phenotypes of leukaemic cells in acute myeloid leukaemias with the FAB classification. PMID- 3311126 TI - Bone marrow transplantation in patients with leukaemia previously transfused with blood products from family members. AB - Transfusions are withheld, whenever possible, from patients with aplastic anaemia who are potential bone marrow transplant recipients because of the increased risk of graft failure associated with transfusions prior to transplantation. Family members are specifically excluded as blood product donors to reduce the likelihood of sensitizing the recipient to antigens shared by the blood and bone marrow donor. This policy of not using family members, particularly the HLA matched bone marrow donor, to provide blood products prior to transplantation has been extended to leukaemia as well. To evaluate this policy we reviewed the outcome of bone marrow transplantation in 18 patients with leukaemia transfused prior to transplantation with platelets and/or leucocytes from related family members. In 15 cases in which the outcome could be evaluated, engraftment was rapid and graft failure did not occur. Transfusion of blood products from related family members to patients with leukaemia prior to transplantation does not appear, therefore, to increase the risk of graft rejection. PMID- 3311127 TI - Platelet antibodies in systemic lupus erythematosus. AB - In systemic lupus erythematosus (SLE), the precise cause of the thrombocytopenia is unknown. Since platelet associated IgG is increased in many patients, it has been suggested that the destruction of platelets might be dependent on specific antibodies. In nine patients with SLE, platelet associated immunoglobulins were found together with free serum antibody which bound to platelets from all normal subjects. Using an immunoblotting technique with membrane proteins from normal platelets incubated with patient sera, target antigens were localized on a band of mol wt 108,000 in two cases (B. and N.) and on a band of mol wt 66,000 in a third (M.). When the same technique was applied to autologous platelets of patient N., autoantibody binding to the protein of mol wt 108,000 was demonstrated. The antigenic determinants were not removed from the platelets by enzyme treatment or by disulphide bond reduction, and were localized in the cytoplasmic fraction of the platelets. PMID- 3311129 TI - Accuracy of the medical interview. PMID- 3311128 TI - Prevalence rates and odds ratios of shoulder-neck diseases in different occupational groups. AB - The aim of the present study was to evaluate the association and impact of occupational exposure and diseases of the shoulder and neck. Prevalence rates, odds ratios, aetiological fractions, and their confidence intervals were computed for pooled and non-pooled data of previous published reports. By comparison with office workers and farmers, dentists had an increased odds ratio for cervical spondylosis (two studies) and for shoulder joint osteoarthrosis. Meat carriers, miners, and "heavy workers" also had significantly higher rates of cervical spondylosis compared with referents. Compared with iron foundry workers, civil servants had a significant odds ratio (4.8) of cervical disc disease and a 0.79 aetiological fraction. Whether this was due to exposure or healthy worker effect was not clear. In four occupational groups with high shoulder-neck load an odds ratio of 4.0 was found for thoracic outlet syndrome with an aetiological fraction of 0.75. Rotator cuff tendinitis in occupational groups with work at shoulder level (two studies) showed an odds ratio of 11 and an aetiological fraction of 0.91. Keyboard operators had an odds ratio of 3.0 for tension neck syndrome (five studies). Unfortunately, owing to the scanty description of the work task, the exposure could be analysed only by job title. Examination of published reports shows clearly that certain job titles are associated with shoulder-neck disorders. High rates and aetiological fractions for rotator cuff tendinitis and tension neck syndrome suggest that preventive measures could be effective. Although job descriptions are brief, the associations noted suggest that highly repetitive shoulder muscle contractions, static contractions, and work at shoulder level are hazardous exposure factors. In reports of cross sectional studies of occupational shoulder-neck disorders presentation of age, exposure, and effect distribution may help for future meta-analysis. PMID- 3311130 TI - Adverse long-term effects of oral contraceptives: a review. PMID- 3311132 TI - Management of the mature selected breech presentation: an analysis based on the intended method of delivery. AB - The outcome of 313 mature singleton breech deliveries, covering a 3-year period at the Queen Charlotte's Hospital, is reviewed. Maternal and fetal outcome were analysed by the intention to deliver vaginally compared with planned caesarean section. There was no serious fetal morbidity or mortality in either of these groups despite considerable mechanical difficulty with vaginal delivery of the head in one patient. One woman in this group required hysterectomy for haemorrhage after an emergency caesarean section. Planned caesarean sections were carried out in 125 cases (40%). Trial of vaginal delivery was abandoned in 59 (40%) of the 149 women where this was attempted. Epidural analgesia appears to increase the duration of the second stage of labour in those who were delivered vaginally. Younger women and those with smaller babies were more likely to succeed with a trial of vaginal delivery but there was no relation between birthweight and the radiological obstetric conjugate and success or failure of trial of labour. PMID- 3311131 TI - Doppler assessment of umbilical artery blood flow for the prediction of outcome in fetal cardiac abnormality. AB - In a series of 244 pregnancies referred for fetal echocardiography, the umbilical artery waveform was also studied by pulsed Doppler ultrasound. In 152 normal pregnancies diastolic flow in the umbilical artery was always detectable after 20 weeks gestation. In 4 of 58 normal patients examined before 20 weeks, diastolic flow was absent in some part of the recording. In 34 fetuses with congenital heart disease detected at between 18 and 37 weeks gestation, 10 were found consistently to have associated absent diastolic flow. Five of these fetuses died in utero between 5 and 21 days after the recording; three were aborted and the remaining two died in the neonatal period at 4 and 7 days after the examination. Fetal congenital heart disease with normal umbilical blood flow also had a poor prognosis in general, but the adverse outcome was much less immediate than in fetuses with absent diastolic flow. No correlation was found between the type of congenital heart disease and the characteristics of the umbilical artery waveform. Absent diastolic flow in the umbilical artery indicates a poor short term prognosis for fetuses with congenital heart disease, particularly after 20 weeks, when fetal death is predictable. PMID- 3311133 TI - Maternal posture in second stage and fetal acid base status. AB - The effect of position during the second stage on outcome was studied in 58 women, with no exclusions because of pregnancy complications or signs of fetal distress, who were randomly allocated to have the second stage conducted in either the dorsal or 15 degrees lateral tilt position. All the women were of parity 0 or 1 and the two groups were well matched except for gestational age at delivery. There were no differences in clinical outcome between the two groups, but overall the dorsal group had lower cord artery pH values (P less than 0.05), higher PCO2 (P less than 0.01) and a greater base deficit, but not significantly so. pH and base deficit were similar in both groups where the second stage did not last greater than 15 min. Thereafter, there was a trend to decreasing pH and increasing base deficit with increasing length of second stage in the dorsal group, but not in the tilt group though this did not reach statistical significance. Low Apgar scores, complicated pregnancy and first pregnancy were each associated with significantly lower pH levels. Prolonged placement of the patient in the flat dorsal position should be avoided in second stage, though a suitable alternative under the conditions described has not been defined. PMID- 3311134 TI - The value of artificial insemination with husband's semen in infertility due to failure of postcoital sperm-mucus penetration--controlled trial of treatment. AB - Artificial insemination with husband's semen into the cervical canal and uterine cavity (high AIH) was assessed by a randomized controlled prospective study in 46 couples whose infertility was due to failure of sperm mucus penetration, as defined by negative postcoital tests, after excluding all interfering female factors and men with sperm density less than 1 x 10(6)/ml. Seminal analysis was abnormal in 18 of the 46 men and sperm antibodies in semen were detected in 19 of the remaining 28 with normal seminal analysis. Overall, the cumulative conception rate after 6 months with AIH was 4.7 (SE 3.8)% and without treatment was 6.6 (SE 3.9)%. The results were unaffected by the findings on seminal analysis or by the presence or absence of sperm antibodies in semen. AIH appeared to be of no benefit. PMID- 3311135 TI - Placenta membranacea. Case reports. PMID- 3311136 TI - Pregnancy following induced abortion: maternal morbidity, congenital abnormalities and neonatal death. Royal College of General Practitioners/Royal College of Obstetricians and Gynaecologists Joint Study. AB - In a prospective cohort study of the long-term sequelae of induced abortion, a comparison is made between a group of 6418 women who had an induced abortion (cases) and a control group of 8059 women recruited with an unplanned pregnancy which was not terminated with an induced abortion (controls). The present paper reports on 729 cases and 1754 controls who had a post-recruitment pregnancy. In general, prior induced abortion had no material effect on the rate of pregnancy related morbidity, nor on the rate of congenital abnormalities and neonatal death in the offspring. There was, however, a significant difference in two specific conditions. In the post-index pregnancy in the cases there was an increased relative risk (RR 2.26) of the occurrence of urinary tract infection and a decreased risk (RR 0.25) of pregnancy-related anaemia. PMID- 3311137 TI - Ultrasound exposure time in routine obstetric scanning. AB - The duration of exposure to ultrasound was measured in 1274 patients having a routine examination during their first visit to an antenatal clinic. The measured median exposure time was 105 s. Since pulsed ultrasound was used (duty cycle of 1 in 800) the actual median maternal exposure time was 131 ms. Exposure of the fetus would usually be less since it rarely occupies the full width of the image. The relevance of exposure time to the safety of diagnostic ultrasound and the implications for users and manufacturers are discussed. PMID- 3311138 TI - Is treatment needed for mild impairment of glucose tolerance in pregnancy? A randomized controlled trial. AB - The study was designed to identify those pregnant women who are diagnosed as having gestational diabetes by National Diabetes Data Group (NDDG) criteria, but normal glucose tolerance (NGT) or impaired glucose tolerance (IGT) by the World Health Organization (WHO) criteria, and to test whether treatment changed the perinatal outcome in those with NGT and IGT. The 216 women with an abnormal 100 g oral glucose tolerance test (OGTT) using NDDG criteria were subjected to a 75 g OGTT. Using the WHO criteria, 111 women (51%) had NGT, 98 (45%) had IGT and 7 (3%) had frank diabetes mellitus. Those with NGT and IGT were randomized into control and treatment groups. The perinatal outcome in these two groups was comparable whether the NGT and IGT groups were analysed together or separately except, that in those who were treated for IGT, smaller babies were born one week earlier than in the control group (3407 g vs 3110 g, P less than 0.01). This suggests that the WHO criteria can safely replace the 100 g OGTT with substantial savings in manpower, money and patients' time. PMID- 3311139 TI - The predictive value of fetal breathing movements in the diagnosis of preterm labour. AB - A real time ultrasound investigation was performed on 64 patients who presented in threatened preterm labour. Fetal breathing movements (FBM) were absent in 17 patients, all of whom were delivered within 56 h. FBM were present in 47 patients of whom five were delivered within 56 h from examination and four of these had spontaneous rupture of membranes and/or chorioamnionitis. In 33 the pregnancy continued for at least 1 week. Two of the fetuses with false negative results showed a distinct breathing pattern different from the rest of the study group. This suggests that pattern recognition of fetal breathing might improve the specificity of this investigation. PMID- 3311140 TI - Characterisation of ocular melanoma with cutaneous melanoma antibodies. AB - It can be difficult to distinguish between various forms of pale intraocular tumour, and in particular between an amelanotic malignant melanoma, a choroidal haemangioma, and a solitary metastasis. If a monoclonal antibody specific for melanoma could be identified, it might be radiolabelled to provide a scanning technique which could distinguish between an ocular melanoma and a similar lesion. This pilot, in vitro study was undertaken to determine if monoclonal antibody against cutaneous melanoma recognises any antigenic similarity in ocular melanomas. Three cutaneous melanoma MoAbs 225.28S, 376.96S, and 763-24T and a non specific MoAb HMFG2 were studied. Cell impressions were obtained from fresh ocular malignant melanomas. Standard staining techniques with immunofluorescence were used. MoAb 225.28S, 376.96S, and 763.24T were positive in melanomas with a dominant epithelioid cell type and in those with a dominant spindle cell type. It is concluded that MoAb 225.28S, 376.96S, and 763.24T may be suitable for imaging ocular melanomas after labelling with 123I, 111In, or 99mTc. PMID- 3311141 TI - Mycobacterium chelonei infection of a corneal graft. AB - We present a case of Mycobacterium chelonei infection in a corneal graft. The chronic ulceration and stromal infiltration followed a well defined course and eventually responded to topical amikacin, though a further graft was required. Previous cases of keratitis due to the M. fortuitum complex are reviewed. PMID- 3311143 TI - Fracture of the hyoid bone--report of a case. AB - The hyoid bone, well protected under the protruding chin, seldom sustains fractures in road traffic accidents. We report such a case and review 14 cases found in the world literature. PMID- 3311142 TI - Mandibular fractures in India during the Second World War (1944 and 1945): analysis of the Snawdon series. AB - The records of Major J. W. E. Snawdon of the No. 2 Indian Maxillofacial Unit provide a rare and detailed insight into the treatment of mandibular fractures during the Second World War. Notable features were the high frequency of civilian type injuries, the considerable delays between injury and definitive treatment, the lengthy periods of intermaxillary fixation required, the high incidence of infections and the common occurrence of delayed union. Despite these problems, only 12% of fractures resulted in non-union, usually when these were missile injuries with considerable destruction. Reporting of the details from Snawdon's records should be of interest particularly to young oral surgeons, whose experience of trauma belongs to an entirely different environment. PMID- 3311144 TI - Food induced granuloma--an unusual cause of a submandibular mass with observations on the pathogenesis of hyaline bodies. AB - A case of a submandibular mass due to a granulomatous reaction to vegetable matter of dietary origin is presented. The histology of the lesion and its pathogenesis are described. It is compared with previous reports of 'hyaline bodies' in relation to chronic mandibular periostitis. PMID- 3311145 TI - Swallowing food without chewing; a simple way to reduce postprandial glycaemia. AB - 1. The degree to which disruption by mastication affects the glycaemic response to four different carbohydrate foods was investigated in healthy human volunteers; each food was eaten by six subjects. 2. Subjects ate meals of sweetcorn, white rice, diced apple or potato on two occasions; on one occasion they chewed the food thoroughly, on the other occasion they swallowed each mouthful without chewing it. 3. When the foods were chewed the postprandial blood glucose levels rose to levels which varied according to the food ingested. 4. Swallowing without chewing reduced the glycaemic response to each food, achieving a similar effect as administration of viscous polysaccharides or 'slow-release' carbohydrates. PMID- 3311146 TI - Purification of a yeast protein kinase sharing properties with type I and type II casein kinases. AB - Cyclic nucleotide independent protein kinases preferring casein as in vitro substrates were resolved into four distinct species. Only one of the enzymes (CKII) was retained by DEAE-cellulose, whereas the three other enzymes (CKI-1, CKI-2, and CKI-3) were absorbed to CM-Sephadex, eluted with 250 and 600 mM NaCl, and fractionated by heparin-Sepharose chromatography. The casein kinase CKI-3 eluting at the highest NaCl concentration (550 mM) was purified to electrophoretic homogeneity by fast protein liquid chromatography. CKI-1 and CKI 2 correspond to mammalian type I casein kinase, because they bind to CM-Sephadex, they are monomeric enzymes of molecular weights below 50,000, they accept ATP exclusively (CKI-1) or predominantly (CKI-2) as phosphate donor, and they are either completely or relatively heparin insensitive. CKII corresponds to type II casein kinase due to its chromatographic properties, complex quaternary structure, nucleotide specificity (both ATP and GTP are phosphate donors), and heparin sensitivity. CKI-3 shares the following properties with type I casein kinases: it is retained by CM-Sephadex but not by DEAE-cellulose, and it consists of a monomeric protein having a molecular weight of 38,000. On the other hand, CKI-3 accepts both ATP and GTP with equal efficiency, and it is heparin sensitive (50% inhibition at 0.3 microgram/mL) like type II casein kinases. CKI-3 differs from the other three yeast casein kinases in requiring a low pH (5.5) and a high MgCl2 concentration (50 mM) for optimal activity. All four casein kinases phosphorylate their own catalytic protein at serine and threonine residues. PMID- 3311147 TI - Identification of a hydroxide ligand at the iron center of ribonucleotide reductase by resonance Raman spectroscopy. AB - The resonance Raman spectrum of protein B2 of ribonucleotide reductase from Escherichia coli shows several features to its oxo-bridged binuclear iron center. A peak at 492 cm-1 is assigned to the symmetric stretch of the Fe-O-Fe moiety on the basis of its 13-cm-1 shift to lower energy upon 18O substitution. The 18O species shows an additional peak at 731 cm-1, which is a good candidate for the asymmetric stretch of the Fe-O-Fe moiety. Its exact location in the 16O species is obscured by the presence of a protein tryptophan vibration at 758 cm-1. A third resonance-enhanced peak at 598 cm-1 is identified as an Fe-OH vibration on the basis of its 24-cm-1 shift to lower energy in H2 18O, its 2-cm-1 shift to lower energy in D2O, and its pH-dependent intensity. A hydrogen-bonded mu-oxo bridge similar to that in hemerythrin is suggested by the unusually low frequency for the Fe-O-Fe symmetric stretch and the 3-cm-1 shift to higher energy of vs(Fe O-Fe) in D2O. From the oxygen isotope dependence of vs(Fe-O-Fe), an Fe-O-Fe angle of 138 degrees can be calculated. This small angle suggests that the iron center consists of a tribridged core as in hemerythrin. A model for the binuclear iron center of ribonucleotide reductase is presented in which the hydroxide ligand sites provide an explanation for the half-of-sites reactivity of the enzyme. PMID- 3311148 TI - Positional oxygen isotope exchange as a probe for the mechanism of catalysis by Escherichia coli succinyl coenzyme A synthetase. AB - Succinyl-CoA synthetase of Escherichia coli has an alpha 2 beta 2 subunit structure. The enzyme shows strict half-sites reactivity with respect to the phosphorylation of a histidine residue in the alpha subunit that represents a step in catalysis. Several lines of evidence indicate that this behavior may result from cooperative interactions between alternatingly functional active sites, so that subsequent steps in catalysis at one site may be promoted by phosphoryl transfer to the site on the neighboring half of the molecule. This study is directed toward learning more about the nature of these cooperative interactions. Here we have used positional isotope exchange (i.e., exchange of 18O between the beta, gamma bridge and the beta nonbridge position of ATP) as a test for transient bisphosphorylation. Succinyl-CoA synthetase was ATP) as a test for transient bisphosphorylation. Succinyl-CoA synthetase was prepared in which one of the two active sites was thiophosphorylated; this species thus has one of its two active-site histidine residues occupied and unavailable for further reaction with ATP. Treatment of this monothiophosphorylated enzyme with [beta, gamma-18O]ATP resulted in no significant scrambling of isotope into the nonbridge position, clearly indicating that the enzyme does not undergo even transient bisphosphorylation. We interpret the results in terms of a model of catalysis in which phosphoryl transfer to the second site occurs in concerted fashion with transfer from the first. PMID- 3311149 TI - Identification of two segments, separated by approximately 45 kilodaltons, of the myosin subfragment 1 heavy chain that can be cross-linked to the SH-1 thiol. AB - The thiol-specific photoactivatable reagent 4-(2-iodoacetamido)benzophenone (BPIA) can be selectively incorporated into the SH-1 of myosin subfragment 1 (S1), and upon photolysis an intramolecular cross-link is formed between SH-1 and the N-terminal 25-kDa region of S1. If a Mg2+-nucleotide is present during photolysis, cross-links can be formed either with the 25-kDa or with the central 50-kDa region [Lu, R. C., Moo, L., & Wong, A. G. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 6392-6396]. Heavy chains with these two types of intramolecular cross links and un-cross-linked heavy chain have different mobility on sodium dodecyl sulfate (NaDodSO4)-polyacrylamide gels and therefore can be purified electrophoretically. Each type of heavy chain was cleaved with Staphylococcus aureus protease, chymotrypsin, or lysyl endopeptidase. The cleavage points were determined on the basis of the molecular weights of weights of peptides containing the N-terminus, which was identified with the use of an antibody. Locations of the cross-links were deduced by comparing the peptide maps of cross linked and un-cross-linked heavy chains. The results indicate that the segment located about 12-16 kDa from the N-terminus of the heavy chain can be cross linked to SH-1 via BPIA independently of the presence of a nucleotide, whereas the segment located 57-60 kDa from the N-terminus can be cross-linked to SH-1 only in the presence of a Mg2+-nucleotide. With use of the avidin-biotin system, it has been shown that SH-1 is located 13 nm from the head/rod junction [Sutoh, K., Yamamoto, K., & Wakabayashi, T. (1984) J. Mol. Biol. 178, 323-339]. Since BPIA spans less than 1 nm, our results show that two regions, separated by approximately 400 amino acid residues and located in the 25- and 50-kDa domains of S1, respectively, are also part of the head structure about 12-14 nm from the head/rod junction. PMID- 3311150 TI - Photochemical properties of Escherichia coli DNA photolyase: selective photodecomposition of the second chromophore. AB - Escherichia coli DNA photolyase contains a stable flavin radical and a second chromophore (SC) of unknown structure. The effects of flash (both conventional and laser) excitation of either the radical alone or both the radical and the second chromophore have been investigated by variation of the excitation wavelengths. Radical excitation leads to an electron abstraction by the lowest excited doublet state of the radical from an amino acid residue, probably a cysteine or tyrosine. On a longer time scale, a back-reaction occurs that can be prevented by the presence of certain electron donors, e.g., thiols, NADH, or tyrosine, but not pyrimidine dimers. Excitation of the second chromophore leads to electronic energy transfer from second chromophore excited states to the ground-state flavin radical doublet state, thus increasing the population of the lowest excited doublet state. Repetitive excitation of the enzyme with white light leads to photodecomposition of the second chromophore but not of the flavin adenine dinucleotide cofactor. Enzyme with photodecomposed SC retains full activity. PMID- 3311151 TI - Cleavage of fibrin-derived D-dimer into monomers by endopeptidase from puff adder venom (Bitis arietans) acting at cross-linked sites of the gamma-chain. Sequence of carboxy-terminal cyanogen bromide gamma-chain fragments. AB - Puff adder venom contains a protease capable of cleaving the gamma-chain of cross linked D-dimer, derived from the plasmin digestion of fibrin, into apparently symmetrical monomers. The cross-linked gamma-chains are separated in the process without apparent loss of mass and without loss of the substituent at the glutamine cross-link site, if fluorescent D-dimer (the lysine analogue dansylcadaverine used as substituent) is used as substrate [Purves, L. R., Purves, M., Lindsey, G. G., & Linton, N. J. (1986) S. Afr. J. Sci. 82, 30]. The gamma-chain from puff adder venom digested D-monomer was isolated and cleaved by cyanogen bromide, and the carboxy-terminal peptide was isolated and sequenced. The carboxy-terminal peptide composition indicated a lower content of histidine, leucine, and glycine than expected. Manual microsequencing by gas-phase Edman degradation demonstrated that two amino-terminal ends were present. By use of the known sequence of the human fibrinogen gamma-chain, the sequencing data could be resolved into a dipeptide cross-linked between lysine-406 and either glutamine 398 or -399 (residues 6 and 13 or 14 from the carboxy-terminal end of the gamma chain) with the loss of residues 401-404 that occur between the cross-link sites of both antiparallel cross-linked gamma-chains. D-dimer is therefore separated into monomers by cleavage of the gamma-chain between the cross-link sites. Two symmetrical fragments are produced consisting of a cross-linked dipeptide with the loss of four amino acids.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311152 TI - Extended X-ray absorption fine structure studies on the iron-containing subunit of ribonucleotide reductase from Escherichia coli. AB - Iron K-edge X-ray absorption spectra were obtained on the protein B2, the small subunit of ribonucleotide reductase from Escherichia coli. Protein B2 contains a binuclear iron center with many properties in common with the iron center of oxidized hemerythrins. The extended X-ray absorption fine structure (EXAFS) measurements on protein B2 were analyzed and compared with published data for oxyhemerythrin. In protein B2 there are, in the first coordination shell around each Fe atom, five or six oxygen or nitrogen atoms that are directly coordinated ligands. In oxyhemerythrin there are six ligands to each iron. As in oxyhemerythrin, one of the ligands in the first shell of protein B2 is at a short distance, about 1.78 A, confirming the existence of a mu-oxo bridge. The other atoms of the first shell are at an average distance of 2.04 A, which is about 0.1 A shorter than in oxyhemerythrin. In protein B2 the Fe-Fe distance is in the range 3.26-3.48 A, and the bridging angle falls between 130 and 150 degrees. On the basis of these data, there is no direct evidence for any histidine ligands in protein B2, but the noise level leaves way for the possibility of a maximum of about three histidines for each Fe pair. The X-ray absorption spectrum of a hydroxyurea-treated sample was not significantly different from that of the native protein B2, which implies that no significant alteration in the structure of the iron site occurs upon destruction of the tyrosine radical. PMID- 3311154 TI - Interdependence of coenzyme-induced conformational work and binding potential in yeast alcohol and porcine heart lactate dehydrogenases: a hydrogen-deuterium exchange study. AB - Binding of NAD coenzymes to yeast alcohol dehydrogenase (YADH) and porcine heart lactate dehydrogenase (PHLDH) was studied by hydrogen-deuterium exchange with the infrared technique. Conformational changes in the enzymes specific to the coenzymes and their fragments were observed, and the pH dependence of the exchange reaction shows that it conforms to the EX-2 scheme. In both YADH and PHLDH the magnitude of the conformational change of measured by exchange retardation is considerably larger for NAD+ than for NADH. Studies with coenzyme fragments like ADP-ribose, ADP, and AMP also highlight the lack of rigorous correlation between structural features such as charge and size and their influence on exchange behavior. Ternary complexes such as YADH-NAD+-pyrazole, PHLDH-NAD+-oxalate, and PHLDH-NADH-oxamate, which mimic the transition state, have a significantly more pronounced effect on exchange rates than the corresponding binary complexes. The outstanding feature of this study is the demonstration that in the binary enzyme-coenzyme complexes the more loosely bound NAD+ is more effective in retarding exchange than the more firmly bound NADH. These differences are attributed to the unequal structural constraints exerted by the two coenzymes upon the enzymes, which translate to unequal expenditure of transconformational work in the formation of the two complexes. The opposing variation in the free energy of binding and the transconformational work expended can be viewed as an unequal partitioning of the net free energy gain resulting from the protein-ligand interaction into a binding term and that required for conformational change. PMID- 3311153 TI - Chorismate aminations: partial purification of Escherichia coli PABA synthase and mechanistic comparison with anthranilate synthase. AB - Chorismate is converted by regiospecific amination/aromatization sequences to o aminobenzoate and p-aminobenzoate (PABA) by anthranilate synthase (AS) and PABA synthase (PABS), respectively. We report here the first partial purification of the large subunit of Escherichia coli PABA synthase, previously reported to be quantitatively inactivated in purification attempts. The subunit encoded by the pabB gene was overexpressed from a T7 promoter and purified 9-fold to 25-30% homogeneity. The pabB subunit appears unusually sensitive to inactivation by glycerol so this cosolvent is contraindicated. The Km for chorismate is 42 microM in the ammonia-dependent conversion to PABA, and we estimate a turnover number of 2.6 min-1. A variety of chorismate analogues have been prepared and examined. Of these compounds, cycloheptadienyl analogue 11 has been found to be the most potent inhibitor of Serratia marcescens anthranilate synthase (Ki = 30 microM for an RS mixture) and of the E. coli pabB subunit of PABA synthase (Ki = 226 microM). Modifications in the substituents at C-3 [enolpyruyl ether, (R)- or (S) lactyl ether, glycolyl ether] or C-4 (O-methyl) of chorismate lead to alternate substrates. The Vmax values for (R)- and (S)-lactyl ethers are down 10-20-fold for each enzyme, and V/K analyses show the (S)-lactyl chorismate analogue to be preferred by 12/1 over (R)-lactyl for anthranilate synthase while a 3/1 preference was observed for (R)-/(S)-lactyl analogues by PABA synthase. The glycolyl ether analogue of chorismate shows 15% Vmax vs. chorismate for anthranilate synthase but is actually a faster substrate (140%) than chorismate with PABA synthase, suggesting the elimination/aromatization step from an aminocyclohexadienyl species may be rate limiting with AS but not with PABS. Indeed, studies with (R)-lactyl analogue 14 and anthranilate synthase led to accumulation of an intermediate, isolable by high-performance liquid chromatography and characterized by NMR and UV-visible spectroscopy as 6-amino-5 [(1-carboxyethyl)oxy]-1,3-cyclohexadiene-1-carboxylic acid (17). This is the anticipated intermediate predicted by our previous work with conversion of synthetic trans-6-amino-5-[(1-carboxyethenyl)oxy]-1,3-cyclohexadiene-1-carbo xylic acid (2) to anthranilate by the enzyme. Compound 17 is quantitatively converted to anthranilate on reincubation with enzyme, but at a 1.3-10-fold lower Vmax than starting lactyl substrate 14 under the conditions investigated; the basis for this kinetic variation is not yet determined. PMID- 3311155 TI - Size and shape of the Escherichia coli lactose permease measured in filamentous arrays. AB - The Escherichia coli lactose permease has been purified on cation exchanger to contain a minimal amount of phospholipids, i.e., 4-5 mol/mol of permease, in the presence of the detergent dodecyl beta-maltoside at its critical micelle concentration. This preparation is active in galactoside binding. When the detergent level is further reduced by dialysis, the lactose permease forms filaments one molecule wide and up to several micrometers long. The filaments tend to associate laterally to form sheets. Analysis of electron micrographs of negatively stained filamentous arrays indicates an average filament spacing of 51 A and a subunit period of 26-30 A along individual filaments. These values most probably correspond to the dimensions of the lactose permease molecule measured parallel to the membrane plane. In many filaments, the subunits show a stain penetrated cleft. It suggests that the lactose permease molecule comprises two domains, which may be correlated with internal repeats between the N- and C terminal halves of the polypeptide sequence. PMID- 3311156 TI - Stoichiometry of lac repressor binding to nonspecific DNA: three different complexes form. AB - The stoichiometry of lac repressor binding to nonspecific DNA was investigated by three different techniques. Four molecules of the fluorescent probe 5,5'-bis(8 anilino-1-naphthalenesulfonate) [bis(ANS)] bind to each repressor subunit with an average dissociation constant of 20 microM. Nonspecific DNA displaces most of this bound bis(ANS), reducing the fluorescence. Titrations of repressor with nonspecific DNA monitored with high [bis(ANS)] (5-15 microM) had end points at 8 base pairs per repressor. Lower [bis(ANS)] (0.1-1 microM) resulted in end points at either 15 or 26 base pairs per repressor, depending on the ionic strength. These end points correspond to complexes containing approximately one, two, or four repressors per 28 base pairs. Boundary sedimentation velocity experiments with saturating amounts of repressor revealed that five repressors can bind to 28 base pairs. By monitoring the circular dichroism as DNA was added to repressor, the sequential appearance of complexes containing approximately four, two, and one repressors per 28 base pairs was observed. The inability of repressor cores or iodinated repressor to bind to complexes containing one or two repressors per 28 base pairs implies that all of the repressors directly contact the DNA in the complex containing four repressors per 28 base pairs. It is proposed that while two subunits of each repressor contact the DNA in complexes containing one or two repressors per 28 base pairs, only one subunit of each repressor contacts the DNA in the complex with four repressors per 28 base pairs. These results suggest a novel mechanism for the one-dimensional diffusion of repressor along DNA. PMID- 3311157 TI - Nickel enzymes. PMID- 3311158 TI - Polypeptide folding and dimerization in bacterial luciferase occur by a concerted mechanism in vivo. AB - Bacterial luciferase is a heterodimeric enzyme comprising two nonidentical but homologous subunits, alpha and beta, encoded by adjacent genes, luxA and luxB. The two genes from Vibrio harveyi were separated and expressed from separate plasmids in Escherichia coli. If both plasmids were present within the same E. coli cell, the level of accumulation of active dimeric luciferase was not dramatically less than within cells containing the intact luxAB sequences. Cells carrying the individual plasmids accumulated large amounts of individual subunits, as evidenced by two-dimensional polyacrylamide gel electrophoresis. Mixing of a lysate of cells carrying the luxA gene with a lysate of cells carrying the luxB gene resulted in formation of very low levels of active heterodimeric luciferase. However, denaturation of the mixed lysates with urea followed by renaturation resulted in formation of large amounts of active luciferase. These observations demonstrate that the two subunits, alpha and beta, if allowed to fold independently in vivo, fold into structures that do not interact to form active heterodimeric luciferase. The encounter complex formed between the two subunits must be an intermediate structure on the pathway to formation of active heterodimeric luciferase. PMID- 3311160 TI - Kinetics of the stages of transcription initiation at the Escherichia coli lac UV5 promoter. AB - The kinetics of initiation by Escherichia coli RNA polymerase on the lac L8UV5 promoter was studied by a gel retardation method that separates protein-DNA complexes from free DNA. The binding constant of the closed complex, the forward and reverse rate constants of isomerization from closed to open complex, and the forward rate constant from the open to initiated complex were measured. Both the forward and reverse isomerization rates were found to be temperature dependent, and the activation energies for these steps were determined. The rates of open complex formation and dissociation were not affected by the addition of ribonucleotide triphosphates; however, the extent of dissociation was greatly reduced if the triphosphates added allowed a short, unstable RNA product to form. The dissociation rate was not affected by heparin, a polyanion competitor that sequesters the polymerase. The rate of initiated complex formation appeared to be dependent on whether the initiating moiety was a mononucleotide triphosphate or dinucleoside monophosphate and on the sequence of the dinucleoside. These results are compared to those found on both the lac L8UV5 and other bacterial and phage promoters by less direct measurements. We use the values obtained for the individual rate constants to investigate the predicted steady-state kinetics of initiation-limited transcription, with the conclusion that the rate-limiting step is formation of the open complex in the limit of low polymerase concentration. However, when RNA polymerase is saturating, the rate is determined by the transition from open complex into the stably initiated ternary complex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311159 TI - Sodium transport and phosphorus metabolism in sodium-loaded yeast: simultaneous observation with sodium-23 and phosphorus-31 NMR spectroscopy in vivo. AB - Simultaneous 23Na and 31P NMR spectra were obtained from a number of yeast suspensions. Prior to NMR spectroscopy, the yeast cells were Na-loaded: this replaced some of the intracellular K+ with Na+. These cells were also somewhat P deficient in that they had no polyphosphate species visible in the 31P NMR spectrum. In the NMR experiments, the Na-loaded cells were suspended in media which contained inorganic phosphate, very low Na+, and a shift reagent for the Na+ NMR signal. The media differed as to whether dioxygen, glucose, or K+ was present individually or in combinations and as to whether the medium was buffered or not. The NMR spectra revealed that the cells always lost Na+ and gained phosphorus. However, the nature of the Na+ efflux time course and the P metabolism differed depending on the medium. The Na+ efflux usually proceeded linearly until the amount of Na+ extruded roughly equalled the amount of NH4+ and orthophosphate initially present in the medium (external phosphate was added as NH4H2PO4). Thus, we presume this first phase reflects a Na+ for NH4+ exchange. The Na+ efflux then entered a transition phase, either slowing, ceasing, or transiently reversing, before resuming at about the same value as that of the first phase. We presume that this last phase involves the simultaneous extrusion of intracellular anions as reported in the literature. The phosphorus metabolism was much more varied. In the absence of exogenous glucose, the P taken up accumulated first as intracellular inorganic phosphate; otherwise, it accumulated first in the "sugar phosphate" pool. In most cases, at least some of the P left the sugar phosphate pool and entered the polyphosphate reservoir in the vacuole. However, this never happened until the phase probably representing Na+ for NH4+ exchange was completed, and the P in the polyphosphate pool never remained there permanently but always eventually reverted back to the sugar phosphate pool. These changes are interpreted in terms of hierarchical energy demands on the cells under the different conditions. In particular, the energy for the Na+ for NH4+ exchange takes precedence over that required to produce and store polyphosphate. This conclusion is supported by the fact that when the cells are "forced" to exchange K+, as well as NH4+, for Na+ (by the addition of 5 times as much K+ to the NH4+-containing medium), polyphosphates are never significantly formed, and the initial linear Na+ efflux phase persists possibly 6 times as long.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311161 TI - Solution structure of the Trp operator of Escherichia coli determined by NMR. AB - We have assigned the majority of the nonexchangeable protons in the NMR spectrum of the 20 base-pair fragment of DNA corresponding to the Trp operator of Escherichia coli. The sequence (CGTACTAGTTAACTAGTACG) also contains a Pribnow box (underlined). Variation of the intrinsic spin-lattice relaxation rate constants of the H8's along the sequence indicates that the structure of the oligonucleotide is not regular. Splitting patterns of the H1' resonances in the deoxyriboses, obtained from a two-dimensional J-resolved experiment, allowed the dominant pucker mode of each nucleotide to be determined. Intranucleotide NOEs from the sugar protons H1', H2', and H3' to the base protons were used to determine the conformation of each nucleotide (puckers and glycosidic torsion angles). The relative orientations of nucleotide units (roll, propeller twist, helical twist angle, and pitch) were calculated by using internucleotide NOEs between protons of neighboring nucleotides in the sequence. All these parameters were determined for each step along the 20-mer. The structure belongs to the B family of conformations, but variations of the local geometry are observed from step to step. Some of the variations, such as the roll and the twist angles, can be predicted by the rules of Calladine and Dickerson [Calladine, C. R., & Dickerson, R. E. (1983) J. Mol. Biol. 166, 419-441]. The puckers of the deoxyriboses of purines are found mainly in conformations near C2' endo, while those of the pyrimidines prefer C3' endo and related conformations. Glycosidic torsion angles obtained for purines are larger than those of pyrimidines. Except for this last observation, the general properties of the operator DNA structure are comparable with those of crystal structures of B DNA of other sequences. PMID- 3311162 TI - trans-Diamminedichloroplatinum(II), a reversible RNA-protein cross-linking agent. Application to the ribosome and to an aminoacyl-tRNA synthetase/tRNA complex. AB - A new approach allowing detection of contact points between RNAs and proteins has been developed using trans-diamminedichloroplatinum(II) as the cross-linking reagent. The advantage of the method relies on the fact that the coordination bonds between platinum and the potential acceptors on proteins and nucleic acids (mainly S of cysteine or methionine residues; N of imidazole rings in histidine residues; N7 of guanine, N1 of adenine, and N3 of cytosine residues) can be reversed, so that the cross-linked oligonucleotides or peptides in contact within a complex can be analyzed directly. The method was worked out with the ribosome from Escherichia coli and the tRNAVal/valyl-tRNA synthetase system from the yeast Saccharomyces cerevisiae. In the first system the platinum approach permitted detection of ribosomal proteins cross-linked to 16S rRNA within the 30S subunits (mainly S18 and to a lower extent S3, S4, S11, and S13/S14); in the second system major oligonucleotides of tRNAVal cross-linked to valyl-tRNA synthetase were detected in the anticodon stem and loop, in the variable loop, and in the 3' terminal amino acid accepting region. These results are discussed in light of the current knowledge on ribosome and tRNAs and of potential applications of the methodology. PMID- 3311163 TI - Sodium ions protect a membrane transport protein from proteolysis. AB - Na+-dependent alanine transport activity in vesicles prepared from pigeon erythrocyte membranes was examined after exposure of the vesicles to some proteinases under various conditions. The presence of sodium ions during proteolysis affords considerable protection of alanine transport activity from the inhibitory action of the proteinases. The concentration of sodium ions required for half-maximum protection is greater than that needed for half-maximum activation of alanine uptake. The site of protective action could be at either or both surfaces of the membrane because the vesicles are very permeable to sodium ions. Neither measurement of residual protein content nor analysis by polyacrylamide gel electrophoresis revealed any differences in the extent of protein degradation occurring in the presence and absence of sodium ions, suggesting that the transporter constitutes only a minor membrane component. We conclude that sodium ions probably induce a conformation change in the transporter. PMID- 3311165 TI - Radioprotective effects of lipid A, liposomes, and liposomes containing lipid A in mice. AB - Lipid A from Gram-negative bacterial lipopolysaccharide (endotoxin) was incorporated into liposomal membranes and examined as a prophylactic radioprotectant compound in lethally irradiated mice. Splenic hematopoietic activity, resulting in increased numbers of spleen cell colonies, was induced both by lipid A alone or more strongly by liposomal lipid A. Increased survival of lethally irradiated animals was induced to a slight extent by liposomes alone, to a greater extent by lipid A, and at the highest level by liposomes containing lipid A. Under conditions where 100% of untreated or saline-treated animals died of acute radiation syndrome after 20 days, more than 90% of the animals pretreated with liposomal lipid A were still alive 30 days after irradiation. We conclude that lipid A had substantial radioprotectant activity by itself, and the activity was enhanced by incorporation into liposomes. Liposomes alone also exhibited mild radioprotectant effects. PMID- 3311164 TI - Perturbation of the lipid bilayer of model membranes by synthetic signal peptides. AB - The interaction of synthetic peptides corresponding to the signal sequences of Escherichia coli alkaline phosphatase: Lys-Gln-Ser-Thr-Ile-Ala-Leu-Ala-Leu-Leu Pro-Leu-Leu-Phe-Thr-Pro-Val-Thr- Lys-Ala - OCH3, chicken lysozyme: Met-Lys-Ser Leu-Leu-Ile-Leu-Val-Leu-Cys(Bzl)-Phe-Leu-Pro-Leu- Ala-Ala-Leu-Gly-OCH2-C6H5 and variant of the chicken lysozyme signal sequence with a charged residue in the hydrophobic region: Lys-Leu-Leu-Ile-Ala-Leu-Val-Leu-Lys-Phe-Leu-Pro-Leu-Ala-Ala- Leu-Gly-OCH3 with model membranes of brain phosphatidylserine (PS) and egg phosphatidylcholine (PC) have been investigated by 90 degrees light scattering and fluorescence spectroscopy. Our results indicate that the association of signal peptides with model membranes results in extensive perturbation of the lipid bilayer so as to cause fusion of PS vesicles and aggregation of PC vesicles. The vesicles are also rendered permeable to hydrophilic molecules like carboxyfluorescein. The variant peptide with the lysine residue in the hydrophobic region also has the ability to perturb lipid bilayers of model membranes. PMID- 3311166 TI - Cation specificity for sugar substrates of the melibiose carrier in Escherichia coli. AB - A study has been made of the sugar substrate specificities and the cation specificities of the melibiose transport system of Escherichia coli. The following beta-galactosides were found to be transported: lactose, L-arabinose beta-D-galactoside, D-fructose-beta-D-galactoside, o- and p-nitrophenyl-beta-D galactosides. These beta-galactosides were cotransported with Na+ but not with H+. The alpha-galactosides raffinose, melibiose and p-nitrophenyl-alpha galactoside were transported with either H+ or Na+. Of the monosaccharides tested D-galactose could use either Na+ or H+ for cotransport whereas D-fucose, L arabinose and D-galactosamine could use only Na+. The sugar specificity requirements for H+ cotransport are therefore more exacting than those for Na+ cotransport. PMID- 3311167 TI - Interference of a nonmetabolized analogue of L-leucine with lipid metabolism in tumoral pancreatic islet cells. AB - The nonmetabolized analogue of L-leucine, 2-aminobicyclo[2,2,1]heptane-2 carboxylic acid (BCH), was recently found to inhibit O2 uptake and insulin release from tumoral islet cells of the RINm5F line. BCH inhibited lipogenesis, stimulated lipolysis, and severely decreased the oxidation of endogenous [U 14C]palmitate in prelabelled RINm5F cells. D-Glucose exerted metabolic effects which were sometimes opposite to those caused by BCH and, within limits, protected the islet cells against the inhibitor action of BCH. Since BCH augments NH4+ production and facilitated the catabolism of 14C-labelled amino acids in the prelabelled cells, it is proposed that the unexpected inhibition of O2 uptake by BCH is mainly attributable to a decrease in the oxidation of endogenous fatty acids. PMID- 3311168 TI - Intravacuolar proteolysis in Plasmodium falciparum digestive vacuoles is similar to intralysosomal proteolysis in mammalian cells. AB - Hemoglobin of intact human erythrocytes was labelled with [125I]iodide and these cells were inoculated with late-stage cultures of Plasmodium falciparum. Subcellular parasite particulate material containing intact digestive vacuoles filled with 125I-labelled hemoglobin was incubated in sucrose-buffer medium and degradation of labelled intravacuolar hemoglobin was measured by precipitation with trichloroacetic acid. Proteolysis was maximal at pH 5.0 or in the presence of MgATP at pH 8.0. The stimulatory effect of MgATP was probably due to energization of a proton pump activity as reported by others (Krogstad, D.J., Schlesinger, P.H. and Gluzman, I.Y. (1984) J. Cell Biol. 101, 2302-2309). Proteolysis was also inhibited by ionophores and antimalarials. These results suggest that P. falciparum digestive vacuoles have an ATP-dependent acidification mechanism similar to mammalian lysosomes but with some exceptions. The properties of this intravacuolar proteolysis were remarkably similar to intralysosomal proteolysis in mouse liver or kidney preparations. PMID- 3311169 TI - [Characteristics of copper-induced streptomycin transport in Escherichia coli]. AB - Copper dependent uptake of streptomycin by resting E. coli cells was studied. It was shown that copper stimulates the aminoglycoside uptake only when bacteria possess endogenic energy sources. Additional accumulation of positive charged molecules of the antibiotic is accompanied by partial depolarisation of the membrane, its steady state distribution between cells and the medium corresponding to the resulted value of the membrane potential. On the basis of the data obtained it was suggested that under the influence of copper membrane permeability for streptomycin increases. PMID- 3311170 TI - [Theoretical analysis of H+/O stoichiometry during aerobic oxidation in E. coli in the stationary state]. AB - A general scheme of E. coli respiratory chain under aerobic oxidation with NAD.H2 is considered. The ratio H+/O is calculated by the currents method for the respiratory chain in a stationary state. The maximal possible stoichiometry is shown to equal 8. The origin of different H+/O values in the respiratory chains is discussed. PMID- 3311171 TI - EMG-activated feedback alarms for the treatment of nocturnal bruxism: current status and future directions. AB - This article reviews published research on the use of EMG-activated feedback paradigms to modify nocturnal bruxism. The first three sections review naturalistic trials, laboratory studies, and comparisons of feedback paradigms with alternative treatment/management approaches. The fourth section overviews several sources of theoretical guidance for further research and delineates some substantive directions. The final section identifies major scientific shortcomings that are common in the literature and offers some correctives. The empirical reviews suggest that nocturnal bruxing feedback is beneficial and competitive with other approaches, particularly when the feedback serves to occasion behaviors that require wakefulness. The theoretical overview points to classical learning theories, biofeedback theories, and theories concerning the etiology of bruxism as guideposts for continued research. The methodological narrative calls for adequately detailed scientific reporting, for increased operational commonality across experiments, and for innovative integrations of actuarial and intrasubject research designs. PMID- 3311172 TI - Maintenance of relaxation-induced blood pressure reductions: the importance of continued relaxation practice. AB - This study examined the long-term importance of continued relaxation practice in the maintenance of relaxation-induced blood pressure reductions. An ABAB withdrawal-reinstatement design was employed with two hypertensive subjects. An objective, unobtrusive measure of home relaxation practice was used to monitor compliance. Subject 1 showed substantial reductions in systolic and diastolic blood pressure during 3 months of relaxation practice, followed by a 60% return to baseline during withdrawal, and a subsequent decrease with reinstatement of relaxation. Subject 2 showed a pattern similar to that of Subject 1 for systolic blood pressure, though the trend for diastolic pressure was unclear owing to a marginal treatment response. These preliminary data suggest that continued relaxation practice may be an important factor in the maintenance of relaxation induced blood pressure reductions. PMID- 3311173 TI - [Limited proteolysis of prolactin in secretory granules from the pituitary gland of estrogenized rats]. AB - The LTH-converting proteolytic activity in LTH granules isolated from estrogenized rat hypophysis was studied. Suspensions of granules were incubated at different values of pH for 4 hours at 37 degrees C. The reaction was controlled by SDS electrophoresis. Intensive proteolysis of LTH was observed at pH 6.0 and 3.9, which was accompanied by the formation of fragments with Mr 10, 12 and 17 kD and probably of smaller peptides. An inhibitory analysis revealed that the formation of the 17 kD fragment at pH 3.9 was partly and selectively inhibited by chloroquine, phenanthroline and phenylmethylsulfonyl fluoride. Pepstatin A fully inhibited the proteolysis, whereas leupeptin had no inhibiting influence. The data obtained testify to the presence in the granular fraction of the endopeptidase LTH-converting activity which is sensitive to pepstatin A, an aspartyl proteinase inhibitor as well as to chelators and a serine proteinase inhibitor. PMID- 3311174 TI - [Catalytic and immunochemical properties of ferritin conjugates with horseradish peroxidase]. AB - The human spleen ferritin--horseradish peroxidase conjugate (HRP--Fer) was synthesized by periodate oxidation of the enzyme carbohydrate fragment. The protein fraction containing 1-2 peroxidase molecules and characterized by kinetic homogeneity was obtained in the peroxidatic ortho-dianisidine (o-DA) oxidation reaction. Gel diffusion precipitation of HRP--Fer with peroxidases and ferritin antibodies was carried out. The precipitation confirms the retention by peroxidase and ferritin of their antigenic properties. The kinetics of peroxidatic oxidation of o-DA by the HRP--Fer conjugate was studied within the temperature interval of 15-37 degrees C. The value of catalytic constant for this reaction exceeds that for native peroxidase 1.75-fold. A kinetic analysis of thermal inactivation of peroxidase and its conjugate was performed within the temperature range of 40-65 degrees C. The effective rate constants of inactivation obtained from the first order equation are higher for HRP--Fer than for the native enzyme. The effect of pH on the rates of inactivation of HRP--Fer and the non-modified enzyme was studied at 50 degrees C. The enzyme and its conjugate were shown to stabilize in acid media. The HRP--Fer conjugate can be used as an effective tool in immunoenzymatic assays of ferritin. PMID- 3311175 TI - [Mechanism of inhibition by local anesthetics of electron transport at the donor site of the photosystem II]. AB - The mechanism of inhibition by local anaesthetics of the procaine group of electron transport at the donor site of photosystem II (PS II) from pea chloroplasts was investigated. It was found that besides the inactivation of the O2 release system the anaesthetics used at one order of magnitude lesser concentration exert an uncoupling effect. With a rise in pH the inhibiting activity increases; however, this process is not coupled with the protonophore effect but is due to the generation of a neutral form of the amine. The increment of the inhibiting activity of the anaesthetics in the course of deprotonation seems to be regulated by changes in the coefficient of distribution between the membrane and the aqueous phase. The rate of inactivation of the H2O-dissociating complex increases considerably upon illumination. Electron transport through PS II in anaesthetic-treated chloroplasts in restored by diphenylcarbaside, but not by hydroxylamine. It is concluded that the anaesthetics induce the inhibition by interacting with the electron carrier. The role of the Ca2+--calmodulin-like protein in the functioning of the electron transport chain of PS II is discussed. PMID- 3311176 TI - [Protease activity of the nuclear matrix of rat hepatocytes]. AB - It was demonstrated that the nuclear matrix of rat liver possesses the protease activity. The specific activity of nuclear matrix proteases exceeds that of intact nuclei 7-fold. The optimum activity of nuclear matrix proteases is observed at pH 8-9. The protease activity of the nuclear matrix is inhibited by p chloromercuribenzoate, N-ethylmaleimide, EDTA, phenylmethylsulfonyl fluoride. This suggests that thiol, serine and metalloproteases are associated with the nuclear matrix. PMID- 3311177 TI - [Exonuclease III from Bacillus amyloliquefaciens]. AB - Bacillus amyloliquefaciens cells were found to contain an exonuclease which catalyzes the sequential hydrolysis of mononucleotides from the 3'-termini of duplex DNA. The enzyme was purified to homogeneity and its molecular weight (as determined by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate) is 29,000. The exonuclease possesses an additional catalytic activity, i.e., 3'-5' exonuclease specific for the RNA strand in an RNA--DNA hybrid duplex (RNase H activity). In terms of physical and catalytic properties the exonuclease of B. amyloliquefaciens is similar to exonucleases III from E. coli and Haemophilus influenzae and can thus be related to the same class of hydrolases, i.e., 3.1.11.2. However, in comparison with exo III from E. coli, the enzyme from B. amyloliquefaciens exhibits a more strict specificity for the structure of the substrate 3'-end. PMID- 3311178 TI - [Functional characteristics of the human olfactory analyzer and methods for its study]. AB - Different methods of studying of the human olfactory system are considered in connection with its anatomo-physiological peculiarities. The character and ways of stimulus delivery (open or closed), optimum time of stimulation and influence of odour concentration upon the emotional response have been considered. The methods of registration of the provoked olfactorial responses, especially based on the recording of the brain potentials, somatic and vegetative indexes are discussed. The advantages and deficiencies of these methods and the spheres of their application are examined. A conclusion on the necessity of the unification and standartisation of the modern methods of olfactometry in man have been drawn. PMID- 3311179 TI - [Disorders in the thrombocyte link of hemostasis during endotoxinemia and their correction with the inhibitor of prostaglandin biosynthesis, indomethacin]. AB - After 10 minutes of endotoxin Salmonella typhimurium (1 mg/kg) injection into rabbits thrombocytopenia appeared, the aggregation and secretory function of circulating platelets reduced, the transformation of platelet forms from disk shaped into spheroidal took place. On the surface of plasmatic membranes the pseudopodies and aggregates examining samples of PRP were observed. Indomethacin, blockator of biosynthesis of prostaglandins results in normalisation of morphofunctional properties of platelets. PMID- 3311180 TI - [Effect of dehydration on microorganisms]. PMID- 3311181 TI - Adrenoleukodystrophy: frequency of presentation as a psychiatric disorder. AB - Adrenoleukodystrophy (ALD) is an inheritable clinical disorder in which very long chain fatty acids accumulate in several tissue types. ALD is underrepresented in the psychiatric literature, although the disorder may cause an organic brain syndrome, often misdiagnosed as another psychiatric problem. A survey of 109 reported cases of ALD revealed that 39% presented with some psychiatric sign or symptom, whereas 17% presented exclusively as a psychiatric problem. A computed axial tomogram (CAT) head scan is recommended to rule out ALD in psychiatric patients suspected of having organic brain disease, as a characteristic image may be found in ALD patients who have brain involvement. PMID- 3311182 TI - The role of molecular genetics in psychiatry. PMID- 3311183 TI - Biochemical characterization of connective tissue reaction to synthetic polymer implants. AB - The present review is concerned with the significance and prospects of the use of biochemical methods to characterize connective tissue reaction to implanted synthetic polymer materials. The necessity of carrying out complex quantitative analysis of capsules developing around the implants in order to elucidate qualitative peculiarities of the reaction and to objectify the assessment of the reactogeneity of the material is emphasized. PMID- 3311184 TI - Further investigations of the soft tissue reaction to the gamma 1 phase (Ag2Hg3) of dental amalgam, including measurements of mercury release and redistribution. AB - The subcutaneous implantation in guinea pigs of powdered gamma 1 phase induced a severe initial tissue response and the majority of the material was extruded from the healing wounds. This process was accompanied by the release of significant amounts of mercury which appeared in the body organs and excreta. The small numbers of particles which remained in the tissues were handled quite differently, undergoing slow degradation in macrophages and giant cells in chronic granulomata. Minute secondary particles containing silver and sulphur were deposited in the tissues and gave rise to macroscopic tattooing of the skin above the implants. PMID- 3311185 TI - Further investigations of the soft tissue reaction to the gamma 2 phase (Sn7-8Hg) of dental amalgam, including measurements of mercury release and redistribution. AB - Following the subcutaneous implantation in guinea pigs of powdered gamma 2 phase with a mercury content only slightly greater than that indicated by the stoichiometric formula Sn7Hg, there was a limited initial release of mercury from extracellular material. Thereafter, chronic granulomata developed around the implants and particles degraded slowly in macrophages and giant cells. Vast numbers of fine secondary particles containing tin were produced and these were associated with macroscopic staining. Mercury seemed to be lost as the result of intracellular particle breakdown but it did not accumulate in the body organs or appear to any great extent in the excreta. PMID- 3311186 TI - A test for a threshold in an ordered sequence of correlated proportions. AB - A test procedure using chi-square statistics is proposed for determining a threshold in an ordered sequence of correlated proportions. The procedure is based on the multivariate Bernoulli model. It is applied to the problem of ascertaining when visual acuity has stabilized in a group of patients with regular follow-up after a vision-reducing acute abnormality. PMID- 3311187 TI - The self-association of zinc-free bovine insulin. A single model based on interactions in the crystal that describes the association pattern in solution at pH 2, 7 and 10. AB - Sedimentation equilibrium studies are used to establish that a new pattern for the self-association of zinc-free insulin in solution is applicable over a wide range of conditions of pH, ionic strength and temperature. In this pattern, which is based on information from the existing literature on the X-ray crystal structure of insulin, the insulin monomer is viewed as having two distinct faces both capable of self-interaction. Sedimentation equilibrium experiments were analysed using expressions formulated for this association pattern that describe the dependence of weight average molecular weight and monomer concentration on total protein concentration. It has thereby been possible to obtain values for the two association constants which govern the system for each set of conditions studied, due allowance having been made for composition dependent non-ideality effects. Furthermore, by relating the pH, temperature and ionic strength dependence of the association constants with properties of various amino acid residues on the surface of the insulin monomer, it has also been possible to assign tentatively each constant to a particular reaction domain. PMID- 3311188 TI - A Raman spectroscopic study of the interaction between nucleotides and the DNA binding protein gp32 of bacteriophage T4. PMID- 3311189 TI - Clinical studies of aclacinomycin A (ACM). AB - Aclacinomycin A (ACM) is a new anthracycline antibiotic, isolated from Streptomyces galilaeus. This agent is presenting major chemical differences from the conventional anthracycline DNR and ADM, as a class II anthracyclines which inhibit more RNA than DNA. In clinical studies, good CR responses ranging about 30% in AML patients depend upon their background. Toxicities consisted of mainly upper GI tract and bone marrow. Cardiac toxicities, especially late cumulative effects are not reported. Some responses noted in malignant lymphomas and breast carcinoma, but needed further studies, including possibility of cross resistance and differentiation effects. PMID- 3311190 TI - Clinical studies of (2''R)-4'-O-tetrahydropyranyl adriamycin (THP). AB - (2'' R)-4'-O-Tetrahydropyranyl Adriamycin (THP) is a new antitumor agent discovered among series of similar anthracycline compound synthesized by Umezawa et al. Phase I study revealed dose limiting factor of leukopenia with upper GI toxicity. Alopecia, cardiac failure and transient hepatic failure were extremely mild. Definite responses were demonstrated in acute leukemia, lymphoma, ovarian carcinoma, head and neck carcinoma, breast carcinoma and GU carcinoma. Pharmacokinetic studies revealed rapid cell uptake and outputs in bile (20%) and urine (8%) in 24 hours. Transfer to third spaces were poor but definite. In vivo a part of THP was converted to ADM in the liver, but not in other tissues including tumors. THP would be an extremely interesting compound, because of comparable spectrum of responses to various tumors with extremely low toxicity compared with other anthracycline compounds. PMID- 3311192 TI - [Pharmacoresistance of Plasmodium falciparum in Rwanda: an in vivo study]. AB - During the period of June to October 1985, a study in vivo was made on 162 patients suffering from malaria by P. falciparum, in order to evaluate the sensitivity of the parasite to the drugs: Chloroquine, Amodiaquine and Pyrimethamine-Sulfadoxine (Fansidar). As an alternative treatment, in the resistant cases, Quinine with Fansidar or Quinine with Tetracycline was given. The following cases of resistance were found: 17 cases to Chloroquine (5-RI, 9 RII, 3-RIII), 7 cases to Amodiaquine (5-RI, 2-RII) and 2 cases to Fansidar (1-RI, 1-RII). It is recommended that the epidemiologic studies of the resistance by P. falciparum to the anti-malarials be increased, following up the evolution of its scope, and the organization of a program to fight against malaria. Also the use of Fansidar is recommended as the principal medicine against P. falciparum in malaria without complications, in the zones where there is strong resistance to the 4-amino-quinoleines. In case of multi-resistance in malaria by P. falciparum, the use of Quinine is recommended. At a prophylactic level we do not advise the use of Chloroquine as the only medicine, nor the use of Fansidar because of its potential toxic effects. PMID- 3311191 TI - [Use of delayed cyclosporin A in after administration of anti-lymphocyte serum in kidney transplantation]. AB - In this randomized one-center study in kidney transplantation delayed administration of CyA following conventional treatment with anti-thymocyte globulin (ATG) (group CyA, 48 patients) is compared with conventional treatment (including ATG) as sole immuno-suppressive treatment (group STD, 27 patients). Graft survival was significantly better with CyA (84% vs. 63% at 3 years). CyA efficacy seemed related with the decrease of rejection severity rather than of its frequency. Delayed introduction of the drug reduced its nephrotoxicity and short and longterm transplant function of patients under CyA were similar to controls. Finally from the 1st year post-grafting corticosteroids were withdrawn in more than 80% of recipients receiving CyA. PMID- 3311193 TI - Contamination of human growth hormone with Creutzfeldt-Jakob disease agent. PMID- 3311194 TI - Degradation artefacts during sample preparation for sodium dodecyl sulphate polyacrylamide gel electrophoresis. AB - Preparation of samples for sodium dodecyl sulphate polyacrylamide gel electrophoresis routinely involves heating the protein in solution containing detergent and reducing agent for at least two minutes. Here we show that this treatment causes fragmentation of the protein glycogen phosphorylase, whether purified or as a component of a skeletal muscle preparation. The fragments are detected as minor bands on western blots and represent the products of discrete breakage point in the peptide sequence. Protease inhibitors cannot suppress the fragmentation. Such small amounts of immunoreactive fragments may be incorrectly identified on western blots as contaminants that were originally present in the antigen preparation. They may also be a source of ambiguity in studies that search for degradation intermediates during proteolysis. PMID- 3311195 TI - Stanley George Mason (20 March 1914-21 April 1987). PMID- 3311196 TI - [Delayed-type hypersensitivity to minor histocompatibility antigens and its genetic restriction]. AB - The analysis of skin allograft survival time and the level of delayed-type hypersensitivity (DTH) reaction to major and minor histocompatibility antigens revealed the correlation between these parameters of the transplantation immunity. The data obtained have shown that histocompatibility in several non-H-2 antigens induces DTH reaction comparable with the reaction caused by H-2 antigens. The effector phase of DTH to non-H-2 antigens is H-2 restricted. No restriction of the afferent phase is revealed. The application of these results to the analysis of the mechanisms of the recognition of minor histocompatibility antigens in DTH is discussed. PMID- 3311197 TI - The HL-60 promyelocytic leukemia cell line: proliferation, differentiation, and cellular oncogene expression. AB - The HL-60 cell line, derived from a single patient with acute promyelocytic leukemia, provides a unique in vitro model system for studying the cellular and molecular events involved in the proliferation and differentiation of normal and leukemic cells of the granulocyte/monocyte/macrophage lineage. PMID- 3311198 TI - Hemoglobin S gelation and sickle cell disease. PMID- 3311199 TI - Oncoplacental protein SP1--a constitutive and inducible late differentiation marker of the human myelomonocytic lineage. AB - The oncoplacental protein SP1 is found in large quantities in human placenta, amniotic fluid, and pregnancy serum. Low levels have been reported in association with malignancy but also in healthy nonpregnant individuals. By indirect immunofluorescence, fluorescence-activated cell sorting, and immunoprecipitation we here demonstrate the presence of SP1 both on the surface and in the cytoplasm of human granulocytes but not in earlier myeloid progenitor cells in bone marrow. Lymphocytes did not contain the protein, and only trace amounts could be found in the cytoplasm of blood monocytes. A major glycoprotein with an apparent mol wt of 90,000 was obtained by immunoprecipitation of surface-labeled granulocytes. Cultivated blood monocytes, while adhering to surfaces or forming multinuclear giant cells, displayed a strong membrane and cytoplasmic expression of SP1. Treatment of the myeloid leukemia cell line ML-2 with tetraphorbol acetate (TPA) strongly induced SP1 in the membrane and cytoplasm as revealed by immunofluorescence and polyacrylamide gel electrophoresis (PAGE) of immunoprecipitates from lysates of surface radiolabeled cells. The induction of synthesis of SP1 in TPA-treated cells was confirmed by immunoprecipitation from lysates of cells metabolically labeled with 35S-methionine. Human lymphoblastoid and erythroleukemic cell lines did not express SP1 either before or after induced differentiation. Thus SP1 provides a late differentiation marker for the myelomonocytic lineage and is strongly induced during macrophage differentiation or by TPA treatment of ML-2 cells. PMID- 3311200 TI - Therapy of severe aplastic anemia in young adults and children with allogeneic bone marrow transplantation. AB - During an 8-year period, 28 young adults (median age 27 years) and 30 children (median age 10 years) with severe aplastic anemia have received allogeneic bone marrow transplantation (BMT) from major histocompatibility locimatched sibling donors after preparation with cyclophosphamide and total lymphoid irradiation (TLI). All recipients were previously transfused. Comparison of post-bone marrow transplantation events in adults and children reveals equivalent median time to engraftment, median duration of hospitalization, median Karnofsky assessment of activity, and equivalent low rejection rate. Although the incidence of moderate and severe acute graft-v-host disease (GVHD) and of extensive chronic GVHD was greater in adults than in children, the projected survival at 4 years of adults (67%; 95% confidence interval [CI] 49% to 85%) and of children (73%; 95% CI 57% to 89%) was equivalent. All survivors are transfusion-free and have normal peripheral blood counts. One of 28 adults and 2 of 30 children have experienced rejection, and 1 of these patients survives after a second transplant. No malignancies have been identified following transplantation. An unexpectedly high incidence of hypothyroidism has been detected and may be attributable to preparation of recipients with TLI. Therapy of severe aplastic anemia with allogeneic BMT after preparation with cyclophosphamide and TLI offers a high rate of transfusion-free survival and a low rejection rate in previously transfused young adults and children. PMID- 3311201 TI - Mixed hematopoietic chimerism following bone marrow transplantation for hematologic malignancies. AB - Twenty-nine of 172 patients (17%) who received an allogeneic bone marrow transplant (BMT) from histocompatible sibling donors for hematologic malignancies were mixed hematopoietic chimeras; ie, they had a mixture of donor and host hematopoietic or lymphohematopoietic cells at greater than or equal to 14 days after transplantation. Twenty-four of the 29 mixed chimeras (83%) have remained in continuous complete remission for up to 116 months (greater than 9 years) following BMT. Four of the 29 patients (14%) have had recurrent leukemia, and 7 of the 29 (24%) have had moderate or severe graft-v-host disease (GVHD). Twelve of these 29 patients have persisted as stable mixed chimeras for greater than or equal to 2 years after BMT, whereas other patients converted to all donor-type hematopoiesis. The incidence of mixed chimerism was independent of the pretransplant regimen, the donor or recipient age (less than 20 v greater than 20 years), remission status (first complete remission of acute leukemia and first chronic phase of chronic myelocytic leukemia v later stages of disease), and type of leukemia. Our data indicate that mixed hematopoietic chimerism is not rare after BMT for hematologic malignancies and that its presence is compatible with long-term disease-free survival. Prospective studies of mixed chimerism after BMT are warranted to achieve better understanding of its biologic importance. PMID- 3311202 TI - Recombinant gibbon interleukin 3 supports formation of human multilineage colonies and blast cell colonies in culture: comparison with recombinant human granulocyte-macrophage colony-stimulating factor. AB - The genetic sequences encoding the gibbon and human interleukin 3 (IL 3) proteins were molecularly cloned. The amino acid sequence of the mature gibbon IL 3 protein proved to share 93% homology with the corresponding human protein. We examined the effects of biosynthetic (recombinant) gibbon IL 3 on the proliferation and differentiation of an enriched population of human hematopoietic progenitors and compared the results with the effects of recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF). Gibbon IL 3 supported the formation of various types of single lineage as well as multilineage colonies by My-10+ bone marrow cells in the presence of human erythropoietin (Ep). In contrast, recombinant human GM-CSF supported the formation of single-lineage colonies and only a small number of multilineage colonies. Both IL 3 and GM-CSF had significant erythroid burst-promoting activity (BPA). Delayed addition of gibbon IL 3 to low serum culture of My-10+ marrow cells supported the formation of blast cell colonies with variable but high replating capability. Human GM-CSF was less effective than IL 3 in support of multipotential blast cell colonies. These results are analogous to the effects of murine IL 3 and GM-CSF on murine progenitors and support the notion that the primary factor for multipotential progenitors is IL 3. PMID- 3311203 TI - Bone marrow transplantation for leukemia following a new busulfan and cyclophosphamide regimen. AB - Busulfan 16 mg/kg and cyclophosphamide 120 mg/kg were used as conditioning prior to allogeneic marrow transplantation in 50 adult patients with acute nonlymphocytic leukemia (ANLL), acute lymphocytic leukemia (ALL), and chronic myelogenous leukemia (CML). A standard risk group of 20 patients included those with acute leukemia in remission and CML in chronic phase. A high-risk group of 30 patients included individuals with refractory acute leukemia, acute leukemia in relapse, acute leukemia following preleukemia, and CML in accelerated and blastic phase. Complete remission and sustained complete engraftment were achieved in all evaluable patients. The duration of aplasia was remarkably short (median of 8 days), resulting in a low infection rate during the period of neutropenia, a reduced need for blood product support, and a short length of hospital stay. Three-year actuarial relapse-free survival in both standard-risk (88.9% +/- 10.5%) and high-risk (50.5% +/- 9.6%) groups compares favorably with that reported with total body irradiation (TBI) containing regimens. PMID- 3311204 TI - Clonogenic hemopoietic precursors in bone marrow transplantation. AB - Multilineage and single-lineage hemopoietic precursors were studied in 102 bone marrow transplant recipients and their respective donors to determine their contribution to clinical outcome as measured by time to engraftment and survival. The patient population was heterogenous with respect to diagnosis and disease status. They included individuals with acute myeloid leukemia (AML), chronic myeloid leukemia (CML), acute lymphoblastic leukemia (ALL), aplastic anemia, and a few other hematopoietic malignancies. The frequency of various clonogenic precursors in the normal donor population varied considerably. The data yielded a symmetrical distribution. In contrast, most bone marrow transplant recipients presented with significantly reduced numbers of clonogenic cells before transplantation, resulting in skewed distribution profiles. Serial studies of recipients demonstrated a significantly lower than normal level of clonogenic precursors even 3 and 4 years after transplantation. The median values and distribution profiles approximated those observed before transplantation but did not return to measurements obtained for normal donors. Patients with ALL deviated from this pattern. The median values and distribution profiles of clonogenic precursors before transplantation approximated the pattern of normal donors. The frequency of clonogenic progenitors after transplantation, however, remained significantly lower than that of their respective donor or pretransplant values. Cell cycle studies performed after normalization of peripheral blood hematopoietic parameters demonstrated for most recipients that a higher than normal proportion of multipotent cells was in S-phase (P = .011). By univariate and multivariate approaches, clonogenic precursors and clinical parameters were assessed for their contributions to clinical outcome as measured by time to engraftment and survival time. The number of nucleated cells in the transplant inoculum contributed to survival independent of other risk factors. Patients with a higher cell load had a higher probability of surviving than did patients with a lower cell concentration in the transplant inoculum (P = .042). The frequency of clonogenic precursors in the transplant inoculum altered neither survival nor time to engraftment. The time to engraftment was significantly influenced by the frequency of clonogenic megakaryocyte precursors (CFU-M) observed in recipients prior to transplantation (P = .003). Patients with high values engrafted faster than did patients with a low frequency of CFU-M. This was independent of both diagnosis and disease status of the patients at time of transplantation. PMID- 3311205 TI - Variability in 4-hydroperoxycyclophosphamide activity during clinical purging for autologous bone marrow transplantation. AB - We examined the effects of varying incubation conditions on the in vitro activity of 4-hydroperoxycyclophosphamide (4HC). 4HC activity against CFU-GM and against the K562 tumor cell line decreased with increasing the RBC concentration of the incubation mixture. Increasing the concentration of nucleated bone marrow cells in the incubation mixture also decreased the 4HC activity. Evaluation of 53 consecutive patients undergoing autologous bone marrow transplantation (BMT) revealed that the incubation RBC concentration during clinical purging showed a similar effect on CFU-GM recovery. Aldehyde dehydrogenase content of RBCs and nucleated marrow cells appears to be the cause of the inhibition of 4HC activity. Although there was no difference in individual CFU-GM sensitivity to 4HC among normals, previously treated patients undergoing autologous BMT showed significant variability in CFU-GM sensitivity to 4HC. The combined effects of incubation RBC concentration and individual patient 4HC sensitivity appear to account for most of the variability in CFU-GM recovery and speed of hematologic recovery after clinical purging with 4HC. PMID- 3311206 TI - A specific assay for anti-HLA antibodies: application to platelet donor selection. AB - Alloimmunization to donor class I HLA antigens represents a major obstacle to successful platelet transfusion therapy. It is desirable to distinguish alloimmunization from nonimmunologic causes of poor platelet survival to assess the need for HLA-matched, single-donor platelets. We describe a new in vitro assay for anti-HLA antibodies and report its application to the problem of platelet crossmatching. In contrast to previously described crossmatch techniques, the immunobead assay is specific for anti-HLA antibodies. The assay was used to evaluate 51 single-donor platelet transfusions given to seven patients from 35 different donors. Recipient plasma was assayed for antibodies directed against HLA antigens present on donor platelets. A one-hour posttransfusion corrected count increment of greater than or equal to 7,500 was considered a successful outcome. Twenty-nine of 33 (87.9%) transfusion episodes associated with a negative immunobead assay had successful outcomes. The four unsuccessful transfusions were associated with potential nonimmunologic causes of poor platelet survival. Only two of 18 (11.1%) episodes associated with a positive assay had successful outcomes. Only one unsuccessful transfusion episode was associated with a negative immunobead assay and a positive radiolabeled antiglobulin test result, which suggested that isolated alloantibodies to antigens other than class I HLA antigens are not a common cause of platelet refractoriness. Platelets stored in suspension at 4 degrees C or frozen in liquid nitrogen were found suitable for crossmatch testing. PMID- 3311207 TI - Expression of c-abl in Philadelphia-positive acute myelogenous leukemia. AB - The identical cytogenetic marker, t(9;22)(q34;q11) (Philadelphia [Ph] translocation), is found in approximately 90%, 20%, and 2% of adult patients with chronic myelogenous leukemia (CML), acute lymphoblastic leukemia (ALL), and acute myelogenous leukemia (AML), respectively. In CML, the molecular events resulting from the Ph translocation include a break within the bcr locus on chromosome 22, transfer of the c-abl protooncogene from chromosome 9 to 22, and formation of an aberrant 210-kD bcr-abl fusion protein (p210bcr-abl). Recently, the absence of bcr rearrangement and expression of a distinct aberrant 190-kd abl protein (p190c abl) has been described in Ph-positive ALL, with the suggestion that the two abl variants may be pathogenetically associated with myeloid v lymphoid leukemogenesis. Here we report that the genomic configuration and translation product of Ph-positive AML can be similar to that of Ph-positive ALL: the break at 22q11 may occur outside the 5.8 kb bcr region and result in expression of a 190-kD abl protein lacking these bcr sequences. Phosphokinase enzymatic activity, a fundamental property of p210bcr-abl, was also associated with AML-derived p190c abl. Our current observations indicate that p190c-abl can be found in cells of lymphoid or myeloid lineage and is therefore unlikely to play a specific role in the development of lymphoid leukemias. Formation of p190c-abl instead of p210bcr abl appears to be a characteristic of the acute rather than the chronic Ph positive leukemic state. PMID- 3311208 TI - Interleukin-2 production and response to interleukin-2 by peripheral blood mononuclear cells from patients after bone marrow transplantation: II. Patients receiving soybean lectin-separated and T cell-depleted bone marrow. AB - The ability of peripheral blood mononuclear cells (PBMC) to produce and respond to interleukin-2 (IL-2) was evaluated in 50 recipients of HLA-identical bone marrow (BM) depleted of mature T cells by soybean agglutination and E rosetting (SBA-E-BM). In contrast to our previous findings in recipients of unfractionated marrow, during weeks 3 to 7 post-SBA-E-BM transplantation (BMT), PBMC from the majority of patients spontaneously released IL-2 into the culture medium. This IL 2 was not produced by Leu-11+ natural killer cells, which were found to be predominant in the circulation at this time, but by T11+, T3+, Ia antigen-bearing T cells. The IL-2 production could be enhanced by coculture with host PBMC frozen before transplant but not by stimulation with mitogenic amounts of OKT3 antibody, thus suggesting an in vivo activation of donor T cells or their precursors by host tissue. Spontaneous IL-2 production was inversely proportional to the number of circulating peripheral blood lymphocytes and ceased after 7 to 8 weeks post SBA-E-BMT in most of the patients. In patients whose cells had ceased to produce IL-2 spontaneously or never produced this cytokine, neither coculture with host cells nor stimulation with OKT3 antibody thereafter induced IL-2 release through the first year posttransplant. Proliferative responses to exogenous IL-2 after stimulation with OKT3 antibody remained abnormal for up to 6 months post-SBA-E BMT, unlike the responses of PBMC from recipients of conventional BM, which responded normally by 1 month post-BMT. However, the upregulation of IL-2 receptor expression by exogenous IL-2 was found to be comparable to normal controls when tested as early as 3 weeks post-SBA-E-BMT. Therefore, the immunologic recovery of proliferative responses to IL-2 and the appearance of cells regulating in vivo activation of T cells appear to be more delayed in patients receiving T cell-depleted BMT. Similar to patients receiving conventional BMT, however, the ability to produce IL-2 after mitogenic stimulation remains depressed for up to 1 year after transplantation. PMID- 3311209 TI - Mixed blood chimerism in T cell-depleted bone marrow transplant recipients: evaluation using DNA polymorphisms. AB - We have used DNA sequence polymorphism analysis to document engraftment after T cell-depleted bone marrow transplantation (BMT), with a selected panel of four DNA probes. In contrast to nondepleted BMT recipients, the patients who received T cell-depleted marrow exhibited a mixed blood chimerism. This mosaicism was observed before graft failure or relapse in six patients. However, in five other patients, this mixed chimerism was not followed by these complications with a follow-up of 9 to 31 months after transplantation. Our results support the hypothesis that transplanted bone marrow T cells may help to maintain engraftment by eliminating host cells that can cause graft failure. PMID- 3311210 TI - The effect of recombinant GM-CSF on the recovery of monkeys transplanted with autologous bone marrow. AB - The regulatory function of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) on granulocyte production in vivo was evaluated in an autologous bone marrow transplantation model using rhesus monkeys. Monkeys were exposed to 9.0 Gy total body irradiation and then transplanted with 5.0 x 10(7) low-density bone marrow cells/kg. Alzet miniosmotic pumps were subcutaneously implanted to deliver rhGM-CSF at a rate of 50,400 U/kg/d. Minipumps, containing either rhGM-CSF or saline, were implanted between zero and five days after transplantation for seven days. Kinetic recoveries of peripheral blood cells after either saline or rhGM-CSF treatment were compared. Treatment with rhGM-CSF accelerated the recovery of neutrophils. Neutrophils in rhGM-CSF treated animals recovered to 80% (3.4 x 10(3)/mm3) pre-irradiation control levels by day 20, in comparison with only 33% (0.9 x 10(3)/mm3) recovery for saline control monkeys. In addition, the recovery of neutrophils was enhanced over that of the controls, reaching 140% v 70% on day 30. Another prominent feature of rhGM CSF-treated monkeys was the accelerated recovery of platelets, reaching near 50% normal levels by day 24 in comparison with 20% of normal levels for controls. The infusion of rhGM-CSF was shown to be an effective regulator of early hematopoietic regeneration, leading to the accelerated recovery of both neutrophils and platelets and then providing a consistent sustained increase of neutrophils even in the absence of rhGM-CSF. PMID- 3311211 TI - Maturation inducer activity and the process of human myeloid leukemia cell differentiation. AB - The process and mechanism of human myeloid leukemia cell differentiation induced by T-cell lymphokine maturation inducer activity was investigated. The maturation inducer activity was purified from conditioned medium of normal peripheral blood lymphocytes and shown to be a 50,000 M.W. protein. The degree of maturation of myeloid cell cultures was directly related to the dosage of the inducer. The interaction of the leukemia cells with the inducer led to initiation of terminal differentiation to monocytic cells. Proliferation cessation of the leukemia cells and the expressions of mature monocytic cells indicated a continuous and multistaged process. PMID- 3311212 TI - Increased cytotoxicity and CD16 (Leu 11) expression in long-term, IL-2-activated human peripheral blood mononuclear cells. AB - CD16 (Leu 11) positive cells are believed to be the effector cells for the so called LAK phenomenon. Current evidence suggests that this cell population is comprised predominantly of IL-2-activated CD3 negative Leu 11+ NK cells and a minor proportion of Leu 11+ CD3+ MHC unrestricted type II cytotoxic T cells. The current study demonstrates a continuous increase in the frequency of Leu 11+ (and CD8+) cells and a decline of CD3 and CD4 positive cells during prolonged culture of human PMBL with high levels of rIL-2. Cytotoxicity also increases in this time period parallel with Leu 11 to a maximum of activity on the twelfth day of culture. This correlation suggests that the long-term activated killer cells generated in this period are Leu 11+, CD8+, CD3-, CD4- activated NK cells. With regard to tumor therapy, the long-term culture of PMBL in rIL-2 may be of advantage over short-term activation protocols. If the Leu 11+ cells are in fact the mediators of the therapeutic response, the long-term culture generates up to six times more effector cells. In addition, this method allows significant savings in the expense for leukophoresis, cell culture, and laboratory personnel. The efficacy of long-term, cultured rIL-2-activated Leu 11+ cells for tumor therapy is currently being investigated in clinical trails. PMID- 3311213 TI - Microenvironmental cytokines and expression of erythroid heme metabolic enzymes. AB - In this study, we demonstrated that benzene and its metabolites, phenol and hydroquinone, were toxic to human burst-forming unit-erythroid (BFU-E) growth, hydroquinone being the most toxic. Phenol (10(-4) M) was also found to have a marked toxicity on stromal cell colony formation. BFU-E binding with human-tumor necrosis factor (rHu-TNF) was linear with the number of BFU-E colonies. Recombinant rHu-TNF suppressed BFU-E growth in a dose-dependent manner and this was reversed with anti-TNF antibody. Binding studies of rHu-TNF for human K562 cells indicated that K562 cells have a binding constant of approximately 1075 per cell. The heme pathway enzymes, uroporphyrinogen deaminase, and heme oxygenase activities were measured in BFU-E cultures exposed to iron, interleukins (1 and 2), and various lymphocyte and macrophage-conditioned media with or without hemin. In most instances, hemin was found to stimulate the heme synthetic pathway in the presence of these agents. Iron and adherent (macrophage) cell conditioned media (CM) were found to stimulate heme oxygenase activity. Macrophage CM was found to suppress erythropoiesis in contrast to phytohemagglutinin-stimulated leukocyte (PHAL)-CM, which enhanced erythroid growth. In addition, porphobilinogen deaminase levels were greater in 14-day cultures containing hemin plus PHAL-CM as compared with hemin alone. These results are discussed with respect to the generation of hematopoietic inhibitory-stimulatory factors by the marrow microenvironment and their effects on heme synthesis and degradation. PMID- 3311214 TI - Stromal cell regulation of lymphoid and myeloid differentiation. AB - In vitro microenvironmental influences seem to be critical for both B lymphocyte and myeloid differentiation. Studies on murine Dexter cultures and Whitlock-Witte lymphocyte cultures suggest the presence of two critical stromal regulatory cells: an alkaline-phosphatase-positive epithelioid cell and a macrophage. Further data suggest that these cells are capable of producing colony stimulating factor-1, granulocyte-macrophage CSF, a myeloid synergizing activity, and probably separate B cell growth factors. Isolation of a cell line from Dexter stroma was accomplished and this line produced CSF-1, GM-CSF, a pre-B cell and myeloid synergizing activity, and an activity acting on differentiated B cells. We speculate that the Dexter and Whitlock-Witte in vitro culture systems are regulated by factors produced by the two adherent cell types. A lineage nonspecific factor capable of inducing cells into the B lineage or synergizing with interleukin-3, GM-CSF, and CSF-1 is produced, which presumably acts on early stem cells. In addition, the cell line produces GM-CSF, CSF-1, and a factor acting on differentiated B cells. We speculate that in these culture systems, these "terminal differentiating hormones" regulate the final pathway of differentiation, whereas the pre-B-synergizing activity supports early stem cells that can then respond to the other differentiating hormones. PMID- 3311215 TI - Production of multilineage growth factors by hematopoietic stromal cells: an intercellular regulatory network involving mononuclear phagocytes and interleukin 1. AB - In the past 8 years, our group has carried out a series of in-vitro studies designed to characterize the role of mononuclear phagocytes as regulators of human hematopoiesis. The results of this program of investigation, some of which are reviewed below, led to the discovery that mononuclear phagocytes are more efficient recruitors of growth factor release by other cells than they are direct stimulators of progenitor cell growth. Specifically, mononuclear phagocytes release soluble factors (MRA) that stimulate other cells, including vascular endothelial cells, skin fibroblasts, and marrow fibroblasts, to release multilineage hematopoietic growth factors. Experiments designed to purify and characterize these monokines indicated unambiguously that the MRA that stimulates granulocyte/macrophage colony stimulating factor (GM-CSF) release is interleukin 1 (IL-1). Based on these observations and recent observations by other groups on the hematopoietic effects of other monokines including tumor necrosis factor alpha, we argue that mononuclear phagocytes serve as important regulators of hematopoiesis by producing monokines that, in turn, induce the expression of multiple hematopoietic growth factor genes in stromal cells of the hematopoietic microenvironment. Because IL-1 molecules and the mononuclear phagocytes producing them are evolutionarily conserved, and in view of the heterogeneous nonhematopoietic effects of these monokines, studies on their role in hematopoiesis may also provide new understanding of the molecular evolution of multicellular organisms. PMID- 3311216 TI - Recombinant human granulocyte-colony stimulating factor: in vitro and in vivo effects on myelopoiesis. AB - The results presented in this paper demonstrate that recombinant human granulocyte-colony stimulating factor (rhG-CSF) is a potent myelopoietic growth and differentiation factor in vivo. RhG-CSF was able to shorten the time period of neutrophil recovery in both cyclophosphamide (CY)-induced myelosuppression and following bone marrow transplantation (BMT) in primates. Its ability to significantly shorten the period of chemotherapy-induced bone marrow hypoplasia may allow clinicians to increase the frequency or dosage of chemotherapeutic agents. In addition, the increase in absolute numbers of functionally active neutrophils may have a profound effect on the rate and severity of neutropenia related sepsis. Furthermore, the activities reported here indicate a potential role for rhG-CSF in the treatment of patients with myelodysplastic syndrome, congenital agranulocytosis, radiation-induced myelosuppression, and after bone marrow transplantation. PMID- 3311217 TI - Cellular interactions and genetic restriction. AB - These studies emphasize the limitations of in vitro colony assays utilizing heterogeneous cell populations for the identification of cell-cell interactions that may involve genetic restriction. Obviously, different strategies are required to determine if Class II molecules have any role, alone or in combination with other determinants, in mediating hematopoietic cell-cell interactions. In this report, we present preliminary data derived from two approaches designed to address this issue. First, clonal cell lines developed to mimic Class II expression of normal precursors have been used to study structure function relationships of HLA-D region gene products. Second, the lymphocyte adhesion assay has been adopted to study binding of precursors to marrow stroma. We hypothesize that the strategies should make it possible to identify hematopoietic cell-cell interactions and determine to what extent Class II molecules participate in these interactions. PMID- 3311218 TI - Granulocyte oxygen radicals as potential suppressors of hemopoiesis: potentiating roles of lactoferrin and elastase; inhibitory role of oxygen radical scavengers. AB - In vitro studies suggest intact endothelial cells and their released growth factors are required for optimal growth and differentiation of hematopoietic cells in culture. Conversely, processes that damage endothelium might, therefore, suppress hematopoiesis. We have studied mechanisms by which stimulated inflammatory cells, particularly granulocytes, damage endothelium and suggest these studies may provide new insights into the hematopoietic suppression of inflammatory diseases. We demonstrate that the granulocyte lysosomal constituent, lactoferrin, which has independently been shown to inhibit in-vitro hematopoiesis, may act by amplifying granulocyte-mediated toxic oxidant damage to endothelium. Its deleterious effects are twofold: 1) it releases iron that catalyses the Haber-Weiss reaction, thereby producing highly toxic hydroxyl radicals; and 2) its highly positive charge facilitates its absorption to target membranes that traffics oxygen-radical damage directly to endothelium. In addition, we demonstrate that another granulocyte lysosomal component, elastase, also perturbs endothelium--not so much by direct lytic effect, but by proteolysing matrix proteins that serve to attach endothelium to its substratum. Thus, elastase promotes endothelial lift-off. Plasma alpha-1-antiproteinase, a potent antielastase, should be protective, but is inactivated by the same granulocyte oxidants that directly lyse endothelial cells. However, antielastase activity can be preserved by antioxidants and a novel, innocuous one--methionine- is described. It is oxidized as a surrogate for the critical-site methionine of alpha-1-proteinase inhibitor, preserving in the process antielastase activity. Our results suggest that strategies to reduce production of inflammatory cell toxic oxygen radicals with reagents such as antilactoferrin antibody or iron chelators might be useful adjuncts in maintaining in vitro hematopoiesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311219 TI - Heme and iron metabolism in aging. AB - Cells from aged animals show a decrease in heme synthesis, an increase in heme degradation, and a maintenance of heme concentration and heme-containing proteins. This raises the possibility that alternate sources of heme are utilized by the old animal to maintain intracellular heme necessary for initiation of protein synthesis. The mechanisms to balance heme and protein synthesis, and cytoplasmic and mitochondrial protein synthesis remain intact with advanced age. Iron remains available to the healthy organism in abundant amounts throughout the life span. The decrease in cellular iron utilization seen with age might conceivably result from availability of heme independent of heme synthesis, as intracellular heme controls the cellular uptake of iron from transferrin. Heme levels in aged cells seem to be maintained via an alternate heme source. The bone marrow in aged animals appears to function adequately as long as there is no stress. Anemia, therefore, should always be considered as a serious sign in illness and never as a normal concomitant of aging. PMID- 3311220 TI - Clinical expression of alpha spectrin mutants in hereditary elliptocytosis. AB - The group of disorders manifesting as hereditary elliptocytosis/pyropoikilocytosis (HE/HPP) represent a unique group of experiments of nature that result from molecular defects of alpha spectrin. At the level of protein structure, these alpha spectrins can be identified by analysis of peptides generated by limited tryptic digestion. Such an approach reveals that the peptide containing alpha spectrin self-association site (the alpha I domain, molecular mass of 80 daltons) is cleaved to peptides of smaller size, presumably due to changes in the primary structure that lead to increased susceptibility of existing cleavage sites or the opening of new sites. Based on the mass of these peptides, we designate these alpha spectrin (Sp) mutants, Sp alpha 1/74, Sp alpha 1/65, and Sp alpha 1/46. At the level of protein function, these mutant alpha spectrins are characterized by a defective self-association of spectrin heterodimers to tetramers, the major structural subunits of the skeleton. One of the most interesting features of this group of disorders is a variable severity of their clinical expression. Molecular determinants of disease severity include the percentage of unassembled, that is, dimeric spectrin in the membrane and the total spectrin content in the cells. Consequently, the most severely affected patients, manifesting as HPP, contain a high fraction of unassembled, dimeric spectrin in the membrane (55 +/- 7%) and are, in addition, partially deficient in spectrin. In contrast, HE individuals and asymptomatic carriers have a moderate (33 +/- 11) or mild (24 +/- 9) increase in spectrin dimers (normals 5 +/- 4%) and they contain normal amounts of spectrin in their membranes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311221 TI - Structural alterations of marrow during inflammation. AB - In response to infections and inflammations, bone marrow reacts to mobilize its granulocyte reserve. Three sets of factors are involved in this mobilization. The structure of the sinus wall is altered and adventitial cells retract to permit interaction of migrating cells with the endothelium. During the maturation process, granulocytes lose their binding potential to the supporting stroma, but their motility, chemotactic ability, and deformability increase. Consequently, they move toward the sinus endothelium with which they interact to enter the circulation. Soluble factors are also involved in granulocyte mobilization. The best characterized of these factors is C3e, an acidic fragment of the alpha chain of C3 with MW of 10-12 KD and ability to bind to granulocyte membrane. Other soluble factors may also be involved, but due to lack of adequate methodology, this area has been relatively underexplored. PMID- 3311222 TI - Induced erythroleukemia differentiation: cellular and molecular aspects. AB - MELC may be induced to terminal erythroid differentiation by HMBA and other agents. Although the mechanism is not known, changes in cell function and gene expression can be identified during an early "latent" period, prior to commitment to terminal differentiation. These include a decrease in diacylglycerol concentration and in Ca+2 and phospholipid-dependent protein kinase C activity, accompanied by suppression of c-myb and c-myc gene transcription, a fall in p53 protein, and an increase in c-fos mRNA. Commitment is first detected by 12 hours and is associated with persistent suppression of c-myb gene transcription. Transcription of the erythroid-specific genes, alpha 1 and beta maj globin, is increased 10- to 30-fold, whereas synthesis of rRNA is suppressed, and there is activation or suppression of a number of additional genes that remain to be characterized. The potential regulatory roles of changes in protein kinase C activity and in proto-oncogene expression in initiating and sustaining the process of differentiation also remain to be elucidated. PMID- 3311224 TI - The molecular biology of the colony-stimulating factors. AB - Our understanding of the biochemistry and molecular biology of the colony stimulating factors (CSF) and the regulation of their production has advanced rapidly with the application of recombinant DNA technology. This report reviews several aspects of the regulation of CSF production and the structural features relating to their function. The structural gene for hGM-CSF is present as a single copy, is 2.5 kilobase long region and is located on the long arm of chromosome 5. The genes for human multi-CSF and M-CSF are also on chromosome 5. The gene for hGM-CSF is organized into four exons. The intron-exon boundaries contain a single consensus splice donor and acceptor sequence. CSFs are elaborated by endothelial cells, fibroblasts, and T lymphocytes in response to inflammatory mediators. Many of these same cell types respond to inflammatory stimuli with production of additional immune mediators such as IL-1, IL-2, or the interferons. Insights are now emerging into important structure--function relationships of the hematopoietic growth factors and molecular events in the regulation of CSF gene expression. PMID- 3311223 TI - Retroviral-mediated gene transfer into mammalian cells. AB - Retroviruses may be used as genetic vectors to transfer genes into mammalian cells with high efficiency. We have shown that the N2 vector will transfer a functional bacterial gene for neomycin resistance (NeoR) into more than 80% of mouse spleen foci. A derivative of the N2 vector was constructed to study transfer and expression of the human gene for adenosine deaminase (ADA) in mammalian lymphoid and hematopoietic stem cells. This vector, termed SAX, contains the human ADA cDNA with an SV40 promoter in addition to the NeoR gene. The SAX vector was found to efficiently transfer and express the ADA gene in an ADA-deficient human T-cell line. Gene transfer by SAX using an autologous nonhuman primate bone marrow transplant model resulted in expression of the human ADA gene in peripheral blood cells of treated animals. Human bone marrow treated with SAX produced 1%-2% of colonies in vitro that were expressing the vector genes. Transfer of genes into circulating hematopoietic stem cells of fetal sheep in utero was most efficient; vector gene expression was evident in 20%-40% of hematopoietic colonies. Therefore, retroviral vectors are capable of transferring functional genes into a wide variety of mammalian lymphoid and hematopoietic cells. Such vectors may be useful for clinical trials of gene therapy, that is, the correction of genetic diseases by insertion of a normal gene into a patient's defective cells. PMID- 3311225 TI - Lymphocytes and lymphokines in aplastic anemia: pathogenic role and implications for pathogenesis. AB - Clinical observations first suggested an immune basis for aplastic anemia. Laboratory studies have implicated a suppressor T lymphocyte producing molecules like gamma-interferon that inhibit hematopoiesis. Extrapolation from in vitro studies is complicated by synergy and antagonism among lymphokines and interleukins, the presence of regulators of proliferation produced by bone marrow cells, and possible differences between endogenous and exogenously administered molecules on cell growth. PMID- 3311226 TI - Human B cell colony assays. PMID- 3311227 TI - Successful bone marrow transplantation from an unrelated donor in a child with AML in second remission. AB - In February 1986 we transplanted a 10-year-old girl with AML in second remission with the bone marrow of an unrelated donor. HLA-types were different for one A- and one B-antigen between patient and donor. Conditioning regimen consisted of 14 Gy total body irradiation with lung shielding, 8 X 3 g/m2 cytosin arabinoside and 90 mg/kg cyclophosphamide. GVHD-prophylaxis was performed with cyclosporin A, methotrexate and prednisolone. Only mild GVHD I of the skin could be observed after rapid engraftment. 100 days after transplantation the patient was in good clinical condition and GVHD-prophylaxis was discontinued without any reactivation of acute or chronic GVHD. Engraftment was documented by sex chromosome and blood group typing. 120 days after transplantation leukemic blasts were detected in the peripheral blood and the child died 130 days after BMT from relapse of the leukemia. Despite the negative outcome, this was the first successful bone marrow transplantation from a unrelated donor in Germany. PMID- 3311229 TI - Parasitic diseases of the liver. PMID- 3311228 TI - Bacterial infections involving the liver. PMID- 3311230 TI - Hepatic fibrosis and cirrhosis in tropical countries (including portal hypertension). AB - The spectrum of diseases seen in patients from certain 'tropical areas' requires that a physician be aware of some of the syndromes discussed here. A high index of suspicion for less usual causes of cirrhosis is imperative when evaluating such patients presenting with hepatocellular disease. The differential must be expanded and the work-up complete. Liver biopsy should be performed as early in the course of disease as is feasible and will often provide valuable diagnostic information. It will not only facilitate treatment but allow for needed clinical trials and may help to increase our understanding of the various disease processes. PMID- 3311231 TI - Tropical splenomegaly syndrome (TSS) and other diseases of the spleen. PMID- 3311232 TI - Infectious diarrhoea in tropical and subtropical regions. PMID- 3311234 TI - The management of acute infectious diarrhoea. PMID- 3311235 TI - Parasitic diseases of the small intestinal tract. AB - The epidemiology, clinical aspects, and treatment of human intestinal infections with Giardia, Cryptosporidium, coccidia and Strongyloides in industrialized countries are reviewed. In well-nourished and immunocompetent persons, inapparent infections or mild, transitory gastrointestinal upsets caused by these parasites are quite common. Some patients develop severe symptoms, such as profuse diarrhoea, dehydration, stool irregularities for weeks or months followed by weight loss and malabsorption of fat, vitamins and iron. In patients receiving immunosuppressive treatment or with lymphotropic viral infections, Cryptosporidium and Strongyloides can cause life-threatening or debilitating disease. By autoinfection or external reinfection these parasites can persist in the intestine for years. Clinicians should consider such infections in immigrants, travellers and former servicemen, even long after their stay in endemic areas, and also in the handicapped and children in day-care centres. PMID- 3311233 TI - Travellers' diarrhoea. AB - Travellers' diarrhoea each year affects six million persons. At highest risk are those originating in an industrialized country for a visit in the Third World; their incidence of diarrhoea is 20-56% for the first 14 days of the stay abroad. Younger travellers, those who care less, and those with a lack of nonspecific gastrointestinal immune factors are more susceptible. The ailment mostly takes a mild and short course. Travellers' diarrhoea is usually due to faecally contaminated food and beverages, the predominant agent being enterotoxigenic E. coli. Therefore, the traditional rules of nutritional prophylaxis play the main role in prevention; drug prophylaxis can hardly ever be recommended. PMID- 3311236 TI - Imported gastrointestinal diseases in industrialized nations. PMID- 3311237 TI - Comparison of platinum concentrations in human head and neck tumours following administration of carboplatin, iproplatin or cisplatin. AB - Tumour tissue levels of platinum were determined in patients with head and neck tumours receiving carboplatin (11 patients, 400 mg/m2) and iproplatin (5 patients, 360 mg/m2). The platinum concentrations ranged from 1.1 +/- 0.4 ng Pt/mg tissue (iproplatin administration) to 1.4 +/- 0.3 ng Pt/mg tissue (carboplatin administration). These results were compared with published platinum levels after cisplatin administration. Although the administered dose of carboplatin (1.08 mmol/m2) and iproplatin (0.86 mmol/m2) was higher than the cisplatin one (0.33 mmol/m2), no significant statistical differences were observed in the resulting platinum tissue levels. The constancy of tumour platinum level after treatment with different platinum complexes could be explained, at least for carboplatin and cisplatin, by both the tumour diffusion properties and the reactivity of the drugs. PMID- 3311238 TI - The antiprogestin RU486 in advanced breast cancer: preliminary clinical trial. AB - Twenty-two oophorectomized or postmenopausal women with metastatic breast cancer resistant to several medical therapies (tamoxifen, or other endocrine therapy, and chemotherapy) were treated in a first trial with 200 mg per day of RU486 for 1 to 3 months. The long-term tolerance was good but there was a moderate decrease in plasma potassium. Plasma cortisol was increased 2-fold without clinical hypo- or hypercorticism. Twelve patients had a partial response or a stabilization of secondary deposits for 6 weeks but the response rate at 3 months was 18%. When available, estrogen and progesterone receptor levels were positive in these patients. This preliminary trial shows for the first time that the antiprogestin RU486 is well tolerated for medium term treatment. It suggests that it might be active on advanced breast cancer becoming resistant to tamoxifen. PMID- 3311239 TI - Model chlorination of plant derived phenolic water contaminants with an assessment of their potential toxicity to Escherichia coli. PMID- 3311241 TI - Afferent pathways for the cough reflex. AB - Cough is most often a reflex act elicited by the stimulation of nervous receptors in the respiratory tract. The most important tussigenic areas are at the level of the larynx and the more distal portion of the trachea with its bifurcation. Laryngeal rapidly adapting receptors with myelinated fibres are promptly activated by tussigenic stimuli, but it is unlikely that they are the only ones responsible for laryngeal coughing. In fact, some evidence supports the involvement of laryngeal C-fibre receptors. Cough in response to inhalation of aqueous aerosols containing low chloride concentrations may involve the same category of receptors with myelinated fibres that mediate apnoea in the newborn. Within the tracheobronchial tree, there are rapidly-adapting irritant receptors responsive to several tussigenic stimuli and concentrated at tussigenic sites. Animal species without this type of ending do not cough. However, some results for the tracheobronchial tree suggest a role for other types of receptors. Slowly adapting stretch receptors may play an indirect role through their stimulatory effect on expiratory muscles. A role for C-fibre receptors is proposed considering the activation of these endings by substances (capsaicin, lobeline, bradykinin, SO2) capable of inducing cough. Bronchial C-fibre receptors, present also in proximal airways, respond to light mechanical probing. Contrary to an involvement of pulmonary C-fibres is the observation that cough is not part of the lung chemoreflex, although during this reflex syndrome (apnoea followed by rapid and shallow breathing, bradycardia and hypotension) cough can be induced by mechanical irritation of the trachea. PMID- 3311240 TI - The role of adenosine in bronchial asthma. PMID- 3311242 TI - Airway anaesthesia and the cough reflex. AB - Topically and intravenously administered local anaesthetic agents are widely used to inhibit cough, but little quantitative, pharmacological data seems to be available. Various aspects of local anaesthetic agents as inhibitors of cough and other airway reflexes are discussed. Nebulized lidocaine dose-dependently inhibited both mechanically (trachea, carina) and ammonia vapour-induced cough. Lidocaine had a similar potency on each type of cough but inhibited that caused by mechanical stimulation for a significantly longer period of time. This observation supports the hypothesis of a more peripheral location for receptors mediating chemical cough. Nebulized tetracaine appeared to be more potent and to have a significantly longer duration of action than lidocaine. The Hering-Breuer inflation reflex was attenuated by both agents and in doses larger than those needed to inhibit cough. This observation is compatible with the view that the cough receptors are located close to the airway lumen and those mediating the Hering-Breuer reflex within the smooth muscle. Airway anaesthesia is commonly used to block the cough reflex during endoscopic procedures. Nebulized lidocaine has been reported also to suppress severe chronic cough but further studies on airway anaesthesia and cough in acute and chronic lung disease are warranted. PMID- 3311243 TI - Cough and bronchoconstriction. AB - Cough is frequently a symptom in bronchial asthma. Appropriate treatment of asthma is usually associated with a reduction in cough. The relationship between cough and bronchoconstriction is outlined and the role of various airway receptors in the genesis of the two responses is discussed. Experimentally, cough and bronchoconstriction may be separated: inhalations of iso-osmolar aerosols of low chloride ion content appear to be selectively tussigenic and do not cause broncho-constriction. Numerous irritants induce cough and broncho-constriction. Topical lignocaine will abolish cough but has no effect on bronchoconstriction. Beta-agonists and anticholinergic drugs will reduce or prevent bronchoconstriction induced by an irritant and may suppress cough. Cough is mediated by airway receptors and it is possible that broncho-dilating agents act as cough suppressors because they "reset" airway receptors. PMID- 3311244 TI - Afferent nerves in reflex bronchoconstriction. AB - Bronchomotor tone is controlled by reflex mechanisms that have afferent pathways originating from different sites and from receptors transducing different stimuli: mechanoreceptors, thermoreceptors, chemoreceptors and nociceptors. Mechanical and chemical irritations of the nasal cavity and the nasopharynx usually lead to a decrease in bronchomotor tone. However, in patients with asthma and chronic obstructive lung diseases, nasal stimulation causes bronchoconstriction. Some experimental data indicate a bronchoconstrictive effect of nasal cooling. At present, it is not possible to identify specific receptors as responsible; but specific cold receptors have been found in the nose. Mechanical and chemical irritations of the larynx, cooling of the larynx, and exposure to both hypo- and hypertonic water solutions cause bronchoconstriction. Of the several receptors described in the larynx the following could be involved: rapidly adapting irregularly firing irritant receptors with myelinated fibres, specific cold receptors and C-fibre receptors. Of possible relevance is the marked inhibitory effect that low temperatures have on laryngeal mechanoreceptors. All the four types of nervous receptors present within the tracheobronchial tree and lung parenchyma contribute to the regulation of bronchomotor tone. Rapidly-adapting irritant receptors, and bronchial and pulmonary C-fibre receptors, that respond to several mechanical and chemical challenges, cause a reflex bronchoconstriction. Slowly-adapting stretch receptors are stimulated by increases in broncho-motor tone and reflexly inhibit bronchoconstriction subserving a negative feedback mechanism. PMID- 3311245 TI - Mediators and mucociliary clearance in asthma. AB - Lung mucociliary clearance is significantly reduced in asthmatic patients compared to healthy controls even during clinical remission. Further retardation in mucous clearance occurs during sleep per se and this may be a contributing factor to nocturnal asthma. Chemical mediators of anaphylaxis appear to have various and, sometimes opposing effects on the two essential components for mucociliary clearance, namely cilia and mucus. Some mediators such as leukotrienes C4 and D4 are potent secretagogues and histamine increases the water flux into the lumen of the airways from the mucosa. Slow-reacting substance of anaphylaxis (SRS-A) reduces mucus transport whereas histamine enhances it. Ciliostimulation has been reported following allergen challenge and this contrasts with the cilioinhibitory effect of asthmatics' sputa. It appears however, that the net effect of the various chemicals of anaphylaxis is one of impairment of mucus clearance. Some pharmacological agents, used for the relief of bronchospasm and control of asthma, also stimulate mucociliary transport, a desirable additional effect. PMID- 3311246 TI - Koch's comma bacillus: the first year. PMID- 3311247 TI - What's in a name? Aspirin and the American Medical Association. PMID- 3311249 TI - Medical practice in imperial Berlin: the casebook of Alfred Grotjahn. PMID- 3311248 TI - The origins of the Islamic hospital: myth and reality. PMID- 3311250 TI - A history of semitertian fever. PMID- 3311251 TI - Medieval English medicine. "Doctors and medicine in medieval England, 1340-1530". By Robert S. Gottfried. Essay review. PMID- 3311252 TI - Defining American biology: new books in the history of American science. Essay review. PMID- 3311254 TI - Hysteria: its nature and explanation. AB - Hysteria is a concept that has led to much confusion and controversy. It is argued that a phenomenon exists which needs to be explained. The main contemporary approaches to hysteria are considered and all are shown to have serious weaknesses. It is argued that the illness behaviour/sick role model does have at least heuristic value in that it leads to asking a rather different set of questions about hysteria which should prove more amenable to experimental investigation. It also avoids the logical difficulties inherent in most of the alternative theories. PMID- 3311255 TI - [Academic elogy of Prof. Marc Herlant, titular member]. PMID- 3311253 TI - Model of synthesis and release of insulin from rat islet beta-cells and the effect of pretreatment with tolbutamide. PMID- 3311256 TI - [Epistemological bases of Pavlov's heritage]. PMID- 3311257 TI - [Blood screening for the first markers of atherosclerosis. Diagnostic progress and therapeutic perspectives]. PMID- 3311259 TI - [Hepatic transplantation: indications for and results in children]. PMID- 3311258 TI - [Academic eulogy of Professor Maurice Welsch, titular member and past president]. PMID- 3311260 TI - [Cryptococcus neoformans, var. neoformans, Cryptococcus neoformans var. gattii, causative agents of cryptococcosis]. PMID- 3311261 TI - Health policy in the United States: issues and options. PMID- 3311262 TI - Osteoarthritis: a 1987 update. PMID- 3311263 TI - Effect of nafazatrom and indomethacin on pulmonary removal of prostaglandin E1 after endotoxin in rabbits. AB - 1 We compared the effects of endotoxin on pulmonary prostaglandin E1 (PGE1) removal in groups of rabbits pretreated with the cyclo-oxygenase inhibitor, indomethacin, or nafazatrom (Bay g 6575), which has been shown to increase plasma prostacyclin concentrations. 2 In untreated animals, endotoxin transiently decreased pulmonary removal of [3H]-PGE1, caused pulmonary hypertension, systemic hypotension and increased plasma concentrations of PGE2 and 6-keto-PGF1 alpha. 3 Indomethacin pretreatment prevented the transient decrease in pulmonary removal of [3H]-PGE1 in response to endotoxin, prevented the haemodynamic effects and inhibited prostaglandin synthesis. Pretreatment with nafazatrom did not affect the decreased pulmonary removal of [3H]-PGE1, exacerbated the haemodynamic response, reduced survival and potentiated the increase in circulating 6-keto PGF1 alpha. 4 We conclude that indomethacin acts to prevent the depression of pulmonary [3H]-PGE1 removal by eliminating surface area changes associated with endotoxin-induced pulmonary vasoconstriction. 5 These data suggest that nafazatrom treatment results in exacerbation of the endotoxin-induced systemic hypotension presumably due to its effect on increased plasma prostacyclin during the later phase of endotoxaemia. PMID- 3311264 TI - Evidence for two different P2-purinoceptors on beta cell and pancreatic vascular bed. AB - 1 The effects of a 2-substituted analogue of adenosine 5'-triphosphate (ATP), 2 methylthioadenosine triphosphate (2-methylthio ATP) have been studied on insulin secretion and flow rate of the isolated pancreas of the rat, perfused in the presence of glucose (8.3 mM). 2 2-Methylthio ATP (16.5-1650 nM) increased insulin secretion in a biphasic and concentration-dependent manner; the kinetics were comparable to those previously obtained with ATP. A comparison of relative potency between ATP and 2-methylthio ATP showed that 2-methylthio ATP was 45 times more potent than ATP. 3 2-Methylthio ATP also provoked a transient decrease of the flow rate in a concentration-dependent manner but at concentrations (165 825 microM) about 1000 fold higher than those needed to increase insulin secretion. A comparison of relative potency between the natural derivative and 2 methylthio ATP showed that 2-methylthio ATP was only twice as potent as ATP. 4 These and other previous results (with phosphate-modified analogues of ATP) provide evidence for two different types of P2-purinoceptors on endocrine cell and vessel cells of the pancreas. A P2Y subtype, mediating an increase of insulin secretion, is present on the beta cell of the pancreas. A P2X subtype, mediating vasoconstriction, is present on the vascular bed of the rat pancreas. PMID- 3311265 TI - Comparative pharmacology of endothelium-derived relaxing factor, nitric oxide and prostacyclin in platelets. AB - 1 The pharmacological effects of endothelium-derived relaxing factor (EDRF), nitric oxide (NO) and prostacyclin on human and rabbit platelets were examined. 2 EDRF is released from porcine aortic endothelial cells, cultured on microcarriers and treated with indomethacin, in sufficient quantities to inhibit platelet aggregation induced by 9,11-dideoxy-9 alpha, 11 alpha-methano epoxy-prostaglandin F2 alpha (U46619) and collagen. 3 The anti-aggregating activity of EDRF was potentiated by M&B 22948, a selective inhibitor of cyclic GMP phosphodiesterase, and by superoxide dismutase (SOD) and was inhibited by haemoglobin and Fe2+. 4 Both NO and prostacyclin inhibited platelet aggregation. 5 The anti-aggregatory activity of NO, but not that of prostacyclin, was potentiated by M&B 22948 and by SOD and was inhibited by haemoglobin and Fe2+. Thus NO is a potent inhibitor of platelet aggregation whose activity on platelets mimics that of EDRF. 6 It is likely that the inhibitory effect of NO on platelets represents the action of endogenous EDRF and therefore this substance, together with prostacyclin, is a regulator of platelet-vessel wall interactions. PMID- 3311266 TI - Positive inotropic and chronotropic effects of trypsin and some other proteolytic enzymes in the guinea-pig heart. AB - 1 In atrial preparations of the young guinea-pig (body weight 150-250 g), five proteolytic enzymes (trypsin, chymotrypsin, bacterial-Al-proteinase (nagarse), bromelain and kallikrein) produced concentration-dependent positive inotropic and chronotropic effects, while they exerted only minimal effects on the papillary muscle preparations. 2 To characterize the effects, further experiments were conducted in atrial preparations using trypsin. There was a strong tendency for tachyphylaxis: a second exposure to the same concentration of trypsin resulted in considerably smaller positive inotropic and chronotropic effects. The positive inotropic and chronotropic effects of this substance were not affected by propranolol (5 X 10(-7)M). However, an accumulation of cyclic AMP was observed and the positive inotropic and chronotropic effects were potentiated by aminophylline (10(-4)M) in association with an augmentation of the accumulation of cyclic AMP. In preparations partially depolarized with high K+ (22mM) medium (contractions ceased under this condition) trypsin 100 micrograms ml-1 reinstated the contraction. Treatment of the preparation with aprotinin (200 u ml-1) resulted in a strong inhibition of the positive inotropic and chronotropic effects. 3 Islet activating protein (IAP), a specific inhibitor of the 'inhibition specific' guanine nucleotide binding regulatory protein of the adenylate cyclase system, did not produce significant inhibition of the positive inotropic and chronotropic effects of trypsin, whereas it produced a complete inhibition of the negative inotropic and chronotropic effects of carbachol. 4. These results suggest that the positive inotropic and chronotropic effects ofproteolytic enzymes are intimately connected with the proteolytic activities through which adenylate cyclase is activated to produce an accumulation of cyclic AMP within the myocardium. The destruction of the 'inhibition specific' guanine nucleotide regulatory protein of the adenylate cyclase was not substantiated as a mechanism of activation of the adenylate cyclase. PMID- 3311267 TI - The burden of care: the impact of functional psychiatric illness on the patient's family. AB - This paper reviews the literature on the effect of severe mental illness on other members of the patient's family. The burdens of caring for a patient at home are considerable. They often affect the caring relative's social and leisure activities, and financial problems arise frequently. Relatives have difficulties in understanding and coming to terms with illness-related behaviour. 'Negative' symptoms are often a particular problem. Despite their burden, relatives do not complain much, although they receive little support, advice or information from the professionals engaged in treating the patient; much is now known about the difficulties relatives face, but we still need to know how they can best be helped. Failure to do this will have bad effects on both relatives and patients. PMID- 3311268 TI - Amnesia: organic and psychogenic. AB - This paper describes the clinical features of selected examples of organic and psychogenic amnesia, and it discusses the nature of the dysfunction that these amnesias entail. The anterograde component of organic amnesia involves a severe impairment in acquiring (or learning) new information, rather than accelerated forgetting, and this may reflect an underlying limbic or neurochemical dysfunction. Retrograde amnesia has a basis which is (at least partially) independent of anterograde amnesia--in some patients, it appears to involve a failure to reconstruct past experience from contextual cues, and this may reflect a super-imposed frontal dysfunction. Two types of confabulation are discussed, one of which ('provoked') is a normal response to poor memory, and the other ('spontaneous') appears to reflect incoherent, context-free retrieval, associated with more severe frontal pathology. It is argued that many cases of psychogenic amnesia may resemble organic amnesia, in that they result from an impaired acquisition of information at the time of initial input, perhaps thereby predisposing the subject to subsequent retrieval difficulties. PMID- 3311269 TI - Asymptomatic abdominal mass in a child. PMID- 3311270 TI - The renal parenchymal junctional line in children: ultrasonic frequency and appearances. AB - The kidneys of 72 children were examined ultrasonically to determine the frequency of visualisation of the parenchymal junctional line (PJL), its variation with age and its ultrasonic appearances. The PJL was seen in 47 cases, usually on the right side. No statistical variation in the frequency of visualisation with age has been established. The usual appearance is of a thin, echogenic, linear structure running from the renal sinus to the cortex in an antero-superior direction. It is believed to originate from a layer of connective tissue which is trapped when a proportion of kidneys form from the fusion of two metanephric elements. The PJL is a common ultrasonic finding in a normal child's kidney and should never be confused with a pyelonephritic scar. PMID- 3311271 TI - A method for thresholding subtracted images in radiolabelled-antibody imaging. AB - The low target-to-background ratio of radiolabelled antibodies often necessitates the use of a subtraction technique to enhance areas of tumour uptake. However, interpretation of the results is often difficult due to noise in the antibody and subtraction images. By performing a linear, least-squares fit to all the pixel values, it is possible to calculate the "prediction interval". This may be used as a variable threshold for the subtracted image to leave only statistically significant counts. The method has been evaluated in models and found to be independent of count density and image processing. Useful results have been obtained in initial patient studies. The technique is fast and objective, and therefore it may have a useful role in the routine analysis of subtracted images. PMID- 3311272 TI - Computer aids to mammographic diagnosis. AB - The improvement of mammographic specificity was investigated by means of identifying specific radiological features. Data are presented on the first 500 patients studied who had previously undergone mammography followed by biopsy. The presence of specific mammographic features on each radiograph, first determined by retrospective examination, was entered into a computer database. Subsequent discriminant function analysis demonstrated the importance of a small number of features whose presence could be used in an algorithm to predict diagnostic outcome. Using this algorithm, this feature-identification approach correctly identified 87.6% of benign and 79% of malignant cases. Specificity was improved to 88% as compared with the original radiological diagnosis of 49%. It is argued that this approach is very promising and a computer-assisted diagnosis based on these findings is described. PMID- 3311273 TI - The Sheffield stereotactic radiosurgery unit: physical characteristics and principles of operation. AB - A stereotactic radiosurgery unit was commissioned in Weston Park Hospital in the summer of 1985. This paper describes the design, principles of operation and the safety features of the multiple-beam cobalt-60 therapy unit. The measurement of the dose around the extremely sharp focus produced by the 201 beams is discussed and the results compared with computed distributions. The results of the radiation protection survey are presented and the design of the purpose-built treatment suite is discussed. The procedure for treatment of a patient is outlined. PMID- 3311274 TI - Renal tubular antigens in regenerative epithelium and renal carcinoma. AB - Antibodies to brush border antigen (BB) and epithelial membrane antigen (HMFG2) have been used in immunocytochemical preparations to define specific portions of the nephron. In both fetal and adult kidney BB was confined to the proximal tubule and HMFG2 to the distal tubule and collecting duct. The distribution of the antigens was studied in regenerative epithelium (15 cases) and renal carcinoma (35 cases). Regenerative epithelium in six cases expressed both antigens, and 29/35 renal carcinomas expressed both antigens. These results demonstrated some antigenic similarities between regenerative hyperplastic tubular epithelium and renal carcinoma. PMID- 3311275 TI - Oral ciprofloxacin as prophylaxis in transurethral resection of the prostate. AB - A new quinolone antibacterial, ciprofloxacin, was evaluated as oral prophylaxis for transurethral resection of the prostate in a randomised controlled trial. A 3 day course of perioperative ciprofloxacin 250 mg twice daily reduced the post operative infection rate, the post-operative hospital stay and the frequency of infective complications. Ciprofloxacin was well tolerated and no significant haematological or biochemical side effects were detected. PMID- 3311277 TI - Anastomotic recurrence in large bowel cancer. PMID- 3311276 TI - Fluid absorption during urological endoscopy. AB - Transurethral prostatectomy (TURP) and, more recently, percutaneous nephrolithotomy and endoureteric procedures for stones in the kidney and ureter have justifiably become popular because of the many advantages offered by these less invasive procedures. Any surgical operation has its attendant complications and absorption of irrigant fluid is a major and potentially fatal complication of all of these endoscopic techniques. This review examines the incidence, the causes and the pathological sequelae of excessive fluid absorption and suggests some ways to prevent it. PMID- 3311278 TI - Urological complications in 600 consecutive renal transplants. AB - The results of 600 consecutive renal transplant operations (540 cadaver and 60 living related donor) in 491 patients were assessed with respect to urological complications. In nearly all cases the ureter was inserted into the bladder using a Leadbetter-Politano ureteroneocystostomy technique. The bladder was drained by Foley catheter for 5 days and the operation site by vacuum drain for a variable period. After 26 operations in 26 patients, 27 episodes of ureteric obstruction were identified (one reobstruction). These occurred between 1 day and 45 months after transplantation and involved the lowest third of the ureter 19 times, the middle third 3 times and the proximal third 4 times. They were due to stricture (11), pelvic collection (7), redundant or twisted ureter (3) or other cause (5). An anatomical predisposing factor in either patient or graft was identified in 31 per cent of these caes. After 18 operations in 18 patients, 21 episodes of urine leakage were identified (three re-leakages). These occurred between 1 day and 6 months after transplantation and an anatomical predisposing factor in either patient or graft was present in 59 per cent. Thus, overall, 7 per cent of patients developed a urological complication in this series. This rate has declined in recent years in parallel with a general reduction in steroid dose for immunosuppression. This last feature, combined with the surgical technique described, has resulted in a low incidence of urological complication after transplantation, being now between 1 and 2 per cent. PMID- 3311279 TI - Prospective assessment of carotid endarterectomy by clinical and ultrasonic methods. AB - Sixty-three carotid endarterectomies in 60 patients were followed by clinical and duplex scanning at 2 weeks postoperatively and at 3-monthly intervals for 3 years (mean 18 months). Four patients died (two of stroke, two of myocardial infarction) and four survivors had recurrent ipsilateral symptoms. Two had an immediate mild hemiparesis which recovered completely within 36 h; in both, the endarterectomized arteries were patent on scanning. The other two experienced amaurosis fugax for 2-3 weeks at 2 and 24 weeks; scanning showed that the sites of both endarterectomies had become occluded. Ultrasound assessment at 2 weeks showed that 43 of 61 (70.5 per cent) endarterectomized arteries were widely patent. There were three occlusions, one stenosis of greater than 75 per cent, three stenoses of greater than 50 per cent and eleven stenoses of less than 50 per cent. At 6 months a total of five vessels were occluded, with greater than 75 per cent stenosis in three and greater than 50 per cent stenosis in eight. At latest follow-up, six of eight arteries with greater than 50 per cent stenosis shown earlier had scans which had reverted to normal. Tacking down of the distal intima was associated with higher incidence of restenosis and occlusion (P less than 0.01). Women were more predisposed to restenosis by neointimal hyperplasia (P less than 0.05). All restenosis occurred within the first 6 months postoperatively (26.2 per cent) and fell to 16.4 per cent at the end of the study. PMID- 3311280 TI - Contact ultrasonography in the detection of liver metastases from colorectal cancer: an in vitro study. PMID- 3311281 TI - Surgical technique. PMID- 3311282 TI - Heller's myotomy for achalasia: is an added anti-reflux procedure necessary? AB - Literature review (1970-85) indicates excellent or good results following Heller's operation in 89 per cent of 5002 patients. The overall mortality was 2.8 per cent with a reoperation rate of 2.8 per cent. When the operation was done through an abdominal incision, gastro-oesophageal reflux was almost twice as common as when it was done through a thoracic incision, regardless of whether an anti-reflux procedure was performed. PMID- 3311283 TI - Conservative management of bleeding duodenal ulcer without a visible vessel: prospective randomized trial. AB - Between January 1983 and December 1985, 305 patients were admitted to our hospital because of bleeding duodenal ulcer. A subgroup of 69 patients aged 50 or above in whom emergency endoscopy showed non-arterial bleeding or signs of recent haemorrhage without a visible vessel entered a prospective therapeutic trial. The patients were randomized to receive either (1) early surgery, implying immediate operation, or (2) expectant management, with surgery reserved only for patients with further haemorrhage. The two groups were homogeneous with respect to age, sex, prior ingestion of ulcerogenic drugs, mode of bleeding, admission haematocrit, number with hypovolaemic shock and number with active bleeding on initial endoscopy. Overall mortality was 8.6 per cent. Mortality in patients submitted to early surgery was five times higher than that in those allocated to expectant therapy (14.7 per cent versus 2.9 per cent; risk ratio 5.07). The results suggest that expectant management is advisable in patients with bleeding duodenal ulcer not bleeding massively and in whom endoscopy does not disclose spurting arterial bleeding or a visible vessel. PMID- 3311284 TI - Loop mattress suture. PMID- 3311286 TI - 'Button hole' incisional hernia: a late complication of abdominal wound closure with continuous non-absorbable sutures. PMID- 3311285 TI - Circumumbilical versus transumbilical abdominal incision. AB - One hundred and fifteen patients were entered into a prospective randomized trial to establish whether midline abdominal incisions through the umbilicus produced any differences in the incidence of wound infection or failure when compared with the more conventional midline incision skirting around the umbilicus. No significant difference was shown between wound infection rates in 58 transumbilical and 51 circumumbilical incisions. Follow-up of surviving patients for at least one year showed no difference in incisional hernia rate between the two groups of patients. No problems were encountered in making the incisions through the umbilicus, but skirting the umbilicus was felt to cause problems with slewing of the scalpel blade, and asymmetry of the scar in 13 circumumbilical incisions. This study has shown that the practice of avoiding the umbilicus in midline abdominal surgery serves no useful purpose. PMID- 3311287 TI - Comparison of acetylcholinesterase and choline acetyltransferase staining patterns in the optic tectum of the goldfish Carassius auratus. A histochemical and immunocytochemical analysis. AB - Although the optic tectum of nonmammalian vertebrates has been extensively studied anatomically, there is little information about the identification of neurotransmitters and the enzymes critical to their synthesis. Choline acetyltransferase (ChAT), the enzyme responsible for acetylcholine synthesis, is presently regarded as the most reliable marker for cholinergic neurons, and its localization within putative cholinergic neurons has been made possible by the development of antibodies specific to ChAT. We have compared the immunocytochemical localization of ChAT to the histochemical staining of acetylcholinesterase (AChE) in the goldfish optic tectum. Goldfish brains reacted with the monoclonal antibody AB8 to ChAT have revealed that: (1) type XIV neurons are the only ChAT-positive cells in the tectum, and there are approximately 15,000 such cells per tectal hemisphere; (2) these neurons and other ChAT containing afferent fibers form bands of label which correspond to those seen after AChE staining, and (3) many AChE-stained neurons do not contain ChAT. The immunohistochemical localization of ChAT has provided a direct method for determining the localization and organization of putative cholinergic structures in the optic tectum of goldfish. Future studies may elucidate the relationship of these cholinergic systems to the retinotectal projections, as there is close correspondence between AChE and ChAT location and the retinotectal termination patterns. PMID- 3311288 TI - The effects of knife cuts of hippocampal pathways on epileptic activity in the seizure-sensitive gerbil. AB - Previous studies have shown morphological differences in the hippocampal formation of seizure-sensitive gerbils as compared to seizure-resistant gerbils. To determine the significance of these differences, lesions were made of hippocampal afferents and efferents. Seizure-sensitive gerbils with bilateral knife cuts of the perforant path, including those with bilateral fornix lesions, showed no seizure activity following surgery. However, bilateral transections of the fimbria of the fornix, unilateral lesions of the perforant path and sham surgeries had no significant effect on seizure activity. The termination of seizure activity with bilateral lesions of the perforant path suggests that this pathway, as opposed to the fornix, is required for motor seizures in this strain of gerbils. PMID- 3311289 TI - Centrally mediated hypoglycemic effect of insulin: apparent involvement of specific insulin receptors. AB - We have studied the involvement of central nervous system (CNS) insulin receptors in mediating the central hypoglycemic effect of insulin by using insulin derivatives modified at regions of the hormone necessary for receptor reactivity and peripheral bioactivity. Acetylation or succinylation of the 3 free amino groups of insulin at positions A1, B1 and B29 resulted in a corresponding decrease in lipogenic activity in isolated rat adipocytes, with concentrations of hormone required to produce half the maximal effect (ED50) being 0.15 ng/ml, 3 ng/ml and 50 ng/ml for native insulin, acetyl3 insulin and succinyl3 insulin, respectively. Moreover, the modified insulins exhibited diminished hypoglycemic effect following central administration in mice, with the doses needed for suppression of plasma glucose to 50% of basal levels being 1 microgram, 10 micrograms and 25 micrograms for native insulin, acetyl3 insulin and succinyl3 insulin, respectively. Because binding of insulin derivatives to CNS receptors can be predicted from their peripheral bioactivity, the present finding of parallel decrements in lipogenic activity in vitro and central hypoglycemic effect in vivo, following modification of insulin at regions implicated in receptor activation, is consistent with the view that insulin exerts its central effect on plasma glucose by interacting with specific CNS receptor sites which are closely related to the peripheral insulin receptors. PMID- 3311290 TI - Loss of parvalbumin-immunoreactive neurones from cortex in Alzheimer-type dementia. AB - The type and cell size of parvalbumin-immunoreactive (PV-Ir) neurones were examined in 14 postmortem brains from elderly control and Alzheimer-type dementia (ATD) patients with the aid of an image analyser. Morphological features of PV-Ir neurones suggested the existence of PV in the non-pyramidal interneurones in the cerebral cortex. A significant loss of PV-Ir cells was found in the frontal and temporal cortex in ATD. A significant reduction in the size of PV-Ir cells was also noted in the temporal cortex in ATD. These findings suggested that PV-Ir neurones in the cortex are affected in ATD. PMID- 3311291 TI - Origin of serotonin innervation of the arcuate and ventromedial hypothalamic region. AB - Combined fluorescence serotonin immunohistochemistry and retrograde transport labelling with Fast blue and Fluoro-gold were used to identify serotonin immunoreactive neurons in the midbrain and pons which project to the region of the arcuate and ventrome-dial hypothalamic nuclei. Approximately 90% of doubly labelled neurons were located in the 3 major mesencephalic serotonin-containing cell groups: dorsal raphe (38%), median raphe (21%) and medial lemniscus group (29%). Within these groups, there were numerous non-retrogradely labelled serotonin-immunoreactive neurons as well as numerous non-serotonin-immunoreactive retrogradely labelled neurons. No doubly labelled neurons were observed caudal to raphe pontis although non-serotonin-immunoreactive neurons were retrogradely labelled in the more caudal raphe nuclei. PMID- 3311292 TI - [[Late ventricular potentials--new computer derived electrocardiographic information?]. PMID- 3311293 TI - [Humoral reaction to 2 different immersions in a tub]. PMID- 3311294 TI - [Culture methods for the study of biocenosis conditions in the vagina]. PMID- 3311295 TI - [IgA-linear dermatosis imitating Lyell syndrome]. PMID- 3311296 TI - [The effect of viruses on the immune system]. PMID- 3311297 TI - [Cryopreservation of pancreatic tissue in experimental animals]. PMID- 3311298 TI - [Use of the microprecipitation reaction in the diagnosis and therapy of toxoplasmosis]. PMID- 3311299 TI - [Sensitivity of Candida albicans to antimycotic antibiotics and chemotherapeutic agents]. PMID- 3311300 TI - The history of mental handicap in Bristol and Bath (Part I). PMID- 3311301 TI - [Survey on the prevalence of goiter in France]. PMID- 3311302 TI - [Contribution of biophysics to the detection of carriers of Duchenne muscular dystrophy]. PMID- 3311303 TI - [Statistical methodology and thermal baths: computerized medical cases]. PMID- 3311304 TI - [Combined vaccination against measles, mumps and rubella]. PMID- 3311305 TI - [Medical education in French-speaking Africa south of the Sahara]. PMID- 3311307 TI - [Odontology is a medical specialty, a section of stomatology]. PMID- 3311306 TI - [Involvement of purinergic receptors in insulin and glucagon secretion]. PMID- 3311308 TI - [Spontaneous subarachnoid hemorrhage. Limits of repeated cerebral angiography]. PMID- 3311309 TI - [From animal magnetism to secret remedies]. PMID- 3311310 TI - [Pathogenesis of atherosclerosis]. PMID- 3311311 TI - [Viral hepatitis B and polyradiculoneuritis: a rare association]. PMID- 3311312 TI - Pelvic exenteration. AB - A survey of the literature over a 30-year period suggests that exenteration operations have not been widely accepted or perhaps not commonly reported except in the United States. Even in the United States, the series reported are usually of very small numbers. The reasons for this are difficult to explain except to say that the most widely indicated factor is carcinoma of the cervix and this has been decreasing in incidence as far as the more advanced stages are concerned. It is being detected at an earlier stage with a greater chance for cure without recurrence. Endometrial and ovarian cancer have been on the increase, with endometrial cancer being diagnosed early with excellent results and ovarian cancer occurring in an advanced stage with a presentation that does not lend itself readily to radical pelvic surgery. It must be stated that in cases where pelvic exenteration is indicated, and these are highly selective ones, there is no other equally curative form of therapy that exists for the distressing problem of recurrent pelvic cancer. With the new stapling techniques and the use of clips along the pelvic wall to control bleeding from the blood vessels in this area, it is possible to perform a pelvic exenteration with much less blood loss and in considerably less time than previously. The improved methods of monitoring these patients with a Swan-Ganz catheter and a better understanding of the metabolic and physiologic process has reduced the mortality rate to less the 5%. Having given these patients a quantity of life, it is important to give them a quality of life. These patients should be rehabilitated and, if needed, a vagina should be reconstructed and the patient encouraged to lead a normal life. Perhaps these patients cannot be described as happy, but at least given a second chance for life they can become well adjusted and make significant contributions to their family and the community. PMID- 3311313 TI - The pulmonary alveolar macrophage and lung cancer. PMID- 3311314 TI - Activation of cellular oncogenes in human and mouse leukemia-lymphomas: spontaneous and induced oncogene expression in murine B lymphocytic neoplasms. PMID- 3311315 TI - Melatonin: a rediscovered antitumor hormone? Its relation to surface receptors; sex steroid metabolism, immunologic response, and chronobiologic factors in tumor growth and therapy. PMID- 3311316 TI - Cancelling stress. PMID- 3311317 TI - [History of the practice of anesthesia in France]. PMID- 3311318 TI - [Nitrous oxide (nitrogen protoxide), its value in anesthesia and its effects on female personnel]. PMID- 3311319 TI - Computer applications in diabetes management and education. PMID- 3311320 TI - The third decade of the Canadian Ophthalmological Society. PMID- 3311321 TI - Modification of Bick's procedure for treatment of eyelid laxity. AB - A modification of Bick's procedure is presented that offers a simple, effective treatment of ectropion and entropion secondary to eyelid laxity. A full-thickness lid-shortening procedure performed at the lateral canthus avoids lid notching, with good cosmetic results. The success of the procedure is determined by suture of the tarsus directly to the orbital periosteum. The modification of Bick's procedure improves the outcome of the operation and simplifies its performance. PMID- 3311322 TI - Cultured juxtaglomerular cells: production and localization of renin. AB - Trypsin- or collagenase-dispersed renal cortical cells from newborn mice were filtered and cultured. The cultures comprised 25% juxtaglomerular cells as identified by immunocytochemistry. Renin was measured by radioimmunoassay in the culture medium and in the cells at various time intervals. This in vitro system was responsive to isoproterenol, which stimulated renin release in a dose dependent manner. PMID- 3311323 TI - Some N-acyl-D-amino acid derivatives having antibotulinal properties. AB - Several N-acyl derivatives of D-tryptophan, D-alanine, D-methionine, D-valine, and D-aspartic acid were synthesized in high yields using the succinimidyl ester method and examined for their antibotulinal properties. In conjunction with 60 ppm of sodium nitrite, sorbyl-D-tryptophan, sorbyl-D-alanine, myristoyl-D aspartic acid, and glycyl-D-alanine were highly inhibitory. In the absence of sodium nitrite, the N-acyl derivatives of the D-amino acids were not inhibitory. On its own, 60 ppm of sodium nitrite was only slightly inhibitory. Sorbyl-L tryptophan and sorbyl-L-alanine had no effect in the presence or absence of 60 ppm of sodium nitrite. PMID- 3311324 TI - The natural history of multiple sclerosis. AB - Studies which have attempted to define the outcome of multiple sclerosis (MS) have methodologic difficulties arising from patient referral biases and the length of follow-up required, which make prospective studies of an inception cohort unrealistic. Means to improve the validity of retrospective natural history studies are suggested. Results of existing series are summarized and compared. Survival is only rarely shortened by MS, but disability to the point of requiring aids for ambulation occurs in 30-70% of patients by 15 years from onset of symptoms. Disagreement as to the percentage of patients who are ultimately bedridden by MS likely arises in large part due to differences in patient ascertainment and follow-up. The need to develop early clinical markers for the patient at high risk for rapid development of major disability is stressed. PMID- 3311325 TI - The management of .22 caliber gunshot wounds of the brain: a review of 49 cases. AB - We analyzed the charts and CT scans of 49 cases of civilian .22 caliber gunshot wounds of the brain admitted to the University of Alberta and Royal Alexandra Hospitals between 1975 and 1985. The average age of the patients was 30 years, 88% were males, 88% were suicide attempts. There were no deaths among patients with an initial coma score above 12 whereas the mortality rate was 85% for those admitted with a score of 7 or less. All those with fixed pupils on admission died. The overall mortality rate of 61% is comparable to that of other series of civilian gunshot wounds including those in which more aggressive surgical management was undertaken. We recommend that no treatment be given those cases with an admission coma score of 3 and/or fixed pupils and that simple scalp wound debridement be employed with those having a coma score of 7 or less. Tract exploration and retrieval of bullet fragments is not indicated, as retained fragments carry a very low incidence of complications (e.g. abscess formation). In patients in good condition (GCS greater than or equal to 12) the management of intracranial hematomas should be independent of their etiology and approached aggressively. PMID- 3311326 TI - Herpes zoster ophthalmicus with delayed cerebral infarction and meningoencephalitis. AB - Herpes zoster ophthalmicus can be complicated by a delayed ipsilateral cerebral angiitis which may cause infarction and a smoldering meningoencephalitis. We describe such a case treated successfully with steroids and acyclovir. It is important to consider the diagnosis of this disorder early since therapeutic intervention may prevent an otherwise high morbidity and mortality. Steroids may have to be continued for some time after clinical resolution, using the ESR as a guideline for decreasing dosages. PMID- 3311327 TI - A syndrome of brain, inner ear and retinal microangiopathy. AB - We report the seventh case of a self-limiting syndrome of brain, inner ear and retinal microangiopathy which affects adult women producing mild to moderate mental status and personality changes, mild pyramidal and cerebellar dysfunction, patchy and asymmetrical visual loss secondary to non-inflammatory retinal infarctions, and asymmetrical neurosensory hearing loss. There is no clinical or laboratory evidence of involvement beyond the brain, the eyes and the ears. Magnetic resonance imaging or brain biopsy in previously reported cases best outline the brain pathology: multiple microinfarcts. All cases have been treated with steroids or cyclophosphamide. The etiology is unknown but may be related to systemic lupus erythematosus. PMID- 3311328 TI - Perioperative hemodilution. AB - Perioperative hemodilution is one way of minimizing the morbidity and mortality associated with blood transfusion. A review of the literature indicates that, for many patients, substitution of crystalloid solutions for surgical blood loss is safe and physiologically advantageous as long as euvolemia is maintained. Increased stroke volume is the principal mechanism responsible for augmented tissue oxygen delivery. Based on this review the surgical population can be divided into three groups: most patients under 60 years of age (group 1); those with important cardiac disease (group 2); and the elderly (group 3). Patients in group 1 can safely undergo hemodilution to a hematocrit of 0.25; patients in the other groups should probably not be subjected to hemodilution. Implementation of this proposal could diminish the risk and expense of many surgical procedures. PMID- 3311329 TI - Peritracheal membranous adipose tissue for early revascularization of the bronchial anastomosis. AB - The effect of a peritracheal wrap of membranous adipose tissue on revascularization of the bronchial anastomosis after left lung autotransplantation was evaluated in four groups of dogs. The bronchial anastomosis was performed just distal to the carina in groups 1 (6 dogs) and 2 (7 dogs) and as close to the lobar division as possible in groups 3 (14 dogs) and 4 (7 dogs). Peritracheal membranous adipose tissue was used in groups 1 and 3 only. The other two groups served as controls. Three dogs from group 2 had elastic Dacron fabric wrapped around the anastomotic site. Revascularization of the distal bronchus through the wrap was demonstrated in all dogs in groups 1 and 3, 7 days after surgery by postmortem injection studies but not in control groups 2 and 4, and serious bronchostenosis was also observed in the latter two groups. Histologic examination of the bronchial anastomosis revealed better structural preservation of the bronchus distal to the suture line with the adipose tissue wrap. The dogs with elastic Dacron fabric wraps showed poor structural integrity below the suture line (necrosis and calcification). Our results suggest that the level of bronchial anastomosis does not alter the healing process of the distal bronchus when a peritracheal membranous adipose tissue wrap is applied to the anastomotic site. They also indicate that the wrap is effective in restoring vascular flow across the suture line within 1 week of lung autotransplantation. PMID- 3311330 TI - Ileorectal anastomosis for ulcerative colitis. AB - Several options can be considered when medical management of ulcerative colitis fails or if a serious complication develops. One alternative to proctocolectomy with ileostomy or ileoanal pull-through is the ileorectal anastomosis. Its main advantage is preservation of the rectal reservoir without risking injury to the pelvic nerves or and sphincter. It is not indicated when the rectum is severely diseased or stenosed or in the presence of rectal carcinoma. Patients older than 55 to 60 years can expect a good functional result in a relatively short time compared with the prolonged adaptation period associated with pull-through procedures. PMID- 3311331 TI - Silastic catheter separation due to subcutaneous suture. AB - The development of large-bore, double-lumen Silastic catheters for introduction into the superior vena cava has made it possible for patients with renal failure to receive immediate dialysis while awaiting maturation of an arteriovenous fistula. Although infections and thrombotic complications have been well documented, separation of Silastic cannulas has seldom been described and is poorly explained. The authors report two such cases. In one the catheter was clearly sheared off due to snaring by a subcutaneous suture. In the second case, awareness of the possibility of such a complication allowed the authors to explore the catheter at the level of the venotomy. By dividing the suture under direct vision, they were able to remove the snared catheter before it became transected. PMID- 3311332 TI - Percutaneous renal surgery. AB - Percutaneous renal surgery was developed initially to remove renal calculi safely without the attendant morbidity of standard open pyelolithotomy. As familiarity with techniques has been obtained, other intrarenal diseases have been treated using this approach. This report reviews the current applications of percutaneous renal surgery and discusses its relation to extracorporeal shock-wave lithotripsy in the management of renal calculi. PMID- 3311333 TI - Contemporary imaging of parotid gland and parapharyngeal space. AB - Clinically, the parotid gland and associated parapharyngeal space can be assessed better using selective diagnostic imaging as an adjunct. It increases the effectiveness of management and the pretreatment staging of disease. This paper reviews the available specific imaging modalities (conventional x-ray films, contrast sialography, computed tomography, magnetic resonance imaging, ultrasonography, angiography and radionuclide scanning), their current indications and potential limitations. PMID- 3311334 TI - Predicting failure in polytetrafluoroethylene vascular access grafts for hemodialysis: a pilot study. AB - In order to determine if serial, noninvasive evaluation of polytetrafluoroethylene (PTFE) vascular access grafts could identify a subgroup of patients at risk for thrombosis, the authors studied flow characteristics, using duplex ultrasonic scanning, in 18 hemodialysis patients with forearm loop grafts. On average, five examinations were performed per patient over the 10 month study period. Seven episodes of thrombosis occurred in six patients. The mean Doppler flow in grafts that subsequently thrombosed was significantly lower than in those that did not (544 +/- 218 ml/min versus 843 +/- 391 ml/min, p less than 0.001). The interval from last examination to thrombosis ranged from 13 to 58 days. At a defined cut-off flow of 450 ml/min, this test yielded a sensitivity of 83% and a specificity of 75% for episodes of thrombosis occurring within 2 to 6 weeks. The authors conclude that episodes of thrombosis in PTFE arm loop grafts are usually preceded by significantly lower Doppler-measured flow than grafts that do not thrombose and that it may be possible, by this means, to identify grafts at risk. PMID- 3311335 TI - The dynasties of research at the Royal Victoria Hospital, Montreal. AB - Progress in medicine comes from new knowledge. Organized research at the Royal Victoria Hospital began with establishment of the McGill University clinic headed by Dr. Jonathan C. Meakins. Two generations of doctors probed the field of respiratory physiology and its alteration in disease. Drs. J.S.L. Browne and E. Venning focused on adrenal glands. Their successors extended their work to thyroid and pituitary glands. The pioneering work of Dr. Arthur Vineberg and his medical colleagues in coronary artery diseases opened up the field of surgical treatment with the saving of many lives. Most recently, Dr. Lloyd MacLean has assembled a group of researchers interested in shock and the relation of host defences to trauma and disease. Along with staff in the many other departments of the Royal Victoria Hospital, these pioneers have made discoveries that have been applied to the treatment of patients and enhanced the reputation of the institution. PMID- 3311336 TI - Historical outlook of aquatic biotoxicology and balneology as related to dermatology. Classification of aquatic dermatoses. PMID- 3311337 TI - Sea snake bites. PMID- 3311338 TI - Miscellaneous dermatoses associated with the aquatic environment. PMID- 3311339 TI - Selected dermatoses of marine mammals. PMID- 3311340 TI - Water-induced pruritus. PMID- 3311341 TI - Natural microbiologic hazards of the aquatic environment. PMID- 3311343 TI - Cutaneous protothecosis and chlorellosis, extraordinary "aquatic-borne" algal infections. PMID- 3311342 TI - Cutaneous Mycobacterium marinum infection ("swimming pool granuloma"). PMID- 3311344 TI - Seaweed (Lyngbya majuscula) dermatitis. PMID- 3311345 TI - The prognostic significance of myelonecrosis after induction therapy in acute leukemia. AB - Myelonecrosis is a rare antemortem finding in acute leukemia and its clinical significance is uncertain. The clinical events in nine patients with acute leukemia whose bone marrow biopsies after induction therapy revealed myelonecrosis were reviewed. No patient gained a complete remission and four patients achieved a partial remission. The median duration of survival was 2 months (range, less than 1 month to 8.5 months) from the start of therapy. Myelonerosis after induction therapy in acute leukemia indicates a very poor prognosis. PMID- 3311347 TI - Fine-needle aspiration biopsy of lymphoblastic lymphoma and leukemia. A clinical, cytologic, and immunologic study. AB - Six cases of lymphoblastic lymphoma or leukemia are reviewed in which fine needle aspiration (FNA) biopsy was used to either initially diagnose or to document relapse of the condition. Accuracy of diagnosis was confirmed by surgical or autopsy material or by subsequent clinical course. Cytologically, aspirates were characterized by numerous blast cells with frequent mitoses. Immunologic confirmation utilizing aspirate material was obtained in all cases. Adequate material for extensive immunologic studies was obtained in five of six cases. The impact of FNA on patient management included; primary diagnosis in three cases; documentation of recurrence in two cases; avoidance of surgical biopsy in a patient considered a poor surgical candidate in three cases; correct subtyping of a lymphoma in which material obtained by surgical biopsy was unclassifiable in one case; and correct subtyping of a lymphoma inaccurately subtyped by surgical biopsy in one case. PMID- 3311346 TI - ras oncogene p21 as a tumor marker in the cytodiagnosis of gastric and colonic carcinomas. AB - This study was undertaken to determine whether the expression of ras oncogene product p21 can be used as a tumor cell marker of gastric and colonic carcinoma in brush smears. To detect p21 an immunocytochemical assay with RAP-5 monoclonal antibody was used. Benign epithelial gastric cells obtained from normal gastric mucosa or benign gastric lesions reacted negatively in 12 out of 13 cases. Similarly, benign epithelial colonic cells from normal colon or benign colonic lesions were negative for p21 in nine out of ten cases. Weakly positive reaction, confined to a few cell clusters only, was observed in one smear of a benign gastric ulcer and one smear of chronic ulcerative colitis. All 20 smears from colonic carcinoma and all 20 smears of gastric carcinoma contained cells that stained positively for p21, and the degree of tumor differentiation had no impact on the staining pattern. The results recorded in this study show that the immunocytochemical assay for the ras oncogene product may prove to represent a new tool for the cytodiagnosis of gastric and colonic carcinomas. PMID- 3311349 TI - On the origins of cancer genetics and cytogenetics. PMID- 3311348 TI - Prognostic factors for gastrointestinal and bronchopulmonary carcinoid tumors. AB - Data collected by population-based cancer registries in Iowa and metropolitan Atlanta were evaluated to determine prognostic factors for gastrointestinal (n = 270) and bronchopulmonary (n = 151) carcinoids. The predictors considered in univariate and multivariate analyses were: age, sex, race, marital status, anatomic subsite, stage, occurrence of other malignancies, and surgery. For surgically treated gastrointestinal tumors, the cumulative percentages of survivors at five years were: appendix, 85.6%; small intestine, 66.0%; and large intestine, 37.7%. The likelihood of death from gastrointestinal carcinoids was found to be related independently to increasing age (P = 0.001), advanced stage (P less than 0.0001), location within the large intestine (P less than 0.0001), and occurrence of another malignancy (P = 0.02). The overall five-year survival rate for bronchopulmonary carcinoids was 87.6%, and lack of surgical treatment (P less than 0.0001) and advanced stage (P = 0.006) were associated independently with unfavorable prognosis. PMID- 3311350 TI - Chromosomal analysis of bladder cancer. III. Nonrandom alterations. AB - Chromosome analysis using G- and C-banding was performed on 13 primary transitional cell carcinomas of the bladder. The chromosome preparations were obtained by a direct method. In eight tumors with a (near) diploid modal chromosome number, the most frequently observed chromosome aberrations were: (partial) monosomy 9 in four cases, deletion of 10q in two cases, and partial trisomy 1 in two cases. In five tumors with a modal chromosome number in the triploid or tetraploid range the chromosomes #1, #3, #7, #9, #11, and #17 were numerically and or structurally abnormal in at least four cases. In three out of ten males, the Y chromosome was missing. These findings suggest that the loss of chromosome #9, and possibly also loss of 10q is a primary event in the karyotypic evolution of transitional cell carcinoma of the bladder. PMID- 3311351 TI - Translocations and deletions with breakpoint on 21q are nonrandomly associated with treatment-related acute nonlymphocytic leukemia and preleukemia. AB - Six of 70 (8.6%) consecutive cases with therapy-related acute nonlymphocytic leukemia (ANLL) or preleukemia had a translocation or deletion with a breakpoint on 21q. Such aberrations were seen in only one of 200 (0.5%) consecutive cases of de novo ANLL examined at our laboratory. The figures reflect a 17.1-fold increased incidence of 21q aberrations in therapy-related ANLL or preleukemia, compared with ANLL de novo. The difference is highly significant (p = 0.003). The increased incidence of 21q aberrations in therapy-related myelodysplastic syndromes was confirmed by literature studies. Band 21q22 was most often involved. Cases with t(8;21), which is strongly associated with the M2 variant of ANLL, or cases with i(21q), which is supposedly due to a centromeric misdivision, were not included in the count. It is concluded that the 21q aberrations are associated with treatment-related ANLL or preleukemia with at least the same degree of specificity as aberrations of #5 and #7. PMID- 3311352 TI - The influence of urinary tract infection on the incidence of urinary tract tumors in N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide induced carcinogenesis in male Sprague-Dawley rats. AB - Epidemiological studies have demonstrated an association between urinary tract infection and the development of bladder cancer. The present study aimed at evaluating the influence of urinary tract infection in male Sprague-Dawley rats exposed to a sub-carcinogenic dose of N-[4-(nitro-2-furyl)-thiazolyl]formamide (FANFT). A single injection of Escherichia coli into the bladder resulted in a persistent upper urinary tract infection in a high percentage of the rats. Thirty two percent of the rats exposed to FANFT and E. coli infection developed urinary tract tumors, all but one occurring in the renal pelvis. Urinary tract tumors were not found in rats treated with FANFT or E. coli alone. The present results support that inflammation resulting from infection is actively involved in urinary tract tumorigenesis and may support the epidemiological studies showing an association between infection and human urinary tract cancer. The formation of dimethylnitrosamine or other nitroso compounds from nitrates in the urine or increased cell proliferation due to chronic inflammation or both may be important pathogenetic factors in tumor development. PMID- 3311353 TI - Relaxation techniques. A self-learning module for nurses: Unit II. PMID- 3311354 TI - Searching for magic bullets: early approaches to chemotherapy-antifolates, methotrexate--the Bruce F. Cain memorial award lecture. PMID- 3311355 TI - Specific induction of local antitumor effector cells mediated in vivo by the circulating lymphocyte pool. AB - Wistar rats are specifically resistant to the growth of the chemical carcinogen induced syngeneic tumors, Mc7 and Mc107 sarcoma, after being immunized with s.c. implants of irradiated tumor tissue. The central lymph of such immunized rats contains cells able to systemically transfer resistance against tumor growth to normal or irradiated recipient rats. The thoracic duct lymphocytes (TDL) from tumor immune donors are not directly cytotoxic against tumor targets. However recipients of i.v. infused immune TDL develop cytotoxic activity in the peritoneal cavity when challenged with the immunizing tumor at that site. Although the induction of maximum cytotoxicity is tumor specific, peritoneal lavage cells are cytotoxic against both Mc7 and Mc107 tumor targets in the 51Cr release assay. Inhibition of cytotoxicity in the assay by addition of unlabeled Mc7 or Mc107 sarcoma cells to labeled tumor targets suggests that there is both specific and nonspecific activity in these peritoneal lavage cells. Resistance to in vivo tumor growth in adoptively immunized recipients of TDL challenged with both Mc7 and Mc107 is specific for the immunizing tumor. However growth of a mixture of Mc7 and Mc107 sarcoma cells is inhibited in recipients of immune TDL. The results support the notion that mediator lymphocytes circulate in tumor immunized rats in a noncytotoxic state, specifically recognize tumor cells at a challenge site, and mediate induction of effector cells locally. These effectors are at least in part nonspecific in their cytotoxic activity. PMID- 3311356 TI - Selective lack of intercellular communication between transformed and nontransformed cells as a common property of chemical and oncogene transformation of BALB/c 3T3 cells. AB - BALB/c 3T3 cells can be transformed by transfection of an activated cellular oncogene as well as by chemicals. When the cells were transformed by pEJ-ras transfection, a marked increase in Mr 21,000 protein expression was found by Western blotting and immunohistochemical staining, whereas no such increase was detected in cells transformed by methylcholanthrene, suggesting two different molecular mechanisms. By directly microinjecting a fluorescent dye (Lucifer Yellow CH) into individual cells, we measured junctional intercellular communication among and between transformed and surrounding nontransformed cells. In both chemical and oncogene transformation studies, transformed cells and surrounding normal cells have similar capacities for gap-junctional communication, but there was complete lack of communication between transformed and nontransformed cells. When BALB/c 3T3 cells were transformed by methylcholanthrene initiation followed by phorbol ester promotion, again we saw no intercellular communication between transformed and nontransformed cells, suggesting that the observed selective communication block between transformed and nontransformed cells may be a general phenomenon in BALB/c 3T3 cells. These results indicate that selective lack of intercellular communication between transformed and surrounding normal cells may be an important phenomenon that separates transformed cells and nontransformed cells, permitting transformed cells to maintain autonomous growth. PMID- 3311357 TI - Reactivity of monoclonal antibody 17.13. with human squamous cell carcinoma and its application to tumor diagnosis. AB - Monoclonal antibody 17.13., derived from a fusion of splenocytes of a BALB/c mouse immunized with a surgically resected poorly differentiated human laryngeal recurrent squamous cell carcinoma (SCC) with mouse Sp2/0 cells, is an IgM-K which recognizes a cytoplasmic component of basal cells. Tissue sections of malignant and normal squamous epithelium, tumors of nonsquamous origin, and normal and malignant cytological specimens were tested with an immunoperoxidase assay. Seventy-nine of 81 (98%) SCC of the head and neck, 26 of 26 (100%) SCC of the cervical and female gynecological tract, 29 of 30 (97%) SCC of the lung, 19 of 19 (100%) SCC of the oral cavity, and 17 of 17 (100%) SCC-involved neck lymph nodes reacted strongly. Various carcinomas from breast, colon, ovary, and others were unreactive. In normal squamous epithelial tissues, monoclonal antibody 17.13. reacts only with basal cells but not the cells above the basal layers. Normal tissues from heart, liver, spleen, kidney, bladder, colon, ovary, stomach, pancreas, breast, lung, prostate, thyroid, and lymph nodes were unreactive with the exception of myoepithelial cells. Monoclonal antibody 17.13. may be useful in the diagnosis and management of SCC. PMID- 3311358 TI - The chemotherapy of lymphomas: looking back, moving forward--the Richard and Hinda Rosenthal Foundation award lecture. PMID- 3311359 TI - Production of lipolytic and proteolytic factors by a murine tumor-producing cachexia in the host. AB - Animals given transplants of the MAC16 colon adenocarcinoma show a progressive decrease in carcass weight as the tumor size increases without a reduction in either fluid or caloric intake when compared with non-tumor-bearing controls. There is a decrease in both carcass fat and muscle mass which is directly proportional to the weight of the tumor. In male animals weight loss occurs when the tumor mass comprises more than 0.3% of the body weight and reaches 30% when the tumor represents 3% of the body weight. There is evidence for the production by the tumor of both lipolytic and proteolytic factors, which may be responsible for the cachexia, since two related mouse adenocarcinomas, which do not produce weight loss, have little lipolytic or proteolytic activity. The lipolytic factor is nondialyzable and is destroyed by both heat and acid. Both insulin and 3 hydroxybutyrate suppress the lipolytic activity of the tumor extract. The MAC16 tumor also contains a serine protease, the activity of which is also completely abolished by insulin and 3-hydroxybutyrate. Animals bearing the MAC16 tumor have an elevated plasma lipolytic and proteolytic activity when compared with non tumor-bearing controls, suggesting a peripheral effect of the tumor products. The catabolic factors elaborated by the MAC16 adenocarcinoma may be responsible for the loss of both the fat and nonfat carcass mass, but they do respond to normal metabolic controls. PMID- 3311360 TI - Flow cytometry and scrape-loading/dye transfer as a rapid quantitative measure of intercellular communication in vitro. AB - We describe two flow cytometric assays performed on populations of cells which have been stained with various fluorescent tracer molecules by the scrape-loading technique. One assay uses a simple one-color analysis on a flow cytometer by quantitating the fluorescence intensity of scrape-loaded lucifer yellow CH (LY) in individual cells. The other assay utilizes a two-color analysis on a cell sorter whereby cells which are initially loaded (donors) are identified by their uptake of both rhodamine isothiocyanate-dextran and LY, whereas the recipients of dye transfer are identified as having LY only. Agents which have been shown to inhibit intercellular communication in other assays exhibit similar blocking activity in LY transfer and this is readily quantitated by flow cytometry. The two-color analysis has the added advantage of being able to identify both donors and recipients in a highly quantitative manner. PMID- 3311361 TI - Application of a new method for detecting the phenotype of target binding cells. AB - A new method was developed for detecting the phenotype of target binding cells (TBC) in a single-cell assay system. This methodology was evaluated during a clinical trial of recombinant interferon alfa-2a (rIFN alfa-2a) for the treatment of 10 metastatic renal cell carcinoma patients. Total TBC with K562 targets, HNK 1+ TBC, and HLA-DR+ TBC were quantitated during rIFN alfa-2a therapy. A significantly increased proportion of lymphocytes bound to target cells on day 9 of therapy bore the HNK-1 marker. This proportion subsequently declined to pretreatment levels. Total TBC paralleled the rise and fall in HNK-1+ TBC. HLA DR+ TBC binding to targets remained constant and low throughout therapy. These findings suggest that rIFN alfa-2a early in therapy (day 9) caused the recruitment of additional HNK-1+ cells into binders. However, with continued therapy, this proportion reverts to pretreatment levels. The results of this clinical trial served to illustrate the ability of the modified single-cell assay system to detect TBC phenotype. PMID- 3311362 TI - Preparation of human saphenous vein for coronary artery bypass grafting impairs its capacity to produce prostacyclin. AB - Prostacyclin production was measured from freshly isolated human saphenous vein and from vein subjected to routine surgical preparation for coronary bypass grafting. Surgical preparation had no effect on spontaneous prostacyclin production but significantly reduced stimulated rates from 16.9(1.1) to 7.1(0.5) pg.min-1 per mg wet weight (n = 27). Stimulated prostacyclin production was not reduced by storage of vein for 2 h at 23 degrees C in blood or saline nor by distension, but it was reduced to 5.0(0.6) pg.min-1 per mg (n = 10) by de endothelialisation. Reduced prostacyclin production, which might in itself contribute to vein graft occlusion, provides a quantitative biochemical estimate of endothelial integrity. PMID- 3311363 TI - Validation of beat by beat pulsed Doppler measurements of ascending aortic blood velocity in man. AB - The volume, velocity, and acceleration of ascending aortic blood were measured in man using a pulsed Doppler ultrasound instrument, with online spectral analysis and offline computer processing of velocity data. This system was firstly validated in a test rig capable of generating pulsatile flow of talc particles in water at physiological velocities and accelerations in a model aorta. Doppler measurements correlated well (r greater than or equal to 0.90) with simultaneous electromagnetic measurements of stroke volume, peak ejection velocity, and maximum acceleration in this rig. In vivo validation was performed firstly by comparing simultaneous Doppler and thermodilution cardiac output (Q) measurements; this yielded the following regression equation: Doppler Q = 0.90 X thermodilution Q + 0.03 litre.min-1, r = 0.92; n = 38. Beat by beat measurements were then validated against simultaneous invasive aortic blood velocity measurements made using a Mills electromagnetic cathetertip probe. When paced single beats of different size were compared within subjects the correlation coefficients between Doppler and electromagnetic measurements averaged 0.89 for stroke volume, 0.91 for peak ejection velocity, and 0.79 for maximum acceleration in five subjects. The absolute values for velocity and acceleration from the Doppler system differed significantly from the absolute values given by the electromagnetic system and this difference was not consistent between subjects. It is concluded that the Doppler system can non-invasively record relative changes in left ventricular ejection in man. PMID- 3311364 TI - A clinical trial of clobetasol propionate in Filipino vitiligo patients. AB - Twenty-five patients with vitiligo lesions were treated intermittently with topical clobetasol propionate cream over a period of eight months or less. After six months of treatment, 22 of the 25 patients showed at least 90% repigmentation. The age of the patient, duration and anatomic site of the lesion, and presence or absence of achromotrichia proved to be significant prognosticators of the response to therapy. The results of the study suggest a possible simplified therapeutic option for this skin disorder. PMID- 3311365 TI - Cerebellar lectin "R1" is related to the receptor of circulating mannosyl glycoproteins of liver sinusoidal cells. PMID- 3311366 TI - Insulin interaction with model membrane systems. PMID- 3311367 TI - Distribution of the major connective matrix components of the stromal reaction in breast carcinoma. An immunohistochemical study. PMID- 3311369 TI - [The present status in the development of immunologic methods]. PMID- 3311370 TI - [Hospitals in Old Prague. I. The development of hospitals in Europe and the beginnings of hospitals in Prague]. PMID- 3311368 TI - [The first clinical and electrocardiographic diagnosis of myocardial infarct in Czechoslovakia]. PMID- 3311371 TI - [Lymphedema (lymphostasis disease) of the extremities. Present views on the definition, diagnosis, and therapy]. PMID- 3311373 TI - [Hospitals in Old Prague. II. Pre-Hussite Prague hospitals]. PMID- 3311372 TI - [Ketanserin in ischemic disease of the lower extremities. Results of a double blind cross-over study]. PMID- 3311374 TI - [Determination of theophylline levels--modification of the spectrophotometric method]. PMID- 3311375 TI - [Diseases and drugs in the life of Jan Neruda]. PMID- 3311376 TI - [Use of radioactive agents in pregnant women]. PMID- 3311377 TI - [Captopril in the treatment of chronic congestive heart failure]. PMID- 3311378 TI - [Rapid detection of Chlamydia trachomatis using monoclonal antibodies in the immunofluorescence test]. PMID- 3311380 TI - Immunocytochemical localization of a novel pituitary polypeptide "7B2" in the gastro-intestinal tract of the rat. AB - Immunoreactivity to the polypeptide designated "7B2" recently isolated from human and porcine pituitary glands, appears to be consistently confined to neuroendocrine and endocrine cells in various tissues. In rat gut, immunoreactive 7B2 was found in endocrine-paracrine cells. Highly labeled cells were found in the antrum of the stomach and, cells with lower concentrations, in the fundus, duodenum, jejunum and ileum. Except for a few cells which were simultaneously positive for 5-hydroxytryptamine, and a few others showing Grimelius's reaction, "7B2" cells do not exhibit argentaffin and/or argyrophil character. The 7B2 polypeptide seems to be distributed amongst several different types of endocrine cells in the gut. PMID- 3311379 TI - Electron-microscopic immunogold localization of a collecting-duct antigen (PCD2) in intercalated and principal cells of rabbit kidney. AB - A monoclonal antibody against an antigen (PCD2) derived from the rabbit renal papilla recognized principal and intercalated cells of the collecting duct system in the adult rabbit kidney. Intercalated cells were heterogeneous in the connecting tubule and the cortical collecting duct, where immunoreactive and unreactive cells were shown to coexist. In the outer medullary collecting duct, all intercalated cells exhibited PCD2-immunoreactivity. Connecting tubule cells proper were not recognized by the antibody, whereas all principal cells of the collecting duct revealed specific immunoreactivity. The immunocytochemical heterogeneity of the intercalated cells is discussed in terms of a functional heterogeneity. Cytologically, the immunogold labeling of principal and intercalated cells was shown to occur along the plasmalemma, in the intracellular membrane structures and along the Golgi transport route. This pattern suggests that the antigenic determinant, which is ubiquitous in both principal and reactive intercalated cells, belongs to a membrane protein. PMID- 3311381 TI - Origin of the right coronary artery from the descending thoracic aorta: angiographic diagnosis and unique coronary artery anatomy at autopsy. AB - An infant born at term with hypoplastic left heart syndrome was found angiographically to have an anomalous artery arising from the descending thoracic aorta which supplied the posterior and right coronary branches. Morphologically, the right coronary artery had atypical and striking elastotic changes and wall thickening. PMID- 3311382 TI - Control of variant surface antigen switching in trypanosomes. PMID- 3311383 TI - From genes to structural morphogenesis: the genesis and epigenesis of a red blood cell. PMID- 3311384 TI - Teratocarcinoma stem cells and early mouse embryos contain only a single major lamin polypeptide closely resembling lamin B. AB - The nuclear lamina in adult mammalian somatic cells is composed of three major proteins, lamins A, B, and C. The expression of these proteins during the differentiation of teratocarcinomas and mouse embryogenesis is described. Embryos up to day 8 of gestation and embryonal carcinoma (EC) cells express only a single lamin species closely resembling, if not identical to, lamin B. Lamins A and/or C were detected in fertilized eggs, but disappear during the first 2-4 cleavage divisions, only reappearing in 8 day post-implantation embryos. These two lamins are absent from EC cells, but are strongly expressed in some of their derivatives. These results show that cells of the early mouse embryo do not have a functional requirement for lamins A and C and imply that the structural organization of the nucleus may change fundamentally during embryogenesis. PMID- 3311385 TI - The in vivo replication origin of the yeast 2 microns plasmid. AB - We have used two-dimensional neutral/alkaline agarose gel electrophoresis to separate the nascent strands of replicating yeast 2 micron plasmid DNA molecules according to extent of replication, away from nonreplicating molecules and parental strands. Analysis of the lengths of nascent strands by sequential hybridization with short probes shows that replication proceeds bidirectionally from a single origin at map position 3700 +/- 100, coincident with the genetically mapped ARS element. The two recombinational isomers of 2 microns plasmid (forms A and B) replicate with equal efficiency. These results suggest that ARS elements may prove to be replication origins for chromosomal DNA. PMID- 3311386 TI - Lymphocyte function-associated antigen 1 (LFA-1) and natural killer (NK) cell activity: LFA-1 is not necessary for all killer: target cell interactions. AB - A panel of five monoclonal antibodies detecting human lymphocyte function associated antigen 1 (LFA-1) was generated and shown by competitive binding studies to react with at least four distinct epitopes on this molecule. The antibodies were then tested for their ability to inhibit the lytic activity of a variety of different human natural killer (NK) populations on a panel of four NK susceptible target cells (K562, MOLT-4, HSB-2, and Jurkat). When heterogeneous NK populations derived from fresh peripheral blood and mixed-lymphocyte culture (MLC)-generated lines were used, these anti-LFA-1 monoclonal antibodies (MAbs) inhibited lysis of all four NK targets; this finding supports the notion that LFA 1 molecules play an important role in NK-mediated lysis. When tested on a cloned line of NK cells (NK 3.3), lysis of K562 was inhibited by these MAbs, but lysis of the other three targets was not affected. This represents an instance where a MAb specific for LFA-1 inhibits the lytic activity of NK cells against some but not all targets; thus the LFA-1 molecule cannot be considered under all circumstances to be an absolute requirement in NK-mediated lysis. PMID- 3311387 TI - NK sensitivity of H-ras transfected fibroblasts is transformation- independent. AB - We have examined the hypothesis that NK cells can preferentially recognize fibroblasts transformed by the H-ras oncogene. 10T1/2 fibroblasts were transfected with the activated T24-H-ras gene and five clones were isolated on the basis of increasingly transformed colony morphology and H-ras expression. A highly significant correlation between H-ras RNA levels and NK lytic sensitivity was observed. However, NIH-3T3 transfected with activated EJ-c-H-ras or transforming amounts of the c-H-ras proto-oncogene were not more NK sensitive than the parental line. Furthermore, induction of H-ras transcription in NIH-3T3 cells transfected with v-H-ras under the control of a glucocorticoid-sensitive MMTV LTR had little effect on lytic sensitivity. These results indicate that the ras-induced increase in NK sensitivity was dependent on the induction of specific cellular characteristics in the recipient fibroblast lines and was not directly related to the transformation event. PMID- 3311388 TI - [Immunochemical determination of antithrombin III]. PMID- 3311389 TI - [Methods of monitoring therapeutic agents. I. Use of homogeneous fluorescence immunoanalysis with substrate markers]. PMID- 3311390 TI - [Steroidogenesis in ovarian tumors]. PMID- 3311391 TI - [The early development of pathologic physiology in Slovakia]. PMID- 3311392 TI - [Review of the comparative endocrinology of calcium and calciotropic effects]. PMID- 3311393 TI - [Aging, elastin and yellow pigments]. PMID- 3311394 TI - [Jan Evangelista Purkinje and the development of ophthalmoscopy]. PMID- 3311395 TI - [Purkinje's study of the anterior segment of the eye]. PMID- 3311396 TI - [Specular microscopy in the endothelium rejection reaction after corneal transplant]. PMID- 3311397 TI - [The personage of docent Eva Sedlackova in the history of Slovak phoniatrics]. PMID- 3311398 TI - [Johannes Evangelista Purkinje from the viewpoint of a pathologist. On the 200th anniversary of his birth--17 December 1787]. PMID- 3311399 TI - [Computerized systems and their use in pathology]. PMID- 3311400 TI - [Detection of class II human transplantation antigens in paraffin sections]. PMID- 3311401 TI - [The reticulo-spinal system. Its role in the organization of the motor segment phase: postural function, locomotion, specific (intentional) movements. I]. PMID- 3311402 TI - [130th anniversary of the birth of Dr. Julius Wagner-Jauregg]. PMID- 3311403 TI - [Prof. Josef Svejcar, D. Sc.--90 years old]. PMID- 3311404 TI - [The Czech Pediatric Clinic at the Prague Foundling Home in my memory and in my life]. PMID- 3311405 TI - [Purkinje's path to the biology and training of children]. PMID- 3311406 TI - [Post-initial remission of diabetes in childhood]. PMID- 3311407 TI - [Levels of lipoproteins and hormonal indicators in children of diabetic mothers]. PMID- 3311408 TI - [Pancreatic antibodies in parotitic pancreatitis]. PMID- 3311409 TI - [Acute examination using computer tomography and ultrasonography]. PMID- 3311411 TI - DNA damage by 5-nitro-2-furylacrylic acid, a nitrofuran derivative. AB - 5-Nitro-2-furylacrylic acid (5-NFA) caused dose dependent inhibition of growth of Escherichia coli K-12 strain AB 2480 (uvr-, rec-), the 37% (D37) and 10% (D10) survival doses being 1.0 microgram/ml.h and 1.75 micrograms/ml.h, respectively. Although much higher doses of drug were required to achieve comparable inhibition of growth of E. coli strain 1157 (repair proficient), significant filamentation of these cells was produced by treatment with 1.0 microgram/ml 5-NFA for 4 hr. Ultraviolet absorption data and thermal chromatography through hydroxyapatite (HAP) column revealed that 5-NFA treatment of E. coli strain AB 2480 produced more than 80% of DNA reversibly bihelical due to the formation of interstrand cross-links and the initial part of the reaction obeyed a first order relation. 5 NFA also produced dose-dependent increase of prophage induction in E. coli strain GY 5027: envA, uvrB, ampA1, strA (lambda). The implications of the action of 5 NFA on DNA in relation to the induction of 'SOS' functions and carcinogenesis were discussed. PMID- 3311410 TI - Changes in autorhythmic heart frequency elicited by redox agents. AB - In isolated frog heart it was established that methylene-blue (MB, an oxidizing agent) decreased, while ascorbate (ASC, a reducing agent) increased the frequency of autorhythmic heart contractions. After MB treatment, in parallel with this phenomenon, the extracellular K+ concentration [K+]o showed a slow increase, but following ASC application a slow decrease occurred. Since these correlations are in good accordance with the idea that the pacemaking ability of heart, among other properties, depends on the voltage and time-dependent decrease in potassium conductance following the spike, changes in [K+]o might be one mechanism by which oxidizing and reducing agents modulate heart frequencies. On the basis of the effect of insulin (INS) and K-strophantoside (STR) on these modulatory influences, it is presumed that the changes in slow delta [K+]o transients might result, at least partly, from the effect of redox agents on the active transport system. In light of the increase in passive K+ fluxes after oxidant treatment and the decrease in this parameter following reductant treatment an effect of redox agents on the characteristics of the K+-channel is also postulated. PMID- 3311412 TI - Model-based relationship between physicochemical properties and inhibitory potency of alkylating 2-furylethylenes on yeast glycolysis. AB - Inhibitory effects of 35 2-furylethylenes, non-specific alkylating agents, on glycolysis in a respiratory mutant of Saccharomyces cerevisiae were correlated with their 1-octanol/water partition coefficients and the rate constants for reaction with 2-mercaptoacetic acid using physiologically based models. The simplest model explaining the data satisfactorily consists of two-step drug receptor interaction involving reversible formation of a structurally non specific non-covalent complex stabilized later covalently. The concentration of the free drug in the receptor surroundings was related to its initial concentration in external medium via a simple form of a disposition function constructed on the basis of time hierarchy of passive membrane transport, non covalent binding to cell constituents and metabolic inactivation of the drug. PMID- 3311414 TI - [Nursing care in digital subtraction angiography]. PMID- 3311413 TI - Antimalarial agents. III. Mechanism of action of artesunate against Plasmodium berghei infection. PMID- 3311415 TI - Co-oxidation of xenobiotics: lipid peroxyl derivatives as mediators of metabolism. AB - Systems which carry out peroxyl-dependent oxidations can serve as activation systems for carcinogenic compounds. Some function via classical peroxidase reactions in which an enzyme-derived oxidant performs the electron abstraction from or oxygen donation to the oxidizable substrate. This mechanism applies to the peroxidative activation of aromatic amines and of the phenolic compound diethylstilbestrol. These classical peroxidase reactions may be initiated by hydrogen peroxide or by organic peroxides, including lipid hydroperoxides. A different mechanism is involved in the oxygenation of polycyclic aromatic hydrocarbons and of aflatoxin B1. In these cases the oxidant is a peroxyl radical, and the reaction occurs by the direct, non-enzymatic interaction of the peroxyl radical and the oxidizable substrate. Most peroxyl radicals in biological systems are lipid-derived. The key reaction which distinguishes the peroxyl radical-dependent oxidations from the classical peroxidase reactions is the ability of the former to epoxidize activated carbon-carbon double bonds. The epoxidation of benzo[a]pyrene derivatives has been studied extensively in subcellular and whole cell and tissue systems, and is discussed as a model for this class of reaction. Determining the generality of this activation path and its role in vivo present the major questions to be answered in regard to the importance of these reactions in chemical carcinogenesis. PMID- 3311416 TI - Biophysical consequences of lipid peroxidation in membranes. AB - This article reviews the biophysical consequences of lipid peroxidation in biological membranes. In the lipid domain, lipid peroxidation (a) causes an increase in the order and "viscosity" of the membrane bilayer, particularly at the depth around acyl-carbon 12, (b) changes the thermotropic phase behaviour, (c) decreases the electrical resistance, and (d) facilitates phospholipid exchange between the two monolayers. Upon lipid peroxidation membrane proteins are crosslinked, and their rotational and lateral mobility is decreased. Studies with microsomal cytochrome P-450 suggest protein aggregation but not the increased lipid order to be the major cause of protein immobilization in peroxidized membranes. PMID- 3311417 TI - The role of physiological oxygen partial pressures in lipid peroxidation. Theoretical considerations and experimental evidence. AB - The oxidative breakdown of membrane lipids, i.e. lipid peroxidation, is considered to be decisively involved in a number of toxicological and pathological processes including liver injury caused by iron overload and halogenated alkanes such as CCl4. Within the physiological oxygen partial pressure (PO2) range, i.e. at PO2 between 1 and 100 mmHg, lipid peroxidation depends on O2 in a complex manner. For instance, CCl4-induced lipid peroxidation exhibits a distinct maximum at PO2 of around 7 mmHg, and iron-induced lipid peroxidation shows marked differences in its O2 dependence between an early lag phase and a later phase of self-accelerating propagation. The O2 dependence of lipid peroxidation is either determined by the O2 dependence of initiation or the O2 dependence of propagation. Factors decisive for this are presented and the underlying alterations in the pattern of the peroxidation-related reactions delineated. PMID- 3311418 TI - Antioxidants in relation to lipid peroxidation. AB - The role of antioxidants in lipid peroxidation is reviewed. Specifically, the rate and mechanism of inhibition of lipid peroxidation by water-soluble and lipid soluble, chain-breaking antioxidants have been discussed. PMID- 3311419 TI - The role of selenium peroxidases in the protection against oxidative damage of membranes. AB - The present review deals with the chemical properties of selenium in relation to its antioxidant properties and its reactivity in biological systems. The interaction of selenite with thiols and glutathione and the reactivity of selenocompounds with hydroperoxides are described. After a short survey on distribution, metabolism and organification of selenium, the role of this element as a component of the two seleno-dependent glutathione peroxidases is described. The main features of glutathione peroxidase and phospholipid hydroperoxide glutathione peroxidase are also reviewed. Both enzymes reduce different hydroperoxides to the corresponding alcohols and the major difference is the reduction of lipid hydroperoxides in membrane matrix catalyzed only by the phospholipid hydroperoxide glutathione peroxidase. However, in spite of the different specificity for the peroxidic substrates, the kinetic mechanism of both glutathione peroxidase and phospholipid hydroperoxide glutathione peroxidase seems identical and proceeds through a tert-uni ping pong mechanism. In the reaction cycle, indeed, as supported by the kinetic data, the oxidation of the ionized selenol by the hydroperoxide yields a selenenic acid that in turn is reduced back by two reactions with reduced glutathione. Special emphasis has been given to the role of selenium-dependent glutathione peroxidases in the prevention of membrane lipid peroxidation. While glutathione peroxidase is able to reduce hydrogen peroxide and other hydroperoxides possibly present in the soluble compartment of the cell, this enzyme fails to inhibit microsomal lipid peroxidation induced by NADPH or ascorbate and iron complexes. On the other hand, phospholipid hydroperoxide glutathione peroxidase, by reducing the phospholipid hydroperoxides in the membranes, actively prevents lipid peroxidation, provided a normal content of vitamin E is present in the membranes. In fact, by preventing the free radical generation from lipid hydroperoxides, phospholipid hydroperoxide glutathione peroxidase decreases the vitamin E requirement necessary to inhibit lipid peroxidation. Finally, the possible regulatory role of the selenoperoxidases on the arachidonic acid cascade enzymes (cyclooxygenase and lipoxygenase) is discussed. PMID- 3311420 TI - Involvement of lipid oxidation products in the formation of fluorescent and cross linked proteins. AB - Age-related fluorescent and cross-linked proteins increase with lipid oxidation of tissues. The fluorophores and cross-links have been considered to be conjugated Schiff bases between amino groups of proteins and malonaldehyde. Our recent studies showed that the fluorophores produced in the in vitro reaction of proteins with malonaldehyde are 1,4-dihydropyridine-3,5-dicarbaldehydes, whose fluorescence characteristics are similar to but not always the same as those of the age-related fluorescent substances, and that the cross-linking is due to less fluorescent conjugated Schiff bases. The in vitro reaction of proteins with oxidized lipids produces fluorescent and cross-linked proteins similar to those in the aging cells or tissues. Monofunctional aldehydes such as alkanals, alk-2 enals and alka-2,4-dienals can also participate in the formation of the fluorophores and cross-links. The fluorescent substances produced from the reaction of primary amines or proteins with these aldehydes showed spectra close to those of the age-related fluorescent substances. PMID- 3311421 TI - Lipofuscin and lipofuscin-like substances. AB - Lipofuscin is defined as being a yellowish brown, lipid-rich, heterogeneous, cytoplasmic granular pigment emitting an intense yellow autofluorescence when excited with ultraviolet light, which accumulates in various tissues of animals during their aging. It is believed that the pigments are derived from the reaction of some of reactive secondary products including malonaldehyde, formed during membranous lipid peroxidation, with amino groups of phospholipids and proteins, etc., and that these formations are accompanied by alteration of the membrane structure and inactivation of the enzymes. The fluorescence measurement of the pigments is widely used as a parameter of lipid peroxidation in vivo as well as in vitro. However, their origin, chemical structure, biological significance or fate has not as yet been fully elucidated. This article introduces and discusses the recent studies on these problems. PMID- 3311422 TI - Secondary products of lipid oxidation. AB - In the last decade, a multitude of secondary products have been identified from the radical and photosensitized oxidations of polyunsaturated lipids. These secondary products consist of oxygenated monomeric materials including epoxy hydroperoxides, oxo-hydroperoxides, hydroperoxy epidioxides, dihydroperoxides, hydroperoxy bis-epidioxides, and hydroperoxy bicycloendoperoxides. More recently, higher molecular weight dimeric compounds have been identified from autoxidized methyl linoleate and linolenate. Decomposition of these oxidation products form a wide range of carbonyl compounds, hydrocarbons, furans, and other materials that contribute to the flavor deterioration of foods and that are implicated in biological oxidation. The interaction of some of these degradation products with DNA may be involved in cell-damaging reactions. PMID- 3311424 TI - Rationale and recommendations for the irradiation of blood products. AB - Blood products are often irradiated to prevent proliferation of lymphocytes which could cause graft-vs.-host disease in immunocompromised recipients. The effects of irradiation on the function of blood components is discussed. It is concluded that 1500 rad is sufficient to prevent lymphocyte proliferation and production of graft-vs.-host disease in vivo, although 10 to 20% of lymphocytes are still capable of proliferation in vitro after 1500 rad. Neutrophils and erythrocytes are extremely radioresistant and their function is unaffected by 1500 rad. There is limited data to suggest that platelet yields may be slightly reduced following irradiation. Guidelines for the use of irradiated blood products are suggested. PMID- 3311423 TI - Cholesterol autoxidation 1981-1986. AB - Literature published between 1980 and 1986 dealing broadly with the topic of cholesterol autoxidation is reviewed. The review builds on the detailed 1981 monographic treatment of the topic by the author and covers new items of chemistry, analysis, and metabolism. PMID- 3311425 TI - Clinical significance of long-term cultures of myeloid blood cells. AB - The long-term maintenance of primitive hemopoietic precursor populations in cultures of human marrow was first described in 1981. This system, which was developed following previous work with murine marrow, appears to establish conditions that reproducibly allow the continuous turnover of a number of primitive progenitor cells, detected by their capacity upon transfer into semisolid assay cultures to generate limited numbers and types of mature blood cells. If not transferred, only those hemopoietic cells that are committed to the granulopoietic pathway are able to undergo terminal maturation. The demonstrated localization of the most primitive hemopoietic cells within the adherent fraction, primarily composed of nonhemopoietic mesenchymal elements expressing markers of fibroblasts, adipocytes, endothelial cells, and smooth-muscle cells has provided indirect evidence that interactions between these cells may be key to the survival and functional integrity of normal stem cells in this system. Such a concept has received additional support from recent studies on the cell cycle control of primitive hemopoietic cells located in and dependent on this adherent network of nonhemopoietic elements. Applications of this culture system to neoplastic populations of hemopoietic cells has revealed a number of intriguing differences in their behavior. Under conditions where maintenance of neoplastic hemopoiesis can be achieved, the most primitive progenitor classes remain continuously in cycle as they do in vivo. Thus the same inability to respond to signals that induce a noncycling state in their normal counterparts appears to be reproduced in the long-term culture system. For some populations, e.g., most CML marrows and many AML marrows, neoplastic hemopoiesis fails to become established. Although the reasons for this are not yet clear, this behavior is of interest, not only because it offers a sensitive method for detecting residual normal cells, but also as a practical approach to purging marrows of leukemic cells for autologous marrow transplantation. PMID- 3311426 TI - Therapeutic considerations in childhood idiopathic thrombocytopenic purpura. AB - This monograph reviews the literature regarding therapy for childhood idiopathic thrombocytopenic purpura (ITP). The role and mechanism of action are discussed for corticosteroids, splenectomy, and intravenous gamma globulin. Alternative therapies with potent immunosuppressive agents are also mentioned. Guidelines for the management of children with ITP are presented. PMID- 3311428 TI - [Cataract after bone marrow grafts]. PMID- 3311427 TI - Immunopathology of childhood idiopathic thrombocytopenic purpura. AB - Modern laboratory techniques have begun to elucidate the pathophysiology of chronic childhood ITP. Quantitative assays of PAIgG, complement, immune complexes, and platelet kinetic studies have all provided important information. Chronic ITP of childhood appears to be similar to adult ITP, with production of an antibody directed against platelets and megakaryocytes. Most of the antibody is produced in the spleen, but other parts of the RES can also produce antibody. Complement, immune complexes, and cell-mediated immunity may play a role in the pathogenesis. Sensitized platelets are cleared by the RES, particularly in the spleen. Platelet kinetic studies show that platelet turnover is usually rapid with compensatory increased thrombopoiesis, but there are some patients who have decreased thrombopoiesis. Acute ITP of childhood is a brief illness, characterized by abrupt onset of hemorrhagic symptoms and complete recovery. It often follows a viral illness, suggesting that immune complexes as well as antibodies are important in the pathogenesis. Both the spleen and liver may be important organs of immune clearance. PMID- 3311430 TI - [Waterhouse-Friderichsen syndrome: surgical aspects]. PMID- 3311429 TI - [Keratomileusis without freezing. Krumeich's technic. Technic. Indications. Results]. PMID- 3311431 TI - [Study of anti-reticulin and anti-gliadin antibodies for the diagnosis of celiac disease]. PMID- 3311432 TI - Comparison of midazolam and diazepam to supplement total intravenous anaesthesia with ketamine for endoscopy. AB - Fifty patients undergoing endoscopy (laryngoscopy, bronchoscopy, mediastinoscopy) were anaesthetised in a double-blind prospective trial using total intravenous anaesthesia. Half of the patients were anaesthetised with an infusion of a solution of 250 mg ketamine and 12.5 mg midazolam. The other patients received an infusion of a solution of 250 mg ketamine and 20 mg diazepam. In addition, both groups were given increments of 50-100 micrograms of fentanyl. The immediate awakening time (t1) was not significantly different between groups, but the patients who had received midazolam-ketamine, had a significantly shorter time to more complete recovery (t2), a significantly lower frequency of emergence reactions and were more satisfied with the anaesthetic than the patients who had received diazepam-ketamine. There was no difference between groups with respect to intraoperative heart rate and blood pressure. No awareness during anaesthesia was reported. PMID- 3311433 TI - Determining gastric contents during general anaesthesia: evaluation of two methods. AB - Two methods used to measure the volume of gastric contents were evaluated in 24 supine anaesthetized adults. Methods compared were: (1) aspiration of stomach contents through a large, vented, multi-orificed gastric tube, and (2) indirect determination by a dye dilution method using polyethylene glycol (PEG) as the marker. The volumes determined by these methods (Vasp and Vpeg respectively) were compared to the total volume (Vtot) present in the stomach, determined by direct inspection of the gastric pouch by the surgeon at the beginning of surgery. The results show that the volume of aspirated gastric fluid, using this type of tube, is a very good estimate of the total volume of gastric residue. The PEG dilution method yields similar results. However, correlation between Vpeg and Vtot was not as close-fitting as the correlation between Vasp and Vtot. PEG dilution is more complicated, time-consuming and offers no advantage over aspiration. PMID- 3311434 TI - The earliest ether anaesthetic in British North America--a first for Saint John, New Brunswick? AB - Literature relating the early history of ether anaesthesia in New Brunswick which, as part of British North America was a British colony until 1867, is reviewed. There is documentary evidence that the first ether anaesthetic for dental surgery in what is now Canada, was administered in 1844 in St. John, New Brunswick. There is also documentary evidence that the first ether anaesthetic for general surgery was administered in St. John on Monday, January 18, 1847, rather than in Montreal in March, 1847. PMID- 3311435 TI - Clinical use of peripheral nerve stimulators in anaesthesia. AB - The use of the peripheral nerve stimulator is essential for adequate assessment of the degree of neuromuscular block. To ensure that the data derived are accurate one must understand the effects of stimulus frequency, electrode type, position and polarity, stimulus intensity, duration, waveform and the various ways used to observe the data, electromechanical, EMG, tactile or visual. Once these features are understood, a better interpretation of the various tests is possible. While a lot of information regarding the proper use of the PNS is derived from meticulous scientific experimentation, it is possible to apply this information for clinical use. Most information is available based on ulnar nerve stimulation. Information on stimulation of other nerves (e.g., current to achieve SMS on the peroneal nerve) is lacking. With this in mind, the authors present in Table III the minimum requirements for a PNS and an algorithm to illustrate use of the PNS, in Figure 6. PMID- 3311436 TI - Antibodies to Pf155, a major antigen of Plasmodium falciparum: seroepidemiological studies in Haiti. AB - The presence of malaria parasites and the serological antibody responses against whole Plasmodium falciparum and the Pf155 antigen were studied in the population of a small rural locality in Haiti in December 1985. Only 7 (1.5%) of the individuals were found to be infected with P. falciparum, the only species observed. Antibodies to P. falciparum were detected in an ELISA in 38.2% of the sera, the positivity rates being age-related. Anti-Pf155 antibodies were detected in 12.5% and 13.6% of individuals by two different techniques used. The anti Pf155 positivity rates increased only after 25 years of age. No trends were detected for a clear-cut protective value of Pf155 antibodies against clinical malaria and further longitudinally conducted field surveys are needed to satisfactorily assess the potential protective effect of Pf155 antibodies. PMID- 3311437 TI - Evaluation of an in vitro test method for the assessment of sensitivity of Plasmodium falciparum to pyrimethamine and sulfadoxine. AB - Twenty three Plasmodium falciparum isolates collected from two highly pyrimethamine/sulfadoxine-resistant areas of Thailand were evaluated for their in vitro responses to pyrimethamine, sulfadoxine and combinations of these two drugs in various conditions. The test procedure was based on inhibition of parasite multiplication and of schizont formation, using the recommended modified RPMI medium 1640 with PABA 0.5 mug per litre and folic acid 10 mug per litre (LPLF). The optimum blood/medium ratios and inoculum sizes for parasite multiplication and for schizont formation were 1:19, 100 mul/well and 1:9, 50 mul/well, respectively. The appropriate incubation period was 48 hours. It was found that inhibition of either parasite multiplication or schizont formation could be used as the endpoint for evaluating the antiplasmodial action of pyrimethamine and combined pyrimethamine/sulfadoxine in vitro for field investigations; however, inhibition of only parasite multiplication should be used for determination of sulfadoxine activity. The actions of pyrimethamine in the combination pyrimethamine/sulfadoxine in ratios of 1:80 and 1:200 were similar. In vitro testing using combined pyrimethamine/sulfadoxine should be more precise than pyrimethamine alone for monitoring parasite susceptibility to the combined drug (Fansidar). PMID- 3311438 TI - A phase II/III double-blind, dose-finding clinical trial of a combination of mefloquine, sulfadoxine, and pyrimethamine (Fansimef) in falciparum malaria. AB - Fansimef is a combination of 250 mg mefloquine (base), 500 mg sulfadoxine, and 25 mg pyrimethamine per tablet. One hundred and fifty adult male Brazilian patients at Belem (Para), who had peripheral blood smears positive for Plasmodium falciparum, with or without clinical symptoms of falciparum malaria, were treated in a double-blind randomized fashion with either one, two or three tablets of Fansimef. Of those receiving one tablet (48 patients), 81% were cured and 19% exhibited RI recrudescences. All the patients receiving two or three tablets of Fansimef (49 patients in each group) were cured. The rates of initial clearance of parasitaemia and fever were similar in all treatment groups. Tolerance was good at all dose levels. The main side-effects included nausea, vomiting, dizziness, diarrhoea and abdominal pain, but these were mild and transient and required no specific treatment. The incidence of vomiting and nausea was highest in patients given the three-tablet dose. The results of various haematological, biochemical and urine analyses were not adversely altered by the administration of Fansimef. PMID- 3311441 TI - The efficiency of sporozoite transmission in the human malarias, Plasmodium falciparum and P. vivax. AB - Reported are malaria sporozoite and inoculation rates over a 1-year period in eight epidemiologically defined villages of different endemicity in Madang Province, Papua New Guinea. In the study, more than 41 000 wild-caught mosquitos were analysed for Plasmodium falciparum and P. vivax sporozoites by ELISA. In a given village the entomological inoculation rates correlated strongly with the prevalences of both these malarial parasites in children. However, the prevalence of P. falciparum infections in children was much higher than that of P. vivax, despite similar inoculation rates for the two species. These data suggest that in Papua New Guinea P. falciparum is more efficiently transmitted than P. vivax from mosquito to man. The increased efficiency of transmission of P. falciparum may be due to the heavier sporozoite densities in wild-caught mosquitos naturally infected with P. falciparum sporozoites that were tenfold greater than the sporozoite densities in mosquitos infected with P. vivax. PMID- 3311439 TI - Mefloquine, sulfadoxine, and pyrimethamine in the treatment of symptomatic falciparum malaria: a double-blind trial for determining the most effective dose. AB - A total of 89 adult male Thai patients who had acute, uncomplicated falciparum malaria were treated in a double-blind randomized trial with a single oral dose of two or three tablets, each consisting of 250 mg mefloquine, 500 mg sulfadoxine, and 25 mg pyrimethamine (MSP). The two-tablet regimen produced a cure rate (S response) of 93%, the three-tablet regimen a cure rate of 98%. The mean duration of parasitaemia for the two- and three-tablet groups was 50 and 29 hours, respectively, while the mean duration of fever was 43 and 40 hours, respectively. Differences between the groups were not statistically significant. Tolerance was good at both dose levels. The main side-effects were abdominal discomfort, nausea, vomiting, dizziness, and diarrhoea, but these were mild, transient, and required no specific treatment. The results of haematological and biochemical investigations and of urinalysis revealed no drug-related changes following administration of MSP. The electrocardiograms of some patients revealed sinus bradycardia or sinus arrythmia, but these conditions were transient, symptomless, and clinically not significant. PMID- 3311442 TI - Breast self-examination for the early detection of breast cancer: a USSR/WHO controlled trial in Leningrad. AB - Breast self-examination (BSE) is of great potential value for the early detection of breast cancer, especially in areas where mammography and regular examinations by physicians are not practicable. However, BSE cannot be recommended for routine public health practice until there is good evidence that it is effective in reducing mortality from breast cancer. Prospective controlled trials of BSE were therefore initiated in 1985 in Leningrad and Moscow, under the auspices of WHO, in order to establish the value of this potentially cost-effective technique. More than 62 000 women aged 40-64 years have been enrolled in the BSE and control groups in Leningrad and another 88 000 will be added in the next three years. This paper presents the results of the study in Leningrad after the first 15 months. PMID- 3311440 TI - A double-blind trial of a fixed combination of mefloquine plus sulfadoxine pyrimethamine compared with sulfadoxine-pyrimethamine alone in symptomatic falciparum malaria. AB - A total of 100 male Zambian patients with symptomatic falciparum malaria were treated with either two tablets of mefloquine plus sulfadoxine-pyrimethamine (Fansimef) or three tablets of sulfadoxine-pyrimethamine (Fansidar) as a single dose. The patients were kept under observation from day 0 (day of treatment) to day 28 and all were cured. An S-type of response was seen in all patients; one patient in the Fansimef group inexplicably remained positive for Plasmodium falciparum trophozoites until day 6. There were no cases of recrudescence.The rate of clearance of parasitaemia was similar in both groups. The rate of clearance of fever was marginally faster in the Fansimef group. Side-effects such as pruritus, diarrhoea and abdominal pain occurred after both drugs but were mild and transient; tolerance was slightly better with Fansimef. Severe orthostatic hypotension occurred in 20% of the Fansidar patients and in only 2% of the Fansimef patients; this was reversed by bed rest. Haematological and biochemical parameters were generally not modified in an undesirable manner by the administration of these drugs. PMID- 3311443 TI - Infections associated with milk and dairy products in Europe and North America, 1980-85. AB - Outbreaks of infection associated with milk and other dairy products in Europe and North America from 1980 to 1985 are reviewed. Salmonella spp. and Campylobacter spp. were the most commonly identified etiological agents, while other infections of animal origin, in particular listeriosis and yersiniosis, were increasingly reported. Most infections were attributed to untreated cows' milk or cheese, but also increasingly to contaminated "heat-treated" products. Heat-treatment is highly effective in controlling foodborne disease, but may be insufficient if not complemented by high standards of hygiene throughout production and processing. Large community outbreaks of salmonellosis, listeriosis, and yersiniosis in Canada, Sweden, the United Kingdom, and the USA that were associated with contaminated "heat-treated" liquid milk, powdered milk, or cheese emphasize the vulnerability of dairy produce. PMID- 3311444 TI - Interaction of cimetidine with oral melphalan. A pharmacokinetic study. AB - The effects of pretreatment with cimetidine (200 mg three times daily, 400 mg at night) on the pharmacokinetics of oral melphalan (10 mg) have been investigated in patients with multiple myeloma. Cimetidine pretreatment reduced the bioavailability of oral melphalan by approximately 30% (P less than 0.05). The elimination rate of melphalan from plasma was significantly increased by cimetidine (P less than 0.05), the half-life being reduced from 1.94 +/- 0.55 h to 1.57 +/- 0.53 h. Cimetidine appeared to reduce the interindividual variability in melphalan absorption, but at the cost of reduced bioavailability. PMID- 3311446 TI - Metabolic activation to a mutagen of 3-hydroxy-trans-7,8-dihydroxy-7,8 dihydrobenzo[a]pyrene, a secondary metabolite of benzo[a]pyrene. AB - 3-Hydroxy-trans-7,8-dihydroxy-7,8-dihydrobenzo[a]pyrene (3-OH-BP-7,8-diol) was isolated from arylsulfatase/beta-glucuronidase-treated bile of rats to which 3 hydroxybenzo[a]pyrene (3-OH-BP) has been administered. This triol was investigated for mutagenicity in Salmonella typhimurium (reversion to histidine prototrophy of strains TA 97, TA 98, TA 100 and TA 1537) and in V79 Chinese hamster cells (acquisition of resistance to 6-thioguanine). When no exogenous metabolizing system was added the triol was inactive, while 3-OH-BP showed weak mutagenic effects with all four bacterial strains. In the presence of NADPH fortified postmitochondrial supernatant fraction (S9 mix) of liver homogenate from Aroclor 1254-treated rats, the mutagenicity of 3-OH-BP was potentiated, and the triol was activated to a mutagen(s). In the presence of S9 mix, the triol was 5-18 times more mutagenic than 3-OH-BP in strains TA 97, TA 100 and TA 1537, but both compounds showed similar mutagenic potencies with strain TA 98. These strain differences strongly suggest that the mutagenicity of 3-OH-BP in the S9 mix mediated test was not exclusively due to metabolites of 3-OH-BP-7,8-diol. Trans 7,8-dihydroxy-7,8-dihydrobenzo[a]pyrene (BP-7,8-diol), like the triol, showed mutagenic effects only in the presence of S9 mix. Strain TA 1537 was reverted by the triol but not by the diol. In the other bacterial strains the diol was more mutagenic than the triol, the difference in potency being largest in strain TA 100 (2.5- to 10-fold, depending on the experimental conditions). In V79 cells, the diol was a potent mutagen, while the triol showed only very weak mutagenic effects. However the triol was more cytotoxic than the diol. High cytotoxicity of the triol was observed even in the absence of S9 mix. The results of the present study demonstrate that metabolites of 3-OH-BP-7,8-diol are biologically-active derivatives of benzo[a]pyrene. Comparison of the mutagenic effectiveness in different bacterial strains also reveals that metabolites of 3-OH-BP-7,8-diol and of BP-7,8-diol substantially differ in the kind of genetic alterations they evoke. PMID- 3311445 TI - Phase III trial of the Japanese Urological Cancer Research Group for Adriamycin: cyclophosphamide, adriamycin and cisplatinum versus cyclophosphamide, adriamycin and 5-fluorouracil in patients with advanced transitional cell carcinoma of the urinary bladder. AB - A non-randomized clinical study on systemic combination chemotherapy was conducted by the Japanese Urological Cancer Research Group for Adriamycin to compare the effectiveness of CAP (cyclophosphamide 200-500 mg/m2, adriamycin 30 50 mg/m2 and cisplatin 30-50 mg/m2) and CAF (cyclophosphamide 200-500 mg/m2, adriamycin 30-50 mg/m2 and 5-fluorouracil 250 mg/m2) in 123 patients (104 evaluable) with advanced and/or metastatic cancer of the urinary bladder. Among 96 patients who were non-randomly selected to receive CAP, 4 achieved complete remission, 12 achieved partial remission, 7 achieved minor response, 30 had stable disease, and 43 had disease progression. The response in the 8 patients who received CAF were: partial remission in 1 and progressive disease in 7. The overall response rate to CAP therapy was 17%, as against 13% for CAF therapy. The median duration of survival with CAP was 29 weeks and with CAF, 22 weeks. The differences between the two groups in duration of survival and response rate were not statistically significant. Complete and/or partial remissions were observed in the lymph nodes, lung and liver in 32%, 24%, and 57% of cases, respectively. There was no objective response in bone metastasis. The main side effects of CAP were anorexia (88%), nausea and/or vomiting (81%), alopecia (65%), leukopenia (72%), anemia (48%), and renal dysfunction (17%). No patients died as a result of toxicity of these combination chemotherapy modalities. PMID- 3311447 TI - Group B streptococcal sepsis in the piglet: effects of fluid therapy on venous return, organ edema, and organ blood flow. AB - We investigated the physiologic effects of normal saline versus 5% albuminated saline fluid resuscitation on 10-12-day-old piglets infected with group B streptococci for four hours. After intravenously receiving 1 X 10(10) bacteria/kg over 45 minutes, one group was untreated while the two fluid-treated groups received enough intravenous fluid to maintain the baseline cardiac output. An increase in the resistance to venous blood return was the major limitation to cardiac output. The resistance nearly quadrupled in the untreated piglets as shown by a 50% decrease in cardiac output with a nearly doubling of the driving pressure for venous return (mean circulatory pressure was normal and atrial pressures decreased by 70%). In both fluid-treated groups, resistance doubled as shown by an unchanged cardiac output with a doubling of the driving pressure (mean circulatory pressure increased by 50%) and atrial pressures remained at baseline). Blood volume was 9% below control in the untreated group and 13% above control in both fluid-treated groups. Much more crystalloid (155 ml/kg) than colloid (58 ml/kg) was necessary to maintain baseline cardiac output; this resulted in a 36% decrease in the plasma protein oncotic pressure of the former group and a 15% increase in the oncotic pressure of the latter group. Organ edema formation (ileum, pancreas, kidney, adrenal gland, lung) occurred only in the saline-treated animals. We conclude that increased resistance to venous return was the primary cause of shock in our model and that this can be effectively treated by giving enough intravenous fluid to elevate the mean circulatory pressure. However, if the plasma protein oncotic pressure is also lowered (saline group), organ edema results. PMID- 3311448 TI - Stimulus-response curve of the renal baroreceptor: effect of converting enzyme inhibition and changes in salt intake. AB - We investigated the effect of converting enzyme inhibition (CEI) on the relationship between renal perfusion pressure (RPP) and steady-state plasma renin activity (PRA) in uninephrectomized conscious dogs on normal-salt (80 meq Na+/day) and low-salt (10 meq Na+/day) diets. Stimulus-response curves for the renal baroreceptor were determined by measuring the steady-state PRA while the RPP was lowered and then held constant by an inflatable cuff placed around the renal artery. On each diet the control stimulus-response curve can be described by two lines intersecting at a threshold pressure; in the higher pressure range PRA is relatively insensitive to changes in RPP, while in the lower pressure range PRA is very responsive to changes in RPP. On the normal-salt diet CEI significantly increases the sensitivity of PRA to RPP in the responsive range without affecting the threshold pressure itself or the values of PRA at pressures greater than the threshold pressure. On the low-salt diet CEI also increases the sensitivity of PRA to RPP significantly in the responsive range; we were unable to determine the effect of CEI on PRA at RPPs greater than the threshold pressure in the low-salt state because CEI causes a significant drop in blood pressure under these circumstances. The effect of CEI was significantly greater in the dogs on the low-salt diet than in the dogs on the normal-salt diet. Thus, CEI and salt depletion interact synergistically to increase the sensitivity of the renal baroreceptor only in the responsive range of the stimulus-response curve, i.e., at renal perfusion pressures below the threshold pressure. PMID- 3311449 TI - Catecholamine stimulation, substrate competition, and myocardial glucose uptake in conscious dogs assessed with positron emission tomography. AB - Uptake of radiolabelled deoxyglucose out of proportion to reduced coronary flow demonstrated by positron emission tomography has been used to identify reversibly ischemic, viable myocardium. For this concept to be applied reliably in the clinical setting, factors that may depress glucose availability independent of tissue viability, such as adrenergic stimulation and substrate competition, must be examined. Accordingly, we studied the effect of catecholamine stimulation by dopamine on myocardial glucose uptake in vivo using chronically instrumented, intact dogs and positron emission tomography. We measured myocardial activity of [2-18F]-2-deoxyglucose (FDG) and 82Rb in glucose-loaded animals randomly studied during dopamine infusion, during insulin infusion, and then during their combined infusion. Myocardial FDG uptake was significantly decreased when animals were treated with dopamine, compared with treatment in the same animals with insulin. When insulin was added to the dopamine infusion, myocardial FDG uptake was restored. In contrast, myocardial activity of 82Rb, which is taken up in proportion to coronary flow, was similar under all three experimental conditions. Plasma glucose, free fatty acid, and lactate concentrations were determined before and during each infusion. The depression of myocardial FDG activity seen during dopamine infusion and its reversal with addition of insulin can be explained on the basis of effects of these hormones on substrate availability and competition. PMID- 3311451 TI - Duplex scanning for diagnosis of aortoiliac and femoropopliteal disease: a prospective study. AB - We compared ultrasonic duplex scanning and angiography for the localization and classification of arterial stenoses and occlusions in 32 patients. The criteria for the detection of a greater than 50% diameter reducing stenosis was an increase in peak systolic velocity of greater than 100%, loss of reverse flow, and spectral broadening. Duplex studies and angiograms were evaluated in a blinded fashion. The agreement between duplex scanning and angiography for the 383 arterial segments studied was not significantly different than the previously reported agreement between two different radiologists reading the same angiograms (kappa of 0.55 vs 0.63). For detecting stenoses that were greater than 50% diameter reducing by angiography, duplex scanning had a sensitivity of 82%, a specificity of 92%, a positive predictive value of 80%, and a negative predictive value of 93%. These results are as good as previously reported comparisons between two different radiologists' readings of the same angiograms. PMID- 3311450 TI - Quantitative ultrasonic tissue characterization with real-time integrated backscatter imaging in normal human subjects and in patients with dilated cardiomyopathy. AB - We have shown previously that the physical properties of myocardium in dogs can be characterized with quantitative ultrasonic integrated backscatter and that interrogation of the tissue with ultrasound can delineate cardiac cycle-dependent changes in ultrasonic backscatter in normal tissue that disappear with ischemia and reappear with reperfusion if functional integrity is restorable. To determine whether this approach can be applied to man, we implemented an automatic gain compensation and continuous data acquisition system to characterize myocardium with quantitative ultrasonic backscatter and to detect cardiac cycle-dependent changes in real time. We developed a two-dimensional echocardiographic system with quantitative integrated backscatter imaging capabilities for use in human subjects that can automatically differentiate ultrasonic signals from blood as opposed to those obtained from tissue and adjust the slope of the gain compensation appropriately. Real-time images were formed from a continuous signal proportional to the logarithm of the integrated backscatter along each A-line. In our initial investigation, 15 normal volunteers (ages 17 to 40 years, heart rates 44 to 88 beats/min) and five patients with dilated cardiomyopathy (ages 22 to 52, heart rates 82 to 120 beats/min) were studied with conventional parasternal long axis echocardiographic views. Diastolic-to-systolic variation of integrated backscatter in the interventricular septum and left ventricular posterior wall was seen in each of the normal subjects averaging 4.6 +/- 1.4 dB (SD) and 5.3 +/- 1.5 dB (n = 127 sites), respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311452 TI - T. Duckett Jones and rheumatic fever in 1986. T. Duckett Jones Memorial Lecture. PMID- 3311453 TI - Effect of acute human cardiac allograft rejection on left ventricular systolic torsion and diastolic recoil measured by intramyocardial markers. AB - Left ventricular systolic torsion and diastolic recoil were quantified in 12 human cardiac transplant recipients with surgically implanted intramyocardial markers with the use of computer-aided analysis of biplane cineradiographic images. Measurements were performed between 6 and 16 weeks after surgery and related to the presence or absence of rejection as determined by cardiac biopsy. Torsional deformation, defined as twisting about the left ventricular long axis of the apical region with respect to the base, was characterized in terms of the rate and amplitude of systolic torsion and the rate of diastolic recoil by means of an internal reference system. Comparison of measurements before, during, and after recovery from 14 rejection episodes allowed assessment of the effects of acute reversible cardiomyopathy on left ventricular torsion and recoil. Compared with prerejection values, the amplitude of torsional deformation in the maximally deforming segment (theta max) decreased by 25% from 21.1 +/- 15.2 to 16.0 +/- 5.7 degrees (p less than .005) during acute rejection with myocyte necrosis; this was associated with significant (p less than .05) decreases in the peak systolic torsion rate (+d theta/dtmax), whereas the peak diastolic recoil rate (-d theta/dtmax) was unchanged. This suggests that the stiffness of elastic components of the myocardium may have increased, maintaining the rate of diastolic recoil when these elements are stretched less. With successful treatment of rejection episodes, the torsional deformation characteristics normalized. Heart rate, mean arterial pressure, left ventricular end-diastolic volume, stroke volume, ejection fraction, and peak left ventricular filling rate were unchanged with rejection episodes, whereas left ventricular end-systolic volume increased (p less than .05) during acute rejection and returned to normal with resolution of the rejection process. These data suggest that left ventricular torsional deformation amplitude and rate are sensitive to episodes of subclinical left ventricular dysfunction and that such intramyocardial marker techniques may provide new insights regarding the elastic properties of the ventricular myocardium and their impact on left ventricular mechanics. PMID- 3311454 TI - Cardiac transplantation in children and adolescents. AB - Cardiac transplantation represents an expanding therapeutic modality for end stage heart disease in children and adolescents. During the past 5 years, 27 patients (15 boys; 12 girls) between the ages of 2 and 18 have undergone cardiac transplantation. The preoperative diagnosis was cardiomyopathy in 24 (six familial), congenital heart disease in two, and endocardial fibroelastosis in one. Immunosuppression included cyclosporine, azathioprine, and prednisone. There were 22 survivors, with four hospital deaths (three infection, one pulmonary hypertension), and one death at 4.5 years from graft atherosclerosis. The actuarial survival at 4 years was 83 +/- 7.4% and that at 5 years was 69 +/- 14.2%. Renal function was stable at 4 years, with an average creatinine clearance of 69.75 +/- 27.0 ml/min/m2. Hypertension was present in 21 of 22 patients, who require multiple drug therapy. Rehabilitation is 100% among discharged patients, with 14 in school, six employed, and two toddlers. PMID- 3311455 TI - Cardiac transplantation: improved quality of survival with a modified immunosuppressive protocol. AB - The effects on renal function on two different immunosuppressive protocols were evaluated retrospectively in two subsequent groups of heart transplant recipients. In group I, cyclosporine was given before the procedure at a loading dose of 17.5 mg/kg and then continued after the procedure to keep a whole blood level about 1000 ng/ml. In group II, cyclosporine was started only after the procedure at a lower dosage and was complemented by azathioprine, which was used for the first postoperative week. Group II showed a better perioperative renal function as determined by serum blood urea nitrogen and serum creatinine levels. Group II also showed a significant decrease of chronic nephrotoxicity secondary to long-term therapy with cyclosporine. Despite this improvement in late renal function, group II still shows a slow rise in serum creatinine. We think that even these lower dosages of cyclosporine can cause chronic nephrotoxicity and that further modification of the immunosuppressive regimen is required to completely abolish this toxic side effect. PMID- 3311456 TI - Elevated pulmonary vascular resistance and cardiac transplantation. AB - Severe elevation of pulmonary vascular resistance has been considered a contraindication to cardiac transplantation. Most centers exclude patients with pulmonary vascular resistance greater than 6 Wood units. Wood units, however, do not correct for variations in body size and therefore may not be the best measure for use in comparison of patients. We performed a retrospective analysis of 82 cardiac transplant recipients and compared preoperative pulmonary vascular resistance (PVR) calculated in two ways to the incidence of right ventricular failure and death. Our data show that the PVR index unit (PVRI) identifies those patients that are at risk for right heart failure better than the Wood unit, which does not correct for body size. Four patients died of right heart failure with resistance less than 6 Wood units, but had PVRI greater than 6 units. High resistance is not an absolute contraindication to cardiac transplantation; 28 of 33 patients operated on with a PVRI greater than 6 survived. The degree of elevation of PVR did not correlate with survival. Ten of 12 patients with a PVRI greater than 9 survived. Testing with nitroprusside at cardiac catheterization was helpful in determining reversibility of pulmonary vascular obstruction. No patients with a PVRI less than 6 developed right heart failure. PMID- 3311457 TI - Clinical and laboratory correlates of accelerated coronary artery disease in the cardiac transplant patient. AB - Accelerated coronary disease in the cardiac allograft (TxCAD) is a major complication affecting long-term survival of heart transplant patients. Since the transplanted heart remains denervated, the first sign of TxCAD may be silent myocardial infarction or sudden death. The prevalence of this disease has been unaltered since the advent of cyclosporine immunosuppression. Serial annual coronary arteriograms in 132 patients undergoing transplantation after 1979 at Stanford revealed 44 patients who developed TxCAD (33%). Multiple variables, including patient lipid profile, extent of donor and recipient tissue match, age of recipient and donor, number of rejection episodes, prednisone dose, and fasting blood sugar were examined in relation to occurrence of TxCAD. Donor age was greater among the 44 patients developing TxCAD that in the 88 patients who did not develop coronary artery disease (23.5 +/- 5.8 vs 21.3 +/- 5.7 years, p less than .05). The fasting plasma triglyceride level 1 year after transplantation was 236.0 +/- 246.3 mg% in the patients with TxCAD vs 170.1 +/- 108.2 mg% in those without TxCAD (p less than .05). No other indexes, including number of rejection episodes during first posttransplant year, number of HL-A mismatches, level of maintenance steroids, fasting blood sugar, and cholesterol subfractions identified patients who developed TxCAD. We conclude that TxCAD has limited correlation with the clinical and laboratory factors analyzed. Higher donor age and elevated plasma triglycerides may be significant predisposing factors for the development of TxCAD. PMID- 3311458 TI - Normalization of sympathetic nervous system function after orthotopic cardiac transplant in man. AB - Plasma norepinephrine (PNE) levels are significantly elevated in patients with endstage congestive heart failure. To assess whether this abnormality is reversible, 32 patients were studied before and 3 to 9 months after orthotopic cardiac transplantation. PNE decreased after the transplant procedure form 739 +/ 363 to 301 +/- 161 pg/ml (p less than .05). In 13 patients, PNE was measured sequentially during the first 3 months after the transplant procedure. PNE decreased from 590 +/- 293 to 321 +/- 208 pg/ml at 2 weeks and remained stable at 1 month (308 +/- 239 pg/ml), 2 months (307 +/- 196 pg/ml), and 3 months (331 +/- 131 pg/ml), even while arterial hypertension developed. No correlation was found between PNE, systolic, diastolic, or mean arterial pressure and cyclosporine A blood levels. These data demonstrate that normalization of plasma levels of norepinephrine occurs shortly after cardiac transplantation in man. This decrease in PNE is probably independent of immunosuppression therapy. Finally, the development of arterial hypertension in cyclosporine A-treated cardiac transplant patients is not due to activation or persistent activation of the sympathetic nervous system. PMID- 3311459 TI - Successful reversal of acute cardiac allograft rejection with OKT*3 monoclonal antibody. AB - The efficacy of OKT*3 monoclonal antibody in reversing acute cardiac allograft rejection was investigated in 10 cardiac transplant recipients aged 5 to 57 years (mean 34 +/- 18) and treated with the same induction and maintenance immunosuppression. Serial endomyocardial biopsies, right heart catheterization, and echocardiograms were performed for rejection surveillance. After intensified immunosuppression with equine antithymocyte globulins and steroids, nine patients showed persistent rejection (lymphocytic infiltration and myocyte necrosis). Conventional immunosuppression was contraindicated in one patient. OKT*3 (5 mg by intravenous push daily for 14 days) resulted in complete resolution of rejection in nine of 10 patients (90%). After therapy with OKT*3 mean right atrial and pulmonary arterial wedge pressure were significantly lower (9.1 +/- 4.0 vs 4.8 +/ 2.0 mm Hg and 13.4 +/- 4.3 vs 8.0 +/- 3.3 mm Hg, respectively; p less than .05). Cardiac index was doubled in two patients with rejection-induced cardiac dysfunction (1.5 vs 3.2 and 1.6 vs 2.7 liters/min/m2). Only two patients developed antibodies to OKT*3. Fever, nausea and headache occurred with the first three doses of OKT*3 and did not recur. One patient developed aseptic meningitis. OKT*3 effectively reverses refractory cardiac allograft rejection before the development of irreversible graft dysfunction. Patients who do not develop antibodies to OKT*3 can be retreated with this drug. Adverse reactions to OKT*3 are self-limited. PMID- 3311460 TI - Noninvasive detection of human cardiac transplant rejection with indium-111 antimyosin (Fab) imaging. AB - Diagnosis of rejection after cardiac transplantation is currently made by right ventricular endomyocardial biopsy. To evaluate antimyosin imaging as a noninvasive means of detecting human cardiac rejection, the Fab fragment of murine monoclonal antimyosin antibodies was labeled with indium-111 and given intravenously to 18 patients (age 45 +/- 12 years) in 20 studies 7 days to 9 years after transplantation. Endomyocardial biopsy specimens were obtained at the time of each imaging study. Eight patients had positive scans confirmed by biopsy as rejection, and eight patients had negative scans and no evidence of rejection on biopsy. Discordance was observed in four studies, two with positive scans and no rejection on biopsy and two with negative scans and positive biopsy. The sensitivity, specificity, and overall accuracy of the technique were each 80%. Imaging with radiolabeled antimyosin antibody Fab fragments may be of value in the noninvasive identification of rejection in the cardiac transplant recipient. PMID- 3311461 TI - Changes in Doppler echocardiographic indexes of left ventricular function as potential markers of acute cardiac rejection. AB - Changes in left ventricular filling and ejection as potential markers of cardiac allograft rejection were evaluated by serial Doppler echocardiography performed in 23 normal volunteers and within 24 hr of endomyocardial biopsy in 22 patients aged 14 to 53 years (mean 37). Peak aortic velocity, left ventricular ejection time index (ETI), isovolumic relaxation time (IVRT), mitral valve pressure half time (PHT), peak early mitral flow velocity (M1), and velocity following donor atrial systole (M2) were measured without prior knowledge of endomyocardial biopsy findings. Biopsy specimens were graded histologically as: no rejection, mild rejection (cellular infiltrate), and moderate rejection (myocyte necrosis). A total of 120 biopsy-correlated Doppler echocardiographic studies were performed during 16 weeks after cardiac transplantation. Heart rate and mean arterial pressure were significantly higher in transplant recipients than in normal subjects. IVRT and PHT were significantly longer, while M1 and M2 were similar. Peak aortic velocity was higher in normal subjects than in transplant recipients, while ejection time was similar. Rejection of increasing severity was associated with a progressive shortening of IVRT and PHT and with an increase in M1 (p less than .0005 for all comparisons). Peak aortic velocity and ejection time index did not change significantly with rejection. These data indicate that acute cardiac rejection is accompanied by alteration in left ventricular filling dynamics detectable by Doppler echocardiography, without measureable changes in systolic function. These changes may provide noninvasive markers for surveillance of rejection. PMID- 3311462 TI - Human IgG subclass measurements in the clinical laboratory. AB - Complement activation, cell surface-receptor binding, blocking activity, and possibly placental transfer are among the biologically important functional differences that have been detected between the four human IgG subclasses by use of polyclonal antisera. In 1985, a IUIS/WHO panel of immunologists, using eight immunological methods, documented the specificity of select monoclonal antibodies for the IgG subclasses. Clinical assays have been developed involving these monoclonal antibodies that allow quantification of the concentration of IgG subclass protein and distribution of the IgG subclass antibodies in human immune responses. This review addresses issues of concern to investigators who are evaluating and (or) developing quantitative human IgG subclass assays in the clinical laboratory. Unique physical (structural) and biological (functional) properties of human IgG subclasses are summarized, with a focus on aspects pertinent to their clinical importance and in vitro quantification. The HP-series monoclonal antibodies with documented specificity are examined within the context of their application to several immunological methods. I describe unique technical aspects of total and antigen-specific IgG-subclass immunoassays involving these monoclonal antibodies. Finally, this report outlines clinical applications and indications for IgG-subclass measurements in the study of human health and disease. PMID- 3311463 TI - Liquid-chromatographic determination of beta 2-microglobulin, alpha 1-acid glycoprotein, and albumin in urine. AB - We report a reversed-phase "high-performance" liquid-chromatographic assay for beta 2-microglobulin, alpha 1-acid glycoprotein, and albumin in urine. The urine samples are chromatographed on a 15 X 3.2 mm C18-column with a solvent gradient between two mixtures: 1 mL of trifluoroacetic acid per liter of water and 1 mL of trifluoroacetic acid per liter of acetonitrile. The proteins are detected at 218 nm. The useful lower limit of sensitivity for quantification is 0.1 micrograms of each protein in 100-microliters injected samples, corresponding to 1 mg of protein per liter of urine. The linear measuring range extends from 0.1 to 100 micrograms of protein for each peak. Mean analytical recoveries ranged from 92 to 100%. The mean within-assay CV was 7.5%, the between-assay CV 15%. Comparison of results with those obtained by immunoturbidimetry and radioimmunoassay shows acceptable correlation. Reproducible and rapid with low operational cost, this method is suitable for use in routine screening and quantification of urinary proteins. PMID- 3311464 TI - Differentiation of renal from non-renal hematuria by microscopic examination of erythrocytes in urine. AB - Recent studies indicate that hematuria of renal parenchymal origin can be differentiated from hematuria of other origin by the presence of dysmorphic urinary erythrocytes (cells exhibiting irregular membranes or small surface blebs). We investigated the utility of this simple screening assay in a routine clinical laboratory. Dysmorphic erythrocytes in urine from 69 patients (18 with renal-parenchymal disease) were quantified on unstained slides by medical technologists using phase-contrast microscopes. Samples stored at 4 degrees C or 23 degrees C for up to 5 h had no significant changes in percentages of dysmorphic erythrocytes (PDE). PDE was also not modified by urea nitrogen concentration, osmolality, or pH over the physiological ranges of these variables. Receiver-operating characteristic (ROC) curves indicated an optimal sensitivity of 88% and specifity of 94% at a decision level of 14% dysmorphic erythrocytes per high-power field. Thus, the presence of fewer than 14% dysmorphic cells is suggestive of extra-renal disease; more than 14% is suggestive of intra-renal disease. PMID- 3311465 TI - Rapid assay of N-acetyl-beta-D-glucosaminidase isoenzymes in urine by ion exchange chromatography. AB - We describe a new method for separating and measuring urinary N-acetyl-beta-D glucosaminidase isoenzymes by "high-performance" liquid chromatography. Isoenzymes are eluted from the anion-exchange column with a one-step linear gradient of NaCl solution. For continuous post-column quantification of the activities of these isoenzymes, we use an on-line post-column reactor and 4 methylumbelliferyl-N-acetyl-beta-D-glucosaminide as substrate; the methylumbelliferone formed in this reaction is quantified fluorimetrically. We discuss the effects of varying different components of the assay: NaCl concentration, the pH of the mobile phase and of the reaction reagent, substrate concentration, incubation temperature, and the geometry of the post-column reactor. PMID- 3311466 TI - A latex agglutination assay for D dimer: evaluation and application to the diagnosis of thrombotic disease. AB - Although latex agglutination assays have been used for some years to diagnose thrombotic disorders, only recently has it been possible to measure specifically the products of fibrin breakdown in the presence of fibrinogen degradation products, by using monoclonal antibodies. We have evaluated a preparation of latex particles coupled to the monoclonal antibody DD-3B6/22, which is specific for cross-linked fibrin degradation products (XDP) and allows accurate discrimination between normal and pathological conditions. Of samples from 515 apparently healthy volunteers, 97.7% failed to agglutinate the latex; the normal reference interval for XDP determined by enzyme immunoassay was less than 78-320 micrograms/L. The use of different anticoagulants with or without the addition of a protease inhibitor had no significant effects on the results of the latex assay. The latex preparation provides a useful, rapid diagnostic tool for assaying small numbers of samples or as an emergency test. PMID- 3311467 TI - Identification and analysis of nine metabolites of cyclosporine in whole blood by liquid chromatography. 2: Comparison of patients' results. AB - We used a "high-performance" liquid-chromatographic assay [for parent cyclosporine (CsA) and nine metabolites] and a radioimmunoassay to detail the diversity of results among whole-blood samples from patients with transplanted organs. Heterogeneous populations of metabolites in samples collected just before the next dose of CsA were detected by HPLC, with CsA, M17, M1, or M8 predominating; M21, M203-218, MUNDF1, and M18 were detected in lesser amounts. Results by HPLC vs RIA for CsA or for individual metabolites vs CsA (or RIA) were diverse, with correlation coefficients (r) ranging from 0.058 to 0.933. RIA vs HPLC(sum of CsA + metabolites) gave the best comparison (slope = 0.931, y intercept 14 micrograms/L, r = 0.933); but the scatter of data about the regression line remained significant (Sy/x = 132 micrograms/L). Most important, RIA/HPLC(CsA) vs HPLC(sum of metabolites) was remarkably poor (r = 0.222). A 12-h pharmacokinetic curve (for drug concentrations in a heart-transplant patient) displayed dissimilar times for peak concentrations of CsA and metabolites; each differed in the proportion (48% to 81% of peak concentration) eliminated from blood over the 12 h. These studies exemplify the utility of a more-inclusive, specific assay to monitor the diverse disposition of cyclosporines in patients and to demonstrate the errors associated with use of the RIA/HPLC ratio technique to predict metabolite concentrations. PMID- 3311469 TI - Electrophoresis and the isomune-LD and LD-1 immuno methods compared for measurement of lactate dehydrogenase isoenzyme-1. AB - We evaluated three different methods for measuring lactate dehydrogenase (EC 1.1.1.27) isoenzyme LD-1 activity--agarose gel electrophoresis and two immunoassays, Isomune-LD (Roche) and LD-1 Immuno (Seragen)--in patients' samples for which measurement of creatine kinase-MB was ordered. Regression analyses of the comparisons gave the following results: LD-1 (%) from Isomune-LD (y) vs electrophoresis (x) (n = 51), y = 1.05x + 1.99, r = 0.92; LD-1 (%) from LD-1 Immuno (y) vs electrophoresis (n = 27), y = 1.05x + 3.94, r = 0.88; LD-1 (%) from LD-1 Immuno (y) vs Isomune-LD (x) (n = 41), y = 1.06x + 0.48, r = 0.95. Comparison by Student's paired t-test yielded significant differences between the mean values by electrophoresis and both Isomune-LD (P less than 0.005) and LD-1 Immuno (P less than 0.001), but no significant difference between the two immunoassays (P greater than 0.2). Analyzing these results by the overlap index, we conclude that electrophoresis shows the best clinical correlation followed, in order, by the Isomune-LD and the LD-1 Immuno methods. Both immunoassays are simpler and more rapid than electrophoresis, but in our hands the Isomune-LD method demonstrated greater precision and better correlation with electrophoretic values. PMID- 3311470 TI - Multiple drugs of abuse in urine detected with a single reagent and fluorescence polarization. AB - We describe a simple polarization fluoroimmunoassay for the detection of several commonly abused drugs in urine. The single reagent used, prepared by mixing four different antisera and three fluorescein-labeled derivatives, produces a polarization signal that is the average of the individual signals of the derivatives. One adds urine to the pre-mixed reagent, incubates at room temperature for a few minutes, then measures fluorescence polarization. The presence of any of several abused drugs, at concentrations of 1 mg/L or more, noticeably decreases the average signal. Although other combinations are possible, the present assay detects the presence of a cocaine metabolite, amphetamine, and (or) several barbiturates. PMID- 3311468 TI - Immunonephelometry of apolipoprotein B with a centrifugal analyzer. AB - We developed an automated immunonephelometric assay for the measurement of apolipoprotein B (apo B) with a light-scattering microcentrifugal analyzer. Pretreating specimens with a dilute solution of Tween 20 or triglyceride lipase decreased the nephelometric response of apo B. Polyethylene glycol is included in the reaction mixture, and the reaction is complete within 4 min. The method is precise (CV = 6.5%, mean = 0.68 g/L) and the standard curve is linear to an apo B concentration of 2.8 g/L. Lipemia does not interfere with the method if grossly lipemic specimens are centrifuged to remove chylomicrons. PMID- 3311471 TI - Participation of peptide moieties in adhesive behavior of antigenic mannans of Candida albicans to the plastic microtiter plate in enzyme-linked immunosorbent assay. AB - We report our studies of the mechanism of the adhesion of mannans of Candida albicans NIH A-207 and C. albicans NIH B-792 strains to the surface of a polystyrene microtiter plate being utilized for enzyme-linked immunosorbent assay (EIA) of antigens of this pathogenic yeast species. This binding was manifested predominantly by the peptide moieties of the mannans forming hydrophobic bonds with the plastic molecule. Eliminating the peptide of each mannan by treating it with a hot aqueous alkaline solution of NaBH4 also eliminated color development in the EIA. PMID- 3311472 TI - Two rapid, sensitive, and specific immunoenzymatic assays of choriogonadotropin in serum compared. PMID- 3311473 TI - Routine use of beta 2-microglobulin assays. PMID- 3311474 TI - Rheumatoid factors. PMID- 3311475 TI - Development and application of an enzyme-linked immunosorbent assay for acid stable trypsin inhibitor (ASTI) in human plasma. AB - An enzyme-linked immunosorbent assay (ELISA) for acid-stable trypsin inhibitor was developed using goat antibodies raised against urinary trypsin inhibitor purified from normal human urine. The assay was highly sensitive and precise, and gave reproducible results in the range of 1-1,000 ng/ml. The specificity and sensitivity of this assay permitted measurement of a low content of acid stable trypsin inhibitor in different tissue extracts and body fluids. Using the new method, the mean level in plasma samples taken from healthy individuals was found to be 54.9 +/- 17.4 (mean +/- SD) micrograms/ml and that of acid-treated plasma was 11.5 +/- 3.0 micrograms/ml (n = 27). The calculated specific activity of acid stable trypsin inhibitor in acid treated plasma was 300 U/mg, while that of highly purified inhibitor is 2,100 U/mg. These results suggest the presence of both acid unstable protein having the same antigenicity as urinary trypsin inhibitor and the inactive form of acid stable trypsin inhibitor. PMID- 3311476 TI - The EEG and clinical evolution in Creutzfeldt-Jacob disease. AB - A total of nine EEGs were recorded serially from a typical, pathologically verified case of Creutzfeldt-Jacob disease (CJD). Typical periodic sharp waves (PSW) showed a progressive increase in duration, but the interval of PSW stayed fairly constant during the course of illness. Early in the illness there were PSW in approximately one-quarter of the records and this reached one hundred percent when clinical CJD was fully developed. Diagnosis of CJD on the basis of the EEG alone is difficult in the early phase of the disease due to the short duration of the PSW. PMID- 3311477 TI - Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency. AB - A basal plasma cortisol value taken in a physically unstressed state in 68 patients with or without hypothalamic-pituitary-adrenocortical disease was compared with the maximal plasma cortisol concentration during an insulin tolerance test. There was a strong positive correlation between the values. Basal cortisol levels above 300 nmol/l (RIA method) almost excluded ACTH-cortisol insufficiency and those below 100 nmol/l strongly suggested dysfunction. A repeated basal cortisol estimation within a month was especially valuable in categorizing patients with levels between 100 and 200 nmol/l. We suggest that a basal cortisol measurement may be used as a first laboratory test in patients evaluated for possible hypothalamic-pituitary-adrenocortical insufficiency; in many patients, this approach obviates more sophisticated and expensive testing. PMID- 3311478 TI - Autoimmune thyroid disease and thyroid cell class II major histocompatibility complex antigens. PMID- 3311479 TI - Recovery of luteal function after interruption of gonadotrophin secretion in the mid-luteal phase of the menstrual cycle. AB - Ovulation was induced by a pulsatile infusion of GnRH in a patient with hypogonadotrophic amenorrhoea. In order to investigate the effect of short-term withdrawal of gonadotrophin support in the luteal phase, the pulsatile infusion was stopped 3 d after ovulation and restarted 48 h later. After stopping the pump gonadotrophin and progesterone concentrations fell rapidly to very low levels, but when the infusion was restarted progesterone concentrations returned to normal mid-luteal values. Menstruation occurred 14 d after the LH surge. We conclude that normal progesterone secretion by the corpus luteum can be restored after temporary withdrawal of gonadotrophin support. PMID- 3311480 TI - Kinetics of insulin disappearance from plasma in cortisone-treated normal subjects. AB - The effect of glucocorticoid excess on insulin disappearance from plasma was examined in eight normal men during cortisone treatment (50 mg orally twice daily for 4 d) and in the absence of any medication (control) in random order. Constant infusion of insulin (1-5 mU/kg/min) was used to achieve different levels of steady state plasma insulin concentrations; normoglycaemia was preserved by a glucose clamp technique. The experimentally determined data were compared using a previously validated model of saturation kinetics. The amount of glucose required to maintain normoglycaemia during the insulin infusions was significantly less in the cortisone study than in the control study, while the parameter estimates for the kinetics of insulin disappearance from plasma were unaffected by cortisone. Thus, insulin action and insulin kinetics in the steady state are dissociated in normal subjects rendered insulin resistant by short-term cortisone treatment. PMID- 3311481 TI - Acid thyroglobulin protease activities in human diseased thyroid glands. AB - The lysosomal acid protease is thought to be a main enzyme in hydrolysis of thyroglobulin. The protease activity of lysosome-rich fractions of various diseased thyroid glands were assayed by the sensitive and reproducible method developed in our laboratory. They included 78 diseased thyroid glands; 37 thyrotoxic goitres, five irradiated thyroids, five Hashimoto's thyroiditis, one granulomatous thyroiditis, six multinodular goitres, 14 'cold' adenomas, four 'hot' adenomas with three paranodular tissues, and six carcinomas. Fifteen paranodular tissues of cold and solitary thyroid nodules were served as controls. The protease activities were significantly increased in thyroid tissues of thyrotoxic goitres, Hashimoto's thyroiditis, adenomas and adenocarcinomas. In thyrotoxic goitres, the protease activity correlated well with the mean area size of colloid follicles. The 'hot' adenomas had higher protease activity than 'cold' ones. The protease activity of multinodular goitres was nearly normal. Only the irradiated thyroid glands had low protease activities. Therefore the high protease activities in hyperfunctioning goitres seem to reflect hormone secretory activities. On the other hand, cold neoplastic goitres seem to have lysosomal protease activities which are not associated with thyroidal secretory process. The assay of acid protease activity will be useful to understand the pathophysiology of lysosomal system in diseased thyroid glands. PMID- 3311482 TI - Hormonal responses to exercise and training: a short review. PMID- 3311483 TI - Effect of obesity and weight loss on the arginine vasopressin response to insulin induced hypoglycaemia. AB - Arginine vasopressin (AVP) response to insulin-induced hypoglycaemia was evaluated in 16 men with normal weight and in 9 obese men. Obese subjects were restudied following substantial weight loss. The decrease in blood glucose concentrations after insulin injection (0.15 U/kg i.v. bolus) had a similar pattern and magnitude in the normal controls and in the obese subjects both before and after weight loss. Basal plasma insulin concentrations in the obese patients were significantly higher than in the normal weight subjects, but were back to normal after weight reduction. During all tests, blood osmolality, haematocrit and blood pressure remained constant. The AVP rise during the insulin tolerance test (ITT) was significantly lower in the obese patients than in the normal controls. The mean peak plasma AVP level was 2.3 times higher than the basal value in the normal controls, but only 1.6 times in the obese patients. After weight loss, the obese men regained normal AVP responses during the ITT. These data indicate that a hypothalamic pituitary disorder affects the AVP response to insulin-induced hypoglycaemia in obese men. PMID- 3311484 TI - The role of modern bioassays in clinical endocrinology. PMID- 3311485 TI - BSER audiometry in haemodialysis patients. AB - The object of this paper was to study the brain stem evoked response in 20 patients suffering from chronic renal failure and having haemodialysis, and to evaluate the effects of this treatment. A further 5 successful renal transplant patients were investigated to analyse the evolution of the brain stem conduction when the metabolic abnormality is removed. In the first group, the responses were minimally abnormal in 30% of cases before the dialysis. The dialysis session showed an improvement of the brain stem conduction. This variation was temporary and, 24 hours following the dialysis treatment, the patients showed the pathological values observed before the dialysis. The results of the successful transplanted patients were consistent with the data obtained in the dialysis group. Before transplantation the nerve impulse conduction was found to be abnormal in 3 subjects. These abnormalities disappeared completely after successful transplantation. These results support the view of those who favour the use of evoked potentials to follow the status of the central nervous system in uraemic patients. PMID- 3311486 TI - Gastric mucus and the mucosal barrier. PMID- 3311488 TI - Small bowel bacterial overgrowth syndrome. PMID- 3311489 TI - Diagnosis of spontaneous bacterial peritonitis in cirrhotic patients. PMID- 3311487 TI - Reflux gastritis syndrome. PMID- 3311491 TI - Forefoot eczema--further studies and a review. PMID- 3311490 TI - Porphyria: practical advice for the clinical gastroenterologist and hepatologist. PMID- 3311492 TI - Sulconazole versus clotrimazole in the treatment of dermatophytosis. PMID- 3311493 TI - Culture grafted leg ulcers. PMID- 3311494 TI - Anti-mitochondrial type 5 antibodies and anti-cardiolipin antibodies in systemic lupus erythematosus and auto-immune diseases. AB - Twenty sera from patients with systemic lupus erythematosus (SLE) and high titre of IgG anti-cardiolipin antibodies (ACA) were studied in order to evaluate the prevalence of anti-mitochondrial type 5 antibodies (AMA 5). None of these sera were found to be AMA 5 positive but five of 18 were positive for VDRL. Twenty sera from patients with AMA 5 were studied in order to evaluate the prevalence of ACA: only six of 20 were positive for ACA. In contrast to this finding, 15 of the 20 sera positive for AMA 5 were also positive for VDRL (P less than 0.001). The six sera positive for ACA and AMA 5 were absorbed with cardiolipin micelles. This absorption eliminated the ACA activity but not the AMA 5 activity. Despite the clinical similarities between the two groups of patients with AMA 5 or ACA, these data suggest that patients with AMA 5 and patients with ACA belong to two different subsets of SLE or SLE-like syndromes and that AMA 5 antigen is different from cardiolipin. PMID- 3311495 TI - Tissue c-myc protein expression and immune response in systemic lupus erythematosus. AB - Frozen sections of kidney tissue from 12 patients with systemic lupus erythematosus were examined for the expression of oncogene proteins. Polyclonal rabbit antibody to c-myc peptide or to whole 65,000 D c-myc protein, was used to identify c-myc protein within tissue sections. Patterns of nuclear staining in the Hep-2 cell line were similar to those seen with monospecific human SLE sera showing anti-Sm reactivity. In addition c-myc staining was not abolished by prior incubation of tissue sections with human serum containing anti-Sm antibodies. Five of 12 kidney biopsy tissues from patients with systemic lupus erythematosus (SLE) showed positive speckled c-myc protein staining within nuclei of monocyte/macrophage cells of glomerular tufts. Positive staining was in all instances completely abolished by prior absorption of anti-c-myc antibody with c myc protein. No c-myc protein was identified within SLE immune complex deposits. PMID- 3311496 TI - Effect of cyclosporin A on autoimmune tubulointerstitial nephritis in the brown Norway rat. AB - The effect of cyclosporin A (CyA) on the development of tubulointerstitial nephritis (TIN) in the brown Norway (BN) rat was assessed. All manifestations of TIN were prevented in rats by subcutaneously injected CyA (20 mg/kg/day). A short 7-day course of CyA beginning the day before immunization suppressed the primary and ongoing antibody response. In addition, delayed CyA treatment (starting on day 10 after immunization), when antibody response was established, drastically reduced the levels of serum anti-TBM IgG, and abrogated the interstitial inflammatory cell response, in spite of persistent kidney-bound TBM antibodies. These results indicate that CyA has a therapeutic effect on the BN rat model of TIN. PMID- 3311498 TI - Human T cell proliferative responses to particulate microbial antigens are supported by populations enriched in dendritic cells. AB - The efficacy of dendritic cells in antigen presentation was studied in eight healthy subjects using a lymphoproliferation assay. Both particulate (Mycobacterium leprae, H37Ra) and soluble (PPD, tetanus toxoid) bacterial antigens were used as stimulants over a concentration range of accessory cells (monocytes (MO) and dendritic cells (DC)) varying from 10 to 0.1% in co-cultures using T-enriched cells. In general, co-cultures with T + MO and T + DC at all concentrations of accessory cells showed significant improvement of antigen induced lymphoproliferation over PBMC cultures. The improvement in delta ct/min of T + DC co-cultures as compared to T + MO with parallel concentrations of accessory cells (P less than 0.05 to less than 0.01) was significant. Of the bacterial antigens used to test the antigen-presenting ability of DC, the particulate antigen (H37Ra) showed the most impressive improvement (380%) of T cell proliferation in DC reconstituted cultures as compared to monocytes. PPD, soluble protein derived from a similar tuberculosis strain of mycobacteria, was not presented as effectively as the particulate equivalent even though the donors of the appropriate cell combinations showed skin test reactivity to this antigen. PMID- 3311497 TI - MHC antigen expression in sequential biopsies from cardiac transplant patients- correlation with rejection. AB - Class I induction on the myocardium of transplanted heart was investigated with regard to its temporal relationship to rejection episodes, how it is affected by anti-rejection therapy and whether it is dependent upon the presence of a T cell infiltrate in the biopsy. Sequential cardiac biopsies (total 114) from 11 patients from the time of transplant to 1 year after transplant were studied using immunocytochemical techniques. The effect of different immunosuppressive regimens on MHC antigen expression was also studied. All the biopsies diagnosed as showing rejection for the first time showed induction of Class 1 on the myocardium with 79% during subsequent rejection episodes. Class I induction was associated with a leucocyte infiltrate, not always containing T cells, and disappeared in 47% of biopsies taken 3-4 weeks after treatment with steroids and/or ATG. Increased expression of Class II, in particular DQ antigens on interstitial structures, paralleled Class 1 induction. MHC antigen expression returned to normal in 8/9 patients, at 1 year after transplant. Different immunosuppressive regimens affected the number of biopsies showing Class 1 induction on the myocardium. Our results suggest that in clinical heart transplantation class I induction is related to the rejection process. PMID- 3311499 TI - Relationship between platelet cytosolic free calcium concentration and plasma renin activity. AB - 1. Plasma renin activity (PRA) and platelet cytosolic free calcium concentration ([Ca2+]i) were simultaneously determined in 18 untreated essential hypertensive subjects and 17 normotensive controls. A significant positive correlation was found between [Ca2+]i and PRA (slope = 42 nmol/l/ng/ml/h) in these 35 subjects. 2. Two determinations more than one week apart in nine subjects confirmed the parallel fluctuations of [Ca2+]i and PRA. A strict sodium restriction produced a progressive PRA elevation associated with a parallel rise in [Ca2+]i in one subject. 3. These results are consistent with the hypothesis that angiotensin II causes a concentration-dependent calcium mobilization. PMID- 3311500 TI - The uridine nucleotides constitute a natriuretic pressor system. AB - 1. Uridine monophosphate was tested in the conscious rat for natriuretic properties and an immunoperoxidase technique was used to localize uridine containing compounds in the rat kidney. 2. Uridine monophosphate, infused in a moderate pressor dose, caused a significant natriuresis compared to the effect of control infusions of solvent vehicle. 3. Uridine-containing compounds were found in most tubular elements with particularly dense staining in the distal and collecting tubules. 4. While the increased sodium excretion may have been due to increased renal perfusion pressure, the high density of uridine staining in distal nephrons suggests that the uridine nucleotides have a specific nephron function, possibly relating to sodium transport. PMID- 3311501 TI - The effect of DOCA and 9 alpha-fludrocortisone on renal renin content and production. AB - 1. DOCA and 9 alpha-fludrocortisone were given to rats. 2. Plasma renin fell rapidly with both treatments. 3. Renal renin fell slowly to a low level. 4. Renal renin fell to a lower level with DOCA than with 9 alpha-fludrocortisone. 5. When DOCA and 9 alpha-fludrocortisone were stopped plasma renin levels rose rapidly and the renal renin levels increased. 6. The data suggest that synthesis is altered rapidly but it takes a prolonged time for the kidney to become depleted of renin due to the high tissue stores and the associated inhibition of release. PMID- 3311502 TI - Angiotensin II-induced contraction of mesangial cells in acute renal artery stenosis in dogs. AB - 1. Renal artery stenosis was induced in anaesthetized dogs, and the kidney rapidly fixed after 30 min. 2. Electron microscopy revealed marked folding of the paramesangial basement membrane in stenotic kidneys (n = 7). The extent of this folding was significantly less in dogs treated with captopril (n = 6). 3. It is suggested that this folding reflects angiotensin II-induced contraction of the mesangial cells, which may help maintain glomerular filtration rate following stenosis. PMID- 3311503 TI - Increased levels of plasma renin, aldosterone, catecholamines and vasopressin in chronic ambulatory peritoneal dialysis (CAPD) patients. AB - Fluid excess can cause hyporeninemia and hypoaldosteronemia in hemodialysis patients. In six patients on CAPD, plasma renin activity (PRA) and plasma aldosterone (PA) were elevated to levels of : PRA 10.2 +/- 2.9 nl (1-5 ng/ml/h), and PA: 47.4 +/- 16.2 (normal 5-20 ng/dl). In 4 patients, data posthemodialysis and later during CAPD revealed that PRA increased from 0.9 +/- 0.3 to 14.1 +/- 4.6 and PA increased from 3.4 +/- 0.3 to 67.4 +/- 24.9 on CAPD (p less than 0.05). Mean arterial pressure was lower on CAPD and serum glucose was higher. No significant difference was seen in weight, hematocrit, BUN, or potassium, however. Plasma volume was not decreased in five CAPD patients: 3619 +/- 358 ml (predicted 3083 +/- 201 ml). Elevated catecholamine levels were seen in CAPD patients: norepinephrine 868.0 +/- 104.1 (normal 358.4 +/- 41.5 pg/ml), epinephrine 386.3 +/- 49.2 (normal 58.3 +/- 10.6 pg/ml). Plasma vasopressin levels were elevated to the range usually seen with hyperosmolality. In eight patients who lost or gained weight on CAPD, levels of PRA and PA changed as expected, but catecholamine levels did not correlate with weight changes. The data suggest that in CAPD patients, PRA and PA may be elevated in association with augmented sympathetic stimulation and elevated vasopressin levels. Serial observations demonstrated that PRA and PA can respond appropriately to changes in body weight, while catecholamine and vasopressin levels seem to be influenced by other factors. PMID- 3311504 TI - Drug-induced oxolinic acid crystalluria and nephrolithiasis. PMID- 3311505 TI - Spontaneous remission of proteinuria in recurrent focal glomerulosclerosis. Reappraisal of plasma exchange treatment. PMID- 3311506 TI - Polycythemia in pediatric renal transplantation. PMID- 3311507 TI - Frank Norman Wilson. PMID- 3311508 TI - Assessment and management of uterine contractions. PMID- 3311509 TI - The ECG waveform. AB - Different portions of the ECG waveform are influenced differently. The QRS waveform is influenced principally by ventricular muscle mass but may be influenced by differences in ventricular filling which occur with cardiac failure or transiently with cord compression. The PR interval normally has a positive correlation with the R-R interval but this correlation becomes negative, probably as a result of catecholamines, when the fetus is stressed. This difference between PR/RR correlation may help distinguish vagally mediated decelerations from those associated with hypoxia. The ST waveform becomes elevated when myocardial oxygen delivery is insufficient to maintain aerobic metabolism to meet the energy demands of the myocardium, and anaerobic metabolism occurs with the production of lactate; this is a dynamic situation and may occur at different levels of oxygenation in different fetuses, depending on their ability to compensate and the workload on the myocardium. It is very likely that changes in PR/RR relationships and the ST waveform will be useful in intrapartum monitoring in the future, and this contention is supported by recent analysis of PR/RR and ST segment shifts (Figure 16). It seems clear that the detailed study of the ECG waveform provides more, and perhaps clinically more useful, information from the same signal and electrode as heart rate, and it is no longer reasonable to ignore it. However, as clinicians we have an extraordinary ability to move with disenchantment from one method of fetal monitoring to another of no proven value, with a firm but unreasoned conviction that it is better. ECG analysis is by no means ready for clinical use if we are to avoid the same pitfalls as continuous FHR monitoring. Further clinical assessment will not be easy. In modern obstetric practice asphyxiated infants are fortunately not common, so there are practical difficulties in monitoring sufficient numbers of patients to evaluate new indices of asphyxia, as well as the difficulties of defining an objective endpoint. Thorough clinical (probably multicentre) studies are needed with well defined endpoints and this is beginning. Further fetal lamb studies are also needed, particularly to examine the interrelationships between changes in heart rate, PR interval and ST waveform; it is hoped that this chapter has emphasized the importance of such animal studies in understanding the physiological and therefore clinical background to any change.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311511 TI - An overview of fetal monitoring. PMID- 3311510 TI - Systolic time intervals of the fetal cardiac cycle. PMID- 3311512 TI - Diagnostic ultrasonography. AB - The use of diagnostic ultrasound has contributed to the evaluation of the fetal condition in two ways--the detection of fetal abnormality and the assessment of fetal growth and development. Routine early pregnancy scanning enables most major structural anomalies to be detected and provides accurate gestational dating. Maternal serum alphafetoprotein screening complements ultrasound in identifying abnormalities, and may also be an indicator of a growth problem in later pregnancy. In high-risk pregnancies, or when growth retardation or acceleration is suspected, abnormalities should always be considered and investigations should include karyotyping. Fetal growth may be assessed by multiple parameters, including measurement of fetal head, trunk, limbs, and amniotic fluid volume, in addition to grading of the placenta. Fetal responses to stimulation can be visualized and quantified. No single parameter may be used alone to predict fetal outcome, but by using this multiple-parameter approach, contributing to a biophysical profile of the fetus, the outcome of pregnancy may be predicted with greater accuracy. PMID- 3311513 TI - Antepartum fetal risk assessment: the role of the fetal biophysical profile score. AB - In the art of medicine we have always known that establishing an accurate diagnosis of health or disease is essential. An active search for the physical signs, both the time honoured and newly discovered, are a crucial step in achieving diagnostic accuracy, in monitoring disease progression, and in assigning prognosis. In extrauterine medicine it is common practice to gather together sets of biophysical data in order to determine immediate health, to monitor condition, and to estimate prognosis: witness the use of vital signs, and, in the newborn, the Apgar score. The providers of perinatal care have known since biblical days that fetal biophysical activities were a reflection of fetal condition (Luke: Chapter 1, Verses 44-45), yet lacked the ability to categorize these activities in an objective and complete manner. The introduction of dynamic ultrasound imaging methods to perinatal medicine at last create the window through which the principles of extrauterine medicine may now be applied to the intrauterine patient--the fetus. Fetal biophysical profile scoring is a method that utilizes this new wealth of information to differentiate the normal fetus from the fetus at risk for death or damage in utero. The method is based on the concept that the discrimination of fetal health and disease improves as more variables are considered. The now extensive clinical experience with the method, in which both overall (gross) and selected (corrected) perinatal death are reduced, while maintaining a remarkably low false negative predictive error, indicate the validity of the concept. Comparative studies lead us to believe that reliance upon single biophysical variables, such as fetal movement counts, or antepartum fetal heart rate monitoring, is no longer of sufficient accuracy to support its use as a sole measure of fetal condition. Looking forward, we anticipate that while the concept on which fetal biophysical profile scoring is based will remain unchanged, inclusion of additional variables is likely to occur. It seems likely that addition of new variables, as may be now measured using high-resolution dynamic ultrasound methods, both B-mode and Doppler, will improve diagnostic accuracy even more. We believe that the application of the current and future modified methods of composite fetal risk assessment will render the occurrence of the tragedy of perinatal loss even more infrequent. While the goal of complete elimination of perinatal deaths remain elusive, this method may be one step towards this goal. PMID- 3311514 TI - Intrapartum fetal monitoring. AB - From the fetal viewpoint, labour is a prolonged contraction stress test which most pass without incident. Labour also represents the obstetrician's last opportunity to influence perinatal outcome and ensure that those fetuses who have suffered chronic hypoxia antenatally are recognized promptly, so that labour is supervised in a way that does not place them at increased risk of either death or birth asphyxia. In the case of the fetus who enters labour healthy, with normal reserves, labour is managed with the same aim in mind, but with the foreknowledge that visualization of a normal volume of clear amniotic fluid and reasonable duration of labour makes the development of hypoxia and asphyxia unlikely. Those at increased risk of hypoxia should be monitored electronically, but, for the remainder, intermittent auscultation is satisfactory until labour lasts in excess of 5 hours, or if the patient requires oxytocin, or if an epidural is placed. If EFM is used, then it is important to provide adequate education in trace interpretation, with particular emphasis on the importance of short-term variability. Widespread use of EFM has provided us with an immense amount of knowledge about fetal physiology, but it is critically important for the practising obstetrician to understand that, in the low-risk patient, EFM is not more effective than IA in preventing death from asphyxia, that EFM does protect against asphyxial seizures, but that widespread use of the technique has not been associated with a significant reduction in the population of permanently handicapped infants. This information is particularly relevant in developing nations where money spent on sophisticated monitoring equipment might be better spent in other areas. From the maternal point of view, intensive fetal monitoring has profound implications by virtue of its usual effect on incidence of Caesarean birth, although the Dublin trial results, with regard to incidence of Caesarean section, emphasize the importance of considering intrapartum fetal monitoring as just one part of the overall supervision of labour. Finally, it must be emphasized that the method of fetal monitoring chosen may be strongly influenced by factors other than scientific evidence, as in the United States where the medicolegal climate is such that failure to rigorously document absence of fetal distress/true birth asphyxia may result in a harrowing lawsuit. It is a position this author has developed considerable sympathy with in recent years. PMID- 3311515 TI - Assessment of fetal acid-base status. PMID- 3311516 TI - Intraluminal allograft restoration of the upper femur in failed total hip arthroplasty. AB - Deep-frozen cancellous allografts have been used to restore the proximal femur of 23 hips following failed total hip arthroplasty. The canal is cleared and reaming is performed under direct vision through a cortical window. A modified Huckstep prosthesis permits early weight-bearing on the distal femur regardless of the state of proximal bone, but retains the option for later restoration of proximal loading once grafts appear mature. This transfer has been performed on four occasions. All 23 patients have had relief of pain with early ambulation. The follow-up periods ranged from six to 30 months. With the exception of one deep infection, the grafts have not undergone resorption in this period of follow-up study. Consolidation appears slower when the defect has followed multiple operations than following an initial revision for prosthetic loosening. The basic bone bank facilities are required for the supply of frozen allografts. PMID- 3311517 TI - Musculoaponeurotic fibromatosis. A report of 28 cases and review of the literature. AB - Although musculoaponeurotic fibromatosis (MAF) is a well-recognized entity, it still provides a histologic diagnostic enigma, particularly in its distinction from a well-differentiated fibrosarcoma. The lesion is histologically identical to a desmoid tumor. The lesion appears as a firm swelling in a limb or limb girdle, with a rare incidence of pain. Although it is more common in the second to fourth decades (premenopausal women predominantly), it does occur in children. The sex incidence in children is equal. A multicentric pattern of behavior may be evident. The mainstay of treatment has been surgical excision of varying extent. Local excision, even if radical, may be followed by up to a 65% recurrence rate. In this review, 40% of the cases had more than one recurrence. Recent evidence suggests radiotherapy, which has been reserved for inoperable lesions, may be of value as an adjunct to primary treatment. Limited local excision with adjunctive radiotherapy may decrease recurrence rate, minimize functional deficit, and improve cosmesis. Radical local resection (compartmental or amputation) may be avoidable. In children, amputation may not result in cure because of the multicentric behavior pattern and radiotherapy may lead to growth retardation. A shorter functional upper or lower limb is preferable to an amputation stump or a limb disfigured from radical excision. PMID- 3311518 TI - Histologic analysis of a retrieved microporous-coated femoral prosthesis. A seven year case report. AB - A microporous-coated femoral prosthesis with an average pore size of 80 to 100 microns was retrieved after seven years in a revision operation on a failed cemented acetabular component. The proximal anterior and lateral aspects of the implant were encrusted with bone. The bone was attached to the porous coating in regions of ingrowth. The implant was stable within the femur although most of the porous coating was not bone ingrown. There was progressive bone resorption in the proximal femur, suggestive of a reactive biologic mechanism. There was also a sizable posterior pocket of granulation tissue containing chronic inflammatory round cells associated with numerous birefringent polymeric particles. Polyethylene wear debris and acrylic cement were engulfed by multinucleated giant cells enveloping the loose cup. PMID- 3311519 TI - Fracture of the femur. A clinical study. By R. Hamilton Russell, 1924. PMID- 3311520 TI - The knee joint meniscus. A fibrocartilage of some distinction. AB - It is now well established that the meniscus performs a number of roles that are important to the efficient performance of the knee joint. Of particular importance is the recognition of its load-bearing function and its stabilization of the joint during flexion-extension. The compression of the wedge-shaped meniscus during loading is translated into circumferential stresses, and the collagen fiber distribution and orientation is well adapted for this mechanical role. Proteoglycans of the meniscus have structural characteristics in common with those of articular cartilage but do not appear to influence the tensile properties of menisci. With aging and degeneration, compositional changes take place within the meniscus that reduce its ability to transmit tensional stresses, and this contributes to failure. Total meniscectomy is not a benign procedure. Partial excision has less deleterious effects on the joint. Surgical repair of meniscus lesions has now emerged as a procedure of some significance and laboratory research suggests that a solution to this problem may be within reach. Experimental studies in dogs also indicate that chondroprotective agents such as semisynthetic sulfated polysaccharides may protect articular cartilage after meniscectomy. PMID- 3311521 TI - Advances in arthroscopic surgery. AB - Removal of the whole meniscus from the knee has been shown to be associated with a high incidence of degenerative change. The degeneration is proportional to the amount of meniscus removed. After meniscal injury, retention of the meniscus in part (partial meniscectomy) or in whole (meniscal suture) is preferable. Replacement of a previously removed meniscus (meniscal transplantation) may be feasible in the future. Fifty patients had arthroscopic partial meniscectomies performed alternately by standard mechanical techniques or by electrosurgical techniques. The latter group was found to have less pain and swelling. Another 46 patients had meniscal sutures performed on one or more menisci. Twenty-one of these patients had a follow-up arthroscopy for recurrence of symptoms and only one meniscus had not healed. Another single patient had a meniscal transplant, and a follow-up arthroscopy six months after surgery revealed the meniscus to be largely intact. PMID- 3311522 TI - [A case of muscular sarcoidosis of palpable nodules type with pseudohypertrophy- comparison of computerized tomography and ultrasound imaging of skeletal muscles]. PMID- 3311524 TI - Ectopic parathyroid gland. Localization with thallium-201 SPECT. AB - Dual isotope Tl-201/Tc-99m subtraction is a useful technique for localization of abnormal parathyroid glands. A case of tomographic localization of nonsubtracted Tl-201 to a mediastinal parathyroid is reported and the possible benefit of this method discussed. PMID- 3311523 TI - Early infantile form of neuronal ceroid lipofuscinosis. Four Dutch cases and review of the literature. AB - In this paper four Dutch cases of early infantile neuronal ceroid lipofuscinosis (NCL) are described, all being boys. NCL is a group of diseases morphologically characterized by accumulation of autofluorescent ceroid lipofuscin-like pigment. Psychomotor deterioration, impairment of vision, and epileptic manifestations are the major clinical features. Onset in early infantile age is rare. We reviewed 71 cases reported in the literature, and compared the symptoms and signs with the findings in our patients. Psychomotor deterioration, visual impairment and myoclonic jerks are often observed early in the disease. Eventually, every patient shows psychomotor deterioration. The outcome is always lethal, usually within a few years. Special attention is paid to diagnostic procedures. PMID- 3311525 TI - Organizing hematoma of the thigh. Multiple imaging techniques. PMID- 3311526 TI - Nephrostomy tube communication with renal vein. Demonstration by antegrade contrast and radioisotopic pyleographic examination. PMID- 3311527 TI - Functional causes of the ductal obstructive pattern on hepatobiliary scans. AB - Hepatobiliary imaging with Tc-99m IDA derivatives has proven value for evaluation of biliary disease. Prompt hepatocellular uptake with persistent nonvisualization of the common bile duct and bowel is usually indicative of a high-grade common bile duct obstruction, but is not pathognomonic. A functional abnormality due to hepatocyte dysfunction resulting in intrahepatic cholestasis can also cause this pattern. Two cases of hepatocellular excretory dysfunction, one due to E. coli endotoxemia with intrahepatic cholestasis and the other due to acute hepatitis A that produces ductal obstructive patterns on Tc-99m disofenin scintigraphy in patients with documented patent biliary ducts, are reported. Transhepatic cholangiography or endoscopic retrograde cholangiography may be useful when the diagnosis of biliary ductal obstruction is in doubt. PMID- 3311528 TI - Utility of gallium-technetium subtraction imaging in evaluation of pulmonary involvement by lymphoma. PMID- 3311534 TI - Escherichia coli cellulitis in children with idiopathic nephrotic syndrome. AB - Although Streptococcus pneumoniae is traditionally considered the preponderant bacterial pathogen in children with nephrotic syndrome, recent data suggest an increase of infections with encapsulated gram-negative organisms. We report two children with idiopathic nephrotic syndrome in relapse who developed spontaneous Escherichia coli cellulitis. The organism was recovered from the cellulitis tissue aspirate of one, and from the blood of the other. Both patients responded to appropriate antibiotic therapy. Initial treatment of sepsis, peritonitis or spontaneous cellulitis in nephrotic patients should include broad spectrum antibiotic coverage pending results of appropriate cultures. PMID- 3311532 TI - Clinical pharmacokinetics of some newer diuretics. AB - Several new diuretics have recently been developed. This review summarises the published knowledge about some of them. Azosemide is a loop diuretic. The bioavailability is about 15% and it has a half-life of 2 to 3 hours. Renal and non-renal clearance are 1.32 and 5.4 L/h, respectively. Etozolin is also a loop diuretic. It is rapidly metabolised to the active metabolite, ozolinone. The gastrointestinal uptake of etozolin is almost complete. The plasma half-life of etozolin and ozolinone are 2 and 10 hours, respectively. The compounds are mainly eliminated as metabolites. Renal and liver impairment do not seem to change the pharmacokinetics. Fenquizone has properties similar to the thiazides. The plasma half-life is approximately 17 hours. Apparent volume of distribution averaged 686 L and renal clearance is 7.2 L/h. Indapamide acts predominantly on the proximal segment of the distal tubule and also has direct vasodilatory effects. Gastrointestinal uptake is at least 80%. The drug binds highly to carbonic anhydrases of red blood cells. Protein binding is about 80%, while terminal plasma half-life is 15 hours and the apparent volume of distribution 25 L. Renal clearance is 0.3 L/h and non-renal clearance 0.9 L/h. Several metabolites have been described, of which one major metabolite is pharmacologically active. Muzolimine is a loop diuretic. Its uptake is almost complete, but decreased substantially by food. The protein binding is about 65%, the apparent volume of distribution is about 1 L/kg and average terminal half-life 10 to 20 hours. Elimination is mainly non-renal, and non-renal clearance ranges between 0.5 and 1.32 L/h. The pharmacokinetics of the drug do not seem to be changed in cardiac failure. Terminal plasma half-life is essentially unchanged in patients with renal failure, except in those with very severe reduction of glomerular filtration rate. Piretanide is a loop diuretic which is about 6 times as potent as frusemide (furosemide). Its bioavailability is most likely complete in healthy subjects and in renal patients. Protein binding in healthy subjects is about 95%. The plasma half-life of the drug is about 1 hour and apparent volume of distribution averages about 17 L. Renal and non-renal clearance are about 6 L/h, although renal clearance is decreased in renal failure: this decrease is correlated with glomerular filtration rate. Non-renal clearance is unchanged in renal failure, as is the apparent volume of distribution.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311530 TI - Therapeutic drug monitoring in oncology. Problems and potential in antineoplastic therapy. AB - Therapeutic drug monitoring is now widely used in many areas of medicine. With its proliferation has come an understanding of the clinical situations in which it is likely to be of value. Factors that can limit the usefulness of therapeutic drug monitoring and situations where it is less likely to be of benefit have also been identified. At present, the routine use of therapeutic drug monitoring in antineoplastic therapy is limited to measurement of plasma methotrexate concentrations after high-dose methotrexate therapy. The lack of a more widespread application of therapeutic drug monitoring in oncology has been due to deficiencies in knowledge about the clinical pharmacology of antineoplastic agents and to factors specific to the chemotherapy of neoplasms. These factors include the broad heterogeneity of malignant neoplasms, the complexities of the drug-tumour interaction, difficulties in assessment of this interaction and the use of combinations of antineoplastic agents with cumulative efficacies and toxicities. Despite these problems, there are many areas in antineoplastic therapy where the use of therapeutic drug monitoring could prove of benefit. The prevention of the chronic pulmonary toxicity of bleomycin, the assessment of the bioavailability of oral chemotherapy, and monitoring drug disposition in the presence of hepatic or renal dysfunction are just some of the potential applications. If recent emphasis on dose as a critical factor in the success of cancer chemotherapy is substantiated, then the need to apply therapeutic drug monitoring within oncology will become more pressing. PMID- 3311533 TI - Stress management techniques in childhood and adolescence. Relaxation training, meditation, hypnosis, and biofeedback: appropriate clinical applications. AB - Many childhood and adolescent stress-related symptoms have a psychophysiological component that involves muscular tension and/or autonomic nervous system dysfunction. Examples of this include recurrent headache, chest pain, abdominal pain, syncope, and dizziness. After a careful medical and psychosocial evaluation, the clinician may identify many patients who are appropriate for the application of stress reduction techniques such as progressive muscular relaxation, meditation, biofeedback, and relaxation/mental imagery (self hypnosis). This review describes these techniques and their application with selected children and adolescents. PMID- 3311531 TI - Antibiotic pharmacokinetics in cystic fibrosis. Differences and clinical significance. AB - Antibiotics are administered to cystic fibrosis patients for chronic endobronchial infection complicated by frequent exacerbations. Agents active against Staphylococcus aureus, Pseudomonas aeruginosa or both are administered. Serum antibiotic concentrations were measured in cystic fibrosis patients in an effort to optimise antibiotic dose and frequency. This led to the observation that cystic fibrosis subjects had (in general) a larger Vd and increased total body clearance of beta-lactams and aminoglycosides than non-cystic fibrosis subjects. The larger Vd is mainly due to the increased amount of lean body mass per kg bodyweight, although increased tissue binding may also account for part of this. The increased total body clearance of beta-lactams appears to be due to increased renal elimination, particularly tubular secretion. Decreased tubular reabsorption and increased non-renal clearance contribute to the increased total body clearance of metabolised beta-lactams and aminoglycosides. However, the lack of concomitant controls in many studies make these generalisations tentative. The result of the apparent cystic fibrosis-specific differences is lower peak serum antibiotic concentrations, a smaller AUC, and a shorter elimination half-life than non-cystic fibrosis subjects. Since sputum (and bronchial mucosal) concentration is dependent on the peak serum concentration (and AUC), cystic fibrosis subjects require larger doses of most antibiotics more frequently. Newer quinolones may be an exception. Studies comparing the efficacy and safety of larger and more frequent antibiotic doses to conventional therapy are not available. Although it appears logical to mimic serum antibiotic concentrations found in non-cystic fibrosis subjects, the lack of information on the ideal sputum concentration versus time curve should temper our enthusiasm for cystic fibrosis-specific dosage regimens. PMID- 3311535 TI - Lung surfactants for replacement therapy: biochemical, biophysical, and clinical aspects. AB - This article characterizes and analyzes current concepts of the pulmonary surfactant system, and its actions and importance in respiration. Much of the discussion concerns the fundamental role of lung surfactant in the respiratory distress syndrome (RDS) of premature infants, and the success of exogenous surfactant replacement in clinical therapy for this disease. In addition, basic descriptions of the biophysical and physiological activity of lung surfactant are provided to define mechanisms behind surfactant replacement therapy, and how it might be optimized by the further development of appropriate synthetic lung surfactant substitutes. PMID- 3311529 TI - Clinical pharmacokinetics of anti-parkinsonian drugs. AB - Of the neurological disorders, none can claim a battery of therapeutic agents based upon as rational a pharmacology as can Parkinson's disease. In this review, the clinical pharmacokinetics of the major classes of anti-Parkinsonian drugs is discussed. Although they are the oldest drugs in the anti-Parkinsonian armamentarium, little pharmacokinetic data are available regarding the anticholinergic and antihistaminic agents. Based on elimination half-lives of 10 to 18 hours, most could probably be effectively given on a twice-daily schedule. Amantadine is unique among anti-Parkinsonian agents both in lacking a clearly defined mechanism of action and in being eliminated from the body exclusively by renal excretion of unchanged drug. Thus the normal decline of renal function in the elderly Parkinsonian population becomes an important factor in avoiding potential drug toxicity. The pharmacokinetics and pharmacodynamics of levodopa are complex. Since it is an amino acid, it follows metabolic pathways and must compete for absorption and brain uptake with a number of large neutral amino acids. It has a short elimination half-life and, as Parkinson's disease progresses, the brain loses its capacity to store the drug and becomes dependent in a moment-to-moment fashion on plasma levodopa concentrations, creating therapeutic response fluctuations in over 50% of patients. Pharmacokinetic considerations in the management of these response fluctuations are discussed. The newest class of anti-Parkinsonian agents are the direct acting dopamine receptor agonists. These drugs, all derivatives of ergot, have more prolonged durations of anti-Parkinsonian action than levodopa. However, other than bromocriptine, clinical experience with members of this class of drugs is still limited. PMID- 3311536 TI - The biochemistry of fetal lung development. AB - Surfactant therapy for RDS is likely to become widespread in the near future. Animal data indicate that this will not preclude a role for hormonal acceleration of lung maturation. In studies with prematurely delivered and ventilated fetal rabbits, Fiascone et al. have shown that the administration of betamethasone antenatally improves lung compliance, as does intratracheal administration of excess amounts of adult rabbit natural surfactant. If the two therapies are combined, however, an additive effect is observed. This suggests that some of the effects of glucocorticoids on lung compliance are not related to surfactant. Prior glucocorticoid therapy may provide a benefit that differs from that of surfactant therapy because steroids mature the lungs anatomically and enhance nonsurfactant-related tissue compliance. It is also possible that surfactant therapy itself may be more effective in the presence of larger and increased numbers of alveoli. It thus seems likely that in the future both hormonal enhancement of lung maturation and surfactant therapy may be used in combination to further reduce the morbidity and mortality from RDS. PMID- 3311538 TI - The management of bronchopulmonary dysplasia. AB - After presentation of the actual knowledge concerning the pathophysiology of bronchopulmonary dysplasia, the prevention and the management of the disease are discussed. Techniques of ventilation, weaning procedures and prescription of drugs are also analyzed. The importance of a slow reduction of oxygen supply and the possibility of discharge with oxygen therapy is emphasized. PMID- 3311537 TI - Neonatal apnea and apneic syndromes. AB - The physiologic factors that predispose premature infants to apnea are reviewed in this article. Management and treatment of "idiopathic apnea" are discussed. "Symptomatic apnea" should be treated according to its primary cause. PMID- 3311539 TI - Pulmonary and chest wall mechanics in the control of respiration in the newborn. AB - Although the respiratory system is not fully developed at birth, the human newborn infant has flexible strategies to sustain breathing and defend blood gas homeostasis in both health and disease conditions. Initially the thresholds for chemoreceptor response to PO2 and PCO2 closely mimic those of the fetus, but the threshold resets to sustain ventilation adequate for blood gas homeostasis appropriate to the extrauterine milieu. The muscles of respiration have been "trained" in utero and effectively assume the function of the respiratory pump, despite their marginal reserve against fatigue. The pliable chest wall is functionally stabilized by the tonic activity of the intercostal muscles, thereby allowing effective ventilation. Finally, expiration is prolonged by the postinspiratory activity of the diaphragm and laryngeal braking as a means of maintaining an elevated lung volume and augmenting FRC. The ventilatory response of the newborn to respiratory disease is limited. The magnitude of the VE response is smaller than that of the adult, and is characterized by an increase in the respiratory rate and a limited increase in the VT. The poor effort reserve of the muscles, especially the diaphragm, predisposes the newborn to muscle fatigue and ventilatory failure. To avoid fatigue, recruitment of accessory muscles occurs, along with laryngeal braking of expiration, thereby decreasing the work of the diaphragm, recruiting new alveoli by an auto-PEEP effect, increasing the FRC volume, and improving gas exchange by an increase in the pulmonary surface area. These mechanisms help to avoid muscle exhaustion and facilitate adequate gas exchange in the presence of lung disease. We do not know precisely the postconceptual age at which the newborn is sufficiently developed to adopt these various defensive strategies of breathing, but the presence of tachypnea and grunting in 28-week-old premature infants suggests that long before term the human infant is capable of remarkable variation in the defense of breathing. PMID- 3311540 TI - High-frequency ventilation in the neonate. AB - HFV is a mode of therapy that allows gas exchange with pressure fluctuations much lower than that required for conventional ventilation, and may consequently decrease the incidence of barotrauma and chronic lung disease. At present the National Institute of Health is sponsoring the first large controlled trial to test the efficacy of HFV using an oscillator in premature infants with respiratory failure. Results of this trial will help to clarify some of the indications for HFV and its usefulness in a large number of infants with respiratory failure secondary to RDS. PMID- 3311541 TI - New strategies for the prevention of bronchopulmonary dysplasia. AB - This article reviews the progress being made into the prevention or arrest of this complex respiratory disease. The key elements in the pathophysiology are reviewed; the current problems in defining, classifying, and predicting the development of this disorder are discussed and potentially useful interventions also are introduced. PMID- 3311543 TI - Molecular basis of pulmonary oxygen toxicity. AB - There has been an explosion of knowledge pertaining to the generation and behavior of partially reduced oxygen metabolites--oxygen free radicals--in aqueous, in vitro systems; lacking is correlation of these intriguing findings to the biologically intact whole animal. Methodologies to study in vivo free radical mediated processes are improving with the use of electron spin trapping of tissue samples, and in the future the precise role of oxygen radicals in oxygen injury may become clearer. With this new work with the chemistry and biochemistry of oxygen radicals, it is crucial to remember the special attributes of oxygen radical behavior in eukaryotic cells. There are many disparate compartments in cells that differ with respect to hydrophobicity, pH, and presence of iron salts and antioxidants. The ability of any oxygen radical; O2-, H2O2, .OH, to cause damage, will depend greatly on these and other factors. The final piece of the oxygen toxicity puzzle is the presence and activity of antioxidant substances, both enzymatic and nonenzymatic. Here again, compartmentalization is important. To provide beneficial protection, the antioxidant must be present in sufficiently high concentrations at the site of radical production or damage. In the special case of the premature infant who requires oxygen therapy, the balance between oxygen radical production and antioxidant capacities will determine whether oxygen injury ultimately occurs. The biologic uniqueness of the premature infant in regards to maturation and growth mandates investigations of these biochemical phenomena in appropriate experimental models, rather than extrapolation from studies conducted in adults and perhaps even full-term newborns. PMID- 3311544 TI - Respiratory infections in the newborn. AB - Respiratory infections, especially pneumonia, are common in the first four weeks of life and are the cause of significant morbidity and mortality. Infants may be infected in utero, during labor and delivery, or postnatally. The etiology of neonatal respiratory infections varies widely and spans the spectrum from bacteria to protozoa. The exposure of the infant to maternal flora, the nursery environment, or household members plays an important role in determining the infecting pathogen. Diagnostic testing includes the chest film, CBC and routine bacterial cultures, but newer techniques such as latex agglutination tests for bacterial antigens or viral antigen detection or culture may be indicated in the appropriate clinical setting. This article reviews all of these aspects of respiratory infections and posits certain steps in their treatment. PMID- 3311545 TI - Clinical aspects of antenatal enhancement of pulmonary maturation. AB - The background, history, and physiologic basis for the use of corticosteroids to enhance fetal pulmonic maturation are presented. Clinical data relevant to this topic are discussed, and recommendations for the use of these agents are proposed. Finally, other pharmacologic agents that may become clinically useful for this indication are described. PMID- 3311542 TI - The relationship of symptomatic patent ductus arteriosus to respiratory distress in premature newborn infants. AB - When left-to-right shunting through the ductus arteriosus contributes to respiratory distress of the newborn premature infant, the condition is termed generally as symptomatic PDA. The physiologic setting of this condition and its definition are considered first in this article. Subsequent sections detail the incidence of symptomatic PDA and predisposing risk factors, followed by a discussion of its clinical presentation, diagnosis, and management. PMID- 3311546 TI - Surfactant replacement therapy: clinical and experimental studies. AB - Surfactant replacement therapy has been investigated extensively both in animal models and clinical studies. Although not yet available for routine clinical treatment, surfactant replacement in HMD holds great promise. This article reviews the current literature in this area. PMID- 3311547 TI - Extracorporeal membrane oxygenation in the management of respiratory failure in the newborn. AB - The history of ECMO and the development of its present-day use is discussed. The results of the National ECMO Registry and the first 100 patients at Children's Hospital National Medical Center are presented. Future developments and directions of ECMO are presented. PMID- 3311548 TI - Analgesic efficacy of two ibuprofen-codeine combinations for the treatment of postepisiotomy and postoperative pain. AB - Our purpose was to compare the analgesic efficacy and safety of single oral doses of the combination of ibuprofen 400 mg plus codeine 60 mg and the combination of ibuprofen 200 mg plus codeine 30 mg with ibuprofen 400 mg alone, codeine sulfate 60 mg alone, and placebo. One hundred ninety-five patients with severe pain resulting from episiotomy, cesarean section, or gynecologic surgery completed a randomized, double-blind, stratified, parallel-group study. Patients were observed during a 4-hour period after medication. Based on the sum of the pain intensity differences (SPID), total pain relief (TOTPAR), and most of the hourly direct measures of pain and relief, both doses of the combination and ibuprofen 400 mg alone were statistically superior to placebo. Codeine 60 mg was statistically superior to placebo based on TOTPAR, the global ratings, and a few hourly measures. The mean effect of the combination of ibuprofen 400 mg plus codeine 60 mg was significantly superior to the mean effect of ibuprofen 400 mg alone 1/2, 1, and 2 hours after medication and to the mean effect of ibuprofen 400 mg alone and codeine 60 mg alone for SPID, TOTPAR, and other measures as well. The low-dose combination was significantly more effective than codeine 60 mg for a few hourly measures but was not significantly superior to ibuprofen 400 mg. Based on these findings it appears that the combination of ibuprofen 400 mg plus codeine 60 mg, particularly in the first few hours after medication, is more efficacious than its constituents. PMID- 3311549 TI - Calcium channel blocker drugs and diabetic control. AB - Calcium channel blockers are now widely used and there have been case reports of hyperglycemia with nifedipine. In a double-blind, randomized, crossover study of the effects of 4 weeks of therapy, each with two dihydropyridine calcium channel blocker drugs, nifedipine and nicardipine, glucose tolerance, plasma insulin levels, and hemoglobin A1 were assessed in 20 patients with non-insulin-dependent diabetes (mean age 59 years). There was no significant difference in glucose tolerance on active therapy (AUC: control, 548.3 +/- 24.8; nifedipine, 559.3 +/- 41.0; and nicardipine, 589.3 +/- 40.3). Similarly, despite producing significant hemodynamic effects, these drugs produced no significant effect on plasma insulin and hemoglobin A1 levels. Calcium channel blocker drugs may be useful alternatives to thiazide diuretics and beta-blockers in the treatment of ischemic heart disease and hypertension, especially in patients with diabetes. PMID- 3311550 TI - A new alpha-glucosidase inhibitor (Bay-m-1099) reduces insulin requirements with meals in insulin-dependent diabetes mellitus. AB - Retardation of meal carbohydrate absorption by inhibition of starch degradation improves glucose tolerance in normal and diabetic humans. To determine the effects of Bay-m-1099, a new alpha-glucosidase inhibitor, on insulin requirements and prandial glucose tolerance in patients with insulin-dependent diabetes mellitus (IDDM), plasma glucose, triglyceride, and free insulin concentrations were measured after ingestion of a standard breakfast, lunch, and dinner in nine patients with IDDM in a single-blind, randomized, crossover design. A 20% reduction in insulin was given 30 minutes before the meals when the subjects received Bay-m-1099 (50 mg). This resulted in the AUC for plasma insulin to be significantly less with Bay-m-1099 (AUC, 8.2 +/- 1.3 vs. 12.8 +/- 1.6 microU/ml/min with placebo; P less than 0.01). Despite this reduction in plasma insulin levels, postprandial plasma glucose concentrations were reduced for the breakfast (73 +/- 15 vs. 112 +/- 14 mg/dl/min with placebo; P less than 0.01) and dinner (23 +/- 8 vs. 4 +/- 1 mg/dl/min with placebo; P less than 0.05) meal with Bay-m-1099. Bay-m-1099 did not affect postprandial plasma triglycerides and was well tolerated, the major side effect being flatulence (4/9) and mild diarrhea (4/9). We conclude that inhibition of intestinal alpha-glucosidases by Bay-m-1099 in IDDM reduces meal insulin requirements by at least 20% and that such an agent could be useful in the management of diabetes mellitus by reducing hyperinsulinemia. PMID- 3311551 TI - Ketoconazole effects on methylprednisolone disposition and their joint suppression of endogenous cortisol. AB - The effects of ketoconazole and methylprednisolone on endogenous cortisol were studied in eight normal subjects. Intravenous methylprednisolone sodium succinate was given alone in doses of 15 or 30 mg. The methylprednisolone dose was reduced by 57% when ketoconazole was administered chronically for 1 week to seek equivalent methylprednisolone AUCs by compensating for the expected reduction in methylprednisolone clearance. Ketoconazole decreased clearance by 46% and increased mean residence time by 37%. The ratio of the cortisol AUC during each drug treatment compared with baseline conditions was used to assess the net extent and duration of cortisol suppression. This cortisol AUC ratio was reduced from 0.45 (methylprednisolone) to 0.39 (methylprednisolone plus ketoconazole), suggesting that ketoconazole modestly enhanced (P less than 0.01) cortisol suppression. Based on the reduction in methylprednisolone clearance and cortisol AUC by ketoconazole, a 50% lower dose of methylprednisolone during concomitant therapy with ketoconazole is recommended. PMID- 3311552 TI - The effect of dietary protein-calorie restriction on the renal elimination of cimetidine. AB - The renal elimination of the weak-base cimetidine was studied in five healthy male subjects during normal and restricted (low-protein, low-calorie) diets in a randomized crossover fashion. An intravenous dose of cimetidine, 7 mg/kg, was administered on day 7 of the normal (100 gm/70 kg protein/day) and the restricted (19 gm/70 kg protein/day) diets. The renal clearance of cimetidine was unchanged by the dietary restriction; however, the fractional excretion of cimetidine increased from 3.06 to 3.94 (P less than 0.05), indicating an apparent increase in net tubular secretion of cimetidine during the restricted diet. We conclude that cimetidine dosage adjustments are apparently not necessary for patients with acutely restricted nutrient intake, although other weakly acidic and basic drugs may require dosage changes. PMID- 3311553 TI - Anomeric specificity of glucose-induced insulin release in normal and diabetic subjects. AB - The alpha- and beta-anomer of D-glucose (3.5 or 5.0 g) were injected intravenously in 15 normal subjects and 13 non-insulin-dependent diabetic patients with mild fasting hyperglycaemia. In the normal subjects, alpha-D glucose increased more than beta-D-glucose the plasma insulin concentration. Thus, 2 min after injection of D-glucose, the concentration of insulin relative to paired basal value was 61% higher in response to alpha- than beta-D-glucose (p less than 0.05). In 8 diabetic subjects, the secretory response to D-glucose was insufficient to allow characterization of its anomeric specificity. In the remaining 5 diabetic patients, a preferential response to alpha-D-glucose was observed in 3 cases, but not so in the other 2 cases. These results indicate that glucose-stimulated insulin release is alpha-stereospecific in normal subjects. A possible perturbation of such a stereospecificity in certain diabetic subjects warrants more extensive investigation on its precise incidence and etiopathogenic significance. PMID- 3311554 TI - Response to cyclosporine administration at onset of diabetes in BB rats. AB - The metabolic and immunological effects of cyclosporine A given at onset of spontaneous Type I diabetes in BB rats were examined, as an analogy to the current use of this agent in newly-diagnosed human diabetics. Diabetes-prone (BBdp) rats were monitored until appearance of hyperglycemia, at which time treatment with both cyclosporine (10 mg/kg/day) and insulin was immediately started. Cyclosporine induced no remission in any rats and did not affect their daily insulin requirements. After 9 weeks of cyclosporine treatment, islet morphology showed the typical "end-stage" picture in all rats, with essentially total beta cell loss. Pancreatic insulin contents were less than 1% of normal levels. During the 9 weeks of cyclosporine treatment, there was a decrease in numbers of peripheral blood Ia-positive lymphocytes, an increase in OX8+ lymphocytes (suppressor/cytotoxic and natural killer cells) but no change in the other subsets. There was a significant increase in plasma creatinine. We conclude that this dose of cyclosporine started at onset of diabetes in BB rats is unable to arrest and/or reverse the beta cell destructive process. PMID- 3311556 TI - Morphometric analysis of cancellous bone of young diabetic and non-diabetic sand rats (Psammomys obesus). AB - Cancellous vertebral bone of young diabetic sand rats (psammomys obesus) was compared with that of non-diabetic sand rats of the same sex and age. Of 5 morphometric diameters, 3--trabecular area, trabecular surface and osteoblastic surface--showed no statistically significant differences between test and control animals. By contrast, the 2 other parameters determined, namely lacunae containing osteoclasts as well as lacunae devoid of osteoclasts were significantly more numerous in diabetics than in controls. PMID- 3311555 TI - Effect on rat embryos of in vitro culture in sera from human diabetic patients. AB - Recently conditions have been established whereby rat embryos can be cultured in vitro in human serum over the period of their major morphogenesis. By standardizing the amount of glucose in sera from diabetic subjects prior to culture, it has been possible to investigate factors other than hyperglycemia which might account for the increased incidence of congenital defects seen in infants of diabetic mothers. The incidence of abnormalities in rat embryos cultured in sera from chlorpropamide-treated diabetics was not significantly different from that using control sera from normal subjects. On the other hand, sera from insulin-dependent diabetics produced more defects in rat embryos than sera from either normal subjects or diabetics on oral agents. The incidence of abnormal rat embryos does not appear to be correlated with patient age, with the original blood glucose concentration or with the concentration of hemoglobin A1 or, in the insulin group, with the total daily insulin dosage. PMID- 3311557 TI - Sonographic examination of gastric motility in diabetics with autonomic neuropathy. AB - The frequency, intensity and velocity of antral contractions were measured by ultrasonography in 32 patients with insulin-dependent diabetes mellitus and in 12 controls before and up to 60 min after a test breakfast. The examination showed that motility was lower in the diabetics with autonomic neuropathy than in those without and in the non-diabetic controls. The frequency of contractions was determined in the 3 groups as follows: 3.6 +/- 2.0 vs. 4.8 +/- 1.7 vs. 4.8 +/- 1.6 contractions per 2 min (p less than 0.0025); the intensity of contractions was 30.9 +/- 8.2 vs. 41.4 +/- 5.2 vs. 57.5 +/- 8.8 delta % of antral area (p less than 0.025, resp. p less than 0.0005); the velocity of contractions was 4.8 +/- 1.5 vs. 8.2 +/- 1.2 vs. 9.95 + 2.8 delta % of antral area/sec (p less than 0.0125 resp. p less than 0.005). There was a significant difference in the intensity and velocity of contractions between the patients without autonomic neuropathy and the non-diabetic controls (p less than 0.0025 resp. p less than 0.025). 10 min after the test breakfast the motility indices reached a maximum and then decreased continuously towards the end of the test period (p less than 0.01). 20 min after the test meal this decrease was significantly faster in the patients with autonomic neuropathy than in those without and in controls. In all the diabetics the velocity was positively correlated to the coefficient of the variation from beat to beat of the heart, and also positively correlated to the increase of blood glucose concentrations (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311558 TI - Skin microvascular blood flow control in long duration diabetics with and without complications. AB - The integrity of the regulation of skin microvascular blood flow has been studied in Type 1 diabetic patients with and without clinical evidence of microvascular complications after a long duration of diabetes. 13 uncomplicated patients with a mean duration of diabetes of 38 +/- 6 (SD) yr were compared with 10 patients with proliferative retinopathy and a group of healthy control subjects. Using laser Doppler flowmetry 2 distinct microvascular responses were examined in the skin of the finger: (a) reactive hyperaemia following the release of one minute's digital arterial occlusion, a response that is independent of neural mechanisms, and (b) the fall in skin blood flow on venous occlusion that occurs due to the veno arteriolar reflex, a response that depends upon intact local sympathetic nervous function. The duration of reactive hyperaemia was longer in the complicated patients than either the group without complications (69 +/- 38: 23 +/- 17 s, p less than 0.01) or the healthy controls (27 +/- 20 s, p less than 0.05). In contrast the percentage fall in laser Doppler blood flow on venous occlusion was significantly less (p less than 0.01) in both diabetic groups than that achieved in healthy controls, (50 +/- 14% controls; 26 +/- 12% uncomplicated group; 28 +/- 12% patients with retinopathy). There was no difference in current or recent diabetic control in the 2 diabetic groups. These results suggest that some degree of sympathetic neuropathy is almost inevitable after a long duration of Type 1 diabetes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311559 TI - Validation of closed-loop subcutaneous insulin infusion algorithm--application of subcutaneous insulin absorption kinetics. AB - For long-term glycemic normalization with a closed-loop control system, a subcutaneous insulin infusion algorithm has been developed based on the pharmacokinetics of subcutaneously administered insulin. A 3-compartmental model was applied to mathematically express the relation between the insulin injected subcutaneously as an input and the plasma insulin response as an output. A computer simulation study using this model showed that the following insulin infusion algorithm is feasible for closed-loop glycemic control by selecting appropriate parameters (Kp/Kd/Kc = 0.0056/0.92/-0.11), IIR(t) = Kp G(t)+Kd d G(t)/dt+Kc, where IIR(t) is the subcutaneous insulin infusion rate at time t (min), G(t) is the blood glucose concentration and Kp, Kd, Kc are the constants. In 5 pancreatectomized dogs, subcutaneous insulin infusion with this algorithm made it possible to keep postprandial glycemic levels after oral glucose load (2 g/kg) at 168 +/- 14 mg/dl (mean +/- SEM) in 60 min and maintained normoglycemia from 180 to 300 min with the total amount of infused insulin being 0.14 +/- 0.019 U/kg. In 5 insulin-dependent diabetic patients, the peaks of postprandial glycemic levels after meal load (450 kcal) were controlled to 176 +/- 36 mg/dl at 90 min and were reduced to 98 +/- 13 mg/dl at 300 min with the total amount of infused insulin being 0.172 +/- 0.063 U/kg. The mean peak plasma insulin level was 49 +/- 11 microU/ml at 90 min. These results indicate the clinical controllability of postprandial glycemia with the closed-loop subcutaneous insulin infusion algorithm in diabetic patients. PMID- 3311560 TI - Annotation: renal failure radiology-1987. PMID- 3311561 TI - Multilocular renal lesions--a diagnostic challenge. AB - We present six patients with benign cystic lesions of the kidneys and one with a cystic carcinoma with preoperative diagnostic difficulties. Despite the advent of modern imaging techniques and aspiration cytology there are no unequivocally reliable diagnostic signs of benignity in multilocular renal lesions. Therefore surgery is recommended as the therapy of choice. PMID- 3311562 TI - Colour flow mapping of oesophagogastric varices and vessels in and around the liver with trans-oesophageal real-time two-dimensional Doppler ultrasound. AB - Conventional transcutaneous ultrasound examinations are often compromised by intervening intestinal or pulmonary gas and have limited resolution. Ultrasonic probes of frequencies greater than 5 MHz, which enhance resolution, cannot be used successfully on the skin surface, because they do not penetrate enough to to visualise intra-abdominal organs in most adults. To overcome these problems, we have used transoesophageal real-time two-dimensional Doppler echography. The ultrasonic probe, with a 5 MHz, curved array, was integrated into the end of a steerable insertion tube. Fifteen patients with oesophagogastric varices were examined. Oesophagogastric varices were visualised in colour in 10 patients. The direction of blood flow was determined in six patients. The flow velocity was measured quantitatively in five patients by the pulsed Doppler technique. The vessels in and around the liver were also visualised even when they could not be seen with transcutaneous ultrasonography. This technique is useful for the evaluation of both oesophagogastric varices and other abdominal vessels. PMID- 3311563 TI - Magnetic resonance imaging of parenchymal liver disease: a comparison with ultrasound, radionuclide scintigraphy and X-ray computed tomography. The Clinical NMR Group. AB - Fifty-five patients with suspected parenchymal liver disease were examined radiologically immediately prior to percutaneous liver biopsy. Radiological examination consisted of independently performed ultrasound, X-ray computed tomography, proton magnetic resonance and radionuclide liver studies. It was found that none of these scan techniques, alone or in any combinations, could accurately diagnose or exclude liver disease. Calculated mean hepatic T1 relaxation values (measured in vivo at 3.4 MHz) did not indicate the presence or amount of fatty, inflammatory or cirrhotic change in the liver. A tendency for livers with hepatitis and cirrhosis to have a prolonged mean T1 relaxation value was noted, while the pathological accumulation of excess quantities of intrahepatic iron significantly shortened the mean hepatic T1. In patients with clinically suspected parenchymal liver disease who will undergo percutaneous liver biopsy, we see no justification for the use of proton nuclear magnetic resonance imaging techniques or the in vivo measurement of hepatic T1 relaxation time. PMID- 3311565 TI - Prevalence and patterns of spina bifida occulta in 2707 normal adults. AB - Plain radiographs of the urinary tract on 2707 normal volunteers were reviewed to establish the prevalence and patterns of spina bifida occulta in the normal population. Abnormalities in the formation of the posterior arch were identified in 23%, and four different patterns are described. In this group of subjects the condition was twice as common in males as in females (P less than 0.001) and commoner in younger adults. The commonest defects were either in S1 alone or involved S1 and S2 together. Isolated defects at L5 or S2 were rare. The level of opening of the posterior sacral arcs was assessed and a high level of opening was shown to correlate with the presence of spina bifida occulta. PMID- 3311564 TI - Angiographic signs of aortic graft-enteric fistulae. AB - Angiograms of four patients with intestinal bleeding from aortic graft-enteric fistulae collected over 4 years have been reviewed. All showed a bulging dilatation of the graft and aortic anastomosis. False aneurysms of the proximal aortic anastomosis were demonstrated twice. A patent fistula was never demonstrated. Angiograms performed in the same period of 18 consecutive patients without fistulae, after aortic graft reconstruction, were reviewed for comparison. None of these displayed the bulging of the graft seen in the group of graft-enteric fistulae. Thus in a patient with gastrointestinal bleeding and a high suspicion of aortic graft-enteric fistula, the diagnosis is supported angiographically by the presence of this bulge. PMID- 3311567 TI - Recurrent pyogenic cholangitis: ultrasound evaluation compared with endoscopic retrograde cholangiography. PMID- 3311566 TI - Case report: unilateral haematocolpos in uterine duplication associated with renal agenesis. AB - A case of unilateral haematocolpos correctly diagnosed by ultrasound is described in a 13 year old girl known to have a solitary kidney. The association of renal agenesis with Mullerian abnormalities is well recognised and in this case the ultrasound findings ensured that the correct surgical management was undertaken. PMID- 3311568 TI - Insulin action and inaction. PMID- 3311569 TI - Changes in plasma renin, insulin, aldosterone and arginine vasopressin during plasmapheresis. AB - 1. Nineteen patients with a spectrum of immunologically related disorders were studied before and immediately after plasmapheresis for changes in plasma aldosterone, insulin and arginine vasopressin (AVP). Renin was also measured in 11 of these patients by direct radioimmunoassay. 125% of the initial plasma volume was replaced, which corresponded to a predicted removal of 72% for any plasma constituent. 2. The initial, final (experimental) and final (predicted) concentrations (means +/- SEM) were 337 +/- 50, 185 +/- 23 and 100 +/- 16 pg/ml respectively for renin, 465 +/- 86, 146 +/- 38 and 124 +/- 22 pmol/l respectively for aldosterone, 218 +/- 35, 69 +/- 11 and 63 +/- 11 pmol/l respectively for insulin, 7.2 +/- 1.9, 6.1 +/- 0.5 and 1.8 +/- 0.2 pmol/l respectively for AVP. The predicted final concentration was calculated from the initial concentration and the fraction of plasma volume exchanged. The experimental final concentration was lower than the initial concentration for renin, aldosterone and insulin (P less than 0.001) but not for AVP. The predicted final concentration was lower than the experimental final concentration for AVP and renin (P less than 0.001) but not for aldosterone and insulin. Plasma volume, osmolality, glucose, sodium and potassium concentrations did not change significantly. 3. The concentrations of renin, aldosterone, insulin and AVP in the removed plasma were 84 +/- 17 pg/ml, 179 +/- 36, 98 +/- 15 and 4.8 +/- 0.7 pmol/l respectively. The amount subtracted expressed as percentage of the total amount present in plasma was markedly greater for AVP than for the three other plasma constituents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311570 TI - Lack of effect of acute ethanol consumption on active cation fluxes of leucocytes and erythrocytes in healthy humans. AB - 1. Acute ethanol consumption in human volunteers did not appear to alter active cation fluxes by Na+,K+-ATPase, or intracellular electrolyte concentrations, in peripheral leucocytes or erythrocytes. 2. Urinary electrolyte excretion was decreased after ethanol consumption, compared with controls. 3. Neither plasma glucose nor serum insulin was altered by ethanol. 4. After ethanol consumption there was an elevation of endogenous plasma adrenaline levels. This was accompanied by a leucocytosis, which could be attributed to a raised neutrophil count. 5. The raised adrenaline levels were not associated with hypokalaemia. 6. It is possible that in vivo ethanol may prevent adrenaline-induced hypokalaemia by fluidizing the membrane and/or decreasing the affinity of beta-receptors for adrenaline. PMID- 3311571 TI - Effects of a single moderate dose of alcohol on blood pressure, heart rate and associated metabolic and endocrine changes. AB - 1. The effects of a single moderate dose of alcohol on blood pressure, heart rate and associated metabolic and endocrine changes were studied in 10 healthy subjects and compared with those of an isocaloric glucose control drink. 2. Systolic blood pressure rose at 1 h after both alcohol and the control drink. Therefore this early change was not specifically due to alcohol ingestion. Subsequently, there was a tendency (not statistically significant) for supine and erect systolic blood pressure to be reduced up to 8 h after alcohol ingestion. There were no consistent late changes in blood pressure observed over 7 days after alcohol. 3. Alcohol caused a marked tachycardia in both supine and erect postures which persisted beyond the time of detectable blood alcohol levels. 4. Blood sugar rose by a similar amount after alcohol and the isocaloric glucose control drink, but peak plasma insulin levels were higher after the control drink. 5. Plasma sodium rose in keeping with alcohol induced water diuresis. No significant changes in plasma potassium or magnesium were seen after alcohol. 6. Compared with the control drink there was no evidence from measurements of circulating adrenaline, noradrenaline, cortisol, aldosterone or renin of activation of the sympathoadrenal axis, adrenal cortex or renin-angiotensin systems after alcohol. PMID- 3311572 TI - Ciprofloxacin and norfloxacin, two fluoroquinolone antimicrobials. AB - The chemistry, mechanism of action, antimicrobial spectrum, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of ciprofloxacin and norfloxacin are reviewed, and mechanisms of antimicrobial resistance and drug and laboratory interactions are described. Norfloxacin is the first antimicrobial in the fluoroquinolone class to be marketed in the United States; ciprofloxacin is under investigation in clinical trials. The fluoroquinolones are structurally related to nalidixic acid. The activity and spectrum are enhanced by the addition of 6-fluoro and 7-piperazino substituents. Quinolone antimicrobials appear to inhibit DNA gyrase, an enzyme specific and essential for all bacteria, as their primary mechanism of action. As a result, DNA synthesis is inhibited. Ciprofloxacin and norfloxacin are active against gram negative enteric bacteria, Pseudomonas aeruginosa, Haemophilus influenzae, and Neisseria gonorrhoeae. Ciprofloxacin has good activity against Staphylcoccus spp., including methicillin-resistant Staph. aureus. Norfloxacin generally is less potent than ciprofloxacin, particularly against Ps. aeruginosa and Staph. aureus. Peak concentrations occur about one to two hours after an oral administration of either drug. Both drugs are widely distributed in body fluids and tissues and are eliminated by renal excretion, metabolism, and biliary excretion. Dosage reductions are required in severe renal dysfunction. Ciprofloxacin and norfloxacin are effective agents for treating urinary-tract infections, including infections caused by Ps. aeruginosa. The recommended dosage of norfloxacin for urinary-tract infections in adults is 400 mg orally every 12 hours; the drug should be given for 7 to 10 days in uncomplicated infections and for 10 to 21 days in complicated ones. The fluoroquinolones may be useful for treating chronic bacterial prostatitis. Ciprofloxacin is potentially useful for treating sexually transmitted diseases. Ciprofloxacin is active against N. gonorrhoeae, including beta-lactamase-producing strains and strains that are resistant to tetracycline, and Chlamydia spp. Use of ciprofloxacin for treating gastrointestinal infections and for selective decontamination of the gastrointestinal tract is promising. In open studies, ciprofloxacin has been effective against a variety of infections caused by susceptible organisms. Resistance to ciprofloxacin has developed during treatment of infections caused by Ps. aeruginosa, Staph. aureus, and Serratia marcescens. The most frequently reported adverse effects of either drug are gastrointestinal complaints, headache, and dizziness.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311573 TI - Advances in drug therapy of cardiopulmonary arrest. AB - Advances in the selection and use of drugs during cardiopulmonary resuscitation (CPR) are reviewed. In 1985, the American Heart Association and the National Academy of Sciences-National Research Council revised standards and guidelines for CPR and emergency cardiac care. Algorithms were developed for treatment of (1) ventricular fibrillation and pulseless ventricular tachycardia, (2) ventricular tachycardia with pulse, (3) asystole, (4) electromechanical dissociation, (5) paroxysmal supraventricular tachycardia, (6) bradycardia, and (7) ventricular ectopy. Vasoconstriction, aortic diastolic arterial pressure, and coronary perfusion pressure are the most important determinants of the success of resuscitation. Because coronary perfusion occurs only during diastole, it is essential to maintain an adequate diastolic pressure. Arterial and central venous lines are needed for estimating coronary perfusion pressure, but end-tidal carbon dioxide measurement appears promising as a noninvasive alternative. Arterial blood gas measurements indicate respiratory alkalosis during CPR, but underlying tissue acidosis persists; venous blood gases appear to provide more useful information. A large catheter in a central vein above the diaphragm is the preferred route for drug administration during CPR, but an antecubital venipuncture site can be used to avoid interrupting CPR. Peak drug concentrations are higher and are achieved sooner with central venous than with peripheral venous injection. The endotracheal route can be used safely for administration of epinephrine, lidocaine, or atropine; an adequate volume (5 or 10 mL) of diluent is needed, and several insufflations should follow instillation. Drug distribution during CPR is greater to the brain and myocardium than to peripheral tissues. Epinephrine is administered to all patients in cardiopulmonary arrest; its beneficial effect is due to alpha-mediated vasoconstriction. Epinephrine increases cerebral as well as myocardial blood flow. The currently recommended dose of epinephrine hydrochloride is 0.5 to 1.0 mg i.v. at five-minute intervals. For endotracheal administration, an initial 1.0-mg dose is recommended, and subsequent doses are determined by patient response. Epinephrine has a beta adrenergic-stimulating effect that may increase myocardial oxygen demand, but pure alpha agonists such as phenylephrine, methoxamine, and metaraminol have not been found superior to epinephrine. Epinephrine has not been proven to make ventricular fibrillation more susceptible to direct-current countershock. (ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311574 TI - Current concepts in clinical therapeutics: anxiety disorders, Part 1. AB - The diagnosis, epidemiology, classification and clinical presentation, pathophysiology, and treatment of anxiety disorders are reviewed. Anxiety disorders, among the most common mental disorders, must be differentiated from medical diseases with anxious symptoms. A complete physical and mental status examination, as well as a thorough knowledge of the patient's medical, psychiatric, and drug history are required. Epidemiologic studies indicate an incidence of 4-8% in the United States. There are four categories of anxiety disorders: phobic disorders, anxiety states, posttraumatic stress disorders, and atypical anxiety disorders. Several psychoanalytic, behavioral, and cognitive theories have been advanced to explain the pathophysiologic mechanisms causing anxiety disorders. Of most interest are the biological theories involving the catecholamine neurotransmitter norepinephrine and the benzodiazepine receptor. Proper treatment for anxiety disorders involves nonpharmacologic and pharmacologic approaches. The benzodiazepines are widely used and are the mainstay of drug treatment for patients with situational anxiety and generalized anxiety disorder. However, problems with sedation, complications of drug withdrawal, and patients' fear of drug dependency may limit clinical usefulness. Buspirone is the first nonbenzodiazepine anxiolytic to be introduced in the United States in more than 25 years. Its unique role in treating anxiety, compared with the benzodiazepines, may include less sedation, minimal drug abuse potential, and fewer withdrawal symptoms upon drug discontinuation. Nonpharmacologic therapy is used extensively in the treatment of phobic disorders (simple and social phobia). Important advances in the diagnosis and treatment of anxiety disorders have been made. An accurate diagnosis is essential for optimal management. Unfortunately, many anxious patients do not seek treatment and some do not receive the most appropriate treatment. PMID- 3311575 TI - Serum potassium concentration after initiation of captopril therapy. PMID- 3311576 TI - Growth hormone for the treatment of growth failure in children. AB - The etiology, diagnosis, and clinical features of growth failure in children are presented, with discussion of exogenous growth hormone (GH) replacement, its indications, efficacy, and adverse effects. Causes of growth delay include malnutrition, systemic illness, emotional deprivation, deficiency of endogenous growth hormone, thyroid hormone deficiency, and cortisol excess. Growth hormone (somatotropin) is secreted by the anterior pituitary gland in response to various stimuli, including exercise, hypoglycemia, and arginine. This hormone stimulates growth of skeletal muscle and connective tissue, increases rate of protein synthesis, and decreases rate of glucose use. Diagnosis of GH deficiency usually relies upon detection of adequate GH release in response to two stimuli. However, because patients with adequate endogenous GH release (determined by testing) may also grow when given exogenous GH, other methods are being evaluated for diagnosis of GH-dependent states. In many children, exogenous GH replacement produces increased rates of growth within 6 to 12 months; subsequently, growth rates decline. Distribution of the pituitary-derived GH product somatotropin was halted because of reports of Creutzfeldt-Jakob disease in some patients receiving it. Somatrem, a biosynthetic GH produced by recombinant DNA technology, has shown efficacy similar to somatotropin in clinical studies and is currently available to pediatric endocrinologists. Growth hormone replacement is beneficial in idiopathic and acquired GH deficiency, including partial GH deficiency. Further testing is needed to determine the usefulness and cost-benefit of somatrem therapy in GH-dependent and other types of growth failure. PMID- 3311577 TI - Current concepts in clinical therapeutics: ischemic cerebrovascular disease. AB - The classification, epidemiology, pathophysiology, diagnosis, and treatment of ischemic cerebrovascular disease (ischemic stroke) are reviewed, and the major drugs used in the prevention of this disease are discussed. Ischemic stroke is a major problem in terms of morbidity and mortality because of the high prevalence of atherosclerosis in the United States population. The pathogenesis of cerebral ischemia is multifactorial, beginning with an atherosclerotic plaque on the arterial wall that may result in stenosis or ulceration with subsequent thrombosis or embolization. Platelets may adhere to the exposed arterial wall endothelium, stimulating further platelet aggregation and accumulation of leukocytes and fibrin. Consequences of cerebral ischemia include transient ischemic attacks and brain infarcts. Diagnosis is based mainly on patient history and ancillary radiologic studies. Treatment of ischemic cerebrovascular disease is primarily preventive, since the brain has limited capacity to recover neurologic function after an infarction. Transient ischemic attacks are treated with either antiplatelet agents, anticoagulants, or surgery. Treatment of stroke is also preventive, although anticoagulation is sometimes used to prevent stroke progression. Agents that may reverse neurologic impairment following an acute stroke, such as prostacyclin, calcium-channel blockers, and opiate antagonists, are being investigated. Antiplatelet therapy is indicated in subsets of patients with cerebral vascular insufficiency. Anticoagulation therapy, if needed, should be given for only three to four months. PMID- 3311578 TI - Topical minoxidil therapy for hair regrowth. AB - The pathogenesis of hair loss, the postulated mechanisms of minoxidil action on hair growth, and clinical trials, adverse reactions, experimental formulations, and percutaneous absorption of topical minoxidil preparations are reviewed. Topical minoxidil seems to normalize hair follicles and increase blood flow to the scalp. In clinical trials of various formulations, results have varied. Improved hair growth occurred after four to six months of therapy; twice-daily application seems to be indicated. The most frequently reported adverse reactions are mild scalp dryness and irritation and, rarely, allergic contact dermatitis. Current recommendations are to reserve topical minoxidil for patients with normal cardiovascular status and to routinely monitor blood pressure, heart rate, and electrocardiographic changes. A new drug application is pending with FDA for use of topical minoxidil in androgenetic alopecia (male-pattern baldness), which is genetically determined and apparently stimulated by androgens. For alopecia areata, which involves hair loss on the body or scalp, usually patchy and of sudden onset, no reliable treatment has been found, although minoxidil may be efficacious in some patients. Minoxidil has generated new interest in hair-loss research. The etiology of hair loss must be better understood before more effective treatment regimens can be designed. PMID- 3311579 TI - Human cardiovascular adjustments to acute hypoxaemia. AB - Traditionally, cardiovascular adjustments to hypoxaemia are viewed as resultants of competing local vasodilation and vasoconstriction via arterial chemoreflexes with net effects of increased cerebral and coronary blood flows (local) and reduced flow to visceral organs and muscle (reflex). Although true in asphyxia, breathing activates lung mechanoreceptors which reduce vagal outflow and apparently, in humans, abolishes sympathetic vasomotor activity (SNA). During rest, moderate to severe hypoxaemia (PaO2 = 35 to 27 mmHg) caused no splanchnic, cutaneous or muscle vasoconstriction. Local vasodilator effects of hypoxaemia were not sufficient to overwhelm vasoconstriction; splanchnic arterioles responded normally to infused noradrenalin (NA) during hypoxaemia. Possibly, central effects of hypoxaemia blunt SNA or peripheral, prejunctional effects impair neuronal release of NA. Persistent orthostatic tolerance with normal skeletal muscle vasoconstriction and retained spinal venomotor reflexes during hypoxaemia argue against prejunctional inhibition of NA release. Results so far suggest that beyond a certain threshold, hypoxaemia centrally inhibits SNA. In contrast to rest, even moderate hypoxaemia during exercise markedly increases plasma NA concentration (and SNA), but the usual relationship among splanchnic blood flow, plasma NA and heart rate was not observed--NA and heart rate rose together, whereas the predicted splanchnic vasoconstriction was not observed. In moderate hypoxaemia, muscle blood flow and cardiac output are greater than in normoxia at a given submaximal oxygen uptake; but at maximal oxygen uptake, blood pressure, total vascular conductance and maximal cardiac output are unaffected. Given the fixed upper limit to cardiac output and the greater capacity of active muscle to vasodilate and exceed cardiac pumping capacity during hypoxaemia, we conclude that blood pressure is maintained by baroreflex- (not chemoreflex-) mediated vasoconstriction in the active muscle which must be the primary target of increased SNA and the source of NA. PMID- 3311580 TI - Host defense impairments that may lead to respiratory infections. AB - Host defense mechanisms spaced along the respiratory tree and in the alveolar spaces effectively remove or contend with micro-organisms that enter the airways, so serious lung infections occur rarely in healthy people. Special circumstances, such as virgin exposure to a virulent microbe or a large innoculum of a pathogen, can result in illness, but usually routine surveillance host defenses are protective and suffice to keep colonizing airway flora in check. When pneumonia develops or recurrent sinopulmonary infection exists, however, some element of the normal defense apparatus may have failed or is inadequate. This review highlights several components of the apparatus, that is immunoglobulins IgG and IgA and the interaction of alveolar macrophages and lymphocytes, and examines deficiencies in their function that may result in infection. Along the conducting airways, poor mucociliary clearance and/or deficiencies in certain IgG subclass antibodies or destruction of IgA may predispose to sinopulmonary infections; these may be a manifestation of a hereditary disease. In pneumonia the alveolar macrophage is positioned as the central cell which must respond in several directions. This scavenger phagocyte first intercepts the microbe and either can kill or contain it or must call in some other phagocytic cell or inflammatory mediator(s) for assistance. Opsonic antibodies (IgG) and other nonimmune opsonins (complement and surfactant or fibronectin fragments) facilitate phagocytosis, but an absence of antibody may permit infection to develop with encapsulated bacteria (pneumococcus). Insufficient bone marrow reserves of PMNs or a paucity of chemotactic factors to attract them into the alveoli is a situation that may permit gram-negative bacilli and fungal organisms to flourish. Inability of immune T-lymphocytes to energize macrophages, through soluble cellular mediators that provide cell-mediated immunity and activation, makes containment of certain intracellular microbes impossible for these phagocytes (Legionella or mycobacteria). Likewise, concomitant infection of macrophages with viruses (human immunodeficiency virus, and cytomegalovirus or herpes viruses) plus an excessive T-lymphocyte suppressor cell influence may make P. carinii and common bacterial and fungal organisms difficult to contain in the lungs of AIDS patients. Consideration about what the lung host deficiency might be can make therapy more specific through immunization to develop special antibodies, replacement of certain immunoglobulins (IgG subclasses), or selective administration of cell mediators (gamma-interferon or interleukins). PMID- 3311581 TI - The effect of common pharmacologic agents on pulmonary antibacterial defenses: implications for the geriatric patient. AB - Clinical and laboratory observations have raised the possibility that common pharmacologic agents disrupt lung host defense and predispose to bacterial infection of the lower respiratory tract. Epidemiologic data suggest that the potential for an impairment in pulmonary antibacterial mechanisms is greatest among individuals of advanced age. However, lung antimicrobial systems are extremely complex, and patients with pulmonary infections characteristically have a variety of predisposing conditions. Thus, it remains very difficult to assess the relative impact of drug-related derangements on lung antimicrobial systems. Indeed, it is likely that multiple intrinsic and extrinsic factors contribute to the evolution of most bacterial pneumonias. Thus, while medications may not represent major risk factors, they may act in an additive or synergistic manner with other predisposing conditions, such as age-associated changes in immunologic activity and underlying disease, to enhance susceptibility to infectious illnesses of the lung. Clearly, substantial clinical and laboratory study will be required in order to define the role that common pharmacologic agents play in predisposing to bacterial infection of the lower respiratory tract. PMID- 3311582 TI - Cigarette smoking and respiratory tract infection. AB - Although not conclusive, several lines of evidence suggest that cigarette smoking alters the respiratory tract's ability to defend itself from infection. Some subjects with chronic bronchitis have colonization of the lower respiratory tract with bacteria. Both patients with chronic respiratory disease and healthy smokers appear to have a higher frequency of respiratory infections and an increased severity of symptoms when infected. Children exposed passively to cigarette smoke have higher rates of respiratory illnesses. Yet the marked variability in the incidence of infection in the smoking population suggests that there are subtle factors that predispose some smokers to more risk of infection than others. Cigarette smoking is associated with alterations in mechanisms of the host defense system, even in asymptomatic individuals (summarized in Table 3). Ciliary function is impaired, mucous volume is increased, humoral response to antigens altered, and quantitative and qualitative changes in cellular components occur. Some of these alterations in host defense mechanisms are dose related; others revert to normal after smoking cessation. Yet, it is unknown if one or all of these alterations cause any significant compromise of host defense or if other factors, as yet unidentified, may be important. Answers to these questions await a more thorough elucidation of normal host defense function. PMID- 3311583 TI - Utility of radiography and clinical features in the diagnosis of community acquired pneumonia. AB - This article reviews the approach to the differential diagnosis of community acquired pneumonia using clinical clues and radiography. Evidence is reviewed that indicates that the etiology of such pneumonias is changing. The basic clinical patterns, including bacterial, nonbacterial, and mixed presentations are discussed, as well as how aspiration, diabetes, and alcoholism affect the differential diagnosis. PMID- 3311584 TI - Viral infection of the lower respiratory tract. AB - This article describes the epidemiology, transmission, and pathophysiology of viral infection of the lower respiratory tract. Current approaches to diagnosis, treatment, and prevention also are discussed. PMID- 3311585 TI - Legionnaires' disease: respiratory infections caused by Legionella bacteria. AB - This article provides a review of Legionnaire's Disease, a bacterial pneumonia caused by Legionella species, and of Pontiac Fever, the flu-like illness caused by these microorganisms. The authors draw on their personal experience with major human outbreaks of Legionnaire's Disease and with animal models of Legionella pneumonia. Emphasis is placed on the sources in nature from which legionellosis is acquired, the means of dissemination of bacteria, the epidemiology of human infections, the pathogenetic mechanisms of disease and host defense, the clinical manifestations, and the treatment. PMID- 3311586 TI - Bacterial colonization: pathogenesis and clinical significance. AB - Bacterial colonization of the respiratory tract frequently precedes the onset of serious invasive infection. It is increasingly evident that the risk for colonization is greatest in patients with serious underlying illness. These patients have been shown to have increased bacterial binding to their respiratory mucosa. In addition to the patients' own predisposition to infection, many of our medical interventions may further compromise the respiratory tract host defenses and permit successful bacterial growth. Methods for prevention of bacterial colonization have not been very successful to date. Although methods to decrease the introduction of exogenous bacteria to patients have been developed, problems persist with the patients' endogenous enteric gram-negative bacilli. It is hoped that increased understanding of bacterial-mucosal interactions will lead to new therapeutic strategies to prevent bacterial invasion of the respiratory tract. PMID- 3311587 TI - Nosocomial pneumonia. AB - Nosocomial pneumonias are a particularly problematic group of infections. The pathogenesis of these pneumonias, including mechanisms of colonization and pulmonary defense mechanisms, is discussed. An approach to the hospitalized patient with fever and infiltrates, based on the clinical setting, the nature of the host defense defect, the radiographic findings, and the results of invasive diagnostic procedures, is presented. Antimicrobial agents available to treat patients with nosocomial pneumonia are reviewed. PMID- 3311588 TI - An overview of pulmonary fungal infections. AB - An overview of important pulmonary mycoses is presented. Four endemic mycoses occur in restricted geographic areas: histoplasmosis, blastomycosis, coccidioidomycosis, and paracoccidioidomycosis. Three opportunistic mycoses have causative agents that are ubiquitous in nature but cause infection only in compromised hosts: aspergillosis, mucormycosis, and candidiasis. Cryptococcosis is acquired by inhalation but usually presents as a chronic meningitis. Pulmonary sporotrichosis is rare; the usual subcutaneous form of the disease is acquired by inoculation. The clinical features of these infections are discussed, with special emphasis on recent advances in diagnosis and treatment. PMID- 3311589 TI - Diagnosis of pneumonia: techniques and problems. AB - All diagnostic strategies in patients suspected of having pneumonia have considerable limitations. While the diagnostic strategy varies from patient to patient, an overview of one possible approach is summarized in Figures 2 and 3. The diagnosis and management of pneumonia usually poses little difficulty in the community setting, but the value of various diagnostic approaches in patients with hospital-acquired pneumonia is a subject of considerable controversy. Clinical criteria of pneumonia, including fever, purulent tracheobronchial secretions, leukocytosis, and a new infiltrate on chest radiograph are hampered by the high frequency with which these findings are observed in patients without pneumonia. Since tracheobronchial secretions are commonly contaminated by microorganisms colonizing the upper airways, routine culture of expectorated sputum, with the inevitable recovery of a potpourri of potential pathogens, can hardly be regarded as a meaningful exercise for the physician. Such cultures with subsequent extensive susceptibility testing form one of the largest workloads and expenses in microbiology laboratories. Clinical decisions based on such information may result in serious patient mismanagement with antibiotics, with the potential of superinfection and drug complication, which further add to hospital expenditures. Blood cultures are valuable when positive, but negative results are more common even in severe pneumonia. Transtracheal aspiration of tracheobronchial secretions is satisfactory in the diagnosis of community acquired pneumonia in patients without pre-existing lung disease, but its value in the diagnosis of hospital-acquired pneumonia needs further evaluation. Transthoracic aspiration, especially with the newer finer needles, holds considerable promise but the significant risk of barotrauma deters most physicians from employing this procedure in patients requiring mechanical ventilation. Immunologic techniques of detecting microbial antigens, like countercurrentimmunoelectrophoresis and ELISA, are promising but presently inadequate to screen for a wide variety of organisms. Although it also has its limitations, fiberoptic bronchoscopy appears to be the most satisfactory technique if an invasive approach is being considered in a patient suspected of pneumonia. Samples taken with the plugged telescoping catheter technique, when properly performed, combined with quantitative cultures (and possibly antibody coating of bacteria) probably provide the least misleading information when a bacterial pathogen is being considered.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311591 TI - Strategies for the prevention of pneumonia. AB - Pneumonia remains a major source of morbidity and economic cost to our society, despite the availability of new antibiotics for therapy. To truly reduce the impact of this illness, serious efforts at preventing infection must be undertaken. In the area of community-acquired infections, safe and effective vaccines are available against S. pneumoniae, the most common pneumonic pathogen, and influenza. High-risk individuals (Table 2), who should be considered for vaccination, include: the elderly; residents of chronic-care facilities; and patients with chronic cardiac, respiratory, renal, and hematologic illnesses. Influenza vaccine is effective in preventing infections in such high-risk populations, including the elderly. There is some controversy about the efficacy of pneumococcal vaccine in an at-risk population with severe co-morbid illness, but there is little doubt that the vaccine is effective in a more healthy elderly population. Both patients and physicians fail to appreciate the safety and utility of these vaccines as evidenced by their low rates of use. Remarkably, only about 10 per cent of appropriate persons have ever received the pneumococcal vaccine, even though it needs to be given only once in a lifetime. In the area of nosocomial pneumonia, several strategies for prevention have proven to be useful. Most promising is the use of topical antibiotics in the upper and lower airway. Although the efficacy of this approach is well established, its safety has been questioned in prior studies. For many reasons, this position should be reevaluated, and this therapy should be considered for use in carefully selected patients at risk, using modern techniques of aerosol therapy. Active investigation into vaccines against gram-negative bacterial look to yield promising results in the future. In addition, passive "serum" therapy with preformed antibodies is a strategy for preventing gram-negative lung infection that has shown use in animal studies and may circumvent certain logistical problems of vaccine therapy. Infection control methods and sensible handling of respiratory therapy equipment are simple, yet effective, means for preventing contamination of the airway in mechanically ventilated patients. Finally, for patients both in and out of the hospital, an understanding of the nature of host defense impairments leading to pneumonia will allow for strategies to boost host defenses.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311590 TI - "When the pneumonia doesn't get better". AB - Nonresolving pneumonia is a common and frequently misunderstood problem faced by the practicing pulmonologist. While radiographic resolution of most infections is relatively long and lags behind clinical signs of recovery, data suggest that a variety of host defense problems are a consequence of systemic illness and are often involved. When such factors are not implicated, other specific etiologies should be sought, including unusual organisms like mycobacteria, higher order bacteria, and fungi. Noninfectious causes for delayed resolution include neoplastic disease, immunologic disease, thromboemboli, and inhalation injuries. This article discusses the natural history of common pneumonias to establish the usual clinical limits of resolution and outlines a diagnostic strategy to use when these limits are exceeded. PMID- 3311592 TI - Bulimia: diagnosis and treatment. PMID- 3311593 TI - Anorexia nervosa: a syndrome of starvation dependence. PMID- 3311594 TI - Diagnosis and treatment of spontaneous intracerebral hemorrhage. AB - Although ICH continues to decline as a cause of stroke, ICH must be considered in every patient with acute onset of focal cerebral dysfunction even if headache is absent. A variety of diseases leads to the occurrence of ICH, with hypertension continuing to head the list. The prognosis for recovery depends on the cause of the hemorrhage, the site and size of the lesion, and the patient's neurologic status. Each case must be treated individually. Both medical and surgical therapies are important in the management of these difficult problems. As more information is obtained on the natural history of ICH, treatment strategies will continue to evolve. PMID- 3311595 TI - Diagnosis and management of vertigo. AB - Patients with vertigo may be best evaluated when the physician has the various entities that may be responsible clearly in mind. Those diseases listed in group II are more familiar to the primary care physician than those listed in group I, which belong more in the realm of neuro-otology than in general medicine and neurology. The proper use of history, physical findings, and laboratory evaluations will allow the clinician to classify the patient's problem and to initiate treatment and consider appropriate referral when indicated. PMID- 3311596 TI - Neuropsychology of aging. AB - In normal aging, decline in some, but not in all aspects of intelligence and memory are seen. The general health status of the individuals may exacerbate the normal aging process. Moreover, the emotional-motivational characteristics of the elderly seem to play a predominant role in over-all quality of life and psychosocial adjustment to the aging process. PMID- 3311597 TI - Pharmacologic role of rubidium in psychiatric research. AB - Rubidium appears to exert several biologic and pharmacologic effects that are similar if not identical to those of many of the classic antidepressant drugs. This mineral element, if given orally as rubidium chloride, appears to be nontoxic and therapeutically effective in several types of depressive disorders. Currently, however, it is unclear whether or not rubidium will serve as an invaluable pharmacologic agent of a direct clinical nature. Further pharmacometric studies and clinical evaluations are needed to elucidate its mechanism of action and to ascertain its future therapeutic role as an antidepressant drug in clinical psychiatry. PMID- 3311598 TI - Alzheimer's disease: evolving clinical concepts and management strategies. AB - The prevalence of Alzheimer's disease is rising dramatically. This increase results from a "graying" of our population and a redefinition of the term Alzheimer's disease. Alzheimer's disease is recognized to be a progressive neurologic disorder of unknown cause but is not associated with any increased cerebral arteriosclerosis as compared to age-matched controls. The course of the illness on average is about ten years. A variety of inclusion and exclusion criteria, if used conservatively, can accurately predict the pathologic diagnosis of Alzheimer's disease. Whereas no specific cause or clearly effective treatment is currently available, care consists of pharmacologic therapy aimed at specific symptoms and measures designed to reduce patient confusion and care-giver burden. The physician can benefit the patient and care giver by providing an accurate diagnosis, providing therapy where available, counseling the family, and providing referrals to available community-support services. PMID- 3311599 TI - Treating depression in elderly patients. PMID- 3311600 TI - Depression, dementia, and pseudodementia. PMID- 3311601 TI - Widespread codistribution of glycoprotein gp 115 and elastin in chick eye and other tissues. AB - Frozen sections of chick tissues were exposed to affinity-purified monoclonal antibodies raised against chick gp 115 and to affinity-purified antibodies raised against chick tropoelastin to study the distribution pattern of the corresponding antigens by the avidin-biotin immunoperoxidase technique. Laminin and fibronectin antibodies were used for comparison. Gp 115 and tropoelastin antibodies localized to the same structure in several of the tissues examined. The endothelial membrane of the cornea and Bruch's membrane in the choroid were positive, while the corneal epithelial membrane was negative. Both antibodies displayed a peculiar punctate reactivity in the corneal stroma and a very fine fibrillar pattern in the conjunctiva and at the corneal-scleral junction. Liver, heart and large vessels, striated muscle and skin showed a similar pattern both for tropoelastin and gp 115 antibodies. Few differences were seen in the distribution of the reactivity: the pericellular matrix of intestinal smooth muscle cells was stained by gp 115 but not by tropoelastin antibodies. However, the reactivity of gp 115 and tropoelastin antibodies was similarly distributed in the lung smooth muscle cell clusters. The peritubular matrix in the kidney did also not react with tropoelastin antibodies as did the brain intraparenchymal vessels; whereas gp 115 antibody reactivity was present in both sites. We interpret these lack of apparent codistribution in some tissues as a variation in the relative availability of the target antigen for the reaction with the antibody and not as a consequence of a qualitative difference in the distribution of gp 115 and tropoelastin. By the use of anti gp 115 monoclonal antibodies that do not cross react, and presumably recognize different epitopes, it was shown that some but not all antibodies, react with brain intraparenchymal blood vessels; whereas the pattern of distribution in other tissues was the same. This suggests that in vessels with an undetectable level of elastin, certain epitopes of gp 115 molecule might not be recognized as a result of being masked by other components or by a different conformation of the molecule. PMID- 3311603 TI - A synoptic history of health and related services 1970-1985. PMID- 3311602 TI - Passive smoking in the workplace--nuisance or risk? Statement of the Green College Consensus Conference. PMID- 3311604 TI - Pointers from the past: a critical analysis of the teaching of preventive medicine principally in the military environment. PMID- 3311606 TI - Effect of insulin on excretion and retention of infused glutamine amide-N in chickens (Gallus domesticus). AB - 1. The purpose of this study was to examine the effects of insulin on urinary excretion and retention of the intravenously infused glutamine amide-15N in chickens. 2. Insulin pretreatment reduced urinary total 15N excretion (P less than 0.05) and enhanced 15N retention in chicken body (P less than 0.05), but it did not affect non protein-15N retained in the liver and blood. 3. Insulin decreased the incorporation of the infused glutamine amide-15N into urinary uric acid as well as the excretion of other N-derived urinary uric acid (P less than 0.05), which resulted in a significant decrease in total urinary uric acid (P less than 0.05). 4. There was no effect of insulin on urinary appearance of the infused glutamine amide-15N in the form of ammonia. PMID- 3311605 TI - Characterization of an alkaline proteinase of fish muscle. AB - 1. The alkaline proteinase showing pH optimum 8.0 from white croaker (Sciaena schlegeli) skeletal muscle was purified electrophoretically homogeneously (2000 fold) using a combination of DEAE-cellulose chromatography, hydroxylapatite chromatography and Ultrogel AcA 34 gel filtration. 2. It was stable for 1 hr at 50 degrees C. The molecular weight of the enzyme was estimated to be 430,000 by gel filtration, with the enzyme composed of four kinds of subunits, the chain molecular weights of which were 45,000, 48,000, 51,000 and 57,000. 3. From the effects of inhibitors, the enzyme was identified as cysteine proteinase. ATP and Cu2+ inhibited the activity 50% at 10 mM and 70% at 0.1 mM, respectively. 4. Thus the enzyme was characterized as a high molecular weight, heat-stable, alkaline cysteine proteinase (HAP). 5. The enzyme showed hardly any activity below 50 degrees C but considerable activity at around 60 degrees C against myofibrils, digesting myosin heavy chain, actin and tropomyosin. With the addition of 5 M urea the enzyme hydrolyzed myofibrils well at around 30 degrees C. PMID- 3311607 TI - A microcomputer-based vision system for area measurement. AB - A vision system for measuring the area of an arbitrarily shaped object is described. The algorithm consists of a gray-level thresholding technique combined with a region correction procedure based on mathematical morphology. All processing steps are carried out on a microcomputer system equipped with a video digitizer. The algorithm has been successfully applied to a number of images of medical interest including skin wounds and various microscopic-scale objects such as cell cross-sections and multicellular tissues. Excellent agreement between results obtained by the automatic method and by using standard mechanical means has been established experimentally. The approach is demonstrated by a number of experimental examples. PMID- 3311608 TI - Computer assisted psychiatric diagnosis: experiments in software design. AB - The process of psychiatric diagnosis involves the real-time utilization of large amounts of knowledge to maintain and test multiple hypotheses. Therefore, the development of an on-line computerized assistant that can aid a clinician performing psychiatric diagnoses presents challenging problems in data-base organization and retrieval. We have developed the DUNE (Diagnostic Understanding of Natural Events) system architecture that organizes the knowledge around processing structures. The system was designed as a shell for expert-systems that aid diagnoses and assessment tasks in ill-structured domains in general. These domains have previously proven unfeasible for traditional expert-systems such as rule based systems. Currently, DUNE contains sufficient knowledge to aid the diagnosis of anxiety and affective disorders. Among DUNE's advantages: a large degree of tolerance to clinician errors, and flexibility at run time. In this paper, we discuss the general specifications for a program that can aid psychiatric diagnoses, and then describe DUNE and its capabilities. PMID- 3311609 TI - Evaluation of clinical and screening tests on the TI-59. AB - A program for the Texas Instruments TI-59 with print cradle is described that allows evaluation of the results expected, according to Bayes' theorem, when applying one or a series of clinical or screening tests. The results of testing are expressed in terms of predictive values and the probability of correctly classifying a patient. The program was written primarily for instruction of medical students and health professionals. PMID- 3311610 TI - Computerized classification of congenital malformations using a modified Bayesian approach. AB - The diagnostic classification of children with dysmorphic features involves over 200 syndromes and 232 findings, with an average of about 15 findings per syndrome. A knowledge base expressed in terms of Boolean combinations of findings is impractical. The normal Bayesian method requires a very large incidence matrix with the vast majority of cells being zero. A modified Bayesian method is proposed in which each syndrome is described in terms of its associated findings, whose incidence P (S/D) are designated as essential (0.90), prevalent (0.90), occasional (0.70) or rare (0.15), whilst P(S/-D) ranged from (0.08) to (0.10). The Bayesian calculation determines the probability of the presence P(D/S) or the absence P(-D/S) of each syndrome. The differential diagnosis consisted of all syndromes whose presence has a probability greater than 0.85. One hundred and thirty-one cases from the Hanna Khoushi Developmental Pediatrics Center at Haifa's Rothschild Hospital were considered. Of the 42 cases for which the center's specialists reached a diagnosis, the system listed the correct diagnosis for 91%. The system reached a diagnosis in about half of the remaining 89 cases. The medical literature is arranged by syndrome whilst the computer allows a case by case approach, thereby avoiding the need for the physician to consider each syndrome to see if it fits his case. This study shows that our modified Bayesian analysis is a valid method for shortening the physician's search in an area of great diagnostic complexity. PMID- 3311611 TI - The imaging of an intraspinal cervical dermoid tumor by MR, CT, and sonography. AB - Epidermoid and dermoid tumors are uncommon lesions and within the spinal cord are rare. Magnetic resonance imaging has proved sensitive to their detection in the intracranial cavity but the pattern of signal intensities on T1 and T2 weighted images has not been uniform. Utilizing a 0.6 T superconductive magnet an intramedullary cervical dermoid tumor was examined. The correlation between CT demonstrated regions of fat density and the MRI appearance of comparable regions of high intensity signal on T1 weighted images has only rarely been demonstrated in such tumors that have no histologic evidence of adipose tissue. MRI provided all of the information needed pre-operatively. PMID- 3311612 TI - Oral history and contemporary medical education. Works in progress. PMID- 3311613 TI - Introduction to the management of immunosuppression. AMA Council on Scientific Affairs. PMID- 3311614 TI - Reflections on medicine. Revisiting Dr. Schweitzer. PMID- 3311615 TI - The present state of endometrial cancer. Controversies and problems. PMID- 3311616 TI - Consensus development summaries. The management of clinically localized prostate cancer. National Institutes of Health. PMID- 3311617 TI - Aztreonam. PMID- 3311618 TI - The President's Page: Medicare assignment. PMID- 3311619 TI - A comparison of a new graduated estrogen formulation with three constant-dosed oral contraceptives. AB - Four-hundred-twenty-six women, aged 18 to 36, completed a four-cycle comparative, randomized, single-blind (observer blind), multicenter study of a new graduated estrogen formulation with three constant-dosed combination oral contraceptives containing the same synthetic steroid compounds. The products studied were Loestrin 1/20, Loestrin 1.5/30, Norlestrin 1/50, and a new graduated estrogen product, Estrostep. A total of 1,850 cycles were completed and analyzed for efficacy, side effects, metabolic changes, and cycle control. Four pregnancies occurred during the course of the study. None of the pregnancies occurred in the group receiving Estrostep. The new formulation produced the lowest rate of breakthrough bleeding (BTB) compared with the other three products. All four combination oral contraceptives resulted in an increase in high-density lipoprotein cholesterol (HDL-C). The levels of HDL-C were greatest with Estrostep. PMID- 3311621 TI - Pelvic inflammatory disease: bacteriology and sequelae. AB - Pelvic inflammatory disease (PID) is defined as the acute clinical syndrome associated with ascending spread of micro-organisms from the lower to the upper female genital tract. The causative organisms can be divided into exogenous (mostly sexually transmittable) and endogenous agents. During the past three decades' epidemic of sexually transmitted diseases (STDs), STD agents have accounted for 60-80% of PIDs in women below the age of 25. After PID a total of 17.4% of the women become infertile because of post-PID tubal damage. Multiple infections, increasing age at the first infection, and severe infections are followed by a more unfavourable fertility prognosis. The risk of an ectopic pregnancy increases 7-10-fold after PID. In areas with high prevalence of STDs, use of IUDs among women in the high risk age group for PID (15-24 years) seems to increase the risk of acquiring the disease but has no influence on the clinical course of the infection. Use of combined oral contraceptive pills decreases both the risk of acquiring PID and the risk of infertility after the infection. PMID- 3311620 TI - Mechanism of action of intrauterine devices: biochemical changes. AB - The mechanism of action of intrauterine devices varies from one type of device to another, although the principle of action is the same, namely, to interfere with the physiology of reproduction at the endometrial level. The biochemical changes of the endometrial tissue and the composition of the uterine fluid have been reviewed in relation to the use of inert, copper-medicated and steroid-releasing IUDs. All IUDs, whether inert or medicated, provoke a significant increase in the number of neutrophils, mononuclear cells and plasma cells, the presence of which is unrelated to the tissue infiltration of inflammatory cells occurring pre menstrually of the normal menstrual cycle. The increase of leucocytes in IUD users is compatible with a foreign body reaction which may be related to the antifertility effect. The addition of copper to an inert IUD has been shown to significantly alter the metabolism of the endometrial cells, e.g. the enzymatic activity and the DOVA-synthesis. The steroid-medicated IUDs represent a new approach to intrauterine contraception where the morphology of the endometrium is considerably altered, showing massive decidual changes, atrophic glands and sometimes atrophy of the whole functional layer. In addition, there is an important foreign body reaction, similar to that of the inert IUDs. The enzymatic activity, as well as the proliferative activity was significantly altered in the endometrium of these IUD-users. Changes in the endometrial fibrinolytic activity in IUD-users have been demonstrated to be related to the presence of irregular bleeding. Micro-traumata of the endometrium and the increased fibrinolytic activity may also interfere with the protective processes present in the physiologically normal endometrium. Further studies on the factors influencing the fertilizing ability of the spermatozoa in the female genital tract, as well as on the conditions of the human endometrium required for the implantation of a blastocyst, may yield important information for the improvement of intrauterine contraception. PMID- 3311622 TI - Quantitative studies on menstrual blood loss in IUD users. AB - Despite the introduction of new intrauterine devices (IUDs), the most important complication involving their use continues to be excessive menstrual bleeding. IUD use in developing countries with women who are already depleted in body iron stores may prove to be deleterious to their health. Mean amounts of menstrual blood loss (MBL) for women not using contraception in the western world is about 32 ml. This mean is increased to 52-72 ml with use of the Lippes loop and other non-medicated devices up to 24 months after insertion. For the Copper-7 and Copper-T-200 devices this mean increase is to 37-40 ml in the first month, decreasing to 30-38 ml at 12 months after IUD insertion. In the users of the Multiload-250 IUD at one month post-insertion the MBL is from 56 to 63 ml and from 36 to 39 ml at 24 months of use. The mean Multiload-375 device users at one month after insertion lose a mean of 45-73 ml at 24 months, 35-50 ml. With the progestogen-releasing IUD mean MBL is 27-36 ml at 1 month and 9-13 ml at 12 months post-insertion. Intermenstrual blood loss is significant only in the first month of use for all IUDs. Discontinuation rates for pain and bleeding with non medicated IUDs are from 11.0-19.6 per 100 women per year, and for the copper IUDs 4.4 to 6.8 per 100 women in the first year of use. The main problem with prolonged menstrual bleeding is depletion of the body iron stores; this is highly significant with non-medicated devices, less important with copper devices and conversely, iron stores are increased in users of progestogen-releasing devices. This is based on serum ferritin measured up to 24 months after insertion. The ferritin values correlated well with the volumes of MBL. It is suggested, especially for women with low body iron stores, that there is an order of preference for IUDs to be used. This should be: firstly, the progestogen releasing devices; secondly, the Copper-T and Copper-7 IUDs; thirdly the larger surface copper devices (Cu-T-220C, Multiload 250 and 375, Cu-T-380). Non medicated devices are not to be recommended for these women. PMID- 3311623 TI - Treatment of increased menstrual blood loss in IUD users. AB - Although bleeding problems represent the commonest side effect of IUDs and an important medical reason for discontinuation of use, its pathogenesis still remains incompletely understood and a standard universally acceptable therapy is not yet available. Proper insertion, change in size, material or shape of the IUD, as well as custom fitting to avoid dimensional incompatibilities, did not significantly improve the IUD-associated bleeding problems. Addition of copper to inert devices seemed to slightly improve the bleeding by reducing the antifibrinolytic activity but probably more was achieved through reducing the device size. Hormone-releasing devices appear to reduce the amount of bleeding significantly but a post-insertion phase of irregular spotting is a common complaint. Locally released antifibrinolytic agents were tried in limited investigations but a short period of drug release restricted further evaluation. Systemic administration of antifibrinolytic agents and non-steroidal anti inflammatory drugs hold promise for the control of IUD-induced menorrhagia. The duration of bleeding and intermenstrual spotting still remains an unresolved clinical problem that requires further evaluation. This area of clinical concern in IUD use needs more in depth understanding and testing of new agents, particularly in the area of local release of antihemorrhagic agents. PMID- 3311624 TI - The role of prostaglandins and allied substances in uterine haemostasis. AB - This review addresses itself to summarizing the more recent studies published on the bioconversion of arachidonic acid in the human endo- and myometrium during the normal menstrual cycle and in women with increased menstrual blood loss. The data indicate an increased ability of the endo- and myometrium from women with menorrhagia to produce prostaglandins with vasodilator and platelet anti aggregatory properties, viz., prostacyclin and prostaglandin E2. The data on prostaglandin production in endometria of IUD wearers is reviewed and discussed in relation to present knowledge on morphological findings in IUD-influenced endometrium. PMID- 3311625 TI - The mode of action of IUDs. AB - In women, IUDs produce alterations of the uterine environment in terms of a pronounced foreign body reaction. This biological response may interfere with steps of the reproductive process that normally take place before the ovum reaches the uterine cavity. In order to discuss this hypothesis on the mechanism of action of IUDs, this review is focussed on 1) detection in urine and blood of substances alleged to be specifically produced by the embryo, 2) migration of gametes in the female genital tract, and 3) microscopic features of ova recovered from the genital tract. PMID- 3311626 TI - Effectiveness of IUDs: a review. AB - Large, multicenter, randomized trials of IUDs conducted between 1970 and 1986 encompass more than 50,000 woman-years of experience in the two-year interval following device insertion. Taken singly and collectively, these trials demonstrate that IUD failure rates are strongly affected by the age of participants, notably by the proportion of women under age 25 admitted to the studies. Individual trials and overall comparisons indicate further that: 1. Non medicated devices such as the Mahua steel ring and Lippes loop D have pregnancy rates above 2 per 100 woman-years. 2. The first approved copper IUDs, the Copper 7 and the TCu 200, do not markedly differ in pregnancy rates from standard plastic devices with rates significantly above 2 per 100 woman-years. 3. Five more recent, widely used copper IUDs have had failure rates significantly below 2 per 100 woman-years in multicenter trials. The point estimate of the failure rate was less than 1 pregnancy per 100 woman-years for three of these IUDs. One copper bearing device had a failure rate significantly below 1 per 100 woman-years. 4. Devices releasing either 25 mcg/day of progesterone or 2 mcg/day of levonorgestrel have had significantly higher failure rates than the more effective copper-releasing IUDs; however, devices releasing 20 mcg/day of levonorgestrel appear at least as effective as the most effective copper IUDs. Long-term IUD failure rates derived from straight assignment as well as randomized trials indicate 4-year gross cumulative failure rates do not exceed 10 per 100 for any of the standard copper devices or the Lippes loop D. Point estimates of the four-year gross cumulative pregnancy rates have been below 5 per 100 users in studies of the TCu 220C, the Nova T, the TCu 380A, and the MLCu 375. PMID- 3311627 TI - The intrauterine device and ectopic pregnancy. AB - Based on data given by case-control and cohort studies the relationships between current and past IUD use, duration of IUD use and the type of IUD were evaluated to determine the risk of ectopic pregnancy among IUD users. The results of this review indicate that current and past IUD users do not have an increased risk of ectopic pregnancy. No relationship was found between the duration of IUD use, for either current or past IUD users, and the risk of ectopic pregnancy. Pooled data from clinical studies of different types of IUD showed that the lowest risk of ectopic pregnancy was for users of copper-bearing IUDs, and the highest risk was for users of progesterone-releasing IUDs. Further research is needed to evaluate the ectopic pregnancy risks to past IUD users, especially in view of recent studies which have shown that these women may be at a higher risk of infertility. PMID- 3311628 TI - Intrauterine devices and pelvic inflammatory disease: recent developments. AB - The potential relationship between use of intrauterine devices and pelvic inflammatory disease is one of the most important issues in contraception today. A number of large, sophisticated studies published since mid-1980 have clarified this association. All have consistently revealed an increased risk of pelvic inflammatory disease among intra-uterine device users, but the most objective of these studies indicate a relative risk compared to women using no method (1.5 2.6) lower than previous estimates. For most intrauterine device wearers, the increased risk of pelvic inflammatory disease persists for only a few months after insertion. The Dalkon Shield appears associated with a higher risk of pelvic inflammatory disease than the Lippes Loop, Saf-T-Coil, or copper devices. Careful selection of candidates for intrauterine devices may further reduce the risk of intrauterine device-associated pelvic inflammatory disease. PMID- 3311629 TI - [A personal view of the history of the genus Yersinia]. AB - The first recorded experience Australia had of the genus Yersinia was the arrival in 1889 of a French expedition led by Pasteur's nephew, Dr. Adrien Loir. At that time Australia was in the grips of an epidemic of rabbits, and Loir's purpose was to eradicate the rabbits by means of fowl plague (Pasteurella multocida). Sadly, bureaucratic and political obstacles prevailed, and Loir was never granted permission to release his biological control agent. Alexander Yersin had been tempted to join Loir's expedition, but elected in the end to travel to Hong Kong, where he discovered the plague bacillus. Had he gone to Australia, we might not now be speaking of the genus Yersinia... Historically, Yersinia pestis has affected not only world history but literature as well. In Shakespeare's Romeo and Juliet, the tragic denouement can be attributed directly to the consequences of the Great Plague. In times of plague, cities closed their gates to travellers, and houses their doors and windows. Thus Laurence's explanatory letter was prevented from reaching Romeo, who returned to take his life beside the drugged (but living) body of his beloved. Not only was the contemporary literature from which Shakespeare drew inspiration full of references to the plague, but he himself had experienced the social effects of the plague at first hand. The recent rejection of the name Y. pseudotuberculosis var. pestis in favour of Y. pestis is fitting, not simply on the grounds of preventing confusion - after all, Y. pseudotuberculosis can be an equally lethal pathogen. However, a review of the epidemiology for Y. pestis since the First Pandemic in the 6th Century AD lends support to Devignat's hypothesis that Y. pseudotuberculosis evolved from Y. pestis, rather than vice versa. This probably occurred in Europe shortly before the Second Pandemic, and the new mutant spread slowly through the European rodent population, immunising the carriers against plague. In other parts of the world which continued to be affected by plague, the rodent populations remained susceptible because they had not been immunised by exposure to Y. pseudotuberculosis. In some areas which have not been affected by plague, it is also possible that the native rodent populations have been immunised by Y. enterocolitica and its relatives. The plague, the first biological weapon, has killed more people than man's wars. It is our duty, as bacteriologists handling this pathogen, to refuse to allow our work to be used in modern warfare, to refuse to participate in any further warfare against humanity itself. PMID- 3311630 TI - Epidemiological study of Yersinia enterocolitica and Yersinia pseudotuberculosis in Shimane Prefecture, Japan. PMID- 3311631 TI - Yersinia pseudotuberculosis infection in children. Clinical manifestations and epidemiology. PMID- 3311632 TI - Yersinia arthritis. Acute clinical picture and long-term prognosis. PMID- 3311633 TI - Anti-phagocytic role of plasmid-associated outer membrane proteins of Yersinia enterocolitica. PMID- 3311634 TI - Role of virulence-associated plasmid on phagocytosis and killing of Yersinia pseudotuberculosis in vivo. PMID- 3311635 TI - Yersiniae and iron. A study in host-parasite relationships. AB - Most enterobacteria obtain the iron they require for growth by producing low molecular-weight high-affinity iron ligands known as siderophores. These substances chelate and solubilize iron making it available to bacteria. The pathogenic Yersiniae produce no detectable siderophores; thus, they proliferate poorly or not at all under conditions of iron limitation. Most systemic infections with Yersinia enterocolitica occur in patients who are overloaded with iron. This may be due to the presence of excess iron in the tissues of such patients, but the adverse effects of excess iron on immune responsiveness may also be partly responsible. Many patients with iron overload receive treatment with desferrioxamine B, a bacterial siderophore which promotes growth of Y. enterocolitica in vitro and in vivo. Thus, desferrioxamine B may add to the risk of systemic yersiniosis developing in patients with siderosis. Some strains of Yersinia frederiksenii, Yersinia intermedia and Yersinia kristensenii produce the hydroxamate siderophore aerobactin, but, paradoxically, they appear to be unable to proliferate in tissues. PMID- 3311636 TI - Optimal recovery of Yersinia enterocolitica 0:3 and 0:9 from stools of patients with intestinal disorders. PMID- 3311637 TI - Coordinating center follow-up in the Veterans Administration Cooperative Study of Coronary Artery Bypass Surgery. AB - In the VA Cooperative Study of Coronary Artery Bypass Surgery, follow-up by the participating investigators was completed in 1984 and annual centralized follow up by the coordinating center for an additional 5 years was initiated in 1985. Follow-up was restricted to key outcomes that could be reliably obtained in most patients-survival, severity of angina, myocardial infarction and bypass surgery. Ninety-five percent of patients consented to annual follow-up by telephone or mail. At the first annual follow-up, 95% of all survivors were contacted; 95% were also contacted at the second follow-up. In the initial follow-up, survival status was known in all patients and severity of angina was recorded in 93% of survivors; all bypass operations and all but one infarct identified were documented by a discharge summary. Our results indicate that coordinating center follow-up was effective in a long-term study of a chronic disease and depended on the willingness of patients to participate, the experience of the interviewers, and the ability of the coordinating center to contact patients and retrieve outcome data. This report describes the methods used for the centralized follow up of the surviving patients and summarizes the initial follow-up results. The limitations and advantages of this approach are also discussed. PMID- 3311638 TI - The prophylactic clinical trial as a epidemiologic resource. AB - We encourage investigators to use data collected in a clinical trial of a prophylactic agent or procedure to study the epidemiology of the disease or event the prophylactic was meant to prevent. Making additional use of previously collected data is economically attractive. Problems can arise, however, if the sample is not representative of the universe of all people at risk of the disorder, the data set is not adequate to the task, or the prophylactic and/or its correlates influence the risk of the disorder. Investigators should consider modifying data collection procedures in future prophylactic trials so that they are suitable for an epidemiologic study. They and readers of their reports, however, are advised to be cautious in drawing inferences from epidemiologic studies extracted from prophylactic trials. PMID- 3311639 TI - Genetic factors in toxicology: implications for toxicological screening. AB - Methods of assessing the toxicity of xenobiotics have improved substantially during the last decade. However, as compounds become generally safer, the problem of individual variation in response assumes increasing relative importance. Environmental factors such as age, health and nutritional status, and interactions with other xenobiotics account for some of this variation, but genetic differences between individuals and races have important implications. In a few cases, Mendelian loci which control drug susceptibility (e.g., to isoniazid) have been described. However, in most cases the exact mode of inheritance has not yet been determined due to the problems of carrying out genetic studies in man. It is well established that many loci that are polymorphic in man are also so in laboratory animals, so much of this genetic variation should be picked up in preclinical screening, and could be used to more accurately predict potential variation in toxicity in man. Unfortunately, most toxicologists use only a single stock of laboratory animals, which does not show whether the response to a given xenobiotic is under genetic control. The design of animal tests would be improved by using more than one strain of genetically defined animals, and by paying more attention to genetic variation in responses to xenobiotics, both in animals and man. PMID- 3311640 TI - Lipid peroxidation and mechanisms of toxicity. AB - Aerobic organisms by definition require oxygen, and the importance of iron in aerobic respiration has long been recognized, but despite their beneficial roles, these elements can pose a real threat to the organism. During oxygen reduction, reactive species such as O2-. and H2O2 are formed readily. Iron can combine with these species, or with molecular oxygen itself, to generate free radicals which will attack the polyunsaturated fatty acids of membrane lipids. This oxidative deterioration of membrane lipids is known as lipid peroxidation. To protect itself against this form of attack, the organism possesses several types of defense mechanisms. Under normal conditions, these defenses appear to offer adequate protection for cell membranes, but the possibility exists that certain foreign compounds may interfere with or even overwhelm these defenses, and herein could lie a general mechanism of toxicity. This possible cause of toxicity is discussed in relation to other suggested causes. PMID- 3311641 TI - Ethylenethiourea: a review of teratogenicity and distribution studies and an assessment of reproduction risk. AB - Ethylenethiourea (ETU) is a specific neuroteratogen that induces communicating hydrocephalus ex vacuo at oral doses far lower than those that cause any observable toxic sign or 50% death (LD50) in the rat dam. The teratogenic activity appears to be related to ETU itself and not to its metabolites. It is dependent upon the presence of an imidazolidine ring with a specific molecular location of sulfur atom. It is unlikely that ETU-induced alterations in thyroid function or thyroxine levels in the maternal rat are involved in teratogenic activity. The initial target following maternal dosing with ETU is the primitive neuroblast that undergoes necrosis, but the subsequent changes leading to the development of hydrocephalus are not clear. Teratogenicity studies in hamsters, mice, guinea pigs, rabbits, and rats revealed that ETU either required extremely high doses to produce malformations or was ineffective. The results of various distribution studies are summarized. Further, investigations dealing with exposure to ETU in the general population and in exposed workers in the rubber industry as well as those involved in the manufacture and spraying of fungicides are discussed briefly with reference to reducing the exposure levels. PMID- 3311642 TI - Recent advances in the metabolism and toxicity of benzene. AB - Benzene is a heavily used industrial chemical, a petroleum byproduct, an additive in unleaded gas, and a ubiquitous environmental pollutant. Benzene is also a genotoxin, hematotoxin, and carcinogen. Chronic exposure causes aplastic anemia in humans and animals and is associated with increased incidence of leukemia in humans and lymphomas and certain solid tumors in rodents. Bioactivation of benzene is required for toxicity. In the liver, the major site of benzene metabolism, benzene is converted by a cytochrome P-450-mediated pathway to phenol, the major metabolite, and the secondary metabolites, hydroquinone and catechol. The target organ of benzene toxicity, the hematopoietically active bone marrow, metabolizes benzene to a very limited extent. Phenol is metabolized in the marrow cells by a peroxidase-mediated pathway to hydroquinone and catechol, and ultimately to quinones, the putative toxic metabolites. Benzene and its metabolites appear to be nonmutagenic, but they cause myeloclastogenic effects such as micronuclei, chromosome aberrations, and sister chromatid exchange. It is unknown whether these genomic changes, or the ability of the quinone metabolites to form adducts with DNA, are involved in benzene carcinogenicity. Benzene, through its active metabolites, appears to exert its hematological effects on the bone marrow stromal microenvironment by preventing stromal cells from supporting hemopoiesis of the various progenitor cells. Recent advances in our understanding of the mechanisms by which benzene exerts its genotoxic, hematotoxic, and carcinogenic effects are detailed in this review. PMID- 3311643 TI - The application of clinical toxicology. AB - The objective of this review is to assess the role of clinical toxicology as it is practiced today and its possible future development. This includes the legal and ethical aspects of the subject and their application to man. The following issues are considered: extrapolation from animal to man; the logical sequence of the implementation of the stages that constitute good clinical practice; examples of the main invasive and noninvasive techniques employed in the clinical studies; the monitoring of the health of the employee in his working environment; chemically induced chronic disease states; and a retrospective consideration of specific examples of chemical hazards. PMID- 3311644 TI - Characterization of retinal pigment epithelial cells cultured on microporous filters. AB - Retinal pigment epithelium (RPE) cultured on microporous filter supports was compared to RPE cultured on plastic and evaluated for features characteristic of RPE in vivo. RPE cells grown on filters were cuboidal, formed junctional complex structures between cells, and had elaborate microvilli and basal infoldings similar to RPE in vivo, while RPE grown on plastic also formed intercellular junctions but appeared squamous and had few microvilli and basal infoldings. RPE grown on filters or plastic secreted an extracellular matrix at the basal surface and ingested isolated rat rod outer segments at the apical surface. RPE grown on filters coated with laminin or fibronectin became confluent more rapidly than RPE grown on uncoated filters, while RPE grown at the same density on filters coated with collagen type I did not become confluent. The laminin and fibronectin coatings did not alter the RPE cell morphology; however, cells seeded on collagen coated filters grew in large disorganized clusters. RPE grown on laminin-coated filters formed functional tight junctions as evidenced by the capacity of RPE monolayers to prevent the bulk flow of medium and the passage of trypan blue across the filter. Radiolabeled sucrose and inulin were used to measure the paracellular flux through the tight junctions between cells. The passage of these tracers was linear over time, with the lower molecular weight tracer, sucrose, passing through the monolayer more readily than inulin. Values for the flux of radiolabeled bovine serum albumin across RPE monolayers fell between values for sucrose and inulin. The results from these studies show that RPE monolayers cultured on laminin-coated filters maintain a morphology similar to that of RPE in vivo, are capable of ingesting rod outer segments, and form a selectively permeable barrier to various tracers. This culture system should be useful for studies of transepithelial transport, secretion, endocytosis and exocytosis that require independent control of the extracellular environment at the apical and basolateral cell surfaces. PMID- 3311645 TI - Biosynthesis of glycosaminoglycans by trabecular meshwork cells in vitro. AB - We compared the incorporation of radioactive precursors into glycosaminoglycans by cynomolgus monkey trabecular meshwork cells in tissue culture and in organ culture. Hyaluronic acid and a variety of sulfated glycosaminoglycans were synthesized in both systems. In organ cultures, the ratio of chondroitin 6- to chondroitin 4-sulfate was higher than that found in tissue cultures. Also, a greater proportion of total glycosaminoglycans found in the organ culture medium was represented by hyaluronic acid. The higher production of chondroitin 6 sulfate and hyaluronic acid, as noted in some embryonic systems, suggested that cells in organ cultures may resemble an acute wound healing or an early developmental state more closely than did cells in tissue cultures. PMID- 3311647 TI - Titration of continuous positive airway pressure by real-time dual oximetry. AB - The clinical utility of combined pulse and pulmonary artery oximetry (dual oximetry) in titrating continuous positive airway pressure (CPAP) therapy was tested in 17 patients with acute respiratory failure. The level of CPAP was altered in 2.5 cmH2O increments and decrements, while conventional measurements of cardiopulmonary function and continuous dual oximetry were performed. Then, optimum CPAP levels were selected using both techniques independently. The difference in optimum CPAP determined by the two methods was 0 cmH2O in ten of 17 patients, less than or equal to 2.5 cmH2O in 14 of 17 patients, and 5.0 to 7.5 cmH2O in the remaining three patients. When a difference existed, CPAP level determined with dual oximetry was consistently lower than the level selected by conventional means. The results indicate that the estimates of venous admixture and oxygen utilization coefficient obtained using dual oximetry provide sufficient information for rapid and accurate titration of CPAP in the majority of patients with acute respiratory failure. PMID- 3311646 TI - The surgical complications of chemotherapy in the cancer patient. PMID- 3311649 TI - Bayesian statistical theory in the preoperative diagnosis of pulmonary lesions. AB - We used a computerized Bayesian algorithm to assist in the preoperative diagnosis of pulmonary lesions. One hundred consecutive patients who were undergoing exploratory thoracotomy for newly discovered pulmonary lesions were prospectively evaluated. The Bayesian model used a total of 44 preoperative clinical and roentgenographic factors to categorize the lesions as benign or malignant. The Bayesian algorithm correctly categorized 96 of the 100 lesions, thereby providing an accuracy of 96 percent. The sensitivity of the model was 98 percent and the specificity was 87 percent. All but two of the 85 malignant lesions were correctly categorized and 13 of the 15 benign lesions were correctly analyzed by the model. These results indicate that computer-assisted diagnosis using the Theorem of Bayes may provide valuable preoperative information for the management of selected patients. PMID- 3311648 TI - Ketanserin, a new blocking agent of serotonin S2-receptors. Respiratory functional effects in chronic obstruction of the airways. AB - The role played by serotonin (5-HT) in the regulation of bronchomotor tone has up to now been a much debated question, although there is good evidence that it induces intense bronchoconstriction after inhalation in asthmatic patients. Serotonin has been found to contract the tracheobronchial smooth muscle of different animals. Some data suggest that tracheobronchial contraction due to serotonin is mediated by its interaction with the S2-receptor. The blockade of this receptor by ketanserin, a serotoninergic antagonist which primarily binds to S2-serotoninergic receptors, produces bronchodilation. The respiratory effects of intravenously administered ketanserin (10 mg) or placebo were compared in a double-blind crossover study in 14 patients with chronic obstruction of the airways. The forced expiratory volume in one second (FEV1) and the instantaneous forced expiratory flow after 50 percent of the forced vital capacity has been exhaled (FEF50%) did not change after placebo, but they increased significantly after administration of ketanserin. The results suggest that in patients with chronic obstructive pulmonary disease, serotonin may play a role in the development of obstruction of the airways, even if the mechanism remains undefined. PMID- 3311651 TI - [Fetal biophysical profile score]. PMID- 3311650 TI - Congenital arteriovenous malformations between brachiocephalic arteries and systemic veins. AB - Three patients under two years of age are described with unusual fistulas involving the brachiocephalic arteries and the innominate vein or the superior vena cava. Two patients were asymptomatic, and one newborn was cyanotic and in congestive failure. This unusual presentation has only rarely been reported in thoracic arteriovenous malformations. Two of the three patients underwent successful surgical repair. Two-dimensional echocardiography aids in the evaluation of these patients, but cardiac catheterization and angiography are indispensable diagnostic techniques for documenting the extent and location of these lesions and thus guiding proper therapy. PMID- 3311652 TI - [Prevention of superimposed preeclampsia in chronic hypertension]. PMID- 3311653 TI - [The trace elements copper and zinc in pregnancy]. PMID- 3311654 TI - [High-risk factors in ovarian cancers]. PMID- 3311655 TI - [Clinical study of freeze-dried homogenic brephobone graft in periodontal osseous defects]. PMID- 3311656 TI - [The analysis of the effect of KH-570 in the bonding of EB composite resin to Ni Cr alloy]. PMID- 3311657 TI - Evaluation of DNA and nuclear protein features for their use in describing normal and malignant endometrium. AB - Different feature sets (geometric, densitometric, and textural) derived from DNA and nuclear protein staining were evaluated for their use in describing atrophic, secretory, and proliferative endometrium, and well-differentiated stage I and moderately differentiated stage I adenocarcinomas of the endometrium. It was found that the pattern of significant differences among these groups varied between feature sets, while remaining consistent within a set of features. The DNA density and run-length features were not very effective in describing group mean differences, whereas the co-occurrence features revealed significant differences among most groups. The protein run-length features were the only ones that consistently showed a difference between proliferative endometrium and well differentiated adenocarcinomas. Analyses repeated on only cells in the G0/G1 DNA region improved the differentiation between moderately differentiated adenocarcinomas and the other groups. It was concluded that the use of DNA and nuclear protein texture features are effective in describing group differences that cannot be described by DNA content only. PMID- 3311658 TI - Flow cytometric purification of Alzheimer's disease amyloid plaque core protein using thioflavin T. AB - Amyloid plaque core protein (APCP) of Alzheimer's disease obtained from brain tissue homogenate is difficult to recover in pure form, primarily because of contaminating lipofuscin (LF) granules. Thioflavin T, a fluorescent dye previously used to stain amyloid, was found to bind to APCP but not to lipofuscin. The latter, however, is autofluorescent. Fluorometric studies showed that at 370 nm excitation APCP has a maximal emission at 418 nm, whereas the autofluorescent LP has a maximal emission at 450 nm. This difference in emission permitted the use of a flow cytometer-sorter (FACS 440) for purification of APCP. APCP particles fluoresced distinctly from LF granules on the log blue fluorescence parameter. The two entities were sorted using forward light scatter versus fluorescence. A collection apparatus was designed and prepared to facilitate the collection of large volumes of sheath fluid and particles and to minimize fragmentation of particles during the collection process. The sorted APCP fraction was 98% pure. This work demonstrates how old dyes can be used to perform new tricks and provide a useful method for separating complex protein. PMID- 3311659 TI - Immunofluorescent quantification of ribonucleotide reductase M1 subunit and correlation with DNA content by flow cytometry. AB - The cytoplasmic enzyme ribonucleotide reductase is essential for DNA synthesis, and its activity is strongly correlated with cellular proliferation. This paper describes a flow cytometric technique for the simultaneous measurement of DNA content and the M1 subunit of ribonucleotide reductase. Data are presented for cycling cultured human leukemic lymphoblasts in which M1 is constitutively expressed, and peripheral blood lymphocytes in which it is only detectable with certainty after mitogen stimulation. The choice of fixation procedure strongly influenced the amount of M1 subunit detected. Paraformaldehyde (PF) at concentrations of 2% (w/v in PBS) or greater provided optimal results. Fixation at 37 degrees C was significantly more effective in preserving M1 than fixation at room temperature or 4 degrees C. These variables are shown to have affected cytoplasmic retention during postfixation processing. Their relevance to the flow cytometric measurement of other intracellular components by this procedure are discussed. PMID- 3311660 TI - A rapid and simple estimation of cell cycle parameters by continuous labeling with bromodeoxyuridine. AB - The DNA synthesis time (Ts) and other related cell cycle parameters were roughly estimated in HeLa cells labeled with bromodeoxyuridine (BrdUrd) for various durations by using the flow cytometrical technique. The labeling indices increased in proportion to time after addition of BrdUrd. The Ts can be calculated from the slope of the regression line obtained by plotting the serial labeling indices against the labeling time and was equivalent to the value determined by fraction labeled cells in mid S-phase (FLSm) method. These parameters would be determined by only two samples labeled for different times. This simple method using BrdUrd provides rough but rapid estimation of Ts and other cell cycle parameters without complicated mathematical procedures, in addition to cell cycle partition of cell populations. PMID- 3311661 TI - Effects of oral cisapride on interdigestive jejunal motor activity, psychomotor function, and side-effect profile in healthy man. AB - Intravenous cisapride was shown to induce a phase-2-like pattern of human interdigestive jejunal motor activity containing an increased number of propagated contractions. This study investigated the effects of oral cisapride in 12 fasting healthy males. Jejunal pressures were recorded by a pneumohydraulic system and five catheter orifices positioned 10-30 cm aborad the ligament of Treitz. Single oral doses of 5 and 10 mg cisapride, administered 5 min after an activity front under random double-blind conditions, induced a phase-2-like jejunal motor pattern with a significantly higher number and amplitude of contractions and significantly more aborally propagated waves than placebo (P less than 0.001), while the number of subjects with activity fronts decreased with increasing dose. Five and 10 mg cisapride administered tid for three days affected psychomotor function, subjective feelings, and side-effect frequency, apart from increases in systolic blood pressure and heart rate, no more than placebo. It is concluded that in fasting man, oral cisapride induces a highly propagative phase-2-like jejunal motor pattern causing only minor side effects. PMID- 3311663 TI - The role of an immunoperoxidase technique in the diagnosis of oral herpes simplex virus infection in patients with leukemia. AB - Laboratory techniques are often used to confirm a clinical diagnosis of oral herpes simplex virus (HSV) infection in patients with leukemia. In the present study, an immunoperoxidase technique (IPT) was used to examine smears taken from the oral mucosa of 44 patients with leukemia at Vancouver General Hospital. It was found that the IPT was as sensitive and specific as viral culture in confirming the presence of HSV. The IPT was found to be more predictive of symptomatic oral HSV disease than viral culture because it did not give positive results if there was only viral shedding in the absence of clinical disease. As the IPT is rapid and inexpensive as well as being specific, sensitive, and predictive, it has a definite role in the laboratory confirmation of oral HSV lesions in leukemics. PMID- 3311662 TI - Crohn's disease. New concepts of pathogenesis and current approaches to treatment. AB - One theory of the pathogenesis of Crohn's disease is that rather than being caused by a unique environmental agent, it is the result of an abnormal immune response in the gastrointestinal tract. Recent studies indicate that Crohn's disease in its early stages is frequently associated with the presence of circulating antigen-non-specific suppressor T cells. Such T cells are also found in experimental inflammation caused by Chlamydia organisms in the gastrointestinal tract of nonhuman primates. Taken together, these data suggest that the suppressor T cells are markers of an underlying and persistent, antigen specific immune response to an as yet unidentified antigen or set of antigens. We postulate that this underlying antigen-specific response is the result of a primary immunoregulatory abnormality involving an imbalance between the effects of antigen-specific helper and suppressor T cells which recognize a common antigen or antigens present in the mucosal environment. PMID- 3311664 TI - Intermediate filaments in cytological specimens of thyroid tumors. AB - Cytological specimens of thyroid carcinomas and follicular adenomas obtained by fine-needle aspiration biopsies or touch imprints were investigated with antibodies to keratin, vimentin, and neurofilaments. All tumors were keratin positive. In follicular adenomas as well as in papillary thyroid carcinomas, a coexpression of keratin and vimentin was detected; in follicular carcinomas, only some tumors showed coexpression of keratin and vimentin; and in medullary thyroid carcinomas, positive staining of all six tumors studied was seen with the keratin and neurofilament antibodies, with some tumors also showing coexpression of vimentin. The mechanisms of such coexpression is unclear. PMID- 3311666 TI - Malignant carcinoid of the pancreas: a cytologic, ultrastructural, and immunocytochemical study of a case diagnosed by fine-needle aspiration of a supraclavicular node metastasis. AB - Carcinoid tumor of the pancreas is extremely rare. This article describes the case of a 22-year-old woman who manifested a typical carcinoid syndrome; a definitive diagnosis of a metastatic carcinoid tumor was made from needle aspiration of a supraclavicular lymph node using morphologic, immunocytochemical, and ultrastructural criteria. The carcinoid tumor was subsequently shown to be of pancreatic origin. PMID- 3311665 TI - Value of immunocytochemistry in the study of malignant effusions. AB - Recognition of malignant effusion relies heavily on cytologic examination despite the difficulty of distinguishing atypical mesothelial hyperplasia from metastatic carcinoma. The combination of CEA, EMA, vimentin, keratin, high-molecular-weight cytokeratin (HMWK), low-molecular-weight cytokeratin (LMWK), and Alcian blue was tested in 51 cytologic specimens of pleural, peritoneal, and pericardial effusions. These showed metastatic carcinoma in 38 cases (ovary, 14; lung, 8; breast, 7; GI, 4; endometrium, 4; bladder, 1) and mesothelial processes in 13 (hyperplasia, 9; mesothelioma, 4). Strong positivity for EMA (92%), CEA (90%), and Alcian blue (71%) was noted in metastatic carcinoma but not in the mesothelial processes. Keratin was positive in all cases of mesothelioma but occurred also in mesothelial hyperplasias (44%) and metastatic carcinomas (47%). In mesothelial cells, HMWK was consistently stronger than LMWK, whereas in adenocarcinoma the reverse was true. There was no difference in the degree or distribution of positivity of any of the markers among the various primary sites of the neoplasms. Our findings are consistent with the view that immunocytochemistry with a battery of antibodies is useful in the recognition of malignant effusions but cannot, as yet, determine the site of origin of metastatic neoplasms. PMID- 3311668 TI - Potentially curable neoplasms. PMID- 3311667 TI - Subepithelial organisms in trichomonal cervicitis. AB - Trichomonas vaginalis is usually described as a surface-dwelling, noninvasive organism. Most studies of the pathogenicity of this organism have been derived from cytologic studies of uterine cervical epithelium. We employed specific immunoperoxidase techniques that allow the identification of organisms in cytologic and histologic specimens. In a case of trichomonal cervicitis these organisms were demonstrated both on the epithelial surface and in subepithelial tissues. Interpretations and implications of these findings are discussed. PMID- 3311669 TI - Questions that diabetes patients ask. PMID- 3311670 TI - Toward normoglycemia: studies in computer-assisted insulin delivery. PMID- 3311671 TI - A computer program for teaching and auditing patients' knowledge of diabetes. PMID- 3311672 TI - Myths and more myths about insulin injection. PMID- 3311673 TI - State of the art: islet cell antibody tests. PMID- 3311675 TI - Betakid--lessons learned while developing a microcomputer pediatric case simulation. PMID- 3311674 TI - Insulin resistance and the use of U-500 insulin: a case report. PMID- 3311676 TI - Special insulin preparations. PMID- 3311677 TI - Stimulatory activity on prostacyclin production decreases in sera from streptozotocin-induced diabetic rats. AB - We recently reported that serum stimulatory activity on prostacyclin (PGI2) production by cultured bovine aortic endothelial cells decreased in noninsulin dependent diabetic patients. In the present study, this activity was compared in streptozotocin-induced (STZ) diabetic rats and controls. Platelet-poor plasma derived serum (PDS) from Wistar male rats stimulated 6-keto-PGF1 alpha production (a stable metabolite of PGI2) by cultured bovine aortic endothelial cells, rat lung fibroblasts, and rat aortic rings in a time- and dose-dependent manner. Namely, PDS from rats has a stimulatory activity on PGI2 production (PGI2 stimulatory activity; PSA). Furthermore, PSA in PDS from STZ diabetic rats (n = 12) significantly decreased as compared with that from control rats (n = 10) using three types of in vitro systems. The reduction in PDS-stimulated PGI2 production by the vascular wall may lead to platelet hyperaggregation and thrombus formation in diabetics, which is considered to be involved in the pathogenesis of diabetic macro- or microangiopathy. PMID- 3311678 TI - Hormonal and metabolic responses in brittle diabetic patients during feedback intravenous insulin infusion. AB - Twenty-four hour profiles of blood hormones and intermediary metabolites were obtained in seven 'brittle' diabetic subjects during their usual insulin therapy and during feedback intravenous insulin infusion from an artificial pancreas (GCIIS). The results were compared to those in matched stable diabetics and normal controls. Although routine insulin doses were higher in the brittle group than in the stable group (164 +/- 32 (mean +/- SE) vs. 58 +/- 8 U/day, P less than 0.005) during routine therapy, plasma free insulin levels were equal (35 +/- 12 vs. 31 +/- 6 mU/l). In the brittle group feedback i.v. insulin infusion reduced daily requirements to normal levels (80 +/- 13 U/day, P less than 0.025; stable group 71 +/- 4 U/day, NS). On routine therapy blood glucose levels were not different in the two groups (brittle 10.5 +/- 1.6, stable 10.8 +/- 0.6 mmol/l) and were similarly corrected by the GCIIS (6.9 +/- 0.3 and 6.9 +/- 0.3 mmol/l, respectively). Blood lactate and pyruvate levels were markedly abnormal in the brittle group during routine therapy (lactate: brittle group 1.93 +/- 0.27 mmol/l, stable group 0.91 +/- 0.07 mmol/l, P less than 0.025), and this abnormality was not corrected by the GCIIS (1.75 +/- 0.32 and 0.88 +/- 0.08 mmol/l, P less than 0.005). Abnormalities were also found in profiles of blood alanine and glycerol, and serum cortisol. Blood ketone body levels did not differ between the two groups of patients. The results suggest a defect in insulin delivery from subcutaneous tissue into the plasma. These patients have a characteristic metabolic abnormality, unresponsive to short-term normoglycaemia, either as the result of long-term disturbance of diabetic control, or as a marker for the underlying hormonal or biochemical abnormality. PMID- 3311679 TI - Moderate insulinopenia can cause insulin antagonism. AB - Profound insulin deficiency can cause insulin antagonism. To assess whether more modest insulinopenia can also cause insulin antagonism, male Sprague-Dawley and female obese (fa/fa) Zucker rats received streptozotocin injections (20, 30 or 40 mg/kg) or citrate buffer alone. After 1 and 2 weeks, the animals underwent glucose (0.5 g/kg) and insulin (0.2 U/kg)-glucose (0.7 mg/kg) tolerance tests, respectively, after an overnight fast. In the Sprague-Dawley rats: (a) basal glucose concentrations were significantly increased in the 40 mg/kg group; (b) glucose-induced insulin responses were significantly decreased in the 30 and 40 mg/kg groups; (c) glucose disappearance rates after glucose alone were significantly decreased in the 40 mg/kg group; and (d) glucose disappearance rates after insulin and glucose were significantly decreased in both the 30 and 40 mg/kg group. All obese Zucker rats injected with 30 and 40 mg/kg died within the first week with marked hyperglycemia. In the 20 mg/kg groups: (a) basal glucose levels were significantly elevated; (b) glucose disappearance rates and insulin responses were significantly decreased; (c) glucose disappearance rates after insulin and glucose were 20% lower than in the control rats but the difference did not reach statistical significance. In conclusion, Zucker rats are much more sensitive to streptozotocin than Sprague-Dawley rats. In the Sprague Dawley strain, a modest insulin deficiency is associated with insulin antagonism. Since these rats treated with low doses of streptozotocin are characterized by decreased glucose-induced insulin secretion and insulin antagonism, they may serve as an appropriate model for type 2 diabetes mellitus. PMID- 3311680 TI - The effect of short-term basal insulin supplementation with human ultralente insulin on diurnal glycemic control in NIDDM patients. AB - The effect of short-term insulin treatment with a long-acting insulin preparation, Ultratard HM (U-HM) was investigated in eight non-insulin-dependent diabetes mellitus (NIDDM) patients whose previous glycemic control using diet was judged unsatisfactory. The treatment consisted of one daily pre-breakfast injection of U-HM (0.3 IU/kg) for 8 days. Glycemic control, assessed by mean plasma glucose (PG) daily profile and M-value, was improved significantly after U HM treatment (mean PG and M-value, before: 223 +/- 19 mg/dl, 38.2; on the last day of U-HM: 151 +/- 11 mg/dl, 16.3; P less than 0.001; P less than 0.05). Serum insulin (IRI) reached a peak at 14:30 h during U-HM treatment, and mean IRI level increased during U-HM treatment (before: 14.0 +/- 2.8; during U-HM: 19.9 +/- 2.7 microU/ml). The mean C-peptide (CP) level decreased during U-HM treatment. Daily urinary CP excretion also decreased during U-HM treatment (before: 52.7 +/- 4.2; during U-HM: 34.8 +/- 4.2 micrograms/24 h). The data indicated that a single daily injection of U-HM was effective to improve whole-day glycemic control in NIDDM patients. PMID- 3311681 TI - Oral glucose tolerance: relationship with hemoglobin A1c. AB - Fifty-two normal non-obese males and 77 male offspring of two diabetic parents, aged 15-72 years, were studied to identify possible reasons for discordance between the oral glucose tolerance test (OGTT) and hemoglobin A1c (Hb A1c). Subjects were classified into four study groups: group 1 (n = 83), normal OGTT and normal Hb A1c; group 2 (n = 19), normal OGTT and abnormal Hb A1c; group 3 (n = 9), abnormal OGTT and normal Hb A1c; and group 4 (n = 18), abnormal OGTT and abnormal Hb A1c. Glucose and insulin response were analyzed in each study group. Group 2 showed slightly higher mean glucose areas during the first 60 min of OGTT testing when compared with group 1 (P less than 0.01). Insulin levels, insulin areas and insulin/glucose regression coefficients on group 2 did not differ significantly from group 1 during OGTT. Group 3 showed significantly higher mean blood glucose levels than subjects in group 1 (P less than 0.0001) or group 2 (P less than 0.001), but significantly lower mean blood glucose levels than subjects in group 4 (P less than 0.04) throughout the OGTT. During the OGTT, group 3 showed marked absolute hyperinsulinism when compared with all other groups (P less than or equal to 0.002). Also, relative hyperinsulinism in group 3 was suggested by the elevated insulin/glucose regression coefficient (1.86 +/- 0.50) when compared with group 1 (1.17 +/- 0.09), group 2 (0.92 +/- 0.011) or group 4 (0.55 +/- 0.17) (P less than or equal to 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311682 TI - Metabolism and disposition of glycol ethers. PMID- 3311683 TI - Metabolism of nitroaromatic compounds. AB - There appear to be two major pathways for the metabolism of nitrobenzene and substituted nitrobenzenes. The first of these is reduction of the nitro group to yield aniline or substituted anilines. For nitrobenzene and perhaps for pentachloronitrobenzene, reduction of the nitro group to the amine is accomplished by bacteria of the gastrointestinal tract. Addition of a second nitro group results in easier reduction of one of the nitro groups on dinitrobenzenes, since they can be reduced under aerobic conditions by hepatic and erythrocyte enzymes. Bacterial reduction of the dinitrobenzenes is probably not quantitatively important in vivo. The second pathway is replacement of a nitro group by glutathione. The relative importance of this pathway compared to nitro group reduction depends upon the compound. It has not been demonstrated to occur for nitrobenzene. It is the major route of metabolism for 1,2 dinitrobenzene but is not an important route for 1,3- or 1,4-dinitrobenzene in hepatocytes. Tetrachloronitrobenzene isomers in which the nitro group is flanked by chlorines and pentachloronitrobenzene undergo nitro group replacement, but 2,3,4,5-tetrachloronitrobenzene does not. The most important pathway for the metabolism of mononitrotoluenes is methyl group oxidation. All quantitatively important metabolites are apparently formed from the nitrobenzyl alcohols. The mono- and dinitrotoluenes are not significantly reduced to isolatable metabolites by mammalian enzymes in vivo; intestinal microflora reduce these compounds after biliary excretion of the nitrobenzyl glucuronides. The little available evidence suggests that this is not the case for trinitrotoluenes. Urinary metabolites retain the methyl group and bear one or two amino groups. This suggests either that mammalian enzymes are capable of reducing the nitro groups of trinitrotoluenes in vivo or that intestinal microflora gain access to unmodified trinitrotoluene. The nitropolycyclic aromatic hydrocarbons are apparently metabolized by both nitro reduction and ring oxidation. There is good evidence, at least for 1-nitropyrene and 6-nitrobenzo[a]pyrene, that nitro reduction occurs in intestinal microflora. the complexities of foreign compound metabolism are well illustrated by the biotransformation of the nitroaromatic compounds. Positional isomers are preferentially metabolized by markedly different pathways. Substitution to different degrees or with different functional groups greatly affects the types of metabolites formed. Yet these compounds also offer opportunities for understanding the mechanisms of foreign compound metabolism.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3311685 TI - Applications of immunoassay methods to drug disposition studies. PMID- 3311684 TI - Mechanisms of the inhibition of cytochrome P-450-mediated drug oxidation by therapeutic agents. PMID- 3311686 TI - Influenza vaccination today. PMID- 3311687 TI - [Treatment of uncomplicated duodenal ulcer using cimetidine alone and in combination with pirenzepine. A comparative study]. AB - In a double-blind, randomised trial two drug regimens were compared in a group of 129 patients with uncomplicated duodenal ulcers, 64 receiving cimetidine (800 mg) and pirenzepine (50 mg) at bed-time, 65 receiving cimetidine (800 mg) and a placebo at bed-time. Neither statistically nor clinically was there an important difference in effectiveness and tolerance between the two drug regimens. PMID- 3311688 TI - [The acute transfusion reaction]. PMID- 3311689 TI - [Corticotropin-releasing factor. A central nervous regulator of stress reactions]. PMID- 3311690 TI - [Does a single oral dose of famotidine influence the blood alcohol level?]. AB - Six healthy volunteer medical students (three men and three women) on four separate occasions drank 500 ml of beer or 250 ml of white wine 30 min after having taken 40 mg of famotidine or a placebo (after 48 hours of abstinence and six hours of fasting). Administration of drug or placebo followed a double-blind, randomized protocol. There was no demonstrable effect of famotidine on the serum level of alcohol (maximal values 0.29-0.67 mg/dl) or on the time until maximal serum concentrations of alcohol were reached. PMID- 3311691 TI - [Nuclear spin resonance in the diagnosis of the upper abdomen]. PMID- 3311692 TI - [Nonparasitic parenchymatous liver cysts]. PMID- 3311693 TI - [Thirst deficiency in old age]. PMID- 3311694 TI - [Immunosuppressive therapy in transplantation surgery]. PMID- 3311695 TI - [Serological and immunological diagnosis of HIV-1 infection. Studies of 198 infected cases]. AB - Since 1985, a total of 4281 patients at the Department of Dermatology, University of Munich, were tested for HIV-1 antibodies. Using the ELISA test, 273 were found to be positive, of whom 198 were examined clinically. At the time of the first serological test, 76 of these 198 patients (38.4%) had no clinical symptoms, 98 (49.5%) had a lymphadenopathy syndrome, and 29 had the full-blown picture of AIDS (12.1%). The following additional tests were performed on the 198 patients: antibodies against virus envelope and core proteins, concentration of serum immunoglobulins G, A and M and beta 2-microglobulin, absolute leukocyte and lymphocyte counts, T4/T8 ratio, and intracutaneous cellular immune reaction. Antibodies against virus envelope proteins were present in all the patients. Antibodies against virus core proteins were present in 82% of patients in the latent stage, 64% of patients with the lymphadenopathy syndrome, but only 45% of those with AIDS. Clearcut deviations within the three groups were also present with respect to serum levels of IgG and beta 2-microglobulins, as well as the T4/T8 ratio and the intracutaneous reaction against recall-antigens. PMID- 3311697 TI - [Eosinophilic fasciitis]. PMID- 3311696 TI - [Current aspects of the therapy of uremic hyperphosphatemia]. PMID- 3311698 TI - [Risk factors for cerebral hemorrhage in premature neonates]. PMID- 3311699 TI - [Acute hemarthrosis of the knee]. PMID- 3311700 TI - [Management of anal fistulas]. PMID- 3311701 TI - [Transvesical or transvaginal oocyte harvest in test-tube fertilization]. PMID- 3311702 TI - Contemporary approaches to scalp reduction and hair transplantation. PMID- 3311703 TI - The association and implications of anxiety and depression in university medical and paramedical students in Kenya. PMID- 3311704 TI - [Atrophic corpus gastritis and autoimmune gastritis]. AB - The authors tried to clarify relations between autoimmune gastritis and isolated atrophic corpus gastritis by bioptic corporal and antral examinations from 150 probands as well as examinations of gastrin in serum and parietal cell antibody tests. Only 30% of all patients examined with isolated atrophic gastritis of the corpus part revealed criteria of an autoimmune gastritis. Therefore investigations of antibodies against parietal cells are necessary to mark off both clinical pictures. This differentiation seems to be necessary regarding the high risk of gastric cancer following an autoimmune gastritis. PMID- 3311706 TI - [Experimental in vivo and in vitro research on different types of anthophyllite]. PMID- 3311705 TI - [Pathogenesis of hyperoxalurias and calcium oxalate calculi in intestinal diseases]. AB - Hyperoxaluria and calcium oxalate lithiasis have a multifactorial genesis in bowel diseases. The augmented synthesis of oxalic acid in the liver is of minor importance. A diminished bacterial degradation is to asses up to day only hardly. The increasing absorption is of highest importance by deficient production of calcium oxalate in the intestinal tract and by increasing permeability of colonic mucosa above all in steatorrhoea or in patients with augmented calcium absorption. The crystallization of calcium oxalate in the urine is promoted by shortage of vitamin A, citrate, zinc or magnesium. PMID- 3311707 TI - [Spontaneous diabetes in animals]. PMID- 3311708 TI - Opiate withdrawal and electro-stimulation. Double blind experiments. AB - A rapid detoxification technique for heroin addicts is described. The technique uses an impulsional electric current developed by Limoge. The treatment is nonaggressive, very well tolerated by the addicts and leads to a good psychotherapeutic relationship with the medical staff. A successful physical detoxification is achieved in more than 80% of the cases (this figure is based on 400 patients treated by the method). The technique was subjected to two double blind experiments. The first experiment tested the real efficacity of the electrical stimulation. The difference between the group of subjects stimulated and the unstimulated control group had a "p-value" which was significant at the 0,5% level. This leads us to believe that the electrical stimulation has a real positive effect. The second experiment reconfirmed the efficacity of the stimulation and showed that 24 hour continuous stimulation was not sufficient to produce a lasting effect. After about 50 hours stimulation a Naloxone test produced little or no reaction in the patients. PMID- 3311709 TI - [Citalopram. An open study of a highly selective serotonin-uptake inhibitor administered by infusion to depressive patients]. AB - In an open, clinical trial comprising a total of 49 depressed in-patients, a new selective 5-HT uptake inhibitor citalopram was administered by intravenous infusion in doses of 20-60 mg once daily for per 3 weeks. The therapeutic effect was assessed globally and by means of the CPRS subscale for depression (MADRS). About 40 per cent of the patients showed a complete response whereas about 25 per cent showed a partial response. Side effects which were rated globally and recorded according to a check-list were generally mild and infrequent. The side effects most frequently observed were tremor, drowsiness, and dizziness which occurred in about 15 per cent of the patients.' Three patients were withdrawn prematurely because of nausea and one because of a skin rash. Cardiovascular recordings were normal except for one patient, who developed a hypertension which may have been related to the test drug. No pathological laboratory values were detected during the trial period. The authors conclude that intravenously administered citalopram is well suited for the treatment of depressed patients. PMID- 3311711 TI - Reduced proteolytic activity in vitro of lysosomes isolated from "cold" thyroid nodule. AB - The proteolytic activity of lysosomes isolated from solitary "cold" thyroid nodule and morphologically normal perinodular thyroid tissue was examined in parallel in an in vitro system using 125I-labelled rat Tg as substrate. Lysosomes were isolated by centrifugation of the tissue homogenates between 800 and 20,000 x g. The optimal proteolytic activity of acid proteases from human thyroid tissue was observed between pH 3.6 and 4.8. The evident differences in the proteolytic activity of lysosomal acid proteases between nodular and perinodular tissues were observed. It was found that the activity of lysosomal proteases from "cold" nodule in both the same amount of wet weight thyroid tissue and the same amount of lysosomal proteins was significantly lower (29-54%) than in the morphologically normal perinodular tissue used as a control. The reduced proteolytic activity of lysosomes from patients with "cold" nodule provides further confirmation on the low metabolic activity of thyrocytes in non functioning thyroid nodules. PMID- 3311710 TI - [Interaction between non-steroidal anti-inflammatory agents and lithium salts]. AB - Since the first observation in 1978, it has been clearly established that the non steroidal anti-inflammatory drugs (NSAIDs) interfere with the pharmacokinetics of lithium: by reducing urinary clearance of the metal, they can raise the plasma lithium level and thus lead to intoxication. Among the NSAIDs available in France, this interaction has been reported with phenylbutazone (Butazolidine, Carudol), diclofenac (Voltarene), indomethacin (Indocid) and its antalgic derivative clomethacin (Duperan), ketoprofen (Profenid), mefenamic acid (Ponstyl), niflumic acid (Nifluril) and piroxicam (Feldene). This interaction does not occur with aspirin; this exception suggests that the inhibition of prostaglandins synthesis is not the mechanism responsible for the decrease in the urinary elimination of lithium linked with an increase in its tubular reabsorption. In practice, in view of the growing diffusion of NSAIDs, it is necessary to inform all patients under lithium treatment of the risk of interaction resulting from their use. PMID- 3311712 TI - Effect of n-hexane inhalation on insulin degradation in rat blood in vitro. AB - Effect of inhalation of an air-n-hexane mixture on insulin degradation in rat blood in vitro was studied under simultaneous monitoring of n-hexane concentrations in blood (using gas chromatography) and in the inhaled air (using infrared analysis). Inhalation of n-hexane vapours in a concentration of 54,694 +/- 1933 ppm (197 +/- 7 g m-3) resulted in blood n-hexane saturation within 15 min. (0.18 +/- 0.023 mg ml-1) associated with a statistically increased (P less than 0.002) insulin degradation in the blood of exposed rats as compared to control animals 0.152 +/- 0.03 vs. 0.053 +/- 0.003). To rule out possible effects of stress on the results obtained, effects of both, 20 min restraint stress (RS) and equally long handling (HAN) on insulin degradation were also estimated. The data thus obtained were compared with insulin degradation in control (C) rats which were killed by decapitation in the animal room. No significant differences were observed between the individual groups (C: 0.055 +/- 0.08; RS: 0.068 +/- 0.01; HAN: 0.069 +/- 0.015). In vitro addition of n-hexane to pure plasma or to a mixture of blood elements revealed that degradation activities present in the cellular blood compartment are required for the n-hexane-induced enhancement of insulin degradation in the blood to occur. PMID- 3311713 TI - The patient with suspected meningitis. AB - When meningitis presents acutely, therapy should be instituted within 1 hour, based on the patient's age and risk factors. When the presentation is subacute, clinical assessment, with analysis of the cerebrospinal fluid, allows the physician to decide among empiric antimicrobial therapy, observation, or further diagnostic studies. PMID- 3311714 TI - Stimulation by phorbol ester and diacylglycerol of luteinizing hormone glycosylation and release by rat anterior pituitary cells. AB - We studied the effects of protein kinase C (PKC) activators on LH glycosylation and release and the effect of 17 beta-estradiol on PKC activator-induced LH release. Rat anterior pituitary cells were incubated for 4 h with diluent, GnRH, and the PKC activators, phorbol 12-myristate 13-acetate (PMA), L-alpha-1,2 dioctanoyl glycerol (C8), and 1-oleoyl-2-acetyl-glycerol. LH translation and glycosylation were monitored by measuring incorporation of [14C]alanine ([14C]A) and [3H]glucosamine ([3H]GA), respectively, into total (medium + cell) immunoprecipitable LH. Immunoreactive LH (IRLH) was measured by RIA. PMA (10(-9) M) and 1-oleoyl-2-acetyl-glycerol (50-200 microM) had no significant effects. PMA at 10(-7) M elevated (P less than 0.01) medium IRLH, medium and total [3H]GA-LH, and medium but not total [14C]A-LH. PMA at 10(-7) M increased (P less than 0.01) uptake and incorporation of [3H]GA, but not [14C]A, into total pituitary protein. C8 increased both medium IRLH and total [3H]GA-LH (P less than 0.01) without altering total [14C]A-LH. Two hundred micromolar C8 increased medium concentrations of [3H]GA-LH (P less than 0.01) and [14C]A-LH (P less than 0.05). C8 (50-200 microM) had no detectable effects on uptake and incorporation of precursors into protein. GnRH (1 nM) enhanced (P less than 0.01) both medium IRLH and total [3H]GA-LH, but had no effect on total [14C]A-LH. Pretreatment of pituitary cells with 17 beta-estradiol (6 X 10(-10) M) greatly enhanced LH release induced by C8. In conclusion, PMA and C8, like GnRH, stimulated both LH glycosylation and release. These results suggest that PKC may regulate both LH release and glycosylation and may be important in estrogen modulation of LH release. PMID- 3311715 TI - Reduced effect of experimental peripheral hyperinsulinemia to elevate cerebrospinal fluid insulin concentrations of obese Zucker rats. AB - To test the effect of chronic hyperinsulinemia on cerebrospinal fluid (CSF) insulin concentrations in the obese (fafa) Zucker rat, obese and heterozygote lean (Fafa) rats were infused peripherally with insulin or vehicle for 6 days. Both basal levels and the increase of plasma immunoreactive insulin (IRI) were greater in fafa (increase = 713 microU/ml) than in Fafa (increase = 392 microU/ml) rats, P less than 0.0001. Vehicle-infused fafa rats had higher CSF IRI levels than did vehicle-infused Fafa rats (4.3 +/- 1.2 microU/ml vs. 1.5 +/- 0.4 microU/ml, P less than 0.01). CSF IRI was elevated in both insulin-infused groups (P less than 0.001). After insulin infusion Fafa rats had higher CSF IRI levels than did fafa rats (Fafa: 10.0 +/- 1.8 microU/ml vs. fafa: 7.1 +/- 0.1 microU/ml). In contrast to the effect of insulin infusion on plasma IRI, the increase of CSF IRI was greater in Fafa rats (8.5 microU/ml) than in fafa rats (4.0 microU/ml, P less than 0.001). Uptake of insulin from the periphery to the CSF therefore appears to be reduced in obese fafa Zucker rats compared to lean Fafa controls. PMID- 3311716 TI - Evidence that hyperglycemia increases muscarinic binding in pancreatic islets of the rat. AB - We studied the effects of fasting and of diabetes on binding of [3H]methylscopolamine to pancreatic islets of the rat. In nondiabetic rats, fasting for 36 h decreased binding of the muscarinic antagonist by 33% (P less than 0.05). Fasting also abolished the insulin response to 10 microM acetylcholine. Diabetes was induced by injecting streptozotocin (STZ) neonatally in rats. At the time of the experiments (6-10 weeks of age) these rats exhibited hyperglycemia (12.6 +/- 1.0 vs. 7.1 +/- 0.3 mM blood glucose in nondiabetics) but had a normal weight. Relative to islets from age- and sex-matched nondiabetic rats, islets from STZ rats were smaller (0.7 +/- 0.1 vs. 1.9 +/- 0.2 nl islet volume) and contained less insulin (218 +/- 33 vs. 1390 +/- 71 microU/islet). When calculated per islet volume, binding of [3H]methylscopolamine to STZ islets was enhanced by 80% in comparison to binding to normal islets (P less than 0.001). Scatchard analysis indicated that enhanced binding was due to increased number of binding sites. Cholinergic-induced insulin release, as assessed by carbamylcholine, was 37% higher in STZ than in normal islets (P less than 0.05) when expressed per islet volume and 3- to 4-fold enhanced in STZ islets when expressed per islet insulin content. Insulin treatment of STZ rats for 3 days lowered blood glucose, diminished binding of [3H]methylscopolamine, and abolished carbamylcholine-induced insulin secretion. We conclude that the level of glycemia in vivo participates in the regulation of the number of muscarinic receptors in the pancreatic islet and that such regulation is associated with changes in cholinergic-induced insulin secretion. PMID- 3311717 TI - The role of insulin in the stimulation of renal 1,25-dihydroxyvitamin D synthesis by parathyroid hormone in rats. AB - To evaluate the role of insulin in 1,25-dihydroxyvitamin D [1,25(OH)2D] production in response to PTH, 25-hydroxyvitamin D-1 alpha-hydroxylase activity in kidney homogenates as well as serum 1,25(OH)2D concentration was measured both after dietary calcium (Ca) deprivation and after PTH infusion in control and streptozotocin-diabetic rats. Although serum Ca and phosphate (Pi) levels did not change significantly after dietary Ca deprivation for 1 week, urinary cAMP excretion increased significantly, indicating that dietary Ca deprivation caused secondary hyperparathyroidism without a significant change in serum Ca level. In control rats, renal 1 alpha-hydroxylase activity increased markedly from 0.11 +/- 0.05 to 1.70 +/- 0.46 ng/300 mg tissue/20 min in parallel with the change in serum 1,25(OH)2D level from 121 +/- 8 to 360 +/- 54 pg/ml in response to Ca deprivation. In contrast, serum 1,25(OH)2D level (82 +/- 3 pg/ml) and 1 alpha hydroxylase activity (0.07 +/- 0.02 ng/300 mg tissue.20 min) were lower in the diabetic rats on a normal Ca diet than those in control rats, and the increase in both 1,25(OH)2D level and 1 alpha-hydroxylase activity in response to Ca deprivation was suppressed in diabetic rats (136 +/- 24 pg/ml and 0.38 +/- 0.12 ng/300 mg tissue.20 min, respectively, after Ca deprivation). Insulin treatment of the diabetic rats restored the baseline levels of serum 1,25(OH)2D (125 +/- 14 pg/ml) and renal 1 alpha-hydroxylase activity (0.21 +/- 0.02 ng/300 mg tissue.20 min) as well as those after Ca deprivation (340 +/- 52 pg/ml and 2.05 +/- 0.30 ng/300 mg tissue.20 min, respectively). Furthermore, when control and diabetic rats were thyroparathyroidectomized and infused with a maximal stimulatory dose of PTH, the increase in serum 1,25(OH)2D and renal 1 alpha-hydroxylase activity in response to PTH was markedly inhibited in diabetic rats. In addition, the baseline levels of serum 1,25(OH)2D and renal 1 alpha-hydroxylase activity in thyroparathyroidectomized diabetic rats were not different from those in control rats. These results are consistent with the conclusion that insulin plays an important role in the regulation of renal 1 alpha-hydroxylase activity and serum 1,25(OH)2D levels in response to PTH. PMID- 3311718 TI - Chelation of intracellular calcium prevents stimulation of glucose transport by insulin and insulinomimetic agents in the adipocyte. Evidence for a common mechanism. AB - Vanadate, concanavalin A (Con A), H2O2, and the phorbol ester, 12-O-tetradecanoyl phorbol 13-acetate (TPA), seemingly unrelated compounds, have effects on cellular metabolism similar to those of insulin. The mechanism(s) by which these diverse compounds act and their relevance to insulin action remain unclear. The hypothesis that increased intracellular calcium ([Ca2+]i) may provide the common basis for the stimulatory effects of these agents on glucose uptake in adipocytes was tested. This was accomplished by preincubating cells with the membrane permeant ester, quin2-AM (2-[(2-bis[carboxymethyl] amino-5-methylphenoxy]-6 methoxy-8-bis[carboxymethyl]- aminoquinolinetetrakis [acetoxymethyl] ester), which is rapidly accumulated and hydrolyzed by esterases to form the impermeant tetracarboxylate chelator form, quin2. Vanadate, Con A, H2O2, and TPA stimulate D glucose uptake in adipocytes approximately 3-, 3-, 2-, and 0.6-fold, respectively, compared to the 5- to 10-fold stimulation of D-glucose uptake obtained with insulin. Preincubation with quin2-AM produced a dose-dependent inhibitory effect only on the stimulated portion of glucose transport without affecting basal (unstimulated) transport. The concentrations for half-maximal inhibition (IC50) of stimulated glucose transport by quin2-AM were 26, 35, 25, 14, and 34 microM for insulin, vanadate, Con A, H2O2, and TPA, respectively. Quin2-AM maximally inhibited stimulated glucose uptake by greater than 85% for all of the insulin mimetic agents. In contrast the maximal inhibition of insulin stimulated glucose transport by quin2-AM was 55 +/- 4%. Therefore, stimulation of glucose transport by insulin and other diverse compounds appears to involve at least one common calcium-dependent intermediate step. PMID- 3311719 TI - Modulation of aromatase and P450 cholesterol side-chain cleavage enzyme activities of human placental cytotrophoblasts by insulin and insulin-like growth factor I. AB - The placenta is the primary source of estrogens and progesterone during pregnancy. Because pregnant diabetic women are reported to have lower serum estrogen and higher progesterone concentrations than nondiabetic pregnant women, we studied the roles of insulin and insulin-like growth factor I (IGF-I) in the regulation of human cytotrophoblastic aromatase and P450 side-chain cleavage enzyme (P450 SCC) activities. Incubation of cytotrophoblasts with insulin or IGF I for 24 h significantly inhibited the conversion of androstenedione to estrogens by approximately 20-40%. Insulin and IGF-I suppressed aromatization at doses as low as 20 and 10 ng/ml, respectively. Insulin's suppressive effect was demonstrable only after 18-22 h of incubation, suggesting an effect of insulin on aromatase protein mass rather than on aromatase activity. Cytotrophoblasts pretreated with insulin for 24 h possessed 23-30% less aromatase activity than control cells, as quantitated directly by the specific release of 3H2O from [3H]androstenedione, indicating that insulin inhibited estrogen synthesis rather than increased estrogen catabolism. Insulin's suppressive effect on aromatase was not due to a toxic effect of insulin, since incubates exposed to insulin for 24 h showed no decrease in cell number, cellular DNA content, or cellular protein content compared to control incubates. Also, insulin's suppression of aromatization was not due to increased cAMP phosphodiesterase activity, since cotreatment with 1 mM (Bu)2cAMP did not alter insulin's suppressive effect. Blockade of the IGF-I receptor of cytotrophoblasts with alpha IR-3, a monoclonal anti-IGF-I receptor antibody, prevented the suppression of aromatase activity by IGF-I, but did not alter insulin's inhibitory effect. This suggests that the two hormones inhibit aromatization via activation of their specific receptors and not by cross-association. Insulin treatment did not affect P450 SCC activity, whereas IGF-I treatment significantly stimulated P450 SCC activity by 19-36%, as measured by the conversion of 25-hydroxycholesterol to progesterone. These studies indicate that insulin exerts a selective inhibitory effect on cytotrophoblastic aromatase activity, whereas IGF-I inhibits aromatase activity but stimulates P450 SCC activity. Since pregnant diabetic women manifest peripheral hyperinsulinemia, and IGF-I levels in fetal cord sera from diabetic pregnancies are elevated, these observations may help explain the lower serum estrogen and elevated progesterone levels associated with diabetic pregnancy. PMID- 3311720 TI - Acute cigarette smoke exposure causes lung injury in rabbits treated with ibuprofen. AB - We studied lung clearance of aerosolized technetium-labeled diethylenetriamine pentaacetic acid (99mTcDTPA), plasma concentrations of 6-keto-PGF1 alpha and thromboxane B2, and pulmonary edema as indices of lung injury in rabbits exposed to cigarette smoke (CSE). Forty-six rabbits were randomly assigned to 4 groups: control sham smoke exposure (SS, N = 9), sham smoke exposure ibuprofen-pretreated (SS-I, N = 10), CSE (N = 9), sham smoke exposure ibuprofen-pretreated (SS-I, N = 10), CSE (N = 9), and CSE ibuprofen-pretreated (CSE-I, N = 19). Ibuprofen (cyclooxygenase eicosanoid inhibitor) was administered as a single daily intramuscular injection (25 mg/kg) for 7 days before the experiment. Cigarette or sham smoke was delivered by syringe in a series of 5, 10, 20, and 30 tidal volume breaths with a 15-min counting period between each subset of breaths to determine 99mTcDTPA biological half-life (T1/2). In the ibuprofen pretreated group, CSE caused significant decreases in 99mTcDTPA T1/2 and dynamic lung compliance. Furthermore, these changes in lung function were accompanied by severe injury to type I alveolar cell epithelium, pulmonary edema, and frequently death of the rabbits. These findings suggest that inhibition of the cyclooxygenase pathway before CSE exacerbates lung injury in rabbits. PMID- 3311722 TI - Comparative humoral responses to Escherichia coli and sheep red blood cell antigens introduced via the respiratory tract. AB - The numbers of specific antibody-forming cells (AFC) in mediastinal lymph nodes (MLN) and spleen were determined in Balb/cByJ mice following inhalation or intratracheal (IT) injection of acetone-dried E. coli or its lipopolysaccharide (LPS). These responses were compared with those obtained using sheep red blood cells (SRBC), an antigen previously used in studies of pulmonary immunity. Inhalation of aerosolized E. coli for as little as 2 min produced significant numbers of AFC in both MLN and spleen, while equivalent administrations of SRBC produced few AFC at either site. Similarly, IT instillations of E. coli resulted in recovery of AFC from MLN and spleen, while IT SRBC produced AFC in MLN but few splenic AFC. IT installations of radiolabeled SRBC and E. coli were used to examine antigen dissemination, and no differences were found in the amounts of radiolabel recovered from various tissues following instillation of either antigen. Experiments using endotoxin resistant mice, and using administrations of LPS in combination with SRBC, were unable to demonstrate alterations in AFC production due to effects of LPS. It was found, however, that inhaled or IT injected E. coli or LPS produced greater pulmonary inflammation than did similar administrations of SRBC, and this may be at least partly responsible for the enhanced induction of systemic immunization. PMID- 3311723 TI - Induction of SOS functions in Escherichia coli and biosynthesis of nitrosamine in rabbits by nitrogen dioxide. AB - Nitrogen dioxide induced SOS functions in Salmonella typhimurium and Escherichia coli K-12 and was mutagenic in Escherichia coli WP2. When a rabbit was administered aminopyrine intravenously and administered nitrogen dioxide by inhalation, N-nitrosodimethylamine was detected in its blood. Analysis was conducted with 15N-nitrosodimethylamine as an internal standard by a combination of capillary gas chromatography and mass spectrometry. Accompanying administration of cystamine increased the blood concentration of N nitrosodimethylamine in the rabbit, suggesting inhibition of its metabolism. Concurrent sulfur trioxide inhalation increased N-nitrosodimethylamine formation in the rabbit. PMID- 3311721 TI - Dog tracheal epithelial cells in culture synthesize sulfated macromolecular glycoconjugates and release them from the cell surface upon exposure to extracellular proteinases. AB - To determine whether glycoconjugates can be released into airways by surface epithelial cells that do not contain secretory granules and, if so, whether extracellular proteinases can affect this release, we studied dog tracheal epithelial cells after 8-10 days in culture. Ultrastructurally, these cells showed an extensive cell surface coat and no secretory granules. Cells were pulse labeled with radioactive sulfate (Na2 35SO4, 50 microCi/ml/24 h) and washed free of the unbound label. Release of sulfated products was then measured at 20-min intervals under basal conditions and again after 20 min of incubation with various extracellular proteinase. We found that these cells synthesized sulfated products and released them spontaneously and continuously into the medium. In addition, trypsin, Pseudomonas aeruginosa elastase, thermolysin, Staphylococcus aureus proteinase, mast cell chymase, plasmin, and kallikrein (each at 10(-7) M except plasmin, at 5 X 10(-6) M) increased the release of sulfated products to 77 667% over baseline release (p less than 0.01, n = 5 dogs for each); preliminary results showed that human neutrophil elastase was also very potent. The sulfated products released by trypsin had an apparent molecular weight of greater than or equal to 10(6) da as determined by gel filtration on Sepharose Cl-4B. Over 50% of these 35S-labeled products were digested to low-molecular-weight products (500 2000 da) upon incubation with endo-beta-galactosidase or with keratanase, suggesting that they are glycoconjugates containing poly(N-acetyllactosamine) type carbohydrate chains. Decrease in cell staining by lectins specific for poly(N-acetyllactosamine), which accompanied the release of glycoconjugates, indicates that these sulfated glycoconjugates were released by proteinases from the apical cell surface. We conclude that cultured tracheal epithelial cells synthesize and transport sulfated macromolecular glycoconjugates to apical cell surfaces. These glycoconjugates are released from cell surfaces when exposed to extracellular proteinases. We therefore suggest that macromolecular glycoconjugates in airway secretions can originate not only from secretory granules but also from epithelial cell surfaces during airway inflammation. PMID- 3311724 TI - Organic emissions from coal pyrolysis: mutagenic effects. AB - Four different types of coal have been pyrolyzed in a laminar flow, drop tube furnace in order to establish a relationship between polycyclic aromatic compound (PAC) evolution and mutagenicity. Temperatures of 900K to 1700K and particle residence times up to 0.3 sec were chosen to best simulate conditions of rapid rate pyrolysis in pulverized (44-53 microns) coal combustion. The specific mutagenic activity (i.e., the activity per unit sample weight) of extracts from particulates and volatiles captured on XAD-2 resin varied with coal type according to the order: subbituminous greater than high volatile bituminous greater than lignite greater than anthracite. Total mutagenic activity (the activity per gram of coal pyrolyzed), however, varied with coal type according to the order: high volatile bituminous much greater than subbituminous = lignite much greater than anthracite, due primarily to high organic yield during high volatile bituminous coal pyrolysis. Specific mutagenic activity peaked in a temperature range of 1300K to 1500K and generally appeared at higher temperatures and longer residence times than peak PAC production. PMID- 3311726 TI - Biochemical properties of the ras-related YPT protein in yeast: a mutational analysis. AB - Using site-directed mutagenesis, the ras-related and essential yeast YPT1 gene was changed to generate proteins with amino acid exchanges within conserved regions. Bacterially produced wild-type proteins were used for biochemical studies in vitro and were found to have properties very similar to mammalian ras proteins. Gene replacement allowed the study of physiological consequences of the mutations in yeast cells. Lys21----Met and Asn121----Ile substitutions rendered the protein incapable of binding GTP and caused lethality. Ser17----Gly and Ala65 ---Thr substitutions slightly changed the protein's apparent binding capacity for either GDP or GTP and altered its intrinsic GTPase activity. These mutations were without effect on cellular growth. The YPTgly17,thr65 mutant protein displayed a significantly altered relative capacity for guanine nucleotide binding but a GTPase activity comparable to the wild-type protein. In contrast to the Ala65--- Thr substitution, the double mutant displayed a significantly reduced capacity for autophosphorylation and allowed cells to grow only poorly. Cellular growth was improved when this mutant protein was overproduced. PMID- 3311725 TI - Dose-response relationships for carcinogens: a review. AB - We review the experimental evidence for various shapes of dose-response relationships for carcinogens and summarize those experiments that give the most information on relatively low doses. A brief review of some models is given to illustrate the shapes of dose-response curve expected from them. Our major interest is in the use of dose-response relationships to estimate risks to humans at low doses, and so we pay special attention to experimentally observed and theoretically expected nonlinearities. There are few experimental examples of nonlinear dose-response relations in humans, but this may simply be due to the limitations in the data. The several examples in rodents, even though for high dose data, suggest that nonlinearity is common. In some cases such nonlinearities may be rationalized on the basis of the pharmacokinetics of the test compound or its metabolites. PMID- 3311728 TI - Start sites for bidirectional in vitro DNA replication inside the replication origin, oriC, of Escherichia coli. AB - In vitro replication of mini-chromosomes in the absence of DNA ligase activity resulted in replication products with single-strand breaks at specific sites. The occurrence of these nicks was coupled to an active replication process, therefore we expect them to represent start sites for DNA replication. Two positions within oriC for each of the two leading strands of bidirectional replication were found. Within each position are one or two start sites. Counterclockwise synthesis started at positions 194/199 and 265/272, clockwise synthesis at positions 209/219 and 254. The start positions are located close to DnaA protein binding sites. A model for initiation accommodating this observation is discussed. PMID- 3311727 TI - Extracellular release of colicin A is non-specific. AB - The possible involvement of topogenic export sequences within the colicin A polypeptide chain has been investigated. Different constructs have been made using various techniques to introduce deletions in the central and NH2-terminal regions of colicin A. Together, these deletions span the region from amino acid 15 to the end of the protein. None of these regions was found to be required for extracellular release or had any effect on the efficiency of this process. By inserting a termination codon, a Shine-Dalgarno sequence and an initiation codon into the gene for colicin A, the NH2-terminal and central plus COOH-terminal domains could be demonstrated to be released to the same extent when produced as separate polypeptides as when produced as linked ones. The introduction into the COOH-terminal domain of mutations promoting cytoplasmic aggregation had no effect on the secretion of the NH2-terminal polypeptide. These results demonstrated that no specific interaction between the NH2- and COOH-terminal regions of the colicin A polypeptide chain is involved in the release of colicin A. We are led to conclude that there is no topogenic export signal in the polypeptide chain of colicin A involved in the release mechanism. Thus the process is non-specific with respect to the colicin itself and depends solely on the expression of the colicin A lysis protein (Cavard et al., 1985, 1987). The expression of the protein causes the release of not only the colicin but also many other cellular proteins, including beta-lactamase, EF-Tu, and chloramphenicol acetyltransferase. PMID- 3311729 TI - tRNA nucleotidyltransferase is not essential for Escherichia coli viability. AB - The role of tRNA nucleotidyltransferase in Escherichia coli has been uncertain because all tRNA genes studied in this organism already encode the -C-C-A sequence. Examination of a cca mutant, originally thought to contain 1-2% enzyme activity, indicated that it actually produces an inactive fragment of 40 kd compared to 47 kd for the wild-type enzyme due to a nonsense mutation in its cca gene. To confirm that the residual activity in extracts of this strain is due to another enzyme, and that tRNA nucleotidyltransferase is non-essential, we have interrupted the cca gene in vitro, and transferred this mutant gene to a variety of strains. In all cases mutant strains are viable, although as much as 15% of the tRNA population contains defective 3' termini, and no tRNA nucleotidyltransferase is detectable. Mutant strains grow slowly, but can be restored to more normal growth by a relA mutation or by a decrease in RNase T activity. In the latter case the amount of defective tRNA decreases dramatically. These findings indicate that tRNA nucleotidyltransferase is not essential for E. coli viability, and therefore, that all essential tRNA genes in this organism encode the -C-C-A sequence. PMID- 3311731 TI - A case of Plasmodium falciparum infection resistant to chloroquine. PMID- 3311730 TI - Influence of the codon following the AUG initiation codon on the expression of a modified lacZ gene in Escherichia coli. AB - In a lacZ expression vector (pMC1403Plac), all 64 codons were introduced immediately 3' from the AUG initiation codon. The expression of the second codon variants was measured by immunoprecipitation of the plasmid-coded fusion proteins. A 15-fold difference in expression was found among the codon variants. No distinct correlation could be made with the level of tRNA corresponding to the codons and large differences were observed between synonymous codons that use the same tRNA. Therefore the effect of the second codon is likely to be due to the influence of its composing nucleotides, presumably on the structure of the ribosomal binding site. An analysis of the known sequences of a large number of Escherichia coli genes shows that the use of codons in the second position deviates strongly from the overall codon usage in E. coli. It is proposed that codon selection at the second position is not based on requirements of the gene product (a protein) but is determined by factors governing gene regulation at the initiation step of translation. PMID- 3311734 TI - Comparison of the response of Escherichia coli to fosfomycin and fosmidomycin. AB - The responses of Escherichia coli to fosfomycin and fosmidomycin were investigated by continuous turbidimetric monitoring of cultures exposed to the drugs and by microscopy. The activity of both agents was potentiated by glucose-6 phosphate, suggesting that they share the inducible hexose phosphate transport system in Escherichia coli, but several differences of response were also detected: the inoculum effect was much smaller with fosfomycin than with fosmidomycin; inhibition of bacterial growth occurred much more rapidly with fosfomycin than with fosmidomycin; and fosfomycin was able to induce the formation of spheroplasts much more rapidly than fosmidomycin. Stable resistance to fosfomycin and fosmidomycin was readily induced in cultures of Escherichia coli, and some resistant variants retained susceptibility (or partial suceptibility) to the other compound. These observations suggest that although fosfomycin and fosmidomycin may be transported into Escherichia coli by a similar mechanism, the intracellular target site may be different. PMID- 3311733 TI - In vitro susceptibility to aminoglycoside antibiotics in blood and urine isolates consecutively collected in twenty-nine European laboratories. European Study Group on Antibiotic Resistance. AB - The in vitro susceptibilities to gentamicin, tobramycin, amikacin and netilmicin were determined by a standardized microdilution method in unsupplemented Mueller Hinton broth using blood and urine isolates from hospitalized patients in 29 laboratories in 12 European countries. The distribution of bacteria was similar in each laboratory, Escherichia coli and staphylococci predominating. While resistance rates varied between laboratories (e.g., rates of 1.1-34% were reported for gentamicin), they were consistently higher in southern Europe for all four antibiotics. Production of aminoglycoside-modifying enzymes was observed among resistant strains, ANT(2''), AAC(3)-V and AAC(6')-II predominating in gram negative bacilli and APH(2)'' + AAC(6')-I in staphylococci. PMID- 3311735 TI - Detection of TEM beta-lactamase genes by non-isotopic spot hybridisation. AB - A 998 bp fragment of plasmid pBR322, comprising part of the TEM-1 beta-lactamase gene, was labelled with biotin-11-dUTP for use as a DNA probe in a rapid non isotopic spot hybridisation test. Diluted broth cultures of bacteria producing different beta-lactamases were filtered onto nitrocellulose and lysed in situ. Following pre-hybridisation treatment with proteinase K, hybridisation with the labelled probe was demonstrated using a commercially available streptavidine/polyalkaline phosphatase-based detection system. The probe was highly specific, reacting only with strains producing either the TEM-1 or structurally similar TEM-2 enzyme. An inoculum of 3-4 X 10(6) cells gave optimum positive discrimination. When 90 recent ampicillin-resistant strains of Escherichia coli isolated from patients with urinary tract infections were screened using the system, 72% gave a positive hybridisation signal. PMID- 3311732 TI - World-wide development of antibiotic resistance in pneumococci. AB - Antibiotic-resistant pneumococci, especially penicillin-resistant strains, are being increasingly isolated. Pneumococci with intermediate penicillin-resistance (MIC 0.1-1.0 micrograms/ml) have been reported from many parts of the world over the past two decades, and highly resistant strains (penicillin MICs greater than or equal to 2 micrograms/ml) have also appeared. Infection may be acquired in the hospital or community, and nosocomial outbreaks may occur which require control measures to limit organism spread. Most infections occur in children with diminished host responses. Disease caused by pneumococci with intermediate penicillin-resistance may be treated with high doses of penicillin, but disease caused by highly resistant strains, especially meningitis, may require alternative therapy. Pneumococci resistant to sulfonamides, tetracyclines, erythromycin, lincomycin, clindamycin, chloramphenicol, aminoglycosides and rifampin have also appeared. Strains resistant to all the above-mentioned agents, including all beta-lactam antibiotics tested, have been reported from South Africa and Spain. Alternative therapy for resistant strains may include vancomycin, cefotaxime, cefoperazone, ceftriaxone and imipenem. Pneumococci isolated from sites suggestive of infection, especially blood and cerebrospinal fluid, should be routinely tested for penicillin-susceptibility. PMID- 3311736 TI - Bacteria isolated from skin and soft tissue lesions. AB - The pathogens most often isolated from lesions in skin and soft tissues were Staphylococcus aureus and Streptococcus pyogenes. Cultures from venous leg ulcers, decubitus ulcers and infectious gangrene often yielded also Pseudomonas spp., enterobacteria and enterococci. Obligate anaerobes were frequently isolated especially from abscesses and decubitus ulcers. One third of the abscesses and half of the decubitus ulcers yielded obligate anaerobes. PMID- 3311737 TI - Clinical importance of inducible beta-lactamases in gram-negative bacteria. AB - The clinical problems caused by inducible beta-lactamases in certain gram negative bacteria are being recognized with increasing frequency. These problems include the rapid emergence of multiple beta-lactam resistance during therapy with many of the newer beta-lactam antibiotics. Such multiply resistant organisms are now spreading within the hospital and have become important nosocomial pathogens. This has been a particularly difficult problem for intensive care units, cystic fibrosis centers and burn units where there are clusters of patients who are highly susceptible to infections with organisms like Enterobacter spp., Serratia spp. and Pseudomonas aeruginosa, which possess inducible beta-lactamases. Only through an awareness of these problems, their cause, and restriction of the use of certain newer beta-lactam antibiotics can these problems be controlled. PMID- 3311739 TI - Atrio-ventricular block associated with Shigella flexneri infection. PMID- 3311738 TI - Clinical significance of beta-lactamase induction and stable derepression in gram negative rods. AB - Most strains of enterobacteria and Pseudomonas aeruginosa produce chromosomally determined Class I beta-lactamases. When synthesized copiously these enzymes cause resistance to almost all beta-lactams, except imipenem and, sometimes, carbenicillin and tenocillin. Elevated beta-lactamase production arises transiently, via induction, in Pseudomonas aeruginosa and Enterobacter, Citrobacter, Morganella, indole-positive Proteus and Serratia spp. when these organisms are exposed to beta-lactams. Permanent high-level enzyme production arises via mutation, in the stably-derepressed mutants of these species. These mutants arise spontaneously at high frequency (10(-5) -10(-8). Most early penicillins and first-generation cephalosporins are strong inducers of Class I enzymes at sub-inhibitory concentrations, as are cefoxitin and imipenem. Consequently their MICs reflect what lability these antibiotics have to inducibly expressed beta-lactamase. Except with imipenem this lability usually is so great that the inducible enzyme causes clinical resistance. Although most other newer cephalosporins and ureidopenicillins are labile to the Class I enzymes they induce poorly below the MIC, and their lability is not reflected in resistance unless secondary inducers (e.g. cefoxitin or imipenem) are present. Although the weak inducer activity of these agents helps to maintain their activity against the inducible cells it renders the drugs highly selective for the pre-existing stably-derepressed mutants. Many cases have been reported where stably derepressed mutants have overrun inducible populations of bacteria in patients undergoing therapy with beta-lactamase-labile weak inducers such as ureidopenicillin and third-generation cephalosporins. PMID- 3311740 TI - Purification and biochemical properties of calmodulin from Saccharomyces cerevisiae. AB - Calmodulin from the yeast Saccharomyces cerevisiae was purified to complete homogeneity by hydrophobic interaction chromatography and HPLC gel filtration. The biochemical properties of the purified protein as calmodulin were examined under various criteria and its similarity and dissimilarity to other calmodulins have been described. Like other calmodulins, yeast calmodulin activated bovine phosphodiesterase and pea NAD kinase in a Ca2+-dependent manner, but its concentration for half-maximal activation was 8-10 times that of bovine calmodulin. The amino acid composition of yeast calmodulin was different from those of calmodulins from other lower eukaryotes in that it contained no tyrosine, but more leucine and had a high ratio of serine to threonine. Yeast calmodulin did not contain tryptophanyl or tyrosyl residues, so its ultraviolet spectrum reflected the absorbance of phenylalanyl residues, and had a molar absorption coefficient at 259 nm of 1900 M-1 cm-1. Ca2+ ions changed the secondary structure of yeast calmodulin, causing a 3% decrease in the alpha helical content, unlike its effect on other calmodulins. Antibody against yeast calmodulin did not cross-react with bovine calmodulin, and antibody against bovine calmodulin did not cross-react with yeast calmodulin, presumably due to differences in the amino acid sequences of the antigenic sites. It is concluded that the molecular structure of yeast calmodulin differs from those of calmodulins from other sources, but that its Ca2+-dependent regulatory functions are highly conserved and essentially similar to those of calmodulins of higher eukaryotes. PMID- 3311741 TI - Phenylalanine dehydrogenase of Bacillus badius. Purification, characterization and gene cloning. AB - Phenylalanine dehydrogenase produced by Bacillus badius IAM 11059 was purified from the crude extract of B. badius to homogeneity, as judged by disc gel electrophoresis. The enzyme has an isoelectric point of 3.5 and a relative molecular mass, Mr, of 310,000-360,000. The enzyme is composed of identical subunits with an Mr 41,000-42,000. The substrate specificity of the enzyme in the oxidative deamination reaction was high for L-phenylalanine, but rather low in the reductive amination reaction, with phenylpyruvate, p-hydroxyphenylpyruvate, and 2-oxohexanoate. The gene for the enzyme was cloned into Escherichia coli with plasmid pBR322 as a vector. The enzyme was expressed in high level in E. coli. The enzyme produced by E. coli transformant was purified to homogeneity and shown to be identical to that of B. badius IAM 11,059 with respect to the specific activity, Mr, subunit structure and amino acid composition. PMID- 3311742 TI - Fluorescent labeling of cysteinyl residues. Application to extensive primary structure analysis of proteins on a microscale. AB - The specificity and efficiency of fluorescent labeling of proteins by reduction and subsequent alkylation with 5-N-[(iodoacetamidoethyl)amino]naphthalene-1 sulfonic acid (5-I-AEDANS) [J.J. Gorman, (1987) Anal. Biochem. 160, 376-387] has been investigated. Proteins studied include porcine insulin, chicken ovalbumin and bovine serum albumin. Amino acid analysis of the B-chain derivative of insulin revealed quantitative recovery of cysteine in its S-carboxymethyl form and no other carboxymethylated amino acid derivatives. Fast-atom-bombardment mass spectrometric (FAB-MS) analysis of this derivative also indicated specific labeling of cysteine residues and automated stepwise protein sequence analysis of the derivative was performed to completion with initial and average repetitive yields of 73% and 96%, respectively. Tryptic peptides produced from the ovalbumin and serum albumin derivatives were fractionated by HPLC and subsequently analysed by amino acid analysis, FAB-MS and automated stepwise protein sequence analysis. These analyses have revealed that the labeling procedure exhibits a high degree of efficiency and is specifically directed towards S-alkylation of cysteine residues. The high level of fluorescence intensity of the label enabled specific detection of trace quantities of cysteine-containing peptides derived from contaminating protein(s). It is apparent that in addition to facilitating isolation of small quantities of proteins the labeling procedure is compatible with standard protein chemistry techniques involved in obtaining extensive structural data on isolated proteins. PMID- 3311743 TI - Co-expression of both the maize large and wheat small subunit genes of ribulose bisphosphate carboxylase in Escherichia coli. AB - A cDNA clone for the precursor form of the small subunit of wheat ribulose bisphosphate carboxylase has been modified to allow the expression in Escherichia coli of a mature form of small subunit that lacks the transit peptide. Synthesis of the protein is controlled by a lac promoter, and translation is initiated from a lacZ ribosome binding site, giving rise to a small subunit with several beta galactosidase amino acids fused to its N-terminus. A plasmid has been constructed that enables both wheat small subunits and maize large subunits to be synthesized in the bacterial cell, but using different promoters to allow independent expression of the rbcS and rbcL genes. When the small subunit is synthesized in the absence of the large subunit, it is found in the soluble fraction but the polypeptide is unstable and has a half-life of less than 15 min. Its size on sucrose gradients indicates a monomeric or dimeric form. When large subunit synthesis is induced in cells containing the small subunit, both subunits are found predominantly in the insoluble fraction and are fully stable for more than 120 min, suggesting that aggregation of the subunits may occur. The two subunits do not assemble together to form an active holoenzyme in vivo, even when nascent large subunits ware synthesized in a pool of mature small subunits. This indicates that other factors may be required to mediate the assembly of the higher plant enzyme. PMID- 3311744 TI - Kinetic properties of triose-phosphate isomerase from Trypanosoma brucei brucei. A comparison with the rabbit muscle and yeast enzymes. AB - The kinetic properties of Trypanosoma brucei brucei triose-phosphate isomerase are compared with those of the commercially available rabbit muscle and yeast enzymes and with published data on the chicken muscle enzyme. With glyceraldehyde 3-phosphate as substrate Km = 0.25 +/- 0.05 mM and kcat = 3.7 X 10(5) min-1. With dihydroxyacetone phosphate as substrate Km = 1.2 +/- 0.1 mM and kcat = 6.5 X 10(4) min-1. The pH dependence of Km and Vmax at 0.1 M ionic strength is in agreement with the results published for the yeast and chicken muscle enzymes. At ionic strength below 0.05 M the effect of a charged group specific for the trypanosomal enzyme and absent from the yeast and rabbit muscle enzymes becomes detectable. This effect significantly increases Km whereas Vmax becomes slightly higher. Trypanosomal triose-phosphate isomerase is inhibited by sulphate, phosphate and arsenate ions, by 2-phosphoglycolate and a number of documented inhibitors in the same concentration range as are the other triose-phosphate isomerases. The trypanocidal drug, Suramin inhibits T. brucei and rabbit muscle triose-phosphate isomerase to the same extent while leaving the yeast enzyme relatively unaffected. PMID- 3311745 TI - Chlorophyll-protein composition of the thylakoid membrane from Prochlorothrix hollandica, a prokaryote containing chlorophyll b. AB - The chlorophyll-protein complexes of the thylakoid membrane from Prochlorothrix hollandica were identified following electrophoresis under nondenaturing conditions. Five complexes, CP1-CP5, were resolved and these green bands were analyzed by spectroscopic and immunological methods. CP1 contains the photosystem I (PSI) reaction center, as this complex quenched fluorescence at room temperature, and had a 77 K fluorescence emission peak at 717 nm. CP4 contains the major chlorophyll-a-binding proteins of the photosystem II (PSII) core, because this complex contained polypeptides which cross-reacted to antibodies raised against Chlamydomonas PSII proteins 5 and 6. Furthermore, fluorescence excitation studies at 77 K indicated that only a Chl a is bound to CP4. Complexes CP2, CP3 and CP5 contained functionally bound Chl a and b as judged by absorption spectroscopy at 20 degrees C and fluorescence excitation spectra at 77 K. CP2, CP3 and CP5 all contain polypeptides of 30-33 kDa which are immunologically distinct from the LHC-II complex of higher plant thylakoids. PMID- 3311746 TI - Mutants affecting tRNA(Phe) from Escherichia coli. Studies of the suppression of thermosensitive phenylalanyl-tRNA synthetase. AB - Four mutants of pheV, a gene coding for tRNA(Phe) in Escherichia coli, share the characteristic that when carried in the plasmid pBR322, they lose the capacity of wild-type pheV to complement the thermosensitive defect in a mutant of phenylalanyl-tRNA synthetase. One of these mutants, leading to the change C2--- U2 in tRNA(Phe), is expressed about 10-fold lower in transformed cells than wild type pheV. This mutant, unlike the remaining three (G15----A15, G44----A44, m7G46 ---A46), can recover the capacity to complement thermosensitivity when carried in a plasmid of higher copy number. The other three mutants, even when expressed at a similar level, remain unable to complement thermosensitivity. A study of charging kinetics suggests that the loss of complementation associated with these mutants is due to an altered interaction with phenylalanyl-tRNA synthetase. The mutant gene pheV (U2), when carried in pBR322, can also recover the capacity to complement thermosensitivity through a second-site mutation outside the tRNA structural gene, in the discriminator region. This mutation, C(-6)----T(-6), restores expression of the mutant U2 to about the level of wild-type tRNA(Phe). PMID- 3311747 TI - Studies on the sequence and structure of the Escherichia coli K-12 nupG gene, encoding a nucleoside-transport system. AB - The nupG gene, encoding one of the two active nucleoside-transport systems in Escherichia coli K-12, has been cloned on the multicopy plasmid pBR322 and derivatives thereof. The recombinant plasmids complemented a chromosomal nupG mutation. A genetic map was determined by digestion with restriction endonucleases and the nucleotide sequence of a 3-kb stretch of DNA has been determined on fragments cloned into M13 phages. An open reading frame of 1254 bp, encoding a protein with a calculated molecular mass of 45.333 kDa, was deduced to be the coding region of nupG. Minicell-forming strains carrying plasmids containing this gene were shown to produce a hydrophobic, membrane-bound polypeptide with an apparent molecular mass of approximately 43 kDa. PMID- 3311748 TI - A structural and dynamic model for the nicotinic acetylcholine receptor. AB - Folding of the five polypeptide subunits (alpha 2 beta gamma delta) of the nicotinic acetylcholine receptor (AChR) into a functional structural model is described. The principles used to arrange the sequences into a structure include: (1) hydrophobicity----membrane-crossing segments; (2) amphipathic character--- ion-carrying segments (ion channel with single group rotations); (3) molecular shape (elongated, pentagonal cylinder)----folding dimensions of exobilayer portion; (4) choice of acetylcholine binding sites----specific folding of exobilayer segments; (5) location of reducible disulfides (near agonist binding site)----additional specification of exobilayer arrangement; (6) genetic homology ---consistency of functional group choices; (7) noncompetitive antagonist labeling----arrangement of bilayer helices. The AChR model is divided into three parts: (a) exobilayer consisting of 11 antiparallel beta-strands from each subunit; (b) bilayer consisting of four hydrophobic and one amphiphilic alpha helix from each subunit; (c) cytoplasmic consisting of one (folded) loop from each subunit. The exobilayer strands can form a closed 'flower' (the 'resting state') which is opened ('activated') by agonists bound perpendicular to the strands. Rearrangement of the agonists to a strand-parallel position and partial closing of the 'flower' leads to a desensitized receptor. The actions of acetylcholine and succinoyl and suberoyl bis-cholines are clarified by the model. The opening and closing of the exobilayer 'flower' controls access to the ion channel which is composed of the five amphiphilic bilayer helices. A molecular mechanism for ion flow in the channel is given. Openings interrupted by short duration closings (50 microseconds) depend upon channel group motions. The unusual photolabeling of intrabilayer serines in alpha, beta and delta subunits but not in gamma subunits near the binding site for non-competitive antagonists is explained along with a mechanism for the action of these antagonists such as phencyclidine. The unusual alpha 192Cys-193Cys disulfide may have a special peptide arrangement, such as a cis-peptide bond to a following proline (G.A. Petsko and E.M. Kosower, unpublished results). The position of phosphorylatable sites and proline-rich segments are noted for the cytoplasmic loops. The dynamic behavior of the AChR channel and many different experimental results can be interpreted in terms of the model. An example is the lowering of ionic conductivity on substitution of bovine for Torpedo delta M2 segment. The model represents a useful construct for the design of experiments on AChR. PMID- 3311749 TI - Biochemical and immunological evidence for a second nitrate reductase in Escherichia coli K12. AB - Genes different from those of the narGHI operon and encoding a nitrate reductase activity have been cloned by Bonnefoy et al. (unpublished results). We have shown by the use of well-known assay methods that the encoded enzyme activity is catalyzed by a true nitrate reductase and not by trimethylamine-N-oxide reductase or formate dehydrogenase. The biochemical and immunological study, employing anti (nitrate reductase) serum raised against the known enzyme, revealed that Escherichia coli contains a second nitrate reductase (nitrate reductase Z) which shares some similarities as well as differences with the known enzyme. By using a strain with a deletion of the narGHI operon and carrying a multicopy plasmid having the nitrate reductase Z genes, we have shown that nitrate reductase Z is a membrane-bound molybdoenzyme able to couple formate oxidation with nitrate reduction. Like the known nitrate reductase, this enzyme has chlorate reductase activity. The molecular mass and pH and temperature dependence of enzyme Z are similar to these of the known enzyme. On the other hand the two enzymes have significant difference in their electrophoretic mobility on polyacrylamide gels. Unlike the known enzyme, enzyme Z is synthesized in small amounts; the expression of its structural genes does not seem to be induced by nitrate, repressed by oxygen or activated by the product of the fnr gene. The immunological comparison of the two enzymes was performed by rocket immunoelectrophoresis, double diffusion on agar plates and immunoblots. These techniques disclosed a difference between the two enzymes in their recognition by the antiserum and showed that E. coli has two types of nitrate reductase. PMID- 3311750 TI - Characterization of a soluble Mr-30,000 catalytic fragment of the neuronal calmodulin-dependent protein kinase II. AB - Chymotryptic digestion of postsynaptic densities releases a soluble, catalytically active fragment of the alpha (Mr 50,000) subunit of the neuronal cytoskeletal calmodulin-dependent protein kinase II. The purified soluble form of the kinase likewise yields the fragment. Denaturation of the enzyme results in more extensive proteolytic degradation. 125I-Iodopeptide maps of the isolated catalytic portions of both forms of the enzyme are similar and are contained within the map of the isolated alpha subunit. Catalytic fragments of both forms of the enzyme comigrate on two-dimensional SDS-PAGE/isoelectric focusing with pI 6.7-7.2. The fragment phosphorylates microtubule-associated protein (MAP-2) but is not activated by Ca+2/calmodulin nor is it inhibited by trifluoperazine. Km values for MAP-2 and ATP are indistinguishable from those of the holoenzyme, while the Vmax is similar to that of the holoenzyme activated with Ca+2/calmodulin. Overlays of Western blots of fragment with 125I-calmodulin shows a loss of calmodulin binding. Both the number of phosphorylation sites and the ability to autophosphorylate are markedly reduced in the catalytic fragment. Evaluation of the hydrodynamic parameters of the purified fragment yielded Mr value of 25,600 with a frictional ratio (f/f0) of 1.12; the Mr value determined by SDS-PAGE was 30,000. Thus, the catalytic fragment appears to represent an activated form of the kinase with a monomeric, globular structure unlike the native enzyme which exhibits oligomerization and cytoskeletal association. These results are consistent with a tertiary structure for the calmodulin-dependent protein kinase that contains distinct domains responsible for catalytic activity, regulation by calmodulin, cytoskeletal association and the multimeric organization of enzyme subunits. PMID- 3311751 TI - Completion of the amino acid sequence of the alpha 1 chain of human basement membrane collagen (type IV) reveals 21 non-triplet interruptions located within the collagenous domain. AB - The cDNA and protein sequences of the N-terminal half of human basement membrane collagen (type IV) have been determined. Overlapping cDNA clones were constructed by repeated primer extension with synthetic oligonucleotides. They cover 2953 bp, beginning at the 5' end of the corresponding mRNA. At the protein level, the sequence of the cyanogen bromide peptide CB6 adjacent to the 7S domain has been additionally elucidated. The data presented here complete the protein sequence and nearly the entire cDNA sequence of the human alpha 1(IV) chain. The amino terminal half of the alpha 1(IV) chain contains 8 cysteine residues involved in intramolecular and intermolecular cross-links. The entire triple-helical domain of alpha 1(IV) is interrupted by 21 non-triplet regions. PMID- 3311752 TI - Comparative studies on phosphorylation of synthetic peptide analogue of ribosomal protein S6 and 40-S ribosomal subunits between Ca2+/phospholipid-dependent protein kinase and its protease-activated form. AB - Ca2+/phospholipid-dependent protein kinase (protein kinase C) and trypsin activated protein kinase C (protein kinase M) phosphorylated the synthetic peptide R1-A13 (Arg-Arg-Leu-Ser-Ser-Leu-Arg-Ala-Ser-Thr-Ser-Lys-Ala) which contains both cAMP- and insulin-regulated phosphorylation sites in rat liver ribosomal protein S6 [Wettenhall, R. E. H. & Morgan, F. J. (1984) J. Biol. Chem. 259, 2084-2091]. Both enzymes showed essentially the same kinetic properties; V and apparent Km were determined to be 0.16 mumol min-1 mg-1 and 30 microM, respectively. At first, tryptic phosphopeptides were prepared at the early stage of phosphorylation and purified by high-performance liquid chromatography (HPLC). Through these analyses, four radioactive peptides were isolated. When protein kinase C was employed, phosphorylation was observed on all four peptides in a Ca2+/phospholipid-dependent manner. Irrespective of the protein kinase employed, phosphate incorporation into these peptides increased linearly with time; the peptide concentration did not affect the ratio of phosphate distribution into these four peptides. Analysis of amino acid composition and phosphoamino acid of radioactive peptides obtained after extensive phosphorylation showed that phosphates were incorporated into Ser-4, Ser-5, Ser-9 and Ser-11. The latter three serine residues were major phosphorylated sites. When rat liver 40-S ribosomal subunits were employed as substrate for protein kinases C and M, a radioactive protein with Mr,app = 31,000, which corresponded to S6 protein, was detected on an autoradiogram of a sodium dodecyl sulfate/polyacrylamide slab gel. The rate of phosphorylation with protein kinase M was twice as fast as that with protein kinase C. The elution profile of radioactive tryptic peptides in HPLC suggest that phosphorylation occurred on the sites in S6 protein corresponding to Ser-5, Ser-9 and Ser-11 as major sites and Ser-4 as the minor one. These results indicate that protein kinase C has an ability to recognize at least four sites derived from hormone-dependent phosphorylation sites in ribosomal protein S6 irrespective of the mode of activation of this enzyme. PMID- 3311753 TI - Cyclic nucleotide binding to cAMP receptor protein from Escherichia coli. Optical and ligand-binding studies. AB - cAMP receptor protein from Escherichia coli has been purified on a large scale. Analogues of cAMP modified on the 6-NH2 group of the adenosine ring, the ribose 2'OH group or the cyclic phosphate are able to displace cAMP from its binding site with dissociation constants of similar magnitude to that of cAMP. More extensive modification produces weaker binding. Ultraviolet/visible difference spectroscopy and fluorescence spectroscopy show that the environment of the bound adenosine moiety is considerably less polar than that in aqueous solvent, while an anthraniloyl group substituted on the 2'OH position remains accessible to solvent. The 2-NH2 group of cGMP appears to be protonated in the bound form, while no change in the charge state of cAMP is apparent. PMID- 3311754 TI - ECG criteria for assessment of mechanisms of ventricular arrhythmias: a review. PMID- 3311756 TI - Prenatal ultrasonic detection of truncus arteriosus with interrupted aortic arch and truncal valve regurgitation. AB - The echocardiographic appearances in a case of persistent truncus arteriosus with aortic arch interruption and truncal valve dysplasia was noted in a 24 week fetus. Elective termination of pregnancy was carried out and all the echocardiographic findings were confirmed by pathological examination suggesting the possibility of accurate prenatal diagnosis of such lesions. PMID- 3311755 TI - Beta-adrenergic blockade in acute myocardial infarction: a haemodynamic and radionuclide study. AB - While long term beta-adrenergic blockade, introduced in the convalescent stage of myocardial infarction, may reduce subsequent mortality, the value of early beta blockade in the acute phase is less certain. Therefore, the influence of beta blockade on left ventricular performance and eventual infarct size was assessed in 61 consecutive patients with acute myocardial infarction. Metoprolol (15 mg i.v. followed by 200 mg day-1 orally) or placebo was administered in a double blind, randomised fashion with a median delay of 5.9 hours from onset of symptoms. After 15 days of double blind therapy all patients were started on open treatment with metoprolol. All patients underwent haemodynamic monitoring for 24 hours and serial radionuclide ventriculography and thallium 201 scintigraphy. In the first hour metoprolol produced a decrease in cardiac output (1.3 l min-1; P less than 0.001) due to a reduction in heart rate (15 min-1; P less than 0.001) and a decrease in left ventricular stroke work index (10.7 g m m-2; P less than 0.001) due to a reduction in mean arterial pressure (10 mmHg; P less than 0.001). There was then a gradual attenuation in these changes. While metoprolol produced an increase in pulmonary capillary wedge pressure and in both end-diastolic and end-systolic volumes (P less than 0.05), these changes were confined to patients with a baseline pulmonary capillary wedge pressure below the median of 13 mmHg mercury. There was no significant change in stroke volume or in ejection fraction in response to metoprolol. There was no significant difference between the groups in left ventricular performance, as assessed by radionuclide ventriculography, or in scintigraphic infarct size, either at the end of the 15 days double-blind treatment or after 3 months open treatment with metoprolol. Thus, early intervention with metoprolol in acute myocardial infarction appeared to reduce myocardial oxygen consumption with no adverse haemodynamic effect. However, metoprolol failed to preserve left ventricular function, or to reduce apparent infarct size. These data suggest that the modest reduction in mortality reported in the acute phase studies of beta-blockade in myocardial infarction, is unlikely to be due to infarct reduction. It is more likely to be due to a secondary prevention or to an antiarrhythmic effect. PMID- 3311757 TI - Mainz 1986: the European Society of Cardiology changes its course. PMID- 3311758 TI - The social and economic consequences of cardiovascular disease and the need for heart foundations to promote research. PMID- 3311759 TI - The place of heart transplantation: the French experience. PMID- 3311760 TI - The place of heart transplantation: the Italian experience. PMID- 3311761 TI - Organization of heart transplantation in Italy. PMID- 3311762 TI - The place of heart transplantation: the German experience. PMID- 3311763 TI - The place of heart transplantation: the British experience. PMID- 3311764 TI - Thrombolytic therapy for acute coronary thrombosis. PMID- 3311765 TI - Diagnostic accuracy of rest-exercise first pass ventriculography with a fast single crystal gamma camera in detecting coronary artery disease. Study of a group of male subjects without previous myocardial infarction. AB - Rest and exercise radionuclide ventriculograms were performed in 61 non infarcted, male, patients who underwent cardiac catheterization for chest pain and in 16 normal control subjects. Studies were performed using the first pass method with a fast single crystal gamma camera, which allowed a count rate of 140 +/- 19 Kcounts/sec to be reached during left ventricular filling; the count integral on left ventricular area was 10.8 +/- 1.6 Kcounts and the maximum count/pixel 155 +/- 16. We analyzed sensitivity, specificity, positive and negative predictive value of global ejection fraction (EF) and of the regional wall motion in identifying ventricular function abnormalities due to obstructive coronary artery disease. The regional wall motion was evaluated with four functional images: regional ejection fraction (REF), amplitude (A) and phase (PH) from Fourier analysis and systolic transit times (TT). Sensitivity was near 90% for EF, REF, A and TT, while PH was less sensitive (80%); all functional images were more specific (nearly 90%) than EF (80%). Both sensitivity and specificity were lower for the exercise EKG (59% and 63%, respectively) in this patient group. Significant differences between single vessel and multiple vessel disease were also observed either for the EF increase/decrease (-1.34 +/- 7.4 and -7.82 +/- 9.96; P less than 0.05) or for the number of segments which developed wall motion abnormalities during exercise (1.22 +/- 0.73 and 2.15 +/- 1.04; P less than 0.02). In conclusion, with our method, a fast single crystal gamma camera is suitable for obtaining optimal first pass radionuclide ventriculograms with a count density sufficient either for global or regional left ventricular function evaluation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311766 TI - Measurement of glomerular filtration rate with 99mTc-DTPA: a comparison of gamma camera methods. AB - A comparison has been made between three gamma camera methods for estimation of glomerular filtration rate (GFR) using 99mTc-DTPA in a group of 27 patients with widely different renal function. Plasma clearance of 99mTc-DTPA by multiple blood sampling was used as the reference. Percentage uptake of chelate in the bladder and kidneys at 20 min after injection gave the lowest standard error of 8.0 ml/min. Techniques using early uptake of isotope in the kidneys at 2 min after injection gave less accurate estimates. Correction for the vascular activity in the renal region of interest improved the results for the 2 min uptake technique. Gamma camera techniques provide rapid estimates of GFR which are less accurate than those obtained by plasma clearance of labelled chelate. PMID- 3311767 TI - Uptake of 99mTc-DTPA by a renal oncocytoma. AB - In a patient with a large vascular renal mass, a preoperative DTPA scan showed retention of the activity within the tumour. On histology, the tumour proved to be an oncocytoma. PMID- 3311768 TI - Stimulation of breast cancer with estrogens: how much clinical value? PMID- 3311769 TI - Detection method, tumour size and node metastases in breast cancers diagnosed during a trial of breast cancer screening. AB - The relationship between tumour size and lymph node metastases was examined in screening-detected and clinically detected breast cancers. The data used were from a randomized trial of breast cancer screening with mammography. 964 cancers were reviewed, in both arms of the trial, in women aged 40-74. Lymph node status was significantly related to detection method (P less than 0.001), metastases being less common in screening-detected cancers. Node status was also significantly related to tumour size (P less than 0.001), metastases being commoner in larger tumours. Similarly, tumour size was significantly associated with detection method (P less than 0.001), smaller tumours being detected by screening. No significant interaction was observed among all three factors, indicating that the relationship between node status and tumour size did not change with detection method. When detection method was replaced with randomly allocated study (invited to screening) and control (not invited to screening) groups, the same results were observed. It is concluded that if screening detects tumours with a different natural history to that of those which surface clinically, this is not reflected in the relationship between tumour size and lymph node metastases. PMID- 3311770 TI - MK-801 powerfully protects against N-methyl aspartate neurotoxicity. AB - Using the ex vivo chick embryo retina to study the efficacy of antagonists in blocking the excitotoxic effects of excitatory amino acid agonists, we previously identified phencyclidine as the most powerful known anti-excitotoxin. Here we show that MK-801 is 5 times more powerful than phencyclidine as an anti excitotoxin, that its antagonism is specific for N-methyl-asparate toxicity, is non-competitive and does not entail inhibition of excitatory amino acid receptor binding. PMID- 3311772 TI - A post treatment evaluation of multibonded lingual appliances in orthodontics. PMID- 3311771 TI - Role of prostaglandins in the arrhythmogenic effects of ouabain on isolated guinea pig hearts. AB - We examined the hypothesis that endogenous prostaglandins participate in the arrhythmogenic influence of ouabain in guinea pig hearts. Addition of ouabain (10 ng/ml) resulted in a 5-fold increase in the release of 6-keto-prostaglandin F1 alpha in the coronary effluent. Ten of 13 hearts studied (77%) demonstrated arrhythmic activity with a mean time to the onset of arrhythmias of approximately 35 min. The nonsteroidal antiinflammatory drugs indomethacin and acetylsalicylic acid which significantly inhibited the efflux of 6-keto-prostaglandin F1 alpha also reduced the incidence of arrhythmias to 10 of 30 hearts studied. In those hearts in which arrhythmias occurred, the time to onset was significantly increased to approximately 50 and 55 min for acetylsalicylic acid and indomethacin, respectively. In contrast, exogenous prostaglandin F2 alpha (0.1 and 1 ng/ml) and prostacyclin (0.1 and 10 ng/ml) increased the incidence of arrhythmias to 100% (10 of 10 hearts studied) and decreased the time to onset to approximately 10 min. These prostaglandin pretreatments were also able to reverse the protective actions of both acetylsalicylic acid and indomethacin. Other concentrations (10 ng/ml prostaglandin F2 alpha and 1 ng/ml prostacyclin) had no influence either on the incidence of arrhythmias or their time to onset. Prostaglandin E2 (0.1 ng/ml) produced a modest but not significant decrease in the time to onset of arrhythmias although this concentration was significantly effective in reversing the nonsteroidal antiinflammatory drug effects. The inotropic, chronotropic and coronary constricting actions of ouabain were unaffected either by nonsteroidal antiinflammatory drug or prostaglandin pretreatment. These studies suggest that prostaglandins are involved, at least in part, in the arrhythmogenic actions of ouabain in the isolated guinea pig heart. PMID- 3311773 TI - Face mask therapy in children with cleft lip and palate. PMID- 3311774 TI - Generation and partial characterization of monoclonal antibodies reactive with islet cell antigens. AB - Islet cell antibodies have been detected in more than 60% of newly diagnosed type I diabetics. Their pathogenetic role is still unclear. We have generated monoclonal antibodies (mc-ab) reactive with islet cell antigens by fusing mouse myeloma cells with spleen cells from Balb/c mice immunized with pancreatic islet cells. Hybridomas producing islet cell surface antibodies (ICSA) were detected by indirect immunofluorescence on viable cells from rat islets or rat insulinoma. Cytoplasmic islet cell antibodies (ICA) were detected by indirect immunofluorescence on Bouin-fixed sections of mouse pancreas. The ICSA- and/or ICA-producing hybridomas were cloned twice by limiting dilution. This paper describes six different mc-ab. All hybrid cell lines obtained produced IgM antibodies. Four of them mediate complement-dependent cytotoxicity to viable rat islet cells. In the present study the heterogeneity of circulating ICSA is demonstrated. Also, a monoclonal beta cell surface autoantibody K56aF3 was produced by fusion of spleen cells from a mouse treated with sub-diabetogenic doses of streptozotocin in combination with complete Freund's adjuvant. It was cytotoxic against islet cells up to a dilution of 1:1,000 and it could inhibit the insulin secretion from neonatal rat islets cultured in RPMI 1640 as stimulated by glucose or by the phosphodiesterase inhibitor 3-isobutyl-1 methylxanthine common with glucose. The latter effect was reversible as indicated by the recovery of insulin secretion in a subsequent culture period without mc ab. These results suggest that circulating ICSA in type I diabetics may alter beta cell function and thereby contribute to the pathogenesis of type I diabetes. PMID- 3311775 TI - Cell-mediated immune reactions against islets of Langerhans in diabetes-prone BB rats. AB - The intact pancreatic islet can be destroyed by antibody-dependent cell-mediated cytotoxicity (ADCC). T cell-mediated cytotoxicity (CMC) might additionally be important in the pathogenesis of IDDM. However, in vitro alterations of islets due to CMC have so far not been demonstrated. For the evaluation of the cytotoxic attack caused by ADCC and CMC against the islets in the development of IDDM we used a BB rat line with a high incidence of the disease (dp BB/OK). Cytotoxicity tests were carried out on autologous and on nonsyngeneic islets with mononuclear spleen cells and serum from non-diabetic BB rats of different ages. The cytotoxic action of the mononuclear cells was quantified by the specific 51Cr-release from the islets after pretreatment with serum. It was found that an anti-islet cytotoxicity appears with a peak incidence between 40 and 60 days of age. The frequency of cytotoxicity in vitro was related to the incidence of diabetes as normally observed in this rat line. Furthermore, it was shown that both autologous, allogeneic and xenogeneic islets can be destroyed by mononuclear spleen cells and serum of dp BB/OK rats.--The frequency and the strength of anti islet cytotoxicity in vitro were higher in these dp BB/OK animals than in a control group of non-diabetes prone BB/PhiK rats. There was an association between cytotoxic 51Cr-release in the positive assays and a reduction in the hormone content of pancreatic islets.--This report provides evidence of cell mediated immune damage of islets during the prediabetic state of BB rats suggesting that both CMC and ADCC are involved in islet cell killing. PMID- 3311776 TI - Polymorphism of HLA and insulin gene is correlated to type I diabetes. AB - A polymorphic locus flanking the 5'-end of the insulin gene was studied by means of the recombinant DNA technique in 62 diabetic and nondiabetic subjects. The small allele predominantly was found with the following frequencies: 28 insulin dependent diabetics 0.89; 6 probands of a family with one type I diabetic member 0.92; 10 patients with a non-insulin-dependent diabetes mellitus 0.55; 18 control probands (normal glucose tolerance) 0.64. --Because of the relatively high number of all probands with the small allele we assume that the presence of this allele on both chromosomes increases the susceptibility but is not sufficient for the onset of an insulin-dependent diabetes mellitus. By a correlation of the polymorphic region of the insulin gene with other DNA regions (in particular with the major histocompatibility complex) the susceptibility may be further increased. Therefore, the HLA-DR gene polymorphism of type I diabetes is of interest. PMID- 3311777 TI - Natural killer cell and islet killer cell activities in human type 1 diabetes. AB - Peripheral blood mononuclear cells from 14 type 1 diabetic patients were examined for natural killer cell activity using the K562 cell line as 51Cr labeled targets. Mean cytotoxicity of K562 cells by unseparated mononuclear cells derived from new onset type 1 patients (12 +/- 1.6%) was lower (P less than .01) than that observed in non diabetic controls, (25 +/- 4.2%). Mean natural killer cell cytotoxicity mediated by enriched non-T cells from patients (41 +/- 5.8%) was also lower (P less than 0.03) than in the control group (56 +/- 3.7%). Specificity of these findings was evaluated by also examining other diabetic patient subgroups. Mean non T cell mediated natural killer cell activity in type 2 diabetic patients and type 1 patients with long term disease was 65 +/- 5.4% and 62 +/- 4.8% respectively (p less than 0.001 vs new onset type 1 patients). Longitudinal studies of new onset type 1 patients during the remission (honeymoon) phase revealed no improvement of impaired natural killer cell activity. In 30 new onset and 11 remission diabetic patients, mean non-T cell mediated cytotoxicity was also measured using dispersed 51Cr labeled pancreatic islet target cells. Mean islet cytotoxicity mediated by cells from new onset patients was 34 +/- 2.4%, whereas in nondiabetic control subjects mean cytotoxicity was 25 +/- 1.8% (p less than 0.005). During remission, islet cytotoxicity returned to normal values in over half of the patients. There was no correlation between K562 and islet cell cytotoxicity in either of the latter two patient groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311778 TI - A follow-up study of cell-mediated cytotoxicity and beta cell function in type I diabetes. AB - In 20 patients with a newly diagnosed type I diabetes mellitus a cytotoxic effect of blood lymphocytes against beta cells of the pancreas of neonatal rats could be demonstrated. This effect remained nearly unchanged during the first 12 months of control. During the course up to 18 months, the cytotoxicity decreased significantly. After stimulation with glucose and glucagon, a C-peptide secretion was demonstrated in all patients during the first 12 months but it decreased thereafter. The follow-up study showed cell-mediated immune reactions against beta cells in type I diabetics as long as the existence of beta cells can be assumed on the basis of functional tests. Thus the immune process seems to depend on the presence of the specific antigen. PMID- 3311779 TI - Islet cell antibodies and viral infections. AB - The sera of 127 non-diabetic children after mumps-infection were investigated for the presence of islet cell antibodies and islet cell surface antibodies. The study also included 4 children who developed diabetes mellitus shortly after an active mumps vaccination. 21 of the non-diabetic children and four of the vaccinated children exhibited islet cell cytoplasmic antibodies. Islet cell surface antibodies were observed more frequently, namely in 43 out of 68 patients studied after mumps infection and in 32 out of 44 patients studied after different viral diseases. With one exception, none of the mumps-infected children and none of the other viral infected patients developed diabetes mellitus. PMID- 3311780 TI - Induction of a diabetes-like syndrome by cyclosporine in Wistar rats and its reversibility after drug withdrawal. AB - Cyclosporin A exerts dose- and time-related toxic effects on pancreatic B-cells. We investigated the reversibility of Cyclosporin A-induced alterations on glucose tolerance and pancreatic insulin content in Wistar rats either still normoglycaemic or animals being hyperglycaemic after different treatment periods. Both groups of animals either formerly normoglycaemic but glucose intolerant or hyperglycaemic normalized glucose intolerance, glycaemia and reenhanced pancreatic insulin content. This demonstrates that also hyperglycaemic animals are able to recover spontaneously from a diabetes-like state. PMID- 3311782 TI - Pancreatic beta cell function in polycystic ovary syndrome: its relationship to body weight, serum testosterone and serum prolactin levels. AB - Circulating levels of insulin and C-peptide in response to oral glucose administration (75 g) were measured in 25 PCOS patients (13 were obese and 12 non obese) without acanthosis nigricans and in 12 non-obese normal cycling women of similar age. Fasting levels of insulin and C-peptide as well as the sums of their levels in response to glucose were significantly greater in PCO patients than in controls despite similar glucose responses. Obese PCO patients had greater basal levels, maximum increments and sums of insulin and C-peptide levels than non obese PCO patients and controls. PCO patients with increased basal total testosterone levels had significantly greater mean fasting insulin levels (p less than 0.005) than those with normal testosterone levels but their responses to glucose were not significantly different. Hyperprolactinaemic PCO patients had neither basal level nor sums of insulin and C-peptide levels in response to glucose greater than normoprolactinaemic PCO patients. In all PCO patients BMI correlated significantly with insulin (p less than 0.05) and C-peptide levels (p less than 0.001). Total serum testosterone levels correlated significantly with fasting levels and the sum of C-peptide levels in response to glucose. The correlations of total serum testosterone levels with fasting and the sum of insulin levels in response to glucose were also positive but not significant. These results clearly indicate that in PCOS there is a significant degree of hyperinsulinaemia which is mainly related to obesity. PMID- 3311781 TI - Islet cell surface antibodies (ICSA) in subjects with a previous mumps infection- a prospective study over a 4 year period. AB - It has been suggested that the mumps virus may be involved in the etiopathogenesis of Type-I diabetes mellitus. Most studies have analyzed this relationship retrospectively. We, however, carried out a prospective study over a 4 year period after a mumps infection in two age groups (16 years and under [group A no = 32] and over 16 years [group B no = 18]). These subjects with "diabetic risk factors" (impaired glucose tolerance, low insulin response, ICSA and/or HLA-DR3/DR4) were selected from 1581 registered cases, in whom an antecedent mumps infection had occurred in 1980 and 1981. Glucose tolerance and insulin secretion did not change significantly during 4 years after a mumps infection. Overt diabetes was not observed in any of the cases. One year after a mumps infection 35% of children and 63% of adolescents/adults exhibited ICSA (control subjects = 5%; a serum was considered ICSA-positive if more than 25% of the intact rat islet cells showed distinct cell surface immunofluorescence). After 4 years the percentage of subjects with ICSA decreased significantly to 13% and 14%, resp. Only 21% of ICSA-positive sera were found to be cytotoxic on rat islet cells (51Cr-release assay). No relationship could be evaluated between complications resulting from a mumps infection and the appearance of ICSA. There was no correlation between ICSA, glucose tolerance, and insulin secretion. In fact, our prospective study did not reveal any relationship between a mumps infection and Type-I diabetes. ICSA would seem to be of no predictive value. PMID- 3311783 TI - Cell aging in vitro: a historical perspective. AB - This article describes the historical background to the demonstration by Hayflick and Moorhead that human diploid cell strains in culture have limited life-spans. I suggest that the recognition of cell aging in vitro is an example from the biological sciences of a Kuhnian scientific revolution. PMID- 3311785 TI - Recombinant human interleukin-2 restores in vitro T-cell colony formation by peripheral blood mononuclear cells after autologous bone marrow transplantation. AB - Immune reconstitution after autologous bone marrow transplantation (ABMT) was studied in peripheral blood by phytohemagglutinin stimulated T-cell colony formation (CFU-TL) and by surface phenotype analysis of T-lymphocytes with monoclonal antibodies. Twenty-six patients (15 small-cell lung cancer, 5 lymphoma, 3 acute myeloid leukemia [AML], 2 germ cell cancer, and 1 melanoma) were conditioned with high-dose multiple drug combinations (plus total body irradiation in AML patients). No maintenance chemotherapy was given following treatment. Despite a rapid return to normal values of peripheral T3+, T11+ lymphocytes, the T4/T8 ratio remained below 1.0 up to 24 months after transplant, regardless of infection by cytomegalovirus (CMV). A high percentage (26% +/- 3%) of lymphocyte cells with immature phenotype (T8+, Ia+) was found during the first 6 months after transplant. Out of 84 cultures, performed in 26 patients, no growth was observed in 47 instances (22 patients) up to 28 months after grafting. Growth occurred in 37 cultures (11 patients, from 1 to 51 months after transplant) although it never reached the colony numbers of normal controls. Recombinant human interleukin-2 (rIL-2) added to lymphocyte culture induced proliferation in 8 (4 CMV-positive and 4 CMV-negative patients) out of 12 instances of no growth. In cases of depressed CFU-TL (20 cultures), rIL-2 induced a 48% and 92% increase in six CMV-positive patients and nine CMV-negative patients, respectively. These observations show that after ABMT and regardless of CMV status, defects in CFU-TL can be partially corrected by rIL-2. PMID- 3311784 TI - Interactions between purified murine colony-stimulating factors (natural CSF-1, recombinant GM-CSF, and recombinant IL-3) on the in vitro proliferation of purified murine granulocyte-macrophage progenitor cells. AB - Purified preparations of natural CSF-1 (nCSF-1), recombinant GM-CSF (rGM-CSF), and recombinant IL-3 (rIL-3), alone and in combination, were investigated for their proliferative effects on highly enriched murine granulocyte-macrophage progenitor cells (CFU-GM). These CFU-GM had cloning efficiencies of 62%-95% in the presence of 10% (vol/vol) pokeweed mitogen-stimulated spleen cell-conditioned medium, and contained few, if any (less than or equal to 3%), contaminating morphologically recognizable monocytes or lymphocytes. The combination of low concentrations of nCSF-1 plus rIL-3, or nCSF-1 plus rGM-CSF, increased colony number greater than additively compared to the sum of colony formation with each factor alone, whereas total aggregate (colony plus cluster) number increased additively. At plateau concentrations, the previous CSF combinations increased colony number additively. Colony size was increased when nCSF-1 plus either rGM CSF or rIL-3 were added simultaneously at either low or plateau concentrations, when compared to the size of colonies with any of the CSFs alone. Addition of rGM CSF plus rIL-3 demonstrated no cooperative proliferative effect on either colony number or size. It is likely that these effects are mediated at the progenitor cell level and do not require accessory cell participation. PMID- 3311786 TI - Origin of T-lymphocytes in human mixed hematopoietic colonies. AB - The presence of T-lymphocytes in mixed hematopoietic colonies (CFU-MIX) has been reported by some investigators. Though depletion before culturing was performed, residual T cells might be responsible for the observed phenomenon. Using nondepleted marrow or bone marrow depleted to about 2%, T-lymphocytes could be detected in mixed colonies. However, reduction of the T-lymphocytes to less than 0.7% by using a modified E-rosette technique or a cocktail of anti-T-cell monoclonal antibodies (WT1, WT32, WT82) in the presence of baby rabbit complement, resulted in mixed colonies free of T-lymphocytes. After addition of 1.75% T-lymphocytes to this T-cell-depleted bone marrow, T-lymphocytes could be detected in most mixed colonies, but not after the addition of the same percentage of irradiated T-lymphocytes. The presence of T cells in mixed colonies was determined by an adapted immunofluorescence technique (WT32 plus GAM-FITC). The results indicate that mononuclear cells with T-lymphocyte antigens are not the offspring of mixed hematopoietic colony-forming progenitors, but of a low number of T-lymphocytes contaminating the bone marrow after insufficient T-cell depletion. PMID- 3311787 TI - Isolated cells in suspension for biological research--part I. Structure and functional properties of isolated hepatic cells from normal and chronically injured livers. PMID- 3311788 TI - Omental response to long-term implantation of diffusion chambers containing allogeneic and xenogeneic bone marrow. AB - Diffusion chambers were filled with bone marrow from 2-4 weeks old rabbits and dogs, and implanted into the peritoneal cavity of adult animals for 28-45 days. The diffusion chambers were encapsulated by omentum in both dogs and rabbits, and the character of the omental response was influenced by the chamber contents. Empty chambers were enveloped by omentum composed principally of fibrous-fatty tissues, with a thin fibrous layer adherent to the chamber walls. Chambers containing allogeneic marrow evoked a marked cellular and angiogenic response in the adherent omentum. In rabbits, lymphocytes were the predominant cell type. In dogs, large ecchymotic haemorrhages were found immediately adjacent to the chambers, with aggregations of lymphocytes in the surrounding dense fibrous tissue. Diffusion chambers containing xenogeneic marrow were surrounded by a thick fibrous tissue capsule, without any adhesion of the omental tissues to the chambers. The internal layer of the omental capsule was necrotic and chambers were bathed in serosanguinous fluid. It was concluded that antigens on fragments of marrow cells escaping from the diffusion chambers had evoked the various omental responses which were observed. PMID- 3311789 TI - A statement of appreciation and presentation of a perspective honoring Silvio Weidmann. PMID- 3311790 TI - Cardiac electrophysiology: past, present and future. Part I. A symposium. September 10-11, 1986, Bern. Honoring Silvio Weidmann. PMID- 3311791 TI - The conduction of the cardiac impulse 1951-1986. AB - The study of the propagation of the cardiac impulse during the last 35 years is reviewed with special attention to the contributions of Silvio Weidmann and his colleagues. Special emphasis is placed on the need to prove that the cardiac impulse is transmitted electrically, even when it is conducted under very abnormal conditions. PMID- 3311792 TI - Impulse propagation from the SA-node to the ventricles. AB - Normally the pacemaker of the mammalian heart is located in the sinus node. In the rabbit the sinus node can be subdivided into two regions, the center of the node where the impulse originates and the border zone through which the impulse is conducted towards the atrium. Conduction properties of both regions were investigated. It appeared that conduction velocity increases and refractoriness decreases when one goes from the nodal center towards the atrium. The tissue mass of the atrium is large in comparison to the sinus node and normally the resting membrane potential of atrial fibers is more negative than that of nodal fibers; consequently, a potential difference exists causing a current flow between both areas. Evidently this hyperpolarizing current flow depresses impulse formation in the border zone fibers which have better intrinsic pacemaker properties than fibers in the nodal center. If the impulse has reached the atrium it is conducted with a relatively high safety factor and will reach the AV node in principle without difficulty. The AV node, if deprived of sinus nodal dominance, develops spontaneous activity originating from the lower nodal fibers. Also in this structure, electrotonic depression by surrounding tissue causes deceleration of the pacemaker. PMID- 3311793 TI - Mechanisms for cardiac arrhythmias. AB - Possible cellular electrophysiological mechanisms for arrhythmias have been investigated through studies of isolated cardiac tissues. Records through extracellular and intracellular electrodes indicate that arrhythmias may result from either focal or non-focal mechanisms. Focal mechanisms include abnormal impulse initiation (normal or abnormal automaticity), triggering from either early or delayed afterdepolarizations and reflection, whereas the non-focal mechanisms are various forms of reentry due to circus movement. It is reasonable to assume that these mechanisms also occur in vivo. Although it is safe to identify macro-re-entry as the cause of some atrial and ventricular arrhythmias, for the most part direct proof of mechanism usually is lacking for the focal arrhythmias. If 'on line' activation sequence mapping techniques can be developed to quickly and specifically locate arrhythmogenic foci in the in situ heart, it may be possible to use unipolar extracellular recording techniques to identify the exact cellular electrophysiological mechanisms operating within them. PMID- 3311796 TI - HIV infection due to a platelet transfusion after allogeneic bone marrow transplantation. AB - A 30-yr-old man with chronic granulocytic leukaemia received a bone marrow transplant from his histocompatible sister in December 1982. His post-transplant course was complicated by Grade III graft-versus-host disease and multiple infectious episodes until his death from pneumonia on d + 190. He was later found to be seropositive for anti-HIV at the time of his death. Retrospective analysis of stored sera showed a transient period of seropositivity from d + 11 to d + 20 thought to reflect passive transfer of antibody from a blood product transfused prior to d + 11 when he was also exposed to infectious virus. He remained seronegative until d + 78 when anti-HIV was again found. Seropositivity persisted until his death and was attributed to endogenous antibody response. Although it is unclear whether his clinical course was due to AIDS, exposure of an immunosuppressed patient to HIV may be associated with more rapid development of clinical disease. PMID- 3311797 TI - Critical issues in autologous bone marrow transplantation in adult acute leukemia. PMID- 3311795 TI - Cell-to-cell communication in the heart: structure-function correlations. AB - The communicating cell junctions that ensure the electrical and diffusional continuity of the intracellular space in the heart fibres can be switched from their normal conducting, or opened state, to an exceptional non-conducting, or closed state. This electrical uncoupling is observed after cell injury in the presence of Ca2+ ions in the extracellular fluid, after metabolic inhibition and in the presence of aliphatic alcohols (C6 to C9). The correlations between electrical uncoupling and gap junction morphology in the heart are briefly reviewed. A decrease of the distance between P-face particles and between the E face pits has been found in all investigations, but the functional significance of this observation is not understood at present. A quantitatively very similar decrease of the average particle diameter (about -0.7 nm) has been measured in glutaraldehyde-fixed sheep Purkinje fibres and in unfixed, quickly frozen rat auricles that had been electrically uncoupled by three different procedures. About half of this decrease was reversible on short-term electrical recoupling (within 20 min). It is concluded that a measurable decrease of the connexon diameter correlates with electrical uncoupling. PMID- 3311798 TI - [Pharmacological regulation of cardiac adrenoreceptors]. PMID- 3311799 TI - [Importance of chronobiology for pharmacological and toxicological research]. PMID- 3311794 TI - Conduction of the impulse in the ischemic myocardium--implications for malignant ventricular arrhythmias. AB - Ventricular arrhythmias occurring consequent to regional disturbances of myocardial perfusion are the most frequent cause of sudden cardiac death. They are related to marked changes of impulse propagation in the ischemic region, which consist of circulating excitation with re-entry. Mapping of the impulse during ventricular tachycardias and ventricular fibrillation shows that the circus movements change their shape and localization from beat to beat. Zones of tissue which block the impulse during one beat may conduct the impulse at a fast rate during the next beat. The main cause underlying this behavior is the depression of the ischemic action potential. This depression is caused by the partial inactivation and the prolonged recovery of the rapid sodium inward current. In addition to the decrease in resting potential, other factors, such as acidosis, contribute to the inactivation of the inward currents generating the upstroke of the action potential. An increase of coupling resistance between myocardial cells and/or an increase of extracellular resistance appear to be less important for explaining conduction disturbances in acute ischemia. PMID- 3311800 TI - [Current aspects of the search for new anti-arrhythmia agents]. PMID- 3311801 TI - [Cardiac effects of insulin in ethanol intoxication and in the postintoxication period]. AB - Insulin (2 IU/ml) effect on the contractile function, glucose consumption and lactate release by the myocardium was studied in experiments on the isolated rat heart performed at different time after a single (8 g/kg) and 10-fold with a 12 hour interval (8-10 g/kg) intragastric administration of ethanol. A single administration of ethanol failed to influence the contractile function, glucose consumption and lactate release by the isolated heart. The magnitude of a positive inotropic reaction to insulin increased and its stimulating effect on glucose utilization by the myocardium weakened. The reaction of ethanol withdrawal developing after its 10-fold administration led to a disturbance of the contractile and rhythmic functions of the heart and activation of glycolysis. The heart inotropic reaction to insulin in this period weakened and glucose consumption and lactate release stimulated by insulin did not differ from control. During perfusion of intact rat hearts with and without glucose insulin (2 IU/ml) weakened the cardiodepressive effect of ethanol (200 mM). PMID- 3311802 TI - [A new peptide activator of reparative tissue regeneration]. AB - Synthetic analog of leucine enkephalin--hexapeptide dalargin was shown to stimulate healing of skin wounds in rats, dogs and mini-pigs at local and parenteral administration in doses of 0.1-100 micrograms/kg. Acceleration of proliferation with an increase of fibroblast mitoses, earlier and active growth of vascular elements, rapid maturation of granulation tissue and accelerated epithelialization were observed. PMID- 3311804 TI - [Determination of the drug content of saliva in clinical and experimental research on pharmacokinetics]. PMID- 3311803 TI - [Basic principles of pharmacological action in immediate allergy reactions]. PMID- 3311806 TI - Antimycotic action of alkyl derivatives of 5-(benzenesulfonamide)-1,2,3,4 tetrahydro-2-thioxo-4-pyrimidinon e. AB - Several series of mono-, di- and trimethyl derivatives of N-(6-amino-1,2,3,4 tetrahydro-4-oxo-2-thioxo-5-pyrimidinyl)benzene sulfonamide substituted at the benzene ring (Z), were synthesized and studied spectrophotometrically. The spectral and physical data enabled the structures of the methyl derivatives obtained by methylating (Z) to be identified. When assayed biologically as antimycotics, a small percentage of the substances exhibited mild fungicide activity. PMID- 3311805 TI - New heterocyclic derivatives of benzimidazole with germicidal activity. IV--In vivo anticandida activity of 5-fluoro-2-(5'-nitro-2'-furyl) benzimidazole (F-O NO2). AB - We have studied the possible in vitro and in vivo antibacterial activity of 5 fluoro-2-(5'-nitro-2'-furyl)benzimidazole (F-O-NO2). Our data demonstrate that F O-NO2 is able to inhibit the in vitro growth of different mycetes and bacteria, including Candida albicans and Cryptococcus neoformans. We also tested the possible in vivo activity against Candida albicans. The results clearly show that treatment with F-O-NO2 is able to significantly augment the survival of all treated animals; in particular, when injected i.p. at the dose of 120 mg/kg, 30' or 1 hr after Candida albicans challenge, it givens a MST (Medium Survival Time) longer than 60 days. These data demonstrate that F-O-NO2 has antibacterial and antimycotic activity. PMID- 3311807 TI - Heat shock inactivates a supernatant factor(s) specifically required for efficient expression of the amp gene in Escherichia coli. AB - A 160,000 x g supernatant of E. coli extract prepared from cells grown at 30 degrees C stimulated specifically the expression of the amp gene on pBR322 and pBR328 in an in vitro gene expression system from E. coli. This activity of the supernatant was markedly reduced when the cells were exposed to 42 degrees C for 30 min prior to preparing the supernatant. These results are consistent with the view that heat shock-induced repression of the amp gene expression is due to inactivation of a supernatant factor(s) required for effective expression of the amp gene. PMID- 3311808 TI - Regulation and specificity of glucose-stimulated insulin gene expression in human islets of Langerhans. AB - The insulin response of cultured human islets of Langerhans was measured at both mRNA and polypeptide levels in response to natural and pharmacological stimuli. We report a dosage dependent stimulation of both mRNA levels and insulin secretion by extracellular glucose, and present evidence that islet responsiveness can be divided into two temporal phases: an early response, apparently under post-transcriptional control, and a late phase in which insulin messenger accumulates. Although glucose effects in man are similar to rodents, there are important differences, especially with respect to modulation of glucose stimulation by activators of beta-cell protein kinases. PMID- 3311809 TI - Chiral beta and random fractional deuteration for the determination of protein sidechain conformation by NMR. AB - Stereospecific assignments of the aspartic acid and asparagine beta-protons of the 108 residue protein E. coli thioredoxin have been obtained by the use of chiral deuteration. In addition protein samples have been prepared in which all carbon bound hydrogen positions are substituted to an extent of 75% with deuterium. These random fractionally deuterated samples significantly facilitate the measurement of coupling constants and intraresidue NOE intensities which combined with the stereospecific assignments have provided determination of the first sidechain dihedral angle chi 1 for all four asparagine residues and eight of the ten assigned aspartic acid residues. PMID- 3311810 TI - Involvement of a 65 kDa phosphoprotein in the regulation of membrane fusion during exocytosis in Paramecium cells. AB - Antisera were raised against a phosphoprotein of 65 kDa (PP65) from Paramecium cells (shown before to be selectively dephosphorylated during synchronous exocytosis) and specified by immunoblotting. By immunofluorescence PP65 has been localized within the cortex, beneath the cell membrane. This corresponds to data obtained by cell fractionation, applying SDS-PAGE autoradiography to cortices prepared from 32P-prelabeled cells. Antisera against PP65 inhibit exocytosis in vivo (microinjection). Applying anti-PP65 antisera in vitro to cortices we could demonstrate inhibition not only of exocytosis, but also of PP65 dephosphorylation. We conclude that PP65 is involved in the regulation of membrane fusion during exocytosis. PMID- 3311811 TI - Conformational aspects of the reaction mechanisms of polysaccharide lyases and epimerases. PMID- 3311813 TI - A unique amino acid substitution in the outer membrane protein OmpA causes conjugation deficiency in Escherichia coli K-12. AB - The outer membrane protein OmpA of E. coli K-12 can serve as a receptor for phages and is required for stabilizing mating aggregates during F'-mediated conjugation. Selection for resistance to OmpA-specific phages yields mutants with alterations in the protein at four cell surface exposed sites. It is shown that conjugation deficiency can be caused by apparently only one type of amino acid substitution at one of these sites, the replacement of glycine-154 by aspartic acid. This suggests that, in contrast to binding of phages, a ligand of the donor cell recognizes only a very small area of the protein. PMID- 3311812 TI - Differential kinetics of rat insulin I and II processing in rat islets of Langerhans. AB - Synthesis and processing of radiolabelled rat insulin I and II were studied by pulse-labelling freshly isolated rat islets with [3H]leucine and chasing in 2 mM glucose for up to 270 min (which minimized insulin secretion, less than 1%/h). Islet samples were taken during the chase period and analyzed for their rat insulin I and II content by high-performance liquid chromatography. Prior to 60 min chase rat insulin I accounted for greater than 85% of the radiolabelled insulin present. With longer periods of chase, the relative percentage of rat insulin II progressively increased so that by completion of proinsulin to insulin processing the two labelled rat insulins were present in the same proportion as the relative immunoreactive content, approx. 60:40% insulin I/insulin II. Thus, although islets synthesize the two insulins in proportion to their relative immunoreactive content, rat insulin I and II are processed with different kinetics. PMID- 3311814 TI - Influence of Mg2+ and Ca2+ bound to 1,5-IAEDANS-labeled phosphorylated and dephosphorylated heavy meromyosin complexed with F-actin on polarized fluorescence of the fluorophore. AB - Dephosphorylated and phosphorylated heavy meromyosin, fluorescently labeled with 1,5-IAEDANS attached at the SH1 group, was introduced into myosin-free ghost fibres and the polarized fluorescence of the bound label was measured. The results depended on whether the divalent cation binding sites on heavy meromyosin were saturated with Mg2+ or Ca2+. The calculated angles of absorption and emission dipoles and the amount of random fluorophores were significantly changed, indicating that the random mobility and orientation of the fluorophores of phosphorylated and dephosphorylated heavy meromyosin heads complexed with F actin in the ghost fibre depend on saturation of heavy meromyosin with Ca2+ or Mg2+. The presence of bound Ca2+ has an opposite effect on the polarized fluorescence of phosphorylated and dephosphorylated 1,5-IAEDANS-heavy meromyosin. PMID- 3311815 TI - The Ernest Miles memorial lecture. Adventures on a surgical Everest. PMID- 3311816 TI - Oesophageal carcinoma and hypercalcaemia: a clinical study. AB - Out of a retrospective series of 89 consecutive cases of squamous oesophageal carcinoma, twelve cases (13.3%) had hypercalcaemia (one of which is described in detail). Four out of the seven patients (57%) who had bone surveys had bone metastases. In hypercalcaemic patients the median survival was 17 weeks, while in normocalcaemic patients median survival was 19 weeks. The hypercalcaemia was overlooked or ignored in eleven out of the twelve cases. The high incidence of hypercalcaemia in oesophageal carcinoma may not be well recognised. Since a significant percentage of cases may not have bone metastases, the occurrence of a raised calcium does not necessarily preclude attempted curative treatment and, in addition, treatment of the hypercalcaemia may provide valuable relief of what are sometimes distressing symptoms. PMID- 3311817 TI - The use of monoclonal antibodies for the histopathological detection of mammary axillary micrometastases. AB - We have studied the clinical value of immunohistochemical techniques in detecting occult axillary metastases from breast carcinoma in forty patients, all of whom had been assessed as free of nodal metastases by routine histology 5 years earlier. The same sections were restained using monoclonal antibodies against Epithelial Membrane Antigen (EMA). In four patients, occult metastases were detected, giving an increase in diagnostic accuracy of 10%. At 5-year follow-up 12 (30%) patients had developed tumour recurrence, of whom three were detected on immunohistochemical testing, while the other nine patients were reported as free of nodal metastases on staining with Anti-EMA. We conclude that routine application of immunohistochemical staining would further increase the diagnostic yield of axillary metastases from breast carcinoma, but this increase would not be of significant clinical value. PMID- 3311818 TI - Contralateral breast cancer after limited surgery plus radiotherapy of early mammary tumors. AB - Conservative treatment of early breast cancer with limited surgery requires a mandatory irradiation of the affected breast, which implies a low but measurable irradiation of contralateral breast too. As ionizing radiations can produce an oncogenic effect on mammary tissues, the series of 701 patients of the Milano clinical trial on T1 No breast cancer (1973-1980) was investigated to compare the incidence of contralateral breast cancer in the Halsted group (not irradiated) and in the QU.A.RT. group (irradiated on the operated breast with a total dose of 50 Gy plus a limited boost of 10 Gy). In March 1986, a contralateral breast cancer was diagnosed in 17/349 patients (4.9%) of the Halsted group and in 18/352 patients (5.1%) of the QU.A.RT. group after a median follow-up of 108 months. The sites of contralateral cancer were superimposable in the two groups of patients, with a constant prevalence of external quadrants, despite the great difference of dose distribution in the irradiated patients. Our data on the incidence of contralateral breast cancer failed to demonstrate an oncogenic effect of irradiation to date, but the follow-up is still in progress and any future event will be registered and discussed. PMID- 3311819 TI - Advanced gallbladder carcinoma: a case report and review of the literature. AB - A case with carcinoma of the gallbladder and recurrent metastases to regional lymph nodes is reported. Following primary surgery, secondary resection of node recurrence, and long term combination chemotherapy, the patient is alive and disease free after 9 years. The possibility of a successful cancer suppression, as mirrored by a depressed RES-function test during the treatment with anticancer drugs, is discussed. Only nine other cases with advanced gallbladder cancer and 5 year survival are found in the literature. PMID- 3311821 TI - [Female students of I. P. Semmelweis in Transcarpathia]. PMID- 3311820 TI - [Prenatal diagnosis of hereditary diseases and developmental defects]. PMID- 3311822 TI - The ultrastructural pathology of the spermatozoon as a cause of infertility: the role of electron microscopy in the evaluation of semen quality. PMID- 3311823 TI - Cervical mucus changes in relationship to urinary luteinizing hormone. AB - In order to evaluate the relationship between the urinary luteinizing hormone (LH) surge as detected by the OvuSTICK (Monoclonal Antibodies, Inc., Mountain View, CA) method and daily cervical mucus parameters, ten spontaneously ovulating women undergoing infertility evaluation were followed during their cycles with twice daily urinary LH testing as well as daily ultrasound, mucus evaluation, and hormonal assays of serum LH, progesterone (P), and estradiol (E2). Maximal cervical mucus scores, as determined using a modified Insler score, were noted to coincide consistently with the urinary LH surge as detected by twice daily testing and to precede ultrasound evidence of ovulation by 0 to 24 hours. Mucus scores rapidly declined in the 24-hour period following the urinary LH surge. Detection of the urinary LH surge may therefore help identify that period of time during which cervical mucus parameters are optimal and therefore facilitate the timing of artificial insemination, intercourse, or postcoital testing. PMID- 3311824 TI - The effect of insulin on progesterone production and cellular growth in long-term cultures of human granulosa lutein cells. AB - The direct action of insulin on human granulosa lutein cells (GLCs) in long-term cultures obtained from in vitro fertilization (IVF) cycles was investigated. Progesterone (P) secretion by GLC increased progressively in both basal and human chorionic gonadotropin (hCG; 100 mIU/ml) stimulated conditions up to 4 days in culture, and plateaued thereafter. Insulin (0.0025 mU/ml to 2500 mU/ml) had no effect on either basal or hCG stimulation during the culture period. GLC in culture formed a monolayer and multiplied at a rate of approximately once every 3 days. Neither morphology nor cell division was affected by insulin in supraphysiologic levels (25 mU/ml). These results suggest that GLC obtained from preovulatory follicles in an IVF program are already stimulated maximally by in vivo exposure to high doses of human menopausal gonadotropin (hMG)/hCG administered to the women. Contrary to its stimulatory effect on early preovulatory granulosa cells, insulin dose not affect P production, cellular morphology, or growth rate of luteinized granulosa cells. PMID- 3311825 TI - [Dmitrii Grigor'evich Kvasov (1907-1968). On the 80th anniversary of his birth]. PMID- 3311826 TI - [Interaction of cortico-subcortical systems in the organization of the higher nervous activity]. PMID- 3311827 TI - [Activity of enzymes in various parts of the gastro-intestinal tract in ruminants]. PMID- 3311828 TI - An anchor of stability. FDA President Gideon Stocks, DDS. PMID- 3311829 TI - Lipid pigments and aging. AB - It is a short survey of lipid pigment formation in which the role of free radicals in the peroxidation of lipids is particularly stressed. The chemical structure of lipopigments and the role of the chemical moiety in histochemical reactions is shortly overviewed. A new aspect of age in the formation of lipopigments is brought to light. Finally the role of hypoxaemia and no-reflow phenomenon influencing the pigment formation is discussed. PMID- 3311831 TI - Twenty-five years of the Polish Histochemical and Cytochemical Society. PMID- 3311830 TI - Ontogenesis of serotoninergic nuclei in the rat stem. AB - The development of central serotoninergic neurons has been investigated with immunohistochemical techniques using the indirect peroxidase-antiperoxidase (PAP) method in 16-and 19-day-old rat embryos, in 1, 10 and 26 days old young and in adult animals. Immunoreactive neurons were present on embryonic day 16 in the subventricular area of the brain stem. First the countour of nucleus raphe dorsalis became distinct in the subventricular cell mass of the lower midbrain. In the ventral part of the tegmentum, cells were grouped along the midline in bilateral columns from which the nucleus centralis superior, the nucleus raphe pontis and the nuclei pontis differentiated. These nuclei were well defined in the newborn on either side of the midline, and the nucleus centralis superior and nucleus raphe pontis were fused on the midline in 10-day old rat. In the ventral part of the pons and medulla, a bilateral cell mass was also found along the midline. A number of immunoreactive cells moving off the midline constituted the nucleus raphe magnus which was formed on 19. embryonis day. Another contingent of immunoreactive cells remained at the midline and formed the nuclei raphe obscurus and pallidus. In newborn rat, these nuclei were well separated from the nucleus raphe magnus. They would later fuse on the midline, whereas the nucleus raphe magnus would remain a bilateral structure. PMID- 3311832 TI - [Production of monoclonal antibodies to an insulin degrading enzyme and affinity purification of the enzyme]. AB - Monoclonal antibodies to a cytosolic insulin-degrading enzyme (IDE) were produced by fusing spleen cells from mouse immunized highly purified human erythrocyte IDE with mouse myeloma cells. Four monoclonal antibodies were identified by their ability to bind to 125I-insulin covalently linked to a cytosolic IDE from human erythrocytes. All four antibodies were found to remove more than 90% of the insulin-degrading activity from erythrocytes extracts, demonstrating that these antibodies were directed against an enzyme which accounts for most of this activity. By immunoprecipitation from metabolically labelled cells and immunoblot procedure, the enzyme from a variety of tissue was shown to be composed of a single polypeptide chain of apparent Mr = 110 kDa. One of these antibodies; 31H7 was coupled to Affi-Gel 10 and used for the purification of this enzyme. Immobilized antigen was eluted at more than 85% efficiency with buffers consisting of either pH2.3, 2.5M MgCl2 or with 6M urea. However, the antigen eluted under 6M urea retained the highest antigenecity (44%) and biological activity (8%) and the yield of the enzyme obtained from this procedure increased up to 17 fold as compared with the conventional method. NaDodSO4/polyacrylamide gel electrophoresis showed a single band of this protein with apparent Mr 110 kDa. These monoclonal antibodies and the purified enzyme will be useful tools for a better understanding of this enzyme, so may lead to the design of specific inhibitors of this enzyme that may be used to treat patients with excessive insulin degradation. PMID- 3311833 TI - [An international lexicon of dentistry]. PMID- 3311834 TI - [Danger of pulp-dentin injury from thermal stimulation of restored teeth]. PMID- 3311835 TI - [An international lexicon of dentistry]. PMID- 3311836 TI - Practice acts and legislation: an historical perspective. PMID- 3311837 TI - The reemergence of smokeless tobacco. Implications for dental hygiene practice. PMID- 3311838 TI - Oral effects of smokeless tobacco use. PMID- 3311839 TI - Smokeless tobacco. A review of the literature for dental hygienists. PMID- 3311840 TI - [Characterization of antigens reacting with vitiligo and cytoplasmic melanoma antibodies]. PMID- 3311841 TI - Root caries: a rationale for treatment. PMID- 3311842 TI - Dentin adhesives: the current status. PMID- 3311843 TI - A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy. AB - Several prognostic factors in stages I B and II A cervical carcinoma have been widely studied to define groups of patients with a poor prognosis. Most of these factors are interrelated. The characteristics which should be regarded as main factors have not yet been defined, because the studies reported were based on mainly retrospective and non-randomized analysis. Reviewing the literature, lymph node metastasis, differentiation grade, tumor size, parametrial extension, lymph blood vessel invasion and cervical invasion seem to be prognostically important factors, which suggests that the subdivision of patients according to the FIGO classification alone is inaccurate. It seems useful to define subgroups of patients according to tumor characteristics, determined after surgical treatment and accurate histologic examination of the surgical specimen. Patients with one or more of these tumor features need additional treatment to improve survival. The current treatment modalities, such as postoperative radiotherapy, have not been thoroughly evaluated, but doubt exists as to their efficacy. Data in the literature suggest that particularly patients with para-aortic or multiple pelvic lymph node metastasis (greater than 3) have already developed distant metastases at the time of primary treatment and therefore need adjuvant systemic therapy. Patients with tumors larger than 4 cm in diameter, differentiation grade III, lymph-blood vessel invasion or cervical invasion (of more than 70%) seem to have high recurrence rates at both pelvic and distant sites, indicating that there is also a need for better pelvic control. PMID- 3311844 TI - Demonstration of the ability of Hofbauer cells to phagocytose exogenous antibodies. AB - We have studied the effects of the anti-human chorionic gonadotropin and anti human antithrombin III antibodies on Hofbauer cells from human immature placenta, when applied to either intact villi or on cell culture. Trypsin treatment of the villi results in a mixed cell culture mainly composed of isolated Hofbauer cells but which also contains a variable number of mesenchymal cells and a few syncytiotrophoblastic cells. In all samples analysed only 7-8% of the Hofbauer cells and some syncytiotrophoblastic cells exhibited a macrophagic activity 24 h after incubation of the cultures with the antisera. That only certain proportions of Hofbauer and syncytiotrophoblastic cells express macrophagic activity is also seen when intact villi are incubated for 24 h with these antibodies. Indeed, neither all the villi nor all these cells within a single villus are positively stained. The fact that only a fraction of Hofbauer cells and syncytiotrophoblast express a macrophagic activity may suggest that only some cells, amongst both these cell types, are involved in the protection of the fetus against maternal immunological rejection by removing immunological complexes. PMID- 3311845 TI - Tuberous sclerosis and pregnancy; report of a case with renal and pulmonary involvement. AB - Tuberous sclerosis is a very infrequent hereditary disease, usually defined by the triad of epilepsy, mental retardation and adenoma sebaceum, although alterations in other organs can exist. Tuberous sclerosis in its association with pregnancy has seldom been described in the literature. One such case is reported here; that of a 24-yr-old woman whose pulmonary involvement constitutes its differentiating characteristic. We make special mention of the improvement of the respiratory function, without any modification of the renal function, in contrast with other previously published cases. She gave birth spontaneously by vaginal via. Finally, we underline the importance of prenatal diagnosis and genetic advice for these patients. PMID- 3311846 TI - Characterization and expression kinetics of an endothelial cell activation antigen present in vivo only in acute inflammatory tissues. AB - Endothelial cell activation by endotoxin (LPS), tumor necrosis factor (TNF), Interleukin-1-alpha, beta (IL-1-alpha, beta) and phorbolesters (TPA) results in increased monocyte adhesion. Examination of kinetics of monocyte adhesion shows that the onset of adherence enhancement (AE) is similar in all five agents (about 300% AE at 6 h), while its decrease is delayed in LPS/TNF versus IL-1-alpha, beta/TPA-induced activation (LPS versus IL-1-beta:260% versus 60% at 18 h). Monoclonal antibody (4D10), raised against 24 h LPS-stimulated endothelial cells detects an endothelial cell-specific activation antigen at Mr 81,000 that is induced by LPS, TNF, IL-1-alpha, beta and TPA (within 6 h about 100% positive cells). Decrease in antigen-positive cells is delayed in LPS/TNF versus IL-1 alpha, beta/TPA-induced antigen expression (LPS vs. IL-1-beta: 60% vs. 5% at 24 h). In situ the antigen is not expressed in normal and chronic inflammatory tissues. Acute inflammatory tissues, including contact and atopic dermatitis, psoriasis and periodontitis, however, show endothelial cells staining strongly positive. In contact eczemas at different times after elicitation (0, 6, 24, 72, 96 h), expression of the antigen is first seen after 24 h and is still strong at 96 h. These data indicate that LPS/TNF conduct an endothelial cell activation program in vitro, showing the same prolonged kinetics that is found for endothelial cell activation in the acute inflammatory process in vivo. PMID- 3311847 TI - Autoneuralization in the amphibian ectoderm--a species-specific and stage specific phenomenon. AB - Ectoderm from Ambystoma is especially prone to undergo 'autoneuralization'. This assertion has led to the maxim that ectoderm from this species is unsuitable for studying cell differentiation. Here we report that the degree of neuralization in cultured explants is stage-dependent. Control explants from blastulae (stage 8-9) show no neuralization, while explants treated with LiCl (10 mM) give rise to neuralization in about 70% of the cases. This difference between control and experiment decreases during gastrulation, in late gastrulae (stage 12) it is more or less negligible. Ectoderm from Cynops pyrrhogaster reacts like that of Ambystoma when exposed to LiCl, but like Triturus ectoderm it is insensitive to cyclic nucleotides. PMID- 3311848 TI - Ethanol and protein and amino acid metabolism in heart. PMID- 3311849 TI - Evidence of an insulin generated pyruvate dehydrogenase stimulating factor in rat brain plasma membranes. AB - 1. The results of this study indicates that the binding of insulin to brain plasma membranes activates a membrane protease which, by a trypsin like mechanism, produces a soluble factor that modulates the PDH behaviour when added to brain mitochondria. 2. The supernatant from brain plasma membranes incubated with 0.5 mg/ml trypsin added to mitochondria increases PDH activity levels and cancels PDH inhibition by NaF, as has already been seen when the plasma membranes are incubated with 25 microU/ml insulin. No such effects are obtained when the incubation is run out with 0.5 mg/ml chymotrypsin. 3. The supernatants from insulin or trypsin treated plasma membranes retain their activating properties on mitochondrial PDH also after dansylation; from these preparations a dansylated active on PDH material was separated by monodimensional chromatography on HPTLC silica Gel plates, using chloroform/1-butanol (93:7 v/v) as a solvent. 4. Insulin incubation of plasma membranes pretreated with protease inhibitors (leupeptin, phenylmethylsulfonylfluoride) or with exogenous trypsin, but not chymotrypsin substrates (esters of arginine and tyrosine) yields an inactive supernatant on PDH. 5. Insulin treated plasma membrane supernatants lose all stimulating properties on PDH after incubation for 1 hr with 2 mg/ml trypsin or chymotrypsin. PMID- 3311850 TI - Cholecalcin (28-kDa calcium-binding protein) in the rat hippocampus: development in normal animals and in altered thyroid states. An immunocytochemical study. AB - An immunocytochemical study of cholecalcin (28-kDa calcium-binding protein, CaBP, calbindin) was carried out during the development of the rat hippocampus. In normal animals, the protein appeared from Postnatal Day 3 in the granule cells of the dentate gyrus and from Day 5 in the CA1-CA2 pyramidal cells of Ammon's horn. The cells of both regions thus showed positive cholecalcin labeling about 1 week after their formation. The sequence of labeling of the granule cells was a reflection of the major sequences of neurogenesis. Cholecalcin could not be detected in hippocampal cells until dendritic arborization and axon growth had occurred. There was a good correlation between the appearance of cholecalcin and the onset of synaptogenesis. In animals with an experimentally altered thyroid state, in which hippocampal development is retarded or accelerated due to abnormal cell maturation, cholecalcin appearance was similarly retarded or accelerated. Cholecalcin seems to be synthesized at the same time as the hippocampal cells become functional. PMID- 3311851 TI - Fourth cleavage of sea urchin blastomeres: microtubule patterns and myosin localization in equal and unequal cell divisions. AB - This study traces the morphological appearance, organization, and disappearance of the cytoskeletal machinery for cell division during the fourth cell cycle of isolated sea urchin blastomeres by immunolocalization of tubulin and myosin. Mesomere-mesomeres (which divide equally) and macromere-micromeres (which divide unequally) are compared in terms of their asters (both mitotic and so-called interphase asters), spindle apparatus, and contractile ring. The results suggest that the distinctive nuclear positioning of these blastomeres is established in late interphase, that centrosomal alignment occurs in prophase, that all of the dominant astral configurations in the cell cycle belong to a single cycle of assembly-disassembly, that a second interphase-specific cycle of assembly disassembly is confined to a diffuse cytoplasmic reticulum, and that contractile ring myosin concentrates and disperses in precise coincidence with the beginning and end of cleavage furrowing. PMID- 3311852 TI - Interleukin 2 activates BB/W diabetic rat lymphoid cells cytotoxic to islet cells. AB - We compared the cytotoxic effects to islet cells of lymphoid cells from diabetic and diabetes-resistant (DR) BioBreeding/Worcester (BB/W) rats with a 51Cr-release assay to detect lysis of normal rat islet cells. Splenic lymphoid cells from diabetic rats were more cytotoxic to islet cells (11.3 +/- 3.8%) than were lymphoid cells from DR rats (4.0 +/- 2.6%). This difference was amplified by incubating the lymphoid cells for 20 h with 5 micrograms/ml concanavalin A (ConA); islet cell lysis was 39.3 +/- 4.5% by ConA-activated diabetic cells and 9.6 +/- 2.7% by ConA-activated DR cells. The cytotoxic lymphoid cells were identified as natural killer (NK) cells, because treatment of diabetic lymphoid cells with anti-asialo GM1 serum and complement selectively removed a monoclonal antibody-defined subset of NK cells (OX8 +), and the NK-depleted lymphoid cells were not cytotoxic to either islet or NK-sensitive YAC-1 cells, even after culture with ConA. Of several lymphokine products of ConA-stimulated lymphoid cells, interleukin 2 (IL-2), but not interleukin 1 or interferon-gamma, significantly activated splenic lymphoid cells cytotoxic to islet cells, and the lymphoid cells from diabetic rats were more sensitive to IL-2 (3 U/ml) than were the cells from DR rats (30 U/ml). This study reveals the presence of ConA- and IL 2-responsive islet cytotoxic NK cells in the diabetic BB/W rat and suggests that IL-2 activation of NK cells may contribute to islet beta-cell destruction and diabetes in this animal. PMID- 3311853 TI - Accelerated glomerulosclerosis in diabetic rats with immune complex injury. AB - Immune complex-mediated injury has been postulated to contribute to diabetic microangiopathy. To test this hypothesis, immune complex disease was induced in both insulin-deficient (I-) and insulin-treated (I+) rats with streptozocin induced diabetes mellitus (DM), and the rats were compared with their respective controls. Heymann nephritis (HN), an animal model of membranous nephropathy, was induced in rats by immunization with proximal renal tubular brush border antigen. In addition to the homogeneous mesangial deposits of IgG that developed in diabetic rats, diabetic rats with immune injury also developed immune deposits of IgG and tubular antigen. Diabetic animals with Heymann nephritis developed more intense granular mesangial and capillary wall immune deposits, detected by immunofluorescence (ranked-sums test, P = .002) and electron microscopy. Mesangial immune deposits were associated with mesangial hypercellularity, determined by counting nuclei per glomerular cross section. Diabetic animals with immune injury had an increased number of nuclei (DM, I-, HN: 70 +/- 4; DM, I+, HN: 65 +/- 3) compared with animals with only Heymann nephritis (55 +/- 4) or only diabetes [DM, I-: 52 +/- 4; DM, I+: 54 +/- 3 (mean +/- SE); P less than .05, ANOVA]. An increase in the accumulation of mesangial matrix in diabetic animals with Heymann nephritis was also apparent by light microscopy and immunofluorescence staining of the mesangium for fibronectin. Insulin treatment and control of hyperglycemia did not prevent the development of these changes. Animals with only Heymann nephritis had lesser amounts of immune deposits, which were limited to the subepithelial space and not associated with structural alterations of the mesangium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311854 TI - Galactose assimilation in pups of diabetic canine mothers. AB - The effects of enteric galactose alimentation on neonatal glucose turnover and hepatic glycogen synthesis were investigated in a newborn animal model of diabetic pregnancy. Control pups and pups of diabetic dogs were studied in the basal state and after each group of pups was randomly fed equivalent amounts of galactose or glucose by oral-gastric tubes. Basal fasting blood glucose levels were not statistically different between the groups, whereas basal plasma insulin levels were 2-3 times higher in pups born to diabetic mothers. Blood glucose levels at each time point in response to glucose or galactose feeding in pups of diabetic mothers were not statistically different; however, the rise of plasma insulin concentrations was attenuated in pups of diabetic mothers fed galactose. The increase in the systemic rate of appearance of glucose and in glucose clearance were attenuated in pups of diabetic mothers fed galactose compared with those fed glucose. Hepatic glycogen content was augmented above basal levels in pups of diabetic mothers. Although glycogen synthase activity was not different between glucose- or galactose-fed pups of diabetic mothers, the active component of glycogen phosphorylase was reduced by both glucose and galactose feedings. Galactose alimentation had a greater effect on glycogen phosphorylase than did glucose alimentation. The observed increase in glycogen synthesis and reduced systemic glucose appearance after galactose alimentation could not be accounted for by the previously proposed excess of galactokinase over glucokinase activities when the latter enzyme was assayed at saturation. Indeed, neonatal hepatic glucokinase activity appeared to be induced during diabetic pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311855 TI - In vivo insulin action is familial characteristic in nondiabetic Pima Indians. AB - Non-insulin-dependent diabetes mellitus (NIDDM) is a genetic disorder characterized by two major pathogenic processes: reduced insulin action and a relative or absolute decrease in plasma insulin concentrations. We studied 116 nondiabetic siblings from 45 families to determine if in vivo insulin action showed any aggregation among siblings. Subjects were Pima Indians from the Gila River Indian Community in Arizona who, as a group, have the highest reported incidence and prevalence of NIDDM in the world. In vivo insulin action was determined by the euglycemic-clamp technique at two rates of insulin infusion in each subject with resulting mean plasma insulin concentrations of 119 and 1938 microU/ml. After adjustment for age, sex, and degree of obesity, there was significant aggregation among siblings of in vivo insulin action at the high insulin infusion rate (P less than or equal to .0001). Family membership independently accounted for approximately 34% of the variance in this measure of insulin action. Glucose uptake at the lower insulin infusion rate also showed familial aggregation (P less than .01), with family membership independently accounting for approximately 15% of the variance of this measurement. We conclude that in vivo insulin action is a familial characteristic. The familial component of insulin action occurs in addition to the effects of obesity, age, and sex on insulin action. Therefore it is not sufficient to simply know that an individual is lean or obese to predict his/her in vivo insulin resistance, because it must also be known whether he/she is from an insulin-resistant or insulin-sensitive family.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311856 TI - Role of lipid oxidation in pathogenesis of insulin resistance of obesity and type II diabetes. AB - Increased lipid oxidation is generally observed in subjects with obesity and diabetes and has been suggested to be responsible for the insulin resistance associated with these conditions. We measured, by continuous indirect calorimetry, lipid and glucose oxidation and nonoxidative glucose disposal in 82 obese subjects during a 100-g oral glucose tolerance test (OGTT) and in 26 during a euglycemic insulin (40 mU.min-1.m-2) clamp. The obese subjects were subdivided into those with normal glucose tolerance (group A), those with impaired glucose tolerance (group B), and those with overt diabetes (group C). Forty-five healthy nonobese subjects were subdivided into a young and an older control group, which were age-matched to the nondiabetic obese (groups A and B) and diabetic obese (group C) subjects, respectively. In the postabsorptive state, as well as in response to insulin stimulation (both OGTT and insulin clamp), lipid oxidation was significantly increased in all three obese groups in comparison with either young or older controls. Basal glucose oxidation was significantly decreased in obese nondiabetic and obese glucose--intolerant subjects (groups A and B) compared with age-matched controls. During the OGTT and during the insulin clamp, insulin-stimulated glucose oxidation was decreased in all three obese groups. In contrast, nonoxidative glucose disposal was markedly inhibited in nondiabetic and diabetic obese patients during the euglycemic insulin clamp but not during the OGTT. After glucose ingestion, nonoxidative glucose uptake was normal in nondiabetic obese and glucose-intolerant obese subjects and decreased in diabetic obese subjects. Statistical analysis revealed that lipid and glucose oxidation were strongly and inversely related in the basal state, during euglycemic insulin clamp, and during OGTT. The negative correlation between lipid oxidation and nonoxidative glucose uptake, although significant, was much weaker. Fasting and post-OGTT hyperglycemia were the strongest (negative) correlates of nonoxidative glucose disposal in both single and multiple regression models. We conclude that 1) reduced glucose oxidation and reduced nonoxidative glucose disposal partake of the insulin resistance of nondiabetic obese and diabetic obese individuals; 2) hyperglycemia provides a compensatory mechanism for the defect in nonoxidative glucose disposal in nondiabetic obese subjects; however, this compensation is characteristically lost when overt diabetes ensues; and 3) increased lipid oxidation may contribute, in part, to the defects in glucose oxidation and nonoxidative glucose uptake in obesity. PMID- 3311857 TI - Aetiological role of cerebral blood-flow alterations in development and extension of peri-intraventricular haemorrhage. AB - The aetiology and extension of peri-intraventricular haemorrhage (PIVH) are thought to be related to cerebral blood-flow alterations, and especially to increased cerebral blood-flow and fluctuating velocity of blood-flow. Using transcutaneous Doppler technique, the authors investigated cerebral blood-flow in 60 infants with gestations of less than 34 weeks. Pulsatility index (PI) and area under the velocity curve (AUVC) of the anterior cerebral arteries (ACA) were used as qualitative measures of cerebral blood-flow, and the coefficient of variation of PI and AUVC as indicators of fluctuations in blood-flow velocity. A reasonable correlation was found between PI and AUVC and their coefficients of variation in the ACA. First onset of PIVH was related to fluctuating blood-flow velocity, and extension of PIVH with both increased velocity (indicating increased blood-flow) and fluctuating velocity. Increased cerebral blood-flow and its fluctuating pattern were positively correlated with arterial carbon dioxide tension. PMID- 3311859 TI - Factors affecting and patterns of residual insulin secretion during the first year of type 1 (insulin-dependent) diabetes mellitus in children. AB - We measured serum C-peptide, glucose, pH, islet antibodies and insulin antibody binding at diagnosis in 84 children with Type 1 (insulin-dependent) diabetes. In a subgroup of 33 children, residual insulin secretion (basal and peak C-peptide response to Sustacal), insulin antibody binding and HbA1c were measured at 10 days, 1, 3, 6 and 12 months. At presentation C-peptide correlated positively with age at onset and negatively with the blood glucose concentration. Median C peptide concentration at diagnosis was low, rose significantly (p less than 0.05) at 10 days, reached a maximum at 1-3 months and declined gradually to 1 year. C peptide concentration both at diagnosis and at 10 days correlated with that at 3 and 6 months. Of the factors investigated, only age (p less than 0.005) and sex (higher in females, p less than 0.01) were found to have a significant influence on basal/peak C-peptide levels throughout the first year. In particular there was no relationship between C-peptide, HbA1c and insulin dose during this period. A peak C-peptide response at 3-6 months greater than/less than 0.32 nmol/l was used to divide the group into two: 16 had a peak response less than 0.32 nmol/l (low secretors) while in 17, the peak C-peptide was greater than 0.32 nmol/l (high secretors). While the low secretors had significantly (p less than 0.05) lower C peptide levels during the first year, there were no differences between low and high secretors in HbA1c or insulin dose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311858 TI - Pulsatility of insulin and glucagon release: physiological significance and pharmacological implications. PMID- 3311861 TI - Explaining variation in general practitioner referrals to hospital. AB - Reported rates of referral by individual general practitioners to hospitals range from less than 1% of all consultations to more than 20%. Research on variations in rates of referral by general practitioners in the UK is reviewed here. Studies have largely failed to account for variation either in terms of differences in the characteristics of patients or differences in the doctors and their practices. It is argued that this failure arises because most studies do not distinguish between different types of referral or reasons for making a referral. In order to begin to explain variations it is necessary to identify the stages in the complex process of decision making. A theoretical model of the referral decision is advanced, which is intended to provide a framework for further research on the referral process. PMID- 3311862 TI - Quality of life--a review of the literature. AB - This review of the literature looks at the meaning of the concept 'quality of life', the use to which it has been put in various branches of medicine, its meaning in particular in cancer patients, especially those for whom there is no longer expectation of cure, and the instruments already developed for its measurement and their relevance to terminal care. The review concentrates mainly on patients with terminal malignant disease as the quality of life of other patients is a much broader issue. PMID- 3311860 TI - Interleukin 1 dose-dependently affects the biosynthesis of (pro)insulin in isolated rat islets of Langerhans. AB - Human crude and recombinant interleukin 1 (IL-1) was found to dose- and time dependently affect the biosynthesis of (pro)insulin in isolated rat islets of Langerhans. Incubation of rat islets with either 0.5 U/ml or 5 U/ml of crude IL-1 for 1 h had no detectable effect on (pro)insulin biosynthesis. After 24 hours of exposure 0.5 U/ml of crude or 0.6 ng/ml of recombinant IL-1 (beta) increased the (pro)insulin biosynthesis by 42% and 58%, respectively, whereas a 10-fold greater concentration of IL-1 decreased the (pro)insulin biosynthesis by 74% and 89%, respectively. The increase in (pro)insulin biosynthesis was accompanied by an increase in total protein biosynthesis indicating a nonspecific stimulatory action of low IL-1 concentrations. In contrast, high IL-1 concentrations caused a more selective decrease of the (pro) insulin biosynthesis when compared to the total protein biosynthesis. In addition, low IL-1 concentrations were found to increase and high concentrations to decrease the relative levels of pre proinsulin mRNA suggesting that IL-1 may act both at a pre- and post translational level of insulin biosynthesis. PMID- 3311863 TI - Minor burns: a review. AB - Two million burns occur annually in the USA, of which 95% are treated in an out patient setting. The treatment of burns is controversial. There are few data from controlled studies to provide rational guidelines for the frequency of both dressing changes and patient visits for the physician. Conclusions concerning infection drawn from studies on major burns are misleading when applied to the management of minor burns. Trauma to regenerating epithelium caused by frequent dressing change is of relatively less importance in treating major burns, because the control of infection is of overriding importance. In the treatment of minor burns, the traumatic consequences of too frequent changes of dressing may assume greater importance. There is a clear need to study the variables in the treatment of minor burns and to generate criteria for their clinical management that are distinct from those of major burn management. Collaborative studies of out patient populations by providers of primary health care are suggested as a useful approach to such investigation. The effects of several additional therapies are reviewed, including initial cold therapy, debridement of blisters and antibiotics. PMID- 3311864 TI - [Treatment of hyperkinetic ventricular arrhythmias: when, how and why?]. PMID- 3311865 TI - The binding rate of sialic acid to serum alpha 1-acid glycoprotein in patients with chronic hepatic injury. AB - The level of serum orosomucoid, the amount of sialic acid binding to it, and the binding rate of sialic acid to orosomucoid in normal individuals and in patients with chronic hepatitis and liver cirrhosis were determined by affinity column chromatography, SDS electrophoresis and the method of Warren. Although no apparent changes in the level of serum orosomucoid or the amount of sialic acid binding to it in each group were seen, the binding rate of sialic acid to orosomucoid in chronic persistent hepatitis and chronic active hepatitis showed a remarkable increase, compared with normal individuals and patients with liver cirrhosis. Furthermore, the binding rate of sialic acid in liver cirrhosis was the lowest in each group. PMID- 3311866 TI - Protection of liver cells against experimental damage by extract of cultured Lentinus edodes mycelia (LEM). AB - Liver cell damage can be induced when isolated liver cells coated with specific antibodies against the liver cell membrane are cultured with peripheral blood mononuclear cells. Although this antibody-dependent cell-mediated cytotoxicity (ADCC) is dependent on the close contact of effector cells with target cells via specific antibodies, a cytotoxic factor or factors causing the inhibition of protein synthesis in liver cells has been detected in the culture supernatant from the ADCC reaction. Similarly, peritoneal exudate macrophages activated by endotoxin lipopolysaccharide also exert cytotoxic effects on isolated liver cells by production of a cytotoxic substance or substances. The liver cell damage caused by either the ADCC or activated macrophage culture supernatants were significantly reduced by pretreating the isolated liver cells with the extract of cultured Lentinus edodes mycelia (LEM). These results suggest that LEM may protect liver cells from immunological damage. PMID- 3311867 TI - Morphological and biochemical changes in the pancreas of copper-deficient rats. AB - Two types of experimental chronic pancreatic damage were induced in rats by a copper-deficient diet containing D-penicillamine (DP rats) and by a similar diet without D-penicillamine (D rats). At 5-6 weeks after commencement of treatment, serum copper levels showed a significant decrease in both DP rats (1.5 +/- 0.9 micrograms/dl, M +/- SE) and D rats (18.8 +/- 1.4 micrograms/dl) compared with the findings in control rats (111.8 +/- 4.4 micrograms/dl). Histology revealed loss and atrophy of acinar cells in DP rats and mild vacuolar degeneration of acinar cells in D rats, whereas the islets of Langerhans were intact in both groups. The secretion of the exocrine pancreas showed a marked decrease in enzymes and protein output in DP and D rats compared with findings in the control rats. Our study confirmed the relationships between serum copper levels and morphological damage of pancreatic acinar cells or the reduction of enzyme secretion. On the other hand, the reductions in volume and bicarbonate output of pancreatic juice in DP rats and in D rats were detected, but no relationship was found between these reductions and the serum copper levels. The endocrine pancreatic function in DP rats showed a slight disturbance in intravenous glucose tolerance test. These results support the conclusion that copper-deficiency causes disturbances in enzyme-synthesis and selective destruction of acinar cells. PMID- 3311868 TI - Behcet's disease associated with amyloidosis. AB - A case of Behcet's disease associated with amyloidosis is reported. A 34 year-old woman was referred to our Department after suffering diarrhea for one month. She had the complete type of Behcet's disease which began development when she was 12 years old. Diarrhea disappeared after she was admitted to the hospital but stool occult blood was strongly positive. A barium enema revealed the disappearance of haustration in the left colon. Urinalysis was normal. She suffered from cholecystolithiasis, and a cholecystectomy was performed. A histopathological examination revealed amyloid deposits in the stomach, duodenum, large bowel, gallbladder, and kidney. Amyloid was indicated as AA type after treating kidney and colon sections with potassium permanganate. Upon discharge, she was free of symptoms. Up to the present time, 19 cases, including our case of Behcet's disease with amyloidosis, have been reported. Four cases in Japan have been reported in Japanese. Reviewing the 19 cases, however, all of them developed initially as Behcet's disease, followed by amyloidosis and there have only been three cases including ours where the type of amyloid was studied. Our finding was identical to the previous two reports; namely identification of the AA type which is common in secondary amyloidosis. These findings lead to a conclusion that amyloidosis associated with Behcet's disease is secondary. PMID- 3311869 TI - Intrahepatic portal-systemic shunt: its etiology and diagnosis. AB - Four cases of enormous shunt between portal and hepatic veins (portal-hepatic venous shunt) are reported with special reference to sonographic and portographic findings. Ultrasonography, an examination for screening, delineated a snail-like anechoic area in the liver, its connection with the portal and hepatic veins, and marked dilatation of the veins connecting with the shunt. Transarterial or percutaneous transhepatic portography, a method for definitive diagnosis, demonstrated large pooling of the contrast medium flowing from the dilated portal branch and subsequent visualization of the hepatic vein. The etiology and prognosis are unknown at present. The most likely pathogenesis for this shunt seemed to be a congenital anomaly, namely, persistence of the omphalomesenteric venous system. With recent advances in and the more frequent use of real-time ultrasonography, detection of this kind of vascular abnormality will doubtless increase. PMID- 3311871 TI - Effects of cefmetazol, cefoxitin and imipenem on polymorphonuclear leukocytes. AB - 1. We have investigated the effects produced in vitro by Cefmetazol, Cefoxitin and Imipenem on the chemotaxis, spontaneous mobility, adherence, phagocytosis and candidicide power of human polymorphonuclear neutrophils (PMNs). 2. The three antibiotics tested significantly stimulated the adherence of neutrophils to nylon fibre at doses either equal (50 mg/l) or superior (500 mg/l) to the therapeutic one. 3. Cefmetazol, Cefoxitin and Imipenem bring about a maximum increase of chemotaxis at the therapeutic dose, whereas the spontaneous mobility diminishes with any one of the doses used. 4. The capacity of the PMNs to phagocytize and produce lysis of Candida albicans is increased in Cefmetazol with therapeutic doses. Cefoxitin produced an increased lysis of candidas. PMID- 3311870 TI - Efficacy and safety of lasilactone, a new combination diuretic, in essential hypertension. AB - 1. Lasilactone, a new combination diuretic (furosemide 20 mg and spironolactone 50 mg) was evaluated in 30 patients with mild-to-moderate essential hypertension. Each patient received one capsule of lasilactone daily. 2. Significant changes in BP were observed 1 week after initiation of therapy and were sustained during the observation period of 1 year. 3. Supine and standing BP fell from 148.6 +/- 2.6/102.1 +/- 1.9 to 120.8 +/- 1.4/91.7 +/- 1.2 and from 154.4 +/- 2.1/106.1 +/- 1.6 to 125.7 +/- 2.2/90.7 +/- 1.5 mm Hg respectively. 4. There were no changes in the concentrations of plasma glucose, lipids, uric acid and potassium. On the other hand, levels of plasma renin activity rose from 0.69 +/- 0.06 to 3.95 +/- 0.47 ng/ml/hr and urinary aldosterone excretory rate increased from 9.6 +/- 1.6 to 42.8 +/- 4.2 micrograms/day. 5. This study suggests that addition of spironolactone to furosemide improves the hypotensive potency and minimizes the metabolic and electrolyte alterations of the latter. PMID- 3311872 TI - Immunocytochemical evidence for peptidergic (GnRH) and dopaminergic innervation of the gonadotropic cells in the pituitary of the African catfish, Clarias gariepinus. AB - The proximal pars distalis (PPD) of the pituitary of the African catfish, Clarias gariepinus, was studied with immunocytochemical methods at the ultrastructural level. Anti-serum raised against synthetic mammalian luteinizing hormone releasing hormone (LHRH) was applied on Lowicryl-embedded pituitaries and the antigenic sites were visualized with protein A-gold. In nerve fibers contacting the gonadotropic cells, granulated vesicles with a diameter of 90-120 nm were labeled after this procedure, whereas the glandular cells were not labeled. For the immunocytochemical demonstration of dopaminergic fibers, the preembedding method was performed on Vibratome sections, using highly specific antibodies against dopamine. Immunoreactivity was restricted to fibers containing granulated vesicles with a diameter of approximately 80 nm and terminating on gonadotropic cells. The present data support the results of earlier in vivo and in vitro studies on the catfish pituitary, indicating a dual neuroendocrine regulation of the gonadotropic cells. PMID- 3311873 TI - Isolation and structures of alligator gar (Lepisosteus spatula) insulin and pancreatic polypeptide. AB - Insulin and a 36-residue peptide with homology to pancreatic polypeptide (PP) were isolated from the endocrine pancreas of the alligator gar (Lepisosteus spatula), a ganoid fish, by gel filtration and HPLC. Heterologous radioimmunoassays were used to detect insulin-like and PP-like immunoreactivities during purification of the two peptides. The sequence of the 36-amino acid peptide containing a C-terminal tyrosinamide was identical at 31 of 36 positions to porcine neuropeptide Y (NPY). The amino acid sequence of this peptide is YPPKPENPGEDAPPEELAKYYSALRHYINLITRQRY-NH2. The second peptide, gar insulin, contains 52 amino acid residues and is composed of a 21-residue A chain and a 31 residue B chain. The sequence of the A chain is GIVEQCCHKPCTIYELENYCN. The sequence of the B chain is AANQHLCGSHLVEALYLVCGEKGFFYNPNKV. PMID- 3311874 TI - Circannual changes in renin concentration, plasma electrolytes, and osmolality in the freshwater turtle. AB - Seasonal changes in heart rate, blood pressure, plasma and renal renin concentrations, plasma electrolyte concentrations, and osmolality were studied in freshwater turtles (Amyda japonica) exposed to the natural environment. Seasonal changes in heart rate and blood pressure showed a marked increase in summer and a decrease in winter, which correlated directly with that of an environmental temperature. Two peaks in plasma renin concentration were observed in November and May and correlated with the preparation for hibernation and arousal periods. Renal renin content exhibited a marked seasonal variation characterized mainly by an increase in summer, fall, and winter and a decrease in spring. Plasma sodium concentration and osmolality were the highest in summer, the lowest in winter, and intermediate during spring and fall. A change in plasma osmolality correlated closely with that of temperature. However, no marked seasonal variations in the concentrations of plasma potassium, chloride, and calcium were observed. On the basis of these data, we suggest that a circannual rhythm of renin concentration may be related to hibernation. We also suggest that seasonal changes in sodium concentration and osmolality relate closely to environmental temperature, although the mechanisms are not clear. PMID- 3311875 TI - Gene recombination and linked segregations in Escherichia coli. PMID- 3311876 TI - A new type of fusion analysis applicable to many organisms: protein fusions to the URA3 gene of yeast. AB - We have made constructs that join the promoter sequences and a portion of the coding region of the Saccharomyces cerevisiae HIS4 and GAL1 genes and the E. coli lacZ gene to the sixth codon of the S. cerevisiae URA3 gene (encodes orotidine-5' phosphate (OMP) decarboxylase) to form three in frame protein fusions. In each case the fusion protein has OMP decarboxylase activity as assayed by complementation tests and this activity is properly regulated. A convenient cassette consisting of the URA3 segment plus some immediately proximal amino acids of HIS4C is available for making URA3 fusions to other proteins of interest. URA3 fusions offer several advantages over other systems for gene fusion analysis: the URA3 specified protein is small and cytosolic; genetic selections exist to identify mutants with either increased or decreased URA3 function in both yeast (S. cerevisiae and Schizosaccharomyces pombe) and bacteria (Escherichia coli and Salmonella typhimurium); and a sensitive OMP decarboxylase enzyme assay is available. Also, OMP decarboxylase activity is present in mammals, Drosophila and plants, so URA3 fusions may eventually be applicable in these other organisms as well. PMID- 3311877 TI - Mutational analysis of meiotic and mitotic centromere function in Saccharomyces cerevisiae. AB - A centromere (CEN) in Saccharomyces cerevisiae consists of approximately 150 bp of DNA and contains 3 conserved sequence elements: a high A + T region 78-86 bp in length (element II), flanked on the left by a conserved 8-bp element I sequence (PuTCACPuTG), and on the right by a conserved 25-bp element III sequence. We have carried out a structure-function analysis of the element I and II regions of CEN3 by constructing mutations in these sequences and subsequently determining their effect on mitotic and meiotic chromosome segregation. We have also examined the mitotic and meiotic segregation behavior of ARS plasmids containing the structurally altered CEN3 sequences. Replacing the periodic tracts of A residues within element II with random A + T sequences of equal length increases the frequency of mitotic chromosome nondisjunction only 4-fold; whereas, reducing the A + T content of element II while preserving the length results in a 40-fold increase in the frequence of chromosome nondisjunction. Structural alterations in the element II region that do not decrease the overall length have little effect on the meiotic segregation behavior of the altered chromosomes. Centromeres containing a deletion of element I or a portion of element II retain considerable mitotic activity, yet plasmids carrying these same mutations segregate randomly during meiosis I, indicating these sequences to be essential for maintaining attachment of the replicated sister chromatids during the first meiotic division. The presence of an intact element I sequence properly spaced from the element III region is absolutely essential for proper meiotic function of the centromere. PMID- 3311878 TI - [Saccharomyces cerevisiae mutants characterized by increased induced mutagenesis. II. Genetic analysis of mutants]. AB - Induction of forward adenine-dependent (Ade+----Ade-) mutations by HAP was used to analyse genetically yeast mutants with enhanced induced mutagenesis. Three mutations studied in detail segregated as a single mendelian trait and composed independent complementation groups (HIM1, HIM2, HIM3). the him1-1 mutation was centromere-linked, the him3-1 and him2-1 mutations being not. All three mutations did not show any cross-linkage. Uracil-DNA glycosylase activity was determined in crude cell extract from wild type strain and him mutants; no detectable differences were observed. PMID- 3311879 TI - [Genetic analysis of polyauxotrophy and early mitotic progeny of Saccharomyces cerevisiae zygotes. II. Spore-forming segregants in the mitotic and meiotic progeny of polyauxotrophic clones]. AB - This article continues the investigation of polyauxotrophic (PA) clones formed in early mitotic progeny of zygotes. Cloning and segregation analysis of PA progeny suggest an unusual state of diploid genome in these strains, which is expressed as elimination of the dominance effect of the wild allele and as suppression or conversion of either of two loci of mating type. In PA progeny, except for recombinant haploids, sporulating diploids and unstable clones were detected. The tetrad analysis of the diploids points to homozygotization for individual markers. Over-replication of diploid set of chromosomes, prior to meiosis, and replacement of the haploid nucleus (the product of meiosis) for the diploid nucleus may explain the appearance of sporulating segregants in the diploid meiotic progeny. Unstable segregants may be considered as heterokaryons with complex interaction of nuclei. PMID- 3311880 TI - [Genetic study of plasmid integration into yeast chromosomes. V. Mapping of integration sites for the plasmid pYF91]. AB - The data on mapping the episomal plasmid integration sites in yeast chromosomes I, III, IV, V, VII, XV are presented. In addition to the integration site at leu2 of chromosome III localized earlier, 6 more loci containing apparently the homologous yeast transposons, with a copy in a plasmid, were defined. The fact of plasmid integration was proved by colony hybridization technique with the pBR322 probe. The plasmid DNA segregation (the ratio 2:2) and its linkage to pLEU2 plasmid marker gene were observed in hybrids of all integrants studied. PMID- 3311881 TI - Cloning of Streptococcus pneumoniae DNA fragments in Escherichia coli requires vectors protected by strong transcriptional terminators. AB - Unstable recombinant plasmids are frequently encountered when cloning pneumococcal DNA into ordinary Escherichia coli plasmid vectors (e.g., pBR325, pMB9, pHC79). Stassi and Lacks [Gene 18 (1982) 319-328] have shown that the pneumococcal mal region, which exhibits strong promoter activity, interferes with maintenance of a recombinant plasmid in E. coli. In this paper, we report that random pneumococcal DNA fragments cloned in E. coli exhibited a higher frequency of strong promoter activity than did similarly cloned E. coli fragments. Furthermore, shotgun cloning yields for pneumococcal DNA were found to be higher with cloning vectors containing efficient transcriptional terminators surrounding the insertion site than with vectors lacking such protection. Therefore, vectors which carry an efficient transcriptional terminator are likely to be valuable for cloning pneumococcal DNA and stabilizing the recombinants. A new vector, pJDC9, was constructed, containing a lacZ alpha' multiple cloning site surrounded by transcriptional terminators, and an erythromycin-resistant marker expressed both in E. coli and Streptococcus. This plasmid was shown to be unusually effective for cloning of streptococcal genes in E. coli, and is designed to permit excisional cloning of streptococcal DNA in E. coli. PMID- 3311882 TI - High-level secretion of human growth hormone by Escherichia coli. AB - A gene encoding the mature form of human growth hormone (hGH) was fused to the secretion signal coding sequence of the Escherichia coli heat-stable enterotoxin II (STII). This hybrid gene was preceded by two Shine-Dalgarno sequences derived from the trp and STII-coding genes and was expressed in E. coli under the transcriptional control of the E. coli alkaline phosphatase (phoA) promoter. In low-phosphate growth media, cells synthesized about 15 to 25 micrograms of hGH/ml/1 A550 unit of cells. This represents 6 to 10% of total cellular protein. The majority of the hGH produced (more than 90%) was processed precisely and secreted into the periplasmic space. These results demonstrate that E. coli cells are able to synthesize and secrete high levels of this human protein using a prokaryotic signal sequence. PMID- 3311883 TI - Characterization of two new genes essential for vegetative growth in Saccharomyces cerevisiae: nucleotide sequence determination and chromosome mapping. AB - Based on nucleotide sequence determination, we have identified two new yeast genes FUN80 and FUN81 located on chromosome XIII. They are both essential for cellular growth but their function is still unknown. FUN80 is closely linked to the ARGRI (or ARG80) gene while FUN81 is located next to the ARGRII (or ARG81) gene. Interestingly, the proteins encoded by these two genes have a long stretch of acidic amino acids within their C-terminal portions. PMID- 3311884 TI - Regulation of arginine metabolism in Saccharomyces cerevisiae: expression of the three ARGR regulatory genes and cellular localization of their products. AB - Three regulatory proteins are involved in the control of arginine metabolism in yeast: ARGRI, ARGRII and ARGRIII. The control region and part of the coding sequence of the ARGR genes were fused to the Escherichia coli lacZ gene. These chimeras were used to study the expression of the regulatory genes as well as the cellular compartmentalization of the regulatory products. Our results show that the three ARGR proteins are localized in the nucleus and that their synthesis is not regulated by arginine nor by any of the other ARGR products. However, some data suggest that the ARGRIII protein could control ARGRI activity. PMID- 3311886 TI - Expression of protein IIIa of human adenovirus type 2 in Escherichia coli. AB - We have constructed a plasmid encoding the protein IIIa gene of human adenovirus type 2. The gene was expressed under the control of the hybrid tac (trp-lac) promoter; the protein was synthesized at levels up to 5% of newly synthesized protein after IPTG induction. The protein IIIa produced in Escherichia coli has an apparent Mr on sodium dodecyl sulfate-polyacrylamide gels of 67 kDa, and was revealed with anti-adenovirus serum in Western blotting. The protein IIIa produced in bacteria was phosphorylated in the presence of [gamma-32P]ATP. PMID- 3311885 TI - Expression, purification and characterization of recombinant murine granulocyte macrophage colony-stimulating factor and bovine interleukin-2 from yeast. AB - Expression and secretion of two lymphokines, murine granulocyte-macrophage colony stimulating factor (MuGM-CSF) and bovine interleukin-2 (BoIL-2), to levels of 50 60 mg per liter were achieved by placing these cDNAs in a Saccharomyces cerevisiae expression vector that utilized the yeast alcohol dehydrogenase-2 promoter and alpha-factor leader peptide. These lymphokines were purified to homogeneity by direct application of the crude yeast medium to reversed-phase high-performance liquid chromatography. Despite the fact that both lymphokines contain at least one N-glycosylation site and have identical N-terminal residues (Ala-Pro-Thr), recombinant (R) GM-CSF was found to be heterogeneously glycosylated by yeast while RBoIL-2 was secreted without glycosylation. Additionally, approximately 40% of the RGM-CSF was found to be proteolytically cleaved after the second amino acid residue, while RBoIL-2 was found to be intact. PMID- 3311887 TI - Expression of a wheat alpha-gliadin gene in Saccharomyces cerevisiae. AB - A vector was constructed that directs the expression of foreign genes in the yeast Saccharomyces cerevisiae. This vector contains an expression site that was constructed by in vitro modification of the iso-1-cytochrome c (CYC1) gene of S. cerevisiae. The expression of heterologous sequences can be experimentally controlled by catabolite control sequences, promoter and transcription initiation sequences and termination sequence derived from the CYC1 gene. A portion of a genomic wheat alpha-gliadin gene consisting of the entire 861 bp of protein coding sequence, 18 bp of 5' leader sequence and 54 bp of 3'-noncoding sequence was inserted into the expression site. A CYC1::alpha-gliadin transcript of approx. 1050 nucleotides was synthesized in transformed yeast under the control of the CYC1 regulatory region. The transcripts terminated within the alpha gliadin 3'-noncoding region, near a nucleotide sequence similar to the yeast transcription termination consensus sequence. The alpha-gliadin was immunochemically detected in total protein extracts from transformed cells and accounted for approx. 0.1% of the total cellular protein. The size of alpha gliadin synthesized in yeast is the same as that of mature wheat alpha-gliadin. This is consistent with recognition and cleavage of the signal peptide by yeast. Due to the amino acid composition of alpha-gliadin, the availability of glutamine tRNA is a potential translational limitation to high-level synthesis in yeast. PMID- 3311888 TI - Synthesis and secretion of wheat alpha-amylase in Saccharomyces cerevisiae. AB - A wheat alpha-amylase cDNA clone has been fused to the phosphoglycerate kinase initiator methionine to enable synthesis in the yeast Saccharomyces cerevisiae of an alpha-amylase enzyme that is identical in size to the wild-type alpha-amylase. The alpha-amylase is synthesized with an N-terminal plant signal peptide which is recognized in the yeast host, leading to efficient processing and secretion into the medium. The secretion of alpha-amylase into the medium is quite efficient in rich medium, but barely detectable in a minimal medium. PMID- 3311889 TI - Peripheral vascular disease: medical evaluation and treatment. AB - Peripheral arterial obstructive disease with symptoms of ischemia in the limbs is a common cause of disability, morbidity, and even mortality in the elderly. The most important cause is atherosclerosis, which is ultimately a systemic problem, but the cardinal symptom in the limbs is intermittent claudication. Unfortunately, the elderly patient often displays severe ischemia with pain at rest, and ulceration or gangrene of the extremity, even where there was a paucity of prior claudication, perhaps due to associated illness which reduces mobility. The essential aspects of clinical diagnosis and assessment of severity of ischemia involve relatively simple bedside techniques, and noninvasive laboratory methodology is mainly of value in selection of patients for angiography and potential revascularization. While conventional therapy involves bypass surgery, an expanding array of drugs and the advent of interventional angiographic measures including angioplasty offer alternatives which were not available even a few years ago. PMID- 3311890 TI - Hyperosmolar nonketotic diabetic coma: diagnosis and management. AB - Hyperosmolar nonketotic diabetic coma (HHNC) is a syndrome of acute decompensation of diabetes mellitus, occurring mainly in the elderly and characterized by marked hyperglycemia, hyperosmolarity, severe dehydration, occasional neurological signs, obtunded sensorium, and absence of ketonemia or acidosis. The mortality is high. Early aggressive therapy with large amounts of normal or half normal saline, insulin, and potassium is of prime importance. Since associated diseases cause most fatalities the importance of managing these problems effectively cannot be overemphasized. Complications of therapy can be congestive heart failure secondary to excessive fluid administration, hypoglycemia if too much insulin is given, and hypokalemia if potassium is inadequately replaced. PMID- 3311891 TI - Loneliness among the elderly: issues and considerations for professionals in aging. PMID- 3311892 TI - Ultrastructural changes of the rabbit corneal epithelium and endothelium after Timoptic treatment. AB - The purpose of this study was to determine whether timolol maleate (Timoptic) is cytotoxic to the cornea. The drug was applied as topical drops for 1 month to control rabbit eyes and rabbit eyes from which the epithelium had been removed or to de-epithelialized full-thickness autografts. Clinically all corneas and grafts remained clear. Scanning and transmission electronmicroscopy however revealed is drug induced epithelial damage, defective epithelial wound healing, and endothelial changes. The endothelial changes were most prominent in the group of rabbits that underwent de-epithelialization before corneal grafting. PMID- 3311894 TI - Induced intraocular light scatter and the sensitivity gradient of the normal visual field. AB - The influence of intraocular light scatter on the perimetric sensitivity profile of the normal eye was investigated using a series of light-scattering cells containing 0.01%, 0.02% and 0.025% concentrations of 500 nm diameter latex beads. The degree of induced intraocular light scatter was quantified by measuring contrast sensitivity using the Nicolet CS2000 system in the presence and absence of both wide- and narrow-angle glare light. Perimetric sensitivity out to an eccentricity of 30 degrees was assessed, using the Octopus 201 and the Dicon AP3000 automated perimeters, with the three light-scatter cells and in the cell free control condition. The results for both functions were expressed as the difference between the control response and that recorded under the particular experimental condition. Perimetric attenuation increased with increase in intraocular light scatter; the extent of the attenuation varied with stimulus type, bowl luminance and eccentricity. PMID- 3311893 TI - Growth and characterization of rabbit corneal cells in vitro. AB - Primary organ cultures of rabbit corneal epithelium, stroma, and endothelium were established by microdissection. Secondary cultures of epithelial cells, keratocytes, and endothelial cells were established by serial passage. The doubling time for epithelial cells and keratocytes was 18 h, and endothelial cells doubled their number in 5 days. Ultrastructural studies demonstrated characteristic morphological, nuclear, and cytoplasmic features of corneal epithelial cells, keratocytes, and endothelial cells and confirmed the identity of the cell lines. The purity of the three distinct cell types was ascertained by indirect immunofluorescence techniques, using antibodies against keratin, which identified epithelial cells, and fibronectin, which identified keratocytes and endothelial cells. The indirect immunofluorescence technique represents a simple method to screen an aliquot of a cell suspension and determine the purity of corneal cells grown in vitro. PMID- 3311895 TI - Ultrasonographic measurement of the posterior coats of the eye and their relation to axial length. AB - In 159 eyes with a spherical correction varying from +14.0 to -27.0 diopters, the axial length and thickness of posterior ocular coats were measured ultrasonographically. As proven in experimental studies, retina, choroid, and sclera were resolved in a considerable percentage of cases by combining A- and B mode techniques of modern ultrasonographic equipment. The presumed close inverse correlation between the axial length of the eye and ocular coat dimensions was confirmed by statistical analysis. These values were used to calculate the approximative volume of the posterior half of the ocular coats. There was evidence for a constant tissue volume regardless of the difference in surface and axial length parameters between hyperopic and myopic eyes. Results are discussed and compared with theories of axial growth under physiological and pathological conditions. PMID- 3311896 TI - [The status of the hygienic regulation of chemical environmental carcinogens in the USSR and abroad]. PMID- 3311897 TI - [Hematological aspect of contact with poisonous organochlorine and organophosphate chemicals]. PMID- 3311898 TI - [Effect of a change in the level of UV radiation on the toxic manifestations of different pesticides]. PMID- 3311899 TI - An integrated concept of amebicidal action: electron transfer and oxy radicals. AB - Cyclic voltammetry data were obtained for most of the main categories of antiamebic agents, specifically, quinones, heterocyclic nitro compounds, metal derivatives and chelators, and iminium-type ions. The reductions (our data and literature values) were for the most part reversible, with potentials usually in the favorable range of +0.10 to -0.56 V. The drug effect is believed to result generally from the catalytic production of oxidative stress usually arising from the formation of superoxide via electron transfer. In addition, relevant literature data are provided. PMID- 3311900 TI - Flavin radicals: chemistry and biochemistry. AB - The redox properties of free and protein-bound flavin are discussed extensively. The interaction of one and two-electron reduced flavin with oxygen is emphasized. PMID- 3311901 TI - [Polycystic kidney in a fetus detected by ultrasonography]. PMID- 3311902 TI - Independent historical development of the concepts of cluster headache and trigeminal neuralgia. PMID- 3311903 TI - Local IgA subclass alterations in ulcerative colitis and Crohn's disease of the colon. AB - The subclass distribution of IgA producing cells was determined by paired immunofluorescence staining in colonic specimens from 10 patients with ulcerative colitis and eight with Crohn's disease. Compared with normal colonic mucosa, the percentage of IgA1 immunocytes showed a striking increase in both disorders. The proportion of mucosal IgA1 cells was significantly higher (p less than 0.05) in ulcerative colitis (median, 71.2%) than in Crohn colitis (median, 56.9%). Within each category of specimens no significant differences were noted between luminal and basal mucosal zones. The submucosal proportion of IgA1 cells was, however, significantly higher than the mucosal one in both ulcerative colitis (median, 89.1%; p less than 0.002) and Crohn colitis (median, 91.8%; p less than 0.005). The mucosal shift towards IgA1 production paralleled the magnitude of the submucosal IgA1 cell proportion in individual tissue samples. Taken together with the previously reported dramatic increase of local IgG production (particularly observed in the submucosa and basal parts of the mucosa), our findings indicated that there is an influx and/or proliferation of B cells representing systemic secondary immunity in the lesions of both diseases. PMID- 3311904 TI - Single dose tetracycline in cholera. AB - A randomised clinical trial was carried out to explore the efficacy of single dose tetracycline therapy in cholera. One hundred and eighteen adult patients were assigned to receive either tetracycline in a single 1 g, or a single 2 g dose, or tetracycline 500 mg every six hours four times, or no antibiotics as controls. The means of total liquid stool volumes after treatment were lower in the single 1 g dose group (168.0 +/- 20.9 ml/kg), in single 2 g dose group (229.5 +/- 45.6 ml/kg), and multiple dose group (214 +/- 28.5 ml/kg), than in the control group (499.1 +/- 56.5 ml/kg) (p less than 0.05). Similarly, the means of durations of diarrhoea and intravenous fluid requirements were significantly lower in the single dose and multiple dose tetracycline groups, than in the controls (p less than 0.05). The mean durations of excretion of Vibrio cholerae were significantly shortened from 3.9 +/- 0.2 days in the control group to 1.9 +/ 0.2 days in single 1 g dose, to 2.2 +/- 0.4 days in single 2 g dose and 1.3 +/- 0.1 days in multiple dose groups, respectively (p less than 0.05). Three patients in the single 1 g dose group and two patients in single 2 g dose group had clinical relapses with excretion of V cholerae during the relapses, but this was not significantly more frequent than that in the multiple dose group (p greater than 0.05). These findings suggest that although multiple dose tetracycline therapy remains the best choice, a single dose of either 1 g or 2 g tetracycline appears to be a reasonable alternative for the treatment of cholera as an adjunct to rehydration therapy. PMID- 3311905 TI - Treatment of chronic constipation with cisapride and placebo. AB - The effect of cisapride (20 mg bid), a new prokinetic drug, on bowel habits and laxative consumption was studied in patients with idiopathic painless constipation and chronic laxative intake. After a four week base line period, spontaneous defection (frequency without laxative intake) and total defecation (total frequency) were measured. Patients with a spontaneous defecation of less than three stools per week entered the treatment period and were randomly assigned to double blind treatment with either cisapride (n = 64) or placebo (n = 62). After eight weeks of treatment, a four week run out phase on single blind placebo medication was conducted. Cisapride and placebo increased spontaneous stool frequency from 1.1 +/- 0.2 SEM to 3.0 +/- 0.2 per week (p less than 0.001) and from 1.2 +/- 0.1 to 1.5 +/- 0.2 (p greater than 0.05), respectively. Laxative consumption was decreased from 3.6 +/- 0.3 to 1.8 +/- 0.2 doses/week by cisapride (p less than 0.001) and from 3.3 +/- 0.3 to 2.8 +/- 0.3 by placebo (p less than 0.05). Both drugs improved constipation as assessed by the patient by means of a visual analogue scale, but cisapride did so to a larger extent than placebo. The effects of cisapride partly outlasted active medication by at least four weeks. It is concluded that cisapride improves bowel habits in patients with idiopathic constipation and reduces laxative consumption. PMID- 3311906 TI - Chronic portal systemic encephalopathy: update 1987. PMID- 3311908 TI - History of the British Society of Gastroenterology 1937-1987. PMID- 3311909 TI - The meetings. British Society of Gastroenterology. PMID- 3311907 TI - HLA-DR expression, natural killer cells and IgE containing cells in the jejunal mucosa of coeliac children. AB - The expression of HLA-DR by surface and crypt epithelium and the numbers of cells of natural killer (NK) phenotype and of IgE containing cells were studied with monoclonal antisera using the peroxidase technique. We examined 48 jejunal biopsy specimens taken from 35 coeliac children before treatment (11), during gluten free diet (20) and after gluten challenge (17), and 13 control specimens. The luminal surface of the epithelial cells stained with HLA-DR antiserum in all specimens, but the cytoplasm of the surface epithelial cells took up the stain more frequently in the specimens from the controls (5/13) than those from the coeliacs (2/48) (p less than 0.01). In 21/28 specimens taken from coeliacs when on a gluten containing diet the crypt epithelium showed strong HLA-DR expression, while only 4/20 (p less than 0.01) specimens of coeliacs on a gluten free diet and 1/13 specimens of controls had similar staining. Among the intraepithelial lymphocytes no cells of NK phenotype were found in specimens from patients or controls. As compared with control specimens biopsy specimens from untreated coeliac patients showed smaller numbers of NK cells in the lamina propria. No difference was found in the numbers of IgE containing cells between the patients and controls. The strong expression of HLA-DR by the crypt epithelial cells in coeliac children on a normal diet suggest that these cells are involved in the presentation of the antigen. PMID- 3311910 TI - Membership of the BSG 1937-1987. British Society of Gastroenterology. PMID- 3311911 TI - Publication of the Society's proceedings--Gut. PMID- 3311913 TI - The Society promotes gastroenterology as a national specialty. British Society of Gastroenterology. PMID- 3311912 TI - Research, education, science, training. Work of the committees. British Society of Gastroenterology. PMID- 3311914 TI - Gastroenterology in Britain before 1937 and the founding of the Gastro Enterological Club. PMID- 3311915 TI - British Society for Digestive Endoscopy. PMID- 3311916 TI - Awards, lectureships, and medals. British Society of Gastroenterology. PMID- 3311917 TI - Regional societies groups and committees: BSG specialty committees and related but independent societies. British Society of Gastroenterology. PMID- 3311918 TI - The British Digestive Foundation. PMID- 3311919 TI - British Society of Gastroenterology 1937-87: an overview. PMID- 3311920 TI - Urinary incontinence among nursing home patients: issues in research. PMID- 3311921 TI - Dorothy Moses: gerontologist and professional volunteer. PMID- 3311922 TI - Oncogene expression in ovarian cancer: a pilot study of c-myc oncoprotein in serous papillary ovarian cancer. AB - The nuclear-associated protein product of the c-myc gene, p62c-myc, was assayed simultaneously with total DNA using flow cytometry in nuclei extracted from archival biopsies of serous papillary carcinoma of the ovary. The oncoprotein was probed with a synthetic peptide-induced mouse monoclonal antibody which was subsequently labeled with a fluorescent rabbit anti-mouse immunoglobulin and DNA was assayed using the nucleic acid fluorochrome propidium iodide. Serous papillary ovarian carcinoma expressed significantly higher p62c-myc levels compared with normal ovary (P less than 0.00003 Mann-Whitney U test). Biopsies classified as "borderline" low-potential malignancy exhibited levels between normal ovary and carcinoma. The difference between normal and "borderline" was significant at P less than 0.003, but no difference between "borderline" and frankly invasive biopsies was observed, P = 0.149. There was no difference among the histological grades of carcinomas. All normal ovaries had diploid DNA content as did 5/6 cases of "borderline" malignancy. The majority of cases of carcinoma, 28/36, were aneuploid. There was a statistically significant difference in the distribution of aneuploidy, P less than 0.005, between invasive carcinomas and those classified as "borderline" low-potential malignancy. PMID- 3311923 TI - Randomized trial of megestrol acetate vs. megestrol acetate/tamoxifen for the management of progressive or recurrent epithelial ovarian carcinoma. AB - Thirty-three patients were randomly treated with either megestrol acetate (Mg) or megestrol acetate/tamoxifen (Mg/Tx) from November, 1983, to December, 1985. Thirty-two of 33 were previously treated with platinum-based combination chemotherapy. Ten of 32 were also treated with hexamethylmelamine-based second line therapy. Doses were 160 mg/day of Mg and 20 mg/day of Tx. All patients had measurable disease. The two groups did not differ as to progression-free interval. There were no patients who demonstrated tumor regression. Overall, 39% showed stabilization of disease from 4 to 16+ months (median 8.0 months and mean 9.0 months). PMID- 3311924 TI - A randomized study of cyclophosphamide and cis-platinum with or without doxorubicin in advanced ovarian carcinoma. AB - Two hundred sixty-seven patients with advanced epithelial ovarian carcinoma were randomized to cis-platinum and cyclophosphamide versus cis-platinum, cyclophosphamide, and doxorubicin. Complete pathological response, evaluated at second-look laparotomy and survival, showed no differences between the two treatment groups. Recurrence-free survival after negative second look was 61% at 24 months. PMID- 3311925 TI - Magnetic resonance imaging of gynecologic masses. AB - The pelvis of 21 women with various gynecological masses were imaged with magnetic resonance (MR) imagers at 2.0 and 0.5 T. Fifteen normal individuals were used for studying the normal appearance of the female genitalia using spin echo pulse sequences with various pulse repetition (TR) and spin echo (TE) time values. Images were compared with those of the ultrasonic images, intraoperative findings, and the histopathologic examinations. The masses included simple ovarian cyst, cystadenoma, serous cystadenocarcinoma, ovarian teratoma, dysgerminoma, and uterine myoma. MR imaging was useful in demonstrating the anatomy and pathology of the cases examined in this study. It detected the internal structure of some tumors which were sonographically homogeneous. The potential of MR in staging of malignancies was demonstrated. PMID- 3311927 TI - [Assessment by Doppler ultrasound of cerebral blood flow in the human fetus]. PMID- 3311929 TI - [Oculosympathetic paresis, Horner's syndrome, clinical aspects]. PMID- 3311928 TI - [Blast lung injury]. PMID- 3311930 TI - [Intolerance to food additives]. PMID- 3311926 TI - [Comparative study of primary and secondary management of flexor tendon injuries]. AB - In 1974 a replantation service started at the authors' department. Before that time the treatment of flexor tendon injuries was mainly performed secondarily. Therefore, the authors had the opportunity to compare patients after primary and secondary surgery. In 52 primarily and 22 secondarily treated patients the technique of Kleinert was used. Following issues were investigated: functional results, decrease of grip strength, influence of early mobilization on sensibility restoration in cases of nerve injury, relation between sensitivity to cold and vessel and nerve injuries, duration of physiotherapy and disability. The damage of only one finger might lead to decrease of grip strength. Primary surgery was superior to secondary surgery. Early mobilization in cases of additional nerve injuries did not affect sensibility restoration. Poor sensibility increased the chance of cold sensitivity. The duration of physiotherapy and of disability depended on the need for second procedures such as tenolysis which was more common in the group of secondarily treated patients. PMID- 3311931 TI - [The new quinolones]. PMID- 3311932 TI - Evaluation of specific humoral immune responses in human filariasis. AB - Using the antigens prepared from adult worms of B. malayi and D. immitis, a total of 37 malayan and 150 bancroftian serum samples were analysed for the presence of filarial specific antibodies by counterimmunoelectrophoresis and indirect enzyme linked immunosorbent assay. It was observed that microfilaraemic cases do show good specific humoral immune responses against homologous as well as heterologous antigen. Of the two antigens used, B. malayi adult antigen was found to be superior to D. immitis antigen in the detection of filarial antibodies. PMID- 3311933 TI - Pitch and quality characteristics of mutational voice disorders before and after therapy. PMID- 3311934 TI - HIV-infection in forensic autopsy cases. AB - Sudden and unexpected death and violent death of persons with a high risk of acquiring HIV-infections, especially homosexual males and intravenous drug abusers, have to be investigated by forensic autopsies. Therefore every forensic pathologist has to be aware of this infection and should try to make the proper diagnosis. Three typical cases are described: (1) suicide by hanging, (2) homicide by cutting the throat and (3) intravenous heroin overdose. Merely retrospectively it could be cleared up that the deceased were homosexual but did not manifestly suffer from AIDS. The morphological findings in the lymph nodes and the postmortem serological findings are described in detail. PMID- 3311936 TI - [Clinical specular microscopy]. PMID- 3311935 TI - [Electrolyte transport in the epithelium and endothelium of the cornea]. PMID- 3311937 TI - [Method and results of perforating keratoplasty in keratoconus]. PMID- 3311938 TI - [Perforating keratoplasty and cataract extraction--a two-stage or single-stage operation?]. PMID- 3311939 TI - [Tamponade of perforating corneal substance defects using a suture-fixed contact lens and hyaluronic acid]. PMID- 3311940 TI - [Double-blind study of the effectiveness of the prostaglandin synthesis inhibitor diclofenac and dexamethasone phosphate in the treatment of iritis after local administration]. PMID- 3311942 TI - [Trabeculotomy]. PMID- 3311941 TI - [Sclera-covered filter operation]. PMID- 3311943 TI - [Scheie operation]. PMID- 3311944 TI - [Elliot trepanation]. PMID- 3311945 TI - [Iris fistulization]. PMID- 3311946 TI - [The elderly patient in medical consultation. Psychiatric aspects 1: Depressive syndromes in advanced age]. PMID- 3311947 TI - [Emergency sonographic diagnosis. 2: Blunt abdominal trauma, aortic aneurysms, pleural effusion, pericardial effusion]. PMID- 3311949 TI - [The so-called "compensation neurosis"--psychopathologic syndrome or obsolete concept?]. AB - The problems of the muddy concept of "compensation neurosis" are demonstrated under different aspects. The following fields are discussed: terminological questions, clinical picture including psychodynamic reflections and approaches as to the course, the legal bases in the Federal Republic of Germany, in particular for the legal annuity insurance and accident insurance, and the expert's problems when giving his opinion. It is suggested no longer to use the vague and inexact formulation "compensation neurosis", but a detailed description of the symptom complex and the personality as well as the outer and inner situation should be strived after. Tasks of research are mentioned that still require to be tackled. PMID- 3311948 TI - [Premedication before gastroscopy. Midazolam versus midazolam plus pentazocine]. PMID- 3311950 TI - [Psychophysiology of schizophrenic disorders of attention--concepts, findings and working hypotheses]. AB - Starting from early clinical descriptions according to which there exists a polarity of attentional behavior in schizophrenia, we compare a number of pertinent theoretical concepts put forward up to now. Special attention is given to the question of functional hemispherical asymmetries, and here especially to a working hypothesis according to which the neuropsychological deficits in schizophrenics result from a coordination deficit of two differently lateralized attention systems. Taking into consideration certain neurophysiological (especially electro-encephalographical) findings, we discuss a model which places in opposition sensory intake behaviors and sensory rejection behaviors. Then we give a condensed presentation of relevant findings of our own. In particular, it could be shown that clinical improvement goes along with a certain change of the topographical distribution of absolute alpha-power, and that the intensity of some psychopathological symptoms correlates with the lateralization of posterior absolute alpha-power. Relationships also occurred between psychopathology on the one hand and the performance level in a visuo-motor tracking task or the eye movement behavior recorded during a picture viewing task, on the other. A concluding synopsis, comprising both empirically proven and theoretically postulated relationships, serves to formulate working hypotheses for clinical psychophysiological correlation studies to be done in the future. In contrast to the current practice of assigning patients to the usual diagnostic subgroups, we advocate from a research-oriented point of view the grouping of those patients who show certain combinations of clinical and psychophysiological signs at a certain moment. Such a procedure holds out a prospect of solving a central problem of schizophrenia research consisting of the considerable intra- and individual variability of findings. Instead of changeable sick persons, defined systems states would be classified. Knowledge of the dynamics of such systems states could contribute to a rational therapy in the individual patient. PMID- 3311951 TI - Ultrasonography and echo-guided fine-needle biopsy in the diagnosis of focal fatty liver change. AB - The usefulness of ultrasound and echo-guided fine-needle biopsy (FNB) in the diagnosis of focal fatty liver change (FFLC) is stressed, on the basis of a retrospective series of 21 patients (8 of whom with a past history of primary cancer), followed-up for a mean period of 13.7 months. FFLC presented with various echographic patterns, shapes, dimensions and localizations. In 17 patients the diagnosis of FFLC was made by FNB, yielding cytologic and/or histological samples with steatotic, but also normal, hepatocytes. In another 4 patients the diagnosis was made by echographic follow-up. In all patients, clinical, hematological and echographic follow-up excluded the onset of neoplastic disease, confirming the high specificity of FNB in diagnosing FFLC. The possibility of changing appearance over time, and the inconstant correlation of FFLC with known causes of hepatic steatosis are discussed, as well as the hypothesis that the focal defect seen with ultrasound, could be an area of normal hepatic tissue in a fatty liver. The authors affirm the necessity to perform FNB on each doubtful lesion, but certainly when the patient has a history of malignancy. PMID- 3311952 TI - Identification of intrahepatic lymphocyte subpopulations in patients with fulminant hepatitis by the immunoenzymatic technique, using monoclonal antibodies. AB - Intrahepatic lymphocyte subpopulations were studied in 11 patients with fulminant hepatitis (FH) (of whom 9 cases died) by the immunoenzymatic technique, using monoclonal T cell specific antibodies and other reagents. In peripheral blood, the OKT4 positive cells: OKT8 positive cells ratio in FH was higher than that in normal controls. In liver tissue, OKT8 positive cells were the predominant type of T cells, and these cells were in broad contact with the surface of the hepatocyte. Leu7 positive, OKT4/4a positive and Leu 15 positive cells were scarce and did not contact the hepatocyte. These results suggest that cytotoxic T cells may play an important role in hepatocyte necrosis in patients with FH. PMID- 3311953 TI - In-situ hybridisation with HBV-cDNA as a sensitive method for the diagnosis of hepatitis B infection in persistent acute hepatitis. AB - Liver biopsies of 97 patients with persistent acute hepatitis, a morphologically distinct form of hepatitis with only slightly elevated transaminase values, were screened immunohistochemically for HBs and HBc, and with in-situ hybridisation for HBV DNA. Besides the 37 in part inconstantly immunohistochemically-positive patients, 47 others showed exclusively cytoplasmatic HBV DNA, localizing at least the major part of the replication of viral DNA to the cytoplasm of liver cells. A diffuse distribution pattern of HBV DNA-positive liver cells was accompanied by stronger morphological changes than focally accentuated positivity. In HBc positive cases, distribution of HBV DNA corresponded mainly to the cytoplasmic type of HBc. PMID- 3311954 TI - Short-term treatment of reflux oesophagitis with ranitidine 300 mg nocte. Italian multicentre study. AB - A multicentre study involving 9 Italian institutions was carried out to compare the efficacy and safety of ranitidine 150 mg b.i.d. and ranitidine 300 mg nocte in the treatment of reflux oesophagitis. 117 patients with histologically proven oesophagitis were randomly allocated to two comparable treatment groups. Efficacy and reliability were evaluated by clinical and laboratory tests at the beginning of the study, and at 3 and 6 weeks; endoscopy and biopsies were performed at the beginning and at 6 weeks. Treatment with ranitidine for 6 weeks led to total disappearance of gastro-oesophageal reflux symptoms in 60% of patients, with percentages of partial improvement varying between 85% and 95% of cases. Improvement in the results of endoscopic examination was 85%, of which 55% were cured. Microscopic examination revealed an improvement of 36% and 44%, with a cure rate of 18% and 26% respectively. With regard neither to the regression of symptoms nor to the macroscopic and microscopic inflammation of the oesophageal mucosa did statistical examination show significant differences in the therapeutic efficacy of ranitidine 150 mg b.i.d. or 300 mg nocte for treatment of reflux oesophagitis. PMID- 3311955 TI - Physiological relationships between growth hormone level, glycemia and metabolic control in dogs. AB - This study was undertaken to explore the physiological relationships between fasting glycemia, antecedent glycemic control and fasting growth hormone levels in pancreatectomized dogs. In contrast to other studies, we used continuous intravenous infusions of insulin in an attempt not only to normalize fasting plasma glycemia but also to eliminate the characteristic fluctuations of diabetes usually encountered in the postprandial and postabsorptive periods. For comparison, a similar group of healthy animals served as normal controls. In the healthy dogs, fasting growth hormone (GH) levels were stable and well within normal limits for this species, demonstrating an overall mean +/- SD of 2.50 +/- 0.46 ng/ml. In the pancreatectomized group as a whole, the fasting GH levels were significantly elevated (4.63 +/- 2.42 ng/ml, P less than 0.01) and significantly (P less than 0.001) more variable than in the controls. Multiple regression and analysis of variance confirmed the expected significant positive correlation between fasting GH and fasting plasma glucose levels, but also elucidated a heretofore unknown direct relationship between fasting GH levels and the preceding instability of glycemic control. PMID- 3311956 TI - Effects of sparteine sulfate on glucagon secretion in insulin dependent (type-1) diabetic subjects. PMID- 3311957 TI - Seasonal variation in thyroid size in healthy males. AB - Thyroid volume, measured ultrasonically, and serum levels of T4, T3 and TSH were determined every season during one year in 13 healthy males. A mean variation in thyroid volume of approximately 23% between minimum values (15.8 +/- 1.7 ml, summer) and maximum values (19.5 +/- 1.9 ml, winter) was found (P less than 0.01), although no significant differences in the other thyroid variables could be demonstrated. This seasonal variation in thyroid size should be taken into account when goitre frequency, goitrogenic action of drugs, and goitre treatment effects are evaluated. PMID- 3311958 TI - Polycystic disease of the parotid glands: case report of a rare entity and review of the literature. AB - We report a case of polycystic disease of the parotid glands. This is a rare disorder and we know of only two previous documented cases in the literature. The disease presents with painless enlargement of one or both parotid glands and is not associated with any clinical abnormality of salivation or with any apparent anomaly of the other salivary glands. Histologically, the overall glandular architecture is preserved but the lobules are all markedly distended by epithelial-lined cysts, which appear to be derived from the intercalated ducts. Characteristic congophilic laminated spheroliths are present within the cystic spaces. The condition must be differentiated from cystic neoplasms, particularly papillary cystic adenocarcinoma, and from various non-neoplastic disorders including sialectasia, retention cysts and lymphoepithelial cysts. PMID- 3311959 TI - S-100 protein immunostaining in teratomatous well-differentiated tissues. AB - The presence and distribution of S-100 protein were studied in a case of ovarian teratoma using avidin-biotin complex immunoperoxidase method. S-100 immunoreactivity within the well-differentiated teratomatous tissues appeared to mirror that of their normally developed human counterparts, although we could unexpectedly detect S-100 immunoreactivity in bone osteoblasts and osteocytes, and in tooth germ odontoblasts. Choroid plexus-like formations present in the teratoma were also positive. Our results suggest that the presence of S-100 protein might be associated with a basic cell function regardless of the presence of a physiologically end-developed human organism. PMID- 3311960 TI - Paraplast-Piccolyte double embedding of bone marrow biopsies in routine histopathology. PMID- 3311961 TI - Current referral practices of mental health care providers. AB - Psychiatric referral practices of the clergy, primary care physicians, and mental health care specialists are examined in relation to the three stages of the referral process: the identification of a mental health problem, the decision to refer, and the selection of a treating professional. Referral practices within health maintenance organizations are also described to illustrate how organizational structure affects this process. Based on a literature review, the authors identify and discuss ten major factors that shape and define all referrals. They are the practitioner's capacity to recognize and define mental illness, the availability of resources, economic incentives, the amount of clinical information available, patient attitudes toward referral, the practitioner's therapeutic background, the practitioner's role perception, practitioner-patient interaction, interpractitioner relations, and provider group influences. The authors end with a critique of current mental health referrals. PMID- 3311962 TI - Part B costs: outpatient spending fuels surge. PMID- 3311963 TI - No data exist to explain jump in Part B spending. PMID- 3311964 TI - Study says state all-payer systems successful. PMID- 3311965 TI - HMO/CMP review is up and running (finally). PMID- 3311966 TI - Scott dissects Medicare's regulatory process. Interview by Michele Robinson. PMID- 3311967 TI - Chromosome maps of man and mouse, III. AB - Data on loci whose positions are known in both man and mouse are presented in the form of chromosomal displays, a table, and autosomal and X-chromosomal grids. At least 40 conserved autosomal segments with two or more loci, as well as 17 homologous X-linked loci, are now known in the two species, in which mitochondrial DNA is also highly conserved. Apart from the Y, the only chromosome now lacking a conserved group is human 13. Human 17 has a single conserved group which includes both short and long arms, and so may have remained largely intact in mammalian evolution. Human and mouse chromosomal maps show the approximate locations of homologous genes while the mouse map also shows the positions of translocations used in gene location. PMID- 3311969 TI - Review and evaluation of physiological cost prediction models for manual materials handling. PMID- 3311968 TI - Ribonucleotide reductase M2 subunit sequences mapped to four different chromosomal sites in humans and mice: functional locus identified by its amplification in hydroxyurea-resistant cell lines. AB - The sites of sequences homologous to a murine cDNA for ribonucleotide reductase (RR) subunit M2 were determined on human and murine chromosomes by Southern blot analysis of interspecies somatic cell hybrid lines and by in situ hybridization. In the human genome, four chromosomal sites carrying RRM2-related sequences were identified at 1p31----p33, 1q21----q23, 2p24----p25, and Xp11----p21. In the mouse, M2 sequences were found on chromosomes 4, 7, 12, and 13 by somatic cell hybrid studies. By Southern analysis of human hydroxyurea-resistant cells that overproduce M2 because of gene amplification, we have identified the amplified restriction fragments as those that map to chromosome 2. To further confirm the site of the functional RRM2 locus, two other cDNA clones, p5-8 and S7 (coding for ornithine decarboxylase; ODC), which are coamplified with RRM2 sequences in human and rodent hydroxyurea-resistant cell lines, were mapped by Southern and in situ hybridization. Their chromosomal map positions coincided with the region of human chromosome 2 (p24----p25) that also contains one of the four RRM2-like sequences. Since this RRM2 sequence and p5-8 and ODC are most likely part of the same amplification unit, the RRM2 structural gene can be assigned to human chromosome 2p24----p25. This region is homologous to a region of mouse chromosome 12 that also carries one of numerous ODC-like sequences. In an RRM2-overproducing mouse cell line, we found amplification of the chromosome 12-specific restriction fragments. Thus, we conclude that mouse chromosome 12 carries the functional locus for RRM2. PMID- 3311970 TI - Genetic studies of low-abundance human plasma proteins. IV. Improved typing of alpha-1 acid glycoprotein (orosomucoid) by isoelectric focusing and immunoblotting. AB - The sensitivity and specificity of isoelectric focusing (IEF) and immunoblotting have been combined for the routine typing of the plasma protein alpha-1 acid glycoprotein (Orosomucoid, ORM). Optimized conditions have been determined for a reliable classification of different ORM phenotypes. Phenotypic patterns of ORM in simple IEF gels correspond to those observed by other techniques. Addition of 6 M urea in a thin-layer IEF gel revealed additional, informative microheterogeneity in the ORM system, which cannot be detected in simple IEF gels. Applying the improved method, 239 White and 181 Black Americans have been screened to determine the distribution of ORM allele frequencies. Two common alleles, ORM*1 and ORM*2, have been observed and their frequencies are 0.5592 and 0.4408, and 0.6160 and 0.3840 in Whites and Blacks, respectively. Family studies confirm the genetic basis of this variation which is compatible with autosomal, codominant inheritance. PMID- 3311971 TI - What was happening in dentistry exactly 100 years ago? PMID- 3311972 TI - A story about dental science research in dental anthropology and genetics. PMID- 3311973 TI - Handling antineoplastic agents: urine mutagenicity in nurses. PMID- 3311974 TI - Successful pancreatic allografts in combination with bone marrow transplantation in mice. AB - We have established a new method for pancreatic allografts in mice by combining pancreatic transplantation with allogeneic bone marrow transplantation. In this approach, we first transplanted bone marrow to induce tolerance to both donor type and host-type major histocompatibility complex (MHC) determinants. Pancreatic tissue from the same mouse strain as bone marrow donor was then grafted under the renal capsule. Acceptance of the grafts was confirmed by histopathological and immunohistochemical techniques. BALB/c mice reconstituted with C57BL/6J bone marrow cells accepted pancreatic tissue from both bone marrow donor (C57BL/6J)-type and host (BALB/c)-type mice. An immunohistochemical study revealed the presence of functional islets under the renal capsules. Assays for both mixed lymphocyte reaction (MLR) and induction of cytotoxic T lymphocytes indicated that the newly developed T cells are tolerant of both donor (stem cell) type and host-type MHC determinants. By contrast, the T cells of these chimeras showed a significant responsiveness to third party MHC determinants. These findings suggest that pancreatic allografts combined with bone marrow transplantation may become a viable strategy for the treatment of patients with diabetes or patients who have undergone pancreatectomy. PMID- 3311975 TI - Immunology of elastin: study of anti-elastin peptide antibodies by DOT immunobinding assay. AB - In order to further investigate the role of the immune system in the arteriosclerotic process, we investigated the anti-elastin peptide antibodies (AEAb) of the IgG and IgM types by DOT immunobinding assay in the sera of patients suffering from various arteriosclerotic diseases. In total 232 control and pathological sera were studied. In obliterative arteriosclerosis of the legs 90%, ischemic heart disease 67% and hypertension 60% of sera were positive for AEAb of the IgG type independent of age. In the case of diabetes mellitus, however, the duration of the disease was determinant. In rheumatoid arthritis, the results were negative. No clear-cut positivity could be demonstrated in stroke patients either. These results indicate that AEAb can be detected in some diseases and DOT appears to be an appropriate method for the AEAb screening in various diseases. PMID- 3311976 TI - Cyclosporin alters the induction of allospecific tolerance in vivo. AB - CBA mice were made hyporesponsive to A/J alloantigens by either neonatal inoculation of (CBA X A)F1 hybrid lymphoid cells or by intravenous injection of adult mice with A/J bone marrow cells. Specific alloreactivity was assessed in vitro by induction of anti-A/J cytotoxic T lymphocytes (CTL) or in vivo by skin graft rejection. Cyclosporin A given at the same time as the tolerance-inducing regimen of F1 (or parental) lymphoid cells abolished the hyporesponsiveness normally induced by these injections. PMID- 3311977 TI - Antigen density on the surface of mononuclear cells in SLE. AB - Searching for the cause of the known immunological abnormalities in systemic lupus erythematosus (SLE), the density of cell surface antigens was measured after immunofluorescent staining in a cell sorter. The densities of CD3, CD4, CD5, CD8 and sIgM lymphocyte antigens were the same on patients' lymphocytes as on lymphocytes from healthy subjects. The intensity of HLA-DR immunofluorescence was found to be decreased on patients' monocytes, while the expression of HLA-DR on lymphocytes of patients with SLE hardly differed from that in healthy subjects. Pretreatment of normal mononuclear cells with patients' sera free from immune complexes decreased the binding of anti-HLA-DR antibody to normal monocytes, but it hardly caused alteration on lymphocytes. After culturing, the expression of HLA-DR antigen on patients' monocytes became the same as on normal cells. A causal role of anti-HLA-DR autoantibodies is suggested and discussed. PMID- 3311978 TI - Induction of respiratory deficiency in yeast by salts of chromium, arsenic, cobalt and lead. PMID- 3311979 TI - Immune responses in experimental keratitis by Aspergillus fumigatus Fresenius. PMID- 3311980 TI - Insulin binding parameters in erythrocytes of alloxan induced diabetic rats. PMID- 3311981 TI - Ly-34: a new mouse lymphocyte alloantigen. PMID- 3311984 TI - Effect of anti-insulin antibodies on glycemic control in insulin treated diabetic patients. AB - In order to examine the effect of anti-insulin antibodies on serum insulin concentration and glycemic control, sera from 49 insulin-treated diabetic patients (20 males and 29 females) were examined for their titer of anti-insulin antibodies, and concentrations of total insulin (TIRI), free insulin (FIRI) and hemoglobin A1c. Titer of anti-insulin antibodies correlated only with TIRI (r = 0.72, p less than 0.001) and did not correlate with duration of insulin treatment, FIRI concentration, daily dose of insulin, or HbA1c concentration. These results indicate that elevated titer of anti-insulin antibodies in patients under insulin therapy, (1) increases total serum insulin concentration but does not affect serum free insulin level, and (2) has little effect, if any, on glycemic control and the required daily dose of insulin. PMID- 3311983 TI - Fluorescence-linked immunosorbent assay (FLISA) for quantification of antibodies to food antigens. AB - Serum antibodies of the IgG type from rabbits immunized with food antigens (beta lactoglobulin, ovalbumin and gliadin) have been quantified using a fluorescence linked immunosorbent assay (FLISA), with the antigens adsorbed as round spots (about 8 mm in diameter) on glass or plastic microscope slides. The indirect immunofluorescence intensities were determined using a microscope fluorometer, and compared to enzyme-linked immunosorbent assay (ELISA) in microtiter plates and diffusion-in-gel-ELISA (DIG-ELISA) in plastic petri dishes. It was found that FLISA in general became more sensitive when the antigens had been adsorbed onto a plastic (Nunclon) than onto a glass surface. When the antigens were adsorbed to the plastic slides, the relative sensitivity order (maximum serum dilution) of the assays was in general the following, ELISA greater than FLISA greater than DIG-ELISA. The fluorescence-linked method appeared to require equal or less antigen and conjugated antiserum per sample. Due to the visual inspection of the surface, inhomogeneities of the antigen-coating could be readily discovered and evaluated by several measurements within the field of antigen-antibody reaction. It is proposed that spot FLISA may be an alternative to ELISA especially when the amount of antigen or antiserum is limited. PMID- 3311985 TI - Plasmid mediated enterotoxigenicity in Salmonella strains isolated from patients of gastroenteritis. PMID- 3311982 TI - Kidney immunopathology and pathophysiology in rats immunized with proximal tubule cell brush border or basolateral membrane vesicles. AB - Proximal tubule pathology in Heymann nephritis has been attributed to anti-brush border antibodies, but antibodies with other specificities might also be important. To determine whether injury to the basolateral membranes of proximal tubules could occur independently of brush border injury, LEW rats were immunized either with partially purified basolateral or brush border membrane vesicles. Both immunogens produced glomerular immunopathology and pathophysiology identical in magnitude and time course to that seen in Heymann nephritis. Antibodies eluted from the kidneys of rats immunized with either antigen preparation stained the brush border in vitro. However, circulating anti-brush border antibodies were in significant titers only in rats immunized with brush border vesicles, whereas antibodies that stained the cytoplasm of both proximal and distal tubules predominated in rats immunized with basolateral membranes. With the onset of proteinuria, rats immunized with brush border membranes developed the proximal tubule pathology of Heymann nephritis. In rats immunized with basolateral membranes, the brush border and apical aspect of proximal tubule cells remained essentially normal. However, defects of basolateral membrane transport function were present, indicating that those defects need not necessarily be secondary to brush border damage. The dissociation of brush border damage from glomerular injury suggests that different antibody populations may account for each. Furthermore, anti-brush border antibodies may not account for all aspects of proximal tubule pathology in Heymann nephritis. PMID- 3311986 TI - Prevalence survey of filariasis in two villages in Chingleput district of Tamil Nadu. PMID- 3311987 TI - Immunosuppression in clinical filariasis. PMID- 3311988 TI - Silver sulphadiazine in the treatment of mycotic keratitis. PMID- 3311989 TI - Osmotic regulation of vasopressin and renin in spontaneously hypertensive rats. AB - Abnormalities in the vasopressin and renin systems have been reported in spontaneously hypertensive rats (SHR). Therefore, studies were performed to evaluate the responsiveness of these systems to changes in plasma osmolality and sodium concentration. These variables were manipulated in vivo by intraperitoneal administration of distilled water, isotonic saline, or hypertonic saline to 8- and 18-week-old SHR and normotensive Wistar-Kyoto rats (WKY). Animals were decapitated 30 minutes later, and trunk blood was collected. The hypertonic saline injections resulted in an increase in plasma osmolality and serum sodium at both ages (p less than 0.001). Serum vasopressin was higher in all groups of animals receiving hypertonic saline (1200 mosm/kg H2O; p less than 0.05), but the magnitude of increase was not significantly different in the SHR and WKY at either age. Serum renin activity was lower in SHR than in WKY following acute decreases in serum sodium at 8 weeks, but it was the same for both strains at 18 weeks. Both kidney renin content and concentration were lower in SHR than in WKY at 18 weeks but not at 8 weeks. Therefore, the suppressed renin response to acute osmotic challenge in 8-week-old SHR is not the consequence of reduced kidney renin content. The vasopressin response to osmotic stimulation also was evaluated in vitro using hypothalamoneurohypophyseal explants obtained from 5-, 8-, and 18 week-old SHR and WKY.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3311991 TI - Postural stress tests for the clinico-physiological evaluation of cardiovascular reflexes. AB - Postural stress tests are useful in the assessment of cardiovascular reflex response of normal subjects who may be involved in specialised occupations such as flying; in order to study the effects of physiological stresses such as heat stress, hypoxia, simulation of weightlessness; physiological evaluation of cosmonaut candidates, in patients who may have autonomic neuropathy. Most commonly quiet standing is used but head-up tilt table test and the application of lower body suction may provide a better method of evaluation. These three tests for assessing reflex cardiovascular function are discussed. PMID- 3311990 TI - Fructose-induced insulin resistance and hypertension in rats. AB - To determine if hypertension could be produced in normal rats by feeding them a fructose-enriched diet, Sprague-Dawley rats were fed either normal chow or a diet containing 66% fructose as a percentage of total calories for approximately 2 weeks. At the end of this period systolic blood pressure had increased from 124 +/- 2 to 145 +/- 2 (SEM) mm Hg in the fructose-fed rats, whereas no change occurred in the control group. In addition, hyperinsulinemia and hypertriglyceridemia were associated with hypertension in fructose-fed rats. The addition of clonidine to the drinking water inhibited fructose-induced hypertension, but not the increase in plasma insulin or triglyceride concentration seen in fructose-fed rats. Thus, the metabolic changes associated with fructose-induced hypertension are unlikely to be secondary to an increase in sympathetic activity. Whether or not this is also true of the hypertension remains to be clarified. PMID- 3311993 TI - Intensive care in pediatric patients. PMID- 3311992 TI - Trial of ketotifen in childhood asthma. AB - An open trial of Ketotifen was conducted on 29 children suffering from asthma of varying duration. The drug was given orally in a dose of 1 mg twice a day. Children were followed up weekly for a period of 3 months. It was found beneficial (though the benefit was not statistically significant) in children having asthma of less than 2 years duration who were taking one drug regularly or were on occasional treatment. There was marginal effect in children taking salbutamol and theophylline together, but irregularly and no benefit in children taking prednisolone. PMID- 3311994 TI - Intracranial hypertension. PMID- 3311995 TI - Fulminant hepatic failure & hepatic encephalopathy. PMID- 3311996 TI - Heat stroke. PMID- 3311997 TI - Aspirin poisoning. PMID- 3311998 TI - Snake-bites and scorpion sting. PMID- 3311999 TI - Bronchiolitis. PMID- 3312000 TI - Croup syndrome. PMID- 3312001 TI - Cardiac arrhythmias and cyanotic spells. PMID- 3312002 TI - Immunization of mice against tetanus with fragments of tetanus toxin synthesized in Escherichia coli. AB - Two recombinant plasmids, pTet11 and pTet18, which express nontoxic protein fragments of tetanus toxin in Escherichia coli, were constructed. pTet11 protein (86 kilodaltons) is a fusion between part of the E. coli trpE protein and 441 amino acids of tetanus fragment C, and pTet18 (63 kilodaltons) consists of part of fragment B and all of fragment C of tetanus toxin. The synthesis of these proteins was induced in E. coli cultures, and the proteins were partially purified. Mice were immunized with these proteins, and dose-dependent titers of anti-tetanus toxoid antibodies were obtained. The proteins were able to induce neutralizing antibodies in mice, as demonstrated by the ability of mice immunized with 1 microgram or more of protein to survive challenge with 10 50% lethal doses of tetanus toxin. PMID- 3312003 TI - Demonstration of antigenic polymorphism in Plasmodium vivax malaria with a panel of 30 monoclonal antibodies. AB - A panel of 30 monoclonal antibodies was established against asexual erythrocytic stages of Plasmodium vivax and used to investigate the antigenic composition of the parasite. At least 38 different antigenic polypeptides of P. vivax were characterized by the Western blot technique. The possible location of these antigens, as well as their stage and species specificity, was determined on the basis of the staining patterns produced by these antibodies on air-dried parasites in the indirect immunofluorescence test. Immunofluorescence performed with 30 different monoclonal antibodies on 50 different isolates of P. vivax obtained from patients showed that a high level of antigenic polymorphism prevailed in P. vivax. Only six monoclonal antibodies reacted with epitopes that were represented in more than 80% of parasite isolates, and therefore, appeared to be relatively conserved among different isolates. The other 24 monoclonal antibodies reacted with only 20 to 70% of parasite isolates. PMID- 3312004 TI - Enhancement of non-Candida antibody responses by Candida albicans cell wall glycoprotein. AB - Two cell wall glycoprotein extracts from Candida albicans (glycoprotein [GP] and peptidoglucomannan [PGM]) were tested for their influence on antibody responses to type III pneumococcal polysaccharide and sheep erythrocytes. GP was isolated from lipid-extracted cell walls with ethylenediamine, whereas PGM was extracted with dilute sodium hydroxide. Both glycoproteins increased the number of antibody producing plaque-forming cells in the spleens of mice immunized with type III polysaccharide or sheep erythrocytes, although PGM appeared to be about 10 times more effective. PGM could be administered up to 3 days prior to immunization with sheep erythrocytes to elicit enhancement; it did not have to be administered by the same route as the immunogen to cause significant enhancement. Enhancement did not appear to be the result of a direct mitogenic effect of GP and PGM on lymphocytes, nor did these glycoproteins appear to stimulate the production of B cell growth factors or interleukin 2. PMID- 3312005 TI - Plasmid-associated resistance of Salmonella typhimurium to complement activated by the classical pathway. AB - The association of the virulence plasmid of Salmonella typhimurium with resistance to the bactericidal activity of human serum was studied in chromosomally isogenic pairs of strains differing in their virulence plasmid status. The presence of the plasmid correlated in three pairs of strains with resistance to serum. The absence of the plasmid correlated with increased sensitivity to serum, whereas the reintroduction of the plasmid to the cell resulted in the restoration of resistance to serum. Complement was activated by the classical and alternative pathways equally well by both strains of a pair, but the differential bactericidal action of serum was apparent only after the activation of complement by the classical pathway. No differences in the chemical compositions or in the molecular weight ranges of the lipopolysaccharides were apparent between paired strains. This work confirms the presence of a virulence plasmid-associated mechanism of resistance to serum and distinguishes it from lipopolysaccharide-mediated resistance. PMID- 3312006 TI - Contribution of capsular polysaccharide and surface properties to virulence of Escherichia coli K1. AB - We examined the surface properties, susceptibility to the bactericidal activity of serum, and susceptibility to phagocytosis of Escherichia coli K1, a laboratory strain of E. coli (LE392), and strain LE392 carrying a plasmid (pKT274) incorporating a 17-kilobase insert of DNA that encodes the ability to produce surface K1 antigen. As determined by electron microscopy, LE392 was nonencapsulated but both E. coli K1 and LE392(pKT274) possessed a thin capsule. By using charged aqueous two-phase polymer systems, both E. coli K1 and LE392(pKT274) were shown to be significantly more negatively charged than LE392. E. coli K1 was resistant to the bactericidal activity of serum, but both LE392 and LE392(pKT274) were completely inhibited by neonatal serum at a concentration of 20% (vol/vol). As measured by counting endocytosed and nonendocytosed bacteria and by chemiluminescent response, E. coli K1 was highly resistant to phagocytic uptake by polymorphonuclear leukocytes, whereas LE392 was rapidly taken up by such cells; LE392(pKT274) was resistant to endocytosis, although less so than E. coli K1. Most intraphagocytic E. coli LK1 remained structurally intact for up to 60 min, whereas both LE392 and LE392(pKT274) were rapidly degraded. PMID- 3312007 TI - Entry of Shigella flexneri into HeLa cells: evidence for directed phagocytosis involving actin polymerization and myosin accumulation. AB - The enteroinvasive bacterium Shigella flexneri expresses a plasmid-mediated capacity to penetrate into nonphagocytic cells. By using 7-nitrobenz-2-oxa-1,3 diazole-phallacidin (NBD-phallacidin), a fluorescent dye which specifically stains microfilaments, we observed condensations of filamentous actin underneath the plasma membrane of HeLa cells which interacted with the invasive isolate M90T. As demonstrated by indirect immunofluorescence with the antimyosin monoclonal antibody CC-212, myosin accumulated at the same sites. The entry process could be synchronized by using strain SC301, a pIL22 transformant of M90T. pIL22, a recombinant plasmid encoding the Escherichia coli afimbrial adhesin AFA I, rendered shigellae highly adherent to HeLa cells. Using such a system, we demonstrated that the occurrence of bacterial penetration and the appearance of structures brightly stained by NBD-phallacidin were simultaneous events. Such microfilamentous structures resulted from de novo polymerization of the monomeric actin pool in a DNase I inhibition assay, as shown by measurement of the monomeric versus total actin content of infected HeLa cells. These data provide direct evidence that the penetration of S. flexneri into HeLa cells occurs through a mechanism similar to phagocytosis by professional phagocytes. PMID- 3312008 TI - Serological relationships between Escherichia coli and Salmonella smooth- and rough-mutant lipopolysaccharides as revealed by enzyme-linked immunosorbent assay for human immunoglobulin G antiendotoxin antibodies. AB - Reactions of sera from healthy blood donors to smooth and rough mutant lipopolysaccharides (LPS) from Escherichia coli O111:B4 and Salmonella minnesota which had been complexed with polymyxin B were determined by enzyme-linked immunosorbent assay. Relative enzyme-linked immunosorbent assay reactivities were examined for prima facie evidence of cross-reactivity by analyses of correlation and relative scatter. Patterns of reactivity were interpreted in relation to published structures. Evidence was obtained for two dominant epitopes associated with the lipid A-2-keto-3-deoxyoctulosonic acid and heptose regions of the LPS core. Sera demonstrated apparent exclusive antibody homogeneity in that given sera showed only one of the two possible specificities, which occurred with equal frequency. Cross-reactivity was found in the lipid A-2-keto-3-deoxyoctulosonic acid region for all LPS. Cross-reactivity was found in the heptose region for larger rough mutant S. minnesota LPS and smooth S. minnesota LPS and for E. coli O111:B4 LPS but not for E. coli rough mutant J5 LPS, whose heptose region appears to be different from those of the other organisms. PMID- 3312010 TI - Cytoadherence of Plasmodium falciparum-infected erythrocytes to human melanoma cell lines correlates with surface OKM5 antigen. AB - OKM5 antigen and thrombospondin are currently under investigation as potential receptors on the surface of human monocytes, endothelial cells, and melanomas responsible for the cytoadherence of Plasmodium falciparum-infected erythrocytes. We have studies the binding capacity of six human melanoma cell lines and related this property to the cytoplasmic and surface expression of the OKM5 antigen and thrombospondin by using indirect immunofluorescence assays on methanol-fixed and nonfixed melanomas. The presence of OKM5 antigen was detectable only in the melanoma lines which bound P. falciparum-infected erythrocytes. Thrombospondin was present in the cytoplasm of all the melanoma lines but was not detectable on the surface of any cells. Our work demonstrates a direct correlation between surface OKM5 antigen and cytoadherence in vitro. While our results do not exclude thrombospondin as a mediator of cytoadherence to endothelial cells in vivo, they showed no correlation between the presence of thrombospondin and the ability of melanoma cell lines to cytoadhere in vitro. PMID- 3312009 TI - Role of lipopolysaccharide and complement in susceptibility of Klebsiella pneumoniae to nonimmune serum. AB - The role of lipopolysaccharide (LPS) in the susceptibility of Klebsiella pneumoniae to serum and the mechanism of complement activation by serum susceptible (SerS) strains were investigated. The classical and alternative complement pathways are involved in serum killing of susceptible K. pneumoniae strains. The LPS composition seems to play a very important role in the serum bactericidal reaction, while capsular polysaccharide from this bacterium does not play any role. High-molecular-weight LPS from serum-resistant (Serr) K. pneumoniae strains was able to inhibit completely the serum bactericidal activity. LPS from SerS K. pneumoniae strains was not able to inhibit completely the serum bactericidal activity; low-molecular-weight LPS from Serr K. pneumoniae strains could not either. All these findings suggested that LPS composition, especially the O-antigen polysaccharide chains, contributes to the susceptibility of K. pneumoniae strains to complement-mediated serum bactericidal activity. PMID- 3312011 TI - Isolation and characterization of monoclonal antibodies specific for antigen P1, a major surface protein of mutans streptococci. AB - A panel of 15 murine monoclonal antibodies (MAbs; 14 immunoglobulin G1, 1 immunoglobulin G2a) directed against antigen P1, a major surface protein of mutans streptococci, was prepared. All of these MAbs reacted by the enzyme-linked immunosorbent assay with solubilized wall material from Streptococcus mutans Ingbritt 175 (a serotype c strain which retains significant amounts of P1 in its cell wall), culture supernatant fluid from Ingbritt 162 (a strain which excretes large amounts of P1 into the culture medium), and purified P1. By Western immunoblotting, these MAbs were observed to react with a high-molecular-weight polypeptide which comigrated with antigen P1. None of these MAbs cross-reacted with human heart tissue or with various eucaryotic proteins. When whole cells of various strains of mutans streptococci were screened against the panel of MAbs, the strongest reactivities were noted with strains of serotype c and e S. mutans, while a serotype f strain of S. mutans, along with S. sobrinus and S. cricetus strains, reacted somewhat more weakly. S. rattus strains were completely negative. Results obtained with bacterial culture supernatants were qualitatively similar. The surface localization of antigen P1 was confirmed by electron microscopy with an indirect immunogold technique. In sectioned S. mutans cells, labeling appeared to be associated with a fibrillar "fuzzy coat" layer, which was far more prominent on cells of Ingbritt 175 than on those of Ingbritt 162. PMID- 3312012 TI - Cytosolic calcium changes in individual neutrophils stimulated by opsonized and unopsonized Candida albicans hyphae. AB - Previous experiments suggest the critical central role of the neutrophil (PMN) respiratory burst in the prevention and containment of disseminated candidiasis. A rise in cytosolic free calcium concentrations ([Ca2+]i) has been documented as an early event after PMN stimulation which is involved in the subsequent genesis of microbicidal and inflammatory respiratory burst products. [Ca2+]i were therefore determined in individual PMN, loaded with the fluorescent calcium probe fura-2 as they attached to and spread over serum-opsonized or unopsonized Candida albicans hyphae, particles that are too big to be completely ingested. After contact between hyphae and PMN, the PMN rapidly spread over hyphal surfaces. Although both opsonized and unopsonized hyphae stimulated similar magnitudes of peak median increases in PMN [Ca2+]i, the kinetics of responses differed; median [Ca2+]i peaked within 1 min after contact with opsonized hyphae versus 4 min after contact with unopsonized hyphae. Moreover, a detectable calcium transient did not invariably follow contact and spreading of each individual PMN over a hyphal surface. In contrast to patterns seen after stimulation of PMN with opsonized zymosan, in which [Ca2+]i is greatest in the periphagosomal region, there was a more uniform distribution throughout the cytoplasm in PMN stimulated with the noningestable hyphae. These alterations in the early patterns and timing of PMN stimulation may reflect analogous differences in subsequent events which control the efficiency and specificity of microbicidal responses to uningestible hyphae and which also determine whether host tissues are damaged by the generation of toxic PMN activation products. PMID- 3312013 TI - Introduction of Shigella flexneri 2a type and group antigen genes into oral typhoid vaccine strain Salmonella typhi Ty21a. AB - For protection against dysentery caused by Shigella flexneri 2a, an in vivo constructed recombinant plasmid with genes specifying the S. flexneri type and group antigens located near the pro (min 6) and his (min 44) chromosomal markers, respectively, was made and transferred to the galE Salmonella typhi strain Ty21a. Strain Ty21a carrying this recombinant plasmid was shown by immunological and biochemical analyses to express the S. flexneri 2a type and group antigens. Mice immunized with this vaccine strain were found to be protected against challenge with virulent S. flexneri 2a, but not significantly against S. typhi challenge, presumably because synthesis of the Shigella antigens interfered with expression of the typhoid antigens. Elimination of the recombinant plasmid from Ty21a allowed this strain to again express typical S. typhi O antigens. Mouse protection against both S. typhi and S. flexneri 2a challenges was achieved with a whole-cell vaccine mixture composed of equal parts of Ty21a and the Ty21a-S. flexneri 2a hybrid strain. PMID- 3312014 TI - Proteinase production by the parasitic cycle of the pathogenic fungus Coccidioides immitis. AB - Coccidioides immitis is the causative agent of coccidioidomycosis (valley fever), a potentially disseminated fungal disease. We hypothesized that proteinases are expressed by the parasitic life cycle of C. immitis and that they might play an important role in the pathogenesis of coccidioidomycosis by facilitating spherule rupture, endospore dissemination, and tissue invasion and destruction. Filtrate from cultures of the parasitic life cycle of C. immitis was therefore assayed for proteolytic activity at neutral pH. The filtrate degraded 68% of a radiolabeled model of an elastin-rich extracellular matrix. The principal activity was against elastin and glycoprotein in the matrix. Degradation of purified elastin by filtrate was 222 micrograms/h per mg of filtrate protein at 37 degrees C. Denatured type I collagen (Azocoll) degradation was 13.5 mg/h per mg of filtrate protein at 37 degrees C. Proteinase activity peaked at 60 h of culture, correlating with release of endospores from mature spherules in the in vitro culture system. Elastase activity was attributed to a serine proteinase which exhibited an active-site preference for phenylalanine at the P1 site. The subunit molecular mass of the elastase determined by [3H]diisopropylfluorophosphate labeling was approximately 25 kilodaltons. Inhibition of the azocollytic activity of crude filtrate by 2 mM 1,10-phenanthroline and 10 mM EDTA, and stimulation by 2 mM CaCl2, suggested that a metalloproteinase was also present. Gelatin substrate gel electrophoresis with and without inhibitors confirmed that two proteinases were expressed, and they were separated by fast protein liquid chromatography. PMID- 3312015 TI - Expression of Campylobacter jejuni invasiveness in cell cultures coinfected with other bacteria. AB - Enteroinvasive Salmonella, Shigella, and Escherichia coli strains were found to exert an effect which rendered Campylobacter jejuni capable of intracellular localization in epithelial cells in vitro. When monolayers of HEp-2 or A-549 cells were challenged with pure cultures of C. jejuni or Campylobacter coli, none of the eight strains tested invaded the cells. In contrast, four of these strains were able to localize intracellularly when the cells were challenged with a mixture of campylobacters and enteroinvasive Salmonella typhimurium, Shigella flexneri, Shigella boydii, Shigella sonnei, or E. coli strains. Invasiveness of campylobacters was also induced by one nonenteroinvasive strain of E. coli O124. Coinfection with other nonenteroinvasive E. coli strains did not induce invasiveness in C. jejuni. The degree of internalization induced by S. typhimurium was significantly higher than that induced by Shigella or E. coli strains. The invasive capacity of C. jejuni was found to differ considerably between strains. No evidence of an invasive potential was demonstrable for two C. coli strains or for two enterotoxigenic isolates of C. jejuni examined. C. jejuni was only able to localize intracellularly in cell cultures when the interaction occurred in a microaerobic atmosphere. None of the strains tested evoked keratoconjunctivitis in guinea pig eyes (Sereny test), regardless of the presence of coinfectants. The results indicate that a synergistic interaction that exists between C. jejuni and other enteropathogens facilitates invasion by C. jejuni. PMID- 3312016 TI - Ability of intestinal Escherichia coli to survive within mesenteric lymph nodes. AB - Identification of mesenteric lymph node (MLN) bacteria showed that indigenous streptomycin-sensitive Escherichia coli could be recovered from MLN at least 48 h after this organism had been essentially eliminated from the cecal flora by antibiotics and replaced with exogenous streptomycin-sensitive E. coli JK. Additional experiments with antibiotic-treated rats also showed that indigenous streptomycin-sensitive E. coli could be recovered from the MLN 4 days after elimination of this organism from the cecal flora. These findings suggest that the time of bacterial translocation to MLN may be kinetically different from the time of recovery of bacteria from MLN and that the MLN may be a focus of infection with intestinal bacteria. PMID- 3312017 TI - Protein variability among strains of Mycoplasma pulmonis. AB - The proteins of Mycoplasma pulmonis were examined by two-dimensional polyacrylamide gel electrophoresis and immunoblotting. Comparison of profiles from silver-stained two-dimensional polyacrylamide gel electrophoresis of 18 strains of M. pulmonis allowed identification of five proteins that were strain variable. These variable proteins were not dependent on the medium used to grow the organisms and were shown by reaction with serum samples from naturally infected rats and mice to be produced in vivo and not to be medium components. Identification of strain-variable proteins may lead to an explanation of the differences in properties found among M. pulmonis strains. PMID- 3312018 TI - Most Mycobacterium leprae carbohydrate-reactive monoclonal antibodies are directed to lipoarabinomannan. AB - Each of more than 30 monoclonal antibodies that had been raised against Mycobacterium leprae and previously classified as reactive with carbohydrate was shown to be directed against lipoarabinomannan, a prominent, highly pervasive, myo-inositol-phosphate-containing, cross-reactive antigen within the leprosy bacillus. Some of the antibodies preferentially bound to the lipopolysaccharide of M. leprae rather than to that of Mycobacterium tuberculosis, suggesting the presence of distinguishing structural features. The presence of alkali-labile inositol 1-phosphate in the lipopolysaccharide from M. tuberculosis and its apparent absence from the M. leprae product may account for the difference. PMID- 3312019 TI - Epidemiology of hepatitis A and B. PMID- 3312020 TI - The influence of flucloxacillin and amoxicillin with clavulanic acid on the aerobic flora of the alimentary tract. AB - In a randomized study, 42 patients undergoing extensive maxillo-facial surgery (correction of the position of the mandible or maxilla by using autologous bone transplants) received prophylactically ten-day courses of either flucloxacillin or amoxicillin with clavulanic acid. Patients were comparable with regard to age and type of surgery. During the prophylactic treatment the effect of antibiotics used on the microbial flora of the alimentary tract was studied. Patients receiving flucloxacillin showed increased numbers of Klebsiella spp. isolated from the faeces (59% of the patients versus 19% of the patients receiving amoxicillin with clavulanic acid). Patients receiving amoxicillin with clavulanic acid showed higher colonization rates of oropharynx with Enterobacteriaceae than patients receiving flucloxacillin (ten patients versus five patients). 60% of those strains isolated from patients receiving amoxicillin with clavulanic acid were resistant to this combination, as compared to 20% of gram-negative bacilli isolated from patients receiving flucloxacillin. In 50% of patients receiving amoxicillin with clavulanic acid, colonization of the gut with yeast occurred, as compared to 18% of patients receiving flucloxacillin. Only one infection leading to a partial loss of the graft was seen in the group of patients receiving flucloxacillin. PMID- 3312021 TI - Cefuroxime axetil in acute purulent exacerbations of chronic bronchitis. AB - 51 hospitalised patients with acute purulent exacerbations of chronic bronchitis were treated for ten days with two daily 1 g doses of the orally absorbed pro drug cefuroxime axetil. However, some patients were still infected with Haemophilus influenzae or Branhamella catarrhalis at follow-up, and sputum purulence remained. Clinical results were "excellent" or "good" in 60% of the evaluable patients one week after the end of the treatment. Mean peak serum concentrations averaged 12.8 mg/l with mean peak sputum concentrations of 1.8 mg/l. The MIC90 value for H. influenzae was 4 mg/l. Three patients discontinued cefuroxime because of unwanted gastrointestinal drug effects, and three because of insufficient improvement. These results do not suggest that this compound is indicated for such patients. PMID- 3312022 TI - Novel R-factor borne beta-lactamase of Escherichia coli confering resistance to cephalosporins. AB - Strains of Escherichia coli resistant to ceftazidime but susceptible to other third generation cephalosporins were detected in three patients at two different locations (Munchen, Bremen). The resistance was self-transmissible to other E. coli strains. Resistance against ampicillin, kanamycin, chloramphenicol and sulfonamide was co-transferred. The isoelectric point (pI) of the beta-lactamase was similar to the pI of the AER-1 and LCR-1 beta-lactamases. These enzymes, however, do not confer resistance to ceftazidime. Therefore the beta-lactamase described is the first example for a ceftazidimase. PMID- 3312023 TI - Pharmacokinetics of antibiotics in cystic fibrosis patients with particular reference to the bronchopulmonary tree (review). PMID- 3312025 TI - [Ceftazidime II]. PMID- 3312026 TI - [Comparative in vitro study of the antimicrobial activity of ceftazidime against clinical isolates]. AB - The antimicrobial activity of ceftazidime was tested against 1482 gram-negative and 1216 gram-positive strains isolated from fresh clinical specimens and compared with generally used antibiotics including other third generation cephalosporins and broad spectrum penicillins. Minimal inhibitory concentrations were determined in a broth dilution test on microtiter plates. In the group of the gram-negative bacteria ceftazidime was the most active of the antimicrobial agents tested with an MIC of 0.5 mg/l (MIC90) for most of the isolates. Ceftazidime exhibited a broad spectrum of activity against gram-negative pathogenic bacteria including Enterobacteriaceae (Escherichia coli, Klebsiella spp., Proteus spp. Enterobacter spp., Citrobacter spp., Serratia spp.) including frequently resistant strains of Pseudomonas aeruginosa, Acinetobacter spp. and Alcaligenes faecalis. The activity against P. aeruginosa is the most remarkable property of the agent. Ceftazidime is less effective against gram-positive compared to gram-negative bacteria. No inhibitory action can be observed against Streptococcus faecalis. PMID- 3312024 TI - Serologic response to Candida albicans and Aspergillus fumigatus in cystic fibrosis. AB - In order to evaluate the role of fungi in patients with cystic fibrosis, we determined serum IgG antibodies against Candida albicans and Aspergillus fumigatus using an indirect ELISA in patients with or without fungi in the sputum and in sera of healthy individuals. For both C. albicans and A. fumigatus the antibody levels were significantly higher in the CF groups than in the control group, regardless of whether these fungi could be isolated during the observation time or not. In contrast to A. fumigatus, we found that in the majority of cases antibody levels increase significantly with the isolation of C. albicans from sputum. Therefore, we conclude that one has to pay more attention to C. albicans in CF patients. One must also particularly reevaluate long-term antibiotic treatment and look for means to prevent fungal recolonization and reinfection. PMID- 3312027 TI - [Resistance pattern of clinical bacterial isolates. Results of a super-regional multicenter study of the Resistance Study Committee of the Paul Ehrlich Society of Chemotherapy]. AB - In a multicentre study conducted by the Paul-Ehrlich-Gesellschaft we tested about 3,584 clinical isolates from 25 laboratories towards different chemotherapeutics. Using a microdilution test Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis strains regarded as causative pathogens were studied. The data were evaluated for the number, frequency and qualitative characteristics of multiple resistance patterns. None of the strains under test was resistant to all antibiotics tested. Amikacin showed the lowest prevalence of resistance. The significance of such data in the epidemiological control of resistance to chemotherapeutics is discussed. PMID- 3312028 TI - [A comparative review of combination therapy: 2 beta-lactams versus beta-lactam plus aminoglycoside]. AB - We have reviewed the available literature on the controlled use of combinations of beta-lactams in the treatment of fever in neutropenic patients, as compared to that of combinations of beta-lactams and aminoglycosides. We compared overall responses, responses in septicemia and various other infections, according to different pathogens and degree of neutropenia, and we evaluated toxicity. Overall, these results showed that response rates with combinations of two beta lactams are similar to those obtained with combinations of a beta-lactam and an aminoglycoside for infections in immunocompromised patients with serious underlying diseases. They also suggest that the emergence of resistance of pathogens to beta-lactams has often been coped by the use of newer drugs in infections caused by Enterobacteriaceae, but much less effectively in the case of Pseudomonas aeruginosa infections. There are still other important theoretical reasons for preferring an aminoglycoside-containing combination for empiric therapy in febrile neutropenic patients, and our overall conclusion is that a large-scale study comparing beta-lactam combinations to the traditional beta lactam plus aminoglycoside regimens is mandatory. PMID- 3312029 TI - [Results of several different controlled studies with ceftazidime in the treatment of infections in immunosuppressed patients]. AB - At our Division of Hematology eight clinical studies were performed using ceftazidime alone or in combination with other antibiotics. In the first randomised study ceftazidime (45 patients) proved to be statistically superior (p less than or equal to 0.05) to the combination of cefotaxime and gentamicin (45 patients). The poor results of the latter combination - 49% clinical responses compared with 71% for ceftazidime - have been confirmed by the EORTC study group of Klastersky (1). The second study aimed at 30 patients who failed to respond to cefotaxime and gentamicin. All bacteriologically documented infections were cured with ceftazidime. The clinical response rate was 73%. In the third randomised study we compared ceftazidime plus flucloxacillin in 49 patients in order to extend the spectrum to resistant staphylococci with a ceftazidime monotherapy (51 patients). The addition of flucloxacillin did not improve the results substantially. The overall clinical response rate was 81% with the combination and 85% with ceftazidime alone. In the fourth study on 23 patients with allogenic bone marrow transplantations, receiving cyclosporin A as prophylaxis against graft versus host disease, no nephrotoxic effect was observed. The fifth study comprised 20 patients over 65 years of age, in whom no toxicity different from younger patients was seen. In the sixth study with 51 patients per group we compared ceftazidime with the combination ceftazidime plus cephalothin. This study demonstrated an increased efficacy of the combination against Staphylococcus epidermidis and proved that two different cephalosporins, given simultaneously, are not antagonistic. Analysis of 34 Pseudomonas septicaemias in the seventh study with a clinical success rate of 94% demonstrated clearly the potency of ceftazidime against this particularly dangerous organism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312030 TI - [Ceftazidime versus cefotaxime in the therapy of severe infections in intensive care patients]. AB - In a randomized controlled, clinical study the efficacy of ceftazidime at a dosage of 2 g b. i. d. was compared to that of cefotaxime at a dosage of 2 g t. i. d. or more in the treatment of pneumonia or peritonitis in intensive care patients. 61 of 67 assessable cases were evaluable. In the ceftazidime group ten out of 11 patients with pneumonia and 17 out of 20 with peritonitis showed a clinical success. In the cefotaxime group 15 out of 19 patients with pneumonia and eight out of 11 with peritonitis were clinically cured or improved. With ceftazidime an overall success was achieved in 87% of the patients (27 out of 31) and with cefotaxime in 77% of the patients (23 out of 30). Two patients in the cefotaxime group developed a reinfection. Five of the patients treated with cefotaxime and four of those treated with ceftazidime were therapeutical failures. Escherichia coli, Pseudomonas, Klebsiella, Enterobacter and Proteus species as well as Staphylococcus aureus and enterococci were the most frequent organisms isolated prior to therapy. Following ceftazidime therapy 30 of the 32 gram-negative species were eliminated, whereas in the cefotaxime group the number of gram-negative species isolated was reduced from 28 to ten. Gram-positive species isolated in ten cases prior to therapy, were still present in seven cases after ceftazidime therapy and the number of gram-positive organisms was reduced from 19 to ten following treatment with cefotaxime. In one patient therapy with ceftazidime was stopped due to urticaria. Reversible leukopenia was observed in a patient treated with ceftazidime and a cholestatic reaction in a patient treated with cefotaxime. In both groups a slight elevation of transaminases was seen. PMID- 3312031 TI - [Treatment of intra-abdominal infections with beta-lactam antibiotics. Results of some controlled prospective studies]. AB - Between April, 1980 and August, 1985, 240 patients were operated on for localised or generalised intraabdominal infection and in addition received anti-microbial therapy. Thirty-one patients were treated with latamoxef, 33 with ceftazidime, 20 with ceftriaxone, 47 with imipenem/cilastatin, and 109 with a combination of aminoglycosides and clindamycin (control group). The indications for surgery included: post operative peritonitis; gall bladder empyema; perforated gastroduodenal ulcer; perforation of the small intestine with or without ileus; perforated appendicitis; perforation of the colon. On average, treatment with latamoxef amounted to 12 days, with ceftazidime: 9.4 days, with ceftriaxone 8.4 days and with imipenem/cilastatin 6.7 days. The clinical success occurred in 84% of those treated with latamoxef, 79% for ceftazidime, 50% for ceftriaxone and 81% for imipenem/cilastatin. The rate of clinical success for patients treated with an aminoglycoside/clindamycin combination was 58%. The effectiveness of the beta lactam antibiotics studied was at least equal to that of the aminoglycoside/clindamycin combination. The beta-lactam antibiotics had the advantage of a simpler clinical application, unlike treatment with aminoglycosides, where serum level monitoring is necessary. These clinical results were not as a rule improved upon following an extension of the period of treatment by one week. PMID- 3312032 TI - [Ceftazidime with and without tobramycin versus azlocillin plus tobramycin in the therapy of bronchopulmonary infections in intensive care patients]. AB - In a still ongoing open, randomized prospective trial the preliminary data of 50 intensive care patients on artificial ventilation were analysed. The evaluation included clinical and bacteriological efficacy and tolerance of ceftazidime alone or in combination with tobramycin versus azlocillin plus tobramycin. Artificially ventilated patients who had been treated in an intensive care unit for at least five days were selected to enter the study because of a high probability of colonisation with gram-negative bacteria. 16 patients were treated for bronchopulmonary infection with ceftazidime alone, and 17 each were treated with ceftazidime plus tobramycin or with azlocillin plus tobramycin. In the ceftazidime group nine patients were cured and three were improved (75% clinical success). Of the patients treated with ceftazidime plus tobramycin, 11 were cured and one was improved (75% clinical success); one patient died from very severe multiple trauma. In the azlocillin-tobramycin group, six patients were cured and two were improved (57% clinical success). Two patients from this group died from their underlying disease and another died from multiple organ failure due to septicemia. PMID- 3312033 TI - [Comparison of the effectiveness of ceftazidime and cefazolin/tobramycin in patients with inflammatory diseases of the lower respiratory tract]. AB - We compared the efficacy of ceftazidime and cefazolin in combination with tobramycin in the treatment of lower respiratory tract infections. Bacterial pathogens were isolated from sputum or bronchial secretions from 92 patients. The clinical results were identical in both groups: All patients showed an improvement of the clinical symptoms or were cured. 88% of the patients in the ceftazidime-group and 76% of the patients in the cefazolin/tobramycin-group showed an eradication of the pathogens without superinfection. This difference was not statistically significant (p = 0.095). Monotherapy with ceftazidime was clinically and bacteriologically as effective as a combination therapy with cefazolin and tobramycin. PMID- 3312034 TI - [Clinical and bacteriologic effectiveness of ceftazidime in infections with gram positive pathogens]. AB - From June 1984 to March 1985 an open, multicenter study was carried out to evaluate the efficacy and safety of ceftazidime in the empirical treatment of severe nosocomial infections. 3799 patients treated in 513 clinical care units were included and 3477 were evaluable. The majority was older than 60 years; most patients showed severe underlying diseases and were in a critical condition. The clinical and bacteriological results with various monoinfections due to gram positive bacteria are presented. Staphylococcus aureus, Streptococcus pneumoniae and other streptococci were the most frequently isolated organisms. 600 patients with infections due to staphylococci were evaluated separately. The clinical success rate with ceftazidime in S. aureus monoinfections was 90.9%, and the bacteriological success rate was 74.9%. PMID- 3312036 TI - [Ceftazidime in the treatment of pediatric infections--a review]. PMID- 3312035 TI - [Treatment of infections of the lower urinary tract caused by multiresistant gram negative pathogens, with ceftazidime in monotherapy of patients with spinal cord injuries]. AB - In 53 spinal cord injury patients with neurogenic bladder suffering from severe infections caused by multiresistant gram-negative pathogens, treatment with ceftazidime at a fixed dosage schedule of 2 g i.m. for seven days, yielded an overall cure rate of 86.5%. In view of the fact that 28 episodes (52.8%) of acute infection were caused by highly resistant strains of Pseudomonas aeruginosa and considering the many aggravating factors due to the recent polytrauma and paraplegia, we consider the therapeutic results as highly satisfactory. In spinal cord injury patients in whom urinary tract infections are notoriously difficult to cure, repetitive therapy with the potentially nephrotoxic aminoglycosides should be avoided. Ceftazidime offers a valuable alternative with minimal risk of drug toxicity. PMID- 3312037 TI - [Experiences with ceftazidime in the therapy of neonatal infections]. AB - Our experience of ceftazidime during the last three years has in almost every respect been favourable. As monotherapy it has resulted in clinical responses at least as good as those from gentamicin and ampicillin. The pharmacokinetics and activity of ceftazidime are far superior to those of gentamicin. We have not been able to demonstrate any significant haematological or biochemical side effects of ceftazidime therapy nor does it adversely affect neonatal blood clotting mechanisms. The incidence of superficial candidosis has not changed during the last three years. Use of third generation cephalosporins has resulted in an increase in neonatal colonisation with faecal streptococci but this has not resulted in any clinical problems. We have not observed any increase in the number of isolates of Enterobacter spp. nor has there been an increase in the number of ceftazidime resistant microorganisms including Clostridium difficile, since ceftazidime was introduced. Drug accumulation does not occur in neonates receiving 25 mg/kg 12 hourly and throughout the dosage interval the serum therapeutic ratio for ceftazidime against common neonatal pathogens is superior to that of gentamicin with penicillin or ampicillin. PMID- 3312039 TI - The controversy about the artificial heart: artificial organs in today's health care. PMID- 3312040 TI - Clinical significance of blood-device interaction in hemodialysis. A review. AB - The syndrome of dialysis-associated leukopenia and complement activation by cellulosic membranes, including the so-called "first use syndrome", is reviewed and the pathophysiology of these phenomena is discussed. Subsequently the clinical side effects of hemodialysis, including dialysis-associated hypoxemia, are discussed. The hypoxemia, according to the authors, is mainly related to the loss of carbon dioxide through the dialyser. A minor role may be played by complement activation causing temporary sequestration of leukocytes in the pulmonary capillaries with (asymptomatic) peripheral leukopenia on the one hand and plugging of the pulmonary capillary bed with transient pulmonary hypertension and hypoxemia on the other. The question of dialysis-associated eosinophilia and ethylene oxide hypersensitivity is addressed as also contributing to the first use syndrome. The effects of interleukin release from monocytes and of contamination of the dialysis fluid are briefly discussed. The rare syndrome of silicone rubber spallation with hepato-and splenomegaly is also mentioned and finally the pathogenesis and symptomatology of the beta 2 microglobulin amyloidosis syndrome in long-term dialysis patients is presented. PMID- 3312038 TI - [Rational parameters in the treatment of bacterial meningitis with modern cephalosporins]. AB - Modern cephalosporins are by now well established therapeutic drugs in the treatment of bacterial meningitis. Particularly for gram-negative meningitis they are valuable therapeutic tools. In most cases, they are very efficient and less toxic than former therapeutic regimens. Of course, they cannot replace penicillin G in the therapy of meningitis with penicillin-sensitive bacteria. The advantages and disadvantages of the single compounds, cefotaxime, latamoxef, ceftizoxime, cefmenoxime, ceftazidime, ceftriaxone and cefsulodin have to be evaluated. For safety reasons, monotherapy with these drugs is not recommended because there have been reports of failures and relapses of meningitis even in cases with highly sensitive organisms. They are almost or completely ineffective against a few pathogens in meningitis, such as anaerobes or Listeria monocytogenes. An attempt has been made to evaluate the different compounds for their therapeutic usefulness against different pathogens in meningitis. PMID- 3312041 TI - Antibiotic treatment of chronic central venous hemodialysis catheter infection without catheter removal. AB - Most catheter or shunt infections in hemodialysis patients require the removal of the access before the infection is eradicated. A hemodialysis patient is reported who had multiple previous vascular accesses which failed and thus who had very limited sites for future access placement. When a recurrent Proteus mirabilis catheter infection occurred, a 6-week course of ampicillin intraluminal and tobramycin systematically, eradicated the infection and thus the central venous catheter was salvaged. Serum bactericidal levels with these two antibiotics were obtained early in the course and supported the continued use of antibiotics alone to treat the infection. PMID- 3312042 TI - Temporary implantation of the Berlin artificial heart system. PMID- 3312043 TI - Computerized ultrasonic image analysis for placental characterization in normal and hypertensive pregnancies. AB - A technique has been developed for characterizing ultrasonic images of the human placenta by computerized image analysis. An ultrasonic image data base has been assembled from routine obstetric scans collected from 112 patients. A region within the placenta was manually identified in each image, and a series of parameters which mathematically describe the image texture in the region of interest was calculated. Our pilot study has shown that gestational age at scan, placental position and the presence or absence of hypertension can all be correlated with the mathematically defined textural descriptors of the ultrasonic placental image. PMID- 3312044 TI - The athlete's heart syndrome. AB - The athlete's heart is a benign condition, associated with physiologic alterations that can be detected on physical and laboratory examination. Echocardiography is a particularly useful technique is quantitating cardiac adaptation to exercise training and in screening for cardiovascular disorders that can be deleterious to the athlete. Cardiomyopathies are common causes of sudden death in young athletes, and myocarditis in physically-active young military recruits. Coronary disease is usually implicated in middle-aged athletes such as distance runners. Recent well-publicized deaths in several athletes have focused more attention on the need to detect Marfan's syndrome and cocaine use. Published guidelines such as the 16th Bethesda Conference and recent medical advances like new antihypertensive and antiarrhythmic drugs assist the clinician in counseling and managing athletes with cardiovascular disorders. PMID- 3312045 TI - Changes in the broncho-alveolar lavage fluid in smokers and patients with chronic obstructive lung disease. AB - Direct contact of the cells normally present in the bronchial lumen, such as alveolar macrophages, with air pollutants (e.g. cigarette smoke) can lead to the activation of these cells. This activation is beneficial for the cleaning task these cells have in the bronchial tree, but also leads to the release of chemotactic substances, toxic oxygen radicals, enzymes and mediators responsible for bronchial obstruction. As a first step in these processes, an enhanced chemotactic activity can attract neutrophils to the bronchial lumen, where they help by cleaning the lungs from possible dangerous intruders, but can also cause damage to the normal lung architecture. In the present study concerned with the pathogenesis of chronic obstructive lung disease (COLD), broncho-alveolar lavage (BAL) was performed in 35 individuals, who could be divided on he basis of their history and lung function into normal/nonsmokers, normal/smokers, COLD patients/nonsmokers and COLD-patients/smokers. Neutrophilic chemotactic activity was assayed using Boyden chambers where the patients' own neutrophils were tested. More neutrophils and more neutrophilic chemotactic activity were found in the BAL-fluid of the smokers and COLD-patients. A correlation was demonstrated between the amount of chemotactic activity released during the incubation of cells obtained by BAL and the airway resistance or the airway conductance. These data suggest an enhanced chemotactic activity as one of the initiating factors in the pathogenesis of chronic obstructive lung disease. PMID- 3312047 TI - FFA and insulin response dissociation to gradual short-term food restriction in exercising rats. AB - The present study examines the metabolic and hormonal responses of progressive short-term food restriction in rats at rest and during exercise. The night prior to the experiment, previously cannulated rats were assigned to one of three groups: (A) normal diet, (B) 50% food restriction, and (C) 75% food restriction. They were then run continuously for 50 min at 26 m.min-1, 0% grade. Resting liver glycogen levels were decreased in groups B and C (50% and 92%) while B hydroxybutyrate values were increased in group C only. A similar group main effect (resting and exercise values) of a significant (P less than 0.05) increase in free fatty acid concentrations was found in groups B and C as compared to group A, while a decrease in insulin (P less than 0.01) and glucose (P less than 0.05) concentrations was observed in group C only. Norepinephrine and epinephrine concentrations were increased similarly in all three groups following exercise. Resting muscle glycogen levels were progressively reduced following food restrictions. These results indicate that (1) food deprivation at rest and during exercise first affects free fatty acid concentrations and thereafter the insulin response, (2) prolonged exercise following food restrictions increases the metabolic adaptative state of the resting organism. These findings are in disagreement with a sole action of pre-exercise insulin as a determinant of metabolic responses to exercise and provide evidence to the concept that a progressive reduction in liver glycogen might constitute a stimulus for the early free fatty acid response. PMID- 3312046 TI - Review on sobrerol as a muco-modifying drug: experimental data and clinical findings in hypersecretory bronchopulmonary diseases. AB - Sobrerol is an agent with a terpenic structure used to modify mucus characteristics in patients with hypersecretory bronchopulmonary diseases and this review is aimed at listing and discussing all the scientific evidence on this drug. All the toxicological findings testify its excellent tolerability and very low toxicity. In the pharmacological section of the review the effects of sobrerol on mucus production and its characteristics are discussed together with its effect on experimental models. A number of open clinical trials suggesting a therapeutic potential activity of the drug is examined together with a series of randomized double-blind clinical trials confirming its efficacy in relieving obstructive symptoms in chronic bronchitic patients. PMID- 3312048 TI - A promising novel therapy for Achilles peritendinitis: double-blind comparison of glycosaminoglycan polysulfate and high-dose indomethacin. AB - In this double-blind trial in 60 recreational athletes suffering from Achilles peritendinitis, we compared the effect of local injections of glycosaminoglycan polysulfate (GAGPS) with oral indomethacin (IM) administered over a 2-week period. Orthotic devices were prescribed in 66% of the cases to control biomechanical errors. The results after 1-year follow-up showed that GAGPS had a good overall therapeutic effect on two-thirds of the patients compared to one third of the IM treated. In the patients with symptoms lasting longer than 3 months, IM had an effect in only 12% while GAGPS was beneficial in 59%. Twenty five cases of non-responders and relapses underwent a crossover treatment. Those who received IM in this second period did not benefit from this treatment while those who received GAGPS showed a moderate to good effect in 8/17 (47%) after a 2 week follow-up. A different mode of action is suggested as an explanation of the encouraging results. PMID- 3312049 TI - Effects of age, obesity and growth-hormone on adipogenic activity in human plasma. AB - The potential was examined for insulin, growth hormone and insulin-like growth factor (IGF-1) alone or in combinations to stimulate glycerophosphate dehydrogenase (GPDH) activity, a sensitive marker of differentiation of adipose precursor cells in primary culture. Insulin, but not growth hormone or IGF-1, stimulated GPDH in the presence of fetal calf serum and cat serum. The content of growth hormone in adult rat heparinised plasma seemed, however, important for such stimulation, but was also dependent on feeding status of the plasma donor, and was abolished by hypophysectomy of the cell donor. GPDH activity was then analysed in heparinised plasma in the over-night fasting state in humans to examine a potential influence of age, obesity and pregnancy. In comparison with non-obese adults, GPDH-stimulatory activity was higher in plasma from infants and small children. A similar trend was seen in plasma from teenagers. This activity was probably partly dependent on growth hormone, because this increase of activity could be inhibited by excess of anti-human growth hormone antiserum. Obesity in adulthood or among teenagers was not associated with any difference in plasma activity to stimulate cellular differentiation, and plasma from women during late pregnancy had a low stimulating capacity. Simultaneous analyses of the potential of plasma to stimulate lipid accumulation in adipose precursor cells was proportional to the triglyceride concentration. Overall, the inhibitory effect of antihuman growth hormone antiserum on the differentiating capacity of human plasma was small or non-existing. It is therefore suggested that in human plasma, factors other than growth hormone might be important for the differentiation of adipocyte precursor cells. PMID- 3312050 TI - Horizontal or vertical banded gastroplasty after pretreatment with very-low calorie formula diet: a randomized trial. AB - Horizontal and vertical banded gastroplasty (GP) were compared as to their effectiveness and side-effects in patients pre-treated for morbid obesity with a very-low-calorie formula diet (VLCD). The pre-treatment served to select the compliant patients, to minimize the surgical hazard, and to optimize the total weight reduction. Seventy-four consecutive patients (median age 34 years, median body weight 125.1 kg, and median overweight 93 per cent) were included according to the criteria for entry. The median weight loss on VLCD was 25.7 kg (range, 5.8 92.6 kg) and the median overweight reduction reached 46 per cent of the initial overweight (range, 9-83 per cent). Only few and mild side-effects were observed. Sixty-nine per cent of the patients fulfilled our criterion for surgery by reducing their initial overweight by at least 40 per cent. Of these, 23 and 22 patients were assigned respectively to either vertical banded or to horizontal GP. Patients and dietitians were not informed of the assignment. A significant weight loss occurred in both groups. Three months after surgery weight loss after vertical banded GP proved to be the larger (P less than 0.001). The difference became even more pronounced due to an earlier regain among patients treated with the horizontal GP. Thus, at 12 months, the net weight loss after surgery was 9.7 kg (range, -28.2-28.7 kg) in the vertical banded GP group and -1.0 kg (range, 15.0-36.5 kg) in patients treated with horizontal GP (P less than 0.0005). At this time, the total weight loss in the groups was 48.5 kg (range, 6.4-104.0 kg) and 32.6 (range, 3.7-125.1 kg) respectively (P less than 0.02), and the total reduction of overweight was greater in the group treated with vertical banded GP (80 per cent (range, 10-96) versus 56 per cent (range, 8-92), P less than 0.005). There were no deaths, and side-effects to VLCD as well as to GP were generally mild. It is concluded that vertical banded GP is more effective than horizontal GP and that the former operation adds a significant weight loss to that obtained by VLCD. The combined treatments offer a weight reduction comparable to that observed after jejunoileal bypass. However, some regain within 1 year makes it questionable if the vertical banded GP is sufficient to prevent weight regain. PMID- 3312051 TI - Insulin increases triglyceride secretion rate in rats in vivo. AB - To investigate whether insulin regulates triglyceride secretion from the liver in vivo, triglyceride secretion rate (TGSR) and serum insulin were measured in the following three experiments: in rats 12 weeks after ventromedial hypothalamic (VMH) lesions (Exp. 1), in rats 12 weeks after a high fat diet-feeding (Exp. 2), and in rats 10 days after streptozotocin treatment (65 mg/kg) (Exp. 3). Under hexobarbital anesthesia, overnight fasted rats were bled for measuring insulin and triglyceride. Rats were again bled 45 and 90 minutes after Triton WR 1339 (120 mg) injection, for measuring triglyceride. TGSR was calculated from serum triglyceride values measured before and after Triton injection. In Exp. 1, VMH obese rats had higher serum insulin concentrations and TGSR than control rats. There was a significantly positive correlation between serum insulin concentrations and TGSR in VMH lesioned rats alone (r = 0.939, P less than 0.001) and in VMH lesioned and control rats combined (r = 0.958, P less than 0.001). In Exp. 2, high fat diet-fed rats gained more weight than control rats, but they had the same levels of serum insulin concentrations and TGSR as those of control rats. In Exp. 3, streptozotocin treated rats had lower serum insulin concentrations and TGSR than control rats. There was a significantly positive correlation between serum insulin concentrations and TGSR in the two groups of rats combined (r = 0.680, P less than 0.05). From the results of these three sets of in vivo studies, we conclude that insulin increases TGSR in vivo. PMID- 3312052 TI - Regional adipose tissue metabolism in men and postmenopausal women. AB - The metabolism of subcutaneous abdominal and femoral fat cells was studied in postmenopausal women and matched men of similar age and weight index. Lipoprotein lipase (LPL) activity was similar in both regions in the postmenopausal women. However, a group of women who underwent treatment with estrogen and progestins had considerably higher LPL activity in the femoral cells. Testosterone treatment for 7 days did not change LPL in either region in middle-aged men. Femoral adipocytes from both men and postmenopausal women were markedly unresponsive to catecholamine in comparison with abdominal cells. No clear effect of the sex hormones was seen on lipolysis in the women. Treating men with testosterone increased basal lipolysis in the abdominal cells. Abdominal fat cells were more responsive to the antilipolytic effect of insulin. Both responsiveness and sensitivity to insulin were somewhat greater in the abdominal fat cells from men (ED50 approximately 0.02 nm) than from women (ED50 approximately 0.17 nm). Insulin binding, however, was similar in fat cells from the abdominal and the femoral regions when the results were expressed per unit surface area. Thus, regional differences in fat cell metabolism are seen in both postmenopausal women and elderly men. LPL activity in the femoral region seems to be under the control of female sex hormones while lipolysis appears to be less influenced by sex hormones. PMID- 3312053 TI - Conformational analysis of pepstatin and related renin inhibitors by 400 MHz 1H n.m.r. spectroscopy. AB - The conformational behaviour of pepstatin (Iva-Val-Val-Sta-Ala-Sta) and of two derived renin inhibitors, Boc-Phe-Nle-Sta-Ala-Sta-OMe, 1, and Boc-Phe-Nle-X-Ala Sta-OMe, 2 (X = -NH-CH(iPr)-CHOH-CH2-CO-) was assessed in DMSO-d6 at various temperatures and in deuteriopyridine at -35 degrees. Complete assignment of almost all proton signals was achieved by 2D COSY, 2D NOESY and selective NOE experiments. The three compounds show similar extended conformations in both solvents, with the hydrophobic lateral chains extending away from the peptide backbone. In the case of pepstatin the solvated conformation is closely related to the structure found in the crystal of the pepstatin-Rhizopus chinensis complex. Strong NOE effects and precise determination of vicinal coupling constants show the lack of large structural differences between 1 and 2 at the level of the internal Sta or X residues, which are assumed to interact with the aspartyl residues of the renin active-site. This suggests that the 100-fold lower inhibitory potency of 2 is mainly due to unfavorable close contacts of the beta branched residue X with constituent amino acids of the enzyme. PMID- 3312054 TI - H. A. Rosenfeld (1910-1986). PMID- 3312055 TI - [Diagnosis of dental age in medico-legal dentistry. Methods and comparisons]. PMID- 3312056 TI - [The problem of margins in reconstructive dentistry: analysis of the literature]. PMID- 3312057 TI - Major E. coli heat-stress protein do not translocate: implications for cell survival. AB - When Escherichia coli are exposed to heat stress, the majority of proteins in the process of synthesis at the time of heat stress are rapidly translocated to the outer membrane of the bacterium. The synthesis of most of these proteins appears to take place on membrane-bound polyribosomes. With the temperature shift, overall protein synthesis is inhibited while the synthesis of a small group of proteins is initiated. These proteins are not translocated, but remain in the cytosolic compartment, and they are identifiable as heat-stress proteins. Both the translocation phenomenon and the retention of heat-stress proteins in the cytosolic compartment in proximity to the nucleoid could counteract the effects of heat stress. The translocated proteins may operate by stabilizing the outer membrane prior to the induction of heat-stress proteins and the latter, which are confined to the cytoplasmic compartment, may serve to protect the integrity of the nucleoid structures. PMID- 3312058 TI - Proteinase activity in effusions from children with otitis media with effusion. AB - Proteinase activity has been demonstrated in middle ear effusions from patients suffering from otitis media with effusion. Proteinase activity was characterized by various biochemical, chemical and physical parameters. Chelators and sulfhydryl group reacting substances reduced the enzyme activity. Enzyme activity was positively correlated to the number of granulocytes present in the effusion. No correlation to bacteriological findings or to tympanic membrane status was seen and the proteinase activity showed wide ranges within different categories of middle ear effusions. PMID- 3312059 TI - The kindling effect as a model system of sensitization and arousal. AB - The purpose of this paper is to examine the relationship between the general processes of arousal and sensitization and the response increment processes at the cellular level, which have been considered as model systems of behavioural plasticity, i.e. the kindling effect and long-term potentiation in hippocampal pathways. From the published literature it appears that kindling and potentiation may be considered as model systems of sensitization and arousal. Moreover, research on these potentiation effects gives support to the hypothesis of specific arousal systems in the brain which mediate learning and memory. It is proposed that a multidisciplinary approach, including data from behavioural neurobiology and from psychophysiological studies, can contribute to better knowledge of the biological basis of learning. PMID- 3312061 TI - Prostatic cancer protruding into the bladder imaged by transurethral and transrectal ultrasound. AB - A case is described in which the nature of the tumour mass found in the bladder could be evaluated by combining transurethral and transrectal ultrasound. PMID- 3312060 TI - Finding of a bladder stone from the Avar period in southeast Hungary. AB - In the course of a disinterment of an ancient Avar burial place at Szekkutas Kapolna near Hodmezovasarhely, Hungary, the archaeologist conducting the excavations, Miss Katalin B. Nagy, noticed a lithoid body of oval shape in the pelvis of a skeleton. The find was identified on morphological and chemo analytical grounds as a bladder stone. In view of its rarity and its palaeopathological interest, it is described in detail. It is also expected to draw the attention of archaeologists to the possibility of similar findings. A brief review of the pertinent literature is given. PMID- 3312062 TI - Hormonal changes in haemodialysed and in kidney-transplanted patients. AB - A total of 48 haemodialysed patients were studied by radioimmunoassay for the serum concentrations of parathormone, calcitonin, gastrin, insulin, prolactin, T3, T4, rT3, TSH and cortisol. Residual urines were measured for cAMP and ultrafiltrates for iPTH and gastrin. The duration of the dialysis programme, the number of haemodialysis sessions per week, sex distribution, the dialysis alternatives (including haemofiltration, haemoperfusion) and successful kidney transplantations were correlated with the serum hormone levels. Significant increases in PTH, gastrin and prolactin values were demonstrated in the dialysed patients. However, their calcitonin and insulin concentrations decreased, parallel with the time elapsed since the start of the haemodialysis programme (HDP). The number of dialysis sessions per week was found to affect the hormone concentrations diversely. In the course of haemofiltration and haemoperfusion some of the hormone levels (e.g. PTH, gastrin) decreased significantly. The patients were in general euthyroid. One of them, on HDP for several years, developed clinical and laboratory signs indicative of hyperthyroidism. In a considerable proportion of the cases the results of the hormone studies (increased PTH, CT, cAMP) were consistent with secondary hyperparathyroidism. Kidney transplantation was followed by a decline of the serum prolactin, parathormone, calcitonin and aldosterone levels. PMID- 3312064 TI - Cyclosporine in the treatment of steroid resistant rejection episodes in living donor kidney transplants. AB - Cyclosporine had been used to treat steroid resistant rejection episodes in 24 living related donor kidney transplants. The rejection episodes as well as their response to cyclosporine were documented by graft biopsies and/or fine needle aspiration cytology. Ten similar patients suffering from steroid resistant rejection episodes were not given cyclosporine. These cases were evaluated and their outcome was compared to those who received cyclosporine therapy. In the 24 cases who received cyclosporine, there was complete reversal of the rejection episodes in 11, partial reversal in 6, arrest of the rejection crisis in 4 and failure in 3. In all the 10 cases without cyclosporine therapy the grafts were found to be lost. It was concluded that cyclosporine can cure established rejection episodes even when severe and steroid resistant. PMID- 3312063 TI - Evaluation of imaging methods in the diagnosis of vesical tumours. AB - Literary data and personal experience furnished ground for assessing the value and determining the proper employment of imaging methods as used in the detection of bladder carcinoma. It seems highly advisable to perform native radiography and excretion urography. Upon the recording of a transabdominal echogram, intravesical ultrasonography, performed under narcosis simultaneously with biopsy and cystoscopy, constitutes an ideal complement to the latter and has proved to be the most effective diagnostic method to detect a carcinomatous infiltration of the bladder wall. Extravesical propagation is assessed with the help of CT whose degree of reliability increases in proportion with the progression rate of the tumour. Foot-dorsum type lymphography only visualizes juxtaregional lymph nodes, endovesical lymphography the regional ones. Additional modes of metastasis detection include chest X-ray, liver-spleen scintigraphy and bone scintigraphy. Uretero-entero-anastomosis must be preceded by irrigoscopy. PMID- 3312065 TI - Organization, structure, and evolution of mammalian mitochondrial genes. PMID- 3312066 TI - Evolution of reaction centers in photosynthetic prokaryotes. PMID- 3312067 TI - [Muscle pain]. PMID- 3312068 TI - [Muscle pain. Clinical, radiologic, neurophysiologic and biopsy diagnosis]. PMID- 3312070 TI - [Metabolic myopathies]. PMID- 3312071 TI - [Toxic causes of muscle pain]. PMID- 3312069 TI - [Inflammatory muscular diseases]. PMID- 3312072 TI - [Determination of LDL and beta-cholesterol in serum. Clinical significance and methodologic possibilities]. PMID- 3312073 TI - [Abdominal pain attacks and hyponatremia]. PMID- 3312074 TI - [Acute malignant myelofibrosis complicated by factor XIII deficiency, protein C decrease and skin necroses]. PMID- 3312075 TI - [Recurrent pleural effusion in a 40-year-old male over a ten-year period]. PMID- 3312076 TI - Localization of laminin to retinal vessels of the rat and mouse using whole mounts. AB - Using a whole mount procedure in adult and neonatal mice and adult rats, we have developed an immunohistochemical method for the localization of laminin-like immunoreactivity (LLIR) to the retinal vessels. LLIR was localized to the vascular basement membrane, permitting a clear three-dimensional view of the retinal vasculature. Positive stain was seen in the inner limiting membrane, in retracted capillaries, encasing pericytes, and in a banding pattern on retinal arterioles. The major findings with the whole mount preparations were confirmed using paraffin-embedded material, with the additional observation of LLIR in the lens capsule. In whole mounts of retinas from neonatal mice, LLIR was present from the earliest stages of capillary growth, indicating that laminin is likely to be secreted by endothelial cells during retinal angiogenesis. LLIR within the retinal nerve fiber layer does not precede capillary ingrowth, so no evidence was found that laminin acts as a tracker signal for retinal angiogenesis. PMID- 3312077 TI - Growth of retinal capillary endothelia using pericyte conditioned medium. AB - Long-term cultures of bovine retinal capillary endothelial cells (BRCEC) have been established using bovine retinal pericyte conditioned medium (PCM). PCM had greater mitogenic activity on BRCEC than unconditioned medium (P less than 0.01). The mitogenic activity of PCM was not cell specific since bovine Tenon's fibroblast conditioned medium also had significant activity. PCM's activity was not enhanced by heparin though it was additive to that of retinal crude extract. PMID- 3312078 TI - Demonstration of insulin-specific mRNA in cultured rat retinal glial cells. AB - A number of studies have recently demonstrated that insulin may be synthesized outside the pancreas. The present study was designed to investigate whether insulin-like activity exists in retinal glial cells and if so, whether it is due to local synthesis of insulin. Immunocytochemical techniques using insulin antisera were applied to cultured rat retinal glial cells, and insulin-like immunoreactivity was demonstrated in the cytoplasm of these cells. In situ DNA RNA hybridization studies using 3H-labeled rat insulin cDNA indicated that the glial cells, particularly the Muller cells of the retina also contained the mRNA necessary for de novo synthesis of insulin or a closely homologous peptide. This peptide may be important in neuromodulation or regulation of metabolism of retinal cells and capillaries. PMID- 3312079 TI - 5-Methyltetrahydrohomofolate. AB - 5-methyltetrahydrohomofolate was developed in the 1970's as an antifolate with the potential to overcome methotrexate resistance. This review summarizes the preclinical and clinical data which have accumulated to date. It is concluded that more recent, better characterized antifolates offer greater potential in achieving the goals for which this drug was introduced. PMID- 3312080 TI - Absolute and relative activities of platinum-complexes on human tumors as evaluated by an antimetabolic in vitro assay. AB - An in vitro assay, which evaluates drug effect on 3H-thymidine incorporation, was used to investigate the absolute and relative activities of cisplatin (DDP), carboplatin (CBDCA) and iproplatin (CHIP) on 317 specimens from untreated tumors, including breast and ovarian cancers and malignant melanomas. Similar activities were generally observed for DDP and CHIP, whereas CBDCA exhibited a lower, although not significantly different cytotoxicity on breast and ovarian cancers. The relative activities of Platinum analogues were analyzed on 239 two-way drug sensitivity comparisons. The overall agreement rates ranged from 80.2 to 83.9% for the different comparisons. High coresistance, from 61.1 to 93.8%, was observed for all the comparisons, regardless of the tumor type. Cosensitivity rates were poor for breast and ovarian cancers, from 0 to 37.5%, whereas for melanomas an association in sensitivity was observed in 80% of the cases. PMID- 3312082 TI - Breast lesions examined by digital angiography. PMID- 3312081 TI - Cytostatic effects of radiographic contrast media in synchronized cell cultures. AB - The cytostatic effects of conventional high osmolal ionic contrast media (meglumine-calcium metrizoate and Na-metrizoate) and new low osmolal nonionic contrast media (iohexol and iopamidol) in synchronized cell cultures were tested. The cell-cycle prolongation was most pronounced when the contrast media were added in the G1 phase, but there was also a marked effect when the contrast media were added in the S phase or late in the G2 phase. The cytostatic effect even persisted into the first cell cycle following the termination of the exposure. All four contrast media exerted effects stronger than that of equiosmolal saline. Iohexol and iopamidol produced a more severe effect than meglumine-calcium metrizoate and Nametrizoate at equal osmolality. Thus, the cytostatic effect of contrast media cannot be explained only by hypertonicity; the contrast media must have an additional specific cytostatic effect. When the cytostatic effect was related to iodine concentration, the new low osmolal nonionic contrast media influenced the cell cycle less than the conventional high osmolal ionic contrast media. PMID- 3312083 TI - Gonadotrophin releasing hormone therapy in gynaecology--new horizons. PMID- 3312085 TI - Melorheostosis--a case report. PMID- 3312086 TI - Gestational assessment. PMID- 3312084 TI - Pulsatile LHRH therapy for induction of ovulation in patients with hyperprolactinaemia and bromocriptine intolerance. PMID- 3312087 TI - Magnesium: the forgotten cation. PMID- 3312088 TI - Biographical sketch. Brunner. PMID- 3312089 TI - Conservative treatment in the clinical stage T1N0 of breast cancer. AB - A 18-year experience with 643 cases operated for breast cancer is reported. 161 cases belonged to the clinical stage T1N0: 78 underwent modified radical mastectomy (group 1) and 83 underwent conservative surgery (group 2). Conservative treatment consisted in quadrantectomy and axillary dissection of 1st, 2nd and 3rd level with postoperative radiotherapy (5000 rad). Within the two groups the patient's characteristics were homogeneous with juxtaposable curves of overall and disease-free survival after modified radical mastectomy and after conservative surgery. In 15.38% of cases undergoing modified radical mastectomy and in 13.25% of cases undergoing quadrantectomy, histologic examination showed the presence of lymph node metastases (pT1N1) not identified at the clinical examination. The analysis of results showed that early neoplastic recurrence is almost exclusively limited to cases pN1, but the fall in the survival curve it similar in group 1 as well as in group 2. Therefore it should be understood that the prognostic risk is related to positive lymph nodes and not to the chosen treatment. Postoperative complications, irrelevant in group 1, tend to disappear in group 2. The cosmetic result after conservative surgery was excellent in 37.3%, satisfactory in 54.2% and poor in 8.4% of cases, respectively. PMID- 3312090 TI - Intrarectal ultrasonography in the preoperative staging of rectal cancer. AB - Intrarectal ultrasonography is a new imaging method used in the preoperative staging of rectal cancer. Twenty five patients with proven rectal cancer were submitted to preoperative intrarectal ultrasonography; 24 were resected. Real time scanner with a linear probe of 5 MHz was employed. Five sonographic structures corresponding to the five histological layers were evidenced. Ultrasound T staging was compared to pathology, using UICC classification. In all but two cases pathology corresponded to ultrasound T staging (accuracy 92%). Perirectal nodal involvement was also investigated. It is concluded that intrarectal ultrasonography will play a definite role in the preoperative staging as well as in programming treatment of rectal carcinoma. PMID- 3312091 TI - The Emmy Klieneberger-Nobel award lecture. Appealing attributes of mycoplasmas in cell biology research. PMID- 3312092 TI - The Derrick Edward award lecture. Immunologic aspects of Mycoplasma arthritidis induced arthritis. PMID- 3312093 TI - Cloning and expression of Acholeplasma laidlawii membrane acyl proteins in Escherichia coli. AB - Many integral membrane proteins in Acholeplasma laidlawii are enriched in hydrophilic amino acid residues and covalently modified with fatty acids. In order to understand how these proteins are inserted and anchored in the bilayer, we have cloned several of the major A. laidlawii proteins in Escherichia coli: 900 recombinant clones containing 4-kbp DNA fragments, inserted into the BamHI site of the plasmid pAT 153, were screened with antibodies. With antimembrane antibodies, 26 positive clones were detected, and with a mixture of five different monospecific antibodies, another 7 clones were obtained. Immunological analysis of the colonies in situ verified that antigens for A. laidlawii membrane proteins D12, T2, T3, T4a, and unidentified proteins were produced in separate clones. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) followed by immunoblotting showed several fragments [25 to 94 kilodalton (kDa)] for each of these proteins, some of which were even visible on Coomassie Blue stained gels. It is concluded that A. laidlawii membrane proteins can be efficiently expressed in E. coli. PMID- 3312094 TI - Localization of spiralin in Escherichia coli cells transformed with the recombinant plasmid pESI. AB - The expression of spiralin in the transformant strain HB101 Tsp of Escherichia coli has been investigated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), immunodetection after electrotransfer, and crossed immunoelectrophoresis. The protein has been sought in whole cells, cytoplasm, and plasma and outer membranes of the bacterium. Untransformed E. coli cells and Spiroplasma citri cells were used as negative and positive references, respectively. Contrary to earlier claims, spiralin was detected not only in the cytoplasm of E. coli, but also in the inner and outer membranes. In addition, our results show that the protein was not secreted by the bacterium. Three forms of spiralin could be distinguished with respect to differences in apparent molecular mass: 27.5, 29.5 and 30 kilodalton (kDa). The presence of the high molecular mass polypeptide in the two membranes of E. coli invalidates the hypothesis according to which the 27.5-kDa (or 28-kDa) species is a mature form derived from the 30 kDa (or 30.5-kDa) species by the amputation of a signal sequence. Since spiralin is an acyl protein, the possibility of variation in the extent of acylation of the protein in E. coli, with subsequent variation of the apparent molecular mass, should be taken into account. PMID- 3312095 TI - Genetic control of T cell activation induced by Mycoplasma arthritidis. AB - At least three genes are now known to influence T-lymphocyte activation induced by the soluble mitogen derived from Mycoplasma arthritidis (MAM). The I-E region of the murine major histocompatibility complex (MHC) codes for the synthesis of the E alpha chain of the I-E molecule, which acts as a receptor for MAM. Mouse, rat and human E alpha molecules have a similar structure, and lymphocytes from all of these species can be activated by MAM. However, lymphocytes from the BN rat, which also express this molecule, fail or respond only weakly to MAM and lectin mitogens due to the influence of a non-MHC gene(s). The RIIIS mouse strain also expresses the E alpha receptor site for MAM, but possesses a recessive non MHC gene(s) that is associated with an inability of lymphocytes to respond to MAM without influencing their responses to lectin mitogens. There is evidence that in the BN rat and the RIIIS mouse there is a defect in T cell interactions with the mitogen/accessory cells complex. Evidence is also presented that T-lymphocyte activation in vivo may predispose mice to the toxic and necrotizing properties of viable M. arthritidis. PMID- 3312096 TI - Requirements and selection of an animal model. AB - There are two broad classes of models: those based on analogy (similar structures imply similar functions), and those based on homology (structures derived from the same evolutionary precursor have the same or similar functions). There are four main categories of animal models: 1) induced or experimental models, that attempt to reproduce conditions found in the original species, 2) spontaneous or natural models, that are recognized as being similar to some condition in the original species, 3) negative or nonreactive models, that are the normal counterparts of a disease model, and 4) orphan models, that are animal diseases for which no human or animal counterpart is known. The selection of any model, but particularly animal models, for research should be based on the following considerations: 1) appropriateness as an analog, 2) transferability of information, 3) genetic uniformity of organisms, where applicable, 4) background knowledge of biological properties, 5) cost and availability, 6) generalizability of the results, 7) ease of and adaptability to experimental manipulation, 8) ecological consequences, and 9) ethical implications. The criteria for selection or rejection of particular animal models also include customary practice within a particular discipline, the existence of diseases or conditions that might complicate results, the existing body of knowledge on the problem under consideration, and special features of the animal, such as unique responses or microflora, that may make a particular species useful. PMID- 3312097 TI - Attachment of Mycoplasma hominis to human cell cultures. AB - Clinical isolates, cell-culture contaminants, and the type strain PG21 of Mycoplasma hominis were examined for attachment to erythrocytes and human cell cultures. Strain 13428 (from blood, postpartum fever) and strain 1184 (cell culture) attached to human and guinea pig erythrocytes, but there were no differences in attachment activities between these strains. However, five M. hominis strains isolated from different tissue sites showed quantitative differences in attachment to human WiDr (intestinal carcinoma cell cultures), MRC 5 (human embryonic lung fibroblasts) and HeLa (carcinoma of cervix) cell cultures. The relative attachment activities were, in descending order: strain 1184 (cell culture), strain 11932 (cervix), strain 13428 (blood, postpartum fever), 13408 (nongonococcal urethritis), and type strain PG21 (multiple passage, originally from human rectum). Trypsin and pronase treatment of M. hominis strain 1184 markedly reduced attachment, suggesting that surface proteins play a role in M. hominis attachment to mammalian cells. In subsequent studies, strain 1620 (septic arthritis) showed the highest attachment activity, whereas strain 1652 (surgical skin flap) and L01888 (cell culture) showed attachment activity similar to cell culture strain 1184. The differing attachment activities of these M. hominis strains isolated from different infected sites of patients with a variety of diseases may be relevant to the virulence of these strains. PMID- 3312098 TI - DNA probes for the detection of mycoplasmas in genital specimens. AB - The utility of whole-genomic DNA probes for the detection of infections by genital mycoplasmas was investigated in 220 men attending a sexually transmitted diseases clinic. In 144 patients, probe results were compared with quantitative culture results. The prevalence of Mycoplasma hominis was 11% by culture, whereas the prevalence of ureaplasmas was 38%. The M. hominis DNA probe detected 9 of 16 M. hominis culture-positive specimens and 2 of 128 culture-negative specimens. The Ureaplasma urealyticum DNA probe detected 36 of 57 U. urealyticum culture positive specimens and 18 of 87 culture-negative specimens. Most of the probe negative culture-positive specimens had colony counts of less than 10(3) organisms/ml of specimen. The DNA probe does not require viable organisms, and the probe-positive, culture-negative specimens suggest that false-negative cultures occurred, perhaps due to specimen handling or insensitivity of culture methods for some strains of mycoplasmas. PMID- 3312099 TI - Comparative pathogenicity of Mycoplasma bovis and Mycoplasma dispar for the respiratory tract of calves. AB - Mycoplasma bovis and M. dispar are both important in the etiology of calf respiratory disease, but marked differences are evident in the pathogenesis of disease caused by the two species. Both attach to bovine cells but vary in their invasiveness. M. bovis is capable of invading the lung parenchyma from the airways, while M. dispar predominantly infects the ciliated epithelial cells lining the respiratory tract. M. dispar causes ciliostasis in fetal-bovine tracheal organ cultures, whereas M. bovis does not have the same dramatic effect on ciliary activity. The immunological response of the host contributes to the lesions produced by M. bovis. Both T- and B-lymphocytes accumulate in the lung, which becomes a site for the production of antibody. In contrast, M. dispar produces a mild cellular response in the lungs of calves and may have immunosuppressive properties. PMID- 3312100 TI - Pathogenesis of bovine mycoplasma mastitis. AB - Most bovine mastitis due to mycoplasmas is initiated by passage of mycoplasmas through the teat canal into the teat and gland cisterns. Within a few days, mycoplasma numbers increase to as much as 10(6) or 10(8), and the cows react with a strong inflammatory response. Alveolar epithelium undergoes degenerative changes and exudate replaces milk secretion. The interstitium between alveoli is invaded with lymphocytes, macrophages, plasma cells and fibroblasts. The extent and duration of these changes vary greatly. In milder cases, they may be reversed within days or weeks with a return to normal or reduced milk production. Often, destruction and atrophy of alveoli are complete with extensive fibrosis throughout the udder. Milk ducts may undergo invasive and obliterative fibrosis. Cell-mediated responses are suppressed, while hypersensitivity is suspected of enhancing the adverse responses. Immunity in cows that recover is variable and of limited duration. PMID- 3312101 TI - Immune responses in Mycoplasma bovoculi conjunctivitis. AB - Calves infected with Mycoplasma bovoculi respond with conjunctivitis, extensive colonization of cell-adherent mycoplasmas, and a transient influx of neutrophils to ocular surfaces. Antibody responses can be detected in the circulation and in lacrimal fluid by enzyme-linked immunosorbent assay (ELISA). Serum responses were primarily IgM and IgG and included complement-independent metabolic inhibition activity, while lacrimal fluid responses were primarily IgA and did not exhibit metabolic inhibiting activity. Cell-mediated immune responses also followed the initial infection. In all cases, these immune responses were concurrent with persistent colonization of ocular surfaces. Clearance of persistent infections was observed after variable periods of time and was followed by resistance to challenge. Parenteral presentation of antigen gave similar systemic responses with no lacrimal responses. Animals given antigen parenterally exhibited inflammatory responses and persistent colonization after challenge. These reactions were more intense than those following infections in unstimulated cattle. PMID- 3312102 TI - Taxonomy of the Mycoplasma mycoides cluster. AB - Some of the mycoplasmas found in diseases of ruminants, Mycoplasma capricolum, M. mycoides subsp. capri (PG3), bovine group 7 (PG50), strain F38 and strain Y goat show various degrees of relationship to M. mycoides subsp. mycoides (PG1) and to one another, such that they are referred to as the M. mycoides cluster. Studies using serology, DNA homology, isoenzyme analysis and two-dimensional polyacrylamide gel electrophoresis (2-D PAGE) of proteins have been carried out on the type and reference strains of these organisms and some representative strains in an effort to resolve this cluster into well-defined taxa. An ad hoc committee set up by the Subcommittee on the Taxonomy of the Mollicutes examined the known data, but found that it led to conflicting opinions on the classification of the unspeciated strains, partly because of the lack of guidelines on the relative weight to be given to each criterion, and partly because insufficient strains of each member of the cluster had been examined. Although classifications were proposed, total agreement was not achieved on any one proposal, and the committee believes that decisions on the taxonomy would have to await the results of repeat tests, in which several representative strains of each of the six groups would be included with the type strain. PMID- 3312104 TI - Current status of the serodiagnosis of enzootic pneumonia in swine. PMID- 3312103 TI - Vaccination against contagious caprine pleuropneumonia caused by F38. AB - Only F38 isolates of mycoplasma cause classical contagious caprine pleuropneumonia (CCPP). Therefore, research has focused on the development of a vaccine that will prevent serious epidemics of the disease in goats. Goats immunized with two doses of a lyophilized preparation of isolated F38 organisms administered 4 weeks apart were completely immune to experimentally induced CCPP. The minimum immunizing dose was 0.15 mg, and this dose was still effective after storage for 14 months at 4 C and 22 C. The duration of immunity induced by a single dose of lyophilized F38 was at least 12 months. PMID- 3312105 TI - Epidemiology of Spiroplasma citri in the Old World. AB - Epidemics of citrus stubborn disease (CSD) have been known in the Mediterranean citrus-growing areas as early as 1928. One such outbreak of stubborn disease occurred around 1980 in newly established citrus nurseries on the Syrian coast. Natural transmission of Spiroplasma citri could be shown to be involved. Enzyme linked immunosorbent assay (ELISA) and culture of S. citri were used to detect the presence of S. citri in leafhoppers. Over 50 leafhopper species were submitted to these analyses, not only in Syria but also in Morocco and France (Corsica) from 1978 to 1985. Neoaliturus (Circulifer) haematoceps was the only species found to harbor the spiroplasma in Morocco, Syria and France (Corsica). Leafhoppers of this species were collected in Corsica, raised in Bordeaux and shown to be vectors of S. citri. The search for N. haematoceps in nature has revealed that Salsola kali (Chenopodiacae) is a favored host plant of this leafhopper. This plant has a wide geographical distribution. In Iran, for instance, it is well known, and grows close to sugar beet and citrus-growing areas. In such areas, sugar beet is known to be infected by curly top virus, and citrus by CSD. N. haematoceps is a vector of both of these diseases. N. tenellus, the vector of S. citri in the USA, is present in the Mediterranean area, but in view of its paucity it does not seem to be a major vector there. In Iran, even though less abundant than N. haematoceps, it could play a role in S. citri transmission. PMID- 3312106 TI - Cell-assisted culture of fastidious spiroplasmas: initial analysis of growth factors. AB - Half of the spiroplasmas observed microscopically in insects cannot be cultivated and are thus inaccessible to study. Media mixed with cultured insect cells have now been used to isolate two of these spiroplasmas--the sex-ratio organism (SRO) of Drosophila and the Colorado potato beetle spiroplasma (CPBS). Studies described herein indicate that at least one of the cell-supplied factors is involved in redox maintenance. A wide variety of insect cell culture systems were suitable for primary isolation of the CPBS. The SRO and CPBS were found to attach to insect cells in vitro. PMID- 3312107 TI - Spiroplasma plasmids. AB - Extrachromosomal DNA, constituting plasmids or replicative forms of viruses, has been detected in a variety of spiroplasmas, particularly in Spiroplasma citri. Only a few of the S. citri plasmids were characterized by restriction enzyme mapping, and essentially nothing is known on functions encoded by the plasmids. Our studies revealed in S. citri (R8A2) an 8.0-kbp plasmid that differed from previously described plasmids in its restriction map. It was also clonable in pBR322. The plasmid, named pRA1, was found in large quantities as free plasmid in S. citri (R8A2) subclones of low passage level. In subclones of higher passage levels, free plasmid was replaced by plasmid sequences integrated into the spiroplasma chromosome, as revealed by Southern hybridization blots of digested spiroplasmal DNA with nick-translated pRA1 or its recombinant as probes. Significant quantities of integrated plasmid sequences were also observed in S. kunkelii and in Spiroplasma sp. P40. Small quantities of free and/or integrated plasmid DNA were detected in some spiroplasmas serologically and genotypically remote from S. citri. Chromosome-integrated pRA1 sequences were cloned into the Escherichia coli plasmids pUC13 and M13. Hybridization tests and restriction maps of these clones indicated that the integrated plasmid sequences consisted of small repetitive sequences inserted into specific sites on the spiroplasma chromosome. Despite the large number of the inserts they do not appear to affect significantly gene expression in the spiroplasma. Due to the abundance of free and integrated pRA1 in S. citri, nick-translated pRA1 was effective as a DNA probe in detecting small numbers of S. citri in infected periwinkle plants and leafhoppers. PMID- 3312108 TI - Further characterization of an unusual plant Mollicutes species of uncertain taxonomic status. AB - PPAV is a type of Mollicutes that was isolated in SP4 medium from seeds of apples affected by proliferation, a disease in which mycoplasma-like organisms (MLOs) are involved. However, PPAV is probably not the etiological MLO agent for at least two reasons: 1) optimal temperature growth is 43 C, and 2) in spite of numerous isolation attempts over several years, no second PPAV culture could be obtained. PPAV is surrounded by a single cytoplasmic membrane and forms typical fried egg-shaped colonies on solid medium. The organism grows in simplified mycoplasma media, such as BSR. In growth inhibition, it shows no serological relationships with any other mycoplasmas or acholeplasmas, including those cultured from the surfaces of plants. The absence of relatedness of PPAV to other Mollicutes was confirmed by DNA hybridization studies. The genome of PPAV is close to 10(9) daltons and contains 25.2 mol % G + C. Its genome size is similar to that of Acholeplasma spp. and Spiroplasma spp. It has, however, a clearcut sterol requirement and therefore cannot be an acholeplasma. Neither is it a spiroplasma since, though filamentous in BSR medium, it has never shown signs of helicity. Hence, PPAV is a taxonomical paradox. PMID- 3312109 TI - Mycoplasma hominis in patients with pelvic inflammatory disease. AB - The role of Mycoplasma hominis in pelvic inflammatory disease (PID) was studied among 35 patients with laparoscopically confirmed salpingitis or histopathologically confirmed plasma cell endometritis. M. hominis was isolated from the cervix of 15 patients, from the rectum of 13 patients, and from the endometrium of 5 patients. Only two of these five patients had M. hominis isolated from the endometrium in the absence of Chlamydia trachomatis or Neisseria gonorrheae, the major PID-causing organisms. None of the patients had M. hominis isolated from the fallopian tubes. Of the 35 patients, 7 demonstrated a significant change in enzyme immunoassay antibody levels to M. hominis, suggesting a recent infection with the organism. Six of the seven patients had M. hominis isolated from the cervix, and one had the organism isolated from the endometrium. Compared with patients not having M. hominis isolated from the cervix or endometrium, those who did more frequently had positive serum antibody findings for M. hominis and abnormal gas-liquid chromatographic findings of the vaginal fluid, indicative of bacterial vaginosis. PMID- 3312110 TI - DNA probes for detection and identification of mycoplasmas (Mollicutes). AB - DNA probes are expected to prove a specific, sensitive, rapid and inexpensive means for diagnosis of mycoplasma infections, replacing procedures that depend on cultivation of the fastidious organisms. Probes made up of conserved genes, such as rRNA genes, do offer the advantage of identifying and distinguishing multiple species with a single labeled reagent. The mycoplasmal rRNA gene probe pMC5 was effective in detection and identification of mycoplasmas infecting cell cultures. However, use of pMC5 for detection of spiroplasmas and mycoplasma-like organisms (MLOs) in infected plants was hindered by hybridization of this probe with chloroplast rRNA genes. Moreover, for identifying species and strains by pMC5, a complex hybridization procedure--involving DNA purification, digestion, electrophoresis, and Southern blot hybridization--is required. More specific DNA probes, on the other hand, can identify specific Mollicutes by the much simpler, faster and more sensitive dot blot technique. Thus, a probe made of a cloned Spiroplasma citri plasmid could detect by this technique as little as 10 pg of S. citri DNA (equivalent to about 10(3) organisms) in infected plants and insects. DNA probes specific for Mycoplasma pneumoniae and M. genitalium were selected from genomic libraries and prepared in pUC13 by screening the libraries for inserts hybridizing only with DNA of the specific mycoplasma. The probes, labeled by nick translation with 32P-nucleotides, could detect as little as approximately 100 pg of the specific mycoplasmal DNA by dot blot hybridization. To eliminate radioactivity, the above DNA probes were labeled by biotinylation of sulfonation systems. Dot blot hybridization with these probes showed decreased sensitivity of detection by about one order of magnitude, and some nonspecific background reaction with large quantities of nonhomologous DNAs. PMID- 3312111 TI - Identification and isolation of mycoplasmas by immunobinding. AB - This laboratory has developed an immunobinding assay (IBA) to identify and detect mycoplasmas in a variety of specimens. The specimen is inoculated in volumes of 10 microliters onto nitrocellulose (NC) paper, which is then blocked, fixed, and incubated at room temperature. Specific antimycoplasma polyclonal or monoclonal antibody is first added, followed by peroxidase-labeled antibody directed toward the first immunoglobulin. Alternately, antimycoplasma IgG can be purified and conjugated to horseradish peroxidase for use in a direct assay. Addition of a developing solution results in the formation of purple color when mycoplasmas are present. Titers of rabbit antimycoplasma antisera range from 1:1,000 to 1:30,000. This assay can detect approximately 1 x 10(4) colony-forming units (CFU). This IBA has been used routinely to identify mycoplasmal isolates from 132 infected cell cultures. In addition, the procedure successfully detected Mycoplasma pneumoniae in throat swabs from patients with respiratory illness within 2 h. Perfect correlation was obtained with the IBA and microbiological culture of throat swabs for M. orale, M. salivarium and M. pneumoniae. The procedure was successfully used for other Mollicutes. It detected ureaplasmas in urogenital swabs and corn stunt spiroplasmas in infected corn plants and leafhoppers. A modification of the technique has been developed that identifies mycoplasma colonies on agar. It has also been used to assay for antimycoplasma antibodies in serum. PMID- 3312112 TI - In vitro detection of plant mycoplasmas by immunofluorescent staining with monoclonal antibodies. AB - Hybridoma techniques have been applied to develop specific monoclonal antibodies (McAbs) against spiroplasmas and mycoplasma-like organisms (MLOs). Advantages of the McAbs have been clearly demonstrated in the detection of aster yellows (AY) MLO by indirect enzyme-linked immunosorbent assay (ELISA) and immunofluorescent staining, compared with conventionally produced polyclonal antibodies. McAbs have also been applied in the in vitro detection and identification of spiroplasmas and AY MLOs on membrane filters using modified direct-count immunofluorescent staining. Organisms were fixed with glutaraldehyde and treated with McAbs and fluorescein isothiocyanate (FITC)-conjugated antimouse immunoglobulin, by incubating and concentrating them in a microcentrifuge tube before collecting them on polycarbonate membrane. This procedure best conserves the helical integrity of spiroplasmas without altering the configuration of surface antigens recognized by McAbs. This method could be valuable in monitoring the fastidious mycoplasmas during purification or cultivation attempts. PMID- 3312113 TI - Comparative efficacy of nadolol and propranolol in the management of migraine. PMID- 3312114 TI - Periorbital cellulitis. AB - Periorbital cellulitis is a commonly occurring infectious process limited to the eyelids in the preseptal region. It occurs with greater frequency in the pediatric age group. It is important to distinguish this disease from orbital cellulitis, a potentially lethal infectious process involving the contents of the orbit. A retrospective study of clinical and laboratory data from 137 cases with orbital and periorbital cellulitis was performed. Periorbital cellulitis was documented in 98 cases (71%) in contrast to orbital cellulitis, which was noted in 39 (28%) patients. Sinusitis was the most frequently encountered predisposing factor for the development of periorbital cellulitis occurring in 29 patients. All patients with a diagnosis of periorbital cellulitis were hospitalized and received antibiotics, the majority (95%) receiving intravenous therapy. Hemophilus influenzae was the most frequently isolated pathogenic organism. It was necessary to operate on eight patients. Six patients underwent incision and drainage of an eyelid or periorbital abscess. A distinction between periorbital and orbital cellulitis is clarified. The separation of these entities on the basis of physical examination and radiographic studies is stressed. PMID- 3312115 TI - Radiobiologic implications of the microscopic distribution of energy from radionuclides. AB - A significant increase in our understanding of the dosimetry and therapeutic potential of various types of radioactive decay has augmented the possibility of utilizing specific radiolabeled carriers in tumor therapy. At least three types of radioactive decay lend themselves to this approach. Most fastidious in their distribution requirements are the Auger electron emitters whose radiotoxicity can only be realized with their intranuclear localization. Alpha emitters irradiate regions of several cell diameters. Beta emitters are less stringent as far as proximity to the total tumor mass, but doses to normal tissues can be high. The advantages and the limitations of each type of decay are presented. PMID- 3312116 TI - Chemical and physical properties of radionuclides. AB - There are many radionuclides with a wide range of energies and half-lives available for use as non-sealed radiotherapeutic agents. To date, no single radionuclide has emerged as being clearly superior to all others, in the way that 99mTc predominates in diagnostic imaging. It is unlikely that one will emerge. Instead, if a particular application demands certain decay properties, the radionuclide which will be used will be the one for which appropriate chemistry can be developed and which can be produced and distributed most economically. PMID- 3312117 TI - Radioiodine therapy of thyroid disease. AB - Ten "ideal" steps used at the University of Michigan to treat well-differentiated thyroid cancer are presented. Using this in 103 patients with well-differentiated thyroid carcinoma and metastases outside their neck, those that were freed of their disease after 131I therapy survived three times as long as those not cured of their disease. Patients successfully cured of their metastases showed better conformity to the "ideal" steps than the patients with residual metastases. Each of the most commonly asked questions about 131I treatment of thyroid carcinoma following surgical treatment are discussed. PMID- 3312118 TI - Applications of [131I]m-iodobenzylguanidine ([131I]MIBG). AB - The development of the aralkylguanidine [131I]m-iodobenzylguanidine ([131I]MIBG) in the University of Michigan Nuclear Medicine Division has led to diagnostic and therapeutic evaluations of all the neuroendocrine tumors. These tumors share the property of uptake, storage and release of [131I]MIBG uptake in chromaffin granules. This property has allowed the detection of pheochromocytomas, the detection of metastases in 46% of such patients, the treatment of malignant pheochromocytomas, the detection of neuroblastoma metastases, the treatment of neuroblastomas and the detection of a percent of apudomas. We have learned how to improve our results and this is discussed. PMID- 3312119 TI - Methods to label monoclonal antibodies for use in tumor imaging. AB - The use of radiolabeled monoclonal antibodies as a diagnostic tool in nuclear medicine has grown rapidly over the past several years. Early studies utilized antibodies labeled with radionuclides of iodine (i.e. 125I and 131I) although these radionuclides are not ideal for use in tumor imaging. Recent advances and the development of new chemical methods has made it possible to label antibodies with other radionuclides (i.e. 77Br, 111In and 99mTc). The advantages and disadvantages associated with all of the different radionuclides and labeling methods will be discussed. PMID- 3312120 TI - Quality control and the preparative purification of low antibody concentrations for radiolabelling using bifunctional chelates. AB - The conjugation of antibodies (Ab) with DTPA in the presence of contaminating low molecular weight proteins is inefficient. The selective precipitation of Ab with 18% Na2SO4 as a preparative purification method for small aliquots of low Ab concentrations is successful in eliminating all contaminants as monitored by high performance liquid chromatography at 214 nm and in allowing IgG recoveries greater than 94%. Subsequently, this allows efficient conjugation and radiolabelling of Ab. PMID- 3312121 TI - Chromatographic evaluation of the radiochemical purity of Na131I: effect on monoclonal antibody labeling. PMID- 3312122 TI - Transient paraparesis following bacterial meningitis. AB - Transient paraparesis in a nine-year-old girl with pneumococcal meningitis is reported. The literature about the rare involvement of spinal cord in meningitis is reviewed. PMID- 3312123 TI - Immunocytochemical study of the hepatic innervation in the rat after partial hepatectomy. AB - The autonomic nervous system in rats has been assessed by means of indirect immunofluorescence using monospecific antibodies to neuron-specific enolase, neurofilaments, glial fibrillary acidic protein and S-100 protein (10 days after partial (70%) hepatectomy). Different groups of rats were studied: group A: 70% resection and normal dual blood supply (n = 5); group B: 70% resection with only portal blood to the liver remnant (n = 5); group C: 70% resection with only arterial blood to the liver remnant (n = 5); group D: sham operated controls (n = 5). All rats of groups A and D showed normal liver/body weight ratios after 10 days in contrast to groups B and C where liver weights were 50-60% of the preresection weight. In group A the regeneration process was histologically normal and associated with a remarkable increase of autonomic innervation patterns in the portal triad. In contrast, livers of animals in groups B and C showed under the light microscope features of hepatocyte degeneration associated with a decreased autonomic innervation compared to the controls. The changes are identical in groups B and C, and are therefore irrespective of the type of blood deprivation (arterial or portal). These results support the importance of dual blood supply for an optimal regenerative response in liver remnants after liver resection. We suggest that the autonomic nerve supply of the portal triad plays at least an important permissive role in liver regeneration. PMID- 3312124 TI - The effect of phagocytosis of Candida albicans blastospores on alkaline phosphatase levels in rat polymorphonuclear leucocytes. AB - The phagocytic function of young polymorphonuclear leucocytes with high levels of leucocyte alkaline phosphatase, which are present in the peripheral blood during an inflammatory response, was compared with that of normal polymorphonuclear leucocytes. Candida albicans blastospores were used as phagocytic targets. The phagocytic index of polymorphonuclear leucocytes with low levels of leucocyte alkaline phosphatase was higher than that of cells with high levels of enzyme. Monitoring of leucocyte alkaline phosphatase levels with increasing times of incubation of leucocytes with the blastospores showed a progressive decline in the level of the enzyme. Thus loss of the enzyme is linked to the phagocytic function, although the mechanism of this dynamic process is unclear. PMID- 3312126 TI - [Digital subtraction angiography and iodine 123 amphetamine scintigraphy (IMP SPECT) in the diagnosis of acute and chronic inner-ear hearing loss]. AB - Vascular lesions may play a role in the genesis of acute and chronic hearing loss. After exclusion of other causes the vascular status of 33 patients was examined using digital subtraction angiography (DSA) for the supra-aortic vessels, and the N-isopropyl-(I-123)p-iodoamphetamine (IMP-SPECT) technique to investigate cerebral blood flow. Not a single case of stenosis affecting the hemodynamics, of a vascular anomaly or of a cerebrovascular perfusion disorder was found. PMID- 3312125 TI - The limitations of immunoenzyme approaches to distinguish between 'specific' and 'non-specific' antibody-forming cells, with particular respect to immunocytochemical studies on the in situ immune response. AB - After antigenic stimulation, specific antibody-forming cells can be detected in situ in tissue sections of lymphoid organs using an antigen specific immunoenzyme approach. Immunoglobulin-forming cells staining positively with a particular antigen-enzyme conjugate are considered to be specific antibody-forming cells (provided that the right control conjugates show a negative staining). Immunoglobulin-forming cells, staining negatively with the same antigen-enzyme conjugate, may do so for two reasons: (i) they are in fact specific antibody forming cells, but are not detected as such because of limitations of the technique; (ii) they are real-nonspecific immunoglobulin producing cells. In this paper, the limitations of the technique are discussed. PMID- 3312127 TI - [ACPA: the first serologic marker for Wegener's granulomatosis]. AB - The anticytoplasmatic autoantibody against intracytoplasmatic antigens of granulocytes (ACPA) was demonstratable in 23 patients in the active generalised or incomplete remission phase of Wegener's granulomatosis, but absent in 17 patients in the initial or complete remission phase. The test was negative in 900 serum samples from a control group. This autoantibody seems to be a marker of unusual specificity for Wegener's granuloma, and contributes to better assessment of activity in this disease. PMID- 3312128 TI - Initial treatment of purulent meningitis in infants 1 to 3 months of age. PMID- 3312129 TI - Neuropsychiatric involvement in systemic lupus erythematosus: case report and review of the literature. PMID- 3312131 TI - The mother not the father. AB - Otto Rank pioneered in regarding the mother's place as paramount in the emotional life of the child, even when he was enveloped in Freudian orthodoxy, but expanded his viewpoint after he had left the Freudian ranks. His more mature views were to stress separation and individuation as lifelong dilemmas because they were in tension with our urges to seek oneness and to merge with others and not to regard that struggle as a dialectic that got worked through or transcended in an early, pre-Oedipal stage. He believed that fusing and individuating were lifetime issues for all, in or out of their psychoanalyses. Rank showed radical feminist attitudes far ahead of his time, contending that the female is central and superior to male existence, and that women need a psychology that is not warmed over male biases but truly a "female psychology." He foreshadowed later writers who emphasized the motherly warmth and caregiving of psychotherapists. He regarded many of his technical innovations as ways to heighten the reexperiencing of early child-and-mother interactions and thought of the analytic setting itself as being akin to the mother-child relationship. Among psychoanalysts of all colorations respecting their Freudian orthodoxy, there is a special mystique and nostalgia around the Oedipus complex and paramountcy of the father in a child's mental life; but Otto Rank took a militant, yet reasoned, stand against such patriarchal biases. PMID- 3312130 TI - Improved precision of interstitial brain tumor irradiation using the BRW CT stereotaxic guidance system. AB - A technique is described which enables precise temporary interstitial volume implantation of brain tumors using a CT stereotaxic guidance system. This technique has the advantages of designing irregular isodose distributions during the preplanning stage. Although the preplanning stage can be time-consuming, this is performed while the patient is in the hospital room and CT scanner time, anesthesia time, and operating room time is minimized for individual patients. PMID- 3312132 TI - A clinical perspective of the cause-consequence controversy in alcoholic and addictive suffering. PMID- 3312134 TI - A case for neutering pups and kittens at two months of age. PMID- 3312133 TI - Zinc deficiency in anorexia nervosa. AB - Adolescents with anorexia nervosa were evaluated for clinical and biochemical evidence of zinc deficiency. To assess whether these patients would benefit from zinc supplementation, a double-blind, randomized, controlled trial was conducted. The mean zinc intake of the anorexic group calculated on the basis of three-day dietary records was 7.7 +/- 5.2 mg/day, which is significantly below the recommended daily allowance of 15 mg for adolescents (p less than 0.001). The mean urinary zinc excretion in the anorexic group was 257.1 +/- 212.7 micrograms/24 hours compared to 749.9 +/- 897.8 micrograms/24 hours in the control group (p less than 0.005). This result suggests that the zinc status of anorexia nervosa patients may be compromised due to an inadequate zinc intake. Zinc supplementation (50 mg elemental zinc/day) was followed by a decrease in the level of depression and anxiety as assessed by the Zung Depression Scale (p less than 0.05) and the State-Trait Anxiety Inventory (p less than 0.05), respectively. Our data suggest that individuals with anorexia nervosa may be at risk for zinc deficiency and may respond favorably after zinc supplementation. PMID- 3312135 TI - Preparing allied health faculty to use and develop computer-assisted instruction. AB - Microcomputers can be powerful teaching tools if educators learn to develop effective computer-assisted instruction (CAI). This paper reports on an allied health faculty development project that incorporated hands-on workshops and guided individual instruction led by a specialist in the educational uses of microcomputers. Faculty participants gained basic computer literacy skills and learned to assess the salient characteristics of quality software. They also learned specialized skills for designing their own CAI packages. The positive change in participants' knowledge about and attitude toward microcomputers as instructional tools was measured both subjectively by the authors and by a participants' self-report questionnaire. This project can serve as a model for helping allied health educators become computer literate and gain the skills necessary to evaluate and author quality computer-assisted instruction. PMID- 3312136 TI - Effect of orally administered pilocarpine on serum enzymes, organ weights and histopathology in meadow voles. AB - Fifteen mature meadow voles (Microtus pennsylvanicus) were assigned to each of four diets: 1) basal; 2) basal + .001% pilocarpine (PLCN); 3) basal + .01% PLCN; 4) basal + .10% PLCN in a completely randomized design to measure the effect of PLCN on liver, kidney and parotid gland histopathology and feed intake. Meadow voles were fed each treatment for 14 d prior to euthanasia. Serum glutamic oxaloacetate transaminase, glutamic pyruvate transaminase and alkaline phosphatase levels were unaffected by dietary PLCN. Liver fresh weight tended to decrease with PLCN treatment, but kidney weight was not consistently affected. Parotid gland fresh weight decreased by 31% as the dietary level of PLCN increased from 0 to .10%. One of 15 voles on the control treatment died. Twelve of the remaining 14 voles showed no histopathological changes in the organs studied, but one showed segmental cystic dilation of some convoluted tubules and one showed chronic cortical interstitial nephritis. One vole of the 15 on the .001% PLCN treatment died. Eleven of the 14 remaining voles showed no histopathological changes in the organs studied, while two voles showed segmental cystic dilation of some convoluted tubules and one showed slight hydropic degeneration of hepatocytes. There was no mortality among voles fed .01% PLCN. Nine of the 15 voles showed no histopathological changes in the organs, while four showed slight hydropic degeneration of hepatocytes and one showed segmental cystic dilation of some convoluted tubules. Three of 15 voles died while fed .10% PLCN. The remaining 12 voles showed no histopathological changes in the above mentioned organs, although three voles showed slight hydropic degeneration of hepatocytes. PMID- 3312137 TI - Ovulation and embryonic survival in pubertal gilts treated with gonadotropin releasing hormone. AB - An experiment was conducted to evaluate the effect of exogenous gonadotropin releasing hormone (GnRH) on ovulation and embryonic survival in pubertal gilts. Gilts were assigned in replicates to a control (n = 10) and treatment (n = 10) group. Treatment consisted of an iv injection of 200 micrograms of GnRH immediately after initial mating on the first day of detected estrus. Control gilts were similarly injected with physiological saline. Blood samples were collected from the anterior vena cava immediately prior to injection, thereafter at 15-min intervals for 90 min, and subsequently, before slaughter on d 30 of gestation. Serum samples were analyzed for luteinizing hormone (LH) and progesterone by radioimmunoassay. Treatment with GnRH increased the quantity of LH released (P less than .05), with highest serum concentrations (ng/ml, means +/ SE) of gonadotropin in treated gilts (17.3 +/- 3.5) occurring at 75 min post injection. In control gilts, serum concentrations of LH were not affected by injection of saline. Mean number of ovulations in treated gilts was also greater (P less than .05) than that of control animals (14.5 +/- .7 vs 12.1 +/- .6). However, treatment with GnRH did not enhance the number of attached conceptuses (normal and degenerating) present (treated, 10.9 +/- .9 vs control, 10.5 +/- .7) nor the percentage of viable fetuses (treated, 74.7 +/- 6.9 vs control, 83.5 +/- 5.0%) on d 30 of gestation. Although GnRH increased ovulation rate, mean weight of corpora lutea of treated and control gilts did not differ (402.8 +/- 16.3 vs 389.5 +/- 11.3 mg, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312138 TI - Influence of frame size and zeranol on growth, compositional growth and plasma hormone characteristics. AB - A 2 X 2 factorially arranged trial was conducted to compare effects of implant (zeranol) and frame size on weight and compositional gain, and plasma hormone concentrations. Angus, Charolais X Hereford and Hereford X Angus yearling steers (34 steers averaging 270 kg body weight) were randomly assigned to treatments of small (SF) vs large frame (LF) and implant (I) vs no implant (NI). Steers were implanted at 0 and 97 d and individually fed an 81% whole shelled corn and 11.5% corn silage-based diet (dry basis) for a 175-d period. Shrunk weights and body measurements for frame size determination were taken initially and at approximately 28-d intervals; blood was collected via venipuncture at 14-d intervals for analyses of insulin (IN), triiodothyronine (T3), thyroxine (T4) and glucose concentrations. Steers were also counted in a whole body counter for measurement of 40K content and prediction of whole body protein and fat. The I steers showed an improvement (P less than .05) in daily gain regardless of frame size for the total trial. The I LF steers required 18% more dry matter to attain higher daily gain for 97 to 175 d; I steers were more efficient (P less than .05) at converting dry matter to gain during 0 to 97 d and 0 to 175 d. Daily fat deposition was increased (P less than .05) in I steers, while protein deposition was not affected by I. Plasma IN concentrations were numerically elevated (P less than .10) in I steers regardless of frame size, during the initial 97 d. Implant did not influence (P greater than .10) plasma T3, T4 and glucose concentrations regardless of frame size. Steers responded differently to zeranol implant over time regarding plasma T4 concentrations (P less than .003). Steers differing in frame size responded similarly in rate of gain, in feed conversion and in patterns of plasma insulin concentrations to zeranol implants. PMID- 3312139 TI - A neurobiological alternative to the perceptual reinforcement hypothesis of stereotyped behavior: a commentary on "Self-stimulatory behavior and perceptual reinforcement". AB - A perceptual reinforcement theory of stereotyped movements is advanced by Lovaas, Newsom, and Hickman (1987) in an effort to integrate a number of diverse observations about the origins and maintenance of this behavior. We, in turn, argue that the theory, as presented, is logically flawed and fails to take into account important biological findings and theory concerning pathological stereotyped acts. An alternative theory, derived primarily from neurological concepts, is briefly described. PMID- 3312140 TI - Systemic antimicrobial prophylaxis in hysterectomy. PMID- 3312141 TI - Inocula for antimicrobial sensitivity testing: a critical review. PMID- 3312142 TI - Synergy study of carumonam and ceftazidime with aminoglycosides. PMID- 3312143 TI - Chemotherapy of histiocytosis-X. AB - This article discusses the efficacy of various chemotherapeutic agents in the treatment of histiocytosis-X. Although these agents alone and in combination have improved the prognoses for children with histiocytosis-X, the need for more effective methods of treatment still exists. PMID- 3312144 TI - Current role of radiation therapy in the management of histiocytosis-X. AB - With increasing utilization of systemic agents such as prednisone, oral alkylating agents and the vinca alkyloids, the use of radiation has decreased. In this article, current indications for radiation therapy are presented and recommended techniques and dose fractionation discussed. PMID- 3312145 TI - Immunotherapy of histiocytosis-X. AB - This article focuses on the interaction of histiocytosis-X and the immunotherapeutic agent, suppression. Studies with this and other agents have presented us with invaluable insights into the nature of histiocytosis-X. PMID- 3312146 TI - Current controversies. Histiocytosis-X. AB - There are still many areas of controversy concerning Langerhans cell histiocytosis. This article addresses the main controversies and highlights the central factors of this disease, which further investigation should elucidate. PMID- 3312147 TI - Natural history of histiocytosis-X. AB - Histiocytosis-X can involve many organs and tissues in all age groups and in both sexes and occurs most often in caucasians. The signs and symptoms observed in the patient are directly related to the infiltration of Langerhans histiocytes, which compress or displace normal tissues and cause destruction of the tissues and organs involved. The disease tends to be benign and self-limiting when the involvement is limited to only one site. When more than one site is involved, the disease course can be chronic or acute. The chronic course tends to smolder for years, causing significant morbidity and disability but not death. The acute form tends to cause significant morbidity and early mortality. PMID- 3312148 TI - Immunobiology of histiocytosis-X. AB - Recent laboratory investigations of patients with histiocytosis-X and their pathologic tissues demonstrate the close immunologic relationship between the Langerhans-like cells of these patients and normal epidermal Langerhans cells of the mononuclear phagocytic system. A deficiency of a peripheral blood lymphocyte subpopulation is seen in histiocytosis-X patients. Its relevance to the pathogenesis of the disease is yet to be determined. The granuloma of histiocytosis-X contains large numbers of cells similar to epidermal Langerhans cells, components of the mononuclear phagocytic system. The Langerhans cells of histiocytosis-X can now be characterized by a number of immunologic and immunohistochemical techniques. Similarities and differences between them and other components of the mononuclear phagocytic system have been recognized, supporting the concept of the duality of the system's proliferative disorders. There is a deficiency of suppressor T lymphocytes in patients with active histiocytosis-X and a rise in the number of suppressor cells after in vitro incubation with thymic hormones. Increases in the peripheral blood suppressor cell number occur spontaneously or inconsistently after parenteral administration of thymic hormone. It is not known at present what the relationship is between the decrease in suppressor lymphocytes and the reports of thymic abnormalities in these patients. More investigations are needed in patients with active and inactive disease: measuring serum thymic factors, performing clinical trials with thymic products, determining monocyte or macrophage function, and evaluating other possible dysfunctions of suppressor T lymphocytes. PMID- 3312149 TI - Role of the thymus in histiocytosis-X. AB - An increasing number of reports have demonstrated that patients with histiocytosis-X show significant morphologic changes in the thymus gland. The changes include severe dysplasia, dysmorphia, and severe nonspecific involution. These findings are present in all children with histiocytosis-X who die, but can be found even when the disease is limited to one bone and is not fatal. PMID- 3312150 TI - Pathology of Langerhans cell histiocytosis. AB - The spectrum of the histopathology of Langerhans cell histiocytosis was presented with special attention paid to the pathologic Langerhans cell as the diagnostic lesional cell. Features that distinguish this histiocyte from others are defined by electron microscopic demonstration of Birbeck granules and by immunohistochemical characteristics such as possession of antigenic determinant(s) that react with the monoclonal antibody T6. The relationship between Langerhans cells and the other histiocytes from which they are derived seems to be determined by events initiated by surface antigens reacting with specific antibodies. Immunohistochemical tests that are of value in diagnosing and classifying the various histiocytosis syndromes include those used to identify the S-100 antigen, T6 antigenic determinant(s), and peanut agglutinin binding sites. The use of a standard nomenclature and diagnostic criteria for the histiocytosis syndromes is encouraged as a step forward in progress to better understand and communicate about these puzzling disorders. PMID- 3312151 TI - Historical perspectives of Langerhans cell histiocytosis. AB - This brief review of the history of Langerhans cell histiocytosis brings us into touch with the history of medicine of the last 100 years and the opportunity to reflect on the progress in medicine in general. Hand, Christian, Schuller, Letterer, and Siwe represent far more than names to attach to eponyms. This historical overview takes us from the first descriptions of the disease in the literature through the modern efforts to take the X out of histiocytosis-X. PMID- 3312152 TI - Biochemistry and biology of the Langerhans cell. AB - Langerhans cells mainly present in the normal epidermis and are thought to be identical to the proliferating cells in the lesions of histiocytosis-X. The Langerhans cell is positive not only for ATPase, esterase, and acid phosphatase, but also for S-100 protein. Since these findings are similar but distinct from those of monocytes and macrophages, the Langerhans cell may be a cell line independent of the monocyte-macrophage system, designated as T-zone histiocytes. Immunologically, the Langerhans cell has Fc and C3 receptors and Ia-like antigen. Thus, the Langerhans cell may be a member of the immune network, as antigen presenting cells, in the epidermis. One hypothesis is that Langerhans cells activated by external stimuli induce a local immune reaction by activation and proliferation of T-cells, with the interaction of keratinocytes and macrophages. Because of cytochemical and immunologic similarities between Langerhans cells and histiocytosis-X cells, histiocytosis-X may be a proliferative disorder of immature or neoplastic Langerhans cells. PMID- 3312154 TI - Psychological aspects of chronic pain. AB - This paper summarizes psychological factors which can influence a patient's experience of chronic pain--namely personality and social variables, mood disturbance, hysteria and others. Psychological treatments which are available for pain management, including behavioural-cognitive therapies and relaxation, and the functions of multidisciplinary pain units are described. PMID- 3312153 TI - Recent advances in the knowledge of mechanisms of intractable pain. AB - Chronic intractable pain can arise from damage at three separate sites, or a combination of these sites: (a) deep tissue, (b) peripheral nerves, and (c) dorsal roots. At each site there is a complex progression of local and distant effects which are produced by a variety of chemical mediators and neurophysiological events. Damage, no matter at which site, often brings changes far beyond the original lesion. It is only by an understanding of the complex mechanisms involved, and the effects that they cause, that new and rational treatments for pain will be found. PMID- 3312155 TI - Surgical management of benign intractable pain. AB - A multidisciplinary approach to chronic pain will usually obtain reasonable results, but in some selected patients with nonmalignant disease a surgical solution may be sought with benefit. A variety of techniques used are described in detail, including the treatment of trigeminal neuralgia, post-herpetic neuralgia, and the pain associated with avulsion injury of the brachial plexus. PMID- 3312157 TI - Neurological rehabilitation. PMID- 3312156 TI - Drug management of chronic benign pain. AB - Chronic benign pain usually requires treatment with drugs. Three main classes of drugs are used: opiates, non-steroidal anti-inflammatory drugs, and a miscellaneous group which includes psychoactive drugs and a variety of specific agents for individual conditions. The careful selection and combination of drugs, with adequate and appropriate dosage, will bring pain relief in the majority of patients. PMID- 3312158 TI - Research on the clinical interview. PMID- 3312159 TI - Structured diagnostic interviews for children and adolescents: current status and future directions. PMID- 3312160 TI - Child psychiatric diagnosis by computer algorithm: theoretical issues and empirical tests. PMID- 3312162 TI - Role of phenylalanine 150 in the receptor-binding domain of the K88 fibrillar subunit. AB - Recently, we reported the isolation of three peptides, Ile-83-Ala-Phe-85, Ser-148 Leu-Phe-150, and Ala-156-Ile-Phe-158, derived from the K88 fibrillar subunit and found to inhibit the binding of K88 fibrillae to cavia erythrocytes or pig intestinal epithelial cells (A. A. C. Jacobs, J. Venema, R. Leeven, H. van Pelt Heerschap, and F. K. de Graaf, J. Bacteriol. 169:735-741, 1987). The gene encoding the K88 fibrillar adhesin was modified by oligonucleotide-directed site specific mutagenesis such that each of the phenylalanine residues at positions 85, 150, and 158 were replaced by serine. Replacement of phenylalanine 85 or 158 had no apparent effect on the biosynthesis of the fibrillae or on their adhesive capacity. In contrast, substitution of phenylalanine 150 with serine resulted in a dramatic decrease in adhesive capacity of the K88 fibrillae. Apparently, phenylalanine 150 plays an essential role in the interaction of the adhesin with receptor molecules present on eucaryotic cells. PMID- 3312163 TI - Penicillin-binding protein 7 and its relationship to lysis of nongrowing Escherichia coli. AB - The characteristics and possible physiological role(s) of a 30-kilodalton low molecular-size penicillin-binding protein (PBP), PBP 7, in Escherichia coli were investigated. The amount of penicillin required to half saturate PBP 7 was approximately 5 micrograms/ml, and this PBP bound 15% of the total penicillin bound to all PBPs with a deacylation rate of greater than 120 min. This PBP was distinguishable from E. coli PBPs 1 to 6 by the pattern of [3H]penicillin-labeled peptides generated by partial proteolysis. A unique feature of PBP 7 was its capacity to bind numerous members of penem class antibiotics at relatively low concentrations. A striking correlation existed in drugs between capability of lysing amino acid-starved (nongrowing) E. coli and binding to PBP 7. The findings suggest that PBP 7 is a new, physiologically significant target for beta-lactam antibiotics. PMID- 3312161 TI - Regulation of sugar utilization in Saccharomyces species. PMID- 3312164 TI - Parasexual genetics of Torulopsis glabrata. AB - Prototrophic hybrids were generated in the asexual yeast Torulopsis glabrata by the fusion of spheroplasts derived from parent strains which bore complementing auxotrophic markers. The DNA content (per cell) of two hybrids was essentially that predicted by summing the corresponding parental values. UV irradiation of these two hybrids resulted in the formation of sectored colonies with genetic properties consistent with their origin by either mitotic recombination or chromosomal nondisjunction. PMID- 3312165 TI - Mutations in Escherichia coli that effect sensitivity to oxygen. AB - Fifteen oxygen-sensitive (Oxys) mutants of Escherichia coli were isolated after exposure to UV light. The mutants did not form macroscopic colonies when plated aerobically. They did form macroscopic colonies anaerobically. Oxygen, introduced during log phase, inhibited the growth of liquid cultures. The degree of inhibition was used to separate the mutants into three classes. Class I mutants did not grow after exposure to oxygen. Class II mutants were able to grow, but at a reduced rate and to a reduced final titer, when compared with the wild-type parent. Class III mutants formed filaments in response to oxygen. Genetic experiments indicated that the mutations map to six different chromosomal regions. The results of enzymatic assays indicated that 7 of the 10 class I mutants have low levels of catalase, peroxidase, superoxide dismutase, and respiratory enzymes when compared with the wild-type parent. Mutations in five of the seven class I mutants which have the low enzyme activities mapped within the region 8 to 13.5 min. P1 transduction data indicated that mutations in three of these five mutants, Oxys-6, Oxys-14, and Oxys-17, mapped to 8.4 min. The correlation of low enzyme levels and mapping data suggests that a single gene may regulate several enzymes in response to oxygen. The remaining three class I mutants had wild-type levels of catalase, peroxidase, and superoxide dismutase, but decreased respiratory activity. The class II and III mutants had enzyme activities similar to those of the wild-type parent. Our results demonstrate that mutations in at least six genes can be expressed as oxygen sensitivity. Some of these genes may be involved in respiration or cell division or may regulate the expression of several enzymes. PMID- 3312166 TI - High-level expression of a proteolytically sensitive diphtheria toxin fragment in Escherichia coli. AB - ABM508 is a recombinant fusion protein consisting of the N-terminal 485 amino acids of diphtheria toxin joined to alpha-melanocyte-stimulating hormone. When expressed in Escherichia coli under the control of the tox promoter and signal sequence, ABM508 is severely degraded. When overexpressed from a thermoinducible lambda pR promoter fusion, ABM508 is largely insoluble. We compared the expression of ABM508 (501 amino acids) to a full-length mutant form of the toxin (CRM197; 535 amino acids) and found that CRM197 showed minimal proteolysis. Thus, the removal of the C-terminal 50 amino acids of the toxin destabilizes the protein, making it a target for proteases. Proteolysis of ABM508 could be reduced by removal of the tox signal sequence (thereby directing the protein to the cytoplasm) and growth in lon and htpR mutant strains of E. coli. We also showed that the solubility of tox gene products expressed in E. coli was directly related to the growth temperature of the culture. Thus, a fragment A fusion protein (223 amino acids), ABM508, and CRM197 were found in soluble extracts when expressed at 30 degrees C but could not be released by the same procedures after growth at 42 degrees C. On the basis of these observations, we fused the coding sequences for mature ABM508 to the trc promoter (inducible at 30 degrees C by isopropyl-beta-D-thiogalactoside) and expressed this construct in a lon htpR strain of E. coli. This plasmid made 10 mg of soluble tox protein per liter of culture (7.7% of the total cell protein) or 14 times more than our previous maximal level. Extracts from lon htpR cells harboring this plasmid had high levels of ADP-ribosyltransferase activity, and although proteolysis still occurred, the major tox product corresponded to full-length ABM508. PMID- 3312167 TI - Cloning, expression, and primary structure of a Chlamydia trachomatis binding protein. AB - The gene encoding an 18,000-dalton eucaryotic cell-binding protein of Chlamydia trachomatis serovar L2 was cloned into Escherichia coli, and the nucleotide sequence of a 1,658-base-pair PstI restriction endonuclease fragment encoding this protein was determined. The recombinant chlamydial gene consists of a 486 base-pair open reading frame encoding a polypeptide of molecular weight 18,314. The resultant polypeptide, comprising 162 amino acids, possesses a highly charged carboxy-terminal end. The expression of this recombinant protein is under the control of a vector promoter. The recombinant 18,000-dalton protein possessed the same eucaryotic cell-binding characteristics as did the native chlamydial 18,000 dalton protein when electrophoresed and transferred to nitrocellulose. Polyclonal antibodies to the recombinant protein exhibited neutralizing activity. PMID- 3312168 TI - Isolation and expression of the gene encoding yeast mitochondrial malate dehydrogenase. AB - The mitochondrial tricarboxylic acid cycle enzyme malate dehydrogenase was purified from Saccharomyces cerevisiae, and an antibody to the purified enzyme was obtained in rabbits. Immunoscreening of a yeast genomic DNA library cloned into a lambda gt11 expression vector with anti-malate dehydrogenase immunoglobulin G resulted in identification of a lambda recombinant encoding an immunoreactive beta-galactosidase fusion protein. The yeast DNA portion of the coding region for the fusion protein translates into an amino acid sequence which is very similar to carboxy-terminal sequences of malate dehydrogenases from other organisms. In s. cerevisiae transformed with a multicopy plasmid carrying the complete malate dehydrogenase gene, the specific activity and immunoreactivity of the mitochondrial isozyme are increased by eightfold. Expression of both the chromosomal and plasmid-borne genes is repressed by growth on glucose. Disruption of the chromosomal malate dehydrogenase gene in haploid S. cerevisiae produces mutants unable to grow on acetate and impaired in growth on glycerol plus lactate as carbon sources. PMID- 3312169 TI - Fusion of Escherichia coli heat-stable enterotoxin and heat-labile enterotoxin B subunit. AB - The 3' terminus of the DNA coding for the extracellular Escherichia coli heat stable enterotoxin (ST) devoid of transcription and translation stop signals was fused to the 5' terminus of the DNA coding for the periplasmic B subunit of the heat-labile enterotoxin (LTB) deleted of ribosomal binding sites and leader peptide. By RNA-DNA hybridization analysis, it was shown that the fused DNA was transcribed in vivo into an RNA species in close agreement with the expected molecular weight inferred from the nucleotide sequence. The translation products of the fused DNA resulted in a hybrid molecule recognized in Western blots (immunoblots) with antibodies directed against the heat-labile moiety. Anti-LTB antibodies coupled to a solid support bound ST and LTB simultaneously when incubated with ST-LTB cellular extracts. By [35S]cysteine pulse-chase experiments, it was shown that the fused ST-LTB polypeptide was converted from a precursor with an equivalent electrophoretic mobility of 20,800 daltons to an approximately 18,500-dalton species, which accumulated within the cell. The data suggest that wild-type ST undergoes at least two processing steps during its export to the culture supernatant. Blocking the natural carboxy terminus of ST inhibited the second proteolytic step and extracellular delivery of the hybrid molecule. PMID- 3312170 TI - Identification of Treponema pallidum penicillin-binding proteins. AB - Penicillin-binding proteins of 180, 89, 80, 68, 61, 41, and 38 kilodaltons were identified in Treponema pallidum (Nichols) by their covalent binding of [35S]benzylpenicillin. Penicillin-binding proteins are localized in the plasma membranes of many bacterial species and may serve as useful markers for determining plasma membrane intactness in T. pallidum fractionation studies. PMID- 3312171 TI - Escherichia coli strains carrying the cloned cytochrome d terminal oxidase complex are sensitive to near-UV inactivation. AB - To determine if membrane-bound cytochromes function as endogenous near-UV photosensitizers, strains containing the cloned cydA and cydB genes were tested for near-UV sensitivity. A strain containing both cloned genes overproduced cytochromes b558, b595, and d. Another strain containing only cloned cydB overproduced cytochrome b558. Both cytochrome-overproducing strains were hypersensitive to broad-spectrum near-UV inactivation. The presence of excess cytochromes did not affect sensitivity to far-UV radiation and provided protection against H2O2 inactivation. PMID- 3312173 TI - Mapping of the constitutive lysyl-tRNA synthetase gene of Escherichia coli K-12. AB - The constitutive lysyl-tRNA synthetase gene (lysS) was mapped at 62.1 min on the Escherichia coli chromosome by a combination of conjugation and transduction, with physical confirmation by two-dimensional gel electrophoresis. Revertant analysis suggests that the altered isoelectric point and the low amount of the mutant LysS protein may be due to a single mutational event. PMID- 3312172 TI - Changes in peptidoglycan composition and penicillin-binding proteins in slowly growing Escherichia coli. AB - The composition of peptidoglycan of chemostat-grown cultures of Escherichia coli was investigated as a function of growth rate. As the generation time was lengthened from 0.8 to 13.8 h, there was a decrease in the major monomer (disaccharide tetrapeptide) and dimer (bis-disaccharide tetrapeptide), while disaccharide tripeptide moieties increased to greater than 50% of the total wall. The average chain length became much shorter; lipoprotein density tripled, and the number of unusual diaminopimelyl-diaminopimelic acid crossbridges increased fivefold. As cells grew more slowly, amounts of penicillin-binding proteins (PBPs) 1a-1b complex and 4 decreased, while amounts of PBPs 3 and the 5-6 complex increased. We propose that the chemical composition of E. coli cell walls changes with growth rate in a manner consistent with alterations in the activities of PBPs and cell shape. PMID- 3312174 TI - Effects of segregation and selection on instability of plasmid pACYC184 in Escherichia coli B. AB - We use a mathematical model to analyze the dynamics of loss of nonconjugative pACYC184 from populations of Escherichia coli B in glucose-limited continuous culture. This model incorporates both plasmid segregation and selection against plasmid carriage. It is concluded that there is intense selection against plasmid carriage (s = 0.3 per culture generation), which amplifies the frequency of segregants arising de novo. PMID- 3312177 TI - Dextroamphetamine treatment of mania. AB - Five of six acutely manic patients treated with dextroamphetamine experienced a 50% or greater reduction in their mania severity scores. Side effects were noted in only one patient. The treatment results suggest that dextroamphetamine might be useful in the treatment of mania. PMID- 3312176 TI - A fixed-dose clinical trial of fluoxetine in outpatients with major depression. AB - Fixed daily doses of 20 mg, 40 mg, or 60 mg of fluoxetine, a highly specific serotonin reuptake inhibitor, were given to 84 depressed outpatients in a double blind, placebo-controlled, randomized 6-week trial. The 20-mg dose produced improvement of depression in the moderate-severe depression group as expressed in significant reductions of scores on the Hamilton Rating Scale for Depression (p greater than or equal to .007) and the Patient Global Impressions scale (p greater than or equal to .011), and the 20-mg dose caused fewer side effects than did the higher doses. A mildly depressed group of patients showed no improvement at any dose level of fluoxetine. PMID- 3312178 TI - Clonazepam: a review of open clinical trials. AB - Data were collected on 50 patients with panic attacks who were treated with clonazepam to determine the drug's antipanic efficacy. At a mean duration of 54.3 weeks, 62% of the patients remained in treatment and 38% were lost to follow-up. Of those remaining in treatment, 90% had a good response to clonazepam and 10% a poor response. The author concludes that clonazepam demonstrated antipanic efficacy, that the development of tolerance or abuse was not a problem, and that most of the patients are being effectively maintained at 2-3 mg/day of clonazepam. PMID- 3312175 TI - Distribution of shufflon among IncI plasmids. AB - A shufflon or clustered inversion is a novel type of DNA rearrangement originally discovered in the IncI1 plasmid R64 (T. Komano, A. Kubo, and T. Nisioka, Nucleic Acids Res. 15:1165-1172, 1987). In a 1.95-kilobase region of R64 DNA, four DNA segments inverted independently or in groups, resulting in a complex DNA rearrangement. We found similar types of shufflon in other IncI1 plasmids, including delta, pIP111, pIP565, pIP112, pIP186, R144, R163, R483, and R621a. A variant type of shufflon occurs in the IncI1 plasmid ColIb. PMID- 3312181 TI - Cells of an internalization-defective familial hypercholesterolemia mutant secrete low density lipoprotein receptors. AB - Familial hypercholesterolemia (FH) is a congenital disorder of plasma low density lipoprotein (LDL) metabolism resulting from the defect or malfunction of LDL receptors on the cell surface. In most cases of FH, LDL binding to the cell surface is disrupted, while in some special cases LDL binding to the receptors occurs normally but the internalization of the bound LDL is inhibited (internalization-defective type). We studied the biosynthesis and transport of the LDL receptor in cultured fibroblasts obtained from one of the internalization defective mutants by using [35S]methionine labeling and detection with anti-LDL receptor antibody. The mutant cells synthesized LDL receptors with a molecular weight slightly smaller than normal as shown in SDS-polyacrylamide gel electrophoresis. A large portion of the synthesized receptors was secreted into the medium while the other portion was associated with the cells. The apparent molecular weight of the receptors secreted into the medium was about 10 kDa smaller than that of the cell-associated receptors. The cell-associated form was converted into the secreted form following a prolonged incubation of the cells, showing the precursor-product relationship between the cell-associated and the secreted forms. PMID- 3312180 TI - Clonazepam in acute and maintenance treatment of bipolar affective disorder. AB - This is a report on the efficacy of clonazepam in the treatment of acute mania. The advantages of clonazepam over standard neuroleptics are its rapidity of action, its lack of toxicity, and, particularly important, the fact that it does not cause tardive dyskinesia, a potentially disabling neurological side effect of neuroleptic treatment. Results are reported of double-blind, controlled studies comparing clonazepam with lithium and with haloperidol in the treatment of acutely manic patients who were newly admitted through an emergency room. For the maintenance treatment of patients with bipolar illness, a combined approach is outlined that involves medications with different mechanisms of action. Treatment is initiated with lithium, and, if necessary, tryptophan is added to enhance lithium response; drug-resistant patients who fail to respond satisfactorily to lithium or lithium plus tryptophan are given adjunctive clonazepam therapy. PMID- 3312183 TI - Beta-actinin is not distinguishable from an actin barbed-end capping protein in chicken breast muscle. AB - beta-Actinin is an actin-pointed end capping protein in skeletal muscle. Casella et al. have reported that a protein isolated from muscle acetone powder by procedures similar to those used for beta-actinin purification caps the barbed end of an actin filament (J. Biol. Chem. 261, 10915-10921 (1986)). We have confirmed the above results. However, it turned out that the two proteins were identical as to subunit sizes, peptide maps, and cross-reactivities with anti beta-actinin IgG. The binding of the two proteins to opposite ends of an actin filament remains unexplained. PMID- 3312184 TI - Amino acid sequence of the amino-terminal 24 kDa fragment of the heavy chain of chicken gizzard myosin. AB - Chicken gizzard myosin was modified with N-iodoacetyl-N'-(5-sulfo-1-naphthyl) ethylenediamine (IAEDANS) in the presence of ATP and in 0.15 M KCl, where the myosin assumed 10S conformation. From the tryptic digest of the modified myosin, a fluorescent fragment (24 kilodaltons) was isolated by gel filtration on a Sephadex G-100 column followed by chromatography on a CM 52 column. The amino acid sequence of the fragment was analyzed by conventional methods, and was: (S,Z)K-P-L-S-D-D-E-K-F-L-F-V-D-K-N-F-V-N-N-P-L-A-Q-A-D-W-S-A-K-K- L-V-W-V-P-S-E-K H-G-F-E-A-A-S-I-K-E-E-K-G-D-E-V-T-V-E-L-Q-E-N-G-K-K- V-T-L-S-K-D-D-I-Q-K-M-N-P-P K-F-S-K-V-E-D-M-A-E-L-T-C-L-N-E-A-S-V-L- H-N-L-R-E-R-Y-F-S-G-L-I-Y-T-Y-S-G-L-F-C V-V-I-N-P-Y-K-Q-L-P-I-Y-S-E-K-I- I-D-M-Y-K-G-K-K-R-H-E-M-P-P-H-I-Y-A-I-A-D-T-A-Y R-S-M-L-Q-D-R-E-D-Q- S-I-L-C-T-G-E-S-G-A-G-K-T-E-N-T-K-K-V-I-Q-Y-L-A-V-V-A-S-S-H K-G-K. The amino-terminus was blocked, and the fragment was assigned as an amino terminal part of the heavy chain of gizzard myosin. Position 127 was occupied by epsilon-N-trimethyllysine. Trp-130 of rabbit skeletal myosin heavy chain, which was reported to cross-link to an azide derivative of ATP by Okamoto and Yount (Proc. Natl. Acad. Sci. U.S. 82, 1575-1579 (1985], was replaced by glutamine in gizzard myosin. Cys-93 of the fragment is the amino acid residue whose reaction with IAEDANS alters the ATPase activity of gizzard myosin (Onishi, H. (1985) J. Biochem. 98, 81-86). PMID- 3312185 TI - Purification of sarcotoxin III, a new antibacterial protein of Sarcophaga peregrina. AB - A glycine-rich antibacterial protein with a molecular mass of 7,000 termed sarcotoxin III, was purified to homogeneity from the hemolymph of third instar larvae of Sarcophaga peregrina. When the hemolymph was fractionated, this protein was recovered in the same fraction as sarcotoxin I, a group of potent antibacterial proteins that have been purified. But, it was clearly different from sarcotoxin I in amino acid composition and molecular mass. Sarcotoxin III was shown to be induced in the hemolymph in response to injury of the larval body wall. PMID- 3312182 TI - Organ selective induction of cytochrome P-448 isozymes in the rat by 2-methoxy-4 aminoazobenzene and 3-methylcholanthrene. AB - Male Sprague Dawley rats were injected intraperitoneally with 2-methoxy-4-amino azobenzene (2-MeO-AAB) or 3-methylcholanthrene (MC), and then the expression of microsomal cytochrome P-450 isozymes in liver and extrahepatic tissues was investigated by means of immunological methods and a bacterial mutation test. The results of protein A-enzyme-linked immunosorbent assaying and immunoblotting using anti-rat cytochrome P-448 monoclonal antibodies showed that MC induced at least two microsomal cytochrome P-448 isozymes, a high spin form (cytochrome P 448H) and a low spin form (cytochrome P-448L), in liver, but that it induced only cytochrome P-448L in extrahepatic tissues such as lung, kidney, small intestine, and colon. The results also indicated that, in contrast to MC, 2-MeO-AAB selectively induced microsomal cytochrome P-448H in liver but did not induce any cytochrome P-448 isozymes in extrahepatic tissues. The activities of 9,000 X g supernatants from the individual organs, as to the mutagenic conversion of 3 aromatic amines (3-amino-1-methyl-5H-pyrido(4,3-b)indole, 2-amino-6 methyldipyrido(1,2-a: 3',2'-d)-imidazole and 3-methoxy-4-aminoazobenzene), toward Salmonella typhimurium TA 98 bacteria were dependent upon the quantity and/or quality of the microsomal cytochrome P-448 isozymes in the organs. PMID- 3312186 TI - Involvement of the fatty acid oxidation complex in acetyl-CoA-dependent chain elongation of fatty acids in Escherichia coli. AB - The activity of acetyl-CoA-dependent chain elongation of fatty acids in Escherichia coli was enhanced when the organism was grown on oleic acid as the sole carbon source, but not detected when grown on glucose. Antibodies raised against fatty acid oxidation complex of E. coli inhibited both the reaction catalyzed by crotonase and the chain elongation in a similar manner, showing that the oxidation complex participates in the chain elongation. The activities of condensation and the activities of NADH- and NADPH-dependent 3-ketoacyl reduction in the cell-free extract were precipitated by antibodies to the complex in parallel with those of 3-ketoacyl-CoA thiolase and crotonase. These results together with the presence of NADPH-dependent trans-2-enoyl-CoA reductase in E. coli (Mizugaki, et al. (1982) Chem. Pharm. Bull. 30, 2503-2511) indicate that the acetyl-CoA-dependent chain elongation of fatty acids in E. coli occurs by the reversal of fatty acid oxidation other than the step of enoyl reduction. PMID- 3312179 TI - Clonazepam versus alprazolam in the treatment of panic disorder: interim analysis of data from a prospective, double-blind, placebo-controlled trial. AB - The authors present interim results of a prospective, random assignment, double blind, placebo-controlled trial conducted to determine whether clonazepam is as effective as alprazolam in reducing the frequency of panic attacks and whether both agents are superior to placebo. Analysis on 44 of 60 randomized subjects showed no statistically significant differences between the clonazepam and alprazolam groups on the following clinically meaningful outcome measures: total number of panic attacks and percent of time subjects experienced anticipatory anxiety, extent of phobic avoidance, and fear. Statistically significant differences did exist among the drug and placebo groups on these measures. The authors conclude that this interim analysis of the data supports the inclusion of clonazepam in the treatment of panic disorder. PMID- 3312187 TI - The single line system of shading. PMID- 3312188 TI - Russell L. Drake: an historical retrospective. AB - Russell Drake's career reflects the integral relationship between medical illustration and surgery. During a 44-year association with the Mayo Clinic, he observed pioneering efforts of the most accomplished surgeons of the day. It was his task to portray these breakthroughs visually for journals, books, and slides, thereby disseminating information on new techniques to the entire medical and surgical community. Drake executed the illustrations skillfully and aesthetically, inspiring generations of illustrators. His is a vital chapter in the history of medical communication. PMID- 3312189 TI - The existence of an optimal range of cytosolic free calcium for insulin stimulated glucose transport in rat adipocytes. AB - We have examined the effects of extracellular and intracellular Ca2+ concentrations upon basal and insulin-stimulated 2-deoxyglucose uptake in isolated rat adipocytes. In the absence of extracellular Ca2+, both basal and insulin-stimulated glucose uptake were significantly reduced. Insulin-stimulated glucose transport was optimal at 1 and 2 mM Ca2+. Further increases in extracellular Ca2+ concentration (3 mM) significantly diminished insulin stimulated glucose uptake. When intracellular Ca2+ concentrations were augmented by ionomycin (1 microM), insulin-stimulated glucose uptake was significantly reduced at extracellular Ca2+ concentrations of 2 and 3 mM. The levels of intracellular free Ca2+ concentrations were then measured with Ca2+ indicator fura-2. The correlation between the levels of intracellular free Ca2+ and the magnitude of insulin-stimulated glucose uptake revealed that the optimal effect of insulin is observed at Ca2+ levels between 140 and 370 nM. At both extremes outside of this window, both low and high levels of intracellular Ca2+ result in diminished cellular responsiveness to insulin. These data suggest that intracellular calcium concentrations may exert a dual role in the regulation of cellular sensitivity to insulin. First, there must exist a minimal concentration of intracellular calcium to promote insulin action. Second, increased levels of intracellular calcium may provide a critical signal for diminution of insulin action. PMID- 3312190 TI - Dissociation of ionizing groups in the binding cleft inversely controls the endo- and exopeptidase activities of cathepsin B. AB - Negatively charged reactants are sensitive reactivity probes of the active site of cysteine proteases (Halasz, P., and Polgar, L. (1977) Eur. J. Biochem. 79, 491 494). Thus, the thiolate-imidazolium ion pair of papain reacts at an enhanced rate with iodoacetate due to a favorable interaction between the positive imidazolium ion of the ion pair and the negative carboxylate of the alkylating agent. We have found that cathepsin B, the closely related lysosomal cysteine protease, also shows enhanced reactivity toward iodoacetate, indicating the presence of the catalytically competent thiolate-imidazolium ion pair in this enzyme. However, the pH dependence of the reaction is different. Papain exhibits a simple bell-shaped curve, whereas cathepsin B exhibits a complex pH dependence which is controlled by an ionizing group with a pKa of about 5.5. This finding indicates the existence of two reactive forms associated with the active site of cathepsin B: a high reactivity form below pH 5.5 and a low reactivity form above pH 5.5. The former accounts for the exopeptidase (peptidyl dipeptidase) activity of the enzyme and the latter for the endopeptidase activity, measured with the highly specific substrate benzyloxycarbonyl-Arg-Arg-2-naphthylamide. As seen from active site models, cathepsin B, in contrast to papain, contains a triad of charged groups near the thiolate-imidazolium ion pair which is composed of Glu 131, Arg-162, and Glu-205. A net negative charge above pH 5.5 and the positive charge of Arg-162 below pH 5.5 may control the exo- and endopeptidase activities, as well as the alkylation with iodoacetate. This can be mediated through electrostatic interactions with the charged reactants and, possibly, also by causing a conformational change in the geometry of the thiolate-imidazolium ion pair. PMID- 3312191 TI - Oxidation increases the proteolytic susceptibility of a localized region in rhodanese. AB - For the first time, the enzyme rhodanese has been proteolytically cleaved to give species that most likely correspond to individual domains. This indicates cleavage can occur in the interdomain tether. Further, the conditions for cleavage show that availability of the susceptible bond(s) depends on conformational changes triggered by oxidative inactivation. Rhodanese, without persulfide sulfur (E), was oxidized consequent to incubation with phenylglyoxal, NADH, or hydrogen peroxide. The oxidized enzyme (Eox) was probed using the proteolytic enzymes endoproteinase glutamate C (V8), trypsin, chymotrypsin, or subtilisin. The proteolytic susceptibility of Eox, formed using hydrogen peroxide, was compared with that of E and the form of the enzyme containing transferred sulfur, ES. ES was totally refractory to proteolysis, while E was only clipped to a small extent by trypsin or V8 and not at all by chymotrypsin or subtilisin. Eox was susceptible to proteolysis by all the proteases used, and, although there were some differences among the proteolytic patterns, there was always a band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis corresponding to Mr = 16,500. This was the only band observed in addition to the parent species (Mr = 33,000) when Eox was digested with chymotrypsin, and conservation of total protein was observed after digestion up to 90 min. No additional species were observable on silver staining, although there was some indication that the band at 16,500 might be a doublet. The results are consistent with the occurrence of a conformational change after oxidation that results in increased exposure and/or flexibility of the interdomain tether which contains residues that meet the specificity requirements of the proteases used. PMID- 3312192 TI - Influence of negative supercoiling and of the proximity of left-handed Z-DNA on the Escherichia coli lactose repressor-operator interaction. AB - The influence of negative supercoiling and of flanking (dC-dG) tracts in either right-handed B- or left-handed Z-structures on the interaction of the Escherichia coli lac repressor was investigated. The operator was embodied within the lac control sequence, which was 95, 59, or 29 base pairs in length. Thus, the (dC-dG) regions (in either B- or Z-conformations) were at different distances from the repressor-binding site. Surprisingly, the presence of the promoter sequence (-59 to -20 relative to the +1 transcription start site) of the lac operator region increases the binding affinity of lactose repressor to the operator at high negative supercoil densities. This influence of the promoter region on the binding was abolished when the flanking (dC-dG) tracts were in the left-handed Z DNA conformation. In contrast, minimal differences in the binding affinities were observed between plasmids containing shorter operator fragments (59 or 29 base pairs), whether the flanking (dC-dG) tracts were in right-handed B- or left handed Z-forms. The promoter region may be directly involved in the repressor operator complex in a previously unrecognized manner or may exert structural influence on the operator region. In general, increasing the amount of negative supercoiling increases the binding affinity and decreases the dissociation rate constants for the three operator-containing fragments, both with and without flanking Z-DNA tracts. Thus, the lac operator region possesses a previously unrecognized structural pliability, as influenced by negative supercoiling and neighboring sequences and/or conformations, which modulates its biological properties. PMID- 3312193 TI - A mutant insulin receptor with defective tyrosine kinase displays no biologic activity and does not undergo endocytosis. AB - The cDNAs encoding the normal human insulin receptor (HIRc) and a receptor that had lysine residue 1018 replaced by alanine (A/K1018) were used to transfect Rat 1 fibroblasts. Lysine 1018 is a critical residue in the ATP binding site of the tyrosine kinase domain in the receptor beta-subunit. Untransfected Rat 1 cells express 1700 endogenous insulin receptors. Expressed HIRc receptors had levels of insulin-stimulable autophosphorylation in vitro comparable to normal receptors, whereas A/K1018 receptors had less than 1% of that activity. Stimulation by insulin of HIRc receptors in situ in intact cells led to phosphorylation of beta subunit tyrosine residues and activation of tyrosine kinase activity that could be preserved and assayed in vitro after receptor purification. In contrast, A/K1018 receptors showed no such activation, either of autophosphorylation or of kinase activity toward histone. Cells expressing HIRc receptors display enhanced sensitivity to insulin of 2-deoxyglucose transport and glycogen synthase activity. This increased sensitivity was proportional to insulin receptor number at low but not at high levels of receptor expression. A/K1018 receptors were unable to mediate these biologic effects and actually inhibited insulin's ability to stimulate glucose transport and glycogen synthase through the endogenous Rat 1 receptors. Expressed HIRc receptors mediated insulin internalization and degradation, whereas A/K1018 receptors mediated little, if any. Endocytotic uptake of the expressed A/K1018 insulin receptors was also markedly depressed compared to normal receptors. Unlike HIRc receptors, A/K1018 receptors also fail to undergo down-regulation after long (24 h) exposures to high (170 nM) concentrations of insulin. We conclude the following. 1) Normal human insulin receptors expressed in Rat 1 fibroblasts display active tyrosine-specific kinase, normal intracellular itinerary after endocytosis, and normal coupling to insulin's biologic effects. 2) A receptor mutated to alter the ATP binding site in the tyrosine kinase domain had little if any tyrosine kinase activity. 3) This loss of kinase activity was accompanied by a nearly complete lack of both endocytosis and biologic activity. PMID- 3312194 TI - Human copper-zinc superoxide dismutase complements superoxide dismutase-deficient Escherichia coli mutants. AB - An Escherichia coli double mutant, sodAsodB, that is deficient in both bacterial superoxide dismutases (Mn superoxide dismutase and iron superoxide dismutase) is unable to grow on minimal medium in the presence of oxygen and exhibits increased sensitivity to paraquat and hydrogen peroxide. Expression of the evolutionarily unrelated eukaryotic CuZn superoxide dismutase in the sodAsodB E. coli mutant results in a wild-type phenotype with respect to aerobic growth on minimal medium and in resistance to paraquat and hydrogen peroxide. This supports the hypothesis that superoxide dismutation is the in vivo function of these proteins. Analysis of the growth of sodAsodB cells containing plasmids encoding partially active CuZn superoxide dismutases, produced by in vitro mutagenesis, shows a correlation between cell growth and enzyme activity. Thus, the sodAsodB strain provides a controlled selection for varying levels of superoxide dismutase activity. PMID- 3312195 TI - Isolation and characterization of a Mr = 110,000 glycoprotein localized to the hepatocyte bile canaliculus. AB - A Mr = 110,000 glycoprotein, GP 110, was partially purified using wheat germ agglutinin-Sepharose affinity chromatography from a bile canalicular-enriched membrane fraction denoted N2u of rat liver. This fraction was subjected to preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis and the Mr = 110,000 polypeptide was excised and used as an immunogen in rabbits. The antisera were found to specifically recognize a Mr = 110,000 polypeptide, named GP 110, in the N2u membrane fraction. In isolated hepatocytes, GP 110 was readily accessible to cell surface iodination catalyzed by lactoperoxidase at 4 degrees C and was judged by immunoprecipitation studies to contain about 2% of total radioactivity incorporated into externally oriented proteins of the cell. Immunoprecipitated GP 110 was shown by two-dimensional polyacrylamide gel electrophoresis to migrate with an approximate pI of 4.9. Indirect immunofluorescence on frozen liver sections demonstrated that GP 110 was primarily localized in the bile canaliculus. In corroborative studies employing subcellular fractionation, it was found that GP 110 was enriched nearly 19-fold in P2, a plasma membrane fraction primarily derived from the sinusoidal domain, and 44-fold in N2u. In contrast, only low levels of GP 110 were present in endoplasmic reticulum, mitochondrial, cytosolic, and nuclear-enriched fractions of liver. The physiological function of GP 110 is as yet unknown; antisera to it did not immunoprecipitate other known bile canalicular proteins of similar molecular weights. GP 110 was found to be extensively glycosylated relative to other known membrane proteins; approximately 33% of the apparent molecular weight appear to be carbohydrate. In agreement, limited removal of N-linked carbohydrate chains indicated that there are approximately eight chains/GP 110 polypeptide. Neuraminidase treatment of GP 110 resulted in a desialylated Mr = 85,000 polypeptide suggesting that the majority of carbohydrate chains on GP 110 are of the complex type. PMID- 3312196 TI - Binding of nucleotides to the ATP-dependent protease La from Escherichia coli. AB - A critical enzyme in protein breakdown in Escherichia coli is the ATP-hydrolyzing protease La, the lon gene product. In order to clarify the role of ATP in proteolysis, we studied ATP and ADP binding to this enzyme using rapid gel filtration to separate free from bound ligands. In the presence of Mg2+ or Mn2+ and 10 microM ATP, two molecules of ATP were bound to the tetrameric enzyme, while at 100 microM ATP (or higher), four ATP molecules were bound, both at 0 and 37 degrees C. Protease La thus has two high affinity sites (S0.5 less than 10(-7) M) for ATP and two lower affinity sites (S0.5 = 12-15 microM). Binding was reversible. In the absence of a divalent ion, ATP bound to only two sites. However, much lower Mg2+ concentrations (50 microM) were required for maximal ATPase binding than for maximal proteolytic and ATPase activity (2 mM). Decavanadate, which is a potent inhibitor of proteolysis, also blocked ATP binding, but orthovanadate had neither effect. Different ATP analogs bind to these sites in distinct ways. Adenyl-5'-yl imidodiphosphate binds to only one high affinity site, while adenyl-5'-yl methylene monophosphonate binds to two. Nevertheless, both non-metabolizable analogs can activate oligopeptide hydrolysis as well as ATP. Although binding of a single nucleotide can activate peptide hydrolysis, occupancy of all four sites appears necessary for maximal protein breakdown. The ATP molecules on all four sites are hydrolyzed rapidly. The Pi is released, but ADP remains on the enzyme. ADP binds to the same four sites, but this process does not require divalent ions. Protease La shows higher affinity for ADP than for ATP. Therefore, in vivo, ADP should inhibit ATP binding and protease La function. PMID- 3312197 TI - Protein substrates activate the ATP-dependent protease La by promoting nucleotide binding and release of bound ADP. AB - The interaction of protein substrates with protease La from Escherichia coli enhances its ability to hydrolyze ATP and peptide bonds. These studies were undertaken to clarify how unfolded proteins allosterically stimulate this ATPase activity. The tetrameric protease can bind four molecules of ATP, which activates proteolysis, or four molecules of ADP, which inhibits enzymatic activity. Protein substrates stimulate binding of the nonhydrolyzable ATP analog [3H] adenyl-5'yl imidodiphosphate, although they do not increase the net binding of [3H]ATP or [3H]ADP. Once bound, ATP is quickly hydrolyzed to ADP, which remains noncovalently associated with protease La even through repeated gel filtrations. Exposure to protein substrates (e.g. denatured bovine serum albumin at 37 degrees C) induces the release of all the bound ADP from the enzyme. Nonhydrolyzable ATP analogs bound to the enzyme were not released by these substrates. Proteins that are not degraded (e.g. native bovine serum albumin) and oligopeptides that only bind to the catalytic site do not induce ADP release. Thus, polypeptide substrates have to interact with an allosteric site to induce this effect. The protein-induced ADP release is inhibited by high concentrations of Mg2+ and is highly temperature-dependent. Protein substrates promoted [3H]ATP binding in the presence of ADP and Mg2+ (i.e. ATP-ADP exchange) and reduced the ability of ADP to inhibit the enzyme's peptidase and ATPase activities. These results indicate that: 1) ADP release is a rate-limiting step in protease La function; 2) bound ADP molecules inhibit protein and ATP hydrolysis in vivo; 3) denatured proteins interact with the enzyme's regulatory site and promote ADP release, ATP binding, and their own hydrolysis. PMID- 3312198 TI - Diversity in the effects of extracellular ATP and adenosine on the cellular processing and physiologic actions of insulin in rat adipocytes. AB - ATP or adenosine (1 mM) added to extracellular buffer abolished both chloroquine- and monensin-dependent accumulation of [125I]iodoinsulin in isolated rat adipocytes. The effects of ATP were not secondary to its conversion to adenosine and were mimicked by beta, gamma-methyleneadenosine 5'-triphosphate. ATP, but not adenosine, partially inhibited the binding of insulin to the cellular receptor. Neither ATP nor adenosine had any significant effect on both internalization of cell-bound insulin and externalization of the internalized hormone. The degradation of cell-bound insulin was reduced to a considerable extent by both 0.1 mM chloroquine and 5 mM ATP, to a lesser degree by 1 mM ATP, and not significantly by 1 or 5 mM adenosine. Physiologically, (a) 1 mM ATP had a strong, while 1 mM adenosine had a mild inhibitory effect on the insulin-stimulated glucose transport without affecting its basal activity, (b) both ATP and adenosine moderately stimulated basal as well as insulin-stimulated glycogen synthase, and (c) ATP, but not adenosine, transiently stimulated basal cAMP phosphodiesterase without affecting the insulin-stimulated enzyme. Phosphodiesterase in cells that had been exposed to ATP for 30 min was refractory to ATP added afresh, but not to insulin. These data suggest that (a) extracellular ATP may block the degradative pathway of insulin processing, (b) adenosine might render the ordinarily irreversible intracellular traffic of insulin reversible or modulate a pathway which is yet to be identified, (c) the previously reported effect of ATP on glycogen synthase may not involve phosphorylation, (d) ATP stimulates cAMP phosphodiesterase by a mechanism which is distinct from that of insulin, and (e) the degradative pathway of insulin processing may not be involved in the physiologic actions of the hormone on glycogen synthase and phosphodiesterase. PMID- 3312199 TI - Cloning and characterization of the yeast methionyl-tRNA synthetase mutation mes1. AB - The chromosomal mes 1 mutation appears to elevate the Km of methionine for yeast methionyl-tRNA synthetase. The mutation was cloned on a multicopy plasmid by gap repair of a plasmid bearing the wild type MES1 gene for a fragment corresponding to the mes 1 mutation. DNA sequencing established that the mutation consists of a single conversion of guanine into adenine which results in the replacement of a glycine by an aspartic acid at position 502. This causes the enzyme to be labile and inactive in vitro and to show a requirement for high concentrations of methionine in vivo. The mutation is in the COOH-terminal domain of the mononucleotide binding fold of the yeast enzyme and suggests participation of this region in the binding of the amino acid residue. PMID- 3312200 TI - Cloning and sequence analysis of cDNAs encoding mammalian cytosolic malate dehydrogenase. Comparison of the amino acid sequences of mammalian and bacterial malate dehydrogenase. AB - A cDNA clone, named ppcMDH-1 and covering a part of the coding region for the porcine cytosolic malate dehydrogenase (cMDH) mRNA, was isolated from a porcine liver cDNA library. Subsequently, mouse cMDH cDNA clones were isolated from mouse liver and heart cDNA libraries, using the ppcMDH-1 cDNA as a probe. The longest clone, named pmcMDH-5, was sequenced and the primary structure of the mouse cMDH deduced from its cDNA sequence showed that the mouse cMDH consists of the 334 amino acid residues. When the amino acid sequence of the mouse cMDH was compared with that of the porcine cMDH, they shared a 93% homology. On the other hand, the amino acid sequences of mouse cMDH and mitochondrial MDH (mMDH) showed about 23% overall homology. Surprisingly, comparison of the amino acid sequences among the mammalian and bacterial MDHs revealed that the homology between the mouse cMDH and thermophilic bacterial MDH, as well as the homology between the mouse mMDH and Escherichia coli MDH, markedly exceeds the intraspecies sequence homology between mMDH and cMDH from mice. PMID- 3312201 TI - DNA-mediated gene transfer of a human cell surface 170-kilodalton glycoprotein. Evidence for association with an endogenous murine protein. AB - We have previously reported the identification and characterization of two related human cell surface protein complexes, very common antigens 1 and 2 (VCA 1, VCA-2) (Kantor, R. R. S., Mattes, M. J., Lloyd, K. O., Old, L. J., and Albino, A. P. (1987) J. Biol. Chem. 262, 15158-15165). We now report the transfection of DNA sequences encoding the 170-kilodalton heterodimer of VCA-2 from human SK-RC 41 renal cancer cells to B78H1 mouse melanoma cells. B78H1 cells were cotransfected with high molecular weight renal cancer DNA and a plasmid vector containing the neomycin resistance gene. Antibiotic-resistant transfectants were screened for the expression of the 170-kDa heterodimer with mouse monoclonal antibody (mAb) J143. Analysis of mAb J143-positive (J143+) transfectants showed that they expressed a 170-kDa heterodimer with an identical molecular weight, isoelectric point, two-dimensional peptide map, and spatial orientation of surface-exposed epitopes to the homologous 170-kDa species seen in human donor cells. The 170-kDa heterodimer in SK-RC-41 cells is associated with a 140-kDa (designated 140(1] polypeptide to form the VCA-2 complex. The 170-kDa complex and the 140(1)-kDa polypeptides are encoded by genes located on different human chromosomes. J143+ transfectants display a molecule of 140 kDa associated with the 170-kDa complex which is biochemically similar, but non-identical, to the human 140(1)-kDa polypeptide on VCA-2. This evidence supports our interpretation that the transfected human 170-kDa heterodimer associates with a murine counterpart of the human 140(1)-kDa polypeptide in J143+ transfectants. PMID- 3312202 TI - Identification, purification, and characterization of Escherichia coli virus T1 DNA methyltransferase. AB - An Escherichia coli virus T1-induced DNA methyltransferase was identified by activity gel analysis in homogenates of infected E. coli DNA-adenine-methylation deficient strains. Although the Mr of this protein (31,000) is in the same range as that of the E. coli DNA adenine methyltransferase, the two proteins are not closely related; the E. coli dam gene does not hybridize with T1 DNA. Selective conditions for measurement of the T1 activity were developed, and the enzyme was purified to functional homogeneity, as shown by activity analysis in polyacrylamide gels. Requirements for optimal activity of the viral enzyme were determined to be pH 6.9, ionic strengths below 0.1 M KCl, and a temperature between 40 and 43 degrees C. The Km for S-adenosyl-L-methionine is 4.9 microM. The purified T1 DNA methyltransferase is capable of methylating adenine in 5' GATC-3' sites in vitro. PMID- 3312203 TI - A phospho-oligosaccharide mimics the effect of insulin to inhibit isoproterenol dependent phosphorylation of phospholipid methyltransferase in isolated adipocytes. AB - Addition of isoproterenol to isolated rat adipocytes prelabeled with [32P]phosphate caused an increase in the phosphorylation and activation of phospholipid methyltransferase. 32P-Labeled phospholipid methyltransferase was recovered by immunoprecipitation and gel electrophoresis. Analysis of 32P-labeled peptides revealed one site of phosphorylation regulated by isoproterenol, and analysis of phosphoamino acids demonstrated that the incorporation of [32P]phosphate was on phosphoserine. Incubation of adipocytes with isoproterenol in the presence of insulin or a phospho-oligosaccharide inhibited the phosphorylation and activation of this enzyme. The inhibitory effect of insulin on the phosphorylation of phospholipid methyltransferase was reversible, and it was mimicked by a phospho-oligosaccharide. The phospho-oligosaccharide was generated by hydrolysis of an isolated glycophospholipid with phosphatidylinositol-specific phospholipase C from Staphylococcus aureus. The insulin-like effect of this phospho-oligosaccharide on the phosphorylation of phospholipid methyltransferase was demonstrated in isolated adipocytes, and the effect was abolished by treatment of the phospho-oligosaccharide with 10% NH4OH, nitrous acid, or sodium periodate. These data suggest that in intact adipocytes the effect of insulin to inhibit the phosphorylation/activation of phospholipid methyltransferase is mediated by a phospho-oligosaccharide generated by a phosphatidylinositol-specific phospholipase C. PMID- 3312205 TI - Results of transfer of the flexor digitorum superficialis tendons to the flexor digitorum profundus tendons in adults with acquired spasticity of the hand. AB - Thirty-one patients who had transfer of the flexor digitorum superficialis tendons to the flexor digitorum profundus tendons en masse in thirty-four non functional spastic hands were examined at an average of fifty months postoperatively. All of the patients had had a clenched-fist deformity preoperatively, with severe hygienic problems of the palmar skin and no active function of the hand. Postoperatively, all of the hands were in an open position, which allowed for good hygiene of the palmar surface. A minor wound infection developed in three patients. Neurectomy of the motor branch of the ulnar nerve distal to the Guyon canal was needed for control of spasticity of the intrinsic muscles in twenty-five hands. An intrinsic-minus deformity did not develop in any of the hands that had neurectomy of the ulnar nerve, although an intrinsic-plus deformity developed in seven of the nine hands that did not have a neurectomy. PMID- 3312204 TI - Operative versus non-operative treatment of recent injuries to the ligaments of the knee. A prospective randomized study. AB - Two hundred consecutively seen patients who had an injury to either the anterior cruciate ligament or the medial collateral ligament, or both, were randomly allocated to treatment by either conservative or a surgical regimen. Injuries to the medial collateral ligament could not be demonstrated to benefit from surgical treatment in any respect--with or without surgery the results were excellent. With injuries to the anterior cruciate ligament, recovery was more rapid without surgery but otherwise the results differed between the groups in only one respect: the pivot-shift test was more often positive after conservative treatment. The results were good in both treatment groups even though most of the patients who had an injury of the anterior cruciate ligament were somewhat less pleased with the outcome after a period of time. PMID- 3312207 TI - Perioperative cefamandole prophylaxis against infections. AB - Seven hundred and seventeen patients were included in a prospective randomized double-blind trial comparing the efficacy of five doses of cefamandole (group I, 335 patients) with that of a single preoperative dose (group II, 382 patients) for prophylaxis against sepsis in patients who had an operation using either a Moore prosthesis, Ender or Kuntscher nails, a bone plate, or another internal fixation device. Patients who had an open fracture or total joint replacement were not included in the study. The two groups were similar in terms of mean age, sex ratio, duration of preoperative hospital stay, underlying risk factors, and type of surgical procedure. A wound infection developed in none of the seventy four patients in group I and in five (6.6 per cent) of the seventy-six in group II (p = 0.03) who required a Moore prosthesis. A wound infection developed in three patients (1 per cent) in group I and in fifteen (5 per cent) in group II (p = 0.006) who required an internal fixation device other than a Moore prosthesis. Staphylococcus aureus, Staphylococcus epidermidis, and gram-negative bacilli were the most common infecting organisms. The rate of mortality was similar in both groups, while the percentage of postoperative urinary-tract infections was lower in group I (p = 0.04). No adverse side effects of the drug were encountered. PMID- 3312206 TI - The treatment of adamantinoma of the tibia by wide resection and allograft bone transplantation. AB - Since 1975, nine patients who had adamantinoma of the tibia were treated by the orthopaedic oncology service of the Massachusetts General Hospital and the Children's Hospital, Boston, Massachusetts. All patients were followed for two years or more or until a relapse occurred (mean length of follow-up, 5.3 years). Five of the patients were female and four were male; their ages ranged from fourteen to fifty-six years (mean, 19.1 years). The treatment consisted of staging, wide surgical resection of the tumor, and insertion of a segment of intercalary bone allograft (eight patients) or an osteoarticular segment (one patient). All grafts were fixed with compression plates and screws. All but two of the allografts had united at both the proximal and the distal host-donor junction site by twelve months. None of the patients had a local recurrence but pulmonary metastases developed in one. Four of the patients had complications that affected the final result. The functional results were excellent in five patients, good in one, fair in one, and a failure in two. Seven of the nine patients were asymptomatic and fully functional at the time of writing; only one needed a brace to walk. On the basis of this experience we recommend wide resection and implantation of an intercalary allograft in the treatment of adamantinoma of the tibia. PMID- 3312209 TI - The Orthopaedic Associations of the English-Speaking World. Eighth combined meeting. Washington, D.C., May 2-8, 1987. PMID- 3312208 TI - Cyclosporin A and osteonecrosis of the femoral head. AB - A vascular osteonecrosis has occurred in 5 to 40 per cent of patients who have undergone transplantation of a kidney and generally has been considered to be a complication of the use of corticosteroids. Currently cyclosporin A is in general use for its immunosuppressive property, so that a lower dose of corticosteroids is needed. We analyzed the cases of a series of our patients who underwent transplantation of a kidney in order to find out if our present regimen, using cyclosporin A, influenced the prevalence of osteonecrosis of the femoral head. Of a total of 270 patients, osteonecrosis of the femoral head developed in fifteen of 174 who received conventional immunosuppressive therapy and in only one of ninety-six who received cyclosporin A (p less than 0.05). During the first two months after transplantation, the mean dose of prednisone was approximately 2.5 milligrams per kilogram of body weight per day in the group that received conventional immunosuppressive therapy and approximately 1.1 milligrams per kilogram of body weight per day in the group that received cyclosporin A (p less than 0.001). We concluded that the pathogenesis of the osteonecrosis in patients who underwent transplantation of a kidney was probably related to the higher doses of corticosteroids that were administered. PMID- 3312210 TI - The American Orthopaedic Association. Centennial program. May 4, 1987. PMID- 3312211 TI - The evaluation and treatment of partial physeal arrest. PMID- 3312213 TI - Burn depth evaluation with fluorometry: is it really definitive? AB - Clinical evaluation of burn depth soon after injury is subjective, based on gross visual assessment. Previous investigators have quantified this process using fluorometry. Their studies show fluorescein levels in full-thickness burns to be far below control levels and partial-thickness burns to be about 60% of nonburned skin. In both rat and human models, 59 burn sites (eight rats) and 37 burn sites (seven patients) were assessed. Readings were taken for three hours on the rats and one hour on the patients during the first 48 hours, and the procedure was repeated for five days postburn. Maximum values during these periods were determined for burn and nonburn sites, and background levels were subtracted from these values. The rate of fluorescein uptake and the peak times for burn and nonburn sites were then compared. Actual depth of burn was determined by whether or not healing had occurred. The results showed no significant difference between partial-thickness and full-thickness burns using fluorometry, as standard deviations in both models for both depths of burn were large. Therefore, fluorometry did not provide a definitive evaluation of burn depth. These results differ from those reported by previous investigators. PMID- 3312212 TI - Failure of topical steroids and vitamin E to reduce postoperative scar formation following reconstructive surgery. AB - One hundred fifty-nine operative procedures for postburn contractures of interdigital webs (96), the axilla (46), or the neck (17) were prospectively randomized to be treated postoperatively for four months with a topical steroid (Aristocort A), topical vitamin E, or the base cream carrier for these drugs. The nature of the medication was blinded both to the patient and to the evaluator. Patients were followed for one year. Observations were made for range of motion, scar thickness, change in graft size, and ultimate cosmetic appearance. No beneficial effect of either vitamin E or topical steroid could be demonstrated. However, adverse reactions occurred in 16.4% of patients receiving active drug, compared to 5.9% treated only with base cream. Interestingly, the grafts initially contracted and subsequently grew to be a size larger (about 20%) than the original graft by one year. It is concluded that neither topical steroid nor topical vitamin E is effective in reducing scar formation after grafting procedures for reconstruction for postburn contractures. PMID- 3312214 TI - Chemical burns: retrospective review. AB - The records of 51 patients with chemical burns were reviewed to identify demographics, mechanism and place of injury, cause, distribution, initial management, and outcome of treatment. Patients were classified as having received adequate (immediate dilution or neutralization of the chemical treatment--group A, or inadequate (delayed or inappropriate) treatment--group B. Inpatient mortality for chemical burns was 13% compared to 15% overall burn center mortality. Of the burns, 79% occurred in the 21-50 age group; 69% of burns were work-related in men and 17% in women. In group A, 19% required skin grafting (mortality 9.5%); in group B, 36% required grafting (mortality 21%). Alkali were the most frequent cause of burns, followed by sulfuric acid and, less often, gasoline, anhydrous ammonia, white phosphorus, and hydrofluoric acid. PMID- 3312215 TI - A new model for studying the development of human hypertrophic burn scar formation. AB - Hypertrophic scar formation remains the major problem for severely burned patients who survive their injuries. This scarring can result in both cosmetic and functional deformities. One of the major problems in dealing with this complication is the lack of an adequate animal model with which to test various possible therapeutic modalities. We describe an animal model that uses human skin applied to the backs of nude mice to investigate the problem. Immunosuppression is not necessary in this model since the nude mouse lacks a thymus gland and is therefore not able to reject the skin. With this model we have been able to achieve contracture of meshed normal human skin grafts and hypertrophic scar formation in normal human skin that was burned a month after grafting to the mouse. We have also had success in grafting human hypertrophic scars, obtained from burn patients, to the mice. This model offers unique opportunities for investigation of the cause and treatment of burn scars in humans. PMID- 3312217 TI - Partial excision of residual burn lesions. AB - Most burn victims have unattractive residual lesions, which may include hypertrophic donor sites, unsightly skin grafts, hypertrophic scars, and mature scars with altered pigmentation or texture. Some of these lesions can be treated by total excision in one or more stages or they can be reconstructed utilizing grafts, flaps, Z-plasties, or tissue expansion. But frequently these procedures are either not indicated or not elected by the patient. In such a situation, the only surgical option is partial excision, with the goal of making the lesion less conspicuous and more easily concealed by clothing. Whether or not such partial excisions are worthwhile is the obvious question. We could not find an answer in the literature and therefore decided to review our own experience. Between 6/30/81 and 3/12/86, 92 such procedures were performed and followed in 25 patients. Partial excision of hypertrophic donor sites, unsightly skin grafts, and hypertrophic scars did yield improved appearance in most patients. However, partial excision of mature scars, ie, areas of altered pigmentation or texture, did not have the same success. We continue to treat the first three types of lesions in this fashion but no longer include the latter. PMID- 3312216 TI - A prospective controlled trial of Biobrane versus scarlet red on skin graft donor areas. AB - A prospective trial of Biobrane versus scarlet red as a skin graft donor site dressing was done in 21 burn patients with mean total body surface area burns of 31.9%. Corresponding body areas were randomly selected on each patient to receive one of the dressings. Daily evaluations were made of subjective expression of pain, exudate formation and infection, and time of separation of the dressing from the wound. Biobrane was found to be superior in reducing donor site pain. However, with Biobrane there was a higher incidence of infection (57% v 9.5%) and a significant delay in separation from the wound. Scarlet red was found to be more cost-effective. Occlusive dressings have previously been shown to have a high incidence of complications (30%). In extensive burns, isolating the donor site from the wound is difficult and may lead to increased complications. Scarlet red appears to be superior to Biobrane for skin graft donor sites in this patient population. PMID- 3312218 TI - Corneal perforations caused by multiple resistant Pseudomonas organisms: a case report. AB - Pseudomonas aeruginosa is the most common cause of corneal ulcers in the southern United States as well as being the most virulent corneal pathogen; corneal perforations can follow. The emergence of multiple resistant Pseudomonas organisms in burn units may lead to an increased incidence of this tragic complication. PMID- 3312219 TI - Recent trends in the surgical treatment of endomyocardial fibrosis. AB - Several modifications of the traditional treatment of endomyocardial fibrosis have been made based on a personal experience of 51 surgical cases and on the reports of others in the surgical literature during the last decade. Description of these techniques and the author's current concept of the pathological processes are reported herein. PMID- 3312220 TI - Effects of pulsatile cardiopulmonary bypass on carbohydrate and lipid metabolism. AB - The influence of pulsatile perfusion on carbohydrate and lipid metabolism was examined in 40 patients (20 pulsatile and 20 non-pulsatile) who underwent open heart surgery. The pulsatile assist device was used for pulsatile cardiopulmonary bypass during aortic cross-clamping only, and samples of the mixed venous blood were taken every 20 minutes. There were no statistically significant differences between pulsatile and non-pulsatile groups with respect to plasma levels of glucose, insulin, glucagon, free fatty acids and ketone bodies. However, an increase in the plasma level of noradrenaline was significantly suppressed in the pulsatile group, and triglyceride levels were significantly higher in the pulsatile than in the non-pulsatile group. These data suggest that pulsatile flow attenuates the catecholamine stress response to cardiopulmonary bypass and has a protective effect on liver function during bypass. PMID- 3312221 TI - Vascular surgery--then and now. Presidential address--the Leriche memorial lecture, International Society for Cardiovascular Surgery (Monte Carlo, Monaco, August 27, 1985). PMID- 3312222 TI - Direct popliteal valve substitution by Technique II and its efficacy in deep venous insufficiency of the lower limb. AB - The substitute "valve" operation by Technique II using a silastic tendon designed to produce a valve-like mechanism on the popliteal vein is described. The results achieved in 65 limbs with deep venous insufficiency due to reflux in the deep veins have been assessed by Doppler ultrasound, by measurement of ambulatory venous pressure before and one week after operation and by phlebography twenty seven limbs were followed-up one to three years after operation. The clinical improvement in 60 limbs was associated with reduction in the ambulatory venous pressure, with abolition of popliteal reflux and phlebographic evidence of a functioning substitute "valve". PMID- 3312223 TI - Simultaneous aorto-renal reconstruction and consideration to the value of combined approach. A 2-16 years follow-up study, with review of the literature. AB - Thirty five patients who underwent simultaneous aortic and renal artery reconstruction are reviewed, to determine the value of the combined approach. The risk factors determining operative morbidity and mortality are discussed, on the basis of a long term follow-up of more than sixteen years. All patients had a significant renal artery stenosis, in addition to either severe aorto-iliac occlusive disease or an abdominal aortic aneurysm. Twenty seven patients were hypertensive, and eight patients normotensive. Combined aorto-renal reconstruction was carried out prophylactically in eight instances. There were two operative deaths (5.7%). Factors found to be associated with an increased operative risk were advanced age (over 65 years), heart disease with ECG changes, severe hypertension and diabetes. Renal insufficiency with azothaemia and high levels of creatinine, represented a major risk factor. Post operatively, six individuals (24%) were classified as "cured" and thirteen (523) were "improved". Patients with bilateral renal artery stenosis, mild azothemia and moderately elevated creatinine, were found to improve significantly their renal function post operatively. No patient required hemodialysis. Simultaneous aorto-renal reconstruction may be performed with a low mortality and gratifying improvement in hypertensive patients, without evidence of adverse features. PMID- 3312224 TI - True aneurysm of the profunda femoris artery. Literature review, differential diagnosis, management. AB - Aneurysms of the profunda femoris artery rarely occur as isolated lesions. Those cases appearing in the literature generally include only false aneurysms, the result of blunt, penetrating, or high velocity trauma. From a thorough review of the literature, true, aneurysmal dilatation of this artery, even as part of a generalized vascular degenerative process, must be considered obscure. A patient with an aneurysm of the deep femoral artery presented with an enlarging, progressively debilitating mass. The true nature of the lesion escaped definitive diagnosis even after detailed evaluation prior to surgical intervention. A review of the pathophysiologic basis of aneurysm formation strongly suggests this case may be the result of an, as yet undefined, autoimmune process. PMID- 3312225 TI - Effect of contralateral internal carotid stenosis on the accuracy of continuous wave Doppler spectral analysis results. AB - In order to determine the effect of a hemodynamically significant contralateral stenosis on the results of a carotid Doppler study, 333 continuous wave Doppler spectral analysis studies were compared to angiography. For most grades of stenoses, both the peak frequency and the spectral broadening index were increased in the group of patients with contralateral carotid arterial stenoses greater than 50% by comparison with the group with less severe stenoses. Using receiver operating characteristic curves, the diagnostic accuracy was found to be slightly reduced by the presence of significant contralateral disease. Hence, when interpreting the results of carotid Doppler examinations, the presence or absence of a hemodynamically significant contralateral stenosis should be considered in determining the likelihood that an ipsilateral stenosis is present and in evaluating its severity. PMID- 3312226 TI - Aneurysm in a double velour knitted Dacron graft. AB - Double velour knitted Dacron grafts are currently used for aorto-iliac arterial reconstructions to increase encapsulation and enable rapid intimization of the grafts. Reports of an aneurysm arising in the body of a double velour knitted Dacron graft are rare. We experienced a case of aneurysm arising in the body of an innominate-abdominal aortic bypass graft four years after implantation. Microscopically, this focal aneurysm seemed to be related to a structural defect in the manufacturing process. We wish to stress that patients with implanted commercial Dacron prostheses should be carefully and regularly followed. PMID- 3312227 TI - Arterial complications following orthopaedic reconstructions. AB - Arterial complications following orthopaedic reconstructions are quite rare. Three patients with the complication of pseudoaneurysm or migration of a Kirschner wire following an orthopaedic reconstruction are presented. PMID- 3312228 TI - Infected false aneurysm following carotid endarterectomy with vein patch angioplasty. AB - The authors report a case of infected false aneurysm that developed after carotid endarterectomy with vein patch angioplasty. This complication is extremely rare and occurs most commonly when a Dacron patch graft has been employed. Various clinical presentations are described and the etiology of infection is discussed. Surgical management consisted of the resection of the pseudoaneurysm and segmental replacement with vein. Parenteral antibiotic therapy was given for three weeks and topical irrigation with an antiseptic solution performed for two weeks. PMID- 3312229 TI - Effects of cytochalasin and phalloidin on actin. PMID- 3312230 TI - Anionic regions in nuclear proteins. PMID- 3312231 TI - Inhibition of nucleolar reformation after microinjection of antibodies to RNA polymerase I into mitotic cells. AB - The formation of daughter nuclei and the reformation of nucleolar structures was studied after microinjection of antibodies to RNA polymerase I into dividing cultured cells (PtK2). The fate of several nucleolar proteins representing the three main structural subcomponents of the nucleolus was examined by immunofluorescence and electron microscopy. The results show that the RNA polymerase I antibodies do not interfere with normal mitotic progression or the early steps of nucleologenesis, i.e., the aggregation of nucleolar material into prenucleolar bodies. However, they inhibit the telophasic coalescence of the prenucleolar bodies into the chromosomal nucleolar organizer regions, thus preventing the formation of new nucleoli. These prenucleolar bodies show a fibrillar organization that also compositionally resembles the dense fibrillar component of interphase nucleoli. We conclude that during normal nucleologenesis the dense fibrillar component forms from preformed entities around nucleolar organizer regions, and that this association seems to be dependent on the presence of an active form of RNA polymerase I. PMID- 3312232 TI - The subnuclear localization of tRNA ligase in yeast. AB - Yeast tRNA ligase is an enzyme required for tRNA splicing. A study by indirect immune fluorescence shows that this enzyme is localized in the cell nucleus. At higher resolution, studies using indirect immune electron microscopy show this nuclear location to be primarily at the inner membrane of the nuclear envelope, most likely at the nuclear pore. There is a more diffuse, secondary location of ligase in a region of the nucleoplasm within 300 nm of the nuclear envelope. When the amount of ligase in the cell is increased, nuclear staining increases but staining of the nuclear envelope remains constant. This experiment indicates that there are a limited number of ligase sites at the nuclear envelope. Since the other tRNA splicing component, the endonuclease, has the characteristics of an integral membrane protein, we hypothesize that it constitutes the site for the interaction of ligase with the nuclear envelope. PMID- 3312233 TI - Subcellular localization of a protein kinase required for cell cycle initiation in Saccharomyces cerevisiae: evidence for an association between the CDC28 gene product and the insoluble cytoplasmic matrix. AB - The product of the Saccharomyces cerevisiae gene CDC28, a protein kinase required for initiation of the cell division cycle, was localized within yeast cells. By using immunofluorescence methods, the CDC28 product was shown to be primarily cytoplasmic in distribution. The gene product was localized largely to the particulate fraction by differential centrifugation after mechanical disruption in aqueous buffers. The particulate association was not affected by the presence of nonionic detergent. To refine this localization further, a procedure was developed for the preparation of yeast cytoplasmic matrices which resemble the cytoskeletons of vertebrate cells on the basis of methodology, immunochemistry, and gross ultrastructure. A portion of the CDC28 product was found to be tightly associated with these detergent-insoluble cytoplasmic matrices by both immunofluorescence and immunoblotting procedures. Although, for technical reasons, precise quantitation was not possible, it is estimated that a minimum of 2-15% of the total CDC28 product pool is involved in the association with the insoluble matrix. Alcohol dehydrogenase, a soluble cytoplasmic protein, was found not to be associated with the cytoplasmic matrices at any detectable level, whereas, in contrast, approximately 10-40% of the total cellular actin, a bonafide cytoskeletal protein, was present in these structures. The proportion of CDC28 gene product associated with the particulate fraction, and perhaps the insoluble matrix, appears to be substantially decreased during the preparation of spheroplasts. PMID- 3312235 TI - Receptor-mediated vectorial transcytosis of epidermal growth factor by Madin Darby canine kidney cells. AB - Transcellular transport of a variety of ligands may be an important mechanism by which regulatory substances reach their site of action. We have studied the transcellular transport of two 6,000-mol-wt proteins, epidermal growth factor (EGF) and insulin, across polarized Madin-Darby canine kidney (MDCK) cells grown on dual-sided chambers on a nitrocellulose filter substrate. When grown on these chambers, MDCK cells are polarized and express distinct basal and apical surfaces. MDCK cells are capable of unidirectional transport of EGF from the basal-to-apical direction, 50% of bound EGF transported in 2 h. Transport was inhibited by the addition of unlabeled EGF in a dose-dependent manner. Anti-EGF receptor Ab, which inhibited binding, also inhibited transport. No transport in the apical-to-basal direction is noted. Insulin transport is not observed in either direction. Transport correlates with the presence of ligand-specific receptors on the cell surface. Hence, EGF receptors (Ro = 48,000, Kd = 3.5 X 10( 10) M) are found only on the basal surface of the MDCK cells and neither surface expresses insulin receptors. Characterization of the EGF receptors on MDCK cells, as assessed by affinity, molecular mass, and anti-receptor antibody binding reveals that this receptor has similar characteristics to EGF receptors previously described on a variety of cells. Hence, the EGF receptor can function as a transporter of EGF across an epithelial cell barrier. PMID- 3312234 TI - Characterization of new mutants in the early part of the yeast secretory pathway isolated by a [3H]mannose suicide selection. AB - We have adapted a [3H]mannose suicide selection to identify mutations in additional genes which function in the early part of the yeast secretory pathway. Thus far this protocol has led to the identification of two new genes which are implicated in this process, as well as additional alleles of previously identified genes. The new mutants, bet1 and bet2, are temperature sensitive for growth and protein transport. Thin section analysis has revealed the accumulation of a network of endoplasmic reticulum (ER) at the restrictive temperature (37 degrees C). Precursors of exported proteins that accumulate in the cell at 37 degrees C are terminally core glycosylated. These observations suggest that the transport of precursors is blocked subsequent to translocation into the ER but before entry into the Golgi apparatus. The bet1 and bet2 mutants define two new complementation groups which have the same properties as previously identified ER accumulating mutants. This and previous findings (Novick, P., C. Field, and R. Schekman, 1980, Cell, 21:205-215) suggest that protein exit from the ER and entry into the Golgi apparatus is a complex process requiring at least 11 genes. PMID- 3312236 TI - On the mechanism of anaphase A: evidence that ATP is needed for microtubule disassembly and not generation of polewards force. AB - As anaphase began, mitotic PtK1 and newt lung epithelial cells were permeabilized with digitonin in permeabilization medium (PM). Permeabilization stopped cytoplasmic activity, chromosome movement, and cytokinesis within about 3 min, presumably due to the loss of endogenous ATP. ATP, GTP, or ATP-gamma-S added in the PM 4-7 min later restarted anaphase A while kinetochore fibers shortened. AMPPNP could not restart anaphase A; ATP was ineffective if the spindle was stabilized in PM + DMSO. Cells permeabilized in PM + taxol varied in their response to ATP depending on the stage of anaphase reached: one mid-anaphase cell showed initial movement of chromosomes back to the metaphase plate upon permeabilization but later, anaphase A resumed when ATP was added. Anaphase A was also reactivated by cold PM (approximately 16 degrees C) or PM containing calcium (1-10 mM). Staining of fixed cells with antitubulin showed that microtubules (MTs) were relatively stable after permeabilization and MT assembly was usually promoted in asters. Astral and kinetochore MTs were sensitive to MT disassembly conditions, and shortening of kinetochore MTs always accompanied reactivation of anaphase A. Interphase and interzonal spindle MTs were relatively stable to cold and calcium until extraction of cells was promoted by longer periods in the PM, or by higher concentrations of detergent. Since we cannot envisage how both cold treatment or relatively high calcium levels can reactivate spindle motility in quiescent, permeabilized, and presumably energy-depleted cells, we conclude that anaphase A is powered by energy stored in the spindle. The nucleotide triphosphates effective in reactivating anaphase A could be necessary for the kinetochore MT disassembly without which anaphase movement cannot proceed. PMID- 3312237 TI - In vivo microtubules are copolymers of available beta-tubulin isotypes: localization of each of six vertebrate beta-tubulin isotypes using polyclonal antibodies elicited by synthetic peptide antigens. AB - beta-Tubulin is encoded in the genomes of higher animals by a small multigene family comprising approximately seven functional genes. These genes produce a family of closely related, but distinct polypeptide isotypes that are distinguished principally by sequences within the approximately 15 carboxy terminal amino acid residues. By immunizing rabbits with chemically synthesized peptides corresponding to these variable domain sequences, we have now prepared polyclonal antibodies specific for each of six distinct isotypes. Specificity of each antiserum has been demonstrated unambiguously by antibody binding to bacterially produced, cloned proteins representing each isotype and by the inhibition of such binding by preincubation of each antiserum only with the immunizing peptide and not with heterologous peptides. Protein blotting of known amounts of cloned, isotypically pure polypeptides has permitted accurate quantitative measurement of the amount of each beta-tubulin isotype present in the soluble and polymer forms in various cells, but has not revealed a bias for preferential assembly of any isotype. Localization of each isotype in three different cell types using indirect immunofluorescence has demonstrated that in vivo each class of microtubules distinguishable by light microscopy is assembled as copolymers of all isotypes expressed in a single cell. PMID- 3312238 TI - F-actin binds to the cytoplasmic surface of ponticulin, a 17-kD integral glycoprotein from Dictyostelium discoideum plasma membranes. AB - F-actin affinity chromatography and immunological techniques are used to identify actin-binding proteins in purified Dictyostelium discoideum plasma membranes. A 17-kD integral glycoprotein (gp17) consistently elutes from F-actin columns as the major actin-binding protein under a variety of experimental conditions. The actin-binding activity of gp17 is identical to that of intact plasma membranes: it resists extraction with 0.1 N NaOH, 1 mM dithiothreitol (DTT); it is sensitive to ionic conditions; it is stable over a wide range of pH; and it is eliminated by proteolysis, denaturation with heat, or treatment with DTT and N ethylmaleimide. gp17 may be responsible for much of the actin-binding activity of plasma membranes since monovalent antibody fragments (Fab) directed primarily against gp17 inhibit actin-membrane binding by 96% in sedimentation assays. In contrast, Fab directed against cell surface determinants inhibit binding by only 0-10%. The actin-binding site of gp17 appears to be located on the cytoplasmic surface of the membrane since Fab against this protein continue to inhibit 96% of actin-membrane binding even after extensive adsorption against cell surfaces. gp17 is abundant in the plasma membrane, constituting 0.4-1.0% of the total membrane protein. A transmembrane orientation of gp17 is suggested since, in addition to the cytoplasmic localization of the actin-binding site, extracellular determinants of gp17 are identified. gp17 is surface-labeled by sulfo-N-hydroxy succinimido-biotin, a reagent that cannot penetrate the cell membrane. Also, gp17 is glycosylated since it is specifically bound by the lectin, concanavalin A. We propose that gp17 is a major actin-binding protein that is important for connecting the plasma membrane to the underlying microfilament network. Therefore, we have named this protein "ponticulin" from the Latin word, ponticulus, which means small bridge. PMID- 3312240 TI - Rapid in vitro formation of smooth endoplasmic reticulum aggregates within peptide-producing islet cells. AB - We report here that heptanol (3.5 mM) induces in vitro a rapid formation of smooth endoplasmic reticulum aggregates (SERA) within isolated islets of Langerhans. SERA appeared after only 15 min of exposure to the alkanol and increased in number during the first 30 min of incubation. At that time, SERA represented 2% and 6% of the volume of B- and non-B-cells, respectively. Removal of heptanol resulted in the rapid disappearance of SERA, whereas reintroduction of the alkanol rapidly induced these structures again. SERA formation was seen in different types of endocrine and nonendocrine islet cells. In the insulin producing B-cells, SERA formation was not modified by conditions known to alter the secretory activity and the microtubular-microfilament network or to inhibit protein synthesis. By contrast, SERA formation was inhibited by low temperature and by conditions depleting the energy sources of the cells. Similar observations were made in the presence of either octanol (1 mM) or nonanol (1 mM) but not of shorter chain alkanols, alkanes, oxidative derivates of either heptanol or octanol, and of other unrelated lipid-soluble compounds. Incubations in the presence of long-chain alkanols provide, therefore, a unique model to study in vitro the formation and disposal of smooth endoplasmic reticulum, as well as a system in which rapid membrane biogenesis is amenable to direct experimental testing. PMID- 3312241 TI - Contact-inhibition-induced quiescent state is marked by intense nuclear expression of statin. AB - Statin, a nuclear protein of 57,000 daltons, is found in in vitro aged, nonproliferating human fibroblasts but not in their young, replicating counterparts or transformed derivatives; it is also found in the nuclei of young fibroblasts when their growth is arrested but rapidly disappears from the cells once the restriction to growth is removed. We reported earlier that as cells leave the quiescent state, the loss of statin from the nucleus precedes the initiation of DNA synthesis; here we report that in a confluent culture, as cells leave the traverse of the replicative cycle and assume the quiescent phenotype, statin is not expressed maximally until total contact inhibition of growth is achieved. This full manifestation of statin occurs in monolayer culture with cells forming the typical swirling pattern and fibronectin organized into large intercellular cables. The late expression of statin in cells approaching the quiescent state is also verified biochemically by immunoblotting assays. The present results, taken together with those reported earlier, indicate that the nuclear appearance of statin occurs only after the complete cessation of DNA synthesis and that the full manifestation of this protein can be used as a marker for the G0 quiescent state. PMID- 3312239 TI - Visualization of the cytoplasmic surface of Torpedo postsynaptic membranes by freeze-etch and immunoelectron microscopy. AB - The synapse-specific Mr 43,000 protein (43K protein) and the acetylcholine receptor were visualized by freeze-etch immunoelectron microscopy in preparations of purified Torpedo postsynaptic membranes. Vesicles were immobilized on glass and then sheared open by sonication to expose the cytoplasmic surface. Membranes were labeled with monoclonal antibodies to the 43K protein or the acetylcholine receptor. The cytoplasmic surface was devoid of filamentous structure, and the 43K protein and the cytoplasmic projection of the acetylcholine receptor were associated with prominent surface particles. Acetylcholine receptor and 43K protein, in membrane surfaces in direct contact with glass coated with polyornithine, segregated into dense particle aggregates separated by smooth membrane patches, whereas those in contact with glass coated with Alcian Blue underwent little or no detectable rearrangement. After treatment of vesicles at alkaline pH to remove the 43K protein, the cytoplasmic surfaces were still covered by a dense array of particles that were more uniform in shape and appeared slightly shorter than those seen on unextracted membranes, but similar in height to the extracellular projection. Monoclonal antibodies to the acetylcholine receptor labeled these particles, while antibodies to 43K protein did not. We conclude that the 43K protein is in direct association with the receptor and that complexes of the receptor and 43K protein can undergo surface induced lateral redistribution. In addition, the cytoplasmic projection of the acetylcholine receptor is sufficiently large to be readily detected by freeze etch electron microscopy and is similar in height to the extracellular projection. PMID- 3312242 TI - Synthesis and apical and basolateral secretion of thyroglobulin by thyroid cell monolayers on permeable substrate: modulation by thyrotropin. AB - In the thyroid glands, thyroglobulin (Tg) is specifically synthesized by follicular cells and then secreted into the apical lumen where it is concentrated and used as a substrate for thyroid hormone synthesis. The presence of Tg in the circulation has been reported in normal and pathological situations. To determine the domains of the plasma membrane, apical and/or basolateral, involved in Tg secretion, porcine thyroid epithelial cells were cultured as a monolayer on the porous bottom of a culture chamber in which both apical and basal media are independently accessible. Control experiments using labeled Tg ascertained the tightness of the monolayer and showed that within 48 h only 0.2-0.5% of the Tg introduced in the apical medium was transferred through the cell layer into the basal compartment. For kinetic studies of Tg synthesis and secretion, monolayers were cultured for up to 72 h in the presence of 35S-methionine and with or without 100 microU/ml thyrotropin (TSH) in the basal medium. Labeled Tg was measured by double immunoprecipitation and by fluorography of polyacrylamide gel electrophoresis. We showed that 80-95% of total secreted Tg was recovered in the apical medium. The remainder was secreted through the basolateral membranes in the basal medium. The amount of tg secreted into the apical compartment was stimulated two- to threefold by TSH whereas no TSH effect was observed on secretion in the basal compartment. Moreover, measuring apical and basal volumes, we observed a net water flow from the apical to the basal side. It was stimulated threefold by TSH, increasing the Tg concentration in the apical compartment of the stimulated cell layer. During the culture time, the amount of Tg synthesized and secreted was increased by TSH, as was the Tg mRNA content, as determined by the dot-blot hybridization method. PMID- 3312243 TI - Covalent modification of the permeability pathways induced in the human erythrocyte membrane by the malarial parasite Plasmodium falciparum. AB - The intraerythrocytic malarial parasite Plasmodium falciparum induces permeation pathways in the plasma membrane of its host, the red blood cell. The pathways display porelike properties with selectivity toward anions and neutral molecules. They are shown here to be susceptible to chemical modification by 4,4' diisothiocyano-2,2'-dihydrostilbene disulfonic acid (H2DIDS), an amino-reactive reagent which is impermeant to uninfected cells. At pH 7.4 the reagent affected transport only marginally while freely entering into infected cells and reacting with intracellular hemoglobin. On the other hand, at pH above 8.5, the compound blocked the pathways efficiently (IC 50 approximately equal to 50 microM, at 37 degrees C for 10 min) as judged by four criteria: (1) selective lysis of infected erythrocytes in the presence of isotonic polyols; (2) uptake of [14C] sorbitol into infected cells; (3) uptake of the fluorescent anion Nbd-taurine into infected cells under conditions in which the native anion transport systems was inhibited; and (4) labeling of intracellular hemoglobin by the permeating reagent [3H]H2DIDS. The inhibitory effect was observed only with mature forms of parasitized cells, i.e., from the trophozoite stage and onward, while the pathways of immature ring forms were refractive. However, when the probe was incorporated into the interior of hemoglobin-depleted resealed ghosts prepared from ring forms, it was found to inhibit the pore-mediated transport. On the basis of these and other studies we postulate that the H2DIDS-sensitive sites on the pathways are endofacial, thus requiring penetration of the probe (probably through the same pathway) for their inactivation. Labeling studies with the radiolabeled modifier implicate 120-Kd, 63-Kd, and/or 51-Kd polypeptides as candidates for the pore components. PMID- 3312244 TI - Growth regulation of human breast carcinoma occurs through regulated growth factor secretion. AB - We describe studies on human breast cancer in which it is shown that specific growth factors (IGF-I, TGF alpha, PDGF) are secreted by human breast cancer cells and likely to be involved in tumor growth and progression. These activities are regulated by estradiol in hormone-dependent breast cancer and secreted constitutively by hormone-independent cells. These growth factor activities can induce the growth of hormone-dependent cells in vivo in athymic nude mice. Hormone-dependent breast cancer cells also secrete TGF beta, a growth-inhibitory substance, when treated with antiestrogens. TGF beta functions as a negative autocrine growth regulator and is responsible for some of the growth-inhibitory effects of antiestrogens. PMID- 3312245 TI - Estrogen-induced lysosomal proteases secreted by breast cancer cells: a role in carcinogenesis? AB - In an attempt to understand the mechanism by which estrogens stimulate cell proliferation and mammary carcinogenesis, metastatic human breast cancer cell lines (MCF7, ZR75-1) were found to secrete a 52,000 dalton (52K) protein under estrogen stimulation. Following its purification to homogeneity, the 52K protein was identified as a secreted procathepsin-D-like aspartyl protease bearing mannose-6-phosphate signals. This precursor displays an in vitro autocrine mitogenic activity on estrogen-deprived MCF7 cells and is able to degrade basement membrane and proteoglycans following its autoactivation. The total protease (52K + 48K and 34K) was detected and assayed by monoclonal antibodies and was found to be highly concentrated in proliferative and cystic mastopathies. In breast cancer, its cytosolic concentration appears to be correlated more to tumor invasiveness than to hormone responsiveness. The mRNA of the 52K protease accumulates rapidly following estradiol treatment, as was shown by Northern blot analysis with cloned cDNA. The 52K cathepsin-D-like protease is the first example of a lysosomal protease induced by estrogens in cancer cells. Results obtained using different approaches suggest that two cysteinyl cathepsins are also related to cell transformation and invasiveness. It has been proposed that cathepsin-B is involved in breast cancer and metastatic melanoma, and its regulation by estrogen has been shown in the rat uterus. Cathepsin-L corresponds to the major excreted protein (MEP) whose synthesis and secretion are markedly increased by transformation of NIH 3T3 cells with Ki ras and are regulated by several growth factors. In addition to secreted autocrine growth factors and to other proteases (plasminogen activator, collagenase), lysosomal cathepsins may therefore play an important role in the process of tumor growth and invasion as long as their precursor is secreted abundantly. PMID- 3312246 TI - Comparison of basement membrane matrix degradation by purified proteases and by metastatic tumor cells. AB - We have examined the nature of biochemical degradation of an isolated basement membrane matrix (bovine lens capsule) using different methodologies. The first strategy was quantitation of the release of surface-bound 125I and a second the documentation by SDS-PAGE of the appearance of putative cleavage products and the loss of high-molecular-weight components from the matrix. Basement membrane matrix bands resolved on SDS-PAGE were identified by their protease sensitivities as well as by Western immunoblots using monoclonal antibodies developed for this study. Radioiodinated components were found predominantly at positions on the gel equivalent to 160-200 kd and 400 kd proteins. Since these labeled moieties were sensitive to bacterial collagenase digestion and stained with anticollagen type IV antibodies, they were determined to represent various configurations of collagen type IV. Several other lower-molecular-weight bands also stained with the anticollagen IV antibodies. Monoclonal antibodies reactive with laminin exhibited a complex staining pattern on the gels, which included the expected 200 and 400 kd components. We confirmed that lens capsule basement membrane contained only a single heparan sulfate glycosaminoglycan species, and tumor cell-induced glycosaminoglycan degradation within the basement membrane matrix was detected using cellulose acetate electrophoresis. Distinctive putative cleavage products were resolved on SDS-PAGE gels from matrices subjected to digestion by a variety of purified proteases as well as by metastatic tumor cells or their conditioned media. Tumor cells of different histiotypes produced different characteristic cleavage patterns, suggestive of the existence of several pathways of matrix degradation. Overall, primary tumor cells exhibited a greater degradative activity towards the basement membrane matrix than did long-term tissue culture passaged cells. The same tumor cell line could exhibit considerably different patterns of both protein and glycosaminoglycan degradation depending on recent culture history. The relevance of these biochemical studies to the pathogenesis of malignant neoplasms is shown by: 1) the evaluation of degradative activities of B16 tumor cell populations exhibiting enhanced lung-colonizing phenotypes, and 2) the ability of a known antimetastatic moiety with antiprotease activity (Haementeria leech species salivary gland extract) to protect matrix components from degradation by tumor cell-conditioned medium. PMID- 3312247 TI - Transformation of glucocorticoid and progesterone receptors to the DNA-binding state. AB - This brief review explores some recent observations relating to the structure of untransformed glucocorticoid and progesterone receptors and the mechanism by which the receptors are transformed to the DNA-binding state. In their molybdatestabilized, untransformed state, progesterone and glucocorticoid receptors exist as a heteromeric 8-9S complex containing one unit of steroid binding phosphoprotein and one or two units of the 90 kD heat shock protein hsp90. When the receptors are transformed, the steroid-binding protein dissociates from hsp90. In cytosol preparations, temperature-mediated dissociation proceeds much more rapidly in the presence of hormone. The dissociated receptor binds to DNA with high affinity, regardless of whether it is in the hormone-bound or the hormone-free state. These observations raise the possibility that the primary, and perhaps the only, role for the hormone is to promote dissociation of the receptor-hsp90 complex. Molybdate, vanadate, and tungstate inhibit receptor transformation to the DNA-binding form, an effect that appears to reflect the ability of these transition metal oxyanions to stabilize the complex between the steroid receptor and hsp90. By promoting the formation of disulfide bonds, hydrogen peroxide also stabilizes the glucocorticoid receptor hsp90 complex and prevents receptor transformation. A small, heat-stable factor present in all cytosol preparations inhibits receptor transformation, and, when the factor is removed, glucocorticoid receptors are rapidly transformed. This ubiquitous factor has the physical properties of a metal anion, and it is proposed that molybdate and vanadate affect steroid receptor complexes by interacting with a metal anion-binding site that is normally occupied by this endogenous receptor-stabilizing factor. PMID- 3312248 TI - Differential expression of murine macrophage surface glycoprotein antigens in intracellular membranes. AB - A monoclonal antibody recognizing a novel murine macrophage glycoprotein antigen (MAG) was prepared by the hybridoma technique. Using live and permeabilized macrophages to estimate surface and total MAG, respectively, it was found that at least 50% of the total antigen was intracellular. In contrast, another macrophage surface glycoprotein antigen, Mac-1, was undetectable in the intracellular pool. Immunofluorescence studies confirmed the existence of a substantial intracellular pool of MAG antigen. Similar results were obtained with a panel of cultured tumour cell lines. In one such cell line, it was shown that surface MAG existed in a distinct punctate pattern indicative of microdomains, whereas surface Mac-1 antigen gave a uniform distribution. The possible role of the surface microdomains in the differential expression of the two surface glycoproteins in intracellular membranes is discussed. PMID- 3312249 TI - Isolation and culture of high endothelial cells from rat lymph nodes. AB - The isolation and culture of an enriched population of cells from rat lymph nodes that have several properties of high endothelial cells are described. High endothelial cells synthesize a unique sulphated glycolipid. This macromolecule in high endothelial cells was labelled with 35SO4 prior to cell isolation and was used to identify high endothelial cells after isolation. Collagenase digestion of pre-labelled lymph nodes yielded primary lymph node cultures in which two different cell types accounted for greater than 90% of non-lymphoid cells isolated. The majority (greater than 70%) were 20-30 microns diameter, round and 35S-labelled and were therefore high endothelial cells. The remaining unlabelled cells were 10-15 microns diameter and were identified as macrophages by phase contrast microscopy. Isolated cells proliferated after 1-2 days and cultures were enriched for high endothelial cells as macrophages did not persist beyond 7-10 days. Small clumps (2-3 cells) of microvascular endothelial cells and/or adventitial fibroblasts were occasionally seen in primary cultures (angle 1% of isolated cells) but neither cell type proliferated. The identity of high endothelial cells was further substantiated using a polyclonal antiserum raised against lymph node cultures, which stained high endothelium in cryostat sections of lymph nodes. At confluence primary lymph node cultures bound lymphocytes as efficiently as high endothelium in lymphoid tissue and 40-fold more efficiently than rat aortic endothelial cells. It is concluded that lymph node cultures contain high endothelial cells and that these cells continue to express surface determinants for lymphocytes in vitro. PMID- 3312250 TI - The distribution of a 'mitosis-specific' antigen during Drosophila development. AB - We have used MPM-2, a monoclonal antibody raised against mitotic HeLa cells, to stain a Drosophila cell line, whole mounts of Drosophila embryos, and sectioned tissue from embryonic and larval stages of development. MPM-2 recognizes a major phosphoprotein of approximately 125 X 10(3) Mr in Drosophila tissue culture cells that, like the mammalian MPM-2 antigen, appears to be recognized only in mitotic cells. During early embryogenesis, when the embryonic nuclei divide as a syncytium with a very short nuclear division time, MPM-2 antigen is observed within the spindle compartment at all stages of the nuclear division cycle. Upon cellularization of the embryo and lengthening of the duration of the cycle, the antigen is predominantly seen in mitotic cells. Drosophila larvae contain both diploid and polytene tissues: in diploid tissue MPM-2 staining is specifically observed over mitotic cells, as expected from its distribution in cellularized embryos. Surprisingly, antigen is also detected in the nuclei of polytene cells that replicate their DNA but do not undergo mitosis. PMID- 3312251 TI - Gland formation of human colon cancer cells combined with foetal rat mesenchyme in organ culture: an ultrastructural study. AB - The morphogenetic potential of human colon cancer cells was examined by combining cells with foetal rat mesenchyme in organ culture. Out of four cell lines examined, LS174T cells formed glandular structures composed of a simple columnar or cuboidal epithelium with a lumen in the centre of the cell mass. Ultrastructurally, these gland-forming LS174T cells exhibited polarity, with nuclei located basally, microvilli projecting into the lumen, tight junctions at the cell--cell junction facing the lumen, desmosomes at the subluminal region, and basal laminae at the epithelial-mesenchymal interface. Other cell lines did not form such glandular structures, while some cells could form microvilli, tight junctions or basal laminae, which were arranged randomly. It is concluded that it is not the existence but the ordered arrangement of these structures that is essential for gland formation by epithelial cells. The mechanism of gland formation is discussed with special reference to the arrangement of different structures. PMID- 3312252 TI - Biochemical characterization of isolated CHO cell mitotic spindles: identification of calmodulin-binding proteins. AB - Mitotic spindles were isolated from Chinese hamster ovary (CHO) cells and examined morphologically and biochemically. The isolated spindles were observed to be intact structures containing associated chromosomes and were surrounded by a cage of vimentin-containing filaments. Two-dimensional gel electrophoresis of isolated spindles versus whole cell homogenates indicated that isolated spindles were free from significant cytoplasmic contamination and contained tubulin, actin, vimentin and an 80 X 10(3) Mr quadrapeptide as their major protein constituents. Five calmodulin-binding proteins with molecular weights of 200, 160, 130, 60 and 52 (X 10(3] Mr were identified within isolated spindles. These calmodulin-binding proteins may be involved in regulating microtubule organization and depolymerization during karyokinesis. PMID- 3312253 TI - Inhibition of cell adhesion by a synthetic polymer adsorbed to glass shown under defined hydrodynamic stress. AB - A co-polymer with hydrophobic and hydrophilic segments was allowed to adsorb from aqueous solution onto glass previously made hydrophobic by derivatization with octadecyl dimethylchlorosilane. The polymer is thought to adsorb via its hydrophobic segments, leaving the hydrophilic segments free to extend into the water. After allowing cells to settle on the treated surface, the shear stress at the chamber wall required to remove red blood cells, Dictyostelium discoideum amoebae and Escherichia coli was determined in a calibrated laminar flow chamber. On octadecyl glass a shear stress of 2-3 Nm-2 evicts 50% of adherent red cells and E. coli. No D. discoideum amoebae could be removed at 5Nm-2. In striking contrast, the lowest experimentally obtainable shear stress of 0.03 Nm-2 removes 97.0-99.5% of cells of all three types from the polymer-treated surface, even after a cell residence time of 1 h without flow in the absence of free polymer. The minimum shear stress of 0.03Nm-2 corresponds to only approximately equal to 20 times the force of gravity on a red cell. The mechanism of action of the polymer and the implications of the results are discussed. PMID- 3312255 TI - Therapeutic touch as a nursing intervention. PMID- 3312254 TI - An endothelial cell growth factor derived from human lung carcinoma cells grown in serum-free medium. AB - A factor that stimulates the proliferation of human umbilical vein endothelial cells has been shown to be present in serum-free medium conditioned by the prior growth of a cell line (1PT) derived from a poorly differentiated bronchial carcinoma. Preliminary characterization of this factor has revealed that it is a heat-labile, acid-stable proteinaceous material, the activity of which is not diminished by treatment with a reducing agent. In its partially purified state it has been shown to be anionic and to be associated with material exhibiting a broad molecular weight range of 35 X 10(3) to 100 X 10(3). It does not bind strongly to heparin-Sepharose and its mitogenic effect on endothelial cells is not potentiated by heparin. These properties suggest that this factor may differ from other previously described tumour-derived endothelial mitogens. PMID- 3312256 TI - An analysis of the concept of holism in nursing literature. PMID- 3312257 TI - Blood group substances in human salivary glands. PMID- 3312258 TI - The psychological consequences of being small. PMID- 3312259 TI - The development of normal fear: a review. AB - This review synthesizes literature on how human and other mammalian young develop fear. After an early attachment period there is a rise and fall of certain fears in an ontogenetic sequence. Observation and experiment show how experiential, maturational and genetic factors interact in fears of heights, novelty, strangers and separation. PMID- 3312260 TI - Isolation and characterization of a protein detected in inflamed human gastric mucosa. PMID- 3312262 TI - Microplaque immunoperoxidase detection of infectious respiratory syncytial virus in the lungs of infected mice. AB - A rapid microplaque technique was developed for the detection of infectious respiratory syncytial virus (RSV) in the lungs of infected mice. Infected lung homogenates were titrated on microwell HEp-2 monolayers and incubated for 24 or 48 h. The microwells were then fixed with 4% formaldehyde in saline, or methanol containing 0.5% hydrogen peroxide. 24-h single cell infectious foci and 48-h microplaques were detected by an indirect immunoperoxidase (IIP) assay using monoclonal antibodies specific for RSV envelope glycoproteins as the first layer. This method can be used for the quantification of lung RSV in large numbers of samples much more rapidly and economically than conventional plaque assay techniques. In addition, the use of the IIP assay renders the system specific for RSV. PMID- 3312261 TI - Recent developments in derivatization for the chromatographic determination of food additives. AB - Recent applications of chemical derivatization for the determination of a variety of food additives is presented. Several classes of additives such as emulsifiers, stabilizers, preservatives, sweeteners, colors, waxes, gums, and some indirect additives are included. Derivatization or modification reactions for both gas (GC) and liquid chromatography (LC) are discussed. Postcolumn complexation or ion pairing reactions for LC are also included. Derivatization reactions for GC mainly involve esterification, alkylation, or silylation for improving volatility of the analyte. The addition of chromophores (via coupling reactions) for improved detection is the main reason for forming derivatives for LC. PMID- 3312263 TI - Time-resolved immunofluorescence: a sensitive and specific assay for anti-HIV antibody detection in human sera. AB - We describe a new immunoassay, time-resolved fluoroimmunoassay (TR-FIA), for detection of anti-HIV antibodies in human sera. This method is based on the use of a crude virus preparation coated on a polystyrene microtitre plate and of a swine anti-human IgG labelled with a rare earth metal, europium, as fluorescent label chelated with EDTA derivatives. A light pulse from a xenon lamp (340 nm) was used to excite the label and after a 400 microseconds delay time the emission fluorescence was counted for 400 microseconds at 613 nm. This cycle was repeated 1000 times during the total counting time of 1 s. TR-FIA presents considerable advantages over other techniques: (a) it avoids time-consuming, expensive and hazardous virus purification steps; (b) it excludes the use of radiotracers or substrates with potential health risks to reveal the reaction; (c) it has high sensitivity and specificity. A total of 475 serum specimens were tested by ELISA and by TR-FIA. The proportions of positivity were 29.6% by ELISA versus 26.7% by TR-FIA. The sensitivity of both systems was 100%. The specificity was 87.5% for ELISA, whereas it reached a value of 99.4% for immunofluorimetric assay. PMID- 3312264 TI - AIDS in Africa: a public health priority. AB - AIDS and HIV infection are now endemic in many parts of Africa. The infection is mainly transmitted by heterosexual activity, as illustrated by a 1:1 female to male case ratio and high HIV seroprevalence rates in people at risk for sexually transmitted diseases and female prostitutes. Transmission by blood transfusions, contaminated injections and from mother to child is occurring more frequently than in Europe. AIDS will probably have a profound impact on health care programmes and economic development in the continent, and its control should be a public health priority. PMID- 3312265 TI - Screening of antiviral drugs for hepadna virus infection in Pekin ducks: a review. AB - Acyclovir and suramin were examined for their efficacy alone and in combination, against duck hepatitis B virus (DHBV) in persistently infected Pekin ducks. The pharmacokinetics of acyclovir in ducks showed that the peak plasma concentration was reached 30 min after oral administration. Oral acyclovir and suramin administered intravenously suppressed the replication and production of infectious virions as measured by marked reduction of DNA polymerase activity during treatment. However, rebound of enzyme activity was observed soon after cessation of drug therapy. In contrast, sustained reduction of polymerase activity was attained by combined therapy of acyclovir followed by suramin, demonstrating a significant enhancement of anti-DHBV activity which requires confirmation in a larger experimental study. This report reviews the work with the duck model, demonstrating that it is ideal for screening antiviral compounds for treatment of infection with hepadna viruses. PMID- 3312266 TI - Immunofluorescence tests for HIV antibody and their value as confirmatory tests. AB - The enzyme-linked immunosorbent assay (ELISA) is currently being used as a sensitive screening test for HIV antibody. The immunoblot assay (IBA) and indirect immunofluorescence (IF) techniques are two recommended confirmation tests for EIA-positive sera. An indirect IF test has been developed by various laboratories using acetone fixed mixtures of uninfected and HIV-infected cells, which facilitated the reading, since nonspecific reactions were easily differentiated from specific staining. Similar results have been obtained with H9 , CEM-, and HUT78-HIV-infected and uninfected cells. Anti-nuclear antibodies and auto-antibodies resulting in false-positive EIA results, could easily be differentiated by the IF test. Aspecific fluorescence can be removed by absorption of the specimens with non-infected cells. However, IF is not suitable for the screening of large series of specimens. IF is especially well suited for quantitative analysis of serum antibody levels. Whereas serum antibody titers rise initially after infection, they decrease as AIDS develops. Heat inactivation of sera did not affect reactivity in IF, in contrast to a high rate of false positive results obtained with heat inactivated sera in some ELISAs. A well characterized serum from an AIDS patient can be used to perform IF in order to monitor HIV infection of susceptible cells. It has been claimed that titers of neutralizing antibodies significantly correlate with the levels of IF anti-HIV antibodies. An overall correlation of 99% between IF and IBA was reported by different laboratories, when HIV ELISA-reactive European and North American sera were tested. The concordance with IBA was 97% when HIV ELISA-reactive African sera were tested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312267 TI - Potential use of serotherapy in the prevention and treatment of infection with the human immunodeficiency virus. AB - While prevention of infection with the human immunodeficiency virus (HIV) using prophylactic immunization and treatment with anti-viral drugs would appear to be the methods of choice for the prevention and treatment of this infection, neither safe and effective vaccines nor anti-viral agents have yet been developed. A third approach should thus be considered which could be employed both for prophylaxis and treatment of this disease. This approach utilizes specific, anti HIV antibodies, passively administered, to prevent and/or slow the infectious process. The disadvantages of using xenogeneic antibodies and the advantages of using human antibodies are discussed. The need for large quantities of human antibodies to HIV necessitates the production of cell lines producing these antibodies. The various techniques of producing these lines are summarized. Finally, preliminary data supporting the feasibility of producing human cell lines producing antibody to HIV are presented. PMID- 3312268 TI - Perspectives of HIV vaccine developments. AB - Human immunodeficiency virus type 1 (HIV-1) may enter the blood stream as free virus or via infected lymphocytes, which poses problems for vaccine development. The classical vaccine designs, attenuated, inactivated, or subunit vaccine will be discussed with regard to HIV. Development of a recombinant subunit vaccine appears to be the most promising approach. Forthcoming results from experiments involving inoculation of chimpanzees should allow evaluation of the feasibility of using a subunit vaccine based on the env-glycoprotein. Also the use of live recombinant vaccinia merits further investigation. PMID- 3312269 TI - Perinatal transmission of hepatitis B virus in high-incidence countries. AB - Hepatitis B is a serious public health problem throughout the world. Hepatitis B virus (HBV) induces acute hepatitis with a case-fatality rate of about 1%. Even more important, 5-10% of patients infected with HBV become chronic carries and about 25% of these will die due to cirrhosis and hepatocellular carcinoma. The reservoir of HBV chronic carriers in the world is estimated at more than 200 million people and 80% of them reside in Asia and the western Pacific. In high incidence areas, such as south-east Asia, perinatal transmission of HBV from carrier mothers to newborns appears to be the most important factor for the high prevalence of HBV infection and 70-90% of infants born to HBsAg/HBeAg-positive mothers become chronic carriers. Three possibilities of transmission of HBV from carrier mothers to newborns are suggested: (a) transplacental transmission in utero - it was estimated that such transmission occurred in 5-15% of newborns; (b) transmission during delivery, which is considered the main mode of perinatal transmission; (c) postnatal transmission from mother to newborn, which is not common. HBeAg is the main maternal factor in determining whether infection of newborns will occur; the expression of this antigen seems to be determined genetically. Recently it has shown that immunoprophylaxis is highly effective in preventing the development of the carrier state in infants born to HBsAg/HBeAg positive mothers. Only 5-10% of high-risk infants are not protected by vaccination. If it becomes possible to immunize the entire world population including all babies born to carrier mothers at birth, and if our knowledge of the mechanisms of perinatal transmission of HBV is accurate, the carriers and acute cases of HB ought to disappear in two to three generations. PMID- 3312271 TI - Time-related factors in cancer epidemiology. AB - This review provides examples from descriptive, case-control, cohort, and experimental epidemiologic studies which have enabled assessment of time-related factors in cancer etiology. Despite limitations of particular approaches, they complement one another in providing information on temporal characteristics that may yield insights into the origins of cancer, the mechanisms involved, and the means of prevention. PMID- 3312272 TI - The use of time-related epidemiologic data on smoking for planning cancer control programs. PMID- 3312270 TI - An enzyme-immunoassay for antibodies against hepatitis B core antigen: characteristics and clinical validation. AB - An enzyme-immunoassay (EIA) for antibodies to hepatitis B core antigen (anti-HBc) was developed. The new test uses undiluted samples, incubated directly into an HBcAg coated well. Three alternative test procedures are possible. The stability of reagents was studied and a preclinical evaluation was performed intramurally. An assay correlation study was organised. We report the results of the external evaluation performed at 4 centres. A mean analytical sensitivity of 1.1, 1.2 and 0.36 PEI units/ml anti-HBc was found for procedure I (1 h/1 h/30 min), procedure II (30 min/30 min/30 min) and procedure III (16-20 h/1 h/30 min), respectively. In total, 5288 determinations on serum or plasma from various patients and healthy individuals were performed: 10% with procedure I, 52% with procedure II and 38% with procedure III. The qualitative (positive or negative) results were compared with those found with tests used routinely at the centres--47% with Corzyme (Abbott) and 53% with Corab (Abbott)--in a first screening. A final evaluation was made taking into account the repeatability of the results. Based on all results together, the agreement between the new EIA for anti-HBc and the routine tests was 97.6% at the first screening and increased to 99.0% after further evaluation. PMID- 3312273 TI - Time-related factors in research on diet and cancer. AB - Time-related factors have been an integral aspect of laboratory and epidemiologic studies concerning the effects of diet on cancer. In this survey, we illustrate several ways in which consideration of time factors has furthered our understanding in this area. As one of the key dimensions in descriptive studies of secular trends and migrant populations, time factors suggest general associations between diet and cancer. The investigation of time-related parameters such as age, duration of dietary exposure, and time from exposure to cancer, lends greater specificity to the diet-cancer relationship. Both micro- and macro-nutrients are examined, as well as nutrition-mediated factors such as growth and anthropometry. Time-related issues relevant to the design of future observational and intervention studies of diet and cancer (i.e. critical etiologic periods, timing of dietary assessment, biological indicators, and secular trends) are also discussed. PMID- 3312274 TI - Temporal distributions of risk for radiation-induced cancers. AB - Observations of cancer risk in irradiated human populations over time after exposure suggest that there are at least two, and perhaps more, very different patterns of temporal distribution of risk for radiation-induced cancer. The first, exemplified by bone sarcoma following therapeutic injection of 224Ra and chronic granulocytic leukemia in Japanese A-bomb survivors, is an early, wave like pulse consisting of an increase in risk followed by a gradual decline back to baseline levels. The second, exemplified by breast cancer following a brief exposure to external gamma ray or X ray, and by lung cancer and stomach cancer in A-bomb survivors, is an increase in relative risk over about 10 years to a value which appears to remain constant over time thereafter. The first pattern suggests that tumor growth kinetics may play a central role in the temporal distribution of risk following exposure, while the second seems more consistent with multi event models for carcinogenesis, in which radiation or some other cause of early events must be followed by one or more later events whose frequencies depend mainly on attained age. There are, however, other data that appear to conform to neither of the two models just mentioned. Influences of other cancer causes, like tobacco smoking, are potentially serious confounding factors in studies of induction period. PMID- 3312275 TI - Pitfalls in the analysis of exposure-time-response relationships. PMID- 3312276 TI - Incubation periods of cancer: old and new. AB - Following a review of the early efforts in occupational studies and animal experiments that were useful to elucidate concepts of latency and incubation periods in cancer, the paper presents the problem of definitions. In addition to semantic issues, conceptual models have influenced the development of appropriate empirical research in this field. The problems of measurement facing studies of incubation periods include; the assessment of time and nature of exposure, the definition of disease onset and the variation of sources of data used in the estimation of these periods. The different approaches that have been used to measure the incubation periods of cancer include; the direct approach, a study of changes of relative risks with time, calculation of time sequence between an outbreak of disease and the introduction of a suspected exposure, population based incidence studies, analysis of anecdotal information and studies of case clusters using different methods of establishing case linkages. There are well defined practical applications for the study of incubation periods of cancer. These are primarily in the area of etiological investigation, or may have practical relevance in community and patient management in past and future risk assessment. In its final part the paper raises issues that are researcheable in this subject. Does the incubation period of a cancer vary with the different etiologies in a multifactorial model? What is the effect of the dose of carcinogen on the length of the incubation period? Does the incubation period vary with age? PMID- 3312277 TI - Adenosine 3',5'-monophosphate, prostaglandins, and epinephrine stimulate the secretion of immunoreactive gonadotropin-releasing hormone from cultured human placental cells. AB - Cell culture and biochemical procedures were used to identify and study the possible mechanisms regulating the secretion of GnRH-like immunoreactivity (GnRH LI) from human placenta. Monolayer primary cultures of trophoblasts were established after mechanical and enzymatic dispersion of normal human term placenta. The cultured cells stained immunocytochemically positive with anti-GnRH serum, and GnRH-LI extracted from the cells eluted from high performance liquid chromatography with the same retention time as authentic GnRH. One week after plating, exposure to high concentrations of K+ or to various doses of veratridine, a Na+ ionophore, increased GnRH-LI release into the culture medium. This effect was reversed by Ca2+ antagonists (cobalt, EGTA, and verapamil). Dibutyrylcyclic AMP, forskolin, theophylline, and theobromine also increased GnRH LI concentrations in the medium of cultured placental cells in a dose-related manner, as did prostaglandins E2 and F2 alpha and epinephrine. The effect of epinephrine on GnRH-LI concentrations was mimicked by isoproterenol and reversed by propranolol, suggesting an effect mediated by beta-adrenergic receptors. These results indicate that GnRH-LI release from cultured human placental cells is stimulated by the opening of ionic channels and activation of the adenylate cyclase/cAMP system, and that prostaglandins and epinephrine may be involved in the regulation of GnRH-LI release from human placenta. PMID- 3312278 TI - Stimulation of spermatogenesis and biological paternity by intranasal (low dose) gonadotropin-releasing hormone (GnRH) in a male with Kallmann's syndrome: intraindividual comparison of GnRH and gonadotropins for stimulation of spermatogenesis. AB - Intranasal (in) GnRH spray caused induction and maintenance of spermatogenesis and biological paternity in a 28-yr-old man with Kallmann's syndrome. Prior treatment had included GnRH analog administration, which failed to induce puberty, and testosterone (T) enanthate weekly. Prior hCG/human menopausal gonadotropin therapy had resulted in high normal serum T levels and near-normal semen quality, but during subsequent hCG therapy, spermatogenesis markedly decreased. The patient had then received 250 mg T enanthate/month for 2 yr and 7 months; it was discontinued 7 weeks before the in GnRH study began. At its start (July 1984) the subject's testis size was 7 mL, and he had azoospermia, low serum LH and FSH levels, and a serum T of 74 ng/dL (2.6 nmol/L). GnRH was administered in a dose of 200 micrograms (20-120 ng/kg were absorbed into the circulation) every 2 h, seven to nine times a day, between 0700 and 2400 h for 242 days. After 12 days of treatment, serum T had increased to 519 ng/dL (18.0 nmol/L). After 70 days, the patient's sperm count was 11.5 million/mL (4.5 mL ejaculate volume; 70% motility; 36% normal morphology); on day 185, sperm count was 31 million/mL (4 mL ejaculate volume; 54% motility; 36% normal morphology). His spouse conceived on day 162 and delivered a fullterm daughter 265 days later. The probability of paternity was 99.9994%. Our results suggest that induction and maintenance of spermatogenesis as well as fertility in hypothalamic hypogonadism can be achieved with in GnRH therapy if pituitary and testicular function are intact. Spermatogenesis induced by in GnRH has the same quality as spermatogenesis induced by hCG/human menopausal gonadotropin therapy. Patient compliance is probably the most important factor for the success of in GnRH therapy. PMID- 3312279 TI - Antiserum developed for the E peptide region of insulin-like growth factor IA prohormone recognizes a serum protein by both immunoblot and radioimmunoassay. AB - Nucleotide sequencing of the two known cDNAs encoding human insulin-like growth factor I (IGF-I) predicts two different prohormone forms of IGF-I. The predicted prohormone amino acid sequences (E peptide regions) extend the carboxy-terminus of IGF-I by either an additional 35 (IGF-IA) or 77 (IGF-IB) amino acids. We developed an antiserum directed against a synthetic peptide which is unique to the E peptide region of IGF-IA prohormone. In a RIA using this antiserum, synthetic E peptide immunoreactivity was found in the serum of patients with chronic renal failure. The protein recognized by this antiserum has a mol wt of about 13,000 by neutral gel filtration and about 19,000 by sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunoblotting. These data suggest that the E peptide region of the IGF-IA prohormone is expressed and circulates as part of the prohormone. PMID- 3312281 TI - [Purification and partial characterization of streptococcal nephritis-strain associated protein (NSAP)]. PMID- 3312282 TI - [Detection of nephritis-strain associated protein (NSAP) by western blot analysis using anti-NSAP monoclonal antibody (anti-NSAP mAb)]. PMID- 3312280 TI - [Evolution of the brain and a new standpoint in comparative neurology]. PMID- 3312283 TI - Micronized oral progesterone increases the circulating level of endometrial secretory PP14/beta-lactoglobulin homologue. AB - The effect of luteal phase supplementation of micronized oral progesterone, 200 mg daily, on the serum levels of endometrial secretory placental protein 14 (PP14)/beta-lactoglobulin homologue was studied in a double blind/cross-over fashion on five infertile women with apparently normal ovulatory cycles. Blood samples were taken on cycle days 10-12, 20-22 and 24-27, and the serum progesterone and PP14 concentrations were measured by specific radioimmunoassays. In each progesterone cycle the serum progesterone levels were higher than in the corresponding placebo cycle. In each case, the serum concentration of endometrial PP14 was also higher during progesterone than placebo treatment, but this was seen in the late luteal phase only. In view of the previous demonstration of endometrial synthesis of PP14 and the immunological identity between PP14 and progestogen-dependent endometrial protein, these results indicate that endometrial protein secretion can be increased by micronized oral progesterone in infertile ovulatory women whose serum progesterone level is within the normal range. PMID- 3312285 TI - Detection of Pneumocystis carinii by fluorescent-antibody stain using a combination of three monoclonal antibodies. AB - A combination of three monoclonal antibodies, two prepared against human and one against rat Pneumocystis carinii, was used in an indirect fluorescent-antibody stain (IFA) to diagnose P. carinii in both bronchoalveolar lavage and lung biopsy specimens. This combination of monoclonal antibodies was specific for P. carinii and yielded bright fluorescence of both P. carinii cysts and trophozoites. A total of 126 specimens from 93 patients were stained for P. carinii by a toluidine blue O stain and the monoclonal IFA. Forty-five (35.7%) of these were positive for P. carinii by toluidine blue O, and 43 (34.1%) were positive by IFA. There was 98.4% agreement between both methods, with no false-positive and two false-negative occurrences by IFA. An IFA procedure with monoclonal antibodies such as those used in these studies can provide a simple, fast, and sensitive method for diagnosing P. carinii pneumonia by microbiology laboratories. PMID- 3312286 TI - Detection of chlamydial inclusions in cell culture or biopsy tissue by alkaline phosphatase-anti-alkaline phosphatase staining. AB - An immunological technique for detecting Chlamydia trachomatis and Chlamydia psittaci inclusions in infected McCoy cell cultures was developed by using a genus-specific monoclonal antibody to Chlamydia spp., rabbit anti-mouse immunoglobulin G bridging antibody, alkaline phosphatase-anti-alkaline phosphatase (APAAP) monoclonal antibody conjugate, and naphthol AS-phosphate/fast red substrate. Chlamydial inclusions stained red and were easily detected against a background of blue hematoxylin-stained nuclei. After 18 h, inclusions of C. trachomatis serovar L2 LGV434/Bu and C. psittaci strain 6BC were stained by APAAP but not by iodine or Giemsa. At 48 h inclusion counts were significantly higher in the APAAP cultures. Both the APAAP procedure and conventional staining detected 35 of 239 (15%) cultures 48 h after inoculation with urethral or endocervical specimens. However, at 24 h after inoculation 22 of 35 (63%) were positive by APAAP staining while negative by iodine. This immunostain also allowed identification of chlamydial inclusions in endometrial biopsies from patients with tubal factor infertility or pelvic inflammatory disease. PMID- 3312284 TI - Proposed immunopathogenic factors associated with progression from human immunodeficiency virus seropositivity to clinical disease. PMID- 3312287 TI - Comparison of a novel trimethoprim-sulfamethoxazole-containing medium (XT80) with kanamycin agar for isolation of antibiotic-resistant organisms from stool and rectal cultures of marrow transplant patients. AB - A new medium (XT80) containing trimethoprim-sulfamethoxazole (TMP-SMZ) was characterized and compared with kanamycin-containing tryptic soy agar (KA) for the recovery of multiply resistant organisms (MRO) in rectal and stool cultures. Cultures from 151 patients hospitalized for bone marrow transplantation were screened for MRO. A total of 366 MRO were recovered from 702 cultures on 94 patients during a 6-month period. XT80 detected more gram-negative bacilli and Corynebacterium spp. than KA. Detection of Staphylococcus spp. was equivalent for the two media. Multiple-antibiotic resistance, defined as resistance to three or more classes of antibiotics, was confirmed by standard agar disk diffusion susceptibility testing. Growth on XT80 correctly identified heteroresistant strains of methicillin-resistant Staphylococcus spp. XT80 more rapidly detected thymidine-dependent mutants of Staphylococcus spp. and members of the family Enterobacteriaceae. Lipophilic Corynebacterium spp., including Corynebacterium group JK, also were more readily detected with XT80. TMP-SMZ given as prophylaxis against Pneumocystis carinii infection exerts a selective pressure on organisms that colonize immunocompromised patients and appears to select for colonization with MRO. Colonization with MRO preceded infection for 94% of 36 patients who developed bacteremia. XT80 is a useful screening tool; growth on this medium correlates closely with resistance to TMP-SMZ and is as accurate a predictor as KA for the carriage of MRO. PMID- 3312288 TI - Enteroadherent Escherichia coli as a cause of diarrhea among children in Mexico. AB - Enteropathogenic Escherichia coli (EPEC) often exhibits localized adherence or diffuse adherence to HEp-2 cells. We recently provided evidence that HEp-2 cell adherent or enteroadherent E. coli (EAEC) not belonging to EPEC serogroups was the cause of diarrhea among U.S. travelers to Mexico. In the present study, we looked for EAEC and EPEC in stool specimens from 154 children with acute diarrhea and 137 well children seen at several outpatient clinics in Guadalajara, Mexico. EAEC showing localized adherence (EAEC-L) was isolated from 13.0% of the patients and 0.7% of the controls (P less than 0.0001). EAEC showing diffuse adherence (EAEC-D) was recovered from 20.8% of the patients and 7.3% of the controls (P less than 0.001). EPEC was isolated from 4.5 and 6.7% of the patients and controls, respectively. Among all enteropathogens, only enterotoxigenic E. coli occurred as commonly (21.4%) as EAEC-D and EAEC-L did in children with diarrhea. Of the EAEC-L strains isolated from children with diarrhea, 20% belonged to recognized EPEC serogroups, and 3.1% of EAEC-D strains belonged to recognized EPEC serogroups. This study suggests that EAEC may be an important pediatric enteropathogen in Mexican children with diarrhea and further supports the observation that adherence to HEp-2 cells may be a marker of virulence independent of EPEC serogroup among E. coli strains. PMID- 3312289 TI - Detection of Gardnerella vaginalis in vaginal specimens by direct immunofluorescence. AB - The preparation of a fluorescein-labeled Gardnerella vaginalis polyclonal antibody is described, and its usefulness is assessed for the detection of this microorganism in vaginal samples obtained from 263 women attending the gynecological department of a general hospital, 66 of whom harbored an intrauterine device. The direct immunofluorescence technique was positive for G. vaginalis in 21% of the specimens, whereas only 12.5% of the total bacteriological cultures were positive. The frequency was higher in patients harboring intrauterine devices since 34.8% exhibited positive immunofluorescence and 30.3% exhibited positive cultures. PMID- 3312290 TI - Assessment of enzyme immunoassay and immunofluorescence tests for detection of Chlamydia trachomatis. AB - Two rapid diagnostic tests for Chlamydia trachomatis (Microtrak, Syva Co., Palo Alto, Calif.; and Chlamydiazyme, Abbott Laboratories, North Chicago, Ill.) were evaluated in comparison with growth of the organism in tissue culture for 2,030 urogenital specimens from men and women. Neither test performed as well as culture, which detected 296 of 310 positive specimens. The overall sensitivity and specificity for Microtrak were 73 and 99%; corresponding values for Chlamydiazyme were 83 and 98%. The majority of false-negative results with both rapid tests occurred when cultures contained less than 10 inclusions per cover slip. There were also areas of unconfirmed reactivity for both tests that led us to suggest that a reporting category of "suspicious" be developed for certain test results. For Microtrak, the suspicious result is a slide containing fewer than 10 elementary bodies; for Chlamydiazyme, it is any absorbance reading less than 0.4. Creation of a "suspicious" category would lower the sensitivity for Chlamydiazyme considerably, to 64%, and increase the positive predictive value for females to 95%. Although this may result in the underreading of some specimens from males, the tests could then be used with greater confidence in females for whom testing is essential for appropriate treatment. PMID- 3312291 TI - Dot immunobinding assay for detection of human immunodeficiency virus-associated antigens. AB - The detection of human immunodeficiency virus (HIV)-associated antigens was simplified by the application of dot immunobinding on a nitrocellulose matrix. Antigens were detected by applying the polyethylene glycol-precipitated supernatants of experimentally infected cultures directly onto nitrocellulose strips and sequentially incubating the strips with an anti-HIV antiserum and an alkaline phosphatase-conjugated, species-specific antiserum. The immune reaction was developed by adding the precipitable substrate indoyl phosphate. The dot immunobinding assay was nearly as sensitive as the reverse transcriptase assay in detecting HIV antigens in experimentally infected peripheral blood mononuclear cells, as well as in a T-cell line. The technique was also useful in the in vitro evaluation of antiviral agents. The dot immunobinding assay is a simple and sensitive technique that is useful in the detection of HIV antigens in studies of viral pathogenesis. PMID- 3312292 TI - DNA probes for identification of enteroinvasive Escherichia coli. AB - Eighty-one Escherichia coli strains belonging to all known invasive O serogroups were tested with two distinct invasiveness probes (pMR17 and pSF55). All 54 Sereny test-positive strains and 5 strains that lost Sereny positivity during storage hybridized with both probes. Probe-positive strains carried a 120- to 140 megadalton plasmid, did not produce lysine decarboxylase, and, with the exception of certain serotypes, were nonmotile. Motile strains of serotype O144:H25 were for the first time characterized as invasive by hybridization with the probes. PMID- 3312293 TI - Cell culture versus IDEIA for detection of Chlamydia trachomatis. PMID- 3312295 TI - Epidemiology and the public health movement. PMID- 3312296 TI - Reporting colorectal cancer. AB - Reporting colorectal cancer comprises two phases: the careful collection of pathological data; and the division of patients into groups with differing prognoses. Dukes' classification of rectal cancer was the outcome of this dual approach. It evolved over many years, and full details of its final form were not published until 1958, towards the end of his career. Others modified the classification during its evolution, and numerous rival pathological and clinicopathological systems now exist. The resulting confusion that surrounds the Dukes classification may make it impossible to compare pathological findings and the results of treatment between different centres. The importance of meticulous dissection and examination of surgical specimens is emphasised and a simple set of recommendations made. It is shown how modern statistical methods may identify pathological variables that have independent clinical importance. On the basis of this information a new system of prognostic categorisation for patients receiving apparently curative surgery for rectal cancer has been developed, which is superior to the Dukes classification in that it can place many more patients into groups with clear prognostic implications. PMID- 3312294 TI - Clinical assessment of the wider span palatal adhesive retainer. PMID- 3312297 TI - Some aspects of neuroendocrine pathology. AB - The advent of modern microscopical investigative methods for the determination of neuroendocrine differentiation has increasingly given credence to the original concept of a "diffuse endocrine system". These methods include a variety of silver impregnation techniques, technologically advanced light and electron microscopical immunocytochemistry, and, lately, the ability to localise specific binding sites by in vitro autoradiography and mRNA species by in situ hybridisation. Further insight has been gained into the possible role of regulatory peptides contained in the so called "diffuse endocrine system" and into the nature of disease processes by investigating the role of the system in benign and malignant disease. PMID- 3312298 TI - The role of immunocytochemistry in diagnostic pathology. AB - This review suggests that immunocytochemistry in diagnostic pathology can be performed using relatively small panels of antibodies and that it should be reserved for situations in which, for one reason or another, the pathologist cannot exert his or her conventional diagnostic skills. Examples include the diagnosis of tumours the true nature of which is uncertain because of anaplasia or poor morphological preservation; the demonstration of small numbers of cells which are otherwise too rare to be recognised in conventionally stained preparations; and the immunophenotyping of non-Hodgkin's lymphomas. Recently progress has been made in the context of non-Hodgkin's lymphomas by the development of monoclonal antibodies that detect T and B cell associated markers in paraffin wax sections. Most of these reagents, however, recognise either lineage associated (but not lineage specific) variants of the leucocyte common antigen CD45, or antigens that are poorly characterised. A recent promising development has therefore been the demonstration that polyclonal antisera raised against the CD3/T3 T cell specific marker (purified by affinity chromatography) are suitable for staining T cells in paraffin sections. This approach will hopefully enable antibodies to be produced which react with other well defined white cell associated markers in routine biopsy material. PMID- 3312299 TI - Cellular oncogenes in neoplasia. AB - In recent years cellular homologues of many viral oncogenes have been identified. As these genes are partially homologous to viral oncogenes and are activated in some tumour cell lines they are termed "proto-oncogenes". In tumour cell lines proto-oncogenes are activated by either quantitative or qualitative changes in gene structure: activation of these genes was originally thought to be a necessary primary event in carcinogenesis, but activated cellular oncogenes, unlike viral oncogenes, do not transform normal cells in culture. In experimental models cooperation between two oncogenes can induce transformation of early passage cells, and this has become the basis of an hypothesis for multistep carcinogenesis. Proto-oncogene products also show sequence homology to various components in the mitogenic pathway (growth factors, growth factor receptors, signal transducing proteins and nuclear proteins), and it has been postulated that they may cause deregulation of the various components of this pathway. In human tumours single or multiple oncogene activation occurs. The pattern of oncogene activation in common solid malignancies is not consistent within any one class of tumour, nor is it uniform between classes, with three exceptions. In neuroblastoma, breast cancer, and perhaps in lung cancer there is relatively consistent activation of N-myc, neu, and c-myc/N-myc, respectively. Amplification of these genes generally correlates with poor prognosis. The introduction of methods for the direct study of oncogene transcription and their products will undoubtedly broaden our vision of cancer biology in man and, hopefully, add diagnostic and prognostic precision to tumour typing. PMID- 3312300 TI - Automation in clinical microbiology: a new approach to identifying micro organisms by automated pattern matching of proteins labelled with 35S-methionine. AB - A new rapid automated method for the identification and classification of microorganisms is described. It is based on the incorporation of 35S-methionine into cellular proteins and subsequent separation of the radiolabelled proteins by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The protein patterns produced were species specific and reproducible, permitting discrimination between the species. A large number of Gram negative and Gram positive aerobic and anaerobic organisms were successfully tested. Furthermore, there were sufficient differences within species between the protein profiles to permit subdivision of the species. New typing schemes for Clostridium difficile, coagulase negative staphylococci, and Staphylococcus aureus, including the methicillin resistant strains, could thus be introduced; this has provided the basis for useful epidemiological studies. To standardise and automate the procedure an automated electrophoresis system and a two dimensional scanner were developed to scan the dried gels directly. The scanner is operated by a computer which also stores and analyses the scan data. Specific histograms are produced for each bacterial species. Pattern recognition software is used to construct databases and to compare data obtained from different gels: in this way duplicate "unknowns" can be identified. Specific small areas showing differences between various histograms can also be isolated and expanded to maximise the differences, thus providing differentiation between closely related bacterial species and the identification of differences within the species to provide new typing schemes. This system should be widely applied in clinical microbiology laboratories in the near future. PMID- 3312301 TI - Interpretation of the metabolic effects of trauma and sepsis. AB - John Hunter suggested that the body's responses to injury were defensive and had survival value. Now, many years later, we are still uncertain about this. Although our appreciation of the endocrine and metabolic responses to injury, both physical and bacterial, has increased enormously our knowledge of these events, particularly at a molecular level, is still very incomplete. Patterns have been identified, however, in the sphere of energy metabolism, and this provides a basis for interpreting at least some of the biochemical responses to injury. The views developed support the idea that the responses are defensive- initially against the impact of the injury and then to meet the demands of the new "organ" which the wounds or septic focus seem to have added to the body. A reason for wanting to interpret these responses is to improve patient care. Current interpretations at least help to clarify our view of what is happening in the injured or septic patient and sometimes indicate lines of treatment. Nevertheless, many serious problems, particularly changes in protein metabolism, remain to be solved before we can advise on the metabolic care of patients at all stages from accident to recovery. PMID- 3312302 TI - Plasma lipid concentrations: the concept of "normality" and its implications for detection of high cardiovascular risk. AB - The relation between serum cholesterol concentrations and the incidence of coronary heart disease is continuous and curvilinear; there is neither epidemiological nor biological evidence to support the existence of a threshold value. There is a clinical need, however, for an acceptable definition of action limits and desirable ranges, based on the evidence that raised cholesterol concentrations are causally related to atherosclerotic heart disease. The European Atherosclerosis Society has proposed a set of cut off points, which, together with age and the presence of other risk factors, direct the clinician to an appropriate level of treatment. Because the changes of serum cholesterol during adult life appear unphysiological, these action limits do not require adjustment for age. The distribution of serum cholesterol in the United Kingdom population is such that a case finding strategy is required to identify the many persons at very high risk of coronary disease. Measurements of triglyceride, high density lipoprotein, apolipoproteins, and the investigation of hyperlipoproteinemia are informative but less mandatory. PMID- 3312305 TI - Molecular pathology of single gene disorders. AB - Recent studies using recombinant DNA technology have led to an understanding of the basic molecular pathology of single gene disorders. Furthermore, methods are being developed for finding genes for conditions, whose underlying biochemistry is still not understood, or which may contribute to polygenic systems that underlie common diseases. As well as providing new approaches to carrier detection, prenatal diagnosis, and treatment of single gene disorders, these advances promise to provide important information about the pathophysiology of many common polygenic diseases. PMID- 3312303 TI - Clinical biochemistry of the neonatal period: immaturity, hypoxia, and metabolic disease. AB - This review attempts to provide practical information on common problems in the laboratory medicine of newborn infants and also considers unresolved problems in achieving neonatal diagnoses. A common cause of upset in the newborn--intrapartum asphyxia--can now be positively diagnosed. This leaves a small group whom it is necessary to investigate because they may have metabolic disease. The initial investigation of metabolic disease at the district general hospital should be limited to the commoner conditions. PMID- 3312304 TI - The HLA system: structure and function. AB - The HLA system is the major histocompatibility system of man and was found through a search for blood group-like determinants on white blood cells that would be effective in matching for transplantation. The HLA system has its counterparts in other species of mammals, birds, and reptiles including the much studied H2 system of the mouse. The HLA system started from a series of antigens defined by a combination of relatively crude serology and genetics, supported by extensive statistical analysis. It has turned out to be a complex genetic region determining two major sets of cell surface products which mediate essential functional interactions between cells of the immune system, and so have a major role in the control of the immune response. Polymorphism in the HLA region is thus associated with a wide variety of diseases with an immune aetiology. PMID- 3312306 TI - Megaloblastic anaemia, cobalamin, and folate. AB - Developments relating to cobalamin and folate are reviewed. Current work on the relations between these two coenzymes are discussed, particularly those that have emerged in studies using nitrous oxide, which inactivates cobalamin. PMID- 3312307 TI - Prospects for cure in leukaemia. AB - Patients with acute leukaemia have normal or near normal numbers of haemopoietic stem cells in their marrow at diagnosis. Remission is achieved when the administration of cytotoxic drugs eradicates the bulk of the leukaemic population while sparing normal haemopoiesis. The mechanism by which chemotherapy seems to act in this selective manner is essentially unknown. Nevertheless, remission rates of 80-95% can be achieved in children and in 50-80% of adults with acute leukaemia. Attempts to cure patients in remission may entail either "continuing curative chemotherapy" or "supralethal" doses of chemoradiotherapy followed by autologous or allogeneic bone marrow transplantation. The relative merits of these different methods remain highly controversial but chemotherapy is usually the preferred method of continuing treatment for children with acute lymphoblastic leukaemia in first remission; and allogeneic transplantation is recommended for younger adults with acute myeloid leukaemia who have suitable HLA identical sibling donors. The role of autografting is still experimental. Patients with chronic myeloid leukaemia can achieve long term remission and probably cure following allogeneic bone marrow transplantation but the resultant risks of mortality are still appreciable. Chronic lymphocytic leukaemia currently remains incurable. PMID- 3312309 TI - VIP- and CCK-like-immunoreactive neurons in the hedgehog (Erinaceus europaeus) and sheep (Ovis aries) brain. AB - The distribution pattern and the morphology of vasoactive intestinal polypeptide (VIP)- and cholecystokinin (CCK)-like-immunoreactive neurons were studied in the brain of the hedgehog and the sheep by means of the peroxidase-antiperoxidase immunocytochemical method. A total of 34 hedgehogs and 26 sheep of both sexes were used. Fourteen hedgehogs and 13 sheep received an intracerebroventricular injection of colchicine that enhanced the immunostaining and revealed "new" immunoreactive cell bodies. VIP-immunoreactive bipolar and multipolar neurons were observed in both species in the cerebral cortex, hippocampal formation, amygdaloid complex, hypothalamus, and central gray substance of the midbrain. CCK immunoreactive bipolar, bitufted, and multipolar neurons displayed a broader distribution in both mammals than VIP neurons and were found in the cerebral cortex, the hippocampal formation, the amygdaloid complex, the hypothalamus, the mesencephalon, and the pons. In the cortex, in both the hedgehog and the sheep, VIP neurons were located in all layers but were concentrated in layers II and III, with the majority being typical bipolar. CCK neurons were more numerous in the superficial layers (I-III) but were found in the deep layers as well. They were bipolar, bitufted, or multipolar in morphology. From these neurons a small percentage, which were located almost exclusively in layers II and III of the visual cortex, exhibited also VIP immunoreactivity. Perikarya of such double labeled cells were ovoid or round in shape with one or two main processes emanating from each pole of the cell body and oriented perpendicularly to the pia. The coexistence of the two peptides within individual neurons of the cortex has not been reported in other species and its physiological significance is discussed in relation to the GABAergic neurons of the cortex. PMID- 3312310 TI - Counting sectioned cells via mathematical reconstruction. AB - A new method for determining the number of neurons in sectioned tissue is presented. The method does not involve identification of subcellular structures; rather, it uses estimates of the mean diameters of sections of the neuronal somata (with or without nuclei). All such sections are termed profiles. A mathematical model is developed to reconstruct the cell population from a size histogram of the profiles. Although the model is simple, the calculations are numerous and best done on a computer. A program that performs these calculations is provided. We discuss the idealizations on which the model is based and test the method in various ways: on hand- and computer-generated data in which imaginary spheres of known size were sectioned; on two small samples of real cells for which both cell and profile size histograms were available; and on a sample of potatoes, sliced by hand. In every case the estimate was within 10% of the actual number of cells (or potatoes). The method is robust in that it is relatively insensitive to section thickness, sample size, somal morphology, and observer error with respect to missing the small or thin profiles from any given cell. Results from the present model are compared to those obtained by using other cell count correction schemes that are currently employed. We call our method recursive translation. PMID- 3312308 TI - Histopathology and immunohistochemistry of peripheral T cell lymphomas: a proposal for their classification. AB - Based on the results of histological and immunohistochemical observations of a large number of peripheral T cell lymphomas from China, England, Germany and Japan, histological and cytological morphology were correlated with immunophenotype, aetiological association with HTLV-1, and clinical behaviour to produce a working classification of the T cell lymphomas. This classification, based mainly on cytological criteria, divides the peripheral T cell lymphomas into tumours of low grade and high grade malignancy. Adult T cell lymphoma/leukaemia (ATLL) is caused by HTLV-1 and belongs chiefly to the high grade category. Some tumours are characterised by an admixture of other cells (epithelioid cells, follicular dendritic cells, etc) and structures (high endothelial venules, follicles), which may indicate the secretion of lymphokines by the tumour cells. Clear cells seem to be specific for T cell lymphomas and may occur in various types of peripheral T cell lymphoma. PMID- 3312311 TI - Effects of induced thrombocytopenia on viral invasion of the central nervous system in canine distemper virus infection. AB - Groups of canine distemper virus (CDV) susceptible ferrets were treated daily with 2.0 ml of normal goat serum (NGS) or goat anti-ferret platelet serum from 2 days before to 11 days after infection. Each group was subdivided into 2 and one subgroup of each was subsequently injected intraperitoneally with virulent R252 CDV. Ferrets were killed on days 2, 4, 6, 9 and 11 after infection and tissues from the central nervous system (CNS) were examined for histopathological lesions typical for CDV and also of CDV antigen by indirect immuno-fluorescence methods. In NGS-treated animals, a time course-dependent spread of CDV from CNS endothelium during days 2 to 4 after infection through choroid plexus epithelium was observed. In contrast, CDV-infected ferrets treated with anti-platelet antibody exhibited a delay in infection of CNS endothelium until 9 days after infection. The results of this study confirm vascular endothelium as the primary route of invasion of CNS tissues by CDV and implicate the circulating platelet in the initiation of this event. PMID- 3312312 TI - Herpes gestationis. AB - Only 14 years have elapsed since immunofluorescence techniques revised our concept of herpes gestationis. As our inquiry broadens, the answers seem farther away. Yet much knowledge has been gained regarding predisposition and the pathomechanism of this elusive disease. I offer a review of historical context and an update on our current confusions regarding this rare autoimmune dermatosis of pregnancy. PMID- 3312313 TI - Assessment of diphenylcyclopropenone for photochemically induced mutagenicity in the Ames assay. AB - The photochemical conversion of diphenylcyclopropenone to diphenylacetylene has recently been reported. Diphenylcyclopropenone is used in the treatment of alopecia areata and is nonmutagenic in a limited Ames assay. We examined diphenylcyclopropenone and diphenylacetylene, as well as synthetic precursors of diphenylcyclopropenone--dibenzylketone and alpha,alpha'-dibromodibenzylketone- for mutagenicity against TA100, TA98, TA102, UTH8413, and UTH8414. All compounds were nonmutagenic except alpha,alpha'-dibromodibenzylketone, which was a potent mutagen in TA100 with and without S-9 activation. The effect of photochemical activation of diphenylcyclopropenone in the presence of bacteria demonstrated mutagenicity in UTH8413 (two times background) at 10 micrograms/plate with S-9 microsomal activation. 8-Methoxypsoralen produces a mutagenic response in TA102 at 0.1 microgram/plate with 60 seconds of exposure to 350 nm light. In vitro photochemically activated Ames assay with S-9 microsomal fraction may enhance the trapping of short-lived photochemically produced high-energy mutagenic intermediates. This technique offers exciting opportunities to trap high-energy intermediates that may play an important role in mutagenesis. This method can be applied to a variety of topically applied dermatologic agents, potentially subjected to photochemical changes in normal use. PMID- 3312315 TI - Familial incidence of dermatitis herpetiformis. AB - Dermatitis herpetiformis and gluten-sensitive enteropathy are diseases in which exposure to gluten results in an inflammatory response. Both diseases are associated with certain human lymphocyte antigen alleles, and gluten-sensitive enteropathy is well known to cluster in families. Gluten-sensitive enteropathy has also been reported in families of patients with dermatitis herpetiformis. Despite this evidence that dermatitis herpetiformis is a genetic disease, reports of the familial occurrence of dermatitis herpetiformis are rare. We have obtained family histories from 92 patients with dermatitis herpetiformis with 740 first degree relatives. Six of these relatives have dermatitis herpetiformis. Comparison of these data with the expected prevalence of dermatitis herpetiformis shows this incidence to be highly significant (p less than 0.0001), strongly suggesting that dermatitis herpetiformis is a familial disease, presumably because of shared genetic factors but possibly because of a shared environment. PMID- 3312314 TI - Ichthyosiform sarcoidosis. Report of two cases and a review of the literature. AB - Although acquired ichthyosis has been associated with a number of systemic illnesses, an association with sarcoidosis has rarely been reported. We report two patients with acquired ichthyosis of the lower extremities whose diagnosis of cutaneous sarcoidosis was established by histologic examination. Systemic involvement in both patients included ocular and pulmonary disease. A diagnosis of sarcoidosis must be considered when a patient presents with acquired ichthyosis. PMID- 3312316 TI - Benign symmetric lipomatosis Launois-Bensaude. Report of ten cases and review of the literature. AB - Benign symmetric lipomatosis Launois-Bensaude is a disease rarely reported in the American literature and not mentioned in the standard English textbooks of dermatology. It seems, however, to be relatively common in Europe. Between 1981 and 1985 we examined twelve patients, and a number of case reports have been published in French and German literature. We describe ten typical cases and review the literature. The disease is characterized by massive symmetric fat deposits predominantly in the neck and shoulder girdle area. Pathogenetically, the increase in fatty tissue is assumed to result from a localized defect in catecholamine-induced lipolysis. The disease is frequently associated with alcoholism, hepatopathy, glucose intolerance, hyperuricemia, and malignant tumors of the upper airways, requiring thorough clinical evaluation of all patients. Dietary treatment and weight loss are of limited value in the management of benign symmetric lipomatosis. Surgical removal of lipomatous tissue is frequently followed by recurrence and should be restricted to decompression in patients with functional impairment. PMID- 3312317 TI - Microinvasive lentigo maligna melanoma. AB - Ninety-one skin biopsy specimens previously identified as lentigo maligna were examined for the presence of microinvasion, using the demonstration of S100 protein within atypical cells as the means for locating these superficial foci. In 14 cases, atypical melanocytes were identified, most often in the papillary dermis. The mean depth of invasion in this group was 0.23 mm with a range of 0.10 mm to 0.75 mm. In these cases, atypical cells were difficult if not impossible to identify in routinely processed sections, either because the invasive cell was a spindle cell variant and indistinguishable from a fibrohistiocytic cell, because the invasive cells were occasionally solitary or in small groups, or because there was an inflammatory infiltrate that obscured the tumor cells. Recent studies of lentigo maligna melanoma have revealed no better prognosis when compared to that of other forms of malignant melanoma after normalization for depth and body location. We therefore advocate close examination of lentigo maligna with the use of appropriate immunohistochemical techniques if there are areas of dermal fibrosis or inflammation that might obscure invasion. PMID- 3312318 TI - Eosinophilic pustular folliculitis. PMID- 3312319 TI - Verruciform xanthoma of the lower extremity--report of a case and review of literature. PMID- 3312320 TI - Effect of dietary fat and lactation status on insulin binding to bovine milk fat globule membranes. AB - Lactating cows were used to examine the relationship between lactation status and insulin binding to milk fat globule membranes. Variables evaluated were daily milk yield, stage of lactation, breed, age, lactation number, daily milk fat and protein yields, milk fat and protein percentages, breeding status, body weight, body weight.75, and mammary health. Milk yield was correlated with insulin binding and accounted for 20% of the binding variability. No other variables were related to insulin binding. Insulin binding to milk fat globule membranes increased with supplemental dietary fat up to 4% added fat in the diet dry matter. Milk fat globule membranes may provide a useful model for assessing insulin receptor regulation in the mammary gland. Sources of variation in insulin binding to mammary membranes remain to be identified. PMID- 3312321 TI - Quantitative estimates of mammary growth during various physiological states: a review. AB - The parenchymal portion of the mammary gland is immature at birth and begins to grow at a faster rate than the whole body shortly before occurrence of puberty. This accelerated or allometric growth rate is maintained for several estrous cycles, then returns to a growth rate equal to general body growth. Allometric growth of the mammary gland returns at conception and continues in most species for a variable period after parturition. Elevated secretion of estradiol and progesterone throughout pregnancy drives the allometric mammary growth during pregnancy. However, mammary growth during lactation in cows is independent of ovarian secretions and prolactin. Mammary cell numbers during lactation eventually decline as milk production decreases. Concurrent pregnancy reduces mammary cell numbers during lactation, but during the dry period concurrent pregnancy markedly increases mammary cell numbers over those in nonpregnant animals. Dry periods that are short reduce the increments in mammary cell numbers, which normally occur during early stages of the next lactation. Because numbers of mammary epithelial cells are a major determinant of milk yield, understanding the mechanisms that stimulate mammary epithelial cell numbers has the potential to lead to new methods for increasing efficiency of milk production. PMID- 3312322 TI - Does epidermal growth factor control tooth eruption? AB - Despite active research for more than several decades the factors responsible for tooth eruption have remained obscure. For a tooth to emerge in the oral cavity, to reach occlusion, and to continue eruption in adulthood, many changes in the tooth and its surrounding tissues occur; these changes must be synchronized. Epidermal growth factor appears to be involved in the eruptive process. PMID- 3312323 TI - Optimum dosage for prenatal fluoride supplementation (PNF): Part IX. AB - There exists such a wide margin of safety for prenatal fluoride in regard to fluorosis that 2 mg/day can be used as a simplified prenatal fluoride dosage in all areas, regardless of whether they are fluoridated. Any prenatal fluoride dosage between 1 and 4 mg/day is better than no prenatal fluoride at all. PMID- 3312324 TI - The effect of poly(acrylic acid) cleanser on the adhesion of a glass polyalkenoate cement to enamel and dentine. PMID- 3312325 TI - The mechanical strength and microstructure of all-ceramic crowns. PMID- 3312326 TI - The effect on marginal leakage, in vitro, of curing a composite material at elevated temperatures with or without marginal etching of the cavity. PMID- 3312327 TI - The intra-oral soft tissue osteoma: report of two cases. PMID- 3312328 TI - [Treatment of oral aphthous ulceration]. PMID- 3312329 TI - Decision analysis in the evaluation of clinical strategies for the management of mandibular third molars. AB - Quantitative methods of technology assessment that consider the magnitude of the technology's effect and also incorporate the elements of uncertainty, risk, and preference are needed. This study uses the methods of decision analysis to evaluate a common dental problem: whether or not to extract asymptomatic mandibular third molars. Three alternative strategies are considered. The expected disability of an extraction, measured as equivalent "days of standard discomfort" (DSD), is used as the outcome measure of interest. The analysis suggests that under a wide range of assumptions about the likelihood of different impaction types, chance of pathology, probability of extraction complications, and disability associated with each complication, the strategy of extracting only pathologically involved impacted mandibular third molars is generally the risk minimizing option. The sensitivity analysis identifies the severity of the outcome in the presence of pathology as a possible risk factor that requires further investigation. PMID- 3312330 TI - Design of skin flaps with a new technique using templates. AB - Patterned templates were constructed to assist in planning, performing, and teaching skin flap surgery. Templates can be used to design geometrically accurate flaps and to consider different flap orientation strategies. They can be used to align flap tension forces in proper relationship with relaxed skin tension lines. PMID- 3312331 TI - Treatment of telangiectasia: comparison of sclerosing agents. AB - A double-blind, double-paired comparison, placebo-controlled study was undertaken to determine the optimal agent for sclerotherapy of spider telangiectasias of the lower extremities. Sodium tetradecyl sulfate 0.5%, polidocanol 0.25%, heparsal, and normal saline control were evaluated in terms of clinical effectiveness and patient acceptance. Although all of the agents, except for the control, were effective, polidocanol was found to have the fewest adverse reactions and afforded the greatest patient comfort. PMID- 3312332 TI - Piloleiomyoma arising in an organoid nevus: a case report and review of the literature. AB - The case of a 59-year-old woman with a history of an organoid nevus of the scalp is reported. Histologic examination revealed multiple secondary tumors including a tumor of the follicular infundibulum, an apocrine nevus, a syringocystadenoma papilliferum, an apocrine adenoma, and a piloleiomyoma occurring in the absence of sebaceous glands. The types of secondary tumors which may develop within organoid nevi are reviewed. The terminology and pathogenesis of this hamartoma are discussed. PMID- 3312333 TI - Visualized basting sutures in the application of full-thickness skin grafts. AB - This paper describes a simple technique for inserting basting sutures to secure full-thickness skin grafts. By applying the suture under visualized conditions before fully securing the perimeter of the graft, exact placement and knot security of the basting suture can be enhanced, and injury to underlying structures can be avoided. Furthermore, by securing the center of the graft early in the repair, alignment on and conformation to the underlying wound bed is improved. PMID- 3312334 TI - Hyperthermic effects on peripheral lymphocytes isolated from a chronic lymphocytic lymphoma/leukemia patient in vitro. PMID- 3312335 TI - Radioimaging of malignant melanoma xenografts in nude mice using 111In-labeled monoclonal antibody against human malignant melanoma. PMID- 3312336 TI - Clonal variation in expression of p97 antigen in human melanoma cell lines detected by mixed passive hemagglutination. PMID- 3312337 TI - Heterogeneity in basement membranes of skin--electrostatic properties of basal lamina-associated anionic sites. PMID- 3312338 TI - Effect of divalent cations and proteases on skin sulfhydryl oxidase activity. PMID- 3312339 TI - Superoxide dismutase in epidermis (1). PMID- 3312340 TI - Analysis of the in vitro concanavalin A response of mouse regenerating spleen cells after cyclophosphamide treatment. PMID- 3312341 TI - Properdin factor B allotypes in Japanese patients with psoriasis. PMID- 3312342 TI - False-positive Thormahlen test induced by latamoxef sodium. PMID- 3312343 TI - Mating behaviour of Microsporum canis from human ringworm cases in Hokkaido prefecture in Japan. PMID- 3312344 TI - [Determination of plasma fibronectin in congenital epidermolysis bullosa]. PMID- 3312345 TI - Allergic contact dermatitis from cosmetics--a report from Singapore. PMID- 3312347 TI - Comparative studies of treatments for pityriasis lichenoides. PMID- 3312348 TI - Diaper dermatitis with granuloma following surgery for Hirschsprung's disease. PMID- 3312346 TI - A case of cutaneous involvement by sinus histiocytosis with massive lymphadenopathy. PMID- 3312349 TI - Malignant transformation of lymphadenosis benigna cutis: a possibly transformed case and B-cell lymphoma. PMID- 3312350 TI - Cutaneous metastasis of invasive lobular carcinoma of the breast. PMID- 3312351 TI - Epidermolytic hyperkeratosis associated with a dilated pore. PMID- 3312352 TI - [Anaphylaxis and the processes of embryo and tumor development]. PMID- 3312353 TI - [Antigen localization at the ultrastructural level in Clostridium tetani]. PMID- 3312354 TI - Should we still administer calcium during cardiopulmonary resuscitation? PMID- 3312355 TI - Clinical use of differential continuous positive airway pressure in the treatment of unilateral acute lung injury. AB - In some instances of unilateral acute lung injury (ALI) refractory to conventional ventilatory support, the intact lung is still able to ensure an efficient CO2 washout, the concomitant hypoxaemia being due to the loss of volume of the injured parenchyma. In these cases, the administration of a sufficient selective continuous distending pressure by means of differential continuous positive airway pressure may restore to normal the resting volume and thus the ventilatory performance of the affected lung, contemporarily avoiding the occurrence of pulmonary and systemic barotrauma. PMID- 3312356 TI - Treatment of massive unilateral pulmonary embolism by differential lung ventilation. AB - A patient with massive unilateral pulmonary embolism was treated with thrombolytic therapy and differential lung ventilation and selective PEEP. Differential lung ventilation affords besides therapy, selective monitoring of VCO2. Effects of thrombolytic therapy and SPEEP were evaluated by monitoring differential VCO2. Hypercapnia persisting in spite of conventional mechanical ventilation reduced remarkably after starting differential lung ventilation with selective PEEP on the noninjured lung. PMID- 3312357 TI - Essentials of college and university education for professional nursing. PMID- 3312359 TI - The National Commission on Nursing Implementation Project: report to the participants of Nurses in Agreement Conference. PMID- 3312358 TI - Differentiated practice for ADN- and BSN-prepared nurses. PMID- 3312361 TI - Joseph Francis Volker--Alabama's most distinguished adopted son. Part VI- Chanceller of the University of Alabama system. PMID- 3312360 TI - The Maternal-Infant Core Competency Project: report of phase I. PMID- 3312362 TI - Recent research on gender differences in collegiate alcohol use. PMID- 3312363 TI - Screening for problem drinking in college freshmen. PMID- 3312364 TI - Current results of management in transposition of the great arteries, with special emphasis on patients with associated ventricular septal defect. AB - Two hundred forty-five patients less than 15 days of age with transposition of the great arteries with or without a ventricular septal defect or pulmonary stenosis were entered into an ongoing 20 institution treatment study between January 1, 1985 and June 1, 1986. Complete follow-up is available on all patients. The ventricular septal defect narrowed in only 1 of 36 patients with combined transposition of the great arteries and ventricular septal defect; pulmonary stenosis developed or worsened in 3 of these 36 patients and in 3 of the 187 patients with simple transposition. Twelve month overall survival among the 245 patients was 80%. No morphologic feature of transposition was a risk factor for death but major associated cardiac and noncardiac anomalies (more common in patients with combined transposition and ventricular septal defect) and low birth weight were risk factors. Neither arterial switch repair (n = 86), atrial switch (Mustard) repair (n = 21) nor atrial switch (Senning) repair (n = 39) was a risk factor for death, but results in all surgical groups were better in the last part of the experience. Death before repair was less frequent late in the study. Possibly, in low birth weight infants, survival was better with the arterial than with the atrial switch repair. These data suggest that survival at 1 year is similar with either the arterial or the atrial switch repair. The early results of repair of combined transposition of the great arteries and ventricular septal defect are as good as those of simple transposition. Special institutional efforts are required to attain good results with the arterial switch repair and to prevent death before repair. PMID- 3312365 TI - Left ventricular mechanics and contractile state in children and young adults with end-stage renal disease: effect of dialysis and renal transplantation. AB - The potential existence of a specific uremia-associated myocardial depressant factor was explored by evaluating nine pediatric subjects (3 to 21 years) without evidence of coronary artery disease or long-standing hypertension 1) before entering a dialysis program, 2) while undergoing a long-term dialysis regimen, and 3) after successful renal transplantation. Myocardial contractility was quantitated with load-independent indexes using the end-systolic pressure dimension relation (Emax) and the relation of rate-corrected velocity of shortening to end-systolic wall stress. Myocardial loading status was determined by the direct measurement of afterload (end-systolic wall stress) and the functional quantitation of preload (differences between the relation of fractional shortening and velocity of shortening to end-systolic stress). Most patients (55%) were found to have abnormal ejection phase indexes of ventricular function either before or after entry into dialysis. However, contractility was normal in all subjects at each of their evaluations, and no change in contractility was found after dialysis or transplantation. Loading status was highly variable and usually abnormal before transplantation and accounted entirely for the abnormalities of fractional shortening and velocity of shortening. Transplantation invariably resulted in normalization of loading status and ejection phase indexes of ventricular function. In these children and young adults with uremia, abnormal ejection phase indexes of ventricular function were frequent and caused by associated abnormalities in ventricular loading. Contractility, however, was normal and no evidence of a uremia-associated myocardial depressant was found. PMID- 3312366 TI - Quantitation of aortic regurgitation by computer analysis of digital subtraction angiography. AB - Digital subtraction angiography provides the potential to determine aortic regurgitant fraction by computer analysis of time-intensity curves generated from regions of interest positioned over the aorta and left ventricle after aortography. To validate this ability, we studied six dogs instrumented with an electromagnetic flow probe on the ascending aorta. Aortic regurgitation of varying severity was produced by a basket catheter introduced through the right carotid artery. Aortograms were performed using continuous fluoroscopy at 30 frames/s and stored in digital format in a 256 x 256 pixel matrix. An image processing computer was utilized to plot summated pixel intensity versus time for both the aortic and the left ventricular regions of interest. Regurgitant fraction was calculated from the time-intensity curves using an algorithm analogous to that employed by dye-dilution methods. Regurgitant fraction determined from digital angiography was compared with that obtained by electromagnetic flow and was found to correlate well (r = 0.94, SEE = 7.4%) over a wide range of values. Thus, these data indicate that aortic regurgitant fraction can be accurately determined from computer analysis of digitally acquired aortograms in an animal model of acute aortic regurgitation. PMID- 3312367 TI - Starling's law of the heart is explained by an intimate interaction of muscle length and myofilament calcium activation. AB - The results of several different types of investigations over the last decade clearly indicate that muscle length modulates the extent of myofilament calcium ion (Ca2+) activation. Similarly, the fiber length during a contraction, which is determined in part by the load encountered during shortening, also determines the extent of myofilament Ca2+ activation. Thus, "contractile" or "inotropic" state as it refers to the extent of myofilament activation can, in theory, no longer be considered independent of the muscle length, as was formerly thought to be the case. Accordingly, terms such as preload, afterload and myocardial contractile state as they pertain to cardiac muscle properties lose part of their significance in light of current knowledge. PMID- 3312368 TI - Prognostic implications of an early peak in plasma MB creatine kinase in patients with acute myocardial infarction. AB - To determine the prognostic implications of an early peak in plasma MB creatine kinase (MB CK) in patients with acute myocardial infarction who were not treated with an acute intervention, 342 patients with myocardial infarction confirmed by MB CK were retrospectively studied. The patients were classified into those with an early peak MB CK (less than or equal to 15 hours after the onset of symptoms, n = 84) and those with a late peak MB CK (greater than 15 hours after the onset of symptoms, n = 258). Patients with an early peak MB CK were slightly older, were more frequently female and had a higher incidence of prior myocardial infarction, congestive heart failure and arrhythmias compared with patients with a late peak MB CK. Patients with an early peak MB CK more frequently presented with ST segment depression (23 versus 11%, p less than 0.01), with anterior location of ischemia or infarction (71 versus 52%, p less than 0.01) and with a lower mean left ventricular ejection fraction (41.4 versus 47.4%, p less than 0.01). Despite more extensive left ventricular dysfunction at initial presentation, patients with an early peak MB CK had a smaller mean MB CK infarct size index (12.6 versus 18.9 g-Eq/m2, p less than 0.01), with no difference in the incidence of in-hospital complications, including death. The early left ventricular dysfunction improved in the patients with an early peak MB CK, evidenced by a 4.5% increase in ejection fraction from admission to 10 days after infarction, whereas the ejection fraction did not improve in patients with a late peak MB CK. However, the patients with an early peaking MB CK had myocardium in jeopardy as reflected by a higher incidence of ST segment depression and a decrement in the global left ventricular ejection fraction with exercise. The 4 year life table estimate for the rate of recurrent myocardial infarction after hospital discharge was higher in patients with an early peak MB CK (33 versus 22%, p less than 0.05), with an even more striking difference in the 4 year estimate for the rate of fatal recurrent infarction (20 versus 8%, p less than 0.001). The 4 year mortality estimate was markedly higher in hospital survivors with an early peak MB CK than in those with a late peak (47 versus 19%, p less than 0.0001) and, even after adjustment for differences in baseline characteristics, the residual excess mortality in those with an early peak was still significant (p less than 0.02).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3312370 TI - Streptokinase for the treatment of acute myocardial infarction: a brief review of randomized trials. AB - This is a review of the important randomized trials of intracoronary and intravenous streptokinase therapy for treatment of acute myocardial infarction. Trials carried out before 1980 failed to recognize the relations between early coronary reperfusion and myocardial salvage and therefore have not been included in this review. Seven studies on intracoronary streptokinase have been reviewed. The two largest of these studies, the Western Washington trial and the Netherlands trial, show a similar reduction in early mortality. Two other small studies demonstrated a trend toward a reduction in mortality with streptokinase therapy and the other three did not. One small and two large intravenous streptokinase trials are reviewed. Of these, the large GISSI trial in Italy demonstrated a 23% reduction in mortality in patients treated within 3 hours from the onset of symptoms and the Intracoronary Streptokinase in Acute Myocardial Infarction (ISAM) trial showed a similar trend toward reduced mortality. The small Western Washington trial showed an even greater trend toward reduced mortality but this benefit was limited to patients with anterior myocardial infarction who received early therapy. It is concluded that intracoronary and intravenous streptokinase therapy, when initiated within the first 6 hours of acute myocardial infarction, reduces mortality. The therapy is most beneficial for those patients with anterior myocardial infarction and those who can receive therapy within the first 2 to 3 hours from the onset of symptoms. PMID- 3312369 TI - Development and evaluation of anisoylated plasminogen streptokinase activator complex (APSAC) as a second generation thrombolytic agent. AB - Anisoylated plasminogen streptokinase activator complex (APSAC) was developed as a second generation thrombolytic agent in an attempt to overcome some of the limitations to the intravenous application of streptokinase for coronary artery thrombolysis. Temporary protection of the active site on the plasminogen molecule by acylation allows APSAC to be given by rapid injection, confers semiselectivity for clot (at lower doses) and prolonged fibrinolytic action. These properties may simplify intravenous administration, improve coronary reperfusion response and reduce reocclusion potential. Clinical trials with APSAC, still ongoing, allow the following tentative conclusions: the efficacy of intravenous APSAC appears to be equivalent to that of intracoronary streptokinase, when given within 4 hours of the onset of symptoms of myocardial infarction, and superior to that of intravenous streptokinase, but it is easier to administer. Early APSAC therapy leads to reperfusion rates of 60 to 65% and patency rates of 70 to 80%. Early reocclusion rates (within 24 hours) appear to be as low as or lower than those obtained with other agents. Bleeding complications and allergic manifestations after APSAC are acceptably low and comparable with those of equivalent doses of streptokinase. The potential for mortality benefit after APSAC appears to be high and is undergoing additional study. Thus, APSAC therapy, which can be given by simple injection over 2 to 5 minutes, appears promising as a future first line approach to reperfusion therapy in acute myocardial infarction. PMID- 3312371 TI - GISSI trial: early results and late follow-up. Gruppo Italiano per la Sperimentazione della Streptochinasi nell'Infarto Miocardico. AB - In the GISSI trial, 11,712 patients with acute myocardial infarction were randomized to receive either standard care or standard care with 1.5 million units streptokinase intravenously. A highly significant reduction in mortality during hospitalization in streptokinase-treated patients was observed. The mortality at 1 year was determined in 98.3% of the patients who had been originally randomized; the 1 year mortality of patients discharged alive was similar in those patients treated with streptokinase and those who were not; that is, the beneficial effects of streptokinase treatment on survival that were observed in the hospital phase of the study persisted unchanged and with comparable statistical significance for 1 year. However, a higher incidence of reinfarction occurred in the treated versus the control groups both during the hospital phase and at the 6 month follow-up. Streptokinase treatment had no detectable effect in patients with a history of previous infarction. PMID- 3312372 TI - Monosodium L-glutamate-induced asthma. AB - Ingested chemicals, including aspirin and sulfites, are becoming increasingly recognized as provokers of acute severe asthma. In order to investigate the asthma-provoking potential of the widely used flavor enhancer, monosodium L glutamate (MSG), we challenged 32 subjects with asthma, a number of whom gave histories of severe asthma after Chinese restaurant meals or similarly spiced meals. The subjects received an additive-free diet for 5 days before challenge and were challenged in hospital, after an overnight fast, with 500 mg capsules of MSG. They were challenged in a single-blind, placebo-controlled fashion with increasing doses of MSG from 0.5 gm to 5.0 gm. Thirteen subjects reacted. Seven subjects (group 1) developed asthma and symptoms of the Chinese restaurant syndrome 1 to 2 hours after ingestion of MSG. Six subjects (group 2) did not develop symptoms of Chinese restaurant syndrome, and their asthma developed 6 to 12 hours after ingestion of MSG. These challenge studies confirm that MSG can provoke asthma. The reaction to MSG is dose dependent and may be delayed up to 12 hours, making recognition difficult for both patient and physician. PMID- 3312373 TI - Recurrent infections and staphylococcal liver abscess in a child with C1r deficiency. AB - Complete absence of the C1r portion of the first component of complement was found in a 2 1/2-year-old boy of Puerto Rican origin who presented with a staphylococcal liver abscess. His medical history also included two episodes of pneumonia complicated by a pneumatocele and empyema, purulent staphylococcal lymphadenitis, recurrent otitis media, and pneumococcal bacteremia. The C1s component of complement was 50% of normal, and C4 was elevated. Other immunologic tests, including nitroblue tetrazolium test, and IgE were normal. This is the tenth patient reported with C1r deficiency. The patient differs from other reported patients with C1r deficiency in that he presented with a liver abscess, an infection that has not been reported in patients with complement deficiencies, and in that he has an apparent susceptibility to staphylococcal infection. PMID- 3312374 TI - A comparison of taste acuity for salt in renal patients vs. normal subjects. AB - In this pilot study, 30 patients with renal disease receiving renal replacement therapy (10 each in the following groups: continuous ambulatory peritoneal dialysis [CAPD] patients, hemodialysis [HD] patients, and renal transplant recipients) and 10 control subjects were given salt solutions of varying concentrations (0 to 600 mmol/L) and asked to rate them subjectively according to their perceived taste intensity. The mean age in each of the four groups ranged from 31.9 to 34.1 years. No significant differences were found in the ratings of perceived salt intensity among patients and control subjects. On the basis of 3 day food records plus recall of seasonings used, mean intake of sodium was estimated to be higher in CAPD patients and control subjects than in HD and transplant patients (p less than 0.02). Patients on CAPD stated a preference for salty items, whereas control subjects preferred the less salty items despite similar estimated sodium intakes. It thus appears that the ability to perceive various salt tastes may not be impaired in patients on renal replacement therapy. In addition, inappropriate salt intake commonly seen in those patients may be due to increased salt appetite, specifically in those patients managed by CAPD. PMID- 3312375 TI - Age-related olfactory and taste changes and interrelationships between taste and nutrition. AB - This article critically reviews the literature on age-related olfactory and taste changes and the interrelationships between nutrition and taste. Age-related taste alterations are controversial, but there is consensus on an olfactory decline with age. Much of the age-related chemoreceptive research has used inappropriate methodology, thus leaving many findings inconclusive. Changes in the taste system with age may be related to nutrient intake, which in turn can be influenced by taste. Literature on such interrelationships is limited. Vitamins A, thiamin, B 6, B-12, folacin, zinc, and copper are thought to influence taste function. Moreover, those nutrients are of concern in the aged. The use of appropriate methodology is critical not only for the sensory but also for the nutritional aspects, particularly for qualitative and quantitative assessments of nutrient intakes. This review considers the experimental deficiencies (small sample size, inappropriate age range, inadequate psychophysical and stimuli presentation procedures, and poor dietary intake assessment) of studies reported in the literature and suggests major needs for research. PMID- 3312376 TI - Neuroleptic malignant syndrome in elderly patients. PMID- 3312377 TI - What is osteopathic medicine? PMID- 3312378 TI - Surgical success rates in acquired, comitant, partially accommodative and nonaccommodative esotropia. AB - An extensive literature search covering the last 35 years was undertaken to retrieve all English language articles reporting results of surgical management of acquired, comitant, nonaccommodative and partially accommodative esotropia. Thirty-nine studies were found, but only 15 met the minimum criteria which we established for inclusion in our analysis. The functional success rate was 15% in 1170 patients, while the overall cosmetic success rate was 43% in 1473 patients. Direct comparison to optometric studies is not possible since the criteria for success used in surgical studies are considerably different. The most prevalent complication is the need for reoperation as a result of consecutive exotropia. The data indicate that an end result of consecutive exotropia is almost as likely as a functional cure. PMID- 3312379 TI - Binocular anomalies and reading problems. AB - This paper reviews and evaluates the research literature on the relationship of binocular anomalies to reading problems. The weight of the evidence supports a positive relationship between certain binocular anomalies and reading problems. The evidence is positive for exophoria at near, fusional vergence reserves, aniseikonia, anisometropia, convergence insufficiency, and fixation disparity. There is some weak positive evidence for esophoria at near and mixed evidence for stereopsis. The evidence on lateral phorias at distance is negative. PMID- 3312380 TI - Daily variation of food-induced changes in blood glucose and insulin in the rat and the control by the suprachiasmatic nucleus and the vagus nerve. AB - Rats were provided with permanent cardiac catheters allowing free movement and blood sampling without anaesthesia. During food intake the increments of plasma insulin and blood glucose were smaller and more slowly increasing in the light phase than during the dark phase. After vagal blockade the increase in both blood glucose and plasma insulin was reduced. Since this effect was more prominent in the dark phase it suggests that during this phase vagal activity may stimulate an increase in glucose inflow into the blood by activating transport and digestion of food. Electrolytic lesions of the nucleus suprachiasmaticus caused disappearance of the circadian variation of insulin and glucose responses. In this situation in both phases rapid increments of insulin and glucose occurred similar to the controls during the dark phase. It is suggested that the nucleus suprachiasmaticus directly or indirectly controls vagal activity, which determines via its influence on the gastrointestinal tract the circadian variation in blood glucose and plasma insulin responses after food intake. PMID- 3312381 TI - Retrograde tracing shows that CGRP-immunoreactive nerves of rat trachea and lung originate from vagal and dorsal root ganglia. AB - The origins of sensory innervation of the lower respiratory tract are thought to be principally the nodose and jugular ganglia of the vagus nerve. It has been suggested and partially demonstrated that there is also a component arising from dorsal root ganglia, but the segmental levels involved are not known precisely. We have therefore investigated the origins of sensory nerves within the rat respiratory tract, particularly those containing calcitonin gene-related peptide (CGRP), using the technique of retrograde axonal tracing combined with immunohistochemistry. Injections of True blue were made into extra-thoracic trachea (n = 4 rats) and percutaneously into the right and left lung (n = 4 each). Retrogradely labelled neuronal perikarya were detected in vagal and dorsal root ganglia, and sympathetic chain ganglia. CGRP-immunoreactive cells were seen only in vagal and dorsal root ganglia. Tracheal innervation arose bilaterally in the vagal sensory ganglia but those on the right side represented the principal source; the majority of CGRP-containing neurons occurred in the jugular ganglion. A very small component of labelling occurred in spinal ganglia at levels C2-C6. The sensory innervation of the lungs was seen to arise predominantly from the ipsilateral dorsal root ganglia (45% of cells CGRP-immunoreactive) at levels T1 T6. In contrast to the trachea, the contribution of vagal sensory neurones to the lungs appeared to be less than that of the spinal ganglia. These results show that the sensory innervation of the rat lungs has a major origin in the dorsal root ganglia, in which almost half of the involved neurons contain CGRP, and confirm that most CGRP-immunoreactive nerves in the trachea arise in the right jugular ganglion. PMID- 3312382 TI - Stereophotography in ophthalmology: Part I. PMID- 3312383 TI - List of contents (1984-86) and forthcoming articles of the Journal of Endocrinological Investigation. PMID- 3312384 TI - [Serology of Chlamydia trachomatis infections in tubal pregnancies. Apropos of 95 cases]. AB - This study concerns the results of serology for Chlamydia trachomatis in 95 patients who were operated on for tubal pregnancies consecutively. The serology (Ig GAM) was carried out using a micro-immunofluorescence technique. It was considered positive when the levels were higher than or equal to 1/32, suggesting an old or continuing infection. It was positive in 66 cases out of the 95, which gives a percentage of 69.5. The positive serology was apparently significant (p less than 0.01) more often in tubal pregnancy than in the two control groups (sterile patients with normal tubes and normally delivered patients). Our results coincide with that in the literature. It therefore seems worth while to look systematically for chlamydial infection in the couple in cases of tubal pregnancy and, if found, to treat them. PMID- 3312385 TI - [Basic principles of a breast cancer detection program]. AB - The results of different programmes for screening carried out at present in foreign countries give sufficient proof of the value of screening for cancer of the breast in asymptomatic women of over 50 years of age. There is a significant reduction in mortality between 30 and 70%, according to different studies. Women who were screened had their cancers diagnosed at an earlier stage of the illness than those who were not screened whatever the ages of the women were. These results give a basis for planning screening in France. However, controlled pilot studies should still be carried out to widen screening in a country. These studies should in particular look at technical methods, evaluate the quality of the information that is obtained and the acceptability by women, as well as the training of radiologists and the qualities of the methods used. Finally, each programme should be controlled by the Public Authorities who will be paying for it. PMID- 3312386 TI - [An ultrasonic trap: pseudocystic degeneration of uterine myomas]. AB - The authors present a rare case of pseudocystic degeneration of fibroids for which they had used an ultrasound scan before the operation. They point out that the ultrasound pictures they found were very similar indeed to those shown by patients with multiloculated ovarian cysts. They emphasize that ultrasound does have its limits in the diagnosis of pelvic tumours. PMID- 3312387 TI - [Captopril treatment of severe arterial hypertension in pregnancy]. AB - The authors report three cases where captopril was used in pregnancy. This was shown to be more useful in cases of essential hypertension than in toxaemia. There was no bad side effect from the use of Captopril. It did not alter the fetal growth once the hypertension was well controlled. Using it together with other anti-hypertensives has to be thought out very carefully and it has to be used with great care. The state of the newborns at birth was satisfactory. Follow up was without complications except for one case where was a persistent ductus. Whether captopril had any role to play in this is uncertain. Although these results are good, captopril should not be used as first choice treatment in hypertension. PMID- 3312388 TI - An evaluation of the pooling method for detecting enterotoxigenic Escherichia coli. PMID- 3312389 TI - Oral rehydration therapy: comparison of a commercial product with the standard solution. PMID- 3312391 TI - Alcoholic ketoacidosis--a review. AB - Alcoholic ketoacidosis is a frequently encountered metabolic disturbance that follows a prolonged intake of ethanol. Following a brief duration of abstinence, patients typically present with vomiting, abdominal pain, and shortness of breath. Examination reveals Kussmaul breathing, variable volume loss, and coincident manifestations of chronic alcohol usage. Characteristic laboratory findings include anion-gap metabolic ketoacidosis, normal serum glucose, and zero ethanol levels. Phosphate measurements may be depressed, particularly after institution of therapy. Intravascular volume restitution, delivery of dextrose, attention to electrolytes, and discovery of alcohol-related illnesses are the mainstays of therapy. PMID- 3312390 TI - Electrical shock in pregnancy: a case report. AB - Electrical shock in pregnancy is associated with significant perinatal morbidity and mortality. A case of such an electrical shock in pregnancy is reported. A review of the literature follows. The severity of maternal injury does not correlate with the injury sustained by the fetus. Close fetal surveillance following electrical injury is necessary. PMID- 3312393 TI - Relaxation and the healing process. PMID- 3312392 TI - Endotracheal drug administration in the critical care setting. AB - Administration of drugs through an endotracheal tube has been evaluated in a number of animal models. In addition, the technique has been utilized in humans as reported in several published cases. A review of endotracheal drug administration with emphasis on application to the critical care setting is presented. PMID- 3312394 TI - Body therapies: body awareness techniques. PMID- 3312395 TI - A comparative study of dimensions of healthy functioning between families practicing the TM program for five years or more or for less than a year. PMID- 3312396 TI - Hospital procedure and nursing for patients treated with synchronised independent lung ventilation (sILV). PMID- 3312397 TI - Effect of a serotonin precursor and uptake inhibitor in anxiety disorders; a double-blind comparison of 5-hydroxytryptophan, clomipramine and placebo. AB - A double-blind placebo-controlled study of 5-HTP and clomipramine was carried out on 45 patients suffering from anxiety disorders (DSM-III). Clomipramine has shown to be effective in that it induced significant improvement on all rating scales as compared to placebo. 5-HTP showed a moderate reduction of the symptomatology on the 90-item symptoms checklist (SCL-90) and the State Scale of the Spielberger State-Trait Anxiety Inventory. Clomipramine and 5-HTP differed in their efficacy in that 5-HTP did not affect the associated depressive symptomatology. The results support the hypothesis that brain serotonergic pathways are involved in the pathogenesis of anxiety disorders, particularly in agoraphobia and panic disorders. PMID- 3312398 TI - Treatment-resistant schizophrenia: controlled study of moderate- and high-dose thiothixene. AB - Double blind controlled study on fifty treatment-resistant schizophrenic inpatients showed a statistically significant improvement in favour of the high dose group. PMID- 3312400 TI - I.U. School of Medicine revives John Shaw Billings History of Medicine Society. PMID- 3312399 TI - Plasma concentrations of thiothixene and clinical response in treatment-resistant schizophrenics. AB - Plasma concentrations of thiothixene were measured during treatment of 42 treatment-resistant schizophrenic patients. Inter-individual variability was marked even when patients were treated with the same dose or dose regimen. Intra individual variability was less but still considerable. A highly significant correlation was found between dose and plasma concentration, but this relationship was unpredictable for individual patients. A median plasma concentration of 12 to 15 ng/ml might be expected with daily doses of 60 mg. No definite range of therapeutic plasma concentrations could be determined. Patients who attained moderate degrees of improvement did so at a median dose of 26 ng/ml, which is within the range of therapeutic plasma concentrations previously reported for thiothixene in similar patients. PMID- 3312401 TI - Out-of-hospital cardiac arrest: patient survival and neurological recovery. PMID- 3312402 TI - Human geography in the French Institute: new discipline or missed opportunity? AB - The geography section of the Class of Moral and Political Sciences of the French National Institute, which was in existence from December 1795 to January 1803, responded inadequately to the theoretical challenges of Montesquieu, the hygienists, Volney, and Degerando to study thoroughly native peoples to determine the effects of physical geographic conditions on the body and mind. Most geographers had no interest in human geography, and even statistical geography received only superficial discussion. Despite the emergence of the scientific journal, only a few authors partly transcended the stereotypes of the noble ignoble savage. The only expedition partly planned by the Institute in this period had an ambitious exploration program that precluded a linguistically sophisticated study of native peoples. Bonaparte's dissolution of the Class hindered further opportunities for studying human geography during the Empire. PMID- 3312403 TI - Henri Hubert, racial science and political myth. AB - Henri Hubert developed early Durkheimian critiques of racial sciences such as anthroposociology from his perspective as an archeologist, historian, and ethnographer of primitive European religions. His major works on the "primitive" Celts and Germans continue these critiques of racism. But Hubert also engaged in the political mythologizing of French national identity by trading in the republican myth of "celtisme." PMID- 3312404 TI - [Neuropathology of contralateral pain flexor reflexes]. AB - Postmortem neuropathological and neuroanatomical--topographical examinations of brain section series of 10 patients with brain tumours of different histological type and localization with evidence of the Contralateral Pain Flexor Reflex (CPFR), described by Sayk (1982), were performed. In each case could be found an alteration or damage of functionally relevant structures of the ventrocaudal- lateral Thalamus, the intralaminar and intralaminar-reticular nuclei, of the Pulvinar thalami, the lemniscus medialis and the striopallidar nuclei formation by tumuorcellinfiltration and oedema. Possible ways of origin of the CPFR, pathophysiological possibilities and the prognostic relevance of this reflex are discussed. PMID- 3312405 TI - Bibliography of the current world literature in hypertension. PMID- 3312406 TI - Dietary sodium effects on cardiovascular and sympathetic neuroeffector functions as studied in various rat models. PMID- 3312407 TI - Absence of processing enzymes for inactive renin in mouse blood but polymorphonuclear neutrophils contain active renin. AB - The possible role of enzymes in plasma and blood cells for the conversion of inactive renin was investigated in mice of the Balb C strain. The concentrations of both inactive and active renin were unchanged in unfractionated plasma and whole blood during incubation at 37 degrees C for 5 h, indicating, that inactive renin had not been activated. Purified platelets, mononuclear cells (monocytes and lymphocytes), and polymorphonuclear leukocytes were incubated separately with partially purified inactive renin at 37 degrees C for 1 h. Inactive renin was neither activated nor degraded by whole blood cells. Polymorphonuclear neutrophils were also obtained in mice after i.p. injection of fluid thioglycollate medium. Extracts of the polymorphonuclear neutrophils were incubated with partially purified, inactive renin. During incubation at pH 7.5 for 1 h at 37 degrees C, inactive renin was stable and no activation was registered, whereas degradation, without a concomitant increase in active renin, occurred at pH 4.5. Extracts of polymorphonuclear neutrophils were found to contain active, but no inactive renin. The mean amount of renin per cell was 0.5 X 10(-11) Goldblatt units (GU) (range 0.3 X 10(-11) GU - 0.9 X 10(-11) GU; n = 6). These findings argue against a role for the blood cells and plasma in a physiological activation of inactive renin, and do not support the concept that activation of inactive renin in the circulation may participate in homeostasis. PMID- 3312408 TI - Heymann antibodies induce complement-dependent injury of rat glomerular visceral epithelial cells. AB - The aim of this study was to investigate the in vitro role of the complement membrane attack complex (MAC) in the injury induced by nephritogenic anti-brush border vesicle (Fx1A) antibodies on rat glomerular visceral epithelial cells (GEC). Both sheep and rabbit anti-rat brush border vesicle IgG-induced complement dependent lysis of cultured GEC. Fab fragments of sheep anti-rat brush border vesicles and polyclonal or monoclonal gp330 IgG were devoid of lytic activity. Shedding of cell-surface antigens induced by sheep or rabbit anti-rat brush border vesicle IgG protected GEC from subsequent exposure to lytic antibodies and complement, an effect that was not obtained with Fab fragments. When GEC were incubated with sheep or rabbit anti-rat brush border vesicle IgG in capping conditions, the C3 component was co-redistributed with Heymann immune complexes; in contrast, the MAC remained diffusely bound to the cell surface, indicating that it was not associated with the antigen-antibody complexes. The MAC was demonstrated on the surface of GEC by immunofluorescence staining with anti-MAC neoantigen and by electron microscopy of negatively stained membranes showing focal clusters of 110 A MAC lesions. When GEC were treated with sheep IgG or rabbit IgG plus C6-deficient sera, the cells were not lysed and MAC was not demonstrable on the surface; however, lytic activity was restored when C6 deficient sera were reconstituted with purified C6. The results are consistent with the interpretation that injury induced by Heymann antibodies on GEC is MAC dependent. PMID- 3312409 TI - Identification of an interleukin HP1-like plasmacytoma growth factor produced by L cells in response to viral infection. AB - We have recently purified and partially sequenced a new T cell-derived lymphokine with growth factor activity for B cell hybridomas and plasmacytomas, which we named interleukin HP1 (HP1). Here we show that, in response to viral infection or after treatment with poly(rI).poly(rC), L cells produce a factor that is capable of supporting the in vitro growth and survival of HP1-dependent cell lines. Serologic and structural evidence is presented in favor of the identity between the fibroblast factor and HP1, demonstrating that non-T cells can make HP1 related molecules. PMID- 3312410 TI - Induction of granulocyte-macrophage colony-stimulating factor by lipopolysaccharide and anti-immunoglobulin M-stimulated murine B cell lines. AB - The present study was undertaken to elucidate whether B cell lymphoma and hybridoma cell lines can be stimulated by lipopolysaccharides (LPS) or by antibodies against immunoglobulin M (IgM) to produce granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF activity was assayed on the basophil/mast cell line PT-18 which is GM-CSF- and interleukin 3-dependent. Antibodies against murine recombinant GM-CSF were used to identify the colony stimulating factor activity present in the supernatants of the stimulated B cell lines. When these cell lines were stimulated with LPS, two of five lymphoma and five of six hybridoma lines produced GM-CSF. Two cell lines, the B cell lymphoma M12.4.1 and the hybridoma TH2.2, were analyzed more extensively under serum-free conditions. In these two cell lines, the production of GM-CSF was dependent on the dose of LPS used and time of exposure. Antibodies against IgM stimulated the TH2.2 (IgM+) but not the M12.4.1 (IgM-) cells to produce GM-CSF. Northern blot analysis of the M12.4.1 and TH2.2 cells showed that mRNA of GM-CSF can be detected in LPS-stimulated but not in unstimulated cells. Our data show that transformed B cells can be stimulated to produce GM-CSF. The present data and previous studies on GM-CSF production by normal bone marrow-derived B cells suggest a possible participation of B cells in granulopoiesis. PMID- 3312411 TI - Biosynthesis of C8 by hepatocytes. Differential expression and intracellular association of the alpha-gamma- and beta-subunits. AB - The subunit structure of C8 is unusual in that it consists of a disulfide-linked alpha-gamma-dimer and a non-covalently associated beta-chain. To gain insight into the biosynthesis and assembly of C8, we examined its production by short term cultures of rat hepatocytes. Synthesis was detected by functional assays as well as immunologically with antisera against C8, alpha-gamma or beta. Control experiments showed that all three antisera were capable of precipitating C8 from rat serum. When antiserum against C8 was used to analyze hepatocyte cell lysates, precursor as well as mature forms of alpha-gamma and beta were detected. Precursor-product relationships were confirmed by pulse-chase experiments, which also revealed a significantly faster rate of synthesis for alpha-gamma. Importantly, no single chain form of alpha-gamma was detected in the intracellular pool. Evidence that C8 is assembled before secretion was provided by analyzing cell lysates with antiserum specific for alpha-gamma or beta. Precipitation of both subunits with either antiserum confirmed they were associated. Parallel analyses of the extracellular pool revealed that alpha-gamma and beta remain associated in the media but that excess alpha-gamma is secreted as a consequence of a faster synthesis rate. These results provide evidence for differential expression of alpha-gamma and beta and are consistent with the existence of different loci for these subunits. Furthermore, they indicate that association of alpha-gamma with beta is a presecretory event in normal C8 synthesis. PMID- 3312412 TI - The generation of infective stage Leishmania major promastigotes is associated with the cell-surface expression and release of a developmentally regulated glycolipid. AB - A monoclonal antibody, 3F12, was generated which reacted specifically against infective or metacyclic stage Leishmania major promastigotes, but not with noninfective promastigotes obtained from log phase cultures. The antibody recognized a cell surface and released molecule that could be metabolically labeled with [14C]glucose, [3H]mannose, [3H]galactose, and [3H]palmitic acid, but not with [35S]methionine or [3H]leucine. The molecule was the major species surface-labeled by [3H]sodium borohydride after periodate treatment. The glycolipid appeared to be shed primarily as free carbohydrate because 70% of the released material partitioned in the aqueous fraction after phase separation in TX-114. The molecule could be distinguished from the L. major glycolipid which has already been extensively described because its migration on sodium dodecyl sulfate-polyacrylamide gel electrophoresis was of higher relative m.w. However, a close relationship between the two molecules was indicated by the finding that another monoclonal antibody, WIC-79.3, recognized both forms of the glycolipid; one produced and released only by log phase promastigotes, and one produced and released only by metacyclic promastigotes. The loss of agglutination with peanut agglutinin which has been shown to accompany metacyclogenesis was found to be caused by the loss of expression of the log form of the glycolipid which in most cases appeared to be the result of the developmental modification of this molecule. A survey of a number of virulent and avirulent. L. major strains and clones reinforced an absolute association between the ability of these promastigotes to initiate infection in BALB/c mice and their expression and release of the 3F12-binding, developmentally regulated form of the glycolipid. Not only does this glycolipid serve as the first well defined molecular marker for infective stage metacyclic promastigotes, but its unique structure is very likely to contribute to the adaptive changes that allow these parasites to survive within the vertebrate host. PMID- 3312413 TI - Prophylactic immunization against experimental leishmaniasis. VI. Comparison of protective and disease-promoting T cells. AB - In previous studies, we reported that mice immunized i.v. with lethally irradiated Leishmania major promastigotes developed substantial resistance to a subsequent L. major infection. However, such protection could be totally suppressed by prior s.c. injection with the same antigens. Both the protective immunity and the inhibition of its induction could be adoptively transferred with specific Lyt-2- T cells. Here, we present evidence showing that protection and disease promotion resulting from i.v. or s.c. immunization, respectively, are mediated by functionally distinct subsets of T cells. In a series of titration experiments, it was found that freshly isolated T cells derived from prophylactically i.v. immunized BALB/c mice were either protective (greater than 10(7) cells/recipient) or ineffective (less than 10(7) cells/recipient). No exacerbation of disease was observed at any dose. Conversely, T cells from mice immunized s.c. either accelerated disease development and inhibited protective immunization (greater than 10(7) cells/recipient) or had no effect (less than 10(7) cells/recipient). No protection was observed at any dose tested. In mixed transfer experiments, increasing numbers of T cells from s.c. immunized donors progressively inhibited the protective effect of T cells from i.v. immunized donors. Supernatant of T cell cultures from protectively immunized donors contained substantial macrophage-activating factor whereas such activity was not detectable in the supernatant of T cell culture from s.c. immunized donors. Analysis by flow cytometry showed that the spleen and lymph nodes of normal, i.v., or s.c. immunized BALB/c mice contained similar ratios of L3T4+ cells and Lyt-2+ cells. PMID- 3312414 TI - The human beta 2-microglobulin gene. Primary structure and definition of the transcriptional unit. AB - The human genomic clone pb2m13 contains a functional beta 2-microglobulin (B2m) gene, which upon transfection is readily expressed in murine fibroblasts. Here we report the nucleotide sequence of the human beta 2m gene and of a nearly full length cDNA clone. A comparison with the murine beta 2m gene reveals that exon/intron boundaries are absolutely conserved. In the protein-coding regions the similarity is 70%. As far as intron sequences of the murine beta 2m gene are available, no significant similarity between human and murine genes is observed. The transcriptional start site of the human beta 2m gene was determined by S1 mapping, and comparison with the nearly full length cDNA clone now defines the transcriptional unit of the beta 2m gene. In the 5' region of the gene strong clustering of the usually underrepresented CpG dinucleotide is found resembling a similar overrepresentation in the 5' regions of the major histocompatibility complex class I genes. PMID- 3312415 TI - A multi-step isolation scheme for obtaining CD16+ human natural killer cells. AB - A multi-step isolation scheme capitalizing on negative selection protocols is described for obtaining an enriched population of CD16+ human natural killer (NK) cells. The isolation scheme consists of incubating peripheral blood mononuclear cells (MNC) on nylon wool, rosetting the nylon wool non-adherent cells with sheep red blood cells (SRBCs) for 1 h at 29 degrees C and then utilizing a 'panning' technique to remove CD3+, non-rosetting cells. The final working cell population contained 70-80% CD16+ cells, 15% CD2+ cells, 1-3% CD3+ cells, 5-7% SIg+ cells and no detectable MO2+ cells. In comparing the final NK cell population from the multi-step isolation protocol to NK cells obtained by the Percoll density gradient centrifugation technique, the multistep method: (1) yielded a higher percentage of CD16+ cells, (2) mediated a greater degree of cytotoxicity at a 25:1 E:T ratio, and (3) contained fewer contaminating monocytes/macrophages (none were detectable). In addition, the multi-step scheme allowed recovery of 30% of the total CD16+ cells present compared to only 7% recovered by the Percoll density gradient technique. Pretreatment of the enriched NK cells, obtained from the multi-step scheme, with interleukin-2 (3.5 and 7.0 U/ml of activity) resulted in an increase in NK cell-mediated cytotoxicity. In addition, these cells were as effective at synthesizing the cytotoxin, NKCF, at a 25:1 E:T ratio as at 50:1 and 100:1 E:T ratios. This multi-step isolation scheme consistently yields a high percentage of CD16+ NK cells and thus may greatly facilitate studies on the mechanism(s) involved in NK cell-mediated cytotoxicity and may further the study of the cytotoxins involved. PMID- 3312416 TI - The production of recombinant HLA-DR beta and invariant chain polypeptides by cDNA expression in E. coli. AB - In this report we describe the production of recombinant fusion proteins of the HLA-DRw6 beta chain and the murine Ia-associated invariant chain. cDNAs encoding the human HLA-DRw6 beta chain and the murine Ia-associated invariant chain were introduced into bacterial expression plasmids. These plasmids direct the synthesis of the respective molecules as fusion proteins of the bacteriophage MS 2 polymerase by E. coli. Fusion proteins purified from crude E. coli lysates were used to raise antisera in rabbits. These antisera were able to immunoprecipitate biosynthetically labelled class II and invariant chain antigens. Additionally, two anti-DR antisera were raised against single domains of the HLA-DR beta chain thus generating reagents with a defined fine specificity. The anti-murine invariant chain serum was shown to cross-react with the human invariant chain and therefore may be useful for studying invariant chain and Ia antigen expression in different species. The method described here permitted us to produce large quantities of immunologically relevant proteins, for use in the production of polyclonal and monoclonal antibodies. Soluble fragments of the fusion proteins representing certain DR domains may also be useful in functional immunological studies. PMID- 3312417 TI - Skin window chambers, a novel method for recovering the cells involved in delayed type hypersensitivity. AB - A method is described for the recovery of cells involved in the delayed-type hypersensitivity (DTH) reaction in man. A small plastic chamber was placed over DTH sites from which the stratum corneum had been removed by tape stripping. The chambers were then filled with serum. Analysis of cells harvested at 24 and 48 h has shown an antigen-dependent increment in mononuclear and polymorphonuclear cells in donors with a DTH response. T cell clones were established from the recovered cells; these will provide a useful adjunct to a functional analysis of cells participating in the DTH reaction. PMID- 3312419 TI - Cephalosporins in bacterial meningitis: necessity or luxury? PMID- 3312418 TI - Group G streptococcal infections. PMID- 3312420 TI - The role of Bacteroides encapsulation in the lethal synergy between Escherichia coli and Bacteroides species studied in a rat fibrin clot peritonitis model. AB - Encapsulation in Bacteroides species has been thoroughly studied in vivo as a virulence factor in abscess formation. Its pathogenic role in lethal infections caused by a mixture of pathogens has been less well investigated. Our previous studies using the rat fibrin clot peritonitis model have demonstrated lethal synergy between Bacteroides fragilis and Escherichia coli. In order to determine the synergistic role of the encapsulation of the Bacteroides component in this model, inoculations of E. coli plus one of seven Bacteroides strains of differing degrees of encapsulation were assessed for their effect on mortality. Both unencapsulated Bacteroides strains tested (B. distasonis 1244, B. vulgatus 4300) produced an early lethal synergistic effect with E. coli while the heavily encapsulated strain, B. thetaiotaomicron 1603 did not do so. The four other Bacteroides strains tested were encapsulated and their synergy with E. coli was demonstrated. Control Gram-positive strains, Streptococcus faecalis and Staphylococcus aureus, did not alter mortality when mixed with E. coli in this model. These studies support the concept that virulence factors other than encapsulation are important in the outcome of polymicrobial infections in which Bacteroides species play a part. PMID- 3312421 TI - Risk of infection by Brucella melitensis for people living near infected goats. AB - Taking advantage of a local outbreak of brucellosis in a herd of goats, we have assessed the risk of infection for people living nearby. By means of serological tests we have shown that such a risk is small provided that direct contact with contaminated tissues or secretions of goats is avoided. PMID- 3312422 TI - Biochemical changes in desmosomes of bovine muzzle epidermis during differentiation. AB - Biochemical changes taking place in desmosomes during differentiation have been studied. Bovine muzzle epidermis was sliced horizontally into 6 layers, 0.2 mm thick, and desmosomes were isolated from each layer. These were then analyzed by polyacrylamide gel electrophoresis. The electrophoretic patterns of desmosomal proteins from the 6 layers were found to be qualitatively similar to each other, but there was an increase in the ratio of the amount of 150 kD glycoprotein (desmoglein I) relative to 240 and 210 kD proteins (desmoplakins) in the upper layers of the epidermis. This finding was supported by the similar increase observed in electrophoretic patterns of proteins extracted directly from each layer of the epidermis in electrophoretic sample buffer. In order to study the fate of desmosomal components in the stratum corneum, serial skin surface biopsies were stained with antisera against desmosomal components using indirect immunofluorescence techniques. This experiment showed that desmosomal proteins and glycoproteins persist in the stratum corneum but quantitatively decrease in the outer layers. This decrease may play a significant role in desquamation. PMID- 3312423 TI - Human hematoxylin-stainable protein of keratohyalin granules origin. I. Extraction and purification. AB - A human hematoxylin-stainable protein (HSP) was extracted from the massive stratum corneum of epidermal cysts. This protein was purified in two steps; first, through preparative isoelectric focusing, and, second, by affinity column chromatography bound with the specific, monoclonal antibody to keratohyalin granules (Ted-H-1). In sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the purified HSP consisted of two proteins (70 and 62 kilodaltons [kd]), but only the 62-kd protein was detected in the 15,000 g supernatant fraction of the extract using the immunoblotting technique. The amino acid composition of the purified HSP included 30% glycine, 15% serine, 12% glutamic acid, and 4% ornithine, but only 2.3% histidine. Using the indirect immunofluorescent technique, observation showed that the monoclonal antibody, Ted-H-1, to the HSP, formed as a result of the partially purified antigen, was located in three places: 1) the keratohyalin granules; 2) in the cell membrane region of the lower part of the stratum corneum of the skin samples (forearm, cheek, and back); and 3) the keratohyalin granules in the follicular epithelium and on the trichohyalin granules. Reaction product was not seen in either the acrosyringium or in the plantar epidermis. As two positively reacted proteins with the Ted-H-1 were detected in the Tris-HCl extract from the plantar stratum corneum by the immunoblotting assay, however, the above negative result in the indirect immunofluorescent studies may be due to the masking of the antigenic site of keratohyalin granules in vivo. This hematoxylin-stainable protein was synthesized as one component of the keratohyalin granules in the stratum granulosum and may have been transferred to the stratum corneum cell membrane region. PMID- 3312425 TI - Interferon-induced protein synthesis inhibits endocytosis of bacteria in epithelial cells. AB - Previous studies have shown that human leukocyte interferon (IFN), IFN-gamma, and recombinant (r) IFN-alpha-A protect cultured human cells against the invasiveness of salmonellae, shigellae, and enteroinvasive Escherichia coli. To differentiate between effect on endocytosis and adhesiveness, HEp-2 cells were pretreated with cytochalasin B to block endocytosis, and thereafter treated with IFN. Although a significant reduction of adhesion of bacteria to HEp-2 cells was observed, this reduction was far too small to explain the total reduction of bacterial invasiveness. Thus, the anti-invasive effect of IFN on HEp-2 cells is due mostly to inhibition of endocytosis. The IFN effect was not expressed at 4 degrees C, and the ribosomal 60S subunit inactivators, cycloheximide, abrin, and shigella toxin, completely blocked the expression of the IFN-induced anti-invasive state of the cell. Thus, the IFN effect is dependent on continuous ribosomal activity. Our results indicate that the major effect of IFN on bacterial invasiveness is on endocytosis, and that the action is mediated through the effect of IFN-induced protein synthesis. PMID- 3312424 TI - Transesophageal echocardiography in review. PMID- 3312427 TI - Neurodestructive procedures in the management of cancer pain. PMID- 3312426 TI - Fixed-interval v as-needed analgesics in cancer outpatients. PMID- 3312428 TI - A comparison of two relaxation strategies for the relief of pain and its distress. PMID- 3312430 TI - The distinction between physiological and pathological attrition: a review. PMID- 3312431 TI - A clinical report of two types of resin-bonded bridgework. PMID- 3312429 TI - The use of implanted closed-tip catheters for the introduction of thermometry probes during local hyperthermia treatment series. AB - In the past two and a half years custom-made closed-tip catheters have been used to allow extensive temperature monitoring with multi-junction thermocouple probes during local hyperthermia. Data from animal experiments indicate that the use of thermometry probes within such a catheter provides reliable temperature measurements. In order to reduce stress to the patient the catheters were fixed so that they could stay in place during the total treatment series. The catheters, outer diameter 1.22 mm, were introduced through hollow needles under sterile conditions before the first hyperthermia session, and fixed using Histo acryl (tissue adhesive) and Tegaderm (transparent adhesive). Recently, the data concerning the first 180 catheters placed in 74 treatment areas were evaluated. In one patient, an abscess developed 10 days after removal of the (3) catheters, which required surgical intervention, but it was not clear whether these problems had developed as a result of catheter placement. There were no problems with 139 of the remaining 177 catheters (79 per cent) and in 50 treatment fields (68 per cent), respectively, for a duration of 9-55 (mean 23) days. Ten catheters (6 per cent) were lost during the treatment series after 1-22 (mean 10) days. With 28 catheters (16 per cent) infection was observed, 14-27 (mean 19) days after insertion, which necessitated catheter removal before the last treatment session in 11 cases (6 per cent). The complication rate decreased with increasing experience; from 29 per cent (25/85) in the early period to 14 per cent (13/92) in the later period. We conclude that the use of closed-tip catheters under proper control generally causes few, if any, problems. This results in the acquisition of a substantial amount of reliable temperature data at reproducible sites, and it is well tolerated by the patient. PMID- 3312432 TI - [A case report of right aortic arch with aberrant left innominate artery]. PMID- 3312433 TI - [Serum beta 2 microglobulin for the early recognition of acute renal dysfunction after cardiac surgery]. PMID- 3312435 TI - [Nonpenetrating traumatic ventricular septal defect--report of a case]. PMID- 3312434 TI - [Six cases of congenital coronary artery fistula--including one case of bilateral coronary arteries-pulmonary artery aneurysms]. PMID- 3312436 TI - [A case of schwannoma of a rosary-like configuration originated from the left phrenic nerve]. PMID- 3312437 TI - [A preoperatively diagnosed coronary sinus atrial septal defect]. PMID- 3312438 TI - [A case of mediastinal neurofibroma originating from the intrathoracic vagal nerve]. PMID- 3312439 TI - [Digital subtraction angiography of inferior gluteal artery through the infusion catheter of chemotherapy in bladder cancer]. PMID- 3312440 TI - [Clinical trials of interferon-beta (MR-21) on malignant brain tumors]. PMID- 3312441 TI - Renal tubular chloride and renin release. AB - We have suggested that the renal tubular signal for renin release is related to alterations of sodium chloride cotransport in the TALH. Renin release is inhibited by increased sodium chloride transport and stimulated by interrupted sodium chloride transport. Because of the different affinities of the carriers for sodium and chloride, chloride rather than sodium is rate limiting for this cotransport process. Consequently, renin release is related to alterations of chloride delivery rather than sodium delivery to the TALH. The reduction of PRA by selective chloride loading and by short-term infusion of chloride salts is related to increased chloride delivery to the loop and hence increased chloride transport. Alternatively, chlorpropamide and antidiuretic hormone may inhibit renin release by increasing chloride delivery to the loop. Stimulation of renin release may likewise be related either to decreased chloride delivery and hence decreased transport in the loop (hypochloremia related to selective chloride deprivation) or to an intrinsic alteration in the transporting capacity of the loop (loop diuretics, potassium depletion, glucocorticoid deficiency, Bartter's syndrome). The intermediate steps between alterations of sodium chloride transport in the TALH and renin release remain to be defined. PMID- 3312442 TI - Fibronectin gelatin-binding activity: effects of platelet thrombospondin, serum, and plasma. AB - Platelet thrombospondin and an unidentified but biologically similar plasma protein were shown to inhibit the gelatin-binding activity of fibronectin. Inhibition of fibronectin gelatin-binding activity was identified and quantitated by using latex-fibronectin particles in combination with latex-gelatin particles in a new competitive aggregation assay. Inhibition was expressed as the reciprocal of the dilution of test sample required to produce a 50% return of baseline control aggregation rate (inhibitor units). Serum and plasma from healthy donors (n = 60) showed similar reductions in fibronectin gelatin-binding activity (47.9 +/- 12.9 and 49.4 +/- 12.7 inhibitor units per milliliter, respectively). However, serum fibronectin gelatin-binding activity per milligram of fibronectin was significantly less than that of plasma. The addition of calcium chloride to platelet-rich plasma resulted in a similar reduction in fibronectin gelatin-binding activity per milligram of fibronectin. No change was observed after recalcification of platelet-poor plasma. Washed platelets (1 X 10(9)/ml) in Tris HCl buffer released 18 +/- 8 fibronectin inhibitor units per milliliter after calcium ionophore A23187 addition. When inhibitor-rich preparations from platelets and plasma were chromatographed on Sepharose CL-6B, the inhibitors eluted at the same location. Inhibitor-rich eluates from both sources bound to heparin-Sepharose and eluted with 0.45 mol/L NaCl. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of purified inhibitor preparations demonstrated a major protein band with an approximate molecular weight of 185 kd. Western blot analyses using antiplatelet thrombospondin identified the platelet-derived inhibitor as thrombospondin but failed to react with the plasma-derived inhibitor. These data demonstrated that platelet-released thrombospondin was responsible for the reduction in fibronectin gelatin-binding activity seen in serum. An unidentified plasma factor also inhibits fibronectin gelatin binding. PMID- 3312443 TI - Assessment of D dimer assays for the diagnosis of deep vein thrombosis. AB - Sixty-two patients with suspected deep vein thrombosis were subjected to venography and to plasma D dimer assay by both rapid latex agglutination and enzyme immunoassay methods. The latex agglutination method was insensitive to the presence of deep vein thrombosis. In contrast, the enzyme immunoassay method was sensitive although of low specificity and for technical reasons not suitable for performance as an emergency test. PMID- 3312445 TI - U of L Medical School reaches 150. PMID- 3312446 TI - Strategic plan. U of L School of Medicine. PMID- 3312444 TI - Platelet deposition on von Willebrand factor-deficient vessels. Extracorporeal perfusion studies in swine with von Willebrand's disease using native and heparinized blood. AB - Native (nonanticoagulated) and heparinized blood from both normal swine and swine with von Willebrand's disease was exposed to de-endothelialized thoracic aorta from normal pigs under controlled flow conditions. We have shown that these normal de-endothelialized vessel segments do not contain von Willebrand factor (vWF) in the subendothelial surface; thus, the vascular model that we are using here is representative of the conditions in severe von Willebrand's disease. The blood was recirculated for selected periods of time through an extracorporeal circuit (carotid-jugular shunt), containing a tubular perfusion chamber that held the vessel segment. Flow rates and chamber diameters were selected such that the wall shear rates at the vascular segment were 212 to 3380 sec-1. Platelets were labeled with indium 111 and their total deposition determined by a gamma counter; selected areas were also observed by electron microscopy. When native blood was perfused, the deposition of platelets depended on platelet-plasma vWF only at high wall shear rates (1690 sec-1 or greater) typical of the microcirculation, but not at the lower shear rates (212 and 424 sec-1), more characteristic of the larger arteries and veins. In contrast, when heparinized blood was perfused, platelet deposition on the vascular segments depended on the presence of vWF over the entire range of shear conditions studied. These findings demonstrate in an extracorporeal perfusion system that the defect in platelet-vessel wall interaction in swine with von Willebrand's disease is influenced by both the local flow conditions and the level of activation of the coagulation system. In the presence of an intact coagulation system a synergistic interaction between procoagulant moieties and vWF was observed at high shear rates. PMID- 3312447 TI - Partial paralysis following a black widow spider bite. Case report and literature review. PMID- 3312448 TI - Famous ENT surgeons of the past. AB - History teaches us that the development of medicine and surgery, like most human activities, has not been a steady uniform process, but has occurred mainly in a series of dramatic forward spurts separated by long periods of relative inertia. We are certainly living through such an active phase today with evidence of rapid technological change all around us, and there is a tendency to believe that the rate of progress has never been greater; but this is, however, a misconception, as the golden age of medical history was a period of not much more than a decade in the middle of the nineteenth century when the whole face of medicine and surgery was completely transformed by at least seven enormous developments, each of which was dominated by a man (in one case a woman) of genius. It was then that Claud Bernard (Fig. 1) completely transformed and advanced the whole science of physiology, while another Frenchman, Louis Pasteur (Fig. 2) established the principles of practical bacteriology, and a German, Virchow (Fig. 3) founded the speciality of histopathology. By applying the discoveries of Pasteur, Lister (Fig. 4) in Edinburgh, and later in London, developed the whole concept of antiseptic surgery which rapidly led to the aseptic surgery of today. This, together with the simultaneous introduction of anaesthesia, has completely transformed the practise of surgery. PMID- 3312449 TI - Soft tissue reaction to ceramic ossicular replacement prosthesis. AB - Soft-tissue reaction to ceramic ossicular replacement prostheses (CORP) has been evaluated histologically in rabbits and humans. One week after implantation, severe inflammatory and foreign body reaction was observed in the fibrous connective tissue surrounding the prosthesis. Though some inflammatory response was seen after one month, after three months the CORP was surrounded by a layer of fibrous connective tissue without any foreign body giant cell, histiocyte or inflammatory cell infiltration. Our satisfactory clinical results in humans without placing a cartilage between the CORP and the fascia graft may be due to the excellent soft-tissue compatibility of CORP, as demonstrated in this study. PMID- 3312450 TI - Topical treatment of Reinke's oedema with beclomethasone dipropionate (BDP) inhalation aerosol. AB - Reinke's oedema is a disease which is characterized by oedema of the vocal cords. Women in middle age are particularly prone to this disease, which is encountered mostly in habitual smokers and is often connected with vocal abuse. The condition gives rise to a deep hoarse voice. The traditional treatment is decortication of the vocal cords followed by speech therapy, but the results have so far been disappointing. It has been shown by Moesgaard Nielsen et al. (1985) and Matsuo et al. (1983) that, in the long term, the incidence of recurrence is approximately 60 per cent. Medical treatment of this disease is therefore desirable. It is widely known that topical steroids are often used, but the effects of such treatment have not, so far as we know, been documented. We have found it interesting to observe the effects of BDP inhalation aerosol and placebo in the course of a four-week double-blind randomized trial treatment of Reinke's oedema. PMID- 3312451 TI - Laryngeal carcinoma in a six year old with a review of the literature. PMID- 3312452 TI - Neuropathology of acquired cerebral trauma. PMID- 3312453 TI - Consultation in special education (Part II): Training and practice. PMID- 3312454 TI - The "magic cure": a review of the current controversial approaches for treating learning disabilities. PMID- 3312455 TI - Nutritional biochemistry and behavioral disabilities. PMID- 3312456 TI - Medicine as interpretation: the uses of literary metaphors and methods. AB - Theorists at the interface of medicine and the humanities have recently suggested that interpretation as a literary activity can be applied to the practice of clinical medicine. This article reviews such theories and their literary metaphors and methods. In pushing these ideas further, it is proposed that a number of guidelines can be applied to interpretation as a practical activity for clinical medicine. PMID- 3312457 TI - Bioethics as a prescription for civic action: the Japanese interpretation. AB - This paper reports on recent developments in the rise of bioethics in Japan. Much of the recent interest in bioethics in Japan is seen as a response to various civic movements. The women's liberation movement, access to equal opportunity, and the recognition of patients' rights and the importance of informed consent are among some of the movements influencing the development of bioethics in Japan. The author argues that this movement is to be encouraged and fostered by health care professionals, public policy makers, as well as lay persons in Japan. PMID- 3312458 TI - Moral dilemmas in perinatal medicine and the quest for large scale embryo research: a discussion of recent guidelines in the Federal Republic of Germany. AB - This paper reports on recent regulations and guidelines in the Federal Republic of Germany bearing on perinatal medical ethics, embryo research and trophoblast biopsy. Some of the regulations are defensive responses to new moral opportunities. In contrast, this paper calls for a more aggressive moral cost benefit assessment of high technology medicine, which would include large-scale research on embryos prior to the fiftieth day post-menstruation. PMID- 3312461 TI - Peripheral metabolism of thyroxine. PMID- 3312460 TI - Utilizing a microcomputer-based physician incentive compensation program to increase inpatient hospital utilization and improve cost management. AB - This paper will address the complex issues of effective cost management and declining inpatient volume. Utilizing a microcomputer-based physician incentive compensation program, it will show how a hospital developed a plan to increase inpatient hospital utilization and improve cost management. It will discuss the Internal Revenue, HCFA, and legal implications of the plan. PMID- 3312459 TI - Expert systems in psychiatry. A review. AB - Existing computer-based decision aids in the areas of psychiatric diagnosis and consultation are reviewed, and the prospects for expert system development within the mental health field are discussed. Emphasis is placed upon the decision making models used in these systems rather than on their particular application area. The decision-making paradigms discussed are (1) data bank analysis, (2) statistical pattern recognition, (3) Bayesian analysis, (4) logical flow chart method, and (5) knowledge-based (expert system) approaches. For each paradigm, its essential features, its strengths and weaknesses, and some example applications are presented. PMID- 3312462 TI - Structure and function of steroid receptors. PMID- 3312463 TI - Disparate effects of ACTH (1-24) and corticosterone on lipoprotein lipase in rat adipose tissue. AB - The effects of corticosterone and ACTH(1-24) on lipoprotein lipase (LPL) activity of rat epididymal fat tissue were studied. Hypercorticism induced by s.c. administration of 10 mg corticosterone acetate for 3 days led to a decrease in LPL activity. This decrease could be prevented by treatment of the rats simultaneously with synthetic ACTH(1-24). Adrenalectomy also reduced LPL activity. Corticosterone and ACTH(1-24) treatment had a similar effect on LPL activity in adrenalectomized and intact rats. These results indicate that ACTH(1 24) may affect adipose tissue LPL in the rat by a mechanism in which corticosterone is not involved. PMID- 3312464 TI - Prolactin and the control of gonadotrophin secretion. PMID- 3312465 TI - Maintenance of neonatal rat B cells in glucose-depleted medium: a perifusion study. AB - Two groups of monolayer cultures of pancreatic cells from the neonatal rat were maintained in glucose-depleted TCM 199 medium, supplemented with 5.5 mmol galactose/l, with or without 0.1 mmol 2-deoxyglucose/l. Another group was kept in medium with 5.5 mmol galactose/l alone, following exposure for 2 days to a medium with 5.5 mmol galactose/l and 10 mumol iodoacetic acid/l to kill fibroblasts selectively. Each of these monolayers was cultured in a perifusion system for a total of 7 days so that phasic insulin secretion could be compared. On day 0, B cells responded in a monophasic fashion to acute challenge with 16.7 mmol glucose/l whereas, in the presence of 10 mumol forskolin/l and 1 mmol 3-isobutyl 1-methyl-xanthine/l, the same dose of glucose stimulated a biphasic response of approximately the same magnitude. At a concentration of 10 mmol/l, leucine and 2 ketoisocaproate both produced only minimal increase in the second phase of secretion above the basal level. No response to secretagogues was seen under culture conditions without 2-deoxyglucose. In contrast, addition of 2 deoxyglucose to the galactose-supplemented medium stimulated B cells to secrete insulin in a biphasic fashion in response to a single dose of glucose, and the stimulatory effects of leucine and 2-ketoisocaproate were also remarkably increased. Moreover, when exposed to a linear concentration gradient of glucose, leucine or 2-ketoisocaproate, these B cells responded to secretagogues in a dose dependent fashion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312466 TI - Significance of the calcium content of mouse beta cells in the preservation of glucose-induced insulin release during culture. AB - Pancreatic islets containing more than 90% beta cells from obese-hyperglycaemic (ob/ob) mice were cultured for 3 days in different concentrations of Ca2+ and glucose to evaluate the importance of intracellular Ca2+ sequestration in glucose induced insulin release. The islet contents of calcium (total and exchangeable) and immunoreactive insulin were compared with the insulin secretory response to glucose after culture. The turnover of Ca2+ increased with increasing concentrations of glucose and Ca2+. Islets cultured in the presence of 5.5 mmol glucose/l contained more calcium and insulin than those cultured with 1 or 20 mmol glucose/l. During culture in 20 mmol glucose/l, a lowering of the Ca2+ concentration of the medium from 0.42 to 0.025 mmol/l resulted in a paradoxical increase in intracellular calcium, with improvement of the subsequent secretory response to the sugar. When the islets had been exposed to the calcium channel blocker D-600 during culture in a Ca2+-deficient medium, substantial insulin release was noted from islets containing relatively small amounts of calcium. The results suggest that the well-established role of glucose in maintaining insulin release is associated with an ability of the sugar to stimulate the retention of calcium in beta cells. PMID- 3312467 TI - Histochemical demonstration of phenobarbital by immunocytochemistry. AB - A method for the demonstration of the topographical distribution of phenobarbital at the cellular level in various tissues was established. Mice that had been exposed to various doses of phenobarbital by intraperitoneal injection were killed, and their tissues were fixed with 0.1 M phosphate buffer solution (pH 7.4) containing paraformaldehyde and glutaraldehyde. Thereafter, paraffin and frozen sections were made and stained by the indirect immunoperoxidase method using antisera obtained from commercial sources and used for the immunochemical assay of the blood level of phenobarbital in clinical medicine. A specific positive reaction was observed solely in testing the intoxicated tissues, and this reaction was inhibited when phenobarbital was added to the antisera. The minimal sensitivity of the positive reaction, which can be discerned by observing the stained slides macroscopically, was in the range of 10 mg/kg. Thus, the diagnosis of phenobarbital intoxication in the forensic autopsy can be made by immunohistochemistry. A positive reaction was found in various tissue cells, including nerve cells, myelin sheaths, glia cells, hepatocytes, cells of the alveolar and bronchial wall, epithelial cells of the distal part of the renal tubules, and so forth. Endothelial cells of the capillaries in all tissues gave a strong positive reaction. The immunocytochemical electron microscopy of the hepatocytes revealed that the positive reaction in the cytoplasm was located solely in the intraluminal space of the smooth endoplasmic reticulum. These results indicate some interesting aspects of the pharmacokinetics of phenobarbital in vivo. It is expected that the antisera, which are used widely for the assay of the blood concentration of various drugs (phenobarbital, amphetamines, morphine, and so forth), may be regarded as excellent reagents for immunocytochemistry. This clearly indicates that morphological evidence in toxicology, which had so far remained obscure, can be easily obtained by applying these antisera against various drugs. PMID- 3312468 TI - Estimating age at death from immature human skeletons: an overview. AB - Literature on the estimation of age at death of immature human skeletons is critically reviewed. Those estimating age at death for forensic science purposes should consider all available data, but especially rely upon the most appropriate and accurate methods. Estimates should reflect the possible error resulting from the sex differences and population variability known to be associated with the growth process. PMID- 3312469 TI - Homicidal behavior in schizophrenics. AB - This paper emphasizes that homicidal behavior may be part of the clinical manifestation of schizophrenia. The failure to hospitalize potentially violent schizophrenics contributes to the incidence of psychotic homicide. The tendency to diagnose homicidal schizophrenics as personality disorders combined with legal changes brought about a shift of this population from the mental health system to the criminal justice system. PMID- 3312470 TI - Massive metoprolol ingestion associated with a fatality--a case report. AB - An unusual fatality involving a 26-year-old male who intentionally ingested approximately 10 g of metoprolol is presented. Autopsy findings revealed foreign material in the gastric content with an acute thrombosis of the left anterior descending coronary artery. Microscopic studies showed evidence of an extremely early infarct. Metoprolol concentrations in the blood, liver, gastric content, and urine are reported by both capillary gas chromatography and ultraviolet spectrophotometric analysis. A review of the literature confirmed that little information has been published concerning intoxication with this drug. PMID- 3312471 TI - Myocardial infarction in pregnancy. AB - Myocardial infarction occurring during pregnancy or the puerperium is a rare condition, occurring in about 1 per 10,000 deliveries, and carries a mortality of approximately 30%. As a consequence of its rarity, symptoms of impending infarction may be easily mistaken by physicians for much more common and innocuous conditions, especially those (such as gastroesophageal reflux) typically associated with pregnancy. Two cases of infarction in pregnant women are presented, with a discussion of risk factors which may predispose towards development of coronary artery disease or thrombosis in this population. Other, more uncommon, causes of myocardial infarction during pregnancy are also addressed. PMID- 3312472 TI - Return to indemnity system? PMID- 3312473 TI - Analysis of sheath and core structures of the axial filament of Treponema pallidum. AB - Electron microscopy and SDS-PAGE have been used to analyse the polypeptide and antigenic composition of the sheath and core components of the axial filament of Treponema pallidum. The sheath contains a major 37 kDa polypeptide which was solubilized by a combination of trypsin and urea treatments with concurrent loss of binding of anti-37 kDa monoclonal antibody. These studies also indicated some antigenic heterogeneity within the axial filament population. Trypsin treatment alone removed a number of antigenic determinants from the axial filament but left others intact, suggesting differences in their location within the sheath structure. A second 31.5 kDa polypeptide may also be associated with the sheath. The axial filament core comprises at least two components, an antigenically dominant 33.5 kDa polypeptide and a second of 34 kDa. The structure of the axial filament in T. pallidum and Treponema phagedenis biotype Reiterii was similar, but antigenic cross-reactivity of sheath and core components was incomplete. PMID- 3312474 TI - Extracellular acid and alkaline proteases from Candida olea. AB - Candida olea 148 secreted a single acid protease when cultured at acidic pH. In unbuffered medium, the culture pH eventually became alkaline and a single alkaline protease was produced. This was the only proteolytic enzyme produced when the organism was grown in buffered medium at alkaline pH. Both proteolytic enzymes were purified to homogeneity (as assessed by SDS-PAGE). The Mr of the acid protease was 30900, the isoelectric point 4.5; optimum activity against haemoglobin was at 42 degrees C and pH 3.3. This enzyme was inactivated at temperatures above 46 degrees C and was inhibited by either pepstatin and diazoacetyl-norleucine methyl ester but was insensitive to inhibition by either 1,2-epoxy-3-(p-nitrophenoxy)-propane or compounds known to inhibit serine, thiol or metallo proteases. The acid protease contained 11% carbohydrate. The alkaline protease had an Mr of 23400 and isoelectric point of 5.4. The activity of this enzyme using azocoll as substrate above 42 degrees C and was inhibited by phenylmethyl-sulphonyl fluoride and irreversible inactivated by EDTA. The enzyme was also partially inhibited by DTT but was insensitive to either pepstatin or p chloromercuribenzoic acid. PMID- 3312475 TI - Differential translational efficiency of the mRNAs isolated from derepressed and glucose repressed Saccharomyces cerevisiae. AB - Carbon catabolite derepression induced changes in the pool of yeast mRNAs translatable in a protein-synthesizing reticulocyte system. Competition experiments with globin mRNA showed that the mRNA population obtained from derepressed cells possessed a higher translational efficiency than mRNA from repressed cells. The mRNAs that could account for the high translational efficiency of the derepressed mRNA were not detected in cells growing in glucose rich medium. Analysis of protein synthesis in the presence of 7-methylguanosine 5'-phosphate indicated that the initiation factors recognizing the 5'-terminal structure of capped messengers interacted with lower affinity with the repressed than with some specific derepressed mRNAs. PMID- 3312476 TI - Nucleotide sequence of the immunity and lysis region of the ColE9-J plasmid. AB - We have determined the nucleotide sequence of a 1500 bp fragment of the ColE9-J plasmid which encodes colicin E9 immunity and colicin E5 immunity and contains two lys genes. Open reading frames corresponding to the four genes have been located and their position confirmed by transposon mutagenesis of sub-clones of the ColE9-J plasmid. The E9imm gene shows 69% homology at both the nucleotide and the amino acid level to the previously sequenced E2imm gene. The E5imm gene shows little homology to any other E colicin immunity gene which has been sequenced. The lys gene distal to the 3' end of the E5imm gene shows considerable sequence homology to all other previously sequenced E colicin lys genes. The lys gene distal to the 3' end of the E9imm gene is identical to the pColE2 and pColE3 lys genes for the first 59 nucleotides but encodes a much smaller gene product than any other lys gene which has been sequenced. The two lys genes sequenced here are exceptions to Shepherd's rule concerning the number of RNY codons in the three possible reading frames. PMID- 3312477 TI - Novel genetic components controlling invertase production in Saccharomyces cerevisiae. AB - Low levels of invertase (EC 3.2.1.26) activity were observed in most diploid strains of S. cerevisiae used in this work. There was no effect of mating type on invertase levels, and cell surface was not a limiting factor, because an increase in ploidy did not cause further decrease in specific invertase activity. Finally, some diploids showed the activity expected from the additive effects of different SUC genes, and haploid strains possessing two SUC genes expressed very variable invertase activities depending on the strain. This suggested the existence of one or more additional genes which control the levels of invertase. Genetic analysis of SUC5 strains provided evidence of the existence of a new gene, RPS5, which drastically reduced the specific invertase activity in strains possessing active SUC alleles. The recessive allele of this gene (rps5) allows expression of higher levels of invertase. We suggest that genes similar RPS5 are responsible for the low levels of invertase activity observed in diploid strains of S. cerevisiae. PMID- 3312478 TI - The effect of catalase on recovery of heat-injured DNA-repair mutants of Escherichia coli. AB - The apparent sensitivity of Escherichia coli K12 to mild heat was increased by recA (def), recB and polA, but not by uvrA, uvrB or recF mutations. However, addition of catalase to the rich plating medium used to assess viability restored counts of heat-injured recA, recB and polA strains to wild-type levels. E. coli p3478 polA was sensitized by heat to a concentration of hydrogen peroxide similar to that measured in autoclaved recovery medium. The apparent heat sensitivity of DNA-repair mutants is thus due to heat-induced sensitivity to the low levels of peroxide present in rich recovery media. It is proposed that DNA damage in heated cells could occur indirectly by an oxidative mechanism. The increased peroxide sensitivity of heat-injured cells was not due to a decrease in total catalase activity but may be related specifically to inactivation of the inducible catalase/peroxidase (HPI). PMID- 3312479 TI - Uptake of Ca2+ driven by the membrane potential in energy-depleted yeast cells. AB - The time-course of 45Ca2+ influx into yeast cells was measured under non-steady state conditions obtained by preincubating the cells in a Ca2+-free medium containing glucose and buffer. Two components were distinguished: a saturable component which reached a steady-state after about 40 s of 45Ca2+ uptake and a linear increase in cellular 45Ca2+ starting after 60-90 s. Using differential extraction methods it was determined that after 20 s of uptake, 45Ca2+ was localized in the cytoplasmic pool and in bound form with no 45Ca2+ in the vacuole. After 3 min most of the cellular 45Ca2+ was concentrated in the vacuole and in bound form. The initial rate of 45Ca2+ uptake under non-steady-state conditions thus measured 45Ca2+ transport across the plasma membrane without interference by vacuolar uptake. The effect of membrane potential (delta psi) on this transport was investigated in cells depleted of ATP. A high delta psi was produced by preincubating the cells with trifluoperazine (TFP) and subsequently washing the cells free from TFP. Substantial 45Ca2+ influx was measured in the absence of metabolic energy in cells with a high delta psi. Below a threshold value of -69.5 mV the logarithms of the initial rate of 45Ca2+ influx and of the steady-state level of the first component were linear with respect to delta psi. It is suggested that 45Ca2+ influx across the plasma membrane is mediated by channels which open when delta psi is below a threshold value. The results indicated that Ca2+ influx across the plasma membrane was driven electrophoretically by delta psi. PMID- 3312481 TI - Purification and characterization of an elastolytic protease of Vibrio vulnificus. AB - Large amounts of a highly purified, extracellular elastolytic protease of Vibrio vulnificus were obtained by sequential ammonium sulphate precipitation and hydrophobic interaction chromatography with phenyl-Sepharose CL-4B. The protease had an Mr of about 50,500 (estimated by SDS-PAGE), a pI of 5.7, and a temperature optimum range of 55 to 60 degrees C. The pH optimum and the results of inactivation studies suggested that the enzyme was a neutral metalloprotease. The protease had about 429 amino acid residues, and the first 20 amino-terminal amino acid residues were Ala-Gln-Ala-Asn-Gly-Thr-Gly-Pro-Gly-Gly-Asn-Ser-Lys-Thr-Gly Arg-Tyr-Glu- Phe-Gly . The purified protease was toxic for mice (about 1.5 mg kg 1 and 4.5 mg kg-1, intraperitoneal and intravenous LD50 values, respectively), and subcutaneous injection of the enzyme elicited rapid and extensive dermonecrosis. PMID- 3312480 TI - Isolation, complementation and partial characterization of mutants of the methanol autotroph Xanthobacter H4-14 defective in methanol dissimilation. AB - Seven mutants of Xanthobacter H4-14, unable to grow on methanol but capable of growth on formate, were isolated and complemented with a chromosomal clone bank constructed in the broad-host-range cosmid pVK100. One mutant could not be complemented but the others fell into four distinct complementation groups that involved three different recombinant clones. All of the complementing regions were separated by at least 10 kbp. The five complementation classes had different phenotypic characteristics and were defective in different aspects of methanol and formaldehyde oxidation. Class I mutants were defective in methanol oxidation, class II mutants were impaired in formaldehyde oxidation, class III mutants appeared to be defective in a regulatory element involving the methanol oxidation system, and class IV mutants appeared to be defective in a regulatory element involving formaldehyde oxidation. Class V mutants exhibited a methanol-sensitive phenotype, which was correlated with an imbalance between methanol and formaldehyde dehydrogenase activities. Analysis of this class suggested it was defective in a repressor that regulated methanol dissimilation functions. PMID- 3312482 TI - Production of murine monoclonal antibodies to the major axial filament polypeptide of Treponema pallidum. AB - A suitable immunization protocol for the stimulation of a murine antibody response to the axial filament polypeptides of Treponema pallidum was established. A range of monoclonal antibodies (Mabs) specific for different epitopes of the major axial filament polypeptide (37 kDa) was generated which demonstrated diversity in their ability to react with other treponemal species. Immunogold electron microscopy located the 37 kDa antigen on the surface of the axial filament structure. The early appearance of specific antibody to this polypeptide in infected man and rabbit indicates that such Mabs are potentially useful for the diagnosis of early syphilis. PMID- 3312483 TI - Factors reducing and promoting the effectiveness of proline as an osmoprotectant in Escherichia coli K12. AB - Proline accumulation in Escherichia coli is mediated by three proline porters. Proline catabolism is effected by proline porter I (PPI) and proline/delta 1 pyrroline carboxylate dehydrogenase. Proline did not accumulate cytoplasmically when E. coli was subjected to osmotic stress in minimal salts medium. Although PPI is induced when proline is provided as carbon or nitrogen source, its activity decreased following growth of the bacteria in minimal salts medium of high osmotic strength. Proline dehydrogenase was induced by proline in low or high osmotic strength media. Proline porter II (PPII) was both activated and induced in osmotically stressed bacteria, though the dependencies of the two responses on medium osmolarity differed. Osmotic downshift during the transport measurement decreased the uptake of proline, serine and glutamine by bacteria cultured in media of high osmotic strength. Thus, while osmotic upshift caused specific activation of PPII, osmotic downshift caused a non-specific reduction in amino acid uptake. Glycine betaine inhibited the uptake of [14C]proline via PPII and PPIII but not via PPI. The dependence of that inhibition on glycine betaine concentration was similar when PPII was uninduced, induced or activated by osmotic stress, or induced by amino acid limited growth. Thus PPII and PPIII, not PPI, contribute to the mechanism of osmoprotection by proline and glycine betaine. The tendency for exogenous proline to accumulate in the cytoplasm of bacteria exposed to osmotic stress would, however, be countered by increased proline catabolism. PMID- 3312484 TI - A mathematical method for analysing plasmid stability in micro-organisms. AB - A mathematical model describing the instability of plasmids in micro-organisms has been developed. The model is based on the assumption that the overall causes of plasmid instability are described by the segregational instability of the plasmid, R (i.e. the rate at which plasmid-free cells are generated from plasmid bearing cells), and the growth rate difference, d mu (i.e. the difference in growth rate between plasmid-free and plasmid-bearing cells). A method for determining the values of R and d mu (accompanied by 95% confidence limits) for any plasmid-bearing micro-organism is described. This method is based on the observation that, depending on the plasmid, various exponential patterns of plasmid instability are observed. The stability of Escherichia coli 1B373(pMG169), where d mu much greater than R, and E. coli RV308(pHSG415), where R much greater than d mu, are analysed in order to demonstrate the method. PMID- 3312485 TI - Investigation of the effect of growth environment on the stability of low-copy number plasmids in Escherichia coli. AB - The stability of a low-copy-number plasmid, pHSG415, in Escherichia coli, was investigated in batch and continuous culture. The plasmid was unstable in batch culture, but was significantly stabilized by growth in continuous culture with phosphate, nitrogen or potassium limitation. However, the plasmid was very unstable when grown in continuous culture with sulphate limitation. These results contrast with those obtained with multicopy plasmids such as pBR322, which is particularly unstable in carbon- or phosphate-limited continuous culture. The effect of growth rate on the stability of E. coli(pHSG415) grown in continuous culture with glucose limitation was also investigated. The plasmid was significantly more stable in cells grown at higher growth rates. The segregational instability (R) of the plasmid and the difference in growth rate between plasmid-free and plasmid-bearing cells (dmu) were calculated for each condition using the method of Cooper et al. (accompanying paper: Journal of General Microbiology 133, 1871-1880). It was found that the primary cause of the loss of pHSG415 from the cell population was the segregational instability of the plasmid. PMID- 3312486 TI - Effect of temperature on the stability of plasmid pTG201 and productivity of xylE gene product in recombinant Escherichia coli: development of a two-stage chemostat with free and immobilized cells. AB - The effect of temperature on the stability of pTG201, a plasmid carrying the xylE gene (which encodes catechol 2,3-dioxygenase from Pseudomonas putida), and the production of catechol 2,3-dioxygenase in free and immobilized Escherichia coli during continuous culture have been studied at various temperatures. Immobilization of cells increased the stability of pTG201 considerably, even under conditions when expression of the xylE product was enhanced. Since xylE transcription was controlled by the lambda PR promoter and cI857 repressor, increasing derepression temperatures increased catechol 2,3-dioxygenase productivity and decreased pTG201 stability. A two-stage continuous culture system to overcome the impact of the high-level expression of the xylE gene on the stability of pTG201 is described. In the first stage, immobilized cells were grown in the repressed state in order to prevent loss of pTG201, whereas in the second stage, cultures were maintained in the derepressed state. PMID- 3312487 TI - Novobiocin-resistant mutants of Streptococcus sanguis with reduced cell hydrophobicity and defective in coaggregation. AB - Mutants of Streptococcus sanguis resistant to novobiocin (NovR-mutants) were isolated after mutagenesis of strain Challis with ethyl methanesulphonate. The resistance phenotype was transferred by DNA-mediated transformation back into the parent strain at high frequency suggesting resistance was due to mutation(s) in a single gene or in closely-linked genes. Cells of NovR-mutants had normal morphology and secreted similar proteins to the wild-type strain. However, mutant cultures had slower growth rates, the mutant cells had reduced hydrophobicity, and they showed a reduced degree of coaggregation with Actinomyces viscosus and Actinomyces naeslundii. Cell envelopes prepared from NovR-mutants differed from wild-type cell envelopes in that they (a) were impaired in ability to coaggregate with A. viscosus cells, and (b) had altered protein composition as detected by SDS-PAGE. The results suggest that hydrophobic proteins in the cell envelope of S. sanguis may be necessary for coaggregation of this bacterium with actinomycetes. PMID- 3312488 TI - Resistance to oleandomycin in Streptomyces antibioticus, the producer organism. AB - Resistance to oleandomycin in Streptomyces antibioticus, the producer organism, was studied. The organism was highly resistant in vivo to the antibiotic but sensitive to other macrolides and lincosamides. Protein synthesis in vivo by mycelium of S. antibioticus was more resistant to oleandomycin than that by mycelium of Streptomyces albus G, an oleandomycin-sensitive strain, and this resistance was dependent on the age of the culture, older mycelium of S. antibioticus being more resistant to oleandomycin than young mycelium. [3H]Oleandomycin was capable of binding to the same extent to the 50S subunits of the ribosomes of both organisms. Oleandomycin also inhibited in vitro protein synthesis by ribosomes obtained from an oleandomycin-production medium at the time when maximum levels of oleandomycin were being produced. A clear difference between the ability of the two organisms to incorporate exogenous oleandomycin was observed. Thus, while S. albus G took up oleandomycin, S. antibioticus showed a decreased permeability to the antibiotic, suggesting a role for cell permeability in self-resistance. PMID- 3312489 TI - Hyperproduction of polyhedrin-IGF II fusion protein in silkworm larvae infected with recombinant Bombyx mori nuclear polyhedrosis virus. AB - A gene coding for insulin-like growth factor II (IGF II) was constructed from 16 oligodeoxynucleotides synthesized chemically and cloned into EcoRI-SalI sites of pBR322. In this gene at ATG codon for methionine was introduced for cleavage by CNBr at the beginning of mature IGF II. For expressing foreign genes, a new host vector system, with Bombyx mori silkworm larvae as the host and B. mori nuclear polyhedrosis virus (BmNPV) as the vector, has been developed. BmNPV genomic DNA codes polyhedrin which is a major protein of inclusion bodies and is mass produced in infected silkworm larvae. We employed this polyhedrin production system to obtain a large yield of a foreign gene product. The coding region of the carboxy-terminal half of polyhedrin was removed and the remainder was ligated with the IGF II gene in phase to create a fusion protein gene consisting of the coding region of the amino-terminal half of polyhedrin and the IGF II gene. This fusion protein gene was combined in a plasmid with the promoter and 5' and 3' flanking regions of the polyhedrin gene. The resulting plasmid and the wild-type BmNPV genomic DNA were cotransfected into BM-N cells, and a recombinant virus was isolated by the limiting dilution method. The silkworm larvae infected with the recombinant virus produced 3.6 mg of the fusion protein per larva and the infected BM-N cells produced 0.3 mg per ml of culture. IGF II was released from the fusion protein produced by BM-N cells infected with the recombinant virus by CNBr treatment, purified by extraction with guanidine-HCl, column chromatography and HPLC and the correct amino-terminal amino acid sequence confirmed. PMID- 3312490 TI - Secretion of particles of hepatitis B surface antigen from insect cells using a baculovirus vector. AB - The coding sequences of the hepatitis B virus surface antigen were inserted into a baculovirus transfer vector produced from Autographa californica nuclear polyhedrosis virus (AcNPV) so that the foreign gene was under the control of the AcNPV polyhedrin promoter. Spodoptera frugiperda cells infected with the derived recombinant baculovirus produced and secreted 22 nm particles containing the hepatitis B surface antigen. The particles had morphological and antigenic properties identical to those of 22 nm particles isolated from the plasma of chronic active hepatitis patients. PMID- 3312492 TI - Lasers in ophthalmology today. PMID- 3312491 TI - cDNA cloning and sequence analysis of the gene encoding the peplomer protein of feline infectious peritonitis virus. AB - The peplomer gene of feline infectious peritonitis virus (FIPV) strain 79-1146 was isolated from a genomic cDNA library by differential hybridization with RNA 2 and 3 as probes. From the nucleotide sequence a primary translation product of 1452 residues (Mr 160,472) was predicted, containing an N-terminal signal sequence, a C-terminal transmembrane segment and 35 potential N-linked glycosylation sites. By S1 nuclease analysis the 5' end of the presumptive RNA 2 body was located at about 30 nucleotides upstream from the initiating AUG codon. At approximately the same position a nine nucleotide sequence ACUAAACUU was found, which was also present 37 nucleotides downstream from the open reading frame. Comparison of the sequences of the FIPV, murine hepatitis virus and infectious bronchitis virus peplomer proteins showed about 27% overall homology, with most conservation in the C-terminal half. PMID- 3312493 TI - Melatonin synthesis in the pineal gland of the Richardson's ground squirrel (Spermophilus richardsonii): influence of age and insulin-induced hypoglycemia. AB - The nocturnal rises in pineal N-acetyltransferase (NAT) activity and melatonin levels were compared in young (25-35 days old) and adult (at least 1 year old) Richardson's ground squirrels. When expressed as NAT activity per pineal gland, the nighttime rise in the activity of this enzyme was less in young than in the adult animals; conversely, the melatonin content of the pineal glands of young animals was higher at one point (4 a.m., 8 hours after darkness onset) when compared to that in adult squirrels. When data were expressed relative to total protein, the NAT and melatonin rhythms in the pineals of young and adult animals were very similar. The effect of insulin-induced hypoglycemia on both daytime and nighttime NAT and melatonin levels in the pineal gland of the Richardson's ground squirrel was also assessed. Low daytime levels of these constituents were not influenced by the administration of 10 units insulin, a treatment which caused a marked drop in circulating glucose levels. At night, when pineal NAT and melatonin levels were high insulin injection had a very modest stimulatory effect on NAT activity (one point was elevated above saline injected controls) while melatonin levels remained unchanged by the treatment. These findings in the ground squirrel in reference to insulin-induced hypoglycemia, and stressors in general, appear to differ from those in the rat where stress can have a substantial influence or both low daytime and high nighttime levels of pineal NAT and melatonin. PMID- 3312494 TI - Vasoactive intestinal polypeptide levels and distribution in the penis of old rats. AB - Vasoactive intestinal polypeptide (VIP) levels and distribution were studied in the penis of young-adult (3-month-old) and old (30-month-old) Wistar rats by radioimmunoassay and immunofluorescence. No significant changes in tissue VIP concentrations or distribution occurred in the penis of old rats compared to young-adult rats. The present data indicate that the age-related impairment of male sexual function is not dependent on modifications of the VIP-ergic innervation of penile tissue. PMID- 3312495 TI - Amyloid angiopathy of Alzheimer's disease: amino acid composition and partial sequence of a 4,200-dalton peptide isolated from cortical microvessels. AB - The cardinal lesions of Alzheimer's disease are neurofibrillary tangles, senile neuritic plaques, and vascular amyloid, the latter generally involving cortical arteries and small arterioles. All three lesions are composed of amyloid-like, beta-pleated sheet fibrils. Recently, a 4,200-dalton peptide has been isolated from extraparenchymal meningeal vessels, neuritic plaques, and neurofibrillary tangles. The assumption of N-terminal homogeneity in vascular amyloid has been used as an argument for a neuronal (versus blood) origin of the peptide. However, intracortical microvessels from Alzheimer's disease have not been previously isolated. The present studies describe the isolation of a microvessel fraction from Alzheimer's disease and control fresh autopsy human brain. Alzheimer's disease isolated brain microvessels that were extensively laden with amyloid and control microvessels were solubilized in 90% formic acid and analyzed by urea sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The arteriole fraction from the Alzheimer's subject with extensive amyloid angiopathy contained a unique 4,200-dalton peptide, whereas the arterioles or capillaries isolated from two controls and two Alzheimer's disease subjects without angiopathy did not. This peptide was purified by HPLC and amino acid composition analysis showed the peptide is nearly identical to the 4,200-dalton peptide recently isolated from neuritic plaques or from neurofibrillary tangles. Sequence analysis revealed N terminal heterogeneity. The N-terminal sequence was: Asp-Ala-Glu-Phe-Arg-His-Asp Ser-Gly-Tyr, which is identical to the N-terminal sequence of the 4,200-dalton peptide isolated previously from extraparenchymal meningeal vessels and neuritic plaques.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312496 TI - Calcium binding protein in squid brain: biochemical similarity to the 28,000-Mr vitamin D-dependent calcium binding protein (calbindin-D28k). AB - A calcium binding protein that is biochemically similar to vertebrate 28,000-Mr vitamin D-dependent calcium binding protein (calbindin-D28k) has been purified from squid brain. Squid brain calbindin was found to have an isoelectric point of 5.0, was heat stable up to 60 degrees C, and showed increased electrophoretic mobility in the presence of chelator. Amino acid analysis revealed a high content of glutamic and aspartic acids and a low level of methionine, histidine, and tyrosine, a finding similar but not identical to the composition of vertebrate calbindin-D28k. The molecular weight of the squid protein, determined by Ferguson plot analysis of data obtained from sodium dodecyl sulfate-gel electrophoresis, was calculated to be 25,700, as compared with 27,800 for rat renal calbindin. Immunocytochemical analysis demonstrated immunoreactive protein in a selected population of neurons and fibers in several areas of the molluscan nervous system. This study represents the first purification from an invertebrate of a calcium binding protein that is biochemically similar to vitamin D-dependent calcium binding protein. These results demonstrate that calbindin, although not identical in vertebrates and cephalopods, may be phylogenetically conserved in structure. The restricted distribution of immunoreactive calbindin in both the cephalopod and mammalian brain suggests that the function of neuronal calbindin may also be conserved in evolution. PMID- 3312497 TI - Regional variation in the levels of transferrin in the CNS of normal and myelin deficient rats. AB - Transferrin (Tf), the iron mobilization protein, is synthesized mainly in the liver. Recently, both Tf and a mRNA for Tf have been demonstrated in oligodendrocytes in the rat brain. The present study used a biochemical assay for determining the levels of Tf in various brain regions of normal rats compared with the level of those obtained from rats with a genetic mutation characterized by an almost complete failure to develop myelin. In myelin-deficient (md) rats, no Tf-positive oligodendrocytes were seen immunohistochemically in the gray or white matter of the CNS. Quantitatively, levels of Tf throughout the CNS of the md rat were decreased to approximately 5% of the normal values despite a normal hepatic synthetic rate. In the normal rat brain, the cerebellum contained the highest concentration of Tf, followed by the pons, the cerebral cortex, and the caudate-putamen, with the latter two sites being similar. Regional variation in the amount of Tf was in general agreement with published reports on the variation of iron and Tf receptor levels in the CNS. Immunohistochemical examination with antiserum to galactocerebroside (a myelin-specific lipid) was used for extending biochemical reports that glycolipid-synthesizing enzymes are deficient in md rats. No immunostaining in the md rat was observed following immunoreaction for galactocerebroside, whereas white matter oligodendrocytes were intensely marked in the normal rat. Robust astrogliosis was present in both the gray and white matter of the md rats. It is not known at present whether the ability to accumulate Tf is necessary for oligodendrocytic survival or if Tf accumulation is more directly related to myelinogenesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312499 TI - Behavioural manifestations of third ventricular colloid cysts. PMID- 3312498 TI - Increased beta 2-microglobulin in CSF of multiple sclerosis. PMID- 3312500 TI - Hypertension and the kidney: lessons learned from transplantation. AB - This review discusses the analogies between some experimental models of arterial hypertension and some probable causes of hypertension in kidney-transplanted patients. Some subgroups of these patients have striking similarities with some animal models: Data suggest that the genetic predisposition to hypertension can be transmitted with the kidney, similar to the transplantation experiments in genetically hypertensive rat stains. Patients with graft artery stenosis, if previously binephrectomized, present the same puzzling sequence of events in the development of hypertension as the one-kidney one-clip Golblatt hypertension animal models. "Native kidney" hypertension can be related to a state of chronic angiotensin excess as in the chronically angiotensin-infused animals. Confounding variables include chronic steroid therapy, chronic rejection, and the possible role of renal nerve regeneration. There are also animal models available for these contributing factors that allow us to understand the many facets of post transplant hypertension better. PMID- 3312501 TI - The safety and efficacy of once-daily dilevalol in patients with mild hypertension: a placebo-controlled study. AB - Dilevalol is a stereoisomer of labetalol, with a unique combination of beta adrenergic blocking effects and selective beta 2-agonist activity. The safety and efficacy of dilevalol in patients with systemic hypertension were evaluated in a placebo-controlled, double-blind, randomized study. After a 4-week placebo run-in period, patients with mild hypertension (supine diastolic blood pressure of 95 105 mmHg) were randomized to receive either placebo (n = 14) or increasing doses of dilevalol (n = 15), 100-800 mg, once daily, to achieve normalization of pressure and/or a reduction of supine diastolic pressure of greater than or equal to 10 mmHg. This was followed by a 4-week maintenance phase. Compared with placebo, dilevalol, 200-800 mg/day, lowered supine and standing systolic and diastolic blood pressures significantly, while causing a modest reduction in heart rate. The drug was well tolerated without evidence of orthostasis. Dilevalol, in doses of 200-800 mg/day, is a safe and effective drug for the treatment of patients with mild hypertension. PMID- 3312503 TI - Slow pressor mechanisms and smooth muscle mitogens in hypertension. PMID- 3312502 TI - Labetalol compared with propranolol in the treatment of black hypertensive patients. AB - A double-blind parallel group study was conducted to examine the effects of oral labetalol, in doses from 100 to 800 mg BID, and propranolol, 40 to 320 mg, in patients with mild to moderate hypertension. The doses of labetalol (n = 74) and propranolol (n = 79) were titrated weekly to achieve a sitting diastolic blood pressure (DBP) of less than 90 mmHg or at least a 10-mmHg decrease from placebo baseline on two consecutive visits. A 2-month fixed-dose maintenance phase followed in which a diuretic could be added if the sitting DBP was greater than or equal to 100 mmHg on maximum doses of either drug. BP and heart rate were measured 8-12 hours after a dose in the sitting and standing positions. Labetalol was significantly more effective at the end of monotherapy than propranolol was in lowering both the sitting (p less than .05) and standing (p less than .04) DBP. The reduction in the systolic, although more pronounced for those on labetalol, was not significantly different; 53% of patients had a "good" response to labetalol compared with 30% of the propranolol group. Propranolol significantly (p less than 0.01) lowered heart rate compared with labetalol. Nine patients in the labetalol group and 10 in the propranolol group required a diuretic. The decrease in BP after the addition of a diuretic was comparable. Changes in plasma lipids were not significant, but HDL increased 9% with labetalol and decreased 2% with propranolol. Triglycerides increased 25% with labetalol and 31% with propranolol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312504 TI - Cellular mechanisms of vascular growth. PMID- 3312505 TI - Pharmacologic therapy of hypertension in blacks. AB - In summary, hypertensive blacks have an increased overall benefit of therapy in mild hypertension. They also exhibit an accentuated (supersensitive) response to monotherapy with diuretics or calcium channel blockers. They have a blunted response to most beta blocker monotherapy in usual doses, with the possible exceptions of labetalol and pindolol. They also have a blunted response to converting enzyme inhibitor monotherapy, but both beta blocker and converting enzyme responses are equal when diuretic is added. PMID- 3312506 TI - Coronary artery disease in blacks. PMID- 3312507 TI - Cerebrovascular disease in blacks. PMID- 3312508 TI - Renin and aldosterone in hypertensive blacks. PMID- 3312509 TI - Urinary kallikreins and prostaglandins in blacks. PMID- 3312511 TI - Systemic administration of MK-801 protects against ischemia-induced hippocampal neurodegeneration in the gerbil. AB - The neuroprotective effects of MK-801, a noncompetitive antagonist of N-methyl-D aspartate (NMDA) receptors, were evaluated in models of cerebral ischemia using Mongolian gerbils. Bilateral occlusion of the carotid arteries for a period of 5 min resulted in a consistent pattern of degeneration of hippocampal CA1 and CA2 pyramidal neurons, which was quantified using an image analyzer. Systemic administration of MK-801 (0.01-10 mg/kg, i.p.) 1 hr prior to the occlusion caused a dose-dependent protection of the CA1 and CA2 neurons. The ED50 value for neuroprotection by MK-801 was calculated to be 0.3 mg/kg, and at doses greater than or equal to 3 mg/kg the majority of animals were completely protected against the ischemic insult. Systemic administration of MK-801 (1 or 10 mg/kg, i.p.) 1 hr prior to unilateral occlusion of the right carotid artery resulted in significant protection against hippocampal neurodegeneration following 10 min of occlusion, and increased the survival rate after 30 min of occlusion. The potent neuroprotective effects of MK-801 in these cerebral ischemia models add further weight to the evidence that NMDA receptors are involved in the mechanism of ischemia-induced neuronal degeneration. PMID- 3312510 TI - Primary intracranial rhabdomyosarcoma: case report and review of the literature. AB - Invasion of the meninges is a relatively common complication of head and neck rhabdomyosarcoma (RMS), while RMS arising primarily within the brain or meninges is rare. We report the case of an 11-year old child with a primary "primitive" frontal lobe tumor, subsequent leptomeningeal spread and fatal intratumoral hemorrhage; the diagnosis of RMS was discovered only at postmortem examination. The literature contains a total of 34 reported cases of primary intracranial RMS. This tumor has been observed to arise in a variety of central nervous system (CNS) locations in patients of all ages, but most commonly within the posterior fossa of children. Leptomeningeal dissemination and spontaneous intratumoral hemorrhage are important clinical features. Postoperative chemotherapy and craniospinal radiation may improve the anticipated poor prognosis of patients treated with surgery and radiation alone. The diagnosis of RMS may be missed unless electron microscopic and specific immunohistochemical studies are applied to "undifferentiated" or "primitive" CNS tumors. PMID- 3312512 TI - Comparison of high-performance liquid chromatography and microbiological assay for determination of josamycin in rat serum. PMID- 3312513 TI - The tradition of Harvey Cushing commemorated by a stamp in the Great American stamp series. The 1987 AANS (American Association of Neurological Surgeons) presidential address. AB - With the announcement that Harvey Cushing is to be honored by a United States postage stamp in the Great American stamp series, the qualities that this remarkable man possessed are reviewed--artist, author, bibliophile, scientist, soldier, physician, and teacher. The events that led to Cushing becoming a neurosurgeon are summarized. The recognition by the United States Postal Service of physicians and others who have appeared on stamps that had some relationship to Cushing's activities is discussed. Based on the tradition of Harvey Cushing, eight guidelines are presented. PMID- 3312514 TI - Protection against spinal cord ischemia with insulin-induced hypoglycemia. AB - The effect of insulin-induced reduction in blood glucose to 65 +/- 20 mg/dl (mean +/- standard deviation) on recovery of electrophysiological function and extracellular lactate concentration was studied in a rabbit model of spinal cord ischemia. These results were compared to findings in animals with spinal cord ischemia that either were fasted overnight (fasted group: blood glucose 97 +/- 26 mg/dl) or had no pretreatment (control group: blood glucose 172 +/- 65 mg/dl). The aorta was occluded until the postsynaptic waves of the spinal somatosensory evoked potentials (SSEP's) had been absent for 20 minutes, a period of ischemia that produces paraplegia in 100% of untreated rabbits. The total aortic occlusion time was not significantly different in the three groups. Recovery of the SSEP's was significantly better in the insulin-treated animals than in the fasted or control animals. The N3 wave of the SSEP's, which has been found to correlate best with neurological recovery, returned to 65% +/- 48% of the preischemia amplitude in the insulin-treated animals, compared to 40% +/- 34% in the fasted group and 26% +/- 24% in the control animals. Extracellular lactate concentration in the spinal cord increased immediately after occlusion of the aorta, reached a plateau as the postsynaptic waves disappeared from the SSEP's, and then increased a second time during the first 15 minutes of reperfusion. The peak lactate concentration during ischemia and during reperfusion correlated with the preischemia glucose concentration (r = 0.60336 and r = 0.76930, respectively). Lactate concentration in the spinal cord was higher during ischemia and throughout the first 2 hours of reperfusion in the control and fasted animals than in the insulin-treated animals. During the 2nd hour of reperfusion, lactate concentration was significantly higher in the control animals than in the fasted animals. Reduction in blood glucose with insulin improves recovery of electrophysiological function after spinal cord ischemia, probably because of reduced lactic acid production, especially during the early reperfusion period. PMID- 3312515 TI - Symptomatic spinal epidural lipomatosis as a complication of steroid immunosuppression in cardiac transplant patients. Report of two cases. AB - Patients with Cushing's syndrome may develop spinal epidural lipomatosis, an abnormal accumulation of fat in the spinal epidural space. This accumulation of fat may cause compression of the spinal cord or cauda equina with resulting neurological deficit. Two cases of symptomatic spinal lipomatosis are reported in cardiac transplant patients receiving chronic corticosteroid treatment. The literature is reviewed, and diagnostic and therapeutic considerations are discussed. PMID- 3312517 TI - Marshall Brucer still full of acerb wit 30 years after serving as SNM president. Interview by Linda E. Ketchum. PMID- 3312516 TI - Lipoma of the ambient cistern causing obstructive hydrocephalus. AB - A 62-year-old patient with lipoma of the ambient cistern and marked hydrocephalus is described. Intracranial lipomas are maldevelopmental lesions, which rarely produce neurological symptoms. The anatomopathological and clinical features of the lipomas of the ambient cistern are reviewed on the basis of the other reported cases. The importance of the computerized tomography and nuclear magnetic resonance for the diagnosis and the indications for the surgery are also discussed. PMID- 3312518 TI - Adverse reactions to technetium-99m colloids. PMID- 3312519 TI - Managing crises effectively: an intervention model. AB - The nature of our work in health care is such that it lends itself to high levels of ambiguity at best and frequently even to the presence of crisis situations. The ability to manage crisis, therefore, is an increasingly vital skill for nurse executives. Creative and productive possibilities can arise from coping well with such serious and unusual events. This article suggests a model for crisis management. PMID- 3312520 TI - Dietary restriction and aging: historical phases, mechanisms and current directions. AB - Energy intake restriction (ER) without essential nutrient deficiency retards aging and extends life span in all species tested so far, and across wide phylogenetic differences. Historical phases of this model system for studying aging have included modulation of the survival curve, effects on disease susceptibility and effects on physiological indices of aging; the current phase focuses upon possible mechanisms whereby ER influences such widely diverse phenomena. Mechanistic possibilities include effects on the immune system, on basal state and proliferation potential, metabolic rate, DNA repair, levels of free radical scavengers, chromatin structure and protein synthesis and turnover. The ER model may also be useful in analyzing unifactorial versus multifactorial theories of aging, and in clarifying the possible significance of physiological markers that correlate with differences in maximum life spans between species. PMID- 3312522 TI - Dietary calcium and hypertension. PMID- 3312521 TI - Hypercorticism and manganese metabolism in brown adipose tissue of the obese mouse. AB - In ob/ob mice, we showed previously that brown adipose tissue (BAT) has an abnormally low manganese (Mn) content associated with low Mn-superoxide dismutase (MnSOD) and succinate dehydrogenase (SDH) activities. These anomalies can be corrected partially by supplementing the diet with Mn. The present work was designed to find out whether the hypercorticism of the obese mouse plays a role in this anomalous Mn metabolism in BAT. Mn content and MnSOD and SDH activities were determined in BAT from control and adrenalectomized (ADX) obese mice and from control and corticosterone-supplemented lean mice. Adrenalectomy of the obese mouse restored BAT Mn content, SDH activity and lipid peroxidative activity to normal but had little effect on MnSOD activity. Corticosteroid supplementation in the lean mouse did not reproduce the anomalies of Mn metabolism found in the untreated obese mouse. These results show that hypercorticism alone is not responsible for the anomalies of Mn metabolism. It is possible that the hyperinsulinemia of the obese mouse is involved in this process since adrenalectomy corrected hyperinsulinemia in the obese mouse, but corticosteroid supplementation of the lean mouse did not reproduce the high plasma insulin levels or the anomalies in body composition typical of the untreated obese mouse. PMID- 3312523 TI - Possible role of insulin status in the increased lipogenic enzyme activity by dietary medium-chain triglyceride in rat liver. AB - The possible role of insulin status in the increase in liver lipogenic enzyme activities upon feeding medium-chain triglyceride (MCT) was investigated with streptozotocin-induced diabetic rats and insulin-treated diabetic rats. Rats were fed synthetic diets that contained either 2% corn oil (control), fat free, 13% MCT +2% corn oil, or 13% lard +2% corn oil, respectively. Feeding the MCT diet for 3 days increased serum ketone bodies in both the normal and diabetic rats. Insulin levels of MCT-fed rats tended to be higher than in normal animals. MCT feeding caused an enhancement of fatty acid synthetase (FAS) and malic enzyme (ME) in the liver of normal rats, whereas diabetic rats failed to register an increase in those activities due to MCT feeding. Administration of insulin to diabetic rats resulted in a recovery of the level of those enzyme activities to about the same degree as in each of the normal rat groups. It was interesting that diabetic MCT-fed rats with insulin treatment maintained higher enzyme activities in comparison to the lard and control groups. These results suggest that the increase in lipogenic enzyme activities caused by dietary MCT is presumably dependent on differences in insulin status. PMID- 3312524 TI - Hypertension and the ischaemic myocardium. AB - Hypertension and ischaemic heart disease often co-exist. Recent studies, using ambulatory ST-segment and haemodynamic monitoring, have shown that myocardial ischaemia may not necessarily be accompanied by angina pectoris. Unless transient myocardial ischaemia is actively sought it may, therefore, be missed and this may have important prognostic and therapeutic implications. Studies investigating the use of beta-blockers, calcium antagonists and nitrates in angina pectoris have shown that these agents have an equal effect on painless as opposed to painful myocardial ischaemia. While there are no currently completed studies demonstrating the prognostic implication of silent ischaemia in stable angina, it is well known that approximately one-quarter of all myocardial infarctions occur without chest pain. Recent investigation in unstable angina showed that silent ischaemia was an important predictor of future coronary events. PMID- 3312525 TI - Angiotensin converting enzyme inhibition in hypertension. AB - An examination of the principal physiological actions of angiotensin II should make it clear why in vivo attempts to inhibit the rate of angiotensin II generation have been an attractive avenue in pursuing control of high blood pressure. The major physiological effect of angiotensin II relates to its direct pressor effect, but there are supplementary blood pressure regulating actions. Therefore, if we limit the rate of angiotensin II generation by inhibiting the angiotensin converting enzyme (ACE) we should expect to control high blood pressure in a number of clinical syndromes. This paper reviews the future of ACE inhibitors in the treatment of conditions such as hypertension associated with unilateral renal artery stenosis, essential hypertension and severe and previously unresponsive hypertension, with respect not only to efficacy but also to the side-effect profile and ancillary properties. Side effects seen with this class of drug are cough, rashes (both morbilliform and urticarial) and, rarely, angio-oedema. Proteinuria, nephrotic syndrome, leukopenia and taste disturbance were previously reported with captopril but only taste disturbance, and that less frequently, is apparent at the lower doses now employed. Several studies have examined the 'quality-of-life' aspects of ACE therapy and have usually but not always reported favourably. There are features of the ACE inhibitors which make them attractive drugs, and while we should be cautious because of limited experience, we should critically and creatively examine their properties over the next years. PMID- 3312527 TI - Diuretics in hypertension. AB - Thiazide diuretics have been the 'mainstay' of antihypertensive therapy for three decades. They reduce arterial pressure, initially through a fall in plasma volume and cardiac output. However, in time, output returns towards pretreatment levels, thereby accounting for a long-term fall in pressure through decreased vascular resistance. At present, the precise mechanism for this reduced resistance remains unknown. Although the fall in arterial pressure is not due to direct vasodilation, it is not unlikely that it may operate, in part, indirectly through reduced vascular responsiveness, induced prostacyclins and other mechanisms. Attendant unwanted biochemical effects include hypokalaemia, hyperuricaemia, hyperglycaemia, reduced renal excretory function and hyperlipidaemia. Orthostatic hypotension and, of more recent emphasis, sexual impotence are among the more common side effects. A question has been raised as to whether hyperlipidaemia might explain the failure of some multicentre studies to prevent myocardial infarction or progression of coronary heart disease but this is more a 'non issue' although it must be considered. The present data continue to support the conclusion that diuretics are safe, effective and economical for the treatment of hypertension, and they remain a major cornerstone of initial as well as multipharmacological therapy, particularly in volume-dependent forms of essential hypertension, steroid-dependent hypertensions, renal parenchymal disease and in special patient groups (black, obese and elderly. PMID- 3312526 TI - Calcium antagonists in hypertension. AB - Calcium antagonists are potent arterial vasodilators with no long-term effect on sympathetic reflex activity or sodium and volume retention. This favourable haemodynamic profile makes 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 concentrations of free calcium. Clinical studies have proved the efficacy, safety and acceptability of calcium antagonists alone or in combination with other drugs in uncomplicated hypertension; calcium antagonists are particularly effective in older patients, those with low renin levels and, possibly, black patients. These properties and the efficacy of calcium antagonists in the treatment of severe and accelerated hypertension or hypertensive emergencies make them a valuable addition to the drugs already available for the treatment of hypertension. PMID- 3312528 TI - Diuretics, hypokalaemia and arrhythmias in hypertensive patients: still an unresolved problem. AB - Hypokalaemia in man is associated with an increased incidence of cardiac arrhythmias. Thiazide diuretics cause hypokalaemia in a proportion of otherwise healthy hypertensive patients, and there is a risk that in these patients hypokalaemia induced by diuretics may initiate serious cardiac arrhythmias and even sudden death. The data suggest that such circumstances are rare and a study designed to demonstrate an effect on mortality would need to be larger than any reported or current trial. Diuretic-induced hypokalaemia may account for some of the small differences in mortality from heart disease that have been reported in subgroups of patients from recent trials aimed at the prevention of coronary heart disease or treatment of hypertension. There are several therapeutic regimens by which diuretic-induced hypokalaemia may be detected, treated or prevented. Most physicians already take heed of this problem so that it is no longer a major therapeutic issue. PMID- 3312529 TI - Hypertension in the elderly. AB - Hypertension is a common finding in patients aged over 60 years, but the following questions need answering. How dangerous is it? Will lowering the blood pressure reduce the attendant risks? What is the 'cost' of such treatment in terms of side effects, drug-induced disease and health service finance? Two recently completed trials throw light on these problems: EWPHE (European Working Party on Hypertension in the Elderly), a European study based on hospital-clinic attenders, using a diuretic backed up with methyldopa; and HEP (randomized trial of treatment of Hypertension in Elderly Patients in Primary Care), based on general-practice screening in England and Wales using atenolol and bendrofluazide. The results of these trials were compared and the findings were broadly similar in the two studies. Some of the differences may be due to the different selection of patients. It is concluded that elderly patients with sustained blood pressures greater or equal to 170/90 mmHg would benefit from treatment by substantial reduction of stroke. Diuretics or beta-blockers, alone or together, are acceptable treatments in elderly subjects. PMID- 3312530 TI - An update on the Medical Research Council Hypertension Trial. AB - The principal results of the Medical Research Council (MRC) Hypertension Trial were published in mid-1985 and additional papers are in preparation which will give more detailed information about important issues such as the influence of treatment upon ischaemic heart disease. This paper briefly reviews some points about the trial. The main results of the MRC trial were that stroke was reduced on average by about half (69% with bendrofluazide, 27% with propranolol); coronary events, although not reduced across the board, were reduced by one-third in male non-smokers treated with propranolol; and compared with placebo, all cause mortality in the actively treated groups was lower in men but higher in women. The implications of these results are discussed. It is hoped that the MRC trial will open the way to a more intelligently targeted approach that may help to reduce the incidence of stroke and myocardial infarction by skillful selection of patients and drugs. By this selection, many patients who are at very low risk or for whom the risks of treatment may outweight the likely benefits will be spared the cost and inconvenience of prolonged treatment. PMID- 3312531 TI - The registry of the International Society for Heart Transplantation. PMID- 3312532 TI - Effects of prophylactic rabbit antithymocyte globulin in cardiac allograft recipients treated with cyclosporine. AB - The prophylactic use of rabbit antithymocyte globulin (RATG) was evaluated in 13 cardiac allograft recipients who received a low-dose of RATG (175 +/- 32 mg) after transplantation (group 1). The patients were retrospectively compared with 13 parallel cases receiving the same treatment except for the initial RATG (group 2). There were no differences in the patient composition and the level of the basic immunosuppression therapy with cyclosporine. The patients treated with RATG (group 1) showed substantially greater suppression of T helper and total T cells up to 10 and 20 days after surgery, respectively. The incidence of rejection episodes during the initial admission seemed lower in patients receiving RATG, with a borderline significance (1.4 versus 2.4, p = 0.06). This accounts for the reduced requirement of methylprednisolone in treating rejection in patients in group 1 (1.3 gm versus 4.0 gm, p less than 0.02). Moreover, the patients without initial doses of RATG (group 2) more frequently experienced recurrent rejection (five of 12 versus nine of 10, p less than 0.05), which necessitated rescue RATG; the initial difference in the RATG usage disappeared by the time of discharge. Serious infection occurring after antirejection therapy was common in the group 2 patients without initial doses of RATG, although the overall incidence of infection was not statistically different. Prophylactic use of RATG at the dosage used appeared to reduce the incidence of rejection and the requirement for intravenous steroids and other immunosuppressants. It seems warranted to test this approach in a prospective randomized manner. PMID- 3312533 TI - Nutritional program for heart transplantation. AB - Methodist Hospital has completed 52 heart transplants during its 4 1/2-year history. Dietary restrictions for patients have been deemed necessary to offset the side effects from medication. The purpose of this article is to provide information regarding the nutritional program for heart transplant recipients. Evaluation of the dietary program, changes made, and problems encountered are discussed. The first 10 patients were instructed on a type IIA hyperlipoproteinemia (300 mg cholesterol), no concentrated sweets, and 2 to 4 gm sodium-restriction diet with no fresh fruit or vegetables for 6 weeks after the transplantation. These patients had limited follow-up dietary instruction. Of these patients, 50% (five of 10) gained 50 pounds or more above their pretransplant and/or desirable weight; two died within 1 year, and another two within 18 months with accelerated coronary atherosclerosis documented at autopsy. These results were considered unacceptable. The current diet after heart transplantation is 200 mg cholesterol, low saturated fat, low total fat, high fiber, 4 to 5 gm sodium, with limited concentrated sweets. The goals of this diet are discussed. Patients receive nutritional assessment before and after transplantation, care monitoring, and individualized dietary instruction, as well as outpatient follow-up done by the transplant team dietitian as needed. Of these patients, 20% (five of 25) gained 50 pounds or more, and one died with arteriosclerotic-related complications within the first year. The patient's nutritional status before transplant, previous eating habits, educational level, consistency in physician and team member reinforcement of diet are all major factors in long-term compliance. PMID- 3312534 TI - Reimplantation injury after lung transplantation in a rat model. AB - Distant procurement of organs for transplantation requires satisfactory preservation to reduce injury during ischemia and the initial phase of reperfusion. We have studied the mechanism of reimplantation injury after unilateral lung transplantation in isogeneic Fisher rats. The heart and lungs were removed en bloc from donor rats and preserved at 4 degrees C. After 5 hours the left lung was transplanted into a recipient. Radiographic and histologic evidence of pulmonary edema in the transplanted lung at 24 hours confirmed the presence of lung vascular injury. In five rats we performed bronchoalveolar lavage (BAL) of both nontransplanted and transplanted lungs at 24 hours posttransplant, immediately after the animal was killed. Results were compared with five normal control lungs. The results showed not only significantly greater number of cells from transplanted lungs compared with nontransplanted and control lungs but cell profiles showed much greater percentages of neutrophils (mean +/- SD) from transplanted (76.8% +/- 13%) compared with nontransplanted (2.8% +/- 3.1%) or control (0.8% +/- 0.8%) lungs. In seven other rats we measured BAL neutrophil activity with stimulated luminol chemoluminescence from transplanted left and nontransplanted right lungs 24 hours after unilateral left lung transplantation. Results (expressed as millivolt X 10(3) neutrophil +/- SD) showed significantly greater activity from transplanted (2.8 +/- 1.7) compared with nontransplanted (0.72 +/- 0.6) lungs. Reimplantation injury of the lung is characterized by pulmonary sequestration of neutrophils, and these cells may play a primary role in mediating vascular damage. PMID- 3312535 TI - Cardiac sarcoidosis: response to steroids and transplantation. AB - From 1976 to 1986, six cases of cardiac sarcoidosis have been documented by myocardial biopsy in three of five instances; on examination of the explanted heart after transplantation in two, and at autopsy in one patient. Right ventricular end-diastolic pressure was elevated in all four patients with right ventricular involvement with sarcoidosis. Of three patients treated with steroids, improvement in ventricular function and decrease in arrhythmia occurred in two, whereas failure to respond led to transplantation in the other patient. Two further patients have undergone heart transplantation, one for resistant ventricular arrhythmia and the other for congestive heart failure. No recurrence of sarcoidosis has occurred in the grafts. Because two of five patients had sarcoidosis diagnosed on gross examination, a negative endomyocardial biopsy does not exclude the diagnosis of myocardial sarcoidosis, which should therefore be pursued in the setting of unexplained heart failure, conduction abnormalities, and ventricular arrhythmia, particularly when right ventricular end-diastolic pressure is raised. Steroids may result in improvement in some patients even in the presence of severe morphological damage. Heart transplantation may be performed without increased risk of recurrence of sarcoidosis. PMID- 3312536 TI - 81st ODA President. Lowell D. Whitlock, Jr. PMID- 3312537 TI - Long-term results after secondary bone grafting of alveolar clefts. AB - The aim of this study was longitudinally to evaluate the treatment results after secondary bone grafting in 224 cleft patients with an observation period of more than four years. The patients were divided into three groups according to age and eruption stage of the canine at the time of surgery. Group A included 94 patients with a mean age of 10 years, operated before eruption of the canine; group B included 72 patients with a mean age of 13.1 years operated after eruption of the canine; and group C included 58 patients operated after the age of 16 years (mean age, 20.4 years). The evaluation of the treatment results included longitudinal comparison of marginal bone level, periodontal status on cleft-related teeth, dental status in the bone grafted region, esthetical and functional properties of the reconstructed alveolar process, as well as the influence on growth of the maxilla. The marginal bone level was found to be significantly higher among unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) patients in the youngest groups as compared to the other groups. The number of UCLP and BCLP patients who could be treated without bridgework was significantly higher in the youngest age group than in the other groups, as were the esthetic and functional properties of the reconstructed alveolar process. External root resorption occurred in 17 patients in groups B and C. No influence of the procedure on sagittal growth of the maxilla could be demonstrated, whereas the anterior facial height was reduced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312538 TI - Total upper lip reconstruction using a free radial forearm flap incorporating the brachioradialis muscle: report of a case. AB - One-stage reconstruction of the upper lip using a free radial forearm flap was successfully performed with excellent functional and cosmetic results. The free radial forearm flap, including the vascularized and innervated brachioradialis muscle, has a very wide potential for reconstruction of the lip defects due to carcinoma. PMID- 3312539 TI - Middle ear injury resulting from temporomandibular joint arthroscopy. PMID- 3312540 TI - A technique for the compression and carriage of autogenous bone during bone grafting procedures. PMID- 3312541 TI - An evaluation of a lathe-cut high-copper amalgam alloy. AB - Modification of an amalgam alloy may give rise to improved physical properties. The physical properties of a newly formulated, single-composition lathe-cut amalgam alloy were studied and found to be superior to those of a conventional lathe-cut amalgam alloy. However, such modification in formulation may result in changes in the clinical handling properties of the material. The high-copper amalgam alloy was assessed by a panel of general practitioners who found that the general handling properties of the material were similar to those of conventional lathe-cut amalgam alloys. The longer term performance of the high-copper alloy was assessed by means of a blind, controlled clinical trial carried out by two operators. A 1-year assessment of the resulting restorations and tooth replicas could not distinguish between the high-copper alloy and a conventional alloy. The two alloys had both given good clinical results. PMID- 3312542 TI - Force transmission and retentive capabilities utilizing labial and palatal I-bar partial dentures. AB - A maxillary photoelastic model was constructed to determine the retention and force transmission characteristics of a bilateral distal extension base partial denture. Comparisons were made using palatal and labial I-bars. It was shown that there were no significant differences in retention and force transmission between palatal and labial I-bars. From a stress and retention standpoint, it may be concluded that the use of palatal I-bars is a viable alternative to the labial I bars, especially where aesthetics is of primary concern. PMID- 3312544 TI - Quality assurance in histopathology. PMID- 3312543 TI - Ulleval Hospital 1887-Sept. 5-1987. PMID- 3312545 TI - Identification of cells of the human mononuclear phagocyte system with rat monoclonal antibodies. AB - Five rat monoclonal antibodies (McAbs) to human macrophages are described: YTH 8.18, YTH 25.7, YTH 51.1, YTH 85.12.1, and YHB 65.5. These McAbs are divided into three groups, since YTH 8.18, YTH 51.1, and YHB 65.5 are thought to identify the same antigen. These McAbs react with some bone marrow blast cells, granulocytes, and different percentages of peripheral blood monocytes. When studied on different body tissues, they were found to identify all members of the mononuclear phagocyte system (MPS), except Langerhans cells of skin and epithelium and in the case of one group (YTH 8.18/YTH 51.1/YHB 65.5) osteoclasts. In nine reactive lymph nodes the anti macrophage McAbs identified germinal centre macrophages, sinus macrophages, and interdigitating cells, but not dendritic reticulum cells. They also identified epithelioid macrophages and Langhans-type multi-nucleated giant cells in lymph nodes involved in granulomatous lesions (sarcoidosis and toxoplasmosis). In 24 cases of non-Hodgkin's lymphoma, the antimacrophage McAbs identified reactive macrophages in cases of B- or T lymphocyte origin, whereas in three selected cases of true histiocytic lymphoma all the McAbs were found to be reactive with the vast majority of neoplastic macrophages as they were with the cells of a neoplastic macrophage line (U937). The possible use of these McAbs in the identification of benign and malignant macrophages in different systems is discussed. PMID- 3312547 TI - Electron microscopic identification of aberrant melanosomes using a combined dopa/Warthin-Starry technique. AB - A method combining the DOPA and Warthin-Starry techniques is described in order to positively establish the nature of pleomorphic granules observed in the cytoplasm of cells of putative amelanotic melanoma. The technique identifies these granules as aberrant melanosomes by discretely depositing electron dense silver on suitably prepared sections of DOPA-treated tissue blocks. PMID- 3312546 TI - Immunohistochemical analysis of HLA antigens and mononuclear infiltrates of benign and malignant breast. AB - Using immunohistochemistry, the epithelial expression of HLA Class I and II antigens (and beta 2 microglobulin) was compared in benign and malignant breast, and the stromal lympho-histiocytic infiltrate of these tissues quantified. The findings were compared with certain characteristics of the carcinomas. In contrast to other studies, malignancy was found to be associated with a far greater infiltrate of both lymphocytes and macrophages. In carcinomas, lymphocyte but not macrophage numbers showed a positive correlation with epithelial HLA ABC and HLA DR expression. This was particularly striking for T lymphocytes, and especially for the T4 subset. The histological grade of carcinoma is closely related to the degree of HLA ABC and beta 2 microglobulin expression, but no such relationship was found for HLA DR. There were greater numbers of mononuclear cells in the poorer differentiated tumours compared with other grades. Those carcinomas with evidence of lymph node metastasis contained greater numbers of macrophages identified by the antibody Y1/82A, but none of the other parameters studied was found to be associated with local lymph node status. The use of a large panel of monoclonal antibodies against various cellular subtypes has allowed a more detailed analysis of the interaction between breast epithelium and the host response. PMID- 3312548 TI - Silver Jubilee of the Royal College of Pathologists. PMID- 3312549 TI - Recent developments in cutaneous lymphoproliferative disorders. PMID- 3312550 TI - Intraosseous infusions. PMID- 3312551 TI - Characterization of Y chromosomal deoxyribonucleic acid fragments and translocations by Southern blot analysis. AB - Hybridization of Y chromosome-specific probes to Southern blots of genomic deoxyribonucleic acid from patients with chromosomal variants permits direct and rapid characterization of the chromosomal content. We have used two single-copy Y chromosomal sequences specific for the short arm (47z and DP34) and one repeated sequence specific to the long arm (Y3.4) to study several patients with different types of sex chromosomal abnormalities, including three patients with gonadal dysgenesis and the karyotype 45,X/46,X + fragment, two females with Y autosomal translocations involving similar regions of the Y chromosome (46,XX,t(Y;14)(q11,p11) and 46,XY,t(Y;15)(q11,p11), two males with very small Y chromosomes (del(Y)(q12) and i(Yp], and a 45,X male with a small Y autosomal translocation. These techniques are more sensitive than chromosome banding and thus are an important adjunct to karyotyping for analysis of chromosomal content. For patients with gonadal dysgenesis and uncharacterized fragments, demonstration of Y chromosomal sequences identifies an important risk factor for the development of gonadoblastoma. For other patients, accurate identification of Y chromosomal content may facilitate prediction of the patient's phenotype. PMID- 3312553 TI - Effect of heparin infusates in umbilical arterial catheters on frequency of thrombotic complications. AB - We studied 111 infants requiring an umbilical artery catheter, 59 with heparin and 52 without. Thirty-four thrombi were detected, 16 in the heparin group and 18 in the control group. The numbers of thrombi in the two groups was not significantly different, but the number of clotted or nonfunctioning umbilical artery catheters was greater in the control group (P less than 0.05), as was the incidence of hypertension (P less than 0.05). There were no other significant differences between the two groups. We conclude that the use of low doses of heparin may not change the incidence of umbilical artery catheter-related thrombi, but it does appear to lower the incidence of their sequelae. PMID- 3312552 TI - Prevention of symptomatic patent ductus arteriosus with a single dose of indomethacin. AB - To determine the efficacy of indomethacin to prevent the occurrence of symptomatic patent ductus arteriosus (PDA), a randomized clinical trial was conducted involving 32 preterm infants weighing 750 to 1500 g at birth who had hyaline membrane disease. By random assignment, 15 infants were given a single dose of indomethacin, 0.2 mg/kg intravenously, 24 hours after birth. Seventeen infants composed a control group for which indomethacin was reserved as treatment for symptomatic PDA. Birth weight, gestational age, male/female ratio, black/white ratio, and severity of disease were similar for both groups. Only one of the 14 survivors who received prophylactic indomethacin had symptomatic PDA, compared with nine of the 16 survivors in the control group (P = 0.007). There was no difference between the groups in development of bronchopulmonary dysplasia, duration of time endotracheal intubation, was required, duration in oxygen, duration to reach full feedings and regain birth weight, and duration of hospital stay. There was no difference between the two groups in incidence of intraventricular hemorrhage, and none developed necrotizing enterocolitis. These results indicate that the use of prophylactic indomethacin is beneficial in prevention of symptomatic PDA; the lack of differences in pulmonary sequelae or other complications may have been related to a population sample size not large enough to impart sufficient statistical power. PMID- 3312554 TI - Concentrations of antibodies in paired maternal and infant sera: relationship to IgG subclass. AB - Previous studies comparing IgG subclass concentrations in cord and maternal sera have indicated that IgG1 is transported across the placenta to a greater extent than is IgG2. The purpose of our study was to examine the relationship between the transport of IgG1 and IgG2 and the transport of specific antibodies that are relatively restricted to a particular subclass, either IgG1 or IgG2. The concentrations of total serum IgG1 and IgG2 and those of IgG-anti-tetanus toxoid (TT) and anti-group A streptococcal carbohydrate (GAC) were measured in 30 paired maternal and cord sera. Previous studies have shown that anti-TT in adults is predominantly IgG1, whereas anti-GAC is predominantly IgG2. The mean cord/maternal concentration ratios of IgG1 and anti-TT were similar (1.77 +/- 0.56 and 1.93 +/- 0.67, respectively), but differed significantly (P = 0.0001) from those of IgG2 and anti-GAC (0.99 +/- 0.39 and 1.01 +/- 0.45, respectively). We confirmed the difference in cord/maternal concentration ratios of IgG1 and IgG2 antibodies by measuring IgG1 and IgG2 antibodies specific for Haemophilus influenzae type b capsular polysaccharide; the mean cord/maternal concentration ratio of IgG1-anti-Hib PS was significantly higher than that of IgG2-anti-Hib PS (2.23 +/- 0.83 compared with 0.94 +/- 0.49, P = 0.01). These results indicate that placental transport of IgG antibodies is related to their subclass composition. PMID- 3312555 TI - Kawasaki disease: clinical perspective. PMID- 3312556 TI - Ultrastructure of the mitotic apparatus in Cryptococcus neoformans. AB - Mitosis in Cryptococcus neoformans was examined by electron microscopy. Observation of serial sections showed that the separation of chromosomes occurred in the karyokinetic nucleus in the bud, that the microtubule organizing center (MTOC) was composed of two globular elements and a bridged middle piece, and that the nuclear envelope of the karyokinetic nucleus was partially destroyed during mitosis. These findings are similar to those reported in the heterobasidiomycetous yeasts. In addition, some of the prophase cells showed extension of the karyokinetic nucleus into the bud unaccompanied by the MTOC and swelling of the middle piece of the MTOC. PMID- 3312557 TI - Human Exserohilum and Bipolaris infections: report of Exserohilum nasal infection in a neutropenic patient with acute leukemia and review of the literature. AB - A neutropenic patient with acute myeloid leukemia developed nasal and perinasal infection caused by the fungus Exserohilum rostratum. Early amphotericin B treatment along with marrow recovery resulted in resolution of the infection. A review of other previously reported cases of Exserohilum and Bipolaris infections show a favourable outcome in most patients who receive systemic antifungal treatment with amphotericin B. PMID- 3312558 TI - Electrophoretic and serological analyses of cytoplasmic antigens from Aspergillus fumigatus during growth of conidia to mature mycelia. AB - The changes of cytoplasmic components concomitant with conidium to mature mycelium growth of Aspergillus fumigatus strain Ag 507 were analysed by one- and two-dimensional polyacrylamide gel electrophoresis (SDS-PAGE; 2-DE). SDS-PAGE monitored molecular weight differences between components of cytosol preparations obtained from conidia and those through 96 h of mycelial growth. 2-DE analyses indicated that some components characteristic of mature cytosol begin to appear by 7 h. Cytoplasmic preparations absorbed with rabbit immunoglobulins raised to mature cytosol were analysed by 2-DE. Conidia cytosol components were not absorbed to a great degree, unlike those from later stages of mycelial growth, which indicates that cytosol components may be changed and/or synthesized de novo during growth of the fungus. Analysis of the cytosol preparations by fused rocket immunoelectrophoresis showed that some components are synthesized in different amounts at various times during growth: 3, 4, 7, 8, and 18 h of growth, components begin to appear that may be synthesized de novo. Enzyme-linked immunosorbent assay with rabbit antiserum to mature cytosol and cytosol preparations obtained from conidia through 96 h of growth, indicated differences of molecular structures between the cytosol preparations. The anticytosol IgG and IgE titers of sera from patients with allergic bronchopulmonary aspergillosis were both elevated and fluctuated with each preparation. The specific IgG and IgE titers both appeared to be elevated with cytosol preparations obtained from 4, 5, 7, and 9 h of growth and highest against the 96 h preparation. PMID- 3312559 TI - Induction of petite mutation with acriflavine and elevated temperature in Candida albicans. AB - A method of inducing respiratory deficient (petite) mutation in Candida albicans (which has been previously classed as a petite-negative yeast) and characteristics of some isolated mutants are reported. When grown at 42 degrees C in the presence of a cytoplasmic mutagen (acriflavine), C. albicans exhibited diauxie-like biphasic growth. Mutants which were unable to grow on a non fermentable substrate, glycerol, were isolated from the above culture at a frequency of less than 1%. The simultaneous action of both acriflavine and a supraoptimal temperature of 42 degrees C was required to induce respiratory mutation. The respiratory mutants were separated into two groups: i. mutants exhibiting a complete cytochrome spectrum but with low respiratory activity and ii. those deficient in cytochrome aa3. Further characterization of their respiratory activity, colony morphology, mitochondrial morphology and growth manner supported the evidence that members of the latter group can be regarded as petite mutants. PMID- 3312560 TI - Artifacts of measuring during strabismus surgery. AB - Several different artifacts can induce errors in measurements obtained during strabismus surgery. Fixating the severed rectus muscle stump with forceps during strabismus surgery can result in a temporary anterior displacement of the insertion. This may result in inaccuracies in determining the site to which the muscle is to be recessed. This displacement was quantified in a prospective masked manner and was found in some patients to result in as much as 1 mm of error. It can be prevented by measuring the recession prior to fixating the insertion stump with forceps; however, it cannot always be prevented by measuring from the limbus, which also introduces other artifacts due to geometric principles. An "advancement effect" occurs during a rectus muscle recession due to the mechanics of suture placement in the muscle. It was quantified in a masked manner and found to be approximately .5 mm in most cases. A "V" shaped deformity of the insertion stump may occur immediately adjacent to the forceps. This deformity frequently distorts the insertion by as much as several millimeters. PMID- 3312562 TI - Abdominoscrotal hydrocele: a cause of abdominal mass in children: a case report and review of the literature. AB - Abdominoscrotal hydrocele is rare in children. It presents as an intraabdominal mass associated with hydrocele. It should be considered in the differential diagnosis of the lower abdominal mass in children. PMID- 3312561 TI - Epikeratophakia on pediatric traumatized corneas. AB - Four children ranging from 4 to 6 years of age with unilateral aphakia and corneal scarring secondary to penetrating injuries were treated with epikeratophakia. One child had undergone a rotational penetrating keratoplasty to displace the corneal scar from the visual axis prior to the epikeratophakia procedure. In all of the cases, nonlyophilized donor tissue was utilized. The procedure was successful in all four cases. The average best corrected postoperative visual acuity was 20/45. These results confirm prior studies suggesting that epikeratophakia can be performed successfully on partially opaque and scarred corneas in pediatric aphakic eyes. PMID- 3312563 TI - Securing broviac catheters in children. AB - Placement of a single suture in a strategic location helps to insure against inadvertent dislodgement of Broviac or Hickman catheters immediately after insertion. Indwelling Broviac and Hickman type catheters are gaining popularity for long-term venous access, particularly in children and infants. These silicone catheters were introduced in 1973, and many papers have been written since then documenting their efficacy and their incidence of complications. Inadvertent dislodgement of these catheters is rarely mentioned in these reports, but we have seen this complication in a number of patients; therefore, we have modified our insertion technique to prevent this unfortunate complication. PMID- 3312564 TI - Study of appendicitis in children treated with four different antibiotic regimens. AB - This is a prospective and randomized study of 100 patients with acute appendicitis who were less than 10 years old, in which four different antibiotic regimens commonly in use against gram-negative and anaerobic bacteria were compared in terms of postoperative septic complications. The antibiotics were begun immediately preoperatively and continued for five days. Ten percent of the patients developed infection complications, with 4% requiring further surgery. The best results were obtained with cefoxitin (4% of infection), metronidazole plus amikacin and latamoxef (8%), while the regimen of clindamycin plus amikacin was associated with the greatest number of complications (20%). On analyzing the main microbiologic findings of the study, we conclude that some sort of antibiotic treatment is indicated in all types of appendicitis, due to the occult presence of bacteria in the peritoneal cavity, even without clinical evidence of gangrene or perforation. Further, we emphasize the significance of Streptococcus faecalis as being responsible, along with Escherichia coli and Bacteroides fragilis, for serious postoperative complications. PMID- 3312565 TI - Abdominal abscesses in adolescents with Crohn's disease. AB - Little information is available about the development of abdominal abscesses in adolescents with Crohn's disease. We report the clinical presentation of five adolescents with Crohn's disease who developed this complication. The mean time from diagnosis until development of an abdominal abscess was 1.7 years. The admitting diagnosis was an acute abdomen in two patients and recurrent Crohn's disease in the other three. No features of the clinical presentation or laboratory data distinguished this group from other adolescents with Crohn's disease. The use of ultrasound and CT scanning was helpful in making this diagnosis preoperatively. Those patients with active Crohn's disease who do not respond promptly to medical therapy should be evaluated for the development of this complication. PMID- 3312566 TI - Cell proliferation after flap surgery, root conditioning and fibronectin application. AB - This study evaluated the effects of citric acid demineralization and autologous fibronectin application on cell proliferation after mucoperiosteal flap surgery. Three adult rhesus monkeys were used. After flaps were raised, the roots were surgically exposed and planed. Surfaces on the experimental sides were decalcified with citric acid, and after thorough rinsing, the inner aspect of the flaps and the roots were bathed with 1 ml of autologous plasma fibronectin in normal saline (400 micrograms m/ml) and the flaps sutured. Contralateral teeth, acting as controls, were treated only with the surgical procedure. One hour prior to sacrifice, the animals were injected with an intravenous injection of tritiated thymidine (1 microCi/gm body weight). Surgeries were staggered to produce the following time periods: 3, 7, 15, 21 and 28 days. After processing, autoradiographs were obtained for evaluation, and labeled cells were counted in five compartments at 400 x: (1) oral epithelium, (2) crevicular area, (3) supracrestal connective tissue, (4) coronal periodontal membrane and (5) coronal bone marrow. Forty tissue sections per procedure (20 slides per tooth) were counted and means obtained for the three monkeys. Differences between experimental and control values were statistically evaluated for each component, at each time interval, using pairwise t tests. Fibronectin-treated areas showed significantly increased cellular proliferation (P less than 0.01) during the first 2 weeks, affecting mainly all the supracrestal tissues. Histologically, the establishment of a well-organized fibrinous clot at 3 days was noted in these areas. Results show a faster healing after surgery with the use of citric acid and fibronectin. It was concluded that citric acid followed by fibronectin enhanced cellular proliferation. PMID- 3312567 TI - Compliance. A review of the literature with possible applications to periodontics. AB - This paper begins with a review of the literature on compliance. The medical literature suggests that patients with chronic illnesses tend to comply poorly, especially if the disease is not perceived by the patient as particularly threatening. The dental literature covers two principal areas: compliance with oral hygiene regimens and utilization of dental care by the public. These works show that most patients surveyed do not clean their teeth as they have been instructed, and most do not receive routine dental care. The reasons for this noncompliance are highly variable but include lack of pertinent information, fear, economics, and the patient's perception of lack of compassion on the part of the dental therapist. In periodontics the majority of studies have focused on the effectiveness of patient oral hygiene along with its modification and on maintenance therapy. Other work in the periodontal literature is discussed in light of the widespread noncompliance shown by our patients. A number of studies have been undertaken on how best to improve compliance. In general, it has been found that patients comply better when they are informed and positively reinforced, and when barriers to treatment are reduced. Suggestions are made for improving compliance in the periodontal office and for tailoring therapy to predicted compliance levels. PMID- 3312569 TI - [The formation of urinary calculi]. PMID- 3312568 TI - [Comparison of 3 immunologic methods for the analysis of serum gentamycin]. PMID- 3312572 TI - Pharmacokinetics of methylprednisolone succinate, methylprednisolone, and lidocaine in the normal dog and during hemorrhagic shock. AB - Pharmacokinetics of methylprednisolone succinate and methylprednisolone following methylprednisolone sodium succinate administration were studied in five dogs under normal conditions and then during a severe hemorrhagic shock. In order to evaluate hepatic blood flow, lidocaine clearance was simultaneously measured. In the normal state, the clearance of methylprednisolone succinate was 1.64 +/- 0.499 L/h/kg and its half-life was 15.33 +/- 3.84 min. The systemic availability of methylprednisolone from methylprednisolone succinate was 59.9 +/- 8.3%, and the maximal methylprednisolone concentration was observed after a delay of 7.68 +/- 6.31 min. Using a reservoir technique in anesthetized dogs, severe hemorrhagic shock was obtained. Changes in lidocaine clearance indicated a subsequent reduction of hepatic blood flow. The clearance of methylprednisolone succinate decreased to 0.488 +/- 0.240 L/kg/h, and the half-life increased to 40.66 +/- 23.48 min. The exact availability of methylprednisolone from methylprednisolone succinate during shock was not calculable because methylprednisolone kinetics were time dependent. The plasma methylprednisolone concentration was relatively high and persistent during the shock. It was concluded that methylprednisolone sodium succinate is a prodrug which can be released in sufficient quantities as its active moiety (i.e., methylprednisolone) during severe hemorrhagic shock in the dog. In addition, after a single intravenous administration, the slow process of methylprednisolone elimination may give sustained methylprednisolone concentrations for several hours. PMID- 3312571 TI - Antitumor effects of biologic reducing agents related to 3,4 dihydroxybenzylamine: dihydroxybenzaldehyde, dihydroxybenzaldoxime, and dihydroxybenzonitrile. AB - This report describes a structure-activity analysis of isomers of three classes of dihydroxybenzene derivatives, including dihydroxybenzaldoxime, dihydroxybenzaldehyde, and dihydroxybenzonitrile. These derivatives were examined for their effect on ribonucleotide reductase activity, macromolecular synthesis, cell growth, and in vivo antitumor activity against the L1210 murine leukemia. One of the compounds studied exhibited significant antitumor activity against the growth of L1210 leukemia cells. A comparison of the various analogues revealed a possible correlation for 3,4-dihydroxybenzaldoxime between its potent inhibitory effect toward ribonucleotide reductase activity (IC50 = 38 microM) and its superior L1210 antitumor activity [percent increased life span (% ILS) = 100]. PMID- 3312573 TI - Cerebral palsy. A literature review. PMID- 3312570 TI - Adrenalectomy prevents changes in rat pineal melatonin content and N acetyltransferase activity induced by acute insulin stress. AB - The activity of N-acetyltransferase (NAT) and the content of melatonin (MEL) in the rat pineal have been shown to be sensitive to several types of stressors. This study was designed to assess the role of the adrenals in mediating the effect of one such stressor, insulin-induced hypoglycemia, on pineal synthetic activity. Intact and bilaterally adrenalectomized (ADX) adult male rats were kept under light:dark cycles of 14:10 (lights on 0600 h) and injected intraperitoneally with 10 IU insulin at 1300 h, and groups (n = 8) were killed 2, 3, or 4 h postinjection. Plasma catecholamines were assayed by means of high performance liquid chromatography and radioimmunoassay was used to assess pineal NAT activity and MEL content. All injected groups were rendered hypoglycemic by insulin administration. Compared to uninjected controls, plasma epinephrine in hypoglycemic intact rats rose after 2 h, whereas epinephrine did not change in hypoglycemic ADX animals. The increase in epinephrine in intact animals was correlated with a rise in NAT activity at 2 h. Moreover, pineal MEL content at 2, 3, and 4 h was significantly greater than control values. In contrast, no changes in pineal biosynthetic function were found in ADX rats. This differential response by intact and ADX rats suggests that an adrenal product (possibly epinephrine) is responsible for mediating the stimulatory effects of acute insulin-induced hypoglycemic stress on the rat pineal. PMID- 3312574 TI - Osteoid osteoma of the talus. A case report and literature review. PMID- 3312575 TI - Clinical results of the multifocal lens. AB - The multifocal posterior chamber intraocular lens was implanted in 46 eyes of 38 patients as part of the first clinical trial of this target-type implant. No major complications were reported. Visual acuity results for distance and near vision were excellent, with best case visual acuities better than 20/40 in over 95% of eyes in the first three months. PMID- 3312576 TI - [Juvenile periodontitis. Summary of different treatment modalities]. PMID- 3312577 TI - The fit of molded all-ceramic, twin foil, and conventional ceramic crowns. PMID- 3312578 TI - The convergence angle of tooth preparations for complete crowns. PMID- 3312579 TI - A new chemical method for etching metal frameworks of the acid-etched prosthesis. AB - Alloys containing beryllium, silicon, boron, and all nickel base alloys are etched well by the method described, with the exception of Fore alloy manufactured by the Unitek Corp. Alloys containing chrome and cobalt cannot be etched with Met-Etch gel. The advantages of using this method of chemical etching are (1) this conservative procedure can be performed in two clinical sessions, (2) the etching of the framework can be effectively controlled by the dentist or the laboratory technician, and (3) if the metal framework is dislodged it can be cleaned, etched, and reattached during the same appointment. PMID- 3312580 TI - An alternative to cast etched retainers. PMID- 3312581 TI - Composite dowels and cores: effect of moisture on the fit of cast restorations. AB - A study was undertaken to evaluate the effect of interim restorations on the dimensional stability of composite post and core buildups subjected to moisture during the fabrication of cast restorations. Dimensional change associated with composite dowel and core buildups did not significantly alter the fit of cast restorations compared with natural teeth under the same conditions. The use of composite dowels and cores for the restoration of endodontically treated teeth is not contraindicated because of potential dimensional instability of the resin when exposed to moisture. Well-fitting interim restorations for either natural teeth or composite dowel and core buildups improved the fit of cast restorations 23% to 36%. PMID- 3312582 TI - A shear test for the bond strength of ceramometals. AB - An innovative shear-testing method was introduced to study the effect of firing temperature, type of metal, and surface texture on the bond strength of the ceramometals. Two common ceramic/metal alloys were used: Olympia, a precious alloy, and Talladium, a base alloy. A Ceramco II Paint-O-Pake opaque was selected for the study. Each porcelain alloy was prepared in a similar manner before porcelain application to achieve uniform surfaces. A separate category of base alloy samples was subjected to etching after sandblasting. Each category was then divided into two groups. Opaque porcelain was fired according to the manufacturer's instructions in one group and 65 degrees F higher in the other. The bond strengths were compared by statistical analysis and post-tested samples were evaluated visually and microscopically with a scanning electron microscope. PMID- 3312583 TI - A new clinical approach to the problem denture patient. AB - Dentists should consider the diagnosis of depression, which has been shown to have a detrimental effect on the success of denture therapy. Patients who are depressed are rarely aware of the existence of depression. The dentist is responsible to elicit the information that confirms or rules out the diagnosis of depression. Proper referral of these patients will not only enhance the success of denture treatment but will improve the patient's quality of life, which is the foremost goal in patient care. PMID- 3312584 TI - Periodontal reactions related to removable partial dentures: a literature review. AB - In several clinical studies on RPDs, great attention was paid to the occurrence of reactions in periodontal tissues. Some early studies reported extensive periodontal breakdown, often a short time after insertion of a prosthesis. Other studies reported moderate or practically no harmful periodontal changes. In articles on causes of periodontal breakdown related to RPDs, the three main factors discussed were (1) plaque and oral hygiene, (2) coverage of the marginal gingivae by parts of an RPD, and (3) occlusal forces that are transmitted to the remaining teeth and their periodontal tissues by the prosthesis. Longitudinal studies have shown that it is possible for patients provided with RPDs to maintain good plaque control. If plaque control is established, and if the prostheses are regularly checked and indicated procedures performed, the forces transmitted to abutment teeth do not seem to induce periodontal breakdown. However, the scientific documentation about the effects of RPDs in patients with extremely reduced periodontium is scanty. PMID- 3312586 TI - Computer-aided design and manufacturing in dentistry: a review of the state of the art. PMID- 3312585 TI - Bond strength of etched-metal resin-bonded cingulum rest seats. PMID- 3312587 TI - A temporary replacement for an existing complete denture. PMID- 3312588 TI - Phosphoethanolamine transiently enhances excitability of rat hippocampal neurons in vitro. AB - Application of phosphoethanolamine (PEA; more than 1 mM) to rat hippocampal neurons leads to a change in excitability in two phases: a) A transient increase of EPSP amplitude and membrane input resistance (Ri) in the order of minutes that can be observed after local as well as bath application. b) Decrease of EPSP and IPSP amplitude and of Ri are caused by exposure to PEA (over 1 mM; bath application) for more than 20 min. Membrane potential and action potential are not changed by 10 mM PEA for up to half an hour. Depolarizations evoked by N methyl-D,L-aspartate (NMA) given locally are transiently enhanced and then reduced by PEA following a time course similar to the effects a) and b) observed on EPSPs. PEA produces an apparent decrease of calcium activity due to its electrochemical properties. A local application into the soma layer results in a complex calcium signal. A shortlasting drop in calcium activity is followed by a large positive signal indicating an increase of calcium activity. It is concluded that liberation of PEA exacerbates rather than mitigates the harmful consequences of strong excitation and/or excitotoxins. PMID- 3312589 TI - Dieting and depression: a critical review. AB - Investigations of affective changes during weight reduction have produced sharply conflicting results. Studies conducted through the 1950s and 1960s indicated that weight reduction was accompanied by a high incidence of affective disturbance ranging from simple dysphoria to clinical depression and psychosis. More recently, studies of behavioral programs have suggested that weight reduction may actually improve mood. A critical and systematic review of the literature revealed that the conflicting evidence is best explained by differences in mood assessment. The method of mood assessment consistently predicted the affective changes observed in previous reports. Other variables previously thought to influence affective response to weight reduction, including duration of treatment and weight loss, did not independently predict outcome. PMID- 3312590 TI - Psychosocial problems of patients on the renal unit and their relation to treatment outcome. AB - Eighty patients on a renal unit were interviewed to assess their psychiatric status and social functioning, and 68 survivors were re-interviewed one year later. Psychiatric disorders, which were mainly mood disorders, were inversely related to duration of treatment, and had reduced considerably at follow-up. Social disability was more stable and was related to abnormal personal relationships and to treatment status. Psychiatric disorder was only weakly associated with social disability or physical outcome at follow-up. Despite psychiatric and social problems, 11 patients commented positively on some aspect of their experience of life since starting treatment. PMID- 3312591 TI - Does atenolol improve physical and psychological function after coronary artery bypass surgery: a controlled study. AB - A double-blind prospective randomized trial of atenolol (100 mg once daily) was carried out on 88 patients (78 men) awaiting coronary artery bypass graft surgery. Standardized ratings of both psychiatric morbidity and functional capacity were made before, 3 months (n = 82) and 12 months (n = 81) after surgery. One year after surgery men in the atenolol group had a significantly shorter treadmill exercise time than those on placebo (7.21 +/- 0.28 min vs 8.32 +/- 0.40 min; p less than 0.05), but the frequency of reported anginal attacks during the year was similar in both drug groups. Improvement in functional capacity (measured in exercise time) in the 71 men following surgery was related to both physical and psychological variables assessed before the operation. Men with more severe occlusive disease, lower neuroticism and higher extraversion scores pre-operatively showed greater percentage improvement in exercise time after surgery. Women had significantly levels of psychiatric morbidity and shorter treadmill exercise time than men both before and after surgery. Of the psychiatric and psychological variables, only ratings of Type A behaviour fell significantly in the atenolol group (170.9 +/- 5.3 vs 163.0 +/- 5.2; p less than 0.05). This change, which is probably not clinically important, occurred independently of any reduction in either overall psychiatric morbidity score or ratings of somatic symptoms mediated by beta-adrenergic receptors. The atenolol group reported more side-effects of both psychological and physical symptoms than the placebo group. We do not recommend the routine use of atenolol after bypass graft surgery. Our findings failed to support the suggestion that Type A characteristics may reflect an underlying sympathetic nervous system reactivity. PMID- 3312592 TI - The gastroenterological manifestations of AIDS and HIV infection. PMID- 3312593 TI - Bronchogenic and enteric cysts presenting as asymptomatic mediastinal masses at routine chest radiography. PMID- 3312594 TI - A link with Trafalgar. PMID- 3312595 TI - The economic contribution of dental hygienists' activities to dental practice: review of the literature. AB - This article reviews studies of dental practice and essays on practice management that have included information on the economic contributions of oral hygiene services. Several studies found that these services were less remunerative than other services and recommended that dentists delegate these functions when possible. However, one study noted that performance time, as well as delegation, influenced practice productivity and also reflected the practice's concept of care. Some practice management authors indicated that poorly managed practices without an excess of patients do not benefit economically from hiring a hygienist; but for practices with good management capabilities and an excess of patients, a hygienist may be able to make a major contribution to practice productivity. The lower remuneration for hygiene services and the high percentage of practice time required to provide a complete prophylaxis once or twice a year to each patient led several authors to doubt that dentists would or could provide these services themselves. The data in the reported studies, however, are insufficient to support firm conclusions about the profitability of hygienists' activities in dental practice. PMID- 3312596 TI - The Culpeper microscope. PMID- 3312597 TI - Acupuncture for some common disorders: a review of evaluative research. AB - This paper reviews the use of acupuncture to treat several disorders where pain is not the primary symptom. Studies on asthma have shown a small but consistent short-term therapeutic effect of acupuncture. One study of long-term effects found no improvement in asthma after acupuncture while the other reported a modest effect on symptom relief but with a greater impact on medication reduction. Further studies of the long-term effects of acupuncture on asthma would seem desirable even though the currently available findings are equivocal. Sufficient work has now been carried out on sensorineural deafness to conclude that acupuncture has no worthwhile effects on this condition. Only two studies have been carried out on tinnitus; they indicate that the effects of short courses of acupuncture are at best slight. There are some encouraging findings for acupuncture treatment of hypertension, although the study was seriously flawed by the lack of a no treatment control group. With regard to giving up smoking it seems that acupuncture may assist during the withdrawal period and that it compares favourably with other forms of treatment; whether there is any specific effect of the acupuncture is not yet clear. As with other attempts to stop people smoking, however, there is a high relapse rate. The trials of acupuncture on psychiatric disorders have suffered from the lack of detailed assessment and control groups; no conclusions can be drawn without further studies. The studies on weight loss similarly do not permit any firm conclusions about the usefulness of acupuncture. PMID- 3312598 TI - Naloxone evokes large-amplitude GnRH pulses in luteal-phase ewes. AB - Ewes were sampled during the mid-late luteal phase of the oestrous cycle. Hypophysial portal and jugular venous blood samples were collected at 5-10 min intervals for a minimum of 3 h, before i.v. infusions of saline (12 ml/h; N = 6) or naloxone (40 mg/h; N = 6) for 2 h. During the 2-h saline infusion 2/6 sheep exhibited a GnRH/LH pulse; 3/6 saline infused ewes did not show a pulse during the 6-8-h portal blood sampling period. In contrast, large amplitude GnRH/LH pulses were observed during naloxone treatment in 5/6 ewes. The mean (+/- s.e.m.) amplitude of the LH secretory episodes during the naloxone infusion (1.07 +/- 0.11 ng/ml) was significantly (P less than 0.05) greater than that before the infusion in the same sheep (0.54 +/- 0.15 ng/ml). Naloxone significantly (P less than 0.005) increased the mean GnRH pulse amplitude in the 5/6 responding ewes from a pre-infusion value of 0.99 +/- 0.22 pg/min to 4.39 +/- 1.10 pg/min during infusion. This episodic GnRH secretory rate during naloxone treatment was also significantly (P less than 0.05) greater than in the saline-infused sheep (1.53 +/- 0.28 pg/min). Plasma FSH and prolactin concentrations did not change in response to the opiate antagonist. Perturbation of the endogenous opioid peptide system in the ewe by naloxone therefore increases the secretion of hypothalamic GnRH into the hypophysial portal vasculature. The response is characterized by a large-amplitude GnRH pulse which, in turn, causes a large-amplitude pulse of LH to be released by the pituitary gland. PMID- 3312599 TI - Management of complete molar pregnancy. AB - This review of the current management of complete molar pregnancy is based upon the clinical experience at the New England Trophoblastic Disease Center. Suction curettage is the preferred method of molar evacuation regardless of uterine size in patients who desire to preserve fertility. Prophylactic chemotherapy may be useful in the management of high-risk molar pregnancy, especially when hormonal follow-up is either unavailable or unreliable. All patients must be followed with serial human chorionic gonadotropin levels to ensure that remission has occurred. PMID- 3312600 TI - Dialysis related amyloidosis. PMID- 3312601 TI - One infectious agent--many syndromes. PMID- 3312602 TI - Antiinsulin antibodies and clinical characteristics of patients with systemic lupus erythematosus and other connective tissue diseases with steroid induced diabetes. AB - The development of antiinsulin antibodies during insulin therapy for steroid induced diabetes was documented in a group of patients with systemic lupus erythematosus and other connective tissue disorders. No patient had antiinsulin antibodies due to the underlying disorder, but all developed antibodies after treatment with exogenous insulin while receiving steroid therapy. Most antibodies had higher avidity for beef insulin, suggesting that pork or human insulin may be of benefit in the management of these patients. PMID- 3312604 TI - Renin inhibitors based on novel dipeptide analogues. Incorporation of the dehydrohydroxyethylene isostere at the scissile bond. AB - The design and synthesis of renin inhibitors that incorporate the novel dipeptide isostere (4S,5S)-5-amino-6-cyclohexyl-4-hydroxyhex-1-ene-2-carboxylic acid as a transition-state analogue are described. Titanium-promoted condensation of dilithiated N-alkylmethacrylamides with protected amino aldehydes results in efficient preparation of protected dipeptide analogues 7 and 8. Incorporation of 7 into the partial sequence of angiotensinogen affords potent in vitro inhibitors of human renin. Further chemical manipulation of the unsaturated amide moiety allows the study of structure-activity relationships in both the P1' and P2' sites. Details of the syntheses, stereochemical determinations, and in vitro renin inhibition are presented. PMID- 3312603 TI - Nicardipine for the treatment of Raynaud's phenomena: a double blind crossover trial of a new calcium entry blocker. AB - Fifteen patients with Raynaud's phenomenon [systemic lupus erythematosus (6), progressive systemic sclerosis (8) and rheumatoid arthritis (1)] and 12 patients with Raynaud's disease participated in a parallel, 4-week/arm, double blind, crossover study of nicardipine, an experimental calcium channel blocker. Nicardipine significantly improved pain (p = 0.03), decreased number of Raynaud's attacks (p less than 0.03), and was preferred over placebo (p less than 0.05) in the patients with Raynaud's disease, but showed an effect only in the number of attacks (p = 0.049) among the group with Raynaud's phenomenon. Plethysmography showed no drug effects. One patient discontinued the trial after developing headaches while taking placebo. Nonlimiting toxicity occurred more commonly with drug than placebo (15 vs 9 times, p less than 0.05). Our study demonstrated that nicardipine improves symptoms in Raynaud's disease, but is not effective in Raynaud's phenomenon. PMID- 3312605 TI - 2,4-Diamino-5-benzylpyrimidines as antibacterial agents. 8. The 3,4,5-triethyl isostere of trimethoprim. A study of specificity. AB - 3,4,5-Triethylacetophenone was synthesized in 60% yield by a Friedel-Crafts reaction from 4-ethylacetophenone and converted to 2,4-diamino-5-(3,4,5 triethylbenzyl)pyrimidine (2), a trimethoprim (1) isostere, by standard techniques. This compound is more lipophilic than 1 by three log units (log P, octanol/water). Compound 2 was approximately equipotent with 1 in inhibiting Escherichia coli dihydrofolate reductase (DHFR), 2-fold more potent against P. berghei and N. gonorrhoeae DHFR, and 10 and 25 times better an inhibitor of rat and chicken liver DHFR, respectively. Although the 3,4-dimethoxy analogue 19 was 10-fold less inhibitory to E. coli DHFR than 1, it was 3-4 times more potent on the vertebrate isozymes, whereas the diethyl congener 10 followed 19 in its E. coli DHFR binding but was less active on rat and chicken DHFR. Therefore, a significant portion of the selectivity of 1 for bacterial, as opposed to vertebrate, DHFR, involves the methoxy functions. An analysis of the X-ray data on 1 and 2 complexed with chicken DHFR, coupled with kinetic data, led to the conclusion that the difference in binding energies of the methoxy and ethyl compounds probably involve desolvation factors, as well as direct energies of interaction with protein atoms. Thus, one cannot invoke lipophilicity or shape alone in explaining the relationship in properties of 1 and 2. PMID- 3312606 TI - Michel M.J. Lavoipierre. 1920-1984. PMID- 3312607 TI - Detection and quantification of Plasmodium falciparum and P. vivax infections in Thai-Kampuchean Anopheles (Diptera: Culicidae) by enzyme-linked immunosorbent assay. PMID- 3312609 TI - R-plasmid RP1 promotes adhesion of gram-negative bacteria to medical prostheses and glass. AB - The presence of R-plasmid RP1 increased the adhesion of chemostat-grown iron- and carbon-limited Proteus mirabilis to the surfaces of various medical prostheses and to glass. Similar results were obtained with iron-limited Pseudomonas aeruginosa and anaerobically-grown Escherichia coli. Changes in the surface properties of P. mirabilis indicated that the R-plasmid-mediated increase in negative charge was one of the factors that promoted adhesion. PMID- 3312608 TI - Rubinstein-Taybi syndrome. PMID- 3312610 TI - R-plasmid RP1 increases sensitivity of Proteus mirabilis to normal body defences. AB - The bactericidal action of non-immune whole blood on Proteus mirabilis was increased when the bacteria contained the R-plasmid RP1. This effect was due mainly to increased phagocytosis. Iron-depleted stationary-phase cells were more sensitive than carbon-depleted cells. The contribution of serum was usually negligible but was increased during a minor non-specific infection. Most plasmid containing phenotypes were more sensitive than were those without plasmids but there were considerable differences between stationary and exponentially-growing cells. The R-plasmid-mediated increase in sensitivity to phagocytosis may be due in part to the presence of additional glycosylated proteins in the outer membrane. PMID- 3312611 TI - In vitro proliferation of human lymphocytes measured by an enzyme immunoassay using an anti-5-bromo-2-deoxyuridine monoclonal antibody. AB - A previously described, non radioactive method for the measure of in vitro mouse lymphocyte proliferation was applied to human lymphocyte proliferation assays. It involved incorporation into DNA, during cell multiplication, of 5-bromo-2 deoxyuridine (BUdR), a thymidine analogue. BUdR-DNA was then assayed by a sandwich enzyme immunoassay (BUdR-EIA) using an anti-BUdR monoclonal antibody (McAb 76-7). BUdR-DNA from crude cell extracts was first immobilized on microtitration plates coated with McAb 76-7. In a second step BUdR-DNA was reacted again with McAb 76-7 conjugated to horse radish peroxydase. The quantity of peroxydase in microtitration wells was then measured by the coloration of o phenylenediamine (492 nm). Titration curves obtained with dilutions of crude extracts were compared to the curve obtained with a purified BUdR-DNA reference solution. Results were expressed as equivalent ng BUdR-DNA/ml. BUdR-EIA was compared to 3H-thymidine incorporating assay for the measure of lymphocyte proliferation induced by PHA mitogen, candidine and tuberculine antigens and mixed lymphocyte culture. Excellent correlation between both assays was observed for each experiments (r = 0.953 to 0.999). Overall correlation coefficient for the 5 experiments was 0.785, indicating greater variation of BUdR than 3H thymidine incorporation, according to the mitogen or antigen used and the culture conditions. This could be due to that fact that BUdR-EIA measured only BUdR incorporated into DNA, while 3H-thymidine incorporation assay measured 3H thymidine both incorporated into DNA, and stocked into the cell before DNA incorporation. BUdR-EIA would thus reflect cell proliferation more exactly than 3H-thymidine incorporation assay. The sensitivities of both techniques were comparable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312612 TI - Enhancement of host defence by Y-19995 (2,4'-bis(1-methyl-2-dimethyl aminoethoxyl)-3-benzoylpyridine dimaleate), a novel synthetic compound. I. Accelerated restoration from the leukocytopenia and augmented protection against microbial infections in immunocompromised mice. AB - Effects of a novel synthetic compound, Y-19995, on the host defence in immunocompromised mice were investigated in terms of the restoration of leukocytopenia and the protection against several microbial infections. Oral or intravenous administration of Y-19995 into mice after X-irradiation, treatment with cyclophosphamide or mitomycin C prevented the leukocytopenia to some extent and promoted the restoration in cell numbers of both the peripheral blood leukocytes and bone marrow. Intravenous administration of Y-19995 increased significantly the survival rates of X-ray irradiated mice against acute systemic infections with Escherichia coli, Pseudomonas aeruginosa and Candida albicans, and intramuscular infection with Escherichia coli. The clearance of Escherichia coli from the blood of X-ray irradiated mice was also promoted by the treatment with Y-19995. The augmented protection against microbial infections in immunocompromised hosts by Y-19995 may be attributed mainly to the prevention of leukocytopenia or the enhanced restoration from leukocytopenia. PMID- 3312613 TI - Dr. Donald A. Longfield, recipient of the Michigan Dental Association Award: Dentist Citizen of the Year--1987. PMID- 3312615 TI - Mississippi's first pediatrician--Dr. F. Gail Riley. PMID- 3312616 TI - A review of acute conditions affecting the periodontal tissue and their management. PMID- 3312614 TI - Predicting interindividual differences in blood-pressure response to relaxation training in normotensives. AB - In groups of hypertensives blood-pressure (BP) reductions after relaxation training (RT) are generally moderate. One possibility to explain this relative weakness of RT follows from the observation of large interindividual differences in BP response after RT. In a first study we observed this same variability of BP response after RT in normotensives. Subsequently a method was developed to predict individual BP response after RT. The validity of this method was then established in three samples of normotensives: both systolic and diastolic BP changes appear to be predictable after progressive relaxation as well as after autogenic training. PMID- 3312617 TI - Stress-tension reduction in the treatment of sexually tortured women--an exploratory study. AB - Three women who had been tortured and sexually abused during imprisonment as political prisoners during the dictatorship in the Philippines were treated with a nonverbal, manual stress-tension reduction therapy (STRT). All women had difficulty in sexual and social relationships and a series of unspecific complaints such as headache, dizziness, irritability, aggressiveness toward their own children, etc. The therapy is described. A series of four sessions was given each woman, followed by group training. A remarkable improvement was noted, and it is suggested that STRT may be use in other sexological disorders. PMID- 3312618 TI - Thrombosis of noncatheterized internal jugular vein: a unique complication of subclavian catheterization diagnosed by ultrasound. AB - Using portable high-resolution real-time B-mode ultrasound, the authors observed the phenomenon of thrombosed internal jugular vein in four patients who had prolonged indwelling ipsilateral subclavian catheters with or without catheterized subclavian vein thrombosis. Of these, thrombosed internal jugular vein was found incidentally in three patients with no specific findings suggestive of this complication.The origin of this uncommon complication is thought to be flow stasis in the internal jugular vein due to multiple factors associated particularly with turbulence at the jugulo-subclavian junction and the effect of hyperosmolar solution on blood cells. Treatment consists of removal of the catheters and heparinization when indicated. The authors recommend high resolution ultrasound in the detection and follow-up of this unusual complication. PMID- 3312620 TI - Venous bullet embolism: rationale for mandatory extraction. AB - Venous missile embolism is a rare complication of penetrating trauma which poses controversial management options. We report a case of hepatic vein bullet embolism treated by percutaneous transvenous basket relocation and extraction via femoral vein cutdown. A review of 102 reported bullet emboli since 1930 indicates that the morbidity of a retained projectile is substantial (25%), while removal using modern techniques has few complications. Salient features of early extraction include: 1) prevention of proximal migration, 2) transvenous relocation of the missile to an accessible vein, and 3) peripheral surgical removal. Delayed recognition of an asymptomatic bullet embolus demands further judgment in guiding selective operative removal. A management scheme based on time of recognition, patient status, and embolus characteristics is presented for this unusual problem. PMID- 3312619 TI - Extended-field isocentric irradiation for Hodgkin's disease. AB - Extended-field therapeutic irradiation is the treatment of choice for the majority of patients diagnosed with pathologic stages I and II Hodgkin's disease, and total nodal irradiation can be effectively used to treat selected stage III Hodgkin's patients. Standard 100-cm source-to-axis distance extended-field isocentric technique and results are presented. PMID- 3312621 TI - Medical support in the Tangshan earthquake: a review of the management of mass casualties and certain major injuries. AB - The Tangshan earthquake was probably the worst catastrophe in this century. It took a death toll of 242,769, with 164,851 injured in addition. This presentation describes the organization of disaster relief work after the earthquake, the rescue of buried victims, the organization of medical resources, and the sanitation work to forestall epidemics. It also presents the author's reflections on the management of three major injuries, namely, crush syndrome, fracture of pelvis, and traumatic paraplegia, by reviewing the available data pertaining to these injuries. The author concurs with the prevailing opinion that fasciotomy plays an important role in the successful management of crush injury. It not only prevented acute renal failure subsequent to intracompartmental increase of pressure, but also the occurrence of Volkmann's ischemic contracture as a late sequela. Herbs to induce catharsis and diuresis were used to alleviate intracompartmental pressure. For the management of pelvic fractures, two newly developed treatment techniques are described. On analysis of clinical data, it is the author's opinion that traumatic paraplegia should not be given the priority of early surgery in the circumstances of mass casualties. The primary concern should be the stability and restoration of normal curvature of the spine, especially in cases of complete paraplegia. Decompression of the spinal cord through an anterolateral approach gave promising results in hyperflexion type of spinal fracture. PMID- 3312622 TI - Internal fixation vs. conventional therapy in midface fractures. AB - The purpose of this review is to evaluate internal fixation by means of AO miniplates compared to conventional therapy for the treatment of complicated midface fractures. A more precise division of midface fractures into functional units than that afforded by the Le Fort classification was employed to categorize the complexity of injury. The criteria of evaluation were ease of functional rehabilitation, incidence of complications, and results of surgery. The classification system was helpful in surgical planning and in subsequent analysis of results. Forty-nine of the 92 midface fractures treated by open repair between July 1980 and January 1986 were malar fractures, and 41 of these had associated orbital fractures. The remaining 43 had Le Fort II or more complicated midface fractures, only 15 of which could be adequately categorized by the Le Fort classification. Twenty-two of the 43 patients with complicated midface fractures were surgically treated with internal fixation utilizing 67 AO miniplates. The remaining 21 patients were treated with conventional therapy utilizing a combination of intermaxillary fixation (IMF), and/or interosseous wiring, and/or primary bone grafting. Among the problems encountered were a nonunion of the midface in a delayed repair of a severely comminuted midface fracture, which required secondary split rib grafting. Three plates were removed because of intraoral extrusion. There were no plate-related infections. One of the advantages of internal fixation is that the need for primary bone grafting and external fixation is eliminated. Another is that intermaxillary fixation is needed less frequently, allowing immediate access to the oral cavity for control of airway, care of intraoral wounds, and rapid return to normal alimentation with full mandibular function. Most patients with no associated GI problems tolerated a soft diet within 6 days. Tracheostomy tubes were removed within 3 days if no pulmonary failure was present. We can conclude that internal fixation provides excellent stabilization and repair of complicated midface injuries with minimal complications and rapid return to function for most patients. PMID- 3312623 TI - Wound healing of the injured spleen with and without splenorrhaphy. AB - Splenic wound healing was studied following splenorrhaphy and observational therapy for both canine and porcine splenic injury. The splenorrhaphy group included four adult male dogs and two adult male pigs studied 3 weeks postinjury. The observational therapy group included three dogs and three pigs examined at 3 weeks and three dogs and two pigs examined 6 weeks postinjury. The wound breaking strength (WBS) 3 weeks after splenorrhaphy was significantly greater than WBS of normal splenic tissue (0.41 vs. 0.71 kg/cm2 in dogs; 0.22 vs. 0.35 kg/cm2 in pigs). WBS 3 weeks after observant therapy for splenic injury in dogs was significantly less than normal (0.66 vs. 0.37 kg/cm2). No WBS differences were seen 3 weeks after observant therapy in pigs nor 6 weeks after observant therapy in dogs or pigs. Prolonged convalescence following splenic injury treated by repair or by observation appears unwarranted. PMID- 3312624 TI - Antibody to endotoxin core glycolipid reverses reticuloendothelial system depression in an animal model of severe sepsis and surgical injury. AB - To study the effect of severe sepsis on the function of the reticuloendothelial system (RES) we have measured the clearance kinetics and organ distribution of both low-dose technetium tin colloid (TTC) and 75selenomethionine-labelled E. coli in rabbits 24 hours after either sham laparotomy or appendix devascularization. Sepsis resulted in similar delayed blood clearance and reduced liver (Kupffer cell) uptake of both TTC and E. coli. To investigate the ability of polyclonal antibody to E. coli-J-5 (core glycolipid) to improve RES function in the same model of sepsis, further animals were pretreated with either core glycolipid antibody or control serum (10 ml IV) 2 hours before induction of sepsis. TTC clearance kinetics were determined 24 hours later. Antibody pretreated animals showed: a reduced incidence of bacteremia; normalization of the rate of blood clearance and liver uptake of TTC; and a 'rebound' increase in splenic uptake of TTC. We conclude that antibody to E. coli-J-5 enhances bacterial clearance by the RES. PMID- 3312625 TI - 'Low-dose' corticosteroid prophylaxis against fat embolism. AB - The effect of 'low-dose' corticosteroids (9 mg/kg methylprednisolone), given after skeletal trauma, on the incidence of the fat embolism syndrome and isolated arterial hypoxemia was studied in 42 controls and 40 steroid-treated subjects. Fat embolism occurred in ten controls (23.8%) and one steroid-treated subject (2.5%) (p = 0.01). A further 44 subjects developed isolated hypoxemia. This was severe (PaO2 less than 50 mm Hg) in seven of 32 controls (21.9%) and one of 39 steroid-treated subjects (2.6%) (p = 0.01). The overall incidence of hypoxemia was 67.1%, affecting 33 controls (78.6%) and 22 steroid-treated patients (55%) (p less than 0.05). The degree of hypoxemia was severe (PaO2 less than 50 mm Hg) in 12 controls (28.6%) and two (5%) of the steroid-treated subjects (p = 0.005). No control subject died or required mechanical ventilation. One steroid-treated subject without fat embolism died of a fulminant infection. Although methylprednisolone in a relatively low dose provides protection against fat embolism and pulmonary dysfunction after skeletal trauma, the safety of this therapy requires further evaluation. PMID- 3312626 TI - A prospective randomized trial of the Lazarus-Nelson vs. the standard peritoneal dialysis catheter for peritoneal lavage in blunt abdominal trauma. AB - One hundred consecutive injured patients with blunt abdominal trauma requiring peritoneal lavage were prospectively randomized to placement of lavage catheters with an open or percutaneous technique. The Lazarus-Nelson catheter, placed by Seldinger wire technique, was compared to a standard dialysis catheter, placed by direct visualization and incision of the peritoneum. Placement of the catheter was consistently faster using the percutaneous method; no difference was noted in time of lavage, volume recovered, or complications. When not contraindicated, the percutaneous technique was widely preferred by study participants. PMID- 3312627 TI - Iron status and inflammatory processes in anaemic children. PMID- 3312628 TI - Sonographic evaluation of abdominal lymphangiomas in children. AB - Sonography provided an accurate diagnosis in 10 preoperative studies and correctly showed the extent of the lesions in two postoperative examinations in a group of 12 children with surgically proven intraabdominal lymphangiomas. These masses typically contained anechoic fluid in one or more contiguous cystic loculations bounded by or containing one or more 1- to 2-mm thick septa. Thicker septa occurred in several cases with inflammation and/or accumulations of fatty tissue. Chylous or creamy fluid displayed fine diffuse echoes, whereas hemorrhage resulted in coarse echoes and/or solid masses. In two patients unusual renal involvement mimicked polycystic kidney disease. Typical sonographic appearances of lymphangioma may be radically altered by hemorrhage, inflammation, and unusual sites of involvement. PMID- 3312629 TI - Tracheoesophageal fistula in utero. Twenty-two cases. AB - A retrospective review of 22 infants born with tracheoesophageal fistula (TEF) with in utero sonograms was performed and the literature was reviewed. TEF or esophageal atresia should be considered when there is polyhydramnios and an absent fluid-filled stomach; these findings were seen in 32% of our cases. Amniotic fluid flows freely through some TEFs, resulting in a normal amount of amniotic fluid and a fluid filled stomach (six of 22 patients), while in other cases, the fluid does not traverse the fistula easily and polyhydramnios results. Polyhydramnios was present in 62% of our cases and was the most common sonographic finding. The earliest age at which polyhydramnios was diagnosed was 24 weeks. Sonography will detect approximately one third of fetuses with TEF; an improved outcome is expected in these fetuses. PMID- 3312630 TI - The compound renal pyramid. A normal hypoechoic region on the pediatric sonogram. PMID- 3312632 TI - Prone view for cholecyst-sonography. PMID- 3312631 TI - Sonography of intraoperative spinal arteriovenous malformations. PMID- 3312633 TI - Ectopic pregnancy: diagnosis by sonography correlated with quantitative HCG levels. PMID- 3312634 TI - Expression of hepatitis B virus middle and large surface antigen genes in Saccharomyces cerevisiae. AB - The hepatitis B virus genome carries the surface antigen (SAg) gene and an open reading frame that encodes two SAg-related polypeptides: SAg with a 55-amino-acid N-terminal extension polypeptide and SAg with a 174-amino-acid N-terminal extension polypeptide. These are termed middle S and large S, respectively. These polypeptides or their glycosylated derivatives have been detected in Dane particles, but their chemical and biological properties have remained largely unknown because of their limited availability. We attempted to produce these proteins in Saccharomyces cerevisiae by placing the coding regions under the control of the promoter of the yeast glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene. Yeast cells carrying middle S and large S coding sequences produced 33,000- and 42,000-dalton products, respectively, each of which reacted with anti S antibody and bound to polymerized human serum albumin, in accordance with the known properties of pre-S proteins from particles in human sera (K. H. Heermann, U. Goldmann, W. Schwartz, T. Seyffarth, H. Baumgarten, and W. H. Gerlich, J. Virol. 52:396-402, 1984; A. Machida, S. Kishimoto, H. Ohnuma, K. Baba, Y. Ito, H. Miyamoto, G. Funatsu, K. Oda, S. Usuda, S. Togami, T. Nakamura, Y. Miyakawa, and M. Mayumi, Gastroenterology 86:910-918, 1984). The middle S polypeptide is glycosylated and can be assembled into particles whose size and density are similar to those of SAg. However, this polypeptide was highly susceptible to proteolytic degradation into 29,000- and 26,000-dalton polypeptides, of which only the former retained the binding activity to polymerized albumin. The large S polypeptides are nonglycosylated, relatively stable, and do not seem to assemble into particles by themselves. PMID- 3312635 TI - Characterization of herpesvirus sylvilagus glycoproteins released into the culture medium of infected cells: antisera to gp13 and gp32 neutralize viral infectivity in vitro and identify antigens on plasma membranes of infected cells. AB - Polypeptides released into the culture medium of herpesvirus sylvilagus-infected cells were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of extracellular fluid from [35S]methionine- and [3H]glucosamine labeled cell cultures. Virus-induced glycoproteins 31, 32, and 33 (molecular weights of 62,000, 59,000, and 54,000, respectively) were the most abundant species and appeared predominantly in the culture medium. This observation, together with the known cell-associated nature of herpesvirus sylvilagus, suggested that virus-induced glycoproteins 31, 32, and 33 were specifically released. Immunization of rabbits with virus-induced glycoproteins 13 (molecular weight of 130,000) and 32 resulted in the production of antibodies that neutralized viral infectivity in vitro. Both antiserum to gp13 and antiserum to gp32 immunoprecipitated gp13, gp26, gp33a, gp45, and virus-induced polypeptide 39 (molecular weights of 130,000, 77,000, 49,000, 27,000, and 36,000, respectively) from [35S]methionine-labeled cell extracts as well as virus-induced glycoproteins 31, 32, and 33 from the culture medium. In addition, membrane immunofluorescence assays indicate that an antigen(s) reactive with anti-gp13/32 serum was located on the plasma membrane of infected cells. PMID- 3312636 TI - Expression of envelope glycoproteins of human immunodeficiency virus by an insect virus vector. AB - The envelope gene of human immunodeficiency virus was inserted into the genome of an insect virus vector (Autographa californica nuclear polyhedrosis virus). Upon infection of tissue culture cells, this recombinant virus produced immunoreactive polypeptides related to the envelope glycoproteins of human immunodeficiency virus. Serological survey indicates such polypeptides would be of value as antigens in diagnostics for acquired immunodeficiency syndrome. PMID- 3312637 TI - Paraneoplastic syndromes associated with prostatic carcinoma. PMID- 3312638 TI - The current role of pre-transplant blood transfusions and tissue typing in cadaveric renal transplantation. AB - In a retrospective analysis of 74 consecutive cadaveric renal transplants performed at our center during a 38-month period we assessed the influence of random blood transfusions and tissue matching on graft and patient survival. All patients received cyclosporine and low dose prednisone with or without azathioprine as immunosuppressive therapy. Actual patient survival was 100 per cent at 1 year and actuarial 1-year graft survival was 82 per cent. Random blood transfusions and histocompatibility matching at the HLA-DR locus did not influence graft survival. Matching at 2 or more HLA-A and B loci was associated with a significant detrimental influence (p less than 0.05) on graft survival. We conclude that the use of cyclosporine-based immunosuppression overcomes much of the adverse effect of poor tissue matching and may obviate the need for random blood transfusions in cadaveric renal transplantation during the first year of engraftment. PMID- 3312639 TI - An appliance-free, sphincter-controlled bladder substitute: the urethral Kock pouch. AB - A modified Kock pouch was constructed in 16 patients with cancer of the bladder in whom cystoprostatectomy was indicated. Surgery entailed creation of a Kock pouch with 1 valve for prevention of reflux. The pouch then was anastomosed to the urethral stump. There was no operative mortality. Followup ranged between 3 and 9 months. Excretory urograms revealed excellent upper tract function and good evacuation of the pouch with minimal residual urine. Urodynamic studies demonstrated a volume capacity of greater than 300 ml., with pressures of less than 40 cm. water. All patients were continent during the day. Nocturnal enuresis was observed in 4 patients, 3 of whom responded favorably to I-desamino-8-D arginine vasopressin therapy. The procedure is suitable whenever the urethra can be preserved after cystectomy for cancer. PMID- 3312640 TI - Cavernosography in diagnosis of metastatic tumors of the penis: 5 new cases and a review of the literature. AB - Secondary tumors of the penis are rare, with 266 cases having been reported. We describe 5 new cases studied by cavernosography. The primary tumors were bladder cancer in 3 patients and prostatic cancer in 2. Cavernosography suggested the diagnosis, which was confirmed by a guided biopsy or fine needle aspiration biopsy. The prognosis has been poor, with the average survival being less than 9 months. PMID- 3312641 TI - Complications of chronic indwelling urinary catheters among male nursing home patients: a prospective study. AB - We studied prospectively the incidence of symptomatic infections of presumed urinary tract origin requiring antimicrobial therapy among 54 male nursing home patients with chronic indwelling bladder catheters. During 514 patient-months at risk there were 106 episodes of symptomatic infection, for an incidence of 0.21 per patient-month at risk. Of the patients 80 per cent had at least 1 episode and 48 per cent had 2 or more. None of the clinical factors we examined, including age, nutritional status, stool incontinence, diabetes mellitus, episodes of catheter blockage and the use of chronic suppressant antimicrobial therapy, was associated with the development of symptomatic infection. Further research on host and pathogen-related factors that increase the risk for symptomatic infection, and improvements in infection control and catheter care protocols are necessary to decrease catheter-associated morbidity among male nursing home patients who must be managed by chronic indwelling catheterization. PMID- 3312642 TI - Is serological evidence of infection with syphilis a contraindication to kidney donation? Case report and review of the literature. AB - We report successful transplantation of kidneys from a cadaveric donor with serological evidence of syphilis and no transmission of the disease. Existing guidelines prohibiting the use of serologically positive donors and experience with other forms of iatrogenic transmission of syphilis are reviewed. Specific guidelines for the use of serologically positive donors are proposed. PMID- 3312643 TI - A 37-pound scrotal leiomyosarcoma: a case report and literature review. AB - We report a case of a 37-pound scrotal leiomyosarcoma. The literature is reviewed, and the presentation, diagnosis, treatment and survival of patients with scrotal leiomyosarcoma are discussed. PMID- 3312644 TI - Urinary tract infection by Salmonella enteritidis. PMID- 3312645 TI - Use of fresh placental membranes for bladder reconstruction. AB - Several biodegradable and artificial materials have been used in the urinary tract for partial or total replacement of the bladder. Most of the graft materials have resulted in stone formation, collapse, rejection, or extrusion of the graft without adequate reconstruction of a functional bladder. In this paper, we present our assessment of the use of placental membranes as a feasible, economic, and acceptable organic agent for bladder reconstruction. Eight mongrel dogs were subjected to supratrigonal cystectomy, and then a 10 X 10 centimeter patch of human placental membrane was sutured to the remaining trigone in a watertight fashion. The dogs were sacrificed twelve weeks after surgery. Histologic examinations revealed evidence of regeneration of normal-appearing smooth muscle along the path of a retracting placental patch, and thus of reconstitution of a normal-appearing and functioning bladder. On the basis of this study, we believe that placental membranes, because of their low antigenic properties and easy availability, provide an excellent graft material for the urinary tract. Further studies concerning the application of this graft material in various pathological conditions are now in progress. PMID- 3312646 TI - Total and specific immunoglobulin response to acute and chronic urinary tract infections in a rat model. AB - Total and specific levels of immunoglobulins IgG, A and M were determined by an enzyme-linked immunosorbent assay (ELISA) in a rat model of urinary tract infections (cystitis) during the early and late phases of infection. The early response was characterized by rapid rise in IgM in serum and urine. This response decreased rapidly and was undetectable in urine after eight weeks. Correlation between total serum and urine levels of IgM was not found although a chronological relationship was observed. Total and specific serum and urine IgA responses were erratic. Concentrations of IgA were low and this antibody class was undetectable in urine until the infection had been established for six weeks. In contrast, total serum and urine IgG increased in concentration at five days post infection and reached total maximum by weeks four to eight, then declined, but remained detectable over 24 weeks. Specific IgG titers remained elevated in serum but declined in urine between four and 10 weeks. A correlation between total serum and total urine IgG was found. Also, bacteria generated a concomitant nonspecific response, a part of which was detected against a common antigen expressed on E. coli J5 strain that cross-reacts with a number of gram negative genera. The results show that IgM chronologically is the first antibody to appear in increased amounts in the serum and urine, followed by IgG. The data also suggests a relationship exists between total serum IgG and total urine IgG which may affect the host's ability to eliminate urinary infection. PMID- 3312648 TI - Argon laser-welded arteriovenous anastomoses. AB - This study compared the healing of laser-welded and sutured canine femoral arteriovenous anastomoses. Arteriovenous fistulas 2 cm in length were created bilaterally in the femoral vessels of 10 dogs and were studied at 1 (n = 2), 2 (n = 2), 4 (n = 3), and 8 (n = 3) weeks. In each animal, one anastomosis (control) was closed with running 6-0 polypropylene sutures, and the contralateral anastomosis (experimental) was sealed with an argon laser (0.5 watt, 4 minutes of exposure, 1830 J/cm2/1 cm length of anastomosis). At removal all experimental anastomoses were patent without hematomas, aneurysms, or luminal narrowing. Histologic examination at 4 weeks revealed that laser-welded anastomoses had less inflammatory response and almost normal collagen and elastin reorientation. At 8 weeks sutured anastomoses had significant intimal hyperplasia whereas laser repairs had normal luminal architecture. Tensile strength and collagen production, measured by the synthesis of hydroxyproline and the steady-state levels of type I and type III procollagen messenger ribonucleic acids, at the anastomoses and in adjacent vein and artery specimens were similar in sutured and laser-welded repairs at 2, 4, and 8 weeks. We conclude that argon laser welding of anastomoses is an acceptable alternative to suture techniques, with the advantage of improved healing without foreign body response and possible diminished intimal hyperplasia at the anastomotic line. PMID- 3312647 TI - Urolithogenesis of mixed foreign body stones. AB - Urine of male Sprague-Dawley rats was supersaturated for struvite and often contained struvite crystals. Ethylene glycol administration to these rats resulted in elevation of urinary oxalate and calcium oxalate supersaturation, and induced calcium oxalate crystalluria. Implantation of foreign bodies in their urinary bladders and changing their urinary ambient conditions by administering ethylene glycol for two weeks at two week intervals resulted in the formation of urinary stones of mixed composition containing calcium oxalate and struvite. Crystal-onto-crystal epitaxy did not appear to play any role in the development of these stones. PMID- 3312649 TI - Assessment of pressure gradient by Doppler ultrasound: experimental and clinical observations. AB - Three methods for estimating peripheral artery pressure gradients from ultrasound data were assessed by means of an acute canine aortic coarctation with a variable stenosis and retrospective data from 18 patients with iliac stenoses who had duplex scanning studies and pressure measurements at the time of angiography. The measured pressure difference was correlated with end-diastolic velocity, the presence or absence of reverse flow in diastole, and a pressure difference calculated with the modified Bernoulli equation. Although the calculated pressure gradients correlated well with measured values in animal studies (11 animals, r = 0.78, n = 224, SD = 8.1), they did not in the clinical studies (r = 0.54, n = 33, SD = 28). In both cases, pressure gradients were consistently overestimated for mild stenoses. There was a strong correlation between end-diastolic velocity and pressure gradient (r = 0.71, n = 94, SD = 5.2 for animal studies; r = 0.81, n = 36, SD = 23 for clinical studies), but the data were too variable to provide useful pressure estimates. In clinical studies the absence of reverse flow in diastole at the site of the stenosis was the best indicator of a resting pressure gradient of greater than 15 mm Hg. We conclude that the modified Bernoulli equation and end-diastolic velocity correlate highly with the pressure gradient but are not clinically useful because the variability is too great. The absence of reverse flow in diastole is a more reliable indicator of hemodynamically significant stenosis. PMID- 3312650 TI - Incomplete biochemical adaptation of vein grafts to the arterial environment in terms of prostacyclin production. AB - Biochemical (or functional) adaptation of venoarterial grafts has been demonstrated recently. We reexamined one aspect of this biochemical "arterialization" process: prostacyclin (PGI2) production by canine venoarterial autologous grafts and the responsiveness of this biosynthetic pathway to maximal stimulation with substrate enhancement. Four reversed autologous grafts (femoral vein) were interposed into both carotid and femoral arteries in eight dogs. After 12 weeks, the grafts were removed, and radioimmunoassay was used to determine luminal surface production of 6-keto-PGF1 alpha (the stable metabolite of PGI2) in both the basal and stimulated (27 mumol/L arachidonic acid [AA]) states. PGI2 production by the venous autologous grafts was compared with that of control native artery and vein. We confirmed that PGI2 production (measured in nanograms per milliliter) by control artery was greater than vein under both basal conditions (5.8 +/- 0.4 [+/- SEM] vs. 2.7 +/- 0.5, p less than 0.001) and stimulated conditions (8.8 +/- 0.8 vs. 5.5 +/- 0.4, p = 0.002); moreover, AA stimulation significantly increased PGI2 production in both native artery and vein compared with basal PGI2 production. Under basal conditions, graft PGI2 production (6.3 +/- 1.6 ng/ml) was not significantly different than basal arterial levels (p = 0.8) but was higher than basal venous levels (p = 0.05). However, in marked contrast to both native artery and vein, the vein graft flow surface showed no significant response to substrate enhancement with AA: basal (6.3 +/- 1.6 ng/ml) vs. stimulated (5.9 +/- 0.9 ng/ml) (p = 0.8). These observations confirm that canine venoarterial autologous grafts undergo biochemical "arterialization"; however, this process appears to be an incomplete one.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312651 TI - Multicenter validation study of real-time (B-mode) ultrasound, arteriography, and pathologic examination. AB - The ability of high-resolution ultrasound, angiography, and pathologic examination of endarterectomy specimens to identify and quantitate atherosclerosis was compared in a five-center study. The carotid bifurcation in 900 patients was evaluated by angiography and ultrasound. In 216 cases, high quality endarterectomy specimens were available for comparison with the preoperative images. All comparisons were made in a blinded fashion. Results indicate that ultrasound is able to differentiate angiographically normal from abnormal arteries with a sensitivity of 88% (1077 of 1233 arteries) and accuracy of 79% (1251 of 1578 arteries). Angiographic stenoses equal to or greater than 50% diameter were accurately identified by ultrasound imaging in 72% (1133 of 1578 arteries) of cases, and this was improved by the addition of other functional data (i.e., Doppler spectral analysis and oculoplethysmography). There was only modest correlation of absolute measurements of lesion width, minimal lumen, and standard lumen by the two imaging techniques (r = 0.28 to 0.55). Ultrasound measurements of lesion width were on the average 2 mm greater than those of angiography. The lumen averaged 1.5 mm larger when measured by ultrasound techniques. In the subset in which data were available from endarterectomy specimens, ultrasound showed the best correlation with lesion width (mean difference -1.1 mm) and angiography correlated best with minimal lumen (mean difference -0.1 mm). Neither examination consistently identified ulcerated plaques. Although ultrasound imaging alone has limited usefulness in quantitating luminal stenosis, this can be improved by the use of Doppler spectral analysis and oculoplethysmography. Ultrasound is superior to angiography for quantifying atherosclerotic plaque (lesion width) and will be an important tool for further study of atherosclerotic lesions. PMID- 3312652 TI - Spontaneous iliac arteriovenous fistula. AB - The formation of an iliac arteriovenous fistula caused by rupture of an atherosclerotic iliac artery aneurysm is unusual. We describe a case and review the previously reported 18 cases of spontaneous iliac arteriovenous fistula. The presence of a palpable abdominal mass associated with a thrill or bruit and unilateral leg symptoms of venous engorgement or arterial insufficiency, with or without acute onset of congestive heart failure, should result in a high index of suspicion of this entity. Prompt recognition and surgical closure of the iliac fistula are most important in successful management. PMID- 3312653 TI - Soviets attack alcohol problem anew, this time armed with 'perestroika'. PMID- 3312654 TI - Failure of chloroquine treatment to prevent malaria in Americans in West Africa. PMID- 3312656 TI - Obtaining clinical data on the appropriateness of medical care in community practice. AB - We sought the voluntary cooperation of a randomly selected sample of community physicians and hospitals in five states for a study of how appropriately they performed coronary angiography, carotid endarterectomy, and upper gastrointestinal tract endoscopy. Ninety percent of 913 sampled physicians (n = 819) consented to a review of up to 20 of their 1981 Medicare patients' records. These physicians represented seven different specialties and subspecialties and performed 4988 procedures, 92% of the desired sample. Only three of 230 hospitals did not participate. We attribute our method's success primarily to the formation of a network to connect the branches of the profession, respect for office and hospital practice routine, confidentiality, and the development of carefully designed medical record abstraction systems. We conclude that, with effort, cooperative research among disparate segments of the medical community can become a reality even if the topic studied is relatively sensitive. PMID- 3312655 TI - Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures. AB - We studied the appropriateness of use of coronary angiography, carotid endarterectomy, and upper gastrointestinal tract endoscopy and its relationship to geographic variations in the rates of use of these procedures. We selected geographic areas of high, average, and low use of these procedures and randomly sampled Medicare beneficiaries who had received one of the procedures in 1981. We determined the indications for the procedures using a detailed review of medical records and used previously developed ratings of appropriateness to assign an appropriateness score to each case. Differences among sites in levels of appropriateness were small. For example, in the high-use site for coronary angiography, 72% of the procedures were appropriate, compared with 81% in the low use site. Coronary angiography was performed 2.3 times as frequently in the high use site compared with the low-use site. Under the conditions of this study, we did find significantly levels of inappropriate use: 17% of cases for coronary angiography, 32% for carotid endarterectomy, and 17% for upper gastrointestinal tract endoscopy. We conclude that differences in appropriateness cannot explain geographic variations in the use of these procedures. PMID- 3312657 TI - How coronary angiography is used. Clinical determinants of appropriateness. AB - Using ratings of appropriateness derived from an expert physician panel, we measured how appropriately physicians in 1981 performed coronary angiography in a randomly selected, community-based sample of cases in the Medicare population. We studied large geographic areas (three sites) in three states, representing regions of high and low use. The high-use site had fewer procedures classified as appropriate (72%) than either low-use site (77% and 81%, respectively). Over all sites, 17% of procedures were classified as inappropriate. Patients in the high use site were older, had less severe angina, and were less intensively medically treated than patients in either of the low-use sites. Patients without angina who had not undergone exercise testing constituted the most common subgroup of inappropriate cases. Although overall differences in appropriateness were not large, practice differences do exist. This analysis of practice differences among study sites provides the clinical basis for understanding the small, but significant, differences in the appropriateness of use of coronary angiography. The finding of 17% inappropriate use may be cause for concern. PMID- 3312658 TI - A comparative trial of clotrimazole troches and oral nystatin suspension in recipients of renal transplants. Use in prophylaxis of oropharyngeal candidiasis. AB - An open study designed to compare the effectiveness and safety of clotrimazole troches with nystatin oral suspension in the prevention of oropharyngeal candidiasis was conducted. This study was performed as the troche form of clotrimazole was easier to administer and less costly than nystatin oral suspension. Sixty assessable patients were randomized to receive either clotrimazole troches (n = 32) or nystatin oral suspension (n = 28) for a 60-day period after receiving a renal allograft. The two groups were comparable in age, sex, type of transplant, and amount of immunosuppression. Both regimens were 100% effective in preventing the development of thrush in the patients studied. Adverse effects were infrequently seen in either group (one case of mild nausea in the clotrimazole group and three cases in the nystatin group). One patient chose to withdraw from the clotrimazole group, and eight patients withdrew from the nystatin group before completing 60 days of therapy (P = .002). Reasons given for withdrawal were the unpleasant taste of the drugs, or an inability to comply with the protocol. The cost of clotrimazole troches in the prophylactic doses given in this study was approximately one tenth that of nystatin oral suspension. Clotrimazole troches are effective, less expensive, and easier to self-administer than nystatin oral suspension. PMID- 3312659 TI - Low fetal loss rates after ultrasound-proved viability in early pregnancy. AB - Once pregnancy is recognized clinically, it is accepted that 12% to 15% undergo spontaneous abortion. However, the actual time of fetal demise has not yet been determined. To address this question, the outcomes of pregnancies identified before 21 days of conception by serum beta-human chorionic gonadotropin assays were studied. All subjects underwent ultrasound examinations at eight and 12 weeks' gestation. Among 220 women who had a viable pregnancy at eight weeks, only seven (3.2%) experienced a fetal loss thereafter. The results of this study suggest that most clinically recognized spontaneous abortions manifested after eight weeks actually represent pregnancies in which fetal demise occurred before eight weeks. These findings have important implications with respect to the safety of chorionic villi sampling and to the identification of exogenous agents that cause fetal wastage. PMID- 3312661 TI - Aversion therapy. Council on Scientific Affairs. AB - Aversion therapy is a series of techniques designed to reduce unwanted or dangerous behaviors. The most common applications of these techniques are to obesity, tobacco smoking, sexuality, oral habits, self-injurious and aggressive behaviors, and substance abuse. Most enthusiastic reports suffer from lack of control groups and control procedures. At this time, the best accepted application is for the treatment of chronic self-injurious behavior. PMID- 3312660 TI - Testosterone-secreting adrenal adenoma in a peripubertal girl. AB - A 15-year-old girl who presented with primary amenorrhea and virilization had an adrenocortical adenoma that secreted predominantly testosterone. To our knowledge, she is the first peripubertal and second youngest patient with a testosterone-secreting adrenal tumor described. Serum dehydroepiandrosterone sulfate and urinary 17-ketosteroid and 17-hydroxycorticosteroid levels were normal. A tumor was located by a computed tomographic (CT) scan and by uptake of 6-beta-[75Se] selenomethylnorcholesterol. Microscopic examination of the tumor showed typical features of an adrenocortical adenoma with no histologic features characteristic of Leydig cells. Postoperatively, her hirsutism regressed, she rapidly went through puberty, and regular monthly menstruation started four months later. Finding the source of testosterone in a virilized patient can be difficult. Eleven of the 14 previously described patients with testosterone secreting adrenal tumors initially underwent misdirected surgery on the ovaries. Review of these cases revealed that results of hormone stimulation and suppression tests are unreliable and that these tumors are usually large. Therefore, CT scanning of the adrenal glands is recommended in all patients suspected of having a testosterone-secreting tumor. If the adrenal glands on CT scan are normal, then surgery directed at the ovaries can be undertaken. Adrenal and ovarian vein catheterization is rarely necessary. PMID- 3312662 TI - Serosurvey of human immunodeficiency virus infection in parturients. Implications for human immunodeficiency virus testing programs of pregnant women. AB - Although perinatal transmission of the human immunodeficiency virus (HIV) is well documented, seroprevalence rates of HIV in populations of women of reproductive age have not yet been reported. To determine the seroprevalence of HIV in childbearing women from a population with a high incidence of acquired immunodeficiency syndrome, cord blood samples were collected from 602 infants delivered at an inner-city municipal hospital in New York. Demographic and HIV risk factor information was also collected from mothers of these infants. Twelve (2%) of 602 samples (95% confidence interval, 1% to 4%) were positive for HIV on enzyme-linked immunosorbent assay and Western blot analysis. In interviews, seven of 12 seropositive women had risk factors as defined by the Centers for Disease Control, Atlanta; the remaining five seropositive women had no self-identified risk factors. The HIV seroprevalence rate in our hospital (2.0%) is several times higher than that of many other diseases for which screening is already routine. This serosurvey indicates that HIV infection of inner-city parturients is a significant problem that warrants broadly implemented health strategies. Furthermore, the data also suggest that if risk factor information elicited by physicians is used to initiate HIV antibody counseling and testing of pregnant women, a significant number of seropositive parturients is missed. In areas with significant seroprevalence rates of HIV infection, a broader counseling and testing program may be needed. PMID- 3312663 TI - Care of pregnant women infected with human immunodeficiency virus. AB - The Centers for Disease Control and the American College of Obstetricians and Gynecologists have recommended that pregnant women who are at increased risk for acquired immunodeficiency syndrome be tested for antibodies to human immunodeficiency virus. When this recommendation is implemented, some clinicians who undoubtedly have had limited experience with patients infected with human immunodeficiency virus will be responsible for the care of pregnant women found to be asymptomatically infected with human immunodeficiency virus. There is, therefore, a need for information that will ensure that adequate counseling is provided and that appropriate medical and infection control measures are instituted. This article will review issues related to counseling and antepartum, intrapartum, and postpartum care of seropositive pregnant women. PMID- 3312664 TI - Hypochondriasis and somatization. AB - Between 60% and 80% of healthy individuals experience somatic symptoms in any one week. About 10% to 20% of a random sample of people worry intermittently about illness. A substantial proportion of patients present physicians with somatic complaints for which no organic cause can be found. Patients who are hypochondriacal do not understand the benign nature of functional somatic symptoms and interpret these as evidence of disease. Hypochondriacal concerns range from common short-lived worries to persistent and distressing fears or convictions of having a disease. Hypochondriasis can be secondary to other psychiatric disorders (eg, melancholia or panic disorder), and hypochondriacal attitudes remit when the primary disorder is successfully treated. Patients with primary hypochondriasis are also anxious or depressed, but the fear of disease, or the false belief of having a disease, persists and is the most important feature of their psychopathology. There are substantial differences among hypochondriacal patients in their personalities and psychopathologies. Psychotherapy as well as psychotropic drugs are effective in the treatment of functional somatic symptoms. There are no adequate controlled studies on the value of psychotherapy in hypochondriasis; the recommended guidelines are based on uncontrolled studies of hypochondriasis and on controlled studies of the psychotherapy in similar disorders. The prognosis of functional somatic symptoms as well as that of hypochondriasis is good in a substantial proportion of patients. PMID- 3312665 TI - The optimal intensity of oral anticoagulant therapy. PMID- 3312666 TI - Consensus conference. The management of clinically localized prostate cancer. PMID- 3312667 TI - The reactive arthritis of giardiasis. A case report. PMID- 3312668 TI - Immunodeficiency diseases. PMID- 3312669 TI - Immunotherapy with allergens. PMID- 3312670 TI - Anaphylaxis and stinging insect hypersensitivity. PMID- 3312671 TI - Food allergy. PMID- 3312672 TI - Allergic reactions to drugs and biologic agents. AB - In summary, the term adverse drug reaction is used to designate any type of undesirable and unintended response to a drug and can be broadly classified on the basis of either the presence or absence of an immune mechanism. Allergic reactions (immune) constitute only 5% to 10% of adverse drug reactions. Drug intolerance (nonimmune) constitutes the rest of these reactions. Many of these latter reactions are mild and self-limited, and many drug intolerances cannot be exactly characterized. Of those reactions in which an immune mechanism has been indicated or reactions that clinically appear to be "allergiclike," a limited number of in vivo (eg, skin tests) or in vitro (eg, RAST, IgE-ELISA, other antibody, or cell-mediated assays) tests have proved helpful in the diagnosis. Best studied are adverse reactions to aspirin, penicillin, insulin, and RCM. The principal treatment of all adverse drug reactions is to avoid the drug that has been specifically identified as being responsible for the previous reaction. In cases where avoidance is not possible, desensitization is an alternative (eg, penicillin and insulin). Prophylactic treatment of patients who had previously demonstrated a drug intolerance reaction (eg, systemic RCM reaction) with medication--particularly type I activation--may be helpful in some patients. PMID- 3312674 TI - Vesiculobullous skin disease with prominent immunologic feature. PMID- 3312673 TI - Allergic skin disorders. PMID- 3312675 TI - Immunologic aspects of diseases of the eye. PMID- 3312676 TI - The autoimmune diseases. PMID- 3312677 TI - Immunologic aspects of granulomatous and interstitial lung diseases. PMID- 3312679 TI - Immunologic aspects of endocrine diseases. PMID- 3312678 TI - Immunohematologic diseases. PMID- 3312680 TI - Immunologic aspects of neurological and neuromuscular diseases. PMID- 3312681 TI - Reproductive immunology. AB - The maternal immune system is challenged with paternal antigens through exposure to trophoblast tissue and fetal cells crossing the placenta into the maternal circulation. The dose of antigen, the manner of presentation (cellular, subcellular, or soluble), and the nature of the antigen all determine the type of response that will be elicited. It is also clear that complex maternal immunologic responses, including antibodies to red blood cell antigens, HLA-A, HLA-B, HLA-C, and HLA-D antigens, and cell-mediated responses such as proliferation, lymphokines, cytotoxicity, and suppressor cells, are generated to a variety of paternal antigenic determinants. The fact that some of these reactions are detected in vitro in the absence of maternal serum, but not in its presence, suggests that the local milieu is important in influencing their expression in vivo. For example, such factors as hormones (cortisol, progesterone, and estrogen), pregnancy-associated glycoproteins (alpha 2 macroglobulin and beta 1-glycoprotein) and AFP, which have immunosuppressive properties, may all serve nonspecifically to inhibit and decrease the general tone of maternal immunologic responses, particularly at the placental interface, where many of these factors are present in high concentrations. However, these nonspecific factors may not be sufficient to prevent presensitized effector lymphocytes from continuing an ongoing rejection process, as is often the case in the chronic rejection of an allograft. For this purpose, specific enhancing antibodies would play an important role by blocking maternal responses or protecting the fetus. There may be a subtle balance created on the trophoblast cell surface between specific antibodies and trophoblast or embryonic alloantigens, resulting in limited expression of antigens capable of inducing rejection reactions. This could favor the production of blocking antibodies and/or T-suppressor cells, as opposed to cytotoxic antibody and killer cells. In fact, low levels of antigen density on the cell surface favor a blocking effect by IgG rather than cytotoxicity. Blocking or enhancing antibodies can exert their effect on maternal immunologic responses in several ways. They could block the afferent limb by combining with antigen and preventing sensitization or increasing the level of sensitivity. An example of the latter would be the coating of fetal cells that enter the maternal circulation. Enhancing antibodies could work directly on the effector cells to suppress their function. The antibody itself, or more likely antigen-antibody complexes, may be important in this regard.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3312682 TI - Transplantation immunology. PMID- 3312683 TI - Immunization. PMID- 3312684 TI - Immunopharmacology. Immunomodulation and immunotherapy. PMID- 3312685 TI - Use and interpretation of diagnostic immunologic laboratory tests. PMID- 3312686 TI - 20 years after first human heart transplant, 1987 may see 4000 procedures performed worldwide. PMID- 3312687 TI - Artificial heart implants began five years ago. PMID- 3312688 TI - Cardiac transplantation. Update 1987. PMID- 3312689 TI - Risk factors for cutaneous melanoma. A practical method of recognizing predisposed individuals. AB - Cutaneous melanoma is rapidly becoming a potentially curable cancer if it is detected and properly treated in an early phase of development. Unlike other cancers, which are usually hidden from detection until they are relatively large or metastatic disease has occurred, cutaneous melanoma is readily detectable simply by examining the skin. Information is now available that will be useful in selecting individuals at greatest risk. The most important melanoma risk factors (in decreasing order of importance) for a given individual are as follows: a persistently changed or changing mole, adulthood, irregular varieties of pigmented lesions (including dysplastic moles and lentigo maligna), a congenital mole, Caucasian race, a previous cutaneous melanoma, a family history of cutaneous melanoma, immunosuppression, sun sensitivity, and excessive sun exposure. Selective screening and appropriate treatment of individuals who have these risk factors may reduce the morbidity and mortality of cutaneous melanoma. PMID- 3312690 TI - Prognostic value of nutritional indices. PMID- 3312691 TI - Nutritional assessment from the perspective of a clinician. AB - The different uses of nutritional assessment are briefly reviewed. The parameters of nutritional assessment should be determined according to the use for which they are intended, such as nutritional epidemiology, preoperative assessment of nutritional risk, or nutritional monitoring during parenteral or enteral feeding. The roles of some nutritional variables that are used to identify and monitor high-risk patients during nutritional repletion are examined. The main questions that confront the clinician are as follows: (1) are the nutritional indicators of surgical risk altered by poor intake of nutrients? (2) can these indicators be normalized with adequate feeding or are they abnormal as a result of the metabolic impact of the disease? (3) are these variables simple indicators of surgical risk or are they directly involved in the host-defense mechanism? The importance is stressed of an integrated assessment of the patient's status when nutritional support is considered. This involves not only the static evaluation of the nutritional support according to standard parameters, but also a prospective and dynamic evaluation of nutrient requirements, length of hospital stay, and the curability of the basic disease. PMID- 3312692 TI - Optimal nutritional indexes in cancer patients. AB - This paper reviews various parameters that are used to assess the nutritional and functional status of cancer patients. Available information shows that the nutritional status of cancer patients is correlated with their overall prognosis and outcome. However, little information exists concerning the use of nutritional indexes to evaluate the effectiveness of nutritional rehabilitation of cancer patients. It is emphasized that we should concentrate on developing nutritional parameters to assess the functional improvement of patients rather than their body structure and composition. PMID- 3312693 TI - Anthropometric assessment of the adult hospitalized patient. AB - Anthropometry is a technique in which simple measuring instruments are used to describe human form. By applying the measurement directly or through use of additional calculations, the practitioner can partition the body into fat and fat free components. Quantifying these two body spaces provides information on the amount and rate of change over time in whole body energy supply and protein mass. These data can then be used in association with other indices of energy and protein metabolism. Whereas anthropometry is simple, practical, and inexpensive, the technique is limited to a qualitative tool by several sources of error. A thorough understanding of the strengths, limitations, and appropriate applications of anthropometry is essential when applying the method in clinical practice. PMID- 3312694 TI - Determination of water and electrolytes in muscle biopsies in the nutritional assessment of clinical disorders. AB - Nutritional inadequacies profoundly affect the content and distribution of water and electrolytes in muscle tissue. However, most changes in tissue water and electrolytes are nonspecific and reflect the degree of sickness; they cannot be used for evaluation of malnutrition, except to indicate whether there is a loss or excess of intracellular ions, such as potassium and magnesium. In patients without disturbances in potassium metabolism, muscle cell potassium and protein are strongly correlated, but this relationship does not hold true in patients with potassium depletion. Accumulation and loss of potassium occur in parallel with changes in muscle glycogen, independent of other muscle constituents, eg, magnesium. Potassium depletion and excess, as well as changes in muscle glycogen, must be considered when evaluating the relation of lean body mass and total body protein content to total body potassium. PMID- 3312695 TI - Direct biochemical analysis of human muscle tissue in hospital malnutrition. PMID- 3312696 TI - Creatinine excretion as a measure of protein nutrition in adults of varying age. AB - The use of the creatinine height index (CHI) as a measure of protein nutrition is reviewed. Any such cross-sectional measurement is inherently limited. Using published values for urinary creatinine excretion per kilogram body weight in adult subjects of varying age and values for "ideal" weight as a function of height, we have derived normal values for expected creatinine excretion in men and women of varying height. These permit the derivation of an age-corrected CHI. Possible explanations for the normal decrease in creatinine excretion with age include (1) decreasing lean body mass with age, (2) decreasing proportion of muscle in lean body, and (3) lower meat intake in older persons. Diet has an important influence if meat intake is substantial or if consumption of a creatine free diet is prolonged. Creatinine metabolism and extrarenal excretion are minor, except in subjects with reduced renal function. Application of a correction for constant extrarenal clearance of creatinine in patients with chronic renal failure probably is not valid. Further observations of creatinine excretion in normal subjects of varying age and height are needed. PMID- 3312697 TI - Uses and limitations of the balance technique. AB - Classical balance techniques are a powerful, sensitive, and usually accurate technique for assessing the nutritional or metabolic response to changes in nutritional intake or to metabolic or physiological perturbations. Balances are particularly sensitive for examining transient or short-term responses to nutritional or metabolic stimuli. A major factor responsible for the precision and sensitivity of this technique is the precise control of the activities and environment of an individual during a classical metabolic balance study (eg, the carefully defined dietary intake, degree of exercise, and environmental temperature to prevent sweating); these same factors may enhance the precision and sensitivity of other metabolic or nutritional investigations that may be carried out concurrently with a balance study. Finally, for nitrogen balance studies, the measurement of nitrogen (eg, by the Kjeldahl technique) can be very accurate and sensitive. Despite these advantages, there are important limitations and errors that are inherent in the balance technique. The errors tend to overestimate intake and underestimate output, thereby leading to erroneously positive balances. These errors include losses of food on cooking and eating utensils and dishware, losses of feces or urine on toilet paper or in collection containers, and losses through sweat, exfoliated skin, hair and nail growth, saliva, menses, blood sampling, toothbrushing, semen, and, for nitrogen, from flatus and respiration. Cumulative balance measurements are particularly likely to be falsely positive. The magnitude of unmeasured losses vary among healthy individuals, with the magnitude of the nitrogen intake (for nitrogen), in altered environmental conditions (eg, with sweating), and possibly in disease states. Balance studies are also expensive and time consuming.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312698 TI - Measurement of energy expenditure in clinical nutritional assessment. AB - Indirect calorimetry with the ventilated-hood open circuit is a useful and accurate technique to measure energy expenditure in acutely ill patients. This approach should be useful to evaluate the energy and the nutrient needs of a patient under acute conditions. The measurement of energy expenditure is of obvious importance in assessing protein-calorie malnutrition. A better understanding of energy balance and nitrogen balance in critically ill patients is needed to determine the best caloric and nutrient intake to avoid tissue depletion. It is foreseen that this method will become more widely used when reliable equipment is made available. PMID- 3312699 TI - Indirect calorimetry in malnutrition: nutritional assessment or therapeutic reference? AB - The measurement of gas exchange for use in indirect calorimetry is a clinical research tool struggling to find its proper place in the care of acutely ill and nutritionally depleted patients. Some investigators have proposed that it should be used as part of the nutritional assessment. Unfortunately, in common with many other measurements for nutritional assessment, the information provided must be integrated with other information. It is recognized that factors other than malnutrition may influence the level of the metabolic rate. Despite the lack of precision and specificity, the measurement of energy expenditure provides an important reference for determining patients' requirements for energy intake. As with many other procedures in clinical medicine, the more severely ill the patient, the less the accuracy of standard formulas for estimating energy expenditure. Thus, actual measurements of energy expenditure assume special value. PMID- 3312700 TI - Proteinases in catabolism and malnutrition. AB - Protein synthesis and degradation are particularly sensitive to malnutrition and catabolic states. Intracellular protein degradation is determined by the conformation, molecular weight, isoelectric point, and carbohydrate content of the proteins. ATP-stimulated endoproteases appear to catalyse the rate-limiting steps. In the liver, proteolysis is reduced by amino acids and/or insulin, whereas glucagon stimulates protein degradation, probably due to depletion of intracellular gluconeogenic amino acids. In the muscle, protein degradation is promoted by interleukin-1 and inhibited by Ep-475, which specifically inactivates cathepsin B,H, and L. Myofibrillar alkaline proteinase activity increases postoperatively and in patients suffering from malignant tumors, whereas normal proteinase values were observed in these patients following total parenteral nutrition. Increased alkaline proteinase activity is also observed in diabetes mellitus and is normalized by insulin. Extracellular proteolysis has been reported in patients with hypercatabolic acute renal failure and in patients with sepsis or acute pancreatitis. Plasma fractions obtained from hypercatabolic patients with postoperative acute renal failure were proteolytic. Plasma proteinase activity decreases during hemodialysis due to elimination of a metallo proteinase. Plasma alpha 2-macroglobulin decreases in patients with acute renal failure and also during acute pancreatitis. Proteolytic degradation of parathyroid hormone by sera obtained from patients with acute pancreatitis has been observed. Also, there is a decrease of high molecular weight kininogen during experimental acute pancreatitis. Granulocyte elastase increases postoperatively, mainly in patients with sepsis. Sepsis also causes increased proteolytic activity in the urine. In conclusion, intracellular protein degradation can supply important precursors for hepatic and renal gluconeogenesis during malnutrition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312701 TI - Hemodynamic effect of oral TA-064 after dobutamine in congestive heart failure. AB - The hemodynamic effect of oral TA-064 (20 mg), a newly synthesized inotropic agent, was compared with that of intravenous dobutamine (5 micrograms/kg/min) in eight patients with congestive heart failure who had been treated with intravenous dobutamine, digitalis, diuretics, and prazosin. Hemodynamics was measured using a Swan-Ganz catheter during the pre-dobutamine control period, during dobutamine infusion period, during the pre-TA-064 control period and at 90 minutes after oral administration of TA-064. Stroke work index was increased and mean pulmonary capillary wedge pressure was decreased with TA-064 or dobutamine. Cardiac index and stroke index was increased by each drug, and pulmonary and systemic vascular resistances were decreased. Mean systemic arterial pressure, heart rate and pressure-rate product did not significantly change in comparison with the control level. In conclusion, TA-064 has a hemodynamic effect similar to that of dobutamine and may be useful as an oral substitute for dobutamine in patients with congestive heart failure after temporary management with dobutamine. PMID- 3312702 TI - Distribution of cardiac myosin isozymes in cardiomyopathy: immunohistochemical and gene analysis. AB - We characterized cardiac myosin isoforms by immunohistochemical approaches using monoclonal antibodies and demonstrated the existence of a distinctive type of cardiac myosin heavy chain which predominates in the fetal stage but is depressed during postnatal development. Furthermore, we showed that this type of cardiac myosin heavy chain was markedly expressed in patients with dilated cardiomyopathy. The results suggested that the pathologic process involved in dilated cardiomyopathy affects myocardial differentiation by the inhibition of the myosin gene switching that normally occurs during muscle maturation. However, we could not find any polymorphism in myosin gene in our population sample of dilated cardiomyopathy. The pathophysiological role of fetal type cardiac myosin expression in dilated cardiomyopathy will be clarified by the characterization of the myosin near future. PMID- 3312704 TI - [New antimicrobial agent series XX: Ceftizoxime suppositories]. PMID- 3312703 TI - [New antimicrobial agent series. XIX: Potassium clavulanate/amoxicillin granules]. PMID- 3312705 TI - [New antimicrobial agent series XXI: Cefpimizole]. PMID- 3312706 TI - [Confirmative analysis for digitoxose in the alkali extract of Candida albicans cells]. PMID- 3312707 TI - [A novel immunomodulator derived from Mycobacterium bovis BCG which holds many bioactivities in common with endotoxins]. PMID- 3312708 TI - [Anti-tumor effect of total body irradiation of low doses on WHT/Ht mice]. AB - The effect of low dose (0.05-1.0 Gy) of total body irradiation (TBI) on non-tumor bearing and tumor bearing mice were investigated. Mice received TBI of 0.1 Gy during 6-12 hours before tumor cell inoculation demonstrated to need larger number of tumor cells (approximately 2.5 times) for 50 per cent tumor incidence, compared to recipient mice not to receive TBI. On the other hand, in tumor bearing mice given 0.1 Gy of TBI only tumor cell killing effect was not detected, however enhancement of tumor cell killing effect and prolonged growth delay were observed when tumor bearing mice were treated with 0.1 Gy of TBI in combined with local irradiation on tumors, especially cell killing effect was remarkable in dose range over 6 Gy of local exposure. The mechanism of the effect of 0.1 Gy TBI is considered to be host mediated reactions from the other our experimental results. PMID- 3312709 TI - [A case of primary extramedullary plasmacytoma in the posterior cervical portion]. AB - This case involves a 16-year-old woman with a posterior cervical tumor. Histologically, it was found to be a extramedullary plasmacytoma (EMP). Immunohistochemically, IgG was present in the plasma cells that were shown to be atypia by the PAP method. Laboratory data revealed no other abnormalities. A surgical excision of the tumor was performed with a dissection of the relevant lymph nodes. Although irradiation and chemotherapy were administered postoperatively, multiple bone metastasis was found a month after the operation, and the patient died 8 months later. PMID- 3312710 TI - [An autopsy case of an extranodal malignant lymphoma occurring primarily in the chest wall]. AB - This case history involves a 72-year-old male in whom an artificial left pneumothorax had been induced 46 years earlier. Two years ago a subcutaneous tumor was uncovered in his left chest wall, which was reduced with radiation and chemotherapy. Abnormal shadows began to appear in the left lung 5 months prior to his death. On autopsy, tumors were found to have developed in the left pleural cavity and lung, but no tumor cells had infiltrated to the lymph nodes, the liver, the spleen, or the bone marrow. Tumors that were examined by a biopsy or seen on autopsy revealed a diffuse large cell lymphoma, the T cell type. All 7 reported cases in Japan of a primary lymphoma in the thorax have shown a past history of tuberculous pleurisy and/or pyothorax after a pneumothorax. PMID- 3312712 TI - [Collision tumor of the stomach]. AB - In a gastric neoplasm, malignant lymphoma is a relatively rare disease and a malignant lymphoma complicated by a carcinoma is very rarely found in the same stomach. As far as we could determine in a search of the literature, the coexistence of a gastric cancer and a malignant lymphoma was found in only 30 cases including our case and collision was seen in 10 of these. Our report concerns a recent case of malignant gastric lymphoma colliding with II c early gastric cancer, and is followed by a discussion. The patient, a man of 68, had complained of epigastralgia. The case was diagnosed as a gastric malignant lymphoma after an upper gastrointestinal roentgenogram and endoscopy. A biopsy revealed a torous malignant lymphoma (diffuse medium-sized cell type) and an II c early gastric cancer (tub 2) and suggested the collision between them. PMID- 3312711 TI - [Squamous cell carcinoma and adenosquamous cell carcinoma of the thyroid gland]. AB - Two cases of a squamous cell carcinoma and an adenosquamous cell carcinoma of the thyroid gland are presented. Both cases have survived without recurrence for 18 months and 31 months respectively, although these cases have an unfavorable prognosis. A review of the Japanese literature reveals that these two tumors differ significantly in their clinical features. In cases involving a squamous cell carcinoma the ratio of female to male patients is lower, the duration of the illness before treatment is shorter, and the prognosis is poorer than those with an adenosquamous cell carcinoma. These features suggest that the carcinomas have a different histogenesis. PMID- 3312713 TI - [Implication of Ph1 translocation in chronic myelogenous leukemia]. PMID- 3312714 TI - [B cell malignancy associated with Sjogren syndrome and primary biliary cirrhosis: a case report and review]. PMID- 3312715 TI - [Progress in diagnosis and therapeutic systems in cholelithiasis]. PMID- 3312716 TI - [New diagnostic systems--technics, efficiency and limitations. Ultrasonic diagnosis. a) The biliary system viewed by ultrasound]. PMID- 3312717 TI - [New diagnostic systems--technics, efficiency and limitations. Ultrasonic diagnosis. b) Ultrasonic diagnosis of cholelithiasis. Diagnosis and physiopathology of cholelithiasis]. PMID- 3312718 TI - [Hepatolithiasis. Progress of diagnosis of hepatolithiasis]. PMID- 3312719 TI - [Concept, physiopathology and therapy of acute obstructive suppurative cholangitis]. PMID- 3312720 TI - Primary esophageal reconstruction after resection of the cancer in the hypopharynx or cervical esophagus: comparison of free forearm skin tube flap, free jejunal transplantation and pull-through esophagectomy. AB - Sixty-six patients with carcinoma of the hypopharynx or cervical esophagus received esophageal extraction and primary reconstruction. The methods of reconstruction were free forearm skin tube grafting, free jejunal transplantation and immediate pharyngo-gastrostomy after pull-through esophagectomy. Considering the postoperative complications of each method, free forearm skin tube transplantation is the safest, but it can only be used for a short defect of the esophagus. With pull-through esophagectomy, we are able to extract the whole esophagus and have no fear of leaving any remaining cancer in the thoracic esophagus, but the operative burden and the rate at which complications occur are higher. Free jejunal transplantation can be used for a short or long defect of the cervical esophagus with small operative burden. Among three methods of reconstruction, free jejunal transplantation is recommended for primary reconstruction of the cervical esophagus. PMID- 3312721 TI - A case report of pulmonary adenocarcinoma responding to (glycolato-0,0') diammineplatinum (II), a new platinum complex. AB - The first patient to respond to [(glycolato-0,0') diammineplatinum (II)] (254-S) in a clinical phase I study is reported. The patient was a 52-year-old man complaining of nausea and weight loss. A chest X-ray demonstrated a diffuse infiltrating shadow in the right lung. A transbronchoscopic brushing of the right upper lobe and a biopsy specimen from the right supraclavicular lymph node revealed adenocarcinoma of the lung. He was diagnosed as having primary lung cancer with distant lymph node metastasis. 254-S was administered by intravenous drip infusion to a dose of 100 mg/m2. Two weeks after the second 254-S treatment, a chest X-ray demonstrated a more than 50% reduction in the pulmonary shadow and met the WHO criteria for a partial response. Thrombocytopenia, leukocytopenia and moderate nausea were observed as adverse effects of 254-S but renal toxicity was not found. Pharmacokinetics of free platinum in this patient demonstrated biphasic decay with a peak plasma concentration of 8.09 micrograms/ml. A disease oriented phase II study of 254-S against non-small cell lung cancer should be performed to establish the efficacy of this new platinum complex. PMID- 3312722 TI - [Recent advances in the clinical aspects of diabetes mellitus]. PMID- 3312723 TI - [Determination of trace quantities of serum protein by latex photometric immunoassay using COBAS FARA]. PMID- 3312724 TI - [Distribution of endocrine cells based on difference of the pancreatic anlagen]. PMID- 3312725 TI - [Relationship between tumor cell invasion, metastasis and proteinases activities in squamous cell carcinoma, basal cell epithelioma and seborrheic keratosis]. PMID- 3312726 TI - [OKIa+ cells lining the dermo-epidermal junction in bullous pemphigoid]. PMID- 3312727 TI - Genetic recombination between closely linked makers of bacteriophage T4. IV. Mutations which interfere with mismatch repair. AB - T4 phage mutations MCO1 and MCO3 reduced recombination between multiple closely linked markers preferentially and were located between gene 24 and gene 25. The MCO1 and the MCO3 mutants complemented each other. The results of UV-cross reactivation experiments indicated that the MCO1 and the MCO3 mutants could rescue the markets of UV-damaged phage, but could not segregate them from flanking mutations. Therefore, it is concluded that MCO1 mutation and MCO3 mutation interfere with mismatch repair. PMID- 3312728 TI - Highly sensitive analysis of gangliosides in human cerebrospinal fluid with neurological diseases. AB - We have developed a new method for detection and determination of ganglio-series gangliosides by TLC/enzyme-immunostaining. By using this method, even 1 pmole of the gangliosides in cerebrospinal fluid (CSF) from gangliosidoses and other neurological patients could be measured quantitatively. The accumulation of the gangliosides in CSF was demonstrated from patients with gangliosidoses, thus, the diagnosis could be confirmed antemortem. PMID- 3312729 TI - [Production of monoclonal anti-Mallory body antibody]. PMID- 3312730 TI - [Actinomycosis of the ileo-caecal area--a case report and review of the literature]. PMID- 3312731 TI - [Study on group I pepsinogen producing gastric carcinoma by indirect immunoperoxidase staining (PAP-method)]. PMID- 3312732 TI - Retinal autoimmunity: two decades of research. AB - A brief review of our current knowledge of retinal autoimmunity and the pathogenesis of experimental autoimmune uveitis developed over the past two decades is presented. Attention is focused upon the discovery of retinal S antigen, its isolation and characterization, manifestations of the disease produced, mechanisms of experimental autoimmune uveitis, analysis of the activities of the peptide fragments of the antigen, and potential relationships of the model to human ocular disease. PMID- 3312733 TI - T-lymphocyte and experimental autoimmune uveoretinitis. AB - The immunopathogenic mechanisms underlying S-antigen-induced experimental autoimmune uveoretinitis (EAU) were discussed with particular emphasis on the cellular immune response on the basis of the following data: 1) athymic nude rats did not develop EAU unless sensitized lymphocytes obtained from heterozygous rats were transferred into the nude rats; 2) cyclosporine, an immunosuppressant selective to the T-lymphocytes, completely inhibited the cellular immune response to S-antigen as well as EAU induction; 3) a lymphocyte population having the capacity to produce interleukin 2 in response to S-antigen appeared prior to the onset of EAU; and 4) EAU was successfully transferred into syngenic animals by sensitized T-lymphocytes or by a T-cell line specific to S-antigen. These data were thought to indicate that the T-lymphocyte or the cellular immune response to S-antigen constitutes the essential factor for the development of EAU. PMID- 3312734 TI - Microtubules in neutrophils of patients with Behcet's disease--immunofluorescence microscopic study. AB - Cytoplasmic microtubules are one of the various components of the cytoskeleton. They are associated with transport of lysosomes and movement of the cell membrane. Augmentations of the lysosomal enzyme activity and chemotactic activity are found in the neutrophils of patients with Behcet's disease, and colchicine which induces microtubule depolymerization is effective in the treatment of this disease. We examined microtubules in the neutrophils of 24 patients with Behcet's disease, by an indirect immunofluorescence technique, to investigate the significance of the microtubules in this disease. The distribution of the microtubules was different between the patients in the exacerbation stage and normal subjects, and also between the exacerbation stage and the remission stage. These results suggested that microtubules play some significant role in the pathophysiology of Behcet's disease. PMID- 3312735 TI - [Recording the history of public health nursing: achievement of public health nurses in the past 30 years]. PMID- 3312737 TI - [A case of primary diffuse alveolar septal amyloidosis]. PMID- 3312738 TI - [General concepts and the history of chronic obstructive pulmonary disease]. PMID- 3312736 TI - [History of health clinics in Osaka. 1. Early days of public health clinics. (1). Socioeconomic trends associated with the clinics and creation of health counseling services]. PMID- 3312739 TI - [Chronic bronchitis and bronchiolitis]. PMID- 3312740 TI - [Urinary beta 2-microglobulin level and urinary N-acetyl-beta-D-glucosaminidase activity in acute pyelonephritis patients]. PMID- 3312741 TI - [A study of urological tumor associated antigens. II. Detection of ABH antigen by exfoliated urinary cells]. PMID- 3312742 TI - [The study of Thomsen-Friedenreich antigen and prognosis of the patients with bladder tumor]. PMID- 3312743 TI - Bringing nursing care to homeless guests: Barbara McInnis and the Pine Street Inn's Nurses' Clinic. Interview by Dianne M. Danis. PMID- 3312744 TI - Traumatic amputation and successful replantation of the left hand after an industrial accident. PMID- 3312746 TI - Nursing assessment of the ED patient with psychiatric symptoms: a quick reference. PMID- 3312745 TI - Emergency care of the patient with a traumatic amputation. PMID- 3312747 TI - Prevalence of previously undetected hypertension in patients with nonacute conditions. PMID- 3312748 TI - A follow-up program for ED patients. PMID- 3312749 TI - Understanding posttraumatic stress disorder in Vietnam veterans. PMID- 3312750 TI - Law and the emergency nurse: drug screening in the emergency department. PMID- 3312751 TI - Three hospital workers contract AIDS virus. PMID- 3312752 TI - Teaching as an art and a science: one philosophy and method of continuing education for the new nurse educator. PMID- 3312753 TI - Traumatic amputation. PMID- 3312754 TI - "Field" triage and management of an agitated trauma patient. PMID- 3312755 TI - Emergency nursing graduate programs. PMID- 3312756 TI - Pharmacological treatments of congestive heart failure: a look at yesterday, today and tomorrow. PMID- 3312757 TI - [New theories on the role of chylomicrons (alimentary lipemia) in the etiopathogenesis of arteriosclerosis]. PMID- 3312759 TI - Cellular calcium in ischemic acute renal failure: role of calcium entry blockers. PMID- 3312758 TI - [Amiodarone in acute myocardial infarction: a preliminary clinical trial]. PMID- 3312760 TI - Endotoxin provocation of experimental renal cystic disease. AB - Germ free rats provide a unique model in which to assess biological response to environment. In 48 germ-free male, Sprague-Dawley rats we examined the consequences of oral exposure to nordihydroguaiaretic acid (NDGA), a nephrotoxin; to Staphylococcus epidermidis and bacillus species, non-endotoxin-containing bacteria; to Escherichia coli and Proteus mirabilis, endotoxin-containing bacteria; and injected E. coli endotoxin on peripheral leukocyte counts and renal morphology. Morphological changes were evaluated by light microscopy and scored blindly on a 0 to 4+ scale for 15 parameters of renal structure. Means of these renal "pathology scores" correlated with counts of polymorphonuclear leukocytes and lymphocytes in the peripheral blood. The highest counts and scores were found in rats given NDGA and exposed to endotoxin, either by injection or by oral feeding of endotoxin-containing bacteria. Counts and scores were lower in the absence of endotoxin and with non-endotoxin-containing bacteria, given alone or in combination with either NDGA or endotoxin. Results exclude bacterial colonization and intrarenal accumulation of NDGA as causes of nephropathy. They indicate that endotoxin and NDGA act synergistically to provoke renal damage in the germ free NDGA-fed rat and suggest that leukocytes are involved in the process. PMID- 3312761 TI - Comparison of hemodialysis and hypertonic hemodiafiltration on cardiac function [corrected]. AB - This study compared the acute and chronic effects on cardiac function of treatment with hypertonic hemodiafiltration (H HDF) and hemodialysis (HD). Cardiac function was assessed before, during and after a run of H HDF and HD using echocardiography and impedance cardiography in 10 patients in a randomized cross-over sequence, two months after stabilization on each treatment. Blood biochemistry was performed before and after each run. Ejection fraction and fractional shortening were significantly higher before the H HDF run, compared to the HD run, and this difference persisted during and after the treatment runs (both P less than 0.05). There was a corresponding significant difference in the increase of the velocity of circumferential fiber shortening and in the reduction of end systolic diameter during and after H HDF (P less than 0.05). Heart rate, stroke volume, cardiac output, systemic vascular resistance and mean arterial pressure did not differ significantly between the two treatments. Plasma calcium and bicarbonate were significantly higher (P less than 0.03) at the start of H HDF and this difference was enhanced at the end of the run. In conclusion, H HDF compared with HD, is associated with a better myocardial function in both the short and long term treatments. The evidence suggests that this may be due to improved levels of plasma calcium, bicarbonate, and/or the removal of an as yet unidentified myocardial toxin. PMID- 3312762 TI - Immunopathogenesis of crescentic glomerulonephritis and lung purpura. PMID- 3312764 TI - [Echography of the posterior lens capsule before implantation of an artificial lens]. AB - Clinical echographic examinations were performed in 15 cases of traumatic cataract. As a result certain criteria were established which give some information on the condition of the posterior capsule of the lens. Echographic examination prior to reoperation enables the procedure to be optimized with regard to IOL implantation, anterior vitrectomy, or prevention of retinal detachment. PMID- 3312765 TI - [Evaluation of Scheimpflug photographs in transitory hypermetropia]. AB - Scheimpflug photography of lenses with transient hypermetropia in cases of diabetes mellitus revealed an enlargement of the axial diameter of the cortex and especially of the nucleus of the lens. This transient hypermetropia is thought to stem from a decrease in the refractive index of the lens cortex and nucleus. PMID- 3312763 TI - [Diagnosis of ocular Chlamydia infections by direct detection]. AB - Conjunctival smears of 75 patients with a presumptive diagnosis of oculogenital chlamydial infection were evaluated with the monoclonal antibody direct test (SyvaMerck and Orion Research). 69 isolates were correlated with McCoy cell cultures and serum IgG immunofluorescent tests. Sensitivity (100%) and specificity (56-76%) of the monoclonal antibody direct test was comparable to data from recently published studies on genital smears. PMID- 3312766 TI - [Spontaneous rejection of an intraocular foreign body]. AB - The right eye of a 17-year-old patient had been injured by a metallic, nonmagnetic foreign body which had perforated the eye at the limbus at 6 o'clock and become lodged in the posterior part of the ciliary body near the ora serrata. The operation to remove the foreign body was unsuccessful. After three months without any inflammatory reaction the patient noticed it in the conjunctiva. The splinter had been spontaneously rejected via the same route by which it had entered the eye; it was removed from the point of entry under local anesthesia. The special circumstances which, in the authors' opinion, led to spontaneous rejection of this foreign body are discussed. PMID- 3312767 TI - [An unusual case: episcleral and orbital varicose veins]. AB - A rare case of episcleral and orbital varix in a 16-year-old female is reported. The diagnosis was confirmed by CT scan and ultrasonography, and showed during Valsalva's maneuver a typical expansion of the orbital tumor. CT scan showed the tumor to be composed of a plexus of dilated vessels. During Valsalva's maneuver a 10 mm Hg rise in the venous pressure in the episcleral varix was noted, which suggests a direct communication between the episcleral and the orbital varices. PMID- 3312768 TI - [Lens implantation in glaucoma. Choice of surgery in various glaucoma situations]. AB - Eyes suffering from cataract and glaucoma often present particular situations which require particular surgical approaches. The technique to be chosen mainly depends on the depth of the anterior chamber, on the state of the pupil, and on whether or not a fistulizing operation has already been performed. According to the given situation, different surgical options need to be considered. Five such different situations are presented and relevant surgical procedures are described. Although lens implantation in glaucoma usually proves to be more difficult than in normal cataractous eyes, careful selection of an appropriate surgical technique usually provides a good surgical result. PMID- 3312769 TI - [The dawn of Polish strabismology]. PMID- 3312770 TI - [Proceedings of the scientific session of the Western Pomeranian Division of the Polish Ophthalmological Society dedicated to continuing the scientific work of Prof. Starkiewicz. Szczecin, 1985]. PMID- 3312771 TI - [Arrest of intraoperative expulsive hemorrhage without performing posterior sclerotomy]. PMID- 3312772 TI - [Marian Szwarc, rural ophthalmologist and performer of cataract extraction]. PMID- 3312774 TI - [Cardiocirculatory changes in various forms of shock]. PMID- 3312773 TI - [From the bibliographer's files (XXIX). 175, 150 and 100 years ago]. PMID- 3312775 TI - [Hemorrhagic-traumatic shock]. PMID- 3312776 TI - [Cardiogenic shock--diagnosis and therapy]. PMID- 3312777 TI - [Neurogenic and anaphylactic shock]. PMID- 3312778 TI - [Kidney function and shock]. PMID- 3312779 TI - [Measurement and interpretation of hemodynamic parameters in shock]. PMID- 3312780 TI - [Microcirculation disorders in shock]. PMID- 3312781 TI - [Disorders of cerebral function in shock--detection and interpretation]. PMID- 3312783 TI - [Reference values in the detection of disorders of homeostasis in shock]. PMID- 3312782 TI - [Detection and interpretation of intestinal function in shock]. PMID- 3312784 TI - Plasma fibronectin in abdominal sepsis and shock: therapeutic and prognostic value. PMID- 3312786 TI - [Reactions and changes in the endocrine organs in shock]. PMID- 3312785 TI - [Blood changes in shock: pathogenetic significance of mediators]. PMID- 3312787 TI - [Shock-induced changes in cell function]. PMID- 3312788 TI - Insulin binding to erythrocytes in hyperinsulinemic patients with precirrhotic hemochromatosis and cirrhosis. AB - This study investigated insulin receptor binding (number and affinity) to erythrocytes in patients with precirrhotic hemochromatosis, patients with cirrhosis, and healthy subjects. To evaluate plasma glucose and insulin levels, an oral glucose tolerance test (OGTT) was performed in all subjects. In the fasting state, all patients exhibited normal glucose levels. Precirrhotic patients showed slight impairment of glucose tolerance while cirrhotic patients were strikingly glucose intolerant. In both patient groups, fasting plasma insulin levels were increased. Following the glucose load, plasma insulin levels were significantly enhanced in precirrhotic patients at 90 and 120 min and increased at all times in cirrhotic patients. In the postabsorptive state (in the presence of hyperinsulinemia) insulin binding and the number and affinity of insulin receptors of erythrocytes were not different in precirrhotic or cirrhotic patients when compared to controls. We conclude that studies of insulin binding on erythrocytes do not contribute to the evaluation of the pathogenesis of insulin resistance in liver disease. PMID- 3312789 TI - Graft survival and long-term renal function after sequential conventional cyclosporin A therapy in cadaver kidney transplantation--a prospective randomized trial. AB - In a prospective randomized trial 50 renal transplant patients (group A) received a sequential course of 14 days conventional immunosuppression (Lymphocytoglobulin (ALG), azathioprine, steroids) and cyclosporin and steroids thereafter, while 50 patients (group B) received the conventional immunosuppression for 7 days followed by cyclosporin and steroids. In the latter group ALG was tolerated for the whole period while in the first group conversion from conventional to cyclosporin A therapy had to be performed after a mean of 11 days, due to ALG intolerance. Actual patient survival rates 1 year posttransplant were 100% in both groups and graft survival rates 96% in group A and 86% in group B (P less than 0.05). There was a mean dialysis frequency per patient of 0.7 +/- 2.0 in group A and 1.8 +/- 3.4 in group B (P = 0.064). Serum creatinine 1 year posttransplant was 1.8 +/- 0.8 mg/dl in group A and 2.2 +/- 1.4 in group B. A total of 58 patients had a serum creatinine of less than 2 mg/dl at the time of conversion to cyclosporin. These patients had a significantly better graft survival rate (98.3%) and serum creatinine 1 year posttransplant (1.6 +/- 0.5 mg/dl) than the 40 patients with a serum creatinine of more than 2 mg/dl at the time of conversion (85%; 2.4 +/- 1.4 mg/dl), indicating that a delayed onset of cyclosporin therapy might benefit the kidney in the immediate posttransplant period when it is susceptible to nephrotoxicity due to the damage from hypothermic storage. PMID- 3312791 TI - [Alcohol-induced lesions of the locomotor system]. PMID- 3312790 TI - [Thymalin in the treatment of patients with erysipelas]. PMID- 3312792 TI - [Prof. F. G. Ianovskii, Academician of the Ukrainian Academy of Sciences]. PMID- 3312794 TI - [Acquired immunodeficiency syndrome]. PMID- 3312793 TI - [Nikolai Nikolaevich Miklukho-Maklai as a physician]. PMID- 3312795 TI - [Effect of potassium on arterial pressure and its regulatory mechanisms]. PMID- 3312796 TI - [I.v. Davydovskii--an outstanding representative of Russian medicine]. PMID- 3312798 TI - [Madelung's syndrome]. PMID- 3312797 TI - [Immunological aspects of the development and treatment of insulin-dependent diabetes mellitus]. PMID- 3312799 TI - [Polyphepan (lignin) as an hypocholesteremic agent]. PMID- 3312800 TI - [Tactics in using glucocorticosteroids in status asthmaticus in patients with bronchial asthma]. PMID- 3312801 TI - Evaluation of renal functional image using Tc-99m DTPA. PMID- 3312802 TI - A comparison between stereotaxic operation and conservative therapy for thalamic hemorrhage. PMID- 3312803 TI - Quantitation of antibodies to DNA by the spot immunofluorescence test system. PMID- 3312805 TI - [Pediatric sonography]. PMID- 3312804 TI - Right ventricular ejection fraction assessed by digital subtraction angiography using videodensitometric analysis. PMID- 3312806 TI - Reproduction, development and physiology of the gray short-tailed opossum (Monodelphis domestica). AB - The gray short-tailed opossum (Monodelphis domestica) has become a useful marsupial for biomedical research since it breeds reliably in the laboratory. During a 3 year period (1983-1986), a total of 129 litters were born in the colony at NJMS resulting in five generations of captive-born animals. Litter size ranged from 2 to 13 and the average sex ratio at weaning was 1:1. Mean body temperature of M. domestica was approximately 32.3 degrees C and respiratory rate approximately 54 breaths/minute. Systolic blood pressures of approximately 188 mmHg and heart rates of 345 beats/minute were found. Techniques of blood collection, anesthesia, implanting of hormones, ovariectomies and castrations, and treatment of neonates are described as well as current practices of colony management. PMID- 3312807 TI - The silvered leaf monkey (Presbytis cristata) as a model for human bancroftian filariasis. PMID- 3312808 TI - Hepatic copper and metallothionein distribution in Wilson's disease (hepatolenticular degeneration). AB - Wilson's disease is a rare inherited disorder of copper (Cu) metabolism characterized by the deposition of Cu in the liver, brain, and cornea. The levels of metallothionein (MT), Cu, and zinc (Zn) in the livers of two Wilson's disease patients were analyzed in this study. About 50-fold increase in the Cu levels above normal controls was observed in both patients (160 and 298 micrograms/g of wet tissue). About 73% of subcellular Cu was present in the cytoplasmic fraction and most of it was in association with MT. Analysis of hepatic MT levels showed a 3-fold increase (863 micrograms/g of wet tissue) over control human levels (321 micrograms/g of wet tissue). The two forms of MT (MT-I and MT-II) were isolated from one liver sample. Both forms contained high amounts of Cu (11 to 12 g atoms/mole), indicating saturation of MT which had only 2 to 3 g atoms of zinc. The distribution of MT in the hepatocytes was investigated using an immunohistochemical method. In tissue sections with minimal tissue damage, there was intense cytoplasmic staining for MT in hepatocytes whereas both nuclear and cytoplasmic staining was found in tissue sections with extensive necrosis and fibrosis. These results suggest that MT is the major hepatic Cu-binding protein in Wilson's disease, that it is present in a form saturated with Cu, and that only in degenerating hepatocytes is it found in the nucleus as well as the cytoplasm. PMID- 3312809 TI - Hyperplastic polyps of the colon and rectum. An immunohistochemical study with monoclonal antibodies against blood groups antigens (sialosyl-Lea, Leb, Lex, Ley, A, B, H). AB - We studied 40 hyperplastic polyps (HP) immunohistochemically with monoclonal antibodies against 8 different blood group antigens (BGA) comparing their reactivity with normal control colon and colorectal adenocarcinomas. The 8 BGA studied were: Sialosyl-Lea, Lea, Leb, Lex, Ley, A,B, and H. sialosyl-Lea, Lea, Lex, and Ley can be though of as differentiation antigens. The former 2 BGA are expressed on mature (differentiated) epithelium while the latter 2 BGA are expressed by undifferentiated epithelium of the crypt base. A, B, H and Leb are not expressed in the normal distal colon, however, they are extensively expressed on distal colorectal cancers and adenomas and can be considered oncofetal BGA. HP expressed Lea, Lex, Ley in the same compartment of the crypt as normal colon and extensively expressed Sialosyl-Lea throughout the entire length of the crypt. This latter finding indicated maturation at a lower point in the crypt than in normals. All HP failed to express B and H BGA, while 6 of 40 expressed Leb and 5 of 40 HP expressed A BGA. Of the 6 HP expressing Leb BGA, 3 were from patients with synchronous or metachronous cancers and 2 from patients with mixed hyperplastic polyp-adenomas (HP/AD). Two of the HP expressing A BGA were from patients with HP/AD. The expression and distribution of these BGA in HP, especially the extensive expression of sialosyl-Lea correlates with the known cell kinetics of HP. While nonneoplastic in nature, HP may occasionally express true oncofetal BGA. Similarly, the HP component of HP/AD may also express true oncofetal BGA. These data suggest that the lesions classified morphologically as HP may be antigenically heterogenous. PMID- 3312810 TI - Immunogold labeling of cerebrovascular and neuritic plaque amyloid fibrils in Alzheimer's disease with an anti-beta protein monoclonal antibody. AB - A monoclonal antibody raised to a synthetic peptide consisting of residues 8 to 17 of the amyloid beta protein of Alzheimer's disease was employed for immunogold electron microscopic studies on amyloid fibrils of cerebrovascular walls and neuritic plaques in this disease. Electron microscopy revealed a specific gold labeling of the amyloid fibrils in these structures. This provides ultrastructural evidence that beta protein is intimately associated with the amyloid fibril. With previous chemical evidence, this observation supports the concentration that it is an intrinsic component of the fibril. PMID- 3312811 TI - An early refutation of a states' rights medicine doctrine. PMID- 3312812 TI - Flash! PMID- 3312813 TI - Daniel Warren Brickell, M.D., 1824-1881. PMID- 3312814 TI - Thomas T. Earle, M.D., 1845-1921. PMID- 3312815 TI - Effects of computer-assisted instruction on selected interaction skills related to responsible sexuality. AB - This study examined effects of computer-assisted instruction on decision-making, assertiveness, and interpersonal communication related to responsible sexuality. Health science classes from four secondary schools in three midwestern states participated in the quasi-experimental study. The Experimental Group (n = 151) received simulation-based CAI, while Control Group #1 (n = 147) received regular classroom instruction, and Control Group #2 (n = 93) received no intervention. A 46-item questionnaire was administered to determine changes in the dependent variables. Findings indicated CAI, but not RCI, effectively improved decision making knowledge and behavior, assertiveness knowledge and behavior, and interpersonal communication knowledge, attitude, and behavior. However, CAI did not improve assertiveness attitude. Over a five-week period, the effectiveness of CAI decayed for the knowledge variables. The effectiveness of CAI varied according to subject's gender, grade, and school-community setting. Results suggest simulation-based CAI provides an instructional approach that promotes positive change in some interaction skills related to responsible sexuality without many of the risks inherent in regular classroom instruction involving such sensitive topics. PMID- 3312816 TI - Occupational health--past and future. PMID- 3312817 TI - Maximum performance tests of speech production. AB - The maximum performance tests of speech production are those tests that examine the upper limits of performance for selected speech tasks. Among the most commonly used maximum performance tests are the following: maximum duration of phonation, maximum fricative duration, maximum phonation volume, maximum expiratory pressure, fundamental frequency range, maximum sound pressure level, maximum occluding force of the articulators, and diadochokinetic (maximum repetition) rate. Many clinicians use at least some of these tasks as part of an assessment protocol. These tests are analogous to strength, range, or speed tests in clinical neurology. Given the widespread use of these tests and a rather scattered literature on normative values obtained for them, a survey of the data base seemed in order. This paper summarizes the published normative data, discusses the adequacy of these data for clinical application, and recommends interpretive guidelines to enhance the usefulness of maximum performance tests. PMID- 3312818 TI - Different clinical perspectives of good and poor therapy sessions. AB - This study investigated differences in causal attributions made by student clinicians taking actor and observer roles in good and poor therapy sessions. One hundred thirty-four graduate student clinicians in speech-language pathology were asked to imagine a hypothetical good or poor therapy session in which they took either the role of a clinician working with a client in a session or that of a clinician observing the session. To account for the session's hypothesized outcomes, clinicians taking the actor role cited client causes more frequently than other causes while clinicians taking the observer role cited clinician causes. These results are consistent with the actor-observer bias documented extensively in the psychological and educational literatures. Clinicians' causal attributions also differed for good and poor therapy sessions. Implications are discussed in terms of possible impact on the clinical training process in speech language pathology. PMID- 3312819 TI - Shear bond strength between composite resin and variably etched/prepared enamel. Etched enamel shear bond strength. PMID- 3312821 TI - Verbal report methods in clinical research on alcoholism: response bias and its minimization. AB - Verbal report procedures, such as interviews, tests and questionnaires, have become the dominant method to obtain clinical data on alcohol abuse and its modification through treatment. The extent to which this method provides reliable and valid information for research purposes, and how its accuracy and usefulness can be enhanced, is examined. A review of methodological studies in the alcohol literature shows that although the information obtained from alcoholics and heavy drinkers tends to be reliable and valid, there can be considerable variability in accuracy, depending on the sensitivity of the information sought, the specificity of the validation criteria, the personal characteristics of the respondents and the demand characteristics of the task. It is suggested that the question of whether verbal report procedures are valid or invalid is less important than the issue of how they can be improved to the point that confidence can be placed in their findings. To facilitate this process, methodological techniques likely to enhance validity are reviewed. PMID- 3312820 TI - Production and characterization of monoclonal antibodies to 17 alpha hydroxyprogesterone. AB - Hybridoma clones producing antibodies to 17 alpha-hydroxyprogesterone (17-OHP) were established by using a 17-OHP-bovine serum albumin conjugate as an immunogen. Six representative IgG-class monoclonal antibodies of high affinity (10(8)-10(9) M-1) showed differential reactivities with several structurally related steroids. Two enzyme immunoassay (EIA) systems (fluorescence EIA and micro-EIA) for 17-OHP using OHP 4B2.2.3, which showed the lowest cross-reactivity with other steroids, were established. The micro-EIA system was shown to be applicable to the mass-screening of congenital adrenal hyperplasia. PMID- 3312822 TI - Long-term hemodynamic results after cardiac transplantation. AB - Although survival after cardiac transplantation has improved since the introduction of cyclosporine to clinical practice in 1980, the long-term hemodynamic results of transplantation in cyclosporine-treated recipients has not been reported. Annual cardiac catheterization data for 109 cyclosporine-treated recipients were analyzed and compared to those of a nonconcurrent group of 65 recipients treated with azathioprine and corticosteroids. Recipient age, donor age, sex, and human leukocyte antigen mismatch were comparable for the two groups. Satisfactory left ventricular function of the cyclosporine-treated heart was characterized on the first annual study by a normal ejection fraction (60% +/ 10%), cardiac index (3.0 +/- 0.8 L/min/m2) and stroke work index (53 +/- 15 gm m/m2) associated with moderately increased left ventricular end-diastolic pressures (12 +/- 6 mm Hg) and significantly increased mean aortic pressures (116 +/- 8 mm Hg). With the exception of aortic diastolic pressure, which tended to increase with time, the mean values of each variable analyzed did not change significantly over the period of study. In comparison to the azathioprine group, the cyclosporine cohort displayed higher aortic, left ventricular end-diastolic, and pulmonary artery pressures and produced more stroke work at each annual study. Analysis of the azathioprine group over extended (8 year) follow-up suggested excellent preservation of graft function. In summary, the long-term hemodynamic function of the transplanted heart treated with cyclosporine was satisfactory, demonstrated no deterioration over 5 year follow-up, but manifested substantially greater hypertension than hearts from the pre-cyclosporine era. PMID- 3312823 TI - Alexis Carrel: a cardiovascular prophet crying in the wilderness of early twentieth century surgery. PMID- 3312824 TI - Protection of ischemic myocardium by exogenous phosphocreatine. II. Clinical, ultrastructural, and biochemical evaluations. AB - In valve replacement operations on 78 patients with acquired heart disease, the efficiency of phosphocreatine in intraoperative protection of ischemic myocardium was evaluated by clinical, morphologic, and biochemical methods. Phosphocreatine (8 to 10 mmol/L) in a blood cardioplegic solution was used in operations on 41 patients; in the control group (37 patients) standard blood cardioplegia was used. In the group with phosphocreatine treatment we observed more rapid recovery of hemodynamics after release of the aortic cross-clamp, a decreased frequency of fibrillation, and more frequent restoration of sinus rhythm even if there were sinus rhythm disturbances before aortic cross-clamping. Analysis of the biopsy samples taken from the right ventricle showed protection of the sarcolemma against ischemic damage afforded by phosphocreatine and complete preservation of high-energy phosphates. The results obtained confirm the conclusion made by Robinson, Braimbridge, and Hearse (J Thorac Cardiovasc Surg 1984; 87:190-200) that phosphocreatine is an effective additional cardioprotective agent when used in cardioplegic solutions. PMID- 3312825 TI - Prevention of aorta-coronary bypass graft occlusion. Beneficial effect of ticlopidine on early and late patency rates of venous coronary bypass grafts: a double-blind study. AB - The efficacy of coronary bypass grafting obviously being linked to graft patency, it is compulsory to look for any innovation that could improve the patency rate. Ticlopidine, an antiplatelet drug, was tested against placebo in a double-blind trial: 173 patients (475 grafts) subjected to venous coronary artery bypass grafting were randomly treated with ticlopidine (250 mg twice daily) or placebo from the second postoperative day for 12 months. Graft patency was assessed by digital angiography on days 10 (99.4% of the patients), 180 (98.2%), and 360 (91.7%). The effect of treatment on platelet aggregation and bleeding time were measured concomitantly; a clear-cut effect was demonstrated at each interval. Intention-to-treat graft-by-graft analysis shows that ticlopidine significantly reduced the graft occlusion rate on day 10 (7.1% versus 13.4%, p less than 0.05), day 180 (15.0% versus 24.0%, p less than 0.02), and day 360 (15.9% versus 26.1%, p less than 0.01). Sequential grafts to the left anterior descending coronary artery, with side-to-side anastomosis to diagonal branch(es), are less frequently occluded than individual grafts. On the contrary, grafts to endarterectomized vessels occlude more frequently. Individual patient-by-patient analysis shows that patency of all grafts at each study time, is more frequent in the ticlopidine group. The difference is significant when one considers patients without sequential or endarterectomized grafts. The difference is also present at each study time: day 10 (84.4% versus 66.7%, p less than 0.05), day 180 (74.4% versus 52.3%, p less than 0.05) and day 360 (75.0% versus 52.5%, p less than 0.05). Results are even more impressive if one excludes from analysis the four patients in the ticlopidine group in whom administration of the drug was delayed. This supports previous suggestions that early therapy is necessary. These results show that graft occlusion occurs mainly in the first 6 postoperative months. The incidence of occlusion is significantly reduced by ticlopidine therapy. PMID- 3312826 TI - Studies on the differentiation of the human myelomonocytic cell line RC-2A in response to lymphocyte-derived factors. AB - Cells of the human myelomonocytic line RC-2A were induced to differentiate toward macrophages by culturing for up to 12 days in the presence of supernatant from phytohaemagglutinin stimulated human peripheral blood mononuclear cells (PHA LCM). The process of differentiation was monitored by changes in expression of two-macrophage related enzymes (alpha-naphthol butyrate esterase and acid phosphatase), the changes in expression of the monocyte-macrophage cell surface markers detected by the monoclonal antibodies anti-Mo1 and anti-Mo2, HLA class 2 antigen detected by FMC-14, and alteration in cell morphology. Maturation induced by PHA-LCM was accompanied by a marked decrease in the proliferative potential of the cell population, and a reduced ability to form colonies in semi-solid medium. Induced RC-2A cells were able to stimulate in one-way mixed leukocyte culture more effectively than control cells. PMID- 3312827 TI - Serial measurements of beta-2-microglobulin in plasma correlates with white blood cell counts and haptocorrin in chronic myeloid leukemia. AB - The fate of beta-2-microglobulin was investigated in 17 patients with chronic myeloid leukemia by correlation analysis of the plasma concentration and various clinical measurements. The plasma concentration of beta-2-microglobulin correlated individually with white blood cell count, differential counts of band and segmented neutrophils, metamyelocytes and myelocytes, and haptocorrin concentration during the clinical course (p less than 0.002). The neutrophil granulocytes from the differential stage of myelocytes appears to be a major source of beta-2-microglobulin in chronic myeloid leukemia, and our results suggest that beta-microglobulin is is contained within the specific granules or is liberated from the plasma membranes synchronously with degranulation of neutrophils. PMID- 3312828 TI - Genomic diversity of Philadelphia-positive chronic myelogenous leukemia. AB - The incidence of breakpoints in CML patients with variant translocations was investigated. There was no relationship between the length of various chromosomes with breakpoint frequency. However, a significantly higher (p less than 0.05) incidence of breaks were seen on the long arms as compared to the short arms due mainly to the involvement of 9q and 22q in these translocations. Chromosome 17 showed a significantly (p less than 0.005) higher involvement in these translocations, however only when 9q34-qter was not cytogenetically involved. A total of 683 breaks were found in 225 cases. 362 of these were located at c-abl and c-sis, while 110 were at other oncogenetic sites. The prognostic and hematologic features of patients with variant translocations are not significantly different from those of CML cases with the typical 9q;22q translocation. Some of these complex translocation, where the breakpoints are correlated with oncogenetic sites, are further discussed in molecular terms. PMID- 3312829 TI - Artificial intelligence and artificial organs. PMID- 3312831 TI - More news from the molecular front: the human genetics 1985 symposium, October 2 4, 1985 (Paris, France). PMID- 3312832 TI - Leukemia and the regulation of hematopoiesis. PMID- 3312830 TI - New structural chromosomal rearrangements in congenital leukemia. AB - The karyotypic abnormalities and clinical data on three patients in whom acute leukemia was diagnosed within the first 6 months of life are presented. The four structural chromosomal rearrangements detected in the bone marrow from these patients, i.e., t(7;12)(q36;p13) and t(1;19)(q11;q11) in case 1, t(2;10;11;12)(q21q31;p13;q13;q24) in case 2, and t(11;19)(q23;p13) in case 3, have not previously been associated with congenital leukemia. Acquired chromosomal changes have until now been reported in only 31 leukemic infants in this age group. Of the total material, 18 patients had acute lymphoblastic leukemia and 16 had acute nonlymphocytic leukemia. The by far most frequently recorded cytogenetic aberration has been t(4q;11q), seen in 14 cases of lymphoblastic leukemia. Although t(4q;11q) has not been found in a single patient with acute nonlymphocytic leukemia, these leukemias have often had other rearrangements involving the same region of 11q. Hence, genetic material around 4q21 may be active in lymphocytic differentiation, whereas gene(s) in 11q23 may be important in the neoplastic process in a less cell-type specific manner and perhaps particularly vulnerable to neoplastic rearrangement in fetal life. The finding of four cases out of 34 with translocations between 11q23 and chromosome 19 indicates that this rearrangement might characterize a specific cytogenetic subgroup of leukemia in the very young. PMID- 3312833 TI - Classification of acute myeloid leukemias--a comparison of FAB and immunophenotyping. AB - A large number of monoclonal antibodies (McAbs) directed against components on myeloid (granulocytic/monocytic) cells have been generated. Individual McAbs were identified which are selectively reactive with antigenic determinants expressed by myeloid cells at specific stages of differentiation in a lineage-restricted fashion. The composite phenotype obtained by a combination of antimyeloid McAbs allows for a precise definition of the normal or malignant cell type under investigation. Cell binding studies on normal and leukemic cells and the biochemical characterization of the antigens provided the basis for a grouping of those antimyeloid McAbs into clusters of differentiation (CD). The reactivity patterns of CD11, CD13, CD14, CD15, and CD33 McAbs and the characteristics of the respective antigens are reviewed. These CD McAbs distinguish leukemic cells of myeloid from those of lymphoid origin. The monocytic nature of AML cells can be recognized by CD14 McAbs, whereas the other CD McAbs react with both monocytic and nonmonocytic types of acute myeloid leukemia. The expression of these differentiation antigens is not concordant with the morphological-cytochemical French-American-British (FAB) classification of leukemia; nevertheless, tendencies for agreement are apparent. If used in combination, FAB typing and immunophenotyping could provide complementary information. Their potential use for mapping of myeloid differentiation and for cell type recognition in leukemia phenotyping demonstrates the utility of antimyeloid CD McAbs for biological or clinical investigations. The diagnostic value of antimyeloid McAbs is enhanced if the reagents are included in a panel of McAbs standardized for routine immunophenotyping. PMID- 3312834 TI - Heterogeneity in expression of the bcr-abl fusion transcript in CML blast crisis. AB - The 9;22 Philadelphia chromosome translocation in chronic myelogenous leukemia (CML) generates a bcr-abl fusion gene which codes for an aberrant 8-kb bcr-abl hybrid message. CML blast crisis cell lines display enhanced in vitro expression of this aberrant bcr-abl transcript when compared with fresh CML chronic phase cells. We directly compared in fresh patient samples the level of expression of the bcr-abl transcript in CML blast crisis versus chronic phase cells. All chronic phase patients displayed relatively low amounts of this aberrant transcript, while four of 10 blast crisis patients expressed this transcript at significantly higher levels. The remaining six blast crisis samples exhibited low levels of the aberrant transcript comparable to chronic phase cells. The two patients displaying the highest levels of the bcr-abl transcript did not harbor amplified copies of the bcr-abl fusion gene. This heterogeneity in the level of expression of the bcr-abl transcript in CML blast crisis indicates that enhanced expression of this aberrant transcript is not an absolutely necessary condition for blast transformation. PMID- 3312835 TI - Juvenile chronic myeloid leukemia: therapeutic insights. AB - Twelve children with juvenile chronic myeloid leukemia (JCML) received chemotherapy or bone marrow transplants. The median survival of the patients treated with myelosuppressive agents was 19 months. These results demonstrate that intensive chemotherapeutic and supportive measures can prolong survival in JCML but do not affect ultimate outcome. Purported differentiation inducers--low dose ara-C and 13-cis-retinoic acid--were not effective in two patients. Two patients were prepared for bone marrow transplantation with standard antileukemic cytoreduction regimens; one died very early post-transplant, and the other had early reemergence of his disease. The third transplant patient underwent transplantation after his disease had entered an accelerated phase. He received a different immunosuppressive pretransplant regimen, but the leukemia recurred. The latter two patients initially engrafted with mismatched T cell-depleted marrow grafts, but had recurrence of the disease. Our data suggest that marrow transplantation is possible for JCML patients without HLA-identical donors, but for successful marrow transplantation different measures are necessary to eradicate the abnormal stem cell compartment. PMID- 3312836 TI - Deletion of c-fms sequences in the 5q- syndrome. AB - Southern blot analyses demonstrated hemizygosity of c-fms sequences in three cases of the 5q- syndrome, cytogenetically characterized by del(5)(q13;q35) or del(5)(q31;q35). In situ hybridization studies revealed a deletion of this oncogene from the 5q- chromosome in two cases; moreover, we localized c-fms to region 5q31-33. PMID- 3312837 TI - Stochastic or ordered lineage commitment during hemopoiesis? PMID- 3312839 TI - The UCLA experience with type I interferons in hairy cell leukemia. AB - Fifty-one patients have been entered on clinical trials of interferon in hairy cell leukemia. Hematological improvement was seen in 23 (96%) patients treated with recombinant alpha-2b-interferon, nine patients (69%) treated with lymphoblastoid alpha-N1-interferon, and, thus far, in five (71%) patients beginning therapy with recombinant beta-serine-interferon. All patients showing improvement have done so within 1 year and most within 6 months. Rapidity of response, duration of follow-up, and toxicity data are presented. PMID- 3312840 TI - Guidelines for the treatment of hairy cell leukemia. PMID- 3312838 TI - Expression of major histocompatibility class I genes in differentiating leukemic cells is temporally related to activation of c-fos proto-oncogene. AB - The relationship between the expression of the c-fos proto-oncogene and the expression of the class I major histocompatibility (MHC) antigens during the early stages of induced differentiation in three different leukemic cell lines was examined. In the U937 histiocytic lymphoma line TPA induced an increase in mRNA and cell surface MHC expression which followed induction of c-fos. In contrast, in the murine erythro-leukemia cell line, DMSO induced declining constitutive c-fos levels that were accompanied by declining mRNA and cell surface MHC expression. In the pluripotent HL60 promyelocytic line induction of macrophage differentiation with TPA led to c-fos induction and rising MHC levels, whereas induction of granulocyte differentiation with DMSO did not induce c-fos expression and was followed by declining MHC levels. Taken together, the results suggest that the c-fos proto-oncogene might be involved in the control of class I MHC antigen expression during differentiation. PMID- 3312842 TI - The evolution of chemotherapy of lymphomas of adults. AB - Patients with advanced stages of Hodgkin's disease and diffuse large-cell lymphoma are curable with combination chemotherapy. The studies conducted at the National Cancer Institute over the past 20 years are reviewed along with pertinent studies conducted elsewhere. It is the author's contention that there is room for considerable improvement in results with existing therapy if greater attention is paid to dosing and less to trying to improve, by slight modifications, on treatments that should be regarded as a temporary stage in the development of standard lymphoma treatment. PMID- 3312841 TI - Effect of deferoxamine on DNA synthesis, DNA repair, cell proliferation, and differentiation of HL-60 cells. AB - The ribonucleotide reductase inhibitors deferoxamine and hydroxyurea induce monocyte-macrophage cell differentiation in the leukemic cell line HL-60 as judged by the expression of cell surface antigens, nonspecific esterase activity, and morphological changes. Treatment of HL-60 cells with deferoxamine results in inhibition of DNA synthesis and irreversible loss of colony-forming ability. In addition, both deferoxamine and hydroxyurea caused an increase in the number of DNA strand breaks in HL-60 cells. A DNA methylating agent, N-methyl-N'-nitro-N nitrosoguanidine, also caused cellular differentiation in HL-60 cells associated with DNA strand breaks. These observations are consistent with a role for DNA damage or for inhibition of DNA synthesis and repair in the differentiation process of HL-60 cells. PMID- 3312843 TI - A computer program for interpreting immunophenotypic data as an aid to the diagnosis of leukemia. AB - A computer program has been developed for interpreting the immunophenotypic data obtained in cases of leukemia. It has been designed as a logic program, and its reasoning is based entirely on that used by one experienced immunologist. For each case the program gives a conclusion (qualified if necessary), a summary of the underlying reasoning, and suggestions for any further investigations that may be of benefit. Its performance has been considered acceptable for every one of 400 past cases, and these include various uncommon and atypical conditions. PMID- 3312845 TI - Immunophenotypic analysis of neoplastic cells in follicular dendritic cell sarcoma. AB - The existence of a sarcoma derived from the antigen-presenting follicular dendritic cells (FDCs) has been assumed but never confirmed. This report describes a tumor from axillary lymph nodes of a 39-year-old male in which the morphologic, enzyme histochemical, and immune phenotypic data are consistent with the malignant cells being of FDC origin. Morphologically, the tumor showed a tendency toward bi- and polynucleation with areas of storiform growth pattern, resulting in an initial diagnosis of malignant fibrous histiocytoma. However, the tumor cells had interconnections with well-developed desmosomes. Enzyme histochemistry revealed strong 5'-nucleotidase activity. Immunohistologic analysis showed that tumor cells expressed two of three FDC-specific antigens (Ki M4, BU-10, and R4/23) strongly. Virtually all myelomonocytic markers were absent. Like normal FDCs, the leukocyte antigens CD35, CD19, CD21, and CD23 were expressed strongly and CD4 antigen weakly. No staining was evident for CD45 antigen, and no nonhemopoietic cell markers were expressed. The origin of the normal FDC is obscure. Given some evidence suggesting a bone marrow origin for the FDC, this cell may represent a lineage distinct from other known cell lineages derived from bone marrow stem cells since its immune phenotype differs considerably from them. PMID- 3312844 TI - Abnormalities of the short arm of chromosome 9 with partial loss of material in hematological disorders. AB - Clinical, hematological, and cytogenetic data of 32 patients with loss of part of the short arm of chromosome 9 (9p-) are reviewed. There were 20 acute lymphoblastic leukemia (ALL), seven non-Hodgkin lymphoma (NHL), three acute myeloid leukemia, one refractory anemia with excess blasts in transformation, and one chronic myeloid leukemia (CML) in blast crisis. The cytogenetic findings were heterogeneous: 13 cases of del(9)(p21), among them four as sole karyotypic change; five cases of del(9)(p12), three of them as sole karyotypic change; four patients with i(9q), three with unbalanced translocations involving 9p12; and seven with unbalanced translocations involving 9p21. In addition, 10 patients showed known specific translocations for determined subgroups of ALL, NHL, and CML. The immunological phenotypes in the 20 ALL patients were common ALL (35%), pre-B-ALL (35%), B-ALL (5%), T-ALL (15%), and null ALL (10%). Three NHL were of T cell origin and the others of B cell origin. No specific association between the karyotypic change, immunophenotype, and clinical presentation could be ascertained for patients with ALL, acute myeloid leukemia, CML in blast crisis, and B-NHL. In T-NHL, three children with deletion of 9p, T immunoblastic lymphoma originating from common thymocyte and presenting with a mediastinal mass and pleural effusion may constitute a definite subgroup with good prognosis. All other cases had a poor outcome. Previously suggested association of 9p- with T ALL and "lymphomatous features" was not confirmed. PMID- 3312846 TI - Low dose cytosine arabinoside in myelodysplasia and acute myelogenous leukemia: a review. AB - We analyzed clinical trials of low dose cytosine arabinoside (LDARA-C) in 324 patients with acute myelogenous leukemia (AML) and 129 patients with myelodysplasia (MDS). Complete and partial remission rates were 31% and 18%, respectively, in patients with AML, and 24% and 27% in patients with MDS. Toxicity was primarily hematologic. Although in vitro data suggested that LDARA-C acts as a differentiating agent, clinical data generally indicate a cytotoxic mechanism. Given the lack of effective therapeutic options in MDS and high risk AML (patients greater than 65 years old, secondary AML), these data are encouraging. LDARA-C warrants further study, comparing continuous infusion with intermittent subcutaneous administration and comparing LDARA-C to conventional dose therapy. PMID- 3312847 TI - Biosynthetic granulocyte-macrophage colony-stimulating factor enhances neutrophil cytotoxicity toward human leukemia cells. AB - Purified biosynthetic (recombinant) human granulocyte-macrophage colony stimulating factor (GM-CSF) enhances antibody-dependent cell-mediated cytotoxicity (ADCC) of human neutrophils toward human promyelocytic leukemia cells (HL-60), B-lymphoma cells, and human T-leukemia virus II-infected human B lymphoblastoid cells. The stimulation of antibody-dependent cell-mediated cytotoxicity is rapid (less than an hour), occurs at picomolar concentrations of GM-CSF, and does not require the presence of GM-CSF during the killing reaction. Therefore, neutrophils may be targeted toward tumor cells by antibody and their tumoricidal activity enhanced by GM-CSF in vitro. These results suggest that GM CSF may have therapeutic utility in cancer therapy by increasing the number and activity of effector cells directed toward tumors by receptors to the immunoglobulin Fc fragment. PMID- 3312849 TI - Early French Revolutionary studied medicine in Paris. PMID- 3312848 TI - Hodgkin's disease-derived cell lines--conflicting clues for the origin of Hodgkin's disease? AB - The origin of Hodgkin (H) and Reed-Sternberg (RS) cells remains a highly controversial issue. Studies on noncultured, freshly disaggregated biopsy material or of histological sections have not definitely established the cell lineage of HD cells, although evidence has been gathered that has allowed interpretation to favor one or the other hematopoietic cell type. In recent years a number of cell lines have been established from patients with Hodgkin's disease (HD) which are claimed to represent in vitro counterparts of H-RS cells. The phenotypic and functional properties of 7 HD-derived cell lines are reviewed here. The cell lines are not identical; they show many common features, but also a number of important differences in their phenotypes as well as in their in vitro behavior. The cell lines differ with some having characteristics of T cells, others of B cells, and yet others of the monocyte/macrophage cell lineage. This heterogeneity of H-RS established cell lines could be explained in a variety of ways: (a) the heterogeneity of HD itself might result from a disease process which leads to fusion of different cell types resulting in different phenotypic forms of H-RS cells depending on the cells involved; (b) the different cell types might reflect differences in the malignant cells present in the separate subtypes of HD; (c) the difficulty in successfully establishing H-RS cell lines might mean that unrepresentative cell types adapt to in vitro conditions. Rather than resolve the origin of H-RS cells, the established HD-derived cell lines have been consistent with the heterogeneity described in histochemical, immunohistological, and immunocytochemical studies. PMID- 3312850 TI - Symposium on antimicrobial agents. The quinolones. AB - The fluoroquinolones are a new class of antimicrobial agents structurally related to nalidixic acid. They have a broad spectrum of activity against pathogens, including Pseudomonas aeruginosa, other multiresistant gram-negative bacteria, and methicillin-resistant Staphylococcus aureus but not anaerobes. They are well absorbed after oral administration, and some achieve serum and tissue levels well exceeding the minimal inhibitory concentrations for susceptible bacteria. Adverse reactions are rare, and when they occur they are usually mild. Use of quinolones should be avoided in children because of possible damage to developing cartilage. These agents should prove useful in the treatment of urinary tract infections caused by bacteria resistant to other oral agents, bacterial gastroenteritis, and gonococcal infections. The use of quinolones may potentially reduce the cost of treatment of certain systemic infections caused by multiantimicrobial resistant organisms because outpatient oral therapy is possible. PMID- 3312851 TI - Symposium on antimicrobial agents. Metronidazole. AB - Metronidazole, a nitroimidazole derivative, is a unique antimicrobial agent that is active against both bacterial and parasitic organisms, although only the anaerobic members of these groups are susceptible. It has been used for the treatment of trichomoniasis for almost 30 years and is also effective in amebiasis and giardiasis. More recently, metronidazole has emerged as a principal agent for the treatment of anaerobic infections. It is highly effective against all species of anaerobes except certain non-spore-forming gram-positive bacilli and cocci and is the only agent rapidly bactericidal against the Bacteroides fragilis group. The hydroxy metabolite is 65% as effective as metronidazole and may play a major therapeutic role. Clinical studies have substantiated its efficacy for prophylaxis during elective colorectal surgical procedures and the treatment of deep abdominal sepsis (usually in combination with another agent such as an aminoglycoside). Metronidazole is the treatment of choice for bacterial vaginosis and seems to be as effective as vancomycin for treatment of Clostridium difficile-related diarrhea and colitis. Good blood levels are produced after both oral and intravenous administration, and side effects are infrequent and minimal. Metronidazole should not be taken during the first trimester of pregnancy because of concerns about mutagenicity. Tinidazole and ornidazole are recently developed nitroimidazole derivatives that have even greater antimicrobial activity than metronidazole. PMID- 3312852 TI - Antibiotic therapy for severe infections in infants and children. AB - In infants and children, drug absorption, distribution, metabolism, and excretion may differ considerably from these factors in adults; thus, differences also exist in therapeutic efficacy and toxicity of various antibiotics. Because of known toxicity, certain drugs--such as chloramphenicol in high doses, the sulfonamides, and tetracycline--should not be used in neonates. Antibiotic therapy should be modified in neonates because of biologic immaturity of organs important for the termination of drug action. Because of poor conjugation, inactivation, or excretion, the serum concentrations of many antibiotics may be higher and more prolonged in neonates than in older infants. Thus, the dosages of many antibiotics must be lower and the intervals between administration must be longer. The appearance of strains of ampicillin-resistant Haemophilus influenzae, the slow development of resistance to chloramphenicol among gram-negative and gram-positive bacteria, and the development of improved analytic methods to measure chloramphenicol have all resulted in the use of this drug in select cases of serious infection in children beyond the neonatal age. Third-generation cephalosporins have an important role in empiric treatment of pediatric bacterial meningitis because of their ability to penetrate the central nervous system and their effectiveness against ampicillin- or chloramphenicol-resistant Haemophilus strains and against many gram-negative bacteria in the Enterobacteriaceae group. PMID- 3312853 TI - Antimicrobial agents in urinary tract infections. AB - Urinary tract infections are commonly encountered in clinical practice and are usually readily treatable. Although many antimicrobial agents that have been available for some time remain effective in the eradication of bacteriuria, the recent introduction of the fluoroquinolone norfloxacin represents an important addition to the therapeutic armamentarium. The efficacy of single-dose therapy with antimicrobial agents such as trimethoprim-sulfamethoxazole or amoxicillin has been shown to be similar to that with conventional (7- to 10-day) treatment in women with uncomplicated lower urinary tract infections. The long-term administration of agents such as trimethoprim-sulfamethoxazole or nitrofurantoin in low doses is usually effective for suppression or prophylaxis of recurrent bacteriuria. PMID- 3312855 TI - Immunofluorescence method improves clinical utility of myeloma cell labeling indices. PMID- 3312854 TI - Frank C. Mann and transplantation at the Mayo Clinic. AB - Frank C. Mann, a world-renowned experimental physiologist, played a major role in the early laboratory investigation of organ transplantation procedures. During this centennial of his birth, we acknowledge the important contributions of Dr. Mann. PMID- 3312856 TI - Natural history of candidates for balloon aortic valvuloplasty. AB - Recently, balloon aortic valvuloplasty has been proposed for the treatment of severe aortic stenosis in elderly patients when aortic valve replacement has been declined or deferred. The natural history of these patients has not been clearly defined. Therefore, to develop a comparison cohort of patients with unoperated aortic stenosis, we reviewed the records of all Mayo Clinic patients in whom severe aortic stenosis had been diagnosed during the period 1978 through 1985 but no surgical procedure had been performed because the patient declined or the physician deferred this option. Among the 50 patients identified (36 men and 14 women; mean age 77 years, range 60 to 89 years), an operation was declined by 28 and deferred in 22. The diagnosis of aortic stenosis was established clinically by a cardiologist in all 50 patients and independently confirmed by echocardiography, Doppler ultrasonography, or catheterization in 47 of the 50. All patients were symptomatic. Follow-up was complete to September 1986 or death in all 50 patients. Actuarial survival at 1, 2, and 3 years was 57, 37, and 25%, respectively. Survival of age- and sex-matched control subjects was 93, 85, and 77%, respectively (P less than 0.0001 at each 1-year interval). At last follow up, only 13 of the 50 patients (26%) were alive. A cardiac cause was cited for 36 of the 37 deaths. Because of the poor survival in this group of patients, evaluation of alternative nonsurgical therapeutic modalities such as balloon valvuloplasty is imperative when operative intervention is declined or deferred in elderly patients. PMID- 3312857 TI - Intragastric balloons in comparison with standard therapy for obesity--a randomized, double-blind trial. AB - Intragastric balloons are new but commonly used devices for the treatment of obesity; however, their safety and efficacy have not been established. We report our results of a small, double-blind, randomized trial in which the effectiveness of intragastric balloons was compared with that of conventional medical therapy for obesity. Twenty-two patients, who were 21 to 77% over ideal body weight, were studied. Eleven underwent insertion of an intragastric balloon, and 11 underwent sham procedures. One patient with a gastric balloon withdrew from the study after 3 days. Weight loss at 2 to 3 months in the conventional therapy group averaged 2.8 kg; in the balloon-treated group, the mean weight loss was 5.8 kg (P greater than 0.15). Of the 10 balloons, 8 spontaneously deflated, and 1 was passed in the stools. We noted gastric erosions in five patients and multiple gastric ulcers in one. We conclude that the intragastric balloon was not clearly effective in inducing weight loss, had a high rate of spontaneous deflation, and was damaging to the gastric mucosa. Controlled trials should be done before similar weight reduction devices are used in routine clinical practice. PMID- 3312858 TI - [Aspergillus pneumonia in patients with chronic bronchopathy. Presentation of 3 cases]. PMID- 3312859 TI - [Physiopathology of lymphokines and monokines]. PMID- 3312860 TI - [PUVA therapy: long-term degenerative effects. II. Study of ultrastructural changes in the skin induced by PUVA therapy]. AB - The authors studied PUVA induced ultrastructural alterations in a group of 7 patients compared with 6 control subjects of same age. Hyperactivity of melanocytes was observed in all patients. Elastic fibers showed vacuolisation age and dose related. There was a reduplication of the basal layer of dermal capillaries and increased pinocytosis of endothelial cells, age and dose related also. The authors conclude that PUVA therapy induced alterations are degenerative; the target is located in deep dermis (capillaries and elastic fibers). No alterations of keratinocytes nor precancerous epithelial dysplasia was found. This confirms that UVA radiation is less aggressive for keratinocytes than UVB. PMID- 3312861 TI - [Cutaneous manifestations of ulcerative colitis]. AB - Out of 210 cases of ulcerative colitis 41 had skin and mucosal lesions: skin lesions in 23 (11%), oral ones in 11 (5.2%) and perianal in 16 (7.6%). Cutaneous lesions were: maculopapular rashes (5.2%), erythema nodosum (2.9%), pyoderma gangrenosum (1.4%), papulopustular lesions, vasculitis and erythema multiforme (1% each). Aphthae were the commonest oral complication (4.3%) and fissures and fistula the more prevalent perianal ones (4.3% and 3.4%). More than one mucocutaneous complication occurred in 17.1% of the patients and in 18 patients there were associated articular (36.6%), ocular (9.8%) and hepatic (2.4%) changes. The colitic type of arthritis and keratoconjunctivitis sicca were the commoner joint and eye manifestations. PMID- 3312862 TI - [Melasma in pregnancy: reduction of its appearance with the use of a broad spectrum photoprotective agent]. AB - 65 pregnant women distributed in two groups, by a double-blind method received a placebo or a sunscreen cream (Pabafil SPF 10, with absorption range from 290 to 360 nm) for daily use on face during the second quarter of their pregnancy in summer time. In 30 patients "with optimum fulfillment" in the products application (16 with placebo and 14 with sunscreen cream) the melasma appearances were significantly lower in those with sunscreen application. In subgroups of the total number of pregnant women, with similar proportion of patients with placebo and sunscreen, the melasma appearances were significantly lower in skin types I II, and in those that used cosmetics (versus those that did not). No differences were observed in subgroups by age, parity, and with or without history of previous melasma. PMID- 3312863 TI - [Sebaceous trichofolliculoma]. AB - A case of sebaceous trichofolliculoma on the nose of a 42 year old man, present at the birth, is reported. The histology was typical, with a cavity formed by the skin of the nose having numerous well developed sebaceous glands along with vellus and terminal hairs. PMID- 3312864 TI - [Werner's syndrome]. AB - We describe a 35 year old woman with shortness of stature, skin and muscle atrophy of the face and lower limbs, peripheric arthropathies, feet deformity, plantar hiperqueratosis, alopecia, canities, bilateral cataracts and bitonal voice. At the age of 21, the patient started having plantar hiperqueratosis, deformity and stiffness of the feet joints. At the time of the examination the patient had neither diabetes mellitus, nor peripheric arteriopathies or neoplasms. There wasn't a family history and the parents weren't consanguinous. PMID- 3312865 TI - [Urethritis caused by Trichomonas vaginalis in men. Epidemiology]. AB - The interviews of sexually transmitted diseases (STD) done in the Dispensario "Martinez Anido" of Madrid in the period understood between September of 1984 and September of 1985 are revised. Among all of the 1,370 surveys, the trichomonal urethritis in the male, represents 2.2% of all of the urethritis and 4.6% of the nongonococcal urethritis in the male. Mean age of patients was 35 years, the social-economic level was inferior than those which we observed in others STD, all of the cases were heterosexual and the source of contamination was in 100% a prostitute of a low level. The answer to the treatment with metronidazole of the only doses of 2 gr. was satisfactory in all cases. PMID- 3312866 TI - [Epithelioid sarcoma]. AB - A description is given of an epithelioid sarcoma observed in a male patient of 71 years of age. This two-year growth was located in the right leg and presented a clinical picture of a hard walled ulcer. After having been removed surgically the tumour reappeared after seven months at which point amputation was practised at the middle thigh. The patient died twelve months after amputation suffering from pleuropulmonary metastasis. An necropsy was not carried out. The finding of massive arterial neoplastic thrombosis in the histological study confirms the fatal outcome of the patient. The clinical, histological, evolutive and therapeutic characteristics of the epithelioid sarcoma are reviewed. PMID- 3312867 TI - [KID syndrome (keratitis-ichthyosis-deafness)]. AB - The KID syndrome is characterized by congenital ichthyosis, vascular keratitis and neurosensorial deafness. We report a 17 year old female patient, the first case of KID syndrome in Spanish literature. Red, dry, scaling skin was present at birth with sparse hair. At the age of six, malar erythema was prominent, with perioral ragades and onset of progressive neurosensory deafness. At the age of ten, vascularizing keratitis developed. At 12, treatment with etretinate failed to improve the ichthyosis. We review the clinical, pathological and analytical features of KID syndrome and discuss its relationship to other ichthyoses. PMID- 3312869 TI - [Histopathological aspects of tertiary pinta]. AB - A study was made of twenty-two biopsies of achromic lesions of Tikuna Indians, carriers of tertiary pinta, inhabitants of the Umariuassu island, on the Peruvian border, ten of the subjects had been treated two years previously with a single dose of penicillin. The histopathological picture was similar for both groups. In most cases (86.36%) slight hyperkeratosis was found on the epidermis, as well as acanthosis (18.18%), with atrophy in only two cases (9.09%). In all cases there was a reduction of the melanin of the basal layer. The inflammatory lymphocyte infiltrate was predominantly perivascular (88.18%). There wasn't any endothelial swelling. PMID- 3312870 TI - [Clear cell acanthoma. Presentation of a case]. AB - A case of a 72 year-old woman, with a verrucous lesion was presented. The lesion was characterized by a purple colour and measured 2 X 1.5 cm. in diameter. The patient had the lesion for 1 year and reported previous repetitive traumas, suggesting a clinical diagnosis of traumatic seborrheic keratosis. The histological study reveal a clear cell acanthoma. PMID- 3312871 TI - [Etiological variety of balanopreputial pigmentations]. AB - The authors report 17 cases with a similar clinical pattern but corresponding to different processus: lentigo simplex, dermal and junction nevus, lichen planus, lentigo premalignant, secondary Incontinentia pigmenti. The diagnosis of the disorders was made by microscopical study. PMID- 3312868 TI - [Yellow nail syndrome associated with sinusitis, rheumatoid arthritis, and chronic bronchitis]. AB - A case of a 70 year old patient with the "yellow nail syndrome", that was associated to sinusitis, rheumatoid arthritis and chronic bronchitis. We comment the several studies realized (radiologic, mycologic, bacteriologic and laboratory studies) and the low effectivity of the treatment assayed. PMID- 3312872 TI - [Perforating annular granuloma]. AB - This study presents the first Venezuelan case of perforating granuloma annulare in an eleven year-old patient. The cutaneous eruption was characterized by minute lichenoid papules which have persisted for two years. These lesions were asymptomatic and most perforating, appearing in the dorsal side of hands and fingers. The histopathological study showed a classical granuloma annulare with sites of necrobiosis and perforation of the epithelium. This "transepithelial perforation" allows the elimination of collagen and cell detritus observed. The patient responds well to the injection of steroids into lesions. PMID- 3312873 TI - [Subacute cutaneous lupus erythematosus. Treatment with sulfone]. AB - We present a patient with annular subacute cutaneous lupus erythematosus who was successfully treated with low doses of sulfones. A very photosensitive cutaneous eruption and scanty systemic symptoms are characteristics. Also there are ANA and anti-Ro positives but the anti-DNA antibodies negatives as immunological markers. The treatment with sulfones will be a valid treatment when safer drugs have failed. PMID- 3312874 TI - [Stanislawa Woyciechowska (1905-1986)]. PMID- 3312875 TI - [Case reports and review of the literature: autonomous dysreflexia--a complication of high spinal cord injuries]. PMID- 3312876 TI - [The man behind the syndrome: Manes Kartagener. The pulmonologist who named the triade of situs inversus--bronchiectases--chronic sinusitis]. PMID- 3312877 TI - [The man behind the syndrome: Vladimir Bekhterev. The Russian who sowed confusion and reaped glory]. PMID- 3312878 TI - [Kidney donor should be better informed about pain and the risk of complications of the operation]. PMID- 3312879 TI - [Sudden infant death]. PMID- 3312880 TI - [Compatibility of glass-carbon implants in the middle ear--animal experiment studies]. AB - 28 tympanoplastic procedures with destruction and reconstruction of the ossicular chain were performed in rabbits. Vitreous carbon implants were used as prosthetic material. The animals were followed up from 14 days to one year. In 23 cases extensive inflammation of the middle ear mucosa was observed macroscopically. The histological findings were formation of an increasing fibrous capsule with duration of time, permanent foreign body reaction at the surface of the implants and missing formation of new bone or contact with bone respectively. Thus vitreous carbon seems to be a less promising material in middle ear surgery. PMID- 3312881 TI - [Digital subtraction sialography]. AB - In 22 patients we performed 33 sialographies of salivary glands using digital subtraction technique as well as conventional technique (100 mm camera). In the majority of cases the digital subtraction technique was superior to the conventional technique regarding diagnostic image quality. Additionally, digital subtraction technique generally needs a lower number of contrast media application. Hence we recommend digital subtraction technique for radiological imaging of salivary glands and ducts. PMID- 3312882 TI - Cranial bone grafts for post-traumatic facial defects. AB - Recent interest in onlay cranial bone grafts has shown it to be a preferred technique in the reconstruction of facial defects. This paper reports seven patients in whom outer table cranial bone grafts were used to reconstruct post traumatic facial deformities. These included orbital and zygomatic deformities (2 patients), maxillary defects (2 patients), mandibular defects (2 patients), and nasal deformity (1 patient). A brief review of the development of membranous bone grafting for maxillofacial reconstruction is given. Good cosmetic results were obtained in six of seven patients with no evidence of graft resorption. One patient required removal of the graft because of inadequate soft tissue coverage. No patient suffered any significant donor site morbidity. In summary, this technique is extremely useful in treating post-traumatic bony deformities of the facial skeleton. The excellent graft survival and ease in harvesting the graft make this technique preferable to traditional endochondral grafts taken from the iliac crest and rib. PMID- 3312883 TI - [120 years of gastroenterological endoscopy--who was the first?]. PMID- 3312884 TI - [Therapy of hepatic encephalopathy]. AB - Hepatic encephalopathy is a clinical syndrome which appears in the course of hepatic failure. It is due to porto-caval shunts. The major symptoms of hepatic encephalopathy are alterations of intellectual functions, changes of personality and an impairment of neuromuscular functions. The morphological basis of all these changes are a cerebral atrophy, partial cortico-medullary necrosis and the occurrence of macroglial cells. Pathogenetically either an augmented influx of toxic substances from the gut or an increased production of false neurotransmitters might be responsible. Therapeutically restriction of protein intake, sterilisation of the gut and application of branched-chain amino acids or their keto analogs are the major steps for an improvement of the disease. PMID- 3312885 TI - [Consensus development by the German Society for Obesity Research on balloon therapy of obesity using the intragastric balloon]. PMID- 3312886 TI - AIDS: an exhaustive review of medical and legal aspects. PMID- 3312887 TI - Medical lasers and the law. PMID- 3312888 TI - Chronometric causes for obstetrical malpractice. PMID- 3312889 TI - Surrogate motherhood: a womb in livery. PMID- 3312890 TI - Malicious deprivation of hospital staff privileges. AB - The growing problem of discrimination against physicians seeking hospital staff privileges may be met by various tort and contract actions against hospitals and medical staff members. In many jurisdictions, the obstacles presented by common law and statutory immunities and the unavailability of judicial review for actions involving private hospitals pose formidable obstacles. However, the current trend in the courts would seem to be toward actionability. PMID- 3312891 TI - Sustaining quality of life for patients with terminal illnesses. PMID- 3312892 TI - Alternative health care delivery systems: health maintenance organizations and preferred provider organizations. PMID- 3312893 TI - Thermography: medical and legal implications. PMID- 3312894 TI - The potential role of DNA technology in leprosy. PMID- 3312895 TI - Primary dapsone resistance in Bamako and Chingleput: final report; THELEP. Subcommittee on Clinical Trials of the Chemotherapy of Leprosy (THELEP) Scientific Working Group of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases. PMID- 3312896 TI - Studies of reactivity of some Sri Lankan population groups to antigens of Mycobacterium leprae. II. Reactivity to a soluble protein antigen. PMID- 3312898 TI - Indeterminate leprosy. A passing phase in the evolution of leprosy. PMID- 3312897 TI - Immunological effects of lepromin testing in Sri Lankan population groups. II. Effect on reactivity to a soluble protein antigen of Mycobacterium leprae. PMID- 3312900 TI - [Viral infections of the skin due to immunosuppressive therapy]. PMID- 3312899 TI - [Skin and the immunologic response]. PMID- 3312901 TI - [Antithrombin III]. PMID- 3312902 TI - [Reminiscence of the ethics of health service workers as national heroes in Yugoslavia]. PMID- 3312903 TI - Anaphylactoid and anti-ovulatory activities of LHRH antagonists in rats. AB - Studies were conducted with LHRH antagonists examining the relationship of structure to anaphylactoid-like activity and the relationship of anaphylactoid like activity to anti-ovulatory activity in rats. Substitution of basic amino acids appeared to enhance the anaphylactoid-like activity of these peptides but other complex structural characteristics may also be involved. Anaphylactoid and anti-ovulatory activities were clearly independent and potent LHRH antagonists with minimal anaphylactoid-like activity were identified. PMID- 3312904 TI - Effect of serotonin on the basal and gonadotrophin-releasing hormone-induced release of luteinizing hormone from rat pituitary glands in vitro. AB - The effect of serotonin (5-HT) on the basal and gonadotrophin-releasing hormone (GnRH)-stimulated release of luteinizing hormone (LH) was studied in rat adenohypophysis in vitro. Anterior pituitary glands from ovariectomized rats were incubated for 1h in the presence of different doses of 5-HT (0.01 to 3 mumol/l). Serotonin added to the culture medium slightly dimished the basal release of LH and markedly inhibited the release of LH induced by GnRH. Responsiveness to GnRH (3 nmol/l) was significantly reduced, in a dose-dependent manner, by the simultaneous treatment of glands with 5-HT. Maximal inhibition to 65% of the response obtained with GnRH alone, was attained with 1 mumol/l 5-HT. The EC50 value was estimated to be about 1.9 X 10(-7) M. The inhibitory effect of 5-HT was evident within 30 min of incubation. Furthermore, 5-HT appear to exert a short lasting action, since the rate of basal and GnRH-induced release of LH was reduced during the first hour of incubation, but after 2h the suppressive effects of 5-HT were no longer apparent. Methysergide, a serotonin receptor blocking agent, partially antagonized the inhibitory effect of 5-HT on LH release, either basal or GnRH-stimulated. This suggests that a receptor-mediated component may be involved in the mechanism of 5-HT action. The present results indicate that 5-HT can affect the release of LH by acting directly at the pituitary gland level. PMID- 3312905 TI - Labeled oxidation products from [1-14C], [U-14C] and [16-14C]-palmitate in hepatocytes and mitochondria. AB - When [1-14C], [U-14C], and [16-14C]palmitate were oxidized by isolated rat hepatocytes, there was a differential distribution of label as a percent of total oxidized products, such that 14CO2 from [1-14C] greater than [U-14C] greater than [16-14C]palmitate and acid-soluble radioactivity from [16-14C] greater than [U 14C] greater than [1-14C]palmitate. The oxidation of [2,3-14C]succinate to 14CO2 by isolated hepatocytes was only 9.1% of that from [1,4-14C]succinate, demonstrating that the differences in distribution of labeled products are in part due to less 14CO2 production from label in the even carbon positions entering the citric acid cycle. Apparent total ketone body production from [16 14C]palmitate was markedly higher than [1-14C] and [U-14C]palmitate. In addition, the 14C-acetone:14CO2 ratio derived from decarboxylation of labeled acetoacetate from [1-14C]palmitate was less than 1 and positively correlated to the rate of fatty acid oxidation in hepatocytes. These findings indicate that the known preferential incorporation of the omega-C2 unit of fatty acids into 14C-ketone bodies also contributed to the differential distribution of labeled products and that this contribution was greatest at the lower rates of fatty acid oxidation. In isolated mitochondria, the distribution of label to 14CO2 and acid-soluble radioactivity from [1-14C], [U-14C] and [16-14C]palmitate was qualitatively similar to that seen with hepatocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312906 TI - Deconjugation of bile acids by human intestinal bacteria implanted in germ-free rats. AB - Fecal bile acids in germ-free rats were analyzed after inoculation with Bacteroides vulgatus, Bifidobacterium longum, Escherichia coli or Clostridium ramosum. B. vulgatus preferentially deconjugated tauro-beta-muricholic acid and B. longum taurocholic acid. C. ramosum deconjugated both bile acids, but E. coli deconjugated neither. 7 alpha-Dehydroxylation of bile acids was negligible even after 18 days of inoculation, but a small amount of 7-oxo-bile acids, less than 5%, was formed. Fecal excretion of bile acids increased after inoculation with B. vulgatus, B. longum and C. ramosum, but not with E. coli. PMID- 3312908 TI - Withholding life-sustaining treatment from severely defective newborns: who should decide? PMID- 3312907 TI - "Do not resuscitate". PMID- 3312910 TI - Hospitals' liability in American law. PMID- 3312909 TI - Alzheimer's disease: ethical and legal decisions. PMID- 3312911 TI - Ethics and the cognitive development of the dentist. PMID- 3312912 TI - [In the name of mercy and peace]. PMID- 3312913 TI - [Let us restore historical justice]. PMID- 3312914 TI - [The triumph of Leninist ideas]. PMID- 3312915 TI - [Hemorrhagic complications and their treatment in pulmonary tuberculosis]. PMID- 3312916 TI - [The life and adventures of pharmacist William Porter (on the 125th anniversary of the birth of the American writer O. Henry)]. PMID- 3312917 TI - Medical education: barefoot doctors, health care, health education, nursing education, pharmacy education, Part I. PMID- 3312918 TI - MAPS: a microcomputer-aided patient simulation. PMID- 3312919 TI - The McMaster Medical education philosophy in theory, practice and historical perspective. PMID- 3312920 TI - Medical education: barefoot doctors, health care, health education, nursing education, pharmacy education, Part II. PMID- 3312921 TI - [Did AIDS exist in the past?]. PMID- 3312922 TI - [Sexually transmitted diseases and sterility in black Africa]. AB - It is in Africa that sterility of infectious etiology is prevalent: 75% to 85% of female sterility, primary as well as secondary, are the consequence of a pelvic infection. This picture is explained by the high prevalence of genital infections caused by Neisseria gonorrhoeae and by Chlamydia trachomatis in a sanitary under developed environment. Frequency of such sterilities is such as fecundity rates are significantly reduced. PMID- 3312924 TI - Use of streptokinase for the salvage of a free flap: case report and review of the use of thrombolytic therapy. AB - This is the first case report of the clinical use of intraoperative streptokinase to promote free flap salvage. A latissimus dorsi free flap was mobilized to cover a scalping type injury. After 4 1/2 hours of ischemia and recurrent thrombosis, streptokinase was perfused into the thoracodorsal artery (7,500 units of streptokinase in 30 cc of normal saline). The free flap was exposed to this concentration of streptokinase for 10 minutes followed by drainage of the venous effluent in order to avoid possible deleterious systemic effects of the streptokinase. Good flow throughout the free flap resulted, and the flap remained viable, providing good coverage for the patient's skull. Controversies regarding the no-reflow phenomena and the use of various thrombolytic agents are discussed. PMID- 3312925 TI - New method for cardiac transplantation. AB - Rat cardiac transplantation into the femoral region has several advantages compared to cardiac transplantation into the peritoneal cavity. These advantages include increased speed, decreased hypothermia of the recipient, and easier access palpation. However, there is a major discrepancy in the size of the donor and recipient vessels. The donor aorta is two to three times larger than the recipient's femoral artery and thus could be a contraindication to the transplant. To circumvent this problem, we anastomosed the donor's aorta with the recipient's femoral artery by an end-in-end technique whereas the donor's pulmonary artery was anastomosed by conventional end-to-end technique with the recipient's femoral vein. The excess wall of the donor's vessel was plicated on a slant for each anastomosis. Our results compare favorably to those of techniques established previously. We suggest that this new method of cardiac transplantation will be of great value in the study of immunological events involved in graft rejection. PMID- 3312923 TI - [Problems posed by HIV infection in women in tropical zones]. AB - Retroviruses (mainly H.I.V. 1 and H.I.V. 2) are now largely spread over in Central Africa and Caribbean Islands, particularly in large cities. Their transmission is essentially horizontal and mainly sexual. As a matter of fact, sexual transmission is responsible in about 80% of the cases, leaving only a small percentage to transmission by needle (or by any aggressive material), blood or blood by-products. As far as sexual transmission is concerned, it is essentially heterosexual, in spite of the primary epidemic outbreak in the occidental world that focused interest toward male homosexual group, the first exposed to A.I.D.S. Nowadays we know that heterosexual transmission is important and bi-directionnal, even if transmission female to male has seemed to be more difficult to enlight, as it is common in sexually transmitted diseases. Transmission risk to an heterosexual partner is between 20 and 70%. Virus is present in semen, and in cervico-vaginalis secretions during all menstruation cycle. Vertical transmission, mother to child, through placenta or during delivery is frequent, and is of about 50%. First data on heterosexual transmission have been found in Central Africa, indicating high rates for prostitutes, their "customers", unmarried women with numerous partners, women with an other S.T.D. A.I.D.S. in child has been first described in Haiti and in Zaire. The very important role played by heterosexual transmission imposed sanitary education and usage of contraceptives which are efficient but difficult to firmly recommended for social and cultural considerations. PMID- 3312926 TI - Thumb amputation: a review of reconstructive alternatives. PMID- 3312927 TI - The appearance of normal vascular walls and endothelium in small arteries. PMID- 3312928 TI - 2,3-Dimercapto-1-propanesulphonate in heavy metal poisoning. PMID- 3312929 TI - The risk-benefit ratio of anticonvulsant drugs. AB - The concepts underlying the notion of a risk-benefit ratio for anticonvulsant therapy have determined the development of the drug treatment of epilepsy over many years. The risk element in the ratio arises from the various possible physical and psychological adverse effects of anticonvulsant therapy; the benefit is derived from the capacity of therapy to prevent seizures and thus reduce the disadvantages which result from having epilepsy. The physical adverse effects of anticonvulsant therapy may involve many tissues and organs. The drugs tend to depress cerebral, cerebellar and brain stem function, and may slow peripheral nerve conduction. Prolonged intake may cause hypocalcaemia and osteoporosis, folate depletion, various haematological and immunological abnormalities, and overgrowth of subcutaneous and gingival tissues. Idiopathic reactions may involve the skin, lymph nodes, liver, pancreas, kidney and thyroid, and cause electrolyte disturbances, while maternal anticonvulsant intake during pregnancy may be associated with an increased incidence of fetal malformations. Local reactions may occur at drug administration sites, and anticonvulsants may interact pharmacokinetically and pharmacodynamically with co-administered drugs. The taking of anticonvulsants sometimes has undesirable psychological effects on both the patient and his or her family. Epilepsy itself often results in adverse psychological consequences which emanate from the uncertainty and insecurity that is imposed by the unpredictable occurrence of seizures, from the limitations epilepsy sets on the patient's lifestyle and employment prospects, and from unfavourable community attitudes towards the disorder. Contemporary anticonvulsant therapy is not fully effective in all patients, but to the extent that it can control seizures it may help alleviate these emotional burdens that are a result of epilepsy. The consensus of present day medical opinion is that, in the great majority of clinical situations, the benefits of anticonvulsant therapy outweigh the disadvantages. However, to provide optimal management for individual patients, the risk-benefit ratio of therapy must be repeatedly assessed at all stages of a patient's treatment, and therapeutic decisions taken in the light of the ratio as it applies to the individual. PMID- 3312930 TI - Aspirin, paracetamol and non-steroidal anti-inflammatory drugs. A comparative review of side effects. AB - Non-steroidal anti-inflammatory drugs (NSAIDs) effectively control the symptoms of many of the rheumatic diseases although they have little effect on the underlying causes. Their effect is mainly on the mediators of the inflammatory process. Unfortunately, these mediators have important physiological roles in the maintenance of health, particularly in the gastrointestinal tract and the kidney, so that their inhibition results in many unwanted reactions of varying severity. The mechanisms underlying these reactions are described. Their occurrence varies, both qualitatively and quantitatively, and an attempt is made to assess these differences, although it may be that they are related directly to differences in dosage and therapeutic efficacy. In addition, immunologically mediated adverse reactions occur. These mechanisms are outlined and related to the clinical picture. There are considerable differences in frequency of reactions between the compounds: in particular there is a wide variation in the rate of dermatological reactions of this type. Agranulocytosis has been particularly associated with the pyrazolone compounds, although it has been reported with most others. Aplastic anaemia, which may not be an immune-mediated reaction, is also thought of as a pyrazolone reaction, but the incidence with indomethacin approaches a similar level. Although all drugs analysed may cause hepatic reactions, these are rare except with the now withdrawn benoxaprofen. Several types of immunologically mediated renal reactions occur and these rarities are also described. Paracetamol does not have any effect on the inflammatory mediators. Anxieties about this substance relates to the parent compound phenacetin and its necrotic effect on the renal papillae. There is extensive literature on this subject concerning not only paracetamol, but also aspirin and other NSAIDs. This is also assessed and summarised. The danger of paracetamol as a direct hepatic toxin in self-poisoning is discussed. Novel NSAIDs are introduced and others withdrawn with frequent and monotonous regularity. Sometimes the reasons have some medical or scientific plausibility, but often they are over-reactions by registration authorities or pharmaceutical companies in response to uninformed media publicity. The problems of the numerically and scientifically accurate collection and assessment of adverse reaction data are legion and as a result useful agents have been lost. Some of these difficulties are described, and some non-drug 'adverse reactions' are described.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3312931 TI - Clinical consequences of abrupt drug withdrawal. AB - Syndromes due to the abrupt withdrawal of drug treatment occur mainly with adrenal corticosteroids and agents with an action on either the cardiovascular system or central nervous system. The abrupt withdrawal of antihypertensive therapy typically results in symptoms of overactivity in the sympathetic nervous system. Clonidine and beta-adrenoceptor antagonists are clinically the most important of these agents, but numerous other drugs have been implicated. Overall, the problem is small when viewed in the context of the huge scale of prescribing of antihypertensive medicines. A more serious problem is the occurrence of crescendo angina following the abrupt withdrawal of beta adrenoceptor antagonists. Although other factors may be involved, adaptive up regulation of beta-adrenoceptor density is the most likely cause of crescendo angina, and renders the patient more susceptible to sympathetic nervous stimulation following withdrawal of treatment. Besides leading to a recrudescence of the disease being treated, the withdrawal of corticosteroids can cause a variety of syndromes. In particular, problems can arise as a result of treatment induced suppression of the hypothalamic-pituitary-adrenal (HPA) axis. Another steroid withdrawal syndrome of unknown aetiology, without significant abnormalities of the HPA axis occurring, has been described. Benign intracranial hypertension may rarely follow steroid withdrawal in children. The syndromes associated with withdrawal of drugs which have an action on the CNS are poorly understood. Withdrawal of neuroleptic drugs can be followed by symptoms that resemble those described following withdrawal of anticholinergic drugs, and those agents with the greatest muscarinic-receptor-blocking properties are those which are most frequently implicated. However, the less common withdrawal dyskinesias are thought to reflect up-regulation of dopaminergic receptors during long term treatment. Gastrointestinal symptoms predominate following the abrupt withdrawal of antidepressants but hypomania and an 'akathisia-like' syndrome have been reported. Barbiturates are no longer recommended as hypnotics because of severe effects of withdrawal and the existence of safer alternatives. Short acting barbiturates can be withdrawn by replacement with either phenobarbitone (phenobarbitol) or diazepam and subsequent gradual reduction in dose. The recognition of dependency on benzodiazepines has been slow because of the similarity of mild withdrawal symptoms to the original problem which led to treatment being offered.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3312932 TI - Primidone crystalluria following overdose. A report of a case and an analysis of the literature. AB - Seven cases of crystalluria following primidone overdose have been reported since the 1950s. An eighth case of primidone crystalluria following overdose is presented. Because of low aqueous solubility (600 mg/L at 37 degrees C) which is directly proportional to temperature, any factor increasing renal excretion of unchanged primidone predisposes to crystal formation. Renal clearance is dependent on dosage because of negligible protein binding, zero-order conversion to phenobarbitone (phenobarbital) and first-order conversion to phenylethylmalonamide. Therapy with other anticonvulsants known to induce the metabolism to phenobarbitone does not appear to be protective against crystalluria in overdose situations. The critical serum primidone concentration for crystalluria presence seems to be 80 mg/L. There is evidence for nephrotoxicity of the crystals themselves if formed in vivo (actual crystal presence during voiding). The chemical phenomenon of supersaturation of a solution is protective against in vivo crystal formation with subsequent nephrotoxicity. Vigorous hydration to augment elimination and to lessen the propensity for renal toxicity is recommended. PMID- 3312933 TI - Boiled coffee increases serum low density lipoprotein concentration. AB - The effects of boiled coffee, filtered coffee, and tea on serum lipoprotein lipids and apoproteins were compared in 42 middle-aged hypercholesterolemic subjects (21 men and 21 women). The subjects consumed the beverages, eight cups a day, in random order during successive 4-week periods with 2-week run-in intervals in a crossover design. The diet was kept unchanged. Statistically significant differences were found between the periods in serum total cholesterol (P less than .0001 ANOVA), LDL cholesterol (P less than .01), and apoprotein B (P less than .01) levels. All differences were due to significantly higher levels during boiled coffee as compared with filtered coffee and tea. No statistically significant differences were found between the filtered coffee and tea periods. There were no differences in serum VLDL cholesterol or triglyceride, HDL cholesterol, and apoprotein A-I concentrations between the periods. Consumption of boiled coffee thus increased the concentration of low density lipoprotein in the serum without affecting its lipid-protein composition. The effect seemed to be determined by the method of brewing. PMID- 3312934 TI - Whole body leucine, phenylalanine, and tyrosine kinetics in end-stage liver disease before and after hepatic transplantation. AB - The kinetics of leucine, phenylalanine, and tyrosine metabolism following orthotopic human liver transplantation in end-stage liver disease in hospitalized patients were evaluated and compared to controls. The investigation was carried out by protein turnover studies using 13C leucine, D5-phenylalanine, and [U-14C] tyrosine by continuous infusion and employing a stochastic model in 32 patients with end-stage liver disease, 17 of whom went on to receive an hepatic allograft, and 7 controls without significant liver disease who underwent elective abdominal surgery. Mean tyrosine flux in the liver disease group was 3,242 +/- 811 (n = 32) v 2,899 +/- 688 mumol/h in controls (n = 7) (P less than .001), while the tyrosine oxidation was 328 +/- 179 v 422 +/- 185 mumol/h (P less than .001). Tyrosine clearance in pretransplant patients was 719 +/- 345 (n = 17) v 1,193 +/- 568 mL/min (P less than .005) in posttransplant patients (n = 17) with virtually no overlap. There was a significant correlation between serum albumin levels and the tyrosine clearance (r = .60, P less than .05), but correlations with other conventional liver function tests were of a low order. Leucine and phenylalanine kinetics in liver disease patients did not show any significant differences from controls. Leucine and tyrosine fluxes in controls did exhibit a significant correlation (r = .70, P less than .05), but no correlation was observed in patients with liver disease. These findings indicate that the kinetics of the amino acid tyrosine are substantially altered by end-stage liver disease, with the most profound effect on tyrosine clearance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3312935 TI - Increased insulin binding of erythrocytes and insulin sensitivity in adrenal insufficiency. AB - We have studied 125I-insulin binding to erythrocytes (RBC) in five patients with hypoadrenocortisolism, and compared to 17 normal subjects and in nine patients with Cushing's syndrome. In another study insulin sensitivity index (ISI) was measured by the IV insulin tolerance test in four patients with hypoadrenocortisolism (1.82 +/- 0.15 mg/dL/min), and compared to 19 normal subjects and 23 patients with Cushing's syndrome (1.56 +/- 0.1 mg/min/dL). Mean insulin binding in hypocortisolism was 17.9 +/- 0.7%, and was significantly higher (P less than .01) than in normal subjects (12.0 +/- 1.4%) and was significantly (P less than .001) decreased toward normal (11.8 +/- 1.47) during replacement therapy. Increased binding in untreated hypoadrenocortisolism was due to elevated high affinity site receptor concentration as compared to the treated patients (0.10 +/- 0.015 v 0.053 +/- 0.003 nmol/L,P less than .01). These results suggest that increased insulin binding in chronic hypoadrenocortisolism may be attributed to increased insulin binding to the receptor, which can revert to normal by replacement therapy. The role of increased insulin binding to increased insulin sensitivity in hypoadrenocortisolism is discussed. PMID- 3312936 TI - The influence of acute hyperinsulinemia on the insulin-related material in brain, testis, liver, and kidney. AB - Insulin-related material was measured in acid ethanol extracts of brain, testis, liver, and kidney from adult rats acutely injected with insulin or saline. Insulin injection resulted in a twofold to threefold increase in plasma insulin during a two-hour period after injection. Plasma glucose was greatly depressed. Insulin injection had no effect on the insulin-related material in most areas of brain (cerebral cortex, olfactory bulbs, and medial hypothalamus) and the cerebrospinal fluid; lateral hypothalamus was an exception and paradoxically exhibited a decrease of this material. The testis insulin-related material was unaffected; purification of the testis extracts using the C18 Sep pak method revealed no further difference between the animals. In liver, the insulin-related material was not significantly different in the control and the insulin-injected group; however, we found a significant correlation between this material and plasma insulin within the insulin-injected group. In contrast, insulin injection resulted in an important increase in kidney insulin-related material that paralleled the change in plasma insulin. Thus, like chronic experiments, acute hyperinsulinemia revealed that the insulin-related material was largely independent from blood insulin in tissues that exhibit very different insulin uptake from the blood; kidney appeared to be an exception. PMID- 3312937 TI - Low protein and low phosphorus diet in patients with chronic renal failure: influence on glucose tolerance and tissue insulin sensitivity. AB - Ten patients with advanced renal failure (glomerular filtration rate 25 mL/min) were treated with a low phosphorus and low protein diet supplemented with ketoacid analogues. Before starting the diet and four months afterwards, a 50 g oral glucose tolerance test with a three step euglycemic insulin clamp was carried out. A dose-response curve of total body insulin sensitivity was plotted. By the fourth month, glucose tolerance had improved with significantly lower T0, T30, and T60 insulin levels. These results are attributed to the improvement in insulin action as demonstrated by the clamp technique. The dose-response curve had a distinctly higher plateau after dietary treatment, and the tissue sensitivity index to insulin (M/l ratio) was significantly improved. It is suggested that treatment of uremic patients with a low protein diet may reduce levels of a putative insulin inhibitor. PMID- 3312938 TI - Insulin action in non-insulin-dependent diabetes mellitus: the relationship between hepatic and extrahepatic insulin resistance and obesity. AB - To determine the contribution of obesity to the insulin resistance of non-insulin dependent diabetes mellitus, insulin dose response curves for suppression of glucose production and stimulation of glucose utilization were generated in lean and obese diabetic patients and compared to those observed in weight-matched nondiabetic subjects. Glucose utilization during 0.4, 1.0, and 10.0 mU/kg x min insulin infusions (producing insulin concentrations ranging from approximately 50 to 2,000 microU/mL) was lower (p less than .02 to .001) in lean and obese diabetic patients compared to weight-matched nondiabetic subjects indicating insulin resistance. Glucose utilization was not correlated with obesity in the diabetic subjects. Suppression of glucose production was impaired (P less than .03 and .001) in both the lean and obese diabetic subjects at physiologic but not supraphysiologic insulin concentrations. We conclude that patients with NIDDM have both hepatic and extrahepatic insulin resistance, the severity of which appears to be independent of the degree of obesity. PMID- 3312939 TI - Insulin resistance in aged man: relationship between impaired glucose tolerance and decreased insulin activity on branched-chain amino acids. AB - The effects of glucose-induced hyperinsulinemia on plasma amino acid levels were measured in 50 subjects divided into five age groups. Following an oral glucose load the plasma levels of most amino acids decreased, the decline being more pronounced for the three branched-chain amino acids (valine, isoleucine, and leucine). A progressive insulin resistance was proved on the basis of an age related impaired glucose tolerance and a normal or increased insulin response. The plasma disappearance of branched-chain amino acids significantly correlated with age (r = -.514). The effects of the prevailing plasma insulin on branched chain amino acids, measured by the ratio of amino acid changes per total insulin response, progressively declined in older subjects (P = .0005), and strictly correlated with age (r = .652). Insulin resistance in the elderly similarly affects glucose and branched-chain amino acid metabolism, with possible relevant effects on whole-body protein turnover. PMID- 3312940 TI - Isolation of transferrin receptor from human placenta. PMID- 3312941 TI - Receptor assay with radiolabeled transferrin. PMID- 3312942 TI - Transferrin: assay of myotrophic effects and method for immunocytochemical localization. AB - 1. Primary cultures of dissociated embryonic chicken skeletal muscle cells provide an ideal model for investigating the effects of growth factors such as Tf because these cells undergo a highly integrated pattern of differentiation and maturation. 2. The trophic effects of a growth factor such as Tf can be assessed on muscle cultures by the determination of such parameters as acetylcholinesterase and acetylcholine receptors. These proteins are specific to the cultured myotubes, appear in high levels following fusion of myoblasts into myotubes, and are relatively easy to assay. 3. Tf and other growth factors are internalized by a receptor-mediated mechanism (see Trowbridge et al. and Seligman and Allen, this volume). These growth factors can be localized to specific tissues by immunocytochemistry at the light or electron microscopic level. This information on cellular distribution could be very useful in assessing the pattern of growth and differentiation with regard to the particular growth factor under study. PMID- 3312943 TI - Cell culture assay of biological activity of lactoferrin and transferrin. PMID- 3312944 TI - Conjugation of peptide growth factors with toxin to isolate cell variants involved in endocytosis and mitogenic response. PMID- 3312945 TI - Detection of proteins induced by growth regulators. PMID- 3312946 TI - Identification of platelet-derived growth factor-modulated proteins. PMID- 3312947 TI - Effects of miaA on translation and growth rates. AB - We have measured the growth rates and elongation rates for different proteins in wild-type, miaA, rpsL, and miaA, rpsL double mutants of Escherichia coli in the presence as well as the absence of streptomycin. The data show that while miaA and rpsL mutants inhibit elongation rates to equivalent levels, miaA inhibits the growth rate twice as effectively as does rpsL. The double mutant is more effectively inhibited than either single mutant and Sm repairs in part the growth rate as well as protein elongation rates. The data suggest that the conditional streptomycin-dependent phenotype of the double mutant cannot be due simply to the depressed polypeptide elongation rates of the double mutant. PMID- 3312948 TI - Effect of the direction of DNA replication on mutagenesis by N-methyl-N'-nitro-N nitrosoguanidine in adapted cells of Escherichia coli. AB - The methylating agent N-methyl-N'-nitro-N-nitrosoguanidine preferentially induces G:C to A:T transitions at DNA base pairs with the G in one particular strand of the cI gene in a lambda prophage, in this case the nontranscribed strand, in Escherichia coli cells in which the adaptive response is induced. The same preference is found for the cI gene inserted in the genome in the inverse orientation, so the differential effect is not caused by the direction of motion of the DNA replicating fork. PMID- 3312949 TI - Role of the central dinucleotide at the crossover sites for the selection of quasi sites in DNA inversion mediated by the site-specific Cin recombinase of phage P1. AB - The crossover sites for Cin-mediated inversion consist of imperfect 12 bp inverted repeats with non-palindromic dinucleotides at the center of symmetry. Inversion is believed to occur in vivo between the homologous central 2 bp crossover sequences at the inversely repeated crossover sites through introduction of 2 bp staggered cuts and subsequent reciprocal strand exchanges. The site-specific Cin recombinase acts not only on the normal crossover sites but also, less efficiently, on quasi crossover sites which have some homology with the normal sites. We identified 15 new quasi sites including 4 sites within the cin structural gene. Homology at the 2 bp crossover sequences between recombining sites favors selection as quasi crossover sites. The Cin enzyme can occasionally mediate inversion between nonidentical crossover sequences and such recombinations often result in localized mutations including base pair substitutions and deletions within the 2 bp crossover sequences. These mutations are explained as the consequences of heteroduplex molecules formed between the staggered dinucleotides and either their subsequent resolution by DNA replication or subsequent mismatch repair. Occasional utilization of quasi crossover sites and localized mutagenesis at the crossover sequences in enzyme-mediated inversion processes would be one of the mechanisms contributing to genetic diversity. PMID- 3312951 TI - Genetic analysis of the parB+ locus of plasmid R1. AB - Plasmid R1 in Escherichia coli carries two loci which independently contribute to the stable maintenance of the plasmid. A genetic analysis of one of these, parB+, was carried out, and it was shown that the minimal region exerting stabilizing activity comprises at most 580 bp. The nucleotide sequence of the parB+ locus was determined, and indicated the presence of two genes, of which one probably codes for a 52 amino acid polypeptide, whereas the other gene product may be an untranslated RNA. These suggestions, based on the nucleotide sequence information, were supported by gene expression studies employing lac fusions. An incompatibility phenotype connected to parB+ was localized to that part of the 580 bp parB+ region which seems to encode the untranslated RNA. PMID- 3312950 TI - Mutagenic DNA repair in Escherichia coli. XIV. Influence of two DNA polymerase III mutator alleles on spontaneous and UV mutagenesis. AB - We introduced the dnaE486 and polC74 mutations (which are associated with decreased DNA polymerase III replication fidelity) into excision defective Escherichia coli strains with varying SOS responses. These mutations increased the UV-induced frequency of base pair substitution mutations in all strains tested, except recA430 and umuC122 derivatives. This UV mutator effect therefore requires expression of the SOS error-prone repair system. In recA441 lexA51 strains where the SOS system is constitutively expressed, the UV mutator effect of the dnaE alleles was similar in relative terms (though greater in absolute terms). Since these dnaE alleles decrease rather than increase survival after UV it is argued that they promote a burst of untargeted mutations close to UV photoproducts ("hitch-hiking" mutations) rather than increase the number of translesion synthesis events. The fact that there was no UV mutagenesis in dnaE486 umuC122 or polC74 umuC122 strains indicates that infidelity associated with these dnaE alleles did not of itself enable translesion synthesis to occur. The spontaneous mutator effect conferred by dnaE486 and polC74 was not affected by umuC122 or recA430 indicating that it is not dependent upon error-prone repair ability. In recA441 lexA51 bacteria, where SOS error-prone repair is constitutively induced, the mutator effect of dnaE486 was greater and was largely blocked by umuC122. It is suggested that spontaneously occurring cryptic lesions that are themselves unable to induce the SOS system are subject to translesion synthesis under these conditions and trigger a burst of hitch-hiking mutations that are therefore effectively umuC dependent. PMID- 3312952 TI - A complex pattern of sensitivity to simple monofunctional alkylating agents exists amongst the rad mutants of Saccharomyces cerevisiae. AB - The radiation-sensitive rad mutants of the yeast Saccharomyces cerevisiae exhibit a complex pattern of sensitivity to simple monofunctional alkylating agents. The RAD1, RAD2, RAD4 and RAD14 genes of the RAD3 epistasis group are implicated in the repair of ethylations to DNA. The RAD3, RAD10 and RAD16 genes of this group are not involved. The RAD4 and RAD14 genes have a particular role in repair following exposure to those ethylating agents that preferentially alkylate oxygen, but not to those that preferentially ethylate nitrogen. The RAD1 and RAD2 genes are involved in the repair of damage induced by all the ethylating agents used except EMS. The mutants in this group that are sensitive to ENU were not sensitive to MNU, suggesting that nucleotide excision operates on ethylations but not on methylations. In the RAD6 group, the RAD6 and RAD18 genes are involved in DNA repair after exposure to all the alkylating agents tested, whereas RAD8 appears to have a role in the repair of O-alkylations but not N-alkylations. RAD9 operates in the repair of methylations and ethylations, but does not influence events after exposure to EMS. In the RAD52 group, the mutants tested were sensitive to ENU and DES. Thus some members of all three epistasis groups are involved in the repair of alkylations to DNA. PMID- 3312954 TI - An electrophoretic karyotype for Candida albicans reveals large chromosomes in multiples. AB - Using field-inversion gel electrophoresis we defined an electrophoretic karyotype for the yeast, Candida albicans. The karyotype is distinct from other species of Candida and is species specific. A total of five distinct chromosomal mobility groups were observed, at least four of which are composed of a minimum of two fragments each. From the apparent sizes of these fragments relative to the large chromosomes of the morphologically related yeast Saccharomyces cerevisiae, together with the known genome size of this organism, we conclude that the karyotype is the result of the migration of intact chromosomes. PMID- 3312953 TI - Demonstration of an altered phenylalanyl-tRNA synthetase in an analogue-resistant mutant of Aspergillus nidulans. AB - We have isolated and characterized a new class of p-fluorophenylalanine (FPA) resistant mutant in Aspergillus nidulans using a phenA strain as the wild type, by optimizing the conditions of growth. All four spontaneous mutants selected on a medium containing FPA were found to be recessive to their wild-type alleles in heterozygous diploids. Complementation analyses and linkage data showed that they were allelic and mapped at a single locus (fpaU) in the facA-riboD interval on the right arm of linkage group V. Partial purification and characterization of Phe-tRNA synthetase from wild-type and mutant strains revealed that the mutant enzyme had a greatly reduced ability to activate the analogue. It is suggested that mutation in the fpaU gene brings about a structural alteration in Phe-tRNA synthetase. PMID- 3312956 TI - OriC plasmids do not affect timing of chromosome replication in Escherichia coli K12. AB - The variability of the time interval between successive rounds of chromosome replication was estimated by density-shift experiments, by measuring the conversion of heavy DNA to hybrid density and light DNAs upon transfer of a steady-state culture growing in medium with [13C]glucose and 15NH4Cl to medium with light isotopes. The coefficient of variation (CV%) for the interreplication time of the Escherichia coli K12 chromosome was found to be 17%, i.e. similar to that for interdivision time. The presence of additional copies of oriC in the cell on a high copy number plasmid did not increase the CV of interreplication time. It is concluded that a single rate-limiting event is unlikely to time the initiation of chromosome replication. The regulation of initiation at oriC and the coordination with cell division is discussed. PMID- 3312955 TI - The functional stability of the lacZ transcript is sensitive towards sequence alterations immediately downstream of the ribosome binding site. AB - Various synthetic DNA sequences were inserted downstream of the fourth codon of the Escherichia coli lacZ gene on plasmids containing a hybrid lacZ-galK operon. Several different sequences, one as short as 10 bp, reduced the functional stability of the lacZ message three- to fourfold, whereas others had little or no effect. Introduction of synthetic sequences into a plasmid containing the intact lac operon resulted in similar reductions of mRNA stability. The sequence alterations also reduced the translational efficiency and transcription through lacZ as monitored by measurements of galactokinase synthesis from the downstream galK gene. There was no correlation between the average translational frequency and the stability of the lacZ message indicating that some of the inserted sequences reduced mRNA stability directly and not as a consequence of their effect on translation. The reduction of transcription through the lacZ gene correlated with the reduction of translation in agreement with current models of transcriptional polarity. PMID- 3312957 TI - Heterogeneity in the level of ampicillin resistance conferred by pBR322 derivatives with different DNA supercoiling. AB - Cloning of an EcoRI restriction fragment, containing the 900 bp gamma-terminal sequence of transposon Tn1000, into pBR322, resulted in two plasmids, pICV63 and pICV64, which differed in the orientation of the cloned fragment within the replicon and in the level of ampicillin resistance conferred on the host cell. The DNAs of these plasmids differ in superhelicity and we suggest that a change in supercoiling of pICV63 DNA leads to this plasmid conferring resistance to only low levels of ampicillin, probably by reducing the expression of the bla gene. This hypothesis is supported by the fact that topA or supX mutations, which abolish topoisomerase I, reduce still further the level of resistance to ampicillin of pICV63-containing cells, whereas the gyrB226 compensatory mutation renders these cells more ampicillin resistant. Plasmid pICV63, therefore, enables mutant alleles of genes governing DNA topology to be recognized. PMID- 3312960 TI - Mutational specificity of a bacteriophage T4 DNA polymerase mutant, mel88. AB - Several bacteriophage T4 DNA polymerase mutants have been shown to increase the frequency of spontaneous mutations (Speyer et al. 1966; Freese and Freese 1967; de Vries et al. 1972; Reha-Krantz et al. 1986). In order to determine the molecular basis of the mutator phenotype, it is necessary to characterize the types of mutations produced by the mutator DNA polymerases. We show here that at least one DNA polymerase mutator mutant, mel88, induces an increased number of base substitution mutations compared with wild-type. PMID- 3312959 TI - Asymmetric cytosine deamination revealed by spontaneous mutational specificity in an Ung- strain of Escherichia coli. AB - A collection of 164 spontaneous lacI- mutations were recovered from a uracil-DNA glycosylase deficient (Ung-) strain of Escherichia coli and analyzed by DNA sequencing. As predicted by genetic studies, G:C----A:T transitions predominated among base substitution events. However, DNA sequence analysis indicated that these events did not occur at random. Of the 31 G:C----A:T transitions recovered, 24 involved cytosine residues located in the nontranscribed strand of the gene and 15 of the 31 transitions occurred at cytosines located on the 3' side of 3 or more A:T base pairs. These differentials likely reflect the more single-stranded character of the non-transcribed strand of the gene and of regions rich in A:T base pairs. In addition, mutation at the frameshift hotspot was altered in the Ung- strain, suggesting a role for DNA repair in the formation of structural intermediates that potentiate these events. Also, the analysis of non-hotspot frameshifts, deletions and duplications showed that many involved local DNA sequence. Specifically, several of the frameshift, deletion and duplication mutations occurred near the sequence 5'-CTGG-3'. Thus, DNA sequence analysis of mutational specificity in an Ung- strain has provided evidence that gene expression, DNA repair and DNA context can all potentially influence the classes and frequencies of spontaneous mutation. PMID- 3312958 TI - Cotransformation of Aspergillus nidulans: a tool for replacing fungal genes. AB - When a non-selected DNA sequence was added during the transformation of amdS320 deletion strains of Aspergillus nidulans with a vector containing the wild-type amdS gene the AmdS+ transformants were cotransformed at a high frequency. Cotransformation of an amdS320, trpC801 double mutant strain showed that both the molar ratio of the two vectors and the concentration of the cotransforming vector affected the cotransformation frequency. The maximum frequency obtained was defined by the gene chosen as selection marker for transformation. Cotransformation was used to induce a gene replacement in A. nidulans. An amdS320 strain was transformed to AmdS+ and cotransformed with a DNA fragment containing a fusion between a non-functional A. nidulans trpC gene and the Escherichia coli lacZ gene. Ten AmdS+, LacZ+ transformants with a Trp- mutant phenotype were selected. All of these strains could be transformed with a functional copy of the A. nidulans trpC gene, but only two strains yielded TrpC+ transformants which, with a low frequency, had a LacZ- phenotype. These latter transformants had also lost the AmdS+ phenotype. Southern blotting analysis of DNA from these transformants confirmed the inactivation of the wild-type trpC gene, but revealed that amdS vector sequences were also involved in the gene replacement events. PMID- 3312962 TI - tolA, tolB and excC, three cistrons involved in the control of pleiotropic release of periplasmic proteins by Escherichia coli K12. AB - Mutants of Escherichia coli K12 carrying exc mutations inducing the release of the plasmid pBR322-encoded beta-lactamase (EC 3.5.2.6) into the extracellular medium were analysed and compared with previously described excretory mutants carrying lky mutations associated with the release of alkaline phosphatase and to tolA and tolB mutants, originally described as tolerant towards various colicins. The exc, lky and tol mutations mapped near the gal operon at min 16.5 of the E. coli linkage map. A genetic analysis presented in this paper showed that some exc and lky mutations belonged to the tolA and tolB complementation groups. Furthermore, we identified a third cistron, excC, involved in the excretion of periplasmic enzymes but distinct from the two others. PMID- 3312961 TI - Mapping of the sor genes for L-sorbose degradation in the chromosome of Klebsiella pneumoniae. AB - A series of mutants was isolated in Klebsiella pneumoniae strain 1033, among them mutants unable to grow on L-sorbose. Different R' plasmids carrying the sor genes and other surrounding chromosomal genes were also isolated. Each plasmid contained the structural genes sorA for an Enzyme II of the phosphoenolpyruvate dependent carbohydrate:phosphotransferase system, sorD for a D-glucitol 6 phosphate dehydrogenase, sorE for an L-sorbose 1-phosphate reductase, and the corresponding regulator gene sorR. These structural genes are coordinately expressed and inducible by L-sorbose. Cis-dominant and pleiotropic mutations rendering the expression of the sor genes constitutive or eliminating it were isolated. Complementation of a series of mutations in Escherichia coli K12 and K. pneumoniae by various R' and F' plasmids and by P1 transduction in K. pneumoniae located the sor genes within the following gene sequence: rbs rha pfkA metB ppc argH ilv btuB rpoB metA ace sor pgi malB uvrA. The rbs-ilv gene loci tightly linked in E. coli K12 at 84 min, are separated in the map of K. pneumoniae 1033 and located at 86 and 89 min, respectively. PMID- 3312964 TI - The nursing process: a literature review. PMID- 3312963 TI - Cloning and sequencing of the HU-2 gene of Escherichia coli. AB - The Escherichia coli HU-2 gene was cloned using a DNA fragment from the HU-1 gene as a probe. The amino acid sequence of the HU-2 protein deduced from the nucleotide sequence is in good agreement with the published sequence. The nucleotide sequence has a possible promoter and a typical ribosomal binding site upstream of the translation initiation codon (AUG) and a possible rho-independent terminater site downstream of the termination codon (UAA) of the gene. PMID- 3312965 TI - Pregnancy and motherhood following renal transplantation. PMID- 3312966 TI - Morphometric investigation of the microvascular system of pancreatic exocrine and endocrine tissue in the rat. AB - Morphometric data were obtained from the microvasculature in exocrine and endocrine tissue of the rat pancreas. Two groups of anesthetized rats (100 and 300 g body wt, respectively), received intravenous injections of fluorochrome coupled globulins in order to label the entire vascular system. After circulation of fluorescein-isothiocyanate (FITC)-globulin through the vascular system for 30 min and lissamine rhodamine B 200 (RB 200)-globulin for 5 min, the pancreas was frozen rapidly. In frozen sections of the organ, both dyes showed the same intravascular distribution. The mean number of sectioned vascular elements was 970 +/- 40/mm2 in the exocrine parenchyma and 1430 +/- 60/mm2 in islet tissue. The cross-sectional area fraction of the microvascular system, which is equivalent to the intravascular volume fraction, amounted to 0.027 +/- 0.001 mm2/mm2 in the exocrine system and to 0.061 +/- 0.002 mm2/mm2 in the endocrine pancreas. The corresponding values for microvascular surface area (mm2/mm3) were 18.0 +/- 0.8 (exocrine tissue) and 34.2 +/- 2.0 (endocrine tissue). Mean diameters of vessels up to 10 microns in exocrine tissue amounted to 5.5 +/- 0.2 and 6.1 +/- 0.1 microns in exocrine and endocrine tissues, respectively; when all vessels up to 30 microns in diameter were considered, these values amounted to 5.7 +/- 0.2 and 6.7 +/- 0.2 microns, respectively. Especially in light of the fact that flow rate was observed to be much higher in islets than in acini, the present results support the existence of an insular microcirculatory system which is specialized in terms of its exchange capacity. PMID- 3312967 TI - Michigan medicine: a Walker tradition. PMID- 3312968 TI - Michigan has a rich legacy of medical pioneers. PMID- 3312969 TI - Organized medicine has deep roots in Michigan. PMID- 3312970 TI - Sesquicentennial thoughts--Michigan at 150. PMID- 3312972 TI - Dementia--the failure of hippocampal plasticity and dreams. Is there a preventative role for melatonin? AB - Anatomic, chemical, physiologic, pathologic and clinical evidence suggests that senile dementia (Alzheimer's disease) is a dysfunction of the hippocampus. Failure of hippocampal plasticity could be secondary to loss of input from the medial septal nucleus and/or locus ceruleus or due to a functional abnormality. When compared to age-matched controls, demented patients have decreased hippocampal norepinephrine and serotonin, increased hippocampal monoamine oxidase, and decreased REM sleep. These observations could be explained by a melatonin deficiency. A chronic melatonin deficiency, with loss of dreams, could cause dementia. PMID- 3312971 TI - Temperature-modulated physiological characteristics of Candida albicans. AB - Despite numerous investigations on candidiasis, definitive conclusions concerning virulence factors are few because of oftentimes confusing and contradictory results. By utilizing various physiologic tests, which include germ tube induction, inhibition of germination by a morphogenic autoregulatory substance, enzyme production, susceptibility to exogenous chemicals, and cell surface hydrophobicity, we demonstrated that such variability is due, in part, to the environmental conditions in which cells were grown in preparation for analysis. Room-temperature grown cells were generally less sensitive to environmental perturbation and germinated more uniformly than cells grown at 37 degrees C. The implication of these results in relation to pathogenic studies and the epidemiology of candidiasis is suggested. PMID- 3312973 TI - Theoretical mechanisms for synthesis of carcinogen-induced embryonic proteins: XVIII. Biomethylation and differentiation. AB - Many reports have appeared describing a direct relationship between hypomethylated states of genes and gene activity. Even after the introduction of viral genomes, these new genes appear to be controlled by specific DNA methylations. A variety of other studies have shown chromatin structural changes being implicated in the activities of certain gene loci. Modifications of chromatin domains may also be initiated or under the control of methylation reactions. Embryonic genes may be controlled by particular methylations by virtue of a differential (hyper-) sensitivity to concentrations of active methyl groups, on a variety of chromatin domains thereby explaining the variation in S-adenosyl L-methionine synthesis required in developing liver tissue. Also our finding of the ability to manipulate experimentally the activity of the alpha-fetoprotein gene by methyl group availability indicates some methyl-sensitive mechanism is operating with respect to embryonic genes. PMID- 3312974 TI - A romance with urology in Malaysia. PMID- 3312975 TI - Amputation in hand surgery. PMID- 3312976 TI - Prenatal diagnosis of infantile polycystic kidneys: a case report. PMID- 3312977 TI - Dihydroergotamine in acute herpes simplex infections. AB - The effect of the subcutaneous administration of 0.5 mL of dihydroergotamine mesylate (1 mg/mL) compared with that of 0.5 mL placebo on the course of an individual episode of herpes simplex infection in patients, who reported at least two other outbreaks in the previous 12 months, was examined by means of a double blind randomized trial. Thirty-seven patients were entered into the trial. The dihydroergotamine-treated group experienced a shorter duration of the over-all attack until healed skin reappeared, with a shorter duration of both pain and oedema, than did the placebo-treated group. The relatively small number of patients, and the fact that testing in an animal model showed no effect of dihydroergotamine on herpes simplex, suggests that these results need to be treated with caution. PMID- 3312978 TI - [Thyroid gland. Iodine metabolism and treatment of thyroid diseases]. PMID- 3312979 TI - [Dose-response relationship, injury and self repair of the cell. Basis of foreign substance reaction, III]. PMID- 3312980 TI - [Disease and drug abuse. Current problems in drug safety]. PMID- 3312981 TI - Lovastatin for hypercholesterolemia. PMID- 3312982 TI - The biology of non-violence. PMID- 3312983 TI - [Glycosylated hemoglobin compared with blood glucose and lipid parameters in diabetics treated with an insulin preparation and diet]. PMID- 3312984 TI - [The Military Hospital in Petrovaradin]. PMID- 3312985 TI - Mechanism of bactericidal action of aminoglycosides. PMID- 3312986 TI - Yeast metallothionein and applications in biotechnology. PMID- 3312988 TI - Is the clinical expression of primary hyperparathyroidism a function of the long term vitamin D status of the patient? PMID- 3312989 TI - [Etiopathogenetic hypothesis and new therapeutic prospectives of insulin dependent diabetes]. PMID- 3312987 TI - Survival strategies of bacteria in the natural environment. PMID- 3312990 TI - [Prenatal and neonatal echographic diagnosis of 2 cases of Beckwith-Wiedemann syndrome]. PMID- 3312991 TI - [Toxicologic screening in poisoning caused by drugs active on the central nervous system using a multiple immuno-enzymatic method]. PMID- 3312993 TI - [Medium-term results of treatment with biosynthetic human insulin in diabetic children already in therapy with insulin of animal origin]. PMID- 3312992 TI - [Transient protein-losing hypertrophic gastropathy in children. Description of 2 clinical cases and review of the literature]. PMID- 3312994 TI - Testicular infarction associated with incarcerated inguinal hernia. PMID- 3312995 TI - [Physiopathological assessment of the TMJ. Clinical study and therapeutic procedure]. PMID- 3312997 TI - [Dentistry at the University of Bologna from its origins]. PMID- 3312996 TI - [Nasolabial cysts. Clinical, histological and therapeutic aspects]. PMID- 3312999 TI - Mechanism of formation and quantitation of imines, pyrroles, and stable nonpyrrole adducts in 2,5-hexanedione-treated protein. AB - The condensation of gamma-diketones with protein epsilon-amino moieties to yield alkylpyrrole adducts has been demonstrated in many in vitro and in vivo systems, although certain features of this reaction remain unclear. The present in vitro study was designed to examine additional aspects of gamma-diketone-protein interactions, including the possible formation of imine intermediates and stable nonpyrrole products, and the potential for conformational changes in pyrrolylated protein. Values for total, stable covalent binding were consistently higher than p-dimethylaminobenzaldehyde (DMAB)-detectable pyrrole adduct concentrations when bovine serum albumin (BSA) was incubated (24 hr, 37 degrees C) with [14C]-2,5 hexanedione (2,5-HD) at diketone:lysine ratios greater than or equal to 5:1 (at pH 9.5) or 1:1 (at pH 7.4). Treatment of pyrrolylated BSA with proteases before the DMAB assay decreased but did not eliminate the difference between these parameters. Quantitative amino acid analysis of pyrrolylated BSA revealed molar decreases in lysine content equivalent to DMAB-detectable pyrrole adduct concentrations; no other amino acids were significantly altered. Cleavage of disulfide bonds in pyrrolylated BSA by dithiothreitol resulted in an apparent decrease in DMAB-detectable pyrrole, which was reversible upon subsequent protease treatment. A similar decrease was not seen with pyrrolylated concanavalin A, a protein that lacks disulfide linkages. Samples of BSA were incubated with [14C]-2,5-hexanedione for 2-144 hr and a portion of each incubation mixture treated with NaCNBH3 to selectively reduce imines to stable amines. Substantial levels of an imine intermediate were detected at 2, 6, and 24 hr but not at 144 hr. The above findings support proposed mechanisms involving imine intermediates in the pyrrolylation reaction. In addition, evidence for the formation of stable nonpyrrole adducts at high diketone:amine molar ratios has been provided. Results consistent with potential conformational alterations in pyrrolylated protein have also been demonstrated. PMID- 3312998 TI - Humoral immune response to mammalian allergens. AB - Solid-phase enzyme immunoassay and passive hemagglutination were used to study the occurrence of antibodies of various isotypes against feline and bovine epithelial extracts in RAST-positive patients, exposed subjects (cat fanciers and senior veterinary students) and healthy controls. A high proportion of the patients had positive results, whereas the findings in exposed subjects varied, depending on the antigen and test technique. These observations caution against making far-reaching conclusions on the basis of narrow studies. PMID- 3313000 TI - Alterations in the activities of rat tissue hexose monophosphate dehydrogenases in response to premature weaning and dietary restriction at mid-lactation. AB - The activities of the hexose monophosphate dehydrogenases increased in adipose tissue, remained unchanged in liver and decreased in mammary gland following the weaning of rats at mid-lactation (day 14). When dietary intake was restricted at mid-lactation, the activities of the hexose monophosphate dehydrogenases increased in adipose tissue, decreased in liver, but were unaltered in mammary gland. Premature weaning on day 14 postpartum resulted in maternal increases in both plasma insulin and glucose, which peaked at day 16. The plasma insulin levels decreased from day 14 to day 18 postpartum in the normal lactating rat, and a similar trend was observed for animals on a restricted dietary intake. Daily food consumption in the lactating rat decreased from 50 g to 20 g after premature weaning. The live weight of pups raised on dams given a restricted food intake from day 14 had decreased by day 17 postpartum, whereas an increase in daily live weight gain was recorded for the litters from the lactating controls. The results demonstrate that the activities of the hexose monophosphate dehydrogenases are regulated differentially between tissues of the lactating rat. PMID- 3313001 TI - The nuclear matrix--its role in the spatial organization and replication of eukaryotic DNA. PMID- 3313002 TI - Identification and regulation of a gene required for cell fusion during mating of the yeast Saccharomyces cerevisiae. AB - We have devised a screen for genes from the yeast Saccharomyces cerevisiae whose expression is affected by cell type or by the mating pheromones. From this screen we identified a gene, FUS1, whose pattern of expression revealed interesting regulatory strategies and whose product was required for efficient cell fusion during mating. Transcription of FUS1 occurred only in a and alpha cells, not in a/alpha cells, where it was repressed by a1 X alpha 2, a regulatory activity present uniquely in a/alpha cells. Transcription of FUS1 showed an absolute requirement for the products of five STE genes, STE4, STE5, STE7, STE11, and STE12. Since the activators STE4, STE5, and STE12 are themselves repressed by a1 X alpha 2, the failure to express FUS1 in a/alpha cells is probably the result of a cascade of regulatory activities; repression of the activators by a1 X alpha 2 in turn precludes transcription of FUS1. In addition to regulation of FUS1 by cell type, transcription from the locus increased 10-fold or more when a or alpha cells were exposed to the opposing mating pheromone. To investigate the function of the Fus1 protein, we created fus1 null mutants. In fus1 X fus1 matings, the cells of a mating pair adhered tightly and appeared to form zygotes. However, the zygotes were abnormal. Within the conjugation bridge the contained a partition that prevented nuclear fusion and mixing of organelles. The predicted sequence of the Fus1 protein (deduced from the FUS1 DNA sequence) and subcellular fractionation studies with Fus1-beta-galactosidase hybrid proteins suggest that Fus1 is a membrane or secreted protein. Thus, Fus1 may be located at a position within the cell where it is poised to catalyze cell wall or plasma membrane fusion. PMID- 3313003 TI - Transcription of the constitutively expressed yeast enolase gene ENO1 is mediated by positive and negative cis-acting regulatory sequences. AB - There are two enolase genes, ENO1 and ENO2, per haploid yeast genome. Expression of the ENO1 gene is quantitatively similar in cells grown on glucose or gluconeogenic carbon sources. In contrast, ENO2 expression is induced more than 20-fold in cells grown on glucose as the carbon source. cis-Acting regulatory sequences were mapped within the 5'-flanking region of the constitutively expressed yeast enolase gene ENO1. A complex positive regulatory region was located 445 base pairs (bp) upstream from the transcriptional initiation site which was required for ENO1 expression in cells grown on glycolytic or gluconeogenic carbon sources. A negative regulatory region was located 160 bp upstream from the transcriptional initiation site. Sequences required for the function of this negative regulatory element were mapped to a 38-bp region. Deletion of all or a portion of these latter sequences permitted glucose dependent induction of ENO1 expression that was quantitatively similar to that of the glucose-inducible ENO2 gene. The negative regulatory element therefore prevents glucose-dependent induction of the ENO1 gene. Hybrid 5'-flanking regions were constructed which contained the upstream regulatory sequences of one enolase gene fused at a site upstream from the TATAAA box in the other enolase gene. Analysis of the expression of enolase genes containing these hybrid 5'-flanking region showed that the positive regulatory regions of ENO1 and ENO2 were functionally similar, as were the regions extending from the TATAAA boxes to the initiation codons. Based on these studies, we conclude that the negative regulatory element plays the critical role in maintaining the constitutive expression of the ENO1 structural gene in cells grown on glucose or gluconeogenic carbon sources. PMID- 3313004 TI - Identification and isolation of the gene encoding the small subunit of ribonucleotide reductase from Saccharomyces cerevisiae: DNA damage-inducible gene required for mitotic viability. AB - Ribonucleotide reductase catalyzes the first step in the pathway for the production of deoxyribonucleotides needed for DNA synthesis. The gene encoding the small subunit of ribonucleotide reductase was isolated from a Saccharomyces cerevisiae genomic DNA expression library in lambda gt11 by a fortuitous cross reaction with anti-RecA antibodies. The cross-reaction was due to an identity between the last four amino acids of each protein. The gene has been named RNR2 and is centromere linked on chromosome X. The nucleotide sequence was determined, and the deduced amino acid sequence, 399 amino acids, shows extensive homology with other eucaryotic ribonucleotide reductases. Transplason mutagenesis was used to disrupt the RNR2 gene. A novel assay using colony color sectoring was developed to demonstrate visually that RNR2 is essential for mitotic viability. RNR2 encodes a 1.5-kilobase mRNA whose levels increase 18-fold after treatment with the DNA-damaging agent 4-nitroquinoline 1-oxide. CDC8 was also found to be inducible by DNA damage, but POL1 and URA3 were not inducible by 4-nitroquinoline 1-oxide. The expression of these genes defines a new mode of regulation for enzymes involved in DNA biosynthesis and sharpens our picture of the events leading to DNA repair in eucaryotic cells. PMID- 3313006 TI - Immunological evidence for the association of p53 with a heat shock protein, hsc70, in p53-plus-ras-transformed cell lines. AB - A rabbit antiserum was prepared against the C-terminal peptide of 21 amino acids from the human heat shock protein hsp70. These antibodies were shown to be specific for this highly inducible heat shock protein (72 kilodaltons [kDa] in rat cells), and for a moderately inducible, constitutively expressed heat shock protein, hsc70 (74 kDa). In six independently derived rat cell lines transformed by a murine cDNA-genomic hybrid clone of p53 plus an activated Ha-ras gene, elevated levels of p53 were detected by immunoprecipitation by using murine specific anti-p53 monoclonal antibodies. In all cases, the hsc70, but not the hsp70, protein was coimmunoprecipitated with the murine p53 protein. Similarly, antiserum to heat shock protein coimmunoprecipitated p53. Western blot (immunoblot) analysis demonstrated that the hsc70 and p53 proteins did not share detectable antigenic epitopes. The results provide clear immunological evidence for the specific association of a single heat shock protein, hsc70, with p53 in p53-plus-ras-transformed cell lines. A p53 cDNA clone, p11-4, failed to produce clonable cell lines from foci of primary rat cells transfected with p11-4 plus Ha ras. A mutant p53 cDNA clone derived from p11-4, SVKH215, yielded a 2- to 35-fold increase in the number of foci produced after transfection of rat cells with SVKH215 plus Ha-ras. When cloned, 87.5% of these foci produced transformed cell lines. SVKH215 encodes a mutant p53 protein that binds preferentially to the heat shock proteins of 70 kDa compared with binding by the parental p11-4 p53 gene product. These data suggest that the p53-hsc70 protein complex could have functional significance in these transformed cells. PMID- 3313007 TI - Changes in repeat number, sequence, and reading frame in S-antigen genes of Plasmodium falciparum. AB - The S antigens from different isolates of Plasmodium falciparum exhibit extensive size, charge, and serological diversity. We show here that the S-antigen genes behave as multiple alleles of a single locus. The size heterogeneity results from different numbers, lengths, and/or sequences of tandem repeat units encoded within the S-antigen genes. Two genes studied here encode antigenically different S antigens but nevertheless have closely related tandem repeat sequences. We show that antigenic differences can arise because repeats are translated in different reading frames. PMID- 3313005 TI - Heterologous expression and characterization of the human R-ras gene product. AB - We directly expressed human R-ras 23,000-dalton protein (p23) cDNA in Escherichia coli under the control of the trp promoter. GTP-dependent phosphorylation of a p23 threonine 85 substitution mutant was observed. This result is in direct analogy to the autokinase activity of H-ras and K-ras threonine 59 substitution mutants. Normal p23 protein was detected in the human fibrosarcoma cell line HT1080 by immunoprecipitation with rabbit antibodies raised against an E. coli expressed R-ras fusion protein. The R-ras p23 protein was found to be 3H labeled in the presence of [9,10(n)-3H]palmitic acid and is associated with the P100 membrane fraction of HT1080 cells. These data suggest that human R-ras p23 has biochemical properties very similar to those of the p21 products of the H-, K-, and N-ras proto-oncogenes. We constructed an R-ras minigene and engineered the expression of normal and mutant alleles from the simian virus 40 early region promoter. Normal and mutant R-ras gene products were authenticated by transient expression in COS-7 cells and immunoprecipitation. The valine 38-substituted R ras p23 displayed reduced electrophoretic mobility. R-ras p21-like proteins, made by eliminating the first 26 R-ras codons, displayed evident mobility differences between the pro form and mature form, along with a valine 12 substitution dependent change in electrophoretic mobility. Rat-1 fibroblasts were transfected with normal and mutant R-ras alleles and normal and activated H-ras alleles. Unlike the human T24 bladder oncogene-encoded p21, mutant R-ras alleles do not cause monolayer focus formation or growth in soft agar of rat fibroblasts. PMID- 3313008 TI - Antibodies to Xenopus egg S6 kinase II recognize S6 kinase from progesterone- and insulin-stimulated Xenopus oocytes and from proliferating chicken embryo fibroblasts. AB - Ribosomal protein S6 becomes highly phosphorylated during progesterone- or insulin-induced maturation of Xenopus laevis oocytes. We have previously purified an Mr 92,000 protein as one of the major S6 kinases from Xenopus unfertilized eggs. In this paper we confirm by renaturation of activity from a sodium dodecyl sulfate-polyacrylamide gel that this protein is an S6 kinase. This enzyme, termed S6 kinase II (S6 K II), was used for the preparation of polyclonal antiserum. Immunocomplexes formed with the antiserum and purified S6 K II were able to express kinase activity with the same substrate specificity as that of the purified enzyme, including autophosphorylation of S6 K II itself. The antiserum did not react with S6 kinase I, another major S6 kinase present in Xenopus eggs, which is chromatographically distinct from S6 K II. The administration of progesterone to oocytes resulted in a 20- to 25-fold increase in S6 kinase activity in extracts of these cells. Immunocomplex kinase assays done on extracts revealed that anti-S6 K II serum reacted with S6 kinase from progesterone-treated oocytes. This antiserum also reacted with the activated S6 kinase from insulin stimulated oocytes. In addition, anti-S6 K II serum reacted with activated S6 kinase from chicken embryo fibroblasts stimulated with serum or transformed by Rous sarcoma virus. These results indicate that S6 K II or an antigenically related S6 kinase(s) is subject to regulation by mitogenic stimuli in various cell types. PMID- 3313009 TI - Comparison of tRNA gene transcription complexes formed in vitro and in nuclei. AB - The nucleoprotein structure of single-copy tRNA genes in yeast nuclei was examined by DNase I footprinting and compared with that of complexes formed in vitro between the same genes and transcription factor C. Transcription factor C bound to both the 5' and 3' intragenic promoters of the tRNA(SUP53Leu) gene in vitro, protecting approximately 30 base pairs at the 3' promoter (B block) and 40 base pairs at the 5' promoter (A block) and causing enhanced DNase I cleavages between the protected regions. Binding to the two sites was independent of the relative orientation of the two sites on the helix and was eliminated by a single point mutation in the 3' promoter. The chromosomal tRNA(SUP53Leu) and tRNA(UCGSer) genes showed a pattern of protection and enhanced cleavages similar to that observed in vitro, indicating that the stable complexes formed in vitro accurately reflect at least some aspects of the nucleoprotein structure of the genes in chromatin. PMID- 3313010 TI - The first intron in the human c-abl gene is at least 200 kilobases long and is a target for translocations in chronic myelogenous leukemia. AB - The c-abl protooncogene is unusual in two respects; it has multiple, widely space N-terminal coding exons transcribed by different promoters, and it is the target of the translocations that form the Philadelphia chromosome found in cells of chronic myelogenous leukemia patients. To understand the organization of the gene in normal and chronic myelogenous leukemia patient DNA we have mapped c-abl by pulsed field gradient gel electrophoresis. We find that one of the alternative 5' exons of the gene lies at least 200 kilobases upstream of the remaining c-abl exons, posing formidable transcription and splicing problems. The 5'-most c-abl exon includes an unusually long 1,276-base-pair segment that contains 15 ATG codons and multiple short open reading frames, upstream of the abl initiator codon. Its peculiar structure suggests that c-abl may be decapitated in most chronic myelogenous leukemia patients, and we demonstrate that this is the case in the chronic myelogenous leukemia cell line K562. PMID- 3313012 TI - A single domain of yeast poly(A)-binding protein is necessary and sufficient for RNA binding and cell viability. AB - The poly(A)-binding protein (PAB) gene of Saccharomyces cerevisiae is essential for cell growth. A 66-amino acid polypeptide containing half of a repeated N terminal domain can replace the entire protein in vivo. Neither an octapeptide sequence conserved among eucaryotic RNA-binding proteins nor the C-terminal domain of PAB is required for function in vivo. A single N-terminal domain is nearly identical to the entire protein in the number of high-affinity sites for poly(A) binding in vitro (one site with an association constant of approximately 2 X 10(7) M-1) and in the size of the binding site (12 A residues). Multiple N terminal domains afford a mechanism of PAB transfer between poly(A) strands. PMID- 3313011 TI - In vivo DNA-binding properties of a yeast transcription activator protein. AB - UV light can serve as a molecular probe to identify DNA-protein interactions at nucleotide level resolution from intact yeast cells. We have used the photofootprinting technique to determine during which of three regulated states (uninduced, induced, and catabolite repressed) the transcriptional activator protein encoded by GAL4 binds to its recognition sites within the GAL1-GAL10 upstream activating sequence (UASG). GAL4 protein is bound to at least four, and probably five, related sequence blocks within UASG under both induced and uninduced states. GAL4-dependent photofootprints are lost under conditions of catabolite repression. We observed no footprint patterns unique to catabolite repressed cells, which suggests that binding of a repressor to the UASG is not involved in this process. Photofootprints of the GAL10 TATA element are strictly correlated with transcription: uninduced, catabolite-repressed, and delta gal4 cells exhibit footprints characteristic of the inactive promoter; induced and delta gal80 cells, which express GAL10 constitutively, display footprints unique to the actively transcribed gene. PMID- 3313013 TI - The yeast acid phosphatase can enter the secretory pathway without its N-terminal signal sequence. AB - The repressible Saccharomyces cerevisiae acid phosphatase (APase) coded by the PHO5 gene is a cell wall glycoprotein that follows the yeast secretory pathway. We used in vitro mutagenesis to construct a deletion (delta SP) including the entire signal sequence and four amino acids of the mature sequence of APase. An APase-deficient yeast strain was transformed with a high-copy-number plasmid carrying the PHO5/delta SP gene. When expressed in vivo, the PHO5/delta SP gene product accumulated predominantly as an inactive, unglycosylated form located inside the cell. A large part of this unglycosylated precursor underwent proteolytic degradation, but up to 30% of it was translocated, core glycosylated, and matured by the addition of mannose residues, before reaching the cell wall. It appears, therefore, that the signal sequence is important for efficient translocation and core glycosylation of yeast APase but that it is not absolutely necessary for entry of the protein into the yeast secretory pathway. mRNA obtained by in vitro transcription of PHO5 and PHO5/delta SP genes were translated in vitro in the presence of either reticulocyte lysate and dog pancreatic microsomes or yeast lysate and yeast microsomes. The PHO5 gene product was translocated and core glycosylated in the heterologous system and less efficiently in the homologous system. We were not able to detect any translocation or glycosylation of PHO5/delta SP gene product in the heterologous system, but a very small amount of core suppression of glycosylated material could be evidenced in the homologous system. PMID- 3313014 TI - Relationship between proteins encoded by three human gamma-crystallin genes and distinct polypeptides in the eye lens. AB - Although individual gamma-crystallins from the human eye lens have not been successfully purified and sequenced, most of the genes coding for these lens specific structural proteins have been cloned and characterized. To investigate the relationship between these genes and the gamma-crystallins of the human lens, we made use of mouse cell lines which contain stably integrated copies of the coding sequences for three of the human gamma-crystallin genes coupled to the human metallothionein IIA promoter. The proteins produced by these hybrid genes in cell culture were detected immunologically and compared by physical characteristics with the gamma-crystallins from the human lens. The protein encoded by the G3 gene showed properties identical to those of the 21,000 molecular-weight gamma-crystallin from 11-month-old lens. The protein isolated from the cells expressing the G4 gene was similar to a 19,000-molecular-weight lens gamma-crystallin, while gene G5 encodes a highly basic gamma-crystallin which may be synthesized in only limited amounts in the human lens. These correlations provide a basis for future investigations on the relationship between putative mutations in human gamma-crystallin genes and altered proteins in hereditary lens cataracts. PMID- 3313016 TI - [Introduction to scanning electron microscopy]. PMID- 3313015 TI - A burst of c-fos gene expression in the mouse occurs at birth. AB - Expression of the c-fos gene during murine perinatal development was studied. Before birth, all eight of the prenatal organs tested expressed undetectable or low levels of c-fos mRNA. On the day of birth, there occurred a 10- to 100-fold increase in the level of c-fos message in all of these organs. The expression was transient, in that 1 day after birth, the level of c-fos mRNA precipitously dropped. The c-fos gene expression at birth is unrelated to the expression of the c-myc gene and major histocompatibility complex class I genes, which display distinct kinetics during the perinatal development. The c-fos gene was also expressed locally and transiently in the gravid uterus 1 to 2 days prior to delivery. These results indicate that an event associated with birth induced c fos gene expression in the mother and newborn. PMID- 3313017 TI - [Reconstruction with composite materials of missing anterior teeth]. PMID- 3313018 TI - [Preliminary study of the efficacy of various types of surface treatments of metals used for fixed partial dentures with resins]. PMID- 3313019 TI - [Nutritional problems of the edentulous]. PMID- 3313020 TI - [Acquired immunodeficiency syndrome (AIDS) in childhood. Current status]. AB - The spectrum of the acquired immunodeficiency syndrome (AIDS) has broadened to include children. A review of the literature revealed 452 pediatric patients with AIDS. Based on these data, relevant and practically oriented information is given concerning epidemiology, clinical features and laboratory findings, diagnosis and differential diagnosis, management, and prognosis of this newly recognized disorder. PMID- 3313021 TI - [Detection of pathogens in bacterial meningitis. Comparison of Gram staining, culture, latex agglutination test and counterimmunoelectrophoresis]. AB - To look for the etiologic agent in cerebrospinal fluids of 44 children with meningitis, Gram stain, traditional culture, latex agglutination and counterimmunoelectrophoresis were simultaneously performed. The sensitivity of all four methods was roughly equal. The outstanding importance of the Gram technique has to be emphasized, however. Differences with regard to antigen detection could be observed in patients previously treated with antibiotics, where etiologic agents could still be detected by latex agglutination and counterimmunoelectrophoresis, but not by traditional cultures. A further advantage of the two methods is that they provide results rapidly. The use of all four methods simultaneously allows for optimal results in the detection of causative organisms in cerebrospinal fluid in meningitis. PMID- 3313022 TI - [B streptococcal infections in the neonatal period and infancy]. AB - From January 1975 to March 1985 37 newborns and infants with B streptococcal infections were treated in the Pediatric Hospital of the Karl Marx University in Leipzig. The percentage of B streptococcal infections of all neonatal bacterial infections rose in this time from 6.9% to 15.7%. There were 23 early onset type infections and 14 late infections; 12 of the 37 infants died. Septicemia and meningitis were the most important clinical features. The time of beginning of the clinical symptoms in the postnatal period and the results of serotyping suggest a connatal infection in most cases. PMID- 3313023 TI - [Prevention of migraine with flunarizine and acetylsalicylic acid. A double-blind study]. AB - 30 children between 7 and 17 years suffering from at least 2 attacks/month of common or classical migraine since more than 1 year were studied. After clinical exclusion of symptomatic headache 4 weeks were documented by means of a migraine diary. Prophylaxis with Calcium entry blocker Flunarizine (Sibelium) or Thromboxane A inhibitor Acetylsalicylic acid (ASS) was carried out in a double blind design for 3 months. Medication was given as one dosage in the evening: 2-5 mg/kg KG ASS or 5-10 mg Flunarizine. Documented attack frequency and duration were controlled at monthly physical examinations. Final results showed no differences in significant reduction of attack frequency or symptoms between both different therapeutic principals. 72.4% (ASS 73.3%; Flunarizine 71.4%) of patients were attack-free or had at least a 50% reduction. Migraine frequency of initially 7-8 was reduced to 1-2 attacks/month. Duration remained constant in both groups (1-3 h). Side effects were slight body weight gain or abdominal pain after intake, prophylaxis had not to be interrupted therefore. Longtime prognosis is not yet possible because the time of observation is too short so far. CONCLUSION: Both substances are definitely useful and have few side effects in childhood migraine. If the response to one is insufficient the other substance should be tried. PMID- 3313024 TI - [Massive fatty liver in cystic fibrosis in infancy]. AB - Cystic fibrosis is diagnosed in an infant with dystrophy and hepatomegaly by ultrasonography, liver-biopsy and sweat-test. PMID- 3313025 TI - Newborn screening for sickle cell disease and other hemoglobinopathies. PMID- 3313026 TI - [Molecular cloning of the human insulin gene]. AB - Isolation of genomic clones containing the human insulin gene by screening the human genomic library for this gene using the cDNA rat insulin probe is reported. The analysis of promoter-enhancer region and exons sequences has revealed their identity to analogous sequences determined earlier. PMID- 3313027 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/1. Genetic effects of ethanol. AB - Alcoholics have a higher frequency of chromosomal aberrations and sister chromatid exchanges (SCEs) in their peripheral lymphocytes. In human and mammalian cells in vitro, ethanol generally does not induce genetic damage, but it induces SCEs in the presence of an exogenous metabolic system. In human lymphocytes in vitro, ethanol induces SCEs in the presence of alcohol dehydrogenase. In animals in vivo, ethanol induces a variety of genetic effects, including SCEs, micronuclei, dominant lethal mutations and aneuploidy in mouse eggs. There is some indication that ethanol may lead to genetic damage in sperm. In bacteria, ethanol is at best marginally active. Ethanol leads to anomalous chromosome segregation in Aspergillus, to mutations in yeast, to chromosomal aberrations and SCEs in plant root tips and to disturbances of meiosis and micronuclei in tetrads in Zea and Tradescantia respectively. The first metabolite of ethanol, acetaldehyde is mutagenic in a variety of test systems. The mutagenic activity of acetaldehyde in bacteria is questionable, but there is no doubt of its mutagenic activity in a variety of eukaryotic test systems in vitro as well as in vivo. PMID- 3313029 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/3. Human acetaldehyde levels: aspects of current interest. AB - The determination of acetaldehyde levels in blood and other tissues is a difficult task, and depends on the method used. Different methods and their pros and cons are discussed in detail. Quantitative results are shown for endogenous acetaldehyde levels and for acetaldehyde levels during alcohol intoxication. One article pertains to acetaldehyde bound to blood and tissue proteins. PMID- 3313028 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/2. Metabolism and metabolic effects of ethanol, including interaction with drugs, carcinogens and nutrition. AB - Different pathways of alcohol metabolism, the alcohol dehydrogenase pathway, the microsomal ethanol-oxidizing system and the catalase pathway are discussed. Alcohol consumption leads to accelerated ethanol metabolism by different mechanisms including an increased microsomal function. Microsomal induction leads to interactions of ethanol with drugs, hepatotoxic agents, steroids, vitamins and to an increased activation of mutagens/carcinogens. A number of ethanol-related complications may be explained by the production of its first metabolite, acetaldehyde, such as alterations of mitochondria, increased lipid peroxidation and microtubular alterations with its adverse effects on various cellular activities, including disturbances of cell division. Nutritional factors in alcoholics such as malnutrition are discussed especially with respect to its possible relation to cancer. PMID- 3313030 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/4. Genetic aspects of the relation between alcohol metabolism and consumption in humans. AB - Alcohol consumption is believed to involve genetic factors. In this paper genetically determined metabolic factors influencing the alcohol metabolism, such as different types of alcohol dehydrogenase and aldehyde dehydrogenase are discussed. PMID- 3313031 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/5. Acute aldehyde syndrome and chronic aldehydism. AB - Different types of alcohol dehydrogenase and of aldehyde dehydrogenase lead to different blood acetaldehyde levels. With respect to acetaldehyde levels in human blood 3 types can be distinguished: (1) the normal range, (2) the acute aldehyde syndrome, and (3) the chronic aldehydism. Acetaldehyde is electrophilic and reacts with nucleophilic groups of various macromolecules including DNA. Acetyldehyde inhibits synthetic and metabolic pathways, it interferes with the polymerization of tubulin and stimulates collagen synthesis. By depletion of cellular glutathione levels, acetaldehyde leads to lipid peroxidation and to the formation of malonaldehyde. There are indications that acetaldehyde may play a role in positively reinforcing mood changes induced by alcohol in humans. PMID- 3313032 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/6. Effect of ethanol on nitrosamine metabolism and distribution. Implications for the role of nitrosamines in human cancer and for the influence of alcohol consumption on cancer incidence. AB - Alcohol consumption is associated with an increase in the incidence of cancers of several sites, including oesophagus, larynx and mouth. The mechanism of the induction of cancer by alcohol is not clear. Humans are exposed to a variety of carcinogenic N-nitroso compounds. Ethanol changes the pharmacokinetics of nitrosamines in rats particularly by decreasing the ability of the liver to metabolize them. A hypothesis is put forward that the influence of alcohol on human cancer is mediated by its effect on the metabolism and distribution of nitrosamines from the diet, from tobacco smoke and from endogenous synthesis. PMID- 3313033 TI - International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/7. Reproductive consequences of alcohol abuse: males and females compared and contrasted. AB - The adverse effects of ethyl alcohol on the hypothalamic pituitary gonadal axes of men and women are discussed with particular attention being given to effects of alcohol upon reproduction. Data obtained from acute and chronic alcohol exposure studies are presented. The putative pathophysiologic mechanisms responsible for disturbed reproductive performances in alcohol abusing individuals are discussed where sufficient data are available. PMID- 3313034 TI - Mutagenicity of aryl propylene and butylene oxides with salmonella. AB - 10 aryl propylene oxides and 6 aryl butylene oxides were synthesized. Dose mutagenicity relationships were studied for these compounds and for 1,2 epoxybutane, using both the preincubation and plate incorporation Ames tests with Salmonella typhimurium strains TA100 and TA1535. Structure-mutagenicity relationships were further examined by concurrent testing at single doses with the plate incorporation assay in strain TA100. In both series of compounds, mutagenicity showed very correlation to chemical reactivity, molar volume and partition values. However, all compounds were mutagenic in at least one system with the propylene oxides being more mutagenic than the corresponding butylene oxide derivatives. The naphthyl derivatives in each series were the most mutagenic. PMID- 3313035 TI - Mutagenicity in salmonella of hazardous wastes and urine from rats fed these wastes. AB - 15 hazardous industrial waste samples were evaluated for mutagenicity in the Salmonella plate-incorporation assay using strains TA98 and TA100 in the presence and absence of Aroclor 1254-induced rat liver S9. Dichloromethane/methanol extracts of the crude wastes were also evaluated. 7 of the crude wastes were mutagenic, but only 2 of the extracts of these 7 wastes were mutagenic; extracts of 2 additional wastes also were mutagenic. In addition, 10 of the crude wastes were administered by gavage to F-344 rats, and 24-h urine samples were collected. Of the 10 raw urines evaluated, 3 were mutagenic in strain TA98 in the presence of S9 and beta-glucuronidase. The 3 crude wastes that produced these 3 mutagenic urines were, themselves, mutagenic. Adequate volumes of 6 of the 10 raw urines were available for extraction/concentration. These 6 urines were incubated with beta-glucuronidase and eluted through Sep-Pak C18 columns; the methanol eluates of 3 of the urines were mutagenic, and these were the same 3 whose raw urines also were mutagenic. In general, the C18/methanol extraction procedure reduced the cytotoxicity and increased the mutagenic potency of the urines. To our knowledge, this is the first report of the mutagenicity of urine from rodents exposed to hazardous wastes. Based on the present results, the use of only strain TA98 in the presence of S9 might be adequate for general screening of hazardous wastes or waste extracts for genotoxicity. The urinary mutagenesis assay does not appear to be a useful adjunct to the Salmonella assay for screening hazardous wastes. The problems associated with chemically fractionating diverse types of hazardous wastes for bioassay are also discussed. PMID- 3313036 TI - Mutagenic activity of 27 dyes and related chemicals in the salmonella/microsome and mouse lymphoma TK+/- assays. AB - A total of 27 dyes and related chemicals were tested for mutagenicity in both the Salmonella typhimurium plate-incorporation and FMN-modified assays as well as the mouse lymphoma TK+/- assay. Half of the compounds tested were monoazo dyes (14); the remainder consisted of disazo (3), aminotriphenylmethane derivatives (4), and other miscellaneous (6) color compounds. The results obtained in this study are compared with data from dyes of the same batch tested in other laboratories in the Salmonella plate-incorporation assay and in both in vitro and in vivo/in vitro UDS assays. Agreement of results from the various assays that could be compared (excluding results that were equivocal or indeterminate) ranged from 80 to 91%. Sufficient data were available to provide an overall index of in vitro activity for 15 chemicals; of these, 14 compounds could be compared to and agreed with reports of their carcinogenic potential in the literature. PMID- 3313037 TI - [Fungi as pathogens in infection--results of a multicenter study]. PMID- 3313038 TI - Cultural and serological follow-up of two oral administrations of baker's yeast to a human volunteer. PMID- 3313039 TI - Blocking adherence of Candida albicans to buccal epithelial cells by yeast glycolipids, yeast wall lipids and lipids from epithelial cells. PMID- 3313040 TI - Protection by phospholipids of Schistosoma mansoni schistosomula against the action of cytotoxic antibodies and complement. AB - Schistosoma mansoni schistosomula cultured in the presence of phospholipids showed a decreased sensitivity to the lethal complement-mediated action of anti schistosome antibodies. Phosphatidyl choline, sphingomyelin and phosphatidyl ethanolamine had a protective action on the schistosomula transformed in vitro by passage through the skin or by a mechanical procedure. Phosphatidyl choline acted regardless of its fatty acid composition. Phosphatidyl serine and phosphatidic acid did not protect. Thus, it appears that phospholipids can play a role in parasite resistance to immune attack by cytotoxic antibodies and complement, and that this role is specific to certain phospholipid types. PMID- 3313041 TI - Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. AB - In a randomized, double-blind five-year trial, we tested the efficacy of simultaneously elevating serum levels of high-density lipoprotein (HDL) cholesterol and lowering levels of non-HDL cholesterol with gemfibrozil in reducing the risk of coronary heart disease in 4081 asymptomatic middle-aged men (40 to 55 years of age) with primary dyslipidemia (non-HDL cholesterol greater than or equal to 200 mg per deciliter [5.2 mmol per liter] in two consecutive pretreatment measurements). One group (2051 men) received 600 mg of gemfibrozil twice daily, and the other (2030 men) received placebo. Gemfibrozil caused a marked increase in HDL cholesterol and persistent reductions in serum levels of total, low-density lipoprotein (LDL), and non-HDL cholesterol and triglycerides. There were minimal changes in serum lipid levels in the placebo group. The cumulative rate of cardiac end points at five years was 27.3 per 1,000 in the gemfibrozil group and 41.4 per 1,000 in the placebo group--a reduction of 34.0 percent in the incidence of coronary heart disease (95 percent confidence interval, 8.2 to 52.6; P less than 0.02; two-tailed test). The decline in incidence in the gemfibrozil group became evident in the second year and continued throughout the study. There was no difference between the groups in the total death rate, nor did the treatment influence the cancer rates. The results are in accord with two previous trials with different pharmacologic agents and indicate that modification of lipoprotein levels with gemfibrozil reduces the incidence of coronary heart disease in men with dyslipidemia. PMID- 3313042 TI - Gemfibrozil, lipids, and coronary risk. PMID- 3313043 TI - The epidemics that delayed D-Day. PMID- 3313044 TI - NIH: a century of science for health. Dilemmas of decision-making. PMID- 3313045 TI - NIH: a century of science for health. Challenge of change in biology. PMID- 3313046 TI - A c-erb-A binding site in rat growth hormone gene mediates trans-activation by thyroid hormone. AB - The substance 3,5,3-triiodothyronine (T3) stimulates growth hormone gene transcription in rat pituitary tumour cells. This stimulation is thought to be mediated by the binding of nuclear T3 receptors to regulatory elements 5' to the transcriptional start site. Understanding of the mechanism by which thyroid hormone activates gene transcription has been limited by failure to purify nuclear T3 receptors because of their low abundance, and by the absence of defined T3 receptor-DNA binding sites affecting T3 regulation. Recently, human and avian c-erb-A gene products have been shown to bind thyroid hormone with high affinity and to have a molecular weight and nuclear association characteristic of the thyroid hormone receptor. In the present report, we describe the development of an avidin-biotin complex DNA-binding assay which can detect specific, high affinity binding of rat pituitary cell T3 receptors to the sequence 5'CAGGGACGTGACCGCA3', located 164 base pairs 5' to the transcriptional start site of the rat growth hormone gene. An oligonucleotide containing this sequence transferred T3 regulation to the herpes simplex virus thymidine kinase promoter in transfected rat pituitary GC2 cells, and specifically bound an in vitro translation product of the human placental c-erb-A gene. The data provide supporting evidence that the human c-erb-A gene product mediates the transcriptional effects of T3 and also that GC2 cell nuclear extracts contain additional factors that modify the binding of pituitary T3 receptors to the rat growth hormone gene T3 response element. PMID- 3313047 TI - Haemonectin, a bone marrow adhesion protein specific for cells of granulocyte lineage. AB - There is substantial evidence that the haematopoietic microenvironment is crucial to the growth and differentiation of haematopoietic cells. This microenvironment is composed of stromal cells, soluble factors and extracellular matrix (ECM). We have shown that a complex extract of bone marrow ECM can stimulate the growth and differentiation of haematopoietic cells in vitro. Furthermore, the use of inhibitors or stimulators of ECM synthesis in long-term marrow culture affects cell proliferation. On a molecular level, however, the interactions between ECM and haematopoietic cells are not well understood. We have investigated the adhesion between specific bone marrow ECM components and haematopoietic cells, and found a protein, 'haemonectin', of relative molecular mass 60,000 in bone marrow ECM which is a lineage- and organ-specific attachment molecule for cells of granulocyte lineage. This specificity distinguishes haemonectin from previously described adhesion proteins which have a wider tissue distribution and cell type specificity. PMID- 3313048 TI - Seeing eye to eye. PMID- 3313050 TI - Therapy and the ideal of chemistry. PMID- 3313049 TI - Lymphocyte activation. How T cells communicate. PMID- 3313051 TI - LHRH agonists and human breast cancer cells. PMID- 3313052 TI - An LFA-3 cDNA encodes a phospholipid-linked membrane protein homologous to its receptor CD2. AB - Recently the human T cell erythrocyte receptor CD2 has been shown to bind human erythrocytes through LFA-3, a heavily glycosylated surface protein of broad tissue distribution. CD2-LFA-3 interactions are important for cytolytic conjugate formation, for thymocyte adhesion, and for T cell activation. A complementary DNA clone encoding LFA-3 was isolated using a complementary DNA clone encoding LFA-3 was isolated using a novel transient expression system of mouse cells. The cDNA encodes a phospholipid-linked membrane protein whose extracellular domain shares significant homology with CD2. As CD2 is homologous with the neural cell adhesion molecule NCAM in immunoglobulin-like domains, cellular adhesion molecules in both neural and lymphoid tissues could have a common ancestor. PMID- 3313053 TI - Anchoring mechanisms for LFA-3 cell adhesion glycoprotein at membrane surface. AB - The manner in which a membrane protein is anchored to the lipid bilayer may have a profound influence on its function. Most cell surface membrane proteins are anchored by a membrane-spanning segment(s) of the polypeptide chain, but another type of anchor has been described for several proteins: a phosphatidyl inositol glycan moiety, attached to the protein C terminus. This type of linkage has been identified on membrane proteins involved in adhesion and transmembrane signalling and could be important in the execution of these functions. We report here that an immunologically important adhesion glycoprotein, lymphocyte function associated antigen 3 (LFA-3), can be anchored to the membrane by both types of mechanism. These two distinct cell-surface forms of LFA-3 are derived from different biosynthetic precursors. The existence of a phosphatidyl-inositol linked and a transmembrane anchored form of LFA-3 has important implications for adhesion and transmembrane signalling by LFA-3. PMID- 3313054 TI - Identification of the V factor needed for synthesis of the iron-molybdenum cofactor of nitrogenase as homocitrate. AB - Nitrogenase catalyses the ATP-dependent reduction of N2 to NH3, and is composed of two proteins, dinitrogenase (MoFe protein or component I) and dinitrogenase reductase (Fe protein or component II). Dinitrogenase contains a unique prosthetic group (iron-molybdenum cofactor, FeMoco) comprised of Fe, Mo and S, which has been proposed as the site of N2 reduction. Biochemical and genetic studies of Nif- (nitrogen fixation) mutants of Klebsiella pneumoniae which are defective in nitrogen fixation, have shown that the nifB, nifQ, nifN, nifE and nifV genes are required for the biosynthesis of FeMo-co. Recently, a system for in vitro synthesis of FeMoco was described. The assay requires at least the nifB, nifN and nifE gene products, and a low-molecular-weight factor (V factor) produced in the presence of the nifV gene product. We have used this system to study FeMoco biosynthesis. We report here the isolation of V factor and identify it as homocitric acid ([R]2-hydroxy-1,2,4-butanetricarboxylic acid). PMID- 3313055 TI - Distal residues in the oxygen binding site of haemoglobin studied by protein engineering. AB - The geometries of the Fe-O2 and Fe-CO bonds in myoglobin and haemoglobin differ significantly from those in free porphyrin model compounds. It has been suggested that steric hindrance by Val-E11 and His-E7 and a hydrogen bond between His-E7 and oxygen affect the geometry and electronic state of the Fe-ligand bond, and that these interactions may be important in controlling oxygen affinity. We have produced mutant haemoglobins in E. coli having Val(67 beta)E11 replaced by Ala, Met, Leu or Ile and His(58 beta)E7 by Gln, Val or Gly. We have studied the effect of these mutations on the equilibrium and kinetics of ligand binding. The conformation of the new side chains and their effect on the protein structure have been examined by X-ray crystallography, and the vibrational properties of the Fe-CO bond observed by resonance Raman spectroscopy. We found that the steric hindrance of ligand binding by the E11 residue and the polarity of the E7 residue in the beta subunit are critical for fine-tuning ligand affinity. PMID- 3313056 TI - Phospho-dephospho-control by insulin is mimicked by a phospho-oligosaccharide in adipocytes. AB - The mechanism of insulin action is only partly understood. At one end of the signalling chain, the structure of the insulin receptor is known in detail, and at the other end, insulin controls cellular metabolism by regulating the phosphorylation of serine and threonine residues in key target enzymes. The molecular events linking the occupied receptor to changes in target enzyme phosphorylation have remained obscure. Recently, insulin was shown to promote the hydrolysis of a phosphatidylinositol glycan with release of its polar head-group. The head group was reported to activate a high-affinity cyclic AMP phosphodiesterase and pyruvate dehydrogenase, to inhibit catecholamine-stimulated lipolysis, and also to inhibit phospholipid methyltransferase and adenylate cyclase. We report here that in intact adipocytes this head-group faithfully copies the insulin-directed effects on the phosphorylation and dephosphorylation of target proteins of the hormone. PMID- 3313057 TI - Two calcium-binding proteins in infiltrate macrophages of rheumatoid arthritis. AB - The aetiology and cellular mechanism of chronic inflammatory processes are poorly understood. Macrophages act prominently in the inflammatory response and we report here that they express two calcium-binding proteins. The expression of these proteins, referred to as MRP-8 and MRP-14, is specific for cells of myeloid origin, namely granulocytes, monocytes and macrophages, and is observed in blood granulocytes and monocytes but not in normal tissue macrophages. In acutely inflamed tissues, macrophages can express MRP-14 but not MRP-8, and in chronic inflammations, such as primary chronic polyarthritis, infiltrate macrophages express both MRP-8 and MRP-14. Characterization of MRP-8 and MRP-14 could therefore be useful to the understanding of cellular processes induced in chronic inflammation. PMID- 3313058 TI - Calculation of electrostatic potentials in an enzyme active site. AB - To be able to calculate the contributions of individual amino acids to the electrostatic field of a protein would be of considerable value in designing proteins of enhanced or altered function and stability. Recent studies on the serine protease subtilisin provide direct measurements of the electrostatic potential in the active site of the enzyme produced by two charged amino acids. We have used these results to test a recently developed method for the calculation of electrostatic interactions between two specific sites on a protein. The extent of agreement between the theoretical and experimental results suggests that the continuum solvent model used in the calculations reproduces the essential features of the interaction. PMID- 3313059 TI - Prediction of electrostatic effects of engineering of protein charges. AB - Accurate prediction of electrostatic effects on catalytic activity is an essential component of protein design. Site-directed mutagenesis of charged groups in subtilisin of Bacillus amyloliquefaciens has provided experimental measurements of electrostatic interactions which may be used to test such theoretical methods. The pKa of the histidine of the active site has been perturbed by +0.08 to -1.0 units by modifying one or two residues. Electrostatic effects in proteins can be modelled by the algorithm of Warwicker and Watson, which uses classical electrostatics and considers both the charge position and the shape of the molecule. Here we report that the algorithm can model several pKa shifts in subtilisin to fair accuracy. PMID- 3313061 TI - Mutations of the Kirsten-ras proto-oncogene in human preleukaemia. AB - The myelodysplastic syndrome (MDS) or preleukaemia is a haematological disorder characterized by low blood counts, bone marrow cells of abnormal appearance and progression to acute leukaemia in as many as 30% of patients. The distinctive preleukaemic and leukaemic phases of this disease make it an attractive model for neoplastic progression in human tumours. We reasoned that, because dominantly transforming genes (such as mutant alleles of ras proto-oncogenes) are found so frequently in acute leukaemia, the search for these genetic lesions during the clinical course of patients with MDS might give us insight into the function of oncogenes in leukaemogenesis. We report here that bone marrow cells from two of four patients with preleukaemia, and from one patient who progressed to acute leukaemia from MDS, contained a transforming allele of the Ki-ras proto-oncogene. In one preleukaemic patient, a novel mutation in codon 13 of this ras gene was detected in bone marrow cells harvested 1.5 years before the acute leukaemia developed. Our findings provide evidence that ras mutations may be involved in the early stages of human leukaemia. PMID- 3313060 TI - Sir Peter Medawar (1915-1987). PMID- 3313062 TI - Historic exhibits. PMID- 3313063 TI - Cell motility. Movements made visible by microchip technology. PMID- 3313064 TI - Experimentally induced alteration in the polarity of developing neurons. AB - Despite the great diversity of shapes exhibited by different classes of nerve cells, nearly all neurons share one feature in that they have a single axon and several dendrites. The two types of processes differ in their morphology, in their rate of growth, in the macromolecular composition of their cytoskeletons and surface membranes, and in their synaptic polarity. When hippocampal neurons are dissociated from the embryonic brain and cultured, they reproducibly establish this basic form with a single axon and several dendrites, despite the absence of any spatially organized environmental cues, and without the need for cell to cell contact. We have cut the axons of young hippocampal neurons within a day of their development: in some cases the initial axon regenerated, but more frequently one of the other processes, which if undisturbed would have become a dendrite, instead became the axon. Frequently the stump of the original axon persisted following the transection and subsequently became a dendrite. Evidently the neuronal processes that first develop in culture have the capacity to form either axons or dendrites. The acquisition of axonal characteristics by one neuronal process apparently inhibits the others from becoming axons, so they subsequently become dendrites. PMID- 3313065 TI - Novel source of 1,2-diacylglycerol elevated in cells transformed by Ha-ras oncogene. AB - Genes involved in the transduction of signals required for normal cell proliferation commonly appear to be subverted in the neoplastic process. One such group is the highly conserved family of ras genes, which have been detected as transforming genes in a wide variety of naturally occurring tumours. By analogy with other known G proteins, the p21 proteins encoded by ras genes may act as regulatory proteins in the transduction of signals that lead to DNA synthesis. A major pathway involved in the DNA synthesis induced by growth factors is mediated by phosphatidylinositol turnover: cleavage of phosphoinositides by phospholipase C produces 1,2-diacylglycerol, and inositol phosphates. The former acts as an essential cofactor for protein kinase C (ref. 4), and inositol-(1,4,5) triphosphate mobilizes Ca2+ from non-mitochondrial intracellular stores. We demonstrate a reproducible increase in 1,2-diacylglycerol, in the absence of a detectable increase in inositol phosphates, in transformed cells containing Ha ras oncogenes and with different membrane targeting signals for the ras p21 protein. These findings suggest that a source other than phosphoinositides exists for the generation of 1,2-diacylglycerol and that the Ha-ras oncogene specifically activates this novel pathway for 1,2-diacylglycerol production. PMID- 3313066 TI - [Cholinergic nerve endings: cellular function and molecular structure]. AB - Progress made in the study of the cellular and molecular function of cholinergic nerve terminals suggests that the textbook schemes need to be extended. Vesicles contained in cholinergic nerve terminals not only store acetylcholine but also ATP and Ca2+ as well as peptides. These substances when co-released by exocytosis may modulate transmission both pre- and postsynaptically. PMID- 3313068 TI - [History of the Dutch Society for Obstetrics and Gynecology]. PMID- 3313067 TI - [Cholesterol consensus in The Netherlands]. PMID- 3313069 TI - [Myelodysplastic syndromes]. PMID- 3313070 TI - [Potassium and calcium in hypertension]. PMID- 3313071 TI - [Substitution therapy in hypothyroidism]. PMID- 3313073 TI - Experience with hydatid disease in Saudi Arabia. PMID- 3313072 TI - Milestones in the first century of medicine in Nebraska. PMID- 3313074 TI - [Subgingival dental scaling as periodontal therapy]. PMID- 3313075 TI - [Grinding of complete dentures after remounting in an articulator]. PMID- 3313076 TI - [Patients with crowns in general practice: a descriptive study of crown types in specific patients]. PMID- 3313077 TI - [Custom-made resin veneers of the anterior teeth in the maxilla. Results after 2 years]. PMID- 3313078 TI - [The discovery of x-rays and its direct consequences. A historical overview]. PMID- 3313081 TI - A long way from the wilderness: thirty memorable years of the Japanese Neurochemical Society. AB - The history and antecedents of the Japanese Neurochemical Society (JSN) are described. Particulars of the founding in 1958, and of the formal establishment in 1962, are given, together with an outline and description of the JSN's recent activities, including its contributions to the 4th International Meeting of the International Society for Neurochemistry (ISN) in Tokyo in 1973. Suggestions are made for the development of a perspective, and for the promotion, of the ultimate, fundamental purposes of neuroscience, and for the proper internalization of the JSN. PMID- 3313080 TI - [Surgical treatment of supra-clinoid saccular arterial aneurysms admitted 3 weeks following rupture]. PMID- 3313079 TI - [Clinical manifestations of rabies in the human. Case report and review]. AB - Clinical symptoms and course in a 28 year old woman who suffered from rabies are reported. Neurophysiological and neuropathological findings in this patient, who died 21 days after developing initial symptoms, are presented in more detail. This disease appears to be rare in Central Europe. It can be treated effectively only by means of early detection and a special vaccination programme. Late recognition of lyssa specific symptoms in non-vaccinated patients is invariably associated with a fatal outcome. A review of current knowledge concerning rabies research is presented. PMID- 3313082 TI - Should nagarse be used during the isolation of brain mitochondria? AB - When nagarse is used to isolate brain mitochondria, a proportion of the nagarse stays associated with the mitochondrial fraction. This results in no detrimental affect on the respiratory activities. The nagarse is active in the presence of 2.3% sodium dodecyl sulfate and when samples are prepared for sodium dodecyl sulfate-polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate, the nagarse degrades a substantial amount of the mitochondrial proteins. PMID- 3313083 TI - [Our method of projecting onto the skull surface the intracranial lesions diagnosed by computerized tomography]. AB - The author presents an own method for the projection onto the surface of the skull of intracranial lesions demonstrated by means of computerized tomography. The method makes possible a more precise and sparing craniotomy and calculation of the irradiation field in case of radiotherapy. The advantage of the method is its easy availability and independence of computerized calculations. It may be applied only to CT images. PMID- 3313084 TI - [Lacunar strokes]. PMID- 3313086 TI - [Epilepsy and pregnancy. Remarks with regard to treatment]. PMID- 3313085 TI - [Late multiple sclerosis]. PMID- 3313088 TI - [Intracranial meningioma of an infant: a case report]. AB - An 11-month-old male infant with intracranial meningioma is presented. Intracranial meningiomas in infancy under the age of 1 year are extremely rare, and only 22 cases have been reported previously. The authors reviewed the clinical and pathological findings of these meningiomas including our case. The patient feel ill with convulsive attacks followed by unconsciousness at 11 months of age without any other neurological deficit. Computed tomographic scannings revealed a high density lesion in the frontal region. The tumor was located entirely in the frontal lobe 2 cm anterior to the Sylvian vein and was removed en bloc. It was 3 X 3 X 3 cm in diameter and 10 g in weight. Histological diagnosis was of fibroblastic meningioma. He was discharged two weeks after the operation without any neurological deficits. Several characteristic features of meningiomas in infant under 1 year old were drawn from the review of literature in comparison with those of meningiomas in adult. 1) Predominant sex was male (16/23). 2) All meningiomas developed in the supra-tentorium. 3) Eight of 18 tumors being described did not have the dural attachment. 4) Nine of 16 tumors showed cyst formation. 5) The most cases were histologically diagnosed benign (17 of 22), and 15 cases was fibroblastic meningioma. PMID- 3313087 TI - [New trends in radioisotope teletherapy of brain gliomas]. PMID- 3313089 TI - [Association of subdural hematoma and middle fossa arachnoid cyst: report of 3 cases and a review]. AB - Three cases of arachnoid cyst of the middle fossa associated with subdural hematoma were briefly reported. In all three cases diagnosis was confirmed by CT scan and operation. A review of the literature found reports of 21 similar cases with adequate descriptions of clinical and radiological data for analysis. Of a total of 24 such cases including our 3 patients (Group B in Table 2), 21 were male and only 3 were female. The arachnoid cyst was found on the left side in 18, on the right side in 5 and bilaterally in the remaining one. Thirteen patients were in age 11 through 20. When compared Group B with Group A comprising 153 cases of arachnoid cyst of the middle fossa irrespective of presence or absence of associated subdural hematoma, such an association was seen most frequently in the male teenagers, probably reflecting the higher incidence of head injuries. PMID- 3313090 TI - [A case of internal carotid artery aneurysm of the cavernous portion treated by trapping with the detachable balloon technic]. AB - The authors report a case of internal carotid artery aneurysm of the cavernous portion, which was treated by trapping of the internal carotid artery using a detachable balloon technique. In April 1984, 56-year-old female was admitted with chief complaint of ptosis of the left eyelid lasting for the past two years. A neurological examination on admission revealed the left oculomotor nerve palsy. Contrast CT scan and left carotid angiogram showed an aneurysm at the cavernous portion of the internal carotid artery. On June 11th, three days before the trapping, superficial temporal artery-middle cerebral artery anastomosis was performed using short vein graft. On June 14th, the internal carotid artery was trapped at the distal and proximal portions of the aneurysmal neck using two Debrun's No. 16 balloons. Digital subtraction angiography taken two weeks after the trapping showed complete occlusion of the left internal carotid artery with no visualization of the aneurysm. Contrast CT scan taken three months after the trapping highly indicated complete thrombosis of the lumen of the aneurysm. Following the intravascular surgery, the left oculomotor paresis was gradually improved. The authors emphasized that the trapping of the internal carotid artery using a detachable balloon technique was the most safe and beneficial method for the treatment of the aneurysm located in the cavernous portion of the internal carotid artery. PMID- 3313091 TI - Presence of a somatomedin-C-immunoreactive substance in the central nervous system: immunohistochemical mapping studies. AB - Somatomedin C (SMC; insulin-like growth factor I) is thought to mediate the effects of growth hormone (GH) mainly on skeletal growth. SMC is produced in the liver but its production by various other fetal tissues including the brain, suggests a local regulatory role rather than a general one. A substance cross reacting with recombinant human SMC (rSMC) was localized in the central nervous system (CNS) of the normal control and Snell dwarf mice by the unlabeled antibody peroxidase-antiperoxidase technique. rSMC-immunoreactive substance (rSMC-IRS) was found in the neuronal cells of forebrain structures. These included the caudate nucleus/putamen, hippocampus, thalamus, hypothalamus, globus pallidus and amygdala. No positive cells were found in the cerebral cortex. Investigation of the dwarf brain showed rSMC-IRS distributed in identical areas of the brain, although the intensity of the staining of rSMC-IRS was found to be weaker than that of the positive cells in the normal brain. Moreover, the number of positive cells was found to be less than in the normal brain. After treatment with bovine GH for 3 days the reduced number of positive cells and weaker staining in the cerebral sections of the dwarf mice did not change. Thus, rSMC may represent another peptide which is common to both the endocrine and the nervous system, with a potential neurotransmitter/neuromodulator function in the CNS. PMID- 3313092 TI - The effect of estrogen on luteinizing hormone-releasing hormone binding sites in hypothalamic membranes. AB - The binding sites for [125I]LHRH were characterized in membranes from the hypthalamus and the effect of estrogen on the binding characteristics was studied in ovariectomized female rats. The radioligand, [125I]LHRH, was found to bind specifically to membranes from the hypothalamus at a maximal level, with an optimal temperature of 0 degrees C and a pH between 7 and 8. The binding was enhanced by NaCl at a concentration of 0.1-0.2 M. The specifically bound [125I]LHRH was only displaced by LHRH, but not by sodium iodide (NaI), bovine serum albumin and other hormones, such as thyrotropin-releasing hormone, bradykinin, oxytocin, prolactin, luteinizing hormone and growth hormone. The divalent metal ions, copper (Cu2+) and mercury (Hg2+), inhibited the specific binding of [125I]LHRH completely, whereas magnesium (Mg2+) and calcium (Ca2+) caused a decrease in binding. As revealed from Scatchard plot analysis, the binding sites for [125I]LHRH in the hypothalamus had a dissociation constant of 0.40 +/- 0.03 microM and the maximum number of binding sites was 98.55 +/- 4.34 pmol/mg protein. Treatment of female rates (ovariectomized for 3 weeks) with 4 micrograms of estradiol benzoate caused a statistically significant decrease in the maximal number of binding sites without any significant effect on the dissociation constant. However, the direct addition of estradiol hemisuccinate to the membrane preparations had no statistically significant effect on the specific binding of [125I]LHRH. The present study provides the evidence that estrogen decreases the density of binding sites for [125I]LHRH in the hypothalamus in vivo. PMID- 3313093 TI - Arteriovenous malformation associated with multiple aneurysms in the posterior fossa: a case report with a review of the literature. AB - The association of two aneurysms on the distal posteroinferior cerebellar artery with an arteriovenous malformation fed by the same artery is reported. A one stage operation was performed. The other cases in the literature are analyzed with particular regard to the origin of the subarachnoid hemorrhage and the location of the aneurysms. PMID- 3313094 TI - A case of Ollier's disease associated with two intracranial gliomas. AB - Ollier's disease or multiple enchondromatosis is a deforming dysplastic disease of cartilage involving primarily the metaphyses and diaphyses of long bones. It is only rarely associated with sarcomatous degeneration of the enchondromas or other generalized neoplasms. A related disease, Maffucci's syndrome, is, however, associated with generalized tumors. We present the case of a 29-year-old, albino, black man with Ollier's disease who, as a child, underwent a number of orthopedic procedures for multiple limb deformities and fractures. At age 25, he developed hydrocephalus, progressive cranial nerve palsies, and a large enchondroma of the skull base. He subsequently underwent multiple shunt procedures and two suboccipital craniectomies. Eighteen months later, a brain computed tomographic (CT) scan revealed an intracerebellar mass, which was found to be an anaplastic astrocytoma. Two years later, he developed a right hemiparesis and sensory dysfunction with a diffuse supratentorial mass on CT scan. A stereotactic biopsy showed this to be a similar anaplastic astrocytoma. The literature concerning Ollier's disease is reviewed, and the intracerebral lesions associated with both Ollier's disease and Maffucci's syndrome are examined. PMID- 3313095 TI - Mature teratoma in the fourth ventricle of an adult: case report and review of the literature. AB - A 4th ventricular mature teratoma that became symptomatic in an adult man is reported. The literature on teratomas located in the posterior fossa midline is reviewed, and previously reported cases are tabulated. The differential diagnosis of posterior fossa midline mass lesions is discussed. PMID- 3313096 TI - Computed tomography-guided stereotactic aspiration of posterior fossa hematomas: a supine lateral retromastoid approach. AB - We report a supine lateral retromastoid approach for computed tomography-guided stereotactic aspiration of hematomas of the posterior fossa. The method involves horizontal insertion of the aspiration needle at the suboccipital region with the patient in a supine position with the head turned 30 to 40 degrees away from the lesion and with slight forward flexion of the neck. Eleven hematomas have been removed through this approach thus far, nine cerebellar and two pontine. With this technique, general anesthesia is not needed and operative invasion is minimal, allowing hematoma aspiration in patients in whom operation would previously not have been indicated. An additional merit is the suitability of this method for elderly patients. PMID- 3313097 TI - Distribution of neurotensin binding sites in rat brain: a light microscopic radioautographic study using monoiodo [125I]Tyr3-neurotensin. AB - The topographic distribution of specifically labeled neurotensin binding sites was examined by light microscopic radioautography in rat brain sections incubated with monoiodo [125I]Tyr3-neurotensin. Preliminary experiments indicated that under the present experimental conditions [125I]neurotensin specifically binds to a single apparent population of sites with a dissociation constant of 7.7 +/- 0.3 nM, and that fixation of the labeled sections with glutaraldehyde ensures regionally proportional retention of more than 70% of bound [125I]neurotensin molecules. High concentrations of [125I]neurotensin binding sites were detected in the olfactory bulb and tubercle, parts of the neocortex, the lateral septum, the diagonal band of Broca, the caudate putamen, the amygdala, the dentate gyrus, the anterior dorsal nucleus of the thalamus, the suprachiasmatic nucleus of the hypothalamus, the medial habenula, the zona incerta, the substantia nigra and the ventral tegmental area. In certain areas, such as in the diagonal band of Broca, the substantia innominata, the nucleus basalis and the pars compacta of the substantia nigra, discrete accumulations of silver grains were apparent over neuronal perikarya and their proximal dendrites. In most areas, however, the label appeared more or less uniformly distributed over nerve cell bodies and surrounding neuropil. In several instances, the labeling conformed with the distribution of cell bodies of origin and terminal aborizations of specific projection systems, suggesting that neurotensin receptors might be distributed both proximally and distally on the plasma membrane of certain neurons. Such putative "neurotensinoceptive" projection systems might involve part of the mesostriatal, mesocortical and mesolimbic dopamine systems, as well as the raphe prosencephalic serotonin system and the habenulo-interpeduncular and basal forebrain-cortical cholinergic systems. Finally, areas of dense [125I]neurotensin labeling often corresponded to zones previously shown to exhibit intense acetylcholinesterase staining, suggesting the existence of a possible link between the expression of neurotensin binding sites and that of acetylcholinesterase in certain neuronal populations. PMID- 3313098 TI - Synaptic control of pyramidal cell activation in the hippocampal slice preparation in the rat. AB - Recordings were made from CA1 pyramidal neurons in a rat hippocampal slice preparation to compare the effectiveness of orthodromic stimuli when delivered at different distances from the cells under study. A stimulating electrode placed in stratum radiatum was less effective in driving nearby pyramidal cells (within 200 micron) than those farther away (greater than 800 micron). Thus for a given field excitatory postsynaptic potential both the intracellular excitatory postsynaptic potential and the evoked population spike were smaller when evoked from a local stimulating electrode than from one more distant. Laminar mapping experiments indicated that the spatial distribution of activated excitatory synapses over the pyramidal cell dendrites was similar for local and distant stimuli. The firing threshold, and the amplitude of hyperpolarizing inhibitory postsynaptic potentials, were also similar for the two stimuli. Responses evoked by the local stimulating electrode were more sensitive to morphine, penicillin and pentobarbital than responses elicited by the distant stimulus, suggesting that some form of GABAergic inhibition limited the efficacy of the local stimulus. The data suggest that in the CA1 region a vertically oriented synaptic inhibitory system exists that powerfully regulates the ability of an orthodromic stimulus to activate pyramidal cells. These results also illustrate the practical importance of controlling the distance between stimulating and recording electrodes, when performing quantitative pharmacological studies of synaptic transmission in the hippocampus. PMID- 3313099 TI - Comparison of L-baclofen and racemic baclofen in trigeminal neuralgia. AB - L-Baclofen was compared with racemic baclofen (Lioresal) in a double-blind crossover trial in 15 patients with typical trigeminal neuralgia. L-Baclofen was more effective than five times as much racemic baclofen in nine patients. Six of these nine patients have continued pain-free on L-baclofen for 4 to 17 months (mean, 10 months). L-Baclofen was much better tolerated than racemic baclofen. Our results suggest that L-baclofen represents a significant improvement over racemic baclofen in the treatment of trigeminal neuralgia, and support our laboratory observations indicating that D-baclofen antagonizes the action of L baclofen. PMID- 3313100 TI - Cervical epidural abscess. AB - We present 3 new cases of cervical epidural abscess (CEA), a rare condition, along with a review of 12 other case reports. The average patient age was 45 years; just over half were male. The abscesses usually involved the mid to lower cervical region and extended an average of three to four segments. Neck stiffness was present in all patients; root pain and paresthesias were present less often. Weakness of one to four extremities developed in all but one patient. Sensory levels were frequently present, sometimes below the site of the lesion. All but two patients were febrile. All but two had elevated CSF protein, and all but two had a pleocytosis; myelography always revealed a complete or partial block. Staphylococcus aureus was the causative organism in 8 of 11 patients. CEA should be considered in a patient with neck stiffness, paresthesias, and/or radicular pain so that CT or myelography followed by surgical decompression and/or antimicrobial drugs can be initiated before prolonged weakness develops. One of our patients developed a syrinx causing a new neurologic deficit 3 years after treatment. Delayed syringomyelia, a rare complication of extramedullary lesions, lends support to vascular occlusion as the major mechanism of damage in epidural abscess. PMID- 3313101 TI - Evoked potentials predict the clinical changes in a multiple sclerosis drug study. AB - Visual, brainstem auditory, and median nerve somatosensory evoked potential (EP) tests were performed annually during a 3-year, double-blind, placebo-controlled study of azathioprine with or without steroids in chronic progressive MS. Treatment-related visual and somatosensory EP changes became statistically different 1 year before corresponding differences were seen in the Standard Neurological Examination scores. The statistical significance of EP changes was substantially greater than seen for changes in other clinical scales. The degree of significance was increased by using EP latency values, rather than simple criteria for change. EPs are sensitive, objective measurements useful in MS therapeutic trials. PMID- 3313102 TI - Ultrasonic diagnosis of schwannoma. PMID- 3313103 TI - Pathogenesis of Creutzfeldt-Jakob disease. PMID- 3313104 TI - Sherlock Holmes: neurologist. PMID- 3313105 TI - Determination of brain death with 123I-IMP and 99mTc-HM-PAO. AB - Brain imaging with radiolabeled amines, 123I-IMP and 99mTc-HM-PAO, is a rapid, safe, and specific bedside test for confirming brain death in the absence of cerebral blood flow. Therapeutic phenobarbital or thiopental levels do not interfere with the cerebral penetration ability of the lipophilic radiopharmacons. PMID- 3313106 TI - [Cystic disease of the liver. Report of a case of a solitary giant cyst]. PMID- 3313107 TI - [Experience with liver transplantation at the University of Chicago]. PMID- 3313108 TI - [Bypass surgery in inoperable tumors of the exocrine pancreas]. PMID- 3313109 TI - [Secondary prevention of colorectal neoplasms]. PMID- 3313110 TI - [Irritable bowel syndrome. Bio-psycho-social aspects]. PMID- 3313111 TI - [Epidemiology of deep venous thrombosis in digestive surgery]. PMID- 3313112 TI - [Use of diagnostic tests in problems of internal medicine. Analysis of 1,667 ambulatory patients attending the first aid unit of a general hospital]. AB - Patients with problems of internal medicine presenting at first-aid units of city hospitals represent a considerable work load. 1667 patients of this type have been examined retrospectively. The most numerous group had cardiocirculatory (22%) and nervous system (21%) problems, 9% had problems linked to their mental state and 11% dermatology complaints in general. 1047 patients underwent further investigation and/or specialist examination (247 neurological and 166 cardiological). Patients with jaundice, diabetes mellitus and cardiac decompensation underwent the highest number of laboratory examinations. The highest percentage of X-rays was done on patients suffering from chronic bronchitis during an acute episode, the highest percentage of ECGs in patients with prethoracic pain or cardiopalmus. In first aid also, some tests seem to be carried out as routine or for legal medicine purposes while for problems where tests are less easy or harder to understand (e.g. loss of consciousness episodes), a specialist is frequently brought in. The work load on the first-aid out-patients structure can be reduced by promoting greater awareness of the problem on the part of the internist and by rerouting users to non-hospital structures. PMID- 3313113 TI - [Development of the anatomic knowledge of the adrenal glands]. PMID- 3313114 TI - [Motion sickness in the aerospace environment]. AB - After a brief description of the newest and special form of motion sickness known as "space sickness" arising in space flight, and the various hypotheses on its aetiopathogenesis, motion sickness in general and the air or plane sickness deriving from atmospheric flying are discussed. The aetiopathogenesis of air sickness derives from abnormal stimulations that are primarily vestibular but also visual and somesthesic, and generated by irregular movements or variations in attitude of the plane. Reflex action than produces effects that are primarily neurovegetative (nausea, vomiting, pallor, scialorrhea, sweating, bradycardia) and neuropsychological (depression, drowsiness, headache, discomfort and general debility with altered cenesthesia). After a description of the symptoms, the prevention and treatment of air sickness are discussed. PMID- 3313116 TI - [Epidemiologic aspects of sepsis]. AB - Sepsis is increasingly common and is now emerging as a iatrogenic condition, though the increase relates to both hospital-acquired and community-acquired infections. The causes and modalities of sepsis are reviewed with particular emphasis on the invasive treatment now extensively employed in patients with severe concomitant pathologies and immune deficiencies. The changing aetiology of the various forms of sepsis is analysed. These days common opportunistic Gram negative bacilli such as Enterobacteriacea and Pseudomonas as well as Candida mycetes are the most frequent cause of sepsis. The diagnostic importance of blood culture analysis is emphasised. PMID- 3313115 TI - [Clinical medicine of disorders of porphyrin metabolism in man]. AB - Porphyrin metabolism disorders are grouped into three classes. 1) Hereditary porphyrias including those caused by an inherited deficiency in one of the enzymes responsible for porphyrin synthesis. 2) Secondary porphyrias: well defined clinical situations due to disturbed porphyrin metabolism caused by a variety of toxic substances or drugs or secondary to other pathological conditions. 3) porphyrin metabolism disorders as concomitant featured of certain types of poisoning or particular pathologies. This is followed by a brief description of porphyrin synthesis and the enzymes involved in it, and the distribution of porphyrins and their precursors in certain tissues and biological materials. Hereditary porphyrins are treated individually and not classified since all the classification systems proposed are open to criticism. However the value of grouping acute intermittent porphyria, hereditary coproporphyria, variegated porphyria and the porphyria caused by PBG-synthetase deficiency under "acute porphyrias" is recognised since all involve acute attacks with similar symptoms and prognoses, all are triggered by the same factors and all are treated in the same way. The various forms of hereditary porphyrias are grouped into 3 main categories: a) acute attacks featuring abdominal colics and signs of distress on the cerebral and peripheral nervous systems; b) skin alteration due to photosensitisation; c) haemolytic anaemia. Treatment is divided into preventive, symptomatic and aetiopathogenic. The individual hereditary porphyrias are then examined. The secondary porphyrias examined include lead poisoning, porphyria of the skin caused by hexachlorobenzene, subacute or chronic tyrosinaemia and acute intermittent porphyria caused by carbamazepine. Finally the porphyrin metabolism disorders concomitant with other diseases are examined including those encountered in anaemia, liver disease, dermatological conditions and infections and conditions caused by drugs and toxic substances. PMID- 3313117 TI - [Prenatal echographic diagnosis of achondroplastic nanism]. PMID- 3313118 TI - Immunohistochemical differentiation of Schwann and epithelial basal lamina in the rabbit cornea. AB - Transmission electron microscopy has shown that at the point of entry of axons into corneal epithelium, Schwann cell lamina densa merges with lamina densa of epithelial origin. Staining properties and the thickness of lamina densa from these sources are similar. Immunostaining with monoclonal antibodies to laminin and type IV collagen revealed that while Schwann cell basal lamina fluoresced to both of these probes, epithelial basal lamina was visualized only with anti laminin. Monoclonal antibodies to neurofilament protein (70 and 200 kDa) were used to visualize the neural tissue. Segments of the deep stromal and subepithelial innervation appeared similar to those seen following gold chloride impregnation. The results suggest that intercalation of lamina densa from these tissue sources and regulation of the production of basal lamina components by both the epithelial and the Schwann cells probably occur. PMID- 3313119 TI - Immunocytochemical localization of acetylcholine receptors in locust brain using auto-anti-idiotypic acetylcholine antibodies. AB - Auto-anti-idiotypic antibodies have been detected in antisera of rabbits immunized with an acetylcholine (ACh) conjugate. These antibodies were found to bind to ACh receptor (ACh-R) purified from different species membranes. They competed with the ACh-R antagonist alpha-bungarotoxin and some agonists such as ACh conjugate and ACh itself. They did not recognize acetylcholinesterase. Their characterization 'in vitro' suggested their employment as an immunohistological marker for ACh-R. In the locust brain, specific immunoreactivity was found in neuropils of the protocerebrum, the optic lobes, the deutocerebrum and the tritocerebrum. PMID- 3313121 TI - Treatment of obstructive sleep apnea with a nasopharyngeal tube. PMID- 3313120 TI - Immunocytochemical demonstration of luteinizing hormone-releasing hormone in optic nerve and nasal region of fetal rhesus macaque. AB - The brain and nasal region of a fetal (124 days) female rhesus macaque (Macaca mulatta) were fixed in situ, decalcified, sectioned and treated for the immunocytochemical demonstration of LHRH. Immunoreactive neurons and fibers were found in expected sites and also in sites not reported to date in primates: there was an abundant distribution along the pathway of the nervus terminalis and clusters of neurons anterior and ventral to the olfactory bulbs and scattered in the nasal septum. Fibers extended into the epithelium lining the nasal septum. Most unexpectedly, LHRH fibers and a few neurons were observed within the optic nerve. PMID- 3313122 TI - Littre's hernia. PMID- 3313123 TI - Applications of recombinant DNA in biotechnology. PMID- 3313124 TI - Quinoline, quinazoline, and acridone alkaloids. PMID- 3313125 TI - Tobacco isoprenoids. PMID- 3313126 TI - The use of stable isotopes in biosynthetic studies. PMID- 3313127 TI - Guidelines for an effective personal fitness prescription. AB - The growing popularity of personal fitness can be observed in the increasing number of exercise centers and spas, and the burgeoning amount of lay literature. It is estimated that 50 percent of adult Americans engage in some form of regular exercise, but many have little or no concept of what constitutes a safe, effective fitness program. Many advertisements make attaining fitness look almost effortless. This leads the novice to unrealistic expectations. Few health care providers receive formal training in fitness management. As a result, their instructions are often vague. This article discusses the components and importance of personal fitness. Possible risks of exercise are also discussed. The normal physiologic responses to exercise and training are reviewed and the necessary ingredients of an effective fitness prescription presented. Motivational aspects are explored, using the health-belief model as a framework. PMID- 3313128 TI - Recent advances in cancer chemotherapy. PMID- 3313129 TI - Physician framers of the Constitution. PMID- 3313130 TI - Bochdalek hernia in adulthood. PMID- 3313131 TI - Radionuclide imaging in the diagnosis of diaphragmatic hernia associated with neonatal group B streptococcal sepsis. PMID- 3313132 TI - Diaphragmatic hernia. PMID- 3313133 TI - Sugars consumption of Northumbrian children aged 11-14 years. AB - In order to investigate the relationships between diet and tooth decay the authors recently completed the first longitudinal study of diet and dental caries increment in children. 405 children initially aged 11.5 years each recorded their intake of foods and drinks for a total of 15 days over a period of 2 years. This is a review of some of the findings. PMID- 3313134 TI - Sucrose and dental caries. AB - Sucrose is unequivocally implicated in the cause of dental caries. Biochemical, microbiological, animal and human clinical and epidemiological evidence support a causal relationship. The risk of caries is related both to the amount and the frequency of intake of sucrose. The evidence that sucrose is important is that a) extracellular synthesis of polysaccharides by plaque bacteria is dependent on high concentration of sucrose. Without synthesis of polymers S. mutans cannot colonize the mouth in large numbers. b) studies on animals show a relationship between sucrose content of a food and its cariogenicity, c) there is a direct relationship between the quantity of sucrose consumed and caries in humans, d) the relationship between dietary sucrose and caries in humans approximates an S shaped curve that rises more steeply when the sucrose-containing products are consumed frequently and when newly erupted teeth are present in young children and adolescents. Following the sharp rise, the curve flattens out. Sucrose is much more cariogenic than starch in humans. Reduction in sucrose consumption levels by half will benefit dental health and is unlikely to have any detrimental effects on health. PMID- 3313135 TI - Nutrition before conception and the outcome of pregnancy. AB - Close birth spacing increases the risk of miscarriage, congenital malformation and perinatal death because it does not give a mother time to recover from the nutritional depletion caused by the first pregnancy or time to recover a normal hormonal profile before the beginning of the next pregnancy. The placental vitamin pump causes maternal vitamin depletion. Nutritional deficits do more damage to reproduction around the time of conception than later during pregnancy. Vitamin and mineral deficiencies can cause not only direct damage to embryonic development but damage to both male and female germ cells resulting in new mutations before a conception. New mutations can cause pregnancy failure or maldevelopment of the embryo. The realisation that nutritional deficits can be mutagenic opened a new chapter in nutritional science. Some nutrients are antimutagenic and already act as such within the digestive tract, but foods contain many other antimutagenic substances. The juices of many fresh vegetables in particular are antimutagenic. PMID- 3313136 TI - "Nutrition in the promotion of your health" pride, prejudice and propaganda. AB - The association between the organic movement and 'alternative medicine' may have been one reason for the failure of the McCarrison Society in Britain to appeal to many National Health Service doctors and dentists. This is unfortunate because the aims of the McCarrison Society have nothing to do with any system of medical care. Our hope is to prevent disease by promoting McCarrison's teaching that man is perfectly adapted to his food supply as it occurs in nature and that the greatest single cause of the diseases of industrial peoples is their dependence on foods made worthless or harmful by processing and refining. This teaching applies to the modern epidemic of coronary heart disease. The evidence incriminating natural unprocessed fat as a cause of this disease is unconvincing. PMID- 3313137 TI - Metabolic changes induced by sugar in relation to coronary heart disease and diabetes. AB - The effects on the biochemistry and physiology of the human body of diets differing only in the ratio of the two major carbohydrates, starch and sugars are discussed and related to the epidemiology of coronary heart disease and diabetes. PMID- 3313138 TI - Effect of physical activity on skeletal integrity and its implications for calcium requirement studies. AB - A major task confronting those who establish calcium recommendations is the determination of a minimum level of calcium intake that will promote bone mineralization and/or reduce bone demineralization sufficiently to aid in the prevention of osteoporosis. The evidence reviewed here indicates that physical activity plays a primary role in the maintenance of skeletal integrity. Thus, to obtain data on calcium recommendations that are relevant to the general population, it is essential that calcium requirement studies use subjects whose physical activity profile is representative of the general population. PMID- 3313139 TI - Inequalities in nutrition. AB - Inequalities in nutrition are associated with inequalities in health. Many surveys, mainly American, show that there are large variations between individuals in the quality and quantity of food consumed. Variations depend upon up-bringing, education, income and availability of food. In the United Kingdom there is a steep social-class gradient in age-specific death-rates for heart disease and other diseases including cancer. Of all the many possible nutritional factors the strongest inverse correlates with death-rates within the United Kingdom and in other developed countries are the consumption of fresh vegetables and fruit. Among the individual nutrients a low consumption of vitamin A, or its precursor carotene is associated with an increased cancer risk. Whole milk is a major source of vitamin A and carotene in the British diet and is also reported to be protective against osteoporosis and some forms of hypertension including preeclampsia. School meals can set a pattern of life-long eating habits. PMID- 3313140 TI - Sucrose and idiopathic renal stone. AB - Idiopathic renal stone comprises more than 80 per cent of kidney stone disease. Whilst the incidence rate in the Western World is high, that in Africa south of the Sahara is very low. Epidemiological studies point to a dietary aetiology as the basis for stone formation in the kidney. A number of dietary constituents increase the urinary risk factors for stone formation and one of these is sucrose. The sucrose effect is exaggerated when it is consumed in certain forms. There is also the evidence that a third of a normal population responds in an exaggerated manner in respect of an increased excretion of urinary risk factors when sucrose is consumed and this phenomenon has been noted in over 70 per cent of idiopathic stone formers. In studying the mechanism of this, insulin was found to influence distal renal tubular function to increased calcium excretion. Stone formers with an exaggerated urinary risk factor response to sucrose were found to have abnormally high and sustained blood levels of insulin following a standard glucose test meal. Where sucrose or sucrose products are in abundance, quite apart from its effect in increasing urinary risk factors in the population in general, there is particular vulnerability of a significant sub group within the population with this type of insulin response. Sucrose furthermore is known to induce nephrocalcinosis in the kidney of the rodent and similar calcific lesions have been found in the kidney substance of man and these have been observed to begin to appear within the first decade of life.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3313141 TI - Surgical anatomy of the perirectal fascia: a gynecologic perspective. PMID- 3313142 TI - [Reports from the 32 annual meeting of the German Society of Hematology and Oncology. Tubingen 1986. 2: Etiology and pathogenesis of malignant lymphoma. New methods of tumor therapy. The endothelium and blood platelets]. PMID- 3313143 TI - [Endogenous tumor lectins: new tumor markers and targets in cancer therapy?]. PMID- 3313144 TI - [Chromosome aberrations and malignant lymphomas]. AB - Chromosomal findings in malignant lymphomas are correlated to the histopathology and the immunologic phenotype of lymphoma subgroups. The prognostic significance of a cytogenetic analysis and its value for therapy planning are discussed. With respect to tumorigenesis it is emphasized that a number of proto-oncogenes and genes for cell differentiation, such as immunoglobulin and T-cell receptor genes, have been localized at sites of recurring chromosomal rearrangements. One chapter deals with cytogenetic data in correlation to findings of DNA recombination studies in Hodgkin's disease. PMID- 3313145 TI - [Pharmacokinetic aspects in the use of new cytostatic drugs]. AB - A knowledge of pharmacokinetic data is essential for a rational treatment with cytotoxic drugs. The use of pharmacokinetics and insight into the metabolism make it possible to elucidate, predict or prevent toxicities after single and combined drug treatment. In addition, a careful monitoring in early clinical trials might help to find the optimal dose and schedule and to avoid less effective routes of application. This might improve the therapeutic range and efficacy of drug therapy in oncology. PMID- 3313146 TI - [New cytostatic drugs. Status: 1986]. AB - In oncology phase-II studies are planned for testing antitumor activity in a series of malignant tumors. Most important is the development of drugs from entirely new classes of chemicals, fermentation products etc. Clinical research with analogues of known cytotoxic drugs aims at broader spectra of activity and at decreased toxicity in an attempt to avoid, for example, the cardiac toxicity of the anthracyclines or the renal and gastrointestinal toxicities of cis platinum. PMID- 3313147 TI - [Resection of liver metastases]. AB - The result of liver resection for metastases must be calculated against the natural history without therapy, for which Wagner has found a 5-year-survival rate of only 0 to 3%. From 1970 to 1983 at our surgical unit altogether 80 liver metastases were resected by atypical resection or hemihepatectomy with a primary lethality rate of 28% in the first and 8% in the second period of survey. However, this rate has been further reduced since 1983 by the introduction of the CUSA, intraoperative sonography and the use of segmental liver resection. Since October 1984 altogether 110 liver metastases were resected with a primary lethality of only 5%. Our present 5-year-survival rate for curatively resected liver metastases specifically in colorectal cancer, calculated by the actuarial method, is 32%. PMID- 3313149 TI - [Orbital lipogranuloma]. AB - Orbital lipogranulomas are rare inflammatory pseudotumors. Clinical and histopathological findings of 4 own cases are demonstrated and discussed. PMID- 3313148 TI - [Endothelial function and arteriosclerosis]. AB - Elevated levels of plasma LDL have been correlated with morphological endothelial damages, e.g. reduced antithrombogenity of endothelial cells. Numerical and functional defects of endothelial cells probably influence the necessary separation of blood fractions from subendothelial tissues in a negative sense. In order to describe an imaginable endothelial dysfunction with respect to LDL transport we examined human umbilical venous endothelial cells (HUVEC) in culture under physiological flow conditions. HUVEC in culture after incubation with a LDL concentration of 100 micrograms/ml medium were exposed to defined levels of physiological shear stress, fixed with formalin and stained with oil-red-O. After documentation of oil-red-O staining with a photomicroscope, the amount of stain has been characterized semiquantitatively with the help of an image-analysis system (IBAS II/Zeiss). HUVEC not exposed to shear stress only showed a marginal oil-red-O staining at the cell surface. If they were exposed to shear stress of 0.5 dyn/cm2 they showed in orthogonal view an average increase of 1.3%, in cross sectional view an average increase of 0.3%. HUVEC exposed to shear stress of 2.5 dyn/cm2 showed in orthogonal view an average increase of 4.6%, in cross-sectional view an average increase of 8.7%. PMID- 3313150 TI - HIV antibody screening of corneal donors. AB - Because of the risk of transmitting the acquired immune deficiency syndrome through corneal transplantation, health officials have recommended donor screening. We prospectively studied the seropositivity rate for human immunodeficiency virus infection among ocular tissue donors at our eye bank during 1986. Of 1,517 corneal donors, 5 (0.3%) were repeatedly reactive by enzyme immunoassay. For comparison, 131 (0.06%) of 206,415 blood donors in Houston were similarly seropositive during this same 1-year period. Routine serological testing can be successfully implemented by eye banking personnel to potentially reduce the risk of viral transmission by keratoplasty. PMID- 3313151 TI - Spatial summation and the cortical magnification of perimetric profiles. AB - M-scaling of the conventional spot targets of clinical perimetry at low photopic adaptation levels, such as that of the Octopus automated perimeter, does not result in the expected isosensitive profile using the current equations for humans. This disparity has been attributed to variations in the ganglion cell characteristics across the retina, most notably that of spatial summation. The hypothesis was further investigated by M-scaling the perimetric sensitivity recorded under conditions favouring reduced spatial summation, namely an increased adaptation level and a longer stimulus duration afforded by the Humphrey Field Analyzer. The M-scaled data exhibited a paracentral reduction in sensitivity relative to the theoretical isosensitive profile and an increased sensitivity beyond an eccentricity of 12 degrees. This indicates that for perimetric spot stimuli, the current human M-scaling equations under represent the fovea at the visual cortex. The implications for the design of perimetric routines are discussed. PMID- 3313152 TI - Ameloblastic carcinoma: a clinicopathologic study and assessment of eight cases. AB - The term ameloblastic carcinoma is differentiated from the term malignant ameloblastoma and is defined as an ameloblastoma in which there is histologic evidence of malignancy in the primary tumor or the recurrent tumor (or metastasis), regardless of whether it has metastasized. Eight cases of ameloblastic carcinoma from the Armed Forces Institute of Pathology (AFIP) are reported. The mean age of patients was 30.1 years, with no sex predilection noted. Seven cases involved the mandible and one involved the maxilla, with the posterior regions favored. The most common sign was swelling, although pain, rapid growth, trismus, and dysphonia also occurred. Lesions characteristically were evident as ill-defined destructive radiolucencies, with occasional radiopacities noted. Histologic features generally resembled those of conventional ameloblastoma but with cytologic features of epithelial malignant disease. The clinical course was uniformly aggressive with extensive local destruction and spread, frequent recurrences, and one case of neck node metastasis. The nomenclature and classification of odontogenic carcinomas are discussed, as well as entities that should be included in the differential diagnosis. Further reporting of ameloblastic carcinoma is encouraged. PMID- 3313153 TI - Juvenile fibromatosis of the infratemporal fossa. AB - A case of extensive juvenile fibromatosis of the infratemporal fossa in a 2-year old child, which was evident only as progressive mandibular hypomobility, is reported. The current literature is reviewed with regard to the etiology of the fibroproliferative lesions, the histopathologic diagnosis, and treatment modalities. Although complete surgical resection is the treatment of choice, radiation therapy and chemotherapy have been recommended in extensive cases. Because of the immense size and location of the lesion in the case presented herein, the tumor was deemed inoperable and was treated with multimodality chemotherapy. PMID- 3313154 TI - Influence of geometric distortion and exposure parameters on sensitivity of digital subtraction radiography. AB - In the course of digital subtraction radiography (DSR), variation in the alignment of the x-ray source object and image receptor is an undesirable but frequent problem. The influence of angulation changes between the x-ray source and object on the quality of the subtracted image was measured with the visualization of a thin chip of bone (thickness less than or equal to 0.85 mm). Twenty radiographic image pairs that differed by known geometric distortions ranging from 0 to 9 degrees horizontal and vertical were subtracted. The ability to detect a thickness change varied strongly with angular distortion. Under optimal conditions (no distortion), DSR was able to detect a change in thickness of cortical bone of 0.12 mm. Under approximately clinical circumstances (3 degree misalignment), a thickness change of 0.35 mm was detected with 50% accuracy (three of six cases), while a thickness change of 0.42 mm was detected with 100% accuracy (six of six cases). In addition, the influence of exposure parameters on DSR was investigated. Twenty-one radiographic film pairs were subtracted with differing densities and contrasts. Images made at 70 kVp with an optical density of 0.61 in the dentin produced the best subtracted images. However, even images made with one fourth the conventional exposure produced diagnostic information when analyzed with DSR; this was not seen with conventional analysis of the normally exposed radiographic films. PMID- 3313155 TI - Image enhancement of the mandibular condyle through digital subtraction. AB - The use of conventional radiography to visualize the mandibular condylar articulating surface is limited by the superimposition of surrounding bony elements, which can be termed structured noise. This study investigated the application of digital subtraction to reduce such noise. Two conventional radiographs were made of a temporomandibular joint: first a reference radiograph with the condyle seated in the glenoid fossa (simulating a patient with mouth closed), then a radiograph from the identical orientation but with the condyle translated slightly downward and forward (simulating mouth partially opened). The radiographs were digitized and, on a pixel-by-pixel basis, the intensity value of the second image was subtracted from the reference image to produce a third, subtracted image. The subtracted image provided a significantly improved visualization of the condyle's superior surface. PMID- 3313156 TI - Experimental immune system of the inner ear. AB - The observation that certain clinical cases of sensorineural hearing loss could favorably respond to immunosuppressive therapy in addition to experimental studies that support the presence of an inner ear immune system have led to the suggestion that a number of inner ear disorders previously considered to be idiopathic may in fact have an immunological basis. The experimental evidence that establishes the operation of a distinct inner ear immune system is presented. PMID- 3313157 TI - Paraganglioma of the supraglottic larynx. AB - Supraglottic paraganglioma is described in an 80-year-old woman who presented with a small shiny-red mass at the posterior aspect of the left aryepiglottic fold. Histological examination revealed the typical 'zellballen' pattern of extra adrenal paragangliomas. The tumor was locally excised and did not recur at 24 months follow-up. PMID- 3313158 TI - The child with a limp. AB - The child with a limp is a commonly encountered diagnostic challenge. This article discusses normal gait in children and how to assess the limping child. A review of potential catastrophies and a differential diagnosis based on age is presented. PMID- 3313159 TI - Rotational problems of the lower extremities. AB - Rotational problems are common, often the source of great parental concern, but only occasionally is active treatment required. Cast correction of rigid metatarsus adductus in infancy and operative correction in middle to late childhood are occasionally appropriate for severe deformity. PMID- 3313160 TI - Angular deformities of the lower limbs in children. AB - Bowlegs and knock-knees are common concerns in the early years of life. For the majority of children, these problems represent normal physiologic development and they correct spontaneously. A few children will have pathologic malalignment, which may lead to functional or cosmetic problems that may require treatment, usually bracing and occasionally surgery. Physiologic varus and valgus and the common causes of pathologic malalignment, including Blount's disease, rickets, hereditary conditions, infection, and trauma are discussed. PMID- 3313161 TI - Leg length discrepancy. AB - The proper management of LLD requires careful clinical and radiologic assessment, and repeated analysis of past growth in order to predict future growth. Treatment decisions must be re-evaluated constantly in the light of new leg length data and evolving surgical technique. Surgical treatment can be especially gratifying when anatomic, cosmetic, and functional symmetry is restored and a lifetime of shoe lifts, braces, or prostheses is avoided. PMID- 3313162 TI - Congenital malformations of the lower extremities. AB - An understanding of the normal and pathologic development of the lower limb allows the physician a fuller appreciation of the clinical and functional disabilities that each congenital malformation may present. Treatment to allow achievement of each child's fullest potential may then be better attained. PMID- 3313163 TI - Primary bone tumors in children. AB - The combination of clinical information and the findings on conventional radiographs should lead the physician to a narrow differential diagnosis. Before biopsy, appropriate diagnostic and staging studies should be carried out. The biopsy reveals the pathologic diagnosis and a definitive treatment plan then can be instituted. An algorithm is provided for the evaluation and treatment of a child with a suspected bone tumor (Fig. 14). PMID- 3313164 TI - Congenital dislocation of the hip. Treatment in infancy to walking age. AB - Early management of congenital dislocation of the hip has been necessary and has resulted in a high percentage of normal-appearing and functioning hips. The risk of complications and problems has been lessened. Further, the techniques employed are simpler and less demanding or difficult for patients, family, or physicians. PMID- 3313166 TI - Slipped capital femoral epiphysis. AB - SCFE is one of the most potentially damaging conditions of the adolescent hip. The onset may be associated with minor trauma but is often insidious and may present as vague thigh or knee pain. The lateral radiograph is the most sensitive view for detection of a low-grade slip. The contralateral hip must be examined carefully as there may be bilateral disease with the pain and disability of the presenting side masking the symptoms of less involved hip. SCFE is occasionally associated with other metabolic and endocrinologic disease, and these should be screened for in the history and physical examination. Once a slip begins, the hip remains at jeopardy for acute progression until the physeal plate closes. We recommend immediate surgical stabilization and prefer a cannulated screw system. Proper technique is critical to safe and reliable surgery. The most common complications, AVN and chondrolysis, are often related to technical errors and should be minimized with attention to detail. PMID- 3313165 TI - Legg-Calve-Perthes disease. Current concepts and controversies. AB - Legg-Calve-Perthes disease is a common, controversial pediatric hip disorder. It is currently accepted that the disorder represents idiopathic avascular necrosis (osteonecrosis) of the capital femoral epiphysis. Treatment by conservative or surgical containment is recommended primarily for older children with extensive femoral head involvement. The results of containment treatment indicate improved results over the natural history of the disease process. PMID- 3313167 TI - Foot and ankle problems. AB - The most common reason for children presenting to the general or the pediatric orthopedist has to do with foot problems. The usual age group ranges from the neonate to preschool. The authors have made an attempt to present guidelines for our approach to foot problems other than clubfoot in these age groups and have rendered our recommendations for treatment. We feel that pediatric and general orthopedists will be able to utilize our methods in the management of the pediatric patient with the more commonly presenting foot disorders. PMID- 3313168 TI - The complete subtalar release in clubfeet. AB - CSTR is a release of the subtalar joint and the talonavicular joint that corrects calcaneal rotation, a major deformity of the clubfoot, as well as the other major deformities of the midfoot and hindfoot. Indications for the CSTR are presented. These include failure of conservative treatment or unsatisfactory surgical results with residual varus deformity, and a foot longer than 8 cm. Contraindications to CSTR include radiographic evidence of a flat-top talus and uncorrected anterior ankle contractures. The Cincinnati incision, which permits excellent visualization of all the relevant structures and good cosmesis, is described and compared with other approaches. The technique of the CSTR is described in detail. Key steps include marking the knee for later alignment with the foot (a major advantage of this procedure), superficial medial dissection, posterior dissection, lateral dissection, and deep medial dissection. Technical details and criteria for evaluation are provided. Four supplemental procedures and their indications are described. These include metatarsal osteotomy, calcaneocuboid capsulotomy, calcaneal wedge osteotomy, and plantar release. Procedures for pinning and casting are described, with special attention to accuracy of realigning the foot and measures for avoiding avascular necrosis and other complications. The importance of intraoperative radiographs is presented, together with methods for obtaining and assessing these films to assure that surgical correction is complete. It is imperative that these films be taken before tendon repair or wound closure so that pinning procedures can be repeated, if necessary. PMID- 3313169 TI - Sports injuries in the immature athlete. AB - The care of the pediatric athlete should not be viewed as caring for small adults. Growing bones, tendons, ligaments, and muscles respond differently to stress. Proper training and conditioning can remedy most problems in the immature athlete. PMID- 3313171 TI - Assessment and management of the lower extremity in cerebral palsy. AB - For all lower extremity problems in children with cerebral palsy, early attention to overactive spastic muscle groups can aid in preventing bony deformities under most situations. More severely involved children need more aggressive treatment, with early soft tissue procedures to attempt balance of muscle groups surrounding joints. Early aggressive management of soft tissue problems can avoid long-term bony deformity and more severe posturing problems in the lower extremities of children with cerebral palsy. PMID- 3313170 TI - Assessment and management of the lower extremity in myelodysplasia. AB - The goal in managing the lower extremity in a child with spina bifida is to achieve a pattern of development as near normal as possible. Lower limb deformities are produced by muscle imbalance, weight-bearing, and the postural effects of gravity. At any point in time, the management of the lower extremities will depend on the child's general development. Lower limb paralysis, hydrocephalus, bladder infections, hydromyelia, and Arnold Chiari malformation, all contribute to developmental delay. A child's potential for mobility varies with the severity of the motor and sensory deficit. Surgery is done to correct deformity, provide joint stability, and improve joint mobility. The results of surgery will be compromised if the child is not neurologically stable, or if appropriate therapy and orthotic care are not available. Muscle imbalance produces the problem of deformity and instability of the hip. Deformity must be corrected if the child is to assume an upright posture. Instability is of concern only in those children with a strong quadriceps muscle. Hip surgery for instability should be limited to one procedure, which must achieve a stable concentric reduction and balance the muscle forces about the hip. The common deformities seen at the knee are recurvatum, knee flexion contractures, and genu valgum. Most knee deformities can be corrected by soft tissue procedures. Well designed orthoses rocker sole shoes, and appropriate gait training help prevent knee deformities. The goal in managing foot deformities is to achieve a plantigrade foot with stable skin. Whenever there is a problem with sensation, concentrated pressure in one area of a deformed foot will lead to skin breakdown. Surgical procedures must completely correct deformity and restore muscle imbalance. After surgery, meticulous orthotic care is required to prevent skin breakdown and avoid loss of correction. The orthopedist has a significant role in helping a child with spina bifida to achieve a pattern of development as near normal as possible. He or she must work in concert with a team of professionals and realize that orthopedic surgery is but an incident in the habilitative program. This rather chatty narrative is based on spina bifida care experience, in Sheffield, Toronto, and Chicago. PMID- 3313172 TI - [Effect of autosensitization on the survival of skin transplants]. PMID- 3313173 TI - [Vascular complications after fractures of long bones (review of the literature)]. PMID- 3313174 TI - [Methods of diagnosis of acute hematogenic osteomyelitis (review of the literature)]. PMID- 3313175 TI - [External fixation with bone nails]. PMID- 3313176 TI - [Comparative clinical and roentgenologic evaluation of regeneration after crural bone lengthening using demineralized bone]. PMID- 3313177 TI - [Surgical treatment of congenital clavicle defect]. PMID- 3313178 TI - [Radiotherapy in orthopedics and traumatology]. PMID- 3313179 TI - [Current foreign equipment for external fixation (review of the literature)]. PMID- 3313180 TI - [Current knowledge on mitochondrial myopathies and encephalomyopathies]. PMID- 3313181 TI - [Pharmacodynamic examination of Oddi's sphincter using endoscopic manometry]. PMID- 3313183 TI - [Jozsef Jakab Plenck on 18th and 19th century Austro-Hungarian medical relations]. PMID- 3313182 TI - [The effect of allopurinol therapy on kidney processes concomitant with gout]. PMID- 3313185 TI - [Sarospatak and the history of the 400-year old "Magyar Chirurgia"]. PMID- 3313184 TI - [Experience with multiple myeloma]. PMID- 3313186 TI - [Medical and public health subjects in the publication "Nova Posoniensia"]. PMID- 3313187 TI - [Obstetrics and gynecology in the 20th century]. PMID- 3313188 TI - [Bilateral kidney tumors--reoperation of the resected solitary kidney]. PMID- 3313189 TI - [Diagnostic problems in pericardial fluid accumulation]. PMID- 3313190 TI - [Acyclovir in the therapy of varicella zoster-caused disease in children undergoing immunosuppressive therapy]. PMID- 3313191 TI - [Clinical pathology of gastric hemorrhages originating from caliber persistent arteries]. PMID- 3313192 TI - [Enterocyst perforation]. PMID- 3313193 TI - [The influence of European schools of ophthalmology on the course of development of ophthalmology in Hungary in the 19th century]. PMID- 3313195 TI - [Pharmacy in ancient Egypt]. PMID- 3313194 TI - [The role of John Locke in the development of medical thinking]. PMID- 3313196 TI - [Closed-system anesthesia]. PMID- 3313197 TI - [Prenatal diagnosis of the megacystis-microcolon-hypoperistalsis syndrome]. PMID- 3313198 TI - [Frequency of chromosome testing in infants born to mothers over the age of 40]. PMID- 3313199 TI - Sectarian medical periodicals of Pennsylvania. Part One--Development of sects. PMID- 3313200 TI - The behavioral management of pain: a criticism of a response. AB - In response to an earlier published paper by Fordyce, some assumptions underlying the behavior management paradigm of chronic pain are critically discussed. While operant treatment has proved successful, the conclusion that operant factors play an important role in the development and maintenance of chronic benign pain is debated. Some empirical studies, regularly used to demonstrate this role, are re evaluated. An alternative theory is proposed for chronic pain behavior, in which the role of a lower tolerance to proprioceptive stimuli, which may include more than just pain stimuli, is emphasized. PMID- 3313201 TI - Epidural blood patch in the treatment of post-lumbar puncture headache. AB - Post-lumbar puncture headache is a common complication of dural puncture. Treatment of severe cases with an epidural 'blood patch'--injection of 10-20 ml autologous blood into the epidural space at the site of the dural puncture--is an effective and safe method with few and generally mild complications. The method has been used by anesthesiologists for many years with good results, but only rarely by radiologists, neurologists and other specialists who often perform lumbar punctures. The technique of 'blood patching,' its indications, effects, and complications and the epidural blood patch as post-lumbar puncture headache prophylaxis are discussed. PMID- 3313202 TI - Indomethacin: effects on cold-induced pain and the nervous system in healthy volunteers. AB - The sensitivity of the cold-induced pain (CP) model to the non-steroidal anti inflammatory drug (NSAID) indomethacin was studied in healthy volunteers. Effects on the central nervous system were also sought. Subjects received single oral doses of indomethacin 50 and 100 mg, dipipanone 8 mg and placebo, according to a double-blind, randomised, balanced, cross-over design with an interval of 7 days between occasions. A test battery was performed before each treatment and then at 45, 105 and 165 min post treatment. Pain scores were unaltered by indomethacin at either dose, but the drug certainly affected the CNS, increasing respiratory drive and changing self-assessed mood. It is concluded that the CP model is insensitive to indomethacin, even in doses which have clear-cut CNS effects. The respiratory stimulant action of indomethacin may deserve further study. PMID- 3313203 TI - National Association of Orthopaedic Nurses, chapter listing 1987-1988. PMID- 3313204 TI - The activity of drug combinations against established infections of rodent malaria. AB - In the experiments reported here treatment (with a single dose or daily for 4 days) was delayed until 3 days after inoculation. Various combinations of M&B 35,769, 2:4-diamino-5-[3(4-4'-chlorophenylphenoxy)propyl-1-oxy]-6-methylpy rimidine HCl, plus sulphadoxine, and of M&B 35,769 plus dapsone, were examined and it was concluded that no universally ideal ratio of constituents in a combination is possible because the optimum ratio depends upon the activity of the constituents on their own and therefore varies from strain to strain. Activity was assessed on the 24th day after infection. M&B 35,769 was markedly superior to pyrimethamine against all strains when the compounds were given on their own but, although it showed good potentiation with sulphadoxine and dapsone, much of its lead over pyrimethamine was lost in combination. M&B 36,821 2-4-diamino-5-[3-(3,4'-dibromobiphenyl-4-oxy)-propyl-1-oxy]-6-meth yl pyrimidine HCl, was more active than M&B 35,769 against pyrimethamine- and cycloguanil resistant strains but not against sensitive strains. PMID- 3313205 TI - Biology of gyrocotylideans with emphasis on reproduction, population ecology and phylogeny. PMID- 3313206 TI - The in vitro cultivation of P. falciparum ookinetes, and their enrichment on Nycodenz density gradients. AB - Employing a simple method of growing ookinetes of Plasmodium falciparum in culture, 40% of mature gametocytes convert to macrogametes, 4% reach the retort form ookinete stage and 0.45% become mature ookinetes. A single-step gradient centrifugation method on 12.5% Nycodenz enriches both gametocytes and ookinetes. PMID- 3313207 TI - [The bacterial agent of cat-scratch disease]. PMID- 3313208 TI - [Thrombospondin: its role in platelet aggregation]. PMID- 3313209 TI - [Comparative study of plasmid resistance to mercury of 2 bacterial strains of animal origin]. AB - Bacterial resistance to mercury has been studied in two different strains from animal origin, Salmonella typhimurium 9205 and Escherichia coli 467. These two strains are resistant to mercuric chloride but sensitive to phenylmercury, and thus belong to the group of bacteria that possess a "narrow" spectrum resistance. The presence of plasmids within the cells has been demonstrated through conjugation experiments and direct detection of extrachromosomal DNA in transconjugants. These plasmids, termed p9205-1 and p467-30, differ from each other by both their size (100 and 50 Kbp, respectively) and structure, as shown by the restriction patterns arising from digestion by nucleases BamHI, HindIII, PstI and EcoRI. Each plasmid has been treated with enzyme SalI to yield DNA fragments that have been cloned into pBR322. Two recombinant plasmids, p9205 1/Sal and p467-30/Sal, have thus been constructed, each of them harboring a 2 Kbp fragment that appears to contain the merA gene coding for mercuric reductase. From the analysis of the restriction maps of these recombinant plasmids as well as the functional behaviour of the bacteria that they are able to transform, it can be concluded that they are identical. PMID- 3313210 TI - [Treatment of neurological forms of Argentinian hemorrhagic fever with cytarabine]. AB - The effects of cytarabine on neurological forms of Argentina Hemorrhagic Fever were evaluated in 125 patients. The mortality was 12.88 per cent compared to 61.40 per cent in untreated patients. (p less than 0.0001). The efficiency of this treatment depends on its early application. No side effect was observed. PMID- 3313211 TI - [Campylobacter pyloridis: bacteriological study and sensitivity to antibiotics]. AB - Twelve strains of Campylobacter pyloridis isolated in the antrum and/or fundus in 8 patients were analyzed for antibiotype. The results obtained, compared with those in the literature, enabled assessment of the culture media which are the best adapted for isolation, the main criteria for identification (urease, alkaline phosphatase, nitratereductase, growth temperature), their sensitivities (beta-lactamines, tetracyclines, macrolides) or their resistance to antibiotics (colistin, vancomycin, co-trimoxazole, nalidixic acid). PMID- 3313212 TI - [In vitro study of the transplacental passage of chloroquine sulfate]. AB - The authors, by performing in vitro perfusion on six human placentas, have studied the passage of chloroquine sulphate into the placenta. The drug levels were recorded by high performance liquid chromatography (HPLC). The placental perfusions lasted one hour and drug passage into placental tissue was low (14.21%) which seems to be due to the high degree of fixation of chloroquine on placental tissue. PMID- 3313213 TI - [Comparison of minimum inhibitory concentrations of group M penicillins against Staphylococcus aureus. Practical impact on diagnosis and treatment]. AB - The MICs were determined in usual conditions and in special conditions for the detection of heterogeneous methicillin resistance. The study involved 40 strains of Staphylococcus aureus of the 3 categories of homogeneous resistant, heterogeneous resistant and sensitive strains. The MICs of the 4 main compounds of the group M penicillins, methicillin, oxacillin, cloxacillin and dicloxacillin, were lower in the presence of a higher number of chlorine atoms on the molecule. The heterogeneous strains were even sensitive to dicloxacillin. The MIC for a notable fraction of resistant strains were lower than the critical value, i.e. these strains entered the category of dicloxacillin sensitive even in reading conditions theoretically leading to the detection of heterogeneous resistance. These in vitro observations are of value in the presence of methicillin sensitive strains, since antibiotics containing one or two chlorine atoms will probably be more therapeutically effective. But the bacteriologist should pay more careful attention to the detection of methicillin resistant and heteroresistant strains, since the resistance in vivo is extended to other penicillinase-resistant penicillins or penicillins M. PMID- 3313214 TI - [Titers of antibodies binding the complement detected in a healthy population against 32 antigens. A basis of interpretation for routine serology?]. AB - Is it possible to interpret the serological results when we cannot test better than one sample? Concerning complement fixation we tried to answer investigating the prevalence of 32 antigens in 150 blood donors. Antibodies titers distribution is given. A table synthesizes "normal" values and probabilities of "pathological" results. PMID- 3313215 TI - [Lipid peroxidation in human pathology: evaluation of data in literature]. AB - Several methods have been proposed for detecting the oxidation and breakdown of polyunsaturated fatty acids (lipoperoxidation process) in humans. The lipoperoxidation products which hitherto have been measured in sufficiently large groups of subjects are lipid conjugated dienes, malonic dialdehyde and fluorescent byproducts in biological fluids and low molecular weight aliphatic hydrocarbons in expired air. None of these methods can yet be considered as the method of choice. Various analytical pitfalls and several epidemiological and statistical biases cast doubt about the conclusions of the majority of the studies carried out so far in humans. Provided further studies are undertaken to determine the factors which influence the metabolism of low molecular weight hydrocarbons in man, expired air analysis might constitute a practical and promising in vivo approach for detecting an increased lipoperoxidation process. PMID- 3313216 TI - [New species of the genus Listeria: Listeria seeligeri]. AB - Listeria seeligeri is a recently described species which shares 28% to 1% DNA relatedness with the other species of the genus Listeria. G + C% content of the type strain is 36. Peptidoglycan type (variation A1 gamma) as well as teichoic acids are identical to those found in L. monocytogenes. L. seeligeri can be easily distinguished from the other species using the following markers: hemolysis (CAMP-tests with Staphylococcus aureus and Rhodococcus equi) and acid production from D-xylose, L-rhamnose and alpha-methyl-D-mannoside. No specific antigen allow to characterize L. seeligeri strains which belong to serogroups 1/2 (81%), 4 (12%) and 6 (6%). 85% of these strains proved to be phage typable. So far, more than 100 strains were isolated, mainly in Europe, from environment and animal healthy carriers. Unless one case of meningitis in human, strains of this species are experimentally non virulent. PMID- 3313217 TI - [Antiestrogen action of progesterone in the breast]. AB - This review analyzes recent data from international literature concerning the antiestrogen action of progesterone, progestins and the antiprogesterone RU 486 at the level of mammary cells in culture from either breast cancer lines or normal breast obtained from reduction mammoplasties. Most data indicate that progesterone, progestins and even RU 486 have a strong antiestrogen effect on breast cell appreciated by the decrease of estradiol receptor content, the decrease of cell multiplication and the stimulation of 17 beta-hydroxysteroid activity which may be considered as a marker of breast cell differentiation dependent of progesterone receptor. PMID- 3313218 TI - [6 beta-hydroxycortisol: a non-invasive reflection of enzymes of drug metabolism]. AB - 6-beta-hydroxycortisol (6-beta-OHF) is the main unconjugated metabolite of cortisol in human urine. 6-beta-OHF could be assayed in urine by several methods : chromatography followed by colour reaction, high performance liquid chromatography, radioimmunoassay and enzyme immunoassay. Urinary 6-beta-OHF is increased in some physiological conditions (such as pregnancy) and pathological states (such as hypercortisolemia and liver disease). The measurement of 6-beta OHF in human urine may provide a useful index of enzyme induction, its excretion being enhanced by many inducers of the mixed function oxygenase. PMID- 3313219 TI - [From clinical action to the elucidation of mechanism of action: 20 years of research on Primperan]. AB - For twenty years, metoclopramide has been widely used as an antiemetic and digestive motility modifier. The mechanism of metoclopramide's antiemetic effect has been elucidated : it involves a block of the dopaminergic receptors located in the trigger zone of the floor of the fourth ventricle. Metoclopramide's effect on motricity is due to an indirect cholinergic action : metoclopramide enhances cholinergic transmission by blocking serotoninergic receptors. Through its central action, metoclopramide neutralizes the effect of stress on digestive motricity, whereas domperidone, a drug with a strictly peripheral action, is ineffective in this form of digestive pathogenesis. PMID- 3313221 TI - Performance of respirators at fast rates commonly used in neonatal intensive care units. AB - The effect on tidal volume and airway pressure of increasing ventilator rate (30, 60, and 120/min) was tested in six commonly used neonatal ventilators. In all six ventilators increased flow was necessary to maintain mean airway pressure at the higher rates. Tidal volume decreased at rates of both 60 and 120/min in all six ventilators, associated with a change in pressure waveform. The most marked reduction in tidal volume, however, was associated with increased positive end expiratory pressure (PEEP). This was only demonstrated in four ventilators, all incorporating nonassisted expiratory valves. These results stress the necessity for appropriately designed ventilators if fast rates are to be used routinely in clinical practice. PMID- 3313220 TI - Cystic fibrosis: a review of pulmonary infections and interventions. PMID- 3313222 TI - High frequency ventilation--the relationship between ventilator design and clinical strategy in the treatment of hyaline membrane disease and its complications: a brief review. AB - Progress in the application of techniques of HFV to clinical settings has been hampered by a lack of comparative data. Ventilator design and/or strategy place clear limitations on the effective and safe use of these devices. There is a definite need to develop clear therapeutic goals for HFV, to define the operating characteristics and limitations of each device, and to develop effective and safe strategies for their use in various clinical settings. Only then can adequate controlled clinical trials be performed and the role of these techniques be firmly established. PMID- 3313223 TI - [Hypochloremia--new facts and new problems]. PMID- 3313224 TI - [Baron de Lenval Institute of Child Hygiene. Its history, objectives, organization and the report on its activities to date. II. Objectives and organization]. PMID- 3313226 TI - [Classification of disorders of morphogenesis]. PMID- 3313225 TI - [Poles in the Breslau Pediatric Clinic before 1918]. PMID- 3313227 TI - [Etiopathogenesis of celiac disease--facts and theories]. PMID- 3313228 TI - [Baron de Lenval Institute of Child Hygiene. History, objectives, organization ond progress report. III. Progress report]. PMID- 3313229 TI - [Favorable effect of passive inhalation (insufflation) of intal in obstructive bronchitis in children in the first few years of life]. PMID- 3313230 TI - [The Baron de Lenval Institute of Child Hygiene. History, objectives, organization and a progress report. IV. The Pedagogical Department]. PMID- 3313231 TI - Haemophilus b polysaccharide vaccine: need for continuing assessment. PMID- 3313232 TI - Acetaminophen prophylaxis of adverse reactions following vaccination of infants with diphtheria-pertussis-tetanus toxoids-polio vaccine. AB - The effect of acetaminophen on reducing the frequency and severity of adverse reactions following diphtheria-pertussis-tetanus toxoids-polio vaccine was studied in a randomized clinical trial involving 519 vaccinations in 383 infants 2 to 6 months of age and 70 infants 18 months of age. Significantly fewer local and systemic reactions were reported in acetaminophen-treated infants at 2 to 6 months of age. Acetaminophen also reduced the incidence of fever greater than 38.0 degrees C from 44% to 27%. Only 0.9% of acetaminophen-treated infants had overall behavioral changes rated as severe by parents compared to 13% of the placebo group. Infants vaccinated at 18 months of age had higher rates of systemic and local reactions than younger infants. Acetaminophen did not result in significant reductions in reaction rates after the booster at 18 months. We conclude that acetaminophen administered at the time of primary vaccination with diphtheria-pertussis-tetanus toxoids-polio can significantly reduce the frequency and severity of common adverse reactions. PMID- 3313233 TI - Trimethoprim-resistant Shigella and enterotoxigenic Escherichia coli strains in children in Thailand. AB - The percentage of Shigella and enterotoxigenic Escherichia coli (ETEC) strains resistant to trimethoprim (TMP)-sulfamethoxazole isolated from children with diarrhea at the outpatient department of the Children's Hospital in Bangkok increased from 3 and 0%, respectively, in 1982 to 29% and 25% in 1986. One hundred thirty-nine Shigella and 22 ETEC strains resistant to greater than 1024 micrograms/ml of trimethoprim (TMPr) isolated from children with diarrhea in Bangkok in 1984 and 1985 were analyzed for the presence of type I, II and III plasmid-specific dihydrofolate reductase (DHFR) genes. Thirty-two percent (45 of 139) of TMPR Shigella had genes encoding type II and 9% (13 of 139) had genes encoding type I DHFR genes. Fifty percent (11 of 22) of TMPR ETEC had type II and 14% (3 of 22) had type I DHFR genes. Plasmids encoding DHFR were identified by the Southern technique in 24% (14 of 58) of Shigella and 1 of 14 ETEC that contained genes encoding DHFR. Plasmids coding for type II DHFR were transferred to E. coli K12 by conjugation from 13 of 14 Shigella and a plasmid coding for type I DHFR was transferred from the single ETEC containing a plasmid coding for type I DHFR. Genes coding for DHFR were presumably situated on the chromosome in 76% (44 of 58) of Shigella and 93% (13 of 14) of ETEC that contained genes encoding DHFR. Since 58% (81 of 139) of TMPR Shigella and 36% (8 of 22) of TMPR ETEC strains examined did not contain genes encoding type I, II or III DHFR, high level TMP resistance was presumably caused by other types of DHFR genes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3313234 TI - Parasitic infections in day care centers. PMID- 3313235 TI - Candida lusitaniae: an emerging human pathogen. PMID- 3313236 TI - Candida lusitaniae: sepsis and meningitis in a neonate. PMID- 3313237 TI - Evaluation of a rapid test for group A Streptococcus at a physician's office and hospital laboratory in Buenos Aires, Argentina. PMID- 3313238 TI - Orthotopic hepatic transplantation for unimmunized children: a paradox of contemporary medical care. PMID- 3313239 TI - Haemophilus influenzae type b meningitis: manifestations and long term sequelae. AB - The observations made in these studies, which have been enhanced and refined in recently published reviews, 9-11 clearly demonstrate that a wide range of neurologic and learning disabilities are found in a large proportion of survivors of Hib meningitis who were successfully treated with antibiotics at the time of their acute illness and were subsequently considered to be normal by parents, teachers and peers. Despite their apparent normality many children have minimal brain damage and fall behind in intellectual achievement and social adjustment. Clearly no matter how effective therapy is in dealing with acute disease, it cannot prevent the development of handicapping sequelae in all children. For this reason I strongly believe that prevention of Hib meningitis is essential. PMID- 3313240 TI - Epidemiology of Haemophilus influenzae type b infections in the United States. PMID- 3313242 TI - Treatment and prevention of Haemophilus influenzae type b meningitis. PMID- 3313241 TI - Pathogenesis of Haemophilus influenzae meningitis. AB - The hypoxia induced by decreased cerebrocortical blood flow contributes to the neurologic deficits found in many survivors of Hib meningitis. Because reduced blood flow is measurable within 48 hours of acquisition of bacteria, the inability of antibiotic therapy to prevent sequelae is more easily understood insofar as damage has already occurred by the time treatment is initiated. Hydrocephalus is probably due to severe choroid plexus necrosis with aqueductal occlusion. These deficiencies, along with the neuronopathy, contribute to permanent cerebrocortical deficits, including impaired learning ability. PMID- 3313243 TI - Haemophilus influenzae type b: the search for a vaccine. AB - In adults Hib CPS protein conjugates are much more immunogenic than the polysaccharide alone; further studies have shown that they induce a booster response in children. The antibodies produced in response to the conjugates have the same biologic properties, isotype and IgG subclass composition as those elicited by Hib CPS alone or those present in serum after convalescence from Hib disease. More recently attempts have been made to make the conjugates compatible with DTP vaccine. In this procedure DTP is absorbed onto aluminum compounds (aluminum hydroxide or phosphate), with the effect of significantly prolonging diphtheria and tetanus antibody synthesis. Adsorption of the Hib CPS conjugate under controlled conditions does not alter the total amount of antibody elicited in infant rhesus monkeys after the third or final injection. The appearance of Hib CPS antibodies after the first injection, however, is accelerated with conjugate that has been adsorbed. This is an encouraging finding, because it means that more polysaccharide conjugates can be compatible with existing DTP vaccine. PMID- 3313244 TI - Capsular polysaccharide of Haemophilus influenzae type b as a vaccine. AB - The inability of infants to respond to Hib PRP with the production of protective antibodies is probably in large part a consequence of the relative immaturity of their immune system. It has been reported that PRP-induced antibodies in adults are primarily of the IgG subclass 2 and that there is a higher frequency of invasive H. influenzae type b diseases among adults with limited antibody deficiencies when the IgG subclass 2 isotype is not present at normal levels. There is evidence that adult levels of IgG subclass 2 are attained later in life than are adult levels of the other subclasses. Regulation of the level of this IgG subclass will undoubtedly be an important determinant in the induction of anti-PRP antibodies in infants. It seems unlikely that simple modification of PRP, such as by increasing molecular size, would result in an increased effectiveness in younger infants, because this group is inherently unable to synthesize subclass 2 antibodies. Currently intensive efforts are being made in several laboratories to develop vaccines that conjugate PRP with proteins that are capable of eliciting a T cell-dependent response in younger children. Preliminary results of several ongoing clinical trials of vaccines of PRP conjugated with diphtheria and with tetanus toxoids indicate that these vaccines are efficacious in children as young as 7 months of age. Researchers are hopeful that vaccines can be developed to protect infants ages 2 to 3 months. PMID- 3313245 TI - Newer Haemophilus influenzae type b vaccines and passive prophylaxis. AB - PRP-protein conjugate vaccines may prove to be a prototype of a new generation of bacterial vaccines for the prevention of diseases caused by encapsulated bacteria, such as pneumococci, meningococci and Group B streptococci, as well as Hib. These diseases often strike the very young, the very old and individuals with compromised immunity. These vaccines have been "engineered" to maximize immune recognition and response. It is hoped that these vaccines will be adequate to control or possibly eradicate Hib and other invasive bacterial diseases. For high risk populations unable to respond to the vaccines, passive prophylaxis may have a role. PMID- 3313246 TI - Clinical trials of the Haemophilus influenzae type b capsular polysaccharide diphtheria toxoid conjugate vaccine. AB - To date in the United States over 3000 subjects under 2 years of age have received 1 or more doses of PRP-D vaccine. Thus far there have been no statistically significant differences between the rate of local or systemic reactions among recipients of this vaccine and that among those who received the PRP or placebo control vaccines. The vaccine is well-tolerated and is not associated with clinically significant adverse reactions. The PRP-D vaccine has been shown to be a T cell-dependent immunogen, inducing sequential increases in antibody level with repeated immunization and producing a high proportion of IgG relative to IgM. A recall response, or immunologic memory effect, has been demonstrated in children 1 year after receiving PRP-D. PRP-D is consistently immunogenic in all age groups. In adults this vaccine induces a geometric mean antibody response greater than 200 micrograms/ml. In infants 7 to 24 months of age levels greater than 1 microgram/ml have been achieved in over 90% of the subjects with 1 or 2 doses of PRP-D, whereas 90% or more of infants under 7 months of age achieve levels of 0.15 microgram/ml or greater. PMID- 3313247 TI - Immunization of young infants with Edmonston-Zagreb measles vaccine. AB - Recently studies conducted in several countries using Edmonston-Zagreb vaccine administered subcutaneously to infants younger than 9 months of age have shown high seroconversion rates, approaching or equaling those routinely achieved at 9 months of age with the more widely used Schwarz vaccine. These results have raised expectations that the Edmonston-Zagreb vaccine can play an important role in helping to prevent measles in young infants in highly endemic areas. Because of the implications of changing the measles vaccine recommendations, vaccine advisory groups and vaccine manufacturers will require additional studies to confirm the preliminary findings and to answer new questions which have been raised. The needed data will probably be collected over the next year or two in studies already under way or being planned in the hope that a more effective vaccine for young infants can be introduced before the end of this decade. PMID- 3313248 TI - Patterns of adherence of diarrheagenic Escherichia coli to HEp-2 cells. AB - A total of 516 Escherichia coli strains randomly isolated from coprocultures of 154 Chilean children with diarrhea and 66 controls were examined with DNA probes and tested for adherence to HEp-2 cells. Three adherence patterns were distinguished, localized, true diffuse and "aggregative." Enteropathogenic E. coli (EPEC) were detected by EPEC adherence factor probe among 86 of the 372 isolates (23%) from patients with diarrhea vs. 14 of 144 (10%) strains from controls (P less than 0.0002). Of 95 strains that manifested localized adherence, 97% were EPEC adherence factor probe-positive; thus the HEp-2 assay may serve as an alternative to the probe in identifying EPEC adherence factor-positive EPEC. True diffuse adherence was not associated with diarrhea. In contrast the aggregative pattern appears to signify a new, distinct class of diarrheagenic E. coli (enteroadherent-aggregative E. coli). The aggregative pattern was found in only 3 of 27 enterotoxigenic, 0 of 4 enteroinvasive, 0 of 2 enterohemorrhagic and 2 of 86 EPEC strains but in 84 of 253 probe-negative strains (P less than 0.00001) from patients with diarrhea; in comparison only 20 of 134 probe-negative strains from controls were aggregative E. coli (P less than 0.00001 vs. probe negative strains from diarrhea patients). PMID- 3313249 TI - Mechanisms of viral-induced lower airway obstruction. PMID- 3313250 TI - Aerobic microbiology of upper respiratory infections in infants and children. PMID- 3313251 TI - Bacillus sp. sepsis associated with Hickman catheters in patients with neoplastic disease. PMID- 3313252 TI - Valvular insufficiency after bacteriologic cure of Haemophilus influenzae endocarditis in a child. PMID- 3313253 TI - Acoustic reflectometry detection of middle ear effusion. PMID- 3313254 TI - Prevention of neonatal group B streptococcal sepsis. PMID- 3313255 TI - Early intervention for disabled infants and their families: a quantitative analysis. AB - In an evaluation of 31 selected studies, statistical procedures for synthesizing data (meta-analysis) were used to assess the effects of early intervention services on disabled children younger than 3 years of age and on their families. Results indicate that early intervention is effective in promoting developmental progress in infants and toddlers with biologically based disabilities. Programs that served a heterogeneous group of children, provided a structured curriculum, and targeted their efforts on parents and children together appeared to be the most effective. Definitive evaluation of the efficacy of early intervention programs is tempered by the restricted range of outcomes measured and by a paucity of information about the children and families enrolled in such programs, as well as about the specific nature of the services received. Despite their limitations, available data provide the basis for a rational pediatric approach to early intervention programs, while highlighting specific directions for further investigation. PMID- 3313256 TI - Streptococcal perianal disease in children. AB - From October 1985 through June 1986, 31 children in a single pediatric practice were treated for perianal signs and symptoms associated with growth of group A beta-hemolytic streptococci from perianal cultures. Signs and symptoms included perianal dermatitis (90%), perianal itching (78%), rectal pain (52%), and blood streaked stools (35%). Ages ranged from 7 months to 8 years mean 4.25 +/- 1.8 years). There were 24 boys (77%) and seven girls (23%). The 31 cases occurred in 19 families. Intrafamily spread was only to siblings and occurred in 50% of the possible situations. Direct perianal antigen studies had a sensitivity of 89% for predicting positive cultures. Four different T types of group A streptococci were isolated from these cases, but the T type within each family outbreak was identical except in one case. When group A streptococci were found in the pharynx (64% of patients), the T type of the pharyngeal and perianal isolates were identical. Treatment was usually with oral penicillin. Relapses occurred in 39%. Signs of cellulitis were absent in all 31 cases and, therefore, we suggest that the nomenclature for this entity be changed from streptococcal perianal cellulitis to streptococcal perianal disease. PMID- 3313257 TI - Theophylline treatment in the extubation of infants weighing less than 1,250 grams: a controlled trial. AB - The role of theophylline in weaning infants weighing less than 1,250 g at birth from mechanical ventilation was evaluated. Infants were randomized into control or theophylline treatment groups when they required minimal ventilatory support (peak inspiratory pressure 12 cm H2O, positive end-expiratory pressure 2 cm H2O, rate 12 breaths per minute, and FiO2 less than 0.3), and they were extubated 24 hours later. Infants required reintubation if they had (1) PaCO2 greater than 55 mm Hg and pH less than 7.20, (2) FiO2 greater than 0.5, or (3) apnea associated with a heart rate less than 100 beats per minute that required frequent stimulation (more than 20 episodes during a 16-hour period). Among 32 infants (birth weight less than 1,000 g) who reached minimal ventilatory support before seven days after delivery, 13 of 18 (72%) control infants required reintubation, whereas only four of 14 (28%) theophylline-treated infants required reintubation. On the other hand, among infants (birth weight less than 1,000 g) who reached minimal ventilatory support after seven days following delivery, only one of six (17%) of the control group required reintubation and no improvement could be seen with theophylline treatment. Similarly, among control infants (birth weight 1,001 to 1,250 g), only ten of 45 (23%) required reintubation after reaching low intermittent manditory ventilation settings. In summary, most infants recovering from respiratory distress syndrome who had birth weights (1) greater than 1,000 g or (2) less than 1,000 g and who were older than seven days could be successfully extubated from minimal ventilatory support without theophylline treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3313258 TI - American Academy of Pediatrics: Health care financing for the child with catastrophic costs. PMID- 3313259 TI - Dr. Glueck and co-authors' letter of withdrawal. PMID- 3313260 TI - [The renin-aldosterone system in premature infants in the early neonatal period and its relation to maternal lactation]. PMID- 3313261 TI - [Zadeten in the treatment of allergic diseases in children]. PMID- 3313262 TI - Surgical treatment of renovascular hypertension. AB - Unilateral stenosis of the renal artery was verified by angiography in 34 patients with hypertension. The cause-effect relationship between elevated blood pressure and stenosis of the renal artery was proved by detailed renin studies (basic plasma renin activity, plasma renin activity following orthostatic and diuretic stimulation, renal vein renin activity). Surgical treatment was applied in 39 cases: they were aortorenal bypass in 9, autotransplantation in 7, patch graft in 2, denervation in 2, decompression in 3 and nephrectomy in 16 cases. Six months following the operation, 68.4% of the patients were normotensive without drugs and 18.4% of them with a reduced dose of drugs. To achieve normotension preoperative treatment had to be continued only in 13.2% of the patients. Two to four years postoperatively, 29 patients were subjected to control examinations and in 23 cases also to angiography. Restenosis was observed in 4 patients (17.4%). As a result of surgical treatment, the increased response to hyperreninaemia and to various stimuli decreased. Based on the control examinations, 58.7% of the patients could be considered to be cured. PMID- 3313263 TI - Molecular biochemistry and pharmacology of peptic ulcer treatment. A review. AB - The membrane-bound ATP-dependent energy systems (ATP-membrane ATPase-ADP and ATP adenylate cyclase-cAMP) play an essential role in the physiological regulation of the gastrointestinal mucosa and its damage in rat and man. A good, physiologically, hormonally and pharmacologically well controlled and regulated feedback system exists between the two energy systems. The significant increase of ATP transformation into ADP or cAMP represents a causative metabolic background of the development of gastric, duodenal and jejunal ulcer (damage) in man and rat. The ulcer preventive effects of vitamin A, beta-carotene, atropine, cimetidine, prostacyclin I2, and surgical vagotomy were studied in connection with their effects on the membrane-bound ATP-dependent energy systems of the gastric, duodenal and jejunal mucosa in man and rat. Atropine and cimetidine were applied in cytoprotective and antisecretory doses, and the tissue levels of ATP, ADP, AMP, cAMP and lactate were measured. The results indicated that the disturbed equilibrium between the two energy supply systems can be modified (normalized) by drugs and surgical vagotomy; the drug effect depends on the actual biochemism of the gastroduodenal mucosa; the values of affinities (pD2) and intrinsic activities (alpha) of the different drugs differ in relation to membrane-bound ATP-splitting enzymes; the changes in the membrane-bound ATP dependent energy systems of the damaged rat gastric mucosa, produced by vitamin A and beta-carotene, depend on their cytoprotective doses which are connected with their cytoprotective effects; the biochemical changes induced by drugs (given in cytoprotective and anti-secretory doses) differ only quantitatively but not qualitatively; the drug effects on the membrane-located ATP-splitting enzymes (membrane ATPase and adenylate cyclase) in human gastric, duodenal and jejunal mucosa are similar to those in rats, but their affinities (pD2) and also their intrinsic activities (alpha) differ to the enzyme systems. PMID- 3313264 TI - [Focus on neuroblastoma in 1987. 2: Treatment]. AB - Chemotherapy and surgery are both important for the treatment of neuroblastoma. The therapeutic indications depend upon the anatomic form of the tumor, but the quality of the surgical resection is most important. In metastatic neuroblastoma, the prognosis has recently been improved with massive chemotherapy, total body irradiation and bone marrow transplantation. Neuroblastoma occurring before one year of age has a particular position, because of its very good prognosis (90% survivals) but with frequent sequelae due to spinal cord compression. Possible improvements stemming from immunology, genetics and mass screening are discussed. PMID- 3313265 TI - [Methotrexate in pediatric hemato-oncology]. PMID- 3313267 TI - The public perception of science (4): Hands-on antiquity. PMID- 3313266 TI - [Laryngotracheal stenosis in children]. AB - Laryngo-tracheal stenoses in children are a frequent complication after endotracheal intubation and intubation-tracheostomy. It is important to distinguish inflammatory from fibrous stenosis for prognosis and treatment. One must always evoke the diagnosis of stenosis when a child previously had an endotracheal intubation. Endoscopy must be performed with a rigid endoscope. Treatment consists in preventive medical treatment of granulomatous stenoses (steroids, laser dioxide) and laryngoplasty with or without prosthesis when fibrous stenoses is constituted. Anterior ring cricotomy may prevent subglottic stenoses. PMID- 3313268 TI - State-approved schools of nursing L.P.N./L.V.N. 1987. PMID- 3313269 TI - [Scandinavian recommendations on prevention of malaria]. PMID- 3313271 TI - [History time with Arne Sollund]. PMID- 3313270 TI - [Reverend Jonas Ramus and his wife Anna Colbjornsdatter of the Norderhov Church. An odontologic study after more than 200 years]. PMID- 3313273 TI - Sequences implicated in the processing of Thermus thermophilus HB8 23S rRNA. AB - Nuclease S1 mapping analyses were performed in order to detect processing intermediates of pre-23S rRNA from Thermus thermophilus HB8. Two processing sites were identified downstream the start of transcription and several consecutive cleavage sites are associated with the mature 5'-end. In the 3'-flanking region one "primary" site and two cleavages which generate short-living intermediates were detected. A series of successive intermediates in the region of the mature 3'-end implies the existence of--in analogy to Escherichia coli--a 3' exonucleolytic activity. The data were correlated with potential secondary structures within the pre-23S rRNA, which exhibit various repeated sequence elements. M13 sequencing data support the existence of one secondary structural element associated with the strong "primary" cleavage site in the 3'-flanking region. In T. thermophilus we can exclude the formation of an extended base paired and precursor-specific stem enclosing the 23S rRNA which is inferred to mediate recognition by RNase III in E. coli. PMID- 3313274 TI - The effects of alterations within the 3' untranslated region of the pyruvate kinase messenger RNA upon its stability and translation in Saccharomyces cerevisiae. AB - A 53 basepair deletion was constructed within the 3' untranslated region (3' UTR) of the yeast pyruvate kinase (PYK) gene borne upon a centromeric plasmid. Various modular assemblies of the pUC13 polylinker DNA (single unit = 44 bp) were used to replace the deleted region, and the effects of these modifications upon both transcript stability and translation ascertained in yeast. The use of a differential probing stratagem, based on the hybridisation of specific oligonucleotides to either pUC13 polylinker or unaltered PYK 3' UTR sequences, allowed for discrimination between mutant (plasmid borne) and wild-type (chromosomal) PYK transcripts. In no construct was there any significant alteration in mRNA stability, but translation of the PYK mRNA was severely curtailed by truncation of the 3' UTR or the presence of a strong hairpin-loop structure in the 3' UTR. A specific mutation in the N-terminal coding sequences, which created a premature termination codon in both a 3' 'tagged' PYK plasmid and a PYK/LacZ fusion gene, aborted the translation of a majority of their transcripts but left their chemical half-lives unaltered. This observation is at variance with some previously published data (Losson & Lacroute (1979) Proc Natl Acad Sci USA 76, 5134; Pelsey & Lacroute (1984) Curr Genet 8, 277), but is consistent with our own earlier observation that there is no obvious link between ribosome loading and mRNA stability in yeast (Santiago et al. (1986) Nucleic Acids Res 14, 8347). Possible reasons for this disparity are discussed. PMID- 3313272 TI - Relation of the Escherichia coli dnaX gene to its two products--the tau and gamma subunits of DNA polymerase III holoenzyme. AB - The Escherichia coli DNA polymerase III holoenzyme 71.1 kDa tau subunit is a 643 amino acid protein encoded by the dnaX gene. This gene also encodes the holoenzyme 56.5 kDa gamma subunit. The tau factor (as a tau'-LacZ' fusion protein) has been isolated and shown to be cleaved in vitro to form gamma and a 135 kda C-terminal cleavage product. The tau'-LacZ' fusion protein, gamma, and the C-terminal cleavage product have been isolated. N-terminal sequencing has demonstrated that tau and gamma share the same N-terminal sequences and that tau is proteolytically cleaved in vitro between residues 498 and 499 to form gamma. In addition, residues 420-440 were shown to be present in both tau and gamma by use of antibody specific for a synthetic peptide corresponding to that sequence. Some mechanism functions in vivo to ensure that tau and gamma are synthesized in a ratio of about one-to-one, as shown by radioimmune precipitation of tau and gamma from cellular extracts. PMID- 3313275 TI - The nucleotide sequence of the PRI1 gene related to DNA primase in Saccharomyces cerevisiae. AB - The PRI1 gene of Saccharomyces cerevisiae encodes for the p48 polypeptide of DNA primase. We have determined the nucleotide sequence of a 1,965 bp DNA fragment containing the PRI1 locus. The entire coding sequence of the gene lies within an open reading frame, and there are 409 amino acids in the single polypeptide protein if translation is assumed to start at the first ATG in this frame. The 5' and 3' end-points of PRI1 mRNA have been determined by S1 mapping and primer extension analysis. The primary structure and the codon usage of PRI1 suggest that this essential gene is poorly expressed in yeast cells. PMID- 3313276 TI - Isolation and characterization of the positively acting regulatory gene QUTA from Aspergillus nidulans. AB - The positively acting regulator gene QUTA from Aspergillus nidulans has been identified and located within a cluster of quinic acid utilisation (QUT) genes isolated within a recombinant phage lambda (lambda Q1). The DNA sequence of the QUTA gene reveals a single uninterrupted reading frame coding for a protein of mw 90.416 Kd. The QUTA protein sequence has a protein motif in the form of a putative "DNA finger" that shows strong homology to other such motifs in the GAL4, PPR1, ARGRII, LAC9 and QA1F regulatory gene products of S. cerevisiae, K. lactis and N. crassa. The data presented confirm the view deduced by genetical analysis that the QUTA gene of A. nidulans encodes a protein capable of interacting with QUT specific DNA sequences. PMID- 3313277 TI - An analysis of 5'-noncoding sequences from 699 vertebrate messenger RNAs. AB - 5'-Noncoding sequences have been compiled from 699 vertebrate mRNAs. (GCC) GCCA/GCCATGG emerges as the consensus sequence for initiation of translation in vertebrates. The most highly conserved position in that motif is the purine in position -3 (three nucleotides upstream from the ATG codon); 97% of vertebrate mRNAs have a purine, most often A, in that position. The periodical occurrence of G (in positions -3, -6, -9) is discussed. Upstream ATG codons occur in fewer than 10% of vertebrate mRNAs-at-large; a notable exception are oncogene transcripts, two-thirds of which have ATG codons preceding the start of the major open reading frame. The leader sequences of most vertebrate mRNAs fall in the size range of 20 to 100 nucleotides. The significance of shorter and longer 5'-noncoding sequences is discussed. PMID- 3313278 TI - Mutation spectrum in Escherichia coli DNA mismatch repair deficient (mutH) strain. AB - The Dam-directed post-replicative mismatch repair system of Escherichia coli removes base pair mismatches from DNA. The products of the mutH, mutL and mutS genes, among others, are required for efficient mismatch repair. Absence of any of these gene products leads to persistence of mismatches in DNA with a resultant increase in spontaneous mutation rate. To determine the specificity of the mismatch repair system in vivo we have isolated and characterized 47 independent mutations from a mutH strain in the plasmid borne mnt repressor gene. The major class of mutations comprises AT to GC transitions that occur within six base pairs of the only two 5'-GATC-3' sequences in the mnt gene. In the wild type control strain, insertion of the IS1 element was the major spontaneous mutational event. A prediction of the Dam-directed mismatch repair model, that the mutation spectra of dam and mutH strains should be the same, was confirmed. PMID- 3313279 TI - Deletions in the tL structure upstream to the rRNA genes in the E. coli rrnB operon cause transcription polarity. AB - A number of deletions have been constructed within the leader region of the rrnB operon from E. coli. The deletions remove a potential transcription terminator structure downstream from an antitermination recognition sequence (Box A), which precedes the structural gene for the 16S RNA. Cells harbouring plasmids, where the terminator structure was deleted, partially or totally, showed a reduction in growth rate under minimal growth conditions. Measurement of the ribosomal RNA synthesis rates of such cells determined by pulselabeling and hybridisation to appropriate DNA probes, showed that the amount of the more distally located 23S RNA was reduced compared to the promoter-proximal 16S RNA. This polarity in transcription, resulting in a non-stoichiometric synthesis of the ribosomal RNAs, is most likely the result of a defective antitermination. The reduction in the amount of 23S RNA in such cells is compensated for by an increase in the overall ribosomal RNA synthesis, in concordance with the ribosomal RNA feedback regulation model. The accumulation of transcripts of the tRNAGlu2 gene, coded in the spacer region between the 16S and 23S RNA genes, in cells with an altered rRNA stoichiometry supports this interpretation. PMID- 3313280 TI - DNA synthesis is initiated at two positions within the origin of replication of plasmid R1162. AB - DNA synthesis of broad host-range plasmid R1162 is initiated from two positions, flanking a large (40 bp stem, 40 bp loop) inverted repeat. Each start-point is located within a highly conserved, but oppositely oriented, 10 base-pair sequence. Synthesis from the two positions converges within the intervening inverted repeat. An analysis of deletions suggests that both start positions must be present for synthesis. A model describing possible early events in replication of plasmid R1162 is presented. PMID- 3313281 TI - The symbiotic nitrogen fixation regulatory operon (fixRnifA) of Bradyrhizobium japonicum is expressed aerobically and is subject to a novel, nifA-independent type of activation. AB - The Bradyrhizobium japonicum N2 fixation regulatory gene, nifA, was sequenced and its transcription start site determined. Between the start of transcription and the nifA gene an open reading frame of 278 codons was found and named fixR. A deletion in fixR which allowed transcription into nifA resulted in a 50% reduced Fix activity. The fixRnifA operon was expressed in soybean root nodules, in cultures grown anaerobically with nitrate as terminal electron acceptor, in microaerobic cultures, and in aerobic cultures. The transcription start site (+1) was preceded by a characteristic nif(-24/-12)-type promoter consensus sequence. Double base-pair exchanges in the -12 but not in the -24 region resulted in a 'promoter-down' phenotype. A promoter-upstream DNA region between -50 and -148 was essential for maximal promoter activity. Expression from the promoter was not dependent on nifA. We conclude that the fixRnifA promoter is positively controlled, and that it requires a newly postulated transcriptional factor in order to become activated. PMID- 3313283 TI - A promoter probe vector (pJAC4) that utilizes the ampC beta-lactamase gene of Escherichia coli. PMID- 3313284 TI - Sequence of the complete P protein gene and part of the M protein gene from the histidine transport operon of Escherichia coli compared to that of Salmonella typhimurium. PMID- 3313282 TI - Competition between sigma factors for core RNA polymerase. AB - The switch of RNA polymerase specificity from early to late promoters of bacteriophage T4 is achieved by substitution of host sigma factor, sigma 70, with the T4 induced factor, sigma gp55. However, overproduction of sigma gp55 from an expression vector is not detrimental to Escherichia coli growth. Direct competition binding assays demonstrate that sigma 70 readily displaces sigma gp55 from RNA polymerase and thereby reverses the promoter specificity of the enzyme. The displacement also occurs with the core enzyme modified by bacteriophage T4 infection. We postulate that an antagonist of sigma 70 should be formed in T4 infected cells to aid sigma gp55 in the early/late switch. PMID- 3313285 TI - Myocardial scintigraphy with 201Tl: I. Methodology. PMID- 3313286 TI - Myocardial scintigraphy with 201Tl: II. Clinical applications (coronary heart disease). PMID- 3313288 TI - [Use of the preparation Orimeten in the treatment of advanced cases of breast cancer in women]. PMID- 3313289 TI - Catastrophic health insurance: what is needed? PMID- 3313287 TI - [Results of the treatment of patients with advanced lung cancer with the combination of methotrexate, adriamycin, cyclophosphamide and CCNU (MACC)]. PMID- 3313290 TI - Family adjustment to heart transplantation: redesigning the dream. AB - The processes family members of heart transplant recipients use to manage the unpredictability evoked by the need for and receipt of heart transplantation were explored. Twenty family members were theoretically sampled using the grounded theory approach. Three separate family support groups, each of 12 weeks duration, provided data for constant comparative analysis. Redesigning the dream was identified as the integrative theme in the substantive theory that described how family members gradually modify their beliefs about organ transplantation and develop attitudes and beliefs to meet the challenge of living with continual unpredictability. The theory consists of three concepts--immersion, passage, and negotiation--which parallel the stages of waiting for a donor, hospitalization, and recovery. PMID- 3313291 TI - Outcome of multiple usage of disposable syringes in the insulin-requiring diabetic. AB - The majority of diabetics in this country use disposable syringes and needle units for their insulin injections. Health care providers have traditionally recommended that these disposable syringes be discarded after each use to reduce the possibility of infection; manufacturer's instructions also state that the disposable syringes are to be used once and then discarded. Despite the limited research in this area, many American diabetic teaching programs have recently adopted a policy of encouraging ambulatory diabetics to reuse their syringes. However, the subject remains controversial. Of 166 subjects surveyed at a diabetic clinic, 74 (44.6%) reused their insulin syringes. Four syringes were found to be contaminated with normal skin flora. No pathogenic organisms were isolated. In addition, 15.1% of the subjects did not clean their hands or the site prior to the injection. PMID- 3313292 TI - Using PERT to keep a nursing research project humming. PMID- 3313293 TI - [Psychological problems of thalassemic subjects]. AB - Analysis of psychological problems of the thalassemic subject shown with these following tests: Der Baumtest, drawing of the human figure. Moreover, we made meetings with all boys and their parents during their stay in the day-hospital. These tests have shown subjective conflicts (fear and uncertainty of future due to illness felt as aggression and fault, depressive moods and loneliness, problems of communication, hope in a magic recovery opposite to the constant discomfort of the therapeutic dependence) and relational conflicts (ambivalence towards parents, difficulties in becoming a part of the social and school environment). PMID- 3313294 TI - [Vaginal infections in a population of diabetic children and adolescents]. AB - The prevalence of vaginal infections has been evaluated in 51 patient affected by insulin-dependent diabetes (IDDM) and in a control group of girls matched for age. Most frequent infectious agents were Candida Albicans (42.8%) and Streptococcus B (28.5%). No statistical significant relationship was observed between infection and duration of diabetes nor metabolic control, while the relationship was positive between infection and puberty. The peculiarity of this infection during IDDM is stressed and the difficulties in the infection when caused by Streptococcus B are discussed. PMID- 3313296 TI - [Study of the activity of ambroxol in children with aspecific bronchial hyperreactivity]. AB - The authors examined the action of non-specific bronchial reactivity to methacholine (IBA) before and after treatment with ambroxol in a group of a children with clinic symptomatology of recurrent cough and/or rhinitis. The little patients are selected from a pediatric population that, besides the clinical data mentioned above, had a high probability to manifest nonspecific bronchial reactivity for which clinical and anamnestic data predisposed. In all patients were carried out an allergologic examination with the execution of Prick test and determination of total IgE. The results obtained and discussed suggest a favorable employ of the drug that is able to normalize the functional condition of the bronchial mucous membrane and of the ciliary apparatus which alteration are frequently present in subjects with high non-specific bronchial reactivity. PMID- 3313295 TI - [Urinary tract malformations. Symptomatology, delayed diagnosis and urinary tract infections]. AB - The authors examined 88 patients (32 Males and 56 Females) aged between 1 day and 13 years, suffering from urinary tract malformation, diagnosed during 1981-82 . The vesicoureteral reflux was the urinary tract malformation most frequently observed (56.81%). The patients showed symptoms of the illness within the first year of life in a percentage of 52%, while the 82% was symptomatic in 5 years. 30 months and 11 days was the average age at which the symptoms of the illness appeared, while the diagnosis was effected at an average of 47 months and 15 days. The authors pointed out the reasons of this diagnostic delay and the possibilities of filing it up. Urinary tract infection was found at the time of hospitalization in a percentage of 55%. The authors described the kind of germs isolated and their resistance to the most common antibiotics. PMID- 3313297 TI - [Retroperitoneal lymphangioma. Radiologic aspects and diagnostic protocol]. AB - The authors analyze the radiological aspects and the staging problems of the retroperitoneal lymphangioma, a rare neoplasma of infancy. Echography and computer-assisted tomography contributions are particularly emphasized. PMID- 3313298 TI - [2 cases of duodenal hematoma in childhood. Critical analysis of the diagnostic contribution]. AB - The Authors analyze the diagnostic contributions of echography and computer assisted tomography in the diagnosis of duodenal hematoma in pediatric age. PMID- 3313300 TI - The effect of Medicaid criteria on pediatric emergency department visits. AB - The use of the emergency department by children on Medicaid was documented, and the effect of new adult Medicaid criteria on a pediatric emergency department was investigated. Eight percent of daytime visits by all patients were nonemergencies, compared to 15% by Medicaid patients. More Medicaid patients required admission than other children (16% v 10%) seen in the emergency department. Emergency department use by Medicaid patients was not decreased by the new criteria. Documentation of inappropriate denials of emergency care when criteria designed for adults were applied to pediatric patients was presented to state health officials and resulted in a change in the state Medicaid criteria for emergency care of children. PMID- 3313299 TI - [Scaphoid megalourethra. Description of a case and review of the literature]. AB - Authors describe a case of scaphoid megalourethra in a newborn. The child underwent a successful urethroplasty in neonatal period, as described by Nesbitt. In a careful review of the Literature only 47 such cases were found (included the one herein described). Authors discuss etiology, diagnosis and management of this rare malformation and stress the feasibility of an early reconstructive procedure. PMID- 3313301 TI - Electric mixer-inflicted scalp injury: a case report and review of CPSC data. AB - Electric mixers present a major risk for childhood injuries. Scalp injury, although rarely encountered, results from hair entanglement in the mixer blades. Potential for serious injury and disfigurement exists. The US Consumer Product Safety Commission data indicate that most injuries inflicted by electric mixers are either minor electrical shock or traumatized fingers and hands. Constant observation is mandatory when operating an electric mixer in the presence of children. PMID- 3313302 TI - Serious air gun injuries in children: update of injury statistics and presentation of five cases. AB - There were over 70,000 injuries to children caused by air guns reported from 1981 to 1984. The majority of these injuries were minor; however, serious injury resulted in eight deaths. Reported injuries include corneal perforation, liver laceration, stomach and intestinal perforation, intracranial bleeding, cardiac perforation, and hemopneumothorax. Primary care physicians must be aware of the potentially serious or lethal nature of air gun injury and educate their patients accordingly. Legislation is also needed to restrict the sale of these guns, or increase the safety of air gun use. We report five cases of potentially life threatening injury caused by air guns, three of which required emergency laparotomy. PMID- 3313303 TI - Hazardous chemical exposure in children. PMID- 3313304 TI - Hydrocarbon poisoning: a review. AB - This article reviews the mechanisms of pulmonary injury associated with hydrocarbon poisoning. The evolution of clinical and radiographic changes is discussed, along with appropriate treatment. Preventing aspiration in the emergency department is the most effective therapy for these children in the first few hours after ingestion. PMID- 3313305 TI - Clinical characteristics, pathophysiology, and management of hydrocarbon ingestion: case report and review of the literature. AB - Accidental ingestion of hydrocarbons is an important cause of childhood poisoning. Due to the number of hydrocarbon products available as solvents, fuels, and cleaning agents, increased awareness is necessary on the part of health caretakers. The scope of complications involving the respiratory system in petroleum products ingestion is frequently overlooked. Physicians may thus apply standard therapeutic modalities used in treating common poisonings to the child who drank a petroleum distillate. Prompt recognition of presenting symptoms and understanding of pathophysiology are important to planning and providing treatment. The two cases of hydrocarbon ingestion reported in this paper illustrate the wide spectrum of problems associated with this condition. The pathophysiology, current management, and a review of the literature of hydrocarbon ingestion are presented. PMID- 3313306 TI - Childhood conversion reactions in the emergency department: Part I--Diagnostic and management approaches within a biopsychosocial framework. AB - The pediatric emergency physician faces several difficulties when he is unable to diagnose an organic etiology that sufficiently explains a child's somatic symptoms. Biomedical or psychological approaches alone often result in unsatisfactory outcomes, such as continued symptomatology, increased family anxiety, and either excessive or suboptimal use of medical resources to search for less obvious diseases. This paper suggests that the best approach toward a child's unexplained somatic symptoms is a biopsychosocial orientation that includes conversion reaction within the differential diagnosis. Comprehensive strategies are described for both diagnosis and management of conversion reactions so that both organic and psychosocial factors can be understood and addressed in the emergency department setting. Prognosis, epidemiology, and questions involving the definition of conversion reaction are also discussed. A follow-up paper will address specific diagnostic issues regarding both the general features and the most common presentations of conversion reactions. PMID- 3313307 TI - [Zinc: the biochemical and clinical aspects]. PMID- 3313308 TI - [Theories on the development of obesity]. PMID- 3313309 TI - [Secretion of growth hormone, insulin and glucagon in obese persons before and after using low-calorie diet]. PMID- 3313310 TI - [Progress in the treatment of obesity]. PMID- 3313311 TI - [The main problems of undergraduate and graduate training of physicians in Poland for the needs of primary health care]. PMID- 3313312 TI - [Clinical significance of asymptomatic bacteriuria in pregnant women]. PMID- 3313313 TI - [Current model of the management of pregnancy, labor and the puerperium in women with heart diseases]. PMID- 3313314 TI - [Properties and clinical use of human immunoglobulin preparations]. PMID- 3313315 TI - [Calf thymus extract (TFX-Polfa) in the treatment of pollinosis. Clinical trials by the double-blind method using a placebo]. PMID- 3313316 TI - [Immediate results of the treatment of patients with rheumatoid arthritis with a thymus preparation]. PMID- 3313317 TI - [Anaphylactic shock and other allergic reactions in persons sensitized to bee venom]. PMID- 3313318 TI - [Practical problems of bone marrow transplantation in the light of our experiences]. PMID- 3313320 TI - [Pharmacological prevention of coronary thrombosis]. PMID- 3313319 TI - [Introductory lecture in pathological anatomy for 3d-year students of the Medical Department I of the Medical Academy, in Warsaw given on 3 October 1986]. PMID- 3313321 TI - [Clinical evaluation of minoxidil (Loniten)]. PMID- 3313322 TI - [Removal of erythrocytes from the bone marrow before blood group-incompatible hematopoietic transplant using a polysaccharide-ditrizoate density gradient centrifugation]. PMID- 3313323 TI - [Autoimmune thrombocytopenic purpura: diagnosis and treatment]. PMID- 3313324 TI - [Problems of laboratory control of treatment with oral anticoagulants]. PMID- 3313325 TI - Professor Dr Hab. Apoloniusz Dluzniewski, 1920-1986. PMID- 3313327 TI - [Phenazone and its value as an indicator of metabolic efficiency of the liver]. PMID- 3313326 TI - Evaluation of the metabolizing capacity of S9 liver preparations from rats and mice using a test with Salmonella typhimurium TA100. AB - The S9 phenobarbital-induced preparations from Albino rats and 6 strains of inbred and outbred Pzh: SFISS mice were tested by an Ames test for their ability to metabolize the two promutagens 2-aminofluorene (2AF) and cyclophosphamide (CP), and to influence the mutagenic activity of the two directly acting mutagens methyl methanesulphonate (MMS) and N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). 2AF showed a mutagenic activity after incubation with all kinds of microsomal preparations. S9 from B10. mice (Ah+Ah+) was twice as active as that from D2.BN mice (Ah- Ah-). CP was mutagenic exclusively in the presence of S9 from Pzh: SFISS or B10. mice and from rats. Neither fraction deactivated significantly the mutagenicity of MMS. Microsomal preparations from Albino rats and outbred mice were most active in deactivating the mutagenicity of MNNG. PMID- 3313328 TI - [Plasmapheresis--therapeutic aspects]. PMID- 3313330 TI - [Role of phosphoenolpyruvate carboxylase in plants]. PMID- 3313329 TI - [Modulation of immunologic response by lipopolysaccharides]. PMID- 3313331 TI - [Post-translational modifications of glycoproteins]. PMID- 3313332 TI - [Role of phosphorylation and dephosphorylation of proteins in the regulation of the metabolic activity of chloroplasts]. PMID- 3313333 TI - [Enzyme membranes]. PMID- 3313334 TI - [Enzyme membrane receptors]. PMID- 3313335 TI - Allergy and immunology 1947-1987. A PGM retrospective. PMID- 3313336 TI - Food sensitivity. Handling reactions to foods and food additives. AB - Food sensitivity is only one of several types of food-related reactions. Symptoms are not pathognomonic; hence, a broad differential diagnosis is often considered. Unless the anticipated reaction is systemic anaphylaxis, the role of any food suspected (by history, skin testing, and/or radioallergosorbent test) of causing the patient's symptoms should be verified by elimination-challenge testing. Dietary elimination is the most effective treatment, but its success depends on several factors. PMID- 3313337 TI - Adverse effects of immunization. Is prevention possible? AB - Vaccination rates must be kept high to prevent epidemics of infectious disease. At the same time, parents must be informed of the rare possibility of serious adverse effects, including seizure and allergic reaction. Every physician who administers vaccine therefore needs to become familiar with the reactions that may occur with each immunologic agent used. The best safeguard against litigation, when and if a serious reaction follows vaccination, is the indication that these considerations were discussed and that an informed choice was made. PMID- 3313338 TI - Carotid endarterectomy. Current indications for elective and emergency surgery. PMID- 3313339 TI - Management of the patient with ascites. AB - Major factors in the development of ascites in the setting of chronic liver disease include portal hypertension and a reduction in plasma oncotic pressure (hypoalbuminemia). Diagnostic paracentesis is indicated on initial presentation of the patient with ascites, when the amount of fluid increases notably, or when the patient's condition suddenly deteriorates. In the management of ascites, attempts should be made to improve the underlying liver disease, and sodium and fluid intake should be restricted. The peritoneovenous shunt is occasionally used to treat intractable ascites. PMID- 3313340 TI - Oral steroids in rheumatoid arthritis. Helpful but not remittive. AB - Although low-dose oral corticosteroid therapy cannot be considered remittive, it has earned a place in the therapeutic armamentarium for rheumatoid arthritis. Major clinical trials of a group using corticosteroid compared with a control group have not been done since the 1950s. One of these three large trials showed some slowing of the destructive joint changes of rheumatoid arthritis with use of low doses of corticosteroid. However, these agents have well-known side effects, especially when used long-term. Elderly patients or those who have features of the disease that indicate progression (eg, multiple joint involvement, elevated ESR, early evidence of erosion on x-ray films) are likely to benefit from carefully controlled doses of a corticosteroid. Because these drugs diminish bone formation and arthritis itself accelerates osteoporosis, supplemental calcium and vitamin D are useful adjuncts. A remittive agent and aspirin-like drug should be prescribed along with the corticosteroid. Abrupt withdrawal of even a very low dose of corticosteroids in rheumatoid arthritis patients causes a flare. PMID- 3313341 TI - Febrile seizures. When is treatment justified? PMID- 3313342 TI - Acute otitis media--does therapy alter its course? PMID- 3313344 TI - Patellofemoral dysfunction. How to treat, when to refer patients with problematic knees. AB - Patellofemoral dysfunction is a common orthopedic condition. It can be successfully treated by primary care physicians who are familiar with the risk factors, clinical presentation, therapy, and indications for orthopedic referral. Use of a well-tested treatment program can help return most patients to normal function. PMID- 3313345 TI - 'Healthy' prescribing for the elderly. How to minimize adverse drug effects and prevent 'dementia in a bottle'. AB - Despite constituting only 11% to 12% of the US population, the elderly use 31% of all prescription and over-the-counter drugs and, unfortunately, are most vulnerable to the adverse effects of drug therapy. Because of age-related physiologic changes and the likelihood of intercurrent disease, elderly patients need individualized prescribing. This requires the practitioner to be familiar with a few drugs in each class that are tolerated by and effective in elderly patients and to adhere to the principles of healthy prescribing, which have application in any setting. In conclusion, the words of Paracelsus (1493-1541) are worth recalling: "All substances are poisons; there is none which is not a poison. The right dose differentiates a poison from a remedy." PMID- 3313346 TI - Common problems of initiating breast-feeding. The physician's role in encouraging success for the 'nursing couple'. PMID- 3313343 TI - Reducing cardiac deaths with hypolipidemic drugs. PMID- 3313347 TI - Facial dermatitis in young women. PMID- 3313349 TI - Neurology's remarkable rejuvenation. PMID- 3313348 TI - Reactions to drugs and diagnostic agents. Ways to avoid and manage. PMID- 3313351 TI - Intrathoracic lymphoma in an elderly patient. Use of flow cytometry in diagnosis. PMID- 3313350 TI - Demystifying hypoglycemia. When is it real and how can you tell? AB - Contrary to popular belief, hypoglycemia is an infrequently encountered condition and its presence is questionable until confirmed by appropriate tests. In ambulatory patients, blood glucose levels obtained during intake of a normal diet are more reliable than those obtained during a glucose tolerance test. If the blood glucose is actually abnormally low and the other two criteria of hypoglycemia are also satisfied, a search for the cause is in order. In hospitalized patients, excessive doses of insulin or oral hypoglycemic agents, the effect of drugs, or chronic renal failure are the most common causes of hypoglycemia. If these factors are absent, another chronic illness known to cause hypoglycemia may be the source. If the cause is still obscure, a thorough evaluation of the endocrine status is warranted. PMID- 3313352 TI - Colon and rectal disease 1947-1987. PMID- 3313353 TI - Chronic hepatitis B: diagnosis and treatment. AB - The management of chronic hepatitis is reviewed. The importance of making a precise diagnosis and assessing the activity and stage of the disease are stressed. Treatment in relation to these findings is discussed. PMID- 3313354 TI - Reflux oesophagitis: a review. PMID- 3313355 TI - Historical review of management of infections in hospital practice. PMID- 3313356 TI - Sonography of tricuspid incompetence. PMID- 3313358 TI - Hypoglycaemia related to falciparum malaria--a correctable cause of death. PMID- 3313359 TI - Diverse benign cysts. PMID- 3313357 TI - Cancer chemotherapy agent-induced perivenous extravasation injuries. PMID- 3313360 TI - Guillain-Barre neuropathy during treatment with captopril. AB - A patient is described who developed acute peripheral neuropathy of Guillain Barre type occurring shortly after commencement of captopril for moderately severe hypertension and resolving after discontinuation of the drug. PMID- 3313361 TI - Prospects for peptic ulcer prevention. PMID- 3313363 TI - Internal medicine in The Netherlands. AB - In this overview various aspects concerning internal medicine in the Netherlands are discussed. Special attention is given to training, which is likely to be increased from 5 to 6 years in the near future. Current problems in internal medicine are mostly related to under-funding of health care and include unemployment (which necessitates reduction of training facilities), disagreement with the government about finances and an argument with the sickness funds concerning professional responsibility and the termination of free enterprise. Also the issue of task definition of the general internist is reviewed. Funding of research used to be mainly the task of the government. Problems with the national economy, however, have resulted in a reduction of the governmental contribution. Private research foundations related to patients' associations, (pharmaceutical) companies and non-university hospitals have increased in importance. PMID- 3313364 TI - Comparison of therapeutic versus subtherapeutic levels of chlortetracycline in the diet for selection of resistant salmonella in experimentally challenged chickens. AB - Sixteen broiler chicks per group were fed chlortetracycline (CTC) at 0 (control) and 55, 110, and 220 ppm (subtherapeutic levels) continuously for 44 days or 550 ppm (therapeutic level) for three 5-day periods from 1 to 19 days of age. All birds were challenged at 4 days of age with a 10:1 mixture of CTC-sensitive and resistant (CTCr) Salmonella typhimurium. Chicks were sampled periodically through postchallenge day (PCD) 41, half in each pen by cloacal swabbing and the remainder by collection of droppings. Escherichia coli was monitored at PCD 6 and 34. Salmonella recovery from cloacal swabs indicated increased (P less than .05) prevalence of CTCr salmonella-positive birds in the 550 ppm treatment at PCD 6 and 13 compared to all other treatments, and at PCD 27 compared to 0, 55, and 110 ppm CTC. Mean recovery scores followed a similar pattern. Area under the curve analysis of CTCr salmonella scores from cloacal swabs for PCD 3 to 41 confirmed increased (P less than .05) selection for CTCr salmonella by 550 ppm CTC. Isolations from droppings showed increased (P less than .05) CTCr salmonella prevalence at PCD 20 for the 100 ppm treatment group compared to control, and at PCD 34 for the 110 ppm groups compared to all other groups and for 220 and 550 ppm groups compared to 0 and 55 ppm CTC birds. The CTCr salmonella counts in droppings were higher (P less than .05) at PCD 34 for the 110, 220, and 550 ppm groups compared to the control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3313365 TI - High scores for ACE inhibitor in US trial. PMID- 3313362 TI - Critical review of clinical trials in senile dementia--II. PMID- 3313366 TI - Terbutaline by Nebuhaler in young children. PMID- 3313368 TI - The use of relaxation techniques in general practice. PMID- 3313367 TI - Homeopathy. PMID- 3313369 TI - The menopause. PMID- 3313370 TI - Dysfunctional uterine haemorrhage. PMID- 3313371 TI - Urinary incontinence in females. PMID- 3313372 TI - Acute pelvic inflammatory disease. PMID- 3313373 TI - The cervical smear test. PMID- 3313374 TI - Ultrasound in early pregnancy. PMID- 3313375 TI - Herpes infection in gynaecology. PMID- 3313376 TI - [Melanotic schwannoma. Case report and review of the literature]. PMID- 3313377 TI - [Leiomyomatosis peritonealis disseminata. Immunohistochemical case analysis with determination of estrogen and progesterone receptors]. PMID- 3313378 TI - [Mamma supernumeraria dorsalis interscapularis (paravertebralis). A clinico pathologic case report with review of the literature]. PMID- 3313379 TI - The multiple risk factor intervention trial (MRFIT): implications for nurses. PMID- 3313380 TI - Immunoneutralization of circulating pancreatic polypeptide and pancreatic secretion. AB - To determine the role of endogenous pancreatic polypeptide (PP) as a physiological inhibitor of pancreatic secretion, normal rabbit serum (control) or rabbit PP-antiserum was administered intravenously to dogs with chronic esophageal, gastric, and pancreatic fistulas. In all dogs tested, sham-feeding and ordinary feed with a meat meal resulted in a marked rise in the plasma level of immunoreactive PP that coincided with an increase in the exocrine pancreatic secretion of HCO3- and protein. After intravenous administration of PP antiserum, endogenous plasma PP was almost completely bound by infused antibodies to PP, whereas no such binding was detected after infusion of normal rabbit serum. In contrast, plasma gastrin remained unchanged both under basal and stimulated conditions. Immunoneutralization of PP, released endogenously, failed significantly to affect gastric acid and pancreatic protein responses to sham feeding and the pancreatic HCO3- and protein responses to feeding a meat meal in chronic pancreatic fistula dogs. However, the PP antiserum abolished, in part, the inhibitory effect of exogenous PP on pancreatic secretion stimulated by exogenous hormones. We conclude that endogenous PP is not a physiological inhibitor of exocrine pancreatic secretion, as has been suggested previously. PMID- 3313381 TI - Physiopathogenic hypothesis of alcoholic pancreatitis: supranormal ecbolic stimulation of the "pancreon" units secondary to the loss of the negative component of pancreas innervation. AB - In the rat, basal pancreatic secretion is generated and modulated by positive and negative duodeno-pancreatic reflexes. The former activates secretion, the latter acts as a "brake". Impairment of this brake plays a crucial role in the pathogenesis of alcoholic pancreatitis by causing elevation of pancreatic cholinergic tone and inducing increased pancreon ecbolic response to CCK-PZ stimulation. Both factors lead to pancreatic damage by supranormal stimulation of the pancreon. PMID- 3313382 TI - Does the endocrine secretion of the pancreas exert a local control of the exocrine secretion? PMID- 3313383 TI - Internal amino acid sequence analysis of proteins separated by one- or two dimensional gel electrophoresis after in situ protease digestion on nitrocellulose. AB - We have developed a general two-step method for obtaining peptide fragments for sequence analysis from picomole quantities of proteins separated by gel electrophoresis. After separation by one- or two-dimensional polyacrylamide gel electrophoresis, proteins are electrophoretically transferred (electroblotted) onto nitrocellulose, the protein-containing regions are detected by reversible staining and are cut out, and each protein is digested in situ by proteolytic enzymes such as trypsin or staphylococcal V-8 protease. The resulting peptide fragments are separated by narrow-bore reverse-phase HPLC, collected, and sequenced in a gas-phase sequenator. Excellent peptide recoveries and the absence of extraneous contaminants in the separation of the peptide fragment mixture allow the generation of extensive internal sequence information from picomole amounts of protein. The method thus overcomes the problem of obtaining amino acid sequence data from N-terminally blocked proteins and provides multiple, independent stretches of sequence that can be used to generate oligonucleotide probes for molecular cloning and/or used to search sequence data bases for related proteins. This method has been successfully applied to the routine amino acid sequence analysis of a wide range of proteins isolated from one- and two dimensional polyacrylamide gels. PMID- 3313384 TI - Binding of a reduced peptide inhibitor to the aspartic proteinase from Rhizopus chinensis: implications for a mechanism of action. AB - A peptide inhibitor, having the sequence D-His-Pro-Phe-His-Phe psi [CH2-NH]Phe Val-Tyr, with a reduced bond between the two adjacent phenylalanines, has been diffused into crystals of the aspartic proteinase from Rhizopus chinensis (rhizopuspepsin, EC 3.4.23.6). X-ray diffraction data to 1.8-A resolution have been collected on the complex, which has been subjected to restrained least squares refinement to an R-factor (R equals the sum of the absolute value of the difference between the observed and calculated structure factor amplitudes divided by the sum of the observed structure factor amplitudes) of 14.7%. The inhibitor lies within the major groove of the enzyme and is clearly defined with the exception of the amino-terminal D-histidine and the carboxyl-terminal tyrosine. The reduced peptide bond is located in the active site with close contacts to the two catalytic aspartyl groups. The active-site water molecule that is held between the two carboxyl groups is displaced by the inhibitor, as are a number of other water molecules seen in the binding groove of the native enzyme. A mechanism of action for this class of enzymes is proposed from these results. PMID- 3313385 TI - A plasmacytoma-specific factor binds the c-myc promoter region. AB - We used an electrophoretic mobility-shift assay to study proteins that bind to sequences in the 5' flanking region of the murine c-myc gene. By comparing the DNA-protein complexes formed with extracts from cells representing earlier stages of B-cell development with those from plasmacytomas, we identified a plasmacytoma specific protein that binds to a region within the c-myc promoter. Five other regions of this promoter show extensive sequence-specific binding, but the binding is not clearly B-cell stage-specific. Methylation-interference and o phenanthroline/copper-protection experiments identified a single plasmacytoma specific protein binding site 290 base pairs 5' of the transcription start site P1. Homologues of a core sequence, d(AGAAAGGGAAAGGA), within the 25-base-pair binding site are found at three additional sites in the murine c-myc locus. The plasmacytoma-specific occurrence of this protein suggests that it may play a role in the transcriptional repression of the normal c-myc gene observed in plasmacytomas. PMID- 3313386 TI - Tyrosine radicals are involved in the photosynthetic oxygen-evolving system. AB - In addition to the reaction-center chlorophyll, at least two other organic cofactors are involved in the photosynthetic oxygen-evolution process. One of these cofactors, called "Z," transfers electrons from the site of water oxidation to the reaction center of photosystem II. The other species, "D," has an uncertain function but gives rise to the stable EPR signal known as signal II. Z+. and D+. have identical EPR spectra and are generally assumed to arise from species with the same chemical structure. Results from a variety of experiments have suggested that Z and D are plastoquinones or plastoquinone derivatives. In general, however, the evidence to support this assignment is indirect. To address this situation, we have developed more direct methods to assign the structure of the Z+./D+. radicals. By selective in vivo deuteration of the methyl groups of plastoquinone in cyanobacteria, we show that hyperfine couplings from the methyl protons cannot be responsible for the partially resolved structure seen in the D+. EPR spectrum. That is, we verify by extraction and mass spectrometry that quinones are labeled in algae fed deuterated methionine, but no change is observed in the line shape of signal II. Considering the spectral properties of the D+. radical, a tyrosine origin is a reasonable alternative. In a second series of experiments, we have found that deuteration of tyrosine does indeed narrow the D+. signal. Extraction and mass spectral analysis of the quinones in these cultures show that they are not labeled by tyrosine. These results eliminate a plastoquinone origin for D+.; we conclude instead that D+., and most likely Z+., are tyrosine radicals. PMID- 3313387 TI - Primary structure and subcellular localization of the knob-associated histidine rich protein of Plasmodium falciparum. AB - Plasmodium falciparum-infected erythrocytes bind to venular endothelial cells by means of electron-dense deformations (knobs) on the parasitized erythrocyte surface. The primary structure of a parasite-derived histidine-rich protein associated with the knob structure was deduced from cDNA sequence analysis. The 634 amino acid sequence is rich in lysine and histidine and contains three distinct, tandemly repeated domains. Indirect immunofluorescence, using affinity purified monospecific antibodies directed against recombinant protein synthesized in Escherichia coli, localized the knob-associated histidine-rich protein to the membrane of knobby infected erythrocytes. Immunoelectron microscopy established that the protein is clustered on the cytoplasmic side of the erythrocyte membrane and is associated with the electron-dense knobs. A role for this histidine-rich protein in knob structure and cytoadherence is suggested based upon these data. PMID- 3313388 TI - Proposed mechanism for generation and localization of new cell division sites during the division cycle of Escherichia coli. AB - The earliest detectable event at future sites of cell division in Escherichia coli is the appearance of paired periseptal annuli that flank the site of formation of the division septum. The development and localization of these structures were followed as the cell progressed through the division cycle. The data suggest that (i) new periseptal annuli are generated from annuli already in position at the midpoint of the newborn cell; (ii) the nascent annuli are then displaced laterally during cell elongation to positions at 1/4 and 3/4 cell length; and (iii) the annuli at 1/4 and 3/4 cell length are retained during division, becoming the midpoint annuli of the newborn cells at the sites of the forthcoming division septum. The results indicate that the sites of future divisions can be identified and committed to the division process prior to the division cycle in which these sites are utilized for septum formation, and they suggest a model in which preexisting sites of cell division generate future division sites by a replication/displacement mechanism. PMID- 3313389 TI - Polymorphic expression of a human superficial bladder tumor antigen defined by mouse monoclonal antibodies. AB - Three mouse monoclonal antibodies (mAbs), which define a highly restricted antigen, were obtained by simultaneous immunizations with superficial papillary bladder tumor cells and mouse polyclonal serum against normal urothelium. The antigen was detected by the avidin/biotin/peroxidase method in 30/44 superficial bladder tumors (68%) but in only 4/27 infiltrating urothelial cancers (with much less intensity). No normal adult or fetal tissues tested expressed the antigen, including normal urothelium from 40 individuals, 13 of whom had a bladder tumor positive for the antigen. Only 1 of 45 nonbladder tumors showed some reactivity with one of the three mAbs. Serological tests on a large panel of human cancer cell lines and normal cultured cells were negative. The antigen is highly stable and well preserved on paraffin-embedded tissues. Electrophoretic transfer blot experiments with fresh tumor extracts showed that all three mAbs react with a determinant on a component of 300,000 Mr (pI 9.5) and 62,000 Mr (pI 6.5). The antigen shows polymorphic expression at the cellular level on tissue sections and also at a molecular level on immunoblots where the two bands are differentially detected on extracts of a series of tumors but are not visualized on normal urothelium extracts. The characteristics of this antigenic system suggest that it may provide some insights about the biology of bladder cancer. Specific detection of the antigen on 70% of superficial bladder tumors with normal cytology may be useful for their diagnosis and follow-up. PMID- 3313390 TI - Insulin exerts metabolic and growth-promoting effects by a direct action on the liver in vivo: clarification of the functional significance of the portal vascular link between the beta cells of the pancreatic islets and the liver. AB - The functional significance of the portal vascular link between the beta cells of the pancreatic islets and the liver has not been established. Previous studies indicated that insulin does not acutely regulate glucose metabolism by a direct hepatic effect. More recent observations suggest that the role of insulin in regulating body growth may be mediated, at least in part, by the liver. Our experiments were designed to test whether insulin can promote body growth and regulate glucose metabolism by a direct hepatic action in vivo. Rats were made diabetic by injections of streptozotocin, and insulin or solvent was infused into the jugular vein (JV) or the hepatic portal vein (HPV) for 14 days using catheters that were attached to osmotic minipumps. Infusion of a low dose of insulin (2 units per kg per day) into the JV had no effects on the hyperglycemia, body weight gain, tail growth, tibial epiphysial cartilage plate thickness, or serum levels of somatomedin C in the diabetic rats. However, the same dose given into the HPV caused a 30% reduction of blood glucose and stimulated a significant degree of growth, as determined by all indices. Infusion of a higher dose of insulin (5 units per kg per day) into either vein caused full restoration of body weight gain and tail growth and it restored the glycemic status almost to normal. However, it did not increase the tibial epiphysial plate width or serum somatomedin C levels above those of the rats given the low dose of the hormone into the HPV. These results indicate that insulin can act directly on the liver to promote body growth and to regulate glucose metabolism. The significance of direct delivery of insulin from the pancreatic beta cells to the liver may be as much for growth control as for glucose homeostasis. PMID- 3313391 TI - Calcium and calmodulin antagonists inhibit human malaria parasites (Plasmodium falciparum): implications for drug design. AB - The malaria parasite has an obligate calcium requirement for normal intracellular growth and invasion of host erythrocytes. Calmodulin (CaM) is a vital calcium dependent protein present in eukaryotes. We found by radioimmunoassay that free parasites contain CaM. Schizont-infected erythrocytes had CaM levels of 23.3 +/- 2.7 ng per 10(6) cells compared to normals (11.2 +/- 1.5 ng per 10(6) cells). CaM levels were proportional to parasite maturity. Immunoelectron microscopy identified CaM diffusely within the cytoplasm of mature parasites and at the apical end of merozoites within the ductule of rhoptries, which may explain the calcium requirement for invasion. Cyclosporin A (CsA) was also found by electron microscopic autoradiography to concentrate in the food vacuole, as do chloroquine and mefloquine, and to distribute within the cytoplasm of mature parasites. The binding of dansylated CsA to schizont-infected erythrocytes was higher than to normal erythrocytes as analyzed by flow cytometry. Kinetic analysis revealed that binding was saturable for normal and infected erythrocytes and possibly free parasites. Competition for binding existed between dansylated CsA and native CsA as well as the CaM inhibitor W-7 and the classic antimalarial chloroquine. The in vitro growth of Plasmodium falciparum was sensitive to CaM antagonists, and in large part inhibition of the parasite was proportional to known anti-CaM potency. Antagonism existed between combinations of these drugs in multi-drug-resistant strains of P. falciparum, suggesting possible competition for the same binding site. In addition, the malaria parasite was also susceptible to calcium antagonists. PMID- 3313392 TI - Naturally occurring anti-band-3 antibodies and complement together mediate phagocytosis of oxidatively stressed human erythrocytes. AB - Treatment of erythrocytes with the thiol-specific oxidant azodicarboxylic acid bis(dimethylamide) (diamide) enhances their phagocytosis by adherent monocytes. Phagocytosis of diamide-treated erythrocytes required that the cells were opsonized with whole serum, since complement inactivation abolished phagocytosis. Opsonization with whole serum containing 20-100 times the physiological concentration of naturally occurring anti-band-3 antibodies enhanced phagocytosis of diamide-treated erythrocytes. High inputs of anti-band-3 also restored phagocytosis of erythrocytes that had been incubated with complement-inactivated serum. Elevated concentrations of anti-spectrin antibodies were ineffective in whole and complement-inactivated serum. Specific recognition of diamide-treated erythrocytes by anti-band-3 antibodies may be due to generation of anti-band-3 reactive protein oligomers on intact diamide-treated erythrocytes. Generation of such oligomers was dose-dependent with respect to diamide. Bound anti-band-3 alone was not sufficient to mediate phagocytosis. It resulted in deposition of complement component C3b on the cells through activation of the alternative complement pathway in amounts exceeding that of bound antibodies by two orders of magnitude. Thus, anti-band-3 and complement together mediate phagocytosis of oxidatively stressed erythrocytes, which stimulate senescent erythrocytes with respect to bound antibody and complement. PMID- 3313393 TI - Insulin stimulates choline acetyltransferase activity in cultured embryonic chicken retina neurons. AB - The effect of insulin on the appearance of the enzyme choline acetyltransferase (ChoAcT; acetyl-CoA:choline O-acetyltransferase, EC 2.3.1.6) in embryonic chicken retina neurons cultured in defined medium was studied. In the presence of a minimal level of insulin (1 ng/ml), ChoAcT activity increased with time in culture. A correspondence between the insulin concentration in the defined medium (1-100 ng/ml) and both the rate of increase and maximum attained level of ChoAcT activity was observed. Maximal ChoAcT activity was 2- to 3-fold greater in cells cultured in the presence of 100 ng of insulin per ml than in cells cultured in the presence of 1 ng of insulin per ml. To elicit maximum ChoAcT activity, insulin at 100 ng/ml was required in the medium for only the first 4 days of the culture period, at which time insulin could be reduced to maintenance levels (10 ng/ml) without affecting ChoAcT activity. Insulin binding assays performed during a 7-day culture period revealed that irrespective of the insulin concentration in the medium during culture, cell-surface insulin receptors decreased by approximately 90% between 4 and 7 days in culture. This decrease in insulin binding corresponded to the observed decrease in the sensitivity of ChoAcT activity to insulin. Our findings suggest that insulin plays a role in mediating cholinergic differentiation in the embryonic chicken retina. PMID- 3313394 TI - Identification of the M-ring protein of the flagellar motor of Salmonella typhimurium. AB - The M ring is a substructure of the flagellar basal body of bacteria, which lies in the cytoplasmic membrane and is therefore close to the site where the energy of the transmembrane proton potential is converted into mechanical work of rotation of the motor. The protein from which this ring is constructed has not been identified. Flagellar hook-basal body complexes from Salmonella typhimurium were used as the immunogen for the preparation of monoclonal antibodies. An antibody obtained was directed against a major basal-body component, a 65-kDa protein that from mutant studies has been assigned as the product of the flaAII.1 gene. By immunoelectron microscopy, the antibody was observed to bind the innermost feature of the basal body: the cytoplasmic-facing surface of the M ring. We conclude that the 65-kDa protein is a component--probably the main component--of this important substructure of the flagellar motor. PMID- 3313395 TI - Active site of tripeptidyl peptidase II from human erythrocytes is of the subtilisin type. AB - The present report presents evidence that the amino acid sequence around the serine of the active site of human tripeptidyl peptidase II is of the subtilisin type. The enzyme from human erythrocytes was covalently labeled at its active site with [3H]diisopropyl fluorophosphate, and the protein was subsequently reduced, alkylated, and digested with trypsin. The labeled tryptic peptides were purified by gel filtration and repeated reversed-phase HPLC, and their amino terminal sequences were determined. Residue 9 contained the radioactive label and was, therefore, considered to be the active serine residue. The primary structure of the part of the active site (residues 1-10) containing this residue was concluded to be Xaa-Thr-Gln-Leu-Met-Asx-Gly-Thr-Ser-Met. This amino acid sequence is homologous to the sequence surrounding the active serine of the microbial peptidases subtilisin and thermitase. These data demonstrate that human tripeptidyl peptidase II represents a potentially distinct class of human peptidases and raise the question of an evolutionary relationship between the active site of a mammalian peptidase and that of the subtilisin family of serine peptidases. PMID- 3313396 TI - The Stark effect in reaction centers from Rhodobacter sphaeroides R-26 and Rhodopseudomonas viridis. AB - The effect of an electric field on the optical absorption (Stark effect) of reaction centers (RCs) from Rhodobacter sphaeroides and Rhodopseudomonas viridis embedded in films of poly(vinyl alcohol) was measured. The infrared bands were investigated at 295 K and 77 K. In RCs from Rp. viridis at 77 K six peaks (at 982, 849, 835, 818, 803, and 787 nm), associated with the Qy transitions of the six pigments, were resolved; in addition, a small broad band at 865 nm was resolved. In RCs from Rb. sphaeroides only five bands (at 877, 817, 802, 761, and 754 nm) assigned to the Qy transitions were resolved; in addition, two small bands at 697 and 683 nm were observed. The additional bands have been tentatively assigned to vibrational side bands, although the contribution from charge transfer states cannot be excluded. The Stark spectra had line shapes similar to the second derivative of the absorption spectra and were interpreted in terms of the interaction between the applied electric field and the dipole moments of the ground and excited states. Analyses of the spectra yielded the apparent change in dipole moment delta mu app = f delta mu (where the factor f corrects for the difference between the local field and the applied field) and delta, the angle between delta mu---- and the transition moment mu trans. At 77 K the values of delta mu----app and delta for the peaks at 877, 802, and 761 nm in Rb. sphaeroides were 6.5 debye, 38 degrees; 2.1 debye, 23 degrees; and 3.5 debye, 8 degrees. In Rp. viridis the debye values for the peaks at 982, 835, 818, and 787 were 8.2, 40 degrees; 1.8, 50 degrees; 3.4, 14 degrees; and 2.7, 0 degrees. The large values of delta mu app associated with the long-wavelength peak of the bacteriochlorophyll dimers are consistent with a significant charge-transfer contribution to the excited state of the primary donor. PMID- 3313397 TI - Nuclear pore complex contains a family of glycoproteins that includes p62: glycosylation through a previously unidentified cellular pathway. AB - Using a monoclonal antibody (mAb 414), we previously identified a protein of 62 kDa (p62) that was localized to the nuclear pore complex by immunoelectron microscopy. We also showed that p62 binds specifically to wheat germ agglutinin. Therefore, we proposed that this nuclear pore complex protein might be a member of a recently characterized family of glycoproteins that are labeled by in vitro galactosylation of rat liver nuclei and contain O-linked monosaccharidic GlcNAc residues. In support of this, we now show that incubation with N acetylglucosaminidase reduces the molecular mass of p62 by approximately 3 kDa because of the removal of terminal GlcNAc residues. Moreover, p62 can be galactosylated in vitro by using UDP-[3H]galactose and galactosyltransferase. We also show that most of the GlcNAc residues are added within 5 min of synthesis, when p62 is soluble and cytosolic. Thus, the addition of GlcNAc is carried out in the cytoplasm and is clearly distinct from the N- and O-linked glycosylation pathways of the endoplasmic reticulum and Golgi complex. Using another mAb with a broad specificity for nuclear GlcNAc-containing proteins, we show by immunofluorescence and protein blotting of subnuclear fractions that some of these proteins are in the interior of the nucleus, and others are most likely located in the pore complex. PMID- 3313398 TI - Protein phosphorylation is involved in bacterial chemotaxis. AB - The nature of the biochemical signal that is involved in the excitation response in bacterial chemotaxis is not known. However, ATP is required for chemotaxis. We have purified all of the proteins involved in signal transduction and show that the product of the cheA gene is rapidly autophosphorylated, while some mutant CheA proteins cannot be phosphorylated. The presence of stoichiometric levels of two other purified components in the chemotaxis system, the CheY and CheZ proteins, induces dephosphorylation. We suggest that the phosphorylation of CheA by ATP plays a central role in signal transduction in chemotaxis. PMID- 3313399 TI - Model for intermediate steps in monocytic differentiation: c-myc, c-fms, and ferritin as markers. AB - A mature hematopoietic cell represents the end product of a stepwise differentiation process. As a model system for studying differentiation, the human promyelocytic leukemia cell line HL-60 undergoes terminal monocytic/macrophagic differentiation following exposure to either phorbol 12 myristate 13-acetate or 1,25-dihydroxyvitamin D3. We have derived and analyzed a variant HL-60 cell line, 1F10, that permits the study of several intermediate steps in the myeloid differentiation process. These intermediate steps are documented by cell cycle data and phenotype analysis as well as markers such as c myc, c-fms, and both subunits of ferritin. PMID- 3313401 TI - Molecular karyotype of Plasmodium falciparum: conserved linkage groups and expendable histidine-rich protein genes. AB - We describe fractionation of the Plasmodium falciparum genome into 14 chromosomal DNA molecules by pulsed-field gel electrophoresis. This number agrees with the number of chromosomes observed by electron microscopic visualization of kinetochores. The assignment of 25 markers to 12 of the 14 chromosomes in three cloned parasite lines demonstrates that chromosomal size variation can greatly change the relative migration of genetically equivalent chromosomes. Deletions that include genes for three different histidine-rich proteins, located on chromosomes 2, 8, and 13, contribute to size differences in some clones. Other karyotypic differences result from chromosome segregation and/or recombination during meiosis. PMID- 3313400 TI - Increased expression of major histocompatibility complex antigens on lymphocytes from aged mice. AB - Many studies have reported age-related changes in immune responses that could be due to alterations in lymphoid cell numbers or functions. Here we report the results of studies using immunofluorescent staining and in vitro assays of cellular function to compare the expression of cell surface antigens on lymphocytes from mice up to 2 years of age. No significant changes were observed in the frequencies of spleen cells bearing class I or class II major histocompatibility complex (MHC) antigens, surface immunoglobulin, or Thy-1, Ly 1, Ly-2, or L3T4 antigens. However, the densities (per cell) of both class I and class II MHC antigens were increased significantly on cells from aged as compared to young mice, whereas the densities of the other cell surface antigens studied were unchanged or slightly decreased. The increased levels of MHC antigen expression in old relative to young mice were shown to be functionally significant regarding immunological stimulation. These data suggest that T-cell clones silent in young individuals may be activated in comparable situations in older animals, leading to immunological alterations perhaps including increased autoreactivity. PMID- 3313402 TI - Tubulofilaments in negatively stained scrapie-infected brains: relationship to scrapie-associated fibrils. AB - A simple method was devised for negative-stain transmission electron microscopy of brain infected with the agent of scrapie. Brains of infected hamsters contained large masses of tubulofilamentous structures with irregular fuzzy surfaces. Brains of mice infected with Creutzfeldt-Jakob disease agent contained similar tubulofilaments in smaller numbers. The abnormal tubulofilaments resembled but were distinguished from normal microtubules. On grids soaked in sodium dodecyl sulfate the abnormal tubulofilaments were found in stages of fragmentation, an outer coat appearing t0 strip from the surface to reveal thinner fibrillary structures resembling scrapie-associated fibrils (SAF). The unmasked fibrils were identified as SAF by immunogold labeling, while the larger tubulofilaments were not labeled. The findings indicate that in infected brain tissue SAF may occur as an internal part of a larger structure that is disrupted by detergent and are not likely to be an artifact formed during extraction procedures. PMID- 3313404 TI - Measles virus persistence in a hamster brain cell line: cyclical fluctuation of viral expression during serial passages. AB - Measles virus persistence in a hamster brain cell line was examined for the appearance of viral antigens and for the synthesis of infectious virus, viral RNA, and virus-specific proteins during 19 serial passages. Cyclical fluctuation was detected at all levels of measles virus replication. After reaching the maximal activity at the passages 9 to 11 viral synthesis diminished rapidly, being lowest after 2 to 3 subsequent passages. No release of infectious virus was detected at the passages 14 and 15 and only 20% of the cells contained measles virus antigens when tested by immunofluorescence. After the nonproductive phase, the cells released virus again and the number of antigen-positive cells increased. The alternation in the amount of the measles virus-specific proteins and viral RNA correlated directly with the parameters mentioned above. No apparent defects in the synthesis of individual viral proteins were observed. PMID- 3313403 TI - Release of autocrine growth factor by primary and immortalized Schwann cells. AB - Schwann cells derived from neonatal rat sciatic nerve are quiescent in culture unless treated with specific mitogens. The use of glial growth factor (GGF) and forskolin has been found to be an effective method for stimulating proliferation of Schwann cells on a poly(L-lysine) substratum while maintaining their ability to myelinate axons in vitro. We find that repetitive passaging of Schwann cells with GGF and forskolin results in the loss of normal growth control; the cells are able to proliferate without added mitogens. The immortalized cells grow continuously in the absence of added growth factor and in the presence or absence of serum yet continue to express distinctive Schwann cell-surface antigens. The cells can associate with axons in culture, deposit a basal lamina, and ensheath axons, but they gradually lose their capacity to myelinate axons. The immortalized cells release growth-promoting activity into their culture medium. The released activity is effective in stimulating proliferation of primary Schwann cells that retain normal growth properties. Extracellular matrix molecules (laminin and fibronectin) augment the response of primary Schwann cells to the secreted mitogen. Quiescent primary Schwann cells also secrete a growth factor into their culture medium, but its activity is detectable only in the presence of added laminin or fibronectin. The results suggest that both normal and immortalized Schwann cells secrete an autocrine growth factor. Response to the autocrine factor appears to entail a multicomponent mechanism. Unlike primary cells, immortalized Schwann cells have the capacity to secrete all of the necessary components and to respond to them constitutively. PMID- 3313405 TI - Vasoactive intestinal polypeptide enhances hormone content and insulin release in cultured fetal rat islets. AB - The effect of porcine vasoactive intestinal polypeptide (VIP) on development of the biphasic insulin release response in cultured fetal rat islets was investigated. Fetal islets, 21.5 days gestational age, were cultured for 7 days in RPMI 1640 culture medium containing either 2.8 or 11.1 mM glucose adn subsequently challenged with 16.7 mM glucose in a perfusion system. Islets were exposed to VIP at a final concentration of 13.2 nM by adding the peptide to the perifusion buffer (acute exposure) or by adding it to the culture medium throughout the culture period (chronic exposure). Islet hormone and DNA contents were also quantitated at the end of the culture period. Acute exposure to VIP resulted in no alterations of the insulin release pattern after culture in the presence of either glucose concentration. However, chronic treatment of islets with 13.2 nM VIP in the presence of 2.8 mM glucose resulted in significant increases in the maximum rate of insulin release during the first phase and the total amount of insulin release during both phases. Similarly, islets cultured in the presence of 11.1 mM glucose and 13.2 nM VIP demonstrated enhanced biphasic insulin release patterns with increased maximum rate and total amount of release during both phases. The presence of VIP and 2.8 mM glucose increased islet glucagon and somatostatin contents, but islet DNA and insulin contents remained unchanged. These findings indicate that VIP plays a significant role in the in vitro development of the biphasic insulin release pattern and may be a factor controlling the maturation of the fetal islet in vivo. PMID- 3313406 TI - Lack of direct coronary vascular effects of Escherichia coli endotoxin in dogs. AB - This study explored the hypothesis that coronary vascular injury and dysfunction result from intracoronary administration of Escherichia coli endotoxin (0.025 to 0.025 to 0.4 mg/kg) in dogs. Peak hyperemic coronary flow following a 15-sec period of stopped flow and the maximum flow in response to adenosine were used to estimate coronary vascular reserve. The wet-to-dry ratio of myocardial tissue was used to estimate extravascular water content as an indicator of vascular leak due to endothelial injury. Intracoronary saline was used as a control. Peak reactive hyperemia and maximum flow at constant coronary pressure were not different in the animals receiving intracoronary endotoxin (n = 6) and the animals receiving saline (n = 5) during 4 hr following treatment. In addition, wet-to-dry ratios were similar in these two groups. These data fail to support the hypothesis that endotoxin, per se, produces coronary vascular injury of sufficient magnitude to produce myocardial dysfunction. PMID- 3313407 TI - Effects of prostacyclin analogues on platelet aggregation and blood pressure of anaesthetized beagle dogs. PMID- 3313408 TI - Effects of PGI2 and CH-5084 on the arterial smooth muscle tone, blood pressure and platelet aggregation. PMID- 3313409 TI - Increased plasma-6-oxo-PGF1-alpha but normal PGI2 half-life in patients with maxillo-facial tumors. AB - In 56 patients with histologically verified maxillo-facial cancer the plasma 6 oxo-PGF1-alpha was determined prior surgery using a specific RIA and the double antibody technique. Furthermore, the half-life of synthetic PGI2 has been assessed via the disappearance curve of biological activity on platelet aggregation inhibition. Part of the patients has been monitored by the same test different time intervals after radical surgery. Normal values of 6-oxo-PGF1-alpha amount below 1 pg/ml. - normal half-life of PGI2 in plasma in-vitro about 10 minutes. Prior surgery a significantly increased 6-oxo-PGF1-alpha can be seen, whereas the PGI2 half-life is unaffected. In patients without local or general recurrence normal 6-oxo-PGF1-alpha levels are monitored. No change occurred in the half-life of PGI2. These findings underline the additive value of 6-oxo-PGF1 alpha as a tumor marker. The data do not support the view presented earlier, that a change in plasmatic PGI2 half-life might favour the onset and the extent of recurrence at least in patients suffering on maxillo-facial cancer. PMID- 3313410 TI - The antiaggregatory effectiveness of PGI2 and its binding to specific platelet receptors. A comparative study. PMID- 3313411 TI - Acetyl-salicylic acid impairs insulin-mediated glucose utilization and reduces insulin clearance in healthy and non-insulin-dependent diabetic man. PMID- 3313412 TI - Prostacyclin and catecholamines: activators of two steps in cardiac electrogenesis. PMID- 3313413 TI - Different effects of thromboxane synthetase inhibition on PGI2 and PGE2 synthesis in human vascular tissue bathed in clotting blood. PMID- 3313414 TI - Changes in platelet reactivity, prostacyclin and thromboxane production after long-term oral defibrotide in healthy and atherosclerotic rabbits. PMID- 3313415 TI - Nocloprost, a novel prostanglandin E2 analog: significant reduction of aspirin induced grastrointestinal lesions in man. PMID- 3313416 TI - Inhibition of PG synthesis by indomethacin does not influence the exercise induced stimulation of renin-angiotensin-aldosterone system in hypertensives treated with captopril. PMID- 3313417 TI - Cardiovascular and antithrombotic effects of ZK 96 480, a novel metabolically stable carbacyclin derivative with oral activity. PMID- 3313418 TI - Prostaglandin E1 in chronic arterial disease: a multicenter study. PMID- 3313419 TI - Prostacyclin to improve early function in clinical renal transplantation. PMID- 3313420 TI - Prostacyclin in peripheral arterial occlusive disease (PAOD): clinical and hemodynamic findings in patients with PAOD stage III and IV. PMID- 3313421 TI - Clinical benefit and prolongation of platelet half-life induced by CG 4203, a stable PGI2-analogue. PMID- 3313422 TI - Hemodialysis with the stable prostacyclin analogue CG 4203. PMID- 3313424 TI - Prostacyclin formation of the rabbit vessel wall: effects of endotoxin in vivo and in vitro. PMID- 3313423 TI - Profiling prostaglandins, thromboxanes and hydroxy fatty acids using stable isotope dilutions and gas chromatography-mass spectrometry. PMID- 3313426 TI - Approaches to cancer control in Canada, and internationally. PMID- 3313425 TI - Green Mountain Oncology Group--CCOP: an evolving regional cancer program. PMID- 3313427 TI - Light-dependent phospholipase C activity in Musca eye membranes and excitation of photoreceptor cells by inositol triphosphate and 2,3 diphosphoglycerate. PMID- 3313428 TI - Regulation of endothelial growth factor action: solid state control by extracellular matrix. PMID- 3313430 TI - Platelet activating factor; chemical and biochemical characteristics. PMID- 3313429 TI - Immunochemical studies of estrogen receptors. AB - The preparation of specific antibodies, and especially monoclonal antibodies, to human estrophilin has furnished a means of detecting and studying receptor localization, structure and function, independent of its ability to bind labeled steroid. These reagents have been especially useful in providing improved methods for the determination of estrogen receptors in human breast cancers, as a guide to clinical prognosis and therapy, and in facilitating the cloning of estrophilin cDNA leading to an elucidation of the aminoacid sequence of the receptor molecule. PMID- 3313431 TI - Animal glycoglycerolipids. PMID- 3313432 TI - Lipid metabolism in fish. PMID- 3313433 TI - Lung surfactant. PMID- 3313434 TI - How much or how little cholesterol? PMID- 3313435 TI - Influence of prostacyclin on the antilipolytic effect of nicotinic acid in rat fat cells: a comparison with adenosine deaminase and theophylline. AB - Isolated rat fat cells were incubated at pH 8.5 in order to delay PGI2 inactivation. Nicotinic acid, at concentrations lower than 2 mM was ineffective in antagonizing the stimulation of lipolysis induced by norepinephrine (2 microM). The potentiation of norepinephrine effect due to PGI2 (0.1 microM) was abolished by 0.1 mM nicotinic acid and, at higher concentrations of the drug, the rate of the process fell below the one measured in the absence of PGI2, with a resulting decrease of the response to norepinephrine. Nicotinic acid (0.04-0.4 mM) antagonized the stimulation of lipolysis caused by adenosine deaminase (0.5 U/ml) or by theophylline (0.5 mM) and the potentiation of norepinephrine effect due to adenosine deaminase. In cells treated with adenosine deaminase (0.5 U/ml) or with theophylline (0.5 mM), PGI2 (40 nM) inhibited the lipolytic effect of norepinephrine (5 microM) and nicotinic acid acted synergistically with PGI2 at this level. These results indicate that the antilipolytic action of nicotinic acid is influenced by endogenous adenosine and is increased by PGI2. PMID- 3313436 TI - [Structure of anthracycline antineoplastics]. PMID- 3313437 TI - [Pharmacokinetics and -dynamics under the influence of ionizing rays]. PMID- 3313438 TI - [The effectiveness of trapidil and some derivatives on heart function under in vitro and in vivo conditions]. AB - Cardiac and coronary effects of trapidil (Rocornal) and some derivatives were investigated in isolated heart preparations and rabbit hearts in vivo. All substances showed a comparable increase of the coronary flow. Contrary to the cardiotonic influence of trapidil the trapidil derivates induced a negative inotropic effect, possibly due to a weak calcium antagonism. Heart rate was slightly diminished, but in some cases higher doses caused an acute tachycardia. I.v. application of the substances to rabbits in doses of 10 mg/kg and 30 mg/kg induced an initial depression of blood pressure normalizing within 3-5 min. An increase of the myocardial prostacyclin biosynthesis is only demonstrable under trapidil. The results indicate that the cardiac effects of trapidil derivatives are possibly caused by a direct influence on the contractile system and the membrane potential of the cardiac muscle cell. PMID- 3313439 TI - [Progress in the field of drug development. 20]. PMID- 3313440 TI - [The demonstration of proteolytic activity of bovine coronary arteries and the effect of drugs and other substances on it]. AB - Intracellular neutral proteinases activity of bovine coronary arteries was demonstrated, isolated and partially characterized. The enriched crude enzyme preparation can be inhibited by diisopropylphosphofluoridate (DFP) and phenylmethylsulfonylfluoride (PMSF). The inhibitor concentration (pI50 values) by DFP and PMSF in the enzyme preparation and for trypsin are very similar. Several drugs (isoproterenol, propranolol, theophylline) tested on the enriched crude neutral proteinases preparation showed stimulatory or inhibitory activities. The results are discussed with regard to a possible action mechanism such proteinases on the cyclic AMP/cyclic GMP system. PMID- 3313441 TI - [Neubrandenburg pharmacy accounts of 1608-13. A drug history study]. PMID- 3313442 TI - [Sulfones--development of a class of substances]. PMID- 3313444 TI - A comparison of calculated and measured data for total body irradiation by 10 MV x-rays. AB - This paper describes the rationale for using computed rather than measured data as a reference in the dosimetry of total body irradiation. The proof of this statement rests on a comparison of measured dosimetric values for large fields at extended distances with those derived by simple recalculation from the data measured at the isocentre. The depth doses and dose rates were experimentally obtained for 10 MV x-rays at distances of 100, 200 and 300 cm for collimated square fields with sides ranging from 5 to 30 cm. Phantoms of different volumes and shapes, including a RANDO phantom, and a large (50 cm x 50 cm x 50 cm), intermediate (25 cm x 25 cm x 25 cm), and 'mini-phantom' (build-up cap, 4.6 cm diameter) were used. Comparison of the measured and computed data for the largest collimated field shows that (i) calculated dose rates do not differ by more than +1% from the measured data, phantom size and shape having no effect on the results, (ii) depth doses measured in a patient-like RANDO phantom are a maximum of 2% higher than the calculated data but are also 2% lower than the depth doses measured in a standard water tank. For the radiation fields and treatment distances commonly employed in total body irradiation, we conclude that the calculated data can serve as reference values for dosimetry because they have the same inherent uncertainty as the data measured in non-patient-like phantoms. PMID- 3313443 TI - Lithium carbonate: effects on sleep patterns of normal and depressed subjects and its use in sleep-wake pathology. AB - The effects of lithium carbonate on sleep patterns have been investigated both acutely in normal and depressed subjects and chronically in depressed subjects. In normal subjects receiving lithium for two weeks total sleep time did not vary, REM sleep decreased and REM sleep latency increased. In depressed subjects, either on short therm therapy or on long term therapy stages 3 and 4 increased, REM sleep decreased, REM latency increased and REM activity/time spent asleep (an index of REM intensity per minute of sleep) decreased. Plasma lithium levels were negatively correlated with REM sleep percentage and positively correlated with REM sleep latency. Besides, it has been shown in one paper that short term therapy with lithium caused small but significant delays in the sleep-wake circadian rhythm. These effects are of interest in view of polygraphic sleep abnormalities found in affective disorders and possible circadian disturbances accounting for these abnormalities. Indeed lithium might act in correcting spezial sleep abnormalities and/or circadian disturbances. In addition to its predominant use for the prophylaxis of recurrent mania and depression, lithium carbonate has been proposed and tried in the prophylactic treatment of abnormally prolonged sleep episodes featuring the Kleine-Levin syndrome. PMID- 3313445 TI - Pure singlet oxygen cytotoxicity for bacteria. PMID- 3313446 TI - Induction of phr gene expression by pyrimidine dimers in Escherichia coli. PMID- 3313447 TI - Plasma thyroid hormones, thyroid stimulating hormone, and insulin during acute hypometabolic states in man. AB - Acute behavioral rest states in man are associated with marked hormonal and metabolic changes. In order to complete a hormonal profile of these states and to identify possible metabolic regulators, we measured thyroid hormones (T3 and T4), thyroid stimulating hormone (TSH), and insulin during the stylized mental practice of "transcendental mediation" (TM) and during ordinary unstylized eyes closed rest. Except for TSH, which declined acutely, hormone levels were normal and stable throughout the experiment. The stability of T3 and T4, and insulin make it unlikely that these hormones regulate the acute metabolic changes associated with these behavioral states. Decreased TSH, along with stable thyroid hormone levels, may suggest change of the set point for feedback control of TSH secretion during TM and is consistent with primarily neural modulation of TSH secretion by this behavior. PMID- 3313448 TI - Spontaneous insulin fluctuations and the preabsorptive insulin response to food ingestion in humans. AB - Insulin secretion occurs in response to cephalic stimulation by foods; in humans, the response is quite variable and its importance in meal situations is difficult to assess. Insulinemia also varies spontaneously in the absence of food stimulation. In the present work, a comparative study of spontaneous and food associated insulinemia changes was performed. Spontaneous preprandial fluctuations of glycemia and insulinemia were recorded and the presence of significant oscillations or trends was investigated. Premeal changes in insulinemia then served as a basis for evaluating the preabsorptive insulin response (PIR) during food ingestion. A sinewave fitted to preprandial insulin oscillations did not appear satisfactory as a basis for the assessment of the PIR. Significant PIRs were then defined in terms of deviation from a confidence interval (mean of the preprandial values +/- 2 SD). Significant PIRs were more frequent when the food presented was more palatable. Individual differences in responsiveness appeared. The physiological significance of a PIR over a background of spontaneous fluctuations is discussed. PMID- 3313449 TI - Insulin counteracts the satiating effect of a fat meal in rats. AB - The effects of insulin administration of the reduction on food intake which follows a meal of corn oil was examined in normal and streptozotocin-diabetic rats. In the first experiment, a single injection of long-acting, protamine zinc insulin (3 IU) curtailed the decrease in 24-hr food intake that occurred in normal and diabetic rats after ingestion of 2.0 ml of oil. In a second experiment, injection of short-acting, regular insulin (0.5 IU) prevented the depression of food intake which occurred 6-24 hr after ingestion of 1.5 ml of corn oil, but not at earlier time intervals. In a third experiment, the short term suppression of food intake in diabetic rats that occurred within 6 hr after a 1.5 ml meal of oil was reduced by chronic administration of insulin (3 IU/day) via a subcutaneously implanted osmotic pump. The results indicate that a relatively long-lasting effect of insulin counteracts the satiation from ingested fat and suggest that insulin's role in the control of food intake may depend on the composition of the diet. PMID- 3313450 TI - Evidence for the role of insulin-like growth factor II (IGF-II) in the control of food intake. AB - Highly purified insulin-like growth factors I and II and insulin (100 ng peptide/animal) were injected intracerebroventricularly in rats and the effect on 24 hour food consumption examined. IGF-II injections resulted in a 21% decrease in food intake and 4% body weight loss over the 24 hour period following peptide administration whereas IGF-I and insulin had no effect on either parameter. Increasing the amount of IGF-II injected also increased these responses with depressions of 22, 33 and 44% occurring in rats given 33, 100 and 300 ng IGF-II respectively. In addition, tissue concentrations of IGF-II were detected and found to be differentially distributed, via radioimmunoassay, in specific regions of the brain implicated in the regulation of food intake. IGF-I was not found in these same tissue punches despite radioimmunoassay sensitivity of 6 pg. PMID- 3313451 TI - Facilitation of courtship behavior in the male red-sided garter snake (Thamnophis sirtalis parietalis) following lesions of the septum or nucleus sphericus. AB - Courtship behavior in male red-sided garter snakes is limited to the period immediately following spring emergence. Lesions of the septum or nucleus sphericus prior to hibernation facilitate courtship behavior upon emergence the following spring. These lesions also had a significant effect on the reproductive physiology of the male snake. Snakes with lesions in the nucleus sphericus had a significantly higher concentration of circulating androgens compared to the control group. While animals with lesions in the septum exhibited elevated levels of circulating androgens, they were not statistically elevated when compared to the control group. The quantity of sexual granules in the epithelium of the renal sexual segment, a secondary sexual characteristic of male squamate reptiles, was significantly greater in lesioned animals. These results are the first to demonstrate a central inhibitory control of sexual behavior in a snake. PMID- 3313452 TI - Activity rhythms in the circadian domain appear in suprachiasmatic nuclei lesioned rats given methamphetamine. AB - Female rats were lesioned in the suprachiasmatic nuclei (SCN) electrolytically and treated with methamphetamine. The SCN lesions abolished the circadian locomotor rhythm completely. When methamphetamine was administered in the drinking water, robust rhythmicities in locomotor activity appeared in the SCN lesioned rats, which did not entrain to the 24 hr light cycle. The period of the activity rhythm was dose-dependent; the lower the concentration of methamphetamine was, the shorter the period of the rhythm became. When rats were treated with 0.005% methamphetamine, the mean period was 26.4 hours. In addition, activity time (alpha) became shorter, rest time (rho) longer and alpha/rho ratio lower, when methamphetamine concentration was decreased. After methamphetamine withdrawal, the rhythmicity disappeared and locomotor activity became aperiodic again. When methamphetamine was administered continuously by means of an osmotic minipump, similar rhythmicities appeared in locomotor activity of the SCN lesioned rats. It is concluded that methamphetamine manifests an activity rhythm whose period is in the circadian range. The rhythmicity is independent of the SCN and is not entrained by the light-dark cycle. PMID- 3313453 TI - The radial arm maze as a tool in behavioral pharmacology. AB - This paper will review briefly the use of the radial arm maze as a tool to examine the neural systems that are involved in memory, and the influence of pharmacological compounds on memory. Of particular interest is the question of task validity, which is assessed by reference to four different criteria: operational, psychological, ethological, and neural (see also Walsh, this issue; [45, 53, 70, 75]). Each of these types of validity is reviewed below. PMID- 3313454 TI - The use of the radial arm maze in neurotoxicology. AB - The neurotoxicity of a variety of compounds may be uniquely expressed in their ability to disrupt cognitive function. The development of sophisticated behavioral tasks to assess cognitive and mnemonic function in rodents provides necessary tools for addressing these effects. The radial arm maze has been increasingly utilized to examine the psychological and neurobiological substrates of cognitive function. This paper critically examines the usefulness of this task in determining (1) the neurotoxicity of suspected neurotoxic compounds, (2) the neural systems which appear to be uniquely susceptible to a variety of toxicants and degenerative processes, and (3) the degree of behavioral and neural plasticity following neurotoxic insult. It is concluded that the radial arm maze provides an important tool that can be used to address several of the fundamental problems in neurotoxicology. PMID- 3313455 TI - First we are physicians. PMID- 3313456 TI - A simple method for improving skin graft take in patients on Clinitron therapy. PMID- 3313457 TI - New honors for Joseph E. Murray, M.D., and Radford C. Tanzer, M.D. PMID- 3313458 TI - The risk of allergy in asthma. AB - The prevalence of atopy among asthmatics is more than 70 per cent. Atopy is more prevalent among older children and young asthmatic adults. It is inherited, but the pattern of inheritance is not well defined. Increase in total IgE is one manifestation of atopy, and increase in IgE in early infancy is a predictor of atopic illness, including asthma. Sensitization to allergens and repeated exposure is one of the triggers of developing asthma in atopic patients. Allergy even without asthma (allergic rhinitis) is associated with an increase in bronchial reactivity. Allergy is a risk factor in occupational asthma and in exercise induced asthma. In fact, many non-asthmatic allergic rhinitis patients wheeze with exercise. Allergen avoidance and environmental control may contribute to the well-being of many asthmatics. Allergy hyposensitization (immunotherapy) may help control asthma in allergic patients. PMID- 3313460 TI - Urticaria and angioedema. AB - Urticaria and angioedema are common medical problems. This article presents a classification and review of the diverse etiologic factors that can trigger these problems. A practical approach to differential diagnosis and various therapeutic modalities are also explained. PMID- 3313459 TI - Allergy in atopic dermatitis. AB - Approximately 10 per cent of patients with atopic dermatitis have clinical manifestations that are significantly affected by allergens. Food allergies appear to be more common in infants, while aeroallergens probably affect older children and adults more frequently. Patients who do not respond favorably to standard regimens of lubrication, topical corticosteroids, and antihistamines should be evaluated for allergies to foods and aeroallergens. Historical information, radioallergosorbent tests, and prick tests guide in the selection of allergens to be eliminated, but elimination and challenge tests are most useful in the determination of allergens that may affect atopoic dermatitis. PMID- 3313461 TI - Allergic reactions to drugs. AB - Allergic reactions can result from virtually any drug. In the pharmacopeia the possibility of an allergic reaction to a drug must be considered in any instance when a patient reports an adverse effect to a drug. Although most allergic reactions to drugs are mild, they may be severe and at times fatal. Thus, it is imperative that every physician understand the spectra of drug allergy, the methods for diagnosing, and the means of treating allergic reactions to drugs. This review places drug allergies within the context of the over-all spectra of adverse reaction to drugs, defines the spectra of allergic reactions in terms of the organ systems involved and the severity of the reactions, suggests mechanisms for diagnosing drug allergy by historical evaluation, and where possible, by skin testing procedures and provocative dose challenges, and provides a variety of methods for reintroduction of drugs to which patients have been demonstrated to be allergic. The most important aspect of allergic reactions to drugs, however, is the understanding on the part of the physician that any drug has the potential for causing an allergic reaction and that extreme vigilance in terms of the diagnosis and treatment of these reactions is necessary. PMID- 3313463 TI - Allergy in children. AB - Two important and common allergic disorders of childhood, allergic rhinoconjunctivitis and asthma, are reviewed. Pertinent clinical features and laboratory evaluations useful in establishing their diagnosis are presented, with emphasis on items unique or relevant to children. Newer treatment approaches, both pharmacologic and nonpharmacologic, are discussed, focusing mainly on outpatient management. Finally, a brief overview of immunotherapy and food hypersensitivity in children is given. PMID- 3313462 TI - Food allergy for the primary care physician. AB - Interest in food allergy has increased among physicians as well as the public. The symptoms are mainly in the gastrointestinal tract, the skin, and the respiratory system. Other organs are less commonly affected. The offending food can be suspected from the medical history, by skin testing, or by serum-specific IgE antibodies (RAST). Verification, however, depends on documentation of disappearance of symptoms after avoidance of the offending food and their recurrence on reintroduction of that food. Treatment is mainly dietary avoidance. Its success, however, depends on many factors. Pharmacologic agents may be needed in some cases for symptomatic relief and possibly for prophylaxis. The awareness on the part of the primary physician of the manifestations of food allergy and its diagnosis should enhance the physician's expertise in dealing with such patients regarding further management. PMID- 3313464 TI - House dust sensitivity and environmental control. AB - Allergy to foreign proteins in house dust is extremely common. Despite the fact that immunotherapy with house dust extract has been utilized for over sixty years, environmental control is still infrequently employed as a therapeutic measure. In this article the major allergen content of house dust is defined and strategies for decreasing the levels of these allergens in homes are described. PMID- 3313465 TI - Immunotherapy for allergic diseases. AB - The efficacy of immunotherapy is related to the dose administered, and the immune response is specific for the allergen injected. The larger dose will provide the higher level of IgG blocking antibody and will provide the most symptomatic relief of symptoms. Increased frequency of injections seems to stimulate production of blocking antibody. Much work is currently under way to provide modified forms of immunotherapy designed to elicit the immune response without the allergic or adverse reactions of the allergen. Polymerized antigens, allergoids and glutaraldehyde-treated tyrosine-absorbed allergens are examples of such modifications. It is quite possible that within a short time extracts will be available commercially such that a patient will be adequately immunized with only a very few injections. Hymenoptera venom immunotherapy offers virtually complete protection for those patients who in the past were at great risk from stings. Proper history, skin testing, extract prescribing, and extract administration all are vital points in the successful immunotherapy of a patient. PMID- 3313466 TI - [Projection of the family situation by the pupils of the Children's Home in "The bewitched family" drawing test]. PMID- 3313467 TI - [Changes in the proposed mental health act]. PMID- 3313469 TI - [Subcortical dementia syndrome]. PMID- 3313468 TI - [Role of genetic factors in alcohol dependence]. PMID- 3313470 TI - [Apotemnophilia]. PMID- 3313471 TI - [On the 80th birthday of Dr. Zdzislaw Jaroszewski]. PMID- 3313473 TI - Festschrift. Current trends in psychiatry. First Gerald J. Sarwer-Foner Clinical Symposium. June 21, 1986, Ottawa. Proceedings. PMID- 3313472 TI - [Activities of Dr. Zdzislaw Jaroszewski at the hospital in Drewnica]. PMID- 3313474 TI - On Professor Gerald J. Sarwer-Foner's clinical, research, teaching and organizational contributions. PMID- 3313475 TI - Some thoughts on current trends and current concerns in psychoanalysis. PMID- 3313476 TI - Trends in psychiatric education, services, and research in the United States. PMID- 3313477 TI - Recent advances in child and adolescent psychiatry in Canada. PMID- 3313478 TI - Some recent developments in relation to agoraphobia and related disorders and their bearing upon theories of their causation. PMID- 3313479 TI - Technology and the diagnosis of schizophrenia: the search for a biological marker. PMID- 3313480 TI - The Stanton Schwartz syndrome: three cases. PMID- 3313481 TI - Sexually aggressive men. PMID- 3313482 TI - An alternative method of teaching psychotherapy to a foreign medical graduate resident in psychiatry. PMID- 3313484 TI - Psychophysiological effects of methylphenidate (Ritalin). PMID- 3313483 TI - MMPI study of identical twins: cancer patients and bone marrow donors. PMID- 3313485 TI - Hypnotic analgesia and stress inoculation: a critical reexamination of Miller and Bowers. PMID- 3313486 TI - Semantic control of selective attention. PMID- 3313487 TI - Phonetic awareness and reading acquisition. PMID- 3313488 TI - Cognitive functioning and anxiety. PMID- 3313489 TI - Medical care utilization and the transcendental meditation program. AB - This field study compared 5 years of medical insurance utilization statistics of approximately 2000 regular participants in the Transcendental Meditation (TM) program with a normative data base of approximately 600,000 members of the same insurance carrier. The benefits, deductible, coinsurance terms, and distribution by gender of the TM group were very similar to the norm, yet the TM group had lower medical utilization rates in all categories. Inpatient days per 1000 by age category were 50.2% fewer than the norm for children (0-18), 50.1% fewer for young adults (19-39), and 69.4% fewer for older adults (40+). Outpatient visits per 1000 for the same age categories were, respectively, 46.8%, 54.7%, and 73.7% fewer. When compared with five other health insurance groups of similar size and professional membership, the TM group had 53.3% fewer inpatient admissions per 1000 and 44.4% fewer outpatient visits per 1000. Admissions per 1000 were lower for the TM group than the norm for all of 17 major medical treatment categories, including -55.4% for benign and malignant tumors -87.3% for heart disease, -30.4% for all infectious diseases, -30.6% for all mental disorders, and -87.3% for diseases of the nervous system. However, the TM group's admission rates for childbirth were similar to the norm. The issue of self-selection is addressed in terms of previous medical research in this area. PMID- 3313490 TI - Dengue and dengue hemorrhagic fever in the Americas. AB - There has been a constant increase in the incidence of dengue in the Americas over the past 15 years. This has been caused by increased frequency of epidemic activity in most countries, as a result of increased numbers of virus serotypes circulating in the region. The change in disease ecology has resulted in the emergence of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) in the region, first with a major epidemic in Cuba, followed by increased occurrence of sporadic cases of DHF/DSS in many countries. The sequence of events in the Americas in the 1980's has been nearly identical to the pattern observed in Southeast Asia in the 1950's. Prospects for prevention of epidemic DHF/DSS in the American region, therefore, are not good. In the absence of Aedes aegypti eradication, the only hope for effective prevention and control is to develop more effective active surveillance for DHF/DSS and combine that with both emergency and community-based vector control programs. PMID- 3313491 TI - Dengue in Puerto Rico: clinical manifestations and management from 1960's to 1987. AB - Dengue is a viral disease transmitted by the Aedes aegypti mosquito. It is endemic in Puerto Rico and the Caribbean with periodic epidemics occurring at varying intervals. There are three dengue serotypes present in Puerto Rico, at the present time. The clinical manifestations of dengue in Puerto Rico are presented from a historical perspective. Dengue in Puerto Rico has evolved from a clinically mild illness in the 1960's to a devastating disease with hemorrhagic manifestations in the 1980's and dengue shock syndrome in 1987. The approach to clinical diagnosis and management is presented with emphasis on early recognition, performance of tourniquet test, serial hematocrits and aggressive intravenous fluid replacement with crystalloids of colloids in DSS. The best way to treat dengue is eliminating the vector, therefore, prevention. PMID- 3313492 TI - The pupil. PMID- 3313493 TI - Prolactinomas: medical or surgical treatment? PMID- 3313494 TI - Dysplastic epidermal change in immunosuppressed patients with renal transplants. AB - The prevalence of non-melanoma skin cancer has been studied in a group of 85 patients who have undergone renal transplantation. We also investigated the relationship between the development of neoplastic lesions and the duration of immunosuppression, previous sun exposure and infection with human papilloma virus. The overall prevalence of neoplastic and pre-neoplastic epidermal lesions in the group was 25 per cent, higher than that previously reported in studies from the United Kingdom. In patients who had survived for more than 80 months after transplantation the prevalence of these lesions was 38 per cent. There was no apparent relationship between sun exposure or skin type and the development of cutaneous neoplasia, despite the fact that the majority of lesions were found on sun-exposed sites. Exposure to ultraviolet radiation (UVR) is probably important as an initiator or co-factor rather than as a precipitant. In both sexes, high sun exposure was associated with the presence of viral warts. In females, there was a strong association between the presence of viral warts and the occurrence of neoplastic lesions elsewhere, giving support to the hypothesis that ultraviolet radiation may be acting as a co-factor in virally-mediated oncogenesis. Epidermal cell kinetic studies in 39 patients using in-vitro exposure to 3H thymidine and autoradiographic techniques showed no difference between the patients with neoplastic lesions and unaffected patients, and is not therefore a useful method of identifying an 'at risk' group. PMID- 3313495 TI - Porous metal coating--a microretentive alternative to etched metal prostheses. PMID- 3313496 TI - Sutures vs. adhesives: two fixation methods for free gingival grafts. A six-year follow-up study. PMID- 3313497 TI - Changes to the mandibular denture-bearing area following an anterior vestibuloplasty with free skin grafting and mylohyoid ridge resection. PMID- 3313498 TI - Further study of chemically coupled resin bonded restorations. PMID- 3313499 TI - The effect of sharpening stones upon curet surface roughness. PMID- 3313500 TI - Chairside instrument sharpening. PMID- 3313501 TI - The previous refractory die technique for fabricating porcelain crowns and fixed partial dentures. PMID- 3313502 TI - Removal of "black-line" margins and improving esthetics of porcelain-fused-to metal crowns. PMID- 3313503 TI - Detection of "Chlamydia trachomatis" in genital specimens by using an enzyme immunoassay and conventional culture. PMID- 3313504 TI - [Nonspecific vaginitis and Gardnerella vaginalis: methodological and epidemiological notes on 328 cases]. AB - 328 samples of vaginal discharges in adult fertile women, aged between 16 and 48, were examined in this trial. After excluding 95 women (39 were affected by vaginal Trichomoniasis, 55 whose discharge presented yeasts and 1 affected by gonococcal infection), the authors divided the remaining 233 cases into subjects affected or not affected by nonspecific vaginitis (NSV) only using a Gram-stained smear. In the 83 patients affected by NSV, the authors isolated Gardnerella vaginalis in the 90.4% of the cases. After statistically correlating the different parameters described in literature as associated to NSV (pH, KOH-test, Clue Cells, isolation of G. vaginalis, symptoms), the authors concluded that: a) Gram-stained smear may be used as a simple microscopical test for diagnosis, in most of the cases, NSV; b) in most of the cases of NSV are implicated more organisms (essentially G. vaginalis and anaerobic organisms); c) G. vaginalis can be considered as a marker of these infections. PMID- 3313506 TI - [Lethal and mutagenic effect of the XeCl laser on Escherichia coli]. AB - The survival rate and reversions to tryptophan-independence of Escherichia coli after XeCl laser irradiation (lambda = 308 nm) within the dose range from 10(3) to 10(5) J/m2 have been studied to show that LD37 is 10(4) J/m2, the survival rate at a maximum dose of 10(5)J/m2 is 1 per cent, and the number of mutants per 10(6) cells survived is 100. PMID- 3313505 TI - [Release of myoglobin in the blood of irradiated swine showing decreased activity of various enzymes--markers of muscle tissue injury]. AB - Dynamics of changes in the level of myoglobin, hematological indices, and activity of certain enzymes (lactate dehydrogenase, hydroxybutyrate dehydrogenase, and creatine phosphokinase) was studied in blood of exposed (103.2 mC/kg) pigs. As the activity of enzymes decreased the myoglobin content of blood increased 5-7 days following irradiation. The effect of radiation was shown to promote the development of hypoxia in the animal body which was indicated by the ECG changes, the release of functionally deficient erythrocytes to blood, and the occurrence of stable vast hemorrhages. PMID- 3313507 TI - [Relation between the radioprotective effect of helium-neon laser radiation on bacterial cells and the time period between 2 types of irradiation]. AB - The effect of helium-neon laser radiation (lambda = 633 nm) given to E. coli K-12 cells of various genotypes 4 h following X- or alpha-irradiation was shown to increase the number of viable cells. The irreversible ingradient of a radiation injury to cells remained invariable during the first 60 min after irradiation its values being minimal. PMID- 3313508 TI - The changing face of computerised tomography. PMID- 3313509 TI - Quality assurance errors in radiotherapy: an overview. PMID- 3313510 TI - Dental radiography series. 8. Shortcomings of the OPG machine. PMID- 3313511 TI - Ultrasound as a preliminary investigation in tumour diagnosis. PMID- 3313512 TI - Osteomyelitis, acute and chronic. AB - In certain patient populations, osteomyelitis is a significant clinical problem. The judicious use of plain film radiographs and radionuclide bone imaging by the imaging consultant has a critical role in the early detection and diagnosis of osteomyelitis. This complementary imaging approach produces the highest and greatest accuracy in the documentation of skeletal infections. Inadvertent delay in the initiation of appropriate therapy can be obviated utilizing these imaging techniques and undue morbidity averted. PMID- 3313513 TI - Spondyloarthropathies. AB - This paper reviews the radiologic features of disorders involving the spine and sacroiliac joints. Analysis is divided into conditions involving the sacroiliac joints, disorders producing bony bridging in the spine, and disorders producing focal vertebral destruction. Conditions discussed include the seronegative spondyloarthropathies, degenerative disorders, infections, and DISH. PMID- 3313514 TI - [Sialographic and sonographic diagnosis of salivary gland diseases]. AB - The diagnostic value of sialography and ultrasonography was studied retrospectively in 130 patients with diseases of the salivary gland. In the diagnosis of tumours (sensitivity: 97.5% vs 52.5%), acute inflammatory diseases (sensitivity: 70% vs 40%) and abscesses (sensitivity: 100% vs 25%) ultrasound was more accurate than sialography. Even in the diagnosis of calculi, ultrasound gave good results (sensitivity: 71.4%) and should be performed before the more invasive sialography technique. In chronic inflammatory diseases, sialography continues to be the technique of choice. PMID- 3313515 TI - Erosion of the duodenal wall caused by the migration of a retained surgical sponge into the duodenal lumen. AB - A case of erosion of the duodenal wall is reported, which was caused by a retained surgical sponge after choleystectomy. The sponge migrated into the duodenal lumen, giving a peculiar pattern of duodenal filling defect. PMID- 3313517 TI - [Value of transrectal and transvaginal ultrasonic tomography using an electronic linear scanner in staging bladder tumors]. AB - The results of sonographic studies of 48 patients with carcinoma of the urinary bladder are discussed. The value of longitudinal intracavitary sonography for assessment of the local extent of malignant tumors of the bladder was studied. This method is thought to be extremely useful when tumors are localized on the neck, base and front wall of the bladder, whereas transabdominal sonography gives valuable diagnostic information if the lateral and back walls are involved. Combined sonography must be used for assessment of the local extent of carcinoma of the urinary bladder as it is of high accuracy, non-invasive and safe. PMID- 3313516 TI - [Sonographic findings in complications of cystic echinococcosis]. AB - Apart from the difficult differential diagnosis of hydatid liver disease, diagnostic problems may increase in chronic disease because of complications. Compression or infiltration of bile ducts is the most common complication occurring in 16%. Other complications are infiltration of adjacent organs and structures, for instance the right kidney and the diaphragm, or the (often iatrogenic) rupture of hydatid cysts with intraperitoneal spread. Preoperative sonographic diagnosis is important in influencing the surgical procedure. PMID- 3313518 TI - [Molecular mechanism of somatic DNA rearrangements in antigen receptor genes]. PMID- 3313519 TI - [Transformation-sensitive heat-shock protein]. PMID- 3313520 TI - [Origin of mitochondria and chloroplast in the eukaryotic cell]. PMID- 3313521 TI - [Protective effect of metallothionein against toxicity of anticancer drugs]. PMID- 3313522 TI - [Anti-tumor factors in cartilage]. PMID- 3313523 TI - [Effect of technological processing on the structure and mechanical properties of chromium-cobalt alloys]. PMID- 3313524 TI - Role of "local" hormones in regulation of lipolysis. AB - Lipid mobilization from adipose tissue can be activated by two distinct mechanisms, i.e. relief of inhibitory influences or reversal of a preexisting inhibition by lipolytic hormones. Adenosine and prostaglandins which are produced within adipose tissue may serve to maintain a functional state that is susceptible for stimulation and adjust non-stimulated lipolysis to the energetic demands of the organism. PMID- 3313525 TI - Prostaglandin I2 reduces activation of human arterial smooth muscle cells in vivo. AB - Patients suffering from peripheral vascular disease have been "ultima ratio" treated with PGI2 at a rate of 5 ng/kg/min for 6 hours a day and 5 consecutive days i.v. 20 of them underwent surgery thereafter as therapy was not sufficient. A histological examination and quantification of vascular tissue revealed that the number of activated smooth muscle cells was significantly lower in treated patients vascular segments than in untreated ones in all the different age groups. A comparable suppression was found in the intima and the media as well. It is thus concluded, that PGI2 inhibits smooth muscle cell proliferation most probably by inhibiting PDGF-release from the platelets and stimulation of smooth muscle cell cAMP. To achieve a more beneficial PGI2-effect at the vascular level, a prolonged PGI2-therapy looks rather promising. PMID- 3313527 TI - The role of PAF in immunological responses: a review. PMID- 3313526 TI - Effect of platelet-activating factor (PAF-acether) and its specific receptor antagonist, BN 52021, on interleukin 1 (IL1) release and synthesis by rat spleen adherent monocytes. AB - PAF-acether, at doses ranging from 1pM to 0.1 microM did not induce a significative release and/or synthesis of IL1 from monocytes. In contrast, depending upon the dose of the mediator, adverse effects on the lipopolysaccharide (LPS)-induced IL1 release and synthesis were observed. PAF acether at 1pM increased IL1 release by 120 +/- 39% and synthesis by 87 +/- 27% whereas at 0.1 microM a decrease of IL1 release of 52 +/- 9% and synthesis of 46 +/- 6% were observed. BN 52021, a specific PAF-acether receptor antagonist, reversed by more than 70% the increase of inhibition of LPS-induced IL1 release and synthesis induced by 1pM and 0.1 microM of the autacoid, respectively. No direct effect of BN 52021 on IL1 release and synthesis from adherent monocytes was noted. These results indicate that PAF-acether modulates monocytes functions, possibly via specific binding sites. PMID- 3313528 TI - Recovery of prostacyclin capacity of irradiated endothelial cells and the protective effect of vitamin C. AB - Ionizing irradiation has been reported to affect prostacyclin (PGI2) production by intact blood vessels and cultured endothelial cells (EC) due to damage of enzymes of the arachidonate cascade. In the present study, we investigated whether EC can recover from radiation injury and regain their capacity to produce PGI2. Bovine aortic EC were exposed to radiation doses of 3 and 6 Gy and their capacity to produce PGI2 in response to stimulation with arachidonic acid was tested, at various times after irradiation. The results of these experiments showed clearly that EC exposed to single or fractionated irradiation could recover their capacity to produce PGI2 depending on the radiation dose and the time period following radiation. Radiation damage is associated with oxidant stress and the production of free radicals. We therefore tested the ability of an oxygen radical scavenger, vitamin C, to protect the capacity of irradiated EC to produce PGI2. Pretreatment of EC with low concentrations of vitamin C inhibited the radiation induced release of PGI2 to the culture medium. Vitamin C also enhanced the capacity of irradiated EC to produce PGI2 following short stimulation with arachidonic acid. Treatment with this scavenger however, did not protect the cells against the cytopathic effects of radiation. PMID- 3313529 TI - [What's new in psoriasis? IV international symposium in Stanford, 6-11 July 1986]. PMID- 3313530 TI - [Results of the treatment with metronidazole administered by different schedules of trichomonas vaginitis alone and coexistent with gonorrhea, syphilis and bacterial infections]. PMID- 3313531 TI - [Heads of the Departments of Dermatology and Venereology of the Brothers of Mercy Hospital in Cracow. III. Franciszek Walter]. PMID- 3313533 TI - [Congenital pigmented nevi as precursors to malignant melanoma]. PMID- 3313534 TI - [Methods of treating alopecia areata]. PMID- 3313532 TI - [Role of epidermal cells in immunological reactions]. PMID- 3313535 TI - [Liposomes as a dermatological drug form]. PMID- 3313536 TI - [Bacillary dysentery 1985]. PMID- 3313537 TI - More than just pretty. PMID- 3313538 TI - Enhanced preservation of endosecretory granules in PP-cells of the canine pancreas. AB - Standard fixation techniques commonly used for light and electron microscopic studies have resulted in reported differences in the ultrastructural appearance of endosecretory granules of the pancreatic polypeptide (PP) cell. To clarify these differences, canine pancreatic tissues of intact and cultured pseudoislets were studied using a variety of ingredients, additives and fixatives in an effort to better preserve the endosecretory granules of PP cells. Results show that preservation of PP granules is enhanced by addition in zinc chloride (0.5%) to a glutaraldehyde-paraformaldehyde fixative in 0.1 M cacodylate buffer, followed by osmium tetroxide fixation. This fixative is recommended for all light and electron microscopic studies of the pancreatic polypeptide cell. PMID- 3313539 TI - [Correlation of traditional radiology and echography in circumscribed pleural opacities]. AB - The value of ultrasounds in the location of small pleural opacities was investigated. A correlation between conventional radiological and echographic signs was made to define the echographic signs useful in the identification of peripheral pleural and parenchymal lesions. PMID- 3313540 TI - [Ambulatory radiology in gastroesophageal reflux. Comparison of diagnostic tests]. AB - A retrospective analysis is reported of 131 symptomatic patients for gastro esophageal reflux, comparing the radiological diagnosis to endoscopic, manometric and pH-metric results. A low incidence of x-ray examination is found. The role of radiology in gastro-esophageal reflux is considered and discussed. PMID- 3313541 TI - [Echostructural polymorphism of prostatic carcinoma. Anatomo-pathologic correlations in various developmental stages]. AB - The sonographic appearance of prostatic carcinoma was correlated with the corresponding histopathologic studies in 57 patients after transperineal biopsy. In 21 cases the lesions observed were less than or equal to 2 cm (circumscribed) and in 36 were greater than 2 cm (diffuse). Within the first group there was a prevalence of hypoechoic forms (61,9%). While isoechoic and hyperechoic foci were observed in 14.3% and 23.8%. In diffuse prostatic carcinoma, mixed echogenicity was observed in 50% of patients, hypoechoic in 27.8% and isoechoic in 22.2%. The variations in the appearance of prostatic cancer indicate that sonographic texture is related to the size and histopathologic features of the neoplastic growth. PMID- 3313542 TI - [Total cutaneous irradiation with low energy electrons and mycosis fungoides. Technic and dosimetry]. AB - Mycosis fungoides initially involves the epidermis and the superficial layers of derma at a depth of about 1 cm. Wide field irradiation with low energy electrons is therefore the treatment of choice in the initial stages of the disease. In our Institute, total skin electron beam irradiation is delivered with Therac 20 linear accelerator: the lowest available energy is 6 MeV. A lucite sheet of 0.6 cm thickness is used to decrease the energy of the beam. We used film dosimetry to evaluate the homogeneity of dose distribution in an Alderson-Rando phantom with different arrangements of the fields and the lucite sheet: 4 and 6 fields techniques have been compared with different positions of the lucite filter, near the phantom and near the collimator. Six fields yield a better dose distribution: homogeneity is within +/- 3.7%, while with four fields it is within +/- 6%. X rays contamination is less than 2%. "In vivo" dosimetry has been performed using thermoluminescent dosimeters: homogeneity is within +/- 15%. PMID- 3313543 TI - [Elementary approach to signal interpretation in magnetic resonance imaging of the brain]. PMID- 3313544 TI - [Enterogenous cysts of the duodenum]. PMID- 3313546 TI - Metabolism of chlordane in mammals. PMID- 3313545 TI - [Echographic diagnosis of mycosis (fungus ball) in a kidney transplant]. PMID- 3313547 TI - The treatment of oligodontia. PMID- 3313548 TI - [William Cowper (1666-1709) and facial myology]. PMID- 3313549 TI - Purification and properties of a coagulant proteinase isolated from bushmaster (Lachesis muta) venom (Serpentes: Viperidae). AB - The venom of Lachesis muta is a rich source of a thrombin-like enzyme. Its coagulant proteinase was purified by DEAE -Sephadex A -50 followed by agmatine CH -Sepharose and gel filtration on Sephadex G-100. On polyacrylamide gel electrophoresis at pH 8.4 a single band was observed. Its molecular weight by gel filtration was 49,000. The coagulant and esterolytic activities toward human fibrinogen and Tame of the inudasa were 662 NIH units/mg of protein and 4.37 delta OD225/min x 10(-3)/micrograms/ml, respectively. These values represent 23 and 5.7 fold increase over the crude venom. The enzyme mudasa, was evaluated with serum from human patients at Hospital Nacional de Ninos Dr. Carlos Saenz Herrera and found to be a valuable reagent for the quantification of fibrinogen on heparinized plasma. PMID- 3313550 TI - [Laboratory maintenance of Trypanosoma (Herpetosoma) rangeli Tejera, 1920]. AB - Two laboratory maintenance systems of Trypanosoma rangeli were compared. The maintenance by weekly subinoculations in Tobie's culture medium and the intrafemoral inoculation of Rhodnius prolixus with cultured flagellates, resulted in loss of infectivity of the metacyclic salivarian trypomastigotes for mice, ten months after maintenance in culture. With the system of cyclical passes through culture-Rhodnius-mouse-culture-Rhodnius, the infectivity of the metacyclic trypomastigotes for mice, was maintained during the three years of the experiment. The number and percentage of metacyclic trypomastigotes formed in the salivary glands of R. prolixus, previously inoculated intrafemorally or intracoelomically with culture forms of T. rangeli, did not show correlation with the inoculated dose, however the inoculated quantity demonstrated a direct relation with the mortality rate of the insects. The results indicate that T. rangeli requires an adequate maintenance system, so that under experimental condition the biological characteristics, normally expressed under natural conditions, are conserved. PMID- 3313551 TI - Functional and structural analyses of behavior: approaches leading to reduced use of punishment procedures? AB - A common approach to dealing with the serious misbehaviors of handicapped individuals is to use punishment procedures. Although punishment techniques are often effective, many claim that their use is restrictive. Emerging approaches for dealing with inappropriate behavior are to conduct a functional or structural analysis of behavior. These approaches allow practitioners to isolate and manipulate the factors responsible for aberrant behaviors. Such analyses may reveal that a maladaptive behavior results in adult attention, is associated with demand situations, or provides reinforcing sensory feedback. In each case corrective procedures relevant to the function of the inappropriate behavior or its associated stimuli, can be applied. In some cases the analysis will reveal alternative approaches to the use of punishment procedures. In other cases it may not. Presently, there have been relatively few examples of the functional and structural analysis approaches; results thus far, however, have been encouraging. PMID- 3313552 TI - Effects of fenfluramine on the behavior of autistic individuals. AB - The present report, part of a national, multicenter study to investigate the effects of fenfluramine on autistic behavior, describes findings on four autistic children ranging in age from 7 to 20 years. Additional performance and parental observation measures apart from those of the multicenter study are included. Results of this study which indicated no significant side effects, a reduction in some deviant behaviors and an improvement in activity level/attention span, provide support for earlier reports. The possibility that fenfluramine's apparently positive effects might be to simply reduce inappropriate behaviors via lethargy was examined and not supported. PMID- 3313553 TI - Delayed prompting: a review of procedural variations and results. AB - The delayed prompt procedure transfers stimulus control via the introduction of a time delay between the presentation of a stimulus and a prompt. This procedure has received increasingly greater attention in the literature during the past decade. The present paper reviews 26 studies that used the delayed prompt procedure in applied and laboratory settings. Subjects included developmentally disabled children and adults as well as children of normal intelligence who were taught a wide variety of tasks. Procedural variations across studies were noted in delay length and ceiling, criterion for increasing the delay, mastery criterion, and error correction. Results suggest that the delayed prompt procedure is an efficient teaching stategy, with subjects typically acquiring discriminations within a few training sessions or limited number of trials. However, not all subjects have benefited from the procedure. Additionally, little maintenance data have appeared in the literature, raising questions about long term effectiveness. Alternative explanations for the reported success of the procedure as well as future areas of research are discussed. PMID- 3313554 TI - Observational studies of staff working with mentally retarded persons: a review. AB - Experimental or quasi-experimental studies of the behavior of staff working with retarded persons were reviewed and provided the following generalizations: (a) staff often have very low rates of interactions with clients, (b) a disproportionate number of interactions occur with a relatively small number of clients, (c) structured settings promote more interactions, (d) small teaching groups promote interactions, (e) staff involvement in relevant decisions promotes interactions, (f) larger, more global, and ecological assessments of both staff and clients provide important information on the effects of staff management and training, (g) lowering the reading difficulty of training materials increases staff comprehension, (h) lectures tend to improve academic skills while practicum training improves teaching skills, (i) some trained skills generalize while others do not, apparently unsystematically, (j) a system in which supervisors rather than researchers external to the facility do the training is feasible, (k) various low cost systems of public or private feedback can increase staff participation in their duties, (l) implementation of strict administrative policies can reduce tardiness and absenteeism, and (m) staff may be very reactive to announced observation by inspection agencies. PMID- 3313555 TI - [Proteus syndrome: contribution to its clinical delineation]. PMID- 3313556 TI - [Treatment of essential arterial hypertension in the elderly with low-dose captopril and hydrochlorothiazide. Long-term study]. PMID- 3313557 TI - [Renal oncocytoma: a tumor on the increase]. PMID- 3313558 TI - [Osteocalcin. Biochemistry, physiology, normal levels and in different pathologies]. PMID- 3313559 TI - [Salmonella enteritidis pneumonia in immunodeficiency probably acquired by transfusion]. PMID- 3313560 TI - [Susceptibility and/or resistance of larvae of Anopheles (N.) albimanus Wiedemann, 1821 (Diptera: Culicidae) to organophosphorus insecticides]. PMID- 3313561 TI - [Susceptibility and/or resistance of adult Anopheles albimanus Wiedemann, 1821 (Diptera: Culicidae) to insecticides used in public health and in agriculture]. PMID- 3313562 TI - [Results obtained in the laboratory on the breeding of Anopheles albimanus Wiedemann, 1821 (Diptera-Culicidae) in Cuba]. PMID- 3313563 TI - [Changes in disaccharidases in chronic diarrhea caused by giardiasis]. PMID- 3313564 TI - [Filariasis caused by Wuchereria bancrofti Cobbold, 1877 (Nematoda: Filaroidea). Report of a case in Cuba]. PMID- 3313565 TI - [Effectiveness of ND-354 reference product as a mosquito repellent]. PMID- 3313566 TI - [Current development of the Pedro Kouri Institute of Tropical Medicine]. PMID- 3313567 TI - [Influence of ecological factors on the larval density of Anopheles (N.) albimanus Wiedemann, 1821 (Diptera: Culicidae)]. PMID- 3313568 TI - [Effect of distinct photoperiods on the infestation with Romanomermis culicivorax Ross and Smith, 1976 (Rhabditida: Mermithidae) of mosquito larvae of the species Culex quinquefasciatus Say, 1823 under laboratory conditions]. PMID- 3313569 TI - [Preliminary results on the fecundity of the larvivorous fish Poecilia reticulata Peters, 1985 (Cyprinodontiformes: Poecilidae)]. PMID- 3313570 TI - [Meningoencephalitis causes by Salmonella B. Presentation of a case]. PMID- 3313571 TI - [Congenital malaria in Guinea-Bissau]. PMID- 3313572 TI - [Cerebral cysticercosis in a 3-year-old child treated with praziquantel]. PMID- 3313573 TI - [Morpho-functional aspects of the mucosa of the small intestine in children with chronic diarrhea caused by giardiasis]. PMID- 3313574 TI - [Indicators of disability-free life expectancy. Global indicators of the health status of populations]. AB - Disability free life expectancy (DFLE) is an index of mean length of healthy life. It aims at measuring the evolution in the populations state of health. The first calculations were achieved at the end of the 60s and about ten experimental calculations have been made until now, mostly in the United States, Canada, Japan and France. Nowadays this index is very well accepted. Its major qualities are its usefulness for setting health targets and determining the present and future needs. Is DFLE destined for becoming a conjonctural index of health state? The circumstances are undoubtedly propitious. Nevertheless, in order to be used in routine the DFLE index must answer three conditions, which the current approach does not fulfil i.e. the viability of disability measurement for comparisons in time; a registration of period data which is based on the incidence of entrance in disability; a calculation which is adapted to the disability whether it is reversible or not. PMID- 3313575 TI - Prevalence, incidence, prognosis and risk factors of dementia. AB - The epidemiological evidence on the dementing illnesses suggests that dementia poses an important public health problem. Estimates of the prevalence of dementia indicate that in the twelve countries of the European Community 1.5 to 2.5 million people may be suffering of the disease. The available data on the incidence suggest that in these countries 200,000 to 250,000 people are newly hospitalized yearly for dementia. Fruitful epidemiological approaches to identify preventable causes of the dementing illnesses may include incidence studies across populations, family studies, and risk factors studies using Creutzfeldt Jakob disease as a model for dementia of the Alzheimer type. PMID- 3313576 TI - [Thoracoscopic study of 6 cases of catamenial pneumothorax]. AB - Six new cases seen personally, and 72 cases of catamenial pneumothorax found in the literature have had thoracoscopic talcage. We shall discuss several peculiarities of this syndrome: its relative rarity, symptoms linked to periods, the specific and unique endopleural aspects, confirming certain pathogenetic theories, the first among which is pleural endometriosis. Therapeutic methods are also discussed, stressing the sharing of the association between pleural symphysis surgically and above all by thoracoscopy with antigonadotrophic hormone therapy an association which alone gives good results in 95% of cases. PMID- 3313577 TI - Proteolytic activities in bronchoalveolar lavage fluid of interstitial lung diseases: correlation to stage and prognosis. AB - In 18 patients with sarcoidosis, 10 patients with idiopathic pulmonary fibrosis (IPF), 6 patients with exogen allergic alveolitis (EAA), and 9 control persons we investigated proteolytic activities in bronchoalveolar lavage fluid (BALF). In lymphocyte-macrophage alveolitis (i.e. sarcoidosis and EAA) proteolytic activities in BALF were low, but the activities correlated with lung function deterioration within 1 year. In IPF (i.e. in neutrophil alveolitis) we found a striking correlation between proteolytic activities and stage of disease: high activities correlated with early stages, lower values with late stages of IPF. Measurement of proteolytic activity in BALF seems to be of interest to differential diagnosis and to prognosis of interstitial lung disease. PMID- 3313578 TI - Detection of antibodies in serum of patients with idiopathic pulmonary fibrosis against isolated rat alveolar type II cells. AB - The serum of 2 patients suffering from idiopathic pulmonary fibrosis (IPF) repeatedly demonstrated a positive antibody reaction against rat alveolar type II cells isolated by the use of a combination of elastase and trypsin for disaggregation and a Percoll density gradient for purification. Neither of the other 8 IPF patients examined nor any of the controls showed a positive reaction. Because the 2 patients with serum antibodies against alveolar type II cells did not show any antinuclear antibodies, it is concluded that the antibodies against the surface of rat alveolar type II cells found in the serum of IPF patients may be autoantibodies involved in the pathogenesis of IPF. PMID- 3313579 TI - Festschrift in honor of Geraint D. James. PMID- 3313580 TI - The Italian movement. PMID- 3313581 TI - Gerry James of the Royal Northern Hospital. PMID- 3313582 TI - Six months before the Wyvern. PMID- 3313583 TI - David Geraint James. PMID- 3313584 TI - Gerry James: the captain of the ship. PMID- 3313585 TI - David Geraint James. PMID- 3313586 TI - D. Geraint James and continuing medical education. PMID- 3313587 TI - Gerry--Oslerian extraordinaire. PMID- 3313588 TI - Gerry James and the Harveian Society of London. PMID- 3313589 TI - Medical ophthalmology and Gerry James. PMID- 3313590 TI - Three tableaux and the man. PMID- 3313591 TI - Personal tribute to Dr. D. Geraint James. PMID- 3313592 TI - Honor thy teacher: D. Geraint James. PMID- 3313593 TI - An appreciation of a great man. PMID- 3313594 TI - D. Geraint James. An appreciation. PMID- 3313595 TI - Angioendotheliomatosis proliferans systemisata: an angiotropic neoplasm of lymphoid origin. AB - Angioendotheliomatosis proliferans systemisata (APS) is a rare disease entity characterized by intravascular proliferation of undifferentiated tumor cells and associated with complex vascular infolding, proliferation, and tortuosity. Most of the symptomatology results from the microinfarcts caused by clogging of the vessels. The most commonly affected sites are skin and central nervous system. In contrast to the earlier belief, there are distinct histopathologic differences between the so-called benign and malignant type, so that benign form should actually be excluded from the entity of APS. The majority of reported cases now appear to be of lymphoid cell origin, while few cases of other cancers have been reported to present as APS. The original concept of an endothelial origin of APS is in doubt, though a few cases of APS might prove to be endothelial in origin. PMID- 3313596 TI - Angiosarcomas of the skin. AB - Angiosarcomas of the skin develop almost exclusively in the following clinical settings: (1) the lymphedematous extremity, secondary to prior mastectomy in most instances; (2) the face and scalp, usually in elderly individuals; and (3) skin that has been previously radiated. Microscopically, there is a spectrum of architectural patterns. The best differentiated tumors exhibit obvious vascular spaces, which are lined by variably atypical endothelial cells, and that characteristically dissect between fibers of the reticular dermis. With proliferation of the atypical endothelial calls, vasoformative features are less evident, and there is often a syncytium of cellular bands composed of fusiform or spindled cells or, less commonly, cords, nests, and nodules of distinctly epithelioid cells. Overgrowth of the cellular elements can create seemingly patternless sheets of tumor. The foregoing architectural spectrum may be displayed in its entirety within a single biopsy specimen, and a multifocal distribution within the dermis is characteristic. Cytologic pleomorphism and mitotic figures are often obvious, but both criteria of malignancy may be essentially absent in the best differentiated fields. Ultrastructural observations consistently show differentiation toward endothelial cells and, in many cases, findings consistent with differentiation toward blood vessels. Both factor VIII-related antigen and Ulex europaeus lectin are reliable immunohistochemical markers. The outlook for patients with cutaneous angiosarcoma is poor, with a median survival of 20 months and a 5-year survival of 15%. PMID- 3313597 TI - Regressing atypical histiocytosis: a review and critical appraisal. AB - Regressing atypical histiocytosis (RAH) has been defined as a primary cutaneous neoplasm composed of atypical histiocytes. In this study, ten cases of RAH were available for review including the two first reported cases. In addition, one new case was studied immunocytologically, for immunoglobulin and T cell receptor gene rearrangement, and for DNA ploidy analysis. Histologic study of ten cases permitted recognition of microscopic features both common and uncommon to RAH. Clinical follow-up of eight cases suggests an indolent course but with probable substantial long-term risk for development of systemic lymphoma. The histiocytic origin of RAH must now be considered questionable because the results of immunologic phenotyping and the discovery of rearrangement of T cell receptor beta- and gamma-chain genes found in the newly studied case indicate that this primary cutaneous neoplasm, previously considered histiocytic, is most probably of T cell lineage. PMID- 3313598 TI - Salivary gland adenocarcinomas: a clinicopathologic analysis of three distinctive types. AB - Myoepithelial cells play an important role in the histogenesis of adenocarcinomas arising from the salivary duct unit nearest the acini. Prototype adenocarcinomas arising from the intercalated duct are the terminal duct carcinoma and the epimyoepithelial carcinoma, both typically low-grade malignancies. Those salivary adenocarcinomas arising from the larger nonintercalated excretory ducts do not manifest myoepithelial cells in their composition. A prime example is the salivary duct carcinoma, which is a high-grade malignancy. These adenocarcinomas have distinctive clinical and pathologic features and they should be recognized by the examining pathologist. Because of the potential clinical confusion between terminal duct carcinoma and salivary duct carcinoma when rendered as a diagnosis, each should be further qualified, eg, by adding high or low grade. PMID- 3313599 TI - Peripheral nerve sheath tumors of the head and neck. AB - The head and neck region is a common location for benign peripheral nerve sheath tumors (PNST) and a rare site for malignant PNST. The diagnostic distinction between schwannoma (neurilemmoma) and benign neurofibroma remains clinically and prognostically important. Most benign PNST are schwannomas, and these do not have a recognized malignant potential. Malignant PNST arise de novo or from benign neurofibromas. The definitive diagnosis of malignant PNST may be difficult or impossible using only routine light microscopy. Electron microscopy and immunohistochemistry are special techniques that may be helpful. The prognosis in patients with malignant PNST depends heavily on the extent of surgical excision, size of the primary tumor, and presence or absence of von Recklinghausen's neurofibromatosis. PMID- 3313600 TI - The role of immunoglobulins in allergic disease: IgE and IgG4 immunofluorescent study of adenoid tissue. AB - Upper airway allergy is a common problem in children. The most frequent tissue removed from children is adenoid tissue. Although conventional stains offer little help in characterization of the allergic response in this tissue, immunohistologic assessment does offer the opportunity to reveal immunoreactants present. Adenoid tissue from 91 allergic and nonallergic children was examined by a dual immunofluorescent method to detect mast cell membrane bound IgE and IgG4. Positive mast cell membrane staining was seen with IgE (FIEMC) but not with IgG4 in adenoid tissue from allergic children. Numerous IgG4 plasma cells were often seen in close relationship to FIEMC in adenoid stroma where blocking function of IgG4 may take place. False-positive FIEMC patients may represent transient or infrequent encounters with allergens. Disparate clinical allergy and tissue FIEMC status may also reflect different genetic control of IgE regulation and antigen (allergen) recognition. PMID- 3313601 TI - Sarcomatoid carcinoma of the upper aerodigestive tract. AB - Sarcomatoid carcinomas are typically (but not always) biphasic tumors containing both carcinomatous and sarcomatous components. Within the upper aerodigestive tract, they arise from the mucosa and are predominantly composed of pleomorphic spindled cells associated with squamous carcinoma, the latter often presenting focally at the tumor base. Although their histogenesis is still debated, most authors favor metaplastic origin of the sarcomatous cells from carcinoma cells. Indeed, when studied with electron microscopy and/or immunohistochemistry the sarcomatous cells are frequently found to retain epithelial features; however, the sarcomatous metaplasia can be so complete that malignant cartilage, bone, and/or muscle cells are formed. In addition, metastatic deposits may contain sarcomatous and/or carcinomatous components. Sarcomatoid carcinomas are potentially aggressive tumors and should be treated accordingly. Although it is difficult to predict biologic behavior in every case, patients whose tumors are deeply invasive tend to have a poor prognosis, whereas those with superficially invasive tumors usually have an excellent prognosis. PMID- 3313602 TI - Frozen section diagnosis and the thyroid. AB - The diagnostic problems arising from frozen section evaluation of thyroid lesions are complex and beclouded in controversy. Prime examples include follicular and Hurthle cell neoplasms, both of which lack standardization in classification and management. The seemingly straightforward identification of papillary carcinoma is often complicated by the frequent absence of its distinguishing features, some of which are reportedly restricted to formalin-fixed paraffin embedded material. Thyroiditides and thyroidal ectopias present unique and separate differential diagnostic considerations that at the time of frozen section may pose problems for surgeon and pathologist alike. These issues and their controversial aspects are addressed, and potential diagnostic pitfalls related to frozen section diagnosis of thyroid lesions in general are outlined. An analysis of 300 thyroid frozen sections over a 5-year period and the histologic frozen section features of 40 papillary thyroid carcinomas are also presented. The presence of optically clear nuclei was identified in frozen sections from 15 cases, and was extensive in one. Thirty-eight of 40 cases displayed optically clear nuclei within permanent sections. It is suggested that this cytologic feature is not the exclusive domain of permanent section, and when present in the frozen section may be helpful in identifying papillary carcinoma, especially when an obvious papillary component is lacking. PMID- 3313603 TI - Midfacial necrotizing lesions. AB - Because of obvious therapeutic and prognostic implications, as definitive a pathologic diagnosis as possible is necessary for necrotizing lesions of the midfacial mucous membranes. In the beginning of the diagnostic process, the lesions are placed under the noncommittal rubric of midfacial necrotizing lesions, thus forever avoiding confusing nomenclature such as lethal midline granuloma. Following this, the lesions are approached with the full appreciation they may be (1) localized or part of a systemic illness; (2) neoplastic or non neoplastic; (3) caused by a specific agent or organism or be seemingly idiopathic; (4) self-limited or progressively destructive in varying degrees of severity; (5) characterized by a granulomatous or nonspecific tissue reaction with or without vasculitis; and (6) impossible to classify without clinicopathologic correlation. To illustrate these points, a number of necrotizing lesions, including sarcoidosis, Wegener's granulomatosis, and the lymphomatoid granulomatosis-polymorphic reticulosis group are presented. PMID- 3313604 TI - Oncogenes and surgical pathology. AB - The discovery of oncogenes began with identification of genetic material in viruses capable of causing neoplasia in animals. Through processes of "transduction" and "insertional mutagenesis," RNA/retroviruses may (1) alter directly, (2) alter expression of, or (3) move pieces of host cellular genome in ways that they become potential agents of neoplastic transformation. The pieces of host cellular genome, either affected in situ by viral gene insertion or transduced by the virus, are known as oncogenes. Approximately 20 oncogenes have been identified. Although they have yet to be proven to be sufficient or necessary for neoplastic transformation, the evidence for their playing a part in the transformation process is mounting. The functions of the protein products of the various oncogenes are closely related to those of proteins involved in normal cell regulatory and cycle activities. Study of the oncogene products and their functions serves to elucidate the basic character of neoplasia. The functional classes of oncogenes with specific examples of genomic amplification, altered mRNA or protein product expression, or mutational deletion associated with human neoplasia are reviewed herein. Since the techniques for detecting oncogene DNA and mRNA alterations are rapidly becoming a part of our diagnostic armamentarium, surgical pathologists should be prepared for the imminent use of such molecular techniques and information in diagnosis and prognosis of human neoplasia. PMID- 3313605 TI - Tumors of the dental lamina: a selective review. AB - The dental lamina is a thickening of the primitive oral epithelium that begins to develop in the sixth week of embryonic life. Three uncommon tumors derived from the dental lamina include ameloblastic carcinoma, maxillary ameloblastoma, and squamous odontogenic tumor. Such tumors must be differentiated from the more common tumors of oral, oropharyngeal, and paranasal squamous mucosal neoplasms as well as salivary gland neoplasms using clinical, radiographic, and histopathologic evidence. PMID- 3313606 TI - Osteosarcoma chemotherapy effect: a prognostic factor. AB - Chemotherapy has become a routine part of the treatment of osteosarcoma. However, the precise role of preoperative chemotherapy remains in question. Between 1979 and 1982, a group of 40 patients were treated by multimodality therapy consisting of preoperative chemotherapy (intra-arterial cis-platinum and systemic adriamycin), surgery, and postoperative chemotherapy. Survival in this group is 64%, while continuous disease-free survival is 58%. Although age, sex, tumor size, site, and classification were found to be prognostic factors, histologic evidence of response to preoperative chemotherapy, measured as percent tumor necrosis, was found to be the most significant prognostic factor. When continuous disease-free survival was calculated as a function of tumor necrosis it was 91% in patients with greater than or equal to 90% tumor necrosis, while it was 14% in patients with less than 90% tumor necrosis. At initial presentation, 7% of patients were judged limb-salvage candidates. But due to the local effects of preoperative chemotherapy, 60% ultimately underwent limb-salvage surgery. Preoperative arteriograms were a reliable means of monitoring response to chemotherapy and served as an indicator of residual viable tumor. Using arteriogram directed planes of section, postchemotherapy, specimens were "mapped" and analyzed for chemotherapy effect. When present, residual viable tumor was preferentially found at the interface of tumor and normal anatomic structures; "sanctuary sites." It is necessary that standard methods for analyzing postchemotherapy specimens be developed; a technique is described. PMID- 3313607 TI - Oligodendroglioma: diagnosis and prognosis. AB - Oligodendrogliomas represent only 4% to 7% of intracranial gliomas, but accurate diagnosis of this neoplasm is important. They occur almost exclusively in the cerebral hemispheres and are most common in adults in middle life. Although classically associated with calcifications, these may be present in only 50% of cases. Special diagnostic techniques, including touch imprint preparations, electron microscopy, and immunohistochemistry can be useful in diagnosis. Grading systems correlating with prognosis have not been well established, but two recent careful clinical and pathologic studies have provided concrete and apparently valid criteria for grading. There is some evidence that radical surgical excision improves survival. Most patients receive postoperative radiation therapy. Prospective controlled therapeutic trials are lacking, however. PMID- 3313608 TI - Rapid throat-culture as diagnostic aid: ineffective in decreasing antibiotic prescriptions. AB - An overnight slide-culture for the detection of group A streptococci was introduced in a Finnish health centre. The number of patients from whom a throat culture was obtained increased from 55% to 70% with the new method. Despite this increase, the prescribing habits of primary care physicians did not change. Treatment was in most cases (84-90% of those treated) still initiated before culture results were available, and antibacterial medication was discontinued only occasionally (1-3%). Physicians usually decided the treatment during the first consultation. These findings contradict earlier studies where prescriptions decreased during rapid culture. Use of throat cultures as diagnostic aid should be reconsidered, especially when more rapid methods now are available. PMID- 3313610 TI - Urinary tract infection in primary health care in northern Sweden. II. Clinical presentation. AB - In a multipractice prevalence study of uncomplicated urinary tract infection (UTI) in primary health care (PHC), with 355 episodes in 302 individuals during one month, 93% of the episodes occurred in females and Escherichia coli was the dominating causative organism (77%). Most episodes of UTI (84%) were acute and associated with lower (75%), upper (5%) or uncharacteristic symptoms (4%) whereas 16% represented bacteriuria discovered by posttreatment controls. Urgency (77%) and dysuria (70%) were the most common symptoms. Loin pain was highly associated with upper UTI (88%) but was reported also in 23% of episodes of lower UTI. Patient's delay differed between PHC centres and patient categories and was surprisingly long, four weeks in nine per cent and on average 8.4 days. PMID- 3313609 TI - How reliable and useful is the latex agglutination test in diagnosing streptococcal throat infection in general practice? AB - A rapid latex agglutination test for diagnosing streptococcal pharyngitis in general practice was evaluated on 226 patients with acute throat infection. The test had a sensitivity of 96% and a specificity of 91% regarding group A beta hemolytic streptococci. The test was fairly simple to perform and the result was available before the patient left the office. The test was supplied as a self contained kit, was safe to handle and economically acceptable. Even through this test is not a reliable as the traditional microbiological culture, it represents a significant practical and clinical improvement in the daily management of patients with acute throat infections. PMID- 3313611 TI - Use of reference specimens for throat swab cultures on Streptocult. AB - Seventy-five general practitioners (GPs) who regularly used Streptocult for culture of throat swabs participated in a study aimed at evaluating the need for and the possible educational effect of examining reference specimens. Their pre study and post-study accuracy in the interpretation of cultures of simulated throat specimens were analyzed. One group of 38 GPs received instructions as well as supplementary reference specimens during the study, while no instructions were given to the remaining 37 GPs. There was no discernible difference in the post study accuracy of the two groups. Before the study, 80% of the GPs had felt to be in need of reference specimens; after the study, 61% did so. A majority suggested that three reference specimens should be distributed once or twice a year. Eighty six per cent had never checked the temperature in their incubator. After doing so, only 54% measured a temperature within the recommended range of 35-37 degrees C. PMID- 3313612 TI - [Special issue honoring Prof. Maurice Verbanck]. PMID- 3313613 TI - [Contribution of bone histomorphometry to the diagnosis of skeletal diseases]. PMID- 3313614 TI - [Cortisone-induced osteoporosis]. PMID- 3313615 TI - [Study of the role of laminin in tumor invasion]. PMID- 3313618 TI - Cardiorespiratory responses to endurance training in children. AB - With increasing involvement of young children in competitive sports there have been many studies on the cardiorespiratory response of children to endurance training. There were many methodological and design restrictions which limited the depth of studies in this area and made comparisons across studies difficult. Sufficient experimental progress has been made to draw the following conclusions. Trained children exhibit higher VO2max values than do untrained children. These differences are present irrespective of the ages of the children but are more pronounced in many cases in older children. Exercise programmes which are of sufficient intensity, frequency and duration lead to improvements in cardiorespiratory capacity. The minimum and optimum levels for intensity, frequency and duration have not yet been identified. The majority of the current literature assumes that children respond to endurance training in a manner similar to that of adults. This point needs further verification. The age or maturity level during which exercise training exerts its greatest effect on the cardiorespiratory system has not been clearly identified. PMID- 3313616 TI - The effect of exercise on lipid metabolism in men and women. AB - Lipoprotein abnormalities constitute a major risk for development of cardiovascular disease. These substances, which are comprised of various lipids and proteins (apoproteins), are influenced by specific enzymes which effect their concentrations. It has been demonstrated that elevated total cholesterol and LDL cholesterol are directly associated with the development of coronary artery disease, whereas HDL cholesterol has an inverse relationship with coronary heart disease (CHD). Although more controversial, triglycerides may also be directly associated with coronary atherosclerosis. Favourable changes in lipid levels have been shown to reduce coronary mortality. Exercise may constitute a non pharmacological approach to lipoprotein therapy. Many exogenous factors also influence lipoprotein concentrations. Changes in diet, body composition, age, as well as medication and alcohol usage may directly alter lipid levels. In addition, they can be artificially affected by the analytical method. The immediate effects of one to several bouts of physical activity appear to influence lipoprotein level. A reduction in triglycerides has been shown after physical exertion, especially among trained individuals and those with hypertriglyceridaemia. These acute changes may reflect the utilisation of both muscle and plasma triglycerides as fuels during exertion. After more prolonged training, changes in lipoproteins may also occur. However, since exercise is accompanied by many co-variables which also favourably alter these levels (e.g. lower percentage of body fat, dietary alterations), it is difficult to determine the direct effect of regular physical activity. Initial studies of exercise training's effects on total cholesterol did not differentiate changes in HDL and LDL cholesterol. Subsequent research has observed these specific cholesterol fractions. Consistent reduction in LDL cholesterol levels have not been convincingly demonstrated. Although HDL cholesterol has been shown to increase in certain studies, the response has been variable in other investigations. These latter responses may have been due to the fact that HDL cholesterol changes may be dependent on levels prior to conditioning. Assessment of HDL cholesterol subfractions (HDL2 and HDL3), which could additionally impact on cardiovascular risk reduction, have shown favourable increases in HDL2, but as yet these HDL moieties have not been adequately investigated. Reductions in triglyceride levels after training among those with elevated values and beneficial apoprotein changes post-training have been reported, although few studies exist.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3313619 TI - Management and rehabilitation of ligamentous injuries to the ankle. AB - The management of ligamentous injuries to the ankle is controversial. Neither the methods for classification and diagnosis, or the procedures for treatment are clear cut. Ankle sprains are a common occurrence, with the majority involving the lateral ligament complex. Within this complex, the anterior talofibular ligament is injured most frequently, usually while the foot is in the plantar flexed position. Ankle injuries can be diagnosed through physical exam, including the anterior drawer test and/or a stress exam, or through roentgenographic evaluation. The purpose of the stress roentgenogram is to measure the degree of talar tilt. However, it does not always yield consistent, reliable results. This inconsistency has led to the use of arthrography. There is debate over its use as well, however, Ankle sprains can be classified into three groups, according to functional loss. Treatment for first and second degree sprains is usually non operative. The best approach to Grade III sprains is debatable. The issues in the treatment of Grade III sprains are first, whether treatment should be operative or non-operative, and second, whether non-operative treatment should emphasise immobilisation or mobilisation. Brostrom's work is cited as noteworthy. He recommended adhesive strapping followed by mobilisation as the treatment of choice, and reserves surgery for cases of chronic instability. Results demonstrated that strapping yielded shorter disability periods, while surgery produced less instability. The prevention of functional instability is a major concern in the treatment of ankle injuries. There is no consensus for treating a lateral ligament rupture. The authors suggest immobilisation followed by a rehabilitative programme. Three methods of immobilisation are plaster casting, adhesive strapping, and the air-stirrup. The physiological mechanism of cryotherapy and thermotherapy are discussed briefly and recommendations for their use are provided. Aspiration is also discussed. Loss of motion is designated as a primary cause of chronic pain and reinjury, and exercises intended to restore range of motion are provided. Exercises aimed at restoring strength and proprioception are also presented. This allows for return to activity and serves to prevent reinjury. PMID- 3313621 TI - [Bone marrow transplantation 1987]. PMID- 3313617 TI - The effects of consuming carbohydrate-electrolyte beverages on gastric emptying and fluid absorption during and following exercise. AB - A variety of beverages formulated to provide fluid, carbohydrates, and electrolytes during and following exercise are commercially available. Such 'sport drinks' commonly contain 4 to 8% carbohydrate (as glucose, fructose, sucrose or maltodextrins) and small amounts of electrolytes (most often sodium, potassium, and chloride). The efficacy of consuming such beverages has been questioned primarily because of concern that beverage carbohydrate content may inhibit gastric emptying rate and fluid absorption during exercise, thereby jeopardizing physiological homeostasis and impairing exercise performance. Gastric motor activity, and consequently gastric emptying rate, is governed by neural and humoral feedback provided by receptors found in the gastric musculature and proximal small intestine. Gastric emptying rate may be influenced by a variety of factors including, but not limited to, the caloric content, volume, osmolality, temperature, and pH of the ingested fluid, diurnal and interindividual variation, metabolic state (rest/exercise), and the ambient temperature. The caloric content of the ingested fluid appears to be the most important variable governing gastric emptying rate, providing a mean caloric efflux from the stomach of 2.0 to 2.5 kcal/min for ingested fluid volumes less than 400 ml. At rest, gastric emptying is inhibited by solutions containing calories in a manner independent of the nutrient source (i.e. carbohydrate, fat or protein). Consequently, plain water is known to empty from the stomachs of resting subjects at rates faster than solutions containing calories. Gastric emptying is increasingly inhibited as the caloric content of the ingested fluid increases. During moderate exercise (less than 75% VO2max), gastric emptying occurs at a rate similar to that during rest; more intense exercise appears to inhibit gastric emptying. When fluids are consumed at regular intervals throughout prolonged exercise (greater than 2 hours), postexercise aspiration of stomach contents reveals that solutions containing up to 10% carbohydrate empty at rates similar to plain water. There is ample physiological justification for the addition of glucose, fructose, sodium, potassium and chloride to fluid replacement beverages. Fluid absorption in the small intestine is stimulated by glucose and sodium (and to a lesser extent by fructose and other electrolytes). Glucose and sodium are absorbed via a common membrane carrier in the mucosal epithelium of the proximal small intestine. The potentiation of sodium uptake by glucose establishes an osmotic gradient for fluid absorption.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3313620 TI - [Organ transplantation 1986 as exemplified by Zurich]. PMID- 3313622 TI - [Bone marrow transplantation in leukemia in Switzerland. A retrospective analysis by the Working Group on Bone Marrow Transplantation SAKK/Swisstransplant]. PMID- 3313623 TI - [Current status of adjuvant chemo- and hormone therapy in resectable breast carcinoma]. PMID- 3313624 TI - [A case from practice (93). Patient: Mrs. C. L., born 1933, a Swiss female living in Tunisia]. PMID- 3313626 TI - [Light-weight bridge. An overview of the treatment plan and construction]. PMID- 3313625 TI - [Primary pulmonary lymphoma. Radiologic manifestations of well-differentiated lymphocytic lymphoma]. AB - Two cases of primary lymphoma of lung, a rare pulmonary neoplasm, are presented. The radiologic findings are described. One patient showed an interstitial pattern on chest film. In our knowledge, this finding has not been previously reported. PMID- 3313627 TI - [Individual teeth replaced by implants]. PMID- 3313628 TI - [Alginate crown and bridge prosthetics]. PMID- 3313629 TI - [Can the design of a removable partial denture go wrong?]. PMID- 3313630 TI - [Recent advances and perspectives in child neurology]. PMID- 3313631 TI - [Physical working capacity in juvenile rheumatoid arthritis]. PMID- 3313633 TI - [Early diagnosis of gouty nephropathy]. PMID- 3313632 TI - [Determination of Klebsiella pneumoniae antigens in the serum of patients with Bechterew's disease]. PMID- 3313634 TI - [Clinical and enzymatic parallels in rheumatoid arthritis]. PMID- 3313635 TI - [Hyperuricemia in patients with psoriatic arthritis]. PMID- 3313636 TI - [Arthroscopy of the knee joint]. PMID- 3313637 TI - [Nutrition in rheumatic diseases]. PMID- 3313639 TI - [Age-related degeneration of articular cartilage and arthrosis]. PMID- 3313638 TI - [Antibodies to Ro(SSA) and La(SSB) antigens in Sjogren's disease and syndrome]. PMID- 3313640 TI - [Current pathogenetic therapy of systemic scleroderma]. PMID- 3313641 TI - [Contractile function of the myocardium and regional hemodynamics in systemic scleroderma]. PMID- 3313642 TI - [A case of familial systemic lupus erythematosus in distant relatives]. PMID- 3313643 TI - [A rare combination of rheumatoid arthritis and pigmented villonodular synovitis]. PMID- 3313644 TI - [Methodologic problems of teaching the clinical pharmacology of anti-inflammatory and immunosuppressive agents]. PMID- 3313646 TI - [Working classification and nomenclature of rheumatic diseases]. PMID- 3313645 TI - [Working classification and nomenclature of rheumatic diseases]. PMID- 3313647 TI - [Classification and nomenclature of rheumatic diseases]. PMID- 3313648 TI - [Effect of solcoseryl on the acid- and mucus-forming function of the stomach in Sjogren's disease]. PMID- 3313649 TI - [Veno-occlusive disease of the lung]. AB - This paper is a review of current data on a rare pathology which causes primary pulmonary arterial hypertension: pulmonary veno-occlusive disease. The manifestations of the disease consist of dyspnoea of progressive onset, crepitations in the lower pulmonary lobes and diffuse interstitial syndrome with Kerley's B lines. These signs are associated with severe hypoxia and severe pulmonary arterial hypertension with paradoxically normal wedge pressure. Pathological specimens must be obtained to confirm the diagnosis. They show thrombosis of pulmonary veins less than 2 mm in diameter and sometimes of arterioles, presence of connective tissue with few cells and images of recanalization, muscularization of pulmonary arterioles, lesions of interstitial nodular fibrosis and presence of haemosiderin-rich macrophages. The disease is frequently associated with other pathologies, including heart disease, blood disease and pulmonary capillary haemangiomatosis. In recent years, veno-occlusive disease has been found to occur immediately after chemotherapy for cancer and bone marrow or kidney transplantation. Three physiopathological hypotheses have been put forward to explain the disease: infection, autoimmune reaction and toxic reaction. PMID- 3313650 TI - [Value of ultrasonics in acute pelvic infections]. AB - Sonograms performed in 228 women admitted for acute pelvic infection has enabled to find a normal image in 39.9% of the cases. In order of frequency, the abnormalities include: endometrial alterations (31.1%), one (or several) pelvic masses (25.9%) and a collection in the Douglas cul-de-sac (22.8%). The main advantage of the examination in the acute phase is the diagnosis and the study of the mass structure: most of the time, it concerns a "mixed" or heterogeneous aspect, for all of the images of a mass, as well as for images corresponding to a tubo-adnexal collection. The major critic of this examination is the lack of specificity of the images which are very diversified. The risk of confusion with another pathology (gynecological or, exceptionally gastro-intestinal) must be decreased with an examination of good quality and comparison with the clinical context. The presumption of a tubo-adnexal collection cannot, in most cases, be established with certainty. However, the Echography guides the diagnosis by showing an anechogenous image or a particular aspect (Douglas abscess, huge septated images of sequelae) and remains more reliable than clinic to detect the mass (44% of false negative, clinically) and follow the evolution of the disease. The therapeutic advantage is also mentioned, but the tap of an abscess under sonogram guidance is seldom performed. PMID- 3313651 TI - [Deep venous thromboses in obstetrics. Apropos of 19 cases]. AB - Between January 1974 and December 1984, 4 cases of deep venous thrombosis (DVT) during pregnancy and 15 cases in the post-partum period, have been reported. Their frequency reaches 1.5% of the deliveries. The most important encouraging circumstances are a past history of DVT and Caesarean section. The treatment is difficult. In light of the 18 cases reviewed, the surgical treatment gives the best results. PMID- 3313652 TI - [Monitoring of the diabetic pregnancy. Apropos of 34 insulin-treated cases]. AB - This study concerns a series of 34 pregnant diabetic patients, insulin-dependent or requiring insulin, which were followed between January 1st 1980 and May 31st 1986. The blood level of glycolated hemoglobin (HbA1C) decreased constantly, demonstrating the improvement of the balance of the blood sugar, but its level, at the end of the pregnancy, could not be correlated with the presence of a macrosomia (27%) and/or of a neonatal hypoglycemia (24%). On the contrary, the infraclinical hypertrophy of the ventricular septum (HVS) diagnosed systematically by sonogram, and discovered in 6 newborns (nb) could represent a good marker of the harmful role of maternal hyperglycemia, even if moderate. Arterial hypertension, found in 8 cases, has a prognostic value as it is responsible for acute fetal distress (AFD), 2 cases, and for delivery by caesarean section (8 cases). A multidiscipline approach seems to improve the prognosis of pregnancy in diabetic patients, which nevertheless, should still be considered as a high-risk pregnancy. PMID- 3313653 TI - [Thanatophoric nanism: a case of early ultrasonic diagnosis]. AB - The diagnosis of a thanatophorous nanism is evoked in the presence of an abnormality of the size of the long bones. This study records the symptoms which, on sonograms, permit to recognize this fatal form of nanism among other forms of metaphysis chondrodysplasia, in order to establish a diagnosis before deciding to interrupt the pregnancy. PMID- 3313654 TI - [Epidemics of plague in Galatz in the 17th and 18th centuries]. PMID- 3313655 TI - [Standardized diagnostic methods in respiratory tract infections of bacterial origin. Material presented within the framework of the workshop organized under the auspices of WHO in Bucarest, 13-20 December 1985]. PMID- 3313656 TI - Dentin adhesive bonding. PMID- 3313657 TI - Rigid osseous fixation--osteointegrated dental implants as abutments for oral rehabilitation--Part I. PMID- 3313658 TI - Optec HSP: an integrated system for all-ceramic restorations. PMID- 3313659 TI - The Annual Address before the Rhode Island Medical Society, June 13, 1912. PMID- 3313660 TI - Interference of cartilage surface with interaction of granulocyte elastase with alpha 1-proteinase inhibitor. An in vitro model of enzyme inhibition in the joint space. AB - Synovial fluids of patients suffering from rheumatoid arthritis contain elevated levels of granulocyte (PMN) elastase in complex with alpha 1-proteinase inhibitor (alpha 1-PI), whereas free-elastase activity is usually not detectable. This absence of free enzymatic activity in joint effusions has cast some doubt on the pathophysiological relevance of PMN elastase in inflammatory joint destruction. Our in vitro experiments using bovine nasal cartilage demonstrate that incubation with elastase and alpha 1-PI in equimolar concentrations to or even in excess of the serum proteinase inhibitor resulted in significant tissue destruction as assessed by histological staining for proteoglycans, release of uronic acid from the matrix and loss of mechanical stability. Though in the supernatants containing alpha 1-PI, free-elastase activity was not detectable, immunofluorescent staining for elastase evidenced penetration of the enzyme into the matrix. Simultaneous measurements of the incubation media employing a sandwich enzyme-linked immunoadsorption assay (ELISA) revealed PMN elastase in complex with alpha 1-PI but without correlation to the parameters of tissue degradation. In comparison with the results obtained using the chromogenic substrate Suc-Ala-Ala-Ala-pNA (SAPA) for titration of alpha 1-PI against elastase, the employment of cartilage matrix showed that a fourfold increase in inhibitor concentration was necessary to achieve 100% enzyme inhibition. Hence, cartilage surface obviously interferes with the interaction between alpha 1-PI and elastase. Measurements of elastase-inhibitor concentrations or free enzymatic activity in synovial fluid seem to have limited value in predicting cartilage destruction. PMID- 3313662 TI - What's happened to catabolin? AB - Unlike other areas of research into arthritis, it is pleasing to record independent work leading to convergence of ideas instead of divergence and increasing complexity. Catabolin is now identified with interleukin-1, although there is case for the retention of the original name to describe its chondrocyte stimulating function with subsequent matrix degradation. In 10 years, catabolin/interleukin-1 research has yielded much information about cellular interactions within the arthritic joint and has provided a probe with which the intricacies of matrix metabolism are being unravelled. In future, there are prospects of characterizing the naturally occurring inhibitors and developing new compounds which influence the actions of catabolin/IL-1 to the benefit of the patient with arthritis. PMID- 3313663 TI - Structural requirements of DNA used in the Farr assay to detect antibodies directed against double-stranded DNA. AB - The measurement of antibodies to DNA in SLE requires the use of double-stranded DNA (dsDNA), demonstrably free of single-stranded regions. Such dsDNA preparations can, however, contain other structural components. In this study DNA preparations with defined structure, both secondary (single- and double-stranded and random base-paired) and tertiary (superhelical and open circular), were used in the Farr assay to measure the DNA binding of sera from patients with SLE and related connective-tissue diseases. The presence of true single-stranded DNA regions in denatured DNA, native DNA, and dsDNA containing single-stranded regions increased the DNA binding measured in all sera. DsDNA, whether intact or containing small regions of random base-pairing, was bound by sera from the majority of patients with SLE but not by non-SLE sera. Superhelical dsDNA from bacteriophage PM2 was bound by SLE sera to a greater extent than linear dsDNA was. Inhibition experiments suggested that this difference in binding to DNA according to tertiary, as opposed to secondary, structure is because there are fewer available binding sites on superhelical dsDNA. DNA binding, as measured by the Farr assay, can thus be influenced by both secondary and tertiary DNA structure. Using superhelical DNA, advantage can be taken of the dsDNA form plus tertiary structure to enhance DNA binding of SLE sera beyond the levels achieved using linear dsDNA. PMID- 3313661 TI - Dendritic cells in the pathogenesis of rheumatoid arthritis. AB - The cause of rheumatoid arthritis is unknown. It appears that abnormal or overstimulated cell-mediated immune mechanisms are operating. Dendritic cells, with their potent antigen presenting and immunostimulatory properties, have been found in increased numbers of rheumatoid synovial fluids and membranes. It is postulated that these cells play a key role in inducing and perpetuating the immune response with subsequent synovial proliferation and joint destruction. PMID- 3313665 TI - Nutrition and the unborn baby. AB - Nutrition and consequently the development of the unborn baby is profoundly influenced by the maternal nutritional state from conception to birth. This paper reviews the nutritional aspects of pregnancy in the light of current knowledge, with special reference to the effects of various nutrients and vitamins. Perinatal mortality in relation to maternal diet and the teratogenic effects induced by the abuse of antiepileptic drugs and other agents are also discussed. PMID- 3313664 TI - T cell-derived B cell growth and differentiation factors. AB - In the last few years it has been demonstrated that clonal expansion of B lymphocytes and their differentiation into antibody-producing cells are regulated by a complex series of soluble products released by T cells. The application of cloning and recombinant DNA techniques has made it possible to obtain most of these molecules in a purified form and, therefore, to study in more detail their functional properties. To date, three distinct T cell-derived B cell growth factors (BCGFs) and/or B cell differentiation factors (BCDFs), i.e., IL-2, IL-4 and IL-5, have been reported for mouse B cells. Likewise, at least five distinct molecules showing BCGF and/or BCDF activity (IL-2, IFN-gamma, IL-4, the 12 kD BCGF and BSF-2) for human B cells have been identified. Human T cell-derived lymphokines active on B cells are functionally similar but not identical to murine lymphokines. Most T cell-derived lymphokines can exert their activity on the same B cells in different stages of activation and evoke different responses. In addition, some of them are not specific for B cells, but act as competence factors or competence cofactors for different hemopoietic cell lines. Finally, convincing evidence is accumulating to suggest that both activated and resting B cells may have receptors for BCGFs and BCDFs. This makes it clear why although the goal of a directed immune response is to generate antigen-specific antibodies, a large part of this response can actually be polyclonal and nonspecific. PMID- 3313666 TI - Experimental patterns related to multiple sclerosis pathology. AB - In the history of experimental demyelination, allergic encephalomyelitis (EAE) is the most impressive experimental demyelinating disease based on an immunological mechanism. The evolution of the neuropathological process of chronic EAE is very close to that of chronic Multiple Sclerosis. On the other hand experimental inoculation of different viruses can induce various types of demyelination depending on the main target of the virus and the host response, this latter being conditioned by the age, the mechanism of immunity and the persistence of the virus in the brain. The demyelination can be induced by a viral persistent infection primarily affecting oligodendrocytes (CDV, JHM hepatitis virus) or acting through an immunomediate response against myelin (Visna, Theiler virus, human conventional viruses). The experimental demyelinating models show that also in Multiple Sclerosis a viral etiology could be the starting point of a demyelinating process based on a immunologically mediated mechanism. PMID- 3313667 TI - Preliminary reports on a therapeutical trial in multiple sclerosis. AB - A therapeutic trial with azathioprine and steroids has been carried out on a group of definite MS subjects. Such pharmacologic association was suggested by many observations pointing out the possibility of balancing the adverse effects of azathioprine by steroid administration. The therapeutic protocol included an alternate administration of azathioprine 2 mg/Kg/die for 15 consecutive days, followed by triamcinolone 40 mg IM in a single dose during the following 15 days. The patient population was composed of 34 subjects, 7 of which showed a RR course, 15 a RP form and 12 a CP course. Our results showed that this treatment appeared particularly useful in RP forms; it could also be indicated in CP forms, at the beginning of chronic progression. PMID- 3313668 TI - [Metastatic chordoma. General review apropos of 2 cases]. AB - The authors report on two cases of sacrococcygeal chordoma, with complications involving visceral organ metastases and distal bony metastases. Chordomas are malignant tumors which develop in adult subjects which originate from remnants of the embryonic notochord. Sacrococcygeal localization is found in 50% of the 1,300 cases reported in the medical literature, which represents 20% of sacrococcygeal tumors observed. The difficulty and the delay in diagnosing these tumors should decrease by routine CAT scan examination. Diagnostic certainty is based on histological examination, often suggestive of the diagnosis (physaliphore-like cells), possibly combined with ultrastructure and immunohistological study. The clinical course involves local recurrences, but there is a real risk of metastatic development, notably in the case of sacrococcygeal chordomas, with their incidence estimated at 17.5% of cases. Sometimes developing in later stages of their course, histological findings are similar to those of the initial lesion. Organs which are frequently the sites of metastases are the lung (48% of cases) and bone (26%), then the lymphatic organs, the liver, and subcutaneous tissue... Therapeutic management is unsatisfactory, with ideally, complete surgical excision of the initial tumor of its size permits and hence early diagnosis of this condition is a prerequisite for good results. PMID- 3313670 TI - [The liver and rheumatoid arthritis]. PMID- 3313669 TI - [Rheumatism in the non-medical French literature]. PMID- 3313671 TI - [Current aspects of the immunology of articular cartilage]. PMID- 3313673 TI - [100 years since the establishment of the 2d Internal Medicine Clinic of the Medical School of Charles University in Prague]. PMID- 3313672 TI - [Methotrexate in rheumatoid polyarthritis. Review of the literature]. PMID- 3313674 TI - [The Pelnar era at the 2d Internal Medicine Clinic--the time of development of internal medicine specialties]. PMID- 3313675 TI - Assessment of extraarticular reconstructive procedures in management of chronic instabilities of the knee joint. PMID- 3313676 TI - Colorectal polyps. Clinical implications: screening and cancer prevention. PMID- 3313677 TI - Recurrent ulcer after treatment with cimetidine or sucralfate. AB - The recurrence of peptic ulcer disease after successful treatment with 400 mg cimetidine twice daily or 1 g sucralfate four times daily was investigated in a double-blind, 1-year follow-up study. Endoscopy was performed if ulcer symptoms recurred and 2-4 and 9-11 months after endoscopically confirmed healing of the initial ulcer. No anti-ulcer medication was permitted during the follow-up period. The recurrence rates were 71% in the cimetidine group (n = 143) and 68% in the sucralfate group (n = 115) (p greater than 0.3). The rate of asymptomatic ulcer relapse was 26% in the cimetidine and 23% in the sucralfate group (p greater than 0.4). The time to relapse did not differ between the treatment groups (p greater than 0.3). In the cimetidine group smokers had a higher 12 month recurrence rate than non-smokers, 83% compared with 58% (p less than 0.01). The corresponding figures in the sucralfate group were 76% and 57% (p = 0.057). The median time to recurrence in the cimetidine-treated group was 17 weeks among smokers, compared to 43 weeks among non-smokers (p less than 0.001). In the sucralfate-treated group the median time to recurrence was 23 weeks among smokers and 32 weeks among non-smokers (p greater than 0.3). Pre-study use of non steroidal anti-inflammatory drugs and the time to healing of the initial ulcer did not influence the relapse rates in either of the treatment groups. PMID- 3313678 TI - 5-Aminosalicylic acid in the treatment of Crohn's disease. A 16-week double blind, placebo-controlled, multicentre study with Pentasa. AB - The response to 5-aminosalicylic acid (5-ASA) in mild and moderately active Crohn's disease localized in the small bowel was studied in a randomized, double blind, placebo-controlled trial in four centres. Sixty-seven patients were included, of whom 30 were treated with 1500 mg slow-release 5-ASA/day (Pentasa) for a scheduled period of 16 weeks. In the 5-ASA group 40% of the patients improved, versus 30% of the placebo-treated group ('intent to treat' basis; p greater than 0.1). Four of the patients treated with 5-ASA left the study owing to disease deterioration, versus 10 of the placebo-treated patients (p greater than 0.2). Seventeen patients were secondarily excluded, and the remaining 50 patients (23 receiving 5-ASA) were reevaluated in greater detail. No statistically significant differences in outcome were shown. Three patients (one given 5-ASA) were withdrawn from the study because of presumed side effects, but no serious adverse reactions were recorded. The present results indicate that 5 ASA, at least in the dosage used, is not superior to placebo. Nevertheless, trends towards a beneficial effect in Crohn's disease in the small bowel justify further clinical trials with a larger dosage of 5-ASA. PMID- 3313679 TI - Pasteurella multocida bacteremia: report of thirteen cases over twelve years and review of the literature. AB - 13 episodes of bacteremia caused by Pasteurella multocida were seen in a general hospital during a 12-year period. All the patients had an underlying disease (77% had cirrhosis) and 2 were receiving chemotherapy for hematologic malignancy. There was a numerical preponderance of male patients (69%). In 5/13 cases a recent animal-derived trauma could be found. In the other cases the source of the infecting organism was thought to be endogenous (from patients' own pharyngeal commensal flora) or secondary to contact with secretions of a pet animal. The clinical presentation of sepsis caused by this organism was nonspecific. Hypotension was seen in 5 cases. Localized sites of infection were certain in 6 and only clinically suspected in 4 other cases. The overall mortality rate was 31%. The administration of ampicillin seems the appropriate therapy for Pasteurella multocida bacteremia. PMID- 3313681 TI - In vitro activity of ciprofloxacin compared to trimethoprim-sulfamethoxazole against Campylobacter spp., Shigella spp. and Enterotoxigenic Escherichia coli causing travellers' diarrhea in Egypt. AB - The in vitro activity of ciprofloxacin against bacterial enteropathogens isolated from cases of travellers' diarrhea in Egypt was compared to trimethoprim (TMP) and trimethoprim-sulfamethoxazole (SXT). No resistance to ciprofloxacin was noted for any of the Campylobacter jejuni/coli, Shigella spp., and enterotoxigenic Escherichia coli strains examined. However, resistance to TMP and SXT was noted among these same strains. Because of its broad spectrum and lack of resistance, ciprofloxacin is potentially a useful drug for the treatment of diarrhea caused by bacterial enteropathogens encountered in this region of the world. PMID- 3313680 TI - A prevalence study of HIV antibodies in rural Kenya. AB - In order to describe the prevalence of HIV antibodies and AIDS in West Kenya, serological tests, including ELISA, and in some cases immunoblotting, were performed on whole blood collected on filter paper from 603 Kenyans. Serum samples from 55 of these persons underwent the same examinations, and 45 were further examined by immunofluorescence and a commercial ELISA. The majority of the Kenyans examined were residents of a province in West Kenya, while the others were students from other parts of Kenya, predominantly rural areas. Male/female ratio was 62/38. Median age was 18 years (range 0-70). Five Danes with previously demonstrated HIV antibodies, and 10 Danish controls were examined for HIV antibodies in filter paper whole blood, and in serum by ELISA and immunoblotting. The tests carried out on the filter paper blood were found to be reliable. Only one of the examined Kenyans had antibodies to HIV by both ELISA and immunoblotting, representing a prevalence of 0.17% (95% confidence limits: 0.00 0.93%). This low prevalence is not in accord with results previously presented from rural districts in Kenya. PMID- 3313682 TI - [Immunology of liver diseases]. AB - Acute hepatitis A is diagnosed by IgM-anti-HAV antibodies. Cytotoxic immune reactions seem to play a key role in the pathogenesis of hepatitis A, which is an acute self-limited disease. - Acute hepatitis B is diagnosed by IgM-anti-HBc antibodies and can thus be differentiated from other HBV-associated liver diseases. The detection of HBV-DNA in serum serves to differentiate between HBsAg/anti-HBe positive patients, with active viral replication and progressive chronic liver disease, and HBV-DNA negative asymptomatic HBsAg-carriers usually with normal liver histology. In the pathogenesis of HBV-associated liver diseases cytotoxic immune reactions against virus-infected hepatocytes are thought to mediate liver cell destruction. Membrane expressed virus as well as host antigens are candidate target antigens for these immune reactions. Hepatitis delta is always associated with acute and chronic HBV infection. Acute hepatitis delta is diagnosed by delta-RNA in serum and later by antibodies against the delta virus. Little is known about the pathogenesis of delta virus infection. Autoimmune type chronic active hepatitis (CAH) is classified into classical autoimmune type "lupoid CAH" with antinuclear antibodies and liver membrane antibodies as markers, liver-kidney-microsomal (LKM) antibody positive CAH, CAH associated with autoantibodies against a soluble liver antigen (SLA), and CAH associated with high titers of anti-smooth muscle antibodies (SMA). In the pathogenesis of autoimmune type CAH an antibody-mediated cellular cytotoxicity (ADCC) may play a significant role. Primary biliary cirrhosis is to be differentiated as a clinical syndrome associated with cholestasis and anti-mitochondrial antibodies (AMA). By immunoblotting and radioimmunoassay at least two PBC-specific subtypes of AMA can be defined. Immune reactions against self-antigens are thought to be involved in the pathogenesis of PBC, although the precise reactions are unknown. PMID- 3313683 TI - [The value of various imaging technics in the preoperative diagnosis of choledocholithiasis]. AB - In a retrospective study different methods of detecting choledocholithiasis sonography, intravenous cholangiography, computed tomography and transhepatic cholangiography-have been compared to evaluate their accuracy. A total of 130 investigations in 93 patients were analysed. Choledocholithiasis could be predicted by sonography in 42.9%, by intravenous cholangiography in 60% and by transhepatic cholangiography in 85.7%. The overall accuracy rate with a single investigation was 51.6%. The combination of different methods increased the accuracy rate of 81.6%. We use sonography as the screening examination. In unclear cases transhepatic cholangiography has proven helpful in demonstrating choledocholithiasis. Only cholangiography, together with cholangioscopy, is performed intraoperatively. Due to high cost and limited availability, computed tomography should not be used as a basic examination. PMID- 3313684 TI - [Anthropo-analytical relaxation in irritable bowel syndrome: results 40 months later]. AB - Therapy of irritable bowel syndrome is disappointing. Since irritable gut (IG) accounts for 20-40% of all consultations, an investigation was carried out in IG patients treated by relaxation and its effect on the number of consultations, attacks of pain, and psychological profile (MMPI) after a period of time. A control group (C) received conventional treatment. The relaxation group (R) was treated simultaneously for a 6-month period. The number of consultations in the C patients was 53 before and 41 after conventional treatment. Consultations in the R group fell from 74 before to 6 after relaxation therapy. Two-monthly attacks of pain in the R group fell to zero, while there was no change in the C group on this score. The MMPI changes are original and worth stressing. The improvement immediately, and 40 months, after the relaxation course was significant. PMID- 3313685 TI - [Pathophysiological aspects and clinical indications for plasma exchange treatment]. AB - After a rather long initial period fraught with difficulties, plasma exchange has become an adjunct to the treatment of numerous diseases in medicine, such as hyperviscosity syndrome, where it alleviates disease symptoms, hemophilia due to inhibitors to clotting factor VIII, thrombotic thrombocytopenic purpura, rapidly progressing and Goodpasture glomerulonephritis, myasthenia gravis and Guillain Barre syndrome. As yet there are no formal indications for plasmapheresis, i.e. randomized placebo controlled studies are rare and proof of efficacy is often based on clinical criteria only. Therefore this treatment may be a transient means of removing noxious substances from plasma, giving way to more specific apheresis procedures such as plasma filtration, cascade filtration or immunoadsorption over charcoal or over solid-phase bound antibodies against the substance it is desired to remove. The present study presents the various plasmapheresis techniques, outlines the pathophysiological background to this treatment and adopts the now standard classification of indications into hematological, nephrological, neurological and miscellaneous indications. The English speaking reader will find an updated reference list of work published mainly in that language. PMID- 3313687 TI - [Benefits and risks of physical activity from the epidemiological point of view]. AB - The recent epidemiological literature on the health effects of physical activity is reviewed. Habitual physical activity is inversely associated with the risk of lethal and nonlethal myocardial infarction in men, in spite of a transient increase in the risk of sudden death during vigorous activity. Several mechanisms could explain this likely though unproved protective effect of regular exercise on coronary heart disease: lipoprotein pattern, functional cardiac capacity, glucose tolerance, and (presumably) hemostasis and catecholamines are favourably affected by vigorous physical activity, which is also inversely related to obesity and smoking. On the other hand, sports seems to be related in a linear way to musculoskeletal morbidity, especially in men. This negative though poorly documented side effect of physical activity renders preventive recommendations more difficult, but it should be kept in mind alongside the suggested cardiovascular benefits of exercise. PMID- 3313686 TI - [Acute treatment of arterial hypertension using calcium antagonists: comparison between diltiazem and nifedipine]. AB - Calcium antagonists have been used for the acute treatment of hypertension. Among these compounds, diltiazem induces the least tachycardia in response to acute administration. The effects of this agent, in a dose of 0.3 mg/kg given intravenously, on arterial pressure, heart rate and plasma renin activity were assessed in 10 patients with benign moderate to severe essential hypertension; nifedipine (10 mg sublingually) in 10 patients or 5% glucose (placebo) in 4 patients was used as a control. As compared with the 5% glucose group, diltiazem caused a persistent fall in diastolic pressure during 60 minutes, but only a transient decrease in systolic arterial pressure and heart rate; plasma renin activity was unchanged. Nifedipine caused a persistent fall in both systolic and diastolic pressure and a slight but significant increase in plasma renin activity, but did not modify heart rate. The diltiazem-induced decrease in systolic pressure was significantly smaller than the pressure changes caused by nifedipine. Variations in plasma renin activity between the two calcium antagonists were not significant. These findings suggest that in patients with hypertension diltiazem exerts a less marked acute antihypertensive effect than nifedipine. PMID- 3313688 TI - [Clonogenic assays in the evaluation of antitumor chemotherapy]. AB - Clonogenic cell assays are a tool for the study of tumor cells. This article reviews some promising results limited to drug evaluation. The SAKK ovarian cancer study confirms the predictive value of chemosensitivity or chemoresistance determined by these tests. Studies on the CASSG/EORTC show the reproducibility of these techniques and their usefulness in preclinical drug evaluation. Routine use of these methods is limited by inaccessibility of tumor cells and no-growth rate. PMID- 3313690 TI - [Relation between the physician and pharmacist in the Canton of Berne: various historical aspects]. AB - In Berne, various decisions were taken early to regulate relations between doctors and apothecaries with a view to protecting public health. In the 15th century, the two professions were separated and apothecaries were subjected to rigorous state control. As late as the 18th century the town physician was entrusted with supervising dispensing pharmacists. This supervision extended to the quality of the basic products employed, adulteration of remedies and setting of prices, and included inspection of the apothecary's premises. PMID- 3313689 TI - [Disseminated histoplasmosis due to Histoplasma capsulatum in a patient with acquired immunodeficiency syndrome (AIDS)]. AB - Very commonly encountered in the United States, histoplasmosis is rare in Europe, where only 27 patients have so far been infected by this mycosis. In Africa, two varieties of histoplasmosis have been observed: those due to H. capsulatum and H. duboisii. Histoplasmosis due to H. capsulatum is one of the twelve secondary infectious diseases listed in the surveillance definitions of AIDS. This complication has been described only in approximately 20 patients with AIDS; all patients had stayed on the American Continents. We report the case of a 30-year old African male who lived in Switzerland and in Zaire. With AIDS and multiple Kaposi's sarcoma, the patient died from disseminated histoplasmosis due to H. capsulatum; a peripheral blood smear obtained a few hours before death revealed numerous typical yeast forms of H. capsulatum inside polymorphonuclear leukocytes. Post-mortem examination and cultures confirmed the diagnosis of disseminated histoplasmosis. Histoplasmosis should be suspected in AIDS patients even in Europe, especially where they have stayed in endemic areas. Examination of blood smears and bonemarrow aspirate may allow early recognition of the disease and permit appropriate treatment with amphotericin B and ketoconazole. PMID- 3313691 TI - [Predictive value of additional immunohistochemical studies in histological diagnosis]. AB - No exact information exists on the diagnostic value of immunohistochemistry applied to the routine material of an institute of surgical pathology. For this reason 390 cases additionally investigated by immunohistochemistry were analyzed retrospectively. This method was applied to 0.5% of all biopsies studied morphologically. On average 4.4 antisera per case were used. 352 cases (90.3%) initially diagnosed by morphology alone (16 benign lesions of debatable type, 111 lesions not clearly defined as benign or malignant, 225 malignant tumours of unknown subtype) could be clarified by immunohistochemistry. To obtain reliable results specific application of immunohistology and a clearcut formulation of the question are necessary. If these criteria are fulfilled immunohistochemistry represents a powerful tool in surgical pathology. PMID- 3313692 TI - [Dangerous snoring. Sleep-apnea syndrome]. AB - Snoring usually is trivial and unimportant, but it can turn into a social or medical problem. Obesity, hypertension and heart disease are more frequent among snorers than among nonsnorers, and especially snorers with hypersomnia during the day are at risk. Hypersomnia in association with snoring usually signifies obstructive sleep apnea. Increased resistance in the upper airways, together with negative inspiratory pharyngeal pressure and muscular hypotonia during deep non REM and REM sleep, lead to collapse of the pharynx, hypoxia and hypercapnia. Only after arousal from sleep does muscle tone return, pharyngeal obstruction reopen and airflow resume. Since this process can occur 300 or 400 times a night, repetitive alveolar hypoventilation leads to pulmonary-arterial hypertension and cor pulmonale, and the repetitive sympathetic activations can cause systemic hypertension or serious cardiac arrhythmias. The countless arousals deprive the sufferer of deep non-REM and REM sleep and their consequence is sleep fragmentation. The symptoms are excessive daytime sleepiness, intellectual deterioration and personality and behavioral changes. Oronasomaxillofacial, endocrine and neuromuscular anomalies and diseases predispose to sleep apnea, and alcohol or CNS-depressant drugs can favour its occurrence. Diagnosis is made by nighttime oxymetry, and if this is abnormal, by polysomnography. After polysomnography it is possible to distinguish between obstructive and nonobstructive sleep apnea, and the decisions for an adequate treatment can be made. PMID- 3313693 TI - [Early diagnosis of bronchial carcinoma using thoracic roentgen imaging and sputum cytology]. AB - Chest roentgenography and sputum cytology have been used for the early detection of lung cancer since the beginning of the 1950s. Surprisingly, the yield of screening is sufficiently high. In view of the estimated prevalence of lung cancer of 0.5-2% in high risk persons, the detection rate was 0.32-0.95% in three large randomized clinical trials (Cooperative Pilot Study of the American Cancer Society and Veterans Administration 1969, Canadian study of Grzybowski and Coy 1970, National Cancer Institute Cooperative Early Lung Cancer Detection Program 1984). Screening by chest roentgenogram was superior to sputum cytology. More than 70% of all lung cancers were detected by roentgenography alone. Adding sputum cytology, 10-20% more cancers were found. Lung cancers which were additionally detected by cytology were slowly-growing, central squamous cell carcinomas with good prognosis. The sensitivity of chest X-rays varied between 49 and 77% and the sensitivity of sputum cytology between 33-52%. Specificity was higher, the range being 95-99% for chest X-rays and 96-99% for sputum cytology. The costs per lung cancer detected and treated are very high. To these are added the costs which arise from the evaluation of false positive results. The prognosis of lung cancer detected by screening is good: more patients survive, and they live longer than unscreened patients. The overall 5-year survival of patients screened by chest X-rays and sputum cytology of the NCI-study was 35-55% compared with only 15% of patients not screened. However, whether long survival means reduced mortality is uncertain, since long survival only reflects early detection. PMID- 3313694 TI - [Side effects of non-steroidal antirheumatic agents in the lower gastrointestinal tract]. AB - Peptic gastroduodenal lesions due to nonsteroidal antiinflammatory drugs (NSAID) are well known, but not the adverse effects of these preparations in the lower GI tract. The cases of 5 patients with NSAID-induced colitis are described and the pertinent literature is reviewed, which reveals a wide spectrum of alterations ranging from mild non-specific colitis to acute bleeding or perforation. The most important key to correct diagnosis is a careful drug history, and treatment is to discontinue the NSAID. PMID- 3313696 TI - [Probond. A precious metal-sparing reconstruction procedure for metal ceramics]. PMID- 3313695 TI - [Current TSH-sensitive assays simplify thyroid diagnosis]. AB - The methodology and clinical application of sensitive TSH assays are discussed. The new immunometric assays not only distinguish between normal and elevated, but also between normal and suppressed TSH values. Therefore, after clinical examination of the patient, serum TSH measurement by a sensitive assay may be used as a first line test whenever hypo- or hyperthyroidism is suspected. Normal TSH indicates euthyroidism and obviates the need for further thyroid function testing. In patients with elevated or suppressed TSH values, free T4 and (if TSH is suppressed and free T4 normal) free T3 are measured to discriminate between overt and subclinical hypo- or hyperthyroidism. Testing with TRH continues to be useful in some more complex cases, when the above-mentioned tests are not conclusive. PMID- 3313697 TI - [Interdental bleeding. A method for controlling gingival health]. PMID- 3313698 TI - [Should the use of base-metal alloys be limited?]. PMID- 3313699 TI - [Long-term study of the mobility of the abutment teeth in Class I or II patients wearing a lower fixed denture]. PMID- 3313700 TI - [A reconstruction attempt in progressive osteolysis (Gorham disease) of the mandible. A case report]. PMID- 3313701 TI - [Causes of failure of adhesives in adhesive bridges]. PMID- 3313702 TI - [Experience with adhesive bridges and splints--a multicenter observational study. 4. 1986 results]. PMID- 3313703 TI - [The shearing load behavior of different conditioned adhesive retainers]. PMID- 3313704 TI - [Practical periodontology (II). Technics of conservative periodontal treatment: scaling--deep scaling--root planing]. PMID- 3313705 TI - [Recent advances in neuro-immuno-modulation]. PMID- 3313706 TI - [Interleukin 1]. PMID- 3313707 TI - [Macrophages and prostaglandins]. PMID- 3313708 TI - [Advances in oncogenes, fragile site and chromosomal translocation in neoplastic cells]. PMID- 3313709 TI - [Lipid peroxidation and ischemic injury of the cardiac myocyte]. PMID- 3313710 TI - [Artificially induced cell fusion and its mechanisms]. PMID- 3313711 TI - [Drug plasma protein binding and pharmacokinetics]. PMID- 3313712 TI - [Effects of melatonin on brain function]. PMID- 3313713 TI - [Anatomical and functional connections of brain stem noradrenergic neurons with paraventricular nucleus and supraoptic nucleus]. PMID- 3313714 TI - [Effect of hydrogen ion regurgitation and gastric mucosa ischemia on the pathogenesis of stress ulcer]. PMID- 3313715 TI - [Research on retina melatonin]. PMID- 3313716 TI - [Endosonographic diagnosis in uterine tumors]. AB - Endosonography offers two major advantages in the pretherapeutic examinations of a histologically verified carcinoma of the uterus. Endosonography allows (1) an overview of the size and location of the tumour and (2) an evaluation of the spreading and/or involvement of adjacent organs. Both add up to a more objective staging of the tumour and, therefore, may cause a more effective therapeutic approach. Especially in cases with endometrial carcinoma the uterine walls can be visualized either by the well-tolerated method of vaginosonography or by hysterosonography which can be performed only in general anaesthesia. Applying either endosonographical method, the infiltration depth of the myometrium and/or involvement of the cervix can be determined, which seems to be very valuable, particularly when differentiating between stages I and II. Rectosonography, with its transversal scanning probes, offers the advantage of demonstrating the infiltration of a cervical tumour into the parametrium. Here again, the benefit is seen in a more objective evaluation of tumour size and extension. However, tumour growth into the urinary bladder is best shown by cystosongraphy. With this method one cannot only have a view of the epithelium (as in cystoscopy) but one is also able to evaluate the underlying layers of the bladder wall. This seems to be an advantage in findings of a bullous oedema. Once again, rectosonography is advantageous in enhancing the diagnosis of recurrences of malignant tumours in the pelvic region. Like a prolongation of the palpating finger rectosonography is able to depict less echogenic areas located high up on the pelvic wall as local recurrences or tumours.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3313717 TI - [Imaging of endometrial cancer with vaginosonography]. AB - Besides the grading parameters, another decisive criterion of prognosis for the 5 year survival rate of the endometrium carcinoma is the depth of infiltration of the carcinoma. It is possible to detect by vaginal sonography an invasion of the myometrium even in women who subjected to primary irradiation. In 8 out of 25 women the histological findings showed an adenocarcinoma type Ib, G2, where the degrees of infiltration of the myometrium that were diagnosed sonographically, varied from one-third to three-thirds. Using vaginal sonography it is possible to provide a criterion of indication for additional irradiation with telecobalt in patients undergoing primary irradiation. PMID- 3313718 TI - [Sonography of small and occult breast cancer]. AB - The importance of sonography in the diagnosis of the small palpable and occult carcinoma of the female breast is discussed on the basis of the authors' own studies. Of a total of 98 carcinomas in this group, 80 were identified by means of mammography, 7 by ductography and 11 by sonography; a total of 3573 women were examined sonographically in whom results of palpation and x-ray examination required further clarification. Sonography is a valuable additional examination that should be employed strictly on-target according to previously worked-out criteria. PMID- 3313719 TI - [Sensitivity and specificity of sonography and sialography in relation to the diagnosis of parotid tumors]. AB - The results of parotid sialography from a group of patients between 1980 and 1982, were subjected to retrospective evaluation, and compared with sonographic results from another group between 1983 and 1985. In the first period studied sialography showed 75% sensitivity and 100% specificity. Both sensitivity and specificity of sonography were 100% in the second group. Thus, sonography appears superior with regard to diagnosis of intraglandular tumours of the parotid. PMID- 3313720 TI - [Effect of vesicoureteral reflux on kidney density in children]. AB - In 59 children with vesicoureteric reflux (VUR) renal echogenicity was analyzed. The density of the kidneys increase with the intensity of the VUR. The children with VUR grade 1 and 2 mainly showed a normal report. In 50% of the cases with VUR grade 3, a normal report was also found, whereas in the other 50% echogenicity was increased to 1 and 2. Highly significant increases in renal density were seen in ultrasound in children with VUR grade 4-5. PMID- 3313722 TI - [Sonographic imaging of the mobility of the tongue in the newborn infant with cleft jaw and palate]. AB - In newborn with cleft lip and palate malformation real time ultrasound examinations of the position and volubility of the tongue were performed. By comparative studies before and after putting in an orthopaedic appliance, the function and effectivity of this prosthesis can be demonstrated. PMID- 3313721 TI - [Sonographic diagnosis of holoacardius]. AB - In the 28th week of gestation a normal foetus and a holoacardius were diagnosed via sonography in a biamnotic monochoriatic twin pregnancy. The growth of the foetuses was observed under continuous sonographic control up to the 40th week of pregnancy. The patient delivered a healthy twin by Caesarean section and the acardius was subjected to a postmortem. Macroscopic and histological findings in the foetus, the placenta and the umbilical cords are demonstrated. The pathogenesis of the holoacardius is discussed as being due to chromosomal aberrations and foeto-foetal transfusion syndrome. PMID- 3313723 TI - [Ultrasound study of "acute appendicitis," an elective procedure or obligation in general surgery. A prospective study]. AB - 576 patients admitted for suspected acute appendicitis were prospectively assessed by sonography following physical examination. The collective comprised - as proven by operation - 156 patients with acute appendicitis, 178 patients with chronic appendicitis or mesenteric lymphadenitis, as proven by observation, 186 patients suffering from gastroenteritis. 56 patients suffered from other diseases and 21 of them required urgent surgery. Based on clinical symptoms, correct diagnosis had been made in 433 patients (75%): gastroenteritis n = 186, chronic appendicitis or lymphadenitis n = 111 and acute appendicitis n = 136 (87%). In 123 patients the diagnosis was false positive, in 20 patients false negative. Based on sonographic assessment, 537 patients (93%) were correctly diagnosed; thus, in 129 patients (83%) an inflamed appendix was confirmed, in 56 patients; diagnosis of unrelated entities requiring urgent surgery correct in 21 cases. In 12 patients with mesenteric lymphadenitis - as proven by operation-a false positive, in another 27 patients with acute appendicitis a false negative diagnosis was made. The combination of clinical assessment and sonographic diagnosis yielded a correct diagnosis in 97% (560/576) comprising 414 true negative and 146 true positive results (94%) in respect of acute appendicitis. PMID- 3313724 TI - Establishment of a human/Chinese hamster hybrid clone panel. AB - Combined with the chromosome G-banding, followed by Giemsa-11 techniques and chromosomal marker isozyme analysis, 6 out of 200 subclones have been analyzed in detail. A primary hybrid clone panel has been established, which can be used to map genes on chromosomes 4, 5, 8, 12, 20 and 22. Since the panel contains deleted chromosomes 4, 5, 8 and 12, genes on these chromosomes can be mapped regionally. PMID- 3313726 TI - South Dakota State Medical Association Roster--1987. PMID- 3313725 TI - Clinical manifestations of HIV infections. AB - The wide clinical spectrum of HIV infection is reflected in the new CDC classification. Presentations range from acute infection, asymptomatic carriage and persistent lymphadenopathy through constitutional upset and neurological disease to the opportunistic infections and cancers of AIDS. AIDS is an enigmatic disease which presents special clinical diagnostic and management problems. Although any system may be affected the lungs and the brain are the most important target organs. Though the underlying disease is currently untreatable, many of the complications of AIDS are amenable to prompt therapy. Seropositive patients should be monitored to detect early signs of significant HIV disease. Skilled counselling about the avoidance of co-factors which may potentiate HIV infection, is important. PMID- 3313727 TI - Structure of MHC protein solved. PMID- 3313729 TI - Cytokine-induced expression of HIV-1 in a chronically infected promonocyte cell line. AB - A model system for cytokine-induced up-regulation of human immunodeficiency virus type 1 (HIV-1) expression in chronically infected promonocyte clones was established. The parent promonocyte cell line U937 was chronically infected with HIV-1 and from this line a clone, U1, was derived. U1 showed minimal constitutive expression of HIV-1, but virus expression was markedly up-regulated by a phytohemagglutinin-induced supernatant containing multiple cytokines and by recombinant granulocyte/macrophage colony-stimulating factor alone. Recombinant interleukin-1 (IL-1), IL-2, interferon-gamma, and tumor necrosis factor-alpha did not up-regulate virus expression. Concomitant with the cytokine-induced up regulation of HIV-1, expression of membrane-bound IL-1 beta was selectively induced in U1 in the absence of induction of other surface membrane proteins. This cytokine up-regulation of IL-1 beta was not seen in the uninfected parent U937 cell line. These studies have implications for the understanding of the mechanism of progression from a latent or low-level HIV-1 infection to a productive infection with resulting immunosuppression. In addition, this model can be used to delineate the potential mechanisms whereby HIV-1 infection regulates cellular gene expression. PMID- 3313728 TI - Left-handed DNA in vivo. AB - Left-handed DNA is shown to exist and elicit a biological response in Escherichia coli. A plasmid encoding the gene for a temperature-sensitive Eco RI methylase (MEco RI) was cotransformed with different plasmids containing inserts that had varying capacities to form left-handed helices or cruciforms with a target Eco RI site in the center or at the ends of the inserts. Inhibition of methylation in vivo was found for the stable inserts with the longest left-handed (presumably Z) helices. In vitro methylation with the purified MEco RI agreed with the results in vivo. Supercoil-induced changes in the structure of the primary helix in vitro provided confirmation that left-handed helices were responsible for this behavior. The presence in vivo of left-handed inserts elicits specific deletions and plasmid incompatibilities in certain instances. PMID- 3313730 TI - [Anxiety, stress, and relaxation. Hospital experience in patients with coronary disease]. PMID- 3313731 TI - [Hematology: yesterday and today]. PMID- 3313732 TI - Application of peroxidase-antiperoxidase (PAP) staining for detection and localization of dengue-2 viral antigen. II. Observations for the antibody enhancement activity in human monocytes. AB - Peroxidase-antiperoxidase (PAP) staining was applied to measure the antibody enhancement activity in human monocytes. Increasing in number of infected cells can be seen with increasing of staining intensity of the cells by ordinary light microscope. Shifting of the optimum enhancement activity was found in previously tritiated antiserum indicated that for titration of antibody enhancement activity several dilutions of antiserum should be included in each experiment. Validity of the PAP method was made by the comparison of the results with Infectious Center Assay (ICA). With this technique, titration for antibody enhancement for dengue virus infection can be done with non-expensive equipment and can be kept for comparison for months. PMID- 3313733 TI - Oral vaccine against cholera prepared from Vibrio cholerae antigen(s). AB - Albino rats aged 7-8 weeks old purchased from the National Laboratory Animal Centre, Salaya, Nakhon Pathom, were found to be a good animal model for the study on immunogenicity of V. cholerae antigens. Seventy-two rats were fasted for 15 hours before feeding each one with 1 ml of 5% NaHCO3 to reduce gastric acidity prior to immunization. They were divided into 9 groups of 8 rats and immunized orally with 2 ml, each, of the V. cholerae antigens dissolved or suspended in Cassamino acid as follows: group 1 (control): Cassamino acid (Ca) alone; group 2 (control): 2.5% formalinized sheep red blood cells (F-SRBC); group 3: 1,000 micrograms of lipopolysaccharide (LPS); group 4: 100 micrograms of procholeragenoid (P); group 5: 80 haemagglutinating units of cell-bound haemagglutinin (CHA) adsorbed onto the surface of F-SRBC (CH-SRBC); group 6: 500 micrograms of LPS + 50 micrograms of P; group 7: CH-SRBC + 50 micrograms of P; group 8: combined vaccine formula 1 consisted of 500 micrograms of LPS, CH-SRBC and 50 micrograms of P and group 9: combined vaccine formula 2 consisted of 1,000 micrograms of LPS, CH-SRBC and 100 micrograms of P. The immunization was repeated once more 14 days later. Five days, thereafter, the rats were killed and their jejuni were removed for cryostat sectioning. Antibody producing cells against LPS (anti-LPS cells), P (anti-CT cells) and CHA (anti-CHA cells) in the intestinal lamina propria were enumerated by double antibody sandwich method of immunofluorescence using pure LPS, cholera toxin (CT) and pure CHA as the antigens in the assay, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3313734 TI - Immunoprecipitating antibodies against blood stage antigens of Plasmodium falciparum in cerebral and non-cerebral malaria patients. AB - Immunoprecipitating antibodies were determined in paired sera of 31 patients with cerebral malaria (CM), of whom 14 had complicated cerebral malaria (CCM) and 17 had uncomplicated cerebral malaria (UCCM), 15 single specimens of patients with acute uncomplicated (AM) malaria taken on the day of admission and 8 healthy controls. All but one patient were admitted within the first three days of the onset of fever. More than 20 precipitating bands were observed, of which the predominating molecules were the Mr greater than 200, 180, 157, 135, 130, 115, 103, 96, 91, 73, 71, 61, 49, 45, 43, 41 and 14.3 Kd. In general, there were no significant differences in the positive rates among the AM, CCM and UCCM patients except for the pf135 Kd molecule which was more frequently reactive in UCCM patients than the AM and CCM patients. If immunological naiveness in term of protective immunity is the feature in CM patients, the immunoprecipitation test used is inadequate to demonstrate the fundamental differences in immune responses between CM and AM patients. PMID- 3313735 TI - Comparison of washed and unwashed specimens in the Plasmodium falciparum in vitro microculture drug assay. AB - The dose response of Plasmodium falciparum isolates in the standard in vitro assay for drug resistance was compared using blood specimens which were centrifuged and washed before cultivation. Washing of the cultures increased the success of cultivation by greater than 100%. Eight cultures which grew using both methods gave similar results in the determination of resistance or sensitivity. The ED50 as determined by probit analysis, was approximately 50% higher in parasites which had been washed before cultivation. PMID- 3313736 TI - Development of Brugia malayi in Mongolian gerbils previously exposed to Wuchereria bancrofti. AB - Twelve Mongolian gerbils, Meriones unguiculatus, were infected with 100 third stage larvae of Wuchereria bancrofti. One month later these animals, along with 4 control animals, were given 100 third-stage larvae of Brugia malayi. Eleven of the 12 experimental animals and the 4 controls survived, and 8 of the experimental animals and all of the controls demonstrated microfilaremia after 3 months. The animals were killed at 6-months post-infection and examined for parasites. One W. bancrofti larva was found in one of the experimental animals, and 15% of the B. malayi given were recovered as adults from the testes, viscera, and carcass. Thirty-eight percent of the worms given to the controls were recovered from the testes, viscera, and pelt. The worms from the experimental animals also appeared to be smaller. This study suggests that gerbils are able to develop partial resistance to Brugia malayi following a previous infection with Wuchereria bancrofti. PMID- 3313737 TI - In vitro drug response of Plasmodium falciparum in the Philippines: increased resistance to amodiaquine. AB - A long term study was carried out at San Lazaro Hospital, Manila, Philippines, monitoring the in vitro response of Plasmodium falciparum to chloroquine, amodiaquine, mefloquine, and quinine. The in vitro effective dose giving 50% inhibition of schizogony was: 0.68 X 10(-6) M/liter blood for chloroquine; 0.18 X 10(-6) for amodiaquine; 0.2 X 10(-6) for mefloquine; and 1.12 X 10(-6) for quinine. The percent of isolates determined to be resistant in vitro was 85.2% for chloroquine, and 1.2% for both mefloquine and quinine. These figures were relatively unchanged over the course of 3 years studied. The in vitro resistance rate to amodiaquine increased from 5.1% in 1982 to 22.2% in 1984. PMID- 3313738 TI - Filariasis in Tak Province, northwest Thailand: the presence of subperiodic variant Wuchereria bancrofti. AB - The microfilariae found in carriers at Tak Province, Northwestern Thailand were morphologically and morphometrically studied. It was found that the parasites conformed to that of W. bancrofti microfilaria. The microfilarial periodicity as determined from four carriers was found to be nocturnally (early evening) subperiodic type showing a distinct peak at 1800 hours. PMID- 3313739 TI - The effect of mefloquine-sulfadoxine-pyrimethamine vs quinine on patients with complicated falciparum malaria. AB - Sixty-six patients with complicated falciparum malaria (defined as anaemia, hyperpyrexia, jaundice, or more than 2% of RBC parasitised) were studied. Patients with cerebral signs and symptoms were not included in the study. Patients were randomised in pairs to receive either mefloquine 750 mg, sulfadoxine 1500 mg and pyrimethamine 75 mg (MSP) single oral dose or quinine (10 mg/kg tds X 7 days oral therapy). All the patients were admitted in hospital for 7 days and were followed on days 14, 21 and 28. All patients survived. The parasite clearance times in MSP treated patients were significantly shorter then those treated with quinine. There was no difference in fever clearance time in the two groups of patients. One patient was resistant to MSP at RII level and 5 patients were resistant at RI level. Among patients treated with quinine 3 patients were resistant at RI level. PMID- 3313740 TI - Hemolytic uremic syndrome associated with shigellosis: report of two cases. AB - Two patients with hemolytic uremic syndrome admitted to Udornthani Hospital, Thailand, were reported. The preceding illness was shigellosis. The stool culture was positive for Shigella dysenteriae in one patient and Shigella flexneri in another. The management was successful with peritoneal dialysis in one and symptomatic treatment in another. Both patients had complete recovery. PMID- 3313741 TI - Some observations on sympatric populations of the malaria vectors Anopheles leucosphyrus and Anopheles balabacensis in a village-forest setting in South Kalimantan. AB - Human bait collections of biting anopheline mosquitoes were made on five consecutive nights during September 1986 in a remote village located in a heavily forested area of South Kalimantan, Indonesia. Anopheles leucosphyrus and An. balabacensis comprised 97.7% of the total number of specimens collected outside houses in the village. Anopheles balabacensis were slightly fewer in total numbers than leucosphyrus. Mosquitoes were collected simultaneously in the village and the forest on two nights. The numbers of leucosphyrus and balabacensis biting in the forest were small in comparison with the populations encountered in the village. Approximately 75% of the specimens were checked individually for sporozoite infections using ELISA for P. falciparum and P. vivax. Sporozoites of P. falciparum were detected in one specimen of leucosphyrus and one of balabacensis. The sporozoite infection rate was 1.0% for leucosphyrus and 1.3% for balabacensis. PMID- 3313742 TI - Flunarizine and verapamil inhibit chloroquine-resistant Plasmodium falciparum growth in vitro. AB - Using pharmacological properties in relation to the biochemistry of P. falciparum, verapamil, flunarizine, and chlorpromazine which are calcium blockers were selected to test for their antimalarial activity against P. falciparum in vitro. Results revealed that the drugs inhibited parasite population growth in the following order of IC50: verapamil 1 X 10(-6) M, chlorpromazine 3.5 X 10(-6) M, and flunarizine 5 X 10(-6) M. These three calcium blockers have antimalarial effects on chloroquine resistant parasite (alone T9/94) but are less potent when compared with the efficacy of quinine or mefloquine in vitro. PMID- 3313744 TI - Scanning electron microscopic study of third-stage larva of Wuchereria bancrofti and Brugia malayi in Thailand. PMID- 3313743 TI - Aedes (Finlaya) togoi Theobald 1907, Chanthaburi strain, a laboratory vector in studies of filariasis in Thailand. PMID- 3313745 TI - [Immunomodulating action of an Eleuterococcus extract in oncologic patients]. PMID- 3313747 TI - [Evaluation of sensitization to intestinal microflora in allergic diseases]. PMID- 3313746 TI - [Puncture of malignant tumors with ultrasonic control]. PMID- 3313748 TI - [Hemosorption in obliterating diseases of the vessels of the lower extremities]. PMID- 3313749 TI - [Computers in the organization of dietary services]. PMID- 3313750 TI - [Features of the course and treatment of peptic ulcer in women]. PMID- 3313751 TI - [Alcohol and other human factors involved in traffic accidents]. PMID- 3313752 TI - [Review of new findings on the molecular basis of the elimination of immunocomplexes from the circulation]. PMID- 3313753 TI - [Counterregulatory hormonal response in short-term induced hypoglycemia in insulin-dependent diabetics]. PMID- 3313754 TI - [Thrombosis of the subclavian-axillary vein segment]. PMID- 3313755 TI - [Carcinoma of the breast and oral contraceptives]. PMID- 3313756 TI - [Diagnosis of primary hyperparathyroidism]. PMID- 3313757 TI - Comparison of a standard ibuprofen treatment regimen with a new ibuprofen/paracetamol/codeine combination in chronic osteo-arthritis. AB - Twenty-eight patients with osteoarthritis participated in a prospective, double blind, cross-over study to compare the safety and efficacy of a new combination analgesic containing ibuprofen 200 mg, paracetamol 250 mg and codeine phosphate 10 mg per tablet (Myprodol; Rio Ethicals) with a standard treatment regimen (ibuprofen 200 mg per tablet). The combination tablet was found to provide significantly better pain relief than ibuprofen alone (P less than 0.05). Analysis of the results of haematological, hepatic and renal function tests showed no statistically significant differences between treatments. No serious side-effects or clinically important changes were encountered with either drug. PMID- 3313759 TI - Is the teaching of Professor Cuthbert Crichton still relevant? PMID- 3313758 TI - Fine-needle aspiration biopsy cytology of the breast. A review of the Groote Schuur Hospital experience. AB - The results of the first 1,500 cytological diagnoses of fine-needle breast aspirates performed at Groote Schuur Hospital Breast Clinic are compared with the histological diagnoses of Tru-cut and excision biopsies of the same lesions. A cytological diagnosis of malignant disease was made in 358 cases, 349 of which were confirmed histologically. The 10 false-positive and 1 false-negative diagnoses are discussed. The reliability of diagnosis in the first 500 cases is compared with that in the second and third 500 cases. There were no false positive diagnoses in the last 500 cases, and only 3 in the second 500 cases compared with 7 in the first 500 cases. Similarly, the 1 false-negative diagnosis was made in the first 500 cases. The results confirm the reliability of fine needle aspiration biopsy cytology as a diagnostic technique. The number of incorrect diagnoses decreases as experience with the technique increases. PMID- 3313760 TI - The worker with multiple chemical sensitivities: an overview. PMID- 3313761 TI - Workers with multiple chemical sensitivities. PMID- 3313762 TI - The epidemiology of multiple chemical sensitivities (MCS). PMID- 3313763 TI - Environmental illness: a disorder of immune regulation. PMID- 3313764 TI - "Multiple chemical sensitivities:" immunologic critique of clinical ecology theories and practice. AB - The concept of multiple chemical hypersensitivities as a disease entity in which the patient experiences numerous symptoms from numerous chemicals and foods caused by a disturbance of the immune systems lacks a scientific foundation. Published reports of such cases are anecdotal and without proper controls. There is no convincing evidence for any immunologic abnormality in these cases. Diagnostic methods have been shown to be unreliable. Diagnosis, treatment, and theoretical concepts underlying the purported disease are not consistent with current immunologic knowledge and theory. As defined and presented by its proponents, multiple chemical hypersensitivities constitutes a belief and not a disease. PMID- 3313765 TI - Multiple chemical sensitivities and other "environmental illness": a psychiatrist's view. AB - The clinical ecology subculture, like earlier medical subcultures, is the product of patient concerns that the medical establishment cannot allay by treatment or by reassurance. For social and behavioral scientists, it represents a "natural" experiment that can be studied. For those physicians who believe that clinical ecology is without scientific basis generally and/or that its practitioners interpret laboratory results incorrectly, it is a challenge and an irritant. The clinical ecologist-physician feels rejected and the victim of bias and unfair attack. The patient in this subculture feels that finally he has found someone who understands him and is trying to help him, but that he must pay the price of being disapproved or rejected by his former physicians. PMID- 3313766 TI - Environmental evaluation of workers with multiple chemical sensitivities: an industrial hygienist's view. PMID- 3313767 TI - Biochemical abnormalities in patients with multiple chemical sensitivities. AB - Patients with MCS show numerous physiological and biochemical abnormalities and are generally sicker than a control group of allergic patients. Associated with MCS are mitral valve prolapse, hypothyroidism, autoimmune thyroiditis, specific abnormalities of amino acid and essential fatty acid metabolism, and diminished activity of ESOD and EGPx. Equally prevalent among MCS patients and controls are deficiencies of magnesium and Vitamin B6. Since patients with MCS feel sick almost all of the time, it is likely that some of these abnormalities contribute to their general level of ill health, if not to their sensitivities. It is also possible that these various abnormalities are caused by some unidentified fundamental metabolic or neuroendocrine disturbance that is common to states of hypersensitivity. A provocative finding is the high frequency with which impaired anti-oxidant levels were detected. Erythrocyte activity of SOD was low in 89% and EGPx was low in 48% of MCS patients. Furthermore, 41% showed impaired excretion of essential amino acids, despite a high protein diet, and leucocyte vitamin C was low in the 5 patients not taking vitamin C supplements. Anti-oxidant deficiences may certainly contribute to hypersensitivity to environmental pollutants and toxic chemicals. In fact, treatment with anti-oxidants, including selenium, vitamin C, copper, zinc, and sulfur-containing amino acids was associated with major clinical improvement in 14 (25%) of the patients in the MCS group and with limited relief of symptoms in another 10 (18%). In all patients in whom ESOD or EGPx were repeated, improvement in levels was observed following treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3313768 TI - Patients with multiple chemical sensitivities: clinical diagnostic subsets among an occupational health clinic population. PMID- 3313769 TI - Workers with multiple chemical sensitivities: a psychiatric approach to diagnosis and treatment. AB - Individuals considered to suffer from multiple chemical sensitivities comprise a heterogeneous grouping. Regardless of the original etiology of symptoms, these individuals tend to amplify their symptoms and to develop the mistaken belief that these symptoms are indicative of severe disease. Cognitive processes and anxiety contribute to amplification of symptoms and disability, and cognitive and behavioral techniques appear to be clinically useful in alleviating symptoms and disability. Specific psychiatric disorders, in particular major depression, panic disorder, post-traumatic stress disorder, and somatization disorder, may be confused or associated with MCS. When present, specific treatment of these psychiatric disorders is essential. PMID- 3313770 TI - Biological interventions in the treatment of patients with multiple chemical sensitivities. AB - The syndrome of multiple chemical sensitivities has many manifestations and undoubtedly many causes. Treatment must be individualized based on a thorough psychosocial and biological diagnostic evaluation. Careful listening, as is usually the case, not only results in a more complete history but also serves a critical therapeutic purpose in cementing a trusting, working partnership. Family dynamics, and larger social concerns, such as litigation, may figure importantly as obstacles to rehabilitation if they are ignored in treatment planning. In chronically disabled patients, the importance of psychosocial interventions is even greater but should not eclipse attention to relevant medical interventions. The most basic physiologic manipulation involves a program of environmental avoidance. Such a program should be applied with caution since it is not without risks of inadvertent exacerbation of medical and psychologic disabilities. Therefore, from a medical perspective, interventions should focus on improving chemical tolerance by the appropriate application of first aid, chronohygiene, nutrition, psychophysiology, and correction of microbiological disruptions. Thorough investigation for intercurrent disease and its appropriate management is paramount. Attempts to treat the entire problem by isolating attention to one area or based on a single theory are likely to fail. PMID- 3313771 TI - Management of patients with multiple chemical sensitivities at occupational health clinics. AB - The difficult task of managing patients with MCS requires a multidisciplinary effort involving the occupational medicine physician, social worker, occupational therapist, physical therapist, psychologist, vocational rehabilitation specialist, industrial hygienist, and other involved professionals. Important objectives of management include complete review of the history and clinical findings, appropriate choice of diagnostic tests, search for additional exposure information, emphasis of "well" behavior, health education of the patient and prevention of further illness. Because of the chronic nature of MCS and the difficulty many patients have in coping with MCS, pharmacologic and psychologic interventions should be considered. Interaction of the clinic with the patients employer, insurance carrier, or attorney must be carefully planned and communicated only after receiving the patient's informed consent. Patient education should include general principles of toxicology, industrial hygiene measures to reduce hazardous exposures, factors which may aggravate the illness, and resources available to obtain further information and assistance. PMID- 3313773 TI - Multiple chemical sensitivities: summary and directions for future investigators. PMID- 3313772 TI - Workers with multiple chemical sensitivities: psychosocial intervention. AB - Treatment of MCS, an illness characterized by reaction to a multiplicity of factors coming from within the patient and from the social and physical environment, must incorporate multiple types of help, all directed toward supplying what these patients require. Medical, psychiatric, and social work treatment are all significant and all different, with overlap in several areas. As in all practice in the medical setting, the overall function of the social worker is to enable the MCS patient to make use of what the physician has to offer by supporting the patient's capacity to cope with the social and emotional impact of his/her illness. PMID- 3313774 TI - Highly selective vagotomy and serum gastrin levels. AB - Serum gastrin levels were measured preoperatively and at several intervals postoperatively in 262 patients who underwent highly selective vagotomy for duodenal ulcer. An increase of serum gastrin levels was demonstrated postoperatively in all patients, irrespective of sex, length of history, acid secretion data or recurrence. At several years postoperatively, a highly significant secondary rise in serum gastrin levels was observed, which corresponded well to recent physiologic and morphologic data. The most suitable explanation appeared to be that the proximal gastric vagotomy (vagotomy of the fundus and corpus) abolished the vagally mediated inhibition of the G-cells in the antrum (disinhibition of the oxyntopyloric reflex). The serum gastrin values were always higher and the secondary postoperative increase was earlier for patients who had taken cimetidine preoperatively. Contrary to traditional expectations, no correlation at all was found between serum gastrin levels and acid secretion data. Recurrence could not be predicted on the basis of serum gastrin levels. PMID- 3313775 TI - Combined Penrose and silicone drains provide excellent drainage. AB - We designed an effective combination drainage, using available silicone and Penrose drains, the latter placed within the former. Occlusion at the tip by fibrin materials never occurs in clinical application. If complications, such as leakage and abscess have occurred, this drain is extremely effective to ensure drainage and suction or irrigation, or both, as the Penrose drain can be replaced with sump tube drain. This simple hybrid for double lumen drain has proved to be both efficient and safe. PMID- 3313776 TI - [Unwanted side-effects in using mesalazine (5-aminosalicylic acid) during radiotherapy]. AB - In a prospective randomized placebo controlled double blind study, the prophylactic effect of mesalazine (5-aminosalicylic acid. 5-ASA) as suppositories (3 x 250 mg/day) on radiation induced proctitis during radiotherapy for prostatic carcinoma was studied. The study ended when 16 patients had been included (5-ASA: eight, placebo: eight) because of severe side effects in the 5-ASA group. 75% of patients treated with 5-ASA reported symptoms of a severe proctitis while only one patient in the placebo group had similar complaints. The application of mesalazine as suppositories is not useful in preventing radiation induced proctitis during radiotherapy of prostate carcinoma. PMID- 3313777 TI - Hemodynamic assessment of high-compression hosiery in chronic venous disease. AB - Graded high-compression support hosiery have long been recognized as a physiologically significant mode of therapy for chronic venous disease because of their effects on the hemodynamics of venous return. Photoplethysmography (PPG) in the noninvasive vascular laboratory is now recognized as a quick, simple, and noninvasive measurement technique, which correlates well with ambulatory venous pressure in the postphlebitic limb with chronic venous insufficiency. The purpose of this study was to evaluate the hemodynamic effects, as measured by PPG, of 40 mm Hg graded compression support hosiery in the treatment of patients with a documented history of hospital-treated thrombophlebitis. Fifty lower extremities among 38 patients with a documented history of deep vein thrombosis and chronic venous insufficiency were matched against 50 control extremities among patients without disease. All 50 lower extremities in the study group had abnormal noninvasive venous studies, including Doppler ultrasound examination, phleborheography, and PPG (mean, 5.9. seconds). Thus these patients were ascertained to have incompetent deep venous systems, but with normal arterial flow as documented by ankle:brachial ratios. After application of 40 mm Hg gradient compression stockings to the study group, PPG measurements in all 50 limbs initially converted to normal (20.6 seconds). Abnormal PPG measurements were converted to normal in postphlebitic limbs with the application of graded compression stockings in the 29 patients who wore the prescribed hosiery; 21 patients did not wear the gradient stockings after the initial evaluation(s) and were not found to have improved PPG measurements. It can be concluded that such gradient stockings should be associated with a reduction in ambulatory venous pressure, which may, in turn, lead to clinical prevention or improvement of the various sequelae associated with chronic venous hypertension. PMID- 3313778 TI - Ischemic damage prevention by coenzyme Q10 treatment of the donor before orthotopic liver transplantation: biochemical and histologic findings. AB - This study was undertaken to determine whether pretreatment of the donor rat with coenzyme Q10 (CoQ10) would protect against hepatic ischemia induced for 30 minutes at normothermic body temperature. Fresh liver transplants were used as controls (minus warm ischemia of 30 minutes) and gave a 1-week survival rate of 84.6%. CoQ10 was administered intravenously (10 mg/kg body weight) to the donor rat 1 hour before induction of warm ischemia (group A). In another group (B), the same dose was given intravenously not only to the donor rat but also to the recipient rat 1 hour before grafting. None of the placebo group survived more than 2 days. The 1-week survival rates of the groups pretreated with CoQ10 were 45.5% for group A and 50% for group B. There was no significant difference between groups A and B. A statistically significant difference was demonstrated between the placebo group and both CoQ10-treated groups (p less than 0.05). It was therefore assumed that CoQ10, accumulated in the donor liver, was a primary factor in improving survival. Serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), serum alkaline phosphatase (SALP), total bilirubin, and total protein were measured by means of light and electron microscopic examination of the liver 6 months after transplantation. Long-term surviving rats with transplanted, ischemically damaged liver that was pretreated with CoQ10 showed a decrease in the activity of SGOT and SGPT and an increase in levels of total protein to the normal range (as well as to those levels exhibited by fresh-liver-transplanted rats) with practically no change in levels of SALP, total bilirubin, or in histologic findings. These results indicate that donor pretreatment with CoQ10 is useful for increasing survival after warm ischemic damage of rat liver grafts. PMID- 3313779 TI - Low-temperature culture of human islets isolated by the distention method and purified with Ficoll or Percoll gradients. AB - Islets were isolated from human pancreases by the distention method and purified by centrifugation on Ficoll or Percoll gradients. The purity of the final preparations was 60% to 90% islets, making it possible to culture the islet preparations in vitro. Perifusion of the islet preparations after 1, 3, or 7 days of culture at 24 degrees C indicated that the islets were viable and would respond to glucose stimulation. If the islets were returned to 37 degrees C culture for 1 day, then the insulin secretory response at 7 days was comparable with the response during the first day of culture at 37 degrees C. Extending the culture period at 24 degrees C to 14 days damaged the islets as indicated by the lack of response to glucose stimulation. The Ficoll technique was a much more effective method for purifying the islets, since it provided approximately twice the yield of islets and insulin compared with the Percoll procedure. The mean yield of purified islets by the Ficoll technique was 2180 +/- 325 islets/gm of pancreas with a calculated islet mass of 3.7 +/- 0.8 mm3/gm. The findings that massive numbers of purified human islets can be obtained by centrifugation on Ficoll gradients and that the purified islet preparations remain morphologically and functionally intact during 7 days' culture at 24 degrees C make it possible to assess the function of donor islets before human islet transplantation, transplant the islets via the portal vein, and use low-temperature culture as a possible approach for altering the immunogenicity of donor human islets. PMID- 3313781 TI - [Crown construction]. PMID- 3313780 TI - Biliary calculi caused by hemobilia. AB - Formation of biliary calculi caused by hemobilia is rare. Including the two cases reported here, there are only a total of four in the literature. The characteristics of these calculi in vitro, on computerized tomographic scan, and cholecystography are described. The condition for the occurrence seems to be that blood clots remain in the gallbladder sufficiently long (about 6 months) to become encrusted with bile constituents. Patients with hemobilia with clots in the gallbladder should be observed for this complication. PMID- 3313782 TI - [Long-term dispensary observation of patients with so-called low-renin forms of arterial hypertension]. AB - The authors provided an analysis of the results of 3-year follow-up and therapy of 32 patients with hypertension developing with blood renin low activity. A prolonged, statistically significant decrease in the AP level with the improvement of the patients' subjective status was noted in continuous adequate hypotensive therapy. The most severe clinical course was observed in the group of patients with unresected adrenal adenoma. During treatment of patients with primary aldosteronism with spironolactone one should pay attention to the presence of some concomitant diseases (mastopathy, myoma of the uterus) because this drug may turn their course unfavorably, thus making the treatment of patients with adrenal pathology difficult. PMID- 3313783 TI - [Methylxanthine preparations in the therapy of bronchial asthma]. PMID- 3313784 TI - [Indices of body nonspecific reactivity in salmonellosis patients]. AB - A study of the functional-metabolic activity of neutrophilic leukocytes was performed in 54 patients with salmonellosis using cytochemical and luminescent cytofluorimetric methods. The time course of disease revealed regular changes of the most important components of the leukocytic microbicidal system and indices of the NBT test activity depending on a stage, degree of severity, clinical type and type of applied therapy. Profound quantitative and qualitative shifts of the intraleukocytic components of the microbicidal system and indices of the NBT test of neutrophilic granulocytes in the time course of salmonellosis characterized the state of nonspecific body resistance. PMID- 3313785 TI - [Clinical picture of tropical malaria in persons having undergone chemoprophylaxis]. AB - Suppressive therapy with chloroquine and fansidar at standard doses does not prevent malaria at the time of a maximum level of infecting agent transmission but only weakens the expression of clinical manifestations. The main clinical signs are nonspecific symptoms of infectious intoxication. At the seasonal peak of tropical malaria incidence, doses of individual chemoprevention should be doubled as compared to the standard ones. PMID- 3313786 TI - [Normal indices of left ventricular function assessed by using computer technology]. AB - While analysing ventriculograms of 18 persons without any cardiovascular pathology 3 "independent" research workers (to exclude a subjective factor in the appraisal of the left ventricle contours) have developed normal indicators of the total and regional contractility of the left ventricle. The data obtained with the use of angiographic and computer-aided techniques of the recent generation and machine analysis employing unpaired statistics can be recommended for application as normal indicators during the performance of different hemodynamic studies. PMID- 3313787 TI - Origin of abnormality in a human simelian foetus as elucidated by our knowledge of vertebrate development. AB - In this paper we attempt to explain the abnormality of a simelian foetus with reference to our present knowledge of vertebrate development. The various developmental defects seem to have a single common origin: the speeding-up of the progression of cell differentiation in the notochord anlage--which is the organization centre of the embryo--during the regression of the Hensen's node. Cell activity involved in the morphogenetic movements in the chordamesoderm probably stopped before it should have. The elongation of the notochord anlage was not completed, resulting in the defective development of the posterior part of the foetus. A number of pairs of posterior trunk somites were not induced. Consequently (1) the pelvic limb buds, whose posterior parts were missing, fused, bringing in further developmental deviations in the limb skeleton and abdominal muscles; (2) there are no vertebrae between the first sacral vertebra and the misshaped coccyx formed by the tail bud. The derivatives of the posterior endoderm (hindgut, bladder and ureters) were not induced either. The cauda equina is deficient. The absence of functional kidneys and the presence of embryonic urinary tubules in the pelvic cysts which are wrapped up by gut epithelium suggest the induction of the metanephric mesenchyme by ectopic endoderm. The speeding-up of differentiation in the notochord anlage also probably resulted in the excessive extension of its anterior region which is the organizer of brain structures. This explains the overdevelopment of the nose and of the neurocranium, and the low position of the ear. A gene mutation as well as a mechanical stress are the possible causes of the abnormal behaviour of the notochord anlage. PMID- 3313788 TI - Emotional distress and psychosocial adaptation in cancer patients. PMID- 3313789 TI - [Aspirin as a platelet antiaggregant: indications and controversies]. PMID- 3313790 TI - [Posology of drugs in the obese patient]. PMID- 3313791 TI - [Controlled study of a new anti-allergic agent, N-acetyl-aspartyl- glutamic acid (NAAGA), in the local treatment of pollinosis]. PMID- 3313792 TI - [Primary prevention of intermittent claudication and frequently associated arteriopathies]. PMID- 3313793 TI - There were tooth transplants in 1776. PMID- 3313794 TI - The dental secrets of Shakespeare's characters. PMID- 3313795 TI - TIC 1942-1987. PMID- 3313796 TI - [Bone marrow transplantations]. PMID- 3313797 TI - [Allogeneic bone marrow transplantation in Norway]. PMID- 3313798 TI - [Information retrieval by automatic data processing. Who is to search medical literature?]. PMID- 3313799 TI - [Sewage sludge]. AB - Current knowledge of sewage sludge is reviewed, particular reference being made to the possible effect on the health of herds of cattle. The following measures should be urgently and seriously considered: more effective watching of sewage disposal; assessments on sewage disposals, related to the costs of alternatives; stricter checks on diffuse sources of pollution (refuse dumps, agriculture, etc.); development of long-term views to prevent the appearance of waste matter injurious to health and putting a stop to methods of production in which these wastes are released. The disposal of toxic substances in the environment was reduced by fifty per cent in particular sections during the past five years. When this is chosen as an objective, the Netherlands will be clean in approximately fifty years. In the opinion of experts, this would appear to be a practical approach which can be accomplished by considerable economic efforts. When the thoughtless disposal of toxic substances comes to an end, it will be possible to use sewage sludge in agriculture without this becoming a hazard to the health of animals and man. PMID- 3313801 TI - [Meat poisoning in one family. By K. Hoefnagel, 1899]. PMID- 3313800 TI - [Meat poisoning. By H.J.H. Stempel, 1891]. PMID- 3313803 TI - [Piroplasmoses studies in The Netherlands and its colonies. By Prof. L. de Blieck, 1916]. PMID- 3313802 TI - [Health and fertility in relation to production. Embryonal mortality in swine: incidence and possibilities for prevention]. AB - The embryonic mortality rate in the pig is 20-40%. Part of the variation in incidence is due to breed differences. Unavoidable chromosome mutations are unimportant as a cause of embryonic mortality. Within breeds, the incidence depends on factors such as the boar, the interval between parturition and conception, the time of insemination in relation to ovulation, and the level of feeding and stress during early pregnancy. If these factors are taken into consideration, the incidence of embryonic mortality can be reduced. The aetiology of a part of the embryonic mortality is still unknown, and it is thus difficult to predict whether this part can be prevented. In this context, however, recent publications on the relationship between variation in early embryonic development and embryonic mortality, and on the positive effect of the administration of exogenous steroids during early pregnancy on litter size, are promising. PMID- 3313804 TI - [History of pediatric surgery]. AB - For almost two millennia, the sick child received little or no care from physicians. In contrast, the barber-surgeons did treat children of all ages, sometimes leaving behind detailed descriptions of these cases. A gradual awareness of childhood as a separate developmental phase brought to light the characteristic features of childhood diseases, resulting in the genesis of paediatrics. The advent of anaesthesia then led to the development of paediatric surgery as we know it today. PMID- 3313805 TI - [Dr. R.J. Harrenstein, the first pediatric surgeon in The Netherlands]. PMID- 3313806 TI - [Congenital hip dislocation and dysplasia]. AB - In this article a review is presented of the current concepts of diagnosis and treatment of congenital dysplasia of the hip. PMID- 3313807 TI - Multicentric giant lymph node hyperplasia, plasma cell type, with monoclonal gammopathy. AB - The association of multicentric giant lymph node hyperplasia (MGLH) of plasma cell type with monoclonal gammopathy was observed in a 37-year-old man. The present case provides an additional new piece of evidence that MGLH is by no means a benign disorder but can transform into plasma cell dyscrasia or B-cell lymphoma. PMID- 3313808 TI - A great improvement of fusion efficiency in mouse B cell hybridoma production by use of the new culture medium, GIT. AB - The recently established culture medium, GIT, is applicable to many kinds of cells including mouse and human myeloma cells, and most adhesive cell lines. We applied this GIT medium to mouse B cell hybridoma production. When the medium was used to propagate myeloma cells before cell fusion and also for HAT selective medium, the fusion efficiency was more than twice as high as when the regular medium (RPMI-1640 supplemented with FBS) was used. Constantly more than 80% wells were hybridoma positive irrespective of the antigens used. To determine the optimal cell concentration at the hybridoma selection, a graded number of myeloma and spleen cells was distributed to each well; the best result was obtained when 3 X 10(4) myeloma and 3 X 10(5) spleen cells were distributed to each well. In addition, the GIT medium shows very little lot-to-lot variation. These results indicate that fusion efficiency in mouse B cell hybridoma production was greatly improved by using GIT medium. PMID- 3313809 TI - Pricing hospital services. Pricing constraints. PMID- 3313810 TI - Chemical reactivity, cytotoxicity, and mutagenicity of chloropropanones. AB - Studies were conducted to assess the in vitro toxicity of three chloropropanones: monochloropropanone (MCP), 1,1-dichloropropanone (1,1-DCP), and 1,3 dichloropropanone (1,3-DCP). Chloropropanones reacted directly with reduced glutathione (GSH) in sodium phosphate buffer at pH 7.4. All chloropropanones were cytotoxic to suspensions of male rat hepatocytes in a concentration range of 0.5 10 mM. Cytotoxicity was preceded by rapid decline in cellular GSH levels. Mutagenic potencies among the chloropropanones in Salmonella typhimurium bacteria differed greatly. 1,3-DCP was mutagenic in the nanomole range, 1,1-DCP was weakly mutagenic in the micromole range, and MCP was not mutagenic. Mutagenicity of the dichloropropanones was evident without metabolic activation. These results suggest that the three chloropropanones may, in part, be directly cytotoxic but only 1,3-DCP and 1,1-DCP are directly mutagenic. PMID- 3313811 TI - The pathophysiology of proximal neurofilamentous giant axonal swellings: implications for the pathogenesis of amyotrophic lateral sclerosis. AB - Neurofilamentous giant axonal swellings are observed in a number of human disorders, although they can manifest at different locations (i.e. proximal or distal) along the axon. Recent advances in understanding the pathogenesis of these changes has resulted from correlations of ultrastructural changes with abnormalities in the axonal transport of neurofilament proteins in experimental models produced by toxic chemicals. Using single, high doses of either acrylamide or 2,5-hexanedione, a reduction in neurofilament transport has been shown in the rat sciatic nerve. In contrast to the distal axonal swellings observed upon repeated exposures to these agents, modest proximal axonal swellings containing increased neurofilament content are found following high dose exposures. Thus, regardless of the location of swelling production, a defect in slow transport appears to underlie swelling formation. beta,beta'-Iminodipropionitrile (IDPN) produces proximal neurofilamentous giant axonal swellings which are indistinguishable from those observed in some patients with amyotrophic lateral sclerosis (ALS). Although not a model for ALS, IDPN provides a means to study the functional consequences of proximal giant axonal swellings. Intracellular recordings from IDPN-intoxicated cats reveal a number of abnormalities which may have electrophysiological counterparts in ALS, suggesting that the swellings may be important in the expression of the disease. Although axonal degeneration is rarely observed in the cat, perikaryal recordings reveal a number of alterations which are strikingly similar to those obtained from chromatolytic motor neurons following nerve transection. A perturbation of "trophic" signals from the periphery may be involved in the generation of axotomy-like changes in IDPN intoxicated cats. PMID- 3313812 TI - A competitive radioimmunoassay using a monoclonal antibody to detect the factor X activator of Russell's viper venom. AB - A radioimmunoassay (RIA) has been developed for the detection of Russell's viper venom in body fluids. This is a competitive binding technique using a monoclonal antibody directed against the factor X activator of Russell's viper venom. The sensitivity of the test in urine was 4 ng/ml, in 0.1% bovine serum albumin phosphate buffered saline it was 20 ng/ml and in serum it was 5 micrograms/ml. This was adequate to detect venom in the serum of four patients bitten by Russell's viper. Urine from an isolated kidney preparation perfused with Russell's viper venom contained coagulant activity and was positive using the competitive RIA. Testing of sera from other envenomated patients and pure venom from seven other species of snake indigenous to Thailand revealed RIA cross reactivity between cobra venom and Russell's viper venom. In practice, the absence of coagulant activity in cobra venom clearly distinguishes between the two. Although further development is required to elucidate the serum factors interfering with this assay, this is a promising technique, which is of potential value in the diagnosis and investigation of the pathophysiology of Russell's viper envenomation. PMID- 3313813 TI - Venom from southern copperhead snake (Agkistrodon contortrix contortrix). I. Characterization of a protease that preferentially releases fibrinopeptide B. AB - Using gel permeation chromatography with high performance liquid chromatograph (HPLC), a highly purified preparation of a protease has been obtained from the venom of the southern copperhead snake (Agkistrodon contortrix contortrix). Both gel permeation chromatography with HPLC and sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that it had an apparent Mr of 60,000-64,000. It consisted of a single polypeptide chain. The activity was inhibited by dithiothreitol. It neither induced platelet aggregation nor activated plasma factor XIII. It cleaved fibrinopeptide B at a rate much faster than fibrinopeptide A from fibrinogen. This specificity was steadily lowered when the incubation temperature was elevated from 0 degrees C to 45 degrees C. Fibrinopeptides were released only at neutral pH. PMID- 3313814 TI - Common Names Index. Poisonous animals, plants and bacteria. PMID- 3313815 TI - Detection of alpha 2-pregnancy associated-glycoprotein (alpha 2-PAG) in cultured human peripheral blood mononuclear cells. AB - A study of the detection of alpha 2-pregnancy associated-glycoprotein (alpha 2 PAG) by double immunofluorescence in cultured human peripheral blood mononuclear cells (MNC) was performed. MNC was obtained from four healthy adults and isolated on a Ficoll-Hypaque density gradient. MNC was incubated with RPMI-1640 with or without pokeweed mitogen in 5% CO2/air at 37 degrees C for six days. MNC was initially stained with rhodamine-conjugated antihuman IgA, IgM, and IgG antisera, and then stained with FITC-conjugated antihuman alpha 2-PAG antisera. It was concluded that alpha 2-PAG was not produced by IgA, or by IgM and IgG producing cells in healthy adults. PMID- 3313816 TI - Siblings with IgA nephropathy and diffuse proliferative glomerulonephritis (PGN) associated with identical HL-A antigens. AB - Siblings with IgA nephropathy and diffuse proliferative glomerulonephritis without mesangial IgA deposits (PGN) who had identical HL-A antigens are described. A 21-year-old woman suffered from IgA nephropathy and her 27-year-old sister showed diffuse proliferative glomerulonephritis (PGN) distinct from IgA nephropathy. These siblings had identical HL-A alloantigens which were A2, Aw24; Bw16, Bw35; Cw4, Cw7; DR4. Microhematuria and increased serum IgA levels were shown in their father and other sister but renal biopsies were not performed. The serotypes for the HL-A antigens of their father and other sister were A2, Aw24; Bw27, Bw35; Cw4; DR4 and A2; Bw16; Cw7; Dr2, respectively. It is demonstrated that IgA nephropathy and PGN share a common HL-A phenotype including DR4. It is postulated that the presence of DR4 antigens is not directly related to the occurrence of IgA nephropathy. PMID- 3313817 TI - Comparison of lingual sulcus depth obtained with three impression materials. PMID- 3313818 TI - Nitrous oxide pollution hazards and their prevention in dentistry. PMID- 3313819 TI - [Changes in the amount of gingival fluid during controlled tooth cleaning]. PMID- 3313820 TI - [Experience with improving the laboratory stages of preparing porcelain jacket crowns]. PMID- 3313821 TI - [Method of fixing dentures to the edentulous mandible using magnets made of SmCo5]. PMID- 3313822 TI - [Effect of the method of plastics polymerization on the roughness of the inner surface of plate dentures]. PMID- 3313824 TI - [Psychological preparation of patients prior to oral prosthesis]. PMID- 3313823 TI - [The dental clinic of the '20s (on the 65th anniversary of the creation of the State Institute of Dentistry)]. PMID- 3313825 TI - [Effect of tobacco on oral tissues and biochemical indices]. PMID- 3313826 TI - [History of the development and outlook of local injection anesthesia of the teeth]. PMID- 3313827 TI - Early adventures in drug metabolism. 3. Chloramphenicol. AB - The saga of our early experiences with drug metabolism studies in the Parke-Davis Research Laboratories continues with a brief resume of the behavior of chloramphenicol under unusual clinical conditions and a consideration of the toxic effects of this drug and its metabolites in laboratory animals and in humans. The dose-related reversible effects of chloramphenicol upon the ferrokinetic pattern and cellular respiration are clearly separated from its nonreversible effects on the bone marrow cells of susceptible individuals. A number of possible research approaches are suggested for the exploration of these problems. PMID- 3313828 TI - Bone marrow transfers in X-irradiated mice congenic at the lpr locus: some paradoxical effects. AB - MRL/l mice, which are homozygous at the lpr locus, can be inhibited in lpr phenotype expression (lymphadenopathy, accelerated death) by a transfer of MRL/n bone marrow cells following X-irradiation of the recipients (MRL/n bone marrow--- X-irradiated MRL/l chimeras). Female MRL/l bone marrow----X-irradiated MRL/l chimeras express the lpr phenotype with a delay corresponding to the age at the time of cell transfer. However, the equivalent male chimeras resemble MRL/n bone marrow----X-irradiated MRL/l chimeras. When the reverse MRL/l bone marrow----X irradiated MRL/n chimeras are constructed, one finds that whichever the sex is, the chimeras undergo a wasting disease looking like a graft-versus-host disease, with particularly a marked atrophy of the spleen. A similar GVH like disease is observed with C57Bl/6 lpr bone marrow----X-irradiated C57Bl/6 normal mice. These animals survive at least 5 months but manifest a spleen aplasia. When reconstituted with MRL/n bone marrow, MRL/l recipients develop higher levels of antinuclear and anti-ds/ss DNA antibodies than MRL/n recipients. This suggests that the 'lpr environment' of the host may have an influence on the development of B cell hyperactivity. PMID- 3313829 TI - Immunodetection of the thymic epithelial P19 antigen in cultures of normal and pathological human thymic epithelium. AB - We investigated by an immunofluorescence assay the presence of the P19 antigen in cultures of human thymic epithelial cells (HTEC). This antigen is acquired during human thymic ontogeny, and in infants and adults most thymic epithelial cells were shown to display P19 antigen. In cultures of normal human thymic epithelium, we observed that the P19 protein was less expressed than in situ. However, the percentage of P19-containing cells increased with culture age, a finding which could be compared to that obtained recently concerning immunodetection of thymulin-containing cells. Indeed, thymic epithelial cells keep their endocrine function in culture and the number of thymulin-positive cells increases as a function of time. Interestingly, the increase of P19 expression was generally parallel to that of thymulin production. These data may reflect functional modifications of the cells in relation to differentiative effects. Similar results were obtained in pathological thymuses described as hyperplasia in M G patients. In contrast, thymomas behaved differently. Among the three benign thymomas tested, two were consistently P19-negative or faintly stained in culture conditions while one was very brightly stained from the onset and remained P19 positive throughout the culture; this finding correlates with studies on frozen sections. Our data show modifications of P19 antigen expression both in culture and in thymomas and suggest that P19 synthesis may be dependent upon components (factors or cells) which are efficient in the thymic microenvironment but partially defective in the cultures or after neoplastic transformation. PMID- 3313830 TI - A visit by the President to the College of Physicians of Philadelphia on the occasion of the celebration of its 200th anniversary April 1, 1987. A Presidential forum on health issues. PMID- 3313832 TI - William H. Erb 1907-1987. PMID- 3313831 TI - A Presidential forum on health issues. A historical summary. PMID- 3313833 TI - Katharine R. Sturgis 1903-1987. PMID- 3313834 TI - Objections to compulsory health insurance. By Gordon J. Saxon. 1920. PMID- 3313835 TI - Effect of a new immunosuppressant, 15-deoxyspergualin, on heterotopic rat heart transplantation, in comparison with cyclosporine. AB - In this study, 15-deoxyspergualin (DSG) or cyclosporine (CsA) was administered to heterotopically heart-grafted rats for 15 days, commencing on the day of transplantation. In addition, a 31P nuclear magnetic resonance (NMR) technique was applied to investigate the in vivo energy metabolism of the graft. A significant prolongation of graft survival was observed in groups treated with 2.5 mg/kg and 5 mg/kg of DSG, when compared with the control group not treated with an immunosuppressant. One graft in the DSG 2.5 mg/kg-treated group and one in the 5 mg/kg-treated group survived for more than 100 days after grafting. The 31P NMR study demonstrated that, although rejection occurred in the rats treated with 2.5 mg/kg of DSG during the early period after transplantation, 5 mg/kg of DSG inhibited rejection completely. As for CsA, while 2 mg/kg of the drug did not affect graft survival, 5 mg/kg and 14 mg/kg significantly prolonged survival. It was revealed by 31P NMR, however, that CsA 5 mg/kg did not quite inhibit rejection by itself, and 14 mg/kg of CsA, which was the tolerogenic dose, exerted a cardiotoxic effect. In consequence, DSG seems to be a powerful immunosuppressant with a low toxic effect. PMID- 3313837 TI - Two patterns of sensitization demonstrated by recipients of donor-specific transfusion. Limitations to control by Imuran. AB - Characteristics of the sensitization response to donor-specific transfusion (DST) have been studied in the context of the pretransfusion panel reactive antibody (PRA) status of the recipient. Two distinct patterns of response to DST and Imuran treatment have been found. In patients with one-haplotype-matched donors, the panel nonreactive patient (PRA less than 10%) has a 19% incidence of DST sensitization that is further reduced by Imuran treatment to 6%; antibodies are both anti-T cell and anti-B cells, are transient, and are specific to the mismatched HLA antigens of the blood donor. Panel-reactive patients (PRA greater than 10%) have a 56% incidence of DST sensitization; the antibodies appear within 2 weeks of the first transfusion, are anti-T cell, and are generally of broad specificity and persistent duration consistent with amplification of a previous antigenic exposure; Imuran seems to have little or no effect in reducing the incidence of sensitization in these panel-reactive patients. However, panel reactive patients whose PRA levels spontaneously fall to panel-nonreactive levels immediately prior to DST therapy have an exceedingly low (0-8%) incidence of sensitization with or without Imuran coverage. PMID- 3313836 TI - Engraftment following T-cell-depleted bone marrow transplantation. II. Stability of mixed chimerism in semiallogeneic recipients after total-body irradiation. AB - Chronic, stable mixed chimerism of both lymphocytes and erythrocytes was observed in semiallogeneic murine recipients of T-cell-depleted bone marrow transplants that had been conditioned with supralethal total-body irradiation (1100 cGy). Mixed chimerism was extensive, with a wide range of donor engraftment persisting for at least one year after transplant. In both erythrocyte and lymphocyte lineages, decreasing donor engraftment correlated with decreasing marrow dose; however, complete red cell engraftment was more easily achieved than complete lymphocyte engraftment. There were no late graft failures, even among animals exhibiting a substantial host component of hematopoiesis. The extent of mixed hematopoietic chimerism therefore appears to be much greater than had been expected in recipients of T-cell-depleted bone marrow transplants. PMID- 3313838 TI - Toxoplasma antibody titers in renal transplant recipients. Pretransplant evaluation and posttransplant follow-up of 73 patients. AB - In 73 consecutive kidney transplant recipients, anti-Toxoplasma antibodies were determined before transplantation and during a 3-year follow-up after transplantation. In 9 patients, antibody titers increased significantly after transplantation. Antibody titers to various viral antigens determined in parallel remained unchanged, suggesting that the anti-Toxoplasma antibody increase was not due to polyclonal nonspecific stimulation. In 2 of the 24 pretransplant seronegative patients, acquired toxoplasmosis was diagnosed serologically after transplantation, with the observation of a strong IgM and IgG antibody response. The incidence of toxoplasmosis in this group of patients was not found to be significantly different from that in a normal population, suggesting that transmission of Toxoplasma from the transplanted kidney may not be a significant mode of contamination. Among the 49 patients who were seropositive before transplantation, reactivation of toxoplasmosis was suspected in 7 cases on the basis of a significant increase in IgG antibodies. Reactivation occurred more frequently in patients treated with azathioprine and antithymocyte globulin, and a direct relationship between administration of steroids and antibody increase was demonstrated in three patients. Although toxoplasmosis has occasionally been reported as a major infectious problem in kidney transplant recipients, our clinical and serological data show that the potential risk of developing Toxoplasma infection is low since none of the patients with either acquired or reactivated toxoplasmosis developed clinical disease. PMID- 3313839 TI - Specific and nonspecific immunoregulatory factors and renal transplantation. AB - From a study population of 208 consecutive first cadaver renal transplant recipients a proportional hazard model was used to simultaneously quantify the role in graft failure of matching for specific HLA antigens and constitutional factors (age, sex, duration of dialysis (Dt), and pre- (PTr) and peri-(PerTr) operative transfusions) that influence nonspecific immune response. A comparison was also made of graft survival in patients treated by the two principal methods of dialysis, hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). The advisability of including nonimmunological failures in studies of graft survival was also considered. The analysis indicated that factors influencing a patient's innate nonspecific immune response (e.g., Dt and PTr) are important determinants of graft survival and should be taken into account when considering matching for specific HLA-B or DR antigens prior to transplantation. While there was no overall effect of dialysis type on graft survival, the influence of other risk factors depended on the method of dialysis. Failure to identify and exclude graft loss for nonimmunological reasons can give rise to misleading conclusions in analysis of immunoregulatory factors in organ transplantation. PMID- 3313840 TI - Kidney transplant recipients with long incubation-positive antiglobulin-negative T cell crossmatches. AB - Low-affinity, cold-reactive antibodies easily removed by washing were not detected by the antiglobulin technique but killed T lymphocytes when washing was omitted, incubation was prolonged, and cytotoxic tests were incubated at room temperature or at 4 degrees C. These antibodies were present in approximately 25% of sera from dialysis patients. Only a subset of such sera (22%) reacted with autologous lymphocytes. The majority (86%) appeared to detect non-HLA antigens. A small number (14%) detected class I HLA antigens. Two patients transplanted with antiglobulin-negative, T-warm-negative crossmatch results, but positive cytotoxicity after a 2-hr incubation without washing, rapidly lost their grafts (less than 1 month) due to rejection. Their sera contained antibodies against non HLA alloantigens expressed on lymphocytes and platelets, but not on granulocytes or erythrocytes. Two other patients with positive autoantibody tests exhibiting similar crossmatches with the current serum were transplanted recently. Both of them retain their grafts with good function at one month. In two other cases, the recipients were unreactive against the donor in current serum but displayed an antiglobulin-negative, 2-hr cytotoxicity-positive pattern in a previously drawn serum specimen. One patient continues to have stable renal function after 10 months. The other patient lost the transplant as a result of renal artery thrombus thought not to be immunologic in origin. Work is continuing to define the specificity and determine the clinical relevance of such cold-reactive antibodies. PMID- 3313841 TI - Impairment of prednisolone metabolism by cyclosporine treatment in renal graft recipients. AB - Pharmacokinetics of prednisolone were studied in 64 randomly chosen renal transplant patients treated with azathioprine and prednisolone (Aza-Po) or cyclosporine and prednisolone (CsA-Po). Intrinsic clearance for prednisolone was calculated after an oral test dose of 0.5 mg prednisolone/kg bodyweight. In 38 patients on Aza-Po treatment the mean clearance for prednisolone was 0.17 +/- 0.04 1/kg/hr (range 0.11-0.27) and in 39 patients on CsA-Po the mean prednisolone clearance was 0.12 +/- 0.02 (0.07-0.17) (P less than 0.001). Eight patients on CsA-Po were tested on three occasions; prednisolone clearance at 2-4 weeks was 0.13 +/- 0.02 (range 0.11-0.17), at 3-6 months 0.11 +/- 0.01 (0.10-0.12) and at 2 5 years 0.11 +/- 0.02 (0.09-0.14). In 11 patients the treatment was changed from Aza-Po to CsA-Po. The prednisolone clearance then decreased from 0.18 +/- 0.05 1/kg/hr (range 0.13-0.27) to 0.12 +/- 0.03 (0.10-0.16) (P less than 0.001). When the treatment was changed from CsA-Po to Aza-Po in 2 patients the prednisolone clearance increased from 0.12 and 0.10 to 0.17 and 0.12 1/kg/hr, respectively. These data show not only that the prednisolone metabolism is slower in cyclosporine-treated patients but also that this metabolism is retarded when azathioprine is replaced by cyclosporine, and that it is accelerated when cyclosporine is replaced by azathioprine. In the CsA-Po treated patients the prednisolone clearance was also found to be lower after 3-6 months than after less than one month (P less than 0.05) but there has been no further decrease in the prednisolone metabolism after up to more than 4 years of cyclosporine treatment. PMID- 3313842 TI - EKTACHEM bilirubin fraction Bc as a predictor of liver transplant rejection. AB - Bilirubin fractions Bc and DELTA, not routinely available prior to the EKTACHEM Chemistry Analyzer and its slide methodology, were studied in an outpatient population of liver transplant recipients. A preliminary evaluation by the authors has shown that direct bilirubin (DBILI) levels in the normal range consist almost exclusively of DELTA (protein-bound conjugated bilirubin), while at elevated DBILI levels, an increasing amount of Bc (non-protein-bound conjugated bilirubin) is measured as well. The present study evaluated the clinical significance of Bc in the serum of 80 liver transplant recipients as a means of identifying episodes of rejection. Each patient was classified into rejection or nonrejection categories based on clinical status, liver biopsy results, and/or response to therapy. Eighteen patients were classified as experiencing an episode of rejection during the period of this study. Fourteen of these (77.8%) had Bc levels that ranged from 0.1 to 6.8 mg/dl. Sixty two patients were classified in the nonrejection category. Fourteen (22.6%) of these patients had Bc levels that ranged from 0.1 to 0.6 mg/dl. In our outpatient liver transplant recipients with Bc greater than or equal to 0.1 mg/dl, the relative risk of rejection (% of rejection patients with Bc/% of nonrejection patients with Bc) was 3.44. This value indicates that Bc determination may be a helpful adjunct in the assessment of rejection. PMID- 3313844 TI - Markers of allograft viability in the rat. Relationship between transplantation viability and liver function in the isolated perfused liver. AB - The relationship between transplant viability and liver function has been examined. Wistar rat livers were preserved at 4 degrees C for increasing intervals and then transplanted into Wistar rat recipients. Two critical times were identified, the longest preservation period with 100% transplantation success (4 hr) and the shortest preservation period with 100% transplant failure (8 hr). The comparable critical times were also identified in livers preserved at 37 degrees C (1 hr and 2 hr). Liver functions were studied by the isolated perfused liver technique in other rat livers stored at 4 degrees C or 37 degrees C for the critical times. Two liver function tests, AST and LDH concentration in perfusate, discriminated between viable and nonviable livers across as well as within preservation groups. AST gave the best separation between viable and nonviable livers. Some functions such as ALT concentration in perfusate separated viable from non viable allografts only within preservation groups. Other liver functions were more sensitive to preservation temperature than allograft viability. Oxygen consumption after cold preservation for either critical time was about twice control levels. Urea production was far below control levels in warm-preserved livers but almost normal in cold-preserved livers. Our results indicate that AST release into perfusate can be used as a screening technique to optimize preservation methods, reserving transplantation for confirming the most promising results. PMID- 3313843 TI - Differentiation of presumed sepsis from acute graft-versus-host disease by C reactive protein and serum total IgE in bone marrow transplant recipients. AB - Fever after bone marrow transplantation may indicate the onset of bacterial or opportunistic infection, or acute graft-versus-host disease (GVHD). In an attempt to differentiate between infection and GVHD, we prospectively studied 41 bone marrow transplants in 38 patients (24 allogeneic, 17 autologous). Elevation of C reactive protein (CRP) proved to be a good indicator of disseminated infections. In 40 episodes of documented (11) or presumed (29) sepsis, CRP rose above 5 mg/dl in 38 episodes (95%), and above 10 mg/dl in 32 episodes (80%). The CRP concentration paralleled the clinical course of the infectious episodes. Elevated CRP values were not observed in the 15 episodes of acute GVHD without concurrent infection. High peak values of serum total IgE, ranging from 4-fold to over 4000 fold baseline, were observed posttransplant in 18/22 allogeneic BMT recipients, temporally associated with activation of acute GVHD. IgE was elevated neither in episodes of sepsis without concurrent GVHD, nor in viral or focal bacterial infections. In general, septic infections were characterized by high CRP but low IgE levels. Acute GVHD without concurrent infection was characterized by high IgE but low CRP. We conclude that CRP and serum total IgE utilized together in serial fashion are helpful in distinguishing sepsis from acute GVHD. PMID- 3313846 TI - The latex isolator bag--an aid to intraperitoneal organ transplantation in the rat. PMID- 3313845 TI - Cyclosporine-associated thrombotic thrombocytopenic purpura following liver transplantation--successful treatment with plasma exchange. PMID- 3313847 TI - Suppression of thymidine incorporation into alloresponding adult peripheral blood leukocytes in vitro by cyclosporine-pretreated human fetal isletlike cell clusters. PMID- 3313848 TI - Successful renal transplantation of a poorly functioning HLA-identical kidney with reflux nephropathy. PMID- 3313849 TI - Bladder stones as an unusual cause of posttransplant macroscopic hematuria. PMID- 3313850 TI - A new technique of pancreatic exocrine diversion to the esophagus in canine segmental pancreatic autotransplantation. PMID- 3313852 TI - European Society for Organ Transplantation. Third congress. Gothenburg, Sweden, June 11-13, 1987. Proceedings. PMID- 3313851 TI - Toxoplasmosis in two renal transplant recipients from a single donor. PMID- 3313853 TI - Preoperative graft reperfusion with a calcium antagonist improves initial function: preliminary results of a prospective randomized trial in 110 kidney recipients. PMID- 3313854 TI - Rapid indication of allograft function in liver transplantation. PMID- 3313855 TI - Indication, technique, and results of liver graft volume reduction before orthotopic transplantation in children. PMID- 3313856 TI - The influence of combined pancreatic and renal transplantation on advanced diabetic retinopathy. PMID- 3313857 TI - HLA matching analysis of cyclosporine-treated cadaver kidneys transplanted in 1986. PMID- 3313858 TI - The influence of HLA matching in cardiac allograft recipients in a single center. PMID- 3313859 TI - Expression of donor and recipient class I and class II major histocompatibility complex antigens in human liver grafts. PMID- 3313860 TI - Rapid immunodiagnosis of kidney rejection by using activation markers on kidney tubular cells and infiltrating T subset cells. PMID- 3313861 TI - Comparison of segmental pancreatic transplantation with duct obstruction and pancreaticoduodenal transplantation with enteric diversion. PMID- 3313862 TI - Triple therapy including cyclosporine A versus conventional regimen--a randomized prospective study in pediatric kidney transplantation. PMID- 3313863 TI - Improved renal graft function in triple-drug treatment with low-dose cyclosporine. PMID- 3313864 TI - Comparison of antithymocyte globulin antirejection treatment in renal transplant patients with either cyclosporine or azathioprine as basic immunosuppression. PMID- 3313865 TI - Morphological findings in kidney transplants before and after late conversion from cyclosporine A to azathioprine. PMID- 3313866 TI - Conversion of immunosuppression in renal allograft recipients from cyclosporine A to azathioprine and prednisolone 6 months after transplantation. PMID- 3313867 TI - Diabetic polyneuropathy and renal transplantation. PMID- 3313868 TI - Additive effects of cyclosporine and cold preservation upon the integrity of the renal cortical microcirculation. PMID- 3313869 TI - Prophylactic antilymphocyte globulin and HLA-DR matching reduce the incidence of rejection after cadaveric kidney transplantation. PMID- 3313870 TI - Role of HLA matching and pretransplant blood transfusions in cyclosporine-treated recipients of cadaveric renal allografts: 2- to 3-year results. PMID- 3313871 TI - Retransplantation of renal grafts: prognostic influence of previous transplantation. PMID- 3313873 TI - HLA class II induction and cellular infiltration are effectively suppressed by triple therapy in renal allografts. PMID- 3313872 TI - Causes and consequences of previous allosensitization in recipients of cadaveric renal grafts. PMID- 3313874 TI - Differentiation of cyclosporine A-induced nephrotoxicity from acute rejection in renal transplantation using fine-needle aspiration biopsies. PMID- 3313875 TI - Thromboxane and inflammatory cell infiltration of the allograft of renal transplant patients. PMID- 3313876 TI - Predicting waiting time for a beneficially matched graft. PMID- 3313877 TI - Renal transplantation in South America. PMID- 3313878 TI - Follow-up of donors in living related renal transplantation. PMID- 3313879 TI - Donor-recipient DR antigen combinations in cadaver renal graft survival: a new approach to recipient selection. PMID- 3313880 TI - Lewis blood group and HLA matching in renal transplantation. PMID- 3313881 TI - The impact of repeated DR mismatching and preformed antibodies on human kidney retransplantation. PMID- 3313882 TI - Plasma exchange in the treatment of vascular rejection. Relationship between histological changes and therapeutic response. PMID- 3313883 TI - Application of prostacyclin analogue and thromboxane synthetase inhibitor to chronic vascular rejection after kidney transplantation. PMID- 3313884 TI - Cyclosporine in living related renal transplantation--single unit experience. PMID- 3313885 TI - Optimal results in cadaver-donor renal transplantation using prophylactic ALG, cyclosporine, and prednisone. PMID- 3313886 TI - Triple drug immunosuppression (cyclosporine, azathioprine and low-dose prednisolone): a safe and effective regimen in first-cadaver kidney transplantation. PMID- 3313887 TI - Low-dose cyclosporine, ALG, and steroids in first cadaveric renal transplants. PMID- 3313888 TI - Low-dose triple immunosuppression in pediatric cadaveric renal transplantation. PMID- 3313889 TI - Improved results of pediatric renal transplantation. PMID- 3313890 TI - Low-dose cyclosporine monotherapy in renal transplantation. PMID- 3313891 TI - The influence of preexisting clinical vascular disease on patient and graft outcome in diabetic and nondiabetic recipients of primary cadaver kidney transplants. PMID- 3313892 TI - Role of coronary angiography and heart surgery in care of kidney transplant recipients. PMID- 3313893 TI - Transplantation in Jehovah's Witnesses. PMID- 3313894 TI - Nodular regenerative hyperplasia of the liver in renal transplantation. AB - In our series of RT three cases of diffuse NRH of the liver were found. This rare entity is characterized by nodules of regenerative hepatocytes distributed throughout the liver without fibrosis. The incidence was 12.5% and probably is underestimated. Clinically, hepatomegaly, moderate thrombopenia and an elevation of GGT were present, but no case was previously suspected. NRH can lead to PH, and we should think of this entity in the differential diagnosis of PH following RT. PMID- 3313895 TI - Hepatic sinusoidal dilatation with portal hypertension during azathioprine treatment: a cause of chronic liver disease after kidney transplantation. PMID- 3313896 TI - Studies of post-transplant glomerulonephritis in patients immunosuppressed with cyclosporine A. PMID- 3313897 TI - Magnetic resonance imaging in renal transplants. PMID- 3313898 TI - Expression of class II antigens in human renal allografts: comparison of acute rejection, chronic rejection, and cyclosporine nephrotoxicity. PMID- 3313899 TI - Calcium, hyperparathyroidism, and vitamin D metabolism after kidney transplantation. PMID- 3313900 TI - Serum prolactin levels after kidney transplantation. PMID- 3313901 TI - Influence of type of immunosuppressive therapy on gastrin, insulin, glucagon, and pancreatic polypeptide secretion in kidney transplant patients. PMID- 3313902 TI - Polyclonal lymphoma confined to renal allograft: case report. PMID- 3313903 TI - Disseminated Kaposi's sarcoma--full regression after withdrawal of immunosuppressive therapy: report of a case. PMID- 3313904 TI - Kidney transplantation in sensitized patients. PMID- 3313905 TI - Council of Europe study of high sensitization in renal transplantation. PMID- 3313906 TI - Graft survival in highly sensitized patients. PMID- 3313907 TI - Can the profile of preformed HLA antibodies in highly sensitized recipients influence the outcome of their kidney transplants? PMID- 3313908 TI - Plasma exchange and immunosuppressive therapy before renal transplantation in allosensitized patients. PMID- 3313909 TI - Extracorporeal immunoadsorption of anti-HLA antibodies: preliminary clinical experience. PMID- 3313910 TI - Immunosuppressive quadruple drug induction therapy sensitized renal allograft recipients. PMID- 3313911 TI - Long-term results of renal transplantation in Europe. PMID- 3313912 TI - Renal transplantation: complications and results in the second decade. PMID- 3313913 TI - Late mortality and morbidity at 5 to 18 years after kidney transplantation. PMID- 3313914 TI - Long-term prognosis after cadaveric kidney transplantation. PMID- 3313915 TI - Long-term prognosis of renal transplantation: a retrospective study of 90 patients living more than 10 years with a functioning allograft. PMID- 3313916 TI - Long-term results in kidney transplantation: patient and graft survival, causes of graft failure and mortality, renal function and complications after 10 years. PMID- 3313917 TI - Study of 172 patients at 10 to 21 years after renal transplantation. PMID- 3313918 TI - Dynamic evaluation of the coronary circulation in human orthotopic heart transplants. PMID- 3313919 TI - The diagnosis of lung rejection and opportunistic infection by transbronchial lung biopsy. PMID- 3313920 TI - Diagnosis of rejection in rat lung allografts by bronchoalveolar lavage. PMID- 3313921 TI - Sensitivity and specificity of cyto-immunological monitoring in correlation with endomyocardial biopsies in heart transplant patients. PMID- 3313922 TI - Electrocardiographic parameters in allograft rejection after orthotopic cardiac transplantation. PMID- 3313923 TI - Extracorporeal circulation with membrane oxygenation as a bridge to transplantation in cardiac surgical patients. PMID- 3313924 TI - Ultrastructural evidence of cardiodilatin in rat transplanted heart. PMID- 3313925 TI - Heart transplantation in children: initial experience at University of Rome. PMID- 3313927 TI - Liver transplantation in metabolic diseases. Report of five pediatric cases. PMID- 3313928 TI - Use of flexible triple-drug immunosuppressive therapy in liver transplantation. PMID- 3313926 TI - Orthotopic liver transplantation for alpha-1-antitrypsin deficiency: an experience in 29 children and ten adults. AB - Thirty-nine patients (29 children and ten adults) underwent OLT for liver disease associated with A1AD from March 1980 to March 1986. Thirty of thirty-six patients (83%) with available data were homozygous phenotype PiZZ. The other six were Pi heterozygotes, being either PiMZ or PiSZ. The mean A1A activity in homozygous and heterozygous patients was 38.8 mg/dL and 114.3 mg/dL respectively. Eight patients died during the first 3 months after OLT (20%). The 5-year actuarial survival is 83% and 60% in pediatric and adult recipients respectively. Today 30 (76%) of the recipients are alive, with follow-ups of 8 to 64 months (average 27 months). The quality of life in the surviving patients is excellent. PMID- 3313929 TI - Aspiration cytology in the diagnosis of rejection after orthotopic liver transplantation. PMID- 3313930 TI - Monitoring of liver allografts using fine-needle aspiration biopsy: value of hepatocyte MHC-DR expression in the diagnosis of acute rejection. PMID- 3313931 TI - Selective increase of CD8+ CD11+ cells in long-term liver allograft recipients. PMID- 3313932 TI - Metabolic effects of liver replacement in homozygous familial hypercholesterolemia. PMID- 3313934 TI - Markers of biliary epithelial damage in liver allograft rejection. PMID- 3313933 TI - Percentage of portal contribution to hepatic blood flow: utility in liver graft monitoring. PMID- 3313935 TI - Is there a graft-versus-host reaction in liver transplantation? PMID- 3313936 TI - Monitoring of high-density lipoprotein-associated amyloid A protein after liver transplantation. PMID- 3313937 TI - Surgical techniques and results of pediatric liver transplantation in Barcelona. PMID- 3313939 TI - Results of 24 orthotopic liver transplants in Milan. PMID- 3313938 TI - Surgical complications in 200 consecutive liver transplants. PMID- 3313940 TI - Segmental liver transplantation in pigs: use of a fibrin sealant and collagen as hemostatic agents. PMID- 3313942 TI - Monitoring of serum total bile acids as an early indicator of graft function in clinical and experimental liver transplantation. PMID- 3313941 TI - Evaluation of quantitative liver function tests in liver donors. PMID- 3313943 TI - Metabolic function of allografted livers in rats. PMID- 3313944 TI - Comparative effects of orthotopic liver, fetal liver, and hepatocellular transplantation in congenitally albumin deficient rats. PMID- 3313946 TI - Advantages of cuff techniques versus standard microsurgical techniques in heterotopic nonauxiliary liver transplantation in rats. PMID- 3313945 TI - Monitoring of the rejection of intrasplenic hepatocyte allografts and xenografts in the rat using technetium 99m-imidoacetic acid scanning. PMID- 3313947 TI - Minimizing total ischemia time in rat organ transplantation using a mixed cuff microsurgical technique. PMID- 3313948 TI - Experience with human liver grafts obtained after donor cardiac standstill. PMID- 3313949 TI - Pancreas transplantation: North American versus European experience. PMID- 3313950 TI - Recent improvement in clinical pancreas transplantation. PMID- 3313952 TI - Pancreatic transplant revascularization by dual arterial anastomoses. PMID- 3313951 TI - Segmental or whole pancreatic graft? Further comparison of metabolic control between segmental pancreatic grafts and whole pancreas grafts in the long term. PMID- 3313953 TI - Glucose-stimulated hormone responses after paratopic pancreas transplantation. PMID- 3313954 TI - Successful preservation of human pancreas grafts for 28 hours. PMID- 3313955 TI - Changes of diabetic microangiopathy after pancreas transplantation. PMID- 3313956 TI - Pancreatic antibodies as a marker for pancreatic graft rejection. PMID- 3313958 TI - Phosphorus nuclear magnetic resonance spectroscopy studies in the acute rejection of rat pancreatic allografts. PMID- 3313957 TI - Advantages and disadvantages of urinary tract diversion in clinical pancreas transplantation. PMID- 3313960 TI - Combined kidney/pancreas transplantation--poor long-term outcome of renal grafts. PMID- 3313959 TI - Delayed duct occlusion--a new technique of pancreas transplantation. PMID- 3313961 TI - Severe kidney graft rejection in combined kidney and pancreas transplantation. AB - With a low dose, triple drug protocol for immunosuppression, more frequent and severe rejection episodes, and lower, kidney graft survival appeared after combined kidney and pancreas transplantation than after kidney transplantation alone. With increased immunosuppression using the quadruple drug protocol that includes prophylactic ATG treatment, the results after combined transplantations improved. PMID- 3313962 TI - Functional significance of portal venous drainage in pancreas transplantation. PMID- 3313963 TI - Pancreas transplantation: a study of insulin secretion in isolated islets of Langerhans and in sera using a new enzyme-linked immunosorbent assay. PMID- 3313964 TI - Survival of pancreas allografts in rats treated with cyclosporine and bromocriptine. PMID- 3313965 TI - Recent developments in experimental hepatocyte transplantation. PMID- 3313966 TI - Intrasplenic hepatocellular transplantation as a hepatic support measure in cirrhotic dogs: preliminary results. PMID- 3313968 TI - Arterial supply to the pancreas: anatomic variations pertinent to whole organ transplantation. PMID- 3313967 TI - Successful liver allograft function after 24-hour preservation: cumulative effects of prostacyclin plus verapamil. PMID- 3313969 TI - Three-year experience with delayed duct occlusion in intraperitoneal pancreas transplantation. PMID- 3313970 TI - A new approach to duct management in pancreatic transplantation: temporary occlusion with fibrin sealing and enterostomies. PMID- 3313971 TI - Segmental pancreas transplantation with exocrine drainage to the urinary bladder in humans. PMID- 3313972 TI - Effect of immunosuppression on pancreatic graft survival and function. PMID- 3313973 TI - Experimental duodeno-pancreatico-renal composite transplantation: a new alternative to avoid vascular thrombosis? PMID- 3313974 TI - Comparison of the new immunosuppressive agent 15-deoxyspergualin and cyclosporine A after highly allogeneic pancreas transplantation. PMID- 3313975 TI - Deoxyspergualin induces tolerance in allogeneic kidney transplantation. PMID- 3313977 TI - Effect of 15-deoxyspergualin on graft-v-host disease in mice. PMID- 3313976 TI - Immunosuppressive effect of a new drug, 15-deoxyspergualin, in heterotopic rat heart transplantation: in vivo energy metabolic studies by 31P-NMR spectroscopy. PMID- 3313978 TI - Orthoclone OKT3 in liver transplantation: experience in 21 patients. PMID- 3313979 TI - Effects of anti-L3T4 and anti-Lyt 2 monoclonal antibodies on murine cardiac allograft rejection. PMID- 3313980 TI - Xenogeneic heart transplantation with 15-deoxyspergualin. Prolongation of graft survival. PMID- 3313981 TI - Renal function studies in cyclosporine-treated non-kidney transplant recipients of pancreas grafts. PMID- 3313982 TI - Cyclosporine A-related nephrotoxicity after cardiac transplantation: the role of plasma renin activity. PMID- 3313983 TI - Exercise-induced hypertension in normotensive renal transplant recipients receiving cyclosporine A. PMID- 3313984 TI - Correlation of increased serum calcium fractions with the onset of cyclosporine associated hypertension in renal transplant patients. PMID- 3313987 TI - Cyclosporine A interferes with postoperative blood glucose control after clinical pancreas transplantation. PMID- 3313985 TI - Fractional excretion of sodium represents an index of cyclosporine nephrotoxicity in the early post-transplant period. AB - We reviewed the evolution of FENa in the EPP (first 4 weeks) in a group of CyA treated patients as well as Aza-treated patients who did not present with acute rejection during this period of time. The CyA-treated patients showed lower values of FENa than did Aza-treated patients. Values of FENa below 1% were found in 51% of CyA- and 0% Aza-treated patients (P less than .01) before RFR. The finding of low FENa values was accompanied by more prolonged oliguric and RFR phases. Furthermore, the lower the level of FENa, the higher the prolongation of renal failure. We concluded that FENa values could probably be an index of CyA nephrotoxicity in the EPP. PMID- 3313986 TI - Effect of cyclosporine on platelet aggregation in renal transplant recipients. PMID- 3313988 TI - Cyclosporine A in low doses induces functional and morphologic changes in rat pancreatic B cells. PMID- 3313989 TI - Dramatic reduction in sandimmune (CyA) dosage may be effective in reversal of severe hyperbilirubinemia and post-transplant acute kidney failure linked to CyA toxicity. PMID- 3313990 TI - Radioimmunoanalysis of blood cyclosporine concentration in kidney transplant using solid phase sampling. PMID- 3313991 TI - Cyclosporine A-related proximal tubular dysfunction: impaired handling of uric acid. PMID- 3313993 TI - Sequential conventional and cyclosporine therapy in cadaver renal transplantation -a prospective randomized trial. PMID- 3313992 TI - Is cyclosporine-associated nephrotoxicity progressive? PMID- 3313995 TI - Improvement of initial graft function after renal transplantation by fosfomycin. PMID- 3313994 TI - Reduction of cyclosporine nephrotoxicity by prostaglandin E2 after experimental renal transplantation. PMID- 3313996 TI - Cyclosporine A nephrotoxicity in liver graft recipients: determination of nephrotoxic cyclosporine blood concentrations in liver graft recipients as defined by the HPLC and RIA tests. PMID- 3313997 TI - Long-term immunoprophylaxis of hepatitis B virus reinfection in recipients of human liver allografts. PMID- 3313998 TI - Induction of allogeneic unresponsiveness to renal transplants in rhesus monkeys. PMID- 3313999 TI - Liver transplantation in patients with B viral hepatitis and delta infection. PMID- 3314000 TI - Tuberculosis and renal allograft transplantation. PMID- 3314001 TI - Evaluation of core cooling technique for liver and kidney procurement. PMID- 3314002 TI - Intraoperative albumin improves the outcome of cadaver renal transplantation. PMID- 3314003 TI - Tubular function in renal transplants treated with cyclosporine A. PMID- 3314004 TI - Impaired fractional excretion of lithium: a very early marker of cyclosporine nephrotoxicity. PMID- 3314005 TI - Effect of cyclosporin A on glucose-induced insulin secretion by isolated human islets of Langerhans. PMID- 3314006 TI - Organ procurement: a marketing point of view. PMID- 3314007 TI - New approach to preservation of non-heartbeating donor kidneys: total body cooling. PMID- 3314008 TI - Improved renal graft function after prostacyclin pretreatment. PMID- 3314009 TI - Oxygen-free radical scavengers for renal preservation. PMID- 3314010 TI - Post-anoxic hemodynamic performance. The effect of allopurinol and superoxide dismutase/catalase. PMID- 3314011 TI - Levels of ATP and graft function in human cadaver kidneys with prolonged cold ischemia. PMID- 3314012 TI - Successful 24-hour preservation of the lung--evaluation of viability in a rat model. PMID- 3314013 TI - Successful 48-hour preservation of pancreas grafts by cold storage in modified plasma-protein fraction. PMID- 3314014 TI - Cryomicroscopy of islets: an investigation of the parameters that govern the response to low temperature preservation. PMID- 3314015 TI - Cadaver kidney transplantation cases with a cold ischemia time of over 100 hours. PMID- 3314016 TI - Renal transplant vascular resistance--prediction of immediate function. PMID- 3314017 TI - Reduction of graft immunogenicity: a new perspective for preventing rejection of T-depleted grafts in a transplantation model. PMID- 3314018 TI - Differential modification of donor-specific immune reactivity by longstanding heart and kidney allografts transplanted across defined class I MHC barriers in the rat. PMID- 3314019 TI - Identifying a susceptible period following cyclosporine A-induced tolerance of heart grafts in the rat. PMID- 3314020 TI - Minor and class I MHC incompatibilities do not cause rejection of heart grafts but influence the rejection of skin grafts. PMID- 3314022 TI - Transplantation tolerance after short-term administration of 15-deoxyspergualin in orthotopic rat liver transplantation. PMID- 3314021 TI - Hemolytic anemia in cyclosporine-treated recipients of kidney or heart grafts from donors with minor incompatibility for ABO antigens. PMID- 3314024 TI - Cyclosporine A-induced acceptance of major histocompatibility complex incompatible grafts differs immunologically from class I or minor antigen mismatched grafts accepted in the absence of immunosuppression. PMID- 3314023 TI - Skin transplantation in rats and monkeys: evaluation of efficient treatment with 15-deoxyspergualin. PMID- 3314025 TI - Induction of tolerance by combined allogeneic and autologous bone marrow transplantation. PMID- 3314026 TI - Expression of proliferation-associated nuclear antigen on peripheral lymphocytes from heart transplant patients. PMID- 3314027 TI - Relevance of non-major histocompatibility complex antigens in pancreas transplantation. PMID- 3314028 TI - Prolongation of renal allograft survival by adoptive transfer of TDL from blood transfused hosts. PMID- 3314029 TI - Early detection of allograft rejection by donor-specific lymphocyte-mediated cytolysis: cloning of cytotoxic lymphocytes from positive patients. PMID- 3314030 TI - Immunohistochemical findings, idiotypic inhibition and clinical outcome in patients developing donor-specific antibodies after kidney transplantation. PMID- 3314031 TI - Measuring of idiotypes in highly sensitized patients and its relevance in clinical kidney transplantation. PMID- 3314032 TI - B cell dysfunction in renal allograft recipients. PMID- 3314033 TI - Treatment with monoclonal anti-IL2 antibody prolongs cardiac allograft survival in rats. PMID- 3314034 TI - Value of the flow cytometric crossmatch in renal transplantation. PMID- 3314035 TI - The use of monoclonal antibodies against activated human T cells following renal allografting in the baboon. PMID- 3314036 TI - Characterization of cells expressing HLA class I molecules in the human pancreas. PMID- 3314037 TI - Long-term acceptance of pancreatic allografts in rats during trough level controlled cyclosporine A treatment. PMID- 3314038 TI - Prolonged pancreas transplant survival following graft donor pretreatment with cyclosporine A or concanavalin A. PMID- 3314039 TI - Mixed islet-lymphocyte culture as a model for pancreatic islet immunogenicity and cell-mediated immune injury. PMID- 3314040 TI - Cells involved in rejection of rat heart allografts. PMID- 3314041 TI - Serum immunoreactive interleukin-1 in renal transplant recipients. PMID- 3314042 TI - Recent developments in pediatric liver transplantation. PMID- 3314043 TI - Liver transplantation in acute fulminant hepatic failure. PMID- 3314044 TI - Rejection of the liver and review of current immunosuppressive protocols. PMID- 3314045 TI - The role of auxiliary liver transplantation. PMID- 3314046 TI - Heterotopic heart transplantation. PMID- 3314047 TI - Orthotopic liver transplantation in a patient with sclerosing cholangitis. PMID- 3314048 TI - Orthotopic transplantation of resected liver allografts. PMID- 3314049 TI - Epidemiology and control of pertussis. PMID- 3314050 TI - [Significance of inherited fragile sites in the occurrence of chromosome aberrations in tumor cells]. AB - The data on localization of heritable fragile sites and cellular oncogenes on individual human chromosomes involved in tumour-specific aberrations are summarized in the review. Only two fragile sites (8q22 and 11q13) out of eight ones, coinciding with breakage sites in such aberrations are the loci of cellular oncogenes (mos and bcl-1, respectively). Analysis of the data confirms the supposition that heritable fragile sites are predisposing factors for chromosomal rearrangements and in the end for development of the pathological processes. PMID- 3314051 TI - [Focal contacts and the cytoskeleton]. AB - Cultured cells attach to the substratum by means of specialized domains of cell surface, called focal contacts. The inner side of the cell membrane is associated in these structures with cytoskeletal elements, while the outer side is connected with extracellular matrix. The present review describes both light and electron microscopic methods of studying the focal contacts and ultrastructure of adhesion plaque, that is the cytoskeletal domain of focal contact. The proteins of adhesion plaque and focal contact membranes are also characterized. The processes of the formation of focal contacts and their association with the bundles of actin microfilaments in normal cultured fibroblasts are described in detail. Association of focal contacts with other cytoskeletal elements microtubules and intermediate filaments is discussed. The neoplastic transformation induced changes of focal contact system and cytoskeletal structures associated with contact sites are described. PMID- 3314052 TI - [Possible role of protein kinase C in the T-lymphocyte cell cycle]. AB - Experimental results of induction of T-lymphocyte proliferation by means of tumor promotors-activators of protein kinase C (PKC) are reviewed. A hypothesis has been put forward that the discrepancy of the data so far available can be explained on the account of the difference in membrane-associated PKC activation patterns produced by tumor promotors and by interleukin 2. It is established that the former induce a permanent PKC activation, whereas the latter induces a transient one. Although enhancing DNA synthesis, the permanent (non physiological) activation must induce an accumulation of cells in the cell cycle phases following the S-phase. PMID- 3314053 TI - [Cells of the metrial gland: their relation to trophoblast cells and reproductive characteristics]. AB - Data on the origin, morphology and function of metrial gland cells are reviewed. Characteristic features of metrial gland cells are the availability of numerous eosinophilic granules lying near two round or oval nuclei and peripheral zone of the cytoplasm, generally devoid of organelles. This zone can generate pseudopodia like projections. The notable peculiarity of metrial gland cells involves their ability to penetrate into blood vessels, to migrate towards the embryo, and to achieve the ectoplacental cone. The majority of metrial gland cells is accumulated in the decidua basalis zone where the tertiary trophoblast cells usually migrate. The metrial gland cells seem to constitute a cell population analogous to that of decidual cells. Data on the protective role of metrial gland cells are discussed. The metrial gland cells are proven to be polyploid. Polyploid nuclei are found both in mononucleate and binucleate cells. Acytokinetic mitosis is presumably a way leading to polyploidization of metrial gland cells. PMID- 3314054 TI - [Tannic acid as a stabilizer of liposomal lipids in electron microscopic research]. AB - Using electron microscopy the action of tannic acid on the morphology of positively charged liposomes were studied in suspension and after adsorption of the surface membrane of human red blood cell in vitro. After treatment with tannic acid and glutaraldehyde followed by postosmication, an irreversible reconstruction of liposome lipid material with formation of many layers with tight packed lamellae was shown. Similar structures were found on the surface of red blood cells. Monolayer microvesicles 30 nm in diameter were seen after glutaraldehyde fixation postosmication, and final treatment with tannic acid. Similar microvesicles were seen adsorbed on the plasma membrane. PMID- 3314055 TI - Seadragon VI: a 7-day dry saturation dive at 31 ATA. III. Alterations in basal and circadian endocrinology. AB - Four male divers were exposed to an environment of 1 ATA air for 7 d, followed by 7 d of 31 ATA He-O2, and following decompression to a postdive 1 ATA air environment for 3 d. Urine and blood were collected for hormonal measurements. Divided 24-h urine collections were obtained during 3 consecutive d at predive 1 ATA conditions, and at 31 ATA conditions. Two consecutive day collections were obtained at early decompression (31-25 ATA), at late decompression (14-8 ATA), and at postdive 1 ATA. Two blood samples were obtained, at predive 1 ATA, at 31 ATA, and at postdive 1 ATA. Plasma antidiuretic hormone (ADH) concentration decreased about 45% (P less than 0.005), while plasma aldosterone concentration and urinary aldosterone excretion were doubled (P less than 0.005) after the subjects were at 31 ATA. Plasma cortisol concentration and plasma parathyroid hormone concentration were not significantly affected by hyperbaria. Urinary excretion of aldosterone was not significantly different between day (0700-1900) and night (1900-0700) at any time, and both day and night excretion rates were increased at 31 ATA through late decompression (P less than 0.005). Urinary ADH excretion was greater during daytime at predive 1 ATA (P less than 0.005), but not thereafter. Both daytime and nighttime ADH excretion rates were decreased from 31 ATA through late decompression (P less than 0.005). It is concluded that hyperbaria eliminates the circadian release pattern of ADH and that the overall reduction of ADH may contribute to the increased free water clearance observed at hyperbaria. Also, increased parathyroid hormone was not associated with the phosphaturia observed at hyperbaria, but increased aldosterone coexisted with the increased kaliuresis observed. PMID- 3314056 TI - Seadragon VI: a 7-day dry saturation dive at 31 ATA. VI. Hyperbaria enhances renin but eliminates ADH responses to head-up tilt. AB - Three male subjects were passively tilted from a supine to a 90 degree head-up standing position on 2 d each at 1 and 31 ATA, then on 1 d of the postdive period. On each day the subjects were tilted once in the morning (0800-1000) and once in the evening (2000-2200). Before each tilt experiment, the subjects were first intravenously cannulated for blood sampling, then assumed the supine position. A blood sample was taken after 10 min in the supine position, and another sample was taken after 15 min of motionless, supported standing. The plasma was analyzed for antidiuretic hormone (ADH), plasma renin activity (PRA), plasma cortisol, and aldosterone. ADH, PRA, and cortisol were significantly increased by tilt, but the responses varied with time of day or atmospheric pressure. Cortisol increased only in the morning tilt (P less than 0.005) and was not affected by pressure. At 1 ATA, PRA was elevated in the morning tilt experiment (P less than 0.005) and not the evening tilt, but the overall response to tilt was greater at 31 ATA than at 1 ATA (P less than 0.005). The ADH response to tilt (P less than 0.025) was unaffected by time of day, but was eliminated at 31 ATA. The basal levels of ADH were also lower at 31 ATA (P less than 0.005). The mechanism of these responses remains unclear, but the eliminated postural stimulation of ADH may account for the eliminated circadian excretory pattern of the hormones. The altered responses to body fluid shifts possibly contribute to the increased aldosterone and decreased ADH frequently observed at hyperbaria. PMID- 3314058 TI - A new technique for skin closure in hypospadias: ipsilateral penoscrotal approximation for closure. AB - Sixteen patients, between 2 and 45 years old, with hypospadias underwent repair with our new skin closure procedure called ipsilateral penoscrotal approximation for closure (IPSAC). Complete functional success was obtained in all 6 patients with distal hypospadias and in 7 of 10 patients with proximal hypospadias. Meatal regression and urethrocutaneous fistula were complications in one-stage repair. Another urethrocutaneous fistula resulted from fifth-stage repair in the case of an adult hypospadias cripple. Cosmetically, there were two cases with unsightly thickening of the base of the penis in this early series. It was found that this IPSAC procedure had two major advantages: it provided (1) a tension-relieving skin closure, and (2) correction of scrotal deformity, especially in one-stage repair with the parameatal flap and in multi-staged repair with absolute penile skin deficiency. PMID- 3314059 TI - Renal hilus lipomatosis simulating carcinoma of the kidney. AB - We report a case of lipomatosis of the renal hilus which presented with macroscopic painless haematuria. The appearance of the pyelocalyceal system on the intravenous urogram set the diagnosis of renal carcinoma, a diagnosis that both ultrasound and computed tomography did not refute. Final diagnosis was established histologically. PMID- 3314057 TI - Testicular tumors: presentation and role of diagnostic delay. AB - 180 patients with testicular germ cell tumors were evaluated in a retrospective study concerning the features of presentation and diagnostic delay. Mean duration of symptoms was 170 days, being different for seminoma and nonseminoma, and showing a continuous decrease since 1969. Duration of symptoms was longest in stage I seminoma. In the nonseminoma group the longest interval was observed in stage III. It is concluded that only in nonseminoma a prolonged delay exerts adverse effects on prognosis. Short delay (cryosperm conservation) does not seem to cause any harm. A plea is made for periodic testicular self-examination. PMID- 3314060 TI - Early diagnosis of prostate cancer. AB - Approximately 50 per cent of patients with carcinoma of the prostate have either advanced local disease or metastases at the time of diagnosis. To achieve earlier diagnosis of prostate cancer in its localized, most treatable stages, it will be necessary to develop safe, cost-effective screening tests with sufficiently high sensitivity and specificity rates. To date, no single test fulfills these criteria, although advances in the measurement of serologic markers of prostate cancer such as prostate-specific antigen, fine-needle aspiration cytology of the prostate, and transrectal prostatic ultrasonography are being widely investigated as potential screening tests. PMID- 3314062 TI - Radiotherapy versus surgery for localized prostatic cancer. AB - Current data from randomized and nonrandomized clinical trials would indicate that radical prostatectomy offers the optimum method of disease control. The benefit of radical surgery is related to the extent of local disease. Gleason sum of the prostatic primary predicts for the probability of tumor extent. PMID- 3314061 TI - Radical prostatectomy, preservation of sexual function, cancer control. The controversy. AB - In this article, I have addressed some of the important controversies regarding the safety and efficacy of radical prostatectomy with the preservation of sexual function: (1) How often is sexual function preserved? (2) Does preservation of sexual function interfere with cancer control? (3) Are there tricks to performing the operation? and (4) Who is a candidate? Overall, 72 per cent of patients are potent postoperatively. The probability of return of sexual function correlates with the age of the patient and the stage of the lesion. In addition, it appears that only one neurovascular bundle is necessary for the return of sexual function because 69 per cent of men who undergo wide excision of one neurovascular bundle are potent postoperatively. The question whether preservation of sexual function compromises the removal of tumor can be analyzed in several ways. On the basis of operative descriptions and the evaluation of whole-mount cross sections of prostates removed by standard radical perineal and radical retropubic techniques, it appears that the neurovascular bundles were not completely resected in the past using standard techniques. However, with knowledge of the location of these neurovascular bundles, they can now be excised more widely when necessary than was previously possible. Furthermore, evaluation of surgical margins of excision gave no indication that the nerve-sparing modification compromises the adequacy of the removal of cancer, which is determined primarily by the extent of the tumor rather than by the operative technique. However, controversy surrounding this procedure will not be settled until long-term follow-up data are available to determine whether the control of local disease and distant metastases is similar to that achieved with standard radical prostatectomies. To aid in this comparison, we have been careful not to use postoperative adjuvant hormonal or radiation therapy so that we will be able to evaluate the true impact of radical prostatectomy on the control of cancer. To preserve sexual function, a variety of fine points in surgical technique must be observed. These have been discussed in detail. It is my opinion that any patient who is a candidate for radical prostatectomy is a candidate for intra-operative assessment of the extent of tumor and the location of the neurovascular bundles. Based on this information, the surgeon can make an informed decision whether the neurovascular bundles can be safely preserved or excised widely with the specimen. In all surgical approaches to prostatic cancer, the primary goal must be excision of all tumor; preservation of sexual function should be of secondary concern.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3314063 TI - A critical assessment of the role of chemotherapy for endocrine-resistant prostatic carcinoma. AB - Extensive experience with chemotherapy in prostatic cancer has accumulated over the past several years. Assessment of antitumor activity is complicated by a lack of uniform and reproducible criteria in past studies and by difficulties in quantitating tumor mass. Overall, the data illustrate that therapeutic benefits have been marginal at best and survival of patients with endocrine-resistant disease is not affected by chemotherapy. Major efforts should focus on the development of new, effective chemotherapeutic approaches. PMID- 3314064 TI - Early versus delayed lymph-node dissection versus no lymph-node dissection in carcinoma of the penis. AB - Assessment of the inguinal lymph nodes for metastases in patients with penile cancer is inaccurate. About 50 per cent of patients with node enlargement have no tumor on histologic examination, and 20 per cent of patients with clinically negative nodes have micrometastases. Lymph-node biopsies, including sentinel-node biopsy, are of limited staging value. Patients with lesions that do not invade the corpora and who have no palpable nodes should be followed carefully after excision of the primary tumor at 2- to 3-month intervals. If compliance with such a follow-up is doubtful, bilateral superficial groin-node dissection seems appropriate. Those with persistent adenopathy should undergo superficial lymph node dissection first, and if positive nodes are found, bilateral deep-node dissection should then be performed. Bilateral inguinal and pelvic lymphadenectomy is recommended for patients with lesions invading the corpora with clinically negative or positive nodes because of the high incidence of lymph node metastases in such cases. Where adenopathy persists after excision of the primary tumor, we advocate first limited pelvic dissection. If the pelvic nodes are negative or are not extensively involved, bilateral groin dissection should be performed, preferably in two stages. Percutaneous fine-needle aspiration of palpable or nonpalpable nodes can improve preoperative staging in patients with penile cancer. PMID- 3314065 TI - Nephrectomy in metastatic renal cell carcinoma. AB - Progress in the treatment of metastatic renal cell carcinoma in recent decades might be characterized as promising by the optimist, nonexistent by the pessimist, and somewhere between by the realist. Regardless of one's point of view, the dilemma of what to do with the primary tumor persists. With notable exceptions, the duration and quality of survival are not influenced favorably by nephrectomy. PMID- 3314066 TI - The failure of infarction and/or nephrectomy in stage IV renal cell cancer to influence survival or metastatic regression. AB - The success of cancer therapy depends on the destruction of all viable cancer cells in the primary site, as well as in metastatic areas. Surgery alone can do little for the patient whose tumor has produced distant involvement except in those situations where surgical excision, radiotherapy, chemotherapy, or immunotherapy can be relied on to eradicate metastatic disease. Because of the paucity of systemic therapy for renal cell carcinoma, an aggressive surgical approach to the primary tumor is justifiable when all metastatic lesions can be excised or otherwise definitively treated and in experimental protocols in which adjuvant therapy of possible benefit can be combined with palliative nephrectomy. There is no evidence, however, in reported studies to suggest that routine palliative nephrectomy in patients who will not be offered adjuvant systemic therapy or radiation is beneficial. Such practice is also associated with a higher incidence of complications and mortality than is expected for resection of localized renal cell carcinoma. For these reasons, it is reasonable to recommend adjunctive nephrectomy only in certain selected instances, which include (1) the control of a patient's current symptoms related to the primary disease, for example, flank pain, hematuria, fever and toxicity, anemia, erythrocytosis, and hypercalcemia; (2) nephrectomy with the excision of a solitary metastasis; and (3) the patient who is willing to undergo experimental therapy, part of which involves removal of the primary tumor. PMID- 3314067 TI - Newer diagnostic techniques for bladder cancer. AB - As described in the above paragraphs, efforts in the areas of immunology, cytogenetics, molecular biology, and cytopathology have been applied to the problems urologists face in treating the individual patient with bladder cancer. It is hoped that continued investigations in these disciplines will not only lead to earlier diagnosis of bladder cancer and better prediction of tumor behavior but will further our understanding of the molecular basis of oncogenesis. PMID- 3314069 TI - Preoperative radiation therapy in the treatment of bladder cancer. AB - The authors review the role of preoperative radiation therapy in the management of patients undergoing cystectomy and the early results of a prospective randomized clinical trial comparing preoperative radiation and radical cystectomy to radical cystectomy alone. It is concluded that the coupling of preoperative radiation therapy with cystectomy has added little to our treatment of bladder cancer. PMID- 3314068 TI - Evaluation and management of patients with superficial bladder cancer. AB - The outlook for patients with bladder tumors confined to the mucosa or lamina propria has improved. The reasons are several: (1) diagnostic and therapeutic endoscopic instruments continue to improve; (2) pathologists and cytologists are providing more accurate and uniform readings of submitted material; (3) prognostic factors have been identified by cooperative groups; and (4) new effective intravesical agents have been introduced and used. I do not foresee any dramatic advances in the next few years, but I believe that the information gained over the last decade is being widely disseminated. We can hope that this will minimize diagnostic and treatment excesses for patients with little likelihood of progression, reduce the number and frequency of endoscopic resections for those with frequent recurrences, and limit the number of exenterative procedures. PMID- 3314070 TI - An update on the Kock pouch for continent urinary diversion. AB - The authors continue to feel, based on a 4 1/2 year clinical experience in more than 400 patients, that the Kock continent urostomy offers an important alternative to noncontinent forms of diversion. Not only can it provide an improved body image, but the Kock pouch can also help to salvage, both physically and emotionally, those patients with unsatisfactory results from conduit diversion. PMID- 3314071 TI - Alternative techniques for a continent urinary reservoir. AB - A modification of the Gilchrist procedure is used to create a continent urinary reservoir that provides reliable continence and antireflux mechanisms. The tubular form of the cecum is altered by a patch or reconfiguration to prevent bolus contractions of the reservoir. The procedure offers a choice of locations of the reservoir and stoma in most patients. Each step of the procedure uses techniques already familiar to urologists. PMID- 3314072 TI - Penile revascularization. AB - Penile revascularization surgery has dramatically improved the lives of many young patients who otherwise had to consider prosthetic options for treatment of their erectile dysfunction. Nonetheless, it appears that only few patients with erectile impotence are truly excellent candidates. Dynamic infusion cavernosometry and cavernosography studies reveal that corporal leakage syndrome exists in more than 80 per cent with organic erectile dysfunction. As the pathophysiology of corporal leakage syndrome is better appreciated, the role for penile reconstructive surgery will become more obvious. It may be realized that most patients with corporal leakage syndrome will be treated medically with intracavernosal pharmacotherapy. In these cases, reconstructive surgery may be utilized primarily to augment the pharmacologic erectile response. PMID- 3314073 TI - Reduced immunogenicity of rat renal allografts after photochemical donor pretreatment and passive transfer of graft protection. AB - Photochemical pretreatment of the kidney donor (Sprague-Dawley rats/SD) with 8 methoxypsoralen (8-MOP) and ex vivo longwave ultraviolet (UVA) irradiation of the kidney graft (PUVA therapy) significantly prolonged survival in allogeneic recipients (BD IX rats). After more than 100 days 7 long-term surviving PUVA pretreated SD kidneys were retransplanted into BD IX rats. Seven out of 7 secondary recipients survived for more than 100 days. Twenty BD IX recipients of normal SD kidneys were treated at the time of transplantation with serum (1 ml i.v.) and/or spleen lymphocytes (1 X 10(7) i.v.) obtained from the PUVA-treated long-term survivors. A prolonged graft survival was achieved in 7 out of 20 rats, among them 4 out of 8 recipients of the serum-treated group. In conclusion, the long-term survival of PUVA-treated rat renal allografts is associated with a strong reduction of graft immunogenicity and the development of graft protecting humoral as well as cellular effectors. PMID- 3314074 TI - Photochemical donor pretreatment in clinical kidney transplantation--preliminary report. AB - Extended experimental experience with the efficacy of pretreating the kidney donor and the allograft by means of photochemotherapy (photosensitizer + UVA irradiation = PUVA) was adopted in clinical kidney transplantation. In a preliminary unrandomized study similar patient populations were treated by generally uniform methods. Thirty-three PUVA-pretreated kidneys (group A) were compared with the experience regarding 26 non-pretreated kidney allografts (group B). The number of rejection episodes was significantly lower in the first 3 months in group A (p less than 0.05 vs group B) and fewer grafts failed because of irreversible rejection (2 vs 5). Furthermore, in group A the rate of infectious complications was lower (18% vs 34%). The cumulative allograft survival at 3 months was improved from 65% in group B to 81% in group A and at 12 months from 65% 76%, respectively. These differences were not significant. Therefore, our preliminary clinical experience with a photochemical donor pretreatment is encouraging and further use in a randomized study seems to be necessary. PMID- 3314075 TI - Pelvic cake kidney drained by single ureter. AB - We report a rare case of cake kidney with a single unobstructed ureter and without any other malformation. PMID- 3314076 TI - Leiomyosarcoma of inferior vena cava. AB - A case of leiomyosarcoma of the inferior vena cava is presented and pertinent clinical features of 57 reported cases in the English literature are reviewed. PMID- 3314077 TI - [A method of reflecting microscopy of the endothelium in the diagnosis of herpetic uveokeratitis]. PMID- 3314079 TI - [Modification of the surgical approach in operations for inguinal hernia]. PMID- 3314078 TI - [Anterior capsule microsurgery]. PMID- 3314080 TI - [Brephoplasty of extensive bone cavities]. PMID- 3314082 TI - [Surgical activities of women physicians in Russia in the 19th century]. PMID- 3314081 TI - [In memory of Prof. Aleksandr Vasil'evich Smirnov (on the centenary of his birth)]. PMID- 3314083 TI - [Dissolution of biliary calculi with monooctanoin]. PMID- 3314084 TI - [Pathology of the bronchial arteries in chronic nonspecific lung diseases]. PMID- 3314085 TI - [Embolization of the splenic artery in liver cirrhosis]. AB - An experience with 70 embolizations of the splenic artery in 62 patients points to the importance of differential approach in choosing this method of treatment. Of primary importance in solving this problem is thought to be the degree of the disease which must determine the variant of reduction of the splenic bloodflow. PMID- 3314086 TI - [Ultrasonography in the diagnosis of cholelithiasis]. PMID- 3314087 TI - [Webbed neck associated with other developmental defects]. AB - In patients with a combination of congenital webbed deformity of the neck with the Klippel-Weil syndrome, muscular hyperplasia of lateral masses of the neck and latent cerebrospinal hernias favorable cosmetic results could be obtained by an operative dissection of excessive soft tissues including the muscular and cyst ectopic cerebrospinal membrane tissues. PMID- 3314088 TI - [Ways of reducing the main postoperative complications of gastrectomy in patients with gastric cancer]. AB - An analysis of results of 275 gastrectomies in patients with gastric cancer has shown that main causes of death after the operation were pancreanecrosis (2.8%) and incompetence of sutures of the esophago-intestinal anastomosis (1.7%). Sparing operations, measures reducing duodenostasis, administration of protease inhibitors during operation as well as early reestablishment of passage of the intestinal content resulted in less amount of postoperative pancreatitis. The method of performing esophago-intestinal anastomosis after Hilarowicz with block of the upper loop by a circular ligature allow the amount of incompetent sutures of the anastomosis to be minimized and give satisfactory functional results. PMID- 3314089 TI - [Causes of failure of the surgical treatment of urethral strictures]. AB - The work describes and analyzes main causes of failure of treatment of strictures of the posterior parts of the urethra in 199 patients. They were: tunnelization and canalization, lack of special instruments, not complete dissection of scarry tissues in the stricture zone, bad observation of terms between operations, the use of catgut and silk as a suture material with great amount of stitches, prolonged stay of the drain in the urethra, early bougienage of the urethra. PMID- 3314090 TI - [Method of preventing incompetent sutures of the duodenal stump after resections of the stomach]. AB - The authors have developed and successfully used in the clinic an original method of omentoduodenoplasty for prophylactics of incompetence of duodenal stump sutures. Its essence is to form an omental muff-channel between the external part of the sutured duodenal stump cupula and the peritoneum of the frontal abdominal wall with a temporary communication of the omentum channel cavity with the skin of the frontal abdominal wall by means of a drainage tube. PMID- 3314091 TI - [Indications, methods and results of amputations of the extremities in isolated, multiple and associated traumas]. AB - An analysis of 246 observations has shown that in patients with crushed extremities accompanied by shock the amputation is the most important antishock measure. The amputation performed by the method of primary surgical treatment of the wound is the method of choice. The amount of postoperative complications can be considerably reduced by using the primarily delayed suture, carbon sorbents on the stump wound, temporary immobilization of the extremity stump. PMID- 3314092 TI - [Changes in the functional properties of thrombocytes in surgical infection and means of coordination]. PMID- 3314093 TI - [The use of heterotopic transplantation of the liver in children for the treatment of severe forms of hepatic insufficiency]. PMID- 3314095 TI - [Vagotomy in the surgery of perforated pyloroduodenal ulcer]. AB - Under analysis are results of the surgical treatment of 300 patients with perforating pyloroduodenal ulcers. The correct selection of patients for the operation gives best nearest and especially long-term results of vagotomy with antrum resection. The amount of recurrences after a simple suturing of the ulcer in 164 patients was 50%, while after vagotomy with/without various draining operations it was 3.7%. Postoperative lethality after vagotomy was not great, long-term results being considerably better than after the operations of simple suturing the ulcer. PMID- 3314094 TI - [Surgical treatment of "silent" ulcers of the stomach and duodenum complicated by perforation]. AB - Patients with perforating "silent" ulcers and patients with continuous ulcer histories must be subjected to similar surgical treatment. In most cases it may be truncal vagotomy with draining operation on the stomach. Operation of suturing the perforating ulcer is thought to be expedient in patients with acute ulcers (they make up not more than 25%), with severe concomitant diseases, in the terminal phase of diffuse peritonitis and when performed by surgeons with insufficient experience. PMID- 3314096 TI - [Use of a segment of the greater curvature of the stomach in plastic surgery]. AB - Grounds for using a segment of the greater curvature of the stomach for plastic operations of creation of an artificial stomach, for plastic suturing of perforating gastroduodenal ulcers and strengthening of the duodenal stump, esophageal, colonic anastomoses, pyloroplasty are given. The experimental and clinical investigations performed facilitate a wider use of the gastric wall as a plastic material. PMID- 3314097 TI - [Surgical treatment of postburn deformities of the back of the hand]. AB - The authors sum up their experience with the surgical treatment of postburn deformations of the dorsal surface of the hand in 50 patients. They describe the technique of radical dissection of all the scars of the dorsal surface of the hand and fingers and plasty of the interdigital commissures by palmar trapezoid whole thickness grafts. Wounds after excision of the scars were closed by nonperforated grafts of 0.3-0.4 mm thick splitted skin. Long-term results were followed up in 21 patients. All of them showed good functional and cosmetic results. PMID- 3314099 TI - Applications of equine models of acute inflammation. The Ciba-Geigy Prize for Research in Animal Health. AB - The development of reproducible models of acute inflammation in which inflammatory heat is easily quantified and from which inflammatory exudate is readily harvested has facilitated studies in the horse of the actions of steroids and non-steroidal anti-inflammatory drugs (NSAIDS). Blockade of the synthesis of eicosanoids and suppression of inflammatory heat by clinical dose rates of NSAIDS suggests a causal link between the two events and provides further evidence for a role of these compounds in acute equine inflammation. The tendency for enolic and carboxylic acids NSAIDS to accumulate in inflammatory exudate may account for the duration of action of these compounds in inhibiting exudate eicosanoid synthesis and the data confirm clinical experiences with these drugs. A novel NSAID which inhibits both cyclo-oxygenase and lipoxygenase pathways of arachidonic acid metabolism, BW540C, and two anti-inflammatory steroids, betamethasone and dexamethasone, have been evaluated in the models of equine inflammation with some interesting and unexpected findings. This paper emphasises the interrelationships between the inflammatory process and the actions and fate of anti-inflammatory drugs. PMID- 3314098 TI - Inflammation: a clinical perspective. The Ciba-Geigy Prize for Research in Animal Health. AB - The cardinal signs of acute inflammation have been recognised for almost 2000 years, but it is only in the last hundred years that significant progress has been made in understanding the underlying cellular response. Our knowledge of the chemical messengers which regulate and in some cases lead to persistence of the inflammatory process is, as yet, incomplete, but it is hoped that further research at this level will lead to the development of more effective therapeutic agents. PMID- 3314100 TI - Single and combined rinderpest vaccines. PMID- 3314102 TI - Anthelmintics currently licensed for use in dogs and cats. PMID- 3314101 TI - Failure of a Pasteurella haemolytica extract vaccine to protect calves against experimental pneumonic pasteurellosis. PMID- 3314103 TI - Avian clinical pathology. General considerations. AB - General aspects of avian clinical pathology are reviewed. It is concluded that in a clinical setting a volume of blood equivalent to 1 per cent of body weight can be collected safely from avian species for laboratory examinations. The anticoagulant of choice for most laboratory investigations is lithium heparin. In most bird species the right jugular vein is the preferred site for routine blood sampling. The use of a vacuum system greatly facilitates the procedure. The importance of immediately processing blood samples is explained. The many variables that may influence haematological or biochemical parameters are discussed and the reasons for determining blood chemical reference values by non parametric methods are emphasised. PMID- 3314104 TI - Blood chemistry for the diagnosis of hepatobiliary disease in birds. A review. AB - A review is presented of current knowledge with regard to blood chemistry for the diagnosis of hepatobiliary disease in birds. Straightforward conclusions are difficult, because research on this subject has been limited. Jaundice caused by hyperbilirubinaemia occurs infrequently in birds, because the main bile pigment is biliverdin and not bilirubin. A yellow discolouration of avian plasma is often caused by the presence of carotenoids. The diagnostic value of plasma ALAT concentrations is controversial. Although ASAT and LD are not specific for the liver they appear to be sensitive enzymes to detect liver cell damage. GLDH is liver specific in a number of animal species (including birds) and might prove to be a useful enzyme for diagnostic purposes. AP and GGT seem less useful. Little information is available on the diagnostic value of plasma bile acids and plasma dye clearance tests. PMID- 3314105 TI - The diagnostic value of plasma proteins and non-protein nitrogen substances in birds. AB - This paper summarises current knowledge of the diagnostic value of avian plasma proteins and non-protein nitrogen substances. Reference values for total protein, the albumin: globulin ratio, uric acid, creatinine, and urea for various avian species are presented. The importance of the albumin:globulin ratio and the urea:uric acid ratio is emphasised. PMID- 3314106 TI - Epidemiology of Rhodococcus equi infection in horses. AB - Current understanding of the epidemiology of Rhodococcus equi infection on horse farms is reviewed. Infection is widespread in herbivores and their environment, because herbivore manure supplies the simple organic acid substrates on which the organism thrives. There is a progressive development of infection in the soil on horse farms with prolonged use, because: (1) there is a continual supply of nutrients; (2) the organism multiplies progressively as temperatures rise; (3) the bacterium has a robust nature. While this aerobic organism fails to multiply in the largely anaerobic intestine of the adult horse, multiplication to very large numbers may occur in the intestine of a foal in its first 8-12 weeks of life. Farms used for foal breeding over many years may thus become particularly dangerous for foals. Areas for future study include the effectiveness of decontamination, manure-removal programs and dust reduction in reducing challenge to susceptible foals. PMID- 3314107 TI - The immunological response of foals to Rhodococcus equi: a review. AB - Normal horses of all ages regularly show evidence of having responded immunologically to R. equi, thus adding serological support to epidemiological evidence that this organism is a normal intestinal inhabitant. More animals from "diseased" farms show a stronger antibody response when compared with foals from "healthy" farms. Various serological tests have been used to detect evidence of infection and to relate antibody level to severity of disease. Anti-R. equi IgG antibody levels, as measured by ELISA, are raised significantly during natural infection. Clinical severity of pneumonia can be correlated with lower specific antibody responses. Following experimental infection, immunological responses can be detected by complement fixation, indirect immunofluorescence, ELISA, lymphocyte blastogenesis and skin testing. Very little work has been carried out to evaluate vaccines against R. equi infection and results have not been encouraging. Success in treatment has been reported following passive immunisation. Administration of immune leucocyte extracts has had no effect on morbidity or mortality rates. The widespread distribution of this organism, together with the relative infrequency of disease caused by it, suggest that R. equi may initiate infection only in such circumstances as a very high infectious challenge, immunological immaturity or deficiency in the host and genetic predisposition. PMID- 3314108 TI - The pathogenesis of Rhodococcus equi pneumonia in foals. AB - The pathogenesis of Rhodococcus equi pneumonia in foals is reviewed. The main routes of infection are respiratory and alimentary. The latter is probably the chief route of exposure in all foals and probably leads to development of specific immunity. Susceptible foals, those whose maternal immunity wanes before generation of their own immune response, readily develop disease if exposed aerogenously to sufficient numbers of R. equi. Management and environmental circumstances have a major role to play in determining the magnitude of this challenge and, therefore, in the prevalence of the disease. Infection of a naive foal leads to severe, suppurative bronchopneumonia with suppurative lymphadenitis of regional nodes and, in approximately 50% of animals, to necrotizing enterocolitis. The foal is uniquely susceptible to R. equi pneumonia; comparable experimental infections do not produce progressive destructive pulmonary lesions in other animal species. In the naive foal lung, R. equi behaves as a facultative intracellular pathogen, avoiding destruction within the alveolar macrophage by inhibiting phagolysosome fusion and possibly by causing lysosomal degranulation. The role of putative virulence factors, such as equi factor, remains to be elucidated. PMID- 3314109 TI - Use of erythromycin-rifampin combination in treatment of Rhodococcus equi pneumonia. AB - The selection of lipid-soluble antibiotics capable of intracellular penetration is considered critical for the successful treatment of Rhodococcus equi pneumonia and lung abscesses in foals. Two such antibiotics: erythromycin (25 mg kg-1, three times daily) and rifampin (5 mg kg-1 twice daily) have been used in combination for this purpose at the University of Florida since 1981. Positive evidence of R. equi was present on culture of tracheal aspirates in 57 foals, most of which exhibited radiographic evidence of extensive lung abscessation. The duration of therapy ranged from 4 to 9 weeks. Mild diarrhea was sometimes noted, but was never severe enough to require the termination of therapy. No other adverse side effects were apparent. Judged by a return of chest radiographs and hematologic parameters to normal, 50 of the 57 foals were considered to have recovered from the disease; a success rate of 88%. PMID- 3314110 TI - Cellular and humoral defence mechanisms in mares susceptible and resistant to persistent endometritis. AB - Both random and directional migration of blood neutrophils from 9 mares susceptible to persistent endometritis were significantly less (p less than 0.05) than neutrophils from 8 resistant mares. Serum from susceptible mares had significantly more (p less than 0.01) chemotactic activity than serum from resistant mares. Although phagocytosis of yeast blastospores by blood neutrophils from 4 resistant and 3 susceptible mares was similar, uterine neutrophils from susceptible mares were significantly worse (p less than 0.01) at phagocytosis than uterine neutrophils from resistant mares. Uterine washings from 17 susceptible mares were significantly better at opsonising yeast blastospores than washings from 14 resistant mares; however, washings from both groups had a similar ability to promote killing of S. zooepidemicus by neutrophils. When an immunologically non-specific endometritis was induced, washings from 3 susceptible mares were significantly worse at promoting bactericidal activity by 144 h than washings from 4 resistant mares (p less than 0.01). Haemolytic complement activity was significantly greater (p less than 0.001) in washings from 17 susceptible mares than from 14 resistant mares. Induction of acute endometritis resulted in high levels of haemolytic complement activity in 2 of 3 susceptible mares at 24 and 144 h, but only in small increases in 4 resistant mares. Thus, some abnormalities in neutrophil function were detected and a possible defect in promotion of neutrophil bactericidal activity by uterine secretions from susceptible mares but there was no evidence for any deficiency in haemolytic complement activity. PMID- 3314111 TI - An enzyme-linked antiglobulin test for the detection of erythrocyte-bound antibodies in canine autoimmune haemolytic anaemia. AB - A method has been developed which allows identification and quantitation of red cell-bound immunoglobulins and complement in canine blood. The technique utilizes ELISA methodology and the assay identifies cases of autoimmune haemolytic anaemia which are negative by the Direct Coombs test. Further, the amount of antibody present on the red cells shows a close correlation to the haemoglobin level; suggesting that the degree of sensitization of the RBCs influences their rate of destruction. Favourable response to treatment correlates with a decrease in the levels of bound antibody and complement. PMID- 3314112 TI - Review of studies on the immunological capacity in the bursectomized chick. AB - This paper summarizes data on the immunological capacity in the bursectomized chick. A series of experiments described by Glick and Sadler represented the functional importance of the bursa of Fabricius for the humoral immunity in chicken. Later studies of immune responses in bursaless chickens reported by Lerner et al. contributed to our knowledge of bursa-independent humoral immunity and demonstrated an extra-bursal site for B-cell differentiation. Bursectomy at an early stage of chicken development changes the immune responses after hatching. Here I present my current understanding of embryonic B-cell populations (bursa-dependent and independent) following in ovo bursectomy which may influence B-cell differentiation with reference to our experiments on J chain production. PMID- 3314114 TI - [Isolation of conjugated sera for the immunofluorescence demonstration of swine parvovirus]. AB - High-titer, specific serum against porcine parvovirus was obtained via hyperimmunization of rabbits, with the use of a Bulgarian isolate that had been partially purified after a known, modified technique. A specific, high-titer conjugate was produced for the immunofluorescence diagnosis of porcine parvoviruses. The microscopic observation of the lamellae of cell cultures, treated with the conjugate, revealed the presence of a specific, typically granulated perinuclear (mostly unilaterally) and, in some cases nuclear fluorescence--at negative reaction in the control preparations. Immunofluorescent light was also established in cell cultures infected with the virus at highest dilution. It showed that immunofluorescence microscopy could be employed to demonstrate even the lowest amounts of the virus. PMID- 3314113 TI - Swine lymphoid and myeloid neoplasms in Italy. AB - In the decade 1973-1982, data from all the principal diagnostic centers in Italy reveals that swine lymphoid and myeloid neoplasms (LMN) have been observed only few times (78 cases). In a 25-year period (1950-1984) 48 cases were diagnosed in our Institute, among which all the known forms of LMN, including the most uncommon such as multiple myeloma (1) and myeloid forms (4) including 1 chloroma and 1 erythraemic neoplasm. The incidence remains low; 1.17% of the diseased swine sent for necropsy, with no significant increase during the years. In the same period the incidence of other neoplasms was 1.14%. Also the data from the abattoir of Bologna confirm a low incidence: in the last 2 years lymphoid neoplasms were observed only twice among 130,000 slaughtered pigs (15 cases per million). This incidence is therefore similar to that noticed in slaughterhouses in other European countries and in the U.S.A. As for the anatomohistopathological features, lymphosarcoma presents a constant autochthonous production of immature collagen fibrils, but the degree of this production has no significant relation with either the macroscopic type of lesions, nodular or infiltrating (diffuse), or the level of cellular differentiation. Diffusely haemorrhagic lesions were observed in a relatively high percentage (14%) of lymphosarcomas. The incidence of myeloid neoplasms is relatively high compared with that of lymphosarcomas: from 5% of Italian cases as a whole to 14% of the cases studied in our Institute. This confirms that the pig is second to the dog as a domestic animal showing most of these myeloid neoplasms. PMID- 3314115 TI - Crystallization, enzymatic cleavage, and the polarity of the adenovirus type 2 fiber. AB - Crystals of the fiber protein of adenovirus type 2 have been grown. Analysis of these crystals (type I crystals) showed that they were composed of fiber polypeptide with a lower apparent molecular weight (60 kDa) than that of the soluble or virion-incorporated fiber (62 kDa). N-terminal sequencing revealed that the fiber polypeptide chain of 60 kDa was cleaved at tyrosine17 from the N end. The C-terminus remained intact. Assays with protease inhibitors suggested that the spontaneous cleavage of the fiber occurring upon its crystallization was due to a cellular, calcium-dependent, chymotrypsin-like protease co-purifying with the fiber and activated during hydroxyapatite chromatography. Crystallization of fiber purified in the presence of chymostatin provided crystals of a different structure under the electron microscope (crystals of type II), composed of 62-kDa fiber polypeptide units. The 62-kDa fiber from the type II crystals, as well as the 62-kDa fiber isolated from infected cell extracts, were able to associate with the penton base in vitro to form a penton capsomer. The 60-kDa fiber has lost this capacity. The accessibility of the N- and C termini of the fiber inside the penton structure was probed by anti-peptide sera after limited proteolysis. The results are consistent with a polarity of the fiber in which its N-terminus is oriented toward the penton base, the C-terminal domain corresponding to the distal knob. PMID- 3314116 TI - [Characterization of hepatitis B virus surface antigen produced in yeast]. PMID- 3314117 TI - [Tobacco mosaic virus vector]. PMID- 3314118 TI - [Gene structure of the Bunyaviridae family]. PMID- 3314119 TI - [Detection of small defects in the ventricular septum in ambulatory care]. PMID- 3314121 TI - [Non-pharmacologic treatment of hypertension]. PMID- 3314122 TI - [Hemostasis using endoscopic injection in hemorrhagic changes in the stomach and duodenum]. PMID- 3314120 TI - [Use of computer diagnosis in the detection of venous thrombosis and pulmonary embolism]. PMID- 3314123 TI - [Theophylline drugs and monitoring their effects]. PMID- 3314124 TI - [Advantages of ultrasonography in examinations for aneurysms of the abdominal aorta]. PMID- 3314125 TI - [The antiarrhythmic drug Etmozine in the light of new findings]. PMID- 3314126 TI - [The evacuation of wounded by air transport]. PMID- 3314127 TI - [Errors in rendering surgical care in cases of combined eye injuries]. PMID- 3314129 TI - [Medical service of the Navy in the 1st years of Soviet power]. PMID- 3314128 TI - [Skin autograft in eliminating defects and deformities in the oral mucosa, orbit and nose]. PMID- 3314130 TI - [Vitol'd Martselievich Novodvorskii (on the centenary of his birth)]. PMID- 3314131 TI - [Soviet memorial medals honoring military medicine]. PMID- 3314132 TI - [His calling (Viktor Petrovich Maksimenko)]. PMID- 3314133 TI - [Prospects for using thymalin in treating bacterial intestinal infections]. PMID- 3314134 TI - [The fate of the wounded and ill after the Battle of Borodino (on the 175th anniversary of the Russian War of 1812)]. PMID- 3314135 TI - [The year 1917 at the Military Medical Academy]. PMID- 3314136 TI - [Medical support of the Navy in the Russian-Japanese War of 1904-1905]. PMID- 3314137 TI - [Medical support of the military naval forces of Great Britain in the Anglo Argentine conflict]. PMID- 3314138 TI - [Sleep disorders and the use of soporific agents]. PMID- 3314139 TI - [Spontaneous subarachnoid hemorrhage]. PMID- 3314140 TI - [Vitamin supply in various occupational groups and approaches to its optimization]. PMID- 3314141 TI - [Quantitative evaluation of the absorption of intact protein macromolecules and their large fragments from the gastro-intestinal tract into internal organs]. AB - Basing on the literature data and their own findings, the authors assume that for the summary estimation of absorption of protein antigens, simultaneous assay of their content in the portal blood and lymph would be most correct. The method of dissociation with 8M urea of complexes, formed by blood serum proteins and tissues with low-molecular products of protein splitting, has been proposed for the quantitative estimation of exogenous high-molecular compounds that completely lost antigenic determinants of their initial protein. PMID- 3314142 TI - [Alcohol and essential nutritional factors]. PMID- 3314143 TI - [Evaluation of dipyridamole efficacy as an agent for preventing acute respiratory viral diseases]. AB - The epidemiological effectiveness of a low molecular interferon inducer, dipyridamole, as a means of prevention of influenza and ARD was studied in a double-blind epidemiological trial in a period of seasonal rise of ARD (Dec., 26, 1984-March 13, 1985). A statistically significant decrease of ARD incidence (1.91 fold) in the experimental group was confirmed by the results of serological studies and titrations of serum interferon in paired sera collected before the prevention and 10 days after its termination in selected subgroups from the experimental and control groups. The results indicate that the use of dipyridamole may be effective for mass prevention of influenza and ARD. PMID- 3314144 TI - [Possible connection of the vaccinia virus and carcinogenesis]. AB - The data are presented indicating a possible carcinogenic danger of vaccinia virus. Vaccinia virus with reduced lytic properties was shown to be capable of inducing morphological and malignant transformation of cells of primary mammal tissue cultures (mouse, rat, man). PMID- 3314145 TI - [Changes in the organs of the immune system of Syrian hamsters infected by the tick-borne encephalitis virus with various degrees of virulence]. AB - On the model of Syrian hamsters inoculated intracerebrally with 9 tick-borne encephalitis (TBE) virus strains varying in virulence, the specific involvement of the organs of the immune system (spleen and lymph nodes) was established and morphological features of the process described. The most severe destructive changes of these organs were found in the hamsters inoculated with highly virulent strains which appeared to be one of the factors leading to 100% death of the animals. In hamsters inoculated with strains of low virulence, the destructive changes in immunogenesis organs were less marked, but active migration and proliferative processes developed in them. The above-described differences in the involvement of the immune system organs should be taken into consideration in the interpretation of TBE pathogenesis and evaluation of the degree of virulence of the virus strains. PMID- 3314146 TI - [Immunofluorescent detection of viral antigens in the enzymatic processing of histological and cytological matter]. PMID- 3314147 TI - [Acquired immunodeficiency syndrome (AIDS)]. PMID- 3314148 TI - [Mechanisms of the immunoregulatory action of insulin]. PMID- 3314149 TI - Alzheimer's disease: recent advances. PMID- 3314151 TI - Sources of data. International nursing research. PMID- 3314150 TI - Nursing research in New Zealand. PMID- 3314152 TI - Early experiences with anaesthesia and the first recorded use of ether in Jamaica, 1847. PMID- 3314154 TI - Space medicine--a review of current concepts. AB - Space medicine deals with the branch of research involved with the adaptation of humans to the unique environment of space. More than 100 people have traveled in space. The day will come when some human beings will spend all their time in space. Medical problems encountered in space, such as motion sickness, negative nitrogen and calcium balance, anemia and radiation exposure, are issues that already affect medical practice outside aerospace medicine. PMID- 3314153 TI - Electrolyte, blood urea nitrogen and glucose level screening in medical admissions. Impact on patient management. AB - Investigators have failed to show the usefulness of screening electrolyte-sodium, potassium, chloride and bicarbonate-blood urea nitrogen and glucose levels. In spite of this, we observed that that practice continues to be widely used at our university medical center. Using a form of consensus analysis, we examined the records of 301 admissions to the medicine service to determine whether laboratory tests were done for diagnostic or screening purposes and whether screening test results led to changes in patient management. Of the 1,764 tests done, 716 (40.6%) were for screening purposes. Only 2 (0.3%) screening test abnormalities led to any therapeutic changes, and many false-positive tests led to unnecessary diagnostic retesting. PMID- 3314155 TI - Recent advances in the treatment of duodenal ulcer disease. A surgical perspective. AB - Chronic peptic ulceration is a disease process in transition. During the past two decades, the disease has changed in its incidence, in its presentation and in its medical consequences. The pathogenesis of acid-peptic disease has been the major focus of numerous investigations, and major advances in understanding basic gastric physiology have led to specific and increasingly effective therapeutic approaches. With the introduction of H(2)-receptor antagonists, the treatment of peptic ulceration has been radically altered, and many new therapies await clinical trial. Surgeons treating gastroduodenal ulceration will require greater knowledge of gastric physiology and an increasingly refined appreciation of both the power and limitations of various medical and surgical therapies. PMID- 3314156 TI - Chemotherapy for bacterial infections of the central nervous system. AB - Over the past six years, many new agents have become available for the treatment of bacterial central nervous system (CNS) infections. Certain principles guide the use of these agents for CNS infections: first, an antimicrobial agent must be able to penetrate the CNS to be effective; second, the CNS is a "relatively immunoincompetent site" so that an antimicrobial must achieve levels within the CNS capable of killing the offending bacterium. The lack of efficacy of chloramphenicol for meningitis due to gram-negative aerobes is probably due to its failure to achieve such killing levels, whereas the success of the newer cephalosporins, such as cefotaxime and ceftriaxone, is due to their very high killing activity against these organisms. Penicillin remains the first choice for pneumococcal and meningococcal meningitis. Ampicillin plus chloramphenicol is still recommended as initial therapy for meningitis due to Hemophilus influenzae. The newer cephalosporins are now the first choice for the treatment of meningitis due to many gram-negative bacilli. Trimethoprim-sulfamethoxazole may also be useful in some of these infections and those due to Listeria monocytogenes. In the treatment of severe CNS infections, a team approach is advised to ensure optimal therapy. PMID- 3314157 TI - Asthma mortality. AB - These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Drs Homer A. Boushey, Professor of Medicine, and David G. Warnock, Associate Professor of Medicine, under the direction of Dr Lloyd H. Smith, Jr, Professor of Medicine and Associate Dean in the School of Medicine. Requests for reprints should be sent to the Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143. PMID- 3314158 TI - Wound botulism. PMID- 3314159 TI - [Effect of an intrauterine contraceptive device on the endometrium and gonadotropin levels in the peripheral blood]. PMID- 3314160 TI - [Evaluation of the effectiveness of Vepeside (VP-16-213) in the treatment of drug resistant recurrences of malignant lymphatic neoplasms]. PMID- 3314161 TI - [Problems related to aging with special reference to stomatological care]. PMID- 3314162 TI - [Transient total amnesia]. PMID- 3314163 TI - [Diagnostic difficulties in a patient with the cerebral form of malaria]. PMID- 3314164 TI - [A recently found portrait of Georg Andreas Helving]. PMID- 3314165 TI - [Resection of lung tissue in the treatment of pulmonary tuberculosis]. PMID- 3314166 TI - [Angiotensin-converting enzyme inhibitors in the treatment of chronic congestive circulatory failure]. PMID- 3314167 TI - [Amanita phalloides poisoning in children]. PMID- 3314168 TI - [Effect of immersion in water on hemodynamic and endocrine changes in the human body]. PMID- 3314169 TI - [Detection of primary aldosteronism using the captopril test]. AB - In order to evaluate whether changes in the plasma concentration of aldosterone (PA) following the administration of captopril, an inhibitor of angiotensin converting enzyme, will establish the diagnosis of primary aldosteronism we have used this test in 9 healthy subjects and in 22 patients with various forms of hypertension, including 5 patients with primary aldosteronism due to idiopathic adrenal hyperplasia (n = 4) or aldosterone-producing adenoma (n = 1). The response of PA to captopril (25 mg orally) was investigated on an outpatient basis, following a rest period of 120 minutes in the supine position. In healthy subjects PA decreased from a mean basal value of 11.5 +/- 5.9 ng/dl to less than 6.4 ng/dl (4.9 +/- 1.4 ng/dl [p less than 0.01]). Similarly, captopril induced a fall in PA concentration to less than 6.4 ng/dl in patients with essential hypertension, with renal artery stenosis or with an afunctional kidney. Post captopril concentrations of plasma aldosterone were about twice the normal level in 3 of 4 patients with idiopathic adrenal hyperplasia and about four-fold raised above normal in the patient with an aldosterone-producing adenoma. In spite of a false-negative result in one patient with idiopathic adrenal hyperplasia, the administration of captopril appears to be of use in recognizing patients with primary aldosteronism on an outpatient basis. PMID- 3314170 TI - [Decrease in arterial PO2 with captopril administration in secondary pulmonary hypertension and right heart failure]. AB - The ventilation-perfusion match under therapy with captopril was registered in 14 patients with secondary pulmonary hypertension and right heart failure caused by chronic obstructive lung disease. In none of the cases, changes of cranialisation of the perfusion or increasing ventilation-perfusion mismatch was found, but a significant fall in O2 was seen in all patients. This O2-depression is due to decreasing stroke volume of the right to left shunt. PMID- 3314171 TI - [Current status of kidney transplantation. Results in Austria]. AB - Kidney transplantation is the therapy of choice in patients with chronic renal failure. In the present report some factors which improve the results in kidney transplantation were analyzed. Histocompatibility, short warm and cold ischaemia times and an adequate immunosuppressive therapy are of special importance. The use of cyclosporine as an immunosuppressive agent improved the rate of functioning kidney grafts. The diagnosis of the acute rejection is effectively using new biochemical and histological methods. Bacterial and viral infections are still the most important complications after the kidney transplantation in Austria are one of the best in Europe and in the world. PMID- 3314172 TI - [Pyogenic liver abscess. Successful percutaneous ultrasound-controlled drainage]. AB - Successful percutaneous drainage of a solitary pyogenic liver abscess guided by ultrasound is the subject of a case report. The technique of catheter insertion and the follow-up are described in detail. The selection criteria for this procedure are discussed. PMID- 3314173 TI - [Endoscopic evaluation of a retard cimetidine preparation with reference to its effect in stomach and duodenal ulcer. A comparative study with a non-retard cimetidine preparation]. AB - With the development of this new galenic retard administration, we found in conclusion a significant longer action interval. A dose increase, similar to non retard administrations was on no account necessary. The new drug, Cimetidine retard, offers accordingly the opportunity of full utilization of the offered pharmacologic effective substance in combination with low dose administration and poor side effects. PMID- 3314174 TI - Progress symposium--advances in intraoperative ultrasound. PMID- 3314175 TI - The application of ultrasound during brain surgery. PMID- 3314176 TI - The use of ultrasound during spinal cord surgery. PMID- 3314177 TI - The use of high-resolution ultrasound to locate parathyroid tumors during reoperations for primary hyperparathyroidism. PMID- 3314178 TI - The use of operative ultrasonography for the localization of renal calculi. PMID- 3314179 TI - The application of operative ultrasound immediately following carotid endarterectomy. PMID- 3314180 TI - The use of ultrasound during reconstructive arterial surgery of the lower extremities. PMID- 3314182 TI - Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi. PMID- 3314181 TI - The systematic use of operative ultrasound for detection of liver metastases during colorectal surgery. PMID- 3314183 TI - The use of high-resolution intraoperative ultrasound to localize gastrinomas: an initial report of a prospective study. PMID- 3314184 TI - The use of operative sonography in carcinoma of the pancreas. PMID- 3314185 TI - The use of ultrasound during surgery for complications of pancreatitis. PMID- 3314187 TI - Growth, functional capacity and physical fitness in normal and malnourished children. PMID- 3314186 TI - The detection of gastric and esophageal tumor extension by high-resolution ultrasound during surgery. PMID- 3314188 TI - Trace element nutriture of Nigerians. PMID- 3314189 TI - Oestrogens and vitamin B6--actions and interactions. PMID- 3314190 TI - Diet therapy of celiac disease and dermatitis herpetiformis. PMID- 3314191 TI - [Glucocorticosteroid therapy in bronchial asthma with special reference to the prevention of life-threatening bronchial obstruction in high-risk asthma]. AB - The treatment of bronchial asthma with glucocorticosteroids requires consideration of unequivocal principles which include strong indication, considering the individual risk-benefit-relation. Glucocorticosteroids should be fitted in a medicamentous-therapeutic hierarchy. Inhalable glucocorticosteroids hardly cause systemic side effects, so they are very suitable for the continuous treatment, if the need in glucocorticosteroids is low. The indication for systemic application of glucocorticosteroid, their side effects, relative contraindications and pharmacological interactions are given. Careful analyses of cases of death, caused by bronchial asthma in accordance show that an inadequate glucocorticosteroid-therapy was the most important avoidable factor. The attention of the clinicians must be directed on a small group of patients characterised by high risk of death ("high-risk-asthma"). These patients, having certain clinical signs, need not only special intensive care, but also experienced, early and sufficient treatment with glucocorticosteroids to prevent life threatening situations. PMID- 3314192 TI - [Demonstration of artificial mineral fibers using bronchoalveolar lavage in animals]. AB - Inhalation of man-made mineral fibers (MMMF) was performed with mini-pigs and beagles to examine the value of bronchoalveolar lavage for the detection of these fibers in the lung. The preparation of the BAL-fluid without filtration lead to the detection of a plentiful quantity of MMMF. With our investigations we could verify that in the final product mineral-wool a great spectrum of different seized fibers down to particles reaching the alveoli is present. PMID- 3314193 TI - [HLA typing in extrinsic allergic alveolitis]. AB - The present conceptions about the genetic mechanisms in the predisposition to extrinsic allergic alveolitis are summarized in a review. The major complex of histocompatibility is shortly characterized and the method of HLA-typing is described. The own results of HLA-typing in poultry farm workers are compared with the data from the literature on patients with pigeon-, budgerigar-keepers disease and farmer's lung. Persons with HLA-B8- or/and DR3-antigens seem to be predisposed to extrinsic allergic alveolitis. The importance of the investigations for the preventive medicine is stressed. PMID- 3314194 TI - [Infections caused by RS virus in young infants]. AB - We saw 5 young infants with severe pneumonias due to RS virus (diagnosed serologically). Three of these infants were born as premature babies. Artificial ventilation was necessary in two cases. After the case reports follows a discussion of the most important problems of epidemiology, diagnostics and therapy of RS virus infections in young infants. PMID- 3314195 TI - [Etiology of lung fibrosis from the occupational medicine viewpoint]. PMID- 3314196 TI - [The value of histological studies of biopsy material in the review of occupational lung damage]. PMID- 3314197 TI - [Analysis of mineral dust in lung tissue]. PMID- 3314198 TI - [The application of electron microscopic methods in biology and medicine]. PMID- 3314199 TI - [The oscillation method for the diagnosis of respiratory function of adults- arrangement and possibilities for optimization. 4. The oscillatory residual volume determination (RVOS)]. AB - The residual volume can oscillatorily be estimated in an easy way with the help of diving-gas. The oscillatory unit, furnished with a sensor of density, serves as a quick helium-analyser. An overestimation of the residual volume can appear as a result of the high volatility of the used gas, an underestimation can result because of the non-registration of lung parts with entrapped air. Therefore a differentiated interpretation of the curve of wash-in is suggested. Thus a good conformity can be found with the body plethysmographic results also in patients with obstructive airways diseases including persons with disturbances of ventilatory distribution. PMID- 3314200 TI - [Tumor markers as a means of cancer diagnosis--expectations and problems]. AB - The number of tumor markers used clinically has grown rapidly in recent years. The applicability of these substances to the improvement of cancer diagnosis is reviewed. The practical utility of most of the available markers is severely limited by their insufficient specificity and sensitivity. It is emphasized that, at present, the early diagnosis of common tumors by means of screening with specific markers is practically impossible. The suitable markers rather promise to be useful in the postoperative care of cancer patients, especially with respect to the estimation of the therapeutical success, the risk of metastatic processes, and the prognosis. The recently introduced monoclonal antibodies may assist in reaching a higher level of diagnostic statements. The markers CA 12-5, CA 15-3, CA 19-9, CA 50, TPA, and Neopterin are considered in detail. PMID- 3314201 TI - [Epidemiology of Hodgkin's disease from the pathophysiologic viewpoint--review]. AB - The aetiology of Hodgkin's disease remains unclear, however epidemiological characteristics have led to directive conceptions. The description of the rare familiar appearance of lymphogranulomatosis among other things by two cases of our own population and the presentation of milieu factors influencing incidence and prevalence rates give a extensive basis of discussion to develop pathophysiological ideas and to prove it by clinical, pathological, genetical and immunological knowledge. Genetical determination by an autosomal-dominant allele, with incomplete penetrance, predisposing insufficiency of immune suppression and disease inducing virus infection seems less to be three competing aetiologic systems; they rather form a causing trinity, which internal connexions we are at present not able to understand. PMID- 3314202 TI - [Berolina iubilans: Berlin physicians as Halle doctoral candidates (I): Johann Carl Wilhelm Moehsen (1722-1795), Halle doctoral candidate of 1742]. AB - The celebration of the 750th anniversary of the city of Berlin gave rise to remember life and work of several physicians who after their graduation at Halle university set up their practice in Berlin and here performed remarkable accomplishments in various fields. One of these representatives of an ars medica Berolinensis is Johann Carl Wilhelm Moehsen (1722-1795), graduated at Halle university in 1742, a polyhistor, who dealt with several subjects and with his regional-historical studies initiated a historiography of science including history of medicine. PMID- 3314204 TI - [Immunology of the primary inflamed joint]. AB - The primary inflammatory rheumatic joint has a high capacity to start a local autoimmune reaction. Prototype of this reaction is the rheumatoid joint. In this review evidence is provided that the rheumatoid joint exhibits--with a high degree of certainty--autoimmune reactions of both cellular and humoral autoimmunity against IgG, Collagen of various types, proteoglycans, nuclear antigens and C3b. It is also shown that such reactions are not restricted to rheumatoid joints and may be demonstrated in other joint diseases. The local chronic immune reaction may lead to cartilage destruction through four effector cells, that is macrophages, specialised fibroblasts, chondrocytes and neutrophils. PMID- 3314203 TI - [Pathobiochemistry of joint destruction in inflammatory and degenerative joint diseases]. AB - While the biochemical mechanism which leads to the destruction of joints in the course of degenerative and inflammatory arthropathies has not been cleared up completely to this day, basic differences have been noted in the way the two types of arthropathy affect the articular cartilage. The differences are described from the viewpoint of pathobiochemistry as they are fundamental to causal therapy. PMID- 3314205 TI - [Clinical diagnostic strategy in rheumatology]. AB - The diagnosis of rheumatic diseases should follow a pattern of stages, the first comprising family case history, the case history of the patient and basic physical examinations. The second stage should include X-ray examination and basic or, if necessary, more extensive laboratory tests and simple synovia analysis. The third stage would then incorporate articular biopsy, arthroscopy, different biopsies outside the joint, isotope examination, electromyography, thermography, arthrosonography, computed tomography etc. Allowance should be made in this connection for the diagnostic criteria established by different specialist bodies and the different degrees of diagnostic safety involved. While computerized diagnostic systems for rheumatic diseases can be of great help to the GP, they will never be as successful as the experienced rheumatologist. PMID- 3314206 TI - [Perforation of a stomach ulcer into the left heart ventricle. Case report and review of the literature]. AB - We present a case of peptic-ulcer perforation from the stomach into the left ventricle. The patient who had no prior cardiac or abdominal symptoms was admitted with gastrointestinal bleeding and the electrocardiographic signs of myocardial infarction of the posterior wall. After the bleeding had subsided for 5 hours the patient died suddenly from massive upper gastrointestinal bleeding. At autopsy a peptic ulcer was found 3 cm beneath the cardia in the anterior wall on the lesser curvature which had perforated dorsal from the papillar muscle into the left ventricle. In the literature 19 such ulcer perforations have been reported which are compared with the present case. PMID- 3314207 TI - [Development of a modified bypass system for bridging the anhepatic phase in orthotopic liver transplantation]. AB - The tube-system of the biopump equipment (Bio-medicus, Minnesota/USA) is an essential part of the veno-venous bypass during liver-grafting. In this system turbulences of the blood flow have be avoided because of the unability of heparinization. Any conjunctions parts of the system are areas of potential flow changes. The number of junctions in the tube-system increase the risk of blood clotting with consecutive intraoperative complications by embolisms. This paper describes a new tube-system with integrated lines for pressure measurements in order to minimize these problems. PMID- 3314208 TI - Method for vascularized thymus transplantation in rats. AB - The studies established a microsurgical method of vascularized thymus transplantation in continuity with the heart in rats. The thymus-heart graft was joined with abdominal vessels of the recipient. The methodical investigations were performed on outbred Wistar rat strain. Observations in light microscopy and investigation of the graft's microvascular bed performed to the fifteenth day after operation showed well preserved lymphatic tissue and it's sufficient blood supply. PMID- 3314209 TI - [How does the islet cell organ react to glucose following extensive resection of the small intestine?]. AB - Changes in the functional connection between the small bowel and Langerhans islet cells after extensive small bowel resection were analyzed. The extension of resection chosen were as follow: resection of proximal small bowel (75%), resection of distal small bowel (66%), resection of ileum (45%). 28 days after operation we examined the reaction of endocrine pancreas with the intraperitoneal glucose tolerance and with the isolated perfused pancreas on glucose stimulation. After extensive resection of the proximal small bowel we found a decreased sensitivity of islet cells on glucose stimulation. This reaction was similar to that observed in diabetes mellitus. Glucose tolerance, insulin- and pancreatic glucagon release in rats after ileum resection were almost normal. In this case we found a reduced level of fasting plasma glucose and of the basal insulin. This was accompanied with an increased food intake during the postoperative period. PMID- 3314210 TI - [Immunophenotyping and morphometry of inflammatory infiltrates in variants of basalioma]. AB - The inflammatory infiltrate of 5 histologically different types of basal cell carcinoma (BCC) (n = 22) was characterized by means of the alkaline phosphatase monoclonal antialkaline phosphatase technique (APAAP). We proved a distinct stromal pattern of infiltration, which was focally accentuated; in some cases, the cells infiltrated the tumor itself. On phenotyping these cells, we found clear predominance of T cells (75%), which mostly consisted of T helper/inducer cells (45%) and suppressor/cytotoxic cells (32%); in addition, we found B cells (6%) as well as monocytes and macrophages (15%). Morphea-like and adenoid types of BCC showed some tendency to a less pronounced infiltration. Chronic exposure to sunlight and ulceration did not significantly influence the quality or quantity of the inflammatory infiltrate--except for polymorphonuclear leucocytes and macrophages. PMID- 3314211 TI - [PUVA irradiation decreases the binding of membrane and basement membrane markers to human epidermis in vitro]. AB - PUVA effects on frozen sections of human epidermis were investigated (20 micrograms 8-methoxypsoralen/ml; UVA wavelength 365 +/- 5 nm; radiation dose between 2 X 10(2) and 2 X 10(2) J/m2). The quality of the glycocalyx was characterized by lectins labeled with FITC (HPA, PHA, LCA, PNA, SBA, RCA, GCA I, UEA I). Serum antibodies of bullous pemphigoid (BP) served as membrane markers for the basement membrane. Fixed BP antibodies were detected by FITC-antihuman IgG. The fluorescence intensity was markedly decreased at a dose of 2 X 10(5) J/m2; 2 X 10(4) J/m2 were less effective. At 2 X 10(3) J/m2, there was nearly no alteration of the fluorescence intensity observed. Changes were seen in the case of BP antibodies and lectins, except UEA I. The relatively high intensity (radiation dose) and the effects immediately observable suggest direct membrane alterations by PUVA in vitro. PMID- 3314212 TI - [Leading symptom of angina pectoris. Psychophysiologic mechanisms of pain perception in chest pain complaints]. AB - Anginal chest pain represents an important cardiac symptom which proved to have a high pretest probability for the existence of potential heart disease. The occurrence of clinically unapparent or atypically exposed myocardial ischemia, as well as discrepancies in effort angina, provide evidence that the release of a nociceptive stimulus does not guarantee pain perception of the same proportion. The connections between sequential nociceptive nerve impulses at different central nervous regions and particularly at non-specified thalamic nuclei allow learning processes in the development of pain perception. The intensity of pain may be altered to a great extent by the anxiety level. The patient might develop habits of vigilance for low threshold abnormal signals generated from the interior of the body; he might, however, also reach a stage of complete pain suppression by centrifugal control of the nociceptive input. Heart pain is probably one of the moderators in a more complex warning system. PMID- 3314213 TI - [MR tomography in cardiology. II: Flow phenomena]. AB - Flow phenomena modify the information of MR tomograms and can cause artefacts which degrade the image quality. When ECG triggering and suitable modes of excitation are used, flow effects can give diagnostically relevant information concerning global and regional cardiac function and blood flow in vessels. The signal intensity of blood excited by an SE-mode is usually low. The spin echo increases due to the TR-effect. However, the TE-effect reduces the signal of flowing blood with increasing flow velocity. Phase shifts caused by flow generate line-shaped artefacts in the reconstructed tomograms and decrease the signal intensity of all odd spin echoes. The second order phase errors are compensated by phase recombination occurring in all even echoes. Therefore, in double echo acquisition the second spin echo of flowing blood can be higher than the first echo, especially when the flow velocity is physiologically or pathologically reduced. In multi-slice acquisition, time-of-flight effects can be observed, by which a resonance signal induced in one particular slice is shifted to and recorded in another slice. PMID- 3314214 TI - [Heart transplantation in therapy-resistant, recurrent ventricular tachycardias and ventricular fibrillation]. AB - In life-threatening, drug resistant ventricular tachycardia (VT) or ventricular fibrillation (VF), orthotopic heart transplantation should be considered as an alternative to a directed surgical approach or to the implantation of an automatic defibrillator. We report on nine patients with primary VT or VF who underwent transplantation. These comprised eight men and one woman with a mean age of 35 years (range, 19-51 years); dilative cardiomyopathy was present in seven and coronary artery disease in two. Left ventricular ejection fraction was 19% (11-26%), arrhythmia was recurrent VF in five cases, recurrent VT in two, and recurrent VT/VF in two. Two patients died, one due to acute rejection, and the other 8 months postoperatively due to chronic rejection. The seven other patients are all asymptomatic and leading normal lives without arrhythmias or antiarrhythmic drug therapy. Based on our preliminary experience, some advantages and disadvantages of heart transplantation are discussed in comparison with other treatment modalities. Despite limited indications for orthotopic heart transplantation we feel that it should become the therapy of first choice in young patients with progressive, surgically incorrectable cardiac disease complicated by drug resistant VT or VF. PMID- 3314215 TI - [Central and regional vascular hemodynamics of milrinone in experimental heart failure: comparison with captopril and dobutamine]. AB - The present study was designed to evaluate the regional vascular profile of milrinone in the setting of experimental heart failure. Utilizing the rat model of myocardial infarction and failure (average infarct size 28%), we measured cardiac output (CO), arterial pressure (MAP), LVEDP, heart rate and systemic vascular resistance, as well as regional blood flow (radioactive microspheres 15 +/- 5 microns) before and after milrinone i.v. (20 microns/kg bolus, 3 micrograms/kg/min infusion) in the conscious state (LVEDP 22 mm Hg versus 10 mm Hg in the sham-operated group, p less than 0.01). Similarly, central hemodynamics and regional blood flow were determined before and after dobutamine or captopril, administering equipotent doses. Milrinone reduced LVEDP more than dobutamine, both more than captopril; MAP was decreased by captopril only. Although all three drugs reduced SVR to a similar extent and increased CO, a quite different blood flow distribution occurred. Improvement in flow to skeletal muscle and splanchnic circulatory bed was exerted by milrinone only. Thus, milrinone attenuated the vasoconstriction in those circulations known to be impaired in heart failure. In contrast to captopril, the effects of milrinone on renal perfusion were modest. These results demonstrate the potent vasodilator activity of milrinone, which is independent of its direct-positive inotropic effects, being most prominent in the splanchnic, coronary and skeletal muscle circulation. The latter might have clinical relevance since improved muscular flow during exercise is likely to improve exercise capacity in heart failure after long-term treatment. PMID- 3314216 TI - [Nonspecific bacterial spondylitis--an analysis of 32 cases]. AB - With the decrease of tuberculous spondylitis non-specific bacterial spondylitis has got more importance. Regarding the difficult differential diagnosis between non-specific spondylitis, tuberculous spondylitis and tumor the question arises about the role of primary surgical procedure. 32 cases of the orthopedic departments of Brno and Lubeck are demonstrated, in whom surgical intervention has been chosen without exception (exposure with or without spondylodesis). In 19 cases the bacteriological and in all cases the histological findings ensured the diagnosis "non-specific bacterial spondylitis". Diagnostic proceedings corresponded to the descriptions in literature, x-rays (incl. tomograms) and scintigraphy had superior importance, CT had to show the expansion of the inflammatory process into the vertebral canal. Concerning diagnosis, course of disease and duration of therapy blood sedimentation rate and leucocyte count were the dominant parameters. Time of bed-rest and corset-wearing depends on clinical and laboratory findings, antibiotic treatment should be continued until mobilisation and normalisation of clinical and laboratory findings. In one case we had a grave complication during the operation (lesion of v. iliaca), apart from this healing up occurred in all cases within one year, in the course of which radiological stabilisation followed normalisation of clinical and laboratory parameters. PMID- 3314218 TI - [Johann Georg Heine's motive for leaving Wurzburg at the height of his success]. AB - In historical research it has been unclear until now, why J.G. Heine rather unexpectedly left Wurzburg in 1828. After the evaluation of new sources it is assumed today, as opposed to past oppinion, that it was due less to an "unexpected withdrawal" psychologically decompensating, angered personality, but rather a long-planned and consequent decision by Heine, determined primarily by adverse external circumstances, with which he had to come to terms with. Deciding factors included personal hostilities, inadequate academic recognition as an orthopaedist and as a pioneer in his new field, as well as only negligible governmental funding for his Institute, which was undergoing financial difficulties. PMID- 3314217 TI - [Superselective angiography as a therapy control of femur head necrosis treated with a vascular pedicled pelvic bone graft]. AB - This is a report of special operative therapy of idiopathic necrosis of the femoral head. This is based on the idea, that the necrosis of the femoral head is caused by an occlusion of the arteries of the femoral head, especially the arteria circumflexa femoris medialis. The necrotic area of the femoral head is filled up with a pedicle bone graft, which is apart from the spina iliaca and supplied from the art, circumflexa ilium profunda. From a total of 28 superselective angiographies of the arteria circumflexa femoris medialis, which where conducted preoperatively, a pathological finding was shown in 21 cases. Furthermore it is possible, to determine different courses of the art. circumflexa ilium profunda. A superselective angiography of the reset art. circumflexa ilium profunda was conducted in seven patients following the bone graft operation. These findings will be discussed. The angiographies were processed by electronic subtraction to better illustrate the state of the smallest vessels. PMID- 3314219 TI - Tomorrow's hepatitis B vaccines. Arie Zuckerman discusses hepatitis B vaccines of the future and the impact of AIDS on immunization. AB - Recombinant hepatitis B vaccines produced in yeast and in mammalian cells are the first of future vaccines against this important public health problem. Hybrid virus vaccines and the use of baculoviruses for expression of hepatitis B antigens in insect cell cultures will follow shortly and chemically synthetic vaccines are under development. The impact of AIDS on future immunization programmes should be considered. PMID- 3314220 TI - Technological investigations with attenuated strains of Shigella for production of live vaccines. 1. Cultivation in a fermenter of an attenuated strain S. flexneri 2a with two markers. AB - A method was developed for cultivation of the strain Shigella flexneri 2a 77 with two attenuated markers. It ensures the preservation of the initial properties of the strain. The regimen for control of dissolved oxygen level was optimized. It was established that yeast extract is a necessary component of the nutritive medium used. The role of the phase and quantity of the inoculum for growth of the bacterial population has been clarified. Fresh fermenter culture, applied in rats, shows a high immunogenic activity. After lyophilization, the cultures retain 50-70% of the immunogenic activity of the non-lyophilized cultures. The method makes preconditions for the production of a live attenuated dysentery vaccine for oral administration. PMID- 3314221 TI - Comparison of live and inactivated influenza vaccine in high risk children. AB - Bivalent, live attenuated intranasally administered influenza A vaccines were compared to inactivated, parenterally administered influenza A vaccines in a double-blind clinical trial in 55 children and young adults with cystic fibrosis. No qualitative or quantitative difference in symptomatology between the group receiving intranasal live vaccine versus placebo was observed. Serum immune responses to live vaccines were somewhat less than those to inactivated vaccine, particularly in adults. IgA response in nasal secretions was minimal in each vaccine group. In contrast, an IgG response in nasal secretions was commonly seen with both topically applied live vaccine and parenterally administered inactivated vaccine. PMID- 3314222 TI - [Polymorphism and creatine kinase activity. Diagnostic significance]. PMID- 3314223 TI - [Adenosine-5'-triphosphate and transmembrane transport of an extracellular regulatory signal]. PMID- 3314225 TI - [Functional and clinical importance of blood plasma fibronectin]. PMID- 3314224 TI - [Enzymological research on hyperlipidemic states]. PMID- 3314227 TI - [Structural organization of the integrative functions of the brain]. PMID- 3314226 TI - [Detection and characteristics of a lytic proteinase in a Pseudomonas lytica culture lysing pathogenic microorganisms]. PMID- 3314228 TI - [Systems mechanisms of higher nervous activity: theoretical and applied aspects]. PMID- 3314229 TI - [Problems at the neurochemical level of the organization of higher nervous activity]. PMID- 3314230 TI - [Means for developing research on the neuronal mechanisms of higher nervous activity]. PMID- 3314231 TI - [The pathological system in the mechanisms of disorders of higher nervous activity and behavior]. PMID- 3314232 TI - [Importance of the works of I. P. Pavlov for the science of resuscitation]. PMID- 3314233 TI - [New developments in the treatment of chronic circulatory insufficiency]. PMID- 3314234 TI - [Ippolit Vasil'evich Davydovskii (on the 100th anniversary of his birth)]. PMID- 3314235 TI - [The basic methods of treating psoriasis patients]. PMID- 3314236 TI - [Current concepts of the pathogenesis of psoriasis]. PMID- 3314237 TI - [150th anniversary of the birth of Veniamin Mikhailovich Tarnovskii (1837-1987)]. PMID- 3314238 TI - [Neurophysiological mechanisms of internal inhibition]. PMID- 3314239 TI - [Interaction of brain macrostructures during organization of behavior]. AB - The data on anatomical connections, injury consequences, summate and unit activity records may be represented as a chain of events running in sequence and in parallel in the brain of higher mammals. Internal (metabolism) and external (odour, pain, etc.) incentive unconditioned stimuli activate motivational structures of the hypothalamus, which in turn activates the frontal areas of the neocortex and the hippocampus. In case of coincidence of earlier neutral external stimuli with the action of reinforcing unconditioned ones, the hippocampus becomes the first place of convergence of combined afferentiations. After formation of the act, those external stimuli or their engrams which have been accompanied earlier by satisfaction of a certain need, are selected as a result of joint action of the hippocampus and the frontal cortex. By comparison of motivational excitation with available stimuli or their engrams retrieved from memory with the participation of the temporal cortex, an emotional colouring of the stimuli and engrams is formed in the amygdala leading to isolation of a dominant motivation, destined to be satisfied in the first instance. The program formed in the frontal cortex, comes to the basal ganglia where, by means of interaction with the parietal cortex, it confirms to the spatial coordinates of the forthcoming action. From the fronto-striate system, the excitation comes through the motor cortex to the effector organs accomplishing the behavioural act. PMID- 3314240 TI - [Results and prospects of the probability approach to the study of higher nervous activity]. PMID- 3314242 TI - Recent advances in immunization. PMID- 3314241 TI - [Systemic aspects of the organization of animal behavior in the works of I.S. Beritashvili and P.K. Anokhin]. PMID- 3314243 TI - Childhood malaria: aspects of immunity affecting morbidity and mortality. PMID- 3314244 TI - Pneumonia in children in Papua New Guinea. PMID- 3314245 TI - Bacteria and viruses in childhood gastroenteritis. PMID- 3314246 TI - The diagnosis of childhood tuberculosis. PMID- 3314247 TI - The management of reactions in leprosy. PMID- 3314249 TI - [Genetic influences in chronic polyarthritis]. AB - Genetically determined diseases exhibit the following characteristics: 1. They appear with different frequencies in various populations. 2. They show tendencies to aggregate in certain families. 3. The disease risk is higher for monozygotic twins than for dizygotic twins. 4. They show an association with genetically determined markers in a population e.g. certain HLA-antigens. All of these characteristics are observed in rheumatoid arthritis. Despite an abundance of data suggesting a genetic influence in the etiopathogenesis of rheumatoid arthritis, it has not been possible, as yet, to uncover a definitive genetic mechanism. There is evidence to suggest that both histocompatibility-complex associated genetic factors and genes outside the HLA region are of significance for predisposition to the disease and possible for the pathogenesis and course of rheumatoid arthritis. Using modern genetic technology it should be possible to investigate further the influence of genetic factors on the etiology and pathogenesis of rheumatoid arthritis. PMID- 3314250 TI - [Sonographic studies of the dilatation of the kidney pelvis in pregnancy at term]. AB - In 184 pregnant women near term the urinary tract was examined by ultrasound. Dilation of the kidney could be found in 94 women (51.1 per cent). The right kidney was predominant (65.9 per cent). Mechanical and hormonal influences could be the reason. No dilatation could be found in the puerperium. PMID- 3314248 TI - [Causes of postoperative death in pediatric surgery--a comparative analysis of 3 decades]. AB - Causes of postoperative deaths at our clinic from 1949 to 1982 were analysed. The most important results were: the overall lethality of the patients operated on was 1.5%; in 1985, however, it was only 0.19%. Infection was with 27.7% the predominant cause of postoperative death in all patients, followed by pneumonia with 20.3% and death from the underlying disease with 18.8%. Combining the groups infection and pneumonia, it turns out that nearly one-half (48%) of the children succumbed to infectious diseases. Classification of the causes of postoperative deaths in 5 different age groups revealed that more than a half of the deaths occurred in the neonatal period and 20% still in infancy. Furthermore, particularly newborn and infants died from postoperative infection. From 1976 1982 no child beyond the 4th year of life succumbed to an infection or pneumonia. The analysis presented is based on post-mortem protocols. From 1970 on-ward post mortem examination was performed in 80% of the children who had died. PMID- 3314252 TI - [A medal of Paul Zweifel (1848-1927)]. PMID- 3314251 TI - [Comparison of the results of a prenatal care program in twin pregnancies in years with and without ultrasound screening]. AB - It should have been tested if a reduction of perinatal morbidity and mortality of twin pregnancies is possible by starting intensive care earlier. 68 gemini pregnancies of the report period I (1978-80) which were not diagnosed early and 66 gemini pregnancies of the report period II (1982-84) with early diagnosis by sonography-screening have been compared. The prenatal care programme carried out both in out-patients clinic and inside the hospital is illustrated. Perinatal mortality declined from 5.88 per cent in report period I to 3.79 per cent in report period II. PMID- 3314253 TI - Quantitative character of fibrinogen uptake by M+ and M- variants of Streptococcus pyogenes. AB - Fibrinogen was labelled with 125Iodine by mild chemical oxidation and its binding to Streptococcus pyogenes was subjected to quantitative analysis, inhibition and desorption studies. Fibrinogen was bound both by virulent and avirulent (M protein-positive and M protein-negative) matched strains of several serotypes. In all pairs of strains fibrinogen uptake was much higher by the M-positive variants. The ratio of bound fibrinogen to total fibrinogen was highly dependent both on the concentration of fibrinogen and the concentration of cocci. Equilibrium binding studies showed that the binding was a multifactorial process. Probably not only receptor fibrinogen interactions but also interactions between bound and unbound fibrinogen molecules took place. The uptake of fibrinogen was highly depressed in avirulent strains and practically uninfluenced in virulent strains by the presence of albumin or immunoglobulin. The bond between fibrinogen and streptococci is therefore different in virulent and avirulent variants. The fibrinogen receptors on the cell surface are specific. PMID- 3314254 TI - Production and characterization of monoclonal antibodies specific for pathogenic serogroups O:3, O:8, and O:9 of Yersinia enterocolitica. AB - A panel of 7 murine hybridoma derived monoclonal antibodies (MAbs) to Yersinia enterocolitica were produced and characterized by indirect fluorescence assay (IFA) and agglutination reactions. One MAb designated 2D8 (IgG 3) showed specific reactivity both in the IFA and agglutination assays with 70 of the 70 strains belonging to serogroup O:3 of Y. enterocolitica. Three MAbs, 8E9 (IgG 3b), 10G11 (IgG3) and 11G2 (IgG 3), gave unequivocal positive reactions in the IFA and agglutination tests with all the strains representing serogroup O:9 (56/56), but not with serogroup O:3 or O:8 strains. Another MAb coded 1G2 (IgG 1) reacted specially in the IFA test (but not in the agglutination test) with all the strains representing serogroup O:3 (70/70) and O:9 (56/56) indicating that this antibody recognizes an immunodeterminant shared by serogroups O:3 and O:9. Finally, 2 MAbs 4C2 (IgM) and 6G5 (IgM), showed reactivity both in IFA and agglutination assays with "esculin negative" biogroups 1 (pathogenic American strains) strains of serogroup O:8 (12/12), whereas the strains assigned to "esculin positive" biogroup 1 (nonpathogenic) failed to react (6/6). However, 4C2 and 6G5 exhibited narrow cross reactivity with type strains assigned to serogroups O:18, O:20, and O:22. The results of absorption tests and the clear out cell wall immunofluorescence imply that the antigenic molecule(s) recognized by these MAbs are exposed on the bacterial cell surfaces. Some of the MAbs described in this report are useful reagents for precise serotyping of clinical isolates of Y. enterocolitica by simple and rapid slide agglutination assay. They may also allow the development of specific and sensitive tests for probing the presence of pathogenic Y. enterocolitica organism in clinical and food materials. PMID- 3314255 TI - Transmissible drug resistance among Shigellae and other enterobacteriaceae isolated from diarrhoeic human beings in Ibadan, Nigeria. AB - Antibiotic resistance patterns and the distribution of R-factors among Shigella, Salmonella and Escherichia coli isolated from diarrhoeic human beings were studied. Nine multiple antibiotic resistance patterns among which PNS TCK was the most common were observed. All the Shigella, Salmonella and eighteen Escherichia coli isolates transferred part of their r determinants respectively to E. coli K12. It is thought that enforcement of the law regulating the sales and judicious use of antibiotic in Human and Veterinary Medicines would reduce the incidence of multiple drug resistance in Nigeria. PMID- 3314256 TI - Active immunization of NMRI mice against Serratia marcescens. I. Phenol-water lipopolysaccharide fractions and purified metalloproteases. AB - The minimal intraperitoneal (i.p.) immunogenic doses of phenol-hot water lipopolysaccharide (P-W- LPS) preparations from three strains of Serratia marcescens for juvenile NMRI mice ranged from 3.2 to 16 ng following i.p. challenge infection with homologous strains. Dual autoclaving (121 degrees C, 15 min) abolished the cross-immunogenicity of two selected P-W LPS extracts. Four purified metalloproteases from S. marcescens strains SF 178, SH 186, SV O1, and SE 182 shared the following properties: a) inhibition of proteolytic (azocasein hydrolysis) activity by 50 mM of EDTA; b) heat-lability (60 degrees C, 15 min); c) identical molecular weights (54,000 Daltons = 54 K) as documented with the SDS PAGE procedure; d) close serologic relatedness (ELISA technique, polyclonal rabbit immune sera); and e) uniform reactivity of the 54 K polypeptide bands with polyclonal rabbit anti-metalloprotease immune sera (Western blots). The minimal immunogenic dose of metalloprotease SF 178, the sole significantly murine immunogenic enzyme, was 1000 ng = 1 microgram. PMID- 3314258 TI - Group B streptococci in the milk of lactating mothers. AB - A total of 1132 samples of maternal milk expressed from the disinfected breast on the first days after parturition were subjected to microbiological examination. Contamination by group B streptococci (Streptococcus agalactiae) was demonstrated in 40 samples (3.53%). Strains carrying the antigens Ia, Ia/c, Ib/c, II, III and R were represented among the isolates. Type Ia/c was the commonest; antigens II and III were always combined with the R antigen. The milk was either very strongly contaminated with almost pure culture demonstrable by direct cultivation of the milk sediment, or only isolated colonies were obtained in primary culture, often not until after enrichment. If the first samples gave dense growths, second sample cultures were also positive. The strains isolated from samples of the individual mothers milk differed by their antigenic type structure; this gave evidence that the infection was not of nosocomial origin. Immunoglobulin levels in the whey of positive samples were not different from the whey of mothers not shedding group B streptococci. The health of both mothers and infants did not deviate from the general average for normal mothers and infants. No signs common to all the mothers shedding group B streptococci in their milk and no marked effect on the infants' health up to the age of 1-2 years were established. PMID- 3314257 TI - Studies of experimental candidiasis in T-cell-deficient mice. AB - The role of cell-mediated immunity (CMI) in the protection against experimental murine candidiasis was studied. CMI-deficient animals prepared by adult thymectomy and treatment with antimouse thymocyte serum along with controls were challenged with one LD50 (6.6 X 10(4)) dose of Candida albicans. The course of infection in these animals was studied by mortality pattern, delayed type hypersensitivity reaction (DTH) to candida antigen, antibody formation, and viable count of organisms in kidney, spleen and liver at different time intervals. The T-cell-deficient animals were found to be highly susceptible to infection with C. albicans. A correlation was observed in the appearance of DTH and protection. PMID- 3314259 TI - Characterization of proteins, insoluble at low temperature, produced by Clostridium botulinum type C and C. subterminale. Their antigenic relationship with a similar protein synthesized by C. botulinum type G. AB - The production of a protein insoluble at low temperature ("cryoprotein"), by cultures of Clostridium botulinum type G has been shown to be a metabolic characteristic also shared by C. botulinum type C and by C. subterminale. These new cryoproteins have been purified and some of their chemical and immunological properties studied. It was found that both proteins were chemically very similar among themselves and to the cryoprotein isolated from C. botulinum type G. All these proteins are formed by a single polypeptide chain of approximately Mr = 180,000, with closely related amino acid compositions, isoelectric points and do not contain either free cysteine or disulfide bridges. Homologous and heterologous radioimmunoassays established the existence of an antigenic similitude among the cryoproteins from C. botulinum type G and C. subterminale thus becoming the first purified antigens which relate both bacterial species. If the production of cryoproteins can be shown to be a generalized phenomenon within the genus Clostridium these substances would provide an important tool to examine immunological and genetical relatedness between strains in this bacterial group. PMID- 3314261 TI - [Methodologic problems in the detection of indole formation by anaerobic pathogens]. AB - The demonstration of indole formation is of great value for the identification of pathogenic anaerobes. A reduction of the pH to values below the critical range of 5.1-5.3 in complex media 5.5 in simple testing substrates, respectively, which is caused by the presence of fermentable carbohydrates and will result in false negative reactions. For this reason, the indol test should be performed with an adequate buffer capacity and an addition of fermentable carbohydrates should be avoided. Strains showing a false-negative reaction in the spot indole test can be reliably accounted for by means of the rapid test in buffered tryptophan solution described here without having to use additional anaerobic culture methods. PMID- 3314260 TI - [Comparison of 4 methods of bacterial count determination in burn wounds]. AB - The present study includes twelve patients with second and third degree fresh burns involving 10-70 per cent total body surface area. Standardized surface swab, gaze pad contact, Rodac plates, and burn wound biopsy cultures were obtained twice per week. The various techniques were compared by 48 independent measurements. Confluent growth occur in more than 70 per cent of the Rodac agar plates. There was a significant (alpha less than 1%) correlation between the results of the surface swab and the gaze pad method. A comparison of the number of viable bacteria detected with the burn wound biopsy technique and the surface methods (gaze pad and surface swab) showed no significant correlation. In addition, the number of colony forming units in 8 parallel cultures obtained from different sites of the burn wound was determined. The standard error of mean (SEM) varied between 1.01 log (biopsy), 0.91 log (gaze pad) and 0.61 log (surface swab). Several case reports emphasize that the quantitative biopsy culture seems to give most reliable data in predicting burn wound sepsis. PMID- 3314263 TI - Antibiotic treatment, intestinal aerobic microflora and experimental sarcoma L-1 growth in Balb/c-mice. AB - The present paper deals with the influence of a 10 days treatment with mezlocillin, piperacillin, cefotaxime, clindamycin or gentamicin on the endogenous intestinal microflora of Balb/c-mice and on the local growth of sarcoma L-1 tumor. Clindamycin and gentamicin demonstrated no influence, whereas cefotaxime and piperacillin caused the eradication of gram-negative resp. gram positive bacteria but these antibiotics didn't produce a growth inhibition of local L-1 sarcoma tumor. The oral or parenteral application of mezlocillin (a 3 days treatment was sufficient) eradicated the complete aerobic and anaerobic intestinal microflora. This effect was significantly correlated with an increase of the cecum weight and the inhibition of local tumor growth. Possible mechanisms of these effects are discussed. PMID- 3314262 TI - Staphylococcus aureus producing toxic shock syndrome toxin 1 (TSST-1) in clinical specimens and vaginal swabs in Mannheim, West Germany. AB - 624 Staphylococcus aureus strains from our clinical laboratory were screened for toxic shock syndrome toxin 1 (= TSST-1) production and 16.7% of the strains were found to be positive. TSST-1-positive strains were isolated from material which originated from males and females with the same frequency. The strains were found in swabs from the respiratory tract, the conjunctiva, in sputum and wounds. TSST 1-positive strains were more resistant to arsenate and cadmium ions than non producers; their sensitivity to the antibiotics (when tested), was no different. The toxin-producing strains were lysed above all by the bacteriophages 29, 52, 80, 55, 75 and 83A. We isolated 19 S. aureus strains from 321 vaginal swabs: one of these strains was TSST-1-positive. Most of the strains were found in swabs from women using tampons. It has been concluded that the infection with TSST-1 positive S. aureus is either of subclinical course or that in most of the cases, the syndrome is of a less dramatic course than usually described. Quite certainly the syndrome is underdiagnosed in Germany. PMID- 3314265 TI - Quantitative studies on the vaginal flora of asymptomatic women and patients with vaginitis and vaginosis. AB - Vaginal washings of 22 patients with vaginitis, 11 with vaginosis, and 12 healthy subjects were investigated quantitatively and qualitatively for aerobic and anaerobic bacteria and yeasts. Gardnerella vaginalis was recovered from 9 of the vaginitis patients, 7 of the vaginosis patients, and 4 of the asymptomatic subjects. Obligate anaerobes were found in 11 of the vaginitis patients, 4 of the vaginosis patients, and none of the control subjects. Bacteroides bivius was the anaerobe most frequently isolated from symptomatic subjects. Anaerobic vibrios were recovered twice from symptomatic subjects. The counts for Gardnerella vaginalis and anaerobes when present were generally very high. The most frequent aerobes were beta-hemolytic streptococci (group B) and staphylococci. PMID- 3314264 TI - Effect of immunization with Escherichia coli K1 antigen on the course of experimental infection of the urinary tract of the rat. AB - The influence of vaccination with an immunogenic K1 antigen of Escherichia coli on the course of pyelonephritis induced experimentally in rats by infection with Escherichia coli O2:K1:H4 was investigated. The immunogenic properties of K1 antigen are poor. A conjugate of K1 antigen with bovine serum albumin (BSA) was therefore tested. Preliminary experiments showed that the K1-BSA conjugate is immunogenic. Renal inflammatory activity in rats after retrograde infection was significantly reduced after vaccination of the animals with K1-BSA conjugate within six weeks of infection. PMID- 3314266 TI - Immunoreactive estrogen receptor protein in meningiomas: comparison with the androgen receptor and progesterone receptor binding activity. AB - Analyses of gonadal steroid hormone receptor were performed using a monoclonal enzyme immunoassay for human estrogen receptor protein (estrophilin) for the first time and a conventional radioligand binding technique for progesterone and androgen receptors in 70 meningiomas. Low levels of estrogen receptor immunoreactivity (3.7 +/- 0.5 fmol/mg protein) were detected in 37 (53%) tumors, whereas moderate concentrations of androgen receptor binding activity (31.7 +/- 5.3 fmol/mg protein) and high concentrations of progesterone receptor binding activity (189 +/- 29.2 fmol/g protein) were demonstrated in 33 (47%) and 53 (76%) tumors, respectively. The estrophilin immunoreactivity was positively correlated with the androgen receptor binding activity (r = 0.634; p less than 0.001) but no relationship with the progesterone receptor binding activity was found. The presence of gonadal steroid receptors in a large proportion of meningiomas could have implications for diagnosis and tumor therapy. PMID- 3314267 TI - [Cerebral vasospasm following subarachnoid hemorrhage. New aspects of diagnosis and therapy]. AB - A comprehensive survey of the subject is given. Focal points are the discussions of calcium antagonists, pathophysiology of vasospasm and CBF-monitoring. Moreover, a novel neuromonitor is presented permitting bed-side work. In spite of the still unclarified etiology of vasospasm and the site of action of the calcium antagonists their early application is indicated for the prevention of cerebral vasospasm after subarachnoid haemorrhage. PMID- 3314268 TI - A new approach to the preparation of a Toxoplasma gondii membrane antigen for use in ELISA. PMID- 3314269 TI - [Insulin receptor reaction of the lamprey Lampetra fluvialis to hyperinsulinemia induced by administration of the hormone]. AB - Insulin injections to the lamprey Lampetra fluviatilis result in prolonged and significant hyperinsulinemia, but do not decrease the number of receptors in its target cells. These findings were made in studies on the specific binding to 125I insulin by membrane fractions of the brain and cardiac muscle in migrating and winter (fasting) lampreys. It is also suggested that no regulation of the number of the receptors by hormonal level takes place in the lamprey, which is presumably due to a low rate of internalization of hormone-receptor complexes and to a total decrease in the turnover of the receptors in a pre-spawning period. PMID- 3314271 TI - [New developments in research on brain evolution: the hypothesis of parcellation]. PMID- 3314270 TI - [Amino acid sequence of the insulin of the dog salmon Oncorhynchus keta]. AB - It has been demonstrated that A-chain of insulin in the salmon O. keta consists of 21 amino acid residues with N-terminal glycine and C-terminal asparagine. B chain is formed by 29 residues with alanine and lysine as N- and C-terminals correspondingly. PMID- 3314272 TI - [Basic factors in the pathogenicity of Vibrio cholerae and their genetic control]. PMID- 3314273 TI - [Reactive chemoluminescence in a phagocytosis system]. PMID- 3314274 TI - [Hemagglutinating and adhesive capacities of Klebsiella and Enterobacter strains]. AB - The authors analyze the data of studies on the hemagglutinating and adhesive capacity of 290 cultures, including 118 K. pneumoniae strains and 64 E. cloacae strains isolated from sick children, as well as 59 K. pneumoniae strains and 49 E. cloacae strains isolated from healthy children. The hemagglutinating properties of the strains were determined in the hemagglutination test with fresh, formalin- and tannin-treated red blood cells, the adhesive properties were studied by light microscopy. Among K. pneumoniae and E. cloacae strains isolated in acute intestinal infections, mannose-sensitive hemagglutination and pronounced adhesive activity were prevalent in most cases. Poorly adhesive and nonadhesive strains were characteristic of K. pneumoniae and E. cloacae cultures isolated from healthy children. The strains isolated from sick and healthy children differed only by the prevalence of adhesive cultures. PMID- 3314275 TI - [Serological diagnosis of suppurative-septic diseases of staphylococcal etiology]. AB - The parallel examination of osteomyelitis patients by means of the passive hemagglutination (PHA) test with the use of antigenic erythrocyte diagnostic agents, prepared on the basis of hydrochloric acid extract from Staphylococcus aureus strain 209P and teichoic acid extract from S. aureus strain Wood 46 has revealed that these diagnostic agents are practically equal in their diagnostic effectiveness. In the examination of endocarditis patients measurement of the total antibody activity in the PHA test with diagnosticum on the basis of strain 209P has proved to be a more sensitive method, whereas in osteomyelitis patients the total IgG activity has been more accurately measured by ELISA. The treatment of sera with 2-mercaptoethanol essentially decreased the diagnostic effectiveness of the PHA test. The study has shown the diagnostic value of not only IgG but also of IgM antibody measurements. PMID- 3314276 TI - [Content and properties of the antibodies to the outer membrane Re-glycolipid of enterobacteria in mothers and newborn infants]. AB - Antibodies to Re-glycolipid of the outer membrane of enterobacteria have been detected in higher titers in the blood and milk of mothers and in the umbilical blood of newborns than in the blood of nonpregnant women. Re-antibodies in the umbilical blood are mainly resistant to 2-mercaptoethanol and possess higher protective activity with respect to Escherichia coli than Re-antibodies in the venous blood of mothers. PMID- 3314277 TI - [The mouse paw edema test for titrating Shigella toxin and antitoxin and for determining the safety of the anatoxin]. AB - The method for the titration of Shigella dysenteriae I neurotoxin, toxoid prepared from this toxin and different antitoxic preparations in the mouse paw edema test has been developed. The quantitative determination of antitoxin is based on the neutralization test. The conditions of titration (the dilutions of the neurotoxin and the neutralization doses of the antitoxin), as well as criteria for the evaluation of the positive or negative results, have been established. PMID- 3314278 TI - [Methodological aspects of the study of the epidemic process]. PMID- 3314279 TI - [Molecular organization of the tetanus toxin in relation to the characteristics of its biological activities]. PMID- 3314280 TI - [Factors in the pathogenicity of yeast-like fungi in the genus Candida]. PMID- 3314281 TI - [Structural and functional reorganization of the interneuronal contacts of the cerebral cortex after a single convulsive paroxysm]. AB - Using the technique of contrasting the cerebral tissue with phosphotungstic acid, the authors studied the structural and functional status of interneuronal contacts of the molecular layer of the sensomotor cortex in the brain of Krushinsky-Molodkina rats following convulsive sound stimulation and the subsequent audiogenic convulsive paroxysm. Marked reduction in the general number of synapses 4 h after the attack was attended by transformation of some flat functionally mature contacts into concave ones, which reflects the activation of the synaptic pool. The relative levels of concave and flat mature contacts returned to the initial level 8 to 24 h later. PMID- 3314282 TI - [Facial hemispasm--Brissaud's disease (a review)]. PMID- 3314283 TI - [Anxiety and rigidity in the personality structure of patients with neurotic and neurosis-like disorders (a review)]. PMID- 3314284 TI - [Quantitative cytoarchitectonic analysis of human cerebral cortical fields based on the data of automatic morphocorticography]. AB - The authors have demonstrated the stability and reproducibility of the main characteristics (form, position, and relationship between the amplitudes of characteristic extreme values) of the profiles of three fields of the human cerebral cortex (10, 17, and 44) constructed according to the findings of automatic layer-by-layer scanning of a series of sections at an interval of about 15 mm along the layer and measurements of the main morphometric parameters (volumetric ratio, number and the mean area of sections). The study has shown quantitative differences of the cytoarchitectonic structures of fields 10 and 44 which are in agreement with notions about the peculiarities of their morphofunctional organization. PMID- 3314285 TI - [Evaluation of the function of extracranial-intracranial microarterial anastomoses in occlusive diseases of the main arteries of the head (Doppler and angiographic study)]. AB - The comparison of the results of Doppler and angiographic examinations of 82 patients with combined occlusive disorders of the major arteries of the head before and after creating an extra-intracranial microarterial bypass showed a high informative value of Doppler sonography as a noninvasive method of the diagnosis of impairments of the cerebral arteries and as a method of control of microarterial anastomosis functioning. Placement of a microanastomosis between the external carotid and middle cerebral arteries eliminated or reduced the steal phenomenon in relation to the brain or vertebral-basilar bed in combined lesions of the major arteries of the head. PMID- 3314286 TI - [Use of peptides in psychiatry and neurology (review)]. PMID- 3314287 TI - [Brain swelling and edema as a neurosurgical problem]. PMID- 3314288 TI - [Traumatic decerebrate rigidity]. PMID- 3314289 TI - [Principles of intensive therapy of brain edema]. PMID- 3314290 TI - Are Escherichia coli dam- as compared to dam+ hypermutable by base analogs? AB - It was shown that some base analogs, like n2Pur and n2oh6Ade (but not n2om6Ade or oh4Cyd) which strongly inhibit growth of dam- cells, mutagenize and preselect dam populations. As a result dam- mut(-)--devoid of mismatch repair, dam+ revertants, or dam(-)--insensitive to a base analog are exclusively obtained after mutagenesis. The composition of these mutants depends on the base analog applied. By using reconstruction experiments, the frequency of these mutations induced by n2Pur was calculated. PMID- 3314291 TI - Issue dedicated to Prof. David Shugar to celebrate his 70th anniversary. PMID- 3314292 TI - David Shugar--the man and the scientist. PMID- 3314293 TI - Lupin leghemoglobins during root nodule development. AB - Two yellow lupin leghemoglobins, Lb I and Lb II, were purified to homogeneity using the HPLC technique for final separation. Lb I and Lb II were identified by the N-terminal sequences and their reaction with antibodies against electrophoretically pure leghemoglobin. The third Lb species was detected by the combined method of isoelectrofocusing and PAGE of Lb I. It seems that Lb III represents a posttranslational modification of Lb I. Developmental changes in Lb multiple forms were examined using the Western blotting method. The content of leghemoglobin, first detectable approximately 3 weeks after infection, increased up to 6-7 weeks, and then it remained at the same level until 8-9 weeks after the infection. At the early stages of nodule formation Lb I prevailed over Lb II, while later Lb II became the predominant form. This suggests physiological role of particular forms and precise regulation of the expression of Lb genes. PMID- 3314294 TI - Repair of UV-damaged DNA in mammalian skin followed by the immunohistochemical method. AB - DNA repair in murine and guinea pig skin has been studied by the immunohistochemical method. For the detection of DNA photolesions in situ by the indirect immunofluorescence (IF) method two antisera directed against DNA pyrimidine-dimers and DNA-psoralen-photoadducts have been applied. The IF assay enabled to detect the DNA photodamage induced by high UV-doses, exceeding more than fivefold minimal phototoxic response of the skin. It was found that IF staining gradually disappeared due to DNA repair, and at 48 h after UV-exposure both types of the DNA photolesions were no more detectable. Importantly, the IF method revealed that the persistence of DNA-pyrimidine-dimers could be traced for a longer time than that detectable by UV-endonuclease incision method. PMID- 3314296 TI - Anion effects on the kinetics of yeast phosphoglycerate kinase. AB - (A) The effects of phosphate, chloride, nitrate, pyruvate, malate, succinate and glutamate ions on the kinetics of yeast phosphoglycerate kinase (ATP: 3-phospho-D glycerate 1-phosphotransferase, EC 2.7.2.3) were studied with MgATP2- and 3-P glycerate as variable substrates. Three types of patterns were obtained: (1) Nitrate, succinate, malate and glutamate ions, strictly noncompetitive versus both the substrates. (2) Phosphate and chloride ions, noncompetitive versus MgATP2- and mixed versus 3-P-glycerate. (3) Pyruvate ions, being very weak inhibitors, competitive with MgATP2- and noncompetitive with 3-P-glycerate. (B) Based on experiments with simultaneous inhibition by various combinations of two anions the following suggestions were made: The type 1 anions presumably bind to a site outside the active centre. These ions appear to bind to the enzyme independently of type 2. The latter also appears to include sulfate ions, which are competitive versus both the substrates as well as versus the phosphate and chloride ions. Sulfate and phosphate ions are electronically similar, but show different inhibition patterns, presumably due to various effects on the protein conformation. Type 3 inhibition exerted by pyruvate ions was shown earlier for 1 anilino-8-naphthalenesulfonate and salicylate ions, but as these two anions are supposed to bind to the adenine binding pocket of the catalytic centre, the results indicate that pyruvate ions might preferably compete with the nucleotide substrate for the polyphosphate binding site. PMID- 3314295 TI - ATP-stimulated polymerase activity involving DNA polymerase I and a recB dependent factor in extracts of Escherichia coli cells. AB - ATP-stimulated DNA polymerase activity involving DNA polymerase I has been found to be present in cell extracts from wild type and recC mutant strains of Escherichia coli, but not in extracts from recB strain. The activity has been separated from recBC DNase by DEAE-cellulose ion exchange. It is suggested that recB-dependent factor is involved in the ATP-stimulation of polymerase. Evidence is provided that this stimulation may be due to the interaction of recB-dependent factor with DNA polymerase I. PMID- 3314297 TI - Mechanisms of ischemic cardiac pain and significance of silent myocardial ischaemia. PMID- 3314298 TI - Does sodium play an adverse role in hypertension? AB - It is clear that salt is known to be a health hazard from the ancient times. Sodium intake, which was minimal during evolution, increased significantly with the civilization. The rise in prevalence of hypertension in populations with increased consumption of salt suggested a casual relationship. However, several of these studies showed conflicting results. Many investigators agree that salt sensitive persons often have a family history of hypertension. Such individuals possess a sodium transport inhibitor in the arterial smooth muscle cells, which affects their sodium handling (as compared to other persons). However, many of the putative defects related to sodium can be dissociated from blood pressure and sodium consumption status. It is possible that calcium defects of deficiency of potassium and magnesium follow hypertension and sodium status. For example, the pressure response to sodium chloride may be dissociated from sodium, which may be secondary to adverse effects of chloride on calcium homeostasis. Clinical studies also indicate that the role of sodium is controversial in hypertension. Sodium restriction can benefit salt-sensitive persons and might not otherwise. However, most authorities believe that moderation of salt intake to a relevant extent is justifiable. Large scale, long-term intervention studies and shortterm clinical studies in different communities, in the light of recently investigated dietary factors, are necessary to establish the role of sodium in essential hypertension. PMID- 3314299 TI - Group B streptococcal endocarditis mimicking mitral valve myxoma. AB - A patient with group B streptococcal endocarditis and large vegetations resembling mitral valve myxoma is described. Group B streptococcal endocarditis and the differential diagnosis of vegetations and cardiac tumors are briefly reviewed. PMID- 3314300 TI - The influence of experimental diabetes and insulin treatments on the biochemical properties of rat skin incisional wounds. AB - The mechanical properties (tensile strength, extensibility, relative failure energy) of skin incisional wounds were analyzed after 7, 10 and 20 days of healing in normal rats, diabetic rats treated with insulin from the day of wound infliction and diabetic rats treated with insulin from the 5th preoperative day. Untreated diabetes resulted in a reduction of the failure energy of skin wounds during the 20 days of wound healing. After 7 days of wound healing, insulin treatment starting on the day of wound infliction or on the 5th preoperative day did not eliminate this reduction in failure energy of wounds induced by diabetes. However, a positive correlation was found between the duration of the insulin treatment and the failure energy of the wounds. After 10 and 20 days of wound healing, the mechanical parameters of wounds from diabetic rats treated with insulin from the day of wound infliction or from the 5th preoperative day did not differ from those of the control wounds. The experiment demonstrates that insulin treatment is essential for adequate wound healing in diabetes. Insulin treatment from the day of wound infliction or from the 5th preoperative day is not, however, sufficient to prevent the inhibitory effects of diabetes in the early phase of wound healing. PMID- 3314301 TI - Applications of monoclonal antibodies in clinical cytology as exemplified by studies with monoclonal antibody B72.3. The George N. Papanicolaou award lecture. AB - The monoclonal antibody (MAb) B72.3, reactive with a high-molecular-weight, glycoprotein, tumor-associated antigen, designated TAG-72, has been previously shown to be reactive with formalin-fixed, paraffin-embedded tissue sections of adenocarcinomas of the ovary, colon and breast, but not a variety of normal adult tissues. It has demonstrated utility as an immunocytochemical adjunct for the diagnosis of carcinoma in cell blocks and cytocentrifuge preparations of human serous effusions, with selective reactivity for tumor cells (particularly adenocarcinoma) over reactive mesothelium. Using the avidin-biotin complex (ABC) method of immunoperoxidase staining and formalin-fixed, paraffin-embedded cell suspensions, MAb B72.3 detected tumor cells in effusions from all of 21 patients with adenocarcinoma of the breast. No reactivity was demonstrated in any cell type in benign effusions from 41 patients. In contrast, MAb B72.3 showed no reactivity to leukemic or lymphomatous effusions, or to mesothelial cells from malignant effusions. MAb B72.3 also detected adenocarcinoma cells in effusion specimens from 12 of 12 patients with adenocarcinoma of the lung and 16 of 16 patients with adenocarcinoma of the ovary. MAb B72.3 has recently been used with fine needle aspiration (FNA) biopsy specimens and the corresponding surgically excised tumors to determine cellular reactivity. Using the ABC immunoperoxidase method, fine needle aspirates and corresponding surgically excised tumors were analyzed for TAG-72 expression. Positive staining with MAb B72.3 was observed in needle aspirates of 27 of 27 adenocarcinomas and adenosquamous carcinomas of the lung, 17 of 21 adenocarcinomas of the breast, 6 of 6 adenocarcinomas of the colon and in carcinomas from other body sites. In contrast, 21 small-cell carcinomas of the lung, 13 malignant melanomas, 2 lymphomas and 2 sarcomas did not stain with the antibody. Benign lesions from the breast, lung, pancreas, parotid and thyroid also showed no staining. In many patients, tumor-bearing tissue had also been resected and was available for comparative examination with MAb B72.3. In more than 90% of these patients, the staining patterns of the tumor cells in the aspirates were found to be predictive of the patterns of antibody reactivity in the comparable surgically resected tumors. From these studies, it is concluded that MAb B72.3 defines a tumor-associated antigen that is expressed in neoplastic cells versus benign cells, that is most selectively expressed in carcinomas and that may be used as a novel adjunct for the diagnosis of neoplasms in effusions and in fine needle aspiration biopsies. PMID- 3314302 TI - Estrogen receptor determination in fine needle aspirates of the breast. Correlation with histologic grade and comparison with biochemical analysis. AB - Material obtained by fine needle aspiration (FNA) of 25 surgically removed breast carcinomas was tested for the immunocytochemical localization of estrogen receptor (ER) using the peroxidase-antiperoxidase method and a monoclonal antibody developed against human breast cancer ER. The results were compared to those obtained by the conventional biochemical analysis of cytosol protein. A semiquantitative relationship between the immunoperoxidase stain and the biochemical analysis suggests that cases in which greater than 70% of the cells stain and in which intense staining is present are likely to contain ER in a concentration of greater than 250 fmol/mg of cytosol. Less than 15% stained cells and an absence of intense staining is indicative of a concentration of less than 10 fmol/mg. In only one case was there a significant difference in positivity between the two methods, possibly as a result of a functional heterogeneity of the tumor cell population. Intense staining is strongly suggestive of a tumor of low histologic grade and was never seen in tumors with a high histologic grade or nuclear grade. The immunoperoxidase method of ER detection on material obtained by FNA is a semiquantitative means of selecting patients with breast cancer who are likely to respond to hormonal therapy. The method overcomes many important disadvantages of cytosol analysis and provides clinically significant information regarding the ER content and the degree of tumor differentiation. PMID- 3314303 TI - Fine needle aspiration biopsy diagnosis of rhabdomyosarcoma. An immunocytochemical study. AB - Specific antibodies against desmin, skeletal muscle actin and myosin were assessed for their usefulness in the cytodiagnosis of five rhabdomyosarcomas: one well-differentiated, two moderately differentiated and two poorly differentiated lesions. Acetone-fixed smears from fine needle aspiration biopsies and the avidin biotinyl-peroxidase complex technique were used. All aspirates were positively immunostained with antibodies against desmin and actin. Myosin could only be detected in the moderately and well-differentiated tumors. The percentage of tumor cells positive for any of the three proteins was positively correlated with the overall degree of differentiation. However, the number of positive tumor cells decreased in the sequence desmin-actin-myosin. The results indicate the value of antibodies, especially those against skeletal muscle actin, in aiding in the cytodiagnosis of rhabdomyosarcoma, particularly with respect to its differential diagnosis from small round cell tumors in children and pleomorphic sarcomas in adults. PMID- 3314304 TI - Urinary cytologic abnormalities in bone marrow transplant recipients of cyclosporin. AB - The role of urinary cytology in the early diagnosis of cyclosporin nephrotoxicity was studied in 20 bone marrow transplant recipients. There was an evident cyclosporin cytopathy in 35% of bone marrow transplant recipients examined, consisting mainly of degenerative and necrotic abnormalities in cells of the proximal convoluted tubules seen in urinary samples. These findings regressed to normal after reduction of the cyclosporin dose. Urinary cytology proved to be a useful method for the early diagnosis of cyclosporin nephrotoxicity. PMID- 3314305 TI - Urinary cytology in renal transplant recipients with stable graft functions. AB - The utility of routine urinary cytology in renal transplant recipients was investigated. Slides of 79 urine samples obtained from 59 renal transplant patients shortly after transplantation and of 275 urine sediments from 126 patients who had received a transplant before 1978 were screened for abnormal urothelial cells. None of the samples taken within one year of transplantation contained malignant cells. For five patients transplanted before 1978, repeated cytologic examinations showed malignant cells, but neither urologic examination nor clinical nor postmortem follow-up studies revealed a tumor. In all five cases, the abnormal cells disappeared from repeat samples within two to three months. None of the other 121 patients, with repeatedly normal urinary cytologies, exhibited a urinary tract carcinoma in the 24-month follow-up period. It would appear that the cytologic findings in the urine of renal transplant patients who have received long-term immunosuppressive medication may be transiently abnormal. PMID- 3314306 TI - Classics in cytology: II. The diagnosis of cancer of the uterine cervix in smears. PMID- 3314307 TI - New frontiers of gemellology. PMID- 3314308 TI - [Stereotactic cerebral biopsy in acquired immunodeficiency syndrome (AIDS)]. AB - Central nervous system (CNS) complications are currently described in patients with Acquired Immuno-Deficiency Syndrome (AIDS). CT-scan imaging is helpful in the description of the lesions. However, by CT-criteria alone, it is not possible to reliably distinguish toxoplasmosis from other CNS infections and from a primary CNS sarcoma. The authors consider that biopsy of the lesion is recommended to exclude other treatable diseases such as bacterial infections, tuberculosis, fungus and toxoplasmosis. Stereotactic technic gives the optimal precision and security. PMID- 3314310 TI - Experimental allergic myositis: ultrastructural, histochemical, immunological and immunohistochemical studies. AB - The quadriceps femoris muscles of experimental allergic myositis, in strain 13 guinea pigs immunised with rabbit myosin B fraction, were subjected to histochemical, immunohistochemical and electron microscopic studies. They demonstrated a variety of degenerative changes of muscle fibres, infiltration of lymphocytes and macrophages along with deposition of immunoglobulin G (IgG) and complement factor 3 on the surface of the muscle fibres. One third of the infiltrating cells were macrophages with acid phosphatase activity in the cytoplasm. The serum IgG of the model had an affinity for the surface of normal guinea pig muscle fibres and for thick filaments and other organelles. Its affinity for the heavy and light chains of myosin, actin, troponin T and for other proteins was shown by the immunoblotting method combined with one- and two dimensional electrophoreses. PMID- 3314309 TI - Differential expression of glial- and neuronal-associated antigens in human tumors of the central and peripheral nervous system. AB - The immunoreactivity of a panel of poly- and monoclonal antibodies raised against different glial and neuronal antigens was investigated in paraffin-embedded specimens of 116 human tumors of the central and peripheral nervous system. We used antibodies against the HNK-1 epitope, which is shared between natural killer cells and the nervous system, glial fibrillary acidic protein (GFAP), vimentin, neurofilaments, S-100 protein, neuron-specific enolase (NSE) and myelin basic protein (MBP). HNK-1 immunoreactivity was detectable in nearly all neuroectodermal tumors. Especially in those derived from the neuroepithelium, which include the various types of gliomas, we observed a strong staining with this antibody. The only exceptions were the choroid plexus papillomas and individual ependymomas. In tumors derived from the neural crest HNK-1 reactivity was more variable and less intense. In other tumors of the nervous system HNK-1 was not detectable, except for two out of four malignant lymphomas. In addition to its reactivity with human lymphocytes HNK-1, therefore, seems to be a useful 'marker' for neurogenic tumors in general. GFAP expression was prominent in all astrocytomas and the astrocytic cells within mixed gliomas and gangliogliomas. Immunoreactivity was more variable in glioblastomas and ependymomas, while only isolated GFAP-positive cells were present in oligodendrogliomas, medulloblastomas, one plexus papilloma, and some neurinomas. Vimentin immunoreactivity was found in tumor cells of nearly all tumors of the central nervous system with the exception of oligodendrogliomas, most plexus papillomas, neuronal tumors and most medulloblastomas. PMID- 3314311 TI - Immunohistological study of mononuclear cell infiltrate in malignant gliomas. AB - Sixty-five malignant gliomas (astrocytomas grade 3 and 4 and glioblastomas) were examined by means of immunoperoxidase staining on frozen tissue using various monoclonal antibodies directed against macrophages, lymphocytes and natural killer cells. Depending on the antibody used, the presence of macrophages in tumours ranged from 85%-100%. Many of the tumours contained substantial numbers of macrophages not only, as expected, in necrotic areas but also in intact tumour tissue. Eighty-nine percent of 39 tumours tested contained Fc receptor-bearing mononuclear cells in viable tumour. In 100% of 44 tumours tested for HLADR class 2 major histocompatibility complex antigen this antigen was detected in the macrophages. In 40% of these 44 cases, HLADR antigen was also present on the tumour cells. Eighty-eight percent of 53 tumours tested contained T cells in viable tumour and the majority of these cells were T cytotoxic/suppressor (T8). Twenty-four percent of 33 tumours contained no T helper/inducer (T4) lymphocytes and in the other 76% there were few positive cells. Only 9% of 21 tumours contained natural killer cells (NK). B cells were absent from 88% of 61 tumours and almost all of the remainder contained only a small number of B cells. The findings are discussed with reference to a possible host immune response to gliomas and relevant literature is reviewed. PMID- 3314312 TI - Cortical dysplasia in a 23-week fetus with Fukuyama congenital muscular dystrophy (FCMD). AB - A 23-week fetus who is thought to be affected with Fukuyama congenital muscular dystrophy (FCMD) is reported. Cortical dysplasia of the cerebrum was extensive and could be categorized into three major types. The cerebral cortex was thoroughly covered by glio-mesenchymal tissue (extracortical glial layer), in which neuronal clusters were irregularly scattered. Radial bundles of neuroglial tissue frequently extended from the cortex into the extra-cortical glial layer through the focally defective molecular layer and pia mater. The deep cerebral structures, such as basal ganglia, thalamus and white matter, appeared normal in contrast with extensive malformation in the cortex. Glial fibrillary acidic protein-immunoperoxidase stain revealed: (1) presence of abundant radial glial fibers in the ventricular, subventricular and intermediate zones; (2) focal or diffuse lack of glia limitans; (3) focal derangement of radial glial fibers; and (4) proliferation of stellate glial cells in the extra-cortical layer. It is suggested that ectopic accumulation of neurons into the extra-cortical glial layer seems a cardinal pathogenetic process to generate cortical dysplasia in FCMD. Early development of superficial glio-mesenchymal tissue seems essential for upward displacement of migrating neurons. PMID- 3314313 TI - Cavity designs for class II amalgam restorations. A literature review and a suggested system for evaluation. AB - A classification system for variations in cavity design and finish has been developed for application on models of teeth with class II cavities for amalgam restorations. The system was based on a review of the literature, on principles for clinical studies, and on examination of models of 623 teeth in which routine class II cavity preparations had been made. Preliminary data on the agreement of rating of evaluators indicated that the classification system can be used with good consistency for assessment of variations in cavity preparations. Longitudinal clinical studies on the performance of restorations will be decisive for the validity of the selected criteria and for a relevant differentiation between acceptable and unacceptable preparation features. PMID- 3314314 TI - Porosity of resin veneer materials. AB - The present investigation has studied the effects of different types of resins and different processing and curing methods on the number and size of pores occurring in resin facing materials. The mean number of pores per square millimeter varied between 0.5 and 4. The highest numbers occurred in unfilled heat-polymerized acrylic resin and in light-activated resin, whereas the lowest numbers were found in heat-polymerized micro-filled resin. Specimens processed in accordance with the free technique and cured under pressure consistently obtained lower numbers of pores than the corresponding specimens processed in a flask. Most of the pores were less than 50 micron diameter in all test groups. From a clinical point of view, a dense resin with a limited content of pores may give the most favorable results in terms of mechanical, esthetic, and hygienic properties of the veneer. PMID- 3314315 TI - Influence of irradiation time on effect of a light-activated dentin-bonding agent. AB - The marginal adaptation to dentin cavities of a microfilled restorative resin was measured with and without previous use of a light-activated dentin-bonding agent. The investigation was carried out on butt-joint cavities prepared in extracted human teeth. Increasing the irradiation time of the bonding agent from 10 to 80 sec reduced significantly both the width and the extent of the marginal contraction gap. PMID- 3314317 TI - Gingival abrasion and plaque removal after toothbrushing with an electric and a manual toothbrush. AB - The aim of the study was to evaluate the cleanliness achieved with and the number of gingival lesions caused by brushing with a manual, multitufted toothbrush and an electric toothbrush that oscillated horizontally and vertically. Fifteen female dental assistant students participated in the crossover clinical trial. Eight students brushed their teeth for the first 2 weeks with the multitufted manual brush and seven with the electric brush. For the next 2 weeks the brush assignment was reversed. After the two brushing periods the number of gingival lesions and the amount of stained plaque were recorded. The manual toothbrush caused more gingival lesions than the electric brush (P less than 0.05). With regard to plaque scores, no difference was found between manual and electric brushing. PMID- 3314316 TI - Attachment of human gingival fibroblasts to planed root surfaces exposed to human plasma in vitro. AB - We studied the effect of exposing planed dentin surfaces (DS) to human plasma on the attachment of human gingival fibroblasts (HGF) in vitro as compared with their attachment to citric-acid-demineralized DS. Sixty-six DS were prepared from root-planed roots of surgically extracted human third molars. In a pilot experiment 30 DS were demineralized in citric acid (pH 1.0 for 3 min), and each of 3 DS were placed in a culture dish and incubated with fresh plasma for 0, 10, or 30 sec, 1, 10, or 30 min, or 1, 1.5, 2, or 4h. In a second experiment, three culture dishes containing three DS each were assigned to each of four groups. These were untreated (control), incubated with plasma for 2h, acid-demineralized only, or acid-demineralized and then incubated with plasma for 2h. To each dish was added 0.2 X 10(6) HGF, and these were incubated for 2, 6, or 24 h. The unattached cells were then removed, and the DS fixed and processed for SEM. The results showed that exposing demineralized dentin surfaces to plasma causes the absorption of a coating layer, presumably of organic nature, as early as 30 sec after exposure. Acid-demineralized DS alone or together with plasma treatment enhanced both the attachment and the growth of HGF. However, treatment with plasma alone seemed to enhance the HGF attachment less than did acid demineralization alone. PMID- 3314318 TI - Femoral anteversion in children measured by ultrasound. AB - The femoral anteversion was measured by ultrasound and biplanar radiography in 57 children, most of whom had clinical signs of increased anteversion. A modification of previously reported ultrasound techniques was introduced, as the transducer was tilted instead of being kept horizontally. Four different modes of ultrasound examination were evaluated. The most appropriate technique involved only one ultrasound scan at the hip level. The correlation between the results of ultrasound and radiography was good with less than 10 degrees discrepancy in the majority. Ultrasound is suitable for screening children with rotational disorders of the femur. The main advantage of the method is that exposure to radiation is avoided. PMID- 3314319 TI - Mechanical and chemical factors in tendon healing. Effects of indomethacin and surgery in the rabbit. PMID- 3314320 TI - Clinical and laboratory findings in patients with acute tonsillitis. AB - In 82 patients with acute tonsillitis studied, beta-hemolytic group A streptococci were isolated from 30 (37%), and group C or G streptococci from 12 (15%). In the 40 patients with non-streptococcal tonsillitis there was a significantly higher isolation rate of pneumococci, H. influenzae and/or B. catarrhalis, as compared with those with beta-hemolytic streptococci. Patients were classified regarding clinical status according to standardized criteria as severe, moderate, or mild. The patients with group A streptococcal tonsillitis were significantly more often classified clinically as 'severe' and had significantly shorter duration of symptoms before seeking medical care, as compared with those with non-streptococcal tonsillitis. Significant increases in white blood cell count and in anti-DNase B were found in the patients with group A streptococcal tonsillitis, whereas their antistreptolysin O levels did not increase significantly. C-reactive protein concentrations were consistently higher in the patients with group A streptococcal tonsillitis. No evidence of polyclonal beta-lymphocyte stimulation was found when measuring antibodies against pneumococci and group B streptococci. The findings show clinical and simple laboratory tests to be useful aids in distinguishing group A streptococcal tonsillitis from non-streptococcal tonsillitis, and that other bacteria may be involved in non-streptococcal tonsillitis. PMID- 3314321 TI - Influence of antibiotic treatment on the isolation rate of group A streptococci from peritonsillar abscesses. AB - In a prospective one-year study, group A streptococci were cultured from pus specimens from 13 of 71 patients (18%) with peritonsillar abscesses. The isolation rate was significantly lower (7/57 = 12%) in patients who had received antibiotic treatment before specimen collection than in patients who had not received such treatment (6/12 = 50%). Group A streptococcus antigen detection tests on pus, using a commercially available diagnostic kit, had a low sensitivity (5/13 = 38%). It was concluded that in patients treated with antibiotics prior to collection of specimens, the absence of group A streptococcus on culture does not rule out that this organism could have been the principal etiologic agent. PMID- 3314322 TI - Selected papers from recent studies. Dedicated to Professor Kazutomo Kawamoto, on his retirement from the Department of Otorhinolaryngology, Tohoku University School of Medicine. PMID- 3314323 TI - Human cochlear pathology in aminoglycoside ototoxicity--a review. AB - The pathological findings due to aminoglycoside ototoxicity in man, as reported in the literature, is reviewed. 21 cases (40 ears) have been studied after serial sectioning, 8 cases (12 ears) have been investigated by the microdissection and surface preparation technique. The combination of both methods provides maximal information. OHCs are primarily affected, followed by IHC loss. Degeneration starts at the basal coil and proceeds towards the apex. The stria vascularis becomes involved in all turns. It is not clear whether stria degeneration is primary or secondary. Supporting cells, nerve fibres and ganglion cells degenerate secondary to hair cell loss. In some cases ingrowth of myelinated nerve fibres in areas with complete destruction of the organ of Corti has been observed. Ototoxic lesions can be asymmetric. Attention is drawn to the audiometric Z-curve in moderate lesions. PMID- 3314324 TI - Degeneration patterns in the organ of Corti and spiral lamina. AB - The relation between organ of Corti degeneration and radial nerve fibre degeneration in the osseous spiral lamina was studied in two human cochleas. PMID- 3314325 TI - The block surface method for evaluation of human inner ears. AB - Experience with the application of the block surface technique to human inner ears, its advantages and problems are discussed. The usefulness of this technique depends essentially on the fixation quality, which is directly related to the postmortem time delay of efficient fixation by perilymphatic perfusion. Some typical structural features of the human inner ear are shown. PMID- 3314326 TI - Expression of intermediate filaments and actin in the embryonic human inner ear. AB - The immunoreactivity for intermediate filaments (IF) and F-actin was documented in serially cryosectioned human inner ears aged 14-19 gestational weeks. An individual immunoreactivity for IF was documented for different cell types in both the cochlear and vestibular parts of the labyrinth. All secretory epithelia showed a similar expression of the cytoskeleton. In outer hair cells, immunoreactivity for vimentin was documented, but not for other IF types. The cytoskeletal composition is similar in the tectorial membrane and in supporting cells of the great epithelial ridge. Strong immunoreactivity for F-actin occurs close to the surface of all vestibular organs and Kolliker's organ, but not to the same extent in other epithelia lining the endolymphatic space. PMID- 3314328 TI - Ultrastructural evaluation of the microslicing method for the study of temporal bone pathology. AB - Microslices 3 mm thick from undecalcified human temporal bones were prepared with a special cutting machine and then processed for SEM and TEM in order to evaluate advantages and disadvantages of the microslicing technique for the study of the temporal bone pathology. In the examined microslices there was some mechanical distortion of the membranous labyrinth, detachment of soft tissues from bone and a considerable amount of contamination by bone dust and debris which are circulated during sectioning. For SEM the method therefore has limited value. For TEM a relatively contamination free area can be found some distance from the cutting surface of each microslice. PMID- 3314327 TI - Immunohistochemical identification of neuron-specific enolase and calbindin in the vestibular receptors of human fetuses. AB - Immunohistochemical techniques were used to identify neuron-specific enolase (NSE) and calbindin in the vestibular receptors and ganglia of human fetuses at 10 weeks of gestation. NSE was found in vestibular ganglion cells and in a few sensory cells. The pattern of immunoreactivity in the sensory epithelia was characteristic of the appearance of NSE in these structures. Calbindin was found in vestibular ganglion cells and sensory cells which displayed a strong immunoreactivity. These findings are discussed with regard to synaptogenesis and they indicate that the vestibular receptors show biochemical signs of maturation consistent with the possibility of synaptic activity. PMID- 3314330 TI - Localization of ferritin in human liver diseases studied by immuno-histochemical and immuno-electron microscopic procedures. AB - Localization of ferritin using a pre-embedding diffusion technique and an indirect localization sequence has been made in 34 cases of human liver under normal and several pathological conditions. With light microscopic observation, positive immuno-staining for ferritin was demonstrated as diffuse deposits in the hepatocytes and Kupffer cells. Intensity of the positive immuno-staining for ferritin in these cells appeared to roughly coincide with serum ferritin levels of each patient, but showed no disease specificity, although hepatoma cells contained weak deposits or were negative from immuno-staining for ferritin. With electron microscopic studies, intracellular antigen was well preserved in the hepatocytes and Kupffer cells in most cases with the positive immuno-staining for ferritin being observed in cytosol and a few cisternae of rough endoplasmic reticulum. Content of the positive immuno-staining for ferritin differed considerably from one case to another and one cell to another even in the same case. There was no immuno-staining for ferritin in hemosiderin pigment, lysosome, most of rough endoplasmic reticulum, Golgi complexes, and nucleus in both cells. PMID- 3314329 TI - Spontaneous cerebrospinal fluid otorrhea. AB - A case of spontaneous cerebrospinal fluid otorrhea due to a congenital tegmen tympani defect is reported. The etiology and pathogenesis of cerebrospinal fluid otorrhea and of the spontaneous congenital form in particular is discussed, together with the clinical picture and the methods of diagnosis. Reviewing the literature, a middle ear exploration is considered to be the procedure of choice to ascertain the presence and determine the exact locus of the cerebrospinal fluid leak. PMID- 3314331 TI - Bile ductal and ductular changes of the livers in the renal allografted patients. AB - Nine liver biopsies from six renal allografted patients suffering from liver injury were examined by light and electron microscope and immunostaining. The patients had never been on liver dysfunction prior to renal transplantation and after renal transplantation had been administered azathioprine continuously. These patients had shown HBs antigen negative sera. Three of these patients restored normal liver function after withdrawal of azathioprine. Accordingly, the liver diseases of the three were supposedly caused by azathioprine. The liver biopsies of six patients were histologically diagnosed as follows: chronic active hepatitis with severe cholestasis (1 patient), liver cirrhosis with cholestasis (1 patient), acute hepatitis (1 patient), and mild hepatitis (3 patients). The common pathological findings of six patients were degeneration of interlobular bile ducts and ductules, as well as degeneration of liver cells, and mild to moderate inflammatory cell infiltration of portal tracts and sinusoids. The degeneration of bile ductal and ductular cells were classified into two types: light microscopical finding showed vacuolar or eosinophilic cytoplasm and electron microscopic compatible findings showed hydropic cytoplasm scant of free ribosome and organelles, or dense cytoplasm rich in free ribosome and degenerated organelles. The basement membranes of interlobular bile ducts and ductules were always preserved. PMID- 3314333 TI - Neoplastic angioendotheliomatosis. Report of two autopsy cases with special reference to the origin of atypical cells. AB - Two autopsy cases of neoplastic angioendotheliomatosis (NAE) were presented. Both patients were elderly woman, characterized by an ascending progression of transverse myelopathy and abnormal brain shadows similar to metastatic tumor in computer tomographic examination in Case 1, and by typical clinical features of cerebral infarction in Case 2. Postmortem examinations of both cases revealed an exclusive intravascular distribution of large atypical cells in generalized organs, especially in the central nervous system, and associated multiple cerebral infarcts and, in Case 1, widespread demyelination of the spinal cord. There were no distinct lesions suggestive of a primary focus. In both cases only a few atypical cells were immunohistochemically positive for factor VIII-related antigen, likely due to non-specific absorption of serum factor VIII into the cells. On the other hand, almost all of the atypical cells were immunoreactive for LN-1, LN-2, and leukocyte common antigen, suggestive of lymphocytic (B cell) origin. PMID- 3314332 TI - An immunohistochemical study of experimental disseminated intravascular coagulation (DIC). AB - The experiment was focused on clarifying changes in fibrin or fibrinogen related materials (FRMs) in blood, urine, and renal tissues of rats with disseminated intravascular coagulation (DIC). DIC was induced by a continuous infusion of massive volume of physiologic saline (100 ml) immediately after endotoxin injection. FRM response was checked by biochemical and histochemical examinations at various intervals. In the blood of DIC rats, platelet and fibrinogen levels initially decreased, followed by an increasing plasma fibrin degradation products (FDP). Parallel with elevation of blood FDP the percentage of glomeruli with FRMs increased. Thereafter, FRMs were observed in renal tubuli and urine. Our observations indicated that FRMs in renal tubuli were derived from glomerular capillaries via Bowman's space. In conclusion, in DIC the immunoenzymehistochemical (IEH) procedure appeared necessary for an accurate pathological diagnosis, and the presence of FRMs in renal tubuli appeared to be an important finding even in absence of FRMs in glomeruli. PMID- 3314334 TI - Functioning oxyphil cell adenoma in a patient with secondary hyperparathyroidism. AB - A 45-year-old Japanese woman who has been receiving haemodialysis for 13 years suffered from an ectopic calcifying nodule and deformity of the thorax. She was diagnosed as hyperparathyroidism secondary to chronic renal failure. Total parathyroidectomy was performed, and the excised parathyroid glands showed hyperplasia in four and an adenoma in the left upper gland. On the electron microscopic study, the adenoma was composed of oxyphil cells and transitional oxyphil cells, the latter predominating in number. It was revealed from immunohistochemical study that the oxyphil cells in adenoma were strongly stained for parathyroid hormone (PTH). Continuous stimuli to secrete PTH seemed to generate the functioning oxyphil cell adenoma with an ability of PTH production, as well as hyperplasia of parathyroid chief cells. It seems to be the first case of tertiary hyperparathyroidism caused by an oxyphil cell adenoma. Functions of oxyphil cells and transitional oxyphil cells are briefly discussed. PMID- 3314335 TI - In vitro cytotoxic effect of alpha-hemolytic and nonhemolytic Escherichia coli on human blood granulocytes and monocytes. AB - The in vitro cytotoxic effect of Escherichia coli on human phagocytic blood cells in the presence of fresh autologous plasma was assessed using (i) a technique by which cell damage was quantified by measuring the release of chromium 51 from labelled granulocytes and (ii) a technique based on the degree of morphological cell damage induced in monocytes. All of 109 alpha-hemolytic strains were cytotoxic, the cytotoxic effect ranging from very weak to strong. Log-phase cultures had the strongest cytotoxic effect, the individual microorganisms being most cytotoxic in the early log-phase. Plateau-phase cultures progressively lost their cytotoxic ability and 24 h old cultures were almost noncytotoxic. Strongly cytotoxic strains induced high degrees of cell injury, caused an abrupt damage during the first 20 min of incubation and were able to induce injury with few bacteria present. Weakly cytotoxic strains induced only low degrees of cell injury, caused a more gradually developing damage, and were able to induce injury with only high numbers of bacteria present. All of 75 nonhemolytic and 3 beta hemolytic strains were noncytotoxic. PMID- 3314336 TI - Single and multiple acid extract antigens in Campylobacter serology. AB - Campylobacter IgA, IgM and IgG antibody titers of 442 patients with positive isolations of Campylobacter were tested in enzyme immunoassay (EIA). Of the patients, 330 showed elevated antibody end-point titers to a single acid extract antigen prepared from a C. jejuni strain. Sixteen further patients had fourfold or greater antibody titer changes in paired sera. Nine patients, who did not show elevated antibody titers for the single extract, had positive serological responses for a multiple acid extract prepared from six C. jejuni/coli and a C. fetus subsp. fetus strain. The specificity of the test, based on Campylobacter antibodies of 200 healthy blood donors, was 99%. The use of the single acid extract gave a sensitivity of 78%. The additional use of the multiple acid extract raised the sensitivity to 80%. PMID- 3314337 TI - Evaluation of a conventional routine method for identification of clinical isolates of coagulase-negative Staphylococcus and Micrococcus species. Comparison with API-Staph and API-Staph-Ident. AB - A collection of 138 consecutive isolates from blood primarily identified as Gram positive, cluster-forming, coagulase-negative cocci was examined by a conventional routine method for identification of clinical isolates of coagulase negative Staphylococcus and Micrococcus species. The method was based on selected reactions from the Kloos & Schleifer scheme, utilizing the conventional media of Statens Seruminstitut. Double determinations for each isolate were performed by the conventional method. The results were compared with speciation by the commercial micromethods API-Staph and API-Staph-Ident. For control, 31 Staphylococcus and 13 Micrococcus reference strains were included. Of the 31 Staphylococcus spp. (reference strains), the conventional system, API-Staph, and API-Staph-Ident correctly identified 87%, 87% and 81%, respectively. Micrococcus spp. were only identified to genus level by the conventional method as well as by API-Staph. API-Staph-Ident is not designed for Micrococcus identification. Of 138 blood isolates, 121 belonged to the genus Staphylococcus while 17 were Micrococcus spp. S. epidermidis dominated with all three methods, constituting approx. 35% of the isolates tested. In only 57% of the isolates identification by all three methods agreed. The three methods were unable to put a name on 7.5% (conventional method), 10.7% (API-Staph) and 2.5% (API-Staph-Ident) of the isolates. Reproducibility was high with the conventional method (100% for the reference strains and 91% for blood culture isolates) as well as with API-Staph and API-Staph-Ident (88%/81% and 81%/81%, respectively). We concluded that our conventional system was able to identify most clinically significant staphylococcal species by means of relatively few tests with a high certainty and a high degree of reproducibility. PMID- 3314338 TI - [Janos Kabay and the poppy straw process. Commemoration on the 50th anniversary of his death]. PMID- 3314339 TI - Wlodzimierz Niemierko, 1897-1985. PMID- 3314340 TI - Leon P. Marchlewski, 1869-1946. PMID- 3314341 TI - Adolf Beck, 1863-1942. PMID- 3314342 TI - Franciszek Czubalski, 1885-1965. PMID- 3314343 TI - Jerzy Konorski, 1903-1973. PMID- 3314344 TI - 50th anniversary of foundation of the Polish Physiological Society 1936-1986. Eminent Polish life-scientists--biographies and works. PMID- 3314345 TI - The past and the present of the Polish Physiological Society. PMID- 3314346 TI - Jedrzej Sniadecki, 1768-1838. PMID- 3314347 TI - Feliks Nawrocki, 1837-1902. PMID- 3314348 TI - Napoleon Cybulski, 1854-1919. PMID- 3314349 TI - Jakub Karol Parnas, 1884-1949. PMID- 3314350 TI - Effect of in vivo exposure to insulin on glucose metabolism in rat aorta. AB - The effect of administration of insulin in vivo on accumulation of [14C]glucose carbon in rat aorta in vitro was studied. Insulin was injected intravenously in a tail vein 5-60 min before the rats were killed and the accumulation of [14C]glucose was determined after incubation for 30-120 min in 5.6 mM [14C]glucose. When determined 30 min after injection of insulin (4 U kg-1) the aortic [14C]glucose incorporation was significantly increased when an incubation period of 120 min was used, while no significant effect was found after incubation for 30 or 60 min. In subsequent experiments an incubation time of 120 min was used. The aortic [14C]glucose accumulation was not increased when determined 5 or 60 min after injection of insulin (4 U kg-1). Injection of insulin (2 U kg-1) 5 or 30 min before the rats were killed had no effect on the aortic [14C]glucose accumulation but it had a pronounced effect on [14C]glucose accumulation in rat diaphragm. Serum insulin determined 30 min after injection of insulin (2 U kg-1) was 731 +/- 58 mU-1 and in saline-treated control rats 37 +/- 3 mU l-1. These results suggest that the glucose metabolism of vascular smooth muscle has a low sensitivity to the immediate effects of insulin. PMID- 3314351 TI - Glucose stimulates the entry of Ca2+ into the insulin-producing beta cells but not into the glucagon-producing alpha 2 cells. AB - Rat pancreatic beta and alpha 2 cells were purified by autofluorescence-activated cell sorting and used for electrophysiological patch clamp studies and measurements of the initial uptake of 45Ca. Both beta and alpha 2 cells were electrically active, the action potentials of the latter cells also were detected in the absence of glucose. Furthermore, alpha 2 cells differed from beta cells in lacking a glucose-sensitive K+ channel with a single conductance of 50-60 pS (in symmetric 140 mM K+ solutions). The rate of Ca2+ entry into the alpha 2 cells was slower than that into the beta cells, being equivalent to 0.2 mmol, kg-1 dry wt min-1. Whereas raising the glucose concentration to 20 mM significantly increased the amount of Ca2+ entering the beta cells, the sugar was without effect on Ca2+ entry into the alpha 2 cells. PMID- 3314353 TI - Endotoxin-induced prostaglandin (PGF2 alpha) biosynthesis, fever and miosis in dexamethasone-treated goats. AB - Prostaglandin-releasing, adrenocortical, febrile and miotic responses to endotoxin (ET) (E. coli lipopolysaccharide; 0.25 microgram kg-1) were studied in goats with and without prolonged dexamethasone influence. The i.v. injection of ET induced a three-fold peak elevation in plasma 15-ketodihydro-PGF2 alpha at 1.5 h post-injection, that is, between the first and second phase of the temperature elevation. During the latter phase, the plasma concentration of this primary PGF 2 alpha metabolite gradually returned to basal level, which implies that the second phase of ET fever is not PG dependent. The PG response exhibited a similar pattern, but was less pronounced in the dexamethasone-ET experiments, where the duration of maximum temperature elevation and of the miosis became shortened by about 20 min, and the typical biphasic pattern of ET fever was no longer seen. The ET-induced rise in plasma aldosterone concentration was completely blocked by dexamethasone. The corresponding rise in plasma cortisol concentration was prevented for 2 h, but was later only partially inhibited in spite of the repeated dexamethasone treatment. PMID- 3314352 TI - Blood pressure regulation, peripheral renin activity and aldosterone in patients with pyelonephritic renal scarring. AB - Patients with renal scarring due to previous upper urinary tract infections (UTI) are at risk of developing hypertension and renal insufficiency. In this study glomerular filtration rate (GFR), systolic (SBP) and diastolic (DBP) blood pressure, peripheral renin activity (PRA), plasma (p-Aldo) and urine aldosterone (u-Aldo), the urinary excretion of sodium (UNa) and potassium (UK) and the fractional sodium (CNa/CIn) and potassium (CK/CIn) excretion were determined in 22 female patients with verified renal scarring and a history of febrile UTI and in nine age-matched healthy women with normal i.v. urograms. The patients had significantly lower GFR, higher SBP, higher PRA and higher CK/CIn than the healthy controls. A significant correlation between CNa/CIn and SBP (r = 0.51, P less than 0.05), DBP (r = 0.50, P less than 0.05) and PRA (r = -0.47, P less than 0.05) was found. The ratio of UK/UNa was significantly correlated to SBP (r = 0.43, P less than 0.05), DBP (r = -0.44, P less than 0.05), PRA (r = 0.65, P less than 0.01) and p-Aldo (r = 0.68, P less than 0.01). It is concluded that the renin-aldosterone system probably is involved in the pathogenesis of hypertension in patients with pyelonephritic renal scarring and that screening determinations of UNa and UK may prove useful for detection of individuals with increased PRA and p-Aldo. PMID- 3314354 TI - Are anorexia nervosa and bulimia variants of affective disorders? AB - There exists a growing tendency to view anorexia nervosa and bulimia as special forms of depressive illness. An association between eating disorders and affective disorders has been increasingly reported in the recent literature but it still remains a controversial issue. This is due to the confusing data from studies on this association in the following areas: phenomenology, course of illness, biological research, family history, and treatment response. Though some association between eating disorders and mood disturbances is incontrovertible, the hypothesis that anorexia nervosa is just a variant of affective disorder has not been proven. There is more evidence that the aforementioned association- whatever its real nature--prevails more clearly in a subgroup of bulimic patients. PMID- 3314355 TI - [Depression and anxiety]. AB - Anxiety and depression are the two most common syndromes in the practice of psychiatry. The authors look at the differences and similarities on a clinical, etiopathological, therapeutic and neurobiological point of view. Clinicians need to differentiate anxiety with depressive mood from anxious depression. This review tries to focus on this dilemma. PMID- 3314357 TI - Aetiology and mechanisms of anxiety disorders. AB - Theories on the aetiology of pathological anxiety abound. A critical review is given of the most influential approaches (e.g. psychoanalytical, "somatogenic", behavioural, psychophysiological and "biological" theories), with emphasis on panic and agoraphobic disorders. Evidence is presented from epidemiological and genetic research and from observations on the course of illness. A surprisingly constant prevalence of anxiety syndromes, and a familial distribution suggesting a pivotal importance of genetic factors, speak in favour of a biological model. The course of illness, however, points to the importance of environmental influences as triggering factors, and to cognitive and behavioural mechanisms for the perpetuation of the symptoms. Treatment responses hitherto documented support the biological and behavioural concepts, but the cognitive and psychophysiological theories are also supported to some extent. An attempt is made to combine these findings with biochemical and pharmacological findings in an integrated model of panic and agoraphobia. This model takes the form of a vicious circle, and is compatible with biological and neuropharmacological as well as evolutionary and psychological concepts. PMID- 3314356 TI - An update of panic disorders. Somatization, biological markers and treatment outcome. AB - Psychiatric underdiagnosis of panic disorders is due to its particular somatization profiles. Cardial somatization is very common, but focal neurological symptoms and a pattern of gastro-intestinal complaints deserve more attention. Recent research into biological data is discussed, and the importance of psychological issues--childhood separation or sexual victimisation--and cognitive factors is stressed. Breaking up outcome data in degree of remission and relapse rate for an exact judgment of different treatment strategies is needed. PMID- 3314358 TI - Long-term treatment with benzodiazepines: theoretical, ideological and practical aspects. AB - The prevalence of anxiety disorders in a psychiatric sense is 5-10%. If all available data are summed up, it seems evident that about half of these disorders have a prolonged, often chronic course, and thus require some form of long-term or continuous treatment. Accomplishment of long-term treatment will often be prevented by a general fear of dependence and abuse, risk factors that have been strongly emphasized. General restrictivity has also been urged regarding the dosage level, often resulting in a sub-optimal treatment, more harmful than beneficial to the patient. The prescription figures for anxiolytics in relation to the prevalence and course of anxiety disorders do not suggest an unreasonably high prescription rate, on the contrary, the prescribed amount would not be sufficient for treating more than 2.5% of the population. PMID- 3314359 TI - Antidepressant drugs in anxiety disorders. AB - The efficacy of tricyclic antidepressants and monoamine oxidase inhibitors (MAOI) in the treatment of panic syndromes (panic disorder and agoraphobia with panic attacks) and obsessive-compulsive disorders is reviewed. Imipramine has been reported as significantly more effective against panic attacks than placebo or other psychoactive drugs in 12 of 16 studies. Clomipramine has been found superior to placebo or other psychoactive drugs in 5 controlled studies. The effectiveness of these drugs is also reflected in a large number of open trials. The MAOI phenelzine has been reported to be effective in 5 controlled studies. Clomipramine is the best documented drug in the treatment of obsessive-compulsive disorders. Its effectiveness has been documented in 7 controlled studies. Most investigators consider the effects in panic syndromes as well as in obsessive compulsive disorders to be unrelated to the antidepressant effect. PMID- 3314360 TI - Anxiety disorders: classification and diagnosis. AB - Obsessive-Compulsive Disorder and Panic Disorder with or without agoraphobia are emphasized as specific entities that are easily accessible to pharmacological treatment, while more unspecific and heterogeneous syndromes are less predictable in their reaction to treatment. The DSM-III system, not yet official in Sweden, is described and commented on. Agoraphobia has undergone a re-evaluation and should be coupled with Panic Disorder, although the two illness components may have somewhat different genetic and biochemical mechanisms. Obsessive-Compulsive Disorder, on the other hand, should not be listed under Anxiety States, but have a place of its own. The relationship between anxiety and depression is discussed, and it is suggested that there is a clear break between specific affective disorders and specific anxiety disorders, while there may be continuity between Generalized Anxiety and Neurotic-reactive (dysthymic) depression, with mixed cases in between. Still, much work needs to be done in the classification of these disorders. PMID- 3314361 TI - Recent developments in the treatment of panic disorder. AB - The focus of this paper is the treatment of panic disorder with alprazolam. Drug treatments alone are sometimes not sufficient by themselves, to adequately control all of the symptoms or components of this disorder. In the typical case we can identify four targets of treatment: The first target is the biological core of the condition, that is characterized by the unexpected, unprovoked attacks of anxiety. This responds best to medication. The second target is the phobic avoidance behaviour. It appears to be a conditioned or learned complication of the biological core, and appears to follow the laws of learning theory. Unlearning treatments, like behaviour therapy (notably in vivo exposure) are usually necessary to make a full impact against the phobic avoidance behaviour. Thirdly, there is no drug that reverses the psycho-social problems these patients have. Not all of them have such problems, but those that do may need psychotherapy to deal with their conflicts and stresses. Finally, the evidence in several chronic studies, suggest that this is a chronic relapsing disorder in the majority of cases. It is not enough to treat these patients acutely. They must be followed chronically and monitored carefully over many years, if they are to be protected against relapse. PMID- 3314362 TI - A model of panic and agoraphobic development. AB - A model for the development of agoraphobia with panic attacks is proposed. The initiating clinical manifestation is the sudden appearance of spontaneous panic. The inter-panic chronic anxiety may have several components: i.e. conditioning, increasing autonomic distress, and sensitization to the panic leading to avoidance. The illness course is quite variable but usually chronic. The spontaneous panic is blocked by imipramine with primary pharmacological anti panic effects. However, no direct effect of imipramine upon either anticipatory anxiety or avoidance behaviour is hypothesized. Among the psychotherapies, direct in vivo exposure mobilizes the patient more rapidly than office based therapy. Our data are consonant with the theory that the avoidances of agoraphobia are secondary to spontaneous panic attacks, and that the primary benefits of imipramine and exposure therapy are in their respective effects on panic and avoidance. Moreover, laboratory challenge studies, brain imaging studies, and genetic studies all point to a biological diathesis for panic disorder. PMID- 3314364 TI - Experimental models for studying the effects of ethanol on the myocardium. AB - The ability to induce alcoholic cardiomyopathy has been tested in a variety of animal species. Myocardial alterations consistent with subclinical heart disease have been produced in many of these studies through a direct effect of ethanol or its metabolites upon the heart or a neurohumoral mechanism. In the rat most studies have, however, failed to finding diminished contractility in the basal state. In long-term animals the acute left ventricular responses to isoproterenol and calcium as well as pacing were reduced. Long-term studies in mongrel dogs fed 36 per cent of calories as ethanol produced an early decrease in left ventricular diastolic compliance related to interstitial collagen accumulation. Diminished contractility developed by four years. In addition to the morphologic evidence of distorted sarcoplasmic reticulum, in vitro experiments suggest important acute effects. Each mole of ethanol is bound tightly to each mole of protein comprising the Ca-ATPase pump, which is inhibited. Impaired uptake and binding of calcium by the sarcoplasmic reticulum has been observed in chronic alcohol models at one to two day intervals following the last exposure to ethanol. In addition, the flux of calcium ion does not appear normal in terms of access to contractile protein, where the calcium regulated inhibition of the troponin interaction with myosin is impaired. Experimental studies in a canine model of alcoholism revealed that the ventricular fibrillation threshold was moderately reduced in the basal state after 18 months and was diminished further after acute exposure. PMID- 3314363 TI - Simplification of analyses of fatty acids in fish lipids and related lipid samples. AB - The longer chain, highly unsaturated fatty acids up to 22:6 and typical of fish lipids must be included in many current analyses of fatty acids of diets, blood, and eventually of organ lipids. The use of the GLC liquid phase Carbowax-20M in a bonded, or cross-linked form, wall-coated in glass or flexible fused silica capillary columns, eliminates the confusing overlap of component fatty acids of different chain lengths found with polar packed GLC columns. Either isothermal or programmed conditions yield comparable results illustrated with a fish oil analysis. PMID- 3314365 TI - What supports the role of alcohol as a risk factor for stroke? AB - For more than 30 years, clinical observations to link alcohol abuse and stroke have accumulated in several countries. Studies of general populations have indicated that the risk for stroke increases with increasing alcohol consumption. Studies of young victims of stroke where the classical risk factors of stroke are uncommon, have demonstrated that even occasional heavy drinking carries an increased risk for stroke. In particular, the increased occurrence of strokes during weekends, the very time of heavy alcohol consumption in non-alcoholics, supports this notion. Alcoholics seem to get their strokes at an earlier age than non-alcoholics. Paradoxically, the published evidence has implicated drinking in both ischemic and hemorrhagic strokes, which suggests that there may be more than one mechanism by which alcohol can increase the risk. Strokes seem to be precipitated during the alcohol intoxication itself rather than the following withdrawal syndrome, but the contributing mechanisms, except for bleedings caused by external violence, are unknown. Alcohol can produce fluctuations in platelet reactivity and untoward interactions with certain drugs, but it remains to be demonstrated that such effects are temporally related to the onset of ischemic and hemorrhagic strokes. PMID- 3314366 TI - Teaching surgeons to operate--principles of psychomotor skills training. AB - Although the ultimate success of surgery depends on the use of adequate psychomotor skills, the evaluation of the abilities of a trainee and the teaching of these skills has not been systematized. The choice of a trainee in surgery should be based at least partially on his innate abilities, and his training should be begun at an appropriate level. The procedures he may do should be analyzed to determine the skills required for their performance. Then these skills should be taught specifically, initially in non-threatening situations such as laboratory settings, and their acquisition assessed so that he can be progressed to more advanced work at the appropriate time. Ultimately a decision must be made whether to train a candidate to a skill level or whether to train him for a set period and then counsel him regarding which procedures he has the skills to perform. There are well developed concepts in educational psychology that may be used in developing improved methods to assess and train prospective surgeons. PMID- 3314367 TI - Applications of CT-adapted stereotaxis for the diagnosis and treatment of intracranial lesions. AB - Two hundred twenty five patients with intracranial lesions underwent diagnostic and therapeutic stereotactic surgery during the period 1978-1985. In the first 98 cases target coordinates were determined by transferring the information from the CT images to the standard stereotactic films. In the remainder, a simple, CT adapted stereotactic system has been used. Operations were as a rule performed under local anaesthesia. Positive histological diagnosis using paraffin embedding was achieved in 96% of the patients (biopsy success rate). Therapeutic procedures included abscess and cyst aspiration, cyst shunting, interstitial (Ir 192) or intracavitary (Y 90) irradiation and ventriculocisternostomy. Stereotactic surgery implied a refinement of the eventual therapeutic management in 90% of the cases. Transient neurological deficit occurred in 5.7% of the patients and there were three deaths (mortality rate 1.3%). Infection or other complications were not seen. The rationale and indications for non-functional stereotaxis are discussed. PMID- 3314369 TI - Stereotactic excision of deep brain lesions using probe guided brain retractor. AB - A probe guided brain retractor is described. The capability of it being guided by a probe allows it to be used for stereotactic excision of deep brain lesions. It can also be used with the ultrasound guided probe. Method of use with the stereotactic probe and early surgical experience is presented. PMID- 3314370 TI - Advances in stereotactic and functional neurosurgery 7. Proceedings of the 7th meeting of the European Society for Stereotactic and Functional Neurosurgery. Birmingham, 1986. Proceedings. PMID- 3314368 TI - The intraneoplastic chemotherapy in a rat brain tumour model utilizing methotrexate-polymethylmethacrylate-pellets. AB - In an experimental glioma model, using ethylnitrosourea induced and subsequently intracerebrally implanted tumours in BD-IX rats, the effectiveness of intratumoural application of methotrexate (MTX) by stereotactic implantation of polymethylmethacrylate (PMMA) pellets containing MTX, has been studied. Tumour volume 10 days after pellet implantation as well as survival rates of treated, untreated and control animals have been the criteria of the effect of treatment. Tumour volume was significantly smaller in treated compared to untreated animals. The survival rate of untreated to treated animals increased 150 and 233% respectively when compared with the control animals. Thus a positive therapeutic effect of MTX-PMMA pellet implantation in the experimental glioma could be proven. Possible consequences for the treatment of human gliomas are shortly discussed. PMID- 3314371 TI - An intraoperative interactive method to monitor stereotactic functional procedures. AB - A computer graphic technique is presented, which makes it possible to handle neurophysiological and neuroanatomical data collected during functional stereotactic procedures. PMID- 3314372 TI - Cerebellar stimulation for cerebral palsy--double blind study. AB - Twenty spastic cerebral palsy (CP) patients undergoing chronic cerebellar stimulation (CCS) for reduction of spasticity and improvement in function have participated in a double-blind study. Seven US centers involving 9 neurosurgeons (1984-6) have replaced the depleted Neurolith 601 fully implantable pulse generator (Pacesetter Systems Incorp.-Neurodyne Corp., Sylmar, CA) with new units in 19 CP patients, 1 patient entered the study following his initial implant. A magnetically controllable switch was placed in line between the Neurolith stimulator and the cerebellar lead, so allowing switching sequences for the study. Physical therapists, living in the vicinity of the patient's home, carried out two quantitative evaluations: 1. Joint angle motion measurements (passive and active). 2. Motor performance testing was done when possible and included: reaction time, hand dynamonetry, grooved peg board placement, hand/foot tapping, and rotary pursuit testing. Testing was done presurgery, at 2 weeks postimplant, then the switch was activated either "on" or "off" to a schedule, with testing and reswitching at 1, 2 and 4 months, then the switch was left turned "on". Of the 20 patients, 16 finished the tests, 2 patients failed to finish and 2 had switch problems and were deleted from the study. Two of the 16 patients were "off" through the entire testing. Of the 14 that had periods of the stimulator being "on", 10 patients (72%) had quantitative improvements of over 20%, (1 pt: 50+% improvements; 4 pts: 30-50%, 5 pts: 20-30%); while 1 patient (7%) had improvements in the 10-20% level, whereas 3 patients (21%) showed no improvement. PMID- 3314373 TI - Motor and psychological responses to deep cerebellar stimulation in cerebral palsy (correlation with organization of cerebellum into zones). AB - The study includes 68 cases of cerebral palsy stereotaxically operated on from 1977. Deep cerebellar stimulation treatment was performed. The motor and psychological responses to electrical stimulation of 305 points of subcortical regions of cerebellum, mostly lobus anterior were analysed. The characteristic response--slight motor jerk immediately--followed by relaxation and feeling of pleasure, even laughing, to the electrical stimulation from selected points was always found. The level of stimulating current must be adjusted individually. The higher current increased pathological posture, muscular tonus and was conducted with the state of fear. The lower current was without detectable influence on the patient. On the trajectory of electrode, nearly perpendicular to the sagittal plane were narrow areas, which recurred as the strips, from where it was possible or not to elicit characteristic response. The most convenient target is in the region of brachia conjunctiva cerebelli. Localization of the point of stimulation in respect to organization of cerebellum into sagittally oriented zones and the parameters of stimulation seem to contribute to the diversity of responses to cerebellar stimulation. PMID- 3314374 TI - 3-D reconstruction of cerebral angiography in stereotactic neurosurgery. AB - A method is described, that enables the surgeon to appreciate the three dimensional distribution of cerebral vessels within the stereotactic space. PMID- 3314375 TI - Angiographic localizer ring for the BRW stereotactic system. AB - An accessory locating device to the existing BRW stereotactic system is presented. It can be used as a reference device to locate angiographic data with respect to the BRW stereotactic system. Hence, the projection of target points onto angiograms, visible on CT scans, are easily calculated, as well as the stereotactic coordinates of a set of points (e.g., AVM) indicated on at least two angiograms. As a final result integrated images of cerebral blood vessels and an outline of tumor lesions can be generated using more sophisticated computer equipment. PMID- 3314376 TI - Radiosurgery of central pain. AB - Based on experimental and clinical evidence of central pain produced by hyperactivity of deafferented neurones and associated with irritative foci at thalamic or cortical levels, stereotactic low-dose (10 Gy) radiosurgery has been performed in 3 patients with central pain syndromes. SEEG findings and results of stereotactic radiosurgery on painful conditions are presented and mechanisms of action discussed. PMID- 3314377 TI - Electrical impedance recording for localization in functional neurosurgery of the spinal cord and lower brain stem. AB - Functional neurosurgery aims to modify or abolish neural messages. Established techniques use confirmatory electrical stimulation prior to ablation and require local anesthesia. Recently developed procedures take place under general anesthesia increasing the chance of damage to adjacent neural structures with postoperative morbidity. We describe a laboratory study correlating changes in measured electrical impedance with transition from white to grey matter in the brain and spinal cord of two mammalian species; this has not previously been easy to undertake, nor felt reliable. Impedances can now be measured simply and reliably. This study confirms our operating theater experience. We recommend that when stimulation cannot be used, impedance can and should be utilized to indicate the need for an electrode to be resited. PMID- 3314378 TI - Intraoperative CT monitoring during stereotactic brain surgery. AB - This paper reports our experience in performing the entire stereotactic surgical procedure with a CT scanner, which shows that target shifting can occur as the probe approaches the target. Therefore, when sampling of small targets or specific sites within larger targets is desired. CT confirmation of the probe's position ensures that the specific area seen on CT is biopsied. PMID- 3314379 TI - Accessory to the Talairach's apparatus for orthogonal approaches. Technical note. AB - A stereotactic device is described which, without modifying the main characteristics of the Talairach's stereotactic apparatus, increases its flexibility in orthogonal approaches. This accessory, which replaces the double grid system, permits any orthogonal access on the X and Y coordinates and insertion of any type of electrode, catheter or probe, without the constraints of the double grid holes. Its use in different stereotactic operations (brain tumor biopsy or curietherapy, implantation of intracerebral depth electrodes for stereo EEG recording) proved its wide working capability and great reliability. PMID- 3314380 TI - Magnetic resonance planned thalamotomy followed by X-ray/CT-guided thalamotomy. AB - Magnetic resonance imaging (MRI) is currently the optimal neuroradiologic technique for visualizing the anterior and posterior commissure for defining the AC-PC line. CT is the optimal technique for electrode and probe guidance during stereotactic thalamotomy. Various possibilities of transferring or overlying MRI and CT are outlined which in some future might result in more refined methods of CT-MRI guidance for stereotactic surgery. PMID- 3314382 TI - The spatial and morphological assessment of cerebral neuroectodermal tumors through stereotactic biopsy. AB - Stereotactic biopsies were carried out in an attempt to define the grading of 99 neuroectodermal tumors with respect to their modalities of growth and their degree of malignancy. Valuable data has been obtained in all explored tumors. The reliability of the information provided by stereotactic biopsy depends on the careful planning of the procedure by exploring different parts of the tumor as well as of the surrounding brain tissue. PMID- 3314381 TI - MRI-directed stereotactic biopsy of cerebral lesions. AB - Using a modified CT-directed stereotactic system we have performed MRI-directed biopsies in five patients whose intracerebral lesions were not clearly shown by CT. Tissue sampling from targets defined on the MR image enabled a histological diagnosis to be made in four of the five cases. PMID- 3314383 TI - Treatment of cystic astrocytomas with intracavitary phosphorus 32. AB - Cyst formation by astrocytomas can cause progressive neurological deficit and can necessitate multiple surgical procedures. Before the advent of computed tomography (CT) preoperative diagnosis of cystic astrocytomas was difficult and stereotactic management of these lesions was limited. CT-guided stereotaxy provides a safe approach to all cystic astrocytomas including brain stem lesions. Based upon the experience of intracavitary radiation of craniopharyngioma cysts, the authors treated nine patients presenting with cystic astrocytomas utilizing colloidal chromium phosphorus 32 (32P). Control of cyst formation was achieved in eight patients. Our preliminary data suggest that intracavitary 32P may provide a significant adjunctive therapy in the management of cystic astrocytomas. PMID- 3314384 TI - New technique for three-dimensional linear accelerator radiosurgery. AB - A new method for external stereotactic focal irradiation of three-dimensional irregular target volumes is proposed. In this method the target is irradiated by a linear accelerator set in various angular positions around the isocenter. During the irradiation the target is translated in a direction perpendicular to the beam. By controlling the velocity of the translation it is possible to modify the configuration of therapeutic isodoses so as to make them follow the borders of the target. PMID- 3314385 TI - Surgical treatment of hypertensive intracerebral haematoma by CT-guided stereotactic surgery. AB - Ninety consecutive cases of hypertensive intracerebral haematoma were treated with CT guided stereotactic evacuation. The patients were composed of 61 males and 29 females, ranging from 42 to 87 years old. The location of haematoma was either in the putamen (59 cases) or in the thalamus (31 cases). The average volume of the evacuated haematoma was 21.4 ml in the putaminal haematoma and 14.0 ml in the thalamic haematoma. Postoperative follow-up study in 46 patients showed good recovery of neurological deficits both in putaminal and thalamic group. Criteria of surgical indication of CT-guided stereotactic evaluation of intracerebral haematoma were advocated based on the author's clinical experience. PMID- 3314386 TI - Stereotactic evacuation and local administration in intracerebral haematomas. A comparative study. AB - Based on current controversies on optimal treatment for spontaneous intracerebral haematomas, chronic experiments to investigate the validity of open surgery, stereotactic evacuation and local urokinase administration in these lesions were performed in 52 dogs. Under general anesthesia diverse volumes of autologous blood were intracerebrally injected to produce the haematoma. A catheter was introduced and chronically implanted in the contralateral ventricle for intracranial pressure monitoring. The animals were divided in two groups of 26 dogs each, according to haematoma location in subcortical or basal ganglia structures. The natural history was studied in both groups. Different types of treatment consisting in surgery, stereotactic evacuation, urokinase injection within the clot and both latter techniques combined were carried out 24 or 72 hours following haematoma production. Clinical status, systemic arterial pressure, intracranial pressure and CT scanning were used for result evaluation. Brain specimens were submitted for pathological examination. Our results indicate that stereotactic evacuation performed during the first 24 hours after haematoma occurrence was the most effective and innocuous procedure for basal ganglia lesions. Local urokinase plus stereotactic aspiration showed a high efficacy in controlling delayed basal ganglia and subcortical blood collections. Other therapeutic approaches behaved almost as the natural history. PMID- 3314387 TI - The role of feedback in the tremor frequency activity of tremor cells in the ventral nuclear group of human thalamus. AB - Close loop system identification techniques have been used to identify the presence of feedback in the firing pattern of thalamic tremor cells recorded in parkinsonian tremor patients. PMID- 3314388 TI - Stereotaxis and abnormal movements. AB - A series is presented of 106 patients with extrapyramidal syndromes treated by stereotaxy. The importance of preoperative screening to assure favorable results is stressed. Surgical contraindications are elderly patients with dementia and akinesia. Axial dystonia and spasmodic torticollis respond poorly to stereotaxy; and bilateral interventions should be avoided. PMID- 3314389 TI - Stereotactic computer graphic system with brain maps. AB - We have developed a stereotactic computer graphic system with brain maps that runs on a personal computer. This system consists of three parts: 1. firmware for dizitizing radiological films with a TV camera or scanner (when digital image is not directly obtained from floppy disks); 2. software for introducing or processing brain maps by matching them with CT or NMR images; 3. hardware. Our system is designed to: 1. recognize the relevant frame points and calculate targets, their volume and surgical instrument trajectory; 2. match between brain maps of an ideal brain and patient's CT or NMR images with visible and invisible pathology; 3. monitor during surgery the position of the surgical instrument or target modification. The whole procedure and processed images are stored in a data-base for further study. PMID- 3314390 TI - Thalamotomy for tremor after a vascular brain stem lesion. AB - Three patients with a postural tremor caused by a thrombosis in the area of the thalamo-geniculate arteries are presented. The tremor disappeared completely after ventrolateral thalamotomy. The result persisted also after a follow up of more than 5 years. The location of the lesion causing the tremor is discussed. PMID- 3314391 TI - Stereotactic neurosurgery in the treatment of tremor. AB - The results of stereotactical thalamotomy in 40 adult patients suffering from tremor of different etiology are presented. A combination of lesions of VOA-VOP ZI seems to be optimal. Early results have been excellent in 63%, good in 23%, fair in 6% and poor in 8%. Long-term follow-up showed a negative shift with 40% excellent, 6% good and 54% poor results. In Parkinson disease with predominant tremor relief of this invalidating symptom can be achieved. But L-dopa therapy must be continued and surgical treatment does not stop the general disease progression. PMID- 3314392 TI - Interaction of retroviral oncogenes with the differentiation program of myogenic cells. PMID- 3314393 TI - Multistage model of natural killer cell-mediated cytotoxicity involving NKCF as soluble cytotoxic mediators. PMID- 3314394 TI - Shedding of human tumor-associated antigens in vitro and in vivo. PMID- 3314395 TI - Anticarcinogenic action of protease inhibitors. AB - Protease inhibitors are synthesized in biological systems and play a critical role in controlling a number of diverse physiological functions. They participate in blood clotting and lysis of clots, in growth processes by modulation of proteolytic digestion of proteins and thus availability of amino acids, and in the induction of selective DNA amplification. When incorporated into the diet, protease inhibitors appear to suppress many types of cancer. In vitro, they suppress neoplastic transformation caused by chemical carcinogens, ionizing radiation, and oncogenes. These observations offer the hope that judiciously applied protease inhibitors in small concentrations may prevent a wide range of human cancers. This hope is further supported by epidemiological studies which show that populations consuming relatively large amounts of protease inhibitors have a lower occurrence of cancer. The tasks remaining are to determine the kind and the level of protease inhibitors that are most effective in preventing cancer without also having toxic side effects and to incorporate them into our diet. Perhaps the most encouraging investigations are those using small nontoxic protease inhibitors available in pure form (epsilon-aminocaproic acid, a trypsin plasminogen activator inhibitor, and nicotinamide, a chymotrypsin inhibitor and known vitamin). Both agents have been shown to be preventive agents of cancer in animals and in vitro models. Further studies with natural protease inhibitors may yield even more effective agents which when incorporated into our diet will prevent the development of many types of cancer. PMID- 3314397 TI - Role of the abl oncogene in chronic myelogenous leukemia. PMID- 3314398 TI - Studies of quinacrine and of tetracycline for non-surgical female sterilization. AB - The transcervical quinacrine pellet method developed by Zipper and co-workers is potentially a much needed safe, inexpensive, and effective non-surgical method of female sterilization. This method utilizes an intrauterine device inserter to deposit 250 mg of quinacrine hydrochloride as pellets in the uterine cavity. No complications or side effects, other than temporary pain and oligomenorrhea, have been reported. Tetracycline has an established track record for safety. It also has been reported to have properties similar to quinacrine as a sclerosing agent, with potential as a non-surgical method using the quinacrine insertion technique. To expand the experience with quinacrine and to study tetracycline as an alternative, studies were undertaken under the auspices of the Indian Rural Medical Association in Calcutta, India. During the period 14 August, 1979 to 28 June, 1984, 414 women received three insertions of 200 mg of quinacrine. There were 29 failures and a three-year life table failure rate of 8.5. During the period 25 April, 1984 to 28 December 1984, 55 women received three insertions of 200 mg of tetracycline. By 1 June, 1986 there were 32 failures among the 55 cases for a failure rate of 58%. A more recent study using a single dose of 1000 mg of tetracycline also produced unacceptably high failure rates. PMID- 3314396 TI - On the epidemiology of oral contraceptives and disease. PMID- 3314399 TI - Unresolved issues in the study of mammalian ribonucleotide reductase. AB - Although research on mammalian ribonucleotide reductase and its role in cell replication has been intensified in recent years, there remain several areas in which there is not uniform agreement with respect to several of its important properties. The major issues include: 1) whether there is one enzyme which catalyzes the reduction of all four substrates or several enzymes for the four substrates; 2) whether the two subunits are coordinately regulated as the cells pass from G1 to S during the cell cycle; if not which subunit represents the limiting component and what are the respective half-lives of the individual subunits; 3) whether the allosteric regulation which has been demonstrated in the test tube is the actual mechanism in the intact cells; and 4) is mammalian ribonucleotide reductase part of an enzyme complex which channels ribonucleoside diphosphates into DNA. The data which have appeared in the literature are discussed in the context of these unresolved questions. PMID- 3314400 TI - Substrate-inhibitor cooperative interactions with microbial dihydrofolate reductases. AB - Cooperativity in the binding of two substrates to an enzyme is a now well established phenomenon. The x-ray crystallographic structure of the E. coli DHFR binary TMP complex compared with the ternary enzyme-NADPH-TMP complex suggests without too imaginative extrapolation, that the conformational changes resulting from the binding of one ligand aid in favorably positioning potential binding sites for the second ligand. Of greater importance is the fact that the extent to which inhibitor binding is enhanced by the binding of NADPH varies from species to species. To a significant extent, for example, the selectivity of TMP is enhanced by the increase in its binding to the E. coli enzyme when NADPH is present as compared with several mammalian enzymes. The reverse, negative cooperativity (a decrease in binding of a substance when moving from the binary to a ternary complex), is perhaps less common and certainly less well studied. The present paper deals with one such enzyme, the DHFR from C. albicans, and by reference to another, that from S. cerevisiae, where it is shown that the binding of substrates exhibit strong negative cooperativity. It was of interest also to determine the relationship between inhibitor/NADPH cooperativity and the relative insensitivity of N. gonorrhoeae to TMP. Equilibrium studies show that the binding of TMP in binary complex with this enzyme is exceedingly poor and that a 2,200 fold cooperative effect brings the gonococcal enzyme Ki within one order of magnitude of the E. coli enzyme Ki. Even so, it takes synergism of another sort (with sulfamethoxazole) and high doses to make co-trimoxazole therapy feasible for treating gonorrhoeae. The comparative results on the gonococcal enzyme for a family of near relatives of TMP are of interest also for the reason that the structure-activity relationships with this enzyme are quite different from those of the E. coli and other microbial enzymes. Finally, it should be pointed out that although the negative cooperativity found for the candida and saccharomyces enzymes is relatively large, it is the values of the substrate Michaelis constants that are physiologically relevant. The Km values of the yeast enzymes are within the range for other DHFR and therefore the intracellular activity of the enzymes should not be compromised. PMID- 3314402 TI - Imaging of red blood cell and plasma dispersion in the brain cortex. PMID- 3314401 TI - Oxygen transport to renal tissue: effect of oxygen carriers. PMID- 3314403 TI - Anti-anaphylactic properties of BN 52021: a potent platelet activating factor antagonist. PMID- 3314404 TI - Evasion of immunity by nematode parasites causing chronic infections. PMID- 3314405 TI - Cryptobia and cryptobiosis in fishes. PMID- 3314406 TI - The nature and action of host signals. AB - It is clear that excystations in vitro of the coccidia so far examined involves two steps, in the first of which CO2 is important, and the second, in which an external source of chymotrypsin and surface-active agents are required. However, the details of the mechanism of excystment are not clear. We do not know how the presence of CO2 changes the permeability of the oocyst wall. We do not know whether CO2 does anything to the sporozoite or sporocyst; the circumstance that mechanically-released sporocysts readily excyst under appropriate conditions without the necessity for high concentrations of, or perhaps any, CO2 suggests it does not. Circumstantial evidence suggests that the substrate in which chymotrypsin acts is the Stieda body, but whether the enzyme has other roles we do not know. Similarly, the role of bile is ill-defined, although it does seem that the induction of activity is important--but how is this brought about? The techniques available to excyst oocysts are, for many species, very efficient. If CO2 is, as it seems to be, a fundamental stimulus, then efficiency might be enhanced if more attention was given, not so much to increasing the time of exposure and amount of CO2 in the gas phase, but rather to the pH of the medium, which is rarely stated or apparently, controlled. The pH determines the proportion of the different carbonate species in solution, which may be of greater significance than the partial pressure of CO2 in the gas phase (see also Section V A). Although high numbers of excysted sporocysts can be obtained with a particular technique, this does not necessarily mean that all the signals supplied by the host are reproduced in vitro. Jackson (1962) found it necessary to wash oocysts in water or dilute buffers between the primary phase and the secondary phase, a step which implies a deficiency in the methods he used. Commonly, oocysts are exposed to a strong solution of L-cysteine. Does this reflect a general deficiency in the technique, or a counterpart of strongly reducing conditions in ruminant and non-ruminant alike? It seems that we have only a very general outline of excystment, and that we do not understand the details. Yet the problem seems to have been put aside; the most recent relevant reference we have found is dated 1983. PMID- 3314407 TI - Functional morphology of the tybotympanum related to otitis media. PMID- 3314408 TI - Magnetic resonance imaging in otology. PMID- 3314410 TI - An old story: an ivory nasal implant. AB - The author describes the 45-year-old successful survival of a series of ivory implants, used by his father, Dr. Rafael Vilar-Sancho, to repair and reconstruct a severe nasal deformity. PMID- 3314411 TI - Platelets: some historical background. PMID- 3314413 TI - New concepts in the pathogenesis of bronchial hyperresponsiveness. PMID- 3314412 TI - Pharmacological attempts to modulate leukotriene synthesis in aspirin-induced asthma. PMID- 3314414 TI - Platelet activation--an overview. PMID- 3314415 TI - Platelet production in the lungs. PMID- 3314417 TI - PAF and airway hyperreactivity; prospects for novel prophylactic anti-asthma drugs. PMID- 3314416 TI - Properties of PAF relevant to asthma. PMID- 3314418 TI - The role of PAF-acether in anaphylaxis demonstrated with the use of the antagonist BN 52021. PMID- 3314419 TI - [Clinical observation of pheochromocytoma]. AB - Eleven cases of pheochromocytoma observed at our department between 1976 and 1985 are presented. There were 5 males and 6 females and they were between 18 and 59 years old. The site of the tumor was in the right adrenal in 4 cases, left adrenal in 3 cases, bilateral adrenals in 2 cases and extra adrenal in 3 cases, 1 of which had multiple lesions and involvement of the right adrenal. Clinical symptoms observed were hypertension in 10 cases, headache in 7 cases, palpitation in 3 cases and nausea in 2 cases. Atypical adrenal pheochromocytoma was seen in 1 case. Definitive diagnosis was established by determination of urinary catecholamine levels in the 24-hour sample. Urinary levels of catecholamine revealed higher adrenaline levels for paroxysmal type and higher nor-adrenaline levels for extra-adrenal cases. For localization of tumors, computed tomography was most useful with a diagnostic rate of 100%, followed by ultrasonography and adrenal scan. As preoperative treatment, blood transfusion and administration of adrenergic blocking agents were performed in 9 cases. In all but 2 cases, hypertension was improved and no recurrence was seen after the operation. PMID- 3314409 TI - Controversies in plastic surgery: suction-assisted lipectomy (SAL) and the hCG (human chorionic gonadotropin) protocol for obesity treatment. AB - The advent of SAL (suction-assisted lipectomy) has dramatically increased the number of obese patients coming to our consultation offices. Despite several articles suggesting a conservative approach to fat suction, some reports insinuate that SAL might be a useful tool for obesity treatment. This hypothesis is refuted by a vast body of evidence that concludes that the adipose tissue may regenerate in adult humans. Therefore, surgical procedures are not advised as the method of choice to manage the disease. On the other hand, the terms obesity and being overweight may not be interchangeable. Obesity may be a disease whereas being overweight is a sign of the disease. Consequently, proper preoperative selection of candidates for SAL becomes mandatory. The hCG (human chorionic gonadotropin) method for obesity treatment appears to be a complete program for the management of obesity. It contains pharmacologic, dietetic, and behavior modification aspects in a 40-day course of treatment. Some data suggest hCG to be lipolytic, thus explaining former clinical observations regarding body fat redistribution in treated patients. hCG commercial preparations contain beta endorphin, an opioid peptide linked to mood behavior. This article speculates on the possible actions of the complex hCG beta-endorphin in the neuromodulation of mood and energy metabolism. The method comprises a behavior modification that helps in handling the patient better. There are some correlations between a current behavior modification program and the basic guidelines contained in the hCG protocol. Thus, the hCG method appears to be a reasonable alternative in the management of a long-standing, unsolved problem of human metabolism. PMID- 3314420 TI - [The study of the ABH isoantigen of bladder tumors]. AB - ABH isoantigens in 82 cases with bladder tumor of various grades and stages were investigated by the avidin-biotin-peroxidase complex (ABC) method. Correlation of ABC expression for isoantigens with pathological findings on the grading and staging system of the bladder tumors were as follow: Of 60 cases of low grade tumors, 34 (56.7%) were positive and of 22 cases of high grade tumors, 21 (95.5%) were negative. Of 63 cases of low stage tumors, 35 (55.6%) were positive and all 19 cases of high stage tumors, (100%) were negative. The isoantigens in the tissue of the bladder tumors tended to disappear as the histologic anaplasia of the tumor progressed. There was a high correlation between the histological grade, stage and ABC expression (p less than 0.01). In a follow-up study of 38 patients with low grade, low stage, initial transitional cell carcinoma, 9 of the 24 patients positive for ABC expression (37.5%) showed recurrence during the 1 to 6 year follow-up period, whereas 10 of the 14 patients negative for ABC expression 10 (71.4%) did. There was a high correlation between the recurrence rate and ABC expression (p less than 0.05). Therefore, the analysis in the bladder tumors may be valuable for prediction of malignant potential, especially for the low grade, low stage tumors. PMID- 3314422 TI - [Bilateral renal cell carcinoma: report of two cases]. AB - Two cases of bilateral renal cell carcinoma are reported. The first case is of a 54-year-old male who visited our hospital on March 7, 1984 complaining of colicky pain in his left flank. Intravenous urography showed a large mass in the upper pole of the left kidney causing deformity and dislocation of the upper calyces. There were no remarkable findings in the right kidney. Abdominal CT-scan and arteriography revealed a round and hypervascular tumor with soft tissue mass density in the upper pole of both kidneys. Nephrectomy of the left and segmental resection of the upper pole of the right kidney were performed on April 11, 1984. The second case is a 47-year-old male who visited our hospital complaining of total gross hematuria. Intravenous urography showed a large soft tissue mass at the lower pole of the left kidney. Abdominal CT-scan revealed a large tumor mass associated with central necrosis in the left kidney and also a small tumor lesion at the center of the contralateral kidney. Bilateral nephrectomy was performed on December 19, 1984, and the patient was referred to hemodialysis treatment. The cut section of the nephrectomized right kidney specimen revealed multiple minor accessory tumors. Both patients have been doing well without any evidence of recurrence or metastasis. PMID- 3314421 TI - [Adrenal myelolipoma: report of a case]. AB - We report a case of adrenal myelolipoma occurring in a 56-year-old man. The patient complained of lumbago and gross hematuria in October, 1981 and consulted a local doctor who pointed out a right ureteral stone and downward deviation of the left kidney. The patient was referred to our hospital for further examination. An echogram showed a high echogenic mass in the left flank which was compressing the spleen and the kidney. A CT scan revealed a large mass with heterogeneous low density contents. The mass was lobulated into several parts and their density suggested fat tissue. An aortogram showed an avascular mass and an adrenal venogram showed multiple veins which radiated to the periphery. Judging from these findings, a tentative diagnosis of adrenal myelolipoma was made and left adrenalectomy was performed. Histological examination revealed that this tumor was composed of adrenal tissues, fatty tissues and myeloid tissues. The postoperative course was uneventful. We discuss the necessity of aortography and selective adrenal venography to evaluate the origin of the tumor. To our knowledge, this is the tenth case report of adrenal myelolipoma in Japan and we have made a brief review of Japanese literature of adrenal myelolipoma. PMID- 3314423 TI - [Primary carcinoma of the male urethra: a case report]. AB - A case of primary carcinoma of the male urethra is reported. A 72-year-old male who complained of dysuria and a perineal mass, was admitted to our hospital in April, 1982. Irregularity and narrowing of bulbous urethra were detected on the urethrocystogram and the biopsied specimen from the perineal mass showed the histological findings of squamous cell carcinoma. Total penectomy, total cystectomy, construction of ileal conduit and pelvic lymphadenectomy were performed. The tumor, 10 X 6 X 5 cm in size, was located in the bulbous urethra and the histological diagnosis was well differentiated squamous cell carcinoma with no lymph node metastasis. In spite of postoperative administration of bleomycin, local recurrence appeared 3 months after operation and the patient died from disease progression in August, 1983. The age, histopathology, symptoms, past history, site of tumor, treatment and prognosis in 126 Japanese cases of primary male urethral tumor including the present case were reviewed. En bloc exenteration including resection of the inferior rami or pubic bone with chemotherapy and radiotherapy is recommended for advanced carcinoma of bulbomenbrous urethra. PMID- 3314424 TI - [A case of Skene's duct cyst]. AB - We experienced a case of paraurethral cyst in a 40-year-old woman. The cyst was thought to have derived from left Skene's duct and marsupialized. Twenty nine cases with paraurethral cyst in the Japanese literature are also reviewed. PMID- 3314425 TI - [A case of bizarre leiomyoma of the scrotum]. AB - A case report of a bizarre leiomyoma of the scrotum in a 46-year-old male is presented with a review of the literature. The patient was admitted to our hospital with the chief complaint of swelling of the left scrotal content for about 20 years. The tumor was surgically removed easily. Histological findings revealed bizarre leiomyoma. This case is the first report of bizarre leiomyoma of the scrotum in Japan. PMID- 3314426 TI - The three lines: origin of sonographic landmarks in the fetal head. AB - Antenatal sonography consistently reveals three parallel echogenic lines on high axial scans of the fetal head. Previous descriptions of fetal intracranial anatomy assumed that the inner line originates from the interhemispheric fissure and that the outer lines originate from the lateral walls of the lateral ventricles. By studying the three lines sonographically in 25 fetuses and by injecting contrast material into the deep venous system of autopsy specimens, we showed that the outer two lines do not represent the lateral walls of the lateral ventricles, but rather appear to arise from deep intracerebral veins. This finding challenges the validity of lateral ventricular hemispheric ratios in the diagnosis of early hydrocephalus, since such calculations assume that the outer lines originate from the ventricular walls rather than from veins. The results of this study reveal that the two outer lines most likely originate from deep cerebral veins, rather than from the lateral walls of the lateral ventricles. PMID- 3314427 TI - Potential placenta previa: definition, frequency, and significance. AB - Sixty-three (5%) of 1239 women studied by sonography during the second trimester of their pregnancies had a diagnosis of placenta previa. Follow-up was available for 51 of the 63 patients; in three of these, the original diagnosis was complete placenta previa, and in the other 48, the first diagnosis was partial or marginal placenta previa. At term, placenta previa was seen in only four patients for an overall frequency of 0.3% (4/1227). In all three of the patients with complete placenta previa, the condition persisted from the second trimester to term; previa persisted in only one of 48 patients with marginal/partial previa. Because of the infrequent persistence of marginal or partial placenta previa to term, we recommend using the term "potential placenta previa" in the second trimester, with follow-up sonography indicated only for vaginal bleeding. PMID- 3314428 TI - Holoprosencephaly: prenatal sonographic diagnosis. AB - Fourteen cases of holoprosencephaly (HP), including 10 cases of alobar HP and four cases of semilobar HP, were identified by prenatal sonography. Intracranial and extracranial findings were reviewed to determine the accuracy and spectrum of the sonographic features. All 14 cases were reliably distinguished from other causes of fetal hydrocephalus (n = 58) detected during the same period by demonstrating absence of the midline echo (falx cerebri and interhemispheric fissure), fusion of the thalami, and abnormal ventricular configuration. Four cases of semilobar HP demonstrated incomplete fusion of the thalami and partial separation of the ventricles compared with alobar HP. Eight cases demonstrated a dorsal cyst including five with alobar HP and three with semilobar HP. One case demonstrated an unusual extraaxial fluid collection surrounding the brain, thought to be from rupture of a dorsal cyst. Facial features that were identified included a proboscis (three cases), midline facial cleft (three cases), and hypotelorism (five cases). Extracranial abnormalities that were identified included polydactyly (two cases), renal dysplasia (two cases), omphalocele (one case), and fetal hydrops (one case). We conclude that fetuses with HP can exhibit a spectrum of sonographic findings and that alobar or semilobar HP is reliably distinguished from other causes of fetal hydrocephalus by distinctive intracranial findings. PMID- 3314429 TI - False-positive CT diagnosis of gallstones due to thickening of the gallbladder wall. AB - An erroneous CT diagnosis of cholelithiasis was made at our institution during the past year in seven patients who had thickening of the gallbladder wall. In all cases the mucosa, which had a high attenuation value, was misinterpreted as a calcified stone, and the low-attenuation thickened submucosa was misinterpreted as intraluminal bile surrounding the stone. Depending on the attenuation of the actual intraluminal bile, the pseudostone appeared peripherally calcified (five patients) or uniformly calcified (two patients). Careful analysis of the position and configuration of a suspected stone and of the outer margin of the gallbladder can help avoid an incorrect CT diagnosis of gallstones when high-attenuation thickened mucosa simulates a gallstone and low-attenuation submucosa looks like surrounding bile. PMID- 3314430 TI - Sonographically detected hepatic hemangiomas: absence of change over time. AB - Hepatic hemangiomas are the most common benign tumors of the liver and commonly present as incidental findings on sonographic examination of the abdomen. To chart more precisely the natural course of the sonographic appearance of hepatic hemangiomas, 47 patients with 68 hemangiomas were rescanned 1-6 years after the initial study. Fifty-six lesions (82%) showed an identical appearance on follow up study. However, 12 (18%) of the lesions had an appreciably changed sonographic appearance. Three lesions could not be found, seven were less obvious (less echogenic), one was larger, and one smaller. This study shows that once hemangiomas are identifiable sonographically in adults, they have reached a stable size and change in size or appearance only rarely. They do not continue to grow slowly over time. Furthermore, this study also confirms that the sonographic appearance in the appropriate patient can differentiate these hemangiomas relatively reliably from metastases. PMID- 3314431 TI - Prostatic abscess: imaging with transrectal sonography and MR. PMID- 3314432 TI - Coccidioidomycosis in renal dialysis and transplant patients: radiologic findings in 30 patients. AB - Asymptomatic primary coccidioidal infection is common. After the initial infection is contained, the organism can remain dormant in the body for years. Immunosuppression related to renal transplantation or dialysis may reactivate dormant disease. Thus, symptomatic disease may be seen in those with no known history of previous coccidioidomycosis who have visited endemic areas only briefly. To determine if coccidioidomycosis produces characteristic radiographic findings in renal transplant and dialysis patients, we reviewed the records and radiographs of all patients in either of these two categories who are known to have developed active coccidioidal infection in southern Arizona since 1965. Thirty patients (12 undergoing dialysis and 18 transplant recipients) were identified. We conclude that the radiographic manifestations of pulmonary coccidioidomycosis in renal transplant and dialysis patients are highly variable. Interstitial and alveolar patterns of disease are equally likely to occur. Extrathoracic infection without evidence of pulmonary disease occurred in 11 patients (37%), but was radiographically demonstrable only as septic arthritis or perinephric abscess. PMID- 3314433 TI - Septated urinomas in the neonate. AB - Perirenal urinomas may develop when obstruction to urinary flow creates sufficient back pressure to produce extravasation of urine. Such fluid collections have been described as mainly sonolucent. However, in the last 2 years, we have imaged five neonates with multiple, marked septations of the urinoma, four with posterior urethral valves and one with a ureteropelvic junction obstruction. Diagnostic confusion may arise when the kidney is not identified, when the septated nature of the urinoma is not recognized, and when urinary tract obstruction is not seen. PMID- 3314434 TI - Nail signs of systemic conditions. AB - A systematic examination of the nails provides clues to many vascular, nutritional, endocrine and infectious diseases, connective tissue disorders and intrinsic skin diseases. Variations in color and shape, swelling, abnormal blood vessels, bands, indentations and ridges, as well as separation of the nail plate, may be signs of systemic disease. PMID- 3314435 TI - Fibrocystic breast disease. AB - Fibrocystic breast disease is characterized by breast pain, lumpiness or cysts. The few patients who have atypia on breast biopsy are at substantially increased risk for the development of breast cancer. Management of fibrocystic breast disease involves monitoring for breast cancer by repeated physical and mammographic examinations. Alleviation of symptoms may be attempted by reassurance, reduction of methylxanthine intake and treatment with danazol. PMID- 3314436 TI - Otalgia with a normal ear. AB - Ear pain is a diagnostic problem when examination of the ear shows no pathology. Referred otalgia may be caused by neoplasms; dental abnormalities or infections; temporomandibular joint dysfunction; sinus, pharyngeal or salivary gland infections; temporal arteritis; cervical arthritis, or one of the neuralgias. Ear pain may also be psychogenic. PMID- 3314437 TI - Adult polycystic kidney disease. PMID- 3314438 TI - Prostate cancer. AB - Prostate cancer is the most frequent malignancy in elderly men. Common presentations include asymptomatic prostate nodules, unexplained bone pain or bladder outlet obstruction. Histologic grading clearly influences the prognosis. Either potency-saving subcapsular prostatectomy or radiation therapy is effective in treating localized disease. New prospects for hormonal therapy of metastatic prostate cancer include antiandrogens and gonadotropin-releasing analogs. PMID- 3314439 TI - Step management of hypercholesterolemia. PMID- 3314441 TI - Therapeutic options to minimize free radical damage and thrombogenicity in ischemic/reperfused myocardium. PMID- 3314440 TI - Predictive value of immunofluorescence and electron microscopic evaluation of endomyocardial biopsies in the diagnosis and prognosis of myocarditis and idiopathic dilated cardiomyopathy. AB - The distinction between idiopathic dilated cardiomyopathy and myocarditis is controversial, both clinically and pathologically. To increase diagnostic accuracy and provide prognostic information, we prospectively tested the routine application of immunofluorescence and electron microscopy in endomyocardial biopsy evaluation. Biopsy samples from a consecutive series of 79 patients with cardiomyopathy and possible myocarditis were thus evaluated by light (LM), immunofluorescence (IF), and electron microscopy (EM). Patient course was followed prospectively to determine prognostic factors. Immunoglobulin (IgG) and complement (C) in biopsy tissue were graded 0 to 3+ and an IF score was derived as 2 (IgG) grade + C grade. A highly significant association was found between IF score greater than or equal to 2 and the presence of mononuclear cells (lymphocytes plus macrophages) greater than 5/high-power field, confirmed by EM; 12 of 15 (80%) with IF score greater than or equal to 2 had inflammatory cells, vs only 2 of 64 (3%) with IF score less than 2 (p less than 0.000001). EM was used to confirm the identity of infiltrating cells and to grade myofilament loss (0 to 3+) and 11 other ultrastructural features. EM did not provide important predictive information in myocarditis, but confirmed the presence of inflammatory cells. However, the EM finding of myofilament loss provided prognostic information both in patients with and without myocarditis (p less than 0.03). Mortality at 18 months was 37% for patients with 2 to 3+ myofilament loss, vs 10% in those with 0 to 1+ loss. Moreover, myofilament loss was prognostically independent of clinical class and ejection fraction. EM determination of myofilament loss is valuable as a prognostic indicator, whether or not myocarditis is present. Routine IF and EM increase the diagnostic accuracy and prognostic information in endomyocardial biopsies from patients with suspected myocarditis or cardiomyopathy. PMID- 3314442 TI - Factors causing arrhythmias in chronic congestive heart failure. AB - Severe congestive heart failure (CHF) is a common syndrome with a high mortality rate (about 50% in 1 year among patients with symptoms at rest). Severity of left ventricular dysfunction is the most important adverse prognostic factor. Serious arrhythmias are common in CHF and also increase the mortality rate. Sudden death is the mode of death in about 40% of patients with severe heart failure. Multiple factors contribute to arrhythmias in CHF, including left ventricular dysfunction, myocardial ischemia, catecholamines, electrolyte disturbances, and drugs used to treat the heart failure. Minimizing or correcting these influences may be important in reducing serious arrhythmias. Antiarrhythmic drugs may be important in reducing the incidence of sudden death among patients with severe heart failure, although this has not yet been proved. PMID- 3314443 TI - Pharmacologic approaches to management of arrhythmias in patients with cardiomyopathy and heart failure. AB - Interactions between disordered cardiac rhythm and abnormal cardiac hemodynamic function are well recognized. Demonstrations of this relationship include the relationship between prognostic significance of ventricular ectopy and left ventricular ejection fraction, impairment of ventricular function in association with loss of atrial systole in disease states, increased risk of potentially lethal arrhythmias in the myopathic ventricle, and the evolution of advanced grades of ventricular arrhythmias in acute heart failure. With the development of newer and more potent antiarrhythmic agents, in conjunction with drugs that can improve the failing circulation, it is now possible to clarify these interrelationships and perhaps develop new strategies for clinical management. PMID- 3314444 TI - Pharmacokinetics and pharmacodynamics of antiarrhythmic agents in patients with congestive heart failure. AB - Changes in the pharmacokinetics of antiarrhythmic agents may be anticipated in patients with congestive heart failure (CHF), although the magnitude or direction of change is not always predictable. Factors complicating antiarrhythmic therapy in patients with CHF include both physiologic changes resulting from the disease state and unwanted effects of drug therapy for CHF. The volume of distribution is often significantly decreased (by as much as 50%) and loading doses should be reduced proportionately. Decreased blood flow to the liver and kidneys and decreased hepatic drug-metabolizing activity serve to diminish drug clearance. In some cases, simultaneous decreases in volume of distribution and clearance may result in little, if any, change in elimination half-life, despite higher plasma concentrations. Conversely, the elimination half-life of antiarrhythmic agents may be doubled in patients with CHF, necessitating a reduction in dosage. In the latter case, the time needed to reach steady state is lengthened, so that premature escalation of dosage may lead to excessive drug accumulation. In terms of their pharmacodynamics, most antiarrhythmic agents have a degree of negative inotropic effect at some concentration, and patients with reduced myocardial reserve are especially vulnerable to these effects. Some of the newer agents (such as tocainide, mexiletine, and encainide) appear to cause only minimal myocardial depression. Potential complications during therapy with all antiarrhythmic agents that are of special concern in patients with CHF include diuretic-induced hypokalemia, proarrhythmia, and possible interactions with cardiac glycosides and other drugs. Therapy for patients with CHF should be initiated with low doses of the agent selected, and the dosage carefully titrated while the patient is monitored, to confirm both efficacy and the absence of adverse effects. During subsequent outpatient therapy the patient should be carefully observed for sign of unexpected reactions, toxicity, or electrolyte imbalance. PMID- 3314445 TI - Nonpharmacologic treatment of life-threatening cardiac arrhythmias. AB - Numerous nonpharmacologic modalities have been introduced for the management of patients with life-threatening arrhythmias. These include cardiac pacing, insertion of an automatic internal cardiac defibrillator (AICD), cardiac electrosurgery, and catheter ablative techniques. Each modality is effective; AICD shows particular promise because it has demonstrated remarkable efficacy in decreasing the incidence of sudden cardiac death in patients with malignant ventricular arrhythmias. Each modality also has its limitations or contraindications. Nonpharmacologic antiarrhythmic therapy represents an important advance against the serious public health problem of sudden cardiac death. PMID- 3314446 TI - Effects of polyunsaturated fatty acids on factors related to cardiovascular disease. AB - Dietary fats play a critical role in atherogenesis and thrombosis. Both the amount of fat consumed and its composition affect various events associated with coronary artery disease. Dietary unsaturated fatty acids appear to reduce the incidence of these events, in particular polyunsaturated fatty acids (PUFAs), which exert markedly different effects on risk factors related to heart disease. The omega-3 (n-3) PUFAs, at high levels of dietary intake, significantly reduce hyperlipidemia and the production of the prothrombotic substance thromboxane, and they enhance the production of the platelet-antiaggregatory substance prostacyclin. Data from clinical trials indicate a significant reduction of levels of very low density lipoprotein (VLDL). The n-3 PUFAs also depress hepatic fatty acid and triglyceride synthesis and VLDL secretion. The n-3 PUFAs of fish oils displace arachidonic acid from tissue phospholipids and concomitantly increase n-3 PUFA levels, which inhibit thromboxane synthesis. Most significantly, in human subjects the antiaggregatory prostacyclin PGI3 is also synthesized and the net effect is enhanced antiaggregatory/antiadhesive activity. In addition, the chemotactic platelet adhesion-promoting substance leukotriene B4 is suppressed. These composite effects reduce atherogenesis and thrombosis. Fish oil n-3 PUFAs may also reduce blood pressure and blood viscosity. Through the combined vasodilatory effects via prostacyclin (PGI2 and PGI3), fish oils may improve peripheral circulation and thereby facilitate VLDL removal. The n-3 PUFAs of fish oils, by altering membrane fluidity in a specific manner, alter the activities of membrane-bound enzymes and may change receptor activity, specificity and signal transduction. Overall, these data indicate a beneficial role for n-3 PUFAs as part of a dietary approach to minimizing coronary artery disease. PMID- 3314447 TI - Hypolipidemic effects of HMG-CoA reductase inhibitors in patients with hypercholesterolemia. AB - Hypercholesterolemia with increased plasma concentrations of low density lipoproteins (LDL) is a major risk factor for the premature development of coronary atherosclerosis in humans and is best exemplified by patients with familial hypercholesterolemia. The recent development of several specific competitive inhibitors of the rate-limiting enzyme in cholesterol biosynthesis (3 hydroxy-3-methylglutaryl-coenzyme A reductase, HMG CoA reductase) has opened up an important new avenue of therapy for patients with hypercholesterolemia who are not responsive to dietary treatment alone. Three drugs, lovastatin (mevinolin), simvastatin (synvinolin) and pravastatin (CS 514), are currently undergoing clinical trials in North America and Europe; the former has recently been approved for general use. Experience with lovastatin and simvastatin in the treatment of patients with primary and secondary causes of hypercholesterolemia is reviewed. The relative potency of simvastatin appears to be greater than that of lovastatin and pravastatin but, with each drug, decreases in the plasma concentrations of LDL cholesterol of 30% to 50% can be achieved. The hypocholesterolemic effects of HMG CoA reductase inhibitors can be potentiated by combination therapy with other approved lipid-lowering medications including the bile acid sequestrants and nicotinic acid. If long-term safety can be satisfactorily established, specific inhibitors of HMG CoA reductase represent a major advance in the therapy of hypercholesterolemia and afford the potential to reduce substantially the high incidence of premature atherosclerosis that occurs in patients with persistent hypercholesterolemia. PMID- 3314448 TI - Low density lipoprotein receptor regulation and the cellular basis of atherosclerosis: implications for nutritional and pharmacologic treatment of hypercholesterolemia. AB - Blood levels of lipids and lipoproteins are prominent among the factors identified as contributing to the development of coronary artery disease. Studies have demonstrated that reduction of low density lipoprotein (LDL) levels lowers the risk of coronary events and retards the progression of atherosclerotic lesions. LDL receptors play a central role in the metabolism of LDL: they maintain cellular cholesterol homeostasis by effects on cholesterol synthesis, modulate the plasma level of lipoproteins by clearing LDL from the circulation and deliver cholesterol to the adrenal glands and gonads for steroid hormone synthesis and to the liver for bile acid synthesis. The 2 major strategies that have been developed so far to lower LDL levels involve the use of bile acid binding resins, which bind cholesterol in the intestinal lumen, thereby leading to a decrease in intracellular cholesterol, which increases the rate of synthesis of LDL receptors and increases the rate of LDL clearance; and, more recently, the use of inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the key enzyme in the biosynthesis of cholesterol. Further studies are required to assess whether HMG-CoA reductase inhibitors, used alone or concomitantly with bile acid-binding resins, are safe and effective for long-term use in patients with elevated LDL levels. PMID- 3314449 TI - Nonpharmacologic approaches to the treatment of systemic hypertension. AB - There are 3 areas of nonpharmacologic approaches that are recommended at present for control of arterial pressure elevation: (1) weight reduction to ideal body weight, since it reduces risk from hypertension and overall cardiovascular morbidity and mortality, (2) moderation in alcohol consumption to less than 2 ounces a day and (3) dietary sodium restriction to less than 2 g a day, without the promise that it will normalize arterial pressure. These interventions may also facilitate the effectiveness of already prescribed antihypertensive drugs. Other nonpharmacologic approaches have yet to be shown to be effective in controlling arterial pressure and their recommendation at present is, at best, preliminary. PMID- 3314450 TI - Weight reduction for control of systemic hypertension. AB - It has been well documented that antihypertensive treatment can prolong life and decrease cardiovascular disease in patients with hypertension. Weight reduction is an effective means of decreasing blood pressure. We have treated normal-weight to obese hypertensive patients with weight reduction as a nondrug means of controlling mild to moderate hypertension. Adjunctive therapy included reduced sodium intake (initially 1 g of sodium daily, increased to 2 to 5 g daily), increased physical activity and relaxation techniques. Of the 130 protocol patients, 68 (52%) were normotensive while not taking any medication at the end of the program. Additionally, 36 patients (28%) had lower blood pressure, needed less medication or both; 26 patients (20%) did not have a positive response. Weight reduction is a useful method to control hypertension and a reasonable alternative to drug therapy. PMID- 3314451 TI - Medical evaluation and treatment of the obese patient with cardiovascular disease. AB - The incidence of coronary artery disease only weakly correlates with the percent of excess body weight; however, obesity in humans is not a homogeneous condition. Classification of obesity based on anatomic distribution of body fat allows for identification of a group of patients at increased risk for cardiovascular disease. Abdominal (upper body) obesity, measured as the waist/hip ratio, is a strong independent risk factor of cardiovascular disease and should be used to assess a subgroup in need of medical weight loss treatment. A focus on dietary fat intake and the magnitude of overeating "caloric intake" are central to the pathogenesis of cardiovascular disease observed in the obese person. Identification of the process of overeating (magnitude of recent weight gain, episodes of weight cycling) is important in the design of successful medical nutrition treatment programs. A nutrition/medical history that includes age of obesity onset and duration of obesity provides additional criteria for assessment of risk of disease. Childhood-onset obesity and prolonged obesity (greater than 15 years) has been associated with increased cardiovascular disease risk. Recently, grades of obesity based on body mass index have provided a valuable marker for treatment. Each reduction in obesity grade (equal to delta 5 body mass index or delta 11.6 kg) is associated with a decrease in risk of medical illness. The new focus of obesity treatment should be to decrease body weight in 10% to 15% increments (equal to 1 grade) with emphasis on reducing the risk of medical illness and treatment intensity (e.g., number of existing medical visits, hospitalization).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314453 TI - Two forms of vasoconstriction in systemic hypertension. AB - Clinical, pharmacologic and biochemical evidence characterizes essential hypertension as a heterogeneous spectrum of pathophysiologic substances rather than the single entity it has long been presumed to be. Although the causes of essential hypertension remain obscure, 2 different mechanisms for long-term vasoconstriction that sustain diastolic hypertension in the experimental and clinical forms of primary aldosteronism and renovascular hypertension can also be identified and quantified among patients with essential hypertension. The first mechanism is renin independent, requires antecedent sodium retention and appears related to abnormal membrane transport of calcium. This vasoconstriction is identified by low plasma renin and ionized calcium and is correctable by sodium depletion or calcium channel or alpha blockade. The second vasoconstrictor mechanism is renin mediated and involves an increase in cytosolic calcium. This mechanism is quantifiable by the plasma renin level or the hypotensive response to an antirenin-system drug (converting enzyme inhibitor, beta blocker or saralasin). Depending on the state of sodium balance, these 2 mechanisms contribute reciprocally to maintenance of arteriolar tone in experimental models, in both normal and hypertensive people, and in patients with congestive heart failure. In these situations, at the extremes of the range of plasma renin values, one or the other mechanism predominates, whereas in the medium range of renin values both mechanisms can be operative. These interrelations provide a basis for applying more precisely tailored therapy and for stratifying patients pathophysiologically for further study. PMID- 3314452 TI - Electrolytes and dietary fat in hypertensive cardiovascular disease. AB - Nonpharmacologic measures have been increasingly applied to the management of patients with essential hypertension. Published findings concerning dietary factors and blood pressure are reviewed. Specifically, the impact of manipulations of dietary sodium, potassium, magnesium, calcium and dietary fat on blood pressure is considered. The data support a beneficial role for calcium supplementation and sodium restriction, a lesser role for potassium supplementation and a decrease in total and saturated fat intake in at least some hypertensive persons. At this time, no dietary alteration can be recommended for broad application to the population as a whole. PMID- 3314454 TI - Platelet/vessel wall interactions, rheologic factors and thrombogenic substrate in acute coronary syndromes: preventive strategies. AB - Thrombosis is an important pathogenetic factor in acute coronary syndromes, including unstable angina, myocardial infarction and sudden death. In all of these conditions, atherosclerotic plaque fissuring is a key inciting event. Minor injury to the vessel wall brings into play interactions between platelets and the wall. Platelet adhesion and aggregation ensue, modulated by a number of factors and substances. More severe injury to the vessel wall exposes the blood to other thrombogenic substances. Platelet deposition is also affected by rheologic (blood flow) factors at the site of injury, depending on the degree of stenosis and the resulting shear rates. The mechanism of unstable angina appears to be related to these factors in the following sequence: mild stenosis and minor injury with plaque fissuring, platelet responses, labile thrombosis, intermittent ischemia and pain at rest. Vasoconstriction may contribute to the symptoms. Although developing from the same origin, infarction may stem from a greater degree of vessel wall damage resulting in more permanent thrombus. Such considerations provide a focus for preventive strategies, including the optimal use of current inhibitors of platelet adhesion and aggregation and the application of peptide receptor blockers and monoclonal antibodies. Also important is control of rheologic factors by preventing stenosis or correcting it with angioplasty and thrombolytic therapy. Further elucidation of the critical role of thrombosis in coronary syndromes will facilitate progress toward the ultimate goal of primary prevention. PMID- 3314455 TI - Sensitivity, specificity and predictive accuracy of Q wave, QX/QT ratio, QTc interval and ST depression during exercise testing in men with coronary artery disease. AB - One hundred forty-three subjects (107 with coronary artery disease [CAD], 23 without CAD [evaluated by coronary angiography] and 13 athletes) were selected for this study. All subjects underwent exercise testing to evaluate sensitivity, specificity and predictive value of Q wave, QX/QT ratio, QTc interval and ST depression. The Q-wave analysis revealed less sensitivity (49%) and less specificity (83%) than ST depression (71% and 97%, respectively). The QTc criterion had greater sensitivity (80%) than ST depression but less specificity (11%). The QX/QT criterion was no different in sensitivity (74%) but had less specificity (69%). To establish the statistical evaluation of the positive predictive value in CAD, variations in the prevalence of the disease were considered. A 90% prevalence gives the best positive predictive value on all evaluated measurements, between 100% for ST depression and 89% for the QTc criterion. A 5% prevalence, however, gives an acceptable positive predictive value only on ST-segment depression (57%). PMID- 3314456 TI - Association between the severity of diabetes mellitus and coronary arterial atherosclerosis. AB - The relation between the severity of diabetes mellitus (DM) and the risk of significant coronary artery lesions were studied in 7,655 patients undergoing coronary arteriography for suspected coronary artery disease (CAD) between 1972 and 1982. The principal treatment regimen for DM was used to estimate the severity of DM. DM treated with insulin was defined as the most severe (n = 244), followed by DM treated with oral agents (n = 344) and with diet only (n = 380); 6,687 patients did not have DM. Severity of DM in patients with CAD (70% or greater diameter stenosis) was compared with that in control subjects without CAD (0% stenosis) for each of 9 anatomic locations (proximal, middle and distal portions of right, anterior descending and circumflex coronary arteries) using a retrospective case-control approach. The risk of CAD was highest in patients with DM treated with insulin (odds ratio estimate of the relative risk [OR = 3.0]), followed by patients with DM treated with oral agents (OR = 1.8) and lastly in those treated with diet alone (OR = 1.4). Severity of DM was a significant (p less than 0.05) independent predictor of CAD in a multivariate logistic regression model, whereas age at onset and duration of DM were not. The relative risk of CAD was the same (p greater than 0.05) for each of the 9 coronary segments. The data suggest that the risk of CAD increases with the severity of DM, which was a stronger predictor of CAD than duration of DM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314457 TI - Blood pressure reduction after oral glucose loading and its relation to age, blood pressure and insulin. AB - Recently it was shown that blood pressure (BP) in the elderly may decrease after a meal. The pathophysiologic mechanism of this phenomenon is unknown. It has been suggested that a failure of insulin-mediated sympathetic nervous system activation plays a role. To evaluate the role of endogenous insulin, the effects of oral glucose and oral fructose loading on BP, heart rate and norepinephrine levels were studied in 10 young normotensive volunteers (YN), 10 young hypertensive patients (YH), 10 elderly normotensive volunteers (EN) and 10 elderly hypertensive patients (EH). Fructose, 75 g/300 ml of water, elicited--in contrast to the same amount of glucose--only a small increase in insulin and glucose levels. After glucose loading, mean arterial BP decreased by 17 mm Hg in the EH group (p less than 0.001), 6 mm Hg in the EN group (p less than 0.01) and 7 mm Hg in the YH group (p less than 0.001), and did not change in the YN group. After oral fructose loading, BP did not change in any group. In all groups except the YN group, the increases in norepinephrine level and heart rate after both tests were not significantly different. These findings suggest that the BP reduction after glucose loading is related to glucose-mediated factors. A failure of insulin-mediated sympathetic nervous system activation does not appear to play a major role. PMID- 3314458 TI - Comparison of diltiazem and atenolol in young, physically active men with essential hypertension. AB - The antihypertensive efficacy and effect on maximal exercise performance of diltiazem was evaluated and compared with atenolol in patients specifically selected on the basis of their being young and physically active. Diltiazem (sustained-release preparation, 90 mg twice daily) was administered to 14 patients (aged 33 +/- 2 years) and atenolol (50 mg once daily) to 13 patients (aged 30 +/- 2 years) with essential hypertension in a 16-week randomized, double blind, parallel study. The 2 drugs had comparable antihypertensive effects at rest, with mean decreases of 18 and 17 mm Hg (p less than 0.001) for supine and standing diastolic blood pressure (BP), respectively, during diltiazem treatment, and mean decreases of 21 and 18 mm Hg (p less than 0.001) during atenolol treatment. During maximal graded exercise testing, systolic BP, diastolic BP, heart rate and heart rate-BP product were significantly reduced by both drugs. However, the reductions in systolic BP, heart rate and heart rate-BP product during exercise were considerably greater (p less than 0.001) with atenolol than with diltiazem. Maximal exercise performance was essentially unchanged with diltiazem and slightly (3%, p less than 0.05) reduced with atenolol. Thus, diltiazem is effective and well-tolerated single therapy for young patients with mild to moderate essential hypertension who lead a physically active life style and compares favorably with atenolol. PMID- 3314459 TI - Similar efficacy of nitrendipine in young and elderly hypertensive patients. AB - Calcium channel blockers have been postulated to be more effective as monotherapeutic antihypertensive agents in the elderly than in younger patients. To determine if a new dihydropyridine derivative, nitrendipine, is more effective in the elderly (older than 60 years) than in younger hypertensive subjects (younger than 60 years), nitrendipine was administered in a multicentered study to 21 elderly and 33 younger subjects with essential hypertension. After gradual discontinuation of previous antihypertensive therapy and 2 weeks of placebo, the daily dose of nitrendipine (10 to 40 mg) was titrated over 3 weeks to achieve a 10 mm Hg decrease in supine diastolic blood pressure (BP) for patients entering with 90 to 99 mm Hg. For patients entering with at least 100 mm Hg, the dose was titrated to diastolic BP no greater than 90 mm Hg. Titrated dose of nitrendipine was maintained for 4 additional weeks. Propranolol was added for "symptomatic" tachycardia. Nitrendipine reduced BP in 90% of patients completing all phases of the study (n = 49). The proportion of responders was 47% among the elderly and 44% among young subjects. Change in heart rate was similar in both groups (-0.1 +/- 9.9 and +2.9 +/- 8.8 beats/min, mean +/- standard deviation). Two elderly and 1 younger subject required addition of propranolol (difference not significant). There was no correlation between the age of patients and changes in supine systolic and diastolic BP or heart rate (r = 0.21, -0.15 and -0.21, respectively). Adverse effects occurred with equal frequency in older and younger subjects (19 of 21 vs 23 of 33 patients, difference not significant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314460 TI - Dissociation of the prostaglandin and renin angiotensin systems during captopril therapy for chronic congestive heart failure secondary to coronary artery disease. AB - Neurohumoral systems are activated as compensatory mechanisms in congestive heart failure (CHF). A close correlation has been reported between the renin angiotensin and prostaglandin systems in CHF. Furthermore, serum sodium concentration provided an excellent index of hormonal status. In this study, these relations were examined after acute and chronic blockade of renin angiotensin system with captopril. Eight patients with advanced CHF (New York Heart Association III or IV) were studied. Before captopril treatment, all hormone levels were elevated. Mean plasma renin activity was 24 +/- 7 ng Al/ml/hour, angiotensin concentration was 221 +/- 11 pg/ml and aldosterone concentration was 82 +/- 17 pg/ml. Plasma PGE2 metabolite was 1,425 +/- 321 pg/ml. A close correlation was observed between plasma angiotensin II and PGE2 metabolite levels (r = 0.7); inverse correlations existed between serum sodium concentration and PGE2 metabolite levels (r = -0.9) and with plasma renin activity (r = -0.6). Captopril therapy reduced the plasma angiotensin II level to 38 +/- 6 pg/ml and aldosterone concentration to 15 +/- 3 pg/ml, but did not affect plasma renin activity (31 +/- 10 ng Al/ml/hour) when measured in 1 week. Paradoxically, PGE2-metabolite levels increased further (to 3,031 +/- 346 pg/ml) despite blockade of the renin angiotensin system. Serum sodium concentration no longer correlated with hormone levels. These effects were sustained at 2 months of follow-up. Thus, captopril caused a dissociation between the renin angiotensin system and prostaglandin. The activation of prostaglandin is probably due to captopril's effect on prostaglandin biosynthesis and may contribute to captopril's sustained efficacy in CHF. PMID- 3314461 TI - Leeching in the twentieth century. PMID- 3314462 TI - Retractions. PMID- 3314463 TI - Potential for reversibility of pulmonary vascular obstructive disease after cardiac transplantation. PMID- 3314464 TI - Effect of metoprolol on the submaximal stress test performed early after acute myocardial infarction. AB - To determine the effect of beta-adrenergic blockade on the submaximal stress test after acute myocardial infarction (AMI), 36 post-AMI patients performed their treadmill test on 2 separate days, with and without metoprolol, in a double blind, placebo-controlled, crossover design study. Rest and peak submaximal exercise heart rate was diminished by 100 mg of metoprolol administered twice daily (from 84 +/- 3 to 68 +/- 2 beats/min, p less than 0.001, and from 126 +/- 3 to 97 +/- 2 beats/min, p less than 0.001, respectively) compared with placebo. Rest and peak submaximal systolic blood pressure was also decreased (from 121 +/- 3 to 108 +/- 2 mm Hg, p less than 0.001, and from 151 +/- 4 to 124 +/- 3 mm Hg, p less than 0.001). Exercise-induced ST-segment depression of 1 mm or more from baseline occurred in 12 patients taking placebo. However, only 4 of these patients had ST depression when they exercised while taking metoprolol (p less than 0.05). Angina pectoris occurred in 4 patients taking placebo but in only 1 of these taking a beta-blocking drug. It is concluded that beta-blocking therapy renders the post-AMI submaximal stress test less sensitive for markers of exercise-induced ischemia than if the test is performed without the drug. Therefore, when using the prognostic information of published studies, it is important to define the conditions surrounding the exercise test. PMID- 3314465 TI - Special issue dedicated to the memory of M. Hans Elias. PMID- 3314466 TI - M. Hans Elias 1907-1985. PMID- 3314467 TI - 1987 Herman award lecture. A plea for an integrated approach to characterization and management of obesity, type II diabetes, hyperlipidemias, and hypertension: a role for the personal computer? AB - In the Vermont study of experimental obesity, heterogeneity of the response to overfeeding was a striking finding in normal subjects. There is also poorly defined heterogeneity within the areas of obesity, noninsulin-dependent diabetes, hyperlipidemias, and so-called essential hypertension. These disorders may occur in the same individual and have important mechanisms in common. Thus it is logical to strive for an integrated approach to nutritional and medical management rather than an approach fragmented between medical specialties. The rapidly developing computer programs now adapted to microcomputers hold promise of facilitating an integrated approach both in the clinical and in the investigative field. PMID- 3314468 TI - Development of normalized curves for the international growth reference: historical and technical considerations. AB - The World Health Organization recommended in 1978 that the National Center for Health Statistics/Centers for Disease Control growth reference curves be used as an international growth reference. To permit the expression of growth in terms of standard deviations, CDC developed growth curves from the observed data that approximate normal distributions. Because of significant skewness, standard deviations for weight-for-age and weight-for-height were calculated separately for distributions below and above the median. Standard deviations below the median were calculated from the 5th, 10th, 25th, and 50th observed percentiles while those above the median were based on the 50th, 75th, 90th, and 95th observed percentiles. Height-for-age distributions did not show significant skewness, thus, the standard deviations were calculated based on all six of the above observed percentiles. The normalized reference curves provide a highly useful data base that permits the standardized comparison of anthropometric data from different populations. PMID- 3314470 TI - Acute myelofibrosis. Immunohistochemical study of four cases and comparison with acute megakaryocytic leukemia. AB - Four cases of acute myelofibrosis are contrasted to three cases of acute megakaryocytic leukemia. The cases were clinically indistinguishable. Light microscopic examination of hematoxylin and eosin-stained bone marrow biopsy specimens from the cases of acute myelofibrosis showed a trilinear proliferation of mature and immature hematopoietic cells, increased numbers of mature magakaryocytes, and marked fibrosis. In contrast, the blast cells in the cases of acute megakaryocytic leukemia showed a continuous spectrum of differentiation from small blasts to megakaryoblasts. Immunoperoxidase staining showed the blast cells in all three cases of acute megakaryocytic leukemia to be strongly positive for Factor VIII, a marker of megakaryocytic differentiation. These same blasts did not stain with markers of myelomonocytic (lysozyme), lymphocytic (Hle), and myeloid (Leu-Ml) differentiation. In contrast, the blast cells in all four cases of acute myelofibrosis were Factor VIII, Hle, and Leu-Ml negative but did occasionally stain with anti-lysozyme. PMID- 3314469 TI - Glycemic response in children with insulin-dependent diabetes mellitus after high or low-glycemic-index breakfast. AB - To examine the effects of various carbohydrate foods on postprandial glycemia in diabetic children, we fed a mixed, isocaloric diet containing either high- or low glycemic-index (GI) breakfast foods to 22 children with poorly controlled insulin dependent diabetes mellitus (IDDM) and measured blood sugar response with and without adjustment of insulin doses. We found that IDDM children fed a high-GI meal showed a significantly higher serum glucose level than those fed a low-GI meal. However, such differences were not seen when the preprandial dose of regular insulin was adjusted to the amount of carbohydrate in feedings. Thus, as long as proper adjustment of insulin is made, the type of carbohydrate in a single mixed meal does not appear to have a significant effect on the postprandial glycemic response in children with long-standing poorly controlled IDDM. PMID- 3314471 TI - Major improvement in microscopic-image quality of cryostat sections. Combining freezing and microwave-stimulated fixation. AB - In this article the authors describe a procedure to obtain cryostat sections of superior quality using microwave stimulation of a fixation reagent with suitable microwavability properties. In fact, the light microscopic images are of a quality that is comparable to that of the best conventional paraffin technique. The new procedure requires less time than the existing cryostat technique. The only additional piece of equipment needed in this procedure is a relatively inexpensive commercially available microwave oven. PMID- 3314472 TI - Comparison of the TestPack Strep A enzyme immunoassay system with anaerobically incubated cultures for detection of group A streptococci from oropharyngeal swabs. AB - To find a rapid and sensitive test for detection of Group A streptococci (GABS), the performance of the TestPack Strep A (TPSA; Abbott) was compared with culture with the use of rayon-tipped throat swabs from symptomatic patients six months to 90 years of age. Each swab was first inoculated to a 5% sheep blood agar plate and then tested for GABS antigen with the use of the TPSA and the manufacturer's instructions. Cultures were incubated anaerobically at 35 degrees C for 36-48 hours unless positive results were obtained after one night. GABS were identified with a fluorescent antibody method or a latex antibody test. From 1,616 throat swabs, 296 (18.3%) of the cultures contained GABS. The sensitivity and specificity of the TPSA were 73.3% and 94.8%, respectively, whereas the predictive values of positive and negative results were 75.9% and 94.1%, respectively. Results varied significantly, however, with different production lots of TPSA. The TPSA does not appear to provide a sensitive alternative to an anaerobic culture for detection of GABS. PMID- 3314473 TI - An unusual case of splenic abscess and sepsis in an immunocompromised host. AB - Lactobacilli are important members of the vaginal, gastrointestinal, and oral flora in humans. Although these organisms are usually innocuous, increasing numbers of serious infections attributable to these bacilli have recently been reported. The authors report an unusual case of a patient presenting with a splenic abscess and sepsis resulting from lactobacilli and review the literature describing serious infections caused by these organisms. PMID- 3314474 TI - 1987 Ward Burdick award lecture. Clinical decision analysis and the future of academic clinical pathology. PMID- 3314476 TI - Radiological case of the month. Extralobar pulmonary sequestration. PMID- 3314475 TI - A controlled study of the nephrotoxicity of mezlocillin and amikacin in the neonate. AB - The nephrotoxicity of the aminoglycoside amikacin sulfate was evaluated in an open, controlled study of newborns with presumed neonatal sepsis. One hundred twelve neonates were randomly allocated to receive either amikacin-ampicillin or mezlocillin, a semisynthetic penicillin. Neonates receiving amikacin, in contrast to those receiving mezlocillin, showed significant nephrotoxicity as evidenced by a delayed postnatal fall in mean serum creatinine level (82 to 80 mumol/L [0.93 to 0.90 mg/dL] vs 84 to 72 mumol/L [0.95 to 0.82 mg/dL]) and a delayed postnatal rise in mean creatinine clearance per kilogram of body weight (12% vs 38%). Furthermore, 40% of neonates receiving amikacin-ampicillin compared with 19% of neonates receiving mezlocillin had a decline in creatinine clearance (greater than 25%). There was no relationship between amikacin nephrotoxicity and either peak or trough amikacin levels. In summary, in a controlled study of the use of amikacin and mezlocillin in neonates, the combination of amikacin and ampicillin proved more nephrotoxic to the newborn kidney. PMID- 3314478 TI - The use of pelvic ultrasonography in the evaluation of adolescents with pelvic inflammatory disease. AB - To evaluate the use of pelvic ultrasonography in the diagnosis and management of female adolescents with pelvic inflammatory disease (PID), sonograms of 60 patients with PID were compared with those of 40 age-matched controls. Sonograms were evaluated for adnexal volume, adnexal adherence, uterine size, and the presence of cul-de-sac fluid. Eleven (19.3%) of the 57 patients with PID, in whom adequate sonograms were obtained, had tubo-ovarian abscesses; in seven of these patients, the abscesses were diagnosed ultrasonographically before suspected clinically. Even in those patients without tubo-ovarian abscesses, the mean (+/- SD) adnexal volume in the PID group was significantly larger than that of the control group (11.0 +/- 6.8 cm3 vs 5.2 +/- 2.7 cm,3 respectively). Adnexal adherence, uterine size, and the presence of cul-de-sac fluid were not useful in differentiating patients with PID from normal controls. Pelvic ultrasonography can be a useful adjunct in the diagnosis and management of PID in adolescents and may, in some instances, provide diagnoses in the absence of clinical findings. PMID- 3314477 TI - The role of bacterial virulence factors and Tamm-Horsfall protein in the pathogenesis of Escherichia coli urinary tract infection in infants. AB - Forty-three patients and 70 controls were enrolled in an open study to evaluate the role of bacterial virulence factors and Tamm-Horsfall protein (THP) in the pathogenesis of urinary tract infection (UTI) due to Escherichia coli. The ages of the patients and controls ranged from 5 days to 6 months. Nine patients had upper UTIs and 33 patients had lower UTIs, based on bacteremia and radiographic evidence. There were no differences between patients and controls in the percentages of strains showing hemolytic activity of E coli strains isolated from periurethral and rectal cultures. Urinary E coli strains recovered from patients showed a significantly higher percentage of mannose-resistant hemagglutination, greater P and X fimbriation, more type 1 pili, and the presence of mannose sensitive and mannose-resistant hemagglutination when compared with E coli strains recovered from the controls. The O but not the K pyelonephritogenic serotypes were more commonly recovered from patients than from controls. The mean THP concentrations in urine (micrograms of THP per milligrams of creatinine) were 29.9 and 91.4 micrograms/mg for patients and controls, respectively. With the exception of hemagglutination properties and certain pyelonephritogenic O serotypes, other virulence factors of E coli could not be defined in our infant population. The role of THP, if any, in the pathogenesis of UTI remains unresolved. PMID- 3314479 TI - Harness racing injuries and deaths. Report of a fatal accident and review of 178 cases. AB - A case of a harness racing accident in which the driver died of head injuries is presented. To evaluate the victim's head injury and corresponding helmet damage, a videotape of the race was reviewed and analyzed. Based on calculations of a simplified trajectory analysis and testing of the helmet, it was determined that the helmet design did not provide adequate protection for the victim. The standards for harness helmet design are being re-evaluated by the harness racing industry to ensure the safety of the drivers. A review of 178 harness racing injuries and deaths, current harness helmet research, and recommendations for safer helmets are discussed. A protocol for the forensic investigation of sports related injuries and/or deaths is also presented to assist medical examiners in fulfilling their roles as practitioners of preventive medicine. PMID- 3314480 TI - Time since death. An entomological study on corpses. AB - After death, during disintegration, various environmental conditions and fauna play an important role, indicating "time since death." The natural openings of the host body provide the most important breeding place for an agent which could consume the body very quickly, e.g., flies. Wounds are preferred over the natural openings by this agent. In such cases, antemortem wounds become unidentifiable. This paper presents the study of 25 cases in which inferences relating to the maturation of blow fly life stages and the total developmental time of an adult blow fly in breeding experiments in the prevailing environment are drawn. These can be used to help estimate the "time since death" of infested bodies. PMID- 3314481 TI - Ultrastructural and immunofluorescent detection of herpes simplex virus after embalming and burial. AB - The practice of embalming preserves body tissues, and embalmed bodies may resist decay processes for many decades with relatively little change. As the chemicals used for embalming are poisonous to microorganisms, bacterial and viral cultures are futile after such funerary procedures are performed. However, embalming may act as a virtual tissue fixative, especially with arterial perfusion, and identification methods other than culture may be used to detect and identify pathogenic organisms. In the case presented here, a death from a fulminating, but unidentified, illness in a young girl was successfully diagnosed as herpes hepatitis by immunofluorescent and electron-microscopic studies of tissue obtained 3 weeks after she was embalmed and interred. Routine embalming and burial should not eliminate these diagnostic procedures from consideration in specific situations where potentially useful information may be realized. PMID- 3314482 TI - Forensic medicine in Great Britain. I. The beginning. AB - This paper briefly outlines the evolution of modern forensic medicine in Great Britain from the coroner system originally implemented. It focuses on the role of Andrew Duncan, Sr. in creating a chair in medical jurisprudence and establishing a precedent for the teaching of forensic medicine to students and practitioners alike. PMID- 3314483 TI - Small intestinal motility: normal and abnormal function. AB - This review outlines the properties and function of intestinal smooth muscle and the mechanisms that underlie contraction and relaxation. Both tonic and phasic (rhythmic) contraction are mediated by an increase in intracellular calcium. Phasic contraction is paced electrically by rhythmic changes in membrane potential (slow waves) which, upon reaching a threshold, lead to opening of membrane calcium channels and the entry of calcium into muscle cells; this inwardly directed calcium current or spike initiates a cascade of events resulting in contraction. Slow waves and spike potentials and, thus, phasic contraction, are influenced by neurotransmitters, hormones, and drugs. In circular muscle, these agents can also increase calcium by releasing it from intracellular stores, thus inducing tonic contraction. Ingestion of food initiates peristaltic propulsive activity which, in its rhythm, is superimposed on spontaneous phasic activity. The peristaltic reflex consists of two successive phases: relation of circular muscle distal to the distending bolus (descending relaxation) and contraction proximal to the bolus (ascending contraction). In between meals, a different, slower pattern of muscle activity prevails, known as the migrating motor complex, which helps to maintain the lumen of the intestine free of contents. Improved understanding of normal muscle function is beginning to reflect itself in improved management of patients with motility disorders. PMID- 3314485 TI - Liver transplantation: more questions. PMID- 3314484 TI - Socioeconomic aspects of hepatic transplantation. AB - The outcome, cost, length of hospital stay, and extent of rehabilitation were assessed in a series of 55 consecutive patients who received hepatic transplants between May 1982 and June 1985. In the same geographic region, medical costs for patients dying of hepatic failure without transplantation were studied for years 1979 through 1984. One-yr survival in all patients transplanted without cancer was 71%, and the mean cost was $92,866. The mean cost of hospitalization for the last 12 months of life in patients who did not receive transplants was $45,643. Eight-two percent of patients surviving the first yr are fully rehabilitated and restored to pre-illness activity. Length of hospital stay, hospital costs, and the extent of rehabilitation closely correlate with a grading system based on preoperative medical status. We conclude that hepatic transplantation restores high-quality, useful life to patients with endstage liver disease in a predictable and cost-effective manner. PMID- 3314486 TI - Massive hepatic steatosis complicating adult celiac disease: report of a case and review of the literature. AB - Hepatomegaly, chronic diarrhea, and weight loss in a middle-aged woman were found to be due to massive hepatic steatosis and adult celiac disease. After she was on a gluten-free diet for 1 yr, improvement in clinical, laboratory, and pathological parameters was witnessed. Massive hepatic steatosis complicating adult celiac disease is an uncommon occurrence, differing from other, more frequently encountered hepatopathies in this disease, insofar as pathogenetic and prognostic aspects are concerned. PMID- 3314487 TI - Hemodynamic analysis of postsplenectomy portal thrombosis using ultrasonic Doppler duplex system. AB - Using an ultrasonic Doppler duplex system, we investigated the portal hemodynamics of two patients with portal thrombosis after splenectomy and esophageal transection for portal hypertension accompanied by liver cirrhosis. In both cases, the preoperative blood flow volumes of the splenic and portal veins were especially high, but were markedly lower--even than normal--after the operation. However, the results of pre- and postoperative peripheral platelet counts and coagulation function tests did not differ remarkably. The dramatic change in portal hemodynamics caused by the splenectomy was thought to be the main factor in the formation of the portal thrombi. PMID- 3314488 TI - Combination of pirenzepine and cimetidine in the therapy of duodenal ulcer. PMID- 3314489 TI - Prevalence, pathogenesis, and treatment of renal dysfunction associated with chronic lithium therapy. AB - From the analysis of several studies published from 1979 to 1986 comprising 1,172 patients, we estimated that glomerular filtration rate (GFR) was normal in 85% of unselected patients on chronic lithium therapy. The remaining 15% of patients displayed only mild reduction in GFR, clustering at approximately 60 mL/min. Thus, the data available to date do not support earlier concerns that long-term lithium therapy could eventuate into renal insufficiency. The most prevalent renal effect of lithium is impairment of concentrating ability, which we estimated to be present in at least 54% of 1,105 unselected patients on chronic lithium therapy. This defect translated into overt polyuria in only 19% of unselected cases. A renal lesion confined to the collecting tubule has been described in humans who have taken lithium for short periods of time. This lesion may represent the collecting tubule's response to the intracellular accumulation of lithium, which interferes with cAMP formation and results in an early and probably reversible inhibition of antidiuretic hormone (ADH)-mediated water transport. However, long-term lithium therapy may induce a progressive and partly irreversible defect in concentrating ability. The potential risk for dehydration associated with lithium-induced polyuria, as well as the discomfort inherent to this side effect, deserves evaluation and consideration for therapeutic intervention. Amiloride has additional advantages over conventional treatment of nephrogenic diabetes insipidus using thiazide diuretics. The action of amiloride on ADH-mediated water transport seems specific in as much as it is capable of preventing the uptake of lithium in high resistance epithelia and thereby prevents the inhibitory effect of intracellular lithium on water transport. Unlike thiazides, amiloride has a weak natriuretic effect and is less likely to increase plasma lithium levels by causing volume contraction. In addition, amiloride, by conserving potassium, obviates the need for potassium supplementation that is usually required to prevent hypokalemia when thiazides are used to treat lithium-induced polyuria. Since amiloride may prevent chronic intracellular lithium accumulation in the collecting tubule, future studies should elucidate whether amiloride also has a role in preventing lithium-induced chronic tubulo-interstitial damage. PMID- 3314490 TI - The incidence of gout in renal transplant recipients. AB - To determine the frequency of gout in our renal transplant population and to identify any predisposing factors, we retrospectively examined the outpatient records of all patients transplanted between January 1980 and July 1984 in whom the allograft functioned for at least 1 year. Two hundred forty-three charts were sufficiently complete to be evaluated. Of the 211 patients receiving corticosteroids and cyclosporine (CyA) as immunosuppression, 25 had at least one documented episode of gout (9.7% of total, 11.8% of CyA patients); no episodes occurred in the 32 patients receiving azathioprine and corticosteroid therapy (P = .05). The time from transplantation to the first episode of gout ranged from 4 months to 4 years. Of the patients without gout, 103 of the 186 receiving CyA (55.5%) and eight of 32 receiving azathioprine (25%) had asymptomatic hyperuricemia (serum uric acid greater than 8.5 mg/dL for men, greater than 7.0 mg/dL for women, P less than .01). The number of patients receiving diuretics in the CyA treated group was 142 of 211 (67%) v 12 of 32 (37.5%) in the azathioprine group. However, the increased incidence of gout or hyperuricemia in patients receiving CyA was not due to the effect of the diuretic alone. There was no correlation between the serum creatinine and uric acid in either the CyA or azathioprine group (r value for CyA group = -.06 and for the azathioprine group = -.26). Compared with patients receiving azathioprine, we conclude that there is an increased incidence of gout and/or hyperuricemia in renal transplant patients treated with CyA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314493 TI - Hypomagnesemia and renal magnesium wasting in renal transplant recipients receiving cyclosporine. AB - Following the adoption and use of cyclosporine as the drug of choice in the management of renal allograft recipients, several cases of symptomatic hypomagnesemia were noted. These observations prompted the current prospective study of serum concentration and urinary excretion of magnesium in 27 renal transplant recipients treated with cyclosporine and prednisone. Relevant laboratory measurements were obtained shortly before and regularly after transplantation. The results were compared with those obtained in a group of 17 allograft recipients treated with azathioprine and prednisone. The cyclosporine treated patients showed a significant reduction in the serum magnesium concentration and an inappropriately increased urinary excretion and fractional excretion of magnesium, suggesting renal magnesium wasting. The observed hypomagnesemia required magnesium supplementation in nearly all cyclosporine treated patients. In contrast, azathioprine-treated patients showed normal serum magnesium concentrations and required no magnesium supplementation. In conclusion, administration of cyclosporine in renal allograft recipients appears to be commonly associated with renal magnesium wasting and hypomagnesemia. Therefore, it is recommended that serum levels of magnesium be monitored regularly in renal allograft recipients receiving cyclosporine and that magnesium supplementation be employed as needed to avoid magnesium depletion. PMID- 3314492 TI - HLA-B51 may serve as an immunogenetic marker for a subgroup of patients with Behcet's syndrome. AB - Epidemiologic data, family history, clinical data, HLA typing, neutrophilic chemotaxis, and immunofluorescence of clinically normal non-sun-exposed skin were studied in 46 Israeli non-Ashkenazi Jewish and Arab patients with Behcet's syndrome. HLA-B51 was present in 71 percent of the patient group as compared with 13 percent of the control group (relative risk = 17.1). In four of 30 families in the B51-positive group, there was a close relative of the proband with Behcet's syndrome who was carrying the HLA-B51 antigen. Neutrophilic chemotaxis in this group was enhanced in 80 percent of the patients, and in most patients no deposition of immunoglobulin in the dermo-epidermal junction was observed, whereas C3 was present in papillary vessels. In the B51-negative group, the family history was negative for Behcet's syndrome, neutrophilic chemotaxis was enhanced in only two of eight patients, and in four of six patients, IgM deposition was detected in the dermo-epidermal junction. It is concluded that in Israeli non-Ashkenazi Jews and Arabs, there is a significant association between HLA-B51 and the risk of developing Behcet's syndrome. The B51-positive patient group has a family history of the disease, enhanced neutrophilic chemotaxis, and a lack of immunoglobulin deposition in the dermo-epidermal junction. PMID- 3314491 TI - A controlled study of Tourette syndrome. VII. Summary: a common genetic disorder causing disinhibition of the limbic system. AB - Tourette syndrome (TS) is one of the most common genetic disorders affecting man. Approximately one in 100 individuals manifests one or more of the aspects of the TS gene. This series of papers has emphasized that although motor and vocal tics are the hallmark of TS, the complete range of behavioral problems is much broader. This spectrum of behavior can be explained on the basis of the TS gene causing an imbalance of the mesencephalic-mesolimbic dopamine pathways, resulting in disinhibition of the limbic system. PMID- 3314494 TI - Impact of air filtration on nosocomial Aspergillus infections. Unique risk of bone marrow transplant recipients. AB - Bone marrow transplant recipients were found to have a 10-fold greater incidence of nosocomial Aspergillus infection than other immunocompromised patient populations (p less than 0.001) when housed outside of a high-efficiency particulate air (HEPA) filtered environment. Multivariate analysis demonstrated that number of infections, age, and graft-versus-host disease severe enough to require treatment were independent risk factors for development of nosocomial Aspergillus infection in this group. The use of whole-wall HEPA filtration units with horizontal laminar flow in patient rooms reduced the number of Aspergillus organisms in the air to 0.009 colony-forming units/m3, which was significantly lower than in all other areas of the hospital (p less than or equal to 0.03). No cases of nosocomial Aspergillus infection developed in 39 bone marrow transplant recipients who resided in this environment throughout their transplantation period compared with 14 cases of nosocomial Aspergillus infection in 74 bone marrow transplant recipients who were housed elsewhere (p less than 0.001). Thus, although bone marrow transplant recipients had an order-of-magnitude greater risk of nosocomial Aspergillus infection than other immunocompromised hosts, this risk could be eliminated by using HEPA filters with horizontal laminar airflow. PMID- 3314495 TI - Persistent pulmonary infiltrates in an elderly woman with treated tuberculosis. PMID- 3314496 TI - Clinical relevance of culture versus screens for the detection of microbial pathogens in urine specimens. AB - The use of screens to detect "significant levels" of pathogenic microorganisms in urine specimens offers the advantages of both rapidly reporting results and controlling costs. Many of these screens, however, are insensitive at microbial counts below 10(5) colony-forming units (CFU)/ml of urine. It is increasingly apparent that patients with almost any type of urinary tract infection (except for most patients who are asymptomatic or who have pyelonephritis) may have urine concentrations of pathogens as low as 10(2) to 10(3) CFU/ml. This review documents factors that can contribute to diminished concentrations of microorganisms in urine, lists patient populations in whose urine microorganisms in concentrations well below 10(5) CFU/ml have been associated with infection, and makes recommendations for selection of laboratory tests, including rapid screens, for the diagnosis and management of urinary tract infections. PMID- 3314497 TI - Cardiac immunoglobulin deposition in congenital heart block associated with maternal anti-Ro autoantibodies. AB - Isolated congenital complete heart block is frequently found in offspring of mothers who have IgG anti-Ro/SSA autoantibodies. IgG deposition was reported in the heart of a baby who died from heart block and heart failure. The pattern of antibody deposition observed was the same as that reproduced in animal models for anti-Ro/SSA binding. The IgG deposition was present in, but not limited to, the conduction system. Scattered small infiltrates of mononuclear cells and a limited, patchy deposition of complement were also observed. These findings support the possibility that isolated congenital heart block may be causally related to autoantibodies. PMID- 3314498 TI - Poor survival of patients with idiopathic cardiomyopathy considered too well for transplantation. AB - Although the success of cardiac transplantation has encouraged earlier referral of potential candidates, those with mild symptoms of heart failure are frequently considered "too well" for transplantation. Outcome was investigated for 28 patients with non-ischemic dilated cardiomyopathy and ejection fraction of 25 percent or less who were denied transplantation due to lack of severe symptoms. One-year survival without transplantation was 46 percent. Low stroke volume and history of ventricular arrhythmias were independent predictors of early mortality. High risk, defined as either stroke volume of 40 ml or less or history of ventricular arrhythmia, identified 13 of 14 patients who did not survive one year and only one of 12 one-year survivors (p less than 0.001). Low stroke volume predicted hemodynamic failure (p less than 0.05) whereas arrhythmic history predicted sudden death (p less than 0.001). Clinical status improved in only six patients, all of whom had symptom duration of seven or less months at initial evaluation (p less than 0.001). Thus, patients referred to transplantation for dilated cardiomyopathy with an ejection fraction of 25 percent or less have a poor prognosis even if symptoms are mild. Patients with high hemodynamic risk may require early transplantation, whereas those with high arrhythmia risk may require other aggressive therapy in order to avoid transplantation until symptoms become severe. PMID- 3314499 TI - Significance of anticentromere antibody in idiopathic Raynaud's syndrome. AB - Fifty-eight patients with Raynaud's syndrome who had no evidence of definite underlying connective tissue disease had serum analyzed for the presence of anticentromere antibody using indirect immunofluorescence techniques on HEp-2 cell lines. Eighteen patients (31 percent) were anticentromere antibody-positive. The anticentromere antibody-positive group demonstrated significantly more frequent digital telangiectases, digital edema, elevated levels of immunoglobulins, and low C4 values. Photoplethysmography revealed significantly diminished blood flow in the anticentromere antibody-positive group. Capillary microscopy revealed significantly increased avascularity and number of dilated loops in the anticentromere antibody-positive group. Giant loops were seen exclusively in the anticentromere antibody-positive group. The clinical findings in the anticentromere antibody-positive group are suggestive of a transition to a connective tissue disease with features of the CREST syndrome. PMID- 3314500 TI - Disseminated coccidioidomycosis. Unusual manifestations in a cardiac transplantation patient. AB - Because of the immunosuppressive therapy received by patients undergoing cardiac transplantation, disseminated infections, including disseminated fungal infections, often develop. Disseminated coccidioidomycosis developed in a 23-year old man soon after undergoing orthotopic cardiac transplantation. Clinical manifestations included an unusual rash, severe myositis and arthropathy, a rapid downhill course, and pathologic evidence of widespread fungal invasion, including invasion of the cardiac graft. Detailed travel and geographic histories, and perhaps skin testing and antibody determinations for geographic-specific pathogens, should be part of the preoperative evaluation of all transplant candidates. PMID- 3314501 TI - Sarcoidosis and primary biliary cirrhosis. Literature review and illustrative case. AB - An illustrative case of a middle-aged woman with primary biliary cirrhosis and the onset of liver disease coincident with acute, self-limited sarcoidosis is presented. The distinctive characteristics of sarcoidosis and primary biliary cirrhosis are described, and the literature regarding a number of potential relationships between these two disorders is summarized. First, the simultaneous occurrence of primary biliary cirrhosis and sarcoidosis has been documented in a few patients. Second, some of these patients had an overlap syndrome characterized by features of both disorders, inviting speculation regarding a common pathogenesis. Third, in patients with sarcoidosis, advanced cholestatic sarcoid liver disease may develop, which may cause diagnostic confusion with primary biliary cirrhosis. Finally, patients with primary biliary cirrhosis may have pulmonary fibrosis as an associated disease. PMID- 3314502 TI - Ocular complications of Tangier disease. AB - Tangier disease, or familial high-density lipoprotein deficiency, is an inherited disorder resulting in tissue deposition of excessive cholesterol esters. Although associated corneal clouding has been reported to produce little visual impairment, this patient with Tangier disease had corneal clouding, decreased corneal sensation, and cicatricial ectropion and experienced slowly progressive marked visual impairment. All ocular cases of Tangier disease are reviewed. Ectropion and incomplete eyelid closure may precede corneal clouding and should be recognized as signs associated with Tangier disease. The combination of exposure keratopathy and corneal infiltration can cause significant visual impairment. PMID- 3314503 TI - Goldenhar complex in discordant monozygotic twins: a case report and review of the literature. AB - In 1952, Goldenhar described a pair of monozygotic twins who were discordant for epibulbar dermoids, auricular appendages, malformations of the auricle, and hemifacial microsomia. Eighteen twin pairs have subsequently been described in which at least one member exhibited these manifestations. We report on an additional pair of discordant dichorionic monozygotic male twins. All of the 5 monozygotic twin pairs for which placental information is available have been discordant and 2 of these had dichorionic membranes. The failure of discordant monozygotic twins to be limited to monochorionic pairs argues against the hypothesis that developmental abnormalities arising from the placental vascular anastomoses that are commonly found in monozygotic twins is the probable explanation for the discordant expression of these traits in twins. PMID- 3314504 TI - Thrombocytopenia with absent radius in a boy and his uncle. AB - We report a boy and his maternal uncle who have Thrombocytopenia-Absent Radius (TAR) syndrome. The mother of the propositus is normal. A maternal aunt has mild radial hypoplasia, possibly representing partial expression of the syndrome. A review of the literature shows several pedigrees in which relatives other than sibs were affected with TAR. Thus, autosomal recessive inheritance may not account for all cases and alternate modes of transmission should be considered. PMID- 3314505 TI - Renal insufficiency in Williams syndrome. AB - A 19-year-old patient with Williams syndrome and renal cystic dysplasia is presented. This young man has had gradual deterioration of renal function and recurrent, acute episodes of dehydration secondary to a concentrating defect. A review revealed several reports of renal dysfunction in patients with Williams syndrome, but this complication has not been sufficiently emphasized. We recommend that all patients with Williams syndrome undergo periodic ultrasound examination and renal function evaluation. PMID- 3314506 TI - Gonadal mosaicism in pseudoachondroplasia. AB - We report on a family in which a brother and sister have pseudoachondroplasia and normal parents. The brother married a normal woman, and they have 2 daughters; one of them has typical changes of pseudoachondroplasia, the other is normal. The most likely explanation in this family is gonadal (germinal cell) mosaicism in one of the grandparents. Other reports of possible autosomal recessive pseudoachondroplasia are reviewed. It is likely that gonadal mosaicism is responsible for a small percentage of cases with what appears to be a new mutation for pseudoachondroplasia. PMID- 3314507 TI - Neu-Laxova syndrome: report of a case and comments. AB - We report on an infant with Neu-Laxova syndrome [Neu et al, 1971; Laxova et al, 1972; Povysilova et al, 1976; Lazjuk et al, 1979; Scott et al, 1981; Fitch et al, 1982; Mueller et al, 1983; Turkel et al, 1983; Paes et al, 1985], and emphasize the ichthyotic skin lesions as a prominent characteristic change in this syndrome and as the probable cause of some of the other findings. Also, we call attention to the increased fatty tissue beneath the epidermis and the atrophic muscles there embedded. These findings should be considered in the diagnosis of this syndrome. PMID- 3314509 TI - Uncombable hair (pili trianguli et canaliculi): evidence for dominant inheritance with complete penetrance based on scanning electron microscopy. AB - Uncombable or spun-glass hair (pili trianguli et canaliculi) is an uncommon condition in which the hair is "unmanageable" and has a distinct appearance on scanning electron microscopy. The hair is usually grossly abnormal in infancy and childhood, but may become normal later in life. Although dominant inheritance has been observed, most cases have been sporadic. Both recessive and dominant transmission with incomplete penetrance have been suggested as modes of inheritance. We report the occurrence of this condition in a young girl, her brother, and her father. Although the proposita and her brother had characteristically uncombable hair, their father appeared normal and denied any history of hair abnormality. However, the characteristic hair morphology was observed on scanning electron microscopy in all 3 relatives, documenting dominant transmission and complete penetrance of the gene in this family. PMID- 3314508 TI - Neuroaxonal dystrophy presenting with neonatal dysmorphic features, early onset of peripheral gangrene, and a rapidly lethal course. AB - Infantile neuroaxonal dystrophy (IND) is a well-established autosomal recessive neurodegenerative disease. Clinical signs generally begin toward the end of the first or during the second year of life. We are aware of at least 4 cases of pre- or perinatal onset of this condition, and report here on 2 brothers who were affected at birth and had an unusual clinical course with onset of peripheral gangrene that progressed to autoamputation of digits. Both boys died in infancy with pathological changes compatible with IND. The somewhat different clinical course in these brothers leaves open the possibility that this is a variant of neuroaxonal dystrophy due to an X-linked recessive mutation. PMID- 3314510 TI - Further delineation of the 3-M syndrome with review of the literature. AB - The 3-M syndrome is a clinically recognizable disorder characterized by prenatal and postnatal growth retardation and a spectrum of consistent minor anomalies. Intelligence seems normal. Inheritance is probably autosomal recessive, with possible expression of the mutant gene in the heterozygote. Three sibs with the 3 M syndrome are reported, together with an extensive review of the pertinent literature. PMID- 3314511 TI - Decreased superoxide dismutase-2 activity in a patient with ring chromosome 6. AB - Manganese superoxide dismutase (SOD-2) activity was measured in erythrocytes and leukocytes of a patient with ring chromosome 6. Compared to normal control individuals, SOD-2 activity in leukocytes of the patient was lower, whereas cuprozinc SOD (SOD-1) activity was normal. These findings suggest the cause of decreased enzyme activity is the effect of the ring form on production of the enzyme or inherent instability of ring chromosomes. PMID- 3314512 TI - Twinning, nonrighthandedness, and fusion malformations: evidence for heritable causal elements held in common. AB - Certain relatively common congenital malformations that are reported to be excessive in frequency among twins are also found in excess among first-degree relatives of twins. They are familially associated with each other. Like twinning, they are familially associated with nonrighthandedness (NRH). They also share the fact that they affect structures that are built by the fusion of bilateral embryonic halves and then remodeled under the influence of neural crest mesenchyme. This conjunction of associations suggests that twinning, NRH, and the fusion malformations share causal elements, some of which may be heritable. Determination of spatial relationships in embryogenesis ("embryonic body symmetry determination") and the functions of neural crest mesenchyme may be mechanisms unifying these effects. PMID- 3314513 TI - Taking flight. PMID- 3314514 TI - Fetal-induced trauma as a cause of antepartum hemorrhage. AB - External trauma is a well-known cause of antepartum hemorrhage. These two cases demonstrate that fetal trauma may also be a cause of antepartum hemorrhage. Both patients complained of painful fetal movements, and real-time ultrasonography demonstrated that the fetus was striking the placental edge. PMID- 3314515 TI - Antepartum fetal surveillance in the patient with decreased fetal movement. AB - Whenever a patient has the subjective perception of decreased fetal movement, prompt evaluation in the form of antepartum fetal surveillance has been undertaken. The purpose of this report is to describe our experience with 489 pregnant women who came between Jan. 1 and Dec. 31, 1985 to our Antepartum Fetal Surveillance Clinic with this complaint alone or in association with another indication for fetal surveillance. Overall, 838 nonstress tests were performed, and the results were reactive, 93.2%; nonreactive, 6.8%; and fetal heart rate decelerations, 6.1%. Comparison of the first nonstress test results between those with decreased fetal movement alone or in combination with another diagnosis demonstrated a similar incidence of nonreactivity and fetal heart rate decelerations. In those patients whose indication was decreased fetal movement alone, there was a 3.7 times greater likelihood of diminished amniotic fluid volume. When the last test within 7 days of delivery was analyzed, the decreased fetal movement alone group had a lower incidence of cesarean delivery, cesarean delivery for fetal distress, and Apgar scores less than 7 than patients with an additional indication for testing. In summary, decreased fetal movement continues to be an acceptable indication for fetal surveillance. Based on our retrospective experience, the most reasonable approach appears to be a combination of nonstress test and amniotic fluid volume assessment. Unless the patient has additional indications for fetal surveillance, the patient with decreased fetal movement with a reactive nonstress test and a normal amniotic fluid volume does not appear to warrant additional testing. PMID- 3314516 TI - Effects of maternal glucose infusion on fetal acid-base status in human pregnancy. AB - The maternal and fetal metabolic effects of three commonly used intravenous fluids administered before regional anesthesia were studied in 32 gravid women undergoing elective cesarean section at term. Patients were randomized into one of three groups to receive 1 L of either 5% dextrose (50 gm of glucose) or Ringer's lactate or isotonic saline solution before epidural anesthesia. Acute glucose infusion resulted in maternal hyperglycemia, hyperinsulinemia, and an increase in the blood lactate level. Cord blood glucose, insulin, and lactate levels were also increased in this group. The key finding of this study was the significant lowering of pH in the umbilical cord vein (7.31 +/- 0.04) and artery (7.21 +/- 0.06) in the glucose-infused group when compared with the non-glucose infusion groups (p less than 0.05). Confounding perinatal factors such as maternal position, maternal hypotension, and prolonged time of surgery did not influence the fetal acid-base status. Thus acute maternal glucose infusion in normal patients can cause fetal hyperglycemia, metabolic acidosis, and neonatal hypoglycemia. These findings may be of particular clinical importance when fetal distress or fetal hypoxemia is due to other perinatal events. Under these circumstances, acute maternal glucose infusion may further contribute to fetal metabolic acidosis. PMID- 3314517 TI - The use of fetal neuromuscular blockade during intrauterine procedures. AB - Advances in fetal therapy have led to the utilization of such techniques as intravascular transfusion of the Rh-affected fetus, bladder shunt placement in the fetus with obstructive uropathy, and percutaneous umbilical blood sampling. Fetal movement makes these procedures technically more difficult while increasing the risk of fetal injury. However, maternal sedation rarely results in adequate suppression of fetal activity. Thus we tested the sedative effects of intramuscular d-tubocurarine (3 or 1.5 mg/kg) or pancuronium bromide (0.3 mg/kg) injected into the fetal gluteal region under ultrasound guidance in conjunction with 70 invasive in utero procedures. Short-term paralysis of the fetus was induced in all cases. No deleterious effects of this technique were noted on initial examination of the neonates. Neuromuscular blockade was found to be a very useful adjunct to both diagnostic and therapeutic procedures involving the fetus. PMID- 3314518 TI - Abdominal pregnancy: magnetic resonance identification with ultrasonographic follow-up of placental involution. AB - Abdominal pregnancy is a rare event and preoperative diagnosis may be difficult. Recently, sonographic examination and magnetic resonance imaging have proved helpful in the preoperative diagnosis in a patient who presented with advanced abdominal pregnancy after tubal sterilization. As well, ultrasound was of benefit in the follow-up of placental involution after delivery. PMID- 3314519 TI - Theca-lutein ovarian cysts associated with homozygous alpha-thalassemia. AB - We present a case of theca-lutein cysts associated with homozygous alpha thalassemia. Theca-lutein cysts have been associated with various types of nonimmune hydrops fetalis but have not been reported previously in association with homozygous alpha-thalassemia. PMID- 3314520 TI - Endometrial adenocarcinoma estrogen receptor content: association of clinicopathologic features with immunohistochemical analysis compared with standard biochemical methods. AB - Endometrial adenocarcinomas from 96 patients were studied for their biochemical estrogen receptor content as well as immunohistochemical localization of estrogen receptor. A well-characterized specific monoclonal antihuman estrogen receptor antibody (H222 sp gamma) as amplified by peroxidase/antiperoxidase techniques was used for immunohistologic localization. Immunohistochemical evaluation incorporated both the intensity and distribution of staining into a semiquantitative analysis (HSCORE). The total HSCORE was the sum of the relative contributions of the four histologic components: benign epithelium, malignant epithelium, stroma, and myometrium. These results were compared with clinicopathologic features of the tumors. Excellent sensitivity (91.5%) and specificity (93.1%) were observed for immunohistochemical analyses as compared with the biochemical analysis of estrogen receptor for these tissues. The cancer component HSCORE correlated better with grade than did the biochemical estrogen receptor determination. Correlation was also observed between surgical stage and estrogen receptor content. Decreasing biochemical estrogen receptor content predicted advanced surgical stage (p = 0.0003), as did the total HSCORE (p = 0.003); however, the HSCORE of the cancer component only did not correlate with advanced surgical stage (p = 0.11). Although immunohistochemical analyses predicted biologic differentiation better than did the biochemical technique, stage correlated better with biochemical estrogen receptor analysis and total HSCORE than did the cancer component HSCORE. The HSCORE of the cancer component may better predict biologic behavior and therefore identify cancers more likely to respond to hormonal therapy. PMID- 3314521 TI - Treatment of menorrhagia with meclofenamate sodium. AB - A double-blind, placebo-controlled crossover trial was undertaken to determine the efficacy of meclofenamate sodium in the treatment of menorrhagia. Twenty-nine patients who had a baseline menstrual blood loss greater than 60 ml received 2 months' each of meclofenamate sodium, 100 mg by mouth, three times a day, or a placebo. The mean menstrual blood loss was reduced from 141.6 +/- 15.9 ml at baseline to 69.0 +/- 6.3 ml during treatment cycles but remained increased during placebo cycles (135.6 +/- 11.3 ml). The symptoms of dysmenorrhea, backache, and headache were significantly reduced only during active drug periods. The number of days of flow and pads or tampons used was also reduced during drug cycles but not during placebo cycles. Overall, 26 of the 29 patients evaluated had a reduction in menstrual blood loss with the use of meclofenamate sodium. It appears that many women with unexplained menorrhagia may benefit from this treatment. PMID- 3314522 TI - Metabolic effects of oral contraceptives. AB - Combination oral contraceptives (OCs) are probably not an independent risk factor for cardiovascular disease but through their metabolic actions, may partly amplify the effects of known risk factors for cardiovascular disease. This review of the literature and our own data indicate that use of high-dose, progestogen dominant OCs induces a potentially atherogenic lipoprotein profile (high low density lipoprotein-cholesterol:high-density lipoprotein-cholesterol ratio), mostly attributable to the antiestrogenic action of the progestogen content of these OCs. In contrast, lower-dose combination OCs with reduced amounts of progestogens and slight estrogen dominance, either monophasic or multiphasic, produce strikingly fewer adverse effects on lipoproteins. Moreover, use of low dose, as opposed to high-dose, OCs results in almost unchanged glucose tolerance, marginally increased or unchanged insulin and glucagon responses to glucose, and probably unchanged levels and activity of peripheral insulin receptors. Further in-depth studies of low-dose OC formulations are mandatory to ascertain reduced metabolic risk of these OCs. PMID- 3314523 TI - Experiences with gossypol as a male pill. AB - In 1981 to 1983 we performed a clinical study with gossypol involving 152 participants, and in 1983 to 1985 we conducted another study of 120 participants. The first study was aimed at confirming gossypol's antifertility efficacy and determining the existence of side effects. The objective of the latter study was to find out whether the addition of a potassium salt supplement or a potassium sparing agent could alleviate the side effect of hypokalemia. In both studies, the participants took a gossypol pill, 20 mg/day for 60 to 75 days for loading, and 50 mg/wk for maintenance. All participants were followed up for a year. The antifertility efficacy was found to be more than 90%, and the chief side effect was lowered serum potassium. In our 1983 to 1985 study, we concluded that since neither potassium supplementation nor triamterene solved the problem, it is very likely that gossypol is a nephrotoxic agent. With 1 year of gossypol treatment, serum testosterone and serum luteinizing hormone showed no change, whereas serum follicle-stimulating hormone showed some elevation after 6 months. The Shanghai researchers found that in their gossypol users, plasma and urinary beta 2 microglobulin levels were elevated to a certain extent. However, 25 subjects in our 1983 to 1985 study showed no appreciable change. Our volunteers had stopped taking gossypol for more than 1 year. In 1986 we started a third study, which was aimed at finding the lowest antifertility dose to minimize possible renal toxicity. PMID- 3314524 TI - Natural family planning. AB - It is now well accepted that a woman can conceive from an act of intercourse for a maximum of only about 7 days of her menstrual cycle. The reliability of natural family planning depends on identifying this window of fertility without ambiguity. Several symptomatic markers, cervical mucus and basal body temperature, have been used extensively and with considerable success in most women but failures occur. Ovarian and pituitary hormone production show characteristic patterns during the cycle. Urinary estrogen and pregnanediol measurements yield reliable information concerning the beginning, peak, and end of the fertile period, provided that the assays are accurate and performed on timed specimens of urine. We have developed such enzyme immunoassays for urinary estrogen and pregnanediol glucuronides that can be performed at home. In the early versions of the assays, enzyme reaction rates were measured by eye, but more recently, a simple photoelectronic rate meter has been used. The final problem to be solved is not technologic but whether women are sufficiently motivated to expend the same time and effort each day for 10 days a month, with less cost, on fertility awareness as they spend on making a cup of tea. PMID- 3314525 TI - Noncontact trephination of the cornea using a pulsed hydrogen fluoride laser. AB - We used a pulsed hydrogen fluoride infrared laser and a specially designed axicon lens to perform circular corneal trephinations in ten eye bank eyes. This noncontact system focused each laser pulse into an annulus on the cornea. Corneal perforation was achieved in seven to nine seconds at a repetition rate of 10 Hz, using a laser output energy of 100 mJ per pulse. A trephination, 90% of corneal thickness, 6.5 mm in diameter, was produced with 70 pulses. PMID- 3314526 TI - Comparison of the prophylactic effects of 2-deoxycytidine and prednisolone for high-dose intravenous cytarabine-induced keratitis. AB - In a double-masked, randomized fashion, 11 patients with hematologic malignancies received 13 courses of high-dose cytarabine therapy, intravenously (3 g/m2 every 12 hours for five to six days). Each patient received topical prednisolone phosphate 1% in one eye and 2-deoxycytidine 100 microM in the other eye every six hours. Topical therapy was initiated 12 hours before the first cytarabine dose and continued for up to ten days (until four to five days after completion of cytarabine therapy). Slit-lamp biomicroscopy was performed before therapy and then weekly for one month. 2-Deoxycytidine was equally as effective as the topical corticosteroid therapy in reducing photophobia and pain, microcysts, and punctate epithelial erosions, and each treatment gave results significantly better when compared historically to placebo-treated eyes. PMID- 3314527 TI - Immunohistochemical studies of reflux nephropathy. The role of extracellular matrix, membrane attack complex, and immune cells in glomerular sclerosis. AB - Renal tissue obtained from 8 patients with reflux nephropathy was studied by immunofluorescence with well-defined mono- and polyclonal antibodies to extracellular matrix, intermediate filament proteins, membrane attack complex of complement (MAC), and immune cells. In both unscarred and scarred areas of the tissue, intrinsic components of the human glomeruli, such as Type IV collagen, laminin, and fibronectin, accumulated in the expanded mesangium of the glomeruli. Those components were diminished or absent in the hyalinized glomeruli. Type III collagen was occasionally localized to the mesangium and synechiae in the glomeruli and was frequently observed within the nearly hyalinized glomeruli. MAC was co-deposited with C3, C5, C9, and properdin in the sclerotic area of the glomeruli, along with a decrease in the reactivity of podocytes with anti vimentin antibody. Numerous suppressor/cytotoxic T cells were identified in the glomeruli and widened interstitum. Monocytes/macrophages also infiltrated the glomeruli. The present study suggests that accumulation of extracellular matrix, activation of the complement system, and infiltration of suppressor/cytotoxic T cells and monocytes/macrophages are closely associated with the glomerular obsolescence and the progression of reflux nephropathy. PMID- 3314528 TI - Analysis of ras genes and linked viral sequences in rat hepatocarcinogenesis. AB - After long-term feeding of a choline-devoid diet to rats, the authors analyzed rasK, rasH, and rasN transcripts and gene structure in livers and liver tumors. They controlled their analysis by studying cell lines derived from chemically induced hepatomas. Transcripts from all three genes were elevated in all tumors, but not in the livers from which they arose. The transcript elevations may represent an effect of active cell proliferation in the tumors. Clone HiHi-3, derived from the Kirsten murine sarcoma virus, detected a large number of hybridization bands, most of which were not part of the rasK-p21 gene. Most tumors had an altered band at 2.6 kb; some had other altered bands. No alterations were seen in liver DNA, and none of the cell lines showed the 2.6 kb band. At low stringency, a rasH probe, which contains a short segment of a similar viral sequence, also detected altered bands in tumors and a single treated liver. These changes in endogenous viral sequences of the rat genome appear to be characteristic of carcinogenesis by a choline-devoid diet. PMID- 3314529 TI - Pathology of the thymus after allogeneic bone marrow transplantation in man. A histologic immunohistochemical study of 36 patients. AB - A major hypothesis to explain the immunodeficiency associated with bone marrow transplantation states that thymic epithelial damage due to graft-versus-host disease (GVHD) abrogates or delays the recovery of normal immunologic function. This study evaluated the thymus glands of 36 human bone marrow transplant recipients dying between 4 and 1742 days after transplant using histology, histochemistry, and immunohistology. The observations lead to a model of thymic damage by irradiation, chemotherapy, and GVHD in which early injury by all three of these agents results in profound thymic atrophy followed by long-delayed restitution. Patients undergoing total body irradiation showed more severe damage to thymic cortical and medullary epithelium than did patients undergoing chemotherapy alone as preparation for transplantation. Patients with GVHD showed additional damage in the form of individual thymic epithelial cell death and showed HLA-DR surface protein expression on thymic epithelium during GVHD. Longer term survivors showed a profoundly delayed restitution of normal thymic epithelium and delayed evidence of restored lymphopoiesis. A few patients dying late after transplant showed evidence of reconstitution of normal thymic structure or nodules of lymphopoiesis in focal areas of epithelial-cell reconstitution. Evidence of such lymphopoiesis was seen at times ranging between 90 and 1742 days after grafting. The data are consistent with a model of long standing thymic damage caused by GVHD which is reversible after the development of tolerance. PMID- 3314530 TI - The effect of neutrophil migration and prolonged neutrophil contact on epithelial permeability. AB - The effect of neutrophil migration and prolonged neutrophil contact on epithelial permeability was examined. Although neutrophil migration was not associated with a change in epithelial permeability, prolonged neutrophil-epithelial contact following migration resulted in an increase in epithelial permeability. These results were not altered by catalase, a specific neutrophil elastase inhibitor, methoxysuccinyl-Ala-Ala-Pro-Val-chloromethyl ketone or cyclohexamide. This suggests that neutrophil migration does not occur via an H2O2-induced reversible mechanism of junctional opening, which we describe herein. PMID- 3314531 TI - Cytoskeletal lesions in anoxic myocardial injury. A conventional and high-voltage electron-microscopic and immunofluorescence study. AB - The role of cell swelling in mediating myocardial injury was studied in control (normoxic) and anoxic Langendorf perfused rat hearts. Control and 45-, 75-, or 90 minute anoxic hearts were exposed to hypotonic (200 mOsm/l) perfusion media to induce osmotic swelling. Anoxic hearts, but not control hearts, released myoglobin when subjected to osmotic swelling. Control hearts, exposed to hypotonic swelling, retained an intact cytoskeletal system of intermediate filaments, microfilaments and microtubules, intact sarcoplasmic reticulum, and intact sarcolemmal membranes. In contrast, swollen anoxic hearts showed a variety of ultrastructural lesions, including formation of large subsarcolemmal blebs associated with lysis of lateral Z-, M-, and A-band intermediate filament attachments, vesiculation of sarcoplasmic reticulum, and rupture of sarcolemmal membranes. Inter-mediate filament attachments with nuclear membranes were also broken, and microtubules disappeared from the perinuclear space. Sarcomere changes included distortion of Z bands, loss of lateral Z band-sarcolemmal attachments, and separations of myofibrils from internal faces in intercalated disks. Immunofluorescence studies of control hearts showed normal staining patterns for the cytoskeletal-associated proteins vinculin, alpha-actinin, and desmin. After 90 minutes of anoxia, hearts exhibited diminished staining of vinculin and alpha-actinin and relatively little change in desmin staining. The results demonstrate that a critical period of anoxia causes lesions in the cytoskeletal apparatus of myocardial cells which correlate with the increased osmotic fragility of irreversibly injured anoxic myocardial cells. PMID- 3314532 TI - Thrombospondin secretion by cultured human glomerular mesangial cells. AB - Thrombospondin is a high-molecular-weight glycoprotein constituent of extracellular matrices of several cells in culture. Immunoreactive thrombospondin is also present within the normal human renal mesangium. To determine whether this thrombospondin could be a synthetic product of the intrinsic glomerular mesangial cells, we examined cultured human glomerular mesangial cells for the ability to synthesize and secrete thrombospondin. Well-characterized human mesangial cells were found to synthesize and secrete thrombospondin, as determined by specific immunostaining at the light- and electron-microscopic levels. Furthermore, metabolically labeled thrombospondin was immunoprecipitated from the conditioned medium of cultured cells. These studies suggest that the thrombospondin present within the normal mesangium is of intrinsic glomerular cell origin. Mesangial thrombospondin may be an important mediator of cellular function, particularly in disease states characterized by intrinsic glomerular cell proliferation. PMID- 3314534 TI - Autism and emotion: an ethological theory. AB - Autistic symptomatology is described as resulting from three processes which have become integrated in clinical presentation. The basic deficit is hypothesized as an inability to participate in information exchange through systems of emotional communication. These systems have been extensively studied in lower animals and a direct phylogenetic line, from posture display to facial expression to human empathy, can be traced in evolutionary advance. PMID- 3314533 TI - Immunofluorescent studies on S-protein in glomeruli from patients with IgA nephropathy. AB - Detection of S-protein, which is a regulatory component of the membrane attack complex (MAC), and of C9 in glomeruli by immunofluorescence in 11 of 15 patients with IgA nephropathy is described. The study showed that glomerular injuries such as glomerular adhesion to Bowman's capsule and crescent formation were more marked in glomeruli with S-protein and/or C9 in patients with IgA nephropathy. S protein co-existed with C9 in glomeruli from such patients. It is suggested that the deposition of S-protein might reflect certain types of histopathologic injuries in glomeruli from patients with IgA nephropathy. It is concluded that activation of terminal components of complement may be one of the exacerbating factors in patients with IgA nephropathy. PMID- 3314535 TI - Family therapy with drug addicts: an integrated approach. AB - Major causes of drug abuse identified in the literature are outlined. Contributing factors are located on individual, interpersonal, and social levels, with the family of origin established as very important. An integrated approach to family therapy that takes all these levels into account is described employing concepts, hypotheses, and techniques from different kinds of therapy. PMID- 3314536 TI - Can antidepressants cause mania and worsen the course of affective illness? AB - Several investigators have recently challenged the belief that antidepressants can precipitate mania or rapid cycling between mania and depression. With one exception, there appear to be no placebo-controlled studies of switches into mania in bipolar patients during antidepressant treatment. Patients most likely to switch into mania during antidepressant therapy have probably been excluded from maintenance treatment studies and are probably overrepresented in studies at special research facilities. On balance, the available evidence suggests that some bipolar patients become manic, and a few experience rapid cycling, when they are treated with antidepressants. The prevention of these responses will require further research on risk factors and on the antimanic efficacy of coadministered lithium or other mood stabilizers. PMID- 3314537 TI - Psychiatry and the nursing home. AB - In the last two decades, nursing homes have become major providers of health services for the frail elderly. Despite ample evidence of need for specialized psychiatric services in the nursing home setting, the majority of patients who could benefit from such care do not receive it. The authors propose a fourfold role for the psychiatrist, encompassing clinical care, consultation, teaching, and research. Features of this role can be adapted to fee-for-service, community mental health center, and academic models of psychiatric practice. PMID- 3314539 TI - Hospice in transition: Kentucky 1982-85. AB - The ratio of hospice patients to 100 Kentuckians dying of cancer was 8 in 1982 and 12 in 1985. The primary increase occurred in the number of patients served by three hospices which became Medicare-certified during that time period. During this period, the average age of hospice patients increased, and patients became more likely to die at home. Hospices in some counties may have served about 40 per cent of terminally ill cancer patients. PMID- 3314538 TI - Effects of electrode placement on the efficacy of titrated, low-dose ECT. AB - This double-blind, random-assignment study contrasted the relative efficacy of bilateral and unilateral right ECT with a low-dose titration procedure. In 52 patients with primary major depressive disorder, bilateral ECT was markedly superior in short-term symptom reduction to unilateral right ECT. The two conditions did not differ in the duration of generalized seizures or in the number of treatments administered to achieve clinical response. The findings challenge the claim that the elicitation of generalized seizure is, in and of itself, sufficient for the antidepressant properties of ECT. Rather, a dose in excess of seizure threshold may contribute to the efficacy of ECT, particularly with a unilateral right electrode placement. PMID- 3314540 TI - Effect of bovine virus diarrhoea virus on pregnancy in the ewe monitored by ultrasound scanning and levels of 15-keto-13,14-dihydro-PGF2 alpha and progesterone. AB - Fourteen unvaccinated and seronegative ewes were experimentally infected with bovine virus diarrhoea virus around day 60 of pregnancy. Two other groups of pregnant ewes served as control animals. The animals were followed with ultrasound scanning to study the status of the fetus and with frequent blood sampling for analysis of progesterone and 15-keto-13,14-dihydro-PGF2 alpha, two hormones that could reflect the propagation of the infection. The unvaccinated ewes responded to the infection with abortion, resorption of the fetus, mummification or no changes at all. The endocrinological changes reflected in a most adequate way the pathological changes in the uterus. Detailed endocrinological studies can contribute to the understanding of the pathogenesis of some infectious diseases that affect reproduction. PMID- 3314541 TI - Nervous system sports-related injuries. AB - With the evolution of sports medicine as a subspecialty comes a redirection of attention to the medical and athletic communities to the prompt recognition and timely treatment of many potentially serious conditions. Nervous system complications of sports injuries have gone largely unaddressed in the literature. It is the goal of this communication to review the wide range of nervous system injuries due to sports activities, discuss the mechanisms of such injuries, and focus attention on their prevention and management. The role of the neurologist and neurosurgeon as a sports medicine team member will be discussed, as will their roles in planning and development of programs and equipment at the secondary school, collegiate, and professional levels. PMID- 3314542 TI - Ten year experience with the negatively charged glutaraldehyde-tanned vascular graft in peripheral vascular surgery. Initial multicenter trial. AB - The negatively charged glutaraldehyde-tanned vascular graft was developed to determine the utility of grafts of biologic origin to provide satisfactory revascularization for ischemic limbs with advanced arteriosclerotic peripheral vascular disease. The bovine carotid artery was modified under a number of conditions using a large number of variables and evaluated in the carotid artery and aorta of dogs. Eventually ficin-digested carboxylated glutaraldehyde-tanned grafts were selected as being most antithrombotic and most resistant to aneurysm formation. Under an Investigational Device Exemption with the Food and Drug Administration, 146 grafts were evaluated in 108 patients with patency approaching 67 percent for all grafts at 5 years and 59 percent at 9 years plus. Total aneurysm formation has been 4 percent (six grafts) occurring only in hypertensive patients. The graft is now undergoing clinical use and evaluation worldwide. PMID- 3314543 TI - The half-hitch knot: a rational alternative to the square knot. AB - The half-hitch knot, an alternative to the square knot for tying a suture, has been presented. A square knot is satisfactory, but because of its configuration it is difficult to tie, and in actual practice it is seldom used. Instead, a series of half hitches is tied. A half-hitch knot is as secure as a square knot and much easier to tie. However, it too must be tied in proper configuration to be reliable. The technique for tying a half-hitch knot and some of its characteristics are described. PMID- 3314544 TI - [A brief history of eugenics]. PMID- 3314545 TI - [Single-stage double-layer suture of the uterine incision in cesarean section]. PMID- 3314546 TI - [Epidemiological characteristics of the acquired immunodeficiency syndrome (AIDS) in connection with the activities of maternal health care and family planning services]. PMID- 3314547 TI - [Importance of the ultrasonic parameters in the follow-up of multiple pregnancy]. PMID- 3314548 TI - Rapid diagnosis of neutropenic enterocolitis (typhlitis) by ultrasonography. AB - Neutropenic enterocolitis (also termed typhlitis) is an acute necrotizing process involving segments of the large and small intestine that occurs in the setting of agranulocytosis, most commonly in patients with acute leukemia. Rapid diagnosis and treatment is necessary for survival. We present a patient in whom abdominal ultrasonography revealed evidence of bowel wall thickening and ascites, confirming the diagnosis of neutropenic enterocolitis. Sonography offers a rapid, safe, and noninvasive means of diagnosis for this condition. PMID- 3314549 TI - Brain tumors in children. I. Advances in diagnosis. AB - This article emphasizes the contributions that new diagnostic techniques have made toward the management of children with brain tumors. The development of computerized tomographic (CT) scanning has revolutionized both the diagnosis and management of patients with brain tumors and has obviated the previously inevitable delays in diagnosis. The development of magnetic resonance imaging (MRI) has certainly facilitated diagnosis of brain tumors in certain locations with the brain, but it remains unproven in other locations. It is clear that at least some of the early promise of MRI scanning has not been realized. Neither CT nor MRI are able to provide functional detail within the brain, nor are they able to differentiate tumor from peritumoral edema to better delineate the tumor margins. It is hoped that the currently experimental techniques of Positron Emission Tomography (PET) scanning and contrast-enhanced MRI scanning will provide such information in the near future. Neurophysiologic methods of assessing brain tumors merit greater consideration than has been afforded to date. Sensory evoked-potential monitoring provides information about nervous system function. This information is useful both in diagnosis and in monitoring of brain tumors, since the functional information can be localized to discrete regions within the brain. The value of cerebrospinal fluid (CSF) evaluation, both for cytology and tumor markers, cannot be overstated. A significant proportion of childhood brain tumors tend to seed throughout the neuraxis by the CSF pathways. Thus, evaluation of CSF cytology prior to surgical perturbation of the primary tumor should be undertaken whenever safely feasible, in order to avoid the dilemma of postoperative positive CSF cytology and its questionable significance. PMID- 3314550 TI - Brain tumors in children. II. Advances in neurosurgery and radiation oncology. AB - In this article, the contributions of neurosurgery and radiation oncology to the management of childhood brain tumors are described. Progress in a particular discipline rarely occurs in an isolated fashion, and it is clear that neurosurgical advances owe much to similar advances in anesthesiology, neuroradiology, and intensive care management. These advances in various disciplines have all permitted bolder yet safer attempts at radical resection by the neurosurgeon. The goal of radical surgical resection is cure in the case of low-grade brain tumors. However, even in those situations where surgery alone cannot be curative, the reduction of tumor bulk facilitates the task of both radiation therapy and chemotherapy, with improvement in progression-free survival as well as overall survival. For those tumors that cannot be cured by surgical resection alone, the standard of therapy thereafter still remains irradiation of the residual tumor. It is clear that the single major advance in the treatment of childhood medulloblastoma has been Cushing's recognition of the value of craniospinal irradiation. Refinements in radiation machines and treatment planning have permitted more accurate delivery of radiation therapy with a slight reduction in toxicity. Newer approaches, such as hyperfractionated irradiation and interstitial irradiation, attempt to improve therapeutic efficacy while minimizing toxicity. Nevertheless, as more children are surviving their brain tumors following surgery and radiation therapy, the price of the successful therapy is being increasingly realized in terms of developmental deficits, particularly in the very young child. It is the desire of all those involved in the management of children with primary brain tumors to seek alternative approaches to wide-field irradiation of the brain in children with high-grade tumors. PMID- 3314551 TI - Platelet transfusion. Current techniques, remaining problems, and future prospects. AB - The use of platelet transfusions to stop or to prevent bleeding in patients with thrombocytopenia or platelet dysfunction has accelerated in the past decade. Platelet counts and bleeding times, performed in conjunction with careful clinical evaluation of the patient, are appropriate guides in assessing the need for platelet transfusion. Complications of platelet transfusions are similar to those of red cell transfusions, with some additional concerns. Pooled random donor or single-donor apheresis concentrates, either randomly or selectively matched, are the major platelet products available. In most cases, transfusion requirements can be satisfied by use of random donor units. Proper evaluation of the effectiveness of transfused platelets is essential in determining the dose and frequency of future platelet transfusions. Refractoriness to random donor platelets eventually occurs in many recipients. This is most commonly associated with alloimmunization to histocompatibility antigens, but other platelet alloantigens may play a role. Many in vitro tests for platelet antibodies have been developed, and the clinical utility of these assays in selecting compatible platelets is now under evaluation. Strategies and different approaches to the management of thrombocytopenic patients with hypoplastic bone marrow states are also reviewed. PMID- 3314552 TI - Which way to turn? Inuit culture, alcohol, and change. PMID- 3314553 TI - Alcoholics Anonymous: affiliation processes and effectiveness as treatment. AB - Recent findings from the empirical literature on Alcoholics Anonymous (AA) suggest that no clear exclusionary criteria for this organization exist, except that alcohol-dependent individuals who become nonproblem drinkers appear to be less likely to affiliate with or maintain involvement in AA. Of those alcoholics who become long term, active AA members, about 40 to 50% enjoy several years of total abstinence, with about 60 to 68% improving to some extent, drinking less or not at all during their participation. Those who combine AA with other forms of treatment seem to do as well as or better than those who go to AA alone. More active AA participants do as well as or better than those who participate less actively. Compared to professionally treated alcoholics, AA members seem to achieve abstinence at a higher rate. Consideration is given to the apparent unsuitability of AA for problem drinkers who choose the goal of nonproblem drinking. PMID- 3314554 TI - Institutional self-help therapy for alcoholism: clinical outcome. AB - Self-help peer-led therapy can yield improved cost effectiveness and clinical outcome in hospital-based alcoholism treatment. This was demonstrated by comparing two ambulatory alcoholism treatment programs: a control program operated solely by professional staff, and an experimental one based on peer-led self-help (SH). The SH program was staffed by only half as many primary therapists as the control. Patients in both programs were evaluated over the course of one year. By means of the Patient Status Form, a clinical assessment instrument applied monthly, SH patients were found to score significantly higher on social adjustment, although retention and drinking rates, and utilization of Alcoholics Anonymous and disulfiram were no different from controls. This study is the continuation of an initial comparison in which SH patients were found to have enhanced retention in treatment after discharge from an impatient service. PMID- 3314555 TI - Alcohol use among drug abusers: treatment outcome in a therapeutic community. AB - Male and female dropouts and graduates (N = 248) from a traditional drug-free therapeutic community were followed 2 years after treatment. A 4-hr face-to-face interview traced the social adjustment one year pre-, through all years posttreatment. Results showed that (a) success (no crime and no opioid and/or no use of nonopioid primary drug) was maintained through 2 years of follow-up by 34% of the dropouts and 68% of the graduates; (b) success rates were highest among opioid abusers and the lowest among primary alcohol abusers; (c) among the latter, however, abstinence rates were significantly increased and daily use of alcohol significantly decreased as did criminal involvement; (d) among the opioid abstinent group, alcohol use increased posttreatment but heavy drinking was not prominent indicating no significant shift in substance dependency. Overall, the therapeutic community appears most effective for opioid abusers but has a clear impact on a considerable number of those primarily involved with alcohol and other substance use. PMID- 3314556 TI - Role of alcohol use by narcotic addicts as revealed in the DARP research on evaluation of treatment for drug abuse. PMID- 3314557 TI - Effect of age and chronic obstructive pulmonary disease on the Breathalyzer estimation of blood alcohol level. AB - Twenty volunteers, 10 with chronic obstructive pulmonary disease (COPD) and 10 with no disease, ingested a vodka cocktail. Serial determinations of blood alcohol level (BAL) by gas-liquid chromatography and simultaneous Breathalyzer estimations of BAL were used to calculate blood:breath alcohol partition coefficients (PCs). Data from the present study were combined with data obtained in a previous study using identical methodology to examine the relationship between age and BAL estimation. It was found that the Breathalyzer significantly underestimated BAL as a function of age. It was hypothesized that the underestimation may be due to closing volume (CV) as the Breathalyzer samples end expiratory breath. PMID- 3314558 TI - Interaction of dichloromethane and ethanol in rats: toxicokinetics and nerve conduction velocity. AB - The influence of a single combined administration of ethanol (174 mmol/kg per os) plus dichloromethane (1.6, 6.2, or 15.6 mmol/kg p.o.) on blood concentrations of the tested substances and of carboxyhemoglobin, and on nerve conduction velocity was studied in rats. The blood alcohol concentration was not influenced significantly by dichloromethane. The single high dose of ethanol completely inhibited the carboxyhemoglobin concentration increase due to dichloromethane, but did not prevent the dichloromethane-induced decrease of nerve conduction velocity. It produced initially lower, then higher concentrations of dichloromethane in blood than values seen after administration of dichloromethane per se. Rats treated with ethanol plus dichloromethane showed a more pronounced decrease of nerve conduction velocity compared with rats administered dichloromethane only. PMID- 3314559 TI - Differences among five main forms of serum transferrin. AB - Five forms of human serum transferrin with different isoelectric points were purified by isoelectric focusing in agarose gels. They constitute a set of main transferrin forms in serum of healthy individuals. Their relative proportions are changed in serum from alcoholic individuals, where the more basic of these forms are increased. Tryptic peptides of all forms were compared by high performance liquid chromatography (HPLC) patterns (fingerprint analysis). Two major differences were detected between corresponding tryptic peptides of the five transferrin forms. Some minor differences were also noticed. The corresponding peptides were purified from the main form and analyzed for total composition and amino acid sequence. The peptides with the major differences between the forms were found to be the two with the glycosylation attachment at positions 413 and 611. A minor peptide difference between the transferrin forms contains a product that is explained by incomplete stoichiometry in cleavage of the peptide bond at positions 217-218. Successive loss of sialic acid is compatible with the presence of different transferrin forms, and our results indicate that the main differences between the serum transferrin forms from healthy and alcoholic individuals are in successive changes of the carbohydrate chains attached at positions 413 and 611. PMID- 3314560 TI - Calcium differentially alters behavioral and electrophysiological responses to ethanol in selectively bred mouse lines. AB - Sensitivity to the hypnotic action of ethanol has been found to increase in SS/Ibg (SS) but not in LS/Ibg (LS) mice after intracerebroventricular (icv) administration of calcium. In the present investigation, a correlation was found between calcium-induced changes in behavioral sensitivity and in the sensitivity of cerebellar Purkinje neurons to the depressant effects of locally applied ethanol. Cerebellar Purkinje neuron sensitivity was measured as the dose of ethanol pressure ejected from a multibarreled micropipette required to produce a 50% depression of spontaneous firing rate of single neurons. Administration of 0.2-0.4 mumol calcium chloride into the lateral ventricle of the brain increased the sensitivity of SS but not LS mice to the hypnotic behavioral effect of systemically administered ethanol. Similarly, Purkinje neuron sensitivity to locally applied ethanol was also enhanced in SS but not in LS mice 15 min following administration of calcium (0.25 mumol) icv. Furthermore, locally applied ethanol was more effective in depressing spontaneous Purkinje neuron discharge in SS mice when a 1 mM calcium solution was concomitantly pressure ejected with ethanol from the micropipette. Magnesium chloride did not mimic the effects of calcium on either behavioral or electrophysiological effects of ethanol, suggesting that the action of calcium is not a nonspecific effect of divalent cations. These data suggest that calcium-dependent processes may be involved in behavioral and electrophysiological effects associated with ethanol intoxication. Further research will be required to determine if the genetically selected difference in ethanol sensitivity expressed in LS and SS mice is regulated by calcium mechanisms. PMID- 3314561 TI - Prevalence of low monoamine oxidase function in alcoholism. AB - Several studies have found a trend for low platelet monoamine oxidase activity (MAO) in alcoholism but with a great deal of overlap in MAO activity of alcoholics versus controls. The main objective of this study was to carry out a detailed assessment of MAO function that included the measurement of key kinetic parameters (i.e., Km, Vmax) in three groups of male subjects: (a) 51 hospitalized chronic alcoholics, (b) 16 recovering alcoholics with 2-10 years of abstinence, and (c) 21 controls. MAO activity was assayed radiochemically with [14C]tyramine as substrate (43-729 microM). The present study demonstrated that alcoholics had low platelet MAO activity (p less than 0.05). Kinetic analysis revealed a substantial reduction (p less than 0.01) in enzyme Vmax values of chronic and recovering alcoholics. Greater than 95% of the alcoholics had Vmax values lower than the smallest value of control subjects. Moreover, 100% of the alcoholics in both groups exhibited exceedingly low Vmax values that were below the 25th percentile of controls. In summary, results of MAO Vmax determinations provided us with a better separation of the alcoholics from controls. Measurements of platelet MAO function that include enzyme Vmax may provide us a reliable biochemical marker for alcoholism. PMID- 3314562 TI - Carbohydrate-deficient transferrin in serum in patients with liver diseases. AB - Carbohydrate-deficient transferrin (CDT) in serum was analyzed by isocratic microanion exchange chromatography at pH 5.65 followed by a transferrin radioimmunoassay in 102 patients with biopsy-verified liver diseases. CDT values were normal in all of the 87 nonalcohol-abusing patients irrespective of type or degree of liver disease. Thirteen of the 15 alcoholic patients (87%) with current abuse showed elevated CDT values while in abstaining alcoholics with remaining liver disease the values were normal. No correlations were found between CDT level and volume density of liver fibrosis or steatosis or values of a number of clinicochemical liver tests. The only significant correlation demonstrated was between CDT concentration and the level of present daily alcohol consumption in the alcoholic patients. These results indicate that CDT can be used as a marker of present but not previous alcohol abuse, even in patients with various liver diseases. PMID- 3314563 TI - Effects of alcohol on experimental atrial fibrillation. AB - The association of alcohol abuse, especially binge drinking, and atrial fibrillation, recently termed "holiday heart," has been recognized for some time. The effects of alcohol on atrial fibrillation, however, have not been studied. Accordingly, measurements of hemodynamics and duration of electrically induced atrial fibrillation were made in alpha-chloralose anesthetized dogs during the 30 min before and during a 30-min intravenous infusion of 1.7 g/kg of ethanol (25%, v/v), which produced an average infusion concentration of 254 +/- 21 mg/dl. Average cardiac output, left ventricular (LV) peak dp/dt, and pulmonary artery mean pressure did not change, whereas LV systolic (116 +/- 8 to 107 +/- 9 mm Hg, p less than 0.05) and aortic mean (95 +/- 7 to 87 +/- 9 mmHg, p less than 0.05) pressures decreased. Heart rate and atrioventricular conduction in sinus rhythm, and atrial and ventricular activity in atrial fibrillation also did not change. Despite a decrease in arterial pH, duration of atrial fibrillation decreased (356 +/- 143 to 93 +/- 38 sec, p less than 0.05). Moreover, at 15 min, when average ethanol concentration was 208 +/- 20 mg/dl, and aortic mean pressure (95 +/- 7 to 85 +/- 8 mm Hg, p less than 0.05), pulmonary artery mean pressure (16 +/- 2 to 14 +/- 2 mm Hg, p less than 0.05), and LV peak dp/dt (1563 +/- 143 to 1285 +/- 167 mm Hg-sec-1, p less than 0.05) were reduced, duration of atrial fibrillation was less than control (356 +/- 143 to 114 +/- 56 sec, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314564 TI - Auditory brainstem potentials in sons of alcoholic fathers. AB - With the use of event-related brain potentials we have observed sensory as well as cognitive deficits in abstinent alcoholics. By recording auditory brainstem potentials (BSP) from abstinent alcoholics we demonstrated significant delays in brainstem transmission time. We have also reported that P3 amplitudes are significantly reduced in abstinent alcoholics compared to control subjects. Although the neurophysiological deficits observed in abstinent alcoholics are presumed to be alcohol-related effects, it is possible that some of these deficits may exist prior to alcohol exposure, and may be present in subjects at high risk for alcoholism. We have recently observed significantly reduced P3 components in young sons of alcoholics similar to those observed in abstinent alcoholics. In the present study, we examined auditory BSPs in young boys at high risk for alcoholism and matched controls. We found no statistically significant difference in brainstem transmission time between high risk individuals and matched control subjects. These findings suggest that while some brain deficits observed in abstinent alcoholics may antecede the development of alcoholism (P3) and may represent a predisposing factor, other deficits (BSP) appear to be the consequence of alcohol and/or nutritional-related effects. PMID- 3314565 TI - Chemical monitoring of disulfiram compliance: a study of alcoholic outpatients. AB - Poor compliance with disulfiram (Antabuse) therapy may reduce its efficacy in the treatment of alcoholism. This study was designed to examine two questions: (a) Could use of a chemical test for disulfiram ingestion be used clinically to improve disulfiram compliance and if so, (b) could improved disulfiram compliance contribute to improved compliance with other aspects of treatment? The results suggest that disulfiram compliance rates can be increased by clinical use of chemical monitoring data; however in this sample increased compliance with disulfiram did not correlate with improvements in other aspects of treatment compliance. PMID- 3314566 TI - Chronic ethanol consumption affects filipin-cholesterol complexes and intramembranous particles of synaptosomes of rat brain cortex. AB - To assess the effect of ethanol on the planar distribution of cholesterol as well as on the surface architecture of presynaptic terminals of rats, synaptosomes isolated from cerebral cortex of rats chronically exposed to alcohol were incubated with filipin, a cytochemical marker for beta-hydroxycholesterol, and analyzed using both conventional (qualitative and quantitative) and freeze fracture electron microscopy. Synaptosomes incubated in the absence of filipin were used as cytochemical controls. Biochemical determination indicates a 12% increase of cholesterol in synaptosomal membranes from alcohol treated rats. This increase was confirmed by a significant increment in the number of filipin cholesterol complexes. Synaptosomes of treated rats showed a reduction in the total number of synaptic vesicles (SV) as well as a decrease in the density and total number of intramembranous particles (IMP) per synaptosome. In control rats, most synaptosomal IMP were distributed in clusters whereas in those of rats exposed to alcohol they were distributed at random. These changes in distribution of IMP were also observed in presynaptic terminals analyzed "in situ." These findings indicate that ethanol acts on the presynaptic terminals. The variations in cholesterol content as well as in the density and distribution of IMP appear to be related to alcohol-induced changes in the physicochemical properties of components of the synaptosomal membrane. PMID- 3314567 TI - Genetic correlation of ethanol-induced ataxia and cerebellar Purkinje neuron depression among inbred strains and selected lines of rats. AB - In the present study, we compared phenotypic differences in behavioral and neurophysiological responses to acute ethanol administration among six inbred rat strains. Genetic variation was found both for ataxia, as measured by loss of righting response (sleep time) after a hypnotic dose of ethanol, and for the depressant action of ethanol on the spontaneous discharge of cerebellar Purkinje neurons. Results from an analysis of covariance of these phenotypes, measured among the inbred strains, provided strong evidence for a high genetic correlation between sleep time and inhibition of cerebellar Purkinje neuron discharge in response to acute ethanol administration. However, ethanol metabolism was also found to correlate with the behavioral sensitivity of rats to ethanol. Preliminary data from the third generation of replicate lines of rats currently being selectively bred for high and low acute sensitivity to ethanol shows a trend toward divergence of both ethanol sleep time and neuronal sensitivity to acute ethanol. The conclusion from these data supports the hypothesis that the cerebellum is an important locus of ethanol action, and suggests that neuronal sensitivity to ethanol will continue to diverge between these rat lines as selection for the sleep time phenotype progresses. PMID- 3314568 TI - Effect of ethanol on motor performance and hippocampal population spikes in some standard and selectively outbred rat strains. AB - Ethanol sensitivity of Wistar and Long-Evans rats was compared in vivo and in vitro. Ethanol was more effective in reducing motor performance in Long-Evans than in Wistar rats, as determined by the tilting plane test. In addition, ethanol produced a greater reduction in the population spikes recorded from hippocampal slices (in vitro) of Long-Evans rats compared to Wistar rats. When rats from the Wistar, Long-Evans, and Sprague-Dawley strains were crossbred and then selectively outbred for high (ANT) and low (AT) sensitivity to ethanol induced impairment of motor performance, no differences were observed in the ethanol sensitivity of the hippocampal population spike between these two strains. These data suggest that differences in ethanol sensitivity may exist among standard laboratory rodent strains. Selective outbreeding may reduce or eliminate the differences in ethanol sensitivity of brain regions or neurons other than those directly involved in producing the selected behavior. Therefore, it may be incorrect to assume a general difference in ethanol sensitivity when these traits are not coselected during outbreeding, thus indicating different neuronal pools in terms of sensitivity to ethanol. PMID- 3314569 TI - [Cystic formations of the maxilla and mandible (apropos of a case of dentigerous cyst with invasion of the maxillary sinus. Standardization of the nomenclature]. PMID- 3314571 TI - Early textbooks on anaesthesia. PMID- 3314570 TI - [Nasal tuberculosis: an unknown entity]. PMID- 3314572 TI - One lung anaesthesia. Cardiovascular and respiratory function compared during conventional ventilation and high frequency jet ventilation. AB - Ten patients about to undergo left-sided thoracotomy for carcinoma of the lung were entered into a crossover trial to compare cardiovascular and respiratory function during high frequency jet ventilation and conventional mechanical ventilation for one lung anaesthesia. All patients were anaesthetised with a standard technique using double lumen tubes and placed in the lateral position with the left chest open. The results showed no significant differences with regard to ventilation sequence but one lung high frequency jet ventilation gave higher values than one lung conventional ventilation for shunt (p less than 0.01) and positive end expiratory pressure (p less than 0.05) and lower peak inflation pressure values (p less than 0.01). There were no significant differences in cardiac output, pulmonary capillary wedge pressure, arterial carbon dioxide or available oxygen. Surgical conditions were satisfactory during both methods of ventilation and satisfactory gas exchange occurred. It was, however, more difficult to assess adequacy of ventilation during high frequency jet ventilation and the routine use of this method of ventilation is not recommended during one lung anaesthesia. PMID- 3314573 TI - Combined unilateral high frequency jet ventilation and contralateral intermittent positive pressure ventilation. AB - The anaesthetic management of a patient who required right lower lobectomy for bronchial carcinoma associated with emphysema, pneumoconiosis and a previous thoracoplasty for pulmonary tuberculosis, is described. A technique of unilateral high frequency jet ventilation plus conventional intermittent positive pressure ventilation to the contralateral lung was used. PMID- 3314574 TI - Persistent pneumothorax treated with continuous positive airway pressure. AB - A patient who presented with persistent pneumothorax after blunt chest trauma is described. The lung re-expanded partially in response to chest drain suction but some areas remained collapsed. The institution of continuous positive airway pressure on an intermittent basis, was followed by complete re-expansion of the lung and resolution of the pneumothorax. PMID- 3314575 TI - Brunings' bronchoscopic mask. AB - A tubular gauze mask suitable for inhalational anaesthesia for bronchoscopy, designed by Wilhelm Brunings, is described. PMID- 3314576 TI - The new generation gelatins. A review of their history, manufacture and properties. AB - Gelatin solutions of various kinds have been used as intravenous infusions since the First World War and belong to a heterogeneous group of fluids which tend to maintain the colloid osmotic pressure. They are produced by the breakdown of bovine collagen to yield solutions with a range of molecular weights. Anaphylactoid reactions are a rare but well-recognised complication of their use. The solutions help to fill a hiatus that exists between crystalloids and blood products. PMID- 3314577 TI - Measurement of the susceptibility of paramagnetically labeled cells with paramagnetic solutions. AB - A method of measuring the volumetric magnetic susceptibility, in which magnetically labeled cells or other particles are suspended in a paramagnetic solution of known susceptibility over the poles of a magnet, is presented. If the cells are more magnetic than the solution, they are attracted toward the poles; if they are less magnetic, they are repelled. If they have the same susceptibility as the solution, they do not move. Under this condition, the cells are said to be "isomagnetic" with the surrounding solution. Since the volumetric susceptibility of this solution is known, the susceptibility of the cells is obtained. Using the "isomagnetic" method, the volumetric susceptibilities of test metal powders were determined within +/- 8 X 10(-6) SI units. Yeast, colonic carcinoma, and liver cells, rendered magnetic with erbium chloride, had susceptibilities ranging from 13 to 20 X 10(-6). Particles of articular cartilage treated with erbium chloride were heterogeneous, with susceptibilities ranging between 50 and 125 X 10(-6), while particles of bone had a susceptibility of 560 to 580 X 10(-6). Eukaryotic cells labeled with ferritin attained susceptibilities of less than 1 X 10(-6). PMID- 3314579 TI - A sluicing device for reproducibly measuring the strength of attachment of cultured cells to their substrate. AB - We assessed the strength of attachment of cultured human vascular endothelial cells to tissue culture plastic by controlled sluicing of cells, grown on multiwell plates, with isotonic saline using a specially designed nozzle attached to a reciprocating pump. Cells which were not dislodged were trypsinized and counted. The percentage of cells dislodged was proportional to the pump speed and to the volume of saline pumped. For given pump settings the proportion of cells detached was reproducible. The percentage of cells detached by sluicing increased at lower cell densities and decreased when the duration of trypsinizing of cells to be plated in multiwells, prior to sluicing, was increased. Our system is suitable for evaluating effects of biochemical interventions on the strength of cell attachment to the substrate. PMID- 3314578 TI - Preoperative isolation of a reversible protein-protein crosslink generated in 50 S subunits of Escherichia coli ribosomes and identification of its components. AB - The reversible crosslinked protein complex L13-L21 was isolated from Escherichia coli ribosomes in milligram amounts. Tight couples (70 S) were crosslinked with the bifunctional reagent diepoxybutane. The reacted ribosomes were separated into their subunits by sucrose gradient centrifugation in the presence of 1 mM magnesium. The crosslinked subunits were analyzed by symmetrical two-dimensional gel electrophoresis. One crosslinked protein complex detected within the large subunit was purified by salt extraction, acidic acid extraction, and ion-exchange chromatography. Two-dimensional gel electrophoresis and immunological results established L13 and L21 as the components of this crosslink. PMID- 3314580 TI - Location and purification of enzymes on polyacrylamide gels using dialyzable fluorescent markers. AB - A method for the location of proteins/enzymes by polyacrylamide gel electrophoresis using dialyzable low-molecular-weight fluorescent peptide markers is described. The markers prepared by treating the peptic digest of casein with fluorescamine showed several bands on gel electrophoresis which helped in locating the proteins. The located desired protein could subsequently be purified by extraction. PMID- 3314582 TI - Current methods for Saccharomyces cerevisiae. I. Growth. PMID- 3314581 TI - Bacterial adherence on replicas of sodium dodecyl sulfate-polyacrylamide gels. AB - A method for determining which molecules in a complex mixture of proteins can function as bacterial receptors was devised. Salivary proteins were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred to nitrocellulose. Bacteria that were metabolically labeled with 3H or externally labeled with 125I were incubated on the nitrocellulose replicas. After 18 h at 4 degrees C, the unbound cells were removed by repeated washing of the replicas, and the bands to which the radiolabeled bacteria bound were visualized by autoradiography. By this technique, Fusobacterium nucleatum, which adheres via carbohydrate residues on receptor molecules, and Staphylococcus aureus, which recognizes the peptide portion of fibronectin, were shown to bind specifically to their respective receptors. These results suggest that this method can be useful for profiling bacterial binding to either the carbohydrate or the protein portions of molecules present in complex mixtures, such as those composing biological fluids or tissue substrates. Structural specificities, such as recognition sequences formed by certain oligosaccharides, could be further investigated by adding the appropriate simple sugars, as well as oligosaccharide inhibitors, to the incubation medium. The latter approach is particularly important since most glycoproteins carry multiple N- and O-linked carbohydrate substituents that could serve as bacterial receptors. PMID- 3314583 TI - Current methods for Saccharomyces cerevisiae. II. Sporulation. PMID- 3314584 TI - A reverse-phase high-performance liquid chromatography assay for dihydroxy-acid dehydratase. AB - A sensitive method for assaying dihydroxy-acid dehydratase activity is described. This enzyme produces alpha-ketoisovaleric and alpha-keto-beta-methylvaleric acids, respectively, in the biosynthesis of valine and isoleucine. These alpha keto acids, after derivatization with 2,4-dinitrophenyl-hydrazine, were separated and quantified by reverse-phase high-performance liquid chromatography on a Zorbax octadecylsilane C-18 column. As little as 50 pmol of alpha-ketoisovaleric was detected in assays using cell-free extracts from Escherichia coli, whose measured specific activity was 8 mumol of alpha-ketoisovaleric acid produced per hour per milligram protein. PMID- 3314585 TI - Use of extracellular matrix components for cell culture. AB - Extracellular matrix components when used as a substratum in vitro can greatly influence cell behavior. The response observed is dependent on the type of cell and matrix used. Cells in vitro usually respond best to the matrix components with which they are normally in contact in vivo. More differentiated phenotypes are observed and cells generally survive longer on such matrices. In some cases, the presence of such matrices allows cells to be cultured in the absence of serum and growth factors. As more investigators try the matrices and matrix components described, as well as new components and combinations of them, it is anticipated that improvement in the culture of many cells can be expected. PMID- 3314586 TI - A small-scale method for the isolation of insulin-containing secretory granules from islets of Langerhans. AB - A method has been developed which uses small-scale (400 microliter) Percoll gradients and an inexpensive bench-top microcentrifuge for the rapid isolation of insulin-containing secretory granules from islets of Langerhans available from a single rat pancreas. Granule fractions were prepared from homogenates of isolated rat islets by a differential centrifugation step (10 min) to produce a granule enriched membrane pellet, followed by a further centrifugation (10 min) on a discontinuous Percoll gradient to produce a granule fraction. Measurement of membrane-marker enzyme activities suggested that the yield and purity of granule fractions prepared by this method were comparable to those reported for other methods involving longer centrifugation times in ultracentrifuges. Further purification of the granule fractions by removing lysosomal contamination was achieved by an additional centrifugation (10 min) on another small-scale gradient of higher Percoll concentration. The method proved useful for isolating biosynthetically labeled secretory granule membranes and contents from islets of Langerhans which had been cultured in the presence of 35S-labeled amino acids. The speed and simplicity of this method suggest that it will prove useful in studies requiring the rapid isolation of insulin-containing secretory granules from isolated islets. PMID- 3314587 TI - Deglycosylation of a native, protease-sensitive glycoprotein by peptide N glycosidase F without protease inhibitors. AB - The glycoprotein fibrinogen was deglycosylated in its native state and in the absence of protease inhibitors by peptide N-glycosidase F following removal of protease contaminants from the enzyme by HPLC. Fibrinogen is sensitive both to proteolysis by contaminants which may constitute as little as 0.2% of the enzyme protein and to denaturation by 1,10-o-phenanthroline, the only substance known to inhibit the proteolysis. Thus removal of protease contaminants from the enzyme is a prerequisite for the deglycosylation of native fibrinogen. The starting material for the present method is the final material obtained from the purification described by A. L. Tarentino, C. M. Gomez, and T. H. Plummer (1985, Biochemistry 24, 4565). Three sequential passages over a PolyCAT A (20 X .46 cm) cation-exchange column and elutions with a linear gradient of NaCl from 0 to 0.4 M were necessary to completely overcome the tenacious but noncovalent association of peptide N-glycosidase F with contaminants that proteolyze fibrinogen. All three chromatographic runs could be completed in 1 day. Using this "protease free" enzyme at up to a 1:20 molar ratio, fibrinogen that is completely deglycosylated and native has been generated in order to determine the role of the carbohydrate moieties in its function. PMID- 3314588 TI - A rapid method for assay of glycosidases involved in glycoprotein biosynthesis. AB - A rapid procedure to measure processing glycosidases with labeled oligosaccharide as substrate is described, using assay of the specific processing alpha mannosidase from Saccharomyces cerevisiae as an example. After incubation of [3H]mannose-labeled Man9GlcNAc with the mannosidase, a solution of concanavalin A is added, followed by polyethylene glycol to precipitate the oligosaccharide lectin complex. The radioactivity present in the supernatant after centrifugation is then measured to determine the amount of labeled mannose released. It is shown that the results of this procedure are similar to those obtained previously using small columns of concanavalin A-Sepharose (B. Saunier, R. D. Kilker, Jr., J. S. Tkacz, A. Quaroni, and A. Herscovics (1982) J. Biol. Chem. 257, 14155-14161). The precipitation procedure, which can be applied to the assays of other processing enzymes, is much more convenient when a large number of samples must be analyzed. PMID- 3314589 TI - Electrocatalytic reduction of ethylene dibromide by Vitamin B12 in a surfactant stabilized emulsion. PMID- 3314590 TI - Enzymatic electrocatalysis as a strategy for electrochemical detection in heterogeneous immunoassays. PMID- 3314591 TI - [The legal status of the cadaver in West Germany]. AB - This paper will discuss the legal status of the cadaver in the Federal Republic of Germany, especially with respect to donation of remains to anatomy for the scientific education essential for medical students. PMID- 3314592 TI - [A new concept of normal and pathologic development of the primary palate. 2. The formal genesis of the open and covered cleft lip and jaw]. AB - In part 1 of this work we have shown that in each mammalian embryo the nasal fin represents a masked physiological cleft lip and jaw. In this double-layered "Epithelmauer" the process of epithelium separation along the differentiation line may undergo various fates: 1. It can completely fail to take place (resulting in total cleft lip and jaw) or can be interrupted (resulting in incomplete cleft). 2. The persisting oral epithelium of the nasal fin may be loosened and moved away with a little temporal retardation. Thereby the potential osteoblasts and myoblasts cannot meet and join at right time and they retract away from the midline epithelial seam. The minimal and subcutaneous cleft lip and the submucous clefts of the jaw and the mesenchymal bridges may result. 3. Only in very rare cases the cleft lip and jaw develop in another way, namely if the underdeveloped facial processes do not meet. PMID- 3314593 TI - [Functional morphology of the maxillo-mandibular apparatus of the mini-Lewe minipig. 2. Structure of the masticatory muscles of adult animals]. AB - The masseter muscle is the most powerfully developed of the jaw muscles in the miniature pig MINI-LEWE. Its internal skeleton contains 5 Sehnenspiegel. The zygomatico-mandibular muscle acts as a link between the masseter and temporal muscles. The pinnate structure of the temporal muscle results from the internal tendons, which attach to the coronoid process. The medial pterygoid muscle with its 7 Sehnenspiegel has the most complex pinnate structure. The lateral pterygoid muscle has small tendinous slips only in the regions of its origin and attachment. PMID- 3314594 TI - [Functional morphology of the maxillo-mandibular system in the mini-Lewe minipig. 4. Functional analysis of the masticatory muscles at various ages]. AB - The percentage of dry weight distribution of the jaw muscles is described, and muscle growth is calculated by means of second degree homogeneous linear differential equations with constant coefficients. The components of the chewing muscles are calculated from the parallelogram of forces on the basis of their dry weights. Changes in the shape of the skull during postnatal development leads to an increase in the adductive components and a reduction of the protractive components. Changes in the reaction, medial tensile, lateral tensile and depressive components are minor. PMID- 3314595 TI - [A new computer assisted procedure for producing histograms in the morphometry of pancreatic islands]. PMID- 3314596 TI - Pulsed Doppler ascending aortic, carotid, brachial, and femoral artery blood flows during caudal anesthesia in infants. AB - Hemodynamic effects of caudal bupivacaine anesthesia were studied in eight infants 6.5 +/- 0.5 months old (mean +/- SD), weighing 7.4 +/- 4.4 kg anesthetized with halothane 0.2% end-tidal and 60% nitrous oxide. Heart rate and systolic, diastolic, and mean arterial pressure remained unchanged. Cardiac index and stroke index assessed by pulsed Doppler and total vascular resistances were not altered by the caudal block. However, after caudal anesthesia, the authors observed a significant decrease (P less than 0.05) in brachial blood flow assessed by pulsed Doppler (from 49.0 +/- 28.3 to 31.7 +/- 24.6 ml-1.min) and a significant increase (P less than 0.05) in brachial vascular resistance (from 2.9 +/- 1.7 to 5.5 +/- 1.0 mmHg.min.ml-1). Blood flow and vascular resistance in both the femoral and carotid arteries did not change. This study suggests that, in supine position, caudal anesthesia in infants induces a blood pooling in the denervated lower extremities and a reflex vasoconstriction in innervated areas which maintains cardiac output. We conclude that volume loading is not necessary in normovolemic infants after caudal anesthesia with cutaneous analgesia below T5. PMID- 3314597 TI - Dose-response relationship of clonidine in tetracaine spinal anesthesia. AB - The study was undertaken to define a dose-response relationship for clonidine in prolonging canine tetracaine spinal anesthesia. Using a randomized blind cross over design, six mongrel dogs were given subarachnoid injections (1 ml) of the following solutions over an 8-week period: tetracaine 4 mg (control), or tetracaine 4 mg with clonidine in doses of 10, 25, 50, 100, 150, 200, and 300 micrograms. With clonidine doses equal to or exceeding 50 micrograms/ml, motor and sensory blockade were significantly (P less than 0.01) prolonged, when compared to the control times. Analysis of data by second order polynomial regression analysis produced a relationship defined by Y = 23.241 + 1.104(x) - 0.0023(x2) with r2 = 0.92 and P less than 0.001 for sensory blockade and Y = 38.7072 + 1.64425(x) - 0.004125(x2) with r2 = 0.90 and P less than 0.005 for motor blockade. From these curves, a plateau in clonidine dose-response for both sensory blockade and motor blockade occurred at 150 micrograms. The increase in duration of spinal anesthesia with clonidine may be related to a direct post synaptic alpha 2 adrenoceptor arteriolar effect, a spinal cord pre- or post synaptic alpha 2 antinociceptive action or supraspinal alpha 2 modulation of nociception. No animals showed evidence of neurologic dysfunction during the study. The authors conclude that a well-defined dose-response relationship exists for clonidine in canine tetracaine spinal anesthesia. PMID- 3314598 TI - Anesthetic depression of myocardial contractility: a review of possible mechanisms. AB - The bulk of experimental evidence indicates that anesthetics do not produce their negative inotropic effect via an inhibitory action on mitochondrial electron transport. Anesthetics decrease energy need, rather than energy production. Anesthetics also decrease the rate of sequestration of Ca2+ by mitochondria, but, again, this appears not to be an important cause of reduced myocardial contractility. The role played by direct anesthetic depression of the myofibrils in reducing contractility is uncertain. Most experimental evidence now available suggests that significant myofibrillar depression, measured in terms of inhibition of actomyosin ATPase activity or inhibition of force production, occurs only at anesthetic concentrations which are high compared to concentrations employed clinically. This would seem to indicate that the myofibrils are not an important target for anesthetics in regard to the production of depressed myocardial contractility. However, the experimental act of removing myofibrils from their intracellular environment, or of removing the sarcolemma or making it hyperpermeable, appears to prevent some regulatory myofibrillar phosphorylation reactions from taking place. As stated by Winegrad, "certain forms of regulation of the cardiac myofibril are fragile and can be seen only when cellular constituents and structure are maintained." It is possible that this type of regulation is susceptible to inhibition by anesthetics. Methods for preserving this regulation are available, and will need to be employed before a depressant action of anesthetics on the myofibril can be definitely dismissed as a significant cause of the inhibition of cardiac contractility. A single study, of intracellular Ca2+ levels in the intact cell (where myofibrillar regulation was presumably preserved), has indicated that halothane may decrease myofilament Ca2+ sensitivity. However, for reasons stated above, this study cannot be taken as unequivocal proof of such an action. Despite the fact that the normal action potential is little affected by anesthetics, the sarcolemma appears to play a pivotal role in the production of anesthetic-induced contractile depression. Significant depression of the rate of upstroke of the slow (Ca2+ mediated) action potential by clinical concentrations of both inhalation and intravenous anesthetics has been demonstrated by several workers. This has been interpreted to mean that anesthetics inhibit the influx of Ca2+ through the slow channel, and such has been confirmed (to date, for halothane and thiamylal) by direct measurement of the slow inward Ca2+ current using a voltage clamp technique.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3314600 TI - Air embolism associated with veno-venous bypass during orthotopic liver transplantation. PMID- 3314599 TI - Continuous thoracic epidural analgesia for postoperative pain relief following thoracotomy: a randomized prospective study. PMID- 3314601 TI - [Use of insulin-glucose therapy for the correction of carbohydrate metabolism during open-heart surgery]. PMID- 3314602 TI - [Use of ultrasonics for the diagnosis of postoperative complications in an intensive care unit]. PMID- 3314603 TI - [Aneurysms of the subclavian artery caused by a cervical rib. Therapeutic approach]. PMID- 3314604 TI - [Evolution of the treatment of hemorrhoidal disease as a function of recent etiopathogenic concepts]. PMID- 3314605 TI - Appropriate use of the microbiology laboratory in the diagnosis of infectious diseases. AB - The collection and processing of clinical specimens in the diagnosis of infectious diseases is reviewed. Available culture methods, other laboratory tests, and their appropriate use and interpretation are discussed. Particular emphasis is placed on selection of those tests most likely to give a specific diagnosis while avoiding unnecessary laboratory use. PMID- 3314606 TI - [The kallikrein-kininogen-kinin system: current concepts and perspectives]. PMID- 3314607 TI - [TTE-RAS (Titertek-Enterobac-Ras), a new micromethod for the semi-automatic identification of Enterobacteriaceae within 5 hours]. AB - Titertek-Enterobac-Ras (TTE-RAS), a new semi-automated system for the identification of the Enterobacteriaceae-within five hours, has been evaluated and compared with conventional methods. This note presents the results upon 655 strains, mainly Enterobacteriaceae TTE-RAS provided correct identification for about 92 p. cent and 97 p. cent of Enterobacteriaceae respectively before and after carrying out supplementary tests according to manufacturer's instruction. TTE-RAS gave 97 p. cent specific results for Salmonella. On the other hand, the system correctly identified Aeromonas hydrophila, but not the Gram negative strict aerobic bacteria. PMID- 3314608 TI - Growth-stimulating substances in porcine milk. AB - Colostral and milk samples were collected from 6 primiparous sows on postpartum days 0, 9, 18, and 27. Insulin content was measured and epidermal growth factor (EGF) concentration was determined by use of radioimmunoassay and radioreceptor assay, respectively. Total milk protein concentration was measured colorimetrically. Concentrations of insulin, EGF, and protein in the colostral samples were significantly (P less than 0.01) higher than those found in the milk. Milk samples obtained from postpartum days 9, 18, and 27 did not differ significantly in insulin, EGF, or total protein content. PMID- 3314609 TI - Profiles of type-II pneumocytes in rats inoculated intratracheally with bacterial lipopolysaccharide. AB - Ultrastructural and morphometric profiles of type-II pneumocytes (P-II) were investigated in rats killed 18 or 24 hours after a single intratracheal inoculation of bacterial (Escherichia coli) lipopolysaccharide (LPS). Inoculation with LPS induced pulmonary injury and inflammation, as measured by increased lactate dehydrogenase and alkaline phosphatase activities and increased numbers of polymorphonuclear neutrophils in fluid collected by bronchoalveolar lavage. Marked ultrastructural changes and desquamation of a few P-II developed at the time of high activity of lactate dehydrogenase and alkaline phosphatase in bronchoalveolar lavage fluid. Ultrastructural changes included swollen mitochondria and localized cisternal dilatation of the endoplasmic reticulum in which was contained membrane-bound homogenous material of medium electron density. Twenty-four hours after LPS inoculation, point-count stereologic analysis and digitizing morphometry revealed greater than 50% increase in P-II size. Changes in cell size corresponded with ultrastructural finding of swollen cells. Results obtained by point-count stereologic analysis and digitizing morphometry were highly correlated (r = 0.95). Lamellar bodies (LB) comprised 12 to 15% of P-II volume. Volume density and number of LB remained unaltered in LPS injured P-II, and evidence of accelerated release of LB was not detected after LPS inoculation. Exudated polymorphonuclear neutrophils and pulmonary alveolar macrophages were involved actively in the phagocytosis of LB originating from necrotic and desquamated P-II. On the basis of measurement of enzyme activity (enzymes released into the bronchoalveolar space), considerable ultrastructural alterations developed in P-II when maximal LPS-induced pulmonary cell injury took place. PMID- 3314610 TI - A comparison of 99mTc-DTPA and 113mIn-DTPA aerosol clearances in humans. Effects of smoking, hyperinflation, and in vitro oxidation. AB - As an index of permeability of the alveolar epithelium, the clearance of an inhaled aerosol of 99mTc-DTPA is increased in several disease states. However, the usefulness of the test to assess the severity of disease is limited because healthy smokers also have abnormally rapid rates of clearance. Because the stability of the 99mTc-DTPA bond might be a contributory factor, we tested the affinity of 99mTc for DTPA in vitro, and in groups of healthy smokers (n = 13) and nonsmokers (n = 7) we measured the clearances of 99mTc-DTPA and 113mIn-DTPA, which have a similar molecular shape and charge. In vitro, sodium hypochlorite or hydrogen peroxide released as much as 98% of free 99mTc from the 99mTc-DTPA complex. When incubated with human neutrophils stimulated with phorbol myristate acetate, between 4 and 7% of free 99mTc-DTPA was released after 30 min, and 12% was released after 60 min. In vivo, the clearances of both 99mTc-DTPA and 113mIn DTPA in the smokers (n = 13) were faster than in the nonsmokers (n = 7) (p less than 0.05). Within the smokers, the mean 99mTc-DTPA clearance (T1/2 25 +/- 4 min) was faster than the mean 113mIn-DTPA clearance (34 +/- 6 min), (p less than 0.05). For nonsmokers, the difference was smaller (T1/2 99mTc-DTPA, 56 +/- 6; T1/2 113mIn-DTPA, 62 +/- 6) and not significant. During hyperinflation, smokers (n = 8) and nonsmokers (n = 8) both demonstrated an increase in 113mIn-DTPA clearance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314611 TI - The bronchoconstrictor properties of platelet-activating factor in humans. AB - Platelet-activating factor (PAF) is an inflammatory mediator that causes bronchial smooth muscle contraction in vitro and in vivo in experimental animals. To characterize the effect of PAF on human airways, 6 normal subjects and 6 subjects with mild asthma inhaled PAF using a standard bronchoprovocation protocol and nebulizer concentrations ranging from 0.1 to 1000 micrograms/ml. Aerosolized PAF produced bronchoconstriction in 5 of 6 normal and 3 of 6 asthmatic subjects as defined by at least a 35% decrease in specific airway conductance (SGaw). However, in these same subjects, flow rates measured at 30% of vital capacity from a partial forced expiratory maneuver (V30P) did not decrease at least 30% nor did the FEV1 decrease by 20%. The 8 PAF responders were 5 to 836 times more sensitive to PAF than to methacholine when SGaw was used to assess the airway response. The relative airway sensitivity of the PAF nonresponders could not be assessed. Normal and asthmatic subjects could not be differentiated by their airway response to PAF, and there were no clinical features that differentiated PAF responders from nonresponders. The maximal airway response to PAF occurred within 2 to 3 min and lasted 15 to 45 min. There were no late reactions. Both normal (p less than 0.01) and asthmatic (p less than 0.05) subjects exhibited tachyphylaxis to PAF. Finally, PAF sensitized the airways of all normal subjects to methacholine, including the one PAF nonresponder (p less than 0.02), but it did not sensitize the airways of the asthmatic subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314612 TI - Theophylline has a dose-related effect on the airway response to inhaled histamine and methacholine in asthmatics. AB - To study whether theophylline inhibits airway hyperresponsiveness in a dose dependent fashion, we performed inhalation challenges with histamine and methacholine in 9 asthmatic patients. On 4 separate days, 3 consecutive histamine or methacholine tests were carried out, each of them 20 min after saline (placebo) and after 100, 100, and 200 mg intravenous theophylline ethylenediamine given in a cumulative fashion. Airway responsiveness was expressed as the provocative dosage of histamine or methacholine necessary to increase specific airway resistance by 100% (PD100SRaw). After placebo PD100SRaw for histamine showed a small but significant (p less than 0.01) increase not observed after methacholine. Theophylline markedly attenuated airway reactivity in a dose dependent manner. At a mean (SD) serum concentration of 6.14 (0.30) mg/L, theophylline increased geometric mean PD100SRaw for histamine from 2.76 to 6.07 units (p less than 0.01) and for methacholine from 1.52 to 2.60 units (p less than 0.05). At a mean (SD) serum concentration of 12.9 (0.70) mg/L, theophylline increased geometric mean PD100SRaw for histamine from 2.70 to 17.1 units (p less than 0.01) and for methacholine from 1.28 to 4.98 units (p less than 0.01). Thus, there was a protective effect of theophylline on histamine and methacholine responsiveness in patients with bronchial asthma at "subtherapeutic" serum theophylline concentrations with increasing efficacy at higher serum theophylline concentrations. These observations may have therapeutic implications in the treatment of patients with mild asthma. PMID- 3314613 TI - The effect of oral diltiazem on airway reactivity to methacholine and exercise in subjects with mild intermittent asthma. AB - The effect of increasing doses of oral diltiazem on airway reactivity to methacholine was evaluated in 10 volunteers with mild asthma. Then the highest tolerated dose was compared with placebo in preventing exercise-induced bronchoconstriction. Methacholine challenges were performed 1 h before and 100 min after placebo or after 30, 60, 90, 120, or 180 mg of oral diltiazem, given in a single-blind, crossover manner on different days within 2 wk. Diltiazem, at doses above 60 mg prolonged the P-R interval of the electrocardiograph but had no significant effect on FVC, FEV1, or FEF25-75. The mean +/- SEM ratio of the dose of methacholine required to produce a 20% decrease in FEV1 (PD20) after diltiazem to the PD20 before diltiazem, i.e., the fold increase in PD20, was not significantly different from placebo at any dose: 0.93 +/- 0.11 after placebo, 1.2 +/- 0.1 after 30 mg, 1.3 +/- 0.3 after 60 mg, 1.2 +/- 0.2 after 90 mg, 1.1 +/ 0.1 after 120 mg, and 1.0 +/- 0.1 after 180 mg. One hundred minutes before a standardized exercise challenge, 120 to 180 mg of oral diltiazem and identically appearing placebo tablets were administered in a randomized, double-blind, crossover design on separate days at least 48 h apart. The mean +/- SEM maximal postexercise decrease in FEV1 was 25.5 +/- 3.3% after placebo and 17.0 +/- 4.8% after diltiazem (p less than 0.01). There was no correlation between change in FEV1 and serum concentrations of diltiazem or its active metabolite desacetyldiltiazem.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314614 TI - Two-stage skin testing for tuberculosis in a domiciliary population. AB - We scheduled two-stage skin testing for tuberculosis with Candida and mumps controls on 618 residents of our domiciliary unit at the Veterans Administration Medical Center, Johnson City, Tennessee. Of the 618 residents in the unit, 30 (4.8%) were not available for evaluation, 77 (13%) had a prior history of active tuberculosis or positive skin test, and 1 resident refused testing. Of these 510 patients who received first-step testing with purified protein derivative (PPD), 153 (30%) had greater than to 10 mm induration. Those patients with less than 10 mm induration had a repeat PPD 2 wk later. Fifty-nine (19.2%) of the 307 patients who received a second PPD had a booster response. A total of 50.9% of the residents had evidence of tuberculosis exposure by skin testing. There were no differences between patients with significant and nonsignificant reactions when comparing age, length of stay, functional status evaluated by Karnofsky scale, or number of underlying diseases. Second test conversion occurred in 4.3% of those patients who had been in the unit for less than 1 month and in 36% of those who had been residents for a period of 3 to 6 months (p less than 0.05). Regardless of the size of the initial reading, it is important to perform a two-stage PPD in residents of chronic care facilities who have a negative first test. INH prophylaxis should be considered in patients admitted to chronic care facilities such as the domiciliary when they have significant Mantoux reactions. PMID- 3314615 TI - Erythromycin-induced suppression of pulmonary antibacterial defenses. A potential mechanism of superinfection in the lung. AB - Erythromycin is a broad-spectrum antibiotic commonly used in patients with respiratory infections. Certain of these patients become colonized with new microorganisms and develop superinfections. Antibiotics have a number of effects other than simply killing or inhibiting the growth of bacteria and may have direct effects upon host cells, including phagocytes. In vitro and in vivo studies have demonstrated that erythromycin decreases polymorphonuclear leukocyte (PMN) directed migration. To test the hypothesis that erythromycin inhibits normal PMN migration into the alveoli in response to a bacterial challenge, mice were challenged by aerosol inhalation with Proteus mirabilis or Staphylococcus aureus and injected intravenously with erythromycin (50 or 100 mg/kg). Pulmonary bactericidal activity and total lavaged lung cell and differential counts were determined 4 h after bacterial challenge. In control mice, only 24 +/- 2% of the initial inoculum of P. mirabilis was viable at 4 h. At a dose of 100 mg/kg, lung defenses after erythromycin were ablated, allowing the proliferation of P. mirabilis to 113 +/- 5% of the initial inoculum. The number of PMN obtained by lavage after P. mirabilis challenge was also inhibited by erythromycin in a dose dependent manner. In untreated animals, 5.0 +/- 0.2 x 10(6) PMN were recovered as compared with 3.1 +/- 0.4 x 10(6) and 1.1 +/- 0.3 x 10(6) with increasing doses of erythromycin. Intrapulmonary bactericidal activity against S. aureus was not impaired by erythromycin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314616 TI - Diagnostic value of asbestos bodies in bronchoalveolar lavage fluid. AB - Asbestos bodies (AB) were counted by light microscopy in bronchoalveolar lavage (BAL) fluid obtained from 563 subjects. The presence of AB was found to reflect occupational exposure to asbestos and was rarely found in unexposed control subjects at concentrations above 1/ml of fluid (6.9% of white collar workers and 17.8% of blue collar workers). The overlap of results observed between subjects with definite exposure and those without underlines the difficulty in assessing exposure by questioning alone, which leads to underestimations or even overestimations of the risk. The highest counts (log mean, 120.5 AB/ml; range, 0 to 42,600) were found in patients with radiologic evidence of asbestosis, most likely reflecting the known association of this disease with retention of large amounts of long amphiboles, rather than in patients with pleural disease. A considerable overlap of results was also observed between groups with different diseases or without any apparent disease. Apart from uncertainties in the radiologic diagnosis, this may be explained by differences in latency since first exposure, in individual response to asbestos inhalation, or in pathogenic properties of different asbestos types. Because the presence of AB in BAL fluid appears to be a marker of exposure and not of disease, AB are more likely to be detected in patients presenting with asbestos-related diseases but in whom exposure is not confirmed by the occupational history (65 of 78 cases). PMID- 3314617 TI - Growth inhibition of Cryptococcus neoformans by human alveolar macrophages. AB - Macrophage cytotoxicity for Cryptococcus neoformans was investigated by culturing human alveolar macrophage (AM) with a thin-capsuled clone of C. neoformans in a polypropylene culture tube assay system. Yeast replication was quantitated by electronic particle counting after detergent lysis of AM and viability by quantitative plate counts. Under appropriate conditions, fungal replication was inhibited in the presence of human AM. This effect persisted over the 48-h time course that was evaluated. During this period, organisms in medium alone proliferated rapidly, doubling their number every 4 h. Human AM did not require endotoxin, fetal calf serum, or specific rabbit anticryptococcal antibody for fungistasis. Under these conditions, microscopic evaluation of a cytocentrifuge preparation of AM-yeast cocultures, stained by a modified Giemsa technique, revealed all the fungi to be extracellular. In the presence of 10% fresh human serum, AM phagocytized C. neoformans and exhibited fungicidal activity. Tumor necrosis factor did not affect the replication rate of the yeast. These findings suggest that there may be at least 2 mechanisms by which human AM protect against C. neoformans. One is serum-independent and extracellular and results in fungistasis, and the other is dependent on a serum factor and leads to intracellular inhibition of growth and possibly killing of the organism. PMID- 3314618 TI - Surfactant for the treatment of respiratory distress syndrome. PMID- 3314619 TI - [Object loss in criminologic psychiatry or passion according to Werther]. AB - The author's aim is to objectivate the importance of the psychoanalytical concept of "object-loss" in the "criminogenous" passional process, as described by De Greeff. To illustrate his claim, he proceeds to the criminological analysis of Werther, a novel of great psychological realism, by Goethe. He them studies the personality of criminal driven by passion, where borderline and narcissistic features prevail. The object relation with the victim is usually of a narcissistic pregenital type. Any serious threat to this object relation creates a dangerous situation which can resolve in murder, frequently followed by the murderer's suicide. The author finally states that the so-called "passional" crime is not the only form of suicide/homicide, the psychopathology of which involves object-loss. This kind of acting is in fact also observed in melancholia, psychoses and prepsychotic states, depressions with jealousy, borderlines and the actors of "accompanied suicides". PMID- 3314620 TI - [Trial of systematization of the therapeutic approach to digestive behavior disorders]. AB - The aim of this work is to propose a therapeutic model for eating disorders. Among various techniques, emphasis is focused on the importance of the cognitive treatment for in and out patients' eating disorders. PMID- 3314621 TI - [Development of schizophrenia. Methodological problems and review of the literature]. PMID- 3314622 TI - [Study of historical, clinical and psychopathological aspects of limit states]. PMID- 3314623 TI - Thirteenth Daniel C. Baker, Jr, memorial lecture. Monoclonal antibodies: the coming revolution in diagnosis and treatment of human disease. AB - Hybridoma technology has revolutionized the diagnosis of human disease. Owing to the unique specificity of monoclonal antibodies (MABs) of murine origin, hundreds of highly sensitive, accurate in vitro diagnostic tests have been developed for clinical laboratory and at-home use. Major research efforts are now underway to exploit this specificity for direct therapeutic purposes: MABs are being used by themselves in treating lymphomas, and in conjugated form with radionuclides, toxins, and chemotherapeutic drugs to treat a variety of tumors. Human MABs now are being tested in tumor imaging and for treatment of infectious diseases. New technologies have been developed to alter the genetic structure of MABs (eg, chimeric antibodies) to increase their treatment efficacy. As development of therapeutic uses for these reagents continues and, especially, as they receive approval for general clinical use, hundreds of kilograms per year will have to be produced. This paper reviews some of the recent developments in this area and describes two novel technologies that have been developed for large-scale cultivation of hybridoma cells. PMID- 3314625 TI - Use of botulinum toxin to lateralize true vocal cords: a biochemical method to relieve bilateral abductor vocal cord paralysis. AB - Using the mongrel dog as an animal model, we studied the effectiveness of botulinum toxin (Oculinum) to lateralize the true vocal cord. This experiment was undertaken in order to determine whether the toxin can improve the airway in subjects with bilateral abductor vocal cord paralysis. The toxin was injected into the cricothyroid muscle to block neuromuscular transmission at the motor end plate. Paralysis of the cricothyroid muscle was achieved and documented by electromyography and videotaped endoscopy. Paralysis of the cricothyroid muscle decreases the tension of the true vocal cord and allows the cord to take a more lateral position. In this preliminary report, the literature is reviewed, the effect of and action of the toxin are discussed, and the results of the experimental protocol, establishment of dose-response curves, and techniques of injection are presented. Preliminary data suggest that there is an increase in the airway by lateralizing the true vocal cord with this biologic substance, and that this method may have many applications in clinical medicine for the otolaryngologist-head and neck surgeon. PMID- 3314624 TI - Cricothyroidotomy: a decade of experience in Denver. AB - In an attempt to evaluate cricothyroidotomy as described by Brantigan and Grow in 1976, the authors have reviewed the literature and compared it to the decade of experience following Brantigan and Grow's report. The records of over 1,000 patients requiring ventilatory assistance were reviewed. A comparison of this experience with Brantigan and Grow's original series and subsequent reports was used to establish the criteria and technique for cricothyroidotomy. It appears that while cricothyroidotomy has specific advantages, it also has disadvantages and a higher incidence of airway stenosis than either of the procedures it was designed to replace (low tracheotomy or endotracheal intubation). For this reason, its use has been severely restricted in Colorado, where it was popularized. PMID- 3314626 TI - Delineation of a deep neck abscess with magnetic resonance imaging. PMID- 3314627 TI - [Cutaneous lipoma and lipomatosis]. PMID- 3314628 TI - [Technics of nail biopsy]. PMID- 3314629 TI - [Amicrobial pustulosis and calcium]. PMID- 3314630 TI - [Measles virus and the central nervous system]. PMID- 3314631 TI - [Viral vaccines: recent data]. PMID- 3314632 TI - The treatment of breast cancer: a study in evolution. PMID- 3314634 TI - Removal of skin staples in an emergency. AB - We have highlighted this problem as there are situations where skin staples have to be removed rapidly, for example where bleeding and subsequent respiratory distress develop following neck surgery. A survey of junior hospital staff showed that many doctors had never removed skin staples nor were aware how best to remove them in the event of an emergency. Using skin simulation we compared the time to remove sutures and staples, and found it takes 55% longer to remove skin staples. Where the standard staple remover is not immediately available, an artery forceps, correctly applied, is just as quick. PMID- 3314633 TI - The right approach to carcinoma of the cardia and lower oesophagus. AB - Successful surgical palliation for carcinoma of the cardia and lower oesophagus is often compromised by anastomotic failure or local recurrence. These complications follow technical difficulty in achieving adequate resection and a safe anastomosis through inappropriate surgical exposure, often via the left chest. A technique of oesophagogastrectomy is described employing a simultaneous right abdominothoracic approach without division of either costal margin or diaphragm. Synchronous laparotomy and thoractomy facilitates both resection and anastomosis, and obviates the necessity to turn the patient over and redrape halfway through the operation. Closure of the distal stomach and the gastro oesophageal anastomosis are performed using staplers. No anastomotic leaks were detected in the 15 patients described. PMID- 3314635 TI - Monitoring of renal allografts by Doppler ultrasound. AB - Cyclosporin (CyA) associated renal dysfunction may be due to an arteriolopathy which reduces graft perfusion. We have prospectively monitored 27 renal allograft recipients, within 30 days of transplantation, by continuous wave Doppler ultrasound. Changes in the frequency shift waveform should indicate alterations in renal blood flow. Objective analysis was made in 112 waveforms by determining the ratio of the area under the frequency shift/time curve of the first half and the second half of the cardiac cycle (AUC 1/2 ratio). The AUC of the first half of the cycle indicates systolic blood flow plus the first part of diastolic flow, whereas the AUC of the second half indicates the remainder of diastolic flow. The AUC 1/2 ratio during ATN was not significantly different from that during stable renal function. However the ratio was significantly higher during acute rejection episodes and CyA nephrotoxicity. Although a statistical difference was demonstrated between acute rejection and CyA nephrotoxicity, the AUC 1/2 ratio alone does not differentiate these 2 conditions. These preliminary findings suggest CyA nephrotoxicity does reduce renal allograft blood flow and that this non-invasive technique may have a useful role to play in monitoring of patients immunosuppressed with CyA. PMID- 3314636 TI - Acute abdominal pain: computer aided diagnosis by non-medically qualified staff. AB - This report explores the role of computer aided diagnosis in acute abdominal pain when applied by non-medically qualified personnel. Clinical features of 153 patients (75 males, 78 females, aged range 6-92 years, median 35 years) suffering from less than one weeks' abdominal pain were recorded. Junior doctors' diagnostic accuracy with (65 cases) and without (70 cases) structured computer history sheets were compared with first year clinical medical students using the computer system (46 cases: 28 also seen by doctor, 18 cases student only). These students had no previous surgical training or experience. Doctors' diagnostic accuracy of 51% rose significantly to 69% with the use of structured history forms (chi 2 = 4.53, P = less than 0.05). Computer assisted clinical students' diagnostic accuracy matched the improved doctors' accuracy (69.5%). These results have implications not only for medical education but also for isolated paramedical personnel who should be supplied with structured diagnostic forms and, where appropriate, a microcomputer. PMID- 3314637 TI - Digital methods to study abdominal aortic aneurysm. PMID- 3314638 TI - [A rare case of gastric duplication in an adult]. PMID- 3314639 TI - [An artificial rotatory heart. A new concept of an artificial ventricle intended for circulatory assistance or cardiac replacement. Initial experimental results]. PMID- 3314640 TI - [Lipoma of the heart. Apropos of a case and review of the literature]. PMID- 3314641 TI - [Improvement in oxygenation during open chest surgery with lung exclusion by selective continuous positive pressure. Preliminary results in 15 operations]. PMID- 3314642 TI - [Post-radiation coronary diseases. Presentation of 7 cases and review of the literature]. AB - Coronary lesions are one of the complications of mediastinal radiotherapy; they are more uncommon, at least in their clinical expression, than the involvement of the pericardium, but they are interesting by their gravity and occurrence in young patients (35 years old, in an average). We are reporting 7 cases in addition to the 53 already recorded in the literature. The neoplasm which led to the radiation treatment is, in 85 p. cent of the cases Hodgkin's disease and in 10 per cent of the cases a breast cancer. The time of occurrence of the clinical signs is of 5 years, in an average. The revealing symptom is an initial necrosis or an angor, most often unstable (45 p. cent of the cases, for each of them), more exceptionnally it is a sudden death or a pericarditis. The coronary risk factors have been determined in 37 patients; 45 p. cent had none. In half of the cases, the coronary involvement is monotruncular and frequently proximal (the anterior interventricular trunk is affected twice as often as the right coronary); in the other half, there is an equal distribution between bi-troncular and tri-truncular involvement. There are various pathological lesions: typical with isolated fibrosis of the intima and aventitia, pure atherosclerotic lesions or association of the two. The prognosis of these coronary lesions is severe (43 p. cent of deaths), but the patients who underwent revascularization procedures (by-pass or more seldom transluminal angioplasty) have in 80 p. cent of the cases a favorable evolution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314643 TI - [Role of computerized pulmonary angiography by peripheral venous approach in the study of deep venous thromboses of the legs]. AB - A pulmonary angiography through peripheral venous approach was systematically performed in 40 consecutive patients presenting a recent deep venous thrombosis. None of these patients had been sent for a suspected pulmonary embolus. The analysis of the images that were obtained, enabled to confirm the diagnosis of pulmonary migration in 9 of these patients (22.5%). The retrospective study of the files confirms the fact that these pulmonary emboli present few symptoms or are asymptomatic in 17.5 p. cent of the cases. The quality of the images, the good acceptability and the moderate cost of pulmonary angiography through peripheral venous approach allow the performance of this examination during the initial work-up of a deep venous thrombosis. The demonstration of a latent pulmonary embolus must enable to separate high risk patients and thus guide subsequent therapy. PMID- 3314644 TI - [Current aspects of Ebstein's disease]. AB - Ebstein's disease is a rare affection which is more and more frequently discovered since the advent of sonocardiography. As a matter of fact, except in the loud but less frequent neonatal forms, Ebstein's disease appears, most of the time, in the first three decades of life under various, misleading forms. The diagnosis is, today, greatly facilitated by bi-dimensional sonocardiography. This technic enables in fact to precisely define, in typical forms, the different abnormalities of the entire tricuspid valve complex; however, there are also atypical forms which should not be ignored. The prognosis of Ebstein's disease is dominated by rhythm disorders, which should be systematically looked for, and will benefit from modern treatments, and cardiac insufficiency. In this field, recent surgical techniques have also greatly improved so that surgery should be considered as soon as the symptoms become worse (Class III of NYHA). PMID- 3314645 TI - Prevention of postoperative urinary retention after total hip arthroplasty in male patients. AB - The efficacy of phenoxybenzamine in preventing postoperative urinary retention after total hip arthroplasty was investigated in a double-blind placebo controlled study on 60 consecutive male patients with obstructive urinary symptoms. The patients were randomized into two groups, one being given 10 mg phenoxybenzamine orally and the other a placebo immediately after the termination of the operation and 8 and 16 hours later. Only 10% of the patients in the phenoxybenzamine group were affected by retention compared with 48% in the placebo group (p less than 0.01). It is concluded that phenoxybenzamine effectively prevents urinary retention after total hip arthroplasty in male patients with obstructive urinary symptoms. The drug is recommended for routine prophylactic use with patients not presenting with impaired cerebral circulation or serious coronary heart disease, to prevent infection leading to bacteraemia or other complications of urinary catheterization. PMID- 3314646 TI - The heart and the cold. AB - This review presents current epidemiological evidence indicating that a cold environment contributes to increased cardiovascular, especially coronary heart disease, morbidity and mortality, and examines the factors which might explain these findings. Most epidemiological studies have revealed a peak in the coronary morbidity and mortality during the cold season, and a strong negative correlation between the air temperature or its drop and the occurrence of coronary heart disease. These associations could be apparent, indirect or causative. A small part of the increased coronary morbidity and mortality could be due to, for example erroneous recording of cause of death (eg. death due to respiratory diseases). Part of the increased coronary manifestations of cold seem to be due to changes in living circumstances and habits associated with cold. The gradual development of hypothermia among people living in poor socio-economic conditions may lead to a disastrous chain of events. Snowfalls and storms associated with cold weather may increase the incidence of cardiac complications by exposing people to exceptional physical efforts and circumstances. Some of the effects of cold are direct: cold increases the myocardial oxygen demand by increasing sympathetic stimulation, systolic blood pressure and cardiac diastolic pressure and volume. At the same time the myocardial oxygen supply may be impeded by coronary vasoconstriction especially in vessels damaged by atherosclerosis. In addition to these short term effects cold may augment atherosclerosis for example by increasing blood pressure and the blood concentration of cholesterol, catecholamines, corticoids and thrombocytes during the cold season.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314647 TI - Glucagon-C-peptide test as a measure of insulin requirement in type 2 diabetes: evaluation of stopping insulin therapy in eleven patients. AB - The glucagon-C-peptide test was evaluated as a predictor of the requirement of insulin therapy in type 2 diabetes mellitus. Endogenous insulin secretory capacity was measured in a population of 150 insulin-treated adult diabetic patients by determining postprandial glucagon-stimulated plasma C-peptide concentration (Novo, antiserum M 1230). Eleven subjects with C-peptide levels above 1.0 nmol/l comprised the subgroup in which the previously started insulin therapy was discontinued. After an observation period of a week in hospital the metabolic control of the patients was followed in an outpatient clinic for twelve months. During the observation period one patient was managed on diet alone, eight subjects required oral hypoglycaemics agents and two required the reinstitution of insulin therapy. Mean fasting blood glucose and GHbA1 (glycosylated haemoglobin) of non-insulin dependent diabetics increased during the observation period (from 8.8 to 11.8 mmol/l, p less than 0.001, and from 12.2 to 14.1%, p less than 0.05, respectively). No significant changes were found in total or HDL-cholesterol or triglyceride levels. The findings demonstrate that the glucagon-C-peptide test can be used as an aid in judging whether the withdrawal of insulin may be considered without excessive risk of developing diabetic ketoacidosis. However, the test cannot be used as the only criterion when assessing the need for exogenous insulin in type 2 diabetes. Meticulous monitoring of blood glucose levels is necessary when insulin therapy is withdrawn, because diabetic patients with peripheral insulin resistance may not maintain satisfactory glycaemic control without exogenous insulin despite of high residual endogenous insulin secretion. PMID- 3314648 TI - Cellular basis of immunodeficiency. PMID- 3314650 TI - Deficiency of immunoglobulin A. PMID- 3314649 TI - Clinical immunology of immunodeficiency diseases symptoms and signs of primary immunodeficiencies. AB - This article gives a general overview of the signs and symptoms observed in primary immunodeficiencies (PID). These diseases, although rare, are useful in the understanding of the specific functions and properties of the immune system. Emphasis has not been placed on the biological and laboratory features since the principal goal is to describe the clinical approaches for a correct diagnosis in this group of diseases. Schematic indications of therapy are given only in single diseases, when necessary. The report and the classification are organized according to the more recent recommendations of a Special WHO-Committee for Primary Immunodeficiencies. PMID- 3314651 TI - Assessment of B- and T-cell function in immunodeficiency. PMID- 3314652 TI - Defects in phagocytic functions. AB - Phagocytic cells play a critical role in host defence against bacterial infections, often seen as frequent infectious episodes in patients with granulocytopenia, a quantitative phagocytic disorder encountered not infrequently in clinical practice, and in the more rare patients who have a clinically significant qualitative disorder, i.e., a normal number of phagocytes but defects in phagocyte function. In addition to infective agents, phagocytes can be activated by noninfectious structures such as immune complexes. In either case, phagocyte activation, also, inevitably results in destruction of the host's own tissues. Consequently, the degree of phagocyte activity is a double-edged sword: hypoactivity renders the host susceptible to infections while hyperactivity leads to undue phagocyte-mediated tissue injury. This review will discuss the physiology and qualitative defects, including hypoactivity, hyperactivity and inappropriate activation of phagocyte function, as well as the management of the patients. PMID- 3314653 TI - Immunoglobulin G subclasses in immunodeficiency. AB - Immunodeficiencies have been described ranging from stem cell dysfunction to low levels of isolated IgG subclasses. Subclass deficiencies seem in most cases to depend on regulatory defects rather than absence of genes encoding Ig heavy chains. It is, thus, not surprising that low levels of IgG subclasses can be seen in various immunodeficiency syndromes, where regulatory defects of the immune response may be present. Isolated IgG subclass deficiencies, however, are often found among patients with increased susceptibility to e.g. infections. The frequent B and/or T cell abnormalities observed in IgG subclass deficient individuals may explain the increased susceptibility to infections, suggesting that low subclass levels may function as an indicator of a clinically important immunodeficiency. PMID- 3314654 TI - Bone marrow transplantation in the treatment of primary immunodeficiencies. PMID- 3314655 TI - Immunoglobulin replacement therapy. PMID- 3314656 TI - Management of infections in primary immunodeficiency syndromes. PMID- 3314657 TI - Status of current clinical tests for human immunodeficiency virus (HIV): applications and limitations. AB - Two laboratory tests are currently used to detect the human immunodeficiency virus (HIV) specific antibodies that are produced when an individual has been infected by the virus at some time. These include the enzyme-linked immunosorbent assay (ELISA) as the screening test and the Western blot (WB) as the confirmatory test. They are not yet optimally effective and have brought with them some problems, especially when used to screen low risk populations such as asymptomatic blood donors. Currently licensed ELISA tests used to detect HIV have sensitivities that range between 93 percent and 99 percent, and all have specificities greater than 99 percent. An important concern is that the positive predictive value for the ELISA screening test is low in spite of the fairly high sensitivity and high specificity values. This poor predictive value is due to the low prevalence of individuals in the general population who have been infected with HIV. Multiple causes of false positive ELISA and Western blot tests have been identified. They can be eliminated by utilizing reagent antigens which are produced by recombinant deoxyribonucleic acid (DNA). The false negative ELISA and Western blot tests can be reduced by tests designed to detect IgM antibodies to HIV. PMID- 3314658 TI - Platelet-directed antibody in the serum of patients with primary thrombotic thrombocytopenic purpura. AB - Utilizing two platelet antibody assay systems, flow cytometric analysis and a microcytotoxicity assay, it was possible to demonstrate for the first time platelet-directed antibody in the sera of three of six patients with primary thrombotic thrombocytopenic purpura. These results lend support for an immune mediated pathologic process in some patients with this disorder. PMID- 3314659 TI - [Mixed carcinoid tumor-adenocarcinoma of the stomach. Review of the literature, apropos of a case]. AB - We report a case of mixed tumor of the stomach with a double histological population: carcinoid and adenocarcinoma. The carcinoid component presented an usual morphological pattern with "atypical" elements, and without argyrophilic cells; the carcinoid cells were exclusively marked by an anti-serotonin serum. The other component was a poorly differentiated carcinoma, with muco secretion, which was not marked by and anti-carcino-embryonic antigen serum. The limit between the two components was sharp. The association of mucin in the carcinoma and serotonin in the carcinoid component was an argument in favour of the diagnosis of mixed tumor carcinoid-adenocarcinoma (composite tumor) of the stomach. The evolution after operation leaded to a local recurrence and to the death 10 months later, in spite of chemotherapy. The existence of composite tumors raises nosological, histogenetical and diagnostic problems, which are discussed in this work. The prognosis of these tumors is unknown and therapeutic possibilities seem to be scanty. PMID- 3314660 TI - [A case of hepatic sarcoidosis. Review of the literature]. AB - In this paper, the authors discuss an occurrence of hepatic sarcoidosis in a female patient from the French Antilles which was unique in how it was detected (during cholecystectomy), its presence in two organs (bronchus and liver) as evidenced histologically, as well as marked immunological disorders and disturbances of liver function tests. With corticosteroid therapy, the liver function tests were normalized, but histological lesions persisted. PMID- 3314662 TI - [Imaging by magnetic resonance in digestive pathology]. PMID- 3314661 TI - [Iron overload of the liver and protein synthesis. Progress made through experimental models]. AB - To understand the disturbances in protein synthesis observed during idiopathic hemochromatosis, various experimental models may be used. The aim of this research was to review the principal models employed and to demonstrate the value of hepatic tissue culture techniques in each. This method has already made it possible to explain several mechanisms involving the control of proteins in iron metabolism such as transferrin and ferritin. Tissue culture techniques of human hepatocytes should make it possible to elucidate the nature of the basic metabolic disorder in this disease responsible for the iron overload in the near future. PMID- 3314663 TI - A case of interstitial 1q deletion [46,XY,del(q25q32.1)]. AB - A 10-year-old male with interstitial deletion of chromosome 1[46,XY,del(1)(q25q32.1)] is reported. Clinical features of the patient included dwarfism, severe mental retardation, microcephaly, flat nasal bridge, low-set ears, short neck, brachydactyly, clinodactyly of the 5th fingers and bilateral cryptorchidism. Comparison of phenotypic characteristics of the present case with those of six cases previously described with similar deletions of chromosome 1 permits the delineation of an identifiable syndrome. PMID- 3314664 TI - [Partial deletion 10qter. A new case]. AB - A newborn with 10qter deletion is described and compared with the others previously reported cases. We confirm that the clinical features are not characteristic enough to delineate a syndrome in this chromosomal abnormality. PMID- 3314665 TI - The beta amyloid protein (AD-AP) cDNA hybridizes in normal and Alzheimer individuals near the interface of 21q21 and q22.1. AB - The beta amyloid protein gene (AD-AP) has been assigned by in situ hybridization to the vicinity of the 21q21-q22.1 interface, in a normal individual as well as in a patient with Alzheimer disease. PMID- 3314666 TI - Rare syndromes. The Kaufman-McKusick syndrome. A review of the 44 cases reported in the literature. AB - The Kaufman-McKusick syndrome (MK 23670) is a rare autosomal recessive disorder characterized by the triad of hydrometrocolpos, postaxial polydactyly, and congenital heart disease. Multiple other anomalies have been ascribed to this syndrome. Hydrometrocolpos, especially if unrecognized, may be a serious, life threatening condition in the newborn girl. Forty-four cases have been so far reported in the literature. A great phenotypic variability occurs in this syndrome, therefore making it very difficult to identify the disorder at its presentation and classify it correctly. We shall hereafter review current data regarding the prominent clinical features, the diagnosis and treatment of this syndrome. Problems in genetic counseling will be discussed. PMID- 3314667 TI - Partial monosomy 22 as result of an X/22 translocation in a newborn with DiGeorge syndrome. AB - The case of a neonate with clinical symptoms of DiGeorge syndrome is reported. During pregnancy the measurements by ultrasonography revealed already a significant growth retardation of the fetus, for the first time obvious in the 20th week. The child died immediately after birth. A de novo translocation X/22 was observed with the translocation chromosome being late replicating in all mitoses analysed. The own observation is discussed regarding other cases with DiGeorge syndrome and taking the differential diagnoses into account. count. PMID- 3314668 TI - The affected sib method. V. Testing the assumptions. AB - The affected sib methods, which are used to make inferences about the genetic components of HLA associated diseases, have many underlying assumptions which may not always be realistic. These include no selective disadvantage of affected individuals, little or no recombination between the marker loci and the 'disease' locus, a single panmictic population, Mendelian segregation of the disease locus alleles and random distribution of individuals over environments. The effects of breaking these assumptions have been investigated. We have explicitly derived the haplotype sharing identity by descent (IBD) expectations for the cases of selection against affected individuals and recombination between the HLA marker loci and the 'disease' predisposing locus for affected sib trios (as was previously done for affected sib pairs). We have also derived, for both affected sib pairs and trios, the haplotype sharing expectations for non-random mating (positive assortative), admixture, meiotic drive (of disease allele carrying haplotypes), and a random versus shared environmental component for sibs. In order to assess the sensitivity of the affected sib methods to perturbations in the assumptions, the expectation spaces of haplotype sharing in affected sib pairs and sib trios under the single diallelic locus model with varying penetrances and allele frequencies are fully described. The effects on haplotype sharing and subsequent disease parameter estimation are different for each of the factors we have considered. The affected sib methods are found to be robust in many situations. PMID- 3314669 TI - Prognostic factors and response to treatment in non-Hodgkin's lymphomas (review). AB - This review outlines the major prognostic factors as derived from multivariate analysis of recent therapeutic studies in non-Hodgkin's lymphomas. Age at diagnosis (greater than or equal to 60 years vs less than or equal to 60 years), total number of involved sites, tumor bulk (mass size greater than or equal to 10 cm vs less than 10 cm), serum LDH (greater than or equal to 500 Units) and prompt achievement of complete remission following intensive combination regimens appear to be the most important variables predicting for cure in aggressive lymphomas. The clinical prognostic factors in follicular lymphomas were less extensively evaluated through Cox multiple regression analysis compared to large cell lymphomas. These factors include systemic symptoms, hepatosplenomegaly, anemia, as well as response to treatment. Treatment guidelines are provided in relation to high-risk and low-risk subsets rather than the classical stage assignment. PMID- 3314670 TI - Are colony-stimulating factor-producing cells facilitated in the metastatic process? AB - The relationship between production of Colony-Stimulating Factor (CSF) and metastasis has been investigated in the TS/A murine model. CSF production was determined in TS/A cell variants isolated through serial in vivo selection of lung metastatic nodules induced by intravenous or subcutaneous injection of tumor cells (artificial and spontaneous metastases, respectively). All the cell variants selected for high artificial metastatic ability produced higher amounts of GM-CSF in vitro and stronger haematological alterations in vivo than cells obtained by serial selection of spontaneous metastases. Our data suggest that the late, rather than the early, steps of the metastatic process could be enhanced by GM-CSF production. PMID- 3314671 TI - Phase III adjuvant studies in operable malignant melanoma (review). AB - Adjuvant treatments following surgery include nonsurgical and surgical approaches which should be compared to a randomized control. Between the years 1978 and 1986, we identified 21 randomized trials on stage I primary melanoma, using 2,850 patients. None of the systemic chemotherapy, immunotherapy or chemo-immunotherapy protocols improved the results. However, prophylactic isolation perfusion of the limbs with cytostatics represents a promising approach and is currently studied in our international prospective randomized trial (EORTC, WHO, NAPG-NCI) In stage II--regional metastases--15 studies including 1972 patients have been reported. None of the systemic regimen was found efficient. The reasons for these failures are discussed and future approaches are presented. PMID- 3314673 TI - Combined modality therapy of locally advanced breast cancer. One institution's experience and a review of the literature. AB - Fourteen patients with locally advanced breast cancer were treated at Stanford University Medical Center with a combined modality approach. Treatment consisted of an initial 5 day course of cyclophosphamide followed by three cycles of combination chemotherapy (CAF or CMF). Patients subsequently received radiation therapy to the involved breast and regional nodal areas, followed by mastectomy if resistant disease was present following irradiation. Additional chemotherapy (CMF) was administered for 6 cycles. With a median follow up of 42 months, all fourteen patients are free of local disease. Five out of the fourteen patients have experienced distant relapses and two patients died. We conclude that an aggressive combined modality approach to treatment of locally advanced breast cancer can result in excellent local control and survival even in poor prognosis patients. A review of pertinent studies on multimodality treatment for locally advanced breast cancer confirms our findings. PMID- 3314672 TI - Antiblastic treatment does not affect N-myc gene amplification in neuroblastoma. AB - Gene amplification has been found in the genome of cells growing in vivo and/or in vitro. In cell lines with acquired multidrug resistance gene amplification has been frequently detected. Moreover, extra-copies of cellular oncogenes have been located in tumor cells in vivo; particularly N-myc gene amplification was discovered in advanced stage of neuroblastoma (NB). Neuroblastoma, a tumor of neural origin, has a high incidence in children. N-myc amplification has been demonstrated in untreated patient and a positive significant correlation with the progression of the disease has been established. In this paper we report on four NB patients treated with a polychemotherapeutic protocol and showing N-myc amplification. One patient examined before and after treatment displayed a slight change in N-myc gene copy numbers. It was shown that N-myc gene amplification is not affected by drug activities and that minimal residual of cells bearing N-myc amplification may remain in the tumor mass. N-myc amplification can also cause advantageous cell growth in the presence of drugs. The implications in the pharmacologic management of NB patient showing N-myc gene amplification is discussed. PMID- 3314674 TI - Estrogen receptor and binding site for estramustine in metastatic malignant melanoma. AB - Enzyme immuno assay (EIA) of estrogen receptor (ER) has confirmed the results of earlier investigations using steroid binding techniques, namely that ER is present at very low concentrations in samples from metastatic melanoma. Thirty four of 61 samples (56%) were ER positive with EIA. The corresponding figures using isoelectric focusing (IF) for the steroid binding assay were 16 of these 61 samples (26%). The difference between the methods may be due to difficulties in the interpretation of analytical results for IF at low ER concentration levels or to interference from other 3H-estradiol binding components. Estramustine binding site (EMBS) has been found in samples from 15 of 77 patients (20%) with IF in polyacrylamide gels. Estramustine is, together with estramustine, the cytotoxic metabolite of estramustine phosphate (Estracyt). In analogy to the previously suggested therapeutic significance of estramustine binding protein in the treatment of prostatic cancer, the clinical importance of estramustine phosphate should also be studied in metastatic malignant melanoma in correlation with EMBS status. PMID- 3314675 TI - Current status of chemotherapy for advanced gastric cancer. AB - A review of the current status of chemotherapy in advanced gastric cancer is presented. Results of recent randomized trials have questioned the merits of the most commonly used chemotherapy protocols such as combinations of 5-fluorouracil (5-FU) and doxorubicin with mitomycin C or a nitrosourea (FAM, MeFA, FAB) over 5 FU alone. Results of new ("second generation") protocols and the impact of these results on future trials in an adjuvant setting and in advanced disease are discussed. For the time being no "standard" chemotherapy can be advocated and patients should preferably be treated in clinical trials. PMID- 3314676 TI - Sex-steroid receptors and cancer--are we on the right tracks? (Review). AB - Despite the overemphasis on sex-steroid receptors in cancer, the latter remains a multifactorial process. Many hypotheses have been put forward for the interaction of steroids with receptors but relatively little attention has been paid to other binding components, e.g., antioestrogen binding sites, intracellular sex hormone binding globulin, calcium-calmodulin, protein kinases and other receptor independent phenomena, which may be pertinent to malignancy and are reviewed in this article. PMID- 3314678 TI - [Androgen insensitivity syndromes]. AB - The syndromes of androgen resistance illustrate a special field of endocrinology, that is pathology of target-tissues. These syndromes are responsible for male pseudohermaphroditism and provoke in XY subjects, with a normal testicular androgen secretion, abnormalities in the phenotype with all the possibilities from an "idealistically" female phenotype in the testicular feminization syndrome to an almost normal male phenotype in the mildest forms of the incomplete syndrome. Understanding of these syndromes has strongly benefited of progress in biochemistry and molecular biology concerning the mechanism of action of androgens. On the other hand, understanding androgen mechanism expanded markedly from parallel clinical observation and biochemical investigation permitted by methodological progress: plasma hormones assays, 5 alpha-reductase and androgen receptor qualitative and quantitative determinations. The complete form of the testicular feminization syndrome seems to be due--in most cases--to an absence of the androgen receptor whereas the incomplete forms of the syndrome are related either to insufficient amount or qualitative alteration of the receptor or to a defect of 5 alpha-reductase, the key-enzyme which transforms testosterone to its active metabolite dihydrotestosterone in androgen target-cells. In some cases (approximately equal to 10%) the mechanism of androgen insensitivity could not be identified. The abnormality might be downstream the receptor at various possible steps = binding of the complex androgen-receptor to the chromatin, transcription or post-transcription process. These cases can be useful models for understanding the ultimate steps of the androgen mechanism of action. PMID- 3314677 TI - [Implantation of a mutant of Escherichia coli requiring diaminopimelic acid in the digestive tract of gnotobiotic mice]. AB - A DAP- auxotroph mutant of Escherichia coli DP50 requiring DAP and thymidine for growth was used as the receptor strain in genetic engineering. It failed to be implanted in axenic mice. However, when an inoculum containing more than 10(7) bacteria/ml was used, the DAP+ reverse mutant devoid of requirement for DAP became implanted. When axenic mice were previously associated with Clostridium difficile containing DAP in the cell wall, the strain DAP- became implanted even when the inoculum was too small to permit implantation in axenic mice. Conversely, C. butyricum and C. perenne, whose cell walls also contain DAP, did not allow the establishment of a DAP- mutant. In animals associated with complex human flora without enterobacteria, neither of the 2 DAP- and DAP+ mutants became implanted. PMID- 3314680 TI - [Choice of instruments in ophthalmologic echography]. PMID- 3314679 TI - [Congenital anomalies of the pyeloureteral junction in children. Multicenter study of 985 anomalies in 883 children]. AB - The authors report a survey of the French Group of Visceral Pediatric Surgery, concerning 985 congenital anomalies of the pyeloureteric junction in 883 children. 67.3% of them are boys. This article stresses the recent improvements in prenatal ultrasonography and diagnosis which is now able to individualize a homogeneous group of asymptomatic children ready to be repaired in the early post natal period. Early reconstruction is associated with the greatest degree of recovery of renal function. In children, the average age is 4 years 9 months at diagnosis. In 43.6% clinical symptoms suggest an infectious problem. Pain is noted in 35.5% and an abdominal mass is discovered in 13.3%. Excretory urography (IVP), ultrasonography and cystography are still the main investigations to be done in all cases. But it is now necessary to use modern isotopic technics such as DMSA and diuretic DTPA to quantify obstruction with accuracy and follow long term evolution after treatment. Treatment is surgical and conservative in 81.4%. Almost all of the uretero-pyeloplasties are performed according to the dismembered technic usually with temporary nephrostomy drainage. Renal reduction is reserved only for the redundant and decompensated renal pelvis. Morbidity is low (2.5%) and good results can be expected in about 95% of cases. PMID- 3314681 TI - [3d round table discussion: Choice and optimal use of instrumentation in ophthalmology]. PMID- 3314682 TI - [From Doppler to digital angiography]. PMID- 3314683 TI - [Tonometry]. PMID- 3314684 TI - Clinical and immune status of burn patients. PMID- 3314685 TI - Pleiotropic actions of aminoglycosides. PMID- 3314686 TI - The secretory immune system. PMID- 3314687 TI - Eye and immunity. PMID- 3314688 TI - Therapy of Pseudomonas aeruginosa eye infections. PMID- 3314689 TI - [Characteristics of intrarenal ampicillin distribution in chronic pyelonephritis in children]. AB - Pharmacokinetics and characteristic features of ampicillin kidney distribution were studied in 21 children with chronic pyelonephritis without signs of renal insufficiency who had undergone urological operations. It was found possible to provide the antibiotic concentrations efficient against ampicillin sensitive and partially middle sensitive microorganisms in the renal parenchyma, pelvis wall, ureterocele, megaureter and urinary bladder. Ampicillin concentrations in tissues of the urinary system were shown to correspond to a higher extent to the concentrations attained in blood than those in urine. PMID- 3314691 TI - [Protective function of the peptide antibiotics of bacilli]. AB - The modern status of the biological role of peptide antibiotics in vital activity of bacilli is discussed. The published data and the original findings of the author and his coworkers are analyzed from the viewpoint of two hypothesis: regulator and protective. It is shown that at present there is no solid basis for considering antibiotics as positive regulators of sporulation in organisms producing them. Synthesis of antibiotics is thought to be a manifestation of a certain stage in ontogenetic development of bacilli and is associated with production of extracellular enzymes. The enzymes are conjectured to perform in nature hydrolysis of exogenic substrates and thus create nutrient medium for vegetative cell division of antibiotic-producing organisms. The author suggests that the main biological function of peptide antibiotics produced by bacilli is protection of their environment from other microorganisms. PMID- 3314690 TI - [Polysaccharide composition of the cell wall of Streptomyces antibioticus RIA 594(39), a producer of the antibiotic oleandomycin]. AB - The main polysaccharide components of the cell wall in S. antibioticus RIA-594 (39) i.e. peptidoglycan, teichoic acid and polysaccharide were studied. Peptidoglycan consists of the polysaccharide fraction containing equimolar quantities of N-acetylglucosamine and muramic acid and the peptide subunits including alanine, glutamic and L,L-diaminopimelic acids and glycine at a ratio of 1.4:0.9:1:0.9. It is characteristic that certain peptide subunits of the streptomycete contain no alanine. A polysaccharide differing from glycerol teichoic acid and containing galactose and N-acetylglucosamine was isolated from the cell wall. During the streptomycete development the quantity of peptidoglycan remained constant, the quantity of teichoic acid lowered and the quantity of polysaccharide increased. Correlation between the presence of aminosugars in the composition of teichoic acid and polysaccharide specific of the streptomycete cell wall and the presence of aminosugars in the structure of oleandomycin was shown. This is probably connected with characteristic features of the organism physiology. PMID- 3314692 TI - [Enzyme therapy of tumors]. PMID- 3314693 TI - [Immunomodulating properties of antitumor antibiotics]. PMID- 3314694 TI - [Structure and enzyme activity of the insulin receptor]. PMID- 3314695 TI - Genetic engineering of antiviral agents. PMID- 3314696 TI - Pharmacokinetics and bacteriological efficacy of ticarcillin-clavulanic acid (timentin) in experimental Escherichia coli K-1 and Haemophilus influenzae type b meningitis. AB - The pharmacokinetics and bacteriological efficacy of ticarcillin and clavulanic acid administered individually or in combination were assessed in rabbits with experimental Escherichia coli K-1 and Haemophilus influenzae type b meningitis. The mean penetrations into the cerebrospinal fluid (CSF) of infected animals after a single dose of ticarcillin-clavulanic acid were approximately 11 and 28% for ticarcillin and clavulanic acid, respectively. In continuous-infusion experiments, the mean penetrations into CSF were 14.6 and 35% for ticarcillin and clavulanic acid, respectively, in rabbits with E. coli meningitis and 6.1 and 24%, respectively, in rabbits with H. influenzae meningitis. In animals that received a continuous infusion of the two drugs alone or in combination, the median CSF bactericidal titers for E. coli were less than 1:2, less than 1:2, and 1:2 for ticarcillin, clavulanic acid, and ticarcillin-clavulanic acid, respectively, and for H. influenzae the titers were less than 1:2, less than 1:2, and 1:4, respectively. The addition of clavulanic acid potentiated significantly the bacteriological efficacy of ticarcillin in reducing the number of bacteria in CSF of infected rabbits. Additional studies in animals and humans are required before recommendations can be made regarding the use of ticarcillin-clavulanic acid for treatment of meningitis. PMID- 3314697 TI - Autoradiographic study of tobramycin uptake by proximal and distal tubules of normal and pyelonephritic rats. AB - Multiple factors may modify the pharmacokinetics of aminoglycosides and affect their nephrotoxic potential. In the present study, the influence of Escherichia coli pyelonephritis on the renal handling of [3H]tobramycin was investigated. The accumulation of [3H]tobramycin in proximal and distal tubules in both normal and infected rats was compared. Following induction of pyelonephritis, disturbed intrarenal localization of the drug was noted. Grain counts were affected in both proximal and distal tubules. Decreased labeling was observed at all time intervals in the proximal tubules. Electron microscopy showed that radioactivity was associated mostly with lysosomes in both normal and infected rats 1 and 24 h following the injection of the drug. We could detect significantly higher amounts of drug in the distal tubules of the pyelonephritic kidney than the normal levels at 10 min and 24 h postinjection. The drug did not seem to be associated with any particular organelle and was evenly distributed within the distal tubular cells. The present study shows that the transport of tobramycin within the infected nephron is disturbed. These data might shed some light on the influence of infection on the intrarenal pharmacology of aminoglycosides. PMID- 3314698 TI - Cefotaxime stability during in vitro microbiological testing. AB - Cefotaxime is a broad-spectrum cephalosporin which is metabolized or degraded to less active or inactive metabolites by serum esterases, elevated temperatures, or a pH outside of its stability range. Cefotaxime instability during in vitro microbiological susceptibility tests may lead to an underestimation of the antibacterial activity of the compound. Cefotaxime and desacetylcefotaxime solutions were studied under MIC and serum inhibitory titer testing conditions. Cefotaxime concentrations, as measured by high-performance liquid chromatography, decreased 20 to 30% over the incubation period in various systems tested; the greatest decline occurred in systems containing serum in the media. Changes in the results of microbiological susceptibility tests interpreted after 6 and 18 h of incubation were consistent with changes observed in the high-performance liquid chromatography analysis. This study demonstrates cefotaxime instability under conditions of in vitro microbiological testing. PMID- 3314700 TI - Methylotrophic yeasts--1986. PMID- 3314699 TI - Biochemical aspects of methane formation in Methanobacterium thermoautotrophicum. PMID- 3314701 TI - Energetics of C1-compound metabolism. PMID- 3314702 TI - Ventricular assist devices. A bridge to cardiac transplantation. PMID- 3314703 TI - Antimicrobial activity of tertiary amine covalently bonded to a polystyrene fiber. AB - Tertiary amine was covalently bonded to a polystyrene fiber and examined for antibacterial activity. The tertiary amine covalently bonded to a polystyrene fiber (TAF) showed a high antimicrobial activity against Escherichia coli. TAF exhibited a stronger antibacterial activity against gram-negative bacteria (E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Salmonella typhimurium, and Serratia marcescens) than against gram-positive bacteria (Staphylococcus aureus and Streptococcus faecalis) or Candida albicans. This activity against E. coli was accentuated by 0.1% deoxycholate or 10 mg of actinomycin D per ml, to which E. coli is normally not susceptible. This implies that TAF causes an increase of the bacterial outer membrane permeability. On the other hand, the antimicrobial activity was inhibited by adding Mg2+ or by lowering the pH. This suggest an electrostatic interaction between the bacterial cell wall and TAF. Scanning electron microscopy showed that E. coli cells were initially attached to TAF, with many projections on the cell surface, but then were apparently lysed after contact for 4 h. Taken together, these results imply that bacteria initially interact with TAF by an electrostatic force between the anionic bacterial outer membrane and the cationic tertiary amine residues of TAF and that longer contact with TAF damages the bacterial outer membrane structure and increases its permeability. PMID- 3314704 TI - Survival and transport of bacteria in egg washwater. AB - An evaluation of methods for monitoring the quality of water used to wash eggs at grading stations was undertaken to improve maintenance of bacterial viability during overnight sample transport. Bacterial content of samples at analysis would then better reflect conditions at the time eggs were washed. The interactive effects of temperature and the highly alkaline water conditions upon viability were the subjects of this study. Nine transport methods were examined for their efficacy in recovering total and coliform bacteria from recycled water used to wash eggs, and these were compared with samples analyzed at two commercial egg grading stations. Samples were shipped under test to the laboratory for analysis the following day. The survival of Staphylococcus aureus and Escherichia coli was also examined, but in a synthetic washwater matrix under various combinations of temperature (6 to 32 degrees C) and pH (9.5 to 10.5) to determine whether there was likely to be a different response to variations in transport treatment among gram-positive and -negative bacteria. S. aureus was much more resistant to the lethal effects of high pH and moderate temperature than E. coli. These results indicated that samples of high pH should be held (transported) at less than or equal to 13 degrees C to optimize bacterial survival. Considering cost, ease of manipulation, and the ability to protect both coliforms and the bacterial population as a whole, the method of choice for transport of industrial samples was the direct addition of washwater to containers in which powdered KH2PO4 and Na2S2O3 had been placed to yield final concentrations, when dissolved, of 0.2 and 0.05% (wt/vol), respectively. PMID- 3314705 TI - Bactericidal activities of selected organic N-halamines. AB - The bactericidal efficacies of three organic N,N'-dihalamine disinfectants in the class of compounds termed imidazolidinones were determined for combinations of pH, temperature, and water quality treatments by using Staphylococcus aureus and Shigella boydii as test organisms. The compound 1,3-dibromo-4,4,5,5-tetramethyl-2 imidazolidinone was found to be the most rapidly acting bactericide, especially under halogen-demand-free conditions. The mixed N,N'-dihalamine 1-bromo-3-chloro 4,4,5,5-tetramethyl-2-imidazolidinone was found to be intermediate in terms of rate of disinfection, while the compound 1,3-dichloro-4,4,5,5-tetramethyl-2 imidazolidinone was observed to be the slowest acting bactericide. When overall effectiveness was judged on the basis of stability of the disinfectants along with rates of disinfection, the mixed halamine was considered to exhibit great potential for use as a disinfectant in an aqueous solution. PMID- 3314706 TI - Osmotic significance of glycerol accumulation in exponentially growing yeasts. AB - Natural-abundance 13C-nuclear magnetic resonance spectroscopy has shown glycerol to be the major osmotically significant low-molecular-weight solute in exponentially growing, salt-stressed cells of the yeasts Saccharomyces cerevisiae, Zygosaccharomyces rouxii, and Debaromyces hansenii. Measurement of the intracellular nonosmotic volume (i.e., the fraction of the cell that is osmotically unresponsive) by using the Boyle-van't Hoff relationship (for nonturgid cells, the osmotic volume is directly proportional to the reciprocal of the external osmotic pressure) showed that the nonosmotic volume represented up to 53% of the total cell volume; the highest values were recorded in media with maximum added NaCl. Determinations of intracellular glycerol levels with respect to cell osmotic volumes showed that increases in intracellular glycerol may counterbalance up to 95% of the external osmotic pressure due to added NaCl. The lack of other organic osmotica in 13C-nuclear magnetic resonance spectra indicates that inorganic ions may constitute the remaining component of intracellular osmotic pressure. PMID- 3314707 TI - A more accurate method for measurement of tuberculocidal activity of disinfectants. AB - The current Association of Official Analytical Chemists method for testing tuberculocidal activity of disinfectants has been shown to be inaccurate and to have a high degree of variability. An alternate test method is proposed which is more accurate, more precise, and quantitative. A suspension of Mycobacterium bovis BCG was exposed to a variety of disinfectant chemicals and a kill curve was constructed from quantitative data. Data are presented that show the discrepancy between current claims, determined by the Association of Official Analytical Chemists method, of selected commercially available products and claims generated by the proposed method. The effects of different recovery media were examined. The data indicated that Mycobacteria 7H11 and Middlebrook 7H10 agars were equal in recovery of the different chemically treated cells, with Lowenstein-Jensen agar having approximately the same recovery rate but requiring incubation for up to 3 weeks longer for countability. The kill curves generated for several different chemicals were reproducible, as indicated by the standard deviations of the slopes and intercepts of the linear regression curves. PMID- 3314708 TI - Microbial coagulation of alfalfa green juice. AB - Of the different bacterial strains isolated from alfalfa raw material, nine were able to coagulate the protein fraction of alfalfa green juice. The two strains showing the highest efficiency were further used for coagulation experiments. They were classified as Erwinia carotovora and Escherichia coli. Juice samples inoculated (1:10 to 1:100) with stationary-phase cultures were efficiently coagulated. The amount of protein recovered was equivalent to that obtained when the juice was heat treated. A minimal incubation temperature of 30 degrees C was required. The protein coagulum appeared after 8 to 10 h of incubation. During this period no bacterial growth was apparent, but glucose was actively fermented. For both strains no extracellular enzymatic activity could be shown in the culture supernatants. The fermentative metabolism during the incubation period seems to be responsible for protein coagulation. PMID- 3314709 TI - Adaptation to and biodegradation of xenobiotic compounds by microbial communities from a pristine aquifer. AB - The ability of subsurface microbial communities to adapt to the biodegradation of xenobiotic compounds was examined in aquifer solids samples from a pristine aquifer. An increase in the rates of mineralization of radiolabeled substrates with exposure was used as an indication of adaptation. For some compounds, such as chlorobenzene and 1,2,4-trichlorobenzene, slight mineralization was observed but no adaptation was apparent during incubations of over 8 months. Other compounds demonstrated three patterns of response. For m-cresol, m-aminophenol, and aniline intermediate rates of biodegradation and a linear increase in the percent mineralized with time were observed. Phenol, p-chlorophenol, and ethylene dibromide were rapidly metabolized initially, with a nonlinear increase in the percent mineralized with time, indicating that the community was already adapted to the biodegradation of these compounds. Only p-nitrophenol demonstrated a typical adaptation response. In different samples of soil from the same layer in the aquifer, the adaptation period to p-nitrophenol varied from a few days to as long as 6 weeks. In most cases the concentration of xenobiotic added, over the range from a few nanograms to micrograms per gram, made no difference in the response. Most-probable-number counts demonstrated that adaptation is accompanied by an increase in specific degrader numbers. This study has shown that diverse patterns of response occur in the subsurface microbial community. PMID- 3314710 TI - Abundance and distribution of Legionellaceae in Puerto Rican waters. AB - Waters in marine and freshwater areas of Puerto Rico were analyzed for the presence of Legionella spp. by direct fluorescent antibody assay with guinea pig confirmation. Several species, including L. bozemanii, L. dumoffii, L. gormanii, L. longbeachae, L. micdadei, and L. pneumophila, were widely distributed among all sites. Legionellaceae, including L. pneumophila, were found in high densities in water collected in the rain forest from epiphytes in trees 30 ft. (about 9.25 m) above the ground. Both interspecific and intersite variations were significant. L. pneumophila was the most abundant species at all sites, with average densities of 10(4) cells ml-1, very close to the range which is potentially pathogenic for humans. Densities of L. pneumophila were highest in sewage-contaminated coastal waters. These are the highest densities of Legionella spp. ever reported for marine habitats. Densities of L. pneumophila were positively correlated with concentrations of sulfates, phosphates, and pH. A survey of 88 fatal atypical pneumonia cases at a Puerto Rico hospital showed that 15% of the patients had L. pneumophila infections. This study establishes L. pneumophila as a relatively common cause of atypical pneumonia in Puerto Rico and suggests natural aquatic habitats as possible sources or reservoirs of pathogenic Legionella spp. in the tropics. PMID- 3314711 TI - Stimulation of rat liver glycerol-3-phosphate acyltransferase activity by acid- and heat-stable low-molecular-weight substances from skeletal muscle of rats treated with insulin. AB - Experiments were conducted to examine a possible mechanism of activation of rat liver microsomal glycerol-3-phosphate acyltransferase (GPAT) by insulin. Fractions of Mr 1100 were prepared from hind-limb muscles of rats, which had been given intravenous injections of insulin or saline, by a procedure which involved acidification (pH 3.8) and heating (100 degrees C), followed by chromatography on Sephadex G-25 in 50 mM formic acid. These fractions were shown to modify the activity of microsomal GPAT from the livers of fed rats which had not been treated with insulin. The difference in GPAT activity between microsomes supplemented with the Mr 1100 material and those treated with an equal volume of 50 mM formic acid from before the void volume of the column was determined. Relative to the formic acid control, the Mr 1100 material from saline-treated rats decreased GPAT activity, whereas Mr 1100 material from insulin-treated rats increased GPAT activity and the difference of 0.64 nmol/min/mg microsomal protein was significant (P less than 0.01). Fractions of approximately 3000 Da were found to behave in a similar manner and caused a significant (P less than 0.01) increase in GPAT activity of 0.46 nmol/min/mg microsomal protein. These substances, which stimulate GPAT activity, may be related to the putative insulin mediator substance. PMID- 3314712 TI - Comparison of angiotensinogen and tetradecapeptide as substrates for human renin. Substrate dependence of the mode of inhibition of renin by a statine-containing hexapeptide. AB - The kinetic properties of two different substrates for human renin, a synthetic tetradecapeptide and the natural substrate human angiotensinogen, have been compared. While the Vmax was similar for the two substrates, the Km values differed by a factor of 10, i.e., 11.7 +/- 0.7 microM (tetradecapeptide) and 1.0 +/- 0.1 microM (angiotensinogen). The mode of inhibition of renin by a statine (Sta)-containing hexapeptide, BW897C, that is a close structural analog of residues 8-13 of human angiotensinogen (Phe-His-Sta-Val-Ile-His-OMe), was determined for the two substrates. Competitive inhibition was observed when tetradecapeptide was the substrate (Ki = 2.0 +/- 0.2 microM), but a more complex mixed inhibition mode (Ki = 1.7 +/- 0.1 microM, Ki' = 3.0 +/- 0.23 microM) was found with angiotensinogen as substrate. This mixed inhibition probably results from the formation of an enzyme-inhibitor-substrate or enzyme-inhibitor-product complex and reflects the more extensive interactions that the protein angiotensinogen, as opposed to the small tetradecapeptide substrate, can make with renin. We conclude that the mixed inhibition observed when angiotensinogen is used as renin substrate could be important in the clinical application of renin inhibitors because it is less readily reversed by increased concentrations of substrate than is simple competitive inhibition. PMID- 3314713 TI - Bacterial expression and isolation of Petunia hybrida 5-enol-pyruvylshikimate-3 phosphate synthase. AB - 5-enol-Pyruvylshikimate-3-phosphate synthase (EPSP synthase, EPSPS), an in vivo enzyme target of the herbicide glyphosate (N-phosphonomethyl glycine), was purified from a Petunia hybrida suspension culture line, MP4-G, by a small-scale high-performance chromatographic purification procedure. The cDNA encoding the mature petunia EPSPS (lacking the chloroplast transit sequence) was cloned into a plasmid, pMON342, for expression in Escherichia coli. This clone complemented the EPSPS deficiency of an E. coli aroA- mutant, and the plant enzyme constituted approximately 1% of the total extractable protein. Large-scale purification of the enzyme from E. coli cells resulted in a highly active protein which was homogeneous as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and amino terminal sequencing. Antibodies raised against the purified enzyme also reacted with the E. coli EPSPS in Western analyses. The availability of large quantities of the plant enzyme will significantly facilitate mechanistic investigations as well as a comparative study with EPSPS from bacteria and fungi. PMID- 3314715 TI - [Introduction of a new anticancer drug, novantrone]. AB - Novantrone (mitoxantrone) is a novel anticancer drug, having an anthraquinone structure. This compound was selected from many candidate compounds for purpose to find out a drug having lesser cardiac toxicity than doxorubicin and excellent antitumor activities. In the Japanese clinical trials, Novantrone was proved to be active against breast cancer, malignant lymphoma and acute leukemia. Major side effects observed in the clinical trials were: GI-tract toxicities, and mild alopecia, mild disturbance in the circulatory organs, fever and dermatological toxicities. PMID- 3314714 TI - [Clinical trial of SM-108 in myeloproliferative disorders]. AB - SM-108 (4-carbamoylimidazolium-5-olate) is a new purine antagonist which blocks IMP dehydrogenase, the key enzyme of de novo GMP biosynthesis. Eleven patients were entered into a clinical study of SM-108 for the treatment of myeloproliferative disorders. These included 10 cases of chronic myelogenous leukemia (CML) and one case of essential thrombocythemia (ET). Two cases of CML had received prior chemotherapy. SM-108 was given orally at a dose of 400 600mg/m2 daily. Of nine evaluable cases, four cases of CML achieved complete responses and two cases of CML achieved partial responses (response rate = 66.7%). The duration of drug action was short, and the daily dosage required adjustment at frequent intervals. Long-term response without therapy has not been seen with SM-108 in CML. There was no response in the case of ET. The side effects included constipation (1/11), diarrhea (1/11) and mild hepatic toxicity (1/11). No cardiac or renal toxicity was observed. PMID- 3314716 TI - PUVA-induced blisters, complement deposition, and damage to the dermoepidermal junction. AB - We followed the course of 56 patients receiving psoralen plus long-wave ultraviolet light (PUVA) therapy. Nonhemorrhagic blisters developed on clinically normal skin on the limbs of seven patients. Seeming to be related to friction and trauma, the blisters form as a result of damage to the basal and suprabasal layers. Perilesional skin specimens from all blistered patients contained granular deposits of C3 at the dermoepidermal junction, around the upper dermal blood vessels, or at both sites. The average time for initiation and complete formation of suction blisters was measured in 51 patients at different stages during the course of PUVA treatment. Blister separation was in the lamina lucida, with the pemphigoid antigen in the roof while the blister floor contained the lamina densa, laminin, and type IV collagen. This impaired dermoepidermal adhesion was a general phenomenon that occurred in all PUVA-treated patients. The mechanism remains to be determined. PMID- 3314717 TI - Topical minoxidil therapy for androgenetic alopecia. A 30-month study. AB - Seventy-two adult male patients were entered into a double-blind, placebo controlled investigation using 2% to 3% topical minoxidil solution for androgenetic alopecia. Fifty-nine patients completed the initial 12 months, and continued to use 3% topical minoxidil solution in an open study design. Hair regrowth (as measured by hair counts and bald-area diameters) was noted in all treatment groups at four months, and appeared to peak at approximately 12 months. At 30 months, mean hair counts had decreased from the 12-months level, but remained elevated over baseline counts, while mean bald-area diameters returned to baseline. However, 70% of the patients who did continue to use the drug for 30 months had 50% or more hairs than when they originally started the drug therapy. A subset of patients appeared to sustain a continued increase in hair counts after 12 months. No systemic side effects were noted. PMID- 3314718 TI - Evaluation of anthralin in the treatment of alopecia areata. AB - Anthralin cream 0.5% to 1.0% was used to treat 68 patients with severe alopecia areata. Therapy was relatively well tolerated, although all patients experienced pruritus and local erythema and scaling. Cosmetic response was seen in 17 (25%) of the patients, and was maintained during therapy in 12 (71%) of the 17 cosmetic responders. For the patients treated with 0.5% anthralin, the mean time to response (44 of 66 patients) was 11 weeks; the mean time to cosmetic response (13 of 66 patients) was 23 weeks. Duration of the current episode of hair loss did not correlate with cosmetic response. Compared with other currently available topical treatments, anthralin appears to be a reasonable therapeutic option for severe alopecia areata. PMID- 3314719 TI - Continuous four-channel EEG monitoring in the evaluation of echodense ultrasound lesions and cystic leucomalacia. AB - Continuous monitoring by electroencephalography (EEG) was performed in 31 preterm infants with echodense ultrasound lesions using the Oxford Medilog four channel recorder. In 12 infants these densities preceded cyst formation, eight in the periventricular and four in the subcortical region. In the 19 other infants the densities resolved. The most severe EEG depression occurred in the four infants with subcortical cysts, who also had the poorest outcome. Six of eight infants with periventricular lesions had lesser degrees of abnormality though all infants had moderate to severe handicap at follow up. Similar abnormalities were seen on EEG recording in three infants in whom the densities resolved without cyst formation and these infants also had an abnormal outcome. An abnormal EEG recording provides a sensitive early guide to the severity and prognosis of these lesions, even before they can be seen on ultrasonography. PMID- 3314720 TI - Ductus arteriosus blood flow during first 48 hours of life. AB - A volumetric Doppler technique was used to measure net ductus arteriosus shunt during the first 48 hours of life in 30 infants of less than 33 weeks' gestation, and in 10 full term infants. In the full term infants a left to right shunt of 62 ml/kg/minute (95% confidence limits 43-82) shortly after birth decreased rapidly over the first 12 hours and was not measurable by 48 hours. The preterm infants had smaller left to right shunts shortly after birth--49 ml/kg/minute (95% confidence limits 38-59). There was no obvious subsequent change in the mean shunt, although by 48 hours there was greater variation in the size of the shunt. The respiratory distress syndrome did not affect the size of the ductal shunt, but the shorter the gestation period the larger the shunt by 48 hours. A ductal flow of greater than 70 ml/kg/minute at 48 hours of age predicted the subsequent development of a ductal murmur with 75% sensitivity and 100% specificity. PMID- 3314721 TI - Bone marrow transplantation in the treatment of alpha-mannosidosis. AB - Bone marrow transplantation was performed in a patient with alpha-mannosidosis. To our knowledge this is the first time such treatment has been attempted. The patient died 18 weeks after successful grafting and specimens of tissues were obtained at necropsy. Alpha-mannosidase activity in spleen and liver was just below normal (spleen 102 mumol/g/hour, control 113-330; liver 29 mumol/g/hour, control 30-131). Splenic alpha-mannosidase activity was indistinguishable from the control enzyme with respect to the Michaelis constant, heat stability, and inhibition by cobalt ions, as was 86% of the liver enzyme. In brain tissue alpha mannosidase activity was 7% of controls, and less than one third had the properties of the normal enzyme. Oligosaccharides were present only in small amounts in liver and spleen, whereas they were greatly increased in brain tissue. Electron microscopic pictures of liver and spleen tissue showed normal morphology, but brain tissue showed definite vacuolation. These findings suggest that transplantation reversed the somatic changes of alpha-mannosidosis but did not affect lysosomal storage within brain tissue. It is concluded that marrow transplantation may not be a suitable treatment for alpha-mannosidosis. PMID- 3314722 TI - Tay-Sachs disease: a centenary. PMID- 3314723 TI - Mean arterial blood pressure and neonatal cerebral lesions. AB - Computerised continuous measurement of mean arterial blood pressure (MAP) and serial cranial ultrasonography in 33 infants of less than 31 weeks' gestation showed that a MAP of less than 30 mm Hg for over an hour was significantly associated with severe haemorrhage, ischaemic cerebral lesions, or death within 48 hours. No severe lesions developed with a MAP greater than or equal to mm Hg. PMID- 3314724 TI - Successful suprapubic aspiration of urine. AB - When the bladder of neonates requiring suprapubic aspiration of urine was shown to contain urine on ultrasound scanning, suprapubic aspiration was successful on the first attempt in all cases. Without prior scanning only 36% of first attempts at aspiration were successful. PMID- 3314725 TI - Perioperative dissemination of Salmonella. AB - A hypophyseal adenoma was operated on in a patient who was a carrier of Salmonella typhimurium. A chronic salmonella osteitis developed in her calvarium at the site of operation. Our case and reported experience emphasise that asymptomatic carriers of salmonella should be given perioperative antibiotic prophylaxis, especially if they are immunosuppressed. PMID- 3314726 TI - Growth hormone in short, slowly growing children and those with Turner's syndrome. AB - Results of an aborted placebo controlled trial of treatment with human pituitary growth hormone in children with Turner's syndrome and short, slowly growing children are reported. One child in each group had a considerable reduction in growth rate standard deviation score while taking growth hormone. The remaining eight patients with Turner's syndrome and 10 short, slowly growing patients who received growth hormone showed mean rises in growth rate of greater than two standard deviation scores. Neither placebo group showed a mean increase in growth rate standard deviation score. These differences were significant. PMID- 3314727 TI - Effect of diazoxide or glucagon on hepatic glucose production rate during extreme neonatal hypoglycaemia. AB - The relation between hepatic glucose production rate (HGPR) and plasma concentrations of insulin and glucagon was investigated in four term neonates who had severe hypoglycaemia. The hepatic glucose production rate was less than 20% of normal for fasting term neonates in all four babies and yet insulin concentrations were never greater than 12 microU/ml; two babies had very low glucagon concentrations (less than 60 ng/l). Two further neonates with similar histories also had plasma glucagon concentrations that were also extremely low (less than 20 ng/l). A single intravenous bolus of glucagon caused a rapid rise in hepatic glucose production rate towards the normal range, which was sustained for many hours after the bolus had been given. Diazoxide given to one baby suppressed previously 'normal' insulin concentrations still further (4.2 to less than 1.6 microU/ml) and thereby restored the hepatic glucose production rate to normal. In view of the normal plasma insulin concentrations at a time when the hepatic glucose production rate was reduced, we feel that the absolute concentration of insulin may be less important than the insulin/glucagon molar ratio in the control of glucose homeostasis in this group of infants. The changing of this ratio by means of boluses of glucagon may be useful in preventing rebound hypoglycaemia, which so often occurs when dextrose infusions are reduced either accidentally or in an attempt to restart oral feeds. PMID- 3314728 TI - Mitral valve disease in Marfan's syndrome. AB - Cardiovascular disease in Marfan's syndrome presenting in childhood affects the mitral valve more often than the aortic valve or the aorta, as in adults. Early evaluation of the cardiovascular system is necessary for any child in whom Marfan's syndrome is suspected. PMID- 3314729 TI - Polygraphic studies. AB - Polygraphic recordings have provided new information about the wide ranges of normality in various diseases and the process of maturation from birth to childhood. New techniques will help to document clinical events accurately, improve diagnosis, and evaluate treatment. PMID- 3314730 TI - Investigation of children with enuresis and urinary tract infection. PMID- 3314731 TI - Diagnosis and management of urinary tract infections. PMID- 3314732 TI - Differing lectin-binding patterns of malignant melanoma and nevocellular and Spitz nevi. AB - The lectin-binding patterns of primary malignant melanoma, nevocellular nevus, and Spitz nevus were studied on formalin-fixed, paraffin-embedded sections using a series of biotinylated lectins--concanavalin A (ConA), Ricinus communis agglutinin-1 (RCA1), dolichos biflorus agglutinin (DBA), soybean agglutinin (SBA), maclura pomifera agglutinin (MPA), peanut agglutinin (PNA), wheat germ agglutinin (WGA), and Ulex europeus agglutinin-1(UEA1)--and employing the avidin biotin-peroxidase complex method. In nevocellular and Spitz nevi, all of the nevus cells were positively stained with ConA and RCA1. No positive staining was observed, however, with the other lectins and no change in binding patterns occurred following neuraminidase pretreatment. In malignant melanoma, all of the melanoma cells were positively stained with ConA and RCA1, and some were also stained with MPA, PNA, and WGA. In addition, DBA, SBA, MPA, PNA, and WGA labeled all of the melanoma cells after neuraminidase pretreatment. No positive staining was observed with UEA1 despite neuraminidase pretreatment. The present results showed that malignant melanoma and nevocellular and Spitz nevi have different lectin-binding patterns and different responses to neuraminidase pretreatment. We, therefore, believe that the lectin staining on paraffin-embedded sections can be a useful probe for the differentiation of these diseases. PMID- 3314733 TI - Disseminated cicatricial pemphigoid in a child and in an adult. Ultrastructural diagnostic criteria and differential diagnosis with special reference to acquired epidermolysis bullosa. AB - The first case of an infant affected with a rare, disseminated variant of benign cicatricial pemphigoid is described, showing the same ultrastructural features of initial blister formation as an adult patient. These consist in edematous changes within the superficial dermis caused by vesiculation or dissolution of cellular and noncellular connective tissue elements, coalescing into subepidermal blisters. Differential diagnosis excludes other nonhereditary bullous disorders because of the ultrastructure of the dermo-epidermal junction in nascent blisters and in perilesional skin. In spite of evident clinical, histological, and immunohistological similarities as well as controversial and confusing immunological studies, acquired epidermolysis bullosa can be clearly separated from our case by a diagnostic hallmark on the electron-microscopical level, i.e., band-like IgG depositions beneath the basal lamina. This is demonstrated in comparing the two cases of disseminated cicatricial pemphigoid with three patients suffering from acquired epidermolysis bullosa, thus providing evidence that disseminated cicatricial pemphigoid and acquired epidermolysis bullosa are two distinct nosologic entities. PMID- 3314735 TI - Effect of UVB radiation on the skin after allogeneic bone-marrow transplantation in man. PMID- 3314734 TI - Effects of colchicine and cytochalasin B on distribution of concanavalin A receptors in isolated and cultured guinea pig epidermal cells. AB - Regulation of the distribution of concanavalin A (Con A)/receptor complexes by the cytoskeletal contracture system was studied in guinea pig epidermal cells in suspension and culture using the fluorescence double staining method. After treatment with 100 micrograms/ml of Con A at 37 degrees C for 30 min lectin/receptor complexes were endocytosed by the less-differentiated cells in suspension and by the adherent cells in 1- and 3-day cultures that represent a growing cell fraction. The same treatment resulted in diffuse surface distribution of the complexes in the well-differentiated cells in suspension. Colchicine (10(-5) and 10(-6) M) inhibited internalization of the complexes with resultant diffuse distribution in 60% of the adherent cells in culture. Cytochalasin B (5 and 10 micrograms/ml) not only inhibited endocytosis but promoted formation of surface patchy clumps of the complexes in suspended, less differentiated cells and cultured adherent cells. The distribution profile was not influenced by these drug treatments in the well-differentiated cells. SDS polyacrylamide gel electrophoresis and autoradiography of 125I-labelled epidermal membranes revealed several Con A-reactive polypeptides common to the cells at various differentiation steps. The progressive decrease in endocytosis and mobility of Con A/receptor complexes was suggested to occur with differentiation. In the germinative cells the distribution of lectin/receptor complexes seemed to be regulated by microfilaments and microtubules. PMID- 3314736 TI - Chromosomal aberrations in native small mammals (Peromyscus leucopus and Sigmodon hispidus) at a petrochemical waste disposal site: I. Standard karyology. PMID- 3314737 TI - Non-uterine gynecological sarcomas. AB - Sarcomas represent only 2%-3% of all female genital tract malignancies. Only 10% occur outside the uterus (vulva, vagina, ovaries, fallopian tubes, uterine ligaments). The morphology of these tumors is sometimes confusing. Sarcomas are often not diagnosed before they reach a very advanced stage. A large percentage of sarcomas occur in very young women. Treatment is not satisfactory and the prognosis has remained bad despite the use of chemotherapy for some tumors (e.g. embryonal rhabdomyosarcoma). Improvements in diagnosis and therapy require pooling of experience and the establishment of an appropriate tumor registry. PMID- 3314738 TI - Immunocytochemical identification of mitotic Hofbauer cells in cultures of first trimester human placental villi. AB - In cultures of first trimester human placental villi, mitotic Hofbauer cells have been identified using a combined autoradiographic and immunostaining technique for the demonstration of HCG, a marker for Hofbauer cells. PMID- 3314739 TI - Cervical pregnancy: case reports and current concepts in diagnosis and treatment. AB - Cervical pregnancy produces profuse but painless vaginal bleeding. After ultrasound diagnosis early in pregnancy, preservation of the uterus is possible. After the 12th week, hysterectomy is almost always necessary. We review current concepts in the diagnosis and management of cervical pregnancy. PMID- 3314740 TI - [Retroperitoneal liposarcoma. Diagnostic and therapeutic judgement. Synthetic review]. PMID- 3314741 TI - [Diagnostic and therapeutic aspects of cystine lithiasis]. PMID- 3314742 TI - [Giant congenital hydronephrosis of the adult. Contribution of a new case]. PMID- 3314744 TI - [Bladder leiomyosarcoma. Review and contribution of a case]. PMID- 3314743 TI - [Transitional cell papilloma of inverted type: contribution of 2 new cases and review of the literature]. PMID- 3314745 TI - Dialysis down under. PMID- 3314746 TI - Patient access to renal replacement therapies in South Africa. PMID- 3314747 TI - Immunosuppressive protocols: triple and quadruple drug therapy. PMID- 3314748 TI - Carcinoma of the ampulla of Vater. AB - Thirty-five consecutive cases of adenocarcinoma of the ampulla of Vater seen over the past 36 years were reviewed. The introduction of new diagnostic techniques over the course of this study improved the accuracy of preoperative diagnosis but did not lead to earlier diagnosis. The surgical resectability rate was 88%, and 53% of postoperative survivors were free of disease at 5 years. Of the 14 patients with metastases to regional lymph nodes, 27% survived disease-free for 5 years. Surgical mortality was 25% for the entire series but has been reduced to 6.6% over the past decade. Surgical mortality was primarily due to leakage of the pancreaticojejunostomy; the risk of pancreaticojejunostomy leak correlated inversely with the degree of chronic pancreatitis in the pancreatic remnant. In 35% of resected cases, a benign adenomatous component was contained within the cancer of the ampulla of Vater. Cure rates are good for this lesion. The most important factor in maximizing cure rate is careful attention to the technical details of pancreaticojejunostomy in order to minimize surgical mortality. Benign adenomas appear to be a frequent precursor of carcinoma of the ampulla of Vater. PMID- 3314749 TI - Estimation of oxygen utilization by dual oximetry. AB - Total body oxygen utilization coefficient was estimated using continuous pulse and pulmonary artery oximetry (dual oximetry) in 17 patients with respiratory failure. Change in arterial and mixed venous oxygen saturations was induced by altering airway pressure. Continuous measurement of mixed venous oxygen saturation provided an accurate and linear estimate of oxygen utilization coefficient (r = -0.92), the true values being overestimated by 0.05 +/- 0.06 (mean +/- SD). Addition of pulse oximetry improved the correlation (r = 0.93) and decreased the difference between absolute values (0.02 +/- 0.06). Oxygen utilization coefficient can be estimated reliably in an online fashion using pulmonary artery oximetry. However, the use of dual oximetry will further improve the estimate. PMID- 3314750 TI - Effect of optimization of hemodynamics on fibrinolytic activity and antithrombotic efficacy of external pneumatic calf compression. AB - External pneumatic calf compression is effective but imperfect for antithrombotic prophylaxis in surgical patients. In preliminary studies, sequential filling of multisegmented leggings with graded pressure decreasing from ankle to knee increased venous flow velocity and wall shear stress, decreased residual venous volume, and enhanced postoperative fibrinolysis more than uniform compression. To determine if improved hemodynamics also increased antithrombotic activity, we performed a prospective randomized trial in neurosurgical patients comparing sequential application of graded pressure with uniform pressure applied to either a segmented bladder or to a single bladder. Deep vein thrombosis was diagnosed by leg scanning and impedance plethysmography and confirmed by phlebography. Venous thrombosis developed in 3 of 45 patients with graded-sequential filling, 6 of 50 with uniform compression-multiple compartments, and 3 of 41 with uniform pressure single bladder (differences not significant). These results suggest either that uniform compression offers all that can be expected of external pneumatic calf compression in prevention of venous thrombosis, or that even if a study with greater statistical power showed graded-sequential filling to be superior, the benefit/cost ratio of the more complex latter system is not likely to be large. PMID- 3314751 TI - The selective use of antilymphocyte serum for cyclosporine treated patients with renal allograft dysfunction. AB - Eighty-seven adult renal allograft recipients were initially treated with cyclosporine-prednisone immunosuppression. Thirty patients experienced no episode of rejection. Antilymphocyte antibody therapy (ALS) was administered to 21 of the 68 recipients of cadaveric donor allografts for either primary allograft dysfunction or acute rejection, and to 6 of 19 recipients of haploidentical, living-related allografts because of steroid-resistant rejection. The cumulative allograft and patient survival for the entire series (follow-up 9-36 months) was 84% and 95%, respectively. This improvement in the rate of successful transplantation can be attributed to the selective addition of ALS therapy to recipients with specific instances of renal allograft dysfunction. In this report, the indications for the use of ALS preparations following prophylactic CsA immunosuppression are reviewed. Experience with the protocols of the ALS administration is also discussed. In selected cases, the administration of either ATG or OKT3 can significantly benefit CsA recipients who experience either primary allograft nonfunction or an epidose of acute rejection. PMID- 3314752 TI - Improved results from a standardized approach in treating patients with necrotizing fasciitis. AB - Necrotizing fasciitis has been associated with significant morbidity and mortality. Thirty-three patients were studied over a 3-year period. Predisposing factors included intravenous drug abuse (30%), diabetes (21%), and obesity (18%). Severe pain (94%) and abnormal temperature (88%) were present, whereas laboratory data and x-ray were nonspecific. Gram-positive organisms were most frequently recovered (B-hemolytic streptococcus 45%). Treatment consisted of antibiotics, surgical debridement, re-exploration 24 hours before surgery, nutritional support, and early soft tissue coverage as needed. Mean duration from admission to operation was 43 hours. The average number of operative debridements was three and the average length of hospitalization was 47 days. Patients operated on less than 12 hours from admission or greater than 48 hours had shorter hospital stays (36 and 38 days). The critical time period was 12-48 hours after admission; all deaths and amputations were in this group and the average hospital stay was 62 days (p less than 0.05). The number of operations did not correlate to hospital stay. Despite antibiotics and aggressive debridement, significant morbidity exists if operation is delayed more than 12 hours. Methods of early detection such as local bedside diagnostic incision and fascial inspection may be needed in high risk patients to further reduce the morbidity and mortality. PMID- 3314753 TI - Hydatid liver disease, is it a diagnostic problem? Analysis of 42 consecutive cases in Saudi patients. AB - Analysis of 42 patients clinically suspected of having hydatid liver disease is presented. Diagnosis was made using clinical criteria, serology, skin tests and non-invasive imaging techniques. The distribution of the cysts according to age, sex, location and number is discussed. It is suggested that histopathological study is no longer essential to confirm the diagnosis of hydatid disease of the liver. PMID- 3314754 TI - Number of chromosomes, Feulgen-DNA content, and nuclear phenotypes in domestic and wild specimens of Panstrongylus megistus. AB - Specimens of Panstrongylus megistus with different levels of adaptation to a domestic way of life had some of their nuclear and chromosomal characteristics compared, in an attempt to differentiate them by cytological means. The number of chromosomes in male testes was found not to differ. The nuclear frequency and phenotypes of the Malpighian tubules were also found to be the same. On the other hand, Feulgen-DNA values of metaphase chromosomes in insects from a population with a sylvatic distribution were found to be larger than those in specimens from a domestic population. The differences in Feulgen-DNA values, however, may not represent real differences in DNA content, but may possibly be due to differences in DNA-protein complexes. PMID- 3314755 TI - Comparison of different methods for determining pyrimethamine susceptibility in P. falciparum malaria. AB - Resistance against pyrimethamine was determined for Plasmodium falciparum adapted to continuous culture and for 'wild' isolates. The IC50 values were found by incubating for 48 hours or 48 + 24 hours (the last 24 hours without drug) and counting either the total parasites or the ring forms only. It was found that in continuous, asynchronous cultures the IC50 values were not significantly influenced by the choice of method. The IC50 value found when counting ring forms only were slightly lower than those obtained by counting the total number of parasites, but the confidence limits did overlap. The same was the case for the 48 hours and 48 + 24 hours tests. The isolates collected directly from patients with acute malaria were incubated for 48 hours. The percentage of ring forms in the control wells varied between 21% and 63% after 48 hours, indicating that the plasmodial cycle could be prolonged under test conditions. The IC50 values were estimated in two ways, by counting either the total parasitaemia or the ring forms only. On theoretical grounds, estimating the IC50 value from the number of ring forms is the most satisfactory method, as this number corresponds to the number of undamaged schizonts. The IC50 values found by 3H-hypoxanthine incorporation were lower than those found by any other method. PMID- 3314756 TI - Plasmodium falciparum: improved method for continuous in vitro cultivation without daily medium replacement. PMID- 3314757 TI - Lung transplantation: a new era. PMID- 3314758 TI - Survival following nonpenetrating traumatic rupture of cardiac chambers. AB - We report the cases of 3 patients who survived cardiac chamber rupture resulting from blunt external trauma. All were drivers in motor vehicle collisions. All were seen with signs of pericardial tamponade and were treated by pericardiocentesis followed by emergency thoracotomy performed in the operating room. Ruptures of the right atrium and right and left ventricles were repaired by manual suture techniques without cardiopulmonary bypass. The cases of 37 previously reported patients who survived this injury are reviewed. We believe that patients with cardiac rupture who reach the hospital alive can often be saved by prompt diagnosis and immediate surgical treatment. PMID- 3314759 TI - Improved technique for the proximal anastomosis with free internal mammary artery grafts. AB - A method for construction of the proximal aortic anastomosis using an autologous pericardial patch for free internal mammary artery bypass grafts is described. The use of pericardium allows for ease of suturing without the need for saphenous vein harvesting. PMID- 3314760 TI - Acute putrid abscess of the lung. By Harold Neuhof and Arthur SW Touroff. 1936. AB - This 51-year-old report detailed the principles of operative treatment of acute putrid abscess of the lung in the era prior to antibiotic availability. The technical aspects of the surgical approach advocated by Neuhof and Touroff were based on careful clinical and pathological review. In an era of increasing immunosuppressive therapy, both for transplantation and the treatment of malignant disease plus the emergence of new diseases such as acquired immune deficiency disease, there may be a re-emergence of lung abscess in patients too sick to undergo resection. Hence, the technique has present applicability. PMID- 3314761 TI - Preoperative assessment of pulmonary function. PMID- 3314762 TI - Manifestations of sepsis. AB - The clinical manifestations of sepsis may be flagrant or subtle. Awareness of the signs and symptoms of sepsis allows early recognition and prompt, appropriate management. The clinical presentation, relative frequency, and current pathophysiologic understanding of the manifestations of sepsis are reviewed. Special emphasis is placed on the cardiopulmonary manifestations, which are examined in a temporal sequence of preshock, early shock, and late shock states. While therapy for the underlying infection (such as antibiotics and drainage of abscesses) is often sufficient, therapy for the specific manifestations of sepsis may also be necessary. Guidelines for therapy for these manifestations of sepsis are given. PMID- 3314763 TI - Should the elderly hypertensive be treated? Evidence from clinical trials. AB - Clinical trials for over 15 years have addressed the therapeutic utility of treating elderly hypertensives. Many early trials showed no treatment effects. Because of the recent publication of new information, a review of available evidence concerning this issue was undertaken. Eight randomized clinical trials were assessed regarding trial design. The studies varied according to generalizability, diagnostic criteria, choice of therapy, outcome measures assessed, evaluation of compliance, methods of analysis, duration of follow-up, determination of side effects, and ability to exclude a type 2 error. While many of the earlier studies found no treatment effects, they lacked methodologic rigor; more recent studies demonstrated positive treatment effects. Pooling of results from similar trials supports a notable treatment effect in the prevention of stroke. There is also evidence that the elderly are not more susceptible to side effects of antihypertensive drugs, as is generally believed. The best evidence suggests the hypertensive elderly should be treated. PMID- 3314764 TI - Isolated cardiac aspergillosis after bone marrow transplantation. AB - A 15-year-old girl developed isolated cardiac aspergillosis after allogeneic bone marrow transplantation. Predisposing factors included severe graft-vs-host disease with gastrointestinal tract involvement and immunosuppressive therapy including cyclosporine. The patient died of cardiopulmonary failure 11 weeks after transplantation. PMID- 3314765 TI - Acquired hypertrichosis lanuginosa associated with malignancy. AB - A patient is described with acquired hypertrichosis lanuginosa associated with malignancy; the case history and pathologic findings are described. The literature, consisting of 35 cases, is analyzed in respect to the hormonal and pathologic findings, and the age and sex of the patients. No definite hormonal cause is as yet assignable to this syndrome. PMID- 3314766 TI - Shigella bacteremia in adults. A report of five cases and review of the literature. AB - Shigella bacteremia is rare, occurring mainly in children. We describe five adult patients with Shigella bacteremia and review data on 22 cases reported in the English-language medical literature. Eighteen (67%) of 27 patients had either an underlying condition or were aged older than 65 years. Most patients had clinical signs of acute febrile gastroenteritis. However, in six patients, the organism was not isolated from stool. Species isolated from blood included Shigella flexneri in 11 patients, Shigella sonnei in eight, and Shigella boydii and Shigella dysenteriae in one patient each. Isolation of the bacterium from blood only was associated with a high mortality rate, in contrast to its isolation both from blood and stool. It is suggested that blood cultures should be obtained from elderly or immunocompromised patients with acute febrile gastroenteritis to detect shigellemia as well as bacteremia caused by other enteric pathogens, such as Salmonella or Campylobacter. PMID- 3314767 TI - Isolation and composition of the constitutive agglutinins from haploid Saccharomyces cerevisiae cells. AB - Sex-specific agglutinins from the cell surface of haploid cells of Saccharomyces cerevisiae (X2180, mta and mt alpha) were purified and analysed. The constitutive agglutinin from mta cells was extractable with 3 mM dithiothreitol. It was shown to be a glycoprotein (3% mannose) with an apparent Mr of 43,000 based on gel filtration, but in SDS-PAGE it behaved as a much smaller molecule (Mr between 18,000 and 26,000). About one in three amino acids was a hydroxyamino acid. Its biological activity was resistant to boiling for 1 h, but sensitive to pronase. Intact mt alpha cells retained their agglutinability in the presence of dithiothreitol but limited trypsinizing released a biologically active agglutinin fragment. It had an apparent Mr of 320,000 (gel filtration). When analysed by SDS PAGE, a single diffuse band with an apparent Mr of 225,000 was observed. The protein was 94% (w/w) mannose with a trace of N-acetyl glucosamine. Its biological activity was almost completely lost after boiling for 1 h. Both agglutinins behaved as monovalent molecules and specifically inhibited the biological activity of both noninduced and pheromone-induced cells. Pheromone treatment of mta cells resulted in an apparent 32-fold increase in agglutinin activity at the cell surface, whereas pheromone treatment of mt alpha cells only doubled the apparent agglutinin activity. PMID- 3314769 TI - Posttraumatic stress disorder in Israeli combat veterans. Effect of phenelzine treatment. AB - Twenty-five Israeli combat veterans fulfilling DSM-III criteria for posttraumatic stress disorder (PTSD) participated in an open, prospective trial of phenelzine sulfate administration (median daily dose, 60 mg; range, 30 to 90 mg); three patients withdrew early due to side effects. Treatment was continued for at least four weeks in 22 cases and thereafter for as long as it was felt to be of benefit. Therapeutic efficacy was rated using a new PTSD scale, the Hamilton Depression Scale, and the Hamilton Anxiety Scale administered at four weekly intervals. Six patients completed four to eight weeks of phenelzine treatment; seven patients, nine to 13 weeks; and nine patients, 14 to 18 weeks. Comparison of mean prediscontinuation scores with pretreatment ratings showed, at best, only small (23% to 38%) differences (on the PTSD and Hamilton Anxiety scales) in the group treated for nine to 13 weeks. Two patients with a concurrent diagnosis of panic disorder and two with a concurrent diagnosis of dysthymic disorder were the most improved symptomatically but fell short of clinically significant remission. Although statistically significant improvement was observed on seven of the 12 items of the PTSD scale, sleep disturbance was the only symptom showing a clinically impressive change. These results only partially support previous positive reports of phenelzine treatment of PTSD. PMID- 3314768 TI - [Passive immunoprophylaxis of dysentery in suckling pigs using maternal vaccination with attenuated Escherichia coli mutants. 2. Clinical and laboratory results of the combined use of three K88-, K99- and 987-p-containing types derived from Escherichia coli mutants]. PMID- 3314771 TI - Randomized clinical trials in breast cancer: a tabular summary. Part 2: Advanced breast cancer. PMID- 3314770 TI - Electroencephalographic spectra and coherence in the diagnosis of Alzheimer's type and multi-infarct dementia. A pilot study. AB - The accurate diagnosis of dementia is difficult because there are no specific physiologic tests. Computer-analyzed electroencephalography (EEG) has shown promise as a tool for the differential diagnosis of dementia, but topographic methods for data collection and analysis have seldom been used. We used these methods to investigate EEG differences among three groups of elderly subjects: those with mild to moderate dementia of the Alzheimer's type (DAT), those with mild to moderate multi-infarct dementia (MID), and age- and sex-matched normal controls. The two groups of demented subjects were distinguished from the control group by a new criterion, the ratio of high-frequency to low-frequency electrical activity in the left temporal region, which was greatly diminished in demented subjects. Using this single variable, all control subjects and 15 of 18 demented subjects were correctly classified (sensitivity 83%, specificity 100%). The three misclassified subjects were among the least impaired subjects with DAT. Examination of coherence, or synchronization of the EEG signal, enabled us to distinguish subjects with DAT from those with MID. Using discriminant analysis of both EEG frequency and coherence, 92% (22/24) of subjects were accurately classified. These results justify further evaluation of topographic, computer based EEG analysis as a test for the differential diagnosis of dementia. PMID- 3314772 TI - [Attempt at determining the origin of the skull in the collection of the Czartoryski Museum]. PMID- 3314773 TI - [Jan Baptysta Boeckler, court physician of Stanislaus II Augustus (Poniatowski)]. PMID- 3314774 TI - [Polish physicians graduates of Vienna University. VI (T-Z)]. PMID- 3314775 TI - [Medical and surgical practice in paintings, sculpture and caricature. II. The iconography]. PMID- 3314776 TI - [The tragedy of human life and social pathology (marginalia on the philosophical reflections of Miguel de Unamuno)]. PMID- 3314777 TI - [Blood transfusion and fluid infusion in Poland in the 19th century]. PMID- 3314778 TI - [From Heberden to Pawinski and Bieganski]. PMID- 3314779 TI - [The problem of abortion in Polish gynecological literature in the second half of the 19th century]. PMID- 3314780 TI - [Reflections on the borderline between philosophy and medicine. The problem of the origin of scientific language]. PMID- 3314781 TI - [Hermann von Helmholtz (1821-1894) as the creator of psychophysiological optics and acoustics]. PMID- 3314782 TI - [Two contributions to the youthful literary production of Wladyslaw Matlakowski]. PMID- 3314784 TI - [The Krzywda-Lazowski family--Galician pharmacists (I)]. PMID- 3314783 TI - [Dr. Teodora Krajewska, the official physician in Dol. Tuzle and Sarajevo]. PMID- 3314785 TI - Ontogeny and regulation of the immune system. AB - Classic studies in embryology and contemporary research in immunology and molecular biology have disclosed the carefully orchestrated events leading to development of the immune system and immunoregulation that ultimately provide immunohomeostasis. During ontogeny, the pluripotential stem cell emerges and differentiates into all hematopoietic lineages, including three major immunologically relevant components: T-cell differentiation occurs within the thymus; B cells appear within fetal liver, adult bone marrow, and possibly other abdominal sites; and concurrently, the monocyte-macrophage system develops. Under the influence of an array of cytokines and cellular interactions, immune regulation is established. T and B lymphocytes elaborate genetically encoded messages that acquire specificity via transposable genetic elements. Receptors and cytokines provide immune recognition, communication, regulation, and memory for antigens. Inherited and acquired defects in ontogeny and immune regulation are the basis for immunodeficiency disorders. PMID- 3314786 TI - Molecular basis of selected primary immunodeficiency disorders. AB - Three primary immunodeficiency conditions are discussed: X-linked agammaglobulinemia, severe combined immunodeficiency, and the X-linked lymphoproliferative syndrome. Each condition is associated with a fascinating history since publication of the original description. To a large extent, the immunologic features of these conditions have been defined. Now, the power of recombinant DNA technology is being employed to dissect the molecular mechanisms central to each disease. This review traces the history of these X-linked conditions. Particular emphasis is focused on the molecular defects thus far exposed. In the end, the knowledge provided by this technology will facilitate genetic counseling, define the nature of the gene defects, provide a logical rationale for therapy, and elucidate the role of the X chromosome in lymphocyte ontogeny. PMID- 3314787 TI - The thymus gland in secondary immunodeficiency. AB - The microenvironment within the thymus gland and various thymic hormones facilitates the maturation of prothymocytes to functional T lymphocytes. Abnormal thymic morphology is a hallmark feature of several primary and secondary immunodeficiencies. Thymus glands from patients with the acquired immunodeficiency syndrome or graft-vs-host disease and from patients receiving cyclosporine A therapy are depleted of thymocytes, have a striking reduction in thymic epithelial cell mass, and are virtually devoid of Hassall's corpuscles. In malnourished individuals, similar thymic atrophy is present, although the Hassall's corpuscles are present and cystically dilated. Absence of differentiation antigens or anomalous expression of major histocompatibility antigens occurs on thymic epithelial cells in these conditions, and resembles immunologic abnormalities of the thymus in severe combined immunodeficiency. In acquired immunodeficiency syndrome, graft-vs-host disease, and cyclosporine therapy, there is an expansion of cytotoxic/suppressor (CD8) lymphocytes. Experimental evidence suggests that in many situations, such cells may cause damage to the thymic epithelium. The damage to the thymic epithelium may alter the thymic microenvironment and contribute to the immune dysfunction observed in these patients. In addition, a damaged microenvironment may hinder therapeutic efforts to reconstitute immunity. PMID- 3314788 TI - What is the significance of ceroid in human atherosclerosis? AB - This review of the significance of ceroid within the atherosclerotic intima proposes that the macrophages have a central role to play in its production. Ceroid is more than merely an "age pigment." It marks the site of previous oxidative events, possibly including the release of biologically active or toxic, soluble oxidized molecules. This being so, this activity of macrophages may have a significant role in the progression of the lesions. The interactions of macrophages and oxidizable unsaturated lipids therefore merit further investigation. PMID- 3314789 TI - Thyroid carcinosarcoma. AB - A thyroid carcinosarcoma composed of follicular carcinoma intermixed with osteosarcoma and chondrosarcoma was studied. Results of immunoperoxidase staining for thyroglobulin were positive in the areas of follicular carcinoma and negative in the sarcomatous component. Likewise, the carcinomatous areas showed thyroid epithelial characteristics by ultrastructure, while the sarcomatous areas showed typical mesenchymal differentiation. This is an extremely rare neoplasm, with only 16 cases reported in the literature. It occurs predominantly in elderly women, is thought to arise through a process of neoplastic metaplasia, and has a uniformly dismal prognosis. Immunoperoxidase and ultrastructural studies, the first reported in such lesions, proved helpful in ascertaining the sarcomatous nature of the anaplastic, mesenchymal component of this unusual and aggressive neoplasm. PMID- 3314790 TI - Low-energy helium neon laser treatment of thumb osteoarthritis. AB - Eighty-one patients with symptomatic osteoarthritis of the thumb took part in a blinded, controlled study to assess the effectiveness of 0.9 mw continuous wave HeNe laser treatment. The subjects were randomly placed in either a control group or a treatment group. In each group the carpometacarpal (CMC), metacarpophalangeal (MCP), and interphalangeal (IP) joints of the most symptomatic thumb were "treated" with 15 sec irradiations at four equally spaced intervals around each joint three times a week for three weeks. The same protocol was used for both groups except that a hidden switch on the laser was placed in the "on" position for the treated group and in the "off" position for the control group. Although the laser-treated group noted slightly lessened tenderness of the treated MCP and IP joints (p less than 0.01 and 0.05, respectively, Wilcoxon signed-rank test), and a small increase in three-finger chuck pinch strength (p less than 0.04, paired t-test), changes in ROM, pain, joint tenderness, grip and pinch strength, activity level, and medication use, did not significantly differ between the groups. Adverse effects were rare (one in each group), minimal, and subjective. We conclude that HeNe laser irradiation at 0.9 mw is safe, but that it is not an effective treatment of osteoarthritis of the thumb. PMID- 3314792 TI - James Ewing, MD: contemporary oncologist exemplar. The James Ewing lecture. PMID- 3314791 TI - Teen contraception: a review of perspectives on compliance. AB - National attention has been drawn to the near epidemic rates of teen-age pregnancy in this country, with greater psychological understanding of this problem cited as a research need. This paper reviews available literature on teen contraceptive compliance with particular focus on the development of self regulation. In this first section, programs designed to enhance teens' choice and use of birth control are reviewed, with specific attention given to emerging issues and methodological concerns. In the second section, studies that examine factors predictive of contraceptive use in teen-age girls are discussed. This literature is grouped according to three conceptual systems: medical perspectives, behavioral theory, and self-regulation and self-control approaches. A summary is presented, specifying ways in which conceptually based research findings can assist in program development to address the problem of teen pregnancy. PMID- 3314793 TI - The significance of local control in the primary treatment of breast cancer. Lucy Wortham James clinical research award. AB - Two sequential clinical trials were carried out to compare wide excision with radical mastectomy in patients with early breast cancer with clinically negative nodes. In the first study there was an increased incidence of local recurrence in patients who had wide excision, but distant recurrence and survival were unaltered. In the second study, the distant recurrence and survival rates were also significantly impaired. A new analysis showed that there were significantly more patients with T1 tumors in the second study than in the first. Comparison of treatments by T status indicates that radical mastectomy gives significantly better results in patients with T1 tumors. There is no difference between the results of the two treatments in patients with T2 tumors. We comment on the implications of these findings for conservation treatment of early breast cancer. PMID- 3314794 TI - Local recurrence in adult soft-tissue sarcoma. A randomized trial of brachytherapy. AB - We conducted a prospective randomized study of the benefit of adjuvant radiation therapy delivered by the brachytherapy technique in 117 adult patients who had soft-tissue sarcoma that was on an extremity or superficially localized to the trunk. A significant decrease in local recurrence was demonstrated in the patients receiving brachytherapy. The benefit did not appear to be due to any maldistribution in the known prognostic factors of size, site, depth, presentation with recurrence, or histologic grade. The decrease in local recurrence appears to be due to the decreased local recurrence in high-grade sarcomas. Survival differences were not identified, and accrual and follow-up were continued. PMID- 3314795 TI - Cytologic diagnosis of occult breast lesions using stereotaxic needle aspiration. A preliminary report. AB - In mammographically detected breast lesions, only 10% to 25% of biopsy specimens are malignant. Furthermore, the current method of needle localization of these lesions is cumbersome and inefficient. Stereotaxic needle aspiration was used to examine 84 patients. Successful localization with the needle tip within 1 to 2 mm of the suspected lesion was possible in 80 cases (95.2%). Following aspirate cytology, the lesion was localized with indigo carmine and Kopans' wire and every patient underwent a standard open excisional biopsy. Twelve cases of breast cancer were diagnosed histologically. Eleven of these cases were correctly diagnosed cytologically, while one case yielded a false-negative result. In the remaining 72 histologically benign cases, four lesions were reported cytologically to be atypical. There were no complications. Stereotaxic needle aspiration localizes occult breast lesions precisely and in conjunction with mammography, and it is an acceptable preoperative method of diagnosing nonpalpable breast tumors. PMID- 3314796 TI - [Asthmatic children and swimming training. 4. Neutrophil chemotactic activity in the supernatant of human lymphocytes and monocytes challenged with phytohemagglutinin and house dust mite allergen]. PMID- 3314797 TI - [The effect of a specific antagonist of PAF (CV-3988) on airway hyperresponsiveness induced by ozone exposure in beagles]. PMID- 3314798 TI - Acifran: a double-blind, randomized, placebo-controlled efficacy study in type IIa hyperlipoproteinemic patients. AB - The antihyperlipoproteinemic agent acifran (AY-25,712) was administered double blind to 14 Type IIa hyperlipoproteinemic patients for 12 weeks in dosages of 100 mg t.i.d. or 300 mg t.i.d. An additional seven patients received placebo. Fasting plasma lipid and lipoprotein concentrations were determined at baseline (mean of 3 values), Week 8 (mean of 6- and 8-Week values), and Week 12 (mean of 10- and 12 Week values). At Week 8, patients receiving acifran 100 mg t.i.d. showed low density lipoprotein (LDL) cholesterol levels which were 13% lower than pretreatment baseline (p less than 0.01) and 14% lower than patients given placebo (p less than 0.05); high-density lipoprotein (HDL) cholesterol levels were 11% higher compared with either baseline or the placebo group (p less than 0.05); the LDL/HDL ratio was 20% lower than baseline (p less than 0.001) and 21% lower than the placebo group (p less than 0.05); total cholesterol was 8% lower than that of the placebo group (p less than 0.05). There was no apparent relationship between changes in plasma lipid concentrations and acifran dose or treatment duration except for triglycerides, which at Week 12 were 25% lower than baseline (p less than 0.001) and 35% lower than the placebo group (p less than 0.05) only in the acifran 300 mg t.i.d. group, in which HDL-cholesterol was concurrently 18% higher compared with placebo (p less than 0.05). In this 12-week study acifran provided safe and effective treatment for Type IIa hyperlipoproteinemia. PMID- 3314800 TI - [Histochemical determination of SH-groups and cobalt in the tissues for characterizing recovery processes in an experiment]. PMID- 3314799 TI - [Comparative anatomical study of the synovial membrane in representatives of 4 classes of terrestrial vertebrate]. AB - The synovial membrane (SM) of some representatives of four terrestrial vertebrate classes was studied by means of scanning electron microscope (SEM). The figures of SM of the mammals (man, mini-pig), birds (fowl, Gallus domesticus L.), reptiles (lizard, Lacerta viridis Laur. and turtle, Testudo graeca L.) and amphibians (frog, Rana esculanta L.) are documented. The SM of all animal species investigated presents a great locally variable appearance in form and surface arrangement of the living cells. The surface of synoviocytes is mostly very rough, forked, the cells having a plenty of wart-like, spiny-like or leaf-like microvilli, with cytoplasmic projections protruding from cell bodies. The largest possible functional surface of SM in mammals is formed by multiple villi and folds, whereas in other animal classes--by a specific arrangement of the lining cells. Locally variable appearance of synoviocytes from human and rabbit joints was described by Date (1979); we have documented the same in birds, reptiles and amphibians, as well. Three characteristic types of locally variable appearance of the surface lining cells were picked out in representatives of the every animal class cited. These cells correspond to the histological types, classified by Key. Beside these basic types, a number of transitory cells appear, that increase the diversity of the appearance of the lining cells in different regions of the SM. We may conclude that all the synoviocytes present the largest possible functional surface, although their external form differs. Their cytoplasm contains all sorts of organelles necessary for synthesis and secretion of mucopolysaccharides of the synovial liquid, as well as for the resorption and phagocytosis. PMID- 3314801 TI - [A review of material on the problems of teaching anatomy, histology and embryology in medical institutes published in the journal Arkhiv anatomii, gistologii i embriologii during 1980-1985]. PMID- 3314802 TI - [Immunomorphological (light and electron microscopic) diagnosis of human squamous cell cancer using monoclonal antibodies]. AB - It is shown with fluorescent and peroxidase labels for antibodies that the antigen to which the monoclonal antibody A-6/2 is directed, is a marker for cells of the basal stratified epithelium (basal-cell antigen). This antigen persists in squamous cell carcinomas of various sites and degrees of differentiation, but does not occur in tumors of other origins. With electron immunocytochemistry, the antigen was found to be located in tonofilaments and desmosomes of human squamous cell carcinoma. The A-6/2 monoclonal and basal-cell antigen may be used when developing immunomorphologic (light- or electronmicroscopic) procedures for histogenetic diagnosis of these carcinomas. PMID- 3314803 TI - [On the centenary of the birth of I. V. Davydovskii]. PMID- 3314805 TI - [Large intestine obstruction due to a gallstone]. AB - A case of an internal cholecystogastric fistula that closed spontaneously and combined with low large-intestinal obstruction due to a gallstone is described. Other, similar cases reported in the literature are reviewed. PMID- 3314804 TI - [Function of the gastric immune apparatus in duodenal peptic ulcer patients from the standpoint of age]. AB - Results of immunomorphological studies carried out on 48 stomachs resected for duodenal ulcerous disease are reported. Mucosal inflammation described as "immune" and varying in degree in an age-related manner (being lowest in patients aged over 60) was noted in the pyloric part of the stomach. It is shown that the immune inflammation of gastric mucosa in duodenal ulcer patients is mediated by humoral immunopathological mechanisms involving, essentially, locally produced antibody, although delayed-type reactions are also possibly implicated. PMID- 3314806 TI - [Probucol in patients with diabetes mellitus type II with hypercholesterolemia]. PMID- 3314807 TI - [Etiopathogenesis of primary arterial hypertension]. PMID- 3314808 TI - [Severe arterial hypertension. Use of the discriminant function to establish the differential diagnosis]. PMID- 3314809 TI - [Acute hemodynamic and cineangiographic effects of propatyl nitrate in symptomatic ischemic cardiopathy]. PMID- 3314810 TI - [Comparative study of vasodilator drugs in heart valve diseases]. PMID- 3314811 TI - Complex partial seizures of childhood onset. A five-year follow-up study. AB - Few detailed studies have examined the long-term outcome of complex partial seizures (CPS) in children and adolescents. Previous studies have selected patients on clinical criteria only or have included those with benign focal epileptiform discharges of childhood, nonepileptiform sharp transients, and generalized epileptiform discharges. We have followed up 29 patients with clinically and electroencephalographically defined CPS of childhood onset for five years or more. Twelve patients are seizure free, eight of them after having epilepsy surgery. Of the remaining, eight patients have intractable seizures. Only one patient was able to discontinue anticonvulsant therapy after epilepsy surgery. No patient had spontaneous remission of seizures without anticonvulsant medications. School difficulties, behavior problems, and unemployment were seen in half the group. We believe CPS in this age group are difficult to control and need aggressive management. In selected patients, epilepsy surgery offers a good chance of seizure control and improvement of educational, social, and vocational potential. PMID- 3314812 TI - Progressive dystonia with bilateral putaminal hypodensities. AB - Three unrelated patients, aged 4, 18, and 47 years, had generalized dystonia associated with bilateral striatal hypodensities on computed tomography. Mitochondrial encephalopathy was considered to be the most likely diagnosis, but this could not be proved. These patients confirm previous reports linking acquired generalized dystonia with bilateral putaminal lesions and they highlight the problem in differential diagnosis of this clinicoradiologic syndrome. PMID- 3314813 TI - Training in neurology at the University of Michigan in the 1930s. PMID- 3314814 TI - Clinical neuroepidemiology. II. Outcomes. PMID- 3314815 TI - Vacuolar change in Alzheimer's disease. AB - A retrospective neuropathologic study of brains from 66 patients with Alzheimer's disease (AD) demonstrated the presence of a vacuolar change (VC) in 50 cases that was virtually indistinguishable histologically from the spongiform change characteristic of Creutzfeldt-Jakob disease (CJD). Indeed, in several instances, there was initial diagnostic confusion with CJD. Unlike the spongiform change in CJD, however, VC was almost entirely restricted to the medial temporal cortex and amygdala. Furthermore, the severity of VC was usually less intense than the spongiform change observed in cases of CJD with severe neurologic impairment. The VC could be readily distinguished from the fine microvacuolation of the upper layers of the isocortex reported in a number of different conditions, including AD. It also differed from the status spongiosus of the cerebral cortex that occurs in advanced AD and CJD as well as in other degenerative diseases. The artifactual rarefaction that occurs in improperly processed paraffin-embedded brain tissue was excluded as a contributory factor to the VC. Since VC does not invariably occur in AD, it conceivably could represent a subtype of this disorder or may represent a variant of the pathologic changes that can occur. Its relationship to CJD or other slow virus disorders is to date unknown but unlikely. PMID- 3314816 TI - Alteration of regional cerebral glucose metabolic rate in non-Korsakoff chronic alcoholism. AB - That chronic alcoholism yields devastating effects to the central nervous systems of its victims is well known, but the actual physiologic mechanisms underlying that deterioration have yet to be completely identified. What is also known is that many chronic alcoholics seem to recover brain function after a protracted period of abstinence, but the actual mechanisms of that restoration are also not well understood. Using positron emission tomography with the tracer 11C-2-deoxy-D glucose as a probe to measure regional cerebral metabolic rate of glucose (RCMRGlu), we compared the magnitudes of glucose consumption in 44 brain regions between a group of newly abstinent chronic alcoholics without Korsakoff's psychosis and a control group of normal nonalcoholic subjects whose range of age was that of the alcoholic group. We found that RCMRGlu measurements in the brains of alcoholics were significantly lower than in the brains of the control group, and that there were many fewer significant interregional correlations in the brains of the alcoholics than in the brains of the control group. We also found no significant correlation between age and global metabolic rate of glucose in either group. However, even though the number of alcoholic subjects was too few to allow a reliable statistical comparison, the measurements suggest that chronic alcoholics over the age of 50 years suffer a greater decrease of RCMRGlu values than do their counterparts under the age of 50 years. While resting in a bland environment, neither alcoholic nor control subjects were found to have significant differences in RCMRGlu values between their brain hemispheres. In contrast to this similarity, normal dextrous subjects responded to a nonverbal auditory stimulus by increasing the metabolic rate of glucose in their right hemispheres while eight of nine chronic alcoholics did not. The results of this pilot study point to arguments that the alcoholic brain metabolizes glucose at a lower rate than do normal brains, that there are fewer region-to-region functional relationships in the alcoholic brain than in the normal brain, and that alcoholics may be impaired in right hemispheric processing. In subsequent investigations, we will measure the metabolic changes that follow abstinence, if any, by tracking subjects throughout an interval of rehabilitation. Also, we intend to test the findings of this study by measuring greater numbers of alcoholic subjects to separate the consequences of measurement variability, age, and chance from the underlying biologic processes that seem to be affected by chronic alcoholism. PMID- 3314818 TI - Balzac's serous apoplexies. The hesitant acceptance of the discovery of the cerebrospinal fluid by Magendie. AB - The diagnosis of a "serous apoplexy," customary in the first half of the 19th century, was based on the lack of knowledge regarding the normal presence of the cerebrospinal fluid. Balzac's descriptions of three cases of serous apoplexy draw our attention to the fact that the discovery of the cerebrospinal fluid by Francois Magendie was not assimilated into clinical medicine until the second half of the 19th century. PMID- 3314817 TI - Evidence of neurologic dysfunction related to long-term ethylene oxide exposure. AB - Eight hospital workers with chronic ethylene oxide exposure were age-sex matched with eight nonexposed controls with no significant differences in educational backgrounds and vocabulary scores. The exposed group performed more poorly on all eight measures of cognition, memory, attention, and coordination, with 71.3% less accuracy on the Hand-Eye Coordination Test. There was a dose-response relationship between exposure and the following: Continuous Performance Test and sural velocity. These findings suggest that neurologic dysfunction may result from long-term low-dose exposure to ethylene oxide, and that these effects may occur at exposure levels common in hospital sterilizer operations. PMID- 3314820 TI - Dedicated to Professor A. E. W. Miles on the occasion of his 75th birthday. PMID- 3314819 TI - A radioautographic study of the effects of vinblastine on the fate of injected 45calcium and [125I]-insulin in the rat incisor. AB - To examine the effect of vinblastine on the movement of calcium and macromolecules through the enamel organ in the secretion zone and through the odontoblast layer, 45CaCl2 and [125I]-insulin were used as radioautographic tracers. Vinblastine did not alter the localization of either labelled Ca or insulin in the enamel organ and underlying enamel, but eliminated both labels in the pulp, odontoblasts and dentine. It is concluded that vinblastine has no effect on the passage of Ca and macromolecules in the enamel organ and secretory ameloblast layers, whereas its effect on the pulp and odontoblasts prevents passage of these tracers into the predentine and dentine. PMID- 3314821 TI - Professor A. E. W. Miles--the published record. PMID- 3314822 TI - Proteolytic activities in the supragingival plaque of monkeys (Macaca fascicularis). AB - Thirteen peptidase substrates were hydrolysed by this plaque. After fasting the monkeys for 24 h, the rates of hydrolysis of N-leucyl-, N-alanyl-, N-isoleucyl- and N-tyrosyl-2-naphthylamines, glycyl-L-proline 4-nitroanilide, N alpha-benzoyl DL-arginine-2-naphthylamine and L-leucyglycine were significantly increased. Changes in these peptidase activities may serve to enhance the mobilization of amino acids and peptides, and they may explain why the growth rates of dental plaque bacteria in vivo are generally unaffected by the availability of the host's diet. PMID- 3314823 TI - Computed tomography of posterior uveal melanomas. AB - Computed tomographic (CT) scans were obtained from 48 patients with posterior uveal melanoma. The CT measurements of maximal and minimal basal diameters and thickness of each tumor were compared with the assessments of these tumor dimensions obtained by ophthalmoscopic estimation (basal diameters only) and standardized A-scan ultrasonography (thickness only) and with the gross pathologic measurements of these tumors. The correlation between measurements of tumor thickness by CT scanning, standardized A-scan ultrasonography, and gross pathologic analysis was substantially better than that between the CT, ophthalmoscopic, and gross pathologic measurements of tumor basal diameters. Computed tomographic scanning appears to be a good method for determining the in vivo size of choroidal and ciliary body melanomas. PMID- 3314824 TI - Acanthamoeba keratitis and infectious crystalline keratopathy. AB - Two cases of Acanthamoeba keratitis and infectious crystalline keratopathy, occurring simultaneously, are presented. Three and 12 months after initiating topical corticosteroid therapy in cases 1 and 2, respectively, alpha-hemolytic Streptococcus viridans was cultured from each cornea. Topical corticosteroid therapy was initiated for the treatment of an annular stromal opacity, presumably secondary to herpes simplex keratitis. Acanthamoeba was identified in culture following penetrating keratoplasty in case 1, and Acanthamoeba polyphaga, Acanthamoeba rhysodes, and Acanthamoeba castellanii were identified using indirect fluorescent antibody staining in case 2. Histopathologic examination and electron microscopy demonstrated sheets of cocci within stromal lamellae characteristic of infectious crystalline keratopathy and double-walled encysted organisms typical of Acanthamoeba. These case reports alert one to the possibility of developing bacterial keratitis, such as infectious crystalline keratopathy, following the use of topical corticosteroids for the treatment of Acanthamoeba keratitis. PMID- 3314825 TI - Scarring of a recipient cornea following epikeratoplasty. AB - A recipient cornea gradually developed wrinkling and opacification in Bowman's layer following an uneventful myopic epikeratoplasty. The process continued after removal of the lenticule, and the best corrected visual acuity decreased from 20/20 to 20/60. Glare, especially at night, severely compromised the vision in this eye. Six months after removal of the lenticule, a homoplastic myopic keratomileusis was performed to remove the corneal opacity and correct the residual myopia. Morphologic analysis of the patient's excised cornea demonstrated wrinkles and folds in Bowman's layer. To our knowledge, this is the first reported case of scarring of a patient's own cornea after epikeratoplasty and of treatment of a failed epikeratoplasty with homoplastic myopic keratomileusis. PMID- 3314826 TI - General remarks on the role of the vestibular system in weightlessness. AB - Different methods are described to experimentally achieve weightlessness. Since the function of the otolith system depends on the presence of contact forces opposing gravity, it is disabled in weightlessness and may send misleading positional information to the brain. Without the contributions of the otolith system it is difficult in space to distinguish self-motion from object motion. Furthermore, the disintegration of information from the neck position receptors from those of the otolith system can lead to additional illusory positional sensations. Since the function of the semicircular canal system in previous space flights was found to be essentially undisturbed, the vestibular experiments in the Spacelab-D1 missions concentrated more on the otolith system. The function of other orientational cues from the visual system, the semicircular canal system and proprioception can be studied in isolation from the otolith system in space. In the Spacelab-D1 mission, the space vestibular sled was used as a device for studying linear acceleration. The vestibular helmet "permitted" video and EOG recordings of all eye movements and provided caloric and optokinetic stimulation. Various factors contributing to static and dynamic forms of space sickness are identified. PMID- 3314827 TI - Effect of spaceflight on thresholds of perception of angular and linear motion. AB - Psychophysical studies of vestibular function have been carried out in order to study adaptation within the vestibular sensory system to the weightless environment of orbital spaceflight. No significant change in the threshold of detection of whole-body angular acceleration was found, either during flight or post-flight. Experiments involving the perception of whole-body linear acceleration have yielded somewhat inconsistent results, although the weight of evidence points to an elevation and increased variability of threshold in the first few days following spaceflight. Although a change in the excitability of the saccular and macular otoliths in microgravity cannot be excluded, it is more probable that this decreased sensitivity is a manifestation of a central adaptive mechanism, in which the "weighting" of gravi-receptor information is reduced. Enhancement of the ability to detect linear acceleration stimuli, exhibited by some astronauts in microgravity, may be a manifestation of heightened utilization of cutaneous rather than otolithic cues. PMID- 3314828 TI - Light and electron microscopic studies of localized laryngeal amyloidosis. AB - We performed light and electron microscopic studies in a case of localized supraglottic laryngeal amyloidosis involving a 55-year-old woman. Tissue specimens were stained with hematoxylin and eosin, and alkaline Congo red with or without permanganate (KMnO4) treatment, and were also examined with peroxidase antiperoxidase immunohistochemistry. Biopsy specimens from the epiglottis showed diffuse replacement of the subepithelial region by amyloid, which showed a typical green birefringence under polarized light. Tissue affinity for Congo red was persistent after the KMnO4 treatment. However, the tissue sections showed a positive reaction only to the anti-P component antibody. Electron microscopic studies revealed some disorders of the plasma cells, suggesting that these cells play an important role in focal production of amyloid fibrils. PMID- 3314829 TI - The electromagnetic spectrum and the dentist. A biophysical review. PMID- 3314830 TI - Glass ionomer cement fissure sealants applied by operative dental auxiliaries- retention rate after one year. PMID- 3314831 TI - Autologous bone marrow transplantation: present status and future prospects. PMID- 3314832 TI - Does colchicine work? The results of the first controlled study in acute gout. AB - We have performed the first controlled study of colchicine in acute gout, to determine its efficacy and toxicity, and to define the natural history of acute gout. Two-thirds of colchicine-treated patients improved after 48 hours, but only one-third of the patients receiving placebo demonstrated similar improvement. The colchicine-treated patients responded earlier; significant differences from placebo were shown after 18-30 hours. All patients given colchicine developed diarrhea after a median time of 24 hours (mean dose of colchicine 6.7 mg). This side effect occurred before relief of pain in most patients. PMID- 3314833 TI - Dialysis and transplantation in patients with renal failure due to systemic lupus erythematosus. The Australian and New Zealand experience. AB - Between 1977 and 1985, 5726 patients in Australia and New Zealand entered end stage renal failure programmes. Of these, 63 patients had renal failure due to systemic lupus erythematosus (a prevalence of 1.1% of patients entering renal replacement programmes). When compared with patients with other forms of glomerulonephritis, there was a female preponderance and a younger age distribution in patients with renal failure due to lupus nephritis. Integrated patient, dialysis, and transplant survival data showed that results in patients with renal failure due to lupus nephritis were comparable with those in patients with other forms of glomerulonephritis or in patients with renal failure due to any cause. Age at entry significantly affected survival, with significant differences being found in those patients under as opposed to over 50 years of age. Causes of death in patients with lupus nephritis were similar to those in patients with renal failure due to other causes. It is concluded that dialysis and transplantation are acceptable forms of treatment for patients with end stage renal failure due to systemic lupus erythematosus. PMID- 3314834 TI - Palm island reconsidered. Was it copper poisoning? AB - The clinical features of the 'Palm Island mystery disease' cannot be explained on the basis of toxocariasis, nor do they correlate with the known manifestations of algal toxicity. A detailed review of acute and chronic copper poisoning in humans and laboratory animals supports this as a possible explanation for the epidemic. The mechanisms involved in copper intoxication are discussed briefly, and a scenario is proposed to explain the occurrence and pathogenesis of the outbreak. PMID- 3314835 TI - What's new in wound healing. PMID- 3314836 TI - A diamond jubilee. PMID- 3314837 TI - Therapeutic endoscopy in the biliary tract. PMID- 3314838 TI - Myocardial preservation 1987: what is the state of the art? AB - The principles of myocardial preservation by hypothermic cardioplegia are: to induce cardiac arrest rapidly, to minimize energy requirements and prevent ischaemic damage during arrest, and to avoid reperfusion injury after arrest. These principles are put into practice by infusing an effective cold cardioplegic solution at the beginning of ischaemia and then every 20-30 min throughout ischaemia. Myocardial temperature should be maintained below 15 degrees C in all areas of the myocardium by topical cooling, efficient venous drainage and cardiac venting. The use of an oxygenated blood-based cardioplegic solution produces a modest improvement in myocardial recovery compared with a non-oxygenated crystalloid solution. During coronary reperfusion after arrest, ventricular distension should be avoided and coronary pressure should be sufficiently high to perfuse all areas of the myocardium, especially in patients with coronary stenoses. Developing areas in myocardial preservation include metabolic supplementation of the myocardium, the use of free radical scavengers, the prevention of atrial arrythmias and the use of coronary sinus cardioplegia. The increasing numbers of high risk patients presenting for surgery should stimulate the surgeon to adhere closely to the basic principles of myocardial preservation and to apply existing cardioplegic techniques meticulously. It should also challenge the investigator to increase basic understanding and improve methodology in this important area of cardiac surgery. PMID- 3314839 TI - Current status of neck dissection in the management of squamous carcinoma of the head and neck. AB - Classical radical neck dissection (RND) remains the primary treatment for clinically positive lymph nodes among patients with squamous carcinoma of the upper aerodigestive tract. Recurrence rates following RND range from 20 to 70% depending on the number of nodes involved and the extent of extracapsular spread. Modified radical neck dissection (MRND) is associated with less cosmetic and functional morbidity than RND but, used alone, MRND is only appropriate when clinical neck disease is absent or minimal. Both RND and MRND should be combined with adjuvant postoperative radiotherapy when more than one node is positive or extracapsular spread is present. This approach will significantly decrease regional failure, but may not improve survival because of an increased incidence of distant metastases. MRND is especially useful as an elective procedure to stage the clinically negative neck. A survival benefit from elective neck dissection, however, remains to be demonstrated. PMID- 3314840 TI - Sir Douglas Shields (1876-1952): a forgotten Australian surgeon. AB - The remarkable and colourful career of Sir Douglas Shields of Melbourne is unparalleled among Australian surgeons of his generation: Murray Morton describes it as a romance. He graduated in 1897 and was, in turn, a country general practitioner, the principal medical officer of an overcrowded plague-ship bringing home soldiers from the Boer War, senior surgeon of St Vincent's Hospital, Melbourne then, in London, surgeon-in-chief of his own hospital converted to the 'Hospital for Wounded Officers' with promotion to the ranks of brigadier-general and rear-admiral, then knighted and, finally, a consultant surgeon with private hospitals in Park Lane and in Cannes, and with patients largely drawn from the aristocracy, the rich and the famous. His name is now virtually forgotten in Australia but, for many years after he left Melbourne in 1912, stories used to be told about his career and experiences, many of which had little basis in fact, and even the two brief biographical accounts of his career by Murray Morton and Ormond Smith contradict each other. This paper will, I hope, help to preserve the memory of Sir Douglas Shields whom Ormond Smith considered 'one of the brightest ornaments of the Medical School of the Melbourne University'. PMID- 3314842 TI - Veterinary surgeons in Geelong. PMID- 3314841 TI - Implantation of rectal tumour at the site of circum-anal purse-string suture. PMID- 3314843 TI - Pulmonary clearance and lesions of lung and air sac in passively immunized and unimmunized turkeys following exposure to aerosolized Escherichia coli. AB - Two groups of young turkeys, one passively immunized with homologous hyperimmune serum and the other unimmunized but receiving normal turkey serum, were aerosolized with Escherichia coli. Clearance of bacteria from lung and gross and microscopic lung and air-sac lesions were determined after necropsy at timed intervals. The group mean bacterial count in lungs of passively immunized turkeys was significantly less than the mean count in unimmunized turkeys. Lung lesions were generally similar in both groups and were focused in lymphoid nodules, at the junction of primary and secondary bronchi, and at the ostia to the air sacs. Unimmunized birds developed grossly evident purulent airsacculitis by 72 hours after aerosol exposure, whereas passively immunized birds did not. PMID- 3314844 TI - Routine screening of gynaecological and obstetric patients for Chlamydia trachomatis. AB - Chlamydia trachomatis infection of the cervix uteri was diagnosed in 9% of 221 gynaecological and obstetric patients. Infection occurred more commonly among obstetric (12.6%) than gynaecological patients (5.5%). In obstetric patients chlamydial infection was commoner in those complaining of excessive vaginal discharge or spontaneous premature rupture of the membranes. Chlamydial infection in gynaecological patients occurred in those with previous pelvic infection, menstrual disorders or excessive vaginal discharge. No cases of chlamydial infection were detected among intrauterine device users. The enzyme immunoassay we used is an easy and relatively quick method of diagnosis for genital chlamydial infection. PMID- 3314845 TI - Chlamydia trachomatis isolation in women attending a VD clinic in Auckland, New Zealand. AB - Chlamydia trachomatis was isolated from 120 of 504 women (24%) attending a VD clinic at Auckland Hospital. Epidemiological correlates indicated a sexual mode of transmission. The only symptom of significance was lower abdominal pain. Cervicitis was more common in women with chlamydia, especially if they were on hormonal contraceptives. Chlamydia was isolated more commonly in women with gonorrhoea (52%) and genital warts (37%). The high incidence of asymptomatic and unsuspected infection emphasizes the need for routine chlamydial culture in VD clinics. PMID- 3314846 TI - Massive multiple theca lutein cysts complicating nonmolar pregnancy. AB - A case of massive bilateral multiloculated theca-lutein cysts occurring in association with a nonmolar singleton pregnancy is described. Surgical removal of the cysts became necessary and was followed some weeks later by the spontaneous rupture of the membranes at a nonviable stage of gestation. PMID- 3314847 TI - Early midtrimester oligohydramnios: a sign of poor fetal prognosis. AB - The outcome of 6 pregnant women with second trimester oligohydramnios in the absence of ruptured membranes before 20 weeks' gestation is reported. The overall prognosis of these pregnancies was poor with only 2 survivors. Review of the literature confirms the poor outcome of such pregnancies. PMID- 3314848 TI - Assessing dementia. Part I: Difficulties, definitions and differential diagnosis. AB - Despite the pressures of an increasingly ageing population and an ever increasing scientific knowledge, the clinical characteristics of dementia remain poorly defined. This relative lack of clarity in clinical understanding has led to diverse diagnostic problems, including those of mistaken diagnosis as well as over- and under-diagnosis in different settings. This paper focuses on the syndromal and aetiological diagnosis of dementia by outlining current clinical definitions, considering differential diagnosis in detail and reviewing characteristics of common dementing disorders. The past emphasis on a search for treatable causes, the reliance on laboratory investigations and the concept of subcortical dementia are all questioned. Aspects of evaluation that are stressed include the value of brief objective cognitive testing, a knowledge of normal age related cognitive changes, flexible criteria for Alzheimer's disease and a comprehensive individualised evaluation of the person. Broader assessment issues will be dealt with in a second paper. PMID- 3314849 TI - Drugs and prisons. AB - For as long as it has existed, our Australian society has been attempting to deal with addiction and criminal behaviour. Both crime and the taking of illicit drugs are reflections of the divisions, hatreds and wretchedness that have long existed within our society and within the individuals that comprise it. The prison, as a micro-society, brings the larger problems into an intense focus, with consequent difficulties for those who must administer it. This essay is concerned with those difficulties, their history and their management. PMID- 3314850 TI - Panic disorder: evidence for genetic vulnerability. AB - Many studies have suggested that a genetic predisposition to the development of panic disorder exists. These studies are examined and their limitations discussed. It is suggested that only by the analysis of comprehensive family and twin data, coupled with other measures such as the search for possible single gene association or linkage and study of the children of panic disorder patients, will the mechanism for the 'familiarity' noted in panic disorder patients be elucidated. Delineation of the mode of transmission of panic disorder may allow preventative intervention with those at risk before they develop panic. PMID- 3314851 TI - Ainslie Dixon Meares. PMID- 3314852 TI - Considerations in prescribing preflight aerobic exercise for astronauts. AB - Many human responses to the weightless environment have been documented from actual spaceflights. These include physiological effects on the nervous system, cardiovascular system and fluid balance, and the musculoskeletal system, as well as psychological effects. Simulations on Earth have added to our knowledge about the physiology of weightlessness. Early data on orthostatic intolerance after real and simulated spaceflight led some scientists to discourage a high level of aerobic fitness for astronauts. They believed it was detrimental to orthostatic tolerance on return to Earth. However, most of the data available today do not support this contention. Furthermore, aerobic fitness is beneficial to cardiovascular function and mental performance. Therefore, it may be important in performing extra-vehicular activities during flight. Some astronauts claim exercise enhances their feeling of well-being and self image. And, although the cardiovascular system and exercise performance may recover more slowly after flight to preflight levels when fitness level prior to flight is high, the musculoskeletal system may recover more rapidly. Research is needed to determine optimal levels of aerobic training for performing tasks in flight, maintaining health and well-being during flight, and assuring satisfactory recovery on return to Earth. PMID- 3314853 TI - Otolith-organ mechanics: lumped parameter model and dynamic response. AB - The otolith organs comprise a second-order system whose response is overdamped and whose dynamics can be expressed by two time constants. The long time constant has been experimentally measured at 10 s. The short time constant is approximately 0.0002 s using a maximum mechanical displacement criterion for the otoconial layer. With these two values determined, the system dynamic response indicates that, between the two system corner frequencies, the peripheral sensory cells (primary Type II cells) report skull velocity information to the central nervous system, and striolar cells (primary Type I cells) report skull acceleration information to the central nervous system. Below the lower corner frequency, peripheral sensory cells report skull acceleration information to the central nervous system, and striolar sensory cells report rate of change of acceleration information to the central nervous system. PMID- 3314854 TI - Physiologic adaptation of man in space. VII International Man in Space Symposium. February 10-13, 1986, Houston, Texas. Selected papers. Dedicated to Sidney D. Leverett, Jr. PMID- 3314856 TI - [Surgical peritalar reposition with lengthening of the lateral ray of the foot in congenital flatfoot (talus verticalis)]. PMID- 3314855 TI - [Antibiotics--preventive use in hip alloarthroplasty]. PMID- 3314858 TI - [Adjustment of protective age limits]. PMID- 3314857 TI - [Legal punishability of homosexuality--an evaluation from the criminologic viewpoint]. PMID- 3314860 TI - [Familial sexual crime--new emotionalization of an old drama]. PMID- 3314859 TI - [Heterosexual corruption--sexual interaction and criminalization in Paragraph 182 of the penal code]. PMID- 3314861 TI - [Manipulation of growth]. PMID- 3314862 TI - [The Royal Veterinary School in Berlin, 1840]. PMID- 3314864 TI - Participation of ATP in the binding of a yeast replicative complex to DNA. AB - The activity that replicates yeast DNA in vitro can be isolated from cells of the budding yeast Saccharomyces in a high-Mr (approximately 2 X 10(6] form. Several lines of evidence indicate that this fraction contains a multiprotein replicative complex. A functional assay has been developed for the analysis of the interaction of the replicating activity with DNA. Binding of the activity required Mg2+, but did not require the addition of ATP or the other ribo- or deoxynucleoside triphosphates. However, the ATP analogues adenosine 5'-[gamma thio]triphosphate and adenosine 5'-[beta gamma-imido]triphosphate blocked the binding, suggesting that ATP participates in the interaction at some stage. The binding was template (origin)-specific in either the presence or the absence of ATP and the other nucleoside triphosphates; however, ATP stabilized the replicating activity. The preferential inhibition of binding that was observed in the presence of the DNA topoisomerase II inhibitor coumermycin suggests that the requirement for ATP may be at least partially accounted for by the involvement of this enzyme in the initial interaction of the replicating activity with DNA. Finally, the binding was rapid. In contrast, DNA synthesis displayed a lag when assayed directly without first allowing a period for the replicating activity to bind to the DNA. In addition, binding was 'tight', as judged by the resistance of the protein--DNA complexes to salt in comparison with the relative sensitivity of binding. The replicating activity was not readily displaced from the complexes by exogenous DNAs, either possessing or lacking yeast origins of replication. The results suggest that the interaction of the replicating activity with the DNA occurs in more than one stage. PMID- 3314865 TI - Insulin reverses effects of starvation on the activity of pyruvate dehydrogenase kinase in cultured hepatocytes. AB - In tissue culture of hepatocytes, insulin (0.1-1 munits/ml for 4 h) reversed completely the effects of starvation of rats to decrease the activity of pyruvate dehydrogenase (PDH) complex and to increase the activities of PDH kinase and PDH kinase activator protein. It had no effect in hepatocytes from fed rats. Significant effects of insulin were detected with 0.01 munit/ml after 4 h, and in 1-2 h with 1 munit/ml. PMID- 3314866 TI - Mechanisms of leucine- and theophylline-stimulated insulin biosynthesis in isolated rat pancreatic islets. AB - To extend previous observations on the mechanisms of translational regulation of insulin biosynthesis [Welsh, Scherberg, Gilmore & Steiner (1986) Biochem. J. 235, 459-467], we have now compared the intracellular distributions of insulin mRNA after stimulation of insulin biosynthesis by glucose, leucine or theophylline. In comparison with low glucose (3.3 mM) only, the presence of 10 mM-leucine + 3.3 mM glucose resulted in the transfer of insulin mRNA from the pool of the uninitiated mRNA to the free polysome/monosome fraction and an increase in the amount of insulin mRNA associated with the microsomal fraction. Islets exposed to 5 mM theophylline + 3.3 mM-glucose also showed a decreased content of uninitiated insulin mRNA in the cytosol, but these islets showed no increase in insulin mRNA in the microsomal fraction. These results suggest that leucine, a nutrient stimulant of insulin biosynthesis, acts essentially by the same mechanisms as those of glucose, whereas theophylline acts only to stimulate initiation rates. PMID- 3314863 TI - Protein engineering. The design, synthesis and characterization of factitious proteins. PMID- 3314867 TI - Stimulation by D-glucose of mitochondrial oxidative events in islet cells. AB - D-Glucose catabolism was examined in rat pancreatic islets and tumoral insulin producing cells (RINm5F line) exposed to D-[5-3H]glucose, D-[3,4-14C]glucose or D [6-14C]glucose. In normal islets, a rise in D-glucose concentration from 2.8 to 16.7 mM augmented (i) the transfer of NADH, presumably via the glycerol phosphate shuttle, into the mitochondria, (ii) the decarboxylation of pyruvate and (iii) the oxidation of acetyl residues, even when the flow rates were expressed relative to the total rate of D-glucose utilization. Islet cells are thus organized to favour those mitochondrial oxidative events yielding the major fraction of the energy derived from the catabolism of D-glucose. In tumoral islet cells of the RINm5F line, all three oxidative mitochondrial processes, when expressed relative to the overall rate of D-glucose utilization, occurred at a low rate and failed to increase in response to the rise in D-glucose concentration. These findings emphasize the importance of distal regulatory processes in the control of D-glucose catabolism in normal islet cells, and document the perturbation of such processes in a model of dysfunction for this fuel-sensor organ. PMID- 3314868 TI - Rational construction of a 2-hydroxyacid dehydrogenase with new substrate specificity. AB - Using site-directed mutagenesis on the lactate dehydrogenase gene from Bacillus stearothermophilus, three amino acid substitutions have been made at sites in the enzyme which we suggest in part determine specificity toward different hydroxyacids (R-CHOH-COOH). To change the preferred substrates from the pyruvate/lactate pair (R = -CH3) to the oxaloacetate/malate pair (R = -CH2-COO-), the volume of the active site was increased (thr 246----gly), an acid was neutralized (asp-197----asn) and a base was introduced (gln-102 - greater than arg). The wild type enzyme has a catalytic specificity for pyruvate over oxaloacetate of 1000 whereas the triple mutant has a specificity for oxaloacetate over pyruvate of 500. Despite the severity and extent of these active site alterations, the malate dehydrogenase so produced retains a reasonably fast catalytic rate constant (20 s-1 for oxaloacetate reduction) and is still allosterically controlled by fructose-1,6-bisphosphate. PMID- 3314870 TI - Synthesis of 4R- and 4S-tritium labeled NADPH for the determination of the coenzyme stereospecificity of NADPH: protochlorophyllide oxidoreductase. AB - A rapid and easy method for the production of both the 4R and 4S tritium labeled isomers of either NADH or NADPH has been developed. The method requires the use of only a single labeled compound (D-[1(-3)H] glucose), and two enzymes (glucose dehydrogenase from Bacillus sp. and alcohol dehydrogenase from Thermoanaerobium brockii) which are specific for the pro S and pro R hydrogens, respectively, of either NADH or NADPH. The 4R and 4S tritium labeled isomers of NADPH have been used to determine that NADPH:protochlorophyllide oxidoreductase from etiolated wheat was specific for the pro S hydrogen of NADPH. PMID- 3314869 TI - Biochemical and immunochemical similarity between erythrocyte membrane aspartic proteinase and cathepsin E. AB - An aspartic proteinase previously thought to be unique to erythrocyte membranes, termed "EMAP", has been shown to be closely related to cathepsin E. Enzymic comparison revealed that these two enzymes resembled each other in molecular weight, susceptibility to pepstatin and chromatographic behaviors on DEAE Sephacel and Mono P chromatofocusing columns. They were immunoprecipitated by antiserum against human EMAP in a similar way. Immunochemical similarity between the two enzymes was also substantiated by immunoblot analysis. PMID- 3314871 TI - Effector studies of 3'-azidothymidine nucleotides with human ribonucleotide reductase. AB - The 5'-mono-, di- and triphosphate derivatives (N3dTMP, N3dTDP and N3dTTP respectively) of 3'-azidothymidine (N3dThd), a new drug for the treatment of the acquired immune deficiency syndrome (AIDS), were synthesized. The abilities of these analog nucleotides to mimic the effector properties of the corresponding thymidine nucleotides with human ribonucleotide reductase were studied. Surprisingly, the mode of inhibition of CDP reduction by dTTP and dTDP was found to be competitive versus CDP. The Ki values were 22 and 78 microM respectively. Inhibition by N3dTTP and N3dTDP was considerably weaker, with Ki values of 1200 and 550 microM. Neither dTMP nor N3dTMP produced significant inhibition at concentrations up to 500 microM. dTTP was an essential activator for GDP reduction. In the presence of the accessory activator, ATP, the activation constant for dTTP was 7.8 microM. N3dTTP was neither an activator of GDP reduction nor an inhibitor of the activation by dTTP. In view of the intracellular concentrations of these analog nucleotides reached after incubations with N3dThd [Furman et al., Proc. natn. Acad. Sci. U.S.A. 83, 8333 (1986)] and the weakness of their interactions with ribonucleotide reductase, it is unlikely that the antiviral or toxic effects of N3dThd can be attributed to direct effects on this enzyme. The possible indirect effects caused by alterations in the pools of the natural effectors are discussed. PMID- 3314872 TI - [Analysis of the structure and function of creatine kinase active sites using affinity modification]. AB - Data of studies of creatine kinase from rabbit skeletal muscle (EC 2.7.3.2) by affinity labelling and affinity chromatography are reviewed. Efficiencies of these techniques are demonstrated for analysis of cooperative interactions of the enzyme's active sites, nature of non-equivalence of enzyme subunits, distances between active sites which are situated on different subunits, dynamics of enzyme substrate interactions and usefulness of affinity labelling for localization of amino acid residues in the enzyme active sites. PMID- 3314873 TI - [Localization of a histidine residue in the binding site for the initiating substrate of E. coli RNA-polymerase]. AB - E. coli RNA polymerase was selectively labelled in the presence of promoters at a histidine residue of the beta-subunit by treatment with GDP beta-imidazolide and then with [alpha-32P]UTP (or [alpha-33P]UTP). Partial cyanogen bromide cleavage of the labelled polypeptide afforded a series of "single-hit" labelled peptides, the electrophoretic pattern of which suggested that the labelling site was His1237. This conclusion was confirmed by a similar pattern obtained with products of the cyanogen bromide cleavage of a radioactive peptide obtained by the limited trypsinolysis (C-terminal peptide consisting of 423 amino acid residues). Interpretation of our earlier results in favour of His1116 as the labelling point (Dokl. Acad. nauk SSSR, 1985, v. 281, p. 723) was incorrect due to the electrophoretic "compression" of three labelled peptide bands. PMID- 3314874 TI - [Expression of a gene for hybrid protein containing the [Val8] amino acid sequence of calcitonin in yeast cells]. AB - A recombinant plasmid has been constructed, which directs the synthesis of a hybrid protein, yeast repressible acid phosphatase [Val8]calcitonin, in yeast. The plasmid contains a truncated gene (pho5) acid phosphatase lacking 96 C terminal amino acids replaced by the synthetic gene for human calcitonin and sequences required for the plasmid propagation in transformed yeast cells. A modified RIA method using immobilisation of protein extracts on solid supports was developed to monitor the expression of the hybrid protein. By use of this method, as well as by standard RIA of CNBr-cleaved protein extracts, synthesis of a calcitonin-related protein was detected in extracts of transformed strains grown under conditions inducing pho5 promoter. PMID- 3314875 TI - L-lactate enzyme electrode obtained with immobilized respiratory chain from Escherichia coli and oxygen probe for specific determination of L-lactate in yogurt, wine and blood. AB - An enzyme electrode for L-lactate measurements in various biological media was prepared with an immobilized bacterial respiratory chain fixed to a Clark electrode. The enzymatic film, which was easy to prepare, contained bacteria immobilized in gelatin, tanned with glutaraldehyde. This electrode was sensitive to 0.1 mM L-lactate and could be utilized to 10 mM. The apparent K50 was 5 mM. Less than 8% of the respiration rate with L-lactate was measured with D-lactate and succinate. The competitive inhibitors D-lactate and pyruvate had a K50 of 50 mM. They could be quantitatively measured by inhibition in a range between 5 and 50 mM. It was also possible to discriminate between L-lactate and various metabolites of the respiratory chain: L-malate, succinate, 3-glycero-phosphate or NAD(P)H. Growing E. coli on 1% D-L-lactate as the sole carbon source in minimal medium induced L-lactate respiration tenfold. All other respiratory activities remained below 10% of the activity with L-lactate. A computerized instrument allowed successive measurements every 3 min for more than 10 h with the same enzymatic film. Most of the measured samples required dilution but no clarification or purification. This enzyme electrode may have many applications in basic research (metabolism, enzymology) and applied research (blood, yogurt, juices, wine). PMID- 3314876 TI - Arthroscopic and immunohistologic characterization of knee joint synovitis in osteoarthritis. AB - We studied 10 patients who had arthritis of the knee joint, but no other signs of rheumatic disease. The clinical diagnosis of osteoarthritis was corroborated by arthroscopic evidence of characteristic cartilage degeneration. Signs of inflammation were confined to areas of the synovial membrane that lay near the cartilage; thus, the major part of the joint cavity was not affected. The intensity of the synovial inflammation varied within the areas involved, but was always most pronounced in regions rimming the cartilage. Biopsy samples selected from regions of intensely inflamed synovium contained foci of T lymphocytes, which were bordered by immunoglobulin-carrying B lymphocytes and plasma cells, as well as strongly HLA-DR positive dendritic-like cells adjoined to alpha Leu-3a+ T helper lymphocytes. In tissue samples taken from macroscopically noninflamed areas, only a few infiltrating lymphocytes were seen. Thus, the inflammatory synovial changes found in osteoarthritis appear to be anatomically restricted and of varied intensity but, when present, are microscopically indistinguishable from the changes that have been previously described as indicative of rheumatoid arthritis. PMID- 3314877 TI - Effects of psychological therapy on pain behavior of rheumatoid arthritis patients. Treatment outcome and six-month followup. AB - A randomized clinical trial was performed to evaluate a psychological treatment intervention and a social support program, compared with a control program in which no adjunct treatment was rendered, and their effects upon pain behavior, affect, and disease activity of 53 patients with rheumatoid arthritis. The psychological intervention produced significant reductions in patients' pain behavior and disease activity at posttreatment. Significant reductions were also observed in trait anxiety at posttreatment and 6-month followup. Relaxation training may have been the most important component of the psychological intervention. The social support program produced a significant reduction in trait anxiety only at posttreatment. This is the first well-controlled study to demonstrate reduced pain behavior, disease activity, and trait anxiety following psychological treatment. PMID- 3314878 TI - The effect of indication on hypersensitivity reactions associated with zomepirac sodium and other nonsteroidal antiinflammatory drugs. AB - A large, computerized database derived from Medicaid claims was used to evaluate the risk of allergy and/or anaphylaxis associated with the use of nonsteroidal antiinflammatory drugs (NSAIDs) as a class and the risk associated with the use of zomepirac relative to other NSAIDs. We compared 51,797 patients exposed to NSAIDs with 35,634 age- and sex-matched patients who had not been exposed. As a class, NSAIDs were associated with an adjusted relative risk (95% confidence interval) of hypersensitivity reactions of 2.0 (1.3-2.9). The increased risk was accentuated in those with a diagnosis compatible with acute pain (3.6 [2.2-5.9]) and absent in those without such a diagnosis (1.1 [0.6-1.9]). Comparison of those exposed to zomepirac with those exposed to other NSAIDs resulted in an age adjusted relative risk of 2.0 (1.1-4.7). Stratification by the probable indication for NSAID use again suggested that the risk may be explained by the use of the NSAIDs for different indications. We concluded that NSAIDs are associated with an increased risk of allergy and/or anaphylaxis, and the use of zomepirac appears to be associated with an increased risk compared with the use of other NSAIDs. However, that increased risk may be a function of the primary indication for the drug or, more likely, the regimen associated with that indication, rather than an intrinsic property of the drug. PMID- 3314880 TI - Biometrical aspects in the design and analysis of chimpanzees trials assessing hepatitis virus inactivation. AB - Hepatitis virus safety of products derived from blood is achieved by screening of individual blood donations and by production processes efficient in eliminating and inactivating residual amounts of hepatitis viruses. A quantitative measure of process inactivation efficiency is the inactivation factor derived from process overchallenging experiments. A product is safe if the corresponding process inactivation factor is as high as the one of a product whose safety has been clinically established. Reliable information on hepatitis safety cannot be obtained by testing commercial end product samples in chimpanzees. PMID- 3314879 TI - Beta-2-microglobulin origin of dialysis-related amyloid. PMID- 3314881 TI - Lack of mutagenic activity of ademetionine in vitro and in vivo. AB - Studies on the mutagenic activity of ademetionine (S-adenosylmethionine) tested in vitro at concentrations of 2 mg/sample and in vivo at doses up to 1500 mg/kg always gave negative responses. Moreover, a patent lack of abnormal methylated bases in the liver DNA of ademetionine-treated rats suggests that, if abnormal methylation occurs by exogenously administered ademetionine, the amount of formed methylated residues must be quite lower than that removable by the transmethylase enzymes responsible for the in vivo repair. PMID- 3314882 TI - Detection of murine S180 cells expressing a multidrug resistance phenotype using different in vitro test systems and a monoclonal antibody. AB - Doxorubicin (adriamycin) preconditioned S180 cells were more resistant to doxorubicin. The resistance was detected by three different methods (short-term test, colony assay, tissue culture assay). The doxorubicin-resistant S180 cells express the pleitrop drug resistance phenotype. There exists a multidrug resistance to doxorubicin, dactinomycin (actinomycin D), vincristine and colchicine. In addition, collateral sensitivity was found to fluorouracil (5 fluorouracil) and methotrexate. This multidrug phenotype is in accordance with the pleiotropic phenotype of colchicine-resistant CHO cells. Resistant S180 cells express a glycoprotein of Mr 170 kd determined by indirect immunofluorescence using a monoclonal antibody (Mab 265/F4) to the P-glycoprotein of colchicine resistant CHO-cells. The P-glycoprotein could be an important prognostic factors for tumors with multidrug resistance. PMID- 3314884 TI - ASHA 1987 annual convention. November 13-16, New Orleans. PMID- 3314883 TI - Phosphomycin levels in serum and interstitial tissue fluid in a multiple dosage regimen in rabbits. AB - The evolution of phosphomycin (Fosfocina), levels in serum and experimentally induced interstitial tissue fluid and the access of the drug to different organs were studied in rabbits after the administration of a single dose of 60 mg/kg and during a multiple dosage regimen of 60 mg/kg/6 h over three days. Following the administration of a single dose a Cmax value of phosphomycin in interstitial tissue fluid of 80.4 micrograms/ml was reached at 1.2 h. The elimination half life of the drug from the systemic circulation after a single dose had a value of 1.6 h, and was not significantly different from the value found for the same parameter in the multiple dosage regimen. The disappearance half-life of phosphomycin from interstitial tissue fluid, with a value of 1.9 h for the single dose schedule, was not significantly different from the value of the disappearance half-life of the drug from interstitial tissue fluid in the multiple dosage regimen. Finally, the results of the present study confirm the linearity of phosphomycin kinetics, at least in the conditions studied, and show that the drug is not accumulated in the organs considered. PMID- 3314885 TI - Relative distribution of fibronectin and type I, III, IV, V collagens in normal and atherosclerotic intima of human arteries. AB - Spatial distribution of fibronectin and type I, III, IV and V collagen has been investigated in normal arterial intima, fatty streaks, and atherosclerotic plaques by indirect immunofluorescence on transverse sections. Two distinct types of extracellular matrix were revealed in atherosclerotic lesions. The fibrous plaques consisted mostly of interstitial collagen types I and III, contained moderate amounts of type V and none of type IV collagen or fibronectin. In the extracellular matrix of the fatty streaks and in some areas of the fibrous plaques containing large amounts of subendothelial cells, some interstitial collagen was revealed, an increased amount of type IV, some type V collagen and a lot of fibronectin. Similarities of the extracellular matrix in atherosclerotic lesions and granulation tissues are discussed. PMID- 3314886 TI - Effect of insulin therapy on lipoproteins in non-insulin dependent diabetes mellitus (NIDDM). AB - Thirty patients with NIDDM and severe hyperglycemia (fasting plasma glucose greater than 200 mg/dl) were initiated on insulin therapy. Lipoprotein concentrations were measured by the Vertical Autoprofile procedure before insulin therapy and 1, 3, 6 and 26 weeks after insulin initiation. Patients were divided into 4 phenotypes based on their pretreatment lipoprotein profile: HyperVLDL (elevated VLDL), HyperLDL (elevated LDL), HyperVLDL-LDL (elevated VLDL and LDL), and non-hyperlipidemic. There were no differences in the initial fasting plasma glucose, Hgb Alc, or fasting free insulin concentrations between the groups. Both the HyperVLDL and HyperLDL groups had significantly lower HDL-C concentrations that the non-hyperlipidemic group and the HyperVLDL-LDL group had significantly higher IDL-C than any of the other groups. Insulin therapy resulted in similar decreases in fasting plasma glucose and increases in fasting free insulin concentrations in all 4 groups. HDL-C increased in all 4 groups. The most marked improvements in HDL-C were seen in the non-hyperlipidemic (+37%) and HyperLDL (+42%) groups while the HyperVLDL group had only an 18% increase. VLDL-C fell in all groups but in the HyperVLDL group it fell dramatically to almost normal levels within the first week, whereas it took 6 weeks for the HyperVLDL-LDL group to reach its VLDL-C nadir and this was still significantly higher than normal. LDL-C improved modestly in only the HyperLDL patients after 6 weeks of insulin therapy. There were no statistically significant changes in either the IDL-C or Lp(a)-C in any of the groups during insulin therapy. The changes in HDL-C and IDL C were negatively correlated with the fasting plasma glucose and Hgb Alc but not with the free insulin concentration. We conclude that: 1) Insulin therapy can cause dramatic improvements in HDL-C and VLDL-C while it has only a mild suppressive effect on LDL-C and no statistically significant effect on IDL-C or Lp(a)-C. The degree of improvement in the lipid profiles varied considerably between the different lipid phenotypes. 2) The hyperlipidemic phenotypes seen in these patients appear to be determined primarily by factors other than the degree of hyperglycemia and hypoinsulinemia. PMID- 3314888 TI - Coffee and cholesterol in epidemiological and experimental studies. AB - Twenty-two cross-sectional studies involving 130,000 persons from 8 different countries have reported their findings on the association between coffee consumption and cholesterol levels. Results of these reports display a variety of trends in the association between coffee intake and serum cholesterol concentrations: 8 (36%) studies demonstrated a significant positive association in both sexes, and 5 (23%) studies showed no association in men or women. In 3 other reports where both sexes were included, significant positive association was observed only in women. The remaining 6 investigations examined only men with 4 (18%) reporting a significant correlation between coffee and cholesterol. This unexplained incongruity of cross-sectional data points to a relationship between coffee and cholesterol in some populations, which needs to be further explored. In addition, HDL cholesterol levels appeared unrelated to coffee intake in the 11 studies in which it was measured. The 7 available human experiments showed the same low level of agreement in the results among small numbers of volunteers. Experiments involving different brewing methods suggest that a major part of the cholesterol-increasing effect can be explained by different brewing methods. A critical assessment of the published reports leads to the conclusion that the data are insufficient to warrant public health admonitions against coffee drinking, but that it may be of clinical importance in some hypercholesterolemic individuals. PMID- 3314889 TI - Arctic medical history. PMID- 3314887 TI - Prelesional events in atherogenesis. Colocalization of apolipoprotein B, unesterified cholesterol and extracellular phospholipid liposomes in the aorta of hyperlipidemic rabbit. AB - The appearance and accumulation of apolipoprotein B and unesterified cholesterol in the lesion-prone areas of the aorta in rabbits with diet-induced hyperlipidemia were investigated by histo-, and cytochemical techniques. Apolipoprotein B was detected by an indirect immunoperoxidase procedure both in the light and electron microscopy. Unesterified cholesterol was revealed using filipin and tomatine as specific probes. In the prelesional stages of atherogenesis, before the appearance of any structurally detectable lesions, as demonstrated by bright-field and fluorescence microscopy, apolipoprotein B and free cholesterol accumulated progressively in the extracellular matrix of the subendothelial space. At ultrastructural level, extracellular phospholipid liposomes, unesterified cholesterol and apolipoprotein B concomitantly appeared and accumulated focally in the same areas. Apolipoprotein B was preferentially located on the outer surface of the free cholesterol-containing phospholipid lamellae of the extracellular liposomes. In the lesional stages leading to fatty streak formation, the extracellular liposomes, apolipoprotein B and unesterified cholesterol had also topographically a superimposed localization pattern. Intracellular apolipoprotein B and unesterified cholesterol were also colocalized in some intimal lipid-laden cells. In the prelesional stages of hyperlipidemia the prevalent localization of apolipoprotein B around individual unesterified cholesterol-rich extracellular phospholipid liposomes, progressively accumulating in the subendothelial space, suggests their possible origin from serum-derived lipoproteins. PMID- 3314890 TI - Immunology for orthopedists. AB - In summary, the immune system provides two specific types of responses: humoral or B-cell immunity, and T-cell-mediated immunity to a specific stimulus. In response to a noxious stimulus, the inflammatory response utilizes some common cellular elements of the immune system and is not immunologically mediated. The antigen provides the foundation for all specific immune reactions. These molecules are unique and form the basis for transplantation immunology--the human MHC, or major histocompatibility complex. Genes code for molecules on the surface of cells which identify an individual by species-specific and individual-specific markers. Transplanted biologic materials may have cells, but they also have matrix or collagen components that are immunogenic. To determine and characterize these immune responses, a number of diagnostic methods are available. These range from routing H&E histological studies for cell population to sophisticated mitogenic stimulation assays for determining antigenicity and patient sensitization. Certainly immunobiology will be increasingly important as the use of biologic material and transplantation become more widespread. PMID- 3314891 TI - Automated cytology and histology, A historical perspective. AB - The current status of the techniques of image analysis, morphometry and DNA measurements of human cells and tissue samples is reviewed, and the goals of these various techniques, in terms of the detection, diagnosis and prognosis of human cancer, are briefly summarized. Some of the accomplishments and problems of this research are discussed, and targets of future investigations are proposed. It is quite evident that the full value of objective assessment of human cells has not yet been achieved and that many years of additional research may be required to evaluate fully their significance as a scientific tool of objective diagnostic and prognostic value. PMID- 3314892 TI - DNA cytophotometry of voided urine sediment. Comparison with results of cytologic diagnosis and image analysis. AB - Measurements of nuclear DNA were performed in urothelial cells in 54 Feulgen restained cytocentrifuge preparations of voided urine previously studied visually and with an image analysis system. The study included 30 patients with bladder tumors of various grades, 9 patients with prostatic disease and 15 control samples from normal donors. A number of additional control measurements were performed, including measurements in tissue samples of the 30 bladder tumors corresponding to the cytologic samples. It was documented that DNA can be measured in most urinary sediments. The diagnostic performance of the image analysis system reflected the DNA patterns in 47 of the 54 cases. In several instances, particularly in cases of prostatic disease, the image analysis system recognized abnormal DNA patterns in the absence of significant morphologic abnormalities in the urothelial cells. In seven cases, the image analysis findings failed to conform with the DNA patterns. The reasons for these surprising results are discussed, and future modifications of the image analysis system are proposed. PMID- 3314893 TI - CYBEST-CDMS Model 2. Automated cell dispersion and monolayer smearing system for CYBEST. AB - The CYBEST automated cell dispersion and monolayer smearing system (CDMS) employed an autosyringing device and a modified centrifuge to produce specimens with an adequate number of dispersed cells per square millimeter. Since the units of the system were separate, the centrifugation chambers had to be transferred manually. The CYBEST-CDMS Model 2, described in this paper, uses a robot manipulator in a unified system combining the cell dispersion and centrifugation units. Samples in centrifugation chambers are automatically transferred from the autosyringing unit to the centrifugation unit. Using its input and output conveyers, the system can process specimens without interruption. PMID- 3314894 TI - CYBEST Model 4. Automated cytologic screening system for uterine cancer utilizing image analysis processing. AB - CYBEST (Cyto-Biologic Electronic Screening System) utilizes image analysis technology for the automated prescreening of cervical cytology specimens. CYBEST Model 3, which includes a television scan system and automatic shading control, achieved our initial goal of rapid specimen processing (no more than three minutes to achieve a final specimen assessment). This paper describes CYBEST Model 4, developed in 1981; with the minicomputer of Model 3 replaced by a microcomputer, Model 4 is considerably smaller, about the size of a business desk. A new parameter, the intranuclear configuration (chromatin pattern), was added to the four parameters used in Model 3. The five parameters now used for the assessment and ranking of cytologic abnormalities are nuclear size, nuclear cytoplasmic ratio, nuclear optical absorption, nuclear shape and intranuclear configuration. The other features of Model 4 are almost the same as those of Model 3. As an optional function, individual parameter measurement data, assessment of atypicality grade and cell images can be displayed on the CRT monitor by pointing to a cell with a light pen system. After completion of screening of a specimen, the ten cells judged to be most abnormal can be called automatically into the microscope optical field or the CRT monitor (in order ranging from the cell with the highest atypicality rank down) along with their associated data and the system's assessment of the specimen. By connection to a small business computer, all data can be transferred to a floppy disk for later retrieval. PMID- 3314895 TI - [Use of microcomputers in the specialty of anesthesiology and intensive care. 1. Construction of microcomputers and examples of their use in anesthesiology and intensive care]. PMID- 3314896 TI - [Post-traumatic respiratory insufficiency in polytrauma]. PMID- 3314897 TI - [Advances in the puncture of central veins]. PMID- 3314899 TI - Genetics and potential biotechnological applications of thermophilic and extremely thermophilic micro-organisms. PMID- 3314898 TI - Bacterial culture collections: their importance to biotechnology and microbiology. PMID- 3314900 TI - Effects of temperature on lipid unsaturation. PMID- 3314901 TI - Semisynthetic enzymes: design of flavin-dependent oxidoreductases. PMID- 3314902 TI - Biocatalysis with immobilized cells. PMID- 3314903 TI - Safety testing of novel food products generated by biotechnology and genetic manipulation. PMID- 3314904 TI - [Overuse of antibiotics and other erroneous concepts in the treatment of childhood diarrhea]. PMID- 3314905 TI - [Preventive appendectomy using the inversion technic in pediatric patients. Report of 18 cases]. PMID- 3314906 TI - [Imerslund-Grasbeck syndrome]. PMID- 3314907 TI - [The origin and history of the Society of Biological Chemistry]. PMID- 3314908 TI - Partial purification of an oxygen scavenging cell membrane fraction for use in anaerobic biochemical reactions. AB - Anaerobic conditions are necessary to prevent the autoxidation of tetrahydrobiopterin. An enzymatic method for achieving such an anaerobic condition is shown to be obtained by a lactate oxidase activity in the membrane of Escherichia coli when the enzyme concentration exceeds 0.05 unit/ml. A procedure is described for partial purification of the membrane fragment that involves salt precipitation and gel sieve chromatography on Bio-Gel A-50m. The rate of removal of oxygen is used to define the enzyme activity, to determine stability during storage, and to define conditions for stabilization of tetrahydrobiopterin. A second assay procedure that measures the rate of reduction of resazurin is described and is useful when the enzyme concentration is low. PMID- 3314909 TI - Comparison of the properties of the purified beta-glucosidase from the transformed strain of Saccharomyces cerevisiae TYKF2 with that of the donor strain Kluyveromyces fragilis Y610. AB - Saccharomyces cerevisiae TYKF2 was obtained by cloning in S. cerevisiae the gene coding for beta-glucosidase in Kluyveromyces fragilis Y610 (ATCC 12424). The beta glucosidases of both organisms were purified and their biochemical characteristics were determined. The two beta-glucosidases had the same enzymatic properties as those previously described in the literature. The strain S. cerevisiae TYKF2 is able to produce enhanced amounts of enzyme. PMID- 3314910 TI - Generation of Leishmania-specific short-term T-cell lines derived from peripheral blood of cured American cutaneous leishmaniasis patients. AB - The putative protective immune response in localized cutaneous leishmaniasis caused by Leishmania braziliensis braziliensis (Lbb) was analysed by generation of short term T-cell lines from peripheral blood lymphocytes (PBL) of three patients. All had had active skin lesions but were clinically cured at the time of study. PBL were stimulated in vitro with sonicated Lbb promastigotes; blasts were isolated after 5 days and propagated for 9 to 16 days before being tested for proliferative capacity. The majority of propagated cells were T4-positive and reacted with Leishmania antigens. An apparent cross-reactivity with Trypanosoma cruzi (T. cruzi) soluble antigen was recorded. Although preliminary, these data indicate that immune T cells derived from cured LCL patients can recognize antigens common to Lbb and T. cruzi. PMID- 3314911 TI - The effect of Medicare on access to hospice care. Patterns of eligibility requiring the availability of a primary care person. PMID- 3314913 TI - Sex steroid receptor distribution in the human larynx and laryngeal carcinoma. AB - Previous reports of estrogen receptor (ER) and progesterone receptor (PgR) in the human larynx and laryngeal carcinoma have relied on ligand-binding techniques using cytosol from tissue homogenates. These methods obscure the contribution of different tissue components to total receptor content. Recently developed, highly specific monoclonal antibodies to human ER and PgR were able to discern the presence of ER and PgR at the cellular level in 12 specimens of normal laryngeal tissue and eight laryngeal squamous cell carcinomas. Localization of ER and PgR was observed in the nuclei of vocalis muscle. No evidence of ER or PgR was found in epithelial components of the normal larynges or in laryngeal carcinomas. These results extend previous findings in lower primates and rodents to the human larynx and clarify previously reported receptor analyses of laryngeal carcinomas. PMID- 3314912 TI - A comparison of flow cytometric DNA analyses of fresh and fixed squamous cell carcinomas. AB - Aberrations in chromosome number, ploidy abnormalities, have been associated with malignancy and are predictive of outcome. Automated flow cytometry has made DNA analysis applicable to many solid tumors. Analysis can be performed on fixed specimens, allowing archival retrieval. The techniques, however, are unique and must be individually tested for each tumor type. Presently, few studies have been applied to head and neck cancers. This series of flow cytometric DNA analyses compares the results of 17 fresh and fixed head and neck squamous cell carcinoma specimens. Aneuploidy was present to a significant degree (47%). The method produced interpretable results in 100% of cases, with 100% reproducibility. Fresh and fixed tumor specimens yielded comparable results 76% of the time and, in fact, interpretability of fixed specimens was superior. This series demonstrates a practical and accurate flow cytometric DNA assay for fixed squamous cell carcinoma specimens, facilitating rapid retrospective ploidy analysis. PMID- 3314914 TI - Uveitis: a strategy for diagnosis. AB - Uveitis may be the first presentation of a wide variety of underlying ocular and systemic diseases. It is important for the ophthalmologist to make a specific diagnosis in order to instigate specific therapy and give an accurate prognosis. The ability to recognise the clinical patterns of uveitis and to initiate appropriate investigations should form the basis of the ophthalmologist's management of the condition. To this end, we have considered uveitis under four major patterns of presentation--anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis--with subclasses within each of these four groups. We have outlined both the investigations which facilitate diagnosis of the possible underlying causes of inflammation and the interpretation of the results of such investigations. PMID- 3314915 TI - Effect of insulin on phosphorus metabolism in red blood cells from patients with schizophrenia and psychotic depressions. AB - In an exploratory study of the metabolism of selected intermediates of glycolysis in rbc of patients with schizophrenia and with major depressive disorders, statistically significant decreases in the RSA of 2,3-DPG were found in the rbc of patients with psychotic disorders compared to normal subjects. No statistically significant differences were observed in the RSA of any of the other glycolytic intermediates studied comparing patients to normal subjects. PMID- 3314916 TI - [A mouse model of N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine induced parkinsonism: effect of norepinephrine terminal destruction]. AB - N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) has been reported to cause chronic Parkinsonism in humans, primates, and long lasting striatal dopamine depletion in mice. Acute animal models thus produced closely resemble Parkinson's disease. There are, however, two major differences. The one is a lack of Lewy bodies and the other is that norepinephrine system is relatively well preserved in the model. So the acute animal model is better considered a nigrostriatal dopamine deficiency model. We have produced another model by adding N-2 chloroethyl-N-ethyl-2-bromobenzyl-amine (DSP4) to MPTP. This material is known to produce selective destruction of norepinephrine terminal in the central nervous system as well as in the periphery. Both norepinephrine system and dopamine system are severely depressed in this model, and the functional role of norepinephrine system was investigated by comparing two models. 90 male C57 black mice weighing 20-25 grams were used. MPTP (Aldrich) was dissolved in sterile distilled water with 5% ethanol solution. Experimental animals were divided into three groups. i) control group; in this group animals received vehicles alone. ii) MPTP group; in this group, mice received daily i.p. doses of MPTP 30 mg/kg for consecutive 10 days, thus total doses of MPTP was 300 mg/kg. iii) MPTP & DSP4 group; in this group animals received daily i.p. doses of MPTP 30 mg/kg for consecutive 10 days and at the last day of MPTP injection they received DSP4 50 mg/kg i.p.. 7 to 14 days after the last injection of MPTP both treated and control mice received an intraperitoneal injection of L-DOPA (200 mg/kg & aromatic L-amino acid decarboxylase mg/kg) and the effect of this drug on three groups were investigated by using behavioral, biochemical and histofluorescence method. Histofluorescence studies by GA-FAS method revealed severe reduction of nigrostriatal dopamine in MPTP treated mice. Mesolimbic and mesocortical dopamine systems seemed relatively preserved. There was no apparent changes in locus coeruleus norepinephrine system. In MPTP & DSP4 treated mice marked reduction of norepinephrine terminal fluorescence as well as nigrostriatal dopamine system was observed. Chemical analysis of norepinephrine and dopamine by HPLC confirmed histofluorescence studies. Behavioral studies were analyzed by Automex locomotor activity meter. Marked increase of locomotor activity was observed in MPTP treated mice after L-DOPA administration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3314917 TI - [Radiation damage of the brain]. PMID- 3314918 TI - Diffusive and convective mass transport characteristics in beta 2-microglobulin removal. PMID- 3314919 TI - Arteriovenous shunt flow measurement by ultrasonic duplex system. PMID- 3314920 TI - Pathogenesis of acquired renal cysts in hemodialysis patients. The role of oxalate crystal deposition in renal tubules. AB - Although the mechanism responsible for the genesis of acquired renal cysts in hemodialysis patients has not been clearly defined, obstruction of the nephron by deposition of oxalate crystals may be an important factor. We performed this study to investigate this possibility. In 51 dialysis patients, the number and size of acquired cysts as well as kidney size were examined using sonography. Plasma oxalate levels were measured with capillary gas chromatography. Cysts were found in 6 of 18 (33.3%), 12 of 15 (75%), and 15 of 17 (88.2%) dialysis patients treated for 5, 10, and more than 10 years. The mean kidney size was significantly greater in hemodialysis patients with cysts than in those without cysts. There was a significant correlation between plasma oxalate levels and kidney size, particularly in patients dialyzed for longer periods (r = 0.638, P less than 0.01). Mean plasma oxalate levels of dialysis patients with renal cysts were significantly higher than those of noncystic patients (P less than 0.05). Although further evaluation is necessary to confirm these observations, our results suggest that oxalate crystal deposits in renal tubules secondary to hyperoxalemia in hemodialysis patients are a significant contributing factor to the formation of acquired renal cysts in these patients. PMID- 3314921 TI - Silicon in chronic hemodialysis patients. PMID- 3314923 TI - Hydrophilic high flux polyamide membranes for beta-2-microglobulin removal. PMID- 3314922 TI - High flux and cellulosic membranes. Biocompatibility and in vivo clearances. PMID- 3314924 TI - An improved glycerol/insulin formulation for use in implantable pumps. PMID- 3314925 TI - The reliability of a compressed mixture of insulin and palmitic acid to sustain a reduction in hyperglycemia in rodents. PMID- 3314926 TI - Long-lived implanted silastic drum glucose sensors. PMID- 3314927 TI - Removal and prevention of resynthesis of lymphocytotoxic antibodies by plasma exchange prior to cardiac transplantation. PMID- 3314928 TI - Evaluation of a pyridoxylated hemoglobin-polyoxyethylene conjugate solution as a perfusate for liver preservation. PMID- 3314929 TI - The use of a paracorporeal ventricular assist device as a bridge to cardiac transplantation. AB - Our experience with six patients has demonstrated that the Pierce-Donachy VAD is capable of providing adequate circulatory support with acceptable morbidity and mortality in patients awaiting cardiac transplantation. Four of the six patients received cardiac allografts and three patients have been discharged. PMID- 3314930 TI - Rheologic abnormalities in patients with the Jarvik-7 total artificial heart. PMID- 3314931 TI - Clinical experience with textured blood contacting surfaces in ventricular assist devices. PMID- 3314932 TI - Renal failure in patients with ventricular assist devices. PMID- 3314933 TI - A new hybrid artificial liver using a combination of hepatocytes and biomatrix. PMID- 3314934 TI - Multiple regression analysis to identify factors important for maintaining insulin pump therapy. PMID- 3314936 TI - Removal of beta-2-microglobulin by direct hemoperfusion with a newly developed adsorbent. PMID- 3314935 TI - Calcium carbonate as a phosphate binder. One year's experience. PMID- 3314937 TI - A new percutaneous access device for peritoneal dialysis. PMID- 3314938 TI - Right heart assist for acute right ventricular failure after orthotopic heart transplantation. PMID- 3314939 TI - Explant analysis of thirty-three bridge to transplant J7 total artificial heart devices. PMID- 3314940 TI - Long-term hemofiltration in "poor risk" patients. PMID- 3314941 TI - Choice of heart valves. PMID- 3314942 TI - Mercury from dental amalgam fillings in patients. PMID- 3314943 TI - Resin-bonded bridges: chairside methods of cleaning metal surfaces contaminated with saliva. PMID- 3314944 TI - Porcelain facings: a simple clinical and laboratory method. PMID- 3314945 TI - The etch-retained metal restoration in hospital clinical use. PMID- 3314946 TI - The effect of hexetidine 0.1% in the control of dental plaque. PMID- 3314947 TI - The pawn in the gambit? (Grover Cleveland, Ferdinand Hasbrouck). PMID- 3314948 TI - Hypertrophic cardiomyopathy. PMID- 3314949 TI - Valve prostheses and pregnancy. PMID- 3314950 TI - Da Costa's syndrome or neurocirculatory asthenia. AB - The syndrome variously called Da Costa's syndrome, effort syndrome, neurocirculatory asthenia, etc has been studied for more than 100 years by many distinguished physicians. Originally identified in men in wartime, it has been widely recognised as a common chronic condition in both sexes in civilian life. Although the symptoms may seem to appear after infections and various physical and psychological stresses, neurocirculatory asthenia is most often encountered as a familial disorder that is unrelated to these factors, although they may aggravate an existing tendency. Respiratory complaints (including breathlessness, with and without effort, and smothering sensations) are almost universal, and palpitation, chest discomfort, dizziness and faintness, and fatigue are common. The physical examination is normal. The aetiology is obscure but patients usually have a normal life span. Reassurance and measures to improve physical fitness are helpful. PMID- 3314952 TI - Dietary fat and coronary heart disease. PMID- 3314951 TI - The effects of early coronary patency on the evolution of myocardial infarction: a prospective arteriographic study. AB - The effects of early spontaneous coronary patency on the evolution of myocardial infarction were evaluated in 41 patients. They had coronary arteriography (mean (SEM)) 3.1 (0.2) hours after the onset of chest pain with repeat studies 90 minutes and three days later. In 12 (29%) patients the infarct related coronary artery was patent at the first arteriogram (group 1). A further 10 patients, nine of whom received thrombolytic treatment, showed early recanalisation of the infarct related coronary artery within 90 minutes of treatment (group 2). In the remainder the infarct related coronary artery was persistently occluded (group 3). Baseline values for infarct location, the sum of ST elevation in all leads, QRS scores, and serum creatine kinase activity did not permit discrimination between the groups. Nevertheless, patterns of ST segment change and enzyme release in group 1 were closely similar to those that occurred in response to thrombolysis in group 2. Thus compared with group 3, groups 1 and 2 showed earlier 50% reduction in the sum of peak ST elevation in all leads and earlier peaking of serum creatine kinase activity. Importantly, creatine kinase release was significantly attenuated in group 1, rising to a peak serum activity (mean (SEM)) of only 1242 (415) IU/1. Analysis of angiographic left ventricular ejection fractions at three days indicated limitation of infarct size in groups 1 and 2 compared with group 3. Mean (SEM) ejection fraction, however, was best preserved in group 1 (62(6)%) and in this group the frequency of non-Q wave infarction was higher than in groups 2 and 3. Thus in patients who present with a patent infarct related coronary artery early during infarction: (a) there is a reduction in the pattern of infarct size as reflected by attenuation of release of creatine kinase, preservation of left ventricular ejection fraction, and a relatively high frequency of non-Q wave infarction; (b) patterns of ST segment change and creatine kinase release resemble those that occur after successful thrombolytic treatment, suggesting that early coronary patency is the result of spontaneous recanalisation of a previously occluded artery. PMID- 3314953 TI - Congenital heart disease: the ductus arteriosus as pathfinder. PMID- 3314954 TI - Can the technicalities of electrophysiological testing for ventricular tachycardia be simplified? PMID- 3314955 TI - Ventricular defibrillation: the Belfast experience. PMID- 3314956 TI - Efficacy of felodipine in chronic congestive heart failure: a placebo controlled haemodynamic study at rest and during exercise and orthostatic stress. AB - A vascular selective calcium antagonist, felodipine, was evaluated in a randomised, double blind, crossover trial in 18 patients with chronic congestive heart failure of ischaemic cause. Felodipine (10 mg twice daily) or a corresponding placebo was added to conventional treatment. After three weeks haemodynamic function was assessed at rest, during a standard supine leg exercise, and during 45 degrees passive upright tilt. In patients in the supine resting position, felodipine reduced the mean arterial pressure (9%) and systemic vascular resistance (24%) and increased the stroke volume (25%) and cardiac index (23%). The heart rate and right and left ventricular filling pressures were unchanged. During felodipine treatment the standard exercise was accomplished at a similar cardiac index but at a substantially lower heart rate (7%), arterial pressure (10%), systemic vascular resistance (17%), and left ventricular filling pressure (19%), and a higher stroke volume (13%). During both placebo and felodipine administration there were substantial reductions in cardiac filling pressure during upright tilting. Upright tilting during the placebo phase did not increase the heart rate. It also caused a greater fall in systemic vascular resistance while the arterial pulse pressure but not the mean pressure was maintained and the cardiac index and stroke volume increased. The reduced cardiac filling pressures during the felodipine upright tilt were accompanied by reductions in arterial pulse pressure and stroke volume and the patients were able to maintain the mean arterial pressure by an increase in both the heart rate and systemic vascular resistance. Thus three weeks treatment with felodipine improved haemodynamic function at rest and during standard exercise and normalised the baroreflex mediated haemodynamic response in patients with congestive heart failure. The haemodynamic efficacy of the drug in such patients may be associated with a baroreceptor mediated effect as well as direct vasodilatation. PMID- 3314958 TI - Reports from research centres--3. Norway: National Institute for Alcohol Research. PMID- 3314957 TI - High PEEP decreases hyaline membrane formation in surfactant deficient lungs. AB - Lung lavage was performed in 16 anaesthetized rabbits to produce surfactant deficient lungs. This resulted in alveolar collapse, an arterial PO2 of less than 15 kPa on 100% oxygen and an inflection point on the inspiratory limb of the pressure-volume curve at an airway pressure of 8-10 mm Hg. One group of eight animals was then ventilated with a positive end-expiratory pressure (PEEP) equal to the pressure at the inflection point, whilst the second group of eight was ventilated with a PEEP 5 mm Hg less than the inflection point. Animals in the high PEEP group had a significantly greater arterial PO2 than those in the low PEEP group, but the mean survival time for each group was similar. However, there was a significantly greater incidence of hyaline membranes in the low PEEP group. Various mechanisms to explain these findings are discussed. PMID- 3314960 TI - Toward an adult developmental conceptualization of alcohol abuse: a review of the literature. PMID- 3314959 TI - Reports from the research centres--4. The Addiction Research Foundation of Ontario. PMID- 3314962 TI - What do we know about the risks of caffeine consumption in pregnancy? PMID- 3314963 TI - Alcohol and phobias. PMID- 3314961 TI - Alcohol, drugs and traffic safety. PMID- 3314964 TI - Nasal nicotine solution as an aid to cigarette withdrawal: a pilot clinical trial. PMID- 3314965 TI - Rapid prenatal diagnosis of epidermolysis bullosa letalis using GB3 monoclonal antibody. AB - The prenatal diagnosis of epidermolysis bullosa letalis was made by demonstrating a marked reduction of normal immunofluorescence staining with the monoclonal antibody GB3 in a fetal skin biopsy obtained at 18 weeks' gestation. The diagnosis was confirmed by conventional electron microscopy using established techniques. The affected pregnancy continued to term and a baby was delivered who rapidly developed blistering affecting the buttocks, lower limbs and mouth. This technique is simpler and quicker than electron microscopy, yet appears to retain the same degree of accuracy. PMID- 3314966 TI - Linear IgA bullous dermatosis of adults and children: an immunoelectron microscopic study. AB - The ultrastructural localization of the IgA deposits in the skin of 15 patients with linear IgA bullous dermatosis of adults (LAD), 13 with chronic bullous dermatosis of childhood (CBDC) and three with childhood cicatricial pemphigoid (CCP) were studied. The site of the antigen was determined using sera from two LAD, 13 CBDC and two CCP patients. In all 31 patients the IgA was located predominantly below the lamina lucida (sublamina densa). Similarly, the indirect immunoelectron microscopic studies demonstrated the antigen to be present at the same site, below the lamina densa. This suggests that in linear IgA bullous dermatosis the antibody reacts with the antigen in the sublamina densa region of the basement membrane zone. PMID- 3314967 TI - Involucrin expression in skin appendage tumours. AB - The expression of involucrin was examined in 23 skin tumours of hair follicle origin, 17 tumours of sweat gland origin and three tumours of unknown origin, using an immunoperoxidase technique. All tumours from the hair follicle showed a positive reaction for involucrin. In particular keratoacanthoma and the squamous eddies in various tumours stained strongly. Trichofolliculoma, trichilemmoma and pilomatrixoma exhibited characteristic staining patterns which resembled those in the normal hair follicle. On the other hand the majority of the tumours of sweat gland origin did not stain, with restricted positive reactions in areas showing lumen formation or squamous metaplasia. In contrast to the lack of staining in syringoma, a positive reaction was observed in desmoplastic trichoepithelioma, which is histologically similar to syringoma. Clear cell acanthoma, the origin of which is still controversial, showed a staining pattern which indicated that its origin may not be in the sweat gland. These results suggest that testing for involucrin in skin appendage tumours may be very useful for understanding the kinetics of maturation as well as in determining the origin of the tumours. PMID- 3314970 TI - Evidence for absence of histones in the Crithidia luciliae kinetoplast: a study with anti-H2A and monoclonal anti-H3 antibodies. AB - Recently, the specificity of the Crithidia luciliae immunofluorescent assay for the detection of antibodies to double-stranded deoxyribonucleic acid (dsDNA) has been questioned. It has been proposed that the kinetoplast of this trypanosome like organism contains antigenic determinants other than dsDNA, presumably histones. Using anti-H2A and monoclonal anti-H3 antihistone antibodies, we have proved that there are no histones present in the Crithidia luciliae kinetoplast. False-positive results from the assay may be due to binding of antibodies to unidentified kinetoplast acid-extractable antigens other than histones. PMID- 3314968 TI - Bullous pemphigoid with figurate erythema associated with carcinoma of the bronchus. AB - A patient with bullous pemphigoid (BP), a figurate erythema resembling erythema gyratum repens and a bronchial carcinoma is reported. It is suggested that this is a genuine association and that when a figurate erythema occurs with BP, an underlying carcinoma should be excluded. PMID- 3314969 TI - Beta 2 microglobulin expression in keratoacanthomas and squamous cell carcinoma. AB - The cell surface expression of beta-2-microglobulin (beta 2 M) was investigated in 33 keratoacanthomas (KA) and 58 squamous cell carcinomas (SCC) to determine whether this antigen was expressed to a different extent in these two conditions and, thus, whether this constitutes a reliable and practical test for distinguishing them. Loss of beta 2 M expression was not a reliable feature for distinguishing between KA and SCC and seemed to be related more to the degree of cellular differentiation and maturation, than to malignancy as such. PMID- 3314971 TI - Localization of bullous pemphigoid antibody--an indirect immunofluorescence study of 228 cases using a split-skin technique. AB - We have re-examined the site of deposition of IgG anti-basement membrane zone antibodies in 228 sera from suspected cases of bullous pemphigoid (BP), using 1.0 M sodium chloride split-skin as substrate for indirect immunofluorescence. Nine sera (4%) produced fluorescence on the floor of the split suggesting sub-basal lamina antibody deposition compatible with a diagnosis of epidermolysis bullosa acquisita (EBA). This ultrastructural localization was confirmed in only three of these nine by immuno-electron microscopy. Clinical details were available on six of these nine cases, and none had clinical features suggesting EBA. We have found the split-skin immunofluorescence technique unhelpful in identifying 'missed' cases of EBA. The prevalence of EBA presenting as BP would appear to be very low indeed in the U.K. PMID- 3314972 TI - The effect of wavelength, power and treatment pattern on the outcome of laser treatment of port-wine stains. AB - The argon laser was used to treat 220 patients with port-wine stains with moderate efficacy and few complications although perfect cosmetic results were rarely achieved. Primary failure of the argon laser to produce permanent blanching graded good or excellent was the most important factor limiting the final cosmetic results whilst severe scarring was rare (less than 2%). In order to improve the efficacy of this treatment, a randomized controlled study of different parameters of laser treatment was undertaken in test patches of port wine stains in 50 patients. A treatment pattern with contiguous or overlapping laser spots was significantly superior to treatment with spots of 1 or 2 mm separation. Increasing the power level to twice the minimum blanching power did not improve efficacy or significantly increase scarring. A randomized study of selective absorption using a neodymium (Nd) YAG laser showed similar efficacy for the different wavelengths although scarring was greater with the Nd-YAG laser. This study has shown that laser treatment can offer a moderately effective treatment for port-wine stains. For best results spot separation needs to be carefully controlled, whilst wavelength and power level appear to be less important than previously reported. PMID- 3314973 TI - Oral acyclovir for herpes zoster: a double-blind controlled trial in normal subjects. AB - Sixty immunocompetent patients with herpes zoster of various dermatomes were treated 5 times a day for 5 days with either acyclovir at a dose of 400 mg or placebo. Acyclovir was shown to reduce significantly the time to full crusting (P = 0.02). There were also trends in favour of acyclovir for time to first dry vesicle and time to first day without macules or papules, but these were not statistically significant. There were no differences between the groups in the occurrence of adverse events or postherpetic neuralgia. PMID- 3314974 TI - Multiple agminate Spitz naevi: review of the literature and report of a case with distinctive immunohistological features. AB - We describe a 13-year-old girl with multiple pigmented nodules and plaques arranged in a cluster in the right lumbar region, which had developed since infancy. Eleven of 15 lesions which were examined histologically were found to be Spitz naevi. The remaining four lesions were compound naevocellular naevi, and two of them showed focal dysplasia. Eight Spitz naevi were investigated immunohistologically with monoclonal antibodies against HLA-antigens and malignancy-associated melanocytic antigens which are rarely present in common naevi. Naevus cells in all lesions expressed HLA-ABC antigens, but lacked HLA-DR antigens in seven of the eight lesions. All naevi were positive for 'constitutive' (KG-6-56) and 'early' (K-1-2) markers of naevomelanocytic cells. In five of the eight Spitz naevi, at least one of the three malignancy-associated melanocytic antigens PAL-M1, A-1-43 and A-10-33 was found. The expression of malignancy-associated antigens in multiple agminate Spitz naevi is at variance with their benign clinical course. PMID- 3314975 TI - Natural history of severe alopecia areata. PMID- 3314976 TI - Factor XIII: a marker of mono- and megakaryocytopoiesis. AB - Previous studies have shown that human platelets, megakaryocytes and peripheral blood monocytes contain the subunit a of plasma factor XIII (FXIII) which plays a key role in fibrin stabilization. To study the expression of FXIII subunit a during differentiation of the mono- and megakaryocytic cell lines, bone marrow smears were examined by immunomorphological methods. In addition to megakaryocytes, FXIII was detected in a large number of cells by a highly sensitive immunoperoxidase staining. Characterization of these cells was carried out by double immunofluorescent labelling in which the detection of FXIII subunit a was combined by the labelling of either Leu M3 monocyte/macrophage surface antigen or platelet factor 4 (PF4) a marker for megakaryocytic cells. On the course of differentiation from early precursors to mature megakaryocytes all phenotypic form of the megakaryocytic cell line expressed FXIII subunit a though there were considerable changes in its subcellular distribution pattern. Leu M3 positive cells of monocytopoiesis, i.e. monocytes and promonocytes and in all probability monoblasts as well, were also labelled for FXIII. On this basis FXIII subunit a could be considered as a common marker of megakaryo- and monocytopoiesis and its immunomorphological detection might provide a useful diagnostic tool for identifying normal and perhaps also malignant differentiation forms of these cell lines. PMID- 3314977 TI - Possible toxic metal exposure of prehistoric bronze workers. AB - An attempt has been made to assess the possible occupational exposure to arsenic, lead, and mercury during the Bronze Age. Archaeological, metallurgical, and historical evidence is combined to form a picture of the potential toxic hazards. In the case of arsenic a definite picture emerges of the effect of toxicity as a useful material is abandoned for health reasons on discovery of an acceptable alternative. PMID- 3314978 TI - Intraocular reticulum cell sarcoma: diagnosis by choroidal biopsy. AB - A patient with uveitis and retinal pigment epithelial detachments underwent an extensive medical examination and pars plana vitrectomy in an attempt to confirm the clinical diagnosis of reticulum cell sarcoma. None of these examinations revealed the presence of malignancy. Transscleral biopsy of subretinal lesions confirmed the histopathological diagnosis of reticulum cell sarcoma. The patient was begun on systemic chemotherapy and external beam radiation to the eye and orbit, with resultant preservation of the eye, vision, and probable extension of life because of early detection of reticulum cell sarcoma by choroidal biopsy. This technique may be advantageous in the diagnosis cases of eyes with clinical evidence of reticulum cell sarcoma, no systemic signs of malignancy, and negative vitreous biopsies. PMID- 3314979 TI - Nitrogen transactions in the digestive tract of lambs exposed to the intestinal parasite, Trichostrongylus colubriformis. AB - 1. Ten 5-month-old lambs (29 (SE 1.2) kg), reared parasite-free and prepared with rumen duodenal and ileal cannulas, were paired and given rations of Ruminant Diet AA6 (90 g/kg live weight0.75) by means of continuous feeders. From 6 months of age one of each pair was dosed daily with 2500 Trichostrongylus colubriformis larvae for 14 weeks. Untreated animals received the amount of ration consumed by their infected pair-mates the previous day. 2. During three periods, [1) the week before and the first 2 weeks of dosing with infected larvae, (2) during weeks 5-7 and (3) during weeks 11-13 of dosing) all lambs underwent a series of experiments to determine their nitrogen balance, the amounts of N leaving the small intestine, the amount of 51CrCl3-labelled plasma protein leaking into the small intestines, and the disappearance of 35S-labelled bacteria from the small intestine. 3. The infection caused varying degrees of feed refusal in all infected animals. As a result the values for N balance and for the flow of N at the ileum during the latter two periods were regressed against dry-matter intakes for each group in each period. 4. The infection caused a reduction (P less than 0.05) in N retention and increased (P less than 0.05) flow of N at the ileum. The increase in N flow at the ileum of infected lambs was greater (P less than 0.01) at weeks 11-13 of dosing (infected-control 3.6 g N/d (standard error of difference (SED) 0.57), P less than 0.01) than at weeks 5-7 of dosing (infected control 1.5 g N/d (SED 0.57), P less than 0.05). 5. There were no between treatment or between-period differences in the disappearance of 35S-labelled bacteria from the small intestines of infected or control lambs, but the infection did cause an increase in plasma N leakage during both periods. During weeks 5-7 and 11-13, plasma N leakage in infected lambs was 1.1 g N/d (P less than 0.01) and 1.7 g N/d (P = 0.056) respectively higher than that in the control lambs. 6. A proportion of the endogenous secretions which enter the small intestine is likely to be resorbed before the ileum.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3314980 TI - Feeding frequency for lactating cows: effects on rumen fermentation and blood metabolites and hormones. AB - 1. The present paper reports the effects on rumen fermentation and plasma metabolites and hormones of giving fixed rations of hay and high-cereal concentrates at different meal frequencies to lactating cows. In Expt 1 the total ration was given in two and twenty-four meals daily and in Expts 2-4 the concentrates were given in two and five or six meals and the hay in two meals daily. The diets contained 600-920 g concentrates/kg. 2. In Expt 1, minimum rumen pH was higher but mean pH was lower when cows were given their ration in twenty four meals/d rather than two meals/d. 3. In all the experiments, the effects of increased meal frequency on the molar proportions of rumen volatile fatty acids (VFA) were small and not significant, although there was a general tendency for the proportion of acetic acid to increase and that of propionic acid to fall. Increasing the proportion of concentrates in the diet reduced the proportion of acetic acid and increased the proportions of propionic and n-valeric acids. 4. In Expt 3, more frequent feeding was found to reduce the concentration of non esterified fatty acids in the blood, but changes in other metabolites were small and not significant. Increasing the proportion of concentrates in the diet reduced the concentrations of acetic acid and 3-hydroxybutyric acid and increased the concentrations of propionic acid and glucose. 5. The mean daily concentration of insulin in the blood was reduced by more frequent feeding of the higher concentrate diet but not of the lower-concentrate diet. The concentration of glucagon also tended to fall with more frequent feeding. Increasing the proportion of concentrates in the diet increased the concentration of insulin. 6. More frequent feeding reduced the depression in milk-fat concentration caused by feeding the low-roughage diets. About three-quarters of the variation in milk-fat concentration could be related to changes in rumen VFA proportions, but the relations for the two meal frequencies had different intercepts although similar curves. The results suggest that milk-fat depression on low-roughage diets with twice-daily feeding was due to a change in rumen VFA proportions accompanied by elevated plasma insulin concentrations. The improvement in milk-fat concentration due to more frequent feeding could be explained partly by the small change in rumen VFA proportions and partly by a reduction in mean plasma insulin concentrations, but these mechanisms did not fully account for the milk-fat responses observed. PMID- 3314981 TI - The effect of manipulating growth in sheep by diet or anabolic agents on plasma cortisol and muscle glucocorticoid receptors. AB - 1. The cortisol status (total plasma cortisol concentration, free cortisol concentration, transcortin capacity) and the characteristics of skeletal muscle binding for cortisol and dexamethasone were examined in female lambs either implanted with Zeranol or trenbolone acetate or whose dietary intake was restricted. 2. The skeletal muscle glucocorticoid receptor had a high affinity for the glucocorticoid triamcinolone (relative binding affinity 0.85) and cortisol (relative binding affinity 0.51) with virtually no affinity for trenbolone. 3. Trenbolone acetate treatment reduced the binding capacity of sheep skeletal muscle for cortisol within 2 d of implantation. The other treatments had little effect except a small reduction in the animals where food intake was restricted. Similarly, binding capacity for dexamethasone was reduced by trenbolone acetate treatment but was not affected by the other treatments. This reduction in trenbolone acetate-treated animals is, at least in part, due to a reduction in glucocorticoid receptors. 4. Transcortin capacity was elevated by Zeranol treatment but reduced with diet restriction or trenbolone treatment. 5. No support for the suggestion of free cortisol concentration being important in the growth-promoting mechanism of trenbolone or Zeranol was obtained. 6. Although insulin concentrations were not significantly altered by treatment (P greater than 0.05), when combining all the animals there was evidence of a negative correlation between total cortisol/insulin value (P less than 0.05) or free cortisol:insulin value and growth rate (P less than 0.001). Free cortisol was negatively correlated to growth rate (P less than 0.05) and transcortin capacity positively correlated (P less than 0.01). PMID- 3314982 TI - The effect of shearing on the energy metabolism of the pregnant ewe. AB - 1. Metabolizable energy (ME) intakes, heat production, non-protein respiratory quotient (NPRQ) and the plasma concentrations of glucose, non-esterified fatty acids (NEFA), 3-hydroxybutyrate, insulin, growth hormone (GH) and cortisol were measured in shorn and unshorn pregnant ewes. 2. Lamb birth-weight was 17% higher from shorn ewes despite similar ME intakes in the two groups. Shearing resulted in a significant decrease in the digestibility of dry matter and energy. 3. Both shorn and unshorn ewes were found to be in positive nitrogen balance and negative energy balance. Heat production was 28% higher in shorn ewes. This increase in heat production in the shorn group could be completely accounted for by an increase in the oxidation of fatty acids as measured using the NPRQ values. 4. Despite an apparent increase in the use of fat as an energy source there were no effects of shearing on the mean plasma concentrations of NEFA, 3-hydroxybutyrate, GH and cortisol. 5. Measurements made at 1 h intervals for 24 h indicated a tendency for the concentrations of glucose to be increased and insulin decreased in shorn ewes, particularly, between 6 and 11 h after feeding. 6. It is concluded that shearing pregnant ewes at 8 weeks before lambing results in a chronic increase in energy requirements which are met by oxidizing body fat depots. The cold stress induced by shearing may also inhibit insulin secretion resulting in increased plasma glucose concentrations. The effects of shearing on energy metabolism in the ewe are discussed in relation to the nutrient supply for the developing fetus. PMID- 3314983 TI - Effects of the amount and quality of dietary protein on nitrogen metabolism and protein turnover of pigs. AB - 1. The interrelation between protein accretion and whole-body protein turnover were studied by varying the quantity and quality of protein given to growing pigs. 2. Diets with 150 or 290 g lysine-deficient protein/kg were given in hourly meals, with or without lysine supplementation, to female pigs (mean weight 47 kg). 3. After the animals were adapted to the diets, a constant infusion of [14C]urea was given intra-arterially for 30 h, during the last 6 h of which an infusion of [4,5-3H]leucine was also infused at a constant rate. At the same time, yeast-protein labelled with 15N was given in the diet for 50 h. 4. The rate of urea synthesis was estimated from the specific radioactivity (SR) of plasma urea. The rate of leucine flux was estimated from the SR of plasma leucine. The irrevocable breakdown of leucine was estimated from the 3H-labelling of body water. Total N flux was estimated from the 15N-labelling of urinary urea. 5. Addition of lysine to the low-protein diet significantly increased N retention, with a substantial reduction in leucine breakdown, but there was no significant change in the flux of leucine or of total N. 6. Increasing the quantity of the unsupplemented protein also increased N retention significantly, with concomitant increases in leucine breakdown and in the fluxes of leucine and of total N. 7. It is concluded that a doubling of protein accretion brought about by the improvement of dietary protein quality is not necessarily associated with an increased rate of whole-body protein turnover. PMID- 3314984 TI - Urea synthesis and leucine turnover in growing pigs: changes during 2 d following the addition of carbohydrate or fat to the diet. AB - 1. Studies have been made of the time-sequence of protein metabolic and hormonal changes following an abrupt increase in carbohydrate or fat intake. [3H]leucine and [14C]urea were infused for 72 h, via the aorta, into fourteen female pigs (30 38 kg body-weight). At 24 h after the start of the infusion their feed was either changed to one of two isonitrogenous diets containing additional starch (group BS, five animals) or fat (group BF, five animals), or remained unaltered (group BB, four animals). The distribution space of urea was measured by the dilution of a single dose of [14C]urea given both 48 h before and 48 h after the change in diet. The changes in the concentration and specific radioactivity of blood leucine were used to infer changes in protein turnover and those of plasma urea to measure total amino acid catabolism. The concentrations of blood glucose and plasma insulin and cortisol were also measured at approximately two-hourly intervals for the 48 h period following the change in diet. 2. Within 4 h of either change in diet blood leucine concentration was lowered and the leucine specific radioactivity was raised above that in group BB, but after 24 h both the concentration and specific radioactivity of leucine returned to values similar to those in group BB. Eventually the blood leucine specific radioactivity was slightly but not significantly reduced below that of group BB. 3. The addition of starch to the diet significantly reduced the synthesis and concentration of urea within 4 h but, although the addition of fat to the diet eventually lowered the urea concentration and synthesis, both changes were delayed for 18-24 h. 4. In group BS plasma glucose and insulin rose after the addition of starch, but after 24-36 h both returned to values that were the same as those in the animals that received the same diet throughout (group BB). The addition of fat to the diet altered neither blood glucose nor plasma insulin concentrations. The addition of either carbohydrate or fat to the diet eventually reduced plasma cortisol concentrations, but the change did not occur until 24 h after the change in diet. 5. The results suggest that alterations in non-protein energy supply exert their immediate effect on the degradation of whole-body protein. They do not exclude the possibility that these early changes may reflect opposing changes at different sites.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3314986 TI - Site-directed mutation of the active site of influenza neuraminidase and implications for the catalytic mechanism. AB - Different isolates of influenza virus show a high degree of amino acid sequence variation in their surface glycoproteins. Conserved residues located in the substrate-binding pocket of the influenza virus neuraminidase are therefore likely to be involved in substrate binding or enzyme catalysis. In order to study the structure and function of the active site of this protein, a full-length cDNA clone of the neuraminidase gene from influenza A/Tokyo/3/67 was subcloned into aN M13 vector and amino acid substitutions were made in selected residues by using the oligonucleotide mismatch technique. The mutant neuraminidase genes were expressed from a recombinant SV40 vector, and the proteins were analyzed for synthesis, transport to the cell surface, and proper three-dimensional folding by internal and surface immunofluorescence. The mutant neuraminidase proteins were then assayed to determine the effect of the amino acid substitution on enzyme activity. Twelve of the 14 mutant proteins were correctly folded and were transported to the cell surface in a manner identical with that of the wild type. Two of these have full enzyme activity, but seven mutants, despite correct three dimensional structure, have completely lost neuraminidase activity. Two mutants were active at low pH. The properties of the mutant enzymes suggest a possible mechanism of neuraminidase action. PMID- 3314985 TI - The function of zinc in gene 32 protein from T4. AB - Gene 32 protein (g32P), the single-stranded DNA binding protein from bacteriophage T4, contains 1 mol of Zn(II) bound in a tetrahedral complex to -S- ligands, proposed on spectral evidence to include Cys-77, Cys-87, and Cys-90 [Giedroc, D. P., Keating, K. M., Williams, K. R., Konigsberg, W. H., & Coleman, J. E. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 8452]. The Zn(II) can be completely removed by treatment with the mercurial reagent p (hydroxymercuri)benzenesulfonate and ethylenediaminetetraacetic acid. The resultant apo-g32P is rapidly digested by trypsin in contrast to the zinc protein which undergoes specific limited proteolysis to yield a resistant DNA-binding core. Rebinding of Zn(II) to the apoprotein restores the same limited susceptibility to proteolysis displayed by the native Zn(II) protein. In the presence of 150 mM NaCl, Zn(II) g32P reduces the melting temperature Tm of poly[d(A-T)] by 47 degrees C, while apo-g32P is unable to melt poly[d(A-T)] at this salt concentration, as the protein thermally unfolds before melting can take place. At 25 mM NaCl, however, apo-g32P lowers the Tm of poly[d(A-T)] by 36 degrees C, but the melting curve is broad compared to the steep cooperative melting induced by Zn(II) g32P. Association constants Ka calculated from the poly[d(A-T)] melting curves for Zn(II) and apo-g32P differ by 3 orders of magnitude, 4.8 X 10(10) M-1 and 4.3 X 10(7) M-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314987 TI - Yeast DNA primase is encoded by a 59-kilodalton polypeptide: purification and immunochemical characterization. AB - The DNA primase from the yeast Saccharomyces cerevisiae has been purified 9200 fold to homogeneity. The yeast DNA primase is a monomeric protein of molecular weight 59,000, and under conditions described in this report, it is stable at 4 or -80 degrees C. The primase does not bind to DEAE-cellulose, is not inhibited by a high concentration of alpha-amanitin (4 mg/mL), and is capable of synthesizing small (up to 15 nucleotides in length) ribo or ribo-deoxy mixed initiator RNA primers. The primer synthesis is stimulated by ATP; however, other ribonucleotides could be replaced by deoxynucleotides without any measurable effect on the overall DNA synthesis. Thus, the purified primase is distinct from the RNA polymerases of S. cerevisiae. Immunoblot analysis of the polypeptides in a crude cell extract using a mouse polyclonal antibody prepared against the highly purified primase indicates that the 59-kilodalton polypeptide is the native form and not a degraded form of a larger polypeptide; however, primase is degraded rapidly to smaller polypeptides by yeast proteases especially in the absence of protease inhibitors. PMID- 3314988 TI - Isotopically sensitive branching in the formation of cyclic monoterpenes: proof that (-)-alpha-pinene and (-)-beta-pinene are synthesized by the same monoterpene cyclase via deprotonation of a common intermediate. AB - To determine whether the bicyclic monoterpene olefins (-)-alpha-pinene and (-) beta-pinene arise biosynthetically from the same monoterpene cyclase by alternate deprotonations of a common carbocationic intermediate, the product distributions arising from the acyclic precursor [10-2H3,1-3H]geranyl pyrophosphate were compared with those resulting from incubation of [1-3H]geranyl pyrophosphate with (-)-pinene cyclase from Salvia officinalis. Alteration in proportions of the olefinic products generated by the partially purified pinene cyclase resulted from the suppression of the formation of (-)-beta-pinene (C10 deprotonation) by a primary deuterium isotope effect with a compensating stimulation of the formation of (-)-alpha-pinene (C4 deprotonation). (-)-Pinene cyclase as well as (+)-pinene cyclase also exhibited a decrease in the proportion of the acyclic olefin myrcene generated from the deuteriated substrate, accompanied by a corresponding increase in the commitment to cyclized products. The observation of isotopically sensitive branching, in conjunction with quantitation of the magnitude of the secondary deuterium isotope effect on the overall rate of product formation by the (+)- and (-)-pinene cyclases as well as two other monoterpene cyclases from the same tissue, supports the biosynthetic origin of (-)-alpha-pinene and (-)-beta-pinene by alternative deprotonations of a common enzymatic intermediate. A biogenetic scheme consistent with these results is presented, and alternate proposals for the origin of the pinenes are addressed. PMID- 3314989 TI - Microcrystals of tryptophan synthase alpha 2 beta 2 complex from Salmonella typhimurium are catalytically active. AB - An improved and efficient method has been developed for the purification of the tryptophan synthase alpha 2 beta 2 complex (EC 4.2.1.20) from Salmonella typhimurium containing a multicopy plasmid. Microcrystals prepared in 12% poly(ethylene glycol) 8000 containing 2.5 mM spermine are shown by scanning electron microscopy to have the same crystal habit as the larger crystals that are being used for structural analysis by X-ray crystallography. The average dimensions of the crystals are 33 microns (length) X 9 microns (width) X 3 microns (maximum thickness). Our finding that suspensions of microcrystals are active in several reactions catalyzed by the active sites of the alpha and beta 2 subunits demonstrates that both active sites are functional in the crystal and accessible to substrates. Thus the larger crystals being used for X-ray crystallographic studies should form complexes with substrates and analogues at both active sites and should yield functionally relevant structural information. A comparison of the reaction rates of suspensions of microcrystals with those of the soluble enzyme shows that the maximum rate of the crystalline enzyme is 0.8 that of the soluble enzyme in the cleavage of indole-3-glycerol phosphate (alpha reaction), 0.3 that of the soluble enzyme in the synthesis of L-tryptophan by the beta reaction or the coupled alpha beta reaction, and 2.7 that of the soluble enzyme in the serine deaminase reaction. These small differences in rates probably reflect functional differences between the crystalline and soluble enzymes since the reaction rates of the microcrystals are calculated to be virtually free of diffusional limitation under these reaction conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3314990 TI - Reversible unfolding of ribosomal protein E-L30: an NMR study. AB - Ribosomal protein E-L30 unfolds reversibly at pH values between 7.0 and 4.5. Unfolding of the protein involves a fast and a slow equilibrium, which depend on the degree of protonation of His19 and His33. Both the fast equilibrium between protonated and deprotonated histidines and the slow equilibrium between folded and unfolded protein could be monitored by means of 500-MHz 1H NMR spectroscopy. The degree of protonation of His19 and His33 appears to be determinant in the unfolding process of the protein. It is shown however that even when the histidines are uncharged, the protein has only limited stability, probably as a result of the presence of all four Glu's of E-L30 in its triple-stranded beta sheet. At equimolar concentrations of the folded and unfolded form, the rate constant characterizing the transition between these forms is approximately 0.14 s-1. Making use of sequential resonance assignments of the 1H NMR spectrum [van de Ven, F.J.M., & Hilbers, C.W. (1986) J. Mol. Biol. 192, 419-441], the fast equilibrium could be interpreted in terms of alterations in the spatial structure of E-L30 in a specific domain of the molecule. This domain is also affected by temperature although not in exactly the same manner as by pH. PMID- 3314991 TI - On the rational design of renin inhibitors: X-ray studies of aspartic proteinases complexed with transition-state analogues. PMID- 3314992 TI - Homology-dependent changes in adenosine 5'-triphosphate hydrolysis during recA protein promoted DNA strand exchange: evidence for long paranemic complexes. AB - As a first step in DNA strand exchange, recA protein forms a filamentous complex on single-stranded DNA (ssDNA), which contains stoichiometric (one recA monomer per four nucleotides) amounts of recA protein. recA protein monomers within this complex hydrolyze ATP with a turnover number of 25 min-1. Upon introduction of linear homologous duplex DNA to initiate strand exchange, this rate of ATP hydrolysis drops by 33%. The decrease in rate is complete in less than 2 min, and the rate of ATP hydrolysis then remains constant during and subsequent to the strand exchange reaction. This drop is completely dependent upon homology in the duplex DNA. In addition, the magnitude of the drop is linearly dependent upon the length of the homologous region in the linear duplex DNA. Linear DNA substrates in which pairing is topologically restricted to a paranemic joint also follow this relationship. Taken together, these properties imply that all of the available homology in the incoming duplex DNA is detected very early in the DNA strand exchange reaction, with the linear duplex DNA paired paranemically with the homologous ssDNA in the complex throughout its length. The results indicate that paranemic joints can extend over thousands of base pairs. We note elsewhere [Pugh, B. F., & Cox, M. M. (1987b) J. Biol. Chem. 262, 1337-1343] that this duplex acquires resistance to digestion by DNase with a much slower time course (30 min), which parallels the progress of strand exchange. Together these results imply that the duplex DNA is paired with the ssDNA but remains outside the nucleoprotein filament. Finally, the results also support the notion that ATP hydrolysis occurs throughout the recA nucleoprotein filament. PMID- 3314993 TI - Deoxyhexanucleotide containing a vinyl chloride induced DNA lesion, 1,N6 ethenoadenine: synthesis, physical characterization, and incorporation into a duplex bacteriophage M13 genome as part of an amber codon. AB - Organic synthesis and recombinant DNA techniques have been used to situate a single 1,N6-ethenoadenine (epsilon Ade) DNA adduct at an amber codon in the genome of an M13mp19 phage derivative. The deoxyhexanucleotide d[GCT(epsilon A)GC] was chemically synthesized by the phosphotriester method. Mild nonaqueous conditions were employed for deprotection because of the unstable nature of the epsilon Ade adduct in aqueous basic milieu. Physical studies involving fluorescence, circular dichroism, and 1H NMR indicated epsilon Ade to be very efficiently stacked in the hexamer, especially with the 5'-thymine. Melting profile and circular dichroism studies provided evidence of the loss of base pairing capabilities attendant with formation of the etheno ring. The modified hexanucleotide was incorporated into a six-base gap formed in the genome of an M13mp19 insertion mutant; the latter was constructed by blunt-end ligation of d(GCTAGC) in the center of the unique SmaI site of M13mp19. Phage of the insertion mutant, M13mp19-NheI, produced light blue plaques on SupE strains because of the introduced amber codon. Formation of a hybrid between the single strand DNA (plus strand) of M13mp19-NheI with SmaI-linearized M13mp19 replicative form produced a heteroduplex with a six-base gap in the minus strand. The modified hexamer [5'-32P]d-[GCT(epsilon A)GC], after 5'-phosphorylation, was ligated into this gap by using bacteriophage T4 DNA ligase to generate a singly adducted genome with epsilon Ade at minus strand position 6274. Introduction of the radiolabel provided a useful marker for characterization of the singly adducted genome, and indeed the label appeared in the anticipated fragments when digested by several restriction endonucleases. Evidence that ligation occurred on both 5' and 3' sides of the oligonucleotide also was obtained. The adduct was introduced into a unique NheI site, and it was observed that this restriction endonuclease was able to cleave the adducted genome, albeit at a lower rate compared to unmodified DNA. The M13mp19-NheI genome containing epsilon Ade will be used as a probe for studying mutagenesis and repair of this DNA adduct in Escherichia coli. PMID- 3314994 TI - Effects of mutation on the downfield proton nuclear magnetic resonance spectrum of the 5S RNA of Escherichia coli. AB - The imino proton spectra of several mutants of the 5S RNA of Escherichia coli are compared with that of the wild type. Three of the variants discussed are point mutations, and the fourth is a deletion mutant lacking bases 11-69 of the parent sequence, all obtained by site-directed mutagenesis techniques. The spectroscopic effects of mutation are limited in all cases, and the differences between normal and mutant spectra can be used to make or confirm the assignments of resonances. Several new assignments in the 5S spectrum are reported. Spectroscopic differences due to sequence differences permit the products of single genes within the 5S gene family to be distinguished and their fates followed by NMR. PMID- 3314995 TI - Proton nuclear magnetic resonance studies on the wild-type and single amino acid substituted tryptophan synthase alpha-subunits. AB - In order to elucidate the effect of single amino acid substitutions on the conformation of the tryptophan synthase alpha-subunit from Escherichia coli in solution, 1H NMR spectra of the wild-type and mutant proteins were measured at various pHs. Two of the four His C2-proton resonances of the alpha-subunit were assigned to two His residues at positions 92 and 146 by using a mutant protein with Thr substituted for the His at position 92. The replacement did not affect the conformation of the protein significantly. The proton resonances of all the Tyr residues in the aromatic region could be picked up from other resonance peaks, employing the wild-type alpha-subunit deuterated at all of the Phe residues. On comparison of the spectra of the wild-type protein with those of the mutant protein with Met substituted for the Glu at position 49, it was concluded that the substitution affects only the residues close to the substituted residue at acidic pH but that a larger part of the protein is affected at alkaline pH. NOE experiments showed that the five Tyr residues, four of which are located in the proximity of position 49, are close to one another. The present results are discussed in the light of the conformational stability of the protein. PMID- 3314996 TI - Enzyme II of the Escherichia coli phosphoenolpyruvate-dependent phosphotransferase system: protein-protein and protein-phospholipid interactions. AB - The mannitol-specific enzyme II (EII), purified free of phospholipid, exhibits a concentration dependence in its specific activity with P-HPr and mannitol as the donor and acceptor substrates, respectively. This concentration dependence, previously observed only in the case of mannitol----mannitol phosphate exchange reaction, indicates that an oligomeric form of the enzyme is responsible for catalyzing the phosphorylation reaction (P-HPr + mannitol----mannitol-P + HPr) as well as the exchange reaction. Kinetic analysis revealed that the monomeric enzyme has a much lower specific activity than the associated species. The specific activity can be increased by raising the steady-state level of phosphorylation of EII and also by adding phospholipid, demonstrating that phosphorylation and the binding of phospholipid facilitate the association process. Kinetic measurements and fluorescence energy transfer measurements demonstrate a strong preference of EII for phospholipids with specific head group and fatty acid composition. PMID- 3314997 TI - Subversion of growth regulatory pathways in malignant transformation. PMID- 3314998 TI - The influence of major histocompatibility complex class I antigens on tumor growth and metastasis. AB - The work described here demonstrates the importance of major histocompatibility complex class I antigens for the control of tumor growth and metastasis by the host's immune system. In certain murine tumor cells which have lost expression of H-2 class I antigens, a de novo expression of H-2 can be achieved by transfection with syngeneic class I genes. In contrast to the parental cells the transfected tumors do not grow any more in syngeneic mice, or in other cases they do not form metastases. The studies suggest that the de novo expression of the H-2 antigens renders the tumors highly immunogenic and leads to effective recognition of a tumor-associated antigen in conjunction with the transfected H-2 antigen. These conclusions were confirmed in other tumor systems. For example, separation of a heterogeneous tumor into clones expressing high or low amounts of H-2 showed that only the tumor cell with low H-2 grew well in syngeneic mice, whereas the H-2 high tumor clones were rejected. In other studies in vitro induction by IFN-gamma of H-2 antigen on H-2 negative tumors led to reduced tumor growth in vivo which was due to the increased immunogenicity. About 10% of human tumors are also low or defective for HLA class I expression and often these tumors appear to be more malignant. The class I negative tumors could either have arisen from class I low or negative tissues or are HLA loss variants which escaped the attack of the immune system. Altogether, our studies and the data of other laboratories demonstrate the important role of class I antigens for anti-tumor immunity and they suggest that modulation of class I expression by gene transfection or by induction with soluble mediators could be a useful tool for the manipulation of tumor immunity. PMID- 3314999 TI - Prostate tumor progression and metastasis. PMID- 3315000 TI - Mutants of polyomavirus middle-T antigen. AB - Polyomavirus middle-T antigen induces the transformation of established cell lines in culture and is known to interact with and/or modulate the activity of several enzymes (pp60c.src, protein kinase C and phosphatidylinositol kinase) in vitro. This review is a compilation of the reported mutants of middle-T antigen and their biochemical and biological properties as they relate to the transformation event. The mutants of polyomavirus middle-T antigen have been previously classified phenotypically. Given the now large number of mutants, the classification presented here is based upon the position within the molecule. A model of middle-T is presented in which the protein is considered as consisting of three domains: a hydrophobic domain (the putative membrane-binding domain), the amino-terminal half of the molecule (the putative pp60c.src-binding domain) and the intervening amino acids (the putative modulatory domain). A current model for the induction of transformation by polyomavirus middle-T is presented. PMID- 3315001 TI - The fate of thymine-containing dimers in ultraviolet-irradiated Halobacterium cutirubrum. AB - Extremely halophilic bacteria do not recover in the dark from the effects of ultraviolet radiation, although they can be completely photoreactivated, thus proving that pyrimidine dimers are the cytotoxic photoproducts. We have now shown, by studying the fate of thymine-containing dimers during dark liquid holding of Halobacterium cutirubrum, that the lack of dark repair in these bacteria is due to their inability to excise such lesions, in contrast to Escherichia coli B. Nevertheless, extensive nonspecific degradation of DNA occurs in H. cutirubrum following ultraviolet irradiation, so the lack of dimer excision is not due to a generalised inability to degrade DNA after such treatment. These findings raise interesting questions concerning the basis of the resistance of halophiles to ultraviolet radiation. PMID- 3315002 TI - Cell-free translation of human lysosomal alpha-glucosidase: evidence for reduced precursor synthesis in an adult patient with glycogenosis type II. AB - Early events in the biosynthesis of alpha-glucosidase (EC 3.2.1.20) were studied in a wheat-germ cell-free translation system, using control and mutant RNA. In vitro, the primary translation product of the alpha-glucosidase mRNA is a 100 kDa protein. When canine microsomal membranes are added to the translation system, the nascent alpha-glucosidase precursor is cotranslationally transported across the microsomal membranes, yielding a 110 kDa glycosylated form. This protein has the same electrophoretic characteristics as the alpha-glucosidase precursor observed after in vivo labeling of control fibroblasts. Inhibition of glycosylation in vivo by tunicamycin or deglycosylation of the in vivo synthesized alpha-glucosidase precursor by glycopeptidase F reveals a core protein similar in molecular mass to the primary translation product. Total RNA from a patient with the adult form of glycogenosis type II is not able to direct the synthesis of normal amounts of alpha-glucosidase in vitro. Northern blot analysis of the RNA, using cloned alpha-glucosidase cDNA sequences as a probe, demonstrates that in this patient the amount of the 3.4 kb alpha-glucosidase mRNA is highly reduced. The results indicate that the synthesis or stability of the mRNA is affected. PMID- 3315003 TI - Transcription initiation by Escherichia coli RNA polymerase at the gene II promoter of M13 phage: stability of ternary complex, direct photocrosslinking to nascent RNA, and retention of sigma subunit. AB - The initial stages of transcription have been characterized using a template containing the gene II promoter region of M13 phage. Initiation of transcription in the presence of all four nucleotides gives rise to the 140-residue run-off transcript, with a minor pause at the RNA hexamer stage. Cycling, leading to the accumulation of significant amounts of short oligonucleotides [1], was not observed. An RNA hexamer GUUUUU was the sole product when GpU and UTP were used and the ternary complex with the hexamer was stable and resistant to high salt (0.4 M) and S1 nuclease attack. After direct ultraviolet photocrosslinking of the RNA hexamer to RNA polymerase in the ternary complex, the radioactive label incorporation into various subunits was determined by autoradiography after sodium tetradecyl sulfate gel electrophoresis to be as follows: sigma, 86%; beta, 14%; beta' and alpha, negligible. Both electrophoresis and sucrose gradient centrifugation experiments indicate that the sigma subunit is not released from the ternary complex when either the RNA hexamer or the 140-residue RNA is synthesized on this template, even though the complexes are stable. PMID- 3315004 TI - Escherichia coli RNA polymerase binding to a DNA terminus prevents formation of a closed promoter complex. AB - A 302 bp DNA fragment and a 113 bp subfragment of the former, both containing the fd gene VIII promoter (P VIII), were found to exhibit temperature-dependent differential behaviour in RNA chain initiation from P VIII. At 37 degrees C no significant differences were observed, while at 17 degrees C chain initiation was strongly suppressed only with the 113 bp fragment. This phenomenon depended on the presence of the (blunt) DNA terminus upstream from P VIII (position -70). Footprinting revealed that at 17 degrees C RNA polymerase was bound to this DNA fragment in a different mode. Contacts were observed only upstream from position 25. On the contrary, at 37 degrees C only the promoter complex footprint was visible. These results indicate that at 17 degrees C formation of the non initiating complex is more favourable than formation of the promoter complex (which is closed at 17 degrees C; Hofer, B., Muller, D. and Koster, H. (1985) Nucleic Acids Res. 13, 5995-6013) and that formation of both complexes is mutually exclusive. No footprints of RNA polymerase were observed at other DNA termini. This indicates a sequence-specificity for the interaction at the terminus of the 113 bp fragment. The footprint pattern, together with features of the DNA sequence, suggests that the contacts involved in this interaction are similar to those promoter contacts formed upstream from position -20 and that DNA without a -10 region can be specifically recognized by RNA polymerase. PMID- 3315005 TI - Oxidant stress in malaria as probed by stable nitroxide radicals in erythrocytes infected with Plasmodium berghei. The effects of primaquine and chloroquine. AB - Erythrocytes from normal mice and mice infected with the malarial parasite Plasmodium berghei reduce the water-soluble spin probes 2,2,6,6 tetramethylpiperidine-4-hydroxy-N-oxyl (TEMPOL), 2,2,6,6-tetramethylpiperidine-N oxyl (TEMPO) and 2,2,6,6-tetramethylpiperidine-4-keto-N-oxyl (TEMPONE) at similar rates under both air and N2 atmospheres. The ESR signal of the lipid-soluble spin probe 5-doxyl-stearate is stable on incorporation into erythrocytes from normal mice. In contrast, parasitized red cells reduce this nitroxide probe, at a rate which increases with the level of parasitemia. Inhibitors of electron transport such as KCN and NaN3, increase the rate of reduction. We propose that nitroxide reduction occurs via the electron transport chain in the parasite. The antimalarial drug primaquine causes reduction of both water-soluble and lipid soluble spin probes. This action of primaquine is independent of its ability to release H2O2 from oxyhemoglobin, and is ascribed to the ability of primaquine to accelerate flux through the hexose monophosphate shunt. The increased production of NADPH results in increased rates of reduction of the nitroxide radicals. Methylene blue, which also increases flux through the shunt, is even more effective than primaquine at reducing the nitroxides. Chloroquine has no such effect. Parasitized mice treated with chloroquine six hours prior to ESR measurements show less nitroxide reducing capacity than do untreated mice. Chloroquine is known to decrease flux through the hexose monophosphate shunt. The metabolic influences of the two antimalarial drugs are, thus, quite different. PMID- 3315006 TI - 13C-NMR analysis of Aspergillus mutants disturbed in pyruvate metabolism. AB - The metabolic consequences of two defects in pyruvate metabolism of the hyphal fungus Aspergillus nidulans have been investigated by natural abundance 13C-NMR spectroscopy. A pyruvate dehydrogenase complex (pdh) mutant, grown on acetate, accumulates alanine upon starvation which is derived from mannitol reserves. The L-alanine level increases further upon incubation with the non-permissive substrate D-glucose. L-Glutamate is absent from these spectra as it is required both for the transamination of pyruvate and as a reaction on an impaired energy metabolism in such a pdh-deficient strain. A pyruvate carboxylase (pyc) mutant, grown upon acetate, only starts to accumulate alanine after a long incubation period with D-glucose, due to the long-lasting presence of phosphoenolpyruvate carboxykinase and malic enzyme, which are both induced by growth on acetate. When this strain is grown on D-fructose and L-glutamate, alanine also accumulates within 3 h upon transfer to D-glucose. PMID- 3315007 TI - Glucocorticoid binding during the differentiation of 3T3-F442A fibroblasts into adipocytes. A possible regulatory effect of insulin. AB - Until recently, few studies had been carried out on receptors for glucocorticoids in adipocytes, although the role of these steroids is considerable. In the present studies, we chose the pre-adipocyte line 3T3-F442A, which constitutes an excellent model for investigating the differentiation and function of adipocytes. Using a whole cell assay system, we showed the existence of a homogenous class of sites with the characteristics of glucocorticoid receptors, that is, high affinity binding which is reversible, specific and saturable. Whatever the state of cellular differentiation, the affinity of the receptor for dexamethasone did not vary, although we observed an increase in the number of sites during differentiation. When cells were differentiated in the presence of insulin, there was a further increase in the binding capacity; moreover, insulin deprivation of such adipocytes caused a decrease in the number of sites. Our results therefore suggest that factors other than the glucocorticoids themselves influence dexamethasone binding. It is suggested that insulin plays a role in the regulation of the number of glucocorticoid receptors. PMID- 3315008 TI - [Preparation of Escherichia coli 70S ribosomes labeled with 35S]. AB - [35S]--70S ribosomes (150 Ci/mmol) were isolated from E. coli MRE-600 cells grown on glucose-mineral media in the presence of [35S] ammonium sulfate. The labeled 30S and 50S subunits were obtained from [35S] ribosomes by centrifugation in a sucrose density gradient of 10--30% under dissociating conditions (0.5 mM Mg2+). The activity of [35S]--70S ribosomes obtained by reassociation of the labeled subunits during poly(U)-dependent diphenylalanine synthesis was not less than 70%. The activity of [35S]--70S ribosomes during poly(U)-directed polyphenylalanine synthesis was nearly the same as that of the standard preparation of unlabeled ribosomes. The 23S, 16S and 5S RNAs isolated from labeled ribosomes as total rRNA contained no detectable amounts of their fragments as revealed by polyacrylamide gel electrophoresis. The [35S] ribosomal proteins isolated from labeled ribosomes were analyzed by two-dimensional gel electrophoresis. The [35S] label was found in all proteins, with the exception of L20, L24 and L33 which did not contain methionine or cysteine residues. PMID- 3315010 TI - [Cooperative effects during interaction of monoclonal antibodies with insulin dimers]. AB - The interaction of monoclonal antibodies of three types with the ATP-labeled insulin dimer was studied by the luminescent immunocofactor method. It was shown that the effective equilibrium binding constant increases at equimolar antigen/antibody concentrations. This can be due to the formation of multimolecular complexes between the antigens and antibodies. The feasibility of the binding constants increase during the formation of cyclic tetramolecular complexes is considered. A theoretical model for the description of interaction between the bivalent antigen and antibodies based on the increase of the binding constant during the formation of cyclic complexes is proposed. The coefficients of binding constant increase for antigens belonging to three different clones were calculated. PMID- 3315009 TI - [Determination of inhibition sites during hydrolysis of polydeoxyribonucleotides by exonucleases III from Bacillus amyloliquefaciens and Escherichia coli]. AB - The influence of the primary structure of polydeoxyribonucleotides on the rate of hydrolysis with exonuclease III from Bacillus amyloliquefaciens and Escherichia coli was investigated. The substrates used were synthetic oligodeoxyribonucleotides and pBR 322 DNA fragments labeled with 32P at the 5' termini of one of the chains. According to the data from polyacrylamide gel electrophoresis performed under denaturing conditions, the hydrolysis of these substrates by unsaturating concentrations of B. amyloliquefaciens and E. coli exonuclease III proceeds with several reproducible "stops". The decrease of the reaction rate was shown to take place just before the pyrimidine blocks in the digested DNA chain. PMID- 3315011 TI - [Limited proteolysis and phosphorylation of phosphorylase kinase from chicken skeletal muscles]. AB - The changes in the quaternary structure of chicken skeletal muscle phosphorylase kinase during limited proteolysis by trypsin and chymotrypsin were studied. Polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate of the products of phosphorylase kinase limited proteolysis revealed a similarity in the structure of the alpha'- and beta-subunits and some differences in the structure of the gamma-subunits of the chicken and rabbit enzymes. Phosphorylation with the catalytic subunit of cAMP-dependent protein kinase (up to 2 mol of 32P/mol of alpha' beta gamma' sigma monomer) and autophosphorylation (up to 8 mol of 32P/mol alpha' beta gamma' delta monomer) increased the activity of chicken phosphorylase kinase 1.5-fold and 2.0-fold, respectively. The incorporation of phosphate into the alpha' and beta-subunits in the course of the protein kinase-catalyzed reaction was demonstrated. PMID- 3315012 TI - Postprandial glucose and insulin responses to glucose polymers by premature infants. AB - Previous studies have questioned whether neonatal infants can digest and absorb glucose polymers (GP). Thirteen infants of 33-42 weeks of corrected gestational age were fed two glucose polymers with different dextrose equivalents (DE) and glucose. Postprandial glucose and insulin responses were measured consecutively after each feeding. At 60 min, glucose, glucose polymer DE 15 and glucose polymer DE 24 produced serum glucose responses of 138.1, 111.6 and 120 mg/100 ml, respectively. Differences in mean serum glucose and insulin levels were found when glucose or glucose polymers were used as the test carbohydrate. Glucose polymer DE 24 produced a hormonal response closer to that of glucose. This suggests that glucose polymers were hydrolyzed and absorbed and evoked a sufficient glucose and insulin response. Therefore, these glucose polymers would seem to be suitable for use in feeding neonatal infants. PMID- 3315013 TI - Is there gliosis in schizophrenia? Investigation of the temporal lobe. AB - Recent studies have described two indicators of pathology in the schizophrenic brain--gliosis and atrophy. The degree of gliosis in the temporal lobe of groups of schizophrenics (with demonstrable atrophy), affectives, and controls was quantified using immunocytochemical techniques and computer-assisted densitometry. Twenty areas within the temporal lobe were assessed. Our data showed no evidence of increased gliosis in the schizophrenic group compared to controls and affectives. This extends and replicates our previous findings, demonstrating that the atrophy/aplasia in schizophrenia is not associated with pathologically significant gliosis. Our observations are consistent with other studies, suggesting that the structural change in schizophrenic brains is due to an embryonic insult or developmental anomaly of an, as yet, undetermined nature. PMID- 3315014 TI - Detection of relaxin release by porcine luteal cells using a reverse hemolytic plaque assay: effect of prostaglandins E2 and F2 alpha, human chorionic gonadotropin, and oxytocin. AB - The release of relaxin from cultured porcine luteal cells derived from pregnant sows was detected by a reverse hemolytic plaque assay. In this assay, luteal cells are cocultured in monolayers with protein-A-coupled ovine erythrocytes. In the presence of porcine relaxin antiserum and complement, a zone of hemolysis--a plaque--develops around relaxin-releasing luteal cells. Treatment with prostaglandin E2 (10(-8) and 10(-6) M) significantly accelerated the rate of plaque formation; in contrast, human chorionic gonadotropin (10-1,000 IU/ml) inhibited the rate of plaque formation. Oxytocin (10(-8) to 10(-4) M) had no detectable effect on relaxin release. However, none of these treatments or long term preexposure to prostaglandin F2 alpha increased the total proportion of large luteal cells that released relaxin, which remained at about 50%. These results are consistent with the idea that prostaglandins of uterine and/or luteal origin and pituitary luteinizing hormone may contribute, alone or perhaps in combination, to the overall regulation of ovarian relaxin release during pregnancy in the sow. In addition, the results indicate that the effects of prostaglandins are restricted to a subpopulation of large luteal cells that release detectable amounts of relaxin in culture. PMID- 3315015 TI - Identification of antigen in rat spermatogenic cells interacting with an anti human sperm monoclonal antibody. AB - A monoclonal antibody (MAb) raised against human sperm protein, designated YWK II, was used to determine the distribution of antigens in rat spermatozoa and rat testicular germ cells. By an indirect immunofluorescent method, the antibody localized over the rat spermatozoal head, except for the postacrosomal region. In paraffin sections of adult and immature rat testis, germ cells, at every developmental stage, and Sertoli cells stained, while interstitial cells and peritubular myoid cells remained unstained. When cocultures of Sertoli and germ cells were tested, only the germ cells stained intensely. Sertoli cells and peritubular myoid cells in cultures did not stain. In the epididymal sections, strong staining occurred with spermatozoa in the lumen and epididymal epithelial cells, with moderate staining in the myoid layers of epididymis. To determine the sperm antigen interacting with the YWK-II antibody, rat spermatozoa proteins were prepared and analyzed by an immunoblot technique. The monoclonal antibody interacted with a single protein, with an estimated molecular weight of 115,000, present in the cauda epididymal spermatozoa. Among the proteins of the caput epididymal spermatozoa, however, the antibody interacted with a major and a minor band with molecular weights of 115,000 and 88,000, respectively. On the other hand, with proteins prepared from the membrane fraction of adult and immature rat testis, the antibody reacted with two bands with estimated molecular weights of 88,000 and 115,000. In the lysate prepared from germ cells dissociated from Sertoli-germ cell cocultures, the antibody recognized only the 88,000 protein. The present results show that the YWK-II MAb interacts with two proteins with different molecular weights. The amount of the interacting proteins in spermatozoa varied with their location within the epididymis. PMID- 3315017 TI - Oxytocin in baboon (Papio anubis) corpus luteum. AB - Recently, using a highly specific radioimmunoassay, we have demonstrated that the concentration of oxytocin in the corpus luteum of the human and cynomolgus monkey are several fold higher than in the peripheral circulation. In this study, we have examined the corpora lutea and ovarian stroma from the ovaries of normal adult cycling baboons (Papio anubis) for the presence of oxytocin through the use of immunocytochemical procedures. Tissues obtained at laparotomy were fixed in Bouin's solution and embedded in paraffin; immunoreactive oxytocin was localized with peroxidase-antiperoxidase and 3.3' diaminobenzidine. Six corpora lutea with stroma were obtained--two each from the early (Day 14-20), mid-(Day 21-24), and late (Day 25-30) stages of the luteal phase. Immunoreactive oxytocin was localized in all corpora lutea examined but was absent from all stroma samples. Larger areas of the corpus luteum from the mid-luteal phase showed staining for oxytocin, and the intensity of staining for this peptide was maximal in this phase of the cycle. PMID- 3315016 TI - The response of the anterior pituitary and testes to synthetic luteinizing hormone-releasing hormone (LHRH) and the effect of castration on pituitary responsiveness in the maturing chicken fed aflatoxin. AB - The responsiveness of the anterior pituitary to exogenous luteinizing hormone releasing hormone (LHRH; 20 micrograms/kg body weight) and the subsequent stimulation of testosterone secretion by the testes was studied after administration of dietary aflatoxin (10 ppm) to 9-wk-old male chickens. In both control and aflatoxin-treated males, there were significant (p less than 0.05) increases in plasma luteinizing hormone (LH) concentrations following LHRH administration, which peaked at 5 min post injection and declined thereafter. Plasma testosterone levels increased soon after the LHRH injection in control males, secondary to elevated LH levels in the peripheral circulation, and continued to increase throughout the experimental period. In contrast, this LH induced elevation in plasma testosterone was delayed in aflatoxin-treated males, with no substantial increase until 20 min post-LHRH injection. In a subsequent experiment, castration of aflatoxin-fed males resulted in an altered response to exogenous LHRH, as compared to their intact counterparts. Based on these data, it appeared that while the LH-secretory capacity of the anterior pituitary was not diminished in birds receiving aflatoxin, the testicular response to exogenous LHRH was altered during aflatoxicosis. Additionally, the effect of castration on plasma LH profiles after LHRH administration provides preliminary evidence for extra-testicular effects of dietary aflatoxin on reproduction in the avian male. PMID- 3315019 TI - Polymer microbeads in immunology. AB - Synthetic polymer microbeads have been studied extensively and the required properties, including monodispersity and size range 0.05-10 microns can best be achieved by radiation polymerization based on methacrylate derivatives. Fluorochrome-conjugated beads can be used for cell surface markers and simultaneously to study phagocytosis. The paper reviews some of these applications. Cell separation techniques are also described. Future possibilities for immunological and cell biology studies are discussed. PMID- 3315018 TI - The antibody from an infertile woman that induces sperm agglutination interacts with rat testicular cells and sperm. AB - The serum obtained from an infertile woman induced a specific head-to-head agglutination of human and rat sperm. The immunoglobulin G (IgG) fraction of the serum was obtained and found to interact with the proteins of rat sperm in testis and epididymis. Using an indirect immunofluorescent method with rat sperm from vas deferens, we determined that the antibody recognized the protein on the convex and concave regions of the acrosome and over the entire tail. However, with testicular spermatozoa, the antibody recognized only the distal end of the tails. In paraffin sections of adult rat testis, sperm tails located at the luminal region of the seminiferous tubules stained intensely. Weak but significant staining also occurred on late spermatids. In the epididymal sections, staining was restricted to spermatozoa in the lumen. On the other hand, sections of testes from 25-day-old rats containing spermatogonia and early spermatocytes had a completely negative reaction. Testicular somatic cells, including Sertoli cells, peritubular myoid cells and interstitial cells, did not stain. To identify the testicular protein interacting with the antibody, adult rat testis proteins were prepared and analyzed by a sodium dodecyl sulfate polyacrylamide gel electrophoretic (SDS-PAGE) immunoblot technique. The antibody interacted with a protein with an estimated molecular weight of 82,000 in the testicular homogenate and particulate fraction, whereas the reaction was considerably weaker with the testicular cytosol fraction. PMID- 3315020 TI - The mechanical properties of elastomeric poly(alkyl methacrylate)s. AB - A range of poly(alkyl methacrylate)s in the range C5 to C13 with varying degrees of crosslinking, have been studied with respect to stress-strain behaviour. Where the extensions to break were sufficiently high, stress-strain properties conformed well to the statistical theory of rubber elasticity, the Mooney/Rivlin C2 term being sensibly zero. All materials studied were very elastic, exhibiting extremely little permanent set. The energy to break decreases very rapidly as the homologous series is ascended, and 0.5% crosslinking agent is perfectly adequate to give elastic properties. Hence either n-pentyl or hexyl methacrylates are to be preferred in soft prosthesis formulations on mechanical grounds. PMID- 3315023 TI - Exocytosis: post-receptor events in secretory cells. London, 9-10 April 1987. Proceedings. A memorial to Peter Baker. PMID- 3315021 TI - Synthesis and biodegradation of polymers derived from aspartic acid. AB - The synthesis of copolymers derived from aspartic acid hydrochloride, their characterization and their hydrolytic degradation and biodegradation by Aspergillus niger and E. coli have been described. The alpha-amino dicarboxylic acid has been copolymerized with 1,2-ethane diol, 1,3-butane diol, 1,4-butane diol, 1,6-hexane diol and glycerol to get copolyesters I, II, III, IV and V respectively. The polymer samples have been characterized by their number average molecular weight (Mn), elemental analysis and their i.r. spectra. The copolyester V is crosslinked. All of the copolyesters I-V undergo slow hydrolytic degradation in aqueous solution at ambient temperatures as studied by the measurement of the decrease in reduced viscosity and increase in specific conductance of their aqueous solutions. They are also degraded in aqueous suspension by the fungus Aspergillus niger and by the bacterium E. coli. Degradation by Aspergillus niger mainly depends on the polarity of the polymers, the more polar polymers being less degradable. On the other hand, degradation by E. coli is primarily dependent upon the alpha-NH2 group contents of the polymers, the alpha-NH2 group rich polymers being more degradable. The possible use of these polymers as biodegradable drug carriers has been suggested. PMID- 3315022 TI - [Effect of the soft and middle power laser on wound healing in rats]. PMID- 3315024 TI - Molecular mechanisms of membrane fusion: steps during phospholipid and exocytotic membrane fusion. AB - Exocytosis is considered as four separate steps: adhesion, fusion/pore formation, pore widening, and content discharge. Experiments on both synthetic and natural membranes are presented to show each of these steps. Major differences are seen in the two fusing systems. These differences are discussed in terms of molecular mechanisms of fusion. PMID- 3315025 TI - Docking of chromaffin granules--a necessary step in exocytosis? AB - Putative docking of secretory vesicles comprising recognition of and attachment to future fusion sites in the plasma membrane has been investigated in chromaffin cells of the bovine adrenal medulla and in rat phaeochromocytoma (PC 12) cells. Upon permeabilization with digitonin, secretion can be stimulated in both cell types by increasing the free Ca2+-concentration to microM levels. Secretory activity can be elicited up to 1 hr after starting permeabilization and despite the loss of soluble cytoplasmic components indicating a stable attachment of granules to the plasma membrane awaiting the trigger for fusion. Docked granules can be observed in the electron microscope in permeabilized PC 12 cells which contain a large proportion of their granules aligned underneath the plasma membrane. The population of putatively docked granules in chromaffin cells cannot be as readily discerned due to the dispersal of granules throughout the cytoplasm. Further experiments comparing PC 12 and chromaffin cells suggest that active docking but not transport of granules can still be performed by permeabilized cells in the presence of Ca2+: a short (2 min) pulse of Ca2+ in PC 12 cells leads to the secretion of almost all releasable hormone over a 15 min observation period whereas, in chromaffin cells, with only a small proportion of granules docked, withdrawal of Ca2+ leads to an immediate halt in secretion. Transport of chromaffin granules from the Golgi to the plasma membrane docking sites seems to depend on a mechanism sensitive to permeabilization. This is shown by the difference in the amount of hormone released from the two permeabilized cell types, reflecting the contrast in the proportion of granules docked to the plasma membrane in PC 12 or chromaffin cells. Neither docking nor the docked state are influenced by cytochalasin B or colchicine. The permeabilized cell system is a valuable technique for the in vitro study of interaction between secretory vesicles and their target membrane. PMID- 3315026 TI - Reorganisation of peripheral actin filaments as a prelude to exocytosis. AB - Evidence is presented, from studies on the adrenal chromaffin cell, that reorganisation of the cortical actin network is necessary to allow granules to reach exocytotic sites in stimulated cells. This reorganisation may involve changes in actin filament cross-linking, assembly and interactions with secretory granule and plasma membranes. The possibility is discussed that cytoskeletal elements including the membrane-binding proteins caldesmon, p70 and p36 may be involved in granule-plasmalemmal interactions immediately prior to exocytosis. PMID- 3315027 TI - Intracellular Ca2+ in pancreatic acinar cells: regulation and role in stimulation of enzyme secretion. AB - Evidence for a primary role for intracellular Ca2+ in the stimulation of pancreatic enzyme secretion is reviewed. Measurements of cytoplasmic free Ca2+ concentration have allowed direct demonstration of its importance in triggering enzyme secretion and defined the concentration range over which membrane Ca2+ pumps must work to regulate intracellular Ca2+. Current evidence suggests a key role for the Ca2+, Mg-ATPase of rough endoplasmic reticulum in regulating intracellular Ca2+ and accumulating a Ca2+ store which is released by the action of inositol-1,4,5 trisphosphate following stimulation of secretion. PMID- 3315028 TI - Secretory processes in lymphocyte function. AB - The secretion of immunoglobulin by plasma cells has been considered a classical example of the "non-regulated" pathway of protein secretion, in which newly synthesized protein is processed by the Golgi, packaged into small vesicles, and immediately secreted without intracellular storage. In the case of lymphokine secretion by T lymphocytes, it is generally not clear whether this non-regulated pathway is also being used, as opposed to the "regulated" pathway which has been proposed to operate in the cytotoxic lymphocyte mechanism. In this case, as in mast cells and endocrine cells, proteins are synthesized and then stored in cytoplasmic granules. The secretion is triggered (regulated) by a membrane receptor-ligand interaction, which for the cytotoxic lymphocytes is part of the target cell binding process. In cytotoxic T lymphocytes, this secretion process can be measured by following the appearance of a granule serine protease in the medium, and it has been shown to be triggered by target cells or by immobilized antibodies which bind the T cell receptor complex. In addition to cytotoxic lymphocytes, cloned T helper cells contain this serine protease in cytoplasmic granules with a low internal pH. Helper lymphocytes secrete this enzyme in response to (1) soluble antigen which has been processed by cells bearing the appropriate MHC antigens; (2) immobilized antibodies against the T cell receptor complex; (3) a combination of phorbol ester and calcium ionophore. Thus in both helper and cytotoxic lymphocytes, the regulated pathway of protein secretion clearly operates after triggering by the T cell antigen receptor. PMID- 3315029 TI - Calcium and diacylglycerol control of secretion. AB - Measurements of intracellular Ca2+ in adrenal medullary cells suggest that a transient rise in Ca2+ leads to a transient secretory response, the rise in Ca2+ being brought about by an influx through voltage-sensitive Ca channels which subsequently inactivate. The level of Ca2+ observed is much smaller than the Ca2+ needed to trigger secretion when introduced directly into the cell. The discrepancy is removed by the presence of diacylglycerol, which increases the sensitivity of the secretory process to Ca2+. The site of action of Ca2+ and diacylglycerol is probably protein kinase C, and the different secretory responses to increases of Ca2+ and diacylglycerol can be modelled in terms of a preferential order of binding of these two substrates to the enzyme. ATP is needed for secretion: one role is possibly to confer stability to the secretory apparatus; another may involve phosphorylation of some key protein. The kinetics of secretion suggest that if Ca2+ regulates phosphorylation or dephosphorylation, then it is the rate of change of phosphorylation that controls secretion rather than the extent of phosphorylation or dephosphorylation. Guanine nucleotide binding proteins may play a role not only at the level of signal transduction coupling, but also at or near the site of exocytosis, and the mechanism by which some Botulinum toxins inhibit secretion may be associated with these proteins. PMID- 3315030 TI - The dual effector system for exocytosis in mast cells: obligatory requirement for both Ca2+ and GTP. AB - The secretory process is a coordinated cellular response, initiated by occupation of surface receptors and comprising an ordered sequence of biochemical steps subject to multiple controls. Conceptually we can divide the sequence into two main sections comprising early, receptor-mediated events leading to generation of intracellular second messengers, and later events leading to membrane fusion and exocytosis. With the discovery that occupation of Ca2+ mobilising receptors leads to activation of polyphosphoinositide phosphodiesterase (PPI-pde) through the mediation of a G-protein (Gp), all the early events can be ascribed to the plasma membrane. Investigation of the exocytotic stage of secretion has been simplified by the use of permeabilised cells in which the composition of the cytosol can be precisely controlled. We have used streptolysin-O, a bacterial cytolysin which generates protein-sized pores in the plasma membrane, to investigate the exocytotic mechanism of rat mast cells. We find that in addition to the activation of PPI-dpe, GTP also acts in concert with Ca2+ at, or close to, the exocytotic site. Exocytosis can occur after substantial depletion of cytosol lactate dehydrogenase and 3-phosphoglycerate kinase indicating that soluble cytosol proteins are unlikely to play any role. There is no absolute requirement for ATP or phosphorylating nucleotide in exocytosis though when present the effective affinities of the two obligatory effectors (i.e. Ca2+ and GTP) are substantially enhanced. PMID- 3315031 TI - How calcium may cause exocytosis in sea urchin eggs. AB - The process of secretory granule-plasma membrane fusion can be studied in sea urchin eggs. Micromolar calcium concentrations are all that is required to bring about exocytosis in vitro. I discuss recent experiments with sea urchin eggs that concentrate on the biophysical aspects of granule-membrane fusion. The backbone of biological membranes is the lipid bilayer. Sea urchin egg membrane lipids have negatively charged head groups that give rise to an electrical potential at the bilayer-water interface. We have found that this surface potential can affect the calcium required for exocytosis. Effects on the surface potential may also explain why drugs like trifluoperazine and tetracaine inhibit exocytosis: they absorb to the bilayer and reduce the surface potential. The membrane lipids may also be crucial to the formation of the exocytotic pore through which the secretory granule contents are released. We have measured calcium-induced production of the lipid, diacylglycerol. This lipid can induce a phase transition that will promote fusion of apposed lipid bilayers. The process of exocytosis involves the secretory granule core as well as the lipids of the membrane. The osmotic properties of the granule contents lead to swelling of the granule during exocytosis. Swelling promotes the dispersal of the contents as they are extruded through the exocytotic pore. The movements of water and ions during exocytosis may also stabilize the transient fusion intermediate and consolidate the exocytotic pore as fusion occurs. PMID- 3315032 TI - Isolated neurosecretory nerve endings as a tool for studying the mechanism of stimulus-secretion coupling. AB - In the present paper we discuss the properties of a recently developed preparation of isolated neurosecretory nerve endings obtained from the rate neurohypophysis. These nerve terminals release two neurohormones, oxytocin and vasopressin, which are easily assayed by radioimmunoassay. Depolarization-induced secretion is dependent on the same parameters as those regulating release from the whole neural lobe. The isolated nerve endings can be permeabilized by means of digitonin; a treatment which gives direct access to the cytoplasm allowing the study of the minimal requirements for inducing neuropeptide release. Furthermore, some nerve endings are large enough to allow the use of the patch-clamp technique. In the present paper we present evidences which show that the isolated neurohypophysial nerve terminals represent a protent tool for studying the mechanism of stimulus-secretion. PMID- 3315033 TI - Regulation of membrane turnover by ras proteins. AB - Because ras oncogenes mediate abnormal cellular growth, ras proteins have been presumed to play a role primarily in growth control. The biological function of ras proteins may, however, prove to be much more diverse: ras proteins may be involved in cellular functions that control endocytosis and/or exocytosis. PMID- 3315034 TI - Regulation of exocytosis in electrically permeabilized insulin-secreting cells. Evidence for Ca2+ dependent and independent secretion. AB - The regulation of insulin secretion from RINm5F cells exposed to high voltage discharge has been investigated. Electron microscopy revealed that the overall structure of the cells was preserved after permeabilization. In this preparation insulin release was stimulated by Ca2+ (EC50 = 2.4 microM). The stable GTP analogue GTP gamma S enhanced secretion both at intermediate (nano- to micromolar) and vanishingly low (less than 10 pM) Ca2+ concentrations. At optimal Ca2+ (10 microM) the effect of GTP gamma S was greatly reduced. We investigated whether the secretory response to GTP analogues was mediated by any of three enzyme systems regulated by GTP-binding proteins, i.e. generation of cyclic AMP by adenylate cyclase, of diacylglycerol by phospholipase C and of arachidonic acid by phospholipase A2. The involvement of these messenger systems could be excluded as (i) cyclic AMP only had minor, Ca2+ dependent effects, (ii) phospholipase C was not activated in the absence of Ca2+ and insulin secretion due to the phorbol ester TPA displayed a different Ca2+ dependency, (iii) arachidonic acid did not elicit Ca2+ independent insulin secretion. These results, taken together with the finding that insulin secretion due to Ca2+ or TPA is attenuated by the inhibitory guanine nucleotide GDP beta S, suggest the existence of a regulatory site in exocytosis which is sensitive to guanine nucleotides. PMID- 3315035 TI - [Characteristics of endocrine disorders in the early stages of the development of chronic experimental pancreatitis]. AB - The experiments on normal mongrel dogs and those with chronic experimental pancreatitis were performed to reveal the early changes of the endocrine pancreas function. The concentration of immunoreactive insulin and glucagon were studied in afferent vessels of the organ after intraarterial glucose-loading during pancreatic perfusion in situ. The data obtained have shown that in chronic pancreatitis the maximum secretion of insulin is decreased and delayed, as compared to normal animals. At the same time insulin-glucagon secretion ratio remains unchanged. That was indicative of the normal alpha-cell function at the early stages of the disease. PMID- 3315036 TI - [Activation of the production of the tumor-necrosis factor by the combined action of lipopolysaccharide and muramyl dipeptide in vitro and in vivo]. AB - The effect of bacterial lipopolysaccharide (LPS), muramyl dipeptide (MDP) and their combination on the production of tumour necrosis factor by spleen cells in vitro and on tumour regression in vivo has been studied. TNF activity was detected in spleen cell supernatants and serum of mice treated with drugs, using L929 cells as targets. The combination of LPS and MDP was more effective in TNF production than each of the drugs used alone in vitro and in vivo. The injection of LPS and MDP to A/Sn mice with subcutaneous nodes of sarcoma SA-I resulted in total tumour necrosis. The treatment of mice with these drugs in water solutions was more effective, however, more toxic than the administration of LPS-treated splenocytes in MDP solution. PMID- 3315037 TI - [Approaches to the creation of a model of cerebral thrombocytic microembolism and to research on the effects of drugs]. AB - It is shown that the introduction of collagen into the carotid artery brings forth an increase in perfusion pressure during cat cerebral autoperfusion due to blockade of micro-vessels by platelet aggregates. This increase is of a transitory character and is accompanied by changes in the acid-base balance of the arterial blood towards acidosis. It has been established that papaverine and cavinton (vinpocetine) do not cause recanalization of the blocked microvessels, and in case of verapamil it is of a partial character. The infusion of prostacyclin brings about an almost total recanalization of microvessels and prevents intravascular aggregation upon collagen application. It is concluded that this model may prove useful in the selection of drugs for the pathological therapy of cerebral dysfunctions. PMID- 3315038 TI - The 5q- abnormality. PMID- 3315039 TI - Purification of human megakaryocytes by fluorescence-activated cell sorting. AB - For direct studies of growth control, a method was developed to purify viable human megakaryocytes to homogeneity from routine normal bone marrow aspirates. An initial separation of marrow over a 1.050 g/mL Percoll density cut was used to enrich megakaryocytes. After washing, the cells were specifically labeled with a fluoresceinated monoclonal antibody or F(ab')2 fragment to the platelet glycoprotein (GP) IIb/IIIa complex. Megakaryocytes were selectively sorted by using Becton Dickinson FACStar flow cytometer on the basis of a fluorescence intensity greater than 50-fold that of control cells. To increase resolution and purity the sorting rate was adjusted to one cell in 13 formed drops, and negative events that coincided with positive ones were aborted. Two thirds of the isolated cells were large, morphologically recognizable megakaryocytes with a forward light scatter fourfold that of the main cell population. Microscopic examination showed these cells to be greater than or equal to 98% megakaryocytes with a diameter of 20 to 46 microns and a ploidy range of 2N to 64N with a mode of 16N. The small highly fluorescent cells were 10 to 21 microns in diameter, and their ploidy range from 2N to 32N with main ploidy classes of 2N and 4N. The majority of these small cells also positively reacted with monoclonal antibody to platelet GPIb. The isolated cells were cultured in either Iscove's or leucine, lysine deficient RPMI 1640 medium with 10% human plasma. The cells were maintained in culture more than three days and were capable of synthesis of both DNA and protein as assessed by radiolabeled thymidine and amino acid incorporation. Moreover, the isolated megakaryocytes were capable of responding to recombinant granulocyte-macrophage colony-stimulating factor. The data show that human megakaryocytes can be purified from routine marrow aspirates on the basis of a lineage marker and that they are capable of growth in vitro. PMID- 3315040 TI - Expression of myelomonocytic antigens on chronic lymphocytic leukemia B cells correlates with their ability to produce interleukin 1. AB - We analyzed the expression of myelomonocytic-associated antigens on lymphocytes from B cell chronic lymphocytic leukemia (B-CLL) patients. Blood mononuclear cells were depleted of monocytes by one-step Percoll density gradient centrifugation and tested for antigen expression by fluorescent microscopy and flow cytometry. The reactivity of patient lymphocytes was as follows: 26 of 31 were positive for CD14 (Myr), 22 of 31 for a monocyte Fc receptor (MFC-1), 22 of 31 for CD11b (C3bi receptor), eight of 31 for CD15 (Leu-M1), five of 18 for CD13 (My 7), seven of 18 for My 9, and five of 30 for Mo 2. The B lymphocytes of B-CLL patients were also tested for the ability to produce interleukin 1 (IL-1) after depletion of monocytes and T lymphocytes. In 13 of 17 cases, B lymphocytes of patients produced IL-1 as detected in a mouse thymocyte proliferation assay and, in selected cases, a radioimmunoassay specific for IL-1 beta. The 13 cases that produced IL-1 were also positive for the expression of one or more myelomonocytic associated antigens, whereas the four cases that did not produce IL-1 lacked expression of these antigens. In conclusion, the malignant B cells of B-CLL patients frequently express a variety of antigens generally considered specific for myelomonocytic cells, and expression of these antigens is associated with the ability to produce IL-1. PMID- 3315041 TI - Kinetic evaluation of the pool sizes and proliferative response of neutrophils in bacterially challenged aging mice. AB - Clinical observations during infection suggest that in aged patients, the kinetic or proliferative responses of neutrophils to infection may be deranged. To test this hypothesis, the neutrophil responses of 6-month-old and 30-month-old mice were compared. After intrapulmonary injection of Escherichia coli, young mice exhibited neutrophilia and diminution of the neutrophil storage pool (NSP) by a mean of 6.4 x 10(6) neutrophils/two femurs. This was accompanied by an increase in the pool of CFU-GM from a control value of 1.1 x 10(5) cells/two femurs (range 0.7 to 1.4) to 1.5 x 10(5) (1.1 to 1.9) (P less than .05) and the thymidine suicide (relative proliferative rate) of CFU-GM rose from 27% (19 to 42) to 51% (31 to 61) (P less than .05). Furthermore, the CFU-GM of infected young mice displayed enhanced differentiation to the neutrophil series. In contrast, old mice exhibited a greater mean diminution of the NSP: 12.8 x 10(6) neutrophils. Also, old mice experienced a reduction in CFU-GM from 2.3 x 10(5) (1.0 to 3.9) (controls) to 1.3 x 10(5) (1.2 to 1.5)/two femurs (P less than .05), a reduction in the proliferation of CFU-GM and reduced differentiation of CFU-GM to neutrophils. These experiments establish that the neutrophil response of infected old mice is disordered, with exaggerated depletion of the NSP and lack of stimulus-driven granulocytopoiesis as reflected by a paradoxical reduction in the number and proliferative rate of precursors. This defect may be compounded by decreased differentiation of precursors to neutrophils. PMID- 3315042 TI - Spontaneous production of interleukin 1 activity by chronic lymphocytic leukemic cells. AB - Chronic lymphocytic leukemic B cells (B-CLL) were found to produce an IL 1-like growth factor spontaneously in vitro for mouse thymocytes. This factor was comitogenic with concanavalin A (Con A) and nonmitogenic combinations of phorbol ester and calcium ionophore but not with phyto-hemagglutinin (PHA). Growth factor production was dose-related to the number of in vitro cultured cells and detectable at 6 hours using high cell concentrations. A small number of admixed normal T cells was not important for factor production. No growth of autologous B CLL or allogeneic thymocytes was induced by the factor. A chromatographic high performance liquid chromatography (HPLC) analysis and inhibition experiments with a polyclonal rabbit anti interleukin 1 (IL 1) antiserum indicated that the B-CLL derived growth factor belonged to the IL 1 family. This was supported by the direct demonstration of IL 1 beta in supernatants from B-CLL by radioimmunoassay. Possible biologic implications for B-CLL-derived IL 1 are discussed in relation to tumor cell growth in different clinical stages. PMID- 3315043 TI - Evidence for direct action of human biosynthetic (recombinant) GM-CSF on erythroid progenitors in serum-free culture. AB - The biologic activity of human biosynthetic granulocyte-monocyte colony stimulating factor (GM-CSF) was investigated in serum-free culture of erythroid progenitors derived from adult peripheral blood. The morphology of erythroid bursts and the cloning efficiency of BFU-E under serum-free conditions were similar to those observed in dishes with fetal bovine serum (FBS). For these experiments, progenitor cells were partially purified by Ficoll-Paque density centrifugation, adherence to a plastic surface, and complement-mediated cytotoxicity of Leu-1+ elements. For some studies, blastlike cells were harvested directly from 6-day-old semisolid cultures. In serum-free culture of the light density cell fraction, biosynthetic erythropoietin (Ep) was sufficient for formation of pure and mixed erythroid colonies whereas GM-CSF was required for granulocyte-monocytic colonies. When adherent and Leu-1+ cells were removed, or when in vitro differentiated blast cells were used as a source of progenitors, neither Ep or GM-CSF alone induced colony formation. In dishes supplemented with both growth factors, erythroid bursts were detected. Although the presence of GM CSF alone did not induce formation of any colony or clusters, BFU-E were recorded when Ep was added 8 days later, suggesting that BFU-E could be maintained. Terminal maturation of the resulting erythroid bursts was delayed by 8 days. These results provide evidence that GM-CSF acts directly on early erythroid progenitors. Furthermore, they suggest that both Ep and GM-CSF are necessary to start the differentiation process. PMID- 3315044 TI - Recovery of contact hypersensitivity responses following murine bone marrow transplantation: comparison of gamma-irradiation and busulfan as preparative marrow-ablative agents. AB - Bone marrow transplantation (BMT) is often followed by significant morbidity and mortality due to protracted immunodeficiency. We have hypothesized that the bone marrow-ablative regimen may delay the recovery of normal immune function following transplantation by impairing the interaction of host endothelial cells with circulating graft-derived lymphocytes. This report compares the relative effects of busulfan (an alkylating drug) and gamma-irradiation on the tissue specific localization potential of lymphocytes and the eventual recovery of immune function within syngeneic murine transplant recipients. Localization of normal lymphocytes into peripheral lymph nodes of irradiated BMT recipients was markedly less (less than 50%) than in busulfan-treated or normal mice over the first 2 months post-BMT. This finding correlated with irradiation-induced endothelial cell edema and microvascular occlusions within lymphocyte-receptive areas of the nodal microvasculature. The effect of both preparative regimens on the recovery of contact hypersensitivity (CHS) was also analyzed. This response recovered more quickly (between 1 and 2 months) in busulfan-pretreated animals. Further experiments demonstrated that the decrease in CHS responsiveness appeared, in part, related to a depression in the capacity of lymphocytes to localize into skin sites of antigen deposition within irradiated mice. The impairment of tissue-specific lymphocyte localization may represent a novel mechanism by which whole body irradiation can contribute to delayed immunologic reconstitution following bone marrow transplantation. PMID- 3315046 TI - Host origin of the human hematopoietic microenvironment following allogeneic bone marrow transplantation. AB - The origin of marrow stromal cells post allogeneic bone marrow transplantation (BMT) was studied. Two groups of patients receiving HLA-identical marrow grafts from sex mismatched siblings were included in the study: the first group (eight patients) received conventional marrow grafts and the second group (ten patients) received stromal cell and T cell depleted grafts. All patients showed hematopoietic engraftment with donor cells. Marrow aspirates obtained from these patients were used to establish stromal layers in long-term marrow cultures (LTMC) for 4 to 6 weeks. In both groups, karyotype analysis of nonhematopoietic cultured stromal cells showed host origin even as late as day 760 posttransplantation. Immunofluorescence methods using monoclonal antibodies against components of fibroblasts, macrophages, and endothelial cells, showed that the composition of stromal layers was similar to those obtained from normal controls. Our data indicate that marrow stromal progenitors capable of proliferation are nontransplantable and do not originate from a hematopoietic stromal common progenitor. PMID- 3315045 TI - Evidence that plasma lipoproteins inhibit the factor VIIa-tissue factor complex by a different mechanism that extrinsic pathway inhibitor. AB - Factor VIIa participates in blood clotting by activating factor X and/or factor IX by limited proteolysis. The proteolytic activity of factor VIIa is absolutely dependent on a lipoprotein cofactor designated tissue factor. We have examined the ability of purified preparations of human plasma high density, low density and very low density lipoproteins, as well as apolipoproteins A-I and A-II, to inhibit the factor VIIa-tissue factor mediated activation of either factor X or factor IX before and after treatment of the lipoprotein preparation with polyclonal antibody directed against partially-purified human plasma extrinsic pathway inhibitor (EPI). In the absence of anti-EPI IgG, HDL, LDL, VLDL, and apolipoprotein A-II noncompetitively inhibited factor X activation by factor VIIa tissue factor with apparent Ki values of 3.39 mumol/L, 124 nmol/L, 33 nmol/L, and 10.5 mumol/L, respectively. Apolipoprotein A-I had no effect on this reaction. The inhibitory activity of HDL, LDL, VLDL, and apolipoprotein A-II in this reaction was unaffected by the presence of high levels of anti-EPI IgG. In the absence of exogenous factor Xa, none of the lipoproteins studied inhibited the activation of factor IX using the tritiated peptide release assay. In the presence of added factor Xa (1 nmol/L), LDL and VLDL, but not HDL and apolipoprotein A-II, inhibited the activation of factor IX by factor VIIa-tissue factor. This inhibition was completely blocked by prior incubation of the lipoprotein with anti-EPI IgG indicating association of EPI with these particles. Taken collectively, our data indicate that HDL, LDL, and VLDL, at or below their plasma concentration, each selectively inhibits the factor VIIa-tissue factor mediated activation of factor X by a mechanism that appears to be distinct from extrinsic pathway inhibitor. These lipoproteins may not only play a role in the regulation of extrinsic blood coagulation, but may also selectively promote the activation of factor IX by factor VIIa-tissue factor in vivo at low tissue factor concentrations. PMID- 3315047 TI - Hodgkin's disease: the Sternberg-Reed cell. PMID- 3315048 TI - Concentrations of ciclosporin in allogeneic bone marrow recipients. Comparison of assay methods. AB - Thirteen patients in complete remission from acute nonlymphoblastic leukaemia or in chronic phase of chronic myelocytic leukaemia were treated with total body irradiation, cyclophosphamide and allogeneic bone marrow transplantation (BMT). Ciclosporin (CS) was administered for the prevention and the treatment of Graft versus Host Disease. Blood concentrations of CS were determined by Radioimmunoassay (RIA) and by High Performance Liquid Chromatography (HPLC). Trough levels of CS in peripheral blood as measured by RIA exceeded HPLC derived levels in nearly all (56/58) samples with a ratio of RIA:HPLC ranging from 2.43 +/- 1.42 at day 12 to 3.65 +/- 1.86 at day 26 after BMT (means +/- SD). A comparable ratio was found as regards the peak concentrations of CS in peripheral blood. Neither the dose of CS (0.5-3.0 mg/kg/day intravenously; 3.0-5.0 mg/kg/day per os) nor the duration of treatment (12, 19, 26 or 33 days after start of CS) were a significant factor as regards the ratio between HPLC and RIA. Concentrations of CS were also determined in bone marrow nucleated cells at 1 hour after the drug infusion had started. Here the ratio of RIA versus HPLC varied upon the duration of CS treatment with a highest ratio of 8.75 +/- 8.74 at day 12 after BMT. Bone marrow levels corresponded well with blood trough concentrations (p less than 0.01). It is concluded that the concentrations of CS in blood and bone marrow as determined by RIA and HPLC differ significantly, though consistently. At present, no advantage can be attributed to either method of analysis for routine clinical monitoring, as long as detailed information on the immunosuppressive and the toxic characteristics of CS metabolites in humans is lacking. PMID- 3315050 TI - [Dental malocclusions in France from the Neolithic to the Bronze Age]. PMID- 3315049 TI - [Morphological aspects of root surfaces prepared for periodontal surgery by various methods as seen by scanning electron microscopy]. PMID- 3315051 TI - Evaluation of a program to teach health professionals to search MEDLINE. AB - This study analyzes the search behavior of end users who had taken a class in searching MEDLINE on the National Library of Medicine's MEDLARS system. Of the class alumni, 58% obtained passwords. Most of these were still conducting their own searches twelve to eighteen months later. Telephone interviews and search observations indicated that these end users were satisfied with their results and felt they had mastered the basic mechanics of searching. However, appropriate use of explodes and subheadings, as well as locating appropriate search terms, still presented difficulties for them. Further training in these areas may be required. PMID- 3315052 TI - Beyond the online catalog: developing an academic information system in the sciences. AB - The online public access catalog consists essentially of a machine-readable database with network capabilities. Like other computer-based information systems, it may be continuously enhanced by the addition of new capabilities and databases. It may also become a gateway to other information networks. This paper reports the evolution of the Bibliographic Access and Control System (BACS) of Washington University in end-user searching, current awareness services, information management, and administrative functions. Ongoing research and development and the future of the online catalog are also discussed. PMID- 3315053 TI - Searching for patterns in the MeSH vocabulary. AB - NLM revises its MeSH vocabulary annually to reflect changes in biomedical literature and the health sciences community. This study tested two hypotheses about NLM's MeSH vocabulary. The first is that new terms are added to MeSH when their broader terms have an increased number of postings. One examination compared the number of postings for the broader terms of new and existing terms in the current MEDLINE file; the other compared them over time. No significant statistical difference was found in either case. A second hypothesis--that there is a relationship between the patterns of MEDLINE indexing and searching and the organization of the MeSH tree structure--was tested by comparing the distribution of searched terms in the MeSH trees with the distribution of all terms. It was found that certain trees are searched more often than could be predicted by the overall term distribution, while others are searched less frequently than expected. In summary, (1) new terms cannot be predicted by the increase in postings of existing terms, and (2) searchers' and indexers' use of the terms' tree structure does not correlate with the terms' distribution in the MeSH trees. PMID- 3315054 TI - Bibliography of Bioethics and Index Medicus: comparison of coverage, publication delay, and ease of recall for journal articles on bioethics. AB - Citations selected from the bibliographies of recent texts, a specialized subject bibliography, and review articles were checked in both Cumulated Index Medicus (IM) and the Bibliography of Bioethics (BB) to compare coverage, publication delay, probable causes of indexing and retrieval failure, and the ease with which relevant citations were retrieved. The study also attempted to determine whether BB included appropriate articles from the MEDLINE database in a timely and systematic manner. While 98% of the IM citations appeared within a year of publication, 79% of the BB citations appeared two to three years after their publication dates. The average citation appeared twice as frequently in IM as in BB. PMID- 3315055 TI - Library instruction for medical students during a curriculum elective. AB - The University of Minnesota Medical School has an innovative curriculum, called Didactic/Selective, which provides third- and fourth-year medical students with multidisciplinary and multispecialty courses. Within this framework, the Bio Medical Library planned a course to teach the knowledge and skills necessary for library research and information management. It included (1) searching case related topics in print indexes, (2) formulating and processing MEDLINE searches on BRS Colleague, (3) building a personal file with PC-File or Notebook, and (4) exploring various methods for current awareness. Students' evaluations were positive, with the majority indicating that they found the course interesting and the knowledge gained substantial. PMID- 3315056 TI - Holly Shipp Buchanan, President, Medical Library Association 1987/88. PMID- 3315057 TI - Mayo Drake 1924-1986. PMID- 3315059 TI - A tribute to Paul W. Pruyser. PMID- 3315060 TI - In memoriam. Paul W. Pruyser, Ph.D. (1916-1987). PMID- 3315061 TI - Now what? PMID- 3315058 TI - The Nation's Health Information Network: History of the Regional Medical Library Program, 1965-1985. PMID- 3315062 TI - Bibliography of the writing of Paul W. Pruyser, Ph.D. PMID- 3315063 TI - Changing treatment patterns in urinary infections. PMID- 3315064 TI - Diagnosis and treatment of viral infections. PMID- 3315065 TI - Antibiotic therapy in aging patients. PMID- 3315066 TI - Ethical and social issues in the development of new drugs and vaccines. PMID- 3315069 TI - Doppler estimates of cardiac output during pregnancy. PMID- 3315068 TI - Neoplasia in AIDS. PMID- 3315067 TI - The role of the infectious diseases physician in monitoring antimicrobial use: a pharmacy perspective. PMID- 3315070 TI - Hepatic glycogen storage disease. AB - The management of patients with glycogen storage disease is based on an understanding of the biochemistry. The outlook for many patients has improved so that they can now grow up normally. PMID- 3315071 TI - Inborn errors of the urea cycle. AB - Inborn errors of the urea cycle are an important cause of hyperammonaemia throughout childhood, and are associated with high morbidity and mortality rates. If they are diagnosed early and treated appropriately, the outcome for affected children is significantly improved. PMID- 3315072 TI - Plasma lipoprotein disorders in childhood. AB - Disturbances of the plasma lipoproteins occur as a secondary manifestation in many diseases and usually resolve with treatment of the underlying condition. Of the inherited primary disorders familial hypercholesterolaemia is the most common and important, carries a high risk for premature coronary heart disease in adults, and should be diagnosed and treated in childhood. PMID- 3315073 TI - Inborn errors of trace metal metabolism. AB - A variety of complex systemic, hepatic and neuropsychiatric syndromes result from inborn errors of trace metal metabolism. Some of these respond to treatment and prophylactic management while for some intractable conditions prenatal diagnosis is possible. All these abnormalities provide valuable insight into the normal metabolism of these vital elements. PMID- 3315074 TI - The radiology of AIDS. AB - Radiology has an important role to play in the management of patients with AIDS. This article will illustrate the radiological aspects that are seen commonly in AIDS rather than cataloguing every conceivable X-ray abnormality that may be found. The aim has been to indicate those findings which are useful pointers in diagnosing the AIDS-related diseases and conditions. PMID- 3315075 TI - Abdominal surgery in the elderly. AB - While the clinical care of elderly patients does not differ in principle from that which applies to other age groups, there are often differences in emphasis and detail. The presence of degenerative disease, multiple pathology, and diminished psychological reserve pose greater demands on technical surgical skill and clinical judgment. PMID- 3315076 TI - The management of psychopathic offenders. AB - The concept of psychopathic disorders has persisted in mental health legislation despite doubts as to its validity as a diagnosis and its treatability. There is a need for careful selection of those psychopathic offenders most likely to respond to medical treatment in hospital and to admit them under the appropriate section of the Mental Health Act. PMID- 3315077 TI - Limitations of telediaphanography for breast cancer screening. PMID- 3315078 TI - The pouch as an alternative to permanent ileostomy. AB - Restorative proctocolectomy has become a realistic alternative to construction of a permanent stoma for patients with ulcerative colitis and familial polyposis coli. The operation restores intestinal continuity but continent patients have to open their bowels 4-5 times during the day, and over half have to rise at night to defaecate. The potential complications are considerable, but their frequency decreases with experience with the operation. This article reviews the place and results of ileoanal pouch anastomosis. PMID- 3315079 TI - Stoma avoidance in rectal cancer. AB - Advances in surgical techniques have resulted in a renewed enthusiasm for restorative resections in patients with rectal cancer. Although a permanent or temporary stoma may be avoided in the majority of cases the surgical literature is bereft of adequately controlled trials comparing these techniques with abdomino perineal excision of the rectum and anus. Many uncontrolled studies, however, suggest little difference in the results obtained, and in particular local control of the disease. PMID- 3315080 TI - The quality of life with a stoma. AB - This article considers the problems encountered by the ostomate, reviews the present structure and effectiveness of hospital and community-based resources and offers a basis for improving the quality of stoma care. PMID- 3315081 TI - The mechanisms of acupuncture analgesia. AB - Despite ever-increasing popularity as a quick, effective and safe means of pain control, acupuncture is still regarded with some suspicion in conventional medical circles. Nevertheless evidence is accumulating to support a firm physiological basis for its action, a fuller understanding of which will shed light on the essence of pain itself. PMID- 3315082 TI - Early imaging of the infarct. AB - Radionuclide techniques for the detection of acutely infarcted myocardium have been available for several years, but they are rarely used. Recent advances, such as the introduction of single-photon emission computed tomography and the introduction of novel radiopharmaceuticals, have suggested new clinical and research applications for them. PMID- 3315083 TI - Anaesthesia for neuroradiology. AB - Invasive investigation of the brain and spinal cord started in the early part of the 20th century. With advances in the understanding of neurophysiology, improvements in anaesthetic technique and the advent of new drugs, general anaesthesia has become an acceptable alternative to local anaesthesia during these investigations. PMID- 3315084 TI - Thoracotomy: conduct and postoperative management. PMID- 3315086 TI - Anorgasmia from clomipramine in obsessive-compulsive disorder. A controlled trial. AB - Forty-six patients with obsessive-compulsive disorder undergoing a double-blind controlled study of clomipramine and placebo were interviewed to assess changes in sexual function. Of 33 patients with previously normal organism, nearly all of the 24 on clomipramine developed total or partial anorgasmia; none of the 9 on placebo did so. Anorgasmia persisted with minimal tolerance over the five months that clomipramine was taken. Men and women were equally affected. Sexual side effects are easily missed without a structured interview, and can detract from the value of drug treatment. PMID- 3315085 TI - A comprehensive repair of unilateral cleft lip in adults. AB - A comprehensive operation for primary repair of adult cleft lip is described. The technique employs pyriform fossa bone graft, submucosal resection of the nasal septum and alar cartilage onlay graft in addition to a modified rotation advancement with refinements. Good results were obtained in 70% of the cases with no increase in morbidity. PMID- 3315087 TI - Suicide and social response in Fiji: a historical survey. AB - A historical review of suicide in Fiji shows that rates for people of Indian descent have always been higher than those of other groups, yet until now this phenomenon has attracted little official or public attention. Recent changes in the incidence and methods of suicide have led to the introduction of some preventive measures, but the emphasis has been on eliminating some of the methods rather than the reasons for suicide. The continuing high incidence of suicide by hanging involving some sectors of society appears to have been overlooked. Possible causes of this apparent lack of interest are examined, such as the low status historically of Indian immigrants and concepts held about them by other groups in Fiji, and the "invisibility" of groups of people such as rural women and the aged. PMID- 3315089 TI - Obituary. Dr. J. W. D. Bull. PMID- 3315088 TI - Family-genetic studies and identification of valid diagnostic categories in adult and child psychiatry. AB - Family-genetic studies of child and adult psychiatric disorders have become increasingly fashionable over the past decade. The development of structured diagnostic interview schedules, the emergence of uniform diagnostic criteria such as DSM-III, and the use of refined design and analytic techniques from the field of chronic disease epidemiology have made substantial contributions to the methodology of such studies. Advances in molecular genetics, particularly our emerging capacity to perform chromosomal linkage studies throughout the human genome, have renewed hope that the constitutional underpinnings of some psychiatric disorders can be identified and that the pathophysiology of these disorders can be elucidated. Family-genetic techniques in child and adult psychiatry are discussed with a particular focus on their potential value in validating diagnostic categories spanning developmental epochs. PMID- 3315090 TI - A set of X-ray test objects for image quality control in digital subtraction fluorography. I: Design considerations. AB - A set of X-ray test objects has been developed for quality control in digital subtraction fluorography (DSF). Factors which can be assessed include dynamic range, highlight overload and signal-to-noise ratio, low contrast sensitivity, unsharpness, and systematic misregistration. These test objects complement, both in design and calibration, those previously developed to evaluate the imaging performance of television fluoroscopy and small-format fluorography systems. In this article, the first of two, we describe the Leeds DSF test objects, paying particular attention to the reasoning behind their design. PMID- 3315091 TI - A set of X-ray test objects for image quality control in digital subtraction fluorography. II: Application and interpretation of results. AB - In the previous article we introduced a set of test objects for quality control of digital subtraction fluorography (DSF) systems. These test objects have been evaluated using several commercial DSF systems in their clinical environment. In this second article we present test images and results obtained during these trails and explain how the test objects can be used to analyse the imaging performance of DSF systems. PMID- 3315092 TI - Sclerosing stromal tumour of the ovary. PMID- 3315093 TI - The institute at 90: a time for reappraisal? British Institute of Radiology presidential address, 1987. PMID- 3315094 TI - Molecular genetics and polymorphism of class I HLA antigens. PMID- 3315096 TI - Progress in understanding HLA and disease associations. PMID- 3315095 TI - Genetics and polymorphism: class II antigens. PMID- 3315098 TI - The biological consequences of altered MHC expression on tumours. PMID- 3315097 TI - HLA and organ transplantation. PMID- 3315099 TI - The role of class I and II antigens in T cell recognition. PMID- 3315100 TI - The molecular genetics and polymorphism of C2 and factor B. PMID- 3315101 TI - Polymorphism and molecular genetics of human C4. PMID- 3315102 TI - Regulation of HLA class I and class II antigen expression. PMID- 3315103 TI - Structure of class I and class II HLA antigens. PMID- 3315104 TI - Applications of serology and the ethnic distribution of three locus HLA haplotypes. PMID- 3315105 TI - Disorders of the tarsus in the dog. I. PMID- 3315106 TI - Efficacy and financial value of antibiotic treatment of bovine clinical mastitis during lactation--a review. PMID- 3315107 TI - A human teratocarcinoma which expresses a rare neuronal cell surface antigen. AB - A molecular characterization of the events at the cell surface of neurons is pivotal for our understanding of how the nervous system is formed and maintained. This study of cell surface events in the human nervous system may be crucial to the study of human neurological maladies. NTERA-2 is a human teratocarcinoma which is unique amongst the teratocarcinomas for its ability to express many neurons. Tested for the binding of a monoclonal antibody Tor 23, which recognizes a surface antigen on rare and specific neurons, cultures of NTERA-2 cells contained cells with a neuronal morphology which bound the monoclonal antibody Tor 23 on their surface. The data indicate that Tor 23 antigen is a cell surface molecule with the same or very similar properties in rays, rats, and humans. The NTERA-2 cells are thus capable of expressing highly differentiated neuronal cell surface phenotypes and promise to be a powerful model system for the study of cell surface events of the human nervous system in vitro. PMID- 3315108 TI - Two discrete enkephalinergic neuron systems in the superior cervical ganglion of the guinea pig: an immunoelectron microscopic study. AB - Leucine-enkephalin (L-ENK)-like immunoreactive (L-ENKI) structures in the superior cervical ganglion (SCG) were first examined by using immunoelectron microscopy. L-ENKI neurons formed cell clusters and were small. They were filled with large granular or agranular vesicles and small electron lucent vesicles, and had nuclei that lacked a nucleolus. Since these morphological characteristics are identical to those of the small intensely fluorescent (SIF) cells, L-ENKI cells seemed to be a kind of SIF cell. Two types of L-ENKI fibers were identified, a large type filled with large granular or agranular vesicles and a small type filled with small electron lucent vesicles. The large fibers were located near the L-ENKI perikarya and often could be traced directly to the soma. These fibers remained intact after decentralization of the SCG. These findings indicate that the large L-ENKI fibers are processes of L-ENKI SIF cells. The fibers showed a close apposition to the blood vessels and rarely formed synaptic contact with dendrites of the principal cells. On the other hand, the small L-ENKI fibers were found to originate outside the SCG, because they disappeared after decentralization of the SCG. These L-ENKI fibers frequently formed synaptic contact with the dendrites of the principal cells. Thus, the present study demonstrated the presence of two discrete L-ENKI neuron systems in the SCG of the guinea pig, one an intrinsic SIF system and the other an extrinsic L-ENKI system. PMID- 3315109 TI - GABA-like immunoreactivity in the chick vestibular end organs. AB - gamma-Aminobutyric acid (GABA)-like immunoreactivity in the chick vestibular endorgans was examined using an antiserum against GABA coupled with glutaraldehyde to bovine serum albumin. GABA-like immunoreactivity was confined to the cytoplasm of the hair cells in both cristae and maculae. GABA-like immunoreactive cells were evenly distributed throughout the sensory epithelia, and no difference existed between type I and type II hair cells. The results provide evidence that GABA-like immunoreactivity is localized to sensory cells and raises the possibility that GABA may serve as an afferent neurotransmitter in the chick vestibular end organs. PMID- 3315110 TI - The histaminergic innervation of the mesencephalic nucleus of the trigeminal nerve in rat brain: a light and electron microscopical study. AB - Histaminergic fibers in the mesencephalic nucleus of the trigeminal nerve of Long Evans rats were examined by light and electron microscopy after peroxidase antiperoxidase immunocytochemical staining for histidine decarboxylase (HDC) as a marker. By light microscopy, neurons in the mesencephalic nucleus of the trigeminal nerve were seen to be surrounded by a number of HDC-like immunoreactive (HDCI) fibers, suggesting the presence of axo-somatic contact. This finding was supported by immunoelectron microscopic demonstration of synaptic contact of some HDCI fibers with the soma of the neurons in this nucleus. These findings indicate that histamine is involved in the sensory regulation of movement of the masticatory muscles at the level of the trigeminal mesencephalic nucleus. PMID- 3315111 TI - Comparisons of the immunocytochemical localization of choline acetyltransferase in the vestibular nuclei of the monkey and rat. AB - Immunocytochemical studies of the brainstem were done in the squirrel monkey and rat using the same polyclonal antisera for choline acetyltransferase (ChAT). Cells immunoreactive for ChAT (ChATir) were evident in large numbers in visceral and motor cranial nerve nuclei in both species, but virtually no ChATir cells were seen in the vestibular nuclear complex of the rat. In the monkey ChATir cells were distributed in caudal parts of the medial (MVN) and in dorsal parts of the inferior (IVN) vestibular nuclei. Only a few immunoreactive cells were seen in the rostral MVN and none were found in cell group f of the IVN. Nearly all cells of group z and x, which do not receive primary vestibular afferents, were immunoreactive to ChAT. None of the cells in the superior and lateral vestibular nuclei, cell group y, the infracerebellar nucleus or the interstitial nucleus of the vestibular nerve were immunoreactive for ChAT. Cells immunoreactive to ChAT were present in large numbers in the rostral part of the nucleus prepositus in the monkey, but not in the rat. The relatively small number and distribution of ChATir cells in the MVN suggested they could constitute only a small fraction of the MVN neurons that contribute to a massive commissural system. Significant differences in cholinergic vestibular neurons appear to exist between the rat and the monkey. PMID- 3315112 TI - GABAergic neurons containing the Ca2+-binding protein parvalbumin in the rat hippocampus and dentate gyrus. AB - The distribution of Ca2+-binding protein, parvalbumin (PV), containing neurons and their colocalization with glutamic acid decarboxylase (GAD) were studied in the rat hippocampus and dentate gyrus using immunohistochemistry. PV immunoreactive (PV-I) perikarya were concentrated in the granule cell layer and hilus in the dentate gyrus and in the stratum pyramidale and stratum oriens in the CA3 and CA1 regions of the hippocampus. They were rare in the molecular layer of the dentate gyrus, in the stratum radiatum and in the stratum lacunosum moleculare of the hippocampus. PV-I axon terminals were restricted to the granule cell layer, the stratum pyramidale and the immediately adjoining zones of these layers. Almost all PV-I neurons were also GAD immunoreactive (GAD-I), whereas only about 20% of GAD-I neurons also contained PV. The percentages of GAD-I neurons which were also immunoreactive for PV were dependent on the layer in which they were found; i.e. 40-50% in the stratum pyramidale, 20-30% in the dentate granule cell layer and in the stratum oriens of the CA3 and CA1 regions, 15-20% in the hilus and in the stratum lucidum of CA3 region and only 1-4% in the dentate molecular layer and in the stratum radiatum and the stratum lacunosum moleculare of the CA3 and CA1 regions. PV-I neurons are a particular subpopulation of GABAergic neurons in the hippocampal formation. Based on their morphology and laminar distribution, they probably include basket cells and axo axonic cells. PMID- 3315113 TI - Numerous nerves with calcitonin gene-related peptide-like immunoreactivity innervate junctional epithelium of rats. AB - We found an unusually dense concentration of nerves with calcitonin gene-related peptide-like (CGRP-L) immunoreactivity in junctional epithelium of rat gingiva. Adjacent oral epithelium was only sparsely innervated. The CGRP-L innervation may affect the local inflammatory reactions, leukocyte transmigration, and serum outflow that occur in junctional epithelium, as well as having somatosensory functions. PMID- 3315114 TI - Rate of regrowth of damaged retinal ganglion cell axons regenerating in a peripheral nerve graft in adult hamsters. AB - The rate of regrowth of ganglion cell axons regenerating into a peripheral nerve graft implanted into the retina of adult hamster was measured, utilizing the method of retrograde labelling by horseradish peroxidase. The fastest regrowing axons were found, after an initial delay of 4.5 days, to extend at about 2 mm/day in the graft. The role of the cell body in controlling the rate of axonal regeneration was briefly discussed. PMID- 3315116 TI - Blood-brain barrier transcytosis of insulin in developing rabbits. AB - Previous studies with isolated brain microvessels have suggested that blood insulin is selectively transported through the brain capillary, i.e. the blood brain barrier (BBB), by receptor-mediated transcytosis. The purpose of the present study is to demonstrate in vivo the uptake of circulating 125I-insulin by brain using thaw-mount autoradiography. However, metabolism of systemic 125I insulin to 125I-tyrosine would allow for brain uptake of 125I-tyrosine and this would preclude interpretation of the autoradiogram. Therefore, the present studies were performed in developing rabbits, since plasma protein degradation of peptides is greatly reduced in developing animals. 125I-insulin was infused via the carotid artery at a rate of 0.25 ml/min for 1, 5, or 10 min, and the mean brain uptake, relative to a [3H]albumin reference, was 99.3 +/- 5.5%, 110.1 +/- 4.3%, and 143.6 +/- 7.9%, respectively. This uptake was saturable by simultaneously infusing unlabeled insulin. Thaw-mount autoradiography of rabbit brain after a 10-min infusion of 125I-insulin revealed silver grains in the pericapillary space and well within the brain parenchyma. HPLC analysis of acid ethanol extracts of rabbit blood after a 10-min infusion showed virtually all of the 125I-radioactivity co-migrated with a known insulin standard on a reverse phase column, indicating minimal degradation of infused 125I-insulin. HPLC analysis of brain radioactivity showed the major peak co-migrated with 125I insulin and this peak was precipitated by an anti-insulin antiserum. The correlation of the transport data, the autoradiography, and the HPLC analysis support the model that brain insulin originates from blood via receptor-mediated transport of the peptide at the BBB. PMID- 3315115 TI - N-acetylaspartylglutamate immunoreactivity in neurons of the cat's visual system. AB - The acidic dipeptide, N-acetylaspartylglutamate (NAAG) was identified immunohistochemically within neurons of the cat's visual system. In the retina, NAAG-like immunoreactivity was observed in some horizontal and amacrine cells at the inner and outer margins of the bipolar cell layer. NAAG-like immunoreactivity was also observed in many retinal ganglion cell bodies, their neurites, and the neuropil of their target areas, the lateral geniculate nucleus (LGN) and the superior colliculus. Additionally, peptide immunoreactivity was also seen in the projection neurons of the LGN, in cells of the pulvinar nucleus, and in the pyramidal cells of layers III and V in areas 17, 18 and 19 of the cerebral cortex. These data suggest that NAAG or a structurally related molecule may have a prominent role in the communication of visual signals at retinal, thalamic and cortical levels. PMID- 3315118 TI - Corticotropin-releasing factor (CRF) produces analgesia in humans and rats. AB - The analgesic activity of corticotropin releasing factor (CRF) was determined in a clinical model and in the rat hot plate test. Patients administered CRF reported significantly less postoperative pain than patients pretreated with placebo. In rats, injection of CRF resulted in a significant analgesia which was comparable in both intensity and duration to a 300 times greater molar dose of morphine. These findings suggest that endogenous CRF may play a physiologic role in modulating pain when released under conditions of stress. PMID- 3315117 TI - Locus coeruleus (LC) stimulation augments LHRH release induced by medial preoptic stimulation. Evidence that the major LC stimulatory component enters contralaterally into the hypothalamus. AB - Previous studies by others suggest that mid- and hindbrain noradrenergic projections to the hypothalamus may be stimulatory or inhibitory to luteinizing hormone releasing hormone (LHRH) release depending upon the steroid environment of the rat. In the present study we reevaluated the effects of electrical stimulation of the locus coeruleus (LC) in estrogen-primed ovariectomized (OVX) rats anesthetized with chloral hydrate. This anesthetic agent blocked the spontaneous luteinizing hormone (LH) surges which normally occur in estrogen treated OVX rats. In such rats, bilateral LC electrical stimulation was ineffective in altering basal LH concentrations. Thereafter, we evaluated the effects of LC electrical stimulation on patterns and concentrations of plasma LH induced by electrochemical stimulation (ECS) of the medial preoptic nuclei (MPN). Bilateral MPN-ECS induced a significant rise in plasma LH. When the LC was bilaterally stimulated for 15 min beginning 30 min after MPN stimulation, peak LH concentrations were significantly augmented and remained elevated throughout the experiment. To learn more of how LC noradrenergic projections reach regions of the hypothalamus which contain LHRH neurons, the right MPN in a group of rats was unilaterally ECS and 30 min later the right LC was unilaterally stimulated for 15 min. Plasma LH levels increased after MPN activation but no further rise or fall in LH occurred after ipsilateral LC stimulation. In the final group of rats, the right MPN was unilaterally electrochemically stimulated and this was followed 30 min later by contralateral electrical stimulation of the left LC. In these animals, peak plasma LH concentrations were significantly elevated above those obtained after only unilateral MPN stimulation. These data demonstrated that LC stimulation augments LH release but only after preliminary depolarization of LHRH neurons by ECS. Moreover, the stimulatory noradrenergic projections from LC decussate to enter contralateral hypothalamic regions containing LHRH neurons. PMID- 3315119 TI - Effects of physiological manipulations on locus coeruleus neuronal activity in freely moving cats. III. Glucoregulatory challenge. AB - Insulin-induced hypoglycemia and the subsequent administration of glucose were examined for their effects on single unit activity of locus coeruleus noradrenergic (LC-NE) neurons in unanesthetized, unrestrained cats. LC-NE neuronal activity showed an inverse relationship to blood glucose levels. The activity of most cells increased during sustained hypoglycemia, and then decreased following glucose administration. Some neurons were unaffected by hypoglycemia, but were inhibited following glucose. The activation of LC-NE neurons in response to insulin administration generally paralleled the increase in plasma epinephrine, although the adrenal response was more sensitive. These data, together with those reported in the preceding papers, suggest the following general conclusions: (1) physiological stimuli can influence the activity of LC NE neurons in unanesthetized subjects (although they do so less strongly than environmental stimuli); (2) these effects of physiological stimuli upon LC-NE neurons can be exerted independent of changes in behavioral state; (3) LC-NE neurons do not appear to play a specific role in the regulation of any of the systems examined, but may instead play a more global role in the response to physiological challenges in general; (4) LC-NE neurons are generally co-activated with both the neural and hormonal components of the sympatho-adrenal system, although sympathetic activation can occur in the absence of increased LC-NE activity. A previously hypothesized role for LC-NE neurons in facilitating the behavioral response to environmental stressors may thus be extended to include the response to physiological challenges, and perhaps facilitation of the physiological as well as the behavioral components of the stress response. PMID- 3315120 TI - Immunocytochemical localisation of neuropeptide Y and 5-hydroxytryptamine in a subpopulation of amine-handling intracardiac neurones that do not contain dopamine beta-hydroxylase in tissue culture. AB - The colocalisation of neuropeptide Y (NPY)- and 5-hydroxytryptamine (5-HT) immunoreactivities in intracardiac neurones in dissociated cultures from the atria and interatrial septum of newborn guinea pig heart was demonstrated by the sequential application of specific antisera which were visualised by two different fluorochromes. In this way it was observed that most 5-HT immunoreactive neurones also contained NPY-immunoreactivity (approximately 40% of identified neurones), some neurones were 5-HT-immunoreactive alone (approximately 10%), while neurones that were NPY-immunoreactive only were rarely seen. No dopamine beta-hydroxilase (DBH)-immunoreactive intracardiac neurones were demonstrated in any of the culture preparations studied, although DBH immunoreactive neurons could be detected in sections of the newborn guinea pig heart containing intracardiac ganglia. The possible implications of the colocalisation of 5-HT, that has been taken up from the culture medium, with NPY in a population of intracardiac neurones are discussed; and reasons for the loss of expression of DBH by these neurones under the conditions of culture are considered. PMID- 3315121 TI - Microinjection of a benzodiazepine into substantia nigra elevates kindled seizure threshold. AB - The purpose of these experiments was to initiate investigations of the brain site(s) at which the benzodiazepines exert their anticonvulsant effect. We examined the effects of microinjections of clonazepam into substantia nigra (SN) on seizure threshold in the kindling model. We also examined the distribution of microinjected [3H]methylclonazepam with autoradiographic methods. Microinjection of clonazepam bilaterally into substantia nigra pars reticulata (SNR), but not nearby, produced a 75% elevation of generalized seizure threshold. Quantitative analysis of autoradiographic studies indicated that the vast majority of [3H]methylclonazepam was distributed within 400 micron of the injection cannula tip; even optimally placed injections did not result in drug access throughout the entire SN. The data demonstrate that local application of an anticonvulsant benzodiazepine to the substantia nigra alone is sufficient to suppress seizures. We suggest that the substantia nigra is one site at which systemically administered benzodiazepines act to suppress seizures. PMID- 3315122 TI - Characterization of LH-RH immunoreactivity in mammalian pituitary neural lobe by HPLC. AB - High performance liquid chromatography was used to characterize luteinizing hormone-releasing hormone (LH-RH) immunoreactivity that was previously identified immunocytochemically in the pituitary neural lobes of bats, ferrets and humans. Extracts of bat posterior lobe and hypothalamus, ferret posterior lobe and hypothalamus and human neurohypophysis were partially purified with C-18 Bond Elut cartridges. Samples were chromatographed using a C-18 reverse phase HPLC column, and LH-RH-immunoreactive moieties were separated by gradient elution (TFA/acetonitrile solvent system). For bats and ferrets, the major peak of neural lobe LH-RH immunoreactivity eluted with a retention time identical to that of hypothalamic LH-RH. Synthetic mammalian standard added to bat and ferret hypothalamic extracts coeluted as a single peak with the predominant form of LH RH immunoreactivity present in those tissues. In humans, the peak of LH-RH immunoreactivity in neural lobe extracts coeluted with synthetic standard. These results provide strong evidence that the LH-RH-immunoreactive fibers which terminate within the neural lobe contain authentic LH-RH. Additional minor peaks of LH-RH immunoreactivity were observed in posterior lobe and hypothalamic extracts of both bats and ferrets. Comparisons of posterior lobe content of LH-RH immunoreactivity across species verify that the neural lobe projection is a major component of the LH-RH system in bats, whereas it is represented only minimally in the laboratory rat. PMID- 3315123 TI - Simultaneous immunofluorescence and autoradiography: a useful technique for investigating neurotransmitter uptake by neurons and glia in primary central nervous system culture. AB - Previous studies on the localization of radiolabelled neurotransmitters in cultured cells of neural origin have relied on the comparison of cell morphology, as determined by immunocytochemistry, with the patterns of labelling on autoradiograms. We present here a method combining simultaneously autoradiography, following the uptake of tritium-labelled amino acid transmitters, with indirect immunofluorescence using antibodies against both surface and intracellular antigens. Using a fixative containing only a low concentration of glutaraldehyde (4% paraformaldehyde, 0.1% glutaraldehyde), a similar retention of gamma-[3H]aminobutyric acid (GABA) and D-[3H]aspartate was achieved as with the higher concentrations commonly used, with the advantage that the autofluorescence associated with glutaraldehyde fixed tissue was eliminated, and the immunoreactivity of the antigens to be localized was not destroyed. Using this method GABA and D-aspartate accumulating cells, in dissociated mouse central nervous system (CNS) cultures, could be reliably identified as oligodendrocytes, and some multiprocessed astrocytes, by anti-galactocerebroside (GC) and anti glial fibrillary acidic protein (GFAP) immunofluorescence respectively. GABA accumulating neuron-specific enolase (NSE) positive neurons could be clearly identified but no D-aspartate accumulating neurons were found. This technique should have a wide application in the investigation of whether selective transport mechanisms coexist with antigens characteristic of a certain cell type or sub-type. PMID- 3315124 TI - Oligodendroglial and astroglial heterogeneity in mouse primary central nervous system culture as demonstrated by differences in GABA and D-aspartate transport and immunocytochemistry. AB - Using simultaneous autoradiography and immunofluorescence we have investigated the functional heterogeneity amongst oligodendrocytes and astrocytes in primary mouse central nervous system (CNS) culture as expressed by differences in their ability to accumulate gamma-[3H]aminobutyric acid [( 3H]GABA) and D [3H]aspartate. We have used a range of specific antibodies that identify oligodendrocytes and astrocytes, from precursor to fully mature cells, to address the question of whether all neuroglial cells are capable of expressing this function. Our results showing that A2B5-, 03-, and galactocerebroside-positive cells became heavily labelled with these two neuroactive amino acids, whereas cells expressing the myelin proteins 2',3'-cyclic nucleotide 3'-phosphohydrolase (CNP) and myelin basic protein (MBP) did not, demonstrate that this capacity is already present in oligodendrocytes at early developmental stages but may not extend to fully mature cells. Astrocytes in culture exhibited a large degree of variability with respect to their ability to transport GABA and D-aspartate. When grown in either serum-containing or serum-free hormone supplemented culture medium two morphologically distinct of glial fibrillary acidic protein (GFAP) positive astrocyte were identified, process-bearing and epithelioid. Process bearing cells became heavily labelled with the amino acids under both growth conditions, whereas, data showed that although epithelioid astrocytes were not, or only lightly, labelled with either amino acid in serum-containing cultures, when grown in serum-free culture medium they became more heavily labelled. Thus the expression, in culture, by epithelioid astrocytes, of one of the functions attributed to these cells is largely dependent on growth conditions. PMID- 3315125 TI - Effects of beta-carbolines in animal models of anxiety. AB - Animal models of anxiety can be classified into three main groups: those based on conflict or conditioned fear; those exploiting the anxiety produced by novelty; those in which anxiety or aversion is chemically induced. This review briefly describes the existing tests and, where available, the results obtained with beta carbolines. Many of the beta-carbolines are anxiogenic in the tests, however ZK 91296 and ZK 93423 appear to have anxiolytic properties, and ZK 93426 has a similar profile to that of the benzodiazepine receptor antagonist RO 15-1788. By the results across the spectrum of tests, the reliability and sensitivity of the tests is assessed. The evidence that the anxiogenic and anxiolytic actions of the beta-carbolines are mediated by the BDZ binding sites is also discussed. PMID- 3315127 TI - [The significance of ultrasonography in the differential diagnosis of solitary "cold" thyroid gland nodules]. PMID- 3315126 TI - [The effect of short-term administration of tetracycline on the activity of proteolytic enzymes in rat livers]. PMID- 3315129 TI - Festschrift to Brandt F. Steele. PMID- 3315128 TI - Effect of exogenous corticosterone in genetically fat and lean chickens. AB - 1. The effects of daily injections of corticosterone (1 or 5 mg/bird) on growth, fat deposition, liver lipid and plasma concentrations of uric acid, glucose, insulin and growth hormone were studied using genetically selected lines of fat (FL) and lean (LL) chickens. 2. Both doses of corticosterone depressed body weight gain and increased the liver lipid and the abdominal fat to the same extent in both lines. 3. In both lines, corticosterone caused a dose-dependent increase in the plasma concentrations of uric acid, glucose and insulin in the fasted and refed states. 4. In untreated birds, plasma concentrations of growth hormone (GH) were slightly higher in FL than in LL chickens and slightly decreased during refeeding. The response was not modified by injection of 1 mg corticosterone. Injections of 5 mg decreased plasma GH in both lines in the fasting state and in LL chickens during refeeding. In contrast, the same dose increased GH in FL chickens during refeeding. This contradiction remains unexplained. 5. The results suggest that corticosterone sensitivity is not involved in difference of fattening between FL and LL chickens. PMID- 3315130 TI - "Why don't you see what you can do?. PMID- 3315131 TI - Learning a new language with Brandt Steele. PMID- 3315132 TI - The untreatable family. AB - The untreatable family is defined as one in which it is unsafe to permit an abused child to live. Despite the fact that many families turn out to be resistive to treatment, they have received very little attention. In the field of physical abuse, 16-60% of parents reabuse their children following the initial incident. Sexual reabuse is estimated to occur in 16% of cases. Treatment of abusive families also aims to alter family functioning. From studies in physical abuse we find 20-87% of families are unchanged or worse at the end of treatment. In sexual abuse the equivalent figures are 16-38%. Parental factors associated with a poor outcome include parental history of severe childhood abuse, persistent denial of abusive behavior, refusal to accept help, severe personality disorder, mental handicap complicated by personality disorder, parental psychosis with delusions involving the child, and alcohol/drug abuse. Parents lack empathy for their child and fail to see the child's needs as separate from their own. Severe forms of abuse (fractures, burns, scalds, premeditated infliction of pain, vaginal intercourse or sexual sadism) are more likely to prove untreatable. Munchausen by proxy, nonaccidental poisoning, and severe forms of nonorganic failure to thrive are similarly resistant. An early recognition of untreatability may help to reduce burnout by diverting precious resources from the untreatable to the families for whom there is relatively more hope. PMID- 3315135 TI - Film reversing hazards. PMID- 3315133 TI - Behavioral medicine and health psychology in a changing world. AB - Despite long-established roots in experimental psychophysiology and psychosomatic medicine, behavioral medicine and health psychology have only recently emerged as recognized, highly visible disciplines within medicine and the behavioral sciences. The rapid development of these fields has resulted partly from important scientific advances in the biomedical and behavioral sciences and partly from changing societal concerns and values. The latter include a greater preoccupation with individual self-expression and self-fulfillment, a decline in respect for authority per se, and an increased skepticism about social institutions. Coupled with these changes has been an increasing desire to take responsibility for one's own life and, in matters of health, of one's own body. The ways in which scientific advances and social changes have influenced the shape of contemporary behavioral medicine and health psychology are explored with the aid of two illustrations: the growth of a developmental perspective in behavioral medicine and health psychology; and work and health, including the effects of job stress and unemployment. Finally, the author stresses the need for a greater sense of community and concern for others, if we are to succeed in creating a growth-enhancing, health-producing climate for society as a whole and for each of us as individuals. PMID- 3315134 TI - Health Minister Epp grants exclusive CDA interview. PMID- 3315136 TI - Re: Quality of complete dentures. PMID- 3315137 TI - Costa Rican dentist builds bridges not walls as Ambassador. Interview by Carolyn Hackland. PMID- 3315138 TI - Fluoridation. Time for a new base line? PMID- 3315139 TI - Infectious diseases in outpatient practice. PMID- 3315140 TI - Antibiotic administration and oral contraceptive failure. A drug interaction to note. PMID- 3315141 TI - Dental findings in patients with chronic renal failure. An overview. PMID- 3315143 TI - Observations about amyotrophic lateral sclerosis and the parkinsonism-dementia complex of Guam with regard to epidemiology and etiology. AB - For more than 150 years, Chamorro natives of the Mariana Islands in the Western Pacific Ocean, have developed fatal paralysis in middle and later life, which we term amyotrophic lateral sclerosis/parkinsonism-dementia (ALS/PD). The cause of the disease might be exposure to seeds of the indigenous cycad. Motor system disease is induced in cynomolgus monkeys by feeding them beta-N-methylamino-L alanine (BMAA), an amino acid present in cycad seeds. We believe that the cycad seeds which usually cause no immediate adverse symptoms when prepared and eaten as flour, or applied topically as medicine, can give rise to widespread and severe nerve cell degeneration after a latency of many decades. Furthermore, it may be that only a single exposure to this potent but silent toxin(s) can result in fatal neurological disease years later. PMID- 3315142 TI - Guam ALS/parkinsonism-dementia: a long-latency neurotoxic disorder caused by "slow toxin(s)" in food? AB - Parkinsonism (P) with progressive dementia (D) of the Alzheimer type is recognized as a clinical variant of a form of amyotrophic lateral sclerosis (ALS) that has occurred in high incidence among the Chamorro people of the islands of Guam and Rota in the Marianas chain of Micronesia. The declining annual incidence, upward shifting of the age of onset, narrowing of the sex ratio, and occurrence of the disease among non-Chamorros, point to a disappearing environmental causation peculiar to the traditional culture of these islands. Evidence is presented in support of the proposal that heavy use of certain toxic plants, notably cycads, a traditional source of food and medicine for the Chamorro people, plays an important etiological role. Clinical and epidemiological approaches are offered to test for a relationship between ALS/P-D and long-latency plant toxicity. PMID- 3315144 TI - Physiology of the basal ganglia and pathophysiology of Parkinson's disease. AB - This paper reviews current concepts concerning the anatomical organization and functions of the basal ganglia focusing mainly on the role of the basal ganglia in control of movement. Results of several studies which have been carried out on patients with Parkinson's disease are also reviewed and discussed as examples of altered normal physiological mechanisms. PMID- 3315145 TI - Cognition and the basal ganglia: a possible substrate for procedural knowledge. AB - Disruption of neural activity within the basal ganglia of experimental animals causes selective learning deficits in tasks requiring switching between response strategies. These data along with reports of both general and specific intellectual impairment in patients with neurodegenerative disorders such as Parkinson's disease, appear to support the theory of cognitive functions of the basal ganglia. Recent studies have failed to confirm general cognitive or memory deficits in parkinsonian patients, but have identified deficiencies in devising and executing certain cognitive strategies. Following the lead of theorists such as Squire and Mishkin, this brief review emphasizes the distinction between procedural and declarative knowledge and examines the possible role of the basal ganglia in the acquisition and retention of procedural knowledge. PMID- 3315146 TI - Environmental risk factors for Parkinson's disease: the epidemiologic evidence. AB - Descriptive data from several studies suggest variations in the frequency of Parkinson's disease in different population groups. Door-to-door surveys were carried out among a biracial U.S. population (blacks and whites) and in communities in Nigeria and the People's Republic of China. The U.S. investigation revealed no substantial differences in the age-adjusted prevalence ratios by race. However, blacks in Nigeria have a much lower prevalence ratio than blacks in the U.S., suggesting an environmental etiologic factor. Prevalence ratios derived from China are also lower than the U.S. figures. Studies of temporal trends in the incidence rates in one U.S. population (Rochester, Minnesota) show virtually no change over 35 years, indicating that the primary cause(s) of Parkinson's disease must have been present in this nonindustrialized community for many years. Analytic studies generally reveal an inverse association between Parkinson's disease and cigarette smoking, although epidemiologic evidence does not support a direct protective effect of smoking. Preliminary investigations suggest an increased risk associated with the rural environment and the consumption of well water. Further studies are required to discover as yet unknown environmental factors that heighten the risk of Parkinson's disease. PMID- 3315147 TI - Environmental factors in the etiology of Parkinson's disease. AB - Parkinson's disease (PD) has been proposed to result from the interaction of aging and environment in susceptible individuals. Defective metabolism of debrisoquine, inherited as an autosomal recessive, has been associated with this susceptibility. In 35 PD patients and 19 age-matched controls, no significant differences in debrisoquine metabolism were found, although a trend to impaired metabolism was noted in patients with disease onset less than or equal to 40. Foci of PD patients were associated with rural living and well water drinking, or rural living coupled with market gardening or wood pulp mills. In a questionnaire survey, patients with PD onset less than or equal to age 47 were significantly more likely to have lived in rural areas and to have drunk well water than those with onset greater than or equal to age 54 (p less than or equal to 0.01). Because of population mobility in North America, a case-control study designed to test environmental, occupational, dietary and other proposed risk factors for PD was conducted in China, where the population is more stationary and the environment more stable. No significant differences in incidences of head trauma, smoking or childhood measles were found between patients and controls. PMID- 3315148 TI - Update on dopamine agonists in Parkinson's disease: "beyond bromocriptine". AB - Since the initiation of bromocriptine therapy for Parkinson's disease several newer dopamine agonists have been developed. Pergolide has reached the stage of Phase 3 clinical trials and will probably be available for general use sometime in the foreseeable future. Lisuride shows most promise in its parenteral form for infusion therapy of patients with severe fluctuations. Mesulergine, another ergot derivative and ciladopa, a new non-ergot agonist, have been withdrawn from further clinical use due to tumorogenesis in rats. It is questionable how applicable these findings are to the use of the drugs in elderly humans with parkinsonism. Recently a small number of drugs have been found to have postsynaptic dopamine agonist properties only in the setting of denervated supersensitive dopamine receptors. These agents may be particularly effective in the early treatment of patients with Parkinson's disease. This paper will review a number of the dopamine agonists which have been developed since the introduction of bromocriptine therapy. Several of these have shown beneficial effects in early clinical trials while others show promise in preclinical studies of animal models of parkinsonism. PMID- 3315150 TI - Vestibular control of muscular tone and posture. AB - The vestibulospinal system helps to maintain upright posture and head stability. The semicircular canals and their short latency connections to the neck motoneurons, largely via the medial vestibulospinal tract, respond to angular accelerations so as to stabilize the head in space. The paired otolith organs, the utricles placed approximately horizontally, and the saccules vertically, respond to linear acceleration including gravity. Their influence leads, via the lateral vestibulospinal tract, to excitation of ipsilateral extensor motoneurons of the limbs and trunk, and to inhibition of reciprocal flexor motoneurons. Linear displacement of the otoliths leads to bracing of the limbs and body so as to maintain upright posture, and to extend the limbs so as to help in landing after sudden falls. PMID- 3315149 TI - Antioxidant therapy in Parkinson's disease. AB - It is postulated that endogenous oxidative mechanisms are a major factor in the continuing death of dopaminergic neurons and the progression of Parkinson's disease. Scientific evidence in support of, and negating, the free radical auto toxicity and dopamine toxicity concepts is reviewed. There is conflicting evidence whether free radicals are involved in the toxicity of 1-methyl-4-phenyl 1,2,3,6-tetrahydropyridine (MPTP) and attempts to prevent the toxicity of MPTP with antioxidant therapy have had variable results. The oxidation of dopamine by monoamine oxidase produces toxic metabolites however animal studies with high dose longterm levodopa and MPTP have failed to show clear evidence for autoxidation. Firm supportive evidence is obtained from the monoamine oxidase B inhibitor experience which demonstrated a block of the toxicity of MPTP in animals and probable prolongation of the course of human Parkinson's disease. The scientific data available is inconclusive but there is significant hope of retarding progressive catecholaminergic neuron degenerative changes by augmenting the free radical scavenging system with antioxidants (such as Vitamin E) and slowing catecholamine oxidation by monoamine oxidase B inhibition. Careful clinical trials with these agents must be performed. PMID- 3315151 TI - The evaluation of "spasticity". AB - Lesions of the upper motor neuron cause: 1. Alterations in segmental reflex activity. For example increased tendon jerks and velocity dependent stretch reflexes ("spasticity"), clonus, the clasp knife response, release of flexion reflexes and extensor plantar reflexes. 2. Impaired ability to activate motoneurons rapidly and selectively. Voluntary movements may also be restrained by co-contraction of antagonists muscles, by segmental reflexes (enhanced during voluntary effort) or by contractures. A combination of these factors may impair overall functional ability. Segmental reflexes, voluntary power and overall functional abilities can be assessed using clinical scoring systems. Recordings of muscle length, tension and EMG offer more objective measures of reflex and voluntary activity and of overall functions such as locomotion, and can separate weakness from co-contraction, spasticity from contracture. Methods are now available for exploring individual (transmitter specific) segmental reflex pathways and descending pathways in man. Lesions of the upper motor neuron are complicated by secondary changes in segmental neurons. Segmental reflex activity and muscle mechanics depend on the immediate past history of events. These factors must be taken into account. PMID- 3315152 TI - Electromyography in disorders of muscle tone. AB - No single clinical electrophysiological test can evaluate disorders of muscle tone. These disorders, symptomatic of a variety of diseases have a multifactorial physiological basis. The several tests used are complimentary each aiming to study different aspects of spinal and supraspinal reflexes which become deranged. The H reflex and F wave (H max/M max and F max/M max ratios) measure motoneuron pool excitability in general. The tendon reflex includes spindle mechanisms bypassed by the H reflex and, with limitations, comparison of H max/M max and T max/M max yields information about the gamma system. Tonic vibration of a tendon inhibits the H reflex from the same muscle. The TVR measures autogenous presynaptic inhibition exerted by the Ia afferents of the muscle. Recurrent inhibition via Renshaw cells is evaluated by studying the effect of collision on the H reflex. Reciprocal inhibition of the Ia afferents can be assessed by measuring H reflex change induced by stimulating Ia afferents from antagonists. Changes in the H reflex recovery cycle measure polysynaptic influences on spinal motoneuron excitability. Cutaneo-muscular (flexor) reflexes measure poly- and oligosynaptic excitatory drive to spinal motoneurons and the blink reflex evaluates the excitatory drive to brainstem motoneurons. Long loop (segmental) responses can be evaluated by limb pertubation using a torque motor or electrical stimulation applied during voluntary muscle contraction. Finally needle electromyography is a more relevant test in several disorders of muscle tone such as the stiff-man syndrome and Isaacs' syndrome. PMID- 3315153 TI - Pharmacotherapy of spasticity: some theoretical and practical considerations. AB - The availability of new antispasticity agents has greatly extended the therapeutic arm of the neurologist and has obviated the need for destructive neurosurgical procedures in many instances. Baclofen remains the single most useful agent, but in certain circumstances, benzodiazepines and dantrolene sodium are useful alternative or adjunctive treatments. Tizanidine has been recently introduced, and early experience with this agent appears to be favourable. A variety of new drugs are awaiting further evaluation. The effective use of these agents demands an understanding of their principal mechanisms of action, knowledge of their predictable side effects, and a familiarity with the underlying neurological disorders. The monitoring of clinical efficacy is difficult and is often dependent upon subjective evaluation. The application of electrophysiological studies might facilitate the monitoring of treatment and the prediction of optimum treatment strategies for individual patients. The use of these pharmacological agents, from the perspective of a clinician, will be discussed. PMID- 3315154 TI - Multiple sclerosis: assessment of disease progression and effects of treatment. AB - MS could well be a two stage disease. The first stage involves the sequential development of multiple small lesions, mostly inflammatory, that accumulate at a given rate. The second stage could be that of consolidation and confluence of lesions that involves not only demyelination but gliosis. MRI now gives us an opportunity to watch the evolution of these processes and also to monitor treatment effects. It is only after the evolution of this process is understood that we can design rational therapies directed toward the prevention of spasticity in MS. PMID- 3315155 TI - The physiology of idiopathic dystonia. AB - Dystonia is mysterious and its pathophysiology is uncertain. The fundamental motor abnormality is an abnormality of muscle command signals, such that the wrong agonists may be activated for too long, there is abnormal co-contraction of agonist and antagonists, and there is excessive and misdirected action of synergists and postural fixators. The result is action dystonia. In addition, muscle spasms may occur spontaneously. The peripheral motor apparatus, the corticomotoneurone pathway, and (as far as is known) the proprioceptive feedback machinery, are all intact in primary dystonia. However, a defect of interneuronal machinery has been identified in both the brainstem and spinal cord. In blepharospasm there is hyperexcitability of the lower brainstem interneurones responsible for the R2 component of the blink reflex. In the dystonic arm there is loss of the later phases of Ia reciprocal inhibition from extensors to flexors. Both deficits may be due to loss of normal basal ganglia inputs onto interneurones. The known sites of focal lesions that may cause symptomatic dystonia all impair basal ganglia output. However, whether such abnormal interneuronal function is sufficient to explain dystonia is not known. Among many unanswered questions are 1) are the cortical instructions for movement specified correctly, and 2) what is responsible for the spontaneous dystonic spasms? PMID- 3315156 TI - Systemic therapy of dystonia. AB - A number of pharmacologic agents have been found to be effective for the dystonias. Anticholinergic drugs have been shown to be the most effective in terms of percentage of subjects who receive moderate to marked benefit. About 50% of children and 40% of adults obtain such improvement. Peripheral adverse effects are usually overcome by pyridostigmine. It may be necessary to utilize pilocarpine eyedrops for blurred vision. Central adverse effects, such as forgetfulness, can be reduced only by a reduction in dosage of the anticholinergic. In comparing trihexyphenidyl and ethopropazine, we found that children tend to have better tolerance of the former and adults tend to have better tolerance of the latter. The antidopaminergics are the group of drugs that were found to be the next most effective agents in terms of percentage of patients who respond. However, these drugs, particularly the dopamine receptor blockers, have the capacity to induce tardive dyskinesia and tardive dystonia. Tardive syndromes are difficult to treat and can persist indefinitely. Other agents that have shown usefulness in controlling dystonia are levodopa, baclofen, carbamazepine, and the benzodiazepines, either alone or in combination with each other and with the anticholinergics. Stereotactic thalamotomy is particularly useful in contralateral hemidystonia. The risk of adverse effects is less than with bilateral thalamotomy, which may need to be employed when generalized dystonia is severely disabling and not responsive to pharmacotherapy. PMID- 3315157 TI - Progressive supranuclear palsy. AB - Progressive supranuclear palsy (PSP) was first recognized as a distinct morbid entity by Richardson, Steele and Olszewski a quarter century ago. Subsequent experience has confirmed and extended their original observations. PSP has become familiar as a chronic progressive disorder with extrapyramidal rigidity, bradykinesia, gait impairment, bulbar palsy, dementia and a characteristic supranuclear ophthalmoplegia. It is an important cause of parkinsonism. Its etiology remains obscure. Familial concentrations have not been observed. Some cases exhibit no oculomotor dysfunction. Dementia is usually mild. Recent neuropsychological studies have defined features consistent with frontal lobe cortical dysfunction. Seizures and paroxysmal EEG activity may occur. CT and MRI scans show midbrain atrophy early and later atrophy of the pontine and midbrain tegmentum and the frontal and temporal lobes. PET scans have shown frontal hypometabolism and loss of striatal D-2 dopamine receptors. Postmortem studies have documented involvement of both dopaminergic and cholinergic systems. Treatment remains palliative and unsatisfactory. PMID- 3315158 TI - Idiopathic pulmonary fibrosis: a historical review. AB - Hamman and Rich are generally considered to have been the first to describe idiopathic pulmonary fibrosis (IPF) as a new clinical and pathological entity. However, several earlier reports in the German-language literature described autopsy findings consistent with IPF from a contemporary point of view. The author discusses these and later reports in a review of the history, diagnosis and treatment of the disease. PMID- 3315160 TI - Colorectal cancer. AB - Colorectal cancer is one of the leading causes of death in older men and women. Therefore, this age-related cancer is of particular importance to geriatricians. The high incidence of this cancer may be decreased by dietary modifications recommended by the American Cancer Society. Early cancer detection is important to improve survival. When colorectal cancer is detected in the asymptomatic patient, there is a high likelihood of cure. Therefore, screening individuals at high risk is a major goal. Because age is the leading risk factor for colorectal cancer, the American Cancer Society has developed guidelines for screening individuals over age 40 years. Treatment decisions are based on stage of disease. For localized disease, surgical resection is the primary therapy. In advanced disease, palliative treatment may include the use of surgery, radiotherapy, chemotherapy, or a combination of these modalities. Because there is no evidence of an age effect, principles of treatment should be applied similarly in geriatric and younger patients. PMID- 3315159 TI - Is prehospital advanced life support really necessary? PMID- 3315161 TI - Prostatic and bladder cancer in the elderly. AB - Prostate and bladder cancer are the second and fifth leading cancers, respectively, in men over the age of 75 years. Urinary tract cancer represents 4 per cent of all malignancies in women. With careful patient selection, aggressive therapy may be employed with successful outcome. PMID- 3315162 TI - Gynecologic malignancies of the elderly. AB - Gynecologic malignancies account for over 20,000 deaths in the United States each year, and over half of these occur in elderly women. If discovered in their early stages, each of these cancers is curable, but increasing age usually correlates with more advanced stage of disease. Except for ovarian cancer, these diseases can be detected in asymptomatic women by simple screening procedures. Although elderly women may be more difficult to treat because of intercurrent medical illness, when they are treated aggressively, age usually has no independent prognostic significance. PMID- 3315163 TI - Breast cancer in the elderly. AB - Breast cancer is one of the most common serious health problems for elderly women. The study of age-related differences in breast cancer provides useful insights into its pathophysiology. New strategies for treatment, including adjuvant systemic therapy and less aggressive therapy for primary lesions, add new dimensions to a complex and variable disease. PMID- 3315165 TI - Thyroid and parathyroid cancer. AB - The epidemiology, etiology, pathology, and management of thyroid and parathyroid carcinoma are discussed. Emphasis is placed on the clinical differences in the management and treatment of the various histologic subtypes of thyroid cancer. The biologic and prognostic differences among the various histologic types of thyroid cancer and their relationship to age are stressed. PMID- 3315164 TI - Skin cancer in the elderly. AB - Skin cancer is a major concern in geriatric populations. Cumulative exposure to carcinogens and age-related factors both contribute to the high prevalence of cutaneous malignancy in the elderly. Although mortality rates from skin cancer are relatively low, morbidity can be significant, particularly if lesions are neglected. Physicians can have a major impact on the course of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma by nurturing a high index of suspicion for malignancy when unexplained cutaneous lesions are encountered. PMID- 3315167 TI - Primary intracranial neoplasms in the elderly. AB - The most common forms of brain tumor in the elderly are metastasis, glioma, meningioma, pituitary adenoma, and acoustic neuroma. They produce a variety of neurologic symptoms and usually can be readily diagnosed by CT scan. Most of the tumors can be effectively treated with some combination of corticosteroids, surgery, radiation, and chemotherapy. The prognosis of a patient with a brain tumor depends on the tumor's histology, its location, and the patient's ability to tolerate therapy. Early diagnosis is important for successful treatment. PMID- 3315166 TI - Carcinoid and other metabolically active tumors in the elderly. AB - This article reviews the clinical manifestations, diagnostic techniques, and therapy of carcinoid and other metabolically active tumors that occur in the elderly. These tumors secrete monoamine and polypeptide hormones into the vascular compartment. Because these hormones may produce symptoms early in the course of the illness and are amenable to measurement, physicians have the opportunity to make a prompt diagnosis. PMID- 3315168 TI - Sarcomas in the elderly. AB - Though rare, osteosarcomas and soft tissue sarcomas do occur in the geriatric population. When possible, surgical excision is the treatment of choice, with radiation therapy and chemotherapy having largely an adjuvant role. Classic Kaposi's sarcoma is a chronically progressive and ultimately fatal disease of the elderly which can be managed effectively with both radiation therapy and chemotherapy. PMID- 3315169 TI - Alprazolam effects in children with anxiety disorders. AB - Children with overanxious and/or avoidant disorder (DSM-III) were treated with alprazolam (Xanax, Upjohn) to determine its safety, clinical and cognitive effects. Ten male and two female patients (age range 8.8 to 16.5 years; mean 11.5) participated in an open clinical trial consisting of a baseline placebo period (1 week), alprazolam therapy (4 weeks), a drug-tapering period (1 week), and a post-drug placebo period (1 week). There was a drug-free follow-up approximately 4 weeks after termination of the study. Dosages were individually adjusted and the daily maximum ranged from 0.50 mg to 1.5 mg. Evaluations included clinical assessments, parent, teacher and self ratings, and cognitive tests. Clinical global improvement with alprazolam therapy was marked in 1 patient, moderate in 6, minimal in 4, and none in 1. Clinician ratings indicated significant improvements of anxiety, depression, and psychomotor excitation. Parent questionnaires indicated significant improvements of anxiety and hyperactivity while teacher questionnaires showed significant improvement of an anxious-passive factor. Significant improvements in the paired associate learning tasks, maze task and the block design tasks were maintained after drug withdrawal suggesting a practice effect. Adverse effects were infrequent, mild and transient. There were no clinically significant changes of laboratory values, blood pressure, pulse or respiration during the 4 weeks of alprazolam administration. Body weight increased significantly (mean increase was 0.87 kg). Double-blind trials with alprazolam are recommended in child psychiatry disorders. PMID- 3315171 TI - Criteria and methodology for assessing credibility of sexual abuse allegation. AB - This paper will consider three types of interview that are held with sexually abused children. After discussing common problems in technique, it will suggest a methodology designed to help determine a child's credibility and assist in forming and demonstrating a reliable expert opinion for court purposes. Next, it will describe three types of data crucial in investigating allegations of sexual abuse, and will suggest clinical criteria useful in distinguishing true from false allegations. Finally, it will examine the validity of these criteria, comparing them to those of other workers in the field. PMID- 3315170 TI - Assessing the credibility of young children's allegations of sexual abuse: clinical issues. AB - In assessing the credibility of young children's (ages 2-7) allegations of sexual abuse clinicians need to know how dynamics of sexual abuse affect disclosure, what situations are most commonly associated with fictitious allegations and how the child's developmental stage affects disclosures. Understanding these issues allows for clear decision making. A clear decision making process flows naturally from an understanding of these issues. PMID- 3315172 TI - Eating disorders: implications for the 1990's. AB - In the past decade much has been learned about the clinical features, diagnosis and understanding of people with anorexia nervosa and bulimia nervosa. In order to provide the next level of improvement in our care for these patients, our understanding of certain problems must be addressed by empirical research. Areas which require further study include the definition of high risk groups, the refinement of diagnoses, understanding factors which result in chronicity, determining the complications of chronicity and comparative evaluations of different treatments. These five areas are outlined in this article. Populations at risk for anorexia nervosa and bulimia nervosa may be those who must be thin and achieve according to career choice, those with a particular family and personal psychiatric history; obesity and chronic medical illnesses may be further risks. Improved diagnostic understanding has occurred by the differentiation of bulimic from restricting subtypes of anorexia nervosa. Further work must determine the relationship between the bulimic subtype of anorexia nervosa and bulimia in normal weight women and to further clarify the relationship between eating disorders and affective disorders. A number of factors may result in a chronic illness. These have been described on a variety of levels. The consequences of starvation in altering an individual's thinking, feeling and behaviour do play a role. It is not clear what factors at a neurochemical level contribute to this. Elevated endogenous opiates decreased noradrenergic function and decreased serotonin may be important. Information about the chronic complications is required for clinicians to understand the broad range of difficulties that may develop over time so that clinicians may use this information in planning treatment strategies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315173 TI - Combined antiestrogen and cytotoxic therapy with pseudomonas vaccine immunotherapy for metastatic breast cancer. A prospective, randomized trial. AB - One hundred thirty-three consecutive, previously untreated patients who had metastatic breast cancer were treated with a combination of 5-fluorouracil, doxorubicin (Adriamycin), and cyclophosphamide (FAC). They were randomly assigned to receive nonspecific immunotherapy with a heptavalent pseudomonas vaccine. Sixty-five patients were treated with pseudomonas vaccine, whereas 68 did not receive immunotherapy. In addition, all patients with estrogen receptor-positive tumors or tumors with an estrogen receptor status were also treated with tamoxifen. To allow clinical assessment of hormone sensitivity in vivo, tamoxifen was started 6 weeks before chemotherapy except in patients who had life threatening disease. After the initial 6 weeks of tamoxifen, 3% of patients had achieved a complete remission, 9% a partial remission, while 16% achieved a minor response. The maximum response after tamoxifen and chemotherapy included complete remissions in 20% of patients and partial remissions in 61% of patients for an overall remission rate of 81%. The median response duration was 15 months, and the median survival time, 27 months. There were no differences in remission rate, remission duration, or survival time between the groups treated with or without pseudomonas vaccine. Eleven patients with limited metastatic disease received radiotherapy consolidation to initially involved sites. In these patients the median time from radiotherapy to progression of disease was 33 months, and the median survival time was 46 months. We conclude that nonspecific immunotherapy with pseudomonas vaccine failed to increase remission rate or survival time. Furthermore, the addition of tamoxifen to FAC chemotherapy did not improve the remission rate or duration compared to a recent, historical control group of patients treated with only FAC chemotherapy. PMID- 3315174 TI - Blood group ABO and Lewis antigen expression during neoplastic progression of human urothelium. Immunohistochemical study of type 1 chain structures. AB - The deletion of blood group ABO antigen expression in bladder carcinoma has attracted attention because of its potential as a prognostic parameter. Based on recently produced monoclonal antibodies against blood group antigens, it has become possible to elucidate the carcinoma-associated modulation of these antigens at a molecular level. In this study we have used a panel of monoclonal antibodies (H, Lea, Leb, A, ALeb) that are specific to type 1 chain structures. By the use of an immunohistochemical method, the histologic and cytologic location of these antigens in the urothelium was studied in 25 biopsies from transitional cell carcinomas and compared to 21 previously examined normal biopsies. Urothelial blood group reactivity was compared to Lewis and secretor status. The authors found a series of events associated with neoplastic progression of noninvasive urothelium: a disruption of the orderly stratification of blood group antigens in different cell layers; cytostructural relocation of cytoplasmic antigens to the cell surface; loss of correlation between urothelial blood group antigens and secretor status; and gradual deletion of antigens. In the invasive tissue these events were followed by a total deletion of A and H isoantigens and uniform expression of Lewis b and sialyted Lewis a antigen. These findings indicate that there is a complex modulation of blood group antigen biosynthesis associated with the neoplastic progression of the human urothelium. PMID- 3315175 TI - State of the art in comparative cancer clinical trials. AB - In order to investigate the current state of the art in clinical cancer research, a survey of comparative cancer clinical trials was conducted using a MEDLINE literature search of the 6-month interval from July to December of 1985. Data were obtained primarily from the published abstracts. The major observations from the study are as follows. First, trials in cancer research are published in an extraordinarily wide range of journals covering most of the major medical specialties in addition to the many cancer specialty journals. Second, randomization is now used quite extensively. It is the predominant method of control in chemotherapy trials and in trials reported in cancer journals. However, its use is much less common in other specialties, especially surgery, so efforts to popularize randomization in these specialties would be beneficial. Third, sample sizes are highly variable, and the median sample size (96 patients) is too small to reliably detect and evaluate moderate treatment advances. Finally, our survey reveals that published trials show an inordinately large proportion of breakthroughs in treatment compared with the generally accepted view that only slow progress is being made in developing effective cancer treatments. Our view is that this result reflects the strong tendency to publish only studies with positive results. This hypothesis is supported by the fact that in nonrandom trials there tend to be more positive conclusions and an absence of a strong association between conclusions and sample size. PMID- 3315177 TI - The response evaluation of bone metastases in mammary carcinoma. The value of radiology, scintigraphy, and biochemical markers of bone metabolism. AB - The correlation between response of metastatic bone lysis and bone pain, various biochemical markers of bone metabolism, and radiological and scintigraphic findings was investigated in 49 women with breast cancer included in a calcitonin supportive therapy trial. All patients had dominant skeletal disease and were on stable systemic treatment (cytotoxic or hormonal) for a least 6 months before the first response evaluation. Bone pain correlated poorly with treatment response. Changes in sclerotic metastases did not show any apparent relation to changes in lytic lesions. A correlation between bone scans and lytic activity on radiographs was found. The absolute level of biochemical bone markers did not correlate with treatment response, but seemed instead to reflect the rate of bone turnover. The relative level of bone markers with respect to baseline showed better correlation to treatment response. The best conventional marker of disease activity was urinary hydroxyproline/creatinine. Propeptide of Type III procollagen (PIIINP), a novel marker reflecting collagen turnover, promises to be at least as sensitive as hydroxyproline. Stable and regressing patients had the same prognosis and significantly longer survival than progressors. PMID- 3315176 TI - Antiemetic control and prevention of side effects of anti-cancer therapy with lorazepam or diphenhydramine when used in combination with metoclopramide plus dexamethasone. A double-blind, randomized trial. AB - Combinations of metoclopramide and dexamethasone given intravenously control vomiting caused by high doses of cisplatin. Lorazepam and diphenhydramine are useful adjuncts to antiemetics. In a double-blind trial, 120 patients receiving high-dose cisplatin (120 mg/m2) for the first time were randomly assigned to receive either lorazepam (1.5 mg/m2) or diphenhydramine (50 mg) intravenously, 45 minutes prior to cisplatin. In addition, all patients received intravenous dexamethasone (20 mg) 40 minutes prior to chemotherapy along with metoclopramide (3 mg/kg) 30 minutes before and 90 minutes after cisplatin. Patients were directly observed in the hospital after cisplatin administration and completed a subjective assessment questionnaire. Overall, 60% of patients experienced no vomiting, and 83% had two or fewer emetic episodes during the study. There were no significant differences in objective antiemetic control between the two regimens. Only 3% of patients receiving lorazepam experienced treatment-related restlessness as opposed to 19% given diphenhydramine (P = 0.007). Less recall of chemotherapy administration (P less than 0.001), more sedation (P = 0.003), and transient enuresis while sedated (P = 0.0002) were characteristic of patients receiving lorazepam. Patient-generated ratings revealed less anxiety (P = 0.0001) for those individuals given the lorazepam-containing combination. Both regimens were well accepted, with 89% of patients receiving the lorazepam combination and 83% of those given the diphenhydramine regimen wishing to receive the same drugs in the future. Some degree of delayed vomiting occurred in 85% of patients during the 4-day period following this study. During the time that patients are at the greatest risk for emesis, the 24 hours immediately following cisplatin, three drug antiemetic combinations of either lorazepam or diphenhydramine with metoclopramide plus dexamethasone stopped cisplatin-induced emesis for the majority of patients and lessen other treatment-related side effects. Less restlessness and anxiety were observed among individuals receiving the lorazepam containing combination. PMID- 3315178 TI - Heterogeneous in situ immunophenotyping of follicular dendritic reticulum cells in malignant lymphomas of B-cell origin. AB - The phenotype of follicular dendritic reticulum cells (DRC) was analyzed with monoclonal antibodies (DRC-1, OKB7, BA-2, Leu-M3, and antidesmoplakin 1 and 2) in 28 frozen biopsy specimens of both morphologically and phenotypically analyzed B cell lymphomas and 21 normal or reactive controls. The former included 15 follicular center cell lymphomas (FCCL), four intermediately differentiated lymphocytic lymphomas (ILL), four mantle zone lymphomas (MZL), and five well differentiated lymphocytic lymphomas (WDLL). In controls, DRC-1+ and OKB7+ DRC were localized in both follicular centers (FC) and mantle zones (MZ), but BA-2+ and Leu-M3+ DRC were confined to FC only. FCCL were usually accompanied by DRC 1+, OKB7+, and BA-2+ DRC, and either lost or maintained positively with Leu-M3 from case to case. By contrast, MZL consistently lacked BA-2+ and Leu-M3+ DRC, and was associated with DRC-1+ and OKB7+ DRC only. Desmoplakin-positive DRC occurred in variable proportions in both FCCL and MZL. As opposed to FCCL and MZL, all WDLL and all but one of the ILL (associated only with DRC-1+, OKB7+, and desmoplakin+ DRC) did not show any DRC as identifiable with the antibody panel used. Remarkably, the difference in the distribution of BA-2+ and Leu-M3+ DRC in the normal FC and MZ appears to be maintained in their neoplastic counterparts (FCCL and MZL) also. Such a difference represents an example of the possible interactions between lymphoma cells of different phenotype and their microenvironment, as portrayed by phenotypically heterogeneous DRC. PMID- 3315179 TI - Initial and subsequent cytogenetic studies in malignant lymphoma. AB - Two or more cytogenetic studies of lymph node biopsy specimens from 12 patients with non-Hodgkin's malignant lymphoma were performed. Each of the 12 patients had at least one clonal structural chromosome abnormality in their initial biopsy specimen. A comparison of the chromosome abnormalities in the initial lymph node biopsy specimens with those in subsequent biopsy specimens was made. Structural and numerical chromosome changes were not always accompanied by a change in the histologic type of the lymphoma. Similarly, a change in histologic type was not always associated with the appearance of new structural or numerical abnormalities. Serial cytogenetic studies from additional patients will further our understanding relevant to which chromosome changes are associated with lymphomagenesis and which are secondary or more of an evolutionary nature. PMID- 3315180 TI - Primary malignant lymphoma of the breast. Lymphoma of the mucosa-associated lymphoid tissue. AB - Eight cases of primary non-Hodgkin's lymphoma of the breast found in the pathology files of the Institute of Oncology, Ljubljana, Yugoslavia, for a period of 25 years (from 1961 to 1985) were analyzed. During the same period 5711 cases of breast carcinoma were seen. Seven cases were diffuse lymphomas, and one case was nodular. Five cases were high-grade large cell lymphomas and three cases were of low-grade type. One case of the latter group was associated with elevated IgA in the serum and showed monoclonal reaction of plasmacytic lymphoma cells for kappa light chain and IgA. In this case amyloid deposits were seen in the breast tumor. In six cases, focal infiltration of ductal/lobular epithelium by lymphoma cells was found. This so-called lymphoepithelial lesion appears to be an important characteristic of various mucosa-associated lymphoid tissue lymphomas which have been described in different extranodal sites (e.g. gastrointestinal tract, and respiratory tract). They may show different behavior from nodal counterparts, especially in terms of their spread to other mucosal sites which may appear before or without nodal dissemination. The breast appears to be yet another location for these lymphomas. PMID- 3315181 TI - Localization of c-Ha-ras-1 oncogene in the t(7p-;11p+) abnormality of two cases with myeloid leukemia. AB - A reciprocal translocation involving the short arms of chromosomes #7 and #11, t(7;11)(p15;p15), was found in two patients with myeloid leukemia, one with acute myelogenous leukemia (AML-M2) and the other with Philadelphia chromosome-positive chronic myelocytic leukemia (CML) in blastic phase. In both cases, a minor fraction of leukemic blasts in the bone marrow had Auer rods in the cytoplasm. In situ chromosome hybridization showed that the c-Ha-ras-1 oncogene localized to the breakpoint (p15) of chromosome #11 is translocated to the rearranged chromosome #7 in the AML case, whereas, it remained on the conserved region of the rearranged chromosome #11 in the CML case. The significance of the t(7;11) abnormality in myeloid leukemia is discussed. PMID- 3315182 TI - Production of factor(s) that render polymorphonuclear leukocytes cytostatic from spleen cells stimulated with a streptococcal preparation, OK-432. AB - We previously reported the augmentation of tumor cytotoxicity of polymorphonuclear leukocytes (PMN) by in vivo administration of a streptococcal preparation, OK-432 (S. Watabe et al., J. Natl. Cancer Inst., 72: 1365-1370, 1984). The present study was undertaken to elucidate the mechanisms of the phenomena. Mouse and rat spleen cells were stimulated in vitro with OK-432. The culture supernatants from the stimulated spleen cells (OK sup) contained factor(s) that rendered mouse and rat PMN cytostatic [neutrophil activating factor (NAF)]. The stimulation of spleen cells with a small dose of OK-432 (0.05 micrograms/ml) resulted in the production of maximum NAF, and NAF was produced soon (12 h) after OK-432 stimulation. NAF was partially inactivated with 60 degrees C 30-min treatment, and completely inactivated with 100 degrees C 10 min. NAF was sensitive to pH 2 treatment. The treatment of PMN with OK sup for 5 min at 37 degrees C was sufficient to induce cytostatic activity of PMN. That OK sup contained gamma-interferon and recombinant gamma-interferon showed NAF activity indicate that gamma-interferon is a NAF in OK sup. PMID- 3315183 TI - Comparative pharmacokinetics of cisplatin and three analogues in mice and humans. AB - Pharmacokinetics of cisplatin, spiroplatin, ethylenediaminemalonatoplatinum(II) (JM-40), and carboplatin was studied in BALB/c x DBA/2 F1 mice receiving 10% lethal doses of 15.5, 6.8, 100, and 165 mg/kg, respectively. Blood samples were collected for up to 5 days after a single i.v. bolus injection. Total platinum in plasma and non-protein-bound free platinum in plasma ultrafiltrate were determined by flameless atomic absorption spectrometry. Parent JM-40 and carboplatin were determined by high performance liquid chromatography. Calculated pharmacokinetic parameters (peak concentrations, half-lives, areas under the curve) were compared with the corresponding values in patients at the maximal tolerated dose. Peak plasma concentrations were 2.4- to 20-fold higher in mice than in humans. Initial and terminal half-lives in mice were up to 6 times shorter than in patients. However, the areas under the plasma concentration versus time curves (AUCs) were found to agree. The ratios of the AUCs of free platinum in patients (AUCp) and mice (AUCm) measured over the first part of the plasma concentration versus time curve were 1.2, 0.3, 1.1, and 0.9 for cisplatin, spiroplatin, JM-40, and carboplatin, respectively. These values changed to 1.3, 0.3, 2.5, and 1.0 when the time interval was extended to free platinum levels just above the detection limit. Ratios of the AUCs of total platinum in patients and mice measured over 5 days were 2.7, 2.6, 4.2, and 1.8, respectively. Using a ratio of 1 for free platinum originating from JM-40, the retrospectively calculated maximal tolerated dose from AUCp at low dosages was 1021 mg/m2 (n = 7; range, 836-1282), compared to 1200 mg/m2 as found in the phase I trial. This suggests that the AUCp/AUCm ratio of free platinum over the first part of the concentration versus time curve can possibly be used to predict the maximal tolerated dose of platinum analogues in humans, during the early stage of phase I studies. PMID- 3315184 TI - Recognition of ovarian cancer antigen CA125 by murine monoclonal antibody produced by immunization of lung cancer cells. AB - In studies aimed at developing monoclonal antibodies against lung adenocarcinomas, we produced a murine monoclonal antibody designated 130-22 by immunizing mice with lung cancer cells. Since in immunoperoxidase staining experiments this antibody was reactive not only with lung adenocarcinomas but also with ovarian carcinomas, we examined its relationship to the ovarian cancer marker CA125, an antigen recognized by monoclonal antibody OC125 produced by immunization of mice with ovarian carcinoma cells. Although CA125 antigen was adsorbed by 130-22 antibody, 125I-labeled 130-22 did not compete with OC125, indicating that although these two antibodies recognized CA125 antigen, they reacted with separate antigenic determinants. The antigen defined by both antibodies was thought to be heat-labile glycoprotein with a molecular weight of over 1,000,000. A series of immunoradiometric assays was developed using combinations of two monoclonal antibodies in a simultaneous forward sandwich mode. Mixed monoclonal antibodies may provide a more sensitive assay for the detection of CA125 than the homologous assay, in which OC125 was used both as a tracer and as a catcher. These results indicate that CA125 is an antigen with two separate epitopes present in both ovarian and lung adenocarcinomas and that combination use of monoclonal antibodies reactive with different antigenic determinants will give certain advantages to the immunoradiometric assay of cancer markers. PMID- 3315185 TI - Modifications of tumor histology by point mutations in the v-fps oncogene: possible role of extracellular matrix. AB - Fujinami sarcoma virus (FSV) encodes a protein-tyrosine kinase, p130gag-fps, whose enzymatic activity and ability to transform cultured cells to a neoplastic phenotype are reduced by substitution of the major autophosphorylation site tyrosine-1073 with other amino acids. We compared the histopathology of tumors formed in syngeneic immunocompetent rats by Rat-2 cells and by Rat-2 cells transformed in culture with (a) wild type (wt) FSV, (b) mutant FSV where the codon for tyrosine-1073 of p130gag-fps had been changed to codons for phenylalanine or serine, and (c) a revertant FSV, genotypically identical to wt FSV, in which the codon for tyrosine-1073 had been restored. Latency periods from cell inoculation to tumor formation were 12-29 weeks with Rat-2 cells, 6-8 weeks with mutant-transformed Rat-2 cells, and 2-4 weeks with wt FSV- and revertant FSV transformed Rat-2 cells. Untransfected Rat-2 cells formed tumors that histologically resembled low grade fibrosarcomas or fibromas and were characterized by uniform fusiform cells in parallel arrays with a prominent collagenous stroma. The growth pattern of tumors produced by mutant FSV transformed cells was generally similar, although cellular forms and intercellular organization were less uniform. In contrast, Rat-2 cells transformed with either wt FSV or revertant FSV produced tumors that resembled highly malignant sarcomas and were composed of diffuse sheets of pleomorphic, disorganized cells and stroma rich in hyaluronate but poor in fibrous components. Local invasion occurred in 25% of tumors produced by Rat-2 cells and in 53 and 36% of tumors formed by mutant FSV- and wt FSV-transformed cells, respectively. In culture, Rat-2 cells and mutant FSV-transformed cells produced fibrillar pericellular matrices of collagen I and fibronectin. From 5 to 15% of protein secreted by these cells was collagen. Cultures of wt FSV- and revertant FSV transformed cells lacked collagen and fibronectin matrices and collagen secretion was reduced to 0-2%. These results show that clinically relevant histological characteristics of malignant tumors can correlate with single amino acid substitutions previously shown to affect the enzymatic activity and transforming ability of an oncogenic protein tyrosine kinase. The mechanisms underlying some of the histological differences in this system may be related to differences in the production of extracellular matrix components among the transformed cells. PMID- 3315186 TI - Long-term interleukin 2-dependent growth and cytotoxic activity of tumor infiltrating lymphocytes from human squamous cell carcinomas of the head and neck. AB - Tumor-infiltrating lymphocytes (TIL) from 16 squamous cell carcinomas of head and neck (SCCH&N) and four nonsquamous cell carcinomas were studied. By immunoperoxidase staining in situ, the tumors studied were found to be infiltrated mainly by CD2+CD3+ cells, and 30-50% of the T-lymphocytes were HLA-DR positive and transferrin-receptor positive. They also contained scarce NKH1+ cells. When TIL as well as autologous peripheral blood lymphocytes (A-PBL) were cultured in 1,000 U/ml of recombinant interleukin 2 (rIL2), TIL proliferated in all but three cases, and A-PBL proliferated in all but two cases. Frequently, but not always, TIL expanded better than A-PBL. The median expansion for TIL was 100 fold and that for A-PBL was 31-fold in long-term cultures maintained for up to 88 days. TIL obtained from untreated primary SCCH&N were initially delayed for up to 20 days in their proliferative response to rIL2, but then grew well. In contrast, TIL and A-PBL from metastatic SCCH&N either did not proliferate or were delayed in their proliferative response for up to 40 or 50 days. A-PBL, when tested early (days 10-20 in culture), showed the highest cytotoxic activity against cultured and fresh tumor-cell targets, whereas TIL were most active later in culture (days 20-30). On a per culture basis, TIL achieved higher antitumor cytotoxicity than A PBL. By day 80, lytic activities of most TIL cultures declined to undetectable levels. CD3+Leu19- T-lymphocytes were the major expanding cell population in most TIL cultures. However, these cells were poor mediators of antitumor cytotoxicity in TIL or A-PBL cultures as shown in cell sorting experiments. The antitumor effector cells expressed CD3-Leu19+ and/or CD3+Leu19+ phenotypes. On Giemsa stained smears, these two types of IL2-expanded effector cells had the morphology of large granular lymphocytes. Our results indicate that TIL from human SCCH&N could be expanded and reach high levels of antitumor effector function in long term cultures with rIL2. PMID- 3315188 TI - Treatment and prophylaxis of experimental liver metastases of M5076 reticulosarcoma with cis-bis-neodecanoato-trans-R,R-1,2 diaminocyclohexaneplatinum (II) encapsulated in multilamellar vesicles. AB - cis-Bis-neodecanoato-trans-R,R-1,2-diaminocyclohexaneplatinum++ +-(II) (NDDP) was encapsulated in multilamellar vesicles composed of dimyristoyl phosphatidylcholine and dimyristoyl phosphatidylglycerol at a 7:3 molar ratio. Compared with cisplatin, i.v. administration of an equimolar dose of liposome encapsulated NDDP (L-NDDP) resulted in 15-fold higher peak platinum levels in the spleen (204.7 versus 13.3 micrograms/g dry tissue), 5-fold higher in the lungs (116.4 versus 21.0 micrograms/g dry tissue), 3-fold higher in the liver (71.6 versus 23.9 micrograms/g dry tissue), and 4-fold higher in the blood (14.8 versus 3.9 micrograms/ml). At the optimal dose and schedule, L-NDDP administered i.p. in mice bearing peritoneal L1210 leukemia resulted in the percentage of median survival time of treated mice divided by median survival time of control mice (%T/C) of 312 versus 225 for cisplatin and free NDDP. When administered i.v., L NDDP was also more active than cisplatin against L1210 leukemia inoculated i.v. (%T/C 186 versus 142). L-NDDP was markedly active against L1210 leukemia resistant to cisplatin (%T/C, 200 versus 112 for cisplatin). In mice bearing liver metastases of M5076 reticulosarcoma, L-NDDP was significatnly more effective than cisplatin at equimolar doses (mean survival time, 57 +/- 9 (SD) days for L-NDDP versus 42 +/- 3 days for cisplatin, P less than 0.05). L-NDDP was also effective in preventing liver metastases of M5076 when administered up to 24 h prior to tumor inoculation (mean survival, 28 +/- 2 days for L-NDDP versus 22 +/- 2 days for cisplatin, P less than 0.05). L-NDDP is significantly non-cross resistant with cisplatin and more effective against phagocytic and nonphagocytic murine tumors. PMID- 3315187 TI - Heterogeneous DNA damage and repair in the mammalian genome. PMID- 3315189 TI - Abnormal insulin-receptor down regulation and dissociation of down regulation from insulin biological action in cultured human tumor cells. AB - The sensitivity of insulin receptors to down regulation by insulin has been measured in cultured human tumor cells (breast tumor cell lines MCF-7, T-47D, and colon tumor cell line HCT-8). Insulin receptors on breast tumor cells were resistant to down regulation (15-17% maximum loss of insulin binding after 4 h exposure to 170 nM insulin). HCT-8 cells were sensitive to down regulation after 4 h exposure to 3.8 nM insulin, but the extent of down regulation then lessened at higher concentrations of insulin. This paradoxical behavior was associated with increasing affinity of insulin receptors for insulin following exposure to hormone. Insulin-stimulated [3H]leucine incorporation into protein was measured in parallel with studies of receptor regulation to assess the effect of preexposure of cells to insulin on cell metabolism. Maximum down regulation of receptors in all three types of tumor cell by prior exposure to insulin did not significantly alter the responsiveness of any of the cell lines to insulin. Thus insulin receptor down regulation is abnormal in these tumor lines compared with reported studies in normal cells, and this may contribute a metabolic advantage to these malignant cells over normal tissues. PMID- 3315190 TI - Immunocytochemical detection of interaction products of cis diamminedichloroplatinum(II) and cis-diammine(1,1 cyclobutanedicarboxylato)platinum(II) with DNA in rodent tissue sections. AB - Calf thymus DNA was modified in vitro by cis-diamminedichloroplatinum(II) (cisDDP), complexed with methylated bovine serum albumin and used to immunize rabbits. The anti-cisDDP-DNA antiserum obtained was applied in a double peroxidase-antiperoxidase staining procedure to localize cisDDP-DNA and cis diammine(1,1-cyclobutanedicarboxylato)platinum(II) (CBDCA)-DNA interaction products in cryostat tissue sections of mice and rats. Rats received cisDDP (0-10 mg/kg) and were killed after 24 h. Mice received cisDDP (0-15 mg/kg) or CBDCA (200 mg/kg), and were killed after 2 h-162 days. For each time-dose combination two mice or one rat were used; agents were given i.p. Specific nuclear staining was observed in all tissues examined from cisDDP- or CBDCA-treated animals. No significant nuclear staining could be observed in tissue sections from control rats and mice. The extent of staining after cisDDP was dose and time dependent. The lowest dose of cisDDP after which specific nuclear staining could be detected varied from tissue to tissue [e.g., 0.1 mg/kg, pancreas (mouse); 0.5 mg/kg, liver, kidney (mouse, rat)]. The longest time interval after a single dose of 6 mg/kg cisDDP in which adducts could be visualized also depended on the tissue and varied between 9 days (spleen, testis) and 162 days (kidney). The staining intensity in liver and kidney, measured microdensitometrically, decreased relatively fast in the first days after treatment, but much slower thereafter. In the kidney, cisDDP-induced DNA modification showed regional variation: inner cortex greater than outer cortex greater than medulla (rat) and cortex greater than medulla (mouse). In the mouse kidney, a small subpopulation of tubular cells in close association with the renal corpuscles showed a remarkably high staining intensity after both cisDDP and CBDCA administration. Tissues that showed clear cisDDP-induced histological alterations (kidney, pancreas, testis, and duodenum) also showed moderate to high levels of cisDDP-DNA interaction products. A correlation between cell damage (measured histologically) and cisDDP-DNA binding within one tissue type was demonstrated in the rat inner renal cortex, the murine renal cortex, and in duodenal epithelial cells of both mice and rats. PMID- 3315191 TI - Chromosome abnormalities in malignant lymphoma in patients from Saitama. AB - Clonal chromosome abnormalities were found in 89 (97%) of 92 patients with non Hodgkin's malignant lymphoma including immunologically determined 34 B- and 25 T lymphomas; only 3 of 19 T-lymphoma patients examined had serum adult T-cell leukemia/lymphoma-associated antigen antibody. Association of 8q24 translocations with small non-cleaved cell (P less than 0.01) and that of t(14;18) (q32;q21) with follicular histology (P = 0.03) were significant. Several other abnormalities were also found to be correlated with histological or immunological phenotypes: trisomy 5 with diffuse, mixed cell lymphoma (P = 0.03); a break at 3q21 with diffuse, large cell lymphoma (P = 0.04); gain of chromosome 18 or X and rearrangements of 13q with immunoblastic lymphoma (P = 0.02, 0.03, and 0.03, respectively); and rearrangements of 7q with diffuse large cell histology (P = 0.02) and T-cell phenotype (P = 0.02). Multiple clones were more frequently seen in T-cell lymphoma than in B-cell lymphoma (P = 0.01). Structural changes of the long arm of chromosome 4 or 15 and a break in 6p21 were also associated with T lymphoma (P = 0.03, respectively). Since the frequency of T-lymphoma is significantly higher and that of t(14;18) is significantly lower in the adult T cell leukemia/lymphoma nonendemic area of Saitama in Japan than in Minnesota in the United States (P less than 0.01), factors affecting the lymphoma-genesis may be different or operating in different intensities in different areas. PMID- 3315192 TI - Strategies for controlling cancer through genetics. PMID- 3315193 TI - Randomized, double-blind, cross-over study comparing prochlorperazine and lorazepam with high-dose metoclopramide and lorazepam for the control of emesis in patients receiving cytotoxic chemotherapy. AB - To further define optimal combinations of antiemetics, high-dose metoclopramide and lorazepam (M+L) were compared with prochlorperazine and lorazepam (P+L) in a randomized, double-blind, cross-over study. Both patient and observer assessments were documented in 66 patients receiving cisplatin and noncisplatin chemotherapy. M+L significantly reduced the severity of vomiting (P = 0.01), duration of vomiting (P = 0.05), and number of vomiting episodes (P = 0.003). Comparing the severity or duration of nausea, M+L and P+L were not significantly different. M+L significantly reduced severity of vomiting (P = 0.005) and number of vomiting episodes (P = 0.03) in the cisplatin subset. The number of vomiting episodes was also reduced in the noncisplatin subset (P = 0.03). When asked to nominate a preferred regimen, 41% of patients preferred P+L, 35% preferred M+L, and 24% rated them equally. M+L was associated with significantly more anxiety and less sedation than P+L. Patient assessments produced similar results to observer assessments but gave a broader understanding of our patients' tolerance to chemotherapy. M+L is a superior regimen in controlling vomiting induced by chemotherapy. PMID- 3315194 TI - Improved survival of infants less than 1 year of age with acute lymphoblastic leukemia treated with intensive multiagent chemotherapy. AB - Infants with acute lymphoblastic leukemia (ALL) have a poor prognosis. Early disease recurrence, rather than excessive toxicity and complications resulting in limitation of therapy is the major factor responsible for this disappointing outcome. The CCG-192P trial was a groupwide pilot study of the Childrens Cancer Study Group for the treatment of ALL in patients at high risk for relapse, which was defined by wbc count greater than 50 X 10(3)/microliters at diagnosis. Because of the recognized poor prognosis, all infants less than 1 year of age were entered in this study regardless of wbc count at diagnosis. Therapy included intensive induction and consolidation followed by a cyclic, sequential maintenance program. The CNS prophylaxis consisted of intrathecal chemotherapy and cranial irradiation, which was deferred until patients were greater than 1 year of age. During the period January 1982 to January 1984, 27 infants ranging in age from 2 days to 11 months who had ALL were entered in this study; 71% had wbc counts greater than 50 X 10(3)/microliters, and 23% presented with CNS leukemia. Complete remission was achieved in 93% of the patients. The median duration of remission is 17 months. With a median follow-up of 43 months, the life-table estimate of event-free survival (EFS) is 36% at 4 years. A recently reported historical control group of infants with ALL who were treated with previous Childrens Cancer Study Group protocols demonstrated a median remission duration of 8 months and an estimated EFS of only 21% at 4 years. Toxicity and therapy-related complications were not observed more frequently in infants than in older patients treated with this protocol. However, EFS of infants was significantly worse than that of patients greater than 1 year of age (P = less than 0.001). All four CNS relapses occurred in patients who had received cranial irradiation. A wbc count less than 50 X 10(3)/microliters at diagnosis demonstrated significance (P = 0.03) as a favorable prognostic indicator in this small patient sample. Although these data are preliminary, they suggest that intensive therapy is reasonably well tolerated by infants and results in prolongation of remission duration and improved EFS. PMID- 3315195 TI - Pediatric phase I trial of carboplatin: a Childrens Cancer Study Group report. AB - Carboplatin is one of a series of cisplatin analogs now undergoing clinical investigation. Phase I and II trials in adults demonstrate activity in a number of human cancers and less toxicity than might be expected with the parent compound. This phase I trial was undertaken to establish the maximum tolerated dose and the recommended phase II dose in children treated by a 1-hour iv infusion every 4 weeks. Twenty-nine patients with recurrent or progressive tumor were entered in this study at the Children's Hospital of Los Angeles and Children's Memorial Hospital in Chicago between April 12, 1983, and November 27, 1984. Beginning with a dose of 350 mg/m2 (about 80% of the adult phase II dose), we escalated the dose in groups of patients to 670 mg/m2; dose-limiting myelosuppression was encountered at this dose. Fifty-seven infusions are at least partially evaluable for toxicity. Asymptomatic hypomagnesemia, hypocalcemia, and ototoxicity were observed infrequently, and nausea and vomiting were mild. One patient with a mixed glioma of the posterior fossa achieved a good partial response lasting 9 months. Stable disease for greater than or equal to 6 months was observed in three patients: one each with ependymoma, brain stem glioma, and spinal cord astrocytoma. The recommended pediatric phase II dose is 560 mg/m2 given as a 1-hour iv infusion every 4 weeks. PMID- 3315196 TI - How large should a phase II trial of a new drug be? AB - A number of statistical designs for phase II trials have been published. These designs are critically reviewed. A new design is also introduced. Data are presented on the response rates observed for new chemotherapeutic agents introduced by the National Cancer Institute since 1975. Based upon this material, it is recommended that two-stage designs with a target sample size of 35-50 patients and substantial probability of early termination are usually appropriate. It is also recommended that for active drugs, two to three such trials are necessary to estimate the response rate with reasonable precision. Precise estimation of phase II response rates is not always important, however. For very rare diseases or situations where several dose levels of a biologic are to be evaluated, selection designs may be most appropriate. Such designs are described. Tables are presented to facilitate the design of new agent phase II clinical trials. PMID- 3315197 TI - Diagnosis and treatment of malignant pleural effusions. PMID- 3315198 TI - Diffuse bilateral pneumopathies in patients with cancer. PMID- 3315199 TI - Results of radiotherapy and surgery for glottic carcinoma. PMID- 3315200 TI - Chemoembolization in regional cancer chemotherapy: a rationale. PMID- 3315201 TI - Radioimmunotherapy of cancer: clinical studies and limiting factors. PMID- 3315202 TI - A 2D-1H-n.m.r. study of some Shigella flexneri O-polysaccharides. AB - A 1H-n.m.r. study of the O-polysaccharides from different types of Shigella flexneri has been performed. With the aid of 2D-n.m.r. techniques, namely, J resolved, spin-spin correlation, and NOESY experiments, most of the structural features of these polysaccharides could be deduced. Sequences could generally be obtained from the NOESY experiments. When using a prolonged mixing time in these experiments, cross-peaks due to spin diffusion from one anomeric proton to the anomeric proton of an adjacent residue could be obtained, thereby giving complementary sequence information. PMID- 3315204 TI - [Diagnostic problems in the physiopathological characterization of sinus dysfunction]. PMID- 3315205 TI - Bleaching vital teeth: a review and clinical study. PMID- 3315203 TI - Induction of activated natural killer cells from murine spleen cells primed in vivo and subsequently challenged in vitro with the streptococcal preparation OK432. AB - The present study shows that natural killer cell-mediated cytotoxicity of BALB/c mouse spleen cells to syngeneic tumor cells was augmented by in vivo priming or in vitro stimulation with the streptococcal preparation OK432. The augmentation of spleen cell cytotoxicity to syngeneic tumor cells by in vivo priming alone with OK432 was lower than that obtained by in vitro stimulation alone with OK432. When the murine spleen cells primed in vivo with OK432 were rechallenged in vitro with OK432 at various intervals, the natural cytotoxicity was more strongly enhanced than that seen with in vitro stimulation alone. The cell surface phenotype of killer cells activated with OK432 was Thy 1+ and asialo GM1+, suggesting the activated natural killer cell. Next, mice were transplanted with syngeneic colon adenocarcinoma cells, and primed in vivo with OK432. These spleen cells were subsequently challenged in vitro with OK432. These spleen cells displayed a strong cytotoxic activity not only to the transplanted adenocarcinoma cells but also to other syngeneic tumor cells. PMID- 3315206 TI - The current status of dentin adhesives. PMID- 3315208 TI - Periodontal considerations in removable partial denture design. PMID- 3315207 TI - A review of benzodiazepines. PMID- 3315209 TI - Twenty-five month follow-up of an autogenous third molar transplantation in a localized juvenile periodontitis patient: a case report. PMID- 3315211 TI - The removable partial denture design template. PMID- 3315210 TI - Detection and management of the dental patient with Sjorgen's syndrome. PMID- 3315212 TI - Microleakage of posterior composite restorations after rebonding. PMID- 3315213 TI - Gingival crevicular fluid monitoring in the treatment of gingivitis periodontitis. PMID- 3315214 TI - Measurement of isovolumic relaxation: comparison of echocardiographic mitral valve opening and Doppler mitral valve flow. AB - The relation between mitral valve opening and transmitral blood flow was investigated by M-mode echocardiography and Doppler ultrasound in 50 normal subjects to allow the measurement of the timing of the end of isovolumic relaxation. Standard parasternal M-mode echocardiograms of the mitral valve to show the onset of cusp separation were recorded with a simultaneous electrocardiogram and phonocardiogram. Pulse wave Doppler ultrasound using both amplitude and spectral analysis was recorded with a transducer at the apex, and the initial diastolic blood flow towards the transducer was taken as the onset of flow. For each subject five cardiac cycles of similar length were measured using the three methods. Isovolumic relaxation could be measured with a high degree of reliability (retest reliability coefficient greater than 0.94). The echocardiographic measurement of isovolumic relaxation ranged from 52 to 82 ms (mean(SD) 67(9) ms). Isovolumic relaxation measured by Doppler was 52-83 ms (mean(SD) 67(9) ms) using amplitude analysis and 54-89 ms (mean(SD) 72(11) ms) using spectral analysis. There was a strong correlation between the echocardiographic isovolumic relaxation and measurements made using spectral analysis (r = 0.93, slope 0.97) and amplitude analysis (r = 0.97, slope 0.98). Therefore in normal subjects the end of isovolumic relaxation can be reliably measured by echocardiographic and Doppler methods, and whereas the amplitude signal is coincidental with that measured by echocardiography that measured by spectral analysis is delayed by approximately 5 ms. PMID- 3315215 TI - Chemical changes and surface morphology of acid-etching of human enamel treated with topical fluoride agents in vitro. PMID- 3315216 TI - Bonding of fissure sealant to etched demineralized enamel (lesions). PMID- 3315217 TI - [Surgery in what is now Czechoslovakia 100 years ago]. PMID- 3315218 TI - [Initial experience with aspiration biopsy of the pancreas under the control of ultrasound]. PMID- 3315219 TI - [Johannes Evangelista Purkinje--legacy and tradition]. PMID- 3315220 TI - [200 years since the birth of Johannes Evangelista Purkinje]. PMID- 3315221 TI - [Johannes Evangelista Purkinje--a person of standing in world and national science]. PMID- 3315222 TI - [The views of J.E. Purkinje on the importance of science and its organization]. PMID- 3315223 TI - [Johannes Evangelista Purkinje and Libochovice]. PMID- 3315224 TI - [J.E. Purkinje as an inspiration in the arts]. PMID- 3315225 TI - Jan Evangelista Purkyne--life and work. PMID- 3315226 TI - Medical management of the diabetic patient undergoing surgery. PMID- 3315227 TI - Specific proteolysis regulates fusion between endocytic compartments in Xenopus oocytes. AB - We examined the role of proteolytic ligand modification in endosomal targeting using vitellogenin (VTG) uptake by Xenopus oocytes as a model system. Non cleavable VTG is internalized, but does not appear in yolk platelets. We identified two inhibitors of VTG processing into the yolk proteins: the ionophore monensin and pepstatin A, a specific inhibitor of cathepsin D. Pepstatin neither affected ligand binding and internalization, nor inhibited the degradation of nonspecifically incorporated proteins, whereas monensin inhibited all of these processes. Inhibiting VTG processing prevented its deposition into yolk platelets by strongly interfering with endosome-yolk platelet fusion. Monensin treatment resulted in morphologically abnormal endosomes, while pepstatin only inhibited VTG cleavage and the subsequent fusion of endosomes with yolk platelets. Since VTG cleavage is initiated prior to its deposition in platelets, we postulate that ligand proteolysis could be necessary for normal endosomal targeting. PMID- 3315228 TI - An E. coli aminoacyl-tRNA synthetase can substitute for yeast mitochondrial enzyme function in vivo. AB - We have investigated the function of an E. coli aminoacyl-tRNA synthetase in S. cerevisiae strains that are respiration-deficient because of a mutation or a gene disruption in the nuclear encoded gene for the mitochondrial tyrosyl-tRNA synthetase. Although the yeast mitochondrial and E. coli tyrosine tRNAs differ significantly in sequence, expression of the E. coli tyrosyl-tRNA synthetase from a gene fusion restores respiration. The fusion gene contains a presumptive sequence for mitochondrial import from the mitochondrial tyrosyl-tRNA synthetase gene fused to the E. coli coding region. The fusion protein is incorporated into mitochondria. This incorporation and the rescue of the respiratory defect require the presumptive sequence for mitochondrial import. These experiments suggest a more limited definition of the identity of a tyrosine tRNA. PMID- 3315229 TI - Lac repressor is a transient gene-activating protein. AB - We show, using a combination of methods, that contrary to the usual view, lac repressor increases, by more than 100-fold, the initial binding of RNA polymerase to E. coli lac UV5 promoter DNA. Kinetic studies revealed that the repressor acts to block the isomerization step in transcription initiation. When IPTG, a gratuitous inducer, is added, formation of open complex and productive transcription proceed. Because of the large increases in the binding constant, at low polymerase concentrations the presence of lac repressor (and then inducer) actually increases the rate of the first round of productive transcription, thus allowing the system to respond rapidly to the release of repression. This dual role of stabilization of a pretranscriptional complex coupled with blockage of transcription initiation may be a more general model for genetic regulation than that provided by the concept of simple repression. PMID- 3315230 TI - A yeast silencer contains sequences that can promote autonomous plasmid replication and transcriptional activation. AB - Repression of the yeast silent mating type loci requires cis-acting sequences located over 1 kb from the regulated promoters. One of these sites, a "silencer," exhibits enhancer-like distance- and orientation-independence. The silencer demonstrates both autonomous replication sequence (ARS) activity and a centromere like segregation function, suggesting roles for DNA replication and segregation in transcriptional repression. Here we identify three sequences (A, E, and B) involved both in repression and in either ARS or segregation activity. The sequences are functionally redundant: no one is essential for complete transcriptional control, but mutations in any two inactivate the silencer. Surprisingly, elements E and B can each activate transcription from heterologous promoters, and E shows striking homology to several yeast upstream activation sequences. Therefore, sequences individually involved in replication, segregation, and transcriptional activation can, at the silencer, efficiently repress transcription. PMID- 3315231 TI - Purification and cloning of a DNA binding protein from yeast that binds to both silencer and activator elements. AB - A DNA binding protein (RAP1, previously called SBF-E) has been shown to bind to putative regulatory sites at both yeast mating-type silencers, yet is not the product of genetically identified regulators of the silent loci. Here, we report the purification of RAP1 by DNA affinity chromatography, and the isolation of its gene from a lambda gt11 genomic library using antibodies raised against the protein. Disruption of the chromosomal copy of this gene is lethal. We show that RAP1 protein also binds in vitro to the upstream activation site (UAS) of MAT alpha and ribosomal protein genes. In addition, we show that two different UAS associated RAP1 binding sites can substitute in vivo for a silencer binding site. Our results suggest that RAP1 may be a transcriptional regulator that can play a role in either repression or activation of transcription, depending upon the context of its binding site. PMID- 3315232 TI - Activated N-ras controls the transformed phenotype of HT1080 human fibrosarcoma cells. AB - To investigate whether the activated N-ras oncogene of HT1080 human fibrosarcoma cells contributes to the expression of the transformed phenotype, we have isolated flat revertants. In two independent revertant lines, an increase in chromosomal ploidy occurred without a concomitant increase in the number of copies of the N-ras transforming allele. Immunoprecipitation confirms that the level of the mutant N-ras p21 gene product in the revertants is correspondingly lower than in HT1080. Analysis of sporadic tumors derived from the revertant cells reveals an increased dosage of the transforming allele. The revertants also retransform after transfection of cloned activated ras oncogenes. These results imply direct participation of an N-ras oncogene in maintaining the transformed phenotype of a human tumor cell line. PMID- 3315233 TI - Purified intercellular adhesion molecule-1 (ICAM-1) is a ligand for lymphocyte function-associated antigen 1 (LFA-1). AB - Lymphocyte function-associated antigen 1 (LFA-1) is a leukocyte cell surface glycoprotein that promotes intercellular adhesion in immunological and inflammatory reactions. It is an alpha beta complex that is structurally related to receptors for extracellular matrix components, and thus belongs to the integrin family. ICAM-1 (intercellular adhesion molecule-1) is a distinct cell surface glycoprotein. Its broad distribution, regulated expression in inflammation, and involvement in LFA-1-dependent cell-cell adhesion have suggested that ICAM-1 may be a ligand for LFA-1. We have purified ICAM-1 and incorporated it into artificial supported lipid membranes. LFA-1+ but not LFA-1- cells bound to ICAM-1 in the artificial membranes, and the binding could be specifically inhibited by anti-ICAM-1 treatment of the membranes or by anti-LFA-1 treatment of the cells. The cell binding to ICAM-1 required metabolic energy production, an intact cytoskeleton, and the presence of Mg2+ and was temperature dependent, characteristics of LFA-1- and ICAM-1-dependent cell-cell adhesion. PMID- 3315235 TI - Transdermal drug delivery: problems and possibilities. AB - Transdermal drug delivery has, in recent years, attracted considerable interest. However, despite the obvious advantages of this novel route of drug administration to achieve systemic therapeutic effect, there remain important, and sometimes severe, limitations on the physiochemical and pharmacological properties of the agent to be delivered. This article reviews the present status and accomplishments of transdermal drug delivery. The benefits, disadvantages, and, as yet, unresolved problems inherent to drug input via the skin are addressed. Deficiencies in our knowledge of the percutaneous absorption process in man are identified, and approaches to elucidate these unknowns are discussed. Finally, with respect to the future potential of transdermal drug delivery, experimental and modeling techniques, which can be employed to assess the feasibility and promise of a therapeutic candidate, are described and illustrated with pertinent examples. PMID- 3315234 TI - Microencapsulated cells as hormone delivery systems. AB - Transplantation of pancreatic islets of Langerhans has been shown to prevent the development of many of the complications associated with diabetes. Transplanted islets, however, are readily rejected by the immune system. The use of artificial membranes to isolate the transplanted islets from the immune system of the host prolongs islet allografts in experimental animals. We have developed a method for encapsulating islets in semipermeable membranes composed of alginate and polylysine. The same technique can be applied to other endocrine cell types. The capsules are 700 to 800 micron in diameter with a hydrogel membrane approximately 4 micron thick. Intraperitoneal allografts of 5 x 10(3) encapsulated islets reversed diabetes in rats for up to 21 months and intact capsules with viable beta cells could be recovered from the recipients. Microencapsulation of endocrine cells for transplantation could potentially be used in the clinical treatment of hormone deficiency diseases. PMID- 3315236 TI - Polymeric prodrugs. AB - Polymeric prodrugs can be defined as latent pharmaceutical agents which must undergo chemical or enzymatic transformation to the active or parent drug in the organism after administration. Polymeric prodrugs may also be considered special types of drug delivery systems where the drug release is realized by cleavage of a chemical bond. The concept of polymeric prodrugs finds application in the design of novel agents when pharmacokinetical modification of a parent drug is necessary, or when the aim is to achieve selective action at a target site, utilizing enzymatic activation specific for that site. The types of polymeric prodrugs synthetized in the last decade are reviewed regarding the chemical structure of the carrier backbone and the drug linkages applied. Relationship between the chemical structure, physicochemical characteristics of polymeric prodrugs, and their physiological behavior is discussed, with special regard to the bioavailability, body distribution, and rate of elimination of the carrier from the living organism. In vitro and in vivo experimental data concerning drug activation processes, as well as potential clinical applications of polymeric prodrugs, are surveyed. PMID- 3315237 TI - Neurological manifestations of the post-polio syndrome. AB - Patients with late effects of poliomyelitis, i.e., PPS, are being seen at an ever increasing frequency by general physicians, neurologists, and orthopedists. An appropriate time interval for the onset of late manifestations has elapsed since the major epidemics of poliomyelitis in the 1940s and 1950s. Post-polio neurological manifestations primarily include new weakness, atrophy, muscle pain, and fasciculations. Fortunately, the weakness is of a very slow, progressive nature. Abnormal laboratory studies include routine EMG, demonstrating chronic denervation; SFEMG, demonstrating increased fiber density, increased jitter, and blocking; and muscle biopsy most often revealing fiber-type grouping of chronic denervation and small isolated angular (or angulated) fibers and group atrophy in some series, both suggestive of active denervation. Unfortunately, both EMG and muscle biopsy studies suffer from a lack of specificity as they do not appear to distinguish asymptomatic from symptomatic (new weakness, PPMA) patients with prior poliomyelitis. Although the cause of PPMA is unknown, electrophysiological (SFEMG) and muscle biopsy studies suggest that the process involves a loss or dropout of axon terminals of reinnervated motor units. The axons terminal dropout could be due to dysfunction in the cell soma, the axon, or the terminals themselves. Whether motor neuron exhaustion, a persistent viral infection, or immune-mediated mechanisms play a role in the pathogenesis of the late weakness is unclear at present and will require further investigation. Treatment at this time is of a supportive nature. A major controversy involves the role of strengthening exercises in these patients since experimental animal studies suggest that excessive exercise of denervated muscles leads to increased weakness. Clearly, a better understanding of PPS and PPMA will allow more effective management of these patients' problems and might also provide insight into other motor neuron and neuromuscular junction diseases. PMID- 3315238 TI - Molecular and genetic aspects of the pathogenesis of viral infections of the central nervous system. AB - Viral pathogenesis can be defined in terms of a series of successive interactions between a virus and its target host. In order for a virus to injure a target organ such as the central nervous system (CNS), it must first enter the host animal, replicate in some primary site near its place of entry, spread from this site to the CNS and infect and injure specific populations of cells within the CNS. At each of these steps, the virus must avoid or overcome a variety of immunological and nonimmunological host defenses. It has recently become possible to begin to identify the role of specific viral genes and the proteins they encode at specific steps in the pathogenesis cycle. This review focuses on current knowledge concerning the molecular and genetic basis for the pathogenesis of viral infections of the CNS. Emphasis is placed on recent research with a wide variety of neurotropic viruses including reoviruses, bunyaviruses, lymphocytic choriomeningitis virus, rabies virus, polio virus, herpes viruses, lentiviruses, and the unconventional agents responsible for disease such as scrapie. PMID- 3315239 TI - Autoimmune pathogenesis of paraneoplastic neurological syndromes. AB - "Remote effects" of cancer on the nervous system (paraneoplastic syndromes) are disorders of the nervous system of unknown cause that occur almost exclusively, or with greatly increased frequency, in patients with identifiable or occult cancer. There are several hypotheses concerning the pathogenesis of these rare disorders. One hypothesis is that the underlying tumor and portions of the nervous system share antigens and that an autoimmune response generated against the tumor causes the nervous system disorder. Evidence supporting this hypothesis includes the ability to transmit the Lambert-Eaton Syndrome (a paraneoplastic syndrome involving the neuromuscular junction) to experimental animals by infusing IgG from patients with the disorder, the presence of autoantibodies against Purkinje cell neurons in some patients with paraneoplastic cerebellar degeneration, and the presence of autoantibodies against many neurons in patients with sensory neuronopathy and encephalomyelitis. Other evidence supporting the hypothesis is presented in this review. PMID- 3315240 TI - Distribution among tissues and intracellular localization of cofilin, a 21kDa actin-binding protein. AB - Cofilin, a 21kDa actin-binding protein, binds to F-actin in a 1:1 molar ratio of cofilin to actin molecule (Nishida, E., S. Maekawa, and H. Sakai, Biochemistry, 23, 5307-5313, 1984) and is capable of controlling actin polymerization and depolymerization in vitro in a pH-sensitive manner (Yonezawa, N., E. Nishida, and H. Sakai, J. Biol. Chem., 260, 14410-14412, 1985). In this study, immunoblot analysis using monospecific antibodies against cofilin showed that cofilin is ubiquitously distributed in a variety of bovine and rat organs and tissues. Cofilin is also present in various cultured cell lines. Indirect immunofluorescence staining of mouse fibroblastic cells and human epidermoid carcinoma cells indicated that cofilin is distributed nearly uniformly in the cytoplasm and is concentrated in ruffling membranes where F-actin is also concentrated as revealed by staining with rhodamine-phalloin. Stress fiber structures were not strongly stained with the anti-cofilin antibody, although stress fiber staining was sometimes observed near the cell periphery in mouse 3T3 cells. These results suggest that the bulk of cofilin may not be associated with F-actin bundles in vivo. PMID- 3315241 TI - [Johannes Evangelista Purkinje 1787-1987]. PMID- 3315242 TI - [Scientific activity of J.E. Purkinje in various medical specialties]. PMID- 3315243 TI - [Johannes Evangelista Purkinje and Slovakia]. PMID- 3315244 TI - [Approaches to the study of opioid peptides]. PMID- 3315245 TI - [The role of vitamins C and E in detoxification processes]. PMID- 3315246 TI - [Functional properties of the vascular endothelium]. PMID- 3315247 TI - [In the steps of J.E. Purkinje]. PMID- 3315248 TI - [Dr. Adolf Meska--one of the first organizers of health services in Slovakia after 1918]. PMID- 3315249 TI - [Incidence of extracranial carotid occlusive disease in cerebrovascular accidents in older persons]. PMID- 3315250 TI - [Radiodiagnosis of carcinoma of the extrahepatic bile ducts]. PMID- 3315251 TI - [Sonographic diagnosis of focal liver steatosis]. PMID- 3315252 TI - [Sonographic picture of a hematoma in the pectoral muscle arising during anticoagulation therapy]. PMID- 3315254 TI - Natural environmental cues and circadian rhythms of behaviour--a perspective. AB - Natural environmental cycles are often extremely difficult to reproduce under laboratory conditions. Laboratory light-dark cycles differ from natural light dark cycles in terms of intensity and spectral distribution, whilst simulated temperature cycles may differ from natural temperature cycles in waveform. The expression of a free-running rhythm depends upon the 'level' of constant conditions provided. Environmental cues affect the period, phasing, amplitude and activity-rest ratios of circadian rhythms and, if inappropriate, may result in aberrant behaviour patterns which are unlike those observed in nature. PMID- 3315253 TI - Influence of BCG administration time on the in-vivo migration of leukocytes. AB - The temporal variation in the migration of polymorphonuclear leukocytes (PMN) induced by live BCG was studied in the mouse. Ten microliter of a 5 X 10(6) live BCG/ml suspension or sterile saline were placed on a cell trap immediately before its subcutaneous implantation at different clock times: 0100, 0500, 0900, 1300, 1700 and 2100 in animals synchronized with L(0700-1900): D(1900-0700). Eight hours later, the cell trap was removed, prepared for histological identification and counted. PMN counts in the cell trap were maximal 480 min after implantation. Non-specific migration was thought to occur and the peak value of leukocytes of 22.8 +/- 6.1 cells/10,000 micron 2 was obtained when the saline cell-trap was implanted at 0500. In the BCG-treated mice, a circadian rhythm was observed in the migration of leukocytes. The acrophase was at 1700. The results support the hypothesis that the circadian stage of antigen encounter influences the magnitude of the immune response. PMID- 3315255 TI - Ultradian, circadian and circannual rhythms of blood glucose and injected insulins documented in six self-controlled adult diabetics. AB - The aim of the study was to document during one to two years individual rhythmic patterns in blood glucose and injected insulin in self-controlled insulin dependent (C-peptide negative) diabetics with home blood glucose monitoring. Two females and four males with diurnal activity from 0700 to 2300 self-determined their blood glucose three to six times a day over a period of 12-27 months. Circadian and ultradian rhythms were analysed for each subject on a monthly basis to document annual rhythms. Blood glucose (BG) estimated circadian acrophases were located between 2200 and 0300 for all patients and months with few exceptions. A correlation was found between circadian mesors and amplitudes of BG in four subjects. Annual changes in BG were validated for each subject with large interindividual differences in peak times. The individual mean of injected insulin (II) varied from 40 to 80 iU with annual changes validated for each subject. A group pattern was observed with a peak time either in the autumn (four patients) or in the summer (two patients). A circadian rhythm of II was detected in almost all monthly means and for all patients. Locations of computed peak time phi of II exhibited a great stability for a given individual but large interindividual differences. Thus the rather constant phi location of BG for all subjects contrasted with interindividual differences in phi locations of II. These results suggest that rhythmic changes in BG and II should be recognized when forming a realistic strategy for timing and dosing time(s) of insulin. PMID- 3315256 TI - The peptidergic brain-gut axis: influence on gastric ulcer formation. AB - The existence of a relationship between the brain and the formation of gastric ulcers has been suspected since the last century. The advancement of stereotaxic procedures and the use of electrical lesion or stimulation have allowed localization within the limbic system, hypothalamus and brain stem, of discrete nuclei that influence the formation of gastric ulceration in experimental animals. Recently, further progress in the understanding of how the brain may influence gastric pathogenesis has been made by the demonstration that specific peptides act in the central nervous system to induce or prevent the formation of gastric ulcers and to markedly alter gastric secretory and motor function. Peptides established to have a centrally mediated protective effect are bombesin, calcitonin, corticotropin-releasing factor, neurotensin and opioid peptides. Growing evidence suggests a possible role for endogenous thyroptropin-releasing hormone in mediating cold-restraint stress induced gastric lesions. Circadian variations of the content and release of these peptides have been demonstrated in specific brain structures. To what extent such rhythms of peptide secretion are potentially linked to the circadian changes in the susceptibility to ulcer formation is worth investigating. PMID- 3315257 TI - A chronobiologic approach to ethanol and acidified aspirin injury of the gastric mucosa in the rat. AB - Several models of erosive peptic disease have used drug-induced lesions to examine protective mechanisms of the gastric mucosa. Physiological processes such as acid secretion, motility, or epithelial cell turnover have circadian rhythms which may modulate the susceptibility of the gastric mucosa to injury. In this review are described recent studies which demonstrated that susceptibility to gastric mucosal injury by acidified aspirin and absolute ethanol varied with the phases of the light-dark cycle. Acidified aspirin caused significantly more gastric mucosal lesions when administered early in the light phase compared to administration early in the dark phase. The differences in susceptibility were not altered by pretreatment conditions such as immobilization or length of the fasting period. Absolute ethanol also caused significantly greater gastric mucosal injury when administered in the light than in the dark phase, but this difference was only evident in rats immobilized during the pretreatment fasting period. Further studies are needed to correlate circadian susceptibility to drug induced gastric mucosal injury with physiological defense mechanisms. Careful attention to circadian timekeeping may allow us to refine therapy to optimize physiological defense mechanisms in the stomach. PMID- 3315258 TI - Chronobiologic factors in experimental stress ulcer. AB - The available literature on chronobiologic factors in experimental stress ulcer is extremely small and thematically limited. It focuses almost exclusively on circadian rhythms and, within that, on rhythms related to light-dark cycles, activity and body temperature. Among these, only differences in ulcer induction related to circadian activity patterns have been adequately demonstrated. Other circadian patterns and other temporal phase relationships might be profitably explored, including those related to postnatal development. It is also likely that the important relationships between biorhythms and stress ulcer are not limited to ulcer induction. Future studies should address chronobiologic factors in predisposition, severity of illness, the probability of recovery and response to various therapeutic interventions. PMID- 3315259 TI - Development and significance of cysteamine and propionitrile models of duodenal ulcer. AB - Cysteamine is widely used in rodents to induce duodenal ulcer. Herein, the pathogenesis of duodenal ulceration in its earliest stages was reviewed using findings from cysteamine- and propionitrile-induced duodenal ulcer in rodent models, especially taking into account changes in the secretion of gastric acid, duodenal and pancreatic bicarbonate as well as gastroduodenal motility. The effect of cysteamine-HCl in inducing ulcers in rats is circadian rhythm dependent. The effect is greatest from just before the end of diurnal rest to just after the start of nocturnal activity. The chronobiologic effect may be in part due to the circadian rhythm-dependent increased gastric acid production from cysteamine. Titratable acidity was found to be twice as great in the gastric juice of rodents when cysteamine was given by injection at 2000 (just after the start of nocturnal activity) in comparison to when given at 0800 or 1200 (at the beginning or middle span of daily rest). Further studies have shown that adrenalectomy of rats 7 days before cysteamine administration obliterated the observed circadian susceptibility to ulcer formation. Duodenal ulceration, at least in the cysteamine model, appears to be under chronobiologic neuroendocrine control or influence, seemingly mediated by the adrenal glands. PMID- 3315261 TI - A review of seasonal periodicity in peptic ulcer disease. AB - Although several pathogenetic factors have been identified in recent years, the etiology of peptic ulcer disease is yet unknown. During the past few decades several investigators have reported seasonal patterns in peptic and duodenal ulcer disease. A review of the literature reveals vast differences between studies with respect to the type and number of patients selected, diagnostic techniques, the number of examinations and the interval of time between each as well as the method of data analysis. Nevertheless, there is solid evidence to conclude that peptic ulcer disease is lower during the summer than the other seasons of the year. Although many investigators have reported peptic ulcer disease to be more common in the spring and/or autumn, the evidence based on group studies thus far is not persuasive. On the other hand, initial findings on a small sample of patients studied by endoscopy at frequent intervals over at least a one-year period suggest that the season of peptic ulcer disease is a characteristic of each individual patient. Some experience recurrence of disease only in the spring while others experience such only in the autumn. Studies utilizing protocols which call for frequent endoscopic examination at regular (3 month or less) intervals for at least a one-year period are likely to clarify aspects of the seasonality of peptic ulcer disease. PMID- 3315260 TI - Temporal aspects of the pathophysiology of human ulcer disease. AB - In this paper, a peptic ulcer is considered from the perspective that it is representative of a heterogeneous group of multifactorial determined or influenced disorders having a common pathomorphologic expression. This heterogeneity involves pathophysiological attributes, including both functional (including secretory and motility events and their respective driving mechanisms) and morphologic alterations that relate to mucosal resistance. Patients with duodenal ulcer (DU) have been observed to exhibit alterations, in comparison to normal subjects, in the circadian rhythm characteristics of several gastrointestinal functions. Prominent among these are altered amplitudes of several circadian-organized gastric variables, such as intragastric pH, gastrin, pepsinogen and gastric mitotic index. With respect to any given variable, a reduced group amplitude (a measure of one-half the peak-trough difference of a 24 hr rhythm) could signify an increased dispersion of acrophases (the location of the peak of a circadian rhythm along the 24-hr time scale) reflecting interindividual variation in synchronization schedules, sleep-wake patterns, or chronobiologic alterations. A reduced interindividual amplitude further supports the concept of the heterogeneity of peptic disease. A decrease in the intraindividual amplitude of certain gastric rhythms implies an altered temporal pattern over the 24 hr. This is consistent with the hypothesis of a decrease in the amount of time available for recovery of a given function or set of integrated functions, and hence, increased susceptibility to mucosal injury. Normal high-amplitude variation in gastrointestinal functioning over the 24 hr appears to be required for natural restoration of the gut. PMID- 3315262 TI - Day-night patterns in bronchial patency and dyspnea: basis for once-daily and unequally divided twice-daily theophylline dosing schedules. AB - Asthma typically worsens overnight. Although 24-hr variation in environmental conditions may contribute to the worsening of dyspnea at night, this does not fully explain day-night patterns of this disease. Circadian (about 24-hr) rhythms in bioprocesses which influence airways patency constitute major contributory factors. The nighttime exacerbation of asthma may represent the influence of circadian bioperiodicities in bronchial patency, airways hyperreactivity to acetylcholine, histamine and house dust, and altered levels of several plasma constituents such as cortisol, epinephrine, histamine and cyclic AMP. PMID- 3315263 TI - Chronopharmacology and chronotherapeutics: definitions and concepts. AB - Most knowledge of medications has been derived from single- and multiple-dose investigations in which pharmacokinetic and pharmacodynamic phenomena have been evaluated following one, usually, daytime drug administration. Chronopharmacologic studies involving the evaluation of such phenomena after each of several different clock-hour treatments during the day- and nighttime reveal that biological rhythmic processes, such as those of 24 hr, can profoundly affect the kinetics and effects of various medications. Several new concepts have arisen based on findings from chronopharmacologic investigations, such as chronokinetics, chronesthesy and chronergy. These are defined and discussed herein using illustrative examples. A major goal of chronopharmacologic research is to devise chronotherapeutic interventions. Chronotherapeutics is the optimization of drug effects and/or minimization of toxicity by timing medications with regard to biological rhythms. Chronotherapeutics takes into account predictable administration-time-dependent variation in the pharmacokinetics of drugs as well as the susceptibility of target tissues due to temporal organization of physiochemical processes and functions of the body as circadian and other rhythms. The unequally divided and once-daily theophylline treatment schedules for the clinical management of nocturnal asthma, which are discussed in this issue, represent steps toward a chronotherapy. PMID- 3315264 TI - Theophylline steady-state pharmacokinetics: recent concepts and their application in chronotherapy of reactive airway diseases. AB - With the introduction of sustained-release theophylline formulations for once daily dosing or for unequally divided twice-daily dosing, comparison with conventional equally divided twice-daily dosing has been focused on nocturnal serum theophylline concentrations (STCs), plateau properties and peak-trough fluctuation. The merits of various steady-state characteristics such as nocturnal excess, plateau time, residual concentration, peak-trough fluctuation, swing and AUC fluctuation are illustrated by 15 data sets from 7 multiple-dose studies, each including either 10-12 healthy volunteers or 12-20 COPD-patients. In all of the studies, STCs were determined at least every 2 hr over a 24-hr period in steady-state. Included in the studies were 7 sustained-release theophylline formulations which were administered either once daily (in the morning or in the evening), or twice daily (either equally divided, or unequally divided with one third of the dose being given in the morning and two-thirds in the evening. PMID- 3315266 TI - Chrono-optimization of the time of evening administration with unequally divided twice-daily theophylline. AB - The effect of different times of evening administration (2000 hr versus 2200 hr) of sustained-release aminophylline (Euphyllin CR) on pharmacokinetics and lung functions was investigated in 30 patients presenting with moderately severe asthma. The study protocol followed a randomized three-period change-over design including a placebo period. As the dosing of the investigated SR-formulation is circadian rhythm adapted, the major part of the daily dose, namely 2/3, is affected by the change in time of administration. With regard to the nocturnal peak expiratory flow (PEF), no statistically significant difference between the times of evening administration was detected. However, the concomitant requirement for corticosteroids and inhaled beta-2-mimetics complicates the assessment of the relative clinical efficacy of the major dosing of theophylline during the 24 hr even though this drug is usually not given as a monotherapy in severe patients with reversible airway obstruction. PMID- 3315265 TI - Therapeutic advantage of unequal dosing of theophylline in patients with nocturnal asthma. AB - Two theophylline treatments were compared in a randomized, multiple-dose, crossover study on 20 patients present with nonallergic bronchial asthma. Both products (E = Euphyllin CR, A = Afonilum Retard) were capsules containing micropellets. They were administered according to the recommendations of the manufactures and differed in the total daily theophylline dose (642 mg versus 500 mg), the partition of this dose (1/3 in the morning and 2/3 in the evening versus equal amounts in the morning and evening) and the timing of the evening dose (2200 hr versus 2000 hr). The patients were off oral theophyllines at least 2 days prior to study onset and no other drugs were allowed to be administered during the testing periods. On the 4th day of each study period, serum theophylline concentrations (STC) and peak expiratory flow rate (PEF) were determined every 2 hr. Compared with the 24-hr PEF reference profile taken prior to study onset, both theophylline treatments produced a significantly higher 24 hr PEF average (mesor). Treatment E resulted in significantly higher mesor than A; in addition, the PEF amplitude relative to the mesor was reduced by treatment E when compared with placebo. PMID- 3315267 TI - Unequal twice-daily, sustained-release theophylline dosing in chronic obstructive pulmonary disease. AB - Three regimens of sustained-release theophylline (SRT), Theostat were administered to 12 male patients with chronic obstructive pulmonary disease in a randomized cross-over trial. Each 7-day treatment consisted of: treatment A--8 mg/kg at 0700 hr and 4 mg/kg at 1900 hr, treatment B--6 mg/kg at 0700 hr and 6 mg/kg at 1900 hr, treatment C--4 mg/kg at 0700 hr and 8 mg/kg at 1900 hr. Peak expiratory flow (PEF) was recorded each day at 0700, 1100, 1500, 1900 and 2300 hr and theophylline plasma levels were determined on the 7th day of each treatment sequence. Cosinor analysis of the data revealed significant circadian rhythms in PEF for each treatment: the mesor (24-hr average) was significantly higher with C and acrophases (phi, peak time of PEF rhythm) were located at 1426 hr for A and 1425 hr for C; a shift of the acrophase to an earlier timing was detected for B (phi = 0958 hr. These findings suggest that an unequal, twice-daily SRT dosing with the greater amount of drug at night may be beneficial in the treatment of COPD. PMID- 3315269 TI - Treatment of asthma by a controlled-release theophylline tablet formulation: a review of the North American experience with nocturnal dosing. AB - As many as 80 percent of asthmatics experience nighttime or early-morning episodes, which are difficult to treat and potentially fatal. The greater-than normal amplitude of circadian airflow variation in many asthmatics contributes heavily to the genesis of the early 'morning dip'. Beta-agonists and corticosteroids are of limited usefulness in nocturnal asthma, and slow-release theophylline drugs, while potentially effective, vary in 24-hr blood profile and hence their influence on nocturnal episodes. Traditional 12-hr 'symmetric' theophylline regimens, instead of meeting increased nocturnal demands, may actually produce lower night- than daytime blood levels. On the other hand, appropriately timed administration of a once-daily theophylline drug might provide maximum blood levels when needed and help stabilize 24-hr airflow. Accumulated data, summarized in this review, demonstrate the chronotherapeutic potential of single-daily evening doses of a controlled-release theophylline preparation (Uniphyl 400-mg tablets) in nocturnal and early morning asthma. Nighttime blood concentrations with this regimen were higher than were those with Theo-Dur tablets, B.I.D., in the same total daily doses, or with once-daily morning Uniphyl administration. In fed and fasted subjects, evening administration of Uniphyl 400-mg tablets was well tolerated and did not lead to 'dose dumping.' Clinically, this treatment demonstrated advantages over B.I.D. theophylline, over single-daily morning regimens, and over prior theophylline therapy. Advantages of the evening regimen included better early-morning airflow (without significant decline later in the day), more effective symptom control, better patient acceptance, fewer night awakenings, and the obvious convenience of once-daily dosing. In addition, lung function showed greater stability, throughout the day, with once-daily evening therapy than with traditional 12 hr dosing. Uniphyl 400-mg tablets may be administered once daily to provide maximum blood levels at the time of peak bronchoconstriction, whether at night or during the day. PMID- 3315268 TI - Treatment of nocturnal asthma: the role of sustained-release theophylline and oral beta-2-mimetics. AB - In two double-blind, multiple-dose cross-over studies the therapeutic effects of SR theophylline preparations given once each night (mean 11.2 mg/kg per day) versus twice daily in equal doses (mean 10.3 mg/kg per day) (study I) and SR terbutaline in equal doses (mean 0.25 mg/kg per day) versus SR theophylline in unequally divided daily doses (mean 5.3 mg/kg morning dose, 10.6 mg/kg evening dose) study II) were compared in 19 patients with nocturnal asthma. At the end of each treatment period drug serum concentrations and PEFR were measured every 2 hr over a 24-hr period. With the twice-daily, equally divided regimen, serum theophylline concentrations were lower at night than during the day (mean 9.4 +/- 0.9 versus 11.3 +/- 1.0 mg/l). With the single evening administration, serum theophylline concentrations were considerably higher at night (Cmax 16.3 +/- 1.4 mg/l) and the circadian variation of PEFR was significantly reduced. PEFR was higher during night and early morning (283 +/- 14 versus 217 +/- 11 l/min, P less than 0.005). During daytime in study II, PEFR values were slightly higher with theophylline than terbutaline. There was no significant difference in peak flow between either treatment during the night and early morning. However, additional use of inhaled beta-2-mimetics because of asthmatic attacks occurred more often during terbutaline (79 times in 8/10 patients) than theophylline treatment (29 times in 5/10 patients). Symptom scores, number of attacks and side-effects clearly favor the theophylline regimen. We conclude that for patients with nocturnal asthma a once-nightly dose of SR theophylline can be sufficient for stabilization of the airways. PMID- 3315270 TI - Comparison of once-daily evening versus morning sustained-release theophylline dosing for nocturnal asthma. AB - Eight diurnally active (approximately 0730-1100 hr) adults (41-61 yr) suffering from nocturnal asthma volunteered for a double-blind, cross-over randomized study of a once-daily dosing (600-900 mg/24 hr) of Armophylline (Rorer s.a., France), a sustained-release theophylline given either at 0800 hr or 2000 hr for 8-day durations. Study variables monitored daily were: (a) self-measured peak expiratory flow (PEF), heart rate, oral temperature and self-rated fatigue checked every 2 hr during the waking span as well as upon spontaneous nocturnal awakenings and (b) duration and subjective characteristics of sleep rated every morning. In addition, serum theophylline concentration (STC) plus the variables in (a) were sampled every 2 hr during the 24 hr of the eighth day of each timed treatment span. Rx at 0800 hr was associated with a nocturnal dip in PEF of 20 +/ 2.8% (X +/- S.E.M.) from the level achieved at the time of the diurnal crest; Rx at 2000 hr moderated the nocturnal fall; it was only 10 +/- 2.1% and within the physiologic limits of non-asthmatic persons. The STC peak height (Cmax) was greater (P less than 0.05) and time-to-peak (Tmax) shorter (P less than 0.005) with Rx at 0800 hr than at 2000 hr. With Rx at 2000 hr an STC plateau of approximately 12 hr resulted. A statistically significant correlation (r = 0.86; P less than 0.01) between PEF and the corresponding-in-time STC was observed with Rx at 2000 hr but not with Rx at 0800 hr. A small, but statistically significant, higher heart rate resulted from 2000 hr dosings in five out of eight subjects relative to the 0800 hr dosing. There were no differences in the sleep characteristics nor in oral temperature between dosing times. Once-daily (600-900 mg) SRT dosing at 2000 hr controlled the nocturnal dip of bronchial patency with no major side-effects in diurnally active adult patients with nocturnal allergic asthma. PMID- 3315271 TI - Comparison of sustained-release theophylline scheduled conventionally (twice daily, equal interval in equal amount) versus once-daily mornings or evenings on circadian pattern of bronchial patency in asthmatics. AB - The effects of differently timed, but equivalent TheoDur (Key Pharmaceutical Co.) dosage schedules--twice-daily equally divided 12 hr (BID), once-daily evening (OD PM) and once-daily morning (OD-AM)--were compared under steady-state conditions in 10 adult asthmatics with a documented history of nocturnal dyspnea. Assessments of airways function by spirometry were done every 3-hr over one complete 24-hr dosing interval for each dosage schedule under carefully controlled conditions. The different TheoDur regimens did not affect the 24-hr group average FEV1.0, PEF, MMEF or FVC. However, statistically significant circadian variation in airways function existed irrespective of the drug dosing schedule. Airways patency and FVC were least overnight (0200-0500 hr) and best during the morning or afternoon. With regard to FEV1.0 and PEF, which evidenced group circadian change for BID and OD-PM regimen by Cosinor analysis, the peak-to trough (double amplitude) difference expressed as a percentage of the 24-hr average was rather large, being greatest for the OD-PM schedule (20.5% for FEV1.0 and 24.3% for PEF). The data for the 10 participants revealed individual differences in the effectiveness of the 3 studied theophylline dosing regimens when assessed in terms of the mean level and stability of airways function over the 24 hr. Based on the findings, neither the BID, OD-PM nor the OD-AM regimen effectively moderated the nocturnal deterioration of pulmonary function suggesting theophylline as dosed and timed may not be as efficacious as desired for patients with a history of strictly nighttime dyspnea. Thus, the schedule and prescription of TheoDur must take into account differences between patients, including the time when asthma symptoms are most likely to be experienced by each. PMID- 3315272 TI - Administration-time-dependency of the pharmacokinetic behavior and therapeutic effect of a once-a-day theophylline in asthmatic children. AB - Using a double-blind, placebo-control, crossover study design, 8 asthmatic children (8-15 years) were evaluated for temporal patterns in airways function throughout separate study periods when treatment was placebo or Theo-24 once daily on separate occasions at 0600, 1500 or 2100 hr. During 39-hr in-hospital observations, pulmonary function and serum theophylline concentrations (STC) were assessed every 3 hr under all treatments. The pharmacokinetics of Theo-24 varied greatly depending on the dosing time. For the afternoon and evening dosings, the Cmax, Tmax, AUC, % swing, % fluctuation, % AUC fluctuation, % nocturnal excess and Cav(2-6 hr) were all statistically significantly greater than for the morning dosing. Compared with the placebo regimen, dosing patients with Theo-24 at 1500 hr disrupted circadian patterns of airways function, especially airways patency, while dosing at 2100 hr, reduced the amplitude and shifted the acrophase of several spirometric measures to a slightly earlier time. Theo-24 treatment irrespective of dosing time resulted in comparable enhancement of the group 24-hr mean, minimum and maximum values of airways patency with reference to placebo baselines. Theo-24 dosing at 1500 or 2100 hr, however, resulted in the best effect on the airways as assessed by the 24-hr mean FEV 1.0 level in 7 of the 8 asthmatic children. When the drug was given at 1500 hr, the time of lowest FEV 1.0 was shifted from the nighttime hours in 5 of 8 patients. These findings suggest that clinicians need to individualize the theophylline dosing schedule of patients to best control the symptoms of asthma. PMID- 3315273 TI - Food interactions with once-a-day theophylline preparations: a review. AB - At present, theophylline is used predominantly as sustained-release dosage forms. Since the mid-seventies many such products have been introduced and have found huge application for use with a dosage interval of 12 hr ('twice-a-day' preparations). Since 1983 theophylline has also been available as preparations that can be given with an interval of 24 hr ('once-a-day' preparations). The release of theophylline from sustained-release dosage forms can be influenced (either increased or decreased) by concomitant intake of food. Obviously, ultra slow-releasing products are most vulnerable to food effects. With some preparations the composition of the meal, especially its fat content, determines the degree of the food effect. The effect of meal timing and content on once-a day theophylline preparations must be known since rather large doses are ingested all at a single time. If food can alter the release of theophylline in an unexpected manner from ultra-slow preparations, drug effectiveness may be impaired if release is inhibited or toxicity might result if sudden release of drug occurs. Herein, information about food interaction with once-a-day theophylline preparations is reviewed as this topic is important both for clinicians as well as those concerned with chronopharmacologic investigations of such medications. PMID- 3315274 TI - Sustained-release theophylline and nocturnal asthma, once-daily and unequal dosing schedules. AB - Many asthmatic patients experience aggravation of symptoms overnight resulting in disruption of their sleep. Sustained-release theophylline represents at this time a major bronchodilator medication which possesses a sufficient duration of activity to avert the nocturnal breathing distress of asthma. Circadian rhythm adapted theophylline schedules consisting of unequal dosing--more or all the drug taken in the evening--have proven efficacious in clinical investigations for certain patients. Although the kinetic behavior of some formulations is affected by food, the circadian rhythm-adapted schedules represent a significant step forward toward the goal of optimizating sustained-release theophyllines for patients who experience nighttime symptoms. PMID- 3315275 TI - Hairy cell leukemia. AB - Hairy cell leukemia is a chronic lymphoproliferative disorder that has been recognized as a separate clinical pathologic entity for the last 25 years. After a decade of discussions about the origin of the neoplastic cell, it has now been well established that hairy cells represent a certain, rather mature stage of B cell differentiation. Evidence for this has been derived from studies using immunophenotyping with monoclonal and polyclonal antibodies, cytochemistry, and immunoglobulin gene rearrangement. For many years, splenectomy was the only therapy of proven value in hairy cell leukemia. For patients who showed insufficient response to the operation, chemotherapy with low-dose alkylating agents was moderately successful, whereas polychemotherapy often resulted in excessive toxicity. More recently, therapy with alpha-interferon has been shown to be very promising, whereas deoxycoformicin may be an attractive alternative. These new advances in immunology and therapy are reviewed. PMID- 3315278 TI - CPAP circuit for non-ventilated lung during thoracic surgery. PMID- 3315276 TI - The epidural test dose in obstetrics: is it necessary? AB - One must distinguish between what is medically safe and what is legally safe. The authors have the impression that in order to be "legally safe" one must perform a test dose. This is despite the fact that it has not been conclusively shown that the use of test doses improve the safety margin of epidural anaesthesia, when administered by a competent person, with the proper resuscitative equipment immediately available. Until a controlled study is performed, test doses should be done for continuous epidural anaesthesia with the understanding that they are neither 100 per cent sensitive nor specific in preventing complications. It is however one more manoeuvre that may be useful in recognizing some of the patients with accidental subarachnoid placement of epidural catheters. The literature suggests that lidocaine 1.5 per cent in dextrose 7.5 per cent should be the test dose of choice in obstetric epidural anaesthesia in an amount known to produce spinal anaesthesia (30-50 mg). The use of epinephrine in test doses in unpremedicated healthy women in active labour is neither sensitive nor specific in signalling intravascular injection, and it may also be detrimental to fetal wellbeing. Epinephrine 15 micrograms as a test dose for intravenous injection appears to create more problems than it solves. PMID- 3315279 TI - Towards an assessment of toxicity in the treatment of ovarian cancer. AB - Using data from a randomised clinical trial of two platinum drugs at The Royal Marsden Hospital, London, a descriptive model of toxicity has been developed and tested. Toxicity manifests itself in reducing the effectiveness of different body processes; five were selected in this study as being most critical. The model summarises and combines data from these five sites in terms of a clinician's assessment of the associated risk to the patient. It is hoped that the approach will help clarify toxicity information for use in patient management decision making and in the reporting of clinical trial results. PMID- 3315277 TI - Anticoagulants in anaesthesia. PMID- 3315280 TI - Effect of body weight on the pharmacokinetics of cyclophosphamide in breast cancer patients. AB - Cyclophosphamide pharmacokinetics have been studied in 16 female patients with advanced breast cancer. The group included 7 patients who were greater than 20%, less than or equal to 30% over ideal body weight and 5 patients who were greater than 30% over ideal body weight. Cyclophosphamide plasma elimination half-lives ranged between 152 and 984 min (mean 457 min), the apparent volume of distribution between 19.1 and 62.3 1 (mean 36.1 1), and plasma clearance between 25.9 and 166.6 ml/min (mean 69.5 ml/min). There was a significant positive correlation (r = 0.624, P = 0.010) between body weight and plasma elimination half-life, and a significant negative correlation between body weight and cyclophosphamide clearance when normalized to body surface area (r = 0.578, P = 0.019) or normalized to ideal body weight (r = 0.531, P = 0.0345). The apparent volume of distribution did not correlate with body weight. The results show that cyclophosphamide disposition is altered in patients with increased body weight. PMID- 3315281 TI - Phase I study of recombinant human tumor necrosis factor. AB - A phase I clinical and pharmacokinetic study of recombinant human tumor necrosis factor (rH-TNF) was conducted in a single dose schedule in 33 patients with advanced cancer. rH-TNF was given by i.v. infusion over 30 min with a starting dose of 1 x 10(5) units/m2. The dose was escalated up to 16 x 10(5) units/m2 according to the modified Fibonacci scheme. Toxic effects were similar but not identical to those reported with interferons and interleukin-2, and included fever, rigors, nausea and vomiting and anorexia in a non-dose-dependent manner, and hypotension, leukocytosis, thrombocytopenia and transient elevation of transaminases (SGOT and SGPT) in an approximately dose-dependent manner. DIC syndrome was observed in one patient who had received 16 x 10(5) units/m2. The dose-limiting toxicities were hypotension, thrombocytopenia and hepatotoxicity, and the maximum tolerated dose in a single i.v. infusion of rH-TNF appeared to be 12 x 10(5) units/m2 when thrombocytopenia and elevation of SGOT and SGPT were taken as the dose-limiting toxicities. However, if hypotension was included, the maximum safely tolerated dose appeared to be 5 x 10(5) units/m2. PMID- 3315282 TI - Treatment of acute leukemia and malignant lymphoma with (2"R)-4'-O tetrahydropyranyladriamycin. AB - Eighty-four previously treated adult patients with acute leukemia and malignant lymphoma were treated with (2"R)-4'-O-tetrahydropyranyladriamycin (THP). THP (10 55 mg/m2) was administered by i.v. bolus injection daily for acute leukemia, and according to three different schedules for malignant lymphoma: daily, weekly or once every 3-4 weeks. Complete and partial remission (CR and PR) were achieved by 1 (5%) and 3 of 19 patients with acute myelogenous leukemia and by 2 (13%) and 3 of 15 patients with acute lymphoblastic leukemia, respectively. All CRs were in the groups receiving 25 mg/m2 THP daily. CR and PR were achieved by 6 (14%) and 8 of 42 patients with non-Hodgkin lymphoma (NHL) and by 4 (50%) and 2 of 8 patients with Hodgkin's disease (HD), respectively. No particular sensitivity was found among the subtypes of NHL and HD. Response (CR + PR) was noted in 10 (40%) of 25 patients treated every 3-4 weeks, in 1 (17%) of 6 treated weekly, and in 9 (47%) of 19 treated daily. The major side effects were myelosuppression and gastrointestinal toxicities. Alopecia was observed in only 10 (12%) patients. ECG abnormalities were observed in 7 (10%) patients, all of whom had previously been treated with other anthracyclines. No severe cardiotoxicity was observed. PMID- 3315283 TI - Pharmacokinetics of oral and intramuscular methotrexate in children with acute lymphoblastic leukaemia. AB - Repeated methotrexate absorption studies were performed under standard conditions in 127 children receiving either oral or intramuscular methotrexate for acute lymphoblastic leukaemia. There was marked variability in peak concentration, area under the serum concentration curve and clearance both between patients and in repeated studies on the same patient. Although the intramuscular route produced higher serum concentrations and AUC than the oral route, variability within and between patients was considerable and was most marked at higher concentrations. Neither age or sex could account for variation in methotrexate absorption or clearance. Intramuscular methotrexate, although producing higher serum concentrations and AUC, does not reduce the variability observed with oral administration. Prediction of subsequent methotrexate concentrations from the knowledge of one absorption profile is not possible. PMID- 3315284 TI - Repeated high-dose cyclophosphamide administration in bone marrow transplantation: exposure to activated metabolites. AB - Blood levels of cyclophosphamide (CP) and activated metabolites were measured in 11 patients undergoing a 2- to 4-day conditioning chemotherapy for bone marrow transplantation. Urinary excretion of CP was determined in five patients. CP half life decreased after pretreatment from an average of 7.1 h on the 1st day to 5.5 h on the 2nd day (P less than 0.005) and to 4.3 h on the 4th day (P less than 0.005). No characteristic changes in urinary excretion could be observed. At the same time the exposure to non-protein-bound activated metabolites increased from 10.5 to 19.5 and 26.0 nmol x h/ml respectively (P less than 0.005 and P less than 0.04). Thus, in contrast to in vitro and animal studies, no evidence for an inhibition of activating enzymes could be found. On the contrary, pretreatment seems to enhance the production of the cytotoxic metabolites. The possible explanation of these changes by enzyme induction and by the role of saturated protein binding sites is discussed. Exposure to active metabolites might be altered by dose splitting or even by a change in the duration of the infusion. PMID- 3315285 TI - Effect of L-leucine on oral melphalan kinetics in patients. AB - Melphalan uptake in the intestine has recently been shown to be an energy dependent process which is affected by metabolic inhibitors. It is therefore theoretically possible that amino acids in food could reduce melphalan absorption by competing for uptake at the sites of absorption in the intestine. Since L leucine has been shown to be the most potent inhibitor of melphalan transport into cells in vitro, this amino acid was chosen for the present study in patients. Oral melphalan (4.5 +/- 0.5 mg/m2) was given to ten fasting patients with and without a 2-g oral dose of L-leucine on separate randomized occasions at least 1 week apart. Melphalan plasma levels were measured by high-performance liquid chromatography (HPLC) for 5-h after dosing. L-Leucine plasma levels were measured by HPLC before and at 1 h after dosing. The area under the curve for melphalan was lower in seven of the patients after L-leucine. Plasma L-leucine levels 1 h after melphalan administration were 15.4 +/- 3.7 micrograms/ml fasting and 35.4 +/- 5.2 micrograms/ml after L-leucine. The results indicate that L leucine can reduce plasma melphalan levels in some patients, probably through a reduction in absorption of the drug from the gastrointestinal tract. However, the effect, like that of food, is highly variable. PMID- 3315287 TI - A monoclonal antibody against cytochrome P-450 enhances mutagen activation of N nitrosodimethylamine by mouse liver S9: studies on the mode of action. AB - The effect of the monoclonal antibody MAb 2-66-3, directed against the major rat liver phenobarbital (PB)-induced cytochrome P-450 (P-450), on the S9-mediated mutagenicity of N-nitrosodimethylamine (DMN) in Salmonella typhimurium strain TA1530 was studied using liver S9 from PB-treated mice. This MAb enhanced approximately 2-fold S9-mediated mutagenicity of DMN but inhibited both its N demethylation and N-denitrosation by 50%. Thus MAb-mediated enhancement of DMN mutagenesis does not result from altered activation/inactivation pathways, both known to involve P-450 isozymes. DMSO, a hydroxyl radical (HO.) scavenger and desferrioxamine, an inhibitor of HO.-dependent reactions, quenched the MAb mediated enhancement of DMN mutagenesis, implicating the HO.-dependent activation of DMN to mutagenic species. As a mechanism, we propose that the binding of this MAb to P-450 isozyme implicated in DMN metabolism decreases the functional coupling between the reductase and the P-450 complex, leading to an increased electron flow from the reductase towards molecular oxygen to form reduced oxygen species (HO.) at the expense of the monooxygenase functions. PMID- 3315286 TI - A randomised cross-over trial comparing low-dose metoclopramide and chlorpromazine with high-dose metoclopramide in Chinese patients with advanced cancer receiving cisplatinum and 5-fluorouracil. AB - Nineteen Chinese patients receiving chemotherapy for advanced cancer were studied for chemotherapy-induced acute nausea and vomiting. The chemotherapy consisted of cisplatinum 100 mg/m2 i.v. infusion over 4 h on day 1 and 5-fluorouracil (5-FU) 1000 mg/m2 120-h continuous infusion from day 2 to day 6, repeated every 3 weeks. At the first course of chemotherapy the patients were randomized to receive either low-dose metoclopramide and chlorpromazine or high-dose metoclopramide, and then crossed over for the second course. In the high-dose metoclopramide group there was a suggestion of an earlier onset of emesis, with slightly more frequent retching and vomiting and less food consumed. However, the duration of emesis was shorter in the high-dose group. These differences were not statistically significant. There were no major side effects. Mild salutary drowsiness was noticed in patients receiving low-dose metoclopramide and chlorpromazine. This trial suggests that, in the dosage, route and schedule described, high-dose metoclopramide is no more effective than low-dose metoclopramide together with chlorpromazine in preventing cisplatinum-induced nausea and vomiting. The low-dose scheme is more economic and suitable for patients with advanced cancer. PMID- 3315288 TI - Intestinal prostacyclin and thromboxane production in irreversible hemorrhagic shock. AB - Arterial and intestinal venous blood were sampled every hour for measurement of thromboxane B2 (TXB2) and 6-keto-PGF1 alpha, stable metabolites of thromboxane A2 and prostacyclin, respectively, in dogs subjected to hemorrhagic hypotension at 32.8 +/- 1.4 mm Hg for 3 h, followed by reinfusion of the remaining shed blood. Control dogs were treated alike without hypotension. Arterial and intestinal venous TXB2 significantly increased during hypotensive and post-transfusion periods, the venous concentration being significantly higher than the corresponding arterial. The arterial and venous 6-keto-PGF1 alpha increased during hypotension but decreased during post-transfusion periods. Furthermore, arterial and venous TXB2 to 6-keto-PGF1 alpha concentration ratio increased. Intestinal TXB2 release (blood flow X arteriovenous concentration difference) increased progressively, whereas 6-keto-PGF1 alpha release decreased. No significant changes occurred in the control dogs. This study shows an imbalance in intestinal production and release of TXA2 and PGI2, in favor of TXA2 during severe hemorrhagic hypotension and after blood transfusion. The imbalance may contribute to the development of irreversible hemorrhagic shock and reperfusion injury. PMID- 3315289 TI - Glucose kinetics and pyruvate dehydrogenase activity in septic rats treated with dichloroacetate. AB - Decreased pyruvate dehydrogenase (PDH) activity in skeletal muscle has been observed during sepsis and may contribute to the altered glucose kinetics seen in this condition. The purpose of the present study was to determine if dichloroacetate (DCA), a known stimulator of PDH activity, could reverse the sepsis-induced increase in glucose metabolism. Hypermetabolic sepsis was produced in chronically catheterized rats by repeated subcutaneous injections of live Escherichia coli. Whole body glucose kinetics, assessed by a constant iv infusion of [6-3H and U-14C]-glucose, were determined in fasted septic and nonseptic rats before and for 4 hr after an injection of DCA (30 mg/100 g BW, iv). Sepsis produced hyperthermia (+1.6 degrees C) and increased the rates of glucose appearance (Ra; 95%), recycling (318%), metabolic clearance (MCR; 114%), and elevated plasma lactate levels (295%) compared to nonseptic controls. After injection of DCA into septic rats, glucose levels gradually fell, and the sepsis induced hyperlactacidemia was completely reversed. Treatment of septic rats with DCA reversed the elevated glucose Ra; recycling, although reduced, was still elevated by 50% compared to control animals. DCA did not alter the hyperglucagonemia seen in septic animals, but it did reduce the plasma insulin levels by 60%. Hepatic and muscle PDH activities were not different in saline treated septic and nonseptic animals. DCA elevated PDH activity in muscle from septic rats, but the increase was smaller than that seen in control animals. This may explain the smaller decline in glucose recycling and plasma lactate in septic animals. These results are consistent with DCA reducing the elevated glucose Ra in sepsis by partial activation of PDH, which reduces the elevated precursor (lactate) supply for gluconeogenesis. However, alterations in PDH activity did not appear to contribute to the underlying increase in glucose Ra and recycling observed in sepsis. PMID- 3315290 TI - Volume expansion, dobutamine and noradrenaline for treatment of right ventricular dysfunction in porcine septic shock: a combined invasive and radionuclide study. AB - The purposes of the present study were 1) to explore if volume loading in combination with dobutamine or noradrenaline would be superior to volume loading alone in the treatment of right ventricular (RV) dysfunction in septic shock complicated by acute pulmonary hypertension and 2) to determine whether noradrenaline would be superior to dobutamine because of its vasoconstrictor effects on the peripheral circulation, resulting in increased RV coronary perfusion pressure. Experiments were performed on 21 anesthetized, ventilated pigs. Gated blood pool studies and hemodynamic measurements were performed simultaneously. All animals were given 3-4 X 10(8)/kg live E. coli bacteria, resulting in an abrupt increase in pulmonary arterial pressure and a decrease in arterial pressure, cardiac output, and RV ejection fraction. Right ventricular end-systolic volume was unchanged; RV end-diastolic volume and RV coronary perfusion pressure fell. After randomization, the control group (I, n = 5) was subjected to volume loading, and treatment groups (each n = 8) received volume loading in combination with dobutamine (group II, 5-10 micrograms/kg/min) or noradrenaline (group III, 0.25-0.50 micrograms/kg/min). In contrast to volume loading alone, dobutamine and noradrenaline increased cardiac output and RV ejection fraction, but only noradrenaline restored mean arterial pressure. Noradrenaline improved RV contractility, as judged from the RV end-systolic pressure-volume relationship, probably because it increased the RV perfusion. Thus, noradrenaline in combination with volume loading may be the treatment of choice to improve RV performance in porcine septic shock associated with pulmonary hypertension. PMID- 3315291 TI - Metabolism of palmitate in isolated working hearts from spontaneously diabetic "BB" Wistar rats. AB - Myocardial fatty acid metabolism was studied in spontaneously-diabetic "BB" Wistar rats. The study involved 4 groups: control Wistar rats, nondiabetic littermates of "BB" Wistar rats, insulin-treated diabetic "BB" rats, and diabetic "BB" rats in which insulin treatment was removed 24 hours prior to study (uncontrolled diabetes). Hearts were perfused for 30 minutes as isolated working hearts in perfusate containing 1.2 mM (1-14C)-palmitate bound to 3% albumin, and 11 mM glucose. Palmitate oxidative rates, calculated as micromoles palmitate oxidized per gram dry weight per minute, were significantly decreased in both diabetic groups (0.447 +/- 0.043 and 0.528 +/- 0.038 in uncontrolled diabetic and treated diabetic versus 0.584 +/- 0.032 and 0.629 +/- 0.033 in nondiabetic littermate and control rats, respectively). This decrease was accompanied, however, by a significant decrease in the heart rate of these 2 groups when compared with control or nondiabetic animals. If the decreased heart function in the diabetic animals was accounted for, no decrease in palmitate oxidative rates occurred, suggesting that fatty acid oxidative metabolism is not impaired in the diabetic myocardium. In the uncontrolled diabetic rats, an increased rate of palmitate incorporation into myocardial triglycerides was seen compared with treated diabetic, nondiabetic littermates, and control rats (8.5 +/- 0.3 mumol/g dry wt/30 min versus 4.8 +/- 0.3, 5.9 +/- 0.7, and 5.7 +/- 0.3, respectively). Myocardial levels of coenzyme A were elevated in the uncontrolled diabetic rats compared with all other groups (647 +/- 25 nmol/g dry wt versus 484 +/- 27, 508 +/- 56, and 534 +/- 9, in treated diabetic, nondiabetic, and control rats, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315293 TI - Rheumatic fever: the way it was. PMID- 3315292 TI - Myosin light chain isoforms and their phosphorylation in arterial smooth muscle. AB - Arterial smooth muscle myosin contains nonphosphorylated and phosphorylated light chains that appear as 4 spots on two-dimensional, Coomassie blue-stained gel electrophoretograms at the 20,000-molecular weight level (referred to as spots 4 through 1 in order of decreasing isoelectric points). Anti-light chain recognizes the proteins in all 4 light chain spots. Complete dephosphorylation of light chain in muscle homogenate, by inhibiting myosin light chain kinase and by adding phosphatase, leads to 2 spots on two-dimensional gel electrophoretograms; both spots are visible on immunoblots. Stimulation (K+ or stretch) of smooth muscle results in increased light chain phosphorylation. Autoradiography of the gel electrophoretograms reveals that radioactive components are contained in spots 3, 2, 1, and in an additional spot with lower isoelectric point, referred to as spot 0. Phosphoamino acid analysis shows that spots 3 and 1 contain phosphoserine, whereas spots 2 and 0 contain phosphoserine and phosphothreonine. Two-dimensional phosphopeptide mapping of the trypsin-digested proteins from spots 3 and 1 shows predominantly 2 peptides; whereas from spots 2 and 0, it shows 5 peptides. Sodium dodecyl sulfate gel electrophoresis of the phosphopeptides obtained with Staphylococcus aureus V8 digestion gives identical maps for spots 3 and 2, which are different from the identical maps of spots 1 and 0. The results suggest that arterial smooth muscle myosin contains 2 nonphosphorylated 20,000-dalton light chain isoforms with different amino acid sequences and that each isoform can be mono- and diphosphorylated. PMID- 3315294 TI - Seasonal cholesterol cycles: the Lipid Research Clinics Coronary Primary Prevention Trial placebo group. AB - Seasonal variation of plasma cholesterol levels was studied in 1446 hypercholesterolemic 35- to 59-year-old male participants in the Lipid Research Clinics Coronary Primary Prevention Trial placebo group. Each man's serial cholesterol data, obtained at bimonthly intervals for 2.0 to 6.5 years, were analyzed as a separate periodic time series, and distributions of cycle zeniths and amplitudes were calculated. A highly significant (chi 2= 706, 2 degrees of freedom) seasonal effect, 7.4 mg/dl higher on December 30 than on June 30, was found. This effect was similar among the 12 LRC centers, including such disparate climates as those of Minneapolis and San Diego, and tended to be larger in the southern centers. Its magnitude was independent of baseline levels of plasma cholesterol and other baseline characteristics. Observed seasonal differences in weight and diet explained less than one-third of the seasonal variation in plasma cholesterol levels. Plasma low- and high-density lipoprotein cholesterol levels, analyzed similarly, also showed significant synchronous seasonal cycles. Plasma triglyceride levels showed a weaker irregular seasonal pattern, highest in midsummer and late autumn and lowest in spring. The etiologies and mechanisms for these seasonal patterns remain largely unknown. PMID- 3315295 TI - Prehospital trial of emergency transcutaneous cardiac pacing. AB - A prospective alternate-day controlled trial of prehospital transcutaneous cardiac pacing (PACE) of hemodynamically significant bradycardia and asystole was undertaken. All patients had a Glasgow coma scale score of 12 or less. Patients in the control group (n = 101) received standard advanced cardiac life support (ACLS) care. Patients in the pacing group (n = 101) were to receive PACE in addition to standard ACLS treatment; 89 patients were actually paced. The two groups were comparable in terms of age, sex, presenting rhythm, and mean times to cardiopulmonary resuscitation (CPR) and ACLS. For the 144 patients in whom the time of arrest could be estimated, the mean times to CPR and ACLS were 5.3 +/- 4.0 and 10.9 +/- 7.1 min, respectively. For the 65 paced patients in whom the time of arrest could be estimated, the mean time from arrest to pacing was 21.8 +/- 8.8 min (range 2 to 43). Multivariate analysis of outcome variables (presentation to emergency department with a pulse, admission to the hospital, and discharge from the hospital) revealed that an initial rhythm of ventricular tachycardia or fibrillation and a short time to ACLS were correlated with a favorable outcome (p less than .05; logistic regression analysis). A short time to PACE was associated with admission to the hospital (p = .20; logistic regression analysis). The use of a stand-alone transcutaneous pacing device in the prehospital arrest setting was associated with generally long times until pacing and did not appreciably improve outcome. Use of PACE in patients demonstrating prehospital bradycardia without neurologic impairment remains to be evaluated. PMID- 3315296 TI - Measurement of regional myocardial perfusion and mass by subselective hydrogen infusion and washout techniques: a validation study. AB - A technique was developed for measuring regional myocardial perfusion by intracoronary infusions of hydrogen (H2)-saturated saline. H2 concentration was detected during washout in the pulmonary artery by means of the voltage response of a platinum-tipped electrode. Regional myocardial perfusion was calculated from the H2 exponential desaturation curve according to the Kety-Schmidt principle. In 16 anesthetized open-chest dogs, validation of this technique was performed at baseline, reduced (stenosis), and hyperemic (dipyridamole) flow states by means of the radionuclide-labeled microsphere reference withdrawal technique. There was an excellent quadratic correlation between microsphere and H2 washout techniques (range 0.11 to 3.15 ml/min/g) (n = 33, r = .92, y = -0.12x2 + 0.89x + 0.20, SEE = 0.20 ml/min/g; p less than .0001). Hyperemic regional myocardial perfusion was underestimated by H2 washout and severely ischemic regional myocardial perfusion was overestimated. When regional myocardial perfusion values greater than twice normal were excluded, a strong linear correlation was present between H2 and microsphere measurements (n = 27, r = .89, y = 0.76x + 0.22, SEE = 0.18 ml/min/g; p less than .0001). The H2 washout method was further tested in 18 additional open chest dogs for calculations of the mass of an arterial perfusion bed according to the principle that the mass of the bed (g) equals coronary blood flow (ml/min) divided by regional myocardial perfusion (ml/min/g).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315297 TI - Determinants and detection of anaerobic threshold and consequences of exercise above it. AB - During exercise, the level of oxygen consumption (VO2) above which aerobic energy production is supplemented by anaerobic mechanisms causing a sustained increase in lactate and metabolic acidosis is termed the anaerobic threshold. The VO2 at which the anaerobic threshold occurs is influenced by the factors that affect oxygen delivery to the tissues, being increased when oxygen flow is enhanced and decreased when oxygen flow is diminished. The anaerobic threshold is an important functional demarcation since the physiologic responses to exercise are different above the anaerobic threshold as compared with below the anaerobic threshold. Above the anaerobic threshold, in addition to the development of metabolic acidosis, exercise endurance is reduced, VO2 kinetics are slowed so that a steady state is delayed, and minute ventilation increases disproportionately to the metabolic requirement and a progressive tachypnea develops. The anaerobic threshold can be measured directly from lactate concentration with good threshold detection from a log-log transformation of lactate and VO2. This threshold defines the VO2 at which the lactate/pyruvate ratio increases. As bicarbonate changes reciprocally with lactate, its measurement can also be used to estimate the lactate threshold. But most conveniently, changes in gas exchange caused by the physical-chemical event of buffering of lactic acid by bicarbonate can be used to detect the anaerobic threshold during exercise. PMID- 3315298 TI - Circulatory response to exercise in health. AB - Engagement in muscular exercise involves complex local and nervous adjustments of the circulation. In the active muscles, including cardiac muscle, the resistance vessels relax in response to local chemical changes to provide an increase in blood flow adequate for their metabolic requirements. There is increased release of norepinephrine from the sympathetic nerve endings as a result of increased sympathetic outflow; the resultant alpha-receptor activation leads to constriction of both systemic resistance and capacitance vessels outside the active muscles, and the beta-receptor activation leads to an increase in heart rate, shortening of the refractory period, and enhancement of myocardial contractility. As a consequence, the filling pressure of the heart and arterial blood pressure are maintained, and the increase in left ventricular output is directed primarily to the active muscles. During upright exercise, the action of the leg muscle pump contributes to the maintenance of the cardiac filling pressure. As exercise continues and body temperature rises, the skin flow increases to dissipate heat from the body. Static exercise causes a greater increase in arterial blood pressure than dynamic exercise. This is due to the combination of an increase in cardiac output and in total systemic vascular resistance as a consequence of increase sympathetic outflow and mechanical compression of the vessels in the active muscles. The hemodynamic changes result from activation of ergoreceptors in the contracted muscles and from central command. The increase in pressure helps to oppose the mechanical compression. The arterial baroreceptors are reset so that they operate normally around the higher blood pressure. PMID- 3315300 TI - Phadiatop--a novel IgE antibody screening test. AB - The Phadiatop test, which is based on a multi-allergen allergosorbent, proved to be a test that is simple to perform in the laboratory and produces reliable results. When compared with the more conventional RAST atopy screening test for grass, mite and IgE antibodies it produced similar results, except in those rare instances of patients who were RAST-positive only for moulds where the Phadiatop test was decidedly superior. The Phadiatop test disc contains only inhalant allergens and so it could not be used for screening infants and very young children whose IgE response, if any, is probably limited to foods. PMID- 3315301 TI - Assessment of magnesium status. AB - The adult human body contains approximately 24 g (1 mol) of magnesium--about half in bone and half in soft tissues. Only about 0.3% of the total body magnesium is present in serum, yet the majority of analytical data obtained is from this body fluid. Assessing the magnesium status of an individual is difficult, there being at present no simple, rapid, and accurate test to determine intracellular magnesium, but determination of total and free magnesium in tissues and physiological tests provide some information. Changes in magnesium status have been linked to cardiac arrhythmias, coronary heart disease, hypertension, and premenstrual syndrome. A better understanding of magnesium transport and of factors controlling magnesium metabolism is needed to elucidate the role of magnesium in disease processes. PMID- 3315302 TI - Chemiluminescence immunoassay for somatomedin C in serum. AB - To select the best tracer for use in a competitive immunoassay, we conjugated human somatomedin C (SmC) to various chemiluminescent compounds via two different synthetic pathways. Naphthylhydrazides and arylhydrazides, used as the labels, were incorporated via their imidate or their succinimide esters. Conjugating the carboxy terminal of (amino ethyl)ethyl-isoluminol to SmC via a succinimide linkage supplied the most sensitive detection limit and the most immunoreactive conjugate. We developed an immunoassay based on the use of this conjugate, and evaluated dextran-coated charcoal, second-antibody precipitation, and solid-phase immunoprecipitation for separating bound and free label. This chemiluminescent method has a detection limit of 16 pg per tube, and it is accurate and precise. Correlation studies with a conventional radioimmunoassay (x) for SmC gave the following regression equation: y = 0.66x + 3.76 (r = 0.953, n = 30); the slight discrepancies between the two methods are probably ascribable to the use of different antibodies. We thus propose this chemiluminescence immunoassay as an inexpensive and sensitive alternative to radioimmunoassay for measuring SmC in serum or in extracts of serum. PMID- 3315299 TI - Determination of aerobic capacity and the severity of chronic cardiac and circulatory failure. AB - The noninvasive determination of maximal oxygen uptake or VO2max, defined as a plateau in VO2 during incremental treadmill exercise, is an objective, reproducible, and negotiable measure of the severity of chronic cardiac or circulatory failure. Moreover, this noninvasive variable predicts the exercise cardiac output response and thereby the cardiac reserve. The lactate or anaerobic threshold has been validated in these patients from the response of mixed venous lactate to incremental exercise and has been shown to be another objective measure of the severity of chronic cardiac or circulatory failure. The anaerobic threshold can be reliably assessed from the response in breath-by-breath respiratory gas exchange by the use of multiple criteria, several of which can be monitored during the exercise test itself and the remainder of which can be measured during the recovery period. We find the breath-by-breath monitoring of respiratory gas exchange and air flow to provide the best means of assessing the anaerobic threshold and for identifying the plateau in VO2, or VO2max, in response to incremental treadmill exercise. PMID- 3315303 TI - An examination of heart proteins by two-dimensional electrophoresis. AB - We examined specimens from explanted human hearts by two-dimensional electrophoresis. The protocol selected includes: (a) solubilization of the sample in a urea-detergent mix; (b) charge fractionation in the presence of urea and nonionic detergent on a pH 4-10 immobilized pH gradient; (c) size fractionation on a polyacrylamide concentration gradient in the presence of sodium dodecyl sulfate; and (d) staining with silver nitrate. The method is sensitive enough for analysis of biopsies in the 1-3 mg range (wet tissue). We saw, for explanted hearts, variations in the protein pattern with the site of sample dissection. Results are presented for 11 explanted human hearts: one control organ and 10 pathological samples. The recorded pathologies included dilatative cardiomyopathy (six cases), valvulopathy (one case), ischemic cardiopathy (two cases), and graft rejection (one case). The patterns for whole extracts as well as for cytoplasmic proteins and myofibril components are compared. Extensive individual variability was observed both between control and pathological cases and among the abnormal samples. PMID- 3315304 TI - Four methods compared for measuring des-carboxy-prothrombin (PIVKA-II). AB - PIVKA-II (Protein Induced by Vitamin K Absence) is abnormal des-carboxylated prothrombin, which is present in vitamin K deficiency or in patients using warfarin. With a sensitive method for PIVKA-II, biochemical vitamin K deficiency can be established before clinical symptoms occur. We give an overview of methods used to detect PIVKA-II, and four selected methods are inter-compared: (a) measuring total factor II including PIVKA-II by using Echis carinatus snake venom as an activator of prothrombin; (b) measuring PIVKA-II by using snake venom as an activator of factor II after adsorption of functional factor II onto barium sulfate; (c) electrophoresis-immunofixation method; and (d) enzyme immunoassay. We found d to be the most sensitive and reliable method for PIVKA-II. PMID- 3315306 TI - Drug-analysis technology: overview and state of the art. AB - Analytical techniques are available to reliably detect and, if necessary, quantify drugs of abuse and their metabolites in urine. A variety of different immunoassays are likely to remain at the heart of initial screening methods but with an increasing emphasis on confirmation of positive findings by GC-MS. The quality of work in laboratories (which may make considerable financial gain through increased volume of samples) must be guarded by both internal quality assurance and external proficiency testing, but most of all by ensuring that staff are truly forensic toxicologists with adequate credentials and experience. Laboratories must be credible to the courts and to their clients, which is simply not the case today. For the past 20 years, the toxicologist has played an increasingly important role as an ombudsman of public-health issues; this new dimension of professional responsibility has almost frightening proportions. The alarm that is rightly felt in the profession can only be assuaged and brought into perspective by increasing the knowledge base from which toxicological opinions are rendered, and by recognizing that, however critical, the analytical laboratory report is only a part, and never the whole case. Just a few areas of immediate needs have been mentioned, but they are critical, they cannot be avoided, and they must receive appropriate attention very soon. PMID- 3315305 TI - Chemiluminescence immunoassay of thyrotropin with acridinium-ester-labeled antibody evaluated and compared with two other immunoassays. AB - A new chemiluminometric immunoassay of thyrotropin (TSH) involves antibody labeled with acridinium ester ("Magic Lite System," Ciba Corning Diagnostic Corp.). The assay is rapid, with two incubations totaling 2.5 h, requires two standards per run, and takes 10 s per sample for the quantification step. Analytical performance, within- and between-run reproducibilities, and linearity were excellent. The detection limit is 0.04 milli-int. unit/L. Results correlated well with those obtained by immunoradiometric assay (RIA-gnost hTSH, Hoechst Behring) and immunofluorometric assay (hTSH Delfia, LKB): r = 0.975. TSH measurements in 32 euthyroid subjects ranged from 0.4 to 4.8 milli-int. units/L (mean 1.35 milli-int. units/L). TSH values for 51 hypothyroid and subclinically hypothyroid patients ranged from 2 to 65 milli-int. units/L. TSH values for 33 hyperthyroid patients (less than 0.14 milli-int. unit/L, less than 0.04 milli int. unit/L in 16 of the 33) were clearly lower than for most untreated euthyroid subjects. For 169 other individuals whose thyroid function was being routinely assessed. TSH ranged from 0.4 to 4.8 milli-int. units/L, three had TSH less than 0.14 milli-int. unit/L, and four had TSH between 0.14 and 0.4 milli-int. unit/L. This system is as efficient and reliable for screening for thyroid function as the two comparison systems. PMID- 3315307 TI - Some preliminary thoughts on the wisdom of governmental prohibition or regulation of private employee urinalysis testing. PMID- 3315308 TI - Drug-analysis technology--pitfalls and problems of drug testing. PMID- 3315309 TI - Employee drug screening: issues to be resolved in implementing a program. PMID- 3315310 TI - Drug of abuse profile: cocaine. PMID- 3315311 TI - The United States' drug abuse scene: an overview. PMID- 3315312 TI - Drug of abuse profile: cannabis. PMID- 3315313 TI - Alcohol, an abused drug. PMID- 3315314 TI - Laboratory assessments in treatments of substance abuse: utilization and effects on treatment design. PMID- 3315315 TI - Velopharyngeal dysfunction: recommendations for use of nomenclature. AB - A review of literature relating to velopharyngeal dysfunction reveals that there is no consensus regarding the precise definition of the terms "velopharyngeal incompetence," "velopharyngeal inadequacy," or "velopharyngeal insufficiency." Since this represents an obstacle to communication among members of multidisciplinary teams concerned with rehabilitation of velopharyngeal problems, current usage of these terms is reviewed and recommendations for clarification of the nomenclature are provided. PMID- 3315316 TI - Stable isotope dilution analysis of pipecolic acid in cerebrospinal fluid, plasma, urine and amniotic fluid using electron capture negative ion mass fragmentography. AB - A sensitive and accurate stable isotope dilution assay was developed for the measurement of pipecolic acid in body fluids using electron capture negative ion mass fragmentography. The method utilizes [2H11]pipecolic acid as the internal standard. Sample preparation consisted of derivatization in aqueous solution (pH 11.5) of the amine moiety with methyl chloroformate to the N-methylcarbamate, followed by acidic ethyl acetate extraction (pH 2) and further derivatization of the carboxyl moiety to the pentafluorobenzyl ester. Normal values have been determined in cerebrospinal fluid (mean means = 0.041 mumol/l, range 0.010-0.120 mumol/l), in plasma of at term infants (age less than 1 wk, means = 5.73 mumol/l, range 3.75-10.8 mumol/l; age greater than 1 wk, means = 1.46 mumol/l, range 0.70 2.46 mumol/l), in urine of at term infants (age less than 6 mth, means = 32.5 mumol/g. creat., range 9.81-84.5 mumol/g. creat; age greater than 6 mth, means = 6.35 mumol/g. creat., range 0.15-13.6 mumol/g. creat.) and in amniotic fluid (means = 4.65 mumol/l, range 2.24-8.40 mumol/l). The utility of the method was demonstrated for the pipecolic acid quantification in these biofluids of patients with peroxisomal disorders. As affected fetuses with infantile Refsum's disease and Zellweger syndrome showed no significant elevation of pipecolic acid in their surrounding amniotic fluids, the measurement of pipecolic acid in amniotic fluid seemed not to be useful for prenatal diagnosis in these disorders. PMID- 3315317 TI - Biochemical tests in the diagnosis, classification, and management of patients with malignant lymphoma and leukemia. PMID- 3315318 TI - Effect of insulin, S-adenosylhomocysteine, phospholipase C, n-butanol and Triton X-114 on alkaline phosphatase from isolated rat adipocyte plasma membranes. PMID- 3315319 TI - Sandwich enzyme immunoassay of total insulin in the serum containing insulin antibodies. PMID- 3315320 TI - Active and inactive renin in the cat. AB - Pentobarbitone-anesthetized cats underwent peritoneal dialysis and had blood samples removed and kidneys deep frozen at sacrifice. Inactive renin is easily measurable in cat plasma and peritoneal dialysate fluid. Only small amounts are found after acid activation at pH 4.0, but large amounts after trypsin 2 mg/ml at 4 degrees C for 10 minutes. Mean active renin in pentobarbitone-anesthetized cats was 1.8 +/- 0.4 pmoles AI/ml/hr, while inactive renin was 2.3 +/- 0.5 pmoles AI/ml/hr. The increased angiotensin I producing activity after trypsin in peritoneal dialysate was most active at pH 7.0 (plasma and kidney active renin 7.25 and 7.85), and had an apparent molecular weight of 39-40,000. (Plasma active renin had an apparent MW of 33,500 and kidney active renin 36,000. Plasma inactive renin had an apparent MW of 35,500) Cat plasma after cibacron-blue affinity chromatography showed mainly active renin in the breakthrough buffer (30% of total renin eluted), and renin which is almost entirely inactive in the bound peak (70% of total renin eluted). Active renin from plasma and kidney, and activated inactive renin from concentrated peritoneal fluid, showed exactly similar inhibition by the renin inhibitor H77 (IC50 0.3 microM). Cat plasma angiotensinogen had an apparent MW of 53,000. PMID- 3315321 TI - Inactive renin in peritoneal fluid of the cat: responses to acute stimuli which alter plasma renin. AB - Active and inactive renin in plasma and peritoneal dialysate were studied in pentobarbitone anesthetized cats during 8 hours of peritoneal dialysis. In control cats, despite a significant rise in plasma active renin from 1.3 +/- 0.22 to 4.4 +/- 0.76 pmoles AI/ml/hr over 8 hours, plasma inactive renin was unchanged. Four-fold rises in plasma active renin after hemorrhage (15 ml/kg) and captopril (1 mg/Kg I.V.) were unaccompanied by significant change in inactive renin. Bilateral nephrectomy resulted in undetectable plasma active renin after 3 hours but plasma inactive renin was 25-30% of initial levels 6 hours post nephrectomy. In peritoneal dialysate, active renin remained low in control cats but there was a ten-fold rise of inactive renin from 0.06 +/- 0.02 to 0.60 +/- 0.07 pmoles AI/ml/hr. After hemorrhage there was a slight rise of active renin after 3 and 4 hours. Inactive renin was lower than control 6 hours after nephrectomy and captopril, but higher than control 1 and 2 hours after hemorrhage. Dialysate inactive renin accumulation slopes were not different among treatments. Acute changes in plasma active renin have little effect on peritoneal dialysate renin. PMID- 3315322 TI - Adrenoceptors in the kidney: localization and pharmacology. AB - The kidney plays a key role in the regulation of blood pressure. The sympathetic nervous system can influence many aspects of kidney function in relation to blood pressure control, e.g. renal vascular tone, intrarenal renin release and tubular reabsorption of electrolytes and fluid. The intrarenal distribution of adrenoceptors has now been studied on the basis of modern receptor ligand binding techniques combined with microscopic studies. The preferential localization of each adrenoceptor subtype within the kidney is reviewed. Furthermore, an attempt is made to describe the functional correlation of the presence of different adrenoceptor subtypes. Finally, the possible role of renal adrenoceptor abnormalities in the pathogenesis of hypertension is discussed. PMID- 3315323 TI - Neural regulation of renal tubular sodium reabsorption and renin secretion: integrative aspects. AB - Efferent renal sympathetic nerve activity plays an important role in the regulation of renal function. Via its direct influence on renal tubular sodium reabsorption throughout the entire mammalian nephron, alterations in efferent renal sympathetic nerve activity represent an important physiological contribution to the overall role of the kidney in the regulation of external sodium balance and the defense against sodium deficit and surfeit. Abnormalities of this mechanism can lead to inappropriate renal sodium retention and augmentation of renin secretion, two factors which are capable of contributing to the development and maintenance of hypertension. PMID- 3315324 TI - Sympathetic modulation of the pressure-dependent renin release in conscious dogs. AB - The relationship between mean renal artery pressure and renal venous-arterial plasma renin activity-difference (renin stimulus-response curve; RSRC) was studied in 15 conscious dogs by a stepwise reduction of renal artery pressure down to the lower limit of renal blood flow (RBF)-autoregulation. The RSRC has a flat section above threshold and a steep slope - indicating a 100% increase of renin release per 2.5 mmHg - below a well defined threshold pressure (Pth). Pth may remain unchanged for 4 weeks. A reflex activation of the renal sympathetic nerves by common carotid occlusion increased Pth by 16.5 +/- 3.2 mmHg (P less than 0.01); this effect was abolished by intrarenal alpha-blockade (prazosin). A low dose intrarenal infusion of methoxamine, which did not change RBF, increased Pth by 8.5 +/- 0.7 mmHg (P less than 0.001). We conclude that in the resting conscious dog renal perfusion pressure is a powerful factor in the control of renin release. The renal sympathetic nerves modulate the pressure-dependent mechanism within the autoregulatory range of renal blood flow by an alpha adrenergic adjustment of threshold pressure. PMID- 3315325 TI - Pressure-dependent renin release: the kidney factor in long-term control of arterial blood pressure in conscious dogs. AB - In 12 conscious dogs on a normal sodium diet the renal venous-arterial plasma renin activity-difference as a function of mean renal artery pressure (renin stimulus-response curve; RSRC) as well as long-term mean arterial blood pressure (MAP; pressure-histograms) were measured repeatedly. The RSRC has 1) a threshold pressure (Pth), 2) a flat section above Pth (plateau-level), and 3) a steep slope below Pth. From dog to dog the slope varied from -0.20 to -0.54 ng AI/ml/h/mmHg and Pth from 78.4 to 107.1 mmHg. In every dog MAP was higher than Pth (MAP Pth:12.8 +/- 1.58 mmHg). Dogs with a higher Pth regularly showed a higher MAP (r = 0.76; P less than 0.005). Due to its normal variability arterial pressure occasionally falls below Pth and thus causes renin release. Therefore MAP will stabilize at a level above Pth. The pressor effect (MAP-Pth) of this feedback system should depend on the sensitivity of the pressure-dependent renin release mechanism (slope of RSRC). Accordingly we observed a close correlation between the slope of the RSRC and the MAP-Pth difference (r = 0.93; P less than 0.0001). We conclude that in healthy dogs the level of long-term blood pressure can be explained almost completely by Pth and the slope of the pressure-dependent renin release. Our findings may offer new perspectives to the pathogenesis of hypertension. PMID- 3315326 TI - Neurogenic components of hypertension in human renal artery stenosis. AB - In renal artery stenosis activation of the renin-angiotensin system elevates blood pressure by direct peripheral effects and probably through stimulation of sympathetic activity, which can be induced by angiotensin-II either centrally or peripherally. In animals specific brain lesions and afferent renal denervation can either attenuate or prevent renovascular hypertension. We investigated the neurogenic mechanisms responsible for hypertension in 21 patients with unilateral renal artery stenosis off drug therapy, by studying the cardiovascular and hormonal effects of Clonidine. The responses to Captopril served as an indicator of the peripheral effects of angiotensin-II. Both oral and intravenous Clonidine lowered blood pressure substantially and for a prolonged period even in patients who had been refractory to multiple antihypertensive drug therapy. Levels of plasma renin activity were unchanged after Clonidine. Plasma noradrenaline levels fell. Pressor responses to infused angiotensin-II were not reduced. These data suggest that Clonidine lowers blood pressure independently of hormonal and peripheral vascular interactions and is consistent with its predominantly central sympatholytic effects. Oral Captopril, unlike Clonidine, had variable hypotensive effects directly related to the basal level of plasma renin activity. The largest reductions were observed in those with the highest level of renin. Our studies indicate that neurogenic mechanisms, probably centrally mediated, have an important and often major role in maintaining hypertension in human renal artery stenosis. These may result from the central effects of angiotensin-II, and/or from increased afferent renal nerve activity, as demonstrated experimentally. The neurogenic components maintaining hypertension in renal artery stenosis are largely dependent on renal ischaemia as revascularisation (by surgery or angioplasty) or nephrectomy, either ameliorates or cures the hypertension in the majority of our patients. PMID- 3315327 TI - Sodium and vasopressin modulation of renal sympathetic nerve activity. AB - A series of correlative studies show that sympathetic renal nerve activity (RNA) may be influenced by the concentration of sodium (Na+) in the plasma and the cerebrospinal fluid (CSF). Further study of the sites and characteristics of the interaction between Na+ and the renal nerves was undertaken in anesthetized dogs. Cerebroventricular (i.c.v.) injections of hypertonic sodium chloride (NaCl) produced a sympathetic vasoconstrictor response associated with tachycardia, increases in plasma norepinephrine and vasopressin (AVP), and a decrease in the electroneurographic activity recorded from post-ganglionic renal sympathetic nerves. Both bilateral vagotomy and intravenous administration of an AVP antagonist prevented the decrease in RNA caused by i.c.v. hypertonic NaCl, without markedly reducing the magnitude of the pressor response. The same phenomenon, however, could not be duplicated by delivery of the AVP antagonist i.c.v. In another group of dogs, the pressor activity of NaCl injected into the cisterna magna was compared before and after surgical ablation of the area postrema in the dorsal medulla. Removal of this circumventricular organ attenuated the pressor effects of NaCl given into the cisterna magna, but not those produced by i.c.v. delivery of the injectate. The data suggest that acute increases in CSF Na+ cause a differential activation of the sympathetic nervous system mediated in part by structures at or near the area postrema. At this site, circulating AVP apparently augments the inhibitory input from vagal afferents on the preganglionic renal nerve neurons. PMID- 3315329 TI - Ischemic colitis. PMID- 3315328 TI - Cardiovascular effects of afferent renal nerve stimulation. AB - Electrical stimulation of afferent renal nerves elicits an increase in arterial pressure and heart rate. The hypertensive response is presumably due to the widespread activation of the sympathetic nervous system leading to peripheral vasoconstriction. Interestingly, the kidney does not appear involved in this reflex excitatory response to afferent renal nerve stimulation since changes in vascular conductances and excretory functions are equal in both the innervated and denervated kidney, and secondary to changes in renal perfusion pressure. In addition, no changes in renin release from either kidneys are observed during afferent renal nerve stimulation. It is likely that the electrical stimulation of afferent renal nerves activates other reflexes exerting an inhibitory influence on efferent renal nerve activity. Indeed, neural renorenal reflexes which tonically inhibit renal functions have clearly been demonstrated. Furthermore, preferential inhibition of efferent renal nerve activity by cardiopulmonary and sinoaortic receptors has recently been shown during activation of other visceral afferents. PMID- 3315330 TI - Clinical applications of nuclear medicine in gastroenterology. PMID- 3315331 TI - Genetic history: II. The Cohens of London. AB - The genetic history in contemporary pedigree form is a useful tool for historical reading and study. The pedigree provides a guide to related personages and a data base for analysis. These points are illustrated by the family of Levi Barent Cohen, who came to London in the 18th century. There have been comparatively few consanguineous matings in the Cohen family. The family members have played central roles in Anglo-Jewish life in their own right and through marriage to other families such as the Montefiores and Rothschilds. PMID- 3315332 TI - Comparison of techniques for the non-invasive assessment of skin tumours. PMID- 3315333 TI - Clonidine, a widow's cruse for pharmacologists. PMID- 3315334 TI - Effects of angiotensins II and III on glomerulotubular balance in rats. AB - 1. The role of angiotensin as a modulator of proximal glomerulotubular (GT) balance was investigated in anaesthetized rats by examining the relationship between glomerular filtration rate (GFR) and absolute proximal reabsorption (APR) during removal of endogenous angiotensin II (AII) and III (AIII) with enalaprilat (CEI) and then during their subsequent replacement by intravenous infusions. 2. Enalaprilat lowered mean arterial blood pressure (MABP) and increased renal blood flow (RBF), GFR, urine flow rate and sodium excretion. Filtration fraction (FF) was not altered. Absolute proximal reabsorption, derived from fractional lithium clearance, increased by only 48% of the change expected for 'perfect' GT balance. 3. Angiotensin II replacement corrected MABP, GFR and plasma renin level, but reduced RBF and increased FF; APR was decreased and GT balance was restored. Urine flow and sodium excretion remained above control values with AII. 4. Replacement with AIII did not correct the hypotension but completely reversed the renal and renin responses to enalaprilat and restored GT balance without affecting FF. 5. It was concluded that the relation between proximal reabsorption and GFR is considerably modified by the intrarenal angiotensin concentration. The findings are best explained by a direct stimulation of proximal tubular sodium transport by angiotensin at the concentrations existing in anaesthetized rats. PMID- 3315335 TI - Dietary suppression of prostaglandin synthesis does not accelerate DOCA/salt hypertension in rats. AB - 1. This study investigated the effects of dietary modification of prostaglandin (PG) synthesis on blood pressure regulation in DOCA/salt-treated rats. 2. After an initial 4 week period on either a 2-series PG 'inhibitory' diet of fish oil (Max EPA), A 'stimulatory' diet of safflower oil or a control diet of saturated fat, three groups of rats were placed on a DOCA/salt regimen for a further 4 weeks. Another group on the saturated fat diet continued their diet without DOCA/salt administration. 3. All the DOCA-treated groups showed a marked increase in blood pressure. However, both polyunsaturated fat (PUFA)-fed groups had blood pressures significantly lower then the saturated fat control. 4. Rats on the Max EPA showed impaired ability to generate prostanoids in vitro (serum, aorta and kidney) and in vivo (urinary PG excretion). DOCA administration increased urinary PGE2 excretion. 5. Thus, dietary suppression of 2-series PG is not accompanied by accelerated DOCA/salt hypertension. The reduction in blood pressure observed in both the safflower and Max EPA-fed groups may be due to PUFA-induced changes in cell membrane fluidity. PMID- 3315336 TI - Thymic hormone modulation of CD38 (T10) antigen on human cord blood lymphocytes. AB - We studied the in vitro effect of three different thymic factors on the expression of CD38 (T10) antigen on cord T-lymphoid cell surface. The results showed that cord mononuclear cell populations contain variable percentages of CD38+ cells. The CD38 molecule was expressed on cord T and B lymphocyte and monocyte surfaces. Incubation with thymic agents induced a significant increases in the CD38+ cell percentage only in the samples with low CD38 antigen expression, and this modulation was mainly attributable to the T-cell subset. The effect seems to be specific and not correlated with the known high spontaneous DNA synthesis rate of cord mononuclear cells. PMID- 3315337 TI - Isotype and cytotoxicity spectra of anti-lymphocyte antibodies in patients with systemic lupus erythematosus. AB - IgG anti-lymphocyte antibodies (ALA) reactive with resting lymphocytes were demonstrated in sera of patients with systemic lupus erythematosus (SLE) by immunofluorescence and flow cytometry and were shown (i) to bind T cells by non Fc receptor-related mechanisms, (ii) to potentiate antibody-dependent cellular cytotoxicity (ADCC) of lymphocytes in vitro which correlated with binding to T cells, and (iii) to occur at a similar frequency in 29 SLE sera (56%) as IgM ALA (59%). IgG ALA levels in sera negatively correlated with absolute numbers of circulating lymphocytes in patients (r = -0.48, P less than 0.05), as did IgM ALA levels (r = -0.54, P less than 0.05); however, a stronger correlation resulted when levels of both ALA isotypes were considered together (r = -0.61, P less than 0.01). Different groups of SLE patients were distinguished with respect to relative serum content of IgM and IgG ALA and corresponding serum capacity to predominantly mediate ADCC, complement-dependent cytotoxicity (CDC), or both. No correlation existed between serum ADCC and CDC activities in vitro (r = 0.22). However, SLE patient lymphocyte counts negatively correlated with ADCC (r = 0.59, P less than 0.01) and to a lesser but still significant extent with CDC (r = -0.47, P less than 0.05). The latter results suggested that ADCC, induced by serum IgG ALA, was a mechanism of cytoloysis which occurred independently of CDC and which, like CDC, was significantly associated with lymphopenia in vivo. PMID- 3315338 TI - Production and clearance of tumor necrosis factor in rats exposed to endotoxin and dexamethasone. AB - The production and clearance of tumor necrosis factor (TNF) in relation to endotoxinemia was studied by the injection of lipopolysaccharide (LPS) in rats. TNF was released into the circulation as a burst when the serum concentration of LPS was rapidly or gradually increased. The maximum concentration of TNF in serum was attained 60 to 90 min after the injection of LPS. TNF was eliminated from the serum according to a first-order kinetics; the half-life was calculated to be 27 +/- 7 min. No additional release of TNF could be evoked by a persistent high level of LPS. When two LPS injections were given within 3 days, the peak concentration of TNF detected after the second injection was 15% of the concentration detected after the first injection. The results indicate that if TNF is a mediator of septic shock, its role is restricted to the initial phase after the appearance of endotoxin in the circulation. Treatment of the rats with dexamethasone (0.5-2.0 micrograms/g) reduced the LPS-induced peak concentrations of TNF in serum by 70-90%. Maximal suppression of the TNF release was observed when dexamethasone was given 5 hr or more prior to LPS, but was gradually lost at shorter intervals. PMID- 3315340 TI - Alternative metal ceramic alloys. Part 1: Precious dental alloys. PMID- 3315341 TI - Bovine bone grafts to cystic jaw defects--application and surgical management. PMID- 3315339 TI - Structural requirements for the induction of "immunological castration" by linear monomeric LHRH-lys-MDP administered in saline. AB - It was previously shown that "castration" could be obtained in male mice by immunizing them in saline with a conjugate referred to as LHRH-Lys-MDP and containing the decapeptide hypothalamic hormone LHRH covalently linked to the adjuvant glycopeptide MDP-Lys. Since coupling was made using carbodiimide, it could have produced oligomers or isomers as well as monomers. In the present investigation male and female mice were immunized in saline with a linear monomeric MDP linked LHRH molecule obtained by total synthesis. Histological studies showed gonadal alterations in both male and female mice. The study of analogs provided a correlation between the "castrative" activity of LHRH-Lys-MDP and its chemical and antigenic structures. However, because LHRH antibody levels were not very high, mechanisms other than antibody response are discussed. Such totally synthesized molecules including a safe adjuvant could make a clinical use of LHRH immunization possible in endocrine-dependent cancers. PMID- 3315342 TI - White lesions of the mouth. AB - All white, hyperkeratotic lesions of the mouth should be studied by biopsy, unless an infection (thrush) or other obvious cause is recognized. The lesions should be classified as benign, dysplastic, or malignant, and the patient should be treated and followed appropriately. PMID- 3315343 TI - Oral candidiasis. AB - Oral candidiasis is one of the more common infections encountered by man. It manifests itself in a variety of forms, and can arise in any region of the mouth. A generally innocuous and treatable disorder in healthy individuals, it can be the herald of underlying disorders that affect the endocrine or immune systems. In the debilitated or seriously ill, the capacity for seemingly benign oral candidiasis to progress into fulminating fatal infections by hematogenous dissemination must not be ignored. Oral candidiasis in the otherwise healthy patient challenges the physician's ability to identify the contributing factors and associated diseases that predispose to the infection. In the cancer and transplant patient, oral candidiasis is a harbinger of systemic infection, and has become a significant obstacle to successful management of patients with life threatening diseases. Although several efficacious agents are available for uncomplicated candidiasis, there remains a need for better prophylactic agents to prevent dissemination and better therapeutic agents to treat established infections in immunocompromised patients. PMID- 3315344 TI - Oral lichen planus. AB - Oral lichen planus is a common multifactorial disease. This article is not a complete review of the disease, but instead a discussion of selected aspects such as clinical features, possible vascular influences, and the relation of stress and drugs and metals to the disease. Immunologic theories and cancerous potentials are discussed critically. Finally, a detailed treatment plan of the inflammatory disease is presented, including avoidance of stimulating factors and the use of corticosteroids and retinoids. PMID- 3315345 TI - Prevention, early detection and diagnosis of oral cancer. AB - Oral cancer persistently accounts for approximately 3 to 4 per cent of all newly diagnosed cancers each year in the United States, and absolute numbers increase yearly. Morbidity and mortality can be minimized by a combination of early diagnosis and appropriate treatment. Early diagnosis can be aided by application of vital staining with toluidine blue or use of exfoliative cytology combined with adequate tissue biopsy. Prevention--minimizing or avoiding the use of tobacco and alcohol--can play a significant role in oral cancer control, as can proper management of precancerous lesions. PMID- 3315346 TI - Denture sore mouth. AB - Denture sore mouth is most often caused by improperly fitting dentures. Ulcers, stomatitis, hyperplasia, bone resorption, and chronic candidiasis may develop under improperly fitting dentures. If extensive bone resorption occurs, dental implants may be necessary. Malignant changes can develop. PMID- 3315347 TI - Glossodynia and other disorders of the tongue. AB - This article discusses the approach to diagnosis and management of disorders of the tongue. These disorders include glossodynia, geographic tongue and smooth tongue, fissured tongue, and black hairy tongue and furred tongue. A brief review of the examination of the tongue is also included. PMID- 3315348 TI - Oral drug reactions. AB - Oral drug reactions have many clinical manifestations and are produced by numerous medications. These reactions may be the result of an allergic reaction to systemically administered drugs or as an indirect effect of the action of the drug on other tissues. Other oral drug reactions may be the result of local or topical medications. These reactions are either a result of an allergic, delayed type hypersensitivity, or a local primary irritation. The appearance may be nonspecific or it may resemble several distinct clinical entities. The diagnosis of these oral drug reactions is made with a good clinical history and examination, along with a high index of suspicion. Often there are multiple factors involved that complicate the clinical picture. The clinician who is familiar with the types of oral drug reactions caused by medications, the mechanisms by which these reactions occur, and which medications are most likely to cause the reaction will be prepared to make the correct diagnosis and treatment recommendations. PMID- 3315349 TI - Contact stomatitis. AB - Allergic contact stomatitis may be difficult to distinguish from irritant stomatitis and may mimic the oral changes of a vitamin deficiency, certain anemias, uremic stomatitis, stomatitis nicotina, and even candidiasis. When these conditions have been ruled out, skin patch testing may be indicated. There is no need to test the oral mucosa directly because the oral mucosa and skin are sensitized at the same time. PMID- 3315350 TI - Idiopathic gingivostomatitis. AB - Atypical gingivostomatitis is recognized by a combination of clinical findings, a sharply marginated, deep red edematous quality to the attached gingiva, angular cheilitis, and a sore red tongue. Unfortunately, there are no general laboratory tests that are diagnostic of the condition, although biopsy of the gingiva shows a marked plasma cell infiltrate. The etiology remains obscure, although chewing certain gums or using some types of dentifrices precipitates the problem. The disease seems to involute spontaneously in some patients. Treatment is symptomatic. PMID- 3315351 TI - Surgical approaches to oral lesions. AB - Basic surgery of the mouth has been described. Surgery of the anterior one third to one half of the mouth is relatively easy to perform. The patient's medical history, an understanding of the anatomy and histopathology of the oral mucosa, and special instrumentation and techniques are essential to performing oral surgery. PMID- 3315352 TI - Oral mucosal manifestations of AIDS? AB - Oral lesions of opportunistic infections and neoplasms are associated with immunosuppression caused by the human immunodeficiency virus (HIV). These include oral candidiasis, viral lesions such as warts, herpes simplex, herpes zoster and hairy leukoplakia, as well as Kaposi's sarcoma and an aggressive form of periodontal disease. Many of these can occur as the first clinical signs of HIV infection. Thus, careful oral examination is an important part of the clinical evaluation. PMID- 3315353 TI - Immunopathology of oral mucosal inflammatory diseases. AB - Many inflammatory conditions of oral mucous membranes are the end result of altered immune reactivity. Lesions from these disorders, as well as a wide variety of infectious, irritant, and idiopathic conditions, appear clinically similar in the mouth and are difficult to differentiate. New and improved immunologic laboratory techniques have helped to further our understanding of the pathogenesis of many of these disorders and have proved to be valuable in clarifying the diagnosis underlying many of these difficult dermatoses. PMID- 3315354 TI - Diagnosis and management of chronic oral mucosal bullous diseases. AB - Chronic blistering diseases involving the mouth are frequently difficult to diagnose correctly and can present a problem with management. Pemphigus vulgaris, cicatricial pemphigoid, and recurrent oral erythema multiforme may be difficult to separate from each other and from other erosive diseases such as recurrent aphthous stomatitis and erosive lichen planus. Essential to establishing a correct diagnosis is a pertinent history, a physical examination, and histopathologic and direct immunofluorescence studies. Oral pemphigus vulgaris can usually be managed successfully with prednisone alone but occasionally another immunosuppressive medication in concurrence with prednisone is necessary. Dapsone is the most efficacious treatment for oral cicatricial pemphigoid, and brief courses of prednisone usually control individual episodes of severe recurrent oral erythema multiforme. It is important that physicians who undertake treatment of these diseases be fully aware of the untoward effects of the medications that are being utilized. PMID- 3315355 TI - Recurrent aphthous stomatitis. AB - Recurrent aphthous stomatitis is the most common ulcerative disease of the oral mucosa. The lesions of aphthous stomatitis are mucosal manifestations of a variety of conditions, 30 per cent of which may be discerned by history, physical examination, and appropriate laboratory testing. Correction of underlying conditions or deficiencies results in improvement or remission in aphthous disease activity. Treatment of lesions for which an underlying cause cannot be discerned is discussed. PMID- 3315356 TI - Behcet's disease and complex aphthosis. AB - Behcet's disease is a complex disorder that causes considerable morbidity and occasional mortality. Increasing understanding of the pathogenesis of this disorder will, we hope, lead to better treatment modalities. Patients with complex aphthosis, a recently described entity, appear to be at risk for development of Behcet's disease and require close observation. PMID- 3315357 TI - Condyloma acuminatum. AB - Condylomata acuminata, an HPV infection, is a major health concern. The incidence is rising in the young population, and there is no specific therapy. Aggressive HPV viral types, increasingly found in HPV-related infections, suggest that the affected population will experience a dramatic increase in genitourinary neoplasms during the next decade. Until an HPV-specific vaccine is developed we must treat this difficult condition with nonspecific destructive therapy. PMID- 3315358 TI - Vulvar dystrophies and intraepithelial neoplasias. AB - The warmth and moisture present in all intertriginous locations distorts the lesional morphology of many vulvar diseases. Specifically, wetness leads to the development of a nondistinctive, white hyperhydration of any scale that is present, and this, in turn, masks the characteristic features of the underlying pathology. These same factors increase the severity of pruritus and thus lead to scratching and eczematization of what, in other locations, would be more readily recognizable disease. Those diagnostic hallmarks that do remain are emphasized in this article, and those aspects of therapy that are unique to a vulvar location are discussed. PMID- 3315359 TI - Nonvenereal perianal conditions. AB - A variety of conditions can affect the perianal tissues. Evaluation must include a thorough history, which should emphasize hygienic habits, use of topical and oral medications, and a review of systems with particular attention to gastrointestinal symptoms. Examination of other areas of the skin may provide clues to the correct diagnosis. Examination of scrapings for yeast, more rarely dermatophytes, and Tzanck preparations from the base of blisters or erosive lesions are useful office diagnostic techniques. In some conditions biopsy of the involved area can be diagnostic (e.g., Paget's disease); in others it may indicate the need for additional studies. Direct immunofluorescent evaluation and special stains may also be indicated. Culture is important to define deep fungal and mycobacterial infections as well as more common bacterial infections. Proctoscopy and roentgenographic studies may be an important part of evaluation, especially in patients who present with perianal suppuration, masses, or anal fissures. Serologic tests for syphilis cannot be overlooked when lesions are ulcerative, moist, or papillomatous. It must be remembered that the symptoms related to perianal eruptions are nonspecific. It is only with a high index of suspicion and careful evaluation that the correct diagnosis can be established. PMID- 3315360 TI - Pruritus ani. Classification and management. AB - Pruritus ani is a common dermatologic complaint that can be frustrating to treat. Effective therapy depends upon recognition of a variety of etiologic factors that may contribute to the symptom. PMID- 3315361 TI - Raymond Pruitt. PMID- 3315362 TI - Interaction of insulin with its receptor. I. Possible role of a histidine arginine interaction. AB - The interaction of beef and pork insulin with its receptors on rat liver plasma membranes has been studied as a function of pH in tris buffer. The dissociation binding constant decreased from 6.5 to 1.2 nM as the pH was increased from 6.8 to 7.8. Analysis indicated that this was the result of the deprotonation of a single residue with a pK'A of 7.62 at 20 degrees C. The enthalpy change associated with this deprotonation was estimated to be -7,500 cal/mol. On the basis of these parameters it is suggested that this group is a histidine residue on the surface of the insulin receptor. The positively charged group on the insulin molecule which interacts with this histidine was not either of the N-terminal residues, nor the lysine at position B-29; by elimination, it appears to be the B-22 arginine residue. PMID- 3315363 TI - Some effects of the force environment on the heart, lungs and circulation. AB - The data obtained in a series of human and animal experiments carried out during the last 45 years in centrifuges, specially instrumented dive bombers, and during changes in body position are the major bases for this paper. The integrated and highly effective cardiovascular reflexes which allow awake, upright humans to regain and/or maintain vision and consciousness during sustained inertial force environments several times greater than at the surface of planet Earth are particularly impressive. Multiplication of vertical gradients in interserosal pericardial, pleural, abdominal and cerebrospinal fluid pressures and/or forces in proportion, and in the resultant vectorial direction of the force environment play a critical role in this capability both in aerospace flight and everyday life on planet Earth. The differences between the near zero specific gravity of intra-alveolar gas and the (about) 1.05 value for the encompassing blood and tissue, render lung function highly susceptible to the weight determinant force environment. Creation of a womb-like environment by liquid whole-body immersion plus assisted breathing of a respirable liquid, both with specific gravities closely similar to bodily tissues, is a seemingly impractical but technologically and biologically documented expedient for allowing air breathers to endure very high sustained force and pressure environments. PMID- 3315364 TI - Insulin-dependent diabetes mellitus. Introductory perspective. PMID- 3315365 TI - The epidemiology of insulin-dependent diabetes mellitus. AB - Diabetes mellitus is a uniquely interesting disorder to study from an epidemiologic perspective. Information that can be gathered from carefully designed and executed epidemiologic studies carried out on a population-based group of individuals with insulin-dependent diabetes mellitus (IDDM) provides insight into this disorder that cannot be obtained by traditional methods of basic or clinical research. The application of epidemiology as an investigative tool can be illustrated in 3 important areas of diabetes mellitus: (1) the etiology of IDDM, (2) the natural history or clinical course of IDDM, and (3) long-term complications of IDDM. PMID- 3315366 TI - Is insulin-dependent diabetes mellitus a preventable disease? AB - Despite improvements in the ongoing care of individuals with insulin-dependent diabetes, the disease continues to produce significant morbidity and mortality, especially early in life, in individuals developing insulin-dependent diabetes in childhood or adolescence. In order to have a major impact on disease outcome, the best therapeutic approach is disease prevention. Because insulin-dependent diabetes results from autoimmune pancreatic beta cell destruction, the disease may be amenable to immunological intervention with immunotherapy. This is particularly exciting as we develop tools, such as islet cell autoantibody determinations, that allow diagnosis of individuals prior to clinical presentation. It is during this time-period when immune manipulation may be most efficacious in preventing further beta cell destruction, and otherwise eventual insulin dependence. As such trials are highly experimental, they must be conducted only in research centers staffed by physicians and scientists with expertise in diabetes, autoimmunity, and immunology. PMID- 3315367 TI - Effects of environmental factors on the development of insulin-dependent diabetes mellitus. AB - The development of insulin-dependent diabetes mellitus is thought to be dependent on either the autoimmunity or the interaction of environmental agents with the pancreatic beta cells, or both in a genetically susceptible host. As environmental factors affecting the induction of type I diabetes, diabetogenic chemicals and viruses are likely candidates as primary injurious agents for pancreatic beta cells in man and animal. A number of structurally diverse chemicals including alloxan, streptozotocin, chlorozotocin, vacor, and cyproheptadine are diabetogenic mainly in rodents and sometimes in man. The possible mechanisms for the beta cell destruction by these chemicals include (a) generation of oxygen free radicals and alteration of endogenous scavengers of these reactive species; (b) breakage of DNA and consequent increase in the activity of poly ADP ribose synthetase, and enzyme depleting NAD in beta cells; and (c) inhibition of active calcium transport and calmodulin-activated protein kinase activity. Regarding viruses, a number of different viruses including encephalomyocarditis virus, Mengovirus, Coxsackie B viruses, and Reoviruses can infect and destroy pancreatic beta cells mainly in rodents and sometimes in humans. In the murine model, the development of encephalomyocarditis and Coxsackie B virus-induced diabetes is dependent on the genetic background of the host and the genetic makeup of the virus. Mengo-2T virus has caused diabetes in strains of mice resistant to encephalomyocarditis virus-induced diabetes. In contrast to encephalomyocarditis virus, Coxsackie B viruses, and Mengovirus, reovirus type 1 seems to be somewhat associated with an autoimmune response in the induction of diabetes. In addition to the murine model, cotton rats become diabetic when inoculated with Mengovirus 2T. Furthermore, cumulative environmental insults with Coxsackie B viruses and chemicals result in diabetes in non-human primates. In man, there may be 2 possible roles for viruses in the pathogenesis of insulin-dependent diabetes mellitus. The one is acute cytolytic infection of beta cells (e.g., Coxsackie B viruses), which may sometimes induce diabetes in genetically predisposed individuals, and the other one is slow and persistent infection (e.g., congenital cytomegalovirus and Rubella), which may induce autoimmunity, leading to type I diabetes. PMID- 3315368 TI - Diminished complications in a non DR3 DR4 family with insulin-dependent diabetes. AB - A family is reported in which the mother and both of her children developed insulin-dependent diabetes mellitus between 9 and 19 months of age, reflecting the importance of heredity in the natural history of this disease. That overt complications of diabetes were not present in any of the individuals, and that blood sugars were maintained close to normal on relatively small amounts of exogenous insulin, suggests a protective function in these patients related to residual secretion of insulin by beta cells. Human lymphocyte antigen (HLA) typing in this family showed that, although the diabetic children had identical HLA types, neither the mother nor her children possessed the diabetes-associated antigen HLA-DR3 or HLA-DR4. This raises the possibility that selective loss of diabetes-susceptible fetuses (suggested to be responsible for the low risk of diabetic mothers producing diabetic offspring) may be influenced by the HLA type of the mother. PMID- 3315369 TI - Factors affecting insulin antibody binding in children with insulin-dependent diabetes mellitus. AB - We measured insulin antibody binding in 2 groups of patients: Study 1, 32 children with newly diagnosed IDDM before onset of insulin therapy, and, in 20 of these, 10 days, 1, 3, and 6 months after beginning therapy; and Study 2, 35 children with long-standing IDDM, 20 of whom had free insulin concentrations measured before, and for 2 hours following subcutaneous injection of 0.25 U/kg regular insulin. Almost 35% of new onset subjects had insulin antibody binding above control levels. In those studied prospectively, binding increased significantly with time. Pre-treatment binding did not correlate with later insulin antibody binding nor metabolic control. In Study 1 we have confirmed previous studies showing abnormally high insulin antibody binding in children with IDDM pre-treatment. We have been unable to demonstrate a relationship between this binding and that found 6 months after initiation of therapy. In Study 2, we have shown that insulin antibody binding is not related to either the level of metabolic control or the rate of rise of free insulin levels in children with IDDM. PMID- 3315370 TI - Residual beta-cell function in children with type 1 diabetes: measurement and impact on glycemic control. AB - We studied residual beta-cell function in 84 children with IDDM to assess (1) relationship between basal and stimulated C-peptide concentrations; (2) reproducibility of testing (Group 1, n = 20); (3) the effect of exogenous insulin on test interpretation (Group II, n = 20); and (4) impact on metabolic control. Sustacal (a mixed liquid meal) was utilized as the test stimulus. In C-peptide positive subjects (n = 44) there was a strong correlation between basal and peak C-peptide concentrations (r = 0.88, p less than 0.001). In Group 1 subjects, Sustacal proved to be a highly reproducible test stimulus producing identical results on two tests 7-14 days apart. The results of the tests were not affected by the administration of subcutaneous regular insulin prior to the second test in Group II. Peak C-peptide correlated inversely with HbA1, insulin dose, and disease duration (r = -0.29, -0.40, and -0.33 respectively, p less than 0.05) and positively with age (r = 0.34, p less than 0.05). We conclude that Sustacal is a highly reproducible stimulus to residual beta-cell function in IDDM and is not affected by exogenous insulin. This residual insulin secretion has a small but significant effect on glycemic control. PMID- 3315371 TI - Immunosuppression in autoimmune disease: the double-edged sword. AB - We have developed a protocol of prophylactic cyclosporin A administration which confers complete and permanent protection against insulin-dependent diabetes mellitus in diabetes-prone BioBreeding rats. Spontaneous insulin-dependent diabetes mellitus developed in about 50% of BioBreeding rats, between 10 and 18 weeks of age. Prophylactic cyclosporin A (10 mg/kg/day p.o.), started at 6 weeks of age and terminated at 21 weeks of age, completely prevented insulin-dependent diabetes mellitus: 0% (0/25) cyclosporin A-treated compared to 46% (11/24) control rats developed insulin-dependent diabetes mellitus (p less than 0.001). Protection against insulin-dependent diabetes mellitus was lifelong, provided cyclosporin A prophylaxis was initiated when insulitis was minimal or absent, and pancreatic insulin content was normal. Cyclosporin A prophylaxis initiated later, but still before the onset of clinical symptoms (8-9 weeks), and terminated at 22 23 weeks, was only partially effective; 5/20 (25%) of cyclosporin A-treated rats developed insulin-dependent diabetes mellitus, compared to 60% (12/20) of controls (p less than 0.05). Cyclosporin A prophylaxis started at the appropriate time (6 weeks) but terminated prematurely (17-19 weeks of age) was not effective; insulin-dependent diabetes mellitus developed in 20% (3/15), compared to 50% (7/14) controls (p greater than 0.05); insulin-dependent diabetes mellitus developed after cessation of therapy. We conclude that effective and permanent moderate-dose cyclosporin A prophylaxis of insulin-dependent diabetes mellitus in BioBreeding rats requires (1) early initiation of treatment, when islet morphology and hormone content are still normal; and (2) prolonged treatment, with continuation of prophylaxis past the end of the at-risk period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315372 TI - [Scientific approach to the evaluation and treatment of vertebral diseases in workers. Report of the Quebec Working Group on the clinical aspects of vertebral diseases in workers]. PMID- 3315373 TI - Studies of nontraumatic osteonecrosis. The role of core decompression in the treatment of nontraumatic osteonecrosis of the femoral head. AB - This study reports a five-year experience with core decompression for treatment of nontraumatic osteonecrosis of the femoral head. There were 25 patients (39 hips) with predominantly steroid-associated osteonecrosis followed postoperatively for a minimum of two years. All patients were evaluated functionally, roentgenographically, histologically, and hemodynamically. At latest follow-up examination, two of 12 hips (17%) with Stage I disease, seven of 12 hips (58%) with Stage IIA disease, four of four hips with Stage IIB disease, and nine of 11 hips (82%) with Stage III disease have progressed roentgenographically and/or clinically. A lack of correlation between pressure manometrics, venography, and clinical outcome in this study suggests that mechanisms other than progressive ischemia may be involved. Current indications for core decompression are Ficat Stage 0, I, and IIA (sclerotic predominant) disease. PMID- 3315375 TI - Cement disease. AB - Does "cement disease" exist? The bony environment surrounding a loosened cemented prosthesis is an abnormal pathologic condition which, if left unattended, will progress to a total failure of the joint including an inhibition of function and immobilizing pain. That biomaterial properties of the cement used for fixation also contribute to the pathologic state separates this disease from other modes of loosening. This leads inevitably to the conclusion that "cement disease" does exist. Methyl methacrylate has revolutionized the treatment of severe joint dysfunction. There can be no doubt that improving surgical technique, cement handling, and the cement itself will continue to improve the results and reduce the incidence of failure due to loosening. Cement is undoubtedly satisfactory for elderly patients with low activity levels and relatively short life expectancies. However, because of the inherent biologic and biomechanical properties of methyl methacrylate, it is unlikely that it can be rendered satisfactory in the long run for the young, the active, or the overweight patient, for whom alternatives are currently being sought. In such cases, the elimination of "cement disease" can only occur with the elimination of cement. Alternatives include the search for other grouting materials and the development of prostheses with satisfactory surfaces for either press-fit or biologic ingrowth. PMID- 3315374 TI - Studies of nontraumatic osteonecrosis. Manometric and histologic studies of the femoral head after chronic steroid treatment: an experimental study in rabbits. AB - High-dose methylprednisolone was administered to adult rabbits over a five- to nine-week period, according to previously described experimental models of nontraumatic osteonecrosis (NON). Manometric studies were performed using a sensitive computer-directed microvolume flow system. Osteocyte viability within the femoral head was assessed by counting empty osteocyte lacunae in five random high-power fields of hematoxylin- and eosin-stained sections. There was no significant elevation of intramedullary pressure or venous outflow resistance in femoral heads of animals receiving steroids, and a significant random loss of osteocytes was observed in these femoral heads. The clinical relevance of these studies is as follows. NON associated with steroids may not simply be the result of progressive ischemia. Ischemia and elevated intramedullary pressure may be epiphenomena, and a direct cytotoxic effect of steroids on osteocytes may be the earliest event in the development of nontraumatic osteonecrosis. The stress test, as it is currently being used in the clinical setting, may be unreliable. PMID- 3315376 TI - Revision total hip arthroplasty. Current role of polymethylmethacrylate. AB - In 29 consecutive failed total hip arthroplasties revised during a 15-month period, cement fixation was used in 14 and cementless fixation in 11. A combination of the two techniques was used in four patients. Analysis of the indications for one or the other fixation type showed that the quality of bone stock and the location of bone deficiency were the most important criteria. The use of a fixation technique that suited the method of bone repair, i.e., autografts, allografts, or a combination of the two, was all-important. Cement technique alone was generally used when bone stock was intact and healthy. Cement was also used in combination with protrusio screens and allografts for gross acetabular deficiencies. Cementless, porous ingrowth technique, together with autografts, was preferred for femoral deficiencies or minor acetabular deficiencies. Bipolar prostheses with compressed, fragmented allografts were used as salvage procedures in gross acetabular deficiencies in older patients, especially when the femoral component did not need to be exchanged. PMID- 3315377 TI - Proximal femoral allografts in revision total hip arthroplasty. AB - Patients with total hip arthroplasty (THA) and aseptic loosening associated with severe bone deficiency were treated with freeze-dried bone allografts of the proximal one-third of the femur. Twenty-two of the first 25 patients were available for review with an average follow-up period of 28 months. Significant functional improvement was obtained in 16 patients (73%). The following complications occurred with allograft revisions: dislocation, wound hematoma, joint instability, nonunion, implant failure, and acetabular loosening. Nine patients required additional surgical procedures. There have been no infections or rapid lysis indicative of an allograft rejection phenomenon. The 73% success at the two-year postoperative interval of incorporation of freeze-dried allografts for salvage situations has been encouraging. However, the long-term durability of these grafts is not known and will require further follow-up study. PMID- 3315378 TI - Sir Astley Cooper. Prototype of the modern day academic orthopedist. PMID- 3315379 TI - Earliest evidence of cartilage and bone development in embryonic life. AB - Some aspects of the development of cartilage and bone during embryonic life are discussed in this review and an attempt is made to show that studies of development, even when performed on species far removed from humans, are relevant to clinical orthopedic surgery. Initially, some definitions of skeletal tissues and cells are presented to illustrate the nontrivial problem of how to tell whether cells are capable of becoming osteoblasts or chondroblasts and of depositing bone or cartilage. This leads to a discussion of the best criteria to use to identify differentiating osteogenic and chondrogenic cells. Cytodifferentiation is immediately preceded by the appearance of the membranous skeleton, consisting of the mesenchymal condensations in which bone and cartilage will develop. Condensation formation in normal development and defective condensations leading to abnormal skeletogenesis are related to cellular properties of mesenchymal cells. The remainder of the review is on the development of membrane bone in the craniofacial skeleton, subperiosteal bone in embryonic avian long bones, and subperiosteal and endochondral bone in developing mammalian long bones. In each case the emphasis is on the embryologic origins of the skeletogenic cells, cell migration, and the factors and influences involved in the initiation of cell differentiation. The relevance of developing systems to clinical practice is stressed throughout. PMID- 3315380 TI - Artificial impaction in hip fracture. By F. J. Cotton, 1911. AB - Frederic Jay Cotton (Fig. 1) was born in Prescott, Wisconsin, and educated at Harvard. After postgraduate study in New York and in Europe, he returned to Boston where he had an association with most of the important hospitals. In addition to great surgical talent, he also was an able administrator and medical politician. He is remembered primarily for his work on fractures, which is summarized in his book, Dislocations and Joint Fractures. The two editions of this book were illustrated by many of the author's own drawings. Cotton was a founder of the American College of Surgeons and served as Regent of the College as well as on the Committee on Fractures. He served in both the Spanish American War and World War I. In the summer of 1918, he was the Chief of Surgery at Walter Reed Army Hospital in Washington, D.C. This article on "Artificial Impaction in Hip Fracture" is an example of the application of a clinical observation to the development of an improvement in the care of patients. It had been known for a long time that impacted fractures of the neck of the femur healed, while displaced fractures did not. Cotton was the first to suggest that impaction, after reduction of the fracture, would be of value. Cotton published three additional papers on the use of impaction in the treatment of hip fractures, the last in 1938, the year of his death. Impaction of fractures of the neck of the femur after reduction of the displacement was rapidly incorporated into all of the procedures for internal fixation of such injuries. PMID- 3315381 TI - Revision total hip arthroplasty with osseous allograft reconstruction. A clinical and roentgenographic analysis. AB - One hundred twelve irradiation-sterilized, -70 degrees frozen allografts have been used in 72 patients who were available for follow-up study in a prospective analysis of allograft revision total hip arthroplasty. Clinical objectives were achieved in 85% of patients with a follow-up period ranging from six to 72 months. Based on clinical and roentgenographic analysis, specific recommendations are made to further improve the success rate of revision total hip arthroplasty associated with protrusio, shelf, acetabular, calcar, and large fragment femoral allografts. PMID- 3315382 TI - Natural history of congenital hip dislocation (CDH) and hip dysplasia. AB - For normal development of the hip joint to occur, there must be a delicate, genetically determined balance between growth of the acetabular and triradiate cartilages and a well-centered femoral head. This balance may be profoundly affected by the intrauterine environment. Without treatment, it is uncertain how many dysplastic, unstable hips will retain their dysplastic features throughout life. The natural history of untreated complete dislocation varies considerably and is affected by societal considerations. There may be little, if any, functional disability in many cases. Significant roentgenographic degenerative disease and poor clinical results, however, may develop in completely dislocated hips with well developed false acetabulae. In unilateral cases, ipsilateral knee deformity and pain may develop. Congenital subluxations have a particularly poor long-term outcome. A significant percentage of these patients have roentgenographic degenerative joint disease and clinical disability. The age of symptom onset and roentgenographic degenerative joint disease is related to the amount of subluxation and dysplasia. The natural history of acetabular dysplasia in the absence of subluxation is difficult to predict. Physical signs may be absent, and the diagnosis only established with symptom onset or as an incidental roentgenographic finding. While degenerative joint disease may ensue, current roentgenographic parameters are not predictive. PMID- 3315383 TI - Natural history of autografts and allografts. AB - The clinical outcome of bone grafting procedures depends on many factors, including type and fixation of the bone graft as well as the site and status of the host bed. Bone grafts serve one or both of two main functions, as a source of osteogenetic cells and as a mechanical support. Autografts, both cancellous and cortical, are usually implanted fresh and are often osteogenetic, whether by providing a source of osteoprogenitor cells or by being osteoinductive. The latter is a process whereby the transplanted tissue induces mesenchymal cells of the recipient to differentiate into osteoblastic cells. Cortical grafts, whether autogeneic or allogeneic, at least initially act as weight-bearing space fillers or struts. All bone grafts are initially resorbed, but cancellous grafts are completely replaced in time by creeping substitution, while cortical grafts remain an admixture of necrotic and viable bone for a prolonged period of time. The three-dimensional framework, which supports invasion of the bone grafts by capillaries and osteoprogenitor cells, termed "osteoconduction", is another important function of both autografts and allografts. Fresh allografts are more slowly and less completely replaced by host bones because they invoke both local and systemic immune responses that diminish or destroy the osteoinductive and conductive processes. Although freezing or freeze-drying of allografts improves acceptance, their failure rate is still too high. These processes are also influenced by the vascularity and composition of the host bed. Thus, the interaction of the host and the bone graft determines the success of these procedures, which ultimately is to provide a mechanically efficient support structure. PMID- 3315385 TI - Management issues for collaborative study in hematology. Sickle cell anemia, hemophilia, and ITP. PMID- 3315384 TI - Upper gastrointestinal bleeding from the biliary tract (hematobilia). Detection by technetium-99m DTPA. AB - A case of hematobilia causing upper gastrointestinal bleeding is demonstrated by Tc-99m DTPA. The advantages of Tc-99m DTPA over Tc-99m sulfur colloid and RBCs are discussed. PMID- 3315386 TI - Clinical and biologic features of childhood acute lymphoblastic leukemia. PMID- 3315387 TI - Schamberg's purpura in children: case study and literature review. AB - Schamberg's purpura or progressive pigmentary dermatosis is uncommon in pediatric patients. A case study and literature review are presented to encourage the inclusion of Schamberg's purpura in the differential diagnosis of purpuric eruptions in childhood. PMID- 3315388 TI - The therapeutic revolution. PMID- 3315389 TI - Cardiovascular effects of verapamil in essential hypertension. AB - Calcium antagonists may affect the regulation of body sodium and adrenergic dependent mechanisms. Exchangeable sodium, blood volume, plasma norepinephrine, renin, aldosterone, pressor responsiveness to norepinephrine, heart rate responses to isoproterenol, and lipid metabolism were studied in 15 patients with essential hypertension after 8 weeks of treatment with verapamil (348 +/- 68 (SD) mg/day). Supine blood pressure decreased from 153/103 +/- 19/12 mm Hg to 140/95 +/- 14/12 mm Hg (P less than 0.01). Exchangeable sodium, blood volume, plasma norepinephrine, renin and aldosterone, serum total cholesterol, the lipoprotein fractions, and apoprotein levels were unchanged. The norepinephrine pressor and the isoproterenol chronotropic doses tended to increase, whereas the dose response curve of blood pressure related to plasma norepinephrine was significantly displaced to the right (F = 5.34; P less than 0.05). The antihypertensive effect of verapamil is associated with a decreased cardiovascular pressor responsiveness to norepinephrine without changes in endogenous noradrenergic activity. Moreover, verapamil does not modify the sodium/fluid volume state, the activity of the renin-angiotensin aldosterone axis, or lipid metabolism. PMID- 3315390 TI - Linogliride fumarate, representing a new class of oral hypoglycemic agent for diabetes. AB - This study presents the first multiday therapy trial of linogliride fumarate, a representative of a new class of oral hypoglycemic agents. Linogliride demonstrated a significant hypoglycemic activity in 26 patients with non-insulin dependent diabetes mellitus receiving 1 week of therapy. In a dose range of 150 to 400 mg b.i.d., fasting glucose levels fell from 237 +/- 52 mg to 199 +/- 59 mg by day 7 (P less than 0.01). Eight-hour glucose AUCs fell from 2121 +/- 617 mg/dl/8 hr baseline to 1781 +/- 631 mg/dl/8 hr on day 7 of treatment (P less than 0.01). This was associated with a significant increase in insulin AUC from 380 +/ 327 to 610 +/- 417 on day 7 (P less than 0.01). Thus its initial action appears to be by an insulin secretagogue mechanism. No patient had any major adverse effect. This initial study indicates that linogliride fumarate is an effective hypoglycemic agent that significantly lowers fasting and postprandial glucose levels with short-term use. Linogliride fumarate represents a new group of hypoglycemic agents that may be shown to have therapeutic utility. PMID- 3315392 TI - Metocurine kinetics in patients undergoing operations requiring cardiopulmonary bypass. AB - Metocurine kinetics were determined in 10 patients undergoing operations requiring hypothermic cardiopulmonary bypass (CPB) and nine patients of similar age undergoing operations of similar duration but not requiring CPB. The metocurine dosage regimen was a bolus of 0.3 mg/kg given concomitantly with the commencement of an infusion at a rate of 0.04 mg/kg/hr; this regimen was designed to produce and maintain a plasma metocurine concentration associated with 95% depression of the twitch response. Metocurine kinetics were affected minimally by hypothermic CPB. The kinetic parameters including volumes of distribution at steady state of 0.35 L/kg and 0.34 L/kg and elimination clearances of 1.3 ml/min/kg and 1.1 ml/min/kg in the control and CPB groups, respectively, are in agreement with the results of others. Changes in neuromuscular blockade with the onset of CPB and the return to original blockade intensities with rewarming suggest a decreased sensitivity to the effects of metocurine at lower temperatures. PMID- 3315391 TI - The hypouricemic effect of chlorprothixene. AB - The hypouricemic effect of chlorprothixene (Taractan), a major tranquilizer from the group of thioxanthenes, was evaluated in 30 psychiatric patients who took the drug as part of their regular treatment. Levels of serum uric acid, urea, and creatinine before, during, and after the treatment were measured, as well as creatinine clearance and uric acid clearance before and during the treatment. A uricosuric effect, resembling that of probenecid, was found that exerts itself in all the patients, regardless of age, sex, diagnosis, and associated drugs. The resulting hypouricemia starts as soon as 24 hours from the beginning of treatment, stabilizes within 10 days, and averages, at that time, 48% of the initial level. It is reversible within 10 days from the end of treatment. PMID- 3315393 TI - Attrition, abrasion and erosion: diagnosis and therapy. PMID- 3315394 TI - Replacement of a maxillary canine with an etched metal resin-bonded prosthesis. PMID- 3315395 TI - [Material selective imaging and determination of density using the dual energy method. II. Clinical use of dual energy radiography]. AB - The use of dual energy methods in digital radiography allows selective imaging of soft tissues or calcified structures and contrast media. The value of this method is demonstrated on the basis of 400 patient examinations. The isolated imaging of soft tissues without skeletal superposition gives particular advantages in diagnosis of the chest and the cranio-cervical region. Soft tissue calcifications and calcium-containing concrements in the bile ducts and in the urinary tract are well demonstrated without soft tissue superposition. The disadvantages and the limits of the method are discussed, its potential and possible future developments are shown. PMID- 3315396 TI - AIDS: immunopathogenic mechanisms and research strategies. PMID- 3315397 TI - Short-term studies on the use of amino acids as an osmotic agent in continuous ambulatory peritoneal dialysis. AB - 1. A 1% amino acid dialysis solution with a high concentration of the branched chain amino acids has been compared with 1.36% glucose in short-term studies. 2. The 1% amino acid solution was as effective an agent as 1.36% glucose with respect to ultrafiltration and clearance of creatinine, urea and potassium. 3. Levels of branched-chain amino acids rose to the upper end of the normal range within 1 h and remained at this level over the entire period of the study. Total and non-essential amino acids had returned to baseline by the end of the cycle. 4. Blood glucose rose to significantly greater levels during the 1.36% glucose exchange than during the 1% amino acid exchange. There was an increase in serum insulin levels during both cycles; this was significantly greater with the 1% amino acid solution than the 1.36% glucose. 5. There was no evidence of short term metabolic complications with the 1% amino acid solution. PMID- 3315399 TI - Impaired insulin-mediated erythrocyte magnesium accumulation in essential hypertension. AB - 1. This study was designed to investigate variations in erythrocyte magnesium in the presence of insulin (0.1 unit/l) in hypertensive subjects. 2. Plasma and erythrocyte magnesium levels were found to be significantly lower in hypertensive than in normotensive subjects. 3. The impaired response to insulin (0.1 units/l) of erythrocytes from hypertensive patients was not reversed by elevated extracellular Mg2+ (3.6 mmol/l). 4. Erythrocytes of hypertensive subjects showed an increased membrane microviscosity compared with normotensive subjects. 5. Lidocaine decreased erythrocyte membrane microviscosity and increased erythrocyte magnesium levels in the presence of insulin. PMID- 3315398 TI - Haemodialysis-associated amyloidosis: beta 2-microglobulin alone or associated with globin chains? AB - 1. The protein constituents of amyloid fibrils were characterized in amyloid deposits extracted from surgical material obtained from a 66-year-old patient undergoing maintenance haemodialysis and operated for a carpal tunnel syndrome. 2. Sodium dodecyl sulphate/polyacrylamide-gel electrophoresis disclosed the presence of bands at 12 and 14 kDa. Two-dimensional electrophoresis and Western blotting confirmed that the proteins were beta 2-microglobulin (beta 2M) and globin chains. 3. When the effluent of high-performance gel filtration chromatography corresponding to molecular masses of 10-15 kDa was subjected to Edman degradation, only one amino acid residue was found at each step. The 18 residues determined corresponded to the N-terminal sequence of beta 2M. 4. Although globin chains were clearly present in the amyloid material, they were not accessible for sequence determination. The identification of the other protein constituents present in the amyloid material, along with beta 2M, should provide a better understanding of haemodialysis-associated amyloidosis, the mechanisms of formation of which have not yet been completely determined. PMID- 3315400 TI - Treatment and prevention of infections of cerebrospinal fluid shunts. AB - The etiology, pathogenesis, clinical manifestations, diagnosis, and treatment of cerebrospinal fluid (CSF) shunt infections are reviewed. Infection is a frequent complication of neurosurgical procedures performed for the treatment of hydrocephalus. Shunt infections generally occur within the first two months after surgery. Staphylococcus epidermidis is the most common cause of infections of both ventriculoatrial and ventriculoperitoneal shunts. The preferred treatment of CSF shunt infections involves intravenous antimicrobial therapy, surgical removal of the infected shunt, installation of an extraventricular drainage device, and placement of a new shunt once the CSF is sterile. However, many aspects of therapy are controversial because few controlled, comparative studies have been reported. Intravenous vancomycin is the drug of choice for empiric treatment of shunt infections. Nafcillin is recommended for infections caused by methicillin sensitive strains of staphylococci. Vancomycin should be used for infections caused by methicillin-resistant strains of staphylococci or in patients who are allergic to penicillin. The addition of rifampin has eradicated infections that failed to respond to monotherapy with vancomycin or nafcillin. Intraventricular antimicrobial therapy is indicated if the risks associated with surgery are high or if ventriculitis is persistent and refractory to systemic antimicrobial therapy. The role of prophylactic antimicrobial therapy is controversial. Infection continues to be an important complication of CSF shunt placement; many aspects of treatment are controversial. PMID- 3315401 TI - Adverse effects of anabolic steroids in athletes. AB - The effects of anabolic steroid use on athletic performance and the adverse effects associated with the use of anabolic steroids are reviewed. Anabolic steroids increase protein synthesis in skeletal muscles and reverse catabolic processes. Because of these properties, some athletes use anabolic steroids in an attempt to improve their athletic performance. However, studies indicate that increases in muscle mass and strength during anabolic steroid administration are observed only in athletes who already are weight-trained and who continue intensive training while maintaining high-protein, high-calorie diets. Adverse effects attributed to anabolic steroid use occur frequently. Serious adverse effects include hepatic and endocrine dysfunction; cardiovascular and behavioral changes also are reported. Some of the adverse effects associated with the use of these agents are irreversible, particularly in women. The use of anabolic steroids to improve athletic performance has become prevalent. However, the reported benefits are tempered by numerous adverse reactions. PMID- 3315402 TI - Influence of obesity on drug disposition. AB - Physiologic changes associated with obesity and their effects on the distribution, protein binding, metabolism, and renal excretion of drugs are described. Changes in the volume of distribution correlate with drug lipophilicity. Drugs that have a high affinity for adipose tissue have an increased volume of distribution, whereas the distribution of drugs that have low partition coefficients is not altered substantially. Albumin and total protein concentrations are comparable in lean and obese subjects, but concentrations of alpha 1-acid glycoprotein are increased. Consequently, protein binding of acidic drugs is unchanged, but the free fraction of basic drugs may be decreased. Changes in hepatic drug clearance are complex. Phase 1 reactions and acetylation, a Phase 2 reaction, appear to be unaffected by obesity, but activity of Phase 2 glucuronidation and sulfation pathways is enhanced. Available physiologic and pharmacokinetic data on the effect of obesity on systemic clearance of highly extracted drugs are conflicting. Both glomerular filtration and tubular secretion appear to be increased in obese individuals, and tubular secretion may be disproportionately increased compared with filtration. Clearance of drugs that depend on glomerular filtration for elimination is consistently higher in obese subjects. Differences among patient populations, other conditions associated with obesity, and the small study populations described to date may account for some discrepancies in reported results. Awareness of the physiologic effects of obesity is essential for ensuring appropriate drug therapy in obese patients. PMID- 3315403 TI - Severe musculoskeletal syndrome in patients with renal failure and hypoalbuminemia receiving bumetanide. PMID- 3315404 TI - Klebsiella pneumoniae colonization in patients with spinal cord injury. AB - Klebsiella pneumoniae colonization of 53 patients with spinal cord injury was studied. Cultures of multiple body sites from patients, the environment, food, and hospital personnel were obtained. K. pneumonaie was cultured from one or more body sites in 46% of male patients. Significant bacteriuria was found in 10% of male patients. Positive cultures of the urethra and perineum for K. pneumoniae were significantly associated with the use of the external condom catheter (p less than 0.05, Fisher's exact test). K. pneumoniae colonization increased with length of stay in the hospital. Serotype 64, the predominant serotype found, was isolated only from patients who had been in the hospital for at least 4 wk and primarily in those patients using the external condom catheter. Urinary drainage bags were frequently colonized with K. pneumoniae at a time when the patients did not have significant bacteriuria. Colonized male patients were found to be the primary reservoir of K. pneumoniae and may serve as the major source for cross contamination. PMID- 3315405 TI - Rapid detection of influenza virus in cell culture by indirect immunoperoxidase staining with type-specific monoclonal antibodies. AB - Seventy respiratory specimens culture-positive for influenza virus were stored at -70 degrees C and retested in duplicate by virus isolation and by indirect immunoperoxidase (IPA) staining of cell monolayers 24 hr postinoculation using influenza type-specific monoclonal antibodies. The IPA stain was positive for 24 of 28 specimens from which influenza virus was reisolated and for eight specimens from which influenza virus was not reisolated. PMID- 3315407 TI - Diagnosis and treatment of hypothyroidism in children. AB - Congenital hypothyroidism is a relatively common endocrine disorder, affecting one in 4000 newborn infants. Undiagnosed and untreated congenital hypothyroidism will result in un-toward consequences, including mental retardation and other significant neurologic sequelae. For these reasons, programs to screen newborns were developed to detect congenital hypothyroidism before clinical features become obvious enough to suggest the diagnosis. The most common clinical features include prolonged jaundice, skin mottling, hypotonia, umbilical hernia, constipation, and macroglossia. Congenital hypothyroidism may be caused by several different disorders; ectopic thyroid glands represent the most common cause. There is accumulating evidence that autoimmune thyroid disease as manifested by TBII may be the cause of thyroid dysgenesis in some cases. The diagnosis is easily confirmed by finding a low serum free T4 or total T4 and elevated serum TSH concentration. The treatment of choice is levothyroxine; these infants must be followed carefully to ensure normal growth and development and maintenance of serum T4 and TSH within the normal ranges. With appropriate treatment and follow-up, the large majority of these infants have an excellent prognosis, with an IQ no different from comparison populations. However, it appears that there is still a small percentage of infants who are the most severely affected, who manifest the lowest serum T4 levels, thyroid aplasia, and retarded bone ages, and who may run the highest risk for some degree of retardation and other neurologic sequelae. Acquired hypothyroidism is also a relatively common disorder, occurring in one in 500 to one in 1000 school-age children. These children most commonly have a slowdown in growth, short stature, a goiter, and a drop in school performance. Other clinical features may be subtle or absent except in more severe or long-standing cases. The most common cause is chronic lymphocytic thyroiditis. The diagnosis is easily established by finding low serum-free T4 or total T4 and elevated serum TSH concentrations. Again, levothyroxine is the treatment of choice. With appropriate treatment and follow up, all clinical features that develop after age 3 should be reversible and the prognosis should therefore be very good. PMID- 3315406 TI - Metabolic emergencies of the newborn: hypoxemia and hypoglycemia. PMID- 3315408 TI - The challenges of managing insulin-dependent diabetes mellitus in childhood. PMID- 3315409 TI - Living with cystic fibrosis: patient, family, and physician realities. AB - The challenge for patient, family, and healthcare professionals alike is to separate the disease's insidiousness from the potential the patient and family have to enjoy life within the patient's abbreviated life span. We must emphasize that most patients with CF and their families do make a successful psychological adjustment. Simultaneously, parents must fulfill the varied physical and psychological needs of the child. A young adult patient with CF summarizes the patient's task: "Projecting a life goal, living it, having the goal altered by luck and by fate, accomplishing that goal, and then reflecting on what has been done. That is life. That is a life compressed for us; CF is myopic. We cannot look through the long vista of life. That is disappointing, frustrating, and cursed at. We can live now. We can do the best we can. Set goals that fit on our playing field and accomplish them." An emotionally adjusted family makes the patient's task possible. Achieving the goal of adequate adjustment also depends on the physician's having the medical expertise to manage this complex multisystem illness and the ability to make the medical knowledge comprehensible for patient and family. PMID- 3315410 TI - Recurrent abdominal pain in childhood: an approach to common disorders. AB - Recurrent abdominal pain is a challenging clinical problem for which the rewards are the return of the ill or disabled child to an active life. I hope that the approach outlined here will hasten recovery, reduce iatrogenesis, and potentially lessen lifelong pain in these children. PMID- 3315411 TI - Etiology, prognosis, and management of paroxysmal tachycardia in the young. PMID- 3315412 TI - Identification and management of the child with bacteremia. PMID- 3315413 TI - Diagnosis, management, and prognosis of asthma in children. PMID- 3315414 TI - Calcium and hypertension. AB - Although the complexities of cardiovascular physiology preclude any one factor from assuming the role of the key determinant of elevated blood pressure, the large body of evidence that is accumulating based on epidemiologic observation and studies in experimental and human hypertension support the contention that maintenance of normal calcium metabolism is associated with a lower arterial pressure. Dietary calcium supplementation in human essential hypertension appears to be an effective nonpharmacologic means of lowering blood pressure in some patients, especially those with evidence of a calcium-deficient state. In addition, preliminary evidence has raised questions as to whether a relationship exists between salt sensitivity and disordered calcium homeostasis in some hypertensive patients, and whether there is an important role for calcium in the regulation of other hormonal systems involved in blood pressure regulation. PMID- 3315416 TI - Indications for coronary artery bypass graft surgery. AB - ACBGS is indicated in patients with stable angina who have left main coronary artery disease; three-vessel disease; three or four of the clinical variables set forth in the Veterans Administration Cooperative Study; obstruction in proximal third of left anterior descending coronary artery as part of two- or three-vessel disease; and two- or three-vessel disease and exercise-induced ischemic ST segment depression greater than or equal to 1.5 mm. ACBGS may increase survival in patients with limited exercise capacity. Finally, ACBGS may be indicated to increase the quality of life in patients with disabling angina that is refractory to medical treatment. Patients with unstable angina who have an inadequate response to intensive medical therapy should have emergency ACBGS. Indications for elective ACBGS in patients with unstable angina who respond adequately to medical therapy are the same as those for stable angina. Patients with rupture of the ventricular septum, acute severe mitral regurgitation, and cardiogenic shock with vessels suitable for ACBGS should have urgent ACBGS after acute myocardial infarction. Patients with postinfarction angina after the first few days following acute myocardial infarction, especially non-Q-wave infarction, should be considered for ACBGS. Indications for elective ACBGS in postinfarction patients are the same as those in stable angina. Patients with coronary artery disease, especially those with a significant amount of ischemic myocardium, who must undergo cardiac surgery for valvular heart disease or for congenital heart disease should probably have ACBGS performed at the time of surgery. PMID- 3315415 TI - New options in the management of congestive heart failure. PMID- 3315418 TI - Serum apolipoprotein measurements: an improved discriminator for assessing coronary heart disease risk. PMID- 3315419 TI - Plasmalogens and O-alkylglycerophospholipids in aquatic animals. AB - 1. Qualitative and quantitative distribution of ether phospholipids was studied in several aquatic organisms. 2. Brain, nerve and gills of these animals were rich in ether glycerophospholipids. 3. 1-alkenyl ethers were in general more abundant than alkyl ones. The alkenyl ethers were mainly components of PE in all aquatic animals. Those of PS occurred in mollusca only. 4. Alkyl ether moieties appeared to be essentially located in PE and PC. 5. This review suggests that ether phospholipids may play an important role in the permeability properties of biological membranes. PMID- 3315417 TI - Treatment of hypertension in the elderly. AB - The objective of treating the elderly patient with hypertension should be to reduce blood pressure to safe levels (systolic blood pressure less than 180 mm Hg), while minimizing adverse effects and changes in life-style. If the clinician considers the unique physiologic, pharmacologic, and psychosocial characteristics of this population, he will be successful in attaining these goals. PMID- 3315420 TI - Glucoregulatory effects of bombesin in lean and genetically obese hyperglycaemic (ob/ob) mice. AB - 1. Plasma glucose and insulin responses to bombesin were examined in 12-15-week old 12 hr fasted lean and genetically obese hyperglycaemic (ob/ob) mice. 2. Bombesin (1 mg/kg ip) produced a prompt but transient increase of plasma insulin in lean mice (maximum increase of 50% at 5 min), and a more slowly generated but protracted insulin response in ob/ob mice (maximum increase of 80% at 30 min). Plasma glucose concentrations of both groups of mice were increased by bombesin (maximum increases of 40 and 48% respectively in lean and ob/ob mice at 15 min). 3. When administered with glucose (2 g/kg ip), bombesin (1 mg/kg ip) rapidly increased insulin concentrations of lean and ob/ob mice (maximum increases of 39 and 63% respectively at 5 min). Bombesin did not significantly alter the rise of plasma glucose after exogenous glucose administration to these mice. 4. The results indicate that bombesin exerts an insulin-releasing effect in lean and ob/ob mice. The greater insulin-releasing effect in ob/ob mice renders bombesin a possible component of the overactive entero-insular axis in the ob/ob mutant, especially if it acts within the islets as a neurotransmitter or paracrine agent. PMID- 3315421 TI - Glycoproteins of trypanosomes: their biosynthesis and biological significance. AB - 1. Trypanosomes are unicellular parasites that cause human sleeping sickness in Africa and Chagas' disease in South America. Glycoproteins are important components of their plasma membrane. 2. The bloodstream form of the extracellular salivarian African trypanosome (e.g. Trypanosoma brucei) has the ability to express on its cell surface a repertoire of variant surface glycoproteins (VSGs) and in so doing, evades the immune response of the host (antigenic variation). 3. The VSG is probably synthesized initially in a manner like that of the membrane bound glycoproteins of mammalian systems, but it also undergoes some novel post translational modifications. 4. The stercorarian South American trypanosome (Trypanosoma cruzi) is an intracellular parasite which expresses different glycoproteins on its plasma membrane at various stages of its life-cycle, but does not exhibit antigenic variation. 5. The biosynthesis and functions of trypanosomal glycoproteins are compared with those of mammalian glycoproteins, and are discussed with particular reference to potential targets for chemotherapy and immunotherapy of trypanosomiasis. PMID- 3315422 TI - Methuselah--an expert system for diagnosis in geriatric psychiatry. AB - This report is based on the notion that criteria for "successful" diagnosis differ for different medical specialties. Diagnostic judgement in highly unstructured task domains is best characterized as clinical problem formulation with pragmatic implications for interventions. This concept is illustrated by the implementation of a computer-based diagnostic expert system for geriatric psychiatry. The program begins with guiding the patient's interview by the clinician. This is followed by the diagnostic process which is conducted in three steps. In the first step, candidate syndromes of disease states are identified by matching the presenting complaints with symptom lists of clinical syndromes. In the second step, the candidate syndromes serve as the organizers for gathering additional patient data (e.g., information from referral source and past illnesses) to seek constellations of findings which form a coherent clinical context. In this phase, the program can also prompt the clinician to obtain additional information from the patient or other available sources to resolve conflicts or, if necessary, invoke the concurrent presence of two independent syndromes to attain convergence (i.e., minimize the number of unexplained findings). In a final step, the syndromes with highest credence value, reflected by the number of linkages to patient data, are sharpened to specific diagnostic formulations. This is accomplished by frames of diagnoses which are associated with each syndrome. Once again, the patient data can be consulted to achieve optimal matches. A summary statement to the clinician lists the essential supporting evidence for the chosen diagnosis and can communicate alternatives or unresolved issues for clarifying interventions. Although no decisive evidence is available, informal observations of clinicians support the notion that clinical reasoning in highly unstructured domains is largely contextual and seeks apprehension of "gestalts" in successive steps. The diagnostic program of this report aims at simulating this process. PMID- 3315423 TI - Computer-assisted localization of nervous system injuries. AB - Expert systems to assist in neurological diagnosis require a representation of anatomical relationships. In order to test one representational method, a prototype expert system was developed. It accepts patient signs of neurological dysfunction and identifies the site of nervous system injury. The system's knowledge base is contained in a semantic network which represents nervous system anatomy and the physical signs of injuries. When provided with an individual's physical signs, the network is searched by a simple algorithm; the anatomical locations which best explain the physical signs are the system's output. Medical expert systems which require anatomical reasoning can use a direct representation of spatial relationships to avoid the difficulties of encoding clinical associations in the form of If-Then rules. PMID- 3315424 TI - Issues in the adoption of a new educational technology. AB - The interactive laser videodisc, with its large data base and rapid random access capability, has the potential to play a significant role in health care education. The introduction of this new technology in the last few years has been made difficult by several barriers to the acceptance of the technology. These barriers are grouped into issues of cost, quality and the resistance to change. PMID- 3315426 TI - Causal reasoning in computer programs for medical diagnosis. AB - Over the last decade substantial advances have been made in the use of causal pathophysiological knowledge in artificial intelligence-based programs for medical diagnosis. Various forms of causal representations have been used. They include probabilistic models, quantitative models, qualitative models, and models that describe causal relations at multiple levels of detail. This paper briefly analyses these methods using three representative systems. Outstanding problems and possible direction in further exploitation of causal reasoning for medical decision-support systems are also discussed. PMID- 3315425 TI - The use of computer simulation in teaching clinical diagnosis. AB - Previous studies have shown that feedback of the weighting used in making complex judgements can greatly improve learning when the correct weighting is known. This paper describes the application to teaching medical diagnosis of a microcomputer program which calculates and displays factor weighting based on answers to clinical case simulations. In one application, students learning to diagnose urinary tract infusion with computer feedback of weighting progressed much more rapidly than a control group who received outcome feedback alone. Other applications in the clinical setting suggest that this type of learning can improve diagnostic accuracy and predictive calibration through more accurate assimilation of the clinical information available. PMID- 3315427 TI - Modeling diagnostic reasoning: a summary of parsimonious covering theory. AB - Parsimonious covering theory is a formal model of diagnostic reasoning. Diagnostic knowledge is represented in the theory as a network of causal associations, and problem-solving is represented in algorithms that support a hypothesize-and-test inference process. This paper summarizes in informal terms the basic ideas in parsimonious covering theory. PMID- 3315430 TI - The future of Medicare policy reform. AB - The Medicare program, the largest health insurance program in the United States, is clearly at a crossroads as it enters its third decade. Historical increases in health care expenditures, plus a changing political and economic landscape, have set the groundwork for policy reform. Two basic reform strategies--reimbursement arrangements and program funding mechanisms--are discussed. In 1983, Congress enacted the Prospective Payment System (PPS) which initiated a fundamental change in the way hospitals are paid for care delivered to Medicare beneficiaries. But the PPS is only a stepping-stone to broader reforms such as capitation. In addition, new methods of program funding may be necessary, especially in light of policymakers' considerations of coverage of services such as long-term care and organ transplants. PMID- 3315429 TI - Radiologic automated diagnosis (RAD). AB - RAD is a program currently being developed to interpret neuroimages. Given the clinical information usually available on the imaging request, RAD will analyze the scan directly from the data generated by the scanning machine to produce a differential diagnostic list explaining any lesions it discovers. RAD uses a computerized three-dimensional stereotaxic atlas of the nervous system as a model of normal structures in the analysis of scans. PMID- 3315428 TI - Progress in image processing technology related to radiological sciences: a five year review. AB - The past five years of progress in image processing technology related to radiography applications is reviewed. The following topics are included: image acquisition (computed radiography, X-ray film digitizer); 512, 1024 and 2048 image processor technology; image compression (block quantitation, full-frame bit allocation); image storage (real-time magnetic disk, optical disk); image workstation (input station, display station, diagnostic workstation); and picture archiving and communication systems (PACS). It is anticipated that the growth in this field will continue for many years to come. PMID- 3315431 TI - Liability and responsibility for clinical software in the Federal Republic of Germany. AB - Western Europe is faced with the same technological developments in the field of medical computer systems as the U.S.A. Differences in the medical and legal systems can provide opportunities for analysis of different approaches to the same problems. This paper traces the development of medical computer systems and the corresponding developments of legal requirements for such systems. Proposals are made for a novel regulatory approach to realize the advantages of this technology without unnecessary risks. PMID- 3315432 TI - Selected papers from the Tenth Annual Symposium on Computer Applications in Medical Care. Washington, DC, 25-26 October 1986. Dedicated to Prof. Dr. med. Peter L. Reichertz. PMID- 3315433 TI - Ten years of medical informatics. Introduction. AB - The discussions of the Tenth Anniversary of the Symposium on Computer Applications in Medical Care (SCAMC) are summarized. Eight different subject areas are addressed: Medical informatics and medical education; Decision making, medical artificial intelligence, modelling and simulations; Image processing, 3-D graphics, and computer networks; Reimbursement policy, legal and regulatory issues; Encoding and representation of medical meaning; Ambulatory medical records systems; Hospital information systems; and Software environments for developing medical information systems. The activities of the 10th SCAMC consisted of Tutorials, Panel Discussions, a Plenary Session, Scientific Demonstrations, and an International Student Paper Competition in Medical Informatics. PMID- 3315435 TI - Contact dermatitis after ultrasonography and electrocardiography. AB - We report 4 patients who developed allergic contact dermatitis after ultrasound investigations. Patch testing was positive with conducting gels, and in 2 cases with propylene glycol. Contact dermatitis to gels is also seen in electrographic practice and after transcutaneous electrical analgesia. PMID- 3315434 TI - Preparing for change: concepts and education in medical informatics. AB - Medical informatics as a medical discipline has developed over the last decades in parallel with an even more amazing proliferative development in medicine. The question is raised whether this new science, based on formalized and methodological approaches, may contribute to the development of a general theory in medicine as a consequence of the recognition of the influence of control mechanisms and structured information in molecular biology. It is suggested that medical informatics dedicates research to problems 'inside medicine' and that curricula are developed which bring a basic understanding for medical informatics to the medical student. The following teaching is suggested: basic mandatory courses, electives and inclusions of aspect of medical informatics in the various parts of clinical teaching. The possibility is discussed that the resulting teaching approaches may also be used to convey knowledge in medicine: teaching concepts versus teaching details. Finally, a description of the functional topology of expert systems as they develop is attempted and brought into relation to the architecture of hospital information systems. The increasing importance of expert systems also raises the question of 'decisional trials' as verification procedures when these new tools enter medical practice. PMID- 3315436 TI - Propolis allergy. (I). Origin, properties, usage and literature review. AB - Propolis or bee-glue, a resinous bee-hive product, is the cause of an increasing number of cases of allergic contact dermatitis. Formerly only observed in bee keepers, propolis allergy today is mainly seen in individuals who use propolis in bio-cosmetics and self treatment of various diseases. Nearly 200 cases are summarized in an overview, including the first description of 'poplar bud' contact dermatitis from 1887. As practically all flavonoid aglycones and most of the other phenolics present in propolis are identical with the bud secretion of poplars, evidence is given that the poplar bud constituents are responsible for propolis hypersensitivity. PMID- 3315437 TI - A 40-year prospective of pediatric cardiology: from Powers to Pearson. PMID- 3315438 TI - Tripterygium wilfordii, a Chinese herb effective in male fertility regulation. AB - A refined extract from the root xylem of Tripterygium wilfordii Hook. f. (the so called multi-glycosides of the plant), available in the market as tablets for the long-term treatment of rheumatoid arthritis and various skin disorders, has recently been shown to possess a powerful antifertility effect in male rats and in men after oral administration at dose levels not showing apparent toxicity or side effects. Fertility appears to be reversible after cessation of treatment. Moreover, preliminary data indicated that the effective antifertility dose in men is only 1/3 of the recommended dose for the treatment of rheumatoid arthritis or skin diseases. This fact supports additional optimism that the side effects of this small dose will be much less as compared with those of the regular dose level. However, a large amount of further investigation is required before one can predict the future of the drug, which seems to hinge upon the successful isolation of the active principle(s) and the careful toxicological evaluation of the safety of the latter. The present paper is a review article summarizing the chemistry, the general pharmacology and the fertility regulatory effect of the plant. PMID- 3315439 TI - Heat sterilisation of Safe-Lock connectors using the Thermoclave. PMID- 3315440 TI - Induction of interleukin-1 during CAPD. PMID- 3315442 TI - Names and codes of the diseases and clinical signs of dogs, cats, horses, cattle, sheep, goats and swine from the consultant diagnostic database. AB - A complete listing of the clinical signs and diseases of dogs, cats, horses, cattle, sheep, goats and swine in the CONSULTANT database for computer assisted diagnosis is presented, along with the codes used to record this data. This list may be useful to those teaching, researching or writing on the diseases of domestic animals, and is of particular use to those who need such a resource for developing diagnostic coding and computer-assisted information retrieval. PMID- 3315441 TI - Peritoneal membrane defence mechanism in CAPD. PMID- 3315443 TI - Studies on induced Klebsiella mastitis with relationships among N-acetyl-beta-D glucosaminidase, bacterial and somatic cell counts. AB - Mastitis was induced by infusion of 3,000-7,000 colony-forming units of Klebsiella pneumoniae into the left rear quarter of four primiparous Holstein Freisians. Greater than 100 organisms were recovered from a quarter milk sample within 2 hr and in 87.5% of the hourly cultures taken after 8 hr. Bacteria, California Mastitis Tests, somatic cell counts and N-acetyl-beta-D glucosaminidase levels differed significantly from that of control quarters in infused cows after hr 6, 8, 9 and 9 respectively. High correlations were obtained between somatic cell count and N-acetyl-beta-D-glucosaminidase (r = .97) and N acetyl-beta-D-glucosaminidase and natural log bacterial count (r. = .88). N acetyl-beta-D-glucosaminidase was related to natural log bacterial counts of samples taken 1, 2, 3, and 4 hr prior to the test (rN-acetyl-beta-D glucosaminidase and natural log bacterial count (r = .91, .92, .93, and .95). PMID- 3315444 TI - Treatment of hypertension in the geriatric patient. PMID- 3315445 TI - Antihypertensive treatment in mild hypertension, its problems and future trends. PMID- 3315446 TI - Guanfacine (Estulic) in the treatment of hypertension. PMID- 3315448 TI - Guanfacine in the treatment of hypertensives with a pronounced response to exercise and diabetes mellitus. AB - The authors assessed the antihypertensive effect of guanfacine (Estulic Sandoz) in 28 stage II hypertensive patients with a pronounced pressure response to the isometric test. Over a period of 4.3 months on the average, they managed to normalise both resting and exercise blood pressure in 89% of subjects. In another study, the authors administered guanfacine to 30 I- and II- type diabetics with essential, primarily stage I, hypertension. Over an average of 6 months, blood pressure normalised in 81% and, when using a guanfacine-saluretic combination, in additional 11%, that is, in a total of 92% of patients. It has been demonstrated that guanfacine has no adverse metabolic action. By contrast, the level of compensation of diabetes mellitus improved allowing 50% of patients to decrease their doses of oral antidiabetic drugs and insulin as well. The authors believe that, in diabetics with hypertension, guanfacine can be rightly regarded as the drug of first choice since it is effective in single-drug therapy and can be used with advantage in patients with whatever complication of diabetes mellitus. PMID- 3315447 TI - Long-term clinical experience with guanfacine. AB - Efficacy of guanfacine was studied in 20 hypertensive patients and 20 patients with diabetes mellitus and hypertension in a 12-month follow-up. Besides routine biochemical parameters, glycaemia, platelet aggregation and the parameters of serotonergic and adrenergic activity (5-hydroxyindoleacetic acid and vanilmandelic acid urinary excretion) were investigated. Blood pressure was well controlled and no changes in glucose levels occurred in either of the study groups. The decrease in the urinary excretion of vanilmandelic and 5 hydroxyindoleacetic acid was more marked in hypertensive patients with normal glucose tolerance. These data suggest that activity of both adrenergic and serotonergic systems may be more impaired in diabetes. Further, changes in the serotonergic system are not caused only by antiserotonergic drugs. Finally, guanfacine was shown to be an effective and suitable drug for the long-term treatment of hypertension, particularly in patients with diabetes mellitus II. PMID- 3315449 TI - Small and large doses of guanfacine (Estulic Sandoz) in the treatment of hypertension. AB - The paper offers therapeutic experience with guanfacine (Estulic Sandoz) in large and small doses in patients with hypertension. A daily dose of 3-4 mg of guanfacine led to a decrease in blood pressure in about half of patients with moderate to severe hypertension. However, therapy had to be discontinued in several instances due to frequent occurrence of adverse side effects. The recently recommended smaller doses (2 x 1 mg) of guanfacine indicated primarily in patients with renal dysfunction or diabetes mellitus resulted in an extremely good therapeutic response; the frequency of undesirable effects was about the same as with other antihypertensive therapeutic protocols. The drug seems to offer more benefits in special indications with a concomitant disease rather than as a third drug of a combination used in severe hypertension. PMID- 3315450 TI - Improved exercise performance of hypertensive patients treated with guanfacine (Estulic Sandoz). AB - Guanfacine (trade name Estulic Sandoz), has turned out to be a very effective antihypertensive drug. During follow-up of 20 men with a hypertensive response to exercise, and with blood pressure values reaching or exceeding 230/120 mmHg, administration of 1-2 mg of the drug daily led to a decrease in heart rate and blood pressure. At the same time, patients' performance during exercise increased considerably, from 705 W prior to guanfacine administration, to 1.128 W after three-week therapy. Of the biochemical parameters monitored, a statistically significant decrease was observed in the levels of cholesterol, triglycerides and non-esterified fatty acids. There was an insignificant decrease in glycaemia. PMID- 3315451 TI - The effect of small doses of guanfacine (Estulic Sandoz) on the lipid levels and catecholamine excretion in patients with essential hypertension. AB - During three-month therapy with small doses of guanfacine (Estulic Sandoz) that were sufficient to control blood pressure in patients with stage II essential hypertension and led to a decrease in excretion of noradrenaline and vanillylmandelic acid, the authors found a decrease in the level of blood cholesterol in patients with hyperlipidaemia. There was no adverse effect on the levels of triglycerides, beta, pre-beta and alpha lipoproteins. The authors conclude that Estulic therapy is indicated in patients who, in addition to essential hypertension, have hyperlipidaemia. PMID- 3315452 TI - Acute corneal edema in pellucid marginal degeneration or acute marginal keratoconus. AB - This article reports a case of bilateral corneal pellucid marginal degeneration. The right cornea had an acute hydrops. Both eyes underwent penetrating keratoplasty. A histopathological study of the corneal specimens was performed by light and electron microscopy. The histological changes observed on the right cornea showed breaks on Bowman's layer, edema and disorganization of the stromal collagen, and break of Descemet's membrane. The ultrastructural changes were similar to those observed in acute keratoconus, leading to the belief that these two corneal diseases are closely related. PMID- 3315453 TI - Oval host wounds and postkeratoplasty astigmatism. AB - Penetrating keratoplasty frequently results in postoperative astigmatism. A rabbit model was used to investigate the relationship between the ovality of the recipient bed and the resulting postoperative astigmatism as measured by keratometry. Animals were grouped based on the extent that the recipient bed deviated from a 7.25-mm diameter circle (ovality of bed). All animals received a round 7.75-mm donor corneal button. With increasing ovality of the recipient bed, there was a corresponding increase in the postoperative astigmatism at 3 months after all sutures were removed. PMID- 3315454 TI - Preoperative metabolic analysis of donor corneas using magnetic resonance spectroscopy. AB - Successful corneal transplantation was accomplished following metabolic phosphorus magnetic resonance analysis. Four cat corneas were analyzed using phosphorus-31 magnetic resonance following storage in modified McCarey-Kaufman (M K) medium for 24 h. Corneas were re-stored in M-K medium and transplanted 24 h after MR analysis. Four control corneas (contralateral eye, no magnetic resonance analysis performed) were also transplanted following storage in M-K medium under identical conditions. Successful corneal transplantation was accomplished with minimal ATP tissue levels. Corneas stored for 48 h maintained a pH of 7.3. The phosphorus-31 spectral modulus, which is the ratio of the high-energy phosphates to the low-energy phosphates, was calculated using the spectral integral (range, 0.49-0.77). No difference in endothelial cell density or morphology was detected between corneas following magnetic resonance analysis and control corneas when evaluated by specular microscopy. PMID- 3315455 TI - Removal of closed-loop anterior chamber intraocular lenses during penetrating keratoplasty. PMID- 3315457 TI - Calcium deposition in a corneal graft. AB - Corneal calcification can be broken down into two distinctly different types: calcific band keratopathy and calcareous corneal degeneration. Both have been described in patients with ocular inflammatory disorders, with elevated serum calcium, or following ocular surgical procedures. This is the first case report of corneal calcification in a donor corneal button following penetrating keratoplasty, and it closely resembled calcareous corneal degeneration. PMID- 3315456 TI - The frequency of corneal dystrophies requiring keratoplasty in Europe and the U.S.A. AB - A clinical and pathologic review of 1,335 corneal buttons received from 1964 to 1985 revealed 185 (13.9%) corneal dystrophies treated with keratoplasty. Fuch's endothelial dystrophy accounted for 132 (9.9%), occurring in females 80% of the time. Corneal dystrophies other than Fuchs' accounted for 53 cases (4.0%). Among the latter, the frequencies varied; 38% were granular, 30% were macular, and 19% were lattice dystrophies. The overall prevalence in series from Los Angeles and Baltimore is the same. However, there is a striking difference in the distribution of the frequencies of non-Fuchs' dystrophies. In the Erlangen series, granular dystrophy dominates (38%), while it is rare in the Baltimore series (4%); the reverse is true for lattice dystrophy (Erlangen 19%; Baltimore 37%), while macular dystrophy rates are similar. PMID- 3315458 TI - Endothelial cell loss due to repeated traumatic wound dehiscence after penetrating keratoplasty. AB - A patient with keratoconus suffered two traumatic ruptures of her corneal graft wound, both of which were successfully repaired with restoration of graft clarity. There were also two apparently unrelated episodes of rejection. The endothelium was monitored by specular microscopy during this period. Our findings suggest that the insult to a transplanted cornea from an episode of rejection may be greater than that from traumatic wound rupture. PMID- 3315459 TI - Impact of routine inquiry legislation in Oregon on eye donations. AB - Routine inquiry legislation can significantly affect procurement of donor eye tissues. Oregon Revised Statute (ORS) 97.268 was the first legislation of this type passed in the United States. In the first 12 months under this legislation, the Oregon Lions Eye Bank obtained, 2,312 eyes, sustaining a 135% increase in donor eye procurement over the yearly average for 1984-1985. During the first 12 months of routine inquiry, 484 corneas suitable for penetrating keratoplasty were obtained versus an annual average of 291 corneas for 1984-1985. Tissues for other transplant purposes and for research have similarly become more available. Age of donor tissue appears to be increasing slightly due to the disproportionate increase of donor eyes from the 70-or-over population. The Oregon Donor Program, the public and professional education coalition of the transplant programs in the state of Oregon, has played an invaluable role in making this penalty-free law a success. PMID- 3315460 TI - Corneal rim cultures. AB - We performed a retrospective analysis of 291 consecutive scleral rim cultures, taken at the time of corneal transplantation, from 1981 to 1986. There were 82 positive cultures (39%), and the most common pathogen was Staphylococcus epidermidis, with 24 positive cultures (30%). Ten of these (42%) were resistant to gentamycin. There were no cases of endophthalmitis or other infections in the immediate postoperative period. We also found 15 positive cultures of Streptococcus viridans. Of these, 13 (87%) were resistant to gentamycin but sensitive to most other antibiotics. Even though endophthalmitis is rare following penetrating keratoplasty, the emergence of resistant strains of Streptococcus viridans and Staphylococcus epidermidis suggests that eyebanks need to consider the addition of a second antibiotic to their MK medium. PMID- 3315462 TI - Structure and function of E. coli promoter DNA. AB - The process of transcription initiation requires both the recognition of a promoter site by RNA polymerase and the melting of a short stretch of DNA. In this review I discuss the properties of promoters that are relevant to sequence recognition and to the ability of the polymerase to act as a melting protein. The regulation of promoter activity is thus dependent on both factors interacting with RNA polymerase and so altering its affinity for promoter sites and also modulations of DNA structure. PMID- 3315461 TI - Aspects of the structure, function, and applications of superoxide dismutase. AB - The current status of superoxide dismutase (SOD) is that it is an enzyme with diverse ramifications. This review attempts an understanding of SOD as a structural, functional, and biological entity. Accordingly, the review is in three parts. The first part discusses SOD in terms of protein structure, proceeding from primary to secondary and three-dimensional structure for the three forms of SOD: copper/zinc SOD, manganese SOD, and iron SOD. This is the order of structural knowledge of the enzyme. Iron SOD is an enzyme of prokaryotes and some higher plants. Manganese SOD is an enzyme of prokaryotes and eukaryotes. Copper/zinc SOD is an enzyme of eukaryotes and certain prokaryotes. The evolutionary relationships of the three forms of SOD, the status of the copper/zinc SOD gene in prokaryotes, and the cloning and sequencing of SOD genes are discussed. The second part of the review deals with the catalytic mechanism of SOD in the three forms of the enzyme. Structural and mechanistic conclusions from various spectroscopic studies are critically considered. A detailed picture is given of the active site of copper/zinc SOD. The third part is a review of SOD in the general context of oxygen toxicity. After consideration of the question of superoxide toxicity and superoxide pathology, several areas in which SOD has been investigated or used as a tool in a biochemical, pharmacological, or clinical context are discussed, including population genetics; trisomy 21; development and senescence; the nutritional copper, zinc, and manganese status; hemolysis and anemia; oxygen toxicity in the lung and nervous system; inflammation, autoimmune disease and chromosome breakage, ischemia and degenerative changes; radiation damage; and malignancy. A comprehensive picture is given of measurements of SOD activity in disease states, and the question of superoxide-related disease is considered at several points. PMID- 3315463 TI - Aluminum and Alzheimer's disease: perspectives for a cytoskeletal mechanism. AB - A considerable volume of literature has accumulated concerning the association of aluminum with Alzheimer's disease. The pathogenic mechanisms resulting in Alzheimer's disease remain unknown, but recent investigations have focused on cytoskeletal abnormalities as perhaps the key lesion in Alzheimer's disease and related neurological disorders. The diversity of neuronal functions that are dependent on cytoskeletal integrity suggests that subtle effects on polymerization, assembly, transcription, or processing of cytoskeletal elements may have significant and far-reaching neurological effects. That aluminum may participate in the development of neuropathological lesions characteristic of Alzheimer's disease is suggested by evidence that aluminum is a potent cytoskeletal toxin, produces cognitive deficits in laboratory animals, and can be detected within abnormal neurons isolated from brain tissue from Alzheimer's disease patients. In this review, a critical look will be taken at the enigmatic role aluminum has played in Alzheimer's disease research, the possibility of its pathogenicity, and its use as a tool for the investigation of cytoskeletal changes that may result in the biochemical and, ultimately, clinical manifestations of Alzheimer's disease. PMID- 3315464 TI - Additive solutions for better blood preservation. AB - For several decades the standard blood preservative solution consisted of citrate, dextrose, and, later, phosphate (ACD and CPD). In 1978 a new solution containing adenine (CPDA-1) was introduced to permit extension of red cell shelf life from 21 to 35 days. The success of CPDA-1 and the high percentage of blood units processed into components (estimated 87% in 1983) have stimulated a burst of research and development activity to develop improved red cell preservation systems. Most of these systems have taken the form of "additive solutions" in which the blood is drawn in CPD or CP2D and processed into components. Then the packed red cells are stored by addition of a solution customized for their preservation. This review evaluates these additive solutions in detail. Innovative systems for pH control (buffers and resins) have also been explored. Our review concludes with discussion of the safety aspects of new preservative solutions and the methodological problems of evaluating these solutions. PMID- 3315466 TI - Effects of continuous positive-pressure ventilation on hepatic blood flow and intrahepatic oxygen delivery in dogs. AB - The effect of mechanical ventilation with PEEP of 0, 10, and 20 cm H2O (continuous positive-pressure ventilation [CPPV]) on hepatic blood flow (HBF) and intrahepatic oxygen delivery was studied in 26 mongrel dogs anesthetized with fentanyl. Hepatic arterial and portal venous blood flow was measured by an electromagnetic flowmeter. CPPV caused a significant decrease in HBF, which was related to the PEEP level. A linear correlation was seen between HBF and cardiac output. Intrahepatic oxygen delivery decreased more than HBF and cardiac output. The reduced oxygen delivery was due mainly to the decrease in portal venous oxygen content. PMID- 3315465 TI - Melatonin: perspectives in laboratory medicine and clinical research. AB - We are presently at a point in human pineal research where we have recognized through melatonin assay the presence of pineal dysfunction in a variety of disease categories. Melatonin may now be quickly and accurately quantified in a range of body fluids, and our well-developed knowledge of the basic biochemistry and neuroanatomical connections of the pineal enables us to see at least how abnormalities in melatonin secretion occur, if not why. The reported increases in melatonin secretion in early malignancy with a reduction in secretion during the neoplastic process is interesting, as is the great decline in the elevated melatonin level of oncological patients following institution of chemotherapy. The correlations between estrogen receptor status of breast cancer and melatonin level, and between neoplastic status of the prostate and melatonin secretion, points to interesting differential diagnostic utilities of melatonin analysis in these conditions. Furthermore, an etiological involvement of melatonin in neoplasia is suggested by experiments which have demonstrated the capacity of melatonin to induce mitotic arrest, and to increase the affinity of mammary carcinoma estrogen receptors for their substrate. These are important observations among many others of direct relevance to research and treatment in oncology, and warrant much further investigation. Melatonin assay may also prove useful in the prognostic monitoring of patients treated for melatonin-secreting pineal tumors, and in such cases may form a logical part of follow-up investigation in the screening for metastatic complication. In psychiatry research, melatonin analysis has functioned as a tool by which alterations in pineal function within specific psychiatric diagnoses have been demonstrated and assessed. Its uses in the assessment of the effects of antidepressant drugs on central beta-receptor function, as a tool in the investigation of light-induced alterations in pineal function in manic-depressive individuals, and as a tool in the investigation of the putative pineal-adrenocortical functional interaction have produced the fundamental building blocks of modern research into the pineal and psychiatry. The experimental clinical utility of melatonin assay is not localized to oncology and psychiatry, and significant alterations in melatonin secretion have been reported in several other disease categories. Indeed, the demonstration of markedly elevated melatonin secretion in patients with spina bifida occulta might suggest that assay of melatonin in amniotic fluid could be useful as an experimental adjunct in the prenatal diagnosis of this condition.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3315468 TI - Effect of positive end-expiratory pressure in severe acute asthma. PMID- 3315467 TI - Detection of lung edema. PMID- 3315469 TI - Long-term follow-up of 500 patients with mild to moderate hypertension who had successfully completed a 3-month general practice study of a timolol bendrofluazide combination ('Prestim'). AB - A sample of 500 patients with mild to moderate hypertension, who had been successfully controlled on once daily timolol/bendrofluazide at the end of a 3 month general practice study, was followed up after approximately 1 year of treatment. Physicians who had participated in the trial were questioned on the current status of these patients. Out of 479 reports received, data showed that 358 (75%) patients were still normotensive 47 weeks after starting treatment with timolol/bendrofluazide and in a further 8 patients other antihypertensive agents had been added to this therapy. Of the 113 patients no longer receiving timolol/bendrofluazide, only 38 (7.9%) had stopped therapy due to adverse effects. It is concluded that the results are a further indication that timolol/bendrofluazide offers an acceptable and balanced long-term form of therapy in hypertension for both the patient and the physician. PMID- 3315470 TI - Diabetes mellitus and the surgeon. PMID- 3315471 TI - Transport enhancement and the activity of insulin. AB - The transport properties of insulin have been analysed with respect to the Brewer membrane model. Polar molecules are transported into the cell through their association with cations. The abilities of cations and their associated polar molecules to enter the cell membrane depend upon the activity of the cation and the quantum state of multivalent membrane bonds, principally the P = O located in the head of phospholipids. The active cation K forms an association with glucose and can enter the membrane when the bonds are in the ground state. Less active cations, such as Na, Ca and Mg, form larger and more complex associations but can only enter the membrane when the bonds are in an excited state. Insulin's effect on the transport of polar molecules is shown to correspond with its effect on the transport of cations. A possible model for insulin action on the cell membrane is explained. PMID- 3315472 TI - AIDS in Denmark 1980-1984. Immunological, epidemiological and clinical studies among patients and high risk groups. PMID- 3315473 TI - Inhaler use in children with asthma. AB - 1. Coordination difficulties, stop of inhalation at actuation and fast inhalations are the most important problems children experience when using a PA while difficulties with correct loading and splitting of the capsule are the most prevalent problems with the RO. 2. Most children older than 5 years can be taught effective use of an inhaler and once the correct technique has been learned is it rarely forgotten if the inhaler is used regularly. 3. Insufficient instruction at the time of prescription is the major cause of inefficient inhaler use in children who use their inhalers regularly. 4. Use of a TS makes it easier for children to inhale slowly. Furthermore, compared with a PA and TS reduces the occurrence of coordination problems and stop of inhalation when the aerosol is fired; otherwise there seems to be little clinical difference between a PA and a TS. 5. Problems with correct inhaler use are accentuated during episodes of acute wheeze when supervision or help from an adult may be needed. 6. Pauses between doses of inhaled bronchodilators are likely to improve bronchodilation during episodes of acute wheeze, whereas there is no need to recommend pauses between the puffs of bronchodilators or between puffs of bronchodilators and corticosteroids in the routine day to day management of patients. 7. Children using a TS should be taught to inhale as slowly as possible. Tilting the head back during inhalation, breath-holding after the inhalation and exhalation through the nose do not enhance response. Furthermore, the lung volume at which the aerosol is actuated is relatively unimportant as long as the child inhales as deeply as possible after actuating the aerosol. 8. The effect of powder inhalers is dependent upon a certain inspiratory flow rate and therefore there is a risk of reduced effect during episodes of acute wheeze or in children with low pulmonary function. This risk may be greater with a RO than with a FPI. 9. Children using a Rotahaler or a Fenoterol powder inhaler should be taught to inhale as fast as possible. They need not tilt the head backwards during inhalation or hold their breath afterwards. 10. Conclusions from one inhaler should be applied with caution to other inhalers. 11. The long list of instructions currently considered to represent the essentials of correct inhalation technique can be markedly simplified without any significant loss of effect in children receiving inhaled therapy with bronchodilators and corticosteroids.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3315474 TI - Ultrasound studies of patients with bleeding in early pregnancy. PMID- 3315475 TI - Salmonella infections of the urinary tract. AB - Infection of the urinary tract is a relatively rare manifestation of salmonellosis, most often seen in elderly and debilitated patients. The literature is reviewed briefly with a focus on the mechanisms whereby the urinary tract may be involved in salmonellosis, i.e. ascending or haematogenous invasion of the urinary tract. Predisposing factors, clinical course, and recommendations for follow-up of patients are commented on. Ten cases of urinary tract infections caused by various Salmonellae illustrate the nosology. PMID- 3315476 TI - Obesity and cancer. A review of epidemiological studies on the relationship of obesity to cancer of the colon, rectum, prostate, breast, ovaries, and endometrium. AB - Cancer of the colon, rectum, prostate, breast, ovaries and endometrium may be associated with obesity. The present paper reviews both prospective and retrospective studies of the potential associations between obesity and these cancers. This research is especially difficult because of the complex interrelations between weight and diet, physical activity, cigarette smoking, and other conditions. Epidemiological studies of body weight are subject not only to biases of sampling, selection, and confounding but also to marked difficulties in definition and measurement. Bearing in mind the methodological shortcomings, there is a distinct and reproducible association between obesity and cancer of the endometrium and postmenopausal breast cancer. The studies of cancer of the colon, rectum, prostate, and ovaries are too inconclusive to elucidate whether obesity implies an increased risk. It is recommended that future studies in this field include a standardised assessment of the distribution of fat tissue, the onset and duration of the condition, and the associated confounding factors. It is concluded that obesity, especially in females, should be avoided as a part of the general cancer preventive effort. PMID- 3315477 TI - [Clinical assessment of the materials Isopast and Isofil in the milk teeth and young permanent teeth]. PMID- 3315478 TI - Early methylprednisolone treatment for septic syndrome and the adult respiratory distress syndrome. AB - From November 1, 1982 through December 31, 1985, there were 19 centers and 382 patients that evaluated the effect of methylprednisolone sodium succinate (MPSS) on the septic syndrome. Seventeen of these centers enrolled 304 patients in a prospective, randomized, double-blind, placebo-controlled study to determine if early treatment with MPSS would decrease the incidence of severity of the adult respiratory distress syndrome (ARDS) in patients at risk of ARDS from sepsis. To ensure early institution of the MPSS or placebo therapy (PLA), patients with the presumptive diagnosis of sepsis were identified. That diagnosis was based on the presence of fever or hypothermia (temperature greater than 38.3 degrees C or less than 35.5 degrees C, rectal), tachypnea (greater than 20 bpm), tachycardia (greater than 90 bpm) and the presence of one of the following indices of organ dysfunction: a change in mental status, hypoxemia, elevated lactate levels or oliguria. The treatment, either MPSS 30 mg/kg or PLA, was given in four 20-minute infusions six hours apart and was initiated within two hours of the presumptive diagnosis of sepsis. The development and reversal of the adult respiratory distress syndrome (ARDS) was followed and resulted in data on 304 of the 382 randomized patients. A trend toward increased incidence of ARDS was seen in the MPSS group 50/152 (32 percent) compared to the placebo group 38/152(25 percent) p = 0.10. Significantly fewer MPSS patients reversed their ARDS 15/50 (31 percent) compared to placebo 23/38 (61 percent) p = 0.005. The 14-day mortality in patients with ARDS treated with MPSS was 26/50 (52 percent) compared to placebo 8/22 (22 percent) p = 0.004. We conclude that early treatment of septic syndrome with MPSS does not prevent the development of ARDS. Additionally, MPSS treatment impedes the reversal of ARDS and increases the mortality rate in patients with ARDS. PMID- 3315479 TI - Hyperbaric oxygen. A therapy in search of diseases. AB - The application of HBO to the therapy of various human diseases developed over a 300 year period. Like most of medicine, the basis of these applications was and continues to be pragmatic in nature, and involves uncritical and untested judgments. The possibility of risks has been understated and possible benefits have been overstated. Individual physicians offering HBO and organized groups, such as the Undersea Medical Society, advocating its use may well be highly motivated, well meaning, and sincerely convinced that HBO is an important therapeutic approach. It may be that, buried among the host of indications, will be some disorders for which HBO is uniquely and highly effective. If so, the present nonsystem for evaluating responses to HBO will require modification, so that these potentially valuable additions to therapeutics are not lost. Because of its almost global application to a wide variety of diseases, HBO therapy lends itself easily to medical adventurism (therapy in search of a disease) and economic exploitation. If there is some patient benefit to come from the experience of the last 300 years, changes in approach, initiated by baromedical devotees or by medicine generally, or resulting from pressures outside of medicine, will be required. PMID- 3315480 TI - Bronchiolitis obliterans and Nocardia asteroides infection of the lung. AB - This report describes a patient with right lower lung (RLL) pneumonia of a subacute nature. Sputum and bronchial washings both grew N asteroides. Open lung biopsy showed bronchiolitis obliterans. Both the clinical and radiologic picture dramatically improved during three weeks of treatment with trimethoprim and sulfamethoxazole (TMP - SMX), indicating the possibility that N asteroides infection contributed to bronchiolitis obliterans pneumonia in this patient. PMID- 3315481 TI - Right ventricular function during positive end-expiratory pressure. Thermodilution evaluation and clinical application. AB - Right ventricular (RV) function was studied in 13 patients under controlled mechanical ventilation with positive end-expiratory pressure (PEEP) for adult respiratory distress syndrome. The assessment of RV function was made by the thermodilution technique. Calculations of RV ejection fraction (RVEF) and RV end diastolic volume (RVEDV) were performed. In 11 patients, increasing PEEP was accompanied by a progressive decrease in blood pressure (BP), stroke volume (SV), RVEDV, and no change in RVEF. Increasing PEEP further was accompanied by a further decrease in RV preload. The remaining two patients exhibited a decrease in BP, SV, RVEF and an increase in RVEDV. One of these two patients exhibited a large decrease in cardiac output (CO). Thus, measurement of RVEDV (best parameter of ventricular preload) and RVEF are easily performed at the patient's bedside using a special thermodilution technique. This allows selection of the best treatment of PEEP-induced decrease in CO. PMID- 3315483 TI - Projective measures in the clinical evaluation of sexually abused children. PMID- 3315482 TI - Inhalant use among American Indian youth. PMID- 3315484 TI - Freud, psychodynamics, and incest. AB - The author distills the essence of Freud's thinking about incest, placing it within the context of childhood sexuality. He discusses clinical and research implications concerning the relationship between sexual trauma and emotional disturbances, and poses certain perplexing questions that are far from answered. PMID- 3315485 TI - [Echography in inflammatory and degenerative pathology of the Achilles tendon]. PMID- 3315486 TI - [Partial resection of the distal end of the humerus and reconstruction with autoplastic graft taken from the ilium]. PMID- 3315487 TI - [A modified de-epiphysiodesis technic]. PMID- 3315488 TI - [Catheter embolization of intrarenal arteriovenous fistula formations]. AB - Catheter embolization of renal arteriovenous fistulas is an effective alternative treatment to surgery; general anaesthesia is not necessary and the hospitalization is limited to 2-3 days. Suitable catheters, permanent occlusion material, such as butylcyanoacrylate, and balloon occlusion technique provide a safe and successful embolization even in cases with massive arteriovenous malformations. PMID- 3315489 TI - [Ravo and Ger intracolonic anastomosis protection. Method, indications and results]. PMID- 3315490 TI - [Personnel of the Academy of Surgery]. PMID- 3315491 TI - [Pierre Fredet, 1870-1946. Last president of the National Society and first president of the Academy of Surgery]. PMID- 3315492 TI - [Henri Le Brigand (1913-1985)]. PMID- 3315493 TI - [Pelvic exenteration. Apropos of a series of 86 cases]. PMID- 3315494 TI - [Right hemocolectomy in primary adenocarcinoma of the appendix. 12 cases and review of the literature]. PMID- 3315495 TI - [Isolated panglandular pancreatic serous cystadenomatosis. Apropos of a case]. PMID- 3315496 TI - Mammalian kinetochore/centromere composition: a 50 kDa antigen is present in the mammalian kinetochore/centromere. AB - The composition of the mammalian kinetochore/centromere was studied by indirect immunofluorescence and immunoblotting protocols using serum from a patient with the CREST variant of scleroderma. The results of these studies suggest that a protein with a molecular weight of 50 kDa is localized at the surface of the primary constrictions (the kinetochore region) of both human and Indian muntjac chromosomes. In addition, we were able to verify the presence of a 19.5 kDa antigen (CENP-A), previously detected in human centromeres, within the kinetochore region of the Indian muntjac. These data suggest that the composition of the kinetochore region of the primary constriction is complex and that there is conservation in composition within the mammals. These features may reflect the important role of this unique chromosomal domain in the maintenance of ploidy. PMID- 3315497 TI - Rhythm scrambling: good, bad or indifferent? AB - The scrambling of rhythms, i.e. their mixing-up or throwing into disorder, on a variety of schedules of lighting and feeding, left the average overall life span of several groups of mice unaffected. One particularly scrambled schedule prolonged 10th-decile survival time. The phase-shifting of rhythms, in a mammalian simulation of shift-work schedules, need not be harmful and can be indifferent or even beneficial. Such findings have important implications for health, performance and safety in human shift-work by both sexes and for the choice of other schedules, such as those for drug treatments or exercise. PMID- 3315498 TI - Idiotypes and autoimmunity. AB - By the analysis of hybridomas constructed from B cells early in development we have shown that: (i) the early neonatal B cell repertoire consists of a highly autoreactive set of B cells showing extensive multispecificity and interconnectivity; (ii) many of these antibodies express anti-idiotypic activity towards autologous germline-encoded idiotypic antibodies; (iii) the anti idiotypic activities of such B cells and/or their antibody products play a major role in establishing the clonal dominance of certain well-characterized idiotypes in the responses to phosphorylcholine (PC) and alpha 1----3 dextran; and (iv) results obtained in comparisons between antibodies to the acetylcholine receptor and alpha 1----3 dextran in humans and mice showed extensive idiotypic connectivity. Some of the anti-idiotypic specificities involved were also apparent in the neonatally derived antibodies. These results suggest that there are extensive idiotype-directed interactions between B cells early in development which appear to be essential for establishing the adult B cell repertoire and the accompanying clonal dominance of appropriate idiotypes. Similar interactions may also play a role in the development of certain autoimmune disorders. PMID- 3315499 TI - Molecular basis for the cross-reactive idiotypes on human anti-IgG autoantibodies (rheumatoid factors). AB - High titres of anti-IgG autoantibodies (rheumatoid factors, RF) are characteristic of patients with rheumatoid arthritis, Sjogren's syndrome, and mixed cryoglobulinaemia, and may contribute to immune complex formation and tissue damage. The monoclonal RFs from cryoglobulinaemia patients frequently display cross-reactive idiotypes. The genetic basis for the cross-reactive idiotypes on RF autoantibodies has not been determined. To clarify structural and genetic relationships among RFs from unrelated subjects, a series of anti-peptide antibodies have been generated that define primary sequence-dependent idiotypes on RF heavy and light chains. Multiple monoclonal and polyclonal RFs from unrelated individuals have been probed by Western blotting with the anti idiotypic reagents. The results show that sequences in the kappa light chain variable region represent a common structural element among RF autoantibodies. This hypothesis is confirmed by the cloning and sequencing of the conserved germline variable region gene which encodes human RF kappa chains. PMID- 3315500 TI - Autoimmunity and immunodeficiency disease. AB - There is a high incidence of autoimmune disease in patients with primary immunodeficiency. In almost all instances autoantibodies are to antigenic determinants of the formed elements of the blood--erythrocytes, platelets and neutrophils. In some rare cases, autoantibodies to T or B lymphocytes can cause immunodeficiency. IgA is unique in inciting autoantibodies to this serum protein in some patients with IgA deficiency. Organ-specific autoimmune disease is extremely rare in immunodeficiency states. In contrast, drug allergy and allergic contact dermatitis are extremely common in patients with deficiencies of B lymphocytes. Patients with the syndrome of immunodeficiency with elevated IgM (hyper-IgM deficiency) almost invariably develop autoantibodies to formed elements of the blood. Autoantibody production can be suppressed with anti idiotypic antibodies. PMID- 3315501 TI - Monoclonal anti-Ia antibody therapy in animal models of autoimmune disease. AB - Allele-specific monoclonal anti-I-A antibodies are capable of specifically suppressing the immune response to antigens under the control of the allele towards which the antibody is directed, without suppressing the response to antigens under the control of the alternative allele of the I-A alpha and beta chain genes in an F1 heterozygote. This phenomenon, which has been termed 'allele specific immunosuppression', is antigen-specific, long-lasting and transferrable with Thy-1-positive spleen cells. This type of immunosuppression has been applied to animal models of autoimmune disease, in both homozygous and heterozygous animal models. Anti-I-A monoclonal antibodies are capable of preventing, suppressing and treating experimental allergic encephalomyelitis (EAE), of partially suppressing experimental autoimmune myasthenia gravis, and of preventing the onset of type I insulin-dependent diabetes in the BB/W diabetic rat. In addition, this type of immunotherapy has succeeded in almost completely suppressing nephritis in NZB X NZW F1 mice, which normally develop severe lupus like nephritis. Significant toxicity, which may be due to anti-allotype antibodies, anti-idiotype antibodies, or to impurities in the monoclonal antibody preparations, has been encountered in the BB/W diabetic rat. In addition, attempts to extend these observations to EAE in the cynomolgus monkey have encountered significant mortality which appears to be attributable to the monoclonal antibody injections (anti-HLA-DR). The mechanism of this toxicity and means of circumventing it are currently under investigation. These results demonstrate the critical role of I-A molecules in the induction and continuance of the autoimmune process in these experimental animal models. PMID- 3315502 TI - Monoclonal antibodies for the depletion of specific subpopulations of lymphocytes. AB - A number of rat monoclonal antibodies of the IgG2b subclass have been used to deplete mice of T lymphocyte subsets. It has been possible to produce long-term depletion where antibodies are administered to mice thymectomized in their adult life, or short-term depletion in euthymic animals. It is therefore feasible to ablate a T lymphocyte subpopulation at any stage in the course of an immune response and to examine in detail the role of a particular subset in the induction or effector phases of that response. We have used such ablative procedures to define the T cell subsets which participate in graft rejection, graft-versus-host disease, antigenic competition and antiviral and anti-self immunity and have attempted to exploit such knowledge to establish immunological tolerance in an adult animal. PMID- 3315503 TI - Manipulation of idiotype networks in autoimmunity. AB - The spontaneous occurrence of anti-idiotypes associated with the amelioration of disease activity in some autoimmune disorders encourages the view that one may be able to develop a therapeutic strategy based upon manipulation of idiotype networks. Attempts to abrogate autoimmunity by using heterologous anti-idiotype reagents have been rather disappointing and there may well be an expansion of idiotype-negative antibody clones. We argue that idiotypic reagents based on T cells or antibodies derived from the species being treated are more likely to lead to success because they interact more profoundly with the individual's own networks than do heterologous antibodies. PMID- 3315504 TI - Specific immunoabsorption. AB - Rapidly progressive glomerulonephritis occurs in patients developing autoantibodies to the glomerular basement membrane (GBM) and in multisystem vasculitic syndromes such as Wegener's granulomatosis (WG) and microscopic polyarteritis (MPA). In anti-GBM disease the pathogenicity of the autoantibodies has been established by transfer experiments; new solid-phase radioimmunoassays (RIAs) for circulating autoantibodies allow early diagnosis and effective monitoring of treatment. Sequential measurements of antibody levels showed that their generation is self-limiting (even without treatment) and that their production can be arrested more quickly with immunosuppressive therapy (cyclophosphamide and high dose steroids) together with intensive plasma exchange. In systemic vasculitis, no pathogenic agent has been identified and the diseases are rarely self-remitting. In WG, antibodies to cytoplasmic components of normal human neutrophils (and monocytes) were reported to be detectable by indirect immunofluorescence, with titres correlating with disease activity. We confirmed this and showed that antigen can be extracted from normal human neutrophils and used as ligand in a solid-phase RIA. Sera from patients with other forms of systemic vasculitis, such as MPA, as well as WG, are positive in this assay. The antigens have been further characterized by HPLC fractionation on a Toyosoda TSK gel filtration column. In WG, antibodies were directed towards cytoplasmic fractions of 100, 6 and 2 kDa; in MPA, antibody reacted only with the 100 kDa fraction. These findings suggest a humoral pathogenesis in these disorders and indicate that this approach may be helpful in the classification, diagnosis and monitoring of therapy in the systemic vasculitides. Further characterization of the autoantigen and its potential use in specific immunoabsorption are discussed. PMID- 3315505 TI - Intracellular autoantigens: diagnostic fingerprints but aetiological dilemmas. AB - Autoimmune diseases such as systemic lupus erythematosus, scleroderma, Sjogren's syndrome, mixed connective tissue disease and dermato/polymyositis are each characterized by distinct sets of autoantigens and antibodies which confer on each disease a specific immune profile or fingerprint. These immune fingerprints have advanced our management of this group of diseases, as aids in differential diagnosis and earlier recognition. In lupus and scleroderma, multiple antigen/antibody systems characterize these fingerprints and the autoantigens appear to be located in separate cell compartments of the nucleus, nucleolus and cytoplasm. Because these antibodies are so distinctive for each disease, the response must be antigen driven or at least antigen directed. However, the apparent multi-focus location of the autoantigens poses a problem. It now appears that in scleroderma this dilemma may be explained by the consideration that at a certain time point in cell metabolism all the known autoantigens may be assembled at one location to form a single structural entity. It is possible that this assembly of antigens may be required for a specific cellular function. An autoimmune response to this transiently assembled structure comprising several different proteins and nucleic acids could result in the complex immune response seen in this disease. PMID- 3315506 TI - Significance of carbohydrate components of cell surfaces. AB - This article is focused on a family of carbohydrate structures which are (a) target antigens of autoantibodies and (b) onco-developmental antigens which change during embryonic development, cell differentiation, maturation and oncogenesis. Among the carrier molecules of these saccharide structures is the receptor for epidermal growth factor. Perturbation of these structures on the isolated receptor enhances autophosphorylation of the receptor glycoprotein. This suggests that the carbohydrate chains may be part of a growth regulatory network which may be 'tuned' or perturbed via interactions with endogenous lectins or by adhesins of infective agents. Certain sialylated forms of these oligosaccharide structures serve as receptors for a pathogen of man, Mycoplasma pneumoniae which, following infection, elicits anti-erythrocyte autoantibodies. These autoantibodies are directed against the backbone domain of the carbohydrate receptor and are therefore anti-receptor antibodies. These observations suggest that complex formation between the adhesins of infective agents and specific saccharides of host-cell membranes may be a 'new' mechanism for eliciting autoantibodies. PMID- 3315507 TI - Regulation of HLA class II expression and its role in autoimmune disease. AB - Excessive HLA class II expression is found on the target tissues of the majority of human autoimmune diseases, together with activated (interleukin 2 receptor expressing) T lymphocytes, suggesting that the target tissues act as antigen presenting cells for infiltrating autoreactive cells, which in turn produce molecules that maintain class II expression. This vicious cycle has been shown to operate in Graves' thyroiditis, because interferon-gamma (IFN-gamma) induces class II expression on thyrocytes, and thyrocytes expressing class II antigens present their autoantigens to T cells cloned from thyroid tissue of Graves' disease patients. These results led us to consider whether the same mechanisms operate in other autoimmune diseases. In investigations into class II induction in other cell types we found that IFN-gamma is not the only regulator of HLA class II expression and that synergy exists among mediators regulating class II differentially on different cell types. This concept makes it possible to envisage selective diminution of class II antigens on target tissues without loss of class II on antigen-presenting cells. The study of mediators regulating class II expression on cells in vitro led us to ask whether the appropriate regulator molecules are important in disease states. To investigate this question we have developed the use of cDNA probes to analyse the expression of lymphokines, other cytokines, and receptors in small local biopsy samples of tissue from patients with autoimmune diseases. Results obtained so far indicate that mRNAs for many lymphokines are present in synovial fluid cell samples from patients with rheumatoid arthritis. PMID- 3315509 TI - Adjuvant therapy for colorectal cancer. The EORTC experience and a review of the literature. AB - In spite of the improvements in surgical techniques and intensive care therapy, no appreciable improvement in the prognosis for patients with colorectal cancer has been made in recent years. Several types of adjuvant treatment, including radiotherapy, chemotherapy, and immunotherapy, have therefore been proposed and used in clinical trials, mainly in the United States and western Europe. The results obtained by the Gastrointestinal Group of the European Organization for Research and Treatment of Cancer (EORTC), using preoperative radiation therapy with 3450 rads, are reported here; this therapy results in a reduction in the number of local recurrences and also appears to prolong the five-year survival period, although a longer follow-up is required to confirm this. According to the Gastrointestinal Tumor Study Group (GITSG), postoperative radiation therapy with chemotherapy seems to prolong the tumor-free interval in stages B2 and C when compared to surgery alone. Nonspecific immunotherapy does not appear to improve surgical results either in terms of local recurrences or survival. Some clinical trials suggest that systemic polychemotherapy benefit subgroups of patients with colorectal cancer. Toxicity is still very high, however; 5-FU is the more active and safe single agent but, due to the low response rate, it appears essential to identify new, more active drugs. Particular attention has been focused recently on prophylactic infusion chemotherapy of the liver, and clinical trials are now being made by several groups, including the EORTC. Preliminary results seem to show a reduced incidence of liver metastases in patients infused with 5-FU after radical surgery. Adjuvant therapy in colorectal cancer patients undergoing radical surgery has so far given encouraging results. Future results are awaited with optimism, but they must be achieved through prospective clinical trials conducted by well-organized cooperative groups. PMID- 3315508 TI - [Stereotactic thalamotomy in the treatment of Parkinson's disease]. PMID- 3315510 TI - Anaplastic solitary extramedullary plasmacytoma of the cecum. Report of a case confirmed by immunoperoxidase staining. AB - Solitary extramedullary plasma cell tumors, although uncommon, have been reported with increasing frequency over the last few years. Approximately 5 to 10 percent of the tumors arise in the gastrointestinal tract. This report demonstrates that a solitary anaplastic cecal extramedullary plasmacytoma can mimic a polypoid carcinoma, both grossly and, to an extent, microscopically. Immunoperoxidase stains for cytoplasmic immunoglobulin proved useful in establishing the correct diagnosis. PMID- 3315511 TI - John Houston 1802-1845. Observations on the mucous membrane of the rectum. 1830. PMID- 3315512 TI - Reproducibility of beta-cell function estimates in non-insulin-dependent diabetes mellitus. AB - We evaluated the reproducibility of different estimates of endogenous insulin secretion in 30 patients with non-insulin-dependent diabetes mellitus (NIDDM). Fasting blood glucose concentration was similar on the 2 days of study. The coefficients of variation of fasting plasma C-peptide, plasma C-peptide 6 min after the injection of 1 mg i.v. glucagon, and the increment in plasma C-peptide after glucagon were 16.0, 14.8 and 24.1%, respectively. The coefficients of variation of the corresponding plasma insulin values were 19.2, 24.8, and 34.8%, respectively. The coefficient of variation of 24-h urinary C-peptide excretion was 22.1%. Because fasting plasma C-peptide correlated closely with plasma C peptide 6 min after glucagon (test 1: r = .70, P less than .01; test 2: r = .76, P less than .01), it seems that these two values can be used equally well as assessment of beta-cell function in NIDDM. In conclusion, fasting plasma insulin, fasting plasma C-peptide, and plasma C-peptide 6 min after glucagon stimulation showed a similar and acceptable degree of reproducibility. Plasma insulin 6 min after glucagon and increments in plasma insulin and C-peptide, as well as urinary C-peptide, seem to be less reproducible. PMID- 3315513 TI - Prevention of metabolic alterations by insulin supplements administered either before or after 2-h nocturnal interruption of CSII. AB - To evaluate the efficacy of a bolus insulin injection to prevent the metabolic alterations induced by a 2-h nocturnal interruption of a continuous subcutaneous insulin infusion (CSII), nine type I (insulin-dependent) C-peptide-negative diabetic patients were studied from 2200 to 0800 h during two randomized tests. An insulin bolus (2.1 +/- 0.2 U) was administered via the pump either at 2300 h, just before CSII interruption, or at 0100 h, after reactivating the pump at its usual basal rate (1.05 +/- 0.11 U/h). The insulin bolus at 2300 h induced a significant rise in plasma free-insulin levels at 2400 h (+6.9 +/- 1.8 mU/L, P less than .01), resulting in an early and marked fall in blood glucose concentrations between 2300 and 0100 h (-2.7 +/- 0.5 mM, P less than .001), with hypoglycemic values in five patients. The insulin bolus at 0100 h counteracted the fall in plasma free-insulin levels observed between 2300 and 0100 h and significantly increased plasma insulin at 0200 h (+3.2 +/- 0.8 mU/L, P less than .01). Blood glucose concentrations that remained stable during the 2-h arrest of the pump fell significantly between 0100 and 0400 h (-2.1 +/- 0.5 mM, P less than .005). This fall rate was significantly lower than that measured within the 3 h after the insulin bolus given before CSII interruption but significantly higher than that observed in a reference control group of patients whose pump was functioning normally throughout the night.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315514 TI - Long-term use of intranasal insulin in insulin-dependent diabetic patients. AB - This study, in 3 phases, compared the long-term acceptability and efficacy of insulin administered by nasal spray with an intensified subcutaneous regimen in nine type I (insulin-dependent) diabetic subjects on baseline therapy with ultralente insulin. In phase 1, patients were begun and stabilized on a regimen of ultralente daily and Actrapid insulin three times daily. Phase 2 consisted of 4 mo of this intensified subcutaneous regimen. In phase 3, intranasal administration of insulin, with 1% (wt/vol) sodium glycocholate, replaced Actrapid insulin for 4 mo. Glycemic control was compared in each of the three phases. It was possible to maintain the dose of ultralente insulin relatively constant in only six of the nine subjects during the intranasal phase of the study. The six subjects showed a significant rise in glycosylated hemoglobin during the intranasal phase (10.4 +/- 0.6% intranasal vs. 9.1 +/- 0.3% subcutaneous, P less than .05) but not in plasma or urinary glucose levels. There was no significant change in the incidence of hypoglycemic episodes during intranasal insulin therapy in this group. The other three subjects were considered treatment failures. Six of the nine original subjects expressed a preference for intranasal insulin, and one subject complained of mild nasal irritation insufficient to cease treatment. The intranasal route of administration of insulin has the potential to replace short-acting insulin as an adjunct to longer-acting insulin in some insulin-treated diabetic patients. PMID- 3315516 TI - Consensus Development Conference on Diet and Exercise in Non-Insulin-Dependent Diabetes Mellitus. National Institutes of Health. PMID- 3315515 TI - Improved glycemic control after supervised 8-wk exercise program in insulin dependent diabetic adolescents. AB - Eight insulin-dependent adolescents (4 boys, 4 girls) participated in an 8-wk program of supervised exercise, and 8 matched controls were encouraged to exercise on their own without supervision. All 16 subjects were asked to follow a standard ADA diet plan, kept a self-reported log of caloric intake, and met with a dietitian weekly to review their diets. Exercise for the supervised subjects was scheduled between the routine afternoon snack and the evening meal, and subjects were asked not to consume additional food on exercise days. After the 8 wk program, glycemic control, as measured by glycosylated serum albumin and blood glucose values (but not by glycosylated hemoglobin), improved in the supervised exercise group despite reduced daily insulin dosage. Cardiorespiratory fitness, as measured by voluntary maximum treadmill time (Bruce protocol) and submaximal exercise heart rates, also improved. No changes were observed in the unsupervised control group. PMID- 3315517 TI - Islet cell autoantibodies: pathobiology and clinical applications. AB - Autoimmunity directed against pancreatic islet cells results in slowly progressing beta-cell destruction, culminating over years in clinically manifested insulin-dependent diabetes mellitus (IDDM). Circulating serum autoantibodies directed against the endocrine cells of the islets of Langerhans are an important hallmark of this disease. Assays for these islet cell antibodies (ICA) have facilitated the investigation and understanding of several facets in the pathogenesis of autoimmune diabetes. Their applications have begun to extend into clinical practice and have opened new avenues for early preclinical prediction and preventive prophylaxsis in IDDM. PMID- 3315518 TI - Institution of insulin therapy reverses retinal vascular leakage: a case report. PMID- 3315519 TI - Insulin autoantibodies: their role in the pathogenesis of IDDM. PMID- 3315520 TI - Immune intervention studies in insulin-dependent diabetes mellitus. PMID- 3315521 TI - Immunobiology of the allograft response. PMID- 3315522 TI - Pancreas transplantation. AB - The number of pancreas transplants being performed and the success rate have continued to increase. Most pancreas transplants have been placed in diabetic recipients of kidney transplants, but application to nonuremic, non-kidney transplant recipients without end-stage disease is increasing. Drainage of pancreatic graft duct into the bladder allows exocrine function to be assessed directly and has led to earlier diagnosis and treatment of rejection episodes. The improvement in graft survival rates has been associated with the use of cyclosporine in combination with other immunosuppressants. The effect that establishment of a euglycemic state by successful pancreas transplantation has on the specific complications of diabetes is just beginning to be discerned but appears to be favorable if the transplant is performed sufficiently early in the course of the disease. PMID- 3315523 TI - Islet morphologic changes. PMID- 3315524 TI - The "natural" history of type I diabetes. PMID- 3315525 TI - Mechanisms of autoimmunity: relevance to the pathogenesis of type I (insulin dependent) diabetes mellitus. PMID- 3315526 TI - Environmental factors and insulin-dependent diabetes mellitus. PMID- 3315527 TI - Islet-specific immune mechanisms. PMID- 3315528 TI - Cell-mediated autoimmunity in type I diabetes. PMID- 3315529 TI - Osteopenia. AB - Osteopenia in the elderly is responsible for 1.3 million fractures per year in the United States. The acute care costs associated with this disorder are between $6 and $10 billion dollars annually. Although much has been learned over the last few years of the factors that predispose patients to osteoporosis and how these factors may be avoided, the precise pathophysiologic mechanisms for bone loss remain obscure. Significant technological advances have been made in the 1980s in the development of noninvasive methods for measuring bone mineral density that give indirect assessments of bone mass. However, these methods are very controversial, are not suitable for mass screening for detecting subjects potentially at risk, and have a limited place in routine clinical care. Osteoporosis is characterized by thinning and fragmentation of trabecular bone, which is probably irreversible when it is far advanced. The most reasonable therapeutic approach may be prevention, which can be achieved in many patients by estrogen therapy in the perimenopausal years and insuring an adequate dietary calcium intake, particularly in adolescents and in the elderly. Physical activity throughout life is also likely to be important in maintaining adequate bone mass. It is important to differentiate osteoporosis from other causes of osteopenia, for example, osteomalacia, primary hyperparathyroidism, and malignant diseases such as myeloma, since these bone diseases have a different natural history, pathophysiology, and treatment. PMID- 3315531 TI - [Aeration affects DNA supercoiling in bacterial cells]. PMID- 3315530 TI - [Squamous cell carcinoma of the ascending colon--a case report and review of literature]. AB - One case of squamous cell carcinoma of the ascending colon is reported. The patient, a sixty two year old woman, was admitted because of right abdominal pain for three months. A mass, 6 X 5 cm in size, was palpated. 13 cm colonic mucosa destruction was shown by barium enema. Right hemicolectomy was done. A squamous cell carcinoma of the ascending colon was diagnosed by light and electron microscope. Squamous cell carcinoma of the colon is rare. Squamous cell carcinoma and adenoacanthoma, occurring in the colon and upper rectum, comprise 0.5% of all colonic malignancies. 18 cases have been collected in the literature and this case is the first one reported in China. Etiology of squamous cell carcinoma of the large bowel is reviewed. PMID- 3315532 TI - [The srm mutations which reduce mitochondrial rho-mutability affect the stability of ring minichromosomes in Saccharomyces cerevisiae]. PMID- 3315533 TI - [Molecular mechanisms of deletions induced as a result of double-strand DNA breaks]. PMID- 3315534 TI - [Analysis of the primary structure of gene sup1 and its protein product in connection with the possible evolutionary origin of the gene]. PMID- 3315535 TI - Esaprazole in the treatment of gastric ulcer: preliminary clinical trial. AB - The activity and tolerability of esaprazole administered once a day at doses of 900 and 1350 mg/day in the treatment of gastric ulcer were evaluated in a preliminary study carried out in 47 patients. The results failed to show any difference between the two doses in terms of percentage of ulcer healing after 4 weeks (43% and 45% respectively) or 8 weeks (86% and 82%), or in the course of symptoms and signs, which improved rapidly. The safety of esaprazole was good, no modifications of laboratory parameters being observed. Although the study involved only a small number of patients, the findings obtained indicate the potential usefulness of esaprazole in the treatment of gastric ulcer. PMID- 3315536 TI - A study on the prevention of duodenal ulcer recurrence with pirenzepine. AB - A double-blind, controlled study with either 50 mg of pirenzepine or a placebo once a day was performed in 128 patients to determine the effect of pirenzepine against relapses of duodenal ulcer, the healing of the subjects' former ulcers having been confirmed endoscopically. The study lasted 12 months at longest; endoscopy was performed at 3,6,9 and 12 month intervals during the study, as well as when subjective symptoms developed. Cumulative non-relapse rates were obtained every 3 months according to the life expectancy table; at 3 and 6 months, they were 85.7% and 73.0% for the pirenzepine group and 67.9% and 49.0% for the placebo group, thus indicating significantly lower relapse rates in favour of the pirenzepine group (p less than 0.05). There was no significant difference between the two groups with regard to the 12-month cumulative non-relapse rate. Comparison of background factors in relapsed and non-relapsed cases suggested that relapses were more frequent among pirenzepine-treated patients who had required a shorter course of treatment or had received H2 antagonists in the treatment of their previous ulcer. Relapses of duodenal ulcer were closely correlated with relapses of subjective symptoms, but there was no significant difference between the pirenzepine group and the placebo group with regard to the frequency of subjective symptoms at the time of ulcer recurrence. Pirenzepine, like H2 antagonists, proved to prevent ulcer relapses temporarily. The relapse rate with the compound appeared to be higher in cases where the former ulcer had been treated with H2 antagonists. PMID- 3315537 TI - Long-term therapy with biosynthetic human insulin: importance of short acting/intermediate-acting insulin ratio on determining efficacy of treatment. AB - This report describes the efficacy of biosynthetic human insulin (BHI) in long term (one year) therapy of type I diabetic patients previously treated with conventional insulins. The results were compared with those obtained in a group of diabetic patients kept on their usual treatment. In the latter, fasting plasma glucose, HbA1, insulin dose and relative proportions of insulin formulations remained constant throughout the study. In patients switched to BHI, hypoglycaemic episodes occurred during the first week of treatment and fasting plasma glucose was higher than basally at the first two visits (7th and 30th days). Both hypoglycaemia and high fasting plasma glucose were avoided by reducing the amount of short-acting insulin and increasing that of intermediate acting insulin, so that the short-acting/intermediate-acting insulin ratio was significantly lower during BHI therapy, although the total daily insulin dose remained unchanged. HbA1 levels remained fairly constant throughout the study. It was concluded that in order to achieve full clinical efficacy of BHI, it is important to modify the proportions of short- and intermediate-acting insulin preparations accurately when switching patients from conventional insulin to biosynthetic human insulin. PMID- 3315538 TI - Community-based approaches to highway safety: health promotion and drinking driving. AB - Traditional preventive tactics in road safety have emphasized technology, legislation and regulation. There is growing awareness and evidence that these methods need to be complemented with alternative approaches, particularly those that acknowledge the importance of life style as a determinant of risky driving. Accordingly, new approaches are emerging that emphasize the need for long-term, individual and community-based approaches in road safety, particularly as a tactic for addressing complex problems, like drinking-driving, that are determined by psychosocial and life style factors. PMID- 3315539 TI - Which NSAID? PMID- 3315541 TI - Aztreonam: a narrow spectrum against gram-negative aerobes. PMID- 3315540 TI - NSAIDS for renal and biliary colic: intramuscular diclofenac. PMID- 3315542 TI - [Indomethacin and furosemide in patients with cardiac insufficiency. Kidney function, the renin-angiotensin system and renal prostaglandins]. AB - Ten patients in heart failure of various etiologies underwent a placebo controlled study to determine the effect of indomethacin (150 mg daily by mouth) on urine volume, sodium chloride excretion, glomerular filtration rate, renal prostaglandins, as well as plasma renin and aldosterone concentrations before and after administration of 40 mg frusemide by mouth. None had hyponatremia and plasma renin levels were within normal limits, but prostaglandin synthesis inhibition by indomethacin significantly reduced urine volume (-50%), sodium excretion (-70%) and glomerular filtration rate (-50%), as well as the urinary excretion of prostaglandin E2 (-80%) and 6-keto-prostaglandin F1 alpha (-70%). Frusemide-induced diuresis was halved by indomethacin. The suppression of renal prostaglandin excretion induced by inhibition of cyclooxygenase was not much influenced by frusemide. Plasma renin and aldosterone concentrations after indomethacin administration were not significantly raised by frusemide. The results indicate that renal prostaglandin synthesis is of great importance in the pathophysiology and treatment of mild to moderate heart failure. PMID- 3315543 TI - [Singultus--causes and therapy]. PMID- 3315544 TI - [Escherichia coli O 157:H7 in hemorrhagic colitis]. PMID- 3315545 TI - [Diuretic therapy in renal insufficiency]. PMID- 3315546 TI - [Problems and results of heart valve replacement surgery]. PMID- 3315547 TI - [Aeromonas hydrophila as the causative agent of ileocolitis]. PMID- 3315548 TI - [Possibility of errors in conventional Doppler sonography of the carotid arteries]. AB - Results of Doppler sonography and angiography were compared in 100 consecutive patients with ischaemia in the area of carotid arterial supply. In 15 there were important differences. Three Doppler "occlusions" were angiographically demonstrated to be carotid arterial stenoses; significant additional information was provided by angiography in two patients with stenoses at the origin of the internal carotid artery, while in ten--despite unremarkable Doppler findings- angiography revealed disease in the carotids. PMID- 3315549 TI - [Management of rejection following heart transplantation using oral steroid medication]. AB - After 47 orthotopic heart transplantations with long-term immunosuppression (cyclosporin A, 3-10 mg/kg; azathioprine, 1-2 mg/kg; prednisolone 0.1 mg/kg) there were 306 episodes of acute rejection. In 44 of these (14.8%) the oral prednisolone dosage was increased, from a mean of 10.8 +/- 2.95 mg/d to 36.6 +/- 7.2 mg/d, followed by stepwise reduction to the original maintenance dose. Compared with the customary intravenous bolus administration (1.0 g/d for three days: success rate 89%), the oral schedule was successful in 33 of the 44 episodes of rejection (75%). It is concluded that in selected patients acute rejection episodes after heart transplantation can be successful treated by an increase in the oral dose of steroids without changing the dosage of the other two immunosuppressive drugs. PMID- 3315550 TI - [Acute tumor lysis syndrome]. PMID- 3315551 TI - [Choosing the right time for orthotopic liver transplantation. A transplantation index]. PMID- 3315552 TI - [Campylobacter pylori. Current aspect in gastritis and ulcer disease]. PMID- 3315553 TI - [Biliary shock-wave lithotripsy. Fragmentation and lysis--a new procedure]. AB - Between September 1986 and April 1987, extracorporeal shock-wave lithotripsy, supplemented by oral chemolitholysis, was undertaken on 157 patients with symptoms of gallstones. Partial or complete stone fragmentation was achieved in 148 (94.3%). Freedom from stones was maintained under continuous chemolysis treatment for an average observation period of 8.5 weeks in 31 (19.7%). Considerable fragment reduction was obtained in 97 (61.8%), of whom 26 (16.6%) were demonstrated to have only minimal stone residues. Insufficient fragmentation and (or) no response to litholysis occurred in 29 (18.5%). These preliminary results suggest that, if there are moderately sized (less than 25 mm) and only a few (1-3) noncalcified cholesterol stones, these two methods in combination promise to be an effective alternative to cholecystectomy. PMID- 3315554 TI - [Highly differentiated adenocarcinoma in a villous adenoma of the common bile duct near the papilla]. AB - A 65-year-old man, in hospital for treatment for bladder carcinoma, was by chance found also to have a so far asymptomatic obstructive jaundice with hydrops of the gallbladder. Endoscopic retrograde cholangiography revealed, in addition to a papilla distorted by tumour, a clearly obstructed choledochal duct with dilated intrahepatic bile ducts, caused by a 2-3 cm prepapillary intraductal choledochus tumour, which in the biopsy specimen corresponded to papillomatous structures with occasional medium-grade epithelial dysplasias. The patients, who initially declined operation, was five weeks later re-admitted with the clinical picture of an acute abdomen. In view of the history the surgeon performed a partial duodenopancreatectomy despite the acute emergency. Histology revealed a highly differentiated adenocarcinoma within a villous adenoma of the choledochal duct near the papilla. PMID- 3315555 TI - [Sperm transfer, insemination and their significance in Greek mythology]. PMID- 3315556 TI - [New perceptions in the area of insemination of domestic fowl using deep frozen sperm]. PMID- 3315557 TI - [Unusual case of a testicular tumor in a newborn calf]. PMID- 3315559 TI - [The value of statistical surveys based on examples from andrology]. PMID- 3315558 TI - [Control of the sexual cycle of beef heifers with PGF2alpha and GnRH (decapeptide) for natural mating in pastures]. PMID- 3315560 TI - [Collection and preservation of semen of the swamp beaver (Myocastor coypus)]. PMID- 3315561 TI - [Comparison of laboratory parameters after freezing bull sperm with a freezing machine and the usual freezing in nitrogen]. PMID- 3315562 TI - [Computer-controlled videomicrographic evaluation for the determination of sperm motility in the bull model]. PMID- 3315563 TI - [Effects of optical and acoustic stimuli on animal behavior]. PMID- 3315564 TI - [Modification of corpus luteum function and estrus induction in cattle by PGF2alpha]. PMID- 3315566 TI - [Renal glucose loss after intravenous glucose infusion in the calf]. PMID- 3315565 TI - [Differential symptomatology of painful illnesses in cattle]. PMID- 3315567 TI - [Production of transgenic rabbits by microinjection of a uteroglobin-CAT fusion gene into fertilized rabbit oocytes]. PMID- 3315568 TI - [Establishment of modern equine insemination centers]. PMID- 3315569 TI - [Is a male dog still fit for breeding after unilateral loss of a testis and epididymis?]. PMID- 3315570 TI - [The effect of nitrofurazone on the state of sperm in the stallion]. PMID- 3315571 TI - [New aspects of preservation of boar sperm by deep freezing in plastic tubes]. PMID- 3315572 TI - [Deep freezing of elephant semen]. PMID- 3315573 TI - Symposium on anisoylated plasminogen streptokinase activator complex (APSAC). Proceedings of an international symposium. Guernsey, 5-6 November 1986. PMID- 3315574 TI - Summary of early clinical experience with anisoylated plasminogen streptokinase activator complex in the treatment of acute myocardial infarction. AB - Preliminary investigations using a single intracoronary dose of APSAC (up to 30U) revealed dissolution of intracoronary thrombi in 59 of 83 patients (71%) with acute myocardial infarction, as indicated by reperfusion of coronary arteries. Reocclusion of arteries occurred in 20.5% of patients. Based on these findings, a subsequent study was undertaken in 302 patients with evidence of recent acute myocardial infarction. Single intravenous bolus doses of APSAC (5 to 30U) produced reperfusion in 79% of patients, with reocclusion occurring in only 9% of patients receiving the higher doses. Adverse effects included an initial hypotension/bradycardia reaction, a later syndrome featuring pyrexia, nausea and vomiting, and bleeding complications, including 4 patients with cerebrovascular accidents. In these early studies APSAC appeared to be as effective as streptokinase, as reported in the literature, and to produce a lower incidence of reocclusion than tissue plasminogen activator. PMID- 3315575 TI - Early clinical evaluation of the intravenous treatment of acute myocardial infarction with anisoylated plasminogen streptokinase activator complex. AB - 50 consecutive patients with acute myocardial infarction and symptoms of less than 4 hours duration were treated with anisoylated plasminogen streptokinase activator complex (APSAC) 30U intravenously as a bolus injection over 5 minutes. An open infarct-related artery was found in 32 patients (64%) when the first coronary angiography was taken 66 +/- 21 minutes after APSAC. Complete reperfusion was subsequently seen in 10 of 18 patients with an occluded infarct related artery 74 +/- 16 minutes after injection of APSAC. Thus, a patient infarct-related artery was seen in 42 patients (84%) within 68 +/- 20 minutes. A control coronary angiography was performed in 37 patients (74%) after 25 +/- 19 days. Reocclusion was found in 5 patients. The minimal cross-sectional area of the residual coronary stenosis increased from 1.3 +/- 0.9 mm2 to 1.8 +/- 1.9 mm2. Patients with residual thrombi after coronary thrombolysis (n = 13) demonstrated an increase of the minimal cross-sectional area of the residual stenosis from 1.2 +/- 0.8 to 2.6 +/- 2.3 mm2, whereas those without residual thrombi showed only minor changes of the minimal cross-sectional area (1.3 +/- 0.9 to 1.2 +/- 1.2 mm2). Thus, APSAC demonstrated a high patency rate and a low reocclusion rate after intravenous administration. The prolonged fibrinolytic activity of APSAC leads to a further regression of the residual coronary stenosis among patients with coronary thrombi after reperfusion. PMID- 3315576 TI - Achievement of coronary artery patency by use of anisoylated plasminogen streptokinase activator complex in acute myocardial infarction. AB - Anisoylated plasminogen streptokinase activator complex (APSAC) is a recently developed thrombolytic agent with high fibrin-binding potential and sustained release pharmacokinetics (plasma half-life 70 minutes). Following studies of its intracoronary use, the efficacy was examined, in an open study using coronary angiography, of a single bolus dose of 30U given intravenously to 94 patients within 6 hours (mean 2.97 hours) from the onset of symptoms of myocardial infarction. After thrombolytic therapy, patency of the left anterior descending artery was demonstrated in 32 of 42 patients with anterior infarctions (76%), and in 12 of 13 patients with circumflex (92%) and 28 of 36 with right coronary artery infarcts (78%) in the inferior infarction group. The overall incidence of reocclusion was 24%, which occurred within the first 12 days after hospitalisation. Successful thrombolysis was associated with rapid resolution of the acute ST segment change, and an early peak of creatine phosphokinase (CK) compared with patients whose vessels remained occluded. No major systemic bleeding complications were experienced. Single dose intravenous APSAC appears to be a highly effective and relatively safe thrombolytic agent which has the major advantage over other such agents of easier administration. This makes it suitable for use in district hospitals and in the community, as well as in specialised cardiac centres. PMID- 3315577 TI - Dose-ranging studies of anisoylated plasminogen streptokinase activator complex. Studies in healthy volunteers and in patients with acute myocardial infarction. AB - Anisoylated plasminogen streptokinase activator complex (APSAC) is well tolerated when given as an intravenous bolus dose over 2 to 4 minutes. The intravenous administration of 30U was rapidly effective in patients with coronary artery occlusion, with 82% of successfully treated patients responding to the initial APSAC dose after a mean time of about 30 minutes. The plasma fibrinogen and plasminogen concentrations decreased in all patients receiving APSAC 30U, which indicates that APSAC at this dose is not sufficiently fibrin-specific to dissolve thrombi without producing a lytic state. Side effects, complications and mortality were as expected for thrombolytic agents, with only 1 bleeding episode other than at the catheterisation site. Thus, APSAC offers unique advantages of rapid and simple bolus intravenous administration, with reperfusion rates achieved that are similar to those expected for intracoronary streptokinase and for intravenous tissue plasminogen activator. PMID- 3315579 TI - A randomised placebo-controlled pilot dose-response study with anisoylated plasminogen streptokinase activator complex in acute coronary artery occlusions. AB - The aim of this study was to determine the dose-response relationship of anisoylated plasminogen streptokinase activator complex (APSAC) by means of a between group double-blind comparison of the new agent and placebo. 50 patients with symptoms of acute myocardial infarction of less than 6 hours duration and whose coronary artery occlusion had been confirmed by coronary angiography were randomly allocated to 5 treatment groups (15, 20, 25 or 30U of APSAC, or placebo) and treatment was given as an intravenous injection over 2 minutes. Angiography was performed again at 15, 30, 45, 60 and 90 minutes and the films were assessed centrally by 2 independent cardiologists. Six patients were excluded from the angiographic analysis, 4 because their angiograms revealed patent arteries before APSAC was administered, 1 patient was excluded because streptokinase had been infused just after randomisation because of cardiogenic shock and 1 because the angiogram was not available due to problems in the film development. Clinical and laboratory examinations carried out for 72 hours after treatment showed that the drug was well tolerated. The reperfusion rates were as follows: placebo, 0/9; APSAC 15U, 5/8; APSAC 20U, 5/9; APSAC 25U, 6/9; APSAC 30U, 5/9. Reperfusion was achieved in 60% of treated patients but no dose relationship was revealed. PMID- 3315578 TI - Physiological balance of haemostasis and bleeding. AB - A complex series of cellular and molecular interactions is involved in fibrinolysis, which is controlled by mechanisms that provide for localised activation or suppression without systemic effects, thereby providing an orderly process of haemostasis, healing and response to thrombotic injury. Excessive or deficient fibrinolysis may be congenital or acquired, the latter including iatrogenic interventions, and such variations in the balance may result in accelerated recovery from disease or a thrombotic or haemorrhagic complication. PMID- 3315580 TI - A placebo-controlled patency study of intravenous anisoylated plasminogen streptokinase activator complex 30U in acute myocardial infarction. PMID- 3315581 TI - Intravenous anisoylated plasminogen streptokinase activator complex versus intravenous streptokinase in evolving myocardial infarction. Preliminary data from a randomised multicentre study. AB - The efficacy of a single intravenous bolus of anisoylated plasminogen streptokinase activator complex (APSAC 30U in 4 to 5 minutes) versus an intravenous infusion of streptokinase (1.5 X 10(6) U in 60 minutes) was assessed in 86 patients with evolving myocardial infarction of less than 6 hours duration in a cooperative randomised study. The patency of the infarct-related artery was assessed by coronary angiography at, on average, 90 minutes after therapy (mean time: APSAC 95 minutes, streptokinase 105 minutes). The treatment groups were similar with respect to sex, age, location of myocardial infarction and the delay from onset of pain to treatment. The 90-minute patency rate (grade 2 to 3) was 71.8% in the APSAC group and 55.8% in the streptokinase group; the difference was not statistically significant. There was no difference between the drop in fibrinogen concentrations in the 2 groups at 3 or 24 hours. The minimal concentration obtained at the first assessment was +/- 0.2 g/L in the streptokinase group and 0.5 g/L in the APSAC group. One patient in the APSAC group, who had a previous meningeal bleeding, had a non-fatal cerebrovascular accident. In a subgroup of 38 patients who had 3 control coronary angiograms at 90 minutes, 24 hours and 3 weeks, the patency rate was 63, 82 and 93%, respectively, in the APSAC group and 48, 88 and 92%, respectively, in the streptokinase group (the difference was not statistically significant). None of the patients in the APSAC group presented with reocclusion, whilst 3 patients in the streptokinase group had reocclusions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315582 TI - An interim report of a double-blind placebo-controlled recanalisation study of anisoylated plasminogen streptokinase activator complex in acute myocardial infarction. AB - This is an interim report of the initial 36 patients entered into the first double-blind, placebo-controlled invasive arteriographic study of intravenous anisoylated plasminogen streptokinase activator complex (APSAC) for coronary recanalisation in acute myocardial infarction. Coronary arteriography was performed before and 90 minutes after a single intravenous bolus injection of APSAC or placebo given over 2 to 5 minutes. Pretreatment coronary arteriography was performed in 36 patients at a mean time of 189 +/- 75 minutes after the onset of symptoms. 28 patients had occluded infarct-related coronary arteries and were randomised to receive APSAC 30U (n = 15) or placebo (n = 13) by intravenous injection 195 +/- 72 minutes after the onset of symptoms. Coronary arteriography 90 minutes after treatment demonstrated recanalisation of the infarct-related coronary artery in 8 APSAC-treated patients compared with only 1 placebo-treated patient (p less than 0.02). Repeat coronary arteriography 3 days after treatment showed reocclusion in 1 of the 8 APSAC-treated patients and persistent perfusion in the single patient who reperfused on placebo. All patients with patent vessels at pretreatment coronary arteriography (3 APSAC, 5 placebo) remained patent throughout the study period. There were no haemorrhagic complications related to APSAC therapy. These data confirm that APSAC is a safe, effective thrombolytic agent which, when administered by the intravenous route, resulted in a 53% recanalisation rate. PMID- 3315583 TI - Comparison of intravenous anisoylated plasminogen streptokinase activator complex with intracoronary streptokinase in acute myocardial infarction. AB - In a randomised trial the efficacy and safety of anisoylated plasminogen streptokinase activator complex (APSAC) administered intravenously and streptokinase administered by intracoronary infusion were compared in patients with proven acute myocardial infarction. Occlusion of the infarct-related vessel, reperfusion and reocclusion were all assessed angiographically. Fibrinolytic therapy was started within 4 (mean 2.4) hours of the onset of symptoms. 85 patients entered the study; 42 were treated with a single intravenous injection of APSAC (30U) given over 3 to 5 minutes and 43 with an intracoronary infusion of streptokinase (250,000U) given over 60 minutes. 12 patients were excluded because of protocol violation. Reperfusion at 90 minutes was confirmed in 23/36 patients (63.9%) in the APSAC group and 25/37 (67.6%) in the streptokinase group; at 24 (+/- 6) hours reocclusion had occurred in 1/22 (4.5%) and 4/23 (13.0%) patients in each group, respectively. These results indicate that APSAC (30U intravenously) is as effective as intracoronary streptokinase (250,000U). The major advantages of APSAC in acute myocardial infarction are its rapid, convenient administration and its low rate of arterial reocclusion. PMID- 3315584 TI - Reperfusion in acute myocardial infarction. A multicentre randomised trial of early intracoronary streptokinase and intravenous anisoylated plasminogen streptokinase activator complex in the United States. AB - To compare the reperfusion potential of anisoylated plasminogen streptokinase activator complex (APSAC), administered intravenously, and intracoronary streptokinase (the accepted standard for comparison in the United States), a randomised multicentre reperfusion trial was undertaken in the United States. A preliminary evaluation of results was made, based on the first 93 patients. Patients with acute myocardial infarction were studied angiographically, and those with coronary occlusion grade 0 or 1 were randomised and treated within 6 hours from symptom onset (mean 3 hours 25 minutes) with intracoronary streptokinase (20,000U bolus, then 2000 U/minute), or APSAC (30U over 2 to 4 minutes). Reperfusion was defined by a blinded reader as grade 2 or 3 flow after 90 minutes. Entry characteristics of patients in the 2 groups were comparable. Reperfusion rates were similar [19/39 (49%) of evaluable streptokinase patients and 19/43 (44%) of APSAC patients] and were dependent on the initial occlusion grade [38% of patients with grade 0 (streptokinase = 10/27, APSAC = 13/34), but 71% of patients with grade 1 (9/12, 6/9, respectively); p less than 0.02]. Grade 1 occlusion was present in 30% of patients treated within 4 hours, versus 16% treated at over 4 hours (p = 0.3). APSAC as a 2 to 4 minute infusion was well tolerated, and the change in mean blood pressure was minor (-6 mm Hg). Thus, APSAC and streptokinase provide similar reperfusion results, but APSAC is easier to administer, and shows excellent haemodynamic tolerance. PMID- 3315585 TI - Acute coronary occlusion and reperfusion. Reliability of angiographic classification and grading. AB - 93 patients with acute myocardial infarction entered into a multicentre, randomised fibrinolytic therapy study underwent coronary angiography prior to treatment with intracoronary streptokinase or intravenous anisoylated plasminogen streptokinase activator complex (APSAC). Subsequent to administration of fibrinolytic therapy, coronary arteriography of the infarct-related artery was also performed at 15, 30, 45, 60, 75 and 90 minutes. Angiographically defined coronary perfusion was graded as follows: grade 0--no perfusion; grade 1--vessel penetration by contrast without perfusion; grade 2--partial perfusion with delayed flow and/or clearance; grade 3--normal flow and clearance. Two independent readers at separate sites reviewed all serial angiograms with consensus achieved with a third reader. Disagreement potentially affecting therapeutic outcome (grades 1 vs 2, 0 vs 2, 0 vs 3, and 1 vs 3) occurred for only 15 angiographic views. Evaluation of agreement by the K index demonstrated a reasonable level of agreement for all grades (K = 0.73). In order to assess the effect of angiographic classification and timing upon reperfusion percentage rates, 4 reperfusion criteria were applied to these serial angiograms: group A = grade 2 or 3 flow at 90 minutes; group B = grade 2 or 3 flow at any time; group C = grade 1, 2 or 3 flow at any time in patients with control grade 0 or 1 flow; group D = grade 1, 2 or 3 flow at any time in patients with only grade 0 flow at control. Percentage reperfusion varied widely depending upon reperfusion criteria: group A: streptokinase 49%, APSAC 44%; group B: streptokinase 70%, APSAC 50%; group C: streptokinase 86%, APSAC 67%; group D: streptokinase 79%, APSAC 59%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315587 TI - Anisoylated plasminogen streptokinase activator complex versus streptokinase in acute myocardial infarction. Preliminary results of a randomised study. AB - 25 patients with acute myocardial infarction pain lasting more than 20 minutes which was not relieved by nitrates, whose ECGs showed ST segment elevations of 1 mm or more in 2 or more ECG leads, and who presented less than 3 hours after onset of their symptoms were randomly assigned to one of 2 thrombolytic treatment groups: a single intravenous bolus of anisoylated plasminogen streptokinase activator complex (APSAC) 30U in 5 minutes or an intravenous infusion of streptokinase 1,500,000U over 60 minutes. 3 to 4 hours after the administration of the thrombolytic agent, all patients received intravenous heparin at full dosage for 24 hours. The patency of the infarct-related coronary vessels was assessed by angiography 1 to 4 hours after administration of the thrombolytic agent. Clinical signs, ECGs, pulse, blood pressure and temperature were monitored regularly for 24 hours after treatment or as clinically appropriate. APSAC seemed to be at least as effective as streptokinase in terms of patency of the infarct related vessel (92% vs 63%, respectively). The adverse events were similar and none was life-threatening. APSAC and streptokinase caused similar falls in blood fibrinogen levels. APSAC, given as a bolus injection over 5 minutes, was easier to administer than streptokinase, which was given as an infusion during 60 minutes. PMID- 3315586 TI - Evaluation of 2 intravenous thrombolytic agents (anisoylated plasminogen streptokinase activator complex versus streptokinase) in patients with acute myocardial infarction. AB - Ten patients with symptoms of acute myocardial infarction of less than 6 hours duration were randomised to receive either anisoylated plasminogen streptokinase activator complex [APSAC] (30U) or streptokinase (1,500,000U) intravenously. The aims of the study were to compare the angiographic patency of the infarct-related coronary arteries and to monitor drug safety and tolerance for up to 24 hours. The left anterior descending artery was occluded in 3, the left circumflex in 3 and right coronary artery in 4 patients. Time between onset of pain and treatment ranged from 150 to 330 minutes. At 90 minutes, 8 patients, 3 of 5 (60%) of the APSAC group and all of the streptokinase group, had patent arteries. No significant differences were found in measurements of coagulation. There were no haemorrhagic complications. One patient of the APSAC group had reinfarction 6 hours after treatment and died in cardiogenic shock. APSAC seems safe and is easier to use than streptokinase, and both agents result in patency in the majority of patients, although too few patients were included to allow a valid comparison. However, thrombolysis should be considered only a temporary solution in acute myocardial infarction, associated mainly with 3-vessel disease. PMID- 3315588 TI - Intracoronary streptokinase versus intravenous anisoylated plasminogen streptokinase activator complex in the treatment of acute myocardial infarction. AB - As part of a randomised multicentre study, 16 patients with acute myocardial infarction were treated with either anisoylated plasminogen streptokinase activator complex (APSAC) administered as an intravenous bolus of 30U or 250,000U of streptokinase by the intracoronary route. The reperfusion was documented angiographically during a 90-minute period and possible reocclusion was assessed at 90 minutes and 24 hours after the start of therapy. The percentage of reperfusion obtained in the APSAC group was 83% versus 63% in the streptokinase group. One reocclusion was seen after 24 hours in the APSAC group. Fibrinolytic activity was more pronounced in the APSAC group but there were no major bleeding problems in either group. The administration of 30U of APSAC by an intravenous bolus injection produced results at least as good as those obtained with intracoronary streptokinase and in addition offered the advantage of a simpler and quicker administration. PMID- 3315589 TI - Intravenous bolus application of streptokinase and of anisoylated plasminogen streptokinase activator complex in acute myocardial infarction. Clinical and haemostaseological findings. PMID- 3315590 TI - Evaluation of the efficacy and safety of anisoylated plasminogen streptokinase activator complex in early myocardial infarction. Preliminary results. PMID- 3315591 TI - Left ventricular function after anisoylated plasminogen streptokinase activator complex. AB - Limitation of the reduction in left ventricular function after acute myocardial infarction is an important indicator of benefit following thrombolytic therapy. Therefore, left ventricular function was studied by radionuclide ventriculography in 91 patients entering 3 separate studies of anisoylated plasminogen streptokinase activator complex (APSAC) administered within 4 hours of acute myocardial infarction. Global left ventricular ejection fraction was measured at 10 days and at 6 months to assess early and late effects of therapy, with particular emphasis on the timing of treatment and the site of infarction. Successful therapy with APSAC in anterior infarction resulted in preservation of left ventricular function at 10 days. The magnitude of benefit declined with increasing symptom duration before treatment, and was maintained at 6 months in those patients without reocclusion. The benefit of successful therapy was less marked in the inferior infarct group at 10 days. By 6 months, no significant benefit was detected because of an increase in ejection fraction in the placebo and occlusion or reocclusion group with inferior infarction. Early therapy results in greater preservation of left ventricular function, and recovery of function may be more rapid than with later treatment. More emphasis on early administration of thrombolytic therapy is indicated. PMID- 3315592 TI - Electrocardiographic and enzymatic infarct size in a randomised study of intracoronary streptokinase and intravenous anisoylated plasminogen streptokinase activator complex in acute myocardial infarction. AB - The effect of thrombolytic therapy on ECG and enzymatic indices, including estimates of relative infarct size, was studied in 93 patients with acute myocardial infarction randomised to intracoronary streptokinase or intravenous anisoylated plasminogen streptokinase activator complex (APSAC) therapy within 6 hours of the onset of symptoms. 90 minutes after treatment, 49% (19/39) of the evaluable streptokinase patients and 44% (19/43) of the APSAC patients had reperfused (p = NS). The time from treatment to reperfusion was less in the streptokinase patients (30 +/- 18 minutes for streptokinase and 42 +/- 22 minutes for APSAC, p less than or equal to 0.02). Resolution of ST segment elevation, 90 minutes after treatment, was greater in the streptokinase patients (residual ST segment elevation 47 +/- 36% of initial value for streptokinase and 70 +/- 49% for APSAC, p less than or equal to 0.06) and in the patients reperfused by either agent (residual ST segment elevation 46 +/- 34% for reperfused and 68 +/- 52% for non-reperfused, p less than or equal to 0.10). ECG infarct size at discharge, determined by sum of Q waves and a 29-point QRS score, relative to the degree of initial ST segment elevation was similar in the streptokinase and APSAC patients, but smaller in reperfused than non-reperfused patients (p less than or equal to 0.01 for sigma Q). Peak serum creatine kinase and MB isoenzyme of creatine kinase levels were similar in the streptokinase and APSAC, and in reperfused and non reperfused patients. Lower peak lactic acid dehydrogenase and especially lactic acid dehydrogenase isoenzyme values (by 16% and 22%, respectively) were observed in reperfused patients, but differences did not achieve significance. However, the time to peak enzyme levels was significantly shorter in the reperfused patients. Early intracoronary streptokinase and intravenous APSAC therapy have similar effects on ECG and enzymatic infarct size. Reperfusion by either agent, given at a mean of 3 hours 25 minutes, may reduce estimates of infarct size modestly. PMID- 3315593 TI - The effect of thrombolytic therapy with anisoylated plasminogen streptokinase activator complex on the indicators of myocardial salvage. AB - The role of anisoylated plasminogen streptokinase activator complex (APSAC) in acute myocardial infarction, in effecting thrombolysis, in limiting infarct size and in preserving myocardial function, was assessed by comparing APSAC and placebo in a double-blind, randomised trial. Between October 1984 and April 1985, 43 patients (mean age 57.3 years) with evolving infarctions (19 anterior/24 inferior) were randomised. All patients received treatment within 3 hours of the onset of pain. Patients over 70 years of age or with contraindications to thrombolytic therapy were excluded. Response to therapy was assessed by comparing reductions in summated ECG R wave amplitude and changes in QRS score at 24 hours and 7 days in the leads with ST abnormalities on admission. Radionuclide ejection fractions (EF) were performed 2 to 6 months after infarction. Evidence of successful reperfusion was based on non-invasive parameters. Mean time to peak cardiac enzyme release was shorter in the active treatment group, indicating effective thrombolysis (11.5 hours vs 17.6 hours; p less than 0.01). No differences were found in R wave reduction or QRS score at either 24 hours or 7 days, between active and placebo groups in total or when divided by infarct site. No difference was seen between the EFs of the groups in total or between inferior infarct groups. The mean EF of the treated anterior group was higher than that of the untreated group (p less than 0.05). Successful thrombolysis was seen in the actively treated group. Evidence of myocardial salvage and preservation was seen among treated patients with anterior infarcts only. PMID- 3315594 TI - Assessment of left ventricular function in a randomised study of intravenous anisoylated plasminogen streptokinase activator complex versus heparin in acute myocardial infarction. Preliminary results of the European Multicentre Study (Belgian Centres). AB - Patients admitted within 4 hours of the onset of chest pain suggestive of acute myocardial infarction were randomised to either intravenous anisoylated plasminogen streptokinase activator complex (APSAC) 30U or heparin 5000U (44 vs 38 patients). Angiograms were obtained between days 10 and 15 after admission. Late coronary patency was recorded in a significantly higher proportion of patients in the APSAC group (79% vs 42%, p less than 0.001). The global ejection fraction showed only a favourable trend: 55.3 +/- 12% for the APSAC group vs 54.1 +/- 13.1% for the heparin group; this trend was only observed in the inferior infarction group. Regional wall motion analysis did not show any significant difference between treatment groups. PMID- 3315595 TI - Recent clinical developments in thrombolysis in acute myocardial infarction. AB - Intracoronary streptokinase can accomplish reperfusion in 70 to 75% of patients with acute myocardial infarction (AMI), and intravenous streptokinase in approximately 50% of those with prior documented coronary occlusion. The time constraints for accomplishing significant myocardial salvage have proved to be quite restrictive, however. Studies in which treatment has begun after an average of 4 hours of symptoms have not shown significant improvement in ventricular function. In contrast, those in which intervention has been applied earlier, particularly in less than 2 to 3 hours, have consistently shown benefit. The price for applying thrombolytic therapy includes the risk of severe bleeding (about 5%) but, fortunately, mortality as a result of bleeding has been rare (less than or equal to 0.5%). Reperfusion may be only transient or incomplete (and insufficient). An early reocclusion rate of about 15 to 20% has been commonly noted, in fact. Recently, major studies have pointed to a reduction in early mortality in patients treated early (within about 3 hours) after the onset of symptoms. Much interest is now being focused on developing safer, more effective thrombolytic agents such as tissue plasminogen activator and anisoylated plasminogen streptokinase activator complex (APSAC). Adjunctive therapy with coronary angioplasty is also being applied. In the judgement of many, reperfusion therapy may represent the greatest advance in the approach to AMI of the current decade. PMID- 3315596 TI - Treatment of acute myocardial infarction with anisoylated plasminogen streptokinase activator complex in a district hospital. Efficacy data. PMID- 3315597 TI - Randomised multicentre trial of anisoylated plasminogen streptokinase activator complex versus heparin. Interim results. PMID- 3315598 TI - AIMS. The design and conduct of a multicentre mortality study comparing placebo and anisoylated plasminogen streptokinase activator complex 30 units intravenously for the treatment of acute myocardial infarction of less than 6 hours duration. UK APSAC Advisory Committee. PMID- 3315599 TI - Should we intervene following thrombolytic therapy? The SWIFT study in progress. UK APSAC Advisory Committee. PMID- 3315600 TI - Prehospital administration of anisoylated plasminogen streptokinase activator complex in acute myocardial infarction. AB - 25 patients have been included in a randomised trial aimed to compare prehospital and hospital administration of anisoylated plasminogen streptokinase activator complex (AP-SAC). Patients were first seen, at home, by a noncardiologist doctor working in a mobile-care unit and were then evaluated for entry into the study. If they had evidence of myocardial infarction lasting for less than 3 hours and if there was no contraindication to thrombolytic therapy they were randomly allocated to APSAC 30U or placebo. They were next referred to an intensive coronary unit (ICU). On arrival in the ICU patients were reevaluated and received APSAC if they had previously received placebo. For 24 patients, diagnosis of myocardial infarction was confirmed. One patient died at home after having received placebo. There was 1 hospital death. At-home injection was made within a median of 124 minutes after the beginning of pain, whereas hospital administration was made after a median of 180 minutes. On a clinical basis reperfusion occurred in 16 out of 21 evaluable patients. Four patients had coronary artery bypass graft surgery and 9 had angioplasty. We conclude that prehospital administration of APSAC is feasible, well-tolerated and is a good way to shorten the delay of thrombolytic treatment in myocardial infarction. PMID- 3315601 TI - Fibrinogen concentration and coronary artery reperfusion after intravenous anisoylated plasminogen streptokinase activator complex or intracoronary streptokinase therapy. AB - In a US study, anisoylated plasminogen streptokinase activator complex (APSAC), 30U intravenously over 2 minutes, was compared with streptokinase, about 150,000U by intracoronary infusion over 60 minutes. Included in the study were 106 patients with acute myocardial infarction for whom both angiographic data and coagulation study results were available. 58 of these patients received APSAC and 48 streptokinase. The degree of hypofibrinogenaemia and the percentage of patients who had a drop of greater than 10% in plasma fibrinogen was more evident with high dose intravenous APSAC treatment than with lower dosages of intracoronary streptokinase. This laboratory abnormality was not predictive of successful reperfusion in APSAC-treated patients. The dose of streptokinase administered was not correlated with the presence or absence of the lytic state or with reperfusion. However, 10 patients treated with streptokinase showed reperfusion without an apparent effect on the fibrinogen concentration and further studies are needed to determine whether treatment effects were limited to the coronary artery by regional infusion. Similarly, 2 APSAC-treated patients had groin bleeding without a decrease in plasma fibrinogen. Therefore, a final conclusion regarding the contribution of a lytic state to bleeding must await further analysis. PMID- 3315603 TI - Analysis of coagulation and fibrinolysis after intravenous anisoylated plasminogen streptokinase activator complex or heparin in patients with acute myocardial infarction. A Belgian multicentre study. AB - A multicentre randomised trial including 87 patients admitted for acute myocardial infarction compared the effects of a single intravenous bolus of an anisoylated plasminogen streptokinase activator complex (APSAC) 30 units with those of heparin treatment on haemostasis during the first 4 days after treatment. In the APSAC group, a rapid and significant reduction in fibrinogen, plasminogen and alpha 2-antiplasmin was observed, associated with an increase of fibrin(ogen) degradation products, reflecting a strong systemic lytic activity. None of these parameters were significantly modified by heparin, but the anticoagulant effect was apparent as assessed by the activated partial thromboplastin time. The systemic fibrinolysis induced after different regimens of streptokinase infusion demonstrated that an intravenous bolus of APSAC 30U was as potent as streptokinase 500,000 or 1,500,000IU administered intravenously over 45 minutes and definitely more fibrinolytic than intracoronary infusion of streptokinase 250,000IU. Despite the demonstrated fibrin specificity of the drug at a low dose, a high dose of APSAC (30U intravenously) induced an important systemic lytic state for at least 12 hours. PMID- 3315602 TI - Systemic effects of anisoylated plasminogen streptokinase activator complex and streptokinase therapy in acute myocardial infarction. Coagulation aspects of the Dutch Invasive Reperfusion Study. AB - The systemic effects of intravenous anisoylated plasminogen streptokinase activator complex (APSAC; 30U) and intracoronary streptokinase (250,000U) were compared in 54 patients with acute myocardial infarction. In 3 patients, no signs of a systemic lytic state were observed. In all other patients, significant reductions of coagulation and fibrinolytic factors occurred: fibrinogen levels decreased by 86% in the APSAC group and 81% in the streptokinase group; for plasminogen the decreases were 68 and 66%, and for alpha 2-antiplasmin activity greater than 95 and 94%, respectively. Fibrin(ogen) degradation products were increased 68- and 38-fold, respectively. Although there was a trend for the lytic state to be more profound in the APSAC-treated patients, there was no difference between treatment groups with regard to bleeding complications or therapeutic efficacy, the latter being 79 and 73%, respectively, for APSAC and streptokinase. Total fibrinolytic activity, measured as euglobulin clot lysis time, was sustained for longer in the APSAC group, which may explain the low reocclusion rate in this group in comparison with the streptokinase group. PMID- 3315604 TI - Anisoylated plasminogen streptokinase activator complex versus placebo. A preliminary multicentre study of safety and early mortality in acute myocardial infarction. AB - 90 patients were enrolled into this preliminary multicentre study of the efficacy and safety of 30 units intravenous anisoylated plasminogen streptokinase activator complex (APSAC) compared with placebo in patients with acute myocardial infarction. 45 patients received APSAC and 45 placebo; the groups were similar for age, weight and site of infarction. There were significantly more women treated with APSAC (p less than 0.02). The mean time to treatment was 3.3 hours after symptoms of myocardial infarction for APSAC and 3 hours for placebo. The 30 day mortality was 7 patients in the placebo group and 1 in the APSAC group (p = 0.058). Adverse events were generally minor and were of similar overall frequency in both groups. There were more haemorrhagic events with APSAC, from which all patients recovered, and more cardiovascular events with placebo including 2 deaths from cardiogenic shock. APSAC showed a trend towards a reduction in 30-day mortality. Experience from this study has led to the initiation of the APSAC in myocardial infarction multicentre mortality study (AIMS). PMID- 3315606 TI - Comparative tolerance and complications in a multicentre trial of intracoronary streptokinase and intravenous anisoylated plasminogen streptokinase activator complex in acute myocardial infarction. AB - The safety and tolerance data of the preliminary results of a randomised, parallel group, multicentre trial of intracoronary streptokinase and intravenous anisoylated plasminogen streptokinase activator complex (APSAC) in patients with myocardial infarction are presented. The frequency of side effects was similar in the 2 groups. The most frequently encountered side effect was bleeding, overwhelmingly from the groin puncture site from angiography. There was no significant difference between amount or incidence of bleeding complications between the two groups, as measured by number of bleeding episodes, transfusion requirements, or mean drop in haematocrit or haemoglobin. PMID- 3315605 TI - Biological study of intravenous anisoylated plasminogen streptokinase activator complex in acute myocardial infarction. AB - An anisoylated plasminogen streptokinase activator complex (APSAC) has been administered as a bolus intravenous injection of 30U to 14 patients with acute myocardial infarction. Systemic effects on coagulation and fibrinolysis were studied. In 1 patient, the treatment produced no biological modification, which could be explained by an increased streptokinase resistance in this patient, apparent from the sample collected before treatment. In the other patients, as expected, fibrinogen, plasminogen, alpha 2-antiplasmin and factors V and VIIIc fell dramatically, while there was an increase in serum fibrinogen degradation product concentrations. In addition, plasma fibrin derivatives increased during APSAC therapy, both in patients who had occluded or patent coronary arteries. Discrepancies were found between methods used to measure fibrinogen: with the Ellis and Stransky method, concentrations were higher than with the Clauss method; and for plasminogen, automated methods using different analysers may give higher results in some patients. PMID- 3315607 TI - Comparison of the safety and tolerance of intravenous anisoylated plasminogen streptokinase activator complex and intracoronary streptokinase in acute myocardial infarction. PMID- 3315609 TI - Treatment of acute myocardial infarction with anisoylated plasminogen streptokinase activator complex in a district hospital. Tolerance data. PMID- 3315608 TI - Safety and side effects of anisoylated plasminogen streptokinase activator complex and streptokinase in patients with acute myocardial infarction. Interim report of the IRS II Study. AB - 86 patients with a first myocardial infarction presenting within 6 hours of the onset of symptoms were randomly allocated to treatment with intravenous streptokinase or anisoylated plasminogen streptokinase activator complex (APSAC). Side effects were observed in 34.1% of patients (15 of 44) in the streptokinase group and 23.8% (10 of 42) in the APSAC group. These effects included injection related effects (in 4 patients on streptokinase versus 6 on APSAC) and neurological complications (0 vs 2 patients, respectively). Femoral haematoma accounted for the majority of bleeding events. Death occurred as a consequence of haemorrhage in 2 patients (1 receiving streptokinase and the other APSAC). PMID- 3315611 TI - Preliminary safety and tolerance data obtained in the comparative study of anisoylated plasminogen streptokinase activator complex versus heparin. AB - The safety/tolerance of anisoylated plasminogen streptokinase activator complex (APSAC) versus heparin therapy in acute myocardial infarction has been studied in the first 65 patients treated in a multicentre study. A transient marked hypotensive effect was observed in 2 patients on APSAC given over 2 minutes. Primary ventricular arrhythmias during the first 4 hours after treatment occurred in 16 APSAC-treated patients and in 7 patients who received heparin; in 88% of the cases on APSAC these arrhythmias were reported by the investigators as being associated with reperfusion. Vomiting, shivering and fever were reported transiently in 2 APSAC-treated patients. Bleeding occurred in 7 patients in the APSAC group; none of these required transfusions, but the heparin dosage was adjusted in 1 patient. A reduction of blood haemoglobin was observed in 4 APSAC- and 2 heparin-treated patients; these were possibly drug-related. Three patients on APSAC died, while in the heparin group 4 deaths were reported. PMID- 3315610 TI - Safety and tolerance data from the Belgian multicentre study of anisoylated plasminogen streptokinase activator complex versus heparin in acute myocardial infarction. AB - In the European Multicentre Study (EMS), the safety and efficacy of a single 30U intravenous injection of anisoylated plasminogen streptokinase activator complex (APSAC) was studied in patients with acute myocardial infarction. The present study discusses the Belgian data on safety and tolerance from the EMS study. 87 patients were randomised to treatment with APSAC or heparin. The reperfusion rate was 60.5% (APSAC) versus 20.5% (heparin control), and reocclusion occurred in 21% of the reperfused APSAC patients. Drug-related adverse events consisted of bleeding problems (7 events in patients on APSAC and 1 event in a patient on heparin and moderate allergic reactions (12 events in 9 patients on APSAC and 1 event in a heparin patient). There was 1 drug-related death in the APSAC group (hypovolaemic shock due to central vein puncture during lytic state) which could have been avoided. It is concluded that thrombolytic treatment of acute myocardial infarction with APSAC is effective and safe, as long as the standard precautions for thrombolytic treatment are respected. Bleeding and allergic-type events are infrequent, usually well tolerated and easily treated. PMID- 3315612 TI - An interim report of the efficacy and safety of anisoylated plasminogen streptokinase activator complex (APSAC). AB - Anisoylated plasminogen streptokinase activator complex (APSAC) is a thrombolytic agent which can be administered to patients with acute myocardial infarction by intravenous injection rather than prolonged infusion, and which has sustained fibrinolytic activity, inducing thrombolysis with a low risk of early rethrombosis. In clinical trials, APSAC 30U intravenously produced angiographically confirmed reperfusion in 86/156 patients (55%) and coronary patency (in the absence of pretreatment angiography) in 131/161 patients (81%) up to 90 minutes after treatment. These figures compared with a reperfusion rate of 65% (71/110 patients) for intracoronary streptokinase, and a patency rate of 53% (27/51 patients) with intravenous streptokinase. Reperfusion occurred at a mean of about 45 minutes after either APSAC or streptokinase, and APSAC was more effective when administered within 4 hours, than between 4 and 6 hours, after the onset of symptoms of infarction. Reocclusion occurred in 4% (3/80) of infarct related arteries assessed angiographically 1 to 3 days after APSAC, compared with 10% (7/74) after streptokinase. Preliminary analysis of mortality data from studies involving APSAC suggests a trend towards improved survival with APSAC in comparison with conventional therapy. Among 1855 patients treated with APSAC, and observed for periods of 1 month to 1 year, there have been 115 deaths (6.2%). This compares with a mortality of 12.3% among patients receiving non-thrombolytic therapy (n = 708). The results of large controlled mortality studies are awaited before evaluation of the precise extent of improvement with APSAC can be made. APSAC has been associated with relatively few serious side effects. Analysis of case records for 834 patients who received APSAC 30U intravenously revealed at least 1 suspected side effect in 44%, compared with in 33% of placebo-treated patients (n = 138). Cardiovascular (e.g. arrhythmias and reduction in blood pressure) and haemorrhagic events (mostly associated with puncture sites) were reported most frequently. Cerebrovascular accidents occurred in 15/1598 patients (0.9%) treated with APSAC, of which 10 cases could possibly have been related to treatment. Allergic-type reactions (e.g. anaphylaxis, bronchoconstriction, skin rashes) occurred in 61/1152 patients (5%) after APSAC and may have resulted from previous exposure to streptococcal infection. APSAC induces systemic fibrinogenolysis and a 'lytic' state characterised by reductions in fibrinogen, plasminogen, Factors II, V and VIII and alpha 2-antiplasmin, and an increase in fibrin degradation products, which return to normal over a period of 2 days.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3315613 TI - Preclinical pharmacological evaluation of anisoylated plasminogen streptokinase activator complex. AB - An ideal thrombolytic (or fibrinolytic) agent is one which would generate the formation of plasmin only where it is required, i.e. bound to fibrin within the thrombus. However, the capacity of even the newer thrombolytic agents to achieve localised plasmin generation within the thrombus is relative and depends on the concentration of the agent administered. For all available activators, the concentration required for effective clinical thrombolysis is also capable of converting plasminogen to plasmin within the circulation (plasminaemia). Since the action of plasmin is not specific to fibrin, plasminaemia results in dissolution not only of fibrin but also of several other clotting factors. For example, plasmin can degrade fibrinogen and cause impaired haemostasis. The plasminogen activators which are available, or have been developed to date, include streptokinase, urokinase, pro-urokinase, anisoylated plasminogen streptokinase activator complex (APSAC) and tissue plasminogen activator (t-PA). All of these agents have the same biochemical mechanism of action, cleaving an arginine-valine bond in the plasminogen molecule to form plasmin, but they differ with regard to other important properties. The first property to be considered is clot specificity; the ability to dissolve fibrin as opposed to fibrinogen, and also to dissolve the clot as opposed to a haemostatic plug. Unfortunately, fibrin specificity does not equate entirely with thrombus specificity, and all currently developed plasminogen activators, by dissolving fibrin, will induce the destruction of haemostatic extravascular plugs as well as intravascular thrombi. Thus, no agent is thrombus-specific in this respect. The degree of fibrinogenolysis does vary between plasminogen activators. Those which have the least effect on haemostasis or clotting capability would seem, at first, to be preferable. However, a short term reduction in fibrinogen could also be beneficial, since it may reduce the incidence of early reocclusion and, by reducing blood viscosity, improve microcirculation to the infarct zone. The intrinsic efficiency of the plasminogen activators is a second important property. In vitro, under conditions pertaining to the circulation, urokinase is about 10 times more efficient than t-PA at converting glu-plasminogen to plasmin (on the basis of the Vmax to Km ratio), while streptokinase-plasmin is 20 times more efficient. The efficiency of these activators is increased in the presence of fibrin and lys-plasminogen, 1800-fold for t-PA, 8-fold for urokinase and 180 fold for streptokinase-plasmin.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3315614 TI - Consequences of antibody binding in vitro on the pharmacological properties of anisoylated plasminogen streptokinase activator complex. PMID- 3315615 TI - Non-exchange of streptokinase from anisoylated plasminogen streptokinase activator complex and other acylated streptokinase-plasminogen complexes. PMID- 3315616 TI - Deacylation studies in vitro on anisoylated plasminogen streptokinase activator complex. PMID- 3315617 TI - Evidence for a sustained fibrinolytic response to anisoylated plasminogen streptokinase activator complex in vitro. PMID- 3315618 TI - Pharmacokinetic properties of anisoylated plasminogen streptokinase activator complex and other thrombolytic agents in animals and in humans. PMID- 3315619 TI - The preclinical toxicology of anisoylated plasminogen streptokinase activator complex. AB - The preclinical toxicological evaluation of anisoylated plasminogen streptokinase activator complex (APSAC) was designed with specific regard to the potential for immunogenic effects in animals arising from the high molecular weight of the complex. Animals were treated with multiples of the human dose by use of a dose regimen spanning that proposed clinically and in conventional repeat dose toxicity studies employing the maximum practicable dose level and duration. Few adverse effects were noted, despite the large doses administered with respect to the clinical dose. The thrombolytic activity of APSAC resulted in pronounced acute effects on blood coagulation times and fibrinogen levels in rats and dogs but there was little evidence of clinically relevant systemic toxicity in either species. Evidence of a possible effect on the liver was seen 24 hours after single doses much higher than the proposed human dose in the rat (40-fold higher) and dog (9-fold higher). No hepatic effects were apparent following repeated administration. The main adverse effect was focal acute myocarditis, which was seen only in rats of the Sprague Dawley strain. Administration of human plasminogen alone or in combination with streptokinase also produced this lesion, suggesting that plasminogen may play a central role in its appearance. Experiments in anaesthetised dogs showed APSAC to be devoid of undesirable haemodynamic effects. An intravenous acute toxicity study in rats with p-anisic acid, which is released on deacylation of APSAC, showed the levels of p-anisic acid which occur in humans to be of no toxicological significance. Finally, in a series of tests designed to investigate potential genetic toxicity, no mutagenic activity was detected. PMID- 3315620 TI - Tenoxicam. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. AB - Tenoxicam is a new non-steroidal anti-inflammatory and analgesic agent of the oxicam class, and therefore closely related to piroxicam. It possesses a long half-life which enables it to be administered once daily. Clinical trials in patients with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout and non-articular rheumatism suggest that tenoxicam 20mg daily is an equally effective anti-inflammatory and analgesic agent compared with piroxicam 20mg daily, and that it is at least as well tolerated. Additionally, a few small studies in rheumatoid arthritis and osteoarthritis suggest that tenoxicam 20mg daily is as effective and as well tolerated as usual therapeutic dosages of diclofenac, ibuprofen, indomethacin and naproxen. Transient mild or moderate gastrointestinal symptoms, in 8% of patients at a dosage of 20mg daily, are the most frequently reported side effects. If further studies confirm the initially favourable efficacy and tolerability findings, particularly the relatively low incidence of adverse effects, tenoxicam can be considered a useful new agent for the symptomatic treatment of rheumatic and inflammatory diseases, and a worthwhile alternative to other non-steroidal anti-inflammatory drugs. PMID- 3315623 TI - Intermittent claudication. An update on management. AB - The mainstay of treatment for claudication is reversal of risk factors, especially smoking, and the use of antiplatelet drugs and possibly pentoxifylline. A major factor in the long term management is atherosclerotic involvement in other parts of the circulation resulting in a shortened life span. Treatment should be directed at the disease in general, rather than in the legs alone. Patients disabled by claudication may gain symptomatic relief with relatively low risk using balloon angioplasty or vascular reconstructive procedures. PMID- 3315622 TI - Human insulin. A review of its biological activity, pharmacokinetics and therapeutic use. AB - Human insulin, whether produced by recombinant DNA techniques (biosynthetic, insulin crb) or enzymatic modification of porcine insulin (semisynthetic, insulin emp) is equivalent in biological activity to porcine insulin following intravenous administration. Slight differences between human and porcine insulin in hypoglycaemic activity after subcutaneous injection appear to be related to differences in absorption, and are unlikely to be of major clinical importance. Similarly, reported minor differences in counterregulator hormone response to human insulin compared with porcine insulin need further study, but they are unlikely to have important clinical implications. In clinical use the therapeutic efficacy of human insulin is similar to that of porcine insulin. The lower antigenicity with human insulin relative to purified porcine insulin is of potential therapeutic value, and it is logical to use human insulin in newly diagnosed diabetics, in patients treated intermittently with insulin, in cases of immunological insulin resistance, and in patients with allergy and local reaction against animal insulin. Thus, human insulin seems to have no disadvantages compared with purified porcine insulin and may have some advantages. While there appears to be no compelling reason to change patients whose diabetes is presently well controlled with purified porcine insulin to human insulin, the availability of human insulin at a price equal to or less than that of animal origin makes such a change logical. In the meantime, human insulin should be considered the insulin of 'first choice' for newly diagnosed diabetics requiring insulin therapy and in carbohydrate intolerance and diabetes occurring during pregnancy. PMID- 3315626 TI - Monoclonal antibodies for diagnosis and research in enteric nervous system pathology. A review. AB - Monoclonal antibodies (MAb) directed against neuron-specific epitopes are valuable tools in the diagnosis of congenital and acquired enteric nervous system anomalies. MAb raised against cytoskeleton proteins (neurofilaments) revealed a characteristic staining pattern in patients with various motility disorders of the gut. Application of MAb in the study of the development of the enteric nervous system in the chicken embryo provided new insights into the fate of migrating neural crest cells. The relationship between mesenchymal target cells in the gut and proliferating neural crest cells was studied by means of MAb raised against cell surface markers (HNK-1) in combination with characterization of the microenvironment using monoclonal antibodies raised against cell adhesion molecules (N-CAM). PMID- 3315624 TI - Ceforanide. A review of its antibacterial activity, pharmacokinetic properties and clinical efficacy. AB - Ceforanide is a 'second generation' cephalosporin administered intravenously or intramuscularly. It is similar to cefamandole and cefonicid in its in vitro superiority to 'first generation' cephalosporins against several species of Enterobacteriaceae as well as its activity against Haemophilus influenzae, including beta-lactamase-producing strains. Its activity against Staphylococcus aureus is less than that of cefamandole, cefuroxime and first generation cephalosporins. The in vitro activity against Neisseria gonorrhoeae is excellent. Pseudomonas, Acinetobacter and Serratia species, and Bacteroides fragilis are resistant, as are many strains of Proteus and Providencia species. The elimination half-life is relatively long, although shorter than that of cefonicid, and in most clinical trials ceforanide has been administered twice daily. It appeared to be comparable in therapeutic efficacy to procaine penicillin and cephazolin in the treatment of patients with community-acquired pneumonia, to cephazolin in the treatment of skin and soft tissue infections due to S. aureus or beta-haemolytic streptococci and to cefapirin in S. aureus endocarditis in parenteral drug abusers. Also, it was comparable in efficacy to cephalothin in the prophylaxis of infection in patients undergoing open heart surgery or vaginal hysterectomy, and to cephazolin in patients undergoing cholecystectomy. Thus, ceforanide is an alternative to first and certain other second generation cephalosporins in several important therapeutic and prophylactic situations. It has no advantage over other cephalosporins with regard to spectrum of antibacterial activity, but has a longer half-life than other second generation cephalosporins, except cefonicid, and can be administered according to a twice daily dosage schedule. PMID- 3315627 TI - Mouse spinal cord neurons in serum-free culture media: suitability for patch clamp studies on chemical and electrical excitability. AB - Methods were devised for the serum-free culture of spinal cord neurons derived from 12- to 13-day mouse embryos. Neurons exhibited good attachment if plated for 24 h on poly-d-lysine-coated dishes in the presence of serum. Cultures were subsequently fed with a serum-free medium consisting of minimum essential medium, Earle's salts and the N1 supplement, i.e. insulin, putrescine, transferrin, progesterone and selenium. After 3 weeks in vitro, growth and survival of neurons in this medium were comparable to results obtained using serum-supplemented medium. The presence of putrescine was not essential for the beneficial effects of N1, while insulin was required for long-term survival in serum-free media. Neurons maintained in serum-free media for 3 weeks retained aspects of electrical and chemical excitability characteristic of serum-grown cells. PMID- 3315628 TI - The chronic headache. PMID- 3315621 TI - Sotalol. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use. AB - Sotalol is a beta-adrenoceptor blocking agent devoid of intrinsic sympathomimetic activity, membrane stabilising actions and cardioselectivity. It lengthens repolarisation and the effective refractory period in all cardiac tissues independently of its antiadrenergic properties. Combining Class II and Class III antiarrhythmic properties, sotalol can be given either intravenously or orally and its pharmacokinetic properties permit long dosing (once or twice daily) intervals. Controlled and uncontrolled studies have established the efficacy of sotalol in mild-to-moderate essential hypertension and in angina of effort. Sotalol reduces anginal frequency and glyceryl trinitrate (nitroglycerin) consumption and increases exercise capacity during treadmill stress tests. In addition, although there is evidence that the drug reduces reinfarction rate in survivors of acute infarction, the data for reduction in sudden death rates in these patients are not as compelling as for other beta-blockers. However, comparative and additional long term studies are required before an accurate assessment of the use of sotalol in these disorders can be made. When used in the treatment of mild-to-moderate hypertension sotalol is more effective than placebo and comparable to other beta-blockers in reducing elevated blood pressures. In addition, a synergistic antihypertensive response is achieved when sotalol is combined with hydrochlorothiazide. Still, additional well-controlled comparative studies are required before the value of sotalol relative to other drug treatment regimens in the management of hypertension can be made. In preliminary studies sotalol appeared effective in most forms of supraventricular tachyarrhythmias with its effects being similar to those of other beta-blockers. However, preliminary data indicate that sotalol is likely to be more effective than than conventional beta-blockers in converting atrial flutter and fibrillation to sinus rhythm and maintaining stability post-conversion. Sotalol also appears to be a promising agent in the control of ventricular arrhythmias. In suppressing premature ventricular contractions it is at least as effective as procainamide. In ventricular tachycardia and fibrillation, intravenous sotalol (1.5 mg/kg), prevents reinduction by programmed electrical stimulation in 40 to 50% of cases if double stimuli are used. Both prevention of reinducible arrhythmia and the suppression of spontaneous arrhythmias on Holter recordings are predictive of a long term favourable clinical outcome. In patients with reduced ejection fractions, sotalol depresses ventricular function less than conventional beta blockers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3315629 TI - Dental causes of referred otalgia. PMID- 3315630 TI - [Structural proteins of the cytoskeleton as markers for determining tumor histogenesis]. AB - The data of literature about the structure of cytoskeleton proteins in the normal and malignant cells are analyzed. The possibilities of using a specific polyclonal serum and a monoclonal antibody for a more precise ascertainment of the origin and diagnostic of tumours are discussed. The intermediate and active filaments may be used as a new class of histochemical markers. Laminin, the protein of basement membranes, probably, plays an important role in metastatic spreading. PMID- 3315631 TI - [Glycosphingolipids and antitumor immunity]. AB - Glycosphingolipids are immunogenic components of cell surface whose composition and structure change during the cell transformation. The contemporary state of the question about the influence of glycosphingolipids on specific and non specific antitumour immunity is considered. The available information about shedding of glycosphingolipids from the tumour cell surface, about the change of the ganglioside content in blood serum of the tumour host and about the effect of glycolipids on immunocompetent cells is analyzed. The results obtained by the authors in studies of the influence of glycosphingolipids on effector cells of the body natural resistance system to tumour are discussed. PMID- 3315632 TI - [Fibronectin, its role in the processes of tissue differentiation, regeneration and neoplastic transformation]. AB - The data from literature on certain biological and functional peculiarities of fibronectin which is a high molecular connective tissue glycoprotein of the intercellular matrix are reviewed. Various features of fibronectin, such as its promoting action in cell adhesion, participation in cytodifferentiation, embryogenesis and regeneration are discussed. Several points of view about fibronectin participation in neoplastic transformation are mentioned. Diagnostic and prognostic value of the quantitative and qualitative estimation of plasma fibronectin in the human tumour investigation are emphasized. PMID- 3315633 TI - Effects of immunoneutralization of luteinizing hormone (LH)-releasing hormone on testicular prolactin and LH receptors in the golden hamster and on LH receptors in the Djungarian hamster. AB - In male Syrian hamsters, seasonal transitions between reproductive activity and quiescence are accompanied by major alterations in testicular binding of LH/hCG and PRL. These alterations are believed to be due to the photoperiod-induced changes in PRL secretion, but other adenohypophyseal hormones appear to be involved as well. To elucidate the role of LH and FSH in the control of testicular LH/hCG and PRL receptors, we have examined the consequences of selective suppression of gonadotropin release by immunoneutralization of endogenous LHRH. In adult Syrian hamsters, four weekly injections of LHRH antiserum produced significant reductions in plasma levels of LH, FSH, and testosterone and in the weights of the testes and the seminal vesicles; no change in plasma PRL; and a significant reduction in the total content (femtomoles per testis) of testicular LH/hCG and PRL receptors. The concentration of LH/hCG receptors (femtomoles per mg protein) was significantly increased. In adult males of another seasonally breeding species, the Djungarian hamster (Phodopus sungorus), four weekly injections of LHRH antiserum produced suppression of plasma LH and FSH, no change in plasma PRL, a reduction in the weights of the testes and the seminal vesicles, an increase in the concentration of testicular LH/hCG receptors, and a decrease in their total content. Alterations in testicular LH and PRL binding induced by treatment with LHRH antiserum in the present study were qualitatively similar to changes induced by exposure to short photoperiod or by treatment with bromocriptine. We conclude that gonadotropins normally participate in the regulation of testicular LH/hCG and PRL receptors in the Syrian hamster and LH/hCG receptors in the Djungarian hamster. Seasonal changes in the content of LH/hCG and PRL receptors in the testes appear to be due to photoperiod-induced alterations in the secretion of both PRL and gonadotropins. PMID- 3315634 TI - Analysis of the proteolytic cleavage of prolactin by the mammary gland and liver of the rat: characterization of the cleaved and 16K forms. AB - A cleaved form of PRL (CPRL) has been reported to exist naturally in the pituitary and to be the main product of PRL proteolysis by its target tissues. A 16K fragment derived from CPRL has mammary mitogenic activity. To analyze the possible functional significance of the cleavage of PRL generated by incubation of unlabeled rat (r) PRL with a 25,000 generated by incubation of unlabeled rat (r) PRL with a 25,000 x g pellet from the mammary gland and liver of rats. The optimum pH for cleavage was 3.4. PRL and the cleaved products were easily identified and separated from other proteins in the sample. The mammary gland pellet from lactating rats was significantly more potent at cleaving the rPRL molecule than were those of virgin or pregnant rats. However, the livers of all rats showed a similar PRL-cleaving potency. Thus, target tissues may differ in their PRL-cleaving potencies in different physiological states. The PRL-cleaving activity was also present in rat milk. While cleaved and 16K PRLs were the only proteolytic products obtained from rPRL, the PRLs (ovine and human) or the GHs (rat, bovine, and human) of other species were processed into a variety of low mol wt forms. Human placental lactogen was not modified. Accordingly, the processing of rPRL by target tissue enzymes appears to be hormone and species specific. Cleaved and 16K PRLs had 100% and 6.5% of the binding activity for rat liver PRL receptors as did intact rPRL, respectively. Nevertheless, the 16K form may still be of physiological significance. PMID- 3315635 TI - The trafficking and processing of insulin and insulin receptors in cultured rat hepatocytes. AB - The processing and trafficking of insulin in cultured rat hepatocytes were studied. A time course of binding of radiolabeled insulin to hepatocytes at 37 C revealed a rapid rise in cell-associated radioactivity that reached a steady state by 20 min. Using an acid medium to extract insulin bound to surface receptors, the time courses of receptor binding and internalization of the ligand were characterized. The earliest event in insulin processing was the binding of insulin to surface receptors, reaching steady state by 20 min with a t1/2 of 4 min. The internalization rate of ligand was initially slower than the binding rate, with a t1/2 of 6 min. Similar internalization rates of the insulin receptor were found by measuring the trypsin sensitivity of hepatocyte insulin receptors covalently occupied with a photo-affinity-labeled derivative of insulin [( 125I]B2 (2-nitro-4-azido-phenylacetyl)Des-PheB1-insulin). At steady state, the internalized ligand and receptor comprised approximately 40-45% of the cell associated radioactivity. The time course of intracellular degradation was assessed by trichloroacetic acid (TCA) precipitability and Sephadex G-50 gel chromatography of solubilized cells containing only internalized radioactivity. Intracellular TCA-soluble and low mol wt degradation products first appeared by 5 min and were released from the cell 3 min later. Chloroquine (100 microM) completely inhibited the formation of intracellular low mol wt degradation products as well as their appearance in the medium. The release of intracellular radioactivity was assessed by first removing surface-bound insulin with acid extraction. Eighty percent of the intracellular radioactivity was released in 45 min with a t1/2 of 8 min. The released radioactivity was assessed by TCA precipitability and gel chromatography. These results demonstrate that after 20 min, 43% of the released intracellular radioactivity is intact insulin. The percentage of intact insulin released increases in a dose-dependent fashion as the amount of insulin bound and internalized increases. In conclusion, the earliest event in insulin processing is binding to surface receptors. After a short delay, insulin and its receptor are internalized and trafficked into either a chloroquine-sensitive degradative pathway or a chloroquine-insensitive retroendocytotic pathway. The amount of insulin that traverses the nondegradative retroendocytotic pathway is proportional to the amount of insulin bound and internalized by the cell. PMID- 3315636 TI - Ultrashort feedback control of luteinizing hormone-releasing hormone secretion in vitro. AB - The present experiments were performed to clarify whether LHRH might inhibit its own secretion via an ultrashort feedback mechanism acting directly on the hypothalamus. Using an in vitro system, mediobasal hypothalami (MBHs) of adult male rats were perifused in either the presence or absence of a LHRH agonistic analog [D-Ser(TBU)6,Des-Gly10] LHRH ethylamide shown not to cross-react in the LHRH RIA. In the first series of experiments, six MBHs per chamber were initially perifused with control medium and submitted to two K+ stimulations (110 mM) for 5 min every 30 min; the control medium was then replaced by medium containing the LHRH analog (5 microM), and three additional K+ pulses were applied. In the second series of experiments, a single MBH per chamber was exposed for the duration of the experiments to either control medium or medium containing the LHRH analog (5 microM). In both cases, pulses of K+ were applied to the tissue. The amounts of endogenous LHRH released both under basal conditions and after K+ stimulation were measured in the effluent (1 ml every 5 min) with a specific RIA. The results show that the LHRH analog inhibits basal secretion of endogenous LHRH from the MBH, and diminishes or abolishes the response to K+ stimulations. The specificity of the inhibitory effect exerted by the LHRH analog on LHRH secretion was shown by the inability of TRH to mimic the effect of the LHRH analog. The data are consistent with the hypothesis that LHRH, acting at a hypothalamic level, might participate in the control of its own release via an ultrashort feedback mechanism. PMID- 3315637 TI - Evidence for a negative ultrashort loop feedback mechanism operating on the luteinizing hormone-releasing hormone neuronal system. AB - The present studies were designed to determine whether an ultrashort loop feedback mechanism is involved in the regulation of LHRH secretion. Daily administration of a highly potent LHRH agonist (LHRH-AGO; [D-Ala6,Des-Gly10] LHRH ethylamide) immediately after orchidectomy (ORDX) significantly attenuated the rise of plasma LH from days 2 through 10 after ORDX. Concomitantly with the diminished LH rise after ORDX, a significant increase in LHRH content in the arcuate nucleus was observed in LHRH-AGO-treated rats. Measurement of LHRH levels in hypophyseal portal blood in rats 10 days after ORDX combined with daily agonist treatment revealed a significant decrease in LHRH values in portal plasma compared with those in orchidectomized controls. Arcuate nuclei-median eminence (ME) fragments obtained from ORDX rats treated in vivo with LHRH-AGO for 5 days showed a decreased basal secretion of LHRH and a diminished response to K+ stimulation compared with the release from fragments obtained from ORDX saline treated controls. To evaluate whether a tonic LHRH inhibitory activity operates within the ME, additional experiments were performed in which ME fragments were incubated in vitro in the presence of a potent LHRH antagonist [( D-pGlu1,D Phe2,D-Trp3,6]LHRH). The antagonist significantly enhanced the basal secretion of LHRH in a dose-dependent manner. The latter results suggest that LHRH antagonists may enhance LHRH release, perhaps by interacting with LHRH receptors playing an inhibitory role on the endogenous secretion of the decapeptide. These observations strongly suggest a tonic inhibitory or modulatory role of LHRH neurons in the regulation of their own function. PMID- 3315625 TI - The retinoids. A review of their clinical pharmacology and therapeutic use. AB - With the introduction of the synthetic retinoids, oral therapy with an acceptable risk/benefit ratio became possible for a variety of skin diseases including severe acne, psoriasis and numerous genodermatoses. This article reviews the clinical pharmacology, mechanisms of action and therapeutic use of the retinoids, particularly isotretinoin (13-cis-retinoic acid) and etretinate. The free aromatic acid of etretinate, etretin, and the new polyaromatic retinoid compounds (arotinoids) are also discussed. Isotretinoin is used clinically for oral therapy of severe acne, but is also recommended for severe Gram-negative folliculitis and rosacea not responding to traditional therapy. The results of several studies have established that acne therapy should be started with 1.0 mg/kg/day for 2 to 3 months after which the daily dosage should be lowered to 0.2 to 0.5 mg/kg/day for another 2 to 3 months. This therapeutic regimen of isotretinoin has proven to be the most successful in preventing relapses. Etretinate is particularly useful for oral therapy of widespread plaque-like, pustular and erythrodermic psoriasis, and of generalised lichen planus, Darier's disease and severe congenital ichthyoses. Whereas pustular forms of psoriasis require a high daily dosage of 1.0 mg/kg/day, erythrodermic psoriasis should be treated with a lower dosage of 0.25 to 0.35 mg/kg/day. In chronic plaque-like psoriasis, a mean daily dosage of 0.5 mg/kg/day over several weeks to months, usually combined with photo(chemo)therapy, tar or dithranol, is recommended. Other indications for oral etretinate therapy are adequately treated with a moderate dosage of 0.4 to 0.75 mg/kg/day. Etretin differs from etretinate in having a much shorter elimination half-life of 2 to 3 days, in contrast to 80 to 100 days after long term administration of etretinate. Moreover, it has not been shown to increase serum cholesterol levels. However, its clinical efficacy is not yet clearly established. Among the arotinoids, arotinoid ethylester (Ro 13-6298) has revealed the best anti-psoriatic and anti-inflammatory effects at extremely low dose levels. Furthermore, no significant elevations of serum lipids have been observed. Taking its prolonged elimination half-life and its efficacy/side effect ratio into account, the drug is comparable to etretinate. The free arotinoid carboxylic acid (Ro 13-7410) is currently undergoing clinical investigation. Another arotinoid, the parent compound Ro 15-0778, has not demonstrated any convincing clinical efficacy in acne or psoriasis, but topical anti-inflammatory effects were evident in some models.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3315639 TI - Serum thyroglobulin concentration in patients with diabetes mellitus. AB - The serum thyroglobulin (Tg) concentration was measured in 97 patients with diabetes mellitus (39 males, 58 females). Hyper Tg-nemia which exceeds the normal range (1.0-26.6 ng/ml) was observed in 10 patients (3 out of 21 cases treated with diet alone, 3 out of 50 cases treated with oral hypoglycemic agents, 4 out of 26 cases treated with insulin). There was no significant correlation between concentrations of serum Tg and triiodothyronine (T3), thyroxine (T4), fasting plasma glucose (FPG), and hemoglobin A1c (HbA1c). However, a positive correlation was observed between serum concentrations of Tg and thyroid stimulating hormone (TSH). Patients with diabetes were divided into three groups according to the mode of treatment (Group I; diet alone, n = 21, Group II; oral hypoglycemic agents, n = 50, Group III; insulin, n = 26). No significant difference in the serum Tg concentration was observed among the three groups. They were also divided into two groups; normal Tg-nemia (Group A, n = 87) and hyper Tg-nemia (Group B, n = 10). There was no difference between levels of T3, T4, FPG, and HbA1c in the two groups. The serum TSH concentration measured by double antibody RIA and two site immunoradiometric assay in Group B was significantly higher than that in Group A. These results suggest that hyper Tg-nemia in patients with diabetes could be due to the increased TSH concentration which reflects latent subclinical primary hypothyroidism in them. PMID- 3315638 TI - Cell blotting: a new approach to quantify hormone secretion from individual rat pituitary cells. AB - A new technique is described for quantification of PRL secretion from individual pituitary cells incubated 1-6 h on ImmobilonTM, a high protein binding capacity transfer membrane. After incubation, the membrane is processed according to procedures commonly used in Western blotting. Individual cells and their "zone of secretion" can be seen by light microscopy. Purified hormone, incubated and processed in a similar fashion, is used to generate a PRL standard curve. An OasysTM Image Analysis System is used to measure area and intensity of released hormone. PRL release ranged from 0.1-1.5 pg/cell, depending upon time of incubation and cell donor. Heterogeneity of hormone release from single cells was obvious. PMID- 3315640 TI - Pancreatic B-cell function in non-insulin-dependent diabetes mellitus during successive periods of sulfonylurea and insulin treatment: serum C-peptide response to glucagon and urine C-peptide excretion. AB - Serum C-peptide responses to glucagon and daily urine C-peptide excretion in successive periods of different treatment in two groups of patients with non insulin-dependent diabetes mellitus (NIDDM) (mean interval between two tests less than 1 month) were compared. In group A patients (n = 8), the glycemic control was improved after transferring the treatment from sulfonylurea (SU) to insulin (fasting plasma glucose: SU: 192 +/- 47, insulin: 127 +/- 21 mg/dl, mean +/- S.D., p less than 0.01). Fasting serum C-peptide immunoreactivity (CPR) was significantly lower at the period of insulin treatment (SU: 1.93 +/- 1.01, insulin: 1.47 +/- 0.79 ng/ml, p less than 0.05), but there was no difference in the increase in serum CPR (maximal--fasting) (delta serum CPR) during glucagon stimulation in the two periods of treatment (SU: 1.70 +/- 0.72, insulin: 1.47 +/- 0.98 ng/ml). In group B patients (n = 7), there was no significant difference in glycemic control after transferring the treatment from insulin to SU (fasting plasma glucose: insulin: 127 +/- 24, SU: 103 +/- 13 mg/dl). Fasting serum CPR was significantly lower during the period of insulin treatment (insulin: 1.39 +/- 0.64, SU: 2.21 +/- 0.86 ng/ml, p less than 0.025), but delta serum CPR during glucagon stimulation still showed no significant difference between the two periods (insulin: 1.97 +/- 1.16, SU: 2.33 +/- 1.57 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315641 TI - Thyroid antigen-antibody nephritis: possible involvement of fucosyl-GM1 as the antigen. AB - Hyperthyroidism, microscopic hematuria, and proteinuria developed in an 11-year old girl. Proteinuria decreased during treatment of hyperthyroidism with an antithyroid drug. On admission, serum anti-thyroglobulin antibody, antimicrosomal antibody, and immune complex were present. The thyrotropin binding inhibitory immunoglobulin (TBII) level was low. On the other hand, an antibody to the ganglioside component (fucosyl-GM1) was detected by an enzyme linked immunosolvent assay (ELISA). A thyroid biopsy specimen showed massive lymphocytic infiltration and interstitial fibrosis. A renal biopsy specimen showed marked proliferation of mesangial cells and increased mesangial matrix with focal segmental capillary wall abnormality. Electron microscopec studies demonstrated mild paramesangial dense deposits. By indirect immunofluorescence, granular glomerular basement membrane and mesangial staining were not detected with rabbit antibody to thyroglobulin, but were detected with rabbit antibody to fucosyl GM1. Fucosyl GM1 was also seen along the basilar aspect of the thyroid follicular epithelial cells. These observation suggests the development of glomerulonephritis mediated by thyroid antigen, particularly ganglioside component. PMID- 3315643 TI - Direct pulp capping: a review. PMID- 3315642 TI - The effect of triiodothyronine (T3) and thyroxine (T4) upon insulin secretion from isolated rat pancreatic islets. AB - In order to observe the effect of triiodothyronine (T3) or thyroxine (T4) on glucose-induced insulin release from pancreatic islets, isolated pancreatic islets from Wistar male rat were incubated in modified Krebs-Ringer bicarbonate solution (0.2% BSA, pH 7.4) with 3 mM, 5 mM or 10 mM glucose for 60 min with or without exposure to T3 (2.5 micrograms/ml or 7.5 micrograms/ml) or T4 (2.5 micrograms/ml or 7.5 micrograms/ml). Direct exposure of isolated pancreatic islets to T3 or T4 did not have any effect on glucose-induced insulin release from pancreatic islets during 60 min incubation. But, in successive 60 min incubations following 60 min rest periods after exposure to T3 or T4 in the first incubation, glucose-induced insulin release from isolated pancreatic islets previously exposed to T4 was reduced at 5 mM and 10 mM glucose concentrations and previous exposure to T3 had no effect on glucose-induced insulin release. A delayed effect of T4 on the mechanism of insulin secretion from pancreatic islets was suggested. PMID- 3315644 TI - Endoscopic therapy of upper gastrointestinal bleeding. PMID- 3315645 TI - Feasibility and effectiveness of school-based relaxation in lowering blood pressure. AB - Progressive muscle relaxation (PMR) is a broadly useful anxiety reduction technique that has been found to lower blood pressure (BP) in essential hypertension. The present investigation is the first to evaluate the feasibility and efficacy of wide-scale PMR instruction as a public health promotion strategy aimed at adolescents. Students (N = 1,400) in Grades 9 and 10 at two large Baltimore City public high schools underwent BP screening; those with BP persistently above the 85th percentile were randomly assigned to (a) 12 weeks daily PMR instruction provided in class for academic credit or (b) a control condition. The latter students had their BP measured at the same frequency as the PMR students and completed the PMR course during the following year. Approximately two thirds of eligible students entered and completed the study. Results demonstrated that treatment students (n = 51) enjoyed daily PMR, mastered the technique, and achieved reduced systolic BP at posttest relative to the untrained controls (n = 59). At follow-up 4 months later, group BP differences were not significant. Implications for use of PMR to promote cardiovascular health are discussed. PMID- 3315646 TI - Laryngeal surgery--150 years on. PMID- 3315647 TI - A review of environmental and host factors in relation to equine respiratory disease. AB - This paper reviews the environmental and host factors which interact to affect the incidence and severity of episodes of respiratory disease in stabled horses. The folly of accepting housing criteria and management practices for the horse, based on direct extrapolations from intensive housing of meat producing animals, is discussed. The factors which affect air hygiene and physical environment of stables are considered in terms of short-term athletic performance and long-term welfare. PMID- 3315648 TI - The 5'-proximal region of the wheat Cab-1 gene contains a 268-bp enhancer-like sequence for phytochrome response. AB - We have previously reported that the expression of the wheat Cab-1 gene is subject to phytochrome regulation and a 1.8-kb 5' upstream sequence of this gene is sufficient for the regulated expression. To delineate sequences for the phytochrome response we analyzed a series of 5' deletion mutants as well as chimeric gene constructs comprising different sequences of the Cab-1 upstream region in transgenic tobacco seedlings. We found that a deletion mutant containing a 357-bp 5' upstream sequence still exhibits maximal levels of phytochrome-regulated expression. A 268-bp enhancer-like element, located between -89 and -357, is responsible for the phytochrome response of the Cab-1 gene; sequences upstream from -357 to -843 and downstream from -124 to +1100 are probably not involved. Finally, we show that the Cab-1 mRNA stability is not regulated by phytochrome. PMID- 3315650 TI - Microtubules containing detyrosinated tubulin are less dynamic. AB - Peptide antibodies specific for tyrosinated (tyr-tubulin) or detyrosinated alpha tubulin (glu-tubulin) have been generated for studying the relative stability of microtubules enriched in either form of alpha-tubulin. Treatment of Vero cells with nocodazole has revealed that interphase microtubules rich in glu-tubulin (glu-microtubules) are resistant to higher concentrations of the microtubule disrupting drug than the microtubules containing only tyr-tubulin (tyr microtubules). Glu-tubulin is enriched in centrioles and mid-bodies, but absent from the first interphase microtubules that have repolymerized in late telophase. Tubulin (including both forms) has been labeled with rhodamine (rh-tubulin) and microinjected into Vero cells to study in vivo the dynamic properties and incorporation rates of tubulin into microtubules rich in either glu- or tyr tubulin. Tyr-microtubules are significantly more rapidly labeled by the microinjected rh-tubulin than glu-microtubules. Ten minutes after injection, rh tubulin is present in virtually all tyr-microtubules. The half-time of turnover of glu-microtubules is approximately 1 h. Even several hours after microinjection, some of the glu-microtubules have consistently not incorporated visible amounts of rh-tubulin. These results suggest that tyr- and glu microtubules respectively represent relatively dynamic and stable subclasses of interphase microtubules. PMID- 3315649 TI - Characterization of the cell adhesion molecules L1, N-CAM and J1 in the mouse intestine. AB - To gain insight into the cellular and molecular mechanisms underlying epithelial cell surface interactions in the adult mouse intestine, we have characterized the cell adhesion molecules L1, N-CAM and J1 by immunocytological, biochemical and cell biological methods. Whereas N-CAM and J1 expression was found to be confined to the mesenchymal and neuroectodermally-derived parts of the intestine, L1 was localized in the proliferating epithelial progenitor cells of crypts, but not in the more differentiated epithelial cells of villi. L1 was detected in crypt cells by Western blot analysis in the molecular forms characteristic of peripheral neural cells, with apparent mol. wts of 230, 180 and 150 kd. Aggregation of single, enriched crypt, but not villus cells, was strongly inhibited in the presence of Fab fragments of polyclonal L1 antibodies. These observations show that L1 is not confined to the nervous system and that it may play a functional role in the histogenesis of the intestine in the adult animal. PMID- 3315652 TI - The pAR5 mutation and the allosteric mechanism of Escherichia coli aspartate carbamoyltransferase. AB - Mutation pAR5 replaces residues 145'-153' at the C terminus of the regulatory (r) chains of Escherichia coli ATCase by a new sequence of six residues. The mutated enzyme has been shown to lack substrate cooperativity and inhibition by CTP. Solution X-ray scattering curves demonstrate that, in the absence of ligands, its structure is intermediate between the T form and the R form. In the presence of N phosphonacetyl-L-aspartate, the mutant is similar to the wild type. An examination of the crystal structure of unligated ATCase reveals that the mutated site is at an interface between r and catalytic (c) chains, which exists only in the T allosteric form. A computer simulation by energy minimization suggests that the pAR5 mutation destabilizes this interface and induces minor changes in the tertiary structure of r chains. The resulting lower stability of the T form explains the loss of substrate cooperativity. The lack of allosteric inhibition may be related to a new electrostatic interaction made in mutant r chains between the C-terminal carboxylate and a lysine residue of the allosteric domain. PMID- 3315653 TI - Structure-mutagenicity relationships of benzidine analogues. AB - The mutagenic activities of benzidine, its dihydrochloride salt, and 12 of their analogues were compared in the Ames test using strains TA100 and TA98 with and without rat liver S9 activation. With the exceptions of 4,4'-methylenebis(3 nitroaniline) in both strains and 3,3-dichlorobenzidine in TA98, little or no mutagenicity was observed in the series when tested without S9 activation. All compounds, except tetramethylbenzidine, exhibited some activity in TA100 with S9 activation; dichlorobenzidine and 4-aminobiphenyl were significantly more mutagenic than the other compounds. This was in contrast to the TA98 results where the bridged diphenyl compounds, with the exception of the nitroaniline derivative, were only slightly mutagenic compared to the more planar biphenyl series. Only the nitroaniline compound was mutagenic in both strains in the presence or absence of S9 activation. For benzidine and the 3,3'-disubstituted benzidines (the dimethoxy-, diamino-, and dichloro- compounds), an increase in mutagenicity correlated to a decrease in basicity of the parent anilines in both TA100 and TA98. PMID- 3315654 TI - Mutagenicity testing of ethylene oxide in Escherichia coli strains with different repair capacities. AB - Mutagenicity of ethylene oxide in Escherichia coli B strains with different repair capacities was studied. Deficiencies in excision repair (uvrA, polA) led to a considerable increase in mutation frequency compared with that in the wild type strain and in strains deficient in error-prone repair (recA, lexA). PMID- 3315651 TI - The influenza hemagglutinin precursor as an acid-sensitive probe of the biosynthetic pathway. AB - The hemagglutinin of influenza virus (HA), an acid-activated membrane fusion protein, is synthesized in the endoplasmic reticulum and transported through the Golgi complex to the cell surface of infected cells as an uncleaved, fusion incompetent precursor, HA0. The mature, proteolytically activated HA is known to undergo a rapid, irreversible, acid-induced conformational change which mediates membrane fusion and virus penetration. On the basis of antigenic modifications and the acquisition of trypsin susceptibility, we demonstrate here that HA0, while unable to cause fusion, is acid sensitive. It undergoes irreversible conformational changes quite similar to those of HA at mildly acidic pH (pH less than 6.0). The ectodomain of HA0 does not, however, acquire hydrophobic properties and the changes occur in a less concerted manner (the pH dependence is much broader and the rate of conversion slower). These differences are likely to account for the inability of acid-treated HA0 to trigger membrane fusion. It was shown, moreover, that HA0 acquired its acid-sensitive properties immediately following trimerization in the endoplasmic reticulum. Since HA0 did not convert to the acid form at any point during its intracellular transport, we concluded that the trans-Golgi compartment, known to be more acidic than the cytosol and involved in constitutive membrane transport, is not likely to have a pH less than 6.0. PMID- 3315655 TI - Mutagenic and lethal effects of near-ultraviolet radiation (290-400 nm) on bacteria and phage. AB - Despite decades of study of the effect of near-ultraviolet radiation (NUV) on bacterial cells, insights into mechanisms of deleterious alterations and subsequent recovery are just now emerging. These insights are based on observations that 1) damage by NUV may be caused by a reactive oxygen molecule, since H2O2 may be a photoproduct of NUV; 2) some, but not all, of the effects of NUV and H2O2 are interchangeable; 3) there is an inducible regulon (oxyR) that responds to oxidative stress and is involved in protection against NUV; 4) a number of NUV-sensitive mutants are defective either in the capacity to detoxify reactive oxygen molecules or to repair DNA damage caused by NUV; and 5) recovery from NUV damage may not directly involve induction of the SOS response. Since several distinctly different photoreceptors and targets are involved, it is unknown whether NUV lethality and mutagenesis result from an accumulation of damages or whether there is a particularly critical photoeffect. To fully understand the mechanisms involved, it is important to identify the chromophore(s) of NUV, the mechanism of toxic oxygen species generation, the role of the oxidative defense regulon (oxyR), the specific lesions in the DNA, and the enzymatic events of subsequent repair. PMID- 3315656 TI - Stability and inactivation of mutagenic drugs and their metabolites in the urine of patients administered antineoplastic therapy. AB - Urine samples from patients administered mutagenic antineoplastic drugs are mutagenic in the Ames assay, and hence may pose a genotoxic hazard to hospital personnel or family members caring for the patient. The urine samples in the present study were tested for mutagenicity in several strains of Salmonella typhimurium that were uvr negative (TA98, TA100) or positive (TA102, UTH8413, UTH8414), and were analyzed for the presence of drugs and their metabolites using high-pressure liquid chromatography (HPLC). Urine samples from cancer patients were kept at room temperature and their mutagenicity as well as the chemical stability of the drugs was tested for a period of 14 days. It was observed that, in general, the urine remained mutagenic for the 14-day period while the parent compound degraded within the first seven days. An exception was cisplatin, which was chemically stable as platinum, but the urine decreased in mutagenicity with time. This decrease was probably the result of ligand exchange with the platinum. Inactivation methods were developed to reduce the genotoxic hazard posed by the mutagenic compounds in the urine. Cisplatin was inactivated by complexing with sodium diethyldithiocarbamate (DDTC). Oxidation of urine containing mitomycin C and doxorubicin (sodium thiosulfate must be added to urine containing doxorubicin) with 5.25% sodium hypochlorite solution (bleach) results in mutagenic inactivation. Urine containing cyclophosphamide and its metabolites was oxidized with alkaline potassium permaganate and the active degradation products trapped with sodium thiosulfate. Both chemical and mutagenic assays are necessary to determine the reduction of risk. Methods of inactivation of mutagenic urine developed in this study are both effective and practical for the reduction of exposure to genotoxic hazards. PMID- 3315657 TI - A modified mouse peripheral blood lymphocyte culture system for cytogenetic analysis. AB - A detailed methodology is presented for culturing mouse peripheral blood lymphocytes isolated on density gradients and stimulated to divide using either phytohemagglutinin, concanavalin A, or lipopolysaccharide. The techniques described yield more than sufficient numbers of mitotic cells for analyzing sister chromatid exchange, chromosome aberrations, and micronuclei following in vitro or in vivo exposure to chemicals or radiation. PMID- 3315658 TI - Presence and measurement of sample histidine in the Ames test: quantification and possible elimination of a source of false-positive mutagenicity test results. AB - Both histidine and dipeptides that can be converted to histidine can potentially interfere with the Ames test by increasing the number of spontaneous revertants. Such interference might be especially evident when urine and other biological samples are studied in this assay. We have developed a turbidimetric bioassay that utilizes a nonrevertible Salmonella typhimurium histidine auxotroph, NS1135. The assay is linear with histidine over at least a 300-fold range (0.015-5 micrograms/ml of L-histidine.HCl.H2O). Data indicate that several histidine containing dipeptides can be utilized as efficiently as free histidine. Our data suggest that this assay may be used to measure biological samples accurately for their histidine content and thereby permit an adjustment for sample histidine during the setup of Ames assays, thus eliminating increased reversion caused by sample histidine. PMID- 3315659 TI - Mutagenic and clastogenic properties of 3-chloro-4-(dichloromethyl)-5-hydroxy-2 (5H)-furanone: a potent bacterial mutagen in drinking water. AB - 3-Chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone (MX) was found to be a direct-acting mutagen in the Ames test for strains TA1535, TA1538, TA92, TA97, TA98, TA100 and TA102. The highest mutagenic response (approximately 13,000 revertants/nmol) was seen in strain TA100. The TA100 response was six- to tenfold higher than in TA98, TA97, and TA102, and 100- to 500-fold higher than in TA1535, TA92, and TA1538. The addition of a 9,000 x g supernatant fraction (S-9) from livers of polychlorinated biphenyl-treated rats, along with cofactors for NADPH generation, resulted in a 90% reduction in the TA100 mutagenicity. MX induced chromosomal aberrations in Chinese hamster ovary cells after 6-8 hr exposure without S-9 at a dose as low as 4 micrograms/ml, and after 2 hr exposure with S-9 at a dose of 75 micrograms/ml. The oral dose of MX lethal to 50% (LD50) in Swiss Webster mice was determined to be 128 mg/kg. MX did not induce micronuclei in mouse bone marrow when administered by oral gavage at doses up to 70% of the LD50. PMID- 3315660 TI - Modulation by insulin and glucagon of noradrenaline-induced activation of isolated brown adipocytes from the rat. AB - 1. The effects of insulin (2 nM and 4 nM) upon oxygen consumption (VO2), lipolysis rates and indirectly derived rates of fatty acid utilization, by isolated brown adipocytes from warm-acclimated (W cells) and cold-acclimated (C cells) animals, induced by noradrenaline and glucagon separately and conjointly, are reported. 2. Changes in interrelationships (coupling) between the parameters under different treatment regimes were assessed using bivariate regression analyses. 3. Administration of glucagon with noradrenaline increased lipolysis/fatty acid utilization coupling without concomitant increase of VO2 suggesting that glucagon may increase re-esterification through glycogenolytic generation of glycerol 3-phosphate, trapping intracellular fatty acid in excess of the capacity of disposal mechanisms, thus conserving respiratory substrate. 4. W cells were unresponsive to glucagon in terms of lipolysis and VO2, C cells responded to glucagon with parallel increases in lipolysis rate and VO2. Both cell types responded to noradrenaline alone and conjointly with glucagon; C cells were more sensitive to these agonists than W cells. 5. Lipolysis/VO2 coupling was reduced in C cells suggesting that in cold acclimation, noradrenaline-induced lipolysis rates are in excess of the capacity of cellular oxidation/re esterification mechanisms. 6. Insulin inhibited noradrenaline and glucagon induced lipolysis, simultaneously increasing VO2, supporting the hypothesis that glucose may be a thermogenic substrate in brown adipase tissue, permitting concurrent thermogenesis and lipogenesis. C cells were more insulin-sensitive than W cells. 7. The data indicate that insulin may mediate its effects (additively with noradrenaline) by activation of pyruvate dehydrogenase, generating glycolytic flux and, in the presence of noradrenaline-inhibited lipogenesis, generate additional oxaloacetate, permitting increased beta oxidation. PMID- 3315661 TI - Electron microscopic study on the size of pyruvate dehydrogenase complex in situ. AB - Isolated pig heart pyruvate dehydrogenase complex (PDC) has been reported to have a molecular mass of 8000 kDa (large PDC) and a diameter of about 45 nm. Studies were carried out to determine the size of PDC in situ. Active enzyme centrifugation showed that extracts of pig heart mitochondria contain, in addition to large (S20,w = 100-200 S) active complexes, catalytically active small PDC (S20,w = 30 S). In addition, small PDC (1000-3000 kDa) could be obtained by gel filtration of mitochondrial extract. If pure large PDC was chromatographed in Triton X-100, then a fraction of it appears in the 1000-3000 kDa range. Isolation of small PDC and rechromatography showed the formation of large PDC. Anti-PDC and ferritin-labeled second antibody were used in an attempt to determine the size of PDC in isolated inner membrane vesicles containing PDC and in permeabilized mitochondria. In both studies no large aggregates of ferritin particles were found which would correspond to the size of large PDC. The conclusion of these experiments is that PDC exists in situ in a smaller form than the isolated pure enzyme. PMID- 3315663 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(3'NH2). AB - For discrimination between isoleucine and the other 19 naturally occurring amino acids by isoleucyl-tRNA synthetases from baker's yeast and from Escherichia coli MRE 600 discrimination factors have been determined from kcat and Km values in aminoacylation of the modified tRNA(Ile)-C-C-A(3'NH2). Discrimination factors D1 are products of an initial discrimination factor and a proof-reading factor: D1 = I1.II1. From discrimination factors and AMP formation stoichiometry factors I1 and II1 were calculated. D1 values obtained with the enzyme from E. coli are generally higher than those observed with the yeast enzyme, in some cases up to ten times. With both enzymes low D1 values are found for cysteine, valine, and tryptophan (20-200), the highest values for glycine, alanine, and serine (600 4000). I1 values calculated for the E. coli enzyme are slightly higher (4-145) than the factors observed with the yeast enzyme (1-85), proof-reading factors II1 of the E. coli enzyme are scattering about a mean value about 70, those of the yeast enzyme about a mean value about 50. Initial discrimination factors I1 are directly related to hydrophobic interaction forces between the substrates and the enzymes. Plots of Gibbs free energy differences calculated from these factors are linearly related to the accessible surface areas of the amino acids. A hypothetical model of the binding site can be given in which selection of amino acids is achieved by hydrophobic forces and removal of steric hindrance. PMID- 3315662 TI - Endotoxic properties of synthetic pentaacyl lipid A precursor Ib and a structural isomer. AB - A pentaacyl precursor of lipid A biosynthesis, termed precursor Ib, and a structural isomer have been chemically synthesized. These compounds were, in comparison to synthetic Escherichia-coli type lipid A or lipopolysaccharide, analyzed for their activity in typical endotoxin test systems. It was found that both precursor Ib and the isomer exhibited similar or only slightly lower pyrogenic, lethal and Shwartzman-phenomenon-inducing activity than lipid A. All preparations were comparable in their B-lymphocyte mitogenicity, macrophage activating capacity and immunoreactivity towards lipid A antisera. The proton nuclear magnetic resonance spectra of the 1-dephospho derivative of synthetic and bacterial precursor Ib were indistinguishable proving that the previously proposed structure for precursor Ib is correct. PMID- 3315664 TI - Mistranslation in twelve Escherichia coli ribosomal proteins. Cysteine misincorporation at neutral amino acid residues other than tryptophan. AB - The misincorporation of cysteine (codon: UGU/C) into twelve ribosomal proteins devoid of cysteine has been studied. Although it is generally assumed that cysteine is misincorporated at arginine and tryptophan residues (codons: CGU/U and UGG respectively), our results are consistent with the idea that cysteine is also misincorporated at phenylalanine residues (codon: UUU/C) through a second position C:U mismatch. Cysteine was found in ribosomal proteins L29, L32/L33 and S10, under conditions where only its misincorporation at neutral residues was measured. Since these proteins contain no tryptophan, the date imply that cysteine has replaced a neutral amino acid other than tryptophan. Because there was a statistically significant correlation between the total level of cysteine in the twelve proteins under study and their content of phenylalanine and arginine residues, we conclude that there is a likelihood of cysteine misincorporation at phenylalanine residues, in addition to its misincorporation at arginine and tryptophan residues. Our measurements are consistent with the existence of a cluster of ribosomal proteins having an average mistranslation frequency of 2.5 X 10(-4)/residue and another having an average mistranslation frequency of 10(-3)/residue. There was three times less cysteine misincorporated into ribosomal protein L1 than into L7/L12, although the L1 mRNA contains eleven CGU/C codons and four UUU/C codons while the L7/L12 mRNA contains only one arginine and two phenylalanine codons (both proteins are free of tryptophan). Furthermore, the mRNAs for both L1 and L7/L12 contain a CGU codon located in the context GUA-codon-GG and there was as much cysteine incorporated at this codon in L7/L12 [Bouadloun, F., Donner, D. and Kurland, C.G. (1983) EMBO J. 2, 1351-1356] than in the whole of L1. This suggests that, relatively speaking, little cysteine is to be found at the phenylalanine and the other ten arginine positions of L1 and that the phenylalanine residues of L7/L12 are particularly error-prone. PMID- 3315665 TI - Rapid induction by fungal elicitor of the synthesis of cinnamyl-alcohol dehydrogenase, a specific enzyme of lignin synthesis. AB - A fivefold increase in the extractable activity of cinnamyl-alcohol dehydrogenase, an enzyme of phenylpropanoid metabolism specific for lignin synthesis, was observed within 10 h of treatment of cell-suspension cultures of bean (Phaseolus vulgaris L.) with a high-molecular-mass elicitor preparation heat released from mycelial cell walls of the bean pathogen Colletotrichum lindemuthianum. Elicitor caused a rapid, marked but transient increase in the synthesis of cinnamyl-alcohol dehydrogenase with maximum rates 2-3 h after elicitation, concomitant with the phase of rapid increase in enzyme activity. There is a close correspondence between increased polysomal mRNA activity encoding cinnamyl-alcohol dehydrogenase, as measured by incorporation of [35S]methionine into immunoprecipitable enzyme subunits in vitro, and the stimulation of enzyme synthesis in vivo in response to elicitor. This marked increase in polysomal mRNA activity represents an increase as a proportion of total cellular mRNA activity, indicating that elicitor does not stimulate synthesis of this enzyme by selective recruitment from the total pool of cellular mRNA. Elicitor stimulation of cinnamyl-alcohol dehydrogenase activity and enzyme synthesis is more rapid than previously observed for other proteins involved inducible defense mechanisms, such as enzymes of phytoalexin biosynthesis or the apoproteins of cell-wall hydroxyproline-rich glycoproteins. PMID- 3315666 TI - The use of invasive techniques, angiography and indicator dilution, for quantification of valvular regurgitations. AB - Angiographic techniques have been used for the quantification of mitral or aortic and rarely tricuspid regurgitation. Mitral or aortic regurgitant volume per beat and the regurgitation fraction (fao and fm, respectively) are obtained from the angiographic determination of total left ventricular stroke volume (TSV) and forward stroke volume (FSV) estimated by a different technique. Although this procedure is generally accepted as the gold standard for quantification of left heart regurgitations, there are several limitations: In the presence of mitral and aortic regurgitation no separate quantification of fao and fm is feasible; heart rate at the time of determination of FSV (from Fick or dye dilution cardiac output) and of TSV (angio) may be different; there is a tendency to consistently overestimate stroke volume by angio techniques; repeated estimations of TSV by angio are influenced by the circulatory effects of the contrast dye. In contrast indicator dilution techniques, where upstream and downstream sampling allow the simultaneous estimation of forward and regurgitant flow, the accuracy of the determination of FSV is well established and repeated estimations of fao and fm are possible because the indicators do not have cardiovascular effects. These methods are, however, crucially dependent on thorough mixing of the regurgitant volume with the blood in the upstream chamber. In 23 patients with isolated aortic regurgitation there was a positive correlation between fao evaluated by thermodilution and fao determined by the biplane angio-Fick method (r = 0.59). fao by thermodilution averaged 0.40 and fao by angio-Fick 0.46 (NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315667 TI - The use of Doppler techniques for quantitative evaluation of valvular regurgitation. PMID- 3315668 TI - Quantification of valvular regurgitation using radioisotopes. AB - Mitral and aortic regurgitations impose an abnormal volume overload on the left ventricle. Recent advances in radionuclide angiographic measurements of all cardiac volumes have made this a practical technique for the detection, quantification and functional assessment of valvular regurgitations and shunts. The method is based on the comparative evaluation of total and effective left ventricular stroke volume. In the radionuclide technique, the right ventricular stroke volume is most frequently used to represent the effective left ventricular stroke volume although techniques have been presented which used as reference the left ventricular stroke volume calculated from measurements of heart rate and cardiac output (Fick method or dye dilution or scintigraphic techniques). The technique can be performed either during first-pass or at equilibrium. Equilibrium measurements are performed in the left anterior oblique position. The stroke volume ratio and the regurgitant fraction are calculated. This technique has been shown to provide adequate quantitative measurements of mitral and aortic regurgitations. Its specificity is adequate with careful positioning and if regions of interest are determined and care is taken to exclude inadequate studies (as these can be prospectively recognized). The technique can separate moderate from severe regurgitation, provide follow-up values for both left ventricular volume and regurgitant fraction, and assess the effect of interventions on the amount of regurgitation. The technique is, however, not adequate to detect mild or minimal regurgitation. In conclusion, equilibrium scintigraphic measurement of valvular regurgitation is an attractive new technique for measuring valvular regurgitation. Its clinical value lies in its simplicity, its reproducibility and its wide applicability. Its accuracy will be improved by performance of gated tomographic acquisitions. PMID- 3315669 TI - Exercise testing in the indication and evaluation of pacemaker treatment. AB - Comparison of different methods of rate responsive' pacing with expected heart rates at the same work load in normals shows that most systems have not matched rate and effort correctly. P-wave driven pacing tends to produce too fast a rate and QT-driven pacing too slow a rate for the work load. Although there are improvements compared with exercise in fixed rate pacing, these are less impressive than expected. There appears negligible benefit from AV synchrony beyond that achieved by rate increase. PMID- 3315670 TI - Exercise testing in arrhythmias of idiopathic mitral valve prolapse. PMID- 3315671 TI - Exercise testing in the evaluation of ventricular arrhythmias in coronary artery disease. PMID- 3315672 TI - Progression of atherosclerosis: the cell biology. AB - The sequence of events during atherogenesis has been deduced from serial changes that occur in animal models of atherosclerosis and from autopsy studies in humans. In vitro studies have provided insight into the mechanisms of the major features of atherosclerosis. One of the earliest events in atherogenesis is adhesion of monocytes to intact endothelium, followed by migration along a chemotactic gradient into the intima, where they become macrophages. These events appear to be modulated by lipoproteins. Subendothelial macrophages accumulate cholesteryl ester and become the foam cells of the fatty streak. Smooth muscle cells proliferate in response to stimulation by mitogens. Later, intimal macrophages and smooth muscle cells also accumulate lipid, by apparently different mechanisms. Later, lipoproteins accumulate in the extracellular space where they are bound to proteoglycans. Strategies to prevent atherosclerosis should be targeted towards specific events in the cell biology of this disease. PMID- 3315673 TI - Interpopulation correlations between serum cholesterol level and the occurrence of coronary heart disease. AB - Epidemiological studies have established beyond any doubt that diet-related differences in the population distributions for serum total cholesterol (low density lipoprotein cholesterol) explain a large proportion of the interpopulation variation in the occurrence of coronary heart disease (CHD). These findings emphasize the central importance of appropriate dietary changes in the prevention of CHD in populations with high population mean levels for serum total cholesterol and high CHD rates. The possible contribution of differences in the population distributions for serum high density lipoprotein cholesterol to the interpopulation variation in the occurrence of CHD still remains an unsolved issue. PMID- 3315674 TI - The pathology of atherosclerosis with particular reference to the effects of hyperlipidaemia. AB - A brief description has been given of the major processes involved in the genesis of atherosclerosis, and of the morphological features of fatty streaks, gelatinous elevations and fibrolipid plaques. The effects of hyperlipidaemia, genetically and dietarily determined, are described, with special reference to the possible role of macrophages in the development of arterial lesions caused by such hyperlipidaemias. The administration of a competitive inhibitor of HMG-CoA reductase (lovastatin) to genetically hyperlipidaemic rabbits markedly reduced the extent of intimal surface involvement by lipid-rich lesions. PMID- 3315675 TI - Environmental factors in coronary heart disease: diet. AB - The customary diet of a population is the essential factor determining susceptibility to atherosclerosis and coronary heart disease (CHD), and it does so through its effects on lipoproteins, blood pressure and the coagulation system. The simplest and possibly strongest measure of this dietary effect is the serum total cholesterol concentration in the population. Within populations on high-risk diets [high saturated fat intakes and low ratio of polyunsaturated to saturated fatty acids (P/S ratio)], hypertension and cigarette smoking are potent secondary factors. Adipose tissue fatty acid studies support this concept of a dietary basis to CHD; low levels of linoleic acid and high P/S ratios are associated with a higher risk of CHD. Marine long-chain polyunsaturated fats may play a protective role in the CHD story. Monounsaturated fats are as effective in lowering serum total cholesterol as low fat-high carbohydrate diets. Coagulation factors of possible importance to CHD risks can be affected by dietary fat intake. Dietary fats affect blood pressure levels and may initiate hypertension. Coffee and alcohol consumption do not appear to effect the risk of CHD, although coffee may raise the blood cholesterol and alcohol raise the blood pressure. Diet is probably the central environmental factor in the development of CHD. PMID- 3315676 TI - Dietary trials for the prevention of coronary heart disease. PMID- 3315677 TI - Report on the Lipid Research Clinic trials. AB - The Lipid Research Clinic Coronary Primary Prevention Trial was a randomized, double-blind, placebo-controlled intervention trial performed in 3806 hypercholesterolaemic (greater than 265 mg dl-1) but asymptomatic men aged 35-59 at entry. The bile acid sequestrant cholestyramine was used to achieve the cholesterol differential in the treatment group. Both groups received a modest low cholesterol-low fat diet. All subjects were followed for at least seven years (mean duration 7.4 years) during which time a mean fall of 8% and 12% in plasma total cholesterol and LDL cholesterol levels respectively relative to levels in placebo controls were achieved and maintained. The cholestyramine group experienced a 19% reduction in risk (P greater than 0.05) of the primary end point-definite coronary heart disease death and/or definite non-fatal myocardial infarction. In addition, the incidence rates for new positive exercise tests, angina, and coronary bypass surgery were all significantly reduced by 25%, 20% and 21%, respectively, in the cholestyramine group. In the treated group, risk reduction was related directly to reduction in total and LDL cholesterol. In a similar but considerably smaller double blind, placebo-controlled, secondary prevention trial where coronary artery lesion change as determined by serial coronary angiography was the end point (The NHLBI Type II Intervention Trial), cholestyramine treatment significantly delayed the progression of atherosclerotic lesions. Plaque progression related directly to both a fall in low density lipoprotein and a rise in high density lipoprotein. PMID- 3315678 TI - Angiographic evidence that treatment of lipoprotein abnormalities prevents progression of coronary atherosclerosis. PMID- 3315679 TI - Guidelines for individual therapy of hyperlipidaemia. PMID- 3315680 TI - Community intervention to control plasma lipids. AB - A necessary part of the strategy of modification of hypercholesterolaemia to prevent coronary heart disease (CHD) is the detection and treatment, by diet or by drugs, of high risk individuals. There are several drawbacks to this approach: (1) the cost of screening to find individuals at risk and of monitoring by physicians of their therapy; (ii) the problem of labelling asymptomatic people as 'sick' and advising them on special diets; (iii) difficulties in compliance. If the community norm is to eat a diet high in fat, it is difficult for individuals to change, both because it marks them as 'odd' within the culture and because foods low in saturated fat may be difficult to obtain and are expensive. A further limitation is that only those individuals at highest risk may benefit. In a country with a high rate of CHD the problem is that the mean is high. The aim therefore should be to reduce the population mean and shift the whole distribution to the left. This suggests a policy of health education and of policies that remove the barriers against choosing a healthy diet. Even were such policies to be implemented successfully these alone would not abolish social and regional differences in CHD mortality. PMID- 3315681 TI - The use of diet to lower plasma cholesterol levels. AB - The basic principle of a lipid lowering diet is restriction of saturated fat intake. This can be achieved by reducing the consumption of dairy products and fats of animal origin. To keep energy intake constant (in normal weight individuals) complex carbohydrate or unsaturated fat is substituted for saturated fat. Diets with various proportions of complex carbohydrate, monounsaturated fatty acids, and polyunsaturated fatty acids have been proposed. In theory, the latter should be the best substitute for saturated fatty acids in a lipid lowering diet. Polyunsaturated fat has cholesterol lowering activity that is additive to the effect obtained by reducing the amount of dietary saturated fat. In practice, either polyunsaturated fatty acids or monounsaturated fatty acids or complex carbohydrate exert very similar effects on plasma cholesterol levels when substituted for saturated fatty acids in a lipid lowering diet. Their effects on plasma triglyceride are, however, dissimilar. Increased consumption of polyunsaturated fat leads to pronounced reduction in plasma triglyceride concentrations. Conversely, a high carbohydrate diet has a hypertriglyceridemic effect that is more pronounced in individuals with diabetes or preexisting hypertriglyceridemia. Dietary cholesterol should also be reduced in order to lower plasma cholesterol levels. However, the hypocholesterolemic effect of this measure has a large interindividual variation which is further influenced by the fat composition of the diet. Dietary fibre has received attention in more recent years for its ability to reduce plasma cholesterol levels. Fibre rich foods are not equally effective in this respect, the most active being legumes, fruit and vegetables. When high carbohydrate-high fibre diets are consumed, the hypertriglyceridaemic effect of carbohydrate is counteracted by dietary fibre.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315682 TI - Pharmacological control of serum lipid levels: currently available drugs. PMID- 3315683 TI - The clinical efficacy and safety of lovastatin and MK-733--an overview. PMID- 3315684 TI - Treatment of familial and non-familial hypercholesterolaemia: a review of HMG-CoA reductase inhibitors and probucol. AB - Hypocholesterolaemic agents are powerful modifiers of the plasma lipoprotein pattern. In addition to lowering plasma low density lipoprotein (LDL) cholesterol, such drugs may elevate, decrease or have no effect on high density lipoprotein (HDL) cholesterol. Bile acid binding resins and 3-hydroxy-3 methylglutaryl Coenzyme A (HMG-CoA) reductase inhibitors cause a reduction in hepatic cholesterol content resulting in stimulation of LDL receptor activity. This decreases the plasma LDL level, while HDL cholesterol levels remain unchanged or increase. Probucol, on the other hand, lowers both LDL and HDL cholesterol. It does not act by stimulating LDL receptor activity and is effective in some patients with homozygous familial hypercholesterolaemia who virtually lack LDL receptors. Despite their different lipoprotein-modifying effects, both HMG-CoA reductase inhibitors and probucol are regarded useful in the prevention and retardation of atherosclerosis. PMID- 3315685 TI - The increased echogenicity of the pancreas in infants and children: the white pancreas. AB - An increased echogenicity of the pancreas ("white pancreas") was sonographically found in 25 children with various pancreatic and systemic diseases. Fifteen patients with cystic fibrosis had a small white pancreas. Five patients with haemosiderosis, two with pancreatitis and one with Shwachman-syndrome presented with a normal-sized or slightly enlarged pancreas. Fatty infiltration and calcifications of the pancreas can also increase its echogenicity. PMID- 3315686 TI - Childhood bacterial meningitis: initial symptoms and signs related to age, and reasons for consulting a physician. AB - The relationship of symptoms and signs to age and the reasons for consulting a physician were analyzed in 110 cases of culture-proven childhood bacterial meningitis. H. influenzae caused 74, meningococci 28, pneumococci 6 and streptococci 2 of the cases. Apart from fever (present in 94%), the most common symptoms according to age were as follows: 1-5 months: irritability (85%), 6-11 months: impaired consciousness (79%), 12 months or more: vomiting (82%) and neck rigidity (78%). Absence of neck rigidity at diagnosis was associated with young age (less than 12 months, P less than 0.001) and, in older children, to a short duration of symptoms (P less than 0.01) but not to the degree of CSF pleocytosis. Symptoms of meningitis caused by H. influenzae differed from those of meningococcal meningitis. Meningitis should be suspected in irritable or lethargic febrile children despite absence of neck rigidity. Fever and vomiting were the most frequent reasons for consulting a physician (60% and 31%, respectively). Despite the frequency and alarming character of irritability, impaired consciousness and neck rigidity, their presence led infrequently to a consultation (6%, 22% and 3%, respectively). Parental ignorance of such symptoms or of their importance may cause treatment delay, despite readily available medical services. PMID- 3315687 TI - A once daily theophylline preparation in prevention of nocturnal symptoms in childhood asthma. AB - Twenty school children with chronic asthma who despite regular prophylactic therapy continued to have troublesome nocturnal wheeze or cough entered a double blind cross-over study in which a once daily theophylline preparation was compared with placebo to assess control of these symptoms. Seventeen children completed both phases of the study. Significant improvement was noted in the day and night symptom scores, the morning dip index and daily peak flow readings with a significant reduction in rescue bronchodilator inhaler usage during the active treatment period. Satisfactory serum theophylline concentrations were obtained 11 12 h post dose in all children using a standard dose of 18 mg/kg per day at 2000 hours. Three children were withdrawn because of minor side-effects. The theophylline preparation studied in conjunction with other conventional anti asthma therapy was thus effective in controlling nocturnal symptoms. PMID- 3315689 TI - Relevance of constipation to enuresis, urinary tract infection and reflux. A review. AB - Little attention has been afforded the relevance of constipation to urinary symptoms. Problems of definition and measurement have contributed to this problem. A review of the literature suggests that rectal dilatation may influence the function of the urinary tract leading to urinary tract infection and enuresis. Our studies indicate that constipation may, by causing uninhibited bladder contractions, cause urinary tract infection, enuresis and vesicoureteral reflux. PMID- 3315688 TI - Diabetic polyneuropathy and insulin secretion in type II diabetic patients. AB - Electrophysiological examination was performed on 50 type II diabetic patients to verify whether insulin secretory reserve is a factor influencing the susceptibility to develop polyneuropathy. The results showed that less significant metabolic derangement related to high insulin secretory reserve, and not the high insulin secretory reserve by itself, may prevent the development of neuropathic disorders. These data are consistent with the current opinion that diabetic polyneuropathy is the consequence of the metabolic derangement caused by chronic hyperglycemia. PMID- 3315690 TI - Incidence and distribution of renal anomalies in patients with neural tube defects. AB - In 190 patients with neural tube defects the sensory levels to pin prick were compared with the incidence and distribution of congenital renal anomalies. 17 such anomalies comprised 3 examples of renal agenesis, 5 horseshoe kidneys, 8 ureteral duplications and one simple ureterocele. The pattern of anomalies showed that renal agenesis was associated with a sensory level in the dermatomes T5-8, horseshoe kidneys with T9-L1 and duplications predominantly with the sacral dermatomes. PMID- 3315691 TI - Immunoperoxidase staining of fine-needle aspiration biopsies of renal cell carcinoma using tumor-specific monoclonal antibody. AB - In 30 nephrectomy specimens, fine needle aspiration biopsies (FNAB) were performed both in the tumor and in the macroscopically normal part of the kidney: 18 were well differentiated renal cell carcinoma (RCC), 6 were moderately differentiated RCC, 4 were poorly differentiated RCC, and 2 were oncocytomas. FNAB was also performed in a bone metastasis of RCC. FNAB materials were stained using the immunoperoxidase method with RCC-specific monoclonal antibody and were compared with the staining of frozen sections. In all cases where tumor-antigen expression could be demonstrated in the frozen sections, a FNAB had already proven positive. There were only 2 false-negative cases where sufficient cellular material could not be obtained due to extensive tumor necrosis. There was no false-positive case. Oncocytomas showed no expression of antigen. The use of immunoperoxidase staining of FNAB with tumor-specific monoclonal antibody is discussed. PMID- 3315692 TI - Mixed carcinoma of the prostate with penile metastases and priapism. AB - A case report of mixed prostatic carcinoma metastasizing to the penis is presented. A review of the literature revealed only 55 cases of prostatic carcinoma metastasizing to the penis report to date. To the best of our knowledge, no such unusual case has been reported before. PMID- 3315694 TI - Lack of beta-casein production by human breast tumours revealed by monoclonal antibodies. AB - An immunohistochemical study with four monoclonal antibodies to human beta-casein was carried out to examine the expression of this milk protein in a wide range of normal tissues, in 127 breast tumours and in a heterogeneous panel of 42 malignancies of other histogenesis. The only normal tissue stained positively by the antibodies was the mammary gland in late pregnancy, during lactation and in the post-lactational regression period. None of the tumours of non-mammary origin showed any staining. Furthermore, only two of 40 benign breast lesions and one anaplastic primary carcinoma with its metastasis (among 87 breast carcinomas) showed any reactivity. The immunohistochemical results were supported by immunoblotting data and suggested beta-casein expression has no role to play as a marker in the diagnosis or monitoring of human breast cancer. PMID- 3315693 TI - Effect of ovariectomy, hypophysectomy and/or GnRH analog (HRF) administration on the cell proliferation of the MXT mouse hormone-dependent mammary tumor. AB - The MXT tumor is an experimental mammary neoplasm which is maintained by serial transplantation using B6D2F1 mice, and which contains significant amounts of estrogen and progesterone receptors. The aim of the present study is to examine the effects of ovariectomy (OVX) or ovariectomy plus hypophysectomy (OVX-HX) on both the macroscopic growth and the cell proliferation of this tumor. This cell proliferation was evaluated by means of in vivo tritiated thymidine autoradiography. In addition, we investigated the effects of a GnRH analog (Gonadorelin: HRF, 5-oxo-Pro-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-Gly-hydrochloride) on MTX tumor cell proliferation on 7 day-OVX and 5 day-HX (OVX-HX) mice. The uterine luminal epithelium was chosen to monitor the methodology. Our data clearly demonstrate that there is a delay in the growth of MXT tumors grafted into hypophysectomized animals and, to a lesser degree, ovariectomized animals. With respect to proliferation, castration induced a dramatic decrease of the thymidine labelling index (TLI) in the tissue used to monitor the methodology (the uterine luminal epithemium); in contrast, no cell proliferation was induced by hypophysectomy or HRF administration. In 4-week-old MXT tumors, ovariectomy also markedly decreased the TLI within a few days of its taking place. However hypophysectomy, performed on castrated animals, induced a significant and transient increase of cell proliferation in this neoplasm, an increase which lasted from the 2nd to the 5th day following the operation. The high basal level of MXT cell proliferation recorded in OVX-HX animals decreased dramatically after the administration of HRF between 12 and 48 h prior to the sacrifice of the animals. It is concluded that the HRF exerts a direct effect on the MXT tumor cells, and this HRF might be essential for their growth. PMID- 3315695 TI - A phase II study of carboplatin in advanced or metastatic stomach cancer. PMID- 3315696 TI - Leukocyte adherence inhibition: history, biological basis and clinical usefulness. PMID- 3315697 TI - Characterization of daunorubicin resistance in K562 leukemia cells lacking daunorubicin reductase activity. AB - Daunorubicin (D1)-resistant cells have been isolated from daunorubicin reductase deficient K562 cells, hence, metabolism of D1 to the alcohol metabolite daunorubicinol (D2) will not contribute to the development of resistance. The resistant cell lines were 22-123-fold resistant and were cross-resistant to a variety of drugs. Drug uptake and efflux were altered in the more resistant lines but not in the less resistant cells. Verapamil enhanced D1 cytotoxicity in all resistant lines; it inhibited D1 efflux in the higher resistant line thereby resulting in an increase in the cellular level of D1. However, this was not true for the less resistant line suggesting that verapamil enhancement of D1 toxicity in the less resistant line is probably due to other factors. Additionally, we have been unable to identify a marker glycoprotein in resistant cells. The changes observed in the resistant sublines are moderate and probably drug accumulation differences could not account for the degree of D1 resistance noted, nor could resistance be wholly reversed by calcium antagonist. Other factors may be involved in the development of resistance in these human cells. PMID- 3315698 TI - Combination chemotherapy including epirubicin for the management of non-Hodgkin's lymphoma. AB - One hundred patients with untreated non-Hodgkin's lymphoma were entered in a prospective randomized study in South and West Wales designed to assess the value of the anthracycline antibiotic, epirubicin (4'-epidoxorubicin), in their management. Patients with low grade histology and progressive disease were randomized to receive either epirubicin, vincristine and prednisolone (EVP) or cyclophosphamide, vincristine and prednisolone (CVP). The response rate of 81% in patients receiving EVP with complete remission rate of 52% were similar to a response rate of 88% and complete remission rate of 58% for patients receiving CVP. No difference was observed in survival between the two groups. Patients with high grade lymphoma were randomized to receive either cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) or cyclophosphamide, epirubicin, vincristine and prednisolone (CEOP). The response rate was 71% for CHOP and 84% for CEOP. The complete remission rates were 46% for CHOP and 61% for CEOP. The cardiotoxicity of the two anthracyclines were monitored closely in 45 patients using measurements of systolic time intervals. Patients receiving epirubicin tolerated higher dose per course and higher total cumulative dose with less evidence of compromised left ventricular function than patients receiving doxorubicin. Epirubicin is an effective agent when used in combination chemotherapy in both low grade and high grade lymphoma with less toxicity than doxorubicin. PMID- 3315700 TI - Elaborated corrective feedback and the acquisition of reasoning skills: a study of computer-assisted instruction. PMID- 3315699 TI - Plasma free platinum pharmacokinetics in patients treated with high dose carboplatin. AB - Plasma free platinum (less than 50,000 mol. wt) pharmacokinetics have been studied in eight patients treated with high-dose (800-1600 mg/m2) carboplatin as a 1 h infusion with moderate hydration. Following the infusion, levels decayed biphasically with half-lives (means +/- S.D.) of 83 +/- 15 min and 6.1 +/- 2.8 h. The plasma free platinum area under the concentration vs. time curve (AUC) at 1600 mg/m2 in five patients was 23 +/- 2 mg carboplatin/ml.min. Comparison with data at conventional doses (less than or equal to 500 mg/m2) gave no indication of non-linear kinetics. Total body clearance of free platinum was found to correlate with glomerular filtration rate (r = 0.769, P = 0.03), and haematological toxicity, white cell nadir and duration of thrombocytopenia, correlated with plasma free platinum AUC (r = 0.784, P = 0.02 and r = 0.885, P = 0.01, respectively). Persistence of platinum was demonstrated in tissues removed at autopsy from a patient who had received carboplatin 14 days earlier. Highest platinum levels were found in the liver, kidney, skin and small cell lung tumour. PMID- 3315701 TI - In vitro production of human interleukin 1 alpha and interleukin 1 beta by peripheral blood mononuclear cells examined by sensitive sandwich enzyme immunoassay. AB - The in vitro production of human interleukin 1 alpha (hIL 1 alpha) and interleukin 1 beta (hIL 1 beta) by peripheral blood mononuclear cells was examined by sensitive sandwich enzyme immunoassays which could discriminate hIL 1 alpha and hIL 1 beta without cross-reaction with human IL2. In culture supernatants of mononuclear cells, two components were detected by sandwich enzyme immunoassay for hIL 1 alpha or hIL 1 beta. The molecular weight of one component was shown to be equal to that of recombinant hIL 1 alpha or hIL 1 beta by gel filtration. The elution volume of the other component corresponded to a molecular weight of about 30,000. The sum of the two components for both hIL 1 alpha and hIL 1 beta in culture supernatants of peripheral blood mononuclear cells from healthy subjects increased 1.7 to 38-fold by Escherichia coli lipopolysaccharide. The sum of the two components for hIL 1 beta was 13 to 97 fold larger than that for hIL 1 alpha. PMID- 3315702 TI - [Early pregnancy diagnosis by the ultrasonographical device and observation of fatal growth in cynomolgus monkeys (Macaca fascicularis)]. AB - Usefulness of the ultrasonographical device (USD) for early diagnosis of pregnancy and for observation of fetal growth was examined in the cynomolgus monkey (Macaca fascicularis). Firstly, 50 females, each of which was mated for 24 hours in an individual cage, were used. They were diagnosed for pregnancy by the use of USD 15 to 29 days and 35 days after mating. Then, 20 of them were judged to be pregnant. The early pregnancy diagnosis was based on the detection of gestational sac (GS) in the uterus. The GS was detected 20.0 +/- 1.8 days after mating. The duration from the day on which GS was first detected to the day on which the heart beat of embryo (HBE) was detected averaged 5.6 +/- 1.5 days. In 17 of these 20 pregnancies, GS was detected 17 to 23 days after mating. As regards the remaining three pregnant cases, GS and HBE were simultaneously detected on the 28th day of pregnancy in two cases, and on the 35th day in one case. Secondly, 225 females who were mated by the routine 3 day-mating system were used. Pregnancy diagnosis by USD was conducted on the 21st, 28th and 35th day after mating. Ninety-six of the 225 females were judged to be pregnant. In 33 (34.1%) of the 96 pregnant cases, GS was detected on the 21st day of pregnancy. In 57 females (59.4%), GS was detected on the 35th day. Furthermore, it was able to judge conditions of fetal growth by measuring the size of GS and biparietal diameter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315703 TI - Cancer genes, proto-oncogenes, and development. AB - The retroviral cancer genes have in a number of observations been shown to interfere with the developmental program of target cells. Here we are concerned with the interface between cancer genes/proto-oncogenes and developmental processes. Research in this field serves two purposes; to delineate key developmental controls and to identify these as targets for oncogenic agents. PMID- 3315704 TI - Bovine tubercle bacilli and disease in animals and man. PMID- 3315705 TI - A phage-typing scheme for Salmonella enteritidis. AB - For many years phage typing has proved invaluable in epidemiological studies on Salmonella typhi, S. paratyphi A and B, S. typhimurium and a few other serotypes. A phage-typing scheme for S. enteritidis is described. This scheme to date differentiates 27 types using 10 typing phages. PMID- 3315707 TI - Calculation of the expected increases of coliform organisms, Escherichia coli and Salmonella typhimurium, in raw blended mutton tissue. AB - Samples of blended mutton tissue in small polyvinyl chloride sachets were incubated in water baths for different times and at varying temperatures. The temperature of each bath was recorded accurately throughout each experiment. Using equations previously derived for the lag and generation times of coliform organisms in blended mutton tissue, the expected increases of these bacteria were calculated from the time/temperature recordings. These were compared with the data obtained from plate counts made on the tissue samples in the sachets before and after incubation. The studies were done with a strain of Escherichia coli, one of Salmonella typhimurium and the coliform organisms naturally present on sheep carcasses processed in a commercial abattoir. The calculated growth agreed closely with that measured. Therefore, if mutton, after overnight chilling, is warmed again to temperatures within the growth range of these bacteria, the possible increases in the numbers of cells present can be calculated directly from time and temperature measurements. The implications for the present codes of practice in abattoirs are discussed. PMID- 3315706 TI - Incidence of plasmids in multiply-resistant Salmonella isolates from diarrhoeal patients in Hong Kong from 1973-82. AB - Plasmids present in multiply-resistant salmonella strains including Salmonella typhimurium, S. johannesburg, S. wandsworth, S. derby, S. newport, S. london and S. choleraesuis causing diarrhoea in patients in Queen Mary Hospital in Hong Kong from 1973-82 were studied. In multiply-resistant S. typhimurium, plasmids belonging to groups FIme, H1 or H2 and plasmids encoding trimethoprim-resistance which were compatible with standard plasmids of testable incompatibility groups were detected. In S. johannesburg, both the ASTCKSu- and ASCKSu-resistant strains which were predominant in two consecutive periods of an outbreak were found to harbour the same plasmid which belonged to the incompatibility group FIme. S. wandsworth strains isolated from a hospital outbreak in 1980 harboured an identical R-plasmid belonging to group N. A few strains of the other salmonellae showing resistance to multiple antibiotics were found to harbour R-plasmids belonging to groups H1, H2 and FIme. The only salmonella of the enteric fever group resistant to ampicillin, chloramphenicol and trimethoprim was an S. paratyphi B strain. The resistances were encoded on a plasmid of an unknown incompatibility group. The occurrence and distribution of plasmids in these salmonellae isolated within the 10-year period are discussed. PMID- 3315708 TI - Comparison of alcohol shock enrichment and selective enrichment for the isolation of Clostridium difficile. AB - Two enrichment methods were compared for their ability to recover Clostridium difficile from stool samples. One method used selective enrichment in an antibiotic-containing broth followed by detection with a latex particle agglutination (LPA) reagent. The other used enrichment in a non-selective broth following treatment of the specimen with alcohol. With clinical specimens enrichment culture was significantly more successful at detecting C. difficile than direct plating. Alcohol shock enrichment was twice as effective as direct culture, while selective broth enrichment was three times more effective. The use of LPA for screening selective enrichment broths for C. difficile should prove a cost-effective measure as only positive broths (about 20%) require subculture for confirmation. PMID- 3315709 TI - Psittacosis in a highly endemic area in Italy. AB - In one locality in Italy where the incidence of psittacosis has increased rapidly since 1980, a hospital-based study and a seroepidemiological survey were carried out in order to define the clinical and epidemiological features of psittacosis in that area. Registers of the Virology Unit of the University of Ancona, Italy, were reviewed and all hospitalized patients with a serological diagnosis of psittacosis were identified. A total of 76 cases were found and studied. A presumptive bird source was identified in 80% of 62 patients, on whom a detailed investigation had been possible. Poultry represented the most frequent probable source of infection. Clinically, the predominant pattern of illness was a moderately severe lower respiratory tract infection, with chest X-rays showing pulmonary shadowings in 68 patients (89%). In the seroepidemiological study, 51 out of 143 subjects were exposed to birds (35.7%), but only 7 out of 96 urban adult blood donors (7.3%) were positive for chlamydial antibodies using the microimmunofluorescence test. PMID- 3315710 TI - Strain differentiation of Candida albicans by morphotyping. AB - Strains of Candida albicans can be differentiated by the morphological features of streak colonies developed on malt agar. A morphotyping system is proposed, where numerical codes are assigned primarily on the basis of the nature and extent of marginal fringing and the surface topography of the streak colony. The system allows ready differentiation to be made of morphotypes, requires no specialized equipment or expertise and provides a simple and reproducible means for epidemiological studies of candida and candidosis. PMID- 3315711 TI - Most probable numbers of organisms: revised tables for the multiple tube method. AB - Estimation of numbers of organisms is often made using dilution series, for example when examining water samples for coliform organisms. In this paper the most probable numbers (MPNs) are calculated for a 15-tube series consisting of five replicates at three consecutive tenfold dilutions. Exact conditional probabilities are computed to replace previous approximations. When growth is observed in several of the tubes it is not realistic to select a single MPN. Instead a most probable range (MPR) should be reported. But using an MPR creates problems when comparison has to be made with a legislated, single-valued Standard. It is suggested that the wording of the Standards should be expressed differently when the multiple tube method is used. PMID- 3315712 TI - How are the sub-unit pertussis vaccines to be evaluated? AB - Although an effective whooping cough vaccine has been available in the UK since the 1950s, its current association with neurotoxicity has resulted in poor uptake: as a consequence major epidemics (with significant morbidity and mortality) are still being experienced. Component (sub-unit) vaccines, which incorporate those antigens thought to be concerned with generating a protective effect, have been developed and are now available for field testing. This paper addresses how such a vaccine might be evaluated, the organization of a trial and the difficulties to be expected. PMID- 3315714 TI - Diet in the etiology of breast cancer. PMID- 3315713 TI - Sequential infection or immunization of ferrets with a series of influenza A (H3N2) strains (report to the Medical Research Council's Sub-Committee on influenza Vaccines (CDVIP/IV)). AB - Previous studies of boys at Christ's Hospital school have indicated that annual immunization with influenza virus vaccines did not significantly reduce the total incidence of influenza infection compared to unimmunized subjects. In view of the implications of this result, a similar study was conducted in ferrets to clarify these findings. Groups of ferrets were immunized or infected with a series of influenza A (H3N2) viruses over an 18-month period, and the immunity to subsequent live virus challenge was measured after each virus or vaccine exposure. The results indicated that live virus infection gave a more solid immunity than immunization with inactivated vaccine; and the serum haemagglutination-inhibiting antibody response was greater following immunization than following infection. In addition, differences in immunity could not be explained by measurements of cross-reacting and specific antibody, since the incidence of these antibodies was similar in both infected and immunized animals. The results do not suggest an explanation for the different levels of immunity induced following infection or immunization or the results obtained from the Christ's Hospital study. However, the relative contribution of various immune responses to virus or virus antigen is discussed, and it is suggested that the difference in immunity may lie in the ability of live virus infection to stimulate local antibody. PMID- 3315715 TI - Mammographic parenchymal patterns and breast cancer risk. PMID- 3315716 TI - The interactions of tobacco smoking and other agents in cancer etiology. PMID- 3315717 TI - The prevalence of mental retardation. PMID- 3315719 TI - Obesity in black women. AB - The marked excess of obesity among black women in the United States poses several interesting questions which provide the framework for this review: Is the apparent high prevalence of obesity in black women a valid finding? If so, does it show the expected disease and disease risk associations? Can the contributory genetic and environmental variables be identified? Regarding the validity issue, the high prevalence of obesity in black women seems to be neither artifactual nor primarily an indirect effect of socioeconomic status. On the issue of racial comparability of disease risks among women, the available evidence is less conclusive. Obesity appears to have qualitatively similar health consequences for black women and white women but may be less strongly related to some disease risks (for example, hypertension) in black women than in white women. Obesity risks of black women may, however, be enhanced by the presence of multiple risk factors. On the question of causes, no clear mechanism for the excess obesity in black women can be identified. There is some evidence to support hypotheses based on dietary, lifestyle, and metabolic influences. Genetic factors cannot be ruled out. Several relevant future research possibilities can be suggested. Epidemiologic studies of both genetic and environmental influences in female obesity are needed. Studies among black females might further specify patterns of body weight and body fat distribution according to degree of European admixture and developmental variables such as caloric exposure in utero and in early infancy. Studies to establish more clearly the relative risks of various health outcomes for obese black women are needed to assist in setting public health priorities. For example, what are the attributable and absolute risks of overweight or obesity compared with other risk factors that are potential intervention targets? Studies are needed to define effective means of preventing and treating obesity among black women. Effective interventions are likely to be culture-specific. Definitive comparisons of black women and white women on environmentally mediated aspects of obesity might contribute to models of obesity in the general population and might also elucidate points at which black women and white women diverge. For example, short-term prospective studies are needed to better specify the natural history of weight gain and weight loss among females of both races during critical periods such as adolescence, post partum, lactation and post lactation, and during major life stresses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315720 TI - Epidemiology of ectopic pregnancy. PMID- 3315718 TI - Recent trends in the epidemiology and control of malaria. PMID- 3315721 TI - Blood lipids, lipid-related measures, and the risk of atherosclerotic cardiovascular disease. PMID- 3315722 TI - T-cell depletion of bone marrow transplants: assessment of standard immunological methods of quantification. AB - The efficacy of bone marrow transplant (BMT) T-cell depletion for the prevention of acute graft-versus-host disease (GVHD) has been demonstrated in animal models and in clinical studies. The importance of T-cell depletion has to be evaluated with standardized methods suitable for routine purposes. We report herein an in vitro mature T-cell depletion using a cocktail of three monoclonal antibodies (CD2, CD5, and CD7) and baby rabbit complement in 38 histocompatibility leucocyte antigen (HLA)-identical BMT with no more than grade II acute GVHD. The T-cell depletion was quantified using three prestandardized immunological methods: immunofluorescence (IF) analysis, SRBC-rosetting assay, and PHA proliferation assay. A mean of 97.5% IF-assessed T-cell depletion was achieved in the 38 BMT. The immediate IF analysis using three distinct sets of anti-T-cell monoclonal antibodies allowed us to detect a mean of 1.2% residual T cells. The SRBC rosetting assay was not useful to quantify T-cell depletion because no residual SRBC-rosette-forming cells could be detected in every case. The results of a prestandardized PHA-induced proliferation assay gave a mean 96.7% inhibition of proliferation, and they were correlated with the IF results although the IF threshold of detection was higher. From these data we conclude that our in vitro T-cell-depletion procedure is reproducible and that standardized simple immunological methods such as immediate immunofluorescence analysis and PHA proliferation assay provide good tools to assess a T-cell depletion effective in the prevention of acute GVHD. PMID- 3315723 TI - Modest stimulatory effect of recombinant human GM-CSF on colony growth from peripheral blood human megakaryocyte progenitor cells. AB - Recombinant human granulocyte-macrophage colony-stimulating factor (rGM-CSF) has been previously demonstrated to stimulate colony formation from human myeloid, erythroid, and multipotential stem cells. In this investigation, we evaluated the effects of rGM-CSF on colony growth by human megakaryocyte progenitors (CFU-Meg). rGM-CSF was tested at concentrations of 0.1-100 U/ml in plasma clot cultures of adherent-depleted normal peripheral blood mononuclear cells. Control cultures were concurrently prepared containing either no stimulator or megakaryocyte colony-stimulating factor (Meg-CSF) partially purified from aplastic canine serum. rGM-CSF increased megakaryocyte colony numbers from a baseline of 4.3 +/- 1.4 (+/- SEM) in the unstimulated cultures to a maximum of 21.0 +/- 5.3 colonies at an rGM-CSF concentration of 1.0 U/ml. Corresponding megakaryocytic colony size increased from 4.4 to 8.3 cells/colony. Further increasing the rGM-CSF concentration resulted in decreasing megakaryocyte colony growth, reaching 6.8 +/ 2.9 colonies at 100 U/ml. The maximum number of megakaryocyte colonies stimulated by rGM-CSF was only 23.3% of that achieved in the control cultures containing optimal concentrations of serum-derived Meg-CSF protein (2.0 mg/ml). Megakaryocyte colonies stimulated by rGM-CSF consisted of predominantly low ploidy cells approximately equally distributed in 2N, 4N, and 8N ploidy classes. There was no increase in ploidy with any rGM-CSF concentration. These data indicate that rGM-CSF has modest activity in stimulating human megakaryocyte colony growth that is substantially less than that present in serum-derived Meg CSF. rGM-CSF appears to primarily affect the early mitotic phase of megakaryocyte colony development with little influence on megakaryocyte endoreduplication. PMID- 3315724 TI - Clonal cytogenetic abnormalities in patients with otherwise typical aplastic anemia. AB - Between June 1981 and August 1986, 183 patients with the referring diagnosis of aplastic anemia were evaluated with cytogenetic studies and marrow biopsies. Seven patients (4%) on biopsy were found to have myelodysplasia. Seven of the 176 patients (4%) with marrow biopsies that confirmed the pathologic diagnosis of severe aplastic anemia were found to have clonal cytogenetic abnormalities in unstimulated marrow samples. Among the 169 patients with typical aplastic anemia and no cytogenetic abnormalities, 5 (3%) subsequently developed either myelodysplasia or leukemia. Two of three patients with pathologically confirmed aplastic anemia and clonal cytogenetic abnormalities, who were not transplanted, developed myelodysplasia. These results demonstrate that approximately 4% of patients with aplastic anemia have clonal cytogenetic abnormalities of marrow cells, and that while all patients with aplastic anemia may have some risk of developing leukemia, those with a cytogenetic abnormality have an especially high risk. PMID- 3315725 TI - Enhanced reconstitution of hematopoietic organs in irradiated mice, following their transplantation with bone marrow cells pretreated with recombinant interleukin 3. AB - Lethally irradiated C3H/eb mice were injected with syngeneic bone marrow cells that had been exposed for 4 h in vitro to purified bacterially synthesized interleukin 3 (rIL-3). Control mice were injected with cells exposed to incubation medium only. Mice injected with rIL-3-treated cells exhibited, on day 10 after transplantation an 8.2-fold and 2.7-fold increase in number of myeloid progenitors in their spleen and bone marrow, respectively, but the in vitro differentiation pattern of the myeloid progenitors was not affected. There was, however, an increase in the number of cells per individual in vitro myeloid colony (CFU-C) of the rIL-3-treated mice. The latter mice also showed a 1.6-fold increase in the number of splenic colony-forming units (CFU-S), a higher self renewal capacity of hematopoietic progenitors, and a higher number of leukocytes in the peripheral blood. These results indicate that the injection into lethally irradiated recipients of bone marrow cells briefly pretreated in vitro with rIL-3 significantly enhances the reconstitution of their hematopoietic organs, and suggest that the in vitro pretreatment of bone marrow cells with appropriate stimulating factors could be useful in bone marrow transplantation. PMID- 3315727 TI - Bone marrow cells other than stem cells seed the bone marrow after rescue transfusion of fatally irradiated mice. AB - In a previous publication, iodinated deoxyuridine (125IUdR) incorporation data were interpreted as indicating that spleen colony-forming units (CFU-S) in DNA synthesis preferentially seeded bone marrow. In the present studies, the CFU-S content of marrow from irradiated, bone-marrow transfused mice was directly determined. Pretreatment of the transfused cells with cytocidal tritiated thymidine resulted in an insignificant diminution in CFU-S content when compared with nontritiated thymidine pretreatment, implying that there is no preferential seeding. The 125IUdR incorporation data have been reinterpreted as being a result of the proliferation of other progenitor cells present that have seeded the bone marrow. PMID- 3315726 TI - Establishment of permanent chimerism in a lactate dehydrogenase-deficient mouse mutant with hemolytic anemia. AB - Pluripotent hemopoietic stem cell function was investigated in the homozygous muscle type lactate dehydrogenase (LDH-A) mutant mouse using bone marrow transplantation experiments. Hemopoietic tissues of LDH-A mutants showed a marked decreased in enzyme activity that was associated with severe hemolytic anemia. This condition proved to be transplantable into wild type mice (+/+) through total body irradiation (TBI) at a lethal dose of 8.0 Gy followed by engraftment of mutant bone marrow cells. Since the mutants are extremely radiosensitive (lethal dose50/30 4.4 Gy vs 7.3 Gy in +/+ mice), 8.0-Gy TBI followed by injection of even high numbers of normal bone marrow cells did not prevent death within 5-6 days. After a nonlethal dose of 4.0 Gy and grafting of normal bone marrow cells, a transient chimerism showing peripheral blood characteristics of the wild type was produced that returned to the mutant condition within 12 weeks. The transfusion of wild type red blood cells prior to and following 8.0-Gy TBI and reconstitution with wild type bone marrow cells prevented the early death of the mutants and permanent chimerism was achieved. The chimeras showed all hematological parameters of wild type mice, and radiosensitivity returned to normal. It is concluded that the mutant pluripotent stem cells are functionally comparable to normal stem cells, emphasizing the significance of this mouse model for studies of stem cell regulation. PMID- 3315728 TI - Immunodetection by enzyme-linked immuno-filtration assay (ELIFA) of IgG, IgM, IgA and IgE antibodies in bird breeder's disease. AB - The diagnosis of bird breeder's lung (BBL) depends upon a range of epidemiological, clinical, radiological and immunological arguments. The simple detection of antibodies cannot constitute a pathognomonic criterion of BBL. We applied the enzyme-linked immuno-filtration assay (ELIFA) to the study of 50 sera chosen from 2509 samples taken from subjects exposed to avian antigens. The arc IgAp was detected in all sera samples (n = 27) taken from symptomatic subjects (n = 16), but was only demonstrated 3 times out of 2466 samples taken from exposed asymptomatic subjects. The ELIFA method revealed IgG, IgM, IgA and IgE precipitating antibodies only in the case of clinically ill subjects. Finally, this technique demonstrated a second functional antigenic component (arc-P2) which preferentially induced specific immunoglobulins of different classes. Compared immunological profiles (CIP), established by ELIFA, seem to be highly significant for BBL, and correlate well with pathological symptoms and their evolution. PMID- 3315729 TI - Leiomyoma of the trachea. PMID- 3315730 TI - Plasmodium falciparum: freeze-fracture of the gametocyte pellicular complex. AB - Freeze-fracturing has been used to study the architecture of the pellicular complex of the gametocytes of Plasmodium falciparum. The gametocyte is surrounded by three membranes and a layer of subpellicular microtubules. During freeze fracturing, each of the three membranes is split along its hydrophobic interior to yield a total of six fracture faces. The most obvious feature of each fracture face is the presence of globular intramembranous particles on their surfaces. The six fracture faces differ from one another in arrangement, size, and density of these intramembranous particles. In gametocytes, unlike in sporozoites, the intramembranous particles are always distributed randomly and lack any definite pattern or orientations. A unique feature of gametocytes revealed by the freeze fracturing technique is the presence of several transverse sutures on the middle membrane that encircle the gametocyte and give it a segmented appearance. PMID- 3315731 TI - Inhibition of hemoglobin degradation in Plasmodium falciparum by chloroquine and ammonium chloride. AB - The effect of chloroquine (CQ) and NH4Cl on hemoglobin degradation within Plasmodium falciparum was studied by SDS gel electrophoresis. CQ inhibited hemoglobin digestion such that accumulation of hemoglobin in the parasites occurred. Quantitative analysis indicated that the content of hemoglobin in isolated CQ-treated parasites was increased from 2.39 +/- 0.47 micrograms hemoglobin (Hb)/mg protein to 8.34 +/- 0.77 micrograms Hb/mg protein (P less than 0.001) within 45 min and further to 18.7 +/- 1.23 micrograms Hb/mg protein for 2 hr compared with the untreated parasites. These results suggest that the inhibition of hemoglobin degradation in malarial parasites might be the primary target of CQ antimalarial action. The CQ-like effect on the hemoglobin digestion in P. falciparum was observed with another lysosomotropic weak base, NH4Cl, suggesting that the CQ effect on hemoglobin degradation and its antimalarial action, as well as the effect of NH4Cl, are related to their properties of lysosomotropic weak base. PMID- 3315732 TI - Plasmodium berghei, P. chabaudi, and P. falciparum: similarities in phosphoproteins and protein kinase activities and their stage specific expression. AB - Phosphoproteins from Plasmodium berghei, P. chabaudi, and P. falciparum are compared. A major phosphoprotein of 46 kDa is found in all three species. Peptide mapping indicates that this protein is indeed the same in all three cases and is phosphorylated at similar sites in all three species. Monoclonal antibodies were raised against three other P. berghei phosphoproteins. All three monoclonal antibodies recognize both P. berghei and P. chabaudi proteins. Only one of the monoclonal antibodies crossreacts with a P. falciparum protein of 36 kDa, whereas the equivalent P. berghei and P. chabaudi proteins are 34 and 32 kDa, respectively. The highest rate of synthesis of the phosphoproteins is observed during the early trophozoite stage, whereas the highest rate of phosphorylation is observed during the late trophozoite stage. PMID- 3315733 TI - Trypanosoma cruzi: characterization of in vitro and in vivo synthesized polypeptides from epimastigote forms of different strains. AB - Intact RNAs were isolated from epimastigote forms of different Trypanosoma cruzi strains. Translation of the mRNAs using rabbit reticulocyte lysate and analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed protein profiles comparable to those observed by labeling cells in vivo. No major interstrain differences were observed in the patterns of the polypeptides synthesized in vitro and in vivo, indicating that metabolic proteins are similar among distinct strains. Several T. cruzi polypeptides produced in the rabbit reticulocyte lysate system were immunoprecipitated by specific antisera. The patterns of antigenic polypeptides recognized by antisera raised against epimastigotes from different strains were also very similar. PMID- 3315734 TI - Effect of artemisinin (qinghaosu) and chloroquine on drug-sensitive and drug resistant strains of Plasmodium falciparum malaria: use of [2,8-3H]adenosine as an alternative to [G-3H]hypoxanthine in the assessment of in vitro antimalarial activity. AB - Using [G-3H]hypoxanthine uptake as a radioactive indicator for the growth of malarial parasites, we measured the antimalarial activity of artemisinin (Qinghaosu, QHS) against FCMSU1/Sudan strain (chloroquine-sensitive strain) and FCB K+ strain (chloroquine-resistant strain) of Plasmodium falciparum in continuous culture in vitro. The 50% inhibitory concentrations (IC50) for QHS against FCMSU1/Sudan strain and FCB K+ strain were 2.8 X 10(-8) and 3.0 X 10(-8) M, respectively. On the contrary, the response of the two strains to chloroquine was quite different. The IC50 for chloroquine against FCMSU1/Sudan strain was 5.6 ng/ml, whereas that for the FCB K+ strain was 65.6 ng/ml. Therefore, QHS did not appear to exhibit any cross-resistance with chloroquine. If [2,8-3H]adenosine was used as a radioactive precursor instead of [G-3H]hypoxanthine for the determination of antimalarial activity, virtually identical results were obtained. Therefore, [2,8-3H]adenosine can be used as an alternative to [G 3H]hypoxanthine for the assessment of antimalarial action. PMID- 3315735 TI - Toxocara canis: monoclonal antibodies to larval excretory-secretory antigens that bind with genus and species specificity to the cuticular surface of infective larvae. AB - When maintained in culture, the infective-stage larvae of Toxocara canis produce a group of excretory-secretory antigens. Monoclonal antibodies to these antigens have been produced and partially characterized. Hybridomas were made using spleens from mice that had been given 250 embryonated eggs of T. canis followed by immunization with excretory-secretory antigens. Monoclonal antibodies were first screened against excretory-secretory antigens using an indirect enzyme linked immunosorbent assay. Those antibodies positive in this assay were then screened against the surfaces of formalin-fixed, infective-stage larvae using an indirect fluorescent antibody assay. The two monoclonal antibodies showing fluorescence were also tested against the surfaces of infective-stage larvae of Toxocara cati, Baylisascaris procyonis, Toxascaris leonina, Ascaris suum, a Porrocaecum sp., and Dirofilaria immitis. One of these two antibodies bound to the surface of T. canis and T. cati while the other bound only to the surface of T. canis; neither were reactive with the other ascaridoid larvae or the larvae of D. immitis. Enzyme-linked immunoelectrotransfer blotting techniques were used to demonstrate that the cross-reactive antibody recognized antigens with molecular weights of about 200 kDa while the more specific monoclonal antibody recognized antigens with approximate molecular weights of 80 kDa. The specificity of these two antibodies for T. canis and T. cati should prove helpful in the development of more specific assays for the diagnosis of visceral and ocular larva migrans. PMID- 3315736 TI - Stage-specific surface antigens expressed during the morphogenesis of vertebrate forms of Trypanosoma cruzi. AB - The origin of Trypanosoma cruzi slender and broad forms found in the circulation of the mammalian host has remained obscure and, unlike what has been proposed for African trypanosomes, no precise form-function relationship has been ascribed to them. We show here that parasites circulating in the blood of infected animals display a high degree of polymorphism. Around 10% of the forms found circulating in mice during the acute phase of infection were amastigotes, and the other 90% included slender and broad trypomastigotes and intermediate forms between amastigotes and trypomastigotes. Slender trypomastigotes, from blood or cell culture, undergo extracellularly morphological rearrangements in which the parasites become gradually broader and transform into amastigotes. By scanning electron microscopy a progressive internalization of the flagellum and reorganization of the cell shape in a helical fashion were observed in parasites undergoing transformation. After 48 hr of extracellular incubation the parasite population consisted exclusively of amastigotes with a short protruding flagellum. The morphological changes were associated with the expression of different surface antigens defined by monoclonal antibodies: the trypomastigote specific antigens Ssp-1 (a 100-120-150-Mr glycoprotein), Ssp-2 (a 70-Mr glycoprotein), Ssp-3 (undefined), and Ssp-4, an amastigote-specific surface antigen. Ssp-4 was also detected on intracellular amastigotes (in vitro and in vivo). We conclude that trypomastigotes are programmed to develop into amastigotes whether or not they enter cells, and that the differentiation can occur in the blood of the vertebrate host. These findings raise some questions regarding conventional views on the life cycle of T. cruzi. PMID- 3315737 TI - Plasmodium falciparum: epidemiological studies on the circumsporozoite gene. PMID- 3315738 TI - Serum from Pf195 protected Aotus monkeys inhibit Plasmodium falciparum growth in vitro. PMID- 3315739 TI - Early loss of myocardial myoglobin detected immunohistochemically following occlusion of the coronary artery in rats. AB - The time course of the loss of myoglobin from the rat ventricular myocardium in the early phase of ischemia was studied with the use of an immunohistochemical technique and an image analyzer. The loss of myoglobin, as an index of myocardial injury, was evident in the left ventricular subendocardium as early as 0.5 hr after occlusion of the left main coronary artery. A clear-cut demarcation of the myoglobin-depleted area helped quantification of the injured areas with an image analyzer. The area with depleted myoglobin became transmural and reached maximum after 2 and 3 hr of occlusion, respectively. Electron microscopic observation of the myoglobin-depleted region revealed amorphous dense bodies in the mitochondria, indicating irreversible damage to the myocardial cells. On the other hand, no irreversible changes could be detected with hematoxylin-eosin stain until 6 hr after the start of the ischemia, and the distinction between the reversible and irreversible areas was unclear. We suggest that depletion of myoglobin from the myocardium serves as a marker for irreversible ischemic injury. Quantitative assessment of the injured areas by immunohistochemical staining for myoglobin together with an image analyzer could be of great value for the evaluation of early ischemic myocardial damage. PMID- 3315740 TI - Polyclonal B-cell activation after intravenous immunoglobulin therapy in idiopathic thrombocytopenic purpura--an anti-idiotype response? AB - Polyclonal B cell activation occurred in 3 patients following treatment with intravenous immunoglobulin (i.v. Ig) for idiopathic thrombocytopenic purpura (ITP). The possibility that this may represent an anti-idiotype response and the hypothesis that prolonged remission of ITP may be induced by this mechanism are discussed. PMID- 3315741 TI - Index of biochemical reviews 1986. PMID- 3315742 TI - Covalent flavinylation of 6-hydroxy-D-nicotine oxidase involves an energy requiring process. AB - E. coli cells harbouring the recombinant plasmid pDB222 with the 6-HDNO gene under the control of the tac-promotor were induced with IPTG to synthesize a high amount of 6-HDNO protein. Part of this protein was present as 6-HDNO apoenzyme. The proportion of 6-HDNO apoenzyme formed could be increased when the induction of 6-HDNO synthesis by IPTG was performed in the presence of the inhibitor diphenyleneiodonium. The 6-HDNO apoenzyme thus formed could be transformed into enzymatically active holoenzyme in the presence of FAD by a process requiring an energy-generating system consisting of ATP, phosphoenolpyruvate and pyruvate kinase. This finding suggests that an enzymatic step(s) is (are) involved in the covalent flavinylation of 6-HDNO. PMID- 3315743 TI - Expression of soybean glycinin subunit precursor cDNAs in Escherichia coli. AB - As the cDNAs encoding A1aB1b and A2B1a subunit precursors of the glycinin A2 subfamily contain a unique NcoI site sequence, (A)CCATGG, occurring at their translation initiation sites, plasmids were constructed to direct the synthesis of those precursor proteins by inserting NcoI/PstI fragments derived from those cDNA clones into the NcoI/PstI-pKK233-2 expression vector in Escherichia coli MV1190, respectively. The resultant plasmids directed the expression of 57-kDa protein components that have molecular masses in agreement with those of the in vitro translation products directed by glycinin A2 subfamily mRNAs, by the addition of isopropyl beta-D-thiogalactoside. These proteins, which comprised as much as 1% of the total bacterial protein, are immunoprecipitable with rabbit antibodies specific for glycinin subunits. This procedure makes glycinin subunits available as a model for studying structure-function relationships in seed proteins using site-directed mutagenesis. This is the first expression of glycinin-like storage protein in E. coli. PMID- 3315744 TI - A small, discrete acyl carrier protein is involved in de novo fatty acid biosynthesis in Streptomyces erythraeus. AB - A heat-stable factor, required for de novo synthesis of fatty acids in the erythromycin-producing organism Streptomyces erythraeus, has been purified to homogeneity and identified as an acyl carrier protein (ACP). We conclude that, contrary to previous belief, fatty acid synthase in S. erythraeus more closely resembles the dissociable complex of E. coli than the tightly associated, multifunctional enzyme complex found in the related actinomycete Mycobacterium smegmatis. PMID- 3315745 TI - A significant increase of lysophosphatidylinositol 4-phosphate with insulin in isolated rat fat cells. AB - We studied the effects of insulin on the incorporation of 32Pi into phospholipids in rat fat cells. When the cells were treated with insulin, a new radioactive phospholipid was detected on thin layer chromatography. The substance migrated slower than phosphatidylinositol 4,5-bisphosphate and was hardly detectable in the absence of insulin. This effect of insulin was both time- and dose-dependent with half-maximal stimulation at 120 microU/ml. Pretreatment of insulin with anti insulin antibody or the cells with anti-insulin receptor antibody inhibited the effect of insulin. The product of phosphatidylinositol 4-phosphate hydrolyzed by phospholipase A2 was coincided with the substance on thin layer chromatography. Quinacrine inhibited the formation of the substance in a dose-dependent manner. These results suggested that insulin stimulates the generation of lysophosphatidylinositol 4-phosphate through the insulin-receptor interaction. PMID- 3315746 TI - Iodination-induced alterations in biochemical properties of human placental insulin receptor. AB - Insulin receptors from human placenta have been labeled by using an oxidative iodination procedure (iodogen-mediated or chloramine-T-mediated), Bolton-Hunter reagent or [3H]acetic anhydride. The oxidative iodination procedure reduces the affinity for 131I-insulin and the receptor protein becomes fragmented into smaller pieces with an s20,w value of 5-6. However, treatment with Bolton-Hunter reagent or [3H]acetic anhydride does not alter the Kd of 131I-insulin binding and the s20,w value remains unchanged with respect to the native receptor. It is proposed that for labeling multisubunit sulfhydryl-linked protein drastic oxidative iodination procedures should be avoided. PMID- 3315747 TI - Export and secretion of overproduced OmpA-beta-lactamase in Escherichia coli. AB - The export of beta-lactamase to the periplasm of Escherichia coli can be directed by the OmpA signal peptide in the secretion cloning vector pIN-III. The overproduction of the hybrid precursor specifically induces a delay in the onset of processing of newly synthesized polypeptide chains. However, when the processing starts, no alteration in the rate of cleavage itself is observed. Our results suggest that the temporal mode of processing (which reflects translocation) does not depend on the nature of the signal peptide but rather depends on the nature of the polypeptide chain exported. PMID- 3315749 TI - Weight-related changes in reproduction function. PMID- 3315750 TI - [Forensic dentistry in Hungary between the two World Wars]. PMID- 3315751 TI - [Infection hazards during working with turbine drills]. PMID- 3315748 TI - Primary structures of three highly acidic ribosomal proteins S6, S12 and S15 from the archaebacterium Halobacterium marismortui. AB - The amino acid sequences of three extremely acidic ribosomal proteins, S6, S12, and S15, from Halobacterium marismortui have been determined. The sequences were obtained by the sequence analysis of peptides derived by enzymatic digestion with trypsin. Stapylococcus aureus protease and chymotrypsin, as well as by cleavage with dilute HCl. The proteins, S6, S12 and S15, consist of 116, 147 and 102 amino acid residues, and have molecular masses of 12,251, 16,440 and 11,747 Da, respectively. Comparison of the amino acid sequences of these proteins with ribosomal protein sequences of other organisms revealed that halobacterial protein S12 has homology with the eukaryotic protein S16A from Saccharomyces cerevisiae, while S15 is significantly related to the Xenopus laevis S19 protein. No homology was found between these halobacterial proteins and any eubacterial ribosomal proteins. PMID- 3315752 TI - [15 years' experience in the preparation of metal-ceramic bridges for adolescent patients]]. PMID- 3315753 TI - Concepts of stress management in cardiac rehabilitation. PMID- 3315754 TI - Advances in the safety evaluation of food additives. A conceptual and historical overview of the Acceptable Daily Intake (ADI) and Acceptable Daily Intake 'not specified'. AB - The Acceptable Daily Intake (ADI) is an internationally recognized quantified expression of the acceptability of food additives. It embraces both a concept and a numerical expression. This paper describes the conceptual origin and progression of this instrument of risk assessment and management in the framework of its history which encompasses three sequential stages: developmental, consolidation and contemporary periods. The review narrates in retrospect how the ADI originated, how it developed, and delineates in prospective its future evolution in the light of advances in the safety evaluation of food additives. PMID- 3315756 TI - Tips on doing better dentistry, faster. PMID- 3315755 TI - Review of methodologies for the determination of nonvolatile N-nitroso compounds in foods. AB - An attempt has been made to briefly review methods available for the determination of total N-nitroso compounds, N-nitrosamides, N-nitrosamino acids, and miscellaneous other nonvolatile N-nitroso compounds in foods and beverages, giving special emphasis to the progress made during the past five years. It appears that a wide variety of acceptable methods are available for N-nitrosamino acids and simple hydroxylated N-nitrosamines, but none of them has yet been adequately validated. Only limited progress has been made for the analysis of N nitrosamides, N-nitroso sugar amino acids, and other N-nitroso compounds. Various mass spectrometric methods available for the determination and confirmation of these compounds are also discussed. PMID- 3315757 TI - Excellence in dentistry: acrylic provisional crowns. PMID- 3315758 TI - Disability insurance: why you need it, how to buy it. PMID- 3315759 TI - Clinical use of an air-powder abrasive system. PMID- 3315760 TI - Vibrio anguillarum antigen stimulates mitogenesis and polyclonal activation of salmonid lymphocytes. AB - An antigen preparation of Vibrio anguillarum, a salmonid pathogen, acts as a potent in vitro mitogenic stimulator of splenic and pronephric (anterior kidney) lymphocytes from coho salmon (Oncorhynchus kisutch), chinook salmon (O. tshawytscha) and rainbow trout (Salmo gairdneri). This antigen (VA) is comparable in its mitogenic activity to Concanavalin A (Con A), Escherichia coli lipopolysaccharide (LPS), and phytohemagglutinin (PHA). VA gives peak mitogenic responses in coho five days after initiation of cell culture. VA also appears to be a nonspecific polyclonal activator as determined by the generation of plaque forming cells to trinitrophenyl (TNP) and fluorescein (FI) haptenic determinants. Chemical characterization is limited, but it appears that Vibrio LPS could be responsible for these activities. PMID- 3315761 TI - Mental alertness in response to hypoglycaemia in normal man: the effect of 12 hours and 72 hours of fasting. AB - To study the influence of hypoglycaemia and starvation on mental functions eight healthy male students age 25-34 years with an ideal body mass of 99.9% +/- 2.5% (mean +/- SEM) were recruited. Hypoglycaemia was induced in random order by an insulin-glucose clamp technique (insulin: 2.4 mU/kg/min + glucose at variable rate) keeping the venous blood glucose at 2.2 mmol/l both after an overnight fast and after 72 h fasting. Mental alertness was assessed by measuring the recognition time, moving time and total reaction time to a visual signal and by a verbal mental clearness test and a synonym learning test during normo- as well as hypoglycaemia. Hypoglycaemia prolonged the total reaction time (p less than 0.05) and the time required for the mental clearness test (p less than 0.05). Compared with a control study performed at normoglycaemia the learning effect of the synonym test was reduced by hypoglycaemia. Fasting, which resulted in a body weight reduction of 2.6 +/- 0.3 kg and ketonuria prolonged the total reaction time (p less than 0.005) by increasing the moving time but did not affect the mental clearness test. When hypoglycaemia was preceded by 72 h fasting it did not increase the total reaction time, nor did it modify the mental clearness test. Moreover, the learning effect of the synonym test was less impaired. In conclusion, mental alertness was reduced by moderate hypoglycaemia after an overnight fast while similar hypoglycaemia did not reduce mental alertness after prolonged fasting. This may illustrate a decrease of the glucose dependency of the central nervous system during prolonged fasting. PMID- 3315762 TI - Serum lipid and lipoprotein levels in female type I diabetics: relationships to aerobic capacity and glycaemic control. AB - The aims of this study were to examine the relationships between serum lipoprotein levels, glycaemic control and physical fitness in female Type I diabetic patients. Twenty-one patients were investigated. Those with the best glycemic control, as assessed by measurements of haemoglobin A1 levels, were found to have lower total triglyceride and VLDL triglyceride concentrations. They also had higher HDL and HDL2 cholesterol level than patients with less good control. Patients with high maximal oxygen uptake had higher HDL2 and lower LDL cholesterol levels as well as lower total triglyceride levels. It is concluded that both high aerobic capacity and good glycaemic control may be favourable for lipid status in Type I diabetic patients. PMID- 3315763 TI - Plasma glucose, insulin, proinsulin, C-peptide and glucagon before and after a carbohydrate-rich meal in hyperthyroid patients. AB - The function of the pancreatic B- and A- cell during a carbohydrate-rich meal was investigated in hyperthyroid patients, since these patients frequently present an altered handling of glucose. In basal conditions the plasma levels of glucose, immunoreactive insulin (IRI), C-peptide (CPR), proinsulin were higher in hyperthyroid patients than in normal subjects, whereas plasma glucagon was similar in the two groups. Hyperthyroid patients had high post-breakfast incremental areas of glucose and IRI and those of CPR and glucagon were normal. In post-breakfast plasma, the hyperthyroid patients had high proinsulin and normal insulin levels. The molar ratio between CPR and IRI was low throughout the test in the hyperthyroid group. In conclusion, in the hyperthyroid group the plasma levels of proinsulin were high and those of glucagon were normal; in response to the standard breakfast the levels of insulin and C-peptide were normal. These findings do not explain the altered glucose handling present in these patients. PMID- 3315764 TI - Role of alpha and beta cells in the impaired glucose tolerance of thalassaemic subjects. AB - Fifty healthy and 12 thalassaemic subjects underwent both an oral glucose tolerance test (OGTT) and arginine test in order to investigate their alpha and beta cell activity. While basal plasma levels were similar in both group of subjects (82 +/- 4 vs 74 +/- 4 mg/dl, p = NS), following glucose intake impaired glucose tolerance was observed in thalassaemic subjects. These subjects showed impaired insulin secretion either in steady-state conditions or after glucose intake. When an arginine test was performed in thalassaemic subjects, impaired insulin secretion with concomitant exaggeration of glucagon response was also observed. In the thalassaemic subjects no statistically significant correlations were found between impaired insulin secretion and iron overload. It is suggested that in thalassaemic subjects beta-cell dysfunction and alpha cell overactivity may lead to the development of diabetes mellitus. PMID- 3315765 TI - Human insulin plus sodium glycocholate in a nasal spray formulation: improved bioavailability and effectiveness in normal subjects. AB - Intranasal insulin is effective in raising serum insulin (IRI) levels and lowering blood glucose levels in normal subjects and in diabetics, but its bioavailability is low. Our aim was to improve the bioavailability of intranasally administered insulin in normal subjects as a prerequisite to extended clinical trials. Solutions of regular porcine and human insulin, 40 U/ml, with sodium glycocholate 1 % w/v as a surfactant, administered in drops (0.9 U/Kg b.w.), were equally effective in terms of bioavailability and of hypoglycaemic activity. Spray solutions (0.5 U/Kg b.w.) of human insulin, 100 U/ml, were more effective than drops, and of the two surfactants employed, sodium glycocholate 4 % w/v was significantly more effective than 9-lauryl-ether and more effective than other formulations used here or described by other authors. Although being subject to further improvement, the formulation of human insulin 100 U/ml plus sodium glycocholate 4 % w/v delivered as a spray solution described in this study appears to be worthy of clinical trials in diabetic patients. PMID- 3315766 TI - Insulin-mediated glucose disposal in type 1 (insulin-dependent) diabetic subjects treated by continuous subcutaneous or intraperitoneal insulin fusion. AB - In order to determine if intraperitoneal insulin infusion could improve the insulin resistance of type 1 diabetic patients we have used the englycaemic insulin clamp technique in order to study the effects of insulin on glucose disposal in four C peptide negative type 1 diabetic patients treated by continuous subcutaneous or intraperitoneal insulin infusion and in five control subjects. Compared to control subjects, the diabetic patients treated by subcutaneous insulin infusion had a decreased maximal capacity of glucose utilization (diabetics: 12.6 +/- 0.3 mg.kg-1.min-1; controls: 15.7 +/- 0.7 mg/kg 1.min-1, p less than 0.01) and a trend towards higher half-maximally effective insulin concentrations (diabetics: 70 +/- 11 mU/l-1, controls: 48 +/- 4 mU/l-1). Treatment of the diabetic patients by intraperitoneal insulin infusion for 2 months decreased their mean peripheral free insulin levels (during subcutaneous infusion: 23.5 +/- 2.2 mU/l-1; during intraperitoneal infusion: 18.4 +/- 1.4 mU/l 1, p less than 0.05). However, mean daily insulin requirements were not decreased (during subcutaneous infusion: 0.59 +/- 0.05 U/kg-1.day-1; during intraperitoneal infusion: 0.57 +/- 0.03 U/kg-1.min-1). Moreover, the diabetic patients had a consistently lower maximal capacity of glucose utilization (12.6 +/- 0.7 mg kg 1.min-1) than control subjects (p less than 0.01) without modification of the half-maximally effective insulin concentration (62 +/- 10 mU.l-1). In conclusion, the only benefit of intraperitoneal insulin infusion was a reduction of peripheral free insulin levels; this decrease of peripheral insulinaemia was not associated with an improvement in the insulin resistance of diabetic patients. PMID- 3315768 TI - The effect of insulin mixtures in type I diabetics: influence of the intermediate acting insulin on the action of short acting insulin. AB - We studied the effects of two insulin mixtures on glucose levels and plasma free insulin in 12 type I diabetic patients previously rendered normoglycaemic using an artificial pancreas (Biostator). Mixture Iwas made with 24.5 +/- 1.7 I.U. of isophane protamine insulin (Insulatard Nordisk), mixed with 9.8 +/- 0.78 I.U. of short-acting soluble insulin (velosulin Nordisk). Mixture II consisted of identical doses of an insulin zinc suspension (Monotard Novo) with soluble insulin (Actrapid Novo). 30 minutes after injection, all patients had a standard breakfast and blood samples for glycaemia and insulinemia were taken for the next 6 hours. Plasma glucose levels were significantly lower after the injection of mixture I at 30 and 180 minutes (p 0.01) and at 45, 60, 75, 90, 105, 150, 210 and 240 minutes (p 0.05). Free insulin levels were higher after mixture I, although no statistically significant difference was found at any point. We conclude that mixing insulin zinc suspensions in the same syringe with soluble insulin results in an impairment of the quick action of the soluble component. PMID- 3315769 TI - Plasma membrane-associated cysteine proteinases in human and animal tumors. AB - The ability of tumor cells to invade into and through normal tissue during the metastatic cascade has been attributed to tumor-associated degradative enzymes including proteinases of the metallo, serine and cysteine classes. Work from several laboratories has established that the cysteine proteinases cathepsins L and B are released from tumor cells, primarily as latent precursor forms. In addition, a cathepsin B-like cysteine proteinase has been shown to be associated with the plasma membrane fraction of several animal and human tumors. This form of the enzyme retains activity under physiologic (or pathologic) conditions including at neutral pH and in the presence of low Mr inhibitors. Since we have established that cathepsin B can degrade the basement membrane attachment glycoprotein laminin, we speculate that plasma membrane-associated cathepsin B may participate in focal dissolution of the basement membrane during tumor cell extravasation. PMID- 3315770 TI - A tribute to Winifred M. Watkins. PMID- 3315767 TI - Glucose, insulin and platelet fatty acids following myocardial infarction: an association with infarct size. AB - Fifty-four patients were studied immediately after myocardial infarction to determine the association between infarct size and blood glucose, serum insulin, plasma lipids and platelet phospholipid fatty acids. Infarct size was estimated indirectly from peak plasma lactate dehydrogenase level and in the known diabetics a significant negative correlation was seen between serum insulin and peak LDH levels (Rs = -0.73, p less than 0.05). In the normoglycaemic patients peak LDH level was inversely associated with platelet phospholipid linolenic acid (C18: 3 w3) (Rs = -0.59, p less than 0.01) and with eicosapentaenoic acid (C20: 5 w3) (Rs = -0.51, p less than 0.05). This association may be explained by the role of these fatty acids in platelet aggregation but the potentially protective effect of these fatty acids appears to be lost in diabetic and hyperglycaemic patients. PMID- 3315771 TI - The membrane-binding domain of a rat liver Golgi sialyltransferase. PMID- 3315772 TI - The enzymes of glutathione metabolism: an overview. PMID- 3315773 TI - Glutathione S-transferases in man: the relationship between rat and human enzymes. PMID- 3315774 TI - Glutathione reductase from Escherichia coli: mutation, cloning and sequence analysis of the gene. PMID- 3315775 TI - Clinical and immunological evaluation of oral ribavirin administration in recurrent herpes simplex infections. AB - A total of 38 out-patients with recurrent oral or genital Herpes simplex virus infections received either oral ribavirin (800-1600 mg/day for 7 days) or placebo following a randomized and balanced protocol. Clinical and laboratory parameters, including haematological, metabolic and immunological tests, were checked in order to estimate tolerance to and efficacy of ribavirin on recurrent Herpes simplex virus infection and on the number of recurrences during the 12 months following treatment. Ribavirin showed definite superiority in the treatment of recurrent Herpes simplex virus 1, when compared to placebo, its efficacy being enhanced if treatment is started as soon as possible after infection has started. No significant modification of the parameters used to assess tolerance was noted; moreover there was no modification of the immunological parameters evaluated. PMID- 3315776 TI - Ticlopidine in the treatment of multiple atherosclerotic arteriopathy: a strain gauge plethysmography and Doppler spectrum analysis evaluation. AB - The effect of ticlopidine was compared with flunarizine in patients with iliac femoral and/or femoral-popliteal arteriosclerotic arteriopathy accompanied by lesions of the cervical arteries of no haemodynamic significance. In the lower limbs, plethysmography (strain gauge measurements) and Doppler ultrasonography integrated by spectral analysis of the cervical arteries showed qualitative and quantitative improvements of the regional haematic flow. Side-effects were negligible which suggests that ticlopidine is useful in the treatment of multiple arteriosclerotic arteriopathy. PMID- 3315777 TI - Treatment of urgency and urge incontinence with flavoxate in the People's Republic of China. AB - Flavoxate is a smooth muscle relaxant widely used to treat urgency and urge incontinence. It has been used in an unblinded, uncontrolled clinical trial in 14 urology departments in universities and major hospitals in the People's Republic of China involving 361 patients with urgency/incontinence of various types. Patients were given 200 mg three times daily, orally, for 2 weeks, although 33 patients received a daily dosage of 1200 mg. Frequency, urgency, dysuria, nocturia and incontinence were assessed and scored clinically prior to and after treatment. Three departments also included urodynamic investigations, e.g. monitoring of the end-residual volume. Results from 336 evaluable patients indicate that 228 (67%) were completely cured of urgency/incontinence symptoms, 66 (20%) were improved and 42 (13%) patients were unchanged. Flavoxate was also effective in 77.4% of patients refractory to previous anti-cholinergic treatment. Treatment did not increase the end-residual volume and adverse events occurred only in four (1.3%) patients, two (0.6%) of which discontinued the therapy. The 1200 mg dose produced a complete cure in 82% of patients and improvement in the remaining 18%, with no side-effects. In conclusion, flavoxate is an effective and well tolerated treatment for urgency/incontinence of various causes. PMID- 3315778 TI - Short-term treatment of vaginal candidiasis with fenticonazole ovules: a three dose schedule comparative trial. AB - In an unblinded, randomized parallel group trial three different therapeutic dose schedules of fenticonazole (vaginal ovules) were compared in the treatment of vaginal candidiasis. A total of 60 patients, aged 17-71 years, affected by mycologically confirmed symptomatic vaginal candidiasis were included and randomly allocated to three treatment groups: 200 mg daily, for 3 days; 600 mg in a single administration; and 1000 mg in a single administration. Therapeutic efficacy was assessed by microbiological and clinical criteria 7 days after the end of the treatment. All mycologically cured patients were re-checked, microbiologically and clinically, 2 weeks after the end of treatment to identify and evaluate possible relapses. The results obtained indicate that vaginal application of fenticonazole ovules is highly effective in producing both symptomatic relief and mycological sterilization of vaginal swabs in 75-85% of treated patients. No relapses were noted at the time of re-check. The three administration schedules tested appear to be equally effective and well tolerated. In one case only of the group given 200 mg and two cases of those given 1000 mg, a local burning sensation was noted. These results show that short term treatment of vaginal candidiasis with fenticonazole ovules is effective and well tolerated. PMID- 3315779 TI - Dopamine receptors: molecular structure and function. AB - Two distinct categories of dopamine receptors, termed D1 and D2, have been identified on the basis of pharmacological and biochemical criteria. Some of the progress made in our understanding of the subunit structure, function and signal transduction properties of these important membrane proteins are reviewed. PMID- 3315780 TI - H1 histone synthesis and phosphorylation in mouse mammary gland in vitro. AB - The synthesis and phosphorylation of H1 histones were studied in organ cultures of midpregnant mouse mammary glands exposed to various combinations of insulin, cortisol and prolactin over a 48-h period. The synthesis of specific H1 histone subtypes was changed only when all three hormones were present, and the effect was most pronounced during the first 24 h of culture, a period of cell replication. The 3-hormone combination also stimulated the phosphorylation of the N-terminal region of the H1 histone, and this also occurred maximally during the first 24 h of culture. The enhanced phosphorylation of the N-terminal region of the H1 histone included a site sensitive to phosphorylation by cyclic AMP dependent protein kinase. Thus, hormones which stimulate mammary development in vitro influence the synthesis and specific phosphorylation of H1 histones during a period of cell replication preceding the expression of milk protein genes. PMID- 3315781 TI - Expression and distribution of cell adhesion molecule uvomorulin in mouse preimplantation embryos. AB - We have examined the synthesis and distribution of the cell adhesion molecule uvomorulin in mouse preimplantation embryos. Uvomorulin can already be detected on the cell surface of unfertilized and fertilized eggs but is not synthesized in these cells. Uvomorulin synthesis starts in late two-cell embryos and seems not to be correlated with the onset of compaction. The first signs of compaction are accompanied by a redistribution of uvomorulin on the surface of blastomeres. During compaction uvomorulin is progressively removed from the apical membrane domains of peripheral blastomeres. In compact morulae uvomorulin is no longer present on the outer surface of the embryo but is localized predominantly in membrane domains involved in cell-cell contacts of adjacent outer blastomeres. On inner blastomeres of compact morulae uvomorulin remains evenly distributed. This uvomorulin distribution once established during compaction is maintained and also found in the blastocyst: on trophectodermal cells uvomorulin localization is very similar to that in adult intestinal epithelial cells while uvomorulin remains evenly distributed on the surface of inner cell mass cells. The possible role of the redistribution of uvomorulin for the generation of trophectoderm and inner cell mass in early mouse embryos is discussed. PMID- 3315782 TI - Endogenous chicken nerve growth factor from sheath cells is transported in regenerating nerve. AB - We report the presence of endogenous nerve growth factor (NGF) in chicken peripheral nerve. The molecule has been detected with antibodies to mouse salivary gland NGF, using immunohistochemical and immunoelectrophoretic techniques. Previous studies have shown that these antibodies inhibit the survival activity of extracts of chicken peripheral nerve. The NGF accumulated distal, but not proximal, to a ligature placed on a peripheral sympathetic nerve demonstrating that it was retrogradely transported. This transport was detected in intact nerve fibers as well as in nerves from which the peripheral target had been ablated 6 hr or 7 days previously. The results indicate that avian NGF is present in adult chicken peripheral nerves and that this molecule shares antigenic determinants with the mouse molecule. The results further demonstrate that regenerating neurons retrogradely transport NGF supplied by cells within the peripheral nerve (presumably Schwann). The possibility that these cells also provide NGF to intact neurons is discussed. PMID- 3315783 TI - Harry F. Harlow: rememberance of a pioneer in developmental psychobiology. PMID- 3315784 TI - Cytoadherence of lymphocytes from type I diabetic subjects to insulin-secreting cells. Marker of anti-beta-cell cellular immunity. AB - We studied the ability of lymphocytes from type I (insulin-dependent) diabetic patients to adhere to murine beta-cells. Lymphocytes from 17 recent-onset type I diabetic subjects (less than 6 mo) displayed enhanced ability to form rosettes with RINm5F cells (P less than .001) compared with lymphocytes from 27 healthy subjects forming background rosettes, whereas the number of RIN cytoadherent lymphocytes was unimpaired in 12 type II (non-insulin-dependent) diabetic subjects. This phenomenon tended to decline in 21 subjects with long-standing diabetes (greater than 1 yr) who taken as a group presented a normal number of RIN rosetting lymphocytes. The islet specificity of these diabetic rosettes was confirmed because, compared with controls, lymphocytes from recent-onset type I diabetic subjects also displayed a greater intensity of adherence to normal mouse islets but not to unrelated K562 and TS cell lines. As demonstrated by indirect immunofluorescence studies, these diabetic rosettes contained 54% of T lymphocytes (OKT3+, OKT4+, or OKT8+), whereas only 20% of T-lymphocytes were found in background rosettes. The high percentage (66%) of la+ cells found in diabetic rosettes suggests that at least some of the cytoadherent T-lymphocytes from recent-onset type I diabetic subjects are activated. Natural killer (NK) cells do not seem to be the major cell type implicated in this phenomenon, because Leu 11+ cells were less represented in diabetic rosettes (25%) than in background rosettes (53%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315785 TI - Insulin secretion and clearance. Comparison after oral and intravenous glucose. AB - Insulin secretion and clearance in response to the administration of oral and intravenous glucose was investigated in nine normal men. C-peptide metabolic kinetics were calculated by analysis of individual C-peptide decay curves after the bolus injection of biosynthetic human C-peptide. Glucose was administered to the subjects on three occasions: as a 75-g oral dose, a 75-g i.v. infusion, and an intravenous glucose infusion at a variable rate adjusted to mimic the peripheral glucose levels obtained after the oral glucose load (matching experiment). Glucose, insulin, and C-peptide concentrations were measured for the subsequent 5 h. The glucose level after the oral glucose load (115.9 +/- 2.6 mg/dl, mean +/- SE) closely approximated that after the matching experiment (120.5 +/- 2.5 mg/dl) but was significantly lower than after 75 g i.v. glucose (127.7 +/- 3.4 mg/dl, P less than .05). Analysis of the areas under the peripheral concentration curves (60-360 min) showed that the responses of both insulin (52.7 +/- 5.6 and 46.5 +/- 4.5 pmol.ml-1.300 min-1) and C-peptide (252.7 +/- 27.5 and 267.0 +/- 21.6 pmol.ml-1.300 min-1) were not significantly different after the oral and 75-g i.v. glucose studies, respectively, whereas in the matching experiment, both the insulin (26.1 +/- 3.9 pmol.ml-1.300 min-1) and C peptide (178.0 +/- 18.9 pmol.ml-1.300 min-1) responses were lower (P less than .05) than in the other two studies. Insulin secretory rates were derived from peripheral C-peptide concentrations with an open two-compartment model and individually derived model parameters. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315786 TI - Effect of physical training on insulin action in obesity. AB - We evaluated insulin secretion and insulin action with the hyperglycemic (125 mg/dl above basal) and euglycemic insulin (40 mU.m-2.min-1) clamps in seven moderately obese subjects before and after a 6-wk exercise training program. Thirty-nine normal-weight, age-matched subjects served as controls. Both fasting plasma insulin concentration and glucose-stimulated (hyperglycemic clamp) insulin secretion were significantly (P less than .001) increased in the obese subjects. After the training program fasting insulin levels decreased by 26% (P less than .01). Insulin secretion in response to hyperglycemia decreased by a similar percentage (P less than .01). Nonetheless, total-body glucose metabolism increased significantly (P less than .05) during the hyperglycemic clamp. With the euglycemic insulin clamp, obese subjects were shown to be significantly (P less than .001) insulin resistant compared with controls. The decrease in total body glucose uptake resulted from defects in both peripheral glucose disposal and suppression of hepatic glucose production. After the 6-wk training program, insulin-mediated total-body glucose metabolism increased due to significant improvements in peripheral glucose uptake (P less than .01) and more effective suppression of hepatic glucose production (P less than .05). These results indicate that a moderate-intensity physical conditioning program is capable of ameliorating the insulin resistance and reducing glucose-stimulated hyperinsulinemia observed in obese subjects with normal glucose tolerance. PMID- 3315787 TI - Effect of age and sex on rat endocrine pancreas. AB - Maximal glucose-stimulated insulin secretion was quantified in perfused pancreases of 11-wk-old and 12-mo-old female and male rats. In addition, measurements were made of body weight, total pancreatic weight, and percentage of the pancreas occupied by islet tissue. Body weight (mean +/- SE) of male rats was greater than that of female rats at both 11 wk (319 +/- 3 vs. 237 +/- 13 g) and 12 mo (684 +/- 17 vs. 376 +/- 13 g) of age. Pancreatic weight and percentage of the pancreas occupied by islet tissue were also greater in male rats and increased in approximate proportion to the gain in weight. The first phase and the second phase of maximal glucose-stimulated insulin secretion were both qualitatively and quantitatively similar in all four groups of rats. However, because islet cell mass increased with age, maximal glucose-stimulated insulin secretion declined with age in rats of both sexes when expressed per unit islet tissue. Although the fall in insulin secretion (per islet cell mass) with age was observed in perfused pancreases from both male and female rats, the pancreases of female rats contained relatively less islet tissue and secreted more insulin per unit islet cell mass than pancreases of male rats at either age. Thus, there are sex differences in both islet cell structure and function, but the effect of age on endocrine pancreatic function seems to be independent of sex. PMID- 3315789 TI - 64,000-Mr autoantigen in type I diabetes. Evidence against its surface location on human islets. AB - The sera of type I (insulin-dependent) diabetic subjects are reported to contain autoantibodies against a 64,000-Mr protein identified in [35S]methionine biosynthetically labeled pancreatic islet cells. We have attempted to localize this autoantigen to the surface of the beta-cell and to define its properties. Sera from 10 newly diagnosed type I diabetic subjects, including five of the index sera originally used to identify the autoantigen, were shown to specifically precipitate a reduced protein of 67,000 Mr from Triton-solubilized, surface 125I-labeled cultured adult human islet and rat insulinoma (RINm5F) cells but not from fresh rat spleen cells. Further characterization revealed that this protein was bovine serum albumin (BSA) adsorbed to cells from fetal calf serum (FCS)-supplemented culture medium and precipitated by BSA antibodies present in many diabetic sera. No labeled proteins were specifically precipitated when surface 125I-labeled and solubilized human islet or RINm5F cells were precleared with anti-BSA immunoglobulins or when cells were first cultured in human serum. In contrast, a 64,000-Mr protein, clearly not BSA, was precipitated by diabetic globulins from human islets but not from RINm5F cells labeled with [35S]methionine. In addition, a protein of the same size as well as proteins of approximately 35,000, 43,000, 140,000, and 200,000 Mr were specifically precipitated by diabetic globulins from freshly isolated human islets solubilized in Triton X-100 and then labeled with 125I. These findings suggest that the 64,000-Mr antigen is not expressed on the surface of human islet cells, at least in culture, and therefore question its relevance as a target for islet cell surface antibodies in initiating beta-cell damage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315788 TI - Tissue culture of human fetal pancreas. Effects of human serum on development and endocrine function of isletlike cell clusters. AB - The human fetal pancreas represents a source of insulin-producing beta-cells with a potential for transplantation to diabetic patients. It has previously been shown that such cells can be viably maintained in tissue culture media containing fetal calf serum (FCS) and that these explants continue to synthesize and release insulin. In this study the effects of human serum (HS) on the growth and function of human fetal pancreatic explants have been compared with those of FCS. For this purpose, pancreatic glands, obtained after prostaglandin-induced abortions, were briefly exposed to collagenase, and the digest was cultured in RPMI-1640 medium plus 10% pooled HS or FCS. The outgrowth of isletlike cell clusters (ICCs) was monitored. In 31 of 58 consecutively explanted glands, development of ICCs was observed. In the presence of FCS the outgrowth of ICC took place on top of a fibroblast monocellular cell layer; HS effected less growth of fibroblasts and increased the formation of ICCs about sevenfold compared with explants from the same glands maintained in FCS. However, in the explant cultures with HS, the cell number per ICC, expressed as DNA content, was reduced by 50%. In both FCS and HS the insulin content of the medium showed great variability and progressively declined from day 2 to day 5. The medium glucagon concentration also decreased but not to the same extent as that of insulin. Immunocytochemical-stained ICCs showed insulin- and glucagon-positive cells scattered among most nonstained, presumably nonendocrine cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315790 TI - Thermic effect of glucose in obese subjects with non-insulin-dependent diabetes mellitus. AB - A reduced thermic effect of glucose in non-insulin-dependent diabetes mellitus (NIDDM) has been previously reported. To investigate whether this defect is related to 1) a decreased rate of glucose storage, 2) a reduced energy cost of glucose storage, or 3) a defect in the sympathetically mediated component of thermogenesis, we studied the thermic effect of ingested and infused glucose in nine NIDDM obese Pima Indians [90.5 +/- 3.9 kg, 39 +/- 2% fat, fasting plasma glucose (FPG) 130 +/- 10 mg/dl] and in nine nondiabetic obese Pima Indians (99.3 +/- 7.2 kg, 38 +/- 2% fat, FPG 103 +/- 2 mg/dl). Energy expenditure and glucose storage were derived from indirect calorimetry measurements. The thermic effect of 100 g of glucose was found to be similar in both groups (4.0 +/- 0.9 vs. 5.0 +/- 1.3% of energy ingested in diabetic and nondiabetic subjects, respectively) but lower than that previously reported in nonobese subjects. The cost of glucose storage calculated after stimulating storage by constant glucose infusion (0.46 g/min) and variable insulin infusion (19.5 +/- 3.8 vs. 2.9 +/- 0.6 mU.kg-1.min-1 in diabetic and nondiabetic subjects, respectively; P less than .01) was similar in both groups (approximately 0.35 kcal/g glucose stored) and not different from that reported in lean subjects. As opposed to lean and obese Caucasian subjects, energy expenditure failed to markedly decrease during propranolol infusion in both nondiabetic and diabetic Pima Indians. We postulate that the decreased rate of tissue glucose uptake and storage associated with insulin resistance is the major cause of the lower thermic effect of ingested glucose in NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315792 TI - The declining prevalence of anencephalus and spina bifida: its nature, causes and implications. PMID- 3315791 TI - Stable insulin preparation for implanted insulin pumps. Laboratory and animal trials. AB - The stability and longevity of the polyethylene-polypropylene glycol-stabilized insulin have been tested in vitro and in vivo in an implanted insulin-infusion device, the programmable implantable medication system (PIMS). In vitro tests demonstrated long-term compatibility with refill cycles of up to 3 mo, with a preparation of 400 U/ml. Total test period in vitro was 3.2 device-yr (combined time of device use). Insulin retained 88-93% native structure. A major modification, which was biologically active and nonimmunogenic, was identified and partially characterized. Examination of one device by scanning electron microscopy and X-ray microanalysis after 1 yr of insulin infusion revealed surfaces clean of insulin precipitate or other material along the entire insulin delivery pathway. Surface analysis of the silicone-lined polyethylene catheters after 6 mo of infusion also showed no evidence of major insulin precipitate. In vivo stability trials were accomplished with PIMS implanted in diabetic dogs with an intraperitoneal delivery site. There has been no insulin blockage of the catheter of active pumps after 5.1 dog-yr (combined time of trials) of trials (up to 5 mo between refills in a single dog). Structural stability of insulin was analyzed by high-performance liquid chromatography. On average, 90.8% of the insulin sampled from the reservoir in vivo was native insulin, with an average of 96.2% retention of active forms. PMID- 3315793 TI - Vitamin E deficiency and illness in childhood. PMID- 3315794 TI - Casting shrinkage in an Ni-Cr FPD. PMID- 3315795 TI - The influence of physical training on glucose tolerance, insulin sensitivity, and lipid and lipoprotein concentrations in middle-aged hypertriglyceridaemic, carbohydrate intolerant men. AB - The effects of 9 weeks of moderate intensity exercise training while on a weight maintaining diet were studied in 19 untrained middle-aged, hypertriglyceridaemic, carbohydrate intolerant men. Initial mean maximum oxygen consumption was low (29.7 +/- 1.0 ml.min-1.kg-1; mean +/- SEM) and improved (34.2 +/- 1.4 ml.min-1.kg 1, p less than 0.01) with exercise training. Fasting glucose, insulin, lipid and lipoprotein concentrations did not change. While the abnormal glucose response to oral glucose did not change with training, insulin concentrations were significantly (p less than 0.05) lower at 90 and 120 min during the final oral glucose tolerance test. Insulin mediated glucose uptake did not change, indicating that the degree of exercise training failed to improve in vivo insulin sensitivity. Significant associations were found between the following parameters measured: fasting concentrations of triglycerides and insulin, very low density lipoprotein-triglycerides and glucose, and measures of in vivo insulin resistance and fasting insulin levels, suggesting that insulin resistance in these glucose intolerant subjects may play a role in their hypertriglyceridaemia. These data indicate that moderate increases in physical training alone are not sufficient to improve the carbohydrate, insulin and lipid metabolism of hypertriglyceridaemic, glucose intolerant men. PMID- 3315796 TI - Haemolysis affects insulin but not C-peptide immunoassay. AB - Venous blood was taken at the end of a glucose infusion test in 19 individuals and divided into four aliquots, 3 of which were variably haemolysed by repeated passage through a 23-gauge needle to simulate traumatic venepuncture. Plasma insulin (measured by both a charcoal separation and a double-antibody method), C peptide, and haemoglobin were measured in each aliquot, and haemolysis was also assessed visibly. A significant loss of immuno-assayable plasma insulin was found in samples with only a trace of visible haemolysis, with up to 90% lost in severely haemolysed samples. Plasma C-peptide was unaffected by haemolysis. This represents an additional advantage for the use of plasma C-peptide in assessing insulin secretion. PMID- 3315797 TI - The effect of prehepatic insulin administration on alanine flux rates in diabetic dogs. AB - The in vivo flux rates of glucose (6-3H-glucose) and of alanine (U-14C-alanine) were measured in insulin-dependent chronically diabetic dogs which were infused with insulin employing a bedside-type artificial B cell and either the peripheral or the portal venous route. In comparison with non-diabetic control animals the diabetic dogs had near-normal patterns of glucose metabolism and pancreatic glucagon regardless of the route of insulin administration. They also showed reduced basal portal but moderately elevated peripheral insulin levels on peripheral and near-normal peripheral values on portal insulin infusion. Both concentration and production rates of alanine were reduced on peripheral (0.142 +/- 0.016 mmol/l, 4.73 +/- 0.49 mumol.kg-1.min-1, p less than 0.05) but normal on portal insulin (0.206 +/- 0.030 mmol/l, 6.33 +/- 0.63 mumol.kg-1.min-1). The alanine clearance was slightly elevated or normal in the diabetic dogs, and the glucose production from alanine showed a strongly delayed response to an exogenous glucose load on either route of insulin administration. It is concluded that the peripheral hyperinsulinism during posthepatic insulin administration stimulates glucose utilisation to a normal extent, but inhibits the provision of amino groups in resting muscle. Alanine synthesis is thereby reduced, and the carbon moieties are shunted from glucose into circulating lactate. Long-term studies are needed to elucidate the role of the liver under these conditions. PMID- 3315798 TI - Enhancement of glucose transport by insulin at 37 degrees C in rat adipocytes is accounted for by increased Vmax. AB - The kinetics of 3-O-methyl-D-glucose and D-glucose transport was reinvestigated at 37 degrees C in rat adipocytes exhibiting very slow transport rates in the absence of insulin and approximately 30-fold insulin stimulation. The apparent maximal velocity for 3-O-methylglucose was increased at least 15-fold from 0.04 +/- 0.01 to 0.73 +/- 0.17 mmol.l-1.s-1 (SD, n = 7). The apparent half saturation constant was decreased by insulin from 8.1 +/- 1.6 mmol/l to 3.3 +/- 0.8 mmol/l. However, approximately 10% of the 3-O-methylglucose at a very low concentration was transferred by routes other than the glucose transporter, e.g. via nonmediated diffusion or via the fructose transporter, and the estimated value for the half saturation constant was therefore too high in the nonstimulated cells. After appropriate correction this value was estimated as 5.0 +/- 1.8 mmol/l. The inhibition constant of 3-O-methylglucose on the conversion of 12 mumol/l. 14C labelled glucose to cell-associated products was about 4 mmol/l and was not changed significantly by insulin. Transport experiments with labelled glucose gave results similar to those obtained for transport of 3-O methylglucose. It is concluded that insulin can cause a 15- to 30-fold increase in the maximal velocity for transport of 3-O-methylglucose and glucose, and that a concomitant decrease in the half saturation constant, if present, is insignificant. PMID- 3315800 TI - Molecular structure and properties of fos-oncogene. AB - Finkel, Biskis and Jinkins murine osteosarcoma virus is a retrovirus that induces bone tumors in mice. The cellular homologue of this virus, c-fos, has been found in normal human and murine cells. This protooncogene is activated during several cell steps: is rapidly induced in cells stimulated to growth and to differentiate; often its induction precedes induction by other protooncogenes. The gene product is a phospho-nucleoprotein having a molecular weight of 55,000 d. The function of this protein is not known at the moment, opening a lot of interesting questions about the role of this protooncogene in normal cells. PMID- 3315799 TI - Induction of class II MHC antigens on human and rodent islet parenchymal cells in vitro. PMID- 3315801 TI - [Microbial infections in the drug addict]. PMID- 3315802 TI - [Diet and immunity]. AB - Diet modulates the immune system and cell reactivity in particular since it may induce an early aging. A survey of published data on diet-immune system relationship is presented. Studies performed at the Institute of Microbiology, University of Turin, are discussed more in detail. PMID- 3315803 TI - [Surface characteristics of Streptococci: evaluation technics]. AB - We examined the surface characteristics of 41 strains of Streptococci by using the salt aggregation technique (SAT). While group B, C, D and G Streptococci showed a clearly hydrophilic surface, 57.5% of group A strains revealed so hydrophobic characters as to be autoaggregating. Either the hydrophobicity or the autoaggregation of these Streptococci decreased after subsequent culture passages. A comparison has been done for 5 strains by the hydrophobic interaction chromatography (HIC) demonstrating a good correlation between the two techniques. As the only presence of M protein did not seem to condition the surface characteristics, however treatments with different proteolytic enzymes modify greatly the bacterial surface suggesting the involvement of various protein structures. PMID- 3315804 TI - A brief history of STFM: reflections on our first decade, 1967-1977. PMID- 3315805 TI - Fitting curves to data using nonlinear regression: a practical and nonmathematical review. AB - Many types of data are best analyzed by fitting a curve using nonlinear regression, and computer programs that perform these calculations are readily available. Like every scientific technique, however, a nonlinear regression program can produce misleading results when used inappropriately. This article reviews the use of nonlinear regression in a practical and nonmathematical manner to answer the following questions: Why is nonlinear regression superior to linear regression of transformed data? How does nonlinear regression differ from polynomial regression and cubic spline? How do nonlinear regression programs work? What choices must an investigator make before performing nonlinear regression? What do the final results mean? How can two sets of data or two fits to one set of data be compared? What problems can cause the results to be wrong? This review is designed to demystify nonlinear regression so that both its power and its limitations will be appreciated. PMID- 3315806 TI - Fibroblast growth factors. AB - Fibroblast growth factors (FGFs) are heparin-binding protein mitogens that induce division of most cultured cells derived from embryonic mesoderm and neuroectoderm. Terminally differentiated neurons also respond in vitro by eliciting outgrowth of neurites. In vivo, FGFs have been shown to induce DNA synthesis, cell migration, blood vessel growth, and dermal wound closure. The protein and nucleic acid sequences for two different FGFs, denoted acidic and basic FGF, have been determined and recognized to be homologous. Additional genes recently have been identified that extend this protein family. PMID- 3315807 TI - Free radical tissue damage: protective role of antioxidant nutrients. AB - Highly reactive molecules called free radicals can cause tissue damage by reacting with polyunsaturated fatty acids in cellular membranes, nucleotides in DNA, and critical sulfhydryl bonds in proteins. Free radicals can originate endogenously from normal metabolic reactions or exogenously as components of tobacco smoke and air pollutants and indirectly through the metabolism of certain solvents, drugs, and pesticides as well as through exposure to radiation. There is some evidence that free radical damage contributes to the etiology of many chronic health problems such as emphysema, cardiovascular and inflammatory diseases, cataracts, and cancer. Defenses against free radical damage include tocopherol (vitamin E), ascorbic acid (vitamin C), beta-carotene, glutathione, uric acid, bilirubin, and several metalloenzymes including glutathione peroxidase (selenium), catalase (iron), and superoxide dismutase (copper, zinc, manganese) and proteins such as ceruloplasmin (copper). The extent of tissue damage is the result of the balance between the free radicals generated and the antioxidant protective defense system. Several dietary micronutrients contribute greatly to the protective system. Based on the growing interest in free radical biology and the lack of effective therapies for many of the chronic diseases, the usefulness of essential, safe nutrients in protecting against the adverse effects of oxidative injury warrants further study. PMID- 3315808 TI - Interleukin 4/B cell stimulatory factor 1: one lymphokine, many functions. AB - Lymphokines are multifunctional T cell products that profoundly regulate the activation, growth, and differentiation of many cell types, most notably T cells and B cells. One of the lymphokines with the broadest range of actions is interleukin 4/B cell stimulatory factor 1. The characteristics, function, and regulation of interleukin 4 are reviewed as part of an overall discussion of the mechanism through which T cell-derived lymphokines control immune responses in vivo and in vitro. PMID- 3315809 TI - Trafficking of lysosomal enzymes. AB - The targeting of lysosomal enzymes from their site of synthesis in the rough endoplasmic reticulum (RER) to their final destination in lysosomes is directed by a series of protein and carbohydrate recognition signals on the enzymes. Lysosomal enzymes, along with secretory and plasma membrane proteins, contain amino-terminal signal sequences that direct the vectorial discharge of the nascent proteins into the lumen of the RER. The three classes of proteins also share a common peptide signal for asparagine glycosylation. The next signal is unique to lysosomal enzymes and permits their high-affinity binding to a specific phosphotransferase that catalyzes the formation of the mannose 6-phosphate recognition marker. This carbohydrate determinant allows binding to specific receptors that translocate the lysosomal enzymes from the Golgi complex to an acidified prelysosomal compartment. There the lysosomal enzymes are discharged for final packaging into lysosomes. Two distinct mannose 6-phosphate receptors have been identified, and cDNAs encoding their entire sequences have been cloned. An analysis of the deduced amino acid sequences of the receptors shows that each is composed of four structural domains: a signal sequence, an extracytoplasmic amino-terminal domain, a hydrophobic membrane-spanning region, and a cytoplasmic domain. The entire extracytoplasmic region of the small receptor is homologous to the 15 repeating domains that constitute the extracytoplasmic portion of the large receptor. PMID- 3315810 TI - [Disorders of the autonomic nervous system in mitral prolapse: facts and opinions]. PMID- 3315811 TI - [In vitro and ex vivo effect of antimicrobial agents on the chemotaxis of human neutrophils]. PMID- 3315812 TI - [Opportunistic mycotic infections in AIDS. Brief review and presentation of 2 clinical cases]. PMID- 3315813 TI - [Epidemiology of sustained nosocomial gram-positive infections and therapeutic problems]. PMID- 3315814 TI - [Antimicrobial activity, pharmacokinetic characteristics and possible uses of fluoroquinolones]. PMID- 3315815 TI - [Psychological aspects of adoption]. PMID- 3315816 TI - [Hepatic disorders in patients with chronic terminal renal insufficiency in hemodialysis, transplant or peritoneal dialysis]. PMID- 3315817 TI - [Reflections on medical decision making]. PMID- 3315818 TI - Expression of HLA-DR antigens on colonic epithelium in ulcerative colitis. AB - Although the expression of HLA-DR antigens on colonic epithelium in ulcerative colitis has been observed by several groups, the results of the expression in remission have been conflicting and there has been virtually no study concerning the expression in non-inflamed area in active ulcerative colitis. We studied systematically HLA-DR expression on colonic epithelium in 37 patients with ulcerative colitis chronologically, namely in remission as well as in the active stage and inflamed and non-inflamed areas simultaneously in the active stage. HLA DR antigens were detected by indirect peroxidase staining using anti-HLA-DR monoclonal antibody. We confirmed the previous observation that epithelium from control colon does not express HLA-DR antigens, while epithelium from ulcerative colitis expresses the antigens with high frequency (83.3 percent). In addition, we demonstrated that HLA-DR expression on colonic epithelium in active ulcerative colitis disappeared in remission. Our new finding was that there is no HLA-DR expression on colonic epithelium in non-inflamed mucosa in active ulcerative colitis. Namely HLA-DR antigens were expressed only on inflamed epithelium of ulcerative colitis. These results lead to the conclusion that the expression of HLA-DR antigens on colonic epithelium in ulcerative colitis is closely related to the inflammation of mucosa. PMID- 3315821 TI - The AGA rounds ninety and heads for one hundred. American Gastroenterological Association. PMID- 3315819 TI - Clinical evaluation of glucagon and insulin in therapy of fulminant hepatitis. AB - Forty five patients were examined in order to evaluate the usefulness of glucagon and insulin as a therapy of fulminant hepatitis. Thirty patients were treated with simultaneous infusion of glucagon and insulin, whereas prednisolone was given at a daily dose of 60 to 90 mg in 15 cases. In the former group, 1 mg of glucagon and 10 units of regular insulin were infused over a period of 2 to 6 hours. Two such treatments were given per day in the early critical period of fulminant hepatitis. The therapeutic effect of glucagon and insulin was evaluated in comparison with that of prednisolone, and additionally, with a combination therapy of either blood exchange or plasmapheresis in both groups. The survival rate was superior in the group treated with glucagon and insulin (46%) and in the one with combined infusion of these hormones plus plasmapheresis (33%). PMID- 3315820 TI - Effects of extract of cultured Lentinus edodes mycelia (LEM) on polyclonal antibody response induced by pokeweed mitogen. AB - When polyclonal antibody response induced by pokeweed mitogen (PWM) was estimated by measuring antibody-forming cells produced against trinitrophenylated sheep red blood cells (TNP-SRBC) using hemolytic plaque assay, it was found to be augmented by the extract of cultured Lentinus edodes mycelia (LEM). Since some factor enhancing antibody response was detected in the culture supernatant of LEM treated macrophages, this was fractionated by gel filtration, which revealed a substance with a molecular weight of about 15,000 daltons. This suggested that interleukin-1 (IL-1) was produced, and that it had caused, at least partially, the enhancement of antibody response. This possibility was confirmed by the direct assay of IL-1 activity, which demonstrated increased DNA synthesis in PHA stimulated thymocytes. PMID- 3315822 TI - Presentation of the Friedenwald Medal to Robert M. Donaldson, Jr., M.D. PMID- 3315823 TI - Effectiveness of orthotopic liver transplantation on the restoration of cholesterol metabolism in patients with end-stage liver disease. AB - The effects of end-stage liver disease and orthotopic liver transplantation on components that modulate cholesterol esterification in plasma were assessed. In comparison with healthy controls, patients with end-stage liver disease had significantly decreased concentrations of lecithin-cholesterol acyltransferase mass, apolipoprotein A-1, total phospholipids, and both total and esterified cholesterol. Elevated phosphatidylcholine and reduced lysophosphatidylcholine fractions indicated impairment of cholesterol esterification by lecithin cholesterol acyltransferase. Constituent fatty acids of the patients' phospholipids and cholesterol esters manifested increased saturation and a concomitant reduction of polyunsaturated fatty acids, indicative of impaired hepatic elongation and desaturation of essential fatty acids. By the third month after hepatic replacement, the plasma concentrations of total cholesterol, phospholipids, lecithin-cholesterol acyltransferase, and apolipoprotein A-1 were comparable to those of the healthy subjects. Despite the improvement in cholesterol esterification and the rapid normalization of the enzyme and cofactor involved in this process, the percentage of phosphatidylcholine remained significantly higher and the percentages of lysophosphatidylcholine and esterified cholesterol remained significantly lower than in the healthy subjects at 6 mo. Phospholipid and cholesterol ester fatty acid patterns attained normalcy by the sixth month after transplant. We conclude that hepatic transplantation effectively restores cholesterol and essential fatty acid metabolism in patients with end-stage liver disease. PMID- 3315825 TI - Systemic and hepatic hemodynamics after variceal hemorrhage: effects of propranolol and placebo. AB - Hepatic and systemic hemodynamics were measured in 19 cirrhotic patients with variceal bleeding enrolled in a controlled trial of propranolol for the prevention of rebleeding. The patients were studied on three separate occasions. The first study was performed before randomization within 24 h of the bleeding episode, once hemodynamic stabilization had been achieved. The second study was performed after 10 days of treatment, and the third after 6 mo without rebleeding. Propranolol dosage was titrated according to blood levels. Wedged and free hepatic venous pressures and the hepatic venous pressure gradient were recorded. Hepatic blood flow and cardiac output were also measured. Before treatment, the groups of patients treated with propranolol (n = 11) or placebo (n = 8) were comparable according to clinical, biochemical, and hemodynamic parameters. After 10 days, hepatic venous pressure gradient decreased similarly in the two groups (-20% in the propranolol group, -25% in the placebo group). Cardiac output fell only in the propranolol group (-40%). Hepatic blood flow remained unchanged in either group. After 6 mo, hepatic venous pressure gradient remained lower than the values from the first (within 24 h of bleeding) study in both the propranolol group (n = 5) and the placebo group (n = 6). Our results suggest that portal pressure increases shortly after hemorrhage with a return to baseline values 10 days later, and that propranolol does not further magnify these changes. Spontaneous changes in hepatic hemodynamics after variceal hemorrhage must be taken into account when evaluating the effect of pharmacologic agents on portal pressure. PMID- 3315824 TI - Prospective controlled trial of elective endoscopic sclerotherapy in comparison with percutaneous transhepatic obliteration of esophageal varices in patients with nonalcoholic cirrhosis. AB - The results of a prospective randomized controlled trial of elective endoscopic intravariceal sclerotherapy carried out over a 36-mo period in comparison with elective percutaneous transhepatic obliteration of varices (PTO) are presented. Sixty-six patients with nonalcoholic cirrhosis were randomized after they had stabilized, usually between 7 and 14 days after variceal bleeding had stopped following medical treatment (balloon tamponade and vasopressin infusion). Thirty three patients were assigned to the sclerotherapy group and the other 33 patients were assigned to the PTO group. The mean follow-up period was similar in both groups. There was no significant difference in demographic, clinical, and laboratory data between the two groups. Six patients (18%) in the sclerotherapy group and 21 (64%) in the PTO group had at least one episode of gastrointestinal bleeding during the follow-up period (p less than 0.005). Three patients in the sclerotherapy group and 1 patient in the PTO group bled from lesions other than varices; therefore the incidence of variceal bleeding was 9% in the former and 61% in the latter (p less than 0.005). The cumulative variceal bleeding rate was significantly lower in the sclerotherapy group than the PTO group (p less than 0.05). Five patients in the sclerotherapy group died during the follow-up period but none died of recurrent variceal bleeding. Nineteen patients in the PTO group died and 10 of them died of bleeding from varices. The cumulative survival rate was significantly better in the sclerotherapy group (p less than 0.05). These results indicate that elective endoscopic intravariceal sclerotherapy is superior to elective PTO in the prevention of recurrent variceal hemorrhage and mortality in nonalcoholic cirrhosis. PMID- 3315826 TI - Frequent overexpression, but not activation by point mutation, of ras genes in primary human gastric cancers. AB - To define the extent of involvement of ras oncogenes in human gastric cancers, we surveyed for the presence of ras oncogenes, activated by either point mutations within their coding sequences or overexpression of ras protein p21, by the combined use of several analytic techniques. Primary gastric cancers were first analyzed by deoxyribonucleic acid transfection assay using NIH/3T3 cells as recipients and by restriction enzyme analysis, which detects point mutations at codon 12 of the H-ras gene. None of seven tumors analyzed scored as positive. Furthermore, none of them had ras p21 with altered electrophoretic mobility on immunoprecipitation and Western blotting, confirming the absence of ras oncogenes activated by point mutations in these tumors. However, in 6 of 7 tumors, the amounts of p21 exceeded that in human placenta. Amplification of the K-ras gene was found in 1 of 11 (including the 7 described above) gastric cancers. Immunohistochemical analysis of ras p21 expression in these 11 tumors was then carried out using the anti-ras p21 monoclonal antibody RAP-5. All cancers showed more reactivity with RAP-5 than did normal mucosa adjacent to the cancers, indicating increased expression of ras p21. These results indicated that transformation of the stomach mucosa from the normal to the malignant phenotype is rarely associated with activation of ras genes by point mutations, but is frequently associated with enhanced expression of ras p21. PMID- 3315827 TI - Rapid growth of an intact human liver transplanted into a recipient larger than the donor. AB - Two individuals undergoing orthotopic hepatic transplantation received livers from donors who were on average 10 kg smaller than themselves based on recipient ideal body weight. As a result, the donor livers in these 2 cases were 29%-59% smaller than would be expected had the donor liver and recipient been matched ideally. The liver grafts in the recipients steadily increased in size, as determined by serial computed tomography scanning, to achieve new volumes consistent with those that would have been expected in a normal individual of the recipient's size, sex, and age. Fasting plasma levels of amino acids, glucagon, insulin, and standard liver injury tests were monitored to determine which measure best reflected the changes observed in the size of the grafts over time. No relationship between the changes observed in any of these parameters and hepatic growth was apparent. In both cases, the liver increased in volume at a rate of approximately 70 ml/day. These data demonstrate that a small-for-size liver transplanted into a larger recipient increases in size at a rate of approximately 70 ml/day until it achieves a liver volume consistent with that expected given the recipient's size, age, and sex. PMID- 3315828 TI - Endoscopic surgery: healing the wound. PMID- 3315829 TI - Presentation of the 1987 Rudolf Schindler award to Stephen E. Silvis. PMID- 3315830 TI - An improved overtube for therapeutic peroral endoscopy. PMID- 3315831 TI - Gastrostomy tube migration and gastric outlet obstruction following percutaneous endoscopic gastrostomy. PMID- 3315832 TI - [Niels Stensen (1638-1686)]. AB - The paper reminds of the great Danish anatomist, geologist, and bishop Niels Stensen (1638-1686) whose 300th anniversary of his death was in 1986. In anatomy his name is linked especially with the parotideous duct (Ductus Stenonianus) which was discovered by him in 1660. PMID- 3315834 TI - [Development of a growth model for fetal head and body measurements]. AB - Head parameters BPD, FOD and HC and abdomen parameters ATD, APD and AC have been ascertained in a prospective cross-sectional study in 515 healthy single fetuses between 13 and 40 weeks of gestation by ultrasound. In all cases ultrasound velocity was 1540 m/sec. From these data, a growth model was achieved for each parameter and corresponding growth curves with 5%, 10%, 50%, 90% and 95% percentiles were established. PMID- 3315833 TI - [Immuno-oncologic aspects in invasive squamous cell carcinoma of the uterine cervix]. AB - Five patients with an invasive squamous cell carcinoma of the cervix uteri were investigated histologically and immunohistologically to assess localization and composition of the lymphoreticular infiltrates. The relevant cell populations of local immunomechanisms (T-lymphocytes, monocytes/macrophages and plasma cells) were often found numerous in all neoplasms. It must be emphasized that an in situ histomorphological analysis of the cellular part of the stromal reaction of invasive squamous cell carcinoma of the cervix allows only limited conclusions concerning the functional properties of the tumor-infiltrating lymphoreticular cells. PMID- 3315835 TI - [Burkitt's lymphoma of the ovary. Case report]. AB - Bilateral adnexal masses in an 18-year old turkish girl were diagnosed as Burkitt's lymphoma. Aetiology, diagnosis and therapy (surgery and chemotherapy) of this by gynecologists rarely seen disease are presented. PMID- 3315836 TI - [Is reliable prediction of expected birth weight possible with the sonographically imaged fetal parameters of the biparietal diameter, thoracic diameter and length of the humerus? A prospective study of 285 pregnant patients]. AB - From 1.10.83 to 1.10.85 diagrams of bpd (biparietal-diameter); thorax-d and the length of the humerus were made by single measurements in 285 pregnant women with exact gestational age and sonoanatomical parameters in the first trimenon. The expected individual birth weight at delivery was to be estimated by the degree of individual deviation from these three normal diagrams. There are statistically clear relations between all the three parameters and the factual birth weights if the delivery is around the normal date of delivery. However, the prediction is only a qualitative, not an exactly quantitative one. The bpd seems to be the best one because of its lowest degree of statistical deviations. An early diagnosis of "small-for-gestational-age"-children, at least with these three parameters, remains uncertain, if not impossible. The average duration of pregnancy in our patients was not 280 days p.m., but less: (280)-1.23 days p.m. in the group of statistically "purified" patients (i.e. premature newborn under 2500 gr. and Caesarean-section newborn excluded) and (280)-2.32 days in the group of statistically "not purified" patients. PMID- 3315837 TI - [Transvaginal ultrasound-controlled follicle puncture within the scope of human in vitro fertilization]. AB - From June 1986 to February 1987 125 sonographically guided ovum pickups were performed vaginally. On comparison of the pelviscopic oocyte collection a 4% higher success rate was found using the ultrasound technique with regard to transfer and pregnancy rate. Despite two complications out of these 125 punctures, the sonographically guided aspiration technique has proved to possess several advantages in respect of its applicability and a lower incidence of stress factors for the patient. PMID- 3315838 TI - [The ileocecal vagina]. AB - In 3 patients with vaginal aplasia respectively traumatic vaginal loss a neovagina was created out of the separated ileocecal segment. Advantages of this technique are the excellent blood supply of the ileocecal region and the long vascular pedicle. The additional application of terminal ileum for prolongation of the cecal vaginoplasty allows the tensionless anastomosis between neovagina and vulva even in patients with difficult anatomical conditions. The present paper gives a detailed description of the operative technique and the indications of the ileocecal vaginoplasty. Furthermore the common techniques for vaginal replacement are reviewed and discussed. PMID- 3315839 TI - [Pregnancy and labor following kidney transplantation with cyclosporin A. Case report and review of the literature]. AB - We report on a 22-year old patient who received a cadaveric renal transplant following haemodialysis treatment for five months due to endstage chronic glomerulonephritis. 14 months after successful transplantation while on stable renal function (serum-creatinine 1.0-1.4 mg%) the patient became pregnant. As an immunosuppressive therapy the patient got cyclosporine A and cortisone. The monitoring of the immunosuppressive therapy (Cyclosporine A) was performed by daily measurement of serum concentration by radioimmunoassay. Drug administration was adjusted to maintain serum levels of 250-550 ng/ml. Increased dosages were required from 25th week until delivery. Until the 25th week of gestation the pregnancy was uncomplicated from both the nephrological and obstetrical points of view. At the 25th week of gestation the patient became anuric. This was caused by a postrenal failure due to the compression of the transplantar ureter by the pregnant uterus. Nephrostomy was installed and was used until the end of pregnancy. In the third trimester the foetus showed growth retardation. For this reason a Caesarean section was necessary at the 36th week of gestation. A healthy boy was delivered weighing 2080 g and measuring 45 cm. No congenital malformations were observed, the chromosomal analysis showed no aberrations. After the delivery cyclosporine concentrations in the blood of the mother and the newborn were simultaneously measured. A remarkable difference in these concentrations was observed particularly in the mother's blood 864 ng/ml whereas in the baby's blood the concentration was 312 ng/ml. Three days after the delivery the patient was able to urinate normally so that the nephrostomy could be removed. PMID- 3315840 TI - [What is the placental insufficiency syndrome?]. AB - The concept of "placental insufficiency" appears to offer a plausible explanation for foetal emergency situations; in reality, however, it leads to unproven and possibly wrong ideas on the genesis of these phenomena. It is applied in a semantically inconsistent manner, and that is one of the reasons why it is unsuitable as a term that can be used in scientific language. It is nevertheless being continually used in present-day "medicalese" and even in recent textbooks of obstetrics as a definition of nosological entities. The claim that the term "placental insufficiency" is necessary for mutual communication in obstetrics, is not substantiated or, if at all, with the self-confirming claim that it cannot be eliminated because it is already firmly rooted in clinical thinking. The conditions in the foetus and the newborn labelled "placental insufficiency syndrome" could be defined without additional linguistic effort by means of a number of sufficiently precise and far more important terms, namely "underweight", "dystrophy", "asphyxia/hypoxia". These terms stand for results of direct observation without hypothetical connotations. The conditions they describe are--at least in principle--objectifiable and measurable. The expressions allow and induce further deliberations and studies on actual causes of chronic or acute deficient supply of the foetus, the nascent and newborn infant, and how to avoid these causes. The criticism of the concept "placental insufficiency" presented and reviewed here, is not new.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315841 TI - [Comparative study of the therapeutic action of prodigiozan and pyrogenal on hematopoiesis and parameters of nonspecific resistance in irradiated mice]. PMID- 3315842 TI - [Possibilities and limitations of immunotherapeutic methods in the treatment of acute leukemia]. PMID- 3315843 TI - [Chronic myeloleukemia: criteria of prognosis]. PMID- 3315844 TI - Psychotropic medications in patients with cancer. AB - Psychotropic drug use in the patient with cancer is reviewed from the perspective of the practicing oncologist and the consulting psychiatrist. Guidelines are offered for use of psychotropic agents for specific symptoms, such as nausea and vomiting, pain control, treatment of depression, delirium, anxiety, and psychosis. The importance of careful assessment and treatment of the causes of psychiatric symptoms is stressed. Recommendations for use of specific psychotropic agents are reviewed, including dosage range and route of administration as well as possible drug interactions and other factors affecting the use of these agents in patients. Anecdotal uses of these agents are also considered. PMID- 3315845 TI - Depressive disorder associated with physical illness. The impact of stroke. AB - The consultation-liaison psychiatrist is confronted time after time with depression in the context of physical illness, and the link between the two is of practical and theoretical interest. In addressing this topic, current classification systems are ambiguous. The advent of research diagnostic criteria and the primary/secondary depression dichotomy have not clarified the problem as was hoped. The conventional view that physical illness only precipitates depression in the genetically predisposed has been challenged by recent studies in patients with stroke. These studies point to a specific role for factors such as lesion location, severity of disability, and social support. In addition, the process of adjustment to serious physical illness can be understood in terms of personal vulnerability including low self-esteem, conflict within close relationships (particularly marital), and negative experiences in the developmental history. Acting on this vulnerability is the stressful life event (e.g., illness) that can have particular force if "matched" to the subjects existing psychologic conflicts. A modifying factor on the outcome of the adjustment is the influence of social support in protecting the individual from the life event. A list of potential factors influencing the occurrence of depression with physical illness is proposed. Variables likely to have an important place include 1) family history of psychiatric disorder, 2) a past personal history of depression, 3) the premorbid personality, 4) the impact of life events including the illness, 5) the degree of disability from the illness, 6) the presence of brain pathology and neuroendocrine abnormalities, and 7) the quality of social support during the time of illness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315846 TI - AIDS and ethics. An overview. AB - AIDS has generated a host of ethical questions that are urgent, poignant, and sometimes unprecedented. These questions fall into several familiar categories of ethical problems, including civil liberties vs. public health, distribution of scarce resources, "truth telling," confidentiality, and discrimination, among others. Established ethical principles apply in each of these areas, but certain features of this epidemic require new considerations. Factors such as our current uncertainty about the natural history of infection with HIV, the lack of evidence for transmission through casual contact, the social status of the groups at high risk, the unavailability of any definitive treatment, the tendency of AIDS to affect the central nervous system, and the availability of psychiatric evidence about the effects of hearing the diagnosis should affect the calculation of competing values. In general, there is little ethical justification at this time except in specific and limited situations for infringing on individual civil rights, for permitting discrimination against AIDS patients or those at risk, or for violating confidentiality. PMID- 3315847 TI - What the bacteriologists have learned about heat shock. PMID- 3315848 TI - Sigma 32 synthesis can regulate the synthesis of heat shock proteins in Escherichia coli. AB - The Escherichia coli rpoH (htpR) gene product, sigma 32, is required for the normal expression of heat shock genes and for the heat shock response. We present experiments indicating a direct role for sigma 32 in controlling the heat shock response. Both the induction and decline in the synthesis of heat shock proteins can be controlled by changes in the rate of synthesis of sigma 32. Specifically, we show that: (1) sigma 32 is an unstable protein, degraded with a half-life of approximately 4 min; (2) increasing the rate of synthesis of sigma 32, by inducing expression from a Plac or Ptac-rpoH fusion, is sufficient to increase the rate of synthesis of heat shock proteins; (3) during the shut-off phase of the heat shock response synthesis of sigma 32 is repressed post transcriptionally, and the dnaK756 mutation, which causes a defect in the shut off phase, prevents the post-transcriptional repression of synthesis of sigma 32. These results serve as a basis for understanding the role of DnaK in the heat shock response, the regulation of sigma 32 synthesis, and the role of sigma 32 in controlling transcription of heat shock genes. PMID- 3315849 TI - Genetic rearrangements and gene amplification in Escherichia coli: DNA sequences at the junctures of amplified gene fusions. AB - We describe gene fusions that result from genetic duplications of 5-20 kb, which are amplified 50- to 100-fold. Because one end point of the fusion lies within the sequenced lacI gene, the new junctures created by the duplications are readily identified. Using a procedure for dideoxy sequencing of double-stranded DNA, we show that the duplications occur almost exclusively at short sequence repeats (less than 15 bp), sometimes involving broken homologies, in the 30 cases examined. Most of the duplications place the lacI-Z encoded hybrid repressor-beta galactosidase protein under the control of a downstream promoter, resulting in the production of a more complex hybrid protein with beta-galactosidase activity. In some cases the fusion occurs with the lacY or the lacA gene, which suggests that silent promoters can be uncovered by gene fusion and subsequent amplification. In some ways this system represents a bacterial analog to chromosomal rearrangements of oncogenes in higher cells, since here the expression of a silent gene is the result of a genetic rearrangement that is followed by amplification during selected growth. PMID- 3315850 TI - A novel role for the 3' region of introns in pre-mRNA splicing of Saccharomyces cerevisiae. AB - To investigate the importance of sequences between the yeast (Saccharomyces cerevisiae) branch point (TACTAAC box) and 3' splice site (AG), we generated a series of pre-mRNA substrates that differed in the length of RNA retained on the 3' side of the TACTAAC box. These pre-mRNAs were compared as substrates for the first step of in vitro splicing (5' cleavage and lariat formation) and in vitro spliceosome assembly (complex formation) in a whole-cell yeast extract. The results indicate that for rp51A pre-mRNA at least 29 nucleotides of RNA on the 3' side of the TACTAAC box are required for 5' cleavage and lariat formation, as smaller substrates fail to manifest any detectable cleavage or ligation events. Analysis of splicing complex assembly indicates that these smaller substrates undergo efficient yet incomplete complex formation; they are blocked at a late stage of spliceosome assembly, the complex I to complex II transition (Pikielny et al. 1986), a result which suggests that the failure to form lariats is due to a specific assembly defect. The lariat formation block (and assembly defect) can be relieved by the addition of ribohomopolymer "tails" to the 3' end of the shortened rp51A pre-mRNAs, and similar results were obtained with shortened actin pre-mRNAs. The results of this study indicate that this region of the pre-mRNA serves a specific function late in in vitro spliceosome assembly. PMID- 3315851 TI - Regulation of the promoters and transcripts of rpoH, the Escherichia coli heat shock regulatory gene. AB - In Escherichia coli the product of the rpoH (htpR) gene, sigma 32, directs RNA polymerase to initiate transcription from heat shock promoters at all temperatures. Transcription of the heat shock genes is increased when cells are exposed to high temperatures because of increased transcription initiation by sigma 32-RNA polymerase. As a step toward understanding the regulation of the heat shock response we have examined the transcription of the rpoH gene. Using S1 mapping, promoter cloning, and in vitro transcription, we have identified the promoters and the terminator for the rpoH transcription unit. The rpoH transcripts are monocistronic and originate from at least three promoters. None of the promoters is recognized by sigma 32-RNA polymerase. Two are recognized by sigma 70-RNA polymerase and are active at both low and high growth temperatures. We do not know what form of RNA polymerase recognizes the third promoter. Transcripts from this promoter are abundant only at high temperature and are present after shift to the lethal temperature of 50 degrees C, even at times when there are no detectable transcripts from the other rpoH promoters. The amount of rpoH mRNA increases fivefold by 8 min after shift from 30 to 43.5 degrees C but rpoH mRNA synthesis increases by less than twofold, indicating that there is post transcriptional control of the level of rpoH mRNA and presumably of sigma 32. PMID- 3315852 TI - Induction of the heat shock regulon does not produce thermotolerance in Escherichia coli. AB - The addition of isopropyl thio-beta-D-galactoside (IPTG) to Escherichia coli cells containing multiple copies of the heat shock regulatory gene htpR (rpoH) under the control of an IPTG-inducible promoter (P-tac) induced 15 of the 17 polypeptides of the heat shock (HTP) regulon. The time course and magnitude of the induction closely resembled that caused by a shift to 42 degrees C. Nevertheless the two means of inducing the heat shock regulon differed in outcome. Cultures grown at 28 degrees C and induced by incubation at 42 degrees C for 15 min gave significant protection against a challenge temperature of 50 degrees C, but no protection was afforded by a 15-min IPTG treatment at 28 degrees C. It could be shown that there was no interference by IPTG with the development of thermotolerance at 42 degrees C. Also, treatment of a wild strain of E. coli with various toxic agents revealed no correlation between the development of thermotolerance and the induction of any subset of the heat shock proteins. Thermotolerance appears to develop by processes other than the htpR dependent induction of heat shock proteins. PMID- 3315853 TI - Escherichia coli tryptophan repressor binds multiple sites within the aroH and trp operators. AB - DNase I footprinting and methylation protection studies have been used to analyze the binding of Escherichia coli Trp repressor to the trpR, aroH, and trp operators. The methylation protection assay shows that Trp repressor binds in two successive major grooves of the trpR operator, three successive major grooves of the aroH operator, and four successive major grooves of the trp operator. The simplest model that explains the difference in Trp repressor interaction at the three operators is that the aroH and trp operators are composed of multiple, helically stacked binding sites. When viewed in three dimensions, each site is positioned on a different face of the DNA, and together process up the surface of the DNA helix. Analysis of a deletion derivative of the trp operator supports this model. PMID- 3315854 TI - DNA specificity determinants of Escherichia coli tryptophan repressor binding. AB - We have analyzed the sequence-specific interaction between the Escherichia coli tryptophan (Trp) repressor and its operator using challenge phage vectors. These phages, derivatives of Salmonella phage P22 that have substitutions of synthetic, symmetric trp operators for the P22 mnt operator, provide a genetic assay for DNA binding in vivo. Phages carrying operators that retain the determinants of Trp repressor binding efficiently lysogenize cells producing repressor; in contrast, phages with operators missing critical determinants kill such hosts. The binding determinants revealed by this assay corroborate a simple docking model for the Trp repressor-operator interaction postulated from the repressor crystal structure, and account for both the specificity of repressor binding and the ability of Trp repressor to recognize multiple, tandem DNA sites. PMID- 3315855 TI - Control of synthesis and positioning of a Caulobacter crescentus flagellar protein. AB - The Caulobacter crescentus flagellum is assembled during a defined time period in the cell cycle. Two genes encoding the major components of the flagellar filament, the 25K and the 27.5K flagellins, are expressed coincident with flagellar assembly. A third gene, flgJ, is also temporally regulated. The synthesis of the product of flgJ, the 29K flagellin, occurs prior to the synthesis of the other flagellin proteins. We demonstrate here that the time of initiation of flgJ expression is independent of chromosomal location but is dependent upon cis-acting sequences present upstream of the flgJ structural gene. Evidence that there is transcriptional control of flgJ expression includes the following: (1) The initial appearance of flgJ message was coincident with the onset of 29K flagellin protein synthesis, and (2) expression of an NPT II reporter gene driven by the flgJ promoter was temporally correct. Post transcriptional regulation might contribute to the control of expression, because the flgJ mRNA persisted for a longer period of time than did the synthesis of the 29K protein. The 29K flagellin was found only in the progeny swarmer cell after cell division. In a mutant strain that failed to assemble a flagellum, the 29K flagellin still segregated to the presumptive swarmer cell, demonstrating that positioning of the protein is independent of filament assembly. Analysis of a chimeric flgJ-NPT II transcriptional fusion showed that the flgJ regulatory sequences do not control the segregation of the 29K flagellin to the swarmer cell progeny, suggesting that correct segregation depends on the protein product. PMID- 3315857 TI - Expression of Lassa virus nucleocapsid protein segments in bacteria: purification of high-level expression products and their application in antibody detection. AB - The Lassa virus nucleocapsid protein gene and segments from it were expressed in Escherichia coli under the control of the lac promoter in pUC-based plasmids. Expression of the near full-length protein [amino acid (aa) residues 12-570] fused to an N-terminal sequence of vector-derived 6 aa was not particularly efficient, and neither was that of a smaller N-terminal segment (aa 6-201) which was also fused at its C terminus to the remainder of the lacZ gene product. By contrast, the C-terminal 370 aa could be expressed at levels approaching 10% of total cellular protein. All the recombinant proteins were associated with the insoluble fraction after sonication of the bacteria. The inefficiently expressed products did not appear to be any more susceptible to proteolytic degradation. The distribution of codons rarely used in E. coli genes was relatively uniform along the nucleocapsid gene sequence. These results are consistent with the regulation of transcriptional or translational efficiency by features of the sequence downstream from the promoter and ribosome-binding site. The C-terminal segment (aa 201-570 representing 65% of the authentic protein) was purified by ion exchange chromatography and shown to be active when used as antigen in enzyme linked immunoassays for virus-specific antibodies. PMID- 3315856 TI - Vectors for selective expression of cloned DNAs by T7 RNA polymerase. AB - Plasmid vectors are described that allow cloning of target DNAs at sites where they will be minimally transcribed by Escherichia coli RNA polymerase but selectively and actively transcribed by T7 RNA polymerase, in vitro or in E. coli cells. Transcription is controlled by the strong phi 10 promoter for T7 RNA polymerase, and in some cases by the T phi transcription terminator. The RNA produced can have as few as two foreign nucleotides ahead of the target sequence or can be cut by RNase III at the end of the target sequence. Target mRNAs can be translated from their own start signals or can be placed under control of start signals for the major capsid protein of T7, with the target coding sequence fused at the start codon or after the 2nd, 11th or 260th codon for the T7 protein. The controlling elements are contained on small DNA fragments that can easily be removed and used to create new expression vectors. PMID- 3315858 TI - Reovirus major capsid protein expressed in Escherichia coli. AB - A DNA copy of the open reading frame of the S4 gene of reovirus type 3 was cloned into a temperature-regulated bacterial expression vector. Induction at 42 degrees C resulted in the synthesis of a polypeptide that comigrated with virion capsid protein sigma 3 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and reacted with sigma 3-specific antisera. The protein was expressed in bacteria as insoluble aggregates that accumulated in polar inclusion bodies. Aggregated product also resulted when the expression system was manipulated to induce bacterial sigma 3 (b sigma 3) synthesis at temperatures below 42 degrees C. Various methods used to solubilize b sigma 3 did not yield the monomeric protein. The results indicate that sigma 3, the major surface component of reovirions, is expressed in transfected Escherichia coli as an aggregated, disulfide cross linked protein. PMID- 3315859 TI - Expression of human lysozyme in an insoluble form in yeast. AB - A high level of expression in yeast of a chemically synthesized human lysozyme (hL) gene was achieved by introducing an A-rich DNA fragment just upstream from the ATG start codon. The synthesized recombinant human lysozyme (r-hL) was insoluble and biologically inactive. It was solubilized with 7 M urea (pH 9) from yeast cells and its lytic activity was efficiently regenerated by oxidative renaturation. This renaturation experiment and Western blotting analysis under reducing and non-reducing conditions indicate that the insoluble form might be caused by the formation of incorrect intra- or intermolecular disulfide bonds. The N-terminal amino acid sequence of the purified r-hL was identical with that of authentic hL. PMID- 3315860 TI - Chemical synthesis of a gene coding for human angiogenin, its expression in Escherichia coli and conversion of the product into its active form. AB - A synthetic gene coding for human angiogenin was synthesized by solid support phosphoramidite chemistry as eight long oligodeoxynucleotides which were subsequently assembled and cloned in Escherichia coli. The gene was designed to use codons found in highly expressed E. coli proteins. A pBR322-derived expression vector was constructed containing the E. coli trp promoter, the ribosome-binding site of the bacteriophage lambda cII gene, the angiogenin coding sequence, and the transcription terminator region of the E. coli rrnB operon. Under tryptophan deprivation, angiogenin was strongly expressed in E. coli cells at a yield of 5-10% of total protein. The eukaryotic protein was found to be insoluble but could be easily renatured and purified. The purified angiogenin was demonstrated to be active as an angiogenic factor and exhibited a characteristic RNase activity. PMID- 3315861 TI - Complete nucleotide sequence of the penicillin G acylase gene and the flanking regions, and its expression in Escherichia coli. AB - The pga gene coding for penicillin G acylase (PGA) in Escherichia coli ATCC11105 was cloned, and its complete nucleotide sequence including 5'- and 3'-flanking regions was determined. Two nonidentical subunits that constitute an active PGA enzyme complex are known to be formed by processing of a common precursor molecule [Bock et al., FEMS Microbiol. Lett. 20 (1983) 141-144]. This novel type of protein processing was confirmed by a nucleotide sequencing study together with amino acid sequencing of two PGA subunits. In addition, it was found that the initiation codon, AUG, is preceded by an authentic ribosome-binding site, a consensus promoter sequence and putative cAMP receptor protein (CRP)-binding sites, and that the termination codon, UAA, is followed by a putative transcriptional terminator. The promoter function was confirmed by galactokinase assay using galK fusion plasmids. A recombinant plasmid was constructed to overproduce the enzyme using phage lambda pL promoter. Unexpectedly, thermal induction led to accumulation of the 94-kDa polypeptide rather than active PGA in large amounts. Western immunoblot analysis showed that this large polypeptide is the real precursor of PGA. It is evident, therefore, that the synthesis of active PGA in E. coli is affected by growth temperature and that the precursor processing step(s) is temperature-sensitive. PMID- 3315862 TI - The complete nucleotide sequence of the ilvGMEDA cluster of Escherichia coli K 12. AB - The ilvGMEDA gene cluster of Escherichia coli K-12 has been the focus of intensive genetic and biochemical analysis for the past 30 years. Genetic regulation of the ilvGMEDA cluster involves attenuation, internal promoters, internal Rho-dependent termination sites, a site of polarity in the ilvG pseudogene of the wild-type organism, and autoregulation by the ilvA gene product, the biosynthetic L-threonine deaminase. We have now completed the nucleotide sequence of the 6600-bp cluster and have analyzed it, along with the ilvYC, ilvBN, and ilvIH genes, for codon frequencies and possible evolutionary relationships. The isoleucine content of each of the gene products of the ilvGMEDA cluster is quite similar (less than a two-fold variation), thus excluding one possible interpretation of the isoleucine-specific downstream amplification phenomenon. There is no evidence for retrograde evolution in the cluster since no significant homologies are detectable among genes that catalyze sequential reactions of the pathway. A highly significant homology does exist, however, between the threonine deaminases of yeast mitochondria and E. coli. The sequence at the boundary of the ilvA and ilvD genes is TAATAATG, so that the second TAA stop codon of ilvD overlaps the ATG initiation codon of ilvA. PMID- 3315863 TI - Glycosylation and secretion of human alpha-1-antitrypsin by yeast. AB - Human alpha-1-antitrypsin (alpha-AT) is a major serum protein with protease inhibitory activity. Three asparagine residues in alpha-AT are glycosylated with the mammalian 'complex' pattern of carbohydrate as the protein is secreted from cells in the liver. To examine the glycosylation and secretion of human alpha-AT by Saccharomyces cerevisiae, the yeast invertase secretion signal codons were substituted for the native secretion signal coding DNA of an alpha-AT cDNA, and the fusion gene was placed on an autonomously replicating yeast--Escherichia coli shuttle vector under control of the yeast triosephosphate isomerase (TPI) promoter. Yeast strains transformed with this plasmid produce human alpha-AT and secrete about one-fifth of it into the culture broth. Approximately 80% of the alpha-AT produced in yeast is not in the culture broth but is inside the cell within the secretory pathway. This internal alpha-AT is heterogeneous, consisting of molecules with core carbohydrate on either two or all three of the asparagine receptors. Human alpha-AT secreted into the culture broth contains, in addition to core carbohydrate, variable numbers of mannose outer chains, typical of secreted yeast proteins such as invertase. All carbohydrate is removed by endoglycosidase H treatment. Examination of alpha-AT secreted from an mnn9 mutant, which blocks addition of variable numbers of outer mannose chains, revealed a homogeneous alpha-AT product which, like alpha-AT isolated from human serum, bears carbohydrate on three asparagine residues per molecule. PMID- 3315864 TI - New and versatile cloning vectors with kanamycin-resistance marker. AB - Described here is a pair of small multi-copy kanamycin-resistance plasmids, containing the pUC lacZ alpha-complementation peptide and the pUC18 and pUC19 multiple cloning site. These plasmids and their derivatives allow simple and rapid transfer of inserts from one replicon to another without the necessity of purifying the insert from vector. PMID- 3315865 TI - The angina that signaled more than heart disease. PMID- 3315867 TI - [I. I. Molleson's work "Zemstvo Medicine"--a program of preventive medicine]. PMID- 3315866 TI - Hyposomatomedinemia in the men of a Veterans Administration Nursing Home: prevalence and correlates. AB - A previous study found hyposomatomedinemia to be common in the men of this VA Nursing Home. To gain information on the prevalence and correlates of this endocrine characteristic, we have measured plasma somatomedin C (SmC) in 69 Nursing Home men 55-95 years old (group I), and in 37 independent men 56-87 years old attending our geriatric medicine outpatient clinic (group II). In groups I and II, a clinical data base was compiled comprising: blood chemistries, measures of body composition - nutritional state and functional level, diagnoses, medications, and morbidity and mortality during the year after the SmC analysis. The mean +/- SD for SmC was significantly (p less than 0.05) lower in group I (0.35 +/- 0.21 units/ml) than in group II (0.45 +/- 0.13 units/ml). SmC less than 0.25 units/ml, a range consistent with severe growth hormone deficiency, was found almost exclusively in group I (31.8% of men in group I, 3.7% of men in group II). In either group I, or in groups I and II combined, SmC was significantly (p less than 0.05) correlated with body weight as percentage of ideal, midarm muscle circumference (MAMC) as percent of standard, diagnosis of cerebrovascular disease, and plasma testosterone level. Men with SmC values below 0.25 units/ml had significantly (p less than 0.05) lower values for body weight as percentage of ideal, and for MAMC as percentage of standard. Except for cerebrovascular disease, SmC did not correlate significantly (p greater than 0.05) with diagnosis, drugs, morbidity or mortality. PMID- 3315868 TI - [Current approaches to managing environmental quality abroad]. PMID- 3315869 TI - [The perfume and cosmetics industry and the sanitary protection of the atmosphere]. PMID- 3315871 TI - [The new periodical "Hygiene and Work Safety" (Australia and New Zealand (review of the literature)]. PMID- 3315870 TI - Respite care: a partnership between a Veterans Administration nursing home and families to care for frail elders at home. PMID- 3315872 TI - Nerve plasticity and aberrant regeneration. PMID- 3315873 TI - Varieties of colour naming defects associated with posterior brain damage: a neurolinguistic reappraisal. PMID- 3315875 TI - On Alzheimer's disease: an overview of diagnostic and research issues for the clinical neurologist. PMID- 3315874 TI - Parkinson-like side effects during prolonged treatment with flunarizine. AB - Forty-two elderly patients affected by a generic cerebrovascular disease developed a parkinsonian syndrome after prolonged treatment with flunarizine. Following flunarizine withdrawal the extrapyramidal symptomatology remitted slowly and progressively for 12 weeks, leading to the belief that the observed parkinsonian syndrome is directly linked to the chronic use of this compound. Similar side effects are not described in young populations, however. A periodic flunarizine discontinuation in chronically treated subjects aged 65 or more is suggested. PMID- 3315876 TI - Extra hepatic portal venous obstruction. PMID- 3315877 TI - Demonstration of pepsinogen C in human pancreatic islets. AB - Pancreatic tissue from 16 post mortem kidney donors have been examined for the content of pepsinogens. A zymogen with electrophoretic mobility, isoelectric point and molecular weight equal to that of pepsinogen C of gastric origin was found in all specimens. A comparison between pepsinogen C extracted from pancreatic tissue and gastric mucosa demonstrated immunological identity. Quantitative measurements with a radioimmunoassay showed pepsinogen C concentrations in pancreatic tissue three to 80 times higher than those of blood serum. Immunohistochemical staining gave positive reaction for pepsinogen C only in the alpha cells of the pancreatic islets. PMID- 3315879 TI - Helping the mucosa make sense of macromolecules. PMID- 3315878 TI - Psychological factors in the irritable bowel syndrome. AB - This paper reviews recent psychological studies of patients with the irritable bowel syndrome (IBS) or 'functional abdominal pain'. Many studies have used unreliable or invalid methods of assessment and some have confused personality with treatable psychiatric illness. Reliable and valid measures have indicated that 40-50% of patients with recently diagnosed functional abdominal pain have demonstrable psychiatric illness; these patients have a worse prognosis than those who are psychologically normal. When psychiatric disorder is diagnosed in a patient with IBS there are three possibilities: (1) The patient may have developed abdominal and psychiatric symptoms simultaneously in which case treatment of the latter may relieve the bowel symptoms. (2) Psychiatric disorder may precipitate increased concern about bowel symptoms, and consequent attendance at the gastroenterology clinic, of those with chronic mild symptoms. In this case it is illness behaviour, rather than abdominal symptoms, that is caused by the anxiety/depression. (3) Those with chronic neurotic symptoms as part of their personality must be screened for organic disease if they have a fresh onset of bowel symptoms; but they are at high risk of becoming persistent clinic attenders. Further research is needed to clarify when psychological abnormalities play a role in the aetiology of IBS and when they are coincidental, but lead to illness behaviour. The role of psychological factors in the aetiology of the irritable bowel syndrome (IBS) is far from clear, but a review of the literature suggests that some consistent patterns are emerging in spite of methodological problems. There have been three major defects with studies that have linked IBS with neurotic symptomatology. First, the measurement of psychological factors has generally been imprecise. Second, most studies have considered IBS patients as a single group, without making allowance for differing symptom patterns. Third, conclusions have been drawn about hospital samples and extrapolated to all IBS subjects, without taking account of factors which affect consulting behaviour. Most studies have been concerned with psychological factors so these will be considered in most detail. PMID- 3315880 TI - Endoscopic needle aspiration cytology: a new method for the diagnosis of upper gastrointestinal cancer. AB - A technique for obtaining needle aspiration cytology specimens from upper gastrointestinal lesions at endoscopy is described. The validity of the technique was initially confirmed by applying it to resected gastric carcinomas. Thirty seven endoscopically visualised lesions were then sampled by forceps biopsy, brush and needle cytology. Ten lesions were subsequently found to be carcinomas. Needle aspiration produced identifiable malignant cells from seven of these lesions. In two it was the only sampling method which provided the correct diagnosis. This technique may be a useful addition to conventional endoscopic sampling methods, particularly where tumours lie deep to normal mucosa, or necrotic slough. PMID- 3315881 TI - Ambulatory 24 hour intraesophageal pH-monitoring in the diagnosis of gastroesophageal reflux disease. AB - The results of ambulatory 24 hour oesophageal pH monitoring in 20 patients with established gastro-oesophageal reflux disease were compared with those of 20 healthy individuals with normal endoscopy. Cut off limits of pH 3, 4, and 5 were superior to pH 2 with respect to the discrimination of patients from normal subjects, and for the detection of pathological reflux. Using pH 4 as a cut off limit, the ambulant and recumbent periods of pH monitoring were more discriminatory than the postprandial period. Furthermore, it was possible to get complete separation between patients and normal subjects using several combinations of two reflux variables. Another group of 30 patients and 30 controls were investigated. Using percentage time at pH less than 4 as a single determinant of gastro-oesophageal reflux, the sensitivity and specificity were 87% and 97%, respectively, with 3.4% as upper limit for normality. Twenty four hour oesophageal pH monitoring in an ambulatory outpatient environment afforded clinically useful diagnostic accuracy in separating patients with gastro oesophageal reflux disease from asymptomatic controls. PMID- 3315883 TI - [Physical activity and sports in pregnancy]. PMID- 3315884 TI - [Travel and pregnancy]. PMID- 3315882 TI - Technical aspects of intraluminal pH-metry in man: current status and recommendations. PMID- 3315885 TI - [Automobile driving--problems and dangers]. PMID- 3315886 TI - [Flying and pregnancy]. PMID- 3315888 TI - [Is the lupus band test specific for systemic lupus erythematosus?]. PMID- 3315887 TI - [Constipation in pregnancy--which therapy?]. PMID- 3315889 TI - [Psychopharmacological treatment of post-traumatic stress disorder]. PMID- 3315890 TI - [Postoperative pulmonary complications--risk factors and prophylactic measures]. PMID- 3315891 TI - [Newer aspects of the pathogenesis and treatment of diaper dermatitis]. PMID- 3315893 TI - [The cephalosporins: mode of action and clinical use]. PMID- 3315892 TI - [Pediatric milestones in Israel--historical notes]. PMID- 3315894 TI - [Ultrasonography in congenital dislocation of the hip]. PMID- 3315895 TI - [The immune system in primary nephrotic syndrome in childhood]. PMID- 3315896 TI - [HLA and autoimmune diseases]. PMID- 3315897 TI - [The treatment of familial hypercholesterolemia]. PMID- 3315898 TI - [Apolipoproteins and coronary heart disease]. PMID- 3315899 TI - [Surgical correction of aortic stenosis]. PMID- 3315900 TI - Premenstrual syndrome: psychiatric, physiological, and psychosocial perspectives. AB - Although social workers often work with client systems affected by premenstrual syndrome (PMS), little information has been made available to guide their work. This article reviews the literature on PMS and presents recent advances from psychiatric, physiological, and psychosocial perspectives. Clinical and policy issues also are examined in light of the recent inclusion of PMS in the appendix of the revised edition of the DSM-III. PMID- 3315902 TI - Mutagenicity tests of cashewnut shell liquid, rice-bran oil and other vegetable oils using the Salmonella typhimurium/microsome system. AB - In view of the shortage of edible oils in India, nutritional and toxicological evaluations have been carried out on some unconventional oils to determine whether they might be safe for human consumption. As part of these evaluations, eight unconventional oils were tested by the Ames mutagenicity assay, using Salmonella typhimurium strains TA98 and TA100 with and without metabolic activation with S-9 mix prepared from the livers of rats pretreated with sodium phenobarbitone or Aroclor 1254. Of the oils tested, metsa oil (Hibiscus sabdariffa) and cashewnut shell liquid were mutagenic with and without metabolic activation with S-9 of either source. No mutagenic activity (with or without S-9 of either source) was observed with any of the other oils tested (rice-bran oil, Cleome viscosa oil, mango-kernel oil, mahua oil, kapok oil and neem oil). PMID- 3315901 TI - [Mechanism for acetylcholine receptor localization at nerve-muscle synapse]. AB - This paper summarizes the hypothesis proposed to explain the mechanism for AChR localization at the neuromuscular synapse. Two theories have been proposed to explain the neuronal control of extrajunctional AChR. One theory claimed that motoneurons decreased the ACh sensitivity of the extrajunctional membrane through neurotrophic influence. However, direct electrical stimulation of denervated muscles resulted in a decrease of extrajunctional ACh sensitivity, supporting the other hypothesis that loss of extrajunctional AChR of the innervated muscle is directly related to muscle activity per se. AChR clusters (high density of AChR) at the neuro-muscular junction were supposed to result from the association of nerves with preexisting AChR clusters. However, Xenopus nerve-muscle cocultures clearly demonstrated that AChR clusters at the neuromuscular junction were formed after the nerve came in contact with the muscle membrane. Two hypothesis are proposed for nerve-induced formation of AChR clusters. Preferential insertion of AChR into the end-plate was suggested by the finding that AChR messenger RNA was more abundant near to than far from the end-plate in adult muscle fibers. On the other hand, in cultured and embryonic muscles, AChR clusters were formed at nerve muscle junctions through receptor redistribution which was mediated by the passive diffusion-trap mechanism. PMID- 3315903 TI - Pictorial review: cross-sectional imaging of the foot and ankle. AB - Cross-sectional imaging techniques are becoming increasingly important for the evaluation of foot and ankle disorders. Computed tomography affords superior depiction of osseous anatomy, and is useful in the assessment of acute fractures, degenerative joint disease, and post-operative alterations. Magnetic resonance imaging is particularly well suited to soft tissue disease, including neoplasms, tendinitis, myopathy, and infection, owing to its excellent contrast discrimination capabilities. PMID- 3315904 TI - White matter damage following acute head injury. AB - The study of a series of brains from patients who had a severe head injury and died within 72 h without a lucid interval showed that there was a step-wise progression in the development of retraction balls. At 2 h after injury sinusoidal enlargement of the axons was evident. This progressed over 16 h when the lesions appeared as retraction balls which were fully developed at 72 h. There was a similar increase of staining with an immunoperoxidase method for glial fibrillary acid protein (GFAP) initially around blood vessels spreading diffusely into the white matter. The number of reactive astrocytes also increased. In a control case where the corpus callosum was torn at post-mortem there were sinusoidally distended and torn axons in the absence of GFAP staining. It is proposed that there are three components to a head injury. First, mechanical injury as seen in the control case; second, the development of retraction balls which are an active process probably representing damaged axons which cannot undergo repair where the sinusoidal swellings develop into retraction balls and third, an astrocytic reaction. The sinusoidal change, when present on its own, may not be separable from post-mortem trauma. However, when it is associated with an astrocytic response it should be correlated with coma in the same way as retraction balls. PMID- 3315905 TI - Liver histopathology in autopsied drug-addicts. AB - Liver specimens of 150 randomly selected autopsied drug addicts from the province of Milan (Italy) were studied using light microscopy, polarized light and immunohistochemical methods. Simple histological changes and the main diagnoses are described. The main histological diagnoses in order of frequency were: non specific reactive hepatitis (NSRH) (52%), chronic aggressive hepatitis (CAH) (24%), acute hepatitis (AH) (12%), normal liver (6%), steatosis only (3.3%) and cirrhosis (2%). In 24 cases (16%) one or more viral antigens (HBsAg, HBcAg and Delta Ag) were detected in hepatocytes by immunohistochemical methods. Three liver specimens revealed epithelioid cell granulomas, but in no case was birefringent material identified in the liver. AH and CAH were more frequent in the group of livers with viral antigens. Our histological and immunohistochemical data confirm the current opinion that, in most cases, liver pathology in drug addicts has a viral aetiology, while no significant pathogenic role has been identified for drugs, alcohol or contaminants. Recurrent infections by one or several viruses possibly explain the relatively peculiar histological features of hepatitis in drug addicts. PMID- 3315906 TI - Pigments of fungi (Macromycetes). PMID- 3315907 TI - [From Olympus to Hell? The pathography of Friedrich Holderlin (1770-1843)]. PMID- 3315908 TI - [Transvaginal sonography in gynecology]. PMID- 3315910 TI - [Shoulder pain and its diagnostic differentiation]. PMID- 3315909 TI - [England--the cradle of penicillin. Discovery by accident--further development is complicated]. PMID- 3315911 TI - [Suicide in epileptic patients]. AB - Suicide and attempted suicide occur with above-average frequency in patients with epilepsy. The proportion of suicide in the overall mortality of epilepsy patients is about 8% and thus about four times more frequent than in the general population. Affective disorders may be contemporaneous with epileptic attacks, or they may occur interictally. The affective disorders leading to suicide may be caused reactively, pharmacogenically, or by the epileptic function disorder itself or by an underlying cerebral disease. For prophylaxis of suicide, it is especially important to be informed about pharmacogenic depressive moods, which evidently occur above all in phenobarbital treatment. Rapid help is often possible by change of medication. Otherwise, the rules of therapy in epilepsy patients in danger of suicide correspond to those of crisis intervention in suicidal individuals in general. PMID- 3315912 TI - [Discontinuing anticonvulsant therapy: anthropologic aspects]. AB - The ultimate aim of a successful treatment of epilepsy is freedom from seizures, even after the discontinuation of medicinal treatment. Relapses can however not be excluded even under a favorable course of the disease. In the event of a good medical prognosis in respect of relapses, a recurrence of seizure can lead to a severe threat in the sphere of social and personal life of the individual. On the basis of specimen examples such situations in life are presented, wherein relapse of seizures resulted in serious psycho-social problems. From the unstable periods of life, special emphasis is placed on the second "social" phase of puberty. The complexity of situation in this period of life, together with its closely following transitory phases of one social structure into another (school, professional training, career) demands caution in planning the discontinuation of therapy, as relapses may lead to disturbing consequences on further plans of life. This applies even more to professional part of life, threatening the stability of employment with frequent change of jobs, resulting in a vulnerable area. The consequences of relapses can lead to regression of professional progress, the loss of external existence and lack of one's own self confidence. The significance of fear and anxiety as marked factors contributing for relapses will be emphasized. More over it is important to consider carefully the pathogenic family structure, in which relapse can break out concealed fears and rejections leading to serious disturbances in the private life of the subject. The discontinuation of antiepileptic medication under suitable circumstances is not basically disagreed upon.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315913 TI - [Etiology and therapy of nightmares]. AB - Theories and evidence on the aetiology of the 3 distinct forms of nightmares (REM nightmares, NREM night terrors, posttraumatic nightmares) are exposed. Depth psychological theories try an aetiological integration of the nightmare into their respective theories of dream formation, whereas empirical work stresses the personality-typical traits of nightmare sufferers. Clinical casework reports relate anxiety dreams to existing psychological and somatic pathology. Posttraumatic nightmares are repetitive mental reactions to heavy traumatic or life-threatening events. Nightmare therapy, insofar as it has become an independent variety of psychological intervention, uses drug medication, which is able to suppress the symptom of the sufferer when on the drug, whereas behavioural and insight treatment not only eliminate the dreams, but can have an enduring healing effect. PMID- 3315915 TI - Sensitivity of pancreatic beta cell to calcium channel blockers. An electrophysiologic study of verapamil and nifedipine. AB - Microelectrodes were used to study the comparative effects of 2 calcium channel blockers on glucose-induced electrical activity in mouse beta cells. In 2.8 mM glucose, verapamil (10(-5) M), but not nifedipine (10(-7) M), induces a silent depolarization. In 11.1 mM glucose, verapamil (10(-7) to 5.10(-5) M) induces continuous spike activity by a decrease in the maximum repolarization potential. Nifedipine (10(-10) to 10(-6) M) induces the same activity, but subsequent to a hyperpolarization of the cell at the maximal repolarization potential followed by a silent phase to the plateau potential. The 2 drugs induce a dose-dependent decrease in spike frequency without any change in spike amplitude. In 22 mM glucose exposure to nifedipine, but not to verapamil, induces a transient period of slow-wave activity. The 2 drugs induce a dose-dependent decrease in spike frequency. At higher concentrations (nifedipine greater than 10(-7) M; verapamil greater than 10(-6) M) they induce the disappearance of spikes through a decrease in amplitude. These results show that the beta cell is more sensitive to nifedipine (ED50 = 3 X 10(-8) M) than to verapamil, and that glucose stimulation increases the cell's sensitivity to verapamil (11.1 mM glucose: ED50 = 10(-5) M versus 5 X 10(-7) M in 22 mM glucose) but not to nifedipine. PMID- 3315914 TI - Effects of ketanserin on cardiovascular, sympatho-adrenal and endocrine systems during physical exercise in man. AB - Blood pressure, heart rate, oxygen consumption, plasma concentrations of catecholamines, renin, aldosterone and lactate were measured in 6 normotensive volunteers during a randomized cross-over study of oral ketanserin (20 mg X 7) and placebo; measurements were made at rest and during maximal dynamic exercise on a bicycle ergometer. At rest ketanserin reduced blood pressure without modifying heart rate or plasma noradrenaline and adrenaline. Duration of exercise and blood lactate levels did not differ between the ketanserin and the control group. During exercise only systolic blood pressure was significantly decreased on ketanserin at maximal work rate whereas heart rate did not change. Plasma noradrenaline was significantly increased and plasma aldosterone significantly decreased during exercise in ketanserin-treated subjects whereas plasma renin activity and plasma adrenaline remained unchanged. Finally, under ketanserin oxygen consumption during exercise was reduced. The results suggest that ketanserin might interfere with the sympathetic nervous system and aldosterone secretion in man. PMID- 3315916 TI - Silent ischemia: a timely aspect in coronary artery disease. AB - The phenomenon of silent myocardial ischemia is defined as a transient alteration in myocardial perfusion, function or electrical activity in the absence of chest pain or the usual anginal equivalents. Patients may be classified as having one of three types of silent ischemia: type 1-asymptomatic with no history of myocardial infarction or angina; type 2-asymptomatic with previous myocardial infarction; type 3-angina is present in addition to asymptomatic ischemic episodes. Based on exercise testing, silent ischemia has been found in 2.5% of asymptomatic middle-aged men; a substantial number of such subjects subsequently incur cardiac events. In patients with type 2 silent ischemia, post-infarction mortality appears markedly higher than in cohorts without silent ischemia. In type 3 patients, 75 to 80% can be found to have silent ischemic episodes in addition to typical anginal attacks, the frequency of which may be up to three or four times that of the latter counterpart. In persons with coronary artery disease who succumb to sudden cardiac death, 25% have never had clinical symptoms suggesting that there may be a great number of persons with silent disease in the population at large. PMID- 3315918 TI - Capital pooling or marketplace mechanisms? PMID- 3315917 TI - Silent myocardial ischemia: diagnosis, clinical significance and management. AB - With the inception of continuous ECG monitoring with high-fidelity reproduction of the ST-segment, silent myocardial ischemia has been regarded with increasing importance in the detection and management of coronary artery disease. With the aid of a variety of invasive and noninvasive methods, the validity of ST-segment depression as indicative of myocardial ischemia, even in the absence of symptoms, has been adequately documented. In completely asymptomatic subjects with positive evidence of silent ischemia in the exercise ECG or Holter monitoring, the risk of developing a future manifestation of coronary artery disease may be up to ten fold higher than in individuals with negative tests In patients with established coronary artery disease, concomitant use of continuous ECG monitoring and exercise testing, methods which complement each other rather than being mutually exclusive, a substantial number of patients with otherwise typical angina pectoris may be found to have silent ischemic episodes. An adequate differentiation between those with symptomatic and those who are asymptomatic based on characterization with respect to age, sex, hypertension, coronary anatomy, etc., has not been successful. Patients with silent ischemia during exercise may also exhibit more episodes of silent ischemia during daily activities and up to 75% of ischemic episodes may be asymptomatic. In general, however, silent ischemia during exercise appears more common than silent ischemia only during daily activities. In the latter case, since there is usually no increase in heart rate, the pathophysiology is regarded as dissimilar from that associated with exercise-induced ischemia. While the presence of silent ischemia appears quite common in patients after acute myocardial infarction, its occurrence, to date, has not been confirmed to carry additional risk, whereas in unstable angina, the association of silent ischemia is indicative of a higher probability of subsequent cardiac events. PMID- 3315919 TI - Contradictory policies for foreign medical graduates. PMID- 3315920 TI - Campylobacter pylori: new and renewed insights into gastritis-associated ulcer disease (GAUD). PMID- 3315921 TI - Ileus and intestinal obstruction--ultrasonographic findings as a guideline to therapy. AB - Between September 1, 1982 and January 31, 1986, a study was undertaken in a total of 111 patients to assess the efficacy of ultrasonography in diagnosing intestinal obstruction and ileus. In 109 cases (98%), ultrasonography provided the correct diagnosis. In one case, obstruction was correctly suspected. In another case, the diagnosis was false negative. In 51 cases (46%), ultrasonography yielded the causative diagnosis. Ultrasonography was especially rewarding in the diagnosis of X-ray-negative intestinal obstruction, very high obstruction, clinically concealed incarcerated femoral hernias and in the differentiation of intestinal obstruction and ileus in the postoperative course. Ultrasonographic differential diagnosis was a reliable guideline for adequate treatment modalities in pertinent cases, thus contributing to therapeutic success. PMID- 3315922 TI - Immunoglobulin allotypes and immunoreactivity in chronic liver disease. AB - The immunoglobulin allotypes Gm (a; x; f) and Km 1 have been estimated in 194 patients with chronic liver disease, and compared with the frequency distribution of a representative reference group (Gm : n = 2171; Km : n = 2179). In relation to the Gm phenotypes we have investigated the cell-mediated immunoreactivity by the E rosette test, lymphocyte transformation test and migration inhibition test. Virus-induced chronic liver disease showed significantly higher prevalence of the phenotypes Gm a+x-f+ and Gm a+x+f+ as well as of the marker Km + 1 (p less than or equal to 5%; chi 2-test). In auto-immune chronic liver disease we observed a decrease in the phenotype Gm a+x-f+ while the factor Km + 1 was significantly multiplied. Patients with cryptogenic and alcoholic hepatopathy showed no differences in comparison with the reference group. In the progressive forms of the chronic liver disease (chronic active hepatitis, liver cirrhosis) Gm a+x+f+ was significantly more frequent. The investigations concerning cell-mediated immunity in different Gm allotypes generally showed a trend to increased reactivity in Gm a+x+ in comparison with Gm a-x- in non-alcoholic liver disease. It is possible to presume different genetic and immunologic situations in the various liver diseases as endogenous factors promoting the disease. PMID- 3315924 TI - [Study of the incidence of anuclear oocytes in vitro in aged mice]. AB - For investigating the relationship between maternal age and incidence of molar pregnancy, attempt was made to experiment in animal model. C57BL/6J strain mice were used for experimental animal model because the transition of reproductive age of these animals have a strong resemblance to those of human. It is proved that hydatidiform mole arises from fertilization of "an empty egg" resulting from either enucleation or inactivation of the female pronucleus. Therefore incidence of anuclear oocyte during in vitro maturation process was examined of oocytes obtained from aged mice's ovaries(403-503 days old) in comparison with those of young mice's(108-274d.o.). The results were as follows: 1) Timing of oocyte maturation and ooclasmic maturation rate were the same in aged mice as in mature (young) ones. 2) But incidence of abnormal oocytes such as having two polar bodies were significantly higher in aged than in young mice(9.2% versus 3.6%). (p less than 0.025) 3) Especially incidence of abnormal anuclear oocytes were also very high in aged mice(aged: young = 12.5%:3.6%). (p less than 0.05) This result suggest the increase of molar pregnancy during climacteric in human is due to increase of anuclear oocytes for oocyte maturation. PMID- 3315923 TI - Omeprazole vs. ranitidine in the short-term treatment of duodenal ulcer: an Italian multicenter study. AB - A double-blind, double-dummy, randomized Italian multicenter trial was carried out to compare the efficacy and safety of omeprazole 20 mg in the morning and ranitidine 150 mg b.i.d. in short-term treatment of acute duodenal ulcer. One hundred and twenty-one patients (61 in the omeprazole and 60 in the ranitidine group) with endoscopically proven active duodenal ulcer, completed the study. The healing rates after 2, 4 and 6 weeks were 66, 97 and 100%, respectively, with omeprazole and 53, 85 and 92%, respectively, with ranitidine. The difference was statistically significant (p less than 0.05) at weeks 4 and 6. Night and day pain were markedly reduced during both treatments, as also antacid consumption. Both drugs were well tolerated, and the adverse events were infrequent and moderate. In our experience, omeprazole 20 mg once daily seems to be superior to ranitidine 150 mg b.i.d. in the short-term treatment of duodenal ulcer. PMID- 3315925 TI - [Experimental study on myocardial protection by means of retrograde coronary sinus cooling perfusion (RCSP) during aorto-coronary bypass surgery]. AB - Cold chemical cardioplegia by the antegrade method is a useful, widely employed procedure for protecting the myocardium in aorto-coronary by pass surgery. Perfusion of a cardioplegic solution into the ischemic area is, however, insufficient in the presence of a severe lesion in the coronary artery, leading to postoperative cardiac hypofunction. We performed an experimental study using RCSP, which lessens this problem, in the excised dog heart. Hearts excised from 20 dogs were assigned to normal coronary artery groups (group I consisting of the hearts from 5 dogs and a perfusion solution temperature of 20 degrees C, group II consisting of the hearts from 5 dogs and a temperature of 30 degrees C) and blocked coronary artery groups (group III consisting of the hearts from 5 dogs and a temperature of 20 degrees C, group IV consisting of the hearts from 5 dogs and a temperature of 30 degrees C). RCSP was undertaken for two hours with a new modified Krebs solution. Hemodynamic and myocardial metabolic parameters during a given work load under fixed conditions and heart beat after reopening of the blood flow using our original function circuit were compared between the experimental groups and a control group (consisting of normal hearts studied immediately after excision from 5 dogs not given myocardial protection). In the group with normal coronary arteries, LVW and LV dp/dt were better in group I than in group II throughout the course; these values were significantly lower in group II than in the control group, but there was no significant difference between group I and the control group. These parameters were also improved in group III (with blocked coronary arteries), but there was no significant difference in improvement between group III and the control group 60 minutes after reperfusion. In group IV, on the other hand, improvement was poor. The myocardial metabolic parameters also showed approximately the same results. These results suggested that RCSP with the new modified Krebs' solution at perfusion temperature of 20 degrees C afforded effective protection of the myocardium for two hours. From the fact that a favorable protective effect of the myocardium was obtained in group III, as in group I, RCSP was considered to provide a useful procedure for protection of the myocardium in aorto-coronary bypass for severe or wide-ranging coronary artery diseases. PMID- 3315926 TI - [Immunohistochemical study of ras p21 expression in human gastric cancers and benign lesions]. AB - Expression of ras p21 in human gastric cancers, benign lesions (i.e. dysplasia, intestinal metaplasia and hyperplastic polyps) and normal tissues was immunohistochemically evaluated by the avidin-biotin complex (ABC) immunoperoxidase method with anti-ras p21 monoclonal antibody(rp-28). Positive p21-immunoreactivity was shown in 23(77%) of 30 gastric cancers, in 13(48%) of 27 benign lesions and in 10(22%) of 46 normal mucosa. Among them, strong staining was demonstrated only in 11(37%) of 30 gastric cancers, but not in benign lesions and normal tissues. Cases showing more than 20% positive cell ratio were observed in 22(73%) of gastric cancers, in 11(41%) of benign lesions and 6(13%) of normal mucosa. Furthermore, there was clear difference in intracellular distribution of ras p21 between in gastric cancers and in benign lesions or normal tissues. Plasma membrane and cytoplasm of malignant cells showed positive immunoreactivity in some gastric cancers. On the other hand, ras p21 was observed in cytoplasm of positive cells in benign tissues. The ABC method with this antibody could be useful for clinical differential diagnosis between gastric cancers and benign lesions by investigating three factors: staining intensity, positive cell ratio and intracellular distribution. PMID- 3315927 TI - [Epidemiological studies on the outcome of pregnancy and delivery of the female employees]. AB - Little information exists about the effect of working during pregnancy on pregnancy outcome. In order to determine whether pregnancy outcome was altered when women were employed outside their homes, pregnancy outcomes of 4,395 working women were compared with outcomes of 10,203 women (control) who were not employed. The pregnancy outcomes of working women were also analysed according to the occupation and working hours. Irregularity of the menstrual cycles prior to the pregnancy was observed more frequently in the working women than control (19.5% vs 14.9%, p less than 0.001). There were significant differences between the employees and control in rates of spontaneous abortion and premature delivery (6.8% vs 5.4%, p less than 0.01), spontaneous vaginal delivery (80.7% vs 84.5%, p less than 0.001), small-for-gestational age infant (SGA) (4.6% vs 3.4%, p less than 0.001), and fetal distress (7.6% vs 6.5%, p less than 0.02). However, no statistical differences were noted in rates of EPH gestosis, gestational anemia, neonatal hyperbilirubinemia, perinatal death, or malformation prevalence. Among the 1,888 employees, rates of threatened abortion and threatened premature delivery, and spontaneous abortion and preterm delivery were significantly higher in the working women whose actual work were longer than eight hours per day than those with a shorter work; that is 13.7% vs 10.4% (p less than 0.05) and 9.3% vs 6.1% (p less than 0.02), respectively. Overall the results are reassuring that working during pregnancy is in itself a risk factor for adverse outcome. PMID- 3315928 TI - [Experimental study on orthotopic liver transplantation using veno-venous bypass in the pig--the evaluation of hemodynamic alterations and the estimation of appropriate bypass flow during the period of the ahepatic state]. AB - This is the study on the estimation of appropriate bypass flow during an hepatic phase and on hemodynamic changes in orthotopic liver transplantation. Sixty six pigs weighing 16 to 25 kg were used. Experiment I (the estimation of correct bypass flow); The relationship between bypass flow and hemodynamics was evaluated in six pigs. Bypass model without transplantation was made by following procedures. The pig liver was isolated from the blood circulation and the systemic and splanchnic venous flow was shunted to the external jugular vein via the centrifugal pump. Experiment II (the hemodynamic changes of orthotopic liver transplantation); Evaluation of hemodynamic alterations was carried out in thirty orthotopic liver transplantations. It was concluded as follows; 1. General hemodynamics such as mean arterial pressure, cardiac output, central venous pressure, pulmonary arterial pressure, etc. have not changed significantly under veno-venous bypass, however, portal and vena caval pressure elevated up to 142 and 122 percent respectively, even though the maximum bypass flow was gained. 2. Hemodynamic profile associated with the reduction of bypass flow was the same as that of acute hypovolemic shock. Immediately after the bypass was closed, mean arterial pressure and cardiac output fell down to 42 and 30% of prebypass level respectively. 3. The statistical correlationship was found between bypass flow and cardiac output (r = 0.8565). The expressions; R = (2.454 x X + 0.034)/(4.829 x X + 1.823), was induced through the correlationship between bypass flow (BF, 1/min), the maximum bypass flow (BFmax, 1/min), and cardiac output(CO, 1/min),(e.g. R = BF/CO, X = BF/BFmax). 4. Orthotopic liver transplantation was succeeded in 80% of 25 cases with stable hemodynamics. In conclusion, cardiac output . bypass flow ratio(R) was proved to be useful in orthotopic liver transplantation. A appropriate bypass flow was able to be estimated systematically using this expression. PMID- 3315929 TI - [Influence of intercellular interaction between cancer cells and normal cells on cancer metastasis]. AB - Three highly metastatic and two weakly metastatic clones were obtained from a spontaneously arising mammary adenocarcinoma in an SHR rat. The difference in their capacity to metastasize in lungs was recognized only when the cancer cells were inoculated subcutaneously but not when they were inoculated intravenously. This evidence possibly indicates that the difference in the metastatic capacity of these clones is caused by different potential for detachment from the primary site and for intravasation during the various steps of metastasis. The motility of cancer cells, which is one of the most important factors in these steps of metastasis, showed no difference between the highly and weakly metastatic clones. However, the motility of cancer cells was decreased after the coculture with normal fibroblasts, and the motility of weakly metastatic clones used was more strongly decreased than that of highly metastatic clones. On the other hand, using a dye transfer method to examine the relationship between the metastatic capacity of cancer cells and the capacity of cancer cells to make junctional communications with normal fibroblasts, it was demonstrated that the frequency of communication between weakly metastatic clone cells and fibroblasts was significantly higher than that between highly metastatic clone cells and fibroblasts. These results suggest that the motility of cancer cells is inhibited by interaction with normal fibroblasts, and that one of these forms of interaction may be mediated by intercellular communication. PMID- 3315930 TI - Early disturbance of calcium translocation across the plasma membrane in toxic liver injury. AB - An increased influx and/or a decreased extrusion of calcium across the plasma membrane resulting in an increase in cytosolic-free calcium could play an important role in the initiation of irreversible cell injury. Therefore, the translocation of calcium across the plasma membrane was probed in the perfused rat liver using multiple indicator dilution methodology. The sucrose space corresponding to the extracellular space amounted to 0.35 +/- 0.13 ml per gm liver, and the water space corresponding to the extra- and intracellular spaces was 0.97 +/- 0.08 ml per gm. The calcium space was always slightly larger (0.42 +/- 0.10 ml per gm) than the sucrose space. The calcium space further increased during perfusion with the calcium ionophore A 23187, whereas the sucrose space remained unchanged. Two hours after administration to intact rats of acetaminophen (2 gm per kg) and carbon tetrachloride (2 ml per kg), respectively, the calcium space had increased markedly relative to the sucrose space and relative to the water space, indicating an increased accessibility of the cells to extracellular calcium. Similarly, reperfusion of livers after 90 min of ischemia was associated with an increase in calcium space relative to the sucrose and water spaces. These studies indicate that, in three models of acute liver injury, the net influx of calcium across the plasma membrane is increased early in the evolution of the injury before irreversible damage occurs. PMID- 3315932 TI - Lactitol vs. lactulose in the treatment of acute hepatic encephalopathy in cirrhotic patients: a double-blind, randomized trial. AB - Lactitol (beta-galactosido-sorbitol) is a nonabsorbable disaccharide available as a powder which, in open comparison, is as effective as lactulose in the treatment of chronic hepatic encephalopathy, but is better tolerated. Twenty-five cirrhotic patients experiencing 28 episodes of acute hepatic encephalopathy were randomized blindly to treatment with either lactitol (n = 15) or lactulose (n = 13). The sugars were dispensed in solutions identical in appearance, taste and pH and of similar osmolarity, which contained either 66.7 gm per 100 ml lactitol or 66.7 ml (44.5 gm) per 100 ml lactulose syrup. The initial dose of 0.75 ml per kg was adjusted to produce two semisoft stools per day. Patients were assessed every 12 hr for 5 days. There were no significant differences in sex ratio, age, body weight, clinical status, duration and extent of coma, etiology of liver disease or of hepatic encephalopathy between the two groups of patients on entry to the trial. An adequate catharsis was obtained with an equivalent mean (+/- 1 S.D.) daily dose of 26 +/- 5 gm lactitol or 31 +/- 7 ml (21 +/- 5 gm) lactulose syrup. During the trial, significant improvements occurred in clinical status and psychometric performance and in the electroencephalogram mean cycle frequencies in the majority of patients in both groups. At the end of the trial, 67% of the patients in the lactitol group and 69% of the lactulose group were clinically normal. However, patients treated with lactitol responded significantly more quickly than patients treated with lactulose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315931 TI - Effect of colchicine and phalloidin on the distribution of three plasma membrane antigens in rat hepatocytes: comparison with bile duct ligation. AB - The hepatocyte plasma membrane presents a morphological and functional regionalization into three domains: the sinusoidal; the lateral, and the canalicular. The mechanisms responsible for the biogenesis and maintenance of this regionalization are poorly understood. In this work, we have used colchicine and phalloidin, two drugs known to interfere with the secretory processes in hepatocytes, to study whether they also affect the transport of membrane proteins. The localization of three plasma membrane antigens was studied by light and electron microscopy using monoclonal antibodies identifying either the sinusoidal (A39) or the lateral (B1) or the canalicular (B10) domains in normal hepatocytes. In rats injected with colchicine (0.25 mg per 100 gm), A39 moved from the sinusoidal membrane to the lateral and canalicular ones, whereas B10 was displaced from the canalicular to the sinusoidal and lateral membranes, resulting after 8 hr in an almost equal labeling of the three domains with both antibodies. In rats injected daily for 7 days with phalloidin (50 micrograms per 100 gm), A 39 became mainly localized on the bile canalicular membrane instead of the sinusoidal one; B10 predominated on the canalicular membrane as in controls but in places it labeled the sinusoidal and lateral domains as well. In bile duct ligated rats studied for comparison for 4, 10 or 21 days, A39 and B10 localizations evolved as after phalloidin, but the changes were more marked. B1 was not affected by any of the treatments. In conclusion, colchicine, phalloidin and bile duct ligation do not seem to hinder the antigens in reaching the plasma membrane, but induce a redistribution of two of them, suggesting a disturbance in the biogenesis and/or control of the plasma membrane regionalization. Such an abnormal distribution could be involved in--or contribute to--the initiation of cholestasis. PMID- 3315934 TI - Renal eicosanoids as determinants of renal function in liver disease. AB - The available data suggest that alterations in renal prostaglandin metabolism participate in the pathogenesis of at least two prominent renal complications of liver disease: (a) sodium retention and (b) HRS. Although the data are highly suggestive, additional studies, including experimental manipulations that augment vasodilatory prostaglandins while diminishing vasoconstrictor metabolites of arachidonic acid, will be required to establish the role of prostaglandins or other arachidonic acid metabolites in mediating these renal abnormalities. The clinical caveat emerging from these observations is that every attempt should be made to avoid prescribing drugs which possess cyclooxygenase inhibitory activity to patients with decompensated liver disease who are sodium-avid. PMID- 3315933 TI - Chemoimmunotherapy of experimental hepatic metastases. AB - Previous studies from our laboratory have demonstrated that particulate glucan is efficacious in the therapy of a syngeneic murine reticulum cell sarcoma (M5706), which specifically metastasizes from its primary site to the liver. The present study was undertaken to examine the therapeutic efficacy of a newly developed soluble glucan, in combination with cyclophosphamide in the treatment of hepatic metastatic disease. Male C57Bl/6J mice were injected subcutaneously on Day 0 with 1 x 10(4) sarcoma cells. Glucan (200 mg per kg i.v.), cyclophosphamide (45 mg per kg i.p.) or glucan and cyclophosphamide were administered beginning on Day 20, when hepatic metastases were evident, and continued at 3-day intervals up to Day 50. Combined therapy with glucan and cyclophosphamide resulted in reduction of hepatic metastatic lesions on Day 36, compared to control. Survival data revealed that the combination of glucan and cyclophosphamide significantly (p less than 0.001) extended median survival time and the time to 100% mortality in an additive fashion, when compared to either therapy alone. Glucan-cyclophosphamide therapy was also effective in decreasing primary tumor weight to a level that was significantly (p less than 0.05) less than when therapy was initiated. In vitro studies revealed that Kupffer cell tumoricidal activity against sarcoma was increased (p less than 0.05) following glucan and cyclophosphamide. Glucan and cyclophosphamide also enhanced bone marrow proliferation and splenocyte response to mitogens in vitro. Additionally, glucan was observed to exert a direct cytostatic effect on sarcoma in vitro.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315935 TI - The role of hepatic fat-storing (stellate) cells in retinoid metabolism. PMID- 3315936 TI - Subdivisions of idiopathic autoimmune chronic active hepatitis. PMID- 3315937 TI - Interleukin 1: regulation of hepatic carbohydrate metabolism by insulin or insulinomimesis. PMID- 3315938 TI - FM ultrasonography: a revolution? PMID- 3315939 TI - Graft-versus-host-induced cirrhosis: possible mechanisms. PMID- 3315940 TI - Psychiatric uses of lithium for children and adolescents. PMID- 3315941 TI - HHS considers Medicare MD franchises. PMID- 3315942 TI - Rurals post big PPS pay gains in Senate committee. PMID- 3315943 TI - NRHA threatens suit over dual PPS payments. National Rural Health Association. PMID- 3315944 TI - Committee claims PRO data show drop in quality. PMID- 3315945 TI - Quality Quest gears up for HMO/CMP review. PMID- 3315946 TI - Knack brings experience to group purchasing. PMID- 3315947 TI - Quality of care is high under PPS: HHS study. PMID- 3315948 TI - Do the elderly understand catastrophic bill? PMID- 3315949 TI - Feds gave HMOs good and bad news this year. PMID- 3315951 TI - Catastrophic bill takes center stage in '87. PMID- 3315950 TI - Abrams on states' role in policy and funding. Interview by Emily Friedman. PMID- 3315952 TI - [Monoclonal antibodies against erythrocytic stages of Plasmodium vivax: Ig isotype determination and analysis of species and stage-specific immunofluorescein reactions]. PMID- 3315953 TI - [Analysis of yanshen tablet in the treatment of chronic esophagitis with a randomized control trial]. PMID- 3315954 TI - [A rapid embedding method used in the preparation of paraffin tissue blocks for transmission electron microscopy]. PMID- 3315955 TI - Massive thymic hyperplasia with myoid cell differentiation. AB - A 12-year-old boy with massive true thymic hyperplasia presented with respiratory distress and dysphagia. The thymus weighed 245 g and demonstrated normal cortical and medullary components histologically. The findings in this case were compared with the clinical and pathologic features of seven previously published cases of massive hyperplasia and with cases of mild or "borderline" hyperplasia. By electron microscopy and immunoperoxidase techniques, myoid cell differentiation was demonstrated, the first documented example of myoid cells in thymic hyperplasia. These findings support the hypothesis that myoid cells are a normal component of thymic parenchyma. PMID- 3315957 TI - Immunohistochemical visualization of plasmacytoid T cells in paraffin sections. PMID- 3315956 TI - ras p21 expression in the progression of breast cancer. AB - The differential expression of the ras oncogene product p21 in the primary tumor, regional nodes, and distant metastatic sites in patients with disseminated breast cancer was examined to define the biologic and clinical significance of the ras oncogene in the progression of breast cancer. The avidin-biotin peroxidase complex method was used on formalin-fixed, paraffin-embedded tissues from 16 patients with metastatic disease. The primary antibody used in this protocol was RAP-5, an anti-p21 murine monoclonal IgG2a. p21 antigen staining was similar in the primary tumor and regional nodes from the same patient (P less than 0.05), but the staining of distant metastases was more variable. Expression of ras p21 was consistently increased in invasive components of the primary tumor as compared with intraductal tumor. In addition, a high level of p21 expression was seen in tumor emboli in lymphatics and blood vessels as compared with contiguous tumor in parenchymal tissue. Although p21 staining is present in aggressive primary breast cancers and most metastatic sites, our findings indicate that markedly enhanced p21 expression is associated with the earlier stages (invasion and dissemination) of aggressive breast cancers. PMID- 3315960 TI - Topical anaesthesia with local anaesthetic (lidocaine and prilocaine, EMLA) cream for cautery of genital warts. AB - Removal of genital warts by thermocautery was performed in 108 patients (57 men and 51 women) under topical anaesthesia with a local anaesthetic cream, lidocaine and prilocaine (EMLA). Most men had warts in the preputial cavity, most women had warts situated on the mucous membranes of the vulva, and warts at multiple sites were common. About 1 ml of cream per lesion was applied to the warts for 20 to 105 minutes before the operation. Plastic film (Glad, Union Carbide) was applied over the cream when natural occlusion, such as under the prepuce or on the introitus, was not present. Local pallor was seen in 30% of the patients, redness in 53%, and oedema in 15%, but did not cause any discomfort and were clinically insignificant. Analgesia was sufficient in 96% of the men and in 40% of the women. Additional local infiltration was given to 60% of the women, but was not as painful as injections generally are in the genital area. The analgesic efficacy on women may be further improved by optimising the application time on the genital mucosa. PMID- 3315958 TI - Gene-rich chromosome regions and autosomal trisomy. A case of chromosome 3 trisomy mosaicism. AB - Cases of autosomal trisomy and trisomy mosaicism among liveborn infants are reviewed, and a second case of chromosome 3 trisomy mosaicism is described. The occurrence of autosomal trisomy for a particular chromosome is in general negatively correlated with the number of genes which have been localized to that chromosome. It is also positively related to the Q-brightness of the chromosome, which reflects its content of intercalary heterochromatin. Furthermore there are significantly fewer autosomal trisomics for chromosomes which contain hot spots for mitotic chiasmata in Bloom syndrome (chromosomes 1, 3, 6, 11, 12, 17, 19, and 22), compared with similar-sized control chromosomes 2, 4, 7, 9, 10, 18, 20, and 21. This is interpreted as further evidence for the gene richness of the hot spots which, being active, are extended in interphase and are therefore available for mitotic crossing over. The gene richness of these short Q-dark regions is also borne out by the scarcity of trisomic abortions for the chromosomes involved (the embryo dies before the abortion is recognized) and by the higher number of genes localized to these chromosomes compared with the control chromosomes. PMID- 3315961 TI - Low dose oral ofloxacin to treat gonorrhoea in Hong Kong. PMID- 3315959 TI - Cloning structural genes for Treponema pallidum immunogens and characterisation of recombinant treponemal surface protein, P2 (P2 star). AB - A genomic library consisting of partially digested 10 to 20 kilobase pair fragments of Treponema pallidum deoxyribonucleic acid (DNA) was constructed using bacteriophage lambda EMBL-3 as the vector. Positive clones expressing T pallidum antigens were detected with sera from experimentally infected rabbits. Treponemal proteins ranging in molecular weight from 37,000 daltons to 120,000 daltons were identified by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and immunoblotting of phage lysate proteins. One recombinant phage was examined further and contained an insert encoding a prominent treponemal 37,000 dalton protein. The recombinant protein was not recognised by antiserum directed against a fibronectin binding treponemal adhesion that contained the same electrophoretic mobility. Neither did antibody to the recombinant 37,000 dalton protein react with any treponemal proteins purified by fibronectin affinity chromatography. The recombinant protein in Escherichia coli lysates was labelled P2 (P2 star) to differentiate it from the comigrating adhesin protein called P2. Native P2 protein was present on T pallidum surfaces as shown by radioimmunoprecipitation assays with extrinsically labelled organisms. A cross reactive molecule like P2 was not synthesised by the avirulent spirochaete, T phagedenis biotype Reiter, which indicated that P2 is a protein specific to virulent T pallidum organisms. Finally, only sera of patients with primary syphilis possessed appreciable concentrations of antibody to recombinant P2 protein. PMID- 3315963 TI - Talc. PMID- 3315962 TI - Attapulgite. PMID- 3315965 TI - Brain nicotine binding sites. PMID- 3315964 TI - Genetic polymorphism of haptoglobin subtypes in a Japanese population. AB - Haptoglobin (Hp) subtypes have been determined in the Japanese population by polyacrylamide gel isoelectric focusing followed by immunoblotting and by two dimensional polyacrylamide gel electrophoresis. In the present study, neuraminidase-treated plasma samples were used for subtyping of Hp, without prior purification. These samples were obtained from 372 unrelated healthy donors. Allelic frequencies were: Hp*1F = 0.0014; Hp*1S+ = 0.2688; Hp*2FF = 0.0000; Hp*2FS = 0.7284, and Hp*2SS = 0.0014. The phenotypic distribution was in good accordance with the Hardy-Weinberg equilibrium. PMID- 3315966 TI - Reactivity of anti-HLA class I polymorphic monoclonal antibodies with normal human skin. AB - In this work the reactivity of 16 monoclonal antibodies raised against different HLA class I specificities was tested with human skin of healthy donors of known HLA typing. By indirect immunofluorescence, six antibodies reacted strongly with keratinocytes carrying the corresponding alloantigens. The reactivity of 3 other antibodies which was weak or absent using indirect immunofluorescence, was enhanced by various amplification systems such as avidin-biotin-peroxidase method, biotin-streptavidin-fluorescein complex and especially preliminary trypsin treatment that revealed alloantigens masked in the epidermis. The immunostaining of 4 antibodies was negative regardless of the method used. Some of the antibodies we tested cross-reacted with cytoplasmic antigens of keratinocytes. This study has allowed to select a battery of monoclonal antibodies which can specifically detect alloantigens on keratinocytes and will be useful for the recognition the cell origin in allografting experiments. PMID- 3315967 TI - T-independent activation of single B cells: an orderly analysis of overlapping stages in the activation pathway. AB - This review has three chief purposes. It describes a microculture system in which single, hapten-specific B lymphocytes can be microscopically observed, cultured and assayed for antibody production in isolation and thus are the unequivocal target of ligands present in the culture fluid. It defines the respective roles of antigens and cytokines acting singly or in combination in the four discernible phases of the immunoproliferative cascade, namely activation, clonal expansion, IgM antibody secretion and isotype switching. It then argues that this precise stepwise analysis can yield useful information concerning important immunological situations, such as experimentally induced immunological tolerance or the effects of constitutive expression of the c-myc oncogene. Evidence is presented that initial activation of the resting B cell in "T-independent" triggering can be achieved either by attachment of a molecule that has B-cell stimulatory properties, such as FLU-LPS or FLU-polymerized flagellin (FLU-POL) or by the lymphokine interleukin 4 (IL-4). IL-4 + FLU-POL is somewhat more effective than either agent alone. IL-4 alone or, better, FLU-POL + IL-4 can stimulate clonal proliferation of the B cell, but FLU-POL alone does not achieve this. Moreover, IL-4 or FLU-POL + IL-4 lead to very little antibody formation. None of IL-1, IL-2 or IL-5 acting alone causes either activation or proliferation. IgM antibody formation is stimulated most strongly by FLU-POL + IL-5, somewhat less strongly by FLU-POL + IL-1 + IL-2 and rather weakly with antigen plus only one of the latter cytokines. The cloning efficiency in the single cell system, and the median clone size can be markedly enhanced by the addition of small numbers of fibroblast or other filler cells to the cultures. While filler cell-free clones do not progress to the stage of isotype switching, filler cell-supported ones can do so in up to 30% of cases. The only cloned lymphokine which has so far been found to promote such switching is IL-4, and the fact that it is at least as powerful as a T-cell supernatant may mean that it is the only agent active in this particular system. However, the detailed pattern of secreted isotypes is different from that seen when MHC-restricted, carrier-specific T cells act on hapten-specific B cells. Hapten-specific B cells from animals rendered neonatally tolerant to FLU-HGG exhibit anergy in the single cell system.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3315968 TI - Role of T cell-derived lymphokines in two models of B-cell tolerance. PMID- 3315970 TI - Clonal selection in B-cell growth and differentiation. PMID- 3315969 TI - Control of the cell cycle of murine B lymphocytes: the nature of alpha- and beta B-cell growth factors and of B-cell maturation factors. PMID- 3315971 TI - [Aeromonas spp. as pathogens in human infections: diagnosis and clinical significance]. AB - Aeromonads have been described as causative agents in a wide variety of infections in immunosuppressed as well as in immunocompetent patients. It is still controversial whether or not some or all three currently recognized species have to be considered as enteropathogenic. Clinical and epidemiological data are incomplete and contradictory although laboratory diagnosis does not cause real problems. PMID- 3315972 TI - [Bacteremia caused by Lactobacillus plantarum in endocarditis lenta]. AB - A report is presented on a 43-year-old patient with a subacute endocarditis due to an immunovasculitis and a bloodstream infection caused by Lactobacillus plantarum. The causative agent was isolated six times from blood cultures. L. plantarum was identified according to the standard methods in anaerobe diagnostics (biochemical reactions and gas chromatography). Twenty-two isolations of lactobacilli from bloodstream infection are described in the literature. PMID- 3315973 TI - [Microbiologic-immunologic laboratory diagnosis in suspected meningitis/encephalitis]. AB - The diagnosis on the exclusion of infectious diseases of the central nervous system, especially of bacterial infections still is one of the most important issues in clinical microbiology. In bacterial meningitis, where lethal courses as well as severe sequelae are still frequent, there should be a rapid diagnosis not only with microscopy but also with Limulus test and antigen detection tests because a specific therapy should be initiated as soon as possible. But also viral infections caused by varicella or herpes virus are increasingly susceptible to chemotherapy. The indication for the examination of cerebrospinal fluid, the minimal volume for exhaustive laboratory tests and the possibilities of a stepwise diagnostic procedure are given with reference data from literature for the various techniques. In our experience the synopsis of laboratory results and clinical symptoms yielded in 75% of all cases the exclusion of an infectious etiology of the disease. In 17% a bacterial meningitis or the infection of a hydrocephalus shunt could be diagnosed. Viral infections could be proven in 4% either by antibody or by antigen detection. Only in 1% of all patients the clinical symptoms and the laboratory parameters remained unclear. PMID- 3315974 TI - [Modulation of graft versus host disease by in vitro incubation of donor cells with deoxycoformycin and deoxyadenosine]. AB - The combination of deoxycoformycin and deoxyadenosine was investigated for its capability to deplete T-cells from bone marrow and spleen cells and for its effect on GVHD in MHC-mismatched transplantation in rats. In vitro incubation with DCF/dADO for 18-20 hours resulted in significant but incomplete T-cell depletion without toxicity towards CFU-M. This corresponded with a lower incidence and a modification of GVHD following transplantation of such treated cells into MHC-incompatible recipient rats. However, GVHD could not be completely prevented by the in vitro treatment of donor cells. PMID- 3315975 TI - Influence of Plasmodium chabaudi adami on the isotypic distribution of the antibody response of mice to sheep erythrocytes. AB - The influence of an infection with P. chabaudi adami on the isotypic distribution of the in vivo antibody response to SRBC was investigated. Previous experiments suggested that the IgG1 isotype was poorly represented in the antibody response to plasmodial antigens and in the non-specific B cell response which accompanies an infection with P. chabaudi. The experiments described here indicated that although the magnitude of the total primary or secondary in vivo PFC response to SRBC was relatively unaffected by infection, the SRBC-specific IgG1 PFC response was depressed. Maximum depression of the IgG1 component of the response was observed when the priming dose of SRBC was administered at the same time as or after infection with P. chabaudi organisms. Coincident with the depression in the IgG1 response in infected mice was a corresponding increase in the SRBC-specific IgM response. The IgG1 depression was not a consequence of different kinetics of the generation of an IgG1 response, since at all times measured, the IgG1-PFC response was lower. In addition, the depressed IgG1 responses occurred only during a viable infection and could not be induced by inoculation of large amounts of irradiated erythrocytic stages of the parasite. These data suggest therefore, that there is a selective depression of IgG1 antibodies (but not those of other isotypes) regardless of antigenic specificity as a result of infection of C57BL/6 mice with P. chabaudi adami. PMID- 3315976 TI - Lymphoid dendritic cells. PMID- 3315977 TI - Quantitative immunocytochemical characterization of mononuclear phagocytes. II. Monocytes and tissue macrophages. AB - The purpose of the present study was to compare the monoclonal antibody (Mab) binding patterns of various tissue macrophages with each other and with blood monocytes. To allow recovery from the effects of the isolation procedure, or to obtain purified populations, macrophages were cultured for 24 hr and 48 hr. For comparison, blood monocytes were also cultured for 24 hr and 48 hr. Mab binding to individual cells, detected by the biotin avidin immunoperoxidase method, was quantified cytophotometrically and the results expressed as the median of the specific mean absorbance per 0.25 micron2 cell surface area or as specific integrated absorbance per cell. Analysis of the quantitative data in relation to the results of subjective evaluation of the peroxidase reaction product, demonstrating Mab binding to cells, yielded three classes for description of the intensity of antigen expression by cells: weak (specific mean absorbance per unit cell surface less than 0.07), moderate (values between 0.07 and 0.14), and intense (values more than 0.14). No matter how the results were expressed, comparison of the Mab binding patterns of macrophages with those of blood monocytes showed that spleen macrophages bound significantly less F4/80 and more M5/114 (Ia antigen). Kupffer cells and skin macrophages bound either approximately the same amount or considerably less of the various Mabs than monocytes did. Pulmonary tissue and alveolar macrophages bound significantly more 30.G.12 (leucocyte antigen), M3/38 (Mac-2 antigen), and M3/84 (Mac-3 antigen) and comparable amounts or considerably less of the other Mabs than the monocytes did. Peritoneal macrophages bound significantly more F4/80, M1/70 (complement receptor III), and 2.4.G.2. (Fc receptor II) and comparable amounts or considerably less of the other Mabs than monocytes did. It is concluded that macrophages from different organs and different anatomical sites within one organ differ from one another, for example, peritoneal macrophages do not resemble any other population of macrophages and alveolar macrophages do not resemble pulmonary tissue macrophages, and differentiation of blood monocytes into tissue macrophages does not show a distinct pattern. PMID- 3315978 TI - Roles of IL-2 and antigen in the later stages of the primary antibody response. AB - Spleen cells, obtained 2-5 days after in vivo priming with sheep erythrocytes (SRBC), were cultured to determine the presence of plaque-forming cell (PFC) precursors capable of developing into mature PFC under the influence of various stimulants. Lipopolysaccharide (LPS), added together with SRBC at the initiation of a 48-hr in vitro culture, enhanced the PFC response of primed spleen cells. In vivo priming for a minimum of 3 days was required, and maximal numbers of PFC were obtained from spleen cells primed for 4 days. Depletion of T lymphocytes from Day 3-primed spleen cells abrogated LPS-mediated enhancement, and addition of concanavalin A supernatants to the T-cell depleted system restored the enhancement, suggesting that LPS action required co-operation with a product(s) of activated T cells. Addition of various interleukin-2 preparations including recombinant human IL-2 to the system restored the LPS-mediated enhancement. The response of Day 3 cells from which T cells were eliminated as vigorously as possible was similarly restored by the addition of IL-2, LPS and antigen, suggesting that IL-2 reacts directly with PFC precursors that have developed IL-2 receptors. LPS-mediated enhancement, in the presence or absence of T cells, was also markedly dependent on the presence of SRBC during in vitro culture. These data suggest that, in co-operation with IL-2 and other co-factors, antigen plays a significant role in driving the later stages of differentiation and/or division of PFC precursors to mature PFC. PMID- 3315979 TI - Lymphocyte migration into the lamina propria of the gut is mediated by specialized HEV-like blood vessels. AB - Migration of lymphocytes into the lamina propria of the small intestines was studied in mice using short-term in vivo migration experiments in combination with immunocytochemistry and autoradiography. The results show that, shortly after intravenous injection, most of the lymphocytes present in the lamina propria are actually located within the capillary network of the villi. Furthermore, it was shown that lymphocytes leave the blood stream and enter the lamina propria via small blood vessels at the base of the villi. These blood vessels can be discriminated by their positive staining with MECA-325, a monoclonal antibody that is specific for high endothelial venules (HEV) in lymphoid organs. From the results it is concluded that the gut contains specialized venules at specific sites, involved in the emigration of lymphocytes, comparable to HEV in lymphoid organs. The flatness of the endothelium of these MECA-325-positive intestinal blood vessels, which is in contrast to the situation in lymphoid organs, could not be changed by inducing an intestinal inflammation. This flatness may be directly correlated to the less efficient transmigration of lymphocytes, as demonstrated in our experiments. PMID- 3315980 TI - Endometrial granulocytes in human decidua react with a natural-killer (NK) cell marker, NKH1. AB - Lymphoid cells in decidualized uterine endometrium in early human pregnancy may be essential for successful implantation and placentation. Endometrial granulocytes are prominent in early pregnancy decidua and express some T-cell associated surface antigens (CD2+, CD7+), but little is known of their function. We report the unusually intense binding of the natural-killer (NK) cell marker NKH1 to endometrial granulocytes, which contrasts with their lack of reactivity with other NK-cell markers. PMID- 3315982 TI - Some problem areas in the interaction between viruses and the immune system. PMID- 3315981 TI - The immunogenicity of tumour cells. AB - Immunological mechanisms are demonstrably of central importance in preventing the development of certain virus-associated cancers in animals and man; however, they do not appear to fulfill this role in the majority of 'spontaneous' tumours. This does not, however, necessarily indicate that spontaneous tumours lack potential target antigens for immunologically mediated destruction. Work in the field of transplantation immunology has clearly shown that certain cell types fail to elicit rejection reactions despite their possession of alloantigens. Similarly, some tumour cell types are poorly immunogenic to the point that they can grow in and kill animals despite a major histocompatibility barrier. These tumours are, however, susceptible to destruction in vivo in appropriately allo-sensitized animals. Thus, some tumours may be able to grow in autologous or syngeneic hosts because of their poor immunogenicity, despite the fact that they express potential (tumour-associated) rejection antigens. It may be possible to manipulate this situation for therapeutic purposes. PMID- 3315983 TI - Evasion of host defences by tumours. PMID- 3315984 TI - Antigen expression during early human granulocyte development studied with immuno electron microscopy. AB - Expression of the hapten fucosyl-N-acetyllactosamine was correlated with ultrastructural development in human granulocyte precursors using the monoclonal antibody FMC 10 with immunogold techniques. The antigen was detectable from the myeloblast/early neutrophilic promyelocyte stage onwards and was associated with striking development of the rough endoplasmic reticular system. In addition, low levels of labelling were seen on monocytes, eosinophils and some basophil precursors. Contraction and alignment of the cisternae of the rough endoplasmic reticulum during the promyelocyte stage of neutrophilic differentiation gave the appearance of a plasma cell. However, on closer examination it was apparent that true plasma cells did not react with this antibody. PMID- 3315985 TI - Effects of low or high doses of short wavelength ultraviolet light (UVB) on Langerhans cells and skin allograft survival. AB - Since Langerhans cells (LC) are normally the only cells within the epidermis to express the class II major histocompatibility complex (MHC) transplantation antigens, depletion of LC could be expected to prolong skin allograft survival by reducing the antigenic disparity between host and recipient. To assess this hypothesis, donor C57BL mouse shaved dorsal trunk or tail skin was exposed to high (200 mJ/cm2) or low (40 mJ/cm2) doses of short wavelength ultraviolet light (UVB) before grafting on to the thorax of BALB/c mouse recipients of the same sex. These strains have different major and minor transplantation antigens. The effects of UVB treatments on LC were determined by electronmicroscopy. Skin grafted 1-14 days following a single high dose of UVB irradiation was ultrastructurally depleted of LC and survived significantly longer than unirradiated skin before being rejected. After a 21-day interval between exposure and grafting when LC were again present in the epidermis there was no significant difference between treated and control graft survival. Exposure to low dose UVB irradiation only significantly increased graft survival for skin transplanted 1-3 days after irradiation; skin grafted 4 days following irradiation survived for a similar period to unirradiated control skin grafts. Electronmicroscopy showed that the low UVB dose did not deplete LC from the epidermis. We conclude that after low dose UVB treatment the class II MHC antigens on the LC plasma membrane were lost temporarily, thus prolonging graft survival, but when the plasma membrane antigens were re-expressed graft survival returned to normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3315986 TI - The immunohistochemical localisation of microfibril-associated glycoprotein (MAGP) in elastic and non-elastic tissues. AB - We have previously identified the major antigen of elastin-associated microfibrils as a 31kD glycoprotein which we named microfibril-associated glycoprotein or MAGP. Affinity-purified antibodies to MAGP were shown to localise specifically to elastin-associated microfibrils in sections of bovine foetal nuchal ligament. In the present paper we compare the localisation of anti-MAGP antibodies and anti-tropoelastin antibodies in a range of bovine elastic and non elastic tissues. The results show that anti-MAGP antibodies invariably localised to immuno-reactive elastic fibres, wherever they occurred. Extensive additional localisation was observed in a number of tissues. This extra distribution of anti MAGP antibodies was found to correspond to those structures exhibiting the oxytalan histochemical staining reaction in tissues such as skin, periodontal ligament and ocular zonule. Since these oxytalan fibres have been shown to consist of 12 nm microfibrils which are morphologically similar to those of elastic fibres (and unpublished data from this laboratory confirm this conclusion), the results suggest that MAGP is a component of 12 nm microfibrils in both elastic and non-elastic tissues. Anti-tropoelastin antibodies did not localise to these oxytalan fibres, suggesting that tropoelastin is not a component of 12 nm microfibrils. MAGP was also detected in extracellular matrix regions of tissues such as skeletal muscle, Achilles tendon and spleen, suggesting that 12 nm microfibrils, containing one or more macromolecular constituents in common, make up an important structural system within the extracellular matrix in a wide range of elastic and non-elastic tissues. PMID- 3315987 TI - [Cutaneous disorders in uremia]. PMID- 3315989 TI - Enterotoxigenicity & antibiotic resistance in salmonella strains isolated from patients of gastroenteritis. PMID- 3315988 TI - Serodiagnosis of leprosy with PGL-1 using ELISA technique. PMID- 3315990 TI - Immunohistological demonstration of bone marrow involvement in non-Hodgkin's lymphoma (NHL). PMID- 3315991 TI - Intravenous lignocaine & haemodynamic responses to cystoscopy. PMID- 3315992 TI - Studies on antibiotic resistance and serotypes of Escherichia coli isolated from persons without diarrhea in Delhi. PMID- 3315993 TI - Diagnostic problems of kala azar in non-endemic area. PMID- 3315994 TI - Primary squamous cell carcinoma of the rectum (a case report and review of the literature). PMID- 3315995 TI - Directly-acting mutagens formed from N-nitroso-N-(formylmethyl)alkylamines. AB - Directly-acting mutagens formed from N-nitroso-N-(formylmethyl)alkylamines (I) were isolated and identified as N-nitroso-N-alkyl-1-hydroxyimino-2-oxoethylamines (II). Their structures were elucidated on the basis of nuclear magnetic resonance spectra and confirmed by leading to their crystalline 2,4-dinitrophenylhydrazone. II (alkyl = ethyl and n-butyl) were strongly mutagenic to Salmonella typhimurium TA1535 and Escherichia coli WP2 hcr- without metabolic activation, while II with a tert-butyl group was not mutagenic. The formation of II from I is considered to proceed by the nitrosation of I, indicating a possible involvement of a formylmethyl metabolite in the carcinogenesis of nitrosamines with a 2 hydroxyethyl group. PMID- 3315996 TI - Biochemical and molecular effects of N-nitroso compounds in human cultured cells: an overview. AB - In-vitro models using human tissues and cells provide a bridge between studies of humans and of laboratory animals. Cultured human cells activate N-nitrosamines to DNA-damaging metabolites, including alkyldiazonium ions and aldehydes; these metabolites can also inactivate DNA repair processes, such as O6-alkylguanine DNA alkyltransferase (AAT) activity, and are mutagenic in human cells. Both human epithelial and mesenchymal cells have been transformed in vitro by N-nitroso compounds. PMID- 3315997 TI - Nitrosamine-induced carcinogenesis: experimental models for human malignancies of multifactorial origin. PMID- 3315998 TI - O-Alkyl deoxythymidines are recognized by DNA polymerase I as deoxythymidine or deoxycytidine. AB - The O2- and O4-methyldeoxythymidine triphosphates (O-alkyl dTTP) can be used to substitute for dTTP in Escherichia coli DNA polymerase I (Pol I)-catalysed synthesis of poly[deoxyadenosine-deoxythymidine] (dA-dT). When incorporated into the polynucleotide, no detectable perturbation of structure occurred with even 20% O-methyldeoxythymidine in place of dT. However, on replication of such polymers with Pol I, significant amounts of deoxyguanosine triphosphate (dGTP) were incorporated, as well as high levels of deoxyadenosine triphosphate (dATP), indicating tautomer-like behaviour. Higher homologues, such as O4-ethyl (e4) dTTP or O4-isopropyl (ip4) dTTP, could also replace dTTP, but with lower efficiency. Nevertheless, their presence, like O4-methyl (m4) dT substitutions, caused transitions as well as inhibiting enzyme digestion with a variety of 3' nucleases, particularly to the 3'----5' exonuclease activity (proofreading) of polymerases. Further proof of mutagenicity comes from site-directed experiments placing m4dT or e4dT in place of dT at position 587 in am3 of phi X174, in which all revertants sequenced had A----G transitions. This implies that, since m4dT and e4dT are poorly repaired in eukaryotes, it is likely that they will remain in the DNA and lead to effects on enzyme activity, as well as mutations which contribute to the carcinogenicity of N-nitroso compounds. PMID- 3315999 TI - Escherichia coli infection of the urinary bladder: induction of tumours in rats receiving nitrosamine precursors and augmentation of bladder carcinogenesis by N nitrosobutyl (4-hydroxybutyl)amine. AB - Experimental introduction of Escherichia coli type 04 into the subserosa of the urinary bladder of female Fischer 344 rats produced chronic bacterial infection in more than 90% of animals. Groups of rats with bacterial infection were given sodium nitrate and either piperazine (Group 1) or dibutylamine (Group 2) in the drinking-water. Control, noninfected animals received nitrate and either piperazine (Group 3) or dibutylamine (Group 4). At 40 weeks, transitional-cell carcinomas of the bladder were detected in 9/30 rats in Group 1 compared to 0/34 in Group 3 (p less than 0.0005), and in 11/34 rats in Group 2 compared to 0/32 in Group 4 (p less than 0.0003). Early changes were examined by scanning and transmission electron microscopy as well as autoradiography. Preneoplastic liver foci were detected in infected groups of animals receiving amine and nitrate, indicating reabsorption of the carcinogen synthesized in situ to induce distant organ transformation. In another experiment, E. coli infection augmented bladder carcinogenesis by N-nitrosobutyl(4-hydroxybutyl)amine (NBHBA), as indicated by earlier appearance of bladder tumours (six weeks compared to nine weeks) and, after 25 weeks, higher incidences of transitional-cell carcinomas (41/46 compared to 39/53, p less than 0.05), squamous metaplasia (43% compared to 9%, p less than 0.0001), glandular metaplasia (26% compared to 13%, p less than 0.05) and muscle invasion (30% compared to 11%, p less than 0.01) in the E. coli-infected group receiving carcinogen compared to the noninfected group receiving carcinogen, respectively. These results indicate that bacterial infection of the urinary bladder may play a major role in bladder carcinogenesis, both by helping in-situ nitrosamine synthesis and by augmenting carcinogenesis by nitrosamines. PMID- 3316001 TI - Repair of synthetic oligonucleotides containing O6-methylguanine, O6-ethylguanine and O4-methylthymine, by O6-alkylguanine-DNA alkyltransferase. AB - 32P-Labelled self-complementary oligonucleotides containing O6-methylguanine, O6 ethylguanine, and O4-methylthymine have been synthesized and used as substrates for the DNA repair protein O6-alkylguanine-DNA alkyltransferase (AAT). The reaction was second-order with rate constants of 2.6 X 10(7) M-1 sec-1 for O6 methylguanine, 2.6 X 10(4) M-1 sec-1 for O6-ethylguanine and 2.5 X 10(3) M-1 sec 1 for O4-methylthymine. These oligomers should allow sensitive and specific assay of the mammalian enzyme. PMID- 3316000 TI - N-nitrosamine formation by microorganisms isolated from human gastric juice and urine: biochemical studies on bacteria-catalysed nitrosation. AB - Twelve out of 14 bacterial strains isolated from patients with urinary infections and nine out of 30 microorganisms isolated from gastric juice from patients with gastric achlorhydria were shown to catalyse the formation of N-nitrosomorpholine (NMOR) from nitrite and morpholine at neutral pH. The effects of various metal ions and cofactors on the bacterial nitrosation reaction was investigated. The presence of nitrate in the culture medium was required to induce nitrosating activity in bacteria, but low nitrate concentrations inhibited the nitrosation reaction. PMID- 3316002 TI - Immunocytochemical studies on the formation and repair of O6-alkylguanine in rat tissues. AB - The immunocytochemical visualization of the carcinogen-DNA adducts O6 ethylguanine (O6-etGua) and O6-methylguanine (O6-meGua) in histological sections of a large series of rat tissues, including liver, pancreas, testis and oesophagus, is described. In the liver of rats treated with N-ethyl-N-nitrosourea (ENU), N-nitrosodiethylamine (NDEA) or N-nitrosodimethylamine (NDMA), large differences were found in the formation and/or repair of O6-alkylGua between different cell types, between hepatocytes of different localization, and also between normal and precancerous hepatocytes. Heterogeneity of O6-etGua formation and repair was also found in pancreatic tissue of rats treated with ENU. O6-etGua was relatively persistent in nonparenchymal liver cells, pancreatic islet cells, spermatogonia, renal glomeruli and smooth-muscle cells. Our aim is to extend the immunocytochemical analysis to other DNA adducts, and ultimately to human tissues. PMID- 3316004 TI - Alpha-nitrosaminoaldehydes: highly reactive metabolites. AB - alpha-Nitrosamino aldehydes are highly reactive compounds which are directly acting mutagens and are capable of facile transnitrosation to secondary and primary amines. The latter lead reactions to deamination. N-Nitrosobutyl(2 oxoethyl)amine (NBOEA) undergoes spontaneous decomposition in buffer at pH greater than 7 (25 degrees C) to give glyoxal and products implicating the formation of the butyl diazonium ion. NBOEA reacts with guanosine to produce xanthosine (by deamination), 7-butylguanosine and the 1,N2 glyoxal adduct, among other products. All beta-nitrosaminoethanols investigated undergo liver alcohol dehydrogenase-catalysed oxidation to their corresponding aldehydes. Several of these aldehydes have been shown to be directly-acting mutagens. These data provide strong evidence for an alternative carcinogenic bioactivation route for nitrosamines which does not involve alpha-oxidation. PMID- 3316003 TI - Recent findings on the metabolism of beta-hydroxyalkylnitrosamines. AB - beta-Hydroxynitrosamines appear to be refractory to alpha-oxidation, the common pathway of metabolism of simple dialkylnitrosamines. Some years ago, we postulated that nitrosamines bearing a hydroxyl in the beta position may be activated to alkylating agents by metabolic transformation to sulfate conjugates. Recent evidence has provided support for this hypothesis. A sulfate ester of N nitroso(2-hydroxypropyl)(2-oxopropyl)amine (NHPOPA) has been found in the urine of hamsters treated with the nitrosamine. It has also been found that inhibition of sulfotransferases inhibited the development of DNA single-strand breaks in livers of rats treated with several beta-hydroxy-nitrosamines. Alkylation of rat liver DNA in vivo by N-nitroso(2-hydroxyethyl)methylamine (NHEMA) favoured methylation over 2-hydroxyethylation by a factor of 10. The methylation reaction was inhibited by sulfotransferase inhibitors. Thus, sulfation appears to be an important pathway for activation of beta-hydroxy-nitrosamines. There are, however, other pathways, such as the oxidation of the beta-hydroxyl group to a carbonyl, which may also result in the formation of electrophilic species capable of modifying cellular macromolecules. PMID- 3316005 TI - The Milan hypertensive rat as a model for studying cation transport abnormality in genetic hypertension. AB - Environmental factors, genetic polymorphisms, and different experimental designs have been the main impediments to evaluating a genetic association between cell membrane cation transport abnormalities and human essential or genetic hypertension. We review the results obtained in the Milan hypertensive strain of rats (MHS) and in its appropriate control normotensive strain (MNS) to illustrate our approach to defining the role of cation transport abnormality in a type of genetic hypertension. Before the development of a difference in blood pressure between the two strains, the comparison of kidney and erythrocyte functions showed that MHS had an increased glomerular filtration rate and urinary output, and lower plasma renin and urine osmolality. Kidney cross-transplantation between the strains showed that hypertension is transplanted with the kidney. Proximal tubular cell volume and sodium content were lower in MHS while sodium transport across the brush border membrane vesicles of MHS was faster. Erythrocytes in MHS were smaller and had lower sodium concentration, and Na+-K+ cotransport and passive permeability were faster. The differences in volume, sodium content, and Na+-K+ cotransport between erythrocytes of the two strains persisted after transplantation of bone marrow to irradiated F1 (MHS X MNS) hybrids. Moreover, in normal segregating F2 hybrid populations there was a positive correlation between blood pressure and Na+-K+ cotransport. These results suggest a genetic and functional link in MHS between cell membrane cation transport abnormalities and hypertension. Thus erythrocyte cell membrane may be used for approaching the problem of defining the genetically determined molecular mechanism underlying the development of a type of essential hypertension. PMID- 3316006 TI - The natriuretic response to hydromineral imbalance. AB - Many recent investigations of the mechanism of volume-expansion natriuresis fail to appreciate that the observed renal sodium excretion may not be dependent on an increase in intravascular volume, but rather on the infused sodium load or extracellular fluid volume expansion. With this in mind, the natriuresis of isotonic volume expansion, hypertonic saline infusion, and dehydration have a common basis: they present a relative or absolute sodium load. Lesions of forebrain periventricular tissue prevent the natriuretic response to these three states of body fluid imbalance. In this review we discuss the evidence for a common central nervous system-mediated natriuretic mechanism in response to disturbances of fluid and electrolyte balance. We also propose a role for pars intermedia-derived, proopiomelanocortin-derived peptides as humoral mediators of renal sodium excretion. Evidence from our laboratory, as well as others, provides data for a testable hypothesis to explain central nervous system-mediated natriuresis, as well as an explanation of how central nervous system lesions or neurochemical perturbations affect the renal response to body fluid imbalance. PMID- 3316007 TI - Falciparum malaria. PMID- 3316008 TI - Escherichia coli infection producing pancreatitis and extrahepatic-cholestasis. PMID- 3316009 TI - Acute rheumatic fever and its sequelae during childhood: historical perspective and a global overview. PMID- 3316010 TI - Abdominal ultrasonography in pediatrics. PMID- 3316011 TI - Prenatal ultrasonic evaluation of fetal weight. PMID- 3316012 TI - Sonographic diagnosis of portal cavernoma. PMID- 3316014 TI - Infantile tremor syndrome. PMID- 3316013 TI - Sonography in the diagnosis and management of acute acalculous cholecystitis. PMID- 3316015 TI - Prenatal sonographic diagnosis of sacrococcygeal teratoma. PMID- 3316016 TI - Cavernous hemangiomas of the liver and spleen. PMID- 3316017 TI - Neonatal jaundice: association with neonatal septicemia. PMID- 3316018 TI - Clean intermittent catheterization in management of bladder dysfunction in spina bifida. PMID- 3316019 TI - Rett syndrome. PMID- 3316020 TI - Oral habits. PMID- 3316021 TI - [Progress in the analysis of amino acids with special reference to the determination of the intracellular amino acid pattern]. AB - Intracellular amino acid patterns are nowadays considered as suitable criteria to evaluate the therapeutical effects of newly developed nutritional techniques. Owing to the low sensitivity and resolution of conventional amino acid analysis (ion exchange chromatography with ninhydrin-detection), reproducible and reliable studies to assess alterations in intracellular amino acid concentrations are, however, limited. In this study, for the first time a routinely manageable HPLC method allowing fully automated determination of free amino acids by employing on line precolumn derivatization with ortho-phthaldialdehyde is presented. The highly sensitive fluorescence detection (less than 10 pMol/amino and injection) enables the measurement of intracellular/extracellular amino acid levels in various tissues (blood, muscle, liver, kidney, leukocytes) by using minimum amounts to sample material. Furthermore, the high resolution of the HPLC method facilitates the simultaneous determination of amino acid derivatives as well as short chain peptides. The error and the reproducibility of the method (expressed as the coefficient of variation) ranged between 1.0-4.7% and 0.4-2.2%, respectively. In addition to ortho-phthaldialdehyde, alternative precolumn derivatization reagents are described and evaluated with special regard to their applicability in the routinely manageable determination of intracellular amino acids in biological material. PMID- 3316022 TI - [Hepatic vein catheter technic: method for the detection of metabolic and hormonal variables in the splanchnic area]. AB - The hepatic venous catheterization method permits calculation of net splanchnic output and uptake of substrates and hormones from their respective differences in hepatic venous and arterial concentrations as well as the rate of hepatic plasma or blood flow. Estimates of the latter are made possible by the continuous infusion technique using indocyanine green dye. With determination of splanchnic balance data at hand transsplanchnic and in part even transphepatic handling of metabolic substrates and hormones can be calculated. PMID- 3316023 TI - Improvement of the safety systems in cell separators. The new safety concept for the cell separator AS 104 (Fresenius). AB - The new, extended safety requirements for cell separators call for a new generation of machines to address current safety needs. In order to ensure safe treatment, the complete safety concept is of decisive importance - this includes closed seal-less systems, continuous operation, fractions collected externally to the centrifuge, and pump tubings, connections and clamps which are color and direction coded. 'Human failure' as a cause of fault should be excluded for these highly technical appliances - for example, through the use of 'fail-safe' circuits, drip-controlled ACD flow by a separate adjustable pump, detection of damages to blood components by hemolysis control. PMID- 3316024 TI - Side-effects and technical problems in cytapheresis with cell separators. Results of a retrospective multicenter study. AB - On the basis of a survey, the acute side-effects and technical problems in a total of 77,525 cytaphereses (IFC 36,530, CFC 40,995) in donors at 39 hemapheresis centers were retrospectively analysed statistically. In general, relevant donor side-effects (0.78%-1.05%) were more rare than the primary donor independent disturbances (1.65%-2.63%). The donor side-effects predominated merely with the use of the cell separators Haemonetics M30/Belco (1.06% vs. 0.57%). These were mainly circulatory reactions (0.83%), which were generally much more frequent with IFC (0.54%) than with CFC (IBM/Cobe 0.11%, CS-3000 0.19%). Potentially fatal complications were not reported. The frequency of side effects, disturbances and discontinuations correlated inversely with the separation rate of the individual centers per method. Centers in which two or three methods were applied simultaneously reported a higher frequency of side effects and disturbances. Hemolysis was only observed with IFC (0.09%), but not with the use of the Haemonetics V50. The greater susceptibility to disturbances of technical/methodological/operational origin essentially results from the more elaborate, but not yet perfected technology, including computer control and monitoring, as well as defects in the production of the much more complicated disposable sets. Thus the highest rate of discontinuations was calculated for the system which is so far the most sophisticated technically (CS-3000, 1.85%). Although the primary donor-independent problems sometimes correlate directly with the manifestation of donor side-effects, the greater technological sophistication of automatically controlled and monitored systems cannot be dispensed with, since only in this way can potentially fatal risks for the donors be largely ruled out.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316025 TI - Biologic activities of antibody to a peptidoglycan-associated lipoprotein of Haemophilus influenzae against multiple clinical isolates of H. influenzae type b. AB - A peptidoglycan-associated lipoprotein of about 15 kilodaltons was purified from the outer membranes of Haemophilus influenzae by using nondenaturing detergents. To assess its vaccine potential, rabbit antiserum to the purified protein was obtained. The antiserum was specific for the peptidoglycan-associated lipoprotein in whole cell lysates of H. influenzae and was bactericidal for H. influenzae types a, b, d, e, and f and for 181 of 182 H. influenzae type b clinical strains isolated in widely dispersed geographic areas. The antibody protected infant rats from challenge with each of five clinical H. influenzae type b isolates and was additive to and did not interfere with bactericidal and protective activities of antibody against the type b capsule. These data indicate that the purified peptidoglycan-associated lipoprotein is a potentially valuable vaccine candidate for H. influenzae type b disease and may enhance the effectiveness of preexisting anticapsular antibody. PMID- 3316026 TI - In vivo colonization of the mouse large intestine and in vitro penetration of intestinal mucus by an avirulent smooth strain of Salmonella typhimurium and its lipopolysaccharide-deficient mutant. AB - The relative abilities of an avirulent Salmonella typhimurium strain with wild type lipopolysaccharide (LPS) character, SL5319, and a nearly isogenic LPS deficient mutant, SL5325, to colonize the large intestines of streptomycin treated CD-1 mice in vivo and to penetrate colonic mucus in vitro were studied. Previously it had been shown that, when fed simultaneously to streptomycin treated mice (approximately 10(10) CFU each), the S. typhimurium strain with wild type LPS colonized at 10(8) CFU/g of feces indefinitely, whereas the LPS deficient mutant dropped within 3 days to a level of only 10(4) CFU/g of feces. In the present investigation, when SL5325 was allowed to colonize for 8 days before feeding mice SL5319 or when it was fed to mice simultaneously with an Escherichia coli strain of human fecal origin (10(10) CFU each), both strains colonized indefinitely at 10(7) CFU/g of feces. Moreover, when the wild-type and LPS-deficient mutant strains were fed to mice simultaneously in low numbers (approximately 10(5) CFU each) the strains survived equally well in the large intestines for 8 days, after which the LPS-deficient mutant was eliminated (less than 10(2) CFU/g of feces), whereas the wild-type colonized at a level of 10(7) CFU/g of feces. In addition although both strains were able to adhere to mucus and epithelial cell preparations in vitro, the wild-type strain was shown to have greater motility and chemotactic activity on CD-1 mouse colonic mucus in vitro and to more rapidly penetrate and form a stable association with immobilized colonic mucosal components in vitro. Based on these data, we suggest that the ability of an S. typhimurium strain to colonize the streptomycin-treated mouse large intestine may, in part, depend on its ability to penetrate deeply into the mucus layer on the intestinal wall and subsequently, through growth, colonize the mucosa. PMID- 3316028 TI - Mycobacterium leprae surface components intervene in the early phagosome-lysosome fusion inhibition event. AB - Bone marrow-derived cultured macrophages were infected with Mycobacterium leprae. The bacteria were either used as freshly isolated organisms or incubated with M. leprae antiserum (1:5) for 30 min prior to phagocytosis. Immediately after inoculation (1 to 4 h) and at 1 to 8 days later, macrophages were stained for acid phosphatase activity to assess fusions between phagosomes and lysosomes. Inhibition of fusions was essentially apparent as an early event, which was partially reversed by antiserum treatment of the bacteria, suggesting a role for M. leprae immunogenic surface components in this early phenomenon. Later incubation times (1 to 8 days) did not show any considerable difference between antiserum-treated and nontreated bacteria. The formation of an electron transparent zone around phagocytized bacteria and its role in phagosome-lysosome fusion was investigated, and a direct relationship could not be established. PMID- 3316027 TI - Plasmid-associated virulence of Salmonella typhimurium. AB - We investigated the role of the 100-kilobase (kb) plasmid of Salmonella typhimurium in the virulence of this organism for mice. Three strains, LT2-Z, SR 11, and SL1344, which possessed 100-kb plasmids with identical restriction enzyme digestion profiles, were cured of their respective 100-kb plasmids after Tnmini tet was used to label plasmids. Curing wild-type virulent strains SR-11 and SL1344 raised peroral 50% lethal doses from 3 x 10(5) and 6 x 10(4) CFU, respectively, to greater than 10(8) CFU. Both wild-type strains had intraperitoneal 50% lethal doses of less than 50 CFU, whereas the intraperitoneal 50% lethal doses for cured SR-11 and SL1344 were less than 50 and 400 CFU, respectively. Reintroduction of the Tnmini-tet-labeled, 100-kb plasmid restored wild-type virulence. Invasion from Peyer's patches to mesenteric lymph nodes and spleens after peroral inoculation was the stage of pathogenesis most affected by curing S. typhimurium of the 100-kb plasmid. Wild-type S. typhimurium replicated in spleens of mice inoculated intravenously to a greater extent than did plasmid cured derivatives. Wild-type and cured strains equally adhered to and invaded Henle-407, HEp-2, and CHO cells; furthermore, the presence of the 100-kb plasmid was not necessary for replication of S. typhimurium within CHO cells. The 100-kb plasmid had no effect on phagocytosis and killing of S. typhimurium by murine peritoneal macrophages in vitro and in vivo. Similarly, wild-type and plasmid cured strains were resistant to killing by 90% normal human, rabbit, and guinea pig sera. All wild-type and plasmid-cured S. typhimurium strains possessed complete lipopolysaccharide, as determined by silver staining solubilized cells in sodium dodecyl sulfate-polyacrylamide gels. We have confirmed the role of the 100-kb plasmid of S. typhimurium in virulence, primarily in invasion to mesenteric lymph nodes and spleens after peroral inoculation of mice. Involvement of the 100-kb plasmid in infection of mesenteric lymph nodes and spleens suggests a role for the plasmid in the complex interaction of S. typhimurium with cells of the reticuloendothelial system. PMID- 3316029 TI - Salmonella typhimurium deletion mutants lacking adenylate cyclase and cyclic AMP receptor protein are avirulent and immunogenic. AB - Salmonella typhimurium SR-11 mutants with cya::Tn10 or crp::Tn10 mutations were found to be avirulent and immunogenic for BALB/c mice. Fusaric acid-resistant derivatives with deletions of the Tn10 and adjacent DNA sequences were constructed in S. typhimurium SR-11 strains with or without the virulence plasmid pStSR100. These delta cya delta crp strains grew more slowly than wild-type strains. They possessed wild-type ability to attach to, invade, and persist in gut-associated lymphoid tissue for up to a week but exhibited a diminished ability to reach mesenteric lymph nodes and the spleen. Mice 4 to 8 weeks old were resistant to oral infection with 10(9) cells of several different delta cya and delta cya delta crp strains (the equivalent to 10(4) 50% lethal doses of wild type S. typhimurium SR-11) and 30 days after immunization became resistant to oral challenge with 10(3) to 10(4) 50% lethal doses of wild-type S. typhimurium SR-11. PMID- 3316030 TI - Adherence of group B streptococci to adult and neonatal epithelial cells mediated by lipoteichoic acid. AB - We have investigated the role of lipoteichoic acid in mediating the adherence of different serotypes of group B streptococci to human adult and neonatal epithelial cells. Pretreatment of neonatal buccal and vaginal epithelial cells with lipoteichoic acid, but not with deacylated lipoteichoic acid, induced a marked inhibition in the adherence of all strains tested. Pretreatment of bacteria with substances known to bind lipoteichoic acid, such as monoclonal and polyclonal antipolyglycerophosphate antibodies and albumin, also resulted in adherence inhibition. Group B streptococci adhered in 6- to 10-fold-higher numbers to buccal epithelial cells from neonates older than 3 days than to those from neonates less than 1 day old. This increase in receptiveness for group B streptococci was paralleled by an increased ability of epithelial cells from older neonates to bind group B streptococcal lipoteichoic acid. These data suggest a role for the lipid portion of lipoteichoic acid in the adherence of different serotypes of group B streptococci to vaginal and neonatal epithelial cells. PMID- 3316031 TI - Prior exposure to subimmunogenic amounts of some bacterial lipopolysaccharides induces specific immunological unresponsiveness. AB - Pretreatment (priming) of BALB/c mice with a low (subimmunogenic) dose of Escherichia coli O113 lipopolysaccharide (LPS) generates immunological memory 7 to 30 days later; the direct (immunoglobulin M) plaque-forming cell (PFC) responses produced after subsequent immunization with an optimal dose are 4 to 20 times greater than those of unprimed mice. By contrast, priming with a low dose of E. coli O55 LPS, followed by immunization with an optimally immunogenic dose 2 to 30 days later, resulted in a significantly reduced antibody response. Similar results were obtained with Serratia marcescens LPS. Dose-response studies indicated that such unresponsiveness is antigen specific and could be induced with subimmunogenic amounts of LPS. Priming reduced the magnitude of the PFC response to all immunizing doses of LPS tested. Unresponsiveness is not due to (i) an alteration in the time course of the PFC response or to (ii) a change in the isotype of the anti-LPS antibody produced after priming and immunization. PMID- 3316032 TI - Mechanisms of specific immunological unresponsiveness to bacterial lipopolysaccharides. AB - Low-dose priming of mice with Escherichia coli O113 lipopolysaccharide (LPS) results in the development of immunological memory, whereas low-dose priming with E. coli O55 LPS or Serratia marcescens LPS induces significant antigen-specific unresponsiveness. All three preparations of LPS induced proliferation of mouse splenocytes with similar time course and [3H]thymidine uptake. There was no correlation between the small amounts of serum antibody detected by enzyme-linked immunosorbent assay after low-dose priming and the subsequent generation of either memory or unresponsiveness. Further, the passive transfer of small amounts of LPS-specific antibody had no significant effect on the magnitude of the plaque forming cell (PFC) response elicited after subsequent immunization. Reduction of the PFC response to E. coli O55 LPS occurred after low-dose priming of nu/nu (as well as nu/+) mice; however, unresponsiveness could not be generated in nu/nu mice by low-dose priming with S. marcescens LPS. Thus, although the development of low-dose unresponsiveness to S. marcescens LPS appears to involve T cells, the response of E. coli O55 LPS does not. Enhancement of the primary PFC response to S. marcescens LPS could be transferred with low-dose primed spleen cells depleted of Lyt-2+ T cells; this suggests that the magnitude of the PFC response to this preparation of LPS is negatively influenced by Lyt-2+ T cells and positively influenced by Lyt-2- spleen cells (i.e., L3T4+ T cells). These findings indicate that T cells appear to be involved in regulating the magnitude of the antibody response to some types of bacterial LPS. PMID- 3316033 TI - Role of a 60-megadalton plasmid and Shiga-like toxins in the pathogenesis of infection caused by enterohemorrhagic Escherichia coli O157:H7 in gnotobiotic piglets. AB - Enterohemorrhagic Escherichia coli (EHEC) of serotype O157:H7 has two putative virulence factors: (i) a fimbrial adhesin, specified by a 60-megadalton (MDa) plasmid, and (ii) bacteriophage-specified cytotoxin(s), known as Shiga-like toxin (SLT) or verotoxin. The contribution of these factors to the pathogenesis of EHEC induced disease in gnotobiotic piglets was examined. The bacterial strains included the following: two EHEC strains and their corresponding plasmid-cured derivatives; another EHEC isolate and its derivative which had spontaneously lost the ability to produce SLT; one E. coli K-12 transconjugatant containing a 60-MDa plasmid from an EHEC strain; two K-12 strains into which an SLT-producing phage had been transduced (one of these strains also carried a 60-MDa EHEC-derived plasmid); and the parent K-12 strain. Each strain was fed to four piglets, which were observed for diarrhea and examined for development of characteristic mucosal lesions 3 or 5 days after inoculation. All 24 piglets inoculated with the three EHEC strains and their respective derivatives (two plasmid cured and one SLT negative) showed the typical mucosal lesions of bacterial attachment: effacement of microvillous border and cell membrane dissolution culminating in destruction of surface and glandular epithelium in the cecum and colon. No such lesions were observed in 12 piglets inoculated with three strains of E. coli K-12, including the strain which carried both the 60-MDa plasmid and a phage which specified production of SLT. Moderate to severe diarrhea was observed in 16 piglets inoculated with two EHEC strains and their derivatives (one plasmid cured and one SLT negative). The third EHEC strain and its plasmid-cured derivative produced fewer typical mucosal lesions and no diarrhea. The reason for the reduced virulence of this strain was not clear. These results demonstrate that neither the 60-MDa plasmid nor the capacity to produce SLT is essential for expression of virulence by E. coli O157:H7 in gnotobiotic piglets. PMID- 3316034 TI - Isolation of a membrane-associated Bacteroides gingivalis glycylprolyl protease. AB - A low-molecular-weight proteolytic enzyme was purified 47-fold from outer membranes of Bacteroides gingivalis ATCC 33277 by preparative polyacrylamide gel electrophoresis. The enzyme was present in all B. gingivalis strains tested but was not found in other species of black-pigmented Bacteroides. The molecular weight, determined by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis, was 19,500 when the enzyme was heated to 100 degrees C in SDS before electrophoresis and 29,000 when it was mixed with SDS but not heated. The optimum pH, with azocasein as the substrate, was between 6.0 and 6.5. The activity was inhibited by phenylmethylsulfonyl fluoride, N-alpha-p-tosyl-L-lysine chloromethyl ketone, Hg2+, and various reducing agents. The enzyme was active against azocasein, azocoll, proline-rich protein from saliva, and the synthetic peptide glycyl-L-proline-p-nitroanilide. The enzyme did not degrade acid-soluble collagen nor did it hydrolyze various arginine- and lysine-containing synthetic substrates. PMID- 3316036 TI - Characterization of the secreted antigens of Mycobacterium bovis BCG: comparison of the 46-kilodalton dimeric protein with proteins MPB64 and MPB70. AB - Western blot analysis showed that the 46-kilodalton (kDa) dimeric protein antigen secreted in large amounts by some daughter strains of Mycobacterium bovis BCG corresponded to protein MPB70 present in long-term culture filtrates of the Japanese substrain. The 46/23-kDa antigen is the most abundant protein in supernatant from a 5-day culture but is masked by leaked products in old culture supernatants. No similarities were found between the 46-kDa protein and MPB64, a protein with the same strain distribution, or with the antigen of similar molecular mass recognized by monoclonal antibody SA1.D2D. PMID- 3316035 TI - Molecular analysis of the M protein of Streptococcus equi and cloning and expression of the M protein gene in Escherichia coli. AB - A Streptococcus equi gene bank was constructed in the bacteriophage lambda gt11 cloning vector, and hybrid phage plaques were screened with S. equi M protein antiserum. A hybrid phage expressing the S. equi M protein (lambda gt11/SEM7) was identified and lysogenized into Escherichia coli Y1089. The cloned M protein appeared in immunoblots as three polypeptides with relative molecular weights of 58,000, 53,000, and 50,000. When reacted with S. equi M protein antiserum in an agar double-diffusion assay, the cloned M protein formed a line of identity with a protein in an acid extract of S. equi. Furthermore, lambda gt11/SEM7 protein inhibited opsonization of S. equi by antiserum to S. equi M protein. In addition, the recombinant protein expressed determinants of the antigen in the immune complexes of purpura hemorrhagica. Native M protein obtained from S. equi and recombinant M protein showed very similar molecular weight distributions on immunoblots, appearing as multiple closely spaced bands with molecular weights ranging from 52,000 to 60,000. Antisera prepared separately against each of the acid-extracted polypeptides shown to be important in serum bactericidal responses (molecular weight, 29,000) and nasopharyngeal local antibody responses (molecular weights, 41,000 and 46,000) of the horse each reacted with all three polypeptides in an acid extract. Moreover, antisera against protoplasts and against recombinant M protein of S. equi also reacted with these polypeptides. These results suggest that the entire M protein molecule of S. equi is present in these preparations and that the fragments in acid extracts carry overlapping segments. PMID- 3316037 TI - Fungicidal mechanisms of activated macrophages: evidence for nonoxidative mechanisms for killing of Blastomyces dermatitidis. AB - The mechanism(s) by which lymphokine-activated peritoneal macrophages kill Blastomyces dermatitidis was studied. Resident peritoneal macrophages from BALB/cByJ mice, when treated overnight with lymph node cells plus concanavalin A, supernatants from concanavalin A-stimulated spleen cells, or recombinant gamma interferon, were then able to kill a virulent B. dermatitidis isolate (ATCC 26199) (at levels of 25% +/- 4%, 28% +/- 8%, and 21% +/- 5%, respectively). Killing was not significantly decreased or enhanced in the presence of superoxide dismutase (450 U/ml), catalase (20,000 U/ml), dimethyl sulfoxide (300 mM), or azide (1 mM). Viable B. dermatitidis elicited a brisk oxidative burst and superoxide anion production in activated macrophages as measured by lucigenin enhanced chemiluminescence, e.g., 10(4) cpm. However, these responses were not significantly different from those of control macrophages. Luminol-enhanced chemiluminescence responses by activated or control macrophages were meager (less than or equal to 10(2) cpm). These results indicate that activated macrophages kill B. dermatitidis by a mechanism(s) independent of products of the oxidative burst. PMID- 3316038 TI - Extensive homology between the leukotoxin of Pasteurella haemolytica A1 and the alpha-hemolysin of Escherichia coli. AB - The 19.8- and 101.9-kilodalton leukotoxin proteins of Pasteurella haemolytica (LKTC and LKTA, respectively) share extensive homology with the HLYC and HLYA alpha-hemolysin proteins of Escherichia coli. The leukotoxin LKTA protein cross reacts with hemolysin-specific antisera in Western blot (immunoblot) analysis, indicating that it shares epitopes with the alpha-hemolysin HLYA protein. Both LKTA and HLYA contain a conserved hydrophobic region, as well as a set of tandemly repeated domains. These features have been implicated in the lytic function of the alpha-hemolysin. PMID- 3316039 TI - Alpha interferons in hairy cell leukaemia: a clinical model of biological therapy for cancer. PMID- 3316040 TI - Interferons alpha and beta as cellular regulatory molecules. PMID- 3316042 TI - The safe and effective use of dental amalgam. AB - Case reports in the lay press claim that amalgam restorations may cause a number of local and systemic symptoms. Several recent scientific reports and reviews maintain that dental amalgam is a safe and effective restorative material. The advantages of dental amalgam as a restorative material include its ease of handling, diversity in application, physical characteristics and the infrequency of local and systemic biological side effects. The disadvantages of dental amalgam comprise poor aesthetics, local degradation, occasional allergic responses to some of its components or degradation products, and the toxicity of mercury. The clinical diagnosis of secondary caries constitutes the main reason for the replacement of amalgam restorations in both dentitions. Great variations prevail with regard to the longevity of amalgam restorations. Half of the restorations replaced in permanent teeth are about 8-10 year old, but the range is from 0 to about 40 years. Restorations needing replacement in deciduous teeth are in service for shorter periods of time than those in permanent teeth. In a longitudinal study of more than 600 class II amalgam restorations in permanent teeth, only about 6 per cent were replaced after a 6-7 year observation period. The longevity of amalgam restorations depends on a number of factors, including the quality of the material, its use and manipulation by the dentists and dental assistants and possibly also the oral hygiene of the patient. PMID- 3316043 TI - Wear patterns and rates of posterior composite resins. AB - The use of composite resins as posterior restorative materials has been growing at a rapid rate. In spite of major improvements in both physical and mechanical characteristics secondary caries and resistance to wear are still major concerns. This paper deals with the wear rate and patterns of wear of posterior composite resins. Results of long term clinical studies show that a major difference exists between composites containing submicron or supramicron sized filler particles. In general, the wear rates of the larger filler particles composite resins decrease with time. On the other hand, the microfilled posterior composite resins appear to exhibit a linear rate of wear. The wear patterns of the two different types of posterior composite resins are also dissimilar. Composite resins containing filler particles larger than 1 micron tend to undergo a generalized loss of material. The microfilled composite resins also lose material generally but to a lesser degree. Furthermore, the submicron filled posterior composite resins tend to exhibit localized wear, particularly in centric holding areas. Such a change does not, as a rule, occur with composite resins containing larger filler particles. Finally, the microfilled composite resins tend to develop continuous marginal fractures at tooth restoration interfaces. PMID- 3316044 TI - Dentine and enamel bonding agents. AB - Previous studies have shown that sequential use of aqueous FO (ferric oxalate containing a small concentration of HNO3), acetone solutions of NPG (N phenylglycine), and PMDM (the reaction product of pyromellitic dianhydride and 2 hydroxyethylmethacrylate) yields strong adhesive bonding of composite resins to both dentine and enamel. The purpose of this study was to determine if aluminum ions could be substituted for ferric ions and if the procedure could be simplified. Aqueous solutions containing aluminum oxalate and aluminum nitrate, followed in sequence by acetone solutions of NPG and PMDM, gave strong tensile adhesive bond strengths between a composite and extracted human teeth. Comparable values have been obtained with FO, NPG and PMDM. Aluminum oxalate solutions containing no nitrate gave lower bond strengths, as was the case with FO. Aqueous solutions of acidified aluminum oxalate can dissolve NPG, thereby allowing a simplification of the procedure. Tested for comparison, commercially available dentine bonding agents gave lower average bond strengths on dentine than did some of the experimental materials. PMID- 3316045 TI - Bone-inducing materials: their place in dentistry. AB - Materials and techniques for use in the repair of periodontal defects, alveolar ridge augmentation, ridge maintenance and alveolar ridge recontouring are discussed. An increased sophistication in the use of freeze dried and frozen allogeneic bone banked materials is evident. The principal application in ridge augmentation is to provide a base for the construction of dentures or other appliances in the ageing patient. Recently developed ceramic materials, similar in composition to the normal tooth and/or bone, are being used today for both periodontal defect repair and to maintain or build-up the alveolar ridge. These materials are forms of hydroxylapatite or of beta tricalcium phosphate. Their role in causing bone growth, in providing a matrix for new bone growth and in providing a source of calcium and phosphate ions is discussed. Although the mechanism of action of the synthetic ceramics is not yet known, there is increasing evidence that some are safe and effective, especially in alveolar ridge augmentation. Effectiveness, however, depends very much on careful patient selection prior to surgery. PMID- 3316041 TI - Heart rate, metabolic and hormonal responses to maximal psycho-emotional and physical stress in motor car racing drivers. AB - Motor car racing is representative of concentrative sporting activities, as well as instructive for mental-concentrative and psycho-emotional stress, which predominates with lower intensity, but longer duration in occupational work of today. A group of 20 car racing drivers was investigated both during car races (Formula Ford and Renault-5-Cup) and during progressive bicycle ergometry in the laboratory. Heart rate during car racing reached a mean level of 174.3 +/- 14.1 min-1 (mean +/- SD), corresponding to 90% of the maximal heart rate achieved at the end of exhaustive ergometry (n = 12). Catecholamine excretion in urine (adrenaline + noradrenaline) on average was 252.3 +/- 77.9 ng min-1 during car racing and 121.9 +/- 37.3 ng min-1 during exhaustive ergometry (n = 10). Most of the other metabolic parameters determined in blood (lactate, glucose, FFA = free fatty acids, plasma protein, insulin, HGH = human growth hormone) also showed significant differences between car racing and bicycle ergometry (n = 20). Therefore it is possible to distinguish between psychical and physical strain and the quantify their specific level. Especially blood lactate can be considered as a metabolic indicator of physical strain and FFA of psycho-emotional strain. Furthermore, significant negative correlations could be found between heart rate, FFA level, and catecholamine excretion during car racing and some measures of physical fitness determined on the bicycle ergometer (n = 12 or 10). This suggests a reduced cardiocirculatory and metabolic strain reaction in response to psychical stress situations with increased fitness. Moreover, HDL (high density lipoprotein) was found increased and oral glucose tolerance test was improved with elevated physical fitness (n = 20, respectively 16). From the results of this study it can be concluded that physical activity counteracts atherosclerosis and CHD (coronary heart disease), which are promoted by psycho-emotional and psycho-social stress. PMID- 3316046 TI - Total sugar consumption and dental caries in Europe--an overview. AB - Sugar is the principal substrate for microorganisms causing dental caries. Positive correlations between caries prevalence and total sugar consumption in cross-sectional comparisons between different countries have been shown. This overview aims to relate caries prevalence at the age of 12 years to the total sugar consumption/person in 1970 and 1980 in European countries and also to give information about the trends in the two variables. Nationally representative oral health surveys have been quite rare and only a few studies on sugar consumption were identified. Nevertheless, there seemed to be a clear general trend of decreasing dental caries with only a minor decrease in total sugar consumption in the European countries studied. PMID- 3316048 TI - PULMONOLOGIST: a computer-based diagnosis system for pulmonary diseases. AB - PULMONOLOGIST is a prototype expert system designed as a decision-making aid for physicians in providing accurate diagnosis and treatment of lung diseases. Disease information in the system has been encoded in the form of rules and schemata. The system has been developed using the expert system building tool ART (Automated Reasoning Tool) from Inference Corporation. This paper gives a brief introduction to the expert system concept, and includes a detailed description of the diagnosis system. This system will be tested against clinical data in future studies. PMID- 3316047 TI - A beta 2m amyloidosis. PMID- 3316049 TI - B-cell lymphomas of high-grade malignancy frequently lack HLA-DR, -DP and -DQ antigens and associated invariant chain. AB - The expression of HLA-DR, HLA-DP and HLA-DQ antigens was studied in an unselected series of 66 B-cell lymphomas by means of immunohistology using monoclonal antibodies against non-polymorphic determinants in a sensitive immunoperoxidase technique. In addition, the expression of the MHC class-II antigen-associated invariant chain (li) was examined. The tumors were classified according to the Kiel classification, 30 being of high-grade and 36 being of low-grade malignancy. Only 6 lymphomas of high-grade and 16 lymphomas of low-grade malignancy showed coordinate strong expression of all HLA class-II antigens and invariant chain as observed in the normal peripheral B cell. Six further tumors of high-grade and 8 tumors of low-grade malignancy contained tumor-cell subsets with reduced expression of one or several of the antigens. Eighteen lymphomas of high-grade and 12 lymphomas of low-grade malignancy contained varying tumor-cell subsets that were negative for HLA-DR, -DP, -DQ and li in a selective or combined manner. Three highly malignant tumors were devoid of all class-II antigens and li; 2 highly malignant tumors expressed invariant chain only. The presence of high grade malignancy was significantly correlated with the occurrence of tumor cells lacking HLA-DR (p = 0.004), HLA-DP (p = 0.013), HLA-DQ (p = 0.007) or li (p = 0.024). PMID- 3316050 TI - Effects of a single injection of anti-asialo GM1 serum on natural cytotoxicity and the growth of a regressive colonic tumor in syngeneic rats. AB - The REGb tumor cell line is a cloned variant of the DHD-K12 cell line, established from a colon carcinoma chemically induced in the rat. Unlike the parent DHD-K12 cell line, or other clones, which give progressive tumors when inoculated to the syngeneic rat, REGb cells produce tumors which regress in 3 to 5 weeks and never cause metastasis. In order to explore the role of natural killer (NK) cells in REGb tumor regression, each rat was given one injection of anti-asialoGM1 (anti-asGM1) serum, a known inhibitor of NK activity. This injection was done 24 hr before REGb cell challenge. This injection significantly depressed the in vitro cytotoxicity of peripheral blood lymphocytes on REGb cells for 2 weeks. REGb tumors grew larger and regressed later in the treated animals than those in the controls. Furthermore, a progressive or recurrent tumor was observed in 4 out of 10 treated rats, giving lung and/or lymph-node metastases in 2 cases. Immuno-histological study of the cells infiltrating the REGb tumors in control and treated animals showed a decrease number of asGM1+ and OX8+ lymphocytes, presumably NK cells, after anti-asGM1 treatment. An increase in number of macrophages was demonstrated in the progressive tumors of treated animals. These results suggest that NK cells play an important role in the initial stage of the regression TSb tumors in untreated syngeneic rats. PMID- 3316052 TI - Cardiopulmonary transplantation--growing pains. PMID- 3316051 TI - Metastatic but not primary melanoma cell lines grow in vitro independently of exogenous growth factors. AB - Five out of 6 cell lines derived from metastatic melanoma lesions grew in a chemically defined base medium consisting of a mixture of calcium-supplemented MCDB 153 and L 15 media in the absence of any polypeptide growth factors. In contrast, under these conditions no growth was seen in any of 5 primary melanoma cell lines tested, including 2 cell lines from patients whose metastatic cells proliferated well in base medium. Growth stimulation of all 11 melanoma cell lines by epidermal growth factor (EGF), transferrin, insulin, and insulin-like growth factor (IGF)-1 alone and in various combinations was studied. Insulin represented the strongest single growth factor for primary and metastatic melanoma cell lines. The metastatic cell lines remained growth-responsive to EGF, insulin and transferrin and responded more vigorously to these exogenously provided mitogens than the primary cell lines. No synergistic or additive growth effects of insulin, transferrin, or EGF for primary and metastatic cell lines were observed. Cross-linking studies with 125I-IGF-1 demonstrate surface expression of the type-I IGF receptor on melanoma cells. Growth stimulation by insulin and IGF-1 was inhibited by adding to the culture medium a monoclonal antibody to the type-I IGF receptor. Our studies indicate that IGF-1 and insulin are major growth factors for melanoma cells and act via the type-I IGF receptor. PMID- 3316054 TI - The state of the art of clinical hypnosis. PMID- 3316053 TI - The role of linoleic acid and its metabolites in the lowering of plasma cholesterol and the prevention of cardiovascular disease. AB - An increase in linoleic acid intake lowers plasma cholesterol and is one of the safest methods for achieving this end. However, the amounts that must be consumed are large. Linoleic acid is metabolized via several routes and it is probable that a metabolite, rather than linoleic acid itself, is responsible for the cholesterol-lowering effect. If that metabolite could be identified, safe, drug free, cholesterol-lowering might be achieved with much lower doses. Evidence is reviewed which suggests that a long-chain polyunsaturated fatty acid and/or a prostaglandin metabolite may be responsible for the cholesterol-controlling action of linoleic acid. Such metabolites may be effective also in controlling other risk factors for cardiovascular disease, such as elevated blood pressure and enhanced platelet aggregation. Epidemiological studies suggest that low levels of those metabolites, especially dihomogammalinolenic acid and arachidonic acid, are powerful independent risk factors for development of ischaemic heart disease. Further research in this area is urgently needed now that it is broadly accepted that cholesterol-lowering does indeed reduce the risk of cardiovascular disease. PMID- 3316055 TI - Significant developments in clinical hypnosis during the past 25 years. PMID- 3316056 TI - Significant developments in medical hypnosis during the past 25 years. PMID- 3316057 TI - Research advances in hypnosis: issues and methods. PMID- 3316058 TI - Multicenter double-blind randomized clinical trial of imidazole salicylate versus ibuprofen in patients with osteoarthrosis. AB - Imidazole salicylate (750 mg t.i.d.) was compared with ibuprofen (400 mg t.i.d.) in a 30-day multicenter double-blind clinical trial in patients with osteoarthrosis. Both drugs were effective in relieving joint pain and in reducing the duration of morning stiffness. A statistically significant reduction of the severity of these symptoms was observed already one week after the start of treatment, lasting until the end of the study. No significant differences in efficacy were demonstrated between the two drugs throughout the trial. The systemic tolerability, assessed by changes in tests of hematological, liver and kidney function, was excellent with both treatments. The incidence of side effects (mostly gastrointestinal complaints) was fairly low in both groups, and lower in the group treated with imidazole salicylate. PMID- 3316059 TI - Assessment of the clinical efficacy and tolerance of two new alpha-glucosidase inhibitors in insulin-treated diabetics. AB - The present study aimed at investigating the metabolic effects and tolerance of two desoxynojirimycin derivatives with alpha-glucosidase inhibitory properties (BAY m 1099 and BAY o 1248). The study was performed in a double-blind cross-over manner on 7 insulin-treated outpatient diabetics (6 males, 1 female; mean age 43 +/- 14 years; mean duration of diabetes 5.8 +/- 4.2 years; all within +/- 10% of their ideal body weight). The usual diet containing 24.5 +/- 8 g dietary fibers and 52 +/- 22 g simple sugars was maintained throughout the study. After a 7-day run-in period, 4 consecutive periods of 7 days were considered for each patient. The patients were randomly allocated for 1 week to BAY o 1248 (20 mg with breakfast) or Bay m 1099 (50 mg with breakfast and dinner). After a 7-day wash out period the patients underwent the alternate treatment. At the end of each period, the patients were admitted to the Metabolic Ward for detailed metabolic and hormonal investigations. No significant changes were observed in the daily insulin requirements (45 +/- 15 U/day). HbA1c did not change significantly. Residual insulin secretion was low (plasma C-peptide: 0.077 +/- 0.09 and 0.154 +/ 0.15 pmol/ml during fasting and 2 hours post-breakfast, respectively); it was not modified by the treatments. Increments in blood glucose were significantly lower after breakfast with both drugs. No differences were observed in plasma free insulin. A marked increase in breath hydrogen was observed after lunch with BAY o 1248 only. Clinical and biological tolerance was excellent for both compounds.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316060 TI - Efficacy and tolerance of ceftazidime in the treatment of post-operative respiratory tract infections. AB - Ceftazidime proved particularly effective in the treatment of acute respiratory tract infections arising in the immediate post-operative period, affording complete clinical cures in 88.8% of cases and a substantial improvement in the pathological picture in the other 11.2% of cases treated. The authors also draw attention to the excellent tolerance of the antibiotic, as evaluated on the basis of liver and kidney function and blood chemistry parameters and the total absence of adverse reactions. PMID- 3316061 TI - Effectiveness of pinaverium bromide in the treatment of primitive biliary dyskinesia: 99mTc-P-IDA scintigraphic evaluation. AB - The 99mTc-P-IDA (technetium-p-iminodiacetic acid) hepatocholangiocholecystoscintigraphy is a diagnostic technique which allows information on the liver biligenetic and excretory capabilities to be obtained. It is, moreover, a test that mirrors closely the anatomic and functional conditions of the cholecyst and choledochus. In this study the authors wanted to verify whether pinaverium bromide, a drug with a documented musculotropic spasmolytic activity, was able to induce changes in some abnormal instrumental parameters observed in 24 subjects with primitive biliary dyskinesia. The results revealed that the ti values, characteristically longer in those subjects, were significantly reduced in the group of patients treated with pinaverium bromide. On the contrary, in the group of patients treated with placebo, there was no change with respect to this parameter. PMID- 3316062 TI - Herbal therapy in the treatment of drug use. AB - The use of herbs in the treatment of substance abuse is a relatively new phenomenon, although the practice of herbalism goes back to the dawn of humanity. Herbs are natural botanical substances which have noticeable effects on the human organism. Throughout history man has used herbs for nutritional and healing purposes as well as for getting high. Most current treatment programs for substance abusers take into account only a small portion of the healing spectrum (e.g., psychological counseling, methadone, self-help, therapeutic community). There is a growing awareness of and concern to develop programs for substance abusers which utilize a holistic approach to deal with the mental, physical, emotional, and spiritual problems accompanying substance abuse. The purpose of this article is to review the use of herbal therapy in the treatment of drug abusers. An annotated bibliography is provided. PMID- 3316063 TI - Subliminal stimulation of symbiotic fantasies as an aid in the treatment of drug abusers. AB - Forty-seven heroin addicts being treated at the New York VA Methadone Clinic were divided into an experimental and a control group. In addition to the regular methadone treatment program, both groups received subliminal exposures to a verbal message for 24 sessions (4 times a week for 6 weeks). The messages were MOMMY AND I ARE ONE (experimental) and PEOPLE ARE WALKING (control), administered under double-blind conditions. In keeping with the main hypothesis, the experimental subjects, when compared with controls, showed a greater decrease in their use of heroin and other illicit drugs during the postintervention period. Additionally, on a follow-up questionnaire, the experimental subjects reported being more in control of their drug habits and more effective in their work than did those in the control group. Also, analysis of the patients' reported dreams revealed that the experimental group had more dreams containing positive interactions with a significant woman or son than did the control group. PMID- 3316064 TI - The control-of-consumption approach to alcohol abuse prevention. I. A reconceptualization. AB - The single-distribution theory of alcohol consumption and the derived prevention strategy, the control-of-consumption approach, are conceptualized as three probabilistic relationships between four variables, collectively called "the Ledermann string": availability, average consumption, proportion of heavy drinkers, and prevalence of damage. This conceptualization suggests four different intervention strategies, only one of which is seriously considered by advocates of the single-distribution theory: restrictions on availability. A companion article reviews the scientific literature on the relationships of the Ledermann string. PMID- 3316065 TI - Peer relationships, self-esteem, and the self. PMID- 3316066 TI - The dynamics of intimacy in group therapy. PMID- 3316067 TI - Vicissitudes of countertransference in inpatient group psychotherapy. PMID- 3316068 TI - Therapeutic issues of adolescent children of alcoholics (AdCA) groups. PMID- 3316069 TI - The mental health rationale for policies fostering minors' autonomy. PMID- 3316070 TI - Punitive juvenile justice: some observations on a recent trend. PMID- 3316071 TI - The limits of mental health expertise in juvenile and family law. PMID- 3316072 TI - Juvenile and family mental health law in sociohistorical context. PMID- 3316073 TI - Current taxonomic concepts pertaining to the dermatophytes and related fungi. PMID- 3316074 TI - Psoriasis Day Care Center at Stanford. Part-time and full-time programs. PMID- 3316075 TI - Melanoacanthoma and related disorders. Simulants of acral-lentiginous (P-P-S-M) melanoma. PMID- 3316076 TI - Linear IgA bullous dermatosis mimicking erythema multiforme in adult. AB - This report describes a 49-year-old woman with an erythema multiforme--like rash and direct immunofluorescence showing linear IgA deposits at the dermoepidermal junction. Light microscopy revealed features of bullous pemphigoid, dermatitis herpetiformis, and erythema multiforme; immunoelectron microscopy demonstrated IgA deposition beneath the lamina densa about anchoring fibrils. These data provide additional information about the variable clinical and histologic manifestations of the adult linear IgA bullous dermatosis and emphasize the diagnostic dilemmas of light microscopy, which are resolved by immunohistochemical methods. PMID- 3316077 TI - Depression in intensive care units. AB - There is thought to be a high incidence of depression in intensive care units (ICUs), both as a result of the psychological toll of serious illness and threat to life as well as the physiologic derangements caused by illnesses and treatments. The authors outline a strategy to classify ICU depressions into major depressive illness, adjustment disorders, dysthymic disorder, or organic affective syndrome. Other psychiatric disturbances which may simulate depression are also discussed. A summary of environmental, behavioral, psychotherapeutic, and psychopharmacologic treatments for these disorders and their special application in the ICU setting is presented. The limitations and precautions with antidepressant drugs in this clinical site are reviewed. PMID- 3316078 TI - Depression and internal medicine. AB - Although the Fathers of Internal Medicine described melancholia and wrote extensively about the affective disorders, internists continue to have difficulties diagnosing their medical patients' depressions. Consequently, it often falls to the psychiatric consultant to make the diagnosis amongst the medical population. We present current concepts of affective disorder that should be clinically relevant to the psychiatrist who works with internists and their patients. Early, accurate diagnosis of depressed medical patients requires increased awareness of depression, observation of the patient's appearance and mood, sensitivity to his or her feelings, and specific questioning about symptoms, losses, and stressors. For depressed medical patients, we present a comprehensive treatment program which often should include: 1) supportive psychotherapy, 2) antidepressant medications; and 3) resocialization or rehabilitation. We outline certain indications for psychiatric referral, and urge psychiatrists and internists to work together closely. Increasing the sensitivity of our colleagues in internal medicine toward affective illness should lead to more prompt identification and treatment of medical patients' depressions. PMID- 3316079 TI - Sperm shape abnormalities in mice exposed to californium-252 radiation. AB - Male mice of the B6C3F1 hybrid strain were whole-body irradiated with different doses of 252Cf/60Co. They were killed 35 days later and spermatozoa from cauda epididymides were stained with eosin-Y. The air-dried smears were examined under light microscope for sperm shape abnormalities. There was an increase in the frequency of abnormal sperm in all the treated groups compared to controls. The RBE for the mixed neutron and gamma radiation of 252Cf was 2.6. The RBE for the neutron component was 3.4. The increased frequency of abnormal sperm was associated with a concomitant decrease in testis weight in the irradiated animals. PMID- 3316080 TI - Polyamine content as a marker of radiation injury in the rat spleen. AB - The modifications of the polyamines putrescine (put), spermidine (spd) and spermine (spm) in rat spleen after 3 Gy whole-body irradiation were studied. Rats were irradiated at four different times of the day (00.00, 06.00, 12.00 and 18.00) and sacrificed between 12 h and 62 days after irradiation. Control animals, sacrificed at the same times of the day, showed higher levels of the spd/spm ratio during the hours of light. After irradiation the polyamine content was rapidly and significantly reduced over a period of 20 days. The modification of the amount of spm lasted for a longer period of time. Normal values of polyamine content were reached at later times when the mitotic activity was restored. The results show a close correlation between polyamine concentration and [3H]thymidine uptake. PMID- 3316081 TI - Technique of laryngoscopy. AB - The role of the pediatric laryngologist has changed. He now manages a greater range of clinical problems in the upper airways. Direct laryngoscopy under general anesthesia is fundamental for correct diagnosis and management in infants and children. It is a precise procedure utilizing a range of modern miniaturized instruments. Major technological improvements include quartz iodine and xenon light sources, flexible light carrying leads, fiberoptic rod lighting, special purpose laryngoscopes, rigid telescopes, versatile techniques of anesthesia, microlaryngeal surgery, laser surgery and reliable photographic documentation. PMID- 3316082 TI - Cochlear implants and sensory aids for deaf children. PMID- 3316083 TI - Gabriel F. Tucker Jr. PMID- 3316085 TI - Periodontal and prosthetic considerations in the esthetic restoration of a cleft palate: a case report. PMID- 3316084 TI - The art and science of provisionalization. PMID- 3316086 TI - An interdisciplinary classification of restorative dentistry. PMID- 3316087 TI - How much root planning is necessary to remove the cementum from the root surface? PMID- 3316088 TI - Two-piece retrofit dowel-core: a case report. PMID- 3316089 TI - Computerized periodontal probe with adjustable pressure. PMID- 3316090 TI - SAT and TAT scores as measures of time perspective in institutionalized and community-based senior adults. PMID- 3316091 TI - Biopsychosocial approach in psychiatry and related fields. PMID- 3316093 TI - The stalemate position. AB - The psychosurgical operation of stereotactic subcaudate tractotomy can be a highly effective treatment for chronic and intractable affective disorders. We have lately given increasing attention to cases where the depressed mood appears to lift although there is little improvement in social function. In these cases there has been a failure of rehabilitation and the complexities of this process post-operatively are discussed. In addition, relatives report in some 10% of cases "personality changes" after the operation which are not perceived in this way by an independent medical assessor and these observations seem to depend upon relatives mis-interpreting the resumption of pre-morbid personality function after long illnesses as undesirable side-effects. Case histories illustrating the problems are described. Treatment and rehabilitation strategies are outlined. PMID- 3316092 TI - Oversynthesis of diacetyl and acetoin in a riboflavin deficient mutant of yeast. AB - The relations of diacetyl and acetoin to flavinogenesis were studied using a variety of the riboflavin deficient mutants of yeast. The results obtained indicated that only the mutant N189-10A, which have a defect in the pathway positioned next to the nucleotide precursor, guanosine triphosphate (GTP), produces prodigeous amounts of diacetyl and acetoin among the mutants and the wild strain used. A close relation of diacetyl and acetoin to riboflavin formation at their substrate level or regulator level was discussed. PMID- 3316095 TI - [Muscle involvement in inflammatory rheumatic diseases]. PMID- 3316096 TI - [Polymyalgia rheumatica]. PMID- 3316094 TI - Portal and arterial washout after hypothermic preservation of the pig liver: prevention of hyperkalaemia after revascularization. AB - In an orthotopic liver transplantation (OLT), portal revascularization may produce acidosis and hyperkalaemia due to loss of intracellular acid metabolites and K+ during hypothermic preservation. To verify the effectiveness of portal and arterial washout in preventing hypokalaemia after liver preservation, an OLT was done in 18 large-white pigs. The donor livers were perfused in situ via the portal vein with Hartmann's solution containing 1.000 IU of heparin at 4 degrees C. Afterwards, a cold Collins C2 solution was perfused either in vitro (group A) or in situ (group B). The cold ischemia time in both groups was less than 3 1/2 h. Before doing the portal revascularization of the donor livers, a washout via the portal vein and hepatic artery with saline serum was performed. The concentration of K+, glucose, GOT and LDH in effluents obtained through infrahepatic inferior vena cava were significantly lower in group B than in group A. Simple washout of the livers prior to revascularization prevented hyperkalaemia in both groups. PMID- 3316097 TI - [Psychosomatic aspects of muscle pain]. PMID- 3316098 TI - [Muscle pain in localized and generalized tendomyopathies]. PMID- 3316099 TI - [Possibilities of physical therapy in chronic muscle pain]. PMID- 3316100 TI - [Use of a fully mechanized differentiation system in the hematologic laboratory. I: Development and mechanisms of the Hematrak 590 differentiation system; reproducibility and reliability of differentiation of smears with normal blood cell elements]. PMID- 3316102 TI - [A 51-year-old female with ring erythema and subsequent pain in the lateral thorax]. PMID- 3316101 TI - [A 50-year-old patient with recurrent jaundice and feelings of weakness]. PMID- 3316103 TI - [Acrodermatitis chronica atrophicans and Lyme disease]. PMID- 3316104 TI - Friendenwald award and lecture. PMID- 3316106 TI - Proctor award and lecture. PMID- 3316105 TI - Monitoring communications between photoreceptors and pigment epithelial cells: effects of "mild" systemic hypoxia. Friedenwald lecture. PMID- 3316107 TI - The windfalls of technology in the oculomotor system. Proctor lecture. PMID- 3316108 TI - Intermediate filaments and their organization in human corneal endothelium. AB - The native intermediate filament network within human corneal endothelium was identified by a monoclonal antibody to vimentin intermediate filament protein. Human corneal endothelial cells in tissue culture were shown to react positively to this monoclonal antibody by indirect immunofluorescence microscopy. In cryostat sections of human cornea, only the endothelial cells and keratocytes stained for vimentin. Fluorescent staining patterns of the cultured endothelial cells demonstrated that vimentin forms arrays of cytoplasmic filaments which encapsulate the nucleus and anchor in the apical junctions. These results reveal a previously undescribed cytoskeleton in human corneal endothelium and suggest that the intermediate filament vimentin comprises this structural network which is, in part, responsible for nuclear centration and cell-to-cell contacts. In addition, these results may indicate the possible embryogenesis of the corneal endothelium, since vimentin is a marker for cells of mesenchymal origin. PMID- 3316109 TI - Immediate effects of graded ionic and nonionic contrast injections on coronary blood flow and myocardial function. Implications for digital coronary angiography. AB - The comparative immediate effects of ionic and nonionic contrast agents on coronary blood flow and regional function have not been studied. Therefore, subselective intracoronary injections of iohexol and sodium meglumine diatrizoate (Renografin 76) were compared at different rates (1, 3, and 4 mL/sec) and volumes (2 and 4 mL). Open chest dogs were instrumented with electromagnetic flow probes, subendocardial ultrasonic crystals, and a subselective intracoronary catheter. The 2- and 4-mL volumes of Renografin infused at 3 mL/sec, caused reductions in coronary blood flow that were maximal at 2 to 3 seconds after injection. These changes were significant for the 4-mL dose (61 +/- 19 at control vs. 23 +/- 12 mL/min, mean +/- SD, P less than .01) but not for the 2-mL dose. Iohexol produced identical flow responses but regional function was not significantly altered, whereas Renografin caused significant depression at both dose levels. Injections of 4 mL of Renografin at 1 and 4 mL/sec caused maximal flow decrements at 4.5 and 2 seconds after injection, respectively. Again, iohexol caused identical responses. At these doses, the effects of iohexol on regional function were also identical to those of Renografin. Thus, despite differences in physical properties, no significant differences in early blood flow changes were detected between these two agents. PMID- 3316110 TI - Acquired cystic disease of the kidneys. Computed tomography and ultrasonography appraisal in patients on peritoneal and hemodialysis. AB - Screening chronic hemodialysis patients (CHD) for acquired cystic disease of the kidneys (ACDK) and its complications (hemorrhage and neoplasm) has become accepted management. We evaluated patients on CHD as well as patients on chronic peritoneal dialysis (CPD) for ACDK. The kidneys of 80 chronic dialysis patients were examined by CT and real time sonography. Forty-four were hemodialysis and 36 were peritoneal dialysis patients. ACDK was found in more than 90% of both CHD and CPD patients who had been dialyzed longer than three years. Bilateral renal carcinoma was detected in one hemodialysis patient. Our results show that chronic peritoneal dialysis patients are also at risk for ACDK and its associated complications. A similar natural history for the development of ACDK in both forms of dialysis suggests that the same screening precautions should be instituted for chronic peritoneal dialysis patients. PMID- 3316111 TI - Teen pregnancy. PMID- 3316112 TI - A comparative analysis over a decade of the changing indications for penetrating keratoplasty in Ireland. PMID- 3316113 TI - Trial of vaginal prostaglandin pessary for induction of labour. PMID- 3316114 TI - Claude Bernard and the history of science. PMID- 3316115 TI - Scientific writing and scientific discovery. PMID- 3316116 TI - On Moses: God commands, man resists. PMID- 3316117 TI - Smear biopsy for on-the-spot diagnosis in stereotactic surgery of CNS tumors. Experience of 101 cases. AB - We report the correlation between cytological and histological diagnoses in 101 stereotactic biopsies performed on space-occupying lesions of the CNS. Diagnostic accuracy was 89%, in line with the rates reported by other workers. PMID- 3316118 TI - Alpha-tocopherol: effect on plasma lipoproteins in hypercholesterolemic patients. AB - This study was designed to examine the hypothesis that dl-alpha-tocopheryl acetate (vitamin E) increases the level of high-density lipoprotein cholesterol (HDLC) with a concomitant decrease of the ratio of total cholesterol/HDLC and a resultant amelioration of the coronary risk profile. Vitamin E (500 IU/day) or placebo were administered under double-blind randomized allocation to 69 hypercholesterolemic patients for 3 months. Sixty patients completed the study (30 in the active treatment group and 30 in the placebo group). Vitamin E raised the mean level of HDLC from 1.39 +/- 0.38 (SD) to 1.58 +/- 0.41 mmol, a 13.6% increase. This increase significantly (P less than 0.05) exceeded a parallel smaller increase of only 0.05 mmol (3.8%) in the placebo group. As total cholesterol (TC) declined by similar proportions in the vitamin E (7.8%) and placebo (9.4%) groups, a concomitant reduction of 23% in the TC/HDLC ratio was achieved in the vitamin E group, significantly exceeding a 9.1% reduction under placebo. Significant beneficial effects were noted on apolipoprotein (Apo) A (which rose) and Apo B (which declined). An increase of Apo A/Apo B ratio by 17.9% was observed only in the vitamin E group. These results suggest that the oral administration of vitamin E (500 IU/day) is beneficial in hyperlipoproteinemia and offers a potential tool for treating the increased coronary heart disease risk. PMID- 3316119 TI - Characterization of lipidous antigens derived from erythrocytes infected with Plasmodium berghei. AB - A lipid extract obtained from reticulocyte membranes of Plasmodium berghei infected rats showed antigenic activity against sera from convalescent or immune rats. Following chromatography on silicic acid column, 85% of the activity was recovered from the column with chloroform:methanol (1:3, vol/vol). The active fraction was further resolved by thin layer chromatography (TLC) into four lipid components, two sugar-containing components and two phosphorous-containing components, but neither the individual components nor various combinations of the components showed antigenic activity after elution from the TLC plate. The immunological activity was not affected by phospholipase A2 treatment. PMID- 3316120 TI - Prenatal early sonographic diagnosis of Meckel syndrome. PMID- 3316121 TI - Group B streptococcal bacteremia in a normal splenectomized adult. PMID- 3316122 TI - Positive effects of indomethacin on restoration of splenic nucleated cell populations in mice given sublethal irradiation. AB - Splenic cellularity during the recovery phase after 400-R irradiation was evaluated in mice, in which the level of prostaglandin was regulated by indomethacin and exogenous prostaglandin E2, following sublethal irradiation. Two weeks after irradiation, administration to these mice of indomethacin, an inhibitor of prostaglandin synthesis, augmented the recovery of all nucleated spleen cell populations, whereas the thymus was drastically depopulated. This treatment had little effect upon the total number of bone marrow cells but inversed the ratio of PNA+/PNA- cells. Cell transfer experiments using heavily irradiated mice as recipients showed that the stem cell proliferation was positively affected by indomethacin treatment in the bone marrow rather than in the spleen. These results suggest that cell migration from primary lymphoid organs, particularly from the bone marrow to the spleen, is regulated by a prostaglandin-mediated system and that a prostaglandin E2 synthesis inhibition would have a positive effect on the restoration of peripheral nucleated cells following irradiation. PMID- 3316123 TI - Rate setting and hospital cost-containment: all-payer versus partial-payer approaches. AB - This article explores the relative cost-containment potential of hospital rate setting programs that differ in the extent of payer coverage. While the analysis has implications for the impact that Medicare's prospective payment system (PPS) may have on overall hospital costs, this study is based on a comparison of all payer and partial-payer state systems in the pre-PPS era. Data on hospital costs are drawn from the 1982 and 1983 American Hospital Association's Annual Surveys of Hospitals. The data confirm that all types of mandatory rate-setting systems are effective systems of cost control. The findings suggest that all-payer approaches may have some short-run advantages in terms of reducing the growth in hospital costs but that, as of 1983, they had not attained a lower level of costs (measured on a per-admission basis) than partial-payer systems. PMID- 3316124 TI - Integration of nursing diagnoses in the critical care nursing literature. AB - It has been almost 15 years since the start of the nursing diagnosis movement. Consensus development, research, and infiltration have been slow but progressive. However, integration of nursing diagnoses into the critical care literature has not progressed as much as have other components of the movement. All three nursing diagnosis activities are interdependent, and without infiltration the whole process is slowed. We believe that the process of infiltration through the literature could be greatly accelerated if the recommendations presented here were implemented. This increasing infiltration of nursing diagnoses through the literature would then have a positive effect on all other concurrent activities involved in the nursing diagnosis movement. PMID- 3316125 TI - Measurement and validation of diagnostic concepts: a decade of progress. PMID- 3316126 TI - Amiodarone: current perspectives from Europe. PMID- 3316127 TI - Severe pregnancy-induced hypertension: postpartum care of the critically ill patient. AB - SPIH is a disease of unknown cause that contributes to maternal and neonatal morbidity and mortality rates. Familiarity with the normal physiologic adaptations of pregnancy and the confounding pathologic changes of SPIH will enable the health care professional to better understand the principles of management. Immediate therapeutic interventions are necessary to reverse hypertension and to prevent the life-threatening sequelae that may arise from this condition. Postpartum management is directed toward decreasing vasospasm and central nervous system irritability and maintaining fluid and electrolyte balance. Attention must be given to the special obstetric needs of these patients. PMID- 3316128 TI - Vibrio vulnificus bacteremia: report of a case and review of the literature. PMID- 3316129 TI - Clinical use of streptokinase and urokinase therapy for acute myocardial infarction. PMID- 3316131 TI - Ultrasonic evaluation in the management of postpartum infection. PMID- 3316130 TI - Natural selection and the heritability of fitness components. AB - The hypothesis that traits closely associated with fitness will generally possess lower heritabilities than traits more loosely connected with fitness is tested using 1120 narrow sense heritability estimates for wild, outbred animal populations, collected from the published record. Our results indicate that life history traits generally possess lower heritabilities than morphological traits, and that the means, medians, and cumulative frequency distributions of behavioural and physiological traits are intermediate between life history and morphological traits. These findings are consistent with popular interpretations of Fisher's (1930, 1958) Fundamental Theorem of Natural Selection, and Falconer (1960, 1981), but also indicate that high heritabilities are maintained within natural populations even for traits believed to be under strong selection. It is also found that the heritability of morphological traits is significantly lower for ectotherms than it is for endotherms which may in part be a result of the strong correlation between life history and body size for many ectotherms. PMID- 3316132 TI - A tribute to C. Leslie Mitchell, MD. PMID- 3316133 TI - Altered expression of surface antigens with appearance of HLA class II molecules on a malignant human B-cell line. AB - Class II molecules of the major histocompatibility complex play an important role in mediating cellular interactions and are differentiation antigens on lymphobohematopoietic cells. We have previously characterized a human B-cell line (BALM-3) whose cells fail to express HLA class II molecules unless treated with phorbol acetate (TPA). Recently, we identified a spontaneous variant of BALM-3 whose cells express HLA class II molecules in the absence of TPA. Since normal B cells lose HLA class II molecules on terminal differentiation, these two BALM-3 cell populations may provide a model for a discrete phase of B-cell maturation. Alternatively, they may reflect two B-cell activation states characterized by quantitative differences in their expression of class II molecules. Expression of six of 22 additional surface molecules (HLA class I, CD23, p60, p124, p129, p141) increases by a factor of three or more as BALM-3 cells spontaneously acquire class II molecules while that of one of the 22 (p45) decreases by a comparable amount. Expression of the plasma cell-associated T10/CD38 antigen decreases by a factor of two. These additional surface molecules might also reflect lymphoid differentiation/activation antigens and/or participate in HLA class II-mediated cellular interactions and require further study. Use of TPA to induce the expression of HLA class II molecules produces similar changes in several but not all of these surface antigens. PMID- 3316134 TI - T-cell clonal analysis of HLA-DR2 haplotypes. AB - Individuals carrying the serologically-defined DR2 haplotypes can be further subdivided by utilizing T cell response to define several HLA-Dw/LD clusters: Dw2, Dw12, LD-5a, and a related group composed of FJO, AZH, and MN2. We have used cytotoxic T cell clones generated against these DR2 haplotypes to define the DR and DQ associated Dw/LD polymorphisms. Clones were categorized as DR, DQ, DP, or class I-directed based on monoclonal antibody (MoAb) inhibition studies. We analyzed the distribution of the determinants detected by these clones based on analysis with panels of cells. Some DR-directed clones only lysed cells positive for the Dw subtype of the sensitizing cell. A few DR-directed clones lysed most DR2 positive cells. Other DR-directed clones detected determinants shared by cells of different subtypes: determinants shared by Dw2 and Dw12 positive cells and determinants shared by MN2, FJO, AZH, and LD-5a positive cells. The majority of the DQ-directed clones only lysed cells positive for the sensitizing HLA-Dw subtype. A group of clones primed against an LD-5a HTC, whose cytolytic activity was not blocked by any monoclonal antibodies tested, lysed some, but not all, DR2 positive cells as well as Dw1 and Dw10 positive cells. The results suggest the detection of determinants on these molecules which may be shared by cells of specific Dw subgroups and determinants shared by most cells of the sensitizing serological specificity. The basis of this observed polymorphism and influence on the allogeneic response are discussed. PMID- 3316135 TI - Monomorphic anti-HLA monoclonal antibody (W6/32) recognizes polymorphic H-2 heavy chain determinants exposed by association with bovine or human but not murine beta 2-microglobulin. AB - W6/32 is a mouse anti-HLA class I monoclonal antibody (MoAb) of BALB/c (H-2d) origin with a monomorphic reaction pattern on human cells. In this study, we explain that the previously reported (Ivanyi D et al., Immunogenetics 20:6gg, 1984) cross-reactions of W6/32 with the H-2Db antigen are completely dependent on the formation of a complex between the H-2Db heavy chain with bovine beta 2 microglobulin (beta 2m) from the culture medium. M0Ab W6/32 cross-reacted with various H-2 class I antigens only in the presence of bovine or human beta 2m but not in the presence of beta 2m from other species (goat, sheep, rabbit) or syngeneic mouse beta 2m. The exposure of the W6/32 determinant on mouse cells was dependent on the concentration of human or bovine beta 2m and was influenced by the temperature and time of incubation. The reaction pattern of W6/32 on a large panel of mouse strains showed that the binding is due to at least two critical factors: (i) the H-2 haplotype of the target cells; and (ii) the substitution of murine beta 2m for bovine or human beta 2m. These results show that exposure of a polymorphic class I determinant is dependent on the species origin of beta 2m with which the heavy chain is complexed. Comparison of beta 2m amino acid sequences from various species does not give a clear answer about the shared quality of human and bovine beta 2m. One amino acid position (89) was identified at which human and bovine beta 2m are identical but differ from all other known beta 2m sequences. PMID- 3316136 TI - "Controlled" clinical trials in neutron therapy. PMID- 3316137 TI - Neutrons and other clinical trials: impossible dreams? PMID- 3316138 TI - Rocky Mountain spotted fever. PMID- 3316139 TI - Pregnancy diagnosis in swine: principles, applications, and accuracy of available techniques. PMID- 3316140 TI - Minimum inhibitory concentrations and postantimicrobial effects as factors in dosage of antimicrobial drugs. PMID- 3316141 TI - Ultrasonographic evaluation of renal parenchymal diseases in dogs: 32 cases (1981 1986). AB - The medical records of 32 dogs with microscopically proven renal parenchymal disease were evaluated to characterize the associated ultrasonographic patterns and to assess the contribution of ultrasonography to the diagnosis and management in each case. Ultrasonography provided additional information on internal renal architecture in 18 dogs with radiographic evidence of structural abnormality. Ultrasonography determined the renal origin of 2 abdominal masses, defined the extent and distribution of neoplastic disease in 6 dogs, and identified kidneys not seen on survey radiographs or excretory urograms in 5 dogs because of decreased abdominal contrast or poor function. The ultrasonographic patterns were most specific for focal and multifocal or diffuse neoplasia. Ultrasonographic findings were least specific for diffuse parenchymal disease without architectural disruption such as glomerulo/interstitial nephritis, renal tubular necrosis, and nephrocalcinosis. In these cases, biopsy was recommended. Six interpretive errors were made. Four of these errors were related to the overestimation of renal pelvic and diverticular size because of confusion with medullary papilla. Two errors occurred in the diagnosis of renal lymphosarcoma, one of which was interpreted to be pyelonephritis. The other was an interpretive dilemma because of absence of hypoechoic multifocal nodules. Renal tubular necrosis was confirmed in this case. PMID- 3316142 TI - Vaccination of borderline tuberculoid leprosy patients with BCG plus killed Mycobacterium leprae. PMID- 3316143 TI - The experimental inoculation with Mycobacterium leprae in the congenitally asplenic mouse. PMID- 3316144 TI - The nude mouse as an experimental lepromatous leprosy model (continued): the lepromatoid lesions in mystacial vibrissae located site of injection. PMID- 3316145 TI - The chemoprophylaxis of malaria. PMID- 3316146 TI - Transferable resistance to third-generation cephalosporins in clinical isolates of Klebsiella pneumoniae: identification of CTX-1, a novel beta-lactamase. AB - Approximately 10% (89 isolates) of Klebsiella pneumoniae isolated in 1985 from patients in intensive care units in Clermont-Ferrand exhibited a complex resistance phenotype towards antibiotics. They were resistant to amino-, carboxy- and ureidopenicillins, aminoglycosides (except gentamicin), chloramphenicol, sulphonamides, tetracyclines and, most importantly, to cephalosporins (except cefoxitin and latamoxef) and to aztreonam. The metabolic profile of fifty isolates was identical and seven were selected for further study. All the resistance characters in these isolates were transferable to Escherichia coli by conjugation and were lost en bloc after treatment with ethidium bromide. Agarose gel electrophoresis of crude lysates of the wild types and their transconjugants indicated that the multiple resistances were mediated by a 95kb plasmid, pCF04. The seven isolates selected for study and their corresponding transconjugants, constitutively produced a plasmid-mediated beta-lactamase with a pI of 6.3 that was much more active against third-generation cephalosporins than against cephalothin. The substrate profile and the isoelectric-focusing behaviour of this enzyme differed from those of other known plasmid-mediated beta-lactamases, and the enzyme was designated CTX-1. A chromosomally-encoded SHV-1 (PIT-2) penicillinase (pI 7.7) was also present in the seven K. pneumoniae isolates but did not transfer. Resistance to aminoglycosides in the K. pneumoniae isolates was due to synthesis of a 6'-aminoglycoside acetyltransferase type IV. Our data indicate an epidemic of antibiotic multiply-resistant strains of K. pneumoniae producing a new beta-lactamase. PMID- 3316147 TI - Resistance to erythromycin. PMID- 3316148 TI - Regulatory function of hydrogen ion on the direct lethal action of miconazole. PMID- 3316149 TI - The pharmacokinetics of fusidic acid. PMID- 3316150 TI - Absence of fungistatic antagonism between flucytosine and cytarabine in vitro and in vivo. AB - Determination of the MIC of flucytosine for 16 wild isolates of Cryptococcus neoformans and Candida spp. in YNBG medium containing 10 mg/l cytosine demonstrated antagonism of fungistatic activity compared with that determined in YNBG alone. Determination of the MIC in YNBG containing 10 mg/l cytarabine showed no change in activity for 14 of the strains, an increase for one and a decrease for another. Determination of serum flucytosine concentrations in a patient receiving cytarabine simultaneously revealed therapeutic levels. Fluctuations in serum flucytosine concentrations were observed in samples taken before, during and after concurrent cytarabine therapy but these may have resulted from unstable renal function rather than in-vivo inactivation of flucytosine by cytarabine. These data do not support significant antagonism of the fungistatic activity of flucytosine by cytarabine. PMID- 3316151 TI - Effect of beta-lactams and aminoglycosides on human polymorphonuclear leucocytes. AB - The effects of four beta-lactams (cefotaxime, cefoxitin, ceftazidime and latamoxef) and three aminoglycosides (amikacin, sisomicin and tobramycin) on human polymorphonuclear (PMN) leucocytes were examined. Chemotaxis was studied by agarose migration and in a Boyden chamber. Agarose migration of PMN leucocytes was not affected significantly by ceftazidime and latamoxef (25-200 mg/l). However cefoxitin (50-200 mg/l) decreased agarose migration to 52-65% of the control values, and cefotaxime (25-200 mg/l) reduced migration to 29-67% of control values. The Boyden chamber method showed no significant inhibition of chemotaxis by any of the antibiotics tested. None of these antibiotics affected phagocytosis or killing of Candida albicans by human PMNs. PMID- 3316152 TI - Norfloxacin versus placebo for prophylaxis against travellers' diarrhoea. AB - In a randomized, double blind study, 127 subjects travelling to countries outside Northern Europe were given norfloxacin 200 mg or placebo bid as prophylaxis against diarrhoea. Fifty-six subjects randomized to norfloxacin and 59 to placebo fulfilled criteria for evaluation of efficacy and of those, respectively six and 20 (P = 0.0006) developed diarrhoea. The mean duration of symptoms in the placebo group was 3.6 days, while all subjects on norfloxacin had symptoms for one day only. In travellers to Mediterranean Europe or the Canary Islands, no significant differences were seen between norfloxacin and placebo. Among subjects going to Africa, Asia or Latin America, 4/32 subjects on norfloxacin and 16/30 on placebo developed diarrhoea (P = 0.0004). Adverse effects were few and mild. Faeces for aerobic cultures was obtained before travelling and three weeks and then three months post-treatment. Treatment with norfloxacin resulted in a significant reduction of samples yielding aerobic Gram-negative rods but did not affect enterococci. In the placebo group, Gram-negative organisms other than Escherichia coli were increased on return to Sweden and the subjects frequently acquired Gram negative organisms resistant to antibiotics. In none of the groups was there a tendency towards increased norfloxacin resistance. Biotyping of E. coli showed that in both groups the subjects changed their E. coli strains frequently during and after travelling. This trial showed that norfloxacin is a safe and effective prophylactic agent with no adverse effect on bacterial flora, but that its use should be restricted to travellers to non-European countries. PMID- 3316153 TI - Klebsiella pneumoniae strains more resistant to ceftazidime than to other third generation cephalosporins. PMID- 3316154 TI - The pathogenesis of infective endocarditis. AB - Three aspects of our current understanding of the pathogenesis of infective endocarditis are reviewed: the size of the infected vegetation, host defence mechanisms and conditions which determine the outcome of experimental infection. Animal studies have been conducted with anticoagulants in which fatal infective endocarditis was produced without macroscopic evidence of endocardial vegetations. Detection of such lesions in man would change our perception of the epidemiology and clinical course of the disorder. It is probable that polymorphonuclear leucocytes are important in limiting the development of infected vegetations throughout the vascular system and, because of their ineffectiveness in the left side of the heart, are probably responsible for the preponderance of infections within that particular part of the circulation. Furthermore, polymorphonuclear leucocytes may also contribute to the pathogenesis of valve perforation. Finally, the size of the bacterial challenge, and the duration of catheterization of the heart to induce infection, have been shown to significantly influence the natural history of experimental infection and also the effectiveness of prophylactic antibiotics. Any comparison of the effectiveness of different prophylactic measures will require careful standardization of these conditions. It is difficult to determine the optimal size of the bacterial inoculum in animal studies since so little is known about this factor in man. Peripheral infections in animals may disseminate sufficient bacteria to produce endocardial infection and yet not be easily, if at all, detectable in the circulating blood. PMID- 3316155 TI - A dental view of controversies in the prophylaxis of infective endocarditis. AB - Dental care of patients at risk of endocarditis must reflect changes in dental disease prevalence and in patients' expectations. Simplified recommendations on antibiotic prophylaxis are being widely applied. PMID- 3316156 TI - Prevention of infective endocarditis: the view from the United States. AB - The American Heart Association's recommendations for the prevention of infective endocarditis were first published in February, 1955, and the most recent (fifth revision) in December, 1984. The somewhat controversial nature of these recommendations reflects several issues, including the degree to which infective endocarditis in man is preventable and the relative safety of alternative regimens. Nevertheless, it is apparent that a reasonable fraction of cases are preventable and that antibiotics for this purpose are appropriate. It is also clear that certain patient groups, i.e. those with prosthetic valves or surgically constructed systemic-pulmonary shunts, are at greatest risk and warrant more intensive, primarily parenteral antibiotic regimens. Particularly controversial are recommendations related to the very large group of patients with mitral valve prolapse. The latest American Heart Association recommendations are presented in detail. PMID- 3316157 TI - General principles of the treatment of infective endocarditis. AB - The early diagnosis of infective endocarditis is important so that effective antibiotic treatment may be started without delay. When this is achieved other treatment problems are minimised. Heart failure and rhythm changes are treated in the conventional way. The use of necessary surgery at any stage of the disease has greatly improved the prognosis. The timing of surgery is important and is best achieved by close consultation between cardiologist, microbiologist and surgeon. In general, any failure, either haemodynamic or microbiological, of the patient to make a good response will be an indication to consider surgery. PMID- 3316158 TI - Antimicrobial therapy of streptococcal endocarditis. AB - The majority of patients with endocarditis caused by viridans streptococci or Streptococcus bovis susceptible to less than or equal to 0.1 mg/l of penicillin may be treated successfully for two weeks with penicillin 20 X 10(6) million units intravenously together with streptomycin 7.5 mg/kg body weight intramuscularly twice daily or gentamicin 1 mg/kg body weight intravenously every 8 h. Patients with nutritionally variant viridans streptococcal endocarditis should be treated for four weeks with penicillin combined with an aminoglycoside in dosages as above, which will require adjustment when renal impairment is present. Patients with enterococcal endocarditis should be treated with penicillin together with an aminoglycoside in dosages as above for four to six weeks. Patient with enterococcal endocarditis with symptoms of infection less than three months in duration or with aortic valve endocarditis may be treated successfully for four weeks with antimicrobial therapy; patients with symptoms of infection longer than three months in duration or with mitral valve infection should receive six weeks of antimicrobial therapy. Patients with enterococcal endocarditis who relapse should be treated for six weeks of antimicrobial therapy. PMID- 3316159 TI - The treatment of staphylococcal endocarditis. AB - Staphylococcus aureus may attack normal or damaged native valves, or prosthetic valves, and has a predilection for the tricuspid valve in drug addicts. S. epidermidis most frequently attacks prosthetic valves, but occasionally damaged native valves. There have been few clinical trials of antibiotic regimens in staphylococcal endocarditis. It has a better prognosis in drug addicts than in non-addicts and addicts seldom require valve surgery. In non-addicts staphylococcal endocarditis can be a devastating infection with a significant mortality rate; emergency valve replacement may be required, sometimes early in the antibiotic course. Failure of medical treatment can occur whatever antibiotic regimen is given. Most strains of S. aureus are resistant to penicillin and sensitive to flucloxacillin which is the mainstay of treatment, given intravenously in large doses. Combination therapy is usual but, although it may achieve more rapid clearance of bacteraemia, has not been shown to affect morbidity or mortality. Penicillin should be used for sensitive strains and vancomycin for patients allergic to penicillins and staphylococci resistant to flucloxacillin. Whether rifampicin confers additional benefit to vancomycin is unproven. The optimum length of treatment for staphylococcal endocarditis is unknown but at least 4 weeks is suggested, possibly less in drug addicts. PMID- 3316160 TI - Prosthetic valve endocarditis. AB - About 2% of patients with a prosthetic valve will develop endocarditis. This may occur within a few weeks of the valve replacement operation (early) or many months or years later (late). The infecting organisms, pathogenicity and prognosis differ in the two groups. The incidence of early prosthetic valve endocarditis (PVE) is under 1%; the predominant organisms are staphylococci that are acquired in the operating theatre or in the intensive therapy unit. Early PVE usually follows wound sepsis that may initially appear trivial. The mortality rate is around 70%, but such infections should be preventable by stringent antisepsis, good surgical technique and (perhaps) perioperative antistaphylococcal antibiotics. The incidence of late PVE is about 1% per annum. The infecting organisms are similar to those causing native valve endocarditis, predominantly streptococci. The commonest source of these organisms is the mouth and regular dental care and appropriate prophylactic antibiotics should help to prevent infection. The mortality rate of late PVE is around 10%. Failure of medical treatment in PVE is an indication for surgery to remove the infected valve(s) and this should not be delayed. The optimum length of treatment for PVE is unknown but it is seldom necessary to give antibiotics for more than 6 weeks except in Coxiella burnetii infection. PMID- 3316161 TI - Treatment of prosthetic valve endocarditis. AB - Prevention of early prosthetic valve endocarditis (PVE) depends on rational perioperative antibiotics and early aggressive treatment of wound infections. Successful treatment depends on rapid recognition and treatment and valve re replacement in most instances. Late PVE caused by sensitive organisms can usually be cured by medical treatment provided paraprosthetic abscess formation has not caused valve dehiscence. PMID- 3316162 TI - The microbiological diagnosis of infective endocarditis. AB - Variables affecting the isolation of microorganisms causing endocarditis include the volume of blood cultured, the number of blood cultures obtained, prior antimicrobial therapy, the type of microorganism involved, and blood culture technique. Culture-negative infective endocarditis is most frequently associated with prior antimicrobial therapy and nonbacterial agents, such as fungi, chlamydiae, and rickettsiae. For the diagnosis of bacterial endocarditis, culture of two to three separately collected blood samples of at least 10 ml, and preferably 20 ml, each generally suffices; however, in cases who have recently received antibiotics it may be necessary to culture an additional two to three blood samples or to consider use of beta-lactamase, antimicrobial adsorbent resins, or lysis-concentration, the last of which is also the most effective method for recovering mycobacteria and fungi from blood. PMID- 3316163 TI - The role of the microbiology laboratory in the treatment of infective endocarditis. AB - The antibiotic era has greatly improved the prognosis for patients with infective endocarditis. The need for bactericidal activity against the infecting organism has created an additional role for the clinical microbiology laboratory. This role involves the selection and performance of the proper in-vitro susceptible tests in order to ensure bactericidal activity. However, there are problems in both the performance and the interpretation of bactericidal tests; these include persisters, the 'paradoxical effect', tolerance and the development of resistance. Technical factors include inoculum size, growth phase of the inoculum, insufficient contact between the test organism and the antimicrobial agent, and the volume of transfer for the count of survivors. Appreciation of these factors is important for the laboratory performing bactericidal tests, which include time-kill curves, minimal bactericidal concentrations and the serum bactericidal test. Of these tests, the serum bactericidal test offers the most logical approach. However, the performance of this test and the interpretation of the results has been controversial. Recent attempts at standardization should allow better utilization. In addition to the serum bactericidal test, the clinical microbiology laboratory can offer time-kill curves and minimal bactericidal activity and can offer serum assays of antibiotics to ensure adequate levels without toxicity. The use of any or all of these methods must be tempered by clinical judgement in each individual case. Application of the proper tests can assist in the optimal therapy of infective endocarditis. PMID- 3316164 TI - Aetiology and epidemiology of infective endocarditis in England and Wales. AB - Comparing data relating to the estimated incidence of infective endocarditis and deaths due to this condition highlights the changing age and sex patterns over the last 50 years. Using these data it is estimated that about 20 cases per million population per year can now be expected many of whom will be aged 65 years or more. About 20% of cases die. Viridans streptococci are responsible for almost half the cases of endocarditis, faecal streptococci for 11%, staphylococci for 20% and Coxiella burnetii for 2-3%. The laboratory data for 1976-85 showed that 86 of 821 (10.5%) patients with Staphylococcus aureus endocarditis had valve prostheses and 55 (6.7%) were iv-drug abusers. Of the patients with endocarditis due to coagulase-negative staphylococci 100 of 361 (27.7%) had prostheses. PMID- 3316165 TI - Therapy of streptococcal endocarditis: correlation of animal model and clinical studies. AB - Streptococci (viridans group, Streptococcus bovis, enterococci still account for the majority of cases of infective endocarditis in the non-addict population. Experimental animal models of endocarditis have been used (primarily in rabbits) to delineate the major therapeutic principles of this disease; viz. bactericidal antimicrobial agents must be given parenterally in high dosages for prolonged period of time. Overall, there is a good correlation between results obtained by: (1) in-vitro susceptibility testing (especially killing kinetics in broth); (2) therapeutic comparisons in experimental animal models and (3) clinical trials of different antimicrobial regimens in humans with streptococcal endocarditis. This review contrasts the published results obtained in vivo with experimental animal models to those obtained with various therapeutic approaches to streptococcal endocarditis in humans. The contribution of animal models to current therapeutic recommendations in man is underscored. PMID- 3316166 TI - Relevance of animal models to the prophylaxis of infective endocarditis. AB - Intravascular or cardiac endothelial lesions may become colonized during bacteraemic episodes and lead to the development of bacterial endocarditis (BE). It has therefore long been recommended that patients with known cardiac lesions receive prophylactic antibiotics before undergoing procedures that might release bacteria into the blood stream. Because clinical trials of antibiotic prophylaxis of endocarditis cannot be conducted in humans for ethical as well as for statistical reasons (Durack, 1985), the questions of which antibiotic, what dosage, and for how long are a matter of controversy. Unfortunately, these questions can only be studied in animals, with all the limitations that this type of approach brings with it. However, animal experimental studies have helped in understanding the conditions and, to some extent, the mode of action of antibiotics in preventing the development of endocardial infection, thus allowing some rationale for devising prophylactic recommendations for the various patients at risk of developing BE. PMID- 3316167 TI - Controversies in the prophylaxis of infective endocarditis: a cardiological view. AB - Antibiotic prophylaxis is logical but it is impossible to prove its efficacy. Most cases of infective endocarditis follow seemingly 'spontaneous' bacteraemias and cases of seemingly 'failed' prophylaxis may have done the same, the prophylaxis having been 'successful' for the occasion for which it was given. We cannot find out how many cases of infective endocarditis would have occurred but for successful prophylaxis. PMID- 3316168 TI - Effects of exercise, relaxation, and management skills training on physiological stress indicators: a field experiment. PMID- 3316169 TI - History of the Food and Drug Administration's total diet study--1961 to 1987. AB - The Total Diet Study provides the Food and Drug Administration with baseline information on the levels of pesticide residues, contaminants, and nutrient elements in the food supply and in the diets of specific age-sex groups. The study also identifies trends and changes in the levels of these substances in the food supply and in diets over time and thereby assists in identifying potential public health problems. This paper describes the evolution of the Total Diet Study from 1961 to 1987. Food collections, sites of analysis, diets, food commodity groups, analytes, analytical methodologies, data transfer, publication of results, notable results, resources, and advantages of the study are discussed. PMID- 3316170 TI - Evaluation of AOAC microbial diffusion procedure for analysis of chlortetracycline in high mineral feeds. AB - The performance of the AOAC microbial diffusion assay procedure for the analysis of chlortetracycline was evaluated in mixed feeds and premixes as well as laboratory-prepared feeds, all with various mineral contents. In 100 mixed feeds with a calcium content ranging from less than 1 to greater than 22%, no relationship was shown between calcium content and incidence of chlortetracycline deficiency. In 106 premixes, a relationship was shown between chlortetracycline content and adherence to guarantee: below 10 g/lb, the incidence of deficiency was high; in premixes containing 20 g chlortetracycline and above, the incidences of deficiency were less than 5%. In laboratory-prepared feeds containing 12-15% calcium, grinding and storage at both 4 degrees C and at room temperature (20 degrees C) caused no decrease in the chlortetracycline concentration. Only storage of the ground feed at 37 degrees C caused a distinct loss of activity. The temperature-related loss was attributed to the epimerization of chlortetracycline. PMID- 3316171 TI - Biological photographic collections: the National Library of Medicine prints and photographs collection. PMID- 3316173 TI - [Pelvic echography in Turner's syndrome]. PMID- 3316174 TI - [Value of echography in the systematic detection of cholelithiasis of the gallbladder in children with hemoglobinopathy]. PMID- 3316172 TI - Fenfluramine treatment of autism: relationship of treatment response to blood levels of fenfluramine and norfenfluramine. AB - Nine children meeting DSM-III criteria for infantile autism were treated with fenfluramine hydrochloride or inactive placebo in a double-blind crossover trial that followed the protocol for the fenfluramine multicenter study. Parents of the two children who had had the highest fenfluramine blood levels wished to have their children continue on fenfluramine, although the improvement they saw could not be demonstrated on the various rating instruments employed. The results of the study, while providing minimal support in themselves for the effectiveness of fenfluramine, do raise the possibility that fenfluramine blood levels might be related to treatment response. PMID- 3316175 TI - [Evaluation of arterial substitution in carotid artery stenosis by global suprasigmoid digital angiography. Predictive value in carotid surgery]. PMID- 3316177 TI - Sonographic assessment of transient synovitis of the hip. PMID- 3316176 TI - [Treatment of a case of parietal hydatid cyst by puncture]. PMID- 3316178 TI - A case of aneurysmal arterial lusoria. CT and angiographic studies. PMID- 3316179 TI - Sequence information required for protein translocation from the cytoplasm. PMID- 3316181 TI - Increased expression in Escherichia coli of a synthetic gene encoding human somatomedin C after gene duplication and fusion. AB - A synthetic gene coding for human somatomedin C (SMC) was inserted into an Escherichia coli plasmid vector that contains the bacteriophage lambda pL promoter. Intracellular accumulation of the gene product after induction of the promoter was found to be low. A 200-fold greater yield was obtained with a similar plasmid containing two translationally fused copies of the SMC gene. A series of such tandem genes truncated at their 3' ends were generated with nuclease Bal 31. These gave intermediate expression levels that correlated with the expected sizes of their gene products. Comparison of RNAs extracted from cells containing either the monomer or tandem SMC gene constructions showed that there was no significant difference in expression at the transcriptional level. Pulse-chase experiments demonstrated that the tandem SMC protein was far more stable than the monomer SMC product. PMID- 3316180 TI - Cloning and promoter identification of the iron-regulated cir gene of Escherichia coli. AB - The cir gene, which encodes the colicin I receptor protein and is regulated by both cellular iron content and growth temperature, was cloned into a multicopy number plasmid. Physical mapping and complementation analysis established the position of cir between mgl and nfo on the Escherichia coli chromosome. A gene encoding a 32,000-dalton polypeptide was located downstream of and adjacent to cir, but did not appear to be part of the same transcriptional unit. A 525-base pair fragment from the 5' end of the 1.8-kilobase-pair receptor-coding region directed iron-regulated transcription and translation of a hybrid cir-lacZ gene. Two overlapping promoters were identified by determination of the transcriptional start sites and by sequence analysis. A small open reading frame (120 nucleotides) of unknown significance preceded the receptor-coding sequence. Examination of the amino acid sequence of the receptor purified from the outer membrane revealed that the gene product was processed by removal of a signal peptide and that the mature form had an amino acid sequence near its amino terminus which closely resembled that of several other TonB-dependent proteins. PMID- 3316182 TI - Rhizobium meliloti nifN (fixF) gene is part of an operon regulated by a nifA dependent promoter and codes for a polypeptide homologous to the nifK gene product. AB - An essential gene for symbiotic nitrogen fixation (fixF) is located near the common nodulation region of Rhizobium meliloti. A DNA fragment carrying fixF was characterized by hybridization with Klebsiella pneumoniae nif DNA and by nucleotide sequence analysis. The fixF gene was found to be related to K. pneumoniae nifN and was therefore renamed as the R. meliloti nifN gene. Upstream of the nifN coding region a second open reading frame was identified coding for a putative polypeptide of 110 amino acids (ORF110). By fragment-specific Tn5 mutagenesis it was shown that the nifN gene and ORF110 form an operon. The control region of this operon contains a nif promoter and also the putative nifA binding sequence. For the deduced amino acid sequence of the nifN gene product a striking homology to the R. meliloti nifK protein was found. One cysteine residue and its adjacent amino acid sequence, which are highly conserved in the R. meliloti nifK, R. meliloti nifN, and K. pneumoniae nifN proteins, may play a role in binding the FeMo cofactor. PMID- 3316183 TI - Cloning and sequencing of the genes encoding the large and small subunits of the periplasmic (NiFeSe) hydrogenase of Desulfovibrio baculatus. AB - The genes coding for the large and small subunits of the periplasmic hydrogenase from Desulfovibrio baculatus have been cloned and sequenced. The genes are arranged in an operon with the small subunit gene preceding the large subunit gene. The small subunit gene codes for a 32 amino acid leader sequence supporting the periplasmic localization of the protein, however no ferredoxin-like or other characteristic iron-sulfur coordination sites were observed. The periplasmic hydrogenases from D. baculatus (an NiFeSe protein) and D. vulgaris (an Fe protein) exhibit no homology suggesting that they are structurally different, unrelated entities. PMID- 3316184 TI - Nucleotide sequence of the iap gene, responsible for alkaline phosphatase isozyme conversion in Escherichia coli, and identification of the gene product. AB - The iap gene in Escherichia coli is responsible for the isozyme conversion of alkaline phosphatase. We analyzed the 1,664-nucleotide sequence of a chromosomal DNA segment that contained the iap gene and its flanking regions. The predicted iap product contained 345 amino acids with an estimated molecular weight of 37,919. The 24-amino-acid sequence at the amino terminus showed features characteristic of a signal peptide. Two proteins of different sizes were identified by the maxicell method, one corresponding to the Iap protein and the other corresponding to the processed product without the signal peptide. Neither the isozyme-converting activity nor labeled Iap proteins were detected in the osmotic-shock fluid of cells carrying a multicopy iap plasmid. The Iap protein seems to be associated with the membrane. PMID- 3316185 TI - Distribution of newly synthesized lipoprotein over the outer membrane and the peptidoglycan sacculus of an Escherichia coli lac-lpp strain. AB - The insertion of newly synthesized lipoprotein molecules into the cell wall of Escherichia coli was studied topographically by immunoelectron microscopy. Lipoprotein was briefly induced with isopropyl-beta-D-thiogalactopyranoside in cells carrying lac-lpp on a low-copy-number plasmid in an E. coli lpp host. Specific antibodies bound to the newly inserted lipoprotein molecules, which were exposed at the cell surface after treatment of the cells with Tris-EDTA, were detected with a protein A-gold probe. The average distribution of the gold particles over the cell surface of noninduced cells was determined for cells induced for 5 and 10 min. Analysis of 250 to 350 cells showed that the distribution of newly synthesized lipoprotein over the cell surface was homogeneous in both cases. The binding of lipoprotein to the peptidoglycan layer was studied by the same technique, and visual inspection again revealed a homogeneous distribution of bound lipoprotein over the entire sacculus surface. It is therefore concluded that free lipoprotein is inserted equally over the entire cell wall of E. coli, while binding to peptidoglycan also occurs over the entire cell surface. The rate of lipoprotein synthesis increased with cell length in nondividing cells, whereas it was constant in cells which had initiated constriction. Analysis of cells having different amounts of lipoprotein in their cell wall revealed that the cell shape depended on the total lipoprotein content of the cell. Cells having no or only a small amount of lipoprotein grew as spheres, whereas cells with increasing numbers of lipoprotein molecules gradually changed their shape to short rods. PMID- 3316186 TI - Sulfur metabolism in Beggiatoa alba. AB - The metabolism of sulfide, sulfur, and acetate by Beggiatoa alba was investigated under oxic and anoxic conditions. B. alba oxidized acetate to carbon dioxide with the stoichiometric reduction of oxygen to water. In vivo acetate oxidation was suppressed by sulfide and by several classic respiratory inhibitors, including dibromothymoquinone, an inhibitor specific for ubiquinones. B. alba also carried out an oxygen-dependent conversion of sulfide to sulfur, a reaction that was inhibited by several electron transport inhibitors but not by dibromothymoquinone, indicating that the electrons released from sulfide oxidation were shuttled to oxygen without the involvement of ubiquinones. Intracellular sulfur stored by B. alba was not oxidized to sulfate or converted to an external soluble form under aerobic conditions. On the other hand, sulfur stored by filaments of Thiothrix nivea was oxidized to extracellular soluble oxidation products, including sulfate. Sulfur stored by filaments of B. alba, however, was reduced to sulfide under short-term anoxic conditions. This anaerobic reduction of sulfur was linked to the endogenous oxidation of stored carbon and to hydrogen oxidation. PMID- 3316187 TI - Unique phenotype of opaque cells in the white-opaque transition of Candida albicans. AB - Select strains of Candida albicans switch reversibly and at extremely high frequency between a white and an opaque colony-forming phenotype, which has been referred to as the white-opaque transition. Cells in the white phase exhibit a cellular phenotype indistinguishable from that of most standard strains of C. albicans, but cells in the opaque phase exhibit an unusually large, elongate cellular shape. In comparing the white and opaque cellular phenotypes, the following findings are demonstrated. (i) The surface of the cell wall of maturing opaque cells when viewed by scanning electron microscopy exhibits a unique pimpled, or punctate, pattern not observed in white cells or standard strains of C. albicans. (ii) The dynamics of actin localization which accompanies opaque cell growth first follows the pattern of budding cells during early opaque-bud growth and then the pattern of hypha-forming cells during late opaque-bud growth. (iii) A hypha-specific cell surface antigen is also expressed on the surface of opaque budding cells. (iv) An opaque-specific surface antigen is distributed in a punctate pattern. PMID- 3316189 TI - Production of heat shock protein is independent of cell cycle blockage in the yeast Saccharomyces cerevisiae. AB - In response to certain environmental stresses, cells display a response characterized by the production of heat shock proteins. In this study we showed that blockage of cells of the yeast Saccharomyces cerevisiae at specific points in the mitotic cell cycle was not in itself a stress that induced the production of heat shock proteins. Nevertheless, cell cycle blockage did not preclude a normal heat shock response in arrested cells subjected to elevated temperatures. PMID- 3316188 TI - Catabolic enzymes of the acetogen Butyribacterium methylotrophicum grown on single-carbon substrates. AB - When grown on formate, formate-CO, and methanol-CO, Butyribacterium methylotrophicum contained high levels of tetrahydrofolate (H4folate) and required enzymes, carbon monoxide dehydrogenase, formate dehydrogenase, and hydrogenase. The activities of methylene-H4folate reductase were comparable to other H4 folate activities (which ranged from 0.55 to 9.28 mumol/min per mg of protein) when measured by an improved procedure. The H4folate activities in formate-grown cells were twice those found in formate-CO-grown cells. This result correlated with a growth yield on formate that was one-half that on formate-CO. The stoichiometry of the formyl-H4folate synthetase reaction was 1 mol of ATP per 1 mol of formate. The methylene-H4folate dehydrogenase was NAD+ dependent. We conclude that B. methylotrophicum utilizes these enzymes in homoacetogenic catabolism. PMID- 3316190 TI - Method for localization of cloned DNA fragments on the Escherichia coli chromosome. AB - In exponentially growing cultures of Escherichia coli strains carrying the dnaC28 mutation, DNA replication can be synchronized by temperature changes (R. L. Rodriguez, M. S. Dalbey, and C. I. Davern, J. Mol. Biol. 74:599-604, 1973). We used this synchronization procedure and DNA-DNA hybridization to develop a technique for the localization of cloned chromosomal fragments on the genetic map. Because of the bidirectional nature of replication in E. coli, our method gave two possible positions (one on each replication arm). However because of the precision obtained for each position (+/- 1 map unit), the final mapping with various genetic techniques was greatly facilitated. Using this technique and a simple chromosomal mobilization test, we located at 93.2 +/- 1 min a cloned DNA fragment carrying an extragenic suppressor of dnaA46, a thermosensitive mutation in the dnaA initiation gene. Further analysis showed that the groES (mopA) and groEL (mopB) genes, both located at 94.2 min on the standard map, were indeed carried by the cloned suppressor fragment. PMID- 3316191 TI - Genes encoding two lipoproteins in the leuS-dacA region of the Escherichia coli chromosome. AB - The coding of two rare lipoproteins by two genes, rlpA and rlpB, located in the leuS-dacA region (15 min) on the Escherichia coli chromosome was demonstrated by expression of subcloned genes in a maxicell system. The formation of these two proteins was inhibited by globomycin, which is an inhibitor of the signal peptidase for the known lipoproteins of E. coli. In each case, this inhibition was accompanied by formation of a new protein, which showed a slightly lower mobility on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and which we suppose to be a prolipoprotein with an N-terminal signal peptide sequence similar to those of the bacterial major lipoproteins and lysis proteins of some bacteriocins. The incorporation of 3H-labeled palmitate and glycerol into the two lipoproteins was also observed. Sequencing of DNA showed that the two lipoprotein genes contained sequences that could code for signal peptide sequences of 17 amino acids (rlpA lipoprotein) and 18 amino acids (rlpB lipoprotein). The deduced sequences of the mature peptides consisted of 345 amino acids (Mr 35,614, rlpA lipoprotein) and 175 amino acids (Mr 19,445, rlpB lipoprotein), with an N terminal cysteine to which thioglyceride and N-fatty acyl residues may be attached. These two lipoproteins may be important in duplication of the cells. PMID- 3316193 TI - In vivo cell division gene product interactions in Escherichia coli K-12. AB - Overexpression of plasmid-coded PBP 3 was analyzed in strains harboring ftsA, ftsH, pbpB (ftsI), ftsQ, ftsZ, or recA441 (Tif) mutations. Higher cellular levels of PBP 3, the pbpB gene product, could not restore septum formation of ftsA, ftsQ, ftsZ, and recA (Tif) mutants at 42 degrees C. However, filamentation in strains harboring pbpB and ftsH mutations was fully suppressed by PBP 3 overexpression. Additional observations indicated that the Y16 (ftsH) strain, not transformed with the PBP 3-overproducing plasmid, had no detectable PBP 3 in envelopes after incubation at the restrictive temperature. These results suggest that suppression of filamentation of fts strains overexpressing wild-type cell division proteins after the shift to the restrictive temperature can be a useful strategy to demonstrate in vivo interactions of cell division gene products. PMID- 3316194 TI - Requirement of a heat-labile factor(s) for in vitro expression of the amp gene of pBR322. AB - The amp gene of pBR328 and pBR322 was expressed less efficiently at 45 than at 30 degrees C in an in vitro coupled transcription-translation system of Escherichia coli. Preincubation of S30 extract at 45 degrees C reduced specifically its ability to express the amp gene at 30 degrees C, indicating inactivation of a factor(s) required for efficient expression of the amp gene. PMID- 3316195 TI - Use of autologous pregnancy plasma to treat a flare of juvenile rheumatoid arthritis: case report and literature review. AB - A patient with juvenile rheumatoid arthritis whose disease was in remission during pregnancy underwent third-trimester plasmaphereses. The stored plasma was returned to her 1 year postpartum, when the disease flared, without beneficial results. The literature on the use of blood products in rheumatoid arthritis and pregnancy is reviewed. PMID- 3316192 TI - Sequence analysis of the Escherichia coli dnaE gene. AB - We have determined the sequence of a 4,350-nucleotide region of the Escherichia coli chromosome that contains dnaE, the structural gene for the alpha subunit of DNA polymerase III holoenzyme. The dnaE gene appeared to be part of an operon containing at least three other genes: 5'-lpxB-ORF23-dnaE-ORF37-3' (ORF, open reading frame). The lpxB gene encodes lipid A disaccharide synthase, an enzyme essential for cell growth and division (M. Nishijima, C.E. Bulawa, and C.R.H. Raetz, J. Bacteriol. 145:113-121, 1981). The termination codons of lpxB and ORF23 overlapped the initiation codons of ORF23 and dnaE, respectively, suggesting translational coupling. No rho-independent transcription termination sequences were observed. A potential internal transcriptional promoter was found preceding dnaE. Deletion of the -35 region of this promoter abolished dnaE expression in plasmids lacking additional upstream sequences. From the deduced amino acid sequence, alpha had a molecular weight of 129,920 and an isoelectric point of 4.93 for the denatured protein. ORF23 encoded a more basic protein (pI 7.11) with a molecular weight of 23,228. In the accompanying paper (D.N. Crowell, W.S. Reznikoff, and C.R.H. Raetz, J. Bacteriol. 169:5727-5734, 1987), the sequence of the upstream region that contains lpxA and lpxB is reported. PMID- 3316196 TI - Fluoride varnishes--a review. AB - Fluoride varnishes were developed as alternatives to the conventional topical applications, mainly to prolong contact time between fluoride and teeth. Two marketed products, Duraphat and Fluor Protector, have been extensively tested and are generally accepted for clinical use. In this overview of fluoride varnishes the state of the art of both products is presented. Fluoride uptake, demineralization inhibition and caries prevention induced by varnish applications are discussed. In general it is concluded that varnishes are toxicologically safe, easy to use, and possess excellent cariostatic properties. When re-applied regularly, twice a year, and combined with normal oral hygiene procedures they are topical fluoride agents with very good caries preventive properties. PMID- 3316197 TI - Monoclonal antibodies against mouse molar papilla: preliminary indirect immunofluorescence. AB - A variety of monoclonal antibodies have been produced against native dental papilla and used to stain frozen sections. Five different staining patterns corresponding to unidentified antigens were documented. The suitability of monoclonal antibodies for probing dental cell lineages is discussed. PMID- 3316198 TI - Defective internalization of insulin and its receptor in cells expressing mutated insulin receptors lacking kinase activity. AB - The internalization and degradation of insulin was assessed in Chinese hamster ovary cell lines expressing either the wild-type receptor or mutated receptors lacking kinase activity. The mutated receptors included receptors which differed from the wild-type receptor by a single amino acid (substitution of an arginine for lysine at position 1030, a site critical for ATP binding) as well as receptors which had a deletion of 112 amino acids at the carboxyl terminus. Cells expressing mutated receptors lacking kinase activity were found to internalize and degrade insulin at about half the rate of cells expressing wild-type receptors with kinase activity. Moreover, insulin was found incapable of inducing the internalization of the mutated receptors, whereas it could stimulate the internalization of the wild-type receptor. Finally, the constitutive rate of receptor internalization was found to be the same for the mutant and wild-type receptors. These results implicate the intrinsic tyrosine-specific kinase activity of the insulin receptor in the ligand-induced, but not the constitutive, internalization of this receptor. PMID- 3316199 TI - Purification of the yeast PHR1 photolyase from an Escherichia coli overproducing strain and characterization of the intrinsic chromophores of the enzyme. AB - We have placed the PHR1 gene of Saccharomyces cerevisiae under the transcriptional and translational control of the tac expression cartridge. Under inducing conditions Escherichia coli cells harboring plasmids carrying this construct accumulate approximately 8% of total cellular protein as the Phr1 photolyase. Using a strain devoid of E. coli photolyase activity, we have obtained milligram quantities of the yeast enzyme at greater than 95% purity and have characterized the enzyme. Phr1 photolyase is a monomer in solution with an Mr of 60,000, has a turnover number of 0.7 dimers min-1 molecule-1 in vitro, exhibits absorbance maxima at lambda = 277 and 377 nm, and has a fluorescence excitation maximum at 390 nm and an emission maximum at 475 nm. The near UV absorbance peak is shown to reflect the contributions of two intrinsic chromophores which are noncovalently bound to the enzyme. Spectroscopic, fluorescence, and thin layer chromatographic studies indicate that one of these chromophores is 1,5-reduced FAD rather than 4a,5-reduced FAD as previously proposed (Iwatsuki, N., Joe, C. O., and Werbin, H. (1980) Biochemistry 19, 1172 1176), while the other chromophore has properties similar to the second chromophore of E. coli photolyase. The fact that yeast and E. coli photolyases are similar both with respect to amino acid sequence and chromophore composition provides strong evidence that the enzymes share a common action mechanism which may also be utilized by photolyases from other organisms throughout the phylogenetic tree. PMID- 3316200 TI - Immunoprecipitation of the simian virus 40 late transcription complex with antibody against T-antigen. AB - Tumor antigen (T-antigen) of simian virus 40 (SV40) has been shown to have a number of regulatory roles in both viral replication and early viral transcription. However, the nature of its role on late viral transcription remains unclear. We have analyzed for the presence of T-antigen on SV40 late viral transcription complexes which exhibit RNA polymerase II extension activity in vitro. Nuclear extract or glycerol gradient-isolated transcription complexes were treated with either polyclonal or monoclonal antibodies, and the amount of extension activity that could be immunoprecipitated was determined. Anti-T antibody derived from hamster ascites as well as the anti-T monoclonal antibodies PAb 102, 109, 416, and 419 all precipitated 12-29% of viral transcription complex activity. Immunoprecipitation resulted in significant enrichment of transcription complex activity relative to bulk minichromosomes, indicating a preferential association of T-antigen with the late viral transcription complex. This is the first direct demonstration of the presence of T-antigen on the SV40 late transcription complex. Furthermore, the immunoprecipitated transcription complexes exhibited a salt dependence of their in vitro extension activity which was distinct from that of the total complex population, indicating that T-antigen is present on a specific subclass of transcription complexes. PMID- 3316201 TI - The regulatory protein GAL80 is a determinant of the chromatin structure of the yeast GAL1-10 control region. AB - Chromatin in the regions between the upstream activator sequence and the 5' ends of the yeast GAL1 and GAL10 genes has been analyzed by DNase I chromosomal footprinting and micrococcal nuclease digestion using the indirect end-labeling approach. Comparison of wild type chromatin digests to naked DNA digests shows that there are specific regions of these upstream sequences which are strongly protected in chromatin. Comparison to chromatin digests from cells disrupted for the positive regulatory gene, GAL4, or the negative regulatory gene, GAL80, and thus lacking GAL4 or GAL80 function, shows that these regions of protection in wild type chromatin are GAL80-dependent but not GAL4-dependent. The protected regions include DNA lying on (GAL10) or near (GAL1) the respective TATA boxes. These protections are present in both noninduced and induced cells. Both DNA strands are equally protected. Upstream of GAL1 there is a second protected region. This protection shows considerable expression and strand dependence. These observations provide the first evidence that the GAL80 function influences chromatin structure and suggest possible mechanisms by which GAL80 modulates the GAL1 and 10 promoters in induced cells. Micrococcal nuclease digests also suggest a role for GAL80 in a distinctive higher order organization of the intergenic region, perhaps involving multiprotein complexes. PMID- 3316202 TI - Glucagon gene 5'-flanking sequences promote islet cell-specific gene transcription. AB - Glucagon, a peptide hormone which regulates hepatic carbohydrate metabolism, is processed from a larger precursor, proglucagon. The gene encoding proglucagon is expressed at high levels in the A cells of the pancreatic islets and the L cells of the intestine, indicating that specific factors present in these two phenotypically distinct cells direct cell-specific expression. To characterize the factors that mediate glucagon gene transcription, we analyzed the 5'-flanking region of the rat glucagon gene for the existence of cis-acting sequences that promote glucagon gene transcription. A series of fusion genes containing sequentially shortened 5'-flanking sequences of the rat glucagon gene were constructed and fused to the coding sequence of the reporter enzyme chloramphenicol acetyltransferase. Analyses of the transcription of these fusion genes after their transfection into choriocarcinoma cells, fibroblasts, and islet cell lines of different phenotypes indicate that cis-acting DNA elements promote glucagon gene transcription only in islet cell lines. Transcriptional activity was much higher in glucagon compared to insulin-producing islet cell lines with fusion genes containing 249 or more base pairs of glucagon 5'-flanking sequence. Deletion of DNA sequences upstream of -168 abolished the preferential expression in glucagon-producing cell lines, however glucagon-chloramphenicol acetyltransferase fusion genes containing 168 base pairs or more of 5'-flanking sequence remained transcriptionally active, but only in islet cell lines. Fusion genes containing 115 base pairs of glucagon gene 5'-flanking sequences were transcriptionally inactive. These studies indicate that cis-acting DNA sequences present in the 5'-flanking region of the rat glucagon gene mediate islet cell specific gene transcription. PMID- 3316203 TI - Protein 4.1 in sickle erythrocytes. Evidence for oxidative damage. AB - Sickle erythrocytes are known to undergo excessive auto-oxidation, resulting in the generation of increased intracellular levels of several species of free radical oxidants. This environment is likely to enhance the accumulation of oxidative lesions by membrane components, although, as yet, this has been shown directly only for the sickle membrane phospholipids. We examined the oxidative status of protein 4.1, a major component of the human erythrocyte protein skeleton. We found that protein 4.1 isolated from sickle erythrocytes bound approximately 4-fold less to protein 4.1-stripped membranes than did the normal protein. The binding defect was inherent in the sickle protein and not in its membrane-binding site(s) since normal protein 4.1 bound to sickle protein 4.1 stripped inside-out vesicles similar to normal protein 4.1-stripped inside-out vesicles. Sickle membranes, in particular spectrin-depleted inside-out vesicles, contained less protein 4.1 than normal membranes. Purified sickle protein 4.1 contained 20-40% high molecular weight aggregated protein (Mr greater than 200,000), whereas the purified normal protein contained approximately 10% high molecular weight protein. The high molecular weight protein was immunoreactive with antibodies to protein 4.1 but not with antibodies to spectrin, ankyrin, band 3, glycophorin, or hemoglobin, suggesting that the high molecular weight protein was cross-linked protein 4.1 and not a complex of protein 4.1 and some other membrane protein(s). Purified sickle protein 4.1 was eluted from an anion exchange resin at a higher salt concentration than normal protein 4.1. Oxidizing normal protein 4.1 with diamide resulted in an anion-exchange elution pattern similar to the sickle protein, suggesting that oxidation can affect protein surface charge. Activated thiol beads bound one-half as much sickle protein 4.1 as normal protein 4.1 when both were solubilized directly from membranes, demonstrating that thiol oxidation had occurred in vivo. Direct quantification of protein thiols revealed that the sickle protein contained 1-2 mol% fewer cysteines/protein 4.1 monomer than did the normal protein. By amino acid analysis, sickle protein 4.1 was found to contain less methionine and tyrosine than did the normal protein and contained approximately 1 mol% cysteic acid, whereas the normal protein did not contain any cysteic acid. Taken together, our results strongly suggest that sickle protein 4.1 has sustained oxidative damage in vivo. This damage can alter the functional properties of the sickle protein and may be an underlying factor in the myriad of membrane abnormalities reported in sickle erythrocytes. PMID- 3316204 TI - Malarial parasite hexokinase and hexokinase-dependent glutathione reduction in the Plasmodium falciparum-infected human erythrocyte. AB - The metabolism of glucose in Plasmodium falciparum-infected human erythrocytes is increased 50- to 100-fold. This is accomplished in part by parasite-directed synthesis of a protozoan hexokinase with unique kinetic, electrophoretic, and heat stability properties. The total hexokinase activity is increased approximately 25-fold over that of control uninfected erythrocytes of the same age from the same donor. The parasite hexokinase has a lower affinity for glucose than the mammalian enzyme (Km = 431 microM +/- 21 S.D. for the parasite enzyme versus 98 microM +/- 10 for the erythrocyte enzyme), but the Km for ATP and the Vmax for both glucose and ATP are similar. The NADPH-dependent reduction of oxidized glutathione (GSSG) requires the formation of glucose 6-phosphate which in turn is metabolized by the pentose shunt pathway in which NADPH is generated. Using glucose as the substrate, lysates of P. falciparum-infected normal erythrocytes demonstrated enhanced ability to reduce GSSG. The rate of GSSG reduction was proportional both to the parasitemia and the hexokinase activity of the lysates. However, infected glucose-6-phosphate dehydrogenase-deficient red cell lysates displayed a severely restricted ability to reduce GSSG under the same conditions. In conclusion, P. falciparum-infected red cells contain a parasite-encoded hexokinase with unique properties which initiates the large increase in glucose consumption. In normal infected red cells, reduction of GSSG is also dependent upon hexokinase activity, but in infected glucose-6-phosphate dehydrogenase-deficient red cells, the absence of this pentose shunt enzyme remains the rate-limiting step in GSSG reduction. PMID- 3316205 TI - The D-glucose transporter is tissue-specific. Skeletal muscle and adipose tissue have a unique form of glucose transporter. AB - Using isotopic equilibration with [3H]D-glucose and measurement of D-glucose inhibitable cytochalasin B binding, I show that the erythrocytes of embryonic and newborn rats contain D-glucose transporters. On the basis of cytochalasin B binding and the time course of isotopic exchange, the number of transporters in rat embryonic erythrocytes is only 5% of that in human erythrocytes. Antibodies raised against the human erythrocyte glucose transporter were used as a probe to investigate the structural similarity between transporters. On this basis, the polypeptides of the glucose transporter of human erythrocytes and of embryonic rat erythrocytes are similar but not identical; in addition, certain antibodies showed similar reactivity toward the transporter of rat embryonic erythrocytes and that of rat brain. These antibodies, however, react with brain transporters 5 to 10 times better than with those of skeletal muscle and adipocytes suggesting that insulin responsive tissues may have a different type of glucose transporter. The cellular location of glucose transporters in skeletal muscle, determined by immunofluorescence, is on the plasma membrane or very close to the plasma membrane. PMID- 3316206 TI - Assembly of collagen fibrils de novo by cleavage of the type I pC-collagen with procollagen C-proteinase. Assay of critical concentration demonstrates that collagen self-assembly is a classical example of an entropy-driven process. AB - Type I procollagen was purified from the medium of cultured human fibroblasts incubated with 14C-labeled amino acids, the NH2-terminal propeptides were cleaved with procollagen N-proteinase, and the resulting pC-collagen was isolated by gel filtration chromatography. pC-collagen did not assemble into fibrils or large aggregates even at concentrations of 0.5 mg.ml-1 at 34 degrees C in a physiological buffer. However, cleavage of pC-collagen to collagen with purified C-proteinase (Hojima, Y., (1985) J. Biol. Chem. 260, 15996-16003) generated fibrils that were visible by eye and that were large enough to be separated from solution by centrifugation at 13,000 x g for 4 min. With high concentrations of enzyme, the pC-collagen was completely cleaved in 1 h, and turbidity was near maximal in 3 h, but collagen continued to be incorporated in fibrils for over 10 h. Because the pC-collagen was uniformly labeled with 14C-aminoacids, the concentration of soluble collagen and, therefore, the critical concentration of polymerization were determined directly. The critical concentration was independent of the initial pC-collagen concentration and of the rate of cleavage. The critical concentration decreased with temperature between 29 and 41 degrees C and was 0.12 +/- 0.06 (S.E.) microgram.ml-1 at 41 degrees C. The thermodynamic parameters of assembly were essentially independent of temperature in the range 29 to 41 degrees C. The process was endothermic with a delta H value of +56 kcal.mol-1, but entropy driven with a delta S value of +220 cal.K-1.mol-1. The Gibbs energy change for polymerization was -13 kcal.mol-1 at 37 degrees C. The data demonstrate, for the first time, that type I collagen fibril formation de novo is a classical example of an entropy-driven self-assembly process similar to the polymerization of actin, flagella, and tobacco mosaic virus protein. PMID- 3316207 TI - Characterization of transducin from bovine retinal rod outer segments. Participation of the amino-terminal region of T alpha in subunit interaction. AB - The GTP-induced dissociation of T alpha from T beta gamma initiates the release of transducin from photolyzed rhodopsin and the subsequent activation of the cGMP phosphodiesterase. In this study, site-specific proteolysis and immunoprecipitation were used to map the domain of T alpha that interacts with T beta gamma. We found that Staphylococcus aureus V8 protease rapidly removes a small fragment from T alpha under native conditions, resulting in the formation of a single 38-kDa polypeptide (T alpha'). Under the same conditions, T beta gamma remains intact. A 4.5-fold decrease in the rate of T alpha cleavage by S. aureus protease was observed in the presence of T beta gamma, suggesting T beta gamma binding blocks the protease-sensitive site on T alpha. Amino acid sequence analysis indicated that T alpha' is derived from the cleavage of T alpha at Glu 21. The ability of T alpha' to interact with and activate the retinal phosphodiesterase is not diminished. However, T alpha' is unable to participate in T beta gamma-dependent activities such as the light-stimulated binding of guanine nucleotides, binding to photoexcited rhodopsin, and ADP-ribosylation catalyzed by pertussis toxin. Moreover, the anti-T alpha monoclonal antibody TF16 was able to precipitate T beta gamma in the presence of T alpha, but not with either T alpha' or T alpha-guanosine 5'-O-(3-thiotriphosphate). We conclude that the amino-terminal region of T alpha participates in T beta gamma interaction and discuss our results with respect to the known structure and function of transducin. PMID- 3316208 TI - Crystallization of rat cellular retinol binding protein II. Preliminary X-ray data obtained from the apoprotein expressed in Escherichia coli. AB - Rat cellular retinol-binding protein II (CRBP II) is a member of a family of cytoplasmic proteins which bind hydrophobic ligands. CRBP II is thought to participate in the intestinal absorption and intracellular metabolism of retinoids. We have previously described the crystallization of a homologous rat intestinal fatty acid-binding protein (I-FABP) isolated from Escherichia coli containing a suitably constructed prokaryotic expression vector (Sacchettini, J. C., Meininger, T. A., Lowe, J. B., Gordon, J. I., and Banaszak, L. J., J. Biol. Chem. 262, 5428-5430). We have now efficiently expressed rat CRBP II in E. coli. The E. coli-derived protein, which does not contain any bound retinoid, has been purified and crystals grown from solutions of polyethylene glycol 4000. Crystals of apo-CRBP II are triclinic, space group P1, a = 36.8 A, b = 64.0 A, c = 30.4 A; alpha = 92.8 degrees, beta = 113.5 degrees, gamma = 90.1 degrees. Each unit cell contains two molecules of the 134-residue apoprotein. X-ray diffraction data suggest that the unit cell parameters of crystalline apo-CRBP II resemble those of I-FABP. Comparison of the tertiary structures of E. coli-derived rat I-FABP and CRBP II should provide insights about how these proteins evolved to bind different hydrophobic ligands. PMID- 3316209 TI - Purification and characterization of the repressor for the sn-glycerol 3 phosphate regulon of Escherichia coli K12. AB - The glpR gene encoding the repressor for the sn-glycerol 3-phosphate regulon of Escherichia coli was cloned downstream from the strong pL promoter of bacteriophage lambda. This allowed overproduction of the repressor upon thermal induction of a cryptic lambda lysogen harboring the cI857 gene. The repressor was purified 40-fold to homogeneity from an induced strain. The purification scheme utilized polyethyleneimine and ammonium sulfate fractionation, followed by phosphocellulose and DEAE-Sephadex chromatography. Purification was monitored by measuring the binding of radiolabeled inducer (sn-glycerol 3-phosphate) to the repressor. The purified repressor migrated as a single band exhibiting a subunit molecular weight of 30,000 assessed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The molecular weight of the repressor under nondenaturing conditions was 100,000-130,000 suggesting the repressor is a tetramer under native conditions. Interaction of the repressor with sn-glycerol 3-phosphate was studied using flow dialysis. Scatchard analysis of the data indicated four binding sites/repressor tetramer and a dissociation constant of 31 microM. Interaction of the repressor with DNA was studied using band-shift electrophoresis. The repressor specifically bound DNA fragments containing the control regions for the glpD, glpK, and glpT-A genes. Binding of DNA by the repressor was diminished in the presence of sn-glycerol 3-phosphate. PMID- 3316210 TI - Sugar transport by the bacterial phosphotransferase system. The intrinsic fluorescence of enzyme I. AB - Enzyme I of the bacterial phosphoenolpyruvate: glycose phosphotransferase system has 2 tryptophan residues/monomer, as determined spectrophotometrically. The tryptophan fluorescence has been investigated with the aid of nanosecond time resolved techniques. The decay of the fluorescence intensity was analyzed in terms of a biexponential function. The contribution of the emission associated with the shorter decay constant increases from 17-19% at 1 degree C to 43-44% at room temperature. Decay-associated spectra obtained with Enzyme I indicate different spectral distributions associated with the two decay constants. The measurement of tumbling of Enzyme I as a function of temperature revealed a transition of rotational rates between 5 and 15.5 degrees C. Global analysis allowed decomposition of the anisotropy decay into a formulation consistent with monomer and dimer rotational contributions. PMID- 3316211 TI - Kinetic analysis of the mechanism of Escherichia coli dihydrofolate reductase. AB - A kinetic mechanism is presented for Escherichia coli dihydrofolate reductase which describes the full time course of the enzymatic reaction over a wide range of substrate and enzyme concentrations at pH 7.2 and 20 degrees C. Specific rate constants were estimated by computer simulation of the full time course of single turnover, burst, and steady-state experiments using both nondeuterated and deuterated NADPH. The mechanism involves the random addition of substrates, but the substrates and enzyme are not at equilibrium prior to the chemical transformation step. The rate-limiting step follows the chemical transformation, and the maximum velocity of the reaction is limited by the release of the product tetrahydrofolate. The full time course of the reaction is markedly affected by the formation of the enzyme-NADPH-tetrahydrofolate abortive complex, but not by the enzyme-NADP-dihydrofolate abortive complex. PMID- 3316212 TI - The speEspeD operon of Escherichia coli. Formation and processing of a proenzyme form of S-adenosylmethionine decarboxylase. AB - We have previously shown that the gene (speD) for S-adenosylmethionine decarboxylase is part of an operon that also contains the gene (speE) for spermidine synthase (Tabor, C. W., Tabor, H., and Xie, Q.-W. (1986) Proc. Natl. Acad. Sci. U. S. A. 83, 6040-6044). We have now determined the nucleotide sequence of this operon and have found that speD codes for a polypeptide of Mr = 30,400, which is considerably greater than the subunit size of the purified enzyme. Our studies show that S-adenosylmethionine decarboxylase is first formed as a Mr = 30,400 polypeptide and that this proenzyme is then cleaved at the Lys111-Ser112 peptide bond to form a Mr = 12,400 subunit and a Mr = 18,000 subunit. The latter subunit contains the pyruvoyl moiety that we previously showed is required for enzymatic activity. Both subunits are present in the purified enzyme. These conclusions are based on (i) pulse-chase experiments with a strain containing a speD+ plasmid which showed a precursor-product relationship between the proenzyme and the enzyme subunits, (ii) the amino acid sequence of the proenzyme form of S-adenosylmethionine decarboxylase (derived from the nucleotide sequence of the speD gene), and (iii) comparison of this sequence of the proenzyme with the N-terminal amino acid sequences of the two subunits of the purified enzyme reported by Anton and Kutny (Anton, D. L., and Kutny, R. (1987) J. Biol. Chem. 262, 2817-2822). PMID- 3316214 TI - Escherichia coli thioredoxin confers processivity on the DNA polymerase activity of the gene 5 protein of bacteriophage T7. AB - Bacteriophage T7 gene 5 protein has been purified to apparent homogeneity from cells overexpressing its gene several hundred-fold. Gene 5 protein is a DNA polymerase with low processivity; it dissociates from the primer-template after catalyzing the incorporation of 1-50 nucleotides, depending on the salt concentration. Escherichia coli thioredoxin, a host protein that is tightly associated with the gene 5 protein in phage-infected cells, is not required for this activity. Thioredoxin acts as an accessory protein to bestow processivity on the polymerizing reaction; DNA synthesis catalyzed by the gene 5 protein thioredoxin complex on a single-stranded DNA template can polymerize thousands of nucleotides without dissociation. Conditions that increase the stability of secondary structures in the template (i.e., low temperature or high ionic strength) decrease the processivity. E. coli single-stranded DNA-binding protein stimulates both the rate of elongation and the processivity of the gene 5 protein thioredoxin complex. PMID- 3316213 TI - The yeast ribosomal protein L32 and its gene. AB - The yeast ribosomal protein gene RPL32 of Saccharomyces cerevisiae is of particular interest for two reasons: 1) it is adjacent to another ribosomal protein gene, RP29, whose divergent transcription may be driven from the same control sequences, and 2) it appears that the splicing of its transcript is regulated by the product of the gene, ribosomal protein in L32. RPL32 has been analyzed in detail. It is essential for cell growth. Its sequence predicts L32 to be a protein of 105 amino acids, somewhat basic near the NH2 terminus, rather acidic near the COOH terminus, and homologous to ribosomal protein L30 of mammals. The reading frame has been confirmed by partial NH2-terminal analysis of L32. The nucleotide sequence also predicts an intron of 230 nucleotides, which begins with the unusual sequence GTCAGT and ends 40 nucleotides downstream of the consensus sequence TAC-TAAC. The intron has been confirmed by determination of the sequence of a cDNA clone. Transcription initiates 58 nucleotides upstream of the AUG initiation codon, and the polyadenylation site occurs 100 nucleotides downstream of the termination codon. Regulation of the transcription of ribosomal protein genes has been linked to two related consensus sequences. Analysis of the intergenic region between RP29 and RPL32 reveals three copies of these sequences. A deletion removing all three sequences reduces synthesis of a L32-LacZ fusion protein by more than 90%. Some residual activity, however, remains. PMID- 3316215 TI - Escherichia coli thioredoxin stabilizes complexes of bacteriophage T7 DNA polymerase and primed templates. AB - The DNA polymerase activity induced after bacteriophage T7 infection of Escherichia coli is found in a complex of two proteins, the T7 gene 5 protein and a host protein, thioredoxin. Gene 5 protein is a DNA polymerase and a 3' to 5' exonuclease. Thioredoxin binds tightly to the gene 5 protein and increases the processivity of polymerization some 1000-fold. Gene 5 protein forms a short-lived complex with the primer-template, poly(dA).oligo(dT), in the absence of Mg2+ and nucleotides. Thioredoxin increases the half-life of the preformed primer-template polymerase complex from less than a second to approximately 5 min. The dissociation is accelerated by excess single-stranded DNA in an apparent second order reaction, indicating direct transfer of polymerase between DNA fragments. Thioredoxin also reduces the equilibrium dissociation constant, Kd, of the gene 5 protein -poly(dA).oligo(dT) complex 20- to 80-fold. The salt dependence of Kd indicates that thioredoxin stabilizes the primer-template-polymerase complex mainly through additional charge-charge interactions, increasing the estimated number of interactions from 2 to 7. The affinity of gene 5 protein for single stranded DNA is at least 1000-fold higher than for double-stranded DNA and is little affected by thioredoxin. Under conditions of steady state synthesis the effect of thioredoxin on the polymerization rate is determined by two competing factors, an increase in processivity and a decrease of the dissociation rate of polymerase and replicated template. PMID- 3316216 TI - Sugar transport by the bacterial phosphotransferase system. Reconstitution of inducer exclusion in Salmonella typhimurium membrane vesicles. AB - The accompanying articles (Saffen, D.W., Presper, K.A., Doering, T.L., and Roseman, S. (1987) J. Biol. Chem. 262, 16241-16253; Mitchell, W.J., Saffen, D. W., and Roseman, S. (1987) J. Biol. Chem. 262, 16254-16260) show that "inducer exclusion" in intact cells of Escherichia coli is regulated by IIIGlc, a protein encoded by the crr gene of the phosphoenolpyruvate:glycose phosphotransferase system (PTS). The present studies attempt to show a direct effect of IIIGlc on non-PTS transport systems. Inner membrane vesicles prepared from a wild type strain of Salmonella typhimurium (pts+), carrying the E. coli lactose operon on an episome, showed respiration-dependent accumulation of methyl-beta-D thiogalactopyranoside (TMG) via the lactose permease. In the presence of methyl alpha-D-glucopyranoside or other PTS sugars, TMG uptake was reduced by an amount which was dependent on the relative concentrations of IIIGlc and lactose permease in the vesicles. The endogenous IIIGlc concentration in these vesicles was in the range 5-10 microM, similar to that found in whole cells. Methyl-alpha-glucoside had no effect on lactose permease activity in vesicles prepared from a deletion mutant strain lacking the soluble PTS proteins Enzyme I, HPr, and IIIGlc. One or more of the pure proteins could be inserted into the mutant vesicles; when one of the two electrophoretically distinguishable forms of the phosphocarrier protein, IIIGlc Slow, was inserted, both the initial rate and steady state level of TMG accumulation were reduced by up to 40%. The second electrophoretic form, IIIGlc Fast, had much less effect. A direct relationship was observed between the intravesicular concentration of IIIGlc Slow and the extent of inhibition of the lactose permease. No inhibition was observed when IIIGlc Slow was added to the outside of the vesicles, indicating that the site of interaction with the lactose permease is accessible only from the inner face of the membrane. In addition to the lactose permease, IIIGlc Slow was found to inhibit both the galactose and the melibiose permeases. Uptake of proline, on the other hand, was unaffected. The results are therefore consistent with an hypothesis that dephosphorylated IIIGlc Slow is an inhibitor of certain non-PTS permeases. PMID- 3316217 TI - Cholesteryl ester transfer protein is secreted by Hep G2 cells and contains asparagine-linked carbohydrate and sialic acid. AB - A cholesteryl ester transfer protein (CETP) of apparent Mr 74,000 has recently been purified from human plasma. Cholesteryl ester transfer activity was found to accumulate in the medium of cultured Hep G2 cells. The transfer activity was removed by immunoprecipitation with specific antibodies to the plasma CETP. Sodium dodecyl sulfate gel electrophoresis of immunoprecipitates prepared from the medium of cells pulsed with [35S]methionine revealed a broad specific band of protein of Mr 72,000 to 76,000; by contrast, immunoprecipitates of cellular homogenates showed a sharp specific band of Mr 58,000. The Mr 72,000 to 76,000 band disappears, concomitant with the appearance of lower Mr products, upon neuraminidase or glycopeptidase F treatment of medium immunoprecipitates or of purified CETP. The results indicate that liver cells have the capacity to synthesize and secrete CETP. The CETP peptide acquires asparagine-linked carbohydrate and sialic acid during intracellular processing. PMID- 3316218 TI - Multiphasic control of hepatic protein degradation by regulatory amino acids. General features and hormonal modulation. AB - Previous studies with livers from fed rats perfused in the single-pass mode have shown that regulatory amino acids (Leu, Tyr, Gln, Pro, Met, His, and Trp) as a group as well as leucine alone inhibit deprivation-induced protein degradation optimally at 0.5 and 4 times (X) normal plasma amino acid concentrations. However, they lose inhibitory effectiveness almost completely within a narrow zone centered at normal (1 X) levels (Poso, A. R., Wert, J. J., Jr., and Mortimore, G.E. (1982) J. Biol. Chem. 257, 12114-12120; Poso, A. R., and Mortimore, G. E. (1984) Proc. Natl. Acad. Sci. U. S. A. 81, 4270-4274). We now report similar effects for tyrosine and glutamine and suggest that this multiphasic dose response is a general feature of the regulatory group. Insulin (2.4 micrograms h-1) selectively modulated the response by abolishing the zonal loss, whereas glucagon (10 micrograms h-1) blocked the initial inhibition (0.5 X); proteolytic suppression was restored at 4 X normal plasma levels. Although the zonal loss of inhibition at 1 X was associated with a near maximal increase in the volume density of macroautophagy, the vacuoles differed from those induced by stringent amino acid deprivation in containing 4.5-fold more smooth than rough endoplasmic reticulum and thus represented a separate population. Surprisingly, the leucine analog, L-alpha-hydroxyisocaproate, elicited multiphasic responses identical to those of L-leucine, including inhibition at 0.1 mM (equivalent to 0.5 X Leu). Inasmuch as alpha-ketoisocaproate is not effective at this concentration, the initial suppression of protein degradation could be mediated from a site that recognizes structural features common to leucine and its hydroxyl analog. PMID- 3316219 TI - Transport of proteins into chloroplasts. Partial purification of a thylakoidal processing peptidase involved in plastocyanin biogenesis. AB - Plastocyanin is synthesized in the cytoplasm as a larger precursor and transported across three membranes into the chloroplast thylakoid lumen. Processing to the mature size involves successive cleavages by a stromal and a thylakoidal peptidase. In this report we describe the partial purification and characterization of the thylakoidal peptidase involved. The enzyme has been purified 36-fold from Pisum sativum thylakoids after solubilization using Triton X-100. The peptidase processes the plastocyanin import intermediate to the mature size, but no further, and is capable of processing pre-plastocyanin to the mature size but at a lower rate. No detectable activity is displayed against non chloroplast proteins or precursors of stromal proteins. The enzyme has a pH optimum of 6.5-7 and is activated by chelating agents such as EDTA and EGTA. No inhibitors of the peptidase have been found to date. PMID- 3316220 TI - Comparative structure of the protease-sensitive regions of the subfragment-1 heavy chain from smooth and skeletal myosins. AB - The heavy chain fragments generated by restricted proteolysis of the smooth chicken gizzard myosin subfragment-1 (S-1) with trypsin, Staphylococcus aureus V8 protease, and chymotrypsin were isolated and submitted to partial amino acid sequencing. The comparison between the smooth and striated muscle myosin sequences permitted the unambiguous structural characterization of the two protease-vulnerable segments joining the three putative domain-like regions of the smooth head heavy chain. The smooth carboxyl-terminal connector is a serine rich region located around positions 632-640 of the rabbit skeletal sequence and would represent the "A" site that is conformationally sensitive to the myosin 10 S-6 transition and to its interaction with actin (Ikebe, M., and Hartshorne, D. J. (1986) Biochemistry 25, 6177-6185). A third site which undergoes a nucleotide dependent chymotryptic cleavage which inactivates the Mg2+-ATPase (Okamoto, Y., and Sekine, T. (1981) J. Biochem. (Tokyo) 90, 833-842, 843-849) was identified at Trp-31/Ser-32. It is vicinal to Lys-34 that is monomethylated in the skeletal heavy chain but not at all in the smooth sequence. However, the two trimethyl lysine residues present in the skeletal sequence are conserved in the same regions of the smooth S-1 and may play a general functional role in myosin. The smooth central 50-kDa segment could be selectively destroyed by a mild tryptic digestion in the absence of any unfolding agent, with a concomitant inhibition of the ATPase activities. This feature is in line with the proposed domain structure of the S-1 heavy chain and also suggests a relationship between the specific biochemical properties of the smooth S-1 and the particular conformation of its 50-kDa region. PMID- 3316221 TI - Studies on the molecular organization of rat insulin secretory granules. AB - Secretory granule-enriched fractions prepared from isolated rat islets of Langerhans, previously labeled in culture for 18 h with [3H]leucine, have been lysed and separated into pH 5.4 soluble and insoluble fractions by zonal sucrose gradient centrifugation. A high proportion of both labeled and immunoreactive rat insulins I and II were recovered in the insoluble granule core fraction in the expected ratio of approximately 60/40, respectively. Essentially equivalent amounts of the rat C-peptides on a molar basis were recovered in the granule supernatant fractions. The proportion of labeled proinsulin in the granule core fraction was less than 2% relative to insulin, while the soluble fraction contained about 8%, which probably arose mainly from disrupted proinsulin-rich noncrystalline prosecretory vesicles. Electron microscopic examination of the granule core fraction revealed large numbers of well preserved crystalline cores exhibiting typical dimensions and regular internal spacings of normal mature rat beta-granule inclusions. These results provide direct biochemical evidence that the beta-granules are nonuniform in composition with the insulin contained mainly in a crystalline state in the electron-dense central inclusions while the C peptide is dissolved in the fluid bathing the crystalline hormone. The significance of this structural organization of the beta-granule is discussed. PMID- 3316222 TI - Accessory proteins bind a primed template and mediate rapid cycling of DNA polymerase III holoenzyme from Escherichia coli. AB - DNA polymerase III holoenzyme was assembled from pure proteins onto a primer template scaffold. The assembly process could be divided into two stages. In the time-consuming first stage, beta subunit and gamma.delta subunit complex were required in forming a tightly bound ATP-activated "preinitiation complex" with a single-stranded DNA bacteriophage circle uniquely primed with a synthetic pentadecadeoxyribonucleotide. This finding substantiates an earlier study using crude protein preparations in a homopolymer system lacking Escherichia coli single-stranded DNA binding protein (Wickner, S. (1976) Proc. Natl. Acad. Sci. U. S. A. 73, 3511-3515). In the second stage, the polymerase III core and the tau subunit rapidly seek out and bind the preinitiation complex to form DNA polymerase III holoenzyme capable of rapid and entirely processive replication of the circular DNA. ATP is not required beyond formation of the preinitiation complex. It is remarkable that the fully assembled DNA polymerase III holoenzyme is so stably bound to the primed DNA circle (4-min half-time of dissociation), yet upon completing a round of synthesis the polymerase cycles within 10 s to a new preinitiation complex on a challenge primed DNA circle. Efficient polymerase cycling only occurred when challenge primed DNA was endowed with a preinitiation complex implying that cycling is mediated by a polymerase subassembly which dissociates from its accessory proteins and associates with a new preinitiation complex. These subunit dynamics suggest mechanisms for polymerase cycling on the lagging strand of replication forks in a growing chromosome. PMID- 3316223 TI - Two-step glycosylation of the contact site A protein of Dictyostelium discoideum and transport of an incompletely glycosylated form to the cell surface. AB - Two different types of oligosaccharides, designated type 1 and 2 carbohydrate residues, are present on the contact site A molecule, an 80-kDa glycoprotein involved in the formation of EDTA-stable cell adhesion during cell aggregation in Dictyostelium discoideum. The first precursor detected by pulse-chase labeling with [35S]methionine was a 68-kDa glycoprotein carrying type 1 carbohydrate. Conversion of the precursor into the 80-kDa form occurred simultaneously with the addition of type 2 carbohydrate. Tunicamycin inhibited type 1 glycosylation more efficiently than type 2 glycosylation. The first precursor detected in tunicamycin-treated cells by pulse-chase labeling was a 53-kDa protein lacking both carbohydrates, which was converted through addition of type 2 carbohydrate into a 66-kDa final product. Labeling of intact cells indicated that this 66-kDa glycoprotein is transported to the cell surface. Prolonged treatment with tunicamycin resulted in the accumulation within the cells of the 53-kDa precursor with no detectable exposure of this protein on the cell surface. It is concluded that type 1 carbohydrate, which is cotranslationally added in N-glycosidic linkages, is neither required for transport of the protein to the Golgi apparatus nor for type 2 glycosylation or protection of the protein against proteolytic degradation. Incapability of tunicamycin-treated cells of forming EDTA-stable cell contacts suggests a role for type 1 carbohydrate in cell adhesion. Type 2 carbohydrate is added posttranslationally. It is required in the absence of type 1 glycosylation for transport of the protein to the cell surface. PMID- 3316224 TI - SAM1, the structural gene for one of the S-adenosylmethionine synthetases in Saccharomyces cerevisiae. Sequence and expression. AB - Saccharomyces cerevisiae contains two genes, SAM1 and SAM2, encoding functional S adenosylmethionine synthetases. The gene SAM1 was isolated by functional complementation of a double mutant of S. cerevisiae, and its identity was confirmed by gene disruption. The cloned gene was used to probe wild type chromosomal DNA, and two regions hybridizing with SAM1 were found, one of which is the SAM1 region. The DNA sequence of SAM1 is reported. The translation product shows a high homology with the one deduced from the sequence of the MetK gene encoding the SAM synthetase of Escherichia coli. PMID- 3316225 TI - Insulin-dependent intermolecular subunit communication between isolated alpha beta heterodimeric insulin receptor complexes. AB - The dissociation of the purified human placental alpha 2 beta 2 heterotetrameric insulin receptor complex into an alpha beta heterodimeric state was found to occur in a pH- and dithiothreitol (DTT)-dependent manner. Formation of the alpha beta heterodimeric complex, under conditions which preserved tracer insulin binding and protein kinase activities (pH 8.75 for 25 min followed by 2.0 mM DTT for 5 min) occurred with an approximate 50% efficiency. The resulting nondissociated alpha 2 beta 2 heterotetrameric complexes could then be separated effectively by Bio-Gel A-1.5m gel filtration chromatography at neutral pH. The isolated DTT-treated but nondissociated alpha 2 beta 2 heterotetrameric complex was resistant to any further dissociation by a second round of DTT and alkaline pH treatment, whereas the isolated alpha beta heterodimeric complex was stable to spontaneous reassociation for at least 72 h at pH 7.60. Kinetic analyses of the insulin receptor protein kinase activity demonstrated that the insulin stimulation of glutamic acid:tyrosine (4:1) synthetic polymer phosphorylation for both the alpha 2 beta 2 heterotetrameric and alpha beta heterodimeric complexes occurred via an increase in Vmax without any significant change in Km. Examination of beta subunit autophosphorylation of the alpha beta heterodimeric complex, in the presence but not in the absence of insulin, demonstrated the appearance of the covalent 32P-labeled alpha 2 beta 2 heterotetrameric complex. Further, the initial rate of insulin-stimulated beta subunit autophosphorylation in the isolated alpha beta heterodimeric complex occurred in a dilution-dependent (intermolecular) manner. These data demonstrate that the isolated alpha beta heterodimeric insulin receptor complex is fully capable of expressing insulin dependent activation of the beta subunit protein kinase domain with the covalent reassociation of the alpha beta heterodimeric complex into an alpha 2 beta 2 heterotetrameric disulfide-linked state. PMID- 3316226 TI - Redox-dependent subunit dissociation of Azotobacter vinelandii hydrogenase in the presence of sodium dodecyl sulfate. AB - Hydrogenases catalyze the reversible activation of dihydrogen. We have previously demonstrated that the purified hydrogenase from the nitrogen-fixing microorganism Azotobacter vinelandii is an alpha beta dimer (98,000 Da) with subunits of 67,000 (alpha) and 31,000 (beta) daltons and that this enzyme contains iron and nickel. The enzyme can be purified anaerobically in the presence of dithionite in a fully active state that is irreversibly inactivated by exposure to O2. Analysis of this hydrogenase by sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE) following boiling in SDS yields two protein staining bands corresponding to the alpha and beta subunits. However, when this enzyme was treated with SDS (25-65 degrees C) for up to 30 min under anaerobic/reductive conditions and then analyzed by anaerobic SDS-PAGE, a protein staining band corresponding to an apparent molecular mass of 58,000 Da was observed that stained for hydrogenase activity. Analysis of the 58,000-Da activity staining band by a Western immunoblot or a second aerobic SDS-polyacrylamide gel revealed that this protein actually consisted of both the alpha and beta subunits. Thus, the activity staining band (apparent 58,000 Da) represents the 98,000-Da dimer migrating abnormally on SDS-PAGE. Treatment of the anaerobically purified hydrogenase with SDS under aerobic conditions or under anaerobic conditions with electron acceptors prior to electrophoresis resulted in no activity staining band and the separated alpha and beta subunits. A. vinelandii hydrogenase was also purified under aerobic conditions in an inactive O2 stable form that can be activated by removal of oxygen followed by addition of reductant. This enzyme (as isolated), the activated form, and the reoxidized form were analyzed for their stability toward denaturation by SDS. We conclude that the dissociation of the A. vinelandii hydrogenase subunits in SDS is controlled by the redox state of the enzyme suggesting an important role of one or more redox sites in controlling the structure of this enzyme. PMID- 3316227 TI - Facilitated diffusion properties of melibiose permease in Escherichia coli membrane vesicles. Release of co-substrates is rate limiting for permease cycling. AB - The mechanism of melibiose symport by the melibiose permease of Escherichia coli was studied by looking at the modifications of the facilitated diffusion properties of the permease which arise upon substitution of the coupled cations (H+, Na+, or Li+). Kinetic analysis of melibiose influx and efflux down a concentration gradient, exchange at equilibrium, and counterflow were examined in de-energized membrane vesicles resuspended in media allowing melibiose to be co transported with either H+, Na+, or Li+. The data show that the maximal rates of melibiose efflux coupled to either H+, Na+, or Li+ are between 10 and 40 times faster than the corresponding influxes. This suggests that the permease functions asymmetrically. Cross-comparison between the rates of net [3H]melibiose entry during the influx reactions coupled to either cation and corresponding unidirectional sugar inflow during exchange and counterflow reactions leads to the conclusions that: 1) the step involving release of the co-substrates from the permease on the inner surface of the membrane is sequenced (sugar first and then coupled cation); 2) this step is rate determining for cycling of the permease. The Na+-melibiose passive flux data indicate in particular that release of Na+ ions rather than release of sugar into the intravesicular space is the slowest step during permease cycling. This property would hamper net passive Na+ melibiose influx but should allow exchange of sugar without concomitant exchange of the coupled cation. Finally, evidence is provided suggesting that the relative rates of release of the two co-substrates from the permease on the inner membrane surface varied considerably in relation to the identity of the coupled cation. PMID- 3316228 TI - The multidrug resistance gene PDR1 from Saccharomyces cerevisiae. AB - The Saccharomyces cerevisiae gene PDR1, responsible for pleiotropic drug resistance, was isolated from a genomic DNA cosmid library by hybridization to the flanking LEU1 gene, followed by subcloning the drug-sensitive phenotype into the transformed pdr1-1, pdr1-2, and pdr1-3 drug-resistant mutants. A RNA molecule of 3.5 kilobases was identified as the PDR1 transcript. The nucleotide sequence of the complementing DNA fragment contained a 3192-nucleotide open reading frame. Disruption of the pdr1 and PDR1 genes restored or increased drug sensitivity. Analysis of the PDR1 deduced amino acid sequence revealed several homologies to four different regulatory proteins involved in the control of gene expression, including a cysteine-rich motif suggested to be a metal-binding domain for DNA recognition. A model is proposed of a general transcriptional control by PDR1 of several target genes encoding proteins from plasma, mitochondria, and possibly other permeability barriers. PMID- 3316229 TI - The influence of peptidyl-prolyl cis-trans isomerase on the in vitro folding of type III collagen. AB - Peptidyl-prolyl cis-trans isomerase was extracted from pig kidney cortex and partially purified. Enzyme activity was monitored against the cis-trans isomerization of succinyl-Ala-Ala-Pro-Phe-methylcoumaryl amide by means of a two step process using chymotrypsin as the trans cleaving activity. The in vitro refolding of denatured type III collagen, which is rate-limited by the cis-trans isomerization of peptide bonds, was studied in the presence of peptidyl-prolyl cis-trans isomerase by optical rotatory dispersion and by resistance to tryptic digestion. A 3-fold increase in the initial rate of folding was observed compared to the uncatalyzed refolding. This rate increase is comparable to the rate increase found for the CT-phase in the refolding of urea-denatured ribonuclease A, but it is smaller than the increase in the rate of isomerization of succinyl Ala-Ala-Pro-Phe-methylcoumarylamide. PMID- 3316230 TI - Regulation of manganese-containing superoxide dismutase in Escherichia coli. Anaerobic induction by nitrate. AB - We have previously demonstrated that iron plays an important regulatory role in the biosynthesis of manganese-containing superoxide dismutase in Escherichia coli (Moody, C.S., and Hassan, H.M. (1984) J. Biol. Chem. 259, 12821-12825). In this study, we demonstrated that the effect of iron is at the transcriptional/translational level, whereas the effect of manganese is at the post-translational level. The anaerobic additions of nitrate or nitrate plus paraquat caused a positive change in the redox potential of the growth medium and concomitant induction of the manganese-superoxide dismutase in the cells. By using 59Fe, we were able to identify two unique proteins that were constitutively made, but contained iron only under conditions where the synthesis of manganese superoxide dismutase was fully repressed. The presence of a multicopy plasmid carrying the manganese-superoxide dismutase gene resulted in the anaerobic expression of the gene presumably by neutralizing the limited number of repressor molecules found in the cells. In toto, the data support our previously proposed model for a negatively controlled operon where the repressor molecule is envisioned as an allosteric redox sensing protein. Conditions known to oxidize or to deplete the iron are also found to cause induction of the manganese-superoxide dismutase albeit the absence of dioxygen. PMID- 3316232 TI - The application of the ELISA technique to the serology of chlamydiosis in goats: statistical evaluation of a method. AB - The evaluation of the ELISA technique has been studied in the special case of its application to the serological diagnosis of chlamydiosis in goats. The results showed that this technique is reliable (accurate and reproducible) and efficient. Sera from 96 goats were studied with the ELISA technique, indirect immunofluorescence (IIF) and complement fixation (CF), the latter being the standard method in France. A comparison of the results revealed a similarity of findings with ELISA and indirect immunofluorescence and the greater sensitivity of the ELISA technique relative to that of complement fixation. PMID- 3316231 TI - The effects of deleting the propeptide from human preproapolipoprotein A-I on co translational translocation and signal peptidase processing. AB - The two principal protein components of human high density lipoprotein particles, apoA-I and apoA-II, are initially synthesized as prepropolypeptides. The function of their NH2-terminal prosegments is not known. We have previously shown that deletion of the pentapeptide prosegment (Ala-Leu-Val-Arg-Arg) from human preproapoA-II redirects signal peptidase cleavage to a site located between the second and third residues of the mature protein (Folz, R. J., and Gordon, J. I. (1986) J. Biol. Chem. 261, 14752-14759). The hexapeptide prosegment of human preproapoA-I differs from other NH2-terminal propeptides in that it terminates with paired glutamine residues (Arg-His-Phe-Trp-Gln-Gln). To examine its role in the early events of protein export, we isolated a full-length human preproapoA-I cDNA and deleted its propeptide coding region by oligonucleotide-directed mutagenesis. The effects of this deletion on co-translational translocation and signal peptidase processing were assessed using an in vitro transcription/translation/microsomal membrane processing system. Propeptide deletion reduces the efficiency of co-translational translocation/processing in both reticulocyte and wheat germ lysates but does not affect the fidelity of signal peptidase cleavage. This reduced efficiency does not appear to reflect differences in signal recognition particle-nascent protein interaction as measured by a translational arrest assay. However, differences in translocation/processing rates were noted in a postinitiation translocation/cleavage assay. This assay employed the initiation inhibitor edeine to generate nascent wild type and mutant proteins of increasing chain length which were subsequently presented to canine pancreatic membranes. Unlike preproapoA-I, pre(delta pro)apoA-I retained its ability to undergo translocation and proteolytic processing even after the entire protein was synthesized. These data suggest that the propeptide in human preproapoA-I may play a role in promoting an optimal structure for co-translational translocation and processing. PMID- 3316233 TI - Newly made antibacterial braided nylon sutures. I. In vitro qualitative and in vivo preliminary biocompatibility study. AB - A new type of braided nylon thread with a silver compound coating was made for the purpose of designing a biocidal suture material. The study used standard bacterial culture techniques to evaluate the antibacterial property of the new Ag coated nylon thread. Seven types of bacterial species were tested; S. aureus, E. coli, P. aeruginosa, K. pneumoniae, S. dysenteriae, S. maruslens, and P. mirabilis. The commercial size 2/0 Nurolon suture from Ethicon served as the control. A weak direct current ranging from 0.4-400 microA was applied to the specimens to examine whether the biocidal property of silver could be enhanced by current. The antibacterial property was evaluated by the width and sterility of the clear zone in the bacterial culture plates. It was found that the new nylon thread exhibited very good to moderate bactericidal property toward these seven bacterial species. P. aeruginosa was the most sensitive species, while P. mirabilis was the least sensitive one. Application of direct current through the Ag-coated specimens positively enhanced their antibacterial property and the degree of enhancement depended on the direct current level. The material also exhibited an antibacterial property toward well-established bacterial colonies, but the effect was less strong than the case when direct current was applied simultaneously with incubation. Silver ions released from the coated nylon thread were responsible for the observed antibacterial property; and the application of a weak direct current to the material enhanced this effect. A preliminary biocompatibility study of this new material in rat gluteal muscle indicated that the new material caused less inflammatory reaction than the control Nurolon suture up to 60 days after implantation. PMID- 3316234 TI - Adsorption of fibronectin derived from serum and from human endothelial cells onto tissue culture polystyrene. AB - Human endothelial cells (HEC) suspended in a culture medium containing 20% human serum (CMS) adhere and spread on(to) moderately wettable polymers, such as tissue culture polystyrene (TCPS). We have previously shown that serum derived fibronectin, which is a cell adhesion promoting protein, has a high affinity for TCPS, but that the amount of fibronectin which adsorbed from CMS was relatively small. In this study we investigated whether fibronectin derived from HEC contributes to the adhesion and spreading of the cells on(to) TCPS. Therefore, HEC were seeded in the presence of fibronectin-depleted CMS. The amount of fibronectin detected on TCPS increased with both cell seeding density and incubation time. Although initial HEC adhesion is delayed on TCPS which has been precoated with albumin (Alb), high density lipoprotein (HDL) or immunoglobulin G (IgG), maximal numbers of adhering and spreading HEC were found on these surfaces 6 h after seeding of HEC. Fibronectin was detected on these surfaces, but an exchange of preadsorbed Alb, HDL, or IgG for fibronectin could not be demonstrated. We conclude that HEC deposit fibronectin onto TCPS, irrespective of the presence of a preadsorbed layer of proteins which delay cell adhesion. PMID- 3316235 TI - Maternal deaths in medieval Sweden: an osteological and life table analysis. PMID- 3316236 TI - Osteochondritis dissecans 1887-1987. A centennial look at Konig's memorable phrase. AB - In 1887, Konig claimed that loose bodies in the knee joints of young persons had three causes: (1) very severe trauma; (2) lesser trauma causing contusion and necrosis; and (3) minimal trauma acting on an underlying lesion-for which he suggested the name osteochondritis dissecans. His thesis has stood the test of time. We still confuse the second and third categories but osteochondritis dissecans has been identified as an ossification defect. PMID- 3316237 TI - Operation for acromioclavicular dislocation. A review of 29 cases treated by one method. AB - The place and effectiveness of surgery for acromioclavicular dislocation is disputed. We have reviewed 29 patients all treated by an operation which holds the clavicle down to the coracoid process. This was effective in both acute and late cases, with rapid return to work, a low incidence of complications and no requirement for secondary procedures. We consider it to be the method of choice when operation is indicated. PMID- 3316238 TI - Early mobilisation of Colles' fractures. A prospective trial. AB - The results of a prospective controlled trial of early mobilisation of Colles' fractures in the elderly are presented. Early mobilisation produced less pain and a stronger grip. It did not lead to any greater loss of reduction of the fracture. However, there was no significant improvement in the final range of movement of the wrist. Immobilisation of the wrist for six weeks in plaster is extremely inconvenient for the elderly living alone and the patients greatly appreciated the reduction of this period of time to a minimum. PMID- 3316239 TI - Hip replacement for adults with unreduced congenital dislocation. A new surgical technique. AB - Total hip replacement for adults with unreduced congenital dislocation presents a difficult problem because soft-tissue contractures usually prevent sitting at the normal anatomical level. Extensive soft-tissue division or a high-level acetabulum leads to reduced function and poor fixation of the components. We describe a new technique for hip replacement in such cases. The shortened abductors and flexors are released proximally and excision of the upper third of the ilium allows them to be repaired without tension, while providing bone graft to reconstruct the acetabular roof. We report 12 such replacements in 10 patients with good results and few early complications. PMID- 3316240 TI - Antibiotic prophylaxis with cefuroxime in arthroplasty of the knee. AB - A randomised prospective trial was undertaken of antibiotic prophylaxis given at various intervals before inflation of the tourniquet for arthroplasty of the knee. Cefuroxime assays of bone and subcutaneous fat from samples collected throughout the operation demonstrated that an interval of 10 minutes was necessary to obtain adequate prophylaxis. Improvement in the timing of antibiotic prophylaxis may result in a reduction in the incidence of infection. PMID- 3316241 TI - Association of macrophages detected with monoclonal antibody 25 F 9 with progression and pathobiological classification of gastric carcinoma. AB - Using monoclonal antibody 25 F 9, which reacts with a determinant of mature macrophages, the inflammatory infiltrate of 66 gastric carcinomas was evaluated using a counting grid. The ratio tumor cells/macrophages was determined for every tumor. For a threshold value of 5, carcinomas with a better prognosis, such as the intestinal type according to Laure, the expanding type according to Ming and the differentiated carcinomas according to the WHO had a significantly smaller relative content of 25 F 9-positive macrophages (a minimum of P less than 0.05) than the diffuse type, infiltrative type, and undifferentiated carcinomas. Furthermore, the relative macrophage content tended to increase with the stage of carcinomas spread (P less than 0.1). The results suggested that 25 F 9-positive macrophages in gastric carcinoma are of greater significance in tumor spread than in any defensive reaction against the tumor. PMID- 3316243 TI - Neuron-specific enolase in medullary thyroid carcinoma: immunohistochemical demonstration, but no significance as serum tumor marker. AB - Neuron-specific enolase (NSE) is an enzyme detectable in nervous and neuroendocrine tissue. Increased serum levels of NSE are found in small cell lung cancer and in patients with neuroblastoma, in whom NSE is used as a serum tumor marker. We have investigated 32 patients with histologically proven medullary thyroid carcinoma, a tumor of neuroendocrine origin, in which the classical tumor marker calcitonin (CT) was pathologically elevated. Positive immunocytochemistry for NSE and CT in C-cells was obtained in all cases. Increased serum NSE levels were found in only 5 of 32 patients, there was no correlation between NSE and CT concentrations. We also compared NSE and CT serum levels during long-term follow up and again found no correlation between NSE and CT. After i.v. stimulation tests with pentagastrin and calcium, no correlation was found between NSE and CT serum levels. We conclude, therefore, that in medullary thyroid carcinoma NSE is useful for immunocytochemistry but not a reliable serum tumor marker. PMID- 3316242 TI - Epidermal growth factor receptor expression, proliferation, and colony stimulating activity production in the urinary bladder carcinoma cell line 5637. AB - Addition of epidermal growth factor (EGF) to cultures of the urinary bladder carcinoma cell line 5637 regulated proliferation and production of colony stimulating activity (CSA). The optimal concentration range of EGF for stimulation of cell proliferation was 5-20 ng/ml EGF and for production of CSA 2 20 ng/ml EGF. High EGF concentrations (100-200 ng/ml) showed inhibitory effects on proliferation and to a greater extent on CSA production. Also, EGF binding sites of high affinity (kd:3.25 nM) were demonstrated on the cell surface. In the optimal concentration range for stimulation (5-20 ng/ml EGF) EGF binding sites were occupied half-maximally. The loss in EGF binding after long incubation at 37 degrees C was prevented by the lysosomal inhibitory agent, chloroquine. Nonspecific binding of EGF was very low, the amount of maximally bound EGF was 1430 fmol/mg protein (130,000 bound EGF molecules/cell). A strong band of approximately 170,000 daltons could be detected by means of an anti-erbB serum which recognizes the EGF receptor protein. The protein became phosphorylated upon addition of gamma-32P ATP. The data suggest that EGF initiates its action by binding to specific high affinity receptors and plays a role in growth regulation and differentiation of the urinary bladder carcinoma cell line 5637. PMID- 3316244 TI - The plant vacuolar protein, phytohemagglutinin, is transported to the vacuole of transgenic yeast. AB - Phytohemagglutinin (PHA), the major seed lectin of the common bean, Phaseolus vulgaris, accumulates in the parenchyma cells of the cotyledons. It has been previously shown that PHA is cotranslationally inserted into the endoplasmic reticulum with cleavage of the NH2-terminal signal peptide. Two N-linked oligosaccharide side chains are added, one of which is modified to a complex type in the Golgi apparatus. PHA is then deposited in membrane-bound protein storage vacuoles which are biochemically and functionally equivalent to the vacuoles of yeast cells and the lysosomes of animal cells. We wished to determine whether yeast cells would recognize the vacuolar sorting determinant of PHA and target the protein to the yeast vacuole. We have expressed the gene for leukoagglutinating PHA (PHA-L) in yeast under control of the yeast acid phosphatase (PHO5) promoter. Under control of this promoter, PHA-L accumulates to 0.1% of the total yeast protein. PHA-L produced in yeast is glycosylated as expected for a yeast vacuolar glycoprotein. Cell fractionation studies show that PHA-L is efficiently transported to the yeast vacuole. This is the first demonstration that vacuolar targeting information is recognized between two highly divergent species. A small proportion of yeast PHA-L is secreted which may be due to inefficient recognition of the vacuolar sorting signal because of the presence of an uncleaved signal peptide on a subset of the PHA-L polypeptides. This system can now be used to identify the vacuolar sorting determinant of a plant vacuolar protein. PMID- 3316245 TI - Antibodies to rat pancreas Golgi subfractions: identification of a 58-kD cis Golgi protein. AB - A 58-kD cis-Golgi protein has been identified by generating polyclonal antibodies against heavy (cis) Golgi subfractions. Total microsomes isolated from rat pancreatic homogenates were subfractionated to yield a rough microsomal fraction (B1) and three smooth membrane subfractions (B2-B4) enriched in cis-, middle, and trans-Golgi elements, respectively. The heavy (cis) subfraction, B2 (d = 1.17 g/ml), was fractionated by Triton X-114 phase separation, and the proteins recovered in the detergent phase were used to immunize rabbits. One of the anti B2 antibodies obtained gave a "Golgi"-staining pattern when screened by immunofluorescence on normal rat kidney cells and mouse RPC 5.4 myeloma cells. In rat pancreatic exocrine cells the antibody reacted with the plasmalemma as well as elements in the Golgi region. By immunoelectron microscopy, the antigen recognized by anti-B2 IgG was found to be restricted to cis-Golgi elements in myeloma cells where it was concentrated in the fenestrated cis-most cisterna and in some of the tubules and vesicles located along the cis face of the Golgi complex. By immunoprecipitation and immunoblotting, the anti-B2 IgG exclusively recognized a 58-kD protein in myeloma cells. The anti-B2 IgG reacted with several proteins in solubilized pancreatic B2 membranes, including a 58-kD protein, but affinity-purified anti-58-kD IgG reacted exclusively with the 58-kD protein. These results suggest that the 58-kD protein is a specific component of cis-Golgi membranes. PMID- 3316246 TI - The inner centromere protein (INCENP) antigens: movement from inner centromere to midbody during mitosis. AB - We describe a novel set of polypeptide antigens that shows a dramatic change in structural localization during mitosis. Through metaphase these antigens define a new chromosomal substructure that is located between the sister chromatids. Because the antigens are concentrated in the pericentromeric region, we have provisionally termed them the INCENPs (inner centromere proteins). The INCENPs (two polypeptides of 155 and 135 kD) were identified with a monoclonal antibody that was raised against the bulk proteins of the mitotic chromosome scaffold fraction. These two polypeptides are the most tightly bound chromosomal proteins known. When scaffolds are prepared, 100% of the detectable INCENPs remain scaffold associated. We were therefore unprepared for the fate of the INCENPs at anaphase. As the sister chromatids separate, the INCENPs dissociate fully from them, remaining behind at the metaphase plate as the chromatids migrate to the spindle poles. During anaphase the INCENPs are found on coarse fibers in the central spindle, and also in close apposition to the cell membrane in the region of the forming contractile ring. During telophase, the INCENPs gradually become focused onto the forming midbody, together with which they are ultimately discarded. Several possible in vivo roles for the INCENPs are suggested by these data: regulation of sister chromatid pairing, stabilization of the plane of cleavage, and separation of spindle poles at anaphase. PMID- 3316248 TI - Posttranslational modification and microtubule stability. AB - We have probed the relationship between tubulin posttranslational modification and microtubule stability, using a variation of the antibody-blocking technique. In human retinoblastoma cells we find that acetylated and detyrosinated microtubules represent congruent subsets of the cells' total microtubules. We also find that stable microtubules defined as those that had not undergone polymerization within 1 h after injection of biotin-tubulin were all posttranslationally modified; furthermore dynamic microtubules were all unmodified. We therefore conclude that in these cells the stable, acetylated, and detyrosinated microtubules represent the same subset of the cells' total network. Posttranslational modification, however, is not a prerequisite for microtubule stability and vice versa. Potorous tridactylis kidney cells have no detectable acetylated microtubules but do have a sizable subset of stable ones, and chick embryo fibroblast cells are extensively modified but have few stable microtubules. We conclude that different cell types can create specific microtubule subsets by modulating the relative rates of posttranslational modification and microtubule turnover. PMID- 3316247 TI - Changes in heterogeneous nuclear RNP core polypeptide complements during the cell cycle. AB - Mammalian heterogeneous nuclear RNP (hnRNP) subcomplexes are shown to be comprised of 14-17 basic A and B core group polypeptides (chrp) when subjected to two-dimensional immunoblot analysis. These proteins are normally confined to the nucleus but are distributed throughout the cell during mitosis. However, not all of the 17 protein spots are observed for all stages of the cell cycle. HeLa cell populations have been synchronized and the basic hnRNP core protein complement examined during S, G2, mitosis, and G1. During cell division several distinct chrp polypeptide species at 35 and 37 kD appear, while another of 37 kD and a chrp of 38 kD are diminished. These altered chrp complements are not due to any effects induced by thymidine treatment but appear to be physiological changes in the chrp polypeptide modification state. The new charge isomers found during mitosis are not the result of selective phosphorylation of the chrp polypeptides. However the nature of the modifications has yet to be determined. The mitosis specific modified forms of the chrp polypeptides are found in the cytoplasmic fraction derived from mitotic cell populations. When this fraction is centrifuged upon sucrose density gradients the modified chrp polypeptides sediment from 30 200S in a distribution similar to that of hnRNP complexes isolated from the nuclei of randomly dividing cell populations. RNase digestion experiments indicate that the general substructure of the RNA/protein complexes in mitotic cell cytoplasm is similar to that of nuclear hnRNP isolated from unsynchronized cells or tissue. PMID- 3316249 TI - In vivo coassembly of a divergent beta-tubulin subunit (c beta 6) into microtubules of different function. AB - alpha- and beta-Tubulin are encoded in vertebrate genomes by a family of approximately 6-7 functional genes whose polypeptide products differ in amino acid sequence. In the chicken, one beta-tubulin isotype (c beta 6) has previously been found to be expressed only in thrombocytes and erythroid cells, where it is assembled into a circumferential ring of marginal band microtubules. In light of its unique in vivo utilization and its divergent assembly properties in vitro, we used DNA transfection to test whether this isotype could be assembled in vivo into microtubules of divergent functions. Using an antibody specific to c beta 6, we have found that upon transfection this polypeptide is freely coassembled into an extensive array of interphase cytoplasmic microtubules and into astral and pole-to-chromosome or pole-to-pole microtubules during mitosis. Further, examination of developing chicken erythrocytes reveals that both beta-tubulins that are expressed in these cells (c beta 6 and c beta 3) are found as co polymers of the two isoforms. These results, in conjunction with efforts that have localized various other beta-tubulin isotypes, demonstrate that to the resolution limit afforded by light microscopy in vivo microtubules in vertebrates are random copolymers of available isotypes. Although these findings are consistent with functional interchangeability of beta-tubulin isotypes, we have also found that in vivo microtubules enriched in c beta 3 polypeptides are more sensitive to cold depolymerization than those enriched in c beta 6. This differential quantitative utilization of the two endogenous isotypes documents that some in vivo functional differences between isotypes do exist. PMID- 3316250 TI - Structural localization of the O2-evolving apparatus to multimeric (tetrameric) particles on the lumenal surface of freeze-etched photosynthetic membranes. AB - Isolated appressed chloroplast membranes, highly enriched in photosystem II (PSII) activity, were examined by freeze-etch electron microscopy. The exposed surfaces of these Triton X-100 solubilized membrane fragments correspond to the lumenal or ESs surface of intact stacked thylakoid membrane regions (Dunahay, T. G., L. A. Staehelin, M. Seibert, P. D. Ogilvie, and S. P. Berg. 1984. Biochim. Biophys. Acta. 764:179-193). The sequential removal from this sample of three extrinsic proteins (17, 23, and 33 kD) associated with the O2-evolving apparatus and the concomitant loss of O2 evolution, was related to subtle changes in the height and substructure of characteristic multimeric (often tetrameric) particles that protrude from the ESs membrane surface. After removal of these proteins, the multimeric particles disappeared and dimeric particles of similar diameter but of lesser height (6.1 vs. 8.2 nm in the controls) were observed. Reconstitution of the depleted membrane fragments with the extrinsic proteins led to rebinding of the three proteins, to a 63% recovery of the control rates of O2 evolution, and to the reappearance of the larger multimeric particles. Analysis of the structural changes associated with the loss and rebinding of the extrinsic proteins is consistent with a stoichiometry of one PSII complex for either one or two copies of the 17-, 23-, and 33-kD proteins, and these are symmetrically arranged on the lumenal surface of the complex. These results demonstrate that the multimeric ESs particles correspond to part of the intact O2-evolving apparatus of PSII, thus confirming previous indirect studies relating these particles to PSII. The dimeric particles probably contain the rest of the O2 evolving complex. PMID- 3316252 TI - Transforming growth factor beta regulation of cell proliferation. AB - Two types of transforming growth factors (TGF) have been purified and well characterized, TGF alpha and TGF beta. TGF alpha is a 5.6 kD single chain molecule that shows sequence homology to epidermal growth factor (EGF), binds to the EGF receptor, and has biological effects very similar to those of EGF. TGF beta is different from TGF alpha in its molecular structure and biological activity, and has its own specific cell surface receptor. TGF beta is a 25 kD homodimer of 12.5 kD subunits that shows no sequence homology to TGF alpha. TGF beta is a highly ubiquitous molecule produced by a variety of cell types in an inactive form. Most cells have receptors for TGF beta, suggesting that a major regulatory step in TGF beta action is through activation of the inactive form. Growth stimulatory effects with TGF beta have been observed so far only in fibroblastic cells. In at least one circumstance, there is evidence that the stimulatory effects of TGF beta in fibroblastic cells is indirect through induction of c-sis and autocrine stimulation by platelet-derived growth factor (PDGF)-like material. TGF beta inhibits in vitro proliferation of most cell types tested, including normal epithelial cells. Thus TGF beta is primarily a growth inhibitor and not a classical growth factor. Increased autocrine stimulation by endogenous TGF beta in fibroblastic cells or decreased inhibitory effects in epithelial cells (or other cells normally inhibited by TGF beta) could lead to an increased proliferative potential and thereby contribute to the neoplastic phenotype. PMID- 3316251 TI - Rat hepatocytes in serum-free primary culture elaborate an extensive extracellular matrix containing fibrin and fibronectin. AB - Adult rat hepatocytes cultured on type IV collagen, fibronectin, or laminin and maintained in serum-free medium were examined by indirect immunofluorescence using polyclonal antibodies against extracellular matrix proteins. An extensive fibrillar matrix containing fibronectin and fibrin was detected in all hepatocyte cultures irrespective of the exogenous matrix substratum used to support cell adhesion. Fibrils radiated from the cell periphery and covered the entire culture substratum. In addition, thicker fibers or bundles of fibers were localized on top of hepatocytes. This matrix did not contain laminin or the major types of collagen found in the liver biomatrix (types I, III, and IV). Isolation of the fibrillar matrix and analysis on polyacrylamide gels under reducing conditions demonstrated a major 58-kD polypeptide, derived from beta-fibrinogen as indicated by immunoblotting and two-dimensional peptide mapping. Plasmin rapidly dissolved the matrix. Deposition of the fibrin matrix in hepatocyte cultures was arrested by hirudin, by specific heparin oligosaccharides that potentiate thrombin inhibition by antithrombin III, and by dermatan sulfate, an activator of heparin cofactor II-mediated inhibition of thrombin. The results indicate that hepatocytes in culture synthesize and activate coagulation zymogens. In the absence of inhibitory and fibrinolytic mechanisms, a fibrin clot is formed by the action of thrombin on fibrinogen. Fibronectin attaches to this fibrin clot but fails to elaborate a fibrillar matrix on its own in the presence of coagulation inhibitors. PMID- 3316253 TI - Regulatory features of the epidermal growth factor receptor. AB - The role of EGF receptor concentration in tumor growth was investigated in athymic mice by measuring the rate of growth of clonal human epidermoid carcinoma A431 cells containing different extents of EGF receptor gene amplification and protein expression. A direct correlation-between the rate of tumor growth and EFG receptor concentration was found, supporting previous cell culture studies that quantitated the relationship between activated EGF receptors and cell proliferation. Holo EGF receptor is activated by ligand binding to the extracellular domain to activate cytoplasmic tyrosine protein kinase activity. A model of single molecule transmembrane signaling is proposed. The function of two phosphorylation sites on the EGF receptor has been analyzed by use of site directed mutagenesis. Comparison of normal and mutant hEGF receptors expressed in rodent cells lacking endogenous EGF receptors indicates that: 1) Thr654, located 10 amino acids carboxyl terminal to the inner membrane boundary, is a major site of heterologous regulation via protein kinase C catalyzed phosphorylation, and 2) Tyr1173, the major site of self-phosphorylation, located at the carboxyl terminus, provides a secondary level of regulation of receptor function by acting as a competitive inhibitor with exogenous substrates. PMID- 3316254 TI - Protein kinase C. AB - The combined application of protein structural techniques, immunochemistry, and molecular biology has permitted an analysis of the differential expression of the genes for the three related protein kinases, C-alpha, -beta, and gamma. The evidence now suggests that the type of protein kinase C in a cell may govern the nature and mechanisms of functional responses. PMID- 3316255 TI - Inhibition of cell surface ruffling and fluid-phase pinocytosis by microinjection of anti-ras antibodies into living cells. AB - Fibroblasts transformed by ras oncogenes display enhanced cell surface ruffling and fluid-phase pinocytotic activities. Microinjection of antibodies that specifically bind the ras proteins into these cells results in the inhibition of these two surface activities. The possible underlying biochemical basis of the influence of the ras proteins on membrane ruffling and pinocytosis and the potential relationship of these two biological activities to membrane signal transduction are discussed. PMID- 3316256 TI - A repetitive sequence element 3' of the human c-Ha-ras1 gene has enhancer activity. AB - Efficient expression of the human c-Ha-ras1 gene requires sequences 3' of those specifying the polyadenylation of its transcripts. These sequences can stimulate the expression of heterologous genes in a manner largely independent of position and orientation, arguing that they possess a transcriptional enhancing activity that regulates the c-Ha-ras1 promoter. As this element is associated with a repetitive domain that is highly polymorphic, it is possible that the activity of this enhancer is variable within the human population. PMID- 3316257 TI - Immunological mediators of wound healing and fibrosis. AB - T-lymphocytes, monocytes, and macrophages, which are the central constituents of immunological and chronic inflammatory reactions, generate numerous polypeptides and other factors capable of stimulating and modulating the proliferation and functions of fibroblasts. These principles differ widely in structure, target cell preference, and functional specificity. The involvement of immunological mediators of fibroblast activities in normal wound healing has not been defined, but a role in some chronic fibrosing disorders, including rheumatoid arthritis, has been suggested by the findings of functionally relevant concentrations in affected tissues. The elucidation of both the pathways of production of fibroblast-activating factors (FAFs) and the determinants of fibroblast responses will permit new approaches to the diagnosis and treatment of deficiencies in wound healing and of abnormal fibrosis. PMID- 3316258 TI - Insulin and alpha 2-macroglobulin-methylamine undergo endocytosis by different mechanisms in rat adipocytes: II. Comparison of intracellular events. AB - A previous ultrastructural study showed that gold-labeled insulin (Au-I) and the non-hormonal ligand gold-labeled alpha-2-macroglobulin-methylamine (Au-alpha 2MGMA) underwent endocytosis by dissimilar cell surface structures on rat adipocytes. The present ultrastructural study compared the intracellular routes taken by these two ligands in adipocytes. Intracellular Au-alpha 2MGMA was initially found within apparent coated vesicles but Au-I was not, consistent with the previous demonstration that Au-alpha 2MGMA underwent endocytosis by coated pits whereas Au-I was internalized by uncoated micropinocytotic invaginations. Early in the endocytic pathway, the two ligands were segregated within separate small vesicles and tubulovesicles. Au-alpha 2MGMA was concentrated in a small number of these structures whereas Au-I was sparsely distributed among a relatively large number. Subsequently, the two endocytic pathways converged as the ligands intermingled within pale multivesicular bodies and lysosome-like structures. Au-I was less efficiently transferred to lysosomes than Au-alpha 2MGMA since a greater proportion of intracellular Au-I remained associated with small vesicles and tubulovesicles. This study indicates that early intracellular events in the endocytic pathways of insulin and alpha 2MGMA are distinct. These findings are discussed in light of the fundamentally dissimilar biological roles of these two molecules and the possible involvement of the endocytic pathway in the insulin signaling mechanism. PMID- 3316259 TI - Fort Ancient mandible: an unusual abnormality associated with untreated trauma. PMID- 3316260 TI - Honour volume on the occasion of the 60th birthday of Ervin sz. Kovats. PMID- 3316261 TI - The selection and performance of monoclonal and polyclonal anti-respiratory syncytial virus (RS) antibodies in capture ELISAs for antigen detection. AB - Six monoclonal antibodies directed against fusion protein (F) or nucleoprotein (NP) of respiratory syncytial virus (RS) have been investigated in an antigen capture ELISA for virus detection. The potency, spectrum and pattern of reactivity were investigated with the intention of selecting antibodies reacting with RS-common antigen determinants and with complementary rather than competitive activity. Two anti-F protein antibodies satisfied these criteria and were used with enzyme amplified detection in a two site monoclonal assay (MCA/MCA) or as detectors with a polyclonal antibody as capture (PCA/MCA). Comparative studies were performed with immunofluorescence (FA) as the reference test and nasopharyngeal aspirates processed in different ways. The PCA/MCA assay was superior to that using monoclonal antibodies alone and gave results comparable to the reference method. However, the apparent sensitivity related to FA varied with the type of sample processing used. These results emphasise the need for a critical analysis of the factors which can influence the sensitivity of a particular assay system before judgements on relative sensitivity are made. PMID- 3316262 TI - Sex differences in insulin action on glucose transport and transporters in human omental adipocytes. AB - We examined the effects of insulin on glucose transport and subcellular glucose transporter distribution in isolated omental adipose cells from men and women. 3 O-Methylglucose transport was measured in intact cells, and the number of glucose transporters in plasma membranes and low density microsomal membranes was determined using the cytochalasin B binding assay. Compared to adipocytes from women, omental adipocytes from men were characterized by 1) 2-fold larger cell volume; 2) 4- to 5- and 2.5-fold higher glucose transport rates when calculated per cell or per cell surface area, respectively, in either basal or insulin stimulated cells; 3) similar 2-fold insulin stimulating effect per se; and 4) equal concentrations of transporters in both fractions examined, but a 2-fold increase in their total number per cell. Additionally, although not directly measured, the calculated glucose transporter activity in basal plasma membranes prepared from adipocytes from men was 2.7-fold higher than that in women, and insulin further induced a 30% increase in that activity. Thus, a sex-related difference was found between the number of glucose transporters per cell and the resultant glucose transport activity of the intact cells. Together with the increased specific activity of glucose transporters in men compared to women, our findings indicate a sex-related difference in adipocyte glucose transport, mainly due to an increase in the number and modulation of the intrinsic activity of glucose transporters in the plasma membrane. PMID- 3316263 TI - Estradiol sensitization of cultured human fetal pituitary cells to gonadotropin releasing hormone. AB - In adult women, estradiol (E2) sensitizes the pituitary to GnRH. To assess whether this effect develops during intrauterine life, dispersed pituitary cells from second trimester male and female fetuses were cultured on extracellular matrix-coated plates. E2 (10(-8) mol/L) exposure for 72 h resulted in a significant increase in LH release when cells were stimulated with GnRH and caused a significant shift to the left of the dose-response curve for GnRH stimulated LH release [relative potency ratio, 0.33 +/- 0.05 (+/- SE)]. E2 enhanced LH release was not associated with an increase in cell number, total LH content, or percentage of LH-containing cells (immunocytochemistry). The EC50 of GnRH-stimulated LH release and the degree of E2 sensitization were not sex dependent, although female fetal pituitary cells in the absence of E2 had significantly greater LH content and released more LH under basal and GnRH stimulated conditions than cells from male fetuses. Therefore, E2 sensitization of second trimester human fetal gonadotrophs to GnRH does occur, is not influenced by sex, and may involve an acutely releasable LH pool. At these gestational ages, basal and maximal GnRH-stimulated LH release as well as total LH content are greater in the female than the male. Thus, E2 sensitization of GnRH responsiveness appears to have its origins during intrauterine fetal life. PMID- 3316264 TI - Tissue culture of human fetal pancreas: growth hormone stimulates the formation and insulin production of islet-like cell clusters. AB - The human fetal pancreas (HFP) is a potential source of insulin-producing B-cells for transplantation to insulin-dependent diabetic patients. We recently described a technique for culturing HFP tissue in vitro which results in the development of islet-like cell clusters (ICC). These clusters exhibited (pro)insulin biosynthesis and a modest rate of insulin secretion, and immunocytochemical staining indicated the presence of insulin-positive cells in the cell clusters. In this study this technique was used to evaluate the effects of the addition of 1000 micrograms/L GH to HFP cultured in medium RPMI-1640 plus 10% human serum. ICCs developed in 21 of 33 consecutive cultures. GH increased the yield of ICC by 35% compared to explants supplemented with human serum alone. The insulin content of the ICCs also was increased, but the size of individual ICCs was not affected by GH, as reflected by an unchanged DNA content. GH also caused increased insulin release when the ICCs were stimulated with 16.7 mM glucose plus 5 mM theophylline. However, (pro)insulin biosynthesis was not affected by the addition of GH. These results suggest that GH stimulates the formation of both ICCs and insulin production within the explants. These observations are relevant both for the production of human fetal B-cells intended for transplantation into insulin dependent diabetic patients and for our knowledge of the growth regulation of the HFP B-cell. PMID- 3316265 TI - Influence of simultaneous gonadotropin-releasing hormone agonist and testosterone treatment on spermatogenesis and potential fertilizing capacity in male monkeys. AB - We examined the effect of continuous sc infusion of a GnRH agonist (Ag) and testosterone (T) supplementation on spermatogenesis and the potential fertilizing capacity of sperm in 15 rhesus monkeys. The monkeys were divided into 3 groups of 5 animals each. Groups 1 and 2 received 25 micrograms/day Ag for 44 weeks. Group 2 also received T replacement therapy [sufficient to maintain serum T values within the normal range; 4-5 ng/mL (13.9-17.3 nmol/L)]. Group 3 received a low dose of the Ag (5 micrograms/day for 24 weeks and then 10 micrograms/day for 20 weeks) to prolong the oligospermic phase before the onset of azoospermia. In groups 1 and 3, there was an initial transient (1 week) rise in serum LH and T levels which then fell below pretreatment value where they remained throughout the treatment period. The serum LH and T levels were lower in the group treated with 25 micrograms/day Ag. Similar changes in serum LH levels occurred in group 2, but T supplementation maintained serum T in the physiological range. The decline in serum LH levels was associated with reduced sensitivity to GnRH, since the responses of serum LH and T to GnRH were either abolished or greatly reduced in the 2 groups treated with 25 micrograms/day Ag and were less than 50% of the pre-Ag responses in monkeys treated with 5-10 micrograms/day Ag. Four of five monkeys treated with 25 micrograms/day Ag alone became azoospermic within 21 weeks. All five animals receiving Ag and T supplementation became azoospermic (mean time to onset, 12.6 weeks). Four of five monkeys treated with 5-10 micrograms/day Ag also had azoospermic ejaculates during the late treatment and early recovery period. Sperm counts recovered to the pretreatment levels in most monkeys by 10 weeks of the recovery period. The quality of semen samples taken from oligospermic monkeys was greatly reduced. The percentage of motile and percentage of live sperm per ejaculate, the net negative surface charge on sperm, and the scores of sperm in the hamster oocyte penetration test were subnormal. T supplementation did not improve these measures of semen quality. Testicular biopsies taken at the end of the Ag administration period from monkeys given 25 micrograms/day Ag showed diffuse atrophy of the seminiferous tubules, which contained primarily Sertoli cells and a few spermatogonia and spermatocytes, but no spermatids. The tubular atrophy and the suppression of spermatogenesis did not appear to be influenced by T replacement.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3316266 TI - Activation of human prorenin by neutrophil elastase. AB - Although about 90% of human renin circulates as inactive prorenin, the mechanism of prorenin activation in vivo is not known. We found that human polymorphonuclear leukocytes (PMN) activate prorenin at a neutral pH. Prorenin was partially purified from human amniotic fluid, and its activation was measured by the release of angiotensin I from sheep angiotensinogen. In control experiments, thermolysin was the standard activator. PMN cells were separated from blood and, after N2 cavitation or degranulation by cytochalasin, were fractionated by differential centrifugation. Elastase and cathepsin G activities were determined with synthetic fluorescent substrates. The activators of prorenin concentrated in the azurophil granules were released by Triton; most of the activation was due to elastase. Elastase, purified from human PMN, activated prorenin completely. The activation by the granular fraction was inhibited 77% by a specific elastase inhibitor in the presence of a detergent, but only 22% by a cathepsin G inhibitor. After inhibition of elastase, the residual activity was inhibited by diisopropylfluorophosphate; thus, it was due to a serine protease(s) such as cathepsin G. We suggest that human renin fully activated by elastase may still contain an N-terminal pentapeptide fragment of the propeptide. PMID- 3316267 TI - Corpus luteum insufficiency and fertility: a matter of controversy. AB - This paper analyses different controversial aspects of luteal phase deficiency (LPD) on the basis of our own data and current clinical experience. Conceptual and diagnostic concerns include: (i) the lack of predictive value of mid-luteal plasma progesterone determinations regarding the progestational transformation of the endometrium, and (ii) the need for a minimum of two, or even three, endometrial biopsies for diagnosis of LPD. From an aetiologic point of view follicular phase determinants of LPD are emphasized and conflicting data on claimed predisposing factors of LPD are analysed. Primary therapeutic approaches to LPD and the effectiveness and significance of such therapy on fertility are discussed. PMID- 3316268 TI - Synaptonemal complex studies in the male. AB - Observations in synaptemal complexes in men carrying structural or numerical chromosomal anomalies are reviewed. Chromosome pairing in patients with extra chromosomes, Robertsonian translocations, reciprocal translocations and pericentric inversions is described. Synaptic anomalies in patients with abnormal seminograms, homosynapsis, asynapsis and heterosynapsis and other pairing abnormalities are also discussed. PMID- 3316269 TI - A method to prevent arrest of embryo development by ultrasound coupling gels after transvaginal ultrasound-guided oocyte retrieval. AB - Two commonly used sterile ultrasound coupling gels were found to affect development in vitro of 8-cell mouse embryos adversely. Suggestions made previously by other investigators to prevent these deleterious effects in percutaneous aspiration of human ovaries under ultrasound guidance, appeared not to be applicable in transvaginal ultrasound-guided oocyte retrieval, especially in nulliparous patients. We report a new method, developed in our IVF programme, which allows optimal visualization of the pelvic organs without the risk of impairing embryo development after ultrasound-guided vaginal oocyte retrieval. PMID- 3316270 TI - Follicular status at the menopause. AB - The store of ovarian follicles which is formed before birth progressively diminishes as a result of follicle death (atresia) and recruitment towards ovulation and will become barren in time. Depletion has occurred in the human ovary at or shortly after the menopause bringing reproductive potential, which has been declining for several years, to a final halt. Several factors can affect the timing of menopause and it appears that changes in the rates of follicle death have a greater impact than differences in the initial numbers of follicles. It is argued that the precocious loss of fecundity in humans, as compared with virtually all animals, has arisen adventitiously as a consequence of the evolution of long life relative to body weight. PMID- 3316271 TI - Absence of donor-type major histocompatibility complex class I antigen-bearing microglia in the rat central nervous system of radiation bone marrow chimeras. AB - Localization of bone marrow-originated cells in the central nervous system (CNS) of the rat was investigated by using bone marrow chimeras. In order to do this, Lewis rats which carry major histocompatibility complex (MHC) class I antigens haplotype 1 (RT1.Al) were reconstituted with (Lew X PVG)F1 (RT1.Al/c) bone marrow cells after lethal irradiation. Transferred bone marrow cells were detected by immunohistochemical staining using a monoclonal antibody, OX27, specific for haplotype c of rat MHC class I antigens (RT1.Ac). The spleen and thymus of chimeric rats were fully reconstituted with transferred F1 cells 4 weeks after bone marrow transplantation. At this stage, mononuclear cells in the subarachnoid space of the CNS expressed OX27 antigen indicating that they were of bone marrow origin. A few OX27-positive blood cells were scattered in the CNS parenchyma 4-12 weeks after reconstitution. Ramified microglia, however, remained OX27-negative. Bone marrow-derived microglia were not observed throughout the period of examination until 24 weeks. In addition, experimental allergic encephalomyelitis (EAE) was induced in chimeric rats in order to augment the expression of MHC class I antigens on microglia. Even under this condition, no OX27-positive microglia were observed. Taken together, ramified microglia might be of neuroectodermal origin and there is little possibility that the microglia are derived from the bone marrow. However, if the ramified microglia are derived from blood cells, the microglia may be expected to have characteristic cell kinetics from the following points: (1) the precursor cells of the microglia may enter the CNS only at the perinatal stage; and (2) even under the condition in which lymphocytes and macrophages enter the CNS as observed in EAE, the precursor cells of the microglia are not supplied from the blood. PMID- 3316272 TI - The EEG of drowsiness in normal adults. PMID- 3316273 TI - Osmoprotective activity for Escherichia coli in mammalian renal inner medulla and urine. Correlation of glycine and proline betaines and sorbitol with response to osmotic loads. AB - Escherichia coli are protected against hypertonic NaCl by human urine. We have shown that this is due in part to the presence of glycine betaine and proline betaine. Several investigators have proposed that betaines and sorbitol are concentrated in the cells of the renal inner medulla where they exert a protective role against urea and extracellular osmotic forces. E. coli was used in the present studies as an "osmosensor" to detect osmoprotective activity in mammalian tissues. The greatest activity was found in extracts of renal inner medulla and to a lesser extent in the renal outer medulla and cortex of several mammalian species. Liver extracts were more active than other nonrenal tissues. Bacterial osmoprotective activity and concentration of glycine betaine in the renal inner medulla of rabbits were found to correlate closely with urinary osmolarity. Concentrations of sorbitol were found to be also increased in the renal inner medulla during osmotic stress, but this compound is not osmoprotective for E. coli. Glycine and proline betaine were recovered in urine of rabbits and were increased in those given high osmotic loads. Only small amounts of proline betaine were recovered in the renal inner medulla. The source from which proline betaine is derived is unknown. PMID- 3316274 TI - Role of fibronectin on the clearance and tissue uptake of antigen and immune complexes in rats. AB - In the present study, we have evaluated how plasma fibronectin (FN) and tissue FN can affect the clearance from the circulation and organ uptake of antigen or immune complexes (IC) that have the capacity to bind to FN. Phenylated gelatin (DNP-GL) (a FN binding antigen) and IC composed of DNP-GL and monoclonal IgGl anti-dinitrophenol (DNP) antibodies were tested. These probes were compared with DNP-bovine serum albumin (BSA) (a non-FN-binding antigen) and DNP-BSA IC formed with the same anti-DNP antibody used for the preparation of DNP-GL IC. We found evidence that DNP-GL, but not DNP-BSA, formed complexes with soluble FN in vitro and the data strongly suggest that DNP-GL-FN complexes form in vivo. The formation of complexes with plasma FN aided in the clearance of DNP-GL from the circulation, as shown by the facts that DNP-GL was removed from the circulation much faster than DNP-BSA and that complexes of DNP-GL with plasma FN were removed from the circulation faster than uncomplexed DNP-GL. The sites of deposition of DNP-GL were also different from those of DNP-BSA. Thus, DNP-GL demonstrated higher hepatic, splenic, and renal uptake than did DNP-BSA. Renal uptake of DNP GL was quite high despite the fact that DNP-GL is anionic. Indeed, expressed per gram of tissue, liver and kidney deposition of DNP-GL was not significantly different. By immunofluorescence microscopy, DNP-GL could be demonstrated in hepatic sinusoids and glomerular mesangium. In vitro, DNP-GL bound to FN in the mesangium of frozen sections of kidney tissue. IC formed with DNP-GL or DNP-BSA demonstrated virtually the same size, yet the fate of DNP-GL IC was strikingly different from that of DNP-BSA IC. The removal of DNP-GL IC from the circulation was mediated by the antigen and not by Fc receptors since gelatin (an inhibitor of DNP-GL clearance) but not aggregated IgG (an inhibitor of Fc receptors) inhibited the removal of DNP-GL IC from the circulation. In summary, these studies suggest that the ability of an antigen or IC to bind to FN markedly influences the fate of that antigen or IC. Specifically, binding to FN accelerates clearance from the circulation and favors hepatic and renal (primarily mesangial) uptake of the FN binding antigen of IC. PMID- 3316275 TI - Norepinephrine metabolism in humans. Kinetic analysis and model. AB - The present study was undertaken to quantify more precisely and to begin to address the problem of heterogeneity of the kinetics of distribution and metabolism of norepinephrine (NE) in humans, by using compartmental analysis. Steady-state NE specific activity in arterialized plasma during [3H]NE infusion and postinfusion plasma disappearance of [3H]NE were measured in eight healthy subjects in the supine and upright positions. Two exponentials were clearly identified in the plasma [3H]NE disappearance curves of each subject studied in the supine (r = 0.94-1.00, all P less than 0.01) and upright (r = 0.90-0.98, all P less than 0.01) positions. A two-compartment model was the minimal model necessary to simultaneously describe the kinetics of NE in the supine and upright positions. The NE input rate into the extravascular compartment 2, estimated with the minimal model, increased with upright posture (1.87 +/- 0.08 vs. 3.25 +/- 0.2 micrograms/min per m2, P less than 0.001). Upright posture was associated with a fall in the volume of distribution of NE in compartment 1 (7.5 +/- 0.6 vs. 4.7 +/ 0.3 liters, P less than 0.001), and as a result of that, there was a fall in the metabolic clearance rate of NE from compartment 1 (1.80 +/- 0.11 vs. 1.21 +/- 0.08 liters/min per m2, P less than 0.001). We conclude that a two-compartment model is the minimal model that can accurately describe the kinetics of distribution and metabolism of NE in humans. PMID- 3316277 TI - Cystic fibrosis. PMID- 3316276 TI - Involvement of fertilization antigen (FA-1) in involuntary immunoinfertility in humans. AB - Sera from immunoinfertile patients (n = 32) and fertile controls (n = 20) were analyzed for cross-reaction with a purified and characterized sperm-specific glycoprotein, the fertilization antigen (FA-1), employing an enzyme-linked immunosorbent assay. The immunoinfertile sera demonstrated a strong reaction with FA-1 when compared with fertile control sera. There was no correlation between the reaction of sera with FA-1 and the titers obtained through the sperm agglutination technique and the sperm immobilization technique. Immunoinfertile sera showed binding with the protein bands in the regions corresponding to FA-1 on Western blots involving sodium deoxycholate-solubilized human sperm. Antigens isolated with immunoaffinity chromatography involving immunoinfertile sera also demonstrated antigen bands corresponding to FA-1 in sodium dodecyl sulfate polyacrylamide gel electrophoresis. Of the seven immunoinfertile couples, three that had antibodies to FA-1 in the male as well as female partners demonstrated a block of fertilization (IVF) due to antibodies bound on the sperm surface. The anti-FA-1 antibody activity was detected in serum as well as in follicular fluid and seminal plasma. Immunoinfertile sera that showed an inhibition of human sperm penetration of zona-free hamster ova showed a significant (P less than 0.001) increase in penetration rates after absorption with FA-1. These results indicate that sera from immunoinfertile patients had antibodies reacting with FA-1, and these antibodies are involved in the fertilization process. PMID- 3316278 TI - Effect of cyclosporin A treatment on the production of antibody in insulin dependent (type I) diabetic patients. AB - Anti-islet cell and anti-insulin antibody production was studies over a 12-mo period in 82 recently diagnosed diabetics randomly receiving either cyclosporin or placebo. Cyclosporin had only minimal effects on the production of anti-islet cell antibodies whether directed to islet cytoplasmic (immunofluorescence) or membrane (cytotoxicity assay) antigens even in patients undergoing remission. These data suggest that these antibodies do not play a major role in the pathogenesis of the disease particularly since their (irregular) presence is not predictive of the clinical response to cyclosporin. Conversely, cyclosporin completely suppressed the synthesis of antibodies elicited by exogenous insulin irrespective of the insulin doses received, and decreased the autoantibody production against thyroid antigens, indicating that cyclosporin has variable effects on antibody production against various antigens. PMID- 3316281 TI - Slide immunoenzymatic assay (SIA): improving sensitivity to measure antibodies when samples are very small and dilute, and antigen is scarce. AB - Modifications to the slide immunoenzymatic assay (SIA) using the PAP reagent (SIA PAP) were developed which increase sensitivity considerably. These SIA modifications are particularly useful for measuring speedily antibodies in dilute samples available only in microliter-volumes when antigen is scarce, whether a molecule, or a prokaryotic or eukaryotic cell. PMID- 3316282 TI - Peroxidase-labelled monoclonal antibodies for use in enzyme immunoassay. AB - Desirable characteristics of enzyme-antibody conjugates for use in enzyme immunoassay are labelling uniformity, permanent availability and stability. The use of monoclonal antibodies (McABS) for preparation of enzyme conjugates, in place of polyclonal antibodies, ensures labelling uniformity and permanent availability. The problem of stability still exists. Monoclonal antibody horseradish peroxidase (McAB-HRPO) conjugates produced in our laboratory showed variable stability. After extensive testing of McAB-HRPO conjugates it became obvious that sodium borohydride, used as a reducing agent, did not result in the production of stable conjugates without enzyme pretreatment with fluorodinitrobenzene (FDNB). Ascorbic acid or ethanolamine used as the reducing agent, resulted in McAB-HRPO conjugates which were stable for periods of ten months or more when stored filter sterilized at 4 degrees C. PMID- 3316279 TI - Abnormal regulation of renal kallikrein in experimental diabetes. Effects of insulin on prokallikrein synthesis and activation. AB - The effects of streptozotocin (STZ) diabetes and insulin on regulation of renal kallikrein were studied in the rat. 1 and 2 wk after STZ injection, diabetic rats had reduced renal levels and urinary excretion of active kallikrein. Tissue and urinary prokallikrein levels were unchanged, but the rate of renal prokallikrein synthesis relative to total protein synthesis was reduced 30-45% in diabetic rats. Treatment of diabetic rats with insulin prevented or reversed the fall in tissue level and excretion rate of active kallikrein and normalized prokallikrein synthesis rate. To further examine insulin's effects, nondiabetic rats were treated with escalating insulin doses to produce hyperinsulinemia. In these rats, renal active kallikrein increased. Although renal prokallikrein was not increased significantly by hyperinsulinemia, its synthesis was increased. As this was accompanied by proportionally increased total protein synthesis, relative kallikrein synthesis rate was not changed. Excretion of active kallikrein was unchanged, but prokallikrein excretion was markedly reduced. Therefore, increased tissue active kallikrein seen with hyperinsulinemia can be explained not only by increased synthesis but also by retention and increased activation of renal prokallikrein. These studies show that STZ diabetes produces an impairment in renal kallikrein synthesis and suggest that this disease state also impairs renal prokallikrein activation. The findings also suggest that insulin modulates renal kallikrein production, activation, and excretion. PMID- 3316280 TI - Effect of insulin and plasma amino acid concentrations on leucine metabolism in man. Role of substrate availability on estimates of whole body protein synthesis. AB - We examined the effect of insulin and plasma amino acid concentrations on leucine kinetics in 15 healthy volunteers (age 22 +/- 2 yr) using the euglycemic insulin clamp technique and an infusion of [1-14C]leucine. Four different experimental conditions were examined: (a) study one, high insulin with reduced plasma amino acid concentrations; (b) study two, high insulin with maintenance of basal plasma amino acid concentrations; (c) study three, high insulin with elevated plasma amino acid concentrations; and (d) study four, basal insulin with elevated plasma amino acid concentrations. Data were analyzed using both the plasma leucine and alpha-ketoisocaproate (the alpha-ketoacid of leucine) specific activities. In study one total leucine flux, leucine oxidation, and nonoxidative leucine disposal (an index of whole body protein synthesis) all decreased (P less than 0.01) regardless of the isotope model utilized. In study two leucine flux did not change, while leucine oxidation increased (P less than 0.01) and nonoxidative leucine disposal was maintained at the basal rate; endogenous leucine flux (an index of whole body protein degradation) decreased (P less than 0.01). In study three total leucine flux, leucine oxidation, and nonoxidative leucine disposal all increased significantly (P less than 0.01). In study four total leucine flux, leucine oxidation, and nonoxidative leucine disposal all increased (P less than 0.001), while endogenous leucine flux decreased (P less than 0.001). We conclude that: (a) hyperinsulinemia alone decreases plasma leucine concentration and inhibits endogenous leucine flux (protein breakdown), leucine oxidation, and nonoxidative leucine disposal (protein synthesis); (b) hyperaminoacidemia, whether in combination with hyperinsulinemia or with maintained basal insulin levels decreases endogenous leucine flux and stimulates both leucine oxidation and nonoxidative leucine disposal. PMID- 3316283 TI - Diagnosis of head and neck carcinomas by means of immunological tumour markers (Beta-2-microglobulin, immunoglobulin E, ferritin, N-acetyl-neuraminic acid, phosphohexose-isomerase). AB - In a great number of patients with squamous cell cancer of the head and neck, tumour markers in the serum were determined before any therapy, in order to evaluate their possible usefulness as parameters for monitoring therapy as well as for early detection of cancer. Patients with primary tumours (n = 101) were distributed to groups TI-II and TIII-IV according to the UICC classification 1978, and investigated together with a group of recurrences (n = 105). 50 age matched healthy individuals served as controls. Substances investigated were beta 2-Microglobulin (beta 2-M), Immunoglobulin E (IgE), Ferritin, N-Acetyl-Neuraminic Acid (sialic acid; NANA), Phosphohexose-Isomerase (PHI). Not only were the mean values of the groups compared with each other, but also the percentages of the respective groups displaying increases above the upper norm limit (95. percentile) were calculated. Critical evaluation of the results led to the conclusion that in particular IgE, NANA and--with some reservations--ferritin should be further investigated as biological serum markers in serial determination with special regard to their possible relevance for cancer treatment. PMID- 3316284 TI - The surgical management of lip cancer. AB - The history of surgical reconstruction of the lips is outlined and a series of procedures described, which together enable lip reconstruction to be successfully undertaken in a variety of different circumstances. PMID- 3316285 TI - A case of oromandibular-digital hypogenesis syndrome. AB - The oromandibular-digital hypogenesis syndrome is characterized by failure of development of the intraoral region and the distal extremities. A 12 year old female with an anomaly of the lingual fraenum, hypodontia of the lower incisors and defective fingers and toes was referred to our clinic. The aetiology of the disorder is still obscure. The author has reviewed the literature and discusses the morphological variation of the lingual fraenum. PMID- 3316286 TI - The new morbidity: who should treat it? PMID- 3316287 TI - The effects of parental divorce and parental conflict on children: an overview. AB - Pediatricians and other primary care professionals are frequently called upon to offer their advice concerning the psychosocial problems that families confront. Currently, one area that appears to be of great concern to parents is the effect that parental divorce has on children. However, giving advice in this area is difficult as parental divorce does not have the same effect on all children. Researchers are now beginning to identify and study numerous factors that appear to play a critical role in mediating child adjustment following parental divorce. Understanding these mediating factors will likely prove crucial when addressing questions pertaining to parental divorce. Several investigators believe that one of the most important of these mediating factors is parental conflict. This article reviews the research addressing the relationship between parental divorce, parental conflict, and child adjustment. PMID- 3316288 TI - Use of modified resistogram to type Candida albicans isolated from cases of vaginitis and from faeces in the same geographical area. AB - Ninety strains of Candida albicans were isolated from vaginal swabs taken by general practitioners from cases of vaginal candidosis. One hundred and nine strains were also isolated from 300 specimens of faeces received from outpatients living in the same geographical area. These strains were typed using a modification of the resistotyping method. We were unable to find any significant differences between the two populations of strains. This suggests that no particular resistotype has an increased ability to cause vaginitis. PMID- 3316289 TI - Evaluation of Mast-ID 15 system for identifying Enterobacteriaceae, some Vibrionaceae, and Acinetobacter. AB - Six hundred and twenty one strains (555 Enterobacteriaceae, 46 Vibrionaceae, and 20 Acinetobacter) were examined in the Mast system. The results were consulted in the code book supplied by the manufacturer and those not listed were processed through the manufacturer's full database held on an Apricot microcomputer in our laboratory. The proportion of strains correctly identified was 88%, with 9% not identified, and 3% incorrectly identified. PMID- 3316290 TI - Islet cell necrosis in the neonatal pancreas: a report of three cases. AB - Three cases of islet cell necrosis in neonates are reported. The association of this rare condition with antepartum haemorrhage, anoxia, shock and intravascular coagulation are discussed. The clinical and morphological appearances were compared with previous descriptions of this condition and an association with neonatal hypoglycaemia was made. There are several patho-physiological mechanisms which may be responsible for this unusual pattern of necrosis. PMID- 3316291 TI - 3-Aminopropyltriethoxysilane (APES): a new advance in section adhesion. PMID- 3316292 TI - Immunoperoxidase staining of intermediate filaments in human small bowel. PMID- 3316293 TI - Diagnosis of peritonitis. PMID- 3316295 TI - The choice of computational unit in the statistical analysis of unbalanced clinical trials. AB - Clinical periodontal research often involves the treatment of patients who have disease at several sites in the mouth. Should the units of analysis be the patients, the sites, or a combination of both? These strategies are explored and a worked example given. PMID- 3316294 TI - Immunologic dysfunction in the pathogenesis of periodontal diseases. AB - Despite significant progress in our understanding of the pathogenesis and etiology of periodontal diseases, the nature and contribution of the immune system to this disorder remains unclear. Several studies provide evidence for either a protective or destructive role. These conflicting findings are difficult to reconcile, since most interpretations tend to argue for a static contributory role (i.e., either protective or destructive) of the immune system. Current theories on the role of the immune response do not address these conflicting findings as well as the contradictory observation of a detectable immune response in the face of persistent infection in these patients. In this article, we present a model, based on available data, for the contribution of the immune system to the pathogenesis of periodontal disease. This model ascribes a dynamic role for the immune response. As documented in other infectious diseases, it is entirely possible, for example, that a state of immunologic dysfunction may occur in the earliest stages of periodontal disease progression; this may then be followed by a period of active immune reactivity (humoral and/or cellular) that would represent either a delayed or depressed response. This model is discussed in conjunction with recent findings that several suspected periodontal pathogens are capable of producing immunosuppressive agents. Many of the apparently contradictory clinical observations concerning the host immune response to oral pathogens and its correlation (or lack of) with both the progression and severity of periodontal disease may be accounted for in this model. PMID- 3316296 TI - Prevention of plaque growth with chewing gum containing chlorhexidine acetate. AB - The purpose of the study was to assess the anti-plaque effect of chlorhexidine (CHX) in chewing gum. The 0.80 g pieces of test gum contained 5 mg chlorhexidine acetate with or without a hydrogen peroxide releasing agent. The gum base with flavouring agents but containing neither CHX nor H2O2 was used as a control. 12 dental hygiene students volunteered to participate in the 3 x crossed-over double blind clinical trial. During the 4-day test periods, no other oral hygiene measures were allowed than chewing 2 pieces of gum at the time for approximately 10 min, 5 times daily. Between test periods, meticulous mechanical oral hygiene measures were practised for 3 days. At the beginning and at the end of each test period, the quantity of plaque was assessed using the plaque index, plaque wet weight, and the area of plaque on the tooth surface as criteria. The results indicated that both CHX gums completely inhibited the increase in plaque index and plaque weight. With regard to area of plaque, the difference between the 2 test gums and the control gum was less marked but still present. The test persons subjectively assessed the gum base to have a poor cleansing effect but also the least unpleasant taste. It was concluded that use of both the chlorhexidine gum and the gum-containing chlorhexidine in addition to the hydrogen peroxide releasing agent had an excellent plaque growth inhibiting effect during the 4-day test periods. PMID- 3316297 TI - The effect of subgingival debridement with hand and ultrasonic instruments on the subgingival microflora. AB - The effect of hand or ultrasonic instrumentation on the subgingival microflora of periodontal pockets was investigated. Pockets with probing depths of 6-9 mm were selected in 12 patients and were randomly assigned per patient to the experimental and control groups. After oral hygiene instruction, instrumentation of the experimental pockets was carried out either by ultrasonic or by hand instruments in a split-mouth design. The treatment effect on the subgingival microbiota was evaluated by microscopic and culture studies of subgingival plaque samples, while in addition, supragingival plaque, bleeding after probing and probing pocket depth were scored. Examinations were carried out before and 7, 21 and 49 days after treatment. The hand and ultrasonic treatments were equally effective in reducing probing pocket depths and bleeding scores. At the end of the experimental period, the probing depths of 54% of the hand-treated pockets and 43% of the ultrasonic-treated pockets were reduced to 4 mm or less while the bleeding scores were reduced to 29% and 22%, respectively. The analysis of microscopical and cultural data did not show any differences between hand and ultrasonic debridement. Both treatments reduced the microscopical counts of rods, spirochetes and motiles and reduced the total colony-forming units and number of black-pigmented Bacteroides and Capnocytophaga, resulting in a subgingival microbiota consistent with periodontal health. PMID- 3316298 TI - Clinical immunologic and microbiologic features of active disease sites in juvenile periodontitis. AB - Eight juvenile periodontitis (JP) patients with progressing disease were evaluated for clinical, immunologic, and microbiologic features. Clinically, bleeding on probing, pocket depth, and attachment level were unrelated to progressing disease. Only Actinobacillus actinomycetemcomitans was related to a marked increase in attachment loss when examined on both a site and patient basis. Eikenella corrodens was significantly elevated in progressing sites with A. actinomycetemcomitans as opposed to non-progressing sites harboring A. actinomycetemcomitans. Eikenella corrodens may function synergistically with A. actinomycetemcomitans to enhance disease in JP patients. Darkfield microscopy was of no value in distinguishing disease activity. All patients screened had elevated serum IgG levels to the same serotype of A. actinomycetemcomitans as that isolated from the subgingival flora. Other elevated serum IgG responses were noted to various organisms including F. nucleatum. B. intermedius, B. gracilus, B. gingivalis and E. corrodens. PMID- 3316299 TI - Cardiac arrhythmia, sudden death, and psychoactive agents. PMID- 3316300 TI - Basic concepts in drug metabolism: Part I. PMID- 3316302 TI - Controlled-release formulations of propranolol and verapamil. AB - The in vitro and clinical behavior of new controlled-release formulations of propranolol and verapamil are reviewed. In vitro dissolution studies have proved to be of little value in determining the clinical activity of these new dosage forms. There is a difference between the blood levels found with the new formulations and those of the reference products. The once-daily verapamil product was evaluated in black hypertensive patients with promising results and suggests that this dosage form of verapamil may be successful as monotherapy for treating this patient population. PMID- 3316301 TI - Tiapamil and hydrochlorothiazide: a double-blind comparison of two antihypertensive agents. AB - Tiapamil is an investigational calcium-channel antagonist that is chemically related to verapamil. The antihypertensive efficacies of tiapamil and hydrochlorothiazide (HCTZ) were compared in a randomized double-blind trial. Thirty patients, age 44 to 80 years, with mild to moderate hypertension (World Health Organization stage I-II) entered and completed the study. Previous therapy, if any, was stopped for at least one week prior to study initiation, and patients received placebo tablets for two weeks. The participants were then given active medication, which was titrated for the next three weeks; HCTZ 25 to 50 mg bid or tiapamil 300 to 600 mg bid was given until supine diastolic blood pressure (BP) was no higher than 90 mm Hg or the ceiling dose was reached. Both drugs caused a significant reduction in systolic as well as in diastolic blood pressure (P less than .01). The reduction was seen in both the supine and erect position. The median decrease in supine systolic blood pressure from baseline to the end of treatment was 20 mm Hg in the tiapamil group and 27 mm Hg in the hydrochlorothiazide group, whereas the median decrease in supine diastolic blood pressure was 14 mm Hg and 18 mm Hg, respectively. The median difference in supine diastolic BP reduction after HCTZ and tiapamil administration was 3.8 mm Hg (not significant). There were no significant changes in heart rate. Dizziness occurred in one patient taking tiapamil and in three receiving HCTZ. One patient receiving HCTZ developed acute arthritis urica.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316303 TI - The effects of bendroflumethiazide added to nifedipine in patients with hypertension. AB - It has been suggested that a diuretic added to a calcium antagonist may not reduce blood pressure further in patients with hypertension. Bendroflumethiazide 5 mg was given to 17 patients with essential hypertension who had persistent mild to moderate hypertension despite treatment with nifedipine slow-release tablets 20 mg bid. One group received bendroflumethiazide before (N = 8) and the other after placebo (N = 9) in a double-blind, randomized cross-over trial. Supine blood pressure following active bendroflumethiazide administration was significantly reduced in both groups compared with trial entry (166/105 to 150/96 mm Hg, P less than .01; 170/108 to 156/98 mm Hg, P less than .01). A reduction in serum potassium level and a rise in serum uric acid concentration were seen with combined treatment. We cannot substantiate theoretic arguments for the ineffectiveness of a bendroflumethiazide-nifedipine combination on blood pressure. PMID- 3316305 TI - Basic concepts in drug metabolism: Part II. AB - There are numerous articles available that provide a comprehensive review of basic concepts of drug metabolism. Our intent in this review article was to provide an overview of some of the basic pathways for drug metabolism, how they may be altered, and what influence they may have on drug therapy. Understanding metabolism should help to develop more effective and safer new drugs and to provide safer and more effective regimens for existing drugs. Although intersubject and intrasubject variability in pharmacokinetics is common, much of it may be explained by differences in metabolism. PMID- 3316304 TI - Comparison of moxonidine and clonidine HCl in treating patients with hypertension. AB - In a six-week multicenter, double-blind comparison study, moxonidine and clonidine HCl were tested in 122 and 30 outpatients, respectively, with mild to moderate hypertension (World Health Organization stage I and II; highest measured diastolic blood pressure, 90 to 115 mm Hg). Each agent reduced systolic and diastolic blood pressure to a similar significant extent: moxonidine, 25.4 and 12.4 mm Hg, respectively; clonidine, 25.3 and 10.0 mm Hg, respectively (P less than .001 vs baseline). The mean individually titrated dose of moxonidine and clonidine HCl was found to be 0.36 mg/d. Clonidine slightly reduced heart rate in patients assuming an upright position by 3 beats/min at the end of dose titration (P = .018), while moxonidine did not. Two patients receiving moxonidine and three patients taking clonidine HCl discontinued therapy because of side effects. However, patients administered clonidine experienced significantly more side effects (53%) compared with a 30% incidence of adverse effects associated with moxonidine (P = .031). The most frequent adverse effect of both agents was dryness of mouth, which was mentioned significantly more often with clonidine (47%) than with moxonidine (20%) (P = .005). Edemas were found in 0.8% and 17% of patients during six-week treatment with moxonidine and clonidine, respectively (P = .001). Accordingly, moxonidine was tolerated significantly better than clonidine (P less than .001) in this parallel comparison study. Moxonidine is as effective as clonidine in monotherapy of mild to moderate essential hypertension and, additionally, neither drug produces clinically important changes in biochemical parameters. PMID- 3316306 TI - Psychoactive agents, seizure production, and sudden death in epilepsy. AB - Major tranquilizers as well as antidepressant agents have been associated with clinical seizures in patients administered these agents. The incidence of such seizures is generally low when these drugs are administered in therapeutic doses. However, administration of large doses of these agents has been associated with many cases of convulsion production. The effects that these drugs have on animal models of epilepsy have been examined. It appears that the phenothiazines act as convulsant agents at lower doses, whereas, at higher doses, they act as anticonvulsant drugs. Antidepressants, on the other hand, appear to exert an anticonvulsant effect at low doses and convulsant effects at high doses. The mechanism by which these agents alter the seizure threshold is not yet known. Clinically, drugs of lower seizure production potential should be substituted for those drugs with greater potential in treating epileptic patients for psychiatric ailments. The problem of sudden death in epileptic patients is one that must be confronted. Sudden death has most frequently been attributed to autonomic dysfunction and cardiac arrhythmia in these patients. The contribution of stress in sudden death production also must be taken into account. In addition, some psychoactive agents have been associated with sudden death as well as cardiac arrhythmia and seizure production. Thus, in light of the possible additivity of the factors involved in the production of sudden death, the administration of a psychoactive agent to an epileptic patient should be approached with caution. Those agents that do not alter cardiac rhythm or seizure threshold should be administered if a psychoactive agent is deemed necessary for the management of psychiatric illness in the epileptic patient. PMID- 3316307 TI - Blood protein binding of cyclosporine in transplant patients. AB - The objective of this study was to compare the binding of cyclosporine to blood proteins between four healthy subjects and five liver and eight renal transplant patients. Fresh heparinized blood was obtained, to which sufficient quantities of tritium-labelled cyclosporine and unlabelled cyclosporine were added to blood samples or red blood cell (RBC) suspensions. Concentrations of cyclosporine in whole blood, plasma, RBC suspension, and phosphate buffer were estimated by liquid scintigraphy. The blood:plasma ratio of cyclosporine in transplant patients was significantly lower (P less than .05) than that in healthy volunteers. The RBC:buffer ratio, a measure of affinity of RBCs for cyclosporine, was highest in those with liver transplants and lowest in those with kidney transplants. The unbound fraction of cyclosporine in plasma was less in transplant patients than in healthy volunteers. The results of this study indicate that there are differences in blood protein binding of cyclosporine between transplant patients that may contribute to the differences in the pharmacokinetics and pharmacodynamics of this drug. PMID- 3316309 TI - Comparison of the antihypertensive efficacy and adverse reactions to two doses of bendrofluazide and hydrochlorothiazide and the effect of potassium supplementation on the hypotensive action of bendrofluazide: substudies of the Medical Research Council's trials of treatment of mild hypertension: Medical Research Council Working Party. AB - As substudies of the Medical Research Council's trials of treatment of mild hypertension and of hypertension in the elderly, two studies were carried out comparing the effects of different doses of two diuretics on blood pressure, concentrations of some biochemical variables, and the incidence of subjective adverse reactions. In one study, in which 484 patients with mild hypertension participated, daily doses of bendrofluazide 5 mg and 10 mg, with and without oral potassium supplements, were compared. In the second, involving 701 elderly patients with hypertension, daily doses of hydrochlorothiazide 25 mg together with amiloride 2.5 mg were compared with hydrochlorothiazide 50 mg together with amiloride 5 mg. The mean (+/- SD) durations of treatment were 35 +/- 17 months in the first study and 10 +/- 7 months in the second. Neither study showed any significant difference in blood pressure response to the two doses of diuretic, whereas biochemical changes and the reported incidence of subjective adverse reactions were dose-related. In the first study, potassium supplementation with potassium chloride 16.8 or 33.6 mmol did not have a significant effect on the fall in serum potassium level, which was only slightly reduced, and did not have any significant effect on the antihypertensive effect of either dose of bendrofluazide. PMID- 3316308 TI - Bromocriptine therapy in cocaine withdrawal. AB - Twenty-four cocaine addicts who experienced withdrawal symptoms were studied for six weeks in a double-blind design. Half of the group received daily treatment with bromocriptine and the other half with placebo. Significant relief with bromocriptine was seen almost immediately and continued throughout the detoxification period. The authors speculate that the results are consistent with the "dopamine-depletion model" of cocaine withdrawal. PMID- 3316310 TI - Drug absorption. PMID- 3316312 TI - Alprazolam: an antidepressant? Alprazolam, desipramine, and an alprazolam desipramine combination in the treatment of adult depressed outpatients. AB - The antidepressant efficacy of alprazolam (ALP) was tested in a double-blind controlled comparison with desipramine (DMI) and an ALP-DMI combination in outpatients diagnosed with major depressive disorder by Research Diagnostic Criteria (90% met criteria for endogenous subtype). Following a placebo period of at least 1 week, subjects who continued to meet severity criteria defined by Hamilton Depression Rating Scale (HDRS) scores were administered oral doses of the active medication (N = 79), in a dose ratio of 1 mg ALP:50 mg DMI:1 mg ALP + 50 mg DMI. Treatment continued for 6 weeks, and all subjects who completed at least 2 weeks (N = 69) were included in endpoint analyses. Following the placebo baseline, symptoms were rated again at day 5 and at the end of weeks 1, 2, 4, and 6. Final doses averaged 4.6 +/- 1.3 mg for the ALP group, 230 +/- 61 mg for the DMI group, and 4.6 +/- 1.2 mg ALP + 229.5 +/- 1.2 mg DMI for the combination group. The final outcome was a comparable degree of improvement at the endpoint among the three treatment groups on measures of depression (HDRS and Beck Depression Inventory), anxiety (Hamilton Anxiety Rating Scale), and global improvement (Global Assessment Scale, and Physician and Patient Global Impressions). A similar outcome was found for the subgroup of patients who completed all 6 weeks (N = 56). Endpoint analyses also showed that ALP-treated subjects responded sooner and continued to show improvement throughout the course of the study on measures of depression, anxiety, and global status. These results suggest that ALP alone is as effective as a standard tricyclic for the acute treatment of patients with major depressive disorder and that significant improvement may occur within the first week of medication. Side effect profiles were compared among treatment groups and are discussed, as are other clinical studies that have investigated ALP's potential antidepressant efficacy. PMID- 3316311 TI - A comparative trial of moxalactam plus ticarcillin and clavulanic acid or piperacillin as empiric antibiotic therapy for febrile cancer patients. AB - Resistance of bacteria to beta-lactam antibiotics remains a difficult clinical problem that can be compounded in infected patients with serious underlying illness, especially those who are immunocompromised. In a prospective randomized safety and efficacy trial, febrile cancer patients received either ticarcillin disodium combined with the beta-lactamase inhibitor clavulante potassium (Timentin, Beecham Laboratories, Bristol, TN) plus moxalactam (T+M), or piperacillin plus moxalactam (P+M) as initial empiric antimicrobial therapy. Sixty-six febrile episodes in 53 patients were studied. In the T+M group, 14 (78%) of 18 clinically evaluable infections in patients with profound granulocytopenia improved as did all 14 (100%) such infections in the P+M group. In the T+M group 17 of 21 (81%) similarly evaluable infections improved irrespective of granulocyte count, as did 14 (88%) of 16 of such infections in the P+M group. These results are not statistically significantly different. Serious side effects were infrequent and comparable with both regimens. There was one antibiotic related hemorrhage in the P+M group and a serious episode of nephrotoxicity in a patient who died without recovering renal function in the T+M group. These results suggest that the overall safety and efficacy of Timentin plus moxalactam, and piperacillin plus moxalactam are comparable and similar to previous empiric antibiotic trials. PMID- 3316313 TI - A case of neuroleptic malignant syndrome with myoclonus and triphasic EEG waves. PMID- 3316314 TI - Epithelial odontogenic tumours in domestic animals. AB - Epithelial odontogenic tumours are uncommon, poorly understood and often difficult to diagnose, oral neoplasms. Dental organ pre-ameloblasts and basal lamina induce development of mesenchymal cells into odontoblasts, which produce dentin and induce pre-ameloblasts to mature into secretory ameloblasts. These reciprocal sequential inductive interactions between dental epithelium and mesenchyme form the basis for classifying epithelial odontogenic tumours. There are three tumours classified as non-inductive: ameloblastoma characterized by cords and islands of stellate reticulum with peripheral palisades of polarized columnar cells, adenomatoid ameloblastoma which has acini, rosettes and ducts of polarized columnar cells and stellate reticulum and calcifying epithelial odontogenic tumour which contains foci of Congo-red-positive material surrounded by pleomorphic polygonal epithelial cells. There are five tumours in which induction of mesenchymal tissue is evident: ameloblastic fibroma with characteristics of ameloblastoma plus proliferation of closely associated pulp like mesenchyme; dentinoma consisting of masses of dentin, often with minimal cellular component; ameloblastic odontoma which contains palisaded epithelium and stellate reticulum as in ameloblastoma, as well as foci of dentin and/or enamel; complex odontoma which is a disorderly array of dentin, enamel, ameloblastic epithelium and odontoblasts; and compound odontoma containing denticles with well organized tooth morphology. This paper reviews the embryogenesis of teeth and describes six types of epithelial odontogenic tumours in 13 animals. The literature concerning these tumours in nearly 250 animals is reviewed. The most commonly reported tumour is ameloblastoma and the species in which all types are most commonly reported is the dog. PMID- 3316315 TI - A study of experimental endocarditis in pigs. AB - In a proposed study of fibrinolytic therapy in experimental streptococcal endocarditis, this disease was induced in pigs by preinoculation damage to the aortic valve; the technique of this is described. If untreated, the disease runs a protracted course, similar to that in man. Fibrinolytic activity, normally low in the pig, can be increased by stress, by urokinase, by plasmin and briefly by streptokinase if supplemented by human plasminogen. The proposed experiments were abandoned in pigs, chiefly because of technical difficulties in obtaining frequent samples of blood and maintaining infusions. In experiments on the response of ADP-induced aggregation of pig platelets to prostacyclin, they were found to be about 10 times more resistant than human platelets. It is suggested that this resistance to prostacyclin, together with their usually low state of systemic fibrinolytic activity, may explain the susceptibility of pigs to bacterial endocarditis. PMID- 3316316 TI - Psoralen photochemotherapy. AB - Psoralens and sunlight have been used by the Egyptians and Indians for hundreds of years for the treatment of vitiligo. The combination of oral psoralens and artificial ultraviolet A (PUVA) therapy was approved for the management of severe psoriasis by the Food and Drug Administration in 1982. Since then PUVA therapy has been found to be an effective modality in the treatment of many cutaneous conditions. When properly administered, the major short-term side effects are minimal. The long-term side effects may include an increased risk of squamous cell carcinoma, atypical cutaneous pigmentation, accelerated skin aging, and ophthalmologic abnormalities. By careful patient selection and limiting the cumulative UVA dosage and frequency by using combinations or alternative therapies, these side effects may be reduced. Continued reporting of carefully carried out long-term prospective studies will provide us with more knowledge of the long-term side effects of PUVA. In the meantime, for each patient on PUVA therapy the risk/benefit ratio should be carefully considered. PMID- 3316317 TI - Oral hyposensitization in nickel allergy. AB - In two controlled studies, each including 24 patients with contact allergy to nickel, different protocols were designed in an attempt to diminish the patients' hypersensitivity by oral administration of the antigen. With doses of 5.0 mg nickel sulfate taken once a week for 6 weeks, but not with 0.5 mg daily, the degree of contact allergy was significantly lowered, measured as patch test reactions before and after nickel administration. PMID- 3316318 TI - Dorfman-Chanarin syndrome. A case report and a review. AB - Dorfman-Chanarin syndrome in two sisters of Jewish Iraqi origin is reported. This heritable disorder of the metabolism of neutral lipids was manifested by congenital ichthyosis, vacuoles in the leukocytes, and variable involvement of liver, muscle, central nervous system, and the auditory system. In two asymptomatic members of the family leukocyte vacuoles were found as the only sign of the syndrome. Clinical, pathologic, ultrastructural, and biochemical findings are described. Previous reported cases are reviewed. PMID- 3316319 TI - Familial dyskeratotic comedones. A report of three cases and review of the literature. AB - Three family members, at initial evaluation, had generalized comedonal lesions with histologic changes of acantholysis and dyskeratosis. A total of nine cases of this entity, termed familial dyskeratotic comedones, have been documented in the literature. It appears to have autosomal dominant inheritance and onset in childhood or adolescence. Lesions are asymptomatic except for occasional pruritus or inflammation, and general health is undisturbed. A history of acne vulgaris is seen in four of nine patients and is the only associated skin disease. Treatment with oral isotretinoin produced no improvement in two patients. Electron microscopy revealed changes similar to those seen in Darier's disease. PMID- 3316320 TI - Immediate hypersensitivity. PMID- 3316321 TI - Malignant melanoma arising in an ovarian cystic teratoma in pregnancy. AB - Ovarian cystic teratoma is a common neoplasm, but malignant melanoma arising within such a tumor is exceedingly rare. The small number of previous cases generally occurred in older individuals, usually with a poor outcome. The patient presented herein is remarkable for her youth and an optimistic prognosis. Hers is also the first such case to be associated with pregnancy. The relevant literature is briefly reviewed. PMID- 3316322 TI - CT and ultrasound findings of surgically retained sponges and towels. AB - The CT and ultrasound features of retained sponges (gossypibomas) are described in six patients. They are well-circumscribed cystic masses without surrounding edema. The retained sponges or towels were correctly identified in only three cases. In the other three cases retained sponges were organized and lost their original configuration. Gas was seen in one case and calcification in two cases. Gossypibomas should be included in the differential diagnosis in all patients with a well-circumscribed cystic mass in the abdomen and with a history of previous laparotomy. PMID- 3316323 TI - CT manifestations of Richter syndrome. AB - Richter syndrome is an uncommon complication of chronic lymphocytic leukemia characterized by its transformation into diffuse histiocytic lymphoma. We present two documented cases of Richter syndrome and its radiographic manifestations, which have not previously been reported. These include hepatosplenomegaly, diffuse marked adenopathy, and involvement of the skeletal system. The diagnosis of Richter syndrome should be suggested when these radiographic findings occur with chronic lymphocytic leukemia. PMID- 3316324 TI - Renal biopsy-related hemorrhage: frequency and comparison of CT and sonography. AB - To evaluate the frequency of retroperitoneal hemorrhage related to renal biopsy, we prospectively assessed 182 patients (200 biopsies) using state-of-the-art CT and ultrasound. Our study revealed definite CT evidence of hemorrhage after 90.9% of biopsies. In a blinded analysis of images obtained in biopsied patients and in unbiopsied control patients the overall accuracy of CT was 93.8 versus 76.4% for ultrasound. Our data suggest that detectable hemorrhage is virtually always seen after renal biopsy and its frequency is much higher than noted in earlier studies. PMID- 3316325 TI - Intracystic papillary carcinoma of the breast: mammographic, sonographic, and MR appearance with pathologic correlation. PMID- 3316326 TI - MR imaging of a renal oncocytoma. AB - A renal mass showing no invasion of the pararenal fascia, a distinct margin between tumor and remaining kidney, vascular patency, and large ring-like calcification detected on magnetic resonance imaging may suggest the diagnosis of renal oncocytoma. PMID- 3316327 TI - Postoperative cervical spine: MR assessment. AB - The purpose of this article is to describe the variety of magnetic resonance (MR) findings in the cervical spine following anterior diskectomy and fusion (ADF), corpectomy, and postoperative complications. Toward that end, we retrospectively reviewed MR in 73 postoperative cervical spine patients and correlated the MR with their initial operative reports. Patients imaged within 1 month of ADF showed bone grafts as discrete rectangular areas of altered signal intensity within the central portions of the disk spaces. A spectrum of graft and vertebral body signal changes are seen up to 2 years following ADF. Patients studied greater than 2 years following ADF generally showed solid bony fusions without evidence of the graft or the original disk space. Bony canal stenosis at the operative site (19 of 73 cases) and disk herniations above or below the fusion sites (21 of 73 cases) were the most common postoperative findings. Hypertrophic bone was visualized as anterior extradural defect that was isointense (nine cases), hyperintense (four cases), or hypointense (eight cases) to the vertebral body on T1-weighted images. Disk herniations were evenly distributed above and below the fusion levels. PMID- 3316329 TI - Ultrastructural studies of the skin and cultured fibroblasts in I-cell disease. AB - The skin and cultured fibroblasts from a patient with I-cell disease were examined by electron microscopy. Multiple vacuolations were seen in fibroblast and/or histiocyte-like cells, secretory cells of eccrine glands, and Schwann cells of the skin. Vacuolar inclusions were single membrane-limited, and contained a few reticulo-floccular and vesicular materials, endothelial cells of the dermal capillaries contained other types of inclusions, which were also membrane-limited, more electron dense, and multivesicular. The epidermis and pilosebaceous appendages seemed to be normal. Cultured skin fibroblasts contained prominent inclusions which varied in size and morphology. Acid phosphatase activity was seen in some of those inclusions, indicating their derivation from lysosomes. These findings suggest that the I-cell disease is a type of lysosomal storage disease and that electron microscopic examination of normal-appearing skin in this disease may contribute to the diagnosis. PMID- 3316328 TI - An immunopathological study of herpes-associated erythema multiforme. AB - Any pathogenetic mechanism proposed for erythema multiforme (EM) must account for the prominent mononuclear cell infiltrate in the skin lesions. The purpose of this study was to characterize immunopathologically, with monoclonal antibodies to human leukocyte antigens, the inflammatory cells in early target lesions of recurrent herpes-associated EM. Cryostat sections of snap-frozen skin biopsies were studied by the avidin-biotin immunoperoxidase technique with use of the following monoclonal antibodies: anti-HLA-DR, anti-Leu M5, anti-Leu 4 + 5b, anti Leu 3a + 3b, anti-Leu 2a, anti-Leu 14, and anti-Leu 6. The dermal mononuclear inflammatory infiltrate in the EM biopsies consisted of monocyte-macrophages and T-lymphocytes, with both helper and suppressor T cells present. Both the dermal inflammatory infiltrate and the overlying keratinocytes were strongly HLA-DR positive. No definite alteration of Langerhans cell number or distribution was noted. These findings are consistent with the characteristics seen in cell mediated immune reactions in the skin and point to this as a likely immune mechanism for the tissue damage of EM. PMID- 3316330 TI - The relative value of screening instruments in adolescence. AB - The phase of development that equips a child to become an adult is a period of transition. To date no instrument has become established as the routine screening measure for this age group in the same way as the Rutter B2 Scale has in children. During a major population study of adolescent functioning, the pupils drawn from four comprehensive schools were used to compare the validity of several screening measures in this age group. The results show that screen instruments tend to be behaviour specific and that antisocial and neurotic behaviour are relatively sex specific. The Rutter Malaise Inventory had the highest correlation with the psychiatrist's diagnosis of neurotic disorder, although the General Health Questionnaire also proved to be reasonably efficient. The antisocial subscale of the Rutter B2 Scale showed the best correlation with the psychiatrist's diagnosis of conduct disorder. PMID- 3316331 TI - Residential care of youth: convergent versus divergent thinkers. AB - Effective residential care of disturbed adolescents depends on the treatment programmes being integrated. Readily achievable with defined illness, special difficulties exist when dealing with disturbed adolescents. For a unit to be successful an important function of its director is monitoring the therapeutic input so the recurring but inevitable conflicts of aims (e.g. encouraging independence of adolescents but maintaining control of unit functioning) do not render staff ineffective. Amongst the qualities required are a capacity to be at ease with divergent thinking. PMID- 3316332 TI - Testing sealing properties of restorative materials against moist dentin. AB - The objectives of this investigation were (1) to develop a sensitive laboratory system that simulates the physiological and clinical conditions of a prepared human tooth in order to facilitate the determination of the bonding and sealing efficacies of restorative dental materials and (2) to conduct experiments with two dentin bonding agents, two posterior composite resin restorative materials (hybrid and microfilled), and a glass-ionomer type II filling material. The system functioned well and provided data to indicate that, after margination, the two posterior composite resin restorative materials performed equally and both performed better than the glass-ionomer filling material; none of the materials provided a perfect seal immediately after insertion, although some restorations demonstrated perfect seals from 16 hours to 28 days after placement; the seal of the glass-ionomer material improved after 28 days of storage in buffer solution; each successive step in the respective composite resin procedures improved the seal except in one case for the microfilled resin. PMID- 3316333 TI - Factors affecting estimation of dental amalgam mercury exposure from measurements of mercury vapor levels in intra-oral and expired air. AB - Several investigators have attempted to assess the extent of mercury exposure from dental amalgam restorations through the use of mercury vapor measurements of intra-oral or expired air. The sampling times and flow rates of the mercury vapor analyzers used in intra-oral measurements are not comparable with physiological inhalation times or flow rates of air through the mouth during inhalation. Analysis of the assumptions and measurement techniques employed in previous attempts to estimate mercury exposure from amalgam restorations shows that adequate compensation had not been made for these measurement parameters. Calculation of the mercury vaporization rates responsible for the mercury vapor concentration values previously reported enabled the daily dose of mercury to be estimated for subjects with various numbers of amalgam restorations. The corrected estimates for daily dose of mercury from amalgam restorations are a factor of sixteen lower than those previously reported. PMID- 3316334 TI - Surgical treatment of psoriasis: a review including a case report of dermabrasion of hypertrophic psoriatic plaques. AB - Psoriasis is a chronic papulosquamous disease. Koebner and reverse Koebner reactions have been described. Surgical treatments which produce a reverse Koebner reaction in psoriasis are reviewed and a case of dermabrasion of resistant, hypertrophic plaques is presented. These procedures are to be considered only when conventional therapy fails. PMID- 3316335 TI - Free laminar thin band graft--a surgical therapeutic variant in the treatment of leg ulcers. AB - For the past 2 years, we have been using a surgical technique for the treatment of leg ulcers caused by chronic venous insufficiency. This consists of a type of graft biologically and technically intermediate between Reverdin and Thiersh's types. We have named it the "free laminar thin band graft." In contrast to the Thiersh graft, this simple surgical technique requires little equipment, and it can be done quickly and easily as an office procedure, with little risk to the patient. In addition, it is a low cost procedure. In our experience with this technique, healing time is shorter and lesions recur later than with the Reverdin graft. The authors describe the surgical method and report a clinical case. PMID- 3316336 TI - Eruptive keratoacanthoma en plaque in an immunosuppressed patient. AB - Immunosuppressive therapy predisposes to the development of a variety of neoplasms. A 63-year-old man developed multiple eruptive epithelial tumors 15 years after renal transplantation. The tumors included what had been diagnosed as squamous cell carcinomas, Bowen's disease, and solitary and eruptive keratoacanthomas. In addition, he developed a large plaque studded with small nodules that had the histologic features of keratoacanthoma. To our knowledge, this is the first example of acquired eruptive keratoacanthoma forming a large plaque. PMID- 3316337 TI - Frequency-dependent ultrasonic differentiation of normal and diffusely diseased liver. AB - The attenuation coefficient in 38 pathologically graded in vitro liver specimens was measured over a frequency range from 1.25-8 MHz and fitted to the power law model. The attenuation in the normal group (n = 17) exhibited a frequency dependence of the form 0.399f1.139; in the mild disease group (n = 13), it exhibited a dependence of the form 0.395f1.212; and in the moderate/severe disease group (n = 8), it exhibited a dependence of the form 0.391f1.325. Using a Student's t test, it is shown that, due to these differences in the frequency dependence, the statistical significance level at which the null hypothesis regarding the difference between the mean attenuation slopes of any two of these categories is rejected, is a strong function of frequency in the range of 1-4 MHz. The significance level relating to the difference between the normal and moderate/severe disease group is more than one order of magnitude better than the other categories. In all cases, no substantial improvement occurs beyond 4 MHz. It is also shown that attenuation slope values at 3 MHz confirm in vivo literature results obtained via different techniques. PMID- 3316338 TI - The presidents. Harry M. Klenda. 1969-1970. PMID- 3316339 TI - Bone disease metastatic to the jaws. AB - Metastatic lesions of the jaws are relatively rare in relation to other pathological conditions of the oral and maxillofacial region. When present, they provide a diagnostic challenge and create a unique treatment role for the dental practitioner. The radiographic and clinical findings in patients with these lesions may mimic common inflammatory-infectious and posttraumatic conditions of the mouth and jaws. This review looks at the literature and clinical radiographic findings in patients with metastatic disease of the jaws. The role of the dental practitioner in the diagnostic and medical treatment phases is also discussed. PMID- 3316340 TI - Dentistry on stamps. PMID- 3316341 TI - American Dental Association status report on the occurrence of galvanic corrosion in the mouth and its potential effects. Council on Dental Materials, Instruments, and Equipment. PMID- 3316342 TI - Dentistry on stamps (Ambroise Pare). PMID- 3316343 TI - Prognostic importance of the immediate hemodynamic response to nifedipine in patients with severe left ventricular dysfunction. AB - To determine the clinical significance of the occurrence of hemodynamic deterioration after the administration of calcium channel blocking drugs, nifedipine (20 mg orally) was administered to 29 patients with severe left ventricular dysfunction. Thirteen patients showed hemodynamic improvement with the drug (Group 1), as shown by a notable increase in cardiac index associated with a modest decrease in mean arterial pressure. The other 16 patients exhibited hemodynamic deterioration after nifedipine (Group 2), as reflected by a decline in right and left ventricular stroke work indexes accompanied by a marked hypotensive response. These differences were not related to differences in the peripheral vascular response to nifedipine, because both groups showed similar decreases in systemic and pulmonary vascular resistances. Groups 1 (hemodynamic improvement) and 2 (hemodynamic deterioration) were similar with respect to all demographic variables and pretreatment left ventricular performance (cardiac index, left ventricular filling pressure and systemic vascular resistance). Yet, the 1 year actuarial survival in patients in Group 1 was substantially better than that in patients in Group 2 (67 versus 23%, p = 0.009). Group 2, however, had higher values for plasma renin activity (17.7 +/- 6.0 versus 4.3 +/- 1.4 mg/ml per h, p less than 0.05), lower values for serum sodium concentration (134.6 +/- 1.2 versus 139.2 +/- 0.6 mEq/liter, p less than 0.05) and higher values for mean right atrial pressure (15.8 +/- 2.0 versus 7.9 +/- 1.4 mm Hg, p less than 0.01) than did patients in Group 1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316344 TI - Prevalence and characteristics of late asthmatic responses to exercise. AB - The prevalence and characteristics of late asthmatic responses to exercise were studied in an adult asthmatic population. Twenty-four subjects (eight male and 16 female), aged 17 to 39 years (mean, 23.7 years), performed a 6-minute exercise on a bicycle ergometer at 75% of their maximum oxygen intake. FEV1 was measured at regular time intervals up to 8 hours after exercise. Seven subjects demonstrated a late asthmatic reaction defined as a fall in FEV1 greater than 10% between 2 to 8 hours. Bronchial reactivity to histamine was unchanged 24 hours after the exercise, compared to baseline. On a control day, a fall in FEV1 similar to the one observed after exercise was induced by methacholine inhalation. Measurements of FEV1 were done at the same time intervals as on exercise day. Neutrophil chemotactic activity was measured in the serum of 15 subjects, on exercise day for early responders, and on the 3 test days for subjects with a dual response. There was no difference between subjects with an isolated early or late response for age, sex, or atopic status. Baseline expiratory flows and nonspecific bronchial reactivity to histamine were similar in both groups. These results demonstrate the occurrence of a late asthmatic response in 30.4% of the population studied. There was no significant change of nonspecific bronchial responsiveness after the late asthmatic response to exercise. No significant increase in neutrophil chemotactic activity could be observed. PMID- 3316346 TI - The quality of medical care received by older persons. AB - This paper reviews studies published since 1970 on the quality of medical services received by older persons. Although many of the studies were flawed in design or limited in scope, they suggest that there are problems in the quality of care received by older persons in ambulatory, hospital, and nursing home settings. Changes in health care delivery and financing should attempt to improve, rather than merely maintain, the quality of medical and health services received by this vulnerable population. PMID- 3316345 TI - Prolonged evaluation of patients with corticosteroid-dependent asthma stage of allergic bronchopulmonary aspergillosis. AB - Eight cases with stage IV allergic bronchopulmonary aspergillosis (ABPA) (corticosteroid-dependent asthma stage) were observed for a total of 82 patient years with individual patients observed for 7 to 19 years (mean 10.2) years. One case is the first case of ABPA diagnosed in the United States in 1967. A second case has been observed through four stages of ABPA. None of these eight cases has demonstrated pulmonary deterioration by clinical, chest roentgenogram, or pulmonary function analysis. After diagnosis, the maintenance dose of prednisone in seven of eight cases was a low to moderate dose alternate-day prednisone. These results suggest that continuous observation and management of episodes of pulmonary consolidation or asthma exacerbations may prevent the progression of ABPA to stage V (fibrotic end stage). The total IgE may remain elevated in these patients, and therapy should not attempt to reduce total serum IgE to normal levels. After prolonged therapy with prednisone for asthma and control of ABPA, the IgE and IgG antibody indices against Aspergillus fumigatus may remain elevated or may be below the levels that are of diagnostic value. PMID- 3316347 TI - Atypical dementia syndrome in an elderly man. PMID- 3316348 TI - Circulatory and degenerative dementias. PMID- 3316349 TI - Keratitis and contact lens wear: a review. AB - The most feared complications of contact lens wear are keratitis and infectious corneal ulceration. This article first defines terms for the clinical practitioner, and then describes and illustrates clinical presentation and management. PMID- 3316350 TI - Histopathological analysis of the corneal epithelium after contact lens wear. AB - Complications from contact lens wear are seldom examined histopathologically. Understanding of the epithelial reactions in response to contact lens wear would help early diagnosis and direct treatment action. Therefore, this study examines the histopathology of abrasion, epithelial edema, epithelial thinning and superficial punctate staining. Important factors in the etiology of these conditions are various definable lens and tear characteristics as well as mechanical effects from the lens. Observations on corneal innervation that have not been previously reported are used to help explain the reduced corneal sensitivity in the contact lens wearer. It is concluded that the breakdown of the epithelial surface prevents the epithelium from fulfilling its fluid and microorganism barrier functions. In addition, disturbance of the normal epithelial structure interferes with its ability to withstand further trauma and to convey the injury to the brain via the neural pathways. PMID- 3316351 TI - A categorical approach to the diagnosis and management of pre- and post-fit contact lens conditions. AB - There are two essential elements in the successful management of contact lens wear. First, it is necessary to pre-assess common anterior segment disorders which may interfere with wear. Such conditions often require pre-wear remediation and special fitting considerations. Second, post-fit complications must be accurately evaluated regarding risk, etiology and prognosis. Appropriate treatment and follow-up for such complications usually results in continued, successful wear. This paper presents tables including diagnostic and management high-lights of the more common complications. Each table is subdivided into anatomical, diagnostic (alphabetical listings) etiological and risk factor categories for practical referencing. PMID- 3316352 TI - Immunological complications of soft contact lenses. AB - Immunologic reactions may be the basis of some complications associated with the use of soft contact lenses. In the case of giant papillary conjunctivitis, the antigen causing the problem is not known but is presumed to be protein adherent to the lenses. Superior limbic keratoconjunctivitis and dendritic corneal lesions related to soft contact lenses are associated with thimerosal, but occlusive patch tests do not demonstrate consistent delayed hypersensitivity responses to this preservative in these patients, suggesting that a toxic response may be involved. The association of corneal infiltrates and conjunctival hyperemia with delayed hypersensitivity to thimerosal probably represents the strongest immunologic association to date. These patients consistently show delayed hypersensitivity reactions to thimerosal in occlusive patch tests and intradermal tests. PMID- 3316353 TI - Liability and extended wear contact lenses. AB - The fitting and dispensing of extended wear contact lenses places special clinical and legal demands upon optometrists. These patients must be monitored on a regular basis to minimize the risk of complications. To promote better understanding and compliance, the use of printed agreements is recommended. Failure to observe these factors--and to document patient care--may lead to professional liability claims based on allegations of negligence or product liability. PMID- 3316354 TI - Evaluation of the nephrotoxic potential of styrene in man and in rat. AB - The urinary excretion of beta 2-microglobulin, retinol-binding protein and albumin was measured in 65 workers exposed to styrene at levels averaging 50 percent of the current threshold limit value (215 mg/m2) for 1-13 years (mean: 6 years). By comparison with a control group matched for age and socioeconomic status, no significant difference was observed in the urinary excretion of proteins. In rats, styrene was weakly nephrotoxic. No functional or morphological renal change could be disclosed in rats exposed to 565 mg of styrene/m3, 5 days/week for 13 weeks. The repeated i.p. injection of 1 g styrene/kg (1/5 of oral LD50) for 10 days induced only a slight tubular dysfunction as evidenced by a 5-fold increase in beta 2-microglobulinuria. Altogether, these epidemiological and experimental data suggest that the current threshold limit value for styrene (215 mg/m3) proposed by the American Conference of Governmental and Industrial Hygienists does not entail any risk of renal toxicity. PMID- 3316355 TI - A direct assay for detection of chemically induced changes in the rejoining kinetics of radiation induced DNA strand breaks. AB - A simple and sensitive procedure for testing various chemicals affecting DNA repair is presented. Cells, either labelled with [3H]thymidine or [14C]thymidine, were drug-treated or used as references cells. Both cell populations were irradiated with 5 Gy. The number of DNA breaks were determined, after mixing of drug-treated and reference cells of different labelling, at various intervals by the DNA unwinding technique and the drug-dependent DNA breaks were calculated. The drugs benzamide, 3-aminobenzamide, novobiocin and 9-beta-D arabinofuranosyladenine (araA), all known to affect DNA repair, were used to study their effect on the number of DNA strand breaks with the presented technique. It was found that the assay improved the accuracy in determining the influence of DNA repair inhibitors compared to indirect measurements. PMID- 3316356 TI - Isolating and sequencing the infrequent 3'-ends of a specific mRNA. AB - Procedures are described for identification of very infrequent in vivo 3'-ends of RNA. After purification by filter hybridization, the 3'-ends were labeled with [5'-32P] cytosine-3'-P in the RNA ligase reaction. Significantly fewer counts were incorporated in the ligase reaction than in the polynucleotide kinase reaction to label 5'-ends. The incorporation was increased by increasing the RNA concentration 5-10 fold by using only one round of filter hybridization. Non specific RNA binding could be eliminated by RNase A treatment of the filter if a great excess of denatured heterologous DNA was immobilized along with the DNA probe. Significant amounts of DNA were released when eluting the hybrid RNA from such filters. DNA inhibited the ligase reaction, while its DNase products were even more inhibitory. Treatment of the DNase products with alkaline phosphatase completely eliminated the inhibition. We detected no spurious 5'- or 3'-ends generated in the hybrid RNA by RNase A activity used to reduce the non-specific RNA. Also, RNase T1 could be used in place of RNase A to eliminate non-specific RNA binding, but about 25 times more RNase T1 (microgram/microgram) was needed. We used partial alkali digestion to sequence 3'-ends. A major (one hit) and minor (two hit) set of products were produced which could be distinguished from each other by alkaline phosphatase treatment and homochromatography of the products. PMID- 3316357 TI - Selective absorption and scattering of light by solutions of macromolecules and by particulate suspensions. AB - For particulate suspensions and for solutions that scatter light measurably the total absorbance A generally contains contributions due to specific absorption (Aa) and scattering of light (As). The quantity As is closely related to the turbidity tau. In general, spectrophotometry of such systems requires proper modification of the spectrophotometer used in order to permit accurate determination of the absorbance A and of the derived quantities Aa and As. Apparent deviation from Beer's law in such systems is often due to inappropriate experimental technique. After a discussion of the parameters that determine the intensity of light scattered by solutes, an account is given of the experimental precautions to be taken for determination of the absorbance of light scattering suspensions and solutions and of techniques for correcting absorbance spectra for scattering of light. Measurement of the turbidity is briefly confronted with determination of the scattering ratio i90 degrees/Io and the impact of erroneous turbidity measurements on derived molecular parameters is discussed. PMID- 3316358 TI - Validation of a fast, simple and reliable method to assess protein synthesis in individual tissues by intraperitoneal injection of a flooding dose of [3H]phenylalanine. PMID- 3316359 TI - Complications of triple arthrodesis with comparison to select rearfoot fusions. AB - Triple arthrodesis is valuable in the stabilization and correction of foot deformity resulting from postcalcaneal fracture, talipes equinovarus, and neurological deficits. This manuscript summarizes the literature related to the complications of delayed union, hypermobility, and arthrosis following triple arthrodesis. A comparison of the outcome of specific rearfoot fusions is also presented. PMID- 3316360 TI - Talipes equinovarus: two case reports and literature review. AB - Clubfoot, or talipes equinovarus, was introduced into the medical literature by Hippocrates in 400 B.C. The clubfoot deformity is a pathologic condition consisting of inversion and adduction of the forefoot, equinus of the ankle, and inversion of the heel. The condition has also been described as a congenital subluxation of the talocalcaneonavicular joints. This manuscript will review the literature with respect to history, incidence, etiology, anatomy, classification, radiology, and treatment. Two case reports are also presented. PMID- 3316361 TI - Talocalcaneal coalitions: a review and discussion of past and current therapy. AB - This manuscript presents an overview of talocalcaneal coalitions, and information with regard to etiology, clinical presentation, and diagnosis. The treatment of this deformity is a currently contested issue in the literature. Several therapeutic concepts are discussed. PMID- 3316362 TI - Surgical considerations in hallux abducto valgus with rheumatoid arthritis. AB - The rheumatoid arthritis patient often suffers with forefoot complaints. The most frequently seen pedal deformities are hallux abducto valgus and metatarsus primus adductus. Various surgical procedures have been developed to treat these disabling problems. Arthroplasty has been successfully utilized to relieve pain, but often leaves an unpleasant cosmetic result due to shortening and possible return of the deformity. Arthrodesis and implant arthroplasty are alternatives, but introduce other risks and complications for the patient and surgeon. PMID- 3316363 TI - Radiographic features of gout in the foot. AB - The radiographic findings associated with gout have been widely reported since their initial description by Huber in 1896 (1). This review will describe the characteristic alterations associated with involvement of the foot by gout, as well as several less common manifestations of the disease at this site. Brief consideration is also given to the radiographic differential diagnosis of gouty arthritis affecting the foot. PMID- 3316364 TI - Chondrosarcoma of the foot. PMID- 3316365 TI - Sex hormones in obese premenopausal women and their relationships to body fat mass and distribution, B cell function and diet composition. AB - We examined sex hormone blood concentrations in a group of 33 obese non-hirsute premenopausal women with normal menses and in 14 age-matched normal-weight controls, and evaluated their relationship with anthropometric parameters, dietary habits and insulin levels. Obese women showed lower than control sex hormone-binding globulin (24.9 +/- 14.6 vs 38.6 +/- 12.5 nmol/l; p less than 0.005) and 5 alpha-dihydrotestosterone (13.7 +/- 5.4 vs 18.2 +/- 4.8 ng/dl; p less than 0.005) values. Despite their consensual behavior, the correlation coefficient between 5 alpha-dihydrotestosterone and sex hormone-binding globulin was not significant in the obese while in controls it was 0.68 (p less than 0.01). This suggests that mechanisms operating to lower the plasma levels of these compounds may be regulated differently in obesity. Body Mass Index, per cent body fat and its distribution showed a highly significant negative correlation with sex-hormone binding-globulin and 5 alpha-dihydrotestosterone values. Insulin levels did not appear to be correlated with sex hormone values. On the contrary, in the obese women we found a highly significant correlation between dietary lipids and sex-hormone-binding-globulin levels (r = -0.54; p less than 0.005) and between dietary carbohydrates and estrone values (r = 0.47; p less than 0.005); all these relationships were independent of body weight. These results confirm that in premenopausal women obesity may be characterized by detectable changes in sex steroid metabolism and suggest a possible causal role not only of the excessive quantity of metabolically active adipose tissue but also of specific dietary factors. PMID- 3316366 TI - A case of diabetes mellitus associated with anti-insulin autoantibodies without previous insulin injection. AB - A case of diabetes mellitus who had high levels of fasting immunoreactive insulin (IRI) and low levels of immunoreactive C-peptide (CPR) is reported. Examination of her serum disclosed the presence of IgG class k + lambda type anti-insulin autoantibodies. She has never been treated with insulin, nor had drugs which have been reported to be responsible for inducing insulin autoimmune syndrome. Despite the presence of autoantibodies against insulin, she has never experienced hypoglycemia. Significance of the production of autoantibodies against insulin and physicochemical parameters of anti-insulin antibodies in her serum are discussed. PMID- 3316367 TI - Nonprofit and for-profit medical care: shifting roles and implications for health policy. AB - The contemporary expansion of investor-owned health care facilities has stimulated much controversy but little response from policymakers. We believe this results from the apparently ambiguous relationship between ownership and socially valued outcomes. In our assessment, this ambiguity occurs largely because the effects of ownership are mediated in complex ways by characteristics of the services being delivered and the training of health care providers. Reviewing both the history and current performance of nonprofit and for-profit health care facilities, we identify some of the more important of these mediating factors. Taking these into account, there is a consistent influence of ownership on the delivery of health services. On the basis of this analysis, we discuss appropriate policy responses to the future growth of investor-owned health care organizations. PMID- 3316368 TI - The cohesion and fragmentation of organized medicine in France and the United States. AB - The French and American medical professions share similar historical bases for strong political and economic market positions. As professions, the attributes of common education, ethics, and mission tend to keep physicians together in their political organization. But the medical professions in both France and the United States are also subject to intraprofessional forces of division, such as the conflicts which often oppose generalists to specialists. Although organized medicine in France and the United States shares these commonalities, there is a very important difference between the two countries. The French profession tends toward organizational particularism, both ideologically and nonideologically, which serves to splinter it in ways inimical to the interests of the medical profession. By contrast, the American medical profession tends to organize universally-that is, its organizational base is much more often one of unity and accommodation toward the divergent interests of physicians. Thus, organized medicine in the United States has more easily fought off political and economic pressures coming from government and the private sector-but by no means with total success. On the other hand, highly fragmented organized medicine in France has experienced an almost linear decline in the face of pressures coming from a determined and strong state. PMID- 3316369 TI - An end to a consensus on health care in the Federal Republic of Germany? AB - Over the past fifteen years the national government in the Federal Republic of Germany has animated the political debate about rising health care expenditures. However, it has only provided health policy leadership by shifting the burden of financing health and medical care to others. This paper presents three cases that illustrate the political and institutional constraints inherent in the German policy process that limit the proposal and implementation of appropriate policy solutions to rising health care costs. Cost controls have been inhibited because of the near-universal entitlement of national health insurance, the access all social groups have to advanced medical care, and policies targeted at providers rather than users of health services. The paper also underscores the past and future importance of regional policy coalitions in shaping national health policy. PMID- 3316370 TI - Psychosurgery and the abuse of psychiatric authority in Ontario. AB - Over the past two decades political and legal decisions have sharply curtailed psychiatric authority. One area in which psychiatric authority has been most limited is psychosurgery. This paper uses archival evidence from Ontario to show how psychiatrists ordered and administered psychosurgery for a wide variety of reasons. In some cases psychosurgery was administered to ease staffing problems, for experimental purposes, or simply out of sheer curiosity. Often the consent of patients or relatives was not obtained. This egregious abuse of psychiatric authority contributed to the critical movement against psychiatry and to strict laws limiting and sometimes banning resort to psychosurgery. PMID- 3316371 TI - Effect of smoking in a controlled study of ranitidine treatment in gastroesophageal reflux disease. AB - Smoking has been shown to be a factor in acid peptic disease. A recent U.S. multicenter trial investigating use of ranitidine in the treatment of gastroesophageal reflux disease provided an opportunity to compare smokers and nonsmokers with regard to demographic features, manifestations of disease, and symptomatic response to treatment. A comparison of characteristics of smokers and nonsmokers revealed similar pretrial clinical findings. No significant differences between groups were found with regard to previous complications or recent symptoms of gastroesophageal reflux disease. There were also no significant differences in the way smokers and nonsmokers responded to treatment. Subjects on ranitidine, regardless of their smoking status, showed significantly greater improvement in heartburn symptoms and consumed less antacid than subjects who received placebo. Results of these analyses indicate that smoking as an independent variable was not related to symptomatic response or esophageal healing and that ranitidine was similarly effective in decreasing heartburn symptoms in smokers and nonsmokers. PMID- 3316372 TI - Endoscopic techniques and complications in variceal sclerotherapy. AB - Increasing interest in esophageal variceal sclerotherapy (EVS) for bleeding varices is attested to by hundreds of recent articles on the subject. Hardly a medical journal is published that does not contain a report or editorial opinion about the procedure. Indeed, enthusiastic battle lines have been drawn by those who employ the procedure and skeptics who are awaiting proof of its efficacy. On the sidelines is a fairly large group of medical "fence-sitters," whose agnostic critiques keep the entire question lively and worth dissecting. EVS is not without complications, but it is not very difficult to perform. It can control active variceal hemorrhage and prevent rebleeding in stabilized patients. Its effect on survival seems to be related to the underlying liver disease, the endoscopist's ability to obliterate the varices, and treatment-related morbidity and mortality. Prophylactic EVS may be helpful in carefully selected patients. We review current controversies about EVS and offer technical suggestions to improve efficacy and lower EVS-related morbidity and mortality. PMID- 3316373 TI - Corticosteroids in inflammatory bowel disease. A review. AB - Corticosteroids have been used for decades in the treatment of inflammatory bowel disease. Despite considerable information on the clinical response to corticosteroids in inflammatory bowel disease, much less is known concerning corticosteroids' effects on the underlying immunopathology of the disease. In this review, we discuss the known immunologic actions of corticosteroids: their effects on eicosanoid production and on modulating the humoral and cellular immune response. After reviewing the postulated immunological aberrations in inflammatory bowel disease, we speculate on the specific immunologic effects of corticosteroids in this disease. PMID- 3316374 TI - The immunologic approach to analysis of malignant lymphoma. Mantle zone lymphoma of the ileocecal region. AB - We studied an unusual type of lymphoma of the ileocecal region using an established protocol that combines morphologic, flow cytometric, and immunohistochemical analyses. This lymphoma grew as multiple submucosal nodules, some of which had coalesced into a mass in the terminal ileum. Histologically, the lesion resembled a lymphoma of follicular center-cell origin except for germinal centers that appeared reactive and greatly expanded follicular mantles. Flow cytometric studies showed that the lymphoma contained a monoclonal, kappa+ population of B-lymphocytes. Evaluation of sections of frozen tissue by an immunoperoxidase technique revealed that the germinal centers were polyclonal (nonneoplastic) and that the neoplastic cells were confined to the mantle zone. The additional information led to classification of the neoplasm as the mantle zone variant of intermediate lymphocytic lymphoma. This type of lymphoma may pursue a more aggressive course than a follicular lymphoma derived from the germinal center. We review our general approach to the analysis of hematolymphoid neoplasms and discuss how certain techniques may be useful adjuncts in the evaluation of these types of tumors. PMID- 3316375 TI - Diagnosis of inflammatory and neoplastic colonic disease by sonography. AB - By instilling fluid into the large intestine, it is possible to demonstrate the entire colon starting at the recto-sigmoidal boundary and ending at the cecum. Aside from demonstrating the intestinal lumen, a high resolving transducer will also allow detailed evaluation of the intestinal wall and its surrounding tissue. Examination of 61 patients with colonoscopic-verified diagnoses showed that polyps as well as colon cancer can be diagnosed by colonic sonography. Aside from such localized changes, colonic sonography can also demonstrate typical changes of Crohn's disease as well as the extent of colonic inflammatory involvement. Colonic sonography is a diagnostic procedure that permits specific statements regarding diseases involving the large intestine. PMID- 3316376 TI - Correns, an independent discoverer of Mendelism? I. An historical/critical note. PMID- 3316377 TI - Microphotometric quantitation of the reaction product of several indirect immunoperoxidase methods demonstrating monoclonal antibody binding to antigens immobilized on nitrocellulose. AB - The nitrocellulose model and microphotometry were used to investigate whether in immunoperoxidase cytochemical methods the amount of final reaction product reflects the amount of cell surface antigen. The results obtained with four cytochemical peroxidase methods, i.e., those using diaminobenzidine/H2O2 (DAB/H2O)2, DAB/H2O2/COCl2, DAB/H2O2/imidazole, and silver intensification of the DAB end product, were compared first. The quantitative DAB/H2O2/imidazole method proved to be the most sensitive and was selected for further studies. Cell surface antigens prepared by solubilization of peritoneal macrophages with octyl beta-D-glucopyranoside were immobilized on nitrocellulose. Monoclonal antibody binding to these cell antigens was detected by peroxidase immunocytochemistry. Comparison of the sensitivity of the indirect immunoperoxidase and the biotin (strept)avidin immunoperoxidase methods on the basis of the highest detectable dilution of a cell lysate showed that these methods were equally sensitive. A linear relationship between the absorbance of the peroxidase reaction product and the amount of cell lysate immobilized on nitrocellulose was found for all three indirect immunoperoxidase methods. This proves that the amount of final immunocytochemical peroxidase reaction product is proportional to the amount of antigen in cell lysates. However, the relative expression of antigens in intact cells differs from that in cell lysates. Therefore, the present method to solubilize cells and immobilize cell antigens cannot be used to quantitate the antigen content of cells. PMID- 3316378 TI - Jan Evangelista Purkyne. 200th anniversary of birthday. PMID- 3316379 TI - Using SIB and API kits to identify and biotype enterobacteria of different origin. AB - A collection of 26 Enterobacteriaceae reference strains provided by Reference Centres in Moscow (USSR) and Copenhagen (Denmark) as well as a collection of 660 freshly isolated cultures of Gram-negative bacteria of different origin were investigated using SIB indicator systems manufactured at the Gorky Institute of Epidemiology and Microbiology (USSR) and API-20E, Rapid-20E and API-10S kits (API, France) with the aim of species determination. In analyzing freshly isolated cultures, API-20E, API-10S and SIB-B kits proved to be of approximately equal efficiency, whereas the Rapid-20E system enabled species identification in no more than 78% of the tested cultures. In a model biotyping of 284 E. coli cultures of different origin, SIB-B and API-20E kits in combination with the Analytical Profile Index enabled sufficiently rapid and standard identification of Enterobacteriaceae biovars. PMID- 3316380 TI - Serological diagnostics of imported malaria in Czechoslovakia. AB - Two serologic techniques for malaria detection were compared in this study; the indirect fluorescent antibody (IFA) test used in 214 persons (38 Czechoslovak citizens returning from visits to tropical countries and 176 foreign visitors arriving to Czechoslovakia from areas endemic for malaria) and the indirect hemagglutination (IHA) test employed in 125 persons (29 Czechoslovak citizens and 96 foreigners). Comparisons revealed poor correlation between the IFA test and IHA test data. Of the two tests the IFA test appeared to be distinctly more reliable, more sensitive and more specific, the IHA test turned out to yield both false positive and false negative results. The antigen from Plasmodium gallinaceum gave lower IFA titres than P. falciparum antigen, but reacted with antibodies to all species of human plasmodia, and gave reliable test results. Positive serologic responses were appreciably more frequent in foreigners (46.0%) than Czechoslovak citizens (23.7%). The maximum percent positivity for malarial antibody was among individuals from tropical countries of Africa (74.6%), seropositivity in people from malaria endemic areas in Asia and Latin America was far less frequent (28.4% and 44.4%, respectively). PMID- 3316381 TI - Ia-restricted B-B cell interaction. I. The MHC haplotype of bone marrow cells present during B cell ontogeny dictates the self-recognition specificity of B cells in the polyclonal B cell activation by a B cell differentiation factor, B151-TRF2. AB - We have demonstrated that B cell recognition of Ia molecules is involved in polyclonal B cell differentiation by B151-TRF2. The present study was undertaken to examine the Ia recognition specificity of B151-TRF2-responsive B cells in fully major histocompatibility complex (MHC)-allogeneic P1----P2, semiallogeneic P1----(P1 x P2)F1, and double donor (P1 + P2)----(P1 x P2)F1 and (P1 + P2)----P1 radiation bone marrow chimeras. The B cells from both P1----P2 and P1----(P1 x P2)F1 chimeras could give rise to in vitro immunoglobulin M-producing cells upon stimulation with B151-TRF2 comparable in magnitude to that of normal P1 B cells, and their responses were inhibited by anti-I-AP1 but not by anti-I-AP2 monoclonal antibody even in the presence of mitomycin C-treated T cell-depleted P2 spleen cells as auxiliary cells. In contrast, the B151-TRF2 responses of P1 B cells isolated from both (P1 + P2)----(P1 x P2)F1 and (P1 + P2)----P1 double bone marrow chimeras became sensitive to the inhibition of not only anti-I-AP1 but also anti-I-AP2 monoclonal antibody only when the culture was conducted in the presence of P2 auxiliary cells, demonstrating that they adaptively differentiate to recognize as self-structures allogeneic as well as syngeneic Ia molecules. Moreover, the experiments utilizing B cells from H-2-congenic mice and B cell hybridoma clones as auxiliary cells revealed that B151-TRF2-responsive B cells recognize Ia molecules expressed on B cells. Taken together, these results demonstrate that B151-TRF2-responsive B cells recognize Ia molecules expressed by B cells as self-structures and that their self-recognition specificity is dictated by the MHC haplotype of bone marrow cells present during the B cell ontogeny but not by the MHC haplotype of a radiation-resistant host environment. PMID- 3316382 TI - Modification of the cytotoxic T cell repertoire in neonatal tolerance. Evidence for preferential survival of cells with low avidity for tolerogen. AB - Clonal deletion of developing lymphocytes with potential reactivity for self is thought to play a crucial role in the establishment of self tolerance. One prediction of the clonal deletion hypothesis is that cells bearing receptors with high affinity for self are more likely than cells with low affinity receptors to be deleted from the repertoire. Experimental models of B cell tolerance have provided evidence for the preferential survival of low affinity cells with specificity for tolerogen in tolerant animals, but no comparable evidence exists for T cells. To examine this issue in T cells, cytotoxic T cell lines specific for the Kb mutant class I H-2 molecule, bm1, were generated from C57BL/6 mice rendered neonatally tolerant of bm1 and compared with anti-bm1 lines generated from normal mice. Compared with normal lines, those from tolerant mice differed in five ways: 1) they grew more slowly; 2) they were less efficient at lysing bm1 targets; 3) they showed different patterns of lysis against a panel of third party targets; 4) their cytotoxic activity against bm1 could be increased in the presence of leukoagglutinin, whereas the activity of normal lines was not increased by leukoagglutinin; and 5) their cytotoxic activity was more susceptible to inhibition by anti-Lyt-2 antibody. Taken together, these results demonstrate that the repertoire of the remaining tolerogen-specific cytotoxic T cells in neonatally tolerant mice is different from the normal C57BL/6 anti-bm1 repertoire, and the results are consistent with the idea that the remaining tolerogen-specific cells are low avidity cells that have preferentially escaped the clonal deletion process. PMID- 3316383 TI - Kinetics and mechanisms of recombinant human interleukin 1 and tumor necrosis factor-alpha-induced changes in circulating numbers of neutrophils and lymphocytes. AB - Human recombinant interleukins 1 alpha and 1 beta (rIL-1 alpha and -1 beta) both induced monophasic peripheral neutrophilia and lymphopenia in Lewis rats 1.5 hr after i.v. injection. The kinetics of rIL-1 alpha- and -1 beta-induced neutrophilia were similar to those induced by human monocyte-derived IL-1, IL-1 alpha, and IL-1 beta, and the peripheral neutrophilia was accompanied by a marked decrease in marrow neutrophils. Arachidonic acid metabolites are implicated as biochemical intermediates in the production of the neutrophilia but not lymphopenia, since indomethacin and dexamethasone both completely abrogated IL-1 induced neutrophilia but did not affect the IL-1-induced lymphopenia. Acetylsalicylic acid, a cyclooxygenase inhibitor, did not inhibit IL-1-induced neutrophilia, suggesting that products of the lipoxygenase rather than the cyclooxygenase pathway of arachidonate metabolism may contribute to the neutrophilia. Human recombinant tumor necrosis factor-alpha (rTNF) administered i.v. to Lewis rats induced peripheral neutropenia, two peaks of neutrophilia, and lymphopenia. A wide range of doses of rTNF resulted in an initial neutropenia at 0.5 hr after injection followed by a first peak of neutrophilia at 1.5 hr and a second peak of neutrophilia at 6 hr. The initial neutropenia and the first peak of neutrophilia were not inhibited by pretreatment of rats with dexamethasone, indomethacin, or aspirin. The second peak of neutrophilia was inhibited by both dexamethasone and indomethacin, but was not at all inhibited by aspirin, suggesting that the second peak of neutrophilia is mediated by the release of endogenous cytokines, especially by IL-1, since exogenous IL-1-induced neutrophilia is also completely inhibited by dexamethasone and indomethacin but not by aspirin. The TNF-induced peripheral neutrophilia is also accompanied by a significant depletion of bone marrow neutrophils, indicating that the source of increased circulating neutrophils is, at least in part, via recruitment of marrow neutrophils. Systemic blood pressure was not affected by IL-1 or rTNF at the dosages employed, showing that the changes in circulating leukocyte subsets were not attributable to hemodynamic changes nor to the hemodynamic change-related release of adrenal hormones. Adrenalectomy did not alter the IL-1- or rTNF induced neutrophilia or lymphopenia, also demonstrating that neither monokine mediates its hematologic effects on peripheral blood leukocytes via the release of adrenal hormones.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3316384 TI - Molecular basis of elevated c-myb expression in the abnormal L3T4-, Lyt-2- T lymphocytes of autoimmune mice. AB - The presence of the lpr/lpr genotype on a number of murine genetic backgrounds results in a systemic lupus erythematosus-like disease and lymphadenopathy. The T lymphocytes of these mice exhibit a variety of abnormalities; most pertinent to the present report is an abnormally high level of c-myb proto-oncogene mRNA. Since the c-myb protein is presumably the effector molecule that affects cellular functions, it is important to determine whether increased levels of this c-myb protein are produced. With the use of immunoprecipitation with an anti-v-myb reagent, we found high levels of c-myb protein in the lymph nodes of lpr mice. Detailed analysis showed that the c-myb protein is primarily expressed by an abnormal T lymphocyte population that does not express the mature T cell markers, L3T4 and Lyt-2. Analysis by two-dimensional gel electrophoresis showed that the c myb proteins from normal thymocytes and from these L3T4-, Lyt-2-T cells are indistinguishable. DNA analysis with Southern hybridizations showed the lack of amplification, insertions, deletions, and rearrangements, which is in accord with results from the protein studies. Most interestingly, the c-myb gene in lpr L3T4 , Lyt-2- T cells is hypomethylated compared with normal controls. This suggests that a regulatory mechanism, rather than the structural alteration of the gene, is responsible for elevated expression of c-myb in these L3T4-, Lyt-2- cells. PMID- 3316386 TI - Interleukin 5, a mucosal lymphokine? PMID- 3316385 TI - Aberrant immunoglobulin and c-myc gene rearrangements in patients with nonmalignant monoclonal cryoglobulinemia. AB - The status of the immunoglobulin (Ig) genes was investigated in patients with idiopathic nonmalignant monoclonal IgG cryoglobulinemia (NCG). In NCG, monoclonal antibodies are synthesized at an accelerated rate by nonmalignant B lymphocytes. In order to determine whether this high production rate is related to a clonal B cell expansion, the rearrangement of the Ig genes was investigated by Southern blot analysis of genomic DNA extracted from the peripheral blood lymphocytes of four NCG patients. In three of four (VI, BR, and CH) clonal expansion of B cells was detected using probes specific for the c kappa, JH, c gamma 4 genes (in accordance with detecting IgG kappa cryoproteins in these patients). BamHI digestion of DNA from VI and BR produced three rearranged fragments which cohybridized with JH and c mu probes. This finding suggested the presence of additional nonsecretory B cell clones and/or disruption of the gene segments spanned by and detected with the probes. In VI the idiotype of the IgG cryoglobulin was also detected in association with IgM in the supernatant of Epstein-Barr virus-stimulated B lymphocytes using a murine monoclonal anti idiotypic antibody. In addition, the possibility of aberrant gene rearrangements was supported by noting the alteration of the c-myc gene locus in genomic DNA from peripheral blood leukocytes of VI and CH. Northern blot analysis of RNA isolated from peripheral blood B cells of VI and CH demonstrated aberrant transcripts of the c-myc gene, showing an active role of the altered c-myc locus. Detection of c-myc rearrangement in NCG patients clearly shows that this event may not be a final step in malignant B cell transformation; however, it may be related to the clonal expansion and high rate of cryoglobulin synthesis of nonmalignant B lymphocytes. PMID- 3316387 TI - Role of accessory molecules in signal transduction of cytolytic T lymphocyte by anti-T cell receptor and anti-Ly-6.2C monoclonal antibodies. AB - Accessory molecules present on the cell surface of cytolytic T lymphocytes (CTL) play an important role in their activation. Antigen-specific recognition by CTL is inhibited by antibodies against Lyt-2, L3T4, or LFA-1 molecules. Presently it is not known whether these molecules function by binding a ligand such as class I or class II on the target cell or by delivering a signal that down-regulates T cell activation. In the present study we utilized anti-T cell antibodies including anti-T3 and anti-T cell receptor (alpha/beta) as well as an anti-Ly 6.2C monoclonal antibody to activate CTL clones to kill irrelevant targets or secrete BLT esterase. The redirected lysis assay system utilizes the fact that heteroconjugates between anti-T3, and anti-T cell receptor, or anti-Ly-6.2C and anti-trinitrophenyl can trigger CTL lysis of trinitrophenyl-coupled targets that did not express antigen. In this system anti-Lyt-2 antibodies as well as anti-LFA 1 antibodies inhibited triggering via T cell receptor-related molecules but not via the anti-Ly-6.2C heteroconjugate. In addition, the anti-Lyt-2 was shown to inhibit conjugate formation in the heteroaggregate assay system suggesting that the anti-Lyt-2 antibodies acted early in inhibiting CTL activity. Similar results were observed in a system in which the CTL clones were triggered to secrete a BLT esterase-like activity in the absence of target cells. Anti-T3 coated on plastic was shown to activate BLT-esterase secretion. This secretion was inhibited by anti-Lyt-2 and anti-LFA-1. Thus, it would appear that both the Lyt-2 molecule and the LFA-1 molecule act as signal-transducing elements involved in CTL activation. In particular, the Lyt-2 molecule appears to preferentially function in receptor mediated T cell activation. PMID- 3316388 TI - The neutrophil glycoprotein Mo1 is an integral membrane protein of plasma membranes and specific granules. AB - The glycoprotein Mo1 has previously been demonstrated to be on the cell surface and in the specific granule fraction of neutrophils and to be translocated to the cell surface during degranulation. It is not known, however, whether Mo1 is an integral membrane protein or a soluble, intragranular constituent loosely associated with the specific granule membrane. Purified neutrophils were disrupted by nitrogen cavitation and separated on Percoll density gradients into four fractions enriched for azurophilic granules, specific granules, plasma membrane, and cytosol, respectively. The glycoproteins in these fractions were labeled with 3H-borohydride reduction, extracted with Triton X-114, and immunoprecipitated with 60.3, an anti-Mo1 monoclonal antibody Mo1 was detected only in the specific granule and plasma membrane fractions and partitioned exclusively into the detergent-rich fraction consistent with Mo1 being an integral membrane protein. In addition, treatment of specific granule membranes with a high salt, high urea buffer to remove absorbed or peripheral proteins failed to dissociate Mo1. These data support the hypothesis that Mo1 is an integral membrane protein of plasma and specific granule membranes in human neutrophils. PMID- 3316389 TI - Differential expression of the c-myb proto-oncogene marks the pre-B cell/B cell junction in murine B lymphoid tumors. AB - A series of murine B lymphoid tumor cell lines which are representative of the pre-B cell, immature and mature B cell, and plasma cell stages of B cell development have been examined for expression of c-myb proto-oncogene mRNA. The pre-B cell lymphoma cell lines express equivalent high steady state levels of c myb mRNA. In contrast, the B cell lymphoma and plasmacytoma cell lines express steady state c-myb mRNA at levels which are 0.005 to 0.1 times that of the pre-B cell lymphoma lines. These results correlate high levels of c-myb mRNA expression with the pre-B cell stage of development. Subclones of the 1881 pre-B cell lymphoma which express K light chain and are surface IgM-positive as well as two types of hybrid B lymphoid cell lines have been used to demonstrate that surface immunoglobulin expression is not sufficient to result in the down-regulation of c myb mRNA levels or changes in the expression N-myc mRNA, lambda 5 mRNA, or the BP 1 surface antigen which are markers of the pre-B cell stage of development. Thus, changes in the expression of genes which are independent of immunoglobulin expression are associated with transition from the pre-B cell to the immature B cell stage of development. PMID- 3316390 TI - Rapid dissociation of adherent human tumor cells by ultrasound. AB - Cultured human melanoma and gastrointestinal carcinoma cells were detached from substrate and further dissociated by placing the culture vessel into a water filled ultrasonic cleaner (43 kHz) and sonicating it for 10-50 s. Plating efficiency and long-term growth of three melanoma cell lines were similar after ultrasound or trypsin detachment. Binding of monoclonal antibodies that define normal and tumor-associated antigens on melanoma and colorectal carcinoma cells was not affected by ultrasound in 21 out of 23 cases. The 40 kDa colorectal carcinoma-associated antigen defined by monoclonal antibody CO 17-1A was more highly expressed after ultrasonication than trypsinization. The antigen defined by antibody CO 44.1 on these cells was more sensitive to sonication. This method represents a rapid, effective and gentle alternative to trypsin detachment of cultured cells, especially when repeated cell washing or centrifugation steps are required. PMID- 3316391 TI - A new method for the cytological analysis of autoantibody specificities using whole-mount, surface-spread meiotic nuclei. AB - A new method for the cytological analysis of antinuclear antibody binding offers several advantages over conventional techniques. Nuclei in meiosis, prepared by surface-spreading spermatocytes, provide a detailed examination of the constituents of the nucleus--euchromatin, heterochromatin, sex chromatin, nucleoli, centromeres, and dense patches that seem related to RNA metabolism--and each of these structures can be seen to change in morphology and antibody labeling during the course of meiotic prophase. Results using sera from humans and mice with autoimmune disease, and using several mouse monoclonal antibodies, demonstrate the potential of this method for clinical and research applications, both for more common antibody types and for those that bind epitopes which are unique to germ cells. PMID- 3316392 TI - Improvement in the antibody binding characteristics of microtitre wells by pretreatment with anti-IgG Fc immunoglobulin. AB - A preliminary coating of the surface of polystyrene microtitre wells with anti IgG Fc immunoglobulin improves the binding capacity of the wells for antibody and leads to a marked improvement in the reproducibility of immunoassays carried out in the wells. In an enhanced chemiluminescent enzyme immunoassay for oestradiol the binding capacity for oestradiol of wells precoated with anti-IgG Fc immunoglobulin and then coated with anti-oestradiol immunoglobulin was more than twice that of wells coated directly with anti-oestradiol immunoglobulin. Intra assay precision in the precoated wells ranged from 1.3 to 4.0% compared to 2.9 to 6.7% (0-3200 fmol oestradiol) in wells which had not been precoated. PMID- 3316393 TI - Flow cytometry with crystal violet to detect intracytoplasmic fluorescence in viable human lymphocytes. Demonstration of antibody entering living cells. AB - A new method is described for the detection of intracytoplasmic fluorescence and its differentiation from surface staining of viable human lymphocytes using flow cytometry after addition of crystal violet which quenches surface but not internal fluorescence. This has then been used to study antibody penetration of viable human lymphocytes, using FITC-conjugated IgG from normal serum or serum containing anti-RNP antibody. The results showed that 54 +/- 1% normal lymphocytes were penetrated by anti-RNP antibody and 23 +/- 3% by normal IgG respectively. The lymphocyte population analysed by flow cytometry has been directly demonstrated to be viable by FDA staining. These results provide unequivocal evidence that antibody can penetrate viable human lymphocytes. PMID- 3316394 TI - A comparison of immunocytochemical staining enhancement methods using a rapid microtitre immunocytochemistry assay (MIA). AB - A method is described which allows rapid and quantitative comparison of immunocytochemical staining procedures. Cells grown and fixed in microtitre plates are probed with increasing dilutions of primary antibody and then stained using the procedures under test; the resulting staining intensities are determined using a microtitre plate reader. The microtitre immunocytochemistry assay (MIA) has been used to compare the sensitivities of enhancement procedures based on immunoperoxidase and immunogold staining. Silver enhancement of DAB staining was found to be the most sensitive technique giving up to 200 fold amplification of the peroxidase staining. PMID- 3316396 TI - An indirect enzymoimmunological assay for hyaluronidase. AB - The use of a hyaluronic acid-binding proteoglycan (hyaluronectin) as a probe for the detection of hyaluronic acid has facilitated the development of an indirect enzymo-immunological assay for hyaluronidase. Plastic microtest ELISA plates were coated with hyaluronic acid. Incubation with hyaluronidase led to the destruction of insolubilized hyaluronic acid in proportion to the hyaluronidase concentration of samples. Residual hyaluronic acid was assayed by its capacity to bind immune complexes made up of hyaluronectin supplemented with alkaline phosphatase conjugated anti-hyaluronectin antibodies. The technique was very sensitive and permitted the detection of as little as 10(-10) NFU of bovine testicular hyaluronidase. Hyaluronidase was detected by this technique in human sera, bee venom and culture medium of human hepatoma cell lines. PMID- 3316395 TI - Injection of physiological saline facilitates recovery of ascitic fluids for monoclonal antibody production. AB - The intraperitoneal injection of physiological saline into anti-C-reactive protein (anti-CRP) hybridoma tumor-bearing mice facilitates extraction of diluted ascitic fluids. The dilution with physiological saline before withdrawal of ascitic fluid reduces the processing time in large scale operations, facilitates further manipulations, increases the number of extractions per animal and permits the recovery of ascitic fluid containing monoclonal antibodies from solid tumor bearing mice. PMID- 3316397 TI - Instantaneous roll-blot from cellulose acetate after electrophoresis. A versatile tool for monoclonal antibody characterization. AB - An instantaneous blotting method from cellulose acetate to nitrocellulose was developed using a high pressure roll apparatus. This method was applied to the early characterization of monoclonal antibody specificity and to monoclonal immunoglobulin typing in mouse hybridoma supernatants, human sera or unconcentrated urines. Immunoglobulins were then revealed using, successively, anti-isotype specific monoclonal or polyclonal antibodies, avidin-biotinylated peroxidase complexes and cobalt-enhanced diaminobenzidine substrate. PMID- 3316398 TI - Heme increases peroxidase-antibody activity in aged conjugates. AB - Decay of activity in antibody-peroxidase conjugates is faster when highly diluted as in clinical kits. Following aging at 4 degrees C, some of this loss of activity can be restored by incubation with heme just before use. The addition of heme in the conjugate storage buffer prevents some decay of activity and is not due to the pseudoperoxidase activity of heme. This procedure permits conjugates to be presented in an easy ready-to-use form for clinical immunoenzymatic assays. PMID- 3316399 TI - Purification of human autoantibodies from cross-linked antigen immunosorbents. AB - A method is described whereby autoantibodies to the Sjogren's syndrome antigen La (SS-B) can be purified from re-usable immunosorbent columns constructed from covalently linked human autoantibodies to which the antigen is cross-linked. Previous attempts to link the antigen directly to CNBr-Sepharose beads resulted in loss of biological activity and thus each purification of antibody required fresh batches of antigen. The present technique is a significant improvement since the cross-linked immunosorbents prepared from a single batch of antigen can be re-used several times over a 6 month period. Furthermore F(ab')2 fragments of anti-La antibodies can be purified from pepsin-digested serum samples. These antibodies react in ELISA, Western blot and immunofluorescence in an identical way to serum and murine monoclonal anti-La antibodies and show no reaction with the Ro antigen. However, being of human origin the affinity-purified anti-La antibodies have the advantages of bearing the same idiotypes and reacting with the same antigenic epitopes as naturally occurring serum autoantibodies. PMID- 3316400 TI - Performance of the two-site immunoradiometric assay for serum thyroid-stimulating hormone. Effects of changes in solid-phase matrix and antibody coupling chemistry. AB - Ten solid-phases were evaluated for their usefulness in a two-site immunoradiometric assay for serum thyroid-stimulating hormone. The criteria used to assess each reagent included the minimum detection limit attainable, the change of binding over the concentration range (signal: noise ratio), and ease of preparation of the reagents. Of all the solid phases tested, Sepharose CL-4B and activated CH-Sepharose 4B showed the characteristics best suited to IRMA, while epoxy-activated Sepharose 6B and Ultrogel ACA-44 were marginally less effective. PMID- 3316401 TI - Preparation of 67Ga-labeled antibodies using deferoxamine as a bifunctional chelate. An improved method. AB - Radionuclides or anti-cancer drugs may be coupled to antibodies for specific transport to target tissues. We have previously reported that several proteins could be rapidly and efficiently labeled with gallium (67Ga) by using deferoxamine (DFO) as a bifunctional chelating agent. In the present paper, we have described the use of hetero-bifunctional agents for the conjugation of DFO with antibodies and investigated the effect of coupling agents on in vitro properties and biodistribution of 67Ga-labeled antibodies. 67Ga-labeled monoclonal antibodies retained antigen-binding activity when prepared under optimum conditions. The use of hetero-bifunctional reagents, such as succinimidyl 6-maleimido-hexanoate (EMCS) or N-succinimidyl-3-(2-pyridyldithio)-propionate (SPDP), which link thioether bonds and disulfide bridges prevented the formation of polymerized antibodies. Although high non-specific uptake in the liver was observed with radiolabels prepared by the homo-bifunctional agent glutaraldehyde, uptake in the liver was low with conjugates linked by hetero-bifunctional agents. 67Ga-labeled antibodies with thioether bonds showed in vivo stability, but the clearance from the circulation was the fastest with the radiolabel holding disulfide bonds. The coupling reagents used to link DFO and antibodies greatly influenced both in vitro properties and in vivo distribution of labeled antibodies and 67Ga-labeled antibodies provide a good model for the study of coupling methods and biodistribution of antibody conjugates. PMID- 3316402 TI - A colorimetric assay based on cell viability for the indirect detection of intracellular replication and killing of Trypanosoma cruzi. AB - We have developed an 'in vitro' colorimetric assay for the detection of replication and/or destruction of the intracellular amastigote form of Trypanosoma cruzi. The assay can be applied to other intracellular parasites having lytic effects on the infected cells. The assay is based on the relationship between the content of the lysosomal enzyme hexosaminidase and the number of viable cells. The level of this enzyme can be detected by a simple and sensitive procedure in microtiter wells using a p-nitrophenol derivative as enzyme substrate and scanning the absorbance at 405 nm. Macrophages or other suitable host cells which support T. cruzi intracellular replication have detectable levels of this enzyme whereas the protozoan parasites do not. The assay exhibited a good inverse correlation between the number of amastigotes released and the amount of enzyme in the infected cultures. Furthermore, the method was used for the detection of macrophage-activating factors and gave results similar to those obtained by microscopical examination of the cells. The advantages of the procedure are objectivity, sensitivity and simplicity. PMID- 3316403 TI - Estimating the relative avidity of mucosal IgA for antigen. AB - This report concerns the application of a method to estimate the relative avidity of mucosal IgA for casein and beta-lactoglobulin. The chaotropic ion, thiocyanate, was used to disrupt antigen-antibody binding in an enzyme immunoassay. The resultant proportional decrease in optical density of the enzyme immunoassay was directly related to the proportion of IgA eluted from the solid phase-bound antigen. The relative avidity was expressed as the molarity of KSCN resulting in a particular reduction in optical density. The measurement of avidity, the avidity index, was independent of the concentration of mucosal IgA. For anti-casein IgA the interassay coefficient of variation of the index was 14 18%, and the intra-assay coefficient of variation was 6%. For anti-beta lactoglobulin IgA the interassay coefficient of variation was 10-13% and the intra-assay coefficient of variation was 6%. The method is simple and free of complicated calculations. PMID- 3316404 TI - Measurement of antibodies to Candida albicans as a screening test for humoral immunodeficiency. AB - In screening for defects in humoral immunity, as well as measuring serum immunoglobulins it is advisable to have some measure of antibody production, e.g., immunising with a test antigen and measuring the antibody response some days later. However, this delay may be inconvenient and requires a second blood sample. An alternative is to test for antibody to a widespread commensal organism to which the patient must have been repeatedly exposed. The measurement of antibody to E. coli by haemagglutination has been previously used for this purpose. We report here that an equally good and simpler alternative is to measure antibodies to the commensal Candida albicans by immunofluorescence. Using a polyvalent conjugate, all 114 blood donors tested had antibody titres greater than 8 to C. albicans; similar responses were noted in 20 children (aged 6 months 16 years) without recurrent infections. In contrast, anti-candida responses were low or absent as expected in patients with hypogammaglobulinaemia but also in some patients with other immunodeficiency diseases. Overall candida immunofluorescence closely paralleled E. coli haemagglutination. PMID- 3316405 TI - Western-blotting method for detecting antibodies against human muscle contractile proteins in myositis. AB - Many investigators report anti-muscle antibodies using various kinds of methods. The Western-blotting method, however, has not previously been used for this purpose. We have detected antibodies to muscle contractile proteins in sera from patients with collagen disease and muscular dystrophy by this method. The antigens detected included myosin heavy and light chains, tropomyosin and troponin complex. Our method is a quick and sensitive way to determine which are the antigenic muscle contractile proteins. PMID- 3316406 TI - Quantitative flow cytometric and clonogenic evaluation of glass bead affinity fractionation of antibody-labeled murine bone marrow. AB - Monoclonal antibodies and a glass bead affinity fractionation technique were used to selectively deplete subpopulations of murine bone marrow cells. Flow cytometric analyses permitted quantitative measurement of subpopulation depletion and characterization (light scatter and fluorescence intensity) of both the eluted and bound cell subpopulations. Mouse bone marrow cells were labeled with selected monoclonal rat anti-mouse antibodies directed against cell surface antigens and were eluted through a glass bead column coated with goat anti-rat immunoglobulin. Unlabeled cells passed through the column, whereas cells labeled with the antibody were selectively retained. Column operating conditions for optimal depletion of labeled cells were determined. With specific column conditions, 97% of the antibody positive cells were retained on the column. In addition, clonogenic assays on cells sorted from unfractionated and column fractionated preparations provided estimates of the fraction of granulocyte macrophage progenitors (CFU-GM) in the different cell subpopulations. The enrichment of CFU-GM achieved in the eluted cell populations was dependent upon the antibody used for cell labeling and ranged from four- to six-fold. Since large numbers of cells can be processed rapidly, this technique, in combination with antibodies specific for non-clonogenic cells, is particularly suitable when preparations enriched in colony-forming progenitors are required. PMID- 3316407 TI - A fluorometric assay for determining cell growth in lymphocyte proliferation and lymphokine assays. AB - A microplate method for assessing cell growth and viability based on the hydrolysis of fluorogenic substrates by cell esterases has been investigated. Living cells incubated with fluorescein diacetate or 4-methylumbelliferyl heptanoate generate a fluorescent product which is proportional to the number of cells. This can be used as a simple and economical readout for various bioassays such as, for example, the assessment of IL-2 and IL-3 on factor-dependent cell lines, and on antigen- and mitogen-stimulated proliferation of lymphocytes. This fluorometric assay has similar sensitivity to the measurement of [3H]thymidine uptake and greater sensitivity than standard colorimetric assays. Incubation with MUH for a period of 30-60 min at 22 degrees C is adequate. PMID- 3316408 TI - Enumeration of Trypanosoma cruzi-specific antibody-secreting cells by solid-phase immunoenzymatic technique. AB - A specific and sensitive enzyme-linked immunoassay is applied for enumeration of cells secreting specific antibodies to Trypanosoma cruzi antigens. Spleen cells from immunized mice are incubated in antigen-coated plastic tissue culture plates. Individual antibody-producing cells secrete antibody which binds to the antigen at close vicinity of the cells. The areas of bound antibodies are demonstrated by an enzyme-linked antibody assay as dark round spots, which can be easily enumerated. This assay allows the enumeration of specific antibody secreting cells to parasite antigens, overcoming the failures to develop conventional plaque-forming cells assays to complex antigens. PMID- 3316409 TI - [Endorectal prostatic ultrasonography. Advantages and limitations]. PMID- 3316410 TI - Serum from patients with Raynaud's phenomenon inhibits prostacyclin production. AB - Prostacyclin (PGI2) and PGE2, the predominant cyclooxygenase products of endothelial cells are potent vasodilators. An inability to produce appropriate concentrations of these prostanoids may be a factor in the pathogenesis of the digital vasospasm experienced by patients with Raynaud's phenomenon (RP). The effect of sera from normal subjects, patients with primary RP, and patients with RP in association with systemic sclerosis (SS) on the production of PGI2 and PGE2 by cultured human endothelial cells was investigated. All sera produced a dose dependent inhibition of 6-keto-PGF1 alpha, but both the 10% and 20% sera from patients with RP and SS produced a significantly greater inhibition than control sera. The mean production of 6-keto-PGF1 alpha expressed in ng/10(4) cells was 2.278 (normal), 1.9311 (RP), and 2.1824 (SS) after incubation with 1% serum for 24 h. This decreased to 1.3647, 0.5927, and 0.4171, respectively following incubation with 20% sera for 24 h. This represented a 44% (normal), 76% (RP), and 83% (SS) inhibition of 6-keto-PGF1 alpha production compared with serum free media. Similar results were obtained after 1 h incubation experiments. There was a nonsignificant decrease in mean PGE2 production following similar incubations with 1% and 20% sera for 24 h. These results suggest that factor(s) present in the sera of patients with RP may reduce the ability of endothelial cells to synthesize or release the vasodilator and antiaggregatory prostanoid PGI2. PMID- 3316411 TI - Immunoelectron microscopy in subepidermal autoimmune bullous diseases: a prospective study of IgG and C3 bound in vivo in 32 patients. AB - Thirty-two patients suffering from subepidermal autoimmune bullous disease were studied prospectively by clinical examination and immunoelectron microscopy. Clinically, 1 patient had herpes gestationnis, 14 typical bullous pemphigoid (BP), 3 epidermolysis acquisita (EBA), 3 cicatricial pemphigoid (CP), and 11 patients overlapping clinical diseases. These 11 patients shared clinical features of BP, EBA, or CP and a clinical diagnosis could not be done safely. Immunoelectron microscopy revealed diaminobenzidine deposits in 20 patients on the epidermal side of dermo-epidermal junction in the lamina lucida as in BP. In 5 patients, deposits located mostly under the anchoring fibril zone, in the floor of a sublamina densa dermoepidermal separation for 2 of them, were consistent with a diagnosis of EBA. In 6 patients, deposits were located mostly in the lamina densa, in the floor of a dermoepidermal separation occurring in the lamina lucida for 3 of them. This suggests that some of these 6 patients had neither EBA or BP, but another autoimmune bullous disease again, an uncharacterized component of dermoepidermal junction located in the lamina densa. Finally, a correlation exists between the sites of IgG and/or C3 components on epidermal or dermal side of dermoepidermal junction and the presence or absence of characteristic clinical features such as scar, milia formation, or mucosal involvement. PMID- 3316412 TI - Comparison of alloimmunogenicity of Langerhans cells and keratinocytes from mouse epidermis. AB - Among lymphoreticular cells, Langerhans cells and splenic dendritic cells stand alone in their capacity, when hapten-derivatized, to induce vigorous immune responses, irrespective of route of inoculation, including intravenous. We have examined the comparative efficiency of relatively purified populations of Langerhans cells and their epidermal companions, keratinocytes, to induce alloimmunity when injected intravenously into adult mice. It was found that as few as 100 BALB/c Langerhans cells injected intravenously into C3H mice are capable of inducing specific sensitization as evidenced by subsequent accelerated rejection of BALB/c skin grafts. By contrast, 10,000 BALB/c keratinocytes failed to immunize similarly injected C3H recipients. These results emphasize the unparalleled capacity of Langerhans cells to induce sensitization, and they point to Langerhans cells, among cells within the epidermal compartment, as dominant in the alloimmunogenic potential of skin grafts. PMID- 3316414 TI - Urinary tract infections: recent developments. PMID- 3316413 TI - Design of rational infection control policies for human immunodeficiency virus infection. PMID- 3316415 TI - Virulence factors of Escherichia coli in urinary isolates from pregnant women. AB - Urinary isolates from 24 pregnant women with acute pyelonephritis and from 37 pregnant women with bacteriuria detected at screening were characterized for O:K:H serotype, electrophoretic type, adherence, hemolysin production, and serum resistance. Between the two diagnostic groups, only three clones were identical. For the remaining isolates, both the identification markers and virulence traits differed significantly. The strains from pregnant women with pyelonephritis did not significantly differ from those from non-pregnant women. Thus, pregnancy was shown not to abolish the difference in virulence between Escherichia coli causing acute pyelonephritis and asymptomatic bacteriuria. PMID- 3316416 TI - Visualization of defective measles virus particles in cerebrospinal fluid in subacute sclerosing panencephalitis. AB - Measles virus particles were visualized in the CSF of two patients with verified subacute sclerosing panencephalitis (SSPE) by using scanning electron microscopy. Immunologic identification of the accumulated particles was performed with monoclonal antibodies, directly conjugated to carboxylated microspheres, specific for different measles virus antigens. The beads were amassed on the filter surface after a 1-hr incubation in the CSF. Spherical particles with a diameter ranging between 150 and 500 nm were detected. Such particles bound specifically to latex beads covered by monoclonal antibodies to measles virus hemagglutinin but not to beads conjugated with monoclonal antibodies specific for nucleoprotein. Adding the two monoclonal antibodies to measles virus hemagglutinin to the CSF agglutinated the virus particles in a dose-dependent way. Further, no particles in the CSF bound to microspheres conjugated with monoclonal antibodies to non-related antigens of Sendai virus, cytomegalovirus, or human immunodeficiency virus. Similarly sized particles were also identified by transmission electron microscopy after concentrating the CSF. PMID- 3316417 TI - Guidelines for evaluating new antimicrobial agents. AB - Evaluating new antimicrobial agents is governed mostly by interaction between the pharmaceutical industry and the Food and Drug Administration (FDA). Clinical trials are designed to comply with FDA guidelines published in 1977. Basic principles of the 1977 guidelines remain valid; however, changes in the clinical application of anti-infective agents and in the accepted design of clinical trials have occurred. Some changes are inconsistent with the requirements of the 1977 documents. Members of the Infectious Diseases Society of America (IDSA) have the perspective and knowledge needed to assist in updating the 1977 guidelines. It is proposed that the IDSA establish a formal working relationship with the FDA to review and modernize the 1977 guidelines. Industry participation in this process is desirable. If the IDSA can help orchestrate guideline revision in an environment of mutual respect and cooperation, the result may be a more efficient drug-evaluation process that continues to protect the public interest and is more consistent with contemporary concepts of treatment for infectious disease. PMID- 3316418 TI - The large intestine as the site of Clostridium botulinum colonization in human infant botulism. PMID- 3316419 TI - [Clinical problems in mitral valve prolapse: an echocardiographic review]. AB - Several unsolved problems in the echocardiographic diagnosis of mitral valve prolapse were reviewed. At present, two-dimensional echocardiography is the most reliable method for assessing mitral valve prolapse. However, basic knowledge on the anatomical orientation of the mitral annulus, hitherto not sufficiently studied, is indispensable before making adequate echocardiographic diagnosis. The annulus is not like a geometrical plane and occupies certain millimeters' width between the left atrium and the ventricle. Therefore, assuming the left atrial margin of the annulus as the reference, many unmistakable prolapse with mitral regurgitation are overlooked, while assuming the left ventricular margins as the reference, some false positive diagnoses will be inevitable. Consulting several autopsy specimens, the author noticed that the central fibrous body, the site of the anterior mitral valve insertion to the interventricular septum, forms the most inferior part of the mitral annulus. This fact could explain a higher sensitivity of the apical four-chamber view for detecting anterior mitral valve prolapse reported by several investigators, and also more frequent over-diagnosis according to our experience. Although the author prefers the left ventricular margin of the mitral annulus defined by the long-axis view as the reference for echocardiographic diagnosis of mitral prolapse, further investigation should be made in relation to the clinical significance of this abnormality diagnosed by echocardiography. PMID- 3316420 TI - [Syndrome of mitral valve prolapse: past, present and prospects]. AB - A short history of mitral valve prolapse was reviewed to learn what was the knowledge we have and to recognize what should be resolved at the present time and in the near future. Particular emphasis was placed on the detailed studies performed in Japan as compared to those of occidental countries. Prevalence of mitral valve prolapse largely depends on the methods of investigation and is definitely related to the diagnostic criteria. Among those, the echocardiographic criteria are particularly important, but there are pitfalls which cause over- or underdiagnosis. Auscultatory criteria, which should be confirmed by phonocardiography, are not sensitive enough because of the presence of "silent" prolapse, though the auscultatory acumen of the averaged doctors is quite often unexpected. DaCosta syndrome and the related conditions have some connections with mitral valve prolapse syndrome. The relation should extensively be studied, because somatic and mental signs are not conclusively related to the anatomical abnormalities and the cases with borderline prolapse tend to have definite signs and symptoms. Natural course of mitral valve prolapse based on the long follow-up study is far from the conclusion. So far, no comprehensive cases with well-known natural history of this entity. Prognosis should be carefully evaluated, because most of the patients are doing well and several ominous prognostic signs, such as sudden deaths, are thought to be overemphasized. PMID- 3316421 TI - Human interferon-beta 2. PMID- 3316422 TI - Localization and distribution of actin in mammalian sperm heads. AB - Actin was identified in boar and mole spermatozoa by utilizing indirect immunofluorescence, immunoelectron microscopy, and SDS-PAGE, followed by blot and screening with an anti-actin monoclonal antibody. Actin was detected in two places in the sperm head: the equatorial segment of the acrosome and the postacrosomal region. The protein was present in a nonfilamentous form and was localized under the plasma membrane. A small amount of actin was also detected in the sperm tail. The function of actin in the sperm head is discussed. PMID- 3316423 TI - Visualization of RNA polymerase bound to R-loop molecules improves electron microscopic analysis of in vitro transcription. AB - An electron microscope method is described which allows improved analysis of in vitro transcription. Transcription complexes are fixed with glutaraldehyde, subjected to R-loop conditions which allow the nascent RNA chains to hybridize to the DNA templates, and mounted for electron microscopy by a protein-free preparation method. An RNA polymerase molecule (or parts of it) associated with only one end of the R-loop identifies the polarity of the transcript, thus determining the origin and direction of transcription. The method was evaluated using known in vitro promoters on the bacteriophage P1 genome and was used for mapping of additional promoters in their vicinity. PMID- 3316425 TI - Resectability of the pancreas without producing diabetes, with special reference to pancreatic regeneration. AB - The exact resectability of the pancreas without producing diabetes was investigated in dogs, with consideration of pancreatic regeneration. Within the first week after major pancreatectomy, acinar cell division occurred, followed by hypertrophy; these changes resulted in an increase in weight of the remnant pancreas. The regeneration rate correlated well with the resection rate, glucose tolerance, and the insulin secretion of the remnant pancreas. Immediately after resection of more than 92% of the pancreas, severe diabetes developed, and the regeneration rate was 29.9 +/- 6.03% three to six weeks after surgery. Twelve weeks after resection of 74-92% of the pancreas, so-called Sandmeyer's diabetes had developed. The regeneration rate was 45.3 +/- 4.22% in the non-diabetic group, but in the diabetic group it proved to be only 15.4 +/- 2.39%. When less than 74% of the pancreas was resected, diabetes did not occur throughout the postoperative observation periods of 3-18 weeks, and the regeneration rate was 5.5 +/- 6.62%. These results suggested that 74% of the pancreas may be removed without producing diabetes. PMID- 3316424 TI - Acute necrotising pancreatitis--a role for enterokinase. PMID- 3316426 TI - Presence of two distinct acinar cell populations in human pancreas based on their antigenicity. AB - The immunohistochemical localization of ABH- and Lewis (Le)-related blood group antigens, including CA 19-9, a sialylated Lea antigen, was examined using monoclonal antibodies (MoAbs) in 18 normal human pancreases and compared with ABH blood group antigenicity of the individuals. Acinar cells expressed ABH, Leb, Ley, and in some cases, Lex antigen in various proportions, but not Lea and CA 19 9. The reactivity of Leb and Ley was similar with regard to cellular localization and specificity. In all specimens but one, the distribution of Leb (and Ley) and H antigens on the one hand, and of A or B antigens on the other, showed a reciprocal relationship, in that one group of acini expressed Leb (and Ley) and H antigens, but lacked any A or B antigens (type 1 acinar cell); another group of acinar cells had A or B antigens, but expressed neither Leb (Ley) or H antigens (type 2 acinar cell). In ductal cells, four of eight individuals with blood group A, two of three with blood group B, and five of six with blood group O expressed the appropriate antigen, while the remainder did not. Lea antigen was expressed primarily by centroacinar and terminal ductular and ductal cells of medium-sized ducts of all specimens, whereas Leb was present in the cells of small and large ducts in all but four cases. The reactivity of ductal and ductular cells to Lex was negative, except for one case. MoAb-Ley and MoAb 19-9 reacted only with a few ductal cells in six (33%) and 12 cases (67%), respectively. There was no relationship in the expression of Le-related antigens between acinar and ductal/ductular cells; nor were there any sex difference with regard to the binding patterns of any antibodies. However, age appeared to influence the reactivity of some antibodies with acinar cells. Islet cells did not react with any of the antibodies. The results indicate that, although the antigenicity of epithelial cells can be affected by the host blood group types, there might be several regulatory systems for expression of blood group antigens in a cell specific pattern. PMID- 3316428 TI - Pancreatic and duodenal ammonia in dogs: lowering by glucose infusion. AB - Ammonia is produced by some organs and removed by others. Glucose may influence ammonia formation. The contribution of the pancreas to ammonia metabolism is unknown. This study compares pancreatic and duodenal venous ammonia to arterial ammonia in dogs. Pancreatic venous ammonia exceeds arterial ammonia by a factor of 2.8 (range 1.3-9.3); and duodenal ammonia by a factor of 1.1 (range 0.9-2.8). Duodenal venous exceeds arterial ammonia by a factor of 2.4 (range 0.8-5.8). High dose glucose infusion decreased pancreatic venous ammonia by approximately one third and duodenal venous ammonia by approximately one quarter, but left arterial ammonia virtually unaltered. The mechanism of pancreatic ammonia production is unknown. We postulate that it may be related to pancreatic bicarbonate synthesis, binding the hydrogen ions which are liberated during this process. PMID- 3316427 TI - Blood-group antigen expression during pancreatic cancer induction in hamsters. AB - The expression of blood group-related and tumor-associated antigens was examined in pancreatic adenocarcinomas and in the normal pancreas of hamsters to determine if this expression correlated with the host blood group and/or stage of carcinogenicity, respectively. Pancreatic tumors were induced by 4 weekly treatments of hamsters with N-nitrosobis(2-oxopropyl)amine (BOP) and analyzed immunohistochemically during different stages of tumor progression with polyclonal antibodies (PoAbs) and monoclonal antibodies (MoAbs) against A, B, O and Lewis (Le) isoantigens, including X, Y and CA 19-9 monosialoganglioside (gastrointestinal cancer antigen, GICA), as well as with PoAbs detecting human carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP) and the beta-subunit of human chronic gonadotropin (beta-HCG). The red blood cells of both control and tumor-bearing hamsters expressed AB and Le(a+b+)-like blood group types, as detected by polyvalent antisera. However, none of the MoAbs reacted with the hamster red blood cells. In the pancreas, all PoAbs against blood group antigens reacted with hyperplastic ducts and ductules at very early stages of carcinogenesis, as well as with neoplastic lesions, but not with normal pancreatic cells, except for the acinar cells, which were stained with PoAb-B, PoAb-Lea and PoAb-Leb. None of the MoAbs showed any affinity for the normal pancreatic cells; however, they reacted to various degrees with induced hyperplastic and neoplastic tissue. Reactivities of several MoAbs with malignant cells were greater than those with hyperplastic lesions: MoAb-B was highly reactive with all induced lesions, MoAb-A less reactive, and MoAb-H and MoAb-Ley (which has 6 sugar chains) detected only some cancer cells. Neither of the two MoAb-Lex (with 5 carbohydrate chains) reacted with carcinoma cells, although they did bind to a few hyperplastic cells. Neither MoAb-Lea and MoAb CA 19-9, nor PoAbs against CEA, AFP and beta-HCG, reacted with any normal, hyperplastic or malignant cells. These results demonstrate the differential reactivity of these PoAbs and MoAbs in normal and malignant pancreatic tissue and show that blood group antigens, especially the B isoantigens, are specific markers for induced pancreatic duct tumors in hamsters. PMID- 3316430 TI - Evidence for partial exocrine acinar differentiation in experimentally induced pancreatic ductal/ductular cell tumors. AB - The pancreatic carcinomas induced in Syrian hamsters by a nitroso compound are of a ductal/ductular cell type. Electron microscopic examination of such tumors has revealed the presence of an occasional isolated acinar cell within the tumor. Based on their cellular characteristics, these acinar cells seem to have derived from ductular cell precursors. When we used a monoclonal antibody which specifically recognizes hamster acinar cells, a larger number of cells bearing acinar cell membrane markers were found in many tumors by an indirect immunofluorescence technique. Since most of these positively reacting cells did not exhibit the characteristic cytological features of acinar cells, such as rough endoplasmic reticulum and zymogen granules, differentiation of precursor cells to acinar cells may possibly occur at the cell membrane level. The presence of a few acinar cells within exocrine pancreatic tumors implies that acinar differentiation or retrodifferentiation can occur in pancreatic neoplasms. PMID- 3316429 TI - Sequential connective matrix changes in experimental acute pancreatitis. An immunohistochemical and biochemical assessment in the rat. AB - The effects of acute pancreatitis on the rat pancreatic connective tissue matrix were studied following intraductal pancreatic injection of trypsin solution and serial killing of the animals. Pancreatic tissue was examined using light microscopy, hydroxyproline measurement and indirect immunofluorescence, using antibodies against collagen types I, III, IV, procollagen III, fibronectin and laminin. Light microscopy revealed that acute pancreatitis was present for up to four days after injection and that perilobular and intralobular fibrosis appeared at four days and subsequently regressed. Immunofluorescence studies demonstrated an abnormal fibronectin deposit at one day in acute pancreatitis. At four days this deposit was co-located with fibrosis which was composed of collagen and procollagen type III. By eight days the immunofluorescence and light microscopic changes were minimal. Biochemical analysis confirmed a significant rise in hydroxyproline concentration at four days, which was maximal at eight days, subsequently decreasing. This peak at eight days probably reflects collagen breakdown products. PMID- 3316431 TI - Pancreatic lymphoma, diagnosis and management. AB - Eleven cases of non-Hodgkin's lymphoma were referred as patients thought to have pancreatic cancer. It was impossible to make the diagnosis in this particular group of patients preoperatively, by imaging techniques and needle biopsy. For this reason we favor laparotomy for staging followed by Roux-en-Y choledochojejunostomy for those patients with obstructive jaundice because this approach both rapidly resolves the jaundice and enables a more accurate diagnosis. We do not feel that non-surgical means of decompression of the biliary tree by transhepatic or endoscopically placed stents are as safe or effective for patients who are potentially curable because the diagnosis may not be made early enough. We call this group of patients to your attention because recent reports indicate that over 30% of such patients can be cured by chemotherapy. Thus these lesions should be differentiated from others at this location. PMID- 3316432 TI - Laboratory tests in the diagnosis of the chronic pancreatic diseases. Part 1. Secretagogues used in tests of pancreatic secretion. PMID- 3316435 TI - [Nerve growth factor and S6 kinase]. PMID- 3316433 TI - Laboratory tests in the diagnosis of the chronic pancreatic diseases. Part 2. Tests of pancreatic secretion. PMID- 3316434 TI - Exocrine secretion of pancreatic hormones: possible mechanisms. PMID- 3316436 TI - [Structure and activity relationship of lipid A--recent progress in endotoxin researches]. PMID- 3316437 TI - [NAD: cysteine ADP-ribosyltransferase in eukaryotes]. PMID- 3316438 TI - Mast cells, fibroblasts, and fibrosis. New clues to the riddle of mast cells. PMID- 3316439 TI - Molecular biology of the mouse Q region. PMID- 3316440 TI - [Biosynthesis of prostaglandin in human cervical tissue]. AB - It is known that prostaglandin (PG)E2 and PGI2 can contribute to the ripening of the uterine cervix. To study the PG biosynthesis in cervical tissue, 14C arachidonic acid was used to incubate the preparation of human cervical tissue obtained from pregnant women at delivery and non pregnant women at hysterectomy. Labeled PGE2 and 6-keto-PGF1 alpha (6PG), a stable metabolite of PGI2 were isolated on TLC, and the enzymatic activity was calculated from the formation of PGE2 and 6PG from arachidonic acid. The capacity to metabolize arachidonic acid to PGE2 and 6PG in cervical tissue obtained from pregnant women was 6 times higher than that from non pregnant women. Low enzymatic activity in the formation of PGE2 and 6PG were observed in cervical tissues from the patients with placental sulfatase deficiency and preterm delivery which were known to have a low estrogen environment. On the other hand, DHA-S administration to patients increased the formation of both PGE2 and 6PG. These results demonstrate that human cervical tissue possesses the ability to synthesize PGE2 and PGI2, and enzymatic activity increased during pregnancy, and was further enhanced by the administration of DHA-S. The results suggest that the steroids in the fetoplacental unit may be involved in the mechanism controlling the formation of PGs in the cervical tissue which lead the cervix to ripen at term. PMID- 3316442 TI - [Bone transplantation--basic characteristics and clinical application]. PMID- 3316441 TI - [Significance of the serum rheumatoid factor-like substance in the induction of arthritis in the rabbit immunized with Escherichia coli]. AB - Rabbits immunized with heat-killed Escherichia coli 0:14 for 8-10 months developed lymphocyte infiltration in the synovium at a significantly (p less than 0.05) higher rate (61.1%, 22 of 36 knees) than animals immunized for 4 months (31.3%, 10 of 32). Serum rheumatoid factor-like substance (RFLS) was positive (RAHA-titer more than 80) as early as 3 weeks after the initial treatment. After 15 weeks of immunization 90.9% (20 of 22 rabbits) of the animals were RFLS positive. Lymphocyte infiltration in the synovium of knees was observed more frequently (81.8%, 9 of 11 rabbits) (p less than 0.05) in the group with positive RFLS earlier than 8 weeks following immunization than in that with RFLS only after this period (18.2%, 2 of 11). These observations suggest that the long viability of serum RFLS and certain factors inducing early RFLS synthesis might be important in producing arthritis in rabbit immunized with E. coli. PMID- 3316444 TI - [A case of leukopenic hairy cell leukemia]. PMID- 3316443 TI - [Guideline for the treatment of giant cell tumor of bone]. PMID- 3316445 TI - [Coronary artery spasm: definition, clinical characteristics, prognosis and experimental animal models]. PMID- 3316446 TI - [Recent advances in the study of chronic myelogenous leukemia]. PMID- 3316447 TI - [Paracoccidioidomycosis in Japan]. PMID- 3316449 TI - [Kluver-Bucy syndrome in herpes simplex encephalitis]. PMID- 3316448 TI - [A case of testicular tumor with an abdominal mass, multiple pulmonary metastatic lesions, and apparently normal testes]. PMID- 3316450 TI - [A chemist's view on toxicity of dental materials]. PMID- 3316451 TI - [Histological observation on the new bone formation after bone graft in the mandible]. PMID- 3316452 TI - Computer assisted teaching program: a pulmonary patient management problem. AB - The use of computer assisted teaching in medical school could be a valuable adjunct to the more traditionally employed backboard and slides. A computer program based upon a pulmonary patient management simulation was developed to teach and assess pulmonary management skills of junior medical students. Over the period of 18 months, 39 medical students taking their internal medicine rotation at a core teaching hospital used the program. The scores ranged from 45 to 100 with a mean of 74.9%. The participants were awarded points for good clinical decisions and were penalized points for poor clinical decisions. Student evaluation of the program was highly encouraging supporting the value of computer assisted teaching. When the clinical simulation program was used in our learning resource laboratory, it promoted a high level of student-computer interaction and facilitated problem based learning. Our computer assisted teaching program using a pulmonary patient problem as its core was a valuable tool for self assessment and independent study of pulmonary medicine and it effectively complemented traditional modes of teaching medical education. PMID- 3316453 TI - Extravascular lung water measurement by double indicator dilution in shock and respiratory failure. AB - Clinical quantitation of water accumulation in the lungs is imprecise. The technique of measuring extravascular lung water (EVLW) with double indicator dilution utilizing cold indocyanine green dye has become practical with the addition of a microprocessor. The technique, insertion of a special thermistor tipped arterial catheter and potential problems are described. Our studies with resuscitation of 27 patients in shock indicate little increase in EVLW at 24 hours. On the other hand 19 patients with Adult Respiratory Distress Syndrome (ARDS) had marked increases in EVLW from normal of 5-8 ml/kg to 10.7 to 14.4 ml/kg. No further increases in EVLW were observed in eight ARDS patients requiring fluid resuscitation for associated hypovolemia and hypoperfusion. We feel that measurement of EVLW in critically ill patients offers an opportunity to study the pathophysiology of pulmonary failure. PMID- 3316454 TI - [Experimental studies on the tissue response to methylmethacrylate implants in dogs]. PMID- 3316455 TI - Tumor necrosis factor and interleukin-1: role in acute inflammation and microvascular injury. PMID- 3316456 TI - Stereologic analysis of rat type II alveolar cells in vitro. AB - When type II alveolar cells are maintained in culture, they gradually lose their characteristic lamellar bodies and their ability to secrete surface active material. We evaluated the feasibility of using electron microscopy and stereology to quantitate the effects of multiple culture conditions on the ultrastructure of type II alveolar cells, in vitro. The decrease in lamellar body volume density with time in culture was not affected by culturing the cells in the presence of insulin, fibronectin, or complex extracellular matrix. However, dexamethasone significantly prevented this decrease in lamellar body volume density. The mitochondrial volume density of the cells remained constant with time in culture under control conditions and in the presence of insulin, dexamethasone, or fibronectin. There was, however, a significant increase in mitochondrial volume density, for a short period of time (48 hours), when cells were cultured in the presence of complex extracellular matrix. These studies suggest that electron microscopy with stereology provides an excellent technique to quantitate in vitro ultrastructural changes in cultured type II alveolar cells. PMID- 3316457 TI - David Marine (1880-1978). PMID- 3316458 TI - Hearing loss after general anaesthesia (a case report and review of literature). AB - Unilateral hearing loss has been reported as an unusual complication in general anaesthesia, and so far no reports on bilateral hearing loss have been published. In this paper we present a case with bilateral sensorineural hearing impairment immediately following a minor abdominal surgical procedure. The literature is reviewed and the mechanisms causing hearing loss during anaesthesia are discussed. PMID- 3316459 TI - Controversies in otology (The first Sir Morell Mackenzie lecture). PMID- 3316461 TI - International Workshop on Monokines and Other Non-Lymphocytic Cytokines. Hilton Head Island, South Carolina, December 6-10, 1987. Program and abstracts. PMID- 3316460 TI - Self-renewal of pulmonary alveolar macrophages: evidence from radiation chimera studies. AB - Radiation-induced chimeric mice were used to study the origin of pulmonary alveolar macrophages. Unlike in other studies, these radiation chimeras were prepared by using a special fractionated irradiation regimen to minimize the killing of alveolar macrophage colony-forming cells, putative local stem cells. For this study CBA mice with or without T6 chromosome marker were used. Under this experimental condition, the majority of alveolar macrophages in mitosis are of host origin even after 45 weeks. These data suggest that alveolar macrophages are a self-renewing population under normal steady-state conditions. PMID- 3316462 TI - Inhibition of NK and ADCC activity by antibodies against purified cytoplasmic granules from rat LGL tumors. AB - Highly purified preparations of cytoplasmic granules from transplantable rat large granular lymphocyte (LGL) tumor lines (rat natural killer (RNK) tumors) were used to immunize rabbits. Antibodies from these animals gave two precipitin lines with granule extracts in Ouchterlony experiments. They reacted with at least four different bands on nitrocellulose blots of SDS gels of LGL granule proteins. By immunofluorescence, specifically adsorbed antigranule antibodies did not recognize LGL or T cell surface antigens but reacted with the cytoplasmic granules in permeabilized RNK tumor cells as well as with normal rat LGL. These same antisera showed little or no reactivity with a panel of other cells, including peripheral blood T cells, thymocytes, macrophages, and EL-4 tumor cells. F(ab')2 preparations of these antigranule antibodies completely blocked granule-mediated lysis of both SRBC and nucleated targets, while control F(ab')2 preparations from rabbits immunized with EL-4 granules or TNP-KLH showed no significant inhibition of this cytolytic activity at the same antibody concentration. Anti-granule F(ab')2 preparations specifically inhibited (greater than 75%) rat natural killer (NK) and antibody-dependent cellular cytotoxicity (ADCC) activities in a dose-dependent manner but did not effect cytotoxic T cell activity. Pretreatment of either effectors or targets by these antibodies had no effect. Anti-granule F(ab')2 preparations, at concentrations showing strong inhibition of lysis, did not inhibit the binding of LGL to YAC-1 or Ab-coated P815 targets. These results demonstrate that a granule component(s) is necessary for the lytic activity of LGL in both NK and ADCC and provide the first direct evidence that a secretory event involving these granules is part of the lytic process. PMID- 3316464 TI - Financial planning: are you getting the real thing? PMID- 3316463 TI - Tumor necrosis factor-alpha induces increased hydrogen peroxide production and Fc receptor expression, but not increased Ia antigen expression by peritoneal macrophages. AB - It has recently been shown that tumor necrosis factor (TNF) induces increased Ia antigen expression on a malignant murine macrophage cell line, and that TNF is synergistic with gamma interferon (IFN) in inducing Ia expression. This finding raises the possibility that TNF serves as a non-interferon macrophage activating factor in vivo. Since it is known that TNF has different effects on malignant and benign cells, we chose to evaluate the effects of recombinant TNF on primary cultures of murine peritoneal macrophages (MP). Neither human nor murine TNF increased the proportion of MP which expressed Ia antigen, and TNF actually partially prevented the IFN-induced increase in Ia. However, culture with TNF activated MP for increased hydrogen peroxide production in response to phorbol myristate acetate (PMA) and antagonized the IFN-induced decrease in the proportion of the MP bearing receptors for the Fc region of IgG2b. TNF and IFN were additive in increasing peroxide production. Both human and murine TNF had the same effects on MP, and MP from C3H/HeN (endotoxin sensitive) and C3H/HeJ (endotoxin resistant) mice responded comparably to TNF and IFN. Our results support the hypothesis that TNF has some macrophage-activating activity, but its effects are selective and not identical with those of IFN. PMID- 3316465 TI - Corrections and comments on special hospital issue. PMID- 3316466 TI - Shigellemia and hemolytic-uremic syndrome: a case report. PMID- 3316467 TI - Exfoliative type juvenile pemphigus foliaceus: a case report. PMID- 3316468 TI - Primary primitive neuroectodermal (neuroepithelial) tumor of ovary. PMID- 3316469 TI - Tumor necrosis factor/cachectin is an effector of skin and gut lesions of the acute phase of graft-vs.-host disease. AB - Lethally irradiated mice were injected with semiallogeneic, T-depleted bone marrow cells and an amount of peripheral T lymphocytes sufficient to induce graft vs.-host disease (GVHD) becoming apparent on the second week after the graft and leading to an increasing mortality rate within the following weeks (greater than 90% mortality within 80 d). Mice receiving bone marrow cells alone had no GVHD and were used as controls. Beginning on day 8, mice with GVHD were injected weekly with 2 mg of either rabbit anti-mouse recombinant tumor necrosis factor/cachectin (TNF-alpha) IgG, or normal rabbit IgG. On the 16-18th d, mice were killed to examine the skin and intestinal lesions of the acute phase of GVHD. The anti-TNF treatment resulted in an almost complete prevention of the severe lesions seen in the mice treated with normal rabbit IgG, i.e., the skin epidermal cell necrosis, foci of lichenoid hyperplastic reactions, and loss of the hypodermic fat; in the gut dilatation with marked flattening of the villi and elevation of the crypts, with increased numbers of mitoses and isolated crypt cell necrosis. In addition to preventing these acute lesions, anti-TNF treatment resulted in a significantly decreased mortality (approximately 70% survival at 80 d). These results suggest that during acute GVHD, the activation of grafted lymphocytes leads to a local release of TNF in the cutaneous and intestinal mucosae, which induces epithelial cell alterations and increases the inflammatory reaction. PMID- 3316470 TI - Phagocytosis of Legionella pneumophila is mediated by human monocyte complement receptors. AB - We have examined receptors mediating phagocytosis of the intracellular bacterial pathogen, Legionella pneumophila. Three mAbs against the type 3 complement receptor (CR3), which recognizes C3bi, inhibit adherence of L. pneumophila to monocytes by 64 +/- 8% to 74 +/- 11%. An mAb against the type 1 complement receptor (CR1), which recognizes C3b, inhibits adherence by 68 +/- 1%. mAbs against other monocyte surface antigens do not significantly influence adherence. Monocytes plated on substrates of L. pneumophila membranes modulate their CR1 and CR3 receptors but not Fc receptors; such monocytes bind 70% fewer C3b-coated erythrocytes and 53% fewer C3bi-coated erythrocytes than control monocytes. Adherence of L. pneumophila to monocytes in nonimmune sera is dependent on heat labile serum opsonins; adherence is markedly reduced in heat-inactivated serum (84% reduction) or buffer alone (97% reduction) compared with fresh serum. mAbs against CR1 and CR3 receptors also inhibit L. pneumophila intracellular multiplication and protect monocyte monolayers from destruction by this bacterium. This study demonstrates that human monocyte complement receptors, CR1 and CR3, mediate phagocytosis of L. pneumophila. These receptors may play a general role in mediating phagocytosis of intracellular pathogens. PMID- 3316471 TI - Activation and growth of colony-stimulating factor-dependent cell lines is cell cycle stage dependent. AB - Hematopoietic cell development is regulated by a series of growth factors that are progressively restricted in their biological activity. IL-3 is a multi lineage growth factor that supports the growth and differentiation of progenitor cells belonging to multiple lineages. However, the mechanism by which IL-3 induces proliferation and differentiation of these cells is not completely understood. In this report, we have used two IL-3-dependent cell lines, FDC-P1 (a myeloid progenitor) and F15.12 (a lymphoid progenitor) to investigate IL-3 mediated growth and differentiation. When either FDC-P1 or FL5.12 cells are deprived of IL-3, greater than 90% of all cells accumulate in the G0 phase of the cell cycle. Upon readdition of IL-3, the cells will reenter the active phases of the cell cycle. Therefore, IL-3 can act as both a competence (G0----G1) factor, and a progression (G1----M) factor for hematopoietic precursor clones. FDC-P1 cells can also proliferate in response to granulocyte/macrophage colony stimulating factor (G/M-CSF) and IL-4 (B cell stimulatory factor 1 [BSF-1]). However, resting (G0) FDC-P1 cells have lost their ability to grow in response to both G/M-CSF and IL-4, even though both factors can induce a G0----G1 transition. Therefore, G/M-CSF or IL-4 behave as progression factors among certain IL-3 responsive clones, and in those cases only in defined points in the cell cycle. Both IL-4 and G/M-CSF can maintain long-term growth of FDC-P1 cells. Upon removal of factor for 24 h, these clones accumulate in the G1 phase of the cell cycle and do not appear to enter G0 even after 36 h of factor deprivation. Therefore, cells maintained in G/M-CSF or IL-4 have altered growth requirements compared with the IL-3-dependent lines from which they were derived. The ability of various hematopoietic growth factors to regulate cell cycle progression in IL-3-dependent cell lines is dependent not only upon the lineage from which these cells were derived, but also the phase of the cell cycle in which those cells reside. The consequences of these interactions dictate the manner by which various clones will respond to CSFs and whether the cells will grow and/or differentiate. PMID- 3316472 TI - Acute rejection of murine bone marrow allografts by natural killer cells and T cells. Differences in kinetics and target antigens recognized. AB - Lethally irradiated C.B-17 +/+, C.B-17 scid/scid (severe combined immunodeficiency, SCID), BALB/c-nu/nu (nude), and C57BL/6 (B6) mice were challenged with H-2-homozygous or H-2-heterozygous totally allogeneic bone marrow cell (BMC) grafts. Some of the irradiated mice were immunized simultaneously with large numbers of irradiated marrow and spleen cells syngeneic with the viable BMC transferred. Irradiated SCID and nude mice, devoid of T cells but with normal NK cell function, were able to reject H-2-homozygous BMC grafts within 4 d. However, they were unable to reject H-2-heterozygous BMC allografts by 7 d even if they were immunized. B6 and C.B-17 +/+ mice were able to reject H-2 heterozygous BMC allografts by 7-8 d, but not as early as 4 d, if they were immunized. The rejection of H-2-homozygous BMC on day 4 was inhibited by administration of anti NK-1.1 antibodies, but not by anti-Lyt-2 antibodies. Conversely, the rejection of H-2-heterozygous allogeneic BMC on day 8 was prevented by anti-Lyt-2 but not by anti-NK-1.1 antibodies. The data indicate that both NK cells and Lyt-2+ T cells can mediate rejection of allogeneic BMC acutely, even after exposure of mice to lethal doses of ionizing irradiation. NK cells appear to recognize Hemopoietic histocompatibility (Hh) antigens on H-2 homozygous stem cells. The inability of SCID and nude mice to reject H-2 heterozygous totally allogeneic BMC indicate that NK cells do not survey donor marrow cells for self H-2 antigens and reject those cells that express nonself H-2 antigens. The T cells presumably recognize conventional H-2 antigens (probably class I) under these conditions. PMID- 3316473 TI - Synthetic peptide vaccine confers protection against murine malaria. AB - A synthetic peptide, (DPPPPNPN)2D, representing a subunit of the repeat domain of the Plasmodium berghei circumsporozoite protein, was conjugated to tetanus toxoid using bisdiazobenzidine. Immunization of mice and rats with the conjugate induced high serum titers of antibodies to the parasite, and most of the animals were completely protected from malaria infection when challenged with sporozoites. PMID- 3316474 TI - Autocrine stimulation of interleukin 1 beta in acute myelogenous leukemia cells. AB - A significant increase in CD25 antigen-positive cells by IL-1 was observed in cells of a patient with M7 acute myelogenous leukemia. Basal proliferation and expression of CD25 antigen by the M7 leukemic cells were inhibited by addition of anti-IL-1 beta antibody in a dose-dependent manner, but not by rabbit anti-IL-1 alpha antibody. Culture supernatants of these leukemic cells contained IL-1 activity, which was specifically inhibited by addition of anti-IL-1 beta antibody, and Northern blot analysis detected intracellular IL-1 beta mRNA. These results indicated that autocrine secretion of IL-1 beta was involved in proliferation of some myelogenous leukemic cells. PMID- 3316475 TI - Indirect induction of radiation lymphomas in mice. Evidence for a novel, transmissible leukemogen. AB - The transmission of a lymphomagenic agent(s) from the bone marrow of irradiated mice to thymic target cells has been demonstrated by: (a) the induction of T cell lymphomas in nonirradiated thymic grafts implanted in irradiated, Thy-l-congenic mice, (b) the induction of T cell lymphomas of host origin in mice infused with bone marrow from irradiated, Thy-l-congenic donors. The latter procedure also yields an appreciable number of pre-B cell lymphomas of uncertain origin. The results confirm Kaplan's theory that radiation induces thymic lymphomas in mice by an indirect mechanism. However, the previously described radiation leukemia virus is clearly not involved in the majority of transferred lymphomas. We propose that the mediating agent in radiation lymphomagenesis is a novel, transmissible agent induced in the bone marrow, but exerting its transforming activity on cells in the thymus. The nature and mode of action of the agent are under investigation. PMID- 3316477 TI - Enzyme release. AB - Enzyme release was studied in various tissues in intact animals or by means of tissue slices, organ perfusion or isolated and cultured cells. The factors that determine the extent and the time course of the leakage were studied extensively with several liver enzymes. It was found that the molecular properties of the enzymes, their topology within the organ, their intracellular localisation, their inducibility on the one hand, the nutritional and energetic state of the organ, and the respective protein turnover on the other, and finally, the type of the organ lesion all contribute to the different release patterns, which are known from experimental studies, and which are utilized for the diagnosis of diseases. While these preconditions of enzyme release are fairly well understood, the nature of the membrane alterations and the mechanism of detachment and transport of the enzyme proteins are less clear. Different models have been proposed, which may not exclude each other. Alterations of the cytoskeleton and the lipid composition of the plasma membranes are closely linked to ion imbalance, which is, in turn, dependent on the energy state of the individual cellular compartments. PMID- 3316478 TI - Lipoproteins in liver disease. AB - Liver disease is associated with profound and characteristic changes in lipoprotein composition and metabolism. The most pronounced alterations are the formation of lipoprotein-X in intra- and extrahepatic cholestasis, the decrease of apolipoproteins A-I and A-II and the increase of apolipoprotein E. These alterations impair the activities of both lipoprotein lipase and lecithin: cholesterol acyltransferase. They are also responsible for an abnormal receptor mediated uptake of the lipoproteins from plasma. The abnormal lipid and apolipoprotein composition of the lipoproteins in liver disease appears to affect various important functions of cell membranes. The understanding of how these changes occur and their significance in the pathogenesis of other metabolic disturbances secondary to the abnormal lipid metabolism are important challenges for future research. PMID- 3316476 TI - Transfer of experimental allergic encephalomyelitis to bone marrow chimeras. Endothelial cells are not a restricting element. AB - The adoptive transfer of clinical and histopathologic signs of experimental allergic encephalomyelitis (EAE) requires MHC compatibility between cell donor and cell recipient. The results of adoptive transfer studies using F1 to parent bone marrow chimeras as recipients of parental-derived BP-sensitive spleen cells indicate that this restriction is not expressed at the level of the endothelial cell but is confined to the cells of bone marrow derivation. Furthermore, these results indicate that the development of EAE is not dependent on the activity of MHC-restricted cytotoxic cells. PMID- 3316479 TI - Evaluation of a rapid method for diagnosing streptococcal pharyngitis in an office laboratory. PMID- 3316480 TI - Serum immunoreactive insulin levels in intact and regenerating postmetamorphic Xenopus laevis. AB - In order to confirm the presence of immunoreactive insulin (IRI) in the serum of postmetamorphic Xenopus laevis, radioimmunoassay (RIA) methods were used. The concentration of hormone found in samples of blood serum taken from nonanaesthetized intact male and female animals by the guillotine method was 10.46 +/- 0.76 microU/ml. Significantly higher IRI concentrations were found in our intact animals anaesthetized in MS 222 at pH 3.5 (21.9 microU/ml) compared with intact controls anaesthetized in MS 222 adjusted to pH 7.0 (14.4 microU/ml). During the wound-healing stage subsequent to forelimb amputation in the experimental cases (0 hours to 3 days) anaesthetized in MS 222 pH 7.0, there were intervals of significantly elevated serum IRI followed by a period of decreased IRI concentration compared with the levels in anaesthetized (MS 222 pH 7.0) and nonanaesthetized intact controls. These fluctuations were due, presumably, to stress caused by amputational injury and/or anaesthetic. Serum IRI increased steadily from 3 to 14 days postamputation then remained stable for the balance of the regeneration period (28 days) compared with nonanesthetized intact controls. A positive correlation was found between immunoreactive insulin and glucose levels in the serum of our animals. However, no correlation exists between serum IRI levels and serum osmolality in the data. PMID- 3316481 TI - Detection of serum antibody to Clonorchis sinensis by enzyme-linked immunosorbent assay. PMID- 3316482 TI - Ultrasonography of thoracic lesions: analysis of 251 cases. PMID- 3316483 TI - [Immunological recovery in allogenic bone marrow transplantation for thalassemia]. PMID- 3316484 TI - [Retroperitoneal abscess: report of 2 cases]. PMID- 3316485 TI - [Splenic abscess in diabetes mellitus: report of 2 cases]. PMID- 3316486 TI - The mutation rate and variability of eukaryotic viruses: an analytical review. PMID- 3316487 TI - Characterization of proteins associated with hepatitis delta virus. AB - The number and size of proteins associated with hepatitis delta virus (HDV) from serum and liver (human, chimpanzee and woodchuck) in the acute and chronic stages of HDV infection were analysed by immunoblotting. HDV particles in serum were separated from serum proteins by gel filtration and peak fractions of HDV antigens were subjected to PAGE. Immunoblotting with human anti-HDV-positive sera and 125I-labelled Protein A revealed two bands of 27K and 29K. It was not possible to identify any core-like structure from liver homogenates by CsCl gradient centrifugation. HDV proteins from such gradients were degraded to a size of 14K as determined by immunoblotting. HDV RNA was found in fractions at a density of 1.5 g/ml. However, direct homogenization of liver tissue in gel electrophoresis sample buffer, followed by PAGE and immunoblotting resulted in identification of HDV-associated proteins of 27K and 29K, indicating that HDV proteins in liver tissue are the same size as those in serum, but that they degrade rapidly. There was no difference in size of HDV proteins in liver samples from humans, chimpanzees or woodchucks. PMID- 3316488 TI - Ludwig's angina. PMID- 3316489 TI - AIDS in Louisiana. A challenge for every physician. PMID- 3316490 TI - A review of psychoactive substance use and abuse in schizophrenia. Patterns of drug choice. AB - We reviewed studies measuring unsupervised use of psychoactive substances in schizophrenic and control populations and organized the results by substance class. Despite much variation in their methodologies, these studies broadly agreed that schizophrenic groups' use of amphetamines and cocaine, cannabis, hallucinogens, inhalants, caffeine, and tobacco was significantly greater than or equal to use by control groups consisting of other psychiatric patients or normal subjects. Schizophrenic groups' use of alcohol, opiates, and sedative-hypnotics was significantly less than or equal to use by control groups. We discuss the implications of this nonrandom pattern of drug choice for the hypothesis of substance abuse as a form of self-medication in schizophrenia. PMID- 3316492 TI - Rhabdomyolysis in self-induced water intoxication. AB - A 64-year-old patient with major depression who developed self-induced water intoxication associated with rhabdomyolysis is presented. The possible link between acute hyponatremia and muscle injury is discussed and previous reported cases with this association are reviewed. The importance of recognizing this complication in patients with water intoxication is stressed. PMID- 3316491 TI - Sex of parent and offspring in the transmission of alcoholism. A meta-analysis. AB - Familial studies of alcoholism were reviewed to evaluate the role of sex of parent and offspring in alcoholism transmission. Data from 32 familial alcoholism studies were evaluated by meta-analysis. The results indicated that both male and female alcoholic patients more frequently come from homes in which their father, rather than their mother, is alcoholic, even when sex differences in alcoholism prevalence rates are taken into account. Although female offspring of alcoholic mothers show alcoholism rates that are elevated relative to those expected in the general population, male offspring of alcoholic mothers do not. PMID- 3316493 TI - Acetylcholine and affective disorder. AB - We reviewed the evidence for involvement of central cholinergic neurons in affective disorder. Cholinomimetics inhibit speech, thought, and activity in most subjects, decrease manic symptoms and, in some affective disorder patients, produce depressive symptoms. Cholinomimetics also cause ACTH and cortisol secretion and decrease latency to REM sleep. It is unclear whether cholinomimetics are specifically "antimanic" or "depressogenic" or whether their fundamental effect is nonspecific behavioral inhibition; whether the observed effects of cholinomimetics are mediated largely through cholinergic pathways, are secondary to changes in other neurotransmitters or are part of a nonspecific stress response. The suggestion that anticholinergic agents have mood elevating properties has not yet been subjected to controlled investigation. Although the proposal that affective disorders involve cholinergic neurons has received some support from clinical investigation further research is required to substantiate the intriguing observations to date and to clarify the physiologic and psychologic processes mediating them. PMID- 3316495 TI - The association of aluminum Alzheimer's disease, and neurofibrillary tangles. AB - Alzheimer's disease is a progressive neurodegenerative disease characterized by the development of large numbers of neurofibrillary tangles in certain neuronal populations. Aluminum salts inoculated into experimental animals produce neurofilamentous lesions which are similar, but not identical, to the neurofibrillary tangle of Alzheimer's disease. Although a few reports suggest evidence of increased amounts of aluminum in the brains of Alzheimer's disease victims, such bulk analysis studies have been difficult to replicate. Using scanning electron microscopy with x-ray spectrometry, we have identified accumulations of aluminum in neurofibrillary tangle-bearing neurons of Alzheimer's disease. Similar accumulations have been identified in the neurofibrillary tangle-bearing neurons found in the brains of indigenous natives of Guam who suffer from parkinsonism with dementia and from amyotrophic lateral sclerosis. This ongoing research still cannot ascribe a causal role of aluminum in the pathogenesis of the neurofibrillary tangle; however, it does suggest that environmental factors may play an important part in the formation of this abnormality. PMID- 3316494 TI - Neuropathological substrates of Alzheimer's disease and Parkinson's disease. AB - The pathology of Alzheimer's disease (AD) and Parkinson's disease (PD) is characterized by degeneration of certain vulnerable neuronal populations that display several types of cytoskeletal abnormalities (Alzheimer-type lesions and Lewy bodies, respectively). These may serve as diagnostic markers, although they can be found in both types of disorders and, less frequently, in brains of normal aged individuals. AD pathology shows a preponderance for hippocampal, neocortical, and forebrain cholinergic systems; the hallmark of PD is damage to the nigrostriatal dopaminergic system. Both disorders show frequent involvement of subcortical projection systems that can be similar in quality and distribution, with similar multiple neuromediator dysfunction. The results of morphometric studies of some subcortical nuclei in AD and PD are reported and related with neurochemical data. In addition to classical forms of AD and PD, both types of lesions can coexist suggesting an increased risk of PD in patients with AD and vice versa. The basis for an association between the two disorders is unknown. Many AD cases with signs of PD have additional PD pathology, while cortical Alzheimer lesions may be seen in demented PD patients. However, dementia in PD does not imply coexistent cortical AD pathology; prominent subcortical lesions alone, or in combination with cortical AD pathology, may occur. AD and PD may show some differences in the primary locus of degenerative changes in specific cortical and subcortical neuronal systems, but the causative factors, mutual relations, and relative contributions to the clinical syndromes remain to be elucidated. PMID- 3316496 TI - Membrane phospholipid bilayer assembly: phospholipid biosynthetic enzymes and phospholipid transporters. AB - Assembly of the phospholipid bilayer of cellular membranes is a fundamental aspect of cell growth and proliferation. Phospholipids are concomitantly synthesized and inserted at the cytoplasmic surface of the endoplasmic reticulum. Following this asymmetric assembly, transmembrane movement to the lumenal leaflet of the endoplasmic reticulum must occur in order to ensure coordinated growth of the bilayer. For phosphatidylcholine, the predominant phospholipid of eukaryotic membranes, this latter process appears to be facilitated by a specific transport protein. PMID- 3316497 TI - Phospholipid and fatty acid regulation of signal transduction at synapses: potential role for protein kinase C in information storage. AB - Protein kinase C has been proposed by the author to play a pivotal role in the storage of information. Its activation is directly related to synaptic potentiation as is phosphorylation of certain substrates such as protein F1. Protein F1 is found in highest concentration in those regions of temporal cortex critical for storage of information. The possibility is raised that pathology of this protein kinase C/protein F1 endogenous phosphorylation system may lead to or is responsible for the memory loss of Alzheimer's disease. PMID- 3316498 TI - Phosphatidylcholine as a precursor of choline for acetylcholine synthesis. AB - It has been hypothesized that the selective vulnerability of certain brain cholinergic neurons in Alzheimer's disease may reflect the unique way that choline is utilized by these neurons, i.e. not only as a component of major membrane phospholipids, e.g. phosphatidylcholine (PC), but also as a precursor of their neurotransmitter, acetylcholine (ACh). A prolonged utilization of choline liberated from PC, for ACh production, without adequate resynthesis of this lipid, might result in a net loss of the phosphatide followed by an impairment of membrane function and loss of cellular viability. Studies described in this paper, performed on electrically stimulated striatal slices and on cholinergic cell lines, test this hypothesis. 1) Electrically-stimulated striatal slices continue to release ACh, and sustain their free choline and ACh levels, even when perfused with a choline-free medium. Striatal levels of PC decline under these circumstances, and this decline can be blocked by adding tetrodotoxin (which blocks neuronal depolarization) or choline to the medium. The other major membrane phospholipids, phosphatidylserine and phosphatidylethanolamine, also decline proportionately to PC when slices are stimulated in the absence of choline. 2) In a population of purely cholinergic cells (human neuroblastoma, LA N-2), ACh can be synthesized from choline derived from degradation of endogenous PC formed de novo by methylation of phosphatidylethanolamine. 3) PC content of cells in culture (neuroblastoma X glioma hybrid, NG 108-15) can be altered by adding various amounts of choline to the growth media. The proportion of PC in the cells apparently affects cellular survival and rate of growth. Taken together these data demonstrate that cholinergic neurons utilize the choline stored in PC to synthesize ACh; that this process may lead to a depletion in membrane phospholipids (when choline supply is inadequate); and that the resulting changes in neuronal membrane composition might adversely affect cellular viability. PMID- 3316500 TI - Neural transplantation: potential therapy for Alzheimer's disease. AB - Significant progress has been made over the past decade in utilizing the techniques of neural transplantation to promote regeneration and recovery of function in the mammalian brain. The present paper reviews recent advances in our understanding of the properties and mechanisms of action of neural transplants and discusses how these advances might be applied to designing therapeutic approaches for treating Alzheimer's disease. PMID- 3316499 TI - 31P nuclear magnetic resonance (NMR) spectroscopy of brain in aging and Alzheimer's disease. AB - Phosphorus-31 (31P) NMR is proving to be a powerful analytical method for investigating molecular/metabolic issues in neural tissues. Recent studies have demonstrated high levels of phosphomonoesters and phosphodiesters in mammalian brain, and revealed the influence of brain maturation, development, and aging on these levels. Preliminary studies in Alzheimer's disease have demonstrated elevated levels of phosphomonoesters and phosphodiesters in the areas of Alzheimer's brain which exhibit neuropathological changes. Moreover, phosphomonoester levels were also elevated in areas of Alzheimer's brain that were devoid of neuropathological changes. These findings suggest that the phosphomonoester elevations in Alzheimer's brain antedate changes in cellular morphology and structure. Abnormalities in protein kinase function could potentially explain these findings, as well as the reported hyperphosphorylation of tau protein in Alzheimer's brain. Recent studies from this laboratory suggest that aluminum could also be involved in the changes in phosphomonoesters and phosphodiesters. PMID- 3316501 TI - The significance of clinically defined subgroups of Alzheimer's disease. AB - The significance of clinically defined subgroups of Alzheimer's disease (AD) is discussed within a framework of etiologic, pathogenetic, and treatment issues. Cerebral amyloid angiopathy and familial AD are proposed as etiologic subtypes. Clinical heterogeneity associated with age at onset and sex are thought to reflect the presence of secondary pathogenetic factors. Longitudinal studies are necessary to clarify the meaning of various symptomatic patterns. PMID- 3316502 TI - Olfactory deficits in Alzheimer's disease. AB - Altered olfactory function may be important clinically and theoretically in Alzheimer's disease (AD). Initial evidence of poor olfactory recognition performance in AD was followed by other reports of hyposmia in this disorder. Although two of these studies have found significantly better performance in other demented groups, the utility of olfactory testing in the differential diagnostic workup of dementia may have limitations. Neuroanatomical and neurochemical studies relevant to AD and olfaction are reviewed. Finally, the effects of aging on olfactory performance is discussed. It is concluded that these effects cannot be adequately assessed without rigorous control for cognitive status in sampled cohorts. PMID- 3316503 TI - Clinical similarities and differences between Alzheimer's disease and Parkinson's disease. AB - Dementia and extrapyramidal signs combine in both Alzheimer's disease (AD) and Parkinson's disease (PD) to produce various degrees of clinical overlap between the two diseases. Rest tremor, positive motor response to dopaminergic drugs, bradyphrenia and disproportionate deficits in visuospatial function, dating capacity, recency discrimination, sequencing and set-shifting are specific features of PD; myoclonus, orofacial dyskinesia, aphasia and rapidly progressive global dementia favours AD. A clearer analysis of the underlying brain-behaviour relationships is necessary to advance our understanding of the origin of cognitive and motor impairment and its treatment. PMID- 3316505 TI - Double-blind controlled trial of azathioprine in the treatment of multiple sclerosis. PMID- 3316504 TI - CT computerised stereotactic biopsy for low density CT lesions presenting with epilepsy. AB - Thirty five patients presenting with epilepsy alone and non-enhancing low-density lesion on the CT scan underwent a computer-assisted CT-guided stereotactic biopsy with stereotactic angiographic control. There was no mortality or morbidity in this series and the diagnostic yield was 97%. Thirty four patients had low grade intra-axial neoplasms. After an estimation of the pathological extent of the tumour, three patients underwent a computer-assisted stereotactic laser resection and 28 patients had radiotherapy. PMID- 3316506 TI - Creutzfeldt-Jakob disease in Hong Kong. A case report. AB - This is a report of a Chinese male, aged 67, who had been ill for 6 months and who was admitted with left hemiparesis and dementia. The diagnosis of Creutzfeldt Jakob disease (CJD) was confirmed by serial electroencephalographic (EEG), computed tomographic (CT) and neuropathological studies. This is the first formal report of CJD occurring in Hong Kong. PMID- 3316507 TI - Monoclonal antibodies against human astrocytomas and their reactivity pattern. AB - The establishment of hybridomas after fusion of X63-Ag8.653 mouse myeloma cells and splenocytes from BALB/c mice hyperimmunized against human astrocytomas is presented. The animals were primed with 5 X 10(6) chemically modified uncultured or cultured glioma cells. Six weeks after the last immunization step an intrasplenal booster injection was administrated and 3 days later the spleen cells were prepared for fusion experiments. According to the specificity analysis of the generated antibodies 7 hybridoma products (MUC 7-22, MUC 8-22, MUC 10-22, MUC 11-22, MUC 14-22, MUC 15-22 and MUC 2-63) react with gliomas, neuroblastomas and melanomas as well as with embryonic and fetal cells but do not recognize non neurogenic tumors. The selected monoclonal antibodies (McAbs) of IgG1 and IgG2a isotypes are not extensively characterized but these antibodies have been demonstrated to be reactive with a panel of glioma cell lines with varying patterns of antigen distribution. Using the McAbs described above and a series of cryosections of glioma biopsies and paraffin sections of the same material as well as glioma cultures established from these, variable antigenic profiles among glioma cell populations could be demonstrated. From these results it is evident that there is not only a distinct degree of antigenic heterogeneity among and within brain tumors, but also that the pattern of antigenic expression can change continuously. Some of the glioma associated antigens recognized by the selected antibodies persist after fixation with methanol/acetone and Karnovsky's fixative and probably are oncoembryonic/oncofetal antigen(s). The data suggest that the use of McAbs recognizing tumor associated oncofetal antigens in immunohistochemistry facilitates objective typing of intracranial malignancies and precise analysis of fine needle brain/tumor biopsies in a sensitive and reproducible manner. PMID- 3316508 TI - Insulin binding and internalization in cultured fibroblasts from myotonic muscular dystrophy. AB - The binding and internalization of insulin receptors were investigated in 8 adult form and 6 early-onset myotonic muscular dystrophy (MMD) patients and in age- and sex-matched controls, using cultured skin fibroblasts to avoid the in vivo milieu of donors. The specific insulin binding in the presence of [125I]insulin alone at pH 7.4 and pH 8.0 in MMD patients was not significantly different from that of the controls. The competition curves of insulin binding and the Scatchard plots in MMD and control fibroblasts were similar. Insulin receptor affinity in MMD patients was not different from that in the controls. In the presence of chloroquine, a lysosomotropic agent, the rate of increase in cell-associated radioactivity was similar in both MMD groups and controls. Thus, the normal binding and internalization of the insulin receptors in cultured skin fibroblasts from MMD patients suggest that the insulin receptors are not determined by the pathological genetic factors in MMD. Furthermore, the abnormal insulin binding to freshly isolated cells, reported previously, may be a reflection of environmental factors rather than a genetically determined cellular abnormality in MMD. PMID- 3316509 TI - Studies of protease and protease inhibitors in familial amyloidotic polyneuropathy. AB - Serum levels of 6 protease inhibitors, alpha 1-antitrypsin, Cl inactivator, alpha 2-macroglobulin, antithrombin-3, alpha 1-antichymotrypsin and inter-alpha-trypsin inhibitor were measured in patients with familial amyloidotic polyneuropathy (FAP) and a control group without neurologic disease. No significant differences were observed between the 2 groups. The proteolytic effect of brinase, an enzyme from Aspergillus oryzae, on amyloid tissue sections from patients with FAP was also evaluated. Amyloid fibrils were degraded by brinase, while the tissue structure remained fairly intact. PMID- 3316510 TI - Preliminary clinical trial of immunotherapy for malignant glioma. AB - An immunotherapy protocol based on intracranial implantation of stimulated, autologous lymphocytes into the tumor bed following surgical debulking of malignant glioma is described. Phase I clinical trials in human patients are now in progress. Preliminary data representing the first 39 patients treated are presented briefly. PMID- 3316511 TI - Preparation and antitumor effect of macrophage activating factor (MAF) encapsulated in liposomes bearing a monoclonal anti-human melanoma (A375) antibody. AB - We prepared large unilamellar vesicles containing the cell-free culture supernatant of a human T cell hybridoma rich in macrophage activating factor (MAF) and bearing monoclonal antibodies against human melanoma A375 tumor cells; their antitumor activity against A375 cells was examined in vitro and in vivo. Both MAF-immunoliposomes (bearing antibodies) and MAF liposomes (not bearing antibodies) showed macrophage-mediated cytotoxicity in vitro at a high E/T ratio (about 40). But at a low E/T ratio (about 15), only MAF-immunoliposomes showed tumoricidal activity, their activity being more than ten thousand-fold stronger compared with a soluble MAF preparation (MAF solution). MAF-immunoliposomes not only showed tumor neutralization mediated by macrophages in vivo when a mixture of tumor cells, macrophages, and MAF-immunoliposomes was locally injected, but also showed significant inhibition of tumor growth on repeated i.v. systemic administration of them. On the other hand, other samples (MAF-liposomes without the antibody, a MAF solution, and immunoliposomes without MAF) were not significantly effective against tumor growth. These results may constitute evidence that the delivery of lymphokines to the tumor sites is important or even critical when an attempt is made to treat cancer with lymphokines with the expectation of the potentiation of the host's immune system. PMID- 3316512 TI - Coordinated use of sequentially escalated cyclophosphamide and cell-cycle specific chemotherapy (N4SE protocol) for advanced neuroblastoma: experience with 100 patients. AB - A rationally devised induction regimen of vincristine, Adriamycin (Adria Laboratories, Columbus, OH), and sequentially-escalated cyclophosphamide (CPM), followed by S-phase-specific agents (5-fluorouracil [5-FU]/cytosine arabinoside [ara-C]/hydroxyurea), was used in 100 patients with neuroblastoma. Of 17 patients under 1 year of age at diagnosis, complete (CR)/good partial (GPR) responses with long-term disease-free survival were achieved in 11 (85%) of 13 new patients and in two of four previously treated patients; six of the GPRs also received myeloablative therapy with autologous bone marrow rescue to consolidate remission status. The 83 patients over 1 year of age at diagnosis included three groups: (1) 36 new patients whose N4SE included maximal-dose CPM (ie, up to 140 to 160 mg/kg/course); (2) an earlier group of 18 new patients whose N4SE included moderate-dose CPM (ie, up to 80 mg/kg/course); and (3) 29 previously treated patients who all received the maximal-dose N4SE regimen. For new patients, CR/GPR rates were 72% in the maximal-dose group v 39% in the earlier moderate-dose group (P = .029). A CR/GPR rate of 41% and a partial response rate of 17% were observed for the 29 previously treated patients, all but two of whom had large tumor burdens after therapy that included moderate doses of CPM. Despite consolidation with myeloablative therapy, many responders in the three groups ultimately relapsed. The N4SE was strongly myelosuppressive, but only two patients died from associated infection. Extramedullary toxicity was limited to hemorrhagic cystitis in four of 33 CPM previously treated patients; this problem did not occur in the 67 new patients. The data indicate that the maximal-dose N4SE is an effective induction regimen for neuroblastoma, can achieve marked regressions of disease resistant to less intensive therapy, and is sparing of major body organs. This high rate of remission induction must be coupled with improvements in consolidation therapy to assure long-term disease-free survival of poor-risk patients. PMID- 3316513 TI - Treatment of peripheral neuroepithelioma in children and young adults. AB - Seventeen patients with peripheral neuroepithelioma were treated with an intensive chemotherapy regimen of vincristine, Adriamycin (Adria Laboratories, Columbus, OH), and cyclophosphamide (VADRIAC) in combination with radiation therapy. Fifteen patients with stage III (seven) or stage IV (eight) at presentation were treated on a more intensive regimen including total body irradiation (TBI) (8 Gy). Two patients with stage I (one) or II (one) disease received a less intensive chemotherapy regimen of VADRIAC. Therapy was completed within 6 to 7 months in all patients. The disease arose in the chest wall in 12 patients, pelvis in three patients, and extremity in two patients. Sixteen of the 17 (94%) patients achieved a complete remission. With a median follow-up of 18 months, ten patients remain in complete remission with an actuarial survival of 68% and an actuarial relapse-free survival of 56% at 12 months. On the basis of our initial experience with this tumor, we believe that peripheral neuroepithelioma is a chemoresponsive and radioresponsive tumor. PMID- 3316514 TI - Evidence of a castration-mediated effect of adjuvant cytotoxic chemotherapy in premenopausal breast cancer. AB - This prospective randomized trial, conducted by the Danish Breast Cancer Cooperative Group, is the largest study, so far, of adjuvant chemotherapy in premenopausal breast cancer. The trial is unique in that it is nationwide and based on a nonselected population of patients, and is the only adjuvant trial studying the effect of cyclophosphamide monotherapy. After total mastectomy with axillary node sampling, followed by local radiotherapy, 1,032 pre- and perimenopausal women with operable breast cancer were randomized to observation alone, or to adjuvant chemotherapy for 1 year with either cyclophosphamide monotherapy or with a combination of cyclophosphamide, methotrexate, and 5 fluorouracil (CMF). As of January 1987, median follow-up was 68 months. From early on both cyclophosphamide alone and CMF were found to improve recurrence free survival (RFS) significantly and to a similar degree (P = .0001). However, an overall survival advantage did not become evident until 5 years after the start of treatment. So far, this advantage appears to be more pronounced in CMF (P = .0065) than in cyclophosphamide-only patients (P = .08). Thus, the study confirms the findings of the National Surgical Adjuvant Breast Project (NSABP) and Milan trials that adjuvant chemotherapy prolongs the survival of premenopausal women with early breast cancer. A retrospective analysis revealed that, in contrast with CMF, cyclophosphamide alone did not improve RFS significantly in subsets of patients without amenorrhea, with estrogen-receptor (ER) negative tumors, and with tumors of low histological differentiation. Assuming that cyclophosphamide alone is a less tumoricidal treatment than CMF, these findings suggest that the effect of adjuvant cytotoxic chemotherapy is mediated partly through chemical castration, and partly through a purely cytotoxic effect. PMID- 3316516 TI - The effect on survival of initial chemotherapy in advanced breast cancer: polychemotherapy versus single drug. AB - Since current clinical trials assessing new agents occur in patients with advanced breast cancer having failed one and sometimes many polychemotherapy programs, these new agents may not be given a fair trial. In an effort to assess the possibility of using an alternative study design, we analyzed older clinical trials that used a controlled study design, randomizing between a single new drug and an established polychemotherapy program with a cross-over design upon failure. We were interested in noting that the pooled data did display a slight survival advantage (median 3.7 months) for the group receiving polychemotherapy as initial therapy. The survival distributions were clearly not significant using the log rank test, but did approach significance using the Smirnov. It is apparent that, while some slight advantage does occur for that group of patients receiving initial polychemotherapy, the magnitude of this effect is not great and is short in duration. Serious consideration should be given to the assessment of new agents as first-line therapy, particularly should they have a unique mode of action or lessened morbidities or toxicities. PMID- 3316515 TI - Bone marrow transplantation for myelodysplastic and myeloproliferative syndromes. AB - Twenty patients (age range, 4 to 48 years; median age, 36 years) with de novo or drug-induced myelodysplastic syndromes or myeloproliferative disorders were treated with myeloablative immunosuppressive therapy followed by bone marrow transplantation (BMT). Four preparative regimens were used; three regimens consisted of combined total body irradiation (TBI) and chemotherapy and one of combination chemotherapy only. One patient received marrow from his identical twin brother, whereas the other 19 patients were grafted with marrow from histocompatible siblings. In 19 patients the abnormal clone was at least temporarily ablated, while in one patient the congenital myelodysplasia persisted. Eight patients are alive and well for +108 to +3,359 days post transplantation. Nine patients died of transplant-related complications (six of interstitial pneumonia, two of gastrointestinal bleeding, and one of fungal sepsis) and three patients died with persisting or recurring disease. One patient with a late recurrence has undergone a second successful bone marrow transplant procedure. Outcome of BMT was not related to French-American-British (FAB) type, marrow fibrosis, cytogenetic abnormalities, or preparation regimen. Marrow transplantation as a means of providing long-term disease-free survival and possible cure should be considered in patients if a suitable donor is available. PMID- 3316517 TI - A programmable and implantable pumping system for systemic chemotherapy: a performance analysis in 52 patients. AB - We have prospectively evaluated the performance of the implanted battery-powered Medtronic (Minneapolis) SynchroMed infusion system. Between July 1984 and July 1986, fifty-three SynchroMed pumps were implanted in 52 patients for phase I and II trials of low-dose continuous-infusion doxorubicin (N = 35) or vinblastine (N = 17). The median duration of pump function was 145 days (mean, 180; range, 20 to 787 +) and the systems infused drugs for 61% (range, 32% to 100%) of their patient implant time. During 10,045 patient days (27.5 years) of implantation, there have been no failures of the pump mechanism and pump accuracy was excellent (2.2% error rate in 256 analyzed refills). The median cost of the hospitalization for implantation was +17,140 in 14 analyzed cases. Complications requiring a second surgical procedure occurred with 13 systems (24%). Two of the complications were related to localized cutaneous hypersensitivity to vinblastine, four were directly related to system complications, and seven were secondary to implant procedure problems. Seven patients (13%) requested removal of the device after tumor progression occurred. Based on this experience, the company has made improvements in certain aspects of system design and has implemented a comprehensive user training program to minimize procedure-related problems. The Medtronic SynchroMed is an accurate and sophisticated system that allows infusion of low-dose doxorubicin and of vinblastine for prolonged periods. Extravasation of these vesicant agents must be carefully prevented. The financial cost of this implanted system may limit its use to patients with an expected survival of 5 months or longer. PMID- 3316519 TI - High-dose methotrexate: a critical reappraisal. AB - High-dose methotrexate (HDMTX) with leucovorin (LV) rescue has been used as a therapeutic strategy in oncology for more than a decade. Administration of HDMTX results in tumoricidal plasma concentrations of the drug without significant host toxicity, provided that plasma MTX levels are monitored and LV rescue is properly administered. The original premise of LV rescue was that the provision of reduced folate to normal cells would circumvent the metabolic block produced by MTX and allow resumption of DNA synthesis, although the presumed therapeutic selectivity of leucovorin has not yet been adequately explained. Despite a strong pharmacologic rationale and a vast clinical experience, HDMTX with leucovorin rescue has not been shown to be unequivocally superior to conventional doses of MTX in any clinical situation except, perhaps, for treatment of osteogenic sarcoma and childhood acute leukemia. While HDMTX is an important component of effective treatment regimens for these diseases, its precise contribution to the success of these regimens remains undefined. Although HDMTX can theoretically overcome all known mechanisms of MTX resistance, no data exist to suggest that this can be accomplished in the clinic. Thus, this well-known but poorly understood treatment regimen must remain a subject of clinical investigation rather than a part of routine clinical practice. PMID- 3316518 TI - A controlled clinical trial of the addition of transdermal scopolamine to a standard metoclopramide and dexamethasone antiemetic regimen. AB - A randomized prospective clinical trial was conducted to evaluate the potential utility of adding transdermal scopolamine to a standard regimen of metoclopramide and dexamethasone for the prevention of cisplatin-induced emesis. Thirty-one patients who were about to receive their first cycle of chemotherapy, using a combination regimen including cisplatin at a dose greater than or equal to 60 mg/m2 were randomized to receive an antiemetic regimen of either metoclopramide and dexamethasone alone, or these two drugs plus transdermal scopolamine patches. The mean number of episodes of emesis was .63 +/- 1.31 in the 16 scopolamine treated patients, and 2.27 +/- 2.66 in the 15 patients who did not receive scopolamine (P less than .01). The scopolamine appeared to inhibit extrapyramidal reactions to the metoclopramide, but the number of cases was too small for statistical significance. We conclude that the addition of transdermal scopolamine to a standard metoclopramide and dexamethasone antiemetic regimen provides additive benefit in the control of cisplatin-induced emesis. PMID- 3316520 TI - Whither carboplatin? A replacement for or an alternative to cisplatin? PMID- 3316522 TI - Computer assisted stereotactic placement of Ommaya reservoirs for delivery of chemotherapeutic agents in cancer patients. AB - A new technique of Ommaya reservoir placement using computer assisted reconstruction of CT data bases is described. This technique permits stereotactic placement of ventricular catheters in small or normal sized ventricles. It should be particularly useful in patients where the conventional technique is not applicable. PMID- 3316521 TI - The chemotherapy of posterior fossa tumors in childhood. AB - Conventional therapy for brain tumors, consisting of neurosurgical intervention and radiotherapy, has not resulted in the successes achievable in other childhood malignancies. The role of adjuvant chemotherapy, well defined in many childhood cancers, has not yet contributed significantly to the treatment of children with brain tumors. Chemotherapy of recurrent tumors has produced regressions but no cures. The most active agents identified to date in the treatment of recurrent posterior fossa tumors include cisplatinum, cyclophosphamide and methotrexate. Future efforts will need to focus on the rational selection of drugs for study in limited agent histology-stratified phase II trials, with advancement of active agents into large randomized phase III adjuvant therapy trials. PMID- 3316523 TI - Organization of orientation and direction selectivity in areas 17 and 18 of cat cerebral cortex. AB - 1. The organization of subunits and sequences subserving preferred stimulus orientation and preferred direction of stimulus motion in cat cerebral cortical areas 17 and 18 was determined by making vertical, tangential, and oblique microelectrode penetrations into those areas. 2. Quantitative measurements of direction selectivity indicated that not all shades of direction selectivity are equally represented in area 17. Peaks in the distribution of direction indices may correspond to the bidirectional, direction biased, and direction selective categories used in qualitative studies. 3. The relationship between preferred direction and location in the visual field was examined for units with receptive fields centered more than 15 degrees from the area centralis. Simple cells had orientation preferences that tended to be parallel to radii extending out from the area centralis. Wide-field complex cells had orientation preferences that tended to be parallel to concentric circles centered on the area centralis; the direction preferences of this group were biased toward motion away from the area centralis. 4. Unit pairs separated by 200 microns or less were 4.2 times as likely to have the same preferred direction as to have opposite preferred directions, indicating that, on average, strings of five neurons have similar direction preferences. 5. Tracks in area 18 showed a similar pattern to those in area 17. 6. In the vertical tracks in area 17 a small proportion (12%) of the units recorded in infragranular layers had preferred orientations that deviated 30 degrees or more from the first unit recorded in the same column. The presence of these cells most likely reflects the relative crowding of columns in infragranular layers, which occurs at the crown of the lateral gyrus. Columns with such large jumps in preferred orientation were not observed in area 18, which occupies a relatively flat region of cortex. 7. In both areas 17 and 18 direction preference in vertical tracks usually reversed at least once, either between supra- and infragranular layers or within infragranular layers. Along these same tracks, orientation preference usually did not change. 8. In tangential tracks, preferred direction and orientation preferences changed together in small increments. Occasionally a large jump in preferred direction would occur with only a small change in preferred orientation. These large jumps were considered to mark the boundaries of the direction sequences. Most frequently these boundaries were separated by 400-600 microns. This value is approximately half the size of a complete set of orientation preferences (700 1,200 microns).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3316524 TI - Psychophysical evidence for separate channels for the perception of form, color, movement, and depth. AB - Physiological and anatomical findings in the primate visual system, as well as clinical evidence in humans, suggest that different components of visual information processing are segregated into largely independent parallel pathways. Such a segregation leads to certain predictions about human vision. In this paper we describe psychophysical experiments on the interactions of color, form, depth, and movement in human perception, and we attempt to correlate these aspects of visual perception with the different subdivisions of the visual system. PMID- 3316525 TI - Terminal arbors of axons projecting to the somatosensory cortex of the adult rat. I. The normal morphology of specific thalamocortical afferents. AB - A characteristic feature of the rat somatosensory neocortex is a discrete topographic representation of the facial whiskers. Afferent fibers projecting to this vibrissae representation were "bulk-labeled" by injecting horseradish peroxidase into the white matter. Terminal arbors with the morphological characteristics of Lorente de No's (1949) "specific" thalamocortical afferents were then reconstructed through serial sections. These terminal arbors, characterized by the discrete organization of their dense plexus in layer IV, have a laminar distribution of boutons that parallels the laminar pattern of terminal degeneration resulting from lesions of the ventral posterior nucleus of the thalamus. The regional distribution of different-sized arbors corresponds to the distribution of vibrissae-related clusters of different sizes. Larger arbors were found in the posteromedial region corresponding to the mystacial vibrissae representation, while smaller arbors were found in the anterolateral region corresponding to the representation of the anterior sinus hairs. Terminal arbors were also reconstructed from sections stained simultaneously to demonstrate the pattern of vibrissae-related clusters. The greatest concentration of boutons on these axons occurred within a single vibrissae-related cluster. Furthermore, when 2 fibers terminated within a single cluster, their terminal arbors appeared to be largely coextensive. The morphology, size, and distribution of these terminal arbors support the hypothesis that the layer IV plexus of a single specific thalamocortical afferent tends to fill a vibrissae-related cluster. Thus, the organization of specific thalamocortical afferents may be responsible for clustered organization within the somatotopic map of the rodent neocortex. PMID- 3316526 TI - Terminal arbors of axons projecting to the somatosensory cortex of the adult rat. II. The altered morphology of thalamocortical afferents following neonatal infraorbital nerve cut. AB - The organization of the whisker representation within the neocortex of the rat is dependent on an intact periphery during development. To further investigate how alterations in this cortical map arise we examined the organization of thalamocortical afferents to the whisker representation in adult animals in which the infraorbital branch of the trigeminal nerve was cut on the day of birth. The disrupted pattern of thalamocortical projections to the vibrissae representation was apparent in the abnormal pattern of the anterograde transport of horseradish peroxidase from the thalamus, as well as in the abnormal pattern of succinate dehydrogenase activity. To determine the morphology of individual thalamocortical axons associated with this disrupted pattern, terminal arbors were "bulk-labeled" by injections of horseradish peroxidase into the white matter beneath the somatosensory cortex. Terminal arbors were identified by their laminar distribution of boutons corresponding to the specific thalamocortical afferent. The medial to lateral extent of these terminal arbors varied dramatically, from 350 to 1500 microns. In addition, terminal arbors innervating the same local area of cortex appeared to have varying degrees of overlap. Thus, the disruption of the neocortical vibrissae representation appears to involve the abnormal arborization of individual thalamocortical afferents. This finding supports the hypothesis that the fine-grain organization of the somatotopic map is dependent on the morphology and organization of individual thalamocortical arbors, which, in turn, are dependent on the periphery during development. PMID- 3316527 TI - Acidic and basic fibroblast growth factors promote stable neurite outgrowth and neuronal differentiation in cultures of PC12 cells. AB - Acidic (aFGF) and basic (bFGF) fibroblast growth factors are well-characterized peptide hormones that have potent angiogenic activity and that are mitogenic for a variety of cell types. The present findings demonstrate that FGFs can reproduce the entire spectrum of rat pheochromocytoma PC12 cell responses previously shown to be elicited by NGF. These include responses that are rapid (cell flattening, enhanced phosphorylation of tyrosine hydroxylase) or delayed (neurite outgrowth, induction of phosphorylated MAP 1.2, regulation of NILE and Thy-1 glycoproteins, cessation of mitosis, elevation of AChE activity), as well as responses that have been shown to be either transcription-independent (neurite regeneration, promotion of survival) or transcription-dependent (priming, regulation of NILE and Thy-1 glycoproteins, elevation of AChE activity). The only responses for which the FGFs and NGF consistently showed quantitative differences were in the rates for neurite initiation and elongation in serum-containing medium. Thus, while all 3 factors promoted the formation of stable neurites, the network of outgrowth elicited by NGF at any given time of treatment was always of greater density. Togari et al. (1985) have previously reported that bFGF can initiate transient neurite formation in PC12 cell cultures. The present observations describe a variety of additional actions of bFGF on a neuronal cell line, and demonstrate that aFGF is capable of mimicking many, if not all, of these actions. These observations thus extend the range of actions that aFGF and bFGF may potentially exert on nerve cells, either during their development, repair, or maintenance. In addition, this work suggests that the PC12 cell line may serve as a useful model system with which to study the mechanism of action of FGFs on neurons. Since all 3 factors appear capable of eliciting the same wide spectrum of responses, molecular events specifically associated with FGFs and NGF in PC12 cells may prove illuminating of the causal steps involved in neuronal differentiation. PMID- 3316528 TI - Nondirected axonal growth on basal lamina from avian embryonic neural retina. AB - The vitreous surface of the embryonic avian retinal neuroepithelium was isolated by mechanical disruption of the retina mounted between 2 adhesive substrata. The 200-micron-thick sheath covered an area of up to 1 cm2 and consisted of the vitreal basal lamina with a lamina densa, 2 laminae rarae, and a carpet of ventricular cell endfeet on top of the lamina. The vitreal endfeet were removed by detergent treatment and an extracellular basal lamina was obtained. The laminae were further characterized by immunohistochemistry and immunoblotting. A 190 kDa laminin protein was detected in laminae with and without vitreal endfeet, whereas the membrane-bound neural cell adhesion molecule (N-CAM) was detectable only on the endfeet of the ventricular cells and was absent in the detergent treated basal laminae. Neither immunoblotting nor immunostaining revealed fibronectin in these preparations. Explants of retina, sensory ganglia, and cerebellum from chick, quail, and mouse were cultured on the basal lamina as a substratum. In all cases axonal outgrowth was excellent, with a growth rate similar to that in situ. Outgrowing axons from sensory ganglia and cerebellar explants were accompanied by migratory cells, which, in the case of sensory ganglia, were flat cells and, in the case of cerebellar explants, resembled granular neurons. Optic axons grew on the laminae in an asymmetric, explant inherent pattern specific for the position of origin of the explant. On detergent treated basal laminae, as well as on laminin, the retinal axons grew in a clockwise orientation. This axonal growth pattern was specific for retinal tissue and was not observed with axons from other neural explants. In spite of the excellent substrate properties provided by the substratum, cues for growing axons (toward or away from the optic disk) were not detectable in the basal lamina preparations. PMID- 3316529 TI - Yet another targeting device for stereotactic procedures. PMID- 3316530 TI - Ultrasound detection of a choroid plexus papilloma of the third ventricle. PMID- 3316531 TI - Significance of hemorrhage into brain tumors: clinicopathological study. AB - A retrospective clinical and pathological review of 905 consecutive brain tumor cases (excluding pituitary adenoma and recurrent tumor) was conducted to identify cases in which intratumoral hemorrhage was confirmed grossly and/or pathologically. There were 132 cases so identified, for an overall tumor hemorrhage rate of 14.6%; of these, 5.4% were classified as macroscopic and 9.2% as microscopic. The presence of hemorrhage was correlated with the neurological presentation. The highest hemorrhage rate (70.0%) was found in patients with prior neurological history who experienced apoplectic deterioration (acute-on chronic presentation). Only 57.1% of patients with acute deterioration in the absence of prior neurological symptoms had hemorrhages. The highest hemorrhage rate for primary brain tumors was 29.2% for mixed oligodendroglioma/astrocytoma, while the highest hemorrhage rate for any tumor type was 50% for metastatic melanoma. The clinical relevance of tumor hemorrhage is discussed. PMID- 3316532 TI - Recurrent malignant gliomas: survival following interstitial brachytherapy with high-activity iodine-125 sources. AB - The authors report survival data for the first 41 patients treated for recurrent malignant gliomas with interstitial brachytherapy at the University of California, San Francisco (1980-1984). Iodine-125 (125I) sources were temporarily implanted using stereotaxic techniques. The median survival period for 18 patients with recurrent glioblastomas was 52 weeks after brachytherapy; two patients are alive more than 5 years after brachytherapy. The median survival period for 23 patients with recurrent anaplastic astrocytomas is 153 weeks after brachytherapy, with 10 patients alive more than 3 years and four patients alive more than 4 years after brachytherapy. Both groups did significantly better (p less than 0.01) than groups of patients with the same diagnoses and similar general characteristics who were treated at recurrence with chemotherapy alone. Because of deterioration of their clinical condition and evidence of recurrence from computerized tomographic scans, 17 (41%) of 41 patients required reoperation 20 to 72 weeks after brachytherapy. Despite the invariable presence of apparently viable tumor cells mixed with necrotic tissue in the resected specimen, nine patients have survived more than 2 years after reoperation and two of the nine are still alive 4 years after reoperation. The authors conclude that brachytherapy with temporarily implanted 125I sources for well-circumscribed, hemispheric, recurrent malignant gliomas is effective and offers a chance for long-term survival even though focal radiation necrosis can seriously degrade the quality of survival in a minority of patients. PMID- 3316533 TI - Hemodynamic analysis of associated extracranial atraumatic vertebral artery aneurysm and arteriovenous fistula. Case report. AB - A case of atraumatic arteriovenous (AV) fistula of the extracranial vertebral artery associated with an atraumatic aneurysm of the contralateral extracranial vertebral artery is reported. The fistulous lesion was excised after distal and proximal ligation of the vessel. Subsequently, the contralateral aneurysm underwent spontaneous dissolution. Seven cases of extracranial vertebral AV fistulae associated with ipsilateral vertebral artery aneurysms (four traumatic and three as part of vascular dysplastic syndromes) have been reported previously. PMID- 3316534 TI - Modeling: a method for program development. AB - Successful program development is crucial for nursing. The methodology of modeling systematically integrates program development strategies recommended in the nursing literature. In addition to guiding program planning and design, the series of diagrams which modeling generates can be used to guide program implementation, evaluation, refinement, and reformulation. The diagramming also facilitates communication with others about the program. PMID- 3316535 TI - The effects of aerobic exercise on the pregnant woman, fetus, and pregnancy outcome. A review. PMID- 3316536 TI - Use and misuse of balance studies. AB - Balance studies are inadequate tools to determine human requirements for minerals and trace elements. At best, they estimate the amount of an element in a specified diet that maintains the existing pool size of the test subject. The relevance of pool size to health remains to be established by different and independent means. PMID- 3316537 TI - John Fleming Brock. PMID- 3316539 TI - Analysis of nutrient-response relationships. AB - A general mathematical model is proposed to relate biological response to nutrient intake. The mathematical expression is r = sigma k0 alpha ini/sigma l0 beta ini, k less than or equal to l, alpha 0 less than greater than or equal to 0, alpha 1 ... alpha k greater than or equal to 0, beta zero ... beta l greater than or equal to 0. The model provides for saturation behavior with respect to nutrient intake, but it also provides for a wide range of shapes to the nutrient response curve. The characteristics of the nutrient-response curve, as well as the characteristics of transformations of the primary equation, are discussed in detail. Graphical methods are discussed for obtaining quantitative estimates of parameters that describe the nutrient-response relationship. The model is compared with other models used currently in nutrient-response analysis. The steps involved in the graphical procedure are summarized. PMID- 3316538 TI - Effect of calcium supplementation on forearm bone mineral content in postmenopausal women: a prospective, sequential controlled trial. AB - Three hundred ten normal postmenopausal volunteers were invited to enter a controlled trial of the effects of calcium supplementation on forearm mineral content (FMC); 269 entered the study and 210 completed it. Of those who completed the study, 158 were allocated to one of three calcium-supplemented treatment regimes and 52 were allocated to a control group. Twenty-two of the subjects allocated to the treatment group were unable to take supplementary calcium but agreed to remain in the study as additional controls. There were therefore 136 treated subjects, 52 strict controls and 74 controls altogether. During the initial observation period of 9 mo, there was a highly significant loss of bone in all groups (P less than 0.001). During the 9-mo period of treatment, there was a highly significant reduction in the rate of bone loss in the treated subjects (P less than 0.001), a just significant reduction in the strict controls (P less than 0.05) and a nonsignificant reduction in the rate of loss in all controls. The difference between the treated and strict controls in the second period was not significant but the difference between the treated and all controls in the second period was significant (P less than 0.025). When the analysis was applied only to women within 10 yr of menopause, the difference between the treated and strict control groups in period 2 was significant (P less than 0.025) and the difference between the treated and all controls was highly significant (P less than 0.001). PMID- 3316540 TI - Occupational hazards for nurses exposed to radiation and antineoplastic agents. PMID- 3316541 TI - Aluminum in the lung: the pyropowder conundrum. AB - Pulmonary aluminosis is a disease first seen in Germany between 1938 and 1945 which then reappeared in the United Kingdom between 1952 and 1959. All cases were associated with exposure to a submicron-sized aluminum pyrotechnic flake which was lubricated with a non-polar aliphatic oil. Ordinarily, stearic acid, which chemically combines with aluminum to form aluminum stearate, was used as a lubricant to retard surface oxidation during milling of such flake. This new aliphatic lubricant, which simply physically coated the flakes to prevent elemental aluminum oxidation, could be easily washed off of such flakes. In the intracellular milieu, removal of such surface oil permits exposure of oxygen to elemental aluminum; this results in a vigorous exothermic reaction and the potential for tissue damage. It appears that cases occurred only where this oily lubricant was used to manufacture near submicron-sized pyrotechnic flake (ie, United Kingdom, Germany, Sweden), but never where similar flake has been manufactured for almost a century using polar lubricants. PMID- 3316542 TI - Simultaneous assessment of genetic and occupational risk factors. AB - Genetic factors rarely have been considered in studies of occupational risks. This leaves unresolved many questions of differential disease distribution in similarly exposed groups. In this analysis the medical and epidemiologic literature has been surveyed and the methods for assessing genetic and occupational risks in the same study have been identified and critiqued. Five major methodologic approaches have been identified: (1) adjustment for race, ethnicity, and sex; (2) case studies of occupational disease in genetically susceptible workers; (3) cross-sectional evaluations of the prevalence of disease among genetically differentiated groups; (4) case-control studies of the association of genetic characteristics and disease; and (5) family studies of disease aggregations. These approaches, in part, allow for controlling genetic factors or identifying susceptible genes or phenotype markers that may differentiate occupational populations according to risk. However, in many of the studies evaluated, the methods used were not very powerful for detecting gene occupation interactions. More powerful designs need to be utilized for the simultaneous assessment of genetic and occupational risk. PMID- 3316543 TI - A review of nasal cancer in furniture manufacturing and woodworking in North Carolina, the United States, and other countries. AB - Nasal adenocarcinoma in the High Wycombe furniture industry of England during 1956-1965 had an annual incidence of 500 to 1,000 times greater than that of the general population. Excesses of nasal cancer have also been described in France, Australia, Denmark, Finland, Italy, and Holland. Interestingly, one limited study in Canada revealed no excess, whereas a more recent one showed a slight excess. In contrast to the strikingly large excesses of nasal adenocarcinoma in other countries, there has never been any evidence of similarly large excesses in the US woodworking and furniture industry. Modern manufacturing conditions may not present the same degree of risk of developing nasal cancer as was present in the English furniture manufacturing industry. The incidence of nasal cancer associated with furniture manufacturing in the United States is examined in considerable detail in North Carolina, the leading furniture manufacturing state. Furniture manufacturing in the state began around 1890 and has grown steadily since. Utilizing statistics available from the North Carolina Department of Vital Statistics, the absolute mortality of nasal cancer in North Carolina was calculated from 1964 to 1977. The average mortality was approximately 3.5 times greater in the furniture manufacturing industry than in the general population.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316544 TI - Historic changes of occupational work load and mortality from peptic ulcer in Germany. AB - The occurrence of peptic ulcer disease appears to be associated with the amount of occupational work load. Worldwide the number of hospital admissions, surgical operations, and death rates from gastric and duodenal ulcer have declined during recent decades. This communication examines the probability of a correlation between the time trends of gastric and duodenal ulcer mortality in Germany and changes in the occupational work load between 1870 and 1984. Lifetime cumulative hours of work declined for all consecutive cohorts of the population born between 1840 and 1955. The fall occurred similarly in all age groups. However, lifetime cumulative energy expenditure originating from industrial blue collar work showed a peak for the cohorts born during the last quarter of the 19th century. A marked decline occurred in all cohorts born after 1905. A similar birth-cohort pattern was found for mortality from peptic ulcer disease, with those born at the turn of the century showing a higher risk of dying from peptic ulcer disease than any previous or subsequent generation. The coincidence of the birth-cohort patterns of both mortality from peptic ulcer and occupational energy expenditure suggests that birth-cohort pattern of peptic ulcer may be related to the trends of occupational work load that occurred during the industrial revolution. The amount of work hours appears to be a less sensitive measure for the occupational work load. The superimposition of two counteracting historic changes, namely the increased industrial work force and the decreased occupational work load due to legislative regulations, industrial automation, and mechanization may have shaped the rise and fall in the occurrence of peptic ulcer disease. PMID- 3316545 TI - Obstetrical ultrasound: application in a clinic setting. PMID- 3316546 TI - Calcium intake in young adult women: implications for osteoporosis risk assessment. AB - A nonexperimental pilot study surveyed a convenience sample of 41 healthy women, aged 25 to 35 years, who were not pregnant, lactating, or menopausal, to identify those women who may be at risk for osteoporosis based on daily calcium intake. Data analysis suggested that 31 of 41 subjects surveyed consumed less than 1250 mg calcium daily and were, therefore, at risk for osteoporosis in late adulthood. PMID- 3316547 TI - Current controversies in pregnancy and epilepsy: a unique challenge to nursing. AB - Approximately 11,550 women with epilepsy give birth annually, yet maternity nurses receive little information on how to care for these patients. Children of epileptic mothers are born with an increased incidence of birth defects, and have a higher perinatal mortality rate. Complications such as bleeding during pregnancy, and interventions such as cesarean births and labor inductions are more common among epileptic women, and seizures tend to increase during pregnancy in more than one-third of epileptic women. Informed nursing care is essential to ensure the best possible outcome of these pregnancies. PMID- 3316548 TI - Parity and pain during parturition. AB - A descriptive study was undertaken to investigate the differences in pain reported by 17 primiparous and 33 multiparous parturients. Subjects responded to the McGill pain questionnaire during the early, active, and transitional phases of the first stage of labor, and immediately after delivery for the second stage of labor. Although no significant main effect for parity on pain was identified by repeated measures analyses of variance, significant interaction effects suggested that primiparas may experience greater pain during early labor and less pain during second stage than multiparas. PMID- 3316549 TI - Axillary versus rectal temperatures in preterm infants under radiant warmers. AB - Twenty-five preterm neonates were studied to determine whether monitoring of body temperature may be accomplished by taking axillary instead of rectal temperatures. Both axillary and rectal temperatures were taken simultaneously 12 times over a two-day period. Temperatures were recorded at three, five, eight, and ten minutes. The researchers concluded that an axillary measurement of temperature may be adequately substituted for rectal measurement of temperature. PMID- 3316550 TI - Urgent priority transplantation: when should it be done? AB - The success of heart transplantation has created longer waiting lists of candidates, some of whom require transplantation urgently. Decisions must be made regarding which patients require urgent transplantation and how many donor hearts should be committed to urgent transplantation. To determine whether some patients who are considered refractory to medical therapy may be stabilized for elective transplantation, 40 patients transferred for urgent transplantation underwent intensive vasodilator and diuretic therapy, and outcomes were determined. To examine the impact of urgent transplantation on survival, we then determined the survival for urgent priority candidates in the western region. Discharge of the patients who were receiving oral dosages of vasodilators and diuretics was possible for 32 of 40 patients (80%), with a 6-month actuarial survival of 75% on medical therapy, despite an initial ejection fraction of 0.15 +/- 0.04, a cardiac index of 1.9 +/- 0.6 L/min/m2, and a pulmonary wedge pressure of 30 +/- 8 mm Hg. Of 11 patients discharged to await regular priority transplantation, one died suddenly, one died postoperatively, and the others went home 14 +/- 4 days after transplantation. The eight patients unable to be discharged after transfer had lower initial mean arterial pressures and serum sodium levels. Of 59 urgent priority patients from the five western region programs, 50 patients underwent transplantation after 33 +/- 41 days. Subsequent 1-month survival was 88% and overall survival 80%, compared with 97% and 90% in 137 regular priority patients, with a 4.5 times greater risk of early mortality in the urgent group (p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316551 TI - Heart transplantation in patients requiring preoperative mechanical support. AB - Since January 1985, the members of the Heart Transplant Program at Washington University Medical Center, St. Louis, have performed 53 transplants in 50 patients. Thirteen patients have required preoperative mechanical support. These patients ranged in age from 32 to 58 years, with a mean of 47 years. Seven patients had undergone a total of 12 prior cardiac surgical procedures. Preoperative diagnosis was coronary artery disease in nine patients, cardiomyopathy in three, and valvular heart disease in one. Two patients had mechanical ventilatory support before operation. Five patients required preoperative intraaortic balloon counterpulsation (IABP). Five patients required left ventricular assistance with the Bio-Medicus centrifugal pump (Bio-Medicus Inc., Eden Prairie, Minnesota). Two of these patients had the left ventricular assist device (LVAD) inserted at the end of a failed cardiac procedure. One patient required the extracorporeal membrane oxygenator (ECMO) for right ventricular decompensation and cardiac arrest 4 hours after a seemingly successful orthotopic transplantation. Twelve of the 13 patients (92%) who required mechanical assistance of circulation and/or respiration before operation underwent a successful transplant. One patient who had IABP support perioperatively did not survive surgery. All patients who had a bridge to transplantation with the LVAD and the one patient with a bridge to transplant with ECMO are long-term survivors of transplantation. There has been one late death from cardiac causes in a patient who had IABP support before operation; the death was presumed to be from acute rejection, though this could not be documented at autopsy. Actuarial survival in this group is 82% at 12 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316553 TI - Urinary polyamines are noninvasive markers of heart allograft rejection. AB - Histologic evaluation of the heart allograft biopsy is currently the generally accepted method to monitor for rejection after transplantation. A noninvasive marker of host prerejection immunologic activation might be a useful clinical tool and provide the basis for a more continuous evaluation than is available with the biopsy technique. Urinary polyamine levels, in the context of immune activation, may fluctuate as an indicator of lymphocyte proliferation and organ rejection. To test this hypothesis cervical heterotopic heart transplantation was performed in six dogs that did not receive immunosuppression therapy. Daily percutaneous transmural biopsy of the transplanted heart and urine samples were collected. Urinary polyamines were measured by high-pressure liquid chromatography. Between 2 and 4 days after transplantation all allografts showed a histologic picture of mild to moderate rejection. The urinary excretion of total polyamines and putrescine fraction increased during the rejection process after transplantation, attaining a maximum from the first to the third day after operation. This early elevation suggests that urinary polyamines are markers of immune activation and unmodified heart allograft rejection. Further studies need to be done to define a potential clinical application of urinary polyamines as markers of cellular metabolic activity of the immune system and allograft rejection. PMID- 3316552 TI - Total artificial heart as a bridge to retransplantation in acute cardiac rejection. AB - Previous clinical experience in the use of a total artificial heart as a bridge to retransplantation in patients with acute major unresponsive cardiac rejection has shown an extremely high risk at various stages of the sequence. Unsatisfactory recovery during the period with the total artificial heart, surgical complications at retransplantation, and infection and/or rejection account for the lack of long-term survivors. A recent case permits the description of an original technique of implantation, which facilitates both the adequate positioning of the prosthetic ventricles and the surgery at retransplantation. The risks of rejection and infectious complications are discussed. PMID- 3316554 TI - Prolactin as a marker of rejection in human heart transplantation. AB - Prolactin has been shown to play a role in the modulation of the immune system. In addition, recent laboratory evidence suggests that circulating prolactin might fluctuate as a function of immunologic events. To evaluate the role of prolactin as a predictor of rejection, 22 heart and heart-lung transplant patients were studied from July 1985 to May 1986. Daily plasma prolactin levels were measured by radioimmunoassay. Endomyocardial biopsy and histologic evaluation of the allografts were used to define rejection episodes. Thirteen of 14 documented rejection episodes were preceded by a specific elevation of circulating prolactin. A significant elevation of prolactin occurred 6 and 8 days before 14 rejection episodes that were diagnosed by biopsy but not before 109 biopsies were taken that had negative results. The normal values for circulating prolactin are defined by a preoperative mean in a range of 0 to 15 ng/ml (95% confidence limit). The sensitivity of prolactin to predict rejection is 79%, the specificity is 92%, and the positive predictive value is 61%. A large data variability gives a low accuracy to the test as a predictor of allograft rejection. To be useful clinically, the accuracy needs to be improved through a better understanding of prolactin physiology and its relation to the immune system. PMID- 3316556 TI - Endomyocardial biopsy after heart transplantation in children. AB - Clinical evaluation, physical examination, and noninvasive testing have been suggested as adjuncts to endomyocardial biopsy for diagnosing acute graft rejection in children after heart transplantation. Because the consequences of delayed diagnosis or unnecessary treatment of rejection may be serious in pediatric transplant recipients, we reviewed our experience with repeated endomyocardial biopsy in seven children (aged 6 months to 19 years) and assessed the sensitivity and specificity of clinical and noninvasive data for diagnosing acute rejection. There were no serious complications in 71 biopsy procedures. In no patient did the presence of abnormal clinical findings or noninvasive testing coincide with treatable rejection that was proved on biopsy. However, there were nine episodes of treatable rejection in the absence of abnormal physical findings or noninvasive studies. At this time we consider repeated endomyocardial biopsy to be a feasible and safe procedure in infants and children and do not consider clinical findings and noninvasive testing sufficient to make therapeutic judgments in regard to acute graft rejection. PMID- 3316555 TI - Are steroids essential for successful maintenance of immunosuppression in heart transplantation? AB - To determine the necessity for maintenance dosages of prednisone in the management of heart transplant patients, a retrospective study was made of 86 patients undergoing orthotopic heart transplantation and two patients having heart-lung transplantation from June 1985 through October 1986. Group 1 (n = 52) had maintenance immunosuppressive therapy that included cyclosporine, azathioprine, and prednisone. Group 2 (n = 36) received only cyclosporine and azathioprine with no maintenance dosage of steroids. Data were analyzed for frequency of rejections, infections, noninfectious complications, and mortality. The rate of rejection was 1.44 episodes per patient in group 1 and 1.58 episodes per patient in group 2. Twenty of 52 patients (38%) in group 1 had no rejection compared with 12 of 36 patients (33%) in group 2 (p = not significant [NS]). One or more infections occurred in 30 patients (58%) in group 1, whereas only 12 patients (33%) in group 2 had infections (p less than 0.05). Noninfectious complication rates were noted to be similar in both groups (27% versus 25%, p = not significant). There were five deaths in group 1: three from infections, one from rejection, and one from trauma. There were three deaths in group 2: two from infection and one from rejection. Although 14 patients in group 2 eventually were placed on low-dosage steroid maintenance, the remaining 22 patients (61%) never received maintenance dosages of steroids. We conclude that some patients can be successfully managed without maintenance dosages of steroids after heart transplantation. Such patients do not appear to have an increased risk of rejection and may have a reduced rate of infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316558 TI - [A new method of fine needle aspiration biopsy under ultrasonographic imaging]. PMID- 3316557 TI - Heart transplantation in patients with Chagas' disease cardiomyopathy. AB - Among 26 heart transplant patients, four had Chagas' disease cardiomyopathy. They were male patients, aged 28 to 43 years; three were in New York Heart Association class IV, and one was in class II but with refractory arrhythmias. The immunosuppressive protocol was cyclosporine and steroids in the first patient, and cyclosporine, azathioprine, and steroids in the last patient. Three patients had one or more rejection episodes, and one had none. One patient had a lymphoproliferative intestinal disease. Three patients had a new acute phase of Chagas' disease in postoperative days 59, 81, and 420, with fever, skin lesions, and myocarditis. The Trypanosoma cruzi was found in skin lesions in all three patients and in the myocardial biopsy in two patients. The laboratory tests did not show the expected results for the acute phase. All the alterations were reversed by specific therapy in a few days. One patient died on postoperative day 197 from rejection, and the immunosuppression was diminished because of the lymphoproliferative disease; the others were well 107, 160, and 500 days after the transplantation. The conclusions were as follows: (1) It seems that steroid pulse therapy predisposes the patient to a new acute phase of Chagas' disease. (2) Clinical presentation and laboratory test results of the acute phase are not the usual. (3) Specific drug therapy reverses all the alterations of this acute phase in a few days. (4) Although additional care is necessary and specific complications are expected, heart transplantation can be done with good results in patients with Chagas' cardiomyopathy. PMID- 3316559 TI - Current problems in managing streptococcal pharyngitis. PMID- 3316560 TI - Diagnosis of pre-type I diabetes. AB - Islet cell antibodies were found in 71 of 1169 first-degree relatives (6.1%) from 448 families who had a proband with type I diabetes. Seven children have since become insulin dependent. All had islet cell antibodies and were followed up prospectively with measurement of first-phase insulin production during intravenous glucose tolerance testing. In this group the statistical probability of developing type I diabetes within 12 months with 95% confidence was found to be 59% to 100% when the first-phase insulin secretion was less than 25 microU/mL. The identification of the prediabetes time period should allow an opportunity for intervention in the underlying disease process to determine if the onset of type I diabetes can be altered. PMID- 3316561 TI - Altitude and birth weight: commentary. PMID- 3316562 TI - Cholelithiasis after spinal fusion for scoliosis in children. PMID- 3316563 TI - Hypophosphatemic rickets with hypercalciuria and microglobulinuria. PMID- 3316564 TI - A controlled study of the nephrotoxicity of mezlocillin and gentamicin plus ampicillin in the neonate. AB - The nephrotoxicity of the aminoglycoside gentamicin was evaluated in an open, controlled study of newborn infants randomly allocated to receive either combination drug therapy with gentamicin and ampicillin or single drug therapy with mezlocillin for treatment of presumed neonatal sepsis. There were no significant differences in initial clinical characteristics between the groups. Neonates receiving gentamicin, in contrast to those receiving mezlocillin, had significant nephrotoxicity manifested by a smaller postnatal fall in mean serum creatinine concentration (-9%, P NS vs -21%, P less than 0.005, respectively) and a diminished postnatal rise in mean creatinine clearance (+ 21%, P NS vs + 51%, P less than 0.01, respectively). In neonates with a fall in creatinine clearance, the mean decline was significantly greater in those receiving gentamicin (44% vs 20%, P less than 0.01). There was no relationship between the incidence of gentamicin nephrotoxicity and either peak or trough gentamicin levels. For treatment of presumed neonatal sepsis, gentamicin proved more nephrotoxic than mezlocillin. PMID- 3316565 TI - Randomized trial of ceftazidime versus placebo in the management of acute respiratory exacerbations in patients with cystic fibrosis. AB - A randomized trial of ceftazidime versus placebo was conducted in patients with cystic fibrosis hospitalized for acute respiratory exacerbations. Patients 12 years of age or older were included if they had mild to moderately severe illness according to the following criteria: erythrocyte sedimentation rate less than or equal to 50 mm/hr and less than three other abnormalities (leukocyte count greater than or equal to 15,000/microliter, pulse greater than or equal to 100 beats/min, respirations greater than or equal to 30/min, or temperature greater than or equal to 38.5 degrees C). In all 16 episodes treated with ceftazidime, the patients were rated improved in comparison with 10 of 12 patients treated with placebo. Three placebo-treated patients dropped out of the study within 3 to 5 days because they wanted antibiotic therapy. None of the 15 placebo-treated patients showed clinical deterioration. There were no significant differences in rate of improvement of symptom score, weight gain, or pulmonary function between the two treatment groups. There was no difference in the course during the 6 to 24 months after the study period. Intravenous antibiotics are not essential in the management of all acute respiratory exacerbations of mild to moderate severity in patients with cystic fibrosis. PMID- 3316566 TI - Ethics of drug studies in infants: how many samples are required for accurate estimation of pharmacokinetic parameters in neonates? AB - Our study aimed to determine the least number of samples that are required to obtain accurate pharmacokinetic parameters in neonates. Patients treated with either netilmicin or ceftazidime had between five and eight samples drawn for drug concentration measurement after the first or the last dose of the drug. Pharmacokinetic parameters were calculated using all the available points as a reference and then recalculated with 2, 3, or 4 points. Systemic clearance and volume of distribution were significantly different from the reference value when 2 points were used for netilmicin after the first dose and ceftazidime after the last dose. Had parameters obtained from 2 points been used, mean dosage would have been underestimated by 15% for ceftazidime and 11% for netilmicin, and some patients would have received only 65% of the dose calculated from all available points. When 3 points were used, dosage would have been underestimated by a mean of only 1% for ceftazidime and 5% for netilmicin when compared with the dosage estimated from the reference parameters. We conclude that 3 concentration time points may be all that are required for estimation of pharmacokinetic parameters sufficiently accurate for practical purposes in neonates. PMID- 3316567 TI - Metabolic acidosis after acute ibuprofen overdosage. PMID- 3316569 TI - Common carotid velocity waveform patterns. PMID- 3316568 TI - Prenatal diagnosis of arthrogryposis multiplex congenita. PMID- 3316570 TI - Humoral and cellular mechanisms in acute allograft injury. AB - An intact thymus-competent immune system seems both necessary and sufficient for acute allograft rejection. T-lymphocytes fulfill a form of Kochs postulate in this regard: (1) They are present in rejecting allografts; and (2) rejection is abrogated by depriving the host of T cells but can be recreated by providing such T cell-deficient hosts with purified T cells. However, the dilemma of whether Th or Tc cells actually mediate allograft rejection remains. Although belonging to opposite immunologic "teams," they act on each other in many ways, interactions that are probably just the beginning of the complex cascade of both specific and nonspecific host immunologic events, both cell mediated and humoral, that are stimulated by the presence of allogeneic tissues. PMID- 3316571 TI - Therapeutic strategies in immunosuppression after renal transplantation. AB - Immunosuppressive strategies are directed at both the prevention and treatment of rejection. Strategies to prevent rejection are based on cyclosporine, and aim to achieve improved graft survival while decreasing the incidence of nephrotoxicity, and include the use of low doses of cyclosporine, cyclosporine conversion protocols, triple therapy (with low doses of azathioprine, cyclosporine, and steroids), and delayed administration of cyclosporine. There is no agreement as to the most satisfactory protocol at this time, but the use of cyclosporine has allowed the use of low doses of steroids or even discontinuation of steroid therapy, a major advance in pediatric transplantation. The treatment of rejection still depends on the use of high doses of steroids, but heterologous anti lymphocyte globulin and OKT3, a pan-T monoclonal antibody, can be used with success in steroid-resistant rejection episodes. Other monoclonal antibodies directed at leukocyte subpopulations are likely to be of value in time as our understanding of the mechanisms of rejection of renal allograft increases. PMID- 3316572 TI - Parent-to-child transplantation with cyclosporine immunosuppression. AB - The use of cyclosporine, a fungal endecapeptide immunosuppressive agent, has greatly improved the outcome of haploidentical transplantation in adults, but less impressively improved the result of parent to child transplantation. The incidence of allograft loss and treated rejection episodes was much greater in pediatric than in adult recipients, and the evidences of nephrotoxicity lessened. Although resistance of the child's immune system to the effects of the drug cannot be excluded, it appears more likely that this relates to the rapid clearance of the agent in the pediatric age group (39.6 mL/min/kg) versus in adults (12.3 mL/min/kg), thereby reducing the area under the serum concentration curve from 765 +/- 593 to 386 +/- 277 ng/mL/hr per mg/kg (mean +/- SD). This effect caused trough serum levels measured by radioimmunoassay to be below the putative threshold. These findings demonstrate the need for higher cyclosporine doses and frequency in pediatric compared with adult patients. PMID- 3316573 TI - Low-dose cyclosporine therapy combined with standard immunosuppression in pediatric renal transplantation. AB - A new immunosuppressive regimen combining anti-lymphocyte globulin, azathioprine, prednisone, and low doses of cyclosporine was used in 28 children aged 9 months to 17 years (mean 5.8 years) who received primary renal allografts between July 1, 1984, and September 25, 1986. After a mean follow-up of 17.3 months, the patient and graft survival is 100% (18 of 18) for mismatched related kidneys, and 90% (nine of 10) for cadaver kidneys. The single graft failure was the result of a death from technical complications. Serum creatinine concentration after transplantation ranged from 0.3 to 1.7 mg/dL (mean 0.85 mg/dL). The probability of a rejection episode in the first year was 45% and 60% for mismatched-related and cadaver kidneys, respectively. Cyclosporine nephrotoxicity was recognized in only one (3.7%) of 27 children, and was rapidly reversed after cyclosporine was discontinued. An initial group of nine children was weaned from cyclosporine therapy 6 to 12 months after transplantation, but two (22%) had rejection episodes. Our preliminary experience suggests that the use of a quadruple immunosuppressive regimen for both living related and cadaver renal transplants in children is associated with an improved graft function rate and a low incidence of complications. PMID- 3316575 TI - Renal transplantation without steroids. AB - In a randomized, controlled clinical trial, patients undergoing renal transplantation received as immunosuppression either cyclosporine alone (15 to 17 mg/kg) or cyclosporine with prednisolone, 0.3 mg/kg/d. The patients were followed up for 2 to 4 years, but no differences in the survival rates of patients or their transplants were seen. The survival of first cadaver grafts after 1 year was 73% and 76% in groups receiving cyclosporine alone and cyclosporine plus steroids, respectively. Although the patients treated with cyclosporine alone were more susceptible to nephrotoxic effects, the group receiving steroids were significantly more at risk of developing a cushingoid appearance and had an increased incidence of serious infections. After this trial, an additional 45 patients received only cyclosporine, 8 to 10 mg/kg/d, after renal transplantation. Nephrotoxic effects were much less common, and the actuarial survival rate for first cadaver grafts was 83% at 1 year. It is our view that combinations of immunosuppressive agents for kidney transplantation are both unnecessary and possibly harmful and that excellent patient and graft survival rates may be obtained with cyclosporine alone. PMID- 3316574 TI - The pediatric nephrologist's dilemma: growth after renal transplantation and its interaction with age as a possible immunologic variable. AB - Two important criteria for successful end-stage renal disease therapy in children are achievement of optimal growth and possession of a well-functioning renal transplant. We describe eight children with accelerated post-transplant growth. Accelerated and even catch-up growth was achievable if the transplant occurred at an early age (less than 9 years), the daily dose of prednisone was low (less than or equal to 0.24 mg/kg/d), and renal function was excellent (creatinine clearance greater than or equal to 89 mL/min/1.73 m2). However, the benefit to growth of transplanting a kidney in young children may be offset by reduced cadaver graft survival in children younger than 6 years. To study whether the less favorable graft survival was attributable to an increased immunologic responsiveness in the younger child, we examined three tests of nonspecific immune responsiveness, each of which, when increased, may indicate a propensity toward rejection: total T cell absolute number, T helper/suppressor ratio, and spontaneous blastogenesis. Each measurement was significantly increased in 20 uremic children 5 years old or younger, compared with 81 children 6 to 23 years of age. These data suggest that improved growth may be attained by transplanting a kidney in the young child with end-stage renal disease, but the young child may be at increased risk for rejection. This hypothesis suggests that for optimal rehabilitation, strategies should take into account the unique needs of the young child. PMID- 3316576 TI - Effect of cyclosporine on the kidney. AB - Cyclosporine constitutes a major advance in pharmacologic immunosuppression, the benefit of which is now established for solid organ transplantation and is rapidly emerging for many forms of autoimmune disease. By virtue of its potency and selectivity, there has been a marked reduction in steroid requirement with a concomitant reduction in morbidity and mortality. The undesirable effect of cyclosporine on the kidney may thus be considered within this context. The short term functional effect observed to some degree in most patients receiving this drug is rapidly reversible, and is unaccompanied by long-term detriment in studies now extending over 6 years. Progressive deterioration still occurs in a small proportion of patients, but may often be reversed by carefully controlled conversion to alternative combination immunosuppression therapy. For each developing application, the ultimate value of cyclosporine must be determined individually in relation to the severity of the disease process. The challenge that now confronts us is to determine the manner in which this agent may be most safely and effectively used. PMID- 3316577 TI - Cardiac transplantation in children and adolescents. AB - Between June 1984 and October 1986, we evaluated 22 children for possible cardiac transplantation at Columbia-Presbyterian Medical Center. Four children died awaiting donor organs. Fifteen children received transplants; eight had cardiomyopathy, and seven had congenital heart disease. One child received a heterotopic transplant because of extremely high pulmonary vascular resistance. Immunosuppressive therapy consisted of 4 to 40 mg/kg/d cyclosporine and 0.2 to 0.5 mg/kg/d prednisone. Rejection was detected by the presence of myocyte necrosis in surveillance endomyocardial biopsy specimens. There were one intraoperative and three early deaths, two from infection and one rejection. The 11 survivors are observed from a few weeks to more than 2 years after transplantation, and all are in excellent clinical health and participate in age appropriate activities. These data corroborate the experience of other institutions that cardiac transplantation is a valid treatment in children. PMID- 3316578 TI - Indications for pediatric liver transplantation. AB - Two hundred fifty pediatric (less than 18 years of age) patients underwent orthotopic liver transplantation because of end-stage liver disease and were given combination therapy with cyclosporine and prednisone. The most common indications for transplantation in decreasing order of frequency were biliary atresia, inborn errors of metabolism, and postnecrotic cirrhosis. The 5-year actuarial survival for the entire group was 69.2%. Age and diagnosis did not influence survival. Infections were the most common cause of death, followed by liver failure and cerebrovascular accident. The impact of retransplantation on survival depends on the indication. The survival is better when retransplantation is carried out after rejection than because of technical complications, and the latter has a better survival than does primary graft nonfunction. The difference in survival among these groups is statistically significant. The quality of life for 164 of 173 survivors is good to excellent; only nine children are currently experiencing medical problems. A persistent problem in pediatric transplantation is the scarcity of small donors. PMID- 3316579 TI - OKT3 monoclonal antibody reversal of renal and hepatic rejection in pediatric patients. AB - The monoclonal antibody OKT3 was previously shown to be superior to conventional high-dose steroid therapy for reversal of acute rejection of renal allografts. Furthermore, OKT3 was effective in reversing acute renal or hepatic allograft rejection that was resistant to treatment with steroids, anti-thymocyte globulin, or both. Our analysis demonstrates that OKT3 is also effective in pediatric patients in reversing acute rejection of renal allografts (rescue treatment) or hepatic allografts (primary or rescue treatment). PMID- 3316580 TI - Total lymphoid irradiation in alloimmunity and autoimmunity. AB - Total lymphoid irradiation has been used as an immunosuppressive regimen in autoimmune disease and organ transplantation. The rationale for its use originated from studies of patients with Hodgkin disease, in whom this radiotherapy regimen was noted to induce profound and long-lasting immune suppression and yet was well tolerated, with few long-term side effects. Total lymphoid irradiation is a unique immunosuppressive regimen that produces a selective (and long-lasting) reduction in the number and function of helper T cells and certain subsets of B cells. Conventional immunosuppressive drugs show little selectivity, and their effects are short-lived. The most important aspect of total lymphoid irradiation is the potential for achieving transplantation tolerance and permanent remissions in autoimmune disease in laboratory animals. Attempts are being made to achieve similar goals in humans given total lymphoid irradiation, so that immunosuppressive drugs can be ultimately withdrawn from transplant recipients and patients with lupus nephritis. PMID- 3316581 TI - Effects of cyclosporine in recent-onset juvenile type 1 diabetes: impact of age and duration of disease. AB - Administration of cyclosporine resulted in reduced insulin requirements and improved glycemic control in patients with insulin-dependent diabetes mellitus of recent onset, but the drug was less effective in young children. Renal toxic effects and other problems related to therapy resolved after discontinuation of the drug. Sustained remission seemed dependent on continued administration of cyclosporine. Although short-term control of diabetes may be achieved in some patients, more studies are needed to determine whether cyclosporine can be given safely as maintenance therapy to maintain glycemic control and prevent the long term consequences of the disease. PMID- 3316582 TI - Cyclosporine in insulin-dependent diabetes mellitus. PMID- 3316583 TI - Modulation of immune system in disease states and organ transplantation. Proceedings of the First Annual New York Pediatric Nephrology Symposium. October 16-17, 1987. PMID- 3316584 TI - Insulin-dependent diabetes and lactational performance. PMID- 3316585 TI - Membranous obstruction of the inferior vena cava with Budd-Chiari syndrome in children: a report of nine cases. AB - Membranous obstruction of the inferior vena cava (IVC) with Budd-Chiari syndrome is a rare condition in children. Nine children with this lesion are described, eight of them from the Ovambo tribe in Namibia. Clinical features included hepatomegaly, splenomegaly, ascites, and dilated superficial abdominal veins draining cephalad below the umbilicus. Liver enzymes and serum proteins were slightly abnormal in most cases, and the ascitic fluid, when present, had a high protein content. Liver histology showed a wide range of changes, from almost normal to signs of severe chronic congestion. Angiographic appearance varied from a thin membrane between the IVC and right atrium to nonvisualization of the IVC except for dilated collaterals. Simultaneous injection of contrast medium into catheters positioned in the upper IVC and right atrium, through both the femoral and antecubital routes, is the most accurate way of demonstrating the extent of the obstruction and the patency of the hepatic veins. PMID- 3316587 TI - Antibodies to 90 kilodalton glycoprotein in childhood and adolescent celiac disease: relationship to reticulin antibodies. AB - Antibodies to 90 kilodalton (kDa) glycoprotein, a mannose-rich protein of skin and intestinal mucosa, were determined in 31 children or adolescents with untreated celiac disease, in 30 of these patients during gluten withdrawal, and in 17 patients on gluten challenge. Highly elevated antibody levels to 90 kDa glycoprotein were found in patients with untreated celiac disease. Close, positive correlation (r = 0.74, p less than 0.0005) was found between the age of these patients and the level of 90 kDa glycoprotein antibodies. The antibodies to 90 kDa glycoprotein behaved, compared with the reticulin antibodies, in a different manner kinetically. During gluten challenge antibodies to 90 kDa glycoprotein increased on an average 2.6 months later than the antibodies to reticulin. On the other hand, in patients undergoing gluten withdrawal the antibodies to reticulin markedly decreased or disappeared during the first 3 months on the diet, whereas the level of 90 kDa glycoprotein antibodies did not decrease until the 5th to 11th months on the diet. These results suggest that the antibodies reacting with the 90 kDa glycoprotein differ from those reacting with reticulin and that in celiac patients undergoing gluten challenge the synthesis of reticulin antibodies is an earlier event than the production of 90 kDa glycoprotein antibodies. The level of 90 kDa glycoprotein antibodies may reflect the extent of tissue damage. PMID- 3316586 TI - Hepatobiliary scintigraphy with technetium-99m disofenin in the evaluation of neonatal cholestasis. AB - To assess the reliability of technetium-99m disofenin scanning in evaluating neonatal cholestasis, 33 neonates (less than 3 months of age) with direct hyperbilirubinemia were evaluated prospectively by cholescintigraphy. Results of this test were compared to those of standard serum tests of liver function, ultrasonography, and liver biopsy. The diagnosis of biliary atresia was suggested by a serum gamma-glutamyl transpeptidase (gamma-GTP) greater than 300 units/L, absence of the gallbladder on ultrasonography, and a lack of detectable radioisotope in the gastrointestinal and/or extrahepatic biliary tract on cholescintigraphy. Each of these tests lacked sensitivity and/or specificity when compared to liver biopsy. Of the nine neonates with biliary atresia, three had gallbladders identified by ultrasonography and two had gamma-GTP less than 300 units/L. Of the 24 neonates without biliary atresia, eight had cholescintigraphy without detectable radioisotope excretion, four had ultrasonography that failed to visualize the gallbladder, and nine had gamma-GTP greater than 300 units/L. Cholescintigraphy excluded the diagnosis of biliary atresia when gut and/or extrahepatic biliary excretion of isotope was seen. However, cholescintigraphy required more time, 6-8 days, and was less specific than ultrasonography and liver biopsy. We recommend that cholescintigraphy should not be routinely used in evaluating neonatal cholestasis, especially if it delays surgical intervention. PMID- 3316588 TI - Neonatal gallbladder enlargement and alpha 1-antitrypsin deficiency. AB - Patients with clinical signs of alpha 1-antitrypsin deficiency in the neonatal period usually present with prolonged obstructive jaundice. We report a patient with alpha 1-antitrypsin deficiency who presented with gallbladder enlargement in the neonatal period. This gallbladder enlargement may be due to cystic duct hypoplasia or atresia, which has been reported in association with alpha 1 antitrypsin deficiency. The diagnosis of alpha 1-antitrypsin deficiency should be considered in neonates with gallbladder enlargement and prolonged obstructive jaundice. PMID- 3316589 TI - Age adjustment in psychological assessment of children born prematurely. PMID- 3316590 TI - Computer-assisted diagnosis of strabismus. AB - A program for use on a microcomputer was developed to assist in the diagnosis of strabismus. The matrix consists of 41 separate disorders and 59 facts (history and examination findings). The facts are answered in a yes/no format. The relationship between the fact and the disorder is weighted as to whether the fact is always present, usually present, sometimes present, not related, unlikely to be present, not usually present, or never present. The computer makes the diagnosis (or diagnoses) indicating the most likely disorder when several are possible from the information given. Over 300 patient files were tested with the program. Of the last 50 records reviewed (70 disorders), the computer diagnosis agreed with the clinical diagnosis in 91% of the cases. Continued refinement of the program should be able to improve this accuracy. PMID- 3316591 TI - Medial rectus resection strategies for laterally incomitant intermittent exotropia. PMID- 3316592 TI - N-myc oncogene amplification and prognostic factors of neuroblastoma in children. AB - The N-myc oncogene of 28 neuroblastic tumors obtained from 16 untreated and 12 pretreated children was clinically evaluated and compared with known prognostic factors. Significant amplification of the N-myc (more than ten copies) was observed in 0 of 2 tumors in stage I, 1 of 5 in stage II, 2 of 6 in stage III, 6 of 9 in stage IV, and 2 of 6 in stage IVS. In stages II, III, IV, and IVS, all 15 patients with low N-myc amplification (under ten copies) are alive without disease, while among 11 patients with the amplification, seven died with progressive disease and two have a recurrence (P less than .01). All tumors with N-myc amplification originated from the suprarenal region and the amplification appeared in 55% of those from that origin. The amplification also correlated with the age factor. These results suggest that the genomic amplification of N-myc seems to be correlated with known prognostic factors of neuroblastoma, and may be a reliable factor even in the case of preoperatively treated tumors. PMID- 3316593 TI - Comparison of preoperative sonography with intraoperative findings in congenital hypertrophic pyloric stenosis. AB - In 17 infants with hypertrophic pyloric stenosis, the pyloric diameter was measured preoperatively by ultrasound. The mean pyloric diameter was 15.12 +/- 2.11 mm (mean +/- SD), range 11 to 19 mm. During pyloromyotomy, the hypertrophic pylorus was precisely measured craniocaudally and dorsoventrally, and measurements were obtained concerning muscular thickness and length of the pylorus. The preoperative and intraoperative measurements were subsequently compared. Differences of 0.76 +/- 1.68 mm and 1.24 +/- 2.04 mm were found for the dorsoventral and craniocaudal diameters, respectively. The intraoperative measurements were consistently greater than the sonographic findings. The length of the pylorus averaged 22.0 +/- 2.66 mm, the muscular thickness 6.53 +/- 1.68 mm, respectively. This prospective study confirms the diagnostic value of sonography in congenital hypertrophic pyloric stenosis. PMID- 3316595 TI - The role of verbalization in the Rorschach response process: a review. AB - Traditional Rorschach theory has consistently overlooked the linguistic aspect of the response process. Most conceptualizations focus on the perceptual and cognitive aspects of the process, never examining the subject's need to find a linguistic representation for the inner, perceptual process. This review examines the traditional formulations and suggests that new research from information processing, neuropsychological, and dual-coding memory theory paradigms offer new possibilities for Rorschach research that would incorporate an appreciation of the unique cognitive demand of the test--the linking of percept with language. PMID- 3316594 TI - Hydrops of the gallbladder associated with Kawasaki syndrome. AB - Hydrops of the gallbladder is recognized as a major component of the abdominal crisis occurring in children with Kawasaki syndrome. Sixteen patients with hydrops of the gallbladder secondary to Kawasaki syndrome have been diagnosed and treated at the Childrens Hospital of Los Angeles. One patient was treated by cholecystectomy and 15 nonoperatively without untoward sequelae. Nonoperative management with serial ultrasonic evaluation and close clinical monitoring is a safe method of treatment for this entity. Pathologic and clinical data are presented and discussed. Review of diagnosis and treatment of 41 reported cases of hydrops of the gallbladder in Kawasaki syndrome from the English language literature is also presented. PMID- 3316596 TI - Soft intraocular lenses. AB - An in-depth review of the current status of soft intraocular lenses (IOLs) is presented. We have outlined the historical aspects of IOL development from polymethylmethacrylate material to newer soft polymers such as silicones and hydrogels. Chemical, physical, and biomaterial properties as well as the advantages and disadvantages of these materials and lenses are discussed. Clinical results from international investigators are presented, along with some thoughts about future trends in small incision cataract surgery and IOL substitutes. PMID- 3316597 TI - Multicenter trial of an intraocular hydrogel lens implant. AB - Several features suggest that hydrogels may have potential advantages as an intraocular lens material. The IOGEL lens is a single piece hydrogel composed of 38% poly HEMA. Clinical experience with the IOGEL lens in Australia has been published, and the safety and efficacy of the lens is currently being investigated in a multicenter trial in Europe, the U.S.A., Canada, Australia, and Japan. This is the first large-scale study of a hydrogel implant. The IOGEL lens clinical study was initiated in May 1986 in Europe, in September 1986 in the U.S.A., and in November 1986 in Canada and Australia. The enrollment progress in May 1987 showed that 501 cases had been implanted in Europe, Canada, and Australia and 100 cases in the U.S.A. The visual acuity outcome is equivalent to that reported in the literature. Patients in the multinational trial achieved 20/40 or better in 86% of cases and in 96% of cases excluding unrelated pathologies. Although hydrogels have only had limited use in the clinical situation, the results of this study suggest that the IOGEL lens is a viable alternative to polymethylmethacrylate lens implants. PMID- 3316598 TI - The non-selective innervation of muscle fibres and mixed composition of motor units in a muscle of neonatal rat. AB - 1. Motor-unit size was measured by tension recording in neonatal (3-5 day) rat skeletal muscle (fourth deep lumbrical muscle). Each unit was then depleted of glycogen and its fibres studied in mid-belly frozen sections, by staining for glycogen (periodic acid-Schiff reagent and antibody labelling for slow myosin. The contralateral muscle acted as control, and further controls for the method are described. 2. All the motor units contained both slow-myosin-containing (S; antibody-positive) and slow-myosin-free (F; antibody-negative) fibres. 3. The proportion of each unit that was made up of S fibres was compared with the whole muscle. Of the twelve units studied seven were not selectively innervated, four may have been selectively innervated in favour of F fibres, and one was selectively innervated in favour of S fibres. The last unit was much smaller than the others. 4. Fibre cross-sectional areas were measured in units and in the whole muscles. Mean cross-sectional areas for individual F fibres in all the motor units were smaller than in the corresponding whole muscles (ratio 0.71), implying that small fibres have higher levels of polyneuronal innervation than larger ones (each small fibre occurring in more overlapping units than each larger fibre). There was no such difference in S fibres (ratio 0.96). 5. Motor unit sizes (as a percentage of whole muscle) were smaller when obtained from summed fibre cross-sectional areas than from fibre counts (this follows from 4, above). Comparisons with unit sizes from tension recording are discussed. 6. Controls show that there is little, if any, non-specific fatigue of muscle fibres that are not part of the unit subjected to glycogen depletion. 7. Evidence is given that muscle fibre conduction block occurs during the depletion regime, leading to less glycogen depletion towards the ends of the muscle fibres than in the end-plate zone. PMID- 3316600 TI - The cantilever fixed partial denture: a 10-year follow-up. AB - A 10-year study of patients with cantilever fixed partial dentures suggests that these prostheses can be used for both anterior and posterior replacements. Guidelines for cantilever prostheses are described. Fixed cantilever prostheses are favorable alternatives to certain types of unilateral removable partial dentures. Proper oral hygiene is essential. PMID- 3316601 TI - Finishing procedures for the preparation of crown margins. PMID- 3316602 TI - Repair of an overcontoured cemented crown. AB - A method for retracting gingival tissue to allow recontouring of crown surfaces and removal of overhanging margins has been presented. PMID- 3316599 TI - Beta-adrenergic blockade restores glucose's antiketogenic activity after exercise in carbohydrate-depleted athletes. AB - 1. The development of post-exercise ketosis is not abolished by the ingestion of glucose immediately after exercise, despite inducing high insulin/glucagon ratios in the peripheral (and therefore by implication in the portal) blood. 2. To investigate the possibility of autonomic control of the liver influencing its sensitivity to the major counter-regulatory hormones, we administered 50 g glucose, either on its own, or together with 0.5 mg prazosine, 40 mg propranolol, or 15 mg propantheline, to forty-seven 48 h carbohydrate-starved athletes who had just run 25 km. 3. The blood 3-hydroxybutyrate concentration rose from 0.30 +/- 0.05 (mean +/- S.E. of mean) to 0.52 +/- 0.08 mmol/l with exercise, and then to 1.32 +/- 0.40 mmol/l at 6 h after exercise in subjects who had ingested only glucose after exercise. 4. The effects of prazosine and propantheline on the blood ketone body concentration at 2 h after exercise was not statistically significant. Propranolol, on the other hand, significantly lowered the blood 3 hydroxybutyrate concentration (compared with controls) to 0.09 +/- 0.03 mmol/l at 3 h (P less than 0.01), and 0.35 +/- 0.08 mmol/l at 6 h (P less than 0.01) after exercise. 5. The plasma insulin, glucagon, glucose and free fatty acid concentrations were unaffected by propranolol, indicating that the antiketogenesis was the result of a direct effect on ketone body metabolism. 6. Since beta-adrenergic blockade has not previously been shown to have antiketogenic activity, except in somatostatin-induced hyperketonaemia, it is concluded that its effectiveness in post-exercise ketosis can probably be ascribed to a functional hepatic insulin and glucagon deficiency. PMID- 3316603 TI - A handpiece-mounted electronic axial alignment indicator. PMID- 3316604 TI - Recementation of dental castings with zinc phosphate cement: effect on cement bond strength. PMID- 3316605 TI - Calcium metabolism and osteoporotic ridge resorption: a protein connection. AB - The unique interrelationship between excess dietary protein, calcium metabolism, and osteoporosis with its associated ridge resorption has been reviewed. Recommendations for the prevention and management of osteoporosis have been discussed with concern for the calciuretic effect of a high protein diet customarily consumed in American society. Positive calcium balance promoted by the suggested treatment regimen may help to preserve ridge integrity and at the same time prevent the serious debilitating effects of generalized osteoporosis. Further research to evaluate for retardation and possible reversal of osteoporotic ridge resorption as affected by dietary protein intake is warranted. PMID- 3316606 TI - Objective testing of the efficiency of denture-cleansing agents. PMID- 3316607 TI - Changes in the buccolingual polished surfaces of the mandibular denture following anterior vestibuloplasty with free skin grafting and mylohyoid ridge resection. PMID- 3316608 TI - Residual alveolar ridge maintenance with a new endosseous implant material. AB - In an effort to maintain the height of the residual alveolar ridge, Bioglass cones were placed in fresh sockets after tooth extraction. Today the emphasis is on maintaining the residual alveolar ridge instead of letting it resorb and subsequently resorting to heroic efforts for augmentation. To date, 242 cone implants have been placed in 29 patients. Implant follow-up observation time ranged from 12 to 32 months with an average of 19.9 months. Twenty-seven patients have been fitted with dentures. To date seven implants (2.9%) have been lost. The Bioglass implants appear to be highly biocompatible as evidenced by absence of infection, normal mucosal healing, and radiographic evidence of bone healing around the implants. Evaluation of several implants reexposed surgically revealed new bone in direct contact with the immobile implants circumferentially. The problem of implant dehiscence that started to occur after approximately 10 months in other investigations had not manifested itself in the Bioglass implant patients who have been wearing their dentures for at least 12 months. PMID- 3316610 TI - Interfering occlusal contacts and distribution of chewing and biting forces in dentitions with fixed cantilever prostheses. PMID- 3316609 TI - Prosthetic management of postsurgical fistulas in patients with cleft lip and palate. AB - A prosthesis devised for a young adult patient with a remaining cleft is described. This prosthesis would be effective for similar patients because it has the advantages of both fixed and removable partial dentures, a design acceptable to the patient, better hygiene because of easy insertion and removal, simple construction, and a moderate cost. PMID- 3316611 TI - The cranial mechanism: its relationship to cranial-mandibular function. AB - This review and discussion has raised many points relating the importance of the cranial mechanism to cranial-mandibular function. The increase of concern from one joint to 106 joints brings the cranial mechanism into the forefront of dental theory and practice. Every phase of dentistry is affected by mandibular position, and the cranial mechanism offers the dentist an added dimension for solving and avoiding clinical problems. Techniques for correction and evaluation of the cranial mechanism require a thorough knowledge of head and neck anatomy, but its application can be easily fit into the daily routines of clinical dentistry. Great satisfaction can be derived from being able to relax a lateral pterygoid muscle by diagnosing and correcting a frontal bone lesion, often within a few minutes. The importance of relaxing the musculature before final occlusal equilibration is even greater. As more research is devoted to the cranial mechanism, the findings will continue to supply answers to the unmanageable problems that confront dentists. PMID- 3316612 TI - The edentulous population: its use and need of dental services. PMID- 3316613 TI - Reliability of ratings in evaluation of crowns. PMID- 3316614 TI - Limited esthetic try-in for some immediate dentures. PMID- 3316616 TI - A bifurcated ceramometal crown. PMID- 3316615 TI - Porous metal coating to enhance retention of a Rochette prosthesis. PMID- 3316617 TI - Mobile pseudocyst of pancreas--a diagnostic conundrum (a case report). PMID- 3316618 TI - Ano-rectal abscess with retro-peritoneal spread (a case report). PMID- 3316620 TI - Bulimia. PMID- 3316619 TI - Senses and environment. Symposium in honour of the 80th birthday of Prof. Dr. Drs. h.c. mult. Hansjochem Autrum. 5/6th March, 1987, Munchen. Proceedings. PMID- 3316621 TI - Adverse reactions to food additives. PMID- 3316622 TI - Mad dogs and Irishmen. PMID- 3316623 TI - Poisoning as a social phenomenon. The Milroy lecture 1987. PMID- 3316624 TI - The pathogenesis of multiple sclerosis. The Bradshaw lecture 1986. PMID- 3316625 TI - Drain fixation with a subcuticular stitch. PMID- 3316627 TI - Primary follicular adenocarcinoma arising in the thyroglossal tract. PMID- 3316626 TI - Appendicitis associated with Shigella sonnei dysentery. PMID- 3316628 TI - Consecutive successful resections of mycotic aneurysms of the superior mesenteric artery: a case report. PMID- 3316629 TI - Bacteriology swabs during appendicectomy: sample sites and transport media. PMID- 3316630 TI - [Pseudospondylodiscitis in chronic hemodialysis. Apropos of 2 cases and review of the literature]. AB - The spondyloarthropathy of patients on chronic dialysis is a new entity of still obscure pathogenesis. Two cases are reviewed and the documented data analyzed. Radiologic images suggestive of an infectious spondylodiscitis impose performance of a puncture biopsy for bacteriology and histology. PMID- 3316631 TI - [Cavitary tumor lesions of the small intestine. Radio-ultrasonic diagnosis. Apropos of 4 cases]. AB - Excavated lesions of small intestine are rare and generally of a malignant nature, the must frequent cause being metastases. In Tunisia these lesions are usually the aneurysmal type of lymphoma. The etiology in a series of four cases of excavated lesion of small intestine was not always lymphomatous. Radiologic and ultrasound semeiology are outlined and etiologies discussed. Scan images are not available since whole-body scanners are not in use in Tunisia. PMID- 3316632 TI - [Splenic abscess. A new diagnostic and therapeutic approach. Apropos of 7 cases]. AB - Anomalies in seven patients with splenic abscess were invariably observed on ultrasound imaging despite absent or misleading clinical symptomatology splenomegaly was detected in only 3 cases. The abscess was multiple in 6 cases with perisplenic extension in 2 patients. Splenectomy was performed in only 2 cases. In one patient, diagnostic and therapeutic fine needle puncture of spleen was performed. Comparison with CT scan imaging is presented with respect to 3 patients. Ultrasound imaging can suggest a diagnosis of intrasplenic abscess and fine needle puncture is not contraindicated. PMID- 3316633 TI - [Preoperative location of deep subclinical breast lesions using the harpoon technic. Apropos of 149 cases]. AB - Since April 1983, harpoon technique was used for limited excision of subclinical mammography-observed anomalies. The procedure involves the insertion of a harpoon shaped metallic thread, after detection by mammography, to obtain guidance of surgical procedures. The results of 155 procedures in 149 patients included detection of 38 cancers (26%), confirming documented data in this field. PMID- 3316634 TI - Nonsuture microsurgical vessel anastomosis. AB - An alternative microsurgical method for achieving vessel union without applying sutures is presented. The basic principles of the technique involve the creation of an extraluminal cuff that permits exact adaptation of both endothelial layers, without intraluminal damage or application of foreign material. When used for microsurgical procedures, the method can be further simplified by using a Teflon cuff secured by means of a mini-clip. The anastomosis can be accomplished quickly, in an uncomplicated and precise fashion. On the basis of preliminary experiments, this method appears to offer a wide range of applications, particularly if absorbable material is used. PMID- 3316635 TI - Microvascular thermic sleeve anastomosis: a sutureless technique. AB - Microvascular thermic sleeve anastomosis performed with bipolar coagulation was investigated under experimental conditions. Patency rates of 100 percent for arteries (approximately 1.0 mm in external diameter) and 78 percent for veins (approximately 0.7 mm in external diameter) were achieved. The lumen contour was studied with plastic casts done at intervals of three hours, one day, three days, seven days, 15 days, and 30 days postoperative. Histopathologic studies were carried out to determine the changes caused by intussusception and heating spots. PMID- 3316636 TI - Stasis-induced thrombosis of rat microvascular anastomosis. AB - The rate of stasis-induced thrombosis in the rat femoral artery at varying times following microvascular anastomosis, was evaluated by direct inspection as well as by light and electron microscopy. The rate of thrombosis decreased with increasing postoperative time intervals. This decrease appears to coincide with histologic evidence of growth of the neo-intima at the anastomosis site. PMID- 3316637 TI - A simple scoring system for evaluating symptoms, history and urine dipstick testing in the diagnosis of urinary tract infection. AB - Patients presenting with symptoms suggestive of urinary tract infection were recruited in a general practice survey aimed at measuring the predictive value of symptoms, history and urine dipstick testing for diagnosing the presence of bacterial infection. Urine specimens were obtained from 87% of the 521 patients recruited. A diagnosis of infection was established by urine culture producing a colony count in a pure culture exceeding 100 000 organisms per ml or between 10 000 and 100 000 organisms per ml plus a minimum of 100 leucocytes per mm(3).Occurrence rates for symptoms and other items of information in infected and non-infected groups were used to derive their positive and negative predictive values in making the diagnosis. The predictive value of volunteered symptoms was compared with that of elicited and volunteered symptoms combined. The positive predictive value of symptoms was increased where elicited symptoms were included but this was achieved at the cost of diminishing the negative predictive value. The occurrence rates were used to derive a mathematical model for diagnosing infection. The symptoms-history-urinalysis (SHU) score generated in this model compared well with a computer predicted probability. Both were substantially better than the assessment and action (decision to prescribe an antibiotic) of the recording doctor.The scoring method described has been demonstrated in urinary tract infection but may be applied to any symptom combination related to a diagnosis for which there is an agreed definition. PMID- 3316638 TI - Infusion of gonadotrophin-releasing hormone (GnRH) induces ovulation and fertile oestrus in mares during seasonal anoestrus. AB - In Exp. 1, 30 Standardbred mares in deep seasonal anoestrus were divided into 3 equal groups and treated with 0, 50 (G50) or 100 (G100) ng GnRH kg-1h-1 for 28 days via osmotic minipumps. Ovulation occurred in 0/10, 3/10 and 7/10 mares respectively (P less than 0.05). Plasma GnRH profiles (Days -6, 0, 2, 6, 12, 20, 28 and 34 relative to pump insertion) were dose-dependent (P less than 0.01) and peaked on Day 12 of infusion. Mean daily plasma LH concentrations were biphasic in treated mares that ovulated, with LH peaks occurring around Day 6 and Days 16 20. By contrast, in treated mares that did not ovulate the initial LH rise was followed by a steady decline to the end of the experiment. LH pulse frequency in treated mares increased between Day 0 and Day 21 of the experiment. LH pulse frequency in G100 mares was higher (P less than 0.05) than in G50 and control mares on Day 3, and higher than the controls on Days 7 and 21 of the experiment. There were no significant differences in LH pulse amplitude between the groups on the days studied. In Exp. 2, 27 Standardbred mares in shallow seasonal anoestrus received no treatment (N = 13) or a subcutaneous infusion of GnRH (100 ng kg-1h 1) via osmotic minipump for 28 days (N = 14). Mares were served by a stallion during oestrus. Day of ovulation was earlier in treated than in control mares (18.6 +/- 2 vs 41.9 +/- 6 days; P less than 0.001). Likewise, time of conception was earlier in treated than in control mares (25.2 +/- 6 vs 49.1 +/- 9 days; P less than 0.05). One mare in the control group failed to conceive while one treated mare conceived to an undetected ovulation. The results show that constant GnRH infusion induces ovulation and fertile oestrus in mares during deep and shallow seasonal anoestrus. PMID- 3316639 TI - Inhibition of ovulation in the mare by active immunization against LHRH. AB - To investigate the hypothesis that the onset of the breeding season in the mare may be due to a daylength-induced seasonal increase in LHRH pulse frequency, 5 mares were immunized against LHRH. Beginning 1 December, 5 immunized and 5 untreated control mares were exposed to an abrupt, artificial increase in daylength (16L:8D) to advance the onset of the breeding season. In control mares ovulation occurred 49.6 +/- 3.5 (s.e.m.) days later (18 January), whereas in 3/5 immunized mares ovulation had not occurred by 1 April. In the remaining 2 mares, although ovulation occurred once (Mare 79) or twice (Mare 72) during February, a booster immunization restored acyclicity for the duration of the study (No. 72) or to 30 March (No. 79). The absence or occurrence of ovulation in LHRH-immunized mares appeared to be related to antibody titre, such that the highest antibody titres were observed in those mares that remained anovulatory throughout the experimental period, while low titres were seen in the 2 mares that ovulated. In 3 acyclic immunized mares, LH pulses were not observed in blood samples collected frequently at 2-week intervals from November to January. In contrast, LH pulse frequency in control mares, and in the 2 immunized mares that ovulated, increased from 0/12 h (November) to 2-5/12 h (January). These results confirm our previous observation that, in the mare, the onset of the breeding season is associated with an increase in LH pulse frequency. Furthermore, the results suggest that the increase in LH pulse frequency reflects an increase in pulsatile LHRH release from the hypothalamus. PMID- 3316640 TI - Use of push-pull perfusion techniques in studies of gonadotrophin-releasing hormone secretion in mares. AB - Push-pull perfusion was used to study GnRH secretory ability of the hypothalamus in anoestrous, transitional, dioestrous and oestrous Pony mares. The technique involved placement of a concentric (tube within a tube) cannula into the area of the medial basal hypothalamus and perfusing a carrier medium (artificial cerebrospinal fluid) through the inner tube whilst aspirating from the outer tube so that the flow rate within the hypothalamic tissue was essentially constant. The perfusion rate was 0.5 ml/10 min and samples were collected at 10-min intervals for 10-15 h. The carrier medium, which contained GnRH, was acidified and frozen until measurement by radioimmunoassay. Blood samples were taken from the jugular vein simultaneously for measurement of LH. Nineteen mares were perfused, representing anoestrus (N = 3), transition (N = 6), dioestrus (N = 7), and oestrus (N = 3). GnRH secretion was minimal during anoestrus, with the majority of samples being below the level of detection of the assay (1.9 pg/tube). During the transition phase, the overall mean secretory rate was increased, and there appeared to be more secretory episodes. During the breeding season, GnRH secretion was markedly increased over anoestrus and transition, with oestrous mares secreting significantly greater amounts of GnRH than dioestrous mares. There were no significant differences among groups in number of secretory peaks, or the interval between peaks. There was, however, a significant (P less than 0.0001) difference among groups in overall mean secretory rate. These results suggest that GnRH secretion is increased in early transition, thus accounting for the increased FSH secretion that takes place then, but LH is not increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316641 TI - Dynamics of the acute uterine response to infection, endotoxin infusion and physical manipulation of the reproductive tract in the mare. AB - The uterine responses after the infusion of saline (PBS), a bacterial suspension, or lipopolysaccharide derived from Escherichia coli, and after stimulation of the reproductive tract were compared. All infusions provoked a response involving both serum proteins and leucocytes. Protein levels peaked within a few hours of infusion, whereas leucocyte concentration peaked later at around 6 h. Bacterial recovery from the uterus followed a similar pattern, with recovery falling dramatically by 12 h. In mares known to be susceptible to infection large numbers of bacteria were again recovered after 24 h. No differences were apparent between resistant and susceptible mares in protein or leucocyte concentrations. Stimulation of the cervix and uterus resulted in a protein and neutrophil response. In contrast, vaginal stimulation failed to provoke the uterine defences. PMID- 3316642 TI - Factors affecting uterine clearance of inoculated materials in mares. AB - Twelve acyclic mares of various ages (2-29 years) and parity (maiden-multiparous) were given oestradiol-17 beta i.m. (winter 1982) or progesterone i.m. (winter 1983) to induce changes in the endometrium consistent with oestrus and dioestrus, respectively. After hormone treatment, mares were inoculated intrauterine with 50 ml saline containing 5 X 10(5) Streptococcus zooepidemicus bacteria, 51Cr labelled 15-micron microspheres, and 500 mg charcoal (Groups E + B and P + B) or microspheres and charcoal only (Groups EC and PC). At 5 h after inoculation uteri were flushed with 50 ml saline containing tracer amounts of 125I-labelled HSA. In Group E + B inoculated materials were cleared more rapidly in younger than in older mares, and there was a significant positive correlation between age and bacterial concentration, total numbers of bacteria, and amounts of microspheres and charcoal in the uterus and also between age and the WBC concentration and total numbers of WBC. In Group EC there was a significant positive correlation between age and the amounts of microspheres and charcoal remaining in the uterus, and between age and WBC concentration and total numbers of WBC. We suggest that in the oestrogen-dominated uterus physical drainage may be a factor in determining whether a mare is 'resistant' or 'susceptible' to bacterial challenge of the uterus. Physical clearance is increased in younger (resistant) mares in the presence and absence of an antigenic stimulus. In mares in Group P + B there was no correlation between age and the values measured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316643 TI - Evaluation of cellulose acetate/nitrate filters for the study of stallion sperm motility. AB - Stallion semen was diluted in a Hepes-supplemented buffer (CM) (10(6) spermatozoa/ml) and placed in the upper well of a Sykes-Moore chemotaxis chamber. Chambers were incubated in a humidified atmosphere (5% CO2 in air) at 37 degrees C for 1 and 2 h and spermatozoa were allowed to swim through filters with a mean pore size of 3,5 or 8 micron. Spermatozoa entered filters of all three pore sizes. Distance travelled was greater for each increase in pore size (P less than 0.01) but did not differ (P greater than 0.05) between 1 and 2h of incubation. Extended semen from stallions of different fertility was analysed for the minimal concentration of spermatozoa needed to enter filters with a 3 micron pore size. Sperm progression into the filter reflected the motility of the ejaculate. Assuming that sperm motility is a good indicator of fertility, this method may be useful for estimating the fertility of a stallion. Progression of spermatozoa into filters with a pore size of 3 micron was hampered by supernatants from overnight cultures of Streptococcus zooepidemicus and Enterobacter aerogenes. Motility decreased after 2h of incubation in supernatant from S. zooepidemicus diluted 1:5 and E. aerogenes supernatant diluted 1:5 and 1:10 in culture medium. In contrast, the bacterial supernatants were chemokinetic to horse neutrophils and did not affect their viability. PMID- 3316644 TI - Effect of uterine inflammation and ultrasonically-detected uterine pathology on fertility in the mare. AB - The incidence of intrauterine fluid collections during dioestrus (12/43, 28%) and uterine cysts throughout the oestrous cycle (11/73, 15%) found in this study indicates that these ultrasonically detectable abnormalities are prevalent in mares. The hypothesis that uterine cysts do not affect pregnancy was not supported. Intrauterine fluid collections at dioestrus represented the presence of an inflammatory process as indicated by a high biopsy score, reduced progesterone concentrations, and a shorter interovulatory interval. Mares with fluid collections at dioestrus had a lower pregnancy rate at Day 11 and a higher embryonic loss rate by Day 20 than did mares without such collections. The progesterone profile and length of interovulatory interval for mares with uterine inflammation supported the hypotheses that embryonic loss in this herd was due to uterine-induced luteolysis rather than primary luteal inadequacy. PMID- 3316645 TI - Effect of Salmonella typhimurium endotoxin on PGF-2 alpha release and fetal death in the mare. AB - The infusion of Salmonella typhimurium endotoxin into pregnant mares resulted in a biphasic release pattern of PGF-2 alpha as determined by 15-keto-13,14-dihydro PGF-2 alpha concentrations. The initial phase of 1 h duration was followed by accentuated release by 2 h after infusion; concentrations reached basal levels by 6 h. In 7 mares at 23, 26, 29, 33, 36, 53 and 55 days of gestation, fetal death occurred between 36 and 120 h after infusion; 12 mares at 46, 51, 56, 59, 65, 71, 73, 85, 103, 138, 283 and 318 days of gestation did not abort after endotoxin infusion. Luteal activity was compromised in all mares by 9 h after infusion. Progesterone concentrations were consistently lower in mares that aborted (1-2 ng/ml) than in those that did not abort. Mares therefore appear to be vulnerable to fetal loss by a clinical syndrome induced by Salmonella typhimurium endotoxin until about 50-60 days of gestation. PMID- 3316646 TI - Antepartum evaluations of the equine fetus. AB - Measurements were made by real-time ultrasonography in 14 healthy mares to assess fetal growth and estimate newborn foal weights. Intrauterine fluid volumes were estimated and the placenta was measured and observed for maturational changes. The onset and incidence of echogenic particles in the allantoic fluid were recorded. In the second approach, baseline fetal heart rate, physiological rate variations and number, amplitude and duration of recorded accelerations were measured. Estimates of birth weights were within +/- 3.49 kg. Allantoic fluid was evident in all sonographic planes within the uterine cavity. Average vertical axis was 1.9 +/- 0.9 cm. The mean thickness of the ventrally located gravid uterine horn and allantochorion was 1.26 +/- 0.33 cm. No placental maturational changes were noted. Echogenic particles were observed in the allantoic fluid of all mares recorded within 10 days of foaling. Baseline fetal heart rate was 76 +/ 8 beats/min. Spontaneous fetal activity resulted in accelerations in fetal heart rate from 25 to 40 beats/min in amplitude and of 23-36 sec in duration. About 10 accelerations were observed in a 10-min period. In 17 clinical case mares, abnormal records included decreased fetal activity; lack of fetal growth; haemorrhage and fibrin-like tags in the allantoic fluid; fetal tachycardia, bradycardia, arrhythmia, and cardiac deceleration. We suggest that ultrasonic fetal measurements provide useful information with regard to the fetal condition, but additional variables are required for more reliable assessments of fetal stress and distress. PMID- 3316647 TI - Ultrasonography of accessory sex glands in the stallion. AB - The accessory sex glands of 10 stallions were examined by transrectal ultrasonography. Seminal vesicles were 26.4 +/- 5.2 (s.d.) mm in width and 9.2 +/ 3.1 mm in height. Ampullae were 16.3 +/- 3.6 mm in width and 12.9 +/- 3.9 mm in height. Bulbourethral glands were 19.7 +/- 4.6 mm in width and 32.4 +/- 6.7 mm in length. Prostate lobes exceeded 34 mm in width and were 23.5 +/- 5.7 mm in height. The prostatic isthmus was 6.0 +/- 1.4 mm in height. The seminal colliculus, masculine uterus, and deferent ducts were also identified and characterized. Five of these stallions were killed to compare transrectal results with water bath ultrasonograms and gross dissections of the isolated accessory sex glands. Transrectal ultrasonograms were anatomically and acoustically similar to water bath ultrasonograms. The anatomical relationships, physical dimensions and acoustic characteristics of the stallion's accessory sex glands were accurately represented by transrectal ultrasonography. PMID- 3316648 TI - Ontogeny of the Fc gamma receptor in rat small intestine. AB - The time course of Fc gamma receptor expression on isolated enterocytes of the small intestine of rat fetuses and sucklings has been studied. This was achieved principally using indicator sheep red blood cells (SRBC) sensitized with rabbit IgG in an erythrocyte-antibody rosette assay which detects receptors located mainly on the lateral and basal plasma membrane, and in a more limited way using binding of rabbit IgG to metabolically inhibited gut as detected by immunofluorescence and which detects receptors located on the apical brush border. From the time they were first detectable in the rosette assay (20-day-old fetuses) to the time they disappeared (22-day-old sucklings) such receptors were found always to be acid pH dependent and restricted to enterocytes from the proximal region. Acid pH, Fc-dependent binding of rabbit IgG to metabolically inhibited gut was first detectable at 21 days gestation and there were indications that receptors differentiate on enterocytes in a proximal to distal direction. This was also indicated by electron microscope studies using rabbit PAP injected into the duodenum of 21-day-old fetuses. Such studies also provided evidence for the receptor-mediated translocation of IgG across the duodenum of the fetal rat in a manner similar to that described for older sucklings. PMID- 3316649 TI - Expectant management of partial placental abruption in previable pregnancies. A report of two cases. AB - Placental abruption is a major cause of perinatal morbidity and mortality, especially in the preterm infant. Two patients had previable pregnancies complicated by placental abruption and large extraamniotic hematomas. Precise diagnosis and follow-up with real-time ultrasound allowed expectant management until the delivery of viable infants became possible. PMID- 3316650 TI - Artificial intelligence and medicine: discussion paper. PMID- 3316651 TI - Intracranial pressure and its monitoring in childhood: a review. PMID- 3316652 TI - Alcohol and seizures: a review. PMID- 3316653 TI - Prevention of bowel ischaemia following surgery to the abdominal aorta: a review. PMID- 3316654 TI - Building or extending a hospital department: radiology. A path through the planning minefield (9). PMID- 3316655 TI - Renin inhibitors. Free-Wilson and correlation analysis of the inhibitory potency of a series of pepstatin analogues on plasma renin. AB - Free-Wilson and correlation analysis were combined to study a series of 34 pepstatin analogues in which mainly position 2 was varied. A statistically highly significant correlation was found between the inhibitory activity of the analogues on an enriched plasma renin preparation and structural parameters of the amino acid side chain in position 2. The crucial parameters were found to be the NMR chemical shift of the alpha-carbon, the localized electrical (inductive) effect, and the van der Waals radius related steric parameter, which demonstrated the dominating influence of electronic inductive effects compared to steric bulk. The model gives insight into the structural requirements for effective inhibition and suggests the histidine-2 derivative, a positive outlier in this series, as a lead compound for further structure-activity studies. PMID- 3316657 TI - Use of interactive-video programs in education in basic medical science. PMID- 3316656 TI - A comparison of computer-assisted instruction and tutorials in hematology and oncology. AB - In the study reported here, third-year medical students in an internal medicine clerkship were randomly assigned to computer-assisted instruction (CAI) and to tutorials to compare the effectiveness of these methods in teaching hematology and oncology topics. A multiple-choice test was used to assess the students' knowledge after instruction, and the students completed a 14-item questionnaire concerning their opinions of CAI. No statistically significant difference was found between the test scores of the students using CAI and those in the tutorials for oncology; but in hematology the students in the tutorials had higher scores than those using CAI. The study design does not permit a definite explanation of the disparity in outcome for the two topics, but it is possible that the effectiveness of the presentations in the two sections was different. There was no statistically significant correlation between the time spent in the teaching setting and the score attained. The students did not consider CAI more effective than the tutorials but rather seemed to view it as a supplement to traditional teaching by lectures, textbooks, and studying from notes. PMID- 3316658 TI - Expert systems for medical applications. AB - Expert systems, also known as intelligent knowledge based systems (IKBS), are computer programs which act as decision-support systems. They are currently being applied to a number of medical domains, most notably diagnosis and treatment planning. Their function is to assist the medical practitioner by giving ready access to the levels of skill shown by experts in a particular field. Much research effort has been expended but few systems have reached routine medical use. This paper presents a tutorial introduction to expert systems in medicine, explaining the basis of the technology, its current limitations and its prospective uses. PMID- 3316659 TI - Autoantibody analysis of patients with graft versus host disease. AB - The sera of 26 patients with graft versus host disease (GVHD) were analyzed for the presence of autoantibodies. Because the clinical spectrum of GVHD resembles some of the systemic collagen vascular diseases, particular attention was given to antinuclear antibodies and autoantibodies directed against saline soluble cellular antigens. 39% (10/26) of the patients had a positive ANA at a titer of greater than or equal to 1/80. Antibodies to double-stranded DNA were demonstrated in 4 sera (15%), to smooth muscle in 9 (41%) and to nucleoli in 6 (22%). Three sera had precipitating antibodies to saline extracts of rabbit thymus and/or bovine spleen. None of these precipitins showed lines of identity with known autoantibody systems. High titers of ANA were correlated with a previous diagnosis of acute lymphoblastic leukemia and multiple autoantibodies correlated with the severity of GVHD. PMID- 3316660 TI - Microcephaly: a review of genetic implications in its causation. AB - Microcephaly is a clinical sign rather than a nosological entity. It may even represent the extreme of normal variation. In pathological cases, it is always caused by an interruption of the neurobiologic processes of induction and cellular migration, or by a catastrophic insult to the central nervous system. The prime cause of this may be environmental or genetic. There is strong evidence for genetic heterogeneity, even among cases of 'true' or 'primary' microcephaly. Various taxonomies for the classification of microcephaly are discussed, taking into account environmental causation and various genetic mechanisms. PMID- 3316661 TI - Tumors of the small intestine: review, including a new category associated with AIDS. PMID- 3316662 TI - Identification of a vegetative promoter in Myxococcus xanthus. A protein that has homology to histones. AB - A physical map of 330 x 10(3) base-pairs near the replication origin of Myxococcus xanthus chromosome has been established already. Using DNA fragments from this region, Northern blot hybridization analysis was carried out in order to identify the genes expressed during vegetative growth. One of the genes, tentatively designated as vegA, was cloned and its entire DNA sequence was determined. The amino acid sequence of the gene product deduced from the DNA sequence reveals that the VegA protein is a very basic protein with a molecular weight of 18,700. The gene was expressed in Escherichia coli using an expression vector, and its gene product was identified using SDS/polyacrylamide gel electrophoresis. From the results of S1 nuclease mapping, the vegA promoter was found to contain the sequence TAGACA at the -35 region and the sequence AAGGGT at the -10 region. These two regions are separated by 18 nucleotides. Genetic analysis suggests that the vegA gene may be essential for the growth of M. xanthus. From a computer-aided search for homologies to know protein structures, it was found that the VegA protein has homologies to histone H4 of Tetrahymena thermophila and histone H2B of sea urchin. PMID- 3316663 TI - Positive regulation of the Escherichia coli L-rhamnose operon is mediated by the products of tandemly repeated regulatory genes. AB - The rhaC gene, whose product is the positive activator of the genes required for L-rhamnose utilization, has been cloned along with the rhamnose structural genes. The rhaC sequence shows two partially overlapping reading frames, encoding two proteins of molecular weight 32,000 and 35,000 RhaS and RhaR. Both proteins show significant homology to AraC, the positive activator of the arabinose operon. S1 mapping located transcriptional start points and showed that RhaR, and possibly RhaS, positively regulate transcription from the structural gene promoters as well as transcription from their own promoter. In-vivo dimethyl sulfate footprinting and DNase I footprinting indicate that the RhaR protein may bind to DNA elements upstream from its RNA polymerase binding site. PMID- 3316664 TI - Characterization of the bacteriophage T3 DNA packaging reaction in vitro in a defined system. AB - The bacteriophage T3 DNA packaging system in vitro defined here is composed of purified proheads and two non-capsid proteins, the products of genes 18 and 19 (gp18 and gp19). In this system, a precursor complex (50 S complex) accumulates in the presence of adenosine 5'-O-(3'-thiotriphosphate) (ATP-gamma-S), a non hydrolyzable analog of ATP. The 50 S complex is converted to a filled head in the presence of ATP. The conversion of the 50 S complex, formed by preincubation with ATP-gamma-S, to the mature head proceeds in a synchronous manner after the addition of ATP. The lag time for formation of mature heads from the 50 S complex is 1.8, 4.5 and 6.8 minutes at 30, 25 and 20 degrees C, respectively. DNA is translocated into the capsid at a constant rate of 5.7 x 10(3) base-pairs per minute at 20 degrees C. The conversion of the 50 S complex to the mature head exhibits a sigmoidal relationship with respect to the concentration of ATP, the concentration for half-maximal activity being about 20 microM. The transition of the prohead to the expanded capsid occurs at 20 degrees C at one minute 40 seconds after the initiation of DNA translocation, when one-fourth of the genome has been packaged into a prohead. At the same time, the capsid-DNA complex becomes stable to high concentrations of salt. When DNA translocation is interrupted by the addition of ATP-gamma-S, packaged DNA exists at 0 degrees C as well as at 20 degrees C but the exit of DNA stops after one-third of the genome is inside the capsid. After exit, DNA is retranslocated into the expanded capsid by the addition of ATP at a rate of about 5.7 x 10(3) base-pairs per minute at 20 degrees C. The decrease in concentration of ATP interrupts DNA translocation into the capsid but does not induce DNA exit. Interrupted DNA translocation may be reinitiated by the addition of ATP. DNA exit is not induced by the addition of ATP-gamma-S to mature heads or partially filled heads pretreated with DNase. PMID- 3316666 TI - Structure and refinement at 1.8 A resolution of the aspartic proteinase from Rhizopus chinensis. AB - The structure of rhizopuspepsin (EC 3.4.23.6), the aspartic proteinase from Rhizopus chinensis, has been refined to a crystallographic R-factor of 0.143 at 1.8 A resolution. The positions of 2417 protein atoms have been determined with a root-mean-square (r.m.s.) error of 0.12 A. In the final model, the r.m.s. deviation from ideality for bond distances is 0.010 A, and for angle distances it is 0.034 A. During the course of the refinement, a calcium ion and 373 water molecules, of which 17 are internal, have been located. The active aspartate residues, Asp35 and Asp218, are involved in similar hydrogen-bonding interactions with neighboring residues and with several water molecules. One water molecule is located between the two carboxyl groups of the catalytic aspartate residues in a tightly hydrogen-bonded position. The refinement resulted in an unambiguous interpretation of the highly mobile "flap", a beta-hairpin loop region that projects over the binding pocket. Large solvent channels are formed when the molecules pack in the crystal, exposing the binding pocket and making it easily accessible. Intermolecular contacts involve mainly solvent molecules and a few protein atoms. The three-dimensional structure of rhizopuspepsin closely resembles other aspartic proteinase structures. A detailed comparison with the structure of penicillopepsin showed striking similarities as well as subtle differences in the active site geometry and molecular packing. PMID- 3316665 TI - Structural asymmetry in the CTP-liganded form of aspartate carbamoyltransferase from Escherichia coli. AB - The protein and solvent structure of the CTP-liganded form of aspartate carbamoyltransferase from Escherichia coli yields an R-factor of 0.155 for data to a resolution of 2.6 A. The model has 7353 protein atoms, 945 sites for solvent, and two molecules of CTP. A total of 25 of the 912 residues of the model exist in more than one conformation. The root-mean-square deviation of bond lengths and angles from their ideal values is 0.013 A and 2.1 degrees, respectively. The model reported here reflects a correction in the trace of the regulatory chain. One molecule of CTP binds to each of the two regulatory chains of the asymmetric unit of the crystal. The interactions between the pyrimidine of each CTP molecule and the protein are similar. The 4-amino group of CTP binds to the carbonyl groups of residues 89 (tyrosine) and 12 (isoleucine) of the regulatory chain. The nitrogen of position 3 of the pyrimidine binds to the amide group of residue 12; the 2-keto group binds to lysine 60. The 2'-OH group of the ribose forms hydrogen bonds with lysine 60 and the carbonyl group of residue 9 (valine). The binding of the phosphate groups of CTP to the regulatory chain probably reflects an incomplete association of CTP with the enzyme at pH 5.8. A lattice contact influences the interaction between the triphosphate group of one CTP molecule and the protein. For the other CTP molecule, only lysine 94 binds to the phosphate groups of CTP. Of the two regulatory and two catalytic chains of the asymmetric unit of the crystal, there are only two significant violations of non-crystallographic symmetry. The active site in the vicinity of arginine 54 of one catalytic chain is larger than the active site of its non-crystallographic mate. The "expanded" cavity accommodates four solvent molecules in the vicinity of arginine 54 as opposed to two molecules of water for the "contracted" cavity. Furthermore, arginine 54 in the "expanded" pocket adopts two conformations, either hydrogen-bonding to glutamate 86 or to the phenolic oxygen atom of tyrosine 98; residues 86 and 98 are in a catalytic chain related by 3-fold symmetry to the catalytic chain of arginine 54. In the "contracted" pocket, arginine 54 binds only to glutamate 86.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3316667 TI - Kinetics of the spontaneous transient unfolding of a native protein studied with monoclonal antibodies. Monomer/dimer transition in the tryptophan-synthase beta 2 subunit. AB - Included in a series of monoclonal antibodies obtained after immunization with the native holo beta 2 subunit of tryptophan synthase of Escherichia coli (EC 4.2.1.20), are some that interact preferentially with a denatured state of the antigen (Friguet et al., 1984). A study of the equilibrium and kinetic characteristics of the interaction of one of these antibodies with native apo beta 2 (i.e. free of pyridoxal 5'-phosphate) and with one of its proteolytic domains is reported here. The antibody is shown to interact strongly with the isolated domain in accordance with a simple equilibrium. In the presence of native beta 2, the antibody binds exclusively to the dissociated beta-monomer. The interaction of this antibody with native apo beta 2 is used to determine the equilibrium and kinetic constants of the monomer-dimer equilibrium. The values obtained are 4.5 X 10(-8) M for the equilibrium constant and 7.9 X 10(-3) s-1 for the rate constant of the dissociation of apo beta 2 into beta-monomers. PMID- 3316668 TI - Mechanism for chromosome and minichromosome segregation in Escherichia coli. AB - A mechanism for the segregation of chromosomes and minichromosomes into daughter cells during division of Escherichia coli is presented. It is based on the idea that the cell envelope contains a large number of sites capable of binding to the chromosomal replication origin, oriC, and that a polymerizing DNA strand becomes attached to one of the sites at initiation of a round of replication. The attachment sites are distributed throughout the actively growing cell envelope, i.e. lateral envelope and septum, but not in the existing cell poles. This asymmetric distribution of oriC attachment sites accounts for the experimentally observed non-random chromosome and minichromosome segregation, and for the variation in the degree of non-random segregation with cell strain and growth rate. The multi-site attachment concept also accounts for the unstable maintenance of minichromosomes. PMID- 3316669 TI - Solution hybridization of crosslinkable DNA oligonucleotides to bacteriophage M13 DNA. Effect of secondary structure on hybridization kinetics and equilibria. AB - Several DNA oligonucleotides have been photochemically modified with the furocoumarin 4'-hydroxymethyl-4,5',8-trimethylpsoralen (HMT) such that each contained a single HMT furan side monoadduct to thymidine at a unique 5' TpA 3' sequence. When these oligonucleotides were hybridized to their respective complements, the HMT adduct could be driven to form an interstrand crosslink by irradiation of the hybrid with 360 nm light. The ability to crosslink probe target complexes has allowed us to determine the kinetics and the extent of hybridization in solution between these oligonucleotides and their complementary sequences in single-stranded bacteriophage M13 DNA. Our data indicate that these parameters are strongly influenced by the existence of local as well as global secondary structure in the viral DNA. During hybridization, rearrangement of this secondary structure so as to expose the target sequence can be rate-limiting. Upon attainment of equilibrium, only a portion of the target sequence may be hybridized to the probe with the remainder involved in intrastrand base-pairing. Using crosslinkable oligonucleotide probes hybridized and irradiated near the melting temperature of the respective probe-target complex one can partially overcome these secondary structure effects. PMID- 3316671 TI - Elective mutism: a case study of a disorder of childhood. AB - This paper reviews a number of treatment strategies utilized in the treatment of a 6-year-old boy with a history of multiple parental separations. When the patient presented to the child psychiatric clinic, he had a history of not speaking in the preceding four months, following the arrival of a stepmother in the household and a move to a new house in a new locality. Developmental and psychometric assessments are presented and their utility in early diagnosis and later prognosis are discussed. Reluctant speech is differentiated from, and compared with, elective mutism.The management of elective mutism is often complicated by these children not speaking to anyone in certain environments, and very frequently the persons with whom they do speak are not available for participation in treatment programs. Consequently, if a child does not speak to anyone who can participate in the early mapping of treatment modalities, the use of treatment strategies such as stimulus fading is impossible. Suggestions for future management to overcome this difficulty are presented and discussed. PMID- 3316670 TI - Dehydration in the elderly: a short review. AB - Dehydration is the most common fluid and electrolyte problem among the elderly. The usual causes of water loss are frequently absent in dehydrated elderly patients. Age-related changes in total body water, thirst perception, renal concentrating ability, and vasopressin effectiveness probably predispose to dehydration. Dehydration related to infection, high-protein tube feedings, cerebral vascular accidents, and medication-related hypodypsia are particularly relevant for elderly patients. Appropriate treatment depends on accurately assessing the water deficit and slowly correcting that deficit. PMID- 3316673 TI - Evidence for a Euro-American origin of human immunodeficiency virus (HIV). PMID- 3316672 TI - AIDS and the obstetrician-gynecologist. AB - The increasing number of women with the acquired immune deficiency syndrome (AIDS) or with serologic evidence of exposure should alert practicing obstetricians and gynecologists to expect to encounter symptomatic or asymptomatic patients who have been exposed to the human immunodeficiency virus (HIV). The author discusses the role of the obstetrician-gynecologist in the management of AIDS patients and reviews the pertinent literature. PMID- 3316675 TI - Fall City Medical Society and the black physician in Louisville. PMID- 3316676 TI - Melvin E. Jenkins, Jr., MD: pediatrician, educator, and scholar. PMID- 3316674 TI - The status of cardiovascular surgery in West Africa. AB - This report reviews the present status of cardiovascular surgery in West Africa and highlights some of the constraints of development in this field.Rheumatic heart disease is still endemic in the tropics, where it constitutes about 20 percent of all cases of cardiovascular disease (CVD) in Nigeria. Endomyocardial fibrosis is a disease of unknown etiology accounting for 10 to 20 percent of cases. Purulent pericarditis is a common complication of pyomyositis and osteomyelitis found in 5 percent of patients. Chronic constrictive pericarditis is a sequela of infective pericarditis found in 5 percent of all cases of CVD. Calcification is found in 30 percent of cases and pericardiectomy can be performed successfully without cardiopulmonary bypass. Infective endocarditis is equally rare, occurring in 2.5 percent of cases; it is a common source of septic emboli to coronary artery and a very difficult disease to treat in the West African environment.Ischemic heart disease is relatively uncommon, accounting for less than 0.5 percent of patients. The rarity of the disease in black Africans has been attributed to dietary habits and environment rather than to racial and psychosocial factors. Congenital heart disease accounts for 5 percent of all cases of CVD in this review. Ventricular septal defect and patent ductus arteriosus are the most common acyanotic defects, while tetralogy of Fallot and transposition of the great arteries are the most common cyanotic defects.Vascular diseases are uncommon in this series, with traumatic injuries accounting for most of the cases. Abdominal aortic aneurysms, peripheral occlusive vascular disease, and atherosclerotic aortic aneurysms are quite rare. This review further confirms the rarity of deep venous thrombosis and pulmonary embolism in Africans. PMID- 3316677 TI - Psychoneuroimmunology: interactions between central nervous system and immune system. AB - Psychoneuroimmunology, a rapidly developing field, has to do with the complex bidirectional interactions between the central nervous system and the immune system. Neuroendocrine influences modulate immune function, and there is feedback from the immune system to the brain. CNS-immune interaction appears to play a role in psychosocial influences on immunologically resisted and mediated diseases. With the growing evidence now at hand, over 30 "postulates" can be proposed for specific implications of CNS-immune interaction. PMID- 3316678 TI - Interleukin-1-like immunoreactivity in peripheral tissues. AB - Rabbit antisera were raised against a synthetic peptide corresponding to the amino acid residues 169-194 in the murine interleukin-1 sequence. Immunoreactive varicose fibers were observed in the vas deferens, urinary bladder, gastrointestinal tract, and coeliac-superior mesenteric ganglion complex of the rat. Fibers were also encountered around blood vessels in several organs including the thymus, spleen, lymph nodes, liver, and kidney. PMID- 3316679 TI - An in vivo and in vitro analysis of systemic immune function in mice with histologic evidence of neural transplant rejection. AB - Histologic and immunocytochemical analyses of fetal neocortical tissue transplanted to the lateral ventricle of inbred adult mice indicate that this tissue survives transplantation well if the donor and host are isogeneic. The major histocompatibility complex (MHC) of the mouse is known as the H-2 locus. H 2-incompatible neural transplants (allografts), unlike their H-2-identical counterpart (isografts), are characterized by the presence of T cells comprising both major T-cell subsets and macrophages, and by a marked increase in the expression of both class I and class II (Ia) MHC antigens. These findings suggest a recognition of H-2 alloantigens by the host's immune system followed by an appropriate effector response. We report here our attempts to demonstrate systemic host sensitization to alloantigens in mice bearing H-2-incompatible intraventricular neural transplants. We measured the time to rejection of orthotopic skin grafts subsequent to neural transplantation, splenocyte proliferative responses to alloantigens in mixed lymphocyte cultures (MLC), and class I-restricted antigen-specific cytolytic T lymphocyte (CTL) activity. No significant differences were found in any of these tests of host systemic sensitization between mice with allogeneic neural transplants and those with isogeneic transplants or control animals. We conclude that intraventricular neural transplants, while recognized and affected by cells of the host's immune system, do not elicit a detectable systemic sensitization to class I H-2 alloantigens. Rejection of neural transplants may depend on sensitization to class II H-2 alloantigens, to so-called minor histocompatibility antigens, or some combination thereof. PMID- 3316680 TI - Noradrenergic sympathetic innervation of the spleen: I. Nerve fibers associate with lymphocytes and macrophages in specific compartments of the splenic white pulp. AB - Sympathetic noradrenergic nerve fibers, stained with antiserum for tyrosine hydroxylase (TH), richly innervate the splenic white pulp. These fibers distribute with the vascular and trabecular systems, and associate mainly with the central artery and its branches, the periarteriolar lymphatic sheath (PALS), the marginal sinus, and the parafollicular zone, with occasional delicate fibers also present in the follicles. Simultaneous staining of TH-positive nerve fibers and markers for specific lymphoid cells has shown several regions of contact between nerves and lymphocytes or macrophages. The TH-positive nerve fibers in the plexuses around the central arterial system and in the PALS are present among T lymphocytes (OX-19-positive cells) including both T helper and T suppressor cells, and interdigitating cells. At the marginal sinus, TH-positive fibers run adjacent to macrophages (ED3-positive cells), B lymphocytes (IgM-positive), and intensely fluorescent IgM-positive cells. Along the parafollicular zone, TH positive nerve fibers run adjacent to T lymphocytes, peripheral follicular B lymphocytes, and intensely fluorescent IgM-positive cells. Within some follicles, delicate fibers end adjacent to both T and B lymphocytes. These relationships suggest a direct interaction between norepinephrine release from the TH-positive nerve terminals and the lymphocytes and macrophages closely associated with them, and focuses attention on the potential neural modulation of related functions such as T and B lymphocyte entry into the spleen and antigen capture (marginal zone), antigen presentation and T cell activation (PALS), B cell activation (parafollicular zone and marginal zone), and lymphocyte egress (outer marginal zone). PMID- 3316681 TI - Effects of purified fibronectin alone and combined with immunoglobulin G or antithrombin-III on survival during gram-negative peritonitis or endotoxemia in rats. AB - The present study was performed to determine the effects of pretreatment with purified human plasma fibronectin (FN) on survival in rats challenged with Salmonella typhimurium peritonitis or E. coli endotoxemia. The effects on survival of combining FN with immunoglobulin G (IgG) or antithrombin-III (AT-III) were also determined during S. typhimurium peritonitis and E. coli endotoxemia. Permanent survival was increased 15% in the peritonitis group (p less than 0.05) and 15% in the endotoxemic group (p greater than 0.05). There was no enhancement in survival by combining FN with a subprotective dose of IgG preparation. AT-III alone increased survival by 50% over survival in the control group. Combining FN with AT-III increased survival 10% greater than with AT-III alone, which is suggestive of an additive effect. Results from this study suggest that FN provides modest protection during Gram-negative peritonitis or endotoxemia in the rat. Combining FN with AT-III may augment in an additive manner the marked increase in survival observed with AT-III alone in this and previous studies. PMID- 3316682 TI - Metastatic disease to the chest in patients with extrathoracic malignancy. AB - The search for metastases to the lung parenchyma and other intrathoracic structures is a commonly encountered problem. The radiographic appearance of intrathoracic metastases is varied, and multiple imaging modalities may aid in their detection. Knowledge of relative frequency, growth rates, and mechanisms of spread may guide the sequence of radiographic studies. PMID- 3316683 TI - Radiologic investigation of thoracic metastases from unknown primary sites. AB - When a patient presents with thoracic metastases from a tumor whose site of origin is not apparent from the initial history, physical examination, and routine laboratory studies, there is a considerable likelihood that the individual will be subjected to an extensive and frequently unrewarding series of radiologic examinations. An analysis of the "behavior" of so-called tumors of unknown origin suggests that these tumors metastasize to distant sites with a frequency that is different from the more common tumors, that is to say, those whose primary site is readily apparent. While compulsive testing should unquestionably be eschewed, certain radiologic tests are still appropriate. These studies should be supplemented, when necessary, by newer pathologic studies, primarily those that involve the rapidly developing field of immunocytochemistry. PMID- 3316684 TI - Pulmonary tumor embolism: a critical review of clinical, imaging, and hemodynamic features. AB - Pulmonary tumor embolism is a common finding at autopsy but is generally perceived as a difficult diagnosis to make ante mortem. After a retrospective review of 164 reported cases of pulmonary tumor embolism, we identified a typical profile of clinical, laboratory, and imaging features that may permit confident clinical diagnosis in most patients with this condition. The clinical features include a documented or suspected underlying malignancy, acute to subacute onset of dyspnea, and signs of cor pulmonale. Supportive laboratory features are hypoxemia or increased alveolar-arterial oxygen gradient, and invasive or noninvasive evidence of pulmonary artery hypertension. Typical imaging findings are normal chest radiographs; multiple, subsegmental, peripheral perfusion defects on ventilation-perfusion lung scans; and delayed filling with or without subsegmental filling defects but without a thrombus on pulmonary angiogram. Radiolabeled monoclonal antibody imaging and pulmonary microvascular cytology sampling techniques are promising diagnostic tests for early diagnosis of pulmonary tumor embolism. PMID- 3316685 TI - Prospects for radiolabeled monoclonal antibodies in metastatic disease. AB - Many monoclonal antibodies are now available that bind to human cancer cells with varying degrees of specificity. These antibodies can be labeled with various radionuclides, permitting tumor sites in the body to be imaged with scintillation cameras. SPECT, the emission counterpart of x-ray computed tomography, provides both qualitative and quantitative information in three dimensions about antibody distribution. We have detected a metastasis as small as 5 mm in a patient, and the theoretical limit of detection size is less than 1 mm. Tumors that are imaged with radiolabeled antibodies can be effectively treated with the same substance (radioimmunotherapy). PMID- 3316686 TI - Nuclear medicine techniques in the evaluation of pulmonary neoplasia. AB - Many noninvasive imaging techniques are available for evaluating patients with pulmonary neoplastic processes. Computed tomography, magnetic resonance imaging, and gallium scintigraphy, while having made major contributions to the noninvasive workup of patients with pulmonary neoplastic processes, are inadequate for purposes of accurate pathologic staging. A more complete understanding of the potential for existing techniques utilizing gallium 67 and thallium 201 along with the development of new radiopharmaceuticals coupled with recent advances in detection equipment will further expand the role of nuclear medicine in the noninvasive assessment of pulmonary neoplasias. PMID- 3316687 TI - Cochlear implants: a review of the principles and important physiological factors. AB - This is a brief review of some important physiological considerations in regard to direct electrical stimulation of the cochlear nerve. A summary of cochlear implant devices currently in use or under development is provided, together with some discussion on major issues relating to cochlear implantation. PMID- 3316688 TI - Sound code for cochlear implants. AB - This is a review of how various commercially available cochlear prostheses encode speech and complex tones. Arguments in favor of temporal coding through relatively few channels are presented. Advantages of analogue over pulsatile stimuli are explained. Parameters responsible for perception of vowels, consonants, musical pitch and loudness are didactically analyzed. Active rehabilitation is considered an integral part of the coding effort. PMID- 3316690 TI - Sonographic diagnosis of subclavian and internal jugular vein thrombosis. AB - Seven patients with internal jugular and/or subclavian vein thrombosis were studied with real-time sonography and venography. High-resolution real-time sonography was used to tabulate morphologic parameters (venous size, shape, intraluminal echoes, and presence of collateral veins), as well as physiologic parameters (mobile venous valves, distention, compressibility, pulsation). Chronic venous thrombosis was characterized by the presence of collateral veins, spread of the thrombus to other major veins, and loss of normal vascular landmarks with poor visualization of the actual thrombus, the "cut-off sign." Acute catheter-induced thrombosis was confined to one vessel, and the thrombus was seen clearly in all cases. Two new signs of thrombosis, the absence of the beating venous valve and the "cut-off sign," are particularly useful in the sonographic diagnosis of internal jugular vein thrombosis. PMID- 3316691 TI - Intraoperative imaging of the biliary tree. Sonography vs. operative cholangiography. AB - The accepted technique for diagnosing choledocholithiasis at the time of cholecystectomy is operative cholangiography. Reports in the surgical literature suggest that intraoperative ultrasound can replace operative cholangiography in the accurate detection of common duct stones. This prospective study was performed jointly by radiologists and surgeons together in the operating room. Twenty-one patients underwent intraoperative ultrasonography and operative cholangiography at the time of cholecystectomy. In the 16 cases in which both studies were adequate, there were 11 in which no stones were seen on either; three in which stones were seen on both; and two in which stones were diagnosed by sonography alone. In one of these latter cases, the stones were confirmed, making the cholangiogram falsely negative. In the other case, no stones were found so we presume that sonography was falsely positive. Although this technique can be accurate and useful, it is technically demanding, even for an experienced sonologist. We feel that this technique is likely to be of benefit only to the surgeon with considerable ultrasound training, expertise, and motivation. PMID- 3316689 TI - Relative growth of the higher fetal brain structures. AB - In a retrospective review of 90 normal obstetric ultrasonographic examinations obtained between 15 and 35 menstrual weeks, measurements were made of the transverse dimensions of the thalamus, basal ganglia/insula, atrium of the lateral ventricle, and temporal operculum in the standard biparietal diameter plane. At 15 menstrual weeks the echogenic choroid plexus, filling the lateral ventricle, dominates the appearance of the cranium. During later gestation, the cerebral hemispheres and basal ganglia (telencephalic structures) show marked growth, while the diencephalon and lateral ventricles increase much less rapidly in size. This observation is made using a method of measurement that least favors the demonstration of cerebral cortical growth. Of note is that the width of the lateral ventricle remains relatively stable throughout the second and third trimesters. PMID- 3316692 TI - The ultrasonic detection of Apert syndrome. PMID- 3316694 TI - Detection of intracranial arteriovenous malformation by Doppler ultrasound of the extracranial carotid circulation. PMID- 3316693 TI - Sonographic diagnosis of aneurysm of the right portal vein. PMID- 3316695 TI - Circumscribed renal mass in dysplastic kidney. Pseudomass vs. tumor. PMID- 3316696 TI - Pena-Shokeir syndrome. Prenatal diagnosis by ultrasonography. PMID- 3316697 TI - Cerebral cysticercosis. Demonstration by intraoperative neurosonography. PMID- 3316698 TI - Diagnosing Jeune syndrome. PMID- 3316699 TI - Fetal spine morphology and maturation during the second trimester. Sonographic evaluation. AB - We reviewed high-resolution real-time sonographic images (especially selected for a lack of technical artifacts) of the fetal spine of 46 normal fetuses between 18 27 menstrual weeks of development. The degree of visible posterior neural arch ossification was graded and compared with the gestational age. Recognizable early ossification of the laminae was seen in the cervical region of all fetuses studied. Similar ossification followed sequentially in the thoracic, lumbar, and sacral regions; however, sonographically recognizable ossification of the laminae in the lumbar spine was delayed until 22-24 weeks and in the sacral spine until 25 weeks or more. Awareness of these features will help to prevent false-positive diagnoses of dysraphism and, conversely, hopefully augment our ability to detect such lesions. PMID- 3316700 TI - Free radical production in amniotic fluid and blood plasma by medical ultrasound. AB - Evidence is reported that continuous wave and long pulse ultrasonic systems can induce relatively large amounts of free radicals in biological fluids in vitro under conditions similar to those currently in use for therapeutic applications. The operating conditions and approximate threshold intensities under which these instruments can produce free radicals are described. PMID- 3316701 TI - Comparison between endovaginal and transabdominal transducers for measuring ovarian volume. AB - The use of ultrasound for measuring ovarian volume has attracted increasing interest in recent years, as it appears to be a valuable technique for identifying tumors in certain risk groups for ovarian carcinoma. Although in all studies performed to date a transabdominal scanning technique has been used, endovaginal sonography seems more promising for studying the ovaries. The aim of this study is to make a comparison between transabdominal and endovaginal scanning of the ovaries. The study was performed in 17 women with regular menstruation and 11 postmenopausal women. Although no significant difference in ovarian volume was found in comparison of measurements made using an endovaginal and a transabdominal transducer, a much clearer image of the ovaries was obtained with the endovaginal transducer. This scanning technique also seems to be better accepted by the patients since it does not require that the bladder be full. Advantages and disadvantages are discussed. PMID- 3316702 TI - Prominent fetal breasts. A normal variant. PMID- 3316703 TI - Sonographic diagnosis of meconium ileus in utero. PMID- 3316704 TI - Sonography in the diagnosis of neutropenic colitis. PMID- 3316705 TI - Sonography of Bouveret's syndrome. PMID- 3316706 TI - Synthesis of the infectious pancreatic necrosis virus polyprotein, detection of a virus-encoded protease, and fine structure mapping of genome segment A coding regions. AB - Full-length and truncated genome segment A-specific infectious pancreatic necrosis virus cDNA was subcloned into plasmid transcription vectors, and runoff transcripts were produced in vitro. These transcripts were translated in cell free rabbit reticulocyte lysates and the translation products were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Virus-specific polypeptides were gel purified and mapped by partial proteolysis with N chlorosuccinimide and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Peptide profiles were compared with those of the corresponding polypeptides purified from infectious pancreatic necrosis virus-infected cells or prepared by in vitro translation of denatured genomic RNA. The cDNA directed the synthesis of authentic pVP2, VP3, and NS polypeptides as well as a number of previously undescribed polypeptides. A 101,000-molecular-weight polypeptide was isolated and shown to be the unprocessed infectious pancreatic necrosis virus polyprotein. The NS polypeptide appears to be a virus-encoded protease responsible for the cleavage of pVP2 from the polyprotein. The carboxy terminus of NS was mapped to within three or four amino acids on the polyprotein. The most likely internal translation start sites responsible for NS and VP3 production in vitro were also mapped. PMID- 3316707 TI - Immune and histopathological responses in animals vaccinated with recombinant vaccinia viruses that express individual genes of human respiratory syncytial virus. AB - Previous reports have established that vaccinia virus (VV) recombinants expressing G, F, or N protein of respiratory syncytial (RS) virus protect small animals against intranasal challenge with live RS virus. This work demonstrates that a variety of parameters affect the protection induced by recombinant viruses. The route of vaccination, the subtype of challenge virus, and the species used influenced the antibody titers and extent of protection. During these studies, observations were also made on the subclass of antibody generated, and pulmonary histopathological changes induced by challenge after vaccination were noted. The effect of route of inoculation on host response was examined by vaccinating mice intranasally, intraperitoneally, or by scarification with a recombinant VV expressing the RS virus G glycoprotein. Intranasal vaccination induced 25-fold-higher titers of antibody to RS virus in the lung than the intraperitoneal route did, but both routes resulted in complete suppression of virus replication after intranasal challenge 21 days after vaccination. Scarification was a less effective method of vaccination. The antibody induced by recombinant VV in mice was mostly immunoglobulin G2a (IgG2a) with some IgG2b. No antibody to RS virus was detected in the IgA, IgM, IgG1, or IgG3 subclass irrespective of the vaccination route. The G and F glycoproteins were shown to elicit similar subclasses of antibody. However, animals vaccinated with the G and F vectors differed strikingly in their response to challenge by heterologous virus. Mice or cotton rats vaccinated with recombinant VV carrying the G gene of RS virus were protected against challenge only with homologous subtype A virus. Vaccination with a recombinant VV expressing the F glycoprotein induced protection against both homologous and heterologous subtype B virus challenge. The protection induced in mice was greater than that detected in cotton rats, indicating that the host may also affect immunity. Finally, this report describes histological examination of mouse lungs after vaccination and challenge. Vaccinated mice that were subsequently challenged had significantly greater lung lesion scores than unvaccinated challenged mice. The lesions were primarily peribronchiolar and perivascular infiltrations of polymorphonuclear cells and lymphocytes. Further work will establish whether these pulmonary changes are a desirable immune response to virus invasion or a potential immunopathogenic hazard. The results have important implications for planning a strategy of vaccination against RS virus and emphasize potential dangers that may attend the use of recombinant VV as vaccines. PMID- 3316709 TI - Interference with viral infection by defective RNA replicase. AB - RNA-dependent RNA and DNA polymerases have a conserved segment, Tyr-X-Asp-Asp (G. Karmer and P. Argos, Nucleic Acids Res. 12:7269-7282, 1984). To investigate the function of this segment, we changed the Gly residue at position 357 in the conserved sequence Tyr-356-Gly-357-Asp-358-Asp-359 of the replicase of RNA coliphage Q beta to Ala, Ser, Pro, Met, or Val and examined the replicase activity in vivo. Cells carrying the variant plasmids lost the replicase activity and severely inhibited the proliferation of phage Q beta (group III) and related phage SP (group IV) by suppressing phage RNA synthesis. In contrast, substitution of the Gly residue at 390 showed only a slight inhibitory effect, although replicase activity was also lost. These results suggest that the cells harboring an altered replicase at the conserved segment can interfere specifically with the wild-type phage and different but related phage infections. PMID- 3316708 TI - Structural and functional studies of a 39,000-Mr immunodominant protein of vaccinia virus. AB - Little is known about the nature of poxvirus proteins involved in the host immune response. Screening a lambda gt11 expression library of genomic rabbit poxvirus DNA with hyperimmune rabbit anti-vaccinia virus serum and selection of monospecific antibodies identified a highly antigenic viral protein of about 39,000 molecular weight (39K protein). The same-size protein of vaccinia virus was also identified with a monoclonal antibody (MAb B6) obtained from hybridomas generated after fusion of hyperimmunized mouse spleen cells with mouse myeloma cells. Structural analysis revealed that the 39K protein is an acidic polypeptide, that it can exist in two molecular forms because of intramolecular disulfide linkages, and that it is part of the virus core. This protein shares antigenic determinants with a cytoplasmic component(s) from uninfected cells. Functional studies revealed that the 39K protein is synthesized at late times postinfection and appears to be required for virus assembly. This protein is highly conserved in members of the Orthopoxvirus group, but in cowpox virus, a 41K virion protein was specifically recognized by antibodies that reacted against the vaccinia virus 39K protein. Significantly, during long-term passages of Friend erythroleukemia cells persistently infected with vaccinia virus, some virus mutants were found to increase or decrease by about 2 kilodaltons the size of the 39K protein. Mapping analysis localized sequences encoding the 39K protein in a rifampin-sensitive gene cluster between the two major core-associated viral polypeptides, 4a and 4b. The fact that the 39K core protein of vaccinia virus elicits strong humoral immune response, induces antibodies that react against a host component(s), and is subjected to genetic variability suggests that this protein has important biological functions. PMID- 3316710 TI - The chicken c-fos gene: cloning and nucleotide sequence analysis. AB - Using a DNA probe from an avian transforming virus, NK24, that contains the fos gene and that was newly isolated and characterized (M. Nishizawa, N. Goto, and S. Kawai, J. Virol. 61:3733-3740, 1987), we cloned and sequenced the chicken c-fos gene. Results showed that this gene, like the mouse or human c-fos gene, contains four exons encoding a predicted gene product of 367 amino acids which is about 79% homologous to p55c-fos (mouse), excluding several small insertions or gaps. The predicted gene product, however, contains two nonhomologous regions, as suggested by sequence analysis of the NK24 genome. About half the identical amino acids of these gene products are encoded by different codons, and the guanine plus-cytosine content in the third letter of each codon used in the entire chicken c-fos coding region is high (93%). The 5'-flanking region of the TATA box contains a sequence that is homologous to a putative transcriptional regulatory sequence in the mouse or human c-fos gene. The 3'-noncoding region of chicken c fos is strikingly homologous to that of mouse or human c-fos and covers a 67-base pair adenine-plus-thymine-rich stretch which was previously reported to be essential for an inhibitory effect on the expression of the mouse c-fos gene. PMID- 3316711 TI - Expression of dengue virus structural proteins and nonstructural protein NS1 by a recombinant vaccinia virus. AB - A recombinant vaccinia virus containing cloned DNA sequences coding for the three structural proteins and nonstructural proteins NS1 and NS2a of dengue type 4 virus was constructed. Infection of CV-1 cells with this recombinant virus produced dengue virus structural proteins as well as the nonstructural protein NS1. These proteins were precipitated by specific antisera and exhibited the same molecular size and glycosylation patterns as authentic dengue virus proteins. Infection of cotton rats with the recombinant virus induced NS1 antibodies in 1 of 11 animals. However, an immune response to the PreM and E glycoproteins was not detected. A reduced level of gene expression was probably the reason for the limited serologic response to these dengue virus antigens. PMID- 3316712 TI - An overview of intravesical therapy for superficial bladder tumors. PMID- 3316713 TI - The management of clinically localized prostate cancer. National Institutes of Health Consensus Development Conference, June 15-17, 1987. PMID- 3316714 TI - Repeat cadaver kidney transplantation using cyclosporine A immunosuppression. AB - Repeat cadaver kidney transplantation using azathioprine immunosuppression carried a higher risk of graft loss than primary transplants. We analyzed the results of repeat cadaver kidney grafting with cyclosporine A immunosuppression. A total of 33 cyclosporine A-treated patients received the second kidney transplant at varying intervals after failure of the first transplant. Graft survival at 1 year was 66 per cent. A concurrent group of 189 cyclosporine A treated first cadaver kidney recipients had a 1-year graft survival rate of 75 per cent, although this better result was not statistically significant (p greater than or equal to 0.25). A historical group of 31 azathioprine-treated second graft recipients had a significantly worse 1-year graft survival rate of 45 per cent compared to the cyclosporine A second graft group (p less than 0.1). Patient age, sex, early first graft loss, interval between transplants and the presence of panel reactive antibodies were not factors in predicting second graft outcome. A complete DR mismatch appeared to worsen the second transplant survival. These findings indicate that early graft survival of cyclosporine A treated repeat cadaveric transplants is acceptable and is better than azathioprine-treated first or second grafts. PMID- 3316715 TI - The use of transrectal longitudinal real-time ultrasonography in urodynamics. AB - A total of 63 combined transrectal ultrasonographic and urodynamic studies was performed to evaluate the voiding dysfunction in 49 spinal cord injury patients and 7 other patients. Ultrasonography provided excellent real-time imaging of the bladder neck, prostatic urethra, prostate and external sphincter, and allowed for accurate diagnosis of detrusor-sphincter dyssynergia, detrusor-bladder neck dyssynergia, prostatic hypertrophy and bladder neck strictures. In addition to offering these capabilities, ultrasonography is less expensive than x-ray and it does not involve exposure of either the patient or examiner to radiation. However, it does not provide a means to detect vesicoureteral reflux. PMID- 3316716 TI - Multicystic dysplastic kidney: natural history from in utero diagnosis and postnatal followup. AB - Based on our experience with 13 in utero diagnoses we report the changes that may occur in the ultrasonic appearance of a multicystic dysplastic kidney. Macrocysts appear obvious only in the early third trimester of pregnancy. After reaching a maximum size the cysts start to involute either in utero or after birth, which may lead to a small noncystic mass, the so-called aplastic kidney, or even to complete disappearance of the entire dysplastic kidney. The dysplastic kidney seems vulnerable to anoxia or infection, and necrosis may supervene. The multicystic dysplastic kidney is a progressive and changing disorder. If its radiological appearance is typical management may be conservative with ultrasonic monitoring. Nephrectomy should be done if there is any abnormal clinical or ultrasonic change. PMID- 3316717 TI - Retroperitoneal fibrosis and nonmalignant ileal carcinoid. AB - The carcinoid syndrome and fibrosis are unusual but identifiable disease processes. We report a rare case of retroperitoneal fibrosis associated with an ileal carcinoid in the absence of metastatic disease. The literature is reviewed. PMID- 3316718 TI - Divided renal and caval vein plasma renin activity in two-kidney two-clip hypertension in rabbits and variations of blood pressure, plasma volume and renal function following unilateral nephrectomy. AB - Determinations were made of peripheral plasma renin activity, blood pressure, plasma volume and blood urea nitrogen in rabbit models of two-kidney one-clip, two-kidney two-clip or one-kidney one-clip hypertension that were created by staged operation to produce functionally significant renal artery stenosis. The plasma renin activity in the divided renal veins and inferior caval vein was also measured in animals with two-kidney two-clip hypertension. In rabbits with two kidney two-clip hypertension the plasma renin activity was significantly higher in the renal vein on the more involved side and comparable in the renal vein on the less involved side and the inferior caval vein. This response pattern of renin secretion, unilateral hypersecretion with contralateral suppression, was identical with that observed in animals with two-kidney one-clip hypertension. In animals with one-kidney one-clip hypertension there was a marked increase in plasma volume and blood urea nitrogen. The renovascular hypertension was in decreasing order of severity in animals with one-kidney one-clip hypertension, those with two-kidney two-clip hypertension and those with two-kidney one-clip hypertension. PMID- 3316719 TI - A review of wildlife diseases from Scandinavia. AB - The epidemiological and historical aspects of some important and representative wildlife diseases from Scandinavia are discussed. In noninfectious diseases, examples include cataract in moose (Alces alces), atherosclerosis in hybrid hares (Lepus timidus X L. europaeus), and ethmoid tumors in moose. The epizootiological and historical aspects of the recent epizootics of myxomatosis in European rabbits (Oryctolagus cuniculus) and rabies and sarcoptic mange in red foxes (Vulpes vulpes) are reviewed. The decline and subsequent increase in population abundances of tetraonids including the capercaillie (Tetrao urogallus), black grouse (Lyrurus tetrix), and hazel hen (Tetrastes bonasia) are discussed, and an hypothesis on predation by foxes is presented as a possible explanation for these population fluctuations. The potential impact of environmental pollution on wildlife populations is emphasized with reference to mercury in wildlife from Sweden and the possible effects of cadmium and selenium resulting from acidification. A bibliography of important references is presented pertaining to these and other diseases of wildlife from Scandinavia. PMID- 3316720 TI - Massive outbreak of antimicrobial-resistant salmonellosis traced to pasteurized milk. AB - Two waves of antimicrobial-resistant Salmonella typhimurium infections in Illinois totaling over 16 000 culture-confirmed cases were traced to two brands of pasteurized 2% milk produced by a single dairy plant. Salmonellosis was associated with taking antimicrobials before onset of illness. Two surveys to determine the number of persons who were actually affected yielded estimates of 168 791 and 197 581 persons, making this the largest outbreak of salmonellosis ever identified in the United States. The epidemic strain was easily identified because it had a rare antimicrobial resistance pattern and a highly unusual plasmid profile; study of stored isolates showed it had caused clusters of salmonellosis during the previous ten months that may have been related to the same plant, suggesting that the strain had persisted in the plant and repeatedly contaminated milk after pasteurization. PMID- 3316721 TI - Magnetic resonance imaging. Prologue. Council on Scientific Affairs. PMID- 3316722 TI - Landmark article Dec 1, 1906: Excision of cancer of the head and neck. With special reference to the plan of dissection based on one hundred and thirty-two operations. By George Crile. PMID- 3316723 TI - Landmark perspective: The heritage of the radical neck dissection. PMID- 3316724 TI - National Library of Medicine: database gateway. PMID- 3316725 TI - Consensus conference. Differential diagnosis of dementing diseases. PMID- 3316726 TI - Fundamentals of magnetic resonance imaging. Council on Scientific Affairs. AB - Medical imaging methods traditionally have depicted variations in one or two simple physical variables in tissues, eg, physical density, atomic number, acoustic velocity, and radioactivity concentration. Magnetic resonance images reveal differences in several variables, with the prominent variables reflecting complex energy transfer mechanisms that occur at the atomic and nuclear levels. Furthermore, the relative contributions of these variables to the image are readily altered by changing the pulse sequence and the pulsing times within the sequence. These changes dramatically affect the image and its characterization of normal and abnormal anatomy. Hence, magnetic resonance images and their contributions to diagnostic medicine can be properly appreciated only if one has some understanding of the procedures by which they are produced. PMID- 3316727 TI - 3-Hydroxy-3-methylglutaryl--coenzyme A reductase inhibitors in the treatment of hypercholesterolemia. AB - A new class of drugs, which inhibit de novo cholesterol biosynthesis, significantly reduces the blood cholesterol concentrations in hypercholesterolemic patients. Four separate inhibitors have lowered plasma total cholesterol and low-density lipoprotein (LDL) levels in humans by 20% to 40%: mevastatin (Compactin), lovastatin (mevinolin), pravastatin (CS-514, Eptastatin, and SQ 31000), and simvastatin (Synvinolin, MK-733). In addition to lowering total and LDL cholesterol concentrations, the plasma concentration of the potentially atherogenic B apolipoprotein is also reduced by 20% to 40%. The reduction in the levels of circulating atherogenic lipoprotein particles occurs as a result of decreased synthesis and enhanced removal of LDLs by the LDL receptor pathway in hepatocytes. Moreover, the levels of high-density lipoprotein cholesterol, which are inversely related to atherosclerosis, increase in concentration with treatment by these drugs. If the short-term safety of these drugs extends to ongoing long-term studies and if cardiovascular morbidity and mortality are affected by their use, this class of hypolipidemic agent will markedly facilitate the effective treatment of hypercholesterolemia. PMID- 3316728 TI - A physician's guide to adoption. AB - The growing number of couples seeking to adopt may have outstripped the number of babies in the United States available for adoption. Although increased availability and use of abortion have resulted in fewer single women continuing their pregnancies, the increased tendency of unmarried mothers to raise rather than relinquish their children has, in particular, limited the number of babies available for adoption. Despite the unpopularity of adoption among women with unintended pregnancies, addressing this option remains an important part of pregnancy counseling. Appropriate obstetric care of women placing their babies for adoption includes acknowledgment of the loss these women experience. Knowledge of adoption resources and willingness to discuss adoption can help physicians provide better care of unintentionally pregnant as well as infertile patients. PMID- 3316730 TI - The future of obstetrics and gynecology. Council on Long Range Planning and Development with the cooperation of the American College of Obstetricians and Gynecologists. AB - The American Medical Association Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect the future of obstetrics and gynecology practice. The professional liability crisis is among the most potent factors affecting the types and numbers of services that obstetricians and gynecologists will provide in the future. The setting for obstetrics and gynecology practice is likely to be affected by advances in technology and trends in delivery and reimbursement systems. Two factors with potential to affect the organization of practice are the high numbers of women entering the specialty and increasing practice expenses, largely associated with liability costs. Other factors affecting future patterns of delivery include the anticipated aging of the female population and the changing social and economic roles of women. In particular, the feminist movement has focused more attention on women's health care and is expected to have a continuing impact on the delivery of obstetric and gynecologic care. The Council concludes that the most salient issues for the specialty in the future will be the following: (1) the direction of the professional liability crisis, (2) medical practice competition, (3) the feminization of poverty, (4) ethical issues arising from technological and social imperatives, (5) the changing gender profile of the specialty, and (6) the impact of the feminist movement on women's health care. PMID- 3316729 TI - The past, present, and future of continuing medical education. Achievements and opportunities, computers and recertification. AB - Changes in continuing medical education (CME) during the past three decades have been controversial and complex. A 1950s-style, small-scale, voluntary activity has evolved, in 1987, into broad-scale programs with accredited sponsors and with ties to relicensure. Within the next three decades, CME will be directed by methods chosen by specialty boards for recertification and by exploitation of computer and telecommunication technology. Written recertification examinations can waste physicians' time studying material that will not improve care of their patients. We hope improved methods of analysis of individual practices, on-the spot access to pertinent medical information, and better communication among physicians can be incorporated into recertification procedures. Policies established now will shape CME for decades to come. We encourage a coordinated effort by medical specialty boards, medical societies, hospitals, medical schools, computer corporations, telecommunication firms, granting agencies, and the National Library of Medicine to ensure the most effective and efficient recertification and CME policies. PMID- 3316731 TI - [Heart transplantation and anesthesia]. PMID- 3316732 TI - [Review: New antimicrobial agent series XXII: Aspoxicillin]. AB - The results of clinical and laboratory studies on aspoxicillin (ASPC) are summarized in this paper. 1. ASPC possesses a broad antibacterial spectrum in vitro against Gram-positive and Gram-negative bacteria. ASPC shows more potent activity in vivo and stronger bactericidal action than expected from in vitro activity. 2. Peak blood levels of ASPC after intravenous injection or intravenous drip infusion are dose dependent and half-lives of ASPC in these cases are about 1.6 hours. ASPC is excreted in active form mostly into urine via kidney. ASPC is satisfactorily transferred into various tissues and body fluids, such as bile, sputum. The binding rate of ASPC to serum protein is much lower than penicillin derivatives like piperacillin (PIPC), sulbenicillin (SBPC) and ampicillin (ABPC). 3. In an open clinical trial of ASPC, 1,845 cases were evaluated. Clinical effects were excellent in 543 cases (29.4%) and good in 822 cases (44.6%), and the efficacy rate for cases judged as excellent and good comprised 74.0%. 4. Comparative studies in which the efficacy of ASPC was compared to efficacies of PIPC and SBPC were performed in patients with respiratory tract infections, postoperative wound infections and suppurative otitis media. ASPC showed satisfactory clinical effects in all trials. 5. In the above open and comparative clinical studies of ASPC, incidence of adverse side reaction was only 1.95% (45/2,304), and main side effects were skin rash and diarrhea. PMID- 3316733 TI - Calcification of the tricuspid annulus. Case report and review of the relevant literature. AB - We present a case of tricuspid annulus calcification, documented by fluoroscopy, chest X-ray and cross sectional echocardiography. This case is interesting for two reasons: 1) Tricuspid annulus calcification is extremely rare and very few cases have been reported. 2) It is the third case described where two-dimensional echocardiography established the diagnosis of this very rare condition. Previously reported cases of tricuspid annulus calcification are reviewed. PMID- 3316734 TI - [A bronchogenic cyst of the esophageal wall--a case report and differential diagnosis from an esophageal cyst]. AB - A 25-year-old man underwent extirpation of a cystic mass of the esophageal wall. It proved to be an unilocular cyst surrounded by a pseudo-stratified, ciliated columnar epithelium with occasional goblet cells. Outside of the epithelium, a smooth muscle layer was seen and a small foci of seromucous glands were scattered in the wall. Electron microscopic observations of the epithelial layer revealed 5 types of the cells: ciliated columnar cells, mucous cells, brush cells, intermediate cells, and basal cells. Our results suggest that electron microscopic observations are useful for distinguishing the bronchogenic cyst from the esophageal cyst. Nine cases of para-esophageal bronchogenic cysts that have been reported in Japan also are briefly reviewed. PMID- 3316736 TI - [Primary amelanotic malignant melanoma of the vagina--a case report]. AB - A case of a primary amelanotic melanoma of the vagina is reported. The patient was a 58-year-old Japanese female. A polypoid tumor was found on the lateral wall of the vagina and a cytologic examination of a scraping showed a few large atypical cells with cleaved nuclei and intranuclear vacuoles. A lateral junctional spread was histologically observed and stage II melanosomes were found in the cytoplasm. Two years after a radical operation, the patient died of a widespread melanotic metastases. The authors survey the number of incidences of malignant melanoma in the female genital organ. In Japanese women, melanoma is seen more frequently in the vagina than in the vulva, which is quite the opposite in cases of malignant melanomas of the genital organs in women of the United States and Europe. PMID- 3316735 TI - [A case of a primary localized amyloidosis (amyloid tumor) of the renal pelvis and ureter]. AB - A 62-year-old woman complaining of asymptomatic hematuria was hospitalized. Although a cytologic examination of the urine was negative, abnormal findings in the right renal pelvis by DIP, RP and CT led us to suspect a pelvic tumor, and a right nephroureterotomy was performed. Light microscopy revealed deposits of amorphous, eosinophilic material in the pelvis and proximal portion of upper ureter, however tumor cells were not found. Electron microscopy revealed that these materials were aggregates of linear, non-branching fibrils, measuring about 8 nm in diameter. Histochemically, these were seen to be consistent with amyloid, producing an apple-orange birefringence with Congo red staining under a polarized light. Alkali Congo red staining after pretreatment of KMnO4 demonstrate that this amyloid protein was composed largely of AA protein in addition to lesser amounts of non-AA protein, and a primary localized amyloidosis (amyloid tumor) was diagnosed. A clinicopathologic study that was performed on 12 cases of primary localized amyloidosis of the pelvis, including our case, also is reported. PMID- 3316737 TI - [Progress in the study of bronchial asthma]. PMID- 3316739 TI - [Trends in the development of plasmapheresis]. PMID- 3316738 TI - [Bronchial asthma due to non-allergic mechanisms--pathogenesis and clinical characteristics--3) Exercise-induced asthma]. PMID- 3316740 TI - [Progress of three-dimensional CT]. PMID- 3316741 TI - [Hypothetical theory of thromboxane and prostacycline balance in hemostasis and thrombosis]. PMID- 3316742 TI - [Development of new immunoadsorbents]. PMID- 3316743 TI - [Theory and future of water jet surgery]. PMID- 3316745 TI - [Two cases of pure squamous cell carcinoma of the breast]. PMID- 3316744 TI - [Scintigraphy and ultrasonography of various thyroid diseases]. PMID- 3316746 TI - [Two cases of hepatic lobe absence--its radiological features]. PMID- 3316747 TI - Improvement of transplantability of human neoplastic cells to nude mice. AB - It was demonstrated from these results that both splenectomy and irradiation of the nude mice are effective procedures for improving the rate of successful xenotransplantation with nude mice. When there is only a small number of cells in the transplant material, applying only one treatment of either splenectomy or irradiation is not sufficient to effectively improve the rate of successful transplantation. A combination of both treatments was more effective for increasing the successful rate of transplantation. The optimal conditions for maximizing the successful transplantation rate from this study were splenectomy on the 4th day of age and irradiation and transplantation on the 35th day of age for the xenotransplantation of a small number of neoplastic cells. PMID- 3316748 TI - [Color flow mapping of esophageal varices by endoscopic real-time two-dimensional Doppler echography]. PMID- 3316749 TI - [A change in portal blood flow direction in a case of liver cirrhosis during a short clinical course]. PMID- 3316750 TI - Urinary cadmium, NAG activity and beta 2-microglobulin of cadmium pigment workers. PMID- 3316751 TI - [Uric acid clearance in inhabitants of a cadmium-polluted area]. PMID- 3316752 TI - Mutagenicity in machine oils. PMID- 3316753 TI - [Acoustical imaging and processing of peripheral arteries using a 20 MHz ultrasound system]. PMID- 3316754 TI - [Forensic immunochemical studies of methamphetamine--preparation of a specific antibody to methamphetamine]. PMID- 3316756 TI - [Assistance necessary for long-term breast feeding (3). Evaluation of the training program on breast feeding at an ambulatory pediatric department in the past 2 years]. PMID- 3316755 TI - [A study on tooth marks--on the identification of tooth marks by personal image analyze system]. PMID- 3316757 TI - [Urinary protein analysis by Western blotting in children with renal diseases]. PMID- 3316758 TI - [The detection of immune cells in human kidney tissues]. PMID- 3316759 TI - [Usefulness of ethanol-fixation and paraffin-embedding technique for renal biopsy specimens--application of immunoperoxidase technique]. PMID- 3316760 TI - [Distribution of laminin studied by monoclonal antibodies against laminin A chain and A, B chains]. PMID- 3316761 TI - [Effects of angiotensin converting enzyme inhibitor (captopril) on erythrocyte sodium ion transport systems in patients with essential hypertension]. PMID- 3316763 TI - [Focal point of the month. An organization planning specialized geriatric care introduces a list to evaluate the functions of geriatric hospitals]. PMID- 3316762 TI - [Fundamental and clinical studies on the measurement of beta 2 microglobulin using the Dainabot beta 2-micro RIA kit]. PMID- 3316764 TI - [Relationship between suicide and social support network]. PMID- 3316765 TI - [History of nursing in Japan. Pre-modern age]. PMID- 3316767 TI - [History of public health nursing in Osaka area. 2. The early days of public health clinics (2). Creation of public health clinics and public health nursing activities]. PMID- 3316766 TI - [History of nursing in Japan. Pre-modern age]. PMID- 3316770 TI - [Reevaluation of clinical staging in cases of total thymectomy with extensive resection of surrounding invaded organs]. PMID- 3316769 TI - Biliary cystadenoma of the extrahepatic bile ducts: report of a case and review of the literature. AB - Benign neoplasms of the extrahepatic bile ducts are rare and there have only been thirteen reported cases of cystadenoma. One case of cystadenoma of the common hepatic duct and solitary hepatic cyst is presented here and a total of fourteen cases are reviewed. The patient was a 45 year old woman, who complained of abdominal pain with rigidity, but without jaundice. Ultrasonography of the liver showed a 6 cm cyst of the right lobe. Percutaneous transhepatic cholangiography revealed a multilobular cystic mass. At emergency laparotomy, a polypoid multilobular tumor with a stalk was found hanging from the common hepatic duct and was excised. Almost all the patients reported were middle age woman with jaundice. Preoperative diagnosis was made possible by percutaneous transhepatic cholangiography, endoscopic retrograde cholangiography or ultrasonography. The treatment of choice was complete excision. In three cases, a solitary hepatic cyst accompanied the cystadenoma of the common hepatic duct. PMID- 3316768 TI - Cystic adventitial disease of the popliteal artery and of other stem vessels in the extremities. AB - Two hundred and thirty-four cases of cystic adventitial disease were collected from over two hundred world literatures and were classified into two groups: first, typical cystic adventitial disease of the popliteal artery, and second, that of the stem vessels in extremities other than the popliteal artery. The nomenclatures, clinical and pathological features, and etiology were reviewed. From the etiological point of view, the group in which the cyst was connected with joint capsule was identified as the joint group. All cases reported are listed in the two tables except those cases listed already in Flanigan's table. PMID- 3316771 TI - [Pregnancy and delivery of a patient with a prosthetic aortic valve treated with antiplatelet drugs: a case report]. PMID- 3316772 TI - [Surgical treatment of bilateral coronary to pulmonary artery fistulas--case reports and review of the literature in Japan]. PMID- 3316773 TI - [A case of aortic aneurysm suspected of mediastinal tumor]. PMID- 3316774 TI - [Prophylactic use of ceftizoxime (CZX) in cardiac surgery. A clinical study]. PMID- 3316775 TI - [Clinical evaluation of myocardial preservation with modified young-GIK cardioplegia in infant under 6 years of age]. PMID- 3316777 TI - [Development and application of ultrasonically guided puncture for the seminal vesicles]. PMID- 3316776 TI - [An operated case of solitary pulmonary metastasis from carcinoma of the male breast]. PMID- 3316778 TI - [Study on renal transplantation. X: Measurements of intrarenal flow distribution during hypothermic perfusion by hydrogen clearance method]. PMID- 3316779 TI - [Evaluation of prostatic weight by transabdominal ultrasonography (2nd report) normal prostate]. PMID- 3316780 TI - [Renal morphologic changes in pregnancy--ultrasonographic examination]. PMID- 3316781 TI - [Bilateral renal cell carcinoma with intracaval tumor thrombus in a chronic hemodialysis patient]. PMID- 3316782 TI - Relationship between salmonella population and levels of volatile fatty acids in ceca of Eimeria tenella-infected chickens. PMID- 3316783 TI - Gluconeogenesis in the tumor-influenced rat hepatocyte: importance of tumor burden, lactate, insulin, and glucagon. AB - In an attempt to define the relationship between tumor burden (cachexia) and host hepatocyte gluconeogenesis, the following experiments were performed with the use of an F344 male rat bearing a transplantable sarcoma. Food intake of tumor bearing (TB) rats was constant until day 24 following implant and a tumor burden of 18 +/- 5.2% (mean +/- SD), at which time food intake progressively declined daily. Tumor burden was arbitrarily divided at 12.8% to determine if any measured changes occurred prior to or following the approximate time when a significant decline in food intake occurred. Plasma glucose levels decreased with tumor burden. Whole-blood lactate levels increased with tumor burden. Fasting plasma alanine levels decreased with tumor burden. Plasma 3-methylhistidine levels increased with tumor burden. Plasma glucagon levels increased with tumor burden, whereas plasma insulin levels decreased. Hormone changes were noted at small tumor burdens prior to a decline in food intake. Viable hepatocytes were isolated from 4 groups: non-tumor-bearing (NTB), small tumor burden [(STB) 3.5% total body weight (TBW)], moderate tumor burden [(MTB) 14% TBW], and large tumor burden [(LTB) 23% TBW]. As expected in NTB rats, hepatocytes produced significantly more glucose with 20 mM lactate than 20 mM alanine or than Hanks' balanced salt solution (HBSS) alone. Hepatocytes from STB rats demonstrated the same basic relationship for lactate, alanine, and HBSS, but they produced significantly more glucose from lactate and HBSS alone than NTB hepatocytes. With alanine as substrate, the rates of glucose production by hepatocytes were not affected by the presence or size of tumor. However, with lactate as substrate, hepatocytes from MTB and LTB rats produced progressively less glucose as tumor burden increased (r = -0.85, p less than .001), which may partly explain the reduction in blood glucose and elevation in blood lactate levels observed. Elevated gluconeogenesis in TB rats occurred early prior to a decline in food intake. The key precursor appeared to be lactate. The balance between glucagon and insulin appeared to promote the abnormal host carbohydrate metabolism observed. PMID- 3316784 TI - Digital subtraction angiography for breast cancer. PMID- 3316786 TI - Kidney transplantation in Kenya. PMID- 3316785 TI - Extracorporeal renal surgery. PMID- 3316787 TI - [Effect of long-term treatment with verapamil on the clinical picture and exertion tolerance in patients with hypertrophic cardiomyopathy]. PMID- 3316788 TI - [Usefulness of radionuclide ventriculography, ultrasonography and polycardiography in the evaluation of left ventricular contractility in a fixed block of the left branch of the bundle of His]. PMID- 3316789 TI - [Value of electrophysiologic studies of the heart in the examination of supraventricular tachycardia mechanisms]. PMID- 3316790 TI - [Baroreflex mechanisms of the regulation of blood circulation in hypertension]. PMID- 3316791 TI - [Role of transmembrane ion transport disorders in the pathogenesis of hypertension]. PMID- 3316792 TI - [Changes in the regulation mechanisms of plasma angiotensin II production in arterial hypertension]. PMID- 3316793 TI - [Clinical and morphologic characteristics of low-renin hyperaldosteronism]. AB - A comparative assessment of the results of differential-diagnosis load tests and morphologic changes in adrenal tissue removed at surgery has been carried out in patients with arterial hypertension and low-renin hyperaldosteronism. Assessment of plasma aldosterone variations in response to load tests has shown this parameter to be unrelated to the structure of aldosteroma, either before or after the test. Different patterns of aldosterone production control were demonstrated in cases of diffuse-nodular and adenomatous adrenal changes. The study has provided additional information on the pathogenesis of this condition. PMID- 3316794 TI - [Results of the use of relaxation therapy in hypertension]. AB - To assess the efficiency of relaxation therapy (RT) as part of the treatment for essential hypertension (EH), 100 male EH patients, aged 20 to 55 years, were repeatedly examined at 12 months' intervals, using clinical, psychological and psychophysiologic tests. The patients were divided into 2 groups: the main group received RT as autotraining (AT) or using biologic feedback devices, and the control group was not exposed to mental influences. Patients from the main group showed a more marked resting BP drop as well as a smaller and shorter hypertensive response to emotional stress, improved psychosocial status and psychologic adaptation, and better working capacity. A comparative five-year follow-up study of 90 patients was carried out to assess the value of RT for secondary EH prevention. The use of AT is associated with a slower progress of the disease, as compared to the controls, as evidenced by lower BP values, more limited growth of left-ventricular hypertrophy, and lesser neurotization as well as shorter EH-related temporary disability periods. PMID- 3316795 TI - [Preventive pertussis vaccination?]. PMID- 3316796 TI - [The very low birth weight newborn infant (less than 1,500 g): significance, strategy, lower limits, ethical problems, management]. PMID- 3316797 TI - [Respiratory insufficiency caused by tracheal compression by the brachiocephalic trunk]. PMID- 3316798 TI - [The Hollander insulin test and its modification in evaluating the results of vagotomy]. PMID- 3316799 TI - [Creating an esophagogastric anastomosis in proximal resection of the stomach]. PMID- 3316800 TI - [The main principles of suture placement in the stomach and intestines]. PMID- 3316802 TI - [Formation of an anastomosis between the gastric stump and jejunum and its role in preventing postgastrectomy syndromes]. PMID- 3316801 TI - [Various disputable and unsolved problems of vagotomy in penetrating duodenal ulcer]. PMID- 3316803 TI - [Giant duodenal ulcers]. PMID- 3316804 TI - [Methods of preventing incompetence of duodenal stump sutures]. PMID- 3316805 TI - [Ultrasonic examination of children with fractures of the forearm bones]. PMID- 3316806 TI - [Ultrasonic examination in the diagnosis of developmental defects of the kidneys and the upper urinary tract in infants]. PMID- 3316807 TI - [Remote results of the postoperative treatment of megaureter in children by the plication method]. PMID- 3316808 TI - [Our experience in treating perforated duodenal ulcers by the Oppel'-Polikarpov method]. PMID- 3316810 TI - [Acute pyelonephritis]. PMID- 3316809 TI - [Ultrasonic follow-up of patients following extracorporeal lithotripsy of urinary stones]. PMID- 3316811 TI - [Serum enzyme changes in acute surgical diseases of the abdomen]. PMID- 3316812 TI - [Experimental and clinical use of the thermal mode neodymium:YAG laser]. AB - The neodymium:YAG laser may be used to advantage in the thermal mode for iridectomy. A variety of other tasks which are traditionally performed using the argon laser can also be efficiently carried out using this mode of operation. In this article the authors describe in particular the method of transscleral cyclophotocoagulation with the neodymium laser in the treatment of glaucoma, which is becoming increasingly popular. PMID- 3316813 TI - [Abnormal expression of HLA class II antigens in conjunctival epithelia in peripheral corneal ulcers]. AB - Inflammatory mediators originating at the limbus seem to play an important role in the pathogenesis of peripheral corneal ulcers. In this paper, the immunohistological results of conjunctival biopsies of patients with corneal ulcers are reported. The most important result was that an abnormal HLA class II expression was found. The expression of HLA-DR was stronger than that of HLA-DQ and HLA-DP. A model of ulcer formation involving T-cells and lymphokines is presented. PMID- 3316814 TI - [Magnetic resonance tomography in ophthalmology. I. Choroid melanoma]. AB - The value of magnetic resonance tomography (MRT) for the diagnosis of choroidal melanomas is illustrated with reference to 26 cases. The geometric dimensions of the tumors are in good agreement with findings obtained by ultrasonography. The relaxation time T2 varies between 85 and 120 msec in contrast to 145-210 msec in subretinal hemorrhages and 190-400 msec in secondary retinal detachments. In contrast to A-scan a differential diagnosis is possible even with lesions less than 1.5 mm in prominence. In solutions of melanin the relaxation time T2 decreases with increasing melanin concentration. This leads to an interpretation that the pigment content of the melanoma is responsible for the relatively short relaxation times. Thus, the relaxation time T2 is a useful factor in predicting metastasis. PMID- 3316815 TI - [Secondary retinal detachment in ultrasonography and computerized tomography]. PMID- 3316816 TI - [An experimental method of studying the changes in aqueous humor production]. PMID- 3316817 TI - [Effectiveness of Zovirax ointment in patients with viral keratitis]. PMID- 3316818 TI - [Treatment of chalazion by local injections of corticosteroids]. PMID- 3316820 TI - [Acute lung failure within the scope of multiple organ failure]. PMID- 3316819 TI - [From the bibliographer's files (XXX). 75 years ago]. PMID- 3316821 TI - [Single organ failure within the scope of intensive therapy--the brain]. PMID- 3316822 TI - [Pathophysiology of multiple organ failure]. PMID- 3316823 TI - [Cerebral complications in varicella: case report and review]. AB - We present the course of a varicella encephalomyelitis of a 6 1/2 year old boy and discuss the conceptions about etiology, symptoms and prognosis of the neurological diseases associated with varicella. PMID- 3316824 TI - [Chromosome aberrations in Prader-Willi-Labhart syndrome--critical review, documented by 4 unusual cases]. AB - Report on two males who exhibit a syndrome which reminds Prader-Willi-Labhart syndrome (PWLS) because of craniofacial dysmorphy, acromicria, hypogenitalism, obesity and mental deficiency. A supernumerary small marker chromosome was identified as duplication of the juxtameric parts of chromosome 15. In a 15 years old female and in a 4 years old unrelated male deletion of 15q1 is due to translocation with a chromosome 7 and 20 respectively subsequent to 3:1 distribution. Therefore both patients share partial monosomies of chromosome 15 but also of the other autosome involved. Various chromosomal aberrations in PWLS but mostly deletions of chromosome 15 either isolated or associated with translocation are summarized. Patients with a PWLS like syndrome and a marker chromosome consisting of juxtameric parts of chromosome 15 constitute a particular group which is delineated from PWLS but also from a large heterogeneous group of supernumerary marker chromosomes. PMID- 3316825 TI - The Dubowitz syndrome--one more case. AB - A boy with the Dubowitz syndrome is presented. This autosomal recessive disorder is characterized by variable degrees of intrauterine and postnatal growth retardation, microcephaly, mild mental retardation, hyperactivity, "eczema", characteristic facial appearance and combination of minor abnormalities. Thirty eight cases of this syndrome have been reported in the literature. Symptoms and difficulties in differential diagnosis are discussed. PMID- 3316826 TI - [Sonography of the hip in underweight premature infants]. AB - In a prospective study 120 hips of preterm babies below 2,000 g were investigated by ultrasound studies in order to determine the distribution of the types according to Graf's classification. Compared with unselected newborns, preterm babies show a significantly higher incidence of ultrasound types Ib and IIa. The distribution of the ultrasound types of the hips of both groups is compared. PMID- 3316827 TI - [Pubertas praecox in McCune-Albright syndrome--case report and review of the literature]. AB - A patient is presented with the syndrome of polyostatic fibrous dysplasia and precocious puberty (PP). The endocrinopathy in McCune-Albright-syndrome (MAS) has formerly been ascribed to a central (hypothalamic) origin. In this patient the PP was caused by a luteinized follicular cyst, suggesting autonomous hyperfunction of this gland. High serum estradiol levels returned to normal after cystectomie. The review of the literature suggests the peripheral origin of PP to be more frequent in younger age groups (under 6 years). It appears possible that peripheral hypersecretion of sexual steroids may cause a rise of gonadotropins secondarily followed by true PP in older children provided such longstanding hypersecretion leads to a generalized maturation of the body including skeletal maturation. Treatment in pseudoprecocious puberty seems to be not effective with LH-RH-analogues. Cyproteroneacetate alone or in combination with a LH-RH analogue gave the impression of being more successful. Cystectomy can lead to a cure but a recurrence of ovarian cysts is possible. A combination of surgical and drug therapy may be beneficial under these circumstances. Until now there is no sufficient treatment for polyostotic fibrous dysplasia. PMID- 3316828 TI - [Reduction of stomach size in the surgical treatment of alimentary constitutional obesity]. PMID- 3316830 TI - [Various forgotten and little-known facts in the history of studies on leptospirosis]. PMID- 3316829 TI - [Current evaluation of protective factors in the pathogenesis of peptic ulcer]. PMID- 3316831 TI - [Role of Campylobacter pyloridis in the etiology of gastritis and peptic ulcer]. PMID- 3316832 TI - [Homeostatic renal functions in chronic diffuse nephropathies]. PMID- 3316833 TI - [Clinico-pharmacological basis of interaction between drugs and food]. PMID- 3316834 TI - [Role of the kidneys in maintaining calcium homeostasis in hyperparathyroidism after allogeneic kidney transplantation]. PMID- 3316835 TI - [Proteolysis indicators in infectious-toxic shock and acute hepatic insufficiency]. PMID- 3316836 TI - [A dark period]. PMID- 3316837 TI - Advances in flow cytometry for diagnostic pathology. PMID- 3316838 TI - Differential distribution of immunoreactive S100-alpha and S100-beta proteins in normal nonnervous human tissues. AB - Differential distribution of alpha-subunit (S100-alpha) and beta-subunit (S100 beta) of S100 protein in nonnervous tissues was studied by employing the indirect peroxidase-labeled antibody method with monospecific antibodies to human S100 alpha or bovine S100-beta. It became clear that S100-alpha and S100-beta were more widespread than previously reported. In light of this study, together with the previous report describing quantitative differential distribution of S100 alpha and S100-beta (Kato K, Kimura S: Biochim Biophys Acta, 842:146, 1985), S100 alpha was localized at much higher levels in myocardial cells and slow-twitch muscle fibers, at high levels in renal tubules, chondrocytes, follicular cells of thyroid, exocrine cells of salivary, mammary, and eccrine sweat glands, and centroacinar and acinar cells of the pancreas. On the other hand, S100-beta was mainly localized in Schwann cells, chondrocytes, and adipocytes. There were several tissues showing a remarkable differential localization of S100-alpha and S100-beta; heart, skeletal muscle, exocrine tissues such as mammary gland, salivary gland, and pancreas, liver, kidney, testis, epididymidis, and lymphoreticular system. Based on the wide distribution and the characteristic differential localization, the possible biologic significance of S100 proteins and their application for diagnostic pathology were discussed. PMID- 3316839 TI - Rapid microwave fixation of human tissues for light microscopic immunoperoxidase identification of diagnostically useful antigens. AB - Microwave (MW) energy permits rapid tissue fixation for light and electron microscopy but its effects on antigen preservation have not been fully evaluated. We, therefore, fixed three samples of human skin, uterus, and cervix, and two samples of human colon and breast by MW irradiation (5 to 8 seconds) during simultaneous immersion in a dilute aldehyde mixture (2% formaldehyde and 0.05% glutaraldehyde). For comparison, similar portions of each specimen were fixed in formalin. Specimens were processed routinely and embedded in paraffin for light microscopy. Sections from each specimen were stained with hematoxylin and eosin and, by immunoperoxidase techniques, for epithelial membrane antigen, leukocyte common antigen, S-100 keratin, carcinoembryonic antigen, and factor VIII-related antigen, the latter three with and without preliminary trypsinization. Colon sections were also stained for chromogranin. In all cases, light microscopic morphology was comparable for tissues fixed by the MW method and formalin-fixed specimens, as was immunostaining for epithelial membrane antigen, leukocyte common antigen, S-100 protein, and chromogranin. Formalin-fixed tissues required trypsinization for optimal detection of keratin, carcinoembryonic antigen, and factor VIII-related antigen. In contrast, trypsin-pretreatment was not necessary to demonstrate these antigens in MW-fixed specimens and, in fact, resulted in tissue digestion. We conclude that this MW fixation method provides a means for rapidly fixing tissues for immunoperoxidase staining while preserving excellent light microscopic morphology. PMID- 3316840 TI - Walter Peyre Porcher, M.D., 1858-1919. PMID- 3316841 TI - L. Rosa Gantt, M.D. (1875-1935). PMID- 3316842 TI - On-line two-dimensional evaluation of ultrasonic integrated backscatter. AB - We describe an apparatus for the on-line evaluation of integrated backscatter from areas of tissue. The equipment is fully integrated into a B-mode ultrasonic system; there are therefore no new operating procedures to be learned. It provides a simultaneous display of conventional information, together with parameters of tissue characterization. The apparatus is fast and, over a broad diagnostic frequency range, may be used in conjunction with conventional equipment employing transducers. PMID- 3316843 TI - A new in vivo method for repeatedly studying gastric acid secretion and other secretory parameters in awake guinea pig. AB - A new model for measuring gastric secretory parameters in awake guinea pigs is described. A chronic cannula was surgically implanted in the stomach of each guinea pig. The rates of gastric secretion and changes in intragastric volume were measured using a dye dilution technique. In contrast to previous techniques in small laboratory animals, there was no collection of gastric juice via drainage, no oral intubation for aspiration was involved, no special or sophisticated equipment was used, no anesthesia was employed, and there was no stress associated with acute surgery. This method offers a valuable advantage by combining the chronic gastric cannula with a dye dilution technique in that the same animal can be used several times and finally, several gastric secretory parameters can be measured simultaneously. The animals were used from 3 weeks to 10 months after surgery and as many as 15 studies were performed on the same guinea pig. Samples were collected at 10-min intervals and analyzed for acid and dye concentration from which the onset and kinetics of gastric secretion were followed. Basal gastric secretion (11.8 +/- 1.6 mueq/kg/min; all mean +/- 1 SEM) was increased within 20 min after subcutaneous infusion of histamine (30 micrograms/kg/hr) and peaked by 40-60 min at a mean acid output rate of 41 +/- 3 mueq/kg/min. Histamine also increased the intragastric volume from 6.3 to 13.4 ml as it increased fluid output from 1.6 +/- 0.1 ml/10 min to 3.4 +/- 0.2 ml/10 min. The increase in acid output caused by histamine was inhibited by the H2 antagonists cimetidine (3 mumole/kg) and ranitidine at 0.5 mumole/kg. Omeprazole (1.2 mumole/kg), an H-K-ATPase inhibitor, almost abolished acid output under both basal and histamine-stimulated conditions. Thus, the present method is simple and suitable to study the physiology and pharmacology of gastric secretion in the guinea pig with a particular emphasis on the action of histamine. Furthermore, because of the species involved, there is also a significant economical advantage and the guinea pig can also be used as a potential model for studying experimental ulcer. PMID- 3316844 TI - A preliminary study of age-related difference in resistance to sepsis in the rat model. AB - Although the pathophysiology of intraabdominal sepsis is well established in the adult animal, there is a paucity of similar information in the newborn animal. Using the Wichterman (K.A. Wichterman, A.E. Baue, and I.H. Chaudry, Journal of Surgical Research 29: 189, 1980) model of intraabdominal sepsis, 42 Sprague Dawley suckling rat pups and 42 adults underwent cecal ligation followed by a single needle puncture of the cecum. Whereas a mortality of 47.6% was noted in the adult animals, only 7.1% of the suckling animals succumbed by the end of 1 week. After the ip LD50 of Escherichia coli was determined independently in each age group, appropriate doses of the bacteria were injected into the peritoneums of 36 suckling and 30 adult rats. The peritoneal fluid was aspirated at 0, 2, 4, 8, 24, and 48 hr and the bacterial concentration in the suspension was determined. The rate of bacterial clearance from the peritoneum of the suckling rats was found to be significantly greater at 2, 4, and 8 hr as compared with the adult animal. In vitro assay of the phagocytic activity of the peritoneal macrophages demonstrated a significantly higher activity in the cells obtained from the suckling rats than in those from the adult (P less than 0.05). A more efficient bacterial clearance and a higher phagocytic activity in the peritoneal macrophages of the suckling rats may contribute to the difference in the mortality between the two age groups. PMID- 3316846 TI - Autotransplantation for multiple renal lesions. PMID- 3316845 TI - Colorectal cancer in animal models--a review. AB - Colorectal cancer remains the second leading cause of cancer death in the western hemisphere. During the past several decades information regarding epidemiology, etiology and associated factors regarding colo-rectal cancer in humans has been collected through study of experimental colonic tumors in animal models. Much of this work has been influenced by the use of 1,2-dimethylhydrazine as the inducing carcinogen in susceptible populations of animals, although other specific carcinogens have been used. Through application of this experimental model, knowledge of dietary, immunologic, and bacterial factors has been realized in the etiology of colo-rectal cancer. This review details methodology and results of developing experimental models as they pertain to human colo-rectal cancer. PMID- 3316847 TI - Meningoencephalitis in a heart transplant recipient. PMID- 3316848 TI - Murine monoclonal antibody against aldosterone: production, characterization and use for enzymoimmunoassay. AB - Hybridomas secreting monoclonal antibodies to aldosterone were obtained by fusion of myeloma cells and spleen cells from Balb/c mice immunized with aldosterone-3 carboxylmethyloxime-bovine serum albumin. A monoclonal antibody was purified from ascites fluid and characterized. An affinity constant of 1.61 x 10(9) M-1 has been measured and no cross-reactivity with tetrahydroaldosterone (THA), cortisol, cortisone, corticosterone, deoxycorticosterone (DOC), dehydroepiandrosterone (DHA), progesterone and estrone, could be detected. A peroxidase conjugated antibody (1.5 mole of enzyme per mole of antibody) was obtained and used for microwell enzyme immunoassay and Immun-Blot assay. The high affinity and specificity of this antibody should make the direct determination of aldosterone in biological fluids possible at concentrations as low as 5 x 10(-10) M. PMID- 3316849 TI - Mesenteric artery embolization by an unsuspected aortic tumor: diagnostic evaluation and operative management. AB - Malignant tumor embolus recovered at the time of superior mesenteric artery embolectomy is an uncommon experience. A report of such a case is presented and the literature is reviewed. In this clinical setting, guidelines for further diagnostic evaluation are not well defined. We suggest an algorithm for the evaluation and management of these patients. In the near future, use of intraoperative angioscopy and the intravascular laser to eradicate the tumor may represent the optimal method of treatment. PMID- 3316850 TI - Graft versus host disease following transfusion of normal blood products to patients with malignancies. AB - A patient undergoing treatment with cytotoxic chemotherapy for Hodgkin's disease developed graft versus host disease (GVHD) following a transfusion of packed red cells. This is the 28th reported patient with a malignancy who did not have a bone marrow transplant and developed GVHD after transfusion of normal blood or blood products. All patients had received cytotoxic chemotherapy prior to acquiring GVHD. The underlying malignancies included lymphoma, acute leukemia, neuroblastoma, rhabdomyosarcoma, and glioblastoma. Twenty-three of the 28 patients died of GVHD. The incidence of transfusion-related GVHD in this patient population is low but the illness is often fatal as treatment is largely ineffective. Transfusion-related GVHD can be prevented by irradiating all blood products with 1500 rad prior to administration. PMID- 3316851 TI - An integrated approach to the pharmacological evaluation of traditional materia medica. AB - A triple-tiered working model is projected for the pharmacological evaluation of crude drugs prescribed in traditional medical practices. Of the proposed component tests and procedures, the majority have had their usefulness already validated in natural product pharmacological research. First-level investigations (herbalist consultations/professional attestations, hippocratic screening and literature surveys) provide first-hand pharmacological information about traditional materia medica. Second-level investigation comprising bioassay modelled tests (brine shrimp toxicity test, opiate receptor-binding studies, fertilized sea urchin egg test, platelet adenyl cyclase/phosphodiesterase assays, hexobarbital-induced sleeping time test, antimicrobial assays, isolated guinea pig ileum test and pharmacodynamic screening) are designed to extend the mode(s) of drug action suggested by the first-level procedures. Based on data from Level 1 and Level 2 findings, third-level experiments are specific tests tailored to confirm the pharmacodynamic/kinetic properties and clinical efficacy of traditional drugs. Level 2 and Level 3 tests may be combined in monitoring fractionations and subsequent isolation of unique crude drug constituents with potential application in conventional therapeutics. PMID- 3316852 TI - Monoclonal antibodies reveal the global organization of the cerebellar cortex. AB - Electrophysiological mapping of the rat cerebellar cortex has revealed an elaborate functional somatotopy that tract tracing procedures have shown to correlate with specific patterns of afferent and efferent connectivity that encompass the cerebellum as a whole. In contrast, most anatomical and biochemical procedures suggest that the cerebellar cortex is remarkably uniform. To unmask covert molecular heterogeneity underlying the functional map, it is appropriate to use monoclonal antibody technology to search for antigenic epitopes whose cerebellar distribution reflects or encodes the positional information. Given that no preconditions can be set on the biochemical nature of the putative epitopes, a shotgun approach to immunization and screening is required. The construction of monoclonal antibodies and screening for specificities that reveal positional information is discussed with examples from an anti-cerebellar antibody library. PMID- 3316854 TI - Developmental approaches to the analysis of vertebrate central pattern generators. AB - The isolated spinal cord of the chick embryo is a new preparation for analyzing the neural mechanisms and development of vertebrate motor activity. The embryonic cord can be isolated in vitro during the period of development when antagonist alternation of hindlimb motoneurons matures. The preparation is spontaneously active in vitro generating episodes of motor activity that can be recorded from muscle nerves and the ventral roots. The neural mechanisms responsible for the development and genesis of motor activity are being investigated using intra- and extracellular recording from motoneurons and electrotonic recordings of motoneuron synaptic activity from muscle nerves. The results suggest that alternating motor activity in the isolated chick cord may be generated by a mechanism in which a synaptically induced motoneuronal shunt conductance regulates the time of discharge of flexor and extensor motoneurons. PMID- 3316855 TI - [Insulin resistance in female patients with hirsutism]. PMID- 3316853 TI - In vitro CNS preparations: unique approaches to the study of command and pattern generation systems in motor control. AB - In vitro preparations of the nervous system, which were originally developed for investigations of invertebrate neural networks, have recently gained popularity for studying locomotor networks in the vertebrate nervous system. The nervous system is removed from the animal and maintained in a physiological bathing solution. These preparations can be induced to generate locomotor patterns in a number of ways and offer several unique advantages. The function of the motor networks can be manipulated by alterating the composition of the bath, and immobilization of the preparations, either by cutting ventral roots or bath application of curare, greatly facilitates intracellular recordings. In vitro preparations offer the opportunity to acquire the detailed information necessary for understanding vertebrate motor networks at the cellular level. This article reviews some of the many applications of in vitro preparations for studying vertebrate locomotor control using examples derived mainly from work on the lamprey. PMID- 3316856 TI - [Evaluation of the maintenance of cleanliness of insulin vials used by patients: a model study on handling of vials]. PMID- 3316857 TI - Reflections on the ISL. PMID- 3316858 TI - Detection of tyrosine protein kinase substrates in fresh leukemia cells and normal blood cells using an immunoblotting technique. AB - Kinases which phosphorylate proteins on tyrosine residues are of importance in the control of both normal and malignant cell proliferation. The receptors for a number of growth factors have intracellular domains with tyrosine protein kinase activity and several viral oncogenes code for tyrosine protein kinases. An abnormal tyrosine protein kinase has been implicated in the pathogenesis of chronic granulocytic leukemia. Using an immunoblot method and an antiphosphotyrosine antibody, we have detected substrates of tyrosine protein kinases in fresh human leukemia cells and normal blood and bone marrow cells. These substrates were present in all types of cells examined. Cells from patients with acute lymphoblastic leukemia, acute myeloid leukemia, and chronic lymphocytic leukemia contain prominent phosphotyrosine-containing protein bands with molecular weights in excess of 95 kDa. By contrast, chronic granulocytic leukemia cells, as well as normal bone marrow cells, lymphocytes, and monocytes, contain predominantly low molecular weight (less than 95 kDa) tyrosine kinase substrates. When lymphocytes were stimulated to enter cell cycle, however, high molecular weight substrates of similar molecular weights to those detected in acute lymphoblastic leukemia, acute myeloid leukemia, and chronic lymphocytic leukemia became prominent. The implications of these findings in the control of normal and malignant cell proliferation and differentiation are discussed. PMID- 3316859 TI - The first K. Prathap memorial lecture. The contribution of pathology in renal disease. PMID- 3316861 TI - The adolescent patient at discharge and in the post-hospitalization environment: a review. AB - Whereas only cursory mention has been made in the literature concerning adolescent behaviors in relation to impending hospital discharge, implicit is the belief that some evidence of upset continues to emerge following discharge. Adolescent reactions following discharge would appear to be individual and may be related to the medical and surgical procedures used and possibly the method of pre-hospital preparation. Behaviors ranging from a reluctance to leave the hospital to a number of psychological benefits of hospitalization for adolescent patients have also been reported. Although adolescent patients in one recent study (Denholm, 1986) did not show evidence of negative behavior following discharge, this should not minimize the reported reactions, thoughts, and behaviors of adolescents which may occur during the hospitalization. Nor should it imply that, in the light of reduced or absence of upset following discharge as found in one study, all preparation for surgical and medical procedures should cease. What is suggested is that at discharge, the adolescent may perceive the hospitalization experience as a particularly positive event and feel relieved and even pleased with having successfully completed this difficult process. Perhaps having adolescents focus on realistic expectations and return to normal behavior and activities prior to discharge may promote a higher degree of readiness for this event. Adjustment to discharge may also be facilitated by providing information to parents that there is evidence which suggests that some adolescents leave hospital with elevated self-esteem and demonstrate certain psychological gains. PMID- 3316860 TI - Comparative evaluation of two methods for the serological diagnosis of Chlamydia trachomatis infection. PMID- 3316862 TI - William S. Halsted: early American surgeon. PMID- 3316864 TI - [Is a control group necessary?]. PMID- 3316863 TI - [Generalized capillary hyperpermeability syndrome: a rare cause of hypovolemic shock and cyclic generalized edemas. Contribution of 2 cases]. PMID- 3316865 TI - [Heart transplant 1987]. PMID- 3316866 TI - [Osteoporosis: from pediatrics to geriatrics]. PMID- 3316867 TI - [Reactive arthritis]. PMID- 3316868 TI - [Progestogens and estrogens in high doses (hormone pregnancy tests): the risk of appearance of spina bifida and anencephaly]. PMID- 3316869 TI - [Panels of phenotyped donors in the HLA system. Current applications]. PMID- 3316870 TI - [Septic arthritis with microcrystals: a cause of diagnostic error]. PMID- 3316871 TI - [Pharmacological information and the drug industry. The role of its medical departments]. PMID- 3316872 TI - [Types of study]. PMID- 3316873 TI - [Endocarditis caused by Aspergillus fumigatus]. PMID- 3316874 TI - Effects of calcium antagonism on the resting and exercise-stimulated renin aldosterone axis. AB - The effect of short-term calcium antagonism with felodipine on blood pressure and on some biochemical plasma variables such as catecholamines, renin and aldosterone was studied in 10 normal volunteers at rest and during incremental bicycle exercise. At rest, diastolic blood pressure was slightly decreased during felodipine, whereas systolic pressure and heart rate were not significantly changed. The plasma noradrenaline concentration and plasma renin activity were increased during felodipine treatment; the plasma adrenaline and aldosterone concentrations on the contrary, were not significantly changed. The rises in plasma renin activity, plasma aldosterone and plasma adrenaline and noradrenaline concentrations produced by exercise were not significantly affected by felodipine. The plasma calcium concentration was significantly higher during felodipine treatment than during placebo and this was accompanied by an increased urinary calcium excretion. It is concluded that the rise in plasma renin activity during calcium antagonism with felodipine is not accompanied by a significant increase in plasma aldosterone. Furthermore, the present data suggest that, at least during exercise, calcium antagonism does not interfere with the mechanisms underlying the exercise-induced activation of renin and aldosterone release. PMID- 3316875 TI - A workingman's paradise? Reflections on urban mortality in colonial Australia 1860-1900. PMID- 3316876 TI - The early recognition of streptococci as causes of disease. PMID- 3316878 TI - The extended life course. Reflections on a multidisciplinary European symposium in Berlin, 26-28 November 1986. PMID- 3316877 TI - The medical activities of mid-nineteenth-century chemists and druggists, with special reference to Wakefield and Huddersfield. PMID- 3316879 TI - William John Ritchie Simpson (1855-1931): public health and tropical medicine. PMID- 3316881 TI - [Repeated antiviral therapy with acyclovir does not cause resistance]. PMID- 3316880 TI - Illustrations from the Wellcome Institute Library. Charles Joseph Singer, DM, DLitt, DSc, FRCP (1876-1960): papers in the Contemporary Medical Archives Centre. PMID- 3316882 TI - [Simplified colonic anastomosis]. PMID- 3316883 TI - [Consecutive series of 100 colonic resections with a modified continuous suture technic]. AB - Based on a consecutive series it is reported about a modified type of "continuous" suture on the colon, used especially in elderly patients for being a secure and prompt method of anastomosing. The rate of insufficiency and mortality, as far as the clinical relevance is concerned, turns out to be 2% each and there was no relation between mortality and insufficient anastomosis. The complication rate was 11%, whereby the urological complications predominated with 6% of the total. PMID- 3316884 TI - [Spontaneous and other non-tumor-induced esophageal perforations]. AB - The outcome of esophageal perforation is determined by the cause and localisation, but mainly by the time lapse between trauma and therapy. Spontaneous and intraoperative ruptures are most dangerous. Treatment of choice is direct closure and drainage. If this is not possible, esophagectomy or exclusion and diversion in continuity should be considered. The injury may present itself with rather unspecific symptoms. Pathological findings in the plain chest roentgenogram and gastrographin study will confirm diagnosis in nearly all cases. PMID- 3316885 TI - [Clinical, histologic and bacteriologic findings in peritonsillar abscess]. AB - Peritonsillar abscesses are the main complication of chronic inflammation of the tonsils. They should be considered as emergency cases and require quick and adequate treatment. Although abscess tonsillectomy has been reported since 1932, there is still a vivid discussion about this method of choice. We report on our experiences and findings in 284 cases of peritonsillar abscess. Our experiences show that theoretical considerations against this method of surgical treatment are smaller than the advantages for the patient. The authors recommend abscess tonsillectomy at one time and on both tonsils as treatment of choice in peritonsillar abscess without restriction. PMID- 3316887 TI - Primary lymphoma in the salivary glands: report of five cases and review of the literature. AB - The finding of a lymphoma in a major salivary gland could mean one of two things: either it is part of a disseminated process, or it is the first clinicopathologic evidence of lymphoma. In the latter instance, whether the disease originated in the glandular stroma itself or in a paraglandular lymph node and then invaded the stroma, the lymphoma is defined as primary, as long as there is no detectable disease outside the salivary gland. Five cases of primary salivary gland lymphomas are described. All had a complete clinical staging including chest x ray, bilateral bone marrow biopsy, liver-spleen scan, bilateral pedal lymphangiography and/or abdominal CT scan. There was no evidence of lymphoma outside the gland in any of the patients described; hence, these can be labeled as primary lymphomas of the salivary gland. Review of the literature suggests that this presentation of the disease is extremely rare. Although 324 cases of salivary gland lymphomas have been described in the literature, only six may be considered primary by our criteria. The remaining patients were either not adequately staged or had documented evidence of disease elsewhere at the time of diagnosis. The diagnosis of primary salivary gland lymphoma should not be made unless complete staging is performed. PMID- 3316886 TI - Comparison of polysomnography and sonography for assessing regularity of respiration during sleep in adenotonsillar hypertrophy. AB - Increasing awareness of the role of adenotonsillar hypertrophy in the etiology of chronic airway obstruction and disturbed respiration during sleep has created interest in the diagnostic methods available to assess the effects of obstruction. This study evaluates and compares simultaneously-obtained recordings of polysomnography and sleep sonography in children obstructed by adenotonsillar hypertrophy. Four hundred sixty-five 4-minute samples obtained from 18 patients in a clinical studies unit were analyzed and rated as to severity. Agreement between polysomnography and sleep sonography was very high in scoring the respiratory pattern (r = 0.79) and detecting apnea (r = 0.89). These findings demonstrate that sleep sonography is a reliable method for evaluating patients with upper airway obstruction due to adenotonsillar hypertrophy. PMID- 3316888 TI - Inserting and securing the nasogastric tube. PMID- 3316889 TI - Attenuation of D-1 antagonist-induced D-1 receptor upregulation by concomitant D 2 receptor blockade. AB - The effect of chronic selective D-1 and/or D-2 dopamine receptor blockade on regional D-1 receptor binding was studied in rat brain following chronic treatment with the specific D-1 antagonist SCH 23390 and/or the predominantly D-2 antagonist haloperidol. D-1 receptor density and affinity were evaluated by quantitative autoradiography using 125I-SCH 23982. Chronic SCH 23390 treatment increased D-1 receptor density by 30 to 40% in the striatum, accumbens and tuberculum olfactorium; receptor affinity remained unchanged. Haloperidol had no effect on D-1 receptor Bmax or Kd values, although, when administered with SCH 23390, reduced the D-1 receptor upregulation induced by the D-1 antagonist in striatum and tuberculum olfactorium, but not in nucleus accumbens. These results may be attributable to D-1/D-2 dopamine receptor interactions occurring in the striatum and tuberculum olfactorium and may have implications for the prevention and treatment of drug-induced extrapyramidal disorders. PMID- 3316890 TI - Mutagenicity testing of human milk from smokers and non-smokers in the Salmonella/microsome test. AB - Human milk was tested in the Ames plate incorporation test using strain TA98. Pools from smokers and non-smokers respectively, as well as individual samples from 14 smokers and 15 controls were tested. No difference was found between milk from smokers and non-smokers in the concentrations and volumes used. Preliminary to this a cigarette smoke condensate (CSC) was tested. The CSC was then incubated with human milk which was fractionated, concentrated and the different fractions tested for mutagenic activity. 98% of the mutagenic effect added (measured as number of revertants caused by an equivalent volume of CSC) was recovered 52% of the revertant colonies were recovered from the fat fractions, 40% from the skimmed milk and 8% from a precipitate. Breast milk was also incubated with C14 benzo(a)pyrene and then fractionated by density gradient ultracentrifugation. 97% of the radioactivity was found in the lipid fraction. PMID- 3316891 TI - Nicotinic receptor stimulation enhances enkephalin-like peptides processing in chromaffin cells. AB - Acute stimulation of chromaffin cells in cultures with acetylcholine (ACh), 1,1 dimethyl-4-phenylpiperazinium (DMPP), or high potassium gave rise to a significant increase in the release of [Met5]-enkephalin immunoreactive material (ME-IRM) into the assay medium. The cellular content of ME-IRM following the actual release induced by these secretagogues remained constant suggesting the replenishment of the cellular peptides. The repletion of the peptides may occur through an enhancement of the processing rate of the proenkephalin precursor. Furthermore, the increase in secretion as well as the repletion of the cellular ME-IRM were calcium-dependent and were inhibited by the nicotinic receptor antagonist, hexamethonium, but not by atropine. These results indicate that secretion and repletion of the peptides are tightly coupled and activated by nicotinic receptor stimulation. PMID- 3316893 TI - The role of exercise in blood pressure control. PMID- 3316892 TI - Immune electron microscopic demonstration of hepatitis B core antigen (HBcAg) in liver cell plasma membranes. AB - Immune light and electron microscopic examinations were carried out to investigate the localization of HBcAg in biopsies from patients with persistent HBs antigenemia. In biopsies with severe intralobular inflammation HBcAg was mainly observed in the cytoplasm of hepatocytes in contrast to nuclear localization in specimens with less severe histological changes. Immune electron microscopic examination demonstrated two different appearances of HBcAg, according to whether it was or was not associated with core particles. In biopsies with more severe parenchymal damage, an increased amount of non particulate HBcAg was observed in the cytoplasmic matrix; four such biopsies with intracytoplasmic HBcAg also revealed HBcAg on the plasma membrane of the hepatocytes. These findings support the concept that HBcAg may function as a viral target antigen for the immune response in type B hepatitis. PMID- 3316894 TI - Incidental appendectomy: the controversy. PMID- 3316895 TI - Inaugural George Entwisle lecture in hypertension: the comparative impact of diastolic and systolic blood pressure on cardiovascular risk. PMID- 3316897 TI - [History of the opening of the 1st x-ray facility in the Urals]. PMID- 3316896 TI - Heart transplantation: the Johns Hopkins Hospital experience. PMID- 3316898 TI - [Whole-body therapeutic gamma-irradiation using a dose of 3 Gy in acute leukemia- hematologic and clinical aspects of the bone marrow syndrome]. AB - The authors described the time course of changes in the peripheral blood of 18 patients with acute leukemia exposed to total-body single gamma-therapeutic irradiation in a dose of 3 Gy at the stage of complete remission of leukemia. Proceeding from the number of neutrophils the authors defined 3 types of hematological response to irradiation. They also described cytopenic complications and means and methods of maintenance therapy. An attempt was made to modify radiation myelosuppression and to assess the results of the use of cytosine arabinoside in 4 patients who had received the drug in a single dose of 2 g 5-7 days before irradiation. PMID- 3316899 TI - [Acute radiation effects in victims of the accident at the Chernobyl nuclear power station]. AB - Observation made over 115 patients with acute radiation sickness due to exposure to external gamma- and beta-rays confirmed high efficiency of the earlier proposed principles of prognostication of the degree of severity by clinical manifestations of the primary disease response and those of separate syndromes, using the methods of hematological and cytogenetic analyses. Out of 115 victims, 56 persons had radiation burns (RB), 17--intestinal syndrome (IS), 80- oropharyngeal syndrome (ORS), 7--interstitial radiation pneumonitis (IRP). In thanatogenesis, of prime importance were: RB (more than 40% of the body surface)- 19 persons and IRP--7 persons. A severe course of intestinal and oropharyngeal syndromes was combined with other fatal manifestations of radiation injury. Early isolation of patients (II-IV stages), selective decontamination of the intestine, prescription of a wide spectrum antibiotics, antimycotic and antiviral drugs, as well as gamma-globulin could practically remove the risk of the development of fatal infectious complications during a medullary and transitory forms of radiation sickness. PMID- 3316900 TI - [Dynamic scintigraphy with 99mTc-DTPA in the differential diagnosis of arterial hypertension]. PMID- 3316901 TI - [Clinical aspects of multifractionation]. PMID- 3316902 TI - A tape-based system of interactive video for computerised self-instruction. PMID- 3316903 TI - Influence of exercise and quiet rest on state anxiety and blood pressure. AB - A series of investigations was performed in which Ss rested quietly for 40-min and performed aerobic exercise on separate occasions. Blood pressure (BP) and state anxiety were assessed prior to and following the conditions. In the first experiment, 15 normotensive Ss were assessed during the 3-h following the treatments. The results revealed that state anxiety and BP were reduced following both conditions. The exercise-induced BP reductions remained significant for 2 to 3 h (P less than 0.05), whereas the BP reductions returned to baseline within 20 min following cessation of quiet rest. The second experiment involved an evaluation of the effects of exercise and quiet rest on 15 pharmacologically controlled hypertensive Ss. A significant reduction in systolic BP (P less than 0.05) was observed following exercise and quiet rest. State anxiety was reduced following quiet rest and exercise (P less than 0.05). It is concluded that exercise and quiet rest have similar effects on state anxiety, and both conditions are followed by a transitory reduction in blood pressure. These anti anxiety effects, however, are sustained for a longer period following exercise. PMID- 3316904 TI - Effect of different post-exercise sugar diets on the rate of muscle glycogen synthesis. AB - The effect of repeated ingestions of fructose, sucrose, and various amounts of glucose on muscle glycogen synthesis during the first 6 h after exhaustive bicycle exercise was studied. Muscle biopsies for glycogen determination were taken before and after exercise, and every second hour during recovery. Blood samples for plasma glucose and insulin determination were taken before and after exercise, and every hour during recovery. When 0.35 (low glucose: N = 5), 0.70 (medium glucose: N = 5), or 1.40 (high glucose: N = 5) g.kg-1 body weight of glucose were given orally at 0, 2, and 4 h after exercise, the rates of glycogen synthesis were (mean +/- SE) 2.1 +/- 0.5, 5.8 +/- 1.0, and 5.7 +/- 0.9 mmol.kg 1.h-1, respectively. When 0.70 g.kg-1 body weight of sucrose (medium sucrose: N = 5), or fructose (medium fructose: N = 7) was ingested accordingly, the rates were 6.2 +/- 0.5 and 3.2 +/- 0.7 mmol.kg-1.h-1. Average plasma glucose level during recovery were similar in low glucose, medium glucose, and high glucose groups (5.76 +/- 0.24, 6.31 +/- 0.64, and 6.52 +/- 0.24 mM), while average plasma insulin levels were higher with higher glucose intake (16 +/- 1, 21 +/- 3, and 38 +/- 4 microU.ml-1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316906 TI - American College of Sports Medicine position stand on the prevention of thermal injuries during distance running. PMID- 3316905 TI - Select cardiovascular and metabolic responses of diabetic rats to moderate exercise training. AB - The combined influence of diabetes and moderate treadmill exercise training on select metabolic and cardiovascular parameters was investigated with mature male Sprague-Dawley rats assigned to either control diabetic or diabetic groups receiving exogenous insulin. Experimental diabetes was induced with streptozotocin (80 mg.kg-1, i.v.) and verified by blood glucose concentrations greater than 16 mmol. The animals were designated as control, insulin-injected (5 U.kg-1, twice daily), or saline-injected (twice daily), and assigned to either non-trained or trained sub-groups. Insulin treatment partially restored the measured physiological functions to within normal limits. All animals were trained at 60 to 70% maximal oxygen consumption for 9 wk and exhibited higher maximal oxygen consumption values and cytochrome oxidase activity of the soleus muscles. Diabetes caused lower (P less than 0.05) reductions in resting heart rate but training-induced bradycardia did not occur in any group. Heart rate response to atropine sulfate (1 mg.kg-1, atrial choline acetyltransferase activity, atrial acetylcholine concentration, and quinuclidinyl benzilate binding was measured to evaluate changes in the parasympathetic nervous system. Atropine induced cardiac acceleration was most pronounced in control and least effective in diabetic animals. Endurance training had no meaningful influence on this response to cholinergic inhibition. Quinuclidinyl benzilate binding for the diabetic and the diabetic groups receiving insulin revealed no change in receptor number, receptor affinity, or training effects. These findings indicated that 9 wk of exercise training improves the aerobic capability of insulin-deficient rats without changing cardiovascular characteristics associated with the parasympathetic nervous system. PMID- 3316907 TI - American College of Sports Medicine position stand on the use of anabolic androgenic steroids in sports. PMID- 3316908 TI - American College of Sports Medicine position stand on blood doping as an ergogenic aid. AB - Blood doping is an ergogenic procedure wherein normovolemic erythrocythemia is induced via autologous (i.e., re-infusion of athlete's own blood) or homologous (i.e., transfusion of type matched donor's blood) red blood cell (RBC) infusion (11, 27, 28, 34). The resultant hemoconcentration increases arterial oxygen concentration (Ca)2) (9, 23). During peak exercise, oxygen delivery [cardiac output (Q)xCaO2] to skeletal muscle is enhanced, improving maximal oxygen uptake (VO2max) and endurance capacity (9, 28, 29, 31). Such terms as blood boosting, blood packing, and induced erythrocythemia are also variously used to describe this ergogenic procedure (11, 34). It is the position of the American College of Sports Medicine that the use of blood doping as an ergogenic aid for athletic competition is unethical and unjustifiable, but that autologous RBC infusion is an acceptable procedure to induce erythrocythemia in clinically controlled conditions for the purpose of legitimate scientific inquiry. PMID- 3316909 TI - Self-regulation of sport performance. AB - All serious sport participants must engage in goal-directed behaviors in the relative absence of immediate external constraints (i.e., self-regulation). Psychologists have developed theoretical models of self-regulation and produced principles of self-regulation that are summarized by the models. These concepts apply directly to sport performance. The purpose of this paper is to review the most relevant concepts in self-regulation and show how they impact on sport psychology. Several studies are reviewed which have used self-regulatory concepts to help both elite and ordinary athletes improve their performance. For example, the research indicates that when performance is difficult (e.g., at low and moderate skill levels), performance can be improved by keeping track of successes while performing or while viewing videotapes of one's own performance. Keeping track of instances of inadequate performance may prove detrimental except if the tasks being monitored are extremely easy or routine. How to apply this principle and others to sport performance is discussed. PMID- 3316910 TI - A meta-analytic review of aerobic fitness and reactivity to psychosocial stressors. AB - The effects of aerobic fitness on resistance to psychosocial stressors are reviewed. To unravel the inconsistent results in studies examining the relationship between aerobic fitness and psychosocial stress response, a meta analysis was conducted. The results of 34 studies having 92 effect size estimates from 1,449 subjects were statistically combined to compare psychosocial stressor tasks and arousal measures. The average effect size estimate of 0.48 was significantly different from zero (P less than 0.01), indicating that aerobically fit subjects had a reduced psychosocial stress response compared to either control group or baseline values. The test for the homogeneity assumption showed that it could not be rejected, and thus none of the proposed moderating variables altered the aerobic fitness-psychosocial reactivity relationship. Various underlying mechanisms which may contribute to this response are discussed, and future research directions are presented. PMID- 3316911 TI - In vitro methods for the analysis of motor function in the developing spinal cord of the chick embryo. AB - The isolated spinal cord of the chick embryo spontaneously generates episodes of motor activity in vitro that can be recorded from muscle nerves and ventral roots. In vitro systems provide stable conditions for intra- and extra-cellular recordings and enable pharmacological and ionic manipulations of the neuronal environment. Studies of motor activity generated by isolated spinal cord have revealed the existence of co-ordinated motor output from early in development, in which antagonist motoneurons alternate in their activity and synergists are co active. Intra-cellular recordings from single neurons and electronic recordings from muscle nerves have provided insight into the mechanism of flexor and extensor alternation. These studies have revealed that flexor and extensor motoneurons receive a similar de-polarization during each cycle of motor activity, but that the two classes of motoneuron process the de-polarization differently. Flexors fire late in each cycle whereas extensors fire early, which leads to a pattern of alternation. The cellular mechanisms responsible for the differences in the firing behavior of flexor and extensor motoneurons are currently being investigated using techniques that are only possible using the in vitro preparation. PMID- 3316912 TI - Role of trophic factors in muscle differentiation. AB - Muscle genes are developmentally regulated. In vivo, the differential expression of muscle structural genes during myogenesis is controlled in complex ways by extrinsic factors and by a pre-determined genetic program. Terminal differentiation, which is achieved when differentiated myoblasts fuse to form multi-nucleated myotubes, appears mainly regulated by intrinsic factors. Environmental components, on the other hand, play a significant role in the developmental regulation of genes during the course of muscle fiber maturation. In culture, the differential expression of muscle genes is assumed to be solely controlled by intrinsic genetic factors, in the sense that, once precursors cease to proliferate and are committed to become myoblasts, they inevitably progress through terminal differentiation, whatever the environment. The system lacks the necessary elements to proceed towards fiber maturation. Consequently, muscle culture models have, until recently, been limited in studies dealing with the roles played both by genetic and environmental factors in the regulation of muscle gene expression. The accumulating data, however, suggest that under given culture conditions, it is becoming possible to make cells mature beyond embryonic stages and express specific phenotypes in response to extrinsic factors. This paper reviews some of the progress in the development of culture systems which will be useful in studies of muscle plasticity. PMID- 3316913 TI - Motion into mass: how does tension stimulate muscle growth? AB - Tension is an important regulator of skeletal muscle hypertrophy in vivo. When increased constant tension is applied to embryonic skeletal muscle fibers differentiated in a tissue culture environment, many of the same biochemical processes associated with muscle hypertrophy in vivo are also stimulated in vitro, e.g., sodium-dependent amino acid transport, Na+,K+-ATPase (sodium pump) activity, protein synthesis, total protein, and myosin heavy chain accumulation. The molecular mechanisms by which tension induces these growth-related changes are unknown, but several models have been tested using whole animal, organ cultured muscle, and tissue culture model systems. In tissue culture, activation of the plasma membrane sodium pump is closely coupled to, and essential for, stretch and serum-induced skeletal muscle growth. Long-term membrane hyperpolarization is not associated with this sodium pump activation, and muscle growth in vitro is unrelated to the myotube's resting membrane potential, since growth can occur under de-polarizating conditions. Medium growth factors are essential for stretch-induced muscle growth in tissue culture. In medium without growth factor supplements, stretch is able to reduce the rate of atrophy of the cultured muscle cells which are in negative nitrogen balance, but the muscle cells are unable to grow in response to stretch without the presence of some as yet undefined growth factor or factors present in serum. As newer tissue culture environments are designed for growing embryonic skeletal muscle under more in vivo-like conditions, a more complete analysis of the mechanisms by which a physical stimulus (tension) is translated into the biochemical alterations leading to muscle growth will be possible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316914 TI - Amino acid and protein metabolism during exercise and recovery. AB - The integrated use of several energy sources allows high muscular power outputs to be sustained. Muscle glycogen provides the major fuel source for muscular exercise, but other fuels can provide alternative energy sources which allow for muscle glycogen-sparing and an increased potential for prolonged high metabolic rates. Blood-borne glucose, derived from liver glycogenolysis and glyconeogenesis, as well as intra-muscular lipids and plasma free fatty acids derived from adipose tissue provide the main energy alternatives to muscle glycogen. Several amino acids, including the essential amino acid leucine, are also used directly as oxidizable fuels during exercise. Depending on the duration and intensity of exercise and other factors such as glycogen stores and energy intake, amino acids can provide from a few to approximately 10% of the total energy for sustained exercise. Additionally, many amino acids can be converted to glutamate (via glutamate dehydrogenase) and then to alanine (via glutamate pyruvate transaminase). Alanine, along with lactate and pyruvate, are recognized as the major gluconeogenic precursors. Via this mechanism, several amino acids play crucial roles in providing the carbon sources for maintaining blood glucose homeostasis during exercise and glycogen restitution during recovery. And finally, during exercise and recovery, amino acids likely play important anaplerotic functions sustaining the whole metabolic apparatus. PMID- 3316915 TI - Whole-body protein utilization in humans. AB - Recently, several authors have recommended protein intakes as high as 2 to 3 g X kg body weight-1 X d-1 for physically active individuals. Review of the literature cited to support this recommendation, as well as other published and unpublished work, suggests that there are at least three variables which have not been sufficiently controlled or investigated in much of the research done, making such a recommendation premature. These variables are timing of sampling relative to initiation of an exercise program (training), energy and protein intake associated with activity, and intensity of exercise performed. Several investigators report a 12- to 14-d adaptation period following initiation of an activity program during which nitrogen (N) balance falls and then returns near to equilibrium. Data collected during this adaptation period can be expected to reflect a more negative N balance than data collected after that time. Butterfield and co-workers have found that exercise at 40 to 50% of maximal oxygen consumption actually promotes N retention in previously untrained men given sufficient time to adjust to the new exercise regimen, allowing maintenance of N equilibrium on a marginal protein intake. Energy intake, energy balance, and quantity of protein ingested inter-act in this effect. Finally, recent experiments suggest that, at high intensity activities, energy balance becomes even more critical in the utilization of protein: when energy balance is negative, an intake of protein as high as 2 g X kg body weight-1 X d-1 may be inadequate to maintain N equilibrium in previously trained individuals exercising at 64% of maximal oxygen consumption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316917 TI - Protein and exercise: update 1987. AB - Currently, the recommended dietary allowance for protein determined for sedentary individuals is assumed to be adequate for athletes. However, several types of evidence (in vitro, in situ, and in vivo) indicate that exercise causes substantial changes in protein metabolism. In fact, recent data suggest the protein recommended dietary allowance may actually be 50 to 100% higher for individuals who exercise on a regular basis. Optimal intakes, although unknown, may even be higher, especially for individuals attempting to increase muscle mass and strength. The reasons why the recent experimental results contradict older studies are complex and not fully understood. However, dietary (total energy input, percent of each foodstuff, accommodation to treatments), exercise (type, frequency, intensity, duration, training, environment), and methodological (in vitro, in situ, in vivo) considerations are likely very important. This paper reviews the recent findings and discusses their implications to exercise performance. Although, definitive recommendations regarding optimal protein intakes for various athletic groups are not yet possible, it appears that exercise increases protein needs. It is hoped that well-controlled studies will be completed in the near future so that such recommendations will soon be possible. PMID- 3316916 TI - Protein degradation during endurance exercise and recovery. AB - During endurance exercise, there is a net breakdown of body protein and the amino acids so mobilized are available for increased rates of oxidation and gluconeogenesis. At least part of the net loss of protein is due to a decrease in the rate of protein synthesis during exercise. Liver protein degradation is increased during exercise as a result of autophagy and proteolysis of cell material inside the secondary lysosomes. The rate of degradation of contractile proteins is decreased during exercise but is increased during the recovery period if the exercise is of high intensity and of long duration. Preliminary evidence suggests that the rate of degradation of non-contractile proteins in muscle may be increased at the same time that contractile protein degradation is decreased. PMID- 3316918 TI - Nutritional concerns: need for iron. AB - Depletion of iron stores is frequently seen in male and female distance runners. Possible causes of this iron depletion include inadequate iron intake especially among females and increased iron excretion through sweating and gastrointestinal blood loss. Animal studies suggest that iron deficiency without anemia can reduce endurance by lowering tissue cytochromes and the activity of certain muscle tissue enzymes. Iron supplementation appears to be beneficial in reducing blood lactate concentrations following heavy exercise. The amount of iron in the supplement appears to influence the amount of increase in hemoglobin and serum ferritin. PMID- 3316919 TI - Psychological characteristics of elite young athletes. AB - The psychological aspects of youth sports participation is one area of research that has been identified as important by parents, coaches, and sport psychology researchers. Unfortunately, little research has been conducted on this topic with elite young athletes. This paper briefly reviews the psychological research on children in sport in the areas of participation motivation and psychological stress and then focuses on the psychological research with elite young athletes. The last section of the paper discusses issues and recommendations for studying the elite young athlete. PMID- 3316920 TI - 31P nuclear magnetic resonance study of acute renal dysfunction in rat kidney transplants. AB - 31P NMR spectroscopy was used to study renal allografts in rats subjected to allograft rejection, cyclosporine toxicity, ischemia, and ureteral obstruction. Parameters of relative peak areas and intracellular pH were accurately distinguished among the different causes of graft dysfunction. Ureteral obstruction was clearly identified by elevations in the phosphodiester/urine phosphate peak. Ischemia and rejection were both associated with increases in inorganic phosphates and phosphomonesters and decreases in the beta-phosphate peak of adenosine triphosphate but were distinguishable from each other by differences in intracellular pH which was normal in rejected allografts (7.33 +/- 0.07, n = 3) but low in ischemic allografts (7.00 +/- 0.05, n = 3, P less than 0.05). Grafts insulted with cyclosporine toxicity were not distinguishable from normal allografts by any of the parameters studied. These data suggest that 31P NMR spectroscopy may have potential clinical application in differentiating among the causes of graft failure of human renal allografts. PMID- 3316921 TI - Neurologic manifestations of AIDS. AB - An understanding of the biologic characteristics and cellular tropism of human immunodeficiency virus (HIV) is critical to appreciate the diverse neurologic manifestations of HIV infection in patients with the acquired immunodeficiency syndrome (AIDS). Only carefully designed prospective studies can provide information regarding prevalence, incidence, and natural history of the full spectrum of neurologic complications of HIV infection. A degree of tropism for monocyte/macrophages and possibly for cells within the CNS seems certain. One of the most frequent complications is AIDS-related dementia, which reflects central nervous system invasion by HIV. Despite the evidence linking unchecked viral replication within the brain and progressive dementia, the basic pathogenetic mechanisms remain obscure. Further characterization of the cellular targets of HIV within the brain, and the mechanisms which ultimately lead to the dementia, is critical. The demonstration that HIV enters the central nervous system during the earliest stages of infection has major implications for antiviral agents which must penetrate brain parenchyma to clear the virus effectively. Other neurologic complications occur frequently, including myelopathies, peripheral neuropathies, opportunistic CNS infections, and CNS neoplasms. Many of these disorders are novel and incompletely characterized and their etiology is uncertain. While treatment is available for several of these conditions, it is generally not curative, and is often poorly tolerated because of adverse effects. Research directions will focus on better understanding of pathogenetic mechanisms, on earlier and more precise detection of these diverse conditions, and on improved therapeutic agents. For the future, efforts toward the development of a safe, effective vaccine are of critical importance. There are, however, already up to 2 million individuals in the United States who are already infected with HIV and who are thus at risk for developing 1 or several of these neurologic complications. Vaccination, even if it were available now, is not likely to benefit these individuals. While it is hoped that only a fraction of this infected population will develop neurologic symptoms, the prospects of an epidemic of AIDS-related dementia are ominous, particularly as antiviral therapy alone is unlikely to either eradicate the virus or restore brain function. In Africa and worldwide the numbers at risk for HIV-related diseases are enormous, and the risk factors for transmission of HIV less well defined. There, economic and medical resources are less than adequate to deal with a problem of this magnitude. PMID- 3316922 TI - Spontaneous bacterial peritonitis. A review of pathogenesis, diagnosis, and treatment. AB - Spontaneous bacterial peritonitis (SBP) is an increasingly recognized complication of cirrhosis with ascites. However, the presence of ascites from any cause appears to be a risk factor for this infection. The etiology of SBP is multifactorial, including derangements in the reticuloendothelial system, abnormalities of both the serum and ascitic fluid humoral immune systems, and systemic bacteremia. Gram-negative enteric pathogens are the etiologic agents in 70% of the cases; anaerobes are an uncommon cause. Fever and abdominal pain are the most common presenting symptoms. However, asymptomatic patients are being increasingly recognized. When SBP is suspected, paracentesis is indicated. An absolute polymorphonuclear leukocyte count greater than 500/mm3 is highly suggestive of SBP. Ascitic fluid lactate and pH may offer additional diagnostic assistance when the PMN count is ambiguous. Appropriate antibiotic therapy should be initially based on the centrifuged Gram stain of ascites as well as the patient's renal function. Mortality is substantial and appears to be related to the severity of the underlying liver disease. PMID- 3316923 TI - A comparison of amebic and pyogenic abscess of the liver. AB - We evaluated the clinical features of 96 cases of amebic liver abscess and 48 of pyogenic hepatic abscess. Most patients with amebic abscess were young Hispanic males. Those with pyogenic abscess were older, without any ethnic predominance. Symptoms tended to be acute and localized to the right upper quadrant in amebic infection. In pyogenic disease, symptoms were often nonspecific and chronic in nature. A marked shift to the left of the leukocyte count occurred more frequently in pyogenic abscess, as did markedly abnormal values of the serum albumin, direct bilirubin, lactic dehydrogenase and aspartate aminotransferase. Sonography detected all cases of amebic abscess and missed the lesions in 2 of 39 patients with pyogenic abscess. Abscess cultures yielded pathogens in 90% of cases of pyogenic disease, while blood cultures were positive in 50%. Five of 20 patients with positive blood cultures had additional organisms isolated from the abscess that would have required adjustment of antibiotics for optimal coverage. We believe that all pyogenic abscesses should be aspirated to guide antibiotic therapy. In amebic abscess, the diagnosis was usually based on clinical and sonographic findings, aspiration being performed in only 14% of cases. Ninety eight percent of patients were treated with amebicidal agents alone, and all responded to therapy. Therapeutic needle aspiration is rarely necessary. In pyogenic abscess, prolonged fever was common during medical therapy. Even in those eventually cured without surgery, the median time to defervescence was 8 days. Though 19 patients underwent surgical drainage, only 2 clearly did not benefit from medical treatment, having high fevers after more than 2 weeks on a regimen of appropriate antibiotics. Surgery is often performed prematurely because physicians expect fever to resolve quickly, but persistent fever of less than 2 weeks' duration should not constitute an indication for surgical drainage. Seven patients with pyogenic abscess died, 5 as a result of hepatic abscess. In 3 of these cases, the diagnosis was unsuspected till autopsy. Improved awareness of this disease may decrease morbidity and mortality from this treatable condition. PMID- 3316924 TI - Glucose uptake in human adipose tissue. AB - One hundred grams of glucose with 50 microCi U-14C-glucose were given orally to 17 women with widely varying amounts of body fat. Radioactivity and glucose metabolism in vitro were then measured in adipose tissue obtained by needle biopsies in the abdominal and femoral regions after four hours. Radioactivity in triglycerides was then measured in repeated biopsies 1 day, 1 week, and monthly up to 7 months after glucose administration. Glucose label in triglycerides after four hours was higher in abdominal than femoral adipocytes in obese women. It increased slightly during the following week, and then decreased exponentially with a half-life of 12 months in the abdominal region and 19 months in the femoral region. Uptake of glucose carbon in total body fat was estimated from the triglyceride label measured and determinations of body fat mass, and found to be in the order of less than 4% of given glucose. The studies in vitro suggested that much of the glucose taken up in adipose tissue is converted to lactate. If this is the case in vivo, then glucose uptake in adipose tissue might well be of significance for total body glucose homeostasis, particularly in obese subjects, amounting to maximally perhaps one third to one half of the oral glucose given. The majority of this glucose uptake would then, however, leave adipose tissue again as lactate. The shorter half-life of label in abdominal adipocytes is in agreement with findings of increased lipolysis in these adipocytes in vitro. PMID- 3316927 TI - Use of immobilized Achromobacter protease I for semisynthesis of human insulin. PMID- 3316925 TI - Abnormal glucoregulation during exercise in type II (non-insulin-dependent) diabetes. AB - We studied the effects of exercise on the levels of plasma glucose and glucoregulatory hormones before and after 6 weeks of thrice-weekly physical training in 20 sedentary type II (non-insulin-dependent) diabetic patients and 11 control subjects matched for previous physical activity. Parameters were measured at rest, after 30 minutes of bicycle exercise at 70% to 75% of maximal oxygen uptake, and after 30 minutes of recovery. In the untrained state exercise resulted in a decrease in plasma glucose levels in diabetics but not in controls (-12 +/- 5 v + 4 +/- 2 mg/dL, P less than .01) and the expected drop in plasma insulin level was absent in diabetics. These differences in glucose and insulin response persisted after physical training. There was a tendency for patients with diabetes to have a smaller R-R interval variation during deep breathing, an abnormal resting heart rate response to physical training, and a lesser increment in plasma epinephrine levels following exercise, findings consistent with autonomic dysfunction. Physical training resulted in a blunting of the exercise induced increment of plasma epinephrine, growth hormone, and lactate levels in control subjects, but not in diabetics. Our data demonstrate a hypoglycemic effect of exercise in mildly hyperglycemic nonobese type II diabetics. Possible causative factors include: hyperglycemia per se, a lack of physiologic suppression of plasma insulin, and abnormalities of autonomic or hypothalamic regulatory function. PMID- 3316926 TI - In vivo glucose metabolism in the awake rat: tracer and insulin clamp studies. AB - The goals of this study were twofold: (1) to determine the in vivo dose-response relationship in the conscious, unstressed rat between the plasma insulin concentration and total body glucose uptake, and between plasma insulin and suppression of endogenous glucose production; and (2) to develop a physiologic compartmental model to describe the kinetics of plasma glucose in the rat in the basal state. In order to perform repeat insulin clamp studies in the same rat, chronic catheters were implanted in the aortic arch (via the carotid artery) and in the cardiac atrium (via the jugular vein), exteriorized, and fixed to the back of the skull with a dental cement cap. Insulin was infused at rates of 1.2, 2.4, 4.8, 12, and 24 mU/min.kg, and the plasma glucose was held constant at the basal level by a variable glucose infusion (euglycemic insulin clamp). The resulting steady-state plasma insulin concentrations ranged from 40 to 1,300 microU/mL. The dose-response curve for glucose uptake was sigmoidal in shape: in the basal state, total glucose utilization averaged 6.8 mg/min.kg at an insulin concentration of 9 microU/mL, half-maximal glucose uptake (18.3 mg/kg.min) occurred at a plasma insulin concentration between 70 and 80 microU/mL, and maximal uptake (36.6 mg/kg.min) was seen at an insulin level in excess of 100 microU/mL. Residual endogenous glucose production was evaluated by a prime continuous infusion of (3-3H)-glucose. The dose-response curve for suppression of endogenous glucose output also was sigmoidal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3316928 TI - Peptide synthesis using immobilized proteases. PMID- 3316929 TI - Activity and conformation of enzymes in reverse micellar solutions. PMID- 3316930 TI - Equilibrium and kinetically controlled synthesis with enzymes: semisynthesis of penicillins and peptides. PMID- 3316931 TI - Nonseparation enzyme channeling immunometric assays. PMID- 3316932 TI - Identification of receptor proteins for type-alpha transforming growth factor. PMID- 3316933 TI - Radioimmunoassay of somatomedin C/insulin-like growth factor I. PMID- 3316934 TI - Assay of mitogen-induced effects on cellular incorporation of precursors for scavenger, de novo, and net DNA synthesis. AB - In summary we have presented data on [3H]dThd incorporation into DNA for a positive and negative growth modulator. These data clearly do not correspond to those based on net DNA synthesis (ortho[32P]phosphate incorporation into purified DNA) and previous knowledge of the effects of these hormones on cell number and cellular DNA accumulation. The paradox was resolved by directly analyzing effects of hormones on de novo pyrimidine biosynthesis. E2 stimulated both de novo and scavenger pathways in the first wave of DNA synthesis and only de novo in the second (and subsequent) waves. In contrast, tam progressively inhibited de novo pyrimidine biosynthesis. These hormonal effects on intracellulr pyrimidine pool sizes rendered [3H]dThd incorporation data by itself uninterpretable. [3H]dThd is a useful measure of DNA synthesis only if verified by independent measures of net DNA synthesis for the same time course and treatment conditions. In addition it may prove beneficial in various experimental systems to develop direct assays of de novo pyrimidine biosynthesis to assess mitogen effects. The experiments presented may also prove to be useful in evaluating the effects of mitogens and antimitogens on cells synchronized in the cell cycle by any of a variety of means. PMID- 3316935 TI - Assay of growth factor stimulation of fluid-phase endocytosis. PMID- 3316937 TI - A new simple method for biotyping Candida albicans. AB - A simple method which allows rapid, reproducible biotyping of Candida albicans isolates, and is suitable for use in any diagnostic medical microbiology laboratory is described. This system comprises three tests, the API ZYM system, the API 20C system, and a plate test for resistance to boric acid. The system differentiated a possible 234 biotypes, of which 33 were found amongst the 130 isolates of C. albicans taken from oral, genital and skin sites. Major biotypes found amongst oral and non-oral isolates were similar, although differences were found amongst minor biotypes. The new system was found to be reproducible, discriminatory, reasonably fast (48 h), easy to perform, and had no requirement for specialised equipment. Hence this biotyping system is suitable for use in diagnostic microbiology laboratories for epidemiological investigations of C. albicans infections. PMID- 3316936 TI - Effect of different preservative treatments on the microbial population of Nigerian orange juice. AB - The effect of different preservative treatments on the microbial load of Nigerian orange juice was studied over a period of 1 month. Results obtained indicated that pasteurization at 60 degrees and 80 degrees C for 20 to 40 min, freezing at 5 degrees C, and addition of sodium benzoate at a concentration of 0.1 to 0.4% (w/v) could form a microbiological basis for the preservation of the juice for 1 month. Leuconostoc mesenteroides, L. paramesenteroides, Streptococcus avium, Lactobacillus plantarum, L. fermentum, L. fructivorans, Klebsiella pneumoniae and Saccharomyces cerevisiae were the micro-organisms isolated from the untreated and treated juice samples. PMID- 3316938 TI - A simple method for determining extracellular polysaccharide-producing ability of oral streptococci. AB - A simple method is described for determining the types of extracellular polysaccharides produced by oral streptococci. The method yields quantitative results in which the amount of polysaccharides produced is normalised with respect to DNA. Results correlate well with previously published data for oral streptococci, except in the case of Streptococcus oralis for which there is no previously published data. All species within the mutans group produced both soluble and insoluble glucan; while soluble fructan was only produced by strains of Streptococcus rattus and Streptococcus mutans. The major extracellular polysaccharide produced by Streptococcus salivarius was soluble fructan, although some strains produced soluble and insoluble glucan. Most Streptococcus sanguis strains produced soluble and insoluble glucan. Soluble fructan was produced by some strains of S. sanguis and S. oralis. The latter also produced soluble and insoluble glucan. No detectable extracellular polysaccharide was elaborated by Streptococcus milleri, Streptococcus faecalis or Streptococcus lactis. PMID- 3316939 TI - The isolation and characterization of Ni2+ resistant mutants of Saccharomyces cerevisiae. AB - Four Ni2+ resistant mutants of Saccharomyces cerevisiae have been isolated and characterized. In the accumulation of Ni2+, there was no significant difference between the wild type strain and the Ni2+ resistant mutants. The synthesis of RNA in the yeast was severely inhibited by Ni2+ while inhibition of protein synthesis was less pronounced. The inhibitory effect of Ni2+ on both RNA and protein synthesis in Ni2+ resistant mutants of yeast was less pronounced than in the wild type strain, while four Ni2+ resistant mutants were more sensitive to Cd2+ and Cu2+ than was the wild type strain. Ni2+ resistant mechanism(s) appeared to exist within the cells and differed from those of Cd2+ or Cu2+. PMID- 3316940 TI - Dimethyl sulphoxide respiration in Proteus mirabilis. AB - Dimethyl sulphoxide (DMSO) was found to serve as an electron acceptor for the anaerobic growth of Proteus mirabilis on fermentable substrates such as glucose and pyruvate, as well as on oxidizable substrates such as glycerol and lactate. In a complex medium, formate greatly stimulated growth in the presence of DMSO. Cell extracts were found to reduce DMSO to dimethyl sulphide (DMS) in the presence of an electron donor. It was found that NADH, formate, lactate, reduced benzyl viologen, and dithionite can serve as electron donors. Chlorate resistant (chl) mutants were found to be unable to grow using DMSO as an electron acceptor. However, in one chl mutant, growth and DMSO reduction could be partially restored by growth in the presence of high concentrations of molybdate. PMID- 3316941 TI - The origin of antibody-forming cells detected in the bone marrow after thymus independent antigen-stimulation and abnormality in migration of B cells of X linked immunodeficient CBA/N mice. AB - The anti-TNP IgM plaque-forming cells (PFC) were generated in the spleen and bone marrow of non-immunodeficient normal mice after intraperitoneal administration of TNP-LPS. Irradiation of normal mice while shielding bone marrow completely abrogated the generation of bone marrow PFC, indicating that they are derived from extramedullary sites. The bone marrow PFC, response to TNP-LPS was low in X linked immunodeficient CBA/N strain mice, while the spleen response was comparable to that seen in the normal mice. To further study the basis of the deficient bone marrow PFC response in CBA/N mice, spleen cells were adoptively transferred to irradiated syngeneic mice stimulated with TNP-LPS. While spleen cells from normal mice generated high numbers of PFC in recipient bone marrow and spleen, those from CBA/N strain mice could not generate bone marrow PFC. This result was obtained regardless of whether normal or CBA/N recipients were used. These results indicate that TNP-LPS administration normally results in the migration of B lymphocytes from the periphery into the bone marrow and that B cells from immunodeficient CBA/N strain mice bear an inherent defect in this migratory function. This migratory defect was shown to be X-linked, as are the other previously reported B cell defects in this inbred mouse strain. The possible relationship between this migratory defect and the maturational defects of B cell lineage as reported previously in CBA/N strain mice is discussed. PMID- 3316942 TI - Social history of adoption. PMID- 3316943 TI - Application of a frame-based computer-aided learning system in clinical chemistry. AB - A frame-based computer-aided learning system for use on microcomputers has been developed for teaching clinical chemistry. The system presents a case-study model that can be used by students to assess their ability to make a diagnosis, to select patterns of investigations and to institute treatment. PMID- 3316944 TI - Dietary copper: a powerful determinant of cholesterolemia. AB - A new hypothesis suggests that deficiency of copper is important in the etiology and pathophysiology of ischemic heart disease. Several chemicals, called cholesterotropic and cuprotropic, that affect cholesterolemia also affect copper metabolism. Responses to some of these chemicals that have been tested in humans were compared on a molar basis. Dietary copper was approximately one hundred times as active in lowering cholesterol in plasma than was clofibrate which, in turn was six times as active as dietary fat. Dietary copper may be a powerful determinent of cholesterolemia. PMID- 3316945 TI - The definition of a neoplasm. AB - No satisfactory definition of a neoplasm exists. Current criteria are shown to be invalid for strictly definitional purposes. Difficulties relate in part to the difference between descriptions and explanations, and also to the status of definitional "truths". Definitions function to assist recognition, convey meaning and highlight the essence of what requires further explanation. Existing deficiencies and the provision of an adequate alternative are therefore matters of interdisciplinary importance with broad ramifications, particularly for the design of rational therapy. A new definition is proposed which, while saying as much as can be said, is conservative. Criticism of its logical base is anticipated and countered; two possible problems cases are admitted and discussed. PMID- 3316946 TI - Sudden infant death syndrome: congenital copper deficiency. AB - A previous paper describes specific respiratory toxins likely to be associated with Sudden Infant Death Syndrome (SIDS). This paper describes ultrastructural abnormalities in the lung and other tissues in congenital copper deficiency. Congenital copper deficiency is associated with tissue anoxia defects in the development of myelin through a failure of phospholipid synthesis. Phospholipid is part of the membrane structure of cells. The paucity of elastin is attributed to a loss of lysyl oxidase activity. Hypoventilation is considered a feature of SIDS. PMID- 3316947 TI - Pharyngeal structure and function as a determinant of sleep-related breathing disorders: a unifying hypothesis. AB - We propose a hypothesis which relates the pathogenesis of various sleep-related breathing disorders such as snoring, obstructive sleep apnea, and central sleep apnea to pharyngeal structure and function, i.e. pharyngeal area and compliance; these easily measured mechanical properties of the pharynx reflect the complex integrated response of upper airway muscles to changes in neural drive. Our arguments, although hypothetical, are based on the already existing measurements of pharyngeal dynamics in patients with sleep-related breathing disorders. If confirmed, this hypothesis would allow to predict a particular breathing disorder occurring during sleep from simple mechanical measurements performed in an awake subject, and furthermore it would help us to understand the effect of recent therapeutic modalities used in treatment of sleep apnea. PMID- 3316948 TI - Early designs of the myograph. AB - A surge in quantitative muscle physiology began with the mid-nineteenth century introduction of a new instrument capable of measuring contraction events with millisecond resolution. This strictly mechanical device, called a "myograph" by its designer Hermann von Helmholtz, was based on existing technology but included several important innovations that made it suitable for recording accurately the high speed events of muscle contraction. A variety of different myograph designs, each with its own advantages and disadvantages, ultimately came into existence and populated muscle physiology laboratories into the twentieth century. PMID- 3316949 TI - Burns: adding a little culture. PMID- 3316950 TI - The adolescent with cancer: a psychological overview. PMID- 3316951 TI - Transplantation of cultured autologous epidermis to a patient with burns. AB - Explant-derived cultured autologous epidermis was used as a graft in a 41-year old female patient with burns, the first subject in a clinical trial of the technique. A small full-thickness biopsy specimen which was taken on Day 2 of the hospital admission was used to initiate epidermal cultures, four of which were grafted onto the patient's back and right leg 29 and 35 days later. Three of these epidermal cultures engrafted successfully, in spite of infection with Pseudomonas aeruginosa, which resulted in the loss of some of the conventional, split-thickness meshed autografts that were applied concurrently. The fourth graft, which may have been oriented incorrectly onto the graft bed, was largely unsuccessful, and only small islets of epithelial cells remained after 10 days. The successful grafts produced full-thickness, epidermal coverage with a good cosmetic result and little evidence of contraction during a six-months' follow up. PMID- 3316952 TI - The development of the acquired immunodeficiency syndrome after bone-marrow transplantation. AB - Since bone-marrow transplant recipients receive considerable quantities of packed cell, platelet and sometimes leukocyte transfusions, as well as the donor marrow infusion, it would be predictable that acquired immunodeficiency syndrome (AIDS) by blood-product transfusion would occur in this patient population. We report here two patients who received HLA-identical sibling bone-marrow transplants for acute non-lymphoblastic leukaemia during their first remission. Both developed category-A AIDS at days 342 and 546 after transplantation, respectively. Neither patient belonged to any known high-risk group for AIDS, other than having received a blood-product transfusion. One of the two patients is now known to have received blood from a donor who was human immunodeficiency virus (HIV) seropositive. Both patients developed Pneumocystis carinii pneumonia and other opportunistic infections, and both have died of AIDS without evidence of recurrence of their leukaemia. One patient had no chronic graft-versus-host disease (GVHD) and the other had mild chronic GVHD of the mouth. Since severe opportunistic infections are rare after transplantation in the absence of GVHD, their late occurrence after transplantation should raise the suspicion of AIDS. This complication is likely to have an adverse impact on the long-term survival of patients who received bone-marrow transplants between 1981 and the introduction of effective screening tests for HIV infection in blood donors. PMID- 3316953 TI - Successful engraftment of cultured human epidermal allograft in a child with recessive dystrophic epidermolysis bullosa. PMID- 3316954 TI - Dupuytren's contracture: medicolegal aspects. PMID- 3316955 TI - [Parkinson therapy. New agents in the medical treatment of Parkinson disease]. PMID- 3316956 TI - [Disease in pregnancy. Risks, prevention and therapeutic methods]. PMID- 3316958 TI - [Diagnostic IIFT titers in visceral leishmaniasis]. PMID- 3316957 TI - [Diabetes mellitus. Pathogenesis, complications and therapy]. PMID- 3316959 TI - [Echinococcus strains, their role in the epidemiology and epizootiology of echinococcosis]. PMID- 3316960 TI - [Pyrethrins and synthetic pyrethroids (review)]. PMID- 3316961 TI - [Early diagnosis in testicular tumors. Results of a survey]. PMID- 3316962 TI - [Primary (essential) thrombocythemia. Clinical findings, course and therapy in 26 patients]. PMID- 3316963 TI - [Results of combined ultrasound controlled biopsy technics for cytologic and histologic confirmation of suspected intra-abdominal tumorous processes]. PMID- 3316964 TI - [Current status of pathobiochemistry and clinico-chemical laboratory diagnosis of liver fibrosis]. PMID- 3316965 TI - [Surgical therapy of thyroid gland cancers]. PMID- 3316966 TI - [Determination of plasma level in treatment with anticonvulsants]. PMID- 3316967 TI - [Opsi syndrome (overwhelming post-splenectomy infection) in adults]. PMID- 3316968 TI - [Primary fibromyalgia syndrome]. PMID- 3316969 TI - [Treatment of Crohn disease with a formula diet]. PMID- 3316970 TI - [Type I diabetes mellitus: immunopathogenesis and chances of primary immunotherapy]. PMID- 3316971 TI - Leona Bachrach speaks: selected speeches and lectures. PMID- 3316972 TI - Structure and expression of U-snRNA genes. PMID- 3316973 TI - [Addressed protein transport in the cell]. AB - The paper summarizes data on the nature of signals (mainly amino acid sequences) determining the intracellular movement of newly formed polypeptide chains: their secretion, incorporation into the cytoplasmic or endoplasmic reticular membranes, into different compartments of mitochondria and chloroplasts. Some information is given about the polypeptide transport into the nucleus and microbodies (glyoxysomes, peroxysomes, glucosomes). The intracellular movement of polypeptides is supposed to be proteolytically controlled. PMID- 3316974 TI - [Creation of artificial hybrid operons with partially overlapping genes to achieve an expression of heterologous genes in Escherichia coli cells]. AB - A new method of optimization of foreign gene expression in E. coli, based on the construction of hybrid operons with partially overlapping genes is described. The partial overlapping of the translation termination and initiation sites in the formed operon must provide translational coupling of appropriate gene product synthesis. Such an approach has provided the synthesis of human interferon alpha F in E. coli cells under the control of the lacUV5-promotor up to about (3 4).10(7) units per liter of bacterial culture. The reinitiation of the distal gene translation is shown to take place in the intercistronic region. Substitution of the lacUV5 promotor by the more efficient tac one allowed to increase the synthesis level of interferon alpha F to (1-2).10(8) units per liter. The conclusion is made about the equimolarity of distal and proximal to the promotor genes products syntheses when the intercistronic region of E. coli trpE-trpD genes are used for translational coupling. PMID- 3316975 TI - A factor present in fetal calf serum enhances oncogene-induced transformation of rodent fibroblasts. AB - Our previous studies indicated that addition of the tumor promoters 12-O tetradecanoylphorbol-13-acetate (TPA) or teleocidin to Dulbecco modified Eagle medium supplemented with calf serum enhanced T24-induced focus formation in both the murine C3H 10T1/2 and rat 6 embryo fibroblast cell lines. In the present studies we have found that fetal calf serum (FCS) is more potent than 12-O tetradecanoylphorbol-13-acetate in enhancing T24-induced focus formation, in terms of the number and size of the foci, in both C3H 10T1/2 and rat 6 cells. Time course studies indicate that FCS can exert this enhancing effect when it is added several days after the transfection with T24 DNA. In rat 6 cells, an 11 fold increase in T24-induced focus formation occurred when the transfected cultures were maintained for only 1 day in 5% FCS, starting 4 days after the transfection. Several known growth factors, including epidermal growth factor, transforming growth factors alpha and beta, insulin, and platelet-derived growth factor, did not enhance T24-induced transformation in these cell systems. Fractionation studies indicate that the factor present in FCS has a molecular weight of about 1,300, is not lipid soluble, and is acid, base, and heat stable. These findings suggest that a factor(s) normally present in serum may enhance the emergence of tumor cells in vivo, by acting in concert with an activated oncogene, during the multistage carcinogenic process. PMID- 3316976 TI - Interaction of GAL4 and GAL80 gene regulatory proteins in vitro. AB - The GAL80 protein of Saccharomyces cerevisiae, synthesized in vitro, bound tightly to GAL4 protein and to a GAL4 protein-upstream activation sequence DNA complex, as shown by (i) coimmunoprecipitation of GAL4 and GAL80 proteins with anti-GAL4 antiserum, (ii) an electrophoretic mobility shift of a GAL4 protein upstream activation sequence DNA complex upon the addition of GAL80 protein, and (iii) GAL4-dependent binding of GAL80 protein to upstream activation sequence DNA immobilized on Sepharose beads. Anti-GAL4 antisera were raised against a GAL4 URA3 fusion protein, which could be purified to homogeneity in a single step with the use of an affinity chromatographic procedure for the URA3 gene product. PMID- 3316978 TI - The two gene pairs encoding H2A and H2B play different roles in the Saccharomyces cerevisiae life cycle. AB - We have isolated Saccharomyces cerevisiae mutants bearing deletions of one or the other of the two divergently transcribed gene pairs encoding H2A and H2B. The deletions produced diverse effects on the yeast life cycle. Deletion of TRT1, one of the H2A-H2B gene pair sets, affected mitotic growth, sporulation, spore germination, the heat shock response, and exit from the stationary phase; deletion of TRT2, the other H2A-H2B gene pair set, had negligible effects on these same processes. Using a genetic complementation assay, we found that the differential effects of the deletions could be attributed to two features of the gene sets: first, the expression of the TRT1 gene pair, but not the TRT2 gene pair, could compensate for the absence of its partner; second, the protein subtypes encoded by the two gene pairs appear to have different functions in the heat shock response. PMID- 3316977 TI - The heat shock response in HeLa cells is accompanied by elevated expression of the c-fos proto-oncogene. AB - Several known inducers of the heat shock response (heat stress, arsenite, and heavy metals) were shown to cause a significant elevation of c-fos mRNA in HeLa cells. Heat stress resulted in a time- and temperature-dependent prolonged elevation in the level of c-fos mRNA, which was accompanied by increased translation of c-fos protein and its appearance in the nucleus. Elevated expression of c-fos during heat stress was paralleled by induction of hsp 70 mRNA, while levels of c-myc and metallothionein mRNAs declined. Treatment of HeLa cells with arsenite or heavy metals also resulted in increased levels of hsp 70, as well as c-fos mRNA. Although elevated expression of c-fos was prevented by inhibitors of RNA synthesis, analysis of relative rates of gene transcription showed that during heat stress there was a negligible change in c-fos transcription. Therefore, the enhanced expression of c-fos during the heat shock response is likely to occur primarily through posttranscriptional processes. Cycloheximide was also shown to significantly increase the c-fos mRNA level in HeLa cells. There results are consistent with the observation that these inducers of the heat shock response, as well as cycloheximide, repress protein synthesis and suggest that the increase in the level of c-fos mRNA is caused by an inhibition of protein synthesis. This supports the hypothesis that c-fos mRNA is preferentially stabilized under conditions which induce the heat shock response, perhaps by decreased synthesis of a short-lived protein which regulates c-fos mRNA turnover. PMID- 3316979 TI - Purification of the c-fos enhancer-binding protein. AB - We have purified the c-fos enhancer-binding protein from HeLa cell nuclear extracts. The key purification steps involved chromatography on a nonspecific DNA affinity column, from which binding activity and other protein were eluted at low salt concentrations, followed by chromatography on a specific oligonucleotide affinity column, from which the enhancer binding activity was specifically eluted at high salt concentrations. The purified protein had a strong affinity for the c fos enhancer dyad symmetry sequence, with an equilibrium dissociation constant of 3.3 x 10(-11) M. This affinity was at least 50,000-fold stronger than that found for nonspecific DNA sequences. PMID- 3316980 TI - Identification of a signal for nuclear targeting in platelet-derived-growth factor-related molecules. AB - The v-vis gene encodes p28sis, the transforming protein of simian sarcoma virus. This gene resulted from a fusion of the env gene of simian sarcoma-associated virus and the woolly monkey gene for the B chain of platelet-derived growth factor (PDGF). Previous work has shown that the v-sis gene product undergoes signal sequence cleavage, glycosylation, dimerization, and proteolytic processing to yield a secreted form of the protein. It transport across the endoplasmic reticulum is blocked by the introduction of a charged amino acid residue within the signal sequence, the protein does not dimerize, is not secreted, and is no longer transforming as assayed by focus-forming ability in NIH 3T3 cells. Instead, this mutant protein localizes to the nucleus as demonstrated by both indirect immunofluorescence and cell fractionation. Using a series of deletion mutations, we delimited an amino acid sequence within this protein which is responsible for nuclear localization. This region is completely conserved in the predicted human c-sis protein, although it lies outside of regions required for transformation by the v-sis gene product. This nuclear transport signal is contained within amino acid residues 237 to 255, RVTIRTVRVRRPPKGKHRK. An amino acid sequence containing these residues is capable of directing cytoplasmic v-sis mutant proteins to the nucleus. This sequence is also capable of directing less efficient nuclear transport of a normally cytoplasmic protein, pyruvate kinase. Pulse-chase experiments indicate that the half-lives of nuclear and cytoplasmic v sis mutant proteins are approximately 35 min. Using the heat-inducible hsp70 promoter from Drosophila melanogaster, we showed that the nuclear v-sis protein accumulates in the nucleus within 30 min of induction. The identification of a nuclear transport signal in the v-sis gene product raises interesting questions regarding the possibility of some function for PDGF or PDGF-related molecules in the nucleus. PMID- 3316981 TI - Growth factor-deprived BALB/c 3T3 murine fibroblasts can enter the S phase after induction of c-myc gene expression. AB - Induction of quiescent BALB/c 3T3 murine fibroblasts by platelet-derived growth factor (PDGF) or fibroblast growth factor (FGFs) is accompanied by induction of c myc gene expression. To study the role of c-myc in cell growth, we transfected BALB/c 3T3 cells with a plasmid construct containing a glucocorticoid-inducible c myc gene. When these transfected cells were growth arrested in PDGF-FGF freedefined medium, glucocorticoid treatment induced S-phase DNA synthesis. This induction of DNA synthesis was inefficient, and cell proliferation was not evident, suggesting that growth factors act through stimulation of c-myc expression together with other intracellular events. PMID- 3316982 TI - Roles of the 2 microns gene products in stable maintenance of the 2 microns plasmid of Saccharomyces cerevisiae. AB - We have examined the replication and segregation of the Saccharomyces cerevisiae 2 microns circle. The amplification of the plasmid at low copy numbers requires site-specific recombination between the 2 microns inverted repeat sequences catalyzed by the plasmid-encoded FLP gene. No other 2 microns gene products are required. The overexpression of FLP in a strain carrying endogenous 2 microns leads to uncontrolled plasmid replication, longer cell cycles, and cell death. Two different assays show that the level of Flp activity decreases with increasing 2 microns copy number. This regulation requires the products of the REP1 and REP2 genes. These gene products also act together to ensure that 2 microns molecules are randomly segregated between mother and daughter cells at cell division. PMID- 3316984 TI - Identification of the gene for the yeast ribonucleotide reductase small subunit and its inducibility by methyl methanesulfonate. AB - We have identified, cloned, and sequenced the gene for the small subunit of ribonucleotide diphosphate reductase of Saccharomyces cerevisiae. The protein and its transcript are induced about 10-fold by the alkylating agent methyl methanesulfonate, a result which suggests that the gene is induced by DNA damage. PMID- 3316983 TI - Molecular analysis of SSN6, a gene functionally related to the SNF1 protein kinase of Saccharomyces cerevisiae. AB - Mutations in the SSN6 gene suppress the invertase derepression defect caused by a lesion in the SNF1 protein kinase gene. We cloned the SSN6 gene of Saccharomyces cerevisiae and identified its 3.3-kilobase poly(A)-containing RNA. Disruption of the gene caused phenotypes similar to, but more severe than, those caused by missense mutations: high-level constitutivity for invertase, clumpiness, temperature-sensitive growth, alpha-specific mating defects, and failure to homozygous diploids to sporulate. In contrast, the presence of multiple copies of SSN6 interfered with derepression of invertase. An ssn6 mutation was also shown to cause glucose-insensitive expression of a GAL10-lacZ fusion and maltase. The mating defects of MAT alpha ssn6 strains were associated with production of two a specific products, a-factor and barrier, and reduced levels of alpha-factor; no deficiency of MAT alpha 2 RNA was detected. We showed that ssn6 partially restored invertase expression in a cyr1-2 mutant, although ssn6 was clearly not epistatic to cyr1-2. We also determined the nucleotide sequence of SSN6, which is predicted to encode a 107-kilodalton protein with stretches of polyglutamine and poly(glutamine-alanine). Possible functions of the SSN6 product are discussed. PMID- 3316985 TI - Immunofluorescence localization of the Saccharomyces cerevisiae CDC12 gene product to the vicinity of the 10-nm filaments in the mother-bud neck. AB - Budding cells of the yeast Saccharomyces cerevisiae possess a ring of 10-nm diameter filaments, of unknown biochemical nature, that lies just inside the plasma membrane in the neck connecting the mother cell to its bud (B. Byers and L. Goetsch, J. Cell Biol. 69:717-721, 1976). Mutants defective in any of four genes (CDC3, CDC10, CDC11, and CDC12) lack these filaments and display a pleiotropic phenotype that involves abnormal bud growth and cell-wall deposition and an inability to complete cytokinesis. We fused the cloned CDC12 gene to the Escherichia coli lacZ and trpE genes and used the resulting fusion proteins to raise polyclonal antibodies specific for the CDC12 gene product. In immunofluorescence experiments with affinity-purified antibodies, the neck region of wild-type and mutant cells stained in patterns consistent with the hypothesis that the CDC12 gene product is a constituent of the ring of 10-nm filaments. Without careful affinity purification of the CDC12-specific antibodies, these staining patterns were completely obscured by the staining of residual cell wall components in the neck by antibodies present even in the "preimmune" sera of all rabbits tested. PMID- 3316989 TI - Immunoregulatory properties of synthetic peptides, fragments of a proline-rich polypeptide (PRP) from ovine colostrum. AB - It has been previously found that a proline-rich polypeptide (PRP) isolated from ovine colostrum has a regulatory effect on the immune response. A nonapeptide fragment Val-Glu-Ser-Tyr-Val-Pro-Leu-Phe-Pro was isolated from the chymotryptic digest of PRP. The nonapeptide showed biological activity similar to PRP. The determined amino acid sequence was now confirmed by synthesis. Synthetic nonapeptide as well as its C-terminal hexapeptide, Tyr-Val-Pro-Leu-Phe-Pro, showed biological activity similar to PRP and the nonapeptide obtained from PRP. PMID- 3316986 TI - The yeast ARD1 gene product is required for repression of cryptic mating-type information at the HML locus. AB - Mutations in the ARD1 gene prevent yeast cells from displaying G1-specific growth arrest in response to nitrogen deprivation and cause MATa haploids (but not MAT alpha haploids) to be mating defective. Analysis of cell type-specific gene expression by examination of RNA transcripts and measurement of beta galactosidase activity from yeast gene-lacZ fusions demonstrated that the mating defect of MATa ard1 mutants was due to an inability to express genes required by MATa cells for the mating process. The lack of mating-specific gene expression in MATa cells was found to be due solely to derepression of the normally silent alpha information at the HML locus. The cryptic a information at the HMR locus was only very slightly derepressed in ard1 mutants, to a level insufficient to affect the mating efficiency of MAT alpha cells. The preferential elevation of expression from HML over HMR was also observed in ard1 mutants which contained the alternate arrangement of a information at HML and alpha information at HMR. Hence, the effect of the ard1 mutation was position specific (rather than information specific). Although the phenotype of ard1 mutants resembled that of cells with mutations in the SIR1 gene, both genetic and biochemical findings indicated that ARD1 control of HML expression was independent of the regulation imposed by SIR1 and the other SIR genes. These results suggest that the ARD1 gene encodes a protein product that acts, directly or indirectly, at the HML locus to repress its expression and, by analogy, may control expression of other genes involved in monitoring nutritional conditions. PMID- 3316987 TI - Sequences required for transcriptional initiation of the Saccharomyces cerevisiae CYC7 genes. AB - A series of BAL 31 deletions were constructed in the upstream region of the Saccharomyces cerevisiae CYC7 gene to determine sequences required for transcriptional initiation. These deletions identified the TATA box as an alternating A-T sequence at -160 and the initiation sequences as well as the spatial relationship between them. The TATA box was necessary for wild-type levels of expression of the CYC7 gene. Decreasing the distance between the TATA sequence and the initiation site did not alter gene expression, but the site of transcription was shifted 3'-ward. In most cases, transcription initiated at a number of sites, the 5'-most of which was the first suitable site greater than 45 base pairs 3' of the TATA sequence, suggesting a spatial relationship between these sequences. Consensus sequences previously proposed for initiation sites were evaluated with respect to the start sites identified in this study as well as the start sites of other yeast genes. PMID- 3316988 TI - Insertions of up to 17 amino acids into a region of alpha-tubulin do not disrupt function in vivo. AB - Microtubules in yeasts are essential components of the mitotic and meiotic spindle and are necessary for nuclear movement during cell division and mating. The yeast Saccharomyces cerevisiae has two alpha-tubulin genes, TUB1 and TUB3, either of which alone is sufficient for these processes when present in a high enough copy number. Comparisons of sequences from several species reveals the presence of a variable region near the amino terminus of alpha-tubulin proteins. We perturbed the structure of this region in TUB3 by inserting into it 3, 9, or 17 amino acids and tested the ability of these altered proteins to function as the only alpha-tubulin protein in yeast cells. We found that each of these altered proteins was sufficient on its own for mitotic growth, mating, and methods of yeast. We conclude that this region can tolerate considerable variation without losing any of the highly conserved functions of alpha-tubulin. Our results suggest that variability in this region occurs because it can be tolerated, not because it specifies an important function for the protein. PMID- 3316990 TI - Biosynthesis of the third component of complement by the human monocyte-like cell line, U-937. AB - The human monocyte-like cell line, U-937, was shown to synthesize and secrete C3 by hemolytic assays, radioimmunoassays and metabolic labeling experiments. The daily synthesis of antigenic C3 by unstimulated U-937 cells was low (about 3 ng/10(6) cells/24 hr) over a 3 day period. Induction of the cells to differentiate into macrophage-like cells with phorbol myristate acetate (PMA), resulted in 5-fold augmentation of C3 synthesis and secretion into the culture medium. Using a plaque assay for enumerating C3 production by single cells, approx. 5% of unstimulated U-937 cells were found to secrete hemolytically active C3. The proportion of C3-plaque forming cells was increased about 6-fold in PMA stimulated cells. The synthesis of C3 by U-937 cells was reversibly inhibited by cycloheximide. Data from SDS-PAGE analyses showed that U-937 cells synthesized C3 as a precursor polypeptide chain and was capable of processing this pro-molecule into the secreted two chain form. C3 antigen immunoprecipitated from stimulated U 937 cell lysates showed an increased amount of low mol. wt material as compared to C3 antigen immunoprecipitated from the lysates of unstimulated cells. This may be attributable to increased intracellular proteolytic activity in the PMA stimulated cells. The studies show that the U-937 cell line provides a useful model for studies on the synthesis and processing of complement proteins and the physiological regulation of complement production. PMID- 3316991 TI - Streptococcal protein G, expressed by streptococci or by Escherichia coli, has separate binding sites for human albumin and IgG. AB - Protein G is expressed at the cell surface of certain group C and group G streptococcal strains. The protein shows a unique and specific affinity for the Fc region of mammalian polyclonal and monoclonal immunoglobulin G (IgG). We have cloned the streptococcal gene coding for protein G into E. coli, using phage lambda as the vector. The protein G produced by E. coli infected with this phage was detected and analysed in Western blot experiments using radiolabelled IgG Fc fragments as a probe. Three major IgG Fc-binding bands were obtained corresponding to apparent mol. wts of 47,000, 57,000 and 65,000, respectively. Analysis of the expression in E. coli indicates that this heterogeneity is caused by a post-translational degradation of the molecule before lysis of the lambda infected E. coli cells occurred. The protein G produced in E. coli was purified by affinity chromatography on IgG-Sepharose followed by gel-filtration on Sephadex G-200. This highly purified E. coli-produced protein G was compared to protein G solubilized by papain from streptococci, in direct binding experiments and in a competitive binding assay. The two protein G variants were found to interact with polyclonal IgG from different species in a similar way. Streptococcal strains expressing protein G also show affinity for human albumin, and at the molecular level protein G was found to be responsible also for the binding of albumin. Thus, both E. coli-produced protein G and the proteolytic fragment of protein G obtained from streptococci, bound albumin. On the protein G molecule, two different and separate sites were found to bind IgG and albumin. Finally, when whole streptococci were incubated with human plasma, the interactions with protein G caused a coating of the bacteria with albumin and IgG, whereas other plasma proteins showed no affinity for protein G. PMID- 3316992 TI - Epidemiology of hay fever and perennial allergic rhinitis. PMID- 3316993 TI - Epidemiology of allergic contact sensitization. PMID- 3316994 TI - The epidemiology of rheumatoid arthritis. PMID- 3316995 TI - Epidemiology of systemic lupus erythematosus. PMID- 3316996 TI - The epidemiology of asthma. AB - As noted earlier, the clinician and the epidemiologist are in many respects in similar positions in terms of our current understanding of asthma. Through the efforts of the pharmaceutical industry the practitioner has a much wider range of therapeutic tools available to manage reversible airways disease. B-agonists are more specific, have a longer duration of action, minimizing the potential for abuse and coincident toxicity. Theophylline preparations are long-acting and therapeutic drug levels can be accurately assessed. Inhaled corticosteroids provide the opportunity to reduce the negative side aspects of hormonal therapy. Unfortunately, with all these tools, the morbidity and mortality of asthma have not been decreased. In fact, it may be that the disease is a greater worldwide health problem than it was a generation ago. Similarly, epidemiologic research has provided us with increasingly meaningful information, not only of the prevalence of the disease, but with recent longitudinal studies, the factors which impact upon disease remission and relapse. Whether we separate the wheezing syndromes into separate categories of wheezy bronchitis, asthmatic bronchitis, and asthma is probably less important than our understanding of a disease entity which is characterized by bronchial hyper-reactivity in response to a variety of stimuli. The most encouraging aspects of recent epidemiologic research have been the selection of representative populations, using standardized methods, from which significant conclusions can be drawn. At the least, these studies have confirmed and extended our knowledge of a disease that we still do not fully understand. Woolcock et al.[56], and others, have included inhalation challenge testing into their epidemiologic protocols in an attempt to add physiologic assessments to the more traditional symptom complexes. Unfortunately, even this addition has not solved the problem of an asthma diagnosis in the older adult population whose irreversible airways obstructive disease is a confounding variable. Even in younger subjects, as reported by Townley et al.[14], a gradation of responses to methacholine inhalation in atopic subjects, may make the identification of asthmatics more difficult than initially thought. The fact that ex-asthmatics appear to retain their hyper-responsiveness, however, could make inhalation challenge a valuable tool in longitudinal epidemiologic research. What can epidemiologic studies contribute in the future?.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3316997 TI - Epidemiology of autoallergic human thyroiditis. PMID- 3316998 TI - Epidemiology of myasthenia gravis. PMID- 3317000 TI - Clinical features and epidemiology of occupational obstructive respiratory disease caused by small molecular weight organic chemicals. PMID- 3316999 TI - Epidemiology of immunohematologic diseases. PMID- 3317001 TI - Epidemiologic aspects of hypersensitivity pneumonitis. PMID- 3317002 TI - Epidemiology of hypersensitivity pneumonitis/allergic alveolitis. PMID- 3317003 TI - [Significance of elemental diets in the therapy of Crohn disease in childhood]. AB - Aminoacid and oligopeptide formulas of low molecular weight have frequently been used in the past on an empirical basis for nutritional support of patients with Crohn's disease. Improvement of intestinal symptoms and laboratory parameters reflecting the inflammatory process have been demonstrated. Only a few controlled therapeutic trials have compared elemental diets with conventional drug therapy. In small bowel involvement, therapeutic efficiency in active disease is as good as salazosulfapyridine combined with corticosteroids. Elemental diet is less effective in large bowel disease. In the therapeutic application of elemental diets in active disease these formulas should be the only nutritional source for the patient. Particularly in small bowel disease the growth retarding side effects of corticosteroids can markedly be reduced by elemental diets. Children with moderate disease and additional growth retardation may benefit from either supplemental elemental diet and/or high molecular weight formula or from parenteral hyperalimentation. --Crohn-specific fistulas seem to close rarely on elemental diets while favourable results are seen in postoperative fistulas. PMID- 3317004 TI - [Molecular biology aspects of neuroblastoma]. AB - Neuroblastoma is one of the most frequent malignant tumors in childhood. Molecular and cytogenetic methods have led to important advances in our understanding of the biology of this tumor. Amplification and increased expression of the gene N-myc is correlated with the clinical stage. This may be a useful marker for monitoring tumor activity during therapy. In addition, karyotyping and flow cytometric DNA analysis may be useful diagnostic tools for staging and predicting the clinical outcome. PMID- 3317005 TI - [Reye syndrome]. AB - Clinical course, laboratory findings and histopathological features of Reye's syndrome as described. Etiological and pathogenetic aspects are still under discussion although a viral infection preceding Reye's syndrome is a very common finding. Preceding Influenza B, Influenza A and varicella infections were most often seen in the United States. A genetic disposition seems to exists in some cases. Exogenic factors of pathogenetic relevances are aflatoxin, emulging agents, insecticides, paracetamol, acetylsalicylic acid and valproate. In the United States and Great Britain the incidence of Reye's syndrome is about ten times higher than in other European countries, as demonstrated by reports from Spain, Denmark and France. Results of an inquiry in Western Germany on Reye's syndrome between 1983 and 1985 are presented. 99 major pediatric hospitals were included into the study. Clinical data were obtained from 85 hospitals. The incidence of Reye's syndrome in Western Germany during 1983-1985 was 0.04-0.05 cases per 100,000 children under 18 years. 15 cases of Reye's syndrome were reported, i.e. an average of 5 cases per year. 8 children died. 3 patients had been treated with acetylsalicylic acid and 2 patients with paracetamol shortly before the onset of the disease. PMID- 3317006 TI - Role of tumor necrosis factor in monocyte/macrophage tumor cytotoxicity in vitro. AB - The ability of activated monocytes/macrophages to exert cytotoxic effects in vitro which are preferentially manifest on target cells displaying a transformed phenotype has elicited intense efforts aimed at a molecular characterization of the underlying mechanism. This multistep reaction is typified by an apparently stringent requirement for conjugation between the effector and target to facilitate cytotoxicity, which has therefore long caused bias against the role of soluble effector molecules in mediating target cell damage. However, several laboratories have recently demonstrated a compelling role for at least one such mediator, tumor necrosis factor (TNF), in cell-mediated cytotoxicity exerted against certain target cells; these studies indicated that specific anti-TNF antibodies could block direct monocyte/macrophage-mediated cytotoxicity of TNF sensitive targets. More recently we have shown that some targets which are completely resistant to soluble or fluid-phase TNF are effectively lysed by a TNF dependent mechanism upon coculture with activated macrophages under conditions in which conjugation is facilitated. Furthermore, macrophage-mediated cytolysis of both TNF-sensitive and TNF-resistant targets occurs independently of the action of secreted TNF via this mechanism. The purpose of this review is to consider the implications of distinct modes of effector cell delivery of TNF to the target for molecular characterization of the target injury phase of macrophage-mediated tumor cytotoxicity. PMID- 3317007 TI - [Biological markers in affective diseases]. PMID- 3317008 TI - [The language of psychiatry. A linguistic study]. PMID- 3317009 TI - The management of clinically localized prostate cancer. PMID- 3317010 TI - Differential diagnosis of dementing diseases. PMID- 3317011 TI - Diet and exercise in noninsulin-dependent diabetes mellitus. National Institutes of Health Consensus Development Conference Statement. PMID- 3317012 TI - Neurophysiological effects of opiates in the CNS. PMID- 3317013 TI - Neuropharmacology of cocaine: role of monoaminergic systems. PMID- 3317014 TI - Neurobiology of phencyclidine. PMID- 3317016 TI - [Identification of pigments in paraffin sections. II]. PMID- 3317015 TI - Neurophysiological and neuropharmacological effects of opiates. PMID- 3317017 TI - Cyclosporine and liver transplantation. PMID- 3317018 TI - Cyclosporine experience in renal transplantation in children. PMID- 3317019 TI - Small-bowel transplantation: an overview. PMID- 3317020 TI - Superior vena cava syndrome due to mucormycosis in a patient with lymphoma. PMID- 3317021 TI - Avascular necrosis of the femoral head in patients being treated for malignancy. PMID- 3317022 TI - Ultrasound in diagnosis and management of placenta previa at the Mount Sinai Medical Center, 1970-72 and 1981-82. PMID- 3317023 TI - [Multiple drug resistance of tumor cells: manifestations, genetic basis, clinical aspects]. AB - Data are reviewed concerning the results of study of multidrug-resistant (MDR) tumor cells. MDR often develops in the course of chemotherapy or in vitro selection of tumor cells by vincristine, adriamycin, actinomycin D, colchicine, etc. MDR cells are resistant to all these drugs though their targets and mechanisms of toxic action are quite different. Resistance is due to the decreased accumulation by MDR cells of these compounds. The genetic basis for MDR is amplification of a large genomic region that contains a number of genes coding for products and functions that are under extensive study. Specific karyotype and amplified DNA alterations occur during the development of MDR imitating the processes of appearance and variability of multigene families. The obtained data demonstrate the ways of overcoming of tumor multidrug resistance in clinic. PMID- 3317024 TI - DNA methylation and epigenetic defects in carcinogenesis. AB - It is frequently assumed that DNA-damaging agents are carcinogenic because they induce mutations. However, another strong possibility is that the damage leads to heritable changes in the methylation of cytosine in DNA. Considerable evidence exists that gene expression in mammalian cells is in part controlled by methylation of specific DNA sequences. Carcinogens may act by altering the normal epigenetic controls of gene activity in specialised cells, and thereby produce aberrant heritable phenotypes. It is known that agents which inhibit DNA methylation can be carcinogenic and that tumour cells are altered in DNA methylation. PMID- 3317025 TI - Current understanding of UV-induced base pair substitution mutation in E. coli with particular reference to the DNA polymerase III complex. AB - UV mutagenesis in E. coli is believed to occur in two discrete steps. The second step involves continued DNA synthesis beyond a blocking lesion in the template strand. This bypass step requires induced levels of umuD and umuC gene products and activated recA protein. DNA polymerase III may be involved since a dnaE mutator strain (believed to have defective base selection) is associated with enhanced UV mutagenesis in conjunction with a genetic background permitting the bypass step. In non-UV-mutable umu and lexA strains, UV mutagenesis can be demonstrated if delayed photoreversal is given. This is interpreted as indicating that an earlier misincorporation step can occur in such strains but the resulting mutations do not survive because the bypass step is blocked. The misincorporation step does not require any induced SOS gene products and can occur either at the replication fork or during repair replication following excision of a DNA lesion. Neither a dnaE mutator gene (leading to a defective alpha subunit of DNA polymerase III holoenzyme) nor a mutD5 mutator gene (leading to a defective epsilon proofreading subunit) had any effect on the misincorporation step. Although this is consistent with DNA polymerase III holoenzyme not being involved in the misincorporation step, other interpretations involving the inhibition of epsilon proofreading activity by recA protein are possible. In vitro studies are reported in which sites of termination of synthesis by DNA polymerase III holoenzyme on UV-irradiated M13 mp8 DNA were examined in the presence of inhibitors of the 3'-5' proofreading exonuclease (including recA protein). No evidence was found for incorporation of bases opposite photoproducts suggesting that either inhibition is more complete in the cell and/or that other factors are involved in the misincorporation step. PMID- 3317026 TI - Carcinogenic potency in rodents versus genotoxic potency in E. coli: a correlation analysis for bifunctional alkylating agents. AB - The mutagenic (M), recombinagenic (R) and SOS inducing (I) potencies of 6 bifunctional directly acting alkylating agents (mitomycin C, thiotepa, chlorambucil, nitrogen mustard, bis(2-chloroethyl)ether and bis(2 chloroethyl)nitrosourea) were measured in an E. coli test system (E. coli multitest) as the integral under the yield-dose curve obtained for each event. This potency corresponds to the cumulative yield of the affected cell population over the entire effective dose range of the chemical treatment. A weak mutagenic activity was detected only for mitomycin C and thiotepa. Except for bis(2 chloroethyl)ether, all agents were recombinagenic and SOS inducing. When the 3 genotoxic potencies (M, R and I) of these bifunctional alkylating agents were correlated, separately or in combination, with the respective carcinogenic potencies in rodents, a highly significant correlation was obtained with both the recombinagenic and SOS inducing potencies. PMID- 3317027 TI - Mechanisms of aneuploid induction. PMID- 3317029 TI - Epidemiology in protection and prevention against environmental mutagens/carcinogens. Examples from occupational medicine. AB - Subjects occupationally exposed to potential mutagens/carcinogens represent the most suitable groups for epidemiological studies aimed at assessing the risk for the individual or the offspring. Several cancer risks to humans have been detected by epidemiological studies performed in occupational settings. Cancer epidemiology studies have been able (a) to identify specific occupations or agents associated with the risk; (b) to verify the results of experimental studies; (c) to test the effectiveness of changes in production or preventive measures in decreasing risks. Reproductive epidemiology has suggested a risk of spontaneous abortions or of malformation in the offspring of workers exposed to some chemicals or occupations, but data are often conflicting due to methodological problems. With the aim of early assessment of risk in mind, the epidemiological use of indicators of exposure or of the early effect of exposure to genotoxic agents is increasingly applied to occupational groups. Cytological monitoring of subjects at risk of occupational cancer of lung or bladder is carried out mainly to diagnose precancerous lesions of target tissues. Cytogenetic methods (chromosome aberrations, SCE, micronuclei) in somatic cells provide a means for detecting early effects of occupational exposure to known or potential mutagens/carcinogens in selected groups of individuals, but their significance is widely debated. Monitoring of urinary mutagenicity, as applied in nurses handling cytostatic drugs, is an example of how an indicator of exposure to genotoxins can be used to evaluate the impact of preventive measures. Among the perspectives, biochemical epidemiology seems to be promising in detecting individuals genetically susceptible to cancer. PMID- 3317028 TI - Comparisons of tests for aneuploidy. AB - The fundamental problems that face us in the development of suitable assay systems for the detection of potentially aneugenic (aneuploidy-inducing) chemicals include: (a) the diversity of cellular targets and mechanisms where perturbations of structure and function may give rise to changes in chromosome number, and (b) the phylogenetic differences that exist between species in their mechanism and kinetics of cell division and their metabolic profiles. A diverse range of assay systems have been developed, which have been shown to have potential for use in the detection of either changes in chromosome number or of perturbations of the events which may be causal in the induction of aneuploidy. Chromosome number changes may be detected cytologically by karyotypic analysis, or by the use of specialised strains in which aneuploid progeny may be observed due to phenotypic differences with aneuploid parental cells or whole organisms. Techniques for the detection of cellular target modifications range from in vitro studies of tubulin polymerisation to observations of the behaviour of various cellular organelles and their fidelity of action during the division cycle. The diversity of mechanisms which may give rise to aneuploidy and the qualitative relevance of events observed in experimental organisms compared to man make it unlikely that the detection and risk assessment of the aneugenic activity of chemicals will be possible using a single assay system. Optimal screening and assessment procedures will thus be dependent upon the selection of an appropriate battery of predictive tests for the measurement of the potentially damaging effects of aneuploidy induction. PMID- 3317030 TI - Environmental mutagenesis in retrospect. PMID- 3317031 TI - Genotoxic effects of glycidyltrimethylammonium chloride. AB - Evaluation of the genotoxicity of epoxides is best carried out on a case by case basis. Although glycidyltrimethylammonium chloride (GTAC) is widely used in several industrial applications, its genotoxicity is poorly documented. Therefore, we have evaluated GTAC in a battery of 4 in vitro short-term tests for genotoxicity. We report here that GTAC mediates the induction of base-pair substitutions in S. typhimurium, gene conversion in S. cerevisiae (D7), chromosomal aberrations in CHO cells and viral DNA amplification in Chinese hamster CO6O cells. In view of these results, it is advisable to consider GTAC a potential carcinogen. PMID- 3317032 TI - Expression of a novel R-plasmid pEB017 compared to pKM101 in Escherichia coli wild-type, recA and uvrA strains. AB - The expression of bacterial resistance to UV irradiation and nitrofurantoin by a novel R-plasmid pEB017 in DNA-repair-proficient (wild-type) and -deficient (recA; uvrA) host strains was compared to the effects of plasmid pKM101 in the isogenic strains. pEB017 partially protected the uvrA strain, and completely protected the wild-type and recA strains from the killing effect of UV irradiation; pKM101 had no effect on the recA strain and only enhanced the survival of the wild-type and the uvrA strains after UV irradiation. pEB017 conferred nitrofurantoin resistance 10-fold on the wild-type and the recA strains and 4-fold on the uvrA strain; pKM101 did not confer nitrofurantoin resistance on the wild-type and recA strains but gave 4-fold resistance in the uvrA strain. PMID- 3317034 TI - AAEE minimonograph #28: injury to peripheral motor nerves. AB - Nerve injury triggers a sequence of electrophysiological events dependent upon changes occurring both at the neuromuscular junction and the muscle membrane. The time course of these physiologic and morphologic alterations is reviewed in light of recent information provided by studies of extrajunctional acetylcholine receptors, axoplasmic transport, and freeze-fracture electron microscopy. A thorough knowledge of these changes is essential to understanding the clinical impact of nerve injury. PMID- 3317033 TI - SOS-inducing activity of chemical carcinogens and mutagens in Salmonella typhimurium TA1535/pSK1002: examination with 151 chemicals. AB - The umu test system is a newly developed method to evaluate genotoxic activities of a wide variety of environmental carcinogens and mutagens (Oda et al., 1985). In the present study, we further examined the abilities of 151 chemicals to induce umu gene expression in Salmonella typhimurium TA1535/pSK1002. Among the chemicals examined, 72 compounds induced umu gene expression, which could be defined on a basis of increased beta-galactosidase activity by 2-fold over the background level. The potent genotoxic compounds without metabolic activation were adriamycin, bleomycin, daunorubicin, 1,3-dinitropyrene, 1,6-dinitropyrene, 1,8-dinitropyrene, N-ethyl-N'-nitro-N-nitrosoguanidine, furylfuramide, methyl methanesulfonate, N-methyl-N'-nitro-N-nitrosoguanidine, mitomycin C, 1 nitropyrene and 4-nitroquino-line-1-oxide. In the presence of S9, aflatoxin B1, 2 aminoanthracene, Glu-P-1, IQ, MeIQ, MeIQx, Trp-P-1 and Trp-P-2 also induced umu gene expression markedly. Several chemicals such as 2-acetylaminofluorene, 9 aminoacridine, azobenzene, benzanthracene, benzidine, diethyl nitrosamine, 1 nitronaphthalene, paraquat, potassium dichromate and sodium nitrite were weakly genotoxic and the induction by these compounds could be detected only when the incubation time was prolonged from 2 h to 5 h. Data are also presented that some of the chemicals such as dimethyl sulfoxide, m-dioxan, 5-fluorouracil and paraquat, which have been reported to be non-mutagenic in Ames/Salmonella assay, were found to be active in inducing umu gene expression, while the known mutagenic compounds including acrylonitrile, 4,4'-dinitrobiphenyl, furfural, methylene chloride, 1-naphthylamine, sodium azide, o-tolidine and o-toluidine were non-genotoxic in the present assay system. PMID- 3317035 TI - Canine masticatory muscle disorders: a study of 29 cases. AB - The histopathologic features in temporalis muscle biopsies from 29 dogs with masticatory muscle disorders were characterized and used for their subgrouping: 2 without lesions, 3 with nonspecific changes, 7 with neurogenic atrophy, and 16 with myositis. The immunocytochemical and immunochemical features of the muscle biopsies and sera from those dogs were compared among the histopathologic subgroupings and compared with biopsies and sera from healthy dogs and dogs with polymyositis. Of the 14 biopsies from dogs with masticatory muscle myositis, 12 had immune complexes limited to type 2M fibers, whereas 13 of 16 sera samples had detectable antibodies against type 2M fibers. The immune complex deposition was found only in biopsies of dogs with masticatory muscle myositis, and the antibodies were detected in the sera of only one dog that did not have masticatory muscle myositis. Immunoblot assays revealed that the antibodies were most often directed against a 185 K protein, myosin heavy chain, and a band that appeared to be LC2-M (myosin light chain 2-masticatory). PMID- 3317037 TI - Pain and its effects in the human neonate and fetus. PMID- 3317036 TI - Immunohistochemical localization of AMP deaminase in rimmed vacuoles in human skeletal muscle. AB - High AMP deaminase reactivity was detected in the rimmed vacuoles in skeletal muscles in adult onset acid maltase deficiency and distal myopathy with rimmed vacuole formation histochemically as well as immunohistochemically. Acid phosphatase activity was positive but myosin ATPase activity was negative in the vacuoles. AMP deaminase found in rimmed vacuoles does not seem to be associated with myosin but is possibly bound to lysosomes or other related organelles in accordance with the proliferation of autophagic vacuoles. PMID- 3317038 TI - Atopy and airways responsiveness in chronic obstructive pulmonary disease. PMID- 3317039 TI - Misrepresentation and responsibility in medical research. AB - Early in 1985, after being questioned about duplicate data in two of his papers, Robert A. Slutsky, M.D., resigned his appointments as a radiology resident (trainee) and nonsalaried associate clinical professor in the Department of Radiology at the University of California, San Diego. During the following year, faculty committees investigated Slutsky's entire bibliography of 137 articles published in seven years; 77 (including reviews) were classified as valid, 48 were judged questionable, and 12 were deemed fraudulent. The majority of these papers were published while Slutsky was a research or clinical trainee in cardiology, nuclear medicine, and then radiology. Our analysis of this case leads us to conclude that research fraud, although probably rare, in view of the size of the research establishment, may evade detection, and that there are scientists prepared to run the appreciable risk of submitting inaccurate statements for publication. Sophisticated dishonesty can escape detection by peer review and replication. The emphasis on competition and the pressure to produce, while intended to advance the discovery of truth, may foster a conflict between personal career goals and the intellectual motivation of scientists to seek the truth. The scientific community needs to address the issues raised by recent reports of fraud. Each institution and granting agency must have procedures for investigating suspected fraud or unethical practices, procedures that protect both the person who reports such practices and the accused person from premature disclosure. As we heighten awareness, we must avoid a "witch hunt." Deterrence of research fraud is clearly needed, but institution of practices that might stifle originality or discourage cooperative research would be counterproductive. PMID- 3317040 TI - Epidemiologic approach to the etiology of type I diabetes mellitus and its complications. PMID- 3317041 TI - Routine prenatal genetic screening. PMID- 3317042 TI - Long-term treatment of alcoholic liver disease with propylthiouracil. AB - Propylthiouracil has been shown experimentally to protect against alcohol-induced hepatocellular necrosis in hypoxic conditions. An earlier, short-term study of patients with alcoholism and liver disease indicated clinical improvement with propylthiouracil, but the effect on mortality could not be assessed. In the present study, we investigated the effect of propylthiouracil on mortality in patients with alcoholic liver disease in a long-term, double-blind, randomized clinical trial involving 310 compliant patients who received propylthiouracil (n = 157) or placebo (n = 153) for a maximum of two years. There were no differences between the two groups in demographic and clinical characteristics and biopsy confirmed diagnoses at randomization, or in daily urinary alcohol levels during the study. The cumulative dropout rate over two years was not significantly different (propylthiouracil group, 0.68; placebo group, 0.60). The group receiving propylthiouracil (300 mg per day) had a cumulative mortality rate half that in the group receiving placebo (0.13 vs. 0.25 [P less than 0.05] in the total sample, and 0.25 vs. 0.55 [P less than 0.03] in a subgroup of severely ill patients [propylthiouracil group, n = 56; placebo group, n = 41]). Proportional hazards stepwise regression analyses indicated that only propylthiouracil treatment, prothrombin time, hemoglobin levels, and mean daily urinary alcohol levels significantly affected mortality. The hazards ratio for the complete group indicated that mortality in the propylthiouracil group was 0.38 (95 percent confidence interval, 0.20 to 0.83) that of the placebo group. Protection by propylthiouracil was not observed in patients with high morning urinary alcohol levels. No clinically important side effects of propylthiouracil were observed at the dose used. We conclude that the administration of propylthiouracil can reduce mortality due to alcoholic liver disease. PMID- 3317044 TI - HLA matching and corneal transplantation. PMID- 3317043 TI - Current concepts. B lymphocytes. Normal development and function. PMID- 3317045 TI - AIDS and the Index Medicus. PMID- 3317046 TI - Dr. Ira Kirschenbaum. PMID- 3317047 TI - A severe outbreak of Escherichia coli O157:H7--associated hemorrhagic colitis in a nursing home. AB - In September 1985, an outbreak of Escherichia coli O157:H7 enteritis affected 55 of 169 residents and 18 of 137 staff members at a nursing home. The outbreak was characterized by two phases: a primary wave whose source was probably a contaminated sandwich meal and a secondary wave compatible with person-to-person transmission of infection. Among the elderly residents, the incubation period was 4 to 9 days (mean, 5.7 +/- 1.2). Older age and previous gastrectomy increased the risk of acquiring the infection (P = 0.01 and 0.03, respectively). Antibiotic therapy during exposure was associated with acquiring a secondary infection (P = 0.001). Hemolytic uremic syndrome developed in 12 affected residents (22 percent), 11 of whom died. Overall, 19 (35 percent) of the affected residents died, 17 (31 percent) from causes attributable to their infection. Antibiotic therapy after the onset of symptoms was associated with a higher case fatality rate in the more severe cases, possibly because patients with more severe disease tended to be treated with antibiotics. There were no complications or deaths among the affected members of the staff. Evidence of infection by verotoxin producing E. coli O157:H7 was detected in 30 of 70 cases on the basis of isolation of this organism or demonstration of free verotoxin in stools. All isolates belonged to the same phage type. The high morbidity and mortality associated with this condition emphasize the need for proper food hygiene, rapid identification of outbreaks of disease, and prompt institution of infection control techniques among the institutionalized elderly. PMID- 3317048 TI - Current medical and surgical therapy for cerebrovascular disease. PMID- 3317049 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 50-1987. A 43-year-old woman with hepatic failure after renal transplantation because of amyloidosis. PMID- 3317050 TI - Enterohemorrhagic Escherichia coli. PMID- 3317051 TI - Central nervous system lymphomas versus toxoplasmosis in a patient with AIDS. PMID- 3317052 TI - Central nervous system toxoplasmosis and hemolytic uremic syndrome. PMID- 3317053 TI - Failure of nocturnal hypoglycemia to cause fasting hyperglycemia in patients with insulin-dependent diabetes mellitus. AB - To test the hypothesis that nocturnal hypoglycemia causes fasting hyperglycemia (the Somogyi phenomenon) in patients with insulin-dependent diabetes mellitus, we studied 10 patients, who were on their usual therapeutic regimens, from 10 p.m. through 8 a.m. on three nights. On the first night, only a control procedure was performed (blood sampling only); on the second night, hypoglycemia was prevented (by intravenous glucose infusion, if necessary, to keep plasma glucose levels above 100 mg per deciliter [5.6 mmol per liter]); and on the third night, hypoglycemia was induced (by stepped intravenous insulin infusions between midnight and 4 a.m. to keep plasma glucose levels below 50 mg per deciliter [2.8 mmol per liter]). After nocturnal hypoglycemia was induced (36 +/- 2 mg per deciliter [2.0 +/- 0.1 mmol per liter] [mean +/- SE] from 2 to 4:30 a.m.), 8 a.m. plasma glucose concentrations (113 +/- 18 mg per deciliter [6.3 +/- 1.0 mmol per liter]) were not higher than values obtained after hypoglycemia was prevented (182 +/- 14 mg per deciliter [10.1 +/- 0.8 mmol per liter]) or those obtained after blood sampling only (149 +/- 20 mg per deciliter [8.3 +/- 1.1 mmol per liter]). Indeed, regression analysis of data obtained on the control night indicated that the 8 a.m. plasma glucose concentration was directly related to the nocturnal glucose nadir (r = 0.761, P = 0.011). None of the patients was awakened by hypoglycemia. Scores for symptoms of hypoglycemia, which were determined at 8 a.m., did not differ significantly among the three studies. We conclude that asymptomatic nocturnal hypoglycemia does not appear to cause clinically important fasting hyperglycemia in patients with insulin-dependent diabetes mellitus on their usual therapeutic regimens. PMID- 3317054 TI - High-dose corticosteroids in patients with the adult respiratory distress syndrome. AB - Corticosteroids are widely used as therapy for the adult respiratory distress syndrome (ARDS) without proof of efficacy. We conducted a prospective, randomized, double-blind, placebo-controlled trial of methylprednisolone therapy in 99 patients with refractory hypoxemia, diffuse bilateral infiltrates on chest radiography and absence of congestive heart failure documented by pulmonary artery catheterization. The causes of ARDS included sepsis (27 percent), aspiration pneumonia (18 percent), pancreatitis (4 percent), shock (2 percent), fat emboli (1 percent), and miscellaneous causes or more than one cause (42 percent). Fifty patients received methylprednisolone (30 mg per kilogram of body weight every six hours for 24 hours), and 49 received placebo according to the same schedule. Serial measurements were made of pulmonary shunting, the ratio of partial pressure of arterial oxygen to partial pressure of alveolar oxygen, the chest radiograph severity score, total thoracic compliance, and pulmonary-artery pressure. We observed no statistical differences between groups in these characteristics upon entry or during the five days after entry. Forty-five days after entry there were no differences between the methylprednisolone and placebo groups in mortality (respectively, 30 of 50 [60 percent; 95 percent confidence interval, 46 to 74] and 31 of 49 [63 percent; 95 percent confidence interval, 49 to 77]; P = 0.74) or in the reversal of ARDS (18 of 50 [36 percent] vs. 19 of 49 [39 percent]; P = 0.77). However, the relatively wide confidence intervals in the mortality data make it impossible to exclude a small effect of treatment. Infectious complications were similar in the methylprednisolone group (8 of 50 [16 percent]) and the placebo group (5 of 49 [10 percent]; P = 0.60). Our data suggest that in patients with established ARDS due to sepsis, aspiration, or a mixed cause, high-dose methylprednisolone does not affect outcome. PMID- 3317055 TI - Prions and neurodegenerative diseases. PMID- 3317056 TI - Allogeneic bone marrow transplantation after hyperfractionated total-body irradiation and cyclophosphamide in children with acute leukemia. AB - Ninety-seven children with either acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML) received HLA-identical bone marrow transplants from sibling donors, after preparation with 1320 cGy of hyperfractionated total-body irradiation and high-dose cyclophosphamide. Kaplan-Meier product-limit estimates (means +/- SE) of disease-free survival at five years among patients with ALL in second remission, third remission, and fourth remission or relapse were 64 +/- 9, 42 +/- 14, and 23 +/- 11 percent, respectively, with probabilities of relapse of 13 +/- 7, 25 +/- 13, and 64 +/- 16 percent. Among patients with AML in first remission, second remission, and third remission or relapse, five-year disease free survival estimates were 66 +/- 10, 75 +/- 15, and 33 +/- 19 percent, with respective relapse probabilities of 0, 13 +/- 12, and 67 +/- 19 percent. The most frequent cause of death in patients in early remission (ALL in second or third remission or AML in first or second remission) was bacterial sepsis, fungal sepsis, or both, most often in the presence of acute or chronic graft-versus-host disease. Among patients with ALL who received transplants while in second remission, the duration of the initial remission had no effect on the probability of relapse after transplantation. The only pretransplantation factor that significantly affected outcome was the disease status at the time of transplantation; patients in early remission had better disease-free survival. We conclude that transplantation after preparation with hyperfractionated total-body irradiation and cyclophosphamide is an effective mode of therapy in children with refractory forms of acute leukemia. PMID- 3317058 TI - Improving the care of patients with chronic mental illness. PMID- 3317057 TI - Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. AB - We assessed oral 5-aminosalicylic acid (5-ASA) prepared with a pH-sensitive polymer coating in 87 patients with mildly to moderately active ulcerative colitis in a double-blind, placebo-controlled trial. Patients were randomly assigned to receive 5-ASA at a dosage of either 4.8 or 1.6 g per day or placebo for six weeks. The outcome was monitored by flexible proctosigmoidoscopic examinations and physicians' assessments at three-week intervals and by patients' recordings of daily symptoms. Results showed 24 percent complete and 50 percent partial responses in those receiving 4.8 g of 5-ASA per day as compared with 5 percent complete and 13 percent partial responses in those receiving placebo (P less than 0.0001, rank-sum test). At a dosage of 1.6 g per day, the response was twice as good as with placebo, but the difference did not reach statistical significance (P = 0.51). Age, sex, duration of disease, duration of active symptoms, or extent of disease did not affect the clinical outcome. We conclude that oral 5-ASA administered in a dosage of 4.8 g per day is effective therapy, at least in the short term, for mildly to moderately active ulcerative colitis. PMID- 3317060 TI - Action of chlorhexidine on budding Candida albicans: scanning and transmission electron microscopic study. AB - Chlorhexidine is widely used as a bacterial drug whose method of action has been well described in bacteria. Its fungicidal properties have been proved. We show here the effects of a sublethal dose of a preparation of digluconate of chlorhexidine on budding Candida albicans. A fungistatic action is revealed by a decrease in the percentage of budding cells, and two main types of alterations can be observed with transmission electron microscopy (T.E.M.): a loss of cytoplasmic components and a coagulation of nucleoproteins. With scanning electron microscopy (S.E.M.), the cell walls show morphological modifications. PMID- 3317059 TI - Keratomycosis due to Alternaria alternata corneal transplant infection. AB - A 53-year-old woman was found to have an ulcer on her successfully transplanted corneal graft. Many fungal elements were observed in the smear of the ulcerated tissue, and Alternaria alternata was cultured. The ulcer was treated with pimaricin and thimerosol topically, and 5-fluorocytocin (5FC) generally and healed to scar after two months. The ulcer did not invade the host cornea, but remained in the donner cornea in all clinical course. The MIC of five drugs on the isolated strain was following; thimerosal 0.0063, pimaricin 2.0, amphotericin B 3.2, aystatin 6.3 and 5FC 100.0 micrograms/ml each. PMID- 3317061 TI - Genotoxic activity of some mycotoxins using the SOS chromotest. AB - The genotoxic activity of 11 mycotoxins was investigated in Escherichia coli K 12. The induction of the SOS function sfi A whose level of expression is monitored by means of a sfi A::lac Z operon fusion was assayed by measuring the beta-galactosidase activity in the PQ 37 strain. Most of these fungal metabolites did not induce SOS response in this bacterial test. Only aflatoxicol, a reduced metabolite of aflatoxin B1 was well detected as an SOS inducer if metabolic activation was performed. Patulin, penicillic acid and viomellein are only weak inducing agents. The other fungal compounds tested failed to demonstrate a positive SOS inducing activity. Relationship between SOS chromotest, mutagenicity to Salmonella typhimurium and in vivo carcinogenicity was discussed. PMID- 3317062 TI - Growth of Candida albicans in a minimal synthetic medium without biotin. AB - Growth of Candida albicans strain B 311-10 was observed in a minimal synthetic biotin-free medium, using different glucose concentrations, during the first 30 hours of its development at 28 degrees C. The yeast's growth was observed spectrophotometrically at 675 nm reading its optical density every hour. The minimal medium of Shepherd et al., with glucose (15 g/L) and biotin was modified: this vitamin was eliminated and the concentration of glucose was gradually lowered to 0.5 g/L. At 5 g/L of glucose and without biotin very good growth was obtained. Based on our results during the first 30 hours of growth, biotin has no influence on the yeast's growth. This medium would be useful for the study of the physiology of C. albicans during the first period of its development. PMID- 3317063 TI - Evolution: sex among the parasites. PMID- 3317064 TI - Tumour necrosis factor. Another chapter in the long history of endotoxin. PMID- 3317065 TI - Interleukin-1 regulates synthesis of nerve growth factor in non-neuronal cells of rat sciatic nerve. AB - The Schwann cells and fibroblast-like cells of the intact sciatic nerve of adult rats synthesize very little nerve growth factor (NGF). After lesion, however, there is a dramatic increase in the amounts of both NGF-mRNA and NGF protein synthesized by the sciatic non-neuronal cells. This local increase in NGF synthesis partially replaces the interrupted NGF supply from the periphery to the NGF-responsive sensory and sympathetic neurons, whose axons run within the sciatic nerve. Macrophages, known to invade the site of nerve lesion during wallerian degeneration, are important in the regulation of NGF synthesis. Here we demonstrate that the effect of macrophages on NGF-mRNA levels in cultured explants of sciatic nerve can be mimicked by conditioned media of activated macrophages, and that interleukin-1 is the responsible agent. PMID- 3317066 TI - Anti-cachectin/TNF monoclonal antibodies prevent septic shock during lethal bacteraemia. AB - Bacterial infection of the mammalian bloodstream can lead to overwhelming sepsis, a potentially fatal syndrome of irreversible cardiovascular collapse (shock) and critical organ failure. Cachectin, also known as tumour necrosis factor, is a macrophage-derived peptide hormone released in response to bacterial lipopolysaccharide, and it has been implicated as a principal mediator of endotoxic shock, although its function in bacterial sepsis is not known. Anaesthetized baboons were passively immunized against endogenous cachectin and subsequently infused with an LD100 dose of live Escherichia coli. Control animals (not immunized against cachectin) developed hypotension followed by lethal renal and pulmonary failure. Neutralizing monoclonal anti-cachectin antibody fragments (F(ab')2) administered to baboons only one hour before bacterial challenge protected against shock, but did not prevent critical organ failure. Complete protection against shock, vital organ dysfunction, persistent stress hormone release and death was conferred by administration of antibodies 2 h before bacterial infusion. These results indicate that cachectin is a mediator of fatal bacteraemic shock, and suggest that antibodies against cachectin offer a potential therapy of life-threatening infection. PMID- 3317067 TI - Transcription in yeast activated by a putative amphipathic alpha helix linked to a DNA binding unit. AB - Gene activation by a DNA-binding regulatory protein in yeast requires the protein to have two components: one to recognize a specific DNA sequence and a second, the 'activating region', to interact with a general transcription factor or perhaps with RNA polymerase. The activating regions that have been characterized are acidic, and mutational analysis of one indicates that this acidity is important for activity. Here we report the design of an artificial protein bearing a novel 15-amino acid peptide linked to a DNA binding fragment of the yeast regulatory protein GAL4). The synthetic peptide is acidic and should it form an alpha-helix, that helix would be amphipathic, having one hydrophilic face bearing the acidic residues, and one hydrophobic face. When expressed in yeast, the artificial protein bearing this peptide efficiently activates the GAL1 gene which is ordinarily activated by GAL4. An otherwise identical protein with the novel 15 amino acids in a scrambled order, and which is thus unable to form an amphipathic structure, does not activate GAL1 transcription. PMID- 3317068 TI - [Zoophagous fungi]. AB - Fungi which kill microscopic animals of different systematic origin by capturing, invading, and digesting them are described. The focal point is nematode destroying fungi, as being the most abundant, most often isolated and most intensively studied. Their ecology and their probable role in the control of nematodes are discussed. PMID- 3317069 TI - [Modern electron microscopy at cellular and macromolecular levels. Strategies for preparation, imaging and image interpretation]. AB - Conventional electron microscopy has significantly contributed to the understanding of structure-function relationships in living systems on cellular and macromolecular levels. New approaches and strategies will provide further insight into the organization of life. These new developments include cryopreparation and imaging techniques, X-ray microanalysis on frozen samples, electron energy loss spectroscopy, electron spectroscopic imaging, electron microscopic immunocytochemistry, preparation and imaging of ordered two dimensional arrays of macromolecules, and computer image analysis and reconstruction. The techniques are described. Selected examples illustrate potential and limitations of these approaches and strategies. PMID- 3317070 TI - Age-related changes in the response to vasoconstrictor and dilator agents in isolated beagle coronary arteries. AB - Responses to vasoactive agents were compared in helical strips of coronary arteries isolated from beagles of 30 days, 3 months, 2 years and 12 years old. Serotonin contracted the arterial strips dose-dependently, the contraction being greater in the arteries of proximal portion than in the distal arteries. The contraction increases with age from 3 months to 12 years, although EC50 values did not differ. Angiotensin II contracted distal coronary arteries to a greater extent than the proximal ones. Age did not alter the peptide-induced contraction. In prostaglandin F2 alpha-contracted coronary arteries, acetylcholine-induced relaxations, dependent on endothelium, were less in the arteries from senescent beagles than in those from adult beagles (2 years old). Histamine relaxed the infant beagle arteries to a lesser extent than the adult and senescent beagle arteries. Histamine-induced relaxations were attenuated selectively by cimetidine. Relaxations caused by adenosine and prostaglandin I2 did not differ in coronary arteries from beagles of different ages. It may be concluded that greater responsiveness to serotonin of senescent beagle coronary arteries is due preferentially to increased function of serotonergic receptors rather than impaired function of the arterial endothelium responsible for the release of relaxing factor(s), although some impairment of the function is supposed, on the basis of interferences with acetylcholine-induced relaxation in the aged beagle arteries. Histaminergic H2 receptor function appears to develop in beagle coronary arteries until 3 months of age. PMID- 3317071 TI - The current role of radiation in the management of breast cancer. PMID- 3317072 TI - The role of systemic therapy in early breast cancer. PMID- 3317073 TI - [Current developments in the field of infection caused by gram-negative microorganisms; passive immunization using anti-endotoxin antibodies]. PMID- 3317075 TI - [Computer-assisted continuing education]. PMID- 3317074 TI - [Having little to eat is better than swallowing everything]. PMID- 3317076 TI - [Possibilities and limitations of scintigraphy of the parathyroid glands]. PMID- 3317077 TI - [Tumor markers; a review]. PMID- 3317078 TI - [Consensus prevention of neonatal herpes]. PMID- 3317079 TI - [Allogeneic bone marrow transplantation in the treatment of chronic myeloid leukemia]. PMID- 3317080 TI - [Hierarchy rule as a principle of psychopathology]. PMID- 3317081 TI - [Critical comments on the methods of assessing the effectiveness of antidepressive pharmacotherapy]. PMID- 3317082 TI - Recruiting nature's resources in cancer therapy. Enter interleukin 2. PMID- 3317083 TI - Recent insights into the function of hepatic sinusoidal cells. PMID- 3317084 TI - A changeover to U100 insulins in The Netherlands? PMID- 3317085 TI - Congenital deficiency of leukocyte-adherence glycoproteins: a familial defect. PMID- 3317086 TI - A type I diabetic patient with nodule and abscess formation after long-term CSII therapy who benefits from jet therapy. PMID- 3317087 TI - Disseminated Nocardia asteroides infection complicating renal transplantation. PMID- 3317088 TI - Cryptococcus neoformans meningitis following renal transplantation. PMID- 3317089 TI - The changeover to U100 insulin in the United Kingdom. PMID- 3317090 TI - Renal function during recovery from minimal lesions nephrotic syndrome. AB - We followed renal function through the natriuretic phase of 6 occasions of drug induced recovery from minimal lesions nephrotic syndrome (MLNS). Protein excretion started to fall 1-3 days prior to the start of the natriuresis. The natriuresis was accompanied by a rise in glomerular filtration rate (GFR, inulin clearance). The filtration fraction, calculated from the GFR and the p aminohippurate clearance, rose steadily in 5 subjects in whom it was low before therapy. Proximal and distal sodium reabsorption fractions, estimated from the changes in maximum free water clearance, fell, and fractional sodium, lithium, uric acid and free water clearance rose. At the time of these changes plasma protein had hardly risen, whereas renin activity was down. These results are in agreement with the notion that the sodium retention of MLNS is due to a renal defect. Repair of the glomerular filter, evident from the disappearance of proteinuria and the rise in filtration fraction, apparently normalizes the elevated tubular sodium reabsorption proximal to the macula densa, which leads to a fall in renin release. PMID- 3317091 TI - Exercise training reduces depression and increases the performance of pleasant activities in hemodialysis patients. AB - This study compares the effects of a structured exercise training program to the therapeutic benefits of a 'support' group on the depressed mood and reduced performance of pleasant activities by hemodialysis patients. After 6 months of an aerobic exercise training program, the 10 exercisers showed a significant increase in maximal aerobic capacity (VO2max) and a significant decrease in dysphoric mood when compared to 7 patients attending the support group. Support group participants reported a significant decrease in pleasant activities while there was no change in the exercisers. Eighteen months after the exercise training program, the exercisers reported continued low levels of depressed mood, and were performing significantly more pleasant activities than they reported prior to the exercise program. The results of this study suggest an exercise training program may be useful in the psychosocial rehabilitation of some hemodialysis patients. PMID- 3317093 TI - [Ultrasonic diagnosis and follow-up of aneurysms of the ampulla of Galen in infants]. AB - An aneurysm of the vein of Galen can have a varied sonographic appearance in infancy. The classical picture is a spherical posterior third ventricular mass with no internal echoes. With varying degrees of thrombosis of the aneurysm which may occur spontaneously or after surgery, the mass became hyper-echogenic. Our experience in two patients with this spectrum of echographic findings will be demonstrated and correlated with clinical findings CT scan, and angiography. PMID- 3317092 TI - Rabbit nephrotoxic nephritis: effect of a thromboxane synthetase inhibitor on evolution and prostaglandin excretion. AB - Accelerated anti-glomerular basement membrane nephritis was induced in rabbits, and the immunological, clinical and histological evolution studied in relation to urinary immunoreactive thromboxane B2 (i-TXB2) and immunoreactive prostaglandin E2 (i-PGE2) excretion. In control nephritic animals, urinary i-TXB2 increased 5 fold on day +1, but was normal again by day +5. The urinary i-TXB2 showed a positive correlation with creatinine clearance (CCr), proteinuria and anti-sheep immunoglobulin antibody. Urinary i-PGE2 excretion increased by 50% on day +1, but was indistinguishable later from controls. The effects of the specific thromboxane synthetase inhibitor OKY-046 on this model was studied. In non nephritic control animals, OKY-046 did not affect the CCr, the urinary protein excretion or the number of monocytes in glomeruli but reduced the excretion of i TXB2. Although OKY-046 markedly inhibited the i-TXB2 excretion throughout the experiment in nephritic animals, the creatinine clearances were significantly worse, the proteinuria greater, and the number of infiltrating monocytes greater at day +5; by day +10 there was no difference from controls. There was no evidence that TXB2 is involved in the induction of proteinuria, and increased PGE2 synthesis did not protect against later proteinuria and fall in creatinine clearance. Inhibition of thromboxane synthetase appears to make this model of nephritis worse, rather than better. PMID- 3317094 TI - [Aneurysms of the vein of Galen. Angiographic study and morphogenetic considerations]. AB - The angiographic and/or anatomic study of a series of 30 cases of Vein of Galen aneurysm (which is defined as an arterio-venous fistula within the wall of the vein of Galen itself, therefore as a purely extra cerebral lesion) permits the analysis of the afferent arteries, of the efferent veins, and of the aneurysmal sac itself. The examination of the afferent arteries confirms the data from the literature, indicating that most often it consists of the abnormal hypertrophy of otherwise normally organized arteries, including the dural arteries. In particular, the involvement of distal subcallosal branches of the anterior cerebral arteries as well as the arterio-arterial maze extending above the collicular plate, fit well the normal anatomy. The venous side of the malformation nevertheless presents with more unusual features; the most striking is the non-opacification of the straight sinus and/or part of the transverse sinuses in half of the cases; also, an aberrant falcine sinus is frequently observed, which actually represents the persistence of a normal channel in the fetal anatomy. A more complex pattern was observed in two cases in which the aneurysmal sac drained into the straight sinus via a loop made of a falcine sinus, the superior sagittal sinus and then backward through a second falcine sinus. Finally, from the systematization of the afferents arteries, the aneurysmal sac appears to belong both to the (prosencephalic) velum interpositum and to the ambient cistern. Such a vessel cannot be either the true vein of Galen or an internal cerebral vein; therefore it has to be a persistent fetal vein, the median prosencephalic vein, which drains the choroid plexuses of the lateral and third ventricles between the 7th and 12th weeks, and disappears normally to be replaced by the internal cerebral veins, when the intrinsic vascularization of the neural tube develops. The adult pattern of the brain artery being attained during the 8th week, the event that led to the arterio venous fistula should have occurred some time during the 3rd month. Unfortunately, no clue was found to orient to a specific cause for the anomaly. The frequently observed venous occlusions are actually not seen in neonates but rather in older children. This, and the fact that spontaneous thromboses within the malformative veins have been observed in vivo, make likely the conclusion that venous occlusions are a secondary phenomenon only. PMID- 3317095 TI - [Macroscopical appearance of 2 aneurysms of the ampulla of Galen disclosed by acute asystole]. AB - Angiography by an umbilical approach in two neonates with acute asystole at birth showed large arteriovenous malformations drained by Galen's ampulla. Embolization by balloon catheter was attempted in one child (Pr J.J. Merland). The infants died at 3 and 5 days respectively and data from dissection of brains was compared with those of angiography. PMID- 3317096 TI - Selection of patients for clinical drug trials in migraine. AB - General concepts and specific factors to be used in the selection of patients for clinical drug trials in migraine are discussed. The definition of common migraine has been unsatisfactory and new diagnostic operational criteria are recommended. Patients with headaches that are a mixture of tension headache and migraine, and migraineurs who have interval headaches which are not clearly differentiated from migraine should be excluded. The headaches should be of moderate to severe degree, in the range of 2-6 per month, and should last from 3 h to 3 days. It would be best for migraine to have been present for at least 1 year, with 3 months retrospective and 2 months prospective observation prior to drug trial. The age of onset of migraine should be below 50, and the age of entry into the study less than 60. Migraineurs in good health, of either sex, are to be included in the study. Occasional use of minor tranquilizers and sedatives as well as of contraceptive drugs is acceptable, but patients who abuse drugs, who are allergic to compounds related to the trial drug and who require major psychotropic medication should be excluded. Also excluded are those whose compliance with the drug trial is doubtful for intellectual or, more often, psychological reasons. PMID- 3317097 TI - Selection of patients--critical aspects. AB - Proper selection of patients is the most critical aspect in designing clinical trials in migraine research. We establish specific research diagnostic criteria for the definition of migraine. Additional factors in patient selection, migraine frequency, duration, medications and previous treatments, are reviewed. Exclusion criteria and the mixed headache syndrome patient are discussed. PMID- 3317098 TI - Placebo effect and clinical trials in migraine therapy. AB - Migraine is a cyclical condition in which the cycles may occur or remit in an unpredictable fashion. The goal of prophylactic antimigraine therapy is to induce remission of an active cycle of migraine or to inhibit occurrence of individual headaches until the cycle remits for other reasons. The placebo effect probably takes advantage of these cycles. The placebo effect is significant and quite potent. The placebo effect may be divided into (1) the initial effect and (2) the continuing effect which is seen following a stabilization period. The initial placebo effect is dramatic with 62% of 188 subjects improving by 75% after 4 weeks of placebo. The continuing effect is demonstrated by occurrence of 75% further improvement in 28% of 282 subjects in 7 studies in which comparison of results after 4-12 weeks was made with a placebo stabilization period. The placebo effect is a very potent one and must be taken into account in designing and carrying out studies of migraine therapy. PMID- 3317099 TI - Special issue dedicated to Eric M. Shooter and Silvio Varon. PMID- 3317100 TI - Proteolytic enzymes in the post-translational processing of polypeptide hormone precursors. AB - Selective and limited proteolysis is a key step in the post-translational modification of peptide hormone precursors. This process appears to involve a proteolytic machinery including highly specific endoproteases. Some of the enzyme systems possibly involved in the processing of pro-neuropeptides will be described and their mechanism of action discussed. Special emphasis will be on the following: i) the physico-chemical characteristics of proteolytic enzymes which are believed to be involved in the processing of some of these polypeptide hormone precursors; ii) the bio-specificity of these enzymes toward the substrates; iii) the importance of both secondary and tertiary structures of the cleavage domain in recognition by the selective proteases. These properties will be discussed in connection with the possible importance of the maturation enzymes in the in vivo regulation of hormone biosynthesis. PMID- 3317101 TI - Expression of the alpha subunit of 7S nerve growth factor in the mouse submandibular gland. AB - alpha-NGF is an inactive serine protease that is associated in the mouse submandibular gland with a closely related serine protease, gamma-NGF, and the neurotrophic factor, beta-NGF. The heterogeneity of purified alpha-NGF has been examined by DEAE-cellulose chromatography and SDS polyacrylamide gel electrophoresis. A possible explanation for the observed heterogeneity is presented. Antibodies have been prepared against alpha-NGF and purified by affinity chromatography so that they do not cross-react with gamma-NGF. This antibody preparation recognizes two very similar proteins in male mouse submandibular gland RNA-directed cell-free translation mixtures. The expression of only one of these forms is regulated by testosterone. Oligonucleotide probes specific for each of the three NGF subunits have been prepared and used for Northern blot analysis of RNA from the mouse submandibular gland. The three subunits were found to be coordinately expressed and each were 30-fold more abundant in male than in female glands. PMID- 3317102 TI - Homage to Professor J.Z. Young, FRS on his eightieth birthday. J.Z. Young and neuropathology. PMID- 3317103 TI - Antigenic expression by cells derived from human gliomas does not correlate with morphological classification. AB - We have found that cell populations derived from human gliomas can be divided into antigenic classes which are not predictable on the basis of standard morphological analysis and which, most frequently, do not support the lineage assignations of various tumours as determined by traditional neuropathological methods. For example, only 6/60 cultures derived from astrocytomas expressed glial fibrillary acidic protein (GFAP), an astrocyte specific marker, and all six of these cultures were derived from morphological categories which more frequently gave rise to populations which did not express GFAP. None of the seven oligodendrogliomas or four oligo-astrocytomas examined expressed antigens specifically expressed by oligodendrocytes. Most tumour-derived populations, from all classes of tumour and all grades of malignancy, expressed cell-surface fibronectin, an extracellular matrix protein only rarely found on the surfaces of CNS macroglia; such cells did not express glial-specific antigens (e.g., GFAP) in vitro. Investigation of antigen expression in tumour biopsies indicated that some tumours also consisted largely or wholly of cells which expressed fibronectin in situ. Fibronectin-expressing cells were aneuploid and were not contact inhibited in their growth, indicating that they were transformed cells. We have also identified two previously unknown antigenic phenotypes among the gliomas. PMID- 3317104 TI - Damage of thalamus and basal ganglia in asphyxiated full-term neonates. AB - Thalamic-striatal damage of symmetric bilateral distribution was found in four severely asphyxiated neonates born at term. Two patients showed evidence of bilateral thalamic-striatal necrosis and two showed hemorrhage of the same distribution. The four patients had a common history of prolonged asphyxia in the neonatal period combined with severe acidosis and respiratory insufficiency. The outcome was lethal in all children. Three patients survived for some time and showed additional evidence of generalized brain damage including cortical necrosis and subcortical leucomalacia and one patient was found to have intravital calcification of the putamen at 14 days of age. The appearance of thalamic-striatal damage in US, CCT and NMR imaging is discussed. Thalamic striatal damage may not be detectable by US until several days after the initial insult. US does not permit a distinction between necrosis and hemorrhage, but CCT and NMR imaging may be successful. Only five infants with a comparable pattern of brain damage due to asphyxia have been described so far. Our own studies seem to indicate that thalamic-striatal damage is the hallmark of more widespread brain damage, and that it will be found more frequently if carefully looked for in asphyxiated neonates born at term. PMID- 3317105 TI - Tumors of the brachial plexus. AB - Over a 17-year period, 56 patients with 57 tumors involving the brachial plexus were operated upon. The 40 neural sheath tumors included 26 neurofibromas, 8 schwannomas, 4 malignant neural sheath tumors, 1 fibrosarcoma, and 1 meningioma. Nine of the neurofibromas were associated with von Recklinghausen's disease (VRD), and 2 others were what was termed regionalized neurofibromatosis characterized by involvement of one limb with extension along the course of one or more plexus elements. Seventeen tumors were not of neural sheath origin; 7 were benign and 10 were metastatic malignant tumors compressing or invading the plexus. Benign neurofibromas and malignant sheath tumors almost always presented with pain or functional neural deficit, whereas schwannomas often presented with a palpable mass as their only initial symptom. Patients with solitary neurofibromas were significantly older, often female, and more likely to have tumor on the right side than patients with schwannomas, malignant neural sheath tumors, or neurofibromas associated with VRD. Solitary neurofibromas could often be totally resected without added deficit by sacrificing fascicles entering and leaving tumor that were determined to be "nonfunctional" by intraoperative nerve action potential recordings. Resection of neurofibromas associated with VRD sometimes but not always resulted in significant loss. Operation is nonetheless recommended, especially when malignancy is suspected because of rapidly increasing size, when severe pain or neural deficit is present, or when compression of adjacent plexus elements is a concern. Schwannomas and benign non neural sheath tumors can usually be extirpated without damage to plexus elements. Forequarter amputation is advised for malignant intrinsic tumors involving distal plexus elements even though gross total resection seems feasible. PMID- 3317106 TI - Radiofrequency hyperthermia for malignant brain tumors: preliminary results of clinical trials. AB - Local hyperthermia by 13.56-MHz radiofrequency (RF) capacitive heating was evaluated in 16 patients with malignant brain tumors. Intracranial heating during operation was performed in 4 patients. RF applicators with a cooling system were placed on the cerebral convexity and medial brain surface with the tumor between them. RF power was controlled to maintain the brain temperatures under 40 degrees C. Under this condition, the highest temperature of each tumor varied from 44 to 49 degrees C. After heating for about 60 minutes, 2 tumors showed regression on computed tomographic (CT) scans. Extracranial heating was performed in 12 patients with cerebral glioblastoma. RF applicators were placed on the lateral sides of the scalp and applied to diametrically opposite sides of the tumor. To avoid the influence of the skull on RF conduction, we performed a bilateral craniectomy slightly larger than the applicator at the initial operation. Heating was performed for approximately 60 minutes at each session and was repeated twice a week for a total of 4 to 10 times in combination with radiation and ACNU chemotherapy. No anesthetic agent was used during heating. Brain temperatures were maintained under 42 degrees C. The scalp under the applicators remained at 28-35 degrees C during heating, and no heat injury of the scalp was observed after repeated heating. The highest temperatures of the tumor or cavity after tumor removal were 45-46 degrees C in 3 cases, 43-44 degrees C in 3 cases, 42-43 degrees C in 4 cases, and 40-41 degrees C in 2 cases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317107 TI - Solitary eosinophilic granuloma of the frontal lobe. AB - Solitary intracranial eosinophilic granulomas are rare and most frequently involve the hypothalamus. We report an unusual case of solitary eosinophilic granuloma of the frontal lobe in a patient without evidence of systemic disease. Previously reported cases of solitary intracranial nonhypothalamic lesions are reviewed, and the clinical, radiographic, and histological features of this case are discussed. PMID- 3317108 TI - Ganglioglioma of the cerebellum: case report. AB - The authors report a rare case of a cerebellar ganglioglioma. A review of 12 previously reported cases and our case suggest that surgical removal of this neoplasm carries a good prognosis. PMID- 3317109 TI - Fixation system for cervical spinal operation: application of the head fixation system and multipurpose cervical frame. AB - We have designed a multipurpose cervical frame to use with our operative head fixation system and have used it in 60 cervical spinal operations including anterior, posterior, lateral, and transoral approaches, with satisfactory results. We emphasize the following advantages of this system: (a) Both stability and an exact position of the cervical spine can be maintained during operation. (b) Positioning of patients for operation, including those with a halo vest, is efficiently carried out with safety and ease. (c) Our newly designed cervical frame enables exact and refined intraoperative retraction with various kinds of retractors. (d) When microsurgery is performed, the surgeon can sit at the patient's head in an operating chair. PMID- 3317111 TI - Comparison of brain imaging and neuropathology in cases of trisomy 18 and 13. AB - A comparative study of intracranial imaging and brain pathology in cases of trisomy 18 and 13 was performed. Computed tomography (CT) and ultrasonography (US) revealed disproportional dilatation of the lateral ventricles, a wide Sylvian fissure and a large extracerebellar space with a small cerebellum in each case. In addition, it was characteristic that the occipital poles of the cerebrum protruded in the infero-posterior direction in trisomy 18, and the pontine basis was relatively wide in trisomy 13. The brain pathology in trisomy 18 and 13 demonstrated that the large extracerebellar space is due to the cerebellar dysplasia and protruding occipital poles, the wide Sylvian fissures due to the temporal lobes or external capsular dysplasia, and the relatively wide pontine basis due to meningeal glioneuronal heterotopia. Thus, the characteristic intracranial image in trisomy 18 and 13 suggest microdysgenesis of the brain and might be useful for understanding the pathological structure of the central nervous system in these conditions. PMID- 3317110 TI - Giant cystic craniopharyngiomas. AB - Three cases of giant cystic craniopharyngiomas with large areas of extension beyond the suprasellar area are presented. The magnetic resonance (MR) appearance in one case is described. These giant tumors had large, multilobulated cysts that comprised the bulk of the tumors. In one case, there was an unusual extension of the large tumor cyst into the lateral ventricle. In two cases, the tumors extended to the level of the foramen magnum. On CT, the cyst contents of these two tumors were hyperdense and became hypodense postoperatively. All three tumors harbored calcifications in the form of clumps in the suprasellar region and rim calcifications around the cysts. None of the tumors exhibited contrast enhancement. A literature review of the radiographic features of craniopharyngiomas is discussed. PMID- 3317112 TI - Aneurysms of the peripheral portion of the anterior inferior cerebellar artery; report of two cases. AB - Two cases of extremely rare aneurysms of peripheral portions of the AICA are reported with a review of the pertinent literature. According to reported surgical findings, nearly all of the aneurysms originated from arterial loops near the internal acoustic meatus. These aneurysms can therefore, cause the cerebellopontine angle syndrome, with or without subarachnoid hemorrhage. PMID- 3317113 TI - Aging changes in synaptology of luteinizing hormone-releasing hormone neurons in male rat preoptic area. AB - This study was undertaken to examine some aspects of the anatomical substrate for reproductive senescence. Immunocytochemically identified luteinizing hormone releasing hormone neurons and their processes in the male rat brain preoptic area were compared in young adult (2-4 months), middle-aged (12-14 months) and old (20 23 months) animals. At the light microscopic level there were no age-dependent differences in total numbers or sizes of LHRH neurons nor in their distribution in the brain. Examination of these neurons at the electron microscopic level did reveal significant differences in certain organelles and in the degree and kind of synaptic input. Random sections of middle-aged luteinizing hormone-releasing hormone neurons more frequently passed through the nucleolus and the incidence of nematosomes was higher than in luteinizing hormone-releasing hormone neurons from the young and old animals. Quantitative measures of synaptic input to luteinizing hormone-releasing hormone soma and dendrites as well as to unidentified neurons in the same thin section were made. These are reported as percent of membrane that showed synaptic structure. Dendrites of both luteinizing hormone-releasing hormone and nonidentified neurons were more densely innervated than perikarya. The density of synaptic input to luteinizing hormone-releasing hormone neurons was significantly greater than that to nonidentified neurons in young and middle aged animals, but was equal to that of nonidentified neurons by old age. Age related changes were noted in synaptic organization with the most significant change being an increased input to luteinizing hormone-releasing hormone perikarya. Indeed, synaptic input to luteinizing hormone-releasing hormone perikaryal membrane was increased three-fold by middle age and ten-fold by old age. Density of synaptic input to luteinizing hormone-releasing hormone dendritic membrane did not change with age. There were no aging changes in percentage of membrane with synaptic structure in nonidentified elements. Synapses were also classified on the basis of their synaptic vesicle content. There were proportionately more synaptic boutons containing round clear than pleomorphic vesicles in the young sample. The proportion of synapses with pleomorphic vesicles increased with age onto both luteinizing hormone-releasing hormone perikarya and their dendrites. The proportion of boutons containing some electron dense-core vesicles along with clear vesicles decreased with age onto both luteinizing hormone-releasing hormone and nonidentified neurons and their processes. PMID- 3317115 TI - Jerzy Olszewski: cartographer of the brain stem reticular formation. PMID- 3317114 TI - Localization of an epitope of a microtubule-associated protein 1x in outgrowing axons of the developing rat central nervous system. AB - We have shown that monoclonal antibody, G10, labels developing rat cerebellum in a manner consistent with the presence of microtubule-associated protein 1x in growing axons. In this paper we show that all growing axons investigated in post natal and pre-natal developing rat brain contain microtubule-associated protein 1x and that neither dendrites, cell bodies nor glia are labelled by G10. The distribution of the G10 epitope as shown by immuno-electron microscopy is consistent with its localization to axonal microtubules. On Western blots there is only a small decrease in microtubule-associated protein 1x from first-natal day 7 to adulthood, in contrast to the dramatic decrease in immunofluorescence during axonal maturation. The G10 epitope is therefore probably masked in adult brain. The spatial and chronological coincidence of the G10 epitope with axonal elongation offers the possibility of using this monoclonal antibody to probe the function of the cytoskeleton during neuronal growth. PMID- 3317116 TI - [Serratia marcescens endocarditis on an aortic valve prosthesis made from bovine pericardium]. PMID- 3317117 TI - [Critical review of the results of vagotomy in the treatment of duodenal ulcer]. PMID- 3317118 TI - [Current status of the surgical therapy of peptic ulcer]. PMID- 3317119 TI - [Clinical picture of gastro-esophageal and duodeno-gastric reflux]. PMID- 3317120 TI - [Athletic vascular injuries]. PMID- 3317121 TI - [Traumatic vascular lesions of the extremities]. PMID- 3317122 TI - [Update in the treatment of neoplasms of the bile ducts]. PMID- 3317123 TI - [Tumors of the kidney]. PMID- 3317124 TI - [Open problems on the subject of low anterior resection for rectal carcinoma]. PMID- 3317125 TI - [Right hemicolectomy for cancer]. PMID- 3317127 TI - [Update on the surgical treatment of cancer of the breast]. PMID- 3317126 TI - [Role of intraoperative echography in surgery of neoplasms of the bile ducts and pancreas]. PMID- 3317128 TI - Late cosmetic results of wound closure, strips versus suture. AB - Following 264 non-contaminated abdominal operations, skin closure was performed after randomization to Steri-Strip tape suture or conventional continuous 3-o or 4-o Dermalon suture. The cosmetic results were evaluated six and 46 months after the operation. In the six-month review Steri-Strip tape suture showed advantages over conventional suturing. However, follow-up of 217 patients revealed no significant differences in late cosmetic results after about four years. PMID- 3317129 TI - [Problems of therapeutic training in conducting short-term psychotherapy]. AB - On the basis of personal experience several problems facing the psychotherapist in the practice of short-term therapy are reviewed. The paper begins with a brief review of the training given with reference to the time element and the language used in psychotherapy. The chapter entitled "Hard and Soft Elements in Therapy" shows how much influence so-called external or contextual factors have on therapy. This is followed by two short chapters on the involvement of the patient's family or other partners or a health worker in the treatment given. PMID- 3317130 TI - [Pregnancy in women with clinical pre-gestational diabetes. Recent findings in physiopathology, monitoring and therapy]. PMID- 3317131 TI - [Clinical problems of peripartum myocardiopathy]. PMID- 3317132 TI - [Surgery of malignant tumors of the ovary]. PMID- 3317133 TI - Ultrastructural localization of fibroblast growth factor in neurons of rat brain. AB - The distribution of fibroblast growth factor (FGF) at the ultrastructural level in the brain of young (15- and 20-day-old) and adult (3-month-old) rats was investigated by immunocytochemistry. Strong staining was observed in most neurons of the cortex of young rat brain. In the same brain area of adult rat many neurons were also stained intensely, while others were negative. Neurons in the other parts of the brain and especially in the adult rat, were generally more weakly stained. The reaction product was located in the cytoplasm of the neuronal cell bodies and their processes. Astrocytes, oligodendrocytes, microglial cells, meningeal cells, choroid epithelial cells, ependymal cells and capillary endothelial cells showed no staining. PMID- 3317135 TI - Electrophysiological responses of hamster suprachiasmatic neurones to neuropeptide Y in the hypothalamic slice preparation. AB - The rate and pattern of neuronal discharge in the hamster suprachiasmatic nucleus (SCN) was studied using an in vitro hypothalamic slice preparation. The firing rate of hamster SCN neurones (n = 183 cells) exhibited a circadian variation similar to that reported in the rat. SCN neurones tested for responses to pressure ejection of neuropeptide Y (NPY) (n = 49) were either tonically excited (65%) or unresponsive (35%). There was a tendency for more NPY-responsive cells to be recorded during the light phase of the circadian light-dark cycle. PMID- 3317134 TI - Vestibulospinal pathway in rabbit includes GABA-synthesizing neurons. AB - When Fast blue is injected into the rabbit spinal cord it is retrogradely transported into nerve cell bodies located in the medial and the descending vestibular nuclei. Approximately 50% of the Fast blue-positive cells also contain glutamic acid decarboxylase-like immunoreactivity. These neurons presumably synthesize gamma-aminobutyric acid (GABA) and the rabbit vestibulospinal pathway therefore contains a substantial inhibitory component. PMID- 3317136 TI - Chicken II luteinizing hormone-releasing hormone inhibits the M-current of bullfrog sympathetic neurons. AB - The M-current of dissociated bullfrog sympathetic neurons, measured by the whole cell patch clamp technique, is powerfully inhibited by chicken II LH-RH (luteinizing hormone-releasing hormone), with 50% inhibition near 1 nM. Chicken II LH-RH is approximately 100 times more potent than salmon LH-RH, and at least 1000 times more potent than other known naturally occurring LH-RH analogs (chicken I LH-RH, mammalian LH-RH, and lamprey LH-RH). This high potency makes chicken II LH-RH a candidate for the endogenous transmitter mediating the late, slow excitatory postsynaptic potential (EPSP) in bullfrog sympathetic ganglia. PMID- 3317139 TI - Congress adopts new plan for legislative program. PMID- 3317137 TI - Phase shifts in the circadian activity rhythm induced by triazolam are not mediated by the eyes or the pineal gland in the hamster. AB - A single injection of the benzodiazepine triazolam, which is though to act by potentiating the effects of the neurotransmitter gamma-aminobutyric acid (GABA), can induce permanent phase shifts in the circadian rhythm of locomotor activity of hamsters. Occurrence of GABA immunoreactivity and benzodiazepine receptors in the retina, which contains photoreceptors that relay synchronizing light-dark information to the mammalian circadian system, raises the possibility that triazolam may influence circadian rhythmicity via an action on the retina. However, the phase shifting effects of triazolam on the activity rhythm were unaffected by blinding: the direction and the magnitude of the phase shifts were similar in blind hamsters and in sighted hamsters maintained in constant darkness. Furthermore, no change in response to triazolam was observed in hamsters studied through 84 days after blinding. In addition, benzodiazepine binding sites have been found in the mammalian pineal gland, which has also been implicated in circadian rhythmicity. Therefore, its possible involvement in mediating the phase advancing effects of triazolam on the circadian clock has also been tested: the response was similar in blind and blind-pinealectomized animals. These results indicate that the effects of triazolam on the circadian clock are not mediated by the eyes or the pineal gland. PMID- 3317138 TI - 5-Hydroxytryptophan (5-HTP)-immunoreactive neurons in the rat brain tissue. AB - We demonstrated the presence of 5-hydroxytryptophan (5-HTP), the immediate precursor of serotonin (5-HT), in the rat brain tissue using a glutaraldehyde coupled immunohistochemical technique. The immunoreactivity of 5-HTP was intensified in the colchicine-pretreated rat. The distribution of labelled cells was the same as for 5-HT-immunoreactive cells, but they were fewer in number. PMID- 3317140 TI - Treat human diabetes with human insulin. PMID- 3317141 TI - Mandatory assignment of Medicare. PMID- 3317142 TI - Direct third party reimbursement for nursing services: a review of legislation and implementation. PMID- 3317143 TI - Cerebral resuscitation: pathophysiology and therapy. AB - The interest in the possibility of cerebral resuscitation has been growing exponentially during the last decade. It became clear that pharmacotherapeutic interaction can possibly alter the outcome of cerebral hypoxia/ischemia. The present review is an attempt to provide an organizational framework for a systematic integration of studies specifically dealing with pharmacological treatment post-insult. PMID- 3317144 TI - Intracranial self-administration methodologies. AB - Intracranial drug self-administration (ICSA) offers a relatively new approach for investigating the neurobiological mechanisms involved in brain reinforcement processes. Discrete brain regions responsible for the initiation of neuronal activity associated with the response-contingent delivery of a drug reinforcer can be identified using these procedures since the drug is infused directly into a specific brain locus. In the last decade, several papers have appeared in the literature reporting the self-administration of various substances into a number of brain regions. However, different laboratories often employ diverse methodological procedures to demonstrate ICSA, and this can lead to erroneous conclusions when comparing data from different investigations. This review presents a critical evaluation of the current status of research in this area and suggests behavioral as well as methodological guidelines for future investigations to follow. PMID- 3317145 TI - Membrane properties and the signal conduction of the horizontal cell syncytium of the teleost retina. PMID- 3317147 TI - Microcircuitry of the on-beta ganglion cell in daylight, twilight, and starlight. PMID- 3317146 TI - Synaptogenesis in the primate retina proceeds from the ganglion cells towards the photoreceptors. PMID- 3317148 TI - Does melanin do more than protect from light? PMID- 3317149 TI - Photoreceptor processes in visual adaptation. AB - In this paper we have stressed two experimental results in need of explanation: (i) the reduced efficacy with which (remaining, abundant) rhodopsin in the light adapted receptor mediates the flash response; and (ii) the disparity in conditions of irradiation (weak background vs. extensive bleaching) leading to equivalent conditions of threshold. The model discussed above suggests, in molecular terms, a possible basis for both properties of receptor adaptation. On the view developed here, property (i) derives from the ability of photoactivated or bleached pigment (R or B) to restrict dramatically the availability of a substance required for phototransduction. Property (ii) derives in large part from the pronounced disparity in the effectiveness of R (during illumination) and B (remaining after illumination) in reducing the availability of this substance. On this view, the "equivalence" of threshold elevation in states of light- vs. dark-adaptation derives from an overall equality of a product of factors (Q, Etot/Es, and J of equation 2). Under all but extreme conditions, this aggregate of factors is dominated by the term Etot/Es, reflecting the functional state of E. PMID- 3317150 TI - The myth called Medicare. PMID- 3317151 TI - The role of physicians in the life insurance industry in the 19th century. PMID- 3317152 TI - Mandatory Medicare assignment. PMID- 3317153 TI - Bile peritonitis following expectant management of liver fracture. PMID- 3317154 TI - Moses Maimonides and air pollution. PMID- 3317155 TI - Esthetics and dentistry. Cosmetic periodontal surgery--Part I. PMID- 3317157 TI - Post-palatal seal. PMID- 3317156 TI - The story of my heart transplant. A case history. PMID- 3317158 TI - Recent advances in cell labelling. PMID- 3317159 TI - Reproducibility of oesophageal transit studies: several 'single swallows' must be performed. AB - The 'single swallow' technique for the isotopic investigation of oesophageal function has been widely accepted. In our experience the results obtained when several consecutive 'single swallow' tests are performed show considerable variation. Although one or two swallows may be enough to diagnose abnormality, the exclusion of a motility disorder requires more, preferably six consecutive swallows. PMID- 3317160 TI - Radiolabeled sucralfate: a review of clinical efficacy. AB - Radiolabeled sucralfate has been utilized by several investigators to evaluate peptic ulcer, active inflammatory bowel disease, esophageal ulcer, and gastric cancer. A review of the available literature indicates that radiolabeled sucralfate has been used to evaluate peptic ulcer and active inflammatory bowel diseases with high sensitivity and specificity. Other possible uses of radiolabeled sucralfate which have been less thoroughly studied and for which data are inadequate to accurately determine sensitivity and specificity include the detection of gastric cancer and esophageal ulceration. PMID- 3317161 TI - Optimization and batch production of DTPA-labelled antibody kits for routine use in 111In immunoscintigraphy. AB - A procedure for conjugating antibodies in batches with DTPA is described which yields pharmaceutical grade preparations that can be kept in frozen storage until required. Routine radiolabelling is then simply performed by adding 111In chloride to the sterile 'kit' vial. After 1h, a DTPA solution is added to make the preparation ready for use in patients. The effects of pH, DTPA to antibody ratio, and time of reaction were investigated to optimize the preparation. By this method the antibody-DTPA conjugates may be prepared and the quality control performed at regional nuclear medicine centres where facilities and expertise already exist. These 'kits' can then be distributed to other departments where the 111In is added as and when required in a similar way to the preparation of other radiopharmaceuticals. PMID- 3317162 TI - Renal fraction of cardiac output cleared of radioactive indicator in 99Tcm-DTPA gamma camera renography. AB - The renal images recorded during 1 to 2 1/2 min postinjection in 99Tcm-DTPA gamma camera renography were used for determination of the total cleared renal fraction (TCRF) of cardiac output with respect to the radioactive indicator. The left and right cleared renal fractions of cardiac output were determined directly, i.e., assessment of single-kidney uptake function within a few minutes postinjection was also possible. TCRF was proportional to the glomerular filtration rate (GFR) determined by the 51Cr-EDTA plasma clearance in a group of 23 subjects with GFR in the interval 15 to 130 ml/min/1.73 m2. The slope of the regression line of TCRF against GFR was in agreement with the theoretical estimate for it. GFR could be predicted from TCRF with a standard error of estimate from 4 to 15 ml/min/1.73 m2 for values of GFR in the above interval. Intra-observer variability of TCRF was unbiased and varied between 4% (normal GFR) and 9% (decreased GFR). TCRF is proposed to represent an alternative to renal clearance for evaluation of renal uptake function. PMID- 3317163 TI - Radionuclide studies on gastric evacuatory function in health and in the duodenal ulcer disease. II. Regional distribution of emptying index (RDEI) patterns. AB - Studies with a new method for visualizing the stomach evacuatory function - regional distribution of emptying index (RDEI) were performed on 35 healthy subjects and 34 duodenal ulcer patients. The observed gastric RDEI patterns are described in detail, and their pathophysiological meaning is discussed. A significantly higher incidence of an atypical gastric RDEI pattern was found in duodenal ulcer patients compared to normals. Except for a shorter disease duration, however, no other clinical features distinguished the patients with the present atypical gastric RDEI pattern from the remaining ones. It has been hypothesized that antral dysmotility is a cause of the observed phenomenon. PMID- 3317165 TI - Teratoma genetics and stem cells: a review. PMID- 3317164 TI - Measurement of glomerular filtration rate with a portable cadmium telluride detector. AB - The plasma clearance rate constant of 99Tcm-DTPA was measured with a portable cadmium telluride detector over anterior chest wall and lateral leg sites to obtain an empirical estimate of glomerular filtration rate (GFR). Thirteen patients with a range of renal dysfunction were studied to compare the accuracy of the estimates over various time periods compared to GFR estimated from plasma sampling. The chest site was more accurate for GFR assessment over all time periods assessed up to 4 h following injection. The clearance rate constants obtained up to 1 h after injection from the chest site were not significantly less accurate then those from later time periods. PMID- 3317166 TI - Spontaneous fetal loss after demonstration of a live fetus in the first trimester. AB - Chorionic villus sampling is being considered as an alternative to amniocentesis for genetic evaluation. The risk of subsequent spontaneous abortion from this invasive procedure, however, remains unclear. A prospective analysis of pregnancy outcome after ultrasound documentation of fetal viability at eight to 12 weeks' gestation was carried out in an uninstrumented population of patients to establish a background loss rate against which to evaluate the safety of chorionic villus sampling. All patients presenting to the authors' private practice from December 1983 to January 1986 were enrolled in the study. An ultrasound examination was performed at the first visit to confirm intrauterine pregnancy and assess gestational age; in gestations less than eight weeks, the sonogram was repeated four weeks later. Four hundred eighty-nine delivered patients are the subject of this study. We evaluated the differences between this group and those patients presenting either with a blighted ovum or beyond the first trimester, as well as the outcome of those patients with spotting early in gestation. This study suggests that if a live fetus is documented by ultrasonography at eight to 12 weeks' gestation, the risk of spontaneous abortion before 20 weeks' gestation in an uninstrumented population is 2.0%. PMID- 3317167 TI - Recent advances in diagnostic radiology. PMID- 3317168 TI - [Joint spring meeting. Austrian Society for Hematology and Oncology and Austrian Society for Allergology and Immunology. Vienna, 27 March 1987. Abstracts]. PMID- 3317169 TI - [24-hour CA 15/3 serum concentrations in patients with primary and metastasizing breast cancer]. AB - Serum determinations of tumor-associated antigens in breast cancer patients are utilized for detection of metastases as well as prediction of treatment response. That is critically dependent on the validity of single daily marker determination. In our study in patients suffering from primary or metastatic breast cancer we could demonstrate fluctuations of antigens detected with the two monoclonal antibodies 115D8 and DF3 (CA-15/3) during a 24 h observation period. Beside methodical inaccuracies those fluctuating serum concentrations might be related to biological phenomena. However, on basis of our data no intra- or interindividual rhythms could be exhibited. PMID- 3317170 TI - [Toxicity of the CYVADIC modification in patients with soft tissue sarcomas or malignant mesotheliomas]. AB - CYVADIC (cyclophosphamide + vincristine + adriamycin + dacarbazine = DTIC) is frequently used in the treatment of patients with soft tissue sarcomas or malignant mesotheliomas. As a modification of the protocol originally published by Gottlieb, the interval between two cycles was extended to 4 weeks for better bone marrow regeneration and vincristine was given only once instead of twice per cycle. A total of 237 cycles of this modified CYVADIC protocol resulted in tolerable toxicity (except nausea and vomiting) and therapeutic results comparable to the original protocol (6/22 complete remissions and 6/22 partial remissions in sarcomas; 1/5 partial remission in mesotheliomas). Hematotoxicity was cumulative after 6 CYVADIC cycles. In contrast to the original Gottlieb scheme there were no severe infections such as pneumonia or sepsis. Neurotoxicity was weak and reversible; cardiotoxicity was not observed. Compared to the protocol originally suggested by Gottlieb, the modified CYVADIC regimen appears to be as effective but less toxic. PMID- 3317171 TI - [Effect of hormone receptors on the site of metastases in breast cancer]. PMID- 3317172 TI - [Regional distribution of the mortality of cancer patients in the Hamburg city district 1970-1972 and its comparison with the distribution 1960-1962]. PMID- 3317173 TI - [10 years' therapy of Hodgkin's disease in the Oncology Department of the Basel Canton Hospital: a retrospective study]. PMID- 3317174 TI - [Simultaneous occurrence of acute myeloid leukemia in 2 chemical workers of the same industry]. PMID- 3317176 TI - Corneal wedge resection for high astigmatism following penetrating keratoplasty. AB - Fourteen corneal wedge resections performed between April 1980 and January 1986 at the Wills Eye Hospital were retrospectively reviewed. Mean pre-operative refractive (subjective) astigmatism was 8.13 diopters (D), with a range of 3.75 to 15.0 D. Following wedge resection, the mean residual astigmatism was 3.04 D, with a range of 0 to 5.0 D. Although the mean keratometric astigmatism measurements were generally similar to the astigmatism measured during refraction, there was little correlation between them on a case-by-case basis. Corneal wedge resection appears to remain an effective and moderately predictable technique for managing high astigmatism following penetrating keratoplasty. PMID- 3317175 TI - Inheritance and testicular cancer. Arguments based on a report of 3 cases and a review of the literature. AB - Cryptorchidism and antecedent contralateral testicular tumor formation are risk factors for the formation of testicular germ cell neoplasms. The question arises if familial occurrence of testicular cancer constitutes another risk factor. In a series of 184 patients, treated for testicular tumors, three pairs of non-twin brothers were recorded. The analysis of 82 cases reported in the literature to date as well as the clinical features of early age of onset, high incidence of bilateral testicular tumors in familial cases, ethnic differences in occurrence of testicular cancer, HLA studies and the detection of oncogenes give relevance to the concept of the participation of genetic factors in the etiology of testicular germ cell cancer. PMID- 3317177 TI - Delayed nonexpulsive suprachoroidal hemorrhage after trabeculectomy. AB - Five cases of delayed nonexpulsive suprachoroidal hemorrhage after trabeculectomy in aphakic eyes are reported. Four cases were done under general anesthesia and in three there was straining and bucking at extubation. The most common presentation was sudden severe ocular pain one day postoperatively, associated with marked decrease in vision and low intraocular pressure. The prognosis was related to the extent of the hemorrhage; where suprachoroidal hemorrhage was extensive, surgical drainage appeared to help. Our last two patients, both with massive postoperative nonexpulsive suprachoroidal hemorrhage, underwent surgical drainage of suprachoroidal blood and recovered preoperative visual acuity. PMID- 3317178 TI - A simple inferior limbal traction suture for anterior segment surgery. PMID- 3317179 TI - Instrument and book supplement 1987. PMID- 3317180 TI - Traumatic hyphema in children. Treatment with epsilon-aminocaproic acid. AB - Forty-nine patients, ages 3 to 18 years, who sustained nonpenetrating unilateral trauma with hyphemas were assigned randomly to receive either 100 mg/kg of epsilon-aminocaproic acid (EACA), an antifibrinolytic agent, orally every 4 hours for 5 days (maximum 30 g/day) or a placebo. No patients ingested acetylsalicylic acid (ASA)-containing compounds before or during admission. Two patients of 24 treated with EACA and 1 of 25 given placebo had rebleeds. The hyphemas in the EACA-treated group took significantly longer to clear (mean, 5.3 versus 2.6 days; P less than 0.001). Because of the low incidence of rebleeds in the placebo group, the efficacy of EACA in reducing the rate of rebleeds could not be determined. Further studies with this drug, controlling for age, race, sickle trait, and pre-admission antiplatelet agents should be undertaken before its routine use in traumatic hyphema management can be recommended. PMID- 3317181 TI - Wound healing after astigmatic keratotomy in human eyes. AB - The authors analyzed three full-thickness corneal buttons and two corneal scleral rims obtained 5 1/2 to 44 months after three trapezoidal keratotomies (Ruiz), one "L," and one "TL" procedure. The indications for the penetrating keratoplasty were photophobia, corneal edema, and loss of best-corrected vision after the astigmatic keratotomy procedures. Epithelial plugs were seen in all five specimens. Complete basal lamina lined the wounds in two cases. Tangential incisions of the Ruiz procedure were shallower and demonstrated more advanced wound healing than the corresponding semiradial incisions. Two of the three Ruiz procedures demonstrated peripheral separation of the semiradial incisions. Wound healing events after astigmatic keratotomy procedures appear similar to those reported previously after standard radial keratotomy with the exception that tangential incisions appear to heal faster than the semiradial incisions. PMID- 3317183 TI - Epidemiology of microbial keratitis in southern California. A multivariate analysis. AB - Two hundred twenty-seven cases of microbial keratitis reported in nonreferral county practice were studied. The staphylococci, Pseudomonas aeruginosa and Streptococcus pneumoniae, were the major isolates. A multivariate statistical model was developed to evaluate possible predisposing and outcome determinants. Several racial and age-related relationships were shown. The interaction of numerous local ocular and systemic factors played a fundamental role in causing disease. The authors found significant association between S. pneumoniae and topical steroid use, and direct and indirect linkage of S. aureus with diabetes and trauma, respectively. S. pneumoniae and Moraxella were risk factors for major complications (24% of cases); S. pneumoniae was related to enucleation and late perforation. Corneal exposure and prior topical steroids were associated with prolonged hospital stays. Hypopyon was associated with pneumococcal infection, 60 years of age or older, and trauma. The identification of groups at high-risk for microbial keratitis and problems of preventive management are discussed. PMID- 3317182 TI - Recent developments in dry eye management. AB - A concise review of current knowledge in the stimulation and regulation of tear production and its relationship to the ocular surface is presented. A discussion of treatment modalities, their benefits and drawbacks, follows. An approach to developing a rational treatment plan in the management of dry eyes is suggested with specific strategies. The application of these principles and the use of specific treatment modalities to manage the discreet manifestations of dry eye syndrome can lead to successful management in the majority of cases, with the preservation of useful vision and the relief of symptoms. PMID- 3317184 TI - Contact lenses. PMID- 3317185 TI - In memoriam. Paul Henkind, MD, PhD. PMID- 3317186 TI - Anterior segment fluorescein angiography in the surgery of immunologically induced corneal and scleral destructive disorders. AB - Since 1975, 51 patients (55 eyes) have required corneal surgery for immunologically induced destructive corneal and scleral disease. Lamellar keratoplasty is the preferred surgical procedure provided the cornea is not perforated. Surgery will not be successful unless any underlying systemic disease or active ocular inflammatory disease has been treated previously. Anterior segment fluorescein angiography has been found useful in detecting those patients who might require surgery, in monitoring the effect of medical therapy and in deciding the extent of the surgical procedure. The advantages and limitations of the technique are discussed. PMID- 3317187 TI - Eye care for the elderly: looking better! seeing better! Introduction. PMID- 3317188 TI - Can the elderly afford eye care? Can we afford eye care for the elderly? AB - Perhaps no group of Americans has a greater stake in the issues raised by the rapid growth in health care spending than the elderly. The elderly consume a share of the nation's health care that is disproportionate to their numbers. In 1984, per capita health care spending for the elderly was four times that for the rest of the population. Ophthalmic expenses form a significant portion of their health care spending. Increasing numbers of elderly and per capita spending have placed enormous pressure on Medicare. In recent years, changing patterns of ophthalmic care have influenced the size and direction of Medicare expenditures; for example, new technologies in cataract surgery have shifted services from inpatient to outpatient settings. Such shifting of costs and other program changes must be analyzed to determine the impact on future Medicare expenditures and beneficiaries. PMID- 3317189 TI - Titanium fixtures. The periodontist's view. PMID- 3317190 TI - Root surface demineralization. A useful adjunct to periodontal therapy. PMID- 3317191 TI - Subject: porcelain veneers. PMID- 3317192 TI - [50th anniversary of the death of public health physician Zsigmond Gerloczy]. PMID- 3317193 TI - [History of women physicians]. PMID- 3317194 TI - [Public health in Hungary in relation to the 70th anniversary of the Great October Socialist Revolution]. PMID- 3317196 TI - [An unintentional joke in Index Medicus]. PMID- 3317195 TI - [Transient fetal ascites]. PMID- 3317198 TI - [Abbazia in Hungarian medical history]. PMID- 3317197 TI - [Intrathyroidal bleeding, simulating thyroiditis, during anticoagulant therapy]. PMID- 3317199 TI - [Remembering Gyorgy Bekesy, as seen by a disciple]. PMID- 3317200 TI - Direct and indirect bone healing after operative fracture treatment. AB - The knowledge of the entire spectrum of differing healing patterns should help the surgeon to judge the progress of fracture healing. To be able to recognize an abnormal course and deviating patterns will help the surgeon to avoid risks and to improve the mechanical and biologic conditions necessary for successful fracture treatment. PMID- 3317201 TI - AO compression plating technique for treating fractures of the edentulous mandible. AB - The treatment of fractures of the edentulous mandible has posed a significant problem to all physicians treating trauma patients because of the absence of teeth. Dynamic compression plating has been proven over the years by the experience of fracture apposition and excellent fragment immobilization in this difficult group. PMID- 3317203 TI - Use of the AO mandibular reconstruction plate for bridging of mandibular defects. AB - The authors believe that the AO mandibular reconstruction plate provides unique advantages for the reconstruction of mandibular defects. It provides for rigid fixation of the bones and the maintenance of occlusion and contour without the use of intermaxillary fixation or external fixation. The technique adds little time to the procedure, and the expertise needed to apply the technique can be quickly acquired by most surgeons. Although better techniques are being developed and perfected, the mandibular reconstruction plate should be considered for any patients for whom more complex techniques seem inappropriate and for whom reconstruction would otherwise not be considered. PMID- 3317202 TI - The use of lag screws in mandibular fractures. AB - The use of screws and plates in the treatment of fractures and osteotomies of the facial bones promises the abandonment of intermaxillary fixation. For those who are adept with the instrumentation and have experience in applying the screws, such systems offer an approach to fracture treatment and osteotomy stabilization that is very much appreciated by patients. PMID- 3317204 TI - Plate fixation of fractures of the mid and upper face. AB - The principles and techniques of rigid plate and screw fixation for fractures of the mid and upper face are presented. These techniques offer advantages for the repair of fractures in these area, as well as for the stabilization of planned osteotomies. PMID- 3317205 TI - Vitallium Luhr systems for reconstructive surgery of the facial skeleton. AB - The author describes three systems for (1) the treatment of mandibular fractures; (2) the treatment of midface fractures, for reconstructive surgery of the facial skeleton and the skull, and for orthognathic surgery; and (3) the reconstruction of mandibular defects including condyle replacement. PMID- 3317206 TI - Monocortical miniplate osteosynthesis. AB - The theoretic basis of noncompression plating using miniplates and monocortical screws is explained. The technique is described and the range of clinical applications in maxillofacial trauma and elective maxillofacial osteotomies is indicated. PMID- 3317207 TI - Microvascular free-tissue transfer with rigid internal fixation for reconstruction of the mandible following tumor resection. AB - The authors described their experience using rigid internal fixation techniques in combination with free microvascular tissue transfer for the immediate reconstruction of mandibular defects following tumor ablation. The technique allows immediate return of jaw motion and limited function while assuring maintenance of occlusion and reasonable cosmesis. PMID- 3317208 TI - [Clinical usefulness of the preparation Herpestat in the treatment of herpes labialis]. PMID- 3317210 TI - [Polish otolaryngological bibliography from the period of World War II]. PMID- 3317209 TI - [Bibliography of the Polish Otolaryngological Review]. PMID- 3317212 TI - [Sonography of the hip joint--a supplementary study in neonatal orthopedic examination]. PMID- 3317211 TI - And we remember ... (Rita Marie T. Dowd). PMID- 3317213 TI - [On the 70th birthday of University Professor Dr. Ernst Zweymuller]. PMID- 3317214 TI - [25th anniversary of the Austrian Society for Pediatrics]. PMID- 3317215 TI - [E. coli dyspepsia]. AB - The incidence of EPEC infections has decreased dramatically in industrialized countries since the 1960s, 1970s, but EPEC remains an important of acute gastroenteritis in developing countries. PMID- 3317216 TI - [Graft versus host reaction and immune deficiency: a paradox in the immunological reconstitution after human allogeneic bone marrow graft]. PMID- 3317218 TI - [Abstracts of papers presented at the annual seminar of the Hormone Research Foundation. 29 January 1987]. PMID- 3317217 TI - [Serum enzymes and triglycerides in mice with a mammary tumor (Ca-755 adenocarcinoma)]. AB - Investigations on mice inoculated with Ca-755 mammary adenocarcinoma have shown that the levels of serum LDH (especially isozymes resulting from the B sub-unit), TGO and TG are higher than those found in normal mice, while PAL (only bone isozyme) and TGP are lower. Comparisons were made with tumour age (exponential and plateau-growth phases), which appeared to be important for LDH and PAL bone isozyme, since LDH increased and PAL decreased with increasing age of the tumour. For the PAL and TG alterations, there could be assumed an effect of cachectin (TNF: tumour necrosis factor). PMID- 3317219 TI - Primate specific sialoglycoprotein of sperm head plasma membrane defined by an anti-carbohydrate monoclonal antibody. AB - A sialoglycoprotein, an integral component of the head plasma membrane of human spermatozoa, is recognized by the a-HS 1A.1 monoclonal antibody. The antigenicity is associated with the sugar moiety since: a) trypsin digestion did not affect the antigenic determinant; b) pretreatment of the cells with beta-glucosidase, alpha-mannosidase and neuraminidase completely abolished antibody binding. Endoglycosidase D and glycopeptidase F were inactive. The a-HS 1A.1 did not recognize a variety of blood-group related synthetic oligosaccharides. The species specificity was studied by indirect immunofluorescence assay. The antibody also recognized an antigen on Macaca fascicularis sperm, but failed to bind to spermatozoa of boar, bull, goat, ram, stallion, dog, rabbit, rooster, carp and eel. PMID- 3317220 TI - [Biological responses, ultrastructural changes and metabolism of estrone sulfate in line cells of human breast cancer: MCF-7]. AB - The biological responses, the metabolism and the ultrastructural modifications provoked by estrone sulfate in the MCF-7 mammary cancer cell line are studied. The data indicate: 1) A fraction of estrone sulfate is hydrolyzed and the freed hormone is sufficient to elicit a biological response (progesterone receptor). 2) Using [3H]estrone sulfate, 24 h after culture, it is observed that the great part of the radioactive material in the cells is in the form of unconjugated estrogens. 3) The main transformation product of [3H]estrone sulfate is estradiol. This is found particularly in the nucleus. 4) Tamoxifen inhibits very significantly the conversion of estrone sulfate into estradiol. 5) Electronmicroscopic observations indicate that the estrone sulfate provokes an important development in the secretory system. In conclusion, it is suggested that the estrone sulfate can play an important role in the response to estrogens in human mammary cancer. PMID- 3317222 TI - Application of in situ DNA hybridization technology to diagnostic surgical pathology. PMID- 3317221 TI - [Comparison of the kinetics of the response of salivary and plasma 17 hydroxyprogesterone to the administration of HCG in men]. AB - 17-hydroxyprogesterone (17-OHP) time course response to hCG (5,000 IU) was studied simultaneously in the saliva and the plasma of 12 adult healthy men. In both fluids, 17-OHP was determined by radioimmunossay after chromatography on Sephadex LH-20 columns of diethyl ether extracts. The use of an iodinated tracer has greatly increased the sensitivity of the technique. Baseline levels in plasma and saliva were: 1.0 +/- 0.1 ng/ml (mean +/- SEM) and 24 +/- 2 pg/ml respectively. After hCG, a biphasic pattern was observed in both fluids with a similar early response but the peak elicited at 33 h in plasma was not observed in saliva where the levels were lower than those recorded at 24 h. At 48 h saliva 17-OHP increased again to levels similar to those at 24 h. Thus the 17-OHP pattern in saliva was the mirror image of that found in plasma. Since saliva steroids are believed to reflect the plasma non-protein bound fraction, this difference was assumed to be due to the decrease of the unbound fraction of plasma 17-OHP in the late afternoon as a consequence of the increase of the CBG bound fraction since at that time cortisol levels are low. Indeed the ratios of saliva to plasma 17-OHP levels were found to be significantly correlated with plasma cortisol levels: r = 0.44 (p less than 0.01; n = 140). Thus the absence of the secondary peak at 33 h may be due to cortisol circadian rhythm. However the similar response in saliva at 24 and at 48 h after hCG was enough important to make reliable the evaluation of the endocrine testicular function so that saliva may be collected instead of plasma in the hCG stimulation test protocol. PMID- 3317223 TI - Chronic gastritis. The pathologist's role. PMID- 3317224 TI - Necrosis in lymph nodes. AB - When necrosis is identified in a lymph node biopsy, various entities should be considered in the differential diagnosis. Neoplastic conditions, especially lymphoma and metastatic carcinoma, must first be excluded. Numerous benign conditions also cause necrosis in lymph nodes, and the presence or absence of granulomatous inflammation as well as other histologic features are useful in suggesting various possibilities. Clinical information is very important in the differential diagnosis, and lymph node culture or other tests are often required to determine a specific diagnosis. PMID- 3317225 TI - Pathologic changes of osteochondrodysplasia in infancy. A review. PMID- 3317226 TI - A review of adult and pediatric post-transplant liver pathology. PMID- 3317227 TI - Immunohistochemical localization of chromogranin in normal and neoplastic endocrine tissues. PMID- 3317228 TI - [Analysis of the destructive deformities of the left ventricular wall in experimental myocardial infarct]. PMID- 3317229 TI - [Cellular aspects of the pulmonary defense system]. PMID- 3317230 TI - [Intraoperative cytologic studies of nodular changes in the lungs conducted using the imprint method]. PMID- 3317232 TI - Chronic constipation. PMID- 3317231 TI - Functional problems associated with colonic dysfunction: the irritable bowel syndrome. PMID- 3317233 TI - Present concepts of infant colic. PMID- 3317235 TI - Recurrent abdominal pain: an approach to diagnosis and management. PMID- 3317234 TI - Chronic nonspecific diarrhea. PMID- 3317236 TI - Amblyopia: definition, classification, diagnosis, and management considerations for pediatricians, family physicians, and general practitioners. AB - Amblyopia is a reduction in the quality of central, corrected vision resulting from a disturbance in retinal image formation during the first decade of human life. Although the neurophysiology and neuropathology of amblyopia are now better understood than in the past, treatment has not changed significantly in more than 200 years. The earlier amblyopia is detected, the shorter the duration of treatment required to reduce its severity. The mainstay of treatment still consists of forcing the use of the amblyopic eye, most often by occlusion of the sound eye. Complications of treatment include occlusion amblyopia and induction of strabismus in straight-eyed patients. PMID- 3317237 TI - Nystagmus and other abnormal ocular movements in children. AB - This article at first reviews the normal maturation of the ocular system in infants and then progresses to a discussion of the ways that this system can vary and produce nystagmus and nystagmus-like disorders. PMID- 3317238 TI - Refractive errors in children. AB - Optical correction of refractive errors in infants and young children is indicated when the refractive errors are sufficiently large to cause unilateral or bilateral amblyopia, if they are impairing the child's ability to function normally, or if the child has accommodative strabismus. Screening for refractive errors is important and should be performed as part of the annual physical examination in all verbal children. Screening for significant refractive errors in preverbal children is more difficult; however, the red reflex test of Bruckner is useful for the detection of anisometropic refractive errors. The photorefraction test, which is an adaptation of Bruckner's red reflex test, may prove to be a useful screening device for detecting bilateral as well as unilateral refractive errors. Objective testing as well as subjective testing enables ophthalmologists to prescribe proper optical correction for refractive errors for infants and children of any age. PMID- 3317239 TI - Learning disabilities: update comment on the visual system. AB - The role of the eye in vision and its relationship to learning disabilities is discussed in this very timely article. A historical overview is included, as well as a consideration of the more recent neuroanatomic research in this area. PMID- 3317240 TI - Conjunctivitis in children. AB - Conjunctivitis is a common, usually mild, self-limited problem. Pathogens vary at different ages. Conjunctivitis occurs alone or as a manifestation of a systemic infection or a systemic disease. Diagnosis can usually be established by the combination of clinical and laboratory findings. Topical, systemic or combination therapy is used, depending on the agent and extent of infection. PMID- 3317241 TI - Problems of the lacrimal system in children. AB - The lacrimal system is composed of various glands to produce tears and a drainage system for tear removal. The most common abnormality is a defect or blockage in the drainage system, a blocked nasolacrimal duct. Most of the evidence favors conservative management of this condition, reserving probing for those that fail to resolve by one year of age. PMID- 3317243 TI - Retinopathy of prematurity. AB - ROP is a challenging disease of the decade of the 1980s. Answers, even partial answers, to many of its questions may provide information bearing on those same questions in other blinding vascular retinopathies, such as diabetes and sickle cell disease. Answers more clearly defining the role of oxygen, ventilation, antioxidants, blood transfusions, and a host of diseases of the premature infant will lead to better care of that infant. I have tried in this article to present the boundaries of the problem, a theory of its genesis and progression, and a review of the major issues to be confronted by the pediatric, ophthalmologic, and basic science communities through its recurrence today. I have tried to make it clear to the reader when I was so doing. I have used information liberally from studies both under way and in the planning stages to make the reader aware of what is being done, even if these have not yet reached fruition, for the field is a rapidly growing one. Finally, I have tried to point out directions that I believe clinical and experimental work should take on certain critical issues. PMID- 3317244 TI - Special diagnostic and therapeutic modalities in pediatric ophthalmology. AB - Ophthalmology is a specialty rich in instrumentation used for special diagnostic and therapeutic functions. Many of these special modalities are appropriate to pediatric ophthalmology, and this article discusses them in summary fashion for those who may wish to know about the procedures but who may not be involved directly in their use. PMID- 3317242 TI - Uveitis. AB - Diagnosis and management of the child with an ocular inflammation demands that all of the standard tools of medicine be employed: family and individual history, particularly of allergy, social and diet history, system review, physical examination, and basic laboratory testing with special tests for certain microorganisms and allergies. Close cooperation among pediatrician, ophthalmologist, and family is important. Cases are rare, and management often requires special experience. PMID- 3317245 TI - Common plants and their toxicity. AB - This article contains information about plants that have a potential for producing acute toxicity. The two largest sections are in tabular format, that is, a list of plants reported to have a potential for producing acute toxicity and a table of plants that have been used as food suggesting that they have little toxic potential. For each plant cited in the first table, at least one specific category of toxicity is listed, and references are made to brief management overviews that are presented at the end of the article. PMID- 3317246 TI - Pulmonary alveolar microlithiasis in pediatric patients--review of the world literature and two new observations. AB - Report of two new pediatric cases of pulmonary alveolar microlithiasis (PAM). PAM is a rare disease of unknown etiology; not more than 38 cases have been reported aged less than 18 years. The essential features of this disease are (1) a characteristic radiographic appearance of a sand-like opacity of both lungs and linear densities like "beads on a string" along the heart, pleura and interlobar fissures; this is best visualized by fluoroscopy in combination with magnification technique; (2) extremely few clinical signs and almost no laboratory abnormalities. PMID- 3317247 TI - Pulmonary lesions mimicking pericardial effusion on ultrasonography. AB - Two children with right middle lobe lesions mimicking pericardial effusion on ultrasonography are presented. They were admitted with fever and chest radiographs showed atelectasis or consolidation of the middle lobe of the right lung along the right heart border. A low-echogenic layer suggesting pericardial fluid was seen on ultrasonography, but with a spatial distribution closely corresponding to the lesions seen on the chest radiographs. If the possibility that a lung lesion adjacent to the heart can simulate pericardial fluid on ultrasonography is kept in mind, the correct diagnosis should not be difficult to make. PMID- 3317248 TI - Postnatal resolution of large ovarian cysts detected in utero. Report of two cases. AB - Two cases of spontaneous resolution of large ovarian cysts in newborns are presented. In both cases the cysts were detected prenatally with ultrasound. In one case the cyst disappeared before birth; in the other, the cyst resolved several weeks postnatally. Both infants also displayed labial, uterine and vaginal enlargement, signs of maternal estrogen stimulation. These large ovarian cysts are also most likely under some hormonal stimulation and may undergo spontaneous resolution and therefore obviate the need for surgery. PMID- 3317249 TI - Ultrasonography of the infant hip. Part IV: Normal development in the newborn and preterm neonate. AB - Based on preterm and term infants studied by ultrasonography, and on anatomical sections of various gestational ages the physiological maturation of the hip joint is analysed. Current concepts of a linear growth pattern with an arrest immediately after delivery are confirmed. A more rapid growth and ossification of the acetabular edge than of the femoral head postpartum is suggested. To avoid overtreatment, knowledge of the normal range of development as seen in ultrasonography is mandatory. PMID- 3317250 TI - Ultrasonic diagnosis of duodenal diaphragm. AB - A case of duodenal diaphragm diagnosed by ultrasound is presented. The case was associated with situs inversus. PMID- 3317251 TI - Femoral unicameral bone cyst in a medieval child. Radiological and pathological study. AB - Radiological, macroscopic and microscopic study of a unicameral cyst in the femur of a child of the early Middle Ages. The changes are similar to those known for unicameral cyst today. PMID- 3317252 TI - Embolization therapy in the management of infantile hemangioma with Kasabach Merritt syndrome. AB - A case is presented in which a giant infantile hemangioma with thrombocytopenia is managed successfully by serial transcatheter embolization. PMID- 3317253 TI - Biochemical, structural, and functional abnormalities of polymorphonuclear leukocytes in the neonate. AB - The human neonate is uniquely susceptible to serious and overwhelming bacterial and fungal infections. While deficiencies of antibody, complement, and T lymphocytes certainly contribute to this susceptibility, abnormal polymorphonuclear leukocyte function appears to be a major host defense abnormality in the neonate. Functional defects in neonatal polymorphonuclear leukocyte adherence, aggregation, movement, phagocytosis, and intracellular killing have been described in the term or preterm infant. Only recently, however, have the techniques become available to examine the biochemical and structural mechanisms underlying abnormal polymorphonuclear leukocyte function in the neonate. It now appears that there may be developmental defects in signal transduction, cell surface receptor upregulation and mobility, cytoskeletal rigidity, microfilament contraction, oxygen metabolism, and intracellular antioxidant mechanisms. Defining the biochemical and physiologic abnormalities in these cells may lead to therapeutic regimens for pharmacologically correcting these developmental defects in cell function. PMID- 3317254 TI - Type I tyrosinemia: lack of immunologically detectable fumarylacetoacetase enzyme protein in tissues and cell extracts. AB - Type I hereditary tyrosinemia is characterized by the almost complete absence of fumarylacetoacetase in tissues and cells from patients. To investigate the nature of the enzyme deficiency, extracts of tissues (liver and kidney) and cells (lymphocytes and fibroblasts) were immunochemically screened for the presence of fumarylacetoacetase enzyme protein. The antibodies used were raised in rabbits against fumarylacetoacetase purified from beef liver. These antibodies cross reacted strongly with the human enzyme. No cross-reacting material was found in extracts from liver (n = 4) and kidney (n = 1) from patients. Extracts from lymphocytes and cultured skin fibroblasts from patients were investigated as well. However, no cross-reacting material was found in extracts of these cells. PMID- 3317255 TI - Limited maternal fuel availability due to hyperinsulinemia retards fetal growth and development in the rat. AB - We rendered pregnant rats chronically hyperinsulinemic to determine the effect of reduced maternal metabolic fuel availability on fetal growth and development. We implanted osmotically driven insulin loaded minipumps on day 14 (term 21.5 days) in pregnant rats. This significantly increased maternal plasma concentrations of insulin and reduced glucose from day 15 until term. From day 17 until birth, fetal growth was significantly less for hyperinsulinemic mothers (term birth weight 4.53 +/- 0.07 versus 5.64 +/- 0.06 g, p less than 0.001). In fetuses of hyperinsulinemic mothers plasma glucose and insulin concentrations were significantly reduced while glucagon concentrations were increased. Total plasma amino acids were significantly reduced in maternal rats and their fetuses from days 17 to 19 while arteriovenous blood gas tensions and pH did not differ between fetuses of hyperinsulinemic and control mothers. Small for gestational age newborn pups of hyperinsulinemic mothers were hypoglycemic for the first 240 min of life as a result of limited hepatic glycogen stores and a delay in the normally expected induction of hepatic cytosolic phosphoenolpyruvate carboxykinase. This occurred despite significant increases in neonatal plasma glucagon concentrations. These data indicate that limitation of maternal glucose and amino acids with normal placental gaseous exchange retards fetal growth, limits hepatic glycogen deposition, and delays neonatal phosphoenolpyruvate carboxykinase induction. Limited fetal insulin secretion resulting from diminished maternal fuel availability may have also been a factor in retarding growth. The delay in phosphoenolpyruvate carboxykinase induction despite enhanced glucagon secretion during fetal and neonatal life suggests a specific "resistance" to this hormone in the rat growth retarded by limited metabolic fuel availability. PMID- 3317256 TI - Decreased renal perfusion after correction of experimental coarctation. AB - Hemodynamical changes in coarctation were studied with an experimental model. Coarctation of the thoracic aorta was induced in seven puppies at the age of 8 wk. After a 7-month follow-up period a corrective operation with a venous patch was performed. Two dogs were lost a few hours after the correction operation. The remaining five dogs were followed for 12 months postoperatively. Renal perfusion was measured with a 133Xenon washout method just prior to the operation, 1 h, 6 and 12 months postoperatively. The glomerular filtration rate was measured using the 51Cr-EDTA method 1 wk before the operation, 3 wk, 2, 6, and 12 months after it. Six healthy adult dogs were used as controls for glomerular filtration rate measurements. Peripheral renin activity was measured at operation, just before the correction of aortic coarctation, 1/2, 1 h, 1, 3, 7 days, 2 and 6 months after the correction operation. Renal perfusion decreased significantly (p less than 0.05) immediately after the correction operation and rose again during the follow-up. Peripheral renin activity rose significantly (p less than 0.01) from the preoperative values and was at its greatest 1 day after the operation. Later on, peripheral renin activity values returned to normal. Coarctated dogs had significantly (p less than 0.01) lower glomerular filtration rate values than controls in each measurement except at the 2 months postoperative measurement. These results support decreased renal perfusion with resultant increased peripheral renin activity as part of the pathomechanism of the paradoxical hypertension observed after correction of coarctation. PMID- 3317257 TI - The effect of administration of immunoglobulin to newborn rats with Escherichia coli sepsis and meningitis. AB - Newborn rats 24-36 h old were injected transthoracically with various doses of Escherichia coli K1. Eighty-six of 92 rats which received 10(4) colony-forming units/g body weight were dead within 48 h. Two h after injection, E. coli were recovered from the blood of six of six rats and from the cerebrospinal fluid of two of six. Sixteen h after injection, E. coli were recovered from all blood (7/7) and spinal fluid (11/11) specimens cultured. Animals inoculated with 10(4) E. coli/g exhibited neutropenia and depletion of the neutrophil storage pool. In other studies, newborn rats inoculated with E. coli were injected intraperitoneally with various doses of human serum immunoglobulin, modified for intravenous use (MISG). One hundred percent (25/25) injected with 1500 mg/kg lived. In contrast to infected animals injected with albumin (controls), MISG recipients did not develop neutropenia nor did they deplete their neutrophil reserves. The effects of treating infected animals with MISG, antibiotics, or a combination of antibiotics plus MISG were compared. When administered within 2 h after the E. coli, all treatments resulted in survival rates of over 75%. However, when delayed for 6 h, 63% (17/27) of antibiotic recipients, 50% (12/24) of MISG recipients, and 91% (30/33) of those receiving both treatments lived (p less than 0.01 versus antibiotics or MISG). PMID- 3317258 TI - Glucose utilization by the placenta of anesthetized rats: effect of insulin, glucose, and ketone bodies. AB - Placental glucose metabolism and its regulation have been investigated in vivo in the rat using the radioactive 2-deoxyglucose technique. In the basal state, placental glucose utilization rates were similar on days 19 and 21 of gestation: 139 +/- 5 and 155 +/- 22 nmol/min/g at maternal blood glucose concentrations of 4.3 +/- 0.1 and 4.2 +/- 0.1 mmol/1. During hyperglycemic clamps, maternal glycemia was raised to 5.5 mmol/liter, a value similar to that during a meal in the rat. In this condition, the rate of placental glucose utilization at 19 days of gestation was increased by 85%. This was due not only to hyperglycemia but also to glucose-induced hyperinsulinemia. Indeed during hyperinsulinemic euglycemic clamps, placental glucose utilization showed a dose-response relationship to insulin (400 and 5000 microU/ml). At 21 days of gestation, placental glucose utilization was not affected by hyperglycemia or by hyperinsulinemia suggesting that in term placenta, glucose metabolism is no longer regulated. When 19-day pregnant rats were fasted for 48 and 96 h, the resulting low blood glucose and plasma insulin concentrations and the high ketone body concentrations induced, respectively, a 40 and 47% reduction of placental glucose utilization. The decrease in placental glucose utilization probably was due to both maternal hypoglycemia and long term adaptation to hyperketonemia. Indeed, the acute hyperketonemia in fed rats did not alter glucose utilization rate in placenta at 19 days of gestation. These data suggest that glucose metabolism in the preterm rat placenta is modulated in vivo by the maternal metabolic environment, particularly by maternal blood glucose and insulin concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317259 TI - Future research in human milk. AB - Because of the importance of breast-feeding to child health, research in the formation, composition, and biological effects of human milk should be strongly encouraged. Future exploration should include the processes that are responsible for the synthesis and secretion of human milk; the nature and function of the physical compartments in human milk; the structure and function of certain proteins and other components in human milk; and the in vivo fate and effect of a host of constituents including nutrients, growth factors, hormones, inducers, immunological factors, and antiinflammatory agents. Because of the potential public health benefits, these studies should be a high priority in pediatric research for the next decade. PMID- 3317260 TI - Oxygen delivery, oxygen consumption, and metabolic acidosis during group B streptococcal sepsis in piglets. AB - The development of metabolic acidosis during neonatal sepsis with group B streptococci (GBS) has been attributed to progressive tissue ischemia resulting from reduced oxygen delivery (QO2). Using an animal model of GBS disease, we attempted to test this hypothesis by comparing the development of metabolic acidosis in two groups of piglets with comparably diminished systemic QO2, one septic and one not. Eighteen anaesthetized piglets were instrumented to observe aortic pressure, cardiac output, arterial and mixed venous blood gases, oxygen content, and hemoglobin concentration. QO2, oxygen consumption, and oxygen extraction ratio were calculated. Six piglets (group 1) received continuous infusion of live GBS organisms; six piglets (group 2) received continuous infusion of phenylephrine (PE), beginning with 10-micrograms/kg/min and increasing as required to match the PE-induced reduction in QO2 to the fall observed in the group 1 (GBS) piglets at each 30-min interval. Group 3 piglets (n = 6) received 0.9% saline and served as controls. No differences in either cardiac output or QO2 were noted comparing GBS and PE piglets at any time interval from 0-180 minutes. At 120, 150, and 180 minutes, both QO2 and cardiac output were lower in GBS and PE piglets compared to controls. Despite equivalent reductions in cardiac output and QO2, only GBS piglets developed significant metabolic acidosis, while pH and base deficit for PE piglets did not differ from controls. Oxygen consumption did not differ significantly among the three experimental groups at any observation time. Oxygen extraction ratio did not differ comparing PE and GBS piglets at any observation time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317261 TI - The use of transmission ultrasonics to assess bone status in the human newborn. AB - The applicability of transmission ultrasonics as a method for assessment of bone status in human newborns was investigated in two studies. Sound transmission velocity (SCV) through the intact distal radius and ulna was compared to midshaft bone mineral content (BMC) and to midshaft mechanical breaking strength (MBS) in 13 postmortem newborns [gestational age (GA) = 20 to 41 wk]. Midshaft MBS, ranged from 1 to 16 kg; BMC, which ranged from 84 to 88 mg/cm in the term infant, was consistent with previous reported photon absorptiometric data. SCV in the distal radius and ulna was correlated with midshaft MBS (r = 0.69 to 0.82) and BMC (r = 0.85 to 0.93) and increased exponentially with midshaft MBS and BMC. GA was correlated with SCV (r = 0.90 to 0.95). Log GA was correlated with midshaft MBS (r = 0.87 to 0.96) and BMC (0.97 to 0.99) in each of the four measured bones. In the second study, SCV through the distal radius and ulna was measured in 85 live newborns ranging in GA from 28 to 43 wk. SCV increased linearly with GA (r = 0.71 to 0.77). These data demonstrate that SCV through the distal radius and ulna increases linearly with GA and that SCV through the distal bones of the forearm is reliably related to midshaft BMC and MBS during the third trimester of gestation. Transmission ultrasonic measurement of SCV provides a rapid, reproducible, nonionizing, and noninvasive method for assessing bone strength and mineralization in human neonates. PMID- 3317262 TI - Renal cell carcinoma in patients with tuberous sclerosis. AB - An adolescent with anemia and weight loss was found to have bilateral renal cell carcinoma (hypernephroma). Further investigation revealed an underlying tuberous sclerosis that had escaped previous clinical detection. Several reports of this association were subsequently found when the world's literature was reviewed. Physicians treating patients with tuberous sclerosis should be aware of the possible development of these renal malignancies in their patients. PMID- 3317264 TI - Hypoglycemia pathogenesis in children with dumping syndrome. AB - Three children with severe hypoglycemic reactions secondary to dumping syndrome were studied to discern the mechanism by which hypoglycemia occurred. Symptoms in patient 1 developed after fundoplication, generalized autonomic dysfunction occurred in patient 2, and dumping syndrome developed in patient 3 after malplacement of a feeding gastrostomy tube. Average blood glucose levels studied during and after two to seven meals in each child were 375 +/- 97 mg/dL (mean +/- SD) 30 minutes postprandially and 35 +/- 10 mg/dL greater than 120 minutes later. Swings in glucose values were proportional to the volume of meals. Insulin and glucagon levels were followed during a single meal challenge test in each patient; the average glucose concentration increased to 356 +/- 59 mg/dL 30 minutes postprandially and decreased to 32 +/- 11 mg/dL at 150 +/- 30 minutes. Hormonal analyses indicated (1) inappropriate early release of glucagon (300 pg/mL at 15 minutes) in patient 1, (2) exuberant early release of insulin (maximum 190 +/- 15 microU/mL) resulting in rapid decrease in glucose concentration in all patients, (3) development and/or persistence of hypoglycemia after the decline in circulating insulin to undetectable levels, and (4) inadequate glucagon response to hypoglycemia resulting in sustained hypoglycemia. These data indicate that gross disturbances of the insulin-glucagon axis attend childhood dumping syndrome. PMID- 3317263 TI - Primary sclerosing cholangitis in children: study of five cases and review of the literature. AB - Primary sclerosing cholangitis in five children is described and 78 cases in the pediatric age group are reviewed. In 24% of the cases, primary sclerosing cholangitis is not associated with an underlying disease and may appear to be prolonged cholestasis of infancy. When an associated condition is present, chronic inflammatory bowel disease, in particular ulcerative colitis, is most common (47%). Histiocytosis X and a variety of immune disorders account for 15% and 10% of cases, respectively. Primary sclerosing cholangitis should be considered in the differential diagnosis of chronic liver disease in the pediatric age group, even in young infants. Results of this survey demonstrate that neither clinical features nor liver function tests are reliable diagnostic predictors, that histologic changes are often nonspecific, and that cholangiography is essential to establish the correct diagnosis. PMID- 3317265 TI - Acute poststreptococcal polymyalgia with trismus. PMID- 3317266 TI - [Allogeneic transplantation of the bone marrow in the complex treatment of hypoplastic anemia in children]. PMID- 3317267 TI - [Physiological mechanisms of gastrin secretion in newborn infants]. PMID- 3317268 TI - The Differential Diagnostic Technique, a visual motor projective test. AB - The Differential Diagnostic Technique is a projective drawing test in which the individual is asked to copy 14 figures, presented one at a time. Research indicates the usefulness of the test as an objective measure of personality and points to its diagnostic use for certain neuropsychological problems and in research. PMID- 3317269 TI - Effects of dipyridamole on adenosine concentration, insulin sensitivity and glucose utilisation in soleus muscle of the rat. AB - Adenosine has been shown to modulate the sensitivity of skeletal muscle to insulin (Budohoski et al. 1984). In an attempt to further characterize the modulatory action of adenosine on insulin sensitivity in skeletal muscle we have investigated the effect of the nucleoside transport inhibitor dipyridamole in isolated incubated soleus muscle strips. At a concentration of 50 microM, dipyridamole increased the concentration of adenosine in the soleus muscle by 36% and in the incubation medium by 32%. At this concentration of dipyridamole, the basal rates (in the presence of 1 microunit of insulin/ml) of lactate formation, 2-deoxy [2,6-3H]glucose phosphorylation and glucose oxidation were decreased by 48%, 43% and 47% respectively, whilst the rate of glycogen synthesis was unaffected. Insulin-stimulated rates (in the presence of 10,000 microunits of insulin/ml) of lactate formation, 2-deoxy [2,6-3H] glucose phosphorylation, glycogen synthesis and glucose oxidation were decreased by 70%, 30%, 26% and 20% respectively in the presence of 50 microM dipyridamole. Although 50 microM dipyridamole was required to exert a significant effect on medium and soleus muscle adenosine concentrations, statistically significant effects on glycolytic rate were observed at concentrations as low as 2 microM dipyridamole. It is concluded that the results are not consistent with dipyridamole exerting an effect on skeletal muscle carbohydrate metabolism solely through elevation of the intracellular or interstitial adenosine concentration, but strongly suggest that dipyridamole inhibits glucose transport and/or phosphorylation in skeletal muscle. PMID- 3317270 TI - Thermoregulation of the rabbit during the late phase of endotoxin fever. AB - In the late phase of the fever occurring 120 or more min after i.v. injection of endotoxin (1 microgram/kg) to female rabbits, marked shifts of thresholds for respiratory evaporative heat loss and for peripheral vasodilatation to higher body core temperatures were observed. In contrast, the threshold body core temperature for cold thermogenesis was shifted downwards. As a result, the interthreshold zone was widened. Within the body temperature range of 37.4 to 39.9 degrees C neither heat production or heat loss mechanisms were operant and the body temperature was determined mainly by passive heat transfer between the body and the environment. Outside this zone, the sensitivities of the heat and cold defence activities to changes in body core temperature appeared to be unchanged. PMID- 3317271 TI - Tachyphylaxis of juxtaglomerular epithelioid cells to angiotensin II. Differences between the electrical membrane response and renin secretion. AB - A study has been made of desensitization of the depolarizing response to angiotensin II of juxtaglomerular epithelioid and vascular smooth muscle cells in the mouse kidney afferent arteriole, of media cells from the mesenteric artery as well as of cultured smooth muscle and mesangial cells. In all cell types, desensitization to this effect of angiotensin II was observed. There was no cross desensitization between angiotensin II and other depolarizing agonists. Hence, it is concluded that this desensitization is specific, i.e. of the tachyphylaxis type. Substances interfering with receptor recycling, such as chloroquine and monensin, did not block the recovery of the cells from desensitization after removal of the octapeptide. Desensitization to the action of angiotensin II was also observed with respect to its vasoconstrictor effect in the isolated perfused rat kidney. In contrast there was no desensitization of renin secretion in the isolated perfused rat kidney, nor in isolated hydronephrotic mouse tissue, nor in microdissected rat glomeruli. PMID- 3317272 TI - A randomized clinical trial of early hospital discharge and home follow-up of very-low-birth-weight infants. PMID- 3317273 TI - Outcome criteria for physical therapy, speech pathology, and occupational therapy. Florida Association of Home Health Agencies. PMID- 3317274 TI - Alteration of a mitochondrial tRNA precursor 5' leader abolishes its cleavage by yeast mitochondrial RNase P. AB - A mitochondrial specific RNase P is required to process 5' leaders from mitochondrial tRNA precursors in Saccharomyces cerevisiae. Experiments with a pair of mitochondrial pretRNAs(Asp) having leaders of different base composition suggest that this enzyme is unexpectedly sensitive to leader sequence or structure. Asp-AU (75% AU leader) is cleaved by the mitochondrial RNase P while Asp-GC (39% AU) is not. Both are substrates for E. coli RNase P. Partial nuclease digestions show that the tRNA portions of the two precursors differ in tertiary structure, while their 5' leaders differ in secondary structure. It is unusual for an RNaseP to have substrate specificity requirements which preclude processing of a pretRNA known to be a suitable substrate for an RNaseP from another species. PMID- 3317276 TI - Nucleotide sequence of ORF2: an open reading frame upstream of the tRNA ligase gene. PMID- 3317275 TI - The cDNA and deduced amino acid sequence of profilin from Saccharomyces cerevisiae. PMID- 3317277 TI - Nucleotide sequence of Escherichia coli valyl-tRNA synthetase gene valS. PMID- 3317278 TI - Sequence and identification of the nucleotide binding site for the elongation factor Tu from Thermus thermophilus HB8. AB - Two structural genes for the Thermus thermophilus elongation factor Tu (tuf) were identified by cross-hybridization with the tufA gene from E. coli. The sequence of one of these tuf genes, localized on a 6.6 kb Bam HI fragment, was determined and confirmed by partial protein sequencing of an authentic elongation factor Tu from T. thermophilus HB8. Expression of this tuf gene in E. coli minicells provided a low amount of immuno-precipitable thermophilic EF-Tu. Affinity labeling of the T. thermophilus EF-Tu and sequence comparison with homologous proteins from other organisms were used to identify the guanosine-nucleotide binding domain. PMID- 3317281 TI - Breast cancer. The breast report. PMID- 3317280 TI - Transcription of the tRNA-tufB operon of Escherichia coli: activation, termination and antitermination. AB - Signals setting the level of transcription of the tRNA-tufB operon have been studied by deletion mapping. TufB transcription was measured in vivo with plasmid borne tRNA-tufB:galk operon fusions. Removal of the sequences from -133 to -58 with respect to the transcription start point, results in a 90% decrease of tufB transcription. This demonstrates the presence of a region, upstream of the tRNA tufB promoter, that enhances the expression of the operon. DNA fragments bearing this upstream activator region do not display an abnormal electrophoretic mobility, as has been observed for the rrnB P1 upstream activator. Deletions starting in the first tRNA gene and directing towards tufB reveal at least two sites that influence tufB transcription. One signals transcription termination in the intergenic region between thrT and tufB. The other may be involved in antitermination. Possible mechanisms underlying antitermination and termination are considered in the light of the nucleotide sequence. PMID- 3317279 TI - The secondary structure of a messenger RNA precursor probed with psoralen is melted in an in vitro splicing reaction. AB - The secondary structure of the SP6/mouse insulin precursor RNA was determined by psoralen cross-linking experiments. A series of long-range contacts occur within the left half of the pre-mRNA that contains the intervening sequence. Multiple secondary structures for the pre-mRNA exist since some of the interactions share common sites. In splicing buffer but without the splicing extract added, many of these interactions are stable up to at least 50 degrees C. These interactions, however, are dissociated during the in vitro splicing reaction. This dissociation requires ATP and it occurs during the first 30 min. of the splicing reaction. Pre mRNAs containing psoralen cross-links in different locations within the RNA molecule were purified and used as substrates for in vitro splicing. Psoralen cross-links at any of the double-stranded regions resulted in complete inhibition of the splicing reaction. This indicates that destabilization of the secondary structure of the SP6/mouse insulin pre-mRNA is necessary for in vitro splicing. PMID- 3317282 TI - All well for mother and child (Catherina Schrader). PMID- 3317284 TI - Overview of fluids and electrolytes. AB - In order to maintain a constant internal environment, the body has a unique ability to respond to changes that would alter the normal state of homeostasis. A wide range of regulatory processes maintains the fluid, electrolyte, and acid base balance crucial for normal cellular function. An understanding of these processes allows the nurse to identify problems and anticipate various treatment modalities in certain disease states. PMID- 3317283 TI - A disease most foul. PMID- 3317285 TI - Renal and endocrine regulation of water and electrolyte balance. AB - The kidneys have primary responsibility for regulating the body's water and solute balance. Of the 180 L per day that are filtered at the glomerulus, about 98 to 99 per cent is reabsorbed throughout the course of the renal tubule. The kidney can produce a concentrated urine or a dilute urine, depending on the needs of the body. Several hormones, notably aldosterone, ADH, PTH, and calcitonin, as well as vitamin D, are important in the regulation of water and solutes. This article has not discussed other important renal functions as noted in the introduction. PMID- 3317286 TI - Fluid and electrolyte problems associated with diabetes insipidus and syndrome of inappropriate antidiuretic hormone. AB - This article has presented the complex system by which the hypothalamus regulates body fluid balance. In summary, ADH is synthesized and released via the hypothalamohypophyseal system. The supraoptic nucleus in the hypothalamus produces the ADH and the neurohypophysis stores and releases it. Osmoreceptors in the hypothalamus sense minute changes in the extracellular osmolality and stimulate or inhibit ADH synthesis and secretion. At the same time the thirst center of the hypothalamus is stimulated by the extracellular osmolality and brings conscious awareness of thirst into play. Once ADH is secreted, its target organ is the kidney, specifically the collecting ducts and distal tubules. Blood volume, blood pressure, emotional input, medications, and various pathologic conditions also affect ADH synthesis and secretion. As with any complex system there are numerous opportunities for a breakdown to occur. The most common types of pathologic conditions are the various forms of DI and SIADH. Both of these disorders have numerous causes, which must be identified prior to effective treatment. Serum and urine osmolality and sodium content are of use in diagnosing the disorders. Treatment is then geared toward correcting the underlying problem and controlling water balance, usually through pharmacologic agents. Nursing care includes meeting both the physical and psychologic needs of patients and educating them in the process of living with their transient or permanent condition. PMID- 3317287 TI - Fluid and electrolyte problems in renal and urologic disorders. AB - Because the kidneys are primarily responsible for the regulation of fluid and electrolyte balance, acute or chronic changes in renal function can result in multiple imbalances. Acutely, the rapidity of onset of renal deterioration makes nursing assessment and intervention critical to the prevention of complications and potentially fatal outcomes. For patients with chronic renal failure, nursing assessment and intervention are equally significant, since there is an absence of renal regulatory mechanisms. In renal failure, acute or chronic, one most commonly sees patients who have a tendency to develop hypervolemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and bicarbonate deficiency (metabolic acidosis). Sodium is generally retained, but may appear normal, or hyponatremic, because of dilution from fluid retention. Following the relief of a urinary tract obstruction, hypovolemia, hyponatremia (true loss of sodium), hypokalemia, hypocalcemia, hypomagnesemia, and bicarbonate loss are most apt to occur. Electrolyte imbalances after urinary diversion vary depending on the site of urine diversion. PMID- 3317288 TI - Liver failure and pancreatitis. Fluid and electrolyte concerns. AB - Fluid and electrolyte concerns in patients with advanced cirrhosis and acute pancreatitis are presented in this article. Pathophysiology and usual medical treatments are reviewed for both disorders. Nursing considerations related to these fluid and electrolyte concerns are identified. Major nursing diagnoses, expected patient outcomes, and nursing actions are offered. PMID- 3317289 TI - Fluid and electrolyte concerns in intestinal surgical procedures. AB - All surgical patients are at risk for fluid and electrolyte imbalances. This risk increases when a patient undergoes intestinal surgery, because of the role of the gastrointestinal system in providing the body with water and electrolytes. Therefore, throughout the perioperative period the nurse acts to prevent such disturbances. The nurse who is aware of preoperative factors that contribute to fluid and electrolyte imbalances, including pre-existing patient factors, iatrogenic causes, and the body's response to stress, can help prevent disastrous intraoperative events. Furthermore, postoperative patient assessment can prevent complications such as fluid overload and potassium and sodium imbalances. PMID- 3317290 TI - Metabolic bone disorders. Imbalances of calcium and phosphorus. AB - This article describes the physiology of normal calcium and phosphorus metabolism and the influences of various hormonal agents. Clinical variables affecting the interpretation of calcium are explained. In addition, the effects of calcium and phosphorus excess and deficiency are described according to the nursing model. Two metabolic bone disorders, osteoporosis and renal osteodystrophy, are discussed in order to demonstrate the altered metabolic effects of calcium and phosphorus. PMID- 3317291 TI - Implementation of nursing diagnoses. An overview. AB - Widespread interest in nursing diagnosis, its incorporation in most nursing textbooks, and the increasing amount of published research suggest that nurses are finding nursing diagnoses useful in clinical reasoning and judgment. Implementation is important for this reason and, as discussed, for professional, legal, and ethical reasons. Additional reasons for implementation relate to activities supporting or evaluating nursing care. Consistency of the nursing focus is important in both direct and indirect care activities. As nursing diagnosis-based planning of care is implemented, consideration has to be given to the use of diagnosis-based documentation systems, quality assurance programs, staffing, and other support or evaluative activities. Great progress has been made in the classification of nursing diagnoses since the 1970s but much still remains to be done. The role of the North American Nursing Diagnosis Association in this work has been briefly summarized. PMID- 3317292 TI - [Results of a shortened (6 months) schedule of treatment of pulmonary tuberculosis using INH, RMP and PZA]. PMID- 3317293 TI - Monoclonal antilymphocyte antibody (OKT3) treatment of acute renal allograft rejection. AB - Recent advances in immunosuppressive therapy have dramatically improved the survival rates for recipients of organ allografts by reducing the frequency of rejection. Cyclosporine, azathioprine, and prednisone for immunoprophylaxis are especially effective. When rejection occurs, the treatment usually includes high doses of oral or intravenous corticosteroids, antilymphocyte globulin, or antithymocyte globulin. A new monoclonal antilymphocyte antibody, OKT3, promises to improve allograft survival rates further. PMID- 3317294 TI - Norfloxacin: clinical pharmacology and clinical use. AB - Norfloxacin, a nalidixic acid analog, is the first of the fluorinated quinolinecarboxylic acids to be marketed in the United States. It demonstrates potent antibacterial activity against aerobic, gram-negative bacteria including the Enterobacteriaceae, gentamicin-resistant Pseudomonas aeruginosa, and penicillin-resistant Neisseria gonorrhoeae. Norfloxacin exhibits good activity against methicillin-resistant and -sensitive Staphylococcus aureus, but less activity against most other aerobic, gram-positive organisms. Anaerobic bacteria are resistant to the drug. Resistance to norfloxacin is not plasmid mediated, but is secondary to bacterial mutation, and occurs less frequently than nalidixic acid resistance. Its pharmacokinetic properties after a 400-mg oral dose consist of a peak serum concentration of 1.3-1.58 micrograms/ml, an elimination half-life of 3-7 hours, and good penetration into kidney and prostatic tissues. Renal excretion is the major route of elimination. Norfloxacin is highly effective in the treatment of uncomplicated and complicated urinary tract infections, and gonococcal urethritis. Adverse effects are generally well tolerated and usually do not require discontinuation of therapy. PMID- 3317295 TI - The sunburn cell. AB - The sunburn cell, with its pyknotic nucleus and eosinophilic cytoplasm, is characteristic of mammalian epidermis after exposure to UVC and UVB radiation or UVA radiation in the presence of psoralens. The photochemical events that lead to its formation are not known, but there is good evidence that damage to DNA is an important factor. The fate of the sunburn cell, a keratinocyte which shows abnormal and premature keratinization, is not known. Desquamation and/or phagocytosis seem probable. Sunburn cells may be regarded as examples of apoptosis: controlled individual cell death. PMID- 3317296 TI - [Use of computerized tomocisternography in the study of late sequelae of the surgical treatment of intracranial aneurysm]. PMID- 3317297 TI - [Endoscopic and zonographic studies in maxillary diseases]. PMID- 3317298 TI - [Lines, stripes and recesses of the mediastinum on plain films]. PMID- 3317299 TI - [Prenatal diagnosis of grade III congenital heart block]. PMID- 3317300 TI - [Torsion of the large intestine]. PMID- 3317301 TI - [Superselective embolization of intrarenal arteries as an alternative to surgical treatment of hematuria in non-neoplastic diseases]. PMID- 3317303 TI - [Embolization of the hepatic artery in the treatment of liver neoplasm]. PMID- 3317304 TI - [Economic aspects of technologic progress in radiology]. PMID- 3317302 TI - [Osteoblastic neoplastic or neoplasm-like bone changes. I. Osteoid osteoma: dysplasia or neoplasm?]. PMID- 3317305 TI - [A contribution to the history of Polish medical radiology (on the first Polish textbook of roentgenology)]. PMID- 3317307 TI - [A new type of catheter for superselective angiography of branch arteries of the abdominal aorta]. PMID- 3317306 TI - [Radiologic diagnosis of dental caries and periodontal changes]. PMID- 3317308 TI - [Hexamethylenepropylenoxime--a new marker for radioisotope examination of cerebral blood flow]. PMID- 3317309 TI - [Signs of acute renal graft rejection in ultrasonic examination]. PMID- 3317310 TI - [Radiologic picture of multi-organ calcification of soft tissues in patients with hemodialysis-treated renal failure]. PMID- 3317311 TI - Bereavement. State of the art and state of the science. AB - For bereavement research to fulfill its potential, its practical applications with defined patient groups needs to demonstrate a superiority over treatment based largely on intuition and common sense. The "art" of the therapist needs science to move beyond the present impasse in the management of bereavement. PMID- 3317312 TI - Grief following spontaneous abortion. AB - Grief following spontaneous abortion is a common occurrence that is often overlooked by clinicians until serious manifestations occur. Often patients report prolonged distress following this condition. This article defines symptoms and signs of normal and pathologic grief following spontaneous abortion. It discusses the types of psychological disability associated with this condition and makes specific suggestions for interventions. The variables affecting the onset and severity of the condition are further defined as are alternative approaches to treatment. PMID- 3317313 TI - Immune and neuroendocrine changes during bereavement. AB - Several studies document an association between bereavement and both suppressed lymphocyte responses to mitogen stimulation and impaired NK activity. In addition, women who are bereaved and have depressive symptoms show alterations in T cell subpopulations including a loss of T suppressor-cytotoxic cells and an increase in the ratio of T helper to T suppressor-cytotoxic cells. Although depressive symptoms may possibly mediate the immunologic changes during bereavement, the processes that modulate the immune system and link bereavement, changes in CNS activity, and immune function remain unknown. The increased secretion of cortisol in bereaved persons does not appear to mediate the suppression of NK activity, and further studies are necessary to explore the potential role of neuropeptides or catecholamines in altering immune function during bereavement. PMID- 3317314 TI - [Diagnostic problems in injuries of the menisci of the knee joint]. PMID- 3317315 TI - [Ultrasonographic studies in evaluating the degree of advancement of stomach cancer]. PMID- 3317316 TI - [Bilateral malignant lymphoma of the testes]. PMID- 3317317 TI - [Adult respiratory distress syndrome in endotoxic shock]. PMID- 3317318 TI - [The practical value of bronchoscopy]. PMID- 3317319 TI - [Serratia marcescens infection in children in the light of our observations with special reference to changes in sensitivity to commonly used antibiotics]. PMID- 3317320 TI - [Clinical evaluation of Cefoperazone in surgical infections]. PMID- 3317321 TI - [Evaluation of the effectiveness of Cefoperazone in children with various types of bacterial infection]. PMID- 3317322 TI - [Various aspects of African cholera]. PMID- 3317323 TI - Encephalomyelopathies associated with extracerebral malignant tumors. AB - It was the aim of this study to examine the probability of pathogenetical relations between extracerebral malignant tumors and lesions of CNS. The term paraneoplastic should be questioned. Among a running series of 2,000 brain autopsies, 456 patients (22.8%) showed such tumors, 362 of these combined with lesions in brain or spinal cord. Out of these cases, 100 had metastases, meningoses blastomatosae or leukotic hemorrhages, 218 other, non-tumoral lesions, and 44 both tumoral and non-tumoral lesions. The last-mentioned 262 cases were the target of the examination. We distinguished 6 groups: a) various well definable impacts, diseases or genetical defects (n = 18), b) unspecific terminal resp. agonal changes (n = 49), c) vascular or circulatory disorders incl. embolizations (20 non-leukotic hemorrhages, 148 anemic infarctions or selective neuronal necroses), thromboses, angiitis or calcifications, d) infections and other inflammatory alterations (n = 37), e) metabolic and toxic lesions (9 Wernicke's disease, 12 central pontine myelinolyses, f) anomalies difficult to classify (51 cases with subacute cerebellar atrophy, diffuse leukoencephalopathy, focal spongious axonopathic lesions, myelomalacia and other). After analysing the various lesions and discussing the probable pathogenesis we grouped according to the following scheme: I) tumor-unrelated (casual coincidence) (43.2%), II) therapy-dependent (3.7%), III) agony-related (10.7%), IV) homoiogenic disorders (e.g. larynx carcinoma and Wernicke's disease) (2.0%), V) nosocomial disorders (12.9%), VI) tumor-dependent (local neighbourhood effects, primary or secondary remote effects). As the central group there remain the primary remote effects (17.3%), separable into specific functional anomalies by tumorous organ destruction, remote effects of tumor cell-born (ectopic) release of hormones or hormone-like substances (n = 2), tumor antigen-dependent immune reactions (n = 20), and pathogenetically still uncleared mechanisms (n = 51). One should apply the term paraneoplastic only for the three last-mentioned conditions. PMID- 3317324 TI - What's new in the pathology of atherosclerosis? AB - Intimal smooth muscle cell proliferation has been known to be the key event in the development of advanced lesions of atherosclerosis. Since the important role of macrophages in the lipoprotein metabolism has been detected, however, current interest focuses on the macrophage reaction in the arterial wall. Animal experiments have shown that blood monocytes become attached to certain endothelial areas and enter the intima, where they are transformed to macrophages. Subendothelial infiltration of monocytes is the earliest cellular event in the formation of fatty streaks. Transformed to macrophages, they incorporate LDL by receptor-mediated endocytosis and are thus transformed to foam cells. The majority of foam cells in the atherosclerotic plaque is derived from macrophages. Furthermore, the importance of macrophages in the regulation of the lipoprotein metabolism and cholesterol homeostasis is increasingly attributed to their secretory capacities. It has been shown in vitro that they can secrete apolipoprotein E which associates with cholesterol and HDL to form a lipoprotein complex, which targets resecreted cholesterol to the liver cells. Recently, apolipoprotein E secretion of macrophages has also been demonstrated immunohistologically in the human atherosclerotic plaque. Cell culture investigations revealed that macrophages secrete different growth factors for fibroblasts and smooth muscle cells. So they are probably able, among other factors, to initiate smooth muscle cell proliferation in the intima. While smooth muscle cell proliferation and matrix components in the arterial wall had occupied the center of interest in previous investigations, the current focus on the cellular reactions of endothelial cells and monocytes/macrophages, especially in the early stages of atherosclerotic plaque formation, seems well justified. PMID- 3317325 TI - What's new in cancer monitoring? AB - Cancer monitoring by in vitro procedures is intimately linked to the identification of suitable tumor markers. Application of monoclonal antibodies (MAbs) not only led to the definition of new markers, but also to considerable progress in analytical methodology. In addition, monoclonal antibodies may be used for tumor targeting, thus opening the way for new diagnostic procedures (radioimmunolocalization) or therapeutic approaches. PMID- 3317326 TI - What's new in mutagenicity and carcinogenicity--status of short-term assay systems as tools in genetic toxicology and carcinogenesis. AB - The status of short term assay systems as tools in genetic toxicology has shifted from the goal to predict carcinogenic activity of chemicals toward their employment for understanding and elucidating the mechanisms of biological activity. This altered mode of application arises from research development in two main areas. One resulted in the observation that the calculated predictive values of individual assay systems (alone or in combination with supplementary tests) to detect carcinogens as genotoxic and non-carcinogens as non-genotoxic are lower than originally expected. The other is the increasing recognition that by employing relevant in vitro procedures, various aspects of a compound's activity can be studied which may otherwise not be clarified with available in vivo methods. This report focuses on the reasons why mutagenesis assays, or short term genotoxicity assays, in general, are not unambiguously employed for determining the carcinogenic potential of unknown compounds. One reason is that a safe prediction is not possible, since non-genotoxic carcinogens will not induce alterations of the DNA. Another reason is that even genotoxic carcinogens may not accurately respond as positive in a given test system due to the limitations of the specific assay. These are mainly seen in the incomplete metabolic conversion of the test compound, irrelevancy the measured effect may actually have for carcinogenesis, and the lack of regarding pharmacokinetic influences by a host animal, when testing in vitro. A rationale testing strategy compiled of assay systems which individually are included to overcome the restrictions is described.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317327 TI - Extensor tendon repair: a reconstructive technique. AB - Extensor tendon injuries are commonly encountered and are frequently treated with less regard than flexor tendon injuries. However, several factors make them as difficult to treat and more prone to suture line rupture than their palmar counterparts. A technique is described to protect a tendon juncture on the back of the hand following tendon disruption. This allows early finger motion to prevent joint stiffness while preventing suture line disruption. PMID- 3317328 TI - Antimicrobial prophylaxis for arthroplasty: a comparative study of cefonicid and cefazolin. AB - A double-blind, multicenter trial compared cefonicid and cefazolin for prophylaxis against postoperative infection in 117 patients undergoing joint replacement. Cefonicid, which has an extended serum half-life, was administered once daily, while cefazolin was given every eight hours. The drug was administered one half to one hour before surgery and continued for up to 72 hours. Patients were observed throughout their hospitalization period and followed for 30 days after discharge. No evidence of wound or joint infection was observed in any of the patients who met the criteria for evaluation. Adverse reactions consisted mainly of infrequent gastrointestinal symptoms and laboratory abnormalities. Three patients died from causes unrelated to study medication. No differences between the two regimens were found with respect to safety or efficacy in the prevention of postoperative infection after arthroplasty. The effectiveness of once-daily administration should make cefonicid a highly cost effective alternative to many of the more expensive first- and second-generation cephalosporin antibiotics currently used in hospital practice. PMID- 3317329 TI - Sacral ribs. A case report. AB - Supernumerary ribs are a rare anatomic curiosity usually discovered as an incidental finding on routine radiographs. The occurrence of sacrococcygeal ribs are extremely rare. Sacral ribs develop as a consequence of the failure of the rib anlage to fuse with the vertebral centers. The present case is unique from previous reports because of the associated scoliosis and hypoplasia of the ipsilateral gluteal musculature and foramina within the accessory rib. PMID- 3317330 TI - Non-traumatic atlantoaxial subluxation in an adult secondary to retropharyngeal abscess. AB - Non-traumatic atlantoaxial subluxation in an adult due to retropharyngeal abscess has been only sporadically reported. This article presents such a case treated non-surgically, with discussion of clinical presentation, diagnosis, pathogenesis, and treatment. The differential diagnosis of non-traumatic atlantoaxial subluxation is presented for review. PMID- 3317331 TI - Internal fixation of fractures and dislocations in the cervical spine. AB - The treatment of fractures of the cervical spine, like that of fractures of the extremities, has been considerably improved in the last decade. The aim of these changes has been to prevent and correct deformities and to achieve such a high degree of primary stability with the use of different internal fixation techniques that traditional external fixation can be avoided. Non-stable internal fixation and laminectomies, which invariably result in further loss of stability, have thus been completely eliminated from the therapeutic arsenal. The new system implies a considerably milder course of treatment for the patient. Confinement to bed is limited to a few days, even for tetraplegic patients. The duration of stay in the hospital is short and any necessary rehabilitation can be started at an extremely early stage. This article describes some of the new techniques and provides examples of indications for and methods of performing stable internal fixation. PMID- 3317332 TI - Massive congenital intracranial teratoma: a report of two cases. AB - Although intracranial teratoma is a well-recognized entity in the differential diagnosis of pediatric brain tumors, massive congenital intracranial teratoma replacing the cerebral hemispheres of a neonate has seldom been reported. We describe two such instances that histologically exhibit predominantly neuroepithelial differentiation. In 1 case serial prenatal ultrasonography revealed ventricular dilatation prior to identification of the lesion. Theories of pathogenesis are briefly discussed. PMID- 3317333 TI - Concerning alterations in the cerebellum resulting from cerebral hydrocephalus. 1891. PMID- 3317334 TI - Captopril and bronchial reactivity. AB - In order to assess the effect of captopril on bronchial reactivity, 16 consecutive patients with asthma and hypertension were randomized in a double blind crossover study, with increasing doses of placebo or captopril for 4 week periods. Forced expiratory flow (FEV1) and a dose-response curve with methacholine (PD20) were measured before and after treatment . Effective control of hypertension was achieved in all patients on captopril (P less than 0.05), while no changes in FEV1 and PD20 were observed. We conclude that captopril can be used as a first step in the treatment of asthmatic patients with hypertension. PMID- 3317336 TI - Long-term treatment with captopril in paediatric patients with severe hypertension and chronic renal failure. AB - Forty two children with end stage renal failure and hypertension on chronic haemodialysis have been treated with captopril for from 18 to 78 months. Satisfactory control has been obtained in doses of 0.3 to 3.0 mg/kg given every 24 or 48 hours. Tolerance was good. The results of the present study suggest that captopril is a suitable drug for long-term use in paediatric patients. PMID- 3317335 TI - Captopril as a replacement therapy in hypertension improving quality of life--a multicentre study. AB - A multicentre study was undertaken to determine whether side effects induced by hypotensive drugs could be reduced by replacement with low dose captopril. There were 100 patients on combinations of drugs, including diuretics, beta-blocking agents, methyldopa, clonidine and vasodilators. A questionnarie to obtain information on quality of life was completed by the patients. Each patient had major drugs, possibly responsible for side effects, withdrawn. Captopril was added at an initial dose of 12.5 up to 25 mg b.i.d. and titrated to a maximum of 50 mg t.i.d., until the blood pressure was equal to or lower than the level on entry into the study. Blood pressure was measured every two weeks and questionnaries were completed a number of times during the treatment period and scored at random, not in chronological order. A marked drop in blood pressure was obtained: mean systolic blood pressure went down from 173.4 +/- 2 to 154.5 +/- 2 mm Hg and diastolic blood pressure dropped from 104.5 +/- 11 to 9l.5 +/- 12 mm Hg. Neither tachycardia nor orthostasis was observed. Side effects, including inability to concentrate, nightmares, dizziness and sexual dysfunction, were reduced in 36% of the patients. Captopril itself produced no significant additional adverse reactions. It is concluded that captopril is a safe and effective drug, which can replace antihypertensive drugs that have deleterious side effects. PMID- 3317337 TI - Cross-over comparison between captopril and nifedipine. AB - In a cross-over study in 26 patients with mild to moderate essential hypertension The antihypertensive efficacy of captopril 25 mg b.i.d., nifedipine 20 mg b.i.d. and the combination both drugs in non-responders to monotherapy was compared. Of 26 captropril-treated patients 7 were non-responders and needed the addition of nifedipine; of 26 nifedipine-treated patients 3 needed additional captopril. Seven out of 26 patients treated with captopril, 22/26 patients given nifedipine and 9/10 patients receiving the combination reported side effects. In 3 nifedipine patients, 1 captopril patient and 1 patient on both drugs, treatment had to be stopped because of side effects. Captopril and nifedipine in these doses are about equally effective both after acute and chronic administration. The response-rate is somewhat higher with nifedipine, but the side effects are significantly less with captopril. There was no significant additive effect with the combination of the two drugs. PMID- 3317338 TI - Comparative efficacy of captopril and atenolol in moderately severe essential hypertension. AB - A randomized, double-blind study was undertaken to compare atenolol and captopril as second-step agents in the treatment of essential hypertension resistant to 5 mg bendrofluazide daily. Using a cross-over technique 28 patients were administered each drug sequentially for periods of 8 weeks with an intervening washout period of 2 weeks. Both drugs produced a significant reduction in both systolic and diastolic blood pressure (P less than 0.01). Captopril was more effective than atenolol at reducing diastolic pressure (P less than 0.05), but there was no significant difference in the systolic pressure. Neither drug produced side effects of a serious nature, but untoward symptoms were more frequent with atenolol. The effect of the drugs on myocardial function was assessed by comparing pre-treatment with post-treatment left ventricular ejection fractions, both at rest and with exercise, measured by MUGA scan. The resting ejection fraction was unaffected by either drug. During exercise, on captopril, the ejection fraction showed the normal increase over the resting baseline, but on atenolol there was no such increase. PMID- 3317339 TI - Captopril and common carotid blood flow in patients with essential hypertension- a review. AB - The haemodynamic pattern of the common carotid artery was studied before and after administration of captopril isosorbide dinitrate and nitrendipine, in men with sustained essential hypertension. Pulsed Doppler methods were used. Captopril produced both a fall in vascular resistance and an increase in the arterial diameter of the common carotid artery. Thus, in the common carotid artery circulation of patients with essential hypertension only captopril dilated both small and large arteries. PMID- 3317340 TI - Comparison of the efficacy of an ACE-inhibitor and a calcium channel blocker in hypertensive asthmatics. A preliminiary report. AB - A series of 8 adult patients with stable bronchial asthma and an established diagnois of essential hypertension (WHO I and II) was studied in a randomized double-blind cross-over study to assess the effect of captopril (50-100 mg/day) and verapamil (160-240 mg/day) on blood pressure, lung function and asthmatic symptoms. The effect of the medication on blood pressure was significant with a mean of 137/86 mmHg and 148/90 mmHg after 4 weeks on captopril and verapamil, respectively, with fewer orthostatic changes caused by captopril. There were no marked changes of asthmatic symptoms or peak expiratory flow (PEF) measurements during the trial. PMID- 3317341 TI - The effect of captopril on blood pressure and glucose tolerance in hypertensive non-insulin dependent diabetics. AB - Thirteen hypetensive non-insulin dependent diabetics (9 male, 4 female, mean age 61.6 +/- 6 years) were given 6 weeks treatment with captopril in a dose range 75 150 mg/day. Each patient underwent a standard glucose tolerance test and had blood pressure profiles recorded before and after captopril. Supine systolic blood pressure (mmHg) improved from 181 (+/- 16) to 162 (+/- 17) and diastolic blood pressure from 103 (+/- 11) to 89 (+/- 9). A similar improvement was seen in erect systolic (174 +/- 19 to 156 +/- 19) and diastolic (103 +/- 14 to 87 +/- 11) blood pressures. Following treatment there was no significant change in glucose tolerance although the 120 minute plasma glucose value improved from 15.3 +/- 4.2 to 13.9 +/- 3.4 mmol/l (P less than 0.05). The drug was well tolerated and free of adverse effects. Captopril would therefore appear to be an effective and safe anti-hypertensive agent in non-insulin dependent diabetes and did not result in any deterioration of glucose tolerance. PMID- 3317342 TI - Real time ultrasound, arterial pulsation and neonatal cerebral infarction. AB - This paper describes an infant whose cranial ultrasound scan showed marked unilateral cerebral arterial pulsation and enlargement without other abnormality. Subsequent computerized tomogram showed extensive cortical infarction in an area not readily accessed by ultrasound. It is concluded that the real time dimension of cranial ultrasound is of diagnostic value in the absence of demonstrable parenchymal or intraventricular abnormality. PMID- 3317343 TI - Clinical development of a new recombinant DNA hepatitis B vaccine. AB - The clinical development plan for the new recombinant DNA yeast-derived hepatitis B vaccine manufactured by SmithKline Biologicals is summarized. Initially, the emphasis was on assessing the risk of hypersensitivity to yeast-derived contaminants. This was followed by an evaluation of local and general reactions after vaccination. Next, the optimal dose of vaccine to be administered was ascertained followed by an evaluation of the efficacy of different vaccination schedules. The reactogenicity and immunogenicity of the yeast-derived vaccine was compared with that of two commercially available plasma-derived vaccines. The recombinant vaccine's protective efficacy was assessed in chimpanzees and by comparing attack rates in historical homosexual control groups with those in vaccinated homosexuals. Ongoing studies are investigating the protection of neonates born to HBeAg-positive carrier mothers. PMID- 3317344 TI - Reactogenicity and immunogenicity of different lots of a yeast-derived hepatitis B vaccine. AB - Several lots of a yeast-derived hepatitis B vaccine at different doses and a 20 micrograms dose of plasma-derived vaccine were tested in young healthy adults and compared with respect to risk of hypersensitivity reactions, reactogenicity, and immunogenicity. No signs of hypersensitivity either pre-existing or vaccine induced were observed. Reactogenicity was low and similar in all vaccine groups. It was not dose related and unaffected by the number of injections. Immunogenicity was evaluated for a 0, 1, 2, and 12 month vaccination schedule. Seroconversion rates (greater than or equal to 10 IU/l) were not significantly different between the purified yeast- and plasma-derived vaccines one month after the second vaccination whereas the percentage of seroconversion was slightly lower in the groups receiving only partly purified recombinant vaccines. Although geometric mean titres induced by the plasma-derived vaccine were somewhat higher after the first months, the antibody titres induced by the recombinant vaccine were at least as high as those elicited by a plasma-derived vaccine following the booster dose. PMID- 3317346 TI - Reactogenicity and immunogenicity of a recombinant hepatitis B vaccine compared with a plasma-derived vaccine in young adults. AB - A study of the immunogenicity and reactogenicity of three doses of lot L (10, 20, 40 micrograms), two doses of lot N (10, 20 micrograms) of the SmithKline Biologicals recombinant DNA yeast-derived hepatitis B vaccine and a 20 micrograms dose of the Merck, Sharp & Dohme plasma-derived hepatitis B vaccine was conducted in young adults under randomized, double-blind conditions. Immunization was carried out according to a 0, 1, and 6 month vaccination schedule. Results indicated that the yeast-derived hepatitis B vaccine was well tolerated and highly immunogenic. Reactogenicity to both yeast- and plasma-derived vaccines was mild in severity and low in incidence with no significant differences appearing between the study groups. One month after the third dose, the yeast-derived vaccines induced a high degree of seroconversion ranging between 97.8% and 100%. The response was not lot- or dose-dependent. The administration of the plasma derived vaccine resulted in an anti-HBs geometric mean titre approximately twice as high as those elicited by the different yeast-derived hepatitis B vaccine doses one month after the third inoculation. However, 11 months following the third dose of vaccine, the anti-HBs titres were similar in all groups. Revaccination of subjects who no longer had detectable anti-HBs one year after the last vaccine dose resulted in an anamnestic response. PMID- 3317345 TI - Effects of a recombinant yeast-derived hepatitis B vaccine in healthy adults. AB - Under randomized, double-blind conditions, 220 medical students were vaccinated with either a 2.5, 5, 10, or 20 micrograms dose of a recombinant yeast-derived hepatitis B or a 20 micrograms dose of a plasma-derived vaccine. Vaccines were administered at months 0, 1, and 2. After 11 months, all vaccinees received a 20 micrograms booster of the recombinant vaccine. There were no significant differences in adverse reactions between the study groups. Induction of IgE antibodies to yeast was not observed. One month after the third vaccination, seroconversion rates reached 100% in all vaccinees. Mean anti-HBs levels varied between 150 and 1470 IU/l after 3 vaccinations, with the lowest dose resulting in the lowest titres. Following the booster vaccination, dose-dependent effects were no longer observed. These data indicate that the recombinant hepatitis B vaccine is safe and immunogenic for use in man and comparable to the plasma-derived vaccine in terms of safety and efficacy. PMID- 3317347 TI - Comparative multicentre study of the immunogenicity of different hepatitis B vaccines in healthy volunteers. AB - In a comparative study of the immunogenicity of different hepatitis B vaccines, 339 healthy seronegative adults at three different centres were randomly allocated to receive either three doses of a yeast-derived vaccine at one of three different dose levels (10, 20, or 40 micrograms; SmithKline Biologicals) or one of two commercial plasma-derived vaccines at standard dose levels (5 micrograms, Institut Pasteur Production or 20 micrograms, Merck Sharp & Dohme). The subjects were inoculated intramuscularly in the deltoid region according to a 0, 1, and 6 month schedule. No severe or serious adverse reactions attributed to any of the vaccines were observed. One month after the third vaccine dose, seroconversion rates ranged from 95% to 100% in all groups with only 6 subjects failing to seroconvert. Although there were no statistically significant intra centre differences in antibody levels, the Tours/Chateauroux groups generally attained higher antibody levels than those from Limoges for the same yeast derived vaccine dose. This unexplained difference between centres was not found for the plasma-derived vaccines. Older subjects responded less well than younger ones and females attained higher antibody levels than did males. The yeast derived vaccine is comparable to the two commercially available plasma-derived vaccines in terms of reactogenicity and immunogenicity. PMID- 3317348 TI - Persistence of vaccine-induced antibodies to hepatitis B surface antigen and the need for booster vaccination in adult subjects. AB - Protection against hepatitis B virus infection can be achieved by the induction of neutralizing antibodies against the hepatitis B surface antigen (HBsAg). An antibody concentration of 10 IU/l, as measured by radioimmunoassay, is considered to be protective. HBsAg can be produced either from the plasma of chronic carriers or by DNA recombinant technology in yeast cells. Plasma- and yeast derived vaccines have been compared in several studies and their immunological properties were found to be similar, including the persistence of antibodies induced by either type of vaccine. Finally, yeast-derived hepatitis B vaccine can boost anti-HBs responses initially elicited by either plasma- or yeast-derived vaccine equally and effectively. In order to maintain protective immunity after hepatitis B vaccination, antibody determination and, if necessary, booster vaccination should be performed, particularly in high-risk persons. PMID- 3317349 TI - Immunogenicity of yeast-derived hepatitis B vaccines in young adults. AB - A study of the safety and immunogenicity of two different recombinant DNA yeast derived hepatitis B vaccines was conducted in 90 young adults according to a 0-, 1-, and 6-month vaccination schedule. Preliminary results using the 20 micrograms SmithKline Biologicals or 10 micrograms Merck Sharp & Dohme recombinant yeast derived hepatitis B vaccines indicate that both vaccines are clinically safe and immunogenic. Only minor side effects have thus far been reported. Seroconversion rates among vaccine recipients were 80% or greater after the first two injections with either vaccine, and 100% after the third dose of the SmithKline Biologicals recombinant DNA hepatitis B vaccine. PMID- 3317351 TI - Active immunization against hepatitis B: immunogenicity of a recombinant DNA vaccine in females, heterosexual and homosexual males. AB - Three groups of subjects (58 females, 54 heterosexual males, and 50 homosexual males) received three doses of a recombinant DNA yeast-derived hepatitis B vaccine according to a 0, 1, and 6 month vaccination schedule. Local and general side effects were mild. Seroconversion rates after three injections were not significantly different between the groups. Females showed a significantly higher anti-HBs response than both groups of males, and heterosexual males had higher antibody titres than homosexual males. Among the four homosexual non-responders, three were carriers of the human immunodeficiency virus. PMID- 3317350 TI - Immunogenicity of a recombinant DNA hepatitis B vaccine in neonates. AB - Infants of HBsAg-positive mothers (Group I) as well as those born to women without HBV markers (Group II) were vaccinated with a 10 micrograms dose of a recombinant DNA hepatitis B vaccine within 24 hours after birth according to a 0, 1, and 2 month schedule, with a booster dose planned 12 months later. Vaccination results in 14 (Group I) and 47 (Group II) neonates showed that at two months after the third dose of vaccine, 86% (6/7) and 100% (37/37), respectively, seroconverted, with anti-HBs geometric mean titres of 80 IU/l and 266 IU/l in the respective groups. No adverse reactions to the vaccine were observed. These preliminary results indicate that the recombinant DNA hepatitis B vaccine is safe and highly immunogenic in newborns. PMID- 3317352 TI - Immunogenicity and tolerance of a yeast-derived hepatitis B vaccine in homosexual men. AB - A yeast-derived recombinant DNA vaccine against hepatitis B was administered to 314 active homosexual men lacking serum markers for hepatitis B virus. Volunteers were vaccinated intramuscularly in the deltoid region at 0, 1, and 6 months with either a 20- or 40-micrograms dose per injection. Serologic tests for syphilis and human immunodeficiency virus were positive in 3.2% and 2.0%, respectively. The overall seroconversion rates for anti-HBs were 35%, 97%, and 98% after the first, second, and third injection, respectively. The geometric mean titres of anti-HBs antibodies at 7 months were 955 IU/l and 2541 IU/l, for the 20 and 40 micrograms doses, respectively. Among 183 completely vaccinated subjects, 97% had an anti-HBs titre greater than 10 IU/l. Tolerance of the vaccine was excellent. Among the 183 subjects followed up for at least 7 months, two volunteers developed HBsAg and anti-HBc within one month of the first vaccine injection and one anti-HBc just before the third dose of vaccine. However, no subject experienced clinical hepatitis or ALT elevations. PMID- 3317353 TI - Yeast-derived hepatitis B vaccine in thalassaemic patients: a preliminary report. AB - Preliminary results of a trial involving a yeast-derived hepatitis B vaccine administered to 41 transfusion-dependent thalassaemic patients and 2 patients with spherocytosis are reported. Twenty-microgram doses of HBsAg were administered according to either a 0, 1, and 6 month or 0, 1, and 2 month schedule. Serum specimens collected prior to vaccination, one month after each vaccine dose, and again at 5 and 15 months, were tested for HBV markers and ALT. To date, seroconversion (anti-HBs titres greater than 10 IU/l) was observed in 15%, 67%, and 86% of patients one month following the three vaccine doses, respectively. Although the study is still in progress, a comparison of these results with those previously obtained using plasma-derived vaccine indicates that seroconversion to the recombinant yeast-derived vaccine is at least as high as that obtained by plasma-derived vaccines in patients affected by thalassaemia major. PMID- 3317354 TI - Immunogenicity of a recombinant hepatitis B vaccine in haemodialysis patients. AB - The immunogenicity of a recombinant yeast-derived hepatitis B vaccine was evaluated in a randomized trial involving 80 haemodialysis patients in which three 40 microgram doses were administered according to either a 0, 1, 2 month, or a 0, 1, 6 month vaccination schedule. The vaccine induced an anti-HBs seroconversion in 54% of patients who received the three doses at intervals of one month (Group A) and in 55% of those who were vaccinated at months 0, 1, and 6 (Group B). The geometric mean titres (GMT) seven months after the first injection were 37.7 IU/l in Group A and 91 IU/l in Group B. The seroconversion rate in men (53.6%) was slightly lower than in women (60%), and the respective GMTs were 33.3 and 78.5 IU/l. An age-dependent effect was noted in the anti-HBs response, but the type of renal disease and length of time on dialysis did not influence the antibody response. A 0, 1, and 2 month vaccination schedule seems preferable for haemodialysis patients as it induces more rapid protection. PMID- 3317355 TI - Vaccination of newborns of HBsAg-positive carrier mothers with a recombinant DNA hepatitis B vaccine. AB - Thirty neonates born to HBsAg-positive mothers were vaccinated with a 20 microgram dose of the SmithKline Biologicals recombinant DNA yeast-derived vaccine within 24 hours after birth, with similar inoculations repeated 1 and 2 months later. Preliminary results indicate that the recombinant vaccine was well tolerated and immunogenic. A 100% seroconversion rate was achieved 4 months after the first vaccine dose and the anti-HBs geometric mean titres progressively rose from 14 to 31,279 and 361 IU/l at months 1, 2, 4, and 6, respectively. Although a longer period of observation and comparison with a historical control group are needed to evaluate its protective efficacy in this high-risk population, the fact that no vaccinated newborns have been infected is encouraging. PMID- 3317356 TI - Immunogenicity of a yeast-derived hepatitis B vaccine (Engerix-B) in healthy young adults. AB - In a study comparing the safety and immunogenicity of a recombinant DNA yeast derived hepatitis B vaccine with that of a plasma-derived vaccine in young female adults, 50 subjects were vaccinated with the former and 29 with the latter vaccine according to a 0, 1, and 6 month vaccination schedule. Results indicated that the yeast-derived vaccine was safe and highly immunogenic. Two months after the second vaccine dose, 86% of subjects seroconverted, a rate which increased to 100%, 30 days after the booster dose. Moreover, anti-HBs geometric mean titres increased progressively after the first two doses and rose markedly to 1098 IU/l after the booster dose. Although similar rates of seroconversion were obtained with both vaccines, the anti-HBs GMT of the plasma-derived vaccine was higher (P less than 0.05) than that elicited by the yeast-derived vaccine. PMID- 3317357 TI - Summary of clinical findings on Engerix-B, a genetically engineered yeast derived hepatitis B vaccine. AB - Between February 1984 and August 1986 results have been obtained in 58 completed or ongoing clinical studies by 33 investigators in 19 countries on a yeast derived recombinant DNA hepatitis B vaccine (Engerix-B). Among the 6100 subjects enrolled in these studies, 5664 subjects (150 normal neonates, 178 neonates of hepatitis B carrier mothers, 330 children aged 3-10 years, 3697 young healthy adults, 438 homosexual males, 110 older healthy adults, 139 drug addicts, 262 institutionalized mentally retarded patients, 59 thalassaemics, 25 sicklaemics, 270 patients on chronic haemodialysis and 6 haemophiliacs) received one or more (up to 4) injections of different doses of the yeast-derived vaccine according to either a 0, 1, 2, and 12 month or a 0, 1, and 6 month vaccination schedule. In randomized comparative studies 436 subjects received either one of two commercially available plasma-derived vaccines. The results reviewed in the present summary have shown that Engerix-B is safe, clinically well tolerated, gives an anti-HBs response which is qualitatively and quantitatively similar to that obtained with plasma-derived vaccines and confers protection against infection and disease. Engerix-B can be considered as a valid alternative to existing hepatitis B vaccines. PMID- 3317358 TI - Therapeutic measures after hepatitis B virus infection: postexposure prophylaxis. AB - Hepatitis B postexposure prophylaxis is here reviewed. Every contact with hepatitis B virus can cause an infection which may be either acute, subclinical, or progressive, the latter potentially leading to chronic liver disease and hepatocellular carcinoma. Direct injection of large quantities of HBsAg-positive blood is almost invariably contagious. While casual person-to-person contact rarely causes disease, the multiplicity of exposure in the hospital environment or the home increases the risk for transmission. Several studies have shown that postexposure prophylaxis using passive immunization with specific hepatitis B antibodies is possible. Hepatitis B immune globulin (HBIG) with a minimum titre of 100 IU/ml should be used. In practice, most preparations contain 500 IU/ml. The use of HBIG post-exposure prophylaxis should be limited to needlestick injury, sexual exposure, and perinatal contact of neonates with HBsAg-positive mothers. Routine vaccination as an adjunct to HBIG administration is recommended. HBIG does not decrease the immunogenic properties of the vaccine provided that the injection is not made at the same site. With increasing use of hepatitis B vaccines, the need for therapeutic intervention will hopefully be considerably diminished. Prevention rather than therapy should be stressed. PMID- 3317359 TI - Cell-type dependent expression and secretion of hepatitis B virus pre-S1 surface antigen. AB - The human hepatoma cell PLC/PRF/5 contains cloned genomes of hepatitis B virus, one of which was transfected to mouse cells (LTK-) or to human carcinoma cells (HeLa). Expression of the viral surface proteins was measured using monoclonal antibodies. The large protein with the pre-S1 domain was best expressed in HeLa cells and least in LTK- cells. In vivo growth of parental hepatoma cells or transfected HeLa cells increased expression of large, and decreased expression of small protein. Secretion of large protein required an excess of small protein. The secreted HBsAg from transfected HeLa cells contained filaments. Since the virus contains a defined proportion of all three proteins, a special regulatory situation is necessary for maturation of its envelope and its secretion in vivo. PMID- 3317360 TI - Construction and characterization of a Saccharomyces cerevisiae strain (RIT4376) expressing hepatitis B surface antigen. AB - A host/vector system suitable for large-scale production of HBsAg has been constructed and optimized in terms of the expression plasmid and yeast host strain in order to permit fermentation to very high cell densities. The final expression plasmid contains the coding sequence of the major HBsAg protein (P24) flanked by the promoter sequences from a glycolytic gene and by the transcription termination region of the ARG3 gene. The host/vector system was found to be genetically stable under large-scale fermentation conditions as demonstrated by nucleotide sequencing and restriction mapping experiments. The P24 protein is recovered from yeast as particles whose physiochemical properties are very similar to those of plasma-derived HBsAg. PMID- 3317361 TI - The natural history of hepatitis B. AB - Hepatitis B infection is acquired through contact with the blood of a person carrying the hepatitis B virus. The carrier rate of HBsAg varies world-wide. In many endemic areas, infection is largely acquired perinatally, while in other areas of high prevalence, transmission occurs during childhood, with intrafamilial spread being particularly important. Subclinical hepatitis B attacks are extremely frequent. The unusual clinical episode diagnosed in the adult tends to be more severe than that for virus A or non-A, non-B infection although the overall picture is similar. A fulminant course may be related to an enhanced immune response, and in such instances, HBsAg titres may be low or undetectable. About 10% of patients suffering an acute attack, more commonly males, will not clear the virus and will become chronic carriers. These may remain 'healthy' or suffer from various grades of chronic hepatitis and cirrhosis. Chronicity is related to impairment of humoral and cell-mediated immunity. There are two phases of hepatitis B infection, the replicative and the integrated, the former being recognized by the presence of hepatitis B viral DNA in serum. Relapses of chronic hepatitis B may be related to conversion from replicative to integrated stages, to spontaneous reactivation, or to super-added virus infection, especially with delta virus. PMID- 3317363 TI - The protection of chimpanzees against hepatitis B viral infection using a recombinant yeast-derived hepatitis B surface antigen. AB - In order to determine the efficacy of the SmithKline Biologicals recombinant DNA yeast-derived hepatitis B vaccine in inducing protection against hepatitis B infection, two chimpanzees were injected intramuscularly with 20 micrograms according to a 0-, 1-, and 2-month schedule. After the second dose, the vaccinated animals already showed a significant antibody response. One month after the last injection, the animals were challenged with hepatitis B virus. The vaccinated animals were protected while the two unvaccinated controls showed all signs of hepatitis B infection. One year after vaccination, antibodies remained high and were comparable with levels produced by plasma-derived vaccines. PMID- 3317362 TI - Development of a hepatitis B vaccine from transformed yeast cells. AB - The production in yeast cells of the recombinant DNA hepatitis B vaccine of SmithKline Biologicals involves an optimized fermentation process followed by cell disruption and extraction, together with other soluble yeast components of the surface antigen of the hepatitis B virus. The subsequent purification process includes precipitation steps, ion exchange and gel permeation chromatography, and caesium chloride ultracentrifugation. The yeast-derived antigen occurs as spherical particles containing the non-glycosylated HBsAg polypeptide, lipid, and Tween 20. The purity of the polypeptide is above 95% and confirmed by the absence of an immune response to yeast-derived contaminants in vaccinees. Yeast DNA levels were less than 10 pg/vaccine dose. Various biochemical analyses showed that the recombinant polypeptide was faithfully expressed and did not undergo unwanted processing or degradation during fermentation or purification. These results indicate that the recombinant HBsAg can be effectively produced in yeast and processed to a high degree of purity to yield HBsAg particles displaying most of the characteristic properties of plasma-derived HBsAg. PMID- 3317365 TI - Selection for early responsiveness of chicks to Escherichia coli and Newcastle disease virus. AB - A broiler chicken population was divergently selected for high or low early immune responses to Escherichia coli and to Newcastle disease virus (NDV) vaccines. Four selection cycles were performed in one replicate, and a single cycle in a second replicate. Selection was based on sire-family averages of a titer index (TI) calculated as the mean titer of antibodies produced by offspring vaccinated with either E. coli or NDV at 18 or 10 days of age, respectively. After the first selection cycle, TI of the early-high (EH) line were 22 and 38% greater than those of the early-low (EL) line in Replicates A and B, respectively. After four selection cycles, the average immune response to E. coli and NDV of Line EH exceeded that of Line EL by 68%. Viability was greater in the EH than in the EL line. Realized family heritabilities were .72 and .67 in Replicates A and B, respectively and the levels of response to the two antigens were not genetically correlated. The immune response of the EH line developed earlier than that in the EL line as shown by fewer nonresponders against E. coli and the higher response of this line against the two antigens at young ages. Mortality after challenge at 18 days of age and general mortality from hatching to 20 wk of age was lower in Line EH than in Line EL. Body weights at 7 wk were higher in EH than EL chicks. PMID- 3317364 TI - Specifications and quality control of a yeast-derived hepatitis B vaccine. AB - It is essential that the new generation of recombinant DNA yeast-derived hepatitis B vaccines be prepared according to techniques which are adequately controlled to ensure their safety and efficacy. Various national and supra national authorities have already issued guidelines for specifications and standardization of such products. Based on these guidelines, the potential hazards, and the state-of-the-art technology, SmithKline Biologicals has developed specifications and analytical methods to cover all aspects of the quality assessment of its recombinant hepatitis B vaccine, Engerix-B. This includes adequate 'in-process' tests to guarantee the optimal reproducibility and standardization of the entire production process as well as methods to study the characteristics and identity of the expressed antigen protein. Finally, specifications and methods of analysis necessary to control the purified bulk product and vaccine in its final container ensure the purity, safety, identity, potency, and stability of each production lot. PMID- 3317366 TI - Salmonella decontamination of broiler carcasses with lactic acid, L-cysteine, and hydrogen peroxide. AB - Experiments on salmonella decontamination of broiler carcasses with lactic acid, L-cysteine, and hydrogen peroxide were performed. Treatment with lactic acid (1%) and hydrogen peroxide (.5%) resulted in a 4-log cycle reduction in colony forming units of Salmonella typhimurium both with pure cultures and with artificially inoculated broiler carcasses. L-cysteine was nonbactericidal in these experiments. PMID- 3317367 TI - Cholinergic and catecholaminergic modulation of nociceptive reactions. Interactions with opiates. PMID- 3317368 TI - Cholecystokinin and pain. PMID- 3317369 TI - Neurochemical mechanisms of acupuncture analgesia. PMID- 3317370 TI - Analgesic effects of electrical brain stimulation and stress. Brain stem mechanisms. PMID- 3317371 TI - Descending serotoninergic systems. PMID- 3317372 TI - We're going to be accredited. By Sister M. Berenice Beck, 1938. PMID- 3317373 TI - The changing pattern of infective disease in general practice. PMID- 3317375 TI - Gastroenterology in 20 years' time. PMID- 3317374 TI - Computer-aided diagnosis in dyspepsia. PMID- 3317376 TI - Warning--medical imaging can damage your health! PMID- 3317377 TI - Generalised pruritus: still an enigma. PMID- 3317379 TI - Management aspects of cirrhosis. PMID- 3317378 TI - Liver transplantation. PMID- 3317380 TI - New radiological and imaging techniques for the liver. PMID- 3317382 TI - Current imaging techniques. PMID- 3317381 TI - Investigation of the jaundiced patient. PMID- 3317383 TI - Effects of indomethacin on hormonal and blood pressure responses to captopril in spontaneously hypertensive rats. AB - The possible role of vasodilatory prostanoids in the antihypertensive action of captopril was investigated in spontaneously hypertensive rats (SHR). Captopril (100 mg/kg/day for 5 days) decreased systolic blood pressure and increased water consumption, urine excretion and plasma renin activity (PRA). It also enhanced the urinary excretion of the prostacyclin metabolite 6-keto-PGF1 alpha, but did not change the excretion of PGE2. Indomethacin (3 mg/kg/day), given both alone and in combination with captopril, reduced markedly the urinary excretions of 6 keto-PGF1 alpha and PGE2 but did not alter PRA, compared with corresponding groups without indomethacin. The suppression of prostanoid synthesis caused by indomethacin did not affect the antihypertensive effect of captopril or the basal blood pressure in SHR. Neither did indomethacin influence drinking or urine excretion in SHR not receiving captopril, but it reduced the dipsogenic and diuretic effects of captopril. The results suggest that captopril augments the production of vasodilatory prostacyclin. Yet prostanoids have no significant role in the antihypertensive mechanism of captopril in SHR. PMID- 3317384 TI - [Reconstruction of the stump of the clinical crown of multi-rooted teeth using a composite radicular inlay]. PMID- 3317385 TI - [Retention of the resin on an esthetic fixed prosthesis]. PMID- 3317386 TI - Fetal karyotype following ascertainment of fetal anomalies by ultrasound. AB - Data pooled from contributors to a Registry for Cytogenetic Abnormalities and PKU (ReCAP) shows an unbalanced chromosome abnormality rate of 27 per cent (29 fetuses) for 107 fetuses with ultrasonically diagnosed fetal anomalies. Of the abnormal, 12 were trisomic, 6 were monosomy X and 6 were structural abnormalities, 4 were mosaics and one triploid. PMID- 3317387 TI - The value of chromosome analysis in cases of neural tube defects: a case of anencephaly associated with fetal dup(2)(p24----pter). AB - A family is described in which two anencephalic fetuses were identified in two pregnancies. Autopsy revealed kidney anomalies in both fetuses. Chromosome analysis was performed only on the second fetus, which had a 46,XY,10q+ karyotype. Parental chromosome analysis showed the maternal karyotype to be 46,XX,t(2;10)(p24;q26) thus demonstrating that the fetus was carrying a duplication 2(p24----pter). Recurrence risks for anencephaly based on the cytogenetic abnormality were much higher than those which would be quoted for isolated anencephaly. This points out the necessity for complete diagnostic studies when a fetus with a neural tube defect is identified. The literature in regard to the 2p duplication phenotype is reviewed. It is possible that the duplication of the distal segment of 2p results in a neural tube defect/kidney anomaly phenotype. PMID- 3317388 TI - Bilateral renal agenesis in three consecutive siblings. AB - We report here an unusual recurrence of bilateral renal agenesis (BRA) in three consecutive siblings. Chromosome analysis was normal, as were renal ultrasound studies on both parents and their surviving child. Ultrasound was employed prenatally to diagnose Potter's syndrome in both of the recurrences, and autopsy confirmed BRA in otherwise normal fetuses. Recurrence of BRA points to the usefulness of ultrasound in monitoring subsequent pregnancies in couples who have had one such occurrence. Ultrasound studies should also be performed in non affected family members to detect the presence of asymptomatic anomalies of the genitourinary system, but a negative family study does not preclude recurrence of BRA. PMID- 3317389 TI - Trisomy 20 mosaicism in prenatal diagnosis--a review and update. AB - A total of 66 cases with prenatal diagnosis of trisomy 20 mosaicism was reviewed. Since the majority of cases (85 per cent) was associated with grossly normal phenotype and the abnormalities noted in 15 per cent of cases were inconsistent and rather non-specific, no casual relationship between trisomy 20 mosaicism and a specific malformation syndrome can be established. The possibility of an association between an abnormal phenotype and a high percentage of trisomy 20 cells (greater than 60 per cent) must be considered preliminary and be viewed with caution. The fact that cells with trisomy 20 have not been recovered from blood cultures and were detected more frequently from specific fetal tissues, (such as kidney, rectum, oesophagus), and from placental tissues, suggests that trisomy 20 is more likely to be confined to certain fetal organs and to extra embryonic tissues. This review calls for the collection of more data on all cases of trisomy 20 mosaicism diagnosed prenatally, in order to provide more accurate information to the prospective parents. PMID- 3317391 TI - The effect of insulin on oestradiol and progesterone release by normal and diabetic placentae in vitro. AB - In an attempt to define better the metabolic differences between normal, insulin dependent and non-insulin-dependent diabetes, we have compared the effect of insulin on the secretion of oestradiol and progesterone in term placental explant culture. Placentae from non-diabetic and from diabetic, non-insulin-dependent diabetic patients demonstrated a similar response to incubation with insulin. This response consisted of a dose-dependent increase in both oestradiol and progesterone in the incubation media after 24 h. In contrast, the placentae of insulin-dependent diabetics showed a decrease in oestradiol and no change in progesterone secretion following exposure to insulin. These differences in response to insulin may underlie other metabolic differences between the placentae in the different groups. PMID- 3317390 TI - Studies on the elevated amniotic fluid SP1 in Meckel's syndrome: modified glycosylation of SP1. AB - Pregnancy-specific beta 1-glycoprotein (Schwangerschaftsprotein, SP1) is elevated in the amniotic fluid in Meckel's syndrome. In an attempt to clarify this phenomenon, we studied fetal tissues by immunohistochemistry for the distribution of SP1 in normal fetuses and fetuses with Meckel's syndrome. The amount of SP1 was increased in two out of ten Meckel placentae, as semiquantitatively shown by the immunoperoxidase method, but was normal in the rest of the cases. There was no difference in the SP1 distribution or content in the other fetal tissues studied. Fetal cerebrospinal fluid contained only very low levels of SP1 and thus cannot provide a source for elevated amniotic fluid SP1. In addition, binding of amniotic fluid SP1 to concanavalin A (Con-A) was studied in pregnancies with normal fetuses and Meckel's syndrome using affinity chromatography. The proportion not bound to Con-A in normal amniotic fluids decreased with advancing gestation and was lowest when the total SP1 concentrations were highest. An especially low percentage of SP1 not bound to Con A was found in Meckel's syndrome, suggesting an altered carbohydrate structure of SP1 in these amniotic fluids. PMID- 3317392 TI - Garlic (Allium sativum) and onion (Allium cepa): a review of their relationship to cardiovascular disease. AB - Garlic and onion have been used for millenia in the traditional medical practice of many cultures to treat cardiovascular and other disorders. Both Allium species, their extracts, and the chemical constituents of these plants have been investigated for possible effects on cardiovascular disease risk factors--both definite (hyperlipidemia, hypertension and hyperglycemia) and suspected (platelet aggregation and blood fibrinolytic activity). Action of these Allium species on blood coagulability is more clearly defined than their effect on the other risk factors. While many of the studies have serious methodological shortcomings, there is some evidence to suggest that use of certain formulations of garlic and/or onion is accompanied by favorable effects on risk factors in normal subjects and in patients with atherosclerotic disease. The possibility of toxicity resulting from acute and chronic ingestion of large amounts of these plants or their extracts is unresolved. Accordingly, further clinical and epidemiological studies are required before the role of these plants in the prevention and control of cardiovascular disorders is understood and can be realized. Additional research in this area is recommended. PMID- 3317393 TI - Physician-delivered interventions for smoking cessation: strategies for increasing effectiveness. AB - If physicians and other health-care providers were able to facilitate long-term cessation in 1 of every 10 smokers--a safe estimate based on the outcomes of randomized physician-delivered intervention studies--almost 4 million smokers would become former smokers. Evidence from randomized trials and observational studies demonstrates that physicians who intervene with smokers have an impact on their cigarette-smoking behavior. Greater smoking cessation occurs as physician interventions become more intensive and contacts more frequent. Adding modalities such as counseling, self-help booklets, and nicotine-containing chewing gum appears to augment the effectiveness of advice alone. The consistent demonstration of the need for follow-up and the possible use of several modalities is not unlike the demonstrated components of effective overall management approaches to such medical problems as hypertension. Surveys have indicated that physicians often do not intervene because they experience a low success rate with smokers. Educational programs have demonstrated substantial success in training physicians to counsel smokers; therefore, new goals for medical education, house-staff training, and continuing medical education need to include the development of skills and office management practices that can be used by providers to facilitate health-promoting behaviors among their patients. This article reviews the impact of physician-delivered smoking interventions on smokers, physician attitudes toward intervention, and physicians' reported intervention practices. It identifies those strategies that have been demonstrated to be effective in an out-patient office setting and emphasizes the need for every smoker to be considered a candidate for intervention. PMID- 3317394 TI - [Use of thyroid hormones in osteoarticular tuberculosis]. PMID- 3317395 TI - Epidermal growth factor and tooth development. PMID- 3317396 TI - Human renin biosynthesis and secretion in normal and ischemic kidneys. AB - The pathway of renin biosynthesis and secretion in normal and ischemic human kidneys has been investigated by pulse-labeling experiments. The results indicate that in normal human kidney, preprorenin is rapidly processed to 47-kDa prorenin. Microradiosequencing showed that this molecule was generated by cleavage between Gly-23 and Leu-24, yielding a 43-amino acid proregion. Analysis of prorenin secreted by the kidney tissue yielded an identical sequence, indicating that prorenin is secreted without any further proteolysis. An examination of the kinetics of processing and secretion suggested that a majority of the newly synthesized prorenin is quickly secreted, while only a small fraction is processed intracellularly to the mature renin. The differences in secretion kinetics between prorenin and mature renin and the selective inhibition of prorenin secretion by monensin suggest that they are secreted independently via two pathways: a constitutive pathway probably from the Golgi or protogranules that rapidly release prorenin and a regulated pathway that secretes mature renin from the mature granules. A comparison of the kinetics of processing between normal and ischemic tissues suggests that renal ischemia leads to an overall increase in the rate of processing of prorenin to mature renin. In addition, prolonged biosynthetic labeling of renin in the ischemic kidney yielded two smaller molecular weight immunoreactive forms suggestive of renin fragments that may be degradative products. These fragments were not detected in normal kidney tissue labeled for similar lengths of time. PMID- 3317397 TI - A yeast mutant conditionally defective only for reentry into the mitotic cell cycle from stationary phase. AB - We report the isolation of a cold-sensitive mutant of the yeast Saccharomyces cerevisiae that is conditionally defective only for reentry into the mitotic cell cycle from stationary phase. Although actively dividing mutant cells shifted to the restrictive temperature continued to divide, stationary-phase mutant cells placed in fresh medium at the restrictive temperature failed to divide or even perform the cell cycle regulatory step "start" but did lose the characteristic stationary-phase properties of thermotolerance, accumulation of storage carbohydrates, and resistance to cell-wall-lytic enzymes. Order-of-function analysis indicated that the cold-sensitive defect blocked cells during reentry before start of the first mitotic cell cycle. Genetic analysis showed that the mutant phenotype is due to the interaction between two mutations, a cold sensitive mutation gcs1 and a suppressor mutation sed1. These mutations thus provide the genetic basis for further analysis of stationary phase and the G0 state. PMID- 3317398 TI - Pulsed-field electrophoresis: application of a computer model to the separation of large DNA molecules. AB - The biased reptation theory has been applied to the pulsed-field electrophoresis of DNA in agarose gels. A computer simulation of the theoretical model that calculates the mobility of large DNA molecules as a function of agarose pore size, DNA chain properties, and electric field conditions has been used to generate mobility curves for DNA molecules in the size range of the larger yeast chromosomes. Pulsed-field electrophoresis experiments resulting in the establishment of an electrophoretic karyotype for yeast, where the mobility of the DNA fragments is a monotonic function of molecular size for the entire size range that is resolved (200-2200 kilobase pairs), has been compared to the theoretical mobility curves generated by the computer model. The various physical mechanisms and experimental conditions responsible for band inversion and improved electrophoretic separation are identified and discussed in the framework of the model. PMID- 3317400 TI - Control of A-system amino acid transport by a second regulatory gene R2 in Chinese hamster ovary cells CHO-K1 and the possible connection of this gene with insulin activity. AB - Evidence based on a study of alanine-resistant (Alar), constitutive mutants of CHO-K1 cells and the conditions that favor stimulation of the A system of amino acid activity supports the model that the A system of amino acid transport in these cells is repressible and under negative control of regulatory gene R1. In this study, we show that mutant Alar6, when grown under conditions of repression, has an A system of amino acid transport activity similar to that of the derepressed parental cell line, CHO-K1 (wild type) and of the fully constitutive mutant in gene R1, Alar4. However, the A system of Alar6 is further derepressible. The Vmax for proline transport through this system in mutant Alar6 is four times that of the parental culture, with no significant change in Km. Analysis of hybrids produced by crossing mutant Alar6 with the parental culture and with Alar4 shows that mutant Alar6 is recessive to wild type and complements mutant Alar4. Although the amino acid transport A system of CHO-K1 is stimulated by insulin, mutant alar6 is not stimulated by insulin. These results support the hypothesis that mutant alar6 results from mutation in another regulatory gene, R2, that, in conjunction with gene R1, negatively controls the expression of a structural gene for the A-system transport. Evidence also indicates that R2 gene product is not responsive to amino acids and that insulin stimulation of the A system may result from insulin inactivation of this repressor. PMID- 3317399 TI - Isolation, DNA sequence, and regulation of a meiosis-specific eukaryotic recombination gene. AB - The SPO11 gene, required for meiotic recombination in Saccharomyces cerevisiae, has been cloned by direct selection for complementation of the spo11-1 phenotype: lack of meiotic recombination and low spore viability. DNA sequencing indicates that the gene encodes a 398-amino acid protein having a predicted molecular mass of 45.3 kDa. There is no significant similarity between the SPO11 protein and other protein sequences, including those from genes known to be involved in DNA recombination or repair. Strains bearing a disruption allele are viable, indicating that SPO11 is dispensable for mitotic growth. RNA analyses demonstrate that SPO11 produces a 1.5-kilobase transcript that is developmentally regulated and expressed early in the sporulation process. PMID- 3317401 TI - Role of insulin receptor phosphorylation in the insulinomimetic effects of hydrogen peroxide. AB - The oxidant H2O2 has many insulin-like effects in rat adipocytes. To determine whether these effects could be mediated by the tyrosine kinase activity of the insulin receptor, the ability of H2O2 to stimulate receptor phosphorylation in intact adipocytes and partially purified insulin receptors has been examined. Phosphorylation of the beta subunit of the insulin receptor was increased approximately 2-fold by treatment of intact cells with 3 mM H2O2, a concentration that maximally stimulates 2-deoxyglucose uptake. Stimulation of receptor phosphorylation was rapid, reaching maximal levels within 5 min, and preceded activation of glucose transport. Phosphoamino acid analysis of insulin receptors from H2O2-treated adipocytes showed that 32P incorporation into phosphotyrosine and phosphoserine residues of the beta subunit was enhanced. Furthermore, partially purified receptors from H2O2-treated cells exhibit increased tyrosine kinase activity, as measured by phosphorylation of the peptide Glu80Tyr20. In contrast, the direct addition of H2O2 to partially purified insulin receptors did not stimulate tyrosine kinase activity or insulin receptor autophosphorylation. This was not due to breakdown of H2O2 or oxidation of ATP or the required divalent cations. To define the factors involved in H2O2's effect, we have examined receptor phosphorylation in fat cell homogenates and purified plasma membranes. Although insulin stimulated receptor phosphorylation in both of these systems, H2O2 was only effective in the cell homogenates. These data demonstrate that, under certain conditions, H2O2 stimulates insulin receptor phosphorylation and tyrosine kinase activity, suggesting that the insulin-like effects of H2O2 may be mediated by stimulation of insulin receptor phosphorylation. This does not appear to be a direct effect of H2O2 on the insulin receptor and requires nonplasma membrane cellular constituents. PMID- 3317402 TI - Nucleotide sequence of testis-derived c-abl cDNAs: implications for testis specific transcription and abl oncogene activation. AB - The c-abl gene codes for a protein-tyrosine kinase and is expressed in most examined murine cell types as two distinct mRNA species of 5.5 kilobases (kb) and 6.5 kb. In mouse testis, an additional species of 4.0 kb is expressed in very high levels. To study the interrelationship between various c-abl transcripts and to compare their sequence with the v-abl transcript, we prepared c-abl-specific cDNA clones from mouse testis and determined the complete nucleotide sequence of the 4.0-kb cDNA that appears to be the reverse transcript of the testis-specific mRNA. In addition, we have determined the 3' sequence of an additional clone derived from the larger mRNA species that is expressed in somatic as well as germ line cells. These cDNA sequences have been compared with the v-abl sequences to understand the mechanism of activation of this oncogene. The results demonstrate that (i) testis-specific c-abl mRNAs arise as a result of 3' truncation, and (ii) the v-abl gene has arisen from its cellular homologue as a result of an extensive deletional/mutational process. PMID- 3317404 TI - Isolation and sequence of a cDNA corresponding to a src-related gene expressed in murine hemopoietic cells. AB - We have isolated a murine cDNA that shares extensive homology with genes encoding the src (Rous sarcoma virus oncogene)-related family of protein-tyrosine kinases. The cDNA includes an open reading frame of 1509 base pairs, and conceptual translation predicts a protein of 56 kDa. Blot-hybridization analysis indicates that this src-related gene is expressed in normal macrophages and in cell lines representing both the myeloid and lymphoid B-cell lineages and, accordingly, is designated "bmk" (B cell/myeloid kinase). In addition, bmk mRNA levels increase following the induced differentiation of the murine myelomonocytic leukemic cell line WEHI-3B. PMID- 3317403 TI - Four additional members of the ras gene superfamily isolated by an oligonucleotide strategy: molecular cloning of YPT-related cDNAs from a rat brain library. AB - Several oligonucleotide mixtures corresponding to a 6-amino acid sequence that is strictly conserved in all the ras and ras-related proteins (from various organisms) were tested for their ability to hybridize to 11 cloned members of the ras gene superfamily. Among these mixtures, a combination of two sets of partially complementary oligomers were able to hybridize to all the tested sequences. To identify members of the ras superfamily, we screened a rat brain cDNA library with these probes and isolated four genes, denoted rab1, -2, -3, and -4, encoding proteins homologous to the yeast YPT protein. Amino acid homology scores with YPT range from 75% for rab1 to 37% for rab4, whereas the homologies with p21 ras and other ras-related proteins are approximately equal to 30%, and homologous residues were clustered in the regions involved in GTP/GDP binding. Another striking similarity shared by the rab and the other ras-related proteins is the conservation of at least one cysteine residue near the carboxyl-terminal end involved in the membrane binding of the ras proteins. rab1 is a mammalian homolog of the yeast YPT gene, and the four rab genes constitute an additional branch of the ras gene superfamily that to our knowledge has not been described in higher eukaryotes. PMID- 3317405 TI - Molecular cloning of matrix Gla protein: implications for substrate recognition by the vitamin K-dependent gamma-carboxylase. AB - Matrix Gla protein (MGP), a low molecular weight protein found in bone, dentin, and cartilage, contains 5 residues of the vitamin K-dependent amino acid gamma carboxyglutamic acid (Gla). We have used antibodies raised against MGP and oligonucleotide probes to screen a lambda gt11 cDNA library constructed from the rat osteosarcoma cells (line ROS 17/2) that had been pretreated with 1 alpha,25 dihydroxyvitamin D3. By sequencing several cloned cDNAs, we established a 523 base-pair sequence that predicts an 84-residue mature MGP and a 19-residue hydrophobic signal peptide. The 84-residue mature rat MGP predicted from the cDNA sequence has an additional 5 residues at its C terminus (-Arg-Arg-Gly-Ala-Lys) not seen in the sequence of MGP isolated from bovine bone. The structure of rat MGP provides insight into the mechanisms by which the vitamin K-dependent gamma carboxylase recognizes substrate. The present studies show that MGP, unlike other vitamin K-dependent proteins, lacks a propeptide. The absence of an MGP propeptide demonstrates that gamma-carboxylation and secretion of vitamin K dependent proteins need not be linked to the presence of a propeptide or to its proteolytic removal. The propeptides of other vitamin K-dependent proteins are structurally homologous, and there is evidence that this homologous propeptide domain is important to substrate recognition by the gamma-carboxylase. Mature MGP has a sequence segment (residues 15-30) that is homologous to the propeptide of other vitamin K-dependent proteins and probably serves the same role in gamma carboxylase recognition. Rat MGP also has a second sequence that has recently been identified in all known vitamin K-dependent vertebrate proteins, the invariant unit Glu-Xaa-Xaa-Xaa-Glu-Xaa-Cys (EXXXEXC). Since the glutamic residues in this unit are sites of gamma-carboxylation, it has been suggested that the EXXXEXC unit could allow the gamma-carboxylase to discriminate between substrate and product. The demonstration that two structures common to vitamin K-dependent proteins, the homologous propeptides domain and the invariant EXXXEXC unit, are in mature MGP indicates that des-gamma-carboxy-MGP should be an excellent in vitro gamma-carboxylase substrate for analysis of mechanisms involved in substrate recognition and product dissociation. PMID- 3317406 TI - Correlation between the 32-kDa sigma factor levels and in vitro expression of Escherichia coli heat shock genes. AB - S-30 extracts from Escherichia coli cells were used to express heat shock (HS) and non-HS genes in vitro in a DNA-directed protein synthesis system. The S-30 extracts prepared from cells that have been shifted to 45 degrees C express HS genes in vitro approximately 8 times better than extracts from cells at 33 degrees C. In contrast, the expression of non-HS genes in extracts from heat induced cells is only 40% of that seen in extracts from cells at 33 degrees C. These results correlate well with the levels of HS sigma factor and normal sigma factor bound to RNA polymerase. Thus, there was an 8-fold increase in the HS sigma factor and a 60% decrease in the normal sigma factor associated with RNA polymerase at the higher temperature. Part of the increase in the level of the HS sigma factor could be accounted for by a 3-fold increase in the level of HS sigma factor mRNA during heat induction. PMID- 3317409 TI - Sec53, a protein required for an early step in secretory protein processing and transport in yeast, interacts with the cytoplasmic surface of the endoplasmic reticulum. AB - The sec53 mutant is a conditional lethal yeast secretory mutant. At 37 degrees C, precursors to exported proteins become firmly attached to the endoplasmic reticulum membrane and are not released into the lumen in a soluble form. The accumulated precursors are insoluble in the detergent Triton X-100; however, urea, a known protein denaturant, solubilizes them. Using antibody directed against the Sec53 protein, we found that a substantial portion of the Sec53 protein is associated with the cytoplasmic surface of the endoplasmic reticulum membrane. Membrane-bound Sec53 protein is largely insoluble in Triton X-100, but the protein is effectively released from the membrane by urea. We propose that the Sec53 protein may be a member of a complex of proteins required for an early step in protein processing and transport. PMID- 3317408 TI - Autocrine stimulation after transfer of the granulocyte/macrophage colony stimulating factor gene and autonomous growth are distinct but interdependent steps in the oncogenic pathway. AB - Autocrine stimulation of cells by aberrant synthesis of growth factor may lead to malignant transformation, either as a direct consequence of endogenous factor production or as a first step of a series of successive events. Introduction of the granulocyte/macrophage colony-stimulating factor (GM-CSF) cDNA clone into a vector based on the myeloproliferative sarcoma virus allowed efficient transfer and expression of GM-CSF in factor-dependent myeloid cell lines (FDC-P1 and FDC P2). Factor-independent growth was acquired when the vector was introduced into the GM-CSF-responsive FDC-P1 cell line but not the multi-CSF-dependent FDC-P2 line. Nonlinear clonability in the absence of exogenous growth factor and growth inhibition by GM-CSF antiserum support a model of autocrine stimulation that requires interaction of factor and receptor at the outer membrane. However, many, but not all, infected FDC-P1 cells acquired subsequently a second mutation that abrogated the requirement of GM-CSF secretion and external interaction. The nature of the second step, which presumably leads to tumorigenicity of these cells, is not well understood, but its frequency could be correlated with the level of GM-CSF released by an individual cell clone. PMID- 3317407 TI - Linoleic acid, but not cortisol, stimulates accumulation of casein by mouse mammary epithelial cells in serum-free collagen gel culture. AB - A two-step culture system has been developed to analyze the role of hormones in casein accumulation by mammary epithelial cells obtained from adrenalectomized and ovariectomized adult virgin mice. In the first step cells are grown inside collagen gel in medium containing insulin, epidermal growth factor (EGF), and linoleic acid for 9 days; these conditions stimulate very little casein accumulation. Following this growth phase the gels are released to float in medium containing insulin, prolactin, and linoleic acid. During this second phase the mammary cells will accumulate large amounts of casein, but only in the simultaneous presence of insulin, prolactin, and linoleic acid; in the absence of linoleic acid casein accumulation is greatly reduced. The casein accumulation is not dependent on the presence of the glucocorticoid cortisol and will occur in spite of the presence of the antiglucocorticoid agent RU 38 486. To determine if the response to cortisol observed in organ culture by other investigators might be mediated by stromal cells, epithelial cells were grown in collagen gel under fatty acid-free conditions and then cocultured with explants of mammary fat pads from adult virgin mice with or without mammary parenchyma. The cocultures were performed in fatty acid-free medium containing insulin and prolactin with or without cortisol. In the majority of experiments the mammary epithelial cells in the collagen gel accumulate more casein in the presence of cortisol than in its absence, irrespective of the presence of mammary parenchyma in the explant. Thus, mammary epithelial cells are directly dependent on insulin and prolactin for casein accumulation and indirectly dependent on cortisol by means of its effect on the stromal cells. This cortisol effect may be to cause release into the medium of linoleic acid or a metabolic product of linoleic acid from the stromal cells. PMID- 3317410 TI - Antineoplastic bryostatins are multipotential stimulators of human hematopoietic progenitor cells. AB - The bryostatins are macrocyclic lactones, extracted from the marine bryozoan Bugula neritina, and have been reported to be potent antineoplastic agents. Results described here demonstrate that the bryostatins may also be useful as stimulators of normal human hematopoietic cells since they can (i) directly stimulate bone marrow progenitor cells to form colonies in vitro and (ii) functionally activate neutrophils. Structure-activity studies with bryostatin congeners indicate that these stimulatory properties may be dependent on the chain length and the unsaturated nature of the acylated group at carbons 20 and 7 of the bryostatin molecule. These stimulatory properties demonstrate that the naturally occurring bryostatins can mimic many of the biological effects of multipotential granulocyte-macrophage colony-stimulating factor. Thus, the coupling of antineoplastic activity with stimulatory growth properties for normal hematopoietic cells makes this agent an excellent probe to dissect the mechanism(s) of normal hematopoiesis. In addition, bryostatin may represent a clinically attractive agent useful for treating bone marrow failure states. PMID- 3317411 TI - Stage- and tissue-specific expression of the neu oncogene in rat development. AB - The neu oncogene (also referred to as c-erbB-2 and HER2) encodes a 185-kDa transmembrane glycoprotein with tyrosine kinase activity termed p185. The p185 glycoprotein is structurally related to the epidermal growth factor receptor. It is thought that p185 is the receptor for an as yet unidentified growth factor. In the present study, RNA blot analyses and immunohistochemical studies were performed on rat tissues obtained from a variety of prenatal and postnatal stages to examine the expression of the neu oncogene and its product, p185, during normal development. Expression of the neu gene was detected in mid-gestation embryos in a variety of tissues including nervous system, connective tissue, and secretory epithelium, but not in lymphoid tissue. In adult animals, secretory epithelial tissues and basal cells of the skin expressed neu. These studies demonstrate that the neu gene is expressed in a tissue- and developmental stage specific manner. We suggest that the p185 molecule plays an important role in the growth and development of a variety of tissues, and, in particular, in epithelial tissue. PMID- 3317413 TI - Determinants of membrane protein topology. AB - The topology of the integral membrane protein MalF, which is required for maltose transport in Escherichia coli, has been analyzed using fusions of alkaline phosphatase (EC 3.1.3.1). The properties of such fusion strains support a MalF structure previously proposed on theoretical grounds. Several transmembrane segments within MalF can act as signal sequences in exporting alkaline phosphatase. Other transmembrane sequences, in conjunction with cytoplasmic domains, can stably anchor alkaline phosphatase in the cytoplasm. Our results suggest that features of the amino acid sequence (possibly the positively charged amino acids) of the cytoplasmic domains of membrane proteins are important in anchoring these domains in the cytoplasm. These studies in conjunction with our earlier results show that alkaline phosphatase fusions to membrane proteins can be an important aid in analyzing membrane topology and its determinants. PMID- 3317412 TI - Cellular expression of liver and neural cell adhesion molecules after transfection with their cDNAs results in specific cell-cell binding. AB - Mouse L cells, which do not express the known primary cell adhesion molecules (CAMs), were permanently transfected with vectors containing the simian virus 40 early promoter and cDNA sequences encoding chicken liver CAM (L-CAM) or each of the three major polypeptide forms of chicken neural CAM (N-CAM). Transfected cells in culture expressing the Ca2+-dependent L-CAM showed uniform surface expression of the molecule. Unlike untransfected L cells, these cells aggregated readily; the aggregation was inhibited by Fab' fragments of antibodies to L-CAM but not by fragments of anti-N-CAM. These cells spread more efficiently in culture than did their untransfected counterparts, forming small colonies of flattened cells that gradually assumed morphologies resembling closely packed L cells. Transfected L cells expressing either the small or large intercellular domain polypeptide (sd or ld) chains of N-CAM aggregated specifically with each other or bound membrane vesicles from chick brain. Both types of binding were specifically inhibited by Fab' fragments of anti-N-CAM antibodies. These cells, in contrast to those transfected with vectors for L-CAM, showed rounded morphologies and spread inefficiently in culture. L cells transfected with vectors specifying the small surface domain polypeptide (ssd) chain of N-CAM showed no phenotypic changes and no evidence for linkage of ssd chains to the cell membrane by phosphatidylinositol intermediates. Instead, these cells synthesized the molecule and released it into the medium. These findings complete the demonstration that different CAMs have specific roles in ligating the cells that synthesize them, and they provide further evidence that L-CAM and N-CAM bind by homophilic mechanisms. The different phenotypic changes observed for each specific CAM are consistent with the hypothesis that CAM synthesis or differing associations of CAM carboxyl-terminal domains with the cell surface and cortex may lead directly or indirectly to specific alterations in the cells bound together by that CAM. PMID- 3317414 TI - Substitution of tyrosine for either cysteine in beta-lactamase prevents release from the membrane during secretion. AB - Six independent secretion-defective mutations were found that result in failure to release protein from the membrane into the periplasmic space of Salmonella typhimurium after removal of the signal peptide. The mutant protein is found in a membrane-bound form accessible to trypsin added to intact spheroplasts. The phenotype of these mutations supports the existence in general of an intermediate in bacterial secretion. All six mutations changed one or the other of the two cysteine residues in the mature protein to tyrosine, suggesting that these residues are involved in the release of protein into the periplasmic space, most likely by affecting protein folding. PMID- 3317415 TI - Partition site of the P1 plasmid. AB - We have defined a minimal partition site, parS, from the plasmid P1. It contains sufficient cis-acting information to direct accurate segregation of low-copy number plasmids that contain it as long as the two essential P1 Par proteins are supplied in trans. The site is, at most, 34 base pairs and contains a perfect 13 base-pair inverted repeat. Site-directed mutations were made within the repeat sequence that abolished activity whether or not the symmetry of the palindrome was maintained. Partition appears to be a competitive process, as differentially marked plasmids carrying the same type of partition site are not independently segregated but are randomly distributed with respect to each other. We have studied competition between plasmids carrying various fragments encompassing the parS site. As expected, two plasmids carrying the minimal parS site compete with each other. However, a sequence that lies to the left of the minimal parS site acts as a major modulator of this competition, changing the specificity of the competitive effect completely. Thus, this adjacent sequence appears to be an important determinant of the specificity of the wild-type P1 partition system without being necessary for its efficient function. PMID- 3317416 TI - Defective HLA class II expression in a regulatory mutant is partially complemented by activated ras oncogenes. AB - The human B-cell line RJ2.2.5, derived by mutagenesis from a Burkitt lymphoma cell line and selected for loss of HLA class II antigen expression, was infected with recombinant retroviruses containing either the Harvey murine sarcoma virus oncogene v-Ha-ras or the human neuroblastoma homolog NRAS. Both activated ras genes partially complemented the regulatory defect in RJ2.2.5 and specifically increased the expression of the DR and DQ subsets of HLA class II genes. Blot hybridization analysis and RNase mapping indicated that HLA-DQ alpha-chain mRNA in the infected cell lines was increased to a level at least 50% that of the parent B-cell line, Raji. The levels of HLA-DR and -DQ beta-chain RNA also were increased but to a lesser extent. In contrast, we detected no effect of ras on the quantities of other class II, class I, or invariant-chain mRNAs. Fluorescence activated cell sorter analysis with antibodies recognizing HLA-DR, -DQ, and class I antigens supported these observations. Enhancement of HLA class II gene expression by ras genes may have important implications for regulation of the immune system in response to transformation. PMID- 3317417 TI - Purification and characterization of a peptide from amyloid-rich pancreases of type 2 diabetic patients. AB - Deposition of amyloid in pancreatic islets is a common feature in human type 2 diabetic subjects but because of its insolubility and low tissue concentrations, the structure of its monomer has not been determined. We describe a peptide, of calculated molecular mass 3905 Da, that was a major protein component of amyloid rich pancreatic extracts of three type 2 diabetic patients. After collagenase treatment, an extract containing 20-50% amyloid was solubilized by sonication into 70% formic acid and the peptide was purified by gel filtration followed by reverse-phase high-performance liquid chromatography. We term this peptide diabetes-associated peptide, as it was not detected in extracts of pancreas from any of six normal subjects. Diabetes-associated peptide contains 37 amino acids and is 46% identical to the sequences of rat and human calcitonin gene-related peptide, indicating that these peptides are related in evolution. Sequence identities with conserved residues of the insulin A chain were also seen in a 16 residue segment. On extraction, the islet amyloid is particulate and insoluble like the core particles of Alzheimer disease. Their monomers have similar molecular masses, each having a hydropathic region that can probably form beta pleated sheets. The accumulation of amyloid, including diabetes-associated peptide, in islets may impair islet function in type 2 diabetes mellitus. PMID- 3317418 TI - The neuropeptide cerebellin is a marker for two similar neuronal circuits in rat brain. AB - We report here that the neuropeptide cerebellin, a known marker of cerebellar Purkinje cells, has only one substantial extracerebellar location, the dorsal cochlear nucleus (DCoN). By reverse-phase high-performance liquid chromatography and radioimmunoassay, cerebellum and DCoN in rat were found to contain similar concentrations of this hexadecapeptide. Immunocytochemistry with our rabbit antiserum C1, raised against synthetic cerebellin, revealed that cerebellin-like immunoreactivity in the cerebellum is localized exclusively to Purkinje cells, while in the DCoN, it is found primarily in cartwheel cells and in the basal dendrites of pyramidal neurons. Some displaced Purkinje cells were also stained. Although cerebellum and DCoN receive their inputs from different brain regions, their organizations show several similarities, with many neuronal cell types present in one having their presumed homologue in the other. Cerebellin is present in Purkinje and cartwheel cells throughout the cerebellum and the DCoN without site predilection. This should be viewed together with recent data indicating that these two classes of neurons share a similar fate in several murine mutations ("nervous," "lurcher," "Purkinje cell degeneration," and "staggerer"). This situation leads us to conclude that cerebellin represents a marker for a small number of spatially related neuronal cell classes, and that it may play a role in an as yet unknown aspect of a circuit function worthy of further exploration. PMID- 3317421 TI - The use of transrectal ultrasound in the diagnosis and management of prostate cancer. Proceedings of a meeting. Detroit, Michigan, September 11-12, 1986. PMID- 3317422 TI - Prostate cancer 1986: where have we been and where are we going? PMID- 3317420 TI - Unexpected responses of the hypothalamic gonadotropin-releasing hormone "pulse generator" to physiological estradiol inputs in the absence of the ovary. AB - In the rhesus monkey (Macaca mulatta), the frequency of pulsatile gonadotropic hormone release is relatively constant in the face of widely varying levels of estradiol (E2) in the peripheral circulation--e.g., in the course of the follicular phase of the menstrual cycle and after ovariectomy. This suggests that modulation of the hypothalamic gonadotropin-releasing hormone (GnRH) "pulse generator" by this steroid is not of major physiological importance. Herein is described the unexpected inhibition or total blockade of the electrical activity of this pulse generator in ovariectomized monkeys by physiological levels of exogenous E2. This inhibition began 2-4.5 hr after the initiation of E2 infusion and was noted 1 to 3 weeks after subcutaneous implantation of E2-containing capsules. Pulse generator activity was also arrested during the initiation and subsequent development of estrogen-induced surges of luteinizing hormone. We propose that this inhibition of hypothalamic GnRH pulse generator activity by E2 in ovariectomized monkeys reflects the absence of an ovarian factor that normally protects this neuronal system from the inhibitory action of estrogen during the menstrual cycle. PMID- 3317423 TI - Histologic and cytologic diagnosis of prostatic carcinoma by ultrasound-guided needle biopsy. PMID- 3317419 TI - Immunohistochemical localization of a neuronal nicotinic acetylcholine receptor in mammalian brain. AB - A monoclonal antibody generated against purified acetylcholine receptor from Torpedo electric organ was used to immunohistochemically localize a neuronal nicotinic acetylcholine receptor. Regions of the rat brain stained with this antibody paralleled those areas of the brain exhibiting [3H]nicotine binding sites and corresponded to areas in which mRNAs encoding for alpha subunits of the neuronal nicotinic acetylcholine receptor are present. Thus, the anteroventral thalamus, cortex, hippocampus, medial habenula, interpeduncular nucleus, and substantia nigra/ventral tegmental area exhibited significant immunoreactivity. Neurons of the medial habenula and substantia nigra were densely stained, and processes were prominently delineated. Furthermore, in the projection areas of the medial habenula (interpeduncular nucleus and median raphe) axons were strongly immunoreactive and were distributed to distinct subdivisions of the target sites. The present data suggest that there are several discrete neuronal systems in which nicotinic acetylcholine receptors have functional importance. These immunohistochemical studies delineate at the single-cell level the localization within the mammalian central nervous system of certain nicotinic acetylcholine receptors. PMID- 3317424 TI - Preventive oncology project for prostatic cancer. PMID- 3317425 TI - Transperineal I-125 seed implantation in prostate cancer guided by transrectal ultrasound. PMID- 3317426 TI - Prostate gland: anatomy, hyperplasia, cytologic atypia, adenocarcinoma, and tumor markers. PMID- 3317427 TI - The U.S.A. experience: diagnosis and follow-up of prostate malignancy by transrectal ultrasound. AB - Our own experience, and a review of the American literature, suggests a number of areas in the diagnosis and follow-up of prostate cancer in which transrectal ultrasonography is a useful adjunct. Accurate clinical staging in patients with known prostate cancer is an obvious area in which this technique had ready and practical impact. Its performance prior to radical prostatectomy should facilitate further ultrasonographic and histopathologic correlation. This imaging modality may be coupled with other devices to guide in a precise manner subsequent biopsy or implantation. Further collaborative efforts in this area are likely to result in a number of new and ingenious methods of mapping the prostate gland for further diagnostic or therapeutic intervention with pinpoint accuracy. At present, one of the most useful applications of transrectal ultrasound is in determining local response to therapy, whether hormonal, radiotherapeutic, or chemotherapeutic. Normalization of the prostatic image is seen in patients sustaining a favorable response to therapy. It is most likely that changes in the prostate following hormonal therapy or chemotherapy for metastatic prostate cancer would mirror the systemic response to therapy, but the correlation of local and systemic response to treatment requires further study and analysis. Finally, there are unresolved problems in the use and interpretation of transrectal ultrasonography as currently employed. Most significantly, ultrasonographic criteria for the diagnosis of prostate cancer are lacking. The internal echo patterns in particular which characterizes prostate cancer defy precise definition, and prostate disorders may be identified with high sensitivity but low specificity. More recent and convincing reports indicate that most prostate cancers are hypoechoic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317428 TI - The United Kingdom experience: clinical trials for carcinoma of the prostate monitored by ultrasound. PMID- 3317429 TI - The European experience: use of transrectal ultrasound in the diagnosis and management of prostate cancer. PMID- 3317431 TI - The development of a three dimensional prostate model. PMID- 3317430 TI - Future developments in ultrasonic imaging of the prostate. PMID- 3317432 TI - Pertinent physics of an optimal examination. PMID- 3317433 TI - The performance of an optimal transrectal examination of the prostate. PMID- 3317434 TI - Transrectal ultrasound in the diagnosis, staging, guided needle biopsy, and screening for prostate cancer. PMID- 3317435 TI - Molecular structure and organization of filaments in single, skinned smooth muscle cells. AB - The contractile elements of single, skinned amphibian smooth muscle cells were resolved as fibrils containing F-actin and side-polar myosin filaments and adjacent cytoplasmic dense bodies, containing alpha-actinin and actin. The fibrils were found to be linked axially through actin filaments to the dense bodies, by electron microscopy. The arrangement of these two structures provides the essential features of a sarcomere to the contractile elements. The effect of contraction upon the movement of the dense bodies was followed dynamically by optical microscopy as a method of analyzing the organization of the contractile apparatus and resolving contractile units. Averaged over long time periods (30 to 50 seconds), the axial movements of dense bodies was uniform. The dense bodies were not simply displaced passively during contraction because the extent of radial movements averaged over the same (long) time periods were less than would be expected for the observed increases in cell diameter. Measured over short time intervals (3 to 6 seconds), the axial movement of some closely spaced dense bodies was not uniform: individual and groups of bodies moved significantly faster and slower than the mean rate of axial translocation. These shifts in coordinated and independent movements might reveal separate anisometric contractile units, or they could represent a random temporal pattern of localized activation and deactivation of small contractile elements. PMID- 3317436 TI - Caldesmon, a major actin- and calmodulin-binding protein of smooth muscle. PMID- 3317437 TI - Myosin light chain kinases and kinetics of myosin phosphorylation in smooth muscle cells. PMID- 3317438 TI - Selective inhibitors of phosphorylation in smooth muscle. PMID- 3317439 TI - Crossbridge transients initiated by photolysis of caged nucleotides and crossbridge structure, in smooth muscle. PMID- 3317441 TI - Smooth muscle contraction: mechanisms of crossbridge slowing. PMID- 3317440 TI - The effects of calcium on smooth muscle mechanics and energetics. AB - In smooth muscle isometric force, shortening velocity, the ATP utilization under isometric conditions, and tension cost are all functions of calcium. This suggests that both cross bridge number and cycle rate are dependent on calcium. On the other hand, the series elastic component does not exhibit a significant dependence on calcium under conditions in which Vus can be increased with little change in Fo. And although the data is not as extensive, the efficiency in working producing contractions is not a strong function of calcium. Our challenge is to fit these mechanical and energetic data into a mechanism which fits the ever growing and controversial body of evidence on the biochemical basis for the action of calcium on the contractile apparatus. At present the most striking feature is the observation that calcium can control the velocity in a manner which is independent of isometric force and efficiency. This would appear to favor a mechanism in which calcium directly affected cross bridge cycle rate in the absence of an internal load. PMID- 3317444 TI - Cellular site of expression and genetic interaction of the rd and the rds loci in the retina of the mouse. AB - In the retina of mice, the two genes, rd and rds, produce retinal degeneration. Depending on allelic combination and gene dosage at these loci, four different genotypes with distinct phenotypic traits and rates of photoreceptor cell loss are recognized. The cellular site of gene action and the nature of interaction, resulting in the variegation of the retinal phenotypes have been analyzed by comparing gene expression in the retina of pure line (unigenotypic) mice, and in the retina of chimaeric mice, experimentally produced by aggregating embryos of different genotypic constitution. The findings suggest that both rd and rds genes act intracellularly within the photoreceptor cells. The primary expression of the genes, producing specific phenotypic alterations of the photoreceptor cells, are invariant and are not affected by extracellular factors. The lethal effects of the genes, on the other hand, resulting in specified rates of photoreceptor cell death, are influenced by both genetic (intracellular), and environmental factors. PMID- 3317442 TI - Degenerative retinal disorders. Clinical and laboratory investigations. Proceedings of the Sendai Symposium on Retinal Degeneration. Sendai, Japan, September 20-24, 1986. Dedicated to Katsuyoshi Mizuno. PMID- 3317443 TI - DNA linkage studies of degenerative retinal diseases. AB - DNA linkage studies of human genetic diseases have led to rapid characterization of a number of otherwise intractable disease loci. Detection of a linked DNA marker, the first step in "reverse genetics", has permitted cloning of the genes for Duchenne muscular dystrophy, retinoblastoma and chronic granulomatosis disease, among others. Thus, the case for applying these techniques to retinitis pigmentosa and related diseases, and the urgency in capitalizing on molecular developments, is justified and compelling. The first major success regarding RP was in demonstrating linkage of the DNA marker DXS7 (L1.28) to XRP. For autosomal forms of the disease, conventional linkage studies have provided tentative evidence for linkage of ADRP to the Rh blood group on chromosome lp and for linkage of Usher's syndrome to Gc and 4q. These provisional assignments are, at least, an important starting point for DNA analysis. The Support Program for DNA Linkage Studies of Degenerative Retinal Diseases was established to provide access for the scientific community to appropriate families, using the resources of the Human Genetic Mutant Cell Repository to prepare, store and distribute lymphoblast lines. To date, two extensive, well-characterized families are included in the program: the autosomal dominant RP family UCLA-RP01, and the Usher's syndrome families LSU-US01. It is highly likely that rapid progress will be made in mapping and characterizing the inherited retinal dystrophies. We believe the support program will facilitate this progress. PMID- 3317446 TI - Clinical investigation of retinitis pigmentosa. PMID- 3317445 TI - Pathology of human retinal dystrophy. PMID- 3317447 TI - [Fibrositic alveolitis of the lung]. PMID- 3317448 TI - High performance liquid chromatographic separation of DNA adducts induced by cancer chemotherapeutic agents. PMID- 3317449 TI - The formation, isolation and characterization of DNA adducts produced by anticancer platinum complexes. PMID- 3317450 TI - Properties and assay of mammalian O6-alkylguanine-DNA alkyltransferase. PMID- 3317451 TI - Properties and biological consequences of alkylpyrimidine deoxyribonucleosides. PMID- 3317452 TI - Quantitative estimation of cisplatin-induced DNA interstrand cross-links and their repair in mammalian cells: relationship to toxicity. PMID- 3317453 TI - Structure and expression of the complement genes. PMID- 3317454 TI - Photoaffinity labeling of Escherichia coli ribosomes. PMID- 3317455 TI - Nucleoid sedimentation analysis of DNA strand breaks induced in cells exposed to DNA intercalating agents. PMID- 3317456 TI - [Mechanisms and effects of recurrences following active treatment of insufficient perforating veins]. AB - In this study we examine the mechanisms and effects of relapse of incompetence perforating veins occurring after sclerosant injections or surgical operations involving ligation or removal. Five relapse mechanisms are anticipated: 1) faulty surgical technique, 2) sclero-resistance or recanalization of injected perforated, 3) dilatation of healthy perforators as a result of persistent vertical saphenous reflux, 4) growth, forced by the same disorders, of newly formed perforators. There are also "pseudo-successes", when the treated perforator is part of a "deprived saphenofemoral circulation" and is destined to right itself spontaneously after the suppression of the vertical reflux which had dilated it; and there are "pseudo-failures" too, when relapse occurs after the reestablishment of a good local vascular-tissular equilibrium and continues to be well tolerated by the surrounding skin for a very long time. PMID- 3317457 TI - Electrolyte transport by airway epithelia. PMID- 3317459 TI - [We owe them remembrance (the final days of Old Warsaw 1944)]. PMID- 3317458 TI - Neutrophil kinetics and lung injury. AB - The fact that the lung stores a large proportion of the marginated pool of neutrophils is a result of the anatomy of the pulmonary microcirculation. This capillary bed is made up of a network of a very large number of segments, many of which have smaller diameters than the neutrophils. Both neutrophils and erythrocytes must deform to pass through the capillary bed, but as the neutrophils are larger and less deformable, they pass through the segments more slowly. The slower movement of neutrophils through the pulmonary capillaries produces little obstruction to erythrocyte flow because the very large number of segments allows the erythrocytes to stream around those that are filled with neutrophils. The size of the marginated pool of neutrophils in the lung depends on the balance between forces that propel the neutrophils through the capillary segments and those that tend to retard them. Activation of the PMN both decreases their deformability and increases their adherence to endothelium, which results in increased numbers of neutrophils in the lung and a reduction in the number circulating in the blood. There is growing evidence that the adherence of the neutrophil to the endothelial cell is mediated by the CD omega 18 on the surface of the neutrophil. The absence of these proteins leads to lack of neutrophil adherence and migration, whereas factors that enhance adherence lead to increased expression of these glycoproteins. The fact that activated neutrophils can also damage normal tissue has led to several attractive hypotheses concerning the pathogenesis of lung diseases such as emphysema and the ARDS. Further elucidation of factors that cause cells to marginate in the pulmonary circulation and a more complete understanding of the factors that control their adherence to endothelium, migration into the interstitial and airspace, and phagocytic function will undoubtedly lead to a better understanding of both the physiology and pathology of the lung. PMID- 3317460 TI - [Patients with diabetes mellitus]. PMID- 3317461 TI - Trends in ambulatory surgery. The impact of the Sixth Omnibus Reconciliation Act. PMID- 3317462 TI - Rhinoplasty: creating an aesthetic tip. A preliminary report. AB - A new approach for creating an anatomically aesthetic nasal tip is presented. It is based on extensive cadaver dissections which demonstrate that a convex domal segment plus a sharp domal segment-lateral crural drop-off are key determinants of a refined tip. This configuration can be achieved with sutures in a manner similar to creating the anthelical curl in an otoplasty. Two operative variations are presented. One achieves tip refinement with a limited increase in projection, while the other provides maximum projection. Currently, the technique is of value in bilateral cleft lip noses, posttraumatic deformities, certain secondary cases, and very selected primary aesthetic cases where tip refinement and projection are limited. PMID- 3317463 TI - Latissimus dorsi musculocutaneous flap: correction of donor-site defect with reverse latissimus flap. AB - A simple one-stage method for repair of the larger donor defect of the latissimus dorsi musculocutaneous flap is documented. This technique preserves a more natural appearance than could otherwise be obtained from a skin graft. PMID- 3317464 TI - [The readiness potential--movement-correlated changes in bioelectric brain activity]. AB - The Bereitschaftspotential which belongs to the group of slow potentials can be recorded in the period of preparation to a voluntary motor act and is connected with changes of the level of central nervous activation. This paper is concerned with general questions of classification of Bp in the complex of movement-related brain potentials, with the topographic distribution over the scalp, and with the relation of Bp to some motor functions of the cortex. The relationship to psychological factors affecting the Bp is discussed. PMID- 3317465 TI - [Helpful adjustment--helpless accommodation. Physicians and the administration of Lower Saxony during the extermination of psychiatric patients at the time of national socialism]. AB - After a brief introduction describing the development and organisation of the National Socialist extermination programmes to eliminate patients suffering from mental diseases, a description is given of the way these programmes were translated into reality in the then province of Hannover. The provincial government implemented these programmes hesitatingly but nevertheless as ordered, whereas the administrative decrees were complied with in a widely different manner by the individual psychiatric hospitals. These differences in the daily routine on-the-spot realisation of the extermination programmes suggest raising the question of professional ethics in psychiatry, as outlined by the author. PMID- 3317466 TI - On the vicissitudes of Freud's early mothering. I: Early environment and loss. AB - Utilizing case examples and published accounts of Freud's infancy, I attempt to demonstrate that an upheaval in Freud's life, with a desperate turning to his mother and to oedipal issues, was the result of the loss of his nurse. PMID- 3317467 TI - Peer relations and later personal adjustment: are low-accepted children at risk? PMID- 3317468 TI - Accuracy in interpersonal perception: a social relations analysis. PMID- 3317469 TI - Waveform moment analysis in psychophysiological research. PMID- 3317470 TI - Dynamic mental representations. PMID- 3317471 TI - Optimal timing and the Weber function. PMID- 3317472 TI - A psychomotor stimulant theory of addiction. PMID- 3317473 TI - Behavioural energetics: some effects of uncertainty on the mobilization and distribution of energy. PMID- 3317474 TI - Coeliac disease and lymphoma. PMID- 3317475 TI - Chronic meningitis without predisposing illness--a review of 83 cases. AB - Eighty-three previously healthy patients with chronic meningitis presenting to a general hospital were reviewed. The single most common cause was tuberculosis (40 per cent) with cryptococcosis (7 per cent), malignancy (8 per cent) and other definable causes much less frequent. In one-third of patients (34 per cent) no cause was found although most appeared to respond to treatment either with anti tuberculosis drugs or steroids. There were some differences in clinical presentation, the clinical picture being most characteristic in tuberculous meningitis and malignant meningitis. However, there were frequent exceptions to any general rule and, particularly in adults, the clinical features and changes in cell count, protein and glucose in the cerebrospinal fluid (CSF) did not reliably distinguish one form of chronic meningitis from another. Cerebral and meningeal biopsy produced disappointing results with respect to practical guidance in management. It is often necessary to begin treatment before a cause has been identified. Important points in management include the early use of anti tuberculosis treatment and the difficulty in deciding on a trial of treatment with corticosteroids or amphotericin B. Not emphasised in previous reports is a subgroup of patients with idiopathic chronic meningitis who are responsive to treatment with steroids. Those patients tend to follow a more prolonged indolent course and often require long-term immunosuppression to control symptoms. PMID- 3317476 TI - Effects of low X-ray doses in Saccharomyces cerevisiae. AB - Three strains of Saccharomyces cerevisiae with different capacities for repair of radiation damage (RAD, rad18, and rad52) have been tested for their colony forming ability (CFA) and growth rates after application of small X-ray doses from 3.8 mGy to 40 Gy. There was no reproducible increase in CFA observable after application of doses between 3.8 mGy and 4.7 Gy. X-ray doses of 40 Gy causing an inactivation of CFA from 90% to 50%, depending on the repair capacity of the strains used, caused a reduced increase in optical density during 2 h buffer treatment in comparison to unirradiated cells. This reduction however, is reversible as soon as the cells are transferred into nutrient medium. One hour after transfer into growth medium the portions of cells with large buds (G2 and M phase) and cells with small buds (S phase) are drastically different in irradiated cells from those obtained in unirradiated cells. The time necessary for separation of mother and daughter cells is prolonged by X-ray irradiation and the formation of new buds is retarded. PMID- 3317477 TI - Failla memorial lecture. Risk, research, and radiation protection. AB - Radiation protection concerns the risk of stochastic late effects, especially cancer, and limits on radiation exposure both occupationally and for the public tend to be based on these risks. The risks are determined, mainly by expert committees, from the steadily growing information on exposed human populations, especially the survivors of the atomic bombs dropped in Japan in 1945. Risks of cancer estimated up to the early 1980s were in the range 1 to 5 X 10(-2)/Sv, but recent revisions in the dosimetry of the Japanese survivors and additional cycles of epidemiological information suggest values now probably at the high end of this range. These are likely to require an increase in the values used for radiation protection. A major problem with risk estimation is that data are available only for substantial doses and must be extrapolated down to the low dose region of interest in radiation protection. Thus the shape of the dose response curve is important, and here we must turn to laboratory research. Of importance are studies involving (1) dose rate, which affects the response to low LET radiation and often to high-LET radiation as well; (2) radiation quality, since the shapes of the dose-response curves for high- and low-LET radiation differ and thus the RBE, the ratio between them, varies, reaching a maximum value RBEM at low doses; and (3) modifiers of the carcinogenic response, which either enhance or reduce the effect of a given dose. Radiation protection depends both on risk information, and especially also on comparisons with other occupational and public risks, and on research, not only for extrapolations of risk to low doses but also in areas where human information is lacking such as in the effects of radiation quality and in modifications of response. PMID- 3317478 TI - Modification of radiation response by metal complexes: a review with emphasis of nonplatinum studies. AB - There is a need to develop compounds which alter the effects of radiation, particularly in the hypoxic radioresistant cell, following the limited success to date of the electron-affinic nitroimidazoles. The chemistry of transition metals is briefly outlined to point out certain aspects which might be exploited in the design of radiosensitizers. The best known clinical example of a metal complex which enhances the effect of radiation in hypoxic cells is the successful antineoplastic cisplatin. Past studies on enhancement of radiation damage by complexes of metals other than platinum, mainly in bacterial spores and bacterial and mammalian cells, have been summarized according to the metal used. The many mechanisms by which metal complexes could interact with radiation are outlined, and examples are given where possible. This survey emphasizes the need for a systematic study of the effect of metal/ligand variation on radiosensitization with regard to mechanisms of action to assess the potential of these compounds as radiosensitizers. Metal complexes offer many advantages, both for the study of mechanisms by which radiation kills cells and for drug development. PMID- 3317479 TI - The effect of cosmic-ray shielding on the ultraweak bioluminescence emitted by cultures of Escherichia coli. AB - Neither the growth of Escherichia coli nor its associated luminescence was significantly affected when cultures were shielded from the soft component of cosmic rays. The study included experiments in which the cultures were shielded intermittently during their two periods of luminescence emission and experiments in which the cultures were continuously shielded throughout their entire growth cycle. These results do not support previous suggestions that the ultraweak bioluminescences from living organisms might be cosmic-ray-excited fluorescences induced in certain biological molecules synthesized during the various stages of growth. PMID- 3317481 TI - Multiple rhabdomyoma in a neonate: case report. PMID- 3317480 TI - Case study of patient with a disease of the skeletal system. PMID- 3317482 TI - Tumour spread to the inferior vena cava from an adrenal carcinoma. PMID- 3317484 TI - Radionuclide imaging. 2. Renal studies in nuclear medicine. PMID- 3317483 TI - Fetal weight estimation: a practical assessment of two methods. PMID- 3317485 TI - Problems of hypoxyradiotherapy. PMID- 3317486 TI - [Bone marrow changes following half-body irradiation]. PMID- 3317487 TI - Effects of some chemical radioprotectors on 59Fe uptake in blood in whole body gamma irradiated rats. PMID- 3317488 TI - [Radiologic abscess drainage in the retroperitoneal space]. PMID- 3317489 TI - [Interventional radiologic treatment of urinary transport disorders following kidney allotransplantation]. PMID- 3317491 TI - [Clinical pictures of pulmonary aspergillosis]. AB - Pulmonary infection with Aspergillus can present a variety of clinical manifestations. Essentially, allergic bronchopulmonary aspergillosis, aspergilloma, and invasive aspergillosis are the three main forms. The coexistence of more than one of these entities is not unusual. Predisposing factors for such mycotic infections include previous lung-structure damage, immunodeficiency, and disturbances in the equilibrium of the resident flora of the respiratory tract. The radiological changes in pulmonary aspergillosis are described in association with clinical presentations and laboratory findings and are demonstrated by actual examples. PMID- 3317490 TI - Public health risks from low dose medical radiation. PMID- 3317492 TI - [Viral pneumonias: typical and atypical findings]. AB - The clinical and radiological features of viral pneumonias are summarized and discussed. Although viral infections of the lung belong to atypical pneumonias they do not demonstrate always the radiographic pattern of an interstitial pneumonia. Characteristic radiographic findings are quite rare. In most cases the microbial etiology cannot be predicted from chest radiographs. The appearance varies depending on the virulence of the organism and the resistance of the host. In this regard knowledge of epidemiological data as well as patient condition and underlying disease is of utmost importance. Differentiation between community- and hospital-acquired infections may be very helpful. PMID- 3317493 TI - [Value of imaging procedures in the diagnosis and therapy of severe thoracic injuries]. AB - Plain chest radiographs allow the diagnosis of most intrathoracic injuries. However, they are only momentary pictures and give no information on the respiratory function. A tension pneumothorax, rib fractures and subcutaneous emphysema should be diagnosed clinically before radiographs are taken. Computed tomography is helpful in evaluation of intrapulmonary lesions, hemothorax, rupture of the diaphragm and dislocation of the heart. Further diagnostic tools include aortography in suspected aortic rupture, sonography in cardiac injuries and hemopericardium, bronchoscopy in suspected bronchial or tracheal rupture, ECG and enzyme determinations in cardiac contusion, and eventually pneumoperitoneum in suspected rupture of the diaphragm. PMID- 3317494 TI - Lymph nodes of the neck. PMID- 3317495 TI - Multiple cerebral metastases: detectability with Gd-DTPA-enhanced MR imaging. AB - Sixteen patients with suspected cerebral metastases were studied with magnetic resonance (MR) imaging before and after the intravenous administration of 0.1 mmol/kg of gadolinium diethylenetriaminepenta-acetic acid. The images were interpreted blindly by two neuroradiologists; all clinical, radiologic (computed tomographic and MR imaging), and pathologic data were reviewed to arrive at a final "best diagnosis," which was then compared with the prior blinded interpretations. Of seven patients found to have multiple metastases, six (86%) had at least one tumor nodule depicted by postinfusion MR imaging that was missed by one or both observers on review of preinfusion images alone. Lesions missed on preinfusion studies were usually small nodules hidden by or not detected next to regions of high-signal edema thought to be related to the adjacent tumor nodule. The authors believe that contrast enhancement improves detection of metastatic foci with MR imaging and that the findings indicate broader implications for the detection of multiple lesions from other causes. PMID- 3317496 TI - Increased detection of intracranial metastases with intravenous Gd-DTPA. AB - Three patients with intracranial metastases were studied with magnetic resonance imaging at 1.5 T before and after intravenous administration of 0.1 mmol/kg gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA). Axial pre- and postcontrast images demonstrated a total of six and 38 metastases, respectively. Of the 35 lesions detected only after administration of contrast material, all were less than 10 mm, and none had evidence of surrounding edema. Lesion conspicuity was comparable on postcontrast mixed (T1, proton density, and T2) images and T1-weighted images, indicating the feasibility of effectively screening for metastases with a single postcontrast spin-echo sequence providing mixed and T2-weighted images. Sagittal and coronal images depicted temporal lobe lesions not seen on axial images. No discomfort, side effects, or complications resulted from the contrast medium. The detection of additional lesions with Gd DTPA increased the radiologic suspicion of metastatic disease, revealed locations more favorable for biopsy, prompted the search for a primary tumor, and modified therapeutic objectives and methods. PMID- 3317497 TI - Normal hip in children: correlation of US with anatomic and cryomicrotome sections. AB - Full and simultaneous exploitation of features designed to maximize signal-to noise ratio with the new generation of ultrasound equipment enabled detailed sonographic depiction of the anatomy of the hip and its surroundings. Scanning in familiar planes provided images that are easier to interpret. In addition, correlation of these images with cryomicrotome sections and histochemical studies disclosed several new findings. The articular cartilage of infant hips-composed mostly of water-is anechoic. However, the hyaline cartilage-which contains many vascular channels, columns of cartilage cells, and mesenchymal stroma-appears as alternating hypoechoic or anechoic columns and echogenic columns. The fibrocartilage of the limbus, on the other hand, is echogenic, as are other fibrous tissues. As expected, the points of attachment of the distal aspect of the synovial membrane, the fibrous capsule, and the ligaments in relation to the epiphyseal growth plate, varied with age, as did the characteristics of the cartilaginous structures. Familiarization with the sonographic appearance of normal hip anatomy in subjects of all ages is a first step toward recognition of various pathologic entities of the hip. PMID- 3317498 TI - Meconium peritonitis: prenatal sonographic findings and their clinical significance. AB - Ultrasonographic (US) findings were correlated with clinical outcome in seven cases of meconium peritonitis detected with prenatal US during a 2-year period. Nineteen previously reported cases were also reviewed. US findings included intraabdominal calcifications (n = six cases), fetal ascites (n = 3), echogenic ascites without calcifications (n = 1), bowel dilatation (n = 2), and polyhydramnios (n = 5). Following delivery, six infants were still alive after a mean follow-up of 13 months (range, 6-26 months); the seventh died of hydrocephalus. Of the six, four required surgical correction of a small-bowel perforation and two did not. All six are thriving, and none has yet been found to have cystic fibrosis. In the 19 previously reported cases, there were only two cases of cystic fibrosis, neither with intraabdominal calcifications. The presence of calcifications was significantly associated with causes other than cystic fibrosis. Prenatally diagnosed cases of meconium peritonitis are associated with cystic fibrosis less frequently than previous studies suggest. PMID- 3317499 TI - Intracranial abnormalities in infants treated with extracorporeal membrane oxygenation: imaging with US and CT. AB - Findings at neuroimaging in 100 consecutive infants treated with extracorporeal membrane oxygenation (ECMO) are presented. Imaging in these infants consisted of pretreatment cranial ultrasonography (US), daily US studies while on ECMO, and follow-up cranial computed tomography (CT) after treatment. There were findings of abnormalities in 43 patients. Thirty had intracranial bleeding, often of unusual extent and distribution. Thirteen additional infants had nonhemorrhagic abnormalities alone. Bleeding considered to be major was seen in 12% of infants. Large parenchymal hemorrhages and infarcts, cerebellar hemorrhages, and diffuse edema were the most significant abnormalities, with a 50% mortality (eight of 16 patients). No lateralization was noted with respect to distribution of bleeding sites or areas of nonhemorrhagic abnormalities. US was a sensitive but imperfect screening tool for intracranial abnormalities. Abnormalities missed with US included peripheral and small parenchymal lesions, subarachnoid hemorrhage, cerebral atrophy, and sagittal sinus thrombosis. PMID- 3317500 TI - Neurologic status in infants treated with extracorporeal membrane oxygenation: correlation of imaging findings with developmental outcome. AB - A retrospective review was done of intracranial images obtained within the newborn period in 46 infants who had been treated with extracorporeal membrane oxygenation (ECMO). A neuroimaging score was determined on the basis of the extent and severity of findings on both ultrasound and computed tomographic scans. Presence of abnormality at neuroimaging and the neuroimaging score were correlated with the findings of neurodevelopmental evaluations (Bayley scales) performed in infants who were at a mean age of 11.8 months (range, 6-16 months). A significant inverse correlation was found between the neuroimaging score and mental and psychomotor development indexes of the Bayley scale (P less than .005). Mean neuroimaging scores in infants with normal development were significantly lower than those in infants with delayed development (P = .002). Although individual outcomes cannot be predicted with neuroimaging, the neuroimaging score can be a useful adjunct in assigning patients who survive with ECMO treatment to risk categories for developmental outcome. PMID- 3317501 TI - Femoral artery pseudoaneurysm: diagnosis with conventional duplex and color Doppler US. AB - Three patients with clinically suspected pseudoaneurysm as a complication of femoral puncture were referred for ultrasound (US) evaluation with both conventional duplex Doppler US and color Doppler imaging. Pseudoaneurysm (n = 2) and simple hematoma (n = 2) were depicted with both Doppler systems, and a separate pseudoaneurysm and a hematoma were found in one patient. These diagnoses were confirmed surgically. Distinctive Doppler spectral waveforms and color Doppler findings enabled confident diagnoses. Color Doppler imaging allowed faster detection of intraaneurysmal flow, and the track between the injured artery and the pseudoaneurysm was identified only with color Doppler imaging. Duplex Doppler US with color Doppler imaging allows for the rapid, unequivocal diagnosis of pseudoaneurysm, thus enabling prompt treatment without the need for invasive diagnostic modalities. PMID- 3317502 TI - Combined surgical and radiologic intervention for complicated cholelithiasis in high-risk patients. AB - Ultrasound-guided surgical cholecystostomy with local infiltration anesthesia was combined with radiologic removal of gallstones in 36 elderly patients with acute calculous gallbladder disease who were considered to be at high risk due to multiple coexisting diseases. At cholecystostomy, the fundus of the gallbladder was sutured to the anterior abdominal wall resulting in a short surgical track to the gallbladder. This permitted early percutaneous stone removal through the cholecystostomy track under fluoroscopic guidance. All gallstones were removed in 31 of 36 patients, for an overall success rate of 86%. The success rate was 97% for gallbladder stones, 86% for cystic duct stones, and 63% for common bile duct stones that were removed by traversing the cystic duct. The treatment in the five patients in whom radiologic stone removal was incomplete or unsuccessful consisted of elective cholecystectomy in three, with common bile duct exploration in two of these; endoscopic sphincterotomy and stone extraction in one; and expectant management in one. There were no deaths or serious complications. This technique has thus proved safe and effective in these 36 high-risk patients. PMID- 3317503 TI - Invasive pulmonary aspergillosis: radiologic evidence of tracheal involvement. AB - Chest radiographs of invasive pulmonary aspergillosis in immunocompromised patients typically show ill-defined pulmonary nodules. Direct tracheal involvement has not been previously documented radiologically. Radiographs and CT scans of a 16-year-old boy with aplastic anemia and invasive pulmonary aspergillosis showed increased paratracheal opacity, tracheal narrowing, and pneumomediastinum in combination with pulmonary disease. Bronchial lavage cultures grew Aspergillus fumigatus, and the boy died 24 days later. PMID- 3317504 TI - Amebic liver abscess: MR imaging. AB - Hepatic magnetic resonance (MR) imaging was performed in 12 patients with 13 amebic liver abscesses. While no specific image or intensity pattern was noted, most lesions were round or oval with smooth, well-defined margins; had decreased signal intensity compared with that of liver parenchyma on T1-weighted images and increased signal intensity on T2-weighted images; and had prominent, often multiple rims of variable signal intensity. Signal homogeneity within the abscess was present more often on T1- than on T2-weighted images. Diaphragmatic disruption was seen in two cases on coronal MR images. An amebic empyema was differentiable from sympathetic pleural effusions by its hyperintensity on both T1- and T2-weighted images. In patients who also underwent computed tomography (CT) or ultrasonography (US), no lesion was missed with any modality, and except for shape, no consistent features were found among images obtained with the different modalities. The data suggest that CT, US, and MR imaging are comparably effective in the detection of amebic abscess. PMID- 3317505 TI - Medical treatment of hepatic amebic abscess: rare need for percutaneous drainage. AB - Although amebic liver abscess can virtually always be successfully treated medically, percutaneous drainage has been advocated recently. In 96 recently treated patients, therapeutic aspiration and percutaneous drainage were rarely needed. Most cases were correctly diagnosed by means of clinical, laboratory, and sonographic findings. Abscesses in only 13 (13.5%) patients were diagnostically aspirated. An abscess in one patient was therapeutically aspirated because the patient was responding slowly to medical therapy. No patient required catheter drainage. The key to successful amebic abscess management is medical therapy. Therapeutic drainage is rarely needed. Successfully treated patients occasionally respond slowly to medical therapy, and successfully treated amebic abscesses may enlarge or become bizarre-appearing on sonograms. This should not prompt therapeutic drainage. Diagnostic aspiration is appropriate when amebic and pyogenic abscesses are indistinguishable using clinical and imaging findings. Rare indications for therapeutic aspiration or drainage include pyogenic superinfection and large, juxtacardiac abscesses (potential intrapericardial rupture). PMID- 3317506 TI - US-guided percutaneous pancreatography: experience in 75 patients. AB - Seventy-five patients underwent ultrasound (US)-guided percutaneous pancreatography during a 3 1/2-year period. Pancreatography was successful in 67 patients, and there were no significant complications. The technique, which is easy to perform, was primarily employed to assist localization of pancreatic masses at fine-needle aspiration biopsy. It was also used to demonstrate pancreatic duct morphology when endoscopic retrograde pancreatography had failed or proved non-diagnostic. This enabled mapping of the duct system prior to pancreatic surgery. In cases of diagnostic difficulty, assessment of duct appearance with US-guided pancreatography was more accurate in differentiating carcinoma from chronic pancreatitis than was assessment with endoscopic retrograde pancreatography. PMID- 3317507 TI - Primary gastric lymphoma versus gastric carcinoma: endoscopic US evaluation. AB - Endoscopic ultrasonography (US) enables high-resolution imaging of the stomach and can demonstrate the different layers of the gastric wall. It has therefore been proposed for use in evaluating the extension of gastric neoplasms. It was performed in nine patients with primary gastric non-Hodgkin lymphoma and in 36 with gastric carcinoma. The US and pathologic findings were correlated in three surgical specimens of gastric lymphoma. Three different US patterns were found in gastric lymphomas: a polypoid pattern (two cases), localized (two cases) or extended (five cases) hypoechoic infiltration, and thickening with superficial ulcerations. Infiltration was confined to the second and third layers of the gastric wall in six cases and was transmural in three. The study of the gastric lymphoma specimens confirmed the accuracy of US in demonstrating the extent of infiltration. Gastric carcinomas had a more echogenic pattern and a different trend of diffusion, with no extended longitudinal hypoechoic infiltration of the superficial layers or extended hypoechoic transmural infiltration. PMID- 3317508 TI - Colorectal neoplasms: accuracy of US in demonstrating the depth of invasion. AB - Six normal and 16 neoplastic colorectal specimens were examined with 8.5-MHz ultrasound (US). An articulated system facilitated precise spatial correlation between US and histologic sections. Images were blindly interpreted and then compared with histologic results. All six normal specimen showed five distinct echo layers and were distinguished from neoplastic specimens by all the observers. The central echogenic layer, corresponding to the submucosa, is useful in determining the depth of origin of a neoplasm and the presence of submucosal invasion. US had an accuracy of 92.5% in demonstrating invasion of the submucosa and 77% for invasion of the muscularis externa. For mucosal neoplasms with invasion through the muscularis externa and extension into the subserosal tissues, nearly 90% of US interpretations were correct. High-frequency US may be useful in determining the depth of invasion of mucosal tumors with respect to the submucosa and in differentiating mucosal from extramural masses. PMID- 3317510 TI - Cohen ureteral reimplantation: sonographic appearance. AB - The sonographic records of 27 children who underwent a Cohen ureteroneocystostomy were reviewed. In 13 children (48%) sonograms demonstrated an echogenic, nonacoustically shadowing structure at or just above the trigone that was fixed in position within the bladder wall and covered by intact mucosa. This constellation of sonographic findings, which represent the submucosal segment of the reimplanted ureter, produces a "tunnel sign." Awareness of this appearance will enable the sonographer to better evaluate children who have undergone surgical procedures on the bladder. PMID- 3317509 TI - Ectopic pregnancy: surgical-pathologic correlation with US. AB - The ultrasound (US) examinations of 53 patients with proved ectopic pregnancy were reviewed and compared with surgical and pathologic findings. The most common finding with US and surgery was free fluid. Hematosalpinx tended to have sharply defined margins, whereas free pelvic hematomas were poorly defined or filled the pelvis. The echogenicity of the clots was variable but generally in the same range of echogenicity as the uterus. A prominent decidual reaction occurred in 26% of the patients and had a variety of appearances. PMID- 3317511 TI - Augmentation and replacement cystoplasty: sonographic findings. AB - Sonographic evaluation of the urinary tract after bladder augmentation and replacement procedures often reveals unexpected findings that result from incorporation of bowel into the urinary bladder wall. Familiarity with such findings is important to avoid misinterpreting them as abnormalities. The authors reviewed the sonograms of 47 patients. The most common findings were thick or irregularly shaped bladder walls (96%), pseudomasses within the bladder lumen (89%), and fine debris or linear strands (47%). Pseudomasses were potentially the most confusing; they are usually attributable to normal bowel folds, intraluminal mucus collections, or segments of bowel that have been intussuscepted into the bladder to prevent reflux. PMID- 3317512 TI - Transvaginal pelvic abscess drainage with US guidance. AB - Transvaginal catheter drainage of pelvic and intraabdominal abscesses with the use of real-time ultrasound guidance is described. The technique was successfully used in two patients to drain abscesses in the cul-de-sac. Transvaginal drainage is a safe, simple alternative to transabdominal, transgluteal, and transrectal drainage of these abscesses. PMID- 3317513 TI - Suprapancreatic biliary obstruction: CT evaluation. PMID- 3317514 TI - [First outbreak of botulism caused by Clostridium botulinum subtype Af]. AB - In December 1982 an outbreak of foodborne botulism presumably produced by the ingestion of home-made pickled trout occurred in San Rafael, province of Mendoza, Argentina. The toxin detected in blood serum and feces samples of the sole affected patient was preliminarily typed as a plain type A. A strain of Clostridium botulinum was isolated from feces which, after culture by the dialysis method, produced 1 x 10(7) LD50/mouse per ml. Quantitative neutralization tests carried out at different levels of toxin concentration, showed that this toxin consists of a major type A antigenic component (about 99% of the complex) and a minor type F component, defining its identity as a subtype Af. A rabbit antiserum obtained from this toxin neutralizes A and F reference toxins. Despite the antitoxic and supportive treatment, the patient died as a consequence of the poisoning. The polyvalent antiserum administered contained A, B and E antitoxins. Death could be due to the lethal effect of the A fraction, the F fraction or to a combined effect of both toxic components of the toxin. This is the first detection of an outbreak produced by C. botulinum subtype Af, serotype described in Argentina fifteen years ago, and not detected until now in other parts of the world.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317516 TI - 12(R)-hydroxy-5,8,10,14-eicosatetraenoic acid is a chemoattractant for human polymorphonuclear leucocytes in vitro. AB - Increased amounts of 12-hydroxy-5,8,10,14-eicosatetraenoic acid (12-HETE) are found in the lesional skin of patients with the skin disease psoriasis when compared to clinically normal skin. Stereochemical analysis has recently shown that the 12-HETE present in lesional psoriatic scale is the (R), and not the (S) hydroxyl enantiomer, produced by platelets. Since the chemoattractant activity of 12(R)-HETE has not previously been described, the (R) and (S) hydroxyl enantiomers of 12-HETE have now been synthesised and their chemokinetic activity compared in vitro. 12(R)-HETE, was more potent than 12(S)-HETE as a chemokinetic agent for human polymorphonuclear leucocytes but 2000 times less potent than leukotriene B4. In contrast to results obtained with the 12-HETE enantiomers, the chemoattractant compound 5(S)-HETE was found to be more potent than the 5(R) hydroxyl enantiomer. Thus, the configuration of the hydroxyl group appears to be of importance to the chemokinetic activity of the HETEs, and the increased potency of the 12(R) enantiomer may enhance its significance as a mediator of inflammation in psoriasis. PMID- 3317515 TI - Plasma endotoxin and concentrations of stable metabolites of prostacyclin, thromboxane A2, and prostaglandin E2 in postpartum dairy cows. AB - The presence of endotoxin in plasma and patterns of stable metabolites of prostacyclin (PC), thromboxane A2 (TXA2) and prostaglandin E2 (PGE2) were determined during the first postpartum estrous cycles in sixteen dairy cows. These included 8 cows with uterine infections which exhibited shortened luteal phases (SC) and 8 cows which had normal luteal phases (NC) after the first post partum ovulations. Endotoxin was consistently detected in all SC cows during the abbreviated estrous cycles while plasma samples of NC cows were free of endotoxin. Plasma concentrations of TXA2 metabolite was higher in SC cows (p less than 0.05) (1785-3452 pg/ml) compared to NC cows (723-1240 pg/ml). Similarly, plasma concentrations of PC metabolite was higher in SC cows (p less than 0.07) (423-1847 pg/ml) compared to NC cows (159-325 pg/ml). In contrast, plasma concentrations of PGE2 metabolite was higher in NC cows (p less than 0.05) (850 2219 pg/ml) compared to SC cows (455-628 pg/ml). The results of this study suggest that postpartum uterine infections mediate the release of prostaglandins from the uteri by means of the endotoxin and endotoxin appears to stimulate selectively the production of PC and TXA2 favoring early demise of corpora lutea formed after first postpartum ovulations in dairy cows. PMID- 3317517 TI - Effects of E2 levuglandins on the contractile activity of the rat uterus. AB - The effects of E2 levuglandins on the contractile activity of rat uterine horns were studied. LGE2, AnLGE2, delta 9-LGE2 and the synthetic epimer, 8-epi-delta 9 LGE2 all induced contractions in a dose-response fashion. AnLGE2 gave decreased responses with increased bath concentrations. Paired comparisons showed potent and selective inhibitory effects of AnLGE2 on the uterotonic activity of prostaglandins. AnLGE2 inhibited the uterotonic activity of PGE2 at a 0.1:1 ratio, of PGD2 at a 1:1 ratio, but did not inhibit the activity of PGF2 alpha. Exposure of spontaneously contracting uteri to high concentrations of AnLGE2, or prolonged exposure to lower concentrations, suppressed contractions. PMID- 3317518 TI - [Shaping the oedipal triangle constellation in narcissistic and borderline disorders]. PMID- 3317519 TI - Introspection and illness behavior. PMID- 3317520 TI - Affective and cognitive impact of illness on children's body image. PMID- 3317521 TI - An illness behavior bibliography. PMID- 3317522 TI - [New thrombolytic agents]. PMID- 3317523 TI - [Franciszek Rozankowski and his Chronicle]. PMID- 3317524 TI - The dose-rate effect in human tumour cells. AB - The radiation response of 12 cell lines derived from a variety of human tumours has been investigated over the dose-rate range from 150 to 1.6 cGy/min. As the dose rate was lowered, the amount of sparing varied widely; in 2 cell lines it was zero, in the other cell lines the dose required for 10(-2) survival ranged up to twice the value at high dose rate. Low dose-rate irradiation discriminates better than high dose rate between tumour cell lines of differing radiosensitivity. The data are equally well fitted by two mathematical models of the dose-rate effect: the LPL model of Curtis and the Incomplete Repair model of Thames. Analysis by the LPL model leads to the conclusion that the theoretical radiosensitivity in the total absence of repair was rather similar among the 7 cell lines on which this analysis was possible. What differs among these cell lines is the extent of repair and/or the probability of direct infliction of a non-repairable lesion. Recovery from radiation damage was also examined by split dose experiments in a total of 17 human tumour cell lines. Half-time values ranged from 0.36 to 2.3 h and there was a systematic tendency for split-dose halving times to be longer than those derived from analysis of the dose-rate effect. This could imply that cellular recovery is a two-component process, low dose-rate sparing being dominated by the faster component. The extent of low dose rate sparing shows some tendency to correlate with the magnitude of split-dose recovery; in our view the former is the more reliable measure of cellular recovery. The clinical implication of these studies is that some human tumour types may be well treated by hyperfractionation or low dose-rate irradiation, while for others these may be poor therapeutic strategies. PMID- 3317525 TI - The influence of dose and dose rate of total lymphoid irradiation in the rat cardiac allograft model. AB - Immunosuppression generated by total lymphoid irradiation (TLI) may be of use in solid organ transplantation. We have investigated the use of TLI in the rat cardiac allograft model. Lewis rats received TLI from a cobalt-60 machine. The daily dose was 1.25 Gy and treatments were administered 4 days per week. We performed experiments to assess the effect of dose rate upon graft survival. The dose rate was varied by changing the source to animal distance and by using a lead attenuator. Cardiac allografts from each ACI donor rat were transplanted to the recipient Lewis rat's abdomen utilizing microvascular surgical technique. Heart graft survival times (GST) were monitored by direct palpation of the cardiac impulse. Immune function was measured by an activity index of the mixed lymphocyte reaction. In the absence of any immunosuppression there was a mean GST of 6.9 +/- 0.3 days. When a graft was placed the day following completion of TLI, there was an increase in GST as the total TLI dose was increased. Mean GST (+/- S.E.) following 5, 10, and 15 Gy were 12.3 +/- 1.3, 14.5 +/- 1.3, and 25.5 +/- 1.1 days, respectively. Following 20 Gy, GST decreased because of irradiation induced pulmonary toxicity and host death. When 3.5 weeks were allowed to elapse between the completion of TLI and transplantation, GST were less than those seen with equivalent doses of TLI and early transplantation. Mean GST following 5, 10, and 15 Gy and a delayed transplant were 7.2 +/- 0.1, 10.7 +/- 1.2, and 19.0 +/- 3.5 days, respectively. We tested the effect of dose rate upon GST.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317526 TI - Models of genetically engineered organisms and their ecological impact. PMID- 3317528 TI - Fundamental and clinical evaluation of vasoactive intestinal peptide (VIP) in pancreatitis by radioimmunoassay kit. AB - Plasma vasoactive intestinal peptide (VIP) concentrations of normal individuals and patients with pancreatitis were studied using a VIP RIA kit. The inter-assay and intra-assay variation of this kit were between 2.1 and 9.4%. The VIP levels increased in the acute phase of acute pancreatitis and patients with chronic pancreatitis. The VIP concentration increased during the first 30 min of glucose tolerance test, but this increase was much smaller than that in insulin. These results suggest that this kit is useful for physiologic and pathologic changes in the VIP level. PMID- 3317527 TI - Stress-induced changes of circulating neuropeptide Y in the rat: comparison with catecholamines. AB - Circulating concentrations of neuropeptide Y-like immunoreactivity (NPY), noradrenaline (NA) and adrenaline (AD) were measured in conscious, chronically catheterized rats submitted to various stress protocols. Basal plasma levels of NPY, NA and AD (194 +/- 52 fmol/ml, 0.90 +/- 0.11 pmol/ml and 0.52 +/- 0.07 pmol/ml) were increased by handling (+132%, +76% and +629%, respectively) and rose further during electric shock treatment. Adrenalectomy resulted in the complete disappearance of circulating adrenaline but did not alter either control or stress values of noradrenaline. In comparison circulating levels of NPY were reduced, but not significantly in adrenalectomized animals. Insulin stress induced a large increase in plasma AD levels and cold stress induced an increase in plasma NA levels, without any parallel change in NPY concentrations. These results demonstrate that NPY, which is colocalized with catecholamines in the peripheral nervous systems, is also released during stress responses and that its release parallels more closely changes in circulating NA than AD. Furthermore, stress-induced changes in circulating NPY-like immunoreactivity do not originate from the adrenal gland but mainly from the peripheral nervous system, and the release of NPY is dependent upon the nature of the stimulus. PMID- 3317529 TI - [Present status and future trends of neutron radiography]. PMID- 3317530 TI - The role of enzymes in protection mechanisms for human health. PMID- 3317531 TI - Feasibility of dose adjustment based on differences in long-term clearance rates of inhaled particulate matter in humans and laboratory animals. AB - Long-term pulmonary clearance rates were evaluated for several laboratory animal species, dogs, and humans to determine if differences among species exist, and if so, the adequacy of the data for dose adjustment. Within each species, large variations in clearance rates were seen, probably as a result of differences in solubility of the aerosol particles, differences in measurement techniques, possible lung damage, transport to lung-associated lymph nodes, and binding of dissolved chemicals to cellular macromolecules in the lung. While few direct comparisons among species using the same aerosol were available, mechanical clearance of particles from the alveolar regions of dogs and humans was generally slower than in most laboratory species, with t1/2 values several-fold longer. Particle clearance rate variations of this magnitude were shown to induce potentially large differences in bioavailability. This can result in large errors in assessing human risk from animal studies unless a dose adjustment is made. It is suggested that despite limitations on available data, a two- to threefold adjustment of dose when extrapolating from small laboratory animals to humans, for quantitative risk assessment, should be considered, unless solubility half times are very short. PMID- 3317532 TI - Significant risk decisions in federal regulatory agencies. AB - The completion of a risk assessment does not reveal whether the assessed risk is of significant public health importance. Little attention has been paid to the development of rigorous analytic approaches to the determination of risk significance. This paper reviews a number of major FDA, EPA, and OSHA decisions regarding significant carcinogenic risks and identifies several problems that need to be explored more fully to ensure that both the qualitative and quantitative features of a risk assessment are considered in the determination of risk significance. PMID- 3317533 TI - In memoriam Dr. Emil Mrak (1901-1987). PMID- 3317534 TI - [Ultrasonics of the shoulder. Diagnostic possibilities in lesions of the rotator cuff]. AB - Twenty five healthy people and 25 patients with shoulder pain underwent US control over a 12-month period: 24 patients with shoulder pain had rotator cuff and/or biceps tendon lesions. The US findings on rotator cuff and biceps tendon lesions are compared with those of arthrography and/or surgery (96% sensitivity). US is rapid, safe, non invasive, inexpensive and often more accurate, and its use is recommended for the routine examination of the shoulder joint instead of arthrography. PMID- 3317535 TI - [Critical review of 222 cases of neoplastic pathology of the colon. Our experience using a computer]. AB - From August 1983 to December 1985, 2352 radiological examinations of the colon were performed in the Radiology Department of Universita Cattolica del Sacro Cuore of Rome. From this group a sample of 222 patients was analyzed. They included 111 patients with colonic polyps and 111 with cancer. These cases were carefully examined, in terms of age, frequency of this pathology according to sex, symptom-illness rate, and the radiological data were compared with the endoscopic and histological findings. The data were processed using a computerized program. A critical correlation of the data obtained revealed that: 1) The surest symptom of colon carcinoma is blood in faeces with or without changes in defaecation frequency. Nor should isolated bowel disorders be ignored ("irritated" colon due to organic injuries). 2) The diagnostic accuracy of double contrast enema is very close to that of endoscopy, provided that intestinal cleaning is adequate (this in fact is an important aspect of the examination). 3) The mean age of patients in this group is high and cancer is more common than polyps. This seems to be due to the back of a complete diagnostic sequence, in which radiology has a specific and important role. PMID- 3317536 TI - [Hemolytic-uremic syndrome complicated by obstructive uropathy. Apropos of a case diagnosed by ultrasound]. PMID- 3317537 TI - AG-ARF. PMID- 3317539 TI - The radiologic exploration of the gastrointestinal tract. An interdisciplinary enterprise. PMID- 3317538 TI - Viper bite poisoning in India: a review with special reference to renal complications. AB - Viper bites are a significant cause of mortality in India. Acute renal failure is a common finding in cases of lethal envenomization. Coagulation abnormalities and shock are other key clinical features. Some of the renal lesions appear to reflect a direct toxic effect of venom on kidney parenchyma. Glomerular, tubular, interstitial, and vascular lesions have all been described. Experimentally, viper venom causes mesangiolysis, and this may be a significant factor in the pathogenesis of viper bite-induced glomerular disease. Treatment with antivenom is commonly used but is not supported by controlled trials. Dialysis and supportive treatment appear to be the mainstay of therapy in cases complicated by renal failure. PMID- 3317540 TI - Renal cystic disease in childhood. AB - The authors present a comprehensive review of the diagnostic features of eight forms of renal cystic disease that occur in childhood. Sonographic findings are emphasized. PMID- 3317542 TI - CT examination of eleven Egyptian mummies. PMID- 3317541 TI - Imaging of foregut duplication cysts. AB - There are many types of diagnostic imaging studies available for the evaluation of foregut duplication cysts. Esophagography may be helpful in confirming the presence of a mediastinal mass, explaining esophageal symptoms, or defining the location of a lesion, but it is rarely diagnostic. Digital subtraction angiography can successfully be used in place of pulmonary arteriography to define vascular anatomy. Computed tomography is often diagnostic, although the attenuation number may be slightly elevated and not that of water. Computed tomography will clarify the relationship of the mass to adjacent mediastinal structures, and may also assist in percutaneous guided aspiration. Surgical resection is often necessary in an infant because of respiratory distress with airway compromise. In asymptomatic patients with a round to oval, nonenhancing, thin walled, cystic mass demonstrated on CT, a thoracotomy may be avoided and the patients may be followed by chest radiography. PMID- 3317543 TI - James L. Weatherwax: pioneer in the physics of radiology. PMID- 3317544 TI - The radiology of cardiac pacemakers. AB - Radiology is valuable in determining the cause of pacemaker malfunction and in the evaluation of lead position and integrity. PMID- 3317545 TI - The complementary roles of ultrasound and plain film radiography in differentiating pediatric chest abnormalities. AB - Sonography, as a complement to plain film radiography, is reliable for limiting the differential diagnosis and obviating the need for more invasive studies. PMID- 3317546 TI - Real-time sonography of infant hip dislocation. AB - Real-time sonography offers many advantages in the evaluation of suspected hip dislocation: The procedure is short, cost-effective, requires no sedation and does not expose the patient to ionizing radiation. PMID- 3317547 TI - Pediatric case of the day. Focal multicystic dysplasia in lower pole renal duplication. PMID- 3317548 TI - Ultrasound case of the day. Inferior vena cava calcification (calcified thrombus). PMID- 3317549 TI - The good old days with William J. Hogan. PMID- 3317550 TI - Posterior urethral valves: an update and review. AB - Here, in a comprehensive review of an important pediatric problem, the authors discuss the embryology, the clinical and radiological features, the complications and the management of posterior urethral valves. PMID- 3317551 TI - Concepts in computed tomography of the thorax. AB - A number of concepts in the CT evaluation of the thorax have been reviewed. The concepts have been presented through anatomic images generated on a specific CT system, but any equivalent system could have produced similar images. The important conclusions derived as a result of this review are: 1. Slice thickness, volume averaging and volume sampling are interrelated. Slice thickness and the orientation and inherent subject contrast of the anatomy to be studied usually determine the quality of the image obtained. 2. Thin section imaging (i.e., 5 mm and especially 1.5 mm) can demonstrate thoracic anatomy rarely (if ever) observed on thicker images (i.e., 10 mm). Although impractical for general analysis, thin section imaging provides insight into the potential limitations of a standard approach to thoracic evaluation. 3. CT analysis of the normal anatomy of the pericardium is incomplete. Although pathology related to the pericardium has been presented in the literature, more work is required to define: 1, the relationship, on CT, of the pericardium to structures within its confines; 2, abnormalities within the mediastinum that may affect the pericardium, and 3, lesions in the lung that may invade the mediastinum and pericardium. 4. The excellent contrast sensitivity of CT (aided by iodine infusion or bolus injection techniques and dynamic scanning) does not suffice to resolve certain problems in thoracic analysis. Extrapleural signs, the concept of invasion versus abutment, and the discrimination of benign from malignant mediastinal nodes continue to present diagnostic dilemmas in CT analysis of the thorax. 5. Interesting cases provide models for demonstrating CT pitfalls, mimics, and rarities. CT can be a valuable tool in resolving diagnostic dilemmas in some cases but creates dilemmas in others. 6. CT reformation images of the thorax can be dynamically generated on the scanner console. This hands-on technique can be a valuable tool for teaching anatomy in resident training programs. PMID- 3317552 TI - Ultrasound case of the day. Focal fatty infiltration of the liver. PMID- 3317553 TI - Percutaneous management of the urological complications of renal transplantation. AB - Percutaneous interventional procedures can be safely used to diagnose and treat the urological complications of renal transplantation. They can obviate surgery, or may allow conservative therapy until the condition of the patient is optimized for surgical intervention. PMID- 3317555 TI - Ultrasound case of the day. Occipital meningoencephalocele. PMID- 3317554 TI - Urinary tract infections in childhood: a current imaging approach. AB - The authors present their approach to the evaluation of urinary tract infection in childhood based on real time sonography, 99m-Tc-DTPA scintigraphy and voiding cystourethography. PMID- 3317557 TI - Trypanosoma cruzi-like bloodstream trypomastigotes in bats from the State of Piaui, Northeastern Brazil. PMID- 3317558 TI - [Finding of a case of filariasis probably native in the state of Ceara]. PMID- 3317559 TI - A key for identifying faecal smears to detect domestic infestations of triatomine bugs. PMID- 3317556 TI - MRI versus conventional radiologic examinations in the evaluation of the craniovertebral and cervicomedullary junction. AB - MRI is superior to conventional radiographic techniques for demonstrating anatomic CMJ distortion and compression in all patients, regardless of the pathology involved. Because of the high incidence of osseous CVJ abnormalities in patients with a Chiari malformation, complete evaluation of these patients requires examination of the osseous CVJ by conventional radiographic methods in addition to the MRI study. Conventional techniques are also helpful for the complete evaluation of inflammatory and osseous lesions involving the CVJ. Occasionally, designation of tumors as intra- or extraaxial may not be possible by MRI alone; additional studies may be necessary. The failure of MRI to demonstrate calcification is a limitation in the evaluation of a variety of pathologic entities, especially neoplasms in which the demonstration of calcification may be a clue to the histologic diagnosis. PMID- 3317560 TI - [Use of tetracycline and quinine combination in the treatment of Plasmodium falciparum malaria]. PMID- 3317562 TI - [Full-mouth impressions of preparations intended to receive ceramic-metallic crowns]. PMID- 3317561 TI - [Paragonimus westermani in Brazil. Notes on an old study]. PMID- 3317565 TI - Estimated soil ingestion rates for use in risk assessment. AB - Assessing the risks to human health posed by contaminants present in soil requires an estimate of likely soil ingestion rates. In the past, direct measurements of soil ingestion were not available and risk assessors were forced to estimate soil ingestion rates based on observations of mouthing behavior and measurements of soil on hands. Recently, empirical data on soil ingestion rates have become available from two sources (Binder et al., 1986 and van Wijnen et al., 1986). Although preliminary, these data can be used to derive better estimates of soil ingestion rates for use in risk assessments. Estimates of average soil ingestion rates derived in this paper range from 25 to 100 mg/day, depending on the age of the individual at risk. Maximum soil ingestion rates that are unlikely to underestimate exposure range from 100 to 500 mg. A value of 5,000 mg/day is considered a reasonable estimate of a maximum single-day exposure for a child with habitual pica. PMID- 3317563 TI - [Metallic-resinous frames]. PMID- 3317564 TI - [Govert Bidloo's "Anatomia" (1685) and the plagiarism by William Cowper (1698)]. PMID- 3317566 TI - Rumination and vomiting in the developmentally disabled: a critical review of the behavioral, medical, and psychiatric treatment research. AB - Medical and psychiatric research regarding the treatment of vomiting and rumination among developmentally disabled individuals was selectively reviewed. Because of serious methodological flaws which pervade the psychiatric literature, claims for the effectiveness of psychiatric interventions for vomiting and rumination cannot be justified. Medical interventions (e.g., pharmacological and surgical interventions) were found to be effective when rumination was attributable to a specific organic pathology. In the absence of identified organic pathology for rumination, medical interventions are of questionable efficacy and because of the risks and side effects associated with these procedures, are seldom the intervention of first choice for functional rumination. Behavioral procedures for the treatment of vomiting and rumination are described and critically reviewed for their efficacy, side effects, and the generalization and maintenance of their effects. Although methodological weaknesses limit conclusions regarding the efficacy of some behavioral interventions, several procedures have sound experimental support including oral hygiene, differential reinforcement of incompatible behaviors, and food satiation procedures. These behavioral interventions are the treatments of choice when organic causes of rumination cannot be identified. Suggestions for future research and applications are discussed. PMID- 3317568 TI - [Clinical aspects of bacteremia caused by non-typhi Salmonella]. PMID- 3317569 TI - [Hepatic transplantation]. PMID- 3317570 TI - [Cardiac insufficiency and rapidly progressing pneumonia in a patient operated on for pulmonary adenocarcinoma]. PMID- 3317567 TI - [Re-evaluation of the diagnostic efficacy of bronchofibroscopy in bronchial carcinoma]. PMID- 3317571 TI - [Study of renal function under intradural anesthesia with intravenous perfusion of methoxamine]. PMID- 3317572 TI - [Calcium channel blockers and anesthesia]. PMID- 3317573 TI - [Vascular perforation by a central venous catheter: presentation of a case and review of the literature]. PMID- 3317574 TI - [Contribution of endogenous potentials to the study of cognitive development in children: review of the literature]. AB - A review of the studies concerning age-related changes of the cognitive event related potentials is presented. Graded changes (with little or no difference in waveform morphology but shifts in component latency or amplitude) draw to continuous developmental models, but morphological waveform differences are assumed to reflect fundamental differences in modes of cognitive processing. The authors equally present an experimental paradigm indicating that a multifactorial model of amplitude variations is able to reflect the passing from one cognitive stage to the next one, according to Piaget's theory. PMID- 3317576 TI - [Use of abdominal echography in the early diagnosis of emphysematous cholecystitis]. PMID- 3317575 TI - [Value of the study of contingent negative variation in migraine and tension headache]. AB - The aim of this study was to display the result obtained by the contingent negative variation (CNV) recording in patients suffering from headache. Eighty five patients were taken into account: 59 with migraines (M) and 26 with tension headache (TH). A typical CNV pattern (high CNV amplitude with no habituation) differentiated M from TH. Moreover, psychological data were collected through Rorschach ink blot test among 42 headache sufferers (31 M and 11 TH). The typical Rorschach repressive pattern of alexithymia was found as well in M as in TH while CNV amplitude was significantly higher in the 31 M (-25 microV) than in the 11 TH (-19 microV FP less than 0.04). Biochemical data collected among 28 patients (17 M and 11 TH) revealed a positive correlation between CNV amplitude and plasma level of noradrenaline, regardless of the type of headache (r = 0.58; P less than 0.01). Thus, besides psychological factors, catecholaminergic mechanisms seem implicated in the determination of the CNV pattern in migraine. CNV may help the clinician both to specify diagnosis and to decide between the many therapeutic strategies available. PMID- 3317577 TI - [Perianal fistula. Sphincteric section with seton]. PMID- 3317578 TI - [Giant hamartoma of Brunner's glands: apropos of a case and review of the literature]. PMID- 3317579 TI - Mammalian oocyte maturation. PMID- 3317580 TI - The elderly's fear of crime. A critical examination of the research. PMID- 3317581 TI - Effects of a specific thromboxane synthetase inhibitor in equine endotoxaemia. AB - Thromboxane A2 may play a major role in circulatory shock. In some species, thromboxane synthetase inhibitors have a beneficial effect on shock induced by endotoxin, trauma, sepsis and administration of arachidonate. In some shock models, however, results with thromboxane synthetase inhibitors have been conflicting. The effect of UK-38,485, a selective thromboxane inhibitor, was evaluated in ponies injected with endotoxin intraperitoneally. Four groups of ponies were used to compare the effects of endotoxin alone, UK-38,485 alone, treatment with UK-38,485 before endotoxin challenge and treatment with UK-38,485 after endotoxin challenge. Haematological, metabolic, eicosanoid and clinical responses in each group were evaluated. The results indicated that UK-38,485 is an effective inhibitor of thromboxane A2 generation following endotoxin challenge. Prostacyclin values were elevated compared with baseline in ponies administered UK-38,485 and endotoxin. However, prostacyclin values were not significantly different from those of ponies receiving endotoxin alone. Furthermore, UK-38,485 failed to attenuate the haematological, metabolic and clinical manifestations commonly seen in the pony after endotoxin challenge. PMID- 3317582 TI - Clinical pharmacokinetics of five oral cephalosporins in calves. AB - The minimal inhibitory concentrations (MIC) of cephalexin, cephradine, cefaclor, cefatrizine and cefadroxil for Salmonella species, Escherichia coli and Pasteurella multocida isolated previously from young calves were determined. The MIC90 values for cephalexin, cephradine and cefadroxil ranged between 3.12 micrograms ml-1 and 12.5 micrograms ml-1, whereas those of cefatrizine and cefaclor were 3.12 micrograms ml-1 and 0.78 microgram ml-1, respectively. Each drug was administered intravenously and orally to groups of pre-ruminating calves and orally to early ruminating calves. Although the pharmacokinetic characteristics of the drugs after intravenous injection were similar to other beta-lactam antibiotics, significant differences between the cephalosporins examined were found in respect of certain kinetic parameters. The drugs showed rapid absorption into the systemic circulation after oral administration to pre ruminating calves but the elimination half-life values (t1/2 beta) varied between three hours (cefaclor and cefadroxil) and nine hours (cefatrizine). The bioavailability of the drugs was about 35 per cent of the administered dose. Co administration of probenecid with each antibiotic caused a twofold or greater increase in peak serum drug concentrations (Cmax) but the effect on t1/2 beta was variable. Cephalexin, cephradine and cefaclor given to the ruminating calves resulted in very low serum or plasma concentrations and their use should be restricted to younger calves. Cefadroxil was found to give the highest serum concentrations in this age group but had significantly lower bioavailability when compared with the unweaned calves. Provisional oral dosage regimens were computed for each cephalosporin on the basis of the MIC data and the kinetic parameters derived from intravenous and oral drug administration. PMID- 3317583 TI - Detection of antibodies to Eperythrozoon ovis by the use of an enzyme-linked immunosorbent assay. AB - Specific antibody to Eperythrozoon ovis was detected by an enzyme-linked immunosorbent assay (ELISA) in the sera of infected sheep. In the presence of parasite antigen, positive control serum showed a reaction approximately eight times that of negative serum. When compared to an immunofluorescent antibody test (IFAT), the ELISA was eight times more sensitive. Positive control sera gave a titre of 1:3200 by IFAT and 1:25,600 by ELISA. Through the use of a reference titration curve ELISA could be used as a semi-quantitative system to determine antibody levels in test sera. PMID- 3317585 TI - Genetic control of sex determination in the germ line of C. elegans. PMID- 3317584 TI - Genetic control of spermatogenesis in mice. PMID- 3317586 TI - Spermatogenesis in Drosophila. PMID- 3317587 TI - [Neural control of the diaphragm]. PMID- 3317588 TI - [A review on surgical treatment of left coronary artery main trunk lesion]. PMID- 3317589 TI - [The pathophysiology of drown and near-drown]. PMID- 3317590 TI - [Cardiac lymph]. PMID- 3317591 TI - Exercise-induced asthma and exercise-induced anaphylaxis. PMID- 3317592 TI - Exercise, immunology, and infection. PMID- 3317593 TI - Sports psychology: how can it help the adolescent athlete? PMID- 3317594 TI - Progressive disseminated histoplasmosis in patients with the acquired immune deficiency syndrome: a report of 12 cases and a literature review. AB - Progressive disseminated histoplasmosis is an increasingly common cause of infection in patients with acquired immune deficiency syndrome (AIDS) from areas endemic for histoplasmosis. We report 12 cases of progressive disseminated histoplasmosis associated with AIDS and review 20 previously reported cases. The clinical presentation of progressive disseminated histoplasmosis is nonspecific with persistent fever, weight loss, and splenomegaly. Frequently progressive disseminated histoplasmosis was the initial clue to the presence of AIDS. Bone marrow culture is the best method for establishing a diagnosis. Relapses were common both with ketoconazole and after a 2.0 to 2.5 g course of amphotericin B. This suggests a 2.0 to 2.5 g course of amphotericin B followed by long term ketoconazole suppression may be the best therapeutic regimen in these patients. PMID- 3317595 TI - Antigen detection in the diagnosis of fungal respiratory infections. AB - The diagnosis of fungal infections of the respiratory tract is often difficult and may require invasive diagnostic procedures. The detection of soluble fungal antigens in bodily fluids such as serum, pleural fluid, and bronchoalveolar lavage fluid may substantially improve the ability to diagnose fungal respiratory diseases. For instance, uncommon presentations of diseases with the pathogenic fungi, such as chronic cavitary histoplasmosis, coccidioidal empyema, and cryptococcal pneumonia are often difficult to diagnose with present techniques, and the detection of fungal antigens may prove to be more sensitive. There is an especially urgent need for sensitive, reliable, commercially available tests for the diagnosis of opportunistic fungal pneumonias that occur in immunocompromised hosts. Preliminary data holds promise for the noninvasive diagnosis of deep seated candidiasis (including pneumonia) and pulmonary aspergillosis by the detection of fungal antigens in serum and bronchoalveolar lavage fluid. We review current techniques used for the detection of fungal antigens, including their sensitivity and specificity, and their use in diagnosing human infections. PMID- 3317596 TI - Immunodiagnosis of blastomycosis. AB - The diagnosis of blastomycosis has long been a challenge for the clinician. Primarily a pulmonary disease, blastomycosis is difficult to differentiate from other respiratory infections by clinical symptoms alone. Substantial improvement in the diagnosis of blastomycosis can be attributed to the availability of the purified A antigen of Blastomyces dermatitidis and its homologous antibody and the incorporation of these reagents into diagnostic tests. Reliable procedures for accurately and rapidly immunodiagnosing blastomycosis are available. These methods comprise enzyme immunoassay and immunodiffusion tests for detecting diagnostic serum antibody by B dermatitidis, the exoantigen test for identifying mycelial-form cultures of the etiologic agent, and the fluorescent antibody technique for detecting and identifying yeast-form cells in culture or in tissue. These tests, used alone or in combination, can in many cases provide an early and rapid definitive diagnosis of blastomycosis. PMID- 3317597 TI - Epidemiologic aspects of blastomycosis, the enigmatic systemic mycosis. AB - A growing body of epidemiologic information derives from the study of sporadic cases and seven epidemics of blastomycosis, although a complete epidemiologic description of the disease is impeded by the absence of a skin test and difficulty isolating the causative fungus, Blastomyces dermatitidis, from nature. Most cases occur sporadically in humans and dogs in a worldwide distribution. Endemic areas in the United States include southeastern, southcentral, and midwestern states, particularly Arkansas, Kentucky, Mississippi, and Wisconsin. Blastomycosis is acquired by inhalation of spores from nature and acute disease occurs 21 to 106 days (median 43 days) after exposure; cutaneous inoculation and sexual and intrauterine transmission are rare. Most human cases are in middle aged men with occupation-, or leisure-related activities involving the soil or wooded areas. Identification of a point source in nature at a beaver pond and lodge was first accomplished during a 1984 Wisconsin epidemic, advancing knowledge of the natural habitat and ecology of the fungus. Blastomcyces alkali- and water-soluble antigen, utilized for in vitro lymphocyte transformation studies during the epidemic, may hold considerable promise for incorporation into a skin test. PMID- 3317599 TI - Azole antifungal drugs in treatment of coccidioidomycosis. AB - For two decades amphotericin B has been the only antifungal drug with proven efficacy against Coccidioides immitis. The introduction of miconazole in the late 1970s ushered in a new era of antifungal therapy. Miconazole induced remissions in patients with disease refractory to amphotericin B and in patients who had relapsed after amphotericin B treatment. Almost as important, miconazole did not have the nephrotoxicity associated with amphotericin B. However, the necessity of intravenous administration and other toxicities limited the value of miconazole. The first child of miconazole was ketoconazole, which could be administered orally and had markedly less toxicity than amphotericin B or miconazole. Because coccidioidomycosis challenges any antifungal drug, doses were increased to as much as 2,000 mg/d. Ketoconazole can be used for long terms and at high doses, with many patients brought into remission. However relapses and failures still occurred; dose-related endocrine and gastrointestinal toxicities were uncovered. A third generation of azoles, the triazoles, was introduced to minimize these adverse effects, yet retain the efficacy of ketoconazole. Early clinical trials are promising for itraconazole. Other triazoles with advantageous pharmacokinetic properties are also coming into clinical trials. Shortly, we are likely to have available a whole range of antifungal agents for treatment of this most frustrating disease. PMID- 3317598 TI - The immunology of cryptococcal disease. AB - Cryptococcus neoformans is a ubiquitous fungus found in the soil. Upon inhalation, a complex, incompletely understood series of host responses begins that determines whether the infection will be controlled or will progress to local or disseminated disease. Local pulmonary disease may be asymptomatic or may pursue a subacute course with mild pulmonary symptoms and systemic complaints suggestive of tumor. In the compromised host, however, symptomatic pulmonary disease is often the harbinger of systemic dissemination. Early host responses include phagocytosis by polymorphonuclear leukocytes aided by complement activation which provides opsonins. Lymphocytes are activated to produce lymphokines which may enhance macrophage phagocytosis and intracellular killing of ingested cryptococci. Other lymphocytes may function as natural killer-like cells or inhibit the growth of the fungus. Production of antibody further facilitates phagocytosis by both polymorphonuclear leukocytes (PMN) and monocytes (MC). In the presence of antibody, both PMN and MC demonstrate antibody-dependent cell-mediated cytotoxicity. The combination of humoral and cell-mediated immunity in normal hosts appears to provide excellent protection against disseminated infection as evidence by the rarity of disease in exposed individuals with positive skin tests. By contrast, the frequency of cryptococcal disease in steroid-treated individuals, allograft recipients, and AIDS victims highlight the importance of T lymphocyte dependent host defenses. In view of compelling in vitro evidence for the importance of humoral responses, the infrequency of cryptococcal disease in patients with gammopathies remains a puzzle. PMID- 3317600 TI - Treatment of pulmonary sporotrichosis. AB - Pulmonary infection with Sporothrix schenckii is extremely rare. The small number of reported cases and lack of comparative clinical trials make assessment of treatment regimens difficult. Three modalities should be considered: Saturated solution of potassium iodide (SSKI), amphotericin B, and resective surgery. Available data suggest that SSKI is unlikely to be successful in cavitary disease or disease in immunocompromised hosts. Amphotericin B alone has been successfully used to cure cavitary pulmonary sporotrichosis, but overall cure rates probably are no higher than 50%, and the probability of cure in bilateral apical disease is dismal. Surgical resection has been successful when used alone in a small number of cases. The highest cure rates (70% to 80%) appear to be a result of management with amphotericin B or SSKI combined with resective pulmonary surgery. The dosage and duration of amphotericin B or SSKI to be used in conjunction with surgical resection is unknown. PMID- 3317601 TI - Serodiagnosis of histoplasmosis. AB - The standard serologic tests for diagnosis of histoplasmosis include the complement fixation test (CF), which is quite sensitive, and the immunodiffusion test (ID), which is fairly specific. Radioimmunoassay (RIA) is an experimental serological test even more sensitive than CF, but also less specific. Problems with the specificity of serodiagnosis are addressed followed by a discussion of the sensitivity of the three tests in the different forms of histoplasmosis chronic cavitary histoplasmosis, progressive disseminated histoplasmosis, and acute pulmonary histoplasmosis. Next, serologic results from a large point-source outbreak of acute pulmonary histoplasmosis in Orono, Minn, are presented. These results are used to define the sensitivity of the three tests in acute symptomatic pulmonary histoplasmosis and also to detail the time course of the appearance of antibodies measurable by each test. Finally, a case of sporadic severe acute pulmonary histoplasmosis is presented in which the approach to serodiagnosis was based on lessons learned from the Orono outbreak. PMID- 3317602 TI - Antimicrobial activity of phagocyte granule proteins. PMID- 3317604 TI - Determinants of bacterial clearance from the lower respiratory tract. PMID- 3317603 TI - The role of extracellular bactericidal factors in pulmonary host defense. AB - Extracellular killing provides an attractive hypothesis to explain the rapid alveolar killing of inhaled bacterial pathogens in the absence of conventional opsonins for phagocytosis. Some evidence of extracellular killing of inhaled pneumococci has been obtained using histologic studies and bronchoalveolar lavage. Although studies of the antimicrobial activity of lung lavage fluid in vitro have given variable results, a variety of antimicrobial factors have been detected in lung lavage fluids. Studies of lysozyme, peptides, iron binding proteins, free fatty acids and other factors that are found free in lung lavage fluid indicate that some of these factors could be a part of extracellular pulmonary host defenses. However, their precise role is not known. A survey of mechanisms of extracellular killing shows that granulocytes, monocytes, macrophages, and T lymphocytes all have the capacity to kill extracellularly in vitro in some circumstances. It remains to be determined which of these diverse mechanisms operate within the lung and how they function in relationship to other host defenses. PMID- 3317605 TI - Chemotaxis and motility of lung phagocytes. PMID- 3317606 TI - Diagnostic approach to pneumonia in the immunocompromised host. PMID- 3317607 TI - Gram-negative bacterial pneumonia in the immunocompromised host. AB - Gram-negative bacillary pneumonia is common in all groups of iatrogenically immunosuppressed patients. Mortalities are directly proportional to the degree of neutropenia. Those at particular risk for gram-negative pneumonia are neutropenic patients, patients residing in the hospital setting for prolonged periods, and patients in postoperative periods (eg, organ transplant recipients). The most frequent pathogenesis for pneumonia appears to be airway colonization with gram negative bacilli, followed by lowe respiratory tract infection. Thus, attention to infection control measures and surveillance culture data is important. Because sputum production is scant or absent, and blood cultures positive in only 30% to 40% of patients, it is often difficult to identify specific etiologic agents. If bacterial pneumonia is suspected in the immunocompromised host, empiric antibiotic coverage should include drugs active against all common aerobic gram negative bacilli (including P aeruginosa), plus S aureus. Most advocate a beta lactam plus aminoglycoside combination. Adjunctive treatment with granulocyte transfusions should be reserved for patients not responding to traditional regimens. Immune therapy or prophylaxis has not been fully evaluated for the immunocompromised patient population. PMID- 3317609 TI - Mycobacterial infections in immunosuppressed patients. PMID- 3317608 TI - Pulmonary infections due to Legionella in immunocompromised patients. AB - At present, 11 different species of Legionella have been implicated in human disease. It has become apparent that disease caused by Legionella is acquired from a variety of environmental sources and that water is the factor that links many of them. Patients who are immunosuppressed, such as individuals receiving cancer chemotherapy or therapy designed to prevent organ rejection, are particularly susceptible to such environmental sources. It appears that intact cell-mediated immunity is more important in host defense than are adequate numbers of granulocytes or immunoglobulin concentrations. Diagnostic steps should be undertaken in all patients developing nosocomial pneumonia who present with a picture suspicious for this disorder. In the meantime, appropriate antimicrobial therapy with erythromycin and rifampin should be begun. If clusters of cases are detected in a hospital, immediate steps should be taken to attempt to isolate the organism from any aqueous environmental sources, and if found appropriate, steps taken. Awareness of the threat of legionnaires' disease must be maintained among clinicians and hospital epidemiologists because it is unlikely that the problem of nosocomial legionnaires' disease will disappear. PMID- 3317611 TI - Protozoal infections in the lungs of immunosuppressed patients. PMID- 3317610 TI - Fungal pneumonia in the immunocompromised host. PMID- 3317612 TI - Pulmonary infections in the acquired immunodeficiency syndrome. PMID- 3317613 TI - Short-course chemotherapy of tuberculosis: the harsh realities. AB - Recent studies have indicated that it is possible to successfully treat even far advanced tuberculosis with a variety of chemotherapy regimens ranging in duration from 4.5 to 9 months. Furthermore, much or all of some regimens can be given twice-weekly. However, three major barriers remain to widespread success: (1) Noncompliance with prescribed treatment; (2) increasing prevalence of drug resistance; and, (3) sorely limited resources in impoverished segments of the third world. While noncompliance is responsible for a greater number of treatment failures, increasing levels of drug resistance pose a greater long-term threat due to a protracted carrier-vector state, soaring costs for adequate drug regimens, and--ultimately--the conversion of an imminently treatable infection into an unmanageable scourge--the resurrection of the "White Plague." PMID- 3317614 TI - Diagnostic and therapeutic consideration in patients with pulmonary disease due to the rapidly growing mycobacteria. AB - Little is known of the clinical picture or natural history of patients with Mycobacterium fortuitum or Mycobacterium chelonae lung disease. The current author has spent almost 10 years studying these organisms and is in a unique position to study this group of patients. This is the first published attempt to characterize these patients and their disease, and provides a better understanding of what is the rarest but most difficult to treat of the environmental mycobacterial lung disease. PMID- 3317615 TI - Murine models for mycobacterioses. AB - Murine models have proven very useful in studying the pathobiology and chemotherapy of a number of mycobacterioses. While there are a number of significant variations from the human model, a substantial body of experience aids in extrapolating from the murine model to the human condition. The most extensively studied infection is Mycobacterium tuberculosis. However, there have been significant advances recently using the Beige mouse (an immunodeficient mutant) as an acute infection model for disease due to Mycoba avium complex. Less extensively studied have been Mycobacterium kansasii, Mycobacterium fortuitum, and Mycobacterium chelonei, the other relatively common nontuberculous mycobacterioses involving man. PMID- 3317616 TI - Rapid diagnosis of pneumonia in children. AB - Antigen detection techniques are available for the identification of bacterial polysaccharides, viruses, and chlamydia. Viruses and chlamydia are detected by direct immunofluorescence (DFA) or enzyme immunoassay (EIA). Bacterial polysaccharides are detected by latex agglutination or staphylococcal coagglutination of serum or concentrated urine. Most studies have not compared these techniques to the gold standard of lung puncture, so the role of dual infections with bacteria and viruses cannot be adequately determined. The sensitivity of any of these techniques is dependent on the quality of the antisera used. Monoclonal sera are now available for the detection of most viruses and seem to be as sensitive as polyclonal sera. DFA or EIA may offer equal sensitivity but their advantages and disadvantages must be considered by the local diagnostic laboratories. Most DFA and EIA systems have a sensitivity of 90% when compared with viral cultural for the identification of the organism. Agglutination reagents are available commercially for the detection of pneumococcal and Hemophilus influenzae type b polysaccharides. The sensitivity and specificity of each brand should be determined on serum or urine from patients known to have positive blood cultures and those free of disease. The brand chosen should be the one that has reasonable sensitivity and specificity. Rapid diagnostic techniques are helpful if they are used within a clinical context and they are positive. Negative tests do not rule out infection. PMID- 3317619 TI - Used anesthesia equipment: economics, sources, purchase, and use. PMID- 3317617 TI - Pulmonary infections in children with cystic fibrosis. AB - Bronchopulmonary infections continue to be the major determinant of morbidity and mortality in patients with cystic fibrosis (CF). The basic pathogenesis of disease includes abnormal secretions and impaired mucociliary clearance. Colonization of the tracheobronchial tract with bacteria is then associated with a cycle of infection, inflammation and airway obstruction eventually leading to respiratory insufficiency. Early clinical features include persistent cough and failure to thrive. Hyperinflation and bronchial thickening are early radiographic changes suggestive of CF. Staphylococcus aureus is commonly the initial respiratory pathogen. Subsequently, Hemophilus influenzae and Pseudomonas aeruginosa colonize the respiratory tract. In addition, respiratory viruses and other pathogens such as Legionella and mycoplasma are implicated in the etiology of pulmonary infections. The culture of respiratory secretions such as sputum are important guidelines to the etiology of pulmonary infection in CF. The laboratory must be aware of the pathogens that are typical of this disease and use appropriate techniques and media. In large part, advances in treatment in CF over the past two decades are due to the availability of increasingly potent antibiotic agents. However, effective treatment must be multifaceted and include a variety of nonantimicrobial therapies. Different approaches to the antibiotic therapy of pulmonary infection in CF, including prevention, suppression, and definitive treatment are discussed. In addition to traditional antibiotic therapy, a variety of newer methods of therapy in CF are discussed. These include oral antipseudomonal antibiotics, corticosteroid therapy, aerosolized antibiotics, and continuous antimicrobial prophylaxis. PMID- 3317618 TI - Special considerations in anesthesia. PMID- 3317620 TI - Complications in anesthesia. PMID- 3317621 TI - Chemical immobilization of wildlife. PMID- 3317623 TI - Anesthetic management for canine gastric dilatation-volvulus. PMID- 3317624 TI - Malignant hyperthermia. PMID- 3317622 TI - Veterinary acupuncture. PMID- 3317625 TI - The practicality of lumbosacral epidural analgesia. PMID- 3317626 TI - Exposure of veterinary personnel to waste anesthetic gases: is there cause for concern? PMID- 3317627 TI - Diaphragmatic hernia: anesthetic considerations. PMID- 3317628 TI - Coupling renal metabolism to ion transport in renal epithelia. PMID- 3317629 TI - Transport and metabolism in renal cells in culture. PMID- 3317630 TI - Molecular biology of renal function: methods and applications. PMID- 3317631 TI - Electrophysiology of ion transport in renal tubule epithelia. PMID- 3317632 TI - Volume regulation in renal epithelial cells. PMID- 3317633 TI - Membrane fluidity: measurement and relationship to solute transport. PMID- 3317634 TI - Regulation of Na+ and K+ transport by mineralocorticoids. PMID- 3317635 TI - Renal potassium handling. PMID- 3317636 TI - Adaptation for potassium conservation during dietary potassium deprivation. PMID- 3317639 TI - The relationship between disorders of K+ and Mg+ homeostasis. AB - Potassium and magnesium balance are frequently altered by common pathological conditions. Isolated disturbances of potassium balance do not produce secondary abnormalities in magnesium homeostasis. In contrast, primary disturbances in magnesium balance, particularly magnesium depletion, produce secondary potassium depletion. This appears to result from an inability of the cell to maintain the normally high intracellular concentration of potassium, perhaps as a result of an increase in membrane permeability to potassium and/or inhibition of Na+-K-ATPase. As a result, the cells lose potassium, which is excreted in the urine. Repletion of cell potassium requires correction of the magnesium deficit. Are such magnesium dependent alterations in potassium balance of any clinical significance? Within the context of electrolyte disturbances, magnesium replacement is often necessary before hypokalemia and potassium depletion can be satisfactorily corrected with potassium supplements. The hyponatremia often seen with chronic diuretic usage may also be related to depleted intracellular potassium stores. In a small group of patients with chronic congestive heart failure, magnesium replacement alone was sufficient to correct this hyponatremia. Finally, magnesium and potassium depletion may play an important role in the development of cardiac arrhythmias in certain select groups of patients, such as those with overt ischemic heart disease. The frequency of magnesium depletion in some clinical disease states warrants renewed interest in the relationship between magnesium and potassium homeostasis. PMID- 3317637 TI - Renal hyperkalemia. PMID- 3317640 TI - [The Revista Medico-Chirurgicala of the "Society of Physicians and Naturalists" Iasi, a branch of "The Union of Societies of Medical Sciences" of the Socialist Republic of Romania]. PMID- 3317638 TI - Hemodynamic effects of potassium. PMID- 3317641 TI - [A retrospective look at the research activities in the field of pediatrics as reflected in the Revista Medico-Chirurgicala]. PMID- 3317642 TI - [Research in the Bulletin/Revista Medico-Chirurgicala of the Iasi Society of Physicians and Naturalists in its 100 years of existence contributed by Iasi dermatologists]. PMID- 3317645 TI - [Surgical and surgical specialty publishing activity as reflected in the pages of the Iasi Revista Medico-Chirurgicala between 1946 and 1986]. PMID- 3317643 TI - [A word of greeting on the centenary of the Revista Medico-Chirurgicala]. PMID- 3317644 TI - [5 decades of the Iasi surgical tradition as reflected in the pages of the Revista Medico-Chirurgicala (1887-1943)]. PMID- 3317646 TI - [Obstetrical and gynecological publications in the Revista Medico-Chirurgicala during its 100 years of existence]. PMID- 3317647 TI - [The first decades of Iasi radiology as reflected in the pages of the Revista Medico-Chirurgicala]. PMID- 3317648 TI - [Retrospective look at the scientific research and educational activities of dentists as reflected in the Revista Medico-Chirurgicala]. PMID- 3317649 TI - [Promotion of pharmaceutical research through publications in the Revista Medico Chirurgical during its long existence]. PMID- 3317650 TI - [A word of greeting]. PMID- 3317651 TI - [Reflection of toxicological studies in the publication of the Iasi Society of Physicians and Naturalists]. PMID- 3317652 TI - [The field of medicinal plants as reflected in the pages of the Revista Medico Chirurgicala]. PMID- 3317653 TI - [Greetings from the Health Board of Iasi County]. PMID- 3317654 TI - [Scientific concerns of the social science disciplines as reflected in the pages of the Revista Medico-Chirurgicala]. PMID- 3317656 TI - [Scientific and publishing activities of Leon Cosmovici (1857-1921) as a member of the Society of Physicians and Naturalists]. PMID- 3317655 TI - [Vasile Conta in the Bulletin of the Iasi Society of Physicians and Naturalists]. PMID- 3317657 TI - [The scientific activities of Prof. Nicolae Leon published in the Bulletin of the Iasi Society of Physicians and Naturalists between 1901 and 1908]. PMID- 3317658 TI - [Out of the past and into the present. The outlook of Iasi medicine at the end of the 20th century]. PMID- 3317660 TI - [The current significance and competencies of psychiatry]. PMID- 3317659 TI - [The contribution of the Revista Medico-Chirurgicala to the diffusion of scientific research and to public health]. PMID- 3317661 TI - [The cross-disciplinary and specific nature of forensic psychiatry]. PMID- 3317662 TI - [Depressions in the projection of interference between endo- and psychogenesis]. PMID- 3317663 TI - [Medical education in Iasi and the journal of the Society of Physicians and Naturalists]. PMID- 3317664 TI - [Heredity-environment interaction and human behavior]. PMID- 3317665 TI - [Directions and concepts in the development of psychiatry]. PMID- 3317666 TI - [Directions and prospects for rehabilitative psychiatric care]. PMID- 3317667 TI - [Directions in psychology and clinical psychopathology]. PMID- 3317668 TI - [The evolution of physiology in Iasi as reflected in the Revista Medico Chirurgicala]. PMID- 3317671 TI - [The ecosystem of family relations and psychiatric care]. PMID- 3317670 TI - [Importance of using psychometric methods in the early detection of mental deterioration in the psychiatric clinic]. PMID- 3317669 TI - [Sex differentiation disorders: male pseudohermaphroditism. Clinical and etiopathogenetic forms and behavioral aspects]. PMID- 3317672 TI - [A century of publishing activity in the morphological sciences]. PMID- 3317673 TI - [The role of the family in the evolution of the schizophrenic patient. Methodological research problems]. PMID- 3317674 TI - [Medico-social aspects of the family of the behavioral deviant]. PMID- 3317675 TI - [Scientific activities in the fields of general pathology and physiopathology as reflected in the Revista Medico-Chirurgicala]. PMID- 3317677 TI - [Bacteriology and epidemiology in the Iasi medical journal, 1887-1986]. PMID- 3317679 TI - [Clinical immunology in the Revista Medico-Chirurgicala, 1887-1986]. PMID- 3317678 TI - [Virology studies and concerns in the pages of the Revista Medico-Chirurgicala, 1887-1986]. PMID- 3317676 TI - [Old foreign books in the Library of the Society of Physicians and Naturalists (the 16th-18th centuries)]. PMID- 3317680 TI - [The Revista Medico-Chirurgicala and scientific activity in the discipline of biochemistry in Iasi]. PMID- 3317681 TI - [Occupational medicine problems as reflected in the Iasi Revista Medico Chirurgicala (1956-1986)]. PMID- 3317682 TI - [Internal medicine in the pages of the journal of the Iasi Society of Physicians and Naturalists over the period of a century]. PMID- 3317683 TI - [The problems and progress of psychiatry in the contents of the Revista Medico Chirurgicala]. PMID- 3317684 TI - [A century from the appearance of the 1st issue of the Revista Medico Chirurgicala]. PMID- 3317685 TI - [Reflection of the scientific activities in the field of neurology in the Revista Medico-Chirurgicala]. PMID- 3317686 TI - [Endocrinology research reflected in the pages of the Revista Medico Chirurgicala]. PMID- 3317688 TI - [Iasi concerns in balneophysiotherapy as reflected in the Revista Medico Chirurgicala]. PMID- 3317687 TI - [Iasi scientific concerns in the field of infectious pathology as reflected in the Revista Medico-Chirurgicala]. PMID- 3317689 TI - [Clinical considerations on the indications and risks in antidepressive medication]. PMID- 3317690 TI - [Sarcoma of the spleen]. PMID- 3317692 TI - [Achilles, the turtle and...validation of expert systems in medicine]. PMID- 3317691 TI - [Value of the immune response in assessing the efficacy of an antimalarial treatment]. PMID- 3317693 TI - [A manuscript of prescriptions of domestic medicine from the 18th century. II-A]. PMID- 3317694 TI - [Hormone receptors in cancerology of the breast. Where do we stand in 1987?]. PMID- 3317695 TI - [When should we operate in gastric ulcer?]. PMID- 3317696 TI - [A little known complication of arterial hypertension, Binswanger encephalopathy]. PMID- 3317697 TI - [A forest can hide a tree ... Rett syndrome: a second genetic cause of mental retardation in young girls?]. PMID- 3317698 TI - [Comparative study of various methods of gestational age assessment at birth]. PMID- 3317699 TI - [Current indications for surgery in Parkinson's disease]. PMID- 3317700 TI - [Extensive burns in a specialized environment. The treatment of lesions]. PMID- 3317701 TI - [The role of Duoderm in the treatment of superficial and intermediary burns as well as transplant donor sites]. PMID- 3317702 TI - [New data on experimental endotoxic shock]. PMID- 3317703 TI - [Shock conditions. Hemodynamic profiles and treatments]. PMID- 3317704 TI - [Right ventricular failures]. PMID- 3317705 TI - Inotropic support in patients with left ventricular dysfunction. PMID- 3317706 TI - [The Pasteur Institute and the commemoration of its centenary (Paris, 5-10 October 1987)]. PMID- 3317707 TI - [Contractile properties of the skeletal muscles in rheumatoid arthritis patients]. PMID- 3317709 TI - [Information value of indices of the protease inhibitor system in diagnosing the early stage of rheumatoid arthritis]. PMID- 3317708 TI - [Immunocorrection with T-activin in the combined treatment of juvenile rheumatoid arthritis]. PMID- 3317710 TI - [Therapeutic plasmacytapheresis in rheumatology: the status of the problem and developmental outlook]. PMID- 3317711 TI - [Neurological changes in patients with peripheral arthrosis]. PMID- 3317712 TI - [Reflexotherapy of osteoarthritis patients using the action of a UHF electromagnetic field]. PMID- 3317714 TI - [Echocardiography in the diagnosis of functional disorders of mechanical heart valve prostheses]. PMID- 3317713 TI - [Local barotherapy in treating arthroses]. PMID- 3317715 TI - [Alcohol and gout]. PMID- 3317717 TI - [Polymyalgia rheumatica]. PMID- 3317716 TI - [Hypersensitivity syndrome caused by allopurinol (personal case and a review of the literature)]. PMID- 3317719 TI - [The design of a working classification and nomenclature of rheumatic diseases]. PMID- 3317718 TI - [Further comment on diagnostic criteria in osteoarthritis]. PMID- 3317720 TI - [Discussion questions in the classification and nomenclature of rheumatic diseases]. PMID- 3317721 TI - [The vertebro-neurological aspect of a working classification and nomenclature of rheumatic diseases]. PMID- 3317722 TI - [Our thoughts apropos of a working classification and nomenclature of rheumatic diseases (1985)]. PMID- 3317723 TI - [Rheumatic masks of tuberculosis and the difficulties in its diagnosis]. PMID- 3317724 TI - Sleep in restrictive lung disease. AB - Restrictive lung disease patients exhibit a wide range of breathing and oxygenation abnormalities during sleep. The combination of degree of restriction, whether it is intrapulmonary or extrapulmonary, and confounding factors, such as obesity, age, and sex, will ultimately determine the degree of disturbed nocturnal physiology. The sleep literature is still sparse in most restrictive diseases. For patients with interstitial lung disease, the role of nocturnal oxygen in chronic established fibrosis, and also in acute alveolitis (e.g., farmer's lung, bird fancier's lung, etc.), has not been addressed. As fibrotic lung disease progresses, the degree of nocturnal desaturation and breathing dysrhythmias will progress. Changes in sleep architecture are likely related to the progression of the disease, but this is not known with certainty. Long-term evaluation of sleep and breathing in interstitial lung disease will give further insight into whether or not sleep changes are primary or secondary events. For kyphoscoliosis patients, again, we need more information on sleep as the thoracic deformity changes. In addition, the use of drugs (acetazolomide, medroxyprogesterone, and almitrine) and/or nasal CPAP to treat nocturnal desaturation needs to be assessed in a controlled fashion. In neuromuscular disease, the dynamics of gas exchange and sleep structure need to be defined in a larger group of patients. Factors such as degree of muscle weakness, degree of underlying lung diseases, and medications must be taken into consideration. Nocturnal hypoxemia may cause muscle weakness and fatigue, which in time, could cause more nocturnal hypoventilation and further hypoxemia. Supplemental nocturnal oxygen should be evaluated in this population. PMID- 3317725 TI - Interaction between sleep and thermoregulation: an aspect of the control of behavioral states. AB - Studies on the interaction between sleep and thermoregulation are reviewed with regard to the processes underlying the ultradian evolution of behavioral states. The experimental evidence shows that thermoregulatory mechanisms influence the waking-sleeping cycle in both the absence or the presence of a thermal load. Such a control appears to be a functional necessity to maintain physiological homeostasis. PMID- 3317726 TI - George Catlin's "Mal-respiration of sleep": a 19th-century view of sleep physiology and pathophysiology. PMID- 3317727 TI - Achromobacter xylosoxidans bacteremia. AB - Achromobacter xylosoxidans is a rare cause of bacteremia. A case of community acquired pneumonia and bacteremia due to Achromobacter in a patient with concomitant pulmonary tuberculosis is reported herein. The majority of patients who have developed achromobacter bacteremia have had a predisposition to infection (although the predisposing conditions have been diverse). Immunosuppression has been reported in only one of the seven patients with achromobacter bacteremia for whom detailed information is available. Achromobacter is usually resistant to ampicillin, cephalosporins, and aminoglycosides. Antipseudomonal penicillins and trimethoprim-sulfamethoxazole inhibit most isolates. Multiple-drug resistance is common, and optimal therapy is not known. PMID- 3317728 TI - Mycoses caused by Candida lusitaniae. AB - Candida lusitaniae, a fungus with a low incidence of infection in immunocompetent people, is emerging as an opportunistic pathogen in immunocompromised hosts. This yeast is generally resistant to amphotericin B and may present therapeutic difficulties. C. lusitaniae may be misidentified as one of several other fungal species, including Candida tropicalis, Candida parapsilosis, and even Saccharomyces cerevisiae. As judged by in vitro antifungal susceptibility testing, minimal inhibitory concentrations of antifungal agents other than amphotericin B are achievable, but fungicidal levels are not. When encountered in blood or other body sites, C. lusitaniae should be carefully considered as a potential pathogen. PMID- 3317729 TI - Benjamin Waterhouse and the introduction of vaccination. By John B. Blake, 1957. PMID- 3317731 TI - Actinomycosis of the central nervous system. AB - Actinomyces species are rare but treatable causes of CNS infection. Differentiation of actinomycosis from nocardiosis is crucial to the selection of appropriate antimicrobial therapy. A review of 70 cases of CNS actinomycosis was conducted in an effort to characterize clinicopathologic features and identify patients with a high risk of death from infection. Types of lesions included brain abscess (67%), meningitis or meningoencephalitis (13%), actinomycoma (7%), subdural empyema (6%), and epidural abscess (6%). Most infections developed from distant sites (lung, 19 cases; abdomen, four; pelvis, three) or contiguous foci (ear, sinus, and cervicofacial region, 21 cases). For nonmeningitic infection, signs and symptoms were generally those of a space-occupying lesion and were indistinguishable from the manifestations of other pyogenic infections except for a longer interval before diagnosis. Risk factors included dental caries; dental infection; recent tooth extraction; head trauma; gastrointestinal tract surgery; chronic otitis, mastoiditis, or sinusitis; chronic osteomyelitis; tetralogy of Fallot; and actinomyces infection of an intrauterine device. Optimal management combined adequate surgical drainage with prolonged antibiotic therapy (mean duration, 5 months). Overall mortality from treated infection was 28%; 54% of survivors had neurologic sequelae. Features correlated with a poor prognosis were disease onset greater than 2 months before diagnosis and treatment, no antibiotic treatment, no surgery, and needle aspiration drainage of abscess lesions. PMID- 3317730 TI - Role of serology in the diagnosis of toxoplasmic lymphadenopathy. AB - Serologic results obtained in 92 cases of toxoplasmic lymphadenopathy diagnosed by lymph node biopsy were reviewed, and guidelines for serologic diagnosis of this disease were established. When tests were first performed within six months of onset of lymphadenopathy, single high titers of IgG toxoplasma antibodies (suggestive of acute infection) were found with the Sabin-Feldman dye test and the direct agglutination test in 93% and 76% of cases, respectively. Observations of significant rises in titer were uncommon because of the late acquisition of sera. Within the first six months after the onset of lymphadenopathy, IgM toxoplasma antibody was demonstrable by the double-sandwich IgM enzyme-linked immunosorbent assay in 88% of cases and by the IgM-immunofluorescent antibody test in 78%. Twenty percent of patients who had serum samples drawn more than 12 months after onset lymphadenopathy still had IgM toxoplasma antibodies demonstrable by the enzyme-linked immunosorbent assay. No patient first tested six or more months after onset of lymphadenopathy was positive in the IgM immunofluorescent antibody test. These results provide the basis for recommendations on the use of serologic tests for the diagnosis of acute toxoplasmic lymphadenopathy. PMID- 3317732 TI - Reflections on the efficacy of pertussis vaccines. AB - The literature on the protection imparted by conventional whole-cell pertussis vaccines was reviewed, and the extent to which the great variation in estimates of vaccine efficacy is attributable to methodologic problems in study design and analysis or to biologic features of the natural history of pertussis was explored. The protection against disease imparted by pertussis vaccines may be greater than that against infection. Estimates of vaccine efficacy from case control studies are higher than those from studies of household secondary-attack rates; likewise, estimates of efficacy are higher when based on clinically severe or bacteriologically positive cases rather than simply on notified cases. Some of the reported differences in protection by different vaccines may be attributable to relations between the antigenic composition of the vaccine used and that of the circulating strain of Bordetella pertussis. Failure to consider age trends has sometimes led to spuriously high estimates of efficacy. Many biases can affect efficacy studies, and it is usually difficult to assess whether the net effect has been to underestimate or to overestimate "true" efficacy. The immunity imparted by conventional pertussis vaccines may be neither as solid nor as stable as that imparted by many live-virus vaccines. These issues must be considered during the evaluation of acellular pertussis vaccines. PMID- 3317733 TI - Dysgonic fermenter 2 septicemia. AB - Dysgonic fermenter 2 (DF-2) is a slow-growing gram-negative bacillus causing a zoonotic infection that is acquired through dog bites or other contact with dogs. Splenectomized patients and those with alcoholic liver disease are most susceptible to DF-2 infection. The clinical picture can be one of fulminant septicemia and disseminated intravascular coagulation in the splenectomized patient; the presentation is milder in the alcoholic patient. The overall mortality from DF-2 septicemia among the 41 cases reported in the literature is 27%. The organism is sensitive to penicillin, resistant to aminoglycosides, and not easily grown on common media. It appears to be serum-sensitive in tests with normal human serum. Penicillin prophylaxis of dog bite wounds is especially important in high-risk patients. DF-2 infection should be considered when any splenectomized patient develops fulminant septicemia, disseminated intravascular coagulation, and peripheral gangrene. Examination of a gram stain of the peripheral blood or buffy coat is of value in such cases. PMID- 3317734 TI - Prospective study of 114 consecutive episodes of Staphylococcus aureus bacteremia. AB - From 1 April 1983 to 31 October 1985, 114 episodes of Staphylococcus aureus bacteremia (SAB) were identified in 111 patients at the Buffalo Veterans Administration Medical Center. Only 14% of the episodes were community-acquired, and 29% were due to methicillin-resistant strains. The commonest foci of SAB were intravascular catheters (33%), postoperative wounds (11%), skin infections (7%), and pulmonary infections (7%). Complications were infrequent, with endocarditis in two patients and metastatic infection in one. Mortality due to SAB was 32%, with no difference in mortality between community-acquired and hospital-acquired SAB. Although not statistically significant, there was a trend of higher mortality for methicillin-resistant SAB (42%) than for methicillin-sensitive SAB (28%) and for patients with no focus of SAB (43%) than for those with a defined primary focus (28%). A review of studies of SAB published since 1940 revealed several trends. SAB is now predominately a nosocomial infection; intravascular catheter infection has become the commonest cause of SAB; with several exceptions, the risk of endocarditis in patients with SAB is low (5%-20%); mortality due to SAB has decreased over the past 40 years but not over the past 10 years. PMID- 3317736 TI - Salmonellosis during infection with human immunodeficiency virus. AB - Salmonella bacteremia is being identified with increasing frequency in persons infected with the human immunodeficiency virus. Salmonellosis may occur in patients with an established diagnosis of acquired immunodeficiency syndrome (AIDS), or it may be the first manifestation of this disorder. In patients with AIDS, salmonellosis is characterized by recurrent bacteremia despite treatment and a relative paucity of gastrointestinal manifestations. Treatment regimens may be limited by antimicrobial resistance, poor penetration of antibiotics into phagocytes, and drug intolerance; optimal therapy remains to be established. Possible mechanisms to account for this increased frequency and severity of salmonellosis include altered cell-mediated immunity, hemolysis, prior use of antibiotics, and increased exposure to the pathogen. Salmonellae should be considered among the pathogens associated with human immunodeficiency virus infection. PMID- 3317735 TI - Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma. AB - Three cases of endocarditis due to nutritionally deficient (variant) streptococci are presented and the literature is reviewed. In all of the cases reviewed, the patient presented with an indolent subacute course. Prior heart disease was present in 90% of the patients, embolization occurred in 27%, relapse after therapy in 17%, and death in 17%. Bacteriologic failure occurred in 41% of cases, despite sensitivity of the organisms to the antibiotics used in two-thirds of these cases. Combination therapy with penicillin and an aminoglycoside has been recommended previously; however, in 38% of the cases reviewed, bacteriologic failures occurred and the patients required surgery. The results of in vitro antibiotic-sensitivity testing are difficult to interpret and to apply to the expected response to therapy. Further studies on these organisms are needed to reduce the high rates of failure, relapse, and fatality. PMID- 3317737 TI - Q fever: current concepts. AB - Persons with Q fever usually present with severe retrobulbar headache, a fever to 104 degrees F or higher with shaking chills, general malaise, myalgia, chest pain, and sometimes pneumonia and hepatitis. Cattle, sheep, goats, and ticks are the primary reservoirs of the etiologic agent, Coxiella burnetii. Humans are usually infected by inhaling infectious aerosols. Because C. burnetii can survive for long periods in the environment, it poses a continuing health hazard once it is disseminated. Q fever usually occurs sporadically, but large outbreaks are frequently observed throughout the world, particularly among abattoir workers and personnel working in research centers. Q fever endocarditis follows a chronic course and is frequently fatal. Tests for antibodies to C. burnetii are required for confirmation of the diagnosis. Tetracyclines remain the mainstay of treatment for acute Q fever, and tetracyclines in combination with other antibiotics have been advocated for patients with Q fever endocarditis. Vaccines for Q fever have been proven effective in clinical trials. PMID- 3317738 TI - Heterosexual transmission of acquired immunodeficiency syndrome: international perspectives and national projections. AB - The heterosexual transmission of the acquired immunodeficiency syndrome (AIDS) has been documented in the United States by national surveillance data and heterosexual partner studies since the beginning of the epidemic. However, the efficiency of heterosexual transmission and related risk factors remain unclear. Viral transmission from males to their female sexual partners is well documented, although in the United States instances of female-to-male transmission have been observed less frequently. On the other hand, in parts of Africa and Haiti, AIDS appears to be a bidirectional, heterosexually transmitted disease that often occurs concurrently with other sexually transmitted diseases. Although a widespread heterosexual epidemic of AIDS could evolve in the United States, it seems more plausible that, like other sexually transmitted diseases, AIDS will settle in limited segments of the community characterized by certain high-risk behaviors. PMID- 3317739 TI - Neurocysticercosis in the United States: 35 cases and a review. AB - Neurocysticercosis has become more prominent in the United States in recent years because of an increase in immigration from endemic regions and because of improved ease of diagnosis with computed tomography (CT). Neurocysticercosis should be suspected in any patient from a high-risk region who has symptoms or signs of a central nervous system disorder, especially seizures, headaches, or signs of increased intracranial pressure. The best diagnostic test is CT of the head, which usually shows a combination of multiple punctate calcifications; hydrocephalus; and parenchymal, subarachnoid, or intraventricular cysts with and without contrast enhancement. Cysticercosis is confirmed serologically by measurement of cysticercosis antibody titers in serum or cerebrospinal fluid and histologically by biopsy of a lesion. Treatment with praziquantel and dexamethasone is usually sufficient, but ventricular shunting or surgical removal of intraventricular or spinal cysts may be necessary. Whenever a case is identified, other household members should be examined for symptoms and signs of neurocysticercosis and screened for active Taenia solium infection. PMID- 3317741 TI - Beyond the political model of reporting: nonspecific symptoms in media communication about AIDS. AB - Mass media have functioned well in transmitting much of the basic information about the AIDS epidemic; however, media coverage of AIDS has been flawed. In many ways these flaws have resulted from the limitations and conventions of traditional journalism, especially the need to appeal to a large mainstream audience and a reliance on authorities as sources and validators of information. News stories typically rely on a single articulate authority, and articles that involve conspiracy or controversy or have a high entertainment value are favored. Although coverage of politics and social issues is not distorted by these journalistic conventions, coverage of science suffers. Analysis of news coverage of AIDS shows that mass media often respond to sensationalism rather than to important scientific developments. In addition, scientific disagreements are better adjudicated by evidence than by appeals to authority. As a result, media coverage often obscures the process of scientific deliberation. Public health officials need to consider setting up a special channel of communications to clarify information about AIDS. PMID- 3317740 TI - AIDS and the social sciences: review of useful knowledge and research needs. AB - This paper reviews several areas of social science research that are relevant to the critical social dimensions of the AIDS crisis. These dimensions include how to effect changes in behavior so as to break the chain of transmission, how best to inform the public about risks so as to develop reasonable and nondiscriminatory policies and practices based on the best available scientific information, and how to organize health care and social services so as to treat persons with AIDS effectively, humanely, and at reasonable cost. Relevant research in the social sciences includes studies of behavioral risk modification, risk perception, communication and persuasion, attitudes toward civil liberties, and the organization of health care. This work suggests useful avenues for research on AIDS that could provide the understanding necessary to develop effective ways of approaching the problems presented by this devastating disease. PMID- 3317742 TI - Six hundred years: Heidelberg University--crisis and achievements. AB - Throughout its 600 years, Heidelberg University has endured the social and political upheavals of history, repeatedly rising like a phoenix from the ashes of a series of disasters to fulfill its mission as a center of learning and research. Founded in 1386, and buffeted by wars, plaques, and diverse political and social systems ever since, the university has developed along lines determined as much by regional, European, and world politics as by the dynamics inherent in its disciplines. Its history may be divided into the following six historical phases: (1) the scholastic university of the late Middle Ages (1386 1556); (2) the Protestant university (1556-1685); (3) the Catholic university (1685-1807); (4) the university in the age of liberalism and nationalism (1803 1933); (5) the university during National Socialism (1933-1945); and (6) the contemporary university and its efforts to cope with the explosion of knowledge, steadily growing student numbers, and other problems related to growth, expansion, and diversification in all disciplines (1945 to the present). PMID- 3317743 TI - Certain aspects of medical research and its support. AB - The origins of the National Institutes of Health (NIH) are linked with European science. Few Americans had participated in the advances in bacteriology led by Koch and Pasteur when a laboratory from which the NIH eventually developed was established in New York in 1887, but its first director patterned this laboratory after ones already established in Germany, France, and England. The era of modern biomedical research in the United States began during World War II with the cooperation of government and nongovernment (mostly academic) research laboratories. Today, the philosophical foundation underlying all research supporting programs of the NIH is that a close connection exists between improved medical care and research and that any expansion of medical facilities must be accompanied by an expansion of medical training and research. In addition, government grants should not interfere with the freedom and integrity of academic institutions and should allow scientists complete independence in determining the nature, scope, and methodology of their investigations. Discoveries in genetics in the 1950's and 1960's heralded an era of science in which it was necessary to address major questions with immediate relevance to human health. Impelled by pressure from the public, the scientific community, and the Congress, the NIH participates in formulating safety guidelines regarding potential applications of biotechnology. The annual increase in funds appropriated by Congress to the NIH attests to a high level of public commitment to the support of biomedical research and underlines the degree of accountability to which the NIH is subject. PMID- 3317744 TI - Bacterial adherence: the attachment of group A streptococci to mucosal surfaces. AB - It is now recognized that bacteria bind to and colonize mucosal surfaces in a highly selective manner. After the organisms penetrate the nonspecific mechanical and cleansing forces, ligands (or adhesins) on the surface of the bacteria interact in a lock-and-key (or induced-fit) fashion with complementary receptors on mucosal surfaces of the host. The adhesins are usually composed of proteins in the form of fimbriae or fibrillae and the receptors of glycolipids or glycoproteins. In group A streptococci the adhesin, lipoteichoic acid (LTA), is anchored to one or more proteins on the surface of the bacterial cells and interacts through its lipid moiety with fibronectin molecules deposited on and bound to the epithelial cells. In an attempt to locate the region of fibronectin recognized by LTA and group A streptococci, fibronectin was cleaved with thermolysin and the fragment mixture adsorbed with Staphylococcus aureus or Streptococcus pyogenes. Staphylococci adsorbed several high-molecular-weight fragments as well as a 28-kilodalton and a 23-kilodalton fragment, whereas S. pyogenes cells adsorbed only the 28-kilodalton fragment completely. The adsorption of the fragments by S. pyogenes was blocked by LTA. Antibodies raised against a synthetic peptide copying the NH2 terminus of fibronectin reacted in a western blot with the 28-kilodalton fragment; this result indicated that S. pyogenes and its LTA react with the NH2-terminal region of fibronectin at a site distinct from that at which S. aureus reacts. Our findings are consistent with the idea that LTA mediates the attachment of group A streptococci to fatty acid binding sites of fibronectin deposited on mucosal epithelial cells. PMID- 3317745 TI - On the pathogenesis of toxic shock syndrome. AB - Understanding of the pathogenesis of toxic shock syndrome (TSS) has come from the juxtaposition of epidemiologic, clinical, immunologic, and physiologic studies. A hypothesis has been developed for the pathogenesis of menstrually related TSS. Certain tampon fibers that are highly absorbent for water are also ion exchangers for magnesium ions. The latter ions uniquely affect the production of TSS toxin 1 (TSST-1) by appropriate strains of Staphylococcus aureus, with a marked increase in the amount of toxin when magnesium concentrations are limiting and suppression of toxin production when magnesium is in excess. Many epidemiologic features of TSS could be explained by this hypothesis. The absorbability of highly absorptive fibers is not affected by the addition of small amounts of magnesium sufficient to suppress production of TSST-1; thus absorption is distinguishable from toxin production in vitro. TSST-1 stimulates production of interleukin 1 and of tumor necrosis factor and is highly toxic when absorbed slowly. Like TSST-1, staphylococcal enterotoxins are lethal to rabbits when given by slow injection, and some enterotoxins may be more lethal than TSST-1. PMID- 3317746 TI - Review of the molecular requirements of endotoxic actions. AB - Old and new data are compiled to confirm earlier claims and to substantiate new concepts regarding the structural requirements of endotoxic reactions. The major points can be summarized as follows. (1) Recent results obtained by the use of synthetic analogues of lipid A structures proved unequivocally that the lipid moiety of the endotoxin is the carrier of toxic properties. Incomplete or attenuated structures are inactive in some or all toxic reactions, depending on the extent of deviations from the structure of the native product. (2) On the other hand, some beneficial reactions can be initiated not only by the complete structures but by their structural remains, which are no longer toxic. (3) Some of the split products in the lipid-free and polysaccharide-rich preparations can induce beneficial reactions. (4) Gram-negative bacteria can produce endotoxin unrelated and beneficial compounds. Conventional endotoxin preparations are heterogeneous and often contain some of these unrelated substances. (5) Elucidation of the exact structural requirements of endotoxic reactions has just begun. It appears to be safe to predict that individual reactions will require highly specific structures or physicochemical properties. The potential rewards of such research might be quite significant by facilitating our understanding of the molecular events of the beneficial effects of endotoxins and by directing the search for preparations with therapeutic applications. PMID- 3317747 TI - Characterization of a nontoxic monophosphoryl lipid A. AB - Gram-negative bacterial endotoxins constitute some of the strongest immunologic adjuvants known. Precluding their use as adjuvants in humans has been the exquisite toxicity of these compounds in extraordinarily small amounts. With the acquisition of precise knowledge of the structure of the active moiety, detoxifying procedures have been developed. These have resulted in the isolation of a monophosphoryl lipid A with a much reduced toxicity that retains the capacity to act as an adjuvant in young mice as well as in immunodeficient aging mice. PMID- 3317748 TI - Chemical structure and biologic activity of bacterial and synthetic lipid A. AB - The chemical structure of the lipid A component of enterobacterial lipopolysaccharide (LPS) is now known in some detail. For example, lipid A of Escherichia coli consists of a beta(1----6)-linked D-glucosamine disaccharide that carries four (R)-3-hydroxytetradecanoyl groups in positions 2, 3, 2', and 3' and two phosphoryl residues in positions 1 and 4'. The hydroxy fatty acids at positions 2' and 3' are acylated at their 3-hydroxyl groups by dodecanoic acid and tetradecanoic acid, respectively. The hydroxyl groups in positions 4 and 6' are free, the latter serving as the attachment site for the polysaccharide component in intact LPS. On the basis of this structure, E. coli-type lipid A and partial structures thereof have been chemically synthesized (group of T. Shiba, Osaka University, Osaka, Japan) and analyzed for endotoxic activity. In all in vivo and in vitro test systems employed (including lethal toxicity, pyrogenicity, local Shwartzman reactivity, B lymphocyte mitogenicity, macrophage activation, and serologic cross-reactivity with lipid A antiserum), synthetic lipid A has activity identical to that of E. coli lipid A. These findings support the structural proposal for lipid A and prove the previous hypothesis that the endotoxic principle is embedded in lipid A. PMID- 3317749 TI - The function of antibody and complement in the lysis of bacteria. AB - The factors controlling lysis of gram-negative bacteria by complement are being investigated systematically. The first question was how smooth Salmonella minnesota, which has on its surface lipopolysaccharide with long O polysaccharide side chains, avoids lysis. Rough organisms are serum sensitive. In both smooth and rough organisms, complement components are deposited on the surface and the lytic sequence proceeds to completion. However, with serum-resistant organisms the membrane attack complex (MAC), composed of late-acting complement proteins, does not successfully insert into the outer membrane to cause membrane damage. At the completion of the lytic sequence, the hydrophobic MAC is shed. C3b, which directs late component assembly, is deposited on the longest O polysaccharide side chains on these smooth organisms, where it does not direct successful insertion of the MAC into the outer membrane. Serum-resistant gonococci sequester the MAC on the organism's surface in association with specific outer membrane components, where it does no damage to the outer membrane. Antibody appears to mediate site-directed complement component deposition in a number of systems. Thus, depending on antibody specificity, complement may be deposited on the organism's surface to cause successful complement attack or may block complement attack induced by bactericidal antibody. Monoclonal antibodies of the same isotype directed at different epitopes on the same bacterial surface antigen may either induce lysis or block lytic attack. PMID- 3317750 TI - Activated leukocytes and the hemostatic system. AB - Activated leukocytes are capable of activating the blood-clotting system. Upon adequate stimulation (e.g., by endotoxin, by lectins, in the course of immune reactions, and in response to lymphokines of T cell origin), macrophages and monocytes synthesize tissue thromboplastin and expose it on their surface. Leukocyte proteases may interfere with blood coagulation by degrading clotting factors, in particular factors V, VIII, and XIII. Furthermore, these enzymes act as fibrinolytic agents, which also cleave fibrinogen. Leukocyte elastase attacks the platelet glycoproteins Ib (the receptor for von Willebrand factor) and V (a thrombin substrate) and at the same time exposes the platelet fibrinogen receptor. Platelet-activating factor of leukocyte origin may induce platelet aggregation and is a powerful potentiator of other inducers of platelet activity. The last-mentioned property has also been reported for leukotrienes. Activated leukocytes and their products play an important role in the pathogenesis of important disorders of the hemostatic system, with disseminated intravascular coagulation as the most prominent example. PMID- 3317751 TI - Role of leukotrienes in endotoxin action in vivo. AB - The cysteinyl leukotrienes LTC4, LTD4, and LTE4 play an important role within the network of mediators of endotoxin shock since they are capable of eliciting the generation of other lipid mediators of shock. Three lines of evidence support the conclusion that the cysteinyl leukotrienes are involved in the lethal shock inducing action of endotoxin. (1) Endotoxin elicits the systemic production of cysteinyl leukotrienes in vivo. (2) Injection of these leukotrienes into sensitive species causes shock-like reactions, myocardial depression, and extravasation of plasma. (3) Cysteinyl leukotriene receptor antagonists and inhibitors of leukotriene synthesis prevent experimental endotoxin shock. Moreover, endotoxin induces a strong inhibition of the hepatobiliary elimination of cysteinyl leukotrienes, which normally represents the major pathway for deactivation of these mediators. This dual action of endotoxin, comprising enhanced synthesis and simultaneously impaired deactivation of potent mediators, points to a novel type of toxin action. The role of cysteinyl leukotrienes in endotoxin action does not exclude the involvement of additional shock-inducing factors released by endotoxin and their possible contribution to the formation of lipid mediators, including leukotrienes. PMID- 3317752 TI - Human urine-derived inhibitors of interleukin 1. AB - Human urine has been found to contain several different substances that are capable of inhibiting the in vitro effects of interleukin 1 (IL-1). The urine of febrile individuals contains elevated levels of a 30-40 kilodalton (kdal) glycoprotein that is a potent inhibitor of IL-1-induced proliferation of murine thymocytes. This inhibitor from febrile individuals also blocks antigen-induced activation of human peripheral blood lymphocytes in vitro but increases, rather than decreases IL-1-induced production of prostaglandin E2 by fibroblasts. Uromodulin, an 85-kdal glycoprotein derived from the urine of pregnant women, is also a potent inhibitor of IL-1-induced thymocyte proliferation and human lymphocyte activation. Differences in molecular weight, biologic activity, and antigenicity suggest that uromodulin and the febrile inhibitor are distinct entities. Urine of some individuals has also been found to contain large amounts of a third IL-1 inhibitor that is 20-25 kdal in size. Unlike the febrile inhibitor and uromodulin, this 25-kdal molecule has been found to be a potent inhibitor of IL-1-induced production of prostaglandin E2 by fibroblasts as well as of the proliferation of thymocytes. The biologic activities of these three inhibitors indicate that they may be part of an important physiologic system for the regulation of immunity and inflammation in humans. PMID- 3317753 TI - Tumor necrosis factor and interleukin 1 as mediators of endotoxin-induced beneficial effects. AB - Bacterial lipopolysaccharides or endotoxins are known to induce tumor necrosis; enhanced nonspecific resistance to bacterial, viral, and parasitic infections and to radiation sickness; and tolerance to lethal doses of endotoxin. These beneficial effects are achieved by pretreatment with minute amounts of endotoxin. Recombinant tumor necrosis factor (TNF) and interleukin 1 (IL-1) are among the mediators capable of invoking radioprotection or resistance to the consequences of cecal ligation and puncture. Both cytokines are potent inducers of serum colony-stimulating factor (CSF) in C3H/HeJ mice (low responders to endotoxin). The number of splenic granulocyte-macrophage precursors was found to increase 5 days after injection of TNF in these mice. Although with IL-1 no increase in the number of granulocyte-macrophage colonies occurred in culture in the presence of serum CSF, a marked stimulation was observed when TNF was added. This stimulation of myelopoiesis observed in vivo and in vitro may be related to the radioprotective effect of TNF. The data presented suggest that TNF and IL-1 released after injection of endotoxin participate in the mediation of endotoxin induced enhancement of nonspecific resistance and stimulation of hematopoiesis. PMID- 3317754 TI - Kupffer cell function in host defense. AB - High-resolution in vivo microscopic methods have been used to explore the responses to endotoxin of Kupffer cells in the livers of anesthetized mice, rats, hamsters, and guinea pigs under a variety of experimental conditions. These include studies of normal animals as well as of animals sensitized or tolerant to endotoxin, C3H/HeJ mice with a low response to endotoxin, mice rendered septic by cecal ligation and puncture, mice with Kupffer cells selectively destroyed by frog virus 3, and rats with portacaval shunts. The functional state of Kupffer cells was evaluated by measuring both the number of these cells per microscopic field that phagocytosed 1.0-micron latex particles and the rate at which individual Kupffer cells phagocytosed single latex particles. The intrahepatic density and level of activation of Kupffer cells were found to play a role in determining endotoxin sensitivity and to be involved, in conjunction with endotoxin, in the development of tolerance. All of these studies support the concept of a central role for Kupffer cells in host defense mechanisms and of the possible modulation and of this role by gut-derived endotoxins contained in the portal blood. PMID- 3317755 TI - Glucocorticoid-induced impairment of macrophage antimicrobial activity: mechanisms and dependence on the state of activation. AB - Experimental observations indicate that tissue macrophages deployed in great numbers at critical anatomic sites such as the liver, spleen, and lung are major targets for glucocorticoids compromising natural resistance of the host. Therapeutic concentrations of glucocorticoids appear to prevent destruction of microorganisms ingested by macrophages without interfering with phagocytosis, phagolysosomal fusion, and/or secretion of reactive oxygen intermediates. These findings indicate that at the cellular level the glucocorticoid target should be sought for in the nonoxidative armature of the phagocyte and that nonoxidative killing systems of resident tissue macrophages play an important role in natural resistance to opportunistic pathogens. Glucocorticoids do not prevent lymphokine induced activation of oxidative killing systems. Thus, lymphokines such as interferon-gamma can restore the microbicidal activity of macrophages functionally impaired by glucocorticoids. Counterbalance of the suppressive effect of glucocorticoids by lymphokines might only be possible, however, for pathogens susceptible to oxidative killing and not for microorganisms that are more resistant to reactive oxygen intermediates such as Aspergillus spores and Nocardia, opportunists that appear to be particularly associated with hypercortisolism. PMID- 3317756 TI - Mucosal innervation and control of water and ion transport in the intestine. PMID- 3317757 TI - The physiological function of nerve growth factor in the central nervous system: comparison with the periphery. PMID- 3317758 TI - Exercise training and its effect on the heart. PMID- 3317759 TI - ["After-reintervention" in ovarian cancer]. AB - Reoperation in ovarian cancer, following the initial surgery and the subsequent general chemotherapy, is currently agreed upon by most authors: it permits to evaluate the results of chemotherapy; when new lesions appear or lesions that have been left in place increase in size, re-operation enables excision of these lesions. But, after this surgical stage, opinions regarding treatment differ. In the case of complete remission, macroscopic and microscopic, it is possible to do nothing, to resume chemotherapy, to perform an abdomino-pelvic radiotherapy in limited doses. In the case of an incomplete microscopic remission and the persistence or aggravation of previous lesions, only a different type of chemotherapy is performed. Its chances of success are very remote. On the whole, chemotherapy is seldom used; chemotherapy may and must be used, especially in case of minor lesions. It must be emphasized that remission does not mean cure, and that incomplete remission does not obligatorily imply a poor prognosis. PMID- 3317760 TI - [Current treatment of endometrial cancer]. AB - The elements of the poor prognosis of endometrial cancer are well known: grade, degree of infiltration of the myometrium, isthmal localization, pelvic and lumboaortic node invasion. But the ways of improving the results are less known: extension of the surgical procedure and the combination surgery-radiotherapy do not improve survival, except in case of grade 3 tumors invading more than half of the myometrium. However, vaginal curietherapy decreases the number of vaginal recurrences. Additional progesterone therapy is the subject of conflicting results. Preventive therapy consists in avoiding exogenous hyper-estrogenias by an adequate prescription of hormone therapy, in an early diagnosis of hyperplasias in risk patients (obesity, dys-ovulation) by a test with progesterone-like substances and endo-uterine smears, and in treating these hyperplasias with a medical treatment, curettage or hysterectomy, according to the circumstances. PMID- 3317761 TI - [Complications of abdominal hysterectomy for benign gynecologic lesions. Apropos of 1,000 cases]. AB - The authors present a retrospective study of 1,000 total abdominal hysterectomies performed between 1969 and 1975, and they report the main complications. Early complications are dominated by: rare thrombo-embolic accidents (2.2%) since the advent of prophylactic heparin therapy; infectious complications, dominated by the abscess of the abdominal wall and asymptomatic urinary infections, and for which simple measures prevent resorting to prophylactic antibiotherapy. The role of the hysterectomy seems minimal in the occurrence of a prolapse or a stress related urinary incontinence: prolapses after hysterectomy (1.4%) seem more related to tissue aging than to the procedure which modifies very little the supporting system of the pelvis. A post-operative urinary incontinence is, most of the time, the result of an incomplete pre-operative work-up: failure to recognize a potential stress-related incontinence, or an incontinence secondary to an unstable bladder. Prolapse and incontinence must always be treated independently. In the psychological and sexual repercussion, age, ovariectomy and the distress related to the procedure, involving the heart of womanhood, seem to be the most important factors. PMID- 3317763 TI - [A rare complication of delivery: paralysis of the external popliteal sciatic nerve in the postpartum period]. AB - Paralysis of the lateral popliteal sciatic nerve has been known for quite some time, although it is a rare complication. It is probably a compression of the lateral popliteal sciatic nerve within the pelvis when the division of the sciatic nerve is high. But there are many hypotheses. PMID- 3317762 TI - [AIDS and pregnancy. Management of the seropositive pregnant female]. AB - The population of women, HIV positive, and susceptible to become pregnant, increases with time. Pregnancy must be contra-indicated in seropositive women. A termination of pregnancy must be performed in the first trimester and a therapeutic abortion may be offered but left to the mother's decision. Delivery must be carried out via natural passages in the absence of obstetrical dystocia. Nursing is contra-indicated. A number of precautions must be taken by the medical and para-medical personnel during obstetrical procedures. PMID- 3317764 TI - Spinal epidural hematoma without vertebral fracture or dislocation. Report of two cases and review of the literature. AB - Authors present 2 cases of spinal epidural hematoma without vertebral fracture or dislocation and review the literature. 169 fully described cases were found in literature and have been analyzed. Data confirm our opinion that the results of an early diagnosis is a better prognosis. The severity of preoperative neurological status is another important factor for the post-operative recovery, any way the absence of neurological function before the operation is not necessarily leading to a poor prognosis. Prognosis is usually poor when after the removal of the hematoma the dural pulsation is absent. PMID- 3317766 TI - Immunotoxicology: an overview. AB - It is now known that chemicals and drugs may induce selective toxicity which may alter the interactions between immunocompetent cells, especially if the toxicity occurs during proliferation and differentiation. Hence, a flexible panel of sensitive in vivo and in vitro assays has been developed and validated to assess the immunotoxicity or immunopharmacology of suspect agents in rodents. The combined use of such sequential analysis methods with host resistance assays can effectively define immunomodulation following exposure to xenobiotics. Methods development, refinement and validation will be an ongoing requirement because of our rapidly expanding knowledge of the cell biology of the immune system. Classic studies of the comparative preclinical toxicology of several immunosuppressive drugs have substantiated species similarities and have contributed significantly to the development of predictive rodent models for extrapolation to humans. Studies of immunopharmacology and immunotoxicity of cyclosporin A, for example, produced both the desired pharmacology and the undesired toxicity at similar doses in both rodents and humans. When species differences are observed during toxicology studies they are most probably due to differences in absorption, disposition, metabolism, excretion, or delivered dose at the target tissue, rather than major species differences in cellular targets or cell physiology. This assumption is the basis for using rodent species to predict the toxicity of chemicals and drugs under development.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317768 TI - The role of conventional pathology and toxicology in evaluating the immunotoxic potential of xenobiotics. AB - Investigating the immunotoxic potential of candidate drugs as part of a preclinical safety evaluation poses several problems. These include the need for practical, validated tests, the difficulty in establishing the toxicologic significance of positive findings, and a poor understanding of the predictive value such findings hold for drug effects in man. A key component of this investigation is the toxicologic profile generated through preclinical toxicity and safety studies. As this "routine" assessment becomes increasingly comprehensive and sophisticated, most toxicologically significant drug-associated effects are revealed. Such findings may serve as "triggers" for investigating possible immune mechanisms. Decisions to test specifically for immunotoxicity may also be influenced by the molecular structure and pharmacologic profile of the compound, as well as the intended use of the drug. Examples of such indications and follow-up studies are discussed in this review. We are presently poorly equipped to effectively screen drugs indiscriminately for an immunotoxic potential. We are better prepared, however, to investigate whether a drug associated change is due to an adverse effect on the immune system. This problem oriented approach to immunotoxicology challenges us as diagnosticians and immunopathologists, and requires a close working relationship among the toxicologic pathologist, the basic immunologist, the immunopharmacologist, and the clinician. PMID- 3317767 TI - Autoimmune mechanisms in patients and animal models. AB - Autoimmune diseases in patients and animal models are reviewed from the standpoint of immunoregulatory defects which predispose to autoimmunity. New information is provided about autoantibodies which indicates, on the basis of idiotypic cross-reactivity, that they may be closer to normal antibodies than previously thought. The importance of estrogens as a predisposing factor and androgens as a protective factor is discussed in relation to modulation of immune response by sex hormones. Similarities between autoimmune diseases and Acquired Immunodeficiency Syndrome (AIDS) are presented and new therapeutic approaches are discussed. PMID- 3317769 TI - Immune responses in the central nervous system. AB - Immune responses occurring within the central nervous system (CNS) have unique features attributable to the cellular and functional organization of the CNS and to the presence of the blood-brain barrier. Immune responses to viral infection of the CNS involve the participation of most immunologically important cells: T and B lymphocytes, monocytes, and natural killer cells. Normally, helper/inducer T lymphocytes are predominant in the cerebrospinal fluid (CSF) and in perivascular cuffs. After stimulation with antigen in tissue, these cells produce lymphokines, which stimulate mast cells to open capillary tight junctions, stimulate proliferation of lymphocytes, and attract monocytes and B lymphocytes. B lymphocytes mature into immunoglobulin-producing cells that secrete antibody locally which appears in the CSF. Cytotoxic/suppressor T lymphocytes, which damage antigen-containing cells, are predominant in immunopathologic reactions. In other situations the immune response targets normal CNS tissue rather than foreign antigens. Two general types of reactions may be seen: (1) vasculitis with destruction of vessel walls and infarction, and (2) perivascular inflammation with demyelination. The former is associated with immune complex deposition, and the cellular infiltrate includes polymorphonuclear leukocytes. The inflammation associated with perivenular demyelination is composed almost exclusively of mononuclear leukocytes. In the diseases for which pathogenetic mechanisms are understood, cells become sensitized to myelin constituents and induce local demyelinating lesions in which the damage is effected by macrophages. It is not clear whether macrophages are directed in this destructive effort by lymphokines or immunoglobulins or both. PMID- 3317765 TI - Quantitative histopathology in congenital myopathies. AB - A histo-morphometric analysis has been carried out in 23 muscle biopsies obtained from patients with congenital myopathies (6 nemaline m., 10 centronuclear m., 4 central core m., 3 multicore m.) in order to improve diagnosis and to confirm the data available in literature. No relationship has been found between the severity of the disease and the histo-pathological features as previously described. Nevertheless, the following pathological aspects diverge from previous reports: a) the absence of rods within the nuclei and of mitochondrial abnormalities in nemaline myopathy; b) the presence of type I fiber hypertrophy and of mitochondrial alterations in 30% of the patients with centronuclear myopathy; c) the presence of cores even in type II fibers, mitochondrial abnormalities, nucleosis, inflammatory cellular reaction and fibrosis in addition to the absence of rods in central core myopathy; d) the type I fiber hypertrophy in all patients with multicore myopathy. PMID- 3317770 TI - The immunopharmacology of immunotoxicology, and immunorestoration. AB - The first part of this paper focuses on the secondary immunodeficiencies caused by immunosuppressive drugs and environmental chemicals. The mechanism of action and the therapeutic effects of azathioprine, glucocorticosteroids, cyclophosphamide, cyclosporin A, and anticancer drugs will be discussed. The immunotoxic actions of benzene, polychlorinated and polybrominated biphenyls, tetrachlorodibenzo-paradioxin, polycyclic aromatic hydrocarbons, various insecticides, metals and abused drugs or drugs with side effects are also described. Immunorestorative approaches are discussed in the second part, based on our current knowledge of the immune system and the lymphokines and hormones involved in its function. The usefulness of thymic hormones, interleukin 2, macrophage growth factor/colony stimulating factor, and interferons as immunotherapeutic agents is considered. In addition, we address chemically defined drugs, such as levamisole, diethyldithiocarbamate, isoprinosine, muramyl dipeptides, azimexon, ciamexon, bestatin, tuftsin, and pyrimidinoles, and finally conclude that combined use of different immunostimulants may be the most effective way to treat the above mentioned immunodeficiencies. PMID- 3317771 TI - Mechanisms of immunomodulation by drugs. AB - Immunomodulators are those extrinsic or intrinsic substances which regulate or alter the scope, type, duration or competency of the immune response. This paper presents an overview of the mechanisms of immunomodulation, and discusses selected chemical and biologic substances which are capable of modifying the immune or biologic response of the organism. The immunopharmacology, including in vivo and in vitro assays, of a novel acridine immunomodulator is discussed. This low molecular weight compound is an immunomodulator and anti-cancer adjuvant, which has been shown to induce high levels of circulating interferon in mice, protect mice against lethal viral infection, stimulate macrophage and NK cell cytotoxicity for tumor cells, partially restore humoral and cellular immune responses in tumor bearing immunosuppressed mice, and augment the cytotoxic T lymphocyte response to syngeneic tumor cells. Tissue changes, consisting of presence of drug bound to lysosomal membranes, perivascular infiltrates in mouse liver, glomerular hyalinization in mouse kidney, and focal myocardial changes in mice are described. The compound persists intracellularly for extended periods of time in cells with high lysosomal activity. The tissue changes are interpreted to be a result of overloading of cellular mechanisms for elimination from the cells involved. PMID- 3317773 TI - Finding a way, when your patient has the will. PMID- 3317772 TI - Immunotoxicology today. AB - Immunotoxicology is a science which deals with the effects of physical and chemical agents and other toxic substances on the immune system. The discipline includes study of the detection, occurrence, adverse effects, and mechanisms of chemically-induced immune dysfunction. Many drugs and chemicals are known to compromise the immune response of a host which is extremely vulnerable and sensitive to perturbation by these agents. The consequences of immune dysfunction may be expressed in reduced resistance to infectious and neoplastic diseases, or enhanced hypersensitivity and autoimmunity. The immunomodulating profiles of xenobiotics may be diverse, involving several components of the immune system, or they may selectively compromise an individual compartment of the immune response. Many drugs and chemicals are known to result in immune disregulation in animals, but a paucity of information is available to indicate the effects of xenobiotics on systemic immunity in humans. Epidemiological studies and research designed to assess chemical immunomodulation in man are necessary to confirm animal data. Further, a definitive diagnosis for chemically-induced immune dysfunction must include several etiologies and body organ systems, since a triad of reciprocal interactions exists between the immune, endocrine, and central nervous systems. PMID- 3317774 TI - When your pregnant patient has diabetes. PMID- 3317775 TI - [Hyperostotic bone changes of the spine in diabetes mellitus]. AB - The diffuse idiopathic skeletal hyperostosis, especially with manifestation at the vertebral column, is often associated with metabolic disorders, such as diabetes mellitus or hyperuricaemia. Clinical, pathogenetic and radiological aspects are discussed. Routine thoracic x-ray give important informations on the diagnosis of this osteoplastic diathesis. PMID- 3317776 TI - Serum-to-saliva transfer of the immunoreactive insulin (IRI) in children with obesity associated with insulin-resistance. AB - Assuming that the serum-to-saliva transfer of insulin reflects internalization and re-cycling of the hormone in the membrane-located binding sites of salivary epithelial cells and that these cells have in obesity a'marked decrease in insulin receptor content, it has been postulated that insulin resistance in infantile obesity can be detected by the changes in the salivary immunoreactive insulin during the oral glucose tolerance test (OGTT). The study included 31 obese children and adolescents of both sexes, subjected to OGTT. Samples of blood and saliva were collected at 30, 60, 120, 180 and 240 minutes for determinations of glucose and IRI. The blood glucose values were generally normal whereas IRI was excessively high. The dynamics of salivary IRI was similar (easy peak followed by slow descent) with the mean serum values but lower by about two thirds, and the peak was 30-60 minutes delayed. The serum IRI values correlated significantly with the saliva ones at all time-intervals except for the 30-minute ones. The serum IRI values were significantly lower at the 30-minute time interval, whereas the salivary IRI were the lowest (and of borderline significance) at the 60-min. time interval. The mean glucose/kg doses given orally were not significantly different in the two groups. It was concluded that a hormonal activity detectable by IRI assay through the PEG separation method does exist, with a concomitant variation of serum-to-saliva transfer as shown by the OGTT test. It was also concluded that since the salivary values are lower, the direction of the flow is from serum to saliva and not the reverse. Finally, on the basis of our data, an "in situ" synthesis of insulin (hormonogenic exocrinism) can not be ruled out. PMID- 3317777 TI - [Frequency and typology of disorders associated with mental retardation in Galicia]. PMID- 3317779 TI - [On the anniversary of the journal Sbornik Lekarsky]. PMID- 3317778 TI - [Benign metastatic ameloblastoma. A case report and review of the literature]. AB - A 78 year old woman with a history of maxillary ameloblastoma from age of 38 years was found on routine examination to have a pulmonary image of the balloon release type. The lesion was atypical with respect to its clinical tolerance and slow progression. Pathology of several nodules removed by surgical lung biopsy confirmed the benign nature and identity of the maxillary and pulmonary lesions. The diagnosis was therefore pulmonary metastases from a benign ameloblastoma. The age of the patient and slow course of the lesion, combined with the absence of any functional disorder, was the basis for the decision not to operate on the pulmonary lesion. The concept of benign metastatic ameloblastoma is analyzed and findings compared with data in the literature. PMID- 3317780 TI - The postcholecystectomy syndrome: diagnostic and therapeutic strategy. PMID- 3317781 TI - Role of endogenous prostaglandins in protection of rat gastric mucosa by tripotassium dicitrate bismuthate. AB - Gross and microscopic examination of rat gastric mucosa demonstrated that intragastric administration to rats of tripotassium dicitrate bismuthate (TDB), a colloidal bismuth compound, protects against gastric lesions induced by 85% ethanol. Indomethacin, a prostaglandin synthetase inhibitor, significantly blocked the gastric mucosal protective effect of TDB. The release of gastric mucosal prostaglandins was greater in animals treated with TDB than in control animals, both time- and dose-dependently. These results seem to indicate involvement of prostaglandins in the action of TDB. PMID- 3317783 TI - Value of sonography in obstructive jaundice. Limitations of bile duct caliber as an index of obstruction. AB - The diagnostic value of sonography was assessed in 176 patients with jaundice who had a final diagnosis on the basis of surgery, autopsy, liver biopsy, endoscopic retrograde cholangiopancreatography, and serum tests positive for hepatitis A and B. Obstructive (n = 113) versus nonobstructive jaundice (n = 63) was diagnosed with a sensitivity of 91% and a specificity of 95%. Nine of the 10 false negatives had choledocholithiasis. Application of stricter criteria for common duct (CD) dilatation than the one used of CD greater than or equal to 8 mm to greater than or equal to 12 mm would have lowered the sensitivity from 91% to 84%. On the basis of these criteria the predicted level of obstruction would have shifted from distal to proximal in 36% of the patients. Choledocholithiasis was more often associated with decreasing bilirubin values than malignancy: 55% versus 9% (p less than 0.05). The present study indicates that intermittent obstruction, usually associated with choledocholithiasis, constitutes the main problem in detection of obstructive jaundice. Diameter criteria used for diagnosing dilatation of the CD may greatly influence sonographic accuracy. PMID- 3317782 TI - Serum group I pepsinogens during insulin and pentagastrin tests in unoperated and vagotomized duodenal ulcer patients. AB - The level of serum group I pepsinogens (PG I) has been studied during the conventional insulin-pentagastrin test in 29 duodenal ulcer (DU) patients before and 2 months after proximal selective vagotomy (PSV) and in 31 unoperated DU patients. The mean basal serum PG I level was 191.6 +/- 15.4 micrograms/l (mean +/- SEM) before and 143.7 +/- 24.0 micrograms/l after PSV. A significant increase in mean serum PG I above the initial value was found both in unoperated DU patients and in patients after PSV 1 h after insulin injection. In 29 PSV patients the mean serum PG I showed a paradoxical decrease during the 2nd h after insulin injection, and the mean postvagotomy serum PG I 2 h after insulin injection was significantly (p less than 0.01) lower than the respective preoperative value in the same patients, and the value was close to the basal serum PG I. The low level of serum PG I 2 h after insulin injection in vagotomized patients may reflect the deprivation of the reduced store of PG I in the absence of normal vagal tone. Both the basal serum PG I and serum PG I response during insulin-induced hypoglycaemia showed an overlap between unoperated and vagotomized DU patients. Therefore, serum PG I analyses during the insulin test cannot replace acid secretion tests in the assessment of the completeness of vagotomy. PMID- 3317784 TI - A controlled randomized trial of budesonide versus prednisolone retention enemas in active distal ulcerative colitis. AB - Sixty-four patients with active distal ulcerative colitis participated in a multicentre, randomized, investigator-blind trial to compare the effect of budesonide enema, 2 mg/100 ml, with prednisolone disodium phosphate enema, 31.25 mg/100 ml. Budesonide is a new potent corticosteroid with a rapid first-pass elimination. The patients were treated for 4 weeks, and the efficacy of the drugs were evaluated by sigmoidoscopy, histology, and subjective symptoms after 2 and 4 weeks. After 4 weeks of treatment 16 of 31 patients (52%) receiving budesonide enema had healed endoscopically, compared with 8 of 33 (24%) (p = 0.045) receiving prednisolone enema. Budesonide was superior to prednisolone in terms of both significantly improved sigmoidoscopic and histologic scores and subjective symptoms evaluated by visual analogue scales. The patients receiving prednisolone had a significant depression of endogenous cortisol levels during the treatment period, but not the patients receiving budesonide. Budesonide enema seems to be a promising therapy for active distal ulcerative colitis and causes no adverse reactions. PMID- 3317785 TI - Effects of monoclonal anti-T cell antibodies on rat cardiac allografts. AB - Monoclonal antibodies reactive with different T lymphocyte antigens were administered to rats receiving heart allografts. Ox 19 antibodies (directed to the rat Ly 1 equivalent) and Ox 8 antibodies (directed to the rat CD8 equivalent) both prolonged graft survival, whereas W3/25 (anti-CD4), Ox 6 (anti-Ia), and W3/13 (anti-pan T) antibodies did not affect graft rejection. Immunohistological studies were carried out on spleen and graft specimens in order to analyse further the mechanisms behind the prolongation of graft survival. The observed almost complete absence of Ox 8-reactive cells in the spleen after treatment with Ox 8 antibodies corroborates earlier observations that injection of moderate amounts of Ox 8 antibodies leads to complete elimination of suppressor/cytotoxic T cells from peripheral lymphoid organs and blood. The present data on graft survival therefore both support the notion that suppressor/cytotoxic T cells are involved in graft rejection, and suggest that these cells are not the only ones involved. An unexpected and as yet unexplained finding was that Ox 8-reactive molecules were found in large numbers on various inflammatory cells as well as on certain myocytes in the grafted hearts that had experienced a prolonged graft survival due to treatment with Ox 8 or Ox 19 antibodies. PMID- 3317786 TI - Expression of restricted immunoglobulin isotypes in plasmacellular hyperplasia after allogeneic bone marrow transplantation. AB - Plasmacellular hyperplasia in lymphoid tissue was found in 4 out of 9 patients 1 6 months after allogeneic bone marrow transplantation as treatment for leukaemia. In the plasma cell populations, 13-85% expressed a single immunoglobulin light and heavy chain isotype (monotypic Ig expression). DNA analysis, using a DNA probe specific for heavy chain JH gene segments and for light chains, did not reveal the presence of clonally restricted B lymphocytes. The patients' sera lacked homogeneous immunoglobulins. We conclude that plasmacellular hyperplasia found after allogeneic bone marrow transplantation represents a polyclonal B-cell expansion- with a restriction in Ig isotype. PMID- 3317787 TI - Biological activity in sensitized guinea pigs of MPB 70, a protein specific for some strains of Mycobacterium bovis BCG. AB - MPB 70 is a protein found in large quantities in the culture filtrate (CF) of the Tokyo and some other strains of Mycobacterium bovis BCG, and it has a remarkable degree of specificity for these strains. We estimated the molecular weight of MPB 70 to 22,000 by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS PAGE). SDS-PAGE and immunoblotting showed that MPB 70 was present in high quantities in CF from BCG Tokyo, that it could be also demonstrated in BCG Copenhagen, and that it was absent in CF from M. tuberculosis H37Rv. When the purified MPB 70 preparation used in the present study was run in SDS-PAGE, blotted and stained with a polyclonal rabbit or a monoclonal mouse anti-MPB 70 antibody, several bands in addition to the main 22 kDa band were seen, indicating a tendency of the MPB 70 molecules and/or fragments thereof to form very stable aggregates with themselves. The biological activity of MPB 70 was studied in groups of guinea pigs sensitized with live BCG of the Tokyo and Copenhagen strains. Guinea pigs from both groups developed reactivity to tuberculin PPD as assessed by skin tests and lymphocyte stimulation tests with peripheral blood or lymph node lymphocytes. In addition, a strong and persistent reactivity to MPB 70 was demonstrated in the BCG Tokyo group with both methods. Guinea pigs sensitized with the Copenhagen strain were only weakly reactive to MPB 70. Skin reactions in guinea pigs that had been repeatedly tested with MPB 70 and tuberculin were compared with reactions in animals tested only once. Reactions to MPB 70 in BCG Tokyo sensitized guinea pigs were suppressed by repeated tests, whereas tuberculin reactions were boosted by the interim tests. The levels of specific anti-MPB 70 antibodies were higher in BCG Tokyo- than in BCG Copenhagen sensitized guinea pigs. MPB 70 has a high degree of specificity and is a strongly immunogenic protein, which may prove useful in studies of mycobacterial immunology. PMID- 3317788 TI - [Air conditioning plants--construction from the viewpoint of the planning engineer]. PMID- 3317790 TI - [Presence and significance of Legionella in power station cooling systems]. PMID- 3317789 TI - [Legionella in air conditioning plants from the viewpoint of the facility builder]. PMID- 3317791 TI - [Clinical aspects and prognosis of Legionella infections]. PMID- 3317792 TI - [Epidemiologic aspects of Legionella infection]. PMID- 3317794 TI - [Is there a strategy for the prevention of Legionella infection? Experience in the Netherlands]. PMID- 3317793 TI - [Antigen detection in legionellosis: significance for early diagnosis]. PMID- 3317795 TI - [The level of technology and new developments in hot water preparation]. PMID- 3317796 TI - Reconstruction of patellar cartilage defects with free periosteal grafts. An experimental study. AB - The osteo-chondrogenic potential of free periosteal grafts was investigated within the knee joint in 26 rabbits aged four to six weeks. A total of 36 knee joints were operated on. The grafts were stripped from the medial side of the right tibia and sutured on the articular surface of the patella, from which the cartilage had been totally excised to the subchondral bone. In 16 knees the graft was sutured with the cambium layer towards the subchondral bone and in eight knees the fibrous layer faced the bone. In the control group of twelve knees the patellar articular cartilages were excised and no periosteal transplant was grafted to the patellar articular surface. In the transplantation group cartilage formation could be seen already one week after the operation. There were no marked differences between the series with the cambium layer facing the subchondral bone or the group with the fibrous layer facing the bone. At 20 weeks the hypertrophied cartilage had thinned and resembled normal joint cartilage. In the control group the histological picture resembled osteoarthritis. PMID- 3317797 TI - Reconstruction of the mandible with a free iliac bone graft and preformed temporomandibular joint prosthesis. Case report. AB - The use of preformed vitallium TMJ-prosthesis in combination with a microvascular iliac bone graft is an alternative method for hemimandibular reconstruction. It has several advantages compared with earlier described methods, and we have used it successfully in two cases. PMID- 3317798 TI - Soft tissue infection around a skin penetrating osseointegrated implant. A case report. AB - A case is reported where a female patient with bilateral otosclerosis received a bone-anchored and skin-penetrating titanium implant on which a hearing aid was mounted to improve conductive hearing loss. The patient developed an infection that did not cease despite intensive local treatment and skin-grafting. Eventually the implant was removed. The histological examination of the interface between implant and surrounding bone and soft tissues showed an inflammatory reaction in the superficial parts of the soft tissues whereas the deeper portions of the soft tissues and all of the bone tissue were free of inflammation. It is concluded that it is possible to maintain osseointegration in spite of an aggressive soft tissue infection around the implant. PMID- 3317799 TI - Clinical experience with tenoxicam: a review. AB - Tenoxicam, a new non-steroidal anti-inflammatory agent (NSAID) with a long half life, has been evaluated in a series of nine clinical studies over the last five years. Early studies against naproxen in osteoarthrosis (OA) and against ibuprofen in rheumatoid arthritis (RA) suggested the drug was efficacious in both of these conditions. A series of faecal blood loss studies showed that the drug produced less gastrointestinal blood loss than aspirin and comparable blood loss to piroxicam. Comparisons of tenoxicam and piroxicam in OA and ankylosing spondylitis (AS) showed both drugs to be approximately equally efficacious. A pharmacokinetic study showed a half-life for tenoxicam of 45 h in synovial fluid when the half-life was 42 h in plasma. A single and multiple oral dose pharmacokinetic study of tenoxicam in the elderly showed no progressive accumulation with peak plasma levels of 2.6 micrograms/ml after the single dose and 12.4 micrograms/ml at steady state. PMID- 3317800 TI - Efficacy and tolerability of tenoxicam--an overview. AB - One-hundred and thirty-three clinical studies have been conducted with tenoxicam in patients with rheumatoid arthritis, osteoarthrosis, extra-articular rheumatism, ankylosing spondylitis and acute gouty arthritis. Its efficacy has been demonstrated in double-blind comparative studies against placebo, and dose finding studies have found the optimal dose to be 20 mg. Most trials comparing tenoxicam with another NSAID have used piroxicam, an earlier oxicam derivative which also has a long half-life. In general, efficacy was similar in both drugs with a trend in favour of tenoxicam. The tolerability of tenoxicam has also been studied in detail. In short-term studies 11% of patients receiving 20 mg tenoxicam and 18% on 40 mg tenoxicam experienced side-effects (p less than 0.01), as did 20% treated with 20 mg piroxicam (p less than 0.01 against 20 mg tenoxicam). In long-term studies clinical tolerability of 20 mg tenoxicam was found to be superior to that of 20 mg piroxicam. The types of side-effects encountered were mainly gastrointestinal disturbances, followed in frequency by skin rashes. However, all side-effects were generally mild and reversible. The efficacy of tenoxicam is clearly established and its tolerability is acceptable with a 20 mg dose. Tenoxicam thus seems a promising drug and a useful addition to the therapeutic armamentarium. PMID- 3317801 TI - Clinical chronopharmacology with special reference to NSAIDs. AB - Both drug disposition and effects vary as a function of dosing time. A chronotherapeutic study was therefore undertaken with sustained-release indomethacin (ISR) to quantitate any potential therapeutic gain from an optimal time of administration. Four studies were performed on a total of 517 patients with osteoarthritis of the hip or knee. Each patient took the same dose of ISR at 8:00 am for one week, 12:00 noon for one week and 8:00 pm for one week. In addition to conventional evaluation criteria, patients performed self-rating of pain on visual analogue scales. Overall, there were 44 withdrawals (29 associated with morning ingestion). At group level, time-dependent differences in drug effectiveness were small, although large inter-individual differences were documented. Evening ingestion was most effective in patients with predominant nocturnal or morning pain; conversely, morning or noon ingestion was most effective in patients with maximum afternoon or evening pain. A four-fold improvement in tolerance and a doubling of analgesic effectiveness resulted from varying the ingestion time. Chronotherapeutic studies should therefore include careful longitudinal documentation of pertinent marker rhythms such as self rating of pain. PMID- 3317802 TI - New criteria for the diagnosis of ankylosing spondylitis. AB - Criteria for ankylosing spondylitis are useful for two main purposes. First, to provide unity of diagnosis in population surveys; secondly, in the field of therapeutic assessment. This paper is concerned with criteria used largely in the former role, i.e. as an epidemiological tool. Critical formulation and subsequent evaluation of criteria is important if a realistic measure of disease prevalence is to be obtained. The New York criteria have provided the general currency for diagnosis epidemiologically in recent years, but their value, in their originally published form, has been questioned for various reasons. Attempts have been made to improve these criteria or to suggest alternatives. Although increased sophistication of the original New York criteria has doubtless been achieved, the position regarding the diagnosis of ankylosing spondylitis continues to represent a challenge. The main concern is that the present "index of truth" for the disease, radiological sacroiliitis, is all too often a delayed feature, presenting only after pain has been present for some time. A second problem is the difficulty in diagnosing with confidence the early changes of sacroiliac sclerosis and erosion, and the degree of intra- and inter-observer error arising from these changes. Newer techniques such as radioisotope scintigraphy and computerised tomography (CT) are unlikely to replace the traditional pelvic radiograph. The way forward is more likely to be in the direction of how existing data are processed rather than what is used to obtain them. In this vein, suitable mathematical/biological models coupled with computer technology could provide realistic tools through a system of probability weighting of existing criteria. PMID- 3317803 TI - Recent insight into the mechanism of gastrointestinal tract ulceration. AB - Non-steroidal anti-inflammatory drugs (NSAIDs) are well known for their gastrotoxic and duodenotoxic effects. A few years ago the introduction of a sustained-release form of indomethacin led to an apparently high incidence of jejunal and ileal perforations. Recently, Langman in England was able to demonstrate that the intake of some NSAIDs is related to an enhanced incidence of ileal and jejunal perforations in rats and dogs, even after parenteral or rectal administration. We have been able to show that: (i) There is a correlation between biliary excretion of NSAIDs or ester conjugates of these drugs and ileal perforations in rats. (ii) In contrast to dogs there is no (ibuprofen) or little enterohepatic circulation (diclofenac and diflunisal) in man. This agrees with the low incidence of ileal and jejunal ulcers reported with these drugs in contrast to indomethacin or piroxicam. (iii) Reduction of enterohepatic circulation of indomethacin in rats by dietary means reduces the degree of small intestinal erosions and ulcerations in parallel with the reduced biliary excretion of the drug. It may be safely assumed that the enterohepatic circulation of some NSAIDs, particularly indomethacin and piroxicam, may contribute to the reported incidence of ileal and jejunal damage caused by these drugs. These drugs may, on the other hand, have clearcut advantages as well. PMID- 3317804 TI - It is wise to prescribe NSAIDs with modern gastroprotective agents? AB - The administration of non-steroidal anti-inflammatory drugs (NSAIDs) leads to mucosal lesions in the upper gastrointestinal tract. Furthermore, NSAIDs increase the risk of ulcer bleeding and perforation, but the overall risk of fatal complications is relatively small (about 21 per one million prescriptions). Therefore, in asymptomatic patients, it is not justified to prescribe NSAIDs together with gastroprotective agents. The following recommendations can be given with respect to the management of peptic lesions in patients taking NSAIDs: (i) Fibre endoscopy should be performed even when there are relatively mild symptoms since mucosal lesions in rheumatic patients under NSAIDs produce minor or no symptoms. (ii) "Modern" NSAIDs might produce less gastric lesions than aspirin. (iii) Rheumatic patients with peptic disorders should be treated with an H2 antagonist. (iv) After complications such as ulcer bleeding or after rapid recurrence of peptic lesions, maintenance treatment with an H2-antagonist is advisable. PMID- 3317805 TI - Methodology of validation of criteria for SLE. AB - The 1971 preliminary criteria for the classification of systemic lupus erythematosus (SLE) were revised and updated to incorporate new immunological knowledge and improve disease classification. The 1982 revised criteria include fluorescence antinuclear antibody (FANA) and antibody to native DNA and Sm antigen. Some criteria involving the same organ systems were aggregated into single criteria. Raynaud's phenomenon and alopecia were not included because of low sensitivity and specificity. The new criteria were 96% sensitive and 96% specific when tested with SLE and control patient data gathered from 18 participating clinics. When compared with the 1971 criteria, the 1982 revised criteria showed gains in sensitivity and specificity. Development of criteria sets is inherently circular, since the standard of evaluation must consist of the clinical diagnosis. Validation of the diagnosis over time can reduce but not eliminate the circularity. Selection of controls also influences sensitivity and specificity and, ideally, criteria should be developed with controls who represent particularly difficult problems of discrimination. Because the low "prior probability" of the diagnosis in many populations will result in a large number of false positives, preference in general should be for specificity over sensitivity. The 1982 criteria were developed from 177 patients with SLE and 162 control patients from 18 institutions using the next age-, race- and sex-matched patient seen as the control whenever possible. Results of a training sample were validated against a test sample of patients and against 500 patients from other databanks. PMID- 3317806 TI - Diagnostic criteria in rheumatoid arthritis. AB - For rheumatoid arthritis (RA), criteria have been developed for classification of groups of patients in population surveys, selection for therapeutic trials, inter institutional comparison of patients, evaluation of diagnostic trials, diagnosis of RA in individual patients, estimation of disease frequency, and assistance in determining prognosis. The American Rheumatism Association (ARA) "Criteria for the Classification of Rheumatoid Arthritis-Diagnostic Criteria for Rheumatoid Arthritis" were published in 1958 and have become a standard. These criteria are empiric and attempt to incorporate reasonable combinations of sensitivity and specificity. Despite the recognition that these criteria should be expected to change with improved knowledge, no further modification has been published. Other criteria such as the ARA "Proposed Criteria for Rheumatoid Arthritis" represent an important effort to encourage uniformity in definitions and use of the term remission. Yet it is well to remember that they have never been tested in prospective studies and are considered preliminary. The Co-operative Systematic Studies in Rheumatic Diseases, when studying slow-acting anti-rheumatic drugs, have chosen to use clinical endpoints such as 50% improvement in joint tenderness and swelling counts (or scores) rather than combined variables which include morning stiffness and changes in laboratory variables. This approach permits the true assessment of drug effects. In summary, current criteria have served us well. Nonetheless, we should not become complacent and should always question their sensitivity, specificity and application. PMID- 3317807 TI - Criteria for the classification of osteoarthritis of the knee and hip. AB - The Osteoarthritis (OA) Criteria Subcommittee of the American Rheumatism Association set out to develop (a) a classification of OA that includes recognised subsets; and (b) subsets of OA identified by a combination of clinical and laboratory features. For the purposes of classification, OA should be specified if of unknown origin (idiopathic, primary) or if related to a known medical condition or event (secondary). Clinical criteria for classification of idiopathic OA of the knee were developed through a multicentre study group involving 130 patients with OA and 107 comparison patients. Comparison diagnoses included rheumatoid arthritis (RA) and other painful conditions of the knee exclusive of referred or para-articular pain. Variables from the history, physical examination, laboratory test results and radiographs were used to develop sets of criteria that serve different investigative purposes: clinical examination (sensitivity 89%; specificity 88%); clinical examination and laboratory tests (sensitivity 88%; specificity 93%); clinical examination, laboratory tests and radiographs (sensitivity 94%; specificity 88%). In contrast to prior classification criteria, the proposed criteria utilise decision trees or algorithms. Clinical criteria for classification of idiopathic OA of the hip are under development. Comparison groups are comprised of patients with other rheumatic diseases (e.g. RA), periarticular pain (e.g. trochanteric bursitis) and referred pain (e.g low back pain). From a method of opinion sampling, OA of the hip may be suggested by a combination of clinical criteria including the following: age greater than 40 years, weight-bearing pain, pain relieved by sitting, antalgic gait, decreased painful range of motion, a normal erythrocyte sedimentation rate (ESR) and a negative rheumatoid factor test. PMID- 3317808 TI - The fibrositis syndrome: diagnosis, differential diagnosis and pathogenesis. AB - The fibrositis syndrome represents a clinically definable entity, which is characterised by spontaneous pain, especially in the lumbar and cervical region, and more rarely in other movable parts, multiple tendomyosis, tendinitis and insertion tendinitis, as well as a wide variety of functional syndromes, vegetative symptoms and psychological disturbances. The course of the illness is rather variable; its commencement can be slow to develop or acute, initially presenting a localised clinical picture similar to a lumbar or cervical condition, and gradually, or in jumps, showing a deterioration accompanied by a generalisation of complaints. Various factors are probably instrumental in triggering off the fibrositis syndrome. The most important ones are emotional stress whereby symptoms of fear, depression, etc. lead to muscle tension and insertion tendinitis. Somatic factors such as malposition of the spinal column, may also contribute towards the manifestation of the clinical picture. The so called secondary fibrositis syndromes should be defined from the point of view of differential diagnosis; they can develop within the framework of inflammatory rheumatic conditions, through infections and endocrinopathy. Differential diagnosis is very difficult considering depression alongside pain in the movable parts and "psychogenic rheumatism". Smooth transitions are in existence. Polymyalgia rheumatica and polymyositis, which produce similar clinical pictures, must be differentiated from the fibrositis syndrome. PMID- 3317809 TI - Undifferentiated arthritis and spondylarthropathy as a major problem of diagnosis and classification. AB - Epidemiologically-based studies have shown that 20-50% of all cases of early arthritis cannot be classified. More recent data came from experiences with an outpatient clinic especially for early arthritis. Of 149 patients with inflammatory rheumatic disease, 39 (26%) were diagnosed as undifferentiated arthritis and 22 (15%) had a probable diagnosis. Therefore, despite diagnostic progress in recent years, only half of all cases can be diagnosed definitely. Follow-up studies of patients with HLA-B27 positive arthritis and undifferentiated spondylarthropathy show the difficulties of early diagnosis and the heterogeneity of disease course and prognosis. Early diagnostic criteria combining the result of the HLA-B27 test with history, symptoms, erythrocyte sedimentation rate and radiological spinal signs can predict or exclude the development of ankylosing spondylitis (AS) at an early stage of the disease in three-quarters of patients, but the diagnosis of AS should not be excluded before 5 to 10 years' observation. PMID- 3317810 TI - Diagnostic methods for evaluation of activity in inflammatory rheumatic disease. AB - Inflammation is one of the cardinal clinical signs of rheumatic disease, although the pathogenesis of inflammation may differ from one such disease to another. The role played by inflammation in the diverse irreversible changes in the structure of the musculoskeletal system is probably also quite different. Despite this proviso, one of the prime tasks of clinical rheumatology is precise measurement of inflammation, because the information so acquired makes it possible to draw conclusions about the activity of the disease and assess the effect of therapeutic measures. Measurement of inflammation consists, fundamentally, of quantifying the classic symptoms of pain, swelling, heat, redness and limitation of movement. All attempts to measure inflammation by means of a single parameter, for instance of a humoral type (acute phase proteins), or by a single method (scintiscanning with radionuclides or thermography) have failed sooner or later. The only practical approach is to measure a number of subjective and objective parameters. With all these methods, sensitivity and reproducibility are crucial to success. In rheumatoid arthritis, the major rheumatic disease, various authors have compiled indices on the basis of individual parameters: number of painful joints, number of swollen joints, grip strength, duration of morning stiffness, a number of function tests, erythrocyte sedimentation rate (or other humoral inflammation parameters), a special pain measurement (pain scale) and subjective evaluation of the rheumatic condition by the physician and the patient. PMID- 3317811 TI - Methods of clinical and biological assessment of rheumatoid arthritis. AB - Inflammation has long been recognised as notoriously difficult to measure both in clinical practice and in the laboratory. Of all the cardinal features of inflammation, pain relief is really what the patients want, and among disabled persons, rheumatic patients are the only ones who must cope with chronic pain. The rheumatologist, however, is also interested in other parameters that are thought to reflect improvement of the inflammatory process. The methods used to clinically assess rheumatoid arthritis (RA) should share the following four parameters: validity, sensitivity, reliability and simplicity. Unfortunately, at present, no single ideal method is capable of accurately reflecting disease activity in RA. The measurement of pain relief by the visual analogue scale, the determination of the Ritchie index and the duration of morning stiffness, plus patient assessment of global response should be enough to detect clinical activity of the drug in RA. If we are working with slow-acting drugs or so-called disease modifying antirheumatic drugs (DMARDs), it should be appropriate to include X-ray analysis and laboratory tests in the evaluation. A reduction in the number of fresh erosions and/or the healing of present erosions can give reliable information on the capacity of the drug to really modify the course of the disease. At present, measurement of the erythrocyte sedimentation rate and of acute phase serum proteins seems to offer the best available assessment during early weeks of therapy. The other biological tests are of limited value in reflecting or predicting a beneficial clinical response to DMARDs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317813 TI - Advanced computing for medicine. PMID- 3317812 TI - Placebo, belief, and health. A cognitive-emotional model. PMID- 3317814 TI - Artificial chromosomes. PMID- 3317815 TI - [Controlling the position of the central venous catheter using ultrasound]. AB - After the insertion of a central venous line it is necessary to identify the correct position by making an x-ray of the chest. It was demonstrated in this study that it is possible to identify the correct intravascular position of the central venous catheter by ultrasonic evaluation. PMID- 3317816 TI - [Sonography of jugular vein thrombosis]. AB - Based on a case report, angiographic and sonographic findings of jugular venous thrombosis are discussed. On the strength of the sonographic demarcation of anatomical and functional soft tissue structures of the neck ultrasound should rank first in the diagnostic hierarchy after clinical investigation. PMID- 3317817 TI - [Stress sonography of the lower urinary tract]. AB - Mild caliectasis in patients with occult ureteropelvic obstruction can cause difficulties in the decision on operative or non-operative measures. In such situations diuresis renography, diuretic radionuclide urography and perfusion pressure flow studies (Whitaker test) can be very useful. Furosemide-sonography is a new, non-invasive method demonstrating functional subpelvic obstruction. Standardised conditions before and after application of furosemide are necessary. This new diagnostic method is demonstrated based on a evaluation in 22 patients presenting radiological evidence of minor ureteropelvic obstruction. PMID- 3317818 TI - Tooth damage in field voles, wood mice and moles in areas polluted by fluoride from an aluminum reduction plant. PMID- 3317819 TI - Diethylhexylphthalate as an environmental contaminant--a review. AB - Di(2-ethylhexyl)phthalate (DEHP) is a priority pollutant in several countries; annual production amounts to 3-4 million tonnes. Approximately 95% is used as a plasticizer in polyvinylchloride (PVC). DEHP is emitted to the environment during the production of plastics and plastic products, during their use and after disposal. In the environment, physico-chemical degradation of DEHP is practically non-existent. Biodegradation occurs readily under aerobic conditions (t1/2 = 2-4 weeks), but not under anaerobic conditions. The acute toxicity of DEHP to mammals is low. Many subchronic and chronic effects have, however, been identified. The most important of these are: influence on the liver and energy metabolism, teratogenicity, adverse effects on male reproductive organs, carcinogenicity and influence on the immune system. On the basis of figures concerning human exposure, most of these effects are not likely to occur. With respect to carcinogenicity the situation is uncertain, especially for some risk groups. The ecotoxicology of DEHP is especially relevant for aquatic communities where data are contradictory: several authors have found adverse effects on Daphnia and fish species after exposure to the present environmental concentrations; others, however, produced less alarming results. Emissions of DEHP can be reduced by the biological treatment of wastewater and waste gas, the use of alternative plasticizers in PVC or the substitution of other plastics for PVC. PMID- 3317820 TI - Reduction of mutagenicity of municipal wastewaters by land treatment. AB - The disposal of complex mixtures such as wastewater on agricultural lands poses known and unknown environmental risks. Mutagens may be introduced into the ecosystem and perhaps concentrated by crop plants or leached into ground water supplies. The purpose of this study was to determine the biological effect of a mutagenic wastewater before and after application to soil. An XAD-8 methanol extract of wastewater from the municipal sewage treatment facility at Sauget, IL, was a potent, direct acting mutagen when assayed with Salmonella typhimurium. One and 3 ml of extract were brought up to 10 ml volumes with water and added to 10 g of sterile or nonsterile native clay loan. These mixtures were incubated at room temperature for 0, 24 and 48 h. After separation of solid and liquid portions by filtration, dichloromethane was added to extract the organic fractions from each component. Solvent extractions were evaporated to dryness under vacuum and brought up in DMSO. Tests for mutagenic activity were conducted using Ames strain TA98. Addition to the soil for greater periods of time decreased the mutagenic activity. The solid component exhibited greater mutagenic activity than the liquid. PMID- 3317821 TI - Concentrations of polycyclic hydrocarbons in airborne particles in The Netherlands and their correlation with mutagenicity. AB - The concentrations of 15 polycyclic aromatic hydrocarbons (PAH) were determined in ambient air particles sampled at four sites in an urban and industrialized area in The Netherlands, and at one site near the coast (generally upwind). The contributions of sources in the area to the background concentrations as measured at the coastal site, were investigated. The temporal and spatial variation of the PAH profile, i.e. the relative concentrations of the 15 individual PAH, were also investigated. Variation of the PAH profile was predominantly determined by volatility. The variation of the profile of the less-volatile PAH was small compared with the variation these PAH had in common. Slight indications for the influence of differing sources and chemical conversion on the profile were found. The role of chemical conversion was suggested by a linkage of the variation of the profile with differences in reactivity between the PAH. The similarity of the profiles at the background coastal site and at the sites influenced by local sources was striking. The PAH concentrations showed weak-to-moderate correlations with mutagenicity. The correlations increased if the results of samples taken during periods with wind from one sector were considered. PMID- 3317822 TI - Alzheimer's drug trial put on hold. PMID- 3317823 TI - Immunity to schistosomes: progress toward vaccine. AB - Among the major parasitic infections, schistosomiasis may be the most promising candidate for human vaccination. Information about mechanisms of immunity, gained mainly from experimental models but likely to be relevant to human infection, indicates a dynamic balance between protective and regulatory (blocking) mechanisms. Besides cell-mediated responses leading to macrophage activation, antibody-dependent cell-mediated cytotoxicity systems involving precise antibody isotypes and nonlymphoid cells (mononuclear phagocytes, eosinophils, and platelets) appear to be essential effectors of immune attack. The slow development of immunity in humans seems related to the production of antibodies that cross-react with schistosomulum surface antigen and block the binding of antibodies of the effector isotype. Schistosomes that survive in the bloodstream and produce chronic infections may evade the immune system as a result of intrinsic changes in membrane susceptibility and of transient expression of target antigens; at other stages of the parasite life cycle, cross-reactive molecules may be secreted that play an essential role in the induction of immunity. Several schistosome proteins have been characterized as candidates for vaccination. Among these, an antigen of 28 kilodaltons has been cloned and shown to be immunogenic in humans and protective in mice, rats, and baboons. PMID- 3317824 TI - The T cell receptor. AB - The primary structure of T cell receptor proteins and genes is well understood. Immunologists are now trying to understand the properties of these interesting molecules. Evidence suggests that T cell alpha beta receptors recognize a complex of an antigen-derived peptide bound to one of the cell-surface products of the major histocompatibility complex (MHC) genes. It is likely that alpha beta receptors and MHC proteins have coevolved to have some affinity for each other. During T cell development in the thymus, cells bearing self-reactive receptors are deleted by the mechanisms of tolerance, and cells are preferentially allowed to mature if they bear receptors that will be able to recognize antigen plus self MHC after they have become full-fledged T cells. Some explanations for these phenomena have been tested, but no satisfactory theory can yet be proposed to account for them. PMID- 3317825 TI - Development of the primary antibody repertoire. AB - The ability to generate a diverse immune response depends on the somatic assembly of genes that encode the antigen-binding portions of immunoglobulin molecules. In this article, we discuss the mechanism and control of these genomic rearrangement events and how aspects of this process are involved in generating the primary antibody repertoire. PMID- 3317826 TI - Evolutionary and somatic selection of the antibody repertoire in the mouse. AB - The repertoire of antibody variable (V) regions has been subject to evolutionary selection, affecting both the diversity of V region genes in the germline and their expression in the B lymphocyte population and its subsets. In ontogeny, contact with an antigen leads to the expansion of B cells expressing antibodies complementary to it. In a defined phase of B cell differentiation, new sets of V regions are generated from the existing repertoire through somatic hypermutation. Cells carrying advantageous antibody mutants are selected into the memory compartment and produce a stable secondary response upon reexposure to the antigen. PMID- 3317827 TI - The chicken B cell compartment. AB - A very unusual molecular mechanism is involved in generating the preimmune repertoire in the chicken bursa of Fabricius. A unique rearranged V gene is diversified through a program of segmental gene conversion with a pool of noncoding pseudogenes being used as donors. A specifically committed progenitor that originates in the embryonic bursa is responsible for long-term maintenance of the B cell population. Both these properties and the characteristics of the peripheral B cell compartment are discussed in terms of the evolution of the T and B immune systems. PMID- 3317828 TI - Redesigning nature's poisons to create anti-tumor reagents. AB - Immunotoxins are conjugates of cell-reactive antibodies and toxins or their subunits. In this report, the chemistry, biology, pharmacokinetics, and anti tumor effects of first generation immunotoxins; the preparation of improved second generation immunotoxins that display greater anti-tumor efficacy; and the role of genetic engineering in creating third-generation immunotoxins are discussed. PMID- 3317829 TI - Gallo gets itchy feet, looks to Academe. PMID- 3317830 TI - Efflux of chloroquine from Plasmodium falciparum: mechanism of chloroquine resistance. AB - Chloroquine-resistant Plasmodium falciparum accumulate significantly less chloroquine than susceptible parasites, and this is thought to be the basis of their resistance. However, the reason for the lower accumulation of chloroquine was unknown. The resistant parasite has now been found to release chloroquine 40 to 50 times more rapidly than the susceptible parasite, although their initial rates of chloroquine accumulation are the same. Verapamil and two other calcium channel blockers, as well as vinblastine and daunomycin, each slowed the release and increased the accumulation of chloroquine by resistant (but not susceptible) Plasmodium falciparum. These results suggest that a higher rate of chloroquine release explains the lower chloroquine accumulation, and thus the resistance observed in resistant Plasmodium falciparum. PMID- 3317831 TI - The molecular control of blood cell development. AB - The establishment of a cell culture system for the clonal development of blood cells has made it possible to identify the proteins that regulate the growth and differentiation of different blood cell lineages and to discover the molecular basis of normal and abnormal cell development in blood forming tissues. A model system with myeloid blood cells has shown that (i) normal blood cells require different proteins to induce cell multiplication (growth inducers) and cell differentiation (differentiation inducers), (ii) there is a hierarchy of growth inducers as cells become more restricted in their developmental program, and (iii) a cascade of interactions between proteins determines the correct balance between immature and mature cells in normal blood cell development. Gene cloning has shown that there is a family of different genes for these proteins. Normal protein regulators of blood cell development can control the abnormal growth of certain types of leukemic cells and suppress malignancy by inducing differentiation to mature nondividing cells. Chromosome abnormalities that give rise to malignancy in these leukemic cells can be bypassed and their effects nullified by inducing differentiation, which stops cells from multiplying. These blood cell regulatory proteins are active in culture and in the body, and they can be used clinically to correct defects in blood cell development. PMID- 3317832 TI - A complete mapping of the proteins in the small ribosomal subunit of Escherichia coli. AB - The relative positions of the centers of mass of the 21 proteins of the 30S ribosomal subunit from Escherichia coli have been determined by triangulation using neutron scattering data. The resulting map of the quaternary structure of the small ribosomal subunit is presented, and comparisons are made with structural data from other sources. PMID- 3317834 TI - The approaching era of the tumor suppressor genes. AB - Genes that can inhibit the expression of the tumorigenic phenotype have been detected by the fusion of normal and malignant cells, the phenotypic reversion of in vitro transformants, the induction of terminal differentiation of malignant cell lineages, the loss of "recessive cancer genes," the discovery of regulatory sequences in the immediate vicinity of certain oncogenes, and the inhibition of tumor growth by normal cell products. Such tumor suppressor genes will probably turn out to be as, if not more, diversified as the oncogenes. Consideration of both kinds of genes may reveal common or interrelated functional properties. PMID- 3317833 TI - Bacteriophage M13 procoat protein inserts into the plasma membrane as a loop structure. AB - The major coat protein of bacteriophage M13 is synthesized as a precursor, the procoat, with a typical leader (signal) sequence of 23 residues at its NH2 terminus. A fusion protein that contains the NH2-terminal 141 residues of cytoplasmic ribulokinase and all but the first ten residues of M13 procoat was made. The fusion protein inserts into the plasma membrane of Escherichia coli and is processed by leader peptidase to give rise to a leader peptide of 155 residues and the mature coat protein of 50 residues. The NH2-terminus of the leader peptide remains in the cytoplasm and is protected from protease added to the medium outside of the cell. This indicates that M13 procoat inserts into the membrane as a loop structure and that the NH2-terminus of a leader peptide remains within the cytoplasm during membrane insertion. PMID- 3317835 TI - Phagocytosis of Candida albicans enhances malignant behavior of murine tumor cells. AB - Murine tumor cells were induced to phagocytize either Candida albicans or group A streptococcal cells. The presence of microbial particles within the tumor cell cytoplasm had no effect on in vitro tumor cell growth. However, when Candida albicans-infected tumor cells were injected into syngeneic mice, they formed tumors that grew faster, invaded the surrounding normal tissue more rapidly and metastasized more rapidly than control tumor cells. Tumor cells infected with group A streptococcal particles did not grow faster or show increased malignant behavior. These data indicate that the in vivo behavior of malignant tumor cells can be modulated by microbial particles, which are often present in the microenvironment of the growing tumor. PMID- 3317836 TI - Is alcoholism a disease? PMID- 3317837 TI - Walter E. Massey: president-elect of AAAS. PMID- 3317838 TI - The structure of sister minichromosome DNA before anaphase in Saccharomyces cerevisiae. AB - The role of DNA topology in holding sister chromatids together before anaphase was investigated by analyzing the structure of a small circular minichromosome in cell cycle (cdc) mutants of the yeast Saccharomyces cerevisiae. In the majority of cells arrested after S phase but before anaphase, sister minichromosome molecules are not topologically interlocked with each other. The analysis of the ploidy of minichromosomes in cells that are released from arrest demonstrates that the sister molecules are properly segregated when the cell cycle block is removed. Therefore, sister minichromosome molecules need not remain topologically interlocked until anaphase in order to be properly segregated, and topological interlocking of sister DNA molecules apparently is not the primary force holding sister chromatids together. PMID- 3317839 TI - Production, characterization, and use of monoclonal antibodies directed against human blood platelet thrombospondin: immunologic comparison with human endothelial and fibroblast thrombospondins. PMID- 3317840 TI - Thrombospondin in clinical disease states. PMID- 3317841 TI - Interactions of thrombospondin with cells in culture: rapid degradation of both soluble and matrix thrombospondin. PMID- 3317842 TI - Role of thrombospondin in hemostasis and cell adhesion. PMID- 3317843 TI - Osteoporosis: the state of the art in 1987: a review. AB - Osteoporosis affects approximately 15 to 20 million people in the United States and is the underlying cause of 1.3 million new fractures per year in people over age 45. The more common risk factors recognized in this disorder are older age, female sex, white race, physical inactivity, and early menopause. We now have available equipment which can measure bone density at various sites. These include single- and dual-photon densitometry, and single and dual quantitative computed tomography. These procedures are a quantum improvement over plain x-ray in the assessment of the severity of osteoporosis, but measurement at one site may not reflect the density at other sites. The value of these techniques in screening the general population for osteoporosis remains to be demonstrated. They are valuable when used to monitor patients longitudinally to assess the progression of disease and the effects of specific therapeutic regimens. There is no established effective therapy for osteoporosis so prevention is the goal. The effectiveness of different programs of physical activity in preventing bone loss and fractures is unknown but isotonic exercises three times a week for thirty minutes is recommended. There is general agreement that adequate calcium intake is important for maintenance of skeletal integrity, but there is no proof that a high dietary calcium alone will prevent osteoporosis. Estrogen therapy clearly prevents the accelerated bone loss which occurs in all white women at the time of menopause, but the question still remains who should be started on estrogens, and within what period of time after menopause are estrogens still useful in preventing postmenopausal bone loss, and for how long do we continue hormone therapy. Many questions are left to be answered but at least now osteoporosis is recognized as a major medical problem and much research is being done to answer the above questions. PMID- 3317844 TI - Methodologies for the measurement of bone density and their precision and accuracy. AB - Radiographic methods of determining bone density have been available for many years, but recently most of the efforts in this field have focused on the development of instruments which would accurately and automatically measure bone density by absorption, or by the use of x-ray computed tomography (CT). Single energy absorptiometers using I-125 have been available for some years, and have been used primarily for measurements on the radius, although recently equipment for measuring the os calcis has become available. Accuracy of single energy measurements is about 3% to 5%; precision, which has been poor because of the difficulty of exact repositioning, has recently been improved by automatic methods so that it now approaches 1% or better. Dual energy sources offer the advantages of greater accuracy and the ability to measure the spine and other large bones. A number of dual energy scanners are now on the market, mostly using gadolinium-153 as a source. Dual energy scanning is capable of an accuracy of a few percent, but the precision when scanning patients can vary widely, due to the difficulty of comparing exactly the same areas; 2 to 4% would appear to be typical. Quantitative computed tomography (QCT) can be used to directly measure the trabecular bone within the vertebral body. The accuracy of single-energy QCT is affected by the amount of marrow fat present, which can lead to underestimations of 10% or more. An increase in marrow fat would cause an apparent decrease in bone mineral. However, the precision can be quite good, 1% or 2% on phantoms, and nearly as good on patients when four vertebrae are averaged. Dual energy scanning can correct for the presence of fat, but is less precise, and not available on all CT units. QCT of the femoral neck has recently been attempted, but presents difficulties that make it unlikely to become widely accepted. Recently there has been much interest in using gamma cameras for dual energy bone density measurements. Although this can present some difficulties, several groups reportedly have overcome them, and this technique may have more widespread application in the future. PMID- 3317845 TI - Single- and dual-photon absorptiometry in osteoporosis and osteomalacia. AB - Single- and dual-photon absorptiometric methods have been used in the past to identify populations at risk for bone loss, to define the osteoporotic syndrome in terms of bone mass, and to evaluate treatment regimens to prevent bone loss. Technical improvements have made these procedures available for the nontraumatic measurement of bone mineral in the management of the individual patient suspected of having osteoporosis or other bone loss. This requires a different approach to data interpretation because decisions have to be made on the basis of a single measurement. Osteoporosis and osteomalacia cannot be distinguished by bone mineral measurements because both are characterized by a decrease in content of bone mineral. Bone mineral measurements can be used to assess the risk of fracture and, with it, the severity of bone loss. This allows treatment decisions to be made. Repeated measurements made under well-defined conditions allow estimation of long-term rate of bone loss and monitoring of treatment effect. PMID- 3317847 TI - Radionuclide imaging in metabolic and systemic skeletal diseases. AB - Radionuclide imaging with Tc-99m diphosphonates is not an effective method for detecting or ruling out most osteoporotic diseases including senile osteoporosis or accelerated postmenopausal osteoporosis, and the slow loss of bone tissue generally remains undetected by this modality. Nonetheless, it frequently surpasses or supplements radiographic findings in evaluating the focal complications of metabolic bone disease, including fractures, microfractures, stress fractures, vertebral compressions, Milkman-Looser zones, aseptic necrosis, and acute infarction. In contrast to its secondary role in osteoporosis, bone imaging is of prime importance in investigating hypercalcemia, because the major cause of this abnormality is skeletal metastatic malignancy. In defective bone mineralization due to hyperparathyroidism or osteomalacia, a general increase in diphosphonate skeletal uptake is detected more frequently than radiographic abnormalities. However, normal skeletal images do not rule out metabolic bone disease. Biochemical testing is more reliable in detecting primary hyperparathyroidism. On the other hand, in renal osteodystrophy, biochemical abnormalities are variable and bone imaging is helpful in assessing the severity of skeletal involvement, but not its etiology. Many methods of quantitating the kinetics of Tc-99m diphosphonates have been explored, such as plasma clearance, bone-to-soft-tissue ratios, 24-hour total body retention and 24-hour urinary excretion. None of these have been widely accepted. The value of bone imaging is established in other systemic diseases, most notably in Paget's disease, hypertrophic pulmonary osteoarthropathy, sickle cell disease, fibrous dysplasia, and sympathetic dystrophy. PMID- 3317846 TI - Quantitative computed tomography in assessment of osteoporosis. AB - Computed tomography (CT) has been widely investigated and applied in recent years as a means for noninvasive quantitative bone mineral determination. The usefulness of computed tomography for measurement of bone mineral lies in its ability to provide a quantitative image and, thereby, measure trabecular, cortical, or integral bone, centrally or peripherally. For measuring the spine, the potential advantages of quantitative computed tomography (QCT) over dual photon absorptiometry (DPA) are its capability for precise three-dimensional anatomic localization providing a direct density measurement, and its capability for spatial separation of highly responsive cancellous bone from less responsive compact bone. Currently, QCT vertebral mineral determination has been implemented at over 800 sites encompassing a wide geographic distribution and a wide array of commercial scanners. With a world-wide distribution of approximately 8,000 advanced CT body scanners, the capability now exists for widespread application of vertebral bone mineral determination by quantitative computed tomography. These QCT techniques for vertebral mineral determination have been used to study skeletal changes in osteoporosis and other metabolic bone diseases. Longitudinal and cross-sectional bone mass measurements have been obtained at the University of California at San Francisco (UCSF) in over 3,000 patients seen clinically or on research protocols. The results presented here illustrate the use of QCT spinal mineral measurement in the delineation of normal age-related bone loss, in the evaluation of estrogen effects on bone, in the assessment of fracture threshold and risk, and in the study of the effects of various exercise regimens on bone mineral and the determination of relationships to other techniques of bone mineral measurement. The laboratory and clinical results presented herein indicate that QCT provides a reliable means to evaluate and monitor the many forms of osteoporosis and the various interventions aimed at ameliorating this condition. The greatest advantages of spinal QCT for noninvasive bone mineral measurement lie in the high precision of the technique, the high sensitivity of the vertebral trabecular measurement site, and the potential for widespread application. PMID- 3317848 TI - Parathyroid imaging: its current status and future role. AB - The management of autonomous (primary or tertiary) hyperparathyroidism is controversial for two important reasons: (1) Diagnosis of primary or tertiary hyperparathyroidism (as distinct from reactive or secondary hyperparathyroidism) has been revolutionized in the past 20 years as a result of routine inclusion of serum calcium concentration assays in serum multiautomated analysis, now obtained routinely for both hospitalized as well as ambulatory patients. The prevalence of primary hyperparathyroidism in the general population has appeared to rise as a consequence of this assay and the enhanced detection of this disease. This situation has confused the management of hyperparathyroidism since most patients now present with asymptomatic disease, and the need for surgical treatment is controversial in asymptomatic individuals. (2) Primary hyperparathyroidism usually is caused by hypersecretion of parathyroid hormone by an autonomously functioning parathyroid adenoma. In a small percentage of cases, multigland hyperplasia is present. In experienced hands, surgical removal of an adenoma within the thyroid bed cures the hyperparathyroidism 90% to 95% of the time, without performance of a preoperative procedure to localize the adenoma. Approximately 10% of parathyroid tissue is ectopic in location, however. Furthermore, approximately two thirds of "missed" adenomas are within the thyroid bed. Reexploration in the event of a failed operation therefore is not an uncommon occurrence. Parathyroid localization procedures clearly are indicated in patients with primary hyperparathyroidism who have evidence of persistent disease after a failed attempt at surgical cure. In patients first presenting with primary hyperparathyroidism, the need for a localization procedure is less clear, since surgery appears to be successful much of the time without it. Regardless of the nature of the above controversies, surgery for autonomous hyperparathyroidism continues, and localization procedures become more popular. Preoperative localization procedures such as angiography and venography with venous sampling for parathormone are cumbersome and invasive. Noninvasive tests to localize the parathyroid glands have emerged in the past 10 years, including dual tracer radionuclide scintigraphy with 201-thallous chloride and 99m-technetium pertechnetate, high-resolution computer tomography, and fine parts ultrasonography. Dual tracer scintigraphy with thallium and technetium is reported to have a localization sensitivity of 70%-90%. False-negative studies occur primarily in patients with small adenomatous or hyperplastic glands.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3317850 TI - Biology of chronic lymphocytic leukemia. AB - Chronic lymphocytic leukemia (CLL) is a clonal proliferation of mature-appearing, but maturationally immature B cells; T cells are rarely involved. Most data suggest that CLL cells are frozen at an early step in maturation; this can be overcome by several techniques such as in vitro incubation with tumor promotors. Although B-CLL involves B cells, and abnormal T cell function is common, its etiology is uncertain. Oncogene abnormalities and retroviral infection have been reported in rare cases of CLL; their role in more typical cases is unknown. PMID- 3317849 TI - Applications of dose intensity to problems in chemotherapy of breast and colorectal cancer. AB - Studies were analyzed to show the correlation of response with dose intensity of single-agent 5-fluorouracil (5-FU) against colorectal cancer, multiagent CMF (cyclophosphamide, methotrexate, 5-FU) regimens against advanced breast cancer, and adjuvant therapy in stage II breast cancer. In colorectal cancer studies, subgroups in which 5-FU was given by intravenous (IV) bolus, infusion, and orally were analyzed. One study reported delivered dose levels after reductions for toxicity. This allowed calculations of received dose intensity for the three dose levels, and comparison with projected dose intensities. The data suggest that the dose-intensity response line is steep, once a threshold dose intensity has been surpassed. An increase of only 100 mg/m2/wk of received dose intensity of 5-FU increased the response rate from 20% to 29%, which in relative terms was an increase of almost 50%. Received dose intensity may correlate with response, not only in groups of patients, but also in individual patients, and this may, in fact, be the most important application of the concept of dose intensity. PMID- 3317851 TI - B cell development in chronic lymphocytic leukemia. PMID- 3317852 TI - Relevance of murine models in elucidating the origin of B-CLL lymphocytes and related immune-associated phenomena. PMID- 3317853 TI - Prognostic significance of karyotypic abnormalities in B cell chronic lymphocytic leukemia: an update. AB - Cytogenetic analyses by G-banding and/or Q-banding techniques of leukemic B cells were performed in 102 patients with chronic lymphocytic leukemia (CLL), including six with prolymphocytic leukemia (PLL), one with hairy cell leukemia (HCL), and one with Waldenstrom's macroglobulinemia (WM) from 1979 through 1983. Follow-up after cytogenetic study ranged from 24 to 70 months. Seventeen patients had stage 0, 10 had stage I, 31 had stage II, and 44 had stage III or IV. Adequate metaphases were obtained for karyotypic analysis in 86 (84%) of 102 patients. Of these 86 patients with adequate metaphases, 43 had normal karyotypes (50%) and 43 had abnormal karyotypes (50%), of which trisomy 12 was the most frequent. Ten patients had trisomy 12 as the sole abnormality, 14 had trisomy 12 in combination with other abnormalities, and the remaining 19 had other abnormalities without trisomy 12. Abnormal karyotypes were more frequently associated with patients with advanced stages than those with early stages of the disease. Response rate to chemotherapy was significantly higher in patients with normal karyotypes than in those with abnormal karyotypes. Of eight patients who subsequently developed Richter's syndrome, seven initially had complex karyotypic changes with or without trisomy 12. These observations suggest that the chances of development of Richter's syndrome in CLL patients with multiple chromosome changes may be much higher than in those with either simple trisomy 12 or a normal karyotype. Mean frequency of abnormal metaphases was significantly higher in patients with complex trisomy 12 in combination with other changes than in those with trisomy 12 as the sole abnormality.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317854 TI - Prognostic and therapeutic advances in CLL management: the experience of the French Cooperative Group. French Cooperative Group on Chronic Lymphocytic Leukemia. PMID- 3317855 TI - Mechanisms of infection in chronic lymphocytic leukemia. PMID- 3317856 TI - Hematologic complications of alcohol abuse. PMID- 3317858 TI - The liver in acquired immune deficiency disease. PMID- 3317857 TI - Hemostasis in liver disease. AB - Patients with liver disease have a wide range of coagulation problems. Patients with parenchymal liver disease are likely to have reduced synthesis of proteins and inhibitors (Table 1), whereas dysfibrinogenemia and hyperplenism develop in cirrhosis. Patients with cholestasis without cirrhosis often have elevated levels of fibrinogen, Factors V and VIII, probably due to reduced clearance of proteins (Table 1). The hemostatic defects in liver disease are complex and multifactorial. They are often unpredictable and the mechanisms elusive. Developments in molecular genetics and immunology have shown that both qualitative and quantitative abnormalities of coagulation proteins and protein inhibitors contribute to the abnormalities in liver disease. Future research will certainly result in a better understanding of these defects and more effective therapy. PMID- 3317859 TI - Liver disease after human marrow transplantation. PMID- 3317860 TI - Hepatotoxic effects of the anabolic/androgenic steroids. PMID- 3317861 TI - Hepatic toxicity of drugs used for hematologic neoplasia. PMID- 3317862 TI - Malignant lymphomas: pathology of hepatic involvement. PMID- 3317863 TI - Differential diagnosis of jaundice in lymphoma patients. PMID- 3317864 TI - Renal carcinoma: clinical aspects and therapy. PMID- 3317865 TI - Renal cell carcinoma: radiological diagnosis and staging. PMID- 3317866 TI - Other malignant neoplasms of the renal parenchyma. PMID- 3317867 TI - Benign space-occupying conditions of the kidneys. PMID- 3317868 TI - Neoplasms of the renal collecting system. PMID- 3317869 TI - Interventional radiology in renal neoplasms. PMID- 3317871 TI - The influence of traditional medicine in shaping medical care practices in Vietnam today. AB - In Third World countries today one must have a knowledge of and appreciation for traditional medical beliefs and practices if one is to understand each nation's particular adaptation to a modern health care system. Taking the particular example of Vietnam, we discuss the current formal health care system and the traditional herbal medicines, dietary regulations and dermal techniques which are still important elements in the peoples' choice and perception of health care. There is then a discussion of how traditional medical beliefs and practices have shaped the practice of health care in Vietnam today. PMID- 3317870 TI - Afterthoughts on Haldane. PMID- 3317872 TI - The pneumatic theory of female Warao herbalists. AB - Among the Warao Indians of eastern Venezuela herbalism is a nonritualized occupation practiced by women. As a medical practice herbalism complements the ritual occupation of shamanism practiced by men. But whereas Warao herbalism is governed by a theory of supernatural causation of illness mystically brought about by contagion, Warao shamanism is a theory of supernatural causation of illness attributed to spirit aggression and object intrusion. According to herbalist theory, pathogenesis results from odoriferous agents that invade the body regions (head, thorax, abdomen) of the victim. Here they expand in the form of fetid gas, producing clinical symptoms by affecting the organs and the soul of a particular region. Treatment of disease by herbal medicines is allopathic. Upon administration the remedy transforms into an aromatic gas which is denser, hence more powerful, than the noxious gas. This enables the therapeutic air to displace the pathogenic air. A cure is achieved after both gases have left the body, returning the patient to an inodorous state. This study presents physical, cultural and ideational data as they relate to health, disease and herbal medicine among the Warao. The status and role of the female herbalist are described. Warao herbal curers make use of more than 100 plant species from which they prepare 259 remedies. The collecting and processing of materia medica conform to a meticulous protocol which is transmitted from mother to daughter through informal methods of training. Treatment of 'symptom-oriented' diseases is effected through the administration of ablutants, ingestants and/or inhalants. While practicing medicine in a nonritual way Warao herbalists are nevertheless directly aligned with the Mother of the Forest.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317873 TI - Why is humoral medicine so popular? AB - The hot/cold system is perhaps the most widely known medical belief system in the world. I propose that the wide acceptance of hot/cold ideas is due to the fact that they provide a particularly simple, economic coding for common human experience, such as hypothermia, heatstroke, and fevers. Coding of foods as heating or cooling can be understood in terms of a system of sensory cues that make the foods appear hot or cold. This paper deals primarily with data from Chinese culture. PMID- 3317874 TI - The hot and cold in Mesoamerican indigenous and hispanicized thought. AB - While the influence of Hispanic humoral medicine on 16th century and subsequent Mesoamerican indigenous thought is undeniable, recent reexaminations of Aztec, Mayan and Zapotec medicinal and cosmological systems suggest indigenous roots in hot-cold concepts. This paper reviews and compares the growing evidence for independent hot-cold classifications in Mesoamerica, and suggests certain common lines of syncretism in structure, content and applications. Drawing on a model from cognitive psychology previously applied by the author to hot-cold data of the Mitla Zapotec, the paper explores its utility for cross-cultural comparison of hot-cold category development. PMID- 3317875 TI - Hot and cold in women's ethnotherapeutics: the American-Mexican West. AB - The purpose of this paper is to report the current status of hot/cold principles in the ethnotherapeutics of women of southwestern U.S.A., northwestern Mexico. The paper presents a secondary data analysis from three studies, including a data bank of Women's Ethnotherapeutic Agents derived from literature searches, interviews of women in research of Mexican American Grandmothers as Health Care Advisors, and research in the historical roots of the ethnotherapeutic agents used in contemporary domestic medicine. This report presents women's home remedies, what these remedies are believed to do, and the sources of this domestic therapy knowledge. It concentrates on persistence and change in one aspect of the theoretical base of these remedies, their humoral complexional classification. In the analysis of data from these studies, continuation of aspects of the hot/cold theory is demonstrated. It is suggested that the persistence is tacit, with the lack of articulated knowledge of humoral theory today stemming from the content of contemporary remedy books. Instead of arguing either diffusion or independent invention, commonly held ethnophysiological concepts are offered as a possible explanation for the persistence of hot and cold therapy practices. PMID- 3317876 TI - Hot and cold as an explanatory model: the example of Bharuch district in Gujarat, India. AB - The concepts of hot and cold are important in disease etiologies and systems of food classification in many parts of the world. A number of writers on hot-cold beliefs have assumed that the classification of foods is the central element in this system of beliefs, and that it is consistent. They have then proceeded to explain these beliefs in symbolic or adaptive terms, generalizing from systems of classification which have only local applicability. More recently a number of writers have recognized the importance of intracultural variation in the hot-cold classification of foods, and have turned their attention to revealing the underlying principles of classification. But because food classifications are only consistent within a limited geographical area, if they are consistent at all, these 'general principles' are only applicable to a single area or limited cultural context. In this article I describe the hot-cold system in a rural area of the Indian state of Gujarat. I show that by proceeding from the classification of diseases, and not from the classification of foods, it becomes possible to reveal certain underlying classificatory principles which also appear to be applicable to other manifestations of the hot-cold system. These principles seem to be based on the phenomena which accompany temperature changes in nature. Finally I suggest that hot-cold beliefs should be seen as an explanatory model which seeks to make the puzzling and threatening phenomena of disease and death more acceptable and predictable. PMID- 3317877 TI - AIDS as a social phenomenon. AB - AIDS as a new lethal and at present incurable sexually transmitted disease is already having remarkable social repercussions not yet fully explicit and hence it can be termed a social phenomenon. Political, behavioural, economic and legal reactions and social responses such as stigmatization, changes in the sick role and the growth of voluntary organizations and international collaboration are described. Communication, education and information aspects of AIDS are considered using material from the press and it is clear that a massive educational approach to modify behaviour must be the basis for a control programme. PMID- 3317878 TI - AIDS as a social phenomenon. AB - AIDS is an infectious but also a social disease. Next to the major epidemiological question on the natural history of AIDS, important problems have been posed in various fields of social, political, ethical and legal areas extending far beyond traditional medical interest. These create polarization among public, politicians, press and also among physicians. As the situation changes, the gravity of the disease has become more prominent and the consensus on the effectiveness of the means used and proposed is not yet achieved. Social phenomena depend on societal values, the perception of fear and menace of disease to individuals versus perception of the collectivity. Among major risk groups this fear influenced by various ideologies and societal goals, is more pronounced than the response of the society warrant. It is not one of condemnation but of tolerance, and sympathy and has been directed not toward deterring people in engaging in certain kinds of sexual behaviour, but toward doing this with minimum risk. Conflict between the perception of rights (individual versus collective) is bound to grow although it is easy to distinguish in law legitimate epidemiological needs and their possible misuse. The present position of the main risk groups is changing in various ways. The reluctance of society to address openly issues of sexual behaviour has disappeared. There is rapidly accumulating knowledge on the social influence in the spread of the disease, but as yet, scant information on the influence of social factors on the control efforts and effectiveness of preventive behavioural strategies. The effects AIDS will have on the complex social structures in general, on health structures in particular, and on the problems which might shape future attitudes, values and morals cannot be delineated with any degree of precision but only vaguely guessed as the disease progresses now and into the next century. PMID- 3317879 TI - Cultural issues in maternal and child health and nutrition. AB - Social science research on cultural issues in maternal and child health has stressed some aspects and neglected others. From the perspective of both policy applications and theory development, new research efforts could profitably be directed to the following areas: cultural adjustments to changed energy and nutrient requirements in pregnancy and lactation; maternal illness; the mother/infant dyadic interaction; emic views of growth and development; determinants of infant and young child feeding; management of childhood illnesses; popular medicine and childhood illnesses; intra-household food distribution; household composition and maternal and child health; and macrolevel/microlevel linkages and health. PMID- 3317880 TI - Stress and disease: the concept after 50 years. AB - Although there is no generally accepted definition of 'a state of stress' in biological or social systems, biologists and social and behavioral scientists continue to use the term. They communicate meaningfully by describing and measuring sources of stress and their observed effects on living organisms, without attempting to define the intervening variables. Biologists and medical scientists tend to be concerned with sources of stress that are concrete and observable, and can otherwise be considered as 'causes' of illness and injury; social and behavioral sciences tend to be concerned with sources of stress that represent information that arises from outside the person and is mediated by higher centers of the central nervous system. It is clear that such "psychological stresses" can lead to alterations of internal functions down to the biochemical level, and that they are potential 'causes' of disease; but they do not usually act independently of other mechanisms. The central thesis of the stress theory of disease, as elaborated by Cannon and Selye, appears to have been thoroughly established. Disease can be regarded as a phenomenon that occurs when an agent or condition threatens to destroy the dynamic steady state upon which the integrity of the organism depends; and the manifestations of disease appear to be, in large measure, manifestations of the organism's efforts to adapt to, and to contain, threats to its integrity. In this sense, all diseases are to some extent disorders of adaptation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3317881 TI - The study of stress and disease: some developments and requirements. AB - This article considers the study of stress in relation to the onset, course, and outcomes of disease, and is divided into three parts. The first part describes the relationships between personality, environmental stressors, and disease. The second focuses specifically on the requirements that must be fulfilled to allow for the conclusion that there is a relationship between stress and the onset of disease. Finally, in the third part models describing the relationship between stress and the course of disease or medical outcome are presented and discussed. PMID- 3317882 TI - The political abuse of medicine and the challenge of opposing it. AB - A fundamental aim of medicine is to protect and promote health. The practice of medicine has, however, been used to promote political aims which may be detrimental to health. The article attempts to isolate the ways in which political abuses may interfere with good medical practice: by allowing health policies to be influenced by undemocratic political considerations; by using health services to reward or punish political supporters or opponents; by direct medical involvement in political acts which contradict accepted medical ethics; and by the support which conventional medical practises give to perpetuating inequalities in health and social services. Each of these is examined with the use of a number of examples. The ways in which medical personnel have opposed the political abuse of medicine is explored by a brief review of the opposition of Chilean doctors to torture, the involvement of South African doctors in opposing the abuse of health services in perpetuating apartheid, and the growing medical movement in opposition to nuclear war. Some comments concerning the monitoring of a multitude of medical disciplines which are open to political abuse are made. The purpose of the paper is primarily to stimulate debate around this important issue and it does not attempt to provide a comprehensive review of the political abuse of medicine. PMID- 3317883 TI - Toward a comprehensive evaluation of alternative medicine. AB - Recently, there has been an increasing interest from both the health consuming public and governments towards medical systems other than regular cosmopolitan medicine. Whether alternatives from various medical resources is justified needs careful, in-depth investigation. The objectives of assessing alternative medicine (AM) are first discussed as this has a direct bearing on whether or not an impartial assessment can be made. The different titles given to AM are then investigated with a preference given to traditional medicine (TM) rather than AM and others. Different approaches, including time trials, the problem of treating acute-chronic and functional-organic diseases, integrated assessment and an overall and comprehensive approach, are then discussed. Descriptions are based mainly on background material from China, offering an experience of several decades in this regard, which serve as a base for further discussion. PMID- 3317884 TI - Problems in the evaluation of alternative medicine. AB - Evaluation of alternative medicine poses paradigmatic as well as procedural difficulties. Difficulties faced by the scientific community in accepting the 'world view' of acupuncture and homeopathy are described, and possibilities for evaluating alternative medical paradigms are considered. A selection of randomized controlled trials are reviewed and weaknesses in protocol and method identified. PMID- 3317885 TI - Improving the fit between social science and health care practice: suggested next steps for the researcher. AB - The aim of this paper is to assess social science research on health and illness in order to enhance its utility for the practical world of health care. The premise is that both social scientists and health care professionals share complementary intellectual interests in fostering empirical research on health and illness. Barriers built into the orientation and reward structure of both professions impede collaborative efforts. In our view, however, the advantages of working on these problems outweigh the disadvantages. Toward this end, we suggest several substantive and methodological directions to be encouraged and then discuss prospects for collaboration from the perspectives of social science, medicine and the wider society. We see opportunity for comparative work, synthesis and the systematic nesting of findings into a knowledge base that will permit generalizations. Our goal is to improve the fit between social science and health practice by increasing the relevance of social science findings for the delivery of care and the training of health care professionals. In addition, hopefully, our suggestions will advance social research independent of its impact on the health field. PMID- 3317886 TI - Social and psychological care before and during hospitalization. AB - Social and psychological care may be viewed as a series of technical procedures; or it may be seen as a complex set of services rendered by the hospital to its potential and actual patients. In the latter case, an understanding of the structure, the political and economic, as well as the ideological context of the hospital is necessary. A review of studies on the preparation of children for hospitalization, conducted in the theoretical framework of behavioural medicine, provides a significant set of data. Material available from practising clinical social workers in United States hospitals, provides equally useful reports, albeit of far greater contextual nature than the first. The paper proposes that in post-behaviouristic and post-phenomenological times an integration of frames of reference, designs and methodologies ought to be attempted, notwithstanding serious dissonances, disagreements, and professions-bound interests. PMID- 3317887 TI - Social and psychological care before and during hospitalization. AB - Hospitalisation is a stressful experience, especially for children. While maternal separation has been seen as a major cause of distress among younger children, a broader perspective is required to understand the links between the individual, familial, professional, institutional and structural levels of hospital care affecting children. This can be seen in the changing attitudes in hospitals to parents as visitors, and the gradual introduction of open visiting. A model of discontinuity is proposed to analyse the experiences of children, parents, and professional staff in the ward. A variety of ameliorative techniques are discussed, in terms of their implications for change to hospitalised children or to hospital organisation. Studies in the development of children's concepts of illness show the need for providing information relevant to their developmental level. It is suggested that more should be done to involve parents in the care of their children in hospital, and to offer them support during this time. The effects on nursing and other staff are considered. The introduction of play schemes has benefits for children, but may lead to organisational complications if the priorities between therapy and welfare are not reassessed. More attention should be given to the psychological risks of treatment in assessing effects of medical intervention. A move towards more child centred care should in particular involve a change in the role assigned to the family within the medical sphere, and a reduction in the insularity of hospitals and fragmentation of treatment derived from existing medical and nursing practices. PMID- 3317888 TI - A critical review of international mortality data. AB - Mortality data have become increasingly important not only in health related studies but also in development studies as a whole. The demand for data on life expectancy and the infant mortality rate is met by five publications-the UN Demographic Yearbook, World Population Prospects, World Development Report, World Population Trends and Policies Monitoring Report, and World Population. Within these statistical publications, life expectancy and the infant mortality rate are available for nearly every country each year. However, recent empirical information on mortality in most developing exists only for a handful of countries. The estimates published in the World Development Report and World Population Prospects are based on old empirical data updated with assumed rates of improvement in mortality. Neither of these sources provide technical notes explaining the original data source, estimation technique, and updating model used. Fortunately, two sources, the World Population Trends and Policies Monitoring Report and World Population, publish only empirically based data clearly identifying source, year of applicability, and estimation technique. The work in the World Development Report and the World Population Prospects could be made more useful if they provided adequate technical documentation for each estimate. At present, the Monitoring Report and World Population are the only appropriate sources for quantitative analysis of mortality or of change in mortality. PMID- 3317889 TI - Availability, accessibility, acceptability, and adaptability: four attributes of African ethno-medicine. AB - Many years of ethno-medical research in Africa have increased our knowledge of different aspects of indigenous medical systems. Like any other cultural system, indigenous medical systems have been undergoing changes over the years as African countries continue to experience tremendous alterations in their ecological systems, socio-economic activities, political and cultural life. These changes have had some impact on the practice of indigenous medicine in many parts of Africa. Compared with bio-medical services, ethno-medicine is usually characterized as more available, accessible, acceptable, and adaptable. This paper seeks to draw attention to the need to re-examine these attributes as applied to ethno-medical practices in contemporary Africa in view of the present rate of social change in most African countries. PMID- 3317890 TI - Dyadic social-support for cardiac surgery patients--a Canadian approach. AB - Over the past 15 years there has been a substantial increase in the number of cardiac operations being performed. The role of the lay helper volunteer who has successfully recovered from cardiac surgery, offering support to individuals about to undergo similar surgery, is earning a legitimate place in cardiac rehabilitation. This 'living proof' model of support appears to have a significant buffering effect through increasing the cardiac patients' readiness for cardiac surgery and motivation for cardiac rehabilitation. Most literature focuses on individuals who have suffered a myocardial infarction rather than those who must undergo cardiac surgery. The focus of this article is lay volunteer dyadic social-support for open-heart surgery patients. The authors describe such a program operating in Halifax, Nova Scotia, designed to link volunteers who have successfully recovered from open-heart surgery with those individuals about to undergo similar surgery. Comparisons are also made with parallel support programs in Canada and the United States. Thus far, only crude measurements of the effectiveness of this particular social-support intervention are available. The dyadic social-support that volunteers offer cardiac surgery patients seems to be effective as evidenced by the information discussed in this paper. PMID- 3317891 TI - Undergraduate medical education in underdeveloped countries: the case of Pakistan. AB - The type of medical education of a country is closely linked with its system of health care. Any health care system, with its own peculiarities, requires a certain type of doctor who can function effectively in the given environment. The same is the case with underdeveloped capitalist countries, such as Pakistan, where a skewed, elitist, curative model of health care exists. In Pakistan, where the literacy levels in the native tongue are very low, medicine is taught in English, and nearly all prescribed textbooks are written in and for the West. Conditions specific to Pakistan, such as the degree of cheating in exams, the time lost due to closure, and the level of debate concerning the medical system may find their parallels in other UDCs. Since it is the social and economic forces, which, in the final analysis, determine the system of health care and medical education, one cannot expect any significant improvement within the existing class structure. Only in a country where the masses have control over the production and distribution of resources, can the systems of health care and medical education be brought in line with the real needs of the community and of the country. PMID- 3317892 TI - Primary prevention: a new look at basic concepts. AB - Personal health and well-being are gaining priority on the American agenda. A renewed interest in health promotion has been facilitated by the need to contain health care costs, realization of the limits of medicine in preventing illness, and a deeply rooted societal ethic of personal responsibility for individual health. Although the health status of Americans has changed significantly for the better during this century, further improvements are necessary, especially among high risk subgroups within the population who have not been effectively reached by traditional health promotion strategies. Past efforts, aimed at individuals modifying their risk factors, have neglected to address environmental factors that contribute to disease risk. This points to the need for an integrated approach where problems are addressed as properties of the systems in which individuals behave. This paper reviews selected health trends in the United States, discusses limitations of the current approach to health promotion, presents a comprehensive definition of prevention, and provides principles for planning that may facilitate improved health status in this country. PMID- 3317893 TI - Serendipity. PMID- 3317894 TI - Inflammatory aneurysm of the abdominal aorta: diagnosis by computerized tomography and ultrasonography. AB - We correctly diagnosed seven cases of inflammatory aneurysm of the abdominal aorta preoperatively by computerized tomography (CT) and ultrasonography (US). Excessive thickening of the aneurysmal wall and conspicuous enhancement on CT are the characteristic features that led to the correct diagnosis. Ultrasonographic findings are nonspecific, but US is the screening method of choice. If US shows a sonolucent zone anterior or anterolateral to an atherosclerotic aneurysm, CT should be used to delineate the perivascular abnormalities. PMID- 3317895 TI - Preoperative medical consultation and evaluation of surgical risk. AB - Internists are frequently asked to assess the surgical risk of patients with various medical problems. Numerous recent prospective studies have defined specific risk factors for increased morbidity and mortality in the preoperative evaluation of surgical patients. Careful attention to such factors as age, type of operation and anesthesia, underlying pulmonary, hypertensive, cardiac, renal, hepatic, endocrine, and hematologic diseases, and nutritional status can reduce the complication rate and death rate in surgical patients if specific preoperative, operative, and postoperative therapeutic maneuvers are instituted. A comprehensive comparative analysis by the internist, surgeon, and anesthesiologist should be made on all high-risk surgical patients to improve their medical care. PMID- 3317896 TI - The novelty of stress. PMID- 3317897 TI - Tricyclic antidepressant overdose: pharmacology and treatment. PMID- 3317899 TI - Fatal group B streptococcal empyema in an adult. AB - We have reviewed the literature on group B streptococcal empyema in adults and presented an additional case. During the early antibiotic era, this rare infection was described only in women after parturition. Diabetes mellitus or glucose intolerance was present in our patient and in all of the described cases of nonparturient adults. Mortality from this infection was high. The condition differs from classic beta-hemolytic streptococcal (group A) pneumonia and empyema in its predilection for older, more chronically ill persons and in its more frequent nosocomial occurrence. PMID- 3317898 TI - Retrieval of an umbilical artery catheter: a potential for misadventure. AB - We have described an infant in whom migration of a transected umbilical artery catheter resulted in sudden vascular ischemia of an extremity. Early operative retrieval was successful, but long-term effects of this complication were encountered. We have outlined an approach to the initial management of the complication. In addition, this case demonstrates the need for careful follow-up for identification and treatment of the long-term sequelae in the involved extremity. PMID- 3317900 TI - Heparin-induced hyperkalemia. AB - We have described three patients with diabetes and renal insufficiency who had hyperkalemia during heparin therapy. These cases lend support to previous findings, and emphasize the clinical importance of this entity. We believe that heparin-induced hyperkalemia is a potentially life-threatening problem that is more common than previously appreciated. We suggest that in high-risk patients (ie, those with diabetes and/or renal insufficiency) serum potassium be monitored frequently during heparin therapy. PMID- 3317901 TI - Research in expressed emotion. PMID- 3317903 TI - [The Pirogov conferences in the history of Soviet medicine]. PMID- 3317902 TI - [Bolshevik physicians--builders of socialist public health]. PMID- 3317904 TI - [Modelling in the planning and organization of hospital emergency medical care]. PMID- 3317905 TI - [Use of the Iskra-1256 microcomputer in rural public health]. PMID- 3317906 TI - [Formation and development of the public health management system in the Ukrainian SSR]. PMID- 3317907 TI - [Bolshevik and physician L. G. Mokievskaia-Zubok]. PMID- 3317908 TI - [Assessment of the natural science views of N. I. Pirogov]. PMID- 3317909 TI - [Implantation of non-preserved fetal pancreas in the treatment of diabetes mellitus]. PMID- 3317910 TI - [Diamicron in the treatment of diabetes mellitus type 2]. PMID- 3317911 TI - [Effect of weather and climate factors on the course of diabetes mellitus]. PMID- 3317912 TI - [Drug-induced lesions of the endocrine glands]. PMID- 3317913 TI - True intra-articular lipoma of the lumbar spine. PMID- 3317914 TI - [Status of high-frequency roentgen cinematography in the diagnosis of the pharynx and esophagus]. PMID- 3317915 TI - [Sonographic assessment of neck cysts]. PMID- 3317916 TI - [Reflections on the development of Czechoslovak health care and the development of surgery on the 70th anniversary of the Great October Socialist Revolution]. PMID- 3317917 TI - [The life and work of Academician Arnold Jirasek (on the 100th anniversary of his birth)]. PMID- 3317920 TI - [Induction of chronic polyarthritis in PVG/c rats following the intravenous injection of streptococcal cell wall peptidoglycan]. PMID- 3317919 TI - [Clinical trails of piroxicam suppositories in the therapy of rheumatoid arthritis]. PMID- 3317918 TI - [Growth Factors]. PMID- 3317921 TI - 'Planned' or 'on demand' relaparotomy for severe intra-abdominal infection. PMID- 3317922 TI - Privatisation of South African health services--are the underlying assumptions correct? AB - Six key assumptions made by proponents of privatisation are critically appraised in the light of Canadian, US and UK studies. 'Counter' assumptions, equally credible, are: (i) the economic behaviour of the health-care market does not correspond to the idealized rules of the free market nor, given the nature of health care as a 'public good', should it do so; (ii) national health-care systems with a heavy emphasis on private insurance are as or more costly than universal public systems; (iii) private for-profit hospitals do not usually enjoy any cost-efficiency advantages over public hospitals; (iv) subsidizing individuals to purchase private care carries a risk of adding administrative costs, fueling the inflationary spiral in health care, and reducing public accountability of tax money; (v) user-fees and co-insurance will not deter over utilisation without penalising and reducing legitimate use of health services; and (vi) savings from privatisation are unlikely except for the more affluent citizens of the RSA who will carry a slightly reduced tax burden--all others will pay more and may be deterred from seeking necessary care. PMID- 3317923 TI - [Strife between the dispensing physician and the pharmacist--a historical overview. I. To 1840]. AB - The historic origins of the medical and pharmaceutical professions, since the dawn of civilization, are briefly reviewed. The development of these professions in Great Britain as a prototype of the European situation over the past 3 centuries is traced, with emphasis on the developing strife between apothecaries and physicians. The corresponding situation in South Africa over the period 1652 1840 is then reviewed. The first Commission of Inquiry into health matters at the Cape, appointed by the British after their occupation of the region in 1806, was precipitated by complaints regarding unsatisfactory services rendered by apothecaries and medical practitioners. Health services were subsequently regulated by way of two Medical Proclamations in 1807, one Medical Proclamation in 1823 and a Medical Ordinance in 1830. According to this legislation apothecaries in Cape Town were not allowed to treat patients, and doctors were not allowed to sell medicines--but due to a shortage of rural practitioners, apothecaries and doctors were allowed to supplement each other in the country districts. PMID- 3317924 TI - [Strife between the dispensing physician and the pharmacist--a historical overview. II. 1840-1928]. AB - The professional interaction between physicians and the pharmaceutical profession in South Africa in the years 1840-1928 is reviewed. The years 1840-1880 were characterised by relatively peaceful coexistence in metropolitan areas, but rather unorthodox developments in outlying rural areas. Here physicians found it difficult to make a living due to fierce competition from medicine-selling traders, self-medicating farming communities and apothecaries allowed to practise as clinicians (even appointed as district surgeons). The establishment of professional and statutory organisations and the promulgation of appropriate health legislation brought stability to the health scene but failed to remove friction between dispensing doctors and pharmacists. After the unification of South Africa in 1910, the two professions co-operated in fits and starts towards the ultimate formulation of the Medical Dental and Pharmacy Act of 1928. The rise of the pharmaceutical manufacturing industry brought a new perspective to the retail pharmacist's professional role. PMID- 3317925 TI - [Strife between the dispensing physician and the pharmacist--a historical overview. III. 1930-1979]. AB - The uneasy relationship between pharmacists and dispensing doctors during the years 1930-1979 is reviewed. The relatively easy association of the 1930s and the early 1940s ended abruptly in the post-war era when the impact of the manufacturing industry rang the death knell of the old-fashioned dispenser and at the same time made dispensing by doctors easier and safer. The retail pharmacist attempted unsuccessfully to define an acceptable new professional role, and the two professions failed to formulate an amicable working relationship. The promulgation of the Medicines Control Act (1964), the Pharmacy Act (1974) and the Medical, Dental and Supplementary Health Professions Act (1974) brought new dimensions to the strained relationship. PMID- 3317926 TI - [Strife between the dispensing physician and the pharmacist--a historical overview IV. 1979-1987]. AB - In 1981 a liaison committee established between the Medical Association of South Africa (MASA) and the Pharmaceutical Society of South Africa (PSSA) to probe the dispensing-doctor issue, published a joint declaration of co-operation. After a brief truce, however, relationships deteriorated again. Pharmacists claimed that the numbers of dispensing doctors were rapidly increasing and each profession accused the other of breaking the agreement. According to the PSSA many doctors were transgressing the MASA's guidelines and the Medical Council's ethical rule 28 by trading in medicines. Subsequent legislation approved by the Council and designed to obviate this problem brought unexpected complications, and led to a joint effort by the Medical Council and the Pharmacy Council to reach an acceptable compromise. In 1984 a tentative agreement was reached but not endorsed by the full Medical Council, largely because of pending recommendations from the Competition Board which would profoundly affect dispensing by pharmacists and doctors. These recommendations were made public in November 1986, and the Government's response to them is still being awaited. The author finally summarises the status quo of the age-old feud as he perceives it. PMID- 3317927 TI - Reflections on the first heart transplant. PMID- 3317928 TI - Heart transplantation at Groote Schuur Hospital, Cape Town. Twenty years' experience. AB - Human allogeneic heart transplantation was started at Groote Schuur Hospital in Cape Town in 1967. Since then 110 hearts (61 heterotopic and 49 orthotopic) and 12 heart-lung transplantations have been performed in the unit. Ten procedures were retransplantations including 2 third interventions. The patients fall into three groups according to their immunosuppressive therapy: group A (N = 55) from 1967 to 1982 received the so-called 'conventional treatment' (azathioprine, methylprednisolone and antithymocyte globulin (ATG)); group B (N = 15) from 1983 to 1984 received cyclosporin A in high dosage, together with methylprednisolone; and group C (N = 30) received quadruple drug therapy of low-dose cyclosporin A, together with azathioprine, methylprednisolone in lower dosages and antithymocyte globulin (for the first 4-6 days and rescue-ATG for severe rejection). The results have improved significantly over the years. The actuarial survival rate after heart transplantation within the last 12 months is 94%. Several important steps have been inaugurated: in 1973 heterotopic heart transplantation was initiated and in 1984 hormonal therapy of brain-dead organ donors was started. Radionuclide scanning, in combination with endomyocardial biopsies, has proved to be a very sensitive means of monitoring rejection. PMID- 3317930 TI - Porphyria--the UCT experience. AB - Several forms of porphyria are commonly seen in South Africa. Much of the knowledge accumulated in this field has been due to the meticulous research of Professor Lennox Eales and his colleagues at the University of Cape Town. Professor Eales headed the Porphyria Research Group, founded by the CSIR in 1957 and upgraded to a Unit by the MRC in 1979, until he retired in 1983. Since then porphyria research at UCT has continued within the MRC Liver Research Centre. We present here a description of those forms of porphyria commonly seen in South Africa, based in part on recent work carried out at UCT and in part on the work of Lennox Eales, to whom we dedicate this article. PMID- 3317929 TI - Gonadotrophin-releasing hormone--diversity of functions and clinical applications. AB - Gonadotrophin-releasing hormone (GnRH) plays a pivotal role in the regulation of the reproductive system. Chemically synthesised GnRH and analogues have found wide application in clinical medicine. Pulsatile administration of GnRH is used in the treatment of infertility and cryptorchidism. GnRH agonists inhibit gonadotrophin by pituitary desensitisation while antagonists compete out the effects of endogenous GnRH. These agents find application in contraception, the treatment of hormone-dependent neoplasms, precocious puberty, endometriosis, porphyria and disturbances of the menstrual cycle. It is now apparent that GnRH has been co-opted during evolution for functions other than the stimulation of gonadotrophins. GnRH has paracrine (local) effects in the gonads and placenta, acts as a neurotransmitter in the central nervous system, and has autocrine regulatory effects in some tumour cells. Evolutionary studies in non-mammalian vertebrates show that the GnRH gene has been duplicated to produce different molecular forms of unknown function. In addition to producing GnRH, the GnRH precursor is cleaved to produce peptides with novel activities, including prolactin inhibition. PMID- 3317931 TI - Genetic disease in South Africa. A molecular approach. AB - The Department of Human Genetics, University of Cape Town, has accumulated data on more than 11,000 individuals with inherited disorders seen over the last 15 years. Clinical and radiographic data on these persons and their families have been documented and where appropriate they have been investigated in our genetic laboratories. In accordance with current trends, a molecular genetic laboratory has been developed. The approach to South African genetic disease using recombinant DNA techniques is described. PMID- 3317933 TI - Regulation of metabolite fluxes and concentrations in living cells and organisms. AB - A quantitative framework for the analysis of metabolic control depends on the recognition of input and output fluxes occurring in steady-state systems in which the concentrations of intermediates are constant--the fluxes and concentrations peculiar to a given steady state are determined by the catalytic components of the system. Control of the variables is a global function shared among the components in a complex pattern, for reasons which are evident when the detailed properties of such systems are analysed. Such properties include circuit design and a host of factors affecting the sensitivity of catalytic components to substrates and effectors. PMID- 3317932 TI - Paracetamol poisoning at Groote Schuur Hospital. A 5-year experience. AB - A retrospective study was undertaken to investigate experience at Groote Schuur Hospital of paracetamol poisoning from 1981 to 1985. The major points noted in the 91 cases studied were, firstly, that paracetamol poisoning is a common toxicological event at the hospital with approximately 1 admission every 3 weeks. Secondly, there were 5 cases admitted with repeated sub-toxic overdosing with considerable associated morbidity. Thirdly, cimetidine formed part of the therapy in 10 cases, although the clinical use of the drug in this setting is not well established. Thus, although similar in many respects to other studies, this study demonstrates differences which have increased our understanding of the problem locally. PMID- 3317934 TI - A monoclonal antibody to an antigen present in cells from a patient with Hodgkin's disease. AB - A monoclonal antibody-secreting hybridoma cell line, VCD-1, was derived from the fusion of murine myeloma cells with splenocytes from a BALB/c mouse that had been immunised with chronic B-lymphocytic leukaemia cells. The cells came from a patient who had developed the leukaemia approximately 10 years after a course of radiotherapy for nodular sclerosing Hodgkin's disease. The antibody bound to a 30,000-dalton protein that was present in normal and malignant B cells, in monocytes, neutrophils, and interdigitating reticulum cells, and in malignant cells present in Hodgkin's disease lymph nodes. The reactive epitope was not accessible to antibody in viable intact cells; binding to peripheral blood cells could only be seen if the cells were fixed. The antibody recognises a determinant that probably resides on the alpha-chain of HLA class II molecules. PMID- 3317935 TI - The negative effects of mucolytics in otitis media with effusion. AB - Much controversy still exists in the treatment of otitis media with effusion. A double-blind randomised prospective trial during which bromhexine hydrochloride was compared with a placebo is reported. Information from 60 patients was analysed and the results reveal interesting findings on the effects of bromhexine on middle-ear clearance. The data clearly reveal that bromhexine retards resolution of the effusion. Further discussion of the literature gives insight into the controversy surrounding the treatment of middle-ear effusion. Steroids are proposed for further research and clinical trials. PMID- 3317937 TI - Clindamycin--a second line antimalarial agent. PMID- 3317938 TI - Teaching the two faces of medical history. AB - In this article, medical history is described as falling into two large classes. The first is macrohistory, the grand sweep of great events over the centuries. The second is microhistory, the small, detailed, historical development of procedures, drugs, and therapies, as well as diagnostic procedures, that provides the basis for today's treatment in medicine, pediatrics, and surgery. Knowledge of both of these aspects of medical history is essential to the safe practice of medicine, as well as to the enjoyable life of the physician or surgeon working in applied biomedical science. PMID- 3317936 TI - Chloroquine resistance in Plasmodium falciparum in Natal. AB - Out of 110 cultures of Plasmodium falciparum obtained from infected patients in Natal 18 were found to be resistant to chloroquine by in vitro tests: 2 cultures showed schizont development in wells containing 24 pmol chloroquine; in 16 schizont development was present in culture wells containing 48 pmol chloroquine. Seventy-two patients with P. falciparum malaria who apparently did not respond to adequate oral chloroquine therapy were investigated. All responded to one or more treatments with pyrimethamine/sulphadoxine (Fansidar; Roche). It would seem that all the patients were infected in areas not controlled by the South African health authorities. PMID- 3317939 TI - Reference works related to United States surgical history. II. A chronologic bibliography of American textbooks, monographs, and treatises relating to the surgical sciences, 1775-1899. AB - This article discusses reference works concerning American surgical history and provides an extensive bibliography of 453 works relating to the surgical sciences between the years 1775 and 1899. PMID- 3317940 TI - American surgical biographies. AB - Finding adequate biographical data on a given surgeon can cause great difficulty because of the lack of a single source containing biographies of these people. This article provides short biographies of 15 American surgeons of the 18th, 19th, and early 20th centuries: Henry Jacob Bigelow, Joseph Decatur Bryant, Gurdon Buck, John Murray Carnochan, John Syng Dorsey, George Michael Edebohls, Christian Fenger, George Ryerson Fowler, Arpad Geza Charles Gerster, William Gibson, Frank Hastings Hamilton, William Tod Helmuth, Andrew Jackson Howe, Joseph Pancoast, and John Allan Wyeth. PMID- 3317942 TI - A history of The Surgical Clinics of North America. AB - Begun in 1912 by John Benjamin Murphy, one of America's surgical giants, the Surgical Clinics initially comprised verbatim stenographic reports of clinical talks given by Dr. Murphy. After Murphy's death, the Surgical Clinics resumed publication as the Surgical Clinics of Chicago and focused on case reports from surgeons in a single city or well-known clinic. This format remained largely in place through the mid-1970s, when the Clinics took on their current appearance. This article traces the history of the Surgical Clinics and lists all the clinical subjects discussed and the guest editors or sponsoring institutions. PMID- 3317941 TI - A portrait of surgery. Surgery in America, 1875-1889. AB - Between the years 1875 and 1889, extraordinary changes occurred in the practice of medicine and surgery. This article reviews these changes and attempts to understand something of the science of surgery as well as its place in American medicine during these years. The essay uses the two paintings by Thomas Eakins, The Gross Clinic of 1875 and The Agnew Clinic of 1889, as endpoints to the period of discussion. PMID- 3317943 TI - The Surgical Clinics during the 1920s. AB - In the 1920s the Surgical Clinics became an established feature of American surgery. Five articles from the Clinics of this period are reproduced here. The articles provide a cross section of that era's surgical thoughts. The articles are William James Mayo's "Splenic Syndromes"; George W. Crile's "The Factors that Govern the Surgical Mortality of Operations for Hyperthyroidism"; Frank H. Lahey's "Modern Conceptions and Management of Biliary Tract Disease"; Allen B. Kanavel and Sumner L. Koch's "Preoperative and Postoperative Care of Patients"; and W. Wayne Babcock's "Operative Decompression of Aortic Aneurysm by Carotid Jugular Anastomosis". PMID- 3317944 TI - Effect of prophylactic antibiotics upon mixed infections with Bacteroides fragilis. AB - Antimicrobial agents were used alone or in combinations to explore the effect of prophylactic antimicrobial therapy. Subcutaneous abscesses in mice were induced by single and mixed infections of Bacteroides fragilis, Staphylococcus aureus, Group A streptococci and Escherichia coli. The infected mice were treated with three doses of gentamicin, cefoxitin, metronidazole or clindamycin alone or else metronidazole or clindamycin in combination with gentamicin. Mice were sacrificed five days after inoculation and the bacterial contents of the abscesses were determined. Infection induced by a single bacteria always responded to appropriate antimicrobial therapy. However, in infections caused by two organisms, therapy directed at either the Bacteroides fragilis (with metronidazole or clindamycin) or Escherichia coli (with gentamicin) was effective in not only significantly reducing the colony forming units (CFU) of the target organism but also reducing the number of untreated bacteria. Clindamycin alone was effective in reducing the CFU of both components of mixed infections of Bacteroides fragilis with either Staphylococcus aureus or Group A streptococci. Cefoxitin alone and the combination of either clindamycin or metronidazole with gentamicin were effective against all mixed infections. These data support the need to provide coverage for all components of mixed infections with single or combination therapy. PMID- 3317945 TI - A simple technique for accessory papilla sphincteroplasty in pancreas divisum. PMID- 3317946 TI - A historical perspective on the changing methods of management for major trauma of the lower extremity. AB - The quantity of severe injuries to the extremities challenging the modern, civilian surgeon cannot compare with that produced at Gettysburg or other battles of the Civil War. Nonetheless, the extent and severity of the trauma to the extremity generated on our "civilian battlefields" match and often surpass the wounds confronted by our predecessors. In the Civil War, as it had been for many preceeding years, amputation remained the dominant approach to managing a great variety of injuries to the extremities. However, constant surgical progress, as reflected by a gradual reduction in recourse to amputation, had enabled each succeeding generation of surgeons to surpass and distance themselves from their predecessors. Amputation of the traumatized extremity had always defined and continues to represent the prevalent abilities and limitations of conservative and reconstructive surgical efforts. Operative treatment, for much of its existence, represented a collection of dangerous ablative procedures which were used reluctantly when all other measures were exhausted. Its transformation into a successful reconstructive endeavor evolved primarily in this century. The understanding of bone healing and the functional importance of the knee joint led to a transformation in amputation and to changes in the management of fractures which are still evolving. The next revolution in operative treatment came with the ability to restore blood flow in injured extremities. Finally, the recent introduction of a variety of free flaps enables the reconstitution of extensive soft tissue and bony defects and further lowers the number of obligatory amputations. These innovations enabled the surgeon to reduce his or her recourse to amputation of severely injured extremities. Nonetheless, the significant number of amputations still performed constitute a reminder that there is still work to be done. PMID- 3317948 TI - Fedor Andreevitch Serbinenko. PMID- 3317947 TI - Adjunctive chemotherapy as an alternative to ovarian ablation in premenopausal women with carcinoma of the breast. AB - The beneficial effects observed from adjunctive chemotherapy in premenopausal women with carcinoma of the breast may be due only to ovarian ablation. Beneficial effects of chemotherapy induced amenorrhea was noted in four of five reported adjunctive trials. Chemotherapy appears to delay recurrence but has only minimal effect on survival rates. The results of four of five studies comparing ovarian ablation with controls show a consistent, but modest, prolongation of disease-free survival rates from oophorectomy similar to that observed from adjunctive chemotherapy. The benefits are accomplished with less morbidity from ovarian ablation. Additional trials are needed to prove whether or not chemotherapy is more beneficial than adjunctive ovarian ablation in delaying recurrence and if either prolong survival time. Such trials should compare intensive adjunctive chemotherapy with either minimal or no adjunctive therapies. Therapy to be given at the time of recurrence should be defined at the outset to assure comparable over-all treatment among groups. PMID- 3317949 TI - Homicide: a current overview. PMID- 3317950 TI - Alcohol use among children and adolescents. PMID- 3317951 TI - [Treatment of radiation pneumonitis with curative intent--a review]. AB - Therapeutic assays with medicaments intended for the healing of radiopneumonitis have a long tradition. Numerous medicaments have been assayed in men and animals during the last thirty years without having reached any lasting positive results. In the end, the fibrotic stage of this radiogenic side effect has always been refractory. It was, however, possible with some medicaments to relieve the symptoms of the early exudative phase. This study is supposed to give a general survey of the present state of knowledge in this field. PMID- 3317952 TI - [Effect of single 60Co whole-body irradiation on the absolute count and degree-of maturity distribution of reticulocytes in the rat]. AB - Wistar-rats were exposed to a single 60Co-gamma-total body irradiation with 1.5 Gy, 3.0 Gy and 4.5 Gy. The trend of reticulocyte count and the reticulocyte maturation distribution were measured with an automatic analysis system over a period of 30 days. In all animals the reticulocyte count as well as the maturation distribution showed minima at the second and the twelfth day post irradiation. The duration of the minima were dose dependent. The changes of the reticulocyte count and the maturation distribution are equivalent. PMID- 3317953 TI - Tobramycin in ophthalmology. AB - Selman Waksman's laboratory at Rutgers University discovered the first aminoglycoside antibiotic, streptomycin, in 1943. Other aminoglycoside antibiotics, such as gentamicin and tobramycin, soon followed. Tobramycin is compatible with most intravenous fluids and tear substitutes, but it is incompatible with heparin and some beta-lactam antibiotics such as penicillin and cephalosporins. Due to tobramycin's broad spectrum of activity, it has proven useful in controlling both superficial and deep infections of the eye and ocular adnexa (i.e., blepharitis, conjunctivitis, keratitis, and endophthalmitis). However, since tobramycin has been associated with neuromuscular blockade, as well as possessing ototoxic and nephrotoxic effects, care must be taken to minimize toxicity by monitoring patients undergoing systemic tobramycin therapy. PMID- 3317954 TI - Vitreous hemorrhage secondary to age-related macular degeneration. AB - The clinical features of two patients with vitreous hemorrhage secondary to age related macular degeneration and the histopathological findings in one of these cases are reported. Twenty additional cases are reviewed and compared with previously reported series. In patients with vitreous hemorrhage secondary to age related macular degeneration, the appearance of vitreal blood is often preceded by extensive subretinal hemorrhage. Although this condition may be confused with a vitreous hemorrhage accompanying choroidal malignant melanoma, the correct diagnosis is usually apparent from clinical findings and ultrasonography. In most patients the prognosis for visual improvement is poor because of macular degeneration and extensive subretinal hemorrhage. A vitrectomy to remove the vitreous hemorrhage associated with macular degeneration is rarely beneficial. PMID- 3317955 TI - Lest we forget: notes on reading Verhoeff's early correspondence. AB - Dr. Verhoeff's life and work are reexamined by the author in the light of his early correspondence. The letters remind us of the significant contributions of Dr. Verhoeff to ophthalmic pathology in America. His personal qualities, such as candor, ingenuity and intellectual honesty are recalled by his successor in the Howe Laboratory. PMID- 3317956 TI - Malignant glaucoma. AB - The term "malignant glaucoma" referred originally to a rare and highly feared form of glaucoma occurring in certain postoperative patients. Over time the concept of the disease was expanded to include a group of angle closure glaucomas unresponsive to traditional miotic or filtering therapy. The haphazard lumping of many disease entities under such an umbrella term has caused confusion, which we attempt to resolve through a mechanistic approach to elucidating the pathogenesis of malignant glaucoma based on the anatomical location of obstruction to normal aqueous flow; surgical treatments are suggested based on the pathogenesis. Attention is drawn to the role of the vitreous and anterior hyaloid in combination with a block to normal aqueous circulation, redirection of its flow, high intraocular pressure and vitreous swelling in precipitating malignant glaucoma and creating a vicious circle to maintain it. Surgical management is directed to correcting the obstruction to normal aqueous flow and removing aqueous accumulated in the posterior chamber, vitreous or suprachoroidal space. PMID- 3317957 TI - Management of noninfectious corneal ulcers. AB - Noninfectious corneal ulcers can occur as an isolated ocular problem (e.g., sequela of eye injury, Mooren's ulcer) or they may be associated with various collagen vascular or other autoimmune diseases, sometimes being the presenting sign of the disease. Conditions that affect the integrity of the ocular surface epithelium (exposure keratitis, neurotrophic keratitis, keratomalacia, recurrent corneal erosions) may also lead to development of sterile corneal ulcers. Rarely, these ulcers occur as a complication following cataract surgery. With recent advances in the understanding of the causes and pathophysiology of corneal melting, rapid and effective medical and surgical treatment is often able to halt relentless destruction of the cornea. Since treatment varies vastly depending on the underlying cause of the ulceration, prompt and accurate diagnosis is of critical importance. This review presents guidelines for the diagnosis of corneal ulcers, and a stepwise approach to their medical and surgical treatment. PMID- 3317958 TI - The effect of preoperative Lugol's iodine on thyroid blood flow in patients with Graves' hyperthyroidism. AB - A study was conducted to investigate the effect of Lugol's iodine on the superior thyroid artery (STA) blood flow with use of a Duplex ultrasound scanner for 12 patients with Graves' disease. All patients were treated with antithyroid drugs until they were euthyroid and then, with randomization, the patients received either Lugol's iodine, 0.3 ml thrice daily, or placebo for 9 days in a double blind fashion. Antithyroid drugs were continued throughout the study. Reduction in the diameter, time-averaged velocity (TAV), and volume flow (VF) of the STAs was demonstrated in all patients in the treatment group, whereas there were no consistent trends in the placebo group. The changes in TAV and VF were significantly different between the placebo and treatment groups (p less than 0.01 for TAV and p less than 0.005 for VF). These changes were more marked in patients with high initial VF and minimal in patients with low initial VF. On the basis of these results, we recommend that patients with high thyroid blood flow before thyroidectomy should receive Lugol's iodine preoperatively. PMID- 3317959 TI - American Association of Endocrine Surgeons. Presidential address: Lest we forget. PMID- 3317960 TI - The beta-2 microglobulin urine-to-serum ratio: an early marker of renal dysfunction in primary hyperparathyroidism. AB - Human beta-2 microglobulin (beta-2 M) is released into body fluids as a result of cell turnover, excreted by the kidney, and catabolized in the proximal tubule. Urinary excretion rates constitute a sensitive index of renal tubular function. The beta-2 M urine-to-serum ratio was measured in 25 patients with primary hyperparathyroidism (15 preoperative and 10 treated conservatively) in addition to 20 age- and sex-matched control subjects. The ratio was found to be significantly higher in both the operative and the conservatively managed groups compared to controls (p less than 0.05, Mann-Whitney U test). After surgical excision of a single parathyroid adenoma in the 15 operative cases, the beta-2 M urine-to-serum ratio fell to normal limits. These preliminary findings indicate that the urine-to-serum beta-2 M ratio may be of value in detecting change in renal function in asymptomatic patients with hyperparathyroidism. Further studies are indicated to establish whether these subtle changes are associated with long term morbidity. PMID- 3317961 TI - Localizing studies in patients with persistent or recurrent hyperparathyroidism. AB - Preoperative localizing studies are essential for patients with persistent or recurrent hyperparathyroidism requiring reoperation, because of loss of normal tissue planes and because the hyperfunctioning parathyroid tissue that remains is more likely to be situated in an ectopic position. The value of noninvasive and invasive localizing techniques was evaluated in 59 consecutive patients undergoing reoperation for persistent (40 patients) or recurrent (19 patients) hyperparathyroidism. Magnetic resonance imaging was performed in 17 patients; 11 results (65%) were positive, 3 (18%) were negative, and 3 (18%) were false positive. Ultrasonography was performed in 52 patients; 29 (56%) were positive, 16 (31%) were negative, and 7 (13%) were false-positive. Computed tomography was performed on 41 patients; 19 (46%) were positive, 16 (39%) were negative, and 6 (15%) were false-positive. Thallium chloride 201-technetium 99m pertechnetate scans were used in 39 patients; 19 (49%) were positive, 11 (28%) were negative, and 9 (13%) were false-positive. One or more of these noninvasive tests was positive in 78% of the cases. Highly selective venous catheterization with measurement of immunoreactive parathyroid hormone concentration localized the abnormal parathyroid gland in 20 of 28 patients (71%) overall and in 8 of the 14 patients (57%) whose tumors were not identified by the noninvasive techniques. Since false-positive results were common, a combination of localizing studies was helpful in identifying the abnormal gland. Fifty-three of the 59 patients (90%) were successfully treated at the initial reoperation and three were successfully treated at a second reoperation. Advances in parathyroid localization have contributed to the improved surgical results in patients with persistent or recurrent hyperparathyroidism. PMID- 3317963 TI - [This is my fondest memory. Obedience before everything]. PMID- 3317962 TI - [This is my fondest memory. 6 krone per day with room and board, grand!]. PMID- 3317964 TI - [This is my fondest memory. Hard stretch at night--no sleep during the day]. PMID- 3317965 TI - [This is my fondest memory. To be sick was not acceptable]. PMID- 3317966 TI - [From veils to slacks]. PMID- 3317967 TI - [Uniformed nuns: deaconesses' first year of development]. PMID- 3317968 TI - [X-ray features of fibrous osteodystrophy and osteomalacia in patients with chronic renal insufficiency under present-day treatment]. AB - The authors present the results of clinicoroentgenological and biochemical investigations in 102 patients with chronic renal insufficiency after hemodialysis and in 76 patients after kidney transplantation. The nature of secondary hyperparathyroid fibrous osteodystrophy and osteomalacia as main symptoms of nephrogenic osteodystrophy (NO), their interrelation and correlation are analysed. Of 178 patients pathological changes of the bone system were revealed in 94 (52.9%). The combination of fibrous osteodystrophy and osteomalacia (22%) is regarded as a contraindication for parathyroidectomy. Effective kidney transplantation does not prevent NO though its specificity changes: osteomalacia is more marked, osteonecrosis and soft tissue calcification are more common. The chief method of radiodiagnosis of NO is routine radiography of the skeleton supplemented by small feature contact radiography and x-ray image color analysis on the UAR and TELEVAN TV units. Comparative roentgenodensitometry of the bones and CT of the parathyroid glands contributed to obtaining objective information but was of applied value. PMID- 3317969 TI - [Senile amyloidosis]. AB - Basing on the literature data and their own experience the authors have proposed the classification of senile amyloidosis defining senile systemic (cardiovascular) Westermark, senile multi-organic (multisystemic) Schwartz, and senile local (isolated) amyloidosis (isolated atrial, cerebral, aortic, of the pancreatic islets, prostate, and seminal vesicles) with clinicomorphological characterization and data on the prevalence of each type of senile amyloidosis. PMID- 3317970 TI - [Serum precursors of amyloid protein deposits. Attempts at the development of laboratory methods in the diagnosis of amyloidosis]. PMID- 3317971 TI - [The sclerodermatous group of diseases]. AB - The paper is concerned with the author's considerations on a sclerodermic group of diseases including a wide spectrum of diseases with systemic or local "primary" fibrosis on the basis of the results of her own investigations and the literature data. Multifactorial genesis of diseases, cellular mechanisms and the interrelationship of fibrosis with immune and microcirculatory disturbances are discussed with regard to sclerodermia systematic. Recently defined, hitherto unknown diseases and syndromes were described: diffuse eosinophilic fasciitis, the paraneoplastic sclerodermic syndrome "induced" sclerodermia, local fibroses. An analysis of the sclerodermic group of diseases and the chief mechanisms of their development is important for improved diagnosis and development of effective programs of pathogenetic therapy, prevention and mass screening. PMID- 3317972 TI - [Evgenii Mikhailovich Tareev]. PMID- 3317973 TI - [Importance of the determination of antibodies to n-DNA in systemic lupus erythematosus and other rheumatic diseases (comparative study of radioisotope and immunoenzyme technics)]. AB - Altogether 95 patients with systemic lupus erythematosus, 36 patients with rheumatoid arthritis, 10 with sclerodermia systematic, 10 with Bekhterev's disease, 9 with rheumatic fever, and 20 healthy persons were examined. An analysis of the results made it possible to establish that in SLE, sclerodermia systematic and Bekhterev's disease the frequency of detection of higher levels of antibodies to n-DNA using enzyme immunoassay and radionuclide methods was approximately the same. SLE patients were characterized by a 2-fold increase in the level of antibodies to n-DNA as compared to patients with sclerodermia systematic, Bekhterev's disease and rheumatic fever suggesting usefulness for differentiation of these diseases. In rheumatic fever and rheumatoid arthritis antibodies to n-DNA in minimal elevated levels were revealed more frequently under enzyme immunoassay than in radionuclide ones. In SLE high levels of antibodies to n-DNA under the method of radionuclide binding showed significant correlation with a decrease in complement hemolytic activity, high levels of circulating immune complexes, with a higher frequency of detection of the antinuclear factor, and reflected lupus nephritis severity. Enzyme immunoassay used for the detection of antibodies to n-DNA showed correlation of high levels of these antibodies with signs of developing cerebrovasculitis and pulmonary lesion. PMID- 3317974 TI - [Results of substitution therapy of kidney diseases in East Germany]. PMID- 3317975 TI - The Core-vent implant: a report on 78 implants. PMID- 3317976 TI - The adult respiratory distress syndrome--20 years on. PMID- 3317978 TI - Pneumonia due to Histoplasma capsulatum in a bone marrow transplant recipient. PMID- 3317979 TI - Intrathoracic infections due to Eikenella corrodens. PMID- 3317977 TI - Rupture of the tracheobronchial tree. AB - Eleven cases of tracheobronchial rupture are described. Nine were the result of external non-penetrating trauma and all but three had other serious injuries. The remaining two were caused by endobronchial intubation. Of the cases caused by external injury, respiratory tract injury was confined to the cervical trachea in three. Two required tracheostomy and repair and the third was managed conservatively; all made satisfactory recoveries. Intrathoracic rupture was recognised on or soon after admission in three cases. One patient died of uncontrollable pulmonary haemorrhage before he could be operated on; immediate repair gave good long term results in the other two. In three cases rupture of the main bronchus was not recognised until complete obstruction developed three, five, and 12 weeks after the accidents. The strictures were resected and the lung re-expanded. Robertshaw endobronchial tubes ruptured the left main bronchus in two patients undergoing oesophageal surgery. Uneventful recovery followed immediate repair. The difficulty of confirming rupture of a major airway is discussed and the importance of conserving the lung when the diagnosis has been missed is emphasised. PMID- 3317980 TI - [Disopyramide-induced hypoglycemia]. PMID- 3317981 TI - [Early identification of the tolerance profile of agents under clinical investigation]. PMID- 3317982 TI - [Consensus conference on definitions in drug monitoring]. PMID- 3317983 TI - [Amodiaquine-induced agranulocytosis. Description of 4 cases and review of the literature]. PMID- 3317984 TI - [Nephrotoxicity of non-steroidal anti-inflammatory agents. Apropos of 6 case reports and review of the literature]. PMID- 3317986 TI - The ultrasonic detection of platelet aggregates. AB - The echogenicity of platelet aggregates in platelet-rich plasma and whole blood was evaluated in stirring and flowing in vitro models. Real-time two dimensional ultrasonic images were obtained with transducers operating at 3.0, 5.0, 10 and 12 mHz. Platelet-rich plasma was not echogenic. The addition of adenosine diphosphate (ADP) resulted in the formation of multiple, discrete echoes that increased in size and intensity. This echogenicity was time and dose-dependent and could be quantitated by videodensitometry. Whole blood was echogenic, but the addition of ADP resulted in a time and dose-dependent increase in the size and echogenicity of the reflections. The overall echogenicity of whole blood declined with the development of platelet aggregates. There is inter- and intra-aggregate variability in the echogenicity of aggregates. Aggregates were best seen with transducers operating at the higher frequencies. These results imply that the detection of in vivo platelet aggregates may be feasible with ultrasonic imaging. PMID- 3317985 TI - Inactivation of heparin cofactor II by polymorphonuclear leukocytes. AB - Inactivation of purified human heparin cofactor II by polymorphonuclear leukocytes was investigated. A proteolytic mechanism of inactivation was demonstrated by SDS-polyacrylamide gel electrophoresis. Inactivation and related proteolysis did not occur in the presence of unstimulated leukocytes and were prevented by various protease inhibitors. Heparin cofactor II was inactivated more rapidly than antithrombin III. However, heparin (1-10 ug/ml) strongly accelerated the rate of antithrombin III inactivation and slightly protected heparin cofactor II, thus reversing the order of inactivation. Dermatan sulfate had no effect on this process. PMID- 3317988 TI - Donald A. B. Lindberg, MD. Interview by O. K. Harlem. PMID- 3317987 TI - [Can oil be used as an antihypertensive agent?]. PMID- 3317989 TI - [Premature calving (abortion) of cows. By H.V. Stockfleth, 1879]. PMID- 3317990 TI - Characterization and quantification of solubilised HLA-DR antigens from circulating human monocytes using an immunoblotting procedure. AB - An immunoblotting technique was modified to detect and biochemically characterize HLA-DR antigens expressed on circulating human monocytes. Membrane proteins of peripheral blood monocytes were solubilised using the mildly anionic detergent, sodium deoxycholate. These solubilised proteins were resolved by SDS-PAGE and transferred electrophoretically to nitrocellulose. The HLA-DR antigen was detected using a polyclonal antiserum and two monoclonal anti-HLA-DR antibodies. Both immunoperoxidase and 125I autoradiography techniques were used for visualisation of the antigen. The resolution of HLA-DR reactive material was increased when proteins were renatured with 4M urea after blotting. Immunoprobing of a sample of solubilized membrane proteins showed three bands of HLA-DR antigenic reactivity at molecular weights 65kDa, 55kDa and 46kDa. After storage at -70 degrees C for 2 months, only the 46kDa HLA-DR antigen band was detectable. Nonetheless, the 2-chain HLA-DR molecule was found to be an extremely stable complex which could not be dissociated by boiling in sample buffer containing 5% 2-mercaptoethanol and 2% SDS. A stronger reducing agent, 25 mM dithiothreitol, was required to split the HLA-DR molecule into its alpha and beta subunit chains. Finally, in a study of circulating monocytes from normal subjects, the immunoblotting technique was shown to quantitate solubilised HLA-DR antigen in a reproducible manner. PMID- 3317991 TI - The effect of glycemic control on plasma soluble fibrin monomer complexes and fibronectin in diabetic patients. AB - We have shown previously that increased concentrations of plasma soluble fibrin monomer complexes (SFMC) and elevated fibronectin (Fn) levels are closely related to the development of diabetic microangiopathy. The purpose of the present study was to explore whether or not changes in plasma glucose levels could have an effect on these protein constituents. Plasma glucose levels of 25 uncontrolled diabetic patients were brought under control with insulin and serial measurements of SFMC and Fn were made over a period of 4 weeks. Glucose values fell from an average of 312 mg/100 ml to 160 mg/100 ml. Ten patients with macroproteinuria (i.e. greater than or equal to 0.5 g/24 hr) showed initially elevated plasma SFMC and Fn concentrations. These levels fell significantly over the 4 week observation period: from 13.6 mg/100 ml to 9.4 mg/100 ml for SFMC and from 38.4 mg/100 ml to 34.5 mg/100 ml for Fn. The remaining 15 patients had nearly normal levels of both SFMC (7.9 mg/100 ml) and Fn (31.1 mg/100 ml) and glycemic control brought no further reduction. The data indicated that a) elevated SFMC and Fn levels are indeed associated with diabetic microangiopathy, especially in the presence of macroproteinuria; and b) adequate glycemic control is capable of normalizing the plasma concentration of these constituents. PMID- 3317992 TI - Fanconi's anemia as a nature's evolutionary experiment on carcinogenesis. AB - In order to obtain insights into the possible carcinogenetic mechanisms, the cancer incidence of Fanconi's anemia (FA) was surveyed in the literature, and the results were compared with those of other cancer-prone diseases of chromosomal breakage, and primary and secondary immunodeficiency syndromes along with an appropriate control population. With FA, there were 43% of leukemias but no lymphomatous diseases. Epithelial tumors consisting of hepatomas and squamous cell carcinomas were 17 and 38%, respectively. Their age distribution was 14.5 +/ 6.7 years of age for leukemias; 18.5 +/- 9.3 for hepatomas and 23.8 +/- 6.9 for squamous cell carcinomas. Putting aside the hepatomas which may be iatrogenic, the neoplastic trend here again is to show the non-epithelial--epithelial tumor shift (Okuyama and Mishina 1986). Fanconi's anemia can thus be one of the chromosomal breakage syndromes whose leukemogenic and carcinogenetic processes are amplified by an increased DNA damage, NK cell depletion, and IgA deficiency as the result of deficient Cu, Zn-SOD and increased suerpoxide toxicity. PMID- 3317993 TI - Immunogenetically controlled autoimmune reactions induced by mercury, gold and D penicillamine in laboratory animals: a review from the vantage point of premarketing safety studies. AB - Mercury and gold salts as well as d-penicillamine can cause glomerulonephritis by an autoimmune mechanism in man. The susceptibility to this effect of these chemicals is controlled by the genes of the major histocompatibility complex (MHC). The presence of certain alleles confers sensitivity. The role of MHC linked genes has been demonstrated also in the rat and mouse in the development of autoimmunity induced by these chemicals. While Brown Norway rats and ASW mice were sensitive, several other strains were resistant. Also an interaction of MHC with background genes has been shown in determination of the response to HgCl2. In conventional toxicity studies, use of a single inbred strain of laboratory animals obviously handicaps the detection of a reaction of this nature. PMID- 3317995 TI - [Surgical treatment of radiation damage to the skin and its indications]. PMID- 3317994 TI - In vivo-in vitro systems in multistage carcinogenesis. PMID- 3317996 TI - [Risk from radiation exposure during human prenatal development]. PMID- 3317997 TI - [Consequences of prenatal radiation exposure from the radiologic point of view]. PMID- 3317998 TI - [Acceptability of radiation-induced risks]. PMID- 3317999 TI - Measurement variability of carotid atherosclerosis: real-time (B-mode) ultrasonography and angiography. AB - To quantify the within- and between-reader agreement of carotid B-mode ultrasonography and angiography interpretation, images from 117 patients examined by both modalities were read multiple times. Angiographic measurements were more reproducible than those of B-mode scans for all parameters except lesion width, but variations for B-mode scan measurements were similar to those for angiographic measurements. Within-reader agreement on the presence of ulceration was substantial for both modalities, whereas between-reader agreement was poor for B-mode scan and only moderate for angiography. PMID- 3318000 TI - Evaluation of cerebrovascular disease by combined extracranial and transcranial Doppler sonography. Experience in 1,039 patients. AB - Results from 1,039 combined cervical and transcranial Doppler examinations are reported. Satisfactory transcranial signals were not found in 2.7% of the cases. Compared with angiography, the accuracy of transcranial criteria in assessing collateral flow over the circle of Willis was 94 and 88% for anterior and posterior circulation, respectively. The method also appeared very promising for detection of lesions of the intracranial arteries although the number of such cases with angiographic verification was limited in the present series. Arterial narrowing due to cerebral vasospasm was diagnosed with a sensitivity of 80%. In patients with ruptured intracranial aneurysms, an incidence of 93% arterial narrowing in basal cerebral arteries was found. Patients with subarachnoid hemorrhage and no aneurysm on angiography also showed arterial narrowing with an incidence of 56%. It was possible to monitor the time course and severity of cerebral vasospasm. Arteriovenous malformations were characterized by Doppler findings of high velocities and low pulsatilities. These lesions were diagnosed with an accuracy of 95%. PMID- 3318001 TI - Carotid restenosis: long-term noninvasive follow-up after carotid endarterectomy. AB - Recurrent stenosis has not been a primary consideration in the selection of patients for carotid endarterectomy. We have studied the incidence of postoperative restenosis retrospectively in 265 patients following 310 carotid endarterectomies. Two hundred fourteen patients (248 endarterectomies) were examined at 6-12 month intervals using ocular pneumoplethysmography, spectral analysis, and B-mode imaging. The absolute incidence of recurrent carotid disease was 28% (69 of 248), with a 13% (33 of 248) incidence of hemodynamically significant restenosis and a 15% (36 of 248) incidence of hemodynamically insignificant disease. Life table analysis of the data projected a 32% incidence of hemodynamically significant restenosis after 7 years and a 40% incidence of hemodynamically insignificant recurrence. These data demonstrate a progressively increasing rate of restenosis. The incidence of ipsilateral neurologic events was 8% (24 of 310); 12 occurred in association with noninvasively evident recurrent disease (12 of 69, 17%), whereas 11 occurred in noninvasively determined normal arteries (11 of 179, 6%). Noninvasive follow-up was not available in 1 patient. Of the 12 events associated with recurrent disease, 5 occurred in association with hemodynamically significant restenosis (5 of 33, 15%), whereas 7 occurred in association with hemodynamically insignificant disease (7 of 36, 19%). Carotid endarterectomy is a durable operative procedure with 92% (286 of 310) of arteries remaining asymptomatic over the period of clinical follow-up. However, absolute and life table projections of the incidence of asymptomatic restenosis are high, and this factor should be considered in the selection of patients for carotid endarterectomy, particularly in the absence of lateralizing symptoms. PMID- 3318003 TI - Is there a role for heparin in the management of complications of subarachnoid hemorrhage? AB - Proven effective therapy to prevent ischemic deficits and other complications after subarachnoid hemorrhage is lacking despite extensive research efforts. A literature review documented both clinical and experimental evidence suggesting that heparin may be effective in preventing ischemic deficits after subarachnoid hemorrhage by reversing vasospasm, improving blood flow through narrowed vessels, and preventing the development of a proliferative angiopathy. Additional evidence suggests that heparinization of the cerebrospinal fluid following subarachnoid hemorrhage may prevent the development of hydrocephalus. In the only clinical trial using heparin after subarachnoid hemorrhage, the incidence of rebleeding in the heparinized patients was no higher than in the control group. We conclude that the existing preliminary data concerning a role for heparin in the management of the complications of subarachnoid hemorrhage is promising, but further controlled studies are needed prior to clinical application. PMID- 3318002 TI - Extracranial vertebral artery dissections: a review of 13 cases. AB - Clinical and radiologic findings in 13 patients (11 women, 2 men) with extracranial vertebral artery dissection are reported. Dissection was spontaneous in 8 patients, occurred after neck manipulation in 2 and after a potential minor injury to the neck in 3. Six had a history of common migraine, 4 were using oral contraceptives at the time of dissection, and 3 had fibromuscular dysplasia. Dissection was bilateral in 8 patients and associated with carotid dissection in 3. It usually presented with neck or occipital pain preceding basilar ischemic symptoms by a few minutes to 1 month. In 3 patients, transient ischemic attacks were the only manifestation of basilar ischemia, and in 1 patient there was no symptom of basilar ischemia despite bilateral vertebral dissection. In 19 of the 21 dissected vertebral arteries, the angiographic appearance was that of an irregular stenosis, which was associated in 6 arteries with pseudoaneurysmal formation. In 2 patients, 1 vertebral artery was occluded but the contralateral artery showed the typical irregular stenosis. The dissection involved only the third segment in 33%, only the second segment in 24%, and 2 or more segments in 38%. Eleven patients were treated with anticoagulants and 2 with aspirin; 11 recovered without sequelae and 2 had residual deficit. No recurrence was observed (mean follow-up 34 months). At control angiography (n = 12) or ultrasonic study (n = 1), 63% of dissected vertebral arteries had returned to normal, 26% showed marked improvement, and 11% were occluded. Our patient characteristics are compared with those of previously published cases. The validity of the distinction between spontaneous dissection and dissection associated with minor trauma is discussed. PMID- 3318004 TI - A tribute to neuroepidemiologist Dr. Bruce Schoenberg 1942-1987. PMID- 3318005 TI - Carotid endarterectomy: three critical evaluations. North American Symptomatic Carotid Endarterectomy Study Group. PMID- 3318006 TI - Contraceptive failure in the United States: a critical review of the literature. AB - The overall goal of this paper is to provide for the first time a comprehensive critical review of the literature on contraceptive failure in developed countries, primarily the United States. The first two sections of our paper lay the groundwork for a critical assessment of the extensive body of studies on this subject, by systematically exploring the concepts and measurement of contraceptive efficacy and the methodological pitfalls that snare many investigators and compromise their results. The next two sections focus on results in the literature. First we provide a method-by-method critique of the available studies and then we summarize our conclusions in a single table that provides efficacy information necessary for women and couples to make an informed choice of a method of contraception. We close with a set of substantive observations and also a set of methodological recommendations intended to improve the quality and comparability of findings from future research. PMID- 3318007 TI - [Effectiveness of using different proteases in determining the species identity of barely soluble blood stains]. PMID- 3318008 TI - [Pathomorphology of the lungs in death from hypothermia]. PMID- 3318009 TI - [Use of a computer method for the forensic medical determination of the degree of severity of closed craniocerebral injury]. PMID- 3318011 TI - [The Technical Physics Department of the Forensic Medical Research Institute (on the 50th anniversary of its founding)]. PMID- 3318010 TI - [Prof. A. D. Gusev (on the centenary of his birth)]. PMID- 3318012 TI - Cohort, age, and period effects in the analysis of U.S. suicide patterns: 1933 1978. AB - This study employed multiple classification analysis to examine the impact of age, period, and cohort effects on U.S. white male suicide rates between 1933 and 1978. Previous studies of cohort effects with regard to suicide behavior have been descriptive in nature, and have failed to consider the interaction of the three effects. Drawing on a study of pulmonary tuberculosis mortality by W.M. Mason and Smith (1985), the work specified seven models. The Shazam ordinary least-squares computer package was employed to estimate the logit coefficients for the seven models. Period effects were found to be weaker than age and cohort effects for explaining shifts in white male suicide patterns. In this study all of the three effects were measured indirectly, and this fact limits the validity of the findings. Causal analysis, which directly measures at least one of the effects, would have improved the robustness of the findings. PMID- 3318013 TI - Suicide in Texas: a cohort analysis of trends in suicide rates, 1945-1980. AB - Recent clusters of teenage suicides in Texas suburban communities have focused national attention on the rise in teenage suicidal behavior. This study sought to clarify the teenage suicide phenomenon by using a cohort method of data analysis. Beginning with suicide rates for white males aged 15-19 in 1945, suicide rates were calculated and plotted for each 5-year age cohort entering the late teenage years, when suicide risk factors dramatically increase. Our analysis of these cohort patterns confirmed the ever-rising risk factor associated with the ages of 15-19. This trend is consistent with many studies suggesting that teenage suicide is a function of socioeconomic and psychological factors operating across community and national boundaries. In addition, our study revealed that as white males 15-19 years of age in 1945 aged, their suicide rates also increased, confirming earlier findings that the suicide risk factor increases with age. In fact, Texas data for 1980 revealed that older persons, not teenagers, had the highest suicide rates-a finding that confirms other studies' results. Finally, Texas cohort patterns for suicide revealed the recent curvilinearity tendencies of older adult male suicide rates. By 1980 Texas data revealed a bimodal distribution of high suicide risk, with white males in their late 20s and ages 55 and over having the highest rates. PMID- 3318014 TI - [Giant cell arteritis of the aortic arch. An review with reference to a case report]. AB - A case history of a 66 year old woman with an aortic arch syndrome due to giant cell arteritis is described. On the base of this diagnosis, a short review of literature, concerning symptomatology of giant cell arteritis is given, with special emphasis on the angiographic appearance. Special attention is given to the fact that a negative biopsy of the temporal artery does not exclude the diagnosis of giant cell arteritis. PMID- 3318015 TI - A metropolitan hospital in a non-endemic area provides a sampling pool for epidemiological studies on vivax malaria in Sri Lanka. AB - An analysis of records of 494 malaria patients admitted to the General Hospital in Colombo (the capital of Sri Lanka where malaria transmission is not known to occur) from 1981 to 1984 is presented and compared with national malaria data from the entire country. The incidence of predominantly Plasmodium vivax malaria rose sharply over the 3 years; its species distribution and seasonal variation in patients in the General Hospital, Colombo (GHC) generally reflected the disease pattern in the country as a whole. The disease had spread from mainly the endemic dry zone to the non-endemic wet zone. Malaria patients at the GHC were mainly residents of Colombo who had acquired malaria during brief visits to endemic areas, and we have demonstrated how information from them can be used as a sampling method to obtain almost immediate epidemiological information from the whole country. Based on the histories of selected patients we deduced the incubation periods and possible relapse patterns of P. vivax infections in Sri Lanka. This study also provided an insight to the epidemiology of the disease in the city. PMID- 3318016 TI - Induced malaria and antibody titres in acute infections and in blood donors in Kuwait. AB - Concurrent with the increase in the number of imported cases of malaria into non endemic Kuwait during the past 5 years, induced infections have been identified for the first time. We report 10 such cases over a 4-year-period. Of 8 transfusion-induced infections, 4 were due to Plasmodium falciparum and 4 to P. vivax. The mean incubation period for P. falciparum patients was 13 d and for P. vivax, 17 d. An accidental syringe-needle transmission and a congenital infection were due to P. falciparum and P. vivax respectively. Malarial antibody levels were assayed on commercially-available cultured P. falciparum schizonts by the indirect fluorescent antibody (IFA) test. To establish a base line, the sera of patients with blood film-confirmed P. falciparum and P. vivax were assayed. 96% of the P. falciparum sera were positive, the geometric mean titre (GMT) being 10,280. However, all sera from P. vivax patients were reactive but the GMT was lower at 505. 28% of sera from Kuwaitis and 45% of sera of a consecutive group of blood donors were also reactive, the respective GMTs being 38 and 51. The risk of transfusion malaria was calculated as 79 per million units drawn, an unacceptably high figure for a non-endemic country. We suggest a revised blood donor policy. PMID- 3318017 TI - Malaria and loaisis among blood donors at Ibadan, Nigeria. AB - 115 blood donors were screened for the presence of malaria and other blood parasites at the Blood Bank, University College Hospital, Ibadan, between January and July, 1984. 11.3% of these had blood parasites; 7.8% had Plasmodium falciparum with parasitaemias from 0.03-0.2%, and 3.5% had Loa loa microfilaraemia. No other blood parasites were observed. Serological examination by the indirect fluorescent antibody test revealed that 86% of the donors had malaria antibody with reciprocal titres ranging from 16 to 512. There was no significant association between ABO blood group and malaria parasitaemia or antibody titre. PMID- 3318018 TI - Failure of high dose mebendazole as a microfilaricide in patients with loiasis. AB - The effectiveness of mebendazole as a microfilaricide in patients with loiasis was studied. The drug regimen was 1 g twice daily for 21 days in adults. During and after treatment, the microfilarial density was unchanged. Therefore, mebendazole has no direct effect on the microfilarial density of Loa loa. PMID- 3318019 TI - Potentiation of the antimalarial activity of qinghaosu by methoxylated flavones. AB - Interaction between the flavones casticin and artemetin and the antimalarial activity of chloroquine and qinghaosu (QHS) was examined using an in vitro growth assay based on [3H]hypoxanthine incorporation in synchronized cultures of a cloned line of Plasmodium falciparum. Casticin, and to a lesser extent artemetin, selectively enhanced the inhibition of growth by QHS, but had little effect on the activity of chloroquine. The findings suggest that flavones indigenous to Artemisia annua, from which QHS is isolated, might significantly alter the clinical potential of this novel antimalarial drug in the treatment of chloroquine-resistant malaria. PMID- 3318020 TI - Electron microscope observations of Trypanosoma cruzi during development inside the haemocytes of Triatominae. AB - The haemolymph of Panstrongylus megistus, infected by Trypanosoma cruzi, was examined by light and electron microscopy. Numerous parasites lie inside the haemocytes, each one in a vacuole. Their well-preserved morphological features support the concept of parasite multiplication in cells of the insect haemolymph. PMID- 3318021 TI - Mortality and morbidity from malaria among children in a rural area of The Gambia, West Africa. AB - Mortality and morbidity from malaria were measured among 3000 children under the age of 7 years in a rural area of The Gambia, West Africa. Using a post-mortem questionnaire technique, malaria was identified as the probable cause of 4% of infant deaths and of 25% of deaths in children aged 1 to 4 years. The malaria mortality rate was 6.3 per 1000 per year in infants and 10.7 per 1000 per year in children aged 1 to 4 years. Morbidity surveys suggested that children under the age of 7 years experienced about one clinical episode of malaria per year. Calculation of attributable fractions showed that malaria may be responsible for about 40% of episodes of fever in children. Although the overall level of parasitaemia showed little seasonal variation, the clinical impact of malaria was highly seasonal; all malaria deaths and a high proportion of febrile episodes were recorded during a limited period at the end of the rainy season. PMID- 3318022 TI - Transmission blockade of Plasmodium falciparum: its variability with gametocyte numbers and concentration of antibody. AB - The transmission of Plasmodium falciparum through Anopheles stephensi was measured in the presence of anti-gamete (anti-45/48 kDa) and anti-zygote/ookinete (anti-25 kDa) antibodies. With lowering numbers of infectious gametocytes in the presence of the same concentration of antibodies, different results were obtained with the two types of antibodies. Transmission blocking appeared to weaken when using anti-45/48 kDa antibody, whilst, with the anti-25 kDa antibody, transmission inhibition was markedly strengthened with lower parasite numbers. Keeping the parasite numbers constant and progressively lowering the concentration of both types of antibodies resulted in a gradual loss of the latters' blocking ability. No enhancement of transmission occurred at low antibody concentrations. PMID- 3318023 TI - Five cases of chloroquine-resistant malaria in Benin, Africa. PMID- 3318024 TI - Activity of quinoline-containing antimalarials against chloroquine-sensitive and resistant strains of Plasmodium falciparum in vitro. AB - 9 quinoline-containing antimalarials and the phenanthrene methanol halofantrine were tested in vitro against 6 strains of Plasmodium falciparum with known sensitivity to chloroquine. Sensitivity to chloroquine was not uniformly associated with sensitivity to mepacrine (quinacrine), halofantrine, SN-12108 or SN-6911 (3-methylchloroquine, sontochin). Amodiaquine was slightly less potent with chloroquine-resistant strains, whereas SN-12309 closely resembled chloroquine in the pattern of sensitivity. (Bis)desethylchloroquine was nearly as potent as chloroquine against chloroquine-sensitive strains but was about 10-fold less potent than the parent drug against chloroquine-resistant strains. 2 8 aminoquinolines, primaquine and pamaquine, were more potent against chloroquine resistant than chloroquine-sensitive strains. The mutation(s) responsible for chloroquine resistance in P. falciparum greatly reduce(s) the sensitivity to a major metabolite of the drug but also generate(s) parasites which are more susceptible to a different class of drugs, the 8-aminoquinolines. PMID- 3318025 TI - The genetics of bacterial trimethoprim resistance in tropical areas. AB - Resistance to trimethoprim in Gram-negative bacteria is largely manifested by two trimethoprim resistant dihydrofolate reductases (types I and II) encoded by genes originally located on resistance plasmids. Although trimethoprim resistance increased markedly after the clinical introduction of trimethoprim in the West, its spread has slowed and, in Edinburgh at least, has actually been declining. This reduction has been accompanied by the migration of a transposon, encoding the type I plasmid resistance gene, into the bacterial chromosome. In tropical areas, the incidence of trimethoprim resistance is very much higher. In Tanzania, it has spilled over into other bacteria outside the Enterobacteriaceae, but it was in India where the major problem existed. The majority (64%) of the Indian Enterobacteriaceae studied were resistant to the drug and most of the resistance genes were located on very large plasmids which also conferred resistance to many other antibacterial drugs. Some Indian plasmids carried a new trimethoprim resistance gene which is not detectable by conventional sensitivity tests and may be spreading unnoticed elsewhere. The proportion of trimethoprim resistance has been related to the volume of antibacterial drugs used. PMID- 3318026 TI - Micro in vitro test for chloroquine resistance of Plasmodium falciparum: discrepancies attributable to batch variation of plates. PMID- 3318027 TI - Absence of crisis form factor in subjects immune to Plasmodium falciparum in The Gambia, West Africa. PMID- 3318028 TI - Fansidar resistance in the Philippines. PMID- 3318029 TI - Positive immunohematologic and serologic test results due to high-dose intravenous immune globulin administration. PMID- 3318030 TI - ABO blood groups and Escherichia coli sepsis. PMID- 3318031 TI - The arteriovenous fistula in segmental pancreatic transplantation in dogs--a hemodynamic study. AB - Arterial and/or venous thrombosis is a frequent complication in experimental or human pancreatic transplantation. A canine experiment was used to study the hemodynamic effects of spleno-splenic arteriovenous fistula during segmental pancreatic transplantation. An increase in blood flow, without "steal" syndrome in the pancreatic blood supply or pressure increase, was found. Thus this technique can help prevent vascular thrombosis in pancreatic transplant in dogs. PMID- 3318033 TI - Possible causes and consequences of hypertension in stable renal transplant patients. AB - Previous epidemiologic studies of hypertension in renal transplant patients have produced contradictory results. Therefore, the incidence and clinical setting of chronic hypertension were examined in 201 stable renal transplant patients using a multivariate approach. Hypertension was present in 52.7% of patients at one year, and in 46.3% at the time of last follow-up, 5.0 +/- 1.9 years (mean +/- SD) after transplantation. Among possible causative factors, discriminant analysis demonstrated that body weight, the presence of native kidneys, and variables linked to allograft function were most closely associated with hypertension at both one year and last follow-up. One year after transplantation, age, sex, pretransplant hypertensive nephrosclerosis, and diabetes were also independently associated with hypertension. However, renal function declined to a greater degree in hypertensive patients, and only body weight, the presence of native kidneys, and variables linked to allograft function were associated with hypertension at last follow-up. Results also demonstrated that hypertension was associated with elevated serum lipid levels and an increased likelihood of dying or returning to dialysis. Thus, these results suggested several important risk factors for hypertension and its consequences in renal transplant patients. PMID- 3318032 TI - Facilitation of engraftment of DLA-nonidentical marrow by treatment of recipients with monoclonal antibody directed against marrow cells surviving radiation. AB - Past studies in dogs have suggested that marrow graft rejection was mediated by major histocompatibility complex (MHC) class II antigen-positive non-T cells that survived standard doses of total-body irradiation (TBI). We have now raised 4 monoclonal antibodies (mAbs) against marrow cells harvested 6 days after TBI. The mAbs are highly reactive (greater than 70%) with marrow cells surviving radiation and also bind strongly (greater than 50%) to normal marrow cells, lymphocytes, monocytes, and granulocytes. One of the mAbs (34-S3) reacted strongly with NK like cells. In vitro treatment of marrow with mAb and rabbit complement (C') did not affect erythroid colony-forming unit (CFU-E) growth, whereas 2 of the 4 mAbs inhibited granulocyte-macrophage colony-forming unit (CFU-GM) growth, and all 3 mAbs tested suppressed autologous marrow engraftment. One of the mAbs, 69-S5 (IgG1), bound to a 95,000 dalton antigen. It crossreacted with human cells, but not with cells from Rhesus monkeys, baboons, and cats. We administered this mAb intravenously at 0.2 mg/kg/day on days -5 to 0 to dogs given 9.2 Gy TBI on day 0 followed by marrow grafts (less than or equal to 4 x 10(8) cells/kg) from DLA nonidentical unrelated donors. Three of five dogs had sustained grafts. Increasing the dose of mAb ten-fold (2 mg/kg/day) resulted in graft failure (2 of 2 dogs). Treatment with a dose of 0.2 mg/kg/day from day -7 to -2 showed sustained engraftment in 7 of 10 dogs. This result is in contrast to sustained grafts in 3 of 36 dogs not given mAb, and in 1 of 7 dogs treated with an irrelevant mAb (P = 0.0002 and 0.04, respectively). We conclude that treatment of recipients with a mAb raised against marrow cells surviving radiation and not directed at major histocompatibility complex (MHC) class II antigens and NK-like cells can also facilitate engraftment of DLA-nonidentical canine marrow. These results may be relevant for the transplantation of HLA-incompatible marrow in man, particularly after in vivo T cell depletion, where graft failure is frequent. PMID- 3318034 TI - Lymphoid chimerism after allogeneic bone marrow transplantation. Y-chromatin staining of peripheral T and B lymphocytes and allotyping of serum immunoglobulins. AB - Lymphoid cell engraftment was monitored for several years after bone marrow transplantation by Y-chromatin staining of T and B lymphocytes in the peripheral blood and/or by immunoglobulin allotyping in the serum of 20 of 52 pediatric patients grafted successively between October 1973 and October 1983. Data on 2 patients with severe combined immunodeficiency, grafted earlier in December 1968 and April 1971, are also included. These children received an allogeneic bone marrow graft for leukemia (n = 7), severe aplastic anemia (n = 11), or severe combined immunodeficiency (n = 4) and were informative for this study, because they differed from their donor by sex (n = 16) and/or by immunoglobulin phenotype (n = 13). Of 16 pairs in which the donor was of the opposite sex, 11 patients ultimately showed circulating T and B lymphocytes of donor origin after bone marrow transplantation; in the remaining 5, there was an incomplete chimerism of the circulating lymphoid cells. Of 13 pairs with a difference in immunoglobulin phenotype between donor and recipient, 8 patients exhibited donor allotypes 3 months or later after transplantation, in 3 of them together with recipient allotypes. In the remaining 5 patients, recipient allotypes were detected after transplantation, but the simultaneous presence of donor-type immunoglobulin production could not be excluded in 4. The persistence of either a split (T lineage of donor origin and B lineage of recipient origin) or mixed (T and/or B lineage of donor and recipient origin) chimerism was related to the type of disease. In 3 children circulating B cells of donor-origin did not fit with the recipient origin of the sessile immunoglobulin-secreting plasma cells. This implies that different immune compartments--e.g., bone marrow and peripheral lymphoid tissues--should be investigated following allogeneic bone marrow transplantation. A prolonged presence of recipient-type lymphoid cells increased the risk of leukemic relapse in the patients investigated. PMID- 3318035 TI - Erythrocyte repopulation after allogeneic bone marrow transplantation. Analysis using erythrocyte antigens. AB - Blood samples from 31 of 50 consecutive patients receiving bone marrow from an HLA-identical and mixed lymphocyte culture-nonreactive sibling were investigated for the presence of donor and autologous erythrocytes. Simple serological techniques using antigenic differences between donor and recipient and a blood transfusion policy taking these differences into account made this study possible. A total of 71% of the patients had donor erythrocytes demonstrable 4 weeks after bone marrow transplantation; almost all patients did so after 2 months. Disappearance or absence of donor red cells indicated poor patient prognosis. Persistence or reappearance of autologous erythrocytes in small percentages (0.05-10%) occurred without relapse of leukemia. Reappearance in high percentage (50-100%) indicated relapse. PMID- 3318038 TI - Inability of dendritic cells to prevent the blood transfusion effect in a mouse cardiac allograft model. AB - The beneficial effect of blood transfusions before clinical renal transplantation is well established, but this can result in sensitization of some potential first graft recipients. Dendritic cells (DC), present in human blood, are potent stimulators of immune responses in vitro and in vivo, and in different systems they can overcome immune unresponsiveness. We therefore investigated whether DC could prevent the transfusion effect in a murine cardiac allograft model. C57BL/10 (C57) hearts were normally rejected by untreated DBA/2 recipients with a median survival time (MST) of 17 days. Long-term survival (MST greater than 100 days) was induced when the recipients were transfused with C57 blood 14 days before transplantation (d-14). Similar survival times were obtained when up to 1.5 x 10(5) splenic DC were added to the transfused blood. This number of DC or as few as 10(3), in "unsorted" preparations that were 70-85% pure, similarly enhanced when transfused alone at d-14. This enhancement was probably due to the contaminating cells rather than the DC since 10(3) lymphocytes prolonged survival, but an equivalent dose of "sorted" DC (ca. 93% pure, most contaminating cells being removed by sorting on an Ortho Cytofluorograf) did not. Transfusion of unsorted preparations containing 1.5 x 10(5) DC at d-3 led to accelerated graft rejection (MST 4 days). This sensitization was most likely due to the DC because equivalent numbers of lymphocytes were ineffective. Nevertheless, if a blood transfusion was given at d-14 followed by a normally sensitizing dose of DC at d-3, graft survival was still prolonged. Thus in no case were DC able to prevent the blood transfusion effect in this strain combination. Furthermore, DC of donor origin given to DBA/2 recipients with long-surviving C57 hearts, produced by prior blood transfusion, did not trigger rejection of the hearts. PMID- 3318037 TI - Fluorometric study for the noninvasive determination of cellular viability in perfused rat liver. AB - Pyridine nucleotide fluorescence in perfused rat liver for the noninvasive determination of donor graft viability was investigated in relation to other metabolic indices, such as NAD concentration, adenine nucleotides, and mitochondrial phosphorylative activity. The amplitude between oxidation and reduction levels (RxA) in fluorometric trace, and the slope or the velocity of the trace curve from oxidation to reduction (RxV) were determined by the measurement of fluorescence from NAD(P)H, using a new fluorometric device, RxA and RxV decreased proportionally to the duration of preservation period (6, 12, 24, 48 hr) in simple cold storage. Other values of hepatic cell viability, such as total adenine nucleotides, energy charge, and mitochondrial phosphorylation rate, were simultaneously measured and also decreased proportionally to the duration of preservation period. There were close positive correlations between the percentage of RxA and NAD concentration (r = 0.724, p less than 0.01), between the percentage of RxA and total adenine nucleotides (r = 0.887, p less than 0.01), between the percentage of RxV and energy charge (r = 0.715, p less than 0.01), and between the percentage of RxV and phosphorylation rate/cytochrome a(+a3) (r = 0.837, p less than 0.01). These results suggest that this fluorometric method can provide an accurate noninvasive evaluation of donor graft viability--and, unlike the present indices of energy metabolism, it may be applied to evaluate the primary nonfunctioning graft prior to transplantation. PMID- 3318036 TI - Evidence that thymectomized, bone marrow-reconstituted rats do not reject their allografts. AB - We have investigated the reasons why thymectomized, bone marrow-reconstituted (B) rats do not reject their allografts, by comparing the structure of inflammation and functions of inflammatory cells in nonrejecting allografts to rejecting allografts in normal control recipients. The results demonstrate that B recipients mount a specific cellular response towards the graft. The response in B recipients differs from that in normal controls by a smaller intensity of inflammation, fewer blast cells, and activated mononuclear phagocytes in the inflammatory infiltrate, as well as a delay in the appearance of specific donor directed lytic activity in the graft. B rats also have fewer blast cells and an inverted CD4/8 ratio in the spleen. There is no obvious absence of any given cell type or cellular function in the graft inflammatory infiltrate. In light of these results no cell type responsible for allograft nonrejection can be pinpointed. PMID- 3318039 TI - Naturally occurring interspecies and intraspecies antiimmunoglobulin antibodies. PMID- 3318043 TI - Preservation of rat liver grafts. PMID- 3318041 TI - Outpatient renal donor evaluation with intraarterial digital subtraction angiography. PMID- 3318040 TI - Acute appendicitis in the renal allograft recipient. PMID- 3318042 TI - The effect of pretreatment with a single cloned donor class I gene product on cardiac allograft survival in mice. PMID- 3318044 TI - [Cytochemical methods of detecting the ultrastructural localization of calcium]. AB - Conditions and potentialities of electron-cytochemical techniques for calcium detection are analysed in terms of current evidence on the role of membranes in sequestration of intracellular calcium pools. In most cases these conditions did not allow to preserve a native localization of calcium because the lability of calcium pools enclosed within membranes and the action of electron microscopic fixatives on the membrane permeability to Ca2+ and Ca-precipitating agents were not taken into account. Considering these factors it is essential that both the fixator and Ca-precipitating agent could diffuse through membranes simultaneously. The modes to ensure this essential condition as well as the reasons and ways to avoid artifacts in cytochemical studies are given. PMID- 3318045 TI - [Compartmentalization dynamics of the epidermal growth factor in A431 cells]. AB - Dynamics of compartmentalization of epidermal growth factor (EGF) in human carcinoma A431 cells during the first hour after initiation of endocytosis was examined by methods of the organelle fractionation on a 20% Percoll gradient and of the microfluorimetric visualization of endocytosis of rhodamine-labeled EGF (EGF-R). EGF was revealed in small vesicles localized in the peripheral region of cytoplasm in a few minutes after endocytosis initiation. During centrifugation in Percoll these vesicles (endosomes), with an average density of 1.038 g/ml, were seen co-sedimented with Golgi membranes. By one hour after initiation of endocytosis, EGF-R was accumulated in perinuclear zone, in a trans-Golgi region, as numerous big luminous centres that were apparently MB-endosomes and had the same density in Percoll as did small peripheral endosomes. Such centres appeared in several cells already within 5-10 minutes. In A431 cells EGF did not reach lysosomes within 60 minutes, because no accumulation of 125I-EGF was shown in lysosome corresponding regions of Percoll gradient (average density 1.070 g/ml). PMID- 3318047 TI - [Pavel Pavlovich Rumiantsev (on his 60th birthday)]. PMID- 3318048 TI - United States Public Health Service Tuberculosis Therapy Trial 21: preliminary results of an evaluation of a combination tablet of isoniazid, rifampin and pyrazinamide. PMID- 3318046 TI - [Detection and identification of Mycoplasma infections by DNA hybridization]. AB - Infection of cell cultures by mycoplasmas can be detected by hybridization of the DNA of suspected cell cultures with recombinant plasmids containing fragments of the mycoplasma DNA. The test is very sensitive and allows detection of as little as 1 ng of mycoplasmal DNA, roughly equivalent to the DNA amount of 10(6) mycoplasmas. This approach turns out to be effective for detection and identification of mycoplasmas in clinical material, plant and insect tissues. A set of DNA probes for detection of mycoplasmas infecting cell cultures by dot hybridization has been constructed. This set consists of specific DNA probes and universal DNA probe. Recombinant plasmids, pAl32, pMa13, pMh9, containing specific DNA fragments of Acholeplasma-laidlawii, Mycoplasma arginini, Mycoplasma hominis (the prevalent mycoplasma contaminants of home cell cultures) are species specific DNA probes. Recombinant plasmid pMg16 containing rRNA genes of Mycoplasma gallisepticum is the universal DNA probe for detection of any mycoplasma (or any prokaryote) contaminations. These two classes of DNA probes may be considered as complementing each other. These 32P labeled probes do not hybridize with eukaryotic DNA. The set of DNA probes allows not only to detect infection of cell cultures by mycoplasmas but also to identify the species of mycoplasmas and to evaluate the multiplicity of mycoplasma infection. PMID- 3318049 TI - Serum thymidine kinase and beta-2 microglobulin in monoclonal gammopathies. AB - We evaluated the serum thymidine kinase (TK) and beta-2 microglobulin (beta-2) levels of 22 patients with monoclonal gammopathy of undetermined significance (MGUS) and of 29 patients with multiple myeloma (MM). Both parameters were significantly lower in MGUS than in MM patients and in early (stage I + II) than in advanced (stage III) MM. TK was also lower in MGUS than in stage I MM (p less than 0.025). A seven-fold increase of TK level was documented in one patient who developed a full blown picture of MM 6 years after a diagnosis of MGUS. In 3 patients with stage III MM, a sharp decrease in TK (40-77%) and in beta-2 (29 53%) levels at remission was evident with respect to the levels measured at diagnosis. Patients with high levels of TK or beta-2 had a shorter survival than those with low levels; however, this was statistically significant only for beta 2 levels (p less than 0.02). Serum TK as well as beta-2 levels appear to be of clinical value in monoclonal gammopathies and related to the course of the disease. PMID- 3318051 TI - Enzymuria in carboplatin nephrotoxicity. AB - Urinary excretion of N-acetyl-beta-glucosaminidase (NAG) is an early marker of nephrotoxicity. NAG activity was assayed by the fluorimetric method of Leaback and Walker in 17 patients treated (22 courses) with carboplatin (CBDCA, 220-550 mg/m2) before infusion and 24, 48, 72 and 96 h after. Increased excretion of NAG, a sensitive index of renal tubular damage, was observed following 10 of the 22 courses. A transient increase in plasma creatinine and/or abnormal proteinuria was observed in 6 cases. Impaired renal function prior to therapy seems to be a predisposing factor to the nephrotoxicity. PMID- 3318050 TI - Immunohistochemical localization of melanoma-associated antigen p94 kd200 with the use of a modified avidin-biotin-complex lectin method. AB - The immunohistochemical localization of melanoma-associated antigen p94 kd200 was investigated in frozen sections of 3 congenital nevi, 4 benign intradermal nevi, 1 regressing nevus, 1 blue nevus, 1 dysplastic nevus, 1 lentigo maligna, 1 superficial spreading melanoma and 2 metastatic melanomas. The original avidin biotin complex lectin method (Hsu SM, Raine L, Fanger H: Am. J. Clin. Pathol., 75: 734-738, 1981) was modified to detect the antigen. The sections were exposed to the monoclonal antibody to p94 kd200 (Hybritech Inc.), the linking biotin labelled anti-mouse IgG, the avidin-biotin peroxidase complex and the 3-amino-9 ethylcarbazole solution in an incubator at 37 degrees C and 100% humidity. We found that the percentage of cells expressing p94 kd200 varied between 0 and 100% in congenital nevi, between 80 and 100% in benign intradermal nevi, between 0 and 20% in the regressing, blue and dysplastic nevi, and in the lentigo maligna, 80 to 100% in the superficial spreading melanoma, and between 0 and 40% in the metastatic melanomas. Positive cells were found to be hypomelanotic (did not have heavy melanin content). The intensity of labelling or the degree of antigen expression on benign and malignant hypomelanotic cells was also found to vary. These findings 1) reinforce the concept of quantitative rather than qualitative antigenic differences in benign and malignant cells 2) suggest that kd200 is lost with increasing pigment production 3) offer a potentially significant tool to investigate the antigenic changes during cell differentiation. PMID- 3318052 TI - Results of two controlled studies on antiemetic combination against vomiting induced by 5-fluorouracil. AB - A group of 132 patients with different disseminated solid tumors entered two consecutive antiemetic trials in which 5-fluorouracil given in a 120-h continuous infusion was the emetogenic stimulus. The purpose of the trials was to investigate the validity of Peroutka and Snyder's hypothesis. These authors suggested that CNS receptors other than the classical dopamine D-2 (e.g., histamine H-1 and muscarinic cholinergic receptors) were involved in emetic response. Hence, a combination of a phenothiazine (an antidopaminergic drug) with an antihistaminic or a tricyclic antidepressant (H-1 and muscarinic cholinergic blockers) was suggested to be possibly superior to phenothiazine alone against antineoplastic chemotherapy-induced vomiting. The first study showed the antiemetic superiority of a phenothiazine (thiethylperazine) over placebo but failed to show a superiority of the combination of thiethylperazine and an antihistaminic (diphenhydramine) over thiethylperazine alone. In contrast, the second study proved the superiority of the combination of thiethylperazine and a tricyclic antidepressant (amitriptyline) over thiethylperazine alone. In conclusion, tricyclic antidepressants - but not antihistaminics - potentiate the antiemetic activity of thiethylperazine against 5-fluorouracil-induced vomiting. PMID- 3318053 TI - Sebaceous carcinoma arising from the eyelid and from extra-ocular sites. AB - Sebaceous carcinoma is slow growing, locally aggressive and capable of metastatic spread. The natural history of sebaceous carcinoma arising from the eyelid is well known, but less than 100 cases arising from other cutaneous sites have been reported. Five cases of sebaceous carcinoma, 3 of which originated from the eyelid and 2 from extraocular sites are here reported. The patients (3 men and 2 women; median age, 69 years) were treated at the Istituto Nazionale Tumori of Milan between 1974 and 1984. Pathologic features, complete follow-up and natural history are reported. PMID- 3318054 TI - [The role of phosphorylation and dephosphorylation of receptors in the regulation of steroid hormone binding]. AB - Modern conceptions on the ways of possible modification of steroid hormones receptor proteins in cell and a functional significance of the given process are stated. Enzyme systems ensuring the reactions of receptor proteins phosphorylation and dephosphorylation are analyzed. Data on the ATP participation in the processes of receptor proteins phosphorylation and hormone-receptor complex activation are generalized. Participation of the phosphorylation dephosphorylation processes of receptor proteins in the hormonal signal transfer in a cell is shown possible. PMID- 3318055 TI - [Autoradiography method in biological research]. AB - The paper deals with data available in literature about the origin and development of the autoradiography method based on the ability of silver halogenides to be reduced under the effect of radioactive radiation and to reconstruct the image of objects which have incorporated the isotope. The evidence are presented on the development and updating of techniques of the above method, as well as on application of combined sets of emulsions and devices. Successful attempts as to the procedure automation and application of computers for quantitative estimation of the autoradiography data are elucidated. Application of different modifications of the autoradiography method in biological tests is shown through examples. PMID- 3318056 TI - [Polypeptide growth factors from the loach embryo at the blastula stage]. AB - Substances which (depending on their dose) stimulate [3H]thymidine incorporation into the trichloracetic acid insoluble fraction of the in vitro cultured mouse NIH-3T3 cells were isolated from the blastoderm and from the yolk of the teleost fish loach embryos (8-9 hours after the eggs' fertilization) by the acid-ethanol extraction method. In the medium which contained the 0.5% fetal calf serum with addition of 100 micrograms/ml of the above mentioned substances the stimulation of labeled thymidine incorporation into cellular DNA achieved 44-56% of the level which was detected in the presence of 10% serum. The pepsin and trypsin treatment led to a significant decrease in the mitogenic activity of the both investigated factors, that confirmed their polypeptide structure. The factors are sufficiently thermostable as they retain almost completely the activity after 30 min heating at 56 degrees C and lose less than 70% of their activity after boiling for 5 min. Gel-filtration of the growth factors from the loach embryos' yolk on the Biogel P 60 column has shown that the growth stimulating activity is mainly concentrated in the fraction which contains the polypeptides with molecular weight about 5 kDa. The significance of mitogenic factors in the loach embryos at the earliest stages of the embryonic development is discussed. PMID- 3318057 TI - The ultrastructure and immunocytochemistry of renal cell carcinoma. AB - The spectrum of ultrastructural features of a series of primary renal cell adenocarcinomas, including clear cell, granular, oncocytic, and sarcomatoid types, and a group of metastatic renal cell adeno-carcinomas has been studied. The contributions of electron microscopy and immunocytochemistry as adjuncts to light microscopy and histochemistry in the differential diagnosis of metastatic renal cell adenocarcinoma in various anatomic locations are reviewed. PMID- 3318058 TI - Diffuse epithelial mesothelioma: a review of the ultrastructural spectrum. AB - Traditionally, diffuse epithelial mesotheliomas are mainly identified at the ultrastructural level by the numerous, long, wavy-appearing surface microvilli. By electron microscopy of a series of diffuse mesotheliomas of varying subtype (epithelial, biphasic, sarcomatous, and poorly differentiated), it can be demonstrated that the differentiation of this specialized surface organelle is quite variable even in well-differentiated lesions. The presence of only a few, scattered, short microvilli does not exclude a diagnosis of epithelial mesothelioma, particularly if historical, surgical, and radiologic findings support this diagnostic conclusion. Indeed, even the complete absence of surface microvilli is compatible with a diagnosis of diffuse epithelial mesothelioma. It is important to become aware of the spectrum of tumor cell differentiation in serosal tumors, as all of the fine structural diagnostic criteria in mesotheliomas are expressed to varying degrees in individual cases. PMID- 3318059 TI - The ultrastructural spectrum of astrocytic neoplasms. PMID- 3318060 TI - Immunoelectron microscopy in diagnostic virology. PMID- 3318061 TI - The value of morphometry in the ultrastructural diagnosis of Mycosis fungoides. AB - To assess the value of morphometry in the ultrastructural diagnosis of Mycosis Fungoides (MF), skin biopsy specimens from 43 patients with established MF and 28 with non-MF lymphoid skin infiltration were studied by transmission electron microscopy. Morphometrical measurements were done on the nuclei of the infiltrating lymphoid cells. The study showed that the nuclear contour index (NCI) taken alone has a very poor diagnostic value. A more reliable way to assess morphometrically the nucleus of MF cells is to combine two parameters: the nuclear surface area and the NCI, as proposed by McNutt and his group. Although the sensitivity of this method is only 43% (McNutt et al. obtained a sensitivity of 63%, analyzing a smaller number of patients), it surprisingly has a highly significant prognostic value. Most of the patients classified as positive by this method had a very aggressive course of their disease or died from it, while most of the patients who were considered as negative had an indolent course of disease or were at a stage of remission. It is suggested that other cellular expressions may be of importance in the recognition of MF cells. It is therefore proposed that, in combination with ultrastructural immunocytochemistry, such parameters be assessed. It is hoped that the results of such a study will determine the number of parameters necessary to better recognize MF cells, thus making early diagnosis of the disease possible. PMID- 3318062 TI - Postembedding immunoelectron microscopy using protein A-gold. AB - Immunogold techniques offer the advantage of identifying antigens in tissues that show optimal ultrastructural morphology. The technique is applicable to any antigen that can be shown to withstand the denaturizing effects of fixation, osmication, dehydration, and embedding in epoxy resin. The list of antigens that survive these procedures is long and growing. PMID- 3318063 TI - Electron spectroscopic imaging. AB - Electron spectroscopic imaging (ESI) is a short term for electron energy loss spectroscopic imaging. ESI is to date the most sensitive electron microscopic analytical technique and has a spatial resolution of 0.5 nm and a mass resolution of less than 50 atoms. ESI takes advantage of filtered, inelastically scattered, transmitted electrons to form spectroscopic images. This analytical mode was developed by F. P. Ottensmeyer of the Ontario Cancer Institute in Toronto, Canada. Specimens to be analyzed by ESI should not exceed 30 nm in thickness so that multiple scattering of electrons is avoided. Isolated macromolecules constitute ideal specimens. For the analysis of diffusable elements, elaborate techniques involving quick-freezing, drying and embedded in plastic of the specimens have to be used. An example is given in which calcium was analyzed in the mitochondria of the convoluted proximal tubules in the rat kidney in normal and acute ischemic conditions. The example shows that calcium was not extracted during the preparation of the tissue. The high resolution of ESI allows the localization of calcium inside mitochondria. Experiments in progress using homogenous standards will soon render ESI entirely quantitative. It is concluded that ESI will become more and more important as a tool for the study of the pathogenesis of conditions in which modification of the distribution and concentration of elements are involved. PMID- 3318064 TI - Scanning electron microscopy in the backscattered electron imaging (BEI) mode: applications to clinical hematology. AB - Elements of high atomic number backscatter electrons that carry information of cytochemical and of immunocytochemical significance in high resolution scanning electron microscopy (SEM). Reaction products of enzyme cytochemistry containing lead or osmium have been used to localize the sites of phosphatase and of endogenous peroxidase, respectively. Particles of colloidal gold, ranging in diameter from 40 to 13 nm, have been successfully used to label cell surface antigens specifically identified by murine monoclonal antibodies. The diagnostic potential of the scanning electron microscope in clinical hematology appears to be considerably enhanced by the use of the backscattered electron imaging (BEI) mode. Quantitation of the number of gold-labeled epitopes on cell surfaces cannot be achieved in the conventional secondary electron mode of the SEM, but is an attractive possibility in the backscattered electron imaging mode. PMID- 3318066 TI - Have your scanner's acoustic output figures been tissue adjusted? PMID- 3318065 TI - A malignant mediastinal tumor, unclassified, most consistent with thymoma in a 9 year-old girl. PMID- 3318067 TI - Acoustic cavitation and the safety of diagnostic ultrasound. AB - A massive body of screening studies attests to the safety of diagnostic ultrasound. It appears that further progress in analysis of the safety question, will require mechanistic guidance. In theory, transient cavitation can occur under diagnostically relevant conditions if appropriate nuclei exist in the exposed medium. Low-temporal-average-intensity, pulsed ultrasound equivalent to that used in diagnosis has been shown to cause deleterious effects in lower organisms. All available evidence supports the conclusion that these effects are mediated by acoustic cavitation. It is impossible to extrapolate from these observations to human beings. However, all of the information available to us at the present time suggests that if transient cavitation occurs under diagnostic conditions, the events are rare, highly localized and probably would be of minor importance in almost any part of the body with the possible exception of the developing embryo or fetus. Transient cavitation is characterized by sharply defined thresholds. If future studies demonstrate the occurrence of cavitation related effects, they can be eliminated simply by keeping the maximum pressure amplitudes below those thresholds. PMID- 3318068 TI - Analytical modelling of ultrasonically induced tissue heating. AB - Ultrasonically induced heating in biological tissues has been studied for decades because of its implications for the safety of diagnostic systems and for possible therapeutic applications. Analytical models have been developed to study heating for short-term, ablative exposures and for long-term hyperthermia exposures. These models account for many of the acoustic and thermal phenomena implicated in heating but several factors remain to be fully included. Excellent agreement has been found between model results and experimental lesions in the brain and eye. Future developments may provide new capabilities for computer simulations related to safety and therapy. PMID- 3318070 TI - Spectrum analysis in carotid sonography. AB - Numerous Doppler spectral parameters for measurement of carotid obstructive lesions have been developed in recent years. This proliferation of parameters has caused sonologists to wonder which are valid and should be used routinely. This review article surveys the most commonly used Doppler spectral parameters. The physiological basis for each parameter is considered along with clinical applications and limitations. The use of spectral parameters for measuring carotid stenoses is summarized by means of an algorithm. PMID- 3318069 TI - Fetal renal anomalies, a diagnostic dilemma in the presence of intrauterine growth retardation and oligohydramnios. AB - Measurement of the head-to-abdomen (H/A) ratio for differentiating between symmetrical and asymmetrical IUGR may be difficult in the presence of marked oligohydramnios. A total of 76 cases of IUGR with various degrees of oligohydramnios was studied. Sixteen (59%) out of 27 structural defects represented bilateral renal agenesis, 11 of which were diagnosed prenatally. When only the H/A ratio was measured (n = 29) the sensitivity in picking up a structural defect was 50%. Calculation of the pulsatility index in the umbilical artery and fetal internal carotid artery (n = 47), whether or not combined with amnioinfusion (n = 5), resulted in a sensitivity of 76%. It is suggested that the latter two techniques may provide valuable additional information as to the cause of IUGR. PMID- 3318072 TI - Bibliography of biomedical ultrasound. No. 70. PMID- 3318071 TI - Variability in measurement of specific parameters for carotid duplex examination. AB - The variability of four carotid artery frequency parameters used for classifying disease with duplex scanning was prospectively studied. Forty-eight patients (94 patent carotid arteries) were each examined by two technologists. Measured parameters were the peak systolic frequency (PSF) and the first zero slope from the common carotid artery, and the PSF and end diastolic frequency (EDF) from the internal carotid artery. Measurements from all the examinations were made twice by each technologist. Interobserver, intraobserver, and interpatient variability in measurement of the first zero slope was so great that we have abandoned its use. Measurement of variability for PSF and EDF was much less (correlation coefficients 0.68 to 0.92). These parameters were measured with sufficient precision to warrant their continued use for important decision steps in classifying carotid artery disease. Interpatient differences in PSF sufficient to cause disagreement regarding the hemodynamic significance of carotid disease occurred in only three instances. In each of these cases the differences were due to examination technique (failure to identify a very distal internal carotid artery stenosis, difficulty distinguishing between a kink and a stenosis, and failure to recognize an improper Doppler angle). We conclude that the variability of PSF and EDF is within clinically acceptable levels and is mainly due to examination technique rather than measurement of waveform parameters or changes in patient hemodynamics. PMID- 3318073 TI - Two-dimensional and Doppler echocardiography in acute myocardial infarction and its complications. AB - Two-dimensional echocardiography is an outstanding and unique bedside diagnostic and prognostic method for cardiologists facing the early diagnosis and complications of acute myocardial infarction. Its advantages are safety, rapidity, portability, and relatively low costs. It is suitable for evaluation of global and, more importantly, segmental myocardial function. Segmental wall motion analysis reliably detects, localizes, and estimates the extent of myocardial infarction in the first hours after onset of symptoms. In addition, it is the most sensitive method to diagnose right ventricular infarction and provides information predictive of early and late postinfarct complications. In postinfarct hemodynamic deterioration two-dimensional echocardiography allows one to distinguish primary pump failure from mechanical complications as: rupture of the free wall, of the ventricular septum or mitral valve dysfunction. In the subacute stage complications as ventricular (pseudo) aneurysm and thrombus may be diagnosed by two-dimensional echocardiography. Combined Doppler echocardiographic examination provides reliable information about the presence of insufficiency or shunting. Thus, echocardiography has become indispensable at the coronary care unit as it provides a complete picture of cardiac structure and function making it superior to most other methods in the clinical situation of an acute myocardial infarction with such a volatile and unpredictable course. This is an argument to house an echo/Doppler instrument in the coronary care unit. PMID- 3318074 TI - A particulate contrast agent with potential for ultrasound imaging of liver. AB - Ultrasonic backscatter and attenuation coefficients of a medium can be increased by the addition of solid, micron sized inhomogeneities. A potentially useful agent for ultrasonic contrast of liver images has been identified. Iodipamide ethyl ester (IDE) particles can be produced in the form of dense, relatively incompressible solids with high impedance mismatch to water. The chemical, biomechanical, and pharmacological properties of the small, uniform diameter IDE particles permit safe intravenous injection followed by rapid accumulation by reticuloendothelial (RE) cells of the liver and spleen, and later elimination from these organs. Since the particles are phagocytized by RE cells, present in normal liver but not in tumors and many lesions, the selective enhancement of ultrasonic backscatter should improve detectability of lesions which are hypo- or iso-echoic compared to surrounding tissue. The mechanisms of particle-ultrasound interaction may be described by relative motion attenuation, and scattering from a cloud of dense, incompressible spheres for the case of IDE particles in agar. Thus, values of attenuation and backscatter can be controlled by choice of ultrasound frequency and particle concentration and size. When the particles are accumulated in rat livers, additional mechanisms induce attenuation and backscatter in excess of that predicted by IDE in agar. This preliminary work demonstrates that solid, biocompatible particles may be useful as an ultrasonic contrast agent. PMID- 3318075 TI - Bibliography of biomedical ultrasound. No. 69. PMID- 3318077 TI - A method to improve the accuracy of ultrasound geometrical measurements of boundaries in soft tissue. AB - The geometric distortion due to the neglect of refraction in existing ultrasound scanners is demonstrated. An iterative technique to correct for refraction errors in B-mode ultrasound, denoted Second Order Refraction Transposition (SORT), is presented. In vitro experiments were performed that confirm the calculated results. PMID- 3318076 TI - The practical significance of two-dimensional deconvolution in echography. AB - This paper evaluates deconvolution (inverse filtering) as applied to ultrasonic imaging systems, and discusses the obstacles which are encountered employing the technique in practice. A minicomputer is used to generate artificial echo signals, simulating rf signals resulting from a set of point reflectors in a homogeneous medium, as recorded by an electronically focused group-steered linear array scanner. Two-dimensional deconvolution in combination with a Wiener noise reduction filter (i.e., a Wiener-Inverse filter) is applied to these simulated rf signals, which were contaminated with white noise. The efficacy of the Wiener Inverse filter is defined in terms of its ability to resolve two point reflectors with a lateral spacing equal to the local -6 dB width of the ultrasonic beam. In favorable circumstances, the targets are resolved at signal-to-noise ratios (SNR) better than 20 dB, where SNR is defined as the maximum signal power divided by the average noise power level. Nonlinear effects due to quantization or signal clipping are investigated. In order to improve the resolution of an rf signal with a dynamic range of 40 dB, the input signal should be digitized at a minimum of 12 bits. The problem of signal clipping can be circumvented by oversampling. The two-dimensional Wiener-Inverse filter is defined in terms of both temporal and spatial properties of the insonification. Effects of wave diffraction give rise to a depth-dependent ultrasonic beam. As a result of a misfit of the Wiener Inverse filter and the local properties of the ultrasonic beam, erroneous noisy texture arises in the image. Adaptation of the Wiener-Inverse filter with respect to the beam properties gives acceptable results, at the expense of a rather large computational effort. PMID- 3318078 TI - A preliminary study on the angular distribution of scattered ultrasound from bovine liver and myocardium. AB - Measurements were performed on freshly-excised bovine liver and myocardium to determine the ultrasonic scattering nature of the tissues under a variety of experimental conditions. Results for the angular distribution of the differential scattering cross section per unit volume of tissue are reported for scattering angles spanning 170 to 44 degrees for interrogating frequencies of 1.0, 2.25, 3.5 and 5.0 MHz. Fresh and aged tissues, some with abnormally high connective tissue content were analyzed. The results are compared to previously-published works. PMID- 3318080 TI - Frequency diversity speckle processing. AB - Ultrasonic waveform data from a tissue-mimicking phantom containing low contrast targets was digitized, stored and processed prior to creating and displaying ultrasonic images. Speckle reduction was performed by digital filtering of the waveform data with appropriately spaced and weighted digital filters, prior to both coherent and incoherent image averaging. The resultant images showed increased signal-to-target boundaries was noted in the processed, compared to unprocessed, images. Incoherent and coherent processing were investigated, and appeared to be equivalent. PMID- 3318081 TI - [Uncomplicated gonorrhea and disseminated gonococcal infections--clinical aspects, diagnosis and therapy]. AB - Gonorrhoea is not only the oldest but also still one of the most frequent sexually transmitted diseases. Under therapeutic aspects it seems worthwhile to distinguish between uncomplicated and complicated forms. Uncomplicated gonorrhoea - urethritis being its most important variant - can be cured by adequate single injection treatment while complicated disease cannot. Disseminated infection is one of the major threats of gonococcal infection. The outcome is potentially fatal. Therapeutic considerations today have to take antibiotic-resistant or even multi-resistant Neisseria gonorrhoeaestrains into account. Third-generation cephalosporins and second-generation quinolones represent potential alternatives to conventional agents. PMID- 3318079 TI - Pipeline sampled-delay focusing in ultrasound imaging systems. AB - A sampled-delay focusing technique was recently proposed by the authors which completely eliminates the use of analog L-C delay lines for beam focusing in completely eliminates the use of analog L-C delay lines for beam focusing in ultrasound B-mode imaging systems. With this approach, the product of sampling rate and maximum time delay is required to be less than unity. To remove this constraint, we propose in this paper a first-in-first-out pipelining technique. This allows one to perform beam steering and dynamic focusing simultaneously on a resolution-cell basis and in a completely digital fashion without the use of analog L-C delay lines. PMID- 3318082 TI - [Genital Mycoplasma infections--clinical aspects, diagnosis and therapy]. AB - Ureaplasma urealyticum und Mycoplasma hominis are frequently isolated from the urogenital tract of sexually active persons. Their pathogenetic role in urogenital infections and infertility are still controversial. U. urealyticum can cause urethritis and most likely also chronic prostatitis. M. hominis can cause cystitis, salpingitis, and postpartal fever in women and meningitis in newborns. M. genitalium was recently isolated from patients with urethritis and salpingitis. The diagnosis is made by the cultivation of mycoplasmas in high concentrations and rising antibody titers in the serum. As in chlamydial infections, the therapy of first choice is tetracyclin. M. hominis can also be treated with clindamycin, U. urealyticum with erythromycin. PMID- 3318084 TI - [Genital chlamydia infections--clinical aspects, diagnosis and therapy]. AB - Non-gonococcal urethritis and its counterpart in women have become the most frequent genital infection worldwide. As Chlamydia trachomatis is the major causative agent interest has focused on this bacterium. While genital chlamydial infection in men often is manifest the opposite holds true for women. Major complications such as pelvic inflammatory disease can nevertheless turn up. Therefore efficient diagnostic tools are badly needed. If tissue culture procedures are not available direct specimen tests can be performed using fluorescence labelled monoclonal antibodies. For therapy tetracyclines and erythromycin are still the drugs of choice although the cure rates are not totally acceptable. Therefore evaluation of the new quinolones deserves interest. PMID- 3318085 TI - [Latent and manifest acquired syphilis--clinical aspects, diagnosis and therapy]. AB - The annual reported incidence of new syphilis infections in the FRG is decreasing; cases with atypical or oligosymptomatic forms of syphilis, however, show a relative increase. In contrast to the primary or secondary stage, the late stages of syphilis are very rare. Of great diagnostic importance is the serological examination which today can be limited to the VDRL and TPHA tests for screening and the FTA-ABS test for confirmation. In cases with an atypical clinical picture or history, the necessity for treatment can be verified with the 19S-IgM-FTA-ABS test and demonstration of treponemal IgM antibodies. Penicillin is still the drug of choice for the treatment of syphilis. In patients who are allergic to penicillin, the administration of erythromycin, tetracycline and, recently, of cephalosporins can be considered. PMID- 3318083 TI - [Gardnerella vaginalis infection. Clinical aspects, diagnosis and therapy]. AB - The Gardnerella vaginalis-infection of the urogenital tract is of clinical importance in females and of epidemiological importance in males. Females suffer from Bacterial Vaginosis, with a foul-smelling grey vaginal discharge with a pH of 5.0-5.5 which contains "clue cells", and from Sepsis. The isolation and identification of G. vaginalis i necessary in man. If G. vaginalis-infection is suspected, simultaneous infections with further STD-agents such as N. gonorrhoeae, C. trachomatis etc should be excluded. Metronidazole (1 g/day for 5 days) is the drug of choice in G. vaginalis-infection. PMID- 3318086 TI - [Diagnosis and therapy of ulcus molle]. AB - In developing countries of tropical Africa and South-East Asia chancroid is the most important cause of genital ulzerations. In the last decade also in industrial countries of the western hemisphere sporadic epidemics of this sexually transmitted disease were observed. This surprising revival of a disease already thought to have died out induced advances in cultivation and characterization of the etiologic agent as well as new therapeutic approaches. Treatment regimens based on erythromycin, cephalosporins of the third generation or a combination of amoxillin with the beta-lactamase inhibitor clavulanic acid can be recommended. Penicillins and tetracyclines are mostly ineffective because of plasmid-mediated resistance in Haemophilus ducreyi. As in other sexually transmitted diseases simultaneous infections with other pathogens have to be taken into consideration. The sexual partners of the patients should likewise be examined and if need, be treated. PMID- 3318087 TI - [Current status of vaccine development in sexually transmissible diseases]. AB - A prophylactic vaccine represents a major hope for the control of sexually transmitted diseases. The current general vaccine strategies and the status of vaccine development against infections with Neisseria gonorrhoeae, Treponema pallidum, Chlamydia trachomatis and Herpes simplex virus are described. Vaccines consisting of whole infectious agents are replaced by protective subunits. A subunit vaccine has the advantage to be free from other components, which are not relevant for protection and which may confer unwanted side effects. At the present time vaccine development against infections with Neisseria gonorrhoeae and Herpes simplex virus seems to be the most progressed. With monoclonal antibodies several surface components could be identified, which are of importance for the pathomechanism. With Treponema pallidum and Chlamydia trachomatis the development is delayed by unsolved problems of immunity. For the production of vaccines molecular-biologic methods, like protein synthesis or gene cloning will be used. Genetically modified live vaccines or polytope hybrid vaccines will gain importance in the future. PMID- 3318089 TI - Superficial bladder cancer treated by intravesical bacillus Calmette-Guerin or adriamycin: multicenter study interim report. AB - One hundred sixteen patients with superficial bladder cancers (Stages Ta, T1, and TIS) were evaluated and treated with either intravesical bacillus Calmette-Guerin [Tice strain] (BCG) or doxorubicin hydrochloride (Adriamycin [ADR]), in a multicenter study. One hundred nine of these patients currently have follow-up. Of these, 54 were completely resected and 55 incompletely resected. For complete resections, based on recurrence rates per 100 patient months, both BCG (0.22) and ADR (0.91) worked well, although BCG had a slightly lower recurrence rate. However, for incomplete resections, BCG (0.20) had a markedly lower recurrence rate than ADR (2.52). Eighteen patients failed initial treatment, with either BCG or ADR. All have been placed on long-term therapy schedules. Of the 12 failures who currently have follow-up, 11 (92%) have either partially or completely responded with additional intravesical therapy. No patients in this study have yet required cystectomies. PMID- 3318088 TI - BCG in management of superficial bladder cancer. AB - Superficial bladder cancer and particularly carcinoma in situ has the potential for invasiveness for which the treatment is cystectomy with a resultant disappointing 50 per cent five-year survival and urinary diversion with a certain diminished quality of life. BCG therapy is a new method of treating aggressive superficial bladder cancer with better response rates than conventional chemotherapy. It may be immunologically mediated and, if so, may be the first major success of a therapeutic modality that offers less morbidity than the currently standard options of surgery, radiotherapy, or chemotherapy. PMID- 3318090 TI - Prognostic significance of nodal involvement in locally advanced (stage C) carcinoma of prostate--RTOG experience. AB - A total of 500 patients with extracapsular extension (clinical Stage C) carcinoma of the prostate received definitive radiotherapy directed to the prostate and the regional lymphatics. Pretreatment evaluation of the regional lymphatics was optional and was done in 245 patients who underwent either staging laparotomy or lymphangiography. The remaining 255 patients had no nodal evaluation. In 72 of the node-evaluated patients there was evidence of spread to the pelvic lymphatics and in 173 patients lymph nodes were negative. The three populations (lymph nodes not evaluated, lymph nodes-involved, and lymph nodes-not involved) were analyzed as to the distribution of the recognized prognostic variables and compared as to the study end points (locoregional failure, incidence of distant metastases, disease-free survival, and survival). PMID- 3318091 TI - Search for Clostridium botulinum in the South Orkney and Falkland Islands. PMID- 3318092 TI - Comparison of the immune response to variant influenza type B hemagglutinins expressed in vaccinia virus. AB - To compare the immune response induced by influenza hemagglutinin (HA) variants differing by a single amino acid, the genes for each HA variant were cloned and expressed in vaccinia virus. These variant HA genes have been previously described as being present exclusively in either egg-derived or MDCK cell-derived subpopulations of influenza B/England/222/82 virus. By using this approach we were able to vaccinate animals with homogeneous preparations of these viral antigens and thus circumvent the problem of heterogeneity within RNA virus stocks. Immunization and challenge experiments in mice indicated that even though vaccination with the recombinant vaccinia viruses induced different levels of cross-reactive neutralizing antibodies, mice vaccinated with either recombinant vaccinia virus were protected from infection with either subpopulation of influenza virus. Results with this model system support the view that influenza vaccines prepared with egg-derived virus should be protective against microvariants of virus that grow preferentially in MDCK and possibly other mammalian cells. PMID- 3318094 TI - Analysis of the genomic L RNA segment from lymphocytic choriomeningitis virus. AB - The arenavirus genomic L RNA segment represents approximately 70% of the viral genetic material but current understanding of the organization, regulation, and functioning of the viral L products remains limited. Biological studies with reassortant viruses have implicated the L RNA segment in the lethal infection of adult guinea pigs produced by LCMV-WE but no further explanation of the pathogenic process is presently available. We have initiated a detailed molecular analysis of LCMV L products based on construction and characterization of L specific cDNA clones and synthesis of L-specific hybridization probes. Nucleotide sequencing studies have allowed the derivation of a partial amino acid sequence for a predicted L protein and antisera raised against synthetic peptides have demonstrated an L protein in Western blotting experiments. Using this approach we have identified a single high molecular weight protein (approximately 200,000 Da) in purified virions and in viral ribonucleoprotein complexes extracted from acutely infected tissue culture cells. This L protein is translated from a nonpolyadenylated, genomic complementary L mRNA and potentially represents part or all of the viral RNA-dependent RNA polymerase. PMID- 3318093 TI - Heterogeneity of human immunodeficiency virus cell-associated antigens and demonstration of virus type specificities of human antibody responses. AB - We examined the antigens of human immunodeficiency viruses (HIV) expressed on infected H9 cells using live-cell membrane immunofluorescence and immunofluorescence absorption. Application of this nondenaturing serological method permitted analysis of HIV antigenic determinants maintained in their native configurations on the cell surface. Sera from infected individuals were found to react variably with H9 cells productively infected with nine different HIV isolates, and certain sera were completely unreactive with some isolates. Absorption of the sera prior to use in immunofluorescence revealed extensive heterogeneity of HIV cell-surface antigens and multiple type-specific antibodies in patients' sera. Immunoprecipitation and SDS-PAGE analysis of radiolabeled cell surface proteins indicated that the predominant serological reactions were to env encoded proteins. The observed antigenic and antibody heterogeneity likely reflects env sequence heterogeneity which has been previously reported for different HIV isolates. The demonstration of antigenic diversity among HIVs and the importance of defining the native antigenic epitopes, particularly those most widely shared, are important issues that must be considered in vaccine development. PMID- 3318095 TI - Immunogold localization of the intracellular sites of structural and nonstructural tobacco mosaic virus proteins. AB - Antibodies raised against the 126K nonstructural protein (replicase) encoded by tobacco mosaic virus (TMV) RNA or the viral coat protein have been used to localize these proteins within virus-infected tobacco leaf cells by an immunogold labeling technique. A protocol is given for low-temperature fixation to facilitate immunogold labeling. In cells of TMV-infected leaf tissue, the 126K protein immunogold label was found almost exclusively in "viroplasms" in the cytoplasm and in pockets of virus particles at the viroplasmic periphery. When utilizing the coat protein antiserum, very little labeling was seen within the viroplasms, although virus particles throughout the cytoplasm were heavily labeled. Viroplasms contained electron-dense rope-like structures embedded in a ribosome-rich matrix. In their "mature" form, viroplasms are the well-known "X body" inclusions. The rope-like structures were up to 1.2 micron long and appear twisted, undergoing several revolutions throughout their length, but were not of a constant pitch. In transverse section, they appeared to be composed of several hollow, radially segmented cylinders 21 nm in diameter, with a 9-nm hole. Antibody labeling showed them to be composed, at least in part, of the 126K protein. Clusters of virus particles at the edge of or within the viroplasms were also labeled with the 126K antiserum, in contrast to virus particles in other areas of the cell, which were not. TMV-infected tobacco mesophyll protoplasts cultured for up to 27 hr did not contain the rope-like ribbons. Instead, isolated protoplasts contained amorphous cytoplasmic areas which were labeled with 126K antibody. Since the 126K protein is most probably a constituent of the TMV RNA replicating enzyme (replicase), its intracellular location is considered to be indicative of the site of replication of TMV RNA. Therefore these results suggest that replication occurs at the edges of the viroplasms. PMID- 3318096 TI - Pathogen-derived resistance to viral infection using a negative regulatory molecule. AB - The principle of pathogen-derived resistance (the use of pathogen-derived genes to interfere with the pathogenic process and thereby confer disease resistance to the host) has been put forward as a broadly applicable conceptual tool for use in the genetic engineering of resistance to pathogens and parasites. It was previously predicted that four mechanisms of pathogen-derived resistance could be established using the bacteriophage QB and its host, Escherichia coli, as a model system. This paper demonstrates and helps ellucidate the first of these mechanisms by using a viral regulatory protein, the QB coat protein, to block viral replication. The QB coat protein gene was transferred to susceptible E. coli. Expression of this gene had no obvious detrimental effect on the host. Low level, constitutive expression of the coat protein conditions very high levels of resistance to QB infection. The resulting resistance is not associated with RNA interference or loss of pili as attachment sites, and does not appear to be associated with premature encapsidation. This low-level expression of the QB coat protein also produces an intermediate level of resistance to the closely related phage SP, but fails to protect against the unrelated phage f2. Thus the resistance does not result from a generalized antiviral host response induced by the presence of the coat protein. We conclude that the QB coat protein blocks viral infection, as was predicted, due to its action as a negative regulatory molecule. The use of negative regulatory molecules may provide an effective mechanism for use in the genetic engineering of pathogen-derived resistance. PMID- 3318098 TI - [Experimental nonprogrammed freezing of typed lymphocytes on a Terasaki plate]. PMID- 3318097 TI - Changes in p53 mRNA expression during terminal differentiation of murine erythroleukemia cells. AB - The protein p53 is functionally implicated in the normal regulation of cell proliferation. We have previously reported that the rate of p53 protein synthesis is reduced during the cessation of cellular proliferation which accompanies the in vitro induced differentiation of Friend-erythroleukemia cells. In this work we followed the p53 mRNA expression during the differentiation of these cells. We report on a new type of p53 mRNA with a slower electrophoretic mobility on gels, which appeared in the cytoplasmic fraction of the erythroleukemia cells between 1 to 3 days following induction of differentiation and persisted in the cells until Day 7. The larger type of p53 mRNA was found associated with polysomes, suggesting that it is translatable in cells. The difference in size between the noninduced and the differentiation-specific type of p53 mRNAs (about 200 nucleotides) was not abrogated following the deadenylation of the mRNAs, thus excluding the possibility that the altered size might result from a longer poly(A) tract. S1 nuclease mapping of the 3' termini of the p53 mRNAs revealed that the 3' ends of both p53 mRNA types were identical, suggesting that either alternative splicing or a longer 5' noncoding region could cause this heterogeneity in p53 mRNA transcripts. PMID- 3318099 TI - [Autoantibodies in hypertrophic cardiomyopathy. I. Incidence of antibodies against actin]. PMID- 3318100 TI - [Chronic myeloproliferative conditions and chronic myeloid leukemia (new findings and views)]. PMID- 3318101 TI - [Sanatoria born of the October Revolution]. PMID- 3318102 TI - [Mikhail Vladimirovich Mukhin (on the 90th anniversary of his birth)]. PMID- 3318104 TI - [The anti-alcohol policy of the armed forces of capitalist countries]. PMID- 3318103 TI - [Eduard Eduardovich Eikhval'd (on the 150th anniversary of his birth)]. PMID- 3318105 TI - [Role of the State Institute of Physiotherapy (SIP) in the development and use of physical treatment methods]. PMID- 3318106 TI - [Effect of trypsin and kallikrein (andecalin) on the activity of proteolytic enzymes and their inhibitors in acute experimental pancreatitis]. AB - Intramuscular administration of trypsin and kallikrein (andecaline) into rats contributed to more favourable development of acute traumatic pancreatitis. Trypsin and andecaline prevented the activation of proteinases in blood serum and pancreas and promoted an increase in content of trypsin inhibitor in blood serum. The proteinases efficiency appears to depend on elevation of general resistance of the organism to the trauma. PMID- 3318107 TI - [Medical chemistry in the USSR (on the 70th anniversary of the Great October revolution)]. PMID- 3318108 TI - [Characteristics of biogenesis and substrate specificity of lysosomal glycosidases under normal conditions and in glycosidoses]. AB - Main steps are considered of posttranslational modification of lysosomal hydrolases, which are glycoproteins. Processing of the enzymatic carbohydrate moiety in various compartments of endoplasmic reticulum and Golgi apparatus is discussed. Importance of mannose-6-phosphate groups formed during the processing is revealed by studies on binding of these enzymes with specific receptor responsible for their transport into lysosomes. Specificity of lysosomal glycosidases and their isoforms, catalyzing hydrolysis of carbohydrate chains of glycoconjugates and of synthetic substrates dissimilar in the structure, is discussed. Complex structural organization of these enzymes in lysosomes (protein activators and stabilizing factors, presence of marker sites etc) was studied using as an example lysosomal diseases of accumulation, glycosidoses, developed in hereditary deficiency of glycosidases. The data on elevated activity of the majority of lysosomal enzymes in glycosidoses, which are not involved in the primary genetic defect, suggest the possibility of general unspecific response of cells to accumulation of unhydrolyzed compounds. PMID- 3318109 TI - [The role of lysosomal proteinases in tissue destruction]. AB - Action of lysosomal and other proteolytic enzymes on components of the intracellular matrix--collagen, proteoglycans and fibronectin are reviewed. Various types of extra- and intracellular degradation of the intracellular matrix and interrelationship of these types are discussed. Regulatory functions of lysosomal proteinases and their role in activation of latent collagenase and in inactivation of alpha 1-proteinase inhibitor are considered. Some physiological and pathological processes involving local destruction of tissues are discussed. PMID- 3318110 TI - [Lysosomal proteins of neutrophils--factors of antimicrobial protection of cells]. AB - Lysosomal antimicrobial factors in neutrophilic granulocytes, components of oxygen-dependent and oxygen-independent mechanisms are considered. Physico chemical and biological properties om myeloperoxidase, cooperative effect of myeloperoxidase and other cation proteins in neutrophilic lysosomes, interrelation and interaction between various antimicrobial factors in phagocytosis are discussed. Inhibition of the oxygen active forms by means of blood serum proteins is considered. PMID- 3318111 TI - [Lysosomal enzymes of phagocytizing cells in the pathogenesis of inflammation]. AB - General principles of lysosomal hydrolases functional activity in polymorphonuclear leukocytes and macrophages in chronic and acute inflammations are considered. Studies on granulomatous inflammation, simulated in mice liver and lung tissues after intravenous administration of zymosan granules, enabled to analyze the interrelationship between intensity of infiltration and the activity of lysosomal cathepsin D and beta-galactosidase in these tissues. Activity of cathepsin D was mainly increased within early steps of granulomas development, while beta-galactosidase was activated during maturation of macrophages. Advantages of the inflammation model developed for studies on fundamental and applied problems related to treatment of chronic inflammatory diseases are considered. PMID- 3318112 TI - [Protease inhibitors in plants]. AB - Physico-chemical properties, primary structure and mechanism of action of proteins--proteinase inhibitors from plant sources are reviewed. The perspectives of their application in medicine are discussed. PMID- 3318114 TI - [Enzyme systems of lysosomes in cell nutrition]. AB - Lysosomal enzymatic systems were studied in various cell classes--hepatocytes, cardiomyocytes, adipocytes and thrombocytes during ontogenesis, in alteration of the nutritional type from placental to enteral and from enteral to parenteral, in disbalance of protein and lipid compositions, in starvation as well as in some pathological states related to impairment of lipid metabolism. Evolution of the cellular lysosomal apparatus appears to result in enlargement of its functions in cellular nutrition, which may be considered as an instrument of metabolic equilibrium at the step of hydrolytic catabolism participating in multiple physiological reactions. PMID- 3318113 TI - [Steroid hormones and lysosomes]. AB - The data on lysosomotropic effect of steroid hormones are reviewed. The effect of steroid hormones correlated with the type of tissues and dose of hormones. A possible role of lysosomes in realization of hormonal signal in the cell biological response is discussed. PMID- 3318115 TI - [Brain cathepsin as dipeptidylcarboxypeptidase transforming provasopressor, pro opioid and model peptides]. AB - Cathepsin B from brain exhibited both endopeptidase and dipeptidyl carboxypeptidase activity. Recently the factors, contributing to dipeptidyl carboxypeptidase properties of brain cathepsin B, were identified: I. occupation of the enzyme S3 subsite, 2. free C-terminal group of the substrate, 3. specific interaction between the split off dipeptide and the enzyme active site. The identification was carried out using angiotensin I, its C-end tripeptide and chromophore oligopeptides containing p-nitrophenylalanine residue. C-terminal dipeptide was split off in the proopioid peptides dynorphins 1-7 and 1-8, Met enkephalin-Arg6-Phe7, Met-enkephalin-Arg6-Gly7-Leu8; the enzyme hydrolyzed also the C-terminal dipeptide bond in Leu- and Met-enkephalins without the subsequent hydrolysis of the remaining tripeptide. D-Ala2, D-Leu5-enkephalin were not hydrolyzed; the bond Arg9-Pro10 was resistant to proteolysis in dynorphin 1-11. Cathepsin B split off the C-terminal dipeptide in synthetic substrates Leu-Trp Met-Arg-Phe-Ala and Trp-Met-Arg-Phe-Ala but not in Met-Arg-Phe-Ala. These results 06.08 M-15 demonstrated the essential role of branched-chain amino acid residue at the position of P2 and/or P3 of substrates for the enzyme dipeptidyl carboxypeptidase activity. The data obtained suggest that Arg residue at the position P2 (dynorphin 1-7) slowed down, D-amino acid at the position P2 (D-Ala2, D-Leu5-enkephalin) and Pro-Lys bond at the position P1-P2 (dynorphin 1-11) inhibited the cathepsin B dipeptidyl carboxypeptidase activity. PMID- 3318117 TI - [New approaches and prospects for improving antitumor cytostatic therapy on the basis of achievements in immunology]. PMID- 3318116 TI - [The role of active forms of oxygen in the pathogenesis of pneumoconiosis (review of the literature)]. PMID- 3318119 TI - [Hail to the 70th anniversary of the Great October Socialist revolution]. PMID- 3318118 TI - [Primary and secondary prevention of skin melanoma]. PMID- 3318120 TI - [Diabetes mellitus and malignant neoplasms]. PMID- 3318121 TI - Competitive enzyme-linked immunoassay for the quantitation of platelet-associated immunoglobulins (IgG, IgM, IgA) and complement (C3c, C3d) with polyclonal and monoclonal reagents. AB - A competitive enzyme-linked immunoassay (CELIA) was developed for the quantitation of platelet-associated immunoglobulins and complement proteins. The use of unlabeled polyclonal rabbit or monoclonal antibodies to human immunoglobulins and enzyme-labeled anti-mouse or anti--rabbit IgG (double-step technique) resulted in a higher sensitivity compared to the single-step technique using only enzyme-labeled anti-human immunoglobulin antibody preparations. Sensitivity and results obtained by both techniques were compared. The range of normal values for platelet-associated IgG, IgM, IgA, C3c and C3d was assessed upon a large number of normal blood donors. When platelet-associated IgG was concomitantly assayed with polyclonal and monoclonal anti-IgG by the double-step technique on platelets obtained from normal donors and thrombocytopenic patients, identical results were obtained with both reagents. Problems related to the quantitation of immunoglobulins on platelets with different assays and antibody preparations are discussed. PMID- 3318123 TI - Platelet-associated IgG in thrombocytopenia: a comparison of two techniques. AB - The results obtained in the analysis of 130 thrombocytopenic patients with a radioimmunoassay (RIA) for platelet-associated IgG (PA-IgG) and the platelet suspension immunofluorescence test (PIFT) were compared. The RIA was positive in 33 of 41 (82.9%) patients with idiopathic thrombocytopenia (ITP) and in 51 of 79 (64.4%) patients with secondary thrombocytopenia (STP). The PIFT was positive in 37 of the 41 (90.2%) ITP patients and in 57 of the 79 (72.2%) STP patients. Sensitivity and specificity for the diagnosis of ITP of both tests were comparable: 82.9 and 40.9% for the PA-IgG(RIA) and 90.2 and 36.7% for the PIFT. A significant positive correlation was observed between the mean amount of PA-IgG measured and the height of PIFT scores with anti-IgG. Of 38 discrepancies between PA-IgG(RIA) and PIFT with anti-IgG, 15 were due to borderline results, 17 were associated with abnormal platelet-size distribution and 20 were associated with occurrence of IgM antibodies. These results suggest influences of platelet fragments and/or aggregates on accurate measurement of PA-IgG. Both fragments and aggregates escape from accurate platelet counting, while their contribution to the total IgG content remains. Therefore, a falsely elevated PA-IgG (RIA) may be measured. PMID- 3318122 TI - Use of immobilized platelet membrane glycoproteins for the detection of platelet specific alloantibodies in solid-phase ELISA. AB - Platelet membrane glycoproteins were isolated from intact platelets by detergent phase extraction, fixed to the wells of microtiter trays and used as targets for the detection of platelet-reactive alloantibodies by enzymelinked immunospecific assay (ELISA). The final preparations contained 0.4% of total platelet protein. Antibodies reactive with antigens PlA1, PlA2, Baka, Pena and HLA-A2 were specifically detected at dilutions ranging form 1:640 to 1:1.600. Under the conditions utilized, the ELISA was more sensitive than assays involving 51Cr, radiolabeled monoclonal anti-IgG binding, and indirect immunofluorescence testing by one order of magnitude or greater. When platelets were pretreated with chloroquine to remove class I HLA antigens prior to detergent-phase extraction, reactions with HLA-specific antibodies were lost, but reactions with platelet specific alloantibodies were retained. This approach offers a simple, sensitive and rapid method to detect and identify platelet-specific alloantibodies in sera containing HLA-reactive alloantibodies. PMID- 3318124 TI - Anti-A of donor lymphocyte origin in three recipients of organs from the same donor. AB - The development of iso- and alloantibodies reactive with recipient red blood cells subsequent to organ transplantation is an established phenomenon. However, development of self-reactive antibodies in multiple recipients of organs from a single donor source has only been reported in one instance involving the formation of anti-D after transplantation. We observed the development of a delayed hemolytic transfusion reaction 10 days after transplantation of a group O liver into a group A recipient. Serologic studies revealed a positive direct antiglobulin test due to coating of autologous A cells with anti-A. Close follow up of the group A recipients of the kidneys transplanted from the same group O donor revealed development of hemolysis secondary to anti-A on day 11 in one recipient and hemolysis due to anti-A on day 13 in a second recipient. Significant anemia, a 2-3 g/dl drop in hemoglobin, occurred in both kidney recipients. These findings suggest that recipient of organs from donors whose transferred lymphocytes have produced antirecipient RBC antibodies in another recipient may be at risk for developing a similar self-limited hemolytic episode and should be followed accordingly. PMID- 3318125 TI - Recognition of a polymorphic monocyte antigen. AB - 138 sera from renal transplant recipients were screened for the presence of monocyte-specific antibodies. Most of the sera contained antibodies against monocytes, T- and/or B-lymphocytes. One serum was identified which defined a monocyte-specific antigen, MOLI. This serum was investigated in intensive population and family studies for the estimation of the formal genetic criteria of this 'new' monocyte antigen. A gene frequency of 0.0614 was obtained by population analysis. Family investigations conveyed the information that the gene coding for MOLI was transmitted in linkage with HLA genes. A positive linkage disequilibrium of MOLI and HLA-B17 was found. PMID- 3318127 TI - [Problems and prospects for the clinical use of silver preparations (a review of the literature)]. PMID- 3318126 TI - In memoriam Fred H. Allen, Jr. PMID- 3318128 TI - [Microcirculatory characteristics during aging and in arterial hypertension (a review of the literature)]. PMID- 3318129 TI - [Lesions from nuclear fission products: metabolism, clinical picture and pathogenesis (a review of the literature)]. PMID- 3318130 TI - [Evaluation of the phagocytosis disorders in myeloproliferative diseases based on data from the nitroblue tetrazolium reduction test]. PMID- 3318132 TI - [Conditions for efficient antibody binding with proteins of the human immunodeficiency virus studied by immunoblotting]. AB - The authors have investigated the antibody binding with individual HIV protein by "western" blotting method. The optimal condition for binding was incubation of nitrocellulose strips at 37 degrees C for 2 hrs followed by incubation at 4 degrees C overnight. Differences in the serologic activities of a number of sera in "western" blotting were shown by using two different antigens. It was concluded that mixing of different antigens before electrophoresis may be useful for more effective "western" blotting analysis. PMID- 3318131 TI - [Participation of the proteolysis system in promoting the virulence of the influenza virus and development of the infectious process; the antiviral effect of protease inhibitors]. AB - The results of the authors' own studies and data from the literature attesting to an important role of proteolytic mechanisms in influenza virus physiology and the development of the infectious process are summarized. The etiotropic and pathogenetic effectiveness of proteolysis inhibitors in influenza was demonstrated experimentally and clinically. Data are presented on the immunostimulating and prophylactic effect of a proteolysis inhibitor, E aminocaproic acid. It is concluded that the use of proteolysis inhibitors in viral infections holds good promise. PMID- 3318133 TI - [Generation and characteristics of hybridomas producing monoclonal antibodies to the surface antigen of hepatitis B virus]. AB - An optimal schedule for immunization of BALB/c mice has been found, providing a high yield of hybridoma clones producing monoclonal antibody (MCA) to hepatitis B virus surface antigen (HBsAg). Fourteen hybridomas of ZHAK series have been prepared. The cells of 9 hybridomas secrete MCA to the common-type determinant a, and of 5 hybridomas, to the subtype determinant y of HBsAg. The capacity of hybridoma cells for clone production and for induction of ascitic tumors in syngeneic animals was studied. In the cells of two clones marker chromosomes were detected not occurring in the original parent cells. PMID- 3318134 TI - [Changes in the synthesis of the virion antigen of the tick-borne encephalitis virus after passage through ixodid ticks and small mammals]. AB - Large-plaque strains of tick-borne encephalitis (TBE) virus possess a high peripheral activity, and in acute infection in continuous pig embryo kidney cells (PEK) synthesize a virion antigen (VA) whose subpopulations differ in their mobility in agarose gel electrophoresis: the bulk portion of VA moves towards the cathode and a small one towards the anode. After long-term passages of these strains in Ixodid ticks they lose their peripheral activity and produce only small plaques. In reproduction in PEK cells the amount of the infectious virus remains the same but VA synthesis changes significantly. There is almost no synthesis of VA moving towards the cathode and that of VA moving towards the anode remains unchanged or decreases insignificantly. The decrease in the synthesis of the major portion of VA is accompanied by the reduction of the hemagglutinating properties of the strains and retention of the nonvirion antigen production. Reversion to the initial properties of the strains passaged in ticks occurs after their inoculation into natural hosts of tick-borne encephalitis virus: small mammals (bank vole and common vole). PMID- 3318137 TI - Oral cholecystography and sonography of gallbladder in cholecystectomy patients. AB - In comparing the diagnostic specificity and sensitivity of oral cholecystography with that of sonography in 479 patients in a community hospital, the oral cholecystogram, when used with a double dose of contrast agent, showed greater specificity (1.00) and sensitivity (0.99) than the sonogram (0.54 and 0.94, respectively). Because of lower cost, the oral cholecystogram should be used as the initial diagnostic study when cholelithiasis is suspected, unless specific contraindications exist. PMID- 3318136 TI - Patterns of cervical spine injury and their associated lesions. AB - Motorcycle riding and diving into shallow water continue to present a high risk of cervical spine injury, often complicated by spinal cord damage. In patients with high cervical cord trauma, differentiation of arterial hypotension due to losing vasomotor control from the effects of internal hemorrhage can cause difficulty. In a series of 123 consecutive cases of cervical spine injury, no evidence was found that either early surgical treatment or steroid administration exert a favorable influence on recovery from traumatic myelopathy. When compared with other series, differences were found in the nature, frequency and severity of both spinal and associated injuries, resulting from the relative frequency among the population studied of trauma due to a particular mechanism-traffic accident, diving, industrial injury-and the special functions and location of the hospital from which information is gathered. PMID- 3318135 TI - [Immunoenzyme test system based on F(ab)2-antibody fragments for demonstrating influenza virus hemagglutinin]. PMID- 3318139 TI - Plasmodium vivax malaria from Mexico--a problem in the United States. PMID- 3318140 TI - Oregon Health Sciences University School of Medicine celebrates centennial. PMID- 3318141 TI - [An infectious-immunologic theory of the etiology of congestive cardiomyopathy]. PMID- 3318142 TI - [Indications for conducting electrophysiologic studies of the heart]. PMID- 3318138 TI - Nutrition of the fetus and newborn. AB - Both the successful development of healthy, long-term animal models to study fetal nutrition and metabolism and the improved survival of low-birth-weight, preterm infants have focused interest and research on fetal and neonatal nutrition and metabolism. Such a focus is important, given the recent emphasis on promoting neonatal growth in preterm infants at "normal" in utero growth rates. Estimates of nutrient requirements for growth in a human fetus remain ill defined, however. Body composition data appear biased toward thin infants. Animal data suggest that fetal nutrition proceeds according to species-specific growth rates, with variations in fat content largely dependent on placental fat permeability and on maternal nutrient supply as regulated by the placenta. After birth, neonatal nutrition is affected primarily by food intake and the functional integrity and capacity of the gastrointestinal tract. Additionally, muscle activity, thermoregulation and stresses of various kinds and degrees modify a neonate's nutritional requirements. Functional deficits of the gastrointestinal tract have been circumvented by a more aggressive use of intravenous nutrition. Both intravenous and enteral nutrient mixtures have been substantially improved in the quantity of all nutrients and have been modified qualitatively toward compositions that are closer to those of human milk. These nutrient mixtures now produce plasma nutrient concentrations that approximate those of a healthy, breast-fed infant. Although such efforts to improve the nutritional balance and growth of preterm infants have been successful, much remains to be learned about the nutritional requirements of sick infants. PMID- 3318143 TI - [Activities of the Institute of Medical Parasitology in Messina]. PMID- 3318144 TI - [Can muscle relaxation prevent the development of pneumothorax in artificially ventilated newborn infants?]. AB - A retrospective study was conducted on 37 ventilated newborn infants to find out whether muscle paralysis by pancuronium had prevented pneumothorax (pt) in those severely ill newborn infants. In the group of 21 newborns who developed pt, 17 (81%) had been paralyzed with pancuronium. In the group of 16 newborns without pt, 10 (61%) had received pancuronium (chi 2 = 1,568, ns). Thus, muscular paralysis had not prevented pt. Since the newborns in both groups were equally severely ill (mean compliance of the respiratory system 0.48 +/- 0.17 ml/cm H20 in the group with pt, 0.38 +/- 0.12 in the group without pt), we assume that pancuronium was unable to prevent pt in ventilated premature and full-term newborn infants. We therefore caution against the use of pancuronium as a paralytic drug known to have deleterious side effects. PMID- 3318145 TI - [Differentiation of an outcome sample in elective labor induction with PGE2 by the oxytocin sensitivity test]. AB - The goal of the present study was to evaluate whether the implementation of an oxytocin sensitivity test in addition to pelvic scoring would improve prediction of successful induction and could lead to a further reduction in the already low rate of protracted labour and operative deliveries in cases of elective induction by means of prostaglandin (PG) E2 tablets. In order to establish the optimal dosage we compared the endocervical application of 1.5 mg PG E2 with 3 mg intravaginally. Out of 158 women without risk factors examined at term 73.5% decided to have labour induced. In the induction groups given endocervical or intravaginal PG E2 the delivery intervals were significantly shorter and the rate of operative deliveries was reduced. In comparison with those women who decided to await spontaneous onset of labour, the fetal outcome was, however, the same. The endocervical application of 1.5 mg PG E2 did not prove any better than 3 mg given intravaginally. The performance of a pretherapeutic oxytocin sensitivity test yielded additional information about the chances of inducing labour successfully. The results confirmed the efficacy and acceptance of this method of inducing labour. PMID- 3318147 TI - [Stereotaxic biopsy of brain tumors]. AB - The management of patients with a brain tumour is essentially dependent on the knowledge of the histology. Because of its high accuracy and low complication rate stereotactic tumour biopsy has proven to be an important diagnostic procedure, especially in deep-seated lesions. Stereotactic tumour biopsy was carried out in 18 patients with target calculation either from computerized tomography (CT) or magnetic resonance imaging (MR). PMID- 3318146 TI - [Effect of risk factors on early and long-term regional results following kidney transplantation]. AB - An observational study by multifactorial statistical analysis was undertaken on 785 kidney transplants. Risk factors in first transplants for primary non function are cold ischaemic time, donor centre and acute rejection, with a non function rate of 8% and a delayed function of 37%. Risk factors for transplant survival are bad match, no preoperative transfusions, age of recipient below 40 years, male sex, diabetes, conventional immunosuppressive therapy and cadaver donors. Donor centre and delayed primary function have no influence on long-term kidney function. The analysis revealed additive effects of various risk factors. This has to be taken into account in recipient-selecting policy. PMID- 3318148 TI - [The placebo as a nonspecific treatment factor]. AB - Nonspecific drug actions result from the social interaction between physician and patient and the medical environment. Positive (therapeutic) placebo effects are produced in approximately 30-35% of treated patients, especially in cases of vegetative and psychic disturbances. There appears to be no distinct group of individuals with specific personality features that can be classified as "placebo responders". Negative (toxic) placebo effects, which are usually minor, are reported in 4-50% of treated patients. The occurrence of side effects may cause the patient to assume treatment with an active agent, thus increasing the therapeutic efficiency of the treatment (placebo amplification by side effects). On the other hand, the lack of a certain side effect may diminish the therapeutic effect of an active drug. The notion that placebo-induced analgesia is endorphin mediated is not established. Hence at present psychological mechanisms have to be assumed for the placebo effect. The conscious use of a placebo as a therapeutic agent is problematic for ethical reasons, whereas the placebo component of drugs with specific actions should be exploited to enhance their therapeutic efficiency. PMID- 3318149 TI - [The placebo: beyond pretense and the nuisance variable. Arguments in favor of re evaluating a significant protherapeutic concept ("aura curae")]. AB - In this theoretical paper the concept of placebo is being investigated within a field of tension: on one side the conventional understanding of "placebo", that is empirically inconsistent and scientifically and ethically unsatisfactory, and on the other side the upgraded concept of "aura curae" as suggested by the author, that appears to be less contradictory and also richer in heuristic potential and, conceivably, may be closer to the essence of "placebo" itself. This statement is being corroborated by six main arguments. The first three arguments are meant to weaken the conventional concept of "placebo": The first argument deals with the empirical inconsistencies of the traditional placebo concept; the second addresses the possible distortion of scientific conclusions drawn from a conventional "placebo-controlled" trial; the third argument deals with the ethical problems of "pretense" and of "withholding adequate medication". The following three corresponding arguments are put forward in support of the upgraded placebo-concept of "aura curae" (Latin: "air of care"; "unspecific healing context"). The fourth argument introduces the concept of "aura curae" itself; the fifth argument deals with two alternatives to the conventional placebo-controlled trial, namely the "placebo-integration" and the "value added efficacy"; the sixth argument concludes with a discussion of the ethical advantages of implementing the concept of "aura curae" in clinical and research practice. The purpose of this paper is to contribute to a comprehensive "healing context", that would better fit the patient's needs; i.e., in addition to the various traditional "therapies" of specific influence (biological and psychosocial), the "protherapeutic" and unspecific effects of the "aura curae" should be integrated into a systemic patient care. PMID- 3318150 TI - [Recent dermatologic aspects in collagenoses]. AB - Advances in sero-immunological diagnostic procedures have led to more precise nosologic classification or subdivision of the family of the connective tissue diseases. Assessment of the prognosis and the course of the disease has thereby been improved, and more specific therapeutic measures have become possible as well. The current clinical and serological classification of lupus erythematosus and scleroderma are reviewed, new atypical and overlapping forms of connective tissue diseases are also pointed out. Recent clinical and diagnostic aspects of dermato-(poly-) myositis are considered. Several scleroderma-like conditions which are especially important in the differential diagnosis of acroscleroderma are discussed. PMID- 3318151 TI - [The acute external genital]. AB - Under the heading "acute diseases of the external genital organs" affections of the scrotal contents and the penis (without urethra) demanding immediate therapy are summarized. Crucial is the differential diagnosis epididymitis vs. torsion of the spermatic cord for an error may have very serious consequences for the patient as well as for the physician undertaking primary care. As to the other acute diseases of the scrotal contents the increasingly important role of scrotal sonography is stressed. Among the relatively rare acute affections of the penis traumatic rupture of the corpus cavernosum and priapism of various origin deserve particular interest because delayed wrong treatment may lead to loss of erectile potency. PMID- 3318152 TI - [Cyclosporin. A provisional appraisal]. PMID- 3318153 TI - [History of contraception with steroids]. PMID- 3318154 TI - [Estrogens in contraception]. AB - Ehtinylestradiol (EE) and Mestranol (ME) are oral highly effective estrogens. They inhibit pituitary FSH and LH and thus cause inhibition of ovulation. This effect is synergistically increased by progestogens. 50 micrograms EE or ME per day are the minimal dose for inhibition of ovulation for a duration of 8 days. The metabolism of EE and ME is different from that of natural estrogens. They are very little metabolized and have a longer half life. Oral hormonal contraceptives with an estrogen contain either EE or ME. Their doses have been lowered in the last years. The possibilities of contraception with one-phase-, two-phase-, and step-up-preparations and especially the estrogen part of their effects and some side effects are discussed. PMID- 3318157 TI - [Favorable concomitant effects and undesirable side effects of oral contraceptives]. AB - Oral contraceptives can cause favourable or adverse unintended effects. Severe adverse side effects could be reduced by lowering the estrogen dose and lowering the dose and changing the structure of progestogens. So favourable side effects have gained in importance such as correcting disorders of the menstrual bleeding pattern, positive influence on functional ovarian cysts, benign breast diseases, the skin. Concerning the risk for neoplasm there is a certain protective effect against endometrial and ovarian cancer and no higher risk for breast cancer. Medically important adverse side effects on the cervix, the menstrual pattern, the liver and gallbladder, the central nervous system and psyche, or severe side effects like thromboembolic diseases are significantly reduced by dose reduced compounds containing newly developed progestogens. Interactions between oral contraceptives and other drugs are of little clinical significance. PMID- 3318155 TI - [Progestagens in contraception]. AB - The different spectrum of biological actions of the various synthetic progestogens is compared on the basis of their chemical structure, pharmacokinetics and interaction with the multiple receptors. In detail, the mechanism of action of the progesterone derivatives (medroxyprogesterone acetate, chlormadinone acetate and cyproterone acetate), the norethisterone-related (norethisterone, ethynodiol diacetate, lynestrenol and norethynodrel) and the norgestrel-related progestogens (levonorgestrel, desogestrel, gestodene and norgestimate), and a possible influence of some metabolites upon the biological profile are discussed. With regard to the progestogenic activity, the time-course of the serum concentrations of the steroids after the application (pharmacokinetics) which is dependent upon absorption, metabolization in the gastro-intestinal tract and liver (first-pass effect), distribution and storage in fat and other tissues, binding to serum proteins, inactivation, and conjugation, is of particular importance. The various side-effects of the progestogens are mainly based on their influence upon hepatic metabolism (lipids, lipoproteins, serum proteins) and upon other organs which is dependent on their different estrogenic, antiestrogenic, androgenic, antiandrogenic, glucocorticoid and antimineralocorticoid actions. PMID- 3318156 TI - [Oral contraceptives: clinical pharmacology, composition, choice of preparation]. AB - Following introductory terminological clarifications, the pharmacological peculiarities of the synthetic estrogens and progestogens used in oral contraception are outlined. With the low-dose formulations containing less than 50 micrograms estrogen per pill ("micropill") coming in preferential use, the definite differences between the profiles of effects of the three major progestational categories--estranes, gonanes and pregnanes--lost much of their impact on clinical tolerance. Within the three classes of progestogens, the profiles of effects of the various compounds are, anyhow, very similar with major deviations occurring only exceptionally. As to the contraceptive estrogens, ethinyl estradiol differs from mestranol, if any, in quantitative but not in qualitative respect, the latter substance not being commonly used in Europe any longer. Besides potencies and profiles of effects of the individual contraceptive steroids, the quantitative estrogen/progestogen relationship of a "pill" is another variable of great importance for the development of unwanted side effects in the field of lipid and carbohydrate metabolism as well as of blood coagulation. Due to the lack of influence on lipid metabolism, progestogens of the pregnane series, being driven into an outsider position since long, deserve increasing attention again. As a general principle, women of all age groups should at least try to use the "micropill"--either combination-type or tristep formulations--in order to minimize risks. Only a few indications are left for the primary prescription of high-dose combination-type, sequential and step-up preparations as well as for the progestogen-only "minipill". With "micropill" becoming the oral contraceptives of the first choice, also rational reasons for changing formulations have become rare.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318158 TI - [Metabolic effects of oral contraceptives]. AB - Estrogens and the progestogens of an oral contraceptive can cause metabolic effects either by themselves or in combination with each other. Those induced by progestogens seem to be of particular importance. Influences of both steroids on water und electrolyte metabolism are of little relevance, those on carbohydrate metabolism must be expected in diabetic patients and are possible in high-risk patients, weight increase may occur. Progestogens with androgenic properties can have important effects on the synthesis of carrier proteins, such as SHBG, and produce a lipid pattern which is usually associated with atherogenesis. Estrogens are rather anti-atherogenic in this respect. Newly developed progestogens seem to lack these possibly life-threatening influences on protein and fat metabolism. Their use might enable the production of oral contraceptives with less side and after-effects. PMID- 3318159 TI - [Prevention of pregnancy in adolescents and premenopausal females]. AB - The norms of our society have changed in the last decades. This also concerns our general attitude towards sexuality. Professional demands on the parents, increasing material independence of adolescents, excessive exposure to external stimuli lead to sexual contacts at a very early age. Contrary to a more accelerated physical development, which manifests itself in a progressively earlier puberty, psychic development is retarded. According to numerous studies pregnancies in adolescents do not show increased somatic complications. They do, however, influence the psychic maturation of the adolescents in a negative way. Whereas the necessity for sexual education is unquestioned, the efficacy is doubtful. Knowledge of contraception and its correct use is not enough to avoid undesired pregnancies. The psychic structure of the individual may often lead to an undesired pregnancy. Therefore, we recommend for adolescents contraceptives which are reliable, without negative effect on fertility and with neglibile side effects. The number of failures and the inconvenience realted to their use make conventional methods unacceptable. The danger of PID and the risk of later sterility contraindicate the use of IUD in adolescents. Today the method of choice is a low-dose contraceptive which contains a gestagen of the third generation. The premenopausal state is the time in which cycles become irregular and in which an increasing hormonal insufficiency is observed. Therefore, women over forty years need reliable contraception as well as hormonal substitution. Increase of cardiovascular risk was observed in women when high-dose contraceptives were given. This was obvious in the more than forty year old women taking the pill.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318160 TI - Postcoital interception with steroids. AB - At present there is a high demand for PCI. The psychological distress experienced by women after unprotected intercourse while awaiting the onset of her next menses could be avoided with effective postcoital treatment. As demonstrated in countries with good health services, the availability of PCI leads to low abortion rates. PCI is designed for use as an emergency method after unprotected intercourse as an isolated incident. Women who have frequent intercourse however, do better to use a regular, very effective, method of contraception such as a combined oral contraceptive. Postcoital progestagens can well be used in infrequent intercourse since they are to be taken after each coitus, if applicable several times a month. Such use however leads to menstrual cycle disturbances and irregular bleedings. The estrogen-only and the estrogen progestin combination are recommended, but need to be given within 2 or 3 days after the event of unprotected intercourse, preferably periovulatory. The latest development of the anti-progestins as a morning-after pill is promising. Taken from day 27 through 30 of the menstrual cycle it induces menstruation at the expected day. Side effects are minimal and the efficacy is good. Because of the imperfectness of PCI to prevent all pregnancies, sofar this regimen cannot be recommended for monthly use and does not replace regular oral contraceptives. PCI has a definite place in family-planning and fertility regulation. Since different methods are available today careful assessment of individual needs can help to decide for the best suitable method for the individual person. PMID- 3318161 TI - Testing for Chlamydia trachomatis: objective criteria for recommendations for screening using nonculture techniques. PMID- 3318163 TI - Women and mental health: a post-Nairobi perspective. PMID- 3318162 TI - Cavitary lung nodule caused by Hemophilus influenzae. PMID- 3318165 TI - [Current significance of infectious diseases. 2: From symptom to diagnosis- rational diagnosis]. PMID- 3318164 TI - [Possibilities and limits of the diagnosis of aging in sports medicine]. AB - The author orders by the presented survey publication the diagnostic of ageing into the sport medical diagnostic, thereby referring on the promising for the field of sport in future. The term of the so-called age is related to the categories adaptation, vitality and biological age(-ing). By a biography the reader gets informed on the current level of diagnostic of ageing within the national and international framework. Out of that the author draws conclusions for optimizing sports medical diagnostic. PMID- 3318166 TI - ["Conditional health" of diabetic patients]. PMID- 3318167 TI - [On the 200th birthday of Carl Ferdinand von Graefe (1787-1840)]. PMID- 3318168 TI - [Clinical aspects of gallstone disease]. PMID- 3318169 TI - [Diagnostic imaging of bile duct diseases]. PMID- 3318170 TI - [The 50th anniversary of the death of Ludolf Krehl (26 December 1861-26 May 1937)]. PMID- 3318171 TI - [Prenatal monitoring of the child]. PMID- 3318172 TI - [Historical view of the development of ambulatory emergency care in Leipzig]. PMID- 3318173 TI - [Johannes Muller and Ernst Haeckel]. PMID- 3318174 TI - [Nutrition and the etiology of colon cancer: from descriptive epidemiology to dietary prevention]. AB - Colon cancer is one of the most frequent forms of cancer in the Federal Republic of Germany and in most Western countries, but is, however, generally rare in Africa, Asia, and Latin America. Based on epidemiological investigations, differing dietary practices are considered to be main reason for these differences. A high fat and protein consumption was identified as a risk factor, while a high fibre content of the diet was found to be protective. Existing hypotheses of the etiology of colon cancer, which are based on the two-stage initiation-promotion model, regard interactions between initiators, promotors, and inhibitors as decisive for the final outcome of colon cancer. Possible initiators are pyrolysis products of protein-rich food (meat or fish), generated by heating, and products of metabolism of intestinal bacteria (e.g. faecal mutagens, N-nitroso compounds, transformation products of bile acids). Fats probably exert their influence only at the promotional stage. The diet-dependent bacterial formation of deoxycholic and lithocholic acids is a possible mechanism which has been experimentally substantiated. The protective effect of a diet rich in fibre seems to be mediated in particular by dilution and adsorption of harmful compounds. Further protective factors in human diet may be calcium, selenium, vitamin A and beta-carotene. In this paper, evidence, both supporting and refuting the existing hypotheses, is discussed, as well as the possibilities of dietary prevention of colon cancer. PMID- 3318175 TI - [Intestinal liberation and resorption of monosaccharides from carbohydrates of different degrees of polymerization. II. Relations between monosaccharide resorption, blood glucose level and serum insulin concentration]. AB - The small intestines of anaesthetized rats were perfused in situ for 60 min with 0.5% solutions of glucose, maltose, sucrose, maltodextrin DE 20, maltodextrin DE 5 or starch. Blood samples were repeatedly taken from the v. portae and the v. femoralis to estimate blood glucose and serum insulin levels as a function of perfusion time. The experiment was also performed to clarify whether a correlation exists between these parameters and the substrate uptake from the intestinal lumen (determined in the first part of the study). The highest glucose levels in v. portae and the highest portal-peripheral differences were found when glucose and maltose solutions were administered. Glucose levels in v. femoralis were almost independent of the substrate perfused. Perfusion with glucose caused a considerable insulin secretion starting immediately with the onset of perfusion. It was concluded that glucose might also stimulate insulin secretion on the intestinal level. Perfusion with maltose also effected a significant insulin output, the start of which was delayed however, compared with the effect of glucose. PMID- 3318176 TI - [1st international public health exhibition and founding of the German Public Health Museum]. PMID- 3318178 TI - [Indicator value of enterococci in surface water]. PMID- 3318177 TI - [Popularization of medical knowledge in Russia in the second half of the 18th century as exemplified by the Free Economic Society]. PMID- 3318179 TI - [Historical reflections on leprosy with reference to some aspects of military medicine]. PMID- 3318180 TI - [Pathogenetic aspects of chronic urinary tract infections]. AB - Infections of the urinary tract belong to the most frequent bacterially caused diseases. Strains of bacteria which are able to evoke an infection of the urinary tract distinguish themselves by particular properties. Hereby the existence of O- and K-antigens, the demonstration of adhesins (F-antigens), the ability of the formation of haemolysin and production of colicin V (aerobactin), the serum resistance as well the plasmid profile an important role is ascribed. The ability of uropathogenic bacteria to the adhesion to the epithelial cells of the urinary tract is significant for the development and the course of a disease. A connection is to be established between the rate of bacterial attachment of the epithelial cells and the activity of a pyelonephritis. The defence of an infection of the urinary tract takes place above all in the local area, in which cases among others the phenomenon of the antibody coated bacteria and disturbances of the formation of the secretory IgA are of interest. Various pathogenetic aspects of chronic infections of the urinary tract are discussed on the basis of reports from literature and findings of own investigations. PMID- 3318181 TI - [Berolina iubilans: Berlin physicians as Halle doctoral candidates (II): Ernst Ludwig Heim (1747-1834), Halle doctoral candidate of 1772]. AB - Ernst Ludwig Heim (1747-1834), born in the Thuringian village Solz, took his medical education in Halle between 1766 and 1772. After the following educational journey he became medical officer for the municipal and rural districts of Spandau and Osthavelland. From there he changed for Berlin in 1783, where, by his outstanding knowledge and abilities he became the prototype of the faithful family physician, as "Old Heim" the symbol figure for always responsible medical activities. PMID- 3318182 TI - [Pharmacologic principles of fibrinolytic therapy]. AB - Increasing insight into the mechanisms of fibrinolysis, and particularly into the formation and release of plasminogen activator, has led to more effective thrombolytic therapy. The understanding of the mechanism of thrombolysis has provided the possibility to improve the therapeutic effects of the fibrinolytic agents streptokinase and urokinase. Further advances in thrombolytic therapy are expected by the use of the plasminogen activator from endothelium and pro urokinase. Acylation of fibrinolytic enzymes will lead to beneficial effects (depot effect, protection from intrinsic inhibitors). Due to the extensive research into substances with fibrinolytic and thrombolytic effects a new generation of activators of fibrinolysis is expected that interferes with the biosynthesis and release of plasminogen activator of the vessel wall and that is suited for treatment of hypofibrinolytic states. PMID- 3318183 TI - [Cholecystokinin-peptides--new knowledge and possibilities for clinical use]. AB - This issue comprises selected topics of CCK peptides. CCK peptides are linear peptides and were found within and outside the CNS. There is growing evidence that CCK peptides play a physiological role in food intake, contraction of gallbladder and regulation of motility of the gastrointestinal system. New aspects of the CCK research are concentrated on interaction with other transmitter systems especially with the dopamine and opioid system. The therapeutic action to improve clinical symptoms in human is unclear up to new. World-wide, the interest is focused to determine the potential of CCK peptides as an antipsychotic agent by controlled clinical studies. PMID- 3318184 TI - [Berolina iubilans: Berlin physicians as Halle doctoral candidates (III): Carl Ludwig Willdenow (1765-1812), Halle doctoral candidate of 1789]. AB - Carl Ludwig Willdenow (1765-1812) who was trained as a pharmaceutical chemist and awarded the degree of Doctor of Medicine by the Faculty of Medicine of Halle University in 1789 belongs to the great botanists in an era in which the special subject represented by him finally disengages from the complex of medicine. The plant systematizer Willdenow worked on the traces of Linne, trying to note down the complex of species enlarged by him. Under his management the Botanic Garden in Berlin gained a world-wide renown. The Halle dissertation which was remarkable by its details was the intermediate station of Willdenow's professional career. PMID- 3318185 TI - [Recent aspects in the diagnosis and therapy of ascites]. AB - In the diagnosis of malignant ascites the cytological examination of ascitic fluid lacks sensitivity. Therefore, other parameters for the differentiation of malignant and hepatic ascites are needed. Determination of ascitic fluid cholesterol or fibronectin is superior to the traditional protein measurement in the differential diagnosis of ascites. In the therapy of cirrhotic ascites, physical maneuvers as well as dietary sodium and water restriction have long been known. Diuretic therapy, fraught with considerable side effects, has been applied to cirrhotics with ascites for more than 30 years. However, efficacy of only few regimens has been proven by randomized studies. Recently developed diuretics as well as the novel hormone Atrial Natriuretic Factor might bring about therapeutic advances. Paracentesis combined with intravenous albumin infusion might be reconsidered in severe ascites. Refractory ascites may be treated by implantation of peritoneo-venous shunts. PMID- 3318186 TI - [Phenomenology of chronic gastritis]. PMID- 3318187 TI - [Dyspepsia--a multifactorial syndrome]. PMID- 3318188 TI - [Campylobacter pylori--microbiological aspects]. PMID- 3318189 TI - [Campylobacter pylori colonization of the antrum mucosa in patients with chronic gastritis and peptic ulcer]. AB - Campylobacter pylori, a bacterium specifically adapted to the environment of gastric mucous is closely associated with peptic gastric diseases. It is detected within the mucus and in relationship to the intercellular spaces in cases of active chronic gastritis. Approximately 70% of patients with chronic type-B gastritis are infected with C. pylori. In type A or reflux gastritis C. pylori is hardly seen. A causal relationship seems likely. More than 80% of patients with duodenal ulcer and round half of the cases with gastric ulcer show C. pylori in the gastric mucosa. The pathomechanism, how C. pylori facilitates the development of peptic ulcer is since hypothetical. It is discussed that the bacterium leads to a local breakdown of gastric mucosal defence. PMID- 3318190 TI - [Histologic, culture and breath test detection methods and therapy of Campylobacter pylori colonization of the stomach]. PMID- 3318192 TI - [Dose-effect studies with bismuth salts for the elimination of Campylobacter pylori]. PMID- 3318193 TI - [Methodologic problems and initial results of synchronous CTG computer-assisted registration of fetal movements by ultrasound]. AB - Aim of the studies is the registration of latent criteria of hypoxia in fetuses with intrauterin growth retardation diagnosed by ultrasonography. Under standardized conditions, 19 pregnant women with hypotrophic and 20 with eutrophic fetuses were examined between weeks 36 and 40 of gestation. Concomitantly, fetal body and respiratory movements as well as the antenatal phonocardiotocogram were registered. The following apparatuses were used (fig. 1): ultrasound unit "sono Diagnost R" from Philips, FRG; six-channel recorder "6 NEK 401" from VEB Kombinat Messgeratewerk Zwonitz, GDR; lab-oriented computer "K 1520", VEB Kombinat Robotron Dresden, GDR; fetal monitor "MT 810" (with autocorrelation) from Toitu Co., LTD, Tokyo, Japan; There were close correlations between fetal body movements and accelerations in the cardiogram. The duration of the fetal body movements influenced the duration as well as the amplitude of the corresponding accelerations. A. comparison between the two groups examined reveals that these medium term changes in the heart rate were less marked in the hypotrophic fetuses than in the control group. The differences between the two groups were statistically significant (fig. 2, 3, 4, 5). Fetal respiratory movements influence the range of beat-to-beat-variability in the cardiogram. In the group of hypotrophic fetuses this range increased significantly by 1.4 bpm during one segments of respiratory movement. For the group of eutrophic fetuses the increase in the range of beat-to-beat-variability was 1.8 bpm. We did not find a significant difference between both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318194 TI - [Effect of chamomile on wound healing--a clinical double-blind study]. AB - In a double-blind trial, the therapeutic efficacy of chamomile extract was tested on 14 patients. As objective parameters served the epithelial and drying effect on weeping wound area after dermabrasion of tattoos. The period of the healing and drying process was judged by the doctor. The decrease of the weeping wound area as well as the drying tendency was statistically significant. PMID- 3318191 TI - [Serologic diagnosis of Campylobacter pylori colonization]. PMID- 3318195 TI - [Possibilities and limitations of catheter ablation of tachycardia arrhythmia]. AB - Catheter ablation has become an alternative to other non-pharmacological forms of antiarrhythmic therapy. Since supraventricular arrhythmias were first treated by ablation of the AV-conduction system, the clinical use of the technique has recently been extended to treat accessory pathways or ventricular tachycardias. The results of experiences from a number of clinical centers are available. To improve clinical applicability and to avoid complications, besides direct-current ablation, new technologies have been tested experimentally and in some cases already applied to patients. Whereas catheter ablation with radio-frequency alternating current has already been used in patients, the application of laser technology to ablation of arrhythmogenic myocardium has been limited to open heart surgery. Both techniques may offer improvements regarding precision and safety aspects of the method. To perform catheter ablation, a multitude of prerequisites concerning organisatory and safety aspects has to be fulfilled. Thus far, catheter ablation should only be performed in clinical centers with the facilities for cardiac surgery. PMID- 3318196 TI - [Bioequivalence of generic drugs and substitution: example of depot verapamil]. AB - Following oral administration of 240 mg Verapamil-HCl as Isoptin RR, Veramex SR 240 and durasoptin SR 240, plasma concentration time curves of Verapamil and ECG changes were determined in 14 healthy subjects. There was a linear correlation between maximal plasma concentration and prolongation of PQ-intervals of the ECG. No hysteresis was observed when the changes in PQ-interval were plotted against plasma concentration. Comparison of concentration and effect profiles showed that the three formulations were not equivalent and a change in therapy from one to the other cannot be recommended. PMID- 3318197 TI - [Remarriage in the aged]. AB - A comprehensive review of our knowledge on remarriage in old age is presented, based on demographic data and on empirical studies both from Germany and elsewhere. In 1984, more than 8000 people aged 60 years and above remarried after the death of a partner or following divorce. The probability for remarriage in this age group in Germany and other Western industrial countries is about 0.015. The likelihood for men to remarry is approximately five to six times higher and can be best interpreted as a reflector of the distribution of sexes on the "remarriage market", rather than as an expression of any differential priorities or attitudes between sex groups. Other factors influencing remarriage are numeric age, social status, ethnic and religious integration and previous experiences of married life. The interval between loss of a partner and remarriage commonly stretches between 1.5 and 5.5 years. The main motive for remarriage is the wish not be alone. Basic values underlying the choice of a partner are the same as in the previous partnership. There are no apparent differences between the sexes with regard to the estimated success of their partnership. In three out of four cases, remarriage in old age seems to be a successful undertaking. PMID- 3318198 TI - [Violence against the elderly in the family context--a topic in research, practice and public information]. AB - Elder abuse within the family context is an issue that is beginning to be taken up in the Federal Republic of Germany due to the reception of English and American research literature. Since relevant research in the United States relies on information available within the established system of mandatory reporting of incidences of elder abuse, research designs are not transposable. Development of applicable research designs, however, can be based on certain findings, such as the bias to be expected by selection of specific spheres of experience, due to the choice of experts from within a limited number of relevant professions. Difficult problems have to be overcome in defining which active interventions are to be termed as abuse and which failures to intervene may be termed as neglect. In addition, great importance must be attached to procedures that confirm reported findings. A position is taken according to which ethics of research in this field do not allow for the prerogative of systematic gathering of information. Research endeavours must go hand in hand with active prevention of the risks of abuse and neglect or be of practical help in situations where negative action may take place and where help is needed, e.g. in difficult nursing situations within families. Under such pre-conditions, research designs are judged to be realistic in which professionals, in direct touch with families at risk, co-operate with research institutions in offering active support and at the same time systematically gathering relevant research data. PMID- 3318199 TI - [Lipoprotein metabolism and atherogenic risk]. PMID- 3318200 TI - [The effect of the cultivation time of Crithidia luciliae on the binding of antibodies against dsDNA]. PMID- 3318201 TI - [An apparatus for light-protected drying of slides in fluorescence serology]. PMID- 3318202 TI - [Intrapulmonary neuroepithelial bodies]. PMID- 3318203 TI - [Radioligand identification and characterization of alpha- and beta-adrenoceptors in udder tissue of lactating cows]. PMID- 3318204 TI - The inverse relationship between osteoporosis and osteoarthrosis. PMID- 3318205 TI - [Current studies of the influence of hormones in the pathogenesis and prognosis of breast cancer]. PMID- 3318206 TI - [Nizoral. The outlook for its use and side effects]. PMID- 3318207 TI - [Current methods for the specific therapy of urogenital candidiasis]. PMID- 3318208 TI - [Role of endogenous proteinases and their inhibitors in the pathogenesis of pemphigus vulgaris]. PMID- 3318209 TI - [Pathogenesis of mucosal candidiasis (an ultrastructural study)]. PMID- 3318210 TI - The role of the host cell nucleus in vaccinia virus morphogenesis. AB - Despite the fact that cells infected with wild type vaccinia virus synthesize viral DNA and assemble progeny virus particles within the cytoplasm, the host cell nucleus is required for a productive infection. Recent evidence suggests that vaccinia virus selectively recruits components from the host cell nucleus into the cytoplasm for use by the developing virus. One of these components is the largest subunit of the cellular RNA polymerase II (Pol II). PMID- 3318211 TI - [Importance of the position and occlusion of anterior teeth in prosthetic rehabilitation]. PMID- 3318212 TI - [Diagnosis and differential diagnosis of congenital fistulas and cysts of the neck]. AB - Maldevelopment of the embryonal branchial arches may result in widely different cervical midline and ear anomalies. It should generally not be difficult and clinically feasible to diagnose them and differentiate them against other diseases if one is conversant with the associated special embryological and anatomical features. Nevertheless, false diagnoses are still frequent. The rate of diagnostic errors is almost 20% in our own 318 child patients with swellings in the cervical midline. Hence, it is easy to understand why there is a demand for widening the scope of preoperative diagnosis. Sonography offers a highly effective imaging examination technique. Additional information can also be gained occasionally via CT and angiography. We can, however, usually omit punctures and x-ray imaging of fistulas. PMID- 3318213 TI - [Cecil-Duplay/Cecil-Leveuf urethral reconstruction in severe hypospadias]. AB - A total of 199 boys with severe hypospadias were subjected to surgery during 1981 to 1984 at the Department of Surgery of the Red Cross Paediatric Hospital in Siegen and from 1971 to 1984 at the Department of Surgery of the Municipal Paediatric Hospital in Cologne. Plastic reconstruction of the urethra was performed according to a multiple-stage technique after Cecil-Duplay/Cecil Leveuf. It is evident that good results can be obtained in such severe forms of hypospadias by means of differentiated multistep surgery. A fistula rate of 14% is an essential improvement over the results previously obtained by the urethral reconstruction method after Denis-Browne. PMID- 3318214 TI - [Sonographic diagnosis of diaphragmatic rupture following blunt thoracic and abdominal trauma]. AB - A posttraumatic diaphragmatic hernia was diagnosed by ultrasound and x-ray examinations 1 year after a blunt trauma of the chest and abdomen. The diaphragmatic lesion could be seen retrospectively in the initial sonograms which were performed during the acute illness. It was however not possible to confirm the rupture during laparatomy. PMID- 3318215 TI - [Possibilities and limits of family therapy in psychiatric disorders in childhood and adolescence]. PMID- 3318216 TI - [Hemangioma of the kidney--diagnostic and therapeutic problems]. AB - Hemangioma of the kidney as one of the possible causes of "essential hematuria" is discussed with special regard to its diagnostic features in the various modern radiological examinations. Still most important is angiography. Typical findings are demonstrated in a case with complete replacement of the parapelvic fat by a large cavernous hemangioma. The various therapeutic possibilities--conservative treatment, embolisation, partial or complete nephrectomy - are discussed. PMID- 3318217 TI - [Results of surgical therapy of vesico-ureteral reflux in childhood]. AB - During 8 years in the department of paediatric urology of the Clinic of Urology of the Charles University Prague 267 children with a vesicoureteral reflux (VUR) aged between 6 months and 15 years were operated. The sex ratio girls to boys was 4.5 to 1.0. At 89% an infection of the urinary tract was simultaneously present. On an average first symptoms appeared at the age of 3 1/2 years. The operative therapy was performed at the of 6. 221 children with 340 reflux units underwent an after examination 3 to 12 months after operation. Most frequent were the degrees of reflux II and III with altogether 82%. 255 vesicoureteral refluxes were primary refluxes and 85 secondary ones. 208 reflux ureters were modified after Politano-Leadbetter, 105 modified after Gil-Vernet, 17 were treated in form of a pyeloureter anastomosis and 10 by means of nephroureterectomy. A persisting post-operative infection of the urinary tract was existing in 14.5% after 3 months and in 8.8% after 1 year. Implantation stenoses appeared in 2.4% and were successfully reoperated. Altogether the healing of the reflux was successful in 96.4%. An early operative therapy and in refluxes of second and third degree the modified method according Gil-Vernet are recommended. PMID- 3318219 TI - [Our urologic heritage: Maximilian Nitze (1848-1906). His importance in the development of urology]. AB - In this article we remember the Berlin urologist Maximilian Nitze (1848-1906) who with his invention of the cystoscope 110 years ago founded a new epoch of the urologic-endoscopic diagnostics and therapy. After a short description of his life the importance of his scientific work for the development of urology as an independent medical special subject in the second half of the 19th century is pointed out. PMID- 3318218 TI - [Autovaccination in chronic pyelonephritis in the animal experiment--effect of cyclophosphamide on splenic and thymus lymphocytes]. AB - In rats with experimental pyelonephritis, cyclophosphamide leads to changes in the spleen and thymus lymphocyte populations. When cyclophosphamide was given five times a week from the fifth week of infection on, the population of electrophoretically slow moving spleen lymphocytes, which are believed to be B lymphocytes, decreased in the seventh week. This effect is independent of autovaccination. During the same period the number of immature slow moving thymus lymphocytes decreased. Further treatment with cyclophosphamide until the twelfth week of infection led to the differences almost disappearing in the histogramm. Cyclophosphamide showed a slight effect on antibody production and did not influence the elimination of infective agents from the kidneys of animals with pyelonephritis. PMID- 3318220 TI - [Liver diseases in patients with kidney transplants--problems and research tasks]. AB - Patients with transplanted kidneys have a 5 times higher risk of a hepatitis-B infection. The necessary application of immunosuppressive agents leads to the replication of core and surface particles in hepatocytes without any appearance of cell injuries. They become manifest only with the beginning of immunological processes. An analysis of 64 cases of post-mortem examination of persons who underwent a kidney transplantation shows that only 8 had no liver changes and in 24 cases liver diseases were the direct cause of death. From the up to now not yet solved problems results the necessity further to clarify the pathogenesis of liver diseases in patients who underwent a kidney transplantation by means of a combination of clinical, ultrastructural, histologic-immunohistochemica, immunological and laboratory-chemical investigations and to draw conclusions for therapy. PMID- 3318221 TI - [Results of treatment of perforated stomach tumors]. AB - Perforation of a stomach tumour is a rare experience. It occurred to 0.4 per cent of patients treated by the authors for gastro-intestinal tumours and to four per cent of those on whom emergency operations had to be performed. Surgical morbidity was found to be low but so were the chances of survival which ranged between eight and 44 months. That was equally true for patients who had apparently undergone radical surgery. Those findings were not really surprising, since it was known that only advanced carcinomas would perforate. Tumour perforation resulted in spread of carcinoma cells across the peritoneum and thus in canalicular metastasation. That would move the tumour into a phase which could no longer be curatively tackled by surgical approaches alone. Nevertheless, in cases of emergency, surgery should be as radical as possible, and the technique chosen should be identical with that used in no-emergency surgery. PMID- 3318222 TI - [Anaerobic pathogens in gynecologic samples. Incidence and clinical significance]. AB - In 276 gynecological cases the ratio of anaerobic and aerobic germs was investigated. Cultures took place under criteria sufficient for anaerobic and aerobic bacteria as well. Aerobic germs were predominating (55.4%), while anaerobic germs (bacteria) were to be found in 35.5% of cases. The breakdown reveals Bacteroides in 72%. The significance of anaerobic germs (bacteria) derives both from their pathogenicity and their frequency and depends additionally on the origin of the samples. In samples derived from the cervix or the vagina it must be considered anaerobics being a normal finding having been detected in 38.5 and 40% respectively in the own material. In bartholinitis or abscess of the labia and in intrauterine devices 48,4 and 12.5% anaerobic germs are to be found. In pyosalpinx and tubo-ovarian abscess all anaerobic cultures were negative. The same was true for 80% of aerobic cultures of the same origin. These findings are most likely due to a preceding antibiotic therapy. In contrast anaerobics constantly were to be found in abscess of cul-de-sac and pyometra. These facts should be taken into consideration in selecting an appropriate antibiotic therapy. PMID- 3318224 TI - [Changes in the adhesion of Candida fungi to the epithelium during the menstrual cycle]. AB - Changes in the adhesion of Candida cells to the mucous membrane of the oral cavity were studied in vitro in experiments with epithelial cells from 12 normal women at various stages of the menstrual cycle. Fungal cells more actively adhered to the epithelial cells obtained at the follicular phase of the menstrual cycle than to those obtained at its luteal phase. At the follicular phase, both the average level of adhesion and the population of epithelial cells with most pronounced adhesive properties increased. The range of variations in adhesion levels was different in individual subjects and varied from 8% to 37% of the individual mean of the whole cycle. The results of this study indicate the existence of the hormonal control of the adhesion of Candida cells to human epithelial cells. PMID- 3318223 TI - [In vitro studies of amniotic fluid and intrauterine growth retardation]. AB - Until now the intrauterine growth retardation remains as an insufficiently solved problem. The 3H-thymidine incorporation into the DNA of the isolated islets of Langerhans of neonatal Lewis rats was used as a marker for cell dividing activity in vitro. There was no inhibition effect on the 3H-thymidine incorporation in the presence of amniotic fluid from pregnancies with intrauterine growth retardation compared to those of normal pregnancies. PMID- 3318225 TI - [Biological properties of opportunistic microorganisms isolated from patients with acute intestinal diseases]. AB - The comparative study of the incidence of the pathogenicity markers (DNAase, RNAase, phosphatase and hemolytic activity) in shigellae and salmonellae, acknowledged as the causative agents of intestinal infections, and in opportunistic bacteria isolated from the feces of patients with acute intestinal diseases and healthy persons has been made. The study has revealed that DNAase and RNAase activity occurs most frequently in Shigella flexneri, in salmonellae and in opportunistic enterobacteria isolated from the intestinal contents of patients with acute intestinal diseases. In this respect they essentially differ from the same species of opportunistic enterobacteria isolated from healthy persons. PMID- 3318226 TI - [Effect of the influenza A virus on the sensitivity of mice to infection caused by Streptococcus group B]. AB - Study of the capacity of group B streptococci for causing the development of infection in mice has revealed the virulence of the cultures for mice to be determined by the serovar of the streptococcus, the infective dose, and the amount of type-specific polysaccharide. Under the conditions of mixed viral bacterial infection, influenza A virus was shown to influence the development of bacterial infection in the animals in two ways: to increase the virulence of an avirulent strain and to decrease the pathogenicity of a virulent one in streptococcal monoinfections. Simultaneously with viral infection, the stimulation of the multiplication of an avirulent strain in the lungs of mice was observed, while in the control groups of the animals the elimination of bacteria from the lungs was registered. No additional accumulation of the infective virus in the lungs of mice in the presence of streptococci was found. PMID- 3318227 TI - [Changes in the cell wall composition and structure of Streptococcus pyogenes during batch culture]. AB - Changes in S. pyogenes cells in the process of batch cultivation have been studied. The composition of S. pyogenes cell walls has been studied by amino acid analysis; besides, their resistance to enzymatic hydrolysis and the electric conductivity of cell-wall lysates have been determined at different phases of the growth of S. pyogenes. The molar amino acid composition, expressed in percent, is unrelated to the growth phase, while the content of amino acids in preparations changes in the process of growth and reaches its maximum in the middle and in the end of the logarithmic phase. At the same time the electric conductivity of cell wall lysates reaches the minimum level at these growth stages. The authors suggest that additional electrically charged compositions are formed in the cell walls at the beginning of the logarithmic and stationary phases. A considerable increase in the initial rate of cell-wall lysis with muramidase has been found to occur at the end of the logarithmic phase. This difference in the initial rate in the initial rates of lysis of S. pyogenes cell walls at different growth phases decreases after previous treatment of the cell walls with streptolytin possessing proteolytic activity. Analysis of these data leads to a conclusion on the "loose" structure of the outer protein layer of the cell wall at the end of the logarithmic phase of the growth curve. PMID- 3318229 TI - [Serological reaction systems using enzyme-labelled immunospecific reagents]. AB - Different serological test systems, based on the use of enzyme-labeled immunospecific reagents and intended for testing the material under study for the presence of Yersinia pestis capsular antigen and antibodies to it, are described. Comparative data on the evaluation of their sensitivity to the antigen and antibodies to it in different schemes of enzyme immunoassays (EIA) are presented. As shown in this investigation, EIA systems for the detection of the antigen and antibodies to it can comprise, at the minimum, the following set of reagents: monoclonal antibodies to the capsular antigen, staphylococcal protein A, and the conjugates of the capsular antigen and monoclonal antibodies with horse-radish peroxidase. The authors have come to the conclusion that the use of the serological test systems can essentially increase the reliability of the assay of any individual sample by EIA techniques. PMID- 3318228 TI - [Immune stratum of the population in relation to the causative agent of pseudotuberculosis]. AB - The state of population immunity may be controlled by analyses of placental, abortion, and donor blood. The existence of a high direct correlation between the level of the immune stratum of the population and pseudotuberculosis morbidity has been revealed. Regression equations suitable for the prognostication of pseudotuberculosis morbidity have been obtained by means of computers. PMID- 3318230 TI - [The role of R plasmids in the resistance of bacteria in air]. AB - The study of Escherichia coli J 53, used as a model, has revealed that some R plasmids isolated from Serratia marcescens and Klebsiella pneumoniae, found to be the cause of the outbreak of hospital infection, ensure, besides multiple drug resistance, also their viability in the air. PMID- 3318232 TI - [Detection of antibodies to preparations of Staphylococcus aureus peptidoglycan, teichoic acids and polysaccharide in patients' sera]. AB - Enzyme immunoassay systems on the basis of S. aureus teichoic acids, peptidoglycan and polysaccharide-containing preparation are incapable of reliably diagnosing the staphylococcal nature of postoperative complications in oncological patients. PMID- 3318231 TI - [Interferon enhances the bactericidal activity of peritoneal exudate macrophages against Salmonella typhimurium in mice]. AB - The treatment of macrophages of mouse peritoneal exudate has been found to enhance their bactericidal activity with respect to S. typhimurium. This activation depends on the dose of interferon and the cells/bacteria ratio. The action of interferon is species-specific. PMID- 3318233 TI - [Correlation of titers of antibodies to the measles virus by an immunoenzyme method and in the hemagglutination inhibition reaction]. AB - The authors analyze the results of comparative studies on 15 paired sera from children with suspected measles, of 32 sera from children and adolescents aged 1.5 to 16 immunized against measles, and of 21 sera from adults aged 19 to 86 with a history of the disease. EIA proved to be more sensitive than HAIT: the detection rate of positive sera was higher, as were the titers of antibodies detected by it, in examinations of the sera from vaccinated children and the adults. Analysis of the distribution of sera with different titers of antibody to measles virus in EIA and HAIT has revealed a correlation between the titers in the sera with high antibody levels. In the cases with low antihemagglutinin titers, no correlation between the titers determined in the two tests has been observed. PMID- 3318234 TI - [Use of immunological adsorption in a heterologous immunoenzyme analytical system for detecting specific antibodies to serogroup B and D1 Salmonella lipopolysaccharides in healthy donors and in persons with a history of salmonellosis]. AB - The sera obtained from healthy donors and from subjects with a history of Salmonella infections (B, C1, D1 and E1) of medium severity were studied. In the initial testing in the heterologous enzyme immunoassay the levels of antibodies to LPS, groups B and D1, were somewhat higher in the subjects with a history of the infections than in healthy donors. After a single adsorption with homologous LPS the levelling of differences between the two groups was observed. After two adsorptions with heterologous LPS the level of the reaction in both the groups increased, and the differences between these groups augmented. The adsorption of sera with heterologous LPS increased the diagnostic sensitivity of the reaction only to 14-23% in the determination of the serogroup of the causative agent. An increase in the antibody level after adsorption with heterologous LPS was supposedly due to the additional detection of group-specific antibodies with low avidity, which appeared as the result of the elimination of cross-reacting highly avid antibodies, as well as non-immunoglobulin molecules complementary to LPS. PMID- 3318236 TI - [Sorption properties of polystyrene plates used in immunoenzyme analyses]. AB - The capacity of polystyrene carriers used in the enzyme immunoassay (EIA) for adsorbing 131I-labeled human serum albumin under different conditions has been studied, and the comparison of the plates manufactured by Dynatech AG (Switzerland) and by the Leningrad Works of Medical Polymers has been made. At the first stages of the reaction the antigen is separated from the carrier and the amount of the desorbed antigen depends on its initial dose and the dilution of the assayed sera. The irregular desorption of the antigen leads to misinterpretation of the results. Comparison of the polystyrene plates has shown that each plate is characterized by individual adsorption capacity, which impedes at present the standardization of EIA-based test systems. PMID- 3318235 TI - [Determination of pneumococcus antibodies in secretions in acute pneumonia in children]. AB - IgA-antibodies to pneumococcal antigens were measured by enzyme immunoassay in saliva and nasal washings, obtained from 32 children aged 6 months to 14 years with acute pneumonia and from 25 healthy children aged 2.5-11 years. In the secretions of children with acute pneumonia an essential increase in the levels of IgA-antibodies in comparison with those observed in healthy children was detected. The levels of antibodies to pneumococci in saliva and in nasal washings were in direct correlation. These data are indicative of a protective role played, probably, by secretory antibodies at the portals of infection in pneumococcal pneumonia. PMID- 3318238 TI - [Current status and outlook in improving immunoenzyme analyses for solving clinical diagnostic tasks]. PMID- 3318237 TI - [Immunoenzyme analysis of human IgG in the kinetic mode]. AB - A kinetic sandwich enzyme-linked immunosorbent assay for the detection of human IgG (used as a model antigen) has been developed. Rabbit antihuman IgG has been used both for coating polystyrene microtitration plates and for the preparation of the conjugate of anti-human IgG with horse-radish peroxidase. The kinetics of the reaction of the antigen and the antibody-peroxidase conjugate with the reagents immobilized on polystyrene plates has been studied. The assay is optimized with respect to its sensitivity and the duration of intervals for every stage of the assay. The optimal time of the assay is about 10-15 minutes. The correlation between sensitivity and the duration of every stage of the assay has been established. PMID- 3318239 TI - [Use of solid-phase immunoenzyme analysis for determining allergen-specific IgE antibodies]. AB - An ELISA system for the detection of allergen-specific IgE antibodies to ragweed allergen has been developed. The system is highly sensitive and specific. Ragweed pollen allergen has been obtained by the dialysis of water-soluble extract through a kidney membrane. The high molecular fraction of ragweed allergen, showing the whole of the allergenic activity detected by skin tests in untreated patients, has been used for coating polystyrene assay plates. To detect IgE antibodies to ragweed allergen, the conjugate of sheep anti-IgE antibodies with horse-radish peroxidase has been used. The level of allergen-specific IgE antibodies has been determined on the basis of the data on the optical density of the samples in comparison with that of the normal sera. The correlation factor of the results obtained in the assay of specific IgE antibodies with the newly developed assay system and with the commercial kit Phadezyme RAST manufactured by Pharmacia AB (Sweden) has proved to be 0.82 at n = 39, p less than 0.01, while the variation factor in the reproduction of the assay results has proved to be 12% at n = 40. PMID- 3318240 TI - [Determination of ovalbumin-specific IgG antibodies in mouse sera by immunoenzyme analysis using horseradish peroxidase-conjugated staphylococcal protein A]. AB - The article deals with the possibility of using staphylococcal protein A conjugated with horse-radish peroxidase for the detection of specific IgG antibodies to ovalbumin in mice by the indirect and competitive EIA techniques. Studies on specifying the parameters of the EIA system for the detection of specific IgG-antibodies are in progress. PMID- 3318241 TI - [Modification of the immunoenzyme analysis of haptens as exemplified by testosterone determination]. AB - The solid-phase enzyme immunoassay for testosterone (TS), permitting the determination of this hormone at concentrations of up to 0.5 ng/ml, has been developed. The method comprises the adsorption of TS conjugated with soya trypsin inhibitor in the wells of a standard polystyrene assay plate, competition between adsorbed TS and TS under test for the binding sites of specific antibodies, and the detection of antibodies bound to the carrier by means of peroxidase-labeled antispecific antibodies. Antisera to TS have been obtained by the immunization of rabbits with TS conjugated with bovine serum albumin of a known composition. These antisera are specific to TS and do not interact with estrogens and progesterone. The study of their cross reactions with eleven TS derivatives has demonstrated that antibodies reveal the presence of structural changes in ring D of the molecule of TS and are insensitive to variations in ring A. The determinant comprising the 17-OH-group essentially contributes to the binding of antibodies. PMID- 3318242 TI - [Immunoenzyme method of determining thymus polypeptide factor]. AB - A rapid indirect enzyme immunoassay technique for the determination of thymalin, a polypeptide thymus factor, with sensitivity equal to 1.5 X 10(-8) mol/l has been developed. The accuracy of determinations, measured by the variation factor, has proved to be 5-10% in the interassay, 10-15% in the interassay, the reliability in the opening test being 5%. The assay takes 4.5-5 hours. PMID- 3318243 TI - [Immunoenzyme method of sequential saturation for determining antigens using the model of insulin]. AB - The method for the determination of insulin by means of the enzyme immunoassay, based on the use of insulin-peroxidase conjugates, has been developed. In this assay the scheme of the successive saturation of the active sites of antibodies is used. The antigenic properties of two conjugates differing in the method of their preparation are compared. The conjugates were obtained by the covalent binding of peroxidase, oxidized in its carbohydrate component, with insulin (conjugate 1) or hexamethylene-diamine-modified insulin (conjugate 2). The conjugates represented a mixture of oligomers differing in their molecular weight. Conjugate 1 possessed higher affinity to antibodies and higher enzymatic activity than conjugate 2. The method for evaluating the quality of antisera to insulin used in the assay has been proposed. The time of the insulin assay is 5 16 hours, the limit of insulin detection is 5 microU/ml, the variation factor is 3-12%. PMID- 3318244 TI - [Development of an immunoenzyme test system for determining the antigens of feed yeasts]. AB - An enzyme immunoassay (EIA) system for the detection of fodder yeast antigens in the air of production areas at fodder protein producing plants has been developed. The method has proved to be highly sensitive and specific and shows advantages in comparison with the nonspecific method of low sensitivity, currently used at such plants. The sensitivity of solid-phase EIA techniques is 0.001 micrograms/ml (for protein) or 10(2)-10(3) cells/ml, and 10 ng/ml for soluble antigen. No cross reactions with bakers' yeast antigen have been observed. PMID- 3318245 TI - [Antibodies to Staphylococcus aureus teichoic acids in the pathogenesis of chronic osteomyelitis]. AB - The titers of antibodies to S. aureus cell-wall teichoic acids have been determined in 97 orthopedic and traumatic patients with purulent diseases, differing by the activity of the process, by means of the enzyme immunoassay. These antibodies appeared in the patients' blood in active osteomyelitic process of staphylococcal etiology. PMID- 3318246 TI - [Immunoenzyme test system for the quantitative determination of tetanus antitoxin in vaccinated persons using horseradish peroxidase-conjugated staphylococcal protein A]. AB - An enzyme immunoassay (EIA) system for assays of tetanus antitoxin in vaccinees has been developed. As conjugate, staphylococcal protein A labeled with horse radish peroxidase is used in this system. The possibility of using the newly developed EIA system in seroepidemiological surveys of the population is shown. PMID- 3318247 TI - [Choice of the suitability criteria of polystyrene-based solid-phase carriers for performing immunoenzyme analyses]. AB - The authors discuss a tentative approach to the choice of criteria indicating the optimal suitability of different solid-phase carriers made of polystyrene for use in the enzyme immunoassay (EIA), viz. the dependence of specificity, sensitivity, reproducibility and reliability of EIA results on the adsorption properties, transparency expressed in percent and transparency variations of the plates under test. The evaluation of the carriers by four parameters is proposed with the use of assay plates manufactured by Nunc A/S (Denmark) for control. To ensure the objective evaluation of the suitability of polystyrene plates for use in EIA, the choice of uniform criteria is necessary. PMID- 3318248 TI - [Rapid serological screening of human sera for the presence of measles virus antibodies in solid-phase immunoenzyme analysis]. AB - A single dilution technique has been used for the determination of antimeasles antibody titer. The method involved the plotting of the calibration curve and the characterization of the serum by arbitrary "evaluation units" in comparison with the specially selected positive serum whose titer was taken to be equal to 100 "evaluation units". By means of this method 57 sera obtained from children immunized against measles and 118 sera from non-vaccinated adults aged 18-22 years were examined. The values of the calculated titers were similar to those determined experimentally. This recommends this method for seroepidemiological investigations aimed at determining the level of herd immunity to measles. PMID- 3318249 TI - [Diagnosis of viruses infecting essential-oil plant crops by using immunoenzyme analysis]. AB - The use of the EIA point technique permitted the detection of viruses affecting essential-oil plants. The method is simple, highly specific, sensitive and can be used for checking seedlings prior to planting. PMID- 3318250 TI - [Use of direct solid-phase immunoenzyme analysis for assessing the immunological activity of a vaccine against tick-borne encephalitis]. AB - A high correlation between the current index of the effectiveness of tick-borne encephalitis vaccine, its protective activity in mice, and the results of the direct solid-phase enzyme-immunoassay has been established, which permits the use of this assay as an auxiliary method for the immunological evaluation of newly prepared commercial purified tick-borne-encephalitis vaccine. PMID- 3318251 TI - [Diagnostic potentials of a staphylococcal tests system in suppurative surgical pathology of newborn infants]. PMID- 3318252 TI - My sixty years in physiology and biochemistry. PMID- 3318253 TI - [The importance of magnesium in orthopedics. IV. The role of magnesium deficiency in the pathogenesis of osteoarticular diseases]. PMID- 3318254 TI - [Initial clinical experience with autolyzed antigen-extracted allogeneic bone]. PMID- 3318255 TI - [Initial experience with lengthening of the lower extremity using pelvic osteotomy]. PMID- 3318256 TI - Continuous basal insulin infusion without premeal boluses in insulin-dependent diabetes mellitus therapy. AB - Six insulin-dependent diabetic patients, poorly controlled on conventional insulin therapy (CIT), underwent continuous basal insulin infusion (CBII) and continuous subcutaneous insulin infusion (CSII) during 2 subsequent periods of 1 month each, employing a Betatron II insulin infusion pump (Lilly, CPI). During CSII, insulin was infused at a continuous basal rate with 3 premeal boluses. During CBII, from 22(00) to 06(00) a continuous basal nocturnal insulin infusion rate and from 06(00) to 22(00) a diurnal one, which was approximately twice the former, were maintained and total daily calorie intake was subdivided into 6 isoglycidic and isocaloric meals, taken at regular intervals. We obtained better blood glucose control both by CSII and CBII than by CIT, with significant reduction of HbA1 values. Mean blood glucose levels were lower during CBII than during CSII, while M-index, number of hypo- and hyperglycemic events and insulin requirement were not different. However, daily blood glucose excursions were narrower and percent blood glucose increment after the noon meal was reduced during CBII. CBII insulin profile was characterized by a plateau trend with lower levels at meals in comparison with CSII. Our data show that the subdivision of daily calorie intake into 6 isocaloric and isoglycidic meals allows to achieve good metabolic control by continuous basal insulin infusion without need for premeal boluses and could be especially useful in brittle diabetic patients, whose brittle condition may be caused by erratic absorption of subcutaneous boluses of insulin. PMID- 3318259 TI - The addition of glipizide to insulin therapy in type-II diabetic patients with secondary failure to sulfonylureas is useful only in the presence of a significant residual insulin secretion. AB - The present study aimed at 1) investigating the effect of a combined insulin + glipizide treatment on the metabolic control (HbA1c levels) and insulin requirements (Biostator assessment) in ten non-obese Type-II diabetic patients with recent secondary failure to sulfonylureas; and 2) characterizing the relative contributions of changes in endogenous insulin secretion (C-peptide response) and insulin sensitivity (insulin-induced glucose disposal in clamped conditions) to this effect. The patients were treated in a randomized cross-over order with either insulin alone or insulin + glipizide (3 X 10 mg/day) during two periods averaging 6 weeks each. Mean HbA1c levels were similar in both experimental conditions (8.2 +/- 0.6 vs 7.9 +/- 0.6%, NS). In fact, during the combined therapy, HbA1c levels decreased in five subjects (from 8.6 +/- 0.7 to 7.1 +/- 0.5%; 'responder'), but not in the five others ('non-responders'); the 20 h Biostator insulin infusion was significantly decreased in the responders (29%; P less than 0.05), but not in the non-responders. Basal (0.271 +/- 0.086 vs 0.086 +/- 0.017 nmol/l; P less than 0.05) and post-glucagon (0.468 +/- 0.121 vs 0.180 +/- 0.060 nmol/l; P less than 0.05) C-peptide plasma levels were significantly higher in the responders than in the non-responders; in addition, glipizide significantly increased basal C-peptide concentrations in the responders only (+68%; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318257 TI - Sodium salicylate restores the impaired insulin response to glucose and improves glucose tolerance in heroin addicts. AB - Plasma glucose, insulin, C-peptide, glucagon and growth hormone responses to intravenous glucose were evaluated in 10 heroin addicts in the basal state and during an infusion of sodium salicylate, an inhibitor of endogenous prostaglandin synthesis. Ten normal subjects, matched for age, sex and weight served as controls. In the basal state, the heroin addicts had markedly reduced insulin responses to intravenous glucose and low glucose disappearance rates (p less than 0.01 vs controls). The infusion of sodium salicylate caused a striking increase of the acute insulin response to intravenous glucose (from 14.5 +/- 4 microU/ml to 88 +/- 11 microU/ml, p less than 0.001) and restored to normal the reduced glucose tolerance (KG from 1.10 +/- 0.1% min-1 to 2.04 +/- 0.19% min-1). Hypoglycemic values were found in all addicts at the end of the test during salicylate infusion. Indomethacin pretreatment in five additional addicts also caused normalization of the impaired insulin responses to the intravenous glucose challenge and restored to normal the reduced glucose disappearance rate. Plasma glucagon and growth hormone levels were normally suppressed by glucose in addicts in basal conditions; sodium salicylate infusion completely overturned these hormonal responses which became positive in the first 15 min following the glucose challenge. These results demonstrate that the two prostaglandin synthesis inhibitors can restore the impaired B-cell response to glucose in heroin addicts to normal, indicating that this response is not lost but is inhibited by heroin itself or by other substances, perhaps by the endogenous prostaglandins. PMID- 3318258 TI - Plasmatic levels of fibronectin in diabetics with and without retinopathy. Correlation with some hormonal and metabolic parameters. AB - Fibronectin is a high molecular weight alpha-2-glycoprotein. Its peculiar role in the structure of connective tissue, together with its wide involvement in coagulative dynamics, justified the increasing interest for fibronectin in the pathogenesis of diabetic disease and its vascular sequelae. In the present work, we evaluated the levels of plasma fibronectin (PF) in diabetics with and without retinopathy, and studied the possible correlation between the glycoprotein and some hormonal and metabolic parameters, expression of glycometabolic balance. We examined 26 type I and 24 type II diabetics, further divided into retinopathics and not retinopathics, and 43 normal subjects. We did not find any significant difference in PF levels either between normals and diabetics, or between type I and type II patients, or between retinopathics and not retinopathics. PF was significantly correlated to age, both in normals and in diabetics. Diabetic patients showed a significant positive correlation of PF to total cholesterol (r = 0.56; p less than 0.05) and triglycerides (r = 0.36; p less than 0.05). This seems to suggest, although indirectly, the existence of a relationship between the levels of PF and the degree of large vessel involvement. No significant correlation was found with HbA1c, beta-OH, AcAc, lactate, pyruvate, C-peptide, total and free insulin or GH. We further indicated an inverse correlation between PF and plasma glucagon (IRG). Very low levels of PF are commonly associated with high IRG plasma values during acute energy deprivation such as prolonged fasting and ketoacidotic coma. Therefore, PF levels might represent an index of latent to overt energy depletion. PMID- 3318260 TI - Serum profiles and short-term metabolic effect of pituitary and authentic biosynthetic human growth hormone in man. A double-blind cross-over study. AB - In a double-blind cross-over study we compared pituitary and methionine-free biosynthetic human growth hormone (P-hGH and B-hGH) with respect to pharmacokinetics and short-term metabolic effects in 9 hypopituitary children. They treated themselves for 4 weeks with 2 IU sc daily at 20.00 h. After admittance to hospital 2 IU was given: im the first day, and sc the second. They then switched over to the alternative preparation. The serum profiles of B- and P hGH were identical. Comparing im and sc absorption, the latter was slower and resulted in smaller areas under the curves, indicating greater local degradation. Both preparations caused identical increases in somatomedin-C, but slightly more sustained after sc injection. Plasma glucose, plasma glucagon, and serum insulin fluctuated within normal ranges. The glucose profile pointed at a modest anti insulin effect of hGH when given in the morning. The concentration in the blood of lactate, alanine, glycerol and B-OH-butyrate, and in serum of triglyceride, cholesterol and carbamide revealed no abnormalities with either hGH preparation. Finally, no development of anti-GH or E. coli polypeptide antibodies was seen. In conclusion, the pharmacokinetics and short-term metabolic effects of B-hGH and P hGH were identical. PMID- 3318262 TI - Effects of bacterial lipopolysaccharide on the development of adherent colonies in murine bone marrow cell culture. PMID- 3318261 TI - Morphological study of the effects of an GnRH agonist on the canine testis after 4 months of treatment and recovery. AB - After 4 months of treatment of adult male dogs with the GnRH agonist (GnRH-A) [D Trp6]GnRH ethylamide, the seminiferous tubules contained only type A and B spermatogonia, Sertoli cells, and rare primary spermatocytes, thus causing a 64% decrease in testis weight. At the electron microscope level, Sertoli cells showed an increase in phagosomes and lipid droplets. Leydig cells were markedly atrophied with the accumulation of lipid droplets and showed a predominance of mitochondria with lamellar instead of vesicular cristae. Four months after cessation of treatment with GnRH-A, a complete return to normal spermatogenesis and Leydig cell morphology was observed. The full reversibility of spermatogenesis in the dog after chronic GnRH-A treatment suggests that this well tolerated peptide could be used as a reversible method of male contraception. PMID- 3318263 TI - Primary malignant lymphoma of the thyroid gland--clinical, histological and immunohistochemical studies. PMID- 3318264 TI - A new immunocytochemical method to measure cell kinetics of human lymphocytes by using monoclonal antibody against bromodeoxyuridine. PMID- 3318265 TI - A case of plasmacytic lymphadenopathy with polyclonal hypergammaglobulinemia: evidence for T cell dysfunction. PMID- 3318266 TI - Promyelocytic crisis of chronic myelocytic leukemia: case report and review of the literature. PMID- 3318267 TI - Plasma immunoadsorption combined with exchange for removal of isohemagglutinin in major ABO-incompatible bone marrow transplantation: a case report. PMID- 3318268 TI - A haemoglobin dilution method (HDM) for estimation of blood volume variations during transurethral prostatic surgery. AB - A method for estimation of blood volume changes during transurethral prostatic surgery is presented (haemoglobin dilution method (HDM]. It is based on a calculation of the patient's preoperative total haemoglobin content, from which losses are subtracted. The haemoglobin concentration of the blood is used as an indicator of dilution. The HDM was compared to the 131I-RISA technique in 10 patients undergoing transurethral resection of the prostate (TUR). The difference between the HDM and RISA in estimating the total operative procedure blood volume change was 0.03 +/- 0.12 l (ns) with a linearity of 0.90. The blood volume changes were also predicted by a fluid balance formula. With RISA as reference, the formula had a lower precision (0.24 l) and a poorer linearity (0.65) than the HDM. The HDM did not lose in accuracy if repeated several times during the TURs or if a theoretical formula for estimation of the preoperative blood volume was used. PMID- 3318269 TI - Hemodynamic effects of high frequency ventilation superimposed on intermittent positive pressure ventilation in dogs. AB - The hemodynamic effects of high frequency ventilation (HFV) superimposed on intermittent positive pressure ventilation (IPPV) in seven dogs before and after thrombin infusion were investigated. HFV was superimposed on a Servo 900 B ventilator by a Siemens Elema HFV prototype unit. Mean arterial blood pressure, heart rate, central venous pressure, pulmonary artery pressure, cardiac output, right and left ventricular pressures, pleural pressure, arterial blood gases, and right and left ventricular ejection fractions were recorded. Measurements were done during IPPV alone and during HFV superimposed on IPPV. The HFV frequencies were 5, 15, and 20 Hz at a constant minute volume of 5 1. When HFV was started, the IPPV minute volume was reduced to one third of the initial volume. No significant changes in the measured parameters were observed during the different ventilatory modes either before or after thrombin infusion which doubled the pulmonary vascular resistance. It is concluded that high frequency ventilation superimposed on IPPV might be a ventilatory mode that offers cardiovascular stability and reduces the risk of barotrauma. PMID- 3318270 TI - Normal-pressure hydrocephalus associated with spinal cord tumor. AB - While the association of spinal cord tumor and high-pressure hydrocephalus is well known, only 5 cases of spinal cord tumor associated with normotensive hydrocephalus have been reported. Two further cases are described here, discussing the possible pathophysiological mechanism. It is suggested that these patients go through a subclinical stage of high-pressure hydrocephalus and become normotensive later on, a process which might influence the surgical results. PMID- 3318272 TI - Erythropoietin in capillary hemangioblastoma. An immunohistochemical study. AB - Capillary hemangioblastoma is a tumor known to be associated with secondary polycythemia. Therefore, specimens from ten hemangioblastomas were studied by immunohistochemistry for the presence of erythropoietin, renin substrate, and for various endothelial, histiocytic and glial markers. In all tumors scattered cells among the stromal cells showed a positive-staining reaction with both anti erythropoietin and anti-renin substrate. The same cells also stained positively for alpha-1-anti-trypsin. It is concluded that, in addition to the capillary endothelial cells, pericytes and stromal cells, capillary hemangioblastomas harbor cells containing and perhaps producing renin substrate and/or erythropoietin or a substance with similar antigenic determinants. PMID- 3318273 TI - Diisopropanolnitrosamine (DIPN) induced rat thyroid lesions. III. An immunohistochemical study on their functional aspects. AB - The functional aspects of DIPN induced rat thyroid lesions classified as in our previous studies were analyzed by immunohistochemical detection of Tg, T4, and T3 in serial or semi-serial paraffin sections. The type 1 lesions, i.e., foci of cellular alteration of individual follicles, showed the same pattern of immunostaining as seen in the surrounding hyperplastic follicles and in normal controls. On the other hand, the type 3 lesions, i.e., carcinomas, were mostly negative for T4 and T3 with only partial staining for Tg. The type 2 lesions, i.e. proliferative nodules, which might include a state of nodular hyperplasia as well as benign neoplastic nodules, demonstrated intermediate stainability between the type 1 and type 3 lesions. These results suggest that the histological structures of focal lesions of the thyroid gland may be closely related to their functional activities. Also, the importance of follicular structure formation in thyroid hormone synthesis was demonstrated in each type of focal lesion. PMID- 3318271 TI - The comparative immunoreactivities of brain amyloids in Alzheimer's disease and scrapie. AB - An antibody was raised to a synthetic peptide corresponding to a published sequence for the first 24 residues of a cerebrovascular amyloid peptide (CVAP). Immunohistochemical staining of tissue sections revealed that the antibody bound extensively to cerebrovascular amyloid in Alzheimer disease (AD/SDAT) and Down's syndrome cases. The antibody bound less extensively to neuritic plaques (primitive and mature) and indetectably to neurofibrillary tangles. The antibody did not label scrapie plaques, scrapie-associated fibrils, or Gerstmann Straussler syndrome plaques. Immunoblotting experiments showed that the cerebrovascular amyloid peptide epitopes contaminating the neurofibrillary tangle preparations could be extracted with urea, leaving the neurofibrillary tangles intact. These data confirm that the cerebrovascular amyloid peptide is a component of cerebrovascular amyloid, and suggest that its epitopes are also components of neuritic plaque amyloid. The reduced level of immunostaining on amyloid cores in tissue sections suggests that either the cerebrovascular amyloid peptide epitopes are a minor component of amyloid cores, or that their mode of packing or state of processing in amyloid cores renders them relatively inaccessible to the antibody. We also conclude that the cerebrovascular amyloid peptide is not a component of neurofibrillary tangles. The synthetic cerebrovascular amyloid peptide possesses amyloid-like properties: at neutral pH it forms insoluble aggregates consisting of 5-7-nm fibrils, which form red-green birefringent adducts with Congo red and fluoresce with thioflavine S. PMID- 3318274 TI - [Recent advances in studies on nucleoside antiviral agents]. PMID- 3318275 TI - Serum IgE level in end-stage kidney disease patients and in kidney graft recipients. PMID- 3318276 TI - Antibodies to double-stranded deoxyribonucleic acid in end-stage kidney disease patients and in kidney graft recipients. PMID- 3318277 TI - Radioprotective effects of thiomethylhydantoin derivatives on Escherichia coli and mice. AB - Protection of Escherichia coli NIHJ and C57BL mice from the effects of 60Co gamma rays provided by S-alk(en)yl-L-cysteines and their hydantoin derivatives was examined. E. coli (10(6) cells/ml) suspended in a 20 mM aqueous solution of one of the drugs was irradiated with 60 Gy of gamma-rays. Five week-old male mice were exposed to 5.0-9.5 Gy of gamma-rays after a single intraperitoneal injection of 0.75 mmol/kg body weight of each compound. In both E. coli and mice, S-allyl compounds afforded more effective radioprotection than S-propyl compounds. The replacement of the alpha-hydrogen of S-substituted cysteines by methyl groups decreased the radioprotective effect. Hydantoin derivatives were much more radioprotective than the original sulfur-containing amino acids. Especially, DL-5 allylthiomethyl-5-methylhydantoin had a remarkable radioprotective effect in mice. The gamma-radiolysis mechanism of thiomethylhydantoin derivatives was discussed in connection with the radioprotective effect of the drugs. PMID- 3318278 TI - [A pig-tail catheter in 1907]. PMID- 3318279 TI - [Blind-ending bifid ureter: clinical and diagnostic study]. PMID- 3318280 TI - [Treatment with intravesical chemotherapy of deep bladder tumors responding to radiotherapy, decreasing their staging]. PMID- 3318281 TI - [3 cases of prostatic malacoplakia]. PMID- 3318283 TI - Functional morphology of the Golgi apparatus. PMID- 3318282 TI - [Calculus complications in renal transplantation]. PMID- 3318284 TI - The brain stem in a lizard, Varanus exanthematicus. PMID- 3318285 TI - A predominant idiotype in the gut associated lymphoid tissue. PMID- 3318286 TI - Canine Peyer's patches: macroscopic, light microscopic, scanning electron microscopic and immunohistochemical investigations. PMID- 3318287 TI - Specific antibacterial antibody-producing cells in human nasal mucosa. PMID- 3318288 TI - Incidence and distribution of immunocytes in the murine oral mucosa. PMID- 3318289 TI - Switch T cell line, ST, induces an Ig class switch in surface isotype. PMID- 3318290 TI - Cofactor requirements for expression of lactoferrin bactericidal activity on enteric bacteria. PMID- 3318291 TI - Role of LPS responsiveness in urinary tract infection. PMID- 3318292 TI - Experimental models for understanding B lymphocyte formation. PMID- 3318293 TI - The involvement of oncogenes and suppressor genes in human neoplasia. AB - It is clear that there are at least two classes of cancer-related genes. The more characterized of these are the oncogenes, whose activation appears to play a major role in human neoplasia. There are now two families of oncogenes, the myc and ras families, whose cooperation seems capable of transforming normal cells in culture to tumorigenic cells. As such, they appear to form complementation groups with immortalizing and transforming properties, respectively. Moreover, the oncogenes can be subclassified as tyrosine kinases or kinase related, GTP binding proteins, growth factors or growth factor receptors or nuclear proteins. More than 20 viral oncogenes have been identified, for which more than 30 proto oncogenes or pseudogenes exist in the human genome. Many of these have been cloned, characterized to some extent, and mapped to particular chromosomes or regions of chromosomes. Further, more than 20 additional putative oncogenes or transforming genes have been identified by tumor DNA transfection studies or at sites of integration or translocation for which no viral transforming gene cognates exist. Oncogenes can be activated by increased or unregulated expression, increased copy number (duplication, amplification), or somatic mutation resulting in a protein with increased oncogenic potential. Examples of all of these mechanisms can be found in several specific human cancers or leukemias. The cytogenetic correlate of enhanced expression is a translocation between two chromosomes at specific breakpoints with no net loss of genetic material (e.g., increased c-myc expression resulting from the 8;14 translocation in Burkitt's lymphoma). The phenomenon of increased gene copy number can sometimes be visualized as trisomy or tetrasomy for a particular chromosome but more dramatically as the development of extrachromosomal DMs or as chromosomally integrated HSRs (e.g., the N-myc gene amplification seen in neuroblastoma). Finally, certain somatic mutations can be associated with translocations (e.g., the bcr/abl fusion product created as a result of the 9;22 translocation in chronic myelogenous leukemia), but they are more commonly submicroscopic (as characterized by point mutations in the ras gene family). Evidence is accumulating for a second class of cancer-related genes whose absence or inactivation is associated with tumorigenesis. These genes are associated at the cytogenetic level with chromosomal deletions, in which the breakpoints may be variable, but specific, common regions are consistently deleted.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3318294 TI - Shock in the pediatric patient. PMID- 3318295 TI - Pathogenesis of pulmonary edema after premature birth. PMID- 3318296 TI - Carotenemia. PMID- 3318297 TI - Breast milk and breastfeeding jaundice. PMID- 3318298 TI - Sexual abuse of children and adolescents. PMID- 3318299 TI - Suicide in children and adolescents. PMID- 3318300 TI - Neonatal iatrogenesis. PMID- 3318301 TI - Direct and indirect pathogenicity of anaerobic bacteria in respiratory tract infections in children. AB - Bacteroides sp (Bacteroides melaninogenicus, Bacteroides oralis, and Bacteroides fragilis), peptostreptococci, and fusobacteria are important pathogens in respiratory tract infections (RTI). These organisms are often recovered mixed with other aerobic, facultative, and anaerobic bacteria. Evidence supporting their virulence is provided by studies showing their synergistic potentials in mixed infections and their increased virulence when encapsulated. A recent increase in numbers of beta-lactamase producing strains of anaerobic gram negative bacteria in RTI has been associated with increased failure rates of penicillins in eradication of these infections. These infections include chronic otitis media, chronic sinusitis and mastoiditis, chronic recurrent tonsillitis, and lung abscesses. The pathogenicity of these organisms is apparent through their ability not only to survive penicillin therapy but also to protect penicillin susceptible pathogens from that drug. These direct and indirect virulence characteristics of anaerobic bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections. The synergy that exists between different aerobic and anaerobic organisms in the respiratory tract is due to several pathogenic mechanisms. These mechanisms include the production of a capsule, which protects organisms from phagocytosis, and the production of beta-lactamase, which inactivates penicillins and first-generation cephalosporins. Both of these mechanisms enhance infection and induce complications. However, more work is necessary to prevent encapsulation and the production of enzymes. Data, thus far, indicate that there are therapeutic modalities that can be used to prevent these occurrences and eliminate many mixed RTI. PMID- 3318302 TI - Advances in pediatric pharmacology and toxicology. PMID- 3318303 TI - Tumor cell gangliosides. PMID- 3318304 TI - New genetic defects in mitochondrial fatty acid oxidation and carnitine deficiency. AB - There are now nine inherited diseases that have been identified in the pathway of mitochondrial fatty acid oxidation, including LCAD, MCAD, SCAD, and HMG-CoA lyase deficiencies, two forms each of CPT and MAD deficiencies and an incompletely characterized disorder of primary carnitine deficiency. The varied range of clinical manifestations in this new group of diseases should attract the attention not only of general pediatricians (coma, hypoglycemia) but also of pediatric subspecialists in neurology (myopathy), cardiology (cardiomyopathy), and gastroenterology (fatty liver), as well as genetics and metabolism. The presenting features of the genetic defects in fatty acid oxidation fit well with the concept that fatty acid oxidation plays a major role in energy production during prolonged fasting and in working cardiac and skeletal muscle. Life threatening episodes of coma and hypoglycemia induced by fasting are a common presenting feature in most of the fatty acid oxidation disorders (MCAD, LCAD, and HMG-CoA lyase deficiencies, the infantile form of CPT deficiency, the mild form of MAD deficiency, and in some cases of primary carnitine deficiency). The hypoglycemia in these disorders is most easily explained by the inability of affected patients to use fatty acids as a fuel as a substitute for glucose. It should be stressed, however, that the coma in these disorders may occur from direct toxic effects of fatty acids or fatty acid intermediates before plasma glucose concentrations reach hypoglycemic levels. Severe disturbances of muscle function are a feature in several of the disorders; hypertrophic cardiomyopathy and chronic skeletal muscle weakness occur in both the mild and severe forms of MAD deficiency, in primary carnitine deficiency, and in some patients with LCAD deficiency. In contrast, patients with the adult form of CPT deficiency have normal muscle strength but are prone to episodes of painful rhabdomyolysis induced by prolonged exercise. These manifestations presumably reflect the requirement of working cardiac and skeletal muscle for energy supplied from fatty acid oxidation. In two of the disorders, SCAD deficiency and the severe form of MAD deficiency, chronic CNS toxicity is a dominant feature. The severe effects on the brain in these two disorders may reflect the fact that short-chain fatty acids more readily cross the blood-brain barrier than longer-chain fatty acids.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3318305 TI - The University of Melbourne--nucleus multi-electrode cochlear implant. AB - To summarize, our preliminary results indicate that some prelingually deaf patients may get worthwhile help from a multiple-electrode cochlear implant which extracts formants. They can understand words and running speech better when using the cochlear implant with lip-reading compared to lip-reading alone. It has been encouraging that these improvements can occur in young adults and teenagers. It has also been encouraging that some can recognize place pitch as well as rate pitch. There are, however, considerable variations in performance and this may be due to the following factors: whether they have had some hearing after birth, the method of education used, the motivation of the patient and age at implantation. In conclusion it is important to emphasize that deaf children are severely disadvantaged however good their teacher of the deaf. Research on cochlear implants offers hope for profoundly-totally deaf children. These developments will not replace the caring, competent educators but complement their skills. There is also a greater need than ever for an interdisciplinary approach to these children. PMID- 3318306 TI - Leave the abdomen open for peritonitis: yes, no, maybe? PMID- 3318308 TI - Barrett's esophagus. PMID- 3318307 TI - Pancreas divisum: a case against surgical treatment. PMID- 3318309 TI - Clinical significance of gastrointestinal hormones. PMID- 3318310 TI - Extracorporeal membrane oxygenation support in cardiorespiratory failure. PMID- 3318311 TI - Open treatment of peritonitis: an argument against. AB - We conclude that open management of advanced peritonitis may provide improved drainage, but it does so at an intolerable cost of increased mechanical lesions, namely, fistulas. The theories of animal investigators need to be tested at the bedside and in the hospital operating room before this idea receives any further consideration. "Semi-open" treatment has been widely and usefully used by many surgeons. Unfortunately, it provides less than total drainage and has its own set of major problems related to mesh removal and/or ultimate wound closure. We think that a better alternative for future controlled study is the sporadically espoused but impressively effective continuing peritoneal lavage with dilute solutions of antibiotics. PMID- 3318312 TI - Intraoperative ultrasound of the liver and pancreas. PMID- 3318314 TI - Multiple trauma: major extremity wounds; their immediate management and its consequences. PMID- 3318313 TI - Rectovaginal fistula. PMID- 3318315 TI - Surgery for hyperthyroidism. PMID- 3318316 TI - Sclerosing cholangitis. AB - PSC is an unusual disease of unknown etiology. In fact, sclerosis of the bile ducts may be the result of multiple factors, including autoimmune, bacterial, congenital, drug, or viral agents. The most commonly associated diseases are ulcerative colitis and chronic pancreatitis. Except for the earliest stages of the disease, liver histology is not specific. Most patients present with jaundice, pain, and pruritus, although an increasing number of asymptomatic patients with inflammatory bowel disease and abnormal liver function are being diagnosed. Cholangiography is the key to the diagnosis and is usually pathognomonic except in the unusual case where PSC is confused with cholangiocarcinoma. Multiple forms of medical therapy have been tried, including steroids, azothiaprine, D-penicillamine, colchicine, cholestyramine, and antibiotics. To date, however, none of these medications has altered the course of this disease. In recent years, balloon dilation of biliary strictures has been accomplished via endoscopic and percutaneous transhepatic approaches. However, in patients with PSC these nonoperative manipulations must be done repeatedly, may require multiple general anesthetics, and are difficult to perform. A direct surgical approach to the biliary tree with prolonged transhepatic stenting is indicated in patients with severe hilar or extrahepatic stricturing, persistent jaundice and/or recurrent cholangitis, and no evidence of cirrhosis. Hepatic transplantation should be reserved for patients with PSC who have well established cirrhosis and in whom other therapeutic options have failed. PMID- 3318317 TI - [Health education in child and adolescent literature of the German Enlightenment]. PMID- 3318318 TI - King Solomon's portrait of old age by John Smith. PMID- 3318319 TI - British Geriatrics Society award of the Founder's Medal to Dr Trevor Howell. PMID- 3318320 TI - High-level C5a gene expression and recovery of recombinant human C5a from Escherichia coli. AB - Poor expression of a synthetic gene for the inflammatory mediator, C5a, was observed in E. coli grown in rich media. Varying the media composition markedly improved expression, although C5a levels still declined rapidly at the end of log phase. Using a protease-deficient strain, C5a was recovered at stationary phase in high yield (13 mg/liter of culture). Recovery was dependent on guanidinium hydrochloride extraction to solubilize the protein and glutathione treatment to promote correct folding. Two-thirds of the C5a retained an amino-terminal methionine. Both forms of recombinant C5a had activity similar to serum-derived C5a in binding to human neutrophil receptors and inducing chemotaxis. The 700 fold improvement in yield made it feasible to obtain gram amounts of C5a and provides an efficient system for site-directed mutagenesis. PMID- 3318322 TI - Gastric cytoprotection: a critical appraisal of the concept, methodology, implications, mechanisms and future research prospects. AB - Gastric cytoprotection is the property of certain substances, particularly prostaglandins, when used in non-antisecretory doses, to protect the gastric mucosa from becoming inflamed and necrotic on being exposed to noxious agents. An association between alterations in endogenous prostaglandins and gastric mucosal damage induced by a number of drugs has also been observed. The process of adaptive cytoprotection in which mild irritants protect the gastric mucosa against the damaging effects of various necrotizing agents has been shown to be prostaglandin mediated. However, the exact mechanisms underlying this cytoprotective activity have still not been elucidated although a number of hypotheses have been proposed. Recently, thromboxanes, leukotrienes and endogenous sulfhydryls have also been suggested to be involved in the pathogenesis of gastric mucosal damage induced by various necrotizing agents. This review attempts to provide an up-to-date appraisal of the concept, methodology, mechanisms and implications of this phenomenon and suggests that prostaglandins and endogenous sulfhydryls may play a significant role in the pathogenesis of gastric ulceration and may serve an important function in maintaining normal gastric mucosal integrity. PMID- 3318321 TI - Aspects of histamine metabolism. PMID- 3318323 TI - Augmentation of immune responses by a muramyl dipeptide analog, MDP-Lys(L18). AB - The effects of N2-(N-acetyl-muramyl-L-alanyl-D-isoglutamyl)-N6-stearoyl-L-lysine (MDP-Lys(L18], a muramyl dipeptide (MDP) analog, on the immune responses in mice were studied. MDP-Lys(L18) augmented the mitogenic responses of splenic lymphocytes to phytohemagglutinin (PHA) and lipopolysaccharide (LPS) at 0.1-10 micrograms/ml, and antibody formation to sheep red blood cell (SRBC) in normal and immunosuppressed mice, and to dinitrophenyl (DNP)-Ficoll. In addition, MDP Lys(L18) potentiated polyclonal B cell activation both in vivo and in vitro. It was also found that MDP-Lys(L18) augmented the cellular immune responses, such as mixed lymphocyte reaction (MLR) and delayed type hypersensitivity (DTH). These effects of MDP-Lys(L18) were more potent than those of MDP. These findings may be attributed to the interleukin 1 (IL-1)-inducing activity of MDP-Lys(L18). PMID- 3318326 TI - [Tongue disorders. An updated review]. PMID- 3318324 TI - Effects of low molecular weight fibrin degradation products 6A and 6D on rabbit aorta strips. AB - Two small molecular weight fibrin degradation product, the pentapeptide 6A and the undecapeptide 6D, produced relaxations of norepinephrine-contracted rabbit aorta strips. The relaxations were slow-developing and were elicited by both peptides at supramicromolar concentrations; the amplitude of relaxations were small for 6D. The relaxations induced by 6A were not dependent on the presence of endothelium and were not modified by a mixture of indomethacin, pyrilamine, and cimetidine. The amplitude of the relaxations produced by 6A and 6D increased as a function of incubation time in vitro. In another experimental system, peptides 6A and 6D failed to increase 6-keto-PGF1 alpha release from cultured human umbilical endothelial cells. Histamine and bradykinin were both active in this system. PMID- 3318327 TI - [Dental pathology (1): Anomalies of development and evolution]. PMID- 3318328 TI - Present status and perspectives in the treatment of neurological disorders by dietary lecithin. PMID- 3318329 TI - Microscopic study on the distribution of metal salts of phosphatidic acids in yeasts and rats. PMID- 3318325 TI - Adenosine and adenosine receptors in immune function. Minireview and meeting report. PMID- 3318330 TI - Chemistry, preparation and analysis of phospholipids. PMID- 3318331 TI - Radiological diagnosis of developmental disorders of the nervous system and adjacent structures. AB - On the basis of the author's own experiences and drawing on data available in the literature, present possibilities of neuroradiological diagnosis of developmental disorders of the spine and skull, developmental anomalies of meninges of the brain and the spinal cord and of the central nervous system, the brain and the spinal cord are discussed. The rapid development of investigative methods in the past decades has brought about an immense amount of new information gained in the diagnosis of these anomalies and has facilitated their early detection and a more accurate evaluation. The morphological aspect is not, however, the only factor in the estimation of the clinical relevance of these disorders. For this reason not only the morphological, but also the functional relationship of developmental disorders of the nervous system to the adjacent structures is emphasized and, on the other hand, the influence of these anomalies on the nervous system is discussed. Many years' experiences in clinical neurology and problems of manual medicine indicate that these relations may be the cause of the various clinical symptoms. In this respect the presented findings mean a contribution to the treatment of the clinical complaints that are pathogenetically related to developmental disorders. PMID- 3318332 TI - [A case of spontaneous peripelvic extravasation associated with ureteral stenosis caused by retroperitoneal lymph node metastasis of ascending colon cancer]. AB - A case of spontaneous peripelvic extravasation associated with ureteral stenosis caused by retroperitoneal lymph node metastasis of the ascending colon cancer is reported. A 47-year-old woman complained of colic on right costa-vertebral angle. Excretory urograms showed right peripelvic extravasation and CT-scan showed urinoma formation around right kidney. Subsequent examination of right retrograde pyelo-ureterograms showed ureteral stenosis at sacro-iliac region. Operative findings revealed ureteral stenosis caused by retroperitoneal lymph node metastasis of ascending colon cancer, which was regarded as inoperable. There are a few reports of spontaneous peripelvic extravasation caused by a malignant tumor in Japanese literature. Twenty of them are reviewed. PMID- 3318333 TI - [Emphysematous pyelonephritis complicated by liver cirrhosis and diabetes mellitus: a case report and a review of the literature]. AB - A case of emphysematous pyelonephritis is presented and a review of literatures is made. A 67-years-old woman with diabetes mellitus, complained of severe left flank pain and high fever and was referred from the department of gastroenterology. A computed tomography film demonstrated gas in the left renal parenchyma and a diagnosis of emphysematous pyelonephritis was made. She was in a state of shock and died after 4 days of conservative treatment. Emphysematous pyelonephritis is a rare, life-threatening disorder and 85 cases in the world have been reported to date. Our case is the 18th one in Japan. Its etiology, symptomatology, treatment and prognosis are discussed. PMID- 3318334 TI - [Adenomatous polyps with prostatic type epithelium: a report of two cases]. AB - Two cases of adenomatous polyps with prostatic type epithelium are reported. The first case was of a 62-year-old male suffering from asymptomatic hematuria. Cystoscopic findings showed an urethral tumor in the prostatic urethra. He was treated by transurethral resection of the prostate. The second case was of a 47 year-old male with complaints of hematuria and doubtful findings in urinary cytology. Cystoscopic findings showed that he had an urethral tumor in the prostatic urethra as well as bladder tumor. Both were resected transurethrally. Histological examination revealed that both urethral tumors were papillary adenoma of the prostatic urethra, corresponding to the adenomatous polyps with prostatic type epithelium in the classification of AFIP. The peroxidase antiperoxidase complex method was performed using the anti-prostatic acid phosphatase antibody and anti-prostatic-specific antigen antibody, and positive reactions were obtained which confirmed that the tumors originated in the prostatic tissue. Benign urethral tumor in males is not common and description of adenomatous polyps with prostatic type epithelium is very rare. We could find only 11 cases in the Japanese literature. PMID- 3318335 TI - [Familial pheochromocytoma in a daughter (extra-adrenal) and her mother]. AB - The nineteenth kindred of familial pheochromocytoma in Japan is reported. A 13 year-old girl had an extra-adrenal pheochromocytoma and her 40-year-old mother had a right adrenal pheochromocytoma. This is the first case of an extra-adrenal pheochromocytoma in familial pheochromocytoma. A statistical analysis was performed on the 46 cases in 19 kindreds reported so far in Japan. PMID- 3318336 TI - [Usefulness of computed tomography and ultrasonography for the early detection of renal cell carcinoma]. AB - Eighty-three cases of renal cell carcinomas admitted to Nara Medical University and its related hospitals from August, 1962 through July, 1984 were reviewed. We have been using computed tomography (CT) and ultrasonography (US) for early detection of renal cell carcinomas since 1980. Thereafter the number of patients with low stage renal cell carcinoma was significantly increased. Furthermore 6 carcinomas were incidentally detected by CT and/or US examination for checkup of other diseases. We believe that CT and US may be valuable as a screening modality for early detection of renal cell carcinoma. PMID- 3318337 TI - MR angiography of peripheral, carotid, and coronary arteries. PMID- 3318338 TI - Survey of mammography practices. AB - Of the 319 radiologists who responded to a survey concerning mammography practices, 50% were employed in a private hospital and 26% in a private office. Film-screen mammography was used most often (54%) followed by xeromammography (30%) and a combination of film-screen and xeromammography (16%). Of the respondents, 62% had changed their method of performing mammography in the last 10 years. Of these, 50% had switched from xeromammography to film-screen, 23% from direct film to film-screen, 15% from direct film to xeromammography, and 6% from film-screen to xeromammography. Mammographic equipment had been purchased by 71% of respondents after 1983. Most respondents (71%) monitored mammography equipment doses, usually at 6- to 12-month intervals. Manual breast examinations were done at the time of mammography at 42% of the facilities, and breast self examination was taught at 32%. For screening, 87.4% used a two-view examination, 92% required the name of a referring physician to whom the report could be sent, 28% accepted self-referred patients, and only 12% charged a reduced fee for screening. Breast sonography was performed by 53% (93% hand-held vs 7% automated), but none used sonography for screening. Only one respondent reported using thermography; three used light scanning. A need for postgraduate mammography courses for radiologists was indicated by 81%, while 69% recommended technologist courses and 64% recommended 1-week fellowships for radiologists. PMID- 3318339 TI - Ferrite-enhanced MR imaging of hepatic lymphoma: an experimental study in rats. AB - The purpose of this investigation was to define the potential of unenhanced and ferrite-enhanced MR to detect hepatic lymphoma. Rats were implanted with diffuse and focal hepatic lymphoma. Both in vitro measurements of relaxation times and in vivo MR imaging of normal liver and of diffuse and focal hepatic lymphoma were compared. Diffuse infiltrative hepatic lymphoma showed increased T1 (45%) and T2 (41%) relaxation times in vitro, but could not be distinguished from normal control livers on in vivo spin echo (SE) images with a repetition time of 500 msec and an echo time of 30 msec (SE 500/30) or SE 1500/60 images. Focal hepatic lymphoma showed increased T1 (185%) and T2 (115%) relaxation times relative to normal liver tissue. Focal hepatic lymphoma was undetectable on unenhanced SE 500/30 MR images (contrast-to-noise ratio, C/N = 0.4) and was slightly hyperintense on SE 1500/60 images (C/N = 1.1). Ferrite (50 mumol Fe/kg) was administered to improve tissue contrast. In normal control animals, T2 of liver in vitro decreased from 29.3 +/- 3.3 msec to 11.1 +/- 1.2 msec, and image signal to-noise ratio (S/N) of liver in vivo decreased from 16.1 +/- 2.4 to 2.8 +/- 0.3 (p less than .005). Ferrite-enhanced diffuse hepatic lymphoma showed in vitro T2 values and in vivo MR image S/N values indistinguishable from those of normal control animals. The T2 of focal hepatic lymphoma was essentially unaltered by ferrite. On SE 500/30 images, focal hepatic lymphoma became readily detectable, quantitated by a 35-fold increase in tumor-liver C/N. We conclude that clinical studies are warranted to determine the value of ferrite enhanced MR as a technique for the enhanced detection of focal hepatic lymphoma. PMID- 3318340 TI - Focal intrahepatic extramedullary hematopoiesis mimicking neoplasm. PMID- 3318341 TI - Endovaginal sonographic evaluation of ectopic pregnancy: a prospective study. AB - To determine the value of endovaginal sonography for evaluating women with a suspected ectopic gestation, we prospectively studied a group of 84 pregnant women in whom conventional transabdominal sonograms failed to show a living embryo. Of 84 patients studied, 25 had an ectopic gestation, 32 had a normal intrauterine pregnancy, and 27 had an abnormal (nonviable) intrauterine pregnancy. Endovaginal sonography, compared with transabdominal sonography, provided additional information in 50 cases (60%) and less information in only three cases (4%). Of 25 ectopic gestations, endovaginal sonography provided new information in 15 cases (60%) including detection of an extrauterine gestational sac (10 cases), extrauterine embryo (two cases), or adnexal mass (three cases) not observed on transabdominal sonography. Of 32 normal intrauterine pregnancies, endovaginal sonography provided additional information in 26 cases (81%) including detection of a yolk sac (14 cases), living embryo (11 cases), or small gestational sac (one case) not seen on transabdominal sonography. Of 27 abnormal intrauterine pregnancies, endovaginal sonography showed additional information in nine cases (33%) including detection of embryonic demise (three cases), retained intrauterine products (four cases), or a yolk sac (two cases) not seen on transabdominal sonography. Patient acceptance of endovaginal sonography was excellent; 82% of the patients preferred this method to transabdominal sonography, 13% expressed no preference, and 5% preferred transabdominal sonography. We conclude that endovaginal sonography can provide significant additional information in the majority of women who are referred for sonography with a suspected ectopic gestation. We believe that this method should become a integral part of sonographic evaluation in women who are suspected of having an ectopic gestation when conventional transabdominal sonography fails to show a living embryo. PMID- 3318342 TI - Urinary obstruction in azotemic patients: detection by sonography. AB - Renal sonography is frequently requested in patients with an elevated or rising creatinine, often with the instruction to "rule out obstruction." A prospective study of patients undergoing renal sonography for newly discovered azotemia (creatinine greater than 1.8 mg/dl) or worsening renal failure was undertaken to evaluate the clinical utility of the sonographic examination. Patients with known obstructive uropathy, renal calculi, renal mass, or hematuria were excluded. In 189 patients, 17 (9%) had hydronephrosis: 11 unilateral (one with a solitary kidney) and six bilateral. Obstructive causes were subsequently established in the solitary kidney and in four patients with bilateral dilatation. These five patients (2.6%) with clinically significant hydronephrosis were shown subsequently to have a clinical history that strongly suggested the presence of urinary tract obstruction. Our data suggest that, in patients without a clinical history that suggests obstruction (such as calculi, bladder outlet obstruction, or pelvic mass), the likelihood of finding bilateral hydronephrosis by sonography is small. PMID- 3318343 TI - Mineral content of bone: measurement by energy subtraction digital chest radiography. AB - Several methods are presently available for measuring the mineral content of bone. Those in widespread use include dual-photon absorptiometry and quantitative CT. The feasibility of using dual-energy digital chest radiography for determination of the mineral content of posterior ribs on digital chest images was studied by using a prototype unit. The results showed a significant difference in the mineral density of the posterior ribs of control subjects and those of patients who had osteoporosis (251.1 +/- 36 mg Ca2+/cm2 of rib vs 158.8 +/- 48 mg Ca2+/cm2, p less than or equal to .01) and a close correlation with values obtained by dual-photon absorptiometry of the lumbar spine (r = .77). The results suggest that this technique can provide an accurate assessment of the presence or absence of osteoporosis. PMID- 3318344 TI - Evaluation of ECG gating for selective intraarterial carotid DSA. AB - A study comparing ECG-gated and nongated acquisition for selective carotid digital subtraction arteriography was performed on 116 bifurcations in 63 patients. For ECG acquisition, three exposures (systole, early diastole, and late diastole) were obtained for each cardiac cycle. There was no significant difference in the frequency of plaque misregistration between gated (18%) and nongated (23%) acquisitions. In gated studies, the frequency of plaque misregistration was equivalent in systole, early diastole, and late diastole. Gated and nongated studies provided equivalent image quality for selective carotid digital subtraction angiographic studies. PMID- 3318345 TI - Evaluation of ECG gating and hybrid subtraction for intraarterial digital subtraction thoracic aortography. AB - A comparative study was made of ECG-gated and nongated intraarterial digital subtraction angiography of the thoracic aorta by using conventional temporal subtraction and combined temporal/energy (hybrid) subtraction. ECG-gated studies were acquired at three frames per cardiac cycle. In 85% of patients, gated conventional subtraction resulted in studies of superior image quality in comparison with those obtained with hybrid techniques, both gated and nongated. In the 15% in whom hybrid subtraction studies were judged superior, the hybrid images were almost exclusively integrated by video frame averaging and thus were nongated. In a separate subset of patients who had conventional nongated studies, there was no difference in the percentage of diagnostic studies (93%) and nondiagnostic studies (7%) when compared with conventional gated temporal subtraction. Cardiac gating appears to be superior to hybrid subtraction for studies of the thoracic aorta that use intraarterial digital subtraction angiography, but neither technique offered any significant advantage over conventional nongated acquisition. PMID- 3318346 TI - Pancreatic Burkitt lymphoma in AIDS: sonographic appearance. PMID- 3318347 TI - The "discovery" of IgE. PMID- 3318348 TI - Bronchial asthma induced by mediators produced in vitro by sensitized lymphomonocytes. Protective effect of ketotifen. AB - A new procedure for the production in vitro of mediators of asthma is shortly described. This technique can be applied to the study of efficacy of anti asthmatic agents. A double-blind study, which included 23 asthma patients was performed. Half of the patients were treated with Ketotifen 2 mg/day for 7 days, the other half with placebo. The patients were challenged with the cell cultures supernatants before and after the treatment period. The results obtained demonstrate a clear-cut protection of the patients treated with the active substance whereas the placebo group fail to do so. PMID- 3318349 TI - Allergy: a leading role in otitis media with effusion. AB - We have studied 35 children with seasonal allergic rhinitis confirmed by positive skin tests and RAST to grass pollen. Intranasal antigen provocation was performed to evaluate the function of the eustachian tube (ET) and middle ear pressure (MEP). Tympanometry was used to evaluate the changes in MEP, while Valsava and Toynbee tympanometric tests were employed to study the ET function, and the changes in nasal airway resistance were measured by anterior rhinomanometry. ET dysfunction (ETD) and a decrease in MEP and nasal airway resistance were demonstrated in the children under study as compared with the controls. The results suggest a role for allergy in ETD and for the development of OME. PMID- 3318350 TI - Immunobiochemical evaluation of bronchoalveolar lavage (BAL) in atopic bronchial asthma, chronic bronchitis and bronchiectasis. AB - The protease-antiprotease balance and concentration of immunoglobulin was evaluated in some respiratory tract diseases. Analysis was carried out on 24 patients with atopic bronchial asthma, 21 with chronic bronchitis, 27 with bronchiectasis and 18 healthy smokers volunteers. In examination of BAL fluid some selective changes of proteolytic enzymes activities and concentrations of their natural inhibitors were documented. In atopic bronchial asthma the increased activity of acid protease, acid phosphatase and concentration of alpha 2-macroglobulin was the most characteristic. In chronic bronchitis there was an increase of acid protease, alkaline phosphatase and concentration of alpha-1 antitrypsin, haptoglobin, but in bronchiectasis the increase of neutral and acid proteases activities and concentration of all examined natural inhibitors was noted. The changes in concentration of IgA and IgG confirmed their participation in local defense response. All examined BAL enzyme activities and concentrations of inhibitors and immunoglobulins were compared with the results of the parameters in serum, mentioned above. The obtained finding supports the suggestion that the proteolytic enzymes, their natural inhibitors and immunoglobulins play an important role in the respiratory tract pathology. Immunobiochemical analysis of BAL in atopic bronchial asthma, chronic bronchitis and bronchiectasis may be useful for clinical prognosis and pharmacological treatment. PMID- 3318351 TI - Antibodies against spermatozoids. Studies in homosexuals, AIDS and infertile men. AB - The presence of antibodies against spermatozoids was evaluated in one person with AIDS and six homosexuals (HS). Indirect immunofluorescence was utilized along with immunoenzymatic trial with peroxidase (ELISA) in order to detect antibodies class IgG towards spermatozoids and their membrane proteins. Optic densities of the following groups of patients were compared: 1) One patient with AIDS. 2) Six homosexuals (HS). 3) Three HS with cells OKT8 greater than 30%. 4) Three HS with cells OKT8 less than 30%. 5) Three men with auto-antibodies against spermatozoids + infertility. 6) Two men without auto-antibodies against spermatozoids + infertility. 7) Five women, spouses of the infertile men. 8) Five multiparous with more than 3 pregnancies. 9) One man with orchitis. 10) Ten fertile and healthy (C.G.) heterosexual persons. The patient with AIDS and the one with orchitis had the highest optic densities (OD), (groups 1 and 9). Groups 8 and 10 had the lowest, non-significant values. Groups 2, 5 and 7 ranked second in place in reference to O.D. Groups 3, 4 and 6 ranked third in O.D. values. Groups 8 and 10 differed significantly at P less than 0.005 compared with the others. The presence of antibodies against spermatozoids was considered as an important factor associated with AIDS and previous states of the AIDS detected by OKT8 greater than 30% of lymphocytes. The IIF and ELISA were able to detect antigenic system in spermatozoids with allelic form, which may be similar to the mice locus t, or a new tissue specific system. PMID- 3318352 TI - The use of positive inotropic agents in chronic left ventricular failure: time for reflection. PMID- 3318353 TI - Sialolithiasis. AB - Sialolithiasis occurs most commonly in the submandibular gland. The vast majority of salivary stones are single, with only 3 percent occurring bilaterally. Patients with distal submandibular stones may be treated with simple sialolithotomy. Other causes of salivary gland enlargement include mumps, tumors, acute suppurative sialadenitis and granulomatous disease. PMID- 3318354 TI - Respiratory infections in smokers. AB - Cigarette smoking alters lung anatomy and physiology and impairs host immunity long before the appearance of overt chronic obstructive pulmonary disease. These changes promote more frequent and more severe lower respiratory tract infections. Optimal management of patients who continue to smoke includes accurate and early diagnosis of respiratory tract infections and selective use of appropriate antibiotics. Specific interventions can help patients stop smoking. PMID- 3318355 TI - Occupational illness in the arts. AB - Artists and craftspeople are exposed to the same hazardous materials as workers in industry. Art materials, including solvents, stones, clay, metals and dyes, are all potential health hazards. Patients whose symptoms cannot be easily categorized or who do not respond to initial treatment should be questioned about personal activities in the arts and crafts. A questionnaire devised by the Occupational and Environmental Health Committee of the American Lung Association may be useful. PMID- 3318356 TI - The child with febrile seizures. AB - Febrile seizures are common in children. They are associated with disease outside of the central nervous system and are usually generalized, brief and self limited. History and physical examination are usually sufficient to rule out central nervous system disease, and an extensive laboratory work-up is seldom indicated. Prophylaxis with antiseizure medications is only indicated in certain circumstances. The major risk in one febrile seizure is the increased likelihood of another. PMID- 3318357 TI - Rapid assay kits for common microbiologic agents. AB - Commercial rapid assay kits are available to assist in making diagnoses such as gonorrhea, rubella, and chlamydial and Group A streptococcal infections. Most assays contain either antigens to detect antibodies or antibodies to detect the antigens of the specific agents. Methods include latex agglutination, enzyme linked immunosorbent assay, solid-phase enzyme immunosorbent assay and immunofluorescence. Rapid assay kits are best used with an understanding of their principles, their sensitivity-specificity ranges, their limitations and assets, and their cost and shelf life. PMID- 3318358 TI - New approaches in the treatment of renal calculi. AB - Indications for intervention in patients with renal stone disease include persistent pain or bleeding, obstruction, infection and the presence of stones that are too large to pass spontaneously. Extracorporeal shock wave lithotripsy has revolutionized the surgical treatment of kidney stones. Contraindications include anticoagulation, bleeding diathesis, sepsis and renal malignancy. Stones in the renal pelvis and upper ureter are treated with shock wave lithotripsy; those in the lower ureter are best approached with the ureteroscope. PMID- 3318359 TI - Antithrombotic effects of exercise. AB - Regular exercise appears to have antithrombotic effects on the blood. Athlete's anemia, a dilutional pseudoanemia, enhances performance and decreases blood viscosity; it may also decrease platelet adhesion to damaged arteries. Physical conditioning may decrease platelet aggregability. Exercise activates fibrinolysis, and physical fitness seems to enhance the rate of fibrinolysis. The hematologic changes of exercise may help prevent coronary heart disease. PMID- 3318360 TI - Role of Doppler and imaging echocardiography in selection of patients for cardiac valvular surgery. PMID- 3318362 TI - A critical reappraisal of serial electrophysiologic drug testing for sustained ventricular tachycardia. PMID- 3318363 TI - Policy forum: an interview with Don M. Newman. PMID- 3318361 TI - Sex, plasma lipoproteins, and atherosclerosis: prevailing assumptions and outstanding questions. AB - We review the hypothesis that the incidence of coronary heart disease (CHD) is higher in men than in women due to differences in plasma lipoprotein risk factors between the sexes. Men and women appear to be equally susceptible to the effects of lipoprotein risk factors for CHD, and the difference between the sexes in lipoprotein risk factors for CHD appears to be consistent with their being, at least in part, responsible for the sex difference in CHD. This is apparent both when men and women of equal age are compared, and when age-related variations in the sex differences in plasma lipoproteins and CHD are considered. Differences between the sexes in lipoprotein concentrations are still present when sex differences in adiposity, cigarette smoking, physical activity, and diet are taken into account. Evidence relating these sex differences in CHD and lipoproteins to the effects of sex hormones is critically examined. It is commonly accepted that androgens induce changes in lipoprotein concentrations that would predispose towards CHD, whereas estrogens are held to have opposite effects. However, much of the evidence for this comes from studies of changes associated with administration of synthetic gonadal steroids or with changes in gonadal function. Studies of differences in lipoprotein metabolism in normal men and women are extremely limited. In males high-density lipoprotein (HDL) cholesterol levels fall at puberty, correlating with the rise in plasma testosterone concentrations. In females, HDL levels do not change at puberty, despite the rise in estrogen concentrations. Evidence for lipoprotein changes during the menopause, when estrogen levels decline, is equivocal. Similarly, the evidence for an increase in CHD incidence at the menopause is inconclusive. National mortality data indicate that the decreasing sex difference in CHD after 50 years of age is due to a declining rate of increase in men rather than to an acceleration in CHD incidence in women. In men the age-related increase in low density lipoprotein (LDL) concentrations diminishes beyond 50 years of age, whereas in women the rate of increase remains unchanged. Studies of the effects of gonadectomy are of doubtful relevance in assessing the roles of sex hormones in CHD, and have not been performed with sufficient rigor to provide definitive conclusions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3318364 TI - Performance of dust respirators with facial seal leaks: II. Predictive model. AB - A performance model for half-mask and single-use respirators is presented. It represents a possible alternative to field measurements of respirator performance. Experimental data on filter and leak performance given in Part I were used to develop a model that allows one to predict 1) the overall respirator penetration as a function of particle size for any work rate and 2) overall total mass penetration for any work rate and exposure aerosol-size distribution for a known respirator filter and facial seal leak condition. A simplified method based on general regression equations is presented that allows one to estimate these quantities based on QNFT (quantitative fit testing) measurements and a knowledge of the exposure aerosol-size distribution. Example calculations are given for a situation in which QNFT gives a fit factor of 50 for a half-mask with dust, fume and mist filter cartridges, but predicted protection factors for various use conditions range from 20 to 81 depending on exposure particle-size distribution and work rate of the wearer. PMID- 3318365 TI - Sensitivity and specificity of tests: can the "silent majority" speak? PMID- 3318367 TI - Brachiocephalic arterial stenosis associated with atypical aortic coarctation. PMID- 3318366 TI - Clinical and hemodynamic correlates of elevated plasma arginine vasopressin after acute myocardial infarction. PMID- 3318368 TI - Comparative efficacy and safety of oral mexiletine and quinidine in benign or potentially lethal ventricular arrhythmias. AB - The antiarrhythmic efficacy and safety of oral mexiletine hydrochloride and quinidine sulfate were compared at 29 clinical centers in a double-blind, parallel-group trial involving 491 patients with benign or potentially lethal ventricular arrhythmias. Responders were defined as those who had at least a 70% reduction in the frequency of ventricular premature complexes (VPCs) that persisted for 12 weeks, and who experienced no intolerable side effects that required discontinuation of therapy. Of the patients available for analysis, 71 of 232 (31%) in the mexiletine and 73 of 225 (32%) in the quinidine group met these criteria. The dose range used for mexiletine was 200 to 400 mg every 8 hours, and that for quinidine 200 to 400 mg every 6 hours. More than half of the patients in each group were successfully treated with the smallest dose (200 mg every 8 hours mexiletine vs 200 mg every 6 hours for quinidine). Quinidine significantly prolonged the QT interval, whereas mexiletine did not. Proarrhythmic reactions were recorded in 18 of 221 (9%) patients taking quinidine and 10 of 217 (5%) patients taking mexiletine. There was no difference in the incidence of adverse reactions between the 2 groups; in both, the most common side effects were related to the gastrointestinal and central nervous systems. Mexiletine thus represents an alternative to quinidine for the treatment of patients with ventricular arrhythmias. PMID- 3318369 TI - Optimal bandpass filters for time-domain analysis of the signal-averaged electrocardiogram. AB - The optimal bandpass filter for signal averaging of the surface QRS complex to detect late potentials is undefined. A study was conducted in 87 patients; 25 (mean age 34 +/- 10 years) were normal (group I), 29 (60 +/- 20 years) had organic heart disease without ventricular tachycardia (group II) and 33 (62 +/- 15 years) had sustained ventricular tachycardia (group III). In all patients signal-averaged electrocardiography (200 beats) was performed using a sharp, bidirectional filter and data analyzed using the following 7 high-pass filter settings: 10, 15, 20, 25, 40, 80 and 100 Hz. For each filter the duration of the signal-averaged QRS complex, the low-amplitude signals of less than 40 microV and the root-mean-square voltage of the terminal 40 ms (RMS-40) were determined. Normal values for each filter were determined from group I patients. In all 3 groups, quantitative signal-averaged variables were filter dependent. There was a progressive and marked decrease in RMS-40 and a progressive and marked increase in low-amplitude signal duration as the high-pass filtering was increased from 10 to 100 Hz. In contrast, high-pass, filter-dependent changes in signal-averaged QRS duration were less marked. The sensitivity and specificity for each filter using RMS-40 as the index of late potentials in separating group III patients from group II patients were: 10 Hz-64% and 52%; 15 Hz-57% and 72%; 20 Hz-57% and 76%; 25 Hz-42% and 90%; 40 Hz-61% and 83%; 80 Hz-88% and 69%; and 100 Hz-79% and 62%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318370 TI - Identification of normal neurohormonal activity in mild congestive heart failure and stimulating effect of upright posture and diuretics. AB - To characterize further the pathophysiology of the neurohormonal vasoconstrictor pathways in congestive heart failure (CHF), plasma renin activity, plasma norepinephrine, blood pressure, blood volume and renal hemodynamics were measured in 12 patients with mild to moderate CHF. In addition, the response to the gravitational stress of head-up tilt and the influence of 3 weeks of furosemide treatment as stimuli of neurohormonal activity were assessed. Supine plasma renin activity before diuretics was relatively normal at 1.94 +/- 1.6 ng/ml/hr and was significantly increased to 3.9 +/- 2.7 ng/ml/hr after diuretics. During tilt, there was a significant reflex increase in plasma renin activity both before and after diuretics. Plasma norepinephrine was also relatively normal before diuretics (325 +/- 211 pg/ml), did not increase after diuretics, but showed significant increases during tilt both before and after diuretics. Diuretic administration led to decreases in both systolic and diastolic blood pressures, but there was no change in body weight or total blood volume. In addition, diuretic administration did not result in any significant changes of renal blood flow (546 +/- 119 to 634 +/- 204 ml/min/1.73m2), glomerular filtration rate (81 +/- 22 to 90 +/- 27 ml/min/1.73m2) or filtration fraction (0.26 to 0.25). The present study demonstrates that the renin-angiotensin system and the sympathetic nervous system were not activated in the early symptomatic stages of CHF and that baroreceptor stimulation of these pathways during head-up tilt was relatively preserved. Renin secretion increased during diuretic administration, suggesting that the macula densa signal for renin release was also preserved in patients with relatively mild CHF. PMID- 3318371 TI - DPI 201-106 for severe congestive heart failure. AB - DPI 201-106 is a new oral inotropic agent that exerts its effects through a novel mechanism of action, namely, by enhancing sensitivity of myofilaments to calcium and prolonging inward sodium current. In a double-blind, randomized, placebo controlled fashion, single oral doses (80 and 100 mg) of DPI 201-106 were administered to 15 patients with severe congestive heart failure. Dose-dependent increases in cardiac index (25%, p = 0.016), left ventricular stroke work index (24%, p = 0.018), left ventricular stroke volume index (32%,p = 0.005) and QTc interval (7%, p = 0.009) were observed. Significant effects on heart rate and systemic arterial pressure were not observed. Positive correlations of QTc interval with DPI plasma level (r = 0.64, p = 0.0001), stroke work index (r = 0.47, p = 0.0001) and ventricular ectopic activity on ambulatory electrocardiography (r = 0.49, p = 0.0001) were observed. Maximum changes occurred approximately 3 to 4 hours after ingestion and lasted more than 8 hours. Plasma drug levels were consistent with a 2-compartment model exhibiting first order absorption and elimination kinetics. DPI 201-106 produced hemodynamic improvement in patients with severe congestive heart failure. PMID- 3318372 TI - Development and use of the stethoscope in diagnosing cardiac disease. PMID- 3318373 TI - Some good cardiologic books published in 1987. PMID- 3318374 TI - Changes in vascular endothelium and its function in systemic arterial hypertension. AB - The various functions of arterial endothelium may be altered during pulmonary and arterial hypertension. Changes in the endothelium (or function) associated with hypertension are described. In both acute and chronic hypertension, permeability of the endothelium is enhanced. During the acute phase of hypertension, hyperplasia (cell replication) of the endothelium occurs while cell hypertrophy (enlarged cell size) and an increase in homocellular tight junctions are associated with sustained elevations of blood pressure. Endothelium may contribute to the increase in smooth muscle mass or cell number reported with various models of hypertension. Increased endothelial uptake or metabolism of norepinephrine and serotonin occurs during hypertension. The biotransformation of adenine nucleotides and various peptides by the endothelium is not altered by hypertension. Synthesis of prostacyclin is enhanced in the spontaneously hypertensive and Goldblatt hypertensive rat. Metabolism of prostaglandin E2, prostaglandin F2 alpha and prostacyclin by prostaglandin 15-hydroxydehydrogenase is impaired in the genetic models. Responses to endothelium-dependent vasodilators are impaired in acute and chronic models of hypertension. Production of relaxing factor by the endothelium is not inhibited, but rather the vascular smooth muscle fails to respond. Acute, severe hypertension potentiates the response to serotonin, presumably by attenuating the release or response to relaxing factor(s). In the aorta of the spontaneously hypertensive rat, the endothelium releases a constricting factor in response to acetylcholine. Pulmonary arterial endothelium (and other vessels) releases a vasoconstrictor that is blocked by inhibitors of cyclooxygenase. It is not clear whether this pressor factor is thromboxane A2. Cultured endothelial cells release a polypeptide that contracts arteries; however, any relation to hypertension is not known. PMID- 3318375 TI - Sustained-release diltiazem compared with atenolol monotherapy for mild to moderate systemic hypertension. AB - The daily administration of 240 to 360 mg of diltiazem lowered blood pressure in a dose-related pattern similar to that seen in patients taking a daily dosage of 50 to 100 mg of atenolol. Sustained-release diltiazem was administered twice daily and atenolol once. Goal blood pressure was defined as less than 90 mm Hg or a reduction of greater than or equal to 10 mm Hg for patients with baseline pressures of 95 to 99 mm Hg in the supine position and was achieved in 60% of diltiazem-treated and 63% of atenolol-treated patients. The mean diltiazem dosage at the end of the study was 329 mg daily; for atenolol it was 80 mg daily. Adverse reactions considered possibly or probably drug related were reported by 26% of diltiazem patients and 38% of atenolol patients. Although both drugs were associated with a slower heart rate, atenolol patients showed a significantly greater negative chronotropic effect. Diltiazem, in a sustained-release form taken twice daily, is as effective as atenolol as a sole antihypertensive agent. It has a favorable side-effect profile and may be a useful alternative antihypertensive medication compared with existing beta-blocker therapy with atenolol. PMID- 3318376 TI - Efficacy, electrocardiographic and renal effects of intravenous diltiazem for essential hypertension. AB - The acute systemic blood pressure, electrocardiographic and renal function responses to an intravenous bolus infusion of diltiazem (0.2 to 0.5 mg/kg) were evaluated in 18 subjects with mild to moderate essential hypertension. Although a significant blood pressure response occurred within 5 minutes, blood pressure returned to pretreatment levels within 1 to 3 hours. After drug infusion, a variety of rhythm and conduction disturbances were noted; the most important were transient prolongation of the PR Interval (first-degree atrioventricular block), a single episode of second-degree atrioventricular block (Mobitz I) associated with T-wave inversion and a transient episode of junctional escape rhythm and atrioventricular dissociation. Intravenous diltiazem had no consistent effect on glomerular filtration rate or effective renal plasma flow. Natriuresis and kaliuresis were observed only at the highest infusion dose. It is concluded that an alternative dosing regimen will be required if intravenous diltiazem is to be used safely and effectively to control blood pressure in patients with hypertensive disease. PMID- 3318377 TI - High-dose carbonyl iron for iron deficiency anemia: a randomized double-blind trial. AB - To determine if high doses of oral iron could shorten the duration of therapy necessary to treat Fe deficiency anemia, high-dose Fe 600 mg three times per day (given as nontoxic carbonyl Fe) was compared with standard ferrous sulfate 60 mg Fe++ three times per day in a randomized, double-blind, 3-wk trial involving 36 female blood donors with mild Fe deficiency anemia. In animal studies, both forms of Fe have similar bioavailability when administered in equal amounts. High-dose carbonyl Fe was well tolerated with gastrointestinal side effects similar those observed with standard FeSO4 therapy. The 10-fold larger amount of Fe resulted in a mean 1.5-fold increase in estimated Fe absorption. Both regimens corrected anemia but neither replenished storage Fe. These results suggest that the principal advantage to the use of carbonyl Fe would derive from its safety rather than from the large doses that can be given. PMID- 3318378 TI - Dietary copper deficiency and autoimmunity in the NZB mouse. AB - NZB mice were exposed from birth to a diet either adequate or deficient in copper. By age 6 wk the mice exposed to the copper-deficient diet showed symptoms characteristic of copper deficiency (anemia, hypoceruloplasminemia, and achromatrichia). The splenic lymphocytes from the copper-deficient group had reduced numbers of cells expressing the following surface markers: Ly-5, Ly-1, B 220, and sIg. Less than 10% of the splenic lymphocytes in this group were cycling, as determined by flow cytometry analysis. The spontaneous 96-h anti-ss DNA levels in the copper-deficient group were lower than those in the control group. The exogenous colony-forming units (CFUs) were significantly enhanced in the copper-deficient mice. The decreased splenic lymphoid populations, decreased anti-ss-DNA titers, and increased exogenous CFUs in the copper-deficient mice appear to be due to an increase in erythropoiesis at the expense of lymphopoiesis. PMID- 3318379 TI - Intensive insulin therapy justifies simplification of the diabetes diet. PMID- 3318380 TI - A study on Asian Indian and American vegetarians: indications of a racial predisposition to glucose intolerance. AB - Sixty-two Asian Indian and American vegetarians participated in a 3-h glucose tolerance test after an overnight fast to study clinical indices of glucose homeostasis. The Asian Indians had a higher (p less than 0.0035) insulinogenic score than the Americans. The Asian Indians had significantly higher insulin levels than the Americans at every sampling time during the glucose tolerance test except for the 3-h sample. The Indian men had significantly higher (p less than 0.05) plasma glucose than the other three groups at 2 h after the glucose load. American subjects had higher (p less than 0.0008) insulin binding to erythrocytes than the Asian Indian subjects. Scatchard analysis and competition inhibition plots of the insulin-receptor data indicated that decreased binding in the Indian group results from a lowered number and decreased affinity of erythrocyte receptors. These results suggest that Asian Indians exhibit several clinical indications associated with an increased risk for the development of insulin-independent diabetes. PMID- 3318381 TI - Secretion and removal of insulin by diet. AB - The effect of a carbohydrate (C) and a carbohydrate-fat (CF) meal on peripheral plasma insulin and C-peptide levels was studied in seven healthy female volunteers. Lower but prolonged elevation of both hormones was observed after the CF meal. The C-peptide:insulin molar ratio was decreased profoundly at 30 and 60 min after each meal. After the C meal it returned to normal within 120 min but then was increased above the basal value at 180 min. After the CF meal the reduction in the C-peptide:insulin molar ratio persisted until 180 min after food intake and then the ratio increased above the level at 240 min. It is concluded that both meals increase the peripheral insulin level in two ways: increasing secretion and decreasing removal of the hormone. At the end of digestion, the latter effect is reversed and increased insulin removal seems to occur. PMID- 3318382 TI - Comparative physiology on "the lung controls the skin and hair". AB - "The lung is connected with skin and hair" is a theory of traditional Chinese medicine. From the view of comparative physiology we researched the inter relation of lung and skin and hair and found it in water. From living protein to fish respiration is by the structure corresponding to the skin and the organ which originated skin. Though amphibia have lung respiratory effect of skin still locate 2/3. Aves. Mammals and human beings use lungs to respire. In fact air exchanges from nature through the thin water molecular layer of the surface of the pulmonary alveoli. So the lung is derived from "skin and hair" to adapt to inter-respiration. PMID- 3318383 TI - Symbols designed by European alchemists incorporating elements of Chinese origin. AB - Alchemy arose in China as cult of longevity generating life-force by imitating creation. Heaven and Earth, as opposites, were conceived as responsible for creation. They were believed to be round and square-shaped when their emblems became Compass and Carpenter's square. These have been retained in the symbols designed by alchemists of the Medieval Age without, however, revealing their origin or significance. PMID- 3318384 TI - Acid-ethanol extractable compounds from fruits and seeds of the bitter gourd Momordica charantia: effects on lipid metabolism in isolated rat adipocytes. AB - Fruits and seeds of the bitter gourd Momordica charantia (Family Cucurbitaceae) were extracted with acidic ethanol. The extract was adjusted to pH 3 and proteins and peptides were precipitated by addition of a copious volume of acetone. The precipitate was dissolved, dialyzed and lyophilized. The resulting material, designated "p-fraction" was tested for antilipolytic and lipogenic activities. Seed "p-fraction" was further chromatographed on fetuin agarose to yield an unadsorbed fraction (F) which could be fractionated by gel filtration on Sephadex G-10 to give an unretarded fraction (F1) and a retarded fraction (F2). Fruit "p fraction" exhibited antilipolytic activity in hamster adipocytes and stimulated 3H-glucose incorporation into lipids. F1, a saponin containing fraction, inhibited both lipolysis and 3H-glucose incorporation into lipids. F2 enhanced 3H glucose incorporation into lipid. The results are indicative of the presence of compounds with insulinomimetic activities in M. charantia fruits and seeds. PMID- 3318385 TI - Tibetan medicine. Part I: Introduction to Tibetan medicine and the rGyud-bzi (Fourth Tantra). AB - Tibetan medicine is one example of a traditional cultural health care system. Until recently, geographic barriers have permitted this medical tradition to evolve in an uninterrupted way. The history, concepts, and foundations of Tibetan medicine are closely interwoven with those of Buddhism in Tibet The following essay is an introductory overview of Tibetan medicine. The purpose of this essay is to provide a conceptual framework and a proper perspective for understanding a highly edited translation of one chapter from a traditional Tibetan medical text. PMID- 3318386 TI - In situ hybridization and immunocytochemistry for improved assessment of human immunodeficiency virus cultures. AB - The authors characterized the early intracellular events involved in human immunodeficiency virus (HIV) replication after in vitro inoculation into cultures of susceptible human T-cell lines and phytohemagglutinin-stimulated peripheral blood mononuclear cells (PMCs). Within 24 hours of infection, in situ hybridization with HIV DNA probe detected cytoplasmic viral RNA. Viral core antigen was detected in infected cells over the subsequent two to ten days by means of an immunocytochemical assay employing monoclonal antibodies. Several days later, cell-free virus was detected by both reverse transcriptase assay and a p25gag antigen-capture assay. When these methods were applied to monitor cultures of ten sero-positive persons' PMCs, a similar progression of virus replication was apparent: cytoplasmic viral RNA was detected in infected PMCs by day 3, with the subsequent appearance of intracellular viral proteins (days 6-9) and cell-free virus (days 12-21). In situ hybridization and immunocytochemistry offer complementary, sensitive, and specific approaches for monitoring the early stages of acquired immune deficiency syndrome virus replication in vitro. PMID- 3318388 TI - The use of the Prompt Inoculation System in preparing a standardized yeast inoculum. AB - One of the most important steps in performing broth dilution susceptibility testing of yeast isolates is the preparation of the starting inoculum. Although not specifically developed for yeast inoculum preparation, the Prompt Inoculation System (3M) provides a novel alternative approach that may provide a more standardized yeast inoculum than previously employed methods. The authors examined the relationship between the number of colonies picked with the Prompt Inoculation Wand and the hemacytometer and viable colony counts for each of six test organisms, including Candida albicans, Candida tropicalis, Candida krusei, Candida parapsilosis, Candida glabrata, and Cryptococcus neoformans. They found that by picking five colonies 1-2 mm in diameter, inoculum densities of 1 to 5 X 10(6) CFU/mL were obtained with most of the test organisms. A considerably higher inoculum density was observed with C. glabrata (1 to 2 X 10(7) CFU/mL) because of the small size of this organism. No overfilling of the Inoculation Wand was observed when more colonies were touched. This study indicates that the Prompt Inoculation System offers a convenient and simple method for yeast inoculum preparation. PMID- 3318387 TI - Increased sensitivity of detection of the blocking (type I) anti-intrinsic factor antibody. AB - Increasing the ratio of test serum to the intrinsic factor (IF) antigen should increase the sensitivity of anti-IF antibody assay, a useful, specific tool for diagnosing pernicious anemia. We therefore designed an assay in which this ratio was increased 25-fold over that of our current standard assay and 1,000-fold over that of most described methods. This assay was then compared with our standard assay, with one of the original assays, and with a commercial kit. Both of our assays, especially the newer sensitive method, detected antibody in much greater dilutions of positive serum than the other assays. The sensitive assay also detected antibody in 17% of pernicious anemia sera negative by our standard technique. We calculated that anti-IF antibody can be detected with the sensitive assay in 78% of our patients with pernicious anemia, compared with 73% by our standard assay, 65% by the commercial kit, and 61% by the original method of Gottlieb and colleagues. No antibody was detected in 35 control sera with the new assay, which suggests that the increased sensitivity did not come at the expense of diminished specificity. The increased sensitivity enhances the value of the anti-IF antibody as a major screening and diagnostic tool in pernicious anemia. PMID- 3318389 TI - In memoriam. Clarence I. Owen, M.D. (1896-1986). PMID- 3318390 TI - In memoriam. Harry Frank Weisberg, M.D. (1915-1986). PMID- 3318391 TI - Swampscott Anniversary Symposium: reflections and recommendations on the 20th anniversary of Swampscott. PMID- 3318392 TI - A social historical note on the formal emergence of community psychology. AB - Recent interviews of 15 eminent community psychologists, 6 of whom attended the founding conference at Swampscott, highlighted some historically significant aspects of community psychology's emergence and provided background information concerning the conference's processes and content. The interview informants described the idealism of the era in the context of societal unrest, the struggle with psychiatrists' control of extant mental health services, and the uncertain role of a community orientation within academic psychology as key social historical factors. The informants identified some of the behind-the-scenes preparations for Swampscott as well as the conference climate and emergent ideology. The report concludes with a note on the historical status of women in the subdiscipline. PMID- 3318393 TI - Expanding community psychology's domain. AB - Community psychology's twin goals of prevention and empowerment are ill-served when researchers and practitioners restrict their activities to traditional mental health settings. This paper echoes the call of the Swampscott conference for expanding community psychology's domain of inquiry and action. It reviews examples from the research literature of efforts at prevention and empowerment in five classes of behavior settings identified by Barker (1968), namely, schools, work sites, religious settings, voluntary associations, and government, and suggests additional roles community psychologists might play. PMID- 3318394 TI - The peculiar successes of community psychology: service delivery to ethnic minorities and the poor. AB - The 20-year history of community psychology is considered with respect to activities on behalf of ethnic minority participation in psychotherapy, increasing cultural diversity, and to a considerably lesser extent, enhancing community systems. A discrepancy was found between community psychology in principle and community psychology in practice. For the future, community psychologists are advised to identify and seek to strengthen (a) indigenous resources for solving personal and community problems; and (b) pathways of help seeking followed by community members. Community psychology is encouraged to reclaim and enact more vigorously its own legacy. To do otherwise, it is argued, forfeits development of potentially significant research and practice and risks continued ambivalence and dissatisfaction despite worthwhile contribution- suffering the peculiar successes of community psychology. PMID- 3318395 TI - Magnetic versus mechanical expansion with different force thresholds and points of force application. AB - The effects of force magnitude (high versus low) and point of force application (teeth versus direct palatal endosseous pins) on palatal expansion treatment were studied on four juvenile female Macaca fascicularis monkeys. Three subjects received one of the following appliances: (1) conventional type jackscrew maxillary plate bonded to the posterior teeth with a high force magnitude of 2033 g, (2) a similar tooth-borne appliance but with rare earth repulsive magnets having a low force of 258 g, or (3) a specially designed palatal acrylic appliance pinned directly to the palatal shelves also utilizing rare earth repulsive magnets with a low force of 258 g. A fourth animal, the control, received a passive sham appliance bonded to the abutment teeth. Spatial changes of dental markers and facial implants were studied radiographically. In the low force, magnetically induced appliances, treatment was longer (95 days for the palatally pinned appliance and 135 days for the bonded tooth-borne appliance). The force radiated superolaterally, dissipating in the zygomaticofrontal suture, and the overjet significantly increased because of the marked widening of the incisive and transverse sutures. With the conventional jackscrew high-force appliance bonded to the teeth, the treatment lasted 33 days. A diastema developed between the incisors and the force was transmitted superolaterally and then transmedially, thus causing fractures in the nasal complex and other iatrogenic sequelae. The palatally pinned magnetic appliance induced bodily tooth movement, the greatest increase in intermolar distance, and a superior repositioning of the maxillopalatine region. The latter two effects were caused by selective excitation of the transverse suture over the premaxillary suture. Symmetry decreased with remoteness from the point of application. These results suggest reduction of the conventional force by up to eightfold--a level supplied by the rare earth magnets. Extrapolating from these results, the slow palatal expansion regimen for the treatment of Class III malocclusions with maxillary transverse deficiency is preferred at an early age (not more than 6 years). In the event of a suture disorder, the use of direct forces to the palate might be considered. PMID- 3318396 TI - Evaluation of a phenylalanine-free product for treatment of phenylketonuria. AB - Ten children with classic phenylketonuria (PKU) participated in a controlled study of a phenylalanine-free formula recently released in the United States (PKU 2). Control data were obtained in the clinic while the children were receiving their baseline formula. The children were given the study formula and returned to the clinic for follow-up after they had been receiving the new formula for 4, 8, and 12 months. Serum phenylalanine and tyrosine concentrations, other hematologic measurements, urine analysis, growth, electroencephalogram, and physical findings remained similar to baseline values throughout the study. Nutrient intakes were comparable with the exception of a decrease in several micronutrients relative to baseline levels. We found that PKU-2 is appropriate for children with PKU who are over 3 years of age and may prove beneficial for the overweight child with PKU. PMID- 3318397 TI - PCP abuse in New Orleans: a six-year study. AB - Methods for determination of PCP in body fluids are presented and a rapid screening method is suggested. The demographics, psychiatric profiles, forensic aspects, and diagnostic problems of PCP abuse are discussed. PMID- 3318398 TI - Propranolol for the treatment of the alcoholic hangover. AB - Hangover following consumption of alcohol includes many disagreeable signs and symptoms that are suggestive of sympathetic overactivity. We performed a randomized, double-blind, crossover controlled study to assess the effect of beta blockade in preventing the symptoms of hangover. Ten subjects were randomized to receive 160 mg of a long-acting preparation of propranolol or a placebo and then participated in a controlled drinking situation. Patients were then evaluated for symptoms and signs of hangover. The results showed that although beta blockade was achieved, there was no clinically important reduction in symptoms of hangover. We conclude that propranolol does not prevent the symptoms of hangover. PMID- 3318399 TI - Sex differences in addict careers. 1. Initiation of use. AB - Five-hundred-sixty-seven heroin addicts admitted to methadone maintenance treatment programs in southern California were included in the present analysis. Systematic comparisons were made between women and men for Anglo and Chicano subpopulations. The behaviors compared focused on initial drug use and other antecedent behaviors during the year prior to initiation of heroin use including interpersonal relationships, other substance use, drug dealing, legal income, and various criminal behaviors. Unlike men, the initial use of heroin by women was highly influenced by a man, especially by a sex partner who is often a daily heroin user. On the other hand, many women (like men) reported self-initiation of heroin use, multiple drug use, and drug dealing, thus demonstrating that they took an active role in their drug involvement. Other differences between men and women for antecedent behaviors prior to narcotics use appear to be related to traditional expectations about gender roles in American society. PMID- 3318400 TI - Chronobiological susceptibility to alcoholism: a hypothesis. AB - The search for carriers of a specific biologic risk for alcoholism is ongoing. In addition to seeking "the needle in the haystack," the need to monitor a broader phenotypic indicator such as chronobiological interaction is hypothesized. Certain potential mediators of genetic predisposition to alcoholism are subject to periodic rhythmicity in both animal and human investigations. These mediators include prolactin, cortisol, and MOPEG levels along with possible sleep characteristics. Suggestions for future animal and human investigations are outlined using adequate sampling criteria, appropriate rating and recording instruments, and controls predisposed to other psychiatric diagnoses. PMID- 3318401 TI - Role of antacids in the management of disorders of the upper gastrointestinal tract. Review of clinical experience 1975-1985. AB - Unlike the clinical trials of the previous decade, those conducted during the past 10 yr have had considerable impact on current therapeutic practices in the management of disorders of the upper gastrointestinal tract. This article reviews the clinical experience from 1975 to 1985 that pertains to the effectiveness of antacids compared to placebo and other anti-ulcer medications in the prevention and treatment of duodenal and gastric ulcers, stress ulceration and acute gastrointestinal bleeding, and gastroesophageal reflux disease. PMID- 3318403 TI - Comparison of two lymphokines (macrophage migration inhibition, leukocyte adherence inhibition factors) and carcinoembryonic antigen, in colorectal cancer and colonic premalignant lesions. AB - Previous studies in our laboratory on 92 patients with colonic cancer have suggested a promising degree of specificity and sensitivity for a macrophage migration inhibition factor (MIF) test using patient's lymphocytes incubated with a human colon cancer extract. This study compares the results of the MIF technique with serum carcinoembryonic antigen (CEA) levels and with the lymphocyte adherence inhibition (LAI) test in 18 colon cancer patients and 27 patients with conditions considered to predispose to colon cancer (colonic adenomas, ulcerative colitis, and Crohn's disease). Among colonic cancer patients, MIF and LAI were positive in 17 out of 18, but CEA was elevated in eight. MIF and CEA were negative in all 16 normal control subjects; LAI was negative in 13. Among patients with colonic adenomas, MIF and LAI were positive in three of five; CEA was negative in all. In the ulcerative colitis and Crohn's disease group, MIF was positive in seven of 22, LAI was positive in 11, and CEA was negative in all 22. Thus, MIF and LAI appear to be sensitive marker's for human colonic cancer. More extensive studies and precise characterization of these groups are warranted. PMID- 3318402 TI - The effect of 15(R)-15-methyl prostaglandin E2 (Arbacet) on the healing of aspirin or nonsteroidal antiinflammatory drug-induced gastric mucosal lesions: an endoscopic study. AB - Twenty-nine outpatients chronically ingesting daily aspirin or nonsteroidal antiinflammatory drugs for rheumatological disease, who had endoscopically proven gastric mucosal lesions worse than erythema, were evaluated for 4 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. Patients continued their usual daily dose of antiarthritic medication throughout the study period, and an endoscopy was performed on the final day to assess healing. Five of 14 patients (36%) taking Arbacet and two of 15 patients (13%) in the placebo group had complete healing of their gastric lesions after 4 wk. Arbacet at a daily dose of 40 micrograms is not significantly better than placebo in healing gastric lesions caused by aspirin or nonsteroidal antiinflammatory drugs, if antiinflammatory therapy is continued. PMID- 3318404 TI - Solitary cystic dilation of the intrahepatic bile duct: morphology of two autopsy cases and a review of the literature. AB - Solitary cystic dilation of intrahepatic bile ducts with neither extrahepatic biliary anomalies nor renal lesions has been reported previously in only 11 cases. We report two cases which were found as a result of postmortem cholangiography of 149 livers at autopsy. Case 1 had a cystic dilation measuring 1.2 cm in diameter in the left lateral superior area duct. Case 2 showed a cystic dilation measuring 1.0 cm in diameter in the left lateral segment duct. Histologically, the walls of the dilated ducts consisted of fibrous wall with proliferation of periductal mucous glands in both cases. The dilated and adjacent bile ducts in case 2 also contained tiny brown pigment stones and biliary sludge, suggesting that this bile duct lesion is important in the formation of intrahepatic calculi by providing a site for bile stasis and mucous hypersecretion. PMID- 3318405 TI - Biliary cystadenocarcinoma of extrahepatic duct origin arising in previously benign cystadenoma. AB - A case of biliary cystadenocarcinoma arising from the common hepatic duct in a 47 yr-old woman who had two previous attempts at cure by local excision of a then benign biliary cystadenoma is reported, adding further evidence that resection is the preferred treatment of these tumors, even when histologically benign. A review of the literature and of pertinent clinical and pathological features of the 32 previously reported cases is included. PMID- 3318406 TI - Phlegmonous duodenitis complicating multiple myeloma: a successfully treated case. AB - A patient receiving chemotherapy for multiple myeloma suddenly developed an acute abdomen, fever, and neutrophil leukocytosis. At laparotomy, the distal two-thirds of the duodenum was swollen and hemorrhagic and was surgically excised. The specimen displayed an acute phlegmonous (suppurative) duodenitis with submucosal and transmural acute inflammation and edema despite an intact mucosa. Blood cultures grew Group B, beta-hemolytic streptococci and gram-positive cocci were present histologically. The patient recovered uneventfully following the surgery and a course of broad spectrum antibiotic therapy. This case illustrates that localized suppurative intestinal infection should be considered when immunosuppressed patients present with an acute abdomen, and that aggressive surgical and antibiotic therapy is warranted. PMID- 3318407 TI - Crohn's disease of the vulva. AB - Vulvar involvement is an uncommon extraintestinal manifestation of Crohn's disease. A case of "metastatic" vulvar Crohn's disease occurring in a 23-yr-old woman, status post-ileocolectomy, is described. The diagnosis was established by vulvar punch biopsy, and a therapeutic response was achieved with metronidazole and prednisone. The literature on vulvar involvement with Crohn's disease is reviewed and therapeutic options are discussed. PMID- 3318408 TI - Methodologic issues in the use of biologic markers in epidemiologic research. PMID- 3318409 TI - Cytogenetic and environmental factors in the etiology of the acute leukemias in adults. PMID- 3318410 TI - Shigellosis at a Caribbean resort. Hamburger and North American origin as risk factors. AB - During a three-week period in 1984, 339 tourists and expatriate employees with diarrhea visited the infirmary at a Caribbean resort club. Epidemiologic studies suggested that over 60% of the 1,893 tourists at the resort club during that time may have been ill. Shigella flexneri 4a was isolated from seven of 18 stool specimens. A few cases of diarrheal illness occurred at the resort club before the onset of the outbreak, which was temporally related to illness in a butcher. North American residence, eating raw or very rare hamburger, having a roommate who was ill and younger age were significantly associated with acquiring disease. Control measures, principally elimination of ill food handlers from the kitchens, were followed by a prompt and marked reduction in new cases. Isolated resorts pose problems in disease control similar to those on cruise ships, with hundreds of foods available, large numbers of short-stay visitors with few outside exposures, and many food handlers in whom pathogens can persist between groups of visitors. Resort clubs can reduce the risk of traveler's diarrhea, without using mass prophylaxis against pathogenic bacteria, by appropriate handling and preparation of food and by surveillance for diarrheal illnesses. PMID- 3318411 TI - Regulation of adult and embryonic genes in human leukemia cells. AB - In this article, we have reviewed studies showing that altered expression of regulatory genes results in activation of embryonic genes in human leukemia cells. These data have led to important new insights as to how mutations in regulatory genes can lead to disease states in man. PMID- 3318412 TI - Prevention of peritoneal dialysis catheter-related infections. AB - There is a significant correlation between patient morbidity and peritoneal dialysis-associated catheter-related infections. Infection occurs when barriers to microorganism invasion are disrupted. To establish and maintain strong barriers against this invasion, care must be taken with placement of the catheter and with short- and long-term maintenance. There must be particular emphasis on planning placement of the catheter. Exit-site selection, type and configuration of the catheter, whether the catheter will contain one or two cuffs, and whether placement will be midline or lateral are all important factors to be considered. Tips are offered to enhance barrier establishment as the catheter is placed, as is a discussion of postplacement exit-site and wound care, and exit-site care after healing has occurred. Finally, the importance of recognizing catheter related infections is emphasized and four types of infection are defined. Given the anecdotal nature of much of the material presented and the lack of well defined clinical research on the subject, carefully designed randomized prospective studies are needed to determine the best method for both catheter placement and maintenance. PMID- 3318413 TI - The familial occurrence of focal segmental glomerular sclerosis. AB - We have observed the occurrence of focal segmental glomerulosclerosis in all three siblings of a single Hispanic family. Each of the children had the onset of significant proteinuria on or before the age of 10. The two oldest children have had progression of their disease to end-stage with subsequent successful transplantation. The youngest sibling continues to have normal renal function. All three patients had renal biopsies prior to the onset of renal insufficiency and each of the biopsies showed the presence of focal segmental glomerulosclerosis with mild diffuse mesangial hypercellularity. Finally, HLA typing revealed the presence of DRw8 in all three siblings and the father. This report further suggests that genetic factors may be quite important in the development of the lesion of focal segmental glomerulosclerosis. PMID- 3318414 TI - Health experience of workers in the petroleum manufacturing and distribution industry: a review of the literature. AB - A review of 120 papers on the health effects on workers in the petroleum manufacturing and distribution industry revealed inconsistent results. This may be due in part to the variable quality of the epidemiological studies. There is, however, the consistent finding of a deficit for "all causes mortality" and for "all cancers mortality," thus implying that a widespread serious health effect of gasoline exposure seems remote. For specific health effects, the possibility exists that occupational etiological factors may play a part in the pathogenesis of brain cancer and renal disease. The evidence for a link between occupational and other health effects is weak. Further work of better quality is necessary to investigate those diseases in which there remains a suspicion of an occupational etiology. PMID- 3318415 TI - 4,4'-Methylenebis (2-chloroaniline): an unregulated carcinogen. AB - 4,4'-Methylenebis (2-chloroaniline) (MBOCA) is a confirmed animal carcinogen. It is used commercially as a curing agent for polymers containing isocyanate. There are no adequate studies documenting a carcinogenic risk for MBOCA in humans; however, studies in rats and dogs have shown that MBOCA is a carcinogen. Also, MBOCA is structurally similar to aromatic amines, which cause bladder cancer in workers with occupational exposure. Manufacture of MBOCA in the United States ceased in 1979. However, estimates of the number of workers potentially exposed range from 1,400 to 33,000 in the manufacture of MBOCA-cured products. Presently, there are no federal regulations limiting occupational exposure to MBOCA. An occupational standard for MBOCA proposed by the Occupational Safety and Health Administration was remanded by the Third Circuit Court of Appeals on procedural grounds in 1974. NIOSH recommended in 1978 that MBOCA be treated as a potential human carcinogen and that worker exposure be controlled so that it does not exceed 3 micrograms/m3 of air determined as a time-weighted average concentration for up to a 10-hour workshift (the lowest level that can be reliably measured). In this paper, we will review the literature in regard to MBOCA's carcinogenicity, describe industrial use and extent of worker exposure, and review MBOCA's status in relation to occupational regulations in the United States and abroad. PMID- 3318416 TI - Features of i.v. devices and equipment that affect i.v. drug delivery. PMID- 3318417 TI - Considering product features and costs in selecting a system for intermittent i.v. drug delivery. PMID- 3318418 TI - Effect of i.v. drug delivery systems on pharmacokinetic monitoring. PMID- 3318419 TI - Problems in administration techniques and dose measurement that influence accuracy of i.v. drug delivery. PMID- 3318421 TI - Review of the experience with nabumetone in clinical trials outside of the United States. AB - Nabumetone, a new nonsteroidal anti-inflammatory agent, has undergone extensive clinical evaluation in a number of countries. There have been over 4,000 patients treated, including nearly 1,000 elderly patients and over 1,100 patients who have received nabumetone for more than one year. A total of 2,400 of these patients with a variety of rheumatic disorders have been investigated in studies outside of the United States. Studies in rheumatoid arthritis and osteoarthritis have demonstrated that nabumetone is effective in the treatment of these conditions and that this effectiveness is maintained in many patients in the long term. Nabumetone appears to be well tolerated and there is no evidence from patients receiving treatment for 12 months or more of any clinically significant adverse effects on hematologic or biochemical parameters. Thus, these studies support the use of nabumetone in the treatment of rheumatoid arthritis and osteoarthritis. PMID- 3318420 TI - Nabumetone in the treatment of skin and soft tissue injury. AB - Nabumetone, a new nonsteroidal anti-inflammatory agent, has been evaluated for the treatment of skin and soft tissue injury, including sports injury, in clinical trials involving nearly 1,000 patients. Its efficacy, safety, and tolerance in these patients is reviewed. The efficacy of nabumetone in the treatment of soft tissue injury has been demonstrated to be similar to that of soluble aspirin, ibuprofen, and naproxen. It was not possible in these studies to demonstrate a definite advantage over placebo, and the reasons for this are discussed along with some suggestions for future studies. There were no serious adverse experiences reported, and nabumetone was well tolerated and compared favorably with the other agents used, including placebo. It caused significantly fewer gastrointestinal side effects than soluble aspirin. Nabumetone is an appropriate choice of nonsteroidal anti-inflammatory drug for the treatment of sports injury. PMID- 3318422 TI - Safety evaluation of nabumetone in United States clinical trials. AB - A total of 1,924 persons (rheumatoid arthritis, 835; osteoarthritis, 1,073; volunteers, 16) received nabumetone in United States clinical trials. Nine hundred eighty-eight patients have received nabumetone treatment for periods of more than one year, and 375 patients have received treatment for longer than two years. Four hundred eighty patients over 65 years of age have received treatment with nabumetone, and 224 of these elderly patients have received treatment for periods of more than one year. The nabumetone dose most commonly used in all double-blind trials was 1,000 mg at night. In long-term, open-label studies, which were usually extensions of the double-blind trials, patients could increase the dose to 2,000 mg per day. Nine hundred nineteen patients received doses of more than 1,000 mg per day. Adverse experience information was collected at each visit, including information for some patients receiving treatment for more than three years. Laboratory data were collected periodically throughout the trials, and the data were assessed for trends over time. The adverse experience pattern observed for nabumetone is similar to that described for clinical trial data for other nonsteroidal anti-inflammatory drugs. However, it is noteworthy that the pattern observed for nabumetone is from clinical trials with approximately 1,000 patients receiving treatment for periods of one year or more. This long-term patient exposure in clinical trials far exceeds long-term clinical trial data for other agents. The types and frequencies of adverse experiences reported by persons treated with nabumetone are relatively constant over the long time period covered by these trials. Also, the adverse experience patterns remained generally constant over time for various populations: all patients, patients 65 or older, female patients, male patients, and patients who received an increased dose of nabumetone. Although some statistically significant trends were detected for some laboratory parameters, there was little indication of significant clinical patterns. Although there were patients with individually important laboratory values, nabumetone was not associated with clinically important adverse laboratory patterns. Overall, the adverse experience data and laboratory data indicate that nabumetone is safe for the treatment of adult patients with rheumatoid arthritis or osteoarthritis. PMID- 3318423 TI - Endoscopic studies of nabumetone in patients with rheumatoid arthritis. A comparative endoscopic and histologic evaluation. AB - Gastric tolerance to 1 g of nabumetone administered in a single nightly dose was assessed in two trials in patients with rheumatoid arthritis. Gastroscopy and histology of mucosal biopsy specimens were performed before and after the end of treatment in both trials. Trial 1 was an open study that compared the effects of 1 g of nabumetone at night with those of naproxen (dose, 500 mg twice daily) and indomethacin (dose, 50 mg three times daily) in 41 hospitalized patients. After three weeks of treatment, nabumetone was significantly better tolerated than naproxen or indomethacin. Trial 2 was a randomized trial with 24 patients per group that compared 1 g of nabumetone given at night with 250 mg of naproxen given in the morning and 500 mg given at night for a period of three months. This single-blind study revealed that the number of patients with microscopic or macroscopic mucosal lesions was significantly smaller following intake of nabumetone. Concerning efficacy, as judged clinically by a rheumatologist, treatment with nabumetone was superior as well. PMID- 3318424 TI - Endoscopy-controlled study of the safety of nabumetone compared with naproxen in arthritis therapy. AB - Nonsteroidal anti-inflammatory drug (NSAID) gastropathy is now a commonly recognized and reported complication of such arthritis therapy. Significant gastric lesions develop in up to 40 percent of arthritic patients treated with long-term anti-inflammatory doses of NSAIDs, 20 percent of which represents actual ulcer crater disease. This 12-week endoscopy-controlled, double-blind study was constructed to evaluate the safety and efficacy of nabumetone 1,000 mg at bedtime compared with naproxen 250 mg twice daily. A total of 37 patients completed the study, including 29 patients with a diagnosis of osteoarthritis and eight with a diagnosis of rheumatoid arthritis. By posttreatment endoscopy, nabumetone was significantly less toxic to the gastrointestinal tract than was naproxen. The nabumetone-treated group also showed greater improvement in all efficacy variables, with significant improvement noted in three of these five variables in both rheumatoid and osteoarthritic patients. PMID- 3318425 TI - Rheumatoid arthritis: clinical considerations in diagnosis and management. AB - Advances in the understanding of the immune response, in immunogenetics, and in better identification of microbial agents that produce arthritis have made possible more accurate diagnosis of rheumatoid arthritis. Epidemiologic study of groups of rheumatoid patients and their response to therapy has provided a broader perspective of the disease's course and management. Therapy must be guided by the acute or chronic phase of the disease and must embrace chemical, psychologic, and physical modalities to achieve the goals of pain relief and the restoration of immune balance. Rheumatoid arthritis can no longer be considered benign since it impairs the duration as well as the quality of life. Therapy should be aggressive depending upon the predictors of more destructive disease. PMID- 3318426 TI - Nabumetone: a single-center three-week comparison with placebo in the treatment of rheumatoid arthritis. AB - Forty-six patients with definite or classical rheumatoid arthritis were entered into a three-week, double-blind, randomized, parallel study of nabumetone, 1,000 mg at bedtime, compared with placebo. Fifteen nabumetone-treated and 12 placebo treated patients were evaluated for efficacy variables including physician's opinion of rheumatoid arthritis activity, patient's opinion of rheumatoid arthritis activity, articular index, morning stiffness, 50-foot walking time, grip strength, and acetaminophen consumption. Between-group analysis of improvement over baseline was significantly (p less than 0.05) greater for nabumetone-treated patients for six of the seven variables. Nabumetone was significantly favored over placebo in three global evaluations and significantly more placebo-treated (75 percent) than nabumetone-treated (20 percent) patients withdrew from the study due to an unsatisfactory therapeutic response. Of the 38 patients receiving the study medication, 22 percent of nabumetone-treated and 5 percent of placebo-treated patients reported adverse experiences either related to treatment or for which the relationship to treatment was unknown. No patients were withdrawn from the study as a result of these experiences and no long-term sequelae or clinically significant laboratory abnormalities were reported. PMID- 3318427 TI - Evaluation of nabumetone in the treatment of active adult rheumatoid arthritis. AB - The safety and efficacy of nabumetone and placebo were compared in a three-week, multicenter, double-blind, randomized, parallel evaluation involving patients with class II or III definite or classical rheumatoid arthritis. No patient received concomitant treatment with other nonsteroidal anti-inflammatory agents; however, disease-modifying agents (gold, steroids) were permitted. Of the 139 patients who entered the double-blind phase of the study, all were evaluable for safety, and 113 were evaluable for efficacy. Sixty-one patients received 1,000 mg of nabumetone per day at bedtime, and 50 were given placebo tablets; patients in both groups were permitted up to 3,250 mg of acetaminophen per day as needed for pain. After three weeks, nabumetone-treated patients exhibited a greater degree of improvement from baseline than did the placebo-treated patients, and the degree of improvement was statistically significant for four of seven variables. PMID- 3318428 TI - Long-term treatment of rheumatoid arthritis comparing nabumetone with aspirin. AB - This report summarizes the results of a 17-investigator multicenter six-month randomized double-blind parallel group study. The safety and efficacy of nabumetone 1,000 mg taken at bedtime was compared with that of aspirin 900 mg four times daily in the treatment of adult patients with active class II or III classical or definite rheumatoid arthritis. Two hundred sixty-four patients were entered into the study. Two hundred fifty-seven (126 nabumetone and 131 aspirin) patients were evaluable for safety. Two hundred thirty-four (113 nabumetone and 121 aspirin) patients were evaluable for efficacy. There was significant improvement in each of six clinical measurements of efficacy in both treatment groups and little difference between groups. The somewhat greater improvement in articular index and duration of morning stiffness in the nabumetone-treated group did not reach statistical significance. There was an equal percentage of patient withdrawal for lack of efficacy in each group. Overall, the rate of patient withdrawal due to adverse experiences was greater (p = 0.01) for aspirin-treated patients. These experiences were usually dispepsia, abdominal pain, and tinnitus. It was concluded that nabumetone was an effective anti-inflammatory drug in the treatment of rheumatoid arthritis with less toxicity than aspirin. PMID- 3318429 TI - Nabumetone in the treatment of active adult rheumatoid arthritis. AB - One hundred patients were entered in a six-month, double-blind comparison of 1,000 mg nabumetone once daily and 250 mg naproxen twice daily. Forty-two patients in each arm of the study were evaluable for efficacy; all were evaluable for safety. There was a low incidence of adverse experiences during this study, with no patients withdrawing from the study because of side effects from either drug. Efficacy was equal, with both compounds sharing the same degree and rate of improvement. All of the patients completing the double-blind phase were then switched to open-label treatment with nabumetone. The dosage of nabumetone was gradually increased. At the end of one year, 84 patients remained in the study (52 taking 1,000 mg per day, 23 taking 1,500 mg, and nine taking 2,000 mg). This gradual increase has continued, and, at this time, 61 patients remain in the study (seven taking 1,000 mg per day, 24 taking 1,500 mg, and 30 taking 2,000 mg). There have been very few side effects. From this study, it can be concluded that nabumetone is at least as effective as naproxen and, even at higher doses, had an acceptable safety profile for extended use in patients with rheumatoid arthritis. PMID- 3318430 TI - Controlled evaluation of nabumetone in the treatment of active adult rheumatoid arthritis. Nabumetone versus naproxen double-blind parallel study. AB - Nabumetone is a new nonsteroidal anti-inflammatory agent. Therapy with nabumetone 1,000 mg given at bedtime was compared with naproxen 250 mg given twice daily in a prospective double-blind study of patients with rheumatoid arthritis. Both drugs were found to be efficacious in a comparable fashion. Both drugs were well tolerated in terms of patient withdrawal rates, which were 5 and 8 percent, respectively. Gastrointestinal side effects were the most commonly encountered problem. Nabumetone holds promise as an important new therapeutic approach in arthritis. PMID- 3318431 TI - Single-blind comparative study of nabumetone (Relafen) versus naproxen in the treatment of rheumatoid arthritis. AB - Forty-seven patients with active rheumatoid arthritis were entered into a single blind study to compare the safety and efficacy of nabumetone with naproxen. Patients were randomly assigned to receive a daily dose of 2 g of nabumetone or 1 g of naproxen after a placebo-washout period of at least three days. In addition to the usual clinical and laboratory measurements of disease activity, thermographic assessment was carried out at each visit and the heat distribution index was calculated. In addition, the safety and tolerance were assessed. Patients had improvement in severity of pain, severity and duration of morning stiffness, and articular index, and there was no statistical difference between the two treatment groups. By the end of six months, 13 patients had withdrawn from treatment; five patients in the naproxen treatment group and five in the nabumetone group were withdrawn from the study due to lack of efficacy. In no patient from the nabumetone group did an adverse reaction develop. In one patient in the naproxen group, a severe decrease in white blood cell count developed, and a skin rash and swollen gums developed in another patient. We conclude that nabumetone is well tolerated and of equal efficacy to naproxen in the treatment of active rheumatoid arthritis. PMID- 3318432 TI - Nabumetone therapy of osteoarthritis. A six-week, placebo-controlled study. AB - Following a washout period, one hundred six patients with osteoarthritis were randomly assigned single daily doses of either 1,000 mg of nabumetone or placebo given at bedtime as part of a six-week, controlled, double-blind study. Forty seven patients received nabumetone, whereas 48 patients were given placebo. Treatment groups were comparable for demographic characteristics, baseline efficacy assessments, and diagnostic criteria for osteoarthritis. Nabumetone treated patients had absolute improvement, as well as relative improvement in comparison with placebo, both clinically and statistically. There were no clinical or statistical differences in safety variables between the two groups. When given once daily at bedtime, nabumetone was effective and had a good safety profile in patients with osteoarthritis. PMID- 3318433 TI - Results of a six-month study comparing the safety and efficacy of nabumetone and aspirin in the treatment of osteoarthritis. AB - The safety and efficacy of nabumetone (1,000 mg at bedtime) were compared with those of aspirin (900 mg four times daily) in the treatment of osteoarthritis in adult patients in a private practice setting as part of a six-month, double blind, controlled, randomized, parallel group study. At screening, baseline, and Days 7, 14, 28, 56, 112, and 168, efficacy was evaluated according to independent assessments by the patients and the physician of overall osteoarthritic activity and pain and by the physician's assessment with respect to a defined activity. Of the 40 patients enrolled, 37 were evaluable for efficacy (19 in the nabumetone group and 18 in the aspirin group). Demographic parameters and diagnostic criteria for osteoarthritis were comparable between the groups, although there was a preponderance of women in the nabumetone group. Significant improvement from baseline in all five efficacy parameters was observed in both groups. Safety was evaluated for all 20 enrolled patients in each group. The percentage of aspirin-treated patients who withdrew from the study due to adverse experiences was greater (60 percent versus 20 percent), as was the number with at least one treatment-related adverse experience (19, or 95 percent, versus 11, or 55 percent). Treatment-related adverse experiences described as moderate or severe were reported by 70 percent of the aspirin-treated patients and by 35 percent of the nabumetone-treated patients. In this study, nabumetone 1,000 mg at bedtime had an acceptable safety profile and was as effective as aspirin 900 mg four times daily in the treatment of osteoarthritis. PMID- 3318434 TI - Comparison of the safety and efficacy of nabumetone and aspirin in the treatment of osteoarthritis in adults. AB - A six-month, multicenter, double-blind study compared the efficacy and safety of two therapeutic regimens in 332 patients with osteoarthritis. The patients received either 1,000 mg of nabumetone as a single bedtime dose or 900 mg of aspirin in four divided doses. At the end of the study, patients in both treatment groups showed significant improvement from baseline for all five parameters; no statistically or clinically significant differences were observed between the groups. The safety data did reveal clinically and statistically significant differences between the groups. Aspirin-treated patients experienced a greater frequency of withdrawal from the study because of adverse experiences (34 percent versus 13 percent), a greater incidence of having at least one treatment-related adverse experience (73 percent versus 52 percent), a greater percentage of patients with at least one moderate or severe treatment-related adverse experience (47 percent versus 22 percent), and a greater percentage of patients with treatment-related adverse experiences affecting the gastrointestinal system (43 percent versus 32 percent) or the inner ear (32 percent versus 10 percent). The results of this study demonstrated that nabumetone, 1,000 mg at bedtime, is as efficacious as aspirin, 900 mg four times daily, produces fewer adverse effects, and is indicated in the treatment of osteoarthritis. PMID- 3318435 TI - Nabumetone versus naproxen in the treatment of osteoarthritis. A six-month trial. AB - The efficacy and safety of nabumetone (1,000 mg at bedtime) and naproxen (250 mg twice daily) were compared in a six-month, randomized, double-blind study of patients with osteoarthritis. Forty patients were entered in the study and completed a washout phase, and 37 were evaluable for efficacy. Of these, 18 patients received nabumetone and 19 received naproxen. Both treatment groups had significant improvement from baseline in all of the efficacy variables measured. All 40 patients were evaluated for safety. Fifty percent of the patients treated with nabumetone and 65 percent of the patients treated with naproxen had at least one drug-related or unknown-related adverse experience. Fifteen percent of patients in both groups had treatment-related adverse experiences that were moderate or severe. There were no statistically significant differences in the two treatment groups with regard to efficacy or adverse experiences. PMID- 3318436 TI - Six-month multi-center study comparing nabumetone with naproxen in the treatment of osteoarthritis. AB - This six-month, double-blind, controlled, randomized, parallel study at 13 medical centers compared the safety and efficacy of nabumetone (1,000 mg taken at bedtime) with that of naproxen (250 mg twice daily) in the treatment of osteoarthritis in symptomatic adult outpatients. Five efficacy parameters were measured: patients' assessment of overall osteoarthritis activity and pain, physicians' assessment of overall osteoarthritis activity and pain, and physicians' assessment of pain with respect to a declined activity. All 489 patients who took medication were included in the evaluation of safety, and 455 patients (227 in the nabumetone group and 228 in the naproxen group) were evaluated for efficacy. Significant improvement in all five efficacy parameters occurred in both groups. No significant differences were found between the two groups at the end of the study in any of the five efficacy parameters. Twenty three percent of nabumetone and 17 percent of naproxen patients withdrew from the study for lack of efficacy. At least one possible or probable treatment-related adverse experience was reported for 45 percent of nabumetone-treated patients and 42 percent of those given naproxen, and in 19 percent of the nabumetone-treated and 18 percent of the naproxen-treated patients these experiences were moderate or severe. However, only 7 percent of patients in each group withdrew from the study due to adverse experiences. Nabumetone and naproxen have comparable safety and efficacy, suggesting that a single, nighttime dose of nabumetone is a convenient, effective, and safe treatment for osteoarthritis. PMID- 3318437 TI - S-adenosylmethionine and affective disorder. AB - Several open and double-blind studies suggest that SAMe may have an anti depressant effect, and further studies are indicated. SAMe may exert a beneficial effect selectively on endogenous rather than neurotic depression. SAMe crosses the blood-brain barrier. SAMe is involved in several central enzyme pathways relating to transmethylation and folate and monoamine metabolism as well as in membrane function and neuro-transmission. The neuropharmacology of SAMe's effect on mood and the switch mechanism has yet to be fully explored. The actions of SAMe on the dopaminergic system are as yet unclear. SAMe is a physiologic substance that is non-toxic and relatively free of severe side effects (with the exception of mania, which may be a manifestation of the basic mood disorder. PMID- 3318438 TI - Evaluation of S-adenosylmethionine in primary fibromyalgia. A double-blind crossover study. AB - The effect of S-adenosylmethionine (SAMe) and placebo was evaluated in a short term crossover study of 17 patients with primary fibromyalgia. Eleven of 17 patients had a significant depressive state as assessed by either the Hamilton Depression Rating Scale or the Scala di Autovalutazione per la Depressione (SAD) rating scale. The number of trigger points plus painful anatomic sites decreased after administration of SAMe (p less than 0.02) but not after placebo treatment. In addition, scores on both the Hamilton and SAD rating scales improved after SAMe administration (p less than 0.05 and p less than 0.005, respectively), whereas they did not significantly change after placebo treatment. In all the patients, there was a good correlation between scores on the Hamilton rating scale and the number of trigger points. Thus, this preliminary study confirms the close relationship between primary fibromyalgia and psychologic disturbances, particularly with regards to a depressive state. SAMe treatment, by improving the depressive state and reducing the number of trigger points, seems to be an effective and safe therapy in the management of primary fibromyalgia. PMID- 3318439 TI - Pharmacologic aspects of S-adenosylmethionine. Pharmacokinetics and pharmacodynamics. AB - Several studies in animals have shown the efficacy of parenteral S adenosylmethionine (SAMe) as an anti-inflammatory drug. In this article, data are reported on plasma kinetics, distribution, and metabolism of SAMe after oral administration since preference is given to oral dosage in the usual clinical practice. The results demonstrate the intestinal absorption of SAMe and its active metabolism. Experiments confirm the anti-inflammatory activity of the drug by the oral route. Results are also reported on the analgesic effect of SAMe. PMID- 3318440 TI - Primary osteoarthritis: epidemiology, clinical aspects, and general management. AB - The etiology of osteoarthritis, the most common articular disorder, is still unknown. Epidemiologic studies demonstrate a relationship to aging and to certain occupations; relationships to obesity as an etiologic factor remain controversial. An inverse relationship of osteoarthritis and bony density has been observed. Medical management is primarily symptomatic; surgery, particularly of the hip or knee, restores function and relieves pain at late stages of the disease. Investigational trials of specific therapeutic agents suggest possible forthcoming interventions to prevent, retard, or reverse the disease process. PMID- 3318441 TI - S-adenosylmethionine in the treatment of osteoarthritis. Review of the clinical studies. AB - S-Adenosylmethionine (SAMe), a physiologic compound that ranks with ATP as a pivotal molecule in biology, offers physicians an innovative approach to the treatment of osteoarthritis. Experimental investigations suggest that the administration of SAMe exerts analgesic and antiphlogistic activities and stimulates the synthesis of proteoglycans by articular chondrocytes with minimal or absent side effects on the gastrointestinal tract and other organs. The results of extensive clinical trials, which have enrolled about 22,000 patients with osteoarthritis in the last five years, support the clinical effectiveness and the optimal tolerability of SAMe administration. The intensity of therapeutic activity of SAMe against osteoarthritis is similar to that exerted by nonsteroidal anti-inflammatory drugs, but its tolerability is higher. Based on these findings, SAMe is proposed as the prototype of a new class of safe drugs for the treatment of osteoarthritis. PMID- 3318442 TI - Italian double-blind multicenter study comparing S-adenosylmethionine, naproxen, and placebo in the treatment of degenerative joint disease. AB - In a double-blind study, the efficacy and tolerability of S-adenosylmethionine (SAMe) were evaluated in comparison with those of placebo and naproxen in the treatment of osteoarthritis of the hip, knee, spine, and hand. Thirty-three centers, 18 rheumatologic and 15 orthopedic, participated in this study. A total of 734 subjects, including 582 with coxarthrosis (hip osteoarthritis) or gonarthrosis (knee osteoarthritis), were enrolled. SAMe administered orally at a dose of 1,200 mg daily was shown to exert the same analgesic activity as naproxen at a dose of 750 mg daily. Both drugs were more effective than placebo (p less than 0.01). Tolerability of SAMe was significantly better than that of naproxen, both in terms of physicians' (p less than 0.025) and patients' (p less than 0.01) judgments and in terms of the number of patients with side effects (p less than 0.05). There was no difference between SAMe and placebo in the number of side effects. Ten patients in the SAMe group and 13 in the placebo group withdrew from the study because of intolerance to the drug. PMID- 3318443 TI - Double-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis. AB - A double-blind, randomized, 84-day controlled clinical trial was carried out to compare orally administered S-adenosylmethionine (SAMe) (1,200 mg per day) with oral piroxicam therapy (20 mg per day) in the management of unilateral knee osteoarthritis. The ability of each drug to maintain the results achieved at the end of the treatment period was also evaluated during a 56-day follow-up period. Forty-five patients completed the study, 22 in the SAMe group and 23 in the piroxicam group. Both SAMe and piroxicam proved effective in inducing a significant improvement in the total pain score after 28 days of treatment. With regard to the other clinical parameters (i.e., morning stiffness, the distance walked before the onset of pain, active and passive motility), improvement started from about Day 56 in both groups. No significant difference was found between the two treatments in terms of efficacy and tolerability. Patients treated with SAMe maintained clinical improvement achieved at the end of treatment longer than did patients receiving piroxicam. PMID- 3318444 TI - Double-blind comparative clinical trial with S-adenosylmethionine and indomethacin in the treatment of osteoarthritis. AB - In a randomized double-blind study, 36 patients with osteoarthritis of the knee, hip, and/or spine were treated orally with a daily dose of S-adenosylmethionine (SAMe)(1,200 mg) or indomethacin (150 mg) over a period of four weeks. Pretreatment and posttreatment clinical parameters were determined and assessed according to a standard scoring system. SAMe therapy significantly improved the total score obtained by the sum of all clinical findings, as compared with pretreatment values. Similar improvement was evident in indomethacin-treated subjects. Two patients in the SAMe group reported slight nausea after two weeks of therapy, whereas adverse effects developed in seven patients in the indomethacin group. PMID- 3318445 TI - Double-blind clinical trial of S-adenosylmethionine versus ibuprofen in the treatment of osteoarthritis. AB - Thirty-six subjects with osteoarthritis of the knee, the hip, and/or the spine were enrolled in a randomized double-blind study. Patients received a daily oral dose of 1,200 mg of S-adenosylmethionine (SAMe) or 1,200 mg of ibuprofen for four weeks. Morning stiffness, pain at rest, pain on motion, crepitus, swelling, and limitation of motion of the affected joints were assessed before and after treatment. The total score obtained by the evaluation of all the individual clinical parameters improved to the same extent in patients treated with SAMe or ibuprofen. Both treatments were well tolerated and no patient from either group withdrew from the study. PMID- 3318446 TI - A new medical approach to the treatment of osteoarthritis. Report of an open phase IV study with ademetionine (Gumbaral). AB - A non-controlled clinical phase IV trial was carried out involving 20,641 patients with osteoarthritis of the knee, the hip, and the spine and also with osteoarthritic polyarthritis of the fingers, who were treated with ademetionine tablets given in a fixed dosage schedule for eight weeks. No additional analgesic/antirheumatic treatment was allowed. Nevertheless, concomitant medication for other diseases was permissible. The efficacy was described as "very good" or "good" in 71 percent of cases, as "moderate" in 21 percent, and as "poor" in 9 percent of cases. The tolerance was assessed as very good or good in 87 percent, as moderate in 8 percent, and as poor in 5 percent of cases. The trial therapy was discontinued prematurely because of symptoms of intolerance in 5 percent of the patients and because of a lack of efficacy in 2.3 percent of cases. PMID- 3318447 TI - A long-term (two years) clinical trial with S-adenosylmethionine for the treatment of osteoarthritis. AB - In a long-term multicenter open trial involving 10 general practitioners, the efficacy and tolerance of S-adenosylmethionine (SAMe) were studied for 24 months in 108 patients with osteoarthritis of the knee, hip, and spine. At the end of the 24-month observation period, 97 of the patients were still in the study. The patients received 600 mg of SAMe daily (equivalent to three tablets of 200 mg each) for the first two weeks and thereafter 400 mg daily (equivalent to two tablets of 200 mg each) until the end of the 24th month of treatment. Separate evaluations were made for osteoarthritis of the knee, hip, cervical spine, and dorsal/lumbar spine. The severity of the clinical symptoms (morning stiffness, pain at rest, and pain on movement) was assessed using scoring before the start of the treatment, at the end of the first and second week of treatment, and then monthly until the end of the 24-month period. SAMe administration showed good clinical effectiveness and was well tolerated. The improvement of the clinical symptoms during therapy with SAMe was already evident after the first weeks of treatment and continued up to the end of the 24th month. Non-specific side effects occurred in 20 patients, but in no case did therapy have to be discontinued. Most side effects disappeared during the course of therapy. Moreover, during the last six months of treatment, no adverse effect was recorded. Detailed laboratory tests carried out at the start and after six, 12, 18, and 24 months of treatment showed no pathologic changes. SAMe administration also improved the depressive feelings often associated with osteoarthritis. PMID- 3318449 TI - Pharmacology of fenofibrate. AB - This discussion outlines the major aspects of the human pharmacology of fenofibrate, a hypolipidemic agent. In view of its short half-life, efficient absorption, and elimination, fenofibrate would not appear to accumulate in either plasma or tissues. It is extensively absorbed only in the presence of food and is transported through the bloodstream by albumin. Fenofibrate is taken up by both the liver and kidney. Except for a small percentage (about 5 percent) reduced at the ketone moiety before conjugation, most drug is excreted as a conjugate in the urine. Less than 20 percent is excreted through the bile. In normal persons, at steady state with usual doses of 100 mg three times daily, the plasma half-life approximates 30 hours. Because fenofibrate is not dialyzable, it has a markedly prolonged half life in patients with renal failure and should not be used. PMID- 3318448 TI - Neuropharmacology of S-adenosyl-L-methionine. AB - The metabolite S-adenosyl-L-methionine (SAMe), when prepared as the stable p toluene-sulfonate complex of its sulfate salt and given parenterally in high doses, appears to have mood-elevating effects in depressed adults. The material is remarkably well tolerated when given by injection or intravenous infusion for this purpose, even in elderly or demented patients. Assuming that the toluene sulfonate component is inert, SAMe appears to have central neuropharmacologic effects after systemic injection in high doses. Nevertheless, the functional consequences of these remain unclear and, indeed, the ability of exogenous SAMe to reach the brain, and especially neuronal cytoplasm, is limited. SAMe has small effects on monoamine metabolism and, after injection, appears to have effects on the microviscosity of cell membranes that may be related to stimulation of phospholipid synthesis. The recent introduction of an orally administered form of SAMe for use in the treatment of osteoarthritis promises to stimulate further study of SAMe in disease-associated depression, major depressive disorder, and other neuropsychiatric conditions. PMID- 3318450 TI - Comparative toxicity and safety profile of fenofibrate and other fibric acid derivatives. AB - It is estimated that there are approximately six million patient-years of clinical experience with fenofibrate among physicians outside of the United States. A review of the European literature and unpublished studies supplied by the manufacturer (Laboratoires Fournier, Dijon, France) has been compiled with the data recently reported from a double-blind, placebo-controlled study completed in the United States. In general, fenofibrate has been found to reduce serum triglyceride levels by 30 to 60 percent in patients with type II B and IV hyperlipoproteinemia. Serum cholesterol levels were also reduced by 20 to 25 percent in this group of hypertriglyceridemic patients. A similar reduction in serum cholesterol levels was also found in type II A patients (normal triglyceride levels). Low-density lipoprotein levels were usually reduced in those patients with elevated levels and high-density lipoprotein levels increased when baseline levels were low. Fenofibrate also produced a 10 to 28 percent reduction in uric acid that was sustained for years. The incidence of unwanted effects ranged from 2 to 15 percent in the open trials lasting from a few months up to six years. Gastrointestinal problems (abdominal discomfort, diarrhea, and constipation) are most common, occurring in approximately 5 percent of patients. Reports including fatigue, headache, loss of libido, impotence, dizziness, and insomnia were grouped as neurologic and occurred with a total incidence of 3 to 4 percent. In about 1 percent of patients, muscle tenderness developed, often accompanied by elevated creatine phosphokinase levels. These and the gastrointestinal problems occurred with a similar frequency in the placebo treated cohort in controlled studies. In approximately 2 percent of patients, a skin rash developed, an incidence that appears significantly higher than that of placebo control groups. Liver changes in rodents have included marked peroxisome proliferation and increased hepatic carcinomas with very high doses. In humans, only a small increase in incidence of elevated levels of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase seems to be present and is not clearly different from that of the control groups. Alkaline phosphatase, gamma-glutamyl transferase, and bilirubin levels are often decreased with no known undesirable effects. Investigations into the lithogenicity of bile indicated a significant increase in five studies. However, there has been no evidence of a significant rise in the incidence of cholelithiasis in the clinical trials completed to date. PMID- 3318452 TI - Effects of fibric acid derivatives on biliary lipid composition. AB - Fenofibrate, a potent analogue of clofibrate, causes changes in biliary lipid composition similar to those seen with clofibrate and other derivatives of fibric acid, although there is a suggestion that the increase in cholesterol content may be accompanied by an increase in phospholipid content as well as a decrease in bile acid content. This may favor liquid crystal formation, and fenofibrate may have less propensity to cause gallstones than would other derivatives. Many other factors are also important in determining whether supersaturated bile will result in gallstone formation, and the use of this compound should be monitored in the future to determine the clinical importance of these findings. PMID- 3318451 TI - Structure and biochemical effects of fenofibrate. AB - The structures of various fibric acid derivatives are compared. Fenofibrate inhibits de novo hepatic fatty acid synthesis and seems to inhibit hepatic very low-density lipoprotein synthesis, but it enhances mitochondrial and peroxisomal fatty acid oxidation and lipoprotein lipase activity. It produces a very significant reduction in the plasma triglyceride concentration. Fenofibrate also inhibits cholesterol synthesis prior to processing mevalonate, indirectly causing significant reduction of hydroxymethylglutaryl coenzyme A reductase activity. The drug may inhibit acyl-coenzyme A-cholesterol transferase activity, reducing cholesterol ester accumulation within cells. Fenofibrate significantly increases the fractional rate of lecithin-cholesterol acyltransferase activity in normolipidemic and hypercholesterolemic patients. This may explain the increase in cholesterol ester levels observed in high-density lipoproteins. It may stimulate bile acid synthesis from exogenous cholesterol. It causes a marked reduction of increased spontaneous platelet aggregation. Fenofibrate also markedly diminishes the effect of platelet-derived growth factor upon DNA synthesis in vitro, an effect that might impede a key event in early atherogenesis. Thus, fenofibrate has effects not directly related to its lipid- and lipoprotein-lowering action. PMID- 3318453 TI - Effect of fibric acid derivatives on blood lipid and lipoprotein levels. AB - The literature for the last seven years was reviewed in terms of the effect of the various fibric acid derivatives on blood lipid and lipoprotein levels. The criteria for review resulted in a greater focus on three of the newer fibric acid derivatives: bezafibrate, ciprofibrate, fenofibrate. In type II A hyperlipoproteinemia, all fibric acid derivatives produce modest reductions in total plasma cholesterol and low-density lipoprotein cholesterol. The evidence suggests that bezafibrate, ciprofibrate, and fenofibrate may produce greater reductions in low-density lipoprotein cholesterol than those usually observed with clofibrate and gemfibrozil. All fibric acid derivatives produce modest reductions in triglycerides and modest increases in high-density lipoprotein cholesterol in type II A hyperlipoproteinemia. In type II B hyperlipoproteinemia, the low-density lipoprotein cholesterol lowering effect of fibric acid derivatives is generally less than that observed in type II A hyperlipoproteinemia. In type II B hyperlipoproteinemia, there is a mean decrease in low-density lipoprotein cholesterol for all patients studied. However, there is a considerable interpatient variation ranging from significant decreases to significant increases in low-density lipoprotein cholesterol. Further studies are required to assess whether the low-density lipoprotein cholesterol lowering effect is greater with the newer fibric acid derivatives. All fibric acid derivatives produce clinically significant decreases in triglyceride levels in type II B. There is also an associated increase in high-density lipoprotein cholesterol. In type IV hyperlipoproteinemia, all fibric acid derivatives produce clinically significant reductions in triglyceride. There is also an associated increase in high-density lipoprotein cholesterol and generally also an increase in low-density lipoprotein cholesterol levels. The available data do not suggest a clinically significant difference in the hypotriglyceridemic effect of the various fibric acid derivatives in type IV hyperlipoproteinemia. The lipid altering effects of the various fibric acid derivatives were usually less in those studies that contained placebo and dietary controls. Additional controlled clinical trials are needed to accurately discriminate the relative lipid-and lipoprotein-altering effects of the various fibric acid derivatives. PMID- 3318454 TI - Effects of fenofibrate on plasma lipoproteins in hypercholesterolemia and combined hyperlipidemia. AB - To investigate the lipoprotein effect of fenofibrate in hypercholesterolemia or combined hyperlipidemia (types II A and II B hyperlipidemias, respectively), 240 patients were recruited and 227 randomized to a double-blind randomized trial lasting 24 weeks and 192 patients continued to participate in an open-label phase for another 24 weeks. A 100-mg dose of fenofibrate or a matching placebo was given three times daily. Fenofibrate side effects in excess of placebo affected 6 percent of fenofibrate users and were confined almost entirely to skin rashes. In 180 hypercholesterolemic patients randomly assigned to receive fenofibrate versus placebo, triglyceride and very low-density lipoprotein cholesterol levels decreased 38 percent, total cholesterol levels decreased 17.5 percent, and low density lipoprotein cholesterol levels decreased 20.3 percent with fenofibrate treatment. High-density lipoprotein cholesterol levels increased 11.1 percent with a decrease in the low-density lipoprotein cholesterol: high-density lipoprotein cholesterol ratio of 27 percent. All differences were statistically significant (p less than 0.01). In combined hyperlipidemic (type II B) patients, triglyceride levels decreased by 45 percent, very low-density lipoprotein cholesterol levels decreased 52.7 percent, total cholesterol levels decreased 16 percent, low-density lipoprotein cholesterol levels decreased 6 percent, and high density lipoprotein levels increased 15.3 percent for a low-density lipoprotein cholesterol: high-density lipoprotein cholesterol ratio decrease of 13 percent. All differences were again statistically significant (p less than 0.01). In both groups of patients, the onset of the drug effect was generally rapid, with maximal total and low-density lipoprotein cholesterol level lowering achieved within four weeks in hypercholesterolemic patients and maximal triglyceride and cholesterol level lowering in hypertriglyceridemic patients achieved in two weeks. Maximum high-density lipoprotein increases occurred after four weeks in type II A patients and 12 to 16 weeks in type II B patients. Fenofibrate is a well-tolerated drug in the fibric acid series and has putatively beneficial effects on triglyceride, very low-density lipoprotein, low-density lipoprotein, and high-density lipoprotein cholesterol concentrations in both type II A and type II B hyperlipidemic patients. If the lipid hypothesis of atherosclerosis applies to the lipoprotein changes induced by fenofibrate, reductions in cardiovascular disease risk in both type II A and II B hyperlipidemic patients should result from fenofibrate treatment. PMID- 3318456 TI - Changes in lipoprotein kinetics during therapy with fenofibrate and other fibric acid derivatives. AB - The fibric acid derivatives, including fenofibrate, significantly reduce very low density lipoprotein triglyceride concentrations by stimulating lipoprotein lipase activity, thereby increasing very low-density lipoprotein catabolism. These agents may also reduce the hepatic secretion of nascent very low-density lipoprotein, but this effect is less consistent. Effects on low-density lipoprotein metabolism appear to depend upon the lipid disorder present before therapy. If hypertriglyceridemia and normal or low low-density lipoprotein levels are present, fibrate therapy is associated with a rise in low-density lipoprotein levels. This is due to a decreased fractional catabolism of low-density lipoprotein from an unusually high clearance to a more normal value. Treating pre existing hypercholesterolemia usually results in a significant decrease in low density lipoprotein levels. In this disorder, there is a demonstrable increase in low-density lipoprotein receptor-mediated clearance. It is not known at which site these drugs act to increase low-density lipoprotein receptor function in the latter patients. Some studies suggest that fibrate therapy increases high-density lipoprotein apolipoprotein AI production, but how this occurs has not been defined. PMID- 3318455 TI - Fenofibrate affects the compositions of lipoproteins. AB - This study assessed the effects of fenofibrate on lipoprotein levels and lipoprotein compositions in a subgroup of patients who participated in a multicenter fenofibrate study. Eleven men and 10 women aged 29 to 63 were studied, 12 with type II A and nine with type II B hyperlipoproteinemia. Fasting blood samples were obtained every four to six weeks. Lipoprotein lipids were quantified by procedures of the Lipid Research Clinics, and apolipoproteins by radioimmunoassay. Fenofibrate decreased mean triglyceride and cholesterol levels of the type II A patients from 130 to 99 and from 286 to 237 mg/dl, respectively. Levels of very low-density lipoprotein triglycerides, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol decreased and high density lipoprotein cholesterol levels rose. Apolipoprotein B and apolipoprotein E levels decreased, whereas apolipoprotein AI and apolipoprotein AII levels rose. The mean very low-density lipoprotein cholesterol:very low-density lipoprotein triglyceride ratio and low-density lipoprotein cholesterol:low-density lipoprotein triglyceride ratio decreased. The low-density lipoprotein cholesterol:apolipoprotein B ratio and high-density lipoprotein cholesterol: apolipoprotein AII ratio decreased as did the apolipoprotein AI:apolipoprotein AII ratio. In patients with type II B hyperlipoproteinemia, triglyceride and cholesterol levels decreased with fenofibrate therapy with most of the decrease in triglyceride levels due to very low-density lipoprotein triglycerides, whereas the decrease in total cholesterol levels was due to decreases in very low-density lipoprotein and low-density lipoprotein cholesterol. High-density lipoprotein cholesterol levels rose. The decrease in low-density lipoprotein cholesterol levels was not significant in this group. Apolipoprotein E levels decreased and apoliprotein AI and apolipoprotein AII levels rose. Indices of composition in type II B patients were similar to those in type II A patients but the changes were less dramatic. Very low-density lipoprotein cholesterol:very low-density lipoprotein triglyceride ratios decreased significantly, but low-density lipoprotein cholesterol:low-density lipoprotein triglyceride ratios did not change significantly with treatment. The mean low-density lipoprotein cholesterol:apolipoprotein B ratio, high-density lipoprotein cholesterol:apolipoprotein AII ratio, and apolipoprotein AI:apolipoprotein AII ratio all were lowered by therapy. Thus, very low-density lipoprotein and low density lipoprotein lost cholesterol in response to fenofibrate therapy and high density lipoprotein particles became enriched in cholesterol. PMID- 3318457 TI - Fibric acids: effects on lipids and lipoprotein metabolism. AB - The major effect of the fibrates on triglycerides is to promote triglyceride-rich lipoprotein catabolism through increased lipoprotein lipase activity. Fibrates also enhance lipolysis of plasma triglycerides by a means different from that of caloric restriction. Their effect on very low-density lipoprotein metabolism also differs from that of nicotinic acid. The effect of fibrate therapy upon low density lipoprotein-cholesterol concentrations depends upon the patients' overall lipoprotein status. The responsible mechanisms are not understood. In hypertriglyceridemic patients, fibrates often reverse abnormal changes in low density lipoprotein composition; low-density lipoprotein heterogeneity is reduced and small dense low-density lipoproteins are eliminated, apparently secondary to reduced levels of triglyceride-rich lipoproteins. Kinetic studies indicate that fibrates do not enhance low-density lipoprotein formation rates, thus contradicting the idea that fibrate therapy causes increased low-density lipoprotein cholesterol levels via increased conversion of very low-density lipoprotein to low-density lipoprotein. Though enhanced low-density lipoprotein catabolism in hypertriglyceridemia could occur via several mechanisms, the responsible factors are largely reversed by fibrate therapy. In non hypertriglyceridemic patients, fibrates may actually enhance the fractional clearance of low-density lipoprotein and thus reduce low-density lipoprotein levels. Fibrate therapy reverses the typical high-density lipoprotein pattern of hypertriglyceridemic patients, producing more high-density lipoprotein2a and less high-density lipoprotein2b. Such treatment also increases high-density lipoprotein cholesterol levels in patients without definite hypertriglyceridemia. Synthesis rates of apolipoproteins AI and AII may be affected by fibrates. The fibrates' major effects on sterol metabolism are interference with cholesterol and bile acid synthesis and increased cholesterol secretion into bile. Although bile saturation increases in most patients, in only a relatively small percentage do gallstones actually develop; super-saturated bile is not sufficient to induce gallstone formation in most patients. Available data strongly imply that fibrates mobilized cholesterol out of tissue pools, perhaps by altering tissue cell membranes to allow cholesterol release from the cell surfaces. PMID- 3318458 TI - A first description of dyssegmental dysplasia. PMID- 3318459 TI - Growth retardation in childhood renal disease: a hormonal or nutritional problem? PMID- 3318460 TI - IgM nephropathy: morphological study related to clinical findings. AB - This study describes 10 cases of IgM nephropathy in whom the main morphological findings consisted of diffuse mesangial deposition of IgM and varying degrees of mesangial cell proliferation. In addition, focal segmental sclerosis was present in 1 patient and global sclerosis in another. An ill-defined electron-dense deposit was seen within the mesangial area in 1 case. Except for 1 patient, who had hematuria only, all suffered from nephrotic syndrome without deterioration of renal function. In view of the constant and characteristic finding of a diffuse mesangial IgM deposition, it is suggested that this form of nephropathy constitutes an entity separate from focal glomerulosclerosis or minimal change disease. PMID- 3318461 TI - Prevention of posttransplant acute tubular necrosis by the calcium antagonist diltiazem: a prospective randomized study. AB - In a prospective randomized trial we evaluated the influence of the calcium antagonist diltiazem (Dil) on the development of acute tubular necrosis (ATN) in cadaveric kidney transplantation. Dil was added to Eurocollin's solution (20 mg/l) at donor nephrectomy. The graft recipient received a preoperative bolus injection of Dil (0.28 mg/kg) which was followed by an infusion of Dil (0.0022 mg/min/kg) for 2 days. Thereafter, Dil was applied orally. Immunosuppressive therapy consisted of ciclosporin (CS) and low-dose steroids. There were no significant differences between the groups with respect to donor characteristics, HLA matching and ischemic periods. In the control group (n = 22), 9 patients (41%) developed ATN compared to 2 patients (10%) in the Dil group (p less than 0.05). In the control group, 3.5 +/- 0.4 HD per patient were necessary compared to 0.6 +/- 0.2 in the Dil group (p less than 0.05). Although CS blood levels were significantly higher in the Dil group (1st week 1,150 vs. 728 ng/ml; p less than 0.01), the GFR of grafts with primary function was significantly higher in the Dil group (day 7:39 vs. 24 ml/min; p less than 0.05). A significant reduction of the CS dose by 30% (p less than 0.01) led to comparable CS levels. In the Dil group, significantly fewer rejection episodes occurred during the first month. Our data indicate that the application of the calcium antagonist Dil lowered the incidence of posttransplant ATN. In addition, there is a possibility that Dil not only ameliorates ischemic damage in the kidney, but also reduces CS nephrotoxicity. PMID- 3318462 TI - A simple method for utilizing frozen bioptical kidney tissue for light microscopy. PMID- 3318463 TI - Gestational diabetes: maternal response to diet and insulin therapy as reflected by glycosylated hemoglobin concentration. AB - To assess the effects of diet and insulin therapy on pregnancy complicated by gestational diabetes, glycosylated hemoglobin concentration was determined longitudinally in 32 women. Diet was instituted when a diagnosis of gestational diabetes was made and was supplemented with insulin for fasting hyperglycemia. At initial presentation, glycosylated hemoglobin concentration was increased in the 18 women who required insulin compared with the 14 women managed by diet alone (7.1% +/- 0.2% versus 6.2% +/- 0.2%, mean +/- SEM, p less than 0.01). Diet had no effect on glycosylated hemoglobin concentration that remained elevated to 6.1% +/ 0.3% compared with the glycosylated hemoglobin concentration of 5.6% +/- 0.2% for pregnant nondiabetic women (p less than 0.01). Insulin resulted in a decrease in glycosylated hemoglobin concentration within 3 to 5 weeks (p less than 0.05). After 7 to 9 weeks of insulin and diet, the glycosylated hemoglobin concentration in women with fasting hyperglycemia was the same as the glycosylated hemoglobin concentration in women who were managed by diet alone. PMID- 3318464 TI - Formulas for fetal weight estimation by ultrasound measurements based on neonatal specific gravities and volumes. AB - To improve the accuracy of fetal weight estimation by ultrasound measurement, especially in low birth weight infants, including those with intrauterine growth retardation, two new formulas were developed from a new point of view. The formulas were established by (1) actual measurements of the volumes of the neonatal head and trunk with limbs, (2) analysis of the relationship between the sizes of the parts of the fetal body measured by ultrasound examination before birth and the volumes of the parts of the neonatal body, and (3) calculation of the specific gravities of the parts of the neonatal body. The prospective study showed a high correlation between estimated weights and actual birth weights with a small range of error in infants weighing between 450 and 4800 gm. PMID- 3318465 TI - Emotional responses of pregnant women to chorionic villi sampling or amniocentesis. AB - Seventy-four "high-risk" pregnant women interested in participating in a clinical trial comparing chorionic villi sampling and amniocentesis were initially assessed on five background measures and for anxiety, depression, hostility, and concern about abortion. The 61 women who then agreed to be randomized into the chorionic villi sampling and amniocentesis groups were assessed three additional times between 9 and 22 weeks' gestational age. Physical discomfort experienced during the diagnostic procedure was also assessed. Women in the chorionic villi sampling group underwent a reduction in anxiety up to 10 weeks earlier and reported less procedure-related discomfort than women in the amniocentesis group. The group X time interaction for depression was also significant, with women undergoing chorionic villi sampling reporting an earlier decrease in depression than women undergoing amniocentesis. No differences were found between the two groups in hostility or concern about abortion. Findings were discussed in the context of evidence linking prenatal maternal emotionality to an increased risk of obstetric complications. PMID- 3318466 TI - A very rare fetal malformation: the cutaneous widespread vascular hamartomatosis. AB - A rare fetal malformation with a large number of vascular masses over the entire body diagnosed by ultrasound examination at 24 weeks of gestation is described. No report of this anomaly has been found in the international literature. PMID- 3318468 TI - Sonographic diagnosis of a bladder polyp. AB - Presented is a case of a bladder polyp diagnosed by ultrasound and removed by transurethral resection. PMID- 3318467 TI - Updated pregnancy rates for the Today contraceptive sponge. AB - Pregnancy rates (method and user) were evaluated for 2245 women who participated in the phase III clinical trials of the Today contraceptive sponge. User and method pregnancy rates were similar for women of different ages and parities. The 1-year method and user pregnancy rates (life table per 100 women) were 8.2 and 5.6, respectively. PMID- 3318469 TI - Prevention of recurrent idiopathic fetal growth retardation by low-dose aspirin and dipyridamole. AB - In a controlled, nonrandomized trial a treatment group of 24 multigravid women with a history of at least two previous pregnancies, all complicated by idiopathic fetal growth retardation and placental infarction, received 1 to 1.6 mg/kg aspirin and 225 mg dipyridamole daily from 16 to 34 weeks' gestation in a total of 30 pregnancies. The end-point measure of the study was birth weight related to gestational age. Results obtained in the treatment group were compared with those in 27 pregnancies of a control group of 24 multigravid women with a similar history of recurrent fetal growth retardation who received comparable antenatal care without low dose aspirin and dipyridamole. Fetal growth retardation occurred in 61% of the control pregnancies and in only 13% of treated pregnancies; severe fetal growth retardation was not observed in treated pregnancies, but it occurred in 27% of the control group. In treated women, platelet cyclo-oxygenase activity was suppressed to 5% to 10% of its pretreatment level, but no effect on vascular prostacyclin production was demonstrated. Treatment did not produce adverse effects in mothers or infants. Low-dose aspirin and dipyridamole direct prostacyclin/thromboxane A2 balance in pregnancy to the dominance of prostacyclin and may thus prevent idiopathic uteroplacental insufficiency and fetal growth retardation in high-risk patients. PMID- 3318470 TI - Pleural effusions and pulmonary hypoplasia. AB - Nine cases of fetuses with pleural effusions are presented in which the diagnosis was made by ultrasound before the thirtieth week of gestation. A ratio of lung span to hemithorax diameter was calculated and ranged from 0.44 to 0.77 (mean 0.60). At autopsy, pulmonary hypoplasia was confirmed in all cases by criteria based on the ratio of lung weight to total body weight. Because pleural effusions occurring in the midtrimester can be detected and may lead to pulmonary hypoplasia, consideration should be given to definitive in utero therapy when no other major fetal abnormality is detected. PMID- 3318472 TI - The detection of facial anomalies with ultrasound. PMID- 3318471 TI - Effect of chronically elevated androgen or estrogen on the glucose tolerance test and insulin response in female rhesus monkeys. AB - Insulin concentrations, in response to an intravenous glucose bolus after a 24 hour fast, have been studied in female rhesus monkeys in which the circulating levels of androstenedione and testosterone or estrone and estradiol have been increased for as long as 4 1/2 years. No significant differences were observed in the basal insulin or C-peptide concentrations in the androgen or estrogen-treated animals compared with each other or with normal cycling, nontreated control animals. The insulin and C-peptide responses to intravenous glucose were similar in control and androgen-treated monkeys. Compared with both the control and androgen-treated monkeys, the responses of the estrogen-treated monkeys tended to be lower but were not significantly different. The glucose disappearance rate after the intravenous glucose bolus was not significantly different in androgen and control monkeys but was significantly slower during the initial 30 minutes in the estrogen-treated monkeys compared with both the control and androgen-treated monkeys. These studies suggest that chronically elevated androgen levels in the mature female subhuman primate do not lead to insulin resistance or overt glucose intolerance. PMID- 3318473 TI - Conjoined twins in triplet pregnancy. PMID- 3318474 TI - Extracellular matrix of the human lamina cribrosa. AB - We used immunoperoxidase staining and double immunofluorescent staining to demonstrate the macromolecular components of the extracellular matrix of the lamina cribrosa from young human donors. The cribriform plates were made up of a core of elastin fibers with a sparse, patchy distribution of collagen type III. The plates were coated with collagen type IV and laminin; these basement membrane components were presumably made by the astrocytes that were distributed on the surfaces of the plates. The insertion of the lamina cribrosa in the sclera was made up of concentric, circumferential elastin fibers that surrounded the lamina cribrosa and were continuous with the elastin in the cribriform plates. Astrocytic processes extended into the bundles of elastin fibers, whereas the basement membrane components extended into the sclera. The mechanical properties of the macromolecules of the extracellular matrix of the lamina cribrosa may make this tissue compliant and sensitive to intraocular pressure. Perhaps individual differences in the macromolecular components of this tissue contribute to the glaucomatous changes in the optic nerve head. PMID- 3318476 TI - Pyogenic granuloma on a dermis fat graft in acquired anophthalmic orbits. AB - We treated exposure of the orbital implant with a dermis fat graft in two patients with an acquired anophthalmic orbit. During the first six postoperative months, a large polypoid tumor of the conjunctiva developed over the grafted tissue in each patient. Histologic examination of both lesions disclosed a pyogenic granuloma. PMID- 3318475 TI - A double-masked study of timolol and pilocarpine combined. AB - In a double-masked, randomized, multicenter study, 25 patients received timolol 0.5%-pilocarpine 2% twice a day, 25 received timolol 0.5%-pilocarpine 4% twice a day, and 25 received pilocarpine 4% four times a day. The combination drugs showed an immediate, significant reduction in intraocular pressure of 7.2 mm Hg (25%) and 10.7 mm Hg (37%), respectively. The lowered intraocular pressure level was maintained throughout the three-week test period. With pilocarpine alone, intraocular pressure was reduced 5.3 mm Hg (19%). The mean intraocular pressure 12 hours after the last dose compared to two hours after the last dose was significantly higher both in patients receiving pilocarpine four times a day and in patients receiving timolol 0.5%-pilocarpine 4% twice a day (5.1 and 3.6 mm Hg, respectively), but not in patients receiving timolol 0.5%-pilocarpine 2% twice a day (2.6 mm Hg). PMID- 3318477 TI - Functional hand evaluations: a review. AB - Describing hand prehension patterns in the context of functional hand evaluations may not provide the therapist or surgeon with an accurate portrayal of a patient's capabilities. Although dexterity involves both static and dynamic components of hand usage, most descriptions of prehension patterns study the static phase alone. Hand use is a function of anatomic integrity, mobility, strength, sensation, coordination, age, sex, mental status, disease or trauma, and the condition of other proximal extremity joints (shoulder, elbow, wrist). In this study, various descriptions of hand prehension patterns were reviewed and 11 functional hand evaluations were analyzed. The purpose was to see if the descriptions and the evaluations have common elements. The conclusions are that there are no common elements, that no hand function evaluation is appropriate for all types of patients, and that such evaluations should consist of tasks representative of everyday functional activities. PMID- 3318479 TI - Who originated the term occupational therapy? PMID- 3318478 TI - Tendon gliding exercises. AB - An exercise program for tendon gliding is introduced for use in hand treatment and rehabilitation. The program incorporates thumb range of motion and three basic fist positions: book, fist, and straight fist. The anatomic and experimental basis of this program is discussed. The exercises allow the flexor tendons to glide to their maximum potential and can greatly facilitate therapeutic activities when incorporated in a comprehensive program of occupational and hand therapy. PMID- 3318481 TI - The 3-hour therapy criterion: a challenge for rehabilitation facilities. AB - Rehabilitation hospitals and units must meet certain requirements to be reimbursed by Medicare. Section 211 of the Medicare Hospital Manual specifies that at least 3 hours a day of physical and/or occupational therapy must be provided to each patient in addition to other required therapies and services. This article discusses the political and professional context surrounding the implementation of these guidelines and some of the practical issues that managers must address in the process. A case report is used to illustrate the management strategies and specific methods that have been implemented in the Occupational Therapy Department at the Rehabilitation Institute of Chicago in response to the 3-hour criterion. Data are presented to indicate how these efforts have contributed to raising our level of compliance with the criterion during the 1985 1986 fiscal year. The compliance data are discussed in relation to variation in both the number of patients and staff productivity over the course of the year. PMID- 3318480 TI - The influence of the arts-and-crafts movement on the professional status of occupational therapy. AB - This paper explores why occupational therapists use arts and crafts as therapeutic modalities. Beginning with the turn-of-the-century origins of occupational therapy, the paper traces the similarities and differences in the ideas and beliefs of the founders of occupational therapy and the proponents of the arts-and-crafts movement. PMID- 3318482 TI - Cognitive rehabilitation: a model for occupational therapy. AB - A theoretical model that provides a foundation for understanding function and dysfunction in cognition and perception is needed as a prerequisite for the development of effective assessment and treatment tools to be used with the brain injured adult. Such a model and clear definitions are absent in the occupational therapy literature on adult brain function and dysfunction. This paper represents a cognitive rehabilitation model adapted for occupational therapy from the fields of neuropsychology and cognitive psychology. Differentiation of terms, an overview of the model's theory, and evaluation principles are discussed. Cognitive rehabilitation is presented from an information processing perspective. Three other treatment approaches identified in the literature are discussed and compared with cognitive rehabilitation. PMID- 3318483 TI - Activity: occupational therapy's treatment method. 1987 Eleanor Clarke Slagle lecture. AB - A philosophical framework to explain the value of using activity as a treatment method is the challenge pursued for this lectureship. Primary resources came from Soviet psychology, the only social science discipline using the concept of activity as a focus of study. The focus of study selected for occupational therapy is disability, which is explained within the context of doing an activity. The patient's purpose for doing an activity is described by the degree of sensorimotor thought processed during a functional state. A hierarchy of activity analysis is used to begin the development of typologies for feasible operations, satisfactory results, and desirable activities. The philosophical framework is applied to three types of patient populations that pose problems in stating treatment objectives, patients that have (a) a good prognosis but one that is associated with alternative explanations for change, (b) a poor prognosis associated with a lifelong disability, and (c) a grave prognosis associated with a progressive loss of functional abilities. A refined treatment hypothesis is suggested: Therapeutic activity compensates for disability by using remaining capabilities to accomplish desirable activities with satisfactory results. PMID- 3318485 TI - Functional morphology of the tubotympanum related to otitis media: a review. AB - One of the important functions of the tubotympanum is to protect the middle ear from invading organisms. The host develops a number of strategies for this function (e.g., mucociliary protection, antibacterial secretory products, immunodefense, and phagocytosis). The bacteria also develop their strategy to evade the host protection by enhancing adherence to the mucosal surfaces, impairing mucociliary function, and evading phagocytosis. PMID- 3318484 TI - Ossicular reconstruction: a comparison of reported results. AB - The world literature was reviewed to determine which materials in ossicular reconstruction provided good long-term results. Several key publications were selected to illustrate particular points. Attention was paid to numbers of cases reported, reconstruction used, length of follow-up, and influence of middle ear disease. The review concentrated on three materials: bone, Plastipore, and bioglass. Results suggest that bone-to-bone ossicular reconstruction by experienced otologists can provide good long-term results even in high-risk ears. The review also suggests that other materials can provide similar long-term results in low-risk ears. Prospective studies with longer follow-up are needed to determine whether all materials provide comparable results in patients with comparable middle ear disease. PMID- 3318487 TI - Early master hearing aids. PMID- 3318486 TI - Surgical approaches to the human cochlear nuclear complex. AB - Patients with bilateral neural deafness may be candidates for rehabilitation with a device that provides direct electrical stimulation of the central nervous system. The cochlear nuclear complex at the pons-medulla junction is a logical site to implant because it is in the surgical field exposed for acoustic tumor surgery. In this study we compared four surgical approaches commonly used to reach the cerebellopontine angle for ease of access to the cochlear nuclear complex. We found the translabyrinthine approach to be the most satisfactory because the anterior approach facilitates identification of key landmarks, such as the tenia of the choroid plexus and the lateral recess of the fourth ventricle. The suboccipital, or retrosigmoid, approach would be satisfactory after removal of a large acoutic tumor; however, the amount of cerebellar retraction necessary may preclude its use in nontumor cases. PMID- 3318488 TI - A classification of European skulls from three time periods. AB - We analyze the taxonomic structure of European populations at three time periods, the Early Middle Ages, the Late Middle Ages and the Recent Period. The data consist of sample means for 10 cranial variables based on 137, 108, and 183 samples for the three periods. Clustering by standard numerical taxonomic procedures reveals that the data are represented only poorly as hierarchic classifications. The clusters form significant and moderately strong associations with an arrangement of the samples by regions (geography) and by language family. Whereas during the early period, language family showed a stronger association with clusters based on cranial morphology, in the recent populations these clusters correspond better with geography than with language. Ordinations of these populations by means of nonmetric multidimensional scaling shows the continuity of the taxonomic structure at all three periods. Only a few populations are outliers. The relations between phenetic distances (cranial morphology), geography, and language are examined by means of multiple Mantel tests. At all three periods geography is correlated somewhat more strongly with phenetics than is language affiliation, but the correlation with the latter increases with time. When the data are pooled over the three periods, the populations tend to group by language affiliation more than they do by period. Ordination of the pooled data reveals language patterns rather than patterns due to period, showing strong shifts in cranial measurements through time. These analyses show that while there is no clear-cut taxonomic structure in European populations that would justify the traditional classifications based on the crania, there are significant and important associations with both language affiliation, geography, and time period, in this order. These patterns are likely to have become established through the migration and subsequent expansion of populations into their areas of occupation during the time interval studied rather than by geographic differentiation in situ. PMID- 3318489 TI - Cranial variation in European populations: a spatial autocorrelation study at three time periods. AB - This study reports on spatial variation of 10 cranial variables in European populations at 3 time periods. Means for these variables, based on 137, 108, and 183 samples from the Early Medieval, Late Medieval, and Recent periods, were subjected to one-dimensional and directional spatial autocorrelation analyses. Significant spatial structure was found for most variables. It becomes more pronounced as time progresses. The spatial patterns are not strongly clinal. Correlograms based on distances computed from all variables are monotonic only to 900, 1,650, and 1,350 km for the three periods. Regional patterns are seen for most variables and become more structured and significant with time. There is little similarity among the correlograms of the variables at any one period and virtually none among periods. Inferences about spatial structure of these populations, based on spatial autocorrelation analysis, suggest a pattern dominated by migration, followed by expansion and admixture rather than selection or chance fluctuations. The patterns of morphometric change seem to reflect the patterns of linguistic change in these areas. PMID- 3318490 TI - Hypothesis: a selective advantage for cystic fibrosis heterozygotes. AB - European populations have both a particularly long history of pulmonary tuberculosis and extremely high frequencies of cystic fibrosis (CF). While carriers of the recessive gene are asymptomatic for CF disease, their fibroblasts produce excessive amounts of hyaluronic acid, whose role in successful isolation of virulent pathogens appears to be especially adaptive in host resistance to the human strain of Mycobacterium tuberculosis. CF heterozygosity may have been an adaptation to a disease environment once dominated by this infection. PMID- 3318491 TI - Thermic effect of food: possible implication of parasympathetic nervous system. AB - To investigate the effect of the autonomic nervous system on the thermic response to food ingestion, respiratory exchange measurements were performed on seven healthy young men for 1 h and 45 min before and 6 h after ingestion of a mixed meal, approximately 560 kcal, 53% carbohydrate, 30% fat, and 17% protein (control) and under the same conditions during infusion of either propranolol (80 micrograms/kg bolus and 1 microgram.kg-1.min-1), atropine (10 micrograms/kg and 10 micrograms.kg-1.min-1), or atropine plus propranolol. The postabsorptive resting metabolic rates were the same on each occasion and were slightly altered by drug treatment. The thermic responses to the meal were the same with the control and propranolol tests (9.3 +/- 0.9 and 9.2 +/- 0.5%, respectively) and were greater (P less than 0.001) than with atropine 3.6 +/- 0.6% and atropine plus propranolol 3.3 +/- 0.8%. Blockade of the sympathetic nervous system does not decrease the thermic response to food taken orally, whereas muscarinic receptor blockade does. Although some confounding effects of atropine might explain some of this decrease, our results suggest that the parasympathetic nervous system is involved in the thermic effect of food. PMID- 3318493 TI - Hormonal control of postprandial thermogenesis in dogs. AB - The role of catecholamines, insulin, and thyroid hormones on postprandial thermogenesis was determined in dogs. O2 consumption (VO2) and respiratory quotient (RQ) were continuously monitored 1 h before and 2 h after a 1,016-kcal meal under the three following experimental conditions corresponding to 1) normal feeding, 2) sham feeding (with food deflected into an esophageal pouch), and 3) tube feeding intragastrically. A first phase (cephalic phase), lasting at least 45 min, was observed during both normal and sham feeding, whereas a second phase (digestive phase), occurred in both normal and tube feeding. Increases of 260% for norepinephrine (NE) were found during the cephalic phase in both normal and sham feeding. Epinephrine (E) increased by 425 and 600% during this early phase in normal and sham feeding, respectively. No change in plasma catecholamines was found in the tube-feeding experiment. Large increases of 75 and 39 microU/ml of insulin occurred early after the meal in both normal and sham feeding, whereas insulin increased only after 30 min in tube feeding. Thyroxine and triiodothyronine were not changed with any feeding experiment. Insulin change was positively correlated with NE and E changes rather than with glucose change during the cephalic phase after feeding. The results suggest an important role of catecholamines in the increased postprandial thermogenesis during the cephalic phase with a possible modulating effect of insulin. PMID- 3318492 TI - Improved insulin action in muscle, liver, and adipose tissue in physically trained human subjects. AB - The present studies were initiated to assess the effect of insulin on muscle, liver, and adipose tissue in eight control and eight physically trained individuals matched for age and body mass index. Results indicated that percent body fat was 53% lower and maximal oxygen consumption 50% higher in physically trained subjects. Although the plasma glucose response to a standard oral glucose challenge was similar in the two groups, the insulin response was significantly lower in the trained individuals (P less than 0.001). Mean (+/- SE) insulin stimulated glucose uptake, quantified in vivo by the euglycemic hyperinsulinemic clamp technique, was significantly greater in physically trained individuals at steady-state plasma insulin concentrations of approximately 10 microU/ml (3.41 +/ 0.14 vs. 2.73 +/- 0.22 mg.kg fat free mass-1.min-1, P less than 0.05) and 50 microU/ml (13.58 +/- 0.75 vs. 9.82 +/- 0.53 mg.kg fat free mass-1.min-1, P less than 0.001). In addition, mean (+/- SE) hepatic glucose production rate was lower in physically trained subjects at insulin levels of 10 microU/ml (0.63 +/- 0.19 vs. 1.19 +/- 0.22 mg.kg body wt-1.min-1, P less than 0.05) and 50 microU/min (0.18 +/- 0.14 vs. 0.60 +/- 0.17 mg.kg body wt-1.min-1, P less than 0.05). Finally, the ability of insulin to stimulate mean (+/- SE) glucose uptake above basal levels was greater in adipocytes isolated from trained individuals (94 +/- 10 vs. 56 +/- 14 fl.cell-1.s-1, P less than 0.01). On the other hand, no difference in specific binding of insulin to its receptor on monocytes was noted between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318494 TI - Reconstructing the rate of appearance of subcutaneous insulin by deconvolution. AB - In this paper a deconvolution scheme is presented to reconstruct the rate of appearance of subcutaneously injected insulin. Relevant aspects of experiment design are briefly described. Intravenous insulin kinetics are modeled to determine the impulse response of the system. The deconvolution problem is not ill conditioned and is solved using a least-squares method without imposing constraints on the input. An estimate of the error of the reconstructed input is provided. The reliability of the deconvolution scheme is tested by means of an independent validation study. Finally, the different sources of error that affect the method are discussed, and a figure of the global error is derived. PMID- 3318495 TI - Altered sensitivity of the gallbladder to cholecystokinin octapeptide in irritable bowel syndrome. AB - We compared responses of the gallbladder to graded intravenous infusions of cholecystokinin octapeptide (CCK-OP) in normal controls (n = 8) and patients with irritable bowel syndrome (IBS) with predominant constipation (n = 8) or diarrhea (n = 8). The doses of CCK-OP ranged from subphysiological (negligible contraction of the gallbladder) to supraphysiological (90% contraction of gallbladder and abdominal side effects) amounts. All gallbladders contracted progressively in response to CCK-OP, and a Weibull model (power exponential function) described precisely the gallbladder's response to CCK-OP. Patients with IBS responded differently from normal patients; those with constipation contracted their gallbladders more and those with diarrhea contracted less in response to the peptide. Gallbladders were also stimulated with a high-fat, liquid meal; all patients' gallbladders contracted, but clear differences between groups could not be demonstrated postprandially. The results suggest that the smooth muscle of the gallbladder in IBS has an abnormal sensitivity to CCK-OP, and the results support the concept that IBS can be a generalized abnormality of the smooth muscle of the digestive tract. PMID- 3318497 TI - Structure and development of the glomerular capillary wall and basement membrane. AB - The renal glomerular epithelium, Bowman's capsule, and tubule originate from a condensate of mesenchymal cells induced to undergo epithelial differentiation by a branch of the uretic bud. These nephrogenic cells aggregate and begin synthesizing the basement membrane molecules collagen type IV, heparan sulfate proteoglycans, and laminin as shown by immunofluorescence microscopy. Soon, the primitive nephron is invaginated by mesenchymal cells that establish the glomerular endothelium. Electron microscopy, metabolic labeling, and immunocytochemical techniques show that the endothelium and epithelium of early stage glomeruli each synthesize a basement membrane that appears to fuse, giving rise to the glomerular basement membrane (GBM). As development progresses, however, bulk GBM biosynthesis by the endothelium greatly diminishes or ceases. In contrast, GBM assembly by the epithelial podocytes continues and segments of new GBM appear beneath developing foot processes. In vivo labeling experiments with anti-laminin antibodies have shown that this new GBM derived from podocytes is subsequently spliced into existing GBM as capillary loop diameters expand. Molecular mechanisms for basement membrane fusion or splicing are not presently known but may involve partial enzymatic digestion and specific binding interactions among GBM components. The developing glomerular capillary wall, which filters plasma from very early stages, becomes decreasingly permeable to perfused macromolecules such as ferritin or immunoglobulin as the glomerulus matures. Evidence from immunolabeling studies showing that some monoclonal IgGs bind to the GBM only at specific developmental stages also indicates that temporal biochemical changes take place during GBM assembly. Such changes could include molecular rearrangement during basement membrane fusion and splicing and/or enzymatic and compositional modifications during maturation of the filtration barrier. PMID- 3318496 TI - Control of renin release by dietary NaCl in the rat. AB - The purpose of the present study is to determine whether changes of plasma renin activity (PRA) induced by dietary NaCl are mediated by a renal tubular mechanism or by a neural mechanism. Male Sprague-Dawley rats were placed on low-, normal-, or high-NaCl diets for 1 wk (n = 8 for each group). There were no group differences of glomerular filtration rate (GFR), renal plasma flow, Na+ or Cl- delivery to the loop, Na+ or Cl- reabsorption in the loop, Na+ or Cl- concentration in early distal tubular fluid, or Na+ or Cl- delivery to the early distal tubule. PRA of rats on normal NaCl (4.8 ng.ml-1.h-1 +/- 0.8) was greater (P less than 0.05) than that of rats on high NaCl (3.3 +/- 0.4) and less (P less than 0.05) than that of animals on low NaCl (9.1 +/- 1.8). To determine whether alterations of PRA by dietary NaCl might be related to low-pressure baroreceptors with vagal afferents, animals were bilaterally vagotomized after micropuncture. Forty-five minutes after vagotomy, PRA increased (P less than 0.05) on each of the diets, however, after vagotomy mean PRA in animals fed normal (10.9 +/- 1.8) and low NaCl (13.2 +/- 2.2) did not differ. Thus our results do not support the hypothesis that suppression of PRA by dietary NaCl loading is related to a renal tubular mechanism. A vagally mediated mechanism may contribute to renin suppression by dietary NaCl. PMID- 3318498 TI - Luminal and basolateral uptake of insulin in isolated, perfused, proximal tubules. AB - The present study was performed to quantitate and compare the luminal and the peritubular uptake of 125I-labeled insulin in isolated, perfused, proximal tubules from rabbit kidneys. 125I-insulin was added in physiological concentrations of 3.0-7.0 ng/ml or 59.0-89.5 ng/ml (high insulin concentrations) to either the perfusate or the bath fluid for 30 min. The luminal uptake in 30 min averaged 0.76 pg/mm at physiological concentrations and 18.0 pg/mm at high insulin concentrations. About 15-41% of the absorbed insulin was digested and less than 5% was transported from the lumen to the peritubular space as intact insulin. The peritubular binding/uptake of 125I-insulin at physiological and high concentrations in the bath was 0.136 and 0.318 pg, respectively. Addition of excess unlabeled insulin (10(-5) M) to the bath produced significant inhibition of binding (53.7%) at 7.0 ng/ml, but no inhibition at 89.5 ng/ml labeled insulin in the bath. This indicates that insulin is bound/absorbed at the basolateral membranes both by a saturable specific mechanism and a nonspecific, nonsaturable mechanism. The basolateral absorption constituted 15.2 and 1.8% of the total tubular extraction of insulin at physiological and high insulin concentrations, respectively. Electron microscope autoradiography showed that, after luminal as well as basolateral endocytosis, insulin was exclusively accumulated in endocytic vacuoles and lysosomes. PMID- 3318499 TI - Effect of acute renal failure on insulin disposition in the isolated perfused rat kidney. AB - The renal disposition of insulin in acute renal failure has not been evaluated. We used the isolated perfused rat kidney to test the hypothesis that acute renal failure (ARF) decreases renal insulin clearance. We used warm ischemia for 45 min, uranyl nitrate 5 mg/kg, ureter ligation, and nonfiltering kidneys as methods of inducing ARF. Comparisons were made with normal control kidneys. The concentrations of insulin in perfusate and urine was determined by radioimmunoassay. Acute renal failure caused significant reductions in glomerular filtration rate, sodium and potassium reabsorption, and an increased urine pH. Warm ischemia and uranyl nitrate toxicity caused a 50% decrease in the renal clearance of insulin. Nonfiltering kidneys cleared insulin at a rate 90% decreased from controls. Ureteral ligation caused a 32% decrease in insulin clearance. Filtration was necessary for insulin to be cleared from perfusate. We conclude that ARF decreased renal insulin clearance through a decrease in insulin uptake from both the tubular lumen and peritubular surface. PMID- 3318500 TI - Role of prostaglandin in norepinephrine and renin release in canine kidney. AB - We investigated renin and norepinephrine (NE) release during electrical renal nerve stimulation (RNS) in relation to prostaglandin (PG) E2 concomitantly produced by the kidney in anesthetized dogs. During 10 min of continuous RNS (2.5 4 Hz), the increases in renin, NE, and PGE2 secretion rates were determined at 1 and 10 min after the start of stimulation. Under control conditions, almost the same extent of increase in the NE secretion rate was observed at 1 and 10 min of RNS, whereas the increase in renin secretion rate at 1 min of RNS was followed by a further increase at 10 min of RNS. On the other hand, an upward but not significant trend of increase in PGE2 secretion at 1 min of RNS was followed by a substantial level at 10 min of RNS. After administration of indomethacin, the increase in NE secretion rates at both 1 and 10 min of RNS were not altered, but the increase in renin secretion rate at 10 min of RNS was suppressed by approximately 50%, without any reduction of the increase in the renin secretion rate at 1 min of RNS. Consequently, the time-related change in the renin secretion rate during RNS was abolished. These results suggest that renin response to continuous RNS is enhanced by concomitantly generated PGs but not by NE, and furthermore, that endogenously generated PGs do not inhibit the release of NE from canine renal nerve endings. PMID- 3318501 TI - Effects of altered NaCl intake on renal hemodynamic and renin release responses to RNS. AB - Relationships between frequency of renal nerve stimulation (RNS) and renal blood flow (RBF), glomerular filtration rate (GFR), and plasma renin activities (PRA) were evaluated in anesthetized dogs placed on low (5 meq/day)-, normal (40 meq/day)-, and high (200 meq/day)-sodium chloride diets. Arterial pressure, RBF, GFR, and renal venous and arterial PRA were determined before and during direct electrical RNS at 0.5, 1.0, and 2.0 Hz (15 V, 1.0 ms). Dogs on low sodium intakes increased renal venous PRA at 0.5, 1.0-, and 2.0-Hz RNS, whereas dogs on normal sodium intakes did not increase renal venous PRA until RNS reached 2.0 Hz. High sodium dogs did not increase PRA at any frequency of RNS tested. RNS at 0.5 Hz was not associated with any changes in GFR or RBF in any of the groups. Dogs on normal sodium and high sodium intakes decreased both GFR and RBF during 1.0- and 2.0-Hz RNS. Low-sodium dogs, however, only decreased GFR and RBF during 2.0-Hz RNS, and these hemodynamic responses were significantly less than 2.0-Hz GFR and RBF responses of high sodium dogs. These data indicate that renal vasoconstrictor responses to RNS are potentiated, and renin release responses to RNS are reduced by elevation of sodium chloride intake. We suggest that during low sodium intake, activation of sympathetic nerve activity elicits an enhanced renin release response, whereas the renal vasculature may be protected against neurogenic vasoconstriction. PMID- 3318502 TI - Arteriolar oxygen reactivity: where is the sensor? AB - The hypothesis that arterioles are intrinsically sensitive to oxygen was tested by comparing arteriolar diameter responses with local and global PO2 changes in superfused hamster cheek pouch preparations. Local PO2 changes were produced by microapplication of fluid onto the surface of occluded or unoccluded aparenchymal arterioles or by cannulation and perfusion of arterioles in situ. Global changes refer to PO2 changes in the superfusate flowing over the entire preparation. Local, effective PO2 changes had no significant effect on arteriolar diameters. In contrast, global PO2 changes produced significant, reproducible changes in diameter. These observations do not support the hypothesis that arterioles are intrinsically oxygen sensitive, unless the oxygen-sensitive sites are distributed sparsely along the arteriolar tree. The data are consistent with oxygen sensors located either in vessels downstream from 15-micron arterioles (in terminal arterioles, capillaries, or venules) or in the parenchyma. The data also suggest that these sensors detect changes in PO2 and then initiate responses that can be conducted along the vasculature to an arteriole distant from the sensor. PMID- 3318503 TI - Development of coronary collateral circulation in left circumflex Ameroid occluded swine myocardium. AB - Coronary collateral development was examined in 34 pigs after gradual occlusion of the left circumflex coronary artery (LCX) with an Ameroid constrictor. Collateral development was assessed by measurements of myocardial blood flow and regional myocardial function at rest and during exercise over a 16-wk period after placement of the constrictor. Coronary collateral development was adequate to prevent severe infarction and restore blood flow to the collateral-dependent LCX region within 3-7 wk. Infarction averaged 5.0 +/- 1.3% of the LCX region. Blood flows at rest were 1.05 +/- 0.14 and 1.13 +/- 0.15 ml.min-1.g-1 in the subendocardium of the collateral and control regions, respectively, 7 wk postoperatively. Concurrently, collateral vessel development supported normal myocardial function at rest as determined by systolic wall thickening in the LCX region. However, collateral development was limited, since blood flows during moderate and severe exercise were reduced in the LCX region compared with control and left anterior descending and right coronary regions. Blood flow ratios (collateral/control flow) during severe exercise 3 wk postoperatively were 0.23 +/- 0.03 and 0.57 +/- 0.05 in the subendocardium and subepicardium and were constant throughout the 16-wk period throughout the study. Myocardial function of the collateral region also was reduced during exercise and a 30-min recovery period. We suggest that this limited coronary collateral circulation, which develops in response to gradual coronary occlusion in swine, serves as a model for the human collateral circulation for the study of protocols to alter growth and development of coronary collateral vessels. PMID- 3318504 TI - Skeletal muscle blood flow capacity: role of muscle pump in exercise hyperemia. AB - An appreciation for the potential of skeletal muscle vascular beds for blood flow (blood flow capacity) is required if one is to understand the limits of the cardiorespiratory system in exercise. To assess this potential, an index of blood flow capacity that can be objectively measured is required. One obvious index would be to measure maximal muscle blood flow (MBF). However, a unique value for maximal MBF cannot be measured, since once maximal vasodilation is attained MBF is a function of perfusion pressure. Another approach would be to measure maximal or peak vascular conductance. However, peak vascular conductance is different among skeletal muscles composed of different fiber types and is a function of perfusion pressure during peak vasodilation within muscle composed of a given fiber type. Also, muscle contraction can increase or decrease blood flow and/or the apparent peak vascular conductance depending on the experimental preparation and the type of muscle contraction. Blood flows and calculated values of conductance appear to be greater during rhythmic contractions (with the appropriate frequency and duration) than observed in resting muscle during what is called "maximal" vasodilation. Moreover, dynamic exercise in conscious subjects produces the greatest skeletal muscle blood flows. The purpose of this review is to consider the interaction of the determinants of muscle blood flow during locomotory exercise. Emphasis is directed toward the hypothesis that the "muscle pump" is an important determinant of perfusion of active skeletal muscle. It is concluded that, during normal dynamic exercise, MBF is determined by skeletal muscle vascular conductance, the perfusion pressure gradient, and the efficacy of the muscle pump. PMID- 3318505 TI - Osmoregulation and control of vasopressin secretion in healthy humans. AB - The functional characteristics of osmoregulated vasopressin secretion can be defined in terms of an osmotic threshold for its release and a sensitivity of the osmoreceptor and vasopressin-secreting unit. Osmotically stimulated thirst has features similar to osmoregulated vasopressin. There are wide individual variations in the functional characteristics of both thirst and vasopressin release in healthy humans, probably genetic in origin. The influence of aging appears to enhance the sensitivity of vasopressin secretion but blunt thirst appreciation. Yet in many physiological situations changes in osmoregulated vasopressin release and thirst occur in parallel. The fall in plasma osmolality associated with human pregnancy is accounted for entirely by a lowering of the osmotic thresholds for thirst and vasopressin release. Similar but less marked alterations accompany the ovulatory luteal phase of the menstrual cycle. A major nonosmotic stimulus to vasopressin secretion is hypotension and/or hypovolemia, mediated by high- (carotid sinus) and low- (left atrial) pressure receptors. Circulating catecholamines influence the release of vasopressin by alpha- and beta-adrenergic pathways. Drinking by hypertonic humans provides immediate reduction in thirst and vasopressin secretion probably mediated by pathways from the oropharynx. The modest but variable rise in plasma vasopressin in response to hypoglycemia appears to be due to cellular neuroglycopenia and is independent of parasympathetic pathways. Although osmotic and hemodynamic stimuli to vasopressin release do not act independently of each other, the precise subtle interactions between them and other nonosmotic stimuli remain to be clarified. PMID- 3318506 TI - Pressor sensitivities to vasopressin, angiotensin II, or methoxamine in diabetic rats. AB - We investigated the pressor sensitivities to vasopressin, angiotensin II, and methoxamine of intact and ganglion-blocked rats that had been treated 21 days earlier with streptozotocin or saline. No differences in blood pressure or heart rate responses to vasopressin or angiotensin II were found between the intact groups when these peptides were administered intravenously in equimolar doses. After ganglion blockade a significant enhancement in pressor responsiveness to both vasopressin and angiotensin II was observed in the control groups, but in the streptozotocin-treated animals no enhancement in pressor sensitivity to vasopressin was found. Furthermore, although a significant augmentation of the responses to angiotensin II was observed, it was smaller than that seen in the ganglion-blocked control group. Neither group showed enhanced pressor responsiveness to methoxamine. These results indicate that the previously observed diminished contributions from endogenous vasopressin and the renin angiotensin system to blood pressure recovery following ganglion blockade in streptozotocin-treated rats may have been due, at least in part, to diminished pressor responsiveness. PMID- 3318508 TI - Interleukin 1 affects glucose homeostasis. AB - Alterations in glucose metabolism are known to occur during certain types of inflammation and infectious diseases. Interleukin 1 (IL 1), an immune-derived cytokine released during these processes, is proposed to function as a mediator of such alterations, since administration of low subpyrogenic doses of human rIL 1 to mice and rats produced hypoglycemia. In mice this effect was paralleled by increased insulin, glucagon, and corticosterone blood levels. When IL 1 was repeatedly injected, mice remained hypoglycemic for at least 14 h after the last injection. Furthermore, these animals responded normally to a challenge with glucose, thus suggesting that the proper function of the pancreas was preserved. A moderate hypoglycemia, paralleled by increased glucagon and corticosterone blood levels, was also observed in IL 1-injected rats, but no increase in insulin levels was detected. IL 1 administration to adrenalectomized rats resulted in a more marked hypoglycemia and in a profound hypoinsulinemia. The results suggest that IL 1 causes hypoglycemia by increasing insulin blood levels and probably also by mechanisms independent of the insulin secretagogue action of this cytokine. PMID- 3318507 TI - Pulsatile secretion of growth hormone and insulin in relation to feeding in rats. AB - In unrestrained male Wistar rats chronically implanted with intracardiac catheters, blood samples were taken every 20 min throughout the 24 h of the diurnal cycle. Plasma concentrations of growth hormone (GH), insulin, and glucose were measured. The pattern of food intake was continuously monitored. The existence of 3-h pulsatile cycles of GH secretion was confirmed. In addition, short bursts of insulin secretion were observed in the middle of every second GH peak-to-peak interval. Food intake appeared to be enhanced during short periods that corresponded with GH release into the blood and was reduced during the GH peak-to-peak periods in which the bursts of insulin secretion were observed. From these observations this study draws a schematic relationship between the rhythmicity of the secretion of GH and insulin and the probability of occurrence of feeding. We speculate that the rhythmic endocrine activity may be causally related to feeding. PMID- 3318509 TI - Separation of captopril effects on salt and water intake by subfornical organ lesions. PMID- 3318510 TI - Elements of the private therapeutic interview. AB - A previous paper explored the differences between a psychiatric interview that is entirely private and one observed by way of a mechanical device. The attempt to explore such differences raises questions about what are the special elements in the private interview that rely heavily on privacy. This paper focuses on 1) the specific rhythms that are worked out within each patient-therapist dyad; 2) the quality of the concentration of one individual on another; 3) the capacity for undoing, or taking back, previously stated positions; and 4) the difference between the intimacy developed through privacy in everyday social situations and that achieved in the therapeutic relationship. PMID- 3318511 TI - A critical discussion of DSM-III dysthymic disorder. AB - The authors review the history of the concept of dysthymia and the literature on the epidemiology, course, and treatment of chronic depression. They present a critical discussion of DSM-III and DSM-III-R criteria for dysthymic disorder. On the basis of this review, they suggest that future revisions of the nomenclature include further subcategorization of chronic depressive disorders and that the term "dysthymic disorder" be reserved for chronic depressive disorders with an insidious onset at an early age. The relationships between dysthymic disorders and personality disorders and the response of subcategories of chronic depression to different treatment modalities need to be researched. PMID- 3318512 TI - Gastric endocrine cell hyperplasia and carcinoid tumors in atrophic gastritis type A. AB - Immunohistochemical, histochemical, and morphometrical studies of six gastric carcinoid tumors and their possible precursor lesions in gastric mucosa are reported. All tumors, presenting successively at our institute, occurred in the corpus mucosa of 45- to 78-year-old patients. Two neoplasms had already metastasized. Three tumors contained gastrin- and/or serotonin-positive cells. Two groups of carcinoids, one with atrophic gastritis type A [AGA (four cases)], and one without AGA (two cases) were discerned. Only cases with AGA showed antral G cell hyperplasia consistently as well as fundic endocrine cell proliferation and sometimes multifocal tumors. This confirms previous reports that hypergastrinemia might be a predisposing condition for the development of gastric carcinoids in AGA. Fundic endocrine cell increase, verified by quantitative methods, was either diffuse or nodular. Diffuse endocrine cell hyperplasia comprised G, EC, and ECl cells. The observation that endocrine cell nodules comprised a similar mixture of endocrine cells, sometimes communicating with glands of pseudopyloric metaplasia and proving to be reversible in one case, provides evidence that these nodules are hyperplastic, but finally may lead to gastric carcinoid tumors in AGA. Size less than 150 micron, basal location, and mixed hormone content may be helpful criteria for the distinction of hyperplastic endocrine cell nodules from small carcinoid tumors. PMID- 3318513 TI - Idiopathic small airways pathology in patients with graft-versus-host disease following allogeneic bone marrow transplantation. AB - In a retrospective analysis (July 1979 to March 1984) of 120 allogeneic adult bone marrow transplant recipients, we identified seven patients with small-airway disease for whom no microbiologic agent was detected. Six had pulmonary function studies demonstrating air flow obstruction. Five of the seven patients had an open-lung biopsy showing pathologic changes within small airways; these varied from early bronchiolar wall damage to bronchiolitis obliterans. The inflammatory cell infiltrate was peribronchiolar, and consisted of polymorphonuclear leukocytes and lymphocytes in varying proportions. Three of the seven patients recovered following increased immunosuppressive therapy; the other four died. Because all seven patients had acute and chronic graft-versus-host disease, in the absence of any identifiable pathogen, we postulate that small-airway damage represents one of the facets of graft-versus host-disease. An additional analysis of 26 patients with respiratory symptomatology and available histologic material supports the hypothesis that small-airway disease in bone marrow transplant patients represents a risk factor for the subsequent development of respiratory opportunistic infections. PMID- 3318514 TI - The clinical stimulus to research on parasitic disease: lessons from life. PMID- 3318515 TI - In vitro susceptibility of Plasmodium falciparum isolates from Jilore, Kenya, to antimalarial drugs. AB - Twenty-six Plasmodium falciparum isolates obtained during a prophylaxis study at Jilore primary school, Malindi, Kenya, were adapted to in vitro culture and their susceptibility to 13 antimalarial drugs was tested by a modified radioisotopic method. Pyrimethamine, chloroquine, amodiaquine, cycloguanil, chlorcycloguanil, quinine, quinidine and sulfadoxine, and the experimental compounds MB 35769, mefloquine, WR 184806, parvoquone, and menoctone were used. The isolates could be divided into two groups with significantly different susceptibility to pyrimethamine, shown by a 755-fold difference in the mean ID50 values (2.77 +/- 1.98 x 10(-10) mol/l and 2.09 +/- 1.64 x 10(-7) mol/l). The mean susceptibility of the two groups differed 7.7-fold for chlorcycloguanil and 14.6-fold for cycloguanil, but were not significantly different for the other drugs. All isolates were more sensitive to amodiaquine than to chloroquine in vitro. The ratio of the geometric mean ID50 values of chloroquine to amodiaquine was 3.13. The ratio for the chemically related compounds parvoquone to menoctone was 5.63, quinine to quinidine was 5.58, and mefloquine to WR 184806 was 12.16. PMID- 3318516 TI - Low sensitivity to chloroquine and quinine of Plasmodium falciparum isolates from Guinea in March 1986. AB - An in vitro study performed using an isotopic method showed a decrease in susceptibility to chloroquine, quinine, and possibly mefloquine of 44 Plasmodium falciparum isolates collected in and around the city of Conakry in Guinea. Resistance to chloroquine was demonstrated by a mean EC99 at 149 nmol/l, above the cut-off value of 114 nmol/l. The mean EC99 for quinine reached 4,999 nmol/l; that is 5 times higher than that recorded in Gabon. Data collected in Guinea, where for many years drugs have been less readily available than in neighboring countries, do not suggest that drug pressure was essential for selecting resistant parasites. PMID- 3318519 TI - Cellular response against exoerythrocytic forms of Plasmodium berghei in rats. AB - Rats were infected with Plasmodium berghei sporozoites, and 47, 51, and 57 hr later exoerythrocytic parasites were examined by electron microscopy. At 47 hr, approximately 30% of nearly mature exoerythrocytic parasites were degenerating and were surrounded by a cellular infiltrate of Kupffer cells, monocytes, monocyte-derived macrophages, and neutrophils. Neutrophils appeared to be actively ingesting electron-dense fuzzy parasite material which was normally present in the parasitophorous vacuole. By 51 hr other mononuclear cells penetrated with filopodia between the host hepatocyte and exoerythrocytic parasite, and directly into the exoerythrocytic parasite. Exoerythrocytic parasites that formed merozoites at 51 hr lacked any notable cellular infiltration. PMID- 3318518 TI - Antibodies to Pf155, a major antigen of Plasmodium falciparum: longitudinal studies in humans. AB - Antibodies to Pf155, a major Plasmodium falciparum antigen detected in the membrane of glutaraldehyde-fixed and air-dried erythrocytes infected with P. falciparum, were studied in serum samples collected from patients treated for neurosyphilis by induced P. falciparum infection. In 3 patients with no previous documented exposure to malaria, the antibodies were detected late and reached low titers. In 5 patients with extensive previous malaria infections, the antibodies appeared rapidly and reached high titers. The immunofluorescence findings were confirmed by immunoblots. No correlation was observed between antibodies to Pf155 and antibodies detected by standard immunofluorescence with whole parasite antigen. PMID- 3318517 TI - Detection and anatomical localization of Plasmodium falciparum circumsporozoite protein and sporozoites in the afrotropical malaria vector Anopheles gambiae s.l. AB - Salivary glands from Anopheles gambiae s.l. collected in Burkina Faso, West Africa, were analyzed by both microscopic examination and immunoradiometric assay to determine the Plasmodium falciparum sporozoite rates. Using the same mosquito samples, the immunoassay revealed positive salivary glands with low sporozoite loads, which were frequently missed by microscopy. A closer agreement between both techniques was found using salivary glands with high sporozoite loads. We also found a number of mosquitoes with uninfected salivary glands which harbored the circumsporozoite antigen in their thoraces. In a particular village these mosquitoes represented 43.5% of all sporozoite antigen carrying specimens. PMID- 3318520 TI - Knob antigen deposition in cerebral malaria. AB - Plasmodium falciparum-infected erythrocytes attach to the endothelial cells via electron-dense knobs and this attachment has been suggested as one of the contributing factors in the development of cerebral malaria. Monoclonal antibodies against an 80-95 Kd knob protein were prepared and applied to brain tissue from cerebral malaria patients. The deposition of the 80-95 Kd knob protein antibodies was observed in the basement membrane of cerebral capillaries by the peroxidase anti-peroxidase method. This result indicates involvement of knob protein deposition in the pathogenesis of cerebral malaria. PMID- 3318521 TI - Studies of Trypanosoma cruzi clones in inbred mice. III. Histopathological and electrocardiographical responses to chronic infection. AB - Histopathological and electrocardiographical (ECG) changes occur in the heart of C3H/HeN and C57BL/6 mice infected for 1 year with Trypanosoma cruzi clones Sylvio X10/4 (X10/4), Miranda/78 (M/78), or Miranda/80 (M/80). Heart parasitism and a variable degree of inflammation occurred following infection with clones X10/4 or M/78 but not with M/80. Clone X10/4 caused more extensive myocardial inflammation and fibrosis than clone M/78. Myocardial fibrosis was more extensive in C3H than in C57 mice infected with clone X10/4. The normal ECG pattern of C3H mice is distinctly different from C57 mice. The PR intervals of mice infected with clone X10/4 greater than M/78 greater than M/80 approximately equal to controls. ECG abnormalities occurred more frequently in mice infected with clone X10/4 than in controls or mice infected with either M/78 or M/80 regardless of strain or sex and were generally more severe in C57 than in C3H infected with X10/4. First degree atrioventricular block occurred more frequently in C3H mice infected with clone X10/4 or M/78 and C57 mice infected with X10/4 than in all other groups. Complete atrioventricular dissociation occurred frequently in C57 mice infected with X10/4 and rarely in other mice. These results demonstrate that the myocardial response of mice to T. cruzi infection, both histological and electrophysiological, is modulated by both the mouse strain and the parasite isolate used. PMID- 3318522 TI - The ecology of western equine encephalomyelitis virus in the Central Valley of California, 1945-1985. AB - Reeves' concept of the summer transmission cycle of western equine encephalomyelitis virus in 1945 was that the virus was amplified in a silent transmission cycle involving mosquitoes, domestic chickens, and possibly wild birds, from which it could be transmitted tangentially to and cause disease in human and equine populations. Extensive field and laboratory studies done since 1945 in the Central Valley of California have more clearly defined the specific invertebrate and vertebrate hosts involved in the basic virus transmission cycle, but the overall concept remains unchanged. The basic transmission cycle involves Culex tarsalis as the primary vector mosquito species and house finches and house sparrows as the primary amplifying hosts. Secondary amplifying hosts, upon which Cx. tarsalis frequently feeds, include other passerine species, chickens, and possibly pheasants in areas where they are abundant. Another transmission cycle that most likely is initiated from the Cx. tarsalis-wild bird cycle involves Aedes melanimon and the blacktail jackrabbit. Like humans and horses, California ground squirrels, western tree squirrels, and a few other wild mammal species become infected tangentially with the virus but do not contribute significantly to virus amplification. PMID- 3318523 TI - St. Louis encephalitis: lessons from the last decade. AB - In 1980 Reeves wrote that epidemics of St. Louis encephalitis (SLE) are preventable by means of surveillance and vector abatement. This view is examined in the light of epidemic activity during the last decade (1977-1986), in which 9 discrete outbreaks occurred. In addition, 5 interactive factors (virus, vector, viremic host, human immunity, environmental temperature) described by Reeves as essential to the development of an SLE epidemic are reviewed in the light of recent research. Although much progress has been achieved, many questions remain about SLE epidemiology and ecology. Among the most important are: Do Culex pipiens complex mosquitoes play a significant role in SLE virus transmission in the western United States? Is there a sylvatic cycle of SLE virus transmission in the east-central United States? What are the most sensitive and specific predictors of SLE virus activity in the east-central United States? What are the overwintering mechanisms which assure SLE virus recrudescence, and what role does transovarial transmission of virus play? PMID- 3318524 TI - [Epidemiological aspects of ovarian cancer]. PMID- 3318525 TI - [Ultrasonic diagnosis of chronic urethritis, paraurethral fibrosis and paraurethral cysts in women]. PMID- 3318526 TI - [Endometrial polyps]. PMID- 3318527 TI - [Heterozygote carrier state of hemophilia A and B gene and pregnancy]. PMID- 3318528 TI - [Ultrasonic scanning of the kidneys in the diagnosis of acute pyelonephritis in pregnancy]. PMID- 3318529 TI - [Medico-genetic studies of human provisional organs]. PMID- 3318530 TI - [Preventive antibiotic therapy in cesarean section]. PMID- 3318531 TI - Do some patients with morphea and lichen sclerosis et atrophicans have a Borrelia infection? PMID- 3318532 TI - Histological evidence for spirochetal origin of morphea and lichen sclerosus et atrophicans. AB - In order to elucidate the possible spirochetal origin of morphea and lichen sclerosus et atrophicans (LSA), we investigated biopsy specimens from 13 patients with morphea and 13 patients with LSA. Four patients with acrodermatitis chronica atrophicans (ACA), three with erythema chronicum migrans (ECM), and 11 patients with other inflammatory dermatoses served as controls. Formalin-fixed, paraffin embedded sections were stained by an avidin-biotin-immunoperoxidase method, using serum of a patient with ACA that contained IgG antibodies to Borrelia burgdorferi. As positive control substrate, formalin-fixed culture suspensions of B. burgdorferi strain B31 were used. They presented either as thin, mostly linear, but partially dotted, stained spirochetes or, in contrast, as thick, "swollen," heavily stained organisms. Identical structures could also be detected on histological sections of one patient with ECM, four patients with morphea, and six patients with LSA. These findings provide evidence for the spirochetal origin of both morphea and LSA. PMID- 3318533 TI - Generalized hair follicle hamartoma: the third case report in association with myasthenia gravis. AB - A 29-year-old woman, referred because of the development of diffuse papules and plaques on the face and progressive hair loss, was found to have generalized hair follicle hamartoma, a very rare condition previously described in only two female patients. All three patients also suffered from myasthenia gravis. The histological appearance of both the involved and uninvolved skin was similar to trichoepithelioma. PMID- 3318534 TI - Jakob Erdheim. Eminent pathologist of Vienna. PMID- 3318535 TI - Gulliver's travels to the skin, by Chuck Close. PMID- 3318536 TI - [Mario Salazar Mallen, master and friend]. PMID- 3318537 TI - [Evaluation of the immunologic system in patients with allergic bronchial asthma]. PMID- 3318538 TI - Mechanisms and significance of adenosine-induced bronchoconstriction in asthma. PMID- 3318539 TI - The effect of a histamine synthesis inhibitor on the immediate nasal allergic reaction. AB - We studied the effect of alpha-fluoromethyl histidine, an irreversible histamine synthesis inhibitor, on the immediate nasal reaction to antigen challenge in a double-blind, placebo controlled, randomized, parallel study using 13 subjects. The patients received either active drug 100 mg twice daily or placebo, for 3 weeks. A nasal allergen challenge was performed before and after at weekly intervals. Symptoms at challenge were assessed and the levels of histamine, TAME esterase activity and kinins were measured in nasal lavages before and after antigen challenge. Skin tests were also performed at weekly intervals. In addition, the urinary excretion of the main histamine metabolite, telemethylimidazole acetic acid, was measured before and after 3 weeks of treatment. The active treatment induced 60% reduction in histamine levels in the lavage fluids before and after antigen challenge, as well as a reduction in the histamine levels in the lavage fluids before and after antigen challenge, as well as a reduction in the main urinary histamine metabolite. However, no reduction was found in nasal symptoms obtained after antigen challenge. The levels of kinins and TAME-esterase activity were not significantly reduced. PMID- 3318540 TI - Chip pile workers and mould exposure. A preliminary clinical and hygienic survey. AB - Chip pile workers are exposed to high concentrations of airborne mould spores. Few sporadic cases of allergic alveolitis have been reported in Finland. Eight non-smoking workers, six on chip piles and two on bark piles, were examined to study the immunological and clinical response to continuous mould spore exposure. The spore exposure ranged between 10(4) and 10(5) spores/m3. Three of the six chip pile workers had precipitating serum antibodies against Aspergillus fumigatus. The three antibody-positive workers had a tendency to decreased total pulmonary diffusion capacity and vital capacity. Significant respiratory symptoms were not noted. Long-term spore exposure may include an occupational health risk to chip pile workers. PMID- 3318541 TI - [Catheterization of the internal jugular vein using sonography]. AB - Localisation of the internal jugular vein (IJV) by anatomical landmarks is common clinical practice. Specific complications associated with this technique are documented. Cannulation of the IJV is likely to be safer, when performed under direct vision, provided by a sonographic device. Following sonographic visualization, we have cannulated the IJV of 50 patients without complications. The tested device (Echokamera SSD-210 DX combined with the small-part-transducer UST-558-5, 5 MHz, 34 mm) proved useful in facilitating IJV cannulation. PMID- 3318542 TI - [Supraclavicular puncture of the anonymous vein]. AB - The investigation concerns a series of percutaneous, supraclavicular punctures and catheterisations of the anonymous veins conducted in the course of 8 years. 9042 patients were involved. The specific advantages of the anonymous vein puncture and catheterisation pertain to the easy accessibility of the vessel in all circulatory conditions and to the reduced risk of complications (rate of pneumothorax only 0.2%). PMID- 3318544 TI - Sir Ivan Magill. A supplementary bibliography. PMID- 3318543 TI - Analgesia from morphine and ketamine. A comparison of infusions of morphine and ketamine for postoperative analgesia. AB - Ketamine 4 micrograms/kg/minute produced pain relief similar to that from morphine 33 micrograms/minute in a double-blind study that compared analgesia from constant-rate intravenous infusions of the two drugs in 60 patients. The analgesic efficacy of the infusions, as assessed by pain scores and the requirement for supplementary self-administered morphine, was poor. Ventilatory depression, the most significant side effect, occurred only in patients who received morphine infusion. The low dose ketamine infusion did not provide clinically useful analgesia even though adequate plasma concentrations were achieved. PMID- 3318545 TI - [Historical development of obstetrical anesthesia]. AB - Pain is a primary component of normal childbirth as evidenced by the behavior of parturients in primitive societies. Methods of pain relief such as the use of herbs and plant extracts were described in ancient writings. Modern obstetric analgesia employing ether began in 1847, three months after the first successful surgical anesthetic. Administration of chloroform and nitrous oxide followed. Twilight sleep, a combination of morphine and scopolamine, became popular in the beginning of the twentieth century as did regional analgesia, first single injection and later continuous blockade via catheter. Simultaneously, psychologic methods were propagated, but were not uniformly successful. Continuous lumbar extradural analgesia has evolved as the optimal method of bsotetric pain relief, both subjectively and objectively, and its combination with childbirth education is considered to be complementary. The increasing utilization of obstetric analgesia and the recognition of marked physiologic and pharmacologic differences between pregnant and nonpregnant patients has led to the development of the subspecialty of obstetric anesthesia as well as to the foundation of obstetric anesthesia societies. PMID- 3318547 TI - [Affinity of oxygen for hemoglobin--its significance under physiological and pathological conditions]. AB - Hemoglobin as a vehicle for oxygen carries roughly 65 times the volume of oxygen that would otherwise be transported by simple solution in plasma. Conformational shifts of the molecule induce a cooperative oxygen-hemoglobin affinity. This property is reflected in the sigmoidal shape of the oxygen-hemoglobin dissociation curve. The affinity of hemoglobin is affected by temperature, hydrogen ions, carbon dioxide, and intraerythrocytic 2,3-DPG, with all these factors mutually influencing each other. Physiologic conditions associated with shifts in hemoglobin-oxygen affinity are oxygen uptake in the lung, oxygen delivery in the capillaries, and particularly oxygen delivery in working muscle, diaplacental oxygen transfer, and the regulation of erythropoesis. Hemoglobin oxygen affinity attains pathological significance for oxygen supply during respiratory or metabolic alkalosis when the hemodynamic and tissue responses of the individual are limited: the increased affinity can critically lower capillary oxygen tension. Methemoglobin and carbon monoxide shift the oxygen dissociation curve to the left, so that intoxication with both substances reduces both total oxygen capacity and oxygen delivery of the remaining hemoglobin able to bind oxygen. This effect of methemoglobin and carbon monoxide must be considered in intensive care of intoxicated victims. Transfusions of large volumes of stored red cells, whose hemoglobin shows high affinity, can force the capillary oxygen tension down, especially in patients with impaired cardiac performance. The lowered oxygen affinity of patients with chronic renal disease and anemia must be preserved by avoiding an increase in the acidotic plasma pH. In the neonate, hemoglobin possesses a high affinity for oxygen physiologically; the hemodynamic reserve of the neonate is limited. Therefore, the hemoglobin content plays a crucial role in oxygen transport capacity during the initial months of extrauterine life. Consequently, red cell transfusion must be started much earlier in neonatal surgery than in adults. The red cells must be fresh, or at best "rejuvenated". Normally, oxygen affinity is not relevant for oxygen supply, but the position of the oxygen-hemoglobin dissociation curve may be a critical factor in the situations described above, particularly when blood flow is additionally restricted. PMID- 3318546 TI - [Comparative hemodynamic study of anesthesia induction with propofol (Diprivan), thiopental, methohexital, etomidate and midazolam in patients with coronary disease]. AB - In patients undergoing cardiac surgery, the induction of anesthesia is not without risk because of specific cardiovascular effects of the anesthetic and the preoperative state of the patient. The hemodynamic effects of etomidate, midazolam, thiopental, and methohexital are well known: etomidate is an anesthetic that induces only minor cardiovascular changes; its influence on the endocrine system, however, has reduced its clinical indication. Barbiturates such as thiopental and methohexital produce negative inotropic effects in combination with an increase in heart rate and myocardial oxygen consumption; midazolam reduces pre- and afterload in patients with poor left ventricular function. Propofol, a new short-acting induction agent with good anesthetic properties, is said to diminish arterial pressure as well as myocardial oxygen consumption. METHODS: In a randomized study we investigated the hemodynamic effects of intravenous induction with propofol (2 mg/kg body wt.), thiopental (5 mg/kg), methohexital (1 mg/kg), etomidate (0.3 mg/kg), and midazolam (0.15 mg/kg) in 50 patients undergoing coronary artery bypass grafting. All patients were premedicated with flunitrazepam (0.03 mg/kg up to 2 mg) and morphine hydrochloride (0.2 mg/kg up to 15 mg) 100 min before the investigation. After 0.003 mg/kg fentanyl the patients received the induction agent in the above mentioned dosage within 40 s followed by 0.1 mg/kg pancuronium bromide. Hemodynamic measurements were performed 1, 3, and 5 min after the end of the injection as well as 1 and 5 min after intubation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318549 TI - Kinetic implications in the analytical use of enzymes. PMID- 3318548 TI - Evaluation of sulfate esters and glucuronides by enzymatic means. PMID- 3318550 TI - Determination of plasmid copy number by the "boiling" method. AB - A fast and reliable approach for determination of plasmid copy number in Escherichia coli is proposed, based on the "boiling" method (5) for separation of plasmid and chromosomal DNA. The method includes in vivo uniform labeling of total bacterial DNA, separation of DNA into plasmid and chromosomal DNA fractions, and quantitation of DNA in the two fractions by radioactivity measurement. No isolation and purification of native DNA are necessary. PMID- 3318551 TI - Automatic nitrous oxide synchronization of mitotic human cell cultures. AB - Large numbers of human cells can be reversibly arrested in mitosis by high pressure nitrous oxide. The optimum schedule for this arrest requires that the high-pressure block be started around midnight to provide a mitotic population that can be released the next morning to progress in synchrony through the next cell cycle. We describe a simple and safe device which can be set up at the end of the day and automatically exposes the cells to high-pressure nitrous oxide overnight. PMID- 3318552 TI - Chromophoric and fluorophoric peptide substrates cleaved through the dipeptidyl carboxypeptidase activity of cathepsin B. AB - The action of bovine spleen cathepsin B as a dipeptidyl carboxypeptidase on newly synthesized substrates of the type peptidyl-X-p-nitrophenylalanyl (Phe(NO2))-Y (X,Y = amino acid residue) or 5-dimethylaminonaphthalene-1-sulfonyl (Dns) peptidyl-X-Phe(NO2)-Y was investigated. The kinetic parameters of hydrolysis of the X-Phe(NO2) bond were determined by difference spectrophotometry (delta epsilon 310 = 1600 M-1 cm-1) or by spectrofluorometry by following the five- to eightfold increase of Dns-group fluorescence with excitation at 350 nm and emission at 535 nm. The substrates were moderately sensitive to cathepsin B; kcat varied from 0.7 to 4 s-1 at pH 5 and 25 degrees C; Km varied from 6 to 240 microM. The very acidic optima of pH 4-5 are characteristic for dipeptidyl carboxypeptidase activity of cathepsin B. Bovine spleen cathepsins S and H had little and no activity, respectively, when assayed with Pro-Glu-Ala-Phe(NO2)-Gly. These peptides should be a valuable tool for routine assays and for mechanistic studies on cathepsin B. PMID- 3318553 TI - Diagnosis of Alzheimer's disease. PMID- 3318554 TI - Edge cell migration in the extraembryonic mesoderm of the chick embryo. An experimental and morphological study. AB - The expansion of the extraembryonic mesoderm was investigated in chick embryos of 2 and 3 days incubation with special regard to the mesodermal edge cells. These cells are lying immediately distal to the sinus terminalis and have the shape of migrating cells. By SEM examination they appear to be linked together to form a uniform edge which extends numerous spike-like filopodia. The shape of these filopodia corresponds to their microtubule pattern, as shown by immunofluorescence staining. Filopodia contain strong bundles of microtubules. By in vivo observation at high magnification, the migration of edge cells was demonstrated, and the results of SEM and immunofluorescence studies could be confirmed. By local application of cytochalasin D, distal to the region of the sinus terminalis, the migration of edge cells was inhibited selectively. Subsequent to the inhibition of migration, the expansion of the mesoderm stopped although the interstitial growth of the mesoderm in drug-treated regions remained unaffected. Thus the edge cells have a promotor function in the expansive growth of the extraembryonic mesoderm. The proliferating mesoderm, located proximally to the edge cells, has no expansive tendency of its own. The selectivity of the cytochalasin effect was checked by examination of the phalloidin stained actin pattern. Furthermore, by in vivo observations at low magnification and by transplantation of endoderm from quail to chick it could be confirmed that the extraembryonic mesoderm spreads out invasively between ectoderm and endoderm separating the two sheets. The promotion of this invasion can be regarded as an additional function of the edge cells. An expansion of the mesoderm can also be observed after endoderm removal. In regions freed from endoderm the mesoderm expands faster than in adjacent regions still covered by endoderm. There is no promoting influence of endoderm on mesodermal expansion. On the contrary, expansion itself is facilitated, when the conditions for invasion are abolished by removing the endoderm. PMID- 3318555 TI - Isomyosin expression in developing chicken atria: a marker for the development of conductive tissue? AB - Isomyosin expression patterns in embryonic chicken atria during the first two weeks of development were analyzed immunohistochemically. In the 3-days embryonic chicken heart (HH19-20), strong coexpression of both isomyosins can be found as band-like zones at the lateral sides of the sinoatrial junction. The zones converge on the bottom of the atrium and continue as a band around the atrioventricular canal. In the 5-days heart (HH27-28) the coexpression area encompasses the entire sinoatrial junction and extends into parts of the sinus venosus and into the dorsocaudal atrial wall. In the 7-days heart (HH 32-33) the relative extension of coexpression areas reaches its maximum. Coexpression is also found in a ring-like band in the ventral (bottom) wall of the atria peripheral to the ring-like band in the atrioventricular junction. The latter band has now become continuous with the coexpression area in the bottom of the interatrial septum. Caudally coexpression extends behind the atrioventricular cushions towards the interventricular septum and cranially coexpression of the atrioventricular junction has become continuous with that of the ring around the outflow tract (cf Sanders et al. 1986). In the second week of incubation a decrease of coexpression is observed. The isomyosin expression pattern described in this study has put forward additional arguments that the conductive tissue originates from areas that continue to express both isomyosins relatively late in development. PMID- 3318556 TI - The effects of cholesterol depletion on cellular morphology. AB - Cells of the U937 cell line were grown in delipidated calf serum for 24 and 48 hr. These cells are known cholesterol auxotrophs. When grown for 48 hr without an exogenous source of cholesterol, these cells are known to become depleted of their intracellular cholesterol stores by greater than 95%. The result is an aggregation of the cells upon mild agitation of the culture. Examination of the cell aggregate from these cultures revealed cells in various stages of altered morphology. There was a loss of microvilli from the cells. Subsequently, the Golgi complex became dilated, and secondary lysosomes and myelin figures accumulated in the cytoplasm. The cells became swollen, and the rough endoplasmic reticulum became dilated. A small percentage of the cells showed complete disintegration, with release of membrane-bound fragments and other intercellular debris. These events suggest that the depletion of cholesterol results in the inability of the cell to produce usable membrane. As a consequence, the synthetic apparatus of the cell becomes disrupted. PMID- 3318557 TI - Biologically active luteinizing hormone (LH) in Klinefelter's syndrome: response to gonadotropin-releasing hormone (GnRH) and effects of testosterone undecanoate. AB - Basal and gonadotropin-releasing hormone (GnRH)-stimulated levels of biologically active and immunoreactive LH (bLH and iLH) were measured in six patients with Klinefelter's syndrome (KS) (mean age 24.7 years). In the same patients the diurnal rhythm of serum testosterone (T) was investigated (morning values vs. evening values). The results were compared with those obtained in ten normal young men (mean age 29.3 years). Moreover, in one patient with KS we studied the effects of testosterone undecanoate (TU) administration on bLH and iLH basal levels. A sensitive "in vitro" bioassay, based on T production by mechanically dispersed mouse Leydig cells, was employed to assess LH bioactivity. Levels of iLH and T were determined by a double antibody radio-immunoassay technique. Mean basal levels of bLH and iLH were significantly higher (p less than 0.001) in the Klinefelter patients than in normal men, whereas the mean bioactivity to immunoreactivity (b/i) ratio of LH was similar in the two groups. The mean morning T concentration was significantly higher in normal men (p less than 0.001) than in the Klinefelter group. The diurnal T rhythm was lost in the patients with KS. In the Klinefelter patients the relative maximum response of bLH to GnRH (bLH delta%) was significantly lower (p less than 0.02) than in the control men. In addition, the b/i ratio of GnRH-stimulated Lh decreased significantly (p less than 0.05) from basal values in the Klinefelter patients, whereas it remained unchanged in the control group. In the patient with KS treated with androgen replacement therapy, TU decreased iLH serum levels more than bLH concentrations, thereby increasing the b/i ratio of basally secreted LH. PMID- 3318558 TI - Detection of sperm surface related antibodies by indirect immunofluorescence test on sperm suspensions. Indirect IFT on sperm suspensions. AB - An indirect immunofluorescence test (IIFT) using sperm suspensions was carried out on 20 sera with sperm agglutinins (SA) and on 25 negative controls. IIFT gave results highly correlated with the occurrence of sperm agglutinating activity. Moreover, a relation was found among class of Ig involved in IF reactivity, fluorescent stain pattern and type of sperm agglutinations. In all sera with "mixed" or "tail-tail" sperm agglutinating activity, IgG were involved in IF reactivity; the fluorescent stain constantly appeared in a granular pattern along the sperm tail and most often on the head surface too. In relation to high titres of "head-head" sperm agglutinating activity, IgM were involved in IF reactivity; here the fluorescent stain appeared to be localized on acrosomal surface. The results indicate that indirect IFT on sperm suspensions specifically detects sperm surface related antibodies. PMID- 3318560 TI - Clinical pharmacokinetics of carbonated local anesthetics. II: Interscalene brachial block model. AB - A double-blind comparison of 1.1% lidocaine carbonate and 1.0% lidocaine hydrochloride was carried out in 30 healthy adult patients undergoing upper extremity surgery under interscalene brachial plexus block. Epinephrine (1:200,000) was added to both solutions just before injection. As compared to lidocaine hydrochloride, lidocaine carbonate produced, in addition to a 38% reduction in onset time, a remarkable increase in the extent of anesthesia: lidocaine carbonate produced surgical anesthesia of the entire upper extremity including the hand in 87% of the patients, whereas lidocaine hydrochloride produced similar anesthesia in only 53% of the patients. Thus, supplemental blocks were required in 66% of the patients who received lidocaine hydrochloride, whereas they were required in only 25% of those who received lidocaine carbonate. PMID- 3318561 TI - Subclavian venipuncture: a new device using a Doppler probe. PMID- 3318559 TI - Spermatogenetic arrest with inhibition of acrosome and sperm tail development. AB - Testicular biopsies from two brothers with pathologic spermatograms revealed a spermatogenetic arrest at early spermatid maturation. No sign of acrosome or sperm tail formation was found in spermatids. Using a polyclonal antibody against vimentin, Sertoli cells appeared in the normal shape and distribution pattern. At the ultrastructural level no significant pathologic alterations of Sertoli cells were visible. A monoclonal antibody against tubulin gave a diffuse perinuclear reaction in spermatogonia, spermatocytes and spermatids. Some tubulin immunoreactive material was also present in the apical portions of the Sertoli cells. Ultrastructural studies of spermatids revealed a complete absence of the centrioles and axonemal structures in early spermatids. Acrosome formation was inhibited at the early Golgi stage. The numerous spermatids present within germinal epithelium contained an abundance of elongate mitochondria and membrane profiles surrounding the nucleus. The ultrastructural findings indicate a maturation stop of spermatids at a very early stage with complete inhibition of acrosome and sperm tail formation. The underlying mechanism could be a lack of specific structural proteins. PMID- 3318562 TI - The effect of bupivacaine scalp infiltration on the hemodynamic response to craniotomy under general anesthesia. PMID- 3318564 TI - Malignant hyperthermia in a renal transplant recipient. PMID- 3318563 TI - Perioperative management of conjoined twins. PMID- 3318565 TI - Pulse oximetry: a review with emphasis on applications in dentistry. PMID- 3318567 TI - A guideline to local anesthetic allergy testing. AB - Patients with a history of adverse reactions to a local anesthetic may often be incorrectly labeled as "allergic." Determining if a patient is allergic to a local anesthetic is essential in the selection of appropriate pain control techniques. Local anesthetic allergy testing may be performed safely and with reasonable accuracy by a knowledgeable practitioner. This paper presents guidelines for an allergy testing method. PMID- 3318569 TI - Comparison of auscultation, continuous wave Doppler imaging, intravenous digital subtraction angiography and conventional angiography in diagnosis of carotid artery disease. AB - The reliability of auscultation, continuous wave (CW) Doppler imaging, and intravenous digital subtraction angiography (IV DSA) in the assessment of carotid artery disease has been evaluated in comparison with conventional angiography in 30 patients. With auscultation, specificity and sensitivity for internal carotid artery (ICA) stenosis of 50% or more were 81% and 67% respectively. CW Doppler imaging detected ICA stenosis of 50% or more with a sensitivity of 83% and a specificity of 92% and ICA occlusion with a sensitivity of 60%. The specificity of IV DSA was 95% and the sensitivity for ICA stenosis of 50% or more and ICA occlusion were 75% and 100% respectively. Combining CW Doppler and IV DSA findings raised sensitivity for ICA stenosis of 50% or more and ICA occlusion to 89% and 100% respectively and specificity to 95%. The combination of CW Doppler and IV DSA is a safe and accurate test battery in the detection and categorization of carotid disease. PMID- 3318566 TI - Midazolam: a new drug for intravenous sedation. AB - MIDAZOLAM IS SUPERIOR TO DIAZEPAM IN CERTAIN WAYS: it has a more rapid onset; produces greater anterograde amnesia, less postoperative drowsiness, less venous irritation and less likelihood of thrombophlebitis development. However, additional clinical trials may be necessary before it can replace the widely used diazepam. PMID- 3318570 TI - Diagnosis of aortic dissection. Comparison of investigatory methods--case report. AB - A case is presented of a patient with an acute aortic dissection, rapidly followed by thrombosis of the false channel. The classical aortoangiography failed to give adequate information, whereas newer, less invasive investigation methods gave images that finally led to the correct diagnosis. The value of these methods in the diagnosis of aortic dissection is discussed. PMID- 3318571 TI - Viral infections and asthma. PMID- 3318572 TI - The role of suggestion in asthma. I. Effects of inactive solution on bronchial reactivity under bronchoconstrictor or bronchodilator suggestion. AB - Twenty-eight subjects affected by perennial asthma were selected in order to investigate the possibility of inducing or relieving an asthmatic attack by means of suggestion. Twenty-five were positive to methacholine challenge test and, among them, eleven reacted to an ultrasonic nebulized distilled water test. The effect of suggestion on airway response was assessed by eight inhalations of normal saline at 32 degrees C alternately presented as a bronchoconstrictor or as a bronchodilator drug. Eight inhalations of the same diluent without any psychic stimulus were used as control test. Seven patients reacted with bronchoconstriction to both positive and negative suggestion and to control test. Further, this group of patients showed a lower methacholine PD20 when compared with the other subjects. In this study, the effects of suggestion on bronchial reactivity were not observed and bronchoconstriction belonged to an individual hyperreactivity of the airways. PMID- 3318568 TI - Midazolam: review of a versatile agent for use in dentistry. AB - Midazolam is a relatively new benzodiazepine that is widely used in both medicine and dentistry. Its multiplicity of uses makes it unique among the benzodiazepines, and its water solubility and lack of active metabolites give it distinct advantages over diazepam. This paper reviews the clinical pharmacology of midazolam, provides comparison with diazepam and presents current information regarding its indications, limitations, advantages, disadvantages, methods of administration and precautions for use. PMID- 3318573 TI - The role of suggestion in asthma. II. Effects of a bronchoconstrictor drug on bronchial reactivity under bronchoconstrictor or bronchodilator suggestion. AB - Previous studies have shown that suggestion may modify bronchial reactivity to both inactive diluents and pharmacologically bronchoconstrictor or dilator substances. In our study, 14 patients were subjected to two methacholine challenge tests presented, respectively, as a bronchoconstrictor or as a bronchodilator drug. Forced expiratory volumes in one second were recorded and a PD20 was determined. No significant differences were reported in PD20 values of each patient after the two kinds of suggestion. PMID- 3318574 TI - Comparison of inhaled metaproterenol, inhaled atropine sulfate, and their combination in treatment of children with acute asthma. AB - The separate and combined effects of inhaled metaproterenol and atropine sulfate were evaluated in the treatment of 44 episodes of acute asthma occurring in 35 children ranging in age from 13 months to 13 years. Peak expiratory flow rate and pulmonary index were measured before and after each of up to three inhalation treatments. Significant improvement in peak flow rate (P less than .04) was noted after the second inhalation of metaproterenol both with and without the combination of atropine sulfate compared with the effects of atropine alone. Patients treated with metaproterenol and metaproterenol combined with atropine also experienced fewer therapeutic failures (2/15 and 2/16, respectively) compared with those treated with atropine (6/13, P less than .02). Pulmonary index scores did not differ among the treatment groups. Inhaled metaproterenol appears to be more effective than inhaled atropine sulfate in the treatment of children with acute asthma. The addition of inhaled atropine sulfate appears to offer no advantage over treatment with inhaled metaproterenol alone. PMID- 3318575 TI - Adverse reactions to aspirin and nonsteroidal anti-inflammatory drugs. AB - Nonsteroidal anti-inflammatory drugs (NSAID) are among the most frequent causes of adverse drug reactions. The clinical symptoms often resemble allergy and consist of anaphylactic shock, bronchospasm, urticaria, angioedema, and various skin eruptions. Patients with asthma or urticaria are particularly prone to these reactions. In about 10% of adult asthmatics, aspirin and several other NSAID precipitate open asthmatic attacks, most likely through inhibition of cyclooxygenase. This distinct clinical syndrome has a characteristic sequence of symptoms and clinical course. In 20% to 40% of patients with active urticaria, aspirin increases wheals and swelling. Pyrazolones might provoke two different types of clinical reactions, acting as allergens or interfering pharmacologically with cyclooxygenation of arachidonic acid. Other mechanisms might operate in some of the remaining adverse reactions to NSAID. Emerging clinical syndromes help to guide the clinicians through the maze of symptoms and often provide a unique insight into the mechanism of basic disease. PMID- 3318576 TI - Additives and chronic urticaria. AB - In patients with chronic urticaria, adverse reactions to food additives are worth looking for. Improvement on a diet free from the additives and a positive double blind provocation test is today the only way to prove the diagnosis. The mechanism for such adverse reactions is still obscure. PMID- 3318577 TI - Food allergy in infancy and children: state of the art. PMID- 3318578 TI - Milk allergy in infancy. PMID- 3318579 TI - Clinical recognition of the child with food allergy. PMID- 3318580 TI - An overview of the controversy concerning questionable manifestations of food allergy. PMID- 3318581 TI - New diagnostic methods in food allergy. PMID- 3318582 TI - Immune complexes in food allergy: a critical reappraisal. PMID- 3318583 TI - A search for biochemical markers of human mast cell activation in vivo. PMID- 3318584 TI - The gastrointestinal tract as an immunologic organ--state of the art. AB - Mucosal as well as systemic immune responses are extensively influenced by the external environment. The maintenance of the physiologic integrity of the mucosa is complex and depends largely on local immune responses. The physiologic processes of the body are integrated and carefully regulated so that no single event can be considered in the absence of consideration of its interaction with its environment. These principles are perhaps best demonstrated by the models and concepts emerging to explain the apparent idiosyncrasies of the mucosal immune system. How these can be harnessed to promote protection and how they may be manipulated to prevent disease is the subject of extensive current investigation which we have attempted to summarize in this brief review. PMID- 3318585 TI - Production and secretion of immunoglobulins in the gastrointestinal tract. AB - Two decades ago it was shown that the major immunoglobulin (Ig) present in human secretions is a dimeric IgA covalently bound to an epithelial glycoprotein of about 80 kD, now called the secretory component (SC). Pentameric IgM is likewise actively enriched in most exocrine fluids and is associated with SC, although not in a covalently stabilized complex. Three findings explain the selective translocation of polymeric Ig (pIg) into exocrine fluids: (1) preferential local production; (2) J-chain-expressing capacity of pIg-producing immunocytes; and (3) SC-mediated epithelial transport. Human hepatocytes lack SC and the human liver, therefore, cannot act as an efficient "IgA pump". This is in contrast to the rat liver which shows a remarkable capacity for transport of dimeric IgA from blood into the bile. The J chain of pIg and the epithelial SC represent the "lock and key" in the glandular transport of secretory IgA (SIgA) and SIgM. It has recently been shown that SC is synthesized as a transmembrane protein of about 95 kD and constitutes the actual pIg surface receptor. Complexing between ligand and receptor in the plasma membrane is followed by endocytosis. The completed SIgA and SIgM molecules are then translocated in cytoplasmic vesicles through the epithelial cell to the gland lumen along with an excess of free SC. The main function of SIgA is to exert immune exclusion; that is, by intimate cooperation with innate nonspecific defense factors it decreases penetration of soluble antigens and inhibits epithelial colonization of bacteria and viruses. Especially in selective IgA deficiency, SIgM may exert a similar protective function since its synthesis is markedly increased in the intestinal mucosa. Leakage of IgG into exocrine fluids is enhanced by mucosal irritation. Although IgG should not be considered as a SIg, it may contribute to immune exclusion. This is seen especially in the respiratory tract where IgG is less easily subjected to proteolytic degradation than in the intestinal juice. In contrast, by activating complement, IgG antibodies may at the same time be phlogistic and accelerate mucosal penetration of antigens. IgG may thus contribute to persistent immunopathology in mucosal disease. The same is true for IgE antibodies which may be carried into mucous membranes and secretions by mast cells and cause their degranulation with local histamine release. Traces of IgD may likewise be found in the secretions but without obvious biologic significance. Regulation of secretory immunity takes place both in organized lymphoepithelial structures, such as the Peyer's patches, and adjacent to the glands in the lamina propria.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3318586 TI - Intestinal mucosal mast cells. AB - Mast cells are unique tissue cells with high affinity surface receptors for IgE and the capacity to synthesize and store histamine in mediator-containing cytoplasmic granules that stain metachromatically upon exposure to cationic dyes. The prominence of mast cells in the gastrointestinal tract and the potential effects of newly generated and preformed mediators released by stimulated mast cells on surrounding gastrointestinal tissues have raised important questions regarding the role of the mast cell in both physiologic and pathophysiologic events in the gut. The elucidation of the role of the mast cell in the gastrointestinal tract is a complex task as illustrated by studies revealing the presence of heterogeneous populations of mast cells in this organ. Morphologic, biochemical, and functional differences have been demonstrated between mast cells located primarily in the mucosa (atypical or mucosal mast cells) and mast cells distributed throughout the connective tissues of the gut (typical or connective tissue mast cells). Awareness of the distinguishing features of mast cell populations in the gut is an important step in unraveling the functional role of gastrointestinal mast cells and may lead to the development of innovative therapeutic approaches to gastrointestinal diseases in which mast cell activation occurs. PMID- 3318587 TI - Induction and molecular properties of secretory and serum IgA antibodies specific for environmental antigens. AB - A generalized secretory IgA response can be induced by ingestion of various antigens due to dissemination of sensitized precursors of IgA plasma cells from gut-associated lymphoid tissue to various secretory glands. Oral ingestion of a bacterial antigen by volunteers led to the parallel appearance of secretory IgA antibodies in several external secretions that was preceded by a transitory detection of IgA antibody-secreting cells in the peripheral blood. Naturally occurring secretory and serum IgA antibodies as well as secretory and serum antibodies induced by mucosal immunization belong predominantly to the IgA1 subclass; however, in external secretions IgA2 is the predominant subclass of natural antibodies to endotoxin and lipoteichoic acid. Although in external secretions specific IgA antibodies are of polymeric form, serum IgA antibodies to different antigens display considerable variability with respect to their distribution in polymeric and monomeric forms. However, after experimental infection, serum IgA antibodies to the influenza virus hemagglutinin are almost exclusively polymeric. PMID- 3318588 TI - Pathophysiology of intestinal uptake and absorption of antigens in food allergy. AB - An important adaptation of the gastrointestinal tract to the extrauterine environment is its development of a mucosal barrier against the penetration of proteins and protein fragments. To combat the potential danger of invasion across the mucosal barrier, the infant must develop within the lumen and on the luminal mucosal surface an elaborate system of defense mechanisms that act to control and maintain the epithelium as an impermeable barrier to the uptake of macromolecular antigens. These defenses include a unique local immunologic system adapted to function in the complicated milieu of the intestine as well as other nonimmunologic processes such as a gastric barrier, intestinal surface secretions, peristaltic movement, etc, all of which help to provide maximum protection for the intestinal surface. Unfortunately, during the immediate postpartum period, especially for premature and "small-for-date" infants, this elaborate local defense system is incompletely developed. As a result of the delay in the maturation of the mucosal barrier, newborn infants are particularly vulnerable to pathologic penetration by harmful intraluminal substances. The consequences of altered defense are susceptibility to infection and the potential for hypersensitivity reactions and the formation of immune complexes. With these reactions comes the potential for developing life-threatening diseases such as necrotizing enterocolitis, sepsis, and hepatitis. Fortunately, nature has provided a means for passively protecting the "vulnerable" newborn against the dangers of a deficient intestinal defense system: human milk. It is now increasingly apparent that human milk contains not only antibodies and viable leukocytes, but many other substances that can interfere with bacterial colonization and prevent antigen penetration. PMID- 3318589 TI - Immunochemistry of food antigens in IgE-mediated food allergy. PMID- 3318592 TI - No to multicenter trials for MAST use. PMID- 3318591 TI - In-house cardiopulmonary resuscitation--after a quarter of a century. AB - Several variables could have influenced the results of resuscitation after two and one-half decades--selection of resuscitation candidates, resuscitation mechanics, pharmacologic interventions, and post-resuscitation management. However, the outcome of CPR remains consistently poor. It appears that only dramatic changes in candidacy or technique will change the likelihood of survival following in-house CPR. PMID- 3318593 TI - Federal involvement in mental retardation programs. Past, present, and future directions. PMID- 3318590 TI - Through the microcirculatory maze with machete, molecule, and minicomputer (1986 Alza lecture). AB - This is a personal historical essay on meanderings through the jungle of the microcirculatory swamp. Because one pretends that the wandering was purposefully exploratory, a few guideposts are placed at positions where one could discern blaze-marks from earlier wanderers, and the path cut a little wider along some of the routes that may be enjoyed by investigators wanting to put their blazes along more distant paths. Naturally, one starts by coming up the broad rivers, then branching into the little streams. Each of us chooses to seek a different "mother lode," up a different stream. PMID- 3318595 TI - The economic and scientific future of forensic psychological assessment. PMID- 3318594 TI - Normalization and deinstitutionalization of mentally retarded individuals. Controversy and facts. PMID- 3318596 TI - Lightner Witmer. Little-known founder of clinical psychology. PMID- 3318597 TI - Federal impact on psychology in medical schools. PMID- 3318598 TI - Effect of vitamin C on NO2-induced airway hyperresponsiveness in normal subjects. A randomized double-blind experiment. AB - We conducted a double-blind randomized study to determine the effect of vitamin C on NO2-induced airway hyperresponsiveness in normal subjects. Eleven normal subjects were randomly assigned an order for 4 experimental exposures. For each exposure, subjects took either vitamin C (500 mg 4 times a day for 3 days) or placebo followed by exposure either to clean air or to 2.0 ppm NO2. Measurements of lung mechanics and airway responsiveness to methacholine aerosol were obtained. Serum level of ascorbic acid was determined before each exposure. NO2 exposure with placebo resulted in significant enhancement of airway responsiveness to methacholine aerosol (air-placebo 64 +/- 7 to NO2-placebo 53 +/ 8 mg/ml). Pretreatment with ascorbic acid prevented the significant alteration in airway responsiveness to methacholine aerosol (65 +/- 13 mg/ml, p less than 0.04). These results suggest that airway hyperresponsiveness induced by NO2 in normal subjects is completely prevented by pretreatment with ascorbic acid. PMID- 3318599 TI - Analysis of dose-response curves to methacholine. An approach suitable for population studies. AB - Dose-response curves to methacholine were examined in 9 normal and 10 asthmatic volunteers to determine whether the relationship between dose and response can be adequately summarized by means of a single, continuous measure that is not censored at lower levels of bronchial responsiveness. Subjects underwent a standard methacholine challenge test. There was a strong linear relationship between percent decline FEV1 and cumulative dose methacholine. We summarized each dose-response curve by the slope of a line extending from the origin to the last data point obtained. This summary dose-response slope effectively separated asthmatic from normal subjects, and there was a greater than 3,000-fold difference between the least and most responsive subjects. There was a high degree of correlation between the dose-response slope determined by the standard methacholine challenge protocol and that determined by an abbreviated protocol currently being used to examine nonspecific airway responsiveness in a large, longitudinal study of aging. Among the participants of the latter study, there is a unimodal, skewed distribution of dose-response slope. Dose-response slope is proposed as a quantitative measure of nonspecific airway responsiveness that avoids censoring and that may be particularly useful in epidemiologic studies. PMID- 3318600 TI - Shape of the dose-response curve to cold air inhalation in normal and asthmatic subjects. AB - Inhalation of cold air at increasing levels of minute ventilation with assessment of bronchomotor tone between each inhalation (dose-response curve) has been used as a method to assess bronchial hyperresponsiveness. However, no information is available on the shape of the obtained dose-response curve, and it is not known if a plateau of response is reached. We investigated this problem in 13 adult asthmatic subjects (PC20 methacholine results varying from 0.04 to 15.2 mg/ml), 5 normal and 2 former asthmatic individuals (PC20 greater than 8 mg/ml). Inhalation dose-response curves were drawn by asking the subjects to inhale dry cold air ( 20 degrees C) for 3 min at progressively increasing degrees of ventilation (5, 10, 15, 20, etc., L/min) until maximal voluntary ventilation (MVV) or sufficient bronchoconstriction was reached. FEV1 was assessed after each degree until no further decline was seen. No functional recovery was observed before asking the subject to inhale the next dose of cold air. Maximal falls in FEV1 ranged from 20.7 to 56.5% in the current asthmatic subjects, whereas no significant (less than 10%) changes in FEV1 were obtained in the normal and former asthmatic individuals. Seven to 13 points on the individual dose-response curves were obtained for each current asthmatic subject. Curves were analyzed using the common pharmacologic logistic model. The coefficients of correlation were, in general, highly statistically significant. Curves obtained for the current asthmatic subjects represented a truncated sigmoidal pattern without a plateau. Curves were flat in the normal and former asthmatic individuals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318601 TI - Progressive pulmonary calcification complicating successful renal transplantation. AB - Metastatic pulmonary calcification occurs in a chronic form in patients with malignancy, chronic renal failure, and primary hyperparathyroidism. A rapidly progressive form is associated with renal transplant failure. This case report describes chronic progressive pulmonary calcification after successful transplant with no obvious underlying cause. PMID- 3318602 TI - Health effects and sources of indoor air pollution. Part I. AB - Since the early 1970s, the health effects of indoor air pollution have been investigated with increasing intensity. Consequently, a large body of literature is now available on diverse aspects of indoor air pollution: sources, concentrations, health effects, engineering, and policy. This review begins with a review of the principal pollutants found in indoor environments and their sources. Subsequently, exposure to indoor air pollutants and health effects are considered, with an emphasis on those indoor air quality problems of greatest concern at present: passive exposure to tobacco smoke, nitrogen dioxide from gas fueled cooking stoves, formaldehyde exposure, radon daughter exposure, and the diverse health problems encountered by workers in newer sealed office buildings. The review concludes by briefly addressing assessment of indoor air quality, control technology, research needs, and clinical implications. PMID- 3318603 TI - NHLBI workshop summary. Clinical-behavioral aspects of cystic fibrosis: directions for future research. PMID- 3318604 TI - Vascular actions of airway neuropeptides. AB - We have studied effects of several neuropeptides perfusing the cranial tracheal arteries bilaterally in anesthetized dogs. All the neuropeptides tested produced dose-related changes in vascular resistance. Substance P and VIP had similar potencies in decreasing tracheal vascular resistance. Neurokinin A (NKA) was the most potent dilator. Calcitonin gene-related peptide (CGRP) and peptide histidine isoleucine (PHI) were about 10 and 100 times less potent than NKA, respectively. Neuropeptide tyrosine (NPY) was one of the few constrictors of tracheal vessels at doses above 10(-11) mol. There seemed to be major differences between the neuropeptides with regard to the onset and duration of their vascular effects. NKA and PHI usually caused maximal vasodilatation within 15 to 30 s after the injection into the tracheal artery, and their vascular responses subsided within 1 to 2 min. With CGRP, the maximal dilatation of tracheal vessels came somewhat later, and more than half of the vascular response was still present 10 min after the injection of this neuropeptide. The maximal vasoconstrictor response to NPY came slowly, and the constriction showed only a little tendency to subside within 10 min after the injection. These results indicate that the long-acting neuropeptides VIP, CGRP, and NPY may be more important than the short-acting NKA and PHI in the physiologic regulation of airway blood flow. All the neuropeptides studied had effects on the contralateral tracheal vascular resistance. They were much more powerful than the classic mediators histamine and methacholine. PMID- 3318605 TI - Neurogenic inflammation in the respiratory tract: actions of sensory nerve mediators on blood vessels and epithelium of the airway mucosa. PMID- 3318606 TI - The biosynthesis of regulatory peptides. AB - Regulatory peptides are synthesized in their cells of origin as large, usually inactive, precursors. The gene sequences encoding many peptides are now known. Although these indicate the primary structure of the precursor, it remains necessary to define the actual peptide products of cells expressing a particular gene. In several instances, e.g., calcitonin gene-related peptide and preprotachykinin, it is known that there are alternative mRNA splicing mechanisms that generate different precursor molecules. Post-translational processing converts the precursor to smaller active products by cleavage of the chain and by modification to individual residues. The pathways of post-translational processing of the precursors may conveniently be studied using immunochemical methods. These allow detection of products that vary in chain length, or are modified by sulphation, phosphorylation, glycosylation, amidation, or N-terminal acetylation. Patterns of post-translational processing are commonly different between cells expressing the same gene. There are frequently, therefore, multiple active products that can be generated from a precursor, both within a single cell and in different cells expressing the same regulatory peptide gene. Examples are given to indicate the physiologic importance of these mechanisms and how they can be studied. PMID- 3318607 TI - Pulmonary edema in renal transplant patients. AB - A syndrome heralded by fever, deterioration of graft function, respiratory failure accompanied by pulmonary infiltrates has been termed "transplant lung." We hemodynamically studied eight such patients. At the height of their illness, pulmonary artery wedge pressure (PAWP) was elevated to 19.3 +/- 2.6 mm Hg along with mean pulmonary artery pressure (PAP) of 35.0 +/- 3.8 mm Hg in presence of increased cardiac index (CI) of 4.9 +/- 0.9 L.m2.min. Pathophysiology of pulmonary edema appears to include high left ventricular filling pressures, pulmonary hypertension, alterations of oncotic hydrostatic gradient, and increased cardiac output. A partial reversal of pulmonary hypertension was observed with dialysis or diuresis. Our data suggest incipient renal failure and fluid accumulation as the etiology of hemodynamic pulmonary edema in "transplant lung." PMID- 3318608 TI - Penetrating injuries by large objects. Presentation of three cases and review of literature. AB - Penetrating injuries with large objects are uncommon but dramatic. Immobilization of the patient and stabilization of the penetrating object during transport and administration of basic emergency support are essential to avoid increasing the damage already sustained. The object as well as the organs and vessels in its path should be exposed and controlled in the operating room prior to removal of the object. Thorough inspection, evaluation, and repair of injured structures can then be carried out. Aggressive prophylactic medication to prevent infection may further contribute to the improved survival of these patients. PMID- 3318611 TI - William Osler and the new psychiatry. AB - William Osler steered medical education towards knowledge of the natural history of disease and the biological sciences that explain its course and characteristic symptoms. A psychiatric education is now ready to move from a pre-Oslerian period, where the emphasis has been on teaching therapy, to a post-Oslerian discipline, where teaching focuses on distinctions in the presentation of psychiatric disorders and the basic sciences that can illuminate the causes and pathologic mechanisms behind abnormal human behaviors. Educational programs based on such ideas eliminate the denominationalism that has characterized psychiatry and make it more obviously a subdiscipline of medicine. PMID- 3318610 TI - Drugs five years later: acyclovir. AB - In the 5 years since its release for clinical use, acyclovir (9-[2 hydroxyethoxymethyl]guanine) has proved to be a safe and effective agent for therapy of herpes simplex and varicella-zoster infections. The drug's availability in topical, oral, and intravenous preparations has allowed its use in a range of clinical situations. Acyclovir must be phosphorylated by viral thymidine kinase in infected cells, where it then acts to inhibit viral DNA replication specifically. Epstein-Barr virus and human cytomegalovirus infections do not seem to respond to acyclovir therapy, although in-vitro effects on these viruses may be seen. Acyclovir is well absorbed and distributed, with cerebrospinal fluid levels 50% that of plasma. Clearance is almost entirely by the renal route, with a half-life of 20 hours in the anuric patient. Acyclovir has an excellent safety profile, its major adverse effect being transient serum creatinine elevations during high-dose intravenous use. Major uses include treatment of primary and recurrent genital herpes and herpes encephalitis and prophyllaxis and therapy of mucocutaneous herpes and varicella-zoster infections in immunocompromised patients. Resistance to acyclovir in herpes simplex virus is rarely encountered and does not seem to be due to long-term chronic suppressive therapy. PMID- 3318609 TI - Antibiotic prophylaxis for percutaneous endoscopic gastrostomy. A prospective, randomized, double-blind clinical trial. AB - Study Objective. To determine if prophylactic use of cefazolin reduces peristomal wound infection associated with percutaneous endoscopic gastrostomy. Design. Prospective, randomized, double-blind, placebo-controlled clinical trial. Setting. Academic medical center, referral-based, gastroenterology service. Patients. One hundred thirty hospitalized patients, 23 of whom were excluded. Of the remaining 107 patients, 52 (group I) were already using antibiotics at the time of randomization for gastrostomy, whereas 55 (group II) were not. Interventions. Patients received either intravenous saline as a placebo or intravenous cefazolin (1 g) 30 minutes before gastrostomy. Measurements and Main Results. For 1 week after gastrostomy, the peristomal area was evaluated and a score assigned each day for erythema (0 to 4), induration (0 to 3), and exudate (0 to 4). A maximum combined score of 8 or more or the development of pus was a criterion for infection. None of the patients in group I developed a wound infection. Only 2 of 27 group II patients given prophylaxis developed a wound infection, compared with 9 of 28 patients not given prophylaxis, a difference of 25% (95% confidence interval, 4.8 to 44.6%; p less than 0.025). The number of patients who developed a wound infection was 0 of 52 in group I and 2 of 27 in group II patients who received cefazolin, a difference of 7.4% (95% confidence interval, -2.5 to 17.3%; p = 0.07). Conclusion. Cefazolin prophylaxis significantly reduces the risk for peristomal wound infection associated with percutaneous endoscopic gastrostomy. It is needed, however, only for patients not already receiving antibiotic treatment at the time of gastrostomy. PMID- 3318612 TI - The calcium deficiency hypothesis of hypertension. AB - The proposed role of maintenance of calcium homeostasis in the prevention and nonpharmacologic treatment of hypertension has prompted controversial interpretations of the data on which the proposal is based. To provide a more current perspective, we summarize the epidemiologic data, results of clinical studies of calcium metabolism in humans with hypertension, effects of controlled interventions of calcium supplementation in humans, and findings from laboratory studies intended to elucidate possible mechanisms. Data from the epidemiologic and clinical trials support a protective role for calcium in regulating arterial pressure. A potentially important relationship between the "calcium hypothesis" and "salt-sensitivity" may provide further insights into the mechanisms involved. Results of experiments in vascular physiology indicate that dietary calcium's effect in lowering blood pressure is mediated in part through direct action on the vasculature. PMID- 3318614 TI - Physician payment reform: finally. PMID- 3318615 TI - Bone mineral densitometry. Health and Public Policy Committee, American College of Physicians. PMID- 3318613 TI - Salmon calcitonin in the treatment of postmenopausal osteoporosis. PMID- 3318616 TI - [Acedia or the depressed between sin and illness]. AB - Acedia is a term of the classical greek vocabulary that a christian author of the IVth century, Evagre the Pontic, uses in a special sense, to describe a mental state characterized among other things, by disgust and dejection, and which, according to him, falls into what became the first list of deadly sins. The word was conveyed to us by another monk of the egyptian deserts, Jean Cassien, with a change of meaning which made it very difficult to distinguish from sadness: his audience being very different from his predecessor's, as he wrote for Latins, little inclined to anachoretic life but among which developed the first great coenobitic institutions of the Occident. One century later, Pope Gregory the great removes acedia from the list of deadly sins, either because he does not distinguish it from sadness (and laziness) or because he considers it a morbid state and, as such, depending on medical care. The word has nevertheless survived until Thomas Aquinas and later, and its study provides valuable data on the mental states prefiguring our modern depressions. PMID- 3318617 TI - [Artificial intelligence and psychiatry: modeling of diagnostic reasoning]. PMID- 3318618 TI - Basic features of cellular interactions in the immune system. PMID- 3318619 TI - The membrane attack complex of complement at the endplate in myasthenia gravis. PMID- 3318620 TI - The course of myasthenia gravis and therapies affecting outcome. AB - The course of 1,487 patients with myasthenia gravis followed between 1940 and 1985 for a mean of 18 years provides further evidence that the distribution, severity, and outcome of the disease are determined during the first 1 to 3 (occasionally 5) years after onset, suggesting that injury to acetylcholine receptors occurs mainly during this time. In 14%, the disease remained clinically localized to the extraocular muscles, and in the remaining 86% became generalized, in 87% within a year, with the disease reaching maximum severity within the first year after onset of symptoms in 55%, during the first 3 years in 70%, and during the first 5 years in 85%. Male patients tended to have more rapid progression of disease, higher mortality, and lower rates of remission and improvement than females. From 1940 to 1957, when management relied on anticholinesterase compounds, endotracheal intubation or tracheostomy and negative pressure assisted ventilation for respiratory failure, and thymectomy in 26% of patients and thymomectomy in 8%, 31% of patients with generalized myasthenia gravis died of the disease (29% of these during the first year after onset, 27% during the second and third years, and 17% during the fourth and fifth years), 32% improved, 23% remained unchanged, 10% went into remission, and only 5% were worse during the last year seen than during the worst of the first 3 years (or 5 years in the minority of patients who reached maximum weakness after 3 years). From 1958 to 1965, during which time the management of respiratory failure was improved by positive pressure and volume controlled ventilation and improved intensive care, mortality fell to 14% (p less than 0.005), and a higher proportion remained unchanged (p less than 0.005). From 1966 to 1985, when over half the patients received adrenal cortical steroids, mortality fell to 7% (p less than 0.005) and the proportion who improved rose to 47% (p less than 0.05). Even though the patients who received steroids usually had more severe myasthenia, they had a higher rate of improvement than those who received no steroid, 54% compared to 39% (p less than 0.005). Thymectomy was performed in one fourth of patients with generalized myasthenia gravis, more frequently in young females and those with more severe weakness, and less often in older males and those with less severe weakness.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3318622 TI - Specific immunosorbents in diagnosis and management of myasthenia gravis. PMID- 3318621 TI - The role of the thymus in myasthenia gravis: immunohistological and immunological studies in 115 cases. PMID- 3318623 TI - Placebo-controlled, double-blind evaluation of the efficacy and safety of yellow mercuric oxide in suppression of eyelid infections. AB - We tested an over-the-counter ophthalmic ointment, yellow mercuric oxide 1%, for safety and efficacy in decreasing eyelid-margin bacterial-colony counts. Of 150 patients screened for high bacterial levels, 78 were randomized in double-blind fashion to either yellow mercuric oxide bid (41 patients or 53%) or a placebo (37 patients or 47%). Bacterial-colony counts were determined at outset and at days 4 and 7 of treatment. At the conclusion of treatment on day 7, 87% of patients in the mercuric oxide group were successful in decreasing bacterial counts, compared with 59% of patients treated with placebo (P = .01). Side effects were no higher in the active group than in the placebo group. We have shown mercuric oxide 1% to be safe and effective in reducing eyelid bacterial-colony counts in patients with hordeolum and blepharitis. PMID- 3318624 TI - Epikeratophakia without annular keratectomy. AB - Nineteen patients (20 eyes) underwent epikeratophakia for correction of high myopia. In contrast to the conventional surgical method utilizing an annular keratectomy, no keratectomy was performed in these patients. The surgical procedure is discussed. Preliminary results (up to six months) indicate that the omission of an annular keratectomy has no effect on graft clarity or viability. The weighted-average percent correction over six months postoperatively was 102%. PMID- 3318625 TI - [Echo-structural variants of the ovarian hyperstimulation syndrome]. PMID- 3318627 TI - [Tumors of the cerebellopontile angle, with the exception of acoustic neuromas]. AB - Based on a review of 38 cases of tumors of pontocerebellar angle, excluding acoustic neurinoma, and a literature review, clinical, radiologic and therapeutic characteristics of these lesions are described. Diagnosis depends on accurate pre operative identification of the type of tumor. Based on frequency data it can be estimated that tumors of pontocerebellar angle are nearly always acoustic neurinomas : this infers that these other tumors of the angle represent a differential diagnosis where major orientation signs are radiologic. This is fundamental, since when considering all tumors of pontocerebellar angle those requiring a totally different approach to treatment than that for acoustic neurinomas must be distinguished from those for which inability to identify them is not of marked importance since their operatibility is identical. PMID- 3318626 TI - [Behavior of menstrual function in kidney transplant patients treated with cyclosporin A]. PMID- 3318628 TI - Traumatic innominate pseudoaneurysm rupture during laryngeal dilatation. AB - Endotracheal hemorrhage from the innominate artery is, fortunately, a rare problem encountered by the otolaryngologist. We present a patient with a tracheal innominate artery fistula secondary to delayed rupture of a traumatic innominate artery aneurysm. The differential diagnosis of innominate artery hemorrhage is discussed, as is the management of this potentially lethal event. We propose, as the treatment of choice, cessation of hemorrhage through the use of a cuffed endotracheal tube, followed by ligation of the innominate artery using cardiopulmonary bypass. These techniques were used in this patient with a successful outcome. PMID- 3318629 TI - Ultrasonic diagnosis of a metastatic cystic lymph node. PMID- 3318630 TI - Finnish approach to the treatment of acute otitis media. PMID- 3318631 TI - [Lyme disease, a new term for a forgotten pathologic complex]. PMID- 3318632 TI - [Neonatal Proteus infections]. PMID- 3318633 TI - [Algodystrophy, a little known disease in children. General review apropos of 4 cases]. PMID- 3318634 TI - [Echographic changes in the prepubertal uterus as affected by estrogen treatments]. PMID- 3318635 TI - [Congenital malaria: a reality not to be overlooked. Apropos of a case]. PMID- 3318636 TI - [Indications for loperamide in acute infantile diarrhea. Randomized double-blind study]. PMID- 3318637 TI - Mustard gas: clinical, toxicological, and mutagenic aspects based on modern experience. AB - Based on a study of the literature and our own experience treating fisherman poisoned by mustard gas, this article outlines the clinical effects, and toxicological and mutagenic properties of the agent. Mustards are very persistent chemical agents that easily penetrate clothing. Mustard gas usually causes clinical symptoms after the liquid penetrates the skin or the vapor is inhaled. Skin lesions are similar to first- or second-degree burns and usually heal spontaneously in 4 to 6 weeks. Eye symptoms are photophobia and reduced vision. Following inhalation of the agent, pulmonary edema and long-term dyspnea may be seen. As mustard gas is an alkylating substance, it is conceivable that the risk of developing cancer may be increased, as observed in people who were involved with the production of mustard gas and in animals exposed to the gas. Also, transient significantly increased sister chromatid exchange rates have been found in fishermen exposed to mustard gas. Patients exposed to mustard gas must be treated immediately after exposure. Treatment should consist of cleaning of the exposed skin and clothes with an antigas powder and water and soap. The skin lesions should be treated as burns. Eye lesions and respiratory problems should be treated symptomatically. PMID- 3318638 TI - Dupuytren's disease in blacks. AB - Dupuytren's disease in blacks is believed to be rare. Our recent experience with the disease at the John Cochran Veterans Administration Hospital in St Louis is described, including 2 black patients suffering from the condition. The literature is reviewed and some aspects of pathogenesis are discussed. It is our belief that Dupuytren's disease is more common in blacks than previously reported. PMID- 3318640 TI - Useful arterialized flaps for head and neck reconstruction. AB - During the past 10 years, there have been extensive developments in both "island" muscle and musculocutaneous flaps and in "free" microvascular transfers. Competition still exists between these two schools of surgical methodology, even though both methods are known to be complementary and have comparable success rates. Each individual procedure has its commending features, and the reconstructive surgeon should be conversant with both techniques to plan the best reconstruction for each patient. It is therefore important first to place each local flap into context with other local flaps, so that comparisons can then be made with the several free microvascular flaps that are available. PMID- 3318639 TI - The role of perichondrium in modifying curved cartilage: an experimental study. AB - A study of 11 strips of curved cartilage harvested from 11 pigs' ears was undertaken to compare quantitatively the forces required to bend the strips before and after modification. The results show no statistical difference between the intact curvature and curvature produced when skin and perichondrium were resutured over 4 full-thickness, cartilaginous crosscuts. These in vitro findings suggest that, when one attempts to modify the shape of curved cartilage, lasting results may be obtained by shortening the convex surface length using a wedge excision method. The perichondrium is incised on the concave surface or the surface that will become longer with cartilage scoring, such as in otoplasty. If the cartilage surface will require elongation for ultimate straightening, the perichondrium as well as the cartilage must be incised. PMID- 3318641 TI - Management of skin loss in meningococcal infection. AB - The case of a 17-month-old girl with fulminant meningococcemia is presented to illustrate the protean and fulminant course of the disease. Special attention is given to the meningococcal skin manifestation, with guidelines for its treatment. PMID- 3318642 TI - Galactorrhea: a rare complication following reduction mammaplasty. AB - A case of galactorrhea immediately following a reduction mammaplasty is presented. Prolactin levels were elevated postoperatively and could be reduced to normal by a prolactin inhibitor. No other disease or disorder could be found. Based on a review of the literature, it seems that various factors have to contribute to galactorrhea, including stress-related prolactin secretion, rebound phenomenon after discontinuation of birth control pills, and hypersensitivity to prolactin receptors. Their coincidental occurrence, resulting in abundant milk production after surgery, is discussed. PMID- 3318643 TI - Nipple-areolar reconstruction with buried dermal hammock technique. AB - A buried dermal hammock technique for nipple-areolar reconstruction is described that ensures predictable long-term nipple projection. Fifty-one reconstructions have been done since 1981 with good long-term nipple projection and no complications. PMID- 3318644 TI - Calvarial erosion after scalp expansion. AB - A case is described of tissue expansion of the scalp with resultant erosion of the outer table and diploe of the calvaria. This resorption may have resulted from a prolonged period of expansion, excessive tension from inflation, and/or the nature or location of the defect. In cases of scalp expansion where the loose areolar space has become obliterated, periodic limited computed tomographic scanning may be useful to monitor the integrity of the skull. Postexpansion protective headgear may be indicated in selected patients. PMID- 3318645 TI - An atraumatic suture technique for advancing the proximal end of a severed digital flexor tendon through the pulley system. AB - One may encounter difficulty in attempting to advance the proximal digital flexor tendon into the pulley system. The use of (1) a purse-string suture around the tendon end, and (2) simultaneous prolonged tension on both the purse-string and repair sutures may be helpful. Tension on the purse-string suture converts the shape of the tendon end from an accordion into a bullet, easing its entry into the pulley tunnel. PMID- 3318646 TI - Current trends in the treatment of colorectal cancer. AB - In recent years interest in the management of bowel cancer has focussed mainly on two main considerations:- A The prospect of improving the overall curability by:- The achievement of much earlier presymptomatic diagnosis with the aid of Hemoccult screening of sections of the population at risk; The deployment of more radical techniques of operation, especially in regard to rectal cancer; The supplementation of surgical excision with adjuvant radiotherapy and chemotherapy; The development of a more meticulous regime of follow-up after operation, using CEA monitoring and occasional "second look" operations to deal with recurrence. B The greater use of sphincter-saving types of excision for growths of the middle and lower parts of the rectum. To this end several new techniques of rectal resection have become popular--especially the downward extrusion of low anterior resection with the aid of the circular stapler. In addition, for small very favourable low growths local excision or local destruction by diathermy fulguration or contact irradiation have been employed. The rationale and success of these two forms of endeavour are examined. PMID- 3318647 TI - Advances in the medical management of cerebral vascular disease. AB - In the past 20 years treatment appears to have had a major impact on all forms of cerebral vascular disease. Morbidity and mortality from strokes have declined nearly 50% in developed countries. Modern imaging techniques, methodology, and biostatistics have identified risk factors and refined clinical trials such that we question all previous studies of stroke management. Control of moderate and severe hypertension has significantly lowered stroke rates. In borderline and mild hypertension the decision to treat is influenced by other stroke risk factors including diabetes mellitus, cigarette smoking, ischaemic heart disease, plasma lipid levels, gout, haematocrit, and body weight. Current data indicate that anticoagulants are of no value, or hazardous, in atherothrombotic strokes; of unknown value in transient ischaemic attacks; of dubious value in evolving strokes; and beneficial in cardiac embolism. The cardiac causes, including mural thrombus, unstable arrhythmias, and mitral valve prolapse should be actively sought. Aspirin, as the prototype anti-platelet agent, holds promise in transient ischemic attacks and minor strokes at both small and moderate dosages. Ticlopine is now being critically evaluated in America. Use of cerebral vasodilators should be abandoned. Enthusiasm in the use of streptokinase and urokinase has been dampened by the conversion of ischemic infarcts into haemorrhagic infarcts. In subarachnoid haemorrhage epsilon-aminocaprioc acid is useful although hazardous, in preventing rebleeding. Certain calcium ion channel blockers are promising in the reduction of vasopasm. Since the November 1985 article in the new England Journal of Medicine on the failure of external-to-internal carotid arterial bypass to reduce the risk of ischemic stroke, the swing is back to conservative management.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318648 TI - Inhaled corticosteroids in the management of chronic bronchial asthma. AB - Inhaled corticosteroids have become a standard treatment for chronic severe asthma in adults and in children. In patients whose symptoms are not controlled by beta 2 agonist, theophylline preparations and disodium cromoglycate, inhaled corticosteroids can either reduce the need of or substitute for oral corticosteroids. Inhaled corticosteroids are not effective in an acute asthmatic attack when oral corticosteroids are indicated. Patients who are not adequately treated with conventional doses of inhaled corticosteroids may benefit from high dose inhaled corticosteroids. PMID- 3318650 TI - Psychiatric aspects of non-ulcer dyspepsia. AB - Crean et al1 defined dyspepsia as 'any form of episodic or persistent discomfort or other symptom referrable to the upper alimentary tract, excluding jaundice or bleeding', and listed irritable bowel syndrome (IBS) and formal psychiatric illnesses with gastrointestinal manifestations among the common causes of non ulcer dyspepsias. This paper will discuss the psychiatric aspects of non-ulcer dyspepsia and will be divided into four parts: --The effects of stress and emotion on the gastrointestinal tract --Personality traits of IBS sufferers - Psychiatric disorders and non ulcer dyspepsias --Treatment strategies. PMID- 3318649 TI - Special problems in the management of chronic asthma in children. AB - Children with asthma may be misdiagnosed when they present with chronic cough or wheezing following an upper respiratory infection. Such children are more appropriately treated with bronchodilators than with antibiotics and cough medicine. Failure to recognise these presentations of childhood asthma often lead to its increased morbidity. Inappropriate bronchodilator therapy and the failure to consider prophylactic drugs are common causes of poor control of childhood asthma. Wherever possible, the beta 2-sympathomimetics should be prescribed in the inhaled form. The inhalation methods and devices employed should be appropriate for the age of the child. Steroids are often necessary for good control in children with chronic asthma. Fear of their systemic side-effects may delay their use. These side-effects can be avoided if the inhaled beclomethasone dipropionate is used. The majority of chronic asthmatic children will improve with beclomethasone dipropionate without the need for additional oral steroids. It is important to note that successful management of childhood asthma does not only depend on the appropriate use of drugs but also the education of the child and parents on asthma. PMID- 3318651 TI - The investigation of patients with haematuria. AB - Haematuria is a common and very important presenting feature in renal disease. Microscopic or macroscopic haematuria should be fully investigated to elucidate the cause. Urine microscopy is very valuable in determining the source of the haematuria and hence the nature of subsequent investigations. PMID- 3318652 TI - Surgical causes of haematuria--the diagnostic approach. AB - Gross haematuria is one of the most important symptoms in urology, as one of its causes is neoplasm of the urinary tract. The other important causes are urinary stones, urinary tract infection, which may be acute or chronic, trauma, and chronic haemorrhagic radiation cystitis. The differential diagnosis of gross haematuria depends on the age and sex of the patient, and the associated symptoms. The most important associated symptom is pain. PMID- 3318654 TI - Acute pyogenic bone and joint infections. AB - Acute infections of bone and joints is a curable condition and the chance of cure is related to a number of factors like type and virulence of the organism, resistance of the host, choice of antibiotics, early drainage of the joint in septic arthritis and appropriate treatment after early diagnosis with adequate dosage and duration of antibiotic therapy. Late diagnosis and inadequate treatment can often lead to high mortality and morbidity and leave the patient with crippling sequelae like chronic osteomyelitis, joint destruction, pain, shortening, deformity and limp. PMID- 3318653 TI - Paediatric viral infections. AB - Viral infections are probably the most important cause of childhood morbidity and mortality in the world. In many developing countries in South East Asia and the Western Pacific, priority health problems include acute respiratory infections, acute diarrhoeas and arboviral infections. Where studies have been carried out, there is no significant difference in the aetiological agents involved or in the manifestation of clinical childhood disease. Surveillance of these diseases have improved with the introduction of rapid viral diagnosis. The better understanding of the immunopathogenesis of many diseases have also encouraged research in this area and will lead to the better control and management of these diseases. However, the search for antivirals has been disappointing but fortunately new vaccines are on the horizon and the prospect for bringing some of these diseases under control through vaccination are bright. PMID- 3318655 TI - Laser acupuncture anaesthesia and therapy in People's Republic of China. AB - Laser acupuncture anaesthesia has been utilized for operations on thyroid and stomach, and Caesarean sections since 1978 in China. Recently, satisfactory results were reported in stomatology for the extraction of teeth. Laser beams directed at predetermined acupoints produce insensibility in a few minutes without any side effects such as allergy, intoxication, haemorrhage, or infection. This method has been used successfully on more than 5,000 patients for tooth extractions and minor oral and facial operations. Until now, the mechanism of classical acupuncture anaesthesia has been more or less elucidated by the neural or neuro-humoral hypothesis, which states that deep receptors or minute nerve fibres are stimulated mechanically by the needle. But laser irradiation as a stimulant is something different, since it has only low power and short penetration depth, and arouses almost no sensation compared with the acupuncture needle. The mechanism of anaesthesia due to laser irradiation of acupoints on superficial parts of the body should be investigated in further detail. The methods of laser acupuncture anaesthesia, the selection of laser irradiation acupuncture points, the distance and duration of irradiation, and the results of clinical application will be introduced. PMID- 3318656 TI - The onset of dementia. AB - Epidemiological concepts may contribute to the understanding of dementia of Alzheimer type (DAT). The disease follows a variable clinical course determined only partly by the nature and distribution of the organic damage to the brain. Genetic and environmental factors interact with the organic process to determine the degree of functional (mental) impairment, while yet further interactions with environmental factors determine whether in terms of social function the dementia is compensated or decompensated. Knowledge of disease incidence rates can assist in the differential diagnosis of acquired mental impairment. Systematic data on the natural history of the DAT and its range of variation is valuable in recognising intercurrent, possibly remediable illness, and in planning care. PMID- 3318657 TI - Medication in the elderly. AB - Medicine taking is common among elderly patients, especially in those over 75 years. A major problem is their increased rate of adverse drug reactions as a result of multiple drug therapy, altered pharmacokinetics, and variable response of the end organs or target tissues (pharmacodynamics). Some of these alterations have been well documented, especially alterations in excretion via the kidney. Nomograms exist which allow fairly accurate prediction of the required dosage adjustment and for some drugs measurements of their concentrations in blood can provide additional assistance in selecting an appropriate dose. However, for drugs which undergo metabolism, usually within the liver, alterations are more difficult to predict. In general, drugs like propranolol, which exhibit considerable first-pass metabolism, show a greater bioavailability in this age group and a slight prolongation of their half-lives. But other drugs, e.g. anti pyrine, which have no significant first-pass metabolism and show a low rate of clearance from the asytemic circulation, exhibit little change in their pharmacokinetics with age. To date, studies of pharmacodynamic variation with ageing have been comparatively scant. Among those which have been documented are reduced beta-adrenoceptor sensitivity, increased effectiveness of the anticoagulant warfarin, and increased effects of a variety of benzodiazepines. Drug therapy in elderly patients should be kept simple and the number of drugs given simultaneously should be limited, and dosage may need to be reduced when a drug has a narrow therapeutic index or is excreted unchanged via the kidneys. PMID- 3318658 TI - Drugs in feto maternal medicine. AB - The study of drug distribution in pregnancy was limited by ethical, technical and medico-legal considerations as samples of body fluids could only be taken at delivery. In recent times fetal blood samples have been taken with the fetoscope and will provide a new tool to monitor fetal concentrations and metabolic pathways. The advanced technology of ultrasound allows non invasive study of the fetal circulation and early experience of sympathomimetic drugs administered to the mother will be discussed. Auto immune disorders carry high perinatal wastage. New drugs have made reproductive life possible and when used prudently can improve maternal state and increase fetal salvage. The author has personally managed nearly 52 cases of systemic lupus erythematosus and 16 cases of idiopathic thrombocytopenic purpura. The use of steroids and low dosage aspirin therapy with elevated lupus anticoagulant levels will be described. Two cases of early hydrops in the fetus owing to heart failure due to supraventricular tachycardia were treated with digoxin given to the mother. The potential of therapeutic agents in fetal medicine will be discussed as it recognises the fetus as a patient and provides effective intra uterine therapy. PMID- 3318659 TI - Cerebral malaria and mixed falciparum-vivax infections. AB - Of the seventy cases of cerebral malaria seen at the Duchess of Kent Hospital, Sandakan between January 1984 and June 1986, 57 (81.4%) were due to plasmodia falciparum and 13 (18.6%) were due to mixed p. vivax--p. falciparum infections. Mixed infection cerebral malaria was associated with a more severe anaemia and may carry a poorer prognosis. Indigenous children under five years of age are particularly at risk of death from mixed infections. PMID- 3318660 TI - Bonding of teeth. AB - Discolouration and altered morphology of teeth are clinical problems commonly presented by patients seeking dental treatment. These patients usually complain of poor dental aesthetics, impaired speech as well as adverse psychological effect. Recent advances in the development of tooth-coloured materials, techniques in the application of these materials and treatment of tooth surfaces to accept and retain such materials have made it possible for the aforesaid dental conditions to be corrected by the process of bonding tooth-coloured materials to the teeth affected. The objective of this study was to evaluate the efficacy of bonding these new materials to tooth structure. 60 patients were selected with spacing of teeth ranging from 0.5-3.0 mm in width. Using the acid etch regime, the tooth surface was prepared to receive a composite material which was applied with light-polymerisation equipment. The clinical evaluation of retention was made after 1, 6, 12 and 24 months. The results showed that overall 89.2% of the composite restoration were still bonded to tooth structure after a 2 year period. This may be seen as a favourable success rate which could be improved with further material and technique advancement. The implications are discussed. PMID- 3318661 TI - Renal transplantation in primary hyperoxaluria. AB - The increased production and excretion of oxalate in primary hyperoxaluria causes urolithiasis, nephrocalcinosis with renal failure, and systemic oxalosis. Systemic oxalosis occurs late in the course of the disease when there is both oxalate retention and increased oxalate synthesis. The uraemia can be controlled by conventional haemodialysis or peritoneal dialysis but treatment cannot usually keep up with accelerated rate of oxalate production, and dialysed patients develop systemic oxalosis. Most attempts to treat primary hyperoxaluria by renal transplantation have been unsuccessful because of rapid recurrence of nephrocalcinosis with uraemia and systemic oxalosis. Dynamic studies of overall oxalate metabolism in vivo have shown that the renal retention factor becomes a major determinant of oxalosis when the GFR decreases to less than 25 ml min-1 1.73 m-2. We conclude provisionally that vigorous haemodialysis should be begun and transplantation arranged when the GFR reaches this level. Such early transplantation with vigorous perioperative haemodialysis and a large perioperative diuresis of water gives good immediate graft function and oxalate mobilisation from the miscible oxalate pool. The longer term outlook is then influenced more by the factors which determine the success of renal transplantation in non-hyperoxaluric patients. PMID- 3318662 TI - Polycythaemia after renal transplantation. AB - The haematological, biochemical and clinical features of six patients with polycythaemia after renal transplantation were studied. The patients had an absolute increase in red cell mass, but normal plasma and whole blood volumes. Primary proliferative polycythaemia was excluded. Polycythaemia developed within one year of transplantation and persisted for 3-7 years. Chronic rejection, renal artery stenosis, severe hypertension and corticosteroid therapy were probably not the cause of the polycythaemia. There were no occlusive vascular lesions during the observation period and venesections were generally not required. The polycythaemia is probably the result of the cumulative production of erythropoietin by the donor and recipient kidneys. PMID- 3318664 TI - The cardiovascular manifestations of genetic disorders of collagen metabolism. AB - Current research in the biochemistry and molecular genetics of collagen metabolism has produced a sophisticated level of understanding of the mechanisms involved in the pathogenesis of a number of inherited diseases of connective tissue. Nowhere is this better exemplified than in the cardiovascular disorders associated with certain genetic disorders of collagen metabolism. For instance, the life-threatening vascular complications of Ehlers-Danlos syndrome IV, the Sack-Barabas type, appears to be related to a number of defects in the production of Type III procollagen. The large size of the collagen genes and the complexity of the biochemistry of collagen have not made research a simple task. Nevertheless, the location of certain genes is now known with a reasonable degree of accuracy and a few have been cloned in their entirety. The future investigation of these genetic mutations holds great excitement for those engaged in research in this fascinating field. PMID- 3318663 TI - The problems of environmental hazardous substances: an overview. AB - It was decided to present an overview of problems of environmental hazardous substances by selecting three areas of concern which represent different aspects of the overall subject. All three are topics of great interest at the present time. They provide examples of different causes of the hazards and different approaches to their resolution or containment. Aerial and water contamination by radon gas are a natural hazard only recently recognized. Radon can be contained, but it will require cooperative action and expenditure. Herbicides are a continuing problem demanding increased research activity to establish risk benefit decisions. Pollution of estuaries and oceans require new development of models for establishing safe levels of some pollutants and prohibition of others. PMID- 3318665 TI - Lessons from biodegradation. PMID- 3318666 TI - Cell-free immunity in insects. PMID- 3318667 TI - Repetitive proteins and genes of malaria. PMID- 3318668 TI - Specific and rapid identification of medically important fungi by exoantigen detection. AB - Within a decade of its introduction, the exoantigen technique has won general acceptance for accurate and rapid identification of fungal pathogens. This acceptance is emphasized by the fact that positive exoantigen results obtained with the dimorphic pathogenic fungi B. dermatitidis, C. immitis, H. capsulatum varieties capsulatum, duboisii, and farciminosum, and P. brasiliensis are no longer considered presumptive evidence but are considered definitive data for species identification. Technical problems associated with poor sensitivity and false-positives in some of the early tests have been resolved. The test expands the diagnostic capabilities of the laboratory. We encourage the establishment of libraries of antisera for species identification and, where appropriate, for serotyping. Since the test is simple and reagents for many of the pathogens are commercially available, the test can be performed in most laboratories. As highly defined antigens are produced, more standardized and specific tests will be developed. Hybridoma technology may provide the means for producing specific antibodies without the need for highly purified antigens, which have been difficult to produce. The identification of numerous fungi could be facilitated by application of exoantigen techniques. Specific antisera should be developed to achieve this goal and to obtain antigenic data useful for elucidating taxonomic relationships. Some fungi cannot be classified on the basis of morphologic and biochemical qualities alone. Supplementary data obtained with exoantigen analyses could undoubtedly aid in resolving such problems. PMID- 3318669 TI - Genetics of azotobacters: applications to nitrogen fixation and related aspects of metabolism. PMID- 3318671 TI - Biosynthesis of peptide antibiotics. PMID- 3318670 TI - The transient phase between growth and nongrowth of heterotrophic bacteria, with emphasis on the marine environment. PMID- 3318672 TI - Use of organ cultures in microbiological research. PMID- 3318673 TI - Physiology, biochemistry, and genetics of the uptake hydrogenase in rhizobia. PMID- 3318674 TI - The epidemiologic, clinical, and microbiologic features of hemorrhagic colitis. PMID- 3318675 TI - Rapid evolution of RNA viruses. AB - The high error rate inherent in all RNA synthesis provides RNA virus genomes with extremely high mutation rates. Thus nearly all large RNA virus clonal populations are quasispecies collections of differing, related genomes (14, 49). These rapidly mutating populations can remain remarkably stable under certain conditions of replication. Under other conditions, virus-population equilibria become disturbed, and extremely rapid evolution can result. This extreme variability and rapid evolution can cause severe problems with previously unknown virus diseases (such as AIDS). It also presents daunting challenges for the design of effective vaccines for the control of diseases caused by rapidly evolving RNA virus populations. PMID- 3318676 TI - Bacterial biofilms in nature and disease. PMID- 3318677 TI - Enzymatic "combustion": the microbial degradation of lignin. PMID- 3318678 TI - Export of protein: a biochemical view. PMID- 3318679 TI - Chromosomal cephalosporinases responsible for multiple resistance to newer beta lactam antibiotics. PMID- 3318680 TI - High-resolution NMR studies of Saccharomyces cerevisiae. AB - High-resolution NMR studies of yeast cells have contributed to our understanding of metabolism and energetics. The above studies of glycolytic control, enzyme kinetics, and metabolism during dormancy have shown how the strengths of NMR investigations can build upon existing knowledge to create a qualitatively different understanding of the processes in yeast. PMID- 3318681 TI - Microbial ecology of the cockroach gut. PMID- 3318682 TI - Elaboration versus simplification in refining mathematical models of infectious disease. PMID- 3318683 TI - Genetic research with photosynthetic bacteria. PMID- 3318684 TI - Incompatibility group P plasmids: genetics, evolution, and use in genetic manipulation. PMID- 3318685 TI - Molecular genetics in the improvement of brewer's and distiller's yeast. PMID- 3318686 TI - Molecular genetics of yeasts and filamentous fungi and its impact on biotechnology. An international symposium. September 29-October 2, 1987. Proceedings. PMID- 3318687 TI - Mating-type genes and the control of expression of fruiting genes in basidiomycetes. PMID- 3318688 TI - Cell cycle regulation in yeasts and man: towards a unifying mechanism. PMID- 3318689 TI - The expression of homologous and heterologous genes in yeast. PMID- 3318690 TI - The cellulase genes of Trichoderma. PMID- 3318691 TI - Global regulation in fungi. PMID- 3318692 TI - Impact of fungal molecular genetics on biotechnology. AB - The application of biotechnology has a very long history and life has benefited a lot from the application of fungal products. The industrial successful application of the use of fungi has been due to pioneering activities in both universities and industry. The most recent example of the application of a new technique was demonstrated with recombinant DNA techniques. Until now these techniques were mainly applied to rather simple processes. But we might also expect in the near future the application of these techniques to more complex systems. A very interesting area in this respect might be the production of plant secondary metabolites by fungi. As far as the economic benefits are concerned, a good balance has to be found between the economics of the processes and constrains posed on these processes by governmental regulations. PMID- 3318694 TI - Molecular genetics of methylotrophic yeasts. PMID- 3318693 TI - Manipulating protein topogenesis in yeast: sequences involved in intramitochondrial sorting. PMID- 3318695 TI - Evaluation of biological activity of atopic allergens by using histamine standards and some in vitro methods. PMID- 3318696 TI - Design of protocols to evaluate the safety and efficacy of allergenic extracts. PMID- 3318697 TI - Multimodal action of antitumor agents on DNA: the ellipticine series. AB - Most cytotoxic anticancer agents interact directly or indirectly with nuclear DNA, the ultimate target for this class of compounds. For a given type of drug both direct and indirect action at the DNA level usually causes various types of interference or damage. This multimodal mechanism of action is well illustrated by antitumor drugs in the ellipticine series which may bind to DNA through intercalation, may undergo covalent binding, may generate oxidizing species, and may interfere with the catalytic activity of topoisomerase II. The antitumor activity of these compounds may, therefore, result from alternative cytotoxic events. The present review summarizes information obtained with ellipticine compounds on the relation between the nature of the drugs' action on DNA and their cytotoxic and/or antitumor activity. The occurrence of topoisomerase mediated DNA cleavage appears to be responsible for antitumor activity. The capability of the drugs to interfere with the action of topoisomerase II requires the presence of an oxidizable phenolic group on their structure. This feature (or a related one) is shared by all antitumor drugs acting on this enzyme. PMID- 3318698 TI - An immediate and steep increase in ATP concentration in response to reduced turgor pressure in Escherichia coli B. AB - Osmotic treatment with sodium chloride of Escherichia coli B growing in the logarithmic phase induced an immediate increase in ATP concentration in response to increased concentrations of added solute in its growth medium in the first 10 min of the addition. After that, ATP concentration decreased gradually. Sodium arsenate and potassium fluoride almost abolished the ATP increase. The time course of the increase was quite different from that of cells treated with inhibitors of protein synthesis. The osmotic treatment did not decrease the viability of cells. In addition, there was no degradation of RNA by 5 min after sodium chloride addition, and, further, the lag time of ATP increase was extended by an inhibitor of nucleotide synthesis. These results indicated that a major fraction of the stress-increased ATP resulted from de novo synthesis, and that it was mainly dependent upon the reaction of substrate-level phosphorylation, which is regulated by turgor pressure. PMID- 3318699 TI - [Quantitative analysis of cell-kill effects of anticancer drugs: consideration of both in vitro and in vivo experimental systems]. AB - After examining the in vitro cell-kill kinetics of various anticancer drugs by using cultured human cell lines, Shimoyama et al. classified the drugs into two groups according to the types of action: 1) type-I drugs (cytocidal and concentration-dependent action) such as alkylating agents and anticancer antibiotics; 2) type-II drugs (cytostatic and time-dependent action) such as antimetabolites, Vinca alkaloids and L-asparaginase. In the present paper, we will present a rational basis for such a classification by using cell-kill pharmacodynamic models, and consider the optimal dosage regimen depending on the type of drugs by combining the cell-kill kinetic and pharmacokinetic models. In these models, classification of the drugs depends on whether the cell population is kinetically homogenous or not. It is assumed that cell population is homogenous for type-I drugs and there exist both drug sensitive and insensitive cell populations for type-II drugs. The concentration (or dose)-time-cell survival curves in both in vitro and in vivo, which are simulated based on the kinetic models, are consistent with the experimental data found in the literature. Further analysis on the optimal dose regimen according to these kinetic models clarified that the type-I drugs showed a similar cell-kill effect irrespective of the mode of administration as long as the area under the plasma unbound concentration curves (AUCp, free) is kept constant, while the type-II drugs are more effective by multiple dosing or infusion regimen than single administration of a large dose of drugs. In other words, the extents of AUCp, free and the residence time in the plasma (above certain concentrations of drugs) are determinants of the in vivo cell-kill effects of type-I drugs and type-II drugs, respectively. If the pharmacokinetics of newly developed anticancer drugs in human are predicted from the animal data according to the so-called "animal scale-up" technique and combined with the in vitro cell-kill kinetic data by the use of proposed kinetic models, one may obtain not only the optimal dosage regimen but also good screening systems for truly active drugs for the treatment of human cancer. PMID- 3318700 TI - [The biology of human brain tumors]. AB - For the most part, the prediction of prognosis and the design of treatment modalities for patients with brain tumors are judged equivocally by histopathological examination which is empirical and often subjective. While we incompletely understand tumor malignancy, some of the biological features of malignancy such as 1) phenotypic expression, 2) cellular invasiveness, and 3) the rapidity of proliferation should be independently determined. We need some objective methods to analyze these factors quantitatively in order to predict prognosis with certainty and to design tailored treatment modalities. As the brain is encased within the skull, the space available for a tumor to grow before it reaches a size fatal to the patient is severely limited. Thus, prognosis and/or survival of a patient with a brain tumor should be closely related to size and growth rate of an individual tumor and the quantitation of growth potential of an individual brain tumor is extremely important. The development of a monoclonal antibody against bromodeoxyuridine, a thymidine analogue, has made it possible to rapidly estimate proliferative potential of human brain tumors in situ by means of immunohistochemistry. The author reviewed current studies on growth characteristics of various brain tumors and discussed the usefulness of such studies. PMID- 3318701 TI - [Magnetic resonance imaging of brain tumors]. AB - Magnetic resonance imaging (MRI) has been applied to the diagnosis of brain tumors very widely and MRI is now replacing computed tomography (CT). One of the most important advantages of MRI is influence of multiple tissue and machine parameters on the signal intensities. In addition, capability of imaging in various planes and multislices is another advantage for the brain tumor diagnosis. The coronal image is important when the abnormal side can be compared with the normal side and midline lesions can be easily diagnosed with sagittal imaging. Transverse imaging is important when comparison is made with CT. Many brain tumors show increased signal intensity on T2-weighted images and decreased signal intensity on T1-weighted images and decreased signal intensity on T1 weighted images. The difference of signal intensity in various brain tumors including glioma, meningioma and other important tumors are discussed. MRI is superior to CT in many brain tumors, but poor delineation of calcification and hemorrhage is a disadvantage of MRI. PMID- 3318702 TI - [Radiation-therapy of malignant gliomas]. AB - On the surgery of glioblastoma multiforme, most cases are beyond the scope for desirable removal of tumors. The restriction of the surgical treatment has inevitably required postoperative radiation therapy. Although patients treated with postoperative radiation therapy showed significantly extended survival rates as compared to those receiving surgical resection alone, the glioblastoma recurred within a 2cm margin of the primary site in more than 90% of the patients and conventional external radiation therapy with a doses of 50-60 Gy did not result in local cure. However, it was reported that survivals extended in proportion to target absorbed doses and suggested that a higher localized radiation dose would improve the poor prognosis of these tumors. In order to obtain a local cure of glioblastoma, the first step of therapy should be an intensive local treatment. Intraoperative radiation therapy (IOR) and brachytherapy using high activity iodine-125 or iridium-192 become a logical local treatment for sterilizing the remaining malignant remnants by a high target absorbed dose without damaging surrounding brain tissues. IOR for 19 patients with glioblastoma resulted in a 2-year survival rate of 61.4%. Brachytherapy has shown excellent local effects for recurrent tumors. PMID- 3318703 TI - [Chemotherapy of malignant brain tumors]. AB - Chemotherapy of malignant glioma has been discussed in relation to recent attempts to enhance the effect, such as multi-drug combination, local administration and high dose with rescue. Recent studies on drug resistance and attempts to overcome the resistance were also reviewed. PMID- 3318704 TI - [Efficacy of interferon-beta and interleukin-2 as cytokines for malignant brain tumor treatment]. AB - The role of Interferon-beta (IFN-beta) as maintenance therapy for malignant gliomas and medulloblastomas was described. The low dose but continuous long-term administration of IFN-beta as a maintenance treatment for malignant gliomas after the induction therapy with surgery and chemoradiotherapy demonstrated the complete remission of the tumor in six cases of malignant gliomas. Such method of IFN-beta administration did not induce any serious side effects and might be useful for treatment of malignant gliomas. In addition, recent advance of adoptive immunotherapy using lymphokine activated killer cells (LAK) was briefly reviewed. PMID- 3318705 TI - [Antitumor effect of carboplatin and iproplatin on human urinary bladder and prostatic cancers grown in nude mice]. AB - Antitumor effects of carboplatin and iproplatin, a second-generation cisplatin analog were studied using cisplatin sensitive human urinary bladder (NM-B-1) and prostatic cancers (PRO-1) grown in nude mice. Both NM-B-1 and PRO-1 were sensitive to carboplatin and iproplatin. The tumor-regression effect of carboplatin at the fourfold dose of cisplatin was comparable to that of cisplatin. Iproplatin at the eight to sixteen times dose of cisplatin showed a comparable tumor regression to cisplatin. The range of effective dose was wider in carboplatin than cisplatin and that of iproplatin was not so wide as cisplatin. PMID- 3318706 TI - [The mechanism of action of tumor necrosis factor (TNF) on tumor vascularity- study using a transparent chamber]. AB - Effects of human recombinant TNF on the tumor blood vessels and on the thrombus formation were investigated in relation to its mode of antitumor action against Meth-A sarcoma transplanted in BALB/c mice. The extent of the blood vessel lesion was evaluated by using transparent chamber placed in the mouse skin. Bleeding, hyperemia and congestion were observed at 1-2h, 4-6h and 24h after TNF (1 X 10(4)U/mouse) administration, respectively. In contrast, no histological changes in the normal blood vessels were observed microscopically following TNF injection. Thrombus formation was evoked in the tumor vessels 4h after TNF injection. However, when thrombus formation was prevented by heparin, no difference was observed among antitumor action of TNF against Meth-A fibrosarcoma necrotic response and the rate of complete cure. These results suggest that the direct effects of TNF causing lesions in the tumor blood vessels plays an important role in its antitumor action. PMID- 3318707 TI - Panniculitis. New findings in the 'third compartment'. PMID- 3318708 TI - Panniculitis associated with severe alpha 1-antitrypsin deficiency. Treatment and review of the literature. AB - Panniculitis associated with homozygous severe alpha 1-antitrypsin deficiency was documented in three women hospitalized for painful cutaneous and subcutaneous ulcerations (severe panniculitis with spontaneous ulceration and drainage of clear or serosanguineous fluid). None had a history of trauma or infection. One patient responded rapidly and completely to treatment with dapsone. One patient, who had more extensive disease, failed to respond to prednisone plus dapsone; infusions of alpha 1-proteinase inhibitor concentrate led to resolution of her panniculitis. One patient who had severe and extensive panniculitis and pleural effusions failed to respond to corticosteroids but did well when both dapsone and infusions of alpha 1-proteinase inhibitor concentrate were added to her treatment program. PMID- 3318709 TI - Plasma and skin carriers for natural and synthetic retinoids. AB - Human skin contains several proteins that could bind the hydrophobic retinoids. One is retinol-binding protein (RBP), the plasma carrier of natural vitamin A, retinol, albumin, and two specific cellular-binding proteins, one for retinol (CRBP) and one for retinoic acid (CRABP). Adequate techniques for the study of these proteins in human skin have been developed; this was considered a necessary step in the understanding of how natural and synthetic retinoids work in the skin. A polyacrylamide gel electrophoresis technique followed by protein immunoblot analysis with an antiserum specific against RBP was developed. This technique allowed study of the binding of several natural and synthetic retinoids on the plasma carrier of natural vitamin A for the first time; it was found that only natural retinoids, including retinoic acid, bind to RBP in vitro; retinoic acid binding was found to induce major conformational changes in the protein. Isotretinoin did not bind to RBP. The technique was then used for the study of RBP in human epidermal and dermal extracts; it showed that RBP degradation with loss of binding properties for retinol occurred within the epidermis; this suggests that retinol supply is decreased within the epidermis, a fact that could be linked to cornification. A polyacrylamide gel electrophoresis binding assay was developed for studying CRBPs and CRABPs in human skin cytosolic extracts. This assay is more specific and more convenient than previous ones for studying tissue extracts. The CRABP was (1) in much higher levels in normal epidermis than in normal dermis, (2) dramatically elevated in psoriatic plaques and in some retinoid-responsive dermatoses, and (3) up modulated by both topical and systemic administration of natural and synthetic retinoids. Such alterations were not observed for CRBP. From these and other observations reviewed herein, it seems that CRABP should be one of the first candidates to be carefully analyzed in the search of the cellular receptor for the mediation of the synthetic retinoids in pharmacologic effects in human skin. PMID- 3318710 TI - Inborn errors of biotin metabolism. AB - The important role of biotin in human physiology has been highlighted by the recognition of two newly discovered human inborn errors of the metabolism of biotin. The molecular defect in the neonatal-onset disease is in the enzyme holocarboxylase synthetase. The defect in the later infantile-onset disease is in the enzyme biotinidase. Both disorders present with impressive clinical manifestations involving the skin and hair. In the neonatal disease, alopecia totalis is associated with a bright red scaly total body eruption. In biotinidase deficiency, the alopecia is more patchy and the skin lesions resemble acrodermatitis enteropathica. Both disorders are complicated by recurrent episodes of life-threatening acidosis and massive ketosis. PMID- 3318712 TI - Plasma renin activity in infants with congenital heart disease. AB - Plasma renin activity was estimated in 11 infants with severe congestive heart failure. The infants had congenital heart disease with left to right shunts and were receiving diuretic treatment. Plasma renin activity was measured by radioimmunoassay of generated concentrations of angiotensin I. The mean (SD) plasma renin activity was 84 (21) ng angiotensin I/ml/hour, which is considerably above normal infant values. A hyperactive renin-angiotensin system may be detrimental in these patients. Angiotensin converting enzyme inhibitors may be of value in treating infants with severe congestive heart failure. PMID- 3318711 TI - Clinical trials of penicillamine in Indian childhood cirrhosis. AB - The outcome in 15 children with advanced Indian childhood cirrhosis (ICC) treated with penicillamine 20 mg/kg/day was not significantly different from that in untreated children. Among children admitted to a further double blind trial who had ICC but who had not yet developed jaundice or ascites 10 treated with penicillamine and 10 treated with penicillamine plus prednisolone had a significantly improved survival. Fourteen of 29 treated cases made a clinical recovery and were alive 489 to 1460 days from the start of treatment. Biopsy specimens in survivors showed a return to normal liver histology in three, residual fibrosis in six, and inactive micronodular cirrhosis in five. Thus penicillamine, while not shown to be beneficial in advanced ICC, lowered mortality from 93% to 52% in preicteric cases of ICC. PMID- 3318713 TI - Residual insulin secretion in adolescent diabetics after remission. AB - Twenty four hour blood glucose profiles were compared in two groups of insulin dependent adolescent diabetic patients who were beyond their initial partial remission phase. In the group with persistent endogenous insulin secretion, blood glucose profiles were significantly lower but the difference was small and not reflected in average 24 hour concentrations of glucose nor glycosylated haemoglobin. Endogenous insulin secretion must be considered in studies of metabolic control after the remission period but the effect on overall glucose control is probably clinically unimportant. PMID- 3318714 TI - Perianal infection with group A streptococcus. AB - Anal fissure in childhood usually heals quickly after treatment with stool softeners and a local anaesthetic ointment; infection does not usually occur. Two cases are reported in which Lancefield group A beta haemolytic streptococci were isolated from cultures from the perianal skin, which was erythematous and excoriated. PMID- 3318715 TI - Immunohistochemical and biological evidence for a neuromodulator function of neuropeptide Y in the human oviduct. AB - By means of the peroxidase-antiperoxidase technique the existence of neuropeptide Y-immunoreactivity (NPY-IR) in nerve fibers of the normal human uterine tube was established. NPY-IR fibers are found to supply vascular and non-vascular smooth muscles of the uterine tube. In both systems the density of NPY-IR nerves is markedly high. The NPY-IR nerves exhibit a predominance for the arterial portion of the oviductal vasculature in the serosal, the muscle and the mucosal layer. Furthermore in the mucosal layer, some NPY-IR fibers occur in contact with the surface epithelium. In-vitro experiments with helical strips of the human uterine tube reveal no significant effects of NPY alone of the different parameters (resting tension, frequency and amplitude of spontaneous contractions) of mechanical activity while it seems to act in combination with acetylcholine. Thus, the distinct innervation patterns of the NPY-IR nerve fibers as well as the results obtained by bioassay may suggest a neuromodulator function of this neuropeptide in the human uterine tube. In this respect, NPY may play an important role in the transport of the eggs through the tube. PMID- 3318717 TI - Identification of human chorionic gonadotropin (HCG) secreting cells and other cell types using antibody to HCG and a new monoclonal antibody (mABlu-5) in cultures of human placental villi. AB - We have identified cells which secrete human chorionic gonadotropin (HCG) of cultures if first trimester placental villi. As a first step, we identified epithelial cells using a new monoclonal antibody. We then added HCG antibodies to the cultured cells. We found that syncytiotrophoblast (and not cytotrophoblast), Hofbauer cells and some mesenchymal cells stained with HCG antibodies. PMID- 3318718 TI - [Aspiration technics with ultrasound control]. PMID- 3318716 TI - Inhibition of fibroblast proliferation in a culture of human endometrial stromal cells using a medium containing D-valine. AB - A nutrient medium in which D-valine was substituted for L-valine inhibited fibroblast proliferation in a culture of human endometrial stromal cells. Fibroblasts were not killed by D-valine and were able to grow again when D-valine was replaced by L-valine. The stromal cells proliferate in the D-valine medium only when seeded at high density. They were distinguished from fibroblasts by their morphology in light microscopy, their surface characteristics at scanning electron microscopy and their lower staining with fibronectin antibodies. PMID- 3318719 TI - [New knowledge on immunology in gynecologic cancer]. PMID- 3318720 TI - [Retroperitoneal liposarcomas]. PMID- 3318721 TI - [Polycystic kidney in newborn infants]. PMID- 3318722 TI - [Non-functioning corticoadrenal carcinoma: contribution of a case and review of the literature]. PMID- 3318723 TI - A double blind controlled trial of methylprednisolone infusions in systemic lupus erythematosus using individualised outcome assessment. AB - Twenty one patients with severe systemic lupus erythematosus (SLE) were treated with three daily infusions of either 100 mg or 1 g of methylprednisolone on a randomised double blind basis. Nine patients with unsatisfactory outcome subsequently received the alternative therapy. Patients were rated for improvement on a four point scale using individualised criteria. On three occasions patients improved to 'ideal', on 12 there was 'useful' improvement, on 11 the patient remained static, and on four occasions there was deterioration. There was no significant difference between the clinical states after the two doses. The results suggest that any additional benefit of 1 g of methylprednisolone over 100 mg by repeated infusion in the treatment of active SLE is probably not enough to justify the potential hazards and cost involved. PMID- 3318724 TI - Effect of oestrogen treatment on clinical and laboratory manifestations of rheumatoid arthritis. AB - The effect of administration of 12.5 micrograms ethinyloestradiol to 10 female patients with active rheumatoid arthritis was investigated in a prospective double blind crossover study. Some improvement during oestrogen treatment was found in 30 m walking time, haemoglobin concentration, and thrombocytosis. Erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) deteriorated in both periods, but less in the oestrogen period. Grip strength improved during both periods. The number of swollen joints decreased, whereas the joint tenderness score increased during the oestrogen period. PMID- 3318725 TI - Gold colitis induced by auranofin treatment of rheumatoid arthritis: case report and review of the literature. AB - A case of ulcerative colitis occurred during treatment of rheumatoid arthritis with the new oral gold preparation auranofin after a cumulative dose of 2160 mg. A barium enema showed loss of mucosal pattern and a rectal biopsy disclosed deep erosions, mucosal inflammation, and crypt abscesses. Precipitates of gold were seen in the periglandular stroma. On electron microscopy the gold deposits seemed to be identical to granules described in gold nephropathy. As the extrapolated serum gold level was within the normal range at the onset of the complication, the morphological findings suggested a local toxicity of the drug. The patient recovered within 14 days of withdrawal of auranofin and the start of therapy with sulphasalazine and steroids. A review of the published work shows that the previously reported mortality in gold colitis of 40% has decreased in recent years. The causes of this decrease may be both the earlier diagnosis of gold colitis and the improved intensive care of its severe complications. PMID- 3318726 TI - Pyogenic liver abscess. Diagnostic and therapeutic strategies. AB - A retrospective review of 26 adult patients admitted to University of California, Davis, Medical Center (UCDMC) with pyogenic liver abscess (1980-1986) was performed to ascertain the impact of rapid diagnosis and percutaneous drainage. Ultrasonographic examinations and computed tomography (CT) scans were highly sensitive and noninvasive imaging modalities. Sixteen patients had solitary abscesses and seven had multiple microscopic abscesses. The median time interval from admission to diagnosis and therapy was 2 and 3 days, respectively. Origin of the abscess was determined in 22 patients, the biliary tree being the most common source. Medical therapy was successful in three patients with microabscesses but failed in two. Nine patients had percutaneous drainage; two required repetitive percutaneous catheter placement, and two proceeded to surgical drainage. Twelve patients had surgical drainage; one required repetitive surgical drainage. Postdrainage complications were minimal in all groups. Overall mortality role was 11.5% (two patients). Deaths were related to delay in diagnosis, gram-negative sepsis at presentation, and biliary origin of the abscess. PMID- 3318728 TI - Percutaneous ultrasonography-guided cutting biopsy from liver metastases of endocrine gastrointestinal tumors. AB - Ultrasonography-guided cutting needle biopsy of the liver was performed in 186 instances on 95 different patients with carcinoid and endocrine pancreatic tumors. In 171 cases, biopsy specimens were taken from liver metastases found on ultrasonography, and in 93% of these the obtained material was adequate for a correct diagnosis. In the 7% for which an incorrect diagnosis was made, all but one biopsy specimen contained normal liver tissue, indicating that the needle guiding technique, and not the sampling technique, is the most critical part of the biopsy procedure. Tumor specimens were examined with silver stains and immunocytochemistry after application of monoclonal serotonin antibodies. The argyrophil silver stain of Grimelius could be applied on all specimens and had positive results in all but one case, demonstrating the neurohormonal endocrine origin of the metastases. The argentaffin reaction and/or serotonin immunoreactivity could be applied in 152 cases and had positive results in 115 of 122 (94%) of the mid-gut carcinoid tumors and negative results in 27 of 28 (96.4%) of the non-mid-gut carcinoid tumors and endocrine pancreatic tumors. Major complications occurred in 1.5%; none was lethal or required surgery. The results show that the technique used for tumor biopsy is very accurate and provides material sufficient for multiple histopathologic and immunocytochemical analyses without exposing the patients to high complication risks. It is further concluded that the staining techniques and immunocytochemical analyses applied on the biopsy specimens are valid for the prediction of the location of the primary endocrine tumor. PMID- 3318727 TI - Right lower quadrant pain in young patients with leukemia. A surgical perspective. AB - A retrospective review of cecal and appendiceal complications occurring in young patients with acute leukemia since 1969 was performed. The objective of this study was to determine the relative incidence of appendicitis and typhlitis among patients with acute leukemia who had operation or autopsy in this institution as well as to determine the risks of operative intervention. Fifteen patients with these complications were identified among the 400 patients with acute leukemia seen during this time period. Signs and symptoms of an acute abdomen were present despite immunosuppression. The incidence of sepsis at the time of presentation was 53%. Preoperative risk factors identified most frequently were coagulopathy and organ failure resulting from sepsis. Postoperative morbidity (25%) and mortality rates (8%) were related to the development of infectious complications. Appendicitis occurred in eight of the 15 patients studied, whereas typhlitis or its complications was found in seven patients. No preoperative factors could be found to differentiate typhlitis from appendicitis on clinical examination. It is suggested that operation can be safely performed in neutropenic patients who have acute right lower quadrant pain and signs of peritoneal irritation and may be the only effective way of differentiating appendicitis from typhlitis. PMID- 3318729 TI - Portal vein injuries. Noninvasive follow-up of venorrhaphy. AB - The authors report their experience with 14 patients with portal vein injuries (1976-1986) treated at a level I trauma center. Seven patients (50%) survived and included six of 10 patients (60%) who had venorrhaphy and one in whom the portal vein was ligated. Associated injuries were present in all the patients (mean Abdominal Trauma Index: 39.5) and accounted for the high mortality rate. Follow up data after repair or ligation of the portal vein seldom are reported in the literature. The authors studied all three patients who survived portal venorrhaphy since 1982 by real-time ultrasonography. Patency of the repair could be established in two patients. In the third patient postvenorrhaphy thrombosis was diagnosed by ultrasonographic examination. Sequential ultrasonographic examinations demonstrated resolution of the thrombus on anticoagulant therapy. Ultrasonography provides a noninvasive and easily reproducible method of studying the portal vein after repair. PMID- 3318730 TI - Studies on in vitro culture supernatant of P. falciparum. Isolation of antigens for serology. AB - Twenty-four-hour-old in vitro culture supernatant of Plasmodium falciparum was collected and a comparative study was carried out using supernatant antigen and antigen prepared from in vitro culture of P. falciparum parasites in ELISA with sera from slide-positive malaria cases. The results were comparable, and in certain cases higher ELISA readings were observed with the supernatant antigen. PMID- 3318731 TI - Plasma concentrations and toxicity of chloroquine after slow intravenous infusion in patients with falciparum malaria. AB - Five male patients with acute Plasmodium falciparum or Plasmodium vivax infections were infused with chloroquine diphosphate (15 mg kg-1) over four hours. Further does of chloroquine diphosphate (5 mg kg-1) were given at 12, 24, 36 and 60 hours. Plasma chloroquine concentrations were determined before and four hours after each dose and then daily until discharge. No serious cardiovascular toxicity was observed, and plasma chloroquine concentrations exceeding the putative minimum inhibitory concentration (MIC) of sensitive P. falciparum strains were reached within four hours of starting treatment. Further doses produced plasma concentrations which were sustained above the putative MIC, but showed no rapid increase into the range associated with toxicity. PMID- 3318732 TI - Antimalarial activity of Mannich bases derived from 4-(7'-bromo-1',5' naphthyridin-4'-ylamino)phenol and 4-(7'-trifluoromethylquinolin-4' ylamino)phenol against Plasmodium falciparum in vitro. AB - Mono- and di-Mannich bases derived from 4-(7'-bromo-1',5'-naphthyridin-4' ylamino)phenol and 4-(7'-trifluoromethylquinolin-4'-ylamino)phenol were assayed for antimalarial activity (using an in vitro radioisotopic technique) against two isolates of Plasmodium falciparum. Many from these two series of compounds had an IC50 value (concentration of compound causing 50% inhibition of 3H-hypoxanthine incorporation) comparable to or better than those of mefloquine and amodiaquine, for both a chloroquine-sensitive isolate (FCQ-27) and the chloroquine-resistant isolate (K1). At least one compound, 2,6-bis (piperidin-1''-ylmethyl)-4-(7' trifluoromethylquinolin -4'-ylamino)phenol (TN112), showed significant superior activity to the three antimalarials chloroquine, mefloquine and amodiaquine against both isolates. (Statistically superior activity compared to these three antimalarials was found for TN112, except that against the K1 isolate its activity was just outside the range of significance relative to mefloquine.) Some of the 7-bromo-1,5-naphthyridine Mannich bases were appreciably less toxic in mice than amodiaquine. PMID- 3318733 TI - Comparison of the relative in vitro activity of chloroquine and amodiaquine against chloroquine-sensitive strains of P. falciparum. AB - The activities of chloroquine and amodiaquine against a sensitive strain of Plasmodium falciparum found in children in Ibadan were compared using an in vitro technique. The criterion for drug activity was the inhibition of maturation of the parasites. Three sets of experiments were performed with each of the two drugs. The minimum concentration of chloroquine causing 90% inhibition of maturation was 25 nmol as compared with 12 nmol for amodiaquine. This suggests a two-fold increase in activity of amodiaquine when compared with chloroquine against sensitive strains of P. falciparum. The implication is that amodiaquine is a much more potent tool in malaria chemotherapy than the erstwhile overused chloroquine. PMID- 3318734 TI - Community-based malaria control in Saradidi, Kenya: description of the programme and impact on parasitaemia rates and antimalarial antibodies. AB - A community-based malaria control programme initiated in Saradidi, Kenya in 1982 is described. Antimalarial treatment provided by volunteer community health workers was made available in each village. Malaria was holoendemic. Parasitaemia rates by age were high and did not change after the control programme began. Plasmodium falciparum was the most common species and was present alone or mixed in 98.2% of 8105 infections. Virtually all (98.5%) of 2040 blood samples collected in May 1981 were positive (reciprocal titre greater than or equal to 80) to P. falciparum by the indirect fluorescent antibody (IFA) test. Seropositivity rates to P. falciparum in the IFA test or the enzyme-linked immunosorbent assay (ELISA) were high in all age groups and did not change significantly in longitudinal surveys or in a cohort of children zero to nine years old followed at intervals. While the malaria control programme was successful in bringing treatment to each village, malaria prevalence was not reduced. Parasitologic and serologic studies alone were not adequate to describe the impact of the community-based malaria control programme in Saradidi. Morbidity and mortality rates caused by malaria can decline, significantly improving the health of the population, in the absence of any decrease in parasitaemia rates. PMID- 3318735 TI - Malaria chemoprophylaxis to pregnant women provided by community health workers in Saradidi, Kenya. II. Effect on parasitaemia and haemoglobin levels. AB - To determine the effects of chloroquine phosphate (300 mg base weekly) chemoprophylaxis for malaria provided by volunteer village health helpers (VHH's), pregnant women attending antenatal clinics in Saradidi, Kenya, were examined each month. Parasitaemia, haemoglobin level, and the presence of urinary 4-aminoquinolines were determined at each visit. The age composition and parity of women taking chemoprophylaxis were not statistically significantly different from those of the other women. A total of 104 (29.1%) of 357 pregnant women from 23 villages where chemprophylaxis was provided by VHH's said they were taking it. Women 30 to 44 years of age (43.9%) of 82) were more often taking prophylaxis than those younger (25.1% of 271) (P less than 0.0005). An additional 573 pregnant women to whom regular chemoprophylaxis was not provided from 33 control villages were also examined at least once. When compared with those from women not taking prophylaxis, blood samples from pregnant women on antimalarial prophylaxis had lower parasite rates (17.7% of 265 compared with 26.2% of 1700, P less than 0.005), higher haemoglobin levels (59.1% of 127 were greater than or equal to 10.0 g l-1 compared with 49.7% of 1111, P less than 0.05), and a higher mean haemoglobin level (9.95 g dl-1 compared with 9.62, P = 0.019) and urine samples were more often positive for 4-aminoquinolines (15.7% of 255 compared with 8.3% of 1656, P less than 0.0005). For women with two or more parasitologic samples, 69.6% of 79 pregnant women on prophylaxis had no parasites found on any visit compared with 51.6% of 516 women not on chemoprophylaxis (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318736 TI - Malaria chemoprophylaxis to pregnant women provided by community health workers in Saradidi, Kenya. III. Serologic studies. AB - Parasitaemia and antimalarial antibodies were examined from May 1983 to March 1984 in monthly samples taken from 930 pregnant women attending antenatal clinics in Saradidi, Kenya, and 317 of their infants; 104 women were taking chloroquine phosphate 300 mg base weekly for chemoprophylaxis. Seropositivity rates in pregnant women were uniformly high, and mean enzyme-linked immunosorbent assay (ELISA) absorbance values were not related to presence of parasitaemia or history of chemoprophylaxis. Parasitaemia was present in 26.5% of 1677 slides from pregnant women and there was little variation by month of sample. Mean ELISA absorbance values varied by month of sample. Seropositivity rates in infants were high as measured in both the indirect fluorescent antibody (IFA) test (81.6% of 938) and ELISA at 1:100 (83.8% of 1025) and 1:1000 (34.8% of 1025) serum dilutions. Seropositivity rates decreased slightly after birth but by four months of age rates were again high. Parasitaemia was present in 26.5% of 1677 slides from pregnant women. Paired comparisons were made on maternal samples collected less than two months before parturition and samples from the infants collected within two months after birth. The paired antibody response by IFA or ELISA was not dependent on the presence of detectable parasitaemia in the mother. Infants from mothers with a history of antimalarial chemoprophylaxis had significantly (P = 0.04) lower IFA titres than other infants. Measuring the absorbance of a 1:100 serum dilution by ELISA appeared to be an excellent method with which to measure longitudinal serologic changes in a population. PMID- 3318737 TI - Changing response to chloroquine of Plasmodium falciparum in Saradidi, Kenya, from 1981 to 1984. AB - From 1981 through 1984, the response of Plasmodium falciparum to chloroquine was monitored in Saradidi, Kenya, as a part of a community-based health programme to provide treatment for malaria in each village. Before 1983, all 71 infections treated with chloroquine were sensitive in vivo; parasitaemia cleared by day 3 and remained absent to day 7. In June 1983, 23.1% of 26 infections treated with chloroquine base 10 mg kg-1 either recrudesced in seven days (RI resistance, five infections) or decreased but failed to clear (RII resistance, one infection). In September 1983, 16.2% of 68 and in February 1984, 13.2% of 53 infections were resistant in vivo after treatment with chloroquine base 10 mg kg-1. A course of chloroquine base 25 mg kg-1 over three days remained effective; only two (1.6%) of 129 infections examined were resistant in vivo; in both, parasitaemia cleared then recurred (RI). In September 1984, however, nine (10.2%) infections were resistant after treatment with chloroquine base 25 mg kg-1; in four of these parasitaemia decreased but never cleared (RII). Similar results were observed in vitro. In the Rieckmann macro in vitro test, 63.3% of 30 P. falciparum isolates tested were resistant to chloroquine (minimal inhibitory concentration (MIC) greater than or equal to 1.25 X 10(-6) mol 1(-1) blood) in June 1983, as were 61.8% of 34 isolates in the Rieckmann micro test (MIC greater than or equal to 1.14 X 10(-6) mol 1(-1) blood).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318738 TI - Omental pedicle graft in the management of infected ascending aortic prostheses. AB - Two patients had mediastinal infections with chronic draining sinus tracts that involved a vascular prosthesis in the ascending aorta. In 1 patient, a false mycotic aneurysm developed and in the other, a beginning rupture of the proximal suture line. In both patients, the infection was cured by replacing the infected aortic prosthesis combined with wrapping the new prosthesis with a pedicled omental graft. An omental graft was used to protect the vascular prosthesis and minimize the risk of recurrent infection. PMID- 3318740 TI - A comparative study of conventional versus high-frequency jet ventilation with relation to the incidence of postoperative morbidity in thoracic surgery. AB - Sixty-five patients undergoing a thoracic procedure were randomly allocated to one of two groups. The first group received a conventional method of ventilation (double-lumen endobronchial tube and collapse of one lung) and the second, high frequency jet ventilation (HFJV). The incidence of postoperative chest infections (clinical and bacteriological), the chest drain volumes, and the length of postoperative stay in the hospital were recorded. Results showed the jet ventilator group had a significantly reduced mean hospital stay (p less than 0.01), which could be attributed to a lower incidence of postoperative chest infections (p less than 0.001) and significantly improved arterial blood O2 tensions at 4 hours (p less than 0.05), 24 hours, and 7 days postoperatively (p less than 0.001). PMID- 3318739 TI - Left ventricular full-thickness cardiomyoplasty with pericardial neoendocardium: experimental development of a surgical procedure. AB - Cardiomyoplasty, a surgical procedure using stimulated skeletal muscle graft to replace or repair damaged myocardium, has been successfully performed in experimental animals and clinical patients. Whenever feasible, endocardium of the damaged myocardial segment is retained and partial-thickness cardiomyoplasty should be carried out. However, if this procedure were to be applied to enlarge a hypoplastic ventricle or to maintain normal dimensions of the ventricular cavity in some repairs in adults, full-thickness replacement of the ventricular wall with contractile skeletal muscle mass would be required. To develop such a technique, several canine experiments were carried out. In 7 dogs, "simple full thickness cardiomyoplasty" was performed by using a latissimus dorsi muscle graft to repair a full-thickness left ventricular wall defect. We found it was difficult to obtain adequate hemostasis between the nonscarred myocardial tissue and the skeletal muscle graft, and excessive suturing to obtain hemostasis resulted in strangulation of the muscle grafts. The skeletal muscle-blood interface in the left ventricle was found to be highly thrombogenic. The perioperative hemorrhage and the risk of muscle graft strangulation by excessive sutures were avoided by using a pericardial patch as neoendocardium in 5 dogs that underwent similar full-thickness cardiomyoplasty procedures. Although the pericardial neoendocardium was not fully antithrombogenic in this canine model, endothelialization of the endocardium occurred within several weeks after operation. Thus, when combined with an implantable synchronized burst stimulator, this technique may in the future provide an effective "full-thickness dynamic cardiomyoplasty" to enlarge the ventricles and augment myocardial function in select patients. PMID- 3318741 TI - Aneurysmal dilatation of patent ductus arteriosus in a case of Ehlers-Danlos syndrome. AB - A case of Ehlers-Danlos syndrome in a 3-year-old Chinese girl is described. She had aneurysmal dilatation of patent ductus arteriosus. Resection of the dilated patent ductus arteriosus was performed successfully using cardiopulmonary bypass with total circulatory arrest. PMID- 3318743 TI - Tracheoesophageal trauma. PMID- 3318742 TI - Evolving concepts in prevention of spinal cord injury during operations on the descending thoracic and thoracoabdominal aorta. AB - Spinal cord injury following operations on the descending thoracic or thoracoabdominal aorta remains a major problem. In certain subsets of patients, the risk of postoperative spinal cord injury is substantial. Although several adjuncts have been employed clinically to eliminate or reduce the frequency of this complication, none have proven to be completely effective. An important reason for this is the failure of these techniques to reliably and noninvasively localize the level of origin of arteries from the aorta that are critical to spinal cord circulation. Since postoperative spinal cord injury most likely results from ischemia or hypoxia of the lower segment of spinal cord, use of adjunctive techniques to preserve spinal cord function during aortic clamping by perfusing the distal aorta adequately with or without systemic hypothermia should be considered. To practically implement this, partial cardiopulmonary bypass for distal perfusion when the critical intercostal or lumbar arteries originate from the aorta distal to the excluded segment, and total cardiopulmonary bypass with systemic hypothermia and implantation of intercostal and lumbar arteries when these arteries originate from the excluded segment, can be used. In addition, whenever possible, intraoperative monitoring of spinal cord function should be performed. PMID- 3318744 TI - Progressive subcortical gliosis of Neumann: a clinicopathologic study of two cases with review. AB - A clinico-pathological report is given of two cases of progressive dementia of fronto-temporal type associated with variable cortical neuronal loss and extensive subcortical and deep white matter gliosis. There was minimal demyelination of white matter, significant gliosis of thalamus and inferior olivary nuclei. The authors review the condition of progressive subcortical gliosis, compare such changes with white matter changes in other dementias, examine the relationship to Kraepelin's disease, contrast the disorder with atypical Pick's dementia, progressive dementia with motor neuron disease and Creutzfeldt-Jakob dementia. PMID- 3318745 TI - Presenile dementia combined with amyotrophy: a review of 34 Japanese cases. AB - Thirty-four Japanese cases exhibiting presenile dementia combined with amyotrophy were reviewed with four case reports. The clinical feature of dementia was generally unspecific and could not be clearly diagnosed as Pick's disease or Alzheimer's disease. But most of these patients did not exhibit manifest visual agnosia or apraxia suggesting 'posterior dementia'. Brain CTs showed mild diffuse atrophy with non-circumscribed fronto-temporal accentuation. PSD (periodic synchronous discharge on EEG) as seen in Creutzfeldt-Jakob disease (CJD) was not noted in any of these cases. Although individual neurological findings were not contradictory to amyotrophy lateral sclerosis (ALS), the clinicopathologic findings, on the whole, could be regarded as indicative of an atypical spinal progressive muscular atrophy. The brain pathology lacked specific changes. A mild to moderate degree of glial proliferation, subcortical gliosis and a moderate spongy state of the upper cortical layers were seen mainly in the fronto-temporal area. Nigral degeneration was observed in half of the cases. No Pick's cells, Pick's balls, Alzheimer's neurofibrillary changes or senile plaques were observed except in two cases, in whom it could be regarded as physiological. Brain weight was lighter than that of normal Japanese but heavier than that of Pick's disease, Alzheimer's disease or CJD. The brain pathology was similar to that of progressive subcortical gliosis. We have concluded that the disease under discussion might be a new disease entity. PMID- 3318746 TI - Long duration Jakob-Creutzfeldt disease. AB - The first patient was a woman hospitalized at the age of 43 years; she received the diagnosis of presenile dementia because of a progressive deterioration of her intellectual functions over an interval of 3 years. On admission there were no localizing neurological findings. During the ensuing years she became unable to speak and was no longer able to respond to commands. Death occurred at the age of 46 years from bronchopneumonia. The brain showed marked atrophy of the frontal lobes, moderate in the temporal lobes. The anterior horns of the lateral ventricles were greatly dilated. Microscopically cortical atrophy was severe, with marked depletion of neurons in involved regions. Lamination and polarity were not preserved. There was considerable increase of astrocytes and microglia, and focal sponginess was prominent. The hippocampus showed atrophy of Sommer's sector and subiculum. There were no neurofibrillary tangles and no argyrophilic plaques. The occipital sections showed little neuronal loss and no increased astrocytes or sponginess. The insulae showed neuronal loss and gliosis. There was bilateral atrophy of the caudate nuclei and globus pallidus adjacent to the dystrophic anterior limbs of the internal capsule. In the brain stem the frontopontine tracts were partially demyelinated and showed reactive gliosis. Ventral horns were atrophic with moderate glial reaction. In the second patient the microscopic changes were quite similar to those in Case 1, but there was more severe degeneration of the corticospinal tracts and the ventral horns of the spinal cord which showed considerable loss of neurons and degenerative changes in the remaining nerve cells and nerve fibers. There were many instances of axonal degeneration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318747 TI - Circuitry of the frontal association cortex and its relevance to dementia. AB - The prefrontal cortex reaches its peak size and complexity in the human brain where it occupies more than a quarter of the cerebral cortical surface. This paper reviews studies on that portion of the prefrontal cortex that is buried in and around the principal sulcus of macaque monkeys and corresponds to Brodmann's area 46 in man. Neuropsychological research as well as neurophysiology and 2 deoxyglucose metabolic mapping indicate that the principal sulcus is essential for regulation of motor behavior by internalized representations of visuo-spatial events. Conversely, the prefrontal cortex is unnecessary for behavior regulated by external stimuli, as is the case with many associative learning and recognition memory processes. Research over the past decade suggests that the principal sulcus accomplishes its regulatory functions by its interconnections with (1) the posterior parietal cortex which provides it with access to visuo spatial data, (2) the parahippocampal gyrus and subiculum which allows information to be held 'on line' and deposited in long-term storage, and (3) motor centers such as the basal ganglia, deep layers of the superior colliculus and several premotor areas that control head, eye and hand movements. In addition, modulatory influences on prefrontal functions are exerted by (4) dopamine-, norepinephrine- and serotonin-containing fiber systems that originate in the brain stem and innervate the prefrontal cortex in a selective manner. Comparison between syndromes present in patients with a variety of diagnoses and human and nonhuman subjects with prefrontal injuries provides suggestive evidence that prefrontal dysfunction may underly the disordered thinking and abnormal social and affective responses found in many of these diseases. Accordingly, knowledge of the neural mechanisms underlying cognitive processing in nonhuman primates should be helpful in the analysis of the 'neurology' of many neurological and psychiatric illnesses. PMID- 3318748 TI - Behaviour correlates to frontal lobe dysfunction. AB - A resume of conventional neuropsychological tests for assessment of frontal lobe dysfunction is given, focusing on aspects of cognition like the ability to form sequences, abstractions and estimations. Beside these, assessment variables, qualities of behaviour and test-taking attitude are regarded to be vital for the diagnostic statement. The neuropsychological theory is compared with and related to dynamic psychology with special reference to ego functions and adaptive capacities. A possible subdivision of behaviour manifestations within the frontal lobe syndrome is hypothesized from recent neuropathological findings. PMID- 3318749 TI - [Ewing's sarcoma. Retrospective study of 108 cases with review of the literature]. AB - 108 cases of Ewing's Sarcoma are collected at the "Curie Institute" and studied by the authors using the modern Technics of electron microscopy, cytochemistry, immunohistochemistry and cytogenetics. They raise the histogenesis and etiological factors not entirely resolved yet at the light of literature review. PMID- 3318751 TI - Tapering of corticosteroid therapy following exacerbation of asthma. A randomized, double-blind, placebo-controlled trial. AB - Systemic corticosteroids are effective in the treatment of acute asthma, but the optimal schedule for steroid withdrawal following an asthma exacerbation has not been determined. This study was designed to test the hypothesis that tapering the corticosteroid dosage over a longer period of time reduces the number of reexacerbations. Non-steroid-dependent adult men hospitalized for asthma exacerbations during a one-year period (n = 43) were randomly assigned to corticosteroid tapering regimens of one or seven weeks, following an eight-day course of high-dose corticosteroid therapy. There were no significant differences between the long-taper and short-taper groups in rate of reexacerbation (41% vs 52%) or readmission (22% vs 21%) during the 12-week study period. Patients who did not have a reexacerbation during the 12 weeks were evaluated with spirometry, with no significant differences occurring between the two groups. More patients in the long-taper group reported corticosteroid side effects (41% vs 14%). Patients who required mechanical ventilation during the initial hospitalization (n = 7), or who reported more than two days of worse than usual dyspnea in the 12 week period (n = 20), had high rates of reexacerbation (86% and 80%, respectively). These results provide reasonable certainty (90%) that a long taper does not result in a large reduction (50% or more) in reexacerbations compared with a short taper. We conclude that the relapse rate is high in this population regardless of the corticosteroid tapering regimen used, and that a long taper does not appear to provide enough benefit to justify its routine use. PMID- 3318750 TI - Nonsteroidal anti-inflammatory drug gastropathy. Recognition and response. AB - Gastropathy, recognized as gastric lesional disease ranging from erosions to actual ulcer craters, represents the most ubiquitous significant complication of common nonsteroidal anti-inflammatory drug (salicylate and nonsalicylate) use. Recently, this association has been established as distinct from classic peptic ulcer disease, which is primarily acid-mediated, duodenal, and more prevalent in a younger, often male, population. Nonsteroidal anti-inflammatory drug gastropathy is usually antral/prepyloric disease, and research indicates it is mediated through blockade of cyclooxygenase with reduction in cytoprotective gastric prostaglandins. The previous literature has been confounded with short term studies on healthy volunteers and animals that emphasize the resiliency of normal gastric adaptation to heal such gastropathy. Newer long-term studies in patients with arthritis undergoing anti-inflammatory therapy on a sustained basis indicate fatigue of normal adaptation, with persisting gastropathy leading to bleeding and even death. In addition, silent lesions are more common as symptomatology is not synchronous with lesional disease. Since endoscopy is an expensive, not always utilized procedure, it is important to identify the population most at risk for appropriate cytoprotective management as well as modification of the anti-inflammatory therapy program. PMID- 3318752 TI - Ex vivo repair and renal autotransplantations for renovascular disease. PMID- 3318753 TI - The Streptomyces ghanaensis low copy plasmid pSG2 and its use for vector construction. AB - A plasmid, pSG2, was isolated from Streptomyces ghanaensis and characterized by electron microscopy, buoyant density measurement, and restriction enzyme analysis. The length of 13.8 kb, single restriction sites for HindIII, EcoRV and PvuII and the possibility of deleting non-essential regions of the plasmid made pSG2 a suitable basic replicon for vector development. pSG2 has a copy number of about four. Plasmid pSG2 was fused to a pACYC184 derivative modified to harbour a thiostrepton resistance gene. The resulting plasmid, designated pSW1, is a 16.6 kb shuttle plasmid which replicates in Escherichia coli and in several Streptomyces strains, including S. ghanaensis, S. lividans and S. viridochromogenes. Replacement of a BglII-fragment of plasmid pSG2 by a fragment encoding thiostrepton resistance resulted in a low copy 12.2 kb Streptomyces plasmid. This plasmid, designated pSW2, is a Streptomyces broad host range plasmid. PMID- 3318754 TI - An evaluation of family therapy in anorexia nervosa and bulimia nervosa. AB - A controlled trial comparing family therapy with individual supportive therapy in anorexia nervosa and bulimia nervosa was undertaken. Eighty patients (57 with anorexia nervosa; 23 with bulimia nervosa) were first admitted to a specialized unit to restore their weight to normal. Before discharge, they were randomly allocated to family therapy or the control treatment (individual supportive therapy). After one year of psychological treatment, they were reassessed, using body weight, menstrual function, and ratings on the Morgan and Russell scales. Family therapy was found to be more effective than individual therapy in patients whose illness was not chronic and had begun before the age of 19 years. A more tentative finding was the greater value of individual supportive therapy in older patients. To our knowledge, this is the first controlled trial of family therapy in anorexia nervosa and clarifies the specific indications for this treatment. PMID- 3318755 TI - [Epidemiology of cervix cancer--a review]. AB - Cervical cancer behaves epidemiologically like a venereal disease of low infectiousness. Early age at first intercourse and multiple sexual partners have been shown to exert strong effects on risk. There are wide differences in the incidence between different countries also influenced by the introduction of screening. Although the general picture remains one of decreasing incidence and mortality, there are signs of an increasing cervical cancer risk probably due to changes in sexual behavior. HSV 2 infection could not be confirmed to play the anticipated role in the aetiology of cervical cancer. Smoking and HPV 16/18 are currently important issues in a concept of multifactorial, stepwise carcinogenesis at the cervix uteri. PMID- 3318756 TI - Human T cells specifically activated against autologous malignant melanoma. AB - Lymphocytes from ten patients with melanoma were specifically stimulated in vitro with autologous melanoma cells and expanded in interleukin 2. Significant lysis of autologous melanoma cells was demonstrated in T cells derived from six of these patients. The mean percent of lysis of autologous tumor cells at an effector-target ratio of 20:1 was 46% among these six patients. The T cells derived from two patients developed specificity in lysing autologous melanoma cells. In both cases, specificity was enhanced by the in vitro stimulation with autologous tumor cells. Restimulation with autologous melanoma cells was associated with increasing specificity over time. Whether derived from peripheral blood lymphocytes or from lymph node cells, T cells from one patient lysed fresh autologous melanoma cells more potently than K562, allogeneic melanoma cells, and nonmelanoma cells. On day 38, at an effector-target ratio of 10:1, cell lysis of K562, an osteosarcoma, a pancreatic cancer, and three allogeneic melanomas was 3%, 4%, 7%, 8%, 7%, and 2%, respectively, while lysis of autologous melanoma cells was 47%. Specificity was maintained beyond day 60. The T cells could be expanded over 50-fold within one month. PMID- 3318757 TI - Ras oncogene p21 levels parallel malignant potential of different human colonic benign conditions. AB - Ras oncogenes are a specific family of genes believed to play a role in malignant transformation and tumor growth in humans. To gain a better understanding of the role these oncogenes may play in malignant transformation, we evaluated the levels of a ras gene protein product (p21) in formaldehyde-fixed, paraffin embedded specimens of normal human colonic mucosa, hyperplastic polyps, tubular adenomas, villous adenomas, and epithelium from a patient with ulcerative colitis. The p21 protein content was measured using the RAP-5 monoclonal antibody in a semiquantitative immunohistochemical assay. The titer value was expressed as the highest dilution of antibody giving definite staining using the avidin-biotin peroxidase method. Differences in p21 titer values among all classes of polyps were significant (hyperplastic polyps values were less than tubular adenomas values, which were less than villous adenoma values). The p21 titers obtained from ulcerative colitis specimens were similar to those obtained from villous adenomas. We conclude that the levels of ras oncogene protein product increase with the malignant potential of benign human colonic conditions. These findings suggest that the ras oncogene protein product may play an important role in the malignant transformation of benign lesions of the human colon. If these findings are confirmed, as technology progresses to allow molecular probes to measure gene products in biopsy specimens, high-risk patients could be monitored and treated before actual malignant transformation occurs. PMID- 3318759 TI - Laminin expression in colorectal carcinomas varying in degree of differentiation. AB - We are studying the ability of colorectal carcinomas, which vary in degree of differentiation, to assemble a basement membrane and the relationship between differences in this ability and perturbations in laminin expression. For these studies, we are using human colorectal carcinoma cells grown both in vitro and in nude mice as well as tumors obtained at surgery. Immunoperoxidase staining of human tumors indicates that laminin is present in a defined basement membrane in moderately to well-differentiated tumors. This staining pattern is absent in poorly differentiated tumors. In these tumors, staining is discontinuous and sometimes observed intracellularly. The laminin synthesized by in vitro cells was immunoprecipitated and analyzed by acrylamide electrophoresis. Neither poorly nor well-differentiated carcinoma cells exhibit marked differences in the rate of synthesis of laminin. Differences are present in the rate at which newly synthesized laminin is secreted. These differences may result from alterations in posttranslational processing. Such alterations may contribute, along with other factors, to the inability of poorly differentiated tumors to make a basement membrane. PMID- 3318758 TI - Expression of autoantigens in human colorectal carcinomas. Implications for a generic vaccine. AB - The antibody response of patients was used to characterize the autoantigens in human colorectal carcinoma. Twenty-seven primary and 13 metastatic carcinomas with paired normal tissues were extracted and transferred onto nitrocellulose membranes by the Western transfer technique. After the transfers were incubated with the serum of the patient from whom the tumor was derived, autoantigens were identified by indirect immunoperoxidase staining. All tumors contained at least one autoantigen. Six tumor-associated autoantigens, ranging in molecular weight from 26 to 58 kilodaltons (kD), were identified by antibodies in 25% or more of the sera. Eleven metastases expressed a 41-kD autoantigen that was present in only a third of the extracts of normal liver or lung. Thus, the number of dominant polypeptide autoantigens in colorectal carcinoma is restricted to six molecules. These autoantigens may be organ-associated antigens that are expressed by neoplastic cells. The 41-kD autoantigen may be a potential marker for metastases. A generic vaccine appears to be feasible for colorectal carcinoma since the number of dominant antigens is limited. PMID- 3318760 TI - Applications of immunogold labelling in animal and plant virology. PMID- 3318762 TI - [Information and hypotheses on the pathogenesis of malaria]. AB - Recent experimental studies have added greatly to our knowledge of malarial plasmodia and their interaction with the host. However, the current hypotheses on the pathogenesis of malaria and its cerebral complications are still largely based on speculations. Little, if any, consideration is given to biologic properties of the parasite and to postmortem examination findings, even though the processes underlying malaria infection and its complications can be brought to light by collating pathologic, clinical, and parasitologic data. PMID- 3318763 TI - [Johannes Evangelista Purkinje (on the 200th anniversary of his birth)]. PMID- 3318761 TI - The hemagglutinin-neuraminidase (HN) gene of Newcastle disease virus strain Italien (ndv Italien): comparison with HNs of other strains and expression by a vaccinia recombinant. AB - A cDNA library was constructed with poly(A+) mRNA from cells infected with the virulent Italien NDV strain. A clone that hybridized to the HN gene mRNA was sequenced. A long open reading-frame encodes for a protein of 571 amino acids, with a calculated molecular weight of 61,900, including 13 cysteine residues and six potential glycosylation sites. To define the sequence changes that occurred in the avian paramyxovirus hemagglutinin-neuraminidase (HN) during the evolution of virulence, we have studied the HNs of the virulent Italien NDV strain, the mesovirulent Beaudette strain and the nonvirulent Hitchner strain. The majority of amino acid variations are conservative changes but they cluster at 4 preferential sites in the putative head of HN. The clusters of amino acid substitutions are intimately associated or overlap with regions of HN rich in charged amino acid residues and in cysteines. The latter are conserved not only between HNs from all 3 NDV strains but also between HNs of 4 different paramyxoviruses, NDV, SV 5, Sendai and PI 3. The HN coding sequence was inserted into the genome of vaccinia virus under the control of vaccinia P 7.5 K transcriptional regulatory sequences. Expression of native HN proteins at the surface of recombinant HN vaccinia-infected cells was demonstrated by indirect immunofluorescence with 2 anti-HN monoclonals. PMID- 3318764 TI - [Mikhail Matveevich Rudnev (on the 150th anniversary of his birth)]. PMID- 3318765 TI - [Current problems in the morphometry of the heart]. AB - Cardiac morphometric data reported by different authors are difficult to compare. For linear measurements the processing methods need to be standardized and important considerations are the age-thanatogenetic features, and homogeneity of the autopsy material. An essential requirement is determination of the tissue compression coefficient. The specific volumes of structures should be measured in semithin sections. The largest disagreement among measurements have been noted for volumes of cardiac muscle cells and nuclei and for the nucleocytoplasmic ratio. The rules of stereometry are frequently violated in calculating parameters per unit sectional area. Although more than a hundred parameters have been proposed for cardiac morphometry, only two or three of them are of real diagnostic value. Standardizing morphometry of the heart, and of other organs as well, is a matter of high priority. PMID- 3318767 TI - Immunosorbent chemistry: a study of agarose-based column sorbents for the removal of low-density lipoprotein (LDL) from blood. AB - Anti-LDL antibody was covalently attached to agarose beads in order to prepare an immunosorbent for the removal of LDL from plasma or blood. Both the conditions of antibody coupling and the type of agarose matrix used were critical to the optimization of LDL binding capacity. Sorbents binding 6-8 mg lipoprotein cholesterol/ml column volume were obtained using cyanogen bromide or glutaraldehyde coupling procedures and crosslinked 2% agarose beads. The sorbent could be regenerated by washing with 1 M acetic acid, a reagent that was also an effective disinfectant. In vitro perfusions of whole blood over small columns of 212-300 mu beads showed excellent flow rates (2 ml/min/cm2 under 50-100 cm saline pressure); recovery of leukocytes and platelets exceeded 90%, and complement was not activated. Leakage of antibody and bead matrix was negligible. The antibody agarose beads could not be sterilized by conventional techniques, but withstood treatment with 0.34% phosphoric acid in 80% ethanol at 37 degrees C, a novel method of chemical sterilization. PMID- 3318766 TI - [Primary mesangiocapillary glomerulonephritis]. AB - The etiology and clinical and histologic features of primary mesangiocapillary glomerulonephritis (PMCGN) are reviewed, as are its management and prognosis. The problem of PMCGN, which is a well-defined disease entity, is shown to be one of major concern for nephrology today. A number of issues concerning the etiology, natural history, morphology, and treatment of this disease remain unresolved or require closer study. PMID- 3318768 TI - Designs for clinical research. PMID- 3318769 TI - Control of corneal astigmatism following cataract extraction by selective suture cutting. AB - We evaluated the ability of selective suture cutting to reduce postoperative corneal astigmatism in 75 eyes of 68 patients who underwent extracapsular cataract extraction with posterior chamber intraocular lens implantation. Keratometric and refractive measurements were obtained before and at selected intervals (3, 6, 10, 26, and 52 weeks) after surgery. The number of sutures cut during the sixth week after surgery was based on the degree of astigmatism (0.00 to 2.00 diopters (D), no sutures cut; 2.25 to 3.00 D, one suture cut; 3.25 to 4.00 D, two sutures cut; greater than or equal to 4.25 D, three sutures cut). Our analysis demonstrated the following: (1) a spontaneous reduction of 0.5 D in surgically induced astigmatism in eyes without suture cutting, (2) an additional reduction of 1.2 D in postoperative astigmatism for each suture cut, and (3) attainment of 75% to 93% of the total effect of suture cutting within four weeks. The final astigmatism one year after surgery had increased by a mean of 0.9 D, exhibited predominantly with-the-rule properties, and showed no significant difference among the four groups of patients. Vector analysis revealed that only small shifts in the axis of astigmatism occurred after suture cutting. A strong correlation between the keratometric and subjective refractive measurements during all postoperative examinations indicated that corneal astigmatism is primarily responsible for postoperative astigmatism. PMID- 3318770 TI - Transcorneal extrusion of anterior chamber intraocular lenses. A report of three cases. AB - We examined three cases of transcorneal extrusion of anterior chamber intraocular lenses. In each case a preexisting condition (rheumatoid arthritis, glaucoma, and herpes zoster ophthalmicus, respectively) contributed to corneal necrosis and subsequent extrusion of the pseudophakos. The clinicopathologic correlations of this condition are discussed, as well as some causes of corneal decompensation associated with anterior chamber lenses. We emphasize the need for careful evaluation of patients who have preexisting disease before intraocular lens implantation. PMID- 3318771 TI - Drug-induced pemphigoid. A spectrum of diseases. AB - Drug-induced ocular pemphigoid has been reported to occur after long-term use of topical glaucoma medications. We have reviewed the literature on drug-induced ocular pemphigoid and have added our experience with five patients with glaucoma who developed ocular cicatricial (benign mucosal) pemphigoid after treatment with various topical glaucoma medications. We also describe a case of timolol-induced ocular pemphigoid. The presentation and progression of drug-induced ocular cicatricial pemphigoid can be variable. We propose that drug-induced ocular pemphigoid represents a spectrum of diseases ranging from a self-limiting, toxic form to a progressive, immunologic form. PMID- 3318772 TI - Adjustment sensitivity of horizontal rectus muscles in adjustable strabismus surgery. AB - A "marking suture" was used in 12 consecutive cases of adjustable strabismus surgery to determine the relationship between ocular alignment and the amount of horizontal muscle adjustment. The average change in ocular alignment was 2.55 prism diopters for each millimeter of muscle adjustment. Regression analysis revealed the relationship to be linear over the range of adjustments studied. The sensitivity of adjustment was the same whether the adjusted muscle was advanced or further recessed and whether the adjusted muscle was the medial rectus or the lateral rectus. No relationship was found between the distance of a recessed muscle from its normal insertion and the subsequent adjustment sensitivity of that muscle. This information, when used clinically in conjunction with a marking suture, can facilitate the adjustment phase of adjustable strabismus surgery. PMID- 3318773 TI - Botulinum toxin paralysis of adult monkey extraocular muscle. Structural alterations in orbital, singly innervated muscle fibers. AB - Botulinum toxin was injected into the medial rectus muscles of adult rhesus monkeys, with postinjection survival periods of three to 56 days. Light and electron microscopic changes were most apparent in the orbital, singly innervated muscle fibers, which during the acute stage (seven to 28 days), exhibited denervationlike hypertrophy with dispersion of the central mitochondria toward the periphery of the fibers. Withdrawal of the capillary network on which this fiber type normally is dependent for oxidative function was a secondary adaptive response to the disuse resulting from botulinum toxin paralysis of neuromuscular transmission. Neuromuscular junctions still were present on all muscle fiber types, although evidence of sprouting was apparent. In the long term (following return of function at 42 to 56 days), the muscle fibers appeared normal and the vasculature recovered in proportion to the decreased cross-sectional area of the muscle fibers. PMID- 3318774 TI - A preliminary report on the Universal Implant. AB - Extrusion and time-consuming surgical techniques required of implantation have been the major criticisms of quasi-integrated implants such as the Iowa Implant. With these concerns in mind, the Universal Implant (Oculo-Plastik, Montreal) has been designed to offer the motility advantages seen with quasi-integrated implants and the ease of placement of a sphere. The Universal Implant incorporates most of the advantages seen in the Iowa Implant and other quasi integrated implants. In addition, the Universal Implant (1) utilizes a faster surgical technique for implantation; (2) avoids cleaning the muscles; (3) has lower, more rounded, smaller mounds that should decrease the late extrusion rate; (4) can be used as an enucleation implant, evisceration implant, or secondary implant; and (5) has a greater girth and larger radius of the posterior surface that helps support orbital fat and tissues, resulting in a more natural superior sulcus. Considering that the Iowa Implant is presently not available, the Universal Implant should be used by those surgeons who were pleased with the former implant and should be considered as a reasonable alternative to other enucleation implants. PMID- 3318775 TI - Organic acid transport into the cochlear perilymph. AB - The passage of exogenous organic and inorganic substances from blood into perilymph is likely to be controlled by the blood-perilymph barrier. This report reviews published data on the transfer of ten exogenous organic acids from the blood into the perilymph of experimental animal models. Although the range of the molecular weights of these acids is within half an order of magnitude, major differences exist in the perilymph concentration as a percentage of simultaneous serum concentration. Furthermore, these studies show that, contrary to previous suggestions, non-ototoxic compounds can achieve marked concentration gradients within the perilymph. PMID- 3318776 TI - A scanning electron microscopic study of vestibular organ malformation following prenatal gamma irradiation. AB - Pregnant CBA/CBA mice were exposed to 1 and 2 Gy whole-body gamma irradiation on the 13th and 16th gestational days, respectively. The litters were born on the 21st day of gestation and were tested for vestibular function at the age of 1 month. The animals were then sacrificed and their inner ears were analyzed by scanning electron microscopy. No disturbances of vestibular function were noted in the animals studied. However, the cristae ampullares showed severe malformations as regards their gross shape, with irregularities of their outer contours. Type I hair cells seemed to be more severely changed than Type II hair cells, with fusion of sensory hairs, giant hair formation and bulging of the cuticular plate. In certain sites the hair cells were totally missing. These derangements were usually located in the central areas of the cristae ampullares and in the striolar portion of the maculae utriculi. The morphological damage found showed a dose-dependent, time-related pattern. PMID- 3318777 TI - The use of immunofluorescence in the non-decalcified frozen guinea pig cochlea to detect autoantibodies in inner ear disorders. AB - Autoantibodies in the serum of patients with inner ear disorders have been detected using the immunofluorescence technique. In the present study the results of the use of frozen sections of non-decalcified guinea pig cochlea in the indirect immunofluorescence test are described. Human sera with positive anti mitochondrial (AMA), anti-nuclear (ANAS) and anti-nucleolar (ANAN) antibodies were utilized, as well as a negative serum control and sera from three patients suffering from chronic progressive sensorineural hearing loss. The positive reactions obtained were clear and specific. Autofluorescence was minimal and non specific reactions were negligible. The fine structure of the inner ear tissue and the cellular antigenicity present were well preserved. PMID- 3318779 TI - Substratum-bound elastin peptide inhibits aortic smooth muscle cell migration in vitro. AB - Migration of smooth muscle cells (SMCs) of the media through the internal elastic lamina to the intima in response to various chemoattractants is considered to be an important event in the development of atherosclerosis. We evaluated the influence of elastin peptides prepared from normal aorta on migration of cultured rat aortic SMCs in vitro. Studies with filters coated with elastin peptides in a modified Boyden's chamber showed that the migratory response of cultured rat aortic SMCs in response to platelet-derived factors was impeded by filter-bound elastin peptides. The inhibitory effect appeared to be relatively specific for elastin peptides and for SMCs, as other matrix components (Types I, III, IV, and V collagens and fibronectin) did not impede SMC migration, and polymorphonuclear leukocytes were not impeded by elastin peptides. Elastin peptides in solution in the lower well caused the migratory response, and this response was also inhibited by filter-bound elastin peptides. Attractants such as platelet-derived factors and elastin peptides are likely to be present in the matrix around migrating SMCs. These studies suggest that elastin peptides adhering to the substratum or elastin, a major component of elastic fiber, may be one of the natural inhibitors of vascular SMC migration in response to chemoattractants in the fluid phase. PMID- 3318778 TI - Clinical report: cylindrical cell papilloma of the paranasal sinus. AB - We report a case of cylindrical cell papilloma of the paranasal sinuses. This tumor originated in the medial wall of the left maxillary sinus of a 69-year-old man and extended to the surrounding tissues. Pathological study of tissue sections from the tumor showed typical findings of cylindrical cell papilloma with no evidence of associated malignancy. Histochemical and electron microscopic examinations revealed a large number of mitochondria in the cytoplasm of the tumor cells. The tumor was removed through a Denker's approach. The patient did well following surgery and there has been no sign of recurrence in a 2-year follow-up study. PMID- 3318780 TI - Interleukin-1 inhibits the synthesis of von Willebrand factor in endothelial cells, which results in a decreased reactivity of their matrix toward platelets. AB - We have studied the influence of recombinant human and murine interleukin-1 (IL 1) on the synthesis and secretion of von Willebrand factor by human endothelial cells. Treatment of endothelial cells with IL-1 caused a decline in the steady state level of von Willebrand factor mRNA in endothelial cells. This decline resulted in a decreased secretion to the culture medium, a decreased storage of von Willebrand factor in the Weibel-Palade bodies, and a decreased incorporation into the extracellular matrix. As a consequence of the decreased amount of von Willebrand factor in the extracellular matrix we have found a strongly impaired platelet adhesion to these matrices. When the matrices of IL-1-treated cells were incubated with purified von Willebrand factor, their ability to support platelet adhesion was restored. These results suggest that perturbation of endothelial cells by inflammatory mediators like IL-1 results in a decreased adhesion of platelets to the subendothelium owing to a diminished synthesis of von Willebrand factor. PMID- 3318781 TI - Total cholesterol and high density lipoprotein cholesterol levels in populations differing in fat and carbohydrate intake. AB - This paper reviews epidemiological studies on the relationship between diet and high density lipoproteins (HDL), with emphasis on the authors' studies of boys and men from different countries and with different dietary habits. Sera were collected from boys (ages 7 to 9 years) and men (ages 33 to 48 years) in 20 countries, and these were analyzed in one standardized laboratory. In boys, total and HDL cholesterol changed in parallel, from low values in populations in developing countries with low-fat, high-carbohydrate diets to high values in affluent populations. The correlation between HDL and total cholesterol was 0.90 (n = 16 populations). A similar trend was seen in groups of vegetarian and omnivorous boys within one region. Detailed analyses of individual diets of boys in five countries showed a negative relation between carbohydrate intake and HDL cholesterol both for group means (r = -0.99, n = 5) and for individual boys within one country (r = -0.26 to 0.04, n = 109 to 133 boys per country). In these boys, differences in obesity and physical activity were slight, and unrelated to differences in HDL. Total cholesterol rose with saturated fat intake (r = 0.87 for five population means; r = 0.07 to 0.26 within population groups). In adult men, total and HDL cholesterol also tended to rise simultaneously with affluence. However, the relation was much weaker (r = 0.60, n = 13 population groups).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318782 TI - Insulin resistance and impaired glucose tolerance in the atherosclerosis-prone LA/N corpulent rat. AB - The LA/N-cp rat is, when homozygous for the cp gene, hyperphagous, hyperlipidemic, and corpulent. The corpulent males develop atherosclerotic disease and myocardial lesions while corpulent females and lean rats do not. The fasting plasma glucose concentrations of corpulent rats are in the normal range, but insulin concentrations are mildly elevated in corpulent females and markedly elevated in corpulent males. Glucose tolerance testing reveals a glucose intolerance in corpulent rats in the presence of very high insulin concentrations, and this deficiency is more severe in the male rats. Glucagon concentrations are higher in corpulent rats than lean rats at 3 months of age and decrease progressively with age. In contrast, glucagon concentrations increase with age in lean rats and are higher than those in corpulent rats at 9 months. The islets of Langerhans of corpulent rats exhibit marked hyperplasia that increases with age. The hyperplasia is less extreme in corpulent female rats. The abnormalities suggest that this strain of rats has an insulin resistance leading to impaired glucose tolerance and progressive pancreatic disturbance. This process may be related to an accompanying defect causing elevated concentrations of very low density lipoproteins and correlates with the development of atherosclerotic disease. PMID- 3318783 TI - The bond strength of incrementally placed composite resins. PMID- 3318786 TI - A device for establishing the incisal level of registration rims. PMID- 3318784 TI - Clinical evaluation of rebonded acid-etch retained bridges. PMID- 3318785 TI - Review: bupivacaine--a long-acting local anaesthetic. PMID- 3318787 TI - Strokes and ischaemic attacks. PMID- 3318788 TI - Upper abdominal pain: the radiological approach. PMID- 3318789 TI - Vegetarian diet. Good for the heart, but still a matter of balance. PMID- 3318790 TI - Human exposure to low level ionising radiation. PMID- 3318792 TI - Fractures of the lateral process of the talus. AB - This study is a retrospective review of nine patients who sustained isolated fractures of the lateral process of the talus. The majority were caused by inversion or a combination of inversion and dorsiflexion of the foot. Following a review of the literature and anatomical dissections the authors recommend a classification based on anterior-posterior tomography of the talus, into intra- and extra-articular fractures. PMID- 3318791 TI - Combined carotid and coronary surgery. AB - A retrospective review of 40 consecutive patients undergoing combined coronary artery bypass grafting (CABG) and unilateral carotid endarterectomy (CEA) was carried out to determine the stroke rate for the procedure. Patients presenting with severe coronary artery disease judged to be at risk of imminent myocardial infarction, who had signs of cerebral ischaemia (70%) or asymptomatic carotid bruits (30%), were investigated for extracranial carotid vascular disease. Patients with severe stenotic carotid lesions associated with high risk coronary artery disease underwent combined CEA/CABG. Three patients had a previous contralateral CEA. The average age of the patients was 62 years, and there were 31 males and nine females. CEA was completed prior to CABG under the same general anaesthetic. There were 24 CEAs on the left and 16 on the right. Six patients suffered a postoperative cerebral ischaemic event (15.4%): a reversible ischaemic neurological deficit in three (7.7%), a transient ischaemic cerebral event in two (5.1%), and a permanent stroke occurred in one (2.6%). Two deaths occurred and both were cardiac related. Combined CEA/CABG in patients with stenotic lesions of the coronary and extra-cranial carotid vascular systems who are at risk of cerebral or myocardial infarction, can be performed with a permanent stroke rate within the published range for either CEA or CABG alone and with a mortality of 5%. PMID- 3318793 TI - Management of double system ureterocele. AB - Thirty eight patients with double system ureterocele are reviewed. More than half presented in infancy, urinary infection being the commonest clinical feature. Urinary tract ultrasound (US) and renal nuclide scan (RNS) were found to be the most useful diagnostic investigations. Whereas there are various surgical options available, an analysis of the results indicates that the primary operation should usually be an upper pole heminephrourterectomy, particularly in infancy. Secondary bladder surgery will be necessary in many infants but in children with disease confined to the ureterocele segment only, bladder surgery may be avoided. In selected cases, usually beyond infancy, total one stage reconstruction with upper pole heminephroureterectomy and bladder surgery may be justified. PMID- 3318794 TI - Salmonella and Escherichia coli from veterinary and human sources in Australia during 1985 and 1986. PMID- 3318795 TI - Pregnancy diagnosis of fallow deer by ultrasonography. PMID- 3318796 TI - Clinical studies on glass ionomer cements. Part 2--A two year clinical study comparing glass ionomer cement with zinc phosphate cement. PMID- 3318797 TI - Fluorine depth profiles in human enamel after different acid etching times. PMID- 3318798 TI - Keys and lines of occlusion. PMID- 3318799 TI - Nuclear medicine evaluation of motion sickness and medications on gastric emptying time. AB - Diminished gastric motility and lack of bowel sounds have been observed in astronauts aboard the Space Shuttle (4). In this study subjects were given scopolamine 0.6 mg with d-amphetamine 5 mg with and without neostigmine 15 mg. Neostigmine 15 mg alone was also compared with placebo for effect on gastric emptying time. In an additional test, subjects performed head movements in a rotating chair to an end-point of motion sickness short of vomiting. Ten ounces of isotonic saline containing 1 mCl of Tc 99mDPTA was ingested 2 h after the medications and immediately after rotation. The counts from stomach contents were monitored with a Picker small field of view gamma camera every 30 s for 1 h. Gastric motility was inhibited by scopolamine and amphetamine with 14% residual count at the end of 1 h. When neostigmine was added to this combination the results were in the placebo range. Motion sickness produced a profound inhibition of gastric emptying with a 47% residual count. The results indicate that the gastric stasis encountered in space is due mainly to motion sickness with a minimal contribution from the antimotion sickness drugs. PMID- 3318800 TI - Applied relaxation: description of a coping technique and review of controlled studies. PMID- 3318801 TI - International Symposium on Balanced Nutrition and Therapy, Erlangen, in honour of Dr. Werner Fekl on his 60th birthday. PMID- 3318802 TI - Driving force for peptide transport in mammalian intestine and kidney. AB - Transport of small intact peptides across the brush-border membrane of the epithelial cells of small intestine and renal proximal tubule is a well established phenomenon. This peptide transport system recognizes dipeptides and tripeptides as substrates and it is distinct from the transport systems available for absorption of free amino acids. While there is no doubt that active transport of amino acids is energized by a Na+ gradient, the nature of the driving force that energizes peptide transport has been a subject of controversy for many years. Numerous studies with intact tissue preparations have shown that the dependence of peptide transport on a Na+ gradient is at best partial. Recent investigations with isolated brush-border membrane vesicles from small intestine and kidney have clearly established that a H+ gradient rather than a Na+ gradient drives the active transport of intact peptides in these tissues. Since the transport mechanism involves peptide-H+ cotransport, thus rendering the process electrogenic, a membrane potential also plays a role in the energization of this transport system. Nutrient transport driven by an electrochemical H+ gradient is of common occurrence in microorganisms, but peptide transport represents the first example of this kind in mammalian systems. There is strong evidence that a H+ gradient actually exists in vivo across the brush-border membrane of intestinal and renal epithelial cells. The activity of the Na+-H+ exchanger which is located predominantly in the brush-border membrane and which, under physiological conditions, couples the influx of Na+ into the cell with the efflux of H+ from the cell, is primarily responsible for the existence of this H+ gradient. The driving force for the exchanger, a transmembrane Na+ gradient, is in turn generated and maintained at the expense of metabolic energy by the (Na+ K+) ATPase, which is present in the basal-lateral membrane of these cells. Accordingly, peptide transport in small intestine and kidney can be classified as a tertiary active transport system. PMID- 3318803 TI - Mechanisms of peptide transport. AB - This review touches on the development of the concept of transmembrane transport of peptides, which originated more than 100 years ago, and discusses present knowledge of the phenomenon, with special reference to intestinal absorption of peptides. It deals with (1) Peptide transport in animal small intestine and its main features--active transport of di- and tripeptides into the absorptive cells, the question of sodium or proton dependence of peptide transport, the independence of peptide and amino acid transport, competition for transport between peptides, the number of transport systems involved, the influence of molecular structure on peptide transport, transport kinetics and relative rates of absorption of peptides and amino acids, nutritional and therapeutic aspects of peptide transport, mechanisms of absorption of small peptides of dietary origin and mechanisms of absorption of biologically active peptides (2) Peptide transport in other animal cells and tissues (3) Peptide transport in microorganisms (4) Peptide transport in higher plants and (5) Physiological advantages of peptide transport. The concluding remarks stress that though most of the salient features of peptide absorption may have been established by 1975, more investigators might usefully be engaged in studying the many remaining questions concerning peptide transport in the animal body, and point out the unfortunate effects of too narrow an approach to problems in the field. PMID- 3318804 TI - [Arc bone graft-plasty in recurrent anterior shoulder dislocation (1968-1985)]. PMID- 3318805 TI - [History of the treatment of clubfoot]. PMID- 3318807 TI - Proteolytic conversion of proinsulin into insulin. Identification of a Ca2+ dependent acidic endopeptidase in isolated insulin-secretory granules. AB - The nature of the endoproteolytic activity involved in the post-translational processing of proinsulin has been investigated in rat insulinoma tissue. 125I proinsulin was converted by lysed insulin-secretory granules into insulin via an intermediate form identified as des-dibasic-proinsulin. This activity co localized with immunoreactive (endogenous) insulin and carboxypeptidase H upon subcellular fractionation of the tissue, indicating a secretory-granular location. Under optimized conditions, conversion was quantitative. Inhibitor studies demonstrated that processing occurred by a reaction sequence involving cleavage on the C-terminal side of the pairs of basic amino acids, with subsequent removal of the newly exposed basic residues by carboxypeptidase H. Endoproteolytic activity was abolished by EDTA and CDTA (1,2 cyclohexanediaminetetra-acetic acid), but not by 1,10-phenanthroline or by group specific inhibitors of serine, thiol or acidic proteinases. Inhibition by EDTA and CDTA could be reversed by both Ca2+ and Zn2+, although the former appeared to be the ion of physiological importance. Addition of Ca2+ in the absence of chelators stimulated endoproteinase activity, with a maximal effect at 5 mM, a concentration consistent with the intragranular environment. Similarly the pH optimum of 5.5 coincides with the prevailing intragranular pH. Together these properties suggest that the Ca2+-dependent endopeptidase described here is involved in vivo in the proteolytic processing of proinsulin. PMID- 3318806 TI - The role of topogenic sequences in the movement of proteins through membranes. AB - Recent advances have led to considerable convergence in ideas of the way topogenic sequences act to translocate proteins across various intracellular membranes (Table 2). Whereas co-translational translocation and processing were previously considered the norm at the endoplasmic reticulum membrane, several instances of post-translational translocation into endoplasmic reticulum microsomes in vitro have now been described. However, it must be noted that post translational translocation in vitro is much less efficient than when endoplasmic reticulum membranes are present during translation, and it is possible that in the intact cell translocation occurs during translation. Movement of proteins into chloroplasts and mitochondria occurs after translation. When translocation is post-translational, proteins may perhaps traverse the membrane as folded domains, and the conformational effects of topogenic sequences on these domains may be as envisaged in Wickner's 'membrane-trigger hypothesis'. Both signal and transit sequences possess amphipathic structures which are capable of interacting with phospholipid bilayers, and these interactions may disturb the bilayer sufficiently to allow entry of the following domains of protein. There is increasing evidence that GTP is required to bind ribosomes and their associated nascent chains to the endoplasmic reticulum membrane. Precisely how the cell's energy is applied to achieve translocation is not clear, but one possibility at the endoplasmic reticulum is that a GTP-hydrolysing transducing mechanism may exist to couple signal sequence receptor binding to movement of the nascent chain across the membrane. Electrochemical gradients are required for protein movement to the mitochondrial inner membrane and across the bacterial inner membrane. Cytoplasmic factors such as SRP, the secA gene product or a 40 kDa protein (for mitochondrial precursors) may act by binding to topogenic sequences and preventing precursor proteins as they are translated from folding into forms which cannot be translocated. Specificity in the cell may be achieved both by targetting interactions between these cytoplasmic factors and their receptors located in target membranes, and also by specific binding of the topogenic sequences to specific proteins integrated into the target membranes. Possible candidates for the latter are the protein of microsomal membranes that reacts with a photoreactive signal peptide to give a 45 kDa complex (Fig. 1), the secY gene product of the bacterial inner membrane, and receptors on the outer membranes of chloroplasts and mitochondria. Whether these aid translocation as well as recognition is not clear.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3318810 TI - Effects of dexamethasone treatment on insulin-stimulated rates of glycolysis and glycogen synthesis in isolated incubated skeletal muscles of the rat. AB - 1. Rats were treated with dexamethasone for 4 days before measurement of the rates of lactate formation [which is an index of hexose transport; see Challiss, Lozeman, Leighton & Newsholme (1986) Biochem. J. 233, 377-381] and glycogen synthesis in response to various concentrations of insulin in isolated incubated soleus and extensor digitorum longus muscle preparations. 2. The concentration of insulin required to stimulate these processes half-maximally in soleus and extensor digitorum longus muscles isolated from control rats was about 100 muunits/ml. 3. Dexamethasone increases the concentration of insulin required to stimulate glycolysis half-maximally in soleus and extensor digitorum longus preparations to 250 and 300 muunits/ml respectively. The respective insulin concentrations necessary to stimulate glycogen synthesis half-maximally were about 430 and 370 muunits/ml for soleus and extensor digitorum longus muscle preparations isolated from steroid-treated rats. 5. Dexamethasone treatment did not change the amount of insulin bound to soleus muscle. PMID- 3318809 TI - A re-assessment of the role of protein kinase C in glucose-stimulated insulin secretion. AB - Isolated rat islets of Langerhans which had been pretreated with 200 nM-phorbol 12-myristate 13-acetate (PMA) for 20-24 h, a treatment reported in other cell types to deplete cells of protein kinase C activity, were found not to contain detectable Ca2+/phospholipid-dependent protein kinase activity. These islets did not secrete insulin in response to a subsequent exposure to PMA (0.1 or 1 microM) during a 30 min incubation, although insulin secretion could be stimulated by 20 mM-glucose, a response which was enhanced by 20 microM-forskolin. PMA-pretreated islets that had been permeabilized by high-voltage discharge showed unimpaired secretory responses to an increase in Ca2+ concentration, cyclic AMP and forskolin. These results suggest that (i) pretreatment of islets with tumour promoting phorbol esters may be a useful means of investigating the role of protein kinase C in stimulus-secretion coupling in the pancreatic beta-cell and (ii) protein kinase C may not play an essential role in glucose-induced insulin secretion. PMID- 3318808 TI - Nitrogenase of Klebsiella pneumoniae. Kinetic studies on the Fe protein involving reduction by sodium dithionite, the binding of MgADP and a conformation change that alters the reactivity of the 4Fe-4S centre. AB - The kinetics of reduction of indigocarmine-dye-oxidized Fe protein of nitrogenase from Klebsiella pneumoniae (Kp2ox) by sodium dithionite in the presence and absence of MgADP were studied by stopped-flow spectrophotometry at 23 degrees C and at pH 7.4. Highly co-operative binding of 2MgADP (composite K greater than 4 X 10(10) M-2) to Kp2ox induced a rapid conformation change which caused the redox active 4Fe-4S centre to be reduced by SO2-.(formed by the predissociation of dithionite ion) with k = 3 X 10(6) M-1.s-1. This rate constant is at least 30 times lower than that for the reduction of free Kp2ox (k greater than 10(8) M-1.s 1). Two mechanisms have been considered and limits obtained for the rate constants for MgADP binding/dissociation and a protein conformation change. Both mechanisms give rate constants (e.g. MgADP binding 3 X 10(5) less than k less than 3 X 10(6) M-1.s-1 and protein conformation change 6 X 10(2) less than k less than 6 X 10(3) s-1) that are similar to those reported for creatine kinase (EC 2.7.3.2). The kinetics also show that in the catalytic cycle of nitrogenase with sodium dithionite as reductant replacement of 2MgADP by 2MgATP occurs on reduced and not oxidized Kp2. Although the Kp2ox was reduced stoichiometrically by SO2-. and bound two equivalents of MgADP with complete conversion into the less reactive conformation, it was only 45% active with respect to its ability to effect MgATP-dependent electron transfer to the MoFe protein. PMID- 3318811 TI - Uncoupling between the insulin-receptor cycle and the cellular degradation of the hormone in cultured foetal hepatocytes. Effect of drugs and temperature that inhibit insulin degradation. AB - Sequential changes in the numbers of cell-surface receptors induced by a transitory exposure to insulin in cultured 18-day foetal-rat hepatocytes were investigated in the presence of drugs and at a temperature of 22 degrees C, which inhibit cellular insulin degradation. Chloroquine (70 microM) and monensin (3 microM) did not greatly change the initial rate of internalization of cell surface receptor sites after exposure to 10 nM-insulin, but led to a steady state after 20 min, which represented 40% of the initial binding, compared with 5 min and 60% in the absence of the drug. Moreover, these drugs strongly decreased the proportion of receptor sites recovered at the cell surface after subsequent removal of the hormone. They were ineffective when insulin was not present. The removal of monensin together with the hormone allowed partial restoration of cell surface receptor sites and degradation of cell-associated insulin to start again at the initial speed, indicating a reversible effect of the drug. During this phase, the drug concentration-dependence for the two effects showed that receptor recycling was restored with concentrations of monensin not as low as for insulin degradation. The effect of vinblastine (50-100 microM) was similar to that of chloroquine and monensin, whereas no modification in the internalization and recovery processes was observed in the presence of bacitracin concentrations (1-3 mM) that inhibit insulin degradation by 70%. A temperature of 22 degrees C did not prevent the receptor internalization, but had a slowing effect on the recycling process, which appeared to vary in experiments where insulin degradation remained inhibited. The present study shows that the process of insulin degradation mediated by receptor endocytosis is not a prerequisite for insulin-receptor recycling in cultured foetal hepatocytes. PMID- 3318813 TI - Characterization of human and mouse granulocyte-macrophage-colony-stimulating factors derived from Escherichia coli. AB - Human and mouse granulocyte-macrophage-colony-stimulating factors (hGM-CSF and mGM-CSF, respectively), isolated from Escherichia coli cells expressing the corresponding human and mouse genes, have been characterized. The observed properties of the proteins have been compared with those properties which can be deduced from the DNA sequence alone and the published properties of natural GM CSFs. The purified E. coli-derived proteins were found to have the expected molecular masses, amino acid compositions and N- and C-terminal amino acid sequences. The finding of 70-90% unprocessed N-terminal methionine for both proteins is discussed. The four Cys residues were found to be involved in two intramolecular disulphide bonds, linking the first and third, and second and fourth Cys residues. This disulphide bond arrangement is probably the one existing in natural material, since, although not glycosylated, both E. coli derived proteins showed biological activity (colony stimulating assay for hGM CSF, and cell proliferation assay for mGM-CSF) comparable with that reported for the respective proteins purified from animal cells. PMID- 3318816 TI - Genetics and molecular biology of rhythms. PMID- 3318812 TI - Applications of recombinant DNA technology to studies of metabolic regulation. PMID- 3318815 TI - Combinatorial control of structural genes in Drosophila: solutions that work for the animal. PMID- 3318814 TI - Insulin modifies the properties of glucose transporters in rat brown adipose tissue. AB - The properties of glucose transporters associated with plasma and microsomal membranes have been studied in brown adipose tissue of rats after treatment by saline infusion or hyperinsulinaemic/euglycaemic clamp. In this tissue, insulin produces a 40-fold increase in glucose utilization as measured by the 2-deoxy-D glucose technique, and therefore a 40-fold increase in the rate-limiting glucose transport. This increase, promoted by insulin, is associated with: (a) translocation of the transporters from a pool associated with the microsomal fraction to the plasma membrane without modification of the total number of transporters; (b) an increase in the Hill coefficient of the plasma-membrane glucose transporters for cytochalasin B from 1.1 to 2.5, indicating the presence of positive co-operativity; (c) a decrease in the Kd (apparent dissociation constant) of the transporters towards cytochalasin B from 148 to 82 nM; (d) no change in the Hill coefficient or Kd for the transporters associated with the microsomal membranes. These data indicate that, in addition to causing translocation of the glucose transporters, insulin modifies their properties and behaviour towards cytochalasin B. This may reflect modifications in their properties and behaviour towards glucose, and by this contribute to bringing about the marked effect of this hormone on glucose transport in brown adipose tissue. PMID- 3318817 TI - Desmutagens and bio-antimutagens--their modes of action. PMID- 3318818 TI - Metabolic mayhem caused by 2-ketoacid imbalances. PMID- 3318819 TI - The evolution of RNA viruses. PMID- 3318820 TI - Dynamic instability of microtubules. PMID- 3318821 TI - Regulation of non-muscle myosin structure and function. PMID- 3318822 TI - Composition and expression of spectrin-based membrane skeletons in non-erythroid cells. PMID- 3318823 TI - Nuclear lamin proteins and the structure of the nuclear envelope: where is the function? PMID- 3318825 TI - Partial assignment of disulfide pairs in neurophysins. AB - The original report assigning the pairing of neurophysin's 14 half-cystine residues (Schlesinger et al. (1972), Proc. Natl. Acad. Sci., U.S.A., 69,3350 3353) was based on an incorrect amino acid sequence. In the present study, re investigation of the results of proteolytic fragmentation of bovine neurophysins indicates that the majority of the original assignments were incorrect. Three disulfide pairs are now assigned as Cys21-Cys44, Cys67-Cys85 and Cys74-Cys79. The pairing pattern indicates that neurophysin's variable carboxyl terminal region, separately encoded by the third gene exon, does not form a self-contained domain. PMID- 3318824 TI - Improvement of cytotoxicity of tumor necrosis factor (TNF) by increase in basicity of its N-terminal region. AB - Two new recombinant TNFs (named rTNF-Scw1 and -Scw2) with higher basicity than conventional recombinant human TNF-alpha (rTNF-alpha) in the N-terminal region were constructed. Their sequences were constructed based on those of partially purified cytotoxic factors from the culture supernatant of acute monocytic leukemia cells THP-1, which unlike rTNF-alpha are cytotoxic to T24 bladder carcinoma cells in vitro. These new rTNF-Ss showed a broader cytotoxicity to tumor cells than rTNF-alpha. This increase in the basicity of the N-terminal region over that of conventional TNF significantly increased the cytotoxicity on tumor cells in vivo as well as in vitro. PMID- 3318826 TI - Effect of chronic isoproterenol exposure on insulin binding and insulin stimulated hexose transport in isolated rat adipocytes. AB - The effect of chronic exposure of isolated rat adipocytes to the beta-adrenergic agonist isoproterenol has been studied with respect to insulin binding and insulin-stimulated hexose uptake. Isoproterenol exposure led to a progressive decrease in both the number of surface insulin receptors and the stimulation of hexose uptake. The effect on insulin binding was reversible by removal of the beta-agonist within an hour of its addition. Later exposures of adipocytes to isoproterenol resulted in an irreversible cellular defect by leading to a progressive inability of the cells to regain their normal level of insulin stimulated hexose uptake and insulin binding. PMID- 3318827 TI - Inhibition of yeast binding to mouse peritoneal macrophages by wheat germ agglutinin: a novel effect of the lectin on phagocytic cells. AB - The ability of wheat germ agglutinin (WGA) to enhance the binding of bacteria and tumor cells to phagocytic cells, and to induce the killing of tumor cells by macrophages and monocytes, is well established. We observed, however, that WGA inhibits the binding to and phagocytosis of yeast cells by thioglycolate-elicited murine peritoneal macrophages. In order to follow these processes rapidly, the yeasts were labeled with Congo-red and their binding to the macrophages was measured spectrophotometrically after treatment with sodium dodecylsulfate. Phagocytosis was also followed by light microscopy. Binding of the yeasts was inhibited by about 80% after pretreating the macrophages with 150 micrograms/ml of WGA. This effect was reversed by subsequent incubation with N-acetyl-D glucosamine, chitobiose or chitotriose, but was unaffected by methyl alpha-D mannoside, N-acetyl-D-mannosamine, D-mannose or D-galactose. Pretreatment of the Congo-red yeasts with WGA did not inhibit their binding by the macrophages. Of a variety of lectins tested, only WGA and Datura stramonium lectin had this effect. Pretreating the macrophages with sialidase prevented the inhibition induced by WGA. Our findings suggest the presence on the macrophages of a class of WGA receptors not previously reported. PMID- 3318828 TI - The corticotropin releasing hormone gene is expressed in human placenta. AB - Maternal plasma immunoreactive corticotropin-releasing hormone (IR-CRH) increases progressively with pregnancy. This elevated plasma IR-CRH is presumably secreted by the placenta. To investigate further this hypothesis, we searched for the CRH mRNA and its peptide product in full term human placentae. Using a radiolabelled 48-mer oligonucleotide probe complementary to a portion of human CRH mRNA, we identified a 1300 nucleotide RNA from human placenta and rat hypothalami. We next examined the chromatographic characteristics of the placental IR-CRH. The bulk of the IR-CRH extracted from placenta and the IR-CRH secreted in vitro by placental fragments had the same chromatographic profiles as synthetic CRH. These findings indicate that the CRH gene is expressed in human placenta and imply that this organ is a site of CRH biosynthesis during pregnancy. PMID- 3318829 TI - Localization of GTP cyclohydrolase I in human peripheral blood smears using a specific monoclonal antibody and an immune-alkaline phosphatase labeling technique. AB - GTP cyclohydrolase I, the enzyme catalyzing the first step in the cofactor biosynthesis for the aromatic amino acid hydroxylases, has been localized in situ. By the use of a monoclonal antibody specific to human GTP cyclohydrolase I, the enzyme has been visualized immuno-enzymatically by alkaline phosphatase monoclonal anti-alkaline phosphatase labeling. In routine blood smears lymphocytes, monocytes/macrophages, and granulocytes show strong intraplasmatic staining. Premature erythrocytes show clear staining of the reticulated cytoplasmatic structure, while mature erythrocytes are completely negative. Neither is there any staining for GTP cyclohydrolase I in the blast cells of a case of T-cell acute lymphoblastic leukemia. These results closely confirm the prior finding that mature erythrocytes as well as most malignant mononuclear cells lack GTP cyclohydrolase I activity, and they indicate that in these cells the enzyme protein may be absent. PMID- 3318830 TI - Demonstration of phosphatidylinositol anchors on Ly-6 molecules by specific phospholipase C digestion and gel electrophoresis in octylglucoside. AB - Release by phosphatidylinositol-specific phospholipase C is frequently provided as evidence for membrane anchorage of a protein through phosphatidylinositol. Demonstration that the enzyme removes a lipophilic moiety from the protein is stronger evidence, and is presented here for members of the Ly-6 family of lymphocyte antigens: Ly-6A, C and E. Treatment of these molecules with the enzyme greatly increased their electrophoretic mobilities on polyacrylamide gels containing nonionic detergent. Furthermore, the mobilities of the digested, but not native Ly-6 molecules, were independent of detergent. This analytical method was applied to pure antigen, radiolabelled immunoprecipitate, or immunochemically detected Ly-6 antigens on blots. PMID- 3318831 TI - Analysis of proinsulin conversion activated by prior glucose: evidence that glucose stimulates synthesis of the conversion enzyme. AB - We examined the mechanism by which prior glucose exposure accelerates conversion of proinsulin to insulin in pancreatic islets. Using actinomycin A, introduced at different times after a 3H-leucine pulse to block the intracellular transport of proinsulin, transport was found to be slightly accelerated after prolonged glucose. However, computer simulation of pulse-chase experiments showed that activation of conversion is mostly due to increased converting activity. Measurement of islet procathepsin B by immunoprecipitation indicated synthesis of this enzyme was stimulated about two fold after glucose. Pre-exposure with tunicamycin inhibited the acceleration of conversion, suggesting that the converting system requires glycosylation. PMID- 3318833 TI - Sepiapterin reductase in cultured human cells. AB - Sepiapterin reductase, an enzyme involved in the synthesis of tetrahydrobiopterin (the natural cofactor for phenylalanine, tyrosine and tryptophan hydroxylases), has been assayed in cultured human amniotic fibroblasts and in cultured mononuclear blood cells. In both cases, the Michaelis constants for sepiapterin and NADPH were essentially equal; 20 microM and 6 microM respectively for stimulated mononuclear blood cells and 22 microM and 5 microM respectively for amniotic fibroblasts. The inhibition by N-acetylserotonin was also similar in both cases. The concentration that produced 50% inhibition in stimulated mononuclear blood cells and in amniotic fibroblasts was 2 microM. The results strongly suggest that the same enzyme is acting in both types of cells, at least when grown in culture. PMID- 3318832 TI - Antibodies against mammary derived growth inhibitor (MDGI) react with a fibroblast growth inhibitor and with heart fatty acid binding protein. AB - A polypeptide growth inhibitor, designated as mammary derived growth inhibitor, has previously been purified from lactating bovine mammary glands. Polyclonal rabbit antiserum raised against mammary derived growth inhibitor cross-reacts with bovine heart fatty acid binding protein and bovine peripheral myelin P2 protein. These results are consistent with the observation that the amino acid sequence of mammary derived growth inhibitor showed homology to the sequences of these proteins. In a parallel series of immunoblotting experiments, rabbit anti mammary derived growth inhibitor also reacted specifically with a fibroblast growth inhibitor purified from the conditioned medium of cultured mouse 3T3 fibroblasts. These data suggest that bovine mammary derived growth inhibitor and mouse fibroblast growth inhibitor may share common structural features and raise the possibility that these growth inhibitors may together define a new family of growth regulatory molecules. PMID- 3318834 TI - Effect of GDP on the interactions between chloroplast EF-Ts and chloroplast and E. coli EF-Tu. AB - The effects of varying concentrations of GDP on the stability of homologous and heterologous EF-Tu:EF-Ts complexes formed with the elongation factors from the chloroplast of Euglena gracilis and from E. coli have been investigated. The complexes formed with chloroplast EF-Ts were significantly more stable to GDP induced dissociation than those formed with E. coli EF-Ts. The complex between chloroplast EF-Tu and chloroplast EF-Ts required nearly 1,000-fold higher concentrations of GDP for dissociation than the complex between chloroplast EF-Tu and E. coli EF-Ts. The E. coli EF-Tu:chloroplast EF-Ts complex required nearly 100-fold higher levels of GDP for dissociation than the E. coli EF-Tu:E. coli EF Ts complex. PMID- 3318835 TI - Multiple thyroid hormone binding sites on male rat liver nuclear matrices. AB - Equilibrium binding of T3 to nuclear matrices isolated from male rat liver occurred after incubation for 3h at 20 degrees C. Two binding sites, having KD's of 6 and 95 nM, were revealed by Scatchard analysis. T3 and Triac competed for the binding of [125I]T3 to the high affinity site whereas only T3 competed for binding to the lower affinity site. Reverse T3 (rT3) did not compete for the binding of T3 to either class of binding sites. The binding sites were highly DNAse-sensitive, and less sensitive to protease treatment. The effect of binding of T3 to nuclear matrices by ATP, DTT and EDTA indicated that the sites are dissimilar to previously identified cytosolic binding sites. The higher affinity site resembles the T3 receptor in affinity and thyroid hormone specificity. The second site represents a new class of thyroid hormone binding sites. Its role in the regulation of thyroid hormone action warrants further investigation. PMID- 3318836 TI - Transforming growth factor type beta in normal human urine. AB - TGF beta has been identified in normal human urine specimens from five individuals studied for five consecutive days. The peptide was extracted from urine using Sepralyte C1 beads. Detectable levels of [125I]TGF beta competing activity as measured by radioreceptor assay was found in about half of the specimens studied. The protein isolated from urine using C1 Sepralyte beads was further purified using Biogel P-60 column chromatography. Fractions were tested for TGF beta and EGF competing activity using radioreceptor assays. TGF beta and EGF extracted from urine are clearly separated by column chromatography. Two distinct EGF peaks and a single TGF beta peak were observed. Fractions having [125I]TGF beta competing activity were pooled and further purified using reverse phase HPLC. HPLC fractions having [125I]TGF beta competing activity were tested for bioactivity using a soft agar assay. The fractions were capable of stimulating soft agar growth of AKR-2B (clone 84A) cells and cross reacted with a TGF beta antibody in a radioimmunoassay. The presence of TGF beta in normal human urine was also demonstrated by immunoblotting. These results also suggest that C1 bead extraction of urine specimens can be used as a rapid first step in purification of TGF beta. PMID- 3318837 TI - Induction of cytochrome P-448 isozyme(s) in primary cultured rat hepatocytes by drugs which induce different isozymes in vivo. AB - Effect of 2-methoxy-4-aminoazobenzene (2-MeO-AAB) and 3-methylcholanthrene (MC) on the induction of microsomal cytochrome P-448 isozymes in primary cultured rat hepatocytes was examined by means of immunochemical methods such as protein A enzyme-linked immonosorbent assay and immuno-blots using anti-rat cytochrome P 448 monoclonal antibodies and by means of bacterial mutation tests. Although 2 MeO-AAB selectively induced cytochrome P-448H and MC induced both cytochrome P 448H and a low spin form of cytochrome P-448 (P-448L) in the liver of rats, addition of these chemicals to primary cultured rat hepatocytes resulted in selective induction of cytochrome P-448L, as determined by the immunological methods. This was substantiated by the bacterial mutation test using Salmonella typhimurium TA 98 bacteria and two aromatic amine substrates with different specificities to the cytochrome P-448 isozymes. These results suggest that the responses of rat hepatocytes to cytochrome P-450 inducers are different in in vivo and in vitro. PMID- 3318839 TI - T-lymphocyte inhibition by cyclosporine. Potential mechanisms of action. PMID- 3318838 TI - Correlation between phosphorylation and kinase activity of a tyrosine protein kinase: p56lck. AB - P56lck is the product of a cellular oncogene highly expressed in lymphoid cells. Tyrosine kinase activity was measured by using an exogenous substrate: polyamino acid glutamic acid-tyrosine (4:1) (PGT). Different levels of phosphorylation of p56lck were achieved by the utilisation of SH reagents and different lengths of incubation time. The phosphorylation of PGT was proportional to the level of phosphorylation of p56lck. Identical results were obtained with crude membrane preparations and with p56lck partially purified on immunecomplexes. PMID- 3318840 TI - Malotilate reduces collagen synthesis and cell migration activity of fibroblasts in vitro. AB - Diisopropyl-1,3-dithiol-2-ylidenemalonate (malotilate) was studied for and compared with cyanidanol, hydrocortisone and colchicin on its impact on fibroblast cultures. Under in vitro conditions, malotilate specifically reduces collagen synthesis of fibroblasts. In addition, malotilate is an efficient inhibitor of fibroblast migration as tested by a chemotaxis assay in a modified Boyden chamber. Our data may support the notion that malotilate is of potential interest for interfering with fibrotic processes. PMID- 3318841 TI - Fibrinogen, fibrinogen receptors, and the peptides that inhibit these interactions. PMID- 3318842 TI - Inhibitor properties of some 5-substituted uracil acyclonucleosides, and 2,2' anhydrouridines versus uridine phosphorylase from E. coli and mammalian sources. AB - Two series of 5-substituted uracil N(1)-acyclonucleosides, each with a different acyclic chain, were examined as inhibitors of uridine phosphorylase from rat intestinal mucosa, and several against the enzyme from Ehrlich ascites cells. In addition, several 5-substituted analogues of 2,2'-anhydrouridine were tested for their inhibitory effects vs a highly purified uridine phosphorylase from Escherichia coli. The results are compared with previously published data for inhibition of the E. coli enzyme by the acyclonucleosides, and of the rat enzyme by the anhydrouridines. In all instances, the inhibitors were active only vs the uridine, but not thymidine, phosphorylase from E. coli, and inhibition was competitive with respect to uridine as substrate. In general, with one or two exceptions, inhibitory effects were more pronounced against the enzyme from mammalian sources. Amongst the acyclonucleoside analogues, the most effective inhibitor of the enzyme from the rat and Ehrlich ascites cells exhibited a Ki = 0.1 microM, comparable to that reported with the Sarcoma-180 enzyme, whereas the Ki for inhibition of the E. coli enzyme was 0.7 microM. By contrast, another effective inhibitor of the bacterial enzyme was 7-fold less potent against the mammalian enzyme. The 2,2'-anhydrouridines were 10- to 30-fold more effective against the rat, as compared to the E. coli, enzyme. The overall quantitative data provide a reasonably good basis for the further design of potent inhibitors for possible use in chemotherapy. PMID- 3318843 TI - The cytochromes P-448--a unique family of enzymes involved in chemical toxicity and carcinogenesis. PMID- 3318844 TI - Hepatic epoxide hydrolase activities and their induction by clofibrate and diethylhexylphthalate in various strains of mice. AB - The presence of epoxide hydrolase activity in cytoplasm, microsomes and mitochondrial fraction in livers from twelve strains of mice (AKR/J, A/J, BALB/cByJ, CBA/J, C3H/HeJ, G57BL/6J, C57BL/10J, DBA/2J, NZB/B1NJ, PL/J, SEC/1ReJ and SW), and the influence of orally administered clofibrate and di(2 ethylhexyl)phthalate (DEHP) (0.5 and 2%, respectively, in diet) on epoxide hydrolase activities, were studied. Significant differences in basal cytosolic epoxide hydrolase activity, which ranged from 5.6 to 11.2 nmol diol.min-1.(mg protein)-1 using trans-stilbene oxide (TSO) as substrate, were noted among the mice. The highest and lowest enzyme levels were observed in the A/J and DBA/2J strains respectively. Similarly, microsomal epoxide hydrolase activity, monitored with cis-stilbene oxide (CSO), varied with the mouse strain, with the highest and lowest microsomal epoxide hydrolase activity being observed in A/J and SW strains respectively. Variations were also noted in the epoxide hydrolase activity in the mitochondrial fraction (monitored with TSO) with the highest and lowest levels observed in C57BL/6J and SW strains respectively. Clofibrate or DEHP treatment induced both cytosolic and microsomal epoxide hydrolases in nearly all of the strains examined. In contrast, the hydrolysis of TSO by the mitochondrial fraction in these strains was either not affected or decreased by clofibrate or DEHP treatment. The induction of cytosolic epoxide hydrolase was found to range between 1.2- and 2.8-fold, with generally a higher level of induction in mouse strains with low basal levels of cytosolic epoxide hydrolase activity. This level of cytosolic epoxide hydrolase activity, monitored with TSO as substrate, closely reflected the level of cytosolic epoxide hydrolase protein detected by immunoblot. There were also no significant differences observed in the molecular weight, immunological characteristics, pH-dependence and heat stability of hepatic cytosolic epoxide hydrolase activities of control and clofibrate-treated mice from various strains. These results suggest that clofibrate and DEHP induce both cytosolic and microsomal epoxide hydrolases but not the epoxide hydrolase in the mitochondrial fraction. PMID- 3318845 TI - A novel binding assay for phospholipase A2. AB - We have devised a rapid and simple assay for estimating the binding of pancreatic phospholipase A2 to a bilayer lipid membrane. The binding was observed to be extremely rapid at 37 degrees and was absolutely dependent upon Ca2+. Amongst several drugs known to inhibit the catalytic activity of phospholipase only mepacrine at high concentrations (500 microM) and chlorpromazine (100 microM) were active. Treatment of the enzyme with p-bromophenacylbromide did not inhibit binding. Several alcohols potentiated binding whereas detergents tended to inhibit. Amongst several purified proteins tested, only the steroid-induced anti phospholipase protein lipocortin prevented binding. The use of this assay in screening for antiphospholipase agents is discussed. PMID- 3318846 TI - Localization of Ro (SS-A) antigen in the cardiac conduction system. AB - The presence of anti-Ro (SS-A) antibody in maternal serum has been associated with congenital heart block. Using human sera monospecific for anti-Ro (SS-A) antibodies in an indirect immunofluorescence assay, Ro (SS-A) antigen was found to be present in the nuclei of myocardial cells and cells of the cardiac conduction system. The possible relationship between the location of Ro (SS-A) antigen, anti-Ro (SS-A) antibody, and heart block is discussed. PMID- 3318847 TI - The autoimmune antigen Me is distinct and related to undifferentiated connective tissue disease. AB - Using prototype Me serum, a new autoantibody-antigen system has been identified by Ouchterlony immunodiffusion and indirect immunofluorescence. Although immunologically distinct, the Me antigen has physiochemical and biochemical properties similar to those of the Sm antigen. Immunoblot assays indicate that Me sera commonly recognize 4 peptides of molecular weights approximating 100K, 65K, 21K, and 16K. The last of these may be identical to the D peptide recognized by Sm antibodies. The Me antigen may be associated with the RNP-Sm macromolecular complex. Me-positive patients have few clinical symptoms, and the most common diagnosis is undifferentiated connective tissue disease. PMID- 3318848 TI - Charge-charge interactions between articular cartilage and cationic antibodies, antigens, and immune complexes. AB - Bovine articular cartilage was used to examine the binding of cationized antibodies, antigens, and immune complexes to articular cartilage by charge charge interactions. Rabbit antibodies to human serum albumin (anti-HSA) and HSA were cationized to various degrees by the addition of amino groups. When approximately 20 or more new amino groups were added to HSA and approximately 25 or more amino groups were added to anti-HSA, the proteins readily bound to cartilage and penetrated into the matrix. Soluble immune complexes made with the cationic antibodies, including small-latticed complexes, bound only to the surface of the cartilage. When cationic HSA was bound to the matrix of the cartilage, unaltered antibodies bound only to the antigen at the surface and did not penetrate the matrix. This model system defines the manner in which cationic antigens and antibodies bind to and penetrate into the articular cartilage. PMID- 3318849 TI - AIDS: an introduction for speech-language pathologists and audiologists. PMID- 3318850 TI - The clinical PhD: implications for the survival and liberation of communicative disorders as a health care profession. PMID- 3318851 TI - Apolipoprotein B: structure, biosynthesis and role in the lipoprotein assembly process. AB - The complete amino acid sequence of the liver-synthesized apolipoprotein B (apoB) species, apoB 100, has been derived from cloned cDNA. The protein consists of 4536 amino acids (+ a 27 amino acid signal sequence). Cysteine is clustered in the N-terminal 1/10 of the protein, suggesting the presence of a stabilized tertiary structure in this part of the molecule. Three types of structure are suggested to be of importance for the binding of the protein to lipids; (i) hydrophobic sequences with a high probability for beta-sheet structure, (ii) strict amphipathic beta-sheets, and (iii) amphipathic alfa-helices. An apoB 100 molecule is completed within 10-14 min and secreted after approximately 30 min, 1/3 of which is due to the transfer through the endoplasmic reticulum (ER), while 2/3 is spent in the Golgi apparatus. ApoB 100 is co-translationally N glycosylated and 25% of the oligosaccharide chains is processed in the Golgi compartment. Other posttranslational modifications that have been discussed include covalent acylation and phosphorylation. It has also been suggested that the lipid moiety of the apoB 100 lipoproteins are modified during the passage through the Golgi apparatus. The site of lipoprotein assembly is suggested to be separated from the site of apoB 100 synthesis, and apoB 100 appears to be co translationally bound to the ER membrane and from this transferred to the ER lumen. Based on these observations a model for the assembly of apoB 100 lipoproteins is discussed in this paper. The intestinal derived apoB species, apoB 48, has a molecular mass of 210 kDa and appears to correspond to the N terminal 48% of apoB 100. The mechanism by which apoB 48 is formed is still not known. Available data indicate that the protein is formed within the intestinal cells, these data also argue against the possibility that apoB 48 is formed by posttranslational proteolysis of apoB 100. The formation of a separate apoB 48 mRNA by alternative splicing has been suggested, based on the observation of a 7 kb mRNA which corresponds to the 5' portion of the apoB 100 mRNA. However, the most abundant apoB mRNA species found in the intestine have a size that corresponds to that of the apoB 100 mRNA, furthermore the observation that apoB 48 appears to terminate in a 7.5 kb exon that appears to lack alternative splice sites, does not favour the possibility of alternative splicing. PMID- 3318852 TI - Yes Penny, we are listening! PMID- 3318853 TI - The Labor and Delivery Satisfaction Index: the development and evaluation of a soft outcome measure. PMID- 3318854 TI - Support and breastfeeding: a review. PMID- 3318855 TI - History of the Arthroscopy Association of North America. Part I: Its origin and growth. PMID- 3318856 TI - Fluid delivery systems for arthroscopy. PMID- 3318857 TI - Bankart suture repair. PMID- 3318858 TI - Dietary cholesterol recommendations for children. PMID- 3318859 TI - Synthaderm in the management of pre-tibial lacerations: a controlled clinical study. AB - A clinical study of patients with pre-tibial lacerations at King's College Hospital and Guy's Hospital, London, England, compared a non-adhesive dressing with Synthaderm. Treatment was randomly allocated. At King's College Hospital, deep and superficial lacerations were equally distributed, the median time to healing with Synthaderm was significantly (P less than 0.02) reduced; and the median rate of healing (mm/day) was significantly (P less than 0.01) better. At Guy's Hospital, larger and wider wounds were unequally distributed, with fewer in the control group; in the Synthaderm group, the median rate of healing was increased. In both centres, the clinical impression was that Synthaderm reduced nursing dressing time and a better scar resulted. Synthaderm improved the rate of healing in pre-tibial lacerations. PMID- 3318862 TI - [Immunologic aspects of kidney transplant]. PMID- 3318860 TI - Lower limb skin loss: simple outpatient management with meshed skin grafts with immediate mobilization. AB - Traumatic skin loss is a common problem in elderly patients presenting to an accident and emergency department. The authors report their experience with 25 patients in whom pretibial wounds were debrided, and covered with skin grafts taken under local anaesthetic and meshed by hand. All were immediately mobilized and discharged home. Healing was satisfactory in every case and there were no complications. All the patients found the treatment acceptable, and were delighted to avoid admission to hospital. This is a simple and effective outpatient procedure which can readily be carried out in the accident and emergency department. PMID- 3318861 TI - Air rifle breech injuries to digits: a preventable hazard. AB - The obvious injuries attributable to air rifles, namely those caused by pellets, are common and well documented (Batch, 1981; Reid, 1974; Rawson, 1965; Hutchinson, 1981). The author has encountered a series of injuries from air rifles involving a different mechanism. These commonly involve the digits, often in young people, and require considerable hospital time and resources in their treatment. They are essentially preventable. PMID- 3318864 TI - Aged care in Australia: a review of the literature. PMID- 3318863 TI - [Constipation in children]. PMID- 3318865 TI - Laxative drugs. PMID- 3318866 TI - [Preliminary characterization of a new system allowing maltose assimilation by Escherichia coli]. AB - We showed that Klebsiella pneumoniae and Erwinia herbicola possessed a pathway for maltose metabolism which could function in parallel with that encoded by the classical maltose regulon. Indeed, specific DNA fragments isolated from these two bacteria allowed growth on maltose of any of the mal mutants of Escherichia coli when in a multicopy number. The preliminary characterization of the E. herbicola DNA fragment indicated that a 4-Kb region was sufficient to complement the mal mutations of E. coli, and that this region encoded at least one 50-Kd protein. This protein is probably bound to the cytoplasmic membrane and its synthesis is induced by maltose independently of malT, the positive regulator gene of the maltose regulon. PMID- 3318867 TI - In vivo immunosuppression induced by a virulent strain of Yersinia pseudotuberculosis. PMID- 3318869 TI - Major protein components in the cell envelope of Clostridium tyrobutyricum. AB - The overall composition of the Clostridium tyrobutyricum cell envelope did not vary significantly during cell growth and was characterized by a high protein content (about 40% dry weight). Teichoic and teichuronic acids were absent and the neutral sugar content low. Insoluble peptidoglycan represented only 10-12% of the cell envelope (dry weight basis); it contained glucosamine, muramic acid, alanine, diaminopimelic acid and glutamic acid (molecular ratio 1/1/2/1/1). SDS PAGE revealed the presence of about 50 proteins in this cell envelope; however, one high molecular weight protein was largely predominant. They were not covalently bound to the peptidoglycan and their relative amounts were practically constant through cell growth and with various extraction treatments. A brief heat treatment of whole cells in PBS caused selective release of the major cell envelope proteins together with flagellin; this method was used to characterize these proteins in 37 strains of C. tyrobutyricum and some other clostridia. The major envelope proteins had molecular weights ranging from 96 to 145 Kd and the flagellins from 32 to 72 Kd. PMID- 3318868 TI - A subfamily of E. coli palindromic units implicated in transcription termination? AB - We previously described a family of dispersed palindromic sequences highly repeated in Escherichia coli and Salmonella typhimurium genomes. These sequences, called PU (palindromic units), are located outside structural genes. Conflicting results have been reported on the effects of different PU in transcription termination. Two PU located between co-transcribed genes in S. typhimurium were found not to cause transcription termination [25]. One PU located between convergently transcribed genes in E. coli behaved as bidirectional transcription terminators [12]. In the present paper, we show that three PU located between co transcribed genes in E. coli are not a transcription terminator. From the literature, we define a subfamily of PU, which we called PU, located between convergently transcribed genes which we implicate in bidirectional transcription termination. This plus the analysis of another PU which terminates transcription suggest that pecularities in the sequence or in the sequence environment of PU determine their role in transcription termination. PMID- 3318870 TI - Elimination of a virulence plasmid from Shigella sonnei and Escherichia coli by antibiotics. AB - Plasmid pWR105 is a non-self-conjugative plasmid conferring enteroinvasive properties on Shigella sonnei. Loss of this plasmid is accompanied by loss of the invasive phenotype as well as of the form I antigen expression. Thirteen antibiotics belonging to different chemical families were used at subinhibitory concentrations to eliminate pWR105 from S. sonnei and Escherichia coli K12. Rifampicin, novobiocin, chloramphenicol, cotrimoxazole and erythromycin eliminated the plasmid from both strains. Clindamycin eliminated pWR105 from E. coli only. Several other antibiotics gave a low rate of cure (ciprofloxacin, nalidixic acid, oxolinic acid, nifurzide, tilbroquinol, minocycline). We may expect that these antibiotics would destabilize plasmids from other Shigella species and enteroinvasive E. coli, as these extrachromosomal DNA molecules share a high degree of homology. PMID- 3318871 TI - Epidemiology of aerobactin production in Enterobacteriaceae. AB - Clinical isolates (496) of 10 different enterobacterial genera were studied for aerobactin excretion, colicin production and antibiotic resistance. In the case of Escherichia coli, the incidence of aerobactin-positive strains in 108 blood isolates (45%) was not significantly different from that corresponding to faecal sources (41%). Although colicin V production was much more frequently associated with aerobactin production than other colicins, colicin V was only produced by 26% of aerobactin excreters. Some strains were aerobactin-negative and colicin V producers. Aerobactin production seemed to be significantly associated with plasmidic antibiotic resistance. The production of the siderophore is described for the first time in Proteus, Serratia and Morganella strains. PMID- 3318872 TI - [Quantitative study of capillary and venous bacterial diffusion in experimental bacteremia in chickens]. AB - Capillary and venous diffusion of bacteria were studied in chickens after intravenous inoculation with Escherichia coli K12. A first group of 35 chickens was inoculated with 10(7) and a second group of 49 chickens with 10(8) E. coli. Bacterial enumeration showed two types of bacterial blood distributions. Early after inoculation, the level of bacteraemia was higher in venous than in capillary blood; later, the level of bacteraemia was higher in capillary than in venous blood. The difference was significant for the two kinds of inoculum. These results showed a slower clearance of E. coli in capillary than in venous blood. These experimental data confirm the greater sensibility of capillary than of venous sampling, already observed in neonates. PMID- 3318873 TI - Benign lipomatous lesions of the uterus: 3 new cases, review of the literature and histogenetic considerations. AB - Three new cases of benign lipomatous lesions of the uterus are described, with particular attention to the possible relation between symptomatology and the presence of mast cells in the neoformation. The literature is reviewed, a brief history is presented of important stages in the study of these forms, and a new histogenetic theory proposed based on a different concept from those accepted to date. PMID- 3318875 TI - [Neurosonographic observation of deformity in premature infants due to position of the head]. PMID- 3318874 TI - Expression of lymphocyte-associated antigens on neoplastic angioendotheliomatosis. AB - Neoplastic angioendotheliomatosis (NAE) is a rare and fatal disorder and has been regarded as a multifocal in situ neoplastic change of endothelial cells. This report describes a case of NAE from whom a biopsy specimen was obtained and studied immunohistologically using several monoclonal antibodies against lymphocyte-associated antigens. The tumor cells occluding luminal space express both T and B cell markers such as Leu-1, Leu-3, Leu-10, Leu-M3, HLA-DR, and HLA DQ, whereas they do not express Leu-2, Leu-4, lymphocyte-common antigen, and immunoglobulins. Factor VIII as a marker of vascular endothelial cell is false positive in the present case. Since immunoglobulins as a definitive B lymphocyte marker are negative in this case, there is no direct evidence indicating that NAE is a tumor of B lymphocytic lineage as previously reported. These results suggest the two possibilities that NAE is a unique variant of T cell lymphoma or true vascular endothelial tumor sharing the common histogenesis with malignant lymphoma. As it stands the former possibility is more likely than the latter in our case. PMID- 3318876 TI - Early events in mammalian fertilization. PMID- 3318877 TI - Constitutive and regulated secretion of proteins. PMID- 3318878 TI - Oligosaccharide signalling in plants. PMID- 3318879 TI - Cell adhesion in morphogenesis. PMID- 3318880 TI - Myosin structure and function in cell motility. PMID- 3318881 TI - Growth and differentiation in the hemopoietic system. AB - Hemopoiesis is regulated by a complex series of interactions, including interactions among hemopoietic cells themselves, hemopoietic cells and the extracellular matrix, hemopoietic cells and marrow stromal cells, and hemopoietic cells and growth factors. In vitro culture systems have allowed a reductionist approach to the solution of these various problems and have facilitated experiments at the mechanistic level. The hemopoietic system is organized hierarchically with multipotential self-renewing stem cells, committed progenitor cells, and mature cells. The various stimuli necessary for growth and development of these cells are rapidly being elucidated. The nature of commitment (or differentiation) remains an enigma, but model systems have been developed in which various aspects of this problem can be investigated. In this respect, growth and differentiation factors obviously have a major role to play. Now that many of these factors have been molecularly cloned (and pure target cell populations are available) their role in vivo and their mode of action can be examined. PMID- 3318883 TI - Laminin and other basement membrane components. PMID- 3318882 TI - Polypeptide growth factors: roles in normal and abnormal cell growth. AB - An increasing number of polypeptide growth factors have been identified that regulate not only cell proliferation but an extraordinary range of cell activities, including matrix protein deposition and resolution, the maintenance of cell viability, cell differentiation, inflammation, and tissue repair. Normal cells appear to require growth factors for proliferation and for maintenance of viability. Cells that secrete a polypeptide growth factor have an advantage in growth. These factors can act either externally through cell surface receptors or perhaps internally during the transport of receptors and growth factors through the ER and Golgi, causing autocrine stimulation of cell growth. Depending on the cell type, growth factors can also be potent inhibitors of cell growth rather than stimulating growth, and the effects can depend on the presence or absence of other growth factors. Platelet-derived growth factor has been shown to be nearly identical to the product of the v-sis gene of the simian sarcoma virus, which appears to cause cell transformation through its interactions with the PDGF receptor activating the tyrosine kinase activity of the PDGF receptor. Similarly, two proto-oncogenes, c-erbB and c-fms, encode growth factor receptors. The EGF receptor activity of the v-erb oncogene product appears to be constitutively activated without the need for growth factor, perhaps because of the truncation at the amino terminus deleting the EGF binding domain. The induction of the myc and the fos proteins by growth factor stimulation of quiescent cells, as well as the potential for the p21 product of the ras oncogene to act as an intermediate in transducing adrenergic signals, provide direct evidence that these pathways are important for stimulation of cell growth. Cells transformed by the v-sis oncogene always appear to bear PDGF cell surface receptors, which suggests that this oncogene has a specific requirement of the PDGF receptor for transformation. In contrast, cells transformed by the v-erbB and v-fms oncogenes are not stimulated by EGF or by CSF-1. Thus it seems likely that the tyrosine kinase activity of the corresponding receptor is ubiquitously expressed in these cases. Major questions remain unanswered. In particular, what are the mechanisms by which growth factors initiate pathways leading to DNA synthesis? What are the physiological substrates of the growth factor receptor tyrosine kinase? Considerable effort also is needed to further define the cellular specificity of the different growth factors, particularly within intact tissues, and to determine how the various growth factors interact.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3318884 TI - Viruses, immunoresponse, and cancer. A special symposium in honor of Hilary Koprowski. PMID- 3318885 TI - Molecular basis of viral persistence. PMID- 3318886 TI - Multiple sclerosis: facts or artifacts? PMID- 3318887 TI - Control of B-cell proliferation. PMID- 3318889 TI - Bone metastases in breast cancer, prostate cancer and myeloma. AB - This paper reviews the skeletal complications of a variety of tumour types, with particular reference to the clinical problems which confront patients. PMID- 3318888 TI - [The nature of immunohistochemically defined astrocytic cells in rat gliomas]. AB - The nature of astrocytic cells in rat gliomas induced by ethylnitrosourea (ENU) was studied by means of immunohistochemically demonstrating glial fibrillary acidic protein (GFAP), vimentin and beta-subunit of S 100 protein (S 100 beta) on paraffin sections. A special attention was paid to elucidating whether astrocytic cells would be neoplastic or not. The astrocytic cells in tumors were compared with astrocytes in normal rat brains and reactive astrocytes around a stab wound for their morphology, distribution and immunohistochemical characteristics. GFAP positive astrocytic cells in tumors were roughly divided into astrocytic cells and hypertrophic cells that showed morphologically similar appearance to fibrous astrocytes and hypertrophic reactive astrocytes around a stab wound respectively. A few multi-nucleated pleomorphic cells regarded as a kind of hypertrophic cells were also noted in gross tumors. GFAP positive cells were diffusely distributed in early neoplastic proliferations and microtumors, while in gross tumors they tended to be localized at the periphery. The GFAP positive cells were scattered among negative cells of tumors, forming no tumor mass. These findings suggest that the GFAP positive cells show no neoplastic growth, even though histopathologically they exhibit atypism or pleomorphism. The quantitative analysis of GFAP positive cells in tumors indicated more than 8% in most tumors in the white matter, whereas less than 8% in tumors in the gray matter and approximately 5% in gross tumors. The predominance of GFAP positive cells in the white matter was also observed in lesions induced by a stab wound.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318890 TI - Bisphosphonates--history and experimental basis. AB - This paper reviews the mechanisms of action of the bisphosphonates, a new class of recently developed drugs. The geminal bisphosphonates are characterized by a P C-P bond and are thus analogs of pyrophosphate. They bind strongly to hydroxyapatite crystals and in vitro inhibit both crystal formation and dissolution. In vivo, they inhibit soft tissue calcification and in some instances normal calcification. Furthermore, they are very potent inhibitors of bone resorption. The mechanism of action for the inhibition of calcification probably involves an inhibition of calcium phosphate crystal growth. However, the mode of action on bone resorption is not yet known, but is more likely to be cellular. The bisphosphonates are accumulated specifically in mineralized tissues. They are released when bone is resorbed so that osteoclasts and their precursors may be exposed to high local concentrations. Both inhibition of calcification and the effect on bone resorption is highly dependent upon the specific chemical structure of the individual bisphosphonate, so that each bisphosphonate must be considered as a compound per se. The only common characteristic is the tropism to mineral, which is due to the P-C-P group. This opens interesting possibilities for the development of new compounds. PMID- 3318891 TI - Bone resorption and turnover in health and disease. AB - Excessive bone loss is a common cause of disability and presents a major public health problem in western societies. The most common cause is age-related bone loss and osteoporosis, but other common diseases associated with increased bone resorption include malignant disease, primary hyperparathyroidism, and Paget's disease. Despite the frequency of these disorders and the suffering they cause, their pathophysiology still remains obscure. However, recent advances in techniques in bone cell biology are now providing new insights into the pathogenesis and treatment of diseases associated with increased bone resorption. These advances have been paralleled by improvements in techniques for non invasive assessment of bone status in patients with the common metabolic bone diseases. PMID- 3318892 TI - Bonding Class II composite to etched glass ionomer cement. PMID- 3318894 TI - Badges of the dental profession. BDA South Mercia Branch. PMID- 3318893 TI - Professor R. L. Hartles. Interview by Colin Davis. PMID- 3318895 TI - Anaesthesia: a practical or impractical construct? PMID- 3318896 TI - Constant i.v. infusions of nalbuphine or buprenorphine for pain after abdominal surgery. AB - A double-blind, sex-stratified, study compared the analgesic efficacy and side effects of nalbuphine 10 mg ml-1 (group N) and buprenorphine 0.15 mg ml-1 (group B) administered as a continuous infusion (0.2 ml kg-1/24 h), after abdominal surgery. Patients could request additional i.m. analgesic for pain. The study groups were well matched. The trial was stopped after 55 patients had been studied (nalbuphine 29, buprenorphine 26), because nine patients in the nalbuphine group had inadequate pain relief (P less than 0.01) shortly after surgery (mean 2.5 h). Analysis of the results on an "intention to treat" basis showed that the patients who received buprenorphine had significantly greater pain relief at 1, 3, 6 and 20 h after surgery. Patients who received buprenorphine were assessed by the physiotherapist to have less pain and better chest expansion. More additional analgesic was given to the patients receiving nalbuphine. In the patients receiving buprenorphine, the mean ventilatory rate was less (N = 19 b.p.m., B = 14 b.p.m.) (P less than 0.001) and the increase in PaCO2 was greater (N = 0.5 kPa, B = 1.1 kPa) (P less than 0.001), compared with the value before operation. Side effects were equal, and no serious adverse effects were observed in either group. PMID- 3318898 TI - Pharmacokinetics of cyclosporin: influence of rate of constant intravenous infusion in renal transplant patients. AB - 1 The pharmacokinetics of cyclosporin were studied in 12 renal transplant patients. Five patients received a constant rate (7 mg kg-1 day-1) intravenous infusion over 72 h and the remainder received rates of 7, 4 and 10 mg kg-1 day-1, consecutively each for at least 24 h. 2 Plasma, separated at 37 degrees C, was analysed by h.p.l.c. 3 The data were best described by a biexponential model. 4 Following the 72 h infusion, a plateau was reached by 24 h and clearance was 0.60 l h-1 kg-1. 5 Clearance associated with the 10 mg kg-1 day-1 infusion rate (0.43 l h-1 kg-1) was estimated to be lower than that following the 4 and 7 mg kg-1 day 1 rates (0.52 and 0.54 l h-1 kg-1 respectively) but the difference is unlikely to be of clinical significance. PMID- 3318897 TI - Control of hypertension in elderly patients with felodipine and metoprolol: a double-blind, placebo-controlled clinical trial. AB - 1. Forty-nine patients aged 65-80 years, whose Phase V diastolic blood pressure (dBP) was above 95 mmHg after 4 weeks open treatment with metoprolol 50 mg twice daily were randomized to receive, double-blind, the calcium antagonist felodipine (n = 32) 2.5 mg twice daily or placebo (n = 17) in addition to metoprolol for 2 weeks. If the dBP remained greater than 95 mmHg, the dose of felodipine or placebo was doubled for a further 2 weeks; if the dBP was still greater than 95 mmHg, the dose of felodipine was doubled again to 10 mg twice daily or the corresponding placebo dose given. The duration of the double-blind period was 6 weeks, all patients receiving metoprolol 50 mg twice daily throughout. 2. At the end of the double-blind period, the seated dBP was reduced from 103 +/- 5 (mean +/- s.d.) to 88 +/- 7 mmHg (P less than 0.001) by felodipine and from 105 +/- 100 +/- 11 mmHg (NS) by placebo. The differences between these reductions (P less than 0.01) and between the final dBPs (P less than 0.001) were significant. Eighty-nine per cent of patients receiving felodipine and 33% of those receiving placebo (P less than 0.001) had controlled (dBP less than or equal to 95 mmHg) BPs. Half (14/27 completing) of the patients receiving felodipine required 2.5 mg throughout; 9/27 needed 5 mg and 4/27 10 mg twice daily. Adverse events occurred with equal frequency in the two groups, but the profile was different.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318899 TI - Slow release aminophylline in long term management of chronic childhood asthma. PMID- 3318900 TI - Diphenoxylate hydrochloride (Lomotil) in the treatment of acute diarrhoea. PMID- 3318901 TI - Allopurinol. PMID- 3318902 TI - A comparison of two doses of adriamycin in the primary chemotherapy of disseminated breast carcinoma. AB - Forty-eight patients with advanced breast carcinoma who had not received prior chemotherapy (minimum follow up 21 months) were randomised to receive either adriamycin 70 mg m-2 i.v. 3-weekly for 8 cycles (Regimen A) or adriamycin 35 mg m 2 i.v. 3-weekly for 16 courses (Regimen B). Objective responses were seen in 14/24 (58%) patients with regimen A (4 complete) and 6/24 (25%) with regimen B (1 complete) (P less than 0.02). The median duration of response was 14 months with regimen A and 6.5 months with regimen B. The median duration of survival was 20 months and 8 months respectively (P less than 0.01). The toxicity was similar with each regimen. There was no evidence of deterioration in left ventricular ejection fraction nor congestive heart failure in any patient. It is concluded that when given at 3-weekly intervals adriamycin is a more effective treatment for advanced breast cancer at higher rather than lower dosage. PMID- 3318903 TI - The influence of irradiation on the biological half-life of prostacyclin in plasma of patients with gastrointestinal cancer. AB - In seven patients suffering from inoperable pancreatic cancer and in 14 patients with inoperable colonic cancer the half-life (T/2) of prostaglandin (PG)I2 in plasma in vitro has been determined before and at various intervals after irradiation. No significant difference of PGI2-T/2 could be observed either before irradiation, at the end of the irradiation period or 3 and 6 weeks after the last irradiation. Thus irradiation does not appear to interfere with the degradation of PGI2-T/2 in plasma. In patients with inoperable pancreatic and colonic cancer the PGI2-T/2 was not significantly different to that of the PGI2 T/2 of controls. Thus, a shortening of PGI2-T/2 is not a common feature in tumour patients. Hyperaggregation promoting seeding of metastases is not influenced by irradiation via the particular parameter of the PG-system. PMID- 3318904 TI - Stimulatory effects of muramyl dipeptide upon neutrophils isolated from a local bacterial infection. AB - This study examined the effects of muramyl dipeptide (MDP) in vivo upon the local inflammatory response to a bacterial challenge. In addition to quantitative bacteriology of the tissues surrounding an infected suture, polymorphonuclear leucocytes (PMN) involved in the local inflammatory response were extracted and estimations made of their number, viability and phagocytic activity. Fewer bacteria were recovered from the muscle around the suture in MDP-treated animals compared to placebo-treated controls (P less than 0.02), although there was no difference in the number of bacteria on the suture itself. Polymorphonuclear leucocytes were present in greater numbers (P less than 0.01), more PMNs were viable (P less than 0.01) and more PMNs had visibly phagocytosed bacteria (P less than 0.01) in the MDP group compared to the placebo group. These data indicate that MDP enhances the local inflammatory response to infection with increased influx, viability and phagocytic activity of PMNs, resulting in improved local control of a test bacterial challenge. PMID- 3318905 TI - Experimental autoimmune glomerulonephritis in rats by soluble isologous or homologous antigens from glomerular and tubular basement membranes. AB - Experimental autoimmune glomerulonephritis was induced in inbred WKY/NCrj rats and Wistar (closed colony) rats by a single injection of isologous or homologous soluble antigens from glomerular and tubular basement membranes. Glomerular and tubular basement membranes were trypsin digested and applied to an affinity column to which rabbit antibodies to bovine nephritogenic antigen had been coupled. The adsorbed fraction was nephritogenic when it was injected into rat footpads with Freund's complete adjuvant. Glomerulonephritis with long-lasting proteinuria and haematuria developed 2 to 3 weeks after the injection, and it was characterized histologically by endocapillary hypercellularity of mononuclear cells, capsular adhesion, sclerosis of capillary tufts, and crescent formation. Immunofluorescence study revealed the linear deposition of rat IgG along the glomerular basement membrane. Some rats with the nephritis had pulmonary hemorrhage. These results suggest that this experimental model is similar to the experimental glomerulonephritis induced in rats by bovine nephritogenic antigen, and to human anti-glomerular basement membrane antibody-induced glomerulonephritis including Goodpasture's syndrome. PMID- 3318906 TI - Localization and retention of mycobacterial antigen in lymph nodes of leprosy patients. AB - Although leprosy, a chronic disease caused by M. leprae, primarily affects skin and peripheral nerves, pathological changes and granulomas have been observed in lymph nodes which are: (a) present in tuberculoid lymph nodes in the absence of acid-fact bacilli and (b) persistent in lepromatous patients even after prolonged treatment. We detected substantial amounts of mycobacterial antigen in 16 leprous lymph nodes using anti-BCG by the peroxidase anti-peroxidase method. The load and distribution of antigen varied along the spectrum and with the duration of treatment. Tuberculoid and long-term treated lepromatous lymph nodes had a similar distribution of antigen in clusters of cells giving a 'speckled' appearance. The untreated lepromatous had a 'diffuse' staining of antigen in foamy histiocytes whereas lepromatous lesions with a lower bacillary load had a mixed pattern of 'diffuse' and 'speckled'. Antigen was also detected in a number of plasma cells along the spectrum but predominantly in lepromatous lymph nodes. Our observations indicate that: (a) antigen exists in lymph nodes despite prolonged chemotherapy which may be responsible for the persistent granuloma and (b) antigen is not confined to any particular anatomical compartment of the lymph node. PMID- 3318907 TI - On the nature of clear cell acanthomas. AB - Five clear cell acanthomas were studied using a panel of immunohistological markers. The results were compared with those from basal cell papillomas, with and without clear cell change, and with lesions of psoriasis and lichen planus. The results do not support the contention that these lesions are variants of basal cell papillomas nor that they are true neoplasms. PMID- 3318908 TI - Cutaneous fungal infection following renal transplantation: a case control study. AB - The prevalence of cutaneous fungal infection was studied in 72 patients who had undergone renal transplantation and compared with a group of age and sex matched controls. Samples were obtained from toe nails, toe webs, and the upper back; clinically suspicious lesions from other areas were also examined. A total of 576 sites were sampled (288 in each group). Pathogenic fungi were identified from 44 sites (15%) in the renal transplant (RT) group compared with 26 sites (9%) in the control group, (P less than 0.05). However, site-specific differences were less marked; no difference was found between the RT group and controls when the results from the toe nails and toe webs were analysed separately. Trichophyton mentagrophytes was the most common species isolated from both groups. Colonization of the back with Pityrosporum yeasts was significantly more common in the RT group, but few patients in either group had tinea versicolor. 'Mixed infections', with more than one species of fungus isolated in an individual, were only found in the RT group. We also examined the relationship between the presence of fungal infection and the presence or absence of cutaneous malignancy in the renal transplant group. No increase in the prevalence of fungal colonization was found in those patients who had developed cutaneous malignancy compared with those who had not. PMID- 3318909 TI - Does histologic grading of inflammation in bone marrow predict the response of aplastic anaemia patients to antithymocyte globulin therapy? AB - We tested the hypothesis of teVelde and Haak that the degree of bone marrow inflammation in aplastic anaemia might correlate with an immunological process responsive to immunosuppressive therapy. 120 patients with aplastic anaemia but no suitable marrow donor were treated with horse antithymocyte globulin (ATG) and 53 who had matched sibling donors with bone marrow transplants. Pretreatment bone marrow histology in methacrylate and paraffin specimens was graded by degree of inflammatory infiltrate in a four-tiered system. High grade (II-III) was compared to low (O-I) as a correlate of response to ATG. Complete and partial response to ATG was seen in 50% of patients with high grade marrow and 31% of patients with low grade marrow (P = 0.099). Only one of four patients with grade III inflammation responded significantly to ATG treatment. Median survival following ATG therapy was similar in both groups as well. There was a significantly lower median age in the patients with low grade (24.5 years) versus high grade (37.5 years) inflammation (P = 0.016). Grade also had no prognostic value in the marrow transplant group. PMID- 3318910 TI - Interleukin 2 enhances cytotoxic cell function in vitro after T-cell depleted marrow transplantation. AB - After T-cell depleted marrow transplantation, there is a rapid recovery of cytotoxic effector cells, with activity against targets not susceptible to killing by 'resting' natural killer cells. These targets include Epstein-Barr virus transformed B cells and leukaemic cell lines. Activated killer cell function declines by 3 months after transplantation. We find that when CD3 negative effector cells are obtained from these patients and cultured in vitro with interleukin 2 there is a further enhancement of cytotoxic activity against a range of target cells in the early post-transplant period, and a restoration of high level cytotoxic activity to effector cells obtained 3 months or more after the procedure. These results may have relevance to attempts to reduce the incidence of leukaemic relapse, and EBV + ve lymphoma outgrowth after T-cell depleted BMT. PMID- 3318912 TI - High levels of anti-cytoskeleton autoantibodies are frequently associated with chronic GVHD. AB - Twenty-two patients (acute myeloid leukaemia 13, acute lymphoid leukaemia 5, chronic myeloid leukaemia 4) with an average age of 25 years (range 8-36 years), had received allogeneic bone marrow transplantation (BMT) from an HLA identical sibling. The BMT recipients were followed up for a period of 4-65 months. All patients were given cyclophosphamide, total body irradiation and methotrexate in order to prevent graft-versus-host disease (GvHD). Eleven of 22 patients exhibited chronic graft versus host disease (cGvHD) (extensive in five, limited in six at the time of the study) assessed by clinical and histological parameters. Serum samples were collected from these patients, before BMT (except in one case) and then every 2 or 3 months. Sequential studies to determine the presence of autoantibodies against cytoskeletal proteins (actin, tubulin, myosin), dsDNA and dDNA in these sera were performed by an ELISA method. Simultaneously, immunoelectrophoresis and measurement of complement fractions C3, C4 were performed on each sample. High levels of autoantibodies against cytoskeletal proteins were found in 10/11 patients with cGvHD and were absent in 11/11 patients without cGvHD; none of them exhibited anti-DNA activity. At the same time, C4 levels were decreased in seven of these patients with cGvHD. Monoclonal immunoglobulins IgG and IgM (2-15 g/l) were found in 8/11, but the antibody activity was never found to be located within the M component. These results show a direct relationship between the presence of these autoantibodies and occurrence of cGvHD and indicate that they may constitute an immunological marker related to this complication. However, their predictive value is not clearly evident in this retrospective series as in some patients they preceded clinical signs of cGvHD, whereas in others they were associated with the onset of cGvHD. PMID- 3318911 TI - Nuclear c-myc protein, maturation, and cell-cycle status of human haemopoietic cells. AB - Human c-myc protein, p62c-myc, has been quantitated by flow cytometry in the nuclei of normal marrow and peripheral blood cells, and the HL60 cell line. Marrow and peripheral blood cells exhibit nuclear c-myc protein throughout the cell-cycle, at an average level 2-3-fold lower than HL60 cells. In no cells did p62c-myc vary more than 2-fold throughout the cell cycle. A small subset of marrow G0/G1 cells, enriched in early myeloid and blast cell fractions, contained p62c-myc at levels equal to or even exceeding those of HL60. Overall c-myc protein content was higher in myeloid, compared to erythroid and lymphoid marrow fractions. Within the myeloid lineage, the highest average p62c-myc level was present in cells of intermediate maturation, i.e. myelocytes and metamyelocytes. In the erythroid lineage, c-myc protein level was highest in the most immature cells and declined with maturation. Significant amounts of p62c-myc were present in post-mitotic, end-stage neutrophils, but were barely detectable in cycling late erythroblasts or in quiescent lymphocytes and monocytes. HL60 cells, despite c-myc gene amplification and increased gene expression, contain c-myc protein at a level corresponding to promyelocytes in normal human marrow. The virtual absence of p62c-myc in cycling late erythroblasts, and its presence in post mitotic end-stage granulocytes, suggests that c-myc protein may have functions unrelated to cell proliferation. PMID- 3318913 TI - Triple chimaerism after allogeneic bone marrow transplantation for Philadelphia chromosome positive chronic granulocytic leukaemia. PMID- 3318914 TI - Toxicity of metabolites to dopaminergic systems and the behavioural effects of organic solvents. PMID- 3318915 TI - Employers, the government, and industrial fatigue in Britain, 1890-1918. AB - The evolution of the concept of industrial fatigue and the responses of employers and the government in Britain to research initiatives in this field of industrial medicine up to the end of the first world war is explored. The discussion dovetails in with the broader debate about the characteristics and dissemination of scientific labour management in Britain. The first section focuses on attitudes towards human energy expenditure and overwork in the nineteenth century. Following this is a discussion of the shorter hours movement of the 1890s, the important experiment at the Manchester engineering firm of Mather and Platt, and the reaction of British employers and the government to this. Finally, a brief analysis is made of the progress in research into workers' health, fatigue, and efficiency during the 1914-8 war, particularly concentrating on the role of the Health and Munition Workers Committee in pioneering the scientific study of industrial medicine. This led directly to the establishment of the Industrial Fatigue Research Board in 1918. Though there are significant caveats, it is argued that before the first world war a wide gap existed between research findings, best practice, and the common workshop experience and that in general British management (with some notable exceptions) grossly neglected the human element in production, ignored human physiological and psychological limitations, and hence both created and exacerbated serious problems of mental and physical fatigue and overstrain. PMID- 3318916 TI - Doppler ultrasound. PMID- 3318917 TI - Ultrasound measurement of fetal blood flow in predicting fetal outcome. AB - The efficacy of fetal blood flow assessment in predicting fetal outcome was evaluated in 159 pregnancies suspected of intrauterine growth retardation (IUGR). Blood flow in the fetal aorta and umbilical vein was measured with imaging and pulsed Doppler ultrasound. Volume blood flow values and variables describing the waveform of the maximum aortic blood velocity were checked for relations to subsequent fetal outcome. A new semi-quantitative velocity waveform variable, blood flow class (BFC), was designed and tested. The occurrence of IUGR, imminent fetal distress, a low Apgar score at 1 and 5 min, and a low pH in the umbilical artery and vein were adopted to characterize fetal outcome. Receiver operating characteristic curves were used to demonstrate the sensitivity and false positive rate, and the Cohen's Kappa index was used to compare the predictive capacity of the various blood flow variables. BFC, describing the blood velocity waveform with emphasis on its end-diastolic part, was found to be the most powerful marker of imminent fetal asphyxia (Kappa = 0.66) and of intrauterine growth retardation (Kappa = 0.48). PMID- 3318918 TI - Massive subchorionic thrombohaematoma presenting as a placental tumour. Case report. PMID- 3318920 TI - Practical mandibular implantation. AB - The author's experience with an implantation system for use in the mandible, mainly for the support of lower dentures, is described and the results, over the last four years are analysed. PMID- 3318921 TI - Changes to the lower third facial profile following mandibular sulcoplasty with free skin grafting. AB - The lower third facial profile changes following anterior sulcoplasty with free skin grafting and bilateral mylohyoid ridge resection have been assessed. Nineteen patients were selected and were photographed prior to and at one month, 6 months and 1 year following surgery. The patients were photographed from an anterior and lateral position using a telecentric optics system designed to overcome geometric distortion. The patients were photographed both wearing and not wearing their complete dentures. Marked facial profile changes were found following surgery. There was a flattening of the labial mental fold and an increase in the bulk and prominence of the chin. The wearing of dentures enhanced this profile change. The changes were most marked in those patients in whom a larger labial sulcus extension was attempted. PMID- 3318919 TI - Cytological and immunohistochemical study of the limbal form of vernal keratoconjunctivitis by the replica technique. AB - The cellular composition of the inflammatory infiltrate present in 13 patients with the limbal form of vernal keratoconjunctivitis was examined in the conjunctival scrapings and the limbic replicas by means of Giemsa stain and immunohistochemistry. Conjunctival scrapings showed the presence of mast cells, lymphocytes, plasma cells, polymorphonuclear leucocytes, and very few basophils in all the specimens. Eosinophils were present in only four scrapings. The superficial epithelium of the limbic lesion and the adjacent cornea and conjunctiva was studied by the replica technique. The limbic lesion area showed the presence of necrotic epithelial cells mixed with inflammatory cells, including eosinophils, mast cells, lymphocytes, plasma cells, and polymorphonuclear leucocytes and very few basophils. Most of the inflammatory cells were HLA-DR+. Many OKT6+ cells were present, indicating the presence of Langerhans cells. T-lymphocytes including a few helper/inducer cells and many suppressor/cytotoxic cells, were detected in the infiltrate. In addition many B lymphocytes were observed. These findings suggest that other immune mechanisms in addition to type 1 reaction are involved in the pathogenesis of the disease. PMID- 3318922 TI - Recurrent meningioma of the head and neck--two case reports and a review of the literature. AB - Two very unusual cases of recurrent meningioma characterised by cheek swelling and proptosis of the eye are reported. Clinical and histological features are described and the literature reviewed. PMID- 3318923 TI - Effect of insulin on hind-limb and whole-body leucine and protein metabolism in fed and fasted lambs. AB - 1. A combination of isotope-dilution and arterio-venous difference techniques was used to determine rates of leucine metabolism and protein synthesis and degradation in a hind-limb preparation (predominantly muscle) and the whole body of eight lambs fed on milk to appetite and eight lambs fasted from 24 to 48 h. 2. Compared with fed lambs, fasted lambs showed decreased rates of protein synthesis in both whole body and hind-limb, and in hind-limb muscle, elevated rates of protein degradation. 3. The effects of two rates of insulin infusion on whole body and hind-limb-muscle leucine metabolism, and in turn on protein metabolism, were determined. Insulin had no significant effect on leucine flux or oxidation (and hence protein synthesis and degradation) in whole-body or hind-limb muscle of fed lambs. In fasted lambs insulin progressively reduced arterial leucine concentration and whole-body leucine flux and oxidation, indicating a reduction in both protein synthesis and degradation. Insulin reduced the rate of leucine efflux from hind-limb muscle, which was followed by a reduction in leucine uptake. Insulin increased hind-limb-muscle glucose uptake in both fed and fasted lambs. 4. On the basis that hind-limb muscle was representative of skeletal muscle in general, we estimated that muscle accounted for the same percentage (about 27) of whole-body protein synthesis in both fed and fasted lambs. This percentage was unaffected by infusion of insulin, although the absolute rates differed in fed and fasted lambs. PMID- 3318924 TI - Comparison of the structure of the manganese complex in the S1 and S2 states of the photosynthetic O2-evolving complex: an x-ray absorption spectroscopy study. AB - A Mn-containing enzyme complex is involved in the oxidation of H2O to O2 in algae and higher plants. X-ray absorption spectroscopy is well suited for studying the structure and function of Mn in this enzyme complex. Results of X-ray K-edge and extended X-ray absorption fine structure (EXAFS) studies of Mn in the S1 and S2 states of the photosynthetic O2-evolving complex in photosystem II preparations from spinach are presented in this paper. The S2 state was prepared by illumination at 190 K or by illumination at 277 K in the presence of 3-(3,4 dichlorophenyl)-1,1-dimethylurea (DCMU); these are protocols that limit the photosystem II reaction center to one turnover. Both methods produce an S2 state characterized by a multiline electron paramagnetic resonance (EPR) signal. An additional protocol, illumination at 140 K, produces as a state characterized by the g = 4.1 EPR signal. We have previously observed a shift to higher energy in the X-ray absorption K-edge energy of Mn upon advancement from the dark-adapted S1 state to the S2 state produced by illumination at 190 K [Goodin, D. B., Yachandra, V. K., Britt, R. D., Sauer, K., & Klein, M. P. (1984) Biochim. Biophys. Acta 767, 209-216]. The Mn K-edge spectrum of the 277 K illuminated sample is similar to that produced at 190 K, indicating that the S2 state is similar when produced at 190 or 277 K.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318925 TI - Phosphorylation substrates for protein kinase C in intact pituitary cells: characterization of a receptor-mediated event using novel gonadotropin-releasing hormone analogues. AB - The involvement of protein kinase C in the signal transduction of gonadotropin releasing hormone (GnRH) action was investigated with a GnRH superagonist, partial agonists, and antagonists in intact rat pituitary cells. Exposure of 32P labeled cells to GnRH or to the superagonist [D-Nal(2)6]GnRH (200 times GnRH potency in vivo) induced the enhanced phosphorylation of 42-, 34-, 11-, and 10 kDa proteins and the dephosphorylation of a 15-kDa protein as assessed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis/autoradiography. This effect was blocked in a dose-dependent manner by potent GnRH antagonists. At its maximally effective concentration of 10(-9) M, [D-Nal(2)6]GnRH induced an up to 2 times more pronounced phosphorylation of endogenous substrates than GnRH at 10( 7) M. This was in accord with its ability to cause an 8-fold increase in the translocation of protein kinase C to the particulate fraction vs. 3.4-fold for GnRH. This effect correlated with potency for a series of GnRH agonists ( [D Nal(2)6]GnRH greater than GnRH greater than [Gly2]LH-RH) and was prevented by GnRH antagonists, as assessed by a novel phorbol ester receptor binding assay and by a standard kinase assay. Downregulation of protein kinase C by prolonged incubation of the pituitary cells with high concentrations of active phorbol esters abolished protein kinase C activity and also prevented the phosphorylation induced by GnRH, or [D-Nal(2)6]GnRH. The same effect was obtained by preincubating the cells with the protein kinase C inhibitor H-7. In this study we identify for the first time physiological substrates for protein kinase C in intact pituitary cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3318926 TI - Time-resolved tryptophan fluorescence anisotropy investigation of bacteriophage M13 coat protein in micelles and mixed bilayers. AB - Coat protein of bacteriophage M13 is examined in micelles and vesicles by time resolved tryptophan fluorescence and anisotropy decay measurements and circular dichroism experiments. Circular dichroism indicates that the coat protein has alpha-helix (60%) and beta-structure (28%) in 700 mM sodium dodecyl sulfate micelles and predominantly beta-structure (94%) in mixed dimyristoylphosphatidylcholine/dimyristoylphosphatidic acid (80/20 w/w) small unilamellar vesicles. The fluorescence decay at 344 nm of the single tryptophan in the coat protein after excitation at 295 or 300 nm is a triple exponential. In the micelles the anisotropy decay is a double exponential. A short, temperature independent correlation time of 0.5 +/- 0.2 ns reflects a rapid depolarization process within the coat protein. The overall rotation of the coat protein detergent complex is observed in the decay as a longer correlation time of 9.8 +/ 0.5 ns (at 20 degrees C) and has a temperature dependence that satisfies the Stokes-Einstein relation. In vesicles at all lipid to protein molar ratios in the range from 20 to 410, the calculated order parameter is constant with a value of 0.7 +/- 0.1 from 10 to 40 degrees C, although the lipids undergo the gel to liquid-crystalline phase transition. The longer correlation time decreases gradually on increasing temperature. This effect probably arises from an increasing segmental mobility within the coat protein. The results are consistent with a model in which the coat protein has a beta-structure and the tryptophan indole rings do not experience the motion of the lipids in the bilayer because of protein-protein aggregation. PMID- 3318927 TI - Physiological electron donors to the photochemical reaction center of Rhodobacter capsulatus. AB - The nature and number of physiological electron donors to the photochemical reaction center of Rhodobacter capsulatus have been probed by deleting the genes for cytochromes c1 and b of the cytochrome bc1 complex, alone or in combination with deletion of the gene for cytochrome c2. Deletion of cytochrome c1 renders the organism incapable of photosynthetic growth, regardless of the presence or absence of cytochrome c2, because in the absence of the bc1 complex there is no cyclic electron transfer, nor any alternative source of electrons to rereduce the photochemically oxidized reaction center. While cytochrome c2 is capable of reducing the reaction center, there appears no alternative route for its rereduction other than the bc1 complex. The deletion of cytochromes c1 and c2 reveals previously unrecognized membrane-bound and soluble high potential c-type cytochromes, with Em7 = +312 mV and Em6.5 = +316 mV, respectively. These cytochromes do not donate electrons to the reaction center, and their roles are unknown. PMID- 3318928 TI - Properties of the reaction center of the thermophilic purple photosynthetic bacterium Chromatium tepidum. AB - Reaction centers were purified from the thermophilic purple sulfur photosynthetic bacterium Chromatium tepidum. The reaction center consists of four polypeptides L, M, H and C, whose apparent molecular masses were determined to be 25, 30, 34 and 44 kDa, respectively, by polyacrylamide gel electrophoresis. The heaviest peptide corresponds to tightly bound cytochrome. The tightly bound cytochrome c contains two types of heme, high-potential c-556 and low-potential c-553. The low potential heme is able to be photooxidized at 77 K. The reaction center exhibits laser-flash-induced absorption changes and circular dichroism spectra similar to those observed in other purple photosynthetic bacteria. Whole cells contain both ubiquinone and menaquinone. Reaction centers contain only a single active quinone; chemical analysis showed this to be menaquinone. Reaction center complexes without the tightly bound cytochrome were also prepared. The near infrared pigment absorption bands are red-shifted in reaction centers with cytochrome compared to those without cytochrome. PMID- 3318929 TI - Quantitative determination of the lectin binding capacity of small intestinal brush-border membrane. An enzyme linked lectin sorbent assay (ELLSA). AB - A test to determine quantitatively the lectin binding sites in brush-border membranes has been developed. Highly purified bovine small intestinal brush border membranes were prepared, and subsequently coated directly to the bottom of a microtiter plate. Soybean agglutinin conjugated with peroxidase was coupled to its binding sites in the brush-border membranes and the peroxidase activity was determined in a spectrophotometer. The number of soybean agglutinin binding sites in the brush-border membranes has been established by means of iterized computer fit analysis of the data, indicating values for maximal binding of 7.10(-7) M soybean agglutinin per mg of brush-border membrane protein and a dissociation constant of 1.5.10(-5) M. PMID- 3318930 TI - Biochemical characterization and subcellular distribution of the glucose transporter from rat brain microvessels. AB - This study describes the biochemical characterization and subcellular distribution of glucose transporters from isolated rat brain cortical microvessels. The D-glucose inhibitable [3H]cytochalasin B binding assay was used to quantitate glucose transporter binding sites in plasma membranes, high-density microsomes and low-density microsomes prepared from basal and insulin-stimulated cells. Incubation with insulin for 30 min increased the number of glucose transporters in the high-density microsomes by around 33% but had no effect on the number of glucose transporters in the plasma membrane or low-density microsomes. Prolonged incubation with insulin (2 h), however, resulted in a small but significant redistribution of glucose transporters to the low-density microsomes. Preincubation of cells with cycloheximide blocked this insulin induced increase in glucose transporter number, suggesting that this effect of insulin was due to the synthesis of new glucose transport proteins. Specific labeling of glucose transporters was achieved by photoincorporation of [3H]cytochalasin B. Labeled membranes from all fractions contained a single D glucose inhibitable peak, migrating with a molecular size of 55 kDa on SDS polyacrylamide gel electrophoresis. Isoelectric focusing of the 55 kDa protein revealed one major peak of D-glucose inhibitable radioactivity focusing at pH 6.0 in all fractions. PMID- 3318931 TI - Rapid binding of beta 2-microglobulin to renal brush-border membranes. AB - 125I-labelled human beta 2-microglobulin binding to rat renal brush-border membranes was assessed by an in vitro assay under near physiological incubation conditions (i.e. low content of albumin). Binding rate was 55 pmol/min per mg protein in the presence of 200 nM of beta 2-microglobulin and degradation rate was negligible versus binding rate. The binding rate was in reasonable agreement with the in vivo reabsorption rate, supporting the hypothesis of proteins binding to the luminal membrane during the process of reabsorption. Mild solubilizing treatment (Triton 0.1%) of brush border after beta 2-microglobulin binding yielded the labelled molecule associated with a high-molecular-weight component. Aminopeptidase activity and binding ability were to a certain extent co-purified during the course of the brush-border preparation, suggesting that most of the beta 2-microglobulin binding sites were localized in the brush-border membranes. PMID- 3318932 TI - Calcium-dependant binding proteins associated with human placental syncytiotrophoblast microvillous cytoskeleton. AB - Isolated human placental syncytiotrophoblast microvillous plasma membrane vesicles were extracted with Triton X-100 to yield a detergent-insoluble residue. The residue contained approx. 50% of the total membrane protein and was qualitatively different from untreated trophoblast on SDS-polyacrylamide gel electrophoresis, Western blots and dot-immunobinding assay. Three major proteins, with molecular weights of 68, 36 and 34 kDa, dissociated from this non-ionic detergent-insoluble submembranous cytoskeletal fraction in the presence of calcium chelators. They were immunologically related to human lymphocyte cytoskeletal calcium-binding proteins, and the 36 kDa component reacted with antisera to the phospholipase A2 inhibitor, lipocortin II. Anti-lipocortin I sera did not recognise the 34 kDa protein, but did react with a series of trophoblast cytoskeletal proteins in the 34-37 kDa region. Incubation of epidermal growth factor with isolated trophoblast membrane vesicles stimulated the phosphorylation of a 36 kDa protein on tyrosine residues. Immunoprecipitation studies further showed there was no phosphorylation of the 34 kDa protein, but the 68 kDa protein was a major phosphorylated component of isolated syncytiotrophoblast membranes. p68 was principally phosphorylated on serine with slight tyrosine phosphorylation which showed an apparent increase after epidermal growth factor treatment. These results indicate a family of calcium-dependant binding proteins, some of which are phosphorylated, associated with the submembranous cytoskeleton of syncytiotrophoblast microvilli. PMID- 3318933 TI - 7-Oxo-24,25-dihydrolanosterol: a novel lanosterol 14 alpha-demethylase (P 45014DM) inhibitor which blocks electron transfer to the oxyferro intermediate. AB - 7-Oxo-24,25-dihydrolanosterol (3 beta-hydroxy-8-lanosten-7-one, 7-oxo-HDL) was a potent competitive inhibitor for lanosterol 14 alpha-demethylase (cytochrome P 45014DM) of Saccharomyces cerevisiae. Affinity of 7-oxo-DHL for the enzyme was more than 50-times higher than those of the inherent substrates, lanosterol and 24,25-dihydrolanosterol. 7-Oxo-DHL accelerated NADPH-dependent reduction of cytochrome P-45014DM in the reconstituted system consisting of the cytochrome and NADPH-cytochrome P-450 reductase. These observations indicated that 7-oxo-DHL interacted with the substrate site of cytochrome P-45014DM. However, 7-oxo-DHL was not metabolized by the reconstituted system. Incubation of 7-oxo-DHL with the reconstituted system caused accumulation of oxyferro intermediate of cytochrome P 45014DM. It can thus be concluded that 7-oxo-DHL interfered with electron transfer to the oxyferro intermediate of the cytochrome, though it stimulated reduction of the heme iron. So far as we know, 7-oxo-DHL is the first example of a cytochrome P-450 inhibitor which selectively interferes with the electron transfer to oxyferro intermediate. 7 alpha-Hydroxy-24,25-dihydrolanosterol was also a competitive inhibitor of cytochrome P-45014DM. However, this compound was metabolized by the reconstituted system and could not block the electron transfer to oxyferro intermediate. 11-Oxo-24,25-dihydrolanosterol, an isomer of 7-oxo-DHL, did not have such inhibitory effects. These lines of evidence suggest a possibility that the keto group at C-7 of lanost-8-ene skeleton may interact with a certain site of cytochrome P-45014DM which has an important role in the electron transfer to oxyferro intermediate. PMID- 3318934 TI - Effects of growth state and amines on cytoplasmic and vacuolar pH, phosphate and polyphosphate levels in Saccharomyces cerevisiae: a 31P-nuclear magnetic resonance study. AB - The vacuoles of logarithmic and stationary stage cells were compared by 31P-NMR with regard to pH, orthophosphate (Pi) content and average size of polyphosphate. The vacuoles of stationary cells had lower pH, higher Pi content, and polyphosphates of longer average chain length, although total polyphosphate content was about the same as in logarithmic cells. The lower vacuolar pH in stationary cells was the major cause of a larger cytoplasmic-vacuolar pH gradient. Addition of NH4Cl, (NH4)2SO4, methylamine or amantadine at pH 8 to cells in either stage caused an increase in both cytoplasmic and vacuolar pH, with little or no change in the cytoplasmic-vacuolar pH gradient. However, the administration of ammonium salts to the cells at pH 8.0 resulted in rapid hydrolysis of the intravacuolar polyphosphate to tripolyphosphate and Pi, with attendant redistribution of Pi between the vacuolar and cytoplasmic compartments. PMID- 3318935 TI - Isolation and characterization of a collagen fibril-associated dermatan sulphate proteoglycan from bovine lung. AB - Dermatan sulphate proteoglycans have been extracted from bovine lung with 2.0 M CaCl2 and isolated using CsCl density gradient centrifugation, DEAE ion-exchange chromatography, gel chromatography and preparative sodium dodecyl sulphate polyacrylamide gel electrophoresis. Ultrastructurally these proteoglycans are specifically associated with collagen fibrils. Dermatan sulphate (Mr 15.10(3) 35.10(3), with a strong prevalence for the higher Mr) is link via an O-glycosidic bond to a protein core, which is rich in Asx, Glx and Leu. Of the total uronic acid, 91% is iduronic acid. A part of the glucuronic acid residues is located near the protein core and a large cluster of disaccharides is devoid of glucuronic acid residues. An inhibition enzyme immunoassay has been developed to quantitate the proteoglycan. A model for the interaction between dermatan sulphate proteoglycans and collagen fibrils is proposed. PMID- 3318937 TI - [Study of protein dynamics using Mossbauer spectroscopy]. AB - Last experimental results of the study of protein dynamics by Mossbauer absorption spectroscopy and Rayleigh scattering of Mossbauer radiation are reviewed. Dynamical properties of proteins following from the theoretical treatment of these data are described. PMID- 3318936 TI - [Protein stability and hydrophobic interactions]. AB - The paper summarizes results of calorimetric studies of protein denaturation and of dissolution of non-polar substances in water. The analysis of the available experimental data shows that the positive contribution of the hydrophobic interactions in stabilization of the protein compact state is due to van der Waals interactions between the protein non-polar groups, while the contribution of water solvation by these groups, in spite of the widely spread opinion, appears to be always negative. This destabilizing action of water solvation on the protein increases as the temperature decreases, and at a significantly low temperature causes unfolding of the compact structure of protein, i. e. cold denaturation. PMID- 3318938 TI - [The "protein-machine" concept and its consequences]. AB - Analysis is presented of the concept "protein-machine" and implying consequences, both of theoretical and experimental character. The approach "protein-machine" is compared with other approaches--"coherent excitation", "molecular dynamics" and "limited diffusion". In terms of the approach "protein-machine" valuable information inserted in the biological macromolecule and determining its functions is taken into account. It reflects the biological specificity and at the same time removes mystic shadow from this concept. PMID- 3318939 TI - [Malignant transformation and changes in various physico-chemical properties of macromolecules and supramolecular structures. I. Nucleic acids]. AB - The relations between heat and hydrate properties of nucleic acids, proteins and supramolecular structures and concentration of various metal ions in them are shown. Global disturbance of metabolism of metal ions accompanying malignization is described. This disturbance causes some changes in the activity of the central nervous system. Recently there were found disturbances of physico-chemical properties of some (most characteristic) brain regions during the development of malignant tumors in the mammary glands and spleen. PMID- 3318941 TI - [Electrostimulated cell fusion in cell engineering]. AB - A survey of studies on reconstructions of animal and plant cells which apply a new physical method--electrostimulated fusion, is presented. Effects of different factors of the medium on the efficiency of electrofusion is discussed. A detailed account is given of the authors' studies on zygotes reconstruction by combined methods of microsurgery and electrostimulated cell fusion. Advantages of the latter as compared to the widely distributed methods of fusion by polyethylenglycol and Sendai virus are considered. This physical method can play an important role in the progress of cellular engineering. PMID- 3318940 TI - [Free radical lipid oxidation and physical properties of lipid layer of biological membranes]. AB - The results obtained mainly by the author and coworkers are summarized. One efficient method to detect free radicals in biological samples is chemiluminescence (CL). In the absence of activators CL of membraneous systems is due to lipid peroxide free radicals, whereas in the presence of luminol it is initiated by oxygen radicals. Low levels of free radicals in the cells and blood plasma are maintained by antioxidants, enzymes included. Ferrous ions increase free radical concentrations in the cells and tissues. Deleterious action of hydroxyl radicals is the result of the breakage of DNA strains and of lipid peroxidation (LPO). The latter reaction brings about the damage of the membrane barriers due to a decrease of the electrical stability of the membrane lipid bilayer and "self-breakdown" of the membranes by potential differences produced in the living cells. PMID- 3318942 TI - [Photo-oxidative processes in eye structures. Protective function of the lens and shielding pigments]. AB - The results of visual cell photoreceptor membrane light damage mechanism research and some mechanisms of optical and chemical protection of eye structure from photo-sensibilized oxidation are reviewed. PMID- 3318943 TI - Biological activity of luteinizing hormone in the peripartum cow: least activity at parturition with an increase throughout the postpartum interval. AB - The biological (B) and immunological (I) activities of luteinizing hormone (LH) were determined during four peripartum periods in the cow. The sampling periods were PRE-5 (approximately 5 days prior to parturition), POST-3 (Day 2 or 3 postpartum), POST-12 (Day 11 or 12 postpartum) and LUTEAL (Day 11 or 12 following the first observed postpartum estrus). Blood samples were collected at 10-min intervals for either 8 h (PRE-5, POST-3, and POST-12) or 6 h (LUTEAL). Four hours prior to the end of each sampling period, 100 micrograms of luteinizing hormone releasing hormone (LHRH) was injected i.v. Plasma concentrations of LH were analyzed by a validated bioassay (rat interstitial cell testosterone) and a radioimmunoassay. Area under the LHRH-induced LH release curve was calculated by the trapezoidal rule, and endogenous LH was determined by averaging the pre-LHRH treatment values. Paired t-analyses were used to compare LH release between periods. The periods of lowest (p less than 0.05) bioactive LH (BLH) were PRE-5 and POST-3. During POST-12, BLH was maximal. Endogenous immunoactive LH (ILH) was maximal during the POST-12 period, with PRE-5, POST-3, and LUTEAL being the least (p less than 0.05). The B:I ratio was lowest (p less than 0.05) around the time of parturition (PRE-5 and POST-3), then increased (p less than 0.05) by Day 12 postpartum. The ratio then increased (p less than 0.05) again by the LUTEAL period. These data suggest that the biological quality of LH changes throughout the puerperium. We infer from these data that the low biological activity of LH (subquality LH) may contribute to the postpartum infertility in the cow. PMID- 3318944 TI - Expression of a male-specific factor on various stages of preimplantation bovine embryos. AB - Four-cell to blastocyst stage bovine embryos were collected from superovulated donors and cultured for 90 min in Ham's F-10 medium (HF-10) containing 10% (V/V) absorbed anti-histocompatibility (H)-Y antiserum. Embryos were then washed 3 times and placed in HF-10 supplemented with 10% (V/V) fluorescein isothiocynate (FITC)-conjugated goat anti-mouse gamma globulin. After an additional wash, embryos were placed in fresh drops of HF-10, individually evaluated at 200 X magnification, and classified as either fluorescent (H-Y-positive) or nonfluorescent (H-Y-negative). Embryos were then placed in drops of HF-10 containing 14% vinblastin and cultured for 4-6 h. Embryos were coded and individually karotyped, and the sex chromosomes were identified. H-Y antigen was detected as early as the eight-cell stage, but not at the four-cell stage. Seventy-nine percent of fluorescent embryos and 89% of nonfluorescent embryos were XY and XX, respectively. Another experiment was carried out in which H-Y antigen was detected on intact inner cell masses (ICM) isolated by immunosurgery from expanded blastocysts that also had been assayed for H-Y antigen. Eighty eight and 92%, respectively, of ICM classified as fluorescent or nonfluorescent had been scored the same as intact blastocysts. It is concluded from these data that H-Y antigen can be detected on eight-cell to blastocyst stage bovine embryos. There appears to be a localization of detectable antigen in the area of the ICM at the expanded blastocyst stage. Detection of H-Y antigen is an effective, noninvasive method for identification of the sex of preimplantation bovine embryos. PMID- 3318945 TI - Immunocytochemical localization of relaxin in the golden hamster (Mesocricetus auratus) during the last half of gestation. AB - The objective of this study was to determine the tissue source of relaxin in pregnant hamsters by immunocytochemical techniques. Ovarian, uterine, and placental tissues were recovered from hamsters on Days 8, 10, 12, 14, and 15 of gestation and processed for light microscopy. Relaxin immunoreactivity was localized in tissue sections by the avidin-biotin-peroxidase technique using antiserum to porcine relaxin. On Day 8 of gestation, relaxin immunoreactivity was localized in primary giant trophoblast cells (GTC-1s) adjacent to the uterine decidua. On Day 10, relaxin immunoreactivity was localized in GTC-1s, secondary giant trophoblast cells (GTC-2s) adjacent to the ectoplacental cone, and endometrial granulocytes in the wall of sheathed arteries. On Day 12, relaxin immunoreactivity was observed primarily in GTC-2s interspersed among cells of the placental trophospongium but not in cells of the placental labyrinth. The intensity of staining and number of relaxin immunoreactive GTCs increased between Days 12 and 14 but was decreased by Day 15 PM. Relaxin was not localized in uterine glands or corpora lutea. These observations suggest that the placenta is the tissue source of relaxin in pregnant hamsters. PMID- 3318946 TI - Does DNA absorb microwave energy? PMID- 3318947 TI - Morphological transformation and tumorigenicity in C3H/10T1/2 cells transformed with an inducible c-Ha-ras oncogene. AB - A C3H/10T1/2 cell line containing an inducible metallothionein-ras hybrid oncogene was conditionally and reversibly transformed upon exposure to zinc ions. Interestingly, although the cell line was fully malignant when expressing only low levels of ras, complete morphological transformation required much higher levels. PMID- 3318948 TI - Determination of variable severity of anemia in thalassemia: erythrocyte proteolytic activity. PMID- 3318950 TI - Induction of puberty in patients with beta-thalassemia major. PMID- 3318949 TI - ATP-dependent proteolysis in red blood cell precursors. PMID- 3318952 TI - Oropharyngeal colonization with aerobic bacteria in beta-thalassemia/hemoglobin E disease. PMID- 3318951 TI - Infections and Cooley disease. PMID- 3318953 TI - [Modulation of the hypoglycemic effect of insulin during lateral transcerebral electrostimulation]. AB - Experiments on rabbits have studied the effect of lateral transcerebral electrical modulations with weak impulse current on hypoglycemic insulin effect. Two series of experiments were performed on 15 intact animals each. Right-sided electrical stimulation in the first series of experiments produced a trend toward a decrease in fasting blood sugar concentration. In the second series of experiments there was hypoglycemic action of a standard exogenous insulin dose. Transcerebral left-sided electrical stimulation caused no such effects. It has been concluded that the modulation of hypoglycemic exogenous insulin effect was possible due to unilateral transcerebral right-sided electrical stimulation. PMID- 3318954 TI - [Study of the participation of the alpha-chain of the LFA-1 antigen in the phenomenon of lymphocyte adherence inhibition using ICO-11 monoclonal antibodies in vitro]. AB - The influence of monoclonal antibodies (Mabs) ICO-11 on the ability of lymphocytes from breast cancer patients to react in lymphocyte adherence inhibition (LAI) test has been studied in vitro. It has been demonstrated that Mabs ICO-11 in the dilutions 1/4 and higher blocked the reaction to tumor extracts in LAI-test, without affecting the reaction to the extracts of normal tissues and a spontaneous adhesion of lymphocytes of healthy donors as well. The addition of the control supernatants of myeloma cells X63.Ag8. 653 to the test system in the same dilutions caused no influence upon LAI-reaction and spontaneous adhesion of lymphocytes from healthy donors. A possible participation of alpha-chains of function-associated antigens in the binding of tumor associated antigens to T-cells in the inductive phase of the reaction of lymphocyte adherence inhibition in vitro has been suggested. PMID- 3318955 TI - [Early changes in the ultrastructure of axodendritic synapses in the rat sensorimotor cortex following whole-body irradiation with high-dose fast neutrons]. AB - Changes in morphometric parameters have been established in axodendritic synapses of sensorimotor cortex of adult mature rats exposed to neutron irradiation. Neutron irradiation dose and summarized dose rate were 10 Gy and 0.35 Gy, respectively. The changes were observed 0.25, 1, 3, 6 and 24 hours after irradiation. The observations suggest an increase in synaptic activity, with the range of irradiation action and functional characteristics decreasing in subsequent time periods. PMID- 3318956 TI - [Cytohistologic and ultrastructural characteristics of the early stages of the interaction of Candida with epitheliocytes]. AB - Cyto-histological and ultrastructural features of the initial stages of the interaction between Candida cells and epitheliocytes of human and animal mucous membranes were studied in vitro and in vivo. The population of epitheliocytes is heterogeneous in its adhesive properties, 15-20% of cells being several times more adhesive than the rest of the population. Within an individual epitheliocyte the adhesion of blastospores was nonuniform, the majority of the latter attaching to the periphery of the cell and to the intercellular boundaries. This was found in cytological smears, histological film preparations and in SEM micrographs, and was also confirmed by the results of morphometric analysis. Ultrastructural analysis has revealed two phases of the interaction between Candida blastospores and epitheliocytes during adhesion, as well as the cytological effect of the fungal cells. PMID- 3318958 TI - [Radiotherapy-chemotherapy combinations]. AB - The combination of radiotherapy (RT) and chemotherapy (CT) has markedly improved the therapeutic results for those tumors which are both chemosensitive and radiosensitive, such as lymphomas, embryonal tumors, small cell lung carcinomas, breast cancers, etc. Despite some spectacular results reported following non controlled studies, a significant increase in the total survival or the relapse free survival has never been documented in controlled trials in head and neck, anal, ovarian carcinomas. However, in these tumors, a combination of RT and CT may reduce the mutilations and sequellae caused by the treatment and may induce an increase in the survival in some subsets of patients. Further clinical research is needed along these lines. Cross resistance between ionizing radiation and cytotoxic drugs has recently become an important area for experimental research. This cross resistance appears to be relatively infrequent but possible, the best method for circumventing its occurrence is the delivery of both modalities as early as possible during the course of the treatment. This early administration is one of the aims of the integrated alternating regimen which has been developed in Villejuif since 1980. The results obtained in small cell lung carcinoma and non-Hodgkin lymphomas of a poor histologic type are remarkable. In cervix cancers and inflammatory breast cancers, no significant improvement in survival has yet been observed. In those four types of cancers, the early and late tolerance is acceptable and no untoward toxic effect has been identified. PMID- 3318957 TI - A breast cancer Nutrition Adjuvant Study (NAS): protocol design and initial patient adherence. AB - To evaluate the feasibility of using a reduction in dietary fat intake as a component of treatment regimens for patients with resected breast cancer, a multi disciplinary cooperative group protocol was developed. Females 50 to 75 years of age with stage II breast cancer who completed primary local therapy were eligible for randomization to a Control Dietary Group in which dietary fat intake was to remain unchanged from baseline level (at approximately 38% of calories derived from fat) and an Intensive Intervention Dietary Group designed to reduce dietary fat intake. Both Dietary Groups were given tamoxifen 20 mg/day. To facilitate early experience with dietary regimen delivery, patients entered during an initial pilot phase could receive any chemotherapy and/or hormonal treatment. A prerandomization nutrition 'run-in' of clinically eligible patients assessed adherence to nutrition data collection procedures and screened patients for nutrition eligibility criteria. Of 59 patients beginning 'run-in', 49 were randomized and, at present, 32 have completed at least three months follow-up. The change in dietary fat intake (as assessed by Four Day Food Records) seen in both arms is outlined below. Formula see table. The 56% reduction in total daily fat gram intake achieved in the Intensive Intervention Dietary Group suggests that protocols designed to reduce dietary fat intake in an adjuvant treatment setting can be developed and implemented using a multi-institutional, cooperative group approach. PMID- 3318959 TI - Mutagenicity of Tama River sediments. PMID- 3318960 TI - Sub-chronic effect of DDT on humoral immune response to a thymus-independent antigen (bacterial lipopolysaccharide) in mice. PMID- 3318961 TI - Oxidant-antioxidant balance. AB - We briefly consider some examples illustrating the pathophysiologic roles of oxidants in lung injury: pathologic changes induced by hyperoxia (exudative alveolar oedema and proliferation of fibroblasts), cell toxicity (especially endothelial cells) and inactivation of alpha-1-proteinase inhibitor (by oxidation of a methionyl residue at the active site of the inhibitor). These suggest the possibility of a beneficial role for antioxidants in many types of lung injury. PMID- 3318962 TI - Lung protection by thiol-containing antioxidants. AB - It is becoming increasingly clear that certain types of pulmonary injury may be closely related to oxidant-antioxidant imbalance in the lung, resulting from the production of reactive oxygen species within the lung during endogenous metabolism and xenobiotic insult. We have investigated the role of glutathione in pneumoprotection from such reactive species and, in particular, methods of manipulating the resident antioxidant capacity of lung glutathione. One such approach has been the use of the thiol-containing drug N-acetylcysteine. We have shown that N-acetylcysteine is able to both support intracellular glutathione biosynthesis and act as a 'scavenger' of reactive electrophilic species through the chemical reactivity of its thiol group. N-acetylcysteine reduces hydrogen peroxide to water, with the commensurate formation of N-acetylcysteine disulphide both when the peroxide was supplied directly or generated enzymatically. This basal reduction of hydrogen peroxide by N-acetylcysteine was greatly enhanced by the inclusion of catalytic amounts of the selenium-containing heterocycle, Ebselen, in the incubations. Thus, Ebselen mimics the activity of glutathione peroxidase but, unlike the enzyme, is able to use N-acetylcysteine as a co substrate. Thus, the combination of N-acetylcysteine and Ebselen may provide a useful therapeutic tool in conditions of pulmonary toxicity associated with oxidant insult. PMID- 3318963 TI - Biochemical aspects of free radicals metabolism. AB - The lung is particularly exposed to oxidant stresses, such as those that can be brought about by oxygen-derived free radicals. They mainly result from the monovalent reduction of molecular oxygen. The most reactive oxygen metabolite is the hydroxyl radical, whose formation appears to be dependent upon the presence of iron-chelates. Free radicals are normally produced by cellular metabolism. Furthermore, activated phagocytes, during the 'respiratory burst', release oxygen metabolites that are necessary for bacterial killing. Free radicals are highly reactive species. Their target molecules are proteins, DNA and polyunsaturated fatty acids whose alterations can lead to cell death. There are, however, several antioxidant substances which are enzymatic (superoxide dismutases, catalase and glutathione peroxidase) and non enzymatic (reduced glutathione, vitamin E and C etc...). In many experimental systems, an increase in antioxidant defences is associated with higher resistance to oxidant stress. However, the antioxidant system may be overwhelmed by an overproduction of intra and/or extracellular free radicals leading to tissue injury. Recent advances in the understanding of free radical metabolism can suggest some new therapeutic approaches such as the administration of exogenous antioxidant or iron chelators. PMID- 3318964 TI - Toxicity of inhaled methyl isocyanate in experimental animals--a review of studies published less than two years after the Bhopal disaster. PMID- 3318965 TI - Bronchial hyperresponsiveness as a risk factor for progressive airflow obstruction in smokers. PMID- 3318967 TI - Summarizing methacholine bronchoprovocation data in epidemiological surveys. AB - We have performed bronchoprovocation tests with methacholine in 41 patients with asthma due to Western red cedar dust and in 56 office-workers without known respiratory illness. Our purpose was to define a summary statistic for useful bronchial hyperresponsiveness in epidemiologic surveys. We found a significant linear relationship between the concentration of methacholine and the FEV1 response. We noted, in addition, a positive relation between the rate of the FEV1 response per concentration and the level of FEV1. We conclude that a linear dose response slope, which can be calculated for each individual, provides a comprehensive summary of methacholine bronchoprovocation tests and is useful in epidemiologic surveys. PMID- 3318966 TI - Analysis of the methacholine dose-response curve: usefulness of a simplified log logistic model in epidemiological studies. AB - The object of the study was to find a model to summarize all the information from dose-response curves, by determining the coefficients to be used to compare groups of subjects. Three coefficients were calculated from the following model: F(d)/F(o) = ONE - k(d-delta)alpha+, where F(d)/F(o) was the ratio between FEV1 at dose (d) of methacholine and prechallenge FEV1, 'k' the slope of the relative variation of FEV1 with the dose, 'delta' the threshold dose and 'alpha' a shape factor. The model was applied to the study of hyperresponsiveness in a population of 317 men. The results illustrated the interest of this model which was applicable to 91% of the population and permitted fine discrimination of the groups studied. PMID- 3318968 TI - Bronchial responsiveness to methacholine: relation to respiratory symptoms and pulmonary function. AB - A methacholine bronchial provocation test was administered to 290 subjects obtained from the 1,900 male volunteers participating in the Normative Aging Study. A positive response (less than 20% decline in FEV1) was obtained in 83 subjects. A positive response was associated with current smoking, presence of wheeze and reduced FEV1. Bronchial responsiveness, cigarette smoking, normal subjects, FEV1. PMID- 3318970 TI - Almitrine bismesylate: current status. PMID- 3318969 TI - The relevance of hyperresponsiveness but not of atopy to FEV1 decline. Preliminary results in a working population. AB - Five-year FEV1 decline in 329 working men was shown to be significantly related only among eversmokers to methacholine bronchial hyperresponsiveness (assessed at the end of follow-up), allergic rhinitis and rhinitis induced by cold air, independent of asthma and FEV1 level. Positive skin prick test was not associated with FEV1 decline. PMID- 3318971 TI - Almitrine bismesylate: a long-term placebo-controlled double-blind study in COAD- Vectarion International Multicentre Study Group. AB - 701 patients, age 61.9 +/- 8.3 yr (mean +/- SD), with hypoxaemic chronic obstructive airways disease (COAD) were entered into a one yr placebo-controlled double-blind study to determine the effect of oral almitrine bismesylate on arterial blood gas tensions and clinical condition. Initial arterial O2 tension (PaO2) was 7.6 +/- 0.8 kPa (57.0 +/- 6.2 mmHg) and arterial CO2 tension (PaCO2) was 6.0 +/- 0.9 kPa (45.2 +/- 6.7 mmHg). Forced expiratory volume in one second (FEV1) was 0.87 +/- 0.35 l and forced vital capacity (FVC) was 2.31 +/- 0.72 l. 163 patients, evenly distributed between treated and untreated groups, were receiving long-term O2 therapy; other conventional therapy was continued. In a stabilization period before treatment, excellent reproducibility of blood gas tensions and spirometry was achieved. In the placebo group (P; n = 357), little change in physiological measurements or clinical assessment was recorded, 90 patients (25%) were lost from the study, mostly due to deterioration of their respiratory disease or to death; 3.4% withdrew for adverse reactions. The almitrine group (A; n = 344), received 100-200 mg per day orally in two divided doses, depending on the improvement in PaO2 achieved. On entry to the study their blood gas tensions, lung function tests, clinical assessment, history of hospitalization and frequency of right heart failure were not significantly different from the placebo group. After one yr of treatment, PaO2 rose from 7.6 +/- 0.8 kPa (57.4 +/- 6.1 mmHg) to 8.5 +/- 1.3 kPa (63.7 +/- 9.7 mmHg), p less than 0.001 compared with the placebo group. Red cell count decreased p less than 0.001 compared with the placebo group and FEV1 increased from 0.92 l to 0.95 l, p less than 0.001 compared with the placebo group. Dyspnoea, assessed on a 100 mm analog scale was unchanged in the almitrine group as a whole, but some individual patients withdrew on account of breathlessness. A smaller proportion of patients in group A were hospitalized and had episodes of right heart failure during the study than in group P (p less than 0.05). Vital signs, biochemistry and ECG characteristics did not change. 139 patients (40%) in this group did not complete the study, 35 (10%) through deterioration of respiratory symptoms or death (4.9%); 43 (12.5%) withdrew because of adverse reactions, either drug-related or not. The most frequent adverse reactions were gastro-intestinal, central nervous system disturbances, increased dyspnoea and peripheral paraesthesiae.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3318972 TI - Pathophysiology of hypoxaemic pulmonary vascular diseases. AB - Chronic alveolar hypoxia whether due to living at high altitude or to lung disorders, such as chronic obstructive lung disease (COLD), leads to development of pulmonary arterial hypertension (PAH). Sustained PAH is the principal cause of right ventricular hypertrophy (RVH) and failure. The majority of high altitude residents, in spite of having moderate PAH and hypoxemia with some degree of RVH, manage to live actively and productively through acclimatization. Although the processes of acclimatization decrease the magnitude of oxygen (O2) pressure drop at each step of the O2 tension cascade, O2 pressures in the tissue capillaries and mixed venous blood are lower than those at sea level. Since the cardiac output and O2 consumption in residents at high altitude have been shown to be comparable to those of sea level residents, the importance of adaptive changes at the tissue level to facilitate diffusion and utilization of O2 must be emphasized. In patients with COLD and hypoxaemia, most of the adaptive changes that have been shown to operate in high altitude residents do not occur, or have not been observed consistently. At present, only long-term O2 therapy has been shown to improve survival and lower pulmonary artery pressure (Ppa), but the changes of the latter are generally too modest to explain the former. It may be that the improved survival is mainly achieved by correcting hypoxaemia, thereby improving tissue oxygenation, rather than lowering Ppa. PMID- 3318974 TI - Transformation of Trypanosoma cruzi trypomastigote bloodstream forms by immune IgM and its Fab mu fragment into activators of the alternative complement pathway. AB - 1. We report that purified immune IgM obtained from Chagasic patients during the chronic stage of the disease and also immune IgM and its Fab mu fragments obtained from chronically T. cruzi-infected mice are capable of preparing trypomastigote forms of T. cruzi to be lysed by complement. 2. Mouse strains susceptible, moderately susceptible and resistant to T. cruzi infection are equally capable of producing antibodies with lytic activity as well as antibodies detectable by immunofluorescence and by immunoenzymatic assay. 3. The epitopes recognized by polyclonal lytic antibodies are present on the surface of trypomastigotes from many different strains and stocks of T. cruzi. PMID- 3318973 TI - Purine base uptake in Trypanosoma cruzi: adaptations and effects of inhibitors. AB - 1. The pattern of purine base uptake in culture epimastigotes of Trypanosoma cruzi can be predicted from cell growth rate and cell concentration, with the late log phase showing the greatest variability. 2. Uptake rates are unexpectedly low in the reproductive tissue amastigotes and high in the non-reproductive blood trypomastigotes. It is suggested that blood trypomastigotes metabolize and accumulate reserves of purine metabolites, whereas amastigotes depend on degradation of host cell RNA and nucleotides as purine sources. 3. All parasite forms salvage hypoxanthine and guanine in preference to adenine. Nifurtimox, dipyridamole and cytochalasin have no effect on uptake, whereas amphotericin B, allopurinol, xanthine and urate inhibit it. The alterations caused by urate are complex, apparently involving inhibition of the monooxypurine phosphoribosyltransferase and induction of permeation of purines into the cells. PMID- 3318975 TI - Mathematical model of Klebsiella pneumoniae resistance to amikacin and gentamicin. AB - 1. The resistance of Klebsiella pneumoniae to amikacin and gentamicin was studied by a mathematical model to predict the rate of sensitivity decrease. The results accurately matched experimental data, showing that the model is a reliable predicting tool. 2. The observations were carried out over six years and included 2677 cultures that were positive for K. pneumoniae. At the beginning of the observation period, 85.7% of the cultures were sensitive to amikacin and 40.8% were sensitive to gentamicin. Sensitivity to amikacin showed a surprisingly rapid decrease; at the end of the experimental period, amikacin and gentamicin sensitivities were 33.3% and 27.8%, respectively. 3. We conclude that patterns of resistance of other bacteria could be investigated using this method. PMID- 3318976 TI - Demonstration of a proallatotoxin-sensitive period in 4th-instar nymphs of Rhodnius prolixus. AB - 1. Topical application of the proallatotoxin ethoxyprecocene II (60 micrograms/nymph) to 4th-instar nymphs of Rhodnius prolixus at various times before and after a blood meal induced precocious metamorphosis. 2. The highest percentage of adultoids was obtained when proallatotoxin was applied prior to feeding or up to day 3 after the blood meal. 3. The proallatotoxin-sensitive period ended 4 days after feeding just before the maximum peak of ecdysteroid concentration in the hemolymph. 4. The significance of these findings is discussed in terms of the juvenile hormone-sensitive period and the hormonal program which controls molting in this insect. PMID- 3318978 TI - Update on NSAID use in rheumatic diseases. PMID- 3318977 TI - Low-powered ultrasound in the inhibition of tinnitus. AB - An experiment was performed using low-level ultrasound in an attempt to inhibit tinnitus during and after stimulation. The method used a double-blind crossover technique with a placebo. Forty subjects were tested, and they generally reported little or no change in their tinnitus, the results from placebo and ultrasound not being statistically different. It cannot be concluded, therefore, that the ultrasound we were using has any beneficial effect on tinnitus. These results do not confirm the findings of the pilot study using the same ultrasound devices (Carrick et al., 1986). PMID- 3318979 TI - The aetiology of atherosclerosis and coronary heart disease. AB - There are a number of important risk factors in the development atherosclerosis and coronary heart disease. This article considers the pathophysiology, the individual risk factors and the possible mechanism by which they exact an effect. PMID- 3318980 TI - Central venous catheterization and fatal air embolism. AB - Central venous catheterization is an established procedure in medical, surgical and anaesthetic practice. However, the procedure is not without hazard. One complication that may be life-threatening is air embolism. This article considers the causes of air embolism related to central venous catheterization, its treatment and methods of prevention. PMID- 3318981 TI - Prophylactic oophorectomy. AB - There are no generally accepted criteria for the removal or conservation of the apparently normal ovary during surgery for other conditions. In this article the benefits and disadvantages of prophylactic oophorectomy are reviewed and a schema for clinical practice is suggested. PMID- 3318983 TI - Classifying mechanical ventilators. PMID- 3318982 TI - Long-term effects of postmenopausal hormone therapy. AB - Short-term use of hormone replacement therapy is potentially useful in alleviating menopausal symptoms. Some people have suggested that it may also have a role in preventing certain other conditions. This could mean large numbers of women taking this therapy for quite long periods. Do we know enough about the long-term effects to recommend such use? In this article we review the recent evidence. PMID- 3318984 TI - Mechanisms of some pulmonary effects of general anaesthesia. PMID- 3318985 TI - Surgical control of Hailey-Hailey disease. AB - Hailey-Hailey disease is a benign, chronic genodermatosis manifested by recurrent lesions with a predilection for the intertriginous areas. The malodorous, weeping sores are a source of great discomfort to the patient. Medical therapy controls most lesions adequately; however, some are refractory. Experience with excision of skin involved with Hailey-Hailey disease is reported. The best results were obtained in those patients whose wounds were resurfaced with split skin grafts. Primary suture was associated with recurrent disease and residual morbidity. The findings of other isolated reports in the literature are also summarised. The results show that surgical control of Hailey-Hailey disease is indicated in recalcitrant cases. PMID- 3318987 TI - Triple nostrils: a case report and review. AB - In this paper we present a case of a "third nostril" situated below the left nostril and passing posteriorly into the nasal cavity. In all previously published cases the supernumerary nostril has been situated superior to the normal nostrils. PMID- 3318988 TI - The development of the Plastic Surgery Unit in the Nottingham and Derby areas. PMID- 3318986 TI - Facial resurfacing in xeroderma pigmentosum: are we spoiling the ship for a ha'p'orth of tar? AB - A case of xeroderma pigmentosum (XP) is reported whose treatment included sub total excision of facial skin and resurfacing in aesthetic units with grafts of relatively undamaged buttock skin. The principle of resurfacing is logical and supported by this and other reports which are reviewed. Though control was achieved in the grafted areas, tumours continued to develop in adjacent ungrafted skin. The importance of radical excision of exposed skin in severe cases of XP is emphasised. PMID- 3318989 TI - The history of the Plastic Surgery Unit at Wexham Park Hospital. PMID- 3318990 TI - The efficacy of electroconvulsive therapy in the treatment of schizophrenia. A comparative study. AB - The efficacy of ECT was investigated in a double-blind trial. Twenty-two patients with schizophrenia received trifluoperazine and were randomly allocated to receive eight real or eight simulated ECTs. In the first eight weeks, the group receiving real ECTs showed significantly more improvement as measured on the Brief Psychiatric Rating Scale. However, the groups showed no significant differences from the twelfth week onwards. The superiority of real ECT was not confirmed at the end of six months. PMID- 3318991 TI - Reality orientation and reminiscence therapy. A controlled cross-over study of elderly confused people. AB - We compared reality orientation with reminiscence therapy for elderly people in a large residential home, using a controlled cross-over design. Both kinds of therapy group were enjoyed by both staff and residents, and enabled staff to get to know moderately and severely confused residents. The group that received reality orientation followed by reminiscence therapy showed improvement in cognitive and behavioural measures which was not found in the other two groups. It may be important to use reality orientation techniques with confused residents before involving them in a reminiscence group. PMID- 3318992 TI - Psychiatric presentation of Creutzfeldt-Jakob disease. A case report. AB - A patient with Creutzfeldt-Jakob disease is described. Many alternative psychiatric diagnoses were considered, and the true situation only became apparent late in the clinical course. PMID- 3318993 TI - Intra-articular rimexolone in the rheumatoid knee: a placebo-controlled, double blind, multicentre trial of three doses. AB - One-hundred and thirty-seven patients with classical or definite rheumatoid arthritis, involving at least one knee joint, were randomly allocated to a single intra-articular injection of 10, 20 or 40 mg of rimexolone (Org 6216) or placebo. The follow-up period was 84 days, during which clinical and laboratory assessments were done. Clinical improvement of the treated knee joint was measured by the following variables: pain, tenderness, morning stiffness, swelling, range of movement and walking ability. Placebo response was considerable. However, clinical improvement with rimexolone at 20 mg and 40 mg was significantly superior to placebo for most of the variables, whilst with the 10 mg dose only reduction of tenderness was significantly superior. The duration of improvement was longest with 40 mg of rimexolone. One single, intra-articular injection of this dose into the affected knee joint provided significant reduction in pain, tenderness and stiffness and improved the range of movement and walking ability for a period of 8 to 12 weeks. PMID- 3318994 TI - Possibilities for immunoregulation in the rheumatic diseases--seeing in a glass darkly. PMID- 3318995 TI - Seeing things more clearly. PMID- 3318996 TI - Real-time ultrasound measurement of bladder volume: a comparative study of three methods. AB - The accuracy of different ultrasound methods for determining the volume of urine in the bladder was compared using three methods in current use. Each method was applied to the same ultrasound images from 16 patients with prostatic hypertrophy. The calculated volumes were compared with the true volumes derived by measurement of voided and catheter-drained urine. All methods showed similar degrees of accuracy in quantifying bladder volumes. The range of errors of the best method tested was +/- 35% of true volume and this suggests that ultrasound measurement of bladder volume is not sufficiently accurate for many clinical and research applications. PMID- 3318997 TI - Evaluating and comparing imaging techniques: a review and classification of study designs. AB - The designs of studies to evaluate and compare imaging techniques are reviewed. Thirteen principles for the design of studies of diagnostic accuracy are given. Because of the "independence principle" these studies are not able directly to evaluate the contribution of a technique to clinical management. For the latter, the "clinical value" study design is recommended. A classification of study designs is proposed in parallel with the standard classification of clinical trials. Studies of diagnostic accuracy are analogous to Phase II, whereas studies evaluating the contribution to clinical management correspond to the Phase III category. Currently the majority of published studies employ the Phase II design. More emphasis on Phase III studies is required. PMID- 3318998 TI - The accuracy of digital subtraction angiography for the quantification of atherosclerosis. AB - Digital subtraction angiography (DSA) allows the degree of arterial patency or stenosis to be rapidly quantified. We have assessed the accuracy with which a single-plane DSA system is able to quantify area patency by densitometric and geometric methods. Arterial phantoms were designed to test for systematic error; intra-arterial DSA images of critical lesions of the carotid bifurcation and the lower abdominal and peripheral vessels were used to determine intra- and interobserver reproducibility. The densitometric method, which was more accurate than the geometric method, had a mean systematic error of up to 4% and a mean intra-observer variability of about 15% (coefficient of variation). We have identified the principal sources of inaccuracy and ways in which it may be reduced. PMID- 3318999 TI - Submucosal gastric haematoma: a case report and review of the literature. PMID- 3319000 TI - Nuclear reactor accidents: preparedness and medical consequences. Medical basis for the establishment of intervention levels. PMID- 3319001 TI - Regression of the radiological changes of Gaucher's disease following bone marrow transplantation. AB - Seven children with Type I Gaucher's disease have been treated with bone marrow transplantation (BMT). One patient died from the complications of BMT. In five patients computed tomography (CT) of the femora showed initially high attenuation in the marrow, returning towards normal after successful BMT. One of these patients also showed clearing of pulmonary infiltrates following treatment. In the first patient in the series no pre-transplant CT measurements were carried out but plain radiographs have demonstrated a return to normal shape of her femora 21/2 years after BMT. It is hoped that CT of the marrow cavities may provide a simple, non-invasive method for monitoring progress following BMT. PMID- 3319002 TI - Computed tomographic myelography in the investigation of childhood scoliosis and spinal dysraphism. AB - The combined investigations of positive contrast myelography and computed tomographic (CT) myelography were performed on 53 consecutive children. Thirty eight (72%) of these investigations were performed as a routine pre-operative procedure to identify occult spinal dysraphism in patients with childhood scoliosis; the remainder were because of the "orthopaedic syndrome", cervical radiculopathy, back pain and patients with clinical findings to suggest spinal dysraphism. In the 20 patients (38%) with idiopathic scoliosis, there was no case of spinal dysraphism and CT myelography provided no additional information to the myelogram. In the seven patients with spinal dysraphism the plain radiographic abnormalities identified were lumbar vertebral abnormalities (five), thoracic vertebral abnormalities (one), and sacral agenesis (one). Diastematomyelia was found in four patients, a low tethered cord and lipoma in two patients and a large lipoma in one patient. In all of these cases the myelogram indicated the intraspinal abnormalities; however, CT myelography provided more precise anatomical detail. We conclude that CT myelography is not indicated in the initial preoperative assessment of idiopathic scoliosis but should be reserved for patients with congenital or complicated scoliosis where the association with dysraphism is well recognised. PMID- 3319003 TI - Infantile recurrent sialectatic parotitis: the role of sonography and sialography in diagnosis and follow-up. AB - The results of a clinical, sonographic and sialographic study in 10 children (aged 4-10 years) with recurrent sialectatic parotitis are presented. Alteration in the sonographic pattern of the parotid glands, consisting of multiple hypoechogenic areas in the parenchyma, were found in four cases; milder nonhomogeneity was seen in four cases, and an almost normal pattern in two cases. Sonographic follow-up in two children showed a parallel reduction in non homogeneity with symptomatic improvement. A probable therapeutic action following sialography using fat-soluble contrast medium was observed in four of the 10 children. The familial nature of the disease, which has not previously been described, is documented. PMID- 3319005 TI - Cancer of the prostate: epidemiology and aetiology. PMID- 3319004 TI - Translumbar aortography. PMID- 3319006 TI - Incidental detection of renal carcinoma during radiological imaging. AB - The manner of presentation and tumour stage in 16 consecutive patients with renal carcinoma who were treated surgically between 1976 and 1980, and in 37 patients treated similarly between 1981 and 1985, were reviewed. Two patients (13%) were discovered incidentally between 1976 and 1980 compared with 13 (35%) between 1981 and 1985. The renal tumours were discovered incidentally at the time of intravenous urography (IVU), ultrasound, computed tomography (CT) and angiography. There were 13 stage I and two stage II lesions, as assessed pathologically after nephrectomy. The tumours were less than 6 cm in diameter. Thirteen of 15 patients are alive between 6 and 90 months after surgery. No patient died of renal carcinoma. Our data have shown an increase in the proportion of incidentally diagnosed cases. The routine use of intravenous urography, ultrasound and computed tomography has led to earlier diagnosis, lower stage and possibly longer survival in patients with incidentally detected renal carcinomas compared with patients where the diagnosis was suspected. PMID- 3319008 TI - Malakoplakia of the bladder. AB - Malakoplakia is a disease which most commonly affects the bladder. It is probably more common than is realised because the appearance of the lesions is variable and the diagnosis can be difficult to make histologically. It should be considered in patients with recurring Escherichia coli infections and is also associated with immunosuppression and carcinoma. Three patients with malakoplakia of the bladder are reported: two had recurrent Esch. coli urinary tract infections and one had widespread urological malignancy. The pathogenesis is discussed and a simple treatment regime, which was rapidly successful in the patient who received it, is recommended. PMID- 3319007 TI - Evaluation of bladder cancer with a miniature high frequency transurethral ultrasonography probe. AB - A miniature high frequency 10 MHz transurethral ultrasonography probe has been developed which is adaptable to any standard 17 F cystoscope sheath. High frequency contributed to a definite improvement in image resolution but did not allow distinct visualisation of different bladder wall layers. An 80% correlation between ultrasonographic and pathological staging was established after evaluation of 50 consecutive patients with newly diagnosed bladder tumours. Ta/T1 tumours tended to be overstaged with ultrasound. In some patients, the response to conservative treatment (external beam radiation therapy) of deeply infiltrating tumours could be assessed with the miniature probe on an out-patient basis. PMID- 3319009 TI - Combined nephrectomy and live donor renal transplantation for bilateral renal tumours associated with tuberose sclerosis. PMID- 3319010 TI - The epidemiology of testicular cancer. PMID- 3319011 TI - Renal scarring secondary to vesicoureteric reflux. Critical assessment and new grading. AB - One hundred and fifty children with proven urinary tract infection who were assessed by renal ultrasound (U/S), intravenous urography (IVU) and dimercaptosuccinic acid (99mTc DMSA) scan, were studied to identify the sensitivity of each examination and the pick-up rate of renal scarring secondary to vesicoureteric reflux. Sixty-three of these children who had the examinations carried out within a 6-month period were assessed in detail. A DMSA scan is the most accurate method of detecting early renal scars in the young age group (0-2 and 2-5 years), followed by ultrasound. The examinations are equally sensitive over the age of 5. A new grading system of the severity of renal scarring is presented. PMID- 3319012 TI - Double-blind study comparing aztreonam with placebo for prophylaxis of infection following prostatic surgery. AB - In a prospective, randomised, double-blind study, 179 patients undergoing retropubic or transurethral prostatectomy were given pre-operatively either 1 g aztreonam or a placebo. In patients treated with aztreonam there was a significant reduction in the number with post-operative bacteriuria and in the number requiring treatment of post-operative bacteriuria. Other differences were not significant. The mean duration of post-operative hospital stay for patients receiving aztreonam was 7.1 days compared with 6.9 days for those receiving placebo. In patients treated with aztreonam there was no increase in the frequency of infections due to Gram-positive bacterial species. PMID- 3319013 TI - Oral ciprofloxacin as prophylaxis for optical urethrotomy. AB - It is known that urethral strictures predispose to bacteriuria. We studied a series of patients undergoing optical urethrotomy to see if antibiotic prophylaxis was justified. Twenty-three patients were randomised to receive either no prophylaxis or a short peri-operative course of oral ciprofloxacin. Two patients with sterile pre-operative urine and two patients with pre-operative bacteriuria given no prophylaxis had post-operative bacteriuria, whereas all patients given ciprofloxacin had sterile urine after operation. Antibiotic prophylaxis may be indicated in patients undergoing optical urethrotomy. PMID- 3319014 TI - Recent developments in the dosimetry of superficial tissues. PMID- 3319016 TI - Basic principles of the treatment of local radiation injuries. PMID- 3319015 TI - Histopathology of cutaneous and subcutaneous irradiation-induced injuries. PMID- 3319017 TI - Surgical management of irradiated skin in the pig. PMID- 3319018 TI - Indications for the treatment by plastic surgery of the effects of radiation and radiolesions on the skin. PMID- 3319019 TI - Unavoidable sequelae and accidental damage to the skin following irradiation. PMID- 3319020 TI - Experiences with accidents and consequences for treatment. PMID- 3319022 TI - What can the experience of radiation therapy teach us about accidents? PMID- 3319021 TI - Human skin: early and late reactions in relation to dose and its time distribution. PMID- 3319023 TI - Whole-body irradiation plus skin wound: animal experiments on combined injuries. PMID- 3319024 TI - Historical update of past and recent skin damage radiation accidents. PMID- 3319025 TI - The use of dosimetric data for the assessment of the prognosis of the severity and outcome of local radiation injuries. PMID- 3319026 TI - Biophysical methods for assessing the radiation dose causing lesions in the skin and subcutaneous tissues. PMID- 3319027 TI - Insulin resistance in patients with colorectal cancer. AB - The euglycaemic glucose clamp technique has been used to assess insulin resistance in patients with colorectal adenocarcinoma. Ten cancer patients were studied and compared with control subjects matched for age, sex and nutritional status. Forty-one euglycaemic clamps were performed at one of five different insulin infusion rates (20, 30, 40, 100 or 200 milliunits min-1 m-2). Glucose disposal was significantly decreased in the cancer group at all insulin infusion rates, whilst attained insulin levels and metabolic clearance rates of insulin were comparable in the control and cancer groups. Analysis of dose-response data allowed assessment of sensitivity (insulin concentration of half maximal glucose disposal) and responsiveness (maximal glucose disposal). Responsiveness was significantly reduced in the cancer group (40.3 versus 71.5 mumol kg-1 min-1; P less than 0.001), whilst sensitivity was similar (93.7 milliunits l-1 in controls versus 90.8 milliunits l-1 in cancer patients), suggesting a postreceptor defect in insulin action in the cancer group. PMID- 3319028 TI - Postoperative intra-abdominal sepsis. AB - Postoperative intra-abdominal sepsis carries a high mortality. Diagnosis by clinical examination is often difficult, and imaging techniques may be helpful. Diagnostic laparotomy should be considered early, even in the absence of localizing signs. The use of aggressive surgical techniques may improve prognosis. The timing of surgical intervention is as important as the technique. Early diagnosis and treatment is particularly crucial in critically ill patients. PMID- 3319029 TI - Small bowel obstruction: computer-assisted prediction of strangulation at presentation. AB - A multivariate computer analysis has been performed on the presenting data of patients with simple small bowel obstruction that settled with conservative treatment (n = 120) and of patients with viable strangulation small bowel obstruction (n = 38) and non-viable strangulation small bowel obstruction (n = 39) found at operation. Initially only 66 per cent of patients with viable strangulation and 46 per cent of those with non-viable strangulation had been treated by immediate surgery after resuscitation. The remainder had been treated conservatively for a median of 3.8 and 2.2 days respectively before undergoing surgery. The computer predicted on the basis of presenting symptoms and signs that 82 per cent of patients with viable strangulation and 97 per cent of those with non-viable strangulation had or would develop strangulation and should have undergone immediate surgery. We advocate that the computer can assist in the management of patients with small bowel obstruction. PMID- 3319030 TI - Symptomatic submucosal lipoma of the large bowel. AB - Symptomatic large bowel lipomata may be of considerable size and usually present in middle age with symptoms of obstruction or bleeding. Although they are rare, their recognition is important so that patients may be spared unnecessary colonic resection for a presumptive malignant diagnosis. Colonoscopic removal may often be feasible. Six cases are reported together with a review of the literature emphasizing the characteristic features. PMID- 3319031 TI - Inflammation--histamine and 5-hydroxytryptamine. PMID- 3319032 TI - Complement-derived peptide mediators of inflammation. PMID- 3319033 TI - Cytokines as inflammatory mediators. PMID- 3319035 TI - Mediators of crystal-induced inflammation in the joint. PMID- 3319034 TI - Free radicals in biological systems--a review orientated to inflammatory processes. PMID- 3319036 TI - Airway hyperresponsiveness and inflammation. PMID- 3319037 TI - Inflammation and myocardial infarction. PMID- 3319038 TI - Parabrachial lesions increase plasma norepinephrine concentration, plasma renin activity and enhance baroreflex sensitivity in the conscious rat. AB - Electrolytic lesions of the parabrachial nucleus (PBN) caused significant increases in basal plasma renin activity (+433%) and basal plasma norepinephrine concentration (+98%) in conscious rats. Plasma epinephrine concentration, mean arterial pressure, heart rate, hematocrit, plasma osmolality and plasma sodium and potassium concentrations were not significantly affected by the lesions. Atenolol reduced the elevated plasma renin activity in the lesion group to a value similar to that of a control group (sham lesions or lesions in areas adjacent to the PBN). Captopril significantly lowered mean arterial pressure in the lesion group, but it had no effect on arterial pressure in the control group. Lesions of the PBN also increased the baroreflex-mediated bradycardia evoked by an abrupt elevation of arterial pressure. We propose that the PBN tonically inhibits sympathetic activity, sympathetically mediated renin release and baroreflex sensitivity. PMID- 3319039 TI - The ultrastructural localization of acetylcholinesterase-like immunoreactivity in the chicken retina. AB - The localization of acetylcholinesterase (AChE) in the chicken retina was studied using histochemical and immunohistochemical techniques. Using histochemistry, reaction end product was found in amacrine cells, ganglion cells, horizontal cells and in 4 bands in the inner plexiform layer. Ultrastructurally, the reaction end product was located between membranes of the endoplasmic reticulum, between the membranes of the nuclear envelope, surrounding neurites in the inner plexiform layer and filling synaptic clefts. Immunohistochemical techniques using a monoclonal antibody against AChE showed a similar staining pattern to that obtained with histochemistry. Ultrastructurally, AChE-like immunoreactivity was located on, not between, the membranes of the endoplasmic reticulum and nuclear envelope of amacrine cells, ganglion cells and horizontal cells. In the inner plexiform layer, immunoreactivity was on both pre- and postsynaptic membranes, and there was no immunoreactivity in non-terminal regions of the dendritic membranes and none within the synaptic clefts. PMID- 3319040 TI - Some transforming growth factor-alpha connections and their colocalization with enkephalin in the rat central nervous system. AB - Transforming growth factor alpha (TGF alpha) has been immunocytochemically localized in neuronal perikarya throughout the adult rat central nervous system (CNS). In order to determine if any TGF alpha-immunoreactive (TGF alpha-I) cell bodies have long axonal projections, indirect immunofluorescence was used in combination with injections of the fluorescent retrograde tracer, Fluoro-Gold (FG). Both TGF alpha-I and retrogradely transported FG were found within the same neurons in the interpeduncular nucleus (IPN) after bilateral FG injections in the dorsal tegmental nucleus (DTg). Neurons that contain both TGF alpha-I and FG were also found in the raphe magnus, raphe obscurus, raphe pallidus and the gigantocellularis reticular nuclei after FG injections in the upper thoracic spinal cord. Cell bodies double-labeled with TGF alpha-I and FG were found in the dorsal parabrachial nucleus (DPB) following FG injections in the central nucleus of the amygdala (Ce). In addition, Leu-enkephalin immunoreactivity (L-ENK-I) was colocalized with TGF alpha-I in the same projection neurons after the injections described above. These results suggest that cells that contain TGF and the opioid peptide, L-ENK, have long projections in the rat CNS, and that, due to their co localization within the same neurons, they may exert their effects concomitantly. PMID- 3319042 TI - A possible interface between autonomic function and pain control: opioid analgesia and the nucleus tractus solitarius. AB - Opioid peptides appear to be important neurochemical mediators in central nervous system mechanisms of analgesia, cardiovascular control, and many endocrinological responses to stress. The nucleus tractus solitarius (NTS), a brain region expressing all 3 opioid peptide families, is also associated with regulation of autonomic and endocrine functions. We now report that electrical stimulation of the NTS causes pronounced analgesia in rats. This analgesia appears to involve opioids and is pharmacologically dissociable from the hemodynamic changes elicited by NTS stimulation. These results suggest the NTS as a neural substrate for inter-relationships between stress, cardiovascular function, alterations in respiration, and pain sensitivity. PMID- 3319041 TI - Effects on dopamine metabolism of MPTP and MPP+ infused through a push-pull cannula into the caudate nucleus of awake adult male rats. AB - Our previous data demonstrated that both 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) and 1-methyl-4-phenylpyridinium ion (MPP+) exerted potent inhibition on endogenous 3,4-dihydroxyphenylacetic acid (DOPAC) output and potent stimulation on endogenous dopamine (DA) release from the rat corpus striatum superfused in vitro. In this report, using a push-pull perfusion technique, we examined in vivo the acute effects of MPTP and MPP+ on DA metabolism in the rat caudate nucleus (CN). MPTP or MPP+ in modified Krebs-Ringer phosphate buffer at concentrations of 10(-6), 10(-5) and 10(-4) M was administered directly into the CN for 15 min, each 90 min apart. Thirty minutes after the infusion of 10(-6) M MPP+, DOPAC output was reduced to a significantly lower value and subsequent infusions of high concentrations of MPP+ further decreased DOPAC output. Homovanillic acid (HVA) output was also decreased by MPP+ infusions, however, at higher concentrations. In respect to DA release, 1 of 10, 4 of 10 and 7 of 10 animals responded with significant increases to 10(-6), 10( 5) and 10(-4) M MPP+, respectively. On the other hand, MPTP was effective in reducing DOPAC output only at 10(-4) M and ineffective in altering DA and HVA output at all doses tested. In addition, neither drugs had a significant effect on 5-hydroxyindoleacetic acid. Accompanying the dramatic changes in DA metabolism caused by MPP+, two uncommon behavioral syndromes were also observed; tremor-body twist and body shaking.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319043 TI - Vasoactive intestinal polypeptide (VIP) immunohistochemistry in the rabbit retina. AB - A commercially obtained antiserum to vasoactive intestinal polypeptide (VIP) was used with the avidin-biotin-peroxidase immunohistochemical method to localize VIP like immunoreactivity in the adult rabbit retina. A population of cell bodies in the inner nuclear layer is specifically stained. The cells are most dense in the central retina (40-50 cells/mm2), and least numerous in the superior periphery (15-20 cells/mm2). The dendritic fields overlap extensively; cells in the periphery have dendritic fields up to 1 mm in diameter. The processes of the cells are in the inner plexiform layer, where they tend to form a tristratified pattern in sublayers 1, 3 and 5. This pattern of lamination is similar to that described by other laboratories for dopaminergic amacrine cells and provides further evidence for an interaction between these two neuromodulators. PMID- 3319044 TI - Improved immunohistochemical staining of angiotensin II in rat brain using affinity purified antibodies. AB - Recent immunohistochemical studies that have sought to detect angiotensin II/III (AII/AIII) immunoreactive material in the brain have been forced to rely on a small number of antisera because most AII/AIII antibodies have unexplainably proved unsuitable for immunohistochemistry. Although extremely useful tools, these antisera have suffered from high background staining. The purpose of this study was to re-examine and characterize the staining using the most popular AII/AIII antiserum (Denise) before and after purification on an AII CH-sepharose affinity column. The use of crude AII/AIII antiserum resulted in the staining of large varicosities and cell bodies. Fibres were all but invisible owing to extensive background staining. In contrast, the purified antibodies yielded little background staining and produced a discrete staining of AII/AIII fibres with small varicosities in the paraventricular-hypophysial pathway and of cell bodies of large hypothalamic neurones. In addition punctate staining demarcated the perikarya of some neurones and resembled boutons containing immunoreactive AII/AIII. Biochemical and histochemical analysis of the crude antiserum, the affinity purified antibodies and other fractions off the sepharose column demonstrated that a large portion of the total staining (various types of background) seen with crude antiserum and column fractions was not to AII/AIII or several angiotensin-derived fragments. Furthermore, successful preabsorption blanks for the purified antibodies could only be achieved with AII coupled through its N-terminal, suggesting that these purified antibodies reacted best with conjugated angiotensin in the fixed tissue. In total the results of this study indicate that the background staining seen with crude antiserum is not to AII/AIII. The use of affinity purified antibodies greatly enhances resolution, enabling one to visualise even small fibres in rats not treated with colchicine, and should improve our ability to develop accurate maps of central angiotensinergic pathways. PMID- 3319046 TI - The survival of dentate gyrus neurons in dissociated culture. AB - Using a technique for dissociating cells from the area dentata of postnatal rats, we have been able to routinely establish low density cultures of dentate granule neurons that can be grown in the presence or absence of serum. Non-granule neurons from the hilar region and glial cells (both astrocytes and oligodendrocytes) are also present, but can be readily distinguished from the granule cells in these cultures. Unlike dissociated hippocampal pyramidal cells, which frequently resemble their in vivo morphology, dissociated dentate granule cells bear little resemblance to their normal in vivo counterparts, but are very similar in appearance to the ectopic granule cells seen in the reeler mouse. This suggests that extrinsic factors are the principal determinants of the mature form which granule neurons assume in vivo. On the other hand, the dissociated granule cells are able to express certain other aspects of their in vivo phenotype including the synthesis and transport of an antigen which is characteristically found in mossy fibers. Certain neuropeptide-containing non-granule neurons found in these cultures are also capable of maintaining aspects of their in vivo phenotype. PMID- 3319045 TI - Medial prefrontal cortical lesions modulate baroreflex sensitivity in the rat. AB - Previous neuroanatomical studies in rats have demonstrated that the medial prefrontal cortex sends projections to the nucleus of the solitary tract which also receives the bulk of baroreceptor information from primary afferents within the IXth and Xth cranial nerves. The present study examines the influence of the prefrontal cortex on baroreceptor heart rate reflex in conscious rats. Baroreceptor reflex activity was examined in rats with bilateral excitotoxin (N methyl-D-aspartate)-induced lesions of the medial prefrontal cortex and in control rats (artificial cerebrospinal fluid). Seventeen to eighteen days after lesioning, reflex heart rate responses were recorded following intravenous bolus doses of the pressor agent phenylephrine and the depressor agent sodium nitroprusside. Baroreceptor reflex parameters i.e., maximum and average baroreceptor reflex gain (or sensitivity): minimum and maximum heart rate plateaus; heart rate range; upper and lower reflex thresholds, were determined by sigmoidal computerized curve-fitting. Lesioning the medial prefrontal cortex did not affect resting mean arterial pressure and heart rate. However, the lesion reduced maximum and average baroreceptor reflex gain and produced a small reduction in lower reflex threshold. The other parameters were unaffected by the lesion. These observations suggest that although the medial prefrontal cortex does not exert a tonic influence on brainstem vasomotor neurons, there may be a descending excitatory projection from this brain region to medullary neurones involved in the baroreceptor reflex arc. PMID- 3319047 TI - Central and sympatho-adrenal responses to insulin in adult and neonatal rats. AB - In the mature rat, subcutaneous administration of insulin (0.02 IU/g body wt.) produced hypoglycemia and a profound activation of the sympatho-adrenal pathway, as indicated by a marked depletion of adrenal catecholamines. Cellular glucopenia caused by administration of 2-deoxyglucose also produced a sympatho-adrenal response. In contrast, in 2-day-old rats, the systemic injection of insulin evoked only a small depletion of catecholamines even though severe hypoglycemia was present, and 2-deoxyglucose also produced a diminished response. The central administration of insulin at an equivalent dose (0.02 IU/g brain) stimulated brain ornithine decarboxylase activity in both neonates and adults, but was ineffective in evoking hypoglycemia or adrenal catecholamine release. These results suggest that: (a) direct interaction of insulin with its receptors in the central nervous system is not required for activation of the sympatho-adrenal pathway, and (b) the lack of sensitivity of neonatal adrenal catecholamine release to subcutaneous administration of insulin is likely associated with immaturity of splanchnic neurotransmission rather than with absence of central insulin receptors or impaired peripheral responsiveness to insulin. PMID- 3319048 TI - Selective loss of Purkinje and granule cell responsiveness to N-methyl-D aspartate in rat cerebellum during development. AB - Depolarizing responses of Purkinje and granule cells to excitatory amino acid receptor agonists were recorded from rat cerebellar slices at various stages of postnatal maturation using a gap technique. No major developmental changes in relative potency or efficacy of kainate and quisqualate were observed. However, Purkinje and granule neurones both became less responsive to N-methyl-D-aspartate (NMDA) with age, most dramatically so between 14 and 21 days. This transient chemosensitivity to NMDA may reflect a special role of the NMDA receptor system in cerebellar development. PMID- 3319049 TI - Are there epinephrine neurons in rat brain? AB - The present model of epinephrine containing and PNMT containing neurons in rat brain (and by extension other species) implies that epinephrine is primarily a postsynaptic metabolite of norepinephrine in forebrain due to the probable postsynaptic localization of PNMT. As a result the most physiologically relevant pool is found in extracellular space with the bulk of tissue epinephrine found co stored in noradrenergic terminals. Changes in the extracellular pool of epinephrine are effected by changes in the extracellular norepinephrine concentration as in times of increased release, reuptake blockade or inhibition of degradation. alpha 2-Adrenergic receptors associated with cells not necessarily in synaptic contact with the noradrenergic terminal containing epinephrine could be stimulated through this extracellular pool. The majority of PNMT containing cells in the brainstem/medulla appear to also contain other catecholamine biosynthetic enzymes. The present model suggests that epinephrine formed in these neurons is primarily used as a co-transmitter with norepinephrine formed in these same terminals. The balance of norepinephrine to epinephrine found in vesicles in these terminals would be a function of intraneuronal PNMT activity, MAO activity and reuptake which would be the major regulator of intraneuronal norepinephrine concentrations. The literature is reviewed in these contexts, questioning the existence of classical epinephrine neurons. Evidence is presented in support of a model for postsynaptic synthesis of epinephrine in the forebrain, especially during times of high norepinephrine release. The classic model of compartmentalization of biosynthetic enzymes is used in support of a co transmitter role of epinephrine in the brainstem/medulla. Epinephrine is considered a unique metabolite of norepinephrine with important pharmacological actions and a receptor subtype in brain which monitors and regulates its formation. Epinephrine is recognized by the uptake system on noradrenergic terminals and vesicles and can therefore compete for storage in these noradrenergic neurons. Based on the distribution of PNMT and its association with major noradrenergic fiber tracts, epinephrine can be considered a site-selective metabolite of physiological and neuronal importance. Due to the compartmentalization of synthetic enzymes, it is probably not a classical neurotransmitter in the central nervous system, although it may be the primary catecholamine neurotransmitter in some medullary neurons. PMID- 3319050 TI - The effects of aging on hippocampal and cortical projections of the forebrain cholinergic system. AB - It has been proposed that disruption of cholinergic input to the hippocampus and cortex contributes to the learning and memory deficits associated with aging. The data reviewed here, however, suggest that the oft-stated generalization that normal aging is characterized by disruption of cholinergic input to the hippocampus and cortex is not entirely correct. Instead it appears that age related changes are not consistently found on measures such as the activity of ChAT or the content of ACh in these regions, basal levels of ACh release in cortex, and the number of cholinergic neurons in the basal forebrain (source of cholinergic input to the hippocampus and cortex). These observations suggest that unlike Alzheimer's disease, normal aging does not reliably produce a degeneration of the cholinergic innervation of the hippocampus and cortex. The responsivity of the cholinergic system, however, is altered during normal aging. ACh synthesis and stimulation-induced release of ACh are diminished in aged animals. Further, the electrophysiological response of postsynaptic neurons to ACh is reduced during aging. Although some regional differences in these age-related changes may be present, the generalization that the functioning of the cholinergic system is impaired during aging is probably accurate. Thus, investigation of these changes in the dynamic properties of cholinergic input to the hippocampus and cortex during aging may provide clarification of the relationship between cholinergic dysfunction and age-related decline in learning and memory and may also provide a more reasonable rationale for treatment approaches. PMID- 3319051 TI - Immunocytochemical study on the intracellular localization of the type 2 glucocorticoid receptor in the rat brain. AB - The localization of the glucocorticoid receptor (GR) (type 2) in the rat brain was studied with immunocytochemistry using a monoclonal antibody against the rat liver GR. Strong GR immunoreactivity (GR-ir) was observed in neurons of limbic and brainstem structures known to be associated with the stress-activated circuitry, which suggest that these sites are responsive to glucocorticoid feedback. The intracellular localization of GR-ir was examined in CA1 and CA2 pyramidal neurons of the hippocampus. In intact rats GR-ir is predominantly present in the cell nucleus. Adrenalectomy (ADX) caused a slow depletion of the GR-ir signal from the cell nucleus until near detection limits at two weeks postsurgery. At that time, 1 h after administration to longterm ADX rats the synthetic glucocorticoid (type 2) agonist RU 28362 as well as a moderate and high dose of corticosterone (CORT) markedly enhanced the cell nuclear GR-ir. The type 2 antagonist RU 38486 also caused an increase of GR immunostaining in cell nuclei upon acute administration to ADX rats. The mineralocorticoid aldosterone (ALDO) and a low dose of CORT, which bind almost exclusively to type 1 corticosteroid receptors, were ineffective. In conclusion, our data suggest that in the hippocampal CA1-2 neurons type 1 and type 2 corticosteroid receptors may coexist. The steroid-induced changes in cell nuclear immunoreactive GR staining intensity suggest possible cytoplasmic-cell nuclear translocation of GR and/or exposure of immunogenic GR domains. PMID- 3319053 TI - Re-examination of the effect of either a lateral or third ventricular cannula on captopril-induced salt appetite in rats. AB - In Study A, rats were implanted with a cannula aimed at either the lateral (LV) or ventral third (V3V) brain ventricles 1 week prior to starting a chronic oral regimen of captopril. The presence of neither cannula significantly impaired the emergence of captopril-induced appetite for NaCl solution. In Study B, V3V cannulae were implanted in rats after a captopril-induced appetite for NaCl was established. The surgery produced a 1-2 day attenuation of NaCl intake, but this was no greater than that observed in a sham-operated group that received no cannula. These results do not support those of others who suggest that captopril (and, by inference, other agents) can leak across a damaged blood-brain barrier for at least 2 weeks after placement of a cannula. Possible reasons for the differences in results are addressed. PMID- 3319052 TI - The nervus terminalis ganglion in Anguilla rostrata: an immunocytochemical and HRP histochemical analysis. AB - Immunocytochemistry and retrograde horseradish peroxidase (HRP) transport were used to study the ganglion of the nervus terminalis in the American eel, Anguilla rostrata. Luteinizing hormone releasing hormone (LHRH) like immunoreactivity was found in large, ganglion-like cells located ventromedially at the junction of the telencephalon and olfactory bulb and in fibers within the retina and olfactory epithelium. HRP transport from the retina demonstrated direct connections with both the ipsi- and contralateral populations of these ganglion-like cells. Given the well-documented role of both olfaction and vision during migratory and reproductive phases of the life cycle of eels, the robust nature of a nervus terminalis system in these fish may present a unique opportunity to study the behavioral correlates of structure-function organization in a discrete population of ganglion-like cells. PMID- 3319054 TI - [Eulogy for Jean Boyer (1908-1986)]. PMID- 3319055 TI - [Psychotropic drugs, blood alcohol and accidents: study of 341 accident victims]. PMID- 3319057 TI - [Malingering: diagnostic and relational difficulties. Attempted interpretation]. PMID- 3319056 TI - [Dr. Felix Giraud-Teulon (1816-1887). A great destiny, a great discovery]. PMID- 3319058 TI - [Request for authorization to treat plant infusions with ionizing radiation]. PMID- 3319059 TI - [Ethical problems arising from the discovery of unruptured saccular supraclinoid aneurysms of congenital origin (77 cases)]. PMID- 3319060 TI - [Hydrolysis of hormone precursors at the site of basic amino acids. Study of tetrapeptide models]. PMID- 3319061 TI - [Role of halophilic and halotrophic bacteria in the chronic problems of long-term dialysis]. PMID- 3319062 TI - [Plasma exchange in neurologic resuscitation]. PMID- 3319063 TI - [Medicine and justice]. PMID- 3319064 TI - [Certain aspects of AIDS in Belgium]. PMID- 3319065 TI - [Request for authorization to preserve litchi nuts by treatment with sulfurous anhydride]. PMID- 3319066 TI - The problem with scars. PMID- 3319067 TI - Hypertrophic scarring and pressure therapy. PMID- 3319068 TI - The aetiology of scars. PMID- 3319069 TI - Tissue expansion. PMID- 3319070 TI - Scars and collagen implantation. PMID- 3319071 TI - Diphtheria: Dr. Joseph O'Dwyer and his intubation tubes. PMID- 3319072 TI - The Clendening History of Medicine Library and Museum. PMID- 3319073 TI - Arsenic and no lace. PMID- 3319075 TI - The Medical Museum, University Hospital, London, Ontario. PMID- 3319074 TI - Francis X. Dercum and Animal Locomotion. PMID- 3319076 TI - [Is halothane obsolete?]. PMID- 3319077 TI - Normal reproductive parameters in large "California-style" dairies. AB - Reproductive parameters are important in evaluating modern dairy management performance. Successful dairying results from constant attention to daily events, requiring more sensitive and immediate measurements of performance. Definitions of formulas, numerators, denominators, and population included or excluded are essential for proper interpretation and comparison of results. Veterinarians understanding these statistics and indexes, and using stratification of data to investigate production losses, will serve their clients well. My advice is to approach a herd with a perceived reproductive problem by evaluating these parameters; they are the means of determining if a problem exists and, if so, where it is. Find out how the various parameters are calculated so your interpretation will be correct. Herds with average days in milk of less than 165, culling rates below 25 per cent, and a milking rate of 85 per cent or more do not have long-term reproductive problems. If management techniques fail to achieve these levels, first look at those areas involving people. Conception rates measure all the components that, when multiplied, equal fertility: insemination technique, semen quality, heat detection accuracy, and the cow factors involved. Poor conception rates require investigation into these areas individually. Heat detection intensity leading to prolonged days in milk at first service is another common finding. Comparison of inseminators and sires may identify a problem area. Cow factors require more intense investigation to determine their cause. Use the information outlined in the periparturient period to assist you. In most cases, a combination of failures in many of the independent factors creates the problems in reproduction that we encounter. A large data base including all the information discussed and additional information is necessary to define, correct, and monitor reproductive management performance. Since performance ultimately is determined by the quality of the labor force, ongoing monitoring for accountability and education is necessary for success. PMID- 3319078 TI - The effects of periparturient events on breeding performance of dairy cows. AB - Many periparturient events affect breeding performance in dairy cows. These events include disorders, high early lactation milk yield, other cow factors, and calf factors. The effects range in severity from "annoying" to "devastating." PMID- 3319079 TI - Effects of nutrition on reproduction in dairy cows. AB - It is clear that nutrition is closely related to reproduction in the dairy cow. In addition to classic nutrient deficiency and excess, dry cow body condition and postpartum energy balance have a major impact on fertility. Dry cow rations must be designed to prevent milk fever, dystocia, retained placenta, other calving problems, and metritis. Most importantly, milk yield and reproductive performance should be regularly monitored to detect nutritionally associated health and performance changes that precede impairment of reproductive function. PMID- 3319080 TI - Computerized dairy reproductive herd health records. AB - Computerization allows veterinarians providing dairy reproductive herd health services to become a vital part in the record keeping and evaluation systems of the farms in their practices. PMID- 3319081 TI - Dairy Herd Management Program. AB - The Dairy Herd Management Program has served both dairymen and veterinarians very well over the past several years under a variety of conditions. A number of veterinarians have used the Dairy Herd Management Program to provide computerized dairy record service to their clients. In many of these situations, clients have decided to purchase a computer system of their own after discovering the value of having improved, computerized dairy records. The Dairy Herd Management Program is able to efficiently handle data from large dairies without disrupting daily record-keeping routines. With this data, useful reports are generated that measure actual reproductive performance against target levels or goals. Because the Dairy Herd Management Program focuses on specific time intervals and includes data from culled cows, trends or drops in reproductive performance are more quickly detected so that corrective action can be taken to minimize economic losses. The Dairy Herd Management Program's strong points include batch entry of data, an inclusive yet flexible Vet Check List of cows to be examined, and a detailed, comprehensive Reproductive Summary report. Its major weakness is the lack of a custom report generator for specific situations or conditions. This problem is being addressed in the new version. With the improvements scheduled for the new version, the Dairy Herd Management Program should be able to meet all of the needs of dairy managers and veterinarians alike, as well as become a powerful tool for conducting dairy reproductive field trials and research. PMID- 3319082 TI - The Dairy Herd Management System. Application to dairy herd reproductive management as a bureau and on-farm system. AB - This article describes the field use of the Dairy Herd Management System Microcomputer software. The practical experiences gained from the use of the program in dairy reproductive management are discussed for operation both as a bureau service and as an on-farm system. PMID- 3319083 TI - Dairy Comp 305 program. AB - A flexible dairy database program, Dairy Comp 305, is described to illustrate how a dairy database can support the decisions of a dairy producer and provide data for veterinarians to plan their production management programs. PMID- 3319084 TI - Control of venereal disease in infected herds. AB - Losses from trichomoniasis can be controlled by management and treatment strategies. The best strategy for control of campylobacteriosis is vaccination of cows and bulls with a competent vaccine. PMID- 3319085 TI - Mycoplasma, Ureaplasma, and Acholeplasma infections of bovine genitalia. PMID- 3319086 TI - Rationale for treatment of endometritis in the dairy cow. AB - Endometritis is an inflammation of the uterine lining that is commonly initiated at parturition. The degree of its effect on fertility varies with the severity of the inflammation, the time required for resolution of endometrial lesions, and the extent of permanent changes that impair endometrial gland functions and/or alter the uterine and/or oviductal environment. The primary nonspecific organisms associated with endometrial pathology are Corynebacterium pyogenes and the gram negative anaerobes. The majority of postpartum dairy cows have some degree of endometritis but resolve it by 40 to 50 days post partum. Cows with certain periparturient disorders involving the reproductive tract and/or a defective host immune mechanism may acquire persistent infections that impair subsequent fertility. Not all infertile cows or all cows with positive uterine cultures have endometritis. Cows recovering from C. pyogenes endometritis may require 1 month after clearance of the organism for fertility to be restored. These cows, as well as many cows with slightly delayed uterine involution at 30 days post partum, do not benefit from antimicrobial therapy. The effect of endometritis varies between herds. It is associated with prolongation of calving intervals that can vary from less than 2 weeks to 2 months or more. The cost of days open beyond 80 to 110 days post partum is currently estimated to be $2.00 to $2.25 per day. Evaluation of the bovine genital tract is best conducted by a rectal examination combined with a vaginal speculum examination. Cows selected for therapy for endometritis should meet the strict requirements of a grossly enlarged uterus and a severely abnormal uterine discharge. Induction of estrus is the treatment of choice whenever possible. When antimicrobial therapy is indicated, tetracycline is recommended for intrauterine use during the early postpartum period when mixed bacterial populations are present. Commonly used doses are 2 to 3 gm. For systemic signs of illness, systemic administration of penicillin has been recommended. Twice daily doses of 5000 to 10,000 IU of penicillin per kg may be necessary to maintain therapeutic blood concentrations. Systemic administration of an antimicrobial is necessary to achieve therapeutic concentrations in the oviducts, cervix, and vagina. With chronic endometritis due to C. pyogenes, intrauterine administration of 1 to 1.5 X 10(6) IU of procaine penicillin G has been recommended. Multiple daily treatments are desirable. Milk from treated cows should be tested for penicillin before it is added to bulk tank milk. It still is not clear whether antimicrobial therapy is cost effective.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3319087 TI - Heat stress in dairy cows. Its effect on reproduction. AB - The effects of heat stress are most pronounced in the lactating dairy cow. The effects manifest themselves in several physiologic mechanisms and include negative effects on the duration of estrus, embryonic development, uterine blood flow, hormonal relationships, fetal growth, and subsequent milk yield. PMID- 3319088 TI - Reproductive physiology in Zebu cattle. Unique reproductive aspects that affect their performance. AB - This article describes the reproductive physiology of Zebu cattle and specific strategies that, when used in concert with an understanding of the physiologic differences between Zebu and other cattle, can improve reproductive performance. PMID- 3319089 TI - Relationship between nutrition and reproduction in beef cattle. AB - The primary nutrient consideration for optimum reproductive performance in beef cattle is energy. Low energy intake delays the onset of puberty in heifers and bulls. Heifers should reach approximately 66 per cent of mature body weight by 14 to 15 months of age and be bred 30 days prior to breeding the main cow herd. Body conditioning scores (BCS) (1 = emaciated, 9 = obese) should be used to evaluate pregnant cows entering their third trimester. Cows should calve with body conditioning score 5 to 7. Forage quality and environmental factors influence maximum dry matter intake and nutrient requirements and must be considered in the clinical setting. Crude protein dietary content should be 11 to 12 per cent for lactating beef cattle. Mineral (calcium, phosphorus, magnesium, potassium, sulfur, sodium, chloride) nutrition is not a major cause of decreased reproductive performance in beef cattle. Trace mineral deficiencies (particularly selenium, copper, and zinc) can cause decreased reproductive performance. Diagnosis of these trace mineral deficiencies can be confirmed by elemental analysis of blood or tissues. PMID- 3319090 TI - Biotechnology. The key to improved animal production? AB - Biotechnology will influence the reproductive performance of cattle in a number of different ways. In animals breeding, embryo transfer has already had a significant impact on the way in which genetic selection of animals is performed. If other technologies such as embryo splitting, in vitro fertilization, cloning, and sex selection are superimposed on conventional embryo transfer, genetic gains will be achieved at an extremely rapid rate. The net result be a rapidly changing animal population in which genetic gains are maximized. Transgenic animals with altered genetic make-up will also have a dramatic effect on animal production. The general introduction of such animals will be slow and the cost to produce them will be enormous, as conventional selection and progeny testing will be needed to ensure that the "new" introduced genes are functional and do not have detrimental side effects. Simple, sensitive assays of hormones and proteins developed using biotechnology will aid in the monitoring of reproductive performance of animals. PMID- 3319091 TI - Protection and prevention. PMID- 3319092 TI - Dr. Gordon Jessamine. AIDS centre coordinator grants exclusive interview. Interview by John Hardie. PMID- 3319093 TI - Root surface caries. Epidemiology, etiology and control. PMID- 3319094 TI - Oral health status of 13-year-old school children in Alberta Canada. PMID- 3319095 TI - Proposed criteria for matrices. PMID- 3319096 TI - Use of the term 'non-invasive'. PMID- 3319097 TI - Dr. L.E. Van Buskirk. Pioneer maritime dentist was first to use anaesthetic in surgical operation in Canada. PMID- 3319098 TI - Surgical crown lengthening in periodontics. PMID- 3319099 TI - The final results of the Sherbrooke-Lac Megantic fluoride varnish study. PMID- 3319100 TI - Use of a computer simulation for the continuing education of registered nurses. PMID- 3319101 TI - Designing computer simulations. PMID- 3319103 TI - Nursing informatics in The Netherlands. PMID- 3319102 TI - Personal library management. PMID- 3319104 TI - Renal reflexes in the regulation of blood pressure and sodium excretion. AB - The rich innervation of the kidney is distributed to all structures of renal parenchyma thus providing important anatomical support to the functional evidence that the renal nerves can control kidney functions and send signals on the kidney environment to the central nervous system. Efferent renal nerve fibres are known to influence renal haemodynamics by modifying arteriolar vascular tone, renin release by a direct action on juxtaglomerular cells, and the excretion of sodium and water by changing tubular reabsorption of sodium and water at the different tubular levels. Mechano- and chemo-receptors have been shown in the kidney. Afferent fibres connected with renal receptors convey signals to the central nervous system both at spinal and supraspinal levels. The central areas receiving inputs from the kidney are those involved in the control of cardiovascular homeostasis and fluid balance. Activation of renal receptors by the electrical stimulation of renal afferent fibres were found to elicit both excitatory and inhibitory sympathetic responses. Although the existence of excitatory renorenal reflexes has been suggested, electrophysiological and functional data demonstrate that neural renorenal reflexes exert a tonic inhibitory influence on the tubular sodium and water reabsorption and on the secretion of renin from the juxtaglomerular cells. PMID- 3319105 TI - Renal nerves and experimental hypertension: evidence and controversy. AB - Noradrenergic fibers innervate various parts of the nephron and can contribute to sodium and water homeostasis by influencing hemodynamic variables, tubular reabsorptive mechanisms, and renin release. As renal function is considered to be a primary determinant of arterial pressure, efferent renal nerves may be an important link between the central nervous system and the kidney in the development and maintenance of hypertension. Little is known about the relative importance of renal nerves and their interactions with other factors in influencing renal function chronically. There is disagreement about the evidence for enhanced noradrenergic drive to the kidney in hypertensive rats, as the renal nerve firing rate, neurotransmitter release and metabolism, and receptor properties are generally not studied in association with measurements of renal function. However, chronic renal denervation has been shown to significantly affect arterial pressure in diverse forms of experimental hypertension in rats, including genetic models, as well as renovascular, mineralocorticoid, neurogenic, and angiotensin II hypertension. The actual mechanisms responsible for this effect of renal denervation are not clear, but presumably reflect changes in the arterial pressure-urinary sodium output relationship. On the whole, there is reasonable correlation between neurophysiological, biochemical, and renal denervation studies in the spontaneously hypertensive rat, suggesting that renal nerves do play a role in the onset of hypertension in these animals. The effect of renal denervation in other models of hypertension seems less clear, with recent reports showing that renal denervation does not alter the hypertensive process in renovascular, mineralocorticoid, and salt-related hypertension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319106 TI - The renal afferent nerves in the pathogenesis of hypertension. AB - The renal nerves play a role in the pathogenesis of hypertension in a number of experimental models. In the deoxycorticosterone acetate - salt (DOCA-NaCl) hypertensive rat and the spontaneously hypertensive rat (SHR) of the Okamoto strain, total peripheral renal denervation delays the development and blunts the severity of hypertension and causes an increase in urinary sodium excretion, suggesting a renal efferent mechanism. Further, selective lesioning of the renal afferent nerves by dorsal rhizotomy reduces hypothalamic norepinephrine stores without altering the development of hypertension in the SHR, indicating that the renal afferent nerves do not play a major role in the development of hypertension in this genetic model. In contrast, the renal afferent nerves appear to be important in one-kidney, one-clip and two-kidney, one-clip Goldblatt hypertensive rats (1K, 1C and 2K, 1C, respectively) and in dogs with chronic coarctation hypertension. Total peripheral renal denervation attenuates the severity of hypertension in these models, mainly by interrupting renal afferent nerve activity, which by a direct feedback mechanism attenuates systemic sympathetic tone, thereby lowering blood pressure. Peripheral renal denervation has a peripheral sympatholytic effect and alters the level of activation of central noradrenergic pathways but does not alter sodium or water intake or excretion, plasma renin activity or creatinine clearance, suggesting that efferent renal nerve function does not play an important role in the maintenance of this form of hypertension. Selective lesioning of the renal afferent nerves attenuates the development of hypertension, thus giving direct evidence that the renal afferent nerves participate in the pathogenesis of renovascular hypertension. PMID- 3319108 TI - Vasomotor control by subretrofacial neurones in the rostral ventrolateral medulla. AB - In this paper we review our recent work in the rabbit and cat on the role of the rostral ventrolateral medulla in cardiovascular regulation. Microinjection of neuroexcitatory amino acids into a highly circumscribed region, located just ventral to the retrofacial nucleus at the level of the rostral part of the inferior olive, leads to an increase in blood pressure, owing to sympathetic vasoconstriction. Bilateral destruction of this region, which we have termed the subretrofacial nucleus, leads to a profound fall in blood pressure. Anatomical studies show that the subretrofacial nucleus contains a compact group of bulbospinal neurones that project to sympathetic preganglionic nuclei in the thoracolumbar spinal cord. Single-unit recording studies have shown that these bulbospinal neurons are spontaneously active and are powerfully inhibited by baroreceptor inputs. These observations indicate that the subretrofacial bulbospinal cells are sympathoexcitatory and play a major role in the tonic and phasic control of the cardiovascular system. Some important unresolved questions regarding the subretrofacial neurones will be discussed. (i) Are they functionally homogenous, or are they viscerotopically organized with respect to particular end organs? (ii) What are their afferent inputs? (iii) What are their histochemical properties? Specifically, are they part of the group of adrenaline synthesizing cells, or alternatively, substance P cells? PMID- 3319107 TI - Reversal of renovascular hypertension: role of the renal medulla. AB - The fall in blood pressure, which occurs when renovascular hypertension is corrected surgically, offers a means of elucidating the factors responsible for blood pressure control. When Goldblatt two-kidney, one-clip hypertension in the rat is reversed by unclipping the renal artery, or by removal of the ischaemic kidney, restoration of normal blood pressure is due to a fall in peripheral resistance. This is associated with sodium retention and cannot be modified by inhibition of the renin-angiotensin system. The fall is, however, partially inhibited by chemical removal of the renal medulla by means of 2-bromo-ethylamine hydrobromide. When normal rats are chemically medullectomized, moderate hypertension is produced, which cannot be attributed to the renin-angiotensin system or sodium retention. It is concluded that a renomedullary vasodepressor system is ablated by chemical medullectomy: further, this system plays a role in the surgical correction of Goldblatt hypertension. PMID- 3319109 TI - Role of area postrema pressor mechanisms in the regulation of arterial pressure. AB - This article discusses the data which established that angiotensin II modulates the tonic and reflex control of cardiovascular function by actions on the nuclear regions of the dorsal medulla oblongata. Although physiological evidence for the modulatory actions of angiotensin II in structures of the lower brainstem has been gathered over the past 16 years, only the recent application of new neurobiological techniques has allowed a more definitive understanding of its role. The identification of high affinity angiotensin II binding sites within the parenchyma of the area postrema with the technique of in vitro receptor autoradiography has provided anatomical validity for a role of angiotensin II in the central nervous system. The added discovery of angiotensin II binding sites in subnuclear components of the nucleus tractus solitarii and the motor nucleus of the tenth cranial nerve provides additional information on the various mechanisms through which angiotensin II may affect the intrinsic activity of the brainstem neuronal circuits involved in the integration of baroreceptor and sensory visceromotor function. PMID- 3319110 TI - Peptidergic inputs to sympathetic preganglionic neurons. AB - This paper presents data showing that the sympathetic autonomic areas of the cat thoracolumbar spinal cord contain nerve terminals and fibres with immunoreactivity for at least seven neuropeptides. The distribution in the intermediolateral cell column of the terminals and fibres which contain enkephalin-, neuropeptide Y-, neurotensin-, substance P-, and neurophysin II-like immunoreactivity (ENK, NPY, NT, SP, and NP2, respectively) suggests that these peptides are involved in more generalized functions of the autonomic nervous system. On the other hand, peaks in density of immunoreactivity at certain levels suggest that different levels of influence of sympathetic preganglionic neurons by the various peptides may occur along the length of the thoracolumbar cord. The distribution of terminals and fibres containing somatostatin- and oxytocin-like immunoreactivity (SS and OXY) suggests that these peptides may be part of specific pathways to particular sympathetic preganglionic neurons. The possible sources of the terminals and fibres containing ENK, NPY, NT, SS, and SP include the spinal cord and supraspinal areas, whereas the source of these structures with OXY and NP2 is most likely supraspinal. The data suggest that coexistence of peptides and interactions between structures containing different neuropeptides occur in the spinal autonomic areas. It is speculated that neuropeptides have an important role to play in the regulation of the cardiovascular division of the autonomic nervous system. PMID- 3319112 TI - General anesthesia and hepatic circulation. AB - This article describes hepatic circulatory disturbances associated with anesthesia and surgical intervention. The material is presented in three parts: part 1 describes the effects of general anesthetics on the hepatic circulation; part 2 deals with different factors related to surgical procedures and anesthesia; and part 3 analyzes the role of hepatic circulatory disturbances and hepatic oxygen deprivation in anesthesia-induced hepatotoxicity. The analysis of available data suggests that general anesthesia affects the splanchnic and hepatic circulation in various directions and to different degrees. The majority of anesthetics decreases portal blood flow in association with a decrease in cardiac output. However, hepatic arterial blood flow can be preserved, decreased, or increased. The increase in hepatic arterial blood flow, when it occurs, is usually not enough to compensate for a decrease in portal blood flow and therefore total hepatic blood flow is usually decreased during anesthesia. This decrease in total hepatic blood flow has certain pharmacokinetic implications, namely a decrease in clearance of endogenous and exogenous substances with a high hepatic extraction ratio. On the other hand, a reduction in the hepatic oxygen supply might play a certain role in liver dysfunction occurring perioperatively. Surgical procedures-preparations combined with anesthesia have a very complex effect on the splanchnic and hepatic circulation. Within this complex, the surgical procedure-preparation plays the main role in developing circulatory disturbances, while anesthesia plays only a modifying role. Hepatic oxygen deprivation may play an important role in anesthesia-induced hepatotoxicity in different experimental models. PMID- 3319111 TI - Sodium restriction can delay the return of hypertension in patients previously well-controlled on drug therapy. AB - Sodium restriction can reduce blood pressure in hypertensive patients. The present study indicates that if hypertension is well controlled then the reemergence of hypertension can be decreased by the use of a reduced sodium intake. The present paper demonstrates that in such patients on a normal salt diet, 90% become hypertensive within 6 months while only 40% of people on a reduced sodium diet become hypertensive. It is proposed that a high sodium intake activates a number of amplifiers that causes a shift of the dose-response curve to sodium to the left and if not prevented or interrupted leads to the development of hypertension. PMID- 3319113 TI - From arthritis to Alzheimer's disease: current concepts on the pathogenesis of amyloidosis. AB - Amyloid is a generic term referring to a group of diverse but specific extracellular protein deposits which all have common morphologic properties, staining characteristics, and x-ray diffraction and infrared spectra. This review considers the new classification of amyloids, based on the underlying peptides forming the protein fibril, and their diversity. The pathogenesis of inflammation associated amyloid and its relationship to high density lipoprotein metabolism is examined in detail. The lessons learned from models of inflammation-associated amyloid are extended to the other amyloids (e.g., Alzheimer's disease), and potential reasons for the common structural properties of all amyloids are explored. PMID- 3319115 TI - Frequency of Escherichia coli O157:H7 isolation from stool specimens. AB - During a 6-month period, 7252 faeces specimens were examined for Escherichia coli serotype O157:H7. Forty-nine specimens (0.7%) from 19 patients yielded this organism. Escherichia coli O157:H7 was the third most frequently isolated bacterial pathogen, following Campylobacter jejuni and (or) Salmonella sp. Although regional variation between laboratories determined whether Campylobacter jejuni or Salmonella was the primary bacterial pathogen isolated, E. coli O157:H7 was consistently isolated more frequently than either Shigella or Yersinia enterocolitica. PMID- 3319114 TI - Transhepatic absorption and biliary excretion of insulin. AB - The application of insulin to the liver in rats is followed by an increase of the insulin concentration in the bile. The pathway of insulin from the liver surface to the bile may include a secretory process by the hepatic cells, or it may bypass the hepatic cells, using direct anatomical pathways from blood and lymph to bile. The concentration of insulin in arterial and venous blood, in lymph, and in bile was measured following application of insulin to the liver surface and following peritoneal or intravenous administration. The results confirm that insulin is absorbed from the surface of the liver, but the glucose modulating effect was less effective than after intravenous administration. The insulin concentration in bile was increased after insulin administration by all routes, with the highest and most prolonged increases found after intraperitoneal administration. The results suggest that following transhepatic and intravenous administration, insulin reaches the bile without passing through the liver cells. PMID- 3319117 TI - Temperature, pH, and cations affect the ability of Escherichia coli to mobilize plasmids in L broth and synthetic wastewater. AB - Coincubations of plasmid donor and recipient cells in L broth and in synthetic wastewater demonstrated that a large number of environmental factors must be taken into account when measuring the potential for the dissemination of plasmid encoded genes in natural environments. These include salts and detergents in the medium as well as other factors, e.g., pH and temperature. Complex interactions between and among agents were observed, indicating that simple additive effects may not be assumed. Mobilization of genetically engineered nonconjugative plasmid pHSV106 was inhibited by the same compounds that affected conjugative plasmid movement. PMID- 3319116 TI - An electron microscope study of kidney basement membrane changes in the mouse by lipoteichoic acid from Streptococcus pyogenes. AB - Mice injected repeatedly, intraperitoneally or intravenously, for approximately 1 month with a total of 1.04 mg lipoteichoic acid from a nephritogenic strain of Streptococcus pyogenes lost weight. Analysis by electron microscopy revealed that they also exhibited extensive kidney changes in basement membrane morphology which resembled, in part, those observed in human poststreptococcal glomerulonephritis. For example, the glomerular basement membrane became electron dense and exhibited at least a twofold increase in width sporadically within the same preparation after exposure to lipoteichoic acid. Also, whereas appreciable loss or reduction in epithelial foot processes as a result of fusion was clearly evident, epithelial slits and slit membranes or diaphragms between normal foot processes were not selectively affected. In addition, another mostly thickened, highly coiled or serpentinelike basement membrane with amorphous nodules appeared in these preparations. This type membrane was not observed surrounding the capillary lumina and was the most pronounced abnormality apparent in almost all preparations from mice exposed to lipoteichoic acid. Likewise, the proximal tubular basement membrane became variable in width and increased in electron density in mice given lipoteichoic acid as compared with controls. In addition, this membrane was often punctuated with various morphological protrusions originating from only its thickened areas and which extended away from, and not into, the capillary space. This change was only associated with the basement membrane of the proximal tubular capillaries. All membrane changes persisted but gradually subsided, with normal kidney membrane morphology reappearing on the 4th day following the last injection of lipoteichoic acid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319119 TI - Commentary on the significance for modern neurology of the 17th century B.C. Surgical Papyrus. AB - A 17th century B.C. Surgical Papyrus known as "The Edwin Smith Papyrus" was published in facsimile and hieroglyphic transliteration with translation and commentary by James Henry Breasted in 1930. The Papyrus was acquired by Edwin Smith in Luxor, 1862. This document was conceived in the Pyramid Age (3000-2500 B.C.) and remains in material form from the 17th century B.C. It is of importance to the history of Neurology as it contains the earliest mention in oriental literature of (a) the brain and meninges (b) calvarial and cervical vertebral injuries in details of pathology, symptomatology, treatment and prognosis and (c) functional localization in the brain and spine. Most importantly, Papyrus Smith is a statement of the medical ethic of its time. PMID- 3319118 TI - Antibiotic resistance and plasmid pattern of enterotoxigenic ST-a strains of Escherichia coli isolated in Puebla, Mexico. AB - Antibiotic susceptibilities of 22 strains of Escherichia coli isolated from children from 0 to 3 years old at the University Hospital of Puebla were determined. Almost all strains were resistant to ampicillin, tetracycline, streptomycin, and kanamycin. Gel electrophoresis of DNA from 10 clinical strains of E. coli revealed a heterogeneous plasmid population. Plasmid DNA, ranging in molecular mass from 1.8 to 120 megadaltons, was demonstrated in 10 strains. Moreover, the frequency of antibiotic transfer ranged from 1.6/10(8) to 2/10, and the simultaneous transfer of the gene encoding heat-stable enterotoxin was also determined. Six out of 10 strains tested were able to cotransfer ST-a as demonstrated by the suckling mouse test. It is possible that antibiotic selective pressure may increase the isolation of enterotoxigenic E. coli strains. PMID- 3319120 TI - A comparison of bromocriptine (Parlodel) and levodopa-carbidopa (Sinemet) for treatment of "de novo" Parkinson's disease patients. AB - Fifty-one patients were enrolled in a double-blind, parallel group, multicentre study conducted to assess short-term efficacy and tolerance of bromocriptine (Parlodel) or L-DOPA/carbidopa (Sinemet) in patients never treated with amantadine, ergot alkaloids or L-DOPA-based drugs. An attempt to use the lowest effective dose was made. The responder rate for each group was approximately 78%; the mean daily dose for responders was 22.5 mg of bromocriptine or 250 mg of L DOPA/carbidopa. The overall clinical improvement in each group was 62% (bromocriptine) and 55% (L-DOPA/carbidopa) for neurological assessment and 36% (bromocriptine) and 31% (L-DOPA/carbidopa) for functional disability. Comparison between groups did not show any significant difference for both neurological and disability assessments. The most frequent side effect was nausea (L-DOPA, N = 3; bromocriptine, N = 6). PMID- 3319121 TI - Maternal immunologic changes during pregnancy: a critical appraisal. AB - A great variety of approaches have been applied to the study of immunity during pregnancy. Many of the studies have been motivated by an attempt to explain the failure of of the mother to reject the fetus. At times, dramatic findings have been claimed; and, at times, these results have been held to be expected, since no immunologic event (or nonevent) has been more perplexing than the failure of the mother to reject the fetal "allograft." This review will present clinical findings relevant to an understanding of immunocompetence and host defense during pregnancy, as well as the results of laboratory investigations regarding the possibility of altered immunity during pregnancy. PMID- 3319122 TI - Interrelationships between asthma and pregnancy: clinical and mechanistic considerations. AB - Asthma appears to be one of the most common potentially serious medical problems to complicate pregnancy. There is abundant literature suggesting that asthma and pregnancy may have reciprocal influences on each other. This article will review the literature dealing with the effect of asthma on pregnancy and the effect of pregnancy on asthma. For each of the bidirectional relationships, a review of clinical observations will be followed by a review of potentially relevant mechanistic considerations. PMID- 3319123 TI - The management of asthma during pregnancy and lactation. AB - The optimal management of asthma during pregnancy and lactation requires a cooperative approach between the physician managing asthma, the obstetrician gynecologist, and the patient. Goals of therapy include: 1) avoidance of repeated episodes of asthma, 2) avoidance of emergency room visits, 3) avoidance of status asthmaticus, 4) prevention of death in the mother, 5) use of minimal medications in the gravida, and 6) avoidance of maternal medication use with uncertain or deleterious effects on the fetus. Because acute severe asthma may have it onset during pregnancy, the physician must be prepared to diagnose and treat the gravida to avoid or reduce episodes of maternal hypoxemia, hypocarbia or hypercarbia. Status asthmaticus has been associated with maternal and fetal deaths as well as intrauterine growth retardation. Although it is logical to assume that prevention of repeated episodes of asthma would be associated with a more favorable outcome in pregnancy, only recently was this actually documented. The purpose of this manuscript is to review issues in diagnosis and management of asthma during pregnancy and lactation. PMID- 3319125 TI - Perinatal factors influencing the development of allergy. AB - An increase in the prevalence of atopic diseases in industrialized countries has been noted for several years. This has resulted in greater interest in analyzing possible factors that may influence the development of allergic disease, particularly during the perinatal and early infancy periods. In this paper we will discuss various factors during late pregnancy and early infancy that may influence the development of allergic disease later in infancy and childhood (Table 1). The effect of the various external factors to be discussed should always be considered in relation to the genetic constitution of the individual. Several recent studies have shown that the impact of environmental risk factors is quite different in individuals with and without the genetically determined propensity to become sensitized (Fig. 1). PMID- 3319124 TI - Diagnosis and treatment of rhinitis during pregnancy and lactation. AB - Many women develop rhinitis during pregnancy. However, to call this "rhinitis of pregnancy" may be misleading. Many of these women who seem to have "developed" rhinitis during pregnancy turn out, on careful questioning, to have had similar preexisting symptoms. Furthermore, these women and those who truly appear to have developed their symptoms for the first time during pregnancy are often found to have common causes for their rhinitis. Certain factors have been cited to account for the frequent appearance (or reappearance) of rhinitis during pregnancy (Table 1). Nasal vascular pooling from the increased circulating blood volume and possibly from progesterone induced vascular smooth muscle relaxation will enhance nasal stuffiness. Stress associated with even a normal pregnancy may have a similar effect. Hormonally induced increased nasal mucous gland activity also has been suggested. The peak age of onset of classical inhalant allergic disease falls within the child bearing time of life, and hence could be coincidental with a pregnancy. Even routine episodes of bacterial rhinosinusitis are increased up to 6-fold during pregnancy. This report will review the clinical approach to rhinitis in the pregnant patient with reference to pathophysiology, differential diagnosis, and treatment during this complex time in a woman's life. PMID- 3319126 TI - Challenges in the prevention of allergic disease in infancy. AB - The prevention of atopic disease, though admirable, remains a difficult endeavor. One must overcome inherent and natural forces constantly working to sensitize humans to produce IgE antibodies. These multiple risk factors for developing allergies (Table 1) act in concert to oppose preventive efforts. IgE mediated disorders potentially could be prevented by selectively interfering with the major genetic, cellular, and environmental factors that determine the ultimate phenotypic expression of atopy. Present efforts to prevent allergic disease remain relegated to manipulating the environment by reducing the allergenic load. Unfortunately, however, there has yet to exist a definitive, prospective study that conclusively documents and defines optimal or proven effective dietary and environmental regimens that prevent allergic disease. Until such studies emerge, physicians interested in prevention should be cognizant of the data derived from the limited published reports of dietary and environmental prevention efforts in order to appreciate current espoused recommendations. In addition to developing effective and proven prevention regimens, other issues deserving scrutiny include the following: 1) recognition of those groups (individuals) most at risk, amenable, and/or responsive to preventive efforts; 2) determination of the cost effectiveness of such endeavors; and 3) identification of interfering variables, ie, noncompliance to recommendations. PMID- 3319127 TI - Memory and appreciation. Sebastian Klaus Littmann 1931-1986. PMID- 3319128 TI - Transsexualism: syndrome or symptom? AB - The desire to identify with and assume the role of the opposite gender has been present with us since antiquity. Unfortunately, the syndrome of transsexualism as defined by the DSM-III encompasses many individuals who are seeking a gender change perhaps allowing reassignment to take place when not indicated. This paper reviews the major classifications applied to the condition of transsexualism and a new model of classification for individuals with Gender Dysphoria is outlined. It will be shown that by subdividing the condition into those with the hypothesized syndrome (primary (true) transsexualism, or the symptom, secondary transsexualism) a better understanding of gender dysphoria is achieved. By applying this new model of classification, a management/treatment protocol is outlined which is helpful in dealing with the gender dysphoric patient. PMID- 3319129 TI - Magnetic resonance imaging in psychiatry. AB - Magnetic resonance imaging (MRI) is a relatively new radiological technique that may be useful in the study of psychiatric illness. MRI gives detailed structural information about the brain and also allows quantification of functional change. Current areas of study relevant to psychiatry include: schizophrenia, dementia, epilepsy and, to a lesser extent, alcohol and affective disorders. The authors review the basic principles of MRI, discuss the recent application to psychiatry, indicate its potential advantages and comment on the current limitations of this imaging modality. PMID- 3319130 TI - Bone marrow transplantation. Nurses' and physicians' perceptions of informed consent. PMID- 3319131 TI - A cancer services directory. Development and dissemination. PMID- 3319132 TI - Relaxation techniques. A self learning module for nurses: Unit III. PMID- 3319133 TI - Mesenchymal neoplasms associated with type D retroviruses in macaques. AB - The type D subfamily of retroviruses contains five distinct viruses which are found in New and Old World monkeys. The retroviruses found in Old World macaque (genus Macaca) monkeys are exogenous to the species and upon injection induce a fatal simian acquired immune deficiency syndrome (SAIDS). Two serotypes of type D virus, SAIDS retrovirus types 1 and 2 (SRV-1 and SRV-2), are found in captive macaques in primate centres in the United States. In addition to SAIDS, two neoplasms, retroperitoneal fibromatosis (RF) and subcutaneous fibrosarcomas (SF), have been found in macaques with type D retrovirus-induced SAIDS. Only SRV-2 is found in association with RF, and only about 35% of SRV-2-infected macaques develop RF. SF is found in association with both serotypes, but less than 5% of infected monkeys develop SF. The RF in macaques is potentially a model for human disease since the lesions in macaques are similar to the idiopathic RF described in humans. Thus far, RF has not been found in species other than macaque or man. The complete sequence of three type D retroviruses is known. Importantly, no oncogenes are present in the viral genome. Therefore, the mechanisms for tumour induction which involve immunosuppressive or genetic properties of the virus that are distinct from classic oncogenes must be considered. PMID- 3319134 TI - Sheep pulmonary adenomatosis: a contagious tumour and its cause. AB - Sheep pulmonary adenomatosis (SPA) is a contagious lung tumour that can be transmitted experimentally. Two viruses have been associated with the disease, a herpesvirus and a retrovirus. All ovine herpesviruses are related antigenically and have been isolated only from SPA tumour tissues. They do not appear to cause the tumour and their association with SPA appears to arise from reactivation of latent virus in the respiratory tract. SPA tumour tissue and lung fluid contain a retrovirus that has properties similar to those of type B and type D retroviruses. Homogenates of tumour that contain this retrovirus can transmit SPA to experimentally inoculated sheep. Various retroviruses have been cultured from such tumours. Only one of these has properties similar to that of the retrovirus detected in the tumour and it can transmit SPA experimentally. The others appear to be isolates of the non-oncogenic ovine lentivirus, maedi-visna virus, and play no part in the aetiology of SPA. PMID- 3319135 TI - Pharmacokinetics of carboplatin after i.v. administration. AB - Pharmacokinetics of the cisplatin analog carboplatin were studied in ovarian cancer patients who received short-term iv infusions of 290-370 mg/m2. Platinum (Pt) was determined by atomic absorption spectrometry in plasma ultrafiltrate up to 24 hours and in plasma and urine up to 5 days following infusion. Carboplatin was determined in plasma ultrafiltrate and in urine by high-performance liquid chromatography with electrochemical detection. The final half-life of total Pt in plasma was 5.8 +/- 1.6 days. Pharmacokinetics of carboplatin and ultrafilterable Pt (free Pt) were similar with respect to alpha-half-life (16 +/- 6 and 23 +/- 8 mins), beta-half-life (118 +/- 15 and 120 +/- 11 mins), area under curve/dose (18 +/- 5 and 17 +/- 4 min/m2/L), total-body clearance (101 +/- 21 and 107 +/- 19 ml/min), and volume of distribution Vss (9.9 +/- 1.3 and 10.0 +/- 1.4 L/m2). After 6 hours the cumulative urinary excretion of carboplatin and Pt was 41% +/- 14% and 68% +/- 7% of the dose, respectively. After 5 days the cumulative urinary excretion of Pt was 84% +/- 6%. Renal and metabolic clearances of free Pt from plasma were 81 +/- 17 and 26 +/- 11 ml/minute, respectively. The first-order rate constant for metabolic elimination of free Pt (KM = CLM/Vss) was 1.5 X 10(-3) +/- 0.6 X 10(-3) min-1, which is ten times lower than the value calculated from literature data for cisplatin (15 X 10(-3) +/- 1 X 10(-3) min-1). This means that the overall in vivo reactivity of carboplatin is ten times lower than that of cisplatin. PMID- 3319136 TI - Overview of current status and future direction of clinical trials with 5 fluorouracil in combination with folinic acid. PMID- 3319138 TI - Dr. William S. Keith. PMID- 3319137 TI - Reversible central nervous system toxicity associated with high-dose chlorambucil in autologous bone marrow transplantation for ovarian carcinoma. PMID- 3319139 TI - Therapy of neurocysticercosis. AB - The different manifestations of neurocysticercosis are classified and the appropriate therapy in each group is described. PMID- 3319141 TI - Artificial antigens. Synthesis of polyacrylamide copolymers containing 3-deoxy-D manno-2-octulopyranosylonic acid (KDO) residues. AB - Starting from an anomeric mixture of methyl (allyl 4,5,7,8-tetra-O-acetyl-3-deoxy alpha- and -beta-D-manno-2-octulopyranosid)onates, the glycosides sodium (allyl 3 deoxy-alpha- and -beta-D-manno-2-octulopyranosid)onate, sodium O-(sodium 3-deoxy alpha-D-manno-2-octulopyranosylonate)-(2----4)-[allyl 3-deoxy-alpha-D-manno-2 octulopyranosid]onate and sodium (allyl 3-deoxy-7-O-beta-D-ribofuranosyl-beta-D manno-2-octulopyranosid)++ +onate were prepared in several steps. Radical copolymerization of the allyl glycosides with acrylamide afforded linear macromolecular antigens containing mono- and di-saccharide residues corresponding to the KDO-region of Salmonella minnesota rough-form lipopolysaccharide and to partial structures of the capsular polysaccharide from Escherichia coli K 23, respectively. The copolymers were substituted by KDO-residues in a ratio of 1:18 +/- 2 (based on acrylamide) and had molecular masses of 60-100 kdaltons. PMID- 3319140 TI - A case of cebocephaly-holoprosencephaly with an aberrant adenohypophysis. AB - An autopsy case of cebocephaly-holoprosencephaly at 27 weeks' gestation is reported. Chromosome analysis revealed a 46, XX,-7, +der(7), t(7;13) (q32;q34) pat karyotype. Pathological examination disclosed a hypoplastic aberrant adenohypophysis, in which immunohistochemical localization of four anterior pituitary hormones (ACTH, GH, PRL, TSH-beta) was demonstrated. Malformation of the pituitary gland in holoprosencephaly can include ectopic adenohypophysis as well as pituitary dysgenesis, so a careful search for adenohypophysis should be made in future cases for a better understanding of endocrine dysgenesis associated with holoprosencephaly. PMID- 3319142 TI - Nutrition and immunological responses. AB - Interaction between severe malnutrition and immunity have been described in clinical and experimental studies. Effects of marginal malnutrition or deficiency of single nutrients are less well-defined and should be investigated. Studies indicate that T cell function, in particular, is sensitive to many nutritional deficits or abnormalities and may compromise clinical immunological responses. PMID- 3319143 TI - Correlative studies on antigenicity of pancreatic cancer and blood group types. AB - Blood group-related antigenicity in 14 pancreatic cancer patients was examined by immunohistological method using monoclonal antibodies (MoAbs) against A, B, H, Lea, Leb, and CA 19-9 and compared with the phenotypic expression of the individuals' blood groups. MoAb-A reacted strongly with tumor tissue in four of five blood group A patients. Two of two patients with blood type B showed a weak, focal reactivity of their cancer with MoAb-B. H antigen was found in four of five patients from blood group A, while it was present in only one blood group O person and absent in B-type individuals. B antigen was inappropriately expressed in one person with type A blood and in two with type O. Lea antigen was expressed in all but two tumor tissues and Leb antigen in all tumorous tissues, irrespective of Le blood group status. MoAb 19-9 reacted with 11 of 14 cases. PMID- 3319144 TI - Malignant lymphoproliferative disorders of viral origin in transplant patients undergoing immunosuppressive therapy. AB - Although no case of lymphoproliferative syndrome occurred among our first 680 transplant patients, 13 cases developed in a subsequent series of 170 patients. This severe condition involved a proliferation of B cells and/or plasma cells that invaded a number of organs, resulting in the deaths of eight patients. Early tapering off of immunosuppressive therapy enabled five patients to recover without loss of the transplant. The factors likely to be involved in the occurrence of malignant lymphoproliferation are immunosuppressive drugs, and introduction of allogeneic EBV-infected cells or reactivation of EBV. PMID- 3319145 TI - Difficulty in establishing diagnosis from lung biopsies and bronchial washing analysis in children with leukemia following bone marrow transplantation. AB - Three children developed severe respiratory distress at days +12, +11, and +11 following allogeneic bone marrow transplantation from donors. The first child was a 13-year-old Hispanic boy transplanted in relapse of Philadelphia chromosome positive acute lymphoblastic leukemia (ALL). At day -14, a bronchial washing done for a streaky pulmonary infiltrate was negative for acid-fast bacilli. Miliary tuberculosis was discovered at postmortem examination. A second child, transplanted in remission of null-cell ALL, developed severe hypoxia and hypercarbia on day +11 but recovered fully following prolonged mechanical ventilation. An open-lung biopsy showed a pattern of nonspecific, diffuse alveolar damage compatible with respiratory distress syndrome. The third child was transplanted in remission of B-cell ALL and developed fatal fungal and cytomegalovirus pneumonia on day +12. In these latter two cases, it is likely that open-lung biopsy would have missed the diagnosis because of the uneven pulmonary involvement and multiple etiologies observed. All three children received cyclosporine, granulocyte transfusions, and multiple antimicrobials, including amphotericin B. Hyperfractioned total-body irradiation with lung shielding was used in the latter two patients. PMID- 3319146 TI - Passive, adoptive, and active immunotherapy: a review of clinical trials in cancer. AB - The results today of passive immunotherapy with monoclonal antibodies (MAb) are still very limited, even via its indirect methods (in vitro tumor cell clearance of bone marrow before autologous retransplantation, transport of cytostatic chemicals, and radiation). Tumor cell heterogeneity requires the use of several MAb. Adoptive immunotherapy in the form of the graft vs leukemia (GVL) reaction associated with the graft vs host (GVH) reaction, after an allogeneic bone marrow transplantation, first demonstrated in animals in 1962, has been confirmed in man. The material and operational development of tumor immunology, immunopharmacology, and clinical trial methodology should improve active immunotherapy results and help to convert into a cure what is often a significant but only marginal increase: 1) of disease-free survival or 2) of survival or 3) of survival after relapse. The general ineffective management and use of adjuvant chemotherapy for all tumors except breast carcinoma before menopause will, on the other hand, contribute to necessary new concepts of how to manage the postremission, residual, minimal disease. PMID- 3319147 TI - Transfer factor for adjuvant immunotherapy in cervical cancer. AB - In a prospective randomized double-blind study of 60 patients with invasive cervical cancer, 32 were treated with transfer factor (TF) derived from leukocytes of the patients' husbands, and 28 were treated with placebo. Within the first 2 years after radical hysterectomy, five out of 32 TF-treated patients and 11 out of 28 placebo-treated patients developed recurrence of malignancy. Excluding one further patient with intercurrent death this difference is significant (chi 2 = 3.9915; P less than 0.05). Subdividing the collectives, significant differences were found in patients aged below 35 years and in patients with stage I disease. Identical immune profiles were checked in leukocyte donors prior to leukophoresis and were serially checked in patients. Antigen-specific correlations were found between donors' and recipients' reactivities but not between donors' reactivity and recipient's course of the disease. PMID- 3319148 TI - Modulation of antitumor immune responses. AB - Based on experimentation in animal model systems it is reasonable to expect immunomodulation by anticancer drugs and biological response modifiers to be instrumental in at least some of the antitumor effects of such agents. Even in the defined animal models, however, the immunomodulating effects of any given agent are in most cases correlated only with the therapeutic response to that agent, whereas causal relationships still evade unequivocal demonstration. The difficulties in this respect are magnified in humans, in whom the very nature and regulation of antitumor immunity, taken in a broad sense, are not yet well defined; thus at this time the basis on which to interpret the therapeutic or toxicological causative relevance of an immunomodulating effect is insufficient. Despite these limitations and uncertainties, or perhaps responding to the challenge they provide, experimentation evaluating the potential of immunomodulation is being carried out in a number of diversified areas. Salient findings from selected investigations of the actions of 1) drugs, 2) cytokines, and 3) combinations of agents or effectors are discussed as examples of the realization of the potential of this overall approach as well as to outline the requirements for future development of biological response modifiers. PMID- 3319149 TI - Correction of secondary T-cell immunodeficiencies with biological substances and drugs. AB - Secondary T-lymphocyte deficiencies are common in cancer, aging, malnutrition, chronic infection, and AIDS. Reconstitution with thymic hormones has not been successful. The various thymic hormone preparations induce prothymocyte differentiation and promote the differentiated functions of mature T cells, but they do not regulate intrathymic maturation. In contrast, interleukin 2, endotoxin, thymic epithelial cell products, but not interleukin 1 were found to promote functional maturation of immature thymocytes. Logically, thymic hormones may have synergistic interaction with inducers of intrathymic maturation, and preliminary evidence in athymic nude mice supports this notion. Two classes of drugs show thymomimetic actions. Levamisole, diethyl dithiocarbamate, and other sulfur-containing compounds restore T-cell function via induction of a thymic hormone-like factor. Isoprinosine, NPT 15392, and related hypoxanthine derivatives induce T-cell maturation directly and promote T-cell function in vitro and in vivo. An assessment of the combined actions of these drugs and biologicals should improve immunorestoration in T-cell deficiencies. PMID- 3319150 TI - Antitumor and metastasis-inhibitory activities of lentinan as an immunomodulator: an overview. AB - The antitumor and metastasis-inhibitory activities, mode of action, and clinical application of lentinan, a strictly purified beta-1,6:beta-1,3-glucan, are reviewed. Lentinan exerts a prominent antitumor effect and prevents chemical and viral oncogenesis. The antitumor action of lentinan is host-mediated. Compared to other well-known immunostimulants, such as bacille Calmette Guerin (BCG), Corynebacterium parvum, and lipopolysaccharide (LPS), lentinan appears to represent a unique class of immunopotentiator, a T cell-oriented adjuvant. Lentinan triggers the increased production of various kinds of bioactive serum factors associated with immunity and inflammation, such as IL-1, CSF, IL-3, vascular dilation inducer, and acute-phase protein inducer, by the direct impact of macrophages or indirectly via lentinan-stimulated T cells, which results in the induction of many immunobiological changes in the host. Augmented IL-1 production amplifies the maturation of immature effector cells to mature cells capable of responding to lymphokines such as IL-2 and T cell-replacing factors. Because of this mode of action, intact T cell compartments for antitumor activity of lentinan are required. Lentinan has little toxic side effects. Excellent results were obtained in a 4 year follow-up of the randomized control study of lentinan in phase III on patients with advanced and recurrent stomach and colorectal cancer. PMID- 3319151 TI - Do tuftsin and bestatin constitute a biopharmacological immunoregulatory system? AB - Tuftsin is the tetrapeptide Thr-Lys-Pro-Arg. It is spontaneously released from the Fc fragment of IgG by two specific enzymes. One 25-micrograms dose administered to mice in good immunologic status stimulated phagocytosis, macrophage killing of tumor cells, delayed hypersensitivity, cytolytic T-cell activity, antibody production, antibody-dependent cell-mediated cytotoxicity (ADCC), and natural killer (NK) cell activity. Administered for 6 months at the dose of 10 micrograms once a week to old, immunodepressed mice, tuftsin restored macrophage and T-cell cytotoxic activities. At this dosage, tuftsin prevented spontaneous tumor development. Tuftsin was also well tolerated in phase I studies in humans in increased polymorphonuclear leukocytes and OKT4-positive lymphocytes. Bestatin is extracted from Streptomyces olivoreticuli. One 100 micrograms dose of bestatin injected in young mice with normal immunologic status increased macrophage cytotoxicity, antibody production, ADCC, and NK cell activities. Long-term administration of bestatin (100 micrograms once a week) corrected macrophage and T-cell cytotoxicity and prevented age-related spontaneous tumors. Bestatin inhibited lymphocyte membrane aminopeptidase, which degrades tuftsin into a tripeptide that is an antagonist competing with it for receptors. Tuftsin and bestatin constitute a biopharmacologic system that can be developed as other aminopeptidase inhibitors are available for study. PMID- 3319152 TI - Stress-related modulation of immunity: a review of human studies. AB - The assumption that life changes and stressful events can alter host defense is based mainly on studies of changes in a variety of immune and inflammatory reactions. Whether those changes also confer an increased susceptibility to infectious agents and neoplasms, or modify the course of such diseases, is still less well substantiated. Nonetheless, psychological and neural modulation of immunity has recently been possible to approach from a mechanistic viewpoint. For instance, generation of a variety of lipid mediators from arachidonic acid may be under control of dietary and endocrine factors that can be affected by stress. Since these lipids, eg, lipoxygenase products, are potent regulators of leukocyte functional responses, their significance as one of several mechanisms is discussed. The role of various neuropeptides in leukocyte function has only recently been discovered. Since the release of, eg, substance P, enkephalins, and endorphins, which all have modulating effects on leukocyte functional responses, is under neural control and can occur in the vicinity of immunocompetent cells, they might constitute one of several links between the mind and the immune system. PMID- 3319154 TI - Evaluation of mitral regurgitation: echo-Doppler versus cardiac catheterization. PMID- 3319153 TI - [Secondary prevention of myocardial infarct]. PMID- 3319155 TI - Current aspects of non-pharmacologic therapy of tachyarrhythmias. PMID- 3319156 TI - [Venous thrombolysis with the recombinant human tissue-type plasminogen activator (rt-PA) during the first 3 hours following acute myocardial infarction. Controlled pilot study with placebo]. PMID- 3319157 TI - [Anti-angina activity of nifedipine and P0285 in the anesthetized rat]. PMID- 3319158 TI - [Changes in plasma volume, hemodynamics and neurohumors induced by acute administration of furosemide in the human]. PMID- 3319159 TI - [Magnesium and cardiac arrhythmias. Revived interest for an old substance]. PMID- 3319160 TI - Historical aspects of electrocardiography. AB - One hundred years ago, Augustus Desire Waller recorded the human electrocardiogram for the first time, using a capillary electrometer. Electrocardiography only became clinically relevant in 1901 when Willem Einthoven devised his string galvanometer for this purpose. Sir Thomas Lewis was the key figure in showing the value of the electrocardiography for the diagnosis of disorders of cardiac rhythm and conduction, but many others amplified the technique to encompass the assessment of structural heart disease, especially when due to ischemia. Knowledge of their role and work gives us a better perspective when considering the development of surface electrocardiography. PMID- 3319161 TI - Normal and noninfarct Q waves. AB - Pseudo-infarct Q waves occur in a number of conditions, related to physiologic or positional variants, altered ventricular conduction, ventricular enlargement, and non-coronary myocardial damage. Prominent Q waves in asymptomatic individuals may be due to previous "silent" myocardial infarction, normal variants, or some pathologic but non-coronary cause. Differential diagnosis may be aided by echocardiography (normal variants, cardiomyopathies, left or right ventricular enlargement, amyloid deposition, and so on). Failure to recognize pseudo-infarct patterns may result in "electrocardiographogenic disease" if the Q wave is a normal variant, or in missing a critical clue to some important pathology such as hypertrophic cardiomyopathy or pulmonary embolism that has very different therapeutic implications from coronary disease. PMID- 3319162 TI - Significance of transient electrocardiographic Q waves in coronary artery disease. AB - In some clinical situations, an abnormal Q wave may represent intense but reversible ischemia, but the point at which irreversible myocardial damage occurs is seldom known in the acute phase. Unfortunately, the correct diagnosis is presently too cumbersome and takes far too long by means of serial ECGs and enzyme determinations. This delay may preclude rapid therapeutic interventions such as angioplasty, thrombolysis, and emergency coronary bypass surgery to provide myocardial salvage. The remarkable progress in the treatment of unstable coronary artery disease has created the need for more reliable markers of cell death so as to exclude patients from aggressive therapy or to terminate aggressive therapy to salvage what is considered ischemic myocardium. Transient Q waves are being reported far more frequently and have assumed far greater clinical importance because of the current aggressive therapy of MI (and ischemia) with thrombolytic agents, angioplasty, and coronary bypass surgery. A Q wave deflection associated with ST-segment elevation or depression does not invariably indicate MI. The pronouncement of myocardial death has become more complicated than in the past because Q waves are not pathognomonic of myocardial necrosis. Transient ischemic electrical silence with Q waves in the absence of MI is a rare phenomenon and affects the anterior leads much more commonly than the inferior leads. Such Q waves may appear acutely or may be present chronically with the potential of disappearing when coronary perfusion is restored. A transient intraventricular conduction disorder induced by ischemia should always be ruled out before making the diagnosis of a transient ischemic Q wave or electrical silence. Some workers believe that all transient Q waves represent an unstable intraventricular conduction disorder, but recent developments suggest that most transient Q waves in coronary artery disease are engendered by ischemia. Edema and inflammation may play a part in rendering the myocardium electrically inert, and their disappearance may explain the loss of Q waves. The presence of a small MI should not detract from the importance of associated transient Q waves due to potentially salvageable, severely ischemic myocardium, that is, the zone of so-called concussion around the area of necrosis. In evolving Q-wave MI, a new Q wave may reverse acutely if coronary perfusion is restored very early. Disappearance of Q waves several days after MI suggests return of myocardial viability and does not represent a factitious electrical change. Electrical stunning may be associated with myocardial stunning.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3319163 TI - Electrocardiographic diagnosis of myocardial infarction during ventricular pacing. AB - The diagnosis of myocardial infarction during ventricular pacing can be made in a substantial number of patients, mostly by applying the diagnostic criteria that are useful in the presence of complete left bundle branch block. There are, however, important exceptions to this general rule during ventricular pacing, and normal depolarization patterns must be recognized to avoid the erroneous diagnosis of myocardial infarction. PMID- 3319164 TI - The significance of ST abnormalities in myocardial infarction. AB - During the acute phase of myocardial infarction, elevation of the ST segment represents one of the major criteria for location of the injury. Recent studies showed that changes in the ST segment in leads remote from the infarcted area or in right precordial leads may provide additional information on the extent of the infarction and right ventricular involvement. PMID- 3319165 TI - Electrocardiographic effects of reperfusion. AB - This article focuses on the electrocardiographic events that may occur following restoration of flow in an infarct-related vessel. PMID- 3319166 TI - Clinical usefulness of quantitative ECG methods for evaluating ischemic and infarcted myocardium. AB - The complete Selvester QRS scoring system is a validated quantitative method of estimating the size of single myocardial infarcts. It remains to be validated in patients with multiple infarcts and in those with confounding factors such as ventricular hypertrophy or fascicular or bundle branch blocks. Discrepancies in its correlation with other sizing methods might give insight into the amount of infarct reperfusion (versus enzymatic methods) or the amount of residual ischemic myocardium (versus mechanical methods). Several strategies have now been presented for quantitative use of the initial ST segment deviation to indicate important clinical parameters such as the precise location of the coronary occlusion, the amount of myocardium in jeopardy, and the potential for salvage by reperfusion. Comparison of the initial ST deviation with final QRS score and with non-ECG methods of estimating the per cent of LV that is scarred and/or dysfunctional might indicate the effect of therapeutic reperfusion on MI healing. These methods remain to be validated and, as yet, no comprehensive ST segment scoring system has been developed. Use of both QRS and ST methods will be facilitated by the development of new ECG recording systems and by automated application of the various criteria. It is likely that acute coronary care in 1990 will include sophisticated methods for continuous monitoring of QRS and ST and T changes. There will be continuous trending of scores indicating the amount of ischemic and infarcted myocardium. Base-line measurements can be obtained before interventions have begun in order to indicate the potential benefit of altering the natural course for the individual patient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319167 TI - Unstable intraventricular conduction disorders. AB - Unstable bundle branch blocks may be tachycardia dependent, bradycardia dependent, or rate independent. When appearing at the "critical" rates or "critical" cycle lengths they may seem to be rate independent. Conversely, "true" rate-independent blocks may be reversible or irreversible. Determining if a rate unrelated block may disappear can be difficult because irreversile bundle branch block seems to develop through a slow process in time during which rate dependent, rate-independent, and even normal conduction alternate in successive electrocardiograms. PMID- 3319168 TI - Clinical usefulness of the 12-lead electrocardiogram in the Wolff-Parkinson-White syndrome. AB - When used with insight, the 12-lead electrocardiogram can provide a considerable amount of useful data in patients with the Wolff-Parkinson-White syndrome. The 12 lead electrocardiogram during tachycardia usually provides excellent clues as to the mechanism of tachycardia, with the most valuable feature being the relationship of the P wave to the QRS complex. The observation of intermittent loss of preexcitation or loss of preexcitation with late atrial extrasystoles is an indicator of a long anterograde refractory period of the accessory pathway, a clue to a benign prognosis in the event of atrial fibrillation. The preexcited morphology as assessed by the electrocardiogram can provide an accurate first approximation to accessory-pathway location using a few simple guidelines. PMID- 3319169 TI - Diagnostic significance of the QRS wave form in patients with ventricular tachycardia. AB - In contrast to studying QRS complexes of supraventricular origin, examining the QRS wave form of ventricular origin provides the opportunity to explore the profession of the myocardial activation through unspecific pathways. New information can thus be deduced concerning the underlying myocardium as well as the point of origin of the depolarization of the ventricle. PMID- 3319170 TI - Synergistic aerobic and anaerobic infections. AB - Encapsulation affects the virulence and survival of anaerobic bacteria and their protection from phagocytosis. More encapsulated Bacteroides strains and anaerobic and facultative gram-positive cocci are isolated from patients with clinical infections than from healthy people. The pathogenicity of Bacteroides, Fusobacterium, Clostridium, and cocci isolates was demonstrated by their ability to induce subcutaneous abscesses in mice. Encapsulated Bacteroides, Fusobacterium, and cocci isolates generally induced abscesses, whereas nonencapsulated organisms did not. When strains that had fewer than 1% encapsulated organisms were inoculated with other viable or nonviable encapsulated bacteria, many survived in the abscesses and became heavily encapsulated. These strains were then able to induce abscesses when injected alone. Encapsulated Bacteroides species and anaerobic cocci induced bacteremia and translocation and increased the mortality in infected animals more often than did nonencapsulated forms of the same strain. In studies of selective antimicrobial therapy and quantitative cultures of abscesses, it was determined that possession of a capsule generally made Bacteroides species more important in mixed infections than their aerobic counterparts. In vivo synergy was seen between encapsulated Bacteroides species and all tested aerobic bacteria and most anaerobic and facultative gram-positive cocci as well as between most of these cocci and Pseudomonas aeruginosa or Staphylococcus aureus. It is concluded that encapsulated anaerobic bacteria have an important pathogenic role in polymicrobial infections. PMID- 3319171 TI - Controversies in susceptibility testing of anaerobes. AB - Antimicrobial susceptibility testing of anaerobic bacteria is controversial and confusing. A number of laboratory and clinical variables affect the performance and interpretation of the susceptibility data. We know that the various methods used in susceptibility testing have inherent differences that produce significantly contrasting results for certain antibiotics. We also know that some antimicrobials are affected to a greater degree than others, such as I demonstrated with ceftizoxime and cefoxitin (Table IV). We need to study the laboratory variables that lead to differences, such as the effect of inoculum size, various test media, osmolarity, pH, incubation time and environment, and antibiotic resistant endpoints for anaerobes. When we know which variables achieve the most reliable results, we can formulate a standard method by which antimicrobial susceptibility data can be compared. Studies to establish a method that correlates well with the clinical outcome of antimicrobial therapy in patients with infections involving anaerobes is important. These studies may take a long time but are necessary to ensure that the laboratory data are useful to the physician in the management of patients with anaerobic infections. Finally, it is important to determine if time-kill kinetic studies of anaerobes and antimicrobials can be useful in predicting clinical outcome in patients with anaerobic infections. The establishment of the bactericidal activity of antimicrobials at dosing intervals may or may not prove to be more useful than traditional MIC data. PMID- 3319172 TI - Treatment and long-term follow-up of foot infections in patients with diabetes or ischemia: a randomized, prospective, double-blind comparison of cefoxitin and ceftizoxime. AB - The efficacy and safety of ceftizoxime and cefoxitin were compared in a randomized, double-blind study of therapy for lower extremity infections in patients with diabetes mellitus or peripheral vascular disease. Overall clinical responses were satisfactory in 82% (23/28) of patients treated with ceftizoxime and in 68% (17/25) of patients treated with cefoxitin. The difference was not statistically significant. Ceftizoxime had superior in vitro activity against Enterobacteriaceae, especially Enterobacter cloacae, whereas cefoxitin had better activity against the Bacteroides fragilis group. Relapses of infection were common in both groups during long-term follow-up; only about one third of patients in either group maintained satisfactory outcomes after one year. More than half of the patients in both groups responded to one or more courses of medical therapy and avoided major amputations for one year following entry into the study. PMID- 3319173 TI - Intra-abdominal sepsis: controversies and choices in management. AB - Contamination of the peritoneal cavity may lead to generalized peritonitis or abscess formation. Both aerobic and anaerobic bacteria participate in the infectious process. The concentration and the particular mix of aerobes and anaerobes depends on the site of perforation, with the highest concentrations and greatest predominance of anaerobes in the colon. A number of factors contribute to the risk of infection, and a formula has been devised for calculating a given patient's risk for infection following intestinal perforation secondary to penetrating abdominal trauma. The goal of therapy is to reduce morbidity, mortality, and duration of hospital stay. Specific techniques used to achieve this goal are controversial. In essence, the keys to successful management of intra-abdominal sepsis are early diagnosis and surgical intervention, supplemented by systemic antibiotics that are effective against the aerobic and anaerobic components. Considerations in choosing antibiotics are efficacy, safety, and cost-effectiveness. Some second-generation and third-generation cephalosporins often offer an effective, safer, and more economical alternative to antibiotic combinations. PMID- 3319174 TI - Treatment of nosocomial aspiration pneumonia and soft-tissue infections in diabetic patients. AB - Nosocomial aspiration pneumonia and infections of soft tissue are most often caused by mixed aerobic and anaerobic pathogens. Single-agent therapy with a beta lactam antibiotic is tending to replace combination therapy because it is as effective and less toxic. Important considerations in choosing among the beta lactam antibiotics include a long pharmacologic half-life, permitting less frequent administration, and cost per gram. PMID- 3319175 TI - Hypersensitivity of adipose tissue to gastric inhibitory polypeptide action in the obese Zucker rat. PMID- 3319176 TI - [Continuous insulin infusion in diabetics treated with surgical implants]. PMID- 3319177 TI - [140 years since the birth of Emil Holub]. PMID- 3319178 TI - Haemopoietic stem cell proliferation in the bone marrow of S1/S1d mice. AB - In marrow from Sl/Sld mice (but not +/+ mice) day 7 and day 8 CFU-S proliferate whilst day 10 and day 12 CFU-S exhibit negligible proliferation. Media conditioned by both +/+ and Sl/Sld marrow contains an inhibitor of CFU-S proliferation but day 8 CFU-S in +/+ and Sl/Sld marrow show marked dose-response differences to this factor. To inhibit the proliferation of Sl/Sld CFU-S required approximately ten times the concentration of inhibitor that inhibited the proliferation of +/+ CFU-S. Thus abnormally responsive day 8-CFU-S were shown to proliferate in an inhibitory environment. Abnormalities in Sl/Sld CFU-S function were also demonstrated in heterotopic transplantation experiments using +/+ and Sl/Sld donors and hosts to obtain ectopic bone marrow with various stromal (donor) and haemopoietic (host) combinations. Day 8 Sl/Sld CFU-S were seen to proliferate, irrespective of whether the stromal environment was derived from Sl/Sld or +/+ marrow. Sl/Sld mice are generally regarded as animals in which there is a genetically determined defect in haemopoiesis due to an abnormality in the haemopoietic environment. It is difficult, however, to attribute the abnormal CFU-S behaviour in these experiments to environmental factors and the results are consistent with mutation at the Sl locus affecting the responses of CFU-S to regulatory signals, i.e. the genetic defect is not confined to the stromal environment. PMID- 3319180 TI - Hypertrophy of radial and ulnar arteries following denervation of the chicken wing. AB - Denervation of radial and ulnar arteries in the growing and adult domestic fowl was achieved by unilateral sectioning of the brachial plexus. Eight weeks later the denervated arteries and those of the contralateral wing were examined with light- and electron microscopy to determine the effect of denervation on arterial structure. In growing fowls, the area of the media in radial and ulnar arteries was increased by 29% and 25%, respectively, after denervation. The number of smooth muscle layers was also significantly increased by 16% (radial) and 14% (ulnar), but no significant variation was seen in the wall/lumen ratio of either growing artery. In adult fowls, the area of the media was increased by 93% (radial) and 32% (ulnar) following denervation and the number of smooth muscle cell layers increased by 39% (radial) and 11% (ulnar). There was also an increased wall/lumen ratio of 64% (radial) and 92% (ulnar). These results indicate that hyperplasia of smooth muscle has occurred in response to denervation. Flow-cytometric DNA analysis of growing arteries also indicates that the increase in muscle-cell volume is a result of cell division (not polyploidy) since no significant differences were found between the control and denervated arteries in any stages of the cell cycle. PMID- 3319181 TI - The early postnatal development of the primary immune response in rat popliteal lymph node, stimulated with thymus-independent type-1 and type-2 antigens. AB - To examine the development of the postnatal immune response to thymus-independent type-1 (TI-type 1) and TI type-2 antigens, respectively, trinitrophenyl lipopolysaccharide (TNP-LPS) or TNP-Ficoll was injected subcutaneously into the hind footpads of young rats of various ages. After 5 days the popliteal lymph nodes (PLNs) were removed and the localization pattern of specific anti-TNP antibody-containing cells was studied. The first specific antibody-containing cells elicited in rats by TNP-LPS appeared in animals at day 19 after birth. The results suggest that the development of these cells from lymphocyte to plasma cell occurs while they migrate from cortex to medulla. An unexpected finding was the low response to TNP-Ficoll in PLN; from 6 weeks after birth only very few specific antibody-containing cells were found. However, in the spleen numerous anti-TNP antibody-containing cells were found in the periarteriolar lymphocyte sheaths. To test the exclusive role of the spleen in the appearance of anti-TNP antibody-containing cells in lymph node after subcutaneous administration of TNP Ficoll, the experiment was repeated in rats that had been splenectomized. Evidence from these experiments suggests that the spleen plays a major role in the appearance of the above-mentioned cells in lymph nodes. PMID- 3319182 TI - Psychological disorders in Africa. Part 1: Issues of prevalence. PMID- 3319179 TI - Immunocytochemical localization of alkaline phosphatase in absorptive cells of rat small intestine after colchicine treatment. AB - The purpose of this study was to investigate the effect of colchicine and vinblastine on the localization of alkaline phosphatase (AlPase) in rat duodenum in relation to structural changes. AlPase was localized on the membranes of rough endoplasmic reticulum. Golgi stacks, cytoplasmic vesicles, microvilli, on lateral plasma membranes, and in some lysosomes of the duodenal epithelial cells of rats treated with either lumicolchicine or 0.9% NaCl alone. Microvilli were most intensely stained, and AlPase-positive Golgi stacks were regularly distributed in the supranuclear regions. After colchicine treatment, microvilli were shortened and the staining intensity became weaker, whereas basal as well as lateral plasma membranes showed stronger staining. The AlPase-positive microvilli appeared not only on the luminal surfaces, but also on the baso-lateral plasma membranes and even on the surfaces of characteristic intracytoplasmic cysts. Golgi stacks became smaller and their distribution became less localized, and the staining intensity of the Golgi stacks became weaker. AlPase localization in rats treated with vinblastine was almost identical with that of rats treated with colchicine. Thus, colchicine and vinblastine appeared to have elicited a disorientation of intracellular transport of intestinal AlPase by inhibiting microtubule organization. PMID- 3319183 TI - Tuberculosis of the pancreas mimicking carcinoma: report of a case. PMID- 3319184 TI - Psychological disorders in Africa. Part III: Service delivery. PMID- 3319185 TI - Pulmonary varix associated with mitral valve disease. AB - A case of pulmonary varices with mitral valve disease is presented with a detailed review of the literature. Two distinct categories of the disease, with and without left atrial hypertension, are emphasized. PMID- 3319186 TI - Isolation of cDNA encoding transcription factor Sp1 and functional analysis of the DNA binding domain. AB - Transcription factor Sp1 is a protein present in mammalian cells that binds to GC box promoter elements and selectively activates mRNA synthesis from genes that contain functional recognition sites. We have isolated a cDNA that encodes the 696 C-terminal amino acid residues of human Sp1. By expression of truncated fragments of Sp1 in E. coli, we have localized the DNA binding activity to the C terminal 168 amino acid residues. In this region, Sp1 has three contiguous Zn(II) finger motifs, which are believed to be metalloprotein structures that interact with DNA. We have found that purified Sp1 requires Zn(II) for sequence-specific binding to DNA. Thus, it is likely that Sp1 interacts with DNA by binding of the Zn(II) fingers. To facilitate the identification of mutant variants of Sp1 that are defective in DNA binding, we have also devised a bacterial colony assay for detection of Sp1 binding to DNA. PMID- 3319187 TI - Pair-rule genes: do they paint stripes or draw lines? PMID- 3319188 TI - Mechanisms of C. elegans development. PMID- 3319189 TI - The telomere terminal transferase of Tetrahymena is a ribonucleoprotein enzyme with two kinds of primer specificity. AB - We have analyzed the de novo telomere synthesis catalyzed by the enzyme telomere terminal transferase (telomerase) from Tetrahymena. Oligonucleotides representing the G-rich strand of telomeric sequences from five different organisms specifically primed the addition of TTGGGG repeats in vitro, suggesting that primer recognition may involve a DNA structure unique to these oligonucleotides. The sequence at the 3' end of the oligonucleotide primer specified the first nucleotide added in the reaction. Furthermore, the telomerase was shown to be a ribonucleoprotein complex whose RNA and protein components were both essential for activity. After extensive purification of the enzyme by a series of five different chromatographic steps, a few small low abundance RNAs copurified with the activity. PMID- 3319190 TI - Dystrophin: the protein product of the Duchenne muscular dystrophy locus. AB - The protein product of the human Duchenne muscular dystrophy locus (DMD) and its mouse homolog (mDMD) have been identified by using polyclonal antibodies directed against fusion proteins containing two distinct regions of the mDMD cDNA. The DMD protein is shown to be approximately 400 kd and to represent approximately 0.002% of total striated muscle protein. This protein is also detected in smooth muscle (stomach). Muscle tissue isolated from both DMD-affected boys and mdx mice contained no detectable DMD protein, suggesting that these genetic disorders are homologous. Since mdx mice present no obvious clinical abnormalities, the identification of the mdx mouse as an animal model for DMD has important implications with regard to the etiology of the lethal DMD phenotype. We have named the protein dystrophin because of its identification via the isolation of the Duchenne muscular dystrophy locus. PMID- 3319191 TI - Regulatory interactions between macrophages and T cells in Mycobacterium lepraemurium-specific T-cell activation. AB - The antigen-specific proliferative response of draining lymph node cells was found to follow a similar pattern in both C57BL and BALB/c mice following subcutaneous infection with Mycobacterium lepraemurium (MLM), although the two strains differed in their ability to control bacterial growth at the site of infection. The proliferative response, which was maximal 1-2 weeks postinfection, was T-cell dependent as it was abrogated with anti-Thy 1.2 + C treatment. The response was also abrogated by pretreatment with anti-Lyt 1.2 + C and slightly reduced by treatment with anti-Lyt 2.2 + C. The decline in T-cell responsiveness, at least from 4 to 8 weeks postinfection, may have been associated with prostaglandin production by inflammatory macrophages, as it was partially restored by addition of indomethacin. Also highly purified T lymphocytes from lymph nodes taken 6-8 weeks postinfection gave a strong antigen-specific proliferative response when reconstituted with optimal numbers of syngeneic antigen-presenting cells from uninfected mice. Proliferation was inhibited by peritoneal macrophages from Corynebacterium parvum-pretreated mice and macrophages from C57BL but not BALB/c mice infected with M. lepraemurium which had been elicited with heat-killed (HK) MLM and thioglycollate. Resident peritoneal macrophages from both C57BL and BALB/c mice infected subcutaneously with M. lepraemurium were slightly more inhibitory than normal macrophages but not as inhibitory as macrophages from C. parvum-pretreated mice. Macrophage dependent inhibition of T-cell proliferation was partially reversed by addition of indomethacin, suggesting these cells were not defective in processing and presentation of HK-MLM antigens, and that the inhibitory effects were associated with prostaglandin production. Resident peritoneal macrophages from both C57BL and BALB/c mice infected subcutaneously with M. lepraemurium produced comparable or slightly elevated levels of IL-1 on stimulation with LPS or HK-MLM. PMID- 3319192 TI - Changes in the arrangement of the microtubule system of murine peritoneal cells after an antigenic stimulation. AB - We determined two characteristic morphological patterns typical for the organization of microtubule systems of murine peritoneal macrophages and lymphocytes. A small number of both cell types formed uropods with an axial bundle of microtubules. This number remains practically unchanged during 48 h of cultivation in non-antigenic environment but grows rapidly in the presence of an antigen. PMID- 3319193 TI - Functional expression of the cDNA encoding for human lactate dehydrogenase-A in Chinese hamster ovary cells. AB - The cloned cDNA encoding for human lactate dehydrogenase-A was inserted immediately downstream to the SV40 early promoter, and it was shown to synthesize the human LDH-A polypeptide in Chinese hamster ovary cells. The human LDH-A subunit and the endogenous Chinese hamster LDH-a subunit formed in vivo a heterotetrameric LDH-a3A1 functional isoenzyme, indicating the conserved tertiary structure of both LDH-A subunits. PMID- 3319194 TI - Immunofluorescent localization of protein synthesis components in mouse embryo fibroblasts. AB - The distribution of initiation factor 2(eIF-2) and elongation factor 2(EF-2) in cultured mouse embryo fibroblasts was studied and compared with the distribution of ribosomes. We used immunofluorescence microscopy with monospecific antibodies to eIF-2, EF-2, and proteins S3a and S7 of the small ribosomal subunit. Ribosomes and factors eIF-2 and EF-2 were found mainly in the vicinity of the cell nucleus. This perinuclear zone coincides with the endoplasm - the central part of the cell containing numerous membraneous organelles and inclusions. Besides the perinuclear zone, small stained regions could be seen at the periphery of some cells. After treatment of the cells with Triton X-100 in a buffer conditions, that stabilizes the major cytoskeletal structures, some of the ribosomes, eIF-2, and EF-2 remained bound to the insoluble material. These components were found near the nucleus and some were located along the microfilament bundles. PMID- 3319195 TI - Multiple synaptonemal complexes (polycomplexes): origin, structure and function. AB - Multiple synaptonemal complexes (polycomplexes) (PC) are similar in structure to synaptonemal complexes (SC) and are also highly conserved through evolution. They have been described in over 70 organisms throughout all life forms. The appearance of PCs are restricted to meiotic and germ-line derived tissues and are most commonly present after SC formation. However, in a number of animals and plants, both extra- and intranuclear PCs are present during premeiotic and pre pachytene stages. The structure and biochemical composition of PCs is similar to SCs that the basic unit is tripartite, consisting of two lateral elements and a central region (in which transverse elements are located), and the dimensions of such structures are equivalent. Stacking of SC subunits, while still maintaining equivalent SC dimensions, creates a problem since the lateral elements (LE) would then be twice as thick in the PC as compared to the SC. Recently, it has been shown that the LE of the SC is actually multistranded, thus the LE of each subunit of the PC is half as thick as its counterpart in the SC. PMID- 3319196 TI - Fine (2-5-nm) filaments: new types of cytoskeletal structures. AB - Over the past 30 years filaments 2-5 nm in diameter have been found in a number of different types of eukaryotic cells. As a group, these fine filaments lack the similarity of composition and function that characterize the three major classes of cytoskeletal elements--microfilaments, microtubules, and intermediate filaments. Six different proteins that form fine filaments have been identified; proposed functions for these fibers range from cell motility to cytoarchitecture. Recent studies, however, have revealed filaments with similar compositions and/or functions in otherwise different cells, suggesting that the fine filaments may eventually fit into a limited number of subgroups. PMID- 3319197 TI - Vimentin dynamics during the mitogenic stimulation of mouse splenic lymphocytes. AB - We have used double immunofluorescence and electron microscopy to examine the distribution of tubulin and vimentin during the stimulation of mouse splenic lymphocytes by the mitogen concanavalin A. In unstimulated cells, vimentin forms a filamentous network partially coincident with the radial pattern of microtubules. In stimulated cells, the numbers of microtubules assembled from the centrosome have increased and vimentin is organized as an aggregate located near the centrosome. When these cells enter mitosis, vimentin is arranged into a filamentous cage enclosing the mitotic apparatus. During cytokinesis, the polar centrosomes are observed at a position adjacent to the midbody and vimentin is detected as an aggregate, similar to that seen prior to mitosis, close to the centrosome in each daughter cell. Using several agents, such as colchicine, colcemid, nocodazole, and taxol, which affect microtubule assembly, we have observed that the vimentin system, although closely related spatially to the microtubule complex in lymphocytes, can still reorganize independently as these cells progress through the cell cycle. Throughout mitogenic stimulation in the continued presence of taxol, microtubules are reorganized into a few thick bundles while the vimentin system undergoes a sequence of rearrangements similar to those observed during normal stimulation. These data suggest that vimentin dynamics may be important in the progression of lymphocytes through the cell cycle in response to mitogen. PMID- 3319198 TI - Acetylated and detyrosinated alpha-tubulins are co-localized in stable microtubules in rat meningeal fibroblasts. AB - We have examined the distribution of acetylated alpha-tubulin using immunofluorescence microscopy in fibroblastic cells of rat brain meninges. Meningeal fibroblasts showed heterogeneous staining patterns with a monoclonal antibody against acetylated alpha-tubulin ranging from staining of primary cilia or microtubule-organising centers (MTOCs) alone to extensive microtubule networks. Staining with a broad spectrum anti-alpha-tubulin monoclonal indicated that all cells possessed cytoplasmic microtubule networks. From double-labeling experiments using an antibody against acetylated alpha-tubulin (6-11B-1) and antibodies against either tyrosinated or detyrosinated alpha-tubulin, it was found that acetylated alpha-tubulin and tyrosinated alpha-tubulin were often segregated to different microtubules. The microtubules containing acetylated but not tyrosinated alpha-tubulin were cold stable. Therefore, it appeared that in general meningeal cells possessed two subset of microtubules: One subset contained detyrosinated and acetylated alpha-tubulin and was cold stable, and the other contained tyrosinated alpha-tubulin and was cold labile. These results are consistent with the idea that acetylation and detyrosination of alpha-tubulin are involved in the specification of stable microtubules. PMID- 3319200 TI - Intranasal drug delivery for systemic medications. AB - This article is designed to provide a critical literature review on the scientific advances in intra- and transnasal drug delivery for systemic medication. The article discusses the fundamentals, developmental concepts, and biomedical assessment of the transnasal administration of systemically effective drugs which are either easily inactivated when taken orally, due to the extensive hepatic first-pass elimination, or too large in molecular size to be absorbed efficiently, except by i.v. administration. PMID- 3319199 TI - Identification and characterization of a protein associated with the stembody using autoimmune sera from patients with systemic sclerosis. AB - An autoantibody that binds an antigen localized to the stembody of dividing cells has been identified in a patient with systemic sclerosis. Initially, this antigen is associated with the surface of the metaphase chromosomes. At the onset of anaphase the antigen becomes preferentially associated with the forming stembodies. This association is maintained as furrowing progresses during telophase and continues after the intercellular bridge is released from the daughter cells during G-1. Immunoblots indicate that the epitope detected by immunofluorescence is present on a protein with an apparent molecular weight of 38 kD. PMID- 3319201 TI - Introduction to overuse injuries. AB - An understanding of the cellular response to injury helps to explain overuse trauma. Tendons, bursae, cartilage, bone and nerves all can break down owing to the repetitive forces from sporting activities. A precise diagnosis and thoughtful use of medication and modalities in a complete rehabilitation program help to minimize disability. PMID- 3319202 TI - Biomechanics of muscle overuse injuries: a theoretical approach. AB - This article reviews the highlights of biomechanical principles associated with the proper function of the muscle, and extends the discussion to the limits set by the biomechanical concepts that, when exceeded, result in tissue injuries. The principles governing proper muscle functions and its injuries are also used to provide some guidelines for formation of exercise regimens that can minimize potential injuries. PMID- 3319203 TI - Lateral and medial epicondylitis of the elbow. AB - Tennis elbow is a common condition, with the extensor carpi radialis brevis attachment being the usual site of pain. Conservative care including decreased activity, ice, nonsteroidal anti-inflammatory medications, and muscle strengthening will help most people. The small percentage of cases that require surgery usually benefit from debridement of the damaged portion of the extensor carpi radialis brevis attachment. The postoperative course must include muscle strengthening and a gradual return to activity. PMID- 3319204 TI - Overuse injuries of the lower extremity: shin splints, iliotibial band friction syndrome, and exertional compartment syndromes. AB - The authors' discussion of overuse injuries of the lower extremity encompasses shin splints, iliotibial band friction syndrome, and exertional compartment syndromes. Etiology, diagnosis, and treatment are considered for each disorder. PMID- 3319205 TI - The chronically inflamed bursa. AB - Bursitis continues to be a frequent source of disability in the athlete. However, significantly less interest has been focused upon this type of injury than other types of sports injuries. This article presents a review of the problem, starting with anatomy and working through diagnosis to treatment. PMID- 3319206 TI - The chronically inflamed tendon. AB - The cause, diagnosis, and treatment of some of the chronic tendonitides are discussed in this article. Most tendon injuries are "overuse syndromes" and treatment involves the use of combined modalities and exercise. Preventive measures are emphasized. PMID- 3319207 TI - The traction apophysitises. AB - The traction apophysitises are one of the frequently encountered overuse injuries to children. Although known for many years and classed as osteochondroses, the traumatic origin of these disorders--from repetitive microtrauma--is now receiving wider acceptance. Discussion of the assessment, treatment, and prevention of these disorders is included. PMID- 3319208 TI - Stress fractures. AB - Multiple biologic and mechanical factors are involved in creating a stress injury to bone. The most common factor found to modulate this injury in the healthy individual has been the application of cyclic stress. The cessation of stress will allow repair to dominate over resorption. If bony integrity has not yet been lost, immobilization or fixation is not necessarily appropriate. By modulating the application of stress in a judicial manner, the injury is preventable. PMID- 3319209 TI - Application of modalities in overuse syndromes. AB - Improper techniques are often the cause of overuse syndromes. Unless the technique is corrected, the patient is doomed to recurrence. The same is true of improper posture, especially in the lower extremity and trunk areas. The pitcher or tennis player should have his or her style analyzed for proper form. The runner should have his or her muscular imbalances corrected by exercise and orthotic appliances. As with all other modalities used for treating painful conditions, proper evaluation of the etiology and the rectification of the cause is important. When athletes are underway in their sports seasons, it is often difficult to convince them to accept the ideal healing conditions needed to eliminate the problem. Management of the condition with any modality while maintaining an active lifestyle often brings about ethical scrutiny. However, it is the belief of the authors that noninvasive modalities do not provide the pain relief that would enable the athlete to tolerate activity beyond a significant injurious stress level. The modalities allow the athlete to regain the criteria for return, strength, and range of motion more successfully. Short-term goal setting is imperative to proper return. Several plateaus should be successfully completed before full return to activity is allowed. Tennis elbow, for example, may be allowed an initial period of 5 minutes on alternate days, gradually increasing to full activity every other day. Patients are often so anxious to return to activity that they overdo, leading to a decrease in function with a rapid return to the results of inflammation. The goals of successful rehabilitation of the overuse syndrome are pain-free range of motion, strength, and endurance. The use of cold, heat, electrotherapy, and exercise allow the athlete to reach his or her goal of returning to activity more quickly with a reduced risk of reinjury. PMID- 3319210 TI - Evaluation and diagnosis of cervical spine injuries: a review of the literature. AB - Cervical spine injuries pose devastating potential problems for surgeon and patient alike. This review will stress the early diagnosis of cervical spine injuries, with emphasis on early suspicion of injury. This review will focus on the radiology and types of lesions found with cervical spine injury. PMID- 3319211 TI - [Purkinje's description of his own vision and his diagnostic and therapeutic methods in ophthalmology]. PMID- 3319213 TI - One hundred years and looking ahead. PMID- 3319212 TI - [Observations on levels of TXA2 and PGI2 and the generation of platelet MDA in patients with chronic cor pulmonale]. PMID- 3319214 TI - The first kidney transplantation in Sri Lanka. PMID- 3319215 TI - [Prospect and progress in research on trace elements in Chinese traditional herbs]. PMID- 3319216 TI - [Synergism of Astragalus membranaceus with interferon in the treatment of cervical erosion and their antiviral activities]. PMID- 3319218 TI - [Preliminary study on anti-rejection effects of traditional drugs in allo transplantation of the kidney]. PMID- 3319217 TI - [Effects of electric stimulation at the erdan point on gallbladder contraction function. Real-time ultrasonic studies]. PMID- 3319219 TI - [Clinical analysis on 1363 patients with nonspecific ulcerative colitis in China]. PMID- 3319221 TI - [Progress in the pharmacological and clinical study of Yunnan baiyao]. PMID- 3319222 TI - [Current status of traditional Chinese medicine in the treatment of severe hepatitis]. PMID- 3319220 TI - [Effect of ginseng saponins on insulin release from isolated pancreatic islets in the rat]. PMID- 3319223 TI - A survey of chemicals inducing lipid peroxidation in biological systems. AB - A great number of drugs and chemicals are reviewed which have been shown to stimulate lipid peroxidation in any biological system. The underlying mechanisms, as far as known, are also dealt with. Lipid peroxidation induced by iron ions, organic hydroperoxides, halogenated hydrocarbons, redox cycling drugs, glutathione depleting chemicals, ethanol, heavy metals, ozone, nitrogen dioxide and a number of miscellaneous compounds, e.g. hydrazines, pesticides, antibiotics, are mentioned. It is shown that lipid peroxidation is stimulated by many of these compounds. However, quantitative estimates cannot be given yet and it is still impossible to judge the biological relevance of chemical-induced lipid peroxidation. PMID- 3319224 TI - The role of lipid peroxidation in liver damage. AB - The consequences of the peroxidative breakdown of membrane lipids have been considered in relation to both the subcellular and tissue aspects of liver injury. Mitochondrial functions can be impaired by lipid peroxidation probably through the oxidation of pyridine nucleotides and the consequent alteration in the uptake of calcium. Several enzymatic functions of the endoplasmic reticulum are also affected as a consequence of peroxidative events and among these are the activities of glucose 6-phosphatase, cytochrome P-450 and the calcium sequestration capacity. Moreover, a release of hydrolytic enzymes from lysosomes and a decrease in the fluidity of plasma membranes can contribute to the liver damage consequent to the stimulation of lipid peroxidation. Extensive studies carried out in vivo and integrated with the use of isolated hepatocytes have shown that lipid peroxidation impairs lipoprotein secretion mainly at the level of the dismission from the Golgi apparatus, rather than during their assembly. However, such an alteration appears to give a late and not essential contribution to the fat accumulation. A more critical role is played by peroxidative reactions in the pathogenesis of acute liver necrosis induced by several pro-oxidant compounds as indicated by the protective effects against hepatocyte damage exerted by antioxidants. In addition, even in the cases where lipid peroxidation has been shown not to be essential in causing cell death there is evidence that it can still act synergistically with other damaging mechanisms in the amplification of liver injury. PMID- 3319225 TI - Glutathione depleting agents and lipid peroxidation. AB - The mechanisms by which glutathione (GSH) depleting agents produce cellular injury, particularly liver cell injury have been reviewed. Among the model molecules most thoroughly investigated are bromobenzene and acetaminophen. The metabolism of these compounds leads to the formation of electrophilic reactants that easily conjugate with GSH. After substantial depletion of GSH, covalent binding of reactive metabolites to cellular macromolecules occurs. When the hepatic GSH depletion reaches a threshold level, lipid peroxidation develops and severe cellular damage is produced. According to experimental evidence, the cell death seems to be more strictly related to lipid peroxidation rather than to covalent binding. Loss of protein sulfhydryl groups may be an important factor in the disturbance of calcium homeostasis which, according to several authors, leads to irreversible cell injury. In the bromobenzene-induced liver injury loss of protein thiols as well as impairment of mitochondrial and microsomal Ca2+ sequestration activities are related to lipid peroxidation. However, some redox active compounds such as menadione and t-butylhydroperoxide produce direct oxidation of protein thiols. PMID- 3319226 TI - Pathobiochemical mechanisms of hepatocellular damage following lipid peroxidation. AB - In hepatocytes, cytotoxic events induced by haloalkanes or acute iron-overload exhibit neither a quantitative nor a temporal correlation to lipid peroxidation or covalent binding. Thus, secondary pathological mechanisms have been postulated linking initial focal reactions of free radicals and end stage pathological consequences. Due to the crucial role of plasma-membrane integrity in the cytotoxic process it has to be supposed that relevant secondary pathological mechanisms finally impair the physico-chemical and functional properties of this membrane. Based on recent developments a chain of causality is proposed as a two step activation of phospholipase A2 producing cytolytic amounts of lysophosphatides. In this cascade, the initial activating step is a decrease of membrane lipid fluidity induced by lipid peroxidation and/or by calcium binding and intramembranous formation of 4-hydroxynonenal. This enzyme activation is further amplified by the early rise of cytosolic calcium. Consequently, increasing amounts of lysophosphatides progressively impair membrane configuration thus improving the substrate accessibility for phospholipase A2 in a second activation step. Finally, the lysophosphatides reach plasma membrane lytic concentrations by this autocatalytic enzyme activation. PMID- 3319227 TI - Lipid peroxidation and associated hepatic organelle dysfunction in iron overload. AB - Iron overload can have serious health consequences. Since humans lack an effective means to excrete excess iron, overload can result from an increased absorption of dietary iron or from parenteral administration of iron. When the iron burden exceeds the body's capacity for safe storage, the result is widespread damage to the liver, heart and joints, and the pancreas and other endocrine organs. Clear evidence is now available that iron overload leads to lipid peroxidation in experimental animals, if sufficiently high levels of iron are achieved. In contrast, there is a paucity of data regarding lipid peroxidation in patients with iron overload. Data from experiments using an animal model of dietary iron overload support the concept that iron overload results in an increase in an hepatic cytosolic pool of low molecular weight iron which is catalytically active in stimulating lipid peroxidation. Lipid peroxidation is associated with hepatic mitochondrial and microsomal dysfunction in experimental iron overload, and lipid peroxidation may underlie the increased lysosomal fragility that has been detected in homogenates of liver samples from both iron-loaded human subjects and experimental animals. Some current hypotheses focus on the possibility that the demonstrated functional abnormalities in organelles of the iron-loaded liver may play a pathogenic role in hepatocellular injury and eventual fibrosis. The recent demonstration that hepatic fibrosis is produced in animals with long-term dietary iron overload will allow this model to be used to further investigate the relationship between lipid peroxidation and hepatic injury in iron overload. PMID- 3319228 TI - Ferritin and haemosiderin in free radical generation, lipid peroxidation and protein damage. AB - Iron storage proteins, ferritin and haemosiderin, release iron to a range of chelators and reducing agents, including citrate, acetate and ascorbate. Released iron promotes both hydroxyl radical formation in the presence of hydrogen peroxide and lipid peroxidation in liposomes. Ferritin protein is modified in such reactions, both by free radical cleavage and addition reactions with aldehyde products of lipid peroxidation. PMID- 3319229 TI - Lipid peroxidation in erythrocytes. AB - Erythrocytes might be expected to be highly susceptible to peroxidation. Their membranes are rich in polyunsaturated fatty acids; they are continuously exposed to high concentrations of oxygen; and they contain a powerful transition metal catalyst. In fact, autoxidation is held in check in vivo by extremely efficient protective antioxidant mechanisms. These involve cellular enzymes such as superoxide dismutase and glutathione peroxidase, as well as vitamin E; but they mainly reflect effective structural compartmentalisation. This review surveys mechanisms which lead to red cell lipid autoxidation and the role of haemoglobin in these processes. The influence of haemoglobinopathies, of lipid composition and of abnormalities in antioxidant mechanisms induced by exogenous oxidant stress is also considered. PMID- 3319230 TI - Effects of polyunsaturated fatty acids and of their oxidation products on cell survival. AB - The stimulatory, cytostatic and cytotoxic effects of polyunsaturated fatty acids, prostaglandins, thromboxanes, hydroperoxy fatty acids, hydroxy fatty acids and leukotrienes on normal and tumor cells are described. Their effects are related to the ability of the cells to undergo lipid peroxidation. The significance of controlled peroxidation of selected polyunsaturated fatty acids in the control of tumor development is examined. It is suggested that selected polyunsaturated fatty acids if used at appropriate concentrations may have a protective role against cancer development by inducing and/or mediating cytotoxic reactions in malignant cells directly or indirectly through the intermediacy of immune cells. PMID- 3319232 TI - Lipid peroxides and human diseases. AB - Development of a simple and reliable method to determine the lipid peroxide level in human serum or plasma has made it possible to survey the levels in human diseases. Since in some human diseases lipid peroxides are increased in various organs or tissues and leak into the bloodstream, the increased lipid peroxide level in the blood aids the diagnosis of such diseases. Furthermore, determination of the level provides useful information as to their prognosis, since the increased lipid peroxides in the blood primarily attack the endothelial cells of vessels and then intact organs or tissues as well. The present paper describes a method to determine the lipid peroxide level in human serum or plasma and its profile of change in several human diseases. Intervention of lipid peroxides in the pathogenesis of certain diseases is also mentioned. PMID- 3319231 TI - Modification of human serum low density lipoprotein by oxidation- characterization and pathophysiological implications. AB - Plasma low density lipoprotein (LDL) can undergo free radical oxidation either catalyzed by divalent cations, such as Cu2+ or Fe2+ or promoted by incubation with cultured cells such as endothelial cells, smooth muscle cells and monocytes. The content of vitamin E, beta-carotene and unsaturated fatty acids is decreased in oxidized LDL. A breakdown of apolipoprotein-B (apoB), hydrolysis of the phospholipids, an increase of thiobarbituric acid reactive substances and the generation of aldehydes also occur. Changes in the ratio of lipid to protein, the electrophoretic mobility and the fluorescent properties have also been reported to accompany oxidation of this lipoprotein. The functional changes of oxidized LDL include its recognition by the scavenger receptor on macrophages, its cytotoxicity especially to proliferating cells, its chemotactic properties with respect to monocyte-macrophages and its regulation of platelet-derived growth factor-like protein (PDGFc) production by endothelial cells. In this article we summarize some of the contributions to this topic and present speculations relating oxidized LDL to pathological conditions such as atherosclerosis. PMID- 3319233 TI - The experimental and clinical pathology of diene conjugation. AB - The simple spectroscopic measurement of diene conjugation has long been an established but somewhat problematic marker of free-radical activity in biological systems. The main diene-conjugated compounds in human tissues and tissue fluids have now been identified as esters of octadeca-9,11-dienoic acid (18:2(9,11)), a non-peroxide isomer of linoleic acid (18:2(9,12)); and a range of high-performance liquid chromatographic methods has been developed for their detection and measurement. Significant abnormalities of phospholipid-esterified 18:2(9,11) have been found in the serum of chronic alcoholics and in paraquat poisoning and of non-esterified 18:2(9,11) in lipolytic states. The phospholipid esterified 18:2(9,11) is increased in the bile of patients with pancreatic disease. In exfoliated cells from the cervix uteri an abnormal molar ratio between phospholipid-esterified 18:2(9,11) and 18:2(9,12) may prove to be the most sensitive biochemical marker of precancerous change. PMID- 3319234 TI - [Segmental transplantation of the pancreas in juvenile diabetes: clinical experience at the Munich Transplantation Center]. AB - The authors report their data relating to the first combined kidney-pancreas transplants performed at the Munich University Transplant Centre in the years 82 84 and discuss the main technical aspects of explantation and implantation surgery in these cases as well as the results obtained. PMID- 3319235 TI - [Subclavian and innominate steal syndrome (our experience with 29 patients)]. AB - Subclavian steal syndrome and innominate steal syndrome are well-known reasons of cerebral vascular insufficiency. Today this pathology can be corrected by extra anatomic by-passes. In our experience in recent years (1980-1986) these by-pass (in our patients carotid-subclavian and subclavian-subclavian by-pass) gave very good outcomes. These are simple and poor-risk operations. Their patent after many years is very good. PMID- 3319236 TI - [Arterial aneurysms of the upper limbs (our experience and review of the literature)]. AB - The authors discuss about the very low incidence of the upper extremities aneurysms and about their post-traumatic etiology. They show their experience in 6 cases with a Follow up from 2 to 17 years. All the patients were operated on; in 2 cases the authors performed aneurysmectomy only and in 4 cases an axillo brachial by-pass. The results are very good in every patient. PMID- 3319237 TI - [Analysis of 101,379 cases hospitalized for calculi of the bile dusts in the Region of Piedmont]. AB - In a study from hospitals in Piemonte (Italy) were identified (from 1976 to 1981) 101,379 recovery for cholelitiasis. Among this group we have examined some factors like sex, age, residence, surgical procedures, etc. It is concluded that there is a continuous decreased in cholecistectomy rate and that can be explained by a simultaneous rise of new instrumental and farmacological procedures in the treatment of this pathology. PMID- 3319238 TI - [Cancer of the rectum: analysis of incidence and survival at the Casale Monferato Provincial Hospital]. AB - Between 1978 and 1984, 34 patients carrier of rectal neoplasms, were observed and treated in Divisione di Chirurgia Generale of Casale Monferrato Hospital. Twenty of such patients had been operated with curative procedures and 14 with palliative procedures. At the moment of this investigation 14 patients were still alive. The survival rate at 5 years, referred to '78, '79, '80, '81, respectively was 37.2%. For the last three years, the fifth year delay time shall be waited. The survival rates per year, have been reported her, for the whole period of the investigation. The AA, have evaluated the gross incidence rate for male and female patients (3.1 and 2.1 respectively). Survival and incidence data have been composed to those reported in the literature. Whilst survival rates agree with those from other authors, the incidence rates result considerably lower than those from other West Countries. It could be abscribed to an underestimation of the actual number of rectal neoplasm bearing patients, which could escape the investigation because diagnosticed and treated elsewhere. It should be noted nevertheless that the Casale Hospital supplies a scarcely industrialized urban area, and a wide rural environment, so that resident population might be included within one of the groups partially protected by environmental and alimentary conritions against the disease. In conclusion the AA. consider of a primary importance the development of centres suitable for base medicine aimed at assuring a real and effective prevention activity. PMID- 3319239 TI - [The varicocele today (anatomic and physiopathologic aspects)]. AB - Primary varicocele is a very important clinical form in establishing of male infertility. It's origin is'nt ever caused by anatomical alterations of internal spermatic vein. Clinical picture is always joined with histopathological alterations of various degree, which, partial and in concomitance with hemodynamic disorders, explains the arising of spermatogenesis alterations. PMID- 3319240 TI - [Malignant tumors of the breast: instrumental diagnosis]. AB - Nowadays mammary cancer is still the principal cause of neoplastic deaths of females. Early diagnosis, through the complementary use of the various diagnostic techniques, is fundamental to improve the prognosis. PMID- 3319241 TI - [Non-specific solitary ulcer of the transverse colon (presentation of a case and review of the literature)]. AB - In the light of findings emerging from a critical review of the literature, the Authors present a case of solitary non-specific ulcer of the transverse colon successfully treated by surgery. The various pathogenetic theories are examined, and the diagnostic work-up to which the patient must be subjected is discussed. The study concludes with a description of the choice of therapy. PMID- 3319242 TI - [Parapyelic cysts]. AB - The Authors present four cases of major pyelocaliceal obstruction secondary to parapelvic cyst. The treatment was surgical in all four cases and consisted in the cruentation of the wall of the cyst. PMID- 3319244 TI - [Hepatic angioma: a bothersome presence during staging of neoplasms of the digestive system]. AB - On reviewing a consecutive series of 1,200 ultrasonic tomographies of the liver to assess the incidence of liver angiomas, the authors describe their sonographic, tomodensitometric and angiographic characteristics. They emphasise the fact that such lesions, though usually not constituting a serious clinical or diagnostic problem, as a simple sonographic follow-up will suffice to clarify the situation, may nevertheless, in certain particular clinical situations such as in the course of tumour staging of the digestive apparatus, require full diagnostic investigation using all the techniques available (ultrasonic tomography, CAT, liver arteriography, sonographically guided thin-needle biopsy. PMID- 3319243 TI - [Retroperitoneal neurilemmoma (anatomo-pathologic and clinical considerations)]. AB - After extensively reviewing the literature on primary retroperitoneal tumours, the authors present a case of retroperitoneal neurilemmoma. They stress the rareness of this disease and go on to discuss the related epidemiological, histogenetic and anatomo-pathological problems. Finally, they deal at some length with the symptoms of the disease and the diagnostic strategy they adopt, emphasizing the usefulness of CT and ultrasonic tomography in the study of the retroperitoneal region. PMID- 3319245 TI - [Partial splenectomy for epidermoid cysts of the spleen in children. Apropos of 3 cases]. AB - Three cases of epidermoid cyst of the spleen treated by partial splenectomy are reported on children. The diagnosis rests now on the ultrasonography. The operative indication is systematic because of the risks of complication. The polar localisation of the cysts permits one to make a conservative surgery. The partial splenectomy is a technique of choice in this benign tumoral pathology. Postoperative digital intravenous subtraction angiography demonstrated the good vascularization of the remaining part of the spleen. PMID- 3319246 TI - [Anorectal manometry. Practical use in a pediatric surgical clinic]. AB - Over a series of 158 cases of anorectal manometry the authors describe the technique used in a general pediatric surgery department. Results are reported in Hirschsprung's disease specially in the neonatal period, chronic constipation, fecal incontinence after anorectal malformations and meningomyelocele, encopresis. Biofeedback was performed in 28 patients. Technique varies with the etiologies and results are reported. Anorectal manometry to be effective must be simple, reliable, safe and non invasive. The reported technique seems effective for this goal. PMID- 3319247 TI - [Pancreatitis and choledochal cyst]. AB - A six years old girl was rushed to hospital with an acute abdomen. Because of the age of the patient, the clinical examination and the usual biology we diagnose an acute appendicitis. The fortuitous measuring out of the pancreatic enzymology allows us to correct our first diagnostic into the one of pancreatitis with angiocholitis. The check-up shows a congenital choledochal cyst with an abnormality of the choledochus-Wirsung junction explaining the physiological pathology presented. The surgical operation was made up of an cystectomy with cholecystectomy and hepatico-jejunostomy according to an Y shaped loop from Roux. Pancreatitis diagnostic is unusual in childhood, there is a good reason to suspect in those circumstances the existence of a choledochal cyst. PMID- 3319248 TI - Traditional medicine and belief in customs affecting the health of the people in Malawi (formerly Nyasaland) from 1860 to 1927. PMID- 3319249 TI - [Drug sensitivity of malaria in a population of children in Pointe-Noire, Congo, in the first half of 1986]. AB - The study by an isotopic semi-microtest of the sensitivity of 44 P. falciparum strains isolated from Congolese children living in Pointe-Noire demonstrated a high prevalence of chloroquine resistance and partial cross resistance to monodesethylamodiaquine. The sensitivity to quinine was high except for 3 isolates. The assay of amino-4-quinolines by H. P. L. C. on 37 subjects revealed the extent of self-treatment and drug-pressure in this population. A 3-day treatment with 25 mg/kg of chloroquine or amodiaquine in 24 subjects resulted in the disappearance of clinical symptoms in all patients and a parasitological cure on day 7 in 75%. The partial maintenance of efficacy of amino-4-quinolines in this chloroquine-resistant region implies that chloroquine and amodiaquine can be used as first choice drugs for uncomplicated acute malaria, but on condition that the levels of resistance and transmission are monitored. PMID- 3319251 TI - [Status of drug resistance of Plasmodium falciparum in the Central African Republic. Results of studies carried out between 1984 and 1986]. AB - Since August 1983, several cases of chloroquine resistant malaria have been observed in caucasian adults living in the Central African Republic (CAR) despite an antimalarial prophylaxis. Between 1984 and 1985, several studies including both in vitro and in vivo tests have been undertaken in cohorts of children to determine antimalaria drug sensitivity of P. falciparum in two towns of the CAR. In Bangui, out of 60 asymptomatic schoolchildren with asexual parasite count per mm3 of blood equal (or more than) 1,000, treated using a single intake of chloroquine at a dose of 10 mg/kg, three had asexual parasites at day 7 after drug administration. Alternatively, out of 57 other children with clinical malaria treated using a total dose of 25 mg/kg of chloroquine daily distributed within a 3 day period, only one exhibited a RII resistance. In vitro tests performed in a limited cohort of 15 school children showed a high sensitivity to chloroquine, amodiaquine, quinine and mefloquine in P. falciparum malaria. In Bouar, a group of 80 preschool children attending pediatric clinic were treated using either a single dose of 10 mg/kg of chloroquine (25 children) or 25 mg/kg of amodiaquine (21 cases) or 25 mg/kg of chloroquine (34 cases) within a three days period. Asymptomatic parasitaemia persisted or reappeared in 6 children all treated with 10 mg/kg of chloroquine. Therapeutic response to amino-4-quinolines in central african children is up to now satisfactory as compared to that observed in surrounding countries. Further surveys including other rural and urban areas are needed to appreciate the evolution of the phenomenon. PMID- 3319250 TI - [Drug resistance of Plasmodium falciparum in the Congo. 2. Comparative study in vivo of chloroquine and amodiaquine in Brazzaville schoolchildren (November 1986)]. AB - This study was conducted in Brazzaville, the capital of Congo, for the purpose of assessing the resistance to chloroquine and amodiaquine of Plasmodium falciparum. 64 in vivo tests using the WHO protocol--trial period 7 days after administration over 3 days of a dose of 25 mg/kg (N = 31 for chloroquine, 33 for amodiaquine)- were performed in schoolchildren aged 6 to 7 years, with parasite counts of at least 1,000 trophozoites/mm3. The respective percent resistance was found to be 38.7% (9.7% at the RII level, 29% at the RI level) for chloroquine and 21.2% (3% at the RII levels, 18.2% at the RI level) for amodiaquine. Based on these percentages and levels of resistance, and on changes in parasite counts, amodiaquine does not appear to be more efficacious. The emergence and rapid simultaneous spreading of resistance to these two drugs are discussed. PMID- 3319252 TI - [Drug resistance of Plasmodium falciparum malaria in Equatorial Africa. Apropos of cases observed at a military unit stationed in Gabon]. AB - The existence of Plasmodium falciparum chloroquine-resisting clones in equatorial Africa is quite a recent event. Among a French military unit of 138 people who had lived in Gabon from April to August 1986, 24 of them have caught malaria due to Plasmodium falciparum. This allows us to perceive the impact of this event because of the perfect control of chloroquine prophylaxis and the good knowledge of all the attacks of fever which occurred in the field. Admitting 10 of those people into the department of internal medicine of the Military Hospital Desgenettes located in Lyons, we could have seen that trophozoites of Plasmodium falciparum were still persisting 2 months after their return for 8 of them in spite of carrying on chemoprophylaxis. Observing that in the field, sets the problem of the chemoprophylaxis of malaria for the troops maneuvering in chloroquine-resisting areas and warrants, if justified, a work protocol aimed at solving it. PMID- 3319253 TI - [2 cases of multiresistant Plasmodium falciparum malaria contracted in Douala with atypical clinical presentation]. AB - We present two cases of Plasmodium falciparum malaria contracted in Douala despite adequate prophylaxis by Fansidar for one and by chloroquine for the other. Failure of curative treatment by Fansidar for the first case (in vitro chloroquine-resistant strain) and by amodiaquine plus erythromycin for the second. After these therapeutic failures, both patients presented without fever, but with splenomegaly and anaemia. The successful therapeutic was mefloquine. PMID- 3319254 TI - [New focus of chloroquine-resistant malaria in a forestry zone in Cameroon]. AB - In vitro sensitivity of P. falciparum to chloroquine and quinine was studied in Hevecam rubber plantations of la Nyete in Cameroon, located at 45 km in the south east of Kribi in a forest area. More than half of the isolates studied (14/25) were resistant to chloroquine (EC50 greater than 80 nmole/l). The mean EC50 and EC99 were 113 nmole/l and 4,110 nmole/l respectively. The sensitivity to quinine was decreased, as compared to other area of the country. Kribi is the third area of chloroquine-resistance known in Cameroon. PMID- 3319255 TI - [A case of chloroquine-resistant malaria of type R3 originating in Cameroon]. AB - World areas with chloroquine-resistant falciparum malaria are progressively spreading, in Africa from East to West. We are reporting here a new case of resistance, grade III, from Cameroon, carried out in vitro by the WHO standard macrotest. Resistance is determined by the ability of trophozoites to develop into schizonts when therapeutic doses of chloroquine have been administered. PMID- 3319256 TI - [The OCCGE (Organisation de Coordination et de Cooperation pour la Lutte contre les Grandes Endemies) and the surveillance of the drug sensitivity of Plasmodium falciparum to antimalarials]. AB - Spreading of chemoresistance from East Africa to Central Africa is a very worrying problem for Western Africa. In fact, chemotherapy of febrile attacks is at present admitted as malaria control strategy in the framework of Primary Health Care. This new strategy is based on the fact that commonly used antimalarial drugs as chloroquine are surely efficacious. Thus, the surveillance of chemosensitivity of Plasmodium falciparum local strains becomes a priority. From studies carried out in Burkina Faso during many years, Centre Muraz of O.C.C.G.E. has organized a surveillance system with several levels: a Reference Center, a National Center for each country and sentinel centers located in the different epidemiological features of the countries. This surveillance concerning many states can allow to detect more quickly some possible problems in relation with chemoresistance and to take measures to limit its impact. PMID- 3319257 TI - [Surveillance of the sensitivity of Plasmodium falciparum to chloroquine in Western Africa: value of in vivo tests using 5 and 10 mg/kg]. AB - Studies on the in vivo sensitivity of Plasmodium falciparum strains to chloroquine were carried out on shrub savanna areas of Burkina Faso, West Africa and were conducted from 1982 to 1986 in asymptomatic malarial school children. From the result of 431 in vivo tests using a single dose of only 5 or 10 mg/kg b. w. chloroquine base, it was concluded that there was a high sensitive response of P. falciparum to chloroquine. In areas where clinical resistance has not been established, and where there is a high sensibility in the response of P. falciparum to chloroquine, in vivo studies with a single dose of 5 or 10 mg/kg are probably able to detect a decrease of sensitivity before the appearance of clinical resistance to higher regimens. PMID- 3319258 TI - [Sensitivity of Plasmodium falciparum to quinolines and therapeutic strategies: comparison of the situation in Africa and Madagascar between 1983 and 1986]. AB - One thousand and twenty six P. falciparum strains isolated from cases imported in France and field surveys in four regions of Africa and Madagascar were studied in vitro against chloroquine, monodesethylamodiaquine, quinine and mefloquine, 917 in vivo tests were performed during field studies with chloroquine (10 and 25 mg/kg) and amodiaquine (10, 25, 35 mg/kg). In Madagascar, the chemoresistance remained low and stable during the study period, concerning mostly chloroquine (11% in vitro and in vivo) without obvious geographical variation. 25 mg/kg chloroquine or amodiaquine were satisfactory as respectively first and second line therapeutic regimen. In Central Africa, chemoresistance emerged with an epidemic profile and increased dramatically in disseminated urban focus. High level and prevalence of chloroquine resistance and multiresistance were observed few months after the index cases in these foci. In South West Cameroon, amodiaquine remained efficient as curative treatment but only at a dose of 35 mg/kg/5 days. Decrease of in vitro sensitivity and in vivo efficacy of quinine is a matter of concern. Given the heterogeneous and evolutive situation of drug resistance, the need for epidemiological surveillance and monitoring of P. falciparum drug sensitivity in Africa is obvious to adjust therapeutic regimen. PMID- 3319259 TI - [Development of drug resistance in cases of P. falciparum malaria of African origin in a Parisian hospital. Comparison with field data and therapeutic consequences]. AB - The number of P. falciparum malaria cases, contracted in Africa, diagnosed by the department of Parasitology and Tropical diseases of the Pitie-Salpetriere Hospital Group has shown a significant increase in 1985-1986 when compared with the 15 past years (+23%). This fact is related to the spread of chloroquine or amodiaquine resistant falciparum malaria from East Africa (1980-1983: 54%) to Central Africa (1985: 54.5%) and now to a country of west Africa (Benin 1986). PMID- 3319262 TI - [Pitfalls in inquiries relating to malaria]. AB - In two cases of Plasmodium falciparum which could suggest a time interval of three and four years between departure from endemic area and onset of malaria symptoms, the authors insist on the fact that epidemiologic study must be very rigorous. PMID- 3319260 TI - [Current aspects of imported drug-resistant Plasmodium falciparum]. AB - 24 cases of Plasmodium falciparum malaria in a group of 73 non-immune subjects coming mostly from central Africa have been tested in vitro for chloroquine sensitivity: 5 are sensitive, 19 are resistant among whom one is also quinine resistant. The comparison of the major clinical and biological features in the two groups by methods of statistical calculation shows that the parasitological diagnosis is retarded and that hemolysis is more frequent in the strains of Plasmodium falciparum resistant to chloroquine. Thrombopenia is more frequent with chemosensitives strains. In any case, the delay between the first symptoms and the parasitological diagnosis is increased with an average of 17 days in comparison to what was observed in the 1970's. Under the influence of several complex factors including human ones, the clinical aspects are changed in comparison to forms usually observed. In this context of an extension of the emergence of the chemoresistance and in the aim of efficiency, only the quinine I.V., with an average dose of 16.5 mg/kg per day of quinine-base, has been chosen as a curative treatment during 5 days allowing a rapid recovery without after effects for all the cases. PMID- 3319261 TI - [Studies on malaria in a mosaic forest-savanna zone in Central Africa, Brazzaville region. II. Parasite density]. AB - Malaria is holoendemic in rural areas in the Brazzaville region: according to the villages, the crude parasite rate in schoolchildren varies from 81% to 94%. Prevalence of classes 3 to 5 parasite densities is high until the age of 15 (41% 63%) and appears to reflect the entomological inoculation rate. Parasite rates and densities in young children are lower than expected. This is probably due to the widespread use of antimalarials by this age-group. PMID- 3319263 TI - [Malaria, anemia and nutritional status: longitudinal study of their interaction in a sahelian zone (Senegal)]. AB - Two villages in the sahelian zone of the Senegal river Basin, were surveyed during one year. On 5 occasions (May, July, October 1982, January, March 1983) 200 persons were clinically examined and a parasitological (parasite rate and specific antibodies), haematological and biochemical examination was done. At the same time an entomological survey was performed. The two vectors were Anopheles gambiae ss. and A. arabiensis with a predominance of the first. Although the number of infective bites is low, the transmission risk is high, at least one a year. The parasite rate is low (15%) with almost no seasonal variation although transmission occurs only during 3-4 months. Correspondingly low titres of malaria antibodies are present. The nutritional status of the population is on the limit of normal. It was not possible to make significant correlations between malaria and the nutritional status except for anaemia where evolution seems to be more related to malaria than to nutrition. PMID- 3319264 TI - [Value of exchange transfusion in the treatment of severe malaria (apropos of 5 cases)]. AB - Five imported falciparum malaria cases with severe evolution are reported. Treatment associated a blood exchange transfusion and an antimalaria chemotherapy (mefloquine in three patients and quinine in two patients). All patients were successfully cured despite of serious visceral complications occurring in two patients (pulmonary and cerebral oedema). Technical management of treatment is detailed. Exchange transfusion should be considered in falciparum malaria when parasitaemia overcomes 20% and when serious visceral impairment, hemolysis or consumption coagulopathy are occurring. PMID- 3319265 TI - [Malaria prevention today and tomorrow]. AB - Individual chemoprophylaxis against malaria remains mandatory for all trips of brief or intermediate duration in endemic areas. The selected anti-malarial drug must be taken regularly from the beginning of the stay, during the stay and for the 30 days after return (The 30 days following the departure from regions at risk). Presently the following drugs are available: amino-4-quinolines, quinine, antifolinic agents, the association antifolinic-antifolic agents and mefloquine. Specific advantages, side-effects and adverse reactions, as well as dosage used for prophylaxis are given for each drug. The risk of agranulocytosis and severe hepatitis related to amodiaquine forbids its use until more information has become available. The association sulfadoxine + pyrimethamine is no longer recommended for prophylaxis by the French authorities and recently by the W.H.O., because of its potential, although seldom, risk of severe muco-cutaneous disorders. Detailed schemes of prophylaxis are given; they rely on sensitivity or resistance of Plasmodia strains, the length of the stay in at risk areas, and the local situation concerning the hazard of infection and drug resistance of Plasmodia. Chloroquine must be used in priority in areas characterized by sensitivity or low grade resistance to chloroquine. In order to avoid resistance to mefloquine, its administration has to be limited to prophylaxis for short stays and to the treatment of attacks resulting from infections acquired in areas known for resistance against the other drugs. Today, indeed, mefloquine is the single agent efficient in case of multiresistance to Plasmodium falciparum. The treatment of suspected or proved cases of malaria attacks occurring in temporary or permanent expatriates or in local, semi-immune residents, has become strongly advisable. In areas of resistance to chloroquine, either quinine (repeated injections), sulfadoxine-pyrimethamine (per os or unique parenteral injection) or if possible, mefloquine (full dose during 1 day) are to be used for the therapy of acute attacks. Continuous chemoprophylaxis is no longer encouraged for populations living in holoendemic areas. Treatment of suspected or overt malaria crises is, however, mandatory. The limitation to curative therapy is opening the way to more specific prophylaxis: pregnancy, delivery, intercurrent pathological events, such as surgery, trauma, infection... It is hoped that, until the forthcoming of anti-malaria immunoprophylaxis, these newly adjusted designs for chemotherapy will help to keep the progress of malaria and the development of plasmodial resistance under control. PMID- 3319266 TI - Smallpox and its post-eradication surveillance. PMID- 3319267 TI - [Radiation and health]. PMID- 3319270 TI - Principles and lessons from the smallpox eradication programme. AB - The eradication of smallpox required a unique, fully collaborative international effort on the part of WHO and Member States. In the course of the programme, many lessons were learned in its organization, execution and evaluation which have implications for other international activities. Most important among these was the need to establish measurable objectives and to evaluate progress and performance in terms of these; to establish procedures for quality control both of vaccines and performance; to recruit the best possible personnel and support them; and to assure an on-going programme of problem-oriented research which can facilitate activities and resolve apparently paradoxical observations. The inherent capacities of national health services to execute their smallpox eradication programmes was gratifying. It encouraged the belief that other, more complex health measures could be undertaken. Although this would necessitate that adequate numbers of competent leaders be recruited and given delegated responsibility, such persons were usually found to be available although often inexperienced. WHO's roles in catalysing and orchestrating this great effort were critical. Its potential for promoting other efforts in disease prevention and health promotion was apparent although still only partially realized. PMID- 3319269 TI - A collaborative study of an experimental kit for rapid rabies enzyme immunodiagnosis (RREID). AB - Six laboratories took part in a study to assess an experimental kit for the diagnosis of rabies using the rapid rabies enzyme immunodiagnosis (RREID) technique. The test is based on the immunocapture of rabies antigens present in homogenized brain specimens, followed by enzyme immunoassay. A total of 1253 specimens from various geographical locations and 27 animal species were tested with the RREID technique, and also with the fluorescent antibody test (FAT), which was used as a reference method. For 1220 specimens the results in RREID and FAT were the same (651 positive and 569 negative-concordance: 97.4%). However, the RREID technique appeared to be less sensitive, since 22 (3%) of the 673 specimens that were positive with FAT were negative with RREID. The RREID test is therefore specific and convenient and is a useful tool for epidemiological studies and for laboratories not equipped with an ultraviolet microscope. PMID- 3319268 TI - Immunology of HIV infection and AIDS: memorandum from a WHO/IUIS meeting. PMID- 3319271 TI - Chemotherapeutic management of head and neck cancer. AB - The use of chemotherapy in patients with head and neck cancer is increasing. In patients with recurrent head and neck cancer, a large number of chemotherapeutic drugs have shown antitumor activity. These drugs are discussed, and factors which influence response rate and survival are examined. New agents and treatment, including specific agents for combination chemotherapy, are presented. There has been a search for new treatments or procedures in patients with previously untreated and locally advanced cancer of the head and neck. The results, including studies of combined modality therapy and chemotherapy after surgery, are discussed. Chemotherapy in tumor of the salivary glands is briefly discussed, followed by an examination of intra-arterial therapy. PMID- 3319273 TI - Structure-activity relations in carcinogenesis by N-nitroso compounds. AB - For a large number of N-nitroso compounds a comparison of their carcinogenic effects in rats and Syrian golden hamsters has been made. Nitrosamines, which require metabolic activation, and nitrosoalkylamides, which do not, produce quite different tumor responses. There are also large differences in the types of tumor induced in rats and in hamsters. In all the studies doses of the various compounds, equimolar to the extent that was possible, are administered orally. Continuous doses (in drinking water or food) often produce a response different from that after administration of the same compound in pulsed doses (by gavage), even though the same total dose is delivered. Continuous doses of nitrosamines are usually more effective than pulsed doses, but with the nitrosoalkylureas, the reverse is more generally the case. Rat and hamster liver is a common target of many nitrosamines, but rarely of nitrosamides. The most common site of tumor induction in rats by N-nitroso compounds is the esophagus, but the hamster esophagus never responds. The pancreas duct of the hamster is a common target of nitrosamines containing a beta-oxygenated propyl group, but pancreas duct tumors are never seen in rats. Nitrosomethyl-n-alkylamines (with an even numbered carbon chain) induce bladder tumors in rats and hamsters. Many nitrosoalkylureas induce tumors of the nervous system in rats, as well as a great variety of other tumors. In hamsters, nitrosoalkylureas give rise only to tumors of the forestomach and spleen, but no tumors of the nervous system. The similar carcinogenic actions of certain groups of N-nitroso compounds can be related to their generation, directly or by metabolism, of similar simple moieties having certain organs as their target. PMID- 3319272 TI - Drug resistance and DNA repair. AB - DNA repair confers resistance to anticancer drugs which kill cells by reacting with DNA. A review of our current information on the topic will be presented here. Our understanding of the molecular biology of repair of 0(6)-alkylguanine adducts in DNA has advanced as a result of the molecular cloning of the E. coli ada gene but the precise role of this lesion in the cytotoxic effects of alkylating agents in mammalian cells is not completely understood. Less progress has been made in understanding the enzymology and molecular biology of DNA cross link repair even though such lesions are important for the cytotoxic effects of the widely used bifunctional alkylating agents and platinum compounds. It is evident that drug sensitive or resistant phenotypes are as highly complex as are the effects of DNA damage on cell metabolism and various aspects of these effects are discussed. Few clear correlations have been made between quantitative differences in DNA repair capacity and cellular sensitivity but assays which were developed to measure fidelity and intragenomic heterogeneity in DNA repair are beginning to be applied. Such studies may reveal subtle differences between sensitive and resistant cell lines. The molecular cloning of human DNA repair genes by transfection into drug sensitive rodent cells has been attempted. Some success has been achieved in this area but the functions of the cloned genes have yet to be identified. PMID- 3319274 TI - The pros and cons of fecal occult blood testing for colorectal neoplasms. AB - Testing feces for occult blood is widely recommended as a means of detecting subclinical colorectal tumors. Guaiac tests such as Hemoccult are the most widely used, but chemical sensitivity is relatively low and the tests are affected by dietary peroxidases, the state of fecal hydration, and certain drugs. The newly devised HemoQuant and immunologic techniques appear more sensitive and specific, but they require further evaluation before widespread clinical usage can be recommended. Occult blood screening has both merits and weaknesses. Testing does uncover subclinical colorectal cancer, often at a relatively early stage, but whether this actually improves the prognosis remains to be proven. Benign neoplastic polyps are also detected, although it is debatable whether this is a valid rationale for screening. Test sensitivity for malignancy varies from good to moderate, but is poor for benign polyps. Specificity is usually around 97% 98%, yet the predictive value of a positive test for cancer is only about 10%; hence most test-positive individuals are needlessly subjected to invasive colonic investigations. Reported figures on public compliance with occult blood testing vary widely from excellent to poor. Published costs of screening are usually quite low, but these overlook important indirect and hidden expenses and are therefore misleading. On balance, the problems of occult blood testing currently appear to outweight the merits. This could change, however, with the newer testing techniques and with awaited mortality data from controlled clinical trials now underway. PMID- 3319277 TI - In vitro stability, plasma protein binding and blood cell partitioning of 14C carboplatin. AB - Radiochemically pure 14C-labeled carboplatin, cis-diammine [1,1-cyclobutane (1 14C) dicarboxylato (2-)-0,0'] platinum (II), was added to fresh human, dog and rat plasma, at concentrations ranging from 1 to 100 micrograms 14C carboplatin/ml. After 10 min incubation at ambient temperature, the plasma was ultrafiltered in Amicon Centrifree micropartition units to generate protein-free plasma ultrafiltrate (PU). Total radioactivity was determined by liquid scintillation counting. A mean (+/- SD) of 102% +/- 2.0%, 99.5% +/- 1.9%, and 99.0% +/- 1.0% of the 14C-carboplatin added to fresh human, dog, and rat plasma respectively was recovered in the PU. 14C-carboplatin was incubated at 37 degrees C with fresh plasma (60 micrograms/ml) and urine (200 micrograms/ml) from humans and dogs for 120 h, and samples were removed at appropriate times for analysis of carboplatin, 1,1-cyclobutane dicarboxylic acid and cyclobutane carboxylic acid. The latter were separated by HPLC on a C-18 column with a mobile phase of H2O/CH3CN/0.3 M tetrabutylammonium phosphate (880:50:20 v/v/v), and the column eluants at the retention time of each compound were collected and counted for total radioactivity. Carboplatin degraded in each of the matrices with a corresponding release of 1,1-cyclobutane dicarboxylic acid. 14C-carboplatin (50 micrograms/ml) was incubated at 37 degrees C with fresh human, dog and rat blood and the distribution of radioactivity into the cellular fraction was determined. Radioactivity did not distribute into the blood cells of humans or dogs, but after 5 h, 44% of the radioactivity in rat blood was associated with the cellular fraction. These results show that carboplatin, at physiological concentrations, does not bind instantaneously and reversibly to the plasma proteins of rat, dog or human, and that the molecule slowly degrades in plasma and urine in vitro with the release of 1,1-cyclobutane dicarboxylic acid. The remaining diammine platinum (II) portion of the molecule therefore accounts for the essentially irreversible protein binding of the platinum from carboplatin. PMID- 3319275 TI - Hypersensitivity reactions from antineoplastic agents. AB - Antitumor drugs, like any other therapeutic agent, have the ability to incite hypersensitivity reactions. Certain of such drugs (e.g., L-asparaginase and taxol) cause reactions with great enough frequency to be a major impediment to repetitive use of the drug. Very few antitumor drugs have not had at least one reported instance of causing a hypersensitivity reaction. Most reactions are of the type I category in the Gell and Coombs classification, but there also are instances of types II, III, and IV reactions caused by many of the antineoplastic agents. The mechanisms of such reactions have been poorly evaluated in many reports. In analyzing a hypersensitivity reaction in a patient being treated for cancer, one should document that the antitumor drug is indeed the offender, and not an ancillary drug or a formulation product that is being used. There are many tests that evaluate the source and mechanism of hypersensitivity reactions. This article reviews the current information on hypersensitivity reactions to antineoplastic drugs and provides a logical approach for their assessment. PMID- 3319279 TI - Human immunoglobulin subclasses. PMID- 3319278 TI - Endotoxin-induced hemodynamic and prostaglandin changes in ponies: effects of flunixin meglumine, dexamethasone, and prednisolone. AB - Shock was induced in four groups of anesthetized ponies with an intravenous injection of Escherichia coli endotoxin [125 micrograms/kg]. Five minutes after endotoxin injection, the ponies were given no treatment (group A), flunixin meglumine (FM:1.1 mg/kg) (group B), dexamethasone (2 mg/kg) (group C), or prednisolone (10 mg/kg) (group D). Additionally, FM was given every 3 hours, and the steroids were given at 3, 9, and 24 hours following endotoxin. Hemodynamic measurements were made during the 4-hour anesthetic period. Blood samples were collected for the analysis of prostaglandins, blood chemicals, and enzymes until death. Microspheres labeled with one of four radionuclides were used to determine regional blood flow at 0, 0.1, 1, and 2 hours after endotoxin was given. Plasma levels of both thromboxane and prostaglandin I2 increased from less than 1 ng/ml to between 3 and 5 ng/ml following the injection of endotoxin. The elevated thromboxane corresponded with high pulmonary arterial pressure [between 35 and 55 mm Hg] and low mean systemic arterial pressure (between 40 and 65 mm Hg) during the first 5-10 minutes following endotoxin. Increased concentrations of prostaglandin I2 were temporally related to systemic arterial hypotension, which occurred 1-2 hours following endotoxin in all groups except group B. The rise of prostaglandin I2 and hypotension were not observed in the flunixin meglumine treated ponies. Dexamethasone was less effective, and prednisolone was ineffective in preventing the synthesis of prostaglandin I2 and the accompanying hemodynamic changes that occurred during the first 2 hours following endotoxin. This is probably due to the fact that steroids require a longer period of time before prostaglandin synthesis is reduced. Although not statistically significant, increased survival trends were observed in ponies treated with flunixin meglumine. PMID- 3319276 TI - Endogenous galactoside-binding lectins: a new class of functional tumor cell surface molecules related to metastasis. AB - The formation of secondary tumors by circulating cancer cells (blood-borne metastasis) correlates with an increased tendency of the cells to form emboli by aggregation with other tumor cells or with host cells. Although it is evident that cell-cell recognition and adhesion are mediated by cell surface components, the identity of these molecules is only now being unraveled. Over the last decade an increasing number of studies have demonstrated the presence of endogenous carbohydrate-binding proteins on the surface of various normal cells, and it has been proposed that such lectin-like molecules might be involved in intercellular adhesion. We have shown that various tumor cell lines contain endogenous galactose-specific lectins. Lectin activity was detected at the cell surface by the binding of asialofetuin. This glycoprotein also enhanced the aggregation of the tumor cells. After purification by affinity chromatography on immobilized asialofetuin the lectin activity was associated with two proteins of Mr 14,500 and 34,000. By using polyclonal and monoclonal antilectin antibodies in conjunction with various immunologic techniques we have demonstrated that the endogenous lectins are present on the surface of different tumor cells. Quantitation of cell surface lectins by flow cytometric analyses of antilectin antibody binding revealed that among related tumor cells those exhibiting a higher metastatic potential expressed more lectin on their surface. The binding of monoclonal antilectin antibodies to metastatic cells decreased asialofetuin induced homotypic aggregation in vitro and suppressed the ability of the cells to form lung metastases after intravenous injection in the tail vein of syngeneic mice. These results strongly implicate the tumor cell surface lectins in cell adhesion and metastasis. We propose that such lectins can increase the ability of tumor cells that enter the blood stream to form aggregates with other tumor cells, or to adhere to host cells or the extracellular matrix and thereby increase their metastatic potential. Other contributing components to tumor cell host cell interactions are cell surface carbohydrate-binding proteins that have been detected on lymphocytes, platelets, macrophages, hepatocytes, and endothelial cells. These lectin-like molecules might recognize and bind carbohydrates expressed on the surface of tumor cells and enhance emboli formation and organ colonization. PMID- 3319280 TI - Study of the immune complex precipitation-inhibiting capacity of sera of patients with chronic lymphocytic leukaemia. AB - Two procedures measuring the capacity of different sera to prevent the precipitation of nascent immune complexes were compared: a kinetic method with a constant immune complex/serum ratio and a new procedure--the increasing immune complex load method--using different immune complex/serum ratios. Immune complex precipitation inhibition is known to depend on complement. The sera of 25 patients with chronic lymphocytic leukaemia (CLL) and the sera of nine healthy blood donors were compared with the two procedures. The kinetic method discriminated poorly between the patients' sera and the control sera, whereas the increasing immune complex load method showed a highly significant difference between the two groups. Sera with low C4 level had the lowest immune complex precipitation-inhibiting activity. Interestingly, however, in the increasing immune complex load method not only hypocomplementaemic but also normocomplementaemic sera from CLL patients were found to be markedly defective. This finding suggests that the CLL patients' sera contain a factor which modulates complement-dependent inhibition of immune complexes. PMID- 3319281 TI - CALLA-negative, TdT- and CD7-positive acute lymphoblastic leukemia: a phenotype associated with poor prognosis. AB - Eight ALL patients displaying a CD7+, Tdt+, CD10-, T MoAbs-, myeloid MoAbs-, AP+ phenotype are described. Some patients showed well-known risk factors such as cytogenetic abnormalities, high WBC count, mediastinal mass, and/or organomegalies. The clinical behaviour was very poor and only one patient is in CR and off therapy. Therefore such a pre-T phenotype, although sometimes associated with the other risk factors, could be considered a poor prognosis phenotype. PMID- 3319282 TI - Scimitar syndrome. Its diagnosis by digital subtraction angiography and an anatomical review. PMID- 3319284 TI - Calcium channel blockers in the management of arterial hypertension. PMID- 3319283 TI - Intracranial meningioma metastatic to the lung. PMID- 3319285 TI - Diagnostic aspects of alkaline phosphatase and its isoenzymes. AB - The changes in serum alkaline phosphatase that are of main diagnostic importance result from increased entry of enzyme into the circulation. This results from increased osteoblastic activity in bone disease, and increased synthesis of alkaline phosphatase by hepatocytes in hepatobiliary disease. The liver and bone forms of alkaline phosphatase are differently-glycosylated forms of a single gene product. The main value of their specific estimation is found in patients in whom bone and liver diseases co-exist, for example, as a result of cancer. Abnormal expression of genetically-distinct alkaline phosphatase isoenzymes is valuable in monitoring cancers, particularly germ-cell tumors. These isoenzymes include Regan and Nagao isoenzymes, which correspond respectively to normal placental and placental-like alkaline phosphatases, and the Kasahara isoenzyme which appears to result from re-expression of a fetal intestinal alkaline phosphatase gene. PMID- 3319286 TI - An evaluation of a new test kit to screen for galactosemia. AB - A new galactosemia screening kit has been evaluated. The kit employs the Yoshida modification of the Paigen et al. Escherichia coli bacteriophage assay and is produced by Eiken Co. Ltd. of Japan. The assay estimates galactose and galactose 1-phosphate in dried blood specimens. The kit is sufficiently sensitive to detect possible heterozygotes as well as possible homozygotes. PMID- 3319287 TI - Fructosamine: structure, analysis, and clinical usefulness. AB - Glucose molecules are joined to protein molecules to form stable ketoamines, or fructosamines, through glycation, a nonenzymatic mechanism involving a labile Schiff base intermediate and the Amadori rearrangement. The amount of fructosamine in serum is increased in diabetes mellitus owing to the abnormally high concentration of sugar in blood. The concentration of fructosamine in serum thus reflects the degree of glycemic control attained by the diabetic patient and is useful in monitoring the effectiveness of therapy in diabetes over a period of several weeks, in a manner analogous to the determination of glycated hemoglobin. Of the analytical approaches used to measure fructosamine, affinity chromatography with m-aminophenylboronic acid and the nitroblue tetrazolium reduction method appear to be the most practical means for clinical chemists to assay fructosamine quickly, economically, and accurately. Fructosamine values can readily distinguish normal individuals and diabetic patients in good glycemic control from diabetics in poor control. Unlike glycated hemoglobin, which reflects the average blood sugar concentration over the past six to eight weeks, fructosamine reflects the average blood sugar concentration over the past two to three weeks. Thus a clinical advantage is that fructosamine responds more quickly to changes in therapy, thereby allowing for improved glycemic control. Used in conjunction with determinations of blood sugar and (or) of glycated hemoglobin, or by itself, the fructosamine assay can provide clinically useful information for the detection and control of diabetes. PMID- 3319288 TI - Diagnostic performance of sensitive measurements of serum thyrotropin during severe nonthyroidal illness: their role in the diagnosis of hyperthyroidism. AB - Serum thyrotropin (TSH) concentrations were measured serially in 14 heart transplant recipients (group 1) and 21 patients undergoing coronary artery bypass surgery (group 2), all without thyroid disease, and randomly in 158 patients hospitalized for various other nonthyroidal illnesses, including 144 judged euthyroid (group 3), six with increased FT4 and (or) T3 (group 4), and eight classified hypothyroid by conventional tests. The serial measurements indicated profound fluctuations. In group 1, TSH was subnormal in 21% of studies and increased in 10%. In group 2, corresponding abnormalities were found in 7% and 13%, respectively. Transiently low or high TSH tended to be associated with normal free thyroxin (FT4), prolonged subnormal TSH (greater than 1 week) with subnormal FT4. By contrast, subnormal TSH plus elevated FT4, or high TSH plus low FT4, were not encountered, making it unlikely that they occur by chance in severely ill patients who are not also hyper- or hypothyroid. In group 3, a suppressed TSH (plus borderline high FT4, T3/FT3) identified four cases of subclinical hyperthyroidism; however, another 11% of patients had subnormal and 10% had above-normal TSH, paired with normal FT4 and no evidence of thyroid disease. In group 4, suppressed TSH confirmed hyperthyroidism in five of six patients, and all in group 5 had increased TSH. We conclude that, in the hospital setting, sensitive TSH measurement can help to detect or confirm mild hyperthyroidism, but the positive predictive value of TSH alone may be as low as 35%. PMID- 3319290 TI - Determination of cyclosporine concentrations with monoclonal antibodies. AB - We measured cyclosporine in whole blood from normal volunteers administered single oral doses of the drug and from two renal-transplant patients on immunosuppressive maintenance therapy, by liquid chromatography (I) and by radioimmunoassay with use of nonspecific polyclonal (II), specific monoclonal (III), and nonspecific monoclonal (IV) antibodies. Concentrations determined by III were equivalent to I, irrespective of cyclosporine dose, concentration, time after dose, or time after transplant. Concentrations determined by II and IV were consistently higher than those by I, owing to cross reactivity with metabolites. Ratios of values by II and IV to those by I increased from less than 1.5 to about 3-4 between 0.5 and 12 h after a single cyclosporine dose, owing to differences in rates of appearance and disappearance of cyclosporine and cross-reacting metabolites, though for the constant 12-h dose intervals in the two renal transplant patients at steady state these ratios (most within the range 3-4) were relatively stable. Ratios of concentrations measured by IV to those by II (mean of 1.2 for single-dose data, most within the range of 1.2 to 1.5 at steady state) were unaffected by time after dose or time after transplant, suggesting that, despite certain cross-reactivity differences between the two nonspecific antibodies, results are proportional throughout therapy. We therefore propose that III and IV offer alternatives, respectively, to the currently used I and II for cyclosporine monitoring. PMID- 3319289 TI - An enzymic assay for the specific determination of methanol in serum. AB - This method for the specific determination of methanol in serum is based on the following two reactions: (formula; see text) Alcohol oxidase is not specific: it converts all lower alcohols to their corresponding aldehydes; however, formaldehyde dehydrogenase is specific and thus the transformation of NAD+ to NADH (which is used to monitor the reaction) proceeds only if methanol is originally present in the sample. The method was automated with a Roche COBAS FARA centrifugal analyzer. The calibration curve is linear between 0.6 and 12 mmol/L. The detection limit is about 0.6 mmol/L. The CV is 4.6% for a concentration of 3 mmol/L. When 55 serum specimens known to be free of methanol were supplemented with known amounts of methanol and analyzed by the enzymatic method, the results correlated well (r = 0.987) with the true values, the regression equation being: y = 1.016x + 0.661, where x represents the true values. Results are not affected by other alcohols that may be present in serum, by methanol metabolites, or by some commonly prescribed drugs. The major advantage of this new assay is that it can be used 24 h a day in any clinical chemistry laboratory. PMID- 3319291 TI - Feasibility of centralized measurements of glycated hemoglobin in the Diabetes Control and Complications Trial: a multicenter study. The DCCT Research Group. AB - A method for measuring glycated hemoglobin (Hb A1c) and an accompanying method of specimen transport to a central laboratory were developed for the multicenter Diabetes Control and Complications Trial (DCCT). In the DCCT, results for Hb A1c are used to assess chronic glycemic control for data collection and patient management. During the feasibility phase of the trial, central (CHL) and backup laboratories using automated, "high-performance" ion-exchange liquid chromatographic methods were established. Whole-blood samples were stored (4 degrees C) at each of the 21 clinical centers for up to 72 h before air-express shipment to the CHL. Quality-control procedures included daily analyses of three calibration specimens. A pooled hemolysate was assayed frequently over time as a long-term quality control (LTQC). After 18 months, within- and between-run CVs were less than 6%. Mean values for split duplicate samples assayed in a masked fashion at the CHL were nearly identical. LTQC results indicated no significant assay drift over time. More than 6000 samples were assayed (mean interval between obtaining the blood sample and completing the assay: less than six days). Hb A1c evidently can be precisely and reliably measured in the context of a long-term, multicenter trial such as the DCCT. PMID- 3319292 TI - Measurement of progesterone receptors in breast-tumor cytosols by immunoenzymatic assay: preliminary results. PMID- 3319293 TI - Prader-Willi syndrome in two siblings: one with normal karyotype, one with a terminal deletion of distal Xq. AB - Two sibs, a 13-year-old girl and an 11-year-old girl, with typical clinical features of the Prader-Willi syndrome (PWS) are reported. High-resolution chromosome analysis showed the normal karyotype in the elder sister, and 46,X,del(X)(pter----q26.1:) in the younger sister. But an interstitial deletion of 15q was not detected in either of the cases. PWS is most probably an etiologically heterogeneous syndrome consisting of two subgroups, with partial deletion and non-deletion of chromosome 15, respectively. PMID- 3319294 TI - Homozygous variegate porphyria. A severe skin disease of infancy. AB - A boy exhibited severe bullous skin disease a few days after birth, followed by increased fragility of the exposed skin in spring and summer. Examination at 2 1/2 years of age led to characteristic biochemical findings: increased excretion of fecal porphyrins (coproporphyrin 121 to 131 and protoporphyrin 467 to 576 nmol/g dry weight), and increased erythrocyte protoporphyrin concentration (3643 to 4840 nmol/l). Lymphocyte protoporphyrinogen oxidase activity was very low in the patient (0.4 nmol/mg protein/h) and half-normal (2.7 and 2.3 nmol/mg protein/h) in the parents, suggesting that the patient had homozygous variegate porphyria. Severe skin symptoms and a high concentration of red cell protoporphyrin concentration in an infant should prompt suspicion of homozygous acute hepatic porphyria. PMID- 3319295 TI - X-linked muscular dystrophy with early contractures and cardiomyopathy (Emery Dreifuss type). AB - The original Virginia family with X-linked muscular dystrophy with early contractures and cardiomyopathy (Emery-Dreifuss type) has been reinvestigated 25 years later. The findings confirm that a cardiomyopathy, presenting most often as atrioventricular block, is a significant feature of the disease, which is characterized by the triad of: 1) slowly progressive muscle wasting and weakness with a humero-peroneal distribution in the early stages; 2) early contractures of the elbows, Achilles tendons, and post-cervical muscles; and 3) a cardiomyopathy usually presenting as heart block (some female carriers may also develop heart block). Other reported families with X-linked Emery-Dreifuss muscular dystrophy as well as a rare autosomal variant are reviewed, and differentiation from scapulo-peroneal muscular dystrophy and the rigid spine syndrome is discussed. PMID- 3319296 TI - Babes, blisters and basement membranes: from sticky molecules to epidermolysis bullosa. PMID- 3319297 TI - Expert system diagnosis of ichthyosis. PMID- 3319298 TI - Adoptively transferred reactivity to M. leprae in nude mice infected with M. leprae. AB - Reversal reactions are manifestations of delayed hypersensitivity to M. leprae and are thought to be usually accompanied by manifestations of effective cell mediated immunity (CMI) as measured by bacterial clearing. These experiments were designed to study the induction of reversal reactions in M. leprae-infected, congenitally athymic nude mice using adoptive transfer of CMI. Splenic cell suspensions derived from unimmunized heterozygous nu/+ mice, and those vaccinated with heat-killed M. leprae, viable BCG and a mixture of the two antigens were diluted to contain 10(4), 10(5), 10(6), 10(7) lymphocytes/0.1 ml and infused intravenously into multibacillary nude mice. The production of reversal reactions in leprous nude mice in response to adoptively transferred CMI was studied in a quantitative fashion. Dose responsive induction of reversal reactions, apparent by footpad inflammation and swelling, decreased morphological indices (MI) of the bacteria and mononuclear cell infiltrations, histopathologically, were observed. For nude mice receiving cells primed with 3.9 X 10(5) living BCG alone, the effective dose 50% (ED50) was 1.0 x 10(6) lymphocytes to induce reversal reactions. For those receiving cells primed with 10(7) M. leprae the ED50 was 3.7 x 10(5) lymphocytes. For nude mice receiving cells primed with a mixture consisting of 1/2 the above dose of BCG + 1/2 the above dose of M. leprae, the ED50 was 6.8 x 10(4) lymphocytes. PMID- 3319299 TI - Normal and neoplastic plasma cell membrane phenotype: studies with new monoclonal antibodies. AB - Three monoclonal antibodies (MoAb), named 8A, 8F6 and 62B1, reacting with plasma cell-associated antigens, were characterized. 8A was found to be positive throughout the B cell lineage maturation steps from the immature B-committed CD10+ cell to the plasma cells. 8F6 and 62B1 reactivity is restricted to more mature cells and related lymphoid malignancies. In particular 62B1 appears to be limited to hairy cells and plasma cells. The results show that it is possible to obtain reagents reacting with plasma cells by immunizing mice with cells derived from human multiple myelomas. Furthermore, the obtained results suggest that it is possible to elicit antibodies against antigens which are present throughout all the differentiation steps of the B cell lineage. These new MoAb could help in elucidating the phenotype of the plasma cells and the relationships of multiple myelomas with other B cell proliferative disorders. PMID- 3319300 TI - Polyclonal activation of murine B cells by a membrane proteoglycan of Klebsiella pneumoniae. AB - The lymphocyte activating properties of a membrane proteoglycan (MPG) extracted from a mutant non-encapsulated strain of Klebsiella pneumoniae (Kp) (biotype a I 145) were investigated. Kp MPG induced a strong proliferative response of BALB/c spleen cells and Peyer's patches cells. Thymidine incorporation was dose-related (from 1 to 100 micrograms Kp MPG/ml) and reached a maximum at day 3. It was not reduced by removal of most adherent cells, nor by depletion of Thy1-2 positive cells, but it was abrogated by removal of surface immunoglobulin bearing cells. Spleen cells from nude mice and those from C3H/Hej mice were strongly stimulated by Kp MPG. Conversely Kp MPG did not induce interleukin 2 production and did not trigger the proliferation of thymocytes but stimulated interleukin 1 production by adherent spleen cells. Finally, unfractionated or B-enriched spleen cells cultured with Kp MPG synthesized IgM and, to a lesser extent, IgG and IgA. It is concluded that Kp MPG is a T-independent polyclonal B cell activator and an inducer of interleukin 1 production. PMID- 3319301 TI - Characterization of a second major antigen Ag 13 (antigen C) of Aspergillus fumigatus and investigation of its immunological reactivity. AB - A second major antigen of Aspergillus fumigatus (Ag 13) has been identified and characterized as a 70 kD, heat-labile component which is able to bind to the lectin, concanavalin A. Ag 13 proved to be identical to the previously recognized C antigen, known to possess chymotryptic activity. A monospecific antiserum to Ag 13 has been affinity purified and used to develop a sandwich ELISA for measuring levels of Ag 13 specific IgG antibodies in patients' sera. Although all ABPA sera (25/25) had significantly raised levels, some aspergilloma sera (2/5) had only very low levels; of the control sera, 10/10 fungal atopics were negative, but 5/12 farmer's lung sera had low but positive values of Ag 13 specific IgG, i.e. sensitivity 100%, specificity 80%. Ag 13 is therefore a diagnostically important component of A. fumigatus and the antigen-specific ELISA may be of importance for the improved detection of disease-specific antibodies. PMID- 3319302 TI - HLA-A,B,C, HLA-D/DR and HLA-D/DQ expression on unfixed liver biopsy sections from patients with chronic liver disease. AB - The distribution of HLA-A,B,C, HLA-D/DR and HLA-D/DQ molecules was studied by indirect immunofluorescence with an avidin-biotin technique and monoclonal antibodies, in unfixed cryostat sections of liver biopsies from 76 patients with chronic liver diseases of various aetiologies and five normal liver biopsy specimens. In pathological liver, strong cytoplasmic or membrane-like positivity for HLA-A,B,C of hepatocytes was observed in piecemeal necrosis areas in all groups. Cytoplasmic staining was mainly seen in lobular areas in autoimmune, cryptogenic and HBV-related cases with viral replication, while membrane-like positivity was more frequently observed in primary biliary cirrhosis, alcoholic and HBV-related cases without viral replication. A weak cytoplasmic staining for HLA-D/DR was observed in piecemeal necrosis and lobular areas mainly in HBV related cases with viral replication. While bile duct cells were positive for both HLA-D/DR and HLA-D/DQ, hepatocytes were consistently HLA-D/DQ negative. The increased HLA-A,B,C expression on hepatocytes should allow T cytotoxic cell aggression. Hepatocellular HLA-D/DR expression is definite but weak and probably does not allow direct autoantigen presentation and induction of autoimmunity. Negativity for HLA-D/DQ further supports this hypothesis. Since cytoplasmic staining for Class I and II molecules is greatly lowered by fixing cryostat liver sections, prestaining conditions should be taken into account when comparing different studies. PMID- 3319303 TI - Autoimmune disease after neonatal injection of semi-allogeneic spleen cells in mice: involvement of donor B and T cells and characterization of glomerular deposits. AB - Balb/c neonates injected with semi-allogeneic (A/J x Balb/c) F1 hybrid spleen cells develop an autoimmune disease associated with an immune-complex glomerulonephritis. The successful induction and maintenance of B cell chimerism is required for the occurrence of autoimmunity. The percentage of chimeric mice displaying autoimmune features increases in parallel with the number of cells injected at birth. T cell depleted inocula although readily inducing B cell chimerism were found unable to induce hypergammaglobulinaemia, circulating immune complexes and glomerulonephritis. IgG1 is the most and IgG3 the least represented IgG isotype among the immunoglobulins deposited in the glomeruli. Immunoglobulins bearing donor (A/J) allotype are detected in the glomeruli of six out of 11 chimeric mice. Rheumatoid factor activity is significantly concentrated within the immunoglobulins eluted from the kidneys, whereas anti-DNA activity is not. PMID- 3319304 TI - Brain-reactive autoantibody levels in the sera of ageing autoimmune mice. AB - Brain-reactive autoantibodies are thought to play an important role in mediating central nervous system (CNS) disorders in systemic lupus erythematosus (SLE). In this paper the developmental occurrence of these antibodies in the sera of autoimmune mice, i.e. NZB, NZB/W, MRL/l and BXSB mice were examined. All murine strains tested, whether autoimmune or not, showed some degree of serum reactivity toward brain antigens. Autoimmune mice, however, displayed higher levels of serum brain-reactive antibodies, and at earlier ages, than non-autoimmune mice. Immunofluorescence assays against brain sections and adsorption assays, with both neural and non-neural tissue, indicated a heterogeneity in the specificity of the populations of brain-reactive antibodies present. These studies provide an important step in characterizing the appearance and diversity of brain-reactive autoantibodies, with the goal of better understanding their significance and potential role in mediating CNS dysfunction in SLE. PMID- 3319305 TI - Circulating lymphocyte populations and autoantibodies in non-obese diabetic (NOD) mice: a longitudinal study. AB - Several previous observations indicate a role for the immune system in the pathogenesis of insulin-dependent diabetes mellitus (IDDM) in non-obese diabetic (NOD) mice. In order to assess the status of the immune system in this model of spontaneous diabetes we studied the phenotype of circulating lymphocytes and the humoral autoimmunity to islet cells in non-diabetic NOD mice at various ages. Lymphocyte numbers were low in young NOD mice (age less than 160 days) as compared with other strains of mice and increased later to reach values in or above the range of controls. The percentages of circulating T lymphocytes and their L3T4+ and Lyt2+ subsets were higher in NOD mice of all ages and both sexes than in controls; however, no imbalance of the L3T4+ and Lyt2+ subpopulations was found. Anti-insulin autoantibodies were detected by an ELISA assay in all the NOD mice studied throughout the entire period of observation. Autoantibodies reacting with the cytoplasm of islet cells in Bouin's fixed pancreas sections, likely to be anti-insulin antibodies, were found in 47 to 58% of the samples from NOD mice aged 75 to 150 days. Antibodies to surface antigens of rat insulinoma cells were virtually absent in young NOD mice (75-100 days) and appeared in 33 to 43% of the samples from 150 to 185 days old NOD mice. The autoantibodies and the quantitative lymphocyte abnormalities reported here, although not predictive of the appearance of overt diabetes, are likely to be involved in the pathogenesis of the disease and therefore may indicate directions for future investigations. PMID- 3319306 TI - Information explosion and the nursing profession: suggestions from the library. PMID- 3319307 TI - Histopathologic variability of the congenital nephrotic syndrome. AB - Five cases of congenital nephrotic syndrome (CNS) were studied with light microscopic (LM), transmission electron microscopic (TEM) and immunofluorescence microscopic (IFM) techniques. All patients, aged between three weeks and one year, had a nephrotic syndrome (NS) and died soon after the diagnosis. Three patients showed mesangial proliferation, thinning of glomerular basement membranes (GBM) and no deposits by IFM or TEM. They probably represent variants of the Finnish type of CNS. One patient had diffuse sclerosis of the mesangium, irregular and thickened GBMs and electron dense deposits, consistent with the diagnosis of diffuse mesangial sclerosis (DMS). The fifth case also showed changes suggestive of DMS, but was clinically atypical, with an early onset and rapid course. Our findings confirm the morphologic heterogeneity of the CNS and point out the difficulties of classification based on clinical and histological manifestations. PMID- 3319308 TI - Renin-angiotensin-aldosterone system and vasopressin in cyclosporine-treated renal allograft recipients. AB - Eleven patients, who had undergone renal transplantation and who had hypertension, aged 19-56 years, were treated with cyclosporine and prednisolone. We measured plasma renin activity, aldosterone and vasopressin (RIAs) at the first, second and third week and again 9 to 12 months after transplantation. Plasma renin activity was in the low-normal range throughout (0.31 +/- 0.05, 0.30 +/- 0.03, 0.32 +/- 0.05 ng/ml/h on short- vs. 0.32 +/- 0.04 ng/ml/h on long term), aldosterone showed a tendency to decrease (114 +/- 27, 72 +/- 18, 71 +/- 11 pg/ml on short- vs. 54 +/- 23 pg/ml on long-term), whereas vasopressin remained moderately increased during the observation period (10.5 +/- 0.8, 10.4 +/- 1.6, 8.9 +/- 0.6 pg/ml on short- vs. 9.6 +/- 1.0 pg/ml on long-term). We then investigated the reactivity of the renin-system in 5 of the patients by stimulating renin release by captopril. Increases in plasma renin activity were only moderate (0.35 +/- 0.03 vs. 0.66 +/- 0.21 ng/ml/h) and blood pressure dropped only slightly (148 +/- 2.0/98 +/- 1.2 vs. 141 +/- 4.6/95 +/- 4.2 mmHg). Levels of plasma aldosterone were significantly suppressed from a low baseline (46.4 +/- 13.5 vs. 25.3 +/- 6.1 pg/ml, p less than 0.05). The increase in vasopressin was unaffected by captopril (9.6 +/- 1.0 vs. 8.8 +/- 0.4 pg/ml). Our results suggest that in renal transplantation patients with good graft function, the activity of the renin system is unaffected by cyclosporine treatment on short and on long-term. Vasopressin stimulation does not seem to depend on the renin system and might play a role as a vasoconstrictor in the face of a denervated kidney. PMID- 3319310 TI - Amyloid deposition in systemic organs in long-term hemodialysis patients. AB - It has not been yet elucidated whether, in long-term hemodialysis patients, amyloid deposition in the transverse carpal ligament (TCL) is a symptom of systemic amyloidosis or a localized one. In 2 patients amyloid deposition was noted in the TCL which had been resected at operation, and we observed amyloid deposits also in other organs at autopsy after their deaths. In the two patients, no diseases resulting in secondary amyloidosis were observed. The unlabeled antibody peroxidase-antiperoxidase method (PAP method) served to reveal the deposits of beta 2-microglobulin (beta 2M) in the TCL and other organs comparable to the Congo red positive area. And the Congo red staining for the amyloid protein after potassium permanganate treatment was preserved. According to these results, the carpal tunnel syndrome (CTS) in long-term hemodialysis was considered as a symptom of systemic amyloidosis. Amyloid was deposited mainly in the vessel walls and the deposition was not circumferential but segmental. PMID- 3319309 TI - Confirmation of the interaction between cyclosporine and the calcium channel blocker nicardipine in renal transplant patients. AB - We report seven cases out of eight reversible raises (350% of mean increase) of cyclosporine (CsA) plasma levels in patients receiving the new calcium channel blocker nicardipine (Loxen-Sandoz) and CsA after renal transplantation. Nicardipine was introduced 3 to 36 weeks post transplantation in 7 cases of hypertension and 1 case of angina pectoris. CsA plasma levels raised considerably 1 to 30 days after nicardipine introduction and returned to pretreatment levels 1 to 7 days after withdrawal. Serum creatinine increased in 1/8 patients. These data suggest that nicardipine interferes with CsA metabolism and this interaction is reversible after nicardipine discontinuation. These findings point out the fact that at least some calcium channel blockers need to be cautiously used in patients receiving CsA. PMID- 3319311 TI - Jesse Edwards. PMID- 3319312 TI - Antepartum case management. PMID- 3319313 TI - Bone remodeling and bone loss: understanding the pathophysiology of osteoporosis. PMID- 3319314 TI - Noninvasive techniques for measuring bone mass: a comparative review. PMID- 3319315 TI - Exercise: its effect on bone mineral content. PMID- 3319316 TI - The role of nutrition in prevention and management of osteoporosis. PMID- 3319318 TI - New approaches to the treatment of osteoporosis. PMID- 3319317 TI - The menopause: sex steroids and osteoporosis. PMID- 3319319 TI - The role of the gynecologist in osteoporosis prevention: a clinical approach. PMID- 3319320 TI - Biochemical fetal assessment. PMID- 3319321 TI - Monitoring fetal body movement. AB - Early in gestation the fetus is active, with movements reflecting several different central nervous system functions. Specific muscle actions of the limbs and trunk respond to different brain stimuli. Sporadic head, trunk, and limb motions that are spastic in quality eventually give way to more combined, sustained, and regular motions as integration develops. This progressive complexity in stimulus reaction has been evaluated with continuous observation using real-time ultrasound imaging. Monitoring gross fetal body motion has gained acceptance as being useful in predicting impending fetal compromise and even death, especially in the presence of chronic placental insufficiency. Prolonged or frequent body movements noted by maternal perception, electromechanical monitoring, and ultrasound imaging are reassuring findings. Fetal inactivity should be documented and requires a reassessment of any underlying antepartum complication and a more precise evaluation of fetal well-being with the use of other techniques. An adequate interpretation and an explanation of these findings to the pregnant woman is necessary to prevent undue stress from misinformation. PMID- 3319322 TI - Clinical utility of the contraction stress test. PMID- 3319323 TI - The nonstress test. AB - The NST has been used extensively in the management of high-risk pregnancies and has been a useful preliminary screening test. However, lack of standardization and multiple testing protocols have made comparisons of reports difficult. The high false-positive rate for protocols not extended for long periods have required back-up testing with other biophysical means whenever there is nonreactivity. Continued research is required to define "normal" reactivity. Meanwhile, ongoing investigations in the area of fetal stimulation may be helpful in arousing the non-reactive sleeping fetus. The benefit of the NST is in its simplicity. Busy practitioners can use it in the office, and large testing centers can screen greater numbers of patients in an effective manner. Given a reactive test, a high expectation of normal outcome is warranted. The false negative rate, however, for diabetes, postdates, and IUGR, warrant twice-weekly testing. Attention to other baseline characteristics, such as bradycardia and minivariables, coupled with sequential NST evaluation should improve NPV by potentially diagnosing compromise earlier. PMID- 3319324 TI - Antepartum fetal surveillance: the biophysical profile. AB - In summary, it appears, based on a cumulative experience of more than 15,000 patients from several centers, that fetal biophysical profile scoring holds promise as an improved method of fetal risk detection. Antepartum detection, classification, determination of severity, and ultimately, treatment of the fetus at risk for death and damage in utero form the basis of modern perinatal medicine. It remains to be determined whether addition of further variables or refinement of existing variables will improve accuracy still further. The assessment of multiple biophysical variables and responses to intrinsic and extrinsic stimuli is helpful in differentiating a normal sleeping fetus from an asphyxiated one. PMID- 3319325 TI - Doppler measurements of maternal and fetal blood flow. AB - Data accumulated over the last decade suggest that Doppler flow velocity waveforms can be used to study both maternal and fetal circulation. Information obtained with this technique appears useful as a screen for both maternal and fetal risk, as an aid to understanding perinatal anatomy and physiology, and as an adjunct to standard means of fetal surveillance. PMID- 3319326 TI - Comparing and contrasting methods of fetal surveillance. PMID- 3319328 TI - Fetal maturity testing. PMID- 3319327 TI - Diagnosis of intrauterine growth retardation: the use of sequential measurements of fetal growth parameters. AB - Given the current widespread use of diagnostic ultrasound, it is important to identify exactly what information is desirable during the examination. Although dating the pregnancy might be the reason for the initial evaluation, it is important to examine the fetus for structural malformations as well. Both can be accomplished with a second-trimester scan. Once the pregnancy is accurately dated, subsequent measurements of the head, abdomen, and femur should be plotted on growth curves in relation to the age of the fetus, based on the earlier ultrasound examination. The patient should not be related with subsequent examinations. If asymmetric growth failure occurs, then intervention or maternal bed rest should be considered. Intervention should be considered in the presence of abnormal antepartum testing and when fetal growth has arrested following the institution of maternal bed rest. If symmetric IUGR is present, careful evaluation of the fetus for structural malformations and an abnormal karyotype should be considered. PMID- 3319329 TI - Fetal evaluation in early gestational ages. PMID- 3319330 TI - Reversible antepartum fetal distress. AB - Information generated from the various tests of fetal well-being must be interpreted correctly to avoid unnecessary intervention for assumed fetal distress. This applies to both the intrapartum and antenatal period. The presence of normal data (e.g., reassuring fetal heart rate tracing) allows the woman to continue confidently with the pregnancy or labor course. When the information is nonreassuring, the cause of the abnormal data should be identified and corrected. Position change and discontinuation of pitocin are examples of common intrapartum actions. In the antepartum period, a compromised maternal condition is often associated with abnormalities in fetal heart rate testing. Rather than respond with immediate delivery for a potentially compromised fetus, the physician should treat and correct the maternal condition. As demonstrated by these case reports, this often allows for the continuation of pregnancy or labor with improvement of maternal and fetal status as well as avoidance of unnecessary and perhaps dangerous risk of untimely and premature intervention. PMID- 3319331 TI - Cerebellar astrocytomas. Part I. Macroscopic and microscopic features. AB - Some of the pathological features of 112 cerebellar astrocytomas seen at The Radcliffe Infirmary between 1938 and 1984 have been described. These include the following: Macroscopic appearance: Cerebellar astrocytomas, when compared to other gliomas, have an unusual tendency to become cystic. Thus, if all ages are considered only 22% are total solid tumors while the others have either a large solitary cyst or many smaller ones. Although patients with cystic tumors remain free of recurrence far longer than those with totally solid astrocytomas, the proportion of cystic and solid elements does not significantly influence the overall survival period. Moreover, the degree of tumor demarcation is not an absolute indicator of the degree of malignancy. Extent of disease: Approximately 8% of cerebellar astrocytomas infiltrate the brainstem and these cases are associated with the poorest prognosis. Supratentorial invasion is very rare and CSF dissemination is very uncommon. Only one example of the latter was recorded in the present study. It is important to note that subarachnoid spread may also occur from histologically benign tumors as well as malignant cerebellar astrocytomas. Classification by growth pattern: The classification of cerebellar astrocytomas by "growth pattern" is clearly of limited use. This is due to the presence of substantial transitional forms in both the "juvenile" and "diffuse" as well as in the "fibrillary" and "protoplasmic" classifications. Confusion also arises because of the disregard for the quantity and distribution of certain features which, in turn, limits the usefulness of the "A" and "B" type classification system. Failure to define rigorously the cell type which predominates in the "cerebral" and "diffuse" forms also creates substantial difficulties in using Ringertz' nomenclature. Further problems are caused by Zulich's "polar spongioblastomas" since cerebellar astrocytomas are not composed of primitive spongioblasts, the "polar spongioblastomas" merely representing one subtype of cerebellar astrocytoma, namely the piloid or pilocytic variety. Attempts to classify cerebellar astrocytomas in a manner which does not rely upon any specific cell type but which depends instead upon the degree of homogeneity or heterogeneity of cell growth is of limited value. Grading schemes: Although the tumors studied in the present report were not graded, previous authors have shown that "grading schemes" are of little predictive value in assessing the behavior of cerebellar astrocytomas.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3319332 TI - Cerebellar astrocytomas. Part II. Pathologic features indicative of malignancy. AB - The pathologic features which denote poor clinical outcome in a series of 112 cerebellar astrocytomas seen at The Radcliffe Infirmary, Oxford between 1938 and 1984 have been described. These have been reviewed in relation to the findings of numerous other reports in the literature. The conclusions reached are as follows: Pleomorphism: A substantial proportion of cerebellar astrocytomas display significant nuclear and cytoplasmic size variation. This is particularly common after the age of ten. Markedly pleomorphic tumors are, moreover, associated with a very short survival time. Mitotic Figures: Mitotic figures are seen in 8.5% of cerebellar astrocytomas but are found in large numbers, in only 1.1% of cases. They are more common in adults and in totally solid tumors. The presence of any mitotic figures in cerebellar astrocytomas is associated with a marked reduction in survival to death and also a noticeable increase in the rate of recurrence. Cellularity: Marked focal hypercellularity is seen in 13.2% of cerebellar astrocytomas and is especially common in childhood tumors. When marked, it is associated with a significant reduction in survival time to death. Desmoplasia: Desmoplastic reactions adjacent to tumor are seen in one-half of all cerebellar astrocytomas but are only marked in 16% of cases. When marked, however, they are associated with a reduction in overall survival time. Perivascular Pseudorosettes: These are seen in 80.9% of all cerebellar astrocytomas. When found in large numbers, they are more commonly seen in children than in tumors with a mixed cystic and solid form. Their appearance is associated with a favorable outcome when found in association with microcystic change and endothelial hyperplasia but when found in isolation they are associated with poor survival. Necrosis: Small necrotic foci are found in 16.8% of cases. Markedly necrotic tumors are very rare and are more commonly seen in patients with short histories and associated with very poor outcome. Definite malignant features: 1. Pleomorphism, if marked; 2. Mitotic figures, in any number; 3. Cellularity, if marked; 4. Desmoplasia (probably) if marked; 5. Perivascular pseudorosettes, in isolation without microcystic change and endothelial hyperplasia; 6. Necrosis, if marked. Primary malignant cerebellar astrocytomas: These tumors are rare and represent cerebellar astrocytomas with one or more areas containing the aforementioned malignant features. Primary glioblastomas of the cerebellum: These tumors are also rare and resemble both clinically and pathologically glioblastomas found in other parts of the nervous system.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3319335 TI - Vulvar carcinoma: the case for individualization of treatment. PMID- 3319333 TI - Embryonal brain neoplasms in the neonatal period and early infancy. AB - We report on two cases of congenital primitive neuroectodermal tumors located in the posterior cranial fossa. They were symptomatic at birth with occlusive internal hydrocephalus. Clinical investigations had failed to diagnose brain tumors and had led to the suggestion of maldevelopment syndromes. In one of these children a malignant rhabdoid tumor of the kidney was operated at the age of 4 1/2 months. Autopsy revealed medulloblastoma combined with a malignant rhabdoid tumor of the kidney in one case and ependymoblastoma in the other. PMID- 3319334 TI - Endometrial carcinoma: is there a place for radical surgery? AB - Endometrial carcinoma may require a combination of therapeutic modalities to effect a cure. The generalist obstetrician and gynaecologist wishing to treat endometrial carcinoma must be fully conversant with current developments in gynaecological cancer therapy. Referral of patients to centres with special expertise in gynaecological oncology is desirable for accurate clinical evaluation and the selection of optimal treatment. There is a limited place for radical surgery in the treatment of endometrial carcinoma. Evaluation of nodal status is essential to surgical staging and allows for individualization of postoperative therapy. Radical hysterectomy and pelvic lymphadenectomy is reasonable treatment for Stage II disease if the patient is fit and irradiation is contraindicated. There has been little improvement in survival despite the use of radical surgery and improved delivery of radiation. New strategies are needed to combat this disease. We can now identify women with significant risk of metastases and treatment failure. These women need effective adjuvant therapy to achieve improved cure of their cancer. Hormonal manipulations are under investigation and immunotherapy may eventually have a therapeutic role, but is currently experimental. Chemotherapy has a proven effect in some disseminated malignancies. It would seem that we are ready for the development and evaluation of perioperative chemotherapeutic regimens. PMID- 3319336 TI - Vulvovaginal reconstruction following radical surgery. AB - An important aspect of the care of women with a gynaecological malignancy is not only improved survival, but complete rehabilitation. There are a number of reconstructive techniques available which can be used at the time of radical surgery, or at some later date, to correct the untoward effects of therapy. Whenever possible, the least morbid, yet most reliable reconstructive procedure should be performed at the initial surgery to decrease postoperative morbidity and wound infection and improve rehabilitation and body image. For many situations there is no single ideal procedure, therefore one should be familiar with several techniques in order to select or adapt the procedure best suited to the circumstances. The split thickness skin graft (STSG) is used primarily to cover skin defects where there has been little or no loss of subcutaneous tissue, such as after skinning vulvectomy for carcinoma in situ. It is also the procedure of choice for vaginal reconstruction after simple vaginectomy for extensive in situ carcinoma and for congenital absence of the vagina. It may also be useful in the management of vaginal distortion, secondary to previous surgery or radiation therapy. In gynaecology, full thickness skin flaps are used when there has been major loss of skin and subcutaneous tissue of the vulva, groin or vagina. Defined arterial and fasciocutaneous flaps are more reliable than random cutaneous flaps, but they are not mutually exclusive in their application. Thus, one or the other may be used for the same defect in differing patients, depending on the situation. Circumstances that dictate which flap is preferable include size, contour, depth of the deformity, proximity of the deformity to the potential donor site, presence of necrosis and infection, and the requirement for new blood supply, as in an irradiated wound. In appropriately selected patients the myocutaneous flap will provide the most reliable source of a new blood supply. If the requirement for a new blood supply is of paramount importance, and the myocutaneous flap is too thick, the skin and subcutaneous tissue may be sacrificed to reduce the size of the flap. A STSG can then be applied at a later time to achieve the desired result. There are many other situations when several reconstructive procedures used simultaneously, or serially, may be required to achieve a balance between anatomy and function. However, ultimate success will depend largely on patient selection, familiarity with the procedures, and exacting surgical technique. PMID- 3319337 TI - The role of surgery in the management of carcinoma of the vagina. AB - Treatment for vaginal carcinoma should be individualized. Surgery is an option to be considered in an attempt to improve both survival and the quality of life following therapy. Most patients with superficial Stage I vaginal carcinoma can be managed surgically. In patients with central non-metastatic Stage IV disease exenterative surgery should be considered, as well as in patients with central recurrence following radiotherapy. In suitable patients the results of surgery are good, and using modern techniques the incidence of complications is acceptably low. PMID- 3319338 TI - The principles and use of the neodymium-YAG laser in gynaecological surgery. AB - The neodymium-yttrium aluminium garnet (Nd-YAG) laser is one of the most recent surgical instruments to be exploited by gynaecologists. This review discusses the manner in which this laser interacts with tissue compared to other surgical lasers. The safety precautions necessary in using this laser are outlined in view of the potential risk of injury to theatre personnel. This is particularly important with respect to the eye. The most valuable application of the Nd-YAG laser to the gynaecologist is its use in ablating the endometrium in cases of menorrhagia. This technique is successful on account of the coagulating properties of this laser. The endometrium is destroyed to a depth sufficient to ablate the basal layer and bleeding is controlled by the coagulation of vessels. Much of the clinical part of this paper deals with this subject, detailing the choice of patients and the particular risks of the technique and discussing some of the problems. Other uses are outlined. Many of these are equally well treated by other and better-established methods. Undoubtedly the future will see many developments and more applications will become apparent. PMID- 3319339 TI - The role of surgery in the management of ovarian cancer. PMID- 3319340 TI - Para-aortic lymphadenectomy. AB - Para-aortic lymphadenectomy is a procedure that has an undoubted place within the management spectrum of gynaecological malignancies. It should be performed in selected cases by trained gynaecological oncologists who are versed in the technique and in the management of potential complications. The removal and histological examination of nodal tissue remains the most accurate method of assessing the precise extent of disease spread. Its main value, therefore, is as part of a surgical staging procedure, which provides reliable survival information. However, it is still questionable whether treatment planning based on this knowledge, including modification of adjuvant therapy, results in improved survival figures. Until more data are available to clarify the degree of patient benefit, para-aortic lymphadenectomy is a technique that is more suitably practised in investigative oncological centres rather than on a widespread clinical basis. PMID- 3319341 TI - Pelvic exenteration. AB - Exenteration, or complete excision of the pelvic viscera, is an ultra-radical surgical procedure intended for curative treatment of the patient with advanced pelvic malignancy--primary or recurrent. At the time of introduction of this procedure, enthusiasm for its use was marred by the high incidence of serious surgical morbidity and mortality, which approached the five-year survival rate. With more careful physiological and psychological selection of patients, concentration of this kind of procedure in centres familiar with its use, improved urinary conduit techniques and careful attention to covering the pelvic floor with omentum and/or synthetic materials, the morbidity and mortality rate has been significantly reduced thus making exenteration a more acceptable treatment option to a wider spectrum of patients. More sophisticated haemodynamic monitoring, both intra- and postoperatively, intravenous hyperalimentation, prophylactic antibiotics and low-dose heparin are undoubtedly important adjuncts to the improvements in surgical technique and judgment. Psychosexual 'rehabilitation' in the broadest sense must be an integral part of patient care for those undergoing exenteration and in most instances necessitates involvement of the patient's partner. Exenteration has only a very limited role in palliation and all attempts should be made to avoid this procedure when cure is clearly not a possibility. PMID- 3319342 TI - The diagnosis and surgical management of adenocarcinoma of the cervix uteri. PMID- 3319343 TI - Vesicovaginal fistulae. PMID- 3319344 TI - Surgery of intraepithelial neoplasia, CIN, VAIN, and VIN. AB - The various surgical treatments of CIN, VAIN, and VIN have been discussed. The necessity for careful pretreatment, histological diagnosis and colposcopic mapping of the various conditions has been stressed. The relative risks of malignant progression of the various conditions have been discussed along with the various modes and methods of surgical therapy. The facts emerging are that traditional surgical therapy is giving ground to more modern techniques of ablation, particularly that of carbon dioxide laser photoevaporation therapy. Particularly in treatment of CIN and VIN, laser therapy has begun to show many advantages. Traditional surgical techniques for treatment of intraepithelial neoplasia of the lower genital tract in the female have, in response, become more conservative in their application with an emphasis on preservation and reconstruction. However, in some cases confirmation of early results by long-term follow-up will be necessary. The general tendency of close surveillance and conservative treatment befits the management of non-invasive genital tract intraepithelial neoplasia. PMID- 3319345 TI - Leigh syndrome, a mitochondrial encephalo(myo)pathy. A review of the literature. AB - Results of a literature survey of 173 patients with Leigh syndrome are presented, with emphasis on signs and symptoms in relation to age at onset, contributions of technical investigations to the diagnosis, pathophysiology, genetic considerations and therapeutic aspects. Based on this study we are of the opinion that it is possible to come to a diagnosis of "most probable Leigh syndrome" durante vitamin on the combination of clinical signs and symptoms, autosomal recessive mode of inheritance, association with a defect of energy metabolism, and CT or MRI abnormalities. PMID- 3319346 TI - Clinical pharmacokinetics of ethanol. AB - The pharmacokinetics of ethanol after typical doses are described by a 1 compartment model with concentration-dependent elimination. The volume of distribution estimated from blood concentrations is about 37 L/70 kg. Protein binding of ethanol has not been reported. Elimination is principally by metabolism in the liver with small amounts excreted in the breath (0.7%), urine (0.3%), and sweat (0.1%). Metabolism occurs, principally by alcohol dehydrogenase, in the liver to acetaldehyde. Models of ethanol input and absorption are crucial to the description and understanding of the effects of ethanol dose on bioavailability. Little attention has been paid to evaluation of potential models. First-pass extraction of ethanol is predicted to be dependent on hepatic blood flow and ethanol absorption rate, with a typical extraction ratio of 0.2. The overall elimination process can be described by a capacity limited model similar to the Michaelis-Menten model for enzyme kinetics. The maximum rate of elimination of ethanol (elimination capacity or Vmax is 8.5 g/h/70 kg. This would be equivalent to a blood ethanol disappearance rate of 230 mg/L/h if metabolism took place at its maximum rate. The elimination rate is half of the elimination capacity at a peripheral blood ethanol concentration (Km) of about 80 mg/L. Ethanol is readily detectable in expired air. The usual blood:expired air ratio is 2300:1 and breath clearance at rest is 0.16 L/h. The renal clearance of ethanol is 0.06 L/h and sweat clearance is 0.02 L/h. The use of a zero-order model of ethanol elimination has been widespread although the limitations of this model have been known for a long time. Much of the published work on ethanol pharmacokinetics must be regarded with suspicion because of this assumption. PMID- 3319348 TI - Clinical pharmacokinetic significance of the renal tubular secretion of digoxin. AB - Tubular secretion appears to be a major route of the renal elimination of digoxin. Secretion of the drug by the tubules is modulated by renal blood flow, by a number of commonly coadministered drugs (e.g. quinidine, spironolactone, verapamil, amiodarone), and by age. The maximal transport capacity does not appear to be achieved with clinically relevant concentrations. The tubular transport of digoxin does not appear to be associated with the anionic or cationic transport systems, nor the Na+/K+-ATPase receptor. Further studies are needed to elucidate the exact mechanisms involved in the transtubular movement of the glycoside. PMID- 3319350 TI - Detection of insulin antibodies in newly-diagnosed type 1 diabetic children after "acid-stripping" of sera. AB - A sensitive microassay using sera from which endogenous bound insulin was removed by acid-stripping was employed to screen for insulin antibodies in 48 newly diagnosed Type 1 diabetic children and 20 age-matched controls. Using intact diabetic sera, the binding of 125I-insulin exceeded the upper control range in 16/48 (33%); when the sera were acid-stripped at pH 4.2 for 30 minutes at 4 degrees C, binding to the 16 positive sera increased further and in another five sera became significant, making a total of 21/48 positive (44%). Children 5 years of age or less had a higher prevalence of insulin antibodies. Islet cell antibodies, assayed by indirect immunofluorescence, were detected in equal fractions of insulin antibody-positive and -negative sera (76% versus 77%). Assay of insulin antibodies using acid-stripped sera under the conditions described significantly increases the sensitivity of insulin antibody detection. Insulin antibodies appear to be a specific marker of islet autoimmunity, but compared to islet cell antibodies are relatively insensitive, and may be a marker for a particular subgroup of diabetics. PMID- 3319347 TI - Clinical pharmacokinetics of D-penicillamine. AB - Penicillamine exists as 2 stereoisomers, but only the D-isomer is used therapeutically. Its chemical reactivity derives from its functional groups, of which the thiol group seems the most important. It is difficult to determine penicillamine in biological fluids because of its instability, the presence of endogenous compounds with a thiol function, and the various chemical forms in which it occurs, namely reduced free penicillamine, penicillamine bound to proteins, and internal (P-S-S-P) and mixed (P-S-S-C) disulphides. The earliest assay methods (colourimetry, isotopic methods, gas-phase chromatography) were neither sensitive nor specific. High performance liquid chromatography with electrochemical detection has led to a more specific assay for D-penicillamine, with detection based on either derivatisation reactions or on electro-oxidisation of the thiol function. With dual-electrode detectors (Au/Hg) disulphides can be assayed directly. D-penicillamine is absorbed rapidly but incompletely (40 to 70%) in the intestine, with wide interindividual variations. Food, antacids and, in particular, iron reduce absorption of the drug. Its bioavailability is also dramatically decreased in patients with malabsorption states. The peak plasma concentration occurs at 1 to 3 hours after ingestion, regardless of dose, and is of the order of 1 to 2 mg/L after an oral dose of 250 mg; some investigators have reported a double peak in plasma, which is probably not due to an enterohepatic cycle. The concentration in plasma then decreases rapidly, generally following a biphasic curve. When long term treatment is discontinued, there is a slow elimination phase lasting 4 to 6 days, which suggests that there is a 'deep compartment' or 'slow pool of the drug reversibly bound to tissues', particularly the skin. This may explain the persistence of its therapeutic effect and the occurrence of undesirable side effects after treatment has been stopped. During long term treatment plasma concentrations are highly variable between individuals. They do not seem to be correlated with the activity or the toxicity of D-penicillamine in patients with rheumatoid arthritis. More than 80% of plasma D-penicillamine is bound to proteins, particularly albumin. The rest is mainly in the free reduced form or as disulphides. Only a small portion of the dose is metabolised in the liver to S-methyl-D-penicillamine. The route of elimination is mainly renal; disulphides represent the main compounds found in the urine. Faecal excretion corresponds mainly to the non-absorbed fraction of the drug. PMID- 3319349 TI - Renal function and tubular transport effects of sulindac and naproxen in chronic heart failure. AB - Renal function and excretion of water, salt, and the prostacyclin hydration product (6-keto-PGF1 alpha) were evaluated in 10 furosemide-treated patients with well-controlled congestive heart failure. Four doses of sulindac (200 mg b.i.d.) and naproxen (500 mg b.i.d.) were given every 12 hours in a double-blind crossover design. Naproxen significantly decreased the urinary excretion of water (19%), sodium (26%), chloride (26%), and 6-keto PGF1 alpha (76%) and decreased osmolal clearance (18%). No significant changes in these functions were observed in the patients receiving sulindac. Plasma renin activity, plasma aldosterone, freewater clearance, or clearance of furosemide did not change significantly with either treatment. Although the basal glomerular filtration rate (GFR) and renal plasma flow (RPF) were reduced, these patients with cardiac disease, with normal serum sodium concentration, did not have any further reduction of GFR or RPF despite naproxen-induced inhibition of renal prostacyclin synthesis. It is concluded that renal prostaglandins contribute to the natriuretic effect of oral furosemide in patients with compensated congestive heart failure. In this clinical setting, GFR and RPF are not critically dependent on intact renal PGI2 synthesis. The lack of effect on renal prostaglandin synthesis and the renal response to oral furosemide supports the concept of a renal sparing effect of sulindac. PMID- 3319353 TI - Infantile hypertrophic pyloric stenosis--diagnosis from the pyloric muscle index. AB - Measurements of pyloric length, diameter and muscle thickness were made from ultrasound images of 39 babies, 21 of whom were subsequently found at operation to have infantile hypertrophic pyloric stenosis. From these measurements, the volume of pyloric muscle in cm3 was estimated for each case and divided by the body weight in kilograms. The resulting pyloric muscle index proved to be a much more reliable guide to the diagnosis of pyloric stenosis than any of the individual measurements or the volume estimation alone. PMID- 3319354 TI - Acute portal vein thrombosis. AB - The findings in acute portal vein thrombosis in a patient with chronic calcific pancreatitis and two episodes of pancreatic surgery are described. The diagnosis was made by ultrasound, which showed a dilated portal vein filled with low-level echoes, surrounding hepatic oedema, hypertrophy of the hepatic artery, splenomegaly, collateral vessels and ascites. This was confirmed by computed tomography. The ultrasonic differences in appearance between acute and chronic portal vein thrombosis are discussed, in the context of portal hypertension. The diagnosis of acute portal vein thrombosis should be considered in patients in the appropriate situation who suffer a sudden clinical deterioration with right upper quadrant or abdominal pain. Ultrasound is recommended as the imaging modality of first choice because of the flexibility of its scanning plane and its real time and Doppler capabilities. Computed tomography is valuable in patients with an ileus or heavy pancreatic calcification and for its ability to demonstrate patent vessels on intravenous injection of contrast medium. PMID- 3319352 TI - Analysis of 22 immunomodulatory substances for efficacy in low-dose streptozotocin-induced diabetes. AB - Of 22 immunomodulatory substances screened 12 were effective in modulating the course of hyperglycemia following low dose streptozotocin treatment. In this animal model diabetes is induced by administration of low doses of streptozotocin (30-40 mg/kg) body weight to male C57BL/6J/Bom, C57BL/KsJ and C3H/He/Bom mice on 5 consecutive days. Conventional immunosuppressants (azathioprine, cyclophosphamide) largely protected from diabetes development. Partial suppression of hyperglycemia was also seen after administration of B. pertussis, fetal tissue extracts, FTS, inosine pranobex, metronidazole and ADA 202-718. The majority of these substances, when applied with another regimen, and TP5 caused enhancement of diabetes. In conclusion, several substances with a therapeutic potential in experimental diabetes have been identified. Those with little risk of side-effects may deserve further analysis. PMID- 3319351 TI - Serum antibody-bound insulin as a measure of insulin antibodies in diabetic children. AB - The usefulness of the measurement of serum antibody-bound and total immunoreactive insulin (IRI) concentrations in the assessment of insulin antibodies was evaluated in a material comprising 49 insulin-dependent diabetic children with a mean age at onset of 8.6 years (range 0.8-16 years) treated with highly purified porcine insulins. Serum antibody-bound and total IRI concentrations of individual patients were compared with insulin antibody levels measured with 3 different insulin antibody assays. The correlation coefficients of insulin antibody levels with concentrations of serum antibody-bound IRI ranged from 0.75-0.79. In serum samples with moderate or high insulin antibody levels most of the insulin was in the form of insulin-insulin antibody immunocomplexes. Thereby a very close correlation was found between antibody-bound and total serum IRI concentrations (r = 0.98) in this material. Residual endogenous insulin secretion decreased with increasing duration of diabetes. No significant correlation was found between the duration of diabetes and serum antibody-bound IRI concentrations. High serum antibody-bound IRI concentrations were associated with low glucagon-stimulated plasma C-peptide levels. Although the determination of serum antibody-bound IRI concentrations does not characterize insulin antibodies with regard to binding capacity and affinity constants, it yields information of the actual degree of insulin binding in the circulation. This information may be useful in assessing the benefits of transferring diabetics with high insulin antibody titers from conventional to highly purified porcine or human insulin therapy. PMID- 3319355 TI - Unusual cause of biliary endoprosthesis migration. PMID- 3319356 TI - The pathogenesis and significance of bronchial hyper-responsiveness in airways disease. PMID- 3319357 TI - Haemodynamic changes in man during immersion in water at different temperatures. AB - 1. Stroke volume and cardiac output were measured using the Doppler ultrasound technique in 16 normal subjects immersed to the neck in water at 33 degrees C, 35 degrees C, 37 degrees C and 39 degrees C. A standard aortic diameter was assumed and results were expressed as percentage changes from pre-immersion resting values. 2. Cardiac output rose progressively at higher temperatures, increasing by 30% at 33 degrees C and by 121% at 39 degrees C. At thermoneutral temperatures (33 degrees C and 35 degrees C) this was achieved by an increase in stroke volume of 50% despite a significant decrease in heart rate. There was a further rise in stroke volume and pulse rate at higher temperatures and a mean tachycardia of 109 +/- 4 beats/min was noted at 39 degrees C. Calculated peripheral resistance reduced progressively with increasing temperature of immersion. 3. This non invasive and simple technique may provide a non-exercise-related cardiovascular stress test to study cardiovascular responses in a variety of pathophysiological states. PMID- 3319359 TI - Management of breast cancer. Surgery and adjuvant therapy. PMID- 3319360 TI - Zidovudine approved by FDA for treatment of AIDS. PMID- 3319358 TI - Attempts towards a serological diagnosis of ankylosing spondylitis. AB - Polytene chromosomes of salivary glands as well as nuclear proteins from Kc-cells of Drosophila melanogaster have been used as substrate to identify and evaluate the diagnostic value of crossreacting antibodies present in sera of AS patients. The diagnostic significance of the recently described anti-93D antibody (Lakomek et al., 1984) was confirmed by screening sera of patients with definite or suspected AS using cytoimmunofluorescence on the polytene chromosomes. In addition, four new antibodies could be identified in AS sera by immunoblotting. Simultaneous detection of these antibodies supports the diagnosis of AS and is most useful in diagnosis of early stages of this disease. PMID- 3319361 TI - Recognition and importance of Staphylococcus epidermidis infections. AB - The bacteriology, epidemiology, pathogenesis, clinical features, antimicrobial susceptibility, and therapy of Staphylococcus epidermidis infections are reviewed. Staph. epidermidis is often regarded as a culture contaminant, but its importance as a pathogen has been recognized in recent years. Except for native valve endocarditis, most Staph. epidermidis infections are hospital-acquired. Staph. epidermidis is a common cause of infections involving indwelling foreign devices, surgical wound infections, and bacteremia in immunocompromised patients. The occult nature of these infections and low virulence of the organism make diagnosis and treatment difficult. Staph. epidermidis isolates from nosocomial infections frequently are resistant to methicillin; however, resistant isolates often appear to be susceptible to methicillin unless reliable methods of susceptibility testing are used. Cross-resistance between methicillin and cephalosporins occurs in vitro. Virtually all Staph. epidermidis isolates are susceptible in vitro to vancomycin and rifampin. Penicillin G, semisynthetic penicillinase-resistant penicillins, and cephalosporins are effective for the treatment of methicillin-sensitive Staph. epidermidis infections. Vancomycin is the drug of choice for infections caused by methicillin-resistant organisms. Vancomycin, combined with rifampin or gentamicin, or both, is recommended for therapy of serious infections caused by methicillin-resistant strains. Staph. epidermidis is an important pathogen in immunocompromised patients and patients who develop nosocomial bacteremia; treatment usually consists of antimicrobial therapy and removal of indwelling catheters or devices. PMID- 3319362 TI - Current concepts in clinical therapeutics: disease-modifying drugs for rheumatoid arthritis. AB - The epidemiology, pathophysiology, clinical features, diagnosis, and clinical course of rheumatoid arthritis (RA) and the role of disease-modifying antirheumatic drugs (DMARDs) in its treatment are reviewed. RA, a widespread disease affecting people of all races and sexes around the world, has an unknown and perhaps multifactorial etiology. Conflicting evidence supports an immune complex, infectious, metabolic, or genetic basis for RA. The disease affects diarthrodial joints and begins as an immune response to unknown antigenic stimuli. A proliferative process ensues, leading to formation of a vascular lesion called a pannus, which then infiltrates into cartilage, subchrondral bone, and tendon. This destructive phase leads to classic RA symptoms of pain, limitation of motion, swelling, heat, and redness of the affected joint. Symptoms and laboratory tests form the basis for diagnosis. For most RA patients, conservative therapy provides substantial benefit. In those patients who suffer from unrelenting and progressively destructive disease, more aggressive intervention is necessary to prevent permanent disability. The DMARDs are reserved for treatment of this group of patients. DMARDs include such diverse agents as the gold compounds aurothioglucose, auranofin, and gold sodium thiomalate; the antimalarials hydroxychloroquine sulfate and chloroquine phosphate; penicillamine; and the cytotoxic agents azathioprine, methotrexate, and cyclophosphamide. DMARDs are effective but toxic therapeutic agents. Because of the toxicities of these agents, careful monitoring at regular intervals is necessary throughout the duration of therapy. For patients in whom these drugs demonstrate efficacy and are tolerated, the DMARDs may attenuate the disabling effects of long-term erosive disease. PMID- 3319363 TI - Use of midazolam hydrochloride in anesthesia. AB - The chemistry, pharmacology, pharmacokinetics, clinical efficacy, adverse effects, drug interactions, dosage, and cost and availability of midazolam hydrochloride are reviewed. The anxiolytic, sedative, hypnotic, anticonvulsant, muscle-relaxant, and amnesic properties of midazolam are similar to those of other injectable benzodiazepines. Midazolam is approximately two to four times as potent as diazepam. Midazolam hydrochloride is water soluble (resulting in fewer local adverse reactions after injection), has a rapid onset and short duration of action, and causes relatively mild cardiovascular and respiratory effects. The drug generally is well tolerated. Midazolam is a good premedicant for general or regional anesthesia. Its greatest use will probably be for conscious sedation during surgical or diagnostic procedures performed under local or regional anesthesia. Induction of anesthesia with midazolam alone is somewhat unpredictable; opiate pretreatment makes induction more consistent. Midazolam is a less reliable induction agent than thiopental, but because it produces fewer adverse cardiovascular and respiratory effects than thiopental, midazolam appears to be a safer induction agent for elderly patients or patients with cardiovascular disease. The recommended dose of midazolam for preoperative sedation is 0.07-0.1 mg/kg given by intramuscular injection one hour before surgery. For conscious sedation, 0.1-0.15 mg/kg intravenously in divided doses is usually adequate. Lower doses of midazolam are recommended for elderly or debilitated patients and patients who have severe liver disease. The costs of equipotent doses of midazolam and injectable diazepam are similar. An oral dosage form is under investigation in the United States. Midazolam's pharmacologic and pharmacokinetic profile makes it an attractive alternative to other injectable benzodiazepines used in anesthesia. PMID- 3319364 TI - Effect of maturation on drug disposition in pediatric patients. AB - Maturational changes in the physiologic processes that govern drug disposition in pediatric patients are described, and evaluation of data from pediatric drug studies is discussed. Gastrointestinal absorption depends on gastric pH, gastric emptying time, intestinal transit time, and gastrointestinal enzymatic activity; the overall effect of age-related alterations in these variables is poorly understood. Maturational changes in the skin affect percutaneous absorption. Distribution of drugs is affected by alterations in vascular perfusion, body composition, tissue binding, and plasma protein binding. For most water-soluble drugs, volume of distribution is increased in neonates. Age-related changes in biotransformation are complex because the rate of development of phase 1 and phase 2 metabolic pathways varies and metabolic pathways may be induced by in utero exposure to inducing agents. For most drugs, biotransformation is decreased in the neonate, increases from one to five years of age, and decreases after puberty to adult values. The kidneys of neonates are inefficient at drug elimination, leading initially to prolonged elimination half-lives of many drugs. Clearance of some drugs may be greater in infants than in older children and adults because of disproportionate development of renal filtration and secretion in relation to reabsorption. Few data on maturational changes in physiologic processes that affect drug disposition are available for any one drug in a specific pediatric population. In the development of research protocols, careful attention should be paid to the design limitations of published studies. PMID- 3319365 TI - Management of tetanus. AB - Two cases of tetanus are presented, and the diagnosis, clinical features, and management of tetanus are reviewed. The first patient, an 86-year-old woman, had marked muscle rigidity but was able to breathe spontaneously. A dark eschar with purulent drainage was noted on her left foot, but Clostridium tetani was not isolated. She was placed in a semidark room and was treated with penicillin G; tetanus immune globulin (TIG) 5000 units i.m.; tetanus toxoid 0.5 mL i.m.; diazepam, chlorpromazine, and morphine for sedation, muscle relaxation, and analgesia; ranitidine for stress ulcer prophylaxis; heparin for prevention of deep-vein thrombosis; and peripheral-vein nutrition. Her condition improved gradually, and she was discharged to a rehabilitation institute after 32 days. The second patient, a 46-year-old woman, experienced progressive descending paralysis and required ventilatory support. She had a periodontal abscess, but cultures of the drainage were negative. She was placed in a semidark room and treated with erythromycin, TIG, tetanus toxoid, diazepam, pancuronium bromide, morphine, ranitidine, and heparin. Autonomic instability occurred during the second and third weeks, but cardiac output was maintained without treatment. The patient was extubated after five weeks, and was transferred out of the intensive care in the following week. The diagnosis of tetanus is based primarily on characteristic findings of muscle rigidity and reflex spasms; cultures for C. tetani are of limited value. A history of trauma or injury is common. Pulmonary infections and cardiovascular instability are the most common complications. Therapy consists of ventilatory support; control of neuromuscular symptoms with benzodiazepines, narcotics, and neuromuscular blockers; antibiotic therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319366 TI - Diagnostic virology. AB - Diagnostic virology services are increasingly available and pertinent as the number of useful antiviral agents grows. In this article, current methods of diagnosis are reviewed with special emphasis on rapid procedures. Guidelines for interpretation of cultures and other tests are provided. PMID- 3319367 TI - Diagnosis of viral hepatitis. AB - Acute viral hepatitis is a serious infectious disease of the liver caused by several viruses and characterized by acute necrosis of hepatocytes and inflammation. In this article, recent advances in hepatitis serology and virology are briefly reviewed, and practical, up-to-date laboratory tests are outlined. PMID- 3319368 TI - Serologic testing of human immunodeficiency virus infection. AB - This article describes laboratory methods available for testing serum to determine whether a patient is infected with human immunodeficiency virus (HIV). Included is discussion of uses and limitations of the assays, patient counseling, laboratory safety, and interpretation of the test results. PMID- 3319369 TI - Treatment of varicella-zoster virus infections. AB - Effective antiviral therapy is now available for many forms of infection due to varicella-zoster virus. Acyclovir is the most widely prescribed treatment, but the virus is not exquisitely sensitive to this drug, and others are under study. The goals of therapy differ among different kinds of patients and must be considered when designing a treatment program. PMID- 3319370 TI - Effects of feeding lactobacillus GG on lethal irradiation in mice. AB - Mice exposed to 1400 rads of total body irradiation experienced 80%-100% mortality in 2 wk. Bacteremia was demonstrated in all dead animals. Feeding Lactobacillus GG strain reduced Pseudomonas bacteremia and prolonged survival time in animals colonized with this organism. In animals not colonized with Pseudomonas, feeding Lactobacillus GG also produced some reduction in early deaths, and there was less Gram-negative bacteremia in these animals compared with controls. PMID- 3319371 TI - Mechanism of aminoglycoside resistance among beta-lactam-resistant Escherichia coli in the United States. AB - We examined aminoglycoside (AG) resistance in ampicillin-resistant Escherichia coli obtained from nine hospitals participating in the National Nosocomial Infections Study. The isolates were tested to 25 antimicrobials using broth microdilution methods. If the organism was intermediate or resistant to gentamicin, tobramycin, netilmicin, or amikacin, we determined the class of aminoglycoside-modifying enzyme (AME) using the phosphocellulose paper binding assay. Of 423 E. coli, 21 (5%) were intermediate or resistant to one or more of the AGs. All but two of these E. coli isolates had at least one AME. Twelve isolates had phosphotransferase (APH) enzymes; seven had adenyltransferase (ANT) enzymes (all ANT[2"]); and four had acetyltransferase (AAC) enzymes. The seven ANT[2"]-producing isolates were more likely to be acquired in the community than in the hospital (4/7 ANT[2"]-producing E. coli versus one of 14 of the other AG resistant E. coli, p = 0.03, Fisher's exact test). These findings suggest that for E. coli resistant to both ampicillin and an AG, APH enzymes are the predominant AME class. Additionally, isolates with certain AMEs may be acquired both in the community and in the hospital. PMID- 3319372 TI - In vitro chloroquine-resistant falciparum malaria in Malabo, Equatorial Guinea: case reports. AB - For many years the chloroquine-resistant problem in Africa was circumscribed to East Africa, but in the last two years it has been spreading progressively to the West. We report here the two first cases of chloroquine-resistant falciparum malaria imported into Spain from Equatorial Guinea. Both cases show a parasitological grade III resistance in a W.H.O. in vitro macrotest. The clinical recovery with the alternative treatment (Fansidar) was satisfactory. PMID- 3319373 TI - Does Aeromonas hydrophila preferentially colonize the bowels of patients with hematologic malignancies? AB - Weekly cultures of stools from neutropenic patients and bone marrow transplant recipients yielded Aeromonas hydrophila from 8% of 88 patients over a 2-yr period. During this time stools in the routine enteric laboratory yielded A. hydrophila in 0.24% of 1632 patients. Although the patient groups and culture methods were not directly comparable, this significant difference in isolation rate (p less than 0.001) may reflect a higher colonization rate in the immunocompromised patient. PMID- 3319374 TI - Comparison of RapID-ANA and Minitek with a conventional method for biochemical identification of anaerobes. AB - Two micromethods for the identification of anaerobes, one requiring growth (Minitek) and one nongrowth dependent (RapID-ANA), were compared with a conventional identification culture system. For 222 clinical isolates, RapID-ANA agreed with PRAS in 187 (84%) and Minitek agreed for only 170 strains (76%). Both systems identified common isolates well, but encountered some difficulty in identifying less common clostridia and Gram-negative bacilli. Although adequate for most strains, the results from both systems should be interpreted with caution, particularly for less frequently isolated species. PMID- 3319375 TI - Immunocytochemical demonstration of simultaneous synthesis of types I, III and V collagen and fibronectin in mouse embryonic palatal mesenchymal cells in vitro. AB - An immunocytochemical study was made on the palatal mesenchymal cells obtained from mouse embryos during palatal development with special reference to synthesis of types of collagen and fibronectin in vitro. Most cells showed positive staining with antibodies against the four proteins examined. The staining for type I collagen was most intense among the four proteins and was distributed perinuclearly. The staining for type III collagen was quite similar as that for type I collagen but less intense, whereas that for type V collagen was weak and its staining pattern was different from those for types I and III collagen in that the surface of the plasma membrane, in addition to the perinuclear cytoplasm, showed weak staining for type V collagen. Antibodies to fibronectin showed perinuclear and extracellular fibrous staining. These data suggest that palatal mesenchymal cells synthesize types I, III, and V collagen and fibronectin simultaneously. PMID- 3319376 TI - Monoclonal antibodies to bovine collagenase inhibitor. AB - Hybridoma antibodies against bovine collagenase inhibitor were produced by fusion of myeloma cells NS-1 (P3-NS1-1) with spleen cells from mice hyperimmunized with collagenase inhibitor purified from the explant medium of bovine dental pulps. Hybridomas positive by an enzyme-linked immunosorbent assay (ELISA) for bovine collagenase inhibitor were cloned by the dilution method. Seventeen hybridomas producing antibodies were isolated, four of which also recognized purified human collagenase inhibitor in the ELISA. Using a monoclonal antibody-Sepharose affinity column, we easily purified both bovine and human collagenase inhibitors to homogeneity. They showed the same mobility on sodium dodecyl sulfate polyacrylamide gel electrophoresis, corresponding to a molecular mass of 32,000 daltons. PMID- 3319377 TI - Acceleration of cartilage and bone differentiation on collagenous substrata. AB - Chondroprogenitor cells of newborn murine mandibular condyles were cultured on top of collagen sponges for up to 18 days. After 24 h in culture, new chondroblasts developed which subsequently matured showing signs of hypertrophy, while the extracellular matrix revealed positive reactivity for type II collagen, cartilage proteoglycans and mineralization. Light and electron microscopy examinations showed signs of new osteoid formation, a feature that was preceded by positive immunohistochemical reaction for type I collagen, fibronectin and bone specific sialoprotein. A close temporal and spatial association was noted between the development of mature, mineralized cartilage and new osteoid. The differentiation of new cartilage and bone cells was linked to an increased activity of DNA synthesis and cellular proliferation. The de novo bone formation was accompanied by increasing rates of alkaline phosphatase activity and uptake of [45Ca] features that were found to be tightly correlated to each other. The collagen substrata appeared also to facilitate the migration of cells, their replication and their subsequent differentiation to their respective cellular lineage. Hence, collagen sponges in vitro appear to serve as a promising substrata for culture systems involved with the growth and differentiation of mineralizing tissues such as cartilage and bone. PMID- 3319379 TI - Psyxpert: an expert system prototype for aiding psychiatrists in the diagnosis of psychotic disorders. AB - Psyxpert is an expert computer system prototype designed to aid psychiatrists in the diagnosis of mental disorders, in cases where psychotic features are the prominent part of the presenting clinical picture. The knowledge base contains psychiatric knowledge in the form of production rules. The system uses a backward chaining control strategy to guide the consultation. Psyxpert provides a menu driven user interface and an explanation subsystem. The system uses certainty and importance measures to produce a diagnosis with an attached certainty factor and recommendations for further evaluation or therapy. Psyxpert is written in Virginia Tech HC Prolog and runs on Digital Equipment Corporation's VAX 11/780 under the VMS operating system. PMID- 3319378 TI - The origins, content and early development of the curriculum in State Medicine and Public Health 1856-1895. PMID- 3319380 TI - Bayesian diagnostic theory using a programmable pocket calculator. AB - A programmable pocket calculator program has been written to serve as an aid in diagnosis. The program uses a Bayesian statistical algorithm to calculate the relative probability of two diagnostic alternatives. The ability to carry out Bayesian statistical calculations at the bedside should make the use of such techniques more attractive to clinical practitioners. PMID- 3319381 TI - Influence of noise on wave boundary recognition by ECG measurement programs. Recommendations for preprocessing. AB - In the international cooperative project entitled "Common Standards for Quantitative Electrocardiography" (CSE) systematic noise tests have been performed in order to compare measurement results of electrocardiographic computer programs under degraded operational conditions and to develop recommendations for preprocessing and measurement strategies. The influence of seven different high- and low-frequency noise types on the recognition of P, QRS, and T wave onsets and offsets was investigated. The analysis was performed on 160 electrocardiograms derived from two sets of 10 cases each, by eight electrocardiographic and six vectorcardiographic computer programs. The stability and precision of these programs were tested with respect to the results obtained (1) in the noise-free recordings and (2) by a group of five cardiologists who have analyzed the recordings previously in a Delphi reviewing process. Increasing levels of high-frequency noise shifted the onsets and offsets of most programs outward. Programs analyzing an averaged beat showed significantly less variability than programs which measure every complex or a selected beat. On the basis of the findings of the present study, a measurement strategy based on selective averaging is recommended for diagnostic ECG computer programs. However, averaging should be performed only if proper alignment and precise waveform comparison have been performed beforehand in order to exclude dissimilar complexes. PMID- 3319382 TI - The newer antidepressants: promises and realities. PMID- 3319385 TI - Etiological factors of endometriosis. PMID- 3319383 TI - Neglected phenomena in factitious illness: a case study and review of literature. PMID- 3319384 TI - The 1985 journal literature on the personality disorders. PMID- 3319386 TI - Ultrasound as a diagnostic aid in endometriosis. PMID- 3319387 TI - Recurrent endometriosis. PMID- 3319388 TI - Fluid volume and prostanoid concentration during the proliferative and periovulatory phase of the menstrual cycle. PMID- 3319389 TI - Adenomyosis--HSG and ultrasonic scans. PMID- 3319390 TI - Adenomyosis. PMID- 3319391 TI - Treatment of pain in endometriosis. PMID- 3319392 TI - Evaluation of results in infertility therapy. PMID- 3319393 TI - Endometriosis and cancer. PMID- 3319394 TI - Gamete intra-fallopian transfer versus in vitro fertilization and embryo transfer in endometriosis. PMID- 3319395 TI - Endometriosis and medically assisted reproduction. PMID- 3319396 TI - Non-apparent and minimal endometriosis in infertility: therapeutic approach and results. PMID- 3319398 TI - Receptor disorders in endometriosis. PMID- 3319397 TI - Endometriosis-associated infertility. A statistical approach of future research on prognosis and treatment. PMID- 3319399 TI - Immunologic aspects of endometriosis. PMID- 3319400 TI - Pelvic endometriosis: a consequence of stress? PMID- 3319401 TI - Microscopic endometriosis. PMID- 3319402 TI - The problem of idiopathic stone formers presenting with no metabolic disorders. Pathogenesis and management. PMID- 3319403 TI - Computerized in vivo research from the growth of urease-producing bacteria in the presence of antibiotics combined with propionhydroxamic acid. PMID- 3319404 TI - Current status of ESWL in the management of renal calculus disease. PMID- 3319405 TI - Advances in preoperative localization and surgery of the parathyroid glands. PMID- 3319406 TI - Renal handling of calcium and magnesium in idiopathic stone disease. PMID- 3319407 TI - Selection of appropriate antifungal therapy. AB - Although there have been no radical breakthroughs in the treatment of fungal keratitis from the point of view of new antifungal agents, a better understanding of the epidemiology and pathology of the disease, as well as the drugs available and the appropriate surgical interventions, has led to an improvement in the management of this difficult corneal infection. In this paper the therapy of fungal keratitis will be reviewed in detail in the light of the known causative organisms and the pharmacology and pharmacokinetics of available antifungal agents. PMID- 3319408 TI - Reducing the risk of corneal graft rejection. A comparison of different methods. AB - Corneal graft rejection represents the leading cause of failure in corneal transplantation. Two of the major risk factors for graft rejection are previous sensitization, usually in the form of a previous rejected corneal graft and corneal vascularization. The major histocompatibility MHC antigens (HLA, A, B and DR) are the target of the corneal graft rejection process. Because HLA, A, B, and DR antigens have been found in the corneal epithelium, the corneal stroma, and the corneal endothelium, matching patients and donors would seem to reduce the incidence of rejection. The results of studies on HLA, A, B, and DR matching are discussed. Cyclosporin, a fungal by-product, prevents the proliferation of sensitized cytotoxic T cells. Its use topically in corneal transplant patients in a controlled series has also reduced the incidence of rejection. Its use systemically has also been tried in an effort to prevent corneal graft rejection. PMID- 3319409 TI - Tear and serum immunoglobulins during corneal graft rejection. AB - Tear and serum concentrations of IgG, IgA, and IgM were estimated in serially drawn samples of 50 patients undergoing optical keratoplasty. Fifteen healthy individuals served as controls. Samples were collected at different postoperative intervals. An immunological rejection phenomenon was observed in nine patients. The rejection could be reversed in five of these nine cases. A decline in serum immunoglobulins was observed during the postoperative follow-up of these cases. This was unrelated to rejection phenomenon and was attributed to systemic steroid therapy. In tears, IgM was not detectable in majority of samples. No significant variation in tear IgA levels was observed between the cases where rejection was reversed and the ones in which it resulted in an opaque graft. In contrast, significant tear IgG increase was observed during the rejection phenomenon. The increased IgG levels returned to the basal value in each case in which rejection was reversed, but remained elevated much above basal and maximum control values in cases in which rejection could not be reversed. This differential response of tear IgG was highly significant. Our results suggest that raised tear IgG levels and its persistence despite therapy may be an indicator of corneal transplant rejection. PMID- 3319410 TI - Corneal allograft rejection in a pregnant woman. AB - We report a case of corneal allograft rejection that occurred in a gravid woman 1 year following transplantation. This is the first report, to our knowledge, of corneal allograft rejection occurring in a pregnant woman. PMID- 3319411 TI - Diagnosis and management of herpes simplex stromal keratitis. AB - The diagnosis and optimal management of herpes simplex stromal keratitis can be problematic. Clinical features that should be evaluated include the status of the epithelium and the location and type of stromal inflammation. Two principal forms are recognized: nonnecrotizing, or disciform, keratitis and necrotizing keratitis. Both types may coexist and are sometimes accompanied by iridocyclitis and secondary ocular hypertension. Laboratory evaluation is not usually performed, although, lacking a prior history of herpes simplex epithelial keratitis, testing should be considered to seek another cause of stromal inflammation. A topical steroid is generally contraindicated in the presence of herpes simplex epithelial keratitis and has been implicated in prolonging the course of herpetic eye disease. However, judicious topical steroid therapy can be beneficial when used with protective antiviral cover for herpes simplex stromal keratitis without epithelial keratitis. Systemic antiviral therapy may prove to be a valuable adjunctive treatment, and further clinical trials are anticipated. PMID- 3319412 TI - Penetrating keratoplasty for keratoconus. AB - A series of 86 penetrating keratoplasties for keratoconus were analyzed. The surgery, using an 8.2 mm donor cornea into an 8.0 mm recipient opening, was performed over the period January 1983 to January 1986 by one surgeon. The donor cornea was secured by two opposing continuous sutures, placed at full corneal thickness under surgical keratometry control. Both sutures were removed at an average 30 weeks after surgery. The mean postoperative sutures-out astigmatism was 5.4 diopters (range 0-19.0 diopters) and following secondary astigmatism surgery in 17 eyes, the mean group astigmatism was 4.3 diopters (range 0-10.5 diopters). Although graft reaction occurred in 11.6% of cases it was cleared medically and did not affect final vision results. One month after suture removal, with spectacle correction, 45.5% of the primary group saw 20/20, 90.7% 20/30 or better, and 97.7% 20/40 or better. Comparing these results with recently published data on epikeratophakia for the treatment of keratoconus, it is evident that penetrating keratoplasty offers these usually young patients a better chance for recovery of useful industrial acuity. PMID- 3319413 TI - Posterior chamber IOL implantation during keratoplasty for aphakic or pseudophakic corneal edema. AB - Because of their many advantages, posterior chamber (PC) intraocular lenses (IOLs) were sutured to the posterior iris (in the absence of a lens capsule) in combination with penetrating keratoplasty for aphakic and pseudophakic corneal edema in 53 cases. Secondary PC IOL implantations were performed in aphakic corneal edema (nine cases), and IOLs were exchanged for PC IOLs in pseudophakic corneal edema (44 cases). Ninety-six percent of the grafts remained clear. Forty three percent of the eyes had 20/40 or better visual acuity, 38% between 20/50 and 20/200, and 19% worse than 20/200, with an average follow-up time of 6.4 (range 3-13) months. The most common cause of poor vision was cystoid macular edema present preoperatively in 20 eyes and postoperatively in 22 eyes. Other causes of persistent visual impairment included macular degeneration (five cases), retinal detachment (two cases), preoperative glaucoma damage (one case), severe postoperative glaucoma damage (one case), endophthalmitis (one case), and graft rejection (one case). Our short-term results indicate that this procedure may be a viable alternative to the use of secondary anterior chamber IOL implantation during penetrating keratoplasty. PMID- 3319415 TI - Stiffness in healing fractures. AB - Methods are available for direct measurement of stiffness in fracture healing. The methods are generally dissimilar in their technique and in some cases the applied assumptions are contrary to the principles of basic mechanics. External fixation provides the potential for direct measurement of fragment end movement, and techniques associated with this type of treatment have been applied in Belgium on more than 500 patients. These results are generally presented as decreases in flexure of the fixator bar due to constant loading, representative of increases in fracture stiffness. The same procedure is adopted to internal fixation plates and also direct strain gauge application to the healing bone- there are obvious complications due to electrical connections in the latter case. The biomedical changes occurring during healing are illustrated by the work at Cardiff where a biphase characteristic has been identified. The method used has the disadvantage in requiring the removal of the fixator for the application of the stiffness sensor recording deflection and rotation. The advantages of the technique include the more precise modeling of the bending characteristic of the tibia (the results refer to this particular skeletal element). The experimental studies at Oxford show evidence of enhanced osteogenesis when controlled intermittent deformation is applied in a cyclic manner. In a group of some 50 patients treated with induced micromovement, there is evidence that the rate of increasing fracture stiffness would allow removal of the fixator at 15 weeks compared with 24 weeks in the group with rigid fixation. The exact technique of measuring fracture stiffness has to be compared with other noninvasive test methods which include radiological examination, ultrasound, resonant vibration, and modal analysis. Many of these methods are based on linear elastic relationships which are inadequate to describe the anisotropic behavior of bones. The vibration analysis techniques are showing potential as clinical tools, and collaboration within the European community is directed towards a correlation between invasive and noninvasive methods of fracture monitoring. PMID- 3319414 TI - Oxygen transfer in the corneal-contact lens system. AB - The clinical results of contact lens wearers indicate that materials which theoretically are adequate to prevent corneal hypoxia and edema do not perform optimally under actual wearing conditions. Optimization of the cornea-tear-lens system requires an analysis of the modes of oxygen transport, mass transfer resistances, and characteristic dimensions. The lens properties are a function of polymer composition. Thus, investigations for ideal lens materials may result in limitless test copolymers and graft polymers of siloxane, methylmethacrylate, 2 hydroxyethyl-methacrylate, vinylpyrollidone, vinylacetate, and cellulose acetate butyrate of varying degrees of cross-linking and crystallinity. In an attempt to channel research efforts, this review will state the developments to date and the desirable properties of an optimal cornea-tear-lens system. The logic should encompass a theory and model whereby parameters are identified and varied within satisfactory physiological limitations, and experiments which provide data indicative of the in vivo conditions. The parameters must reflect the inherent transport properties of the corneal-contact lens system. Contact lenses may be categorized as soft, gas-permeable rigid/hydrophobic flexible, or hard. The major differences between these three categories are the properties: equilibrium water content or degree of hydration, tendency for water pervaporation and/or dehydration, surface hydrophobicity, thermal conductivity, oxygen diffusivity and solubility, lens thickness, rest height over corneal tear, flexibility, lens mobility over the cornea, cross-linking, crystallinity, stagnant boundary layer resistances, and manufacturing processes. Aside from complications presented by lens coatings and cleansing solutions, the most common problems experienced by lens wearers include corneal edema, dehydration involving the lens and the cornea, "blurry" vision due to localized corneal anoxia, debris trapped under the lens, and deposits on th surface of the lens. All of the aforementioned phenomena are either explicitly or implicitly associated with transport processes through and around the lens. Convection of tear fluid under a lens during a blink, diffusion of oxygen and water through the lens and the stagnant boundary-layer effect for mass transfer in the tear between blinks, and the overall nonisothermal effects on the transport of oxygen and water between the cornea and ambient conditions are reviewed. PMID- 3319416 TI - Candida and candidosis. Proceedings of a symposium. 14th International Congress of Microbiology. Manchester, England, September 1986. PMID- 3319417 TI - Candida infections: an overview. AB - The range of human infections caused by the yeast Candida albicans and a handful of related species is considerable. They range from relatively trivial conditions such as oral and genital thrush to fatal, systemic superinfections in patients who are already seriously ill with other diseases. Interest in Candida infections, and in C. albicans in particular, has become huge in recent years as fatal infections have become more prevalent and new Candida-based pathologies have been recognized. There is now even a large pseudoscientific cult based on the notion that chronic allergy to Candida can cause all sorts of common illnesses. The medical importance of Candida infections and the scientific value of C. albicans as a model for fungal cellular development have stimulated enormous advances in our understanding of the epidemiology of candidosis, pathogenesis of the disease, and the genetics and biochemistry of C. albicans. PMID- 3319418 TI - Sterols in Candida albicans mutants resistant to polyene or azole antifungals, and of a double mutant C. albicans 6.4. AB - Investigations of resistant mutants could help resolve differences and similarities in the action of azole and polyene antifungals whose modes of action are related; both disrupt membrane properties, such as permeability, by interfering with membrane sterols--polyenes by direct binding and azoles by inhibiting their synthesis. Studies of laboratory-derived mutants of Candida albicans which have an altered sterol content and/or an altered sterol composition do not provide evidence for a unified mechanism of polyene resistance. Clinical isolates of azole-resistant C. albicans have an increased or unaltered content of ergosterol and are impermeable to azoles. C. albicans 6.4, a laboratory-derived mutant resistant to both polyenes and azoles, is impermeable to azoles and has an increased content of methylated sterols. This unusual sterol composition resembles that of sensitive strains grown in the presence of azoles and may prevent polyene binding. PMID- 3319419 TI - Adhesion of Candida species to epithelial surfaces. AB - Successful colonization and infection of host tissues by the pathogenic Candida species depend upon the ability of these organisms to adhere to mucosal surfaces. The different species vary in their ability to adhere, and there is a clear correlation between adhesion and virulence. The mechanism of adhesion of the most pathogenic species, Candida albicans, to epithelial cells has been studied in detail and is thought to involve lectin-like interactions between specific binding molecules (adhesins) on the yeast surface and complementary receptor molecules on the epithelial cell surface. Current information suggests that the protein portion of mannoprotein located in fibrils on the yeast surface serves as the adhesin and interacts with glycoside receptors on epithelial cells. The evidence for this proposed mechanism is critically discussed. PMID- 3319420 TI - The genetic basis of resistance to 5-fluorocytosine in Candida species and Cryptococcus neoformans. AB - In terms of genetically determined susceptibility to the clinical antifungal agent 5-fluorocytosine (5-FC), Candida albicans may be homozygous sensitive (FCY/FCY), homozygous resistant (fcy/fcy), or heterozygous (fcy/FCY). Although heterozygotes are only slightly resistant, they occur at significant frequency among clinical strains and carry preexisting resistance determinants which may be responsible, following homozygosis, for treatment failures. There are two resistance genes (FCY1 and FCY2) known. Resistance in fcy1/fcy1 strains was associated with decreased UMP pyrophosphorylase activity, whereas resistance in fcy2/fcy2 strains was associated with decreased cytosine deaminase activity. These results were confirmed and extended in a 19F nuclear magnetic resonance study of 5-FC uptake and metabolism in genetically defined strains. By means of hybridization via spheroplast fusion, a complementation test was devised to test allelism of resistance determinants. Resistance to 5-FC was employed as a useful genetic marker in basic studies. In tetraploid hybrids which bore appropriate fcy markers, it was possible to select for reduction in ploidy by selecting for increased resistance to 5-FC; a novel parasexual system was thus generated (2n x 2n----4n----2n). In linkage studies, the gene FCY1 was shown to be linked to the gene HIS. Reciprocal mitotic recombination was demonstrated repeatedly with fcy1 and his alleles in cis and in trans configurations and evidence for nonreciprocal recombination (mitotic gene conversion) was also obtained. In Cryptococcus neoformans, mutation in either of two genes (FCY1, FCY2) is sufficient to confer resistance. These genes behave as simple Mendelian determinants which recombine freely. Diploid C. neoformans heterozygous for resistance (FCY/fcy) provided useful strains in which to develop genetic mapping methodology based on mitotic recombination. PMID- 3319421 TI - Anti-Candida drugs--the biochemical basis for their activity. AB - The past years have seen a continuous effort toward the synthesis of new antifungal agents. Most of them belong to the N-substituted imidazoles and triazoles. Another interesting series of antifungals are the allylamines. Biochemically, both the azole derivatives and the allylamines belong to the class of ergosterol biosynthesis inhibitors and thus differ from the polyene macrolide antibiotics. Indeed, it is now believed that the antifungal action of the polyenes, nystatin and amphotericin B, is due to a direct interaction with ergosterol itself. A more detailed analysis of the ergosterol biosynthesis inhibitors revealed that ergosterol depletion is the consequence of the interaction of the azole derivatives, e.g., miconazole, ketoconazole, and itraconazole, with the cytochrome P-450 involved in the 14 alpha-demethylation of lanosterol. Both the accumulation of 14 alpha-methylsterols and the concomitant decreased ergosterol content affect the membranes and membrane-bound enzymes of yeast and fungi. The allylamines seem to act by inhibition of the squalene epoxidase resulting in ergosterol depletion and accumulation of squalene. The target for the fluorinated pyrimidine, flucytosine, is completely different. Its antifungal properties may result from its conversion to 5-fluorouracil. The latter is then phosphorylated and incorporated into RNA, thus disrupting the protein synthesis in the yeast cell. These different biochemical targets for the antifungals of use in candidosis are discussed in this paper. PMID- 3319422 TI - Cell envelope of Candida albicans. AB - In this review, the cell envelope of the human pathogenic yeast Candida albicans includes the plasma membrane and the mannoproteins, enzymes, beta-glucans, and chitin of the wall. The organization of the wall is complex and ultrastructural studies show distinct "layers". Mannoprotein is distributed throughout the wall but is concentrated on the exterior surface and adjacent to the plasma membrane. The mannoproteins contain the antigenic determinants of the yeast cells. The major structural components of the wall are beta-1,3- and beta 1,6-glucans, and these two linkages are present in almost equal amounts. Chitin is concentrated at the bud scar, but small amounts are located over the entire wall where it appears to be linked to beta-1,6-glucan. Chemical bonding both within and between wall components confers rigidity on the wall and restricts movement of molecules into and out of the cell. Soluble enzymes are retained within the wall matrix, but a number of enzymes and proteins are excreted. The plasma membrane of C. albicans is similar to that isolated from other fungi and contains the proton pump ATPase and enzymes involved in biosynthesis of the wall such as chitin synthase and beta 1,3-glucan synthase. PMID- 3319423 TI - Cytological aspects of dimorphism in Candida albicans. AB - From a comparison of the growth of yeast and hyphal cells of Candida albicans at 37 degrees C, the present authors suggest that the formation of hyphae is a response to nutrient stress. The major cytological evidence for this is that the formation of a germ tube is chiefly the result of the migration of cytoplasm out of the parent yeast cell, with little biosynthesis occurring other than DNA replication and wall assembly. This explains the linear outgrowth of the germ tube rather than an autocatalytic outgrowth. It is accompanied by the enlargement of the vacuole in the parent cell. Subsequent elongation of the hyphae is accompanied by vacuolation of subapical compartments, and branching only occurs from some of the subapical compartments after they have reformed sufficient cytoplasm. PMID- 3319425 TI - Cell wall of Candida albicans and host response. AB - Modulation in chemistry and organization of cell wall macromolecules play decisive roles in the morphogenic processes and virulence of Candida albicans. Cell wall components also have a diversified range of effects on the host's immune system, including immunopotentiating or immunodepressing activities. Mannan, mannan-protein, and glucan fractions have been especially studied in this context. In in vitro cultured human peripheral blood mononuclear cells, a mannan protein fraction (GMP) from the cell wall of the yeast form acted as a strong antigenic activator by stimulating lymphokine production and lymphocyte proliferation. Cytolytic effectors active against several tumor targets were also generated. In the mouse, GMP was a strong inducer of natural killer lymphocytes. Other cell wall components, mostly the insoluble beta-glucan, modulated the activity of macrophages and monocyte precursors. Some of the immunomodulating properties of artificially extracted components were shared, even with greater potency, by antigens which were released from C. albicans during its growth and hyphal morphogenesis. Altogether, the range of the immunoresponses elicited and the intensity of the observed effects are such as to individuate in this human indigenous fungus a microorganism capable of profoundly affecting the host's immune system. PMID- 3319424 TI - Protoplasts fusion hybrids from Candida albicans morphological mutants. AB - Three pairs of strains, derived from Candida albicans 1001 (wild type) and carrying appropriate selection markers, were crossed by means of protoplast fusion. The corresponding fusion products were regenerated in selection medium and hybrids of rapid growth and more defined characteristics were eventually isolated and analyzed for relevant properties. Hybrids from a cross of two auxotrophic strains with no morphological alteration had a normal morphology but gave rise to rough-filamentous segregants of mostly pseudomycelial appearance, probably through DNA content reduction. The observation was consistent with a previous suggestion that C. albicans 1001 carries recessive mutant alleles that can be unmasked. A permanently filamentous strain (Y- phenotype) when crossed with a mycelium deficient (F-) strain gave rise to wild-type hybrids with a normal capacity for mycelium formation. Finally, two Y- strains, with similar phenotypes consisting of rough colony formation and mostly pseudomycelial morphology of cells under all conditions, also complemented since they gave rise to wild-type hybrids. It is concluded that the determinants of the mutant phenotype must be different in these two strains. PMID- 3319426 TI - Natural auxotrophic heterozygosity in Candida albicans. AB - Candida albicans is imperfect and diploid. This unusual genetic state permits the occurrence of strains heterozygous for recessive deleterious alleles. These alleles can be brought to homozygosity and therefore expression by UV irradiation induced mitotic crossing over. Heterozygosity for recessive auxotrophic alleles is found in 10 to 15% of the strains. A wide variety of auxotrophic alleles have been found in such natural heterozygotes but one type, termed Suf +/- was found at an unusually high frequency. Some 5 to 10% of strains are of the Suf +/- type. Suf- homozygous auxotrophs are defective in sulfite reductase. Such auxotrophs require a source of reduced sulfur such as methionine or cysteine, alternatively inorganic thiosulfate will serve as a supplement. Complementation analysis of a variety of Suf- auxotrophs established that 11 out of 12 strains were in a single complementation group. PMID- 3319428 TI - Colon and rectal carcinoma. AB - In the United States the incidence of carcinoma of the colon or rectum appears to be increasing. Although certain dietary habits appear to be associated with disease incidence, the putative carcinogens in the lumen of the bowel remain unidentified. The use of clinical screening based on a combination of proctosigmoidoscopy and tests for occult fecal blood allows detection of colorectal carcinomas at an early stage; however, it is unclear whether such screening is cost-effective in persons over 40 years of age or if treatment undertaken on the basis of screening results truly alters the natural history of the disease. Surgical resection is the mainstay of curative therapy, and its effectiveness will probably be enhanced by adjuvant x-ray therapy and chemotherapy. PMID- 3319427 TI - The impact of culture on the cognitive structure of illness. AB - This paper presents a theoretical framework for understanding the impact of culture on the processes of symptom recognition, labeling, and help-seeking and consequently on large-scale epidemiological studies involving different ethnic groups. We begin with the assumption that the subjective experience of illness is culture-bound and that the cognitive and linguistic categories of illness characteristic of any culture constrain the interpretative and behavioral options available to individuals in response to symptoms. We hypothesize the existence of learned cognitive structures, through which bodily experiences are filtered, that influence the interpretation of deviations from culturally-defined physical and mental health norms. Certain contradictory findings concerning the self-reported health of Mexican Americans are discussed in order to illustrate the impact of culture on perceived health status. PMID- 3319429 TI - Cardiac pacemakers. PMID- 3319430 TI - Silent myocardial ischemia. PMID- 3319431 TI - Family transitions, crises, and adaptations. PMID- 3319432 TI - Radiographic features of gastritis using the biphasic contrast technique. AB - Gastritis is a group of inflammatory disorders that can be diagnosed radiographically. The optimum radiographic examination of the stomach is the biphasic-contrast technique, which includes the use of a medium-dense barium sulfate suspension and a hypotonic agent. Knowledge of the forms of gastritis, a careful application of biphasic-contrast technique, and a perceptive evaluation of information will help the radiologist to detect this entity with great frequency. PMID- 3319433 TI - Gastric ulcer. PMID- 3319434 TI - Urinary radioimmunoreactive insulin levels predict rejection in cystoduodenal pancreatic allografts. PMID- 3319435 TI - Composite pancreas-kidney transplant in pigs. PMID- 3319436 TI - Effects of glycyl-histidyl-lysine on Morris hepatoma 7777 cells. AB - Glycyl-histidyl-lysine (GHL) has been shown to have growth stimulatory effects on a number of different cell types including hepatocytes and hepatoma cells. In this study, the effects of GHL on Morris hepatoma 7777 cells were investigated. The greatest stimulatory effects on 3H-thymidine and 3H-leucine incorporation were observed at a GHL concentration of 2 ng/ml. In randomly proliferating cells, the incorporation of 3H-thymidine into DNA increased by 50% and that of 3H leucine into protein by 29%. In addition, synergistic effects were observed when insulin and glucagon were included with GHL in the incubation mixture. Experiments with cells rendered quiescent by serum starvation indicated that cells in the G1 phase of the cell cycle are more sensitive to GHL stimulation. In these experiments, 3H-thymidine incorporation increased earlier and peaked at a higher value than in the control cells. This finding suggests that GHL may play a role in stimulating quiescent cells to re-enter the cell cycle. PMID- 3319438 TI - Regional chromosomal assignment of human renin gene to 1q12----qter and use in linkage studies in Charcot-Marie-Tooth disease. AB - The gene for renin, previously mapped to human chromosome 1, was further localized to 1q12----qter using human-mouse somatic cell hybrid DNAs. The renin DNA probe used (lambda HR5) could detect a HindIII restriction fragment length polymorphism. When used in studies of 12 informative families, no linkage could be found between the renin gene and Charcot-Marie-Tooth disease. Furthermore, an association of any renin allele with hypertension was not apparent. PMID- 3319437 TI - Two different XY-quadrivalent associations and impairment of fertility in men. AB - One sterile and one subfertile man with balanced reciprocal autosomal translocations, a t(9;15), and a t(14;21), were analyzed using whole mount pachytene spreads, histology, and semen analyses. In both probands with different types of quadrivalent complexes lack of pairing near the translocation breakpoints and significant associations with XY bivalents were found. Variability in the frequency of XY-quadrivalent contacts and an increase in late pachytene to 52% in t(9;15) and 90% in t(14;21) could be observed. The lower rate was associated with reduced postmeiotic spermatogenesis and the higher rate with complete spermatogenic arrest. In both translocation carriers the XY-quadrivalent association is considered to be the main cause for testicular malfunction rather than nonpaired segments in the multivalent complexes. PMID- 3319439 TI - Primate vocalization: a psychobiological approach. AB - Scientific inquiry, for the most part, can be described as parochial. Not only are there clear demarcations between broad disciplinary categories (i.e., anatomy, physiology, psychology), but subspecialties are common within disciplines. Modern technology has made possible a trend toward greater and greater specialization. In fact, there are now areas of scientific investigation that did not exist a few years ago. This increasing specialization and its concomitant reductionism is not without its pitfalls and problems. There is a tendency to move away from the basic evolutionary concept of living organisms as organized systems functioning and adapting within an ecosystem. The laboratory scientist often ignores the inherent organization of living systems in favor of an intense pursuit of his or her particular chosen bit of the biological puzzle. However, there are still disciplines that not only subscribe to the notion of living organisms as organized systems but have made a valiant attempt to bring this concept under laboratory scrutiny. Often, in order to identify these endeavors, a technique is used to combine two or three words into one. Thus, we have several flourishing disciplines described as psychoneuroimmunology, psychoneuroendocrinology, neurochemistry, physiosociology, and so on. For the investigator who attempts a more integrated approach to the broad biological and psychological universe, the demands are heavy. He or she is faced with the need to maintain credibility in several disciplines, each of which is advancing at an accelerated pace. However, we feel that the value of an integrated approach that crosses traditional disciplinary lines will be illustrated in a small way by this article and, we hope, by the series of articles presented in this symposium section of Child Development. PMID- 3319443 TI - [Reconstruction of the inner meniscus horn in combined injuries of the knee joint. Early results following meniscus suture]. PMID- 3319441 TI - [Use of external fixation in hand surgery]. PMID- 3319440 TI - [The development and state of maxillofacial prosthetics worldwide]. PMID- 3319442 TI - [Preparation of hip joint endoprostheses for qualitative and quantitative morphologic assessment]. AB - The morphological investigation of endoprostheses and the evaluation of the reaction with the surrounding bone tissue require the use of new preparation techniques. A standardized procedure of preparation is suggested to enable a comparison among various study groups. After removing the specimens (at autopsy), x-rays are taken, followed by separation into horizontal and longitudinal sections. These sections are undecalcified embedded retaining the implant/bone interface and grounded to thickness of 5-10 mu. First results of a quantitative analysis of bone loss are presented. PMID- 3319445 TI - [What is a post-traumatic subcapsular hematoma of the liver?]. PMID- 3319444 TI - [Dislocated humeral head fracture with intrathoracic displacement of the calotte fragment]. PMID- 3319446 TI - [Complicated osteitis of the limbs. Results of treatment by Papineau's method. Apropos of 42 cases]. PMID- 3319447 TI - [Clinical use of insertive esophagogastrostomy]. PMID- 3319448 TI - [Reconstruction of ligaments of the knee joint with dermal grafts in the dog. An experimental study]. PMID- 3319449 TI - [Traumatic or hemorrhagic shock and cellular energy metabolism disorders]. PMID- 3319450 TI - Mesenteric panniculitis of the colon. Review of the literature and report of two cases. AB - Eighteen cases of mesenteric panniculitis of the colon collected from the literature, together with two cases from the authors' source, were reviewed. The disease occurred most often in late adult life, with a male predominance. Symptoms were abdominal pain, diarrhea, constipation, and a lower abdominal mass in most patients. Barium enema disclosed narrowing, shortening, and poor extensibility of the colon, and ultrasonography and computed tomography showed thickening of the mesocolon and colonic wall with soft-tissue density. Exploratory laparotomy was done in all patients, and colectomy, colostomy, or other surgical treatments were performed in 17 (85 percent). Gross appearance at the time of surgery was characterized by a marked thickening or a firm mass of the mesocolon with a puckered surface involving the appendices epiploicae of the colon. Microscopically, degeneration of the adipose tissue, revealed by aggregates of lipid-laden macrophages, was diagnostic. Inflammatory infiltration and fibrosis also were present in many patients. Mesenteric panniculitis of the colon seems to be a lesion more advanced than the same condition of the small intestine, and colostomy or bypass surgery may be needed for alleviation of severe symptoms. PMID- 3319451 TI - A concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. AB - A review of the new concepts of the anatomy of the anal sphincter mechanism and the physiology of defecation is presented. The external sphincter is a triple loop system; each loop can function as a separate sphincter through voluntary inhibition action and mechanical compression. Stress defecation resulting from internal sphincter damage is described. A new technique for repair of rectal incontinence is presented, which depends on inducing continence not only by mechanical compression, but also by voluntary inhibition. The mechanism of defecation and rectal continence is described and four types of incontinence presented. Also, the mechanism of both the levator dysfunction syndrome and prolapse is demonstrated and a technique of repair is presented. The study defines two types of rectal anomalies; suprahiatal and infrahiatal. The role of the embryonic anorectal sinus, anorectal band, and epithelial debris in the genesis of perirectal suppuration, chronic anal fissure, pruritus ani, and hemorrhoids is described. The communicating veins, identified between the hemorrhoidal and vesical plexuses, offer an explanation for the vague pathologic aspects of recurrent bacteriuria, urethral discharge, cervicitis, and vaginitis, and provide a proper line for their treatment. They also serve to perform a new radiographic technique--anal cystography--and to administer drugs, including chemotherapeutics, in the treatment of pelvic malignancies. PMID- 3319452 TI - William Heneage Ogilvie 1887-1971. Large-intestine colic due to sympathetic deprivation. A new clinical syndrome. PMID- 3319454 TI - Reproducibility of colonoscopic findings in Crohn's disease: a prospective multicenter study of interobserver variation. Groupe d'Etudes Therapeutiques des Affections Inflammatoires du Tube Digestif (GETAID). AB - We have examined prospectively whether it was possible for a multicenter group (12 centers) to standardize data collection and to achieve a reasonable level of reproducibility of colonscopic findings in Crohn's disease. Each colonoscopy was performed simultaneously by a pair of endoscopists who did not communicate with each other until they had completed a standardized form. A preliminary period was necessary to achieve an agreement on items to be recorded and on lesion definition. Thereafter 112 colonoscopies were carried out by 18 intracenter endoscopist pairs (both endoscopists from the same center) and 21 colonoscopies by 14 intercenter endoscopist pairs (endoscopists from different centers) in patients with Crohn's disease. The following data were recorded: (1) for each segment involved--rectum, sigmoid, and left colon, transverse colon, right colon, and ileum--the nature of elementary lesions (by ticking on a list of nine items) and an estimation of the surface of lesions and of ulcerations on two linear analog scales; and (2) a global assessment of lesion severity on a five-point scale and on a linear analog scale. Reproducibility of lesion detection was fair to excellent (kappa values greater than 0.54, P less than 0.05 or less) except, in the intercenter study, for erythema and swollen mucosa. Agreement on estimation of diseased and ulcerated segmental surfaces was good (intraclass correlation, coefficient, r, greater than 0.85; P less than 0.001) in both intra- and intercenter studies. Global assessment of lesion severity on a five-point scale (intra- and intercenter kappa = 0.64 and 0.55, respectively; P less than 0.001) and on a linear analog scale [intra- and intercenter r = 0.86 (P less than 0.001) and 0.58 (P less than 0.01), respectively was reproducible. In conclusion, reproducible endoscopic data can be collected by a cooperative multicentric group and thus be used in controlled therapeutic trial in Crohn's disease. PMID- 3319453 TI - Lactitol, a second-generation disaccharide for treatment of chronic portal systemic encephalopathy. A double-blind, crossover, randomized clinical trial. AB - A double-blind crossover trial was performed to test the therapeutic usefulness and safety of lactitol, a beta-galactoside sorbitol, against lactose in 18 patients with chronic portal-systemic encephalopathy (PSE). The study included four periods: two for washout and two for lactitol and lactose administration. During washout periods, which lasted two weeks each, patients were stabilized with neomycin plus milk of magnesia. Lactitol and lactose were administered during four weeks each. Ten patients were randomly assigned to receive lactose (group A) and eight patients to receive lactitol (group B) first. PSE parameters, ie, mental state, number connection test performance, asterixis and blood ammonia levels were assessed fortnightly. Electroencephalographic tracings and stool pHs were evaluated at the end of each study period. After the first administration of lactose and lactitol, no statistically significant differences in PSE parameters were found. At the same stage, a significant stool acidification (P less than 0.05) was detected. It is concluded that lactitol seems to be safe and efficacious in treating patients with chronic PSE. PMID- 3319455 TI - Actinomycotic liver abscess. Case report and literature review. AB - A 28-year-old male with hepatic actinomycosis presented with several months of anorexia, weight loss, fever, night sweats, and mild right upper quadrant abdominal tenderness. Despite normal liver function tests, hepatic involvement was demonstrated by imaging studies. A liver biopsy and ultrasound-guided aspirate were, however, unrewarding. Laparotomy was, therefore, necessary to establish a definitive diagnosis. The patients was then successfully treated with intravenous penicillin followed by oral clindamycin. This case is presented to illustrate the diagnostic difficulties that may be encountered in such patients with hepatic actinomycosis. PMID- 3319456 TI - Laboratory assessment of inflammatory bowel disease. AB - Presently there are no specific laboratory tests to diagnose inflammatory bowel disease (IBD). Nonspecific tests to differentiate diarrhea due to mucosal injury from that occurring in patients with normal bowel mucosa (eg, fecal occult blood, leukocytes, etc) are not helpful. Tests to exclude infections agents are very important, since the clinical and radiological appearance of these may mimic IBD, and patients with IBD may suffer from superinfection. There are no laboratory tests which can differentiate Crohn's colitis from ulcerative colitis (UC). The tests used in the assessment and management of severely ill patients (Hgb, WBC, electrolytes, etc) are important, since abnormalities need to be corrected on an ongoing basis. The tests used to assess nutritional status are of little clinical value, since "clinical assessment" is as good as the laboratory assessment. Estimation of disease activity by tests is rarely better than the judgment of the clinician. Workup for malabsorption in Crohn's disease and the assessment of absorptive capacity of the terminal ileum are important for proper planning of management. Laboratory tests are also useful in clarifying the nature of some complications (eg, anemias and joint diseases). PMID- 3319457 TI - Clinical activity assessment in inflammatory bowel disease. AB - Standardized methods of making and recording clinical observations of patients with inflammatory bowel disease are needed for the conduct of controlled clinical trials and for the application of the results of such trials to clinical practice. A number of attempts to develop such methods have been made since the early 1950s, and such efforts continue at present. A universally accepted and acceptable clinical instrument to measure the disease activity of either Crohn's disease or ulcerative colitis will probably never be achieved. However, if interested clinicians can agree on a basic set of observations and how to make and record them, accurate comparisons of therapeutic outcomes across time and space will become possible. Toward this goal several groups of clinicians are currently working. PMID- 3319459 TI - 5-Aminosalicylic acid enemas in treatment of distal ulcerative colitis and proctitis in Canada. AB - The efficacy and safety of 4 g 5-aminosalicylic acid (5-ASA) enemas were assessed in 59 patients with ulcerative colitis involving up to 50 cm of their distal colon. Twenty-nine patients received 5-ASA and 30 received a placebo. There were 12 dropouts (five in the active and seven in the placebo group) during the study because of insufficient efficacy. After six weeks of therapy, 63% of the patients receiving the 5-ASA were considered to be "much improved" by the study physician compared to 20% patients on placebo (P less than 0.0001). A disease activity index (DAI), based upon patient symptoms and sigmoidoscopic appearance, was used to assess efficacy. Mean DAI declined 75% for patients on 5-ASA enemas and 32% for patients on placebo (P less than 0.05). The 5-ASA enemas are well tolerated and are of benefit in the treatment of ulcerative colitis confined to the distal colon. PMID- 3319458 TI - Pharmacology and pharmacokinetics of 5-aminosalicylic acid. AB - There is accumulating clinical evidence that 5-aminosalicylic acid (5-ASA), a primary metabolite of sulfasalazine (SAS), represents the therapeutic active moiety of the azo-compound SAS in the treatment of chronic inflammatory bowel disease (IBD). Since it is presumed that 5-ASA acts from the lumen of the intestine, it is important to know how much 5-ASA is released from its special galenic formulations. After liberation of 5-ASA in the terminal ileum (only slow release oral preparations of 5-ASA) and colon (5-ASA suppositories and enemas), 5 ASA is only partly absorbed. A major part of this 5-ASA is presystemically eliminated, eg, N-acetylated during its first passage through the intestinal mucosa and liver. Mean steady state plasma levels of unchanged 5-ASA are rather low (range 0.02 to 1.2 microgram/ml) whereas those of Ac-5-ASA are always higher (range 0.1 to 2.9 micrograms/ml). This is due to the rapid elimination of 5-ASA (t1/2 = 0.4 to 2.4h) and the slightly slower renal excretion of the Ac-5-ASA (t1/2 = 6 to 9 h, renal clearance = 200 to 300 ml/min). The knowledge of the pharmacokinetic properties of 5-ASA from different drug formulations might contribute to a better understanding of its mode of action in IBD. PMID- 3319460 TI - Efficacy of 5-aminosalicylic acid enemas versus hydrocortisone enemas in ulcerative colitis. AB - A controlled trial has been carried out in order to compare the efficacy of enemas containing a high dosage of 5-ASA (4 g) versus enemas containing hydrocortisone 100 mg. The trial was conducted on 86 patients, 44 of whom received 5-ASA and 42 received hydrocortisone. The results were favorable in terms of clinical, sigmoidoscopic, and histologic criteria for 5-ASA treatment. Other aspects have been investigated, such as retrograde spread of enemas which have been shown to reach the left colon. No nephrotoxicity was detected. The long term experience confirmed the preliminary positive results. PMID- 3319461 TI - Double-blind, placebo-controlled evaluation of 5-ASA suppositories in active distal proctitis and measurement of extent of spread using 99mTc-labeled 5-ASA suppositories. AB - Patients with active distal proctitis received either 5-aminosalicylic (5-ASA) acid or identical placebo suppositories, 500 mg t.i.d. for 6 weeks. Activity at 3 and 6 wks was assessed using a Disease Activity Index (DAI), derived from four categories: number of daily evacuations more than usual, evacuations containing blood, sigmoidoscopy appearance, and physician's overall assessment. Each category was graded 0-3. There was thus 0-12 points scored ranging from complete remission to severe disease. A minimum score of 3 from two categories was necessary for study entry. Of 27 patients randomized, 14 received active medication and 13 placebo. Of the 14 patients, with initial mean DAI 7.1 +/- 1.8, 11 were in complete remission at 6 wks (78.6%). Whereas, there was no significant change in the placebo group, with initial mean DAI 7.1 +/- 1.8. An additional 6 patients with inflammatory bowel disease and 6 healthy volunteers were given 99mTc-labelled 5-aminosalicylic acid suppositories. The extent of spread was limited to the rectum, and the suppositories were retained for 3 hours. There was no absorbed radioactivity. 5-ASA suppositories are safe, well-tolerated, and effective treatment for active distal proctitis. PMID- 3319462 TI - Proctocolitis unresponsive to conventional therapy. Response to 5-aminosalicylic acid enemas. AB - We report results of a prospective study of daily 5-ASA enema therapy in patients with proctocolitis that was unresponsive to conventional therapy. Forty-seven patients with active colonic inflammation distal to the splenic flexure have been followed for three months to three years. Rapid improvement was noted within three months in 41 of 47 (87%) patients, while six failed therapy. Of the 41 patients responding to therapy, 39 achieved complete remission. Nineteen patients have relapsed at least once following discontinuation of 5-ASA, but 23 of 25 (92%) relapse episodes responded to a course of 5-ASA therapy. Complications of 5 ASA therapy were limited to hemorrhoidal irritation and local perianal injury. We conclude that 5-ASA enema is effective in inducing remission in patients with proctocolitis unresponsive to conventional therapy. PMID- 3319463 TI - Epilepsy. AB - "Epilepsy" describes a heterogenous group of disorders bound together by their tendency to produce seizures. Recent advances in the basic neurosciences provide new insights into the pathophysiology and treatment of seizures. In the last decade, revisions of the classification schemata have led to improvements in the recognition of seizure types and of different epilepsies and epileptic syndromes. The clinical utility of these definitions is apparent in diagnosis, therapy, prognostication, and genetic counseling. A plan for the diagnostic evaluation of patients with epilepsy is presented. The therapeutic options for seizure treatment are reviewed including the withdrawal of anticonvulsants. Patients who should probably not be treated with anticonvulsants are identified. Psychological and life-style issues in the management of seizure patients are considered. The concept of adequate control is discussed. Surgical management, an increasingly employed therapeutic modality, is described. PMID- 3319464 TI - Neutrophil function disorders. AB - The polymorphonuclear leukocyte (neutrophil) is the most important phagocytic cell that defends the host against acute bacterial infection. Disorders of neutrophil function are suggested by recurrent cutaneous, periodontal, respiratory, or soft tissue infections. Staphylococcus aureus, gram-negative bacilli, and less commonly, Candida albicans, are the causative organisms. Treatment is supportive involving surgical drainage and antibiotics. Bone marrow transplantation offers hope to some patients. The biochemical and molecular defects have been identified for some of these disorders. Identification of these defects and their physiologic consequences have improved our understanding of how the activated neutrophil is attracted and adheres to inflammatory sites, and produces toxic products that destroy bacteria. However, the activated neutrophil may also damage normal tissue and participate in diseases such as rheumatoid arthritis and the adult respiratory distress syndrome (ARDS). PMID- 3319465 TI - Some concepts on the use of three-dimensional isometric plots for the representation of differential sensitivity. AB - An increasing use is being made of three-dimensional isometric plotting to represent the topography of the visual field. The format of such plots, however, can be manipulated depending upon the parameters of the plotting routine. Problems associated with generating these plots such as resolution of the plotting grid, scaling of sensitivity and orientation of the plot are discussed with reference to both normal and abnormal fields derived by the Octopus 201 automated perimeter (stimulus size III). Recommendations for this type of perimetric representation are suggested. PMID- 3319466 TI - The morning glory disc anomaly: contractile movement, classification, and embryogenesis. AB - A case of the morning glory disc anomaly is reported in which alternating contraction and dilation movements were observed and documented with fundus photographs. The movements are attributed to an anomalous communication between the subretinal and subarachnoid spaces that permits flux of fluid to occur between the two compartments, with consequent variation in the degree of retinal elevation within the excavated portion of the lesion. The clinical features of the morning glory disc anomaly, peripapillary staphyloma and optic disc coloboma are presented, and the relationship among these lesions is discussed. The author concludes that the morning glory disc anomaly is a clinical entity distinct from peripapillary staphyloma and optic disc coloboma. It is thought to be due to dysgenesis of the distal optic stalk leading to anomalous persistence of the extension of the cavity of the optic cup into the stalk. PMID- 3319468 TI - Plasma fibrinopeptide A levels during insulin-induced plasma glucose falls in diabetics. AB - Plasma fibrinopeptide A (FPA) concentration, as a measure of thrombin activity, was determined during an insulin tolerance test in 17 non-obese diabetics. FPA was measured by a modification of the Nossel method. Administration of insulin significantly lowered plasma glucose, accompanied by a significant increase in FPA from 0.9 +/- 0.1 ng/ml to 4.3 +/- 1.6 ng/ml (P less than 0.05) as well as a significant increase in circulating levels of epinephrine and growth hormone. The magnitude of the peak in epinephrine levels correlated well with both the rate of decline of plasma glucose and the magnitude of the peak of FPA. In addition, the FPA increment was suppressed by treatment with heparin. These results indicate that insulin-induced hypoglycemia or a rapid fall in plasma glucose is associated with enhanced thrombin generation and fibrin formation, which may be considered as a contributory factor to the development of diabetic microangiopathy through a hypercoagulable state. PMID- 3319469 TI - Efficacy of a multiple insulin injection regimen in teenagers with insulin dependent diabetes. Carbohydrate and lipid oxidation measured by continuous indirect calorimetry. AB - Our study of insulin-dependent diabetic teenagers proved that a multiple insulin injection regimen (MIR) can be an acceptable and effective method of glycemic control. Further, the artificial beta cell can be used to determine insulin requirements for MIR. And finally, continuous indirect calorimetry can be used to assess metabolic control in diabetes. PMID- 3319470 TI - [Immobilized systems producing fibrinolytic proteinases]. PMID- 3319467 TI - Field processes in stereovision. A description of stereopsis appropriate to ophthalmology and visual perception. AB - There is, as yet, no satisfactory theory of stereopsis, despite the fact that our overt knowledge of "solid seeing" is now about 150 years old, and that contributions to our understanding come today from many fields: ophthalmology, psychology, psychophysics, neurophysiology, computer modelling, and optical-TV display technology. We review herein, and demonstrate for the reader whenever possible, certain key perceptual properties of the stereoscopic event of which any general theory must take account: vector stereoscopy and the neural grid, depth in empty visual fields, the relationship between stereoscopic and cognitive contours, stereoscopic contour formation in the presence of blur (thus, at low levels of central visual acuity), the phenomenon of cortical locking and of neural grid evocation in the presence of either peripheral or central rivalry, certain unusual ranges of figural mismatch and the concept of the horopter in relation to modern single cell electroneurophysiology in animals and to the constancy of visual directions. Some comments are also made on the concept of disparity processing by single cortical neurons, together with a short discussion of the implications of certain views of the genetics of stereovision for the perception of novel random texture sine-wave stereograms. We conclude that any theory pertinent to ophthalmology and visual science must combine the global concepts of cortical integration, the neural lock and the neural grid, herein introduced, with the more classical concepts of particulate or local binocular cortical correspondence. Certain preliminary steps in this direction are presented. PMID- 3319471 TI - [Synthesis of an immunoreactive fragment of human ceruloplasmin in bacterial cells]. PMID- 3319472 TI - Management of hyperlipidaemia. PMID- 3319473 TI - [Ingredients of modern hair dyes]. AB - 70 substances currently used in colouring human hair are reviewed from chemical and structural perspectives. On the basis of structural simularities the question of relationships to known contact allergens, in particular p-phenylendiamine and benzochinones, is examined. Hereby it may be discerned that despite the relatively large number of new substances, the dangers of new potent allergens or cross-reactions with widely encountered existing agents are limited. PMID- 3319474 TI - Drugs that promote renal excretion of riboflavin. AB - Enhanced urinary excretion of vitamins induced by drugs is a major factor in development of vitamin deficiencies. In addition to increasing urinary excretion, drugs can induce vitamin deficiencies by altering their intestinal absorption, transport, storage, and/or metabolic conversions. Aside from drugs, other factors known to influence urinary excretion of vitamins include the level of the vitamin in the diet, the degree of tissue saturation of the vitamin, and the extent of protein binding of the vitamin. Alterations in various aspects of flavin metabolism have been observed following administration of certain drugs, namely, antimalarial, antimicrobial, anticancer, and some tricyclic antidepressant and antipsychotic agents. Of these drugs, boric acid and its derivatives as well as the antipsychotic agent, chlorpromazine, have been shown to promote riboflavinuria in both animals and man. Boric acid complexes with the polyhydroxyl ribitol side chain of riboflavin and greatly increases its water solubility. Individuals who have accidentally consumed boric acid or one of its derivatives excrete high levels of riboflavin within the first 24 to 48 hours following ingestion. The phenothiazine ring of chlorpromazine and the isoalloxazine ring of riboflavin have a number of structural features in common and have been shown to form a molecular complex in vitro. In animals treated for a 3- and 7-week period with chlorpromazine, urinary levels of riboflavin are twice that of pair-fed, saline-treated animals. Recent studies have extended these findings to humans. The administration of certain agents, either therapeutic or toxic, which enhance urinary riboflavin excretion may be of particular concern for high-risk patients who are already nutritionally compromised because of illness or disease. PMID- 3319475 TI - [Duplex sonography of the normal portal vein]. AB - In 50 normal subjects flow velocity and direction on the portal vein was measured by ultrasonic duplex system. The measurements revealed at a mean diameter of 9.7 mm, a mean flow velocity of 15.2 +/- 2.6 cm/s, corresponding to a volume flow of 693 +/- 235 ml/min. Postprandially this increased to 880 +/- 269 ml/min. Inter observer and day to day measurements demonstrated good reproducibility. Thus, this simple non-invasive method is well suited for quantitative assessment of the portal vein system in portal hypertension, thrombosis or after shunt operations. PMID- 3319476 TI - [Therapy in alcoholic delirium]. PMID- 3319477 TI - [The current standard therapy of tuberculosis]. PMID- 3319478 TI - [Liver apudoma simulating cystic liver]. AB - A 36-year-old man in otherwise good general condition and with completely normal laboratory results suffered from right upper abdominal pain. Hepatomegaly was diagnosed as due to cystic liver disease after ultrasound, computed tomography and magnetic resonance imaging. Recurrent abdominal pain continued over several months. Open liver biopsy eventually revealed trabecular-tubular carcinoma (APUDoma). Silver reaction was positive in many tumour cells. Electronmicroscopy demonstrated membrane-bound granules typical for endocrine cells. Immunohistological examinations of various hormones and of neurone-specific enolase were negative, but repeatedly measured high serum levels of pancreatic polypeptide and of beta-HCG nonetheless suggested an endocrine tumour. This case demonstrates that nonparasitic cystic changes in the liver, especially multiple ones, should have a firm diagnosis established by invasive means. Endocrine tumours can be mistaken for polycystic liver disease. PMID- 3319479 TI - [Early recognition of systemic lupus erythematosus]. PMID- 3319480 TI - [Bacteriology and chemotherapy of infectious endocarditis]. PMID- 3319481 TI - [The solution of the riddle of antibody diversity]. PMID- 3319482 TI - [Kinetics of calcium metabolism in sheep under the influence of Trisetum flavescens (yellow oats)]. PMID- 3319483 TI - [A year's experience with a videomicrography system (Cellsoft) for sperm assessment]. PMID- 3319484 TI - [The effect of bacterial contamination on pregnancy rate after in vitro fertilization (IVF) and embryo transfer (ET) in humans]. PMID- 3319485 TI - [Ultrasonic biometry of horse fetuses in utero and sonographic representation of their organs]. PMID- 3319487 TI - ["On the spot" determination of progesterone for ascertaining nonpregnant sows?]. PMID- 3319486 TI - [A method for intra-arterial blood pressure measurement in cattle]. PMID- 3319488 TI - Output of coccidial oocysts (particularly Eimeria crandallis) by naturally infected lambs: daily and hourly patterns and clinical significance. PMID- 3319489 TI - [Pasteurella anatipestifer infection of waterfowl]. PMID- 3319490 TI - Low-dose aspirin in prevention of toxaemia of pregnancy. Does it have a place? PMID- 3319492 TI - Optimum treatment of genital warts. AB - Genital warts (condylomata acuminata) must be treated and controlled carefully because of their frequent relapses and the risk of malignancy. Treatment is by destruction of the lesions. The most frequently used treatment for external warts is podophyllin 20% in ethanol which is applied to the affected area and then carefully washed off after 4 to 6 hours. The effectiveness of this method of treatment varies between 20 and 98%, with the warts generally disappearing in 3 to 4 days. If podophyllin is ineffective or is contraindicated (e.g. in pregnancy), other measures such as surgical removal, electrocautery, cryo-surgery or laser treatment can be used independently or in combination. Other treatments that have been used include topical application of 5-fluorouracil and intralesional or systemic use of interferons. Patients and their sexual partners should be followed for several months after treatment. A Papanicolaou smear should be obtained from women prior to treatment because of the association of human papilloma virus infection with cervical invasive neoplasia. PMID- 3319493 TI - Management of attacks of acute porphyria. AB - The acute porphyrias consists of a group of pharmacogenetic disorders of haem biosynthesis which are characterised by attacks of abdominal pain and neurological dysfunction. Although the genetic and biochemical basis of these diseases is now well established, the pathogenesis of the clinical manifestations remains speculative. Symptomatic and supportive therapy remain an important part of the management of the acute attacks. High carbohydrate intake and parenteral haematin administration are the only proven therapies that can modify an attack, both clinically and biochemically. However, haematin therapy does not provide satisfactory prophylaxis. The future use of luteinising hormone-releasing hormone (LHRH) agonists to prevent recurrent attacks in selected female patients is still under investigation. PMID- 3319494 TI - Cephalosporins 1945-1986. AB - In 1945, after penicillin had been introduced into medicine, an antibiotic producing species of Cephalosporium was isolated from a sewage outfall in Sardinia. Four years later in Oxford, this organism was found to produce several antibiotics, one of which was a penicillin with a new side-chain, penicillin N. During a chemical study in 1953, this penicillin was shown to be contaminated with a second substance, cephalosporin C, which contained a beta-lactam ring but was resistant to hydrolysis by a penicillinase (beta-lactamase). At that time, penicillinase-producing Staphylococci were causing a serious problem in hospitals. The isolation of the nucleus of cephalosporin C (7-ACA) enabled pharmaceutical manufacturers to produce many thousands of cephalosporins, some of which have been effective in the treatment of serious infections by a number of Gram-positive and Gram-negative bacteria. The cephalosporins, like the newer penicillins, have a very low toxicity and have greatly extended the range of chemotherapy. New, sensitive screening methods have revealed further families of clinically useful substances that contain a reactive beta-lactam ring. Genetic engineering has now begun to throw light on the nature of the enzymes that are involved in the biosynthesis of penicillins and cephalosporins, and x-ray crystallography may soon provide detailed 3-dimensional pictures of some of the bacterial enzymes with which the active beta-lactam ring reacts. Rational approaches to the production and design of new and potentially useful compounds may then be within sight. PMID- 3319491 TI - 'Second generation' dihydropyridine calcium antagonists. Greater vascular selectivity and some unique applications. AB - The newer dihydropyridine calcium antagonists are structurally related to nifedipine, but may provide greater vascular selectivity and wider clinical utility. Five new dihydropyridines-nisoldipine, nicardipine, nimodipine, felodipine and nitrendipine-are reviewed with regard to their preclinical pharmacology, haemodynamic effects and clinical indications. Nisoldipine is a potent arterial vasodilator with minimal electrophysiological and negative inotropic effects. Although data are still preliminary, the drug has shown some efficacy in both exertional angina and essential hypertension. The dosing interval is not yet clearly established, but may be twice daily. Utility in congestive heart failure awaits confirmation, but preliminary studies are promising. Nicardipine is an especially potent peripheral, cerebral and coronary arterial vasodilator that causes 10-fold less myocardial depression in animals than nifedipine, and may provide important cardioprotective effects during ischaemia. Human haemodynamic studies have confirmed nicardipine's lack of negative inotropism, its ability to reduce coronary and peripheral vascular resistance, and its lack of effect on cardiac conduction. Several controlled trials have documented its efficacy in exertional angina, vasospastic angina, and essential hypertension. Nicardipine's potential as an antiatherosclerotic agent is currently under investigation. Nimodipine is undergoing a unique clinical development programme aimed at cerebrovascular disorders. In almost all species, nimodipine selectively increases cerebral blood flow and reverses cerebral artery spasm without altering cerebral oxidative metabolism or systemic blood pressure. In humans, a large, double-blind, placebo-controlled trial in subarachnoid haemorrhage showed that nimodipine significantly reduced the severity of neurological deficits associated with delayed cerebral vasospasm. Several uncontrolled trials with larger numbers of patients support these results. Nimodipine has also proved useful in reducing cerebral artery spasm during intracranial surgery, and in the prophylactic treatment of migraine headaches. A preliminary study of nimodipine in acute stroke showed promising results in limiting neurological disability. Felodipine is a very potent systemic arterial vasodilator with negligible myocardial depressant activity. It is also a renal artery vasodilator. Unlike the other new dihydropyridines, felodipine prolongs the A-H interval on electrophysiological testing, but only to about 50% of that observed with verapamil. Felodipine is undergoing clinical trials in essential hypertension.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3319495 TI - Side effects of cephalosporins. AB - Cephalosporins generally cause few side effects. Hypersensitivity reactions are less common than with the penicillins and modern studies have presented data contradicting a true cross-reactivity to cephalosporins in patients who have previously reacted to penicillins. Other hypersensitivity reactions to cephalosporins include fever, arthralgia and exanthema observed in two clusters of children who had been given cefaclor. Nephrotoxicity is not a problem with modern cephalosporins, although slight reductions of renal function have been seen when high doses of ceftazidime were used. Some of the new cephalosporins have a 3-methyl thiotetrazole side-chain, a moiety which confers a risk of reduced synthesis of prothrombin with subsequent risk of bleeding, and of disulfiram-like reactions in patients consuming alcohol following a cephalosporin dose. Other cephalosporins, e.g. ceftriaxone and cefoperazone, are excreted not only via the kidneys but also via the bile. This leads to high biliary concentrations of the active drug, increasing the risk of diarrhoea which may be caused by selection of cytotoxin-producing strains of Clostridium difficile. Laboratory adverse reactions to cephalosporins are rare. Eosinophilia and thrombocytosis are commonly reported, but are most probably not adverse reactions but signs of healing of the infections treated. Other haematological reactions have been reported in very few patients and have been rapidly reversible when treatment was stopped. PMID- 3319498 TI - Classification of cephalosporins. AB - Many cephalosporins are now in clinical use. They have a wide range of activity against different species of bacteria and also differ in their pharmacokinetic and metabolic characteristics. This article outlines a basis for comparison and classification of cephalosporins into 4 groups active mainly against: (1) Gram positive bacteria; (2) Gram-negative rods; (3) Gram-negative rods including Pseudomonas spp.; and (4) Gram-negative rods including Bacteroides spp. Further subdivisions highlight the pharmacological differences. PMID- 3319496 TI - Cephalosporins in gram-positive infections. AB - Infections caused by Gram-positive bacteria are an important and common cause of morbidity and mortality. Staphylococci and streptococci are the most frequent infecting organisms in skin and soft tissue infections, pneumonia, bone and joint infections, and endocarditis. Anaerobic Gram-positive bacteria such as Clostridia spp. cause infections that can rapidly produce tissue necrosis and death. The cephalosporins are indicated for the treatment of infections caused by Gram positive bacteria in certain circumstances. These include selected patients with endocarditis, osteomyelitis, septic arthritis and cellulitis. They are also used as alternatives to the penicillins in penicillin-allergic patients and for 'mixed' infections caused by Gram-positive and Gram-negative organisms. This article discusses the indications for the cephalosporin group of antibiotics in patients suffering from infections caused by Gram-positive bacteria. PMID- 3319499 TI - Cephalosporins in urinary tract infection. AB - Despite their greater cost compared with other antibiotics, the cephalosporins continue to be used in the treatment of urinary tract infections. Most cephalosporins are excreted primarily by the kidney (by glomerular filtration, tubular secretion, or both) and urinary concentrations routinely exceed 1000 mg/L after even a small dose; exceptions include cefoperazone and ceftriaxone which both exhibit significant biliary excretion, and in patients with significant renal dysfunction only minimal concentrations of these drugs may be present in the urine. Although single-dose treatment of uncomplicated lower urinary tract infections with oral cephalosporins has not been as effective as with other antibiotics, cephalexin, cephradine and cefaclor continue to be used. Early clinical trials with cefuroxime axetil also appear promising for short term and single-dose therapy. The parenteral cephalosporins are reserved for use against more resistant strains or in hospitalised patients with upper urinary tract infections, their choice being directed by in vitro susceptibility tests. Newer agents such as ceftazidime and cefsulodin have been shown to be effective in infections due to P. aeruginosa. Recommended cephalosporin dosage regimens for the common urinary tract pathogens are given. PMID- 3319497 TI - Cephalosporins in the treatment of meningitis. AB - The synthesis of new cephalosporin antibiotics has provided agents which can effectively be used to treat most of the different forms of meningitis. None of the first generation cephalosporins can be considered acceptable as agents to treat meningitis. Cefuroxime can be used to treat meningitis due to Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis in children. Agents such as cefotaxime and ceftriaxone are appropriate for neonatal meningitis due to Escherichia coli and group B streptococci, but not Listeria monocytogenes. Cefotaxime, ceftriaxone, ceftizoxime and ceftazidime have all proved effective as therapy of meningitis in children and adults when the pathogens are pneumococci, H. influenzae or N. meningitidis, but they have not been shown to yield an improved mortality or lower morbidity in spite of much greater cerebrospinal fluid (CSF) bactericidal titres. Cefotaxime, ceftizoxime, ceftriaxone and ceftazidime have been effective as therapy of meningitis due to E. coli, K. pneumoniae and Proteus species, but failures have occurred with all of the cephalosporins when used to treat meningitis due to Enterobacter spp. and Serratia marcescens. Only ceftazidime yields adequate CSF concentrations to treat meningitis due to Pseudomonas aeruginosa. Overall, the cephalosporins can now be considered a major component of the therapy of acute bacterial meningitis irrespective of the age group to be treated. PMID- 3319500 TI - Role of cephalosporins in gonorrhoea and other sexually transmitted diseases. AB - Cephalosporins have a role in the treatment of gonorrhoea, and especially infections caused by strains that are penicillin-resistant, either because they produce plasmid-mediated beta-lactamase or they have chromosomally mediated diminished permeability or modified penicillin-binding proteins. Although none of the oral or Group I agents are useful, most of the Group II, III and IV agents are, and especially cefuroxime, cefotaxime, ceftriaxone and cefoxitin. In addition to uncomplicated urethral, cervical or rectal infections, appropriate regimens are also effective for the treatment of pharyngeal infections, disseminated infections and gonococcal ophthalmia. The cephalosporins have no clear role in the treatment of syphilis, granuloma inguinale, Mycoplasma or chlamydial infections or bacterial vaginosis, but ceftriaxone may be effective in chancroid, and cefoxitin in combination with an antichlamydial agent (such as a tetracycline) might be used for the treatment of pelvic inflammatory disease. PMID- 3319502 TI - Use of cephalosporins in the immunologically compromised patient. AB - Infection is a major threat to patients with neutropenia, particularly those with haematological malignancies who are undergoing chemotherapy. Early use of an empirical antibiotic regimen with the broadest possible spectrum of activity is recommended until culture data can guide the choice. A standard combination in many centres is an amino-glycoside and a semisynthetic penicillin with antipseudomonal activity or a cephalosporin. However, no regimen can adequately cover all potential pathogens and in these patients, who are exposed to many toxic insults, the choice of antibiotics may significantly increase the incidence of side effects, particularly nephrotoxicity. There has, therefore, been considerable interest in simpler, less toxic (and less expensive) regimens and the concept of monotherapy has been explored. Although recent studies using ceftazidime alone have supported this as an effective approach, there remain several issues to resolve; and on a more cautionary note preliminary results from the latest EORTC study, which recruited more than 1200 patients, suggest that in Gram-negative bacteraemia, conventional combination therapy remains the treatment of choice in neutropenia. While monotherapy is attractive in an environment of low drug resistance when exposure to third generation cephalosporins is infrequent, this is rarely the case. In addition, the widespread use of tunnelled catheters for venous access had led to an increase in Gram-positive infections, and the more intensive immunosuppression to the emergence of fungal infections. Although these tend not to be rapidly fatal, their presence must be considered in designing treatment strategies. The influence of the host and treatment on the type of infection and the relative merits of the differing concepts in therapy are explored in detail in this article. PMID- 3319501 TI - Treatment of respiratory tract infections with cephalosporin antibiotics. AB - Infections of the respiratory tract are among the most common causes for antibiotic prescribing. Their diagnosis within the community is generally limited to clinical criteria, and microbiological information is frequently lacking. Hospitalised patients with respiratory tract infections are more likely to undergo diagnostic sampling, but difficulties remain in reliably defining a microbial aetiology, thereby providing a confident basis for antibiotic selection. In considering the role of the cephalosporins in the treatment of respiratory tract infections, over 500 published articles have been reviewed. The pharmacokinetic considerations are discussed and the limitations of existing methodology are emphasised. Individual agents are reviewed by site of sepsis and conclusions are drawn from both comparative and non-comparative studies and in relation to currently recommended regimens. Although oral cephalosporins are widely used to treat upper respiratory tract infections, none is considered ideal, especially where Haemophilus influenzae is pathogenic. In the case of lower respiratory tract infections the beta-lactamase stable parenteral cephalosporins have become widely used to treat pneumonia in hospitalised patients, especially where Gram-negative enteric bacilli are of aetiological importance. However, the lack of activity of these drugs against Legionella spp., Mycoplasma pneumoniae and Coxiella burnetii must be emphasised. Another area of increasing use is in the treatment of infective exacerbations in patients suffering from cystic fibrosis of the lungs where Pseudomonas aeruginosa is pathogenic; ceftazidime in particular has proved a useful alternative to earlier antipseudomonal penicillin antibiotics. PMID- 3319503 TI - Cephalosporins in surgery. Prophylaxis and therapy. AB - Prophylactic antibiotics in surgery are intended to prevent morbidity and mortality, as well as to reduce the duration and cost of hospitalisation. The indications for prophylaxis, and its effectiveness, should be evaluated with these criteria in mind. The basis for antibiotic prophylaxis in surgery is either provision of an effective concentration of antibiotic in the tissue site at the time of potential contamination, or (primarily in the case of colorectal surgery) to reduce the inoculum of potentially contaminating bacteria. Cephalosporins are the antibiotics most widely used for prophylaxis in surgery, and have clearly been shown to reduce postoperative morbidity in vaginal hysterectomy, resection of head and neck cancers, vascular grafting, total joint replacement, repair of hip fractures, and high risk gastroduodenal surgery. They are probably also useful in cardiac surgery, abdominal hysterectomy, caesarean section, and colorectal surgery. For orthopaedic, cardiac, gynaecological, and gastroduodenal procedures it is important to select an antibiotic with proven clinical activity against Gram-positive organisms. For head and neck surgery, the spectrum of activity should also include oral anaerobes and Enterobacteriaceae. For biliary surgery an antibiotic effective against both Gram-positive and Gram-negative organisms may offer at least theoretical advantages, while for appendicectomy a cephamycin represents the most appropriate choice. In colorectal procedures, activity against B. fragilis is the major consideration in selecting an antibiotic for systemic prophylaxis. When intra-abdominal sepsis occurs following surgery, a potentially wide range of bacteria may be implicated, but in practice such infections are due to a small number of species, with B. fragilis most commonly implicated. The most useful cephalosporins in this setting are those active against both aerobic Gram-negative bacteria and anaerobes, especially B. fragilis. In practice, an aminoglycoside is often administered concomitantly. Importantly, prompt surgical treatment is the cornerstone of management of abdominal sepsis, and empirical antibiotic therapy should be adjusted as needed when culture and sensitivity tests become available. PMID- 3319504 TI - Microbiological investigation of cephalosporins. AB - The most important role of the clinical microbiology laboratory is to advise clinicians in their choice of antimicrobial therapy. While the application of modern laboratory techniques is enabling sensitivity testing to cephalosporins to be performed with increasing precision, the ability to predict accurately clinical efficacy has not improved in parallel. For the cephem group in particular, the present confusion as to the numerical value of breakpoints and their interpretation, and the overuse of 'class testing' are making the task of the clinical microbiologist more difficult. For most purposes, simple disc sensitivity testing of cephems gives sufficient information, and it is simple to carry out, as no special media or growth conditions are required. Further studies are required to answer an outstanding question of great importance, namely, what the clinical prognostic significance is of results of sensitivity testing of 'methicillin-resistant' Staphylococcus aureus and coagulase-negative staphylococci, as these organisms often appear sensitive to cephems in vitro. For the research worker, the cephems provide tools of almost unrivalled power in the investigation of such microbiologically important topics as cell wall synthesis, bacteriolysis, membrane function and various aspects of enzyme regulation and inhibition. Relatively minor changes in the structure of cephem molecules can markedly affect their binding to bacteria, thus allowing probing of the functions of the individual penicillin-binding proteins. In Gram-negative bacteria, membrane function can be selectively changed by the action of subinhibitory concentrations of cephems, as it is intimately connected to the integrity of the peptidoglycan moiety. Induction and derepression of beta-lactamases may be responsible for a new type of bacterial resistance. PMID- 3319508 TI - [Selection and management of heart procurement]. PMID- 3319509 TI - Emergence of gentamicin-resistant E. coli 0111:K58 in a nursery ward at Kenyatta National Hospital. PMID- 3319507 TI - Pharmacokinetic properties of the cephalosporins. AB - Most cephalosporins can only be administered parenterally. Among agents that are absorbed from the gastrointestinal tract, those with bioavailabilities of 85 to 90% include cefroxadine, cefadroxil, cefsumide, cephalexin, cephradine, cephacetrile, and cefazaflur. Most cephalosporins are eliminated rapidly, with serum half-lives (t1/2s) of 1 to 2 hours. Exceptions are cefonicid with a t1/2 of 4.4 hours, cefpiramide with a t1/2 of 5.0 hours, and cefotetan with a t1/2 of 3.5 hours. The longest half-life is shown by ceftriaxone with a t1/2 of 8.5 hours. Cephalosporins are eliminated mostly by the kidneys, some with a substantial contribution from active tubular secretion, which is blocked by probenecid. The degree of metabolism varies. Only a few cephalosporins have a high biliary elimination. For example, with intravenously administered cefoperazone, about 70% appears in bile. High biliary elimination is also observed with cefmenoxime, ceftriaxone, cefbuperazone, and latamoxef (moxalactam). Because these are not appreciably absorbed from the gastrointestinal tract, the consequence is high intraintestinal concentrations of the drugs and a marked ensuing depression of the normal microflora with simultaneous emergence of resistant bacteria. The untoward ecological impact may even lead to Clostridium difficile-associated enterocolitis. PMID- 3319510 TI - Dysentery associated with invasive E. coli 028ac in an adult: a case report. PMID- 3319505 TI - In vitro antibacterial effects of cephalosporins. AB - Data from many studies on the antibacterial effects of cephalosporins are reviewed. Variations in reports from different workers occur because of the composition of the strains used to carry out determination of minimum inhibitory concentrations (MICs). For this reason, standard MIC50/MIC90 data are used sparingly. Where data are available, the activity has been expressed as the mode activity against fully sensitive strains of a species; and the activity against resistant strains is specified, as far as the data allow, for the mechanisms of resistance exhibited. PMID- 3319512 TI - Dental fluorosis: a review of literature with comments on tropical characteristics. PMID- 3319511 TI - In vitro monitoring of chloroquine sensitivity of Plasmodium falciparum in Ifakara, Kilombero District, south-east Tanzania. PMID- 3319506 TI - Mechanisms of resistance to cephalosporin antibiotics. AB - Cephalosporins, like other beta-lactams, bind to the bacterial penicillin-binding proteins (PBPs). These correspond to the D-ala-D-ala trans-, carboxy- and endo peptidases responsible for catalysing the cross-linking of newly formed peptidoglycan. Resistance arises when the PBPs-and particularly the transpeptidases-are modified, or when they are protected by beta-lactamases or 'permeability barriers'. Target-mediated cephalosporin resistance can involve either reduced affinity of an existing PBP component, or the acquisition of a supplementary beta-lactam-insensitive PBP. beta-lactamases are produced widely by bacteria and may be determined by chromosomal or plasmid DNA. The chromosomal beta-lactamases are species-specific, but can be classified into a few broad groups. The plasmid-mediated enzymes cross interspecific and intergeneric boundaries. The level of beta-lactamase-mediated resistance relates to the amount of enzyme produced with or without induction; to the location of the enzyme (extracellular for Gram-positive organisms and periplasmic in Gram-negative ones); and to the kinetics of the enzyme's activity. In Gram-positive organisms the PBPs are located on the outer aspect of the cytoplasmic membrane and so shielding by permeability barriers is minimal. In Gram-negative cells, however, the PBPs are protected by the outer membrane, which most beta-lactams cross by diffusion through aqueous pores composed of 'porin' proteins. In enterobacteria, a clear correlation exists between porin quantity and cephalosporin resistance, suggesting that the outer membrane is the sole barrier to drug entry. Such relationships are less clear for Pseudomonas aeruginosa, where the cell may contain additional barriers between the outer membrane and the PBPs. Although elevated cephalosporin resistance often is attributed to a single factor (PBP modification, beta-lactamase action or impermeability) an organism's response to a drug often reflects the interplay of several factors. Mathematical models can be proposed to describe this interplay. PMID- 3319513 TI - [Organization of scientific activity in health: problems and perspectives]. AB - The author examines the present state of research in the countries of Latin American and the Caribbean, and the inconsistency between the increase of these activities and the lack of research policies in the health field. He reviews the constraints and problems in the Region--technical as well as institutional, economic and political--which hinder progress and undermine interest in the continuance of scientific work in health ministries. Finally, the reflections prompted by his analysis lead the author to a visualization of the possibilities and prospects for Latin America, predicated on a reorganization of institutions, the emergence of new policies, the identification of the relationships between economic and social development, and the part played in them by science and technology to bring about changes in the world. PMID- 3319514 TI - [Health personnel: graduates from the medical school of the University of the Republic, Uruguay]. AB - The article summarizes the initial findings of a study of the medical labor market, done by the Uruguayan Planning Office and cofinanced by PAHO. The survey, starting in 1880 for graduates and in 1915 for students, brings out the exponential growth of their numbers, the growing participation of women--who are now a majority in the profession--and other indicators that affect health services. The conclusion is that there should be an explicit policy on the training of medical manpower. PMID- 3319515 TI - [The role of modifying factors in the carcinogenic effect of asbestos and asbestos-containing dusts]. AB - The modifying role of adsorption activity, fibre size, fibrogenicity, carcinogens of other classes and of some noncarcinogenic compounds in asbestos carcinogenesis have been considered. It is supposed that the modifying factors play a dominant role in asbestos blastomogenicity. The removal of these factors is an important method for tumours prophylaxis in asbestos workers. PMID- 3319516 TI - [Life span and tumor incidence in animals of various species]. AB - The data presented shown no positive correlation between spontaneous tumour incidence and (1) the life span of species, (2) the life span of different strains or stocks of the same species, and (3) the life span of certain populations of the same strain or stock. This conclusion is in conflict with the concept suggesting a summation effect of the events that cause malignant development irrespective of aging per se, in the age-related increase in the tumour incidence, and indicates an important role of age-related changes occurring in the organism in the realization of carcinogenic effect of endogenous and/or exogenous factors. PMID- 3319517 TI - [Study of sea water pollution by determining the mutagenic activity of sediments]. AB - Extracts from bottom sediments sampled in the Bering Sea and in certain regions of the Pacific Ocean were studied. Benzene and acetone-hexane extracts were tested for mutagenicity by Ames' bacterial test-system using the TA 98 and TA 100 Salmonella typhimurium strains. Extract from 4 stations of the 10 studied ones produced significant increase in the number of revertants. The experiments conducted permit drawing a conclusion on the probable distribution of mutagenic and carcinogenic activity zones in the ocean. PMID- 3319518 TI - [Approaches to ecological monitoring of chemical carcinogens]. AB - The approaches to ecological monitoring of carcinogens including the principles of its organization as well as the choice of the animals and plants as nature monitors are discussed. The classification of integral monitoring of carcinogens including bioecological (natural), sanitary-hygienic and medicobiological monitoring is proposed. PMID- 3319519 TI - [Changes in the total proteolytic activity and inhibitory potential of tumor and lung tissue in mice during growth and metastatic spread of malignant neoplasms]. AB - In tumour tissue and in lungs of mice with carcinoma 3LL, melanoma B-16, adenocarcinoma 755 different changes of proteolytic and antitryptic activities have been revealed. An excessive level of the protease activity and/or a decrease of the inhibitory potential activity are the factors of decompensation of the body's protease-inhibitory system and stimulate development of metastatic process. PMID- 3319520 TI - [The role of air pollution in the etiology of lung cancer]. AB - The paper discusses the role of air pollution, smoking and occupational factors in the etiology of lung cancer. The analysis of the results of the epidemiological studies carried out in the USSR and other countries suggests that air pollution increases the risk of lung cancer, but the role of smoking and occupational factors in the causation of lung cancer in human beings is much more important. PMID- 3319522 TI - Hypothesis testing with principal components analysis: the dissociation of P3b and Nc. PMID- 3319521 TI - Dedication to Samuel Sutton 1921-1986. PMID- 3319523 TI - [GABAergic neuroendocrine regulation. Morphofunctional data]. PMID- 3319524 TI - [Relation between GABAergic and dopaminergic neurons in the basal ganglia]. PMID- 3319526 TI - Experimental investigations into the possibility of differentiating early from invasive carcinoma of the stomach by means of ultrasound. AB - Using high-resolution ultrasound such as is employed, for example, in endoscopic ultrasonography, the walls of hollow organs are visualized as layered structures. The correlation of these "acoustic layers" with the histological layers, is of particular interest for the staging of early malignant lesions. Both clinically and experimentally, we made an attempt to determine the extent to which, at a transducer frequency of 7 MHz, such a correlation is possible. Our investigations show that, although reflection phenomena can mimic and "overlap" anatomical layers, the important boundary between the submucosa and the muscularis propria is principially identifiable. PMID- 3319525 TI - [GABA and mood disorders]. PMID- 3319527 TI - Transintestinal ultrasonography--present and future. PMID- 3319528 TI - The Sebright bantam chicken and the genetic control of extraglandular aromatase. PMID- 3319529 TI - The role of calcitonin in the development and treatment of osteoporosis. AB - CT is a peptide hormone produced predominantly by thyroid C cells and probably to a lesser extent by extrathyroidal tissues. Although its physiological function has not yet been established, it is a pharmacological inhibitor of osteoclastic bone resorption. There is currently no convincing evidence that naturally occurring or iatrogenic CT deficiency is involved in the pathogenesis of osteoporosis; however, a selective examination of patients with various rates of bone turnover would help to resolve this issue. As a pharmacological inhibitor of bone resorption, CT has potential usefulness in the therapy of osteoporosis. CT has been shown to stabilize or modestly increase indices of cortical and trabecular bone mass and total body calcium when administered to patients with established osteoporosis for periods of 1-2 yr. The increments in bone mass seen in some studies appear to be transient and are likely due to reductions in bone resorption with bone formation remaining unaffected until remodeling spaces are filled. The duration and magnitude of these increases are probably limited by the eventual decline in bone formation as remodeling equilibrium is reestablished. Therefore, reduction in the rate of bone loss with maintenance of the existing skeletal mass, rather than significant sustained increases in bone mass, should be considered the most realistic therapeutic goal with this agent. Whether or not a reduction in the rate of bone loss persists for longer periods needs further evaluation as does the important issue of subsequent fracture rates. The identification of patients with increased bone resorption rates (high turnover osteoporosis) should help provide a basis for more selective treatment of those patients who would be most likely to respond to this form of therapy. Whether there is additional benefit to using intermittent CT concurrently or sequentially with bone formation stimulating agents (coherence therapy) also needs to be explored. CT may also be of benefit in the prevention of osteoporosis, particularly in postmenopausal women who are unable or unwilling to take estrogen replacement. These potential benefits must be weighed carefully against the current cost of CT and the inconvenience of it having to be given by injection, problems which should be solved by future research. PMID- 3319530 TI - Mechanism of the stimulatory effect of growth hormone on longitudinal bone growth. PMID- 3319531 TI - The autonomously functioning thyroid nodule: Goetsch's disease. AB - The AFTN was established as a clinical entity by the 1918 report of Goetsch, correlating cellular mitochondrial content with nodular function, and showing the inverse correlation between AFTN function and extranodular tissue function. Degeneration, common in AFTNs, can preclude development of hyperthyroidism, eliminate hyperthyroidism, or even induce transient spontaneously resolving hyperthyroidism. AFTNs are nearly always benign. Most reports of malignant AFTNs are inadequately documented. Whether AFTNs are toxic can be determined by clinical evaluation, with laboratory confirmation using principally serum T3 assays and TRH testing. Whether warm nodules are AFTNs may be determined by suppression imaging. Nontoxic AFTNs are usually observed. For older patients with borderline high serum T3 levels, blunted responses to TRH, or subnormal responses on supersensitive TSH assays, prophylactic therapy may be prudent. Toxic AFTNs may be treated surgically (patients younger than 40) or with radioactive iodine (older patients). High dose radioactive iodine therapy is preferred because it more consistently ablates AFTN function. PMID- 3319532 TI - Assays for thyroid growth immunoglobulins and their clinical implications: methods, concepts, and misconceptions. PMID- 3319533 TI - Kinetics and dynamics of prednisolone. PMID- 3319535 TI - Isolation and amino acid composition of the isotypes of a rat Clara cell specific protein. AB - A protein of molecular weight about 10,000 (Clara cell protein C) present in lung lavage fluid and specific to Clara cells has been shown to have three isotypes. The isotypes have been individually isolated and purified by a combination of molecular sieving, ion exchange chromatography, column chromatofocusing, and reverse phase chromatography. The protein was monitored by immunoblotting and its purity tested by silver staining of the gel following sodium dodecyl sulfate polyacrylamide gel electrophoresis. About 33.7% of the 10-kDa protein present in starting rat lavage was recovered in final pure preparation. The 10-kDa Clara cell protein amounted to 0.38% of the total protein in rat lung lavage fluid. The three isotypes were present in a ratio of 1.0:2.8:8.8, the amounts increasing with decreasing pI. None of the isotypes bound to concanavalin A. The amino acid compositions of the three isotypes were similar and were remarkable in that the contents of leucine, glutamic acid, aspartic acid, serine, and proline were high, tyrosine was present in low amounts, and methionine and histidine were absent. PMID- 3319534 TI - Uteroglobin: structure, molecular biology, and new perspectives on its function as a phospholipase A2 inhibitor. AB - UG or blastokinin is a low molecular weight protein which is secreted by the endometrium of the rabbit during early pregnancy. Its synthesis and secretion by the endometrium are regulated by ovarian steroids, especially P. However, the protein is also produced by tracheo-bronchial, gastrointestinal, prostatic, and seminal vesicular epithelium. In the respiratory tract, UG synthesis is under glucocorticoid control. The hormonal regulation of UG synthesis in organs other than the endometrium and tracheobronchial epithelium is poorly understood. The structure of this protein and its gene has been extensively investigated while its physiological function is still unclear. Since UG, after reduction of its two disulfide bonds, has the ability to bind P and related steroids, it has been suggested that this protein is a P carrier or a P scavenger. However, the protein does not bind glucocorticoids, estrogens, or androgens and its presence in organs other than the uterus cannot be explained on the basis of its P binding. Recent data indicate that UG has other interesting biological properties. These include antichemotactic/antiphagocytic effects on macrophages, monocytes, and neutrophils, tolerogenic effect on both blastomeres and spermatozoa against recognition by maternal lymphocytes, and its ability to inhibit thrombin-induced platelet aggregation. Moreover, UG has been shown to be a potent phospholipase A2 inhibitor. The latter property could suggest a possible mechanism of some of the observed biological effects of this protein. The structural similarities of UG with phospholipase A2 and with other PLA2 inhibitory proteins like lipocortins may suggest that the physiological function of this protein may be primarily immunomodulatory through its function as a PLA2 inhibitor. The possible occurrence of similar proteins in other species, including humans, may confirm this hypothesis. Additionally, our hypothesis may lend support to the suggestion that P may be nature's immunosuppressant during pregnancy. PMID- 3319536 TI - Double-blind dose reduction study of vigabatrin in complex partial epilepsy. AB - Seventy-five epilepsy patients with at least two complex partial seizures/month were treated with gamma-vinyl GABA (GVG) 3 g/day for 3 months. Forty-one patients (54%) showed a reduction of greater than or equal to 50% in seizures. The median monthly seizure frequency decreased from 11.5 to 4 seizures/month. Twenty percent of patients had an improvement in general performance without a significant reduction in seizures. The responders entered the second phase of the study, in which 28 patients were randomly allocated to 3 g/day and 25 patients to 1.5 g/day GVG under double-blind conditions. The dosage of 3 g/day appeared to be clearly more effective than 1.5 g/day. However, even with 1.5 g/day GVG the seizure frequency was significantly reduced as compared to baseline. Drowsiness was the most commonly observed side effect, and it diminished with continued treatment. In three cases side effects led to the withdrawal of GVG therapy. PMID- 3319538 TI - In memoriam Graham Goddard: an appreciation. PMID- 3319537 TI - Oxcarbazepine (GP 47.680): a possible alternative to carbamazepine? AB - A double-blind randomized crossover design trial of carbamazepine (CBZ) and oxcarbazepine (OCBZ) was performed with 48 in-patients with epilepsy. All were stabilized on polytherapy including CBZ and had at least two seizures per week. CBZ was replaced by the trial medication. Each trial period started with a titration, followed by a 12-week steady state. Concomitant medications were kept constant during the trial. The criteria for assessment were seizure fit frequency and severity; tolerability; hematology and blood chemistry; plasma levels of antiepileptic drugs; EEG; cardiovascular parameters; and treatment preference. The following differences regarding OCBZ were detected: 9% reduction of the total number of seizures, with a significant reduction of tonic-clonic (20%) and tonic (31%) seizures; increased alertness and concentration ability in five patients; an allergic skin reaction with CBZ that completely disappeared in two patients while receiving OCBZ; an increase of valproate and phenytoin plasma levels in a number of patients, probably caused by reduced enzyme induction; a slight but significant reduction of serum Na, not causing clinical symptoms; less seizures than in the CBZ period in 25 patients (52%); and a preference for OCBZ in 23 patients (48%). We consider OCBZ at least as effective as CBZ with a slightly better tolerability. In severe cases, the wider therapeutic window might improve seizure control. PMID- 3319539 TI - In memoriam: Bruce S. Schoenberg, 1942-1987. PMID- 3319540 TI - Cognitive dysfunction associated with antiepileptic drug therapy. AB - Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients. PMID- 3319541 TI - Problems and management of the pregnant woman with epilepsy. AB - Pregnancies occurring in women who are epileptic are considered to be high risk. These women are at increased risk of seizures during pregnancy, labor, and delivery and of pregnancy complications and adverse pregnancy outcomes. Pregnancy alters the pharmacokinetics of anticonvulsant drugs, the levels of which decline as pregnancy advances. Not all drugs are altered in a similar manner, however. The rate of congenital malformations in infants of epileptic mothers is 2.4 times higher than in the general population. Malformations occur with all of the commonly used anticonvulsant drugs. The possible mechanisms of teratogenicity include folic acid antagonism, fetal tissue binding, and toxic effects of metabolic intermediates. Therapy with more than one drug increases the risk of congenital malformations. A unique hemorrhagic phenomenon in the infants of epileptic mothers has been reported and appears to be the result of a deficiency of vitamin K-dependent clotting factors. When taken by a pregnant woman, all antiepileptic drugs except valproic acid manifest themselves in breast milk, but only if the infant exhibits evidence of sedation should breastfeeding be discontinued. The dilemma for the physician treating the pregnant epileptic woman is to protect the mother from seizures and the fetus from unnecessary exposure to anticonvulsant medications. PMID- 3319542 TI - Anticonvulsant drugs and cognitive function: a review of the literature. AB - Alterations of cognitive function are separate from disturbances of behavior seen in association with epilepsy. The nature of the cognitive disability may to a certain extent depend on the seizure type. Partial seizures, mainly derived from a temporal lobe focus, impair memory tasks, while generalized seizures seem to have more effect on attentional abilities. A number of studies, reviewed in this paper, suggest that anticonvulsant drugs further impair cognitive function. Maximal impairments are seen in patients receiving polytherapy: rationalization of polytherapy improves cognitive abilities. Studies in children and adults have allowed differentiation of the effects of various commonly used antiepileptic agents. Maximal cognitive deficits are seen with phenytoin, while phenobarbital and sodium valproate induce moderate disturbances, and carbamazepine seems relatively free from such toxicity. Further research is needed on the interrelationship between types of seizure disorders, types of anticonvulsant medications, and cognitive function. PMID- 3319543 TI - Results of a nationwide Veterans Administration Cooperative Study comparing the efficacy and toxicity of carbamazepine, phenobarbital, phenytoin, and primidone. AB - In 1985 a 5-year multicenter Veterans Administration Cooperative Study was completed that compared the efficacy and toxicity of phenobarbital, carbamazepine, phenytoin, and primidone in a double-blind prospective study design. A total of 622 patients, either previously untreated or undertreated, were entered into the study. Strict exclusion criteria limited confounding factors such as drug or alcohol abuse. Results showed that each of the four drugs used as monotherapy were similarly effective in the treatment of generalized tonic clonic seizures, but carbamazepine was significantly more effective in the treatment of complex partial seizures as measured by 100% control. When the results for all four drugs were combined, the data showed that approximately 80% of the patients were adequately managed on monotherapy. Differences in toxicity were the most significant factor that discriminated between these four drugs. Both carbamazepine and phenytoin were associated with significantly lower incidences of intolerable side effects than were primidone or phenobarbital. A behavioral toxicity battery was performed whenever possible prior to administration of any antiepileptic drug and at 1, 3, 6, and 12 months after initiation of monotherapy. Significant differences in performance on all subtests of the battery were found between patients with epilepsy and a control group matched by age, sex, and education. When the differential effects of all four drugs on behavioral toxicity were compared, few statistically significant differences emerged. However, carbamazepine consistently produced fewer adverse effects on tests of attention/concentration and motor performance than did the other three antiepileptic drugs. PMID- 3319544 TI - Clinically significant carbamazepine drug interactions: an overview. AB - Knowledge of the principles of drug action and distribution contributes to an understanding of the occurrence of drug interactions. The pharmacologic action of most drugs is postulated to occur by the formation of a drug-receptor complex at the site of action that is capable of altering the physiologic response of the target system. The therapeutic response observed depends on the sum of the numerous factors that can affect the disposition pattern of a drug. In an individual, the response to a given drug dose remains relatively constant, but in a large population, a fixed dose can produce a range of plasma concentrations and therefore varied clinical responses. For most drugs, there is a linear relationship between the total dose and the plasma concentration achieved at steady state. Saturation, or zero-order, kinetics accounts for nonlinear increases in drug concentration with dosage increase. Drug-drug interactions with carbamazepine include several types. (1) Autoinduction of carbamazepine metabolism increases the carbamazepine clearance rate, decreases the half-life, and decreases serum concentrations; the clinician must reevaluate a patient's serum levels at 4 to 6 weeks after initiation of therapy. (2) Carbamazepine induces the metabolism of other antiepileptic drugs, enhancing the clearance of phenytoin, primidone, valproic acid, clonazepam, and ethosuximide. (3) Other drugs added to the epileptic patient's drug regimen may induce the metabolism of carbamazepine, causing increased serum concentrations. (4) Inhibition of carbamazepine metabolism by other drugs can also occur; symptoms of drug intoxication rapidly follow. Interactions occur between carbamazepine and macrolide antibiotics, cimetidine, propoxyphene, and isoniazid. Drug-drug interactions are preventable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319545 TI - Polytherapy, monotherapy, and carbamazepine. AB - Despite the widespread and traditional use of polytherapy in the treatment of epilepsy, there is little evidence of its advantages over monotherapy. Among other undesirable effects, it can produce subtle cognitive and behavioral changes and sometimes even exacerbate the epilepsy. Recent studies provide evidence that in many patients seizures can be controlled by carefully monitored monotherapy: Approximately 75% of newly diagnosed, previously untreated epileptic patients will enter a 2-year remission with this form of treatment. The theory has even been advanced that early control of seizures may help prevent the evolution of drug-resistant, chronic epilepsy. In some patients with chronic epilepsy, multiple-drug therapy can be reduced to single-drug treatment, usually with an improvement in cognitive function and without increase in seizures. Trials conducted to date have shown no evidence of superiority of any one major antiepileptic drug over another in control of a particular seizure type. The choice of antiepileptic drug for monotherapy may therefore be influenced by differences in toxic effects associated with individual agents. On the basis of clinical and psychometric evidence, carbamazepine has been shown to cause fewer adverse effects than other antiepileptic drugs on cognitive function, mood, and behavior. PMID- 3319546 TI - A review of approaches to the detection of genetic damage in the human fetus. AB - Studies in experimental animals suggest links between genetic damage to the fetus and the etiology of several disorders, including fetal loss, teratogenesis, and cancer. Methods for measuring genetic damage directly in the human fetus could provide epidemiologists and clinical researchers with powerful tools for investigating similar associations in humans. Current methods potentially available for such studies include assays for mutagenic substances in human body fluids and for measuring modifications to genetic material at the three levels of organization of genetic material: the chromosome, the gene or specific locus, and chemical DNA. Results of studies using fetal tissues to investigate each of these end points are reviewed, emphasizing studies of chemical modifications to DNA nucleotides detected in the human placenta. PMID- 3319547 TI - Reproductive immunology: biomarkers of compromised pregnancies. AB - The objective of this paper is to consider several categories of biomarkers of human pregnancy. The design of the report is to discuss useful and promising markers and techniques. Research gaps, needs, and priorities are also defined. Useful markers are mixed lymphocyte culture reactions, measures of lymphocytotoxic antibodies, histocompatibility (HLA) typing, and immunohematological evaluations. Promising markers are measures of major basic protein and early pregnancy factor, as well as determinations of trophoblast lymphocyte cross-reactive (TLX) antigens. Promising techniques are fluorescence activated cell-sorter analysis of maternal blood for fetal and extraembryonic tissues and immunotherapy with TLX and other antigens to prevent spontaneous abortion. It is concluded that immunology has much to offer the development of biomarkers of human pregnancy. PMID- 3319548 TI - Biological markers during early pregnancy: trophoblastic signals of the peri implantation period. AB - The peri-implantation period extends from the time the blastocyst is free in the uterus, through the processes of recognition and attachment, to the beginning of trophoblast differentiation and the interactions between the embryo and the uterine endometrium which initiate establishment of the hemochorial placenta. It is during the peri-implantation period that the embryo and hormonally regulated endometrial cells appear to be most sensitive to factors which introduce risk into the intrauterine environment. There are no markers which can be used practically to assess pregnancy risk during the peri-implantation period of either human or laboratory rodents. Experimental studies, using in vitro laboratory models of differentiating trophoblast cells, have identified peptide hormone markers of pivotal developmental processes. Exposure of trophoblast during the expression of these processes could have severe and far-reaching effects individually and societally. While these trophoblast signals are limited in their utility with respect to health monitoring extrapolation of these findings to human pregnancy, the signals could serve to identify more practical and sensitive markers to assess risk in early gestation. Human chorionic gonadotropin (hCG) has been used extensively as a marker to assess risk during the early stages of pregnancy. Extrapolation of experimental data indicates how hCG could be used more effectively in analyses of possible cause and effect relationships. The limitations of hCG as a marker for risk during the human peri implantation period are discussed. Peptide hormones which could serve to assess risk during this critical period of extraordinary sensitivity to toxic factors are introduced. PMID- 3319549 TI - Animal models of physiologic markers of male reproduction: genetically defined infertile mice. AB - The present report focuses on novel animal models of male infertility: genetically defined mice bearing single-gene mutations that induce infertility. The primary goal of our investigations was to identify the reproductive defects in these mutant mice. The phenotypic effects of the gene mutations were deciphered by comparing the mutant mice to their normal siblings. Initially testicular steroidogenesis and spermatogenesis were investigated. The physiologic markers for testicular steroidogenesis were steroid secretion by testes perifused in vitro, seminal vesicle weight, and Leydig cell histology. Spermatogenesis was evaluated by the enumeration of homogenization-resistant sperm/spermatids in testes and by morphometric analyses of germ cells in the seminiferous epithelium. If testicular function appeared normal, we investigated the sexual behavior of the mice. The parameters of male sexual behavior that were quantified included mount patency, mount frequency, intromission latency, thrusts per intromission, ejaculation latency, and ejaculation duration. Females of pairs breeding under normal circumstances were monitored for the presence of vaginal plugs and pregnancies. The patency of the ejaculatory process was determined by quantifying sperm in the female reproductive tract after sexual behavior tests. Sperm function was studied by quantitatively determining sperm motility during videomicroscopic observation. Also, the ability of epididymal sperm to function within the uterine environment was analyzed by determining sperm capacity to initiate pregnancy after artificial insemination. Together, the experimental results permitted the grouping of the gene mutations into three general categories. We propose that the same biological markers used in the reported studies can be implemented in the assessment of the impact that environmental toxins may have on male reproduction. PMID- 3319551 TI - Toxic effects of lead in the developing nervous system: in oculo experimental models. AB - Modern man is chronically exposed to lead in the biosphere at levels several orders of magnitude higher than the natural level that once existed. There is much concern about the possible adverse effects of this population-wide, low level lead exposure, particularly on the developing organism, wherein the central nervous system may be one primary target. We have developed in oculo test systems, which permit temporal and spatial discrimination of possible effects of lead and other potential neurotoxic agents in the environment on the developing central nervous system as well as on different types of peripheral nerves in the adult. In one experimental protocol, defined areas of the fetal rat brain are grafted to the anterior chamber of the eye of adult rat recipients that are exposed to lead. Such grafts will become vascularized from the host iris and continue developing in oculo. Thus, grafted brain tissue and host brain will share circulation and therefore be exposed to similar amounts of lead. Studies of cerebellar grafts revealed that, although there was a normal gross cytological development in the presence of lead, there was a marked and permanent impairment of spontaneous discharge rates of the grafted Purkinje neurons as observed with electrophysiological techniques long after cessation of lead treatment. The host Purkinje neurons were not affected. A similar, although less dramatic, impairment of cerebellar function could be subsequently demonstrated in intact animals when newborn rats were given lead during the first 20 days of life and studied as adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319552 TI - The neonatal behavioral assessment scale as a biomarker of the effects of environmental agents on the newborn. AB - The organization of the newborn's brain and the nature of the effects of toxins and pollutants conspire to produce complex and difficult problems for the assessment of the behavioral effects of environmental agents. The newborn's brain can be characterized as relatively undifferentiated, and more vulnerable to, but potentially more capable of recovery from, the effects of environmental agents specific to this time period than it will be later in development. Environmental agents tend to have nonspecific, possibly subtle, effects that invade many areas of newborn functioning. These characteristics of the newborn and the behavioral effects of teratogens make assessment at this point in development difficult. Further exacerbating this difficulty is the nature of development. Development is critically dependent on the care the newborn receives. Distortions of a newborn's behavior can produce disturbances in the caretaking environment, and these caretaking disturbances can amplify the original behavioral distortion and produce other distortions. Attention to these types of effects must be built into an assessment. These considerations lead to the conclusion that an apical assessment of newborn behavior is required. The most standardized, valid, and reliable instrument currently available is the Neonatal Behavioral Assessment Scale developed by Brazelton. It assesses the integrated actions of the infant that function to regulate simultaneously the infant's internal state and exchanges with the animate (caretaking) and inanimate environment. The scale uses a set of reflex and behavioral items to assess the critical domains of infant functioning (e.g., the infant's ability to control his states of consciousness).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319550 TI - Morphological and behavioral markers of environmentally induced retardation of brain development: an animal model. AB - In most neurotoxicological studies morphological assessment focuses on pathological effects, like degenerative changes in neuronal perikarya, axonopathy, demyelination, and glial and endothelial cell reactions. Similarly, the assessment of physiological and behavioral effects center on evident neurological symptoms, like EEG and EMG abnormalities, resting and intention tremor, abnormal gait, and abnormal reflexes. This paper reviews briefly another central nervous system target of harmful environmental agents, which results in behavioral abnormalities without any qualitatively evident neuropathology. This is called microneuronal hypoplasia, a retardation of brain development characterized by a quantitative reduction in the normal population of late generated, short-axoned neurons in specific brain regions. Correlated descriptive and experimental neurogenetic studies in the rat have established that all the cerebellar granule cells and a very high proportion of hippocampal granule cells are produced postnatally, and that focal, low-dose X-irradiation either of the cerebellum or of the hippocampus after birth selectively interferes with the acquisition of the full complement of granule cells (microneuronal hypoplasia). Subsequent behavioral investigations showed that cerebellar microneuronal hypoplasia results in profound hyperactivity without motor abnormalities, while hippocampal microneuronal hypoplasia results in hyperactivity, as well as attentional and learning deficits. There is much indirect clinical evidence that various harmful environmental agents affecting the pregnant mother and/or the infant lead to such childhood disorders as hyperactivity and attentional and learning disorders. As the developing human brain is more mature at birth than the rat brain, the risk for microneuronal hypoplasia and consequent behavioral disorders may be highest at late stages of fetal development, in prematurely born and small-for-weight infants, and during the early stages of infant development. Recent technological advances in brain imaging techniques make it possible to test this hypothesis and to assess the possible relationship between the degree of retarded brain development and ensuing behavioral disorders. PMID- 3319553 TI - Behavioral and psychophysiological markers of disordered attention. AB - Behavioral and psychophysiological assays provide the most sensitive indication of whether a presumed neurotoxin has a deleterious effect on the nervous system. The effects of lead on the nervous system are strongly suggestive that this agent can produce disturbances in attention; moreover, there are clinical reports of such effects. The action of lead is also manifest in behaviors described as "hyperactive," or reflecting "minimal brain damage." The core symptom in both disorders is probably impairment in attention. The recent Diagnostic and Statistical Manual (DSM-III) of the American Psychiatric Association uses the term Attention Deficit Disorder to replace such terms as hyperactivity and minimal brain damage. Prior studies of the behavioral toxicity of lead may have used inadequate or incomplete assays of attention; this could in part account for the variability in outcomes. Recent research on attention suggests that it is a complex behavior consisting of a number of elements or components, each of which may be in part dependent upon a different region of the central nervous system. Behavioral assays should examine the components of attentive behavior using tests which are sensitive to the different elements. It is recommended that psychophysiological assays (using cognitive event-related potentials), although more difficult and costly to implement, be used as well. These assays may provide a more dynamic view of altered information processing in the brain and help to localize and characterize the behavioral impairment. PMID- 3319554 TI - Detecting the effects of toxic agents on spermatogenesis using DNA probes. AB - Advances in the molecular biology of spermatogenesis suggest that DNA probes can be used to monitor the effects of toxic agents in male germ cells of mammals. Molecular hybridization analyses with DNA probes can provide a reproducible methodology capable of detecting changes ranging from massive deletions to single base pair substitutions in the genome of exposed individuals. A constantly increasing number of DNA probes that can be used to detect such alterations in human sperm DNA exist for both ubiquitously expressed proteins and for genes solely expressed in the testis. In this chapter, the currently available testicular stage-specific and/or cell type-specific DNA probes and the techniques by which they can be utilized in reproductive toxicology studies are discussed. The advantages, limitations, and future technological advances of this novel biological marker system for the human male reproductive system are also considered. PMID- 3319555 TI - Biomarkers in the detection of human heritable and germinal mutagenesis. AB - An important potential use of biomarkers in human toxicology is the detection of induced mutational events in offspring and germ cells of exposed individuals. The importance, of course, is in risk estimation and the identification and prevention of exposure conditions that are harmful to the human genome. The challenge is to discover methods of sufficient power to find the rare, random, mutational events and to discriminate such events from other sources of molecular variation. Finding mutations is essentially a search for disorder. Normal biomarkers are inherently unsuitable in a positive search for disorder; instead one must either use abnormal markers or be prepared to search negatively, i.e., to look for and somehow validate the rare absence of a normal marker. In spite of these difficulties, there is progress to report and hope of future success in this field. PMID- 3319558 TI - Radiation risk estimation models. AB - Cancer risk models and their relationship to ionizing radiation are discussed. There are many model assumptions and risk factors that have a large quantitative impact on the cancer risk estimates. Other health end points such as mental retardation may be an even more serious risk than cancer for those with in utero exposures. PMID- 3319557 TI - Physiologic assessment of fetal compromise: biomarkers of toxic exposure. AB - Understanding the physiologic and endocrinologic basis of fetal development is a major goal of perinatal biology. During the past decade a number of technological developments have allowed more precise evaluation of the fetus in utero and diagnosis of abnormalities. Despite these methodological achievements, however, there are no specific biological markers currently available to indicate that exposure to a given xenobiotic is associated with a cellular, subcellular, or pharmacodynamic event. This paper evaluates the following issues: What are some of the unique physiologic and endocrinologic features of the fetal milieu interieur? What problems are peculiar to fetal assessment? Of what value are techniques such as ultrasonography, amniocentesis, chorionic villus sampling, fetoscopy, and fetal blood and tissue sampling for obtaining appropriate biomarkers? What are some examples of validated biomarkers and their applicability? What promising biomarkers are on the horizon? What are some of the promising techniques such as the evaluation of fetal body movements, breathing activity, electronic heart rate monitoring, and nuclear magnetic resonance? How may molecular probes be of value as biological markers of fetal compromise? What are some of the major research gaps and needs, and how should research priorities be set? Some of these topics are addressed. Moreover, the more general role(s) that various diagnostic methods and biological markers can have in an understanding of the regulation of fetal growth and differentiation and the role of xenobiotics in affecting the normal course of events are discussed. PMID- 3319556 TI - Development of an assay for a biomarker of pregnancy and early fetal loss. AB - Human chorionic gonadotropin (hCG) is a glycoprotein hormone, secreted by the syncytiotrophoblast cells of the fertilized ovum, that enters the maternal circulation at the time of endometrial implantation. It is composed of two nonidentical subunits; alpha and beta, with molecular weights of 14 kD and 23 kD, respectively. Its alpha subunit is identical in primary structure to its glycoprotein homologs, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and thyroid-stimulating hormone (TSH). Human chorionic gonadotropin binds to the same receptor as hLH and displays the same biological response, namely, to stimulate the declining function of the corpus luteum to produce progestins and estrogen late in the menstrual cycle. The differences in the structures of hCG and hLH have been exploited to develop antibodies that can measure hCG specifically in the presence of hLH. Two-site antibody binding assays have been developed, based on a surface immunological concept of hCG epitopes, that involve four distinct regions to which antibodies against hCG can bind simultaneously. Antibody cooperative effects, in conjunction with kinetic advantages derived from the concentration factors by use of the sandwich assay technique (immunoradiometric assay, IRMA), have enabled development of extremely sensitive and specific measurement protocols for urinary hCG. The assay described herein permits the detection of pregnancy on an average 25.4 days after the first day of the preceding menses, as opposed to 29.5 days for conventional radioimmunoassay techniques. In addition, the greater sensitivity and specificity of this assay method has permitted the detection of episodes of fetal loss not detected by radioimmunoassay of urine specimens. A large scale epidemiological study is in progress using this assay technique as a way to identify pregnancies that are lost before becoming clinically apparent. This methodology provides a valuable tool for the determination of the rate of early fetal loss. PMID- 3319559 TI - Biochemical and molecular epidemiology of human cancer: indicators of carcinogen exposure, DNA damage, and genetic predisposition. AB - The primary goal of biochemical and molecular epidemiology is to identify individuals at high cancer risk by obtaining evidence of high exposure to carcinogens, leading to pathobiological lesions in target cells, and/or increased oncogenic susceptibility due to either inherited or acquired host factors. This emerging and multidisciplinary area of cancer research combines epidemiological and laboratory approaches. Because DNA is considered to be an important target for modification by mutagens and carcinogens, damage to DNA can be used as an internal, molecular dosimeter of carcinogen exposure. The reactive species of these carcinogens may directly bind to DNA to form adducts and may indirectly cause secondary DNA lesions, e.g., via induction of free radicals and aldehydes. Highly sensitive and specific methods have been developed to measure the minute amounts of DNA lesions and DNA repair products found in biological specimens from humans exposed to carcinogens. For example, DNA adducts have been measured in cells and tissues from people occupationally exposed to carcinogenic polycyclic aromatic hydrocarbons. Antibodies recognizing carcinogen-DNA adducts have also been detected in human sera. Inherited predisposition to cancer has been revealed by recent advances in molecular genetics, including restriction-fragment-length polymorphism. For example, the hypothesis that rare alleles of the Ha-ras proto oncogene are associated with an increased risk of lung cancer is currently being tested. These approaches afford the potential of biochemical and molecular epidemiology to predict disease risk for individual persons, instead of for populations, and before the onset of clinically evident disease. PMID- 3319560 TI - Electromagnetic fields and public health. AB - A review of the literature is provided for the topic of health-related research and power frequency electromagnetic fields. Minimal evidence for concern is present on the basis of animal and plant research. General observation would accord with the implication that there is no single and manifest health effect as the result of exposure to these fields. There are persistent indications, however, that these fields have biologic activity, and consequently, there may be a deleterious component to their action, possibly in the presence of other factors. Power frequency electromagnetic field exposures are essentially ubiquitous in modern society, and their implications in the larger perspective of public health are unclear at this time. Electromagnetic fields represent a methodological obstacle for epidemiologic studies and a quandary for risk assessment; there is need for more data. PMID- 3319562 TI - Pulsatile peptide secretion: encoding of brain messages regulating endocrine and reproductive functions. AB - Neuropeptides are defined chemical messengers produced by the brain to modulate its own activity and also to regulate the function of every organ system. These neuropeptides can be viewed as coded chemical signals produced by the brain and secreted into the blood or into other fluids, such as the cerebrospinal fluid, to be transported and to act at a distant site. The signals arrive to the target organ or sometimes to an intermediary station, such as the pituitary gland, where they are decoded, transformed into a more powerful signal, and sent again through the general circulation to reach their final target. Our work has characterized the episodic or pulsatile pattern of secretion of a number of peptide hormones produced by the brain or the pituitary gland and analyzed the brain mechanisms involved in the generation of such a pulsatile pattern of hormone secretion. Molecular biology approaches have provided information on the synthesis, processing, and secretion of these brain messengers. In addition, using computer assisted perifusion systems, we have been able to reproduce in vitro some of the signals produced by the brain and are currently trying to decode the message carried by those signals, as well as determining the intracellular messengers involved in the signal process. The importance of the neuropeptides and of the messages carried by the pulsatile signal is underlined by experiments in which animals treated with a neurotoxin were rendered infertile.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319561 TI - Estrogens and development. AB - The normal development of the genital organs of mammals, including humans, is under hormonal control. A role for the female sex hormone estrogen in this process is still unclear. However, exposure of experimental animals or humans to the potent exogenous estrogen, diethylstilbestrol (DES), results in persistent differentiation effects. Since many chemicals in the environment are weakly estrogenic, the possibility of hormonally altered differentiation must be considered. PMID- 3319564 TI - The evolution of science at the National Institutes of Health and the National Institute of Environmental Health Sciences. PMID- 3319563 TI - MPTP: an industrial chemical and contaminant of illicit narcotics stimulates a new era in research on Parkinson's disease. AB - MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) causes selective destruction of dopaminergic neurons of the nigrostriatal pathway in humans and other primates. It is less specific and much less potent in mice and has only slight effects in rats. Differences in rates and sites of metabolism of MPTP to its active, toxic, highly polar metabolite, MPP+ (1-methyl-4-phenylpyridine), appear to influence species specificity. In rats, type B monoamine oxidase (MAO-B), which mediates the conversion of MPTP to MPP+, may act as an enzymatic barrier at brain microvessels, whereas in primates the enzyme, present mainly in astrocytes, appears important for bioactivation of MPTP into the toxic metabolite. MPP+ is a substrate for catecholamine uptake sites and is concentrated in these neurons. The molecular mechanism of MPP+ toxicity has not been established definitively, but conversion to a free radical or uptake by mitochondria and inhibition of mitochondrial respiratory enzymes, leading to calcium release and cell death have been suggested. The discovery of toxin which causes an animal model of Parkinson's disease has stimulated new research on environmental factors that might contribute to this progressive degenerative disorder and provides a means for assessing new approaches to therapy. PMID- 3319565 TI - Possible neurologic effects of aspartame, a widely used food additive. AB - The artificial sweetener aspartame (L-aspartyl-L-phenylalanyl-methyl ester), is consumed, primarily in beverages, by a very large number of Americans, causing significant elevations in plasma and, probably, brain phenylalanine levels. Anecdotal reports suggest that some people suffer neurologic or behavioral reactions in association with aspartame consumption. Since phenylalanine can be neurotoxic and can affect the synthesis of inhibitory monoamine neurotransmitters, the phenylalanine in aspartame could conceiveably mediate neurologic effects. If mice are given aspartame in doses that elevate plasma phenylalanine levels more than those of tyrosine (which probably occurs after any aspartame dose in humans), the frequency of seizures following the administration of an epileptogenic drug, pentylenetetrazole, is enhanced. This effect is simulated by equimolar phenylalanine and blocked by concurrent administration of valine, which blocks phenylalanine's entry into the brain. Aspartame also potentiates the induction of seizures by inhaled fluorothyl or by electroconvulsive shock. Perhaps regulations concerning the sale of food additives should be modified to require the reporting of adverse reactions and the continuing conduct of mandated safety research. PMID- 3319568 TI - A history of progress: NIEHS, the first 20 years (1966 to 1986). PMID- 3319567 TI - Possible etiologic mechanisms in chemical carcinogenesis. AB - Some highlights in the development of our knowledge about carcinogens as etiological agents for cancer are reviewed briefly. Advances during the past 20 years relating to metabolic activation with the genesis of reactive metabolites, molecular targets and their interactions with activated carcinogens, oncogenes as molecular targets and the dependence on cell proliferation, all relating to the initiation process, are reviewed. Critical to initiation is the new phenotype in the initiated cell, known only in one instance, the rat liver, in which the characteristic change is one of resistance to many xenobiotic influences. The need for clonal expansion of initiated cells as essential for carcinogenic effects is discussed. Differential inhibition has been shown as a dominant mechanistic pattern in the liver. In other systems, the manner in which clonal expansion is achieved is not evident. The need for studies of the processes involved in carcinogenesis, as well as the agents, is emphasized, in view of the continuing validity of the cell concept as the key to integrating the increasingly large volume of data from the molecular with the biological. PMID- 3319566 TI - Metal toxicity in the central nervous system. AB - The nervous system is the principal target for a number of metals. Inorganic compounds of aluminum, arsenic, lead, lithium, manganese, mercury, and thallium are well known for their neurological and behavioral effects in humans. The alkyl derivatives of certain metals--lead, mercury and tin--are specially neurotoxic. Concern over human exposure and in some cases, outbreaks of poisoning, have stimulated research into the toxic action of these metals. A number of interesting hypotheses have been proposed for the mechanism of lead toxicity on the nervous system. Lead is known to be a potent inhibitor of heme synthesis. A reduction in heme-containing enzymes could compromise energy metabolism. Lead may affect brain function by interference with neurotransmitters such as gamma-amino isobutyric acid. There is mounting evidence that lead interferes with membrane transport and binding of calcium ions. Methylmercury produces focal damage to specific areas in the adult brain. One hypothesis proposes that certain cells are susceptible because they cannot repair the initial damage to the protein sythesis machinery. The developing nervous system is especially susceptible to damage by methylmercury. It has been discovered that microtubules are destroyed by this form of mercury and this effect may explain the inhibition of cell division and cell migration, processes that occur only in the developmental stages. These and other hypotheses will stimulate considerable experimental challenges in the future. PMID- 3319569 TI - In vitro analysis of multistage carcinogenesis. AB - Several key events in the multistep process of neoplastic transformation of rat tracheal epithelium (RTE) are described. Whether tracheal epithelium is exposed in vivo to carcinogenic agents or whether primary tracheal epithelial cells are exposed in vitro to carcinogens, initiated stem cells can be detected soon after the exposure by their ability to grow under selective conditions in culture. These initiated stem cells differ fundamentally from normal stem cells in their response to factors normally constraining proliferation and self-renewal. Thus, disruption of inhibitory control mechanisms of stem cell replication appears to be the first event in RTE cell transformation. While the probability of self renewal (PSR) is clearly increased in initiated stem cells, most of the descendants derived from such stem cells differentiate and become terminal and do not express transformed characteristics. Progression from the first to the second stage of RTE cell transformation, the stage of the immortal growth variant (IGV), is characterized by loss of responsiveness to the growth-restraining effects of retinoic acid. In the third stage of neoplastic transformation, the stage during which neoplastic growth variants (NGV) appear, a growth factor receptor gene is inappropriately expressed in some of the transformants. Thus, it appears that loss of growth-restraining mechanisms may be an early event, and activation of a growth stimulatory mechanism a late event, in neoplastic transformation of RTE cells. PMID- 3319570 TI - The role of oncogenes in chemical carcinogenesis. AB - Proto-oncogenes are cellular genes that are expressed during normal growth and developmental processes. Altered versions of normal proto-oncogenes have been implicated in the development of human neoplasia. In this report, we show the detection of activated proto-oncogenes in various spontaneous and chemically induced rodent tumors. The majority of activated proto-oncogenes found in these tumors are members of the ras gene family and have been activated by a point mutation. Characterization of the activating mutation may be useful in determining whether this proto-oncogene was activated by direct interaction of the chemical with the DNA. Comparison of activating lesions in spontaneous versus chemically induced tumors should be helpful in determining whether the chemical acts via a genotoxic or a nongenotoxic mechanism. All of this information may be helpful in the assessment of potential carcinogenic hazards of human exposure to chemicals. PMID- 3319572 TI - Perspectives on testing for toxic agents. AB - A series of observations and comments are made with respect to several areas of toxicology: these are briefly discussed. Some innovative areas receive discussion as representing substantial progress made in the field of toxicology in recent years. Topics included raise a number of questions: what agents should we test, and how should we go about selecting them; what is the importance of allowing for genetic diversity in carrying out tests that are meaningful for humans; and what is the relevance of studies in pharmacokinetics in the laboratory to humans. Human studies, because of ethical considerations, must be indirect, through access to available autopsy and surgical human tissues. Also, drug trials and clinical studies must be exploited. Cancer testing and evaluation is briefly commented on. Systemic toxicity is considered in respect to possible improved ways of determining the "NOEL," that is, the no-observed-effect level. Suggestions for improving study of mixtures of chemicals are considered. The rapid advances in molecular biology have significantly strengthened our ability to trace the action of chemicals in the body from exposure to disease. It is very important that training in toxicology be based on a sound disciplinary training in one of the classic fields of the biomedical sciences, such as biochemistry, pharmacology, molecular biology. It is concluded that advances in the past decade have made the practice of toxicology a much more scientific endeavor, especially in its use of the latest developments in basic biomedical sciences. PMID- 3319571 TI - Comparative evaluation of genetic toxicity patterns of carcinogens and noncarcinogens: strategies for predictive use of short-term assays. AB - The results of a recent comprehensive evaluation of the relationship between four measures of in vitro genetic toxicity and the capacity of the chemicals to induce neoplasia in rodents carry some important implications. The results showed that while the Salmonella mutagenesis assay detected only about half of the carcinogens as mutagens, the other three in vitro assays (mutagenesis in MOLY cells or induction of aberrations or SCEs in CHO cells) did not complement Salmonella since they failed to effectively discriminate between the carcinogens and noncarcinogens found negative in the Salmonella assay. The specificity of the Salmonella assay for this group of 73 chemicals was relatively high (only 4 of 29 noncarcinogens were positive). Therefore, we have begun to evaluate in vivo genetic toxicity assays for their ability to complement Salmonella in the identification of carcinogens. PMID- 3319573 TI - Severity of tubular brush border damage in cadmium-polluted area (Jinzu river basin): clinical role of urinary trehalase. AB - Urinary trehalase activity and leucine aminopeptidase activity were parabolically correlated with urinary beta 2-microglobulin, and these enzymes were observed to be biphasic in relation to urinary beta 2-microglobulin when the study populations included patients of Itai-itai disease and inhabitants of a cadmium polluted area. Furthermore, urinary trehalase activity was parabolically correlated with urinary total protein and urinary glucose. From these results, it is inferred that by measuring both urinary trehalase and urinary beta 2 microglobulin, one can elucidate the degree of tubular damage. PMID- 3319574 TI - Biological activity of organotin compounds--an overview. AB - As a consequence of the rapid expansion of the uses and applications of the organotin compounds, the concern about their environmental and health effects is increasing. The main subject of this overview is the current understanding of the mammalian toxicity of the organotin compounds. Four different types of target organ toxicity, namely neurotoxicity, hepatoxicity, immunotoxicity, and cutaneous toxicity, are discussed in more detail. The effects of the organotin compounds on the mitochondrial and cellular level are summarized and discussed in relation to the mode of action of these compounds on the central nervous system, the liver and bile duct, the immune system, and the skin. PMID- 3319575 TI - Equine shock: the need for prospective clinical studies. PMID- 3319576 TI - Pathogenesis of degenerative joint disease. AB - Proteoglycan degradation is central to the development of degenerative joint disease. Proteoglycans may be degraded by lysosomal enzymes from chondrocytes, synoviocytes or leucocytes. Collagen and matrix degradation occurs either by direct damage or due to degrading enzymes released into synovial fluid. Once the pathological sequence has begun it continues in a cyclic manner unless arrested by the ability of chondrocytes to synthesise sufficient matrix components. Treatment should ideally be directed to this end. PMID- 3319577 TI - Ventilation imaging in the horse with 99mtechnetium-DTPA radioaerosol. AB - This study describes the development of a radioaerosol technique for horses using 99mtechnetium-DTPA (diethylenetriaminepentacetate). In 24 normal, adult horses, very satisfactory ventilation images were obtained with the technique. Four minute administrations of the aerosol resulted in a mean uptake of radioactivity in the lung fields of 3.02 mCi, with mean maximum counts (+/- sd) of 159,800 +/- 75,000 per camera field. The mean clearance half-time for the 99mtechnetium-DTPA from the lung fields was 55.6 +/- 14.2 mins which is very similar to figures obtained for normal human and dog lungs. The results of this study suggest that ventilation imaging with 99mtechnetium-DTPA is a clinically practical method of obtaining regional information on ventilation function in the horse. PMID- 3319578 TI - Interpreting radiographs. 8: Equine cervical vertebrae. PMID- 3319580 TI - Purification and characterization of a heat-shock element binding protein from yeast. AB - The promoters of heat shock genes are activated when cells are stressed. Activation is dependent on a specific DNA sequence, the heat-shock element (HSE). We describe the purification to homogeneity of an HSE-binding protein from yeast (Saccharomyces cerevisiae), using sequential chromatography of whole cell extracts on heparin-agarose, calf thymus DNA-Sepharose and an affinity column consisting of a repetitive synthetic HSE sequence coupled to Sepharose. The protein runs as a closely spaced doublet of approximately 150 kd on SDS polyacrylamide gels; mild proteolysis generates a stable 70-kd fragment which retains DNA binding activity. The relative affinities of the protein for a range of variant HSE sequences correlates with the ability of these sequences to support heat-inducible transcription in vivo, suggesting that this polypeptide is involved in the activation of heat-shock promoters. However, the protein was purified from unshocked yeast, and may therefore represent an unactivated form of heat-shock transcription factor. Study of the purified protein should help to define the mechanistic basis of the heat-shock response. PMID- 3319579 TI - Identification of a primary in vivo degradation product of the rapidly-turning over 32 kd protein of photosystem II. AB - The 32 kd photosystem II protein of plant chloroplasts is rapidly turned over in the light. The initial events in the degradation of the 32 kd protein were studied. A 23.5 kd breakdown product was identified in Spirodela oligorrhiza membranes using immunological analysis. The 23.5 kd polypeptide was shown to be derived from the amino-terminal portion of the 32 kd protein using partial proteolytic fingerprinting. An in vivo precursor--product relationship between the 32 kd protein and the 23.5 kd polypeptide was kinetically demonstrated by radiolabeling and pulse-chase experiments. The cleavage site yielding the 23.5 kd polypeptide was localized to a functionally active region (between helices IV and V) of the 32 kd protein. We propose that an alpha-helix-destabilizing 'degradation' sequence, bordered by arginine residues 225 and 238, is involved in the formation of the 23.5 kd polypeptide. PMID- 3319583 TI - Immunogenetics of autoimmune thyroid disorders. AB - The loci determining polymorphism of genes involved in the immune response feature prominently in the susceptibility to autoimmune thyroid disease. However, disease phenotypes do not segregate perfectly with the genetic markers. The interaction between the influence of these loci on susceptibility is complex, and when taken in the context of the multilayered, multidirectional workings of the immune network and that of as-yet-unspecified environmental factors, our difficulty in predicting the susceptible phenotypes is not surprising. PMID- 3319581 TI - Restoration of u.v.-induced excision repair in Xeroderma D cells transfected with the denV gene of bacteriophage T4. AB - The heritable DNA repair defect in human Xeroderma D cells, which results in failure to incise at u.v. light-induced pyrimidine dimers, has been partially but stably corrected by transfection of immortalised cells with the denV pyrimidine dimer glycosylase gene of bacteriophage T4. Transfectants selected either for a dominant marker on the mammalian vector carrying the prokaryotic gene or for the dominant marker plus resistance to killing by u.v. light, have been shown to express the denV gene to varying degrees. denV expression results in significant phenotypic change in the initially repair-deficient, u.v.-hypersensitive cells. Increased resistance to u.v. light and more rapid recovery of replicative DNA synthesis following u.v. irradiation have been correlated both with improved repair DNA synthesis and with a novel dimer incision capability present in denV transfected Xeroderma cells but not as evident in transfected normal cells. Most of the transfectants contain a single integrated copy of the denV gene; increase in denV copy number does not result in either increased gene expression or enhanced survival to u.v. light. These results show that expression of a heterologous prokaryotic repair gene can partially compensate for the genetic defect in a human Xeroderma D cell. PMID- 3319584 TI - Intrathyroidal MHC class II antigen expression and thyroid autoimmunity. AB - The association between MHC polymorphisms and autoimmune thyroid disease has been complicated by the observation of MHC class II antigen expression by the human thyroid gland. It is possible that the MHC associations observed in animal and human population studies may have mechanistic explanations at the level of the thyroid cell. There is evidence for expression of HLA-DR allospecific antigen in both normal and abnormal human thyroid cells, with enhanced expression in patients with autoimmune thyroid disease. Such MHC class II expression appears to be mediated primarily by lymphokine secretion from intrathyroidal T lymphocytes. Thyroid cell HLA-DR antigen participates in activation and amplification of T cells and is likely to be involved in presentation of thyroid antigen to the immune system. The relationship between these immune interactions and the initial events leading to the development of autoimmune thyroid disease remains to be understood. PMID- 3319582 TI - Formamidopyrimidine-DNA glycosylase of Escherichia coli: cloning and sequencing of the fpg structural gene and overproduction of the protein. AB - An Escherichia coli genomic library composed of large DNA fragments (10-15 kb) was constructed using the plasmid pBR322 as vector. From it 700 clones were individually screened for increased excision of the ring-opened form of N7 methylguanine (2-6-diamino-4-hydroxy-5N-methyl-formamidopyrimidine) or Fapy. One clone overproduced the Fapy-DNA glycosylase activity by a factor of 10-fold as compared with the wild-type strain. The Fapy-DNA glycosylase overproducer character was associated with a 15-kb recombinant plasmid (pFPG10). After subcloning a 1.4-kb fragment which contained the Fapy-DNA glycosylase gene (fpg+) was inserted in the plasmids pUC18 and pUC19 yielding pFPG50 and pFPG60 respectively. The cells harbouring pFPG60 displayed a 50- to 100-fold increase in glycosylase activity and overexpressed a 31-kd protein. From these cells the Fapy DNA glycosylase was purified to apparent physical homogeneity as evidenced by a single protein band at 31 kd on SDS-polyacrylamide gels. The amino acid composition of the protein and the amino acid sequence deduced from the nucleotide sequence demonstrate that the cloned fragment contains the structural gene coding for the Fapy-DNA glycosylase. The nucleotide sequence of the fpg gene is composed of 809 base pairs and codes for a protein of 269 amino acids with a calculated mol. wt of 30.2 kd. PMID- 3319586 TI - The role of T lymphocytes in autoimmune thyroid disease. AB - Abnormalities in cellular mechanisms of immunoregulation are important factors in the initiation and/or propagation of autoimmune thyroid disease and Graves' ophthalmopathy. The primary immunologic lesion, however, remains elusive despite increasingly sophisticated investigations in the areas of antigen presentation and subsequent T-cell responses. Emphasis on functional evaluations of relevant cell populations and advances in lymphokine analysis, interpretation of DR antigen expression, and T-cell cloning offer promise for our future understanding of this complex process. PMID- 3319585 TI - Cytotoxic mechanisms in autoimmune thyroid disorders and thyroid-associated ophthalmopathy. AB - Cytotoxic antibodies against thyroid cells and eye muscle cells, measured as antibody-dependent complement-mediated cytotoxicity and ADCC, have been demonstrated in sera from patients with Hashimoto's thyroiditis and thyroid associated ophthalmopathy, respectively. Such antibodies are probably never present in the absence of target cell damage. Because cell-mediated cytotoxicity plays an important role in experimental autoimmune thyroiditis, further studies are necessary to elucidate the roles of NK cells, K cells, and cytotoxic T lymphocytes in the thyroid cell damage in AITD and orbital cell damage in ophthalmopathy. The socalled aberrant expression of HLA-DR antigens on thyroid cells and orbital cells and the gamma-interferon production by activated T cells may be both intimately associated with the development of autoimmune reactions in the thyroid and the orbit. Cytotoxic antibodies and cytotoxic T lymphocytes against antigens shared between eye muscle cells and thyroid cells may be directly responsible for the eye muscle cell damage in endocrine ophthalmopathy, and they may explain the close association of ophthalmopathy with Graves' hyperthyroidism and Hashimoto's thyroiditis. PMID- 3319587 TI - The spectrum and significance of autoantibodies reacting with the thyrotropin receptor. AB - Autoantibodies that occur in autoimmune thyroid disease and that interact with the TSH receptor are reviewed. Current limited understanding of the nature of the TSH receptor is detailed, and available assays for the different types of antibodies are described. The incidence, clinical significance, and interactions of the various antibodies are summarized. PMID- 3319588 TI - Choice of therapy and criteria for assessing treatment outcome in thyroid associated ophthalmopathy. AB - Treatment recommended for thyroid-associated ophthalmopathy varies with the particular expression of the disease in a given patient. Medical therapy may be beneficial in the early phase before extensive fibrosis of retro-ocular muscles and connective tissue is established. Although corticosteroids reliably suppress acute inflammatory changes, evidence supporting efficacy of plasmapheresis, immunosuppressive drugs, iodine-131 ablation, and radiotherapy is inconclusive. Surgery on eyelids, extraocular muscles, and orbit effectively rehabilitates most patients with even the most severe ophthalmopathy while having no effect on the underlying autoimmune process. Future research should include continued attempts to identify the putative target antigens in the orbit and to define the controls of glycosaminoglycan synthesis. Until prevention by immunologic or other medical means is attainable, surgery on orbit, muscles, and eyelids appears the most effective mode of treatment for correction of the functional and cosmetic consequences of the ophthalmopathy associated with autoimmune thyroid disease. PMID- 3319589 TI - Pathogenesis and treatment of pretibial myxedema. AB - Pretibial myxedema is considered an autoimmune complication or association of Graves' disease, Hashimoto's thyroiditis, and primary myxedema. The mechanism of lesion formation is unknown; the most plausible theory is that it arises as a result of a target cell in the skin, probably the fibroblast, being stimulated to produce abnormally high amounts of glycosoaminoglycans (especially hyaluronic acid) by autoantibodies directed against a thyroid antigen(s)--that is, by a cross reaction. One or more intermediary humoral agents may be involved in pathogenesis. The reason for the localization to the pretibial region is unknown; there is evidence that most patients with the disorder have similar abnormalities in the preradial skin. The condition may persist for months or years but often regresses spontaneously, accompanied by a parallel decline in, or disappearance of, serum anti-TSH-receptor autoantibody levels. Skin biopsies reveal evidence of increased amounts of hyaluronic acid and damage to collagen and elastic fibers. Local symptomatic treatment with corticosteroids is effective in most cases with slight to moderate severity of skin involvement. Repeated treatments are advised until such time that a spontaneous clinical remission occurs. PMID- 3319590 TI - Immunologically mediated hypothyroidism. AB - In this article, new avenues in the understanding of immunologic processes involved in hypothyroidism have been explored. The discovery of a family of TSH-R directed antibodies, including TSI-block, TGI, and TGI-block, has afforded perspectives on the etiology of autoimmune thyroid disorders. Thus, whereas TSI and TSI-block influence thyroid function, TGI and TGI-block are involved in thyroid cell proliferation and maturation. We have focused on three clinical entities that have been elucidated relatively recently--namely, silent thyroiditis, postpartum thyroiditis, and congenital hypothyroidism. Silent thyroiditis, a common form of transient thyroiditis, yields very few clinical symptoms or signs but significant alterations in biological tests, including a thyroid 131I uptake compatible with silent thyroid destruction. Although an autoimmune etiology is really not certain at this moment, it is not completely excluded. Silent thyroiditis does not usually require therapy, except in the rare cases in which symptoms are very severe. Postpartum thyroiditis, probably a special form of silent lymphocytic thyroiditis, differs from silent thyroiditis only by its relation to pregnancy and its higher rate of persistent thyroid disease. It has a high prevalence in pregnant women (5.5 to 10.2 per cent) in all populations studied, and may be responsible for a substantial proportion of cases of postpartum depression. Although the etiology is not clear, an autoimmune process seems to be involved. Although prediction of this state is difficult, a previous episode or high titers of microsomal antibodies in the first trimester show good correlations with the disease. Thyroid hormone replacement therapy is recommended for persistent disease. Congenital hypothyroidism appears to be mediated by passively transferred maternal blocking antibodies. TSI-block is likely responsible for the transient form of congenital hypothyroidism in the same way that TSI may cause transient congenital thyrotoxicosis. Passive transfer of maternal TGI-block appears to be causal in the majority of newborns with the sporadic form of congenital hypothyroidism. Early (in utero) onset of the disease could explain why 15 per cent of adequately treated infants subsequently demonstrate subtle neurologic sequelae. Because screening procedures for TGI blocking antibodies are being made available, it should be possible to detect those potentially severe in utero cases and commence thyroid hormone replacement therapy before birth. PMID- 3319591 TI - Pregnancy and autoimmune thyroid disease. AB - Pregnancy has profound effects on the course of Graves' disease and Hashimoto's thyroiditis. Understanding of this interrelationship may clarify the role of the numerous immunologic gestational alterations that facilitate survival of the fetal allograft. Also, it should provide a more rational basis in the management of Graves' hyperthyroidism during pregnancy. Epidemiologic data indicate that screening for thyroid dysfunction appears justified in women in the postpartum period. The natural history of the postpartum thyroiditis syndrome remains to be fully evaluated, but the evidence indicates thyroid abnormalities can still be found in many patients several years after onset. Accordingly, the importance of follow-up cannot be overemphasized. PMID- 3319592 TI - Recombinant DNA technology in the study of autoimmune thyroid disease. AB - Molecular biology techniques are now beginning to be applied to the study of autoimmune thyroid disease. This review provides a background to the molecular biology techniques used, summarizes the limited data presently available in the area of autoimmune thyroid disease, and describes the potential future application of these techniques for further understanding of autoimmune thyroid disease. PMID- 3319593 TI - Neuroendocrinology of pituitary hormone regulation. AB - Hormone secretion from the pituitary gland is dependent on the intimate association between the hypothalamus and pituitary by vascular and neuronal connections. The anatomic organization of these networks and their specific peptide and/or amide mediators are described in detail. Pertinent factors governing hypothalamic regulation of anterior pituitary secretion are also discussed. PMID- 3319594 TI - Pathology of pituitary tumors. AB - This article reviewed the classification, morphologic features, and pathogenesis of human hypophyseal adenomas and differences between hyperplasia and adenoma. Histologic, immunohistochemical, and electron microscopic investigation obtained a deeper insight into several aspects of pituitary cytopathology. Based on these studies, a meaningful classification has been developed that separates hypophyseal adenomas into distinct entities. It hinges on histology, hormone content, ultrastructural characteristics, cellular composition, and cytogenesis and correlates the morphologic features of adenoma cells with endocrine activity. Although progress has been spectacular during the last two decades in the better understanding of structural characteristics and hormonal function of pituitary adenomas, much more work is necessary to shed light on structure-function correlations and pathogenesis. Collaborative investigations between clinical investigators and basic scientists can further advance knowledge in this intriguing and important field. PMID- 3319595 TI - Neuro-ophthalmologic features of pituitary tumors. AB - The pituitary adenomas are one of the more common and prognostically favorable intracranial tumors. Because of their anatomic proximity to the anterior visual pathways, these tumors should be suspected in every patient with unexplained visual loss. The value of meticulous neuro-ophthalmic examination, especially formal perimetry, cannot be overemphasized. If findings point to optic nerve or chiasmal compression, appropriate radiologic studies should be undertaken without delay. Late diagnosis will often result in irreversible visual loss. The major cause of delay in diagnosis is frequently an inadequate examination. On the other hand, observation of recovery of vision after prompt diagnosis and treatment is a very gratifying experience in neuro-ophthalmology. PMID- 3319596 TI - Differential diagnosis of pituitary tumors. AB - Many parasellar lesions may mimic pituitary adenomas clinically, endocrinologically, and radiologically. Certain patterns do lead suspicion toward the correct diagnosis, whereas in other cases the diagnosis may be difficult. For most of these lesions, the treatment of choice is different from that for a pituitary tumor, so correct diagnosis is of paramount importance. The presenting signs and symptoms as well as radiologic manifestations of parasellar tumors and conditions are discussed. PMID- 3319597 TI - Pituitary surgery. AB - Surgical management of pituitary adenomas continues to be a safe and effective method for dealing with a large number of these lesions. The goal of overall management should be to provide the patient with the most effective means of long term control of this benign but potentially disabling disease. At present, surgery plays a significant role. It is hoped that with advances in understanding of pituitary pathophysiology and with advances in pharmacotherapy, surgical management may become even more focused, more precise, and more effective over time. PMID- 3319598 TI - Radiotherapy of pituitary tumors. AB - The treatment of pituitary adenomas with conventional radiotherapy is safe and effective. Radiation controls the mass effects of large tumors in 80 to 90 per cent of patients and is especially valuable in preventing recurrence after partial resection. In acromegaly, about 80 per cent of patients are controlled; with Cushing's disease, the ultimate cure rate is from 50 to 80 per cent; the control rate for prolactin-secreting adenomas is not yet established. With appropriate radiation technique, including proper dose and daily fraction size, clinically significant complications other than hypopituitarism are rare. PMID- 3319600 TI - Prolactinomas. AB - Prolactin-secreting pituitary tumors are not rare. The diagnosis of a patient with hyperprolactinemia and possible tumor should be carried out in an orderly fashion by first excluding secondary causes. If the patient has pathologic hyperprolactinemia, assessment of pituitary anatomy with a high resolution CT scan (or MRI) should be done. In patients who have a macroadenoma, quantitative visual field examination should be a part of the ophthalmologic examination. The choice of therapy is dependent on the clinical findings, the risks of therapy, and patient preference. Currently, the most effective therapy for a patient with a macroadenoma is medical therapy with a dopamine agonist, but this must be given chronically. Regardless of the therapy selected, these patients must be followed regularly. Once fertility is established, there is usually no contraindication to pregnancy in women who wish to become pregnant. PMID- 3319599 TI - Acromegaly. AB - Acromegaly is caused by GH-secreting pituitary adenomas and, in rare cases, by ectopic production of GRH with resultant hypersecretion of GH. Important systemic manifestations include acral enlargement, swelling, disfigurement, glucose intolerance and diabetes, hypertension, nerve entrapment, arthropathy, and cardiac disease. Tumor-related major manifestations are visual impairment, oculomotor paralysis, and hypopituitarism. Morbidity is substantial, and mortality is increased. Diagnosis should be made as early as possible by measuring plasma GH after an oral glucose load and plasma somatomedin C levels. Assessment of a pituitary lesion is best made by CT scanning in the coronal plane. Therapy is mandatory and consists of surgical removal of the pituitary adenoma (usually by the transsphenoidal route) or of the ectopic source of GRH (carcinoids or islet cell tumors). Adjunctive radiation and/or drug therapy is often necessary if complete surgical ablation of the adenoma is not possible. Radiation therapy can be administered as conventional supervoltage x-ray treatment or in the form of heavy particle beams. Drugs effective in partially lowering GH levels are bromocriptine and (not yet released) somatostatin analogues. Long-term follow-up of treated patients is important to guard against recurrence, progression, or development of hypopituitarism. PMID- 3319601 TI - Gonadotroph cell pituitary adenomas. AB - The frequency of gonadotroph cell adenomas among all unselected pituitary adenomas is likely much higher than previously suspected. The prevalence in one series of 139 men with pituitary macroadenomas was 17 per cent (24 per cent if adenomas secreting only alpha subunit are included). The clinical characteristics of patients with gonadotroph cell adenomas are similar. Most are middle-aged men who have a history of normal pubertal development and a normal fertility history and by examination are normally virilized and have testes of normal size. They are brought to medical attention because of visual impairment, which is the result of the enormous size of the adenoma. The most common hormonal characteristics of gonadotroph cell adenomas in vivo is hypersecretion of FSH, which is often accompanied by hypersecretion of FSH-beta and alpha subunits and less often by hypersecretion of LH-beta or intact LH. Another common characteristic is secretion of FSH and/or LH-beta in response to TRH. A few patients with gonadotroph cell adenomas hypersecrete intact LH and therefore have supranormal serum testosterone concentrations. A larger number have secondary hypogonadism, because the adenomas are not secreting intact LH but are compressing the normal gonadotroph cells and impairing LH secretion. These patients have concentrations of intact LH that are not elevated, despite subnormal testosterone concentrations. The testosterone increases markedly in response to human chorionic gonadotropin. Both the clinical and hormonal characteristics of gonadotroph cell adenomas usually make them readily distinguishable from pituitary enlargement due to long-standing primary hypogonadism. Most gonadotroph cell adenomas are now managed first by transsphenoidal surgery to attempt to restore vision as quickly as possible, and then by supervoltage radiation to prevent regrowth of the remaining adenomatous tissue. Surgery usually does improve vision, as well as the pretreatment hormonal abnormalities, and radiation reduces FSH hypersecretion further. Dopamine agonist therapy is experimental but warrants further trial. The hormonal abnormalities detected prior to treatment, such as supranormal basal concentrations of FSH, alpha, and FSH-beta and the FSH and LH-beta responses to TRH, can be used to monitor the response to therapy. PMID- 3319602 TI - Thyrotropin-secreting pituitary tumors. AB - TSH tumors are associated with both hypothyroid and hyperthyroid states. The proposed mechanism of thyrotroph secretion is illustrated in Figure 8. Pituitary enlargement in hypothyroidism is usually due to reactive hyperplasia and correlates with the degree of TSH elevation. Although this often translates to long-standing hypothyroidism and severe symptoms, this is not always the case. Patients may be asymptomatic or present with other endocrine syndromes. Children may have precocious puberty, and adults may have amenorrhea or decreased libido. One important message to remember is that whenever a patient has evidence of a pituitary tumor, a serum T4 and TSH level must be obtained. The dramatic reduction in pituitary size and resolution of endocrine dysfunction with thyroid hormone is gratifying. Thyrotropinomas producing thyrotoxicosis are autonomous tumors. Given their infrequent occurrence, one could question the cost effectiveness of ordering a serum TSH on all new patients with hyperthyroidism. Features that might favor the possibility of there being a tumor include male sex, headaches, visual impairment, and the absence of ophthalmopathy. Unfortunately, these are not reliable clinical features to suggest the presence of this disorder, and the diagnosis requires a serum TSH determination. Fortunately, the newer assays available are able to provide the sensitivity needed. Therapy should be aimed at the pituitary gland, but currently it is less than optimal. Surgery with or without external irradiation offers the best prognosis and, hopefully, will yield better results when cases are identified earlier. Medical therapy to suppress TSH is still in its infancy. More effective agents will hopefully be discovered in the near future. PMID- 3319603 TI - Nonsecreting pituitary tumors. AB - Nonfunctioning pituitary adenomas represent approximately 25 per cent of all clinically apparent pituitary tumors. The tumors are usually macroadenomas and present with symptoms caused by mass effect or hypopituitarism. In addition to structural studies and assessment of pituitary hormone function, all patients with clinically nonfunctioning tumors should have an alpha-subunit determination. High normal or elevated gonadotropins in this setting are suspicious for an underlying gonadotroph adenoma. Alpha subunit, LH-beta, and FSH-beta can be measured in the serum of some patients with nonfunctioning adenomas. Other groups of patients may have tumors in which defects in hormone biosynthesis or processing prevent detectable hormone hypersecretion, or no hormones are produced. The majority of nonfunctioning adenomas have evidence of gonadotropin or glycoprotein hormone subunit production when studied in vitro. An additional tumor group has evidence of ACTH production without biochemical hypercortisolism. Transsphenoidal decompression is the treatment of choice for patients with nonfunctioning adenomas. Pituitary function may improve following surgery in a subset of patients. Postoperative conventional radiotherapy is recommended when there is evidence of residual tumor and/or extensive extrasellar extension preoperatively. PMID- 3319604 TI - Plant activation of m-phenylenediamine by tobacco, cotton, and carrot cell suspension cultures. AB - Tobacco, cotton, and carrot plant cell suspension cultures activated the promutagen m-phenylenediamine into a mutagen as detected by Salmonella typhimurium strain TA98 with the use of the plant cell/microbe coincubation assay. For each cell line, mid-log phase plant cells at a density of 100-150 mg/ml were coincubated for 1 hr with concentrations of m-phenylenediamine that ranged from 0.1 to 10 mumol per reaction tube in the preincubation test of the plant cell/microbe coincubation assay. Further experiments were conducted to optimize the activation response for each plant cell line. The density of plant cells in the reaction mixture, the time of coincubation of the reaction mixture, and the stage of the growth curve at which the plant cells were harvested for use in the reaction mixture all affected the response. Experiments that used the conditions determined as optimum for each plant cell line were then conducted. With each cell line, the optimized conditions enhanced the activation response that had been observed with the preliminary conditions. A ranking order based on the concentration-response curves indicated a relationship of tobacco cells much greater than carrot cells greater than cotton cells. Tobacco cells were able to activate m-phenylenediamine into a mutagen at concentrations of less than 10 nmol per plate when using TA98 as the genetic indicator organism. Finally, experiments to determine the type of genetic lesion induced by plant-activated m phenylenediamine were conducted. By using five of the Ames strains, m phenylenediamine was shown to be active in inducing revertants in strains TA1538 and TA98 following activation by tobacco cells under the optimized conditions. We conclude that m-phenylenediamine is activated by plant cells into a mutagen that primarily induces frameshift mutations. PMID- 3319605 TI - Cd2+ tolerance in Escherichia coli and Salmonella typhimurium. AB - Relative tolerance of Escherichia coli strains to Cd2+ is induced by prior growth in medium containing low levels of either Cd2+ or Hg2+, and maximal induction appears to be dependent upon recA+ function. Biosynthesis of glutathione is not required for induction or for expression of induced resistance. Salmonella typhimurium strains are relatively resistant to Cd2+, and this resistance is essentially constitutive. PMID- 3319606 TI - Mutagenicity testing of some medicinal herbs. AB - Extracts of four brands of a Pakistani local medicine called naswar and six indigenous herbs commonly used as medicine in children were tested for their ability to induce mutations to prototrophy in Salmonella typhimurium tester strains TA98, TA100, TA1535, and TA1537. Petroleum ether extracts of one brand of naswar, namely green naswar of Peshawar, exhibited mutagenicity in all of the four tester strains. Organic extracts of three herbs, Saussurea lappa, Swertia chiraita, and Skimmia laureola, exhibited mutagenic activity in tester strain TA98. Green naswar of Bannu, grey naswar, red naswar, and the remaining three herbs, namely, Acorous calamus, Azadarachta indica, and Zanthozylum alatum, exhibited no mutagenic activity under the present experimental conditions. The abilities of green naswar of Peshawar and Saussurea lappa to induce mutations was shown to be related to the presence of cyclic aromatic compounds with molecular formulas C34 H44 O9 and C15 H18 O2, respectively. The experimental data are discussed as they relate to the potential hazards of such naturally occurring compounds and to synthetic compounds in excessive and uncontrolled use by the general public in villages in Pakistan. PMID- 3319607 TI - Predicting the carcinogenic potential of environmental nitropyrenes. AB - Nitrated polycyclic aromatic hydrocarbons (nitroarenes) constitute a large group of anthrapogenic environmental contaminants. Some members of the group are mutagenic and genotoxic in a wide spectrum of systems while others are either mutagenic only in Salmonella typhimurium or devoid of activity altogether. Additionally, some nitroarenes are uniformly carcinogenic in rodents while others are not. In view of the logistic and economic problems involved in preparing large quantities of individual nitroarenes in pure (greater than 99.5%) form and assaying them for carcinogenicity in animals, we have analyzed the results that nitropyrenes and related chemicals yield in short-term tests by CPBS, the Carcinogen Prediction, and Battery Selection method, and demonstrate that CPBS classifies them correctly with respect to carcinogenicity. PMID- 3319608 TI - The SIMULTEST: a new approach to screening chemicals with the Salmonella reversion assay. AB - A new Salmonella mutagenicity test method is under development to test a chemical with more than one strain simultaneously (the "SIMULTEST"), that is, different Salmonella typhimurium tester strains are used in combination on the same plate. Strains are combined in two sets: strains with plasmid pKM101 (TA97, TA98, TA100, and TA102) and strains without the plasmid (TA1535, TA1537, and TA1538). The SIMULTEST combinations successfully detect the mutagenic activity of five mutagens in different chemical classes. This approach may be useful in reducing the workload associated with mutagenicity testing with Salmonella. PMID- 3319609 TI - Chromosome aberrations and sister chromatid exchanges in Chinese hamster ovary cells: evaluations of 108 chemicals. AB - Results from the testing of 108 coded chemicals in Chinese hamster ovary (CHO) cells for the induction of chromosome aberrations and sister chromatid exchanges (SCEs) are presented. All chemicals were tested with and without exogenous metabolic activation, using protocols designed to allow testing up to toxic doses. Cell harvest times could also be extended if chemical-induced cell cycle delay was seen. Chromosome aberrations were induced by 43 of the chemicals, and 66 induced SCEs; 37 of the chemicals were positive for both endpoints. PMID- 3319610 TI - Analysis of the polypeptide composition of grana and stroma thylakoids by two dimensional gel electrophoresis. Distribution of photosystem II between grana and stroma lamellae. AB - The polypeptide composition of whole thylakoids and membrane subfragments was studied by using a modified two-dimensional gel electrophoresis technique of O'Farrell [J. Biol. Chem. 250, 4007-4021 (1975)]. The modifications were lithium dodecyl sulphate solubilization instead instead of SDS, reverse isofocusing and sensitive silver staining procedure. This high-resolution technique allowed us to separate and identify about 170 polypeptides of thylakoid membranes. After separating grana and stroma thylakoids it was found that both types of lamellae contained nearly equal amounts of polypeptides, but about 70 polypeptides were different in the two preparations. In grana thylakoids, 54 polypeptides out of 95 were found to be mainly present in grana and 31 of them were only present in grana preparations. In stroma membranes, 43 polypeptides out of 99 were mainly present in stroma lamellae and 38 of these polypeptides were exclusively present in stroma lamellae. In a functional photosystem II preparation, 61 individual polypeptides could be distinguished. Most of these polypeptides were present in both grana and stroma lamellae, but 22 of them were more pronounced in grana than in stroma lamellae. 9 polypeptides of photosystem II were distinctly different in grana and stroma lamellae, and these differences may connect closely with the functional differences of photosystem II in the two types of thylakoids. PMID- 3319611 TI - Primary and tertiary structures of the first domain of Panulirus interruptus hemocyanin and comparison of arthropod hemocyanins. AB - The amino acid sequence of the first domain (positions 1-175) of Panulirus interruptus hemocyanin subunit a has been determined. The sequence of residues 1 158 (18-kDa fragment obtained by limited proteolysis) was derived from peptides obtained by digestion of this fragment with CNBr and trypsin and by subdigestion of these peptides with other enzymes. The peptides were sequences automatically or manually. The amino acid sequence has been fitted into the electron-density map at 0.32-nm resolution. The residues of domain 1 are folded into a large, mainly helical, globular part, containing one disulfide bridge, and a smaller part near the molecular twofold axis. The latter part consists of an alpha helix and a beta strand which contains a covalently attached carbohydrate moiety. The sites susceptible to limited proteolytic cleavage of the subunit are discussed. Comparison of the N-terminal sequence with those of other arthropod hemocyanins revealed, besides an N-terminal extension of five residues, the presence of a 21 residue loop (positions 22-42) in the crustacean sequences. This loop contains helix 1.2, a less defined region in the electron-density map. It is absent in chelicerate sequences. Strong evidence is presented that: (a) the structure of the first 21 residues (including helix 1.1) is the same in all arthropod hemocyanins with known amino acid sequence; (b) a stretch containing about 15 residues (including part of helix 1.3) following the 21-residue loop has a different structure in crustaceans and chelicerates; (c) the rest of domain 1 has the same structure again. It is shown that all conserved residues are in the contact region with the other two domains. PMID- 3319612 TI - Lysosomal and non-lysosomal peptidyl hydrolases of the bloodstream forms of Trypanosoma brucei brucei. AB - African trypanosomes have thiol-dependent proteolytic activity that resembles some of the cathepsin-like activity found in mammalian lysosomes [Lonsdale Eccles, J. D. & Mpimbaza, G. W. N. (1986) Eur. J. Biochem. 155, 469-473]. Here we show that this activity is found in lysosome-like organelles which we have isolated (density = 1.082 g/cm3 in Percoll) from bloodstream forms of Trypanosoma brucei brucei. They are approximately 250 nm in diameter, are bounded by a single limiting membrane, and contain acid phosphatase. The predominant proteolytic and peptidolytic activity of these organelles has a pH optimum about 6.0, exhibits latency, and has the characteristics of mammalian cathepsin L (and possibly cathepsin H) with respect to its hydrolysis of small fluorogenic peptidyl substrates such as benzyloxycarbonyl-phenylalanyl-arginyl-7-amido-4 methylcoumarin. This substrate appears to be a good marker for trypanosomal lysosomes. The cathepsin-L-like activity is inhibited by the thiol-protease inhibitors, E-64, cystatin, leupeptin and mercurial compounds. The proteolytic activity of the lysosome-like fraction is observed as a single band of activity with an approximate molecular mass of 27 kDa when measured after electrophoresis in the fibrinogen-containing sodium dodecyl sulphate/polyacrylamide gels. The addition of mammalian serum to this purified fraction, or to whole trypanosome homogenates, results in the appearance of additional bands of activity, with a concomitant increase in the total observed proteolytic activity. The serum of some species of animal (e.g. goat and guinea pig) appear to lack the ability to generate this new and increased activity, while rat, rabbit, human and bovine sera exhibit varying capacities to generate the new activity, the cow being the most effective. The apparent molecular masses of the new bands of activity are different for each mammalian species, suggesting that the activator is a species specific molecule or class of molecules. We also show that Trypanosoma brucei contains soluble peptidolytic activity with an alkaline pH optimum. It is inhibited by the serine-protease inhibitor diisopropylfluorophosphate, but not by inhibitors such as phenylmethylsulphonyl fluoride, alpha 1-antitrypsin, or aprotinin. Nor is it inhibited by the thiol-protease-specific inhibitors E-64 or cystatin, although it is susceptible to inhibition by tosyllysylchloromethane, leupeptin, HgCl2 and p-chloromercuribenzoate. This enzymic activity has a preference for arginyl residues in the primary binding site (the P1 position), as also does the activity from the lysosomes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3319614 TI - Modes of attachment of acetylcholinesterase to the surface membrane. AB - Acetylcholinesterase (AChE) occurs in multiple molecular forms differing in their quaternary structure and mode of anchoring to the surface membrane. Attachment is achieved by post-translational modification of the catalytic subunits. Two such mechanisms are described. One involves attachment to catalytic subunit tetramers, via disulfide bridges, of a collagen-like fibrous tail. This, in turn, interacts, primarily via ionic forces, with a heparin-like proteoglycan in the extracellular matrix. A second such modification involve the covalent attachment of a single phosphatidylinositol molecule at the carboxyl-terminus of each catalytic subunit polypeptide; the diacylglycerol moiety of the phospholipid serves to anchor the modified enzyme hydrophobically to the lipid bilayer of the plasma membrane. The detailed molecular structure of these two classes of acetylcholinesterase are discussed, as well as their biosynthesis and mode of anchoring. PMID- 3319613 TI - Amino-acid sequence of the cytochrome-b5-like heme-binding domain from Hansenula anomala flavocytochrome b2. AB - Flavocytochrome b2 (L-lactate dehydrogenase) from baker's yeast is composed of two structural and functional domains. Its first 100 residues constitute the heme binding core, which is homologous to cytochrome b5 [B. Guiard, O. Groudinsky & F. Lederer (1974) Proc. Natl Acad. Sci. USA 71, 2539-2543]. We report here the amino acid sequence of the heme-binding domain isolated by tryptic proteolysis of Hansenula anomala flavocytochrome b2. The sequence was established by automated degradation of the whole fragment and of peptides obtained by CNBr cleavage at the unique tryptophan and by proteolysis with thermolysin and endoproteinase Lys C. As isolated, the domain consists of 84 residues without any sulfur amino acids. It shows 49 identities with the heme-binding domain from Saccharomyces cerevisiae and 28 with beef microsomal cytochrome b5. Using the recently published three-dimensional structure of S. cerevisiae flavocytochrome b2 [Z-x. Xia, N. Shamala, P. H. Bethge, L. W. Lim, H. D. Bellamy, N. H. Xuong, F. Lederer and F. S. Mathews (1987) Proc. Natl Acad. Sci. USA 84, 2629-2633], it can be seen that there are only positively charged side chains close to the accessible heme edge, the only negative charges in that area being those of the heme propionates. The implications of this result are discussed in the light of Salemme's model for the cytochrome b5/cytochrome c complex [F. R. Salemme (1976) J. Mol. Biol. 102, 563-568]. PMID- 3319615 TI - A synthetic functional metabolic compartment. The role of propinquity in a linked pair of immobilized enzymes. AB - A system was created to model the influence of microcompartments on linked enzymatic reactions. Creatine kinase and hexokinase were covalently attached to Sepharose beads. The gel could be perfused in a specially constructed chamber inside a 360-MHz NMR spectrometer at different flow rates with solutions containing various concentrations of substrates. 31P NMR studies were carried out on the linked enzymatic reaction, creatine phosphate + glucose----creatine + glucose 6-phosphate in two enzyme gels differing in only one aspect, the average distance between hexokinase and creatine kinase. At a distance on the order of 0.1 mm between the enzymes, the average bulk concentrations of substrates and products in the perfusate determined the overall function of the linked system. At an average distance of the order of 10 nm, flux through the linked pair was much higher and much less dependent on the concentration of the intermediate substrate/product ADP/ATP. Even at adenine nucleotide concentrations far below the Km of hexokinase, substantial amounts of glucose 6-phosphate were produced when the enzymes were near but not when they were distant. From saturation transfer measurements and turnover calculations, the lifetime of ATP in the system is estimated to be 0.14-0.5 s when the enzymes are near. This compares to 6 s for distant enzymes. From this it appears that the pair of linked enzymes comprise a functional compartment supported by propinquity in which hexokinase has preferential access to ATP produced by creatine kinase, and creatine kinase to ADP from the hexokinase reaction. PMID- 3319616 TI - Influence of different 5'-flanking sequences of tRNA genes on their in vivo transcription efficiencies in Saccharomyces cerevisiae. AB - We have investigated the influence of 5'-flanking sequences on the in vivo transcription activities in yeast. Since eukaryotic tRNA genes belong to multi copy gene families monitoring of the activity of a particular tRNA gene is not possible. We therefore used two different tRNA genes from the cellular slime mould Dictyostelium discoideum which are efficiently transcribed and processed in vivo in yeast. The original 5'-flanking sequences of the two tRNA genes were replaced by random plasmid sequences. The modified tRNA genes were introduced into Saccharomyces cerevisiae and bulk tRNAs from the transformants were analyzed for the presence and the relative number of Dictyostelium tRNA gene transcripts. Substantial differences of steady-state levels of RNA transcribed were detected dependent on the 5'-flanking sequence of the tRNA gene. Minute structural changes, such as inserting two additional nucleotides in front of a tRNA gene, can lead to drastic activity changes. The efficiency of tRNA gene transcription can be conferred by sequences located more than 40 nucleotides upstream from the 5' end of the mature tRNA coding region. PMID- 3319617 TI - Secretion of biologically active porcine prophospholipase A2 by Saccharomyces cerevisiae. Use of the prepro sequence of the alpha-mating factor. AB - The cDNA coding for porcine pancreatic prophospholipase A2 (proPLA) has been cloned and expressed in Saccharomyces cerevisiae. Expression and secretion of proPLA could only be obtained after fusing the proPLA to the prepro sequence of the yeast alpha-mating factor. Upon secretion, the fusion protein was cleaved by the KEX2 protease yielding a 140-amino-acid zymogen-like form of the phospholipase A2. This protein was purified in high yield by ion-exchange chromatography. Limited proteolysis with trypsin cleaved the 'zymogen' to yield active phospholipase A2, which was indistinguishable from the authentic porcine pancreatic enzyme. These results show that a protein with a disulphide bridge content as high as 7 per 124 amino acid residues can be correctly processed by the yeast secretory apparatus. PMID- 3319618 TI - Phenol hydroxylase from yeast. A model for phenol binding and an improved purification procedure. AB - The binding of phenol to phenol hydroxylase was studied by equilibrium dialysis, spectrophotometric titration and by steady-state kinetics. A binding model with two identical, negatively cooperative, effector/substrate-binding sites per enzyme dimer is proposed. The spectral perturbation caused by phenol and the kinetics of the overall reaction were analysed with relation to the enzyme-phenol complexes of the binding model. The main part of the spectral perturbation as well as of the increase in NADPH oxidation rate was achieved by one molecule of phenol bound per enzyme dimer. The properties of different enzyme-phenol complexes, in terms of spectral changes, hydroxylase activity, oxidase activity and substrate inhibition are discussed. A new purification procedure is described. PMID- 3319619 TI - Effects of insulin and norepinephrine on glucose transport and metabolism in rat brown adipocytes. Potentiation by insulin of norepinephrine-induced glucose oxidation. AB - Glucose is an important fuel for rat brown adipose tissue in vivo and its utilization is highly sensitive to insulin. In this study, the different glucose metabolic pathways and their regulation by insulin and norepinephrine were examined in isolated rat brown adipocytes, using [6-14C]glucose as a tracer. Glucose utilization was stimulated for insulin concentrations in the range of 40 1000 microU/ml. Furthermore, the addition of adenosine deaminase (200 mU/ml) or adenosine (10 microM) did not alter insulin sensitivity of glucose metabolism. The major effect of insulin (1 mU/ml) was a respective 7-fold and 5-fold stimulation of lipogenesis and lactate synthesis, whereas glucose oxidation remained very low. The 5-fold stimulation of total glucose metabolism by 1 mU/ml of insulin was accompanied by an 8-fold increase in glucose transport. In the presence of norepinephrine (8 microM), total glucose metabolism was increased 2 fold. This was linked to a 7-fold increase of glucose oxidation, whereas lipogenesis was greatly inhibited (by 72%). In addition, norepinephrine alone did not modify glucose transport. The addition of insulin to adipocytes incubated with norepinephrine, induced a potentiation of glucose oxidation, while lipogenesis remained very low. In conclusion, in the presence of insulin and norepinephrine glucose is a oxidative substrate for brown adipose tissue. However the quantitative importance of glucose as oxidative fuel remains to be determined. PMID- 3319620 TI - Cell-wall lytic enzymes (autolysins) of Chlamydomonas reinhardtii are (hydroxy)proline-specific proteases. AB - Two stage specific cell-wall lytic enzymes (autolysins) from different strains of the unicellular, biflagellated green alga Chlamydomonas reinhardtii were isolated and purified to homogeneity. Quantitative and specific photometric assays for biological activity were worked out to follow fractionation and to establish lytic specificity and kinetics. The autolysins were studied for enzymatic properties and screened for biological activity towards several wall components obtained by salt extractions of sporangia and zoospores from C. reinhardtii. The autolysins are proteolytic enzymes, fragmenting proline- or hydroxyproline containing polypeptides in structures like connective tissue. They attack predominantly selected domains within the walls of zoosporangia or gametes. The sporangial autolysins are not only site- and strain-specific but also stage specific, whereas the gamete autolysins lyse cell walls of gametes as well as those of sporangia and zoospores. PMID- 3319622 TI - Value and limitations of abdominal ultrasound in tumour staging--liver metastasis and lymphoma. AB - Real time ultrasound findings in 137 patients with proven or suspected liver metastasis and 51 patients with suspected malignant lymphoma were analyzed in order to define the accuracy of this method in tumour staging procedures. Sensitivity of liver metastasis was low (54.4%), while specificity (92.0%) and negative predictive value (95.8%) were good. Sensitivity for malignant lymphoma was better (84.6%), but specificity was less satisfactory (72.0%). Accuracy was dependent of the type of the primary tumour, bronchial carcinoma resulting in a very poor detection of liver metastases and suspected metastatic lymphoma leading to a large number of false positive results. We conclude from our data that only positive ultrasound findings of liver metastases or multiple lymphoma and probably a negative examination of the liver in patients with colonic carcinoma are sufficiently reliable to be used for therapeutic decisions in patients with malignant diseases. PMID- 3319621 TI - Translation of an mRNA in rat L6 muscle cells is regulated within the cell cycle. AB - In muscle cells two populations of mRNA are present in the cytoplasm. The majority of mRNA is associated with ribosomes and active in protein synthesis. A small population of cytoplasmic mRNA occur as free mRNA-protein complex and is not associated with ribosomes. This apparently repressed population of mRNA from rat L6 myoblast cells was used to construct a cDNA library. Radioactively labeled cDNA preparations of polysomal and free (or repressed) mRNA populations showed that at least ten recombinant clones preferentially annealed to the cDNA from repressed mRNA. One of these clones was extensively studied. The DNA from a recombinant plasmid D12 hybridized to a 1.3-kb poly(A)-rich mRNA. In proliferating myoblast cells, the 1.3-kb mRNA was more abundant in the polysomal fraction and mostly free in the non-dividing myotubes. In contrast to this mRNA, 90% of alpha and beta actin mRNAs were translated in both myoblasts and myotubes. Further analysis of distribution of the 1.3-kb RNA in the polysomal (active) and free (repressed) fractions in fusion-arrested postmitotic myotubes suggested that fusion of myoblasts was not necessary for the control of translation of this mRNA. Withdrawal of muscle cells from the cell cycle appeared to be involved in regulating translation of this mRNA. The presence of this mRNA was not, however, limited to muscle cells. This mRNA was also present in the repressed state in rat liver and kidney cells. These results, therefore, suggest that the 1.3-kb mRNA is probably translated during a particular phase of the cell cycle and is not translated in terminally differentiated non-dividing cells. Messenger RNA homologous to the 600-base-pair insert of the recombinant plasmid D12 was isolated by hybrid selection procedure from both polysomal mRNA of myoblasts and free mRNA of myotubes. Translation of the hybrid selected mRNAs from both myoblasts and myotubes in rabbit reticulocyte lysate cell-free system synthesized a 40-kDa polypeptide. These results suggest that the repressed population of 1.3 kb mRNA can be translated in vitro. The hybridization pattern of DNA from the recombinant plasmid D12 with rat genomic DNA suggested that the 1.3-kb mRNA is derived from moderately repetitive rat DNA with a repetition frequency of approximately 100 copies per haploid genome. PMID- 3319623 TI - Acute renal failure in children. An ultrasonographic-clinical study. AB - Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception of those in the neonatal age group (12%). Improvement in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% +/- 1.40 S.D.) and group B (5.95 mg% +/- 1.96 S.D.), p less than 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity. PMID- 3319624 TI - A pheochromocytoma of the urinary bladder. AB - This case report describes a patient with a pheochromocytoma of the urinary bladder. The patient demonstrated an excessive increase of blood pressure and plasma catecholamines immediately after micturition. Ultrasound and CT-scanning confirmed the localisation of the tumour in the urinary bladder. PMID- 3319625 TI - A new transducer technology--the annular phased array: comparison with a conventional mechanically rotating sector transducer: the upper abdomen. AB - During a 3-month period, 285 patients underwent ultrasonographic examination of the upper abdomen. Scanning was done with a new annular phased array transducer, and a conventional rotating sector transducer. Our study indicates that the annular phased array is more effective for outlining boundaries of the liver, spleen and pancreas in the near and far field. Owing to improved lateral resolution, the new technology permits US imaging of parenchymal organs, even in cases of severe bowel gas obscuration. PMID- 3319626 TI - Tumor promoter and fibronectin induce actin stress fibers and focal adhesion sites in spreading human erythroleukemia (HEL) cells. AB - The effects of plasma fibronectin (pFn) and the tumor promoter 12-0-tetradecanoyl phorbol-13-acetate (TPA) on adhesion and cytoskeletal organization of human erythroleukemia (HEL) cells were studied. HEL cells, that normally grow in suspension, attached rapidly on pFn-coated growth substratum and some cells showed spreading. Upon exposure to TPA most of the cells adhered and showed some degree of spreading also when plated on plastic. The spread cells showed mostly peripheral accumulations of F-actin in addition to actin fibers seen in some of the cells. When the cells were plated in the presence of TPA on pFn or on pFn fragments, containing the cell binding site, all the cells adhered rapidly, spread extensively, organized prominent F-actin stress fibers and typical ventral plaques of vinculin and alpha-actinin. Both proteins were revealed also in the suspended cells by Western blot analysis. When plated on substratum coated with other pFn-fragments or laminin, the HEL cells did not adhere or spread. Both adhesion on pFn as well as formation of stress fibers in the presence of TPA could be prevented by the synthetic peptide Arg-Gly-Asp-Ser (RGDS). HEL cells were also able to organize typical ventral fibrillar arrays of Fn. Immunostaining and metabolic labeling experiments showed that the cells did not contain or synthesize Fn, indicating that the plaques were formed from exogenous pFn by the cells. The results suggest that Fn and TPA synergistically induce the organization of the actomyosin system in HEL cells by promoting the formation of prominent actin stress fibers and focal adhesion sites. PMID- 3319628 TI - Localization of phosphorylase kinase subunits at the sarcoplasmic reticulum of rabbit skeletal muscle by monoclonal and polyclonal antibodies. AB - Molecular structures related to phosphorylase kinase have been localized by light and electron microscopy in tissue sections of rabbit skeletal muscle employing polyclonal antibodies directed against the holoenzyme as well as monoclonal antibodies specific for its alpha-, beta- or gamma-subunits. In frozen sections of prefixed muscle fibres both known major regions of glycogen deposition, the intermyofibrillar space and the perinuclear area, are stained predominantly. In sections of unfixed muscle in which cytosolic phosphorylase kinase was removed by extensive washes prior to immunostaining the immunolabel is mainly associated with the sarcoplasmic reticulum (SR). This membrane location is further confirmed by immunoblot analysis of proteins solubilized from isolated SR with Triton X 114. Employing monoclonal antibodies two membrane proteins are identified as the alpha- and beta-subunits of phosphorylase kinase by Western blots. Immunoprecipitates reveal also the gamma-subunit; the delta-subunit, i.e., calmodulin, is enriched with the solubilized enzyme. It proves that a SR membrane associated form of holophosphorylase kinase exists in muscle. Functionally, this kinase might be involved in phosphorylation of phosphatidylinositol present on the SR Ca2+ transport ATPase and thereby might play a role in regulation of Ca2+ transport. PMID- 3319627 TI - Mitochondrial binding of a protein affected in mutants resistant to the microtubule inhibitor podophyllotoxin. AB - Specific antibodies to a protein P1 Mr approximately equal to 63,000) from Chinese hamster ovary cells, which is affected in mutants resistant to the microtubule inhibitor, podophyllotoxin, and behaves like a microtubule-related protein by certain criteria [14], have been raised. The antibody reacts specifically with the P1 protein in one- and two-dimensional immunoblots, and a cross-reacting protein of similar molecular mass and electrophoretic mobility is also found in cells from various vertebrate and invertebrate species. The observed similarity in the peptide maps of the cross-reacting protein from human, mouse, Chinese hamster and chicken cells indicates that the structure of this protein should be highly conserved. However, no P1-antibody cross-reacting protein was observed in plants (corn, mung), fungus (Neurospora crassa), yeast (Saccharomyces cerevisiae) and bacteria (Escherichia coli and Salmonella typhimurium). Immunofluorescence studies with the P1-antibody show that, in interphase cells of various cross-reacting species, it bound specifically to mitochondria which were associated and distributed on and along the length of microtubules. Similar association and codistribution of mitochondria and microtubules were not observed in mitotic cells. Some implications of the mitochondrial localization of the protein P1 and the observed association between microtubules and mitochondria are discussed. PMID- 3319629 TI - Cardiac events after myocardial infarction: possible effect of relaxation therapy. AB - Comprehensive cardiac rehabilitation aims primarily at improving quality of life, but an effect on morbidity and mortality may also be expected, especially when changes in behaviour and life-style are induced. The value of relaxation therapy and exercise training in post myocardial infarction (MI) patients was investigated. A group of 90 post MI patients were randomly assigned to either exercise training plus individual relaxation and breathing therapy (treatment A), or exercise training only (treatment B). The occurrence of cardiac events, consisting of cardiac death and of readmission to hospital for unstable angina pectoris, coronary artery bypass grafting (CABG) or recurrent infarction, differed significantly for the two treatment groups in the 2-3 years after infarction. Seven out of 42 patients in treatment group A (17%) experienced a cardiac event, in contrast to 17 out of 46 (37%) patients in treatment group B, (P = 0.05, two-tailed). The results suggest that a combination of a behavioural treatment such as relaxation therapy with exercise training is more favourable for the long-term outcome after myocardial infarction than is exercise training alone. PMID- 3319630 TI - Of false negative results in the ultrasound of female breast cancer. AB - The preoperative results of sonography of 108 malignant breast tumors were analysed for reasons of false negative results by correlation of sonographic features with the corresponding clinical, histological and cytological findings. Previously we found no typical sonographic criteria of malignancy. Here we show, that diagnosis was especially difficult in carcinoma of young women, and in estrogen receptor negative, as well in progesterone positive tumors. The accuracy of diagnosis of tubular carcinoma was lower than of solid carcinomas. There was no correlation between false negative ultrasound results an histological or cytological grading, nuclear size, or tumor mitosis rate. We emphasize the importancy of sonography in diagnosis of female breast cancer. PMID- 3319631 TI - CA-125 serum level in the diagnosis of pelvic masses: comparison with other methods. AB - The Authors have evaluated the diagnostic contribution offered by the serum dosage of the antigen CA-125 in the diagnostics of pelvic masses. This method has been compared with the objective and echographic evaluation, as a noninvasive method of enquiry in the diagnosis of malignant neoplasias of the ovary. The Authors endorse the increase in diagnostic sensitivity brought about by the evaluation of this marker, above all if it is inserted into an integrated diagnosis. PMID- 3319632 TI - The diagnostic value of cytology in a case of lymphoma of the uterine cervix. AB - The Authors describe a case of primitive lymphoma of the uterine cervix and review the relevant literature. The presence of this malignant neoplasm was revealed by cytologic examination; colposcopy and biopsy findings were negative. The paper stresses the value of cytology in the diagnosis of lymphoma and discusses the differential diagnosis between plasmacytoid lymphocytic lymphoma of the cervix and stromal sarcoma. PMID- 3319633 TI - Immunohistochemical study in a case of primitive lymphoma of the uterine cervix. AB - An immunohistochemical study using the peroxidase-antiperoxidase technique was conducted in a case of primitive lymphoma of the uterine cervix. The antibodies used were: epithelial membrane antigen, leucocyte common antigen, Lambda, Kappa, lysozome and alpha 1-antichymotripsine. A positive reaction for leucocyte common antigen and Lampda demonstrated a B-cell plasmacytoid lymphocytic lymphoma, a tumour of haemopoietic origin. PMID- 3319634 TI - Phenylketonuria in adolescence. International Symposium on the Advances in the Management of PKU. Brussels, Belgium, October 1986. Dedicated to Horst Bickel. PMID- 3319635 TI - Nutritional requirements of healthy adolescents and their significance during the management of PKU. PMID- 3319636 TI - Atypical cases of phenylketonuria. PMID- 3319638 TI - Salmon calcitonin in the therapy of corticoid-induced osteoporosis. AB - There is uncertainty about the best treatment for steroid-induced osteoporosis. Thirty-six patients with steroid-dependent, chronic obstructive lung disease and associated steroid osteoporosis have been studied, of whom 18 were treated with salmon calcitonin and the other 18 served as controls. Treatment lasted for 6 months and consisted of 100 I.U.s.c. every other day. In the controls there were significant decrements of 1.4% and 3.5%, respectively, in cortical and cortical and trabecular bone mineral content, whereas in subjects on calcitonin there were increments of 2.6% and 2.7%, respectively. Additional evidence of positive effect of calcitonin was derived from the reduced incidence of new fractures occurring during the observation period. A significant reduction in back pain was a further consequence of the hormone therapy. PMID- 3319637 TI - Nicardipine in the treatment of essential hypertension controlled 6-month-study comparing nicardipine with propranolol at rest and during exercise. AB - Thirty patients with mild to moderate essential hypertension entered a randomised double-blind parallel group study for 6 months to compare the effects of the new calcium channel blocker nicardipine 90 mg/day and propranolol 240 mg/day. Both drugs reduced systolic and diastolic blood pressures significantly in the supine and in standing positions. After 6 months of treatment, nicardipine had reduced the supine systolic and diastolic blood pressures by 16 and 17 mm Hg, respectively, and propranolol by 15 and 12 mm Hg. While propranolol treatment led to a marked decline in heart rate, nicardipine caused a small but statistically significant increase in heart rate throughout the study. Both drugs reduced blood pressure during maximal exercise, but propranolol had a greater effect. During exercise nicardipine did not affect the heart rate, whereas propranolol dramatically reduced it. Nicardipine did not produce any ECG changes at rest or during exercise. The side-effects for nicardipine were mild and were related to the vasodilatation induced by the drug. No abnormalities in routine blood chemical tests were found for either of the drugs. Nicardipine appears to be an effective single drug treatment for mild to moderate hypertension. PMID- 3319639 TI - Disposition and hypoglycaemic action of glipizide in diabetic patients given a single dose of nifedipine. AB - Six well controlled Type 2 diabetics who had received glipizide therapy ranging from 5 mg to 30 mg daily for at least the previous 2 months were studied. On Days 1 and 15 nifedipine 20 mg or placebo respectively were given in a random crossover design after an overnight fast and with the morning dose of glipizide. Nifedipine did not influence the disposition of glipizide since there was no significant alteration in the maximum concentration, time to peak plasma concentration, elimination half-life or area under the curve. Neither did it have a major effect on plasma glucose or insulin although there was an early preprandial decrease in insulin level which reached significance at 1 h only (22.66 v 18.50 mIU/l). PMID- 3319640 TI - Comparison of nicardipine and propranolol in the treatment of mild and moderate hypertension. AB - In a double-blind controlled trial 22 patients with mild or moderate essential hypertension were treated with nicardipine 30 mg t.d.s. and 19 patients with propranolol 80 mg t.d.s. as monotherapy for 24 weeks. Blood pressure in both groups at the end of trial was equally and significantly reduced; systolic pressure 22.2 mmHg and diastolic pressure 15.5 mmHg in the supine position, and 24.4 mmHg and 18.4 mmHg, respectively, in the standing position in those on nicardipine, and by 23.7 and 16.2 mmHg and 28.0 and 19.2 mmHg, respectively, in the propranolol group. There was an initial increase in heart rate in the nicardipine group, but the rise was only moderate (3 beats/min supine p = 0.3219, and 7 beats/min standing, p = 0.0203) at the end of the 24 weeks. In the propranolol group heart rate was reduced markedly. Adverse effects occurred in 77% of patients on nicardipine and in 63% of those on propranolol, and there were no unexpected findings. The effects were mild in both groups and did not lead any patient to stop medication. One patient on propranolol was withdrawn from the trial because of poor blood pressure control and suspected angina pectoris after 5 weeks on active medication. There were no significant changes in blood chemistry, including lipoprotein classes. Overall, in comparison with propranolol, nicardipine was effective, well-tolerated and safe to use in the monotherapy of mild or moderate essential hypertension. PMID- 3319641 TI - Effect of cholinergic agonists and antagonists on gallbladder volume in fasting man. AB - The effect of direct cholinergic stimulation and blockade on gallbladder volume, determined by real-time ultrasonography (RUS), was evaluated in twenty normal, fasting subjects. Eleven subjects received atropine sulphate or placebo and 9 subjects a series of 3 injection of prostigmine, bethanechol or placebo, randomly assigned, at intervals of 24 h. RUS was performed under basal conditions after fasting for 12 h and every 5 min after drug injection up to 45 min in the atropine study and up to 60 min after prostigmine and bethanechol. There was no significant variation from fasting gallbladder volume after placebo in either group. After atropine sulphate gallbladder volume at first decreased and then significantly increased. With bethanechol and prostigmine, the volume fell significantly to a trough after 30 to 35 min, and then it returned to the basal value within 60 min. It is suggested that cholinergic mediation is involved in maintaining fasting tone in the gallbladder and that cholinergic stimulation causes contraction of the gallbladder by a direct effect. PMID- 3319642 TI - High-dose metoclopramide by infusion: a double-blind study of plasma concentration-effect relationships in patients receiving cancer chemotherapy. AB - We have carried out a randomized, double-blind trial to investigate the relationship between the dose and plasma concentration of metoclopramide and its anti-emetic efficacy and adverse effects in patients receiving cancer chemotherapy. Seventeen patients received four different infusion regimens of high-dose metoclopramide in random order with four consecutive courses of chemotherapy, to achieve an approximately eight-fold range in plasma metoclopramide concentrations. In patients receiving cisplatin the incidence of vomiting decreased with increasing metoclopramide dose, but the overall efficacy was poor. There was no relationship between anti-emetic efficacy and either dose or plasma concentration of metoclopramide in patients receiving cyclophosphamide and doxorubicin. The adverse effects of high-dose metoclopramide included diarrhoea, which increased in incidence with increasing metoclopramide dose, and sedation and extrapyramidal reactions, which were not related to dose or plasma concentration. Although anti-emetic efficacy increases with increasing metoclopramide dose in patients receiving cisplatin, high-dose metoclopramide alone does not adequately control cisplatin-induced nausea and vomiting. PMID- 3319644 TI - Kinetics of ceftazidime during plasmapheresis. AB - The influence of plasmapheresis (PA) on the elimination kinetics of ceftazidime (Cef) has been investigated. A single dose of Cef was administered intravenously to 11 patients with autoimmune diseases and varying degrees of renal impairment (Group I CLCR less than 50 ml/min, Group II CLCR greater than 50 ml/min). In Groups I and II the mean total clearance of Cef (CL) was 30 and 116 ml/min-1, respectively. The elimination half-life (t1/2 beta) and the volume of distribution (V) were significantly higher in Group I than in Group II (11.9 vs 2.0 h, 27.1 vs 18.5 l). PA had no influence on the plasma level-time profile of Cef. The amount of Cef recovered from separated plasma accounted for only 2 to 9% of the administered dose, being particularly low in patients with normal renal function (4.6%). Thus, since elimination of Cef via PA is negligible, dosage calculations should be based solely on renal function. PMID- 3319643 TI - Kinetics of human and porcine insulins in normal and type I diabetic subjects. AB - Human and porcine insulin were infused intravenously at various rates into 4 normal and 6 Type I diabetic subjects, using a double-blind cross-over design and a euglycaemic glucose clamp, to study the relationship between the steady state plasma free insulin concentration and its plasma disappearance rate. By mathematical model validation procedures both human and porcine insulin were found to obey saturation kinetics in normal subjects and first order kinetics in diabetic subjects in the insulin concentration range studied (0-2 nmol/l). No differences in parameters were observed between the two types of insulin in the study groups. The median clearance rate of insulin in normal subjects was 31 ml.kg-1.min-1 at infinitesinal plasma insulin concentrations versus 21 ml.kg 1.min-1 in the diabetic subjects. Thus, at physiological plasma concentrations both human and porcine insulin disappear faster via the saturable mechanism(s) found in normal subjects than via the apparently linear mechanism(s) found in diabetic subjects. PMID- 3319645 TI - Effect of the calcium antagonist nilvadipine on haemodynamics at rest and during cold stimulation in essential hypertension. AB - The immediate haemodynamic effects of the calcium antagonist nilvadipine have been studied in ten patients with established mild essential hypertension. Nilvadipine 4 mg p.o. reduced both the systolic and diastolic blood pressures within 60 min, associated with a fall in total peripheral resistance and an increase in heart rate and cardiac index. The peak of blood pressure and total peripheral resistance reached during a cold pressor test were reduced by nilvadipine, but it did not affect the haemodynamic responsiveness to cold stimulation. Plasma renin activity was unaltered and the plasma noradrenaline concentration was increased only slightly. Thus, nilvadipine lowered blood pressure at rest and during cold stimulation as a result of arteriolar dilatation. The hypotensive effect at rest was associated with a reflex increase in heart rate and cardiac index. PMID- 3319646 TI - Plasma renin activity does not predict the antihypertensive efficacy of chlorthalidone. AB - It has been established that angiotensin II stimulation may limit the antihypertensive potential of diuretic therapy in some patients. It is less clear, however, whether renin-angiotensin II stimulation is the cause of the flat blood pressure dose-response relationship to diuretics. To investigate this, 75 out-patients with essential hypertension were treated with chlorthalidone 12.5, 25 or 50 mg o.d. for 3 weeks, in a double-blind, placebo controlled cross-over study. Chlorthalidone significantly reduced blood pressure in all the groups, a plateau being reached at 25 mg o.d. Similarly, plasma renin activity was increased by each dose level of chlorthalidone, but it showed a different trend, being increased to a comparable extent at 12.5 mg and 25 mg o.d., and still higher at 50 mg o.d. Thus, greater stimulation of renin was coincident with the levelling of the blood pressure response to chlorthalidone. However no significant correlation was found between interindividual plasma renin activity and change in blood pressure, either in the entire series, or in each treatment subset. The data suggest overall that renin stimulation may influence the characteristic dose-hypotensive response relationship to diuretic agents in antihypertensive therapy, but it is unlikely that measurement of individual plasma renin activity will provide an useful guide to the optimal dose of a diuretic agents. PMID- 3319647 TI - Effect of captopril on renin and blood pressure in cirrhosis. AB - In hepatic cirrhosis neurohumoral vasoconstrictor systems are activated to compensate for circulatory disturbances. To study the renin-angiotensin aldosterone system in more detail, angiotensin converting enzyme in 15 patients with advanced liver disease was inhibited with captopril after moderate sodium restriction. Captopril caused an increase in plasma renin activity (p less than 0.005) and a decrease in plasma aldosterone (p less than 0.025) from an elevated baseline, and a moderate drop in systolic (p less than 0.025) and diastolic (p less than 0.05) blood pressure. Hyperreninaemia after captopril was inversely related to the prevailing plasma sodium level (r = -0.66, p less than 0.01), and the changes in both systolic and diastolic blood pressure were correlated with baseline plasma renin activity (r = 0.49, p less than 0.05 for systolic and r = 0.71, p less than 0.01 for diastolic blood pressure). No change occurred in heart rate or in stimulated plasma noradrenaline and vasopressin levels. The data suggest that in these cirrhotic patients the reactivity of the renin-angiotensin aldosterone system was still intact, although it occurred at a higher level. They confirm the importance of the renin-angiotensin-aldosterone system in arterial blood pressure regulation in cirrhosis. PMID- 3319649 TI - Drug monitoring of quinine by HPLC in cerebral malaria with acute renal failure treated by haemofiltration. AB - The monitoring of quinine by HPLC in 3 patients suffering from cerebral malaria with acute renal failure and treated by haemofiltration is reported. The recommended dose of quinine in this situation is reduced to 10 to 15 mg.kg-1.day 1. However, in the first patient, when given quinine 10 mg kg-1.day-1 the plasma concentration was mainly below the recommended therapeutic range of 5 to 15 mg/l. In consequence, the dose of quinine in the second patient was elevated to quinine dihydrochloride 15.1 mg.kg-1.day-1 which produced plasma concentrations in the low therapeutic range. In the third patient, an unreduced dose of quinine dihydrochloride 25.7 mg.kg-1.day-1 was employed, resulting in plasma concentrations above 15 mg/l, which is generally assumed to be toxic, although, no sign of acute quinine toxicity was seen. The antimalarial effect in all three patients was satisfactory. Quinine was estimated in the haemofiltrate in two patients and was found to be below the limit of sensitivity (0.25 mg/l). Plasma quinine did not change during or shortly after haemofiltration. It is concluded that in case of acute renal failure in cerebral malaria the dose of quinine should be reduced, but that the common recommendation of 10 to 15 mg.kg-1.day-1 may be too low, and that haemofiltration has no marked influence on the total body clearance of quinine. PMID- 3319648 TI - Lack of primary effect of sulphonylurea (glipizide) on plasma lipoproteins and insulin action in former type 2 diabetics with attenuated insulin secretion. AB - A double-blind, placebo-controlled investigation has been made into the effects of 8 weeks of glipizide treatment in diabetics previously classified as Type 2 but with subsequent attenuation of insulin secretion and thence maintained on exogenous insulin. Although all patients were exposed to therapeutic plasma concentrations of glipizide, fasting blood glucose, haemoglobin A1 and plasma lipoproteins (HDL, LDL, total cholesterol and triglycerides) did not show any consistent improvement following this treatment. It appears unlikely that SU (glipizide) has any primary effect on insulin action or on plasma lipoproteins. Its primary action is to augment insulin release and availability, so, its use should be restricted to Type 2 diabetics who retain insulin secretion. PMID- 3319650 TI - Induction of sporozoite-specific memory cells in mice immunized with a recombinant Plasmodium vivax circumsporozoite protein. AB - A recombinant Plasmodium vivax circumsporozoite (CS) protein (rPvCS-1) has been investigated as a possible malaria sporozoite vaccine candidate. Experiments were carried out to determine whether sporozoite-specific memory cells develop in Swiss Webster mice immunized with rPvCS-1. Challenge of rPvCS-1-immunized mice with P. vivax sporozoites resulted in a 100-fold increase in the mean serum anti sporozoite antibody titer. The presence of parasite-specific T helper cells was demonstrated using an in vitro assay. Anti-CS antibodies were detected in the culture supernatants of spleen cells of rPvCS-1-immunized mice following in vitro challenge with P. vivax sporozoite extract. Immune spleen cells depleted of T cells did not produce antibodies when challenged with sporozoite extract in vitro. In conclusion, immunization of mice with the rPvCS-1 protein induced memory T cells which recognized native CS antigen and functioned as T helper cells in the production of anti-sporozoite antibodies both in vivo and in vitro. PMID- 3319651 TI - Phencyclidine analogues inhibit NMDA-stimulated [3H]GABA release from cultured cortex neurons. AB - The inhibition of [3H]TCP binding to rat cortical membranes by substances of the PCP/sigma-opiate type was compared with effects of the same compounds on N-methyl D-aspartate (NMDA) responses in cultured mouse cortex neurons. A new technique of excitatory amino acid-induced [3H]GABA (gamma-amino-butyric acid) release in a continuous superfusion model was used for the purpose. A similar rank order of potencies was found for the substances whether as inhibitors of [3H]TCP binding (MK 801 greater than PCP greater than ketamine-cyclazocine) or as antagonists of NMDA (20 microM)-stimulated [3H]GABA release in the cultured neurons (phencyclidine = MK 801 greater than ketamine greater than cyclazocine). PMID- 3319652 TI - The effect of finger-sucking on the occlusion: a review. PMID- 3319653 TI - The importance of force magnitude on the initial response to mechanical stimulation of osteogenic and soft tissue. PMID- 3319654 TI - A clinical trial of an orthodontic toothbrush. PMID- 3319655 TI - Specific antibody against a protein (p27) present in nonestablished fibroblasts. A putative microfilament-associated protein. AB - A specific polyclonal antibody has been raised against a basic cytoplasmic protein (p27) which is induced by serum in growth-arrested NIH 3T3 cells but is constitutively expressed in nonestablished fibroblasts. Immunoblotting analysis and [35S]methionine labeling show that p27 is absent in tissues and established cell lines of different types. However, it is present in fibroblasts from human, rat, mouse, and chicken origin and is highly conserved as determined by two dimensional gel electrophoresis. Double immunofluorescence shows that p27 colocalizes with actin filaments. These observations would suggest that p27 is an actin-associated protein expressed in nonestablished fibroblasts. PMID- 3319656 TI - Evidence for intermediate filaments in squirrelfish erythrophores of Holocentrus ascensionus (Rufus). AB - We have documented the presence of intermediate filaments (IF) in cultured erythrophores of the squirrelfish Holocentrus ascensionus (Rufus). SDS-PAGE and Western blots with monoclonal antibodies T11 and R12 demonstrated that isolated IF consisted of a pair of polypeptides of 54 and 52 kDa. Immunofluorescent studies revealed that the two proteins formed prominent radially oriented IF networks in erythrophores. Immunoelectron microscopic studies showed that the IF were distributed in a "spider-web"-like network of filaments which occasionally intersected with the microtubule surfaces. The IF proteins also were found in fish iridiphores but not in fish epithelial cells which cocultured with the chromatophores. PMID- 3319657 TI - Isolation of domains of the plasma membrane of hepatocytes. AB - Several recent studies have demonstrated the ability of techniques based on immunoadsorption to selectively isolate specialized subregions of membranes, termed domains, which are derived from a larger more complex parent membrane like the plasma membrane. The immunoadsorbent is directed against a specific antigen that resides exclusively or predominantly in the membrane domain to be isolated. Thus, a monospecific antibody to the domain-specific antigen is required. In the present study we developed a method employing a modified immunoblotting strategy which could utilize polyspecific antibodies to isolate membrane vesicles derived from a specific membrane domain of the hepatocyte plasma membrane. We also used specific cell surface labeling of the hepatocyte plasma membrane by lactoperoxidase-catalyzed iodination at 4 degrees C and preparation of different sized vesicles by sonication to facilitate isolation of the specific domain. For this study, polyspecific antisera were raised in goats against a membrane fraction, denoted N2u, which is enriched in bile canalicular proteins. This antiserum recognizes, among other antigens, a 110,000 Mr polypeptide previously shown to be localized in the bile canaliculus (J. Cook et al. (1983) J. Cell. Biol. 97, 1823-1833). A monospecific antiserum was raised in rabbits against the rat hepatocyte asialoglycoprotein receptor, a sinusoidal domain-specific set of glycoproteins whose major form has a Mr of 43,000. These antisera were each coupled indirectly to different pieces of nitrocellulose by the immunoblotting protocol and were used to isolate membrane vesicles from a crude extract of liver plasma membrane prepared by sonication. The ratio of iodinated asialoglycoprotein receptor to the 110,000 Mr polypeptide in vesicles isolated by the affinity nitrocellulose immunoadsorbent method indicate a 10- to 15-fold enrichment of sinusoidal-derived vesicles relative to bile canalicular-derived membrane vesicles. These results show that the affinity nitrocellulose immunoadsorbent method can be used to isolate domain-specific vesicles. Further, the affinity immunoadsorbent method described here for the isolation of domains of the plasma membrane is an integrative one allowing isolation of vesicles present in relatively small concentration in crude cell extracts and it requires minimal ultracentrifugation time. PMID- 3319658 TI - Extracellular matrix fibers containing fibronectin and basement membrane heparan sulfate proteoglycan coalign with focal contacts and microfilament bundles in stationary fibroblasts. AB - Double-label immunofluorescence microscopy and immunoelectron microscopy were performed on stationary cultures of Nil 8 fibroblasts to determine if fibronectin and basement membrane heparan sulfate proteoglycans play coordinated roles in cell-to-substrate adhesion. Relationships between subcellular matrix fibers containing fibronectin plus proteoglycan, and focal contacts associated with microfilament bundles, were studied simultaneously using interference reflection microscopy, differential interference contrast microscopy, and immunofluorescence microscopy. Cells maintained in 0.3% FBS were doubly stained with monospecific anti-fibronectin IgG and antibodies against a basement membrane proteoglycan purified from the EHS (Engelbreth-Holm-Swarm) tumor. Coincident patterns of fibronectin and proteoglycan-containing fibers were found to codistribute with focal contacts and microfilament bundles in both early (6-h) and late (24-h) cultures. The early cells showed doubly-stained fibers colinear with substrate adhesion sites in 43% of the sample, while 100% of the later cells exhibited these coaligned matrix-cytoskeletal attachment complexes. Immunoelectron microscopy showed that both of these antigens were situated in the same type of extracellular matrix fiber that appeared to be loosely associated with the cell surface membrane. We hypothesize that the appearance of proteoglycan in subcellular matrix fibers of these fibroblasts might stabilize fibronectin containing cell-to-substrate contacts. PMID- 3319659 TI - Dispersal of sperm surface antigens in the plasma membranes of polyspermically fertilized sea urchin eggs. AB - Polyspermically fertilized Strongylocentrotus purpuratus eggs were fixed at varying times after insemination and exposed to a monoclonal antibody (mAb J18/29) directed against a group of sperm surface antigens. Indirect immunofluorescence microscopy reveals that the sperm surface components recognized by mAb J18/29 are quickly incorporated into the egg plasma membrane and begin to disperse as early as 1.5 min after insemination. At subsequent times after insemination, they undergo further dispersal so that by 45 min they are distributed evenly over the entire surface of the egg. These results provide evidence for the free lateral mobility of sperm membrane components in the fertilized egg. PMID- 3319660 TI - Acute respiratory infections and mucociliary clearance. PMID- 3319661 TI - Ceftazidime treatment of chronic Pseudomonas infection in patients with cystic fibrosis. AB - Twenty-one patients with cystic fibrosis (CF), aged 1-18 years, with chronic lower respiratory tract infection caused by Pseudomonas aeruginosa, received 38 treatment courses of ceftazidime of 10-14 days duration. A favorable clinical response was observed in 28 of the 38 treatment courses. The minimal inhibitory concentration values of ceftazidime for the Pseudomonas isolates were concentrated around 0.5-1.0 mg/l, although a wide range of sensitivities was found (less than 0.03-32 mg/l). P. aeruginosa was eliminated after five treatment courses, but recurred after 1 month in four of these patients. The organism was permanently eradicated in one patient until his death 8 months later. Ceftazidime was well tolerated. The doses used in this study (50 mg/kg body weight i.v. twice daily) should probably be increased in order to achieve better microbiological response. PMID- 3319662 TI - Surfactant abnormality after endotoxin-induced lung injury in guinea-pigs. AB - Endotoxin (30 mg/kg) or saline was given endotracheally to guinea-pigs in order to investigate surfactant function in respiratory failure. Six hours later, bronchoalveolar lavage was performed. The lavage was analyzed for protein, phospholipids and surface activity, and fractioned into the phospholipid-rich sediment and the phospholipid-poor supernatant. The latter fraction was analyzed for surfactant inhibitor activity. After endotoxin, PaO2 and static lung-thorax compliance decreased. The lavage from endotoxin-treated animals revealed a 180% increase in protein, a 52 67% decrease in surfactant phospholipids, and increased minimum surface tension, as compared to the controls. After endotoxin, the supernatant contained a 58% higher activity of surfactant inhibitor, and the sediment had slower surface adsorption than after saline. We propose that abnormal surfactant function is important in the pathogenesis of respiratory failure in high-permeability pulmonary edema. PMID- 3319663 TI - Soluble antigen fluorescent antibody (SAFA) test is not useful in childhood tuberculosis. AB - The diagnostic value of the soluble antigen fluorescent antibody (SAFA) test in childhood tuberculosis was studied in 117 children in the age group 0-12 years; 79 cases belonged to the study group, 23 children were non-tuberculous controls and 15 were tuberculin-negative healthy controls. The SAFA test was positive in 35 of 44 children with only pulmonary tuberculous lesions (80%) and in 21 of 35 children with other types of tuberculosis (60%). In the 23 non-tuberculous and 15 healthy controls it was positive in 11 cases (48%) and 7 cases (47%), respectively. The sensitivity, specificity and predictivity of the test were found to be 71%, 53% and 72%, respectively. The diagnostic value of the SAFA test was thus found to be low in childhood tuberculosis, especially in disseminated disease and tuberculous meningitis. PMID- 3319665 TI - Experimental and theoretical work on excitation and excitation-contraction coupling in the heart. AB - A combination of experimental and theoretical work has been used to investigate the movements of calcium during cardiac excitation. In addition to calcium entry through several types of calcium channel, calcium efflux occurs to balance the entry during each cycle of activity. Measurements of net membrane calcium movements have been made with the right time resolution by Don Hilgemann in Los Angeles by investigating fast extracellular calcium transients. This work shows that, in mammalian cardiac cells, net calcium exit occurs quite early during repolarization and is nearly complete by the time the resting potential is re established. These results correlate very well indeed with measurements made in the Oxford laboratory of calcium-activated inward current in single cardiac myocytes. Both approaches are consistent with the view that calcium efflux occurs largely through the sodium-calcium exchange process. Modelling of this process in equations developed recently with Dario DiFrancesco, Susan Noble and Don Hilgemann succeeds in reproducing both the ionic current changes and the fast extracellular calcium transients. PMID- 3319664 TI - Neurotensin and cholecystokinin coexistence within neurons of the ventral mesencephalon: projections to forebrain. AB - The colocalization of neurotensin- and cholecystokinin-like immunoreactivities was demonstrated in neurons of the ventral mesencephalon of the rat by using a double-labeling indirect immunofluorescence procedure for the simultaneous detection of two antigens in the same tissue section. Greater than 90% of the neurotensin-positive perikarya distributed throughout the ventral midbrain (primarily located in the ventral tegmental area, medial substantial nigra, and rostral and caudal linear raphe nuclei) were found to also contain cholecystokinin immunoreactivity. Neurons single-labeled for either peptide were also present, with those immunoreactive for cholecystokinin alone far outnumbering those containing only neurotensin. By combining the double-labeling colocalization technique with fluorescence retrograde tracing, some of the forebrain projections of these neurons were determined. Ventral mesencephalic neurons containing both neurotensin and cholecystokinin were found to project to the nucleus accumbens, prefrontal cortex, or amygdala. The present results, combined with those of previous studies, suggest that there are complex heterogeneous subpopulations of presumed dopaminergic ventral mesencephalic neurons which give rise to the ascending mesotelencephalic systems and which may contain both neurotensin and cholecystokinin, either peptide alone, or neither of these two peptides. PMID- 3319666 TI - Contributions of molecular biology to diagnosis, pathogenesis and epidemiology of infectious diseases. Introduction. PMID- 3319667 TI - Molecular biological methods in the diagnosis of viral disease. AB - Molecular biology allowed considerable improvements in diagnostic procedures by production of new and more specific sonds for the detection of traces of viruses, both on the nucleic acid and protein levels, and by determining the immune response of the host to specific antigens. Improvements in sensitivity and improved correlation to the stage of viral disease are already evident from several applications and strongly suggest a broad application of these approaches. PMID- 3319669 TI - Current status of Pseudomonas cepacia typing systems. AB - Pseudomonas cepacia is an important nosocomial pathogen for which measures of isolate relatedness are being developed. Typing systems based on 4 different strain characteristics have been proposed: serologic reactions, biochemical reactions, plasmid profiles, and bacteriocin production and susceptibility. Serology and bacteriocins distinguish many types, but the sensitivity and specificity of these techniques have not been determined. Improved methods for typing P. cepacia are needed to determine the reservoirs and modes of transmission of this emerging nosocomial pathogen. PMID- 3319668 TI - The epidemiology of Pseudomonas cepacia in patients with cystic fibrosis. AB - Pseudomonas cepacia has emerged as an important nosocomial pathogen colonizing and infecting the respiratory tract of patients with cystic fibrosis (CF). Although assessment of outcomes associated with P. cepacia colonization has been difficult, controlled studies have shown that colonized patients experience more adverse outcomes compared with those not colonized. In the United States, an increasing trend in national incidence and prevalence of P. cepacia colonization has been shown, but cases have been unevenly distributed in a few centers. These estimates, however, may be biased by intercenter differences in laboratory methods for detecting P. cepacia in patient sputum. The source and mode of transmission of P. cepacia have not been adequately demonstrated, and may vary from center to center. Until further studies elucidate the epidemiology of P. cepacia in patients with CF, it may be prudent for CF centers to consider the use of selective media to isolate P. cepacia from sputa of patients with CF, to conduct investigations of clusters of P. cepacia-colonized patients, and to consider adopting infection control precautions recommended for control of multiply resistant gram negative organisms. PMID- 3319670 TI - Rapid methods for the molecular diagnosis of infectious diseases: current trends and applications. AB - Methods for the rapid diagnosis of infectious diseases have become increasingly common in the last decade. The impetus for the development of such techniques has stemmed from the need to provide clinically relevant information without the length of time and complexity inherent to traditional cultivation methods. This is particularly important in high-risk populations for which more effective antibiotics and antiviral compounds are now available. Assay systems for the immunological detection of microbial agents occupy a central role in the molecular diagnosis of infectious diseases and are rapidly appearing on the market. Novel methods of organism detection by nucleic acid hybridization, long considered usable only in highly specialized laboratories, have the potential for use in routine microbiological laboratories and some systems are now commercially available. As more efficient and rapid diagnostics systems are being developed, the selection of the optimal method will depend on the environment in which the system is to be used. Rapid methods for the detection of infectious agents might markedly improve health care in a variety of clinical, laboratory and epidemiologic situations. PMID- 3319671 TI - The epidemiological importance of intraindividual changes in objective pulmonary responses. AB - Debate continues about what constitutes significant and meaningful change in health status of individuals and populations. More importantly, the basic biological and medical criteria that are used for clinical and environmental judgments require further discussion and clarification. What proportion of loss of cardio-pulmonary function, overt disability, or mortality is sufficient to determine an "adverse health effect"? Health-oriented individuals, including researchers and clinicians, may choose to adhere to different criteria than other professional groups (e.g., legal, social). It is proposed in this paper that criteria for defining adverse health effects should represent clinically meaningful, as distinct from only statistically significant, responses. These include pulmonary function test results that indicate obstructive or restrictive diseases, and electrocardiogram results indicating coronary artery disease. Intraindividual changes that predict a meaningful medical change would be included; these changes should meet specific requirements in terms of what constitute normal vs. abnormal ranges of variation. Further, the proportion of the population defined to be impaired should be considered. These issues are the focus of this paper. PMID- 3319672 TI - A study of risk factors of vaginal colonization with group B streptococci in pregnancy. AB - Two hundred pregnant women were screened for vaginal Group B Streptococci carriage just before delivery. Fifty non-pregnant women were also examined. Vaginal colonization rate of pregnant women and of non-pregnant women was identical (12% in both groups). None of the personal and social characteristics investigated (age, profession, residence, marital status and education) were associated with higher or lower colonization rates. However the influence of the number of previous pregnancies proved to be significant, as pregnant women with 2 or more previous pregnancies tended to be more frequently colonized than primigravidae or secundigravidae women. These findings are discussed in relation to the possible reservoir of the microorganisms and the route of infection. PMID- 3319673 TI - Prevalence of anti-Legionella pneumophila antibodies in various groups with different risk factors in Seville (Spain). AB - A study was undertaken to establish the background prevalence of antibodies to L. pneumophila in 324 persons from the area of Seville, Spain. The serum specimens were obtained from healthy volunteers divided into groups with different risk factors. The results were as follows: a prevalence of 1.96% in 51 persons working in a cooling-tower air conditioned building (group A), a prevalence of 25% in 36 persons working in a dry-heat air conditioned building (group B), a prevalence of 16% in 87 underground construction workers (group C) and a prevalence of 1.2% in 150 healthy blood donors with none of the above risk factors (group D). There is statistical significance between D and B and C. PMID- 3319674 TI - Recovery of Yersinia enterocolitica from patients with gastrointestinal disturbances. Lack of efficacy of alkali method. AB - Direct plating medium on cefsulodin-irgasan-novobiocin agar was as effective as 2 day enrichment in peptone-sorbitol-bile salts broth for recovery of Yersinia enterocolitica from fecal samples of patients with gastrointestinal disturbances. Alkali treatment of fecal specimens failed to enhance recovery of Y. enterocolitica through either method. PMID- 3319675 TI - B-cell chronic lymphocytic leukaemia with aberrant expression of CD8 antigen. AB - The monoclonal antibodies against CD8 (T suppressor/cytotoxic) antigen (Leu2/OKT8) were found to bind to leukaemic lymphocytes from a patient with chronic lymphocytic leukaemia. The cells also had an unusual type of rod-like cytoplasmic immunoglobulin of IgM/lambda type as seen by light, fluorescence and electron microscopy, and displayed several antigens characteristic for B lymphocytes. Gene rearrangement analysis showed rearrangement of mu heavy chain gene. In spite of an expression of CD8 antigen, T-cell receptor genes were not rearranged. PMID- 3319676 TI - Danazol in the treatment of myelodysplastic syndromes. AB - 20 patients with myelodysplastic syndromes (MDS) were treated with danazol, 800 mg daily in 4 divided doses. 18 patients were evaluable for response. 3 patients (17%), whose principal problem was anemia, responded to treatment, but only with an increase in platelet count. Responses were short-lived and lacked clinical significance. No patients with anemia or leukopenia responded to treatment and none of the 7 patients with a platelet count less than 30 x 10(9)/l responded. Danazol appears to have limited clinical utility in the treatment of MDS. However, occasional patients with thrombocytopenia may benefit. PMID- 3319677 TI - Primary splenic hairy cell leukaemia: a case report and review of the literature. AB - Hairy cell leukaemia affecting primarily the spleen is a very rare feature of this disease at presentation. Splenectomy in such cases would seem to provide a cure. We report a case of primary splenic hairy cell leukaemia in which clinical and haematological remission were achieved after splenectomy, and we review the literature. PMID- 3319679 TI - Blast crisis supervening on chronic lymphocytic leukaemia. A monoclonal progression of the disease as defined by cell surface markers. AB - Acute leukaemia is a rare event during the course of chronic lymphocytic leukaemia (CLL), and only a small fraction of such cases have been shown to be true acute lymphoblastic crises. 1 case is described where both small lymphocytes and proliferating lymphoblasts have the same monoclonal pattern as defined by direct immunofluorescence of membrane-bound immunoglobulins. Previous cases are reviewed and do not appear to be mere coincidence: acute blast crisis may represent a part of the natural history of CLL. PMID- 3319678 TI - Immunological reclassification of 22 children with a former diagnosis of non-T, non-B ALL. AB - Stored peripheral blood or bone marrow mononuclear cells from 22 pediatric patients with verified acute lymphoblastic leukemia (ALL) previously classified as non-T, non-B ALL were re-investigated by flow cytometric analysis by means of a panel of B cell-specific and -associated monoclonal antibodies (moabs) using a new analytical method described by Platz et al, the so-called Delta Channel Value method. All 22 patients were immunologically re-characterized as pre-B ALL. The reproducibility between the first (acute) and subsequent re-analysis was almost complete. 20 of the tumor cell populations could be assigned to the B cell differentiation scheme recently proposed by Nadler et al. This scheme operates with four stages of pre-B cell differentiation and each stage is defined by the expression of one to four of the following markers: HLA-DR, CD19, CD10 and CD20. Two additional markers, CD24 and CD22, were investigated in our study and allowed further subdivision of the four subgroups proposed by Nadler et al. The composition of a panel of moabs for routine classification of pre-B ALL is proposed. PMID- 3319680 TI - Monosomy 7 predisposes to diabetes insipidus in leukaemia and myelodysplastic syndrome. AB - We studied the chromosomes in the bone marrow of 4 patients who had both diabetes insipidus (DI) and acute non-lymphocytic leukaemia. Clinical findings suggested that, in each case, myelodysplastic syndrome had preceded the onset of acute leukaemia. Two other such patients described in the literature had had a banded karyotype study of bone marrow cells. All 6 patients had deletions of chromosome 7. 3 had monosomy 7 as the sole cytogenetic abnormality, 2 had monosomy 7 associated with other clonal abnormalities and 1 had del(7)(q22) in association with other abnormalities. These data suggest that monosomy 7 or perhaps monosomy for 7q22-qter predisposes to DI. The mechanism by which the proposed predisposition is produced remains to be clarified. PMID- 3319681 TI - Paying for maternity care in the United States. PMID- 3319683 TI - Hypothesizing, circularity, and neutrality revisited: an invitation to curiosity. AB - This essay examines the systemic guiding principles of neutrality, hypothesizing, and circularity, historically developed by the Milan Team of Selvini-Palazzoli, Boscolo, Cecchin, and Prata (12, 13). With the reorganization of these team members (see 11 for a summary of the distinctions between the work of the Selvini Palazzoli and Prata research team and the Cecchin and Boscolo training team), different reconstructions of the original systemic principles have evolved. New understanding of the concepts of circularity, hypothesizing, and neutrality are now possible, given the systemic epistemology on which the early Milan model was based. It should be emphasized, however, that the ideas presented in this essay are most associated with the systemic work of the Cecchin and Boscolo team. PMID- 3319682 TI - A review of maternity care programs in Western Europe. PMID- 3319684 TI - Some principles of an ecological model of the person as a consequence of the therapeutic experience with systems. AB - How do systems therapists' ideas of an individual differ from those of individually oriented therapists? Systems therapists are less interested in stable personality structures than in the contextual variability of a person's behavior. They think that although partnership may restrict, it also triggers the personality's development and shapes and models self-realization. The coevolution of partners can neutralize neurotic dispositions and can have a healing effect. On the other hand, it is the individual who largely decides in what systems he or she will participate, and to what extent and in which manner. In modern, Western society, personal regulations through social systems are becoming increasingly weaker, and the possibility for individuals to realize themselves in interactions is more and more restricted. According to an ecological model of the person, self realization has to rely on relations to other persons in order to make it more real. PMID- 3319685 TI - Family reconciliation as a response to adolescent crises. AB - Concern for adolescents who act in dangerous, life-threatening ways has heightened dramatically in recent years. Many of these adolescents appear to come from nuclear families isolated from their kinship systems. Without the mediating effects of kin, the adolescent transition can become a major crisis. Kinship systems remain cohesive when members can reconcile their beliefs about essential aspects of family functioning with the demands for adaptation during major life transitions. Reconciliation is lost when members believe that kin can no longer be trusted to insure their well-being. Kinship fragmentation ensues as family members leave the field or are excluded. Isolated nuclear families then rapidly lose the resilience to respond to life transitions without resorting to extreme, maladaptive solutions. The Systemic Crisis Intervention Program (SCIP) uses the opportunity of the crisis precipitated by the adolescent's life-threatening behavior to alter family myths that have led to network fragmentation. Crisis teams mobilize and meet with kin in four-hour gatherings to foster reconciliation and kinship system reintegration. PMID- 3319686 TI - [Interaction of drugs with alpha 1-acid glycoprotein (orosomucoid)]. PMID- 3319687 TI - [Development of pharmacology at Moscow University at the beginning of the 20th century]. PMID- 3319688 TI - [Effect of nonsteroidal anti-inflammatory agents on the cardiovascular system]. PMID- 3319690 TI - [Drugs as photosensitizers]. PMID- 3319689 TI - [Proteolytic enzymes and their inhibitors as modulators of immunological reactions]. PMID- 3319691 TI - Thyroid hormone uptake into the cell and its subsequent localisation to the mitochondria. AB - The nature of thyroid hormone uptake into the cell and the possible involvement of the serum carrier proteins and receptor-mediated endocytosis in this process are reviewed. The evidence that there is a specific thyroid hormone-binding receptor in the inner mitochondrial membrane and the relation of this to the adenine nucleotide translocator is discussed. Direct effects of thyroid hormone on mitochondrial function that might be mediated by such a receptor are also considered. PMID- 3319692 TI - Purification and subunit structure of hepatocyte growth factor from rat platelets. AB - A hepatocyte growth factor (HGF) that stimulates DNA synthesis of adult rat hepatocytes in primary culture was purified as a homogeneous material from platelets of 1000 rats by a four-step procedure: stimulation of its release from platelets by thrombin, cation-exchanger fast protein liquid chromatography (FPLC) on a Mono S column, heparin-Sepharose CL-6B chromatography, and reverse-phase HPLC on a C4 column. The purified HGF stimulated DNA synthesis of adult rat hepatocytes in primary culture at 1 ng/ml and was maximally effective at 5 ng/ml, being about twice as potent as EGF at this concentration. HGF did not stimulate DNA synthesis of Swiss 3T3 cells. It was found to be a heat- and acid-labile protein that was inactivated by reduction with dithiothreitol. The purified HGF had a molecular mass of 82 kDa, as estimated by SDS-PAGE, and was found to be a heterodimer which dissociated into a large subunit of 69 kDa and a small one of 34 kDa by SDS-PAGE under reducing conditions. These biological and chemical properties showed that HGF was not identical with any known growth factors, including platelet-derived growth factor (PDGF). PMID- 3319693 TI - Ca2+-mobilizing hormones elicit phosphatidylethanol accumulation via phospholipase D activation. AB - Vasopressin, angiotensin II and epinephrine elicited the accumulation of phosphatidylethanol in rat hepatocytes exposed to ethanol and of phosphatidate in the absence of ethanol. When isolated liver plasma membranes were exposed to ethanol, GTP gamma S stimulated the production of phosphatidylethanol whereas phosphatidate was formed in the absence of ethanol. With increasing ethanol concentrations, phosphatidate formation declined whereas phosphatidylethanol production increased. These findings suggest that rat hepatocytes possess a hormone-dependent phospholipase D activity that can also catalyze the formation of phosphatidylethanol. PMID- 3319694 TI - A ribosome-associated inhibitor of in vitro nonsense suppression in [psi-] strains of yeast. AB - All classes of tRNA-mediated nonsense suppression are much more efficient in yeast cell-free lysates prepared from a [psi+] strain than in those prepared from an isogenic [psi-] strain. Mixed [psi+]/[psi-] lysates do not support efficient suppression. Fractionation of the [psi-] lysate demonstrated the presence of an inhibitor of in vitro suppression that is loosely associated with the 80 S ribosome. The data indicate that the inhibitor is a factor involved in the termination of translation in this simple eukaryote. PMID- 3319695 TI - [Ultrasonic diagnosis in obstetrics and gynecology]. PMID- 3319696 TI - [N. N. Burdenko--the founder of Soviet military field surgery]. PMID- 3319697 TI - [Ultrasonic study of the abdominal cavity organs]. PMID- 3319698 TI - [Emergency states in diabetic patients (their diagnosis and treatment)]. PMID- 3319699 TI - [The half-century anniversary of a medical school]. PMID- 3319700 TI - [Development of pathological physiology in the Ukraine during the years of Soviet power]. PMID- 3319701 TI - [Role of Ukrainian scientists in the development of modern gerontology]. PMID- 3319702 TI - [70 years of a scientific search]. PMID- 3319703 TI - [Physiological science in the Ukrainian SSR during the 70 years of Soviet power]. PMID- 3319704 TI - The cross-reaction patterns of the MRC OX-3, OX-6, and OX-17 monoclonal antibodies on rat inbred and congenic strains. AB - MRC OX-3, MRC OX-6, and MRC OX-17 antibodies directed against rat MHC class II antigens were tested on a panel of rat inbred and congenic strains with different haplotypes using indirect immunoperoxidase and immunofluorescence techniques. In accordance with reports of others the MRC OX-17 was found to define RT1 class II monomorphic and the MRC OX-3 polymorphic determinants. MRC OX-6, giving no reaction with RT1d and RT1dv1 haplotypes, was shown to be directed against a rat MHC class II polymorphic determinant. PMID- 3319705 TI - Health, agriculture and rural development: overview of concepts. PMID- 3319706 TI - The determinants of nutritional status. PMID- 3319707 TI - Institutional considerations in enhancing interaction among the health, nutrition, agriculture and rural development sectors. PMID- 3319708 TI - An approach to the study of food in culture. PMID- 3319709 TI - Assessing the physiologic and clinical characteristics of acute versus chronic pain. Introduction. PMID- 3319710 TI - Quantitating antinociception with experimentally induced pain. Terminology, guidelines, and in vivo models. AB - This article is an introduction to experimental evaluation of putative analgesic agents and experimental paradigms. It reviews the major ethical and legal considerations that must be considered prior to undertaking experimental protocols involving humans or experimental animals. Also considered are those fundamental concepts of the pain response that are important in evaluating analgesic drugs. Finally, a number of representative in vivo models are discussed that have proved useful in this field. PMID- 3319711 TI - Psychological components of pain. AB - Patients with complex orofacial pain conditions often do not respond as expected to dental care. This article discusses the many psychoanalytic factors that are involved in the pain experience of these patients. PMID- 3319712 TI - Neurophysiology of orofacial pain. AB - This article highlights recent advances in our knowledge of the peripheral and central neural mechanisms underlying orofacial pain. It reviews recent research that has identified the critical neural elements and processes associated with the transmission of sensory information related to pain in the mouth and face, as well as recent studies that have improved our understanding of the pathways and mechanisms involved in the modulation of pain. PMID- 3319713 TI - Sensory and motor integration during mandibular function. AB - The subject of pain is intimately related to that of mandibular function. It is now clear that certain types of temporomandibular disorders, particularly myofascial pain dysfunction, result, in part, from rhythmic muscle activity produced by parafunctional oral habits such as diurnal or nocturnal bruxism. Furthermore, in addition to phasic hyperactivity, evidence also suggests that masticatory muscles of patients with MPD are tonically hyperactive. The pain associated with such hyperactive musculature prompts many patients to seek professional help. This article provides an updated historical review of one important aspect of mandibular function and gives insight into the general "state of the art." PMID- 3319715 TI - Diagnosis and treatment of painful temporomandibular disorders. AB - This presentation has reviewed and discussed the various temporomandibular musculoskeletal disorders with which patients present. Also, a step-by-step sequence of treatment has been presented. Following this escalating sequence of conservative yet appropriate therapy will provide a logical plan of treatment for painful temporomandibular disorders and the majority of patients should be treated successfully (Fig. 30). PMID- 3319714 TI - Differential diagnosis of orofacial pain. AB - The successful diagnosis of orofacial pain depends on the following: 1. An accurate and detailed history of the pain 2. A detailed clinical examination of the face and associated organs 3. A thorough knowledge of those conditions that may produce facial pain In regard to the last requirement, Sir William Osler's maxim should always be remembered "What you don't know--you won't diagnose." PMID- 3319716 TI - Pharmacologic rationale for the treatment of acute pain. AB - This article reviews peripheral mechanisms involved in the production of dentinal pain and acute inflammatory pain. The endogenous analgesic system, located in the central nervous system, is also reviewed. The pharmacology of peripheral analgesics (such as aspirin-like drugs), local anesthetics and central analgesics (such as opiates) are discussed. Based on this information, a rational therapeutic strategy, directed toward minimizing the perception of pain and the experience of side effects, is presented. PMID- 3319717 TI - An overview of the multimodal approach to TMJ disorders. AB - This article presents the reader with an overview of the current therapeutic approaches employed in the treatment of TMJ disorders. Included are synopses of the various medications, appliances, and adjunct therapies utilized, as well as brief descriptions of their effects. PMID- 3319718 TI - Transcutaneous electrical nerve stimulation and myoneural injection therapy for management of chronic myofascial pain. AB - The purpose of this article has been to discuss in detail both the rationale and techniques for TENS and myoneural injection therapy as modalities for the management of chronic myofascial pain. In a more subtle sense, we have also interjected some of our philosophy regarding the treatment of chronic myofascial pain. As was discussed earlier in the text of this article, very seldom, if ever, will any single technique stand alone as a "cure" for the patient with chronic pain, but, instead, each modality must be considered as an adjunctive form of multidisciplinary care. The multidisciplinary approach to pain management includes, as a minimum, pharmacotherapy, physical therapy, and behavioral medicine therapy. The concept of the team approach and goals of management, rather than cure, for chronic myofascial pain, cannot be overstated and is often as difficult to impart to the clinician as it is to the patient. To employ any individual form of therapy, the clinician must understand the indications and limitations of each modality in a total treatment program. Over the last several years TENS therapy has become extremely popular to a large extent because it is a noninvasive technique that most patients can be taught to use safely and effectively. An additional advantage to TENS therapy is that it provides many patients with some means of control over their pain, independent of medications and hands-on therapy by health care providers. Myoneural block therapy is often utilized to add a measure of control over the severe pain and dysfunction that may be present during the early phases of active treatment of chronic myofascial pain. It is used to enhance the effects of a conservative multidisciplinary pain management program when utilized on a short-term basis. Myoneural block therapy is often a useful adjunct to physical therapy to improve the patient's overall range of motion and facilitate either treatment by the physical therapist or a home exercise program. The clinician is reminded that myoneural injection therapy can be overutilized. It should be limited as to the number of injections per visit. Also, the total number of visits the patient receives injections should be kept low. After the initial myoneural injection treatment series of three to five sessions, it should be utilized only for severe pain exacerbation that has been unresponsive to conservative, noninvasive management. PMID- 3319719 TI - In memoriam Professor Robert Degos (1904-1987). PMID- 3319720 TI - Glucose tolerance studies in lichen planus. AB - A study of glucose tolerance and insulin response to oral glucose was carried out in 56 consecutive histologically confirmed cases of lichen planus. 30.3% patients showed abnormal glucose tolerance. The pattern of insulin response was similar to that seen in type II diabetes. Insulin/glucose ratio showed the same relationship as seen in type II diabetes. These results reinforce the possibility of glucose intolerance in lichen planus patients. However, no correlation between glucose tolerance abnormalities and duration and distribution of lesions was observed. PMID- 3319721 TI - Additional effect of grenz rays on psoriasis lesions of the scalp treated with topical corticosteroids. AB - In a double-blind study comprising 17 patients with symmetrical psoriasis lesions of the scalp, the combination of grenz ray treatment and topical steroid showed a faster clearing than with the topical steroid alone. The results also indicate a longer remission time with the combination therapy compared to grenz rays alone. Therefore both the faster clearing and the longer remission time with the combination therapy, as compared to our previous study of grenz ray treatment of scalp psoriasis, are probably due to the additional effect of steroid therapy, on grenz rays. PMID- 3319722 TI - One daily application of oxiconazole cream is sufficient for treating dermatomycoses. AB - A single daily application of oxiconazole cream was shown, in a double-blind, randomized, multicentric study, to be effective in treating various dermatomycoses as well as erythrasma. Tolerance was excellent and side effects were negligible. PMID- 3319723 TI - Short-term and long-term considerations in the management of psoriasis with retinoids. AB - Etretinate is a valuable addition to the treatment of psoriasis. Because of its numerous side effects, it should be reserved for only pustular, erythrodermic, and severe cases of plaque-type psoriasis. Many patients whose psoriasis has been recalcitrant to conventional therapy may greatly benefit from this drug. PMID- 3319724 TI - Mucocutaneous and systemic toxicity of retinoids: monitoring and management. AB - Oral retinoid therapy is associated with significant mucocutaneous and systemic toxicity similar to that found in hypervitaminosis A. Beside the well-known mucocutaneous adverse effects like cheilitis, xerosis, desquamation, dryness of mucous membranes, more troublesome findings are ocular effects, hair loss or hypergranulation tissue. The most unwanted systemic side effects under both retinoids (isotretinoin and etretinate) are teratogenicity, bone toxicity and serum lipid increments. Careful patient counselling and monitoring will enable the physician to modulate these effects and reduce their impact on patient compliance. PMID- 3319725 TI - New indications and new retinoids. AB - In addition to well-accepted indications, etretinate has a beneficial effect in a variety of other dermatoses such as the hyperkeratotic eczema of the palms and soles, prurigo nodularis, and other nonpsoriatic, sterile, pustular eruptions. Due to its influence on dermal inflammatory processes and immunomodulation of the tissue response, etretinate is effective in cutaneous lupus erythematosus, certain bullous disorders like pemphigus herpetiformis, the persistent variant of Grover's disease, dermatitis herpetiformis, and bullous pemphigoid. Isotretinoin is reported to be effective in cutaneous sarcoidosis, disseminated granuloma annulare, systemic sclerosis and tumors of the cutaneous appendages. New synthetic retinoids have been developed. Etretin, the main metabolite of etretinate, was shown to be effective and to have a short elimination half-life of approximately equal to 50 h. Arotinoid ethyl ester and arotinoid-free carboxylic acid are effective in minimal doses 500-fold lower than etretinate. Arotinoid ethyl ester was shown not to increase serum lipids. Arotinoid ethyl sulfone is the first retinoid without bone toxicity in animal experiments. Motretinide is the ethylamide of tretinoin and is reported to be effective in the local treatment of acne. Some of the new polyaromatic retinoids appear to have sebosuppressive, antikeratinizing and/or anti--inflammatory effects via topical application. PMID- 3319727 TI - Retinoid effects on the epidermis. AB - Since metaplasia and gap junction stimulation are prominent features of retinoid activity in embryonic and neoplastic epidermis, it is ironic that the mechanism(s) of retinoid action in postnatal tissues, where these drugs are employed clinically, appears to be different. Histologic studies in both animals and man with both topical and systemic retinoids demonstrate acanthosis, hypergranulosis, and changes in the thickness and organization of the stratum corneum, due to a boost in cell turnover. On an ultrastructural level, desmosomes are actively shed at the level of the spinous layer, leading to many new attachment points along the cell membranes of the outer epidermis. This change coupled with decreased tonofilaments, enhanced keratinocyte autolysis, and intercellular deposition of glycoconjugates (not mucin by standard histochemistry and lectin binding) lead to loosening and fragility of the stratum corneum. The biochemical basis of retinoid activity (in addition to increased cell turnover) appears to be global enhancement of glycoconjugate synthesis and the generation of less mature keratins. These epidermal effects of retinoids can be exploited therapeutically: (1) to cause loosening of thickened stratum corneum, e.g., in psoriasis or ichthyosis; (2) to enhance penetration of pharmacologic agents, e.g., 5-FU, across hypertrophic actinic keratoses; and finally (3) in neoplastic epidermis, where mucous metaplasia and gap junction proliferation occur, retinoids can normalize differentiation. PMID- 3319726 TI - Clinical pharmacology of 3 generations of retinoids. AB - The bioavailability, plasma transport and tissue distribution of various retinoids are largely determined by their physicochemical properties; some are extremely lipidsoluble whereas others are relatively hydrophilic. Isotretinoin, a 1st generation retinoid, lacks the problematic affinity for fat. Etretinate, a 2nd generation aromatic retinoid, has been shown to accumulate in both fat tissues and in the adrenals. Etretin, the main free-acid metabolite of etretinate, is less lipophilic and is presently being tested as an alternative drug. Arotinoid ethyl ester, a 3rd generation aromatic retinoid which has as yet only undergone limited trials, is extremely potent making pharmacological evaluation difficult. The search for more potent retinoids has not so far resulted in a complete resolution of the efficacy and toxicity of the drugs. PMID- 3319728 TI - Multistep process of squamous differentiation of tracheobronchial epithelial cells: role of retinoids. AB - The objective of our research is to elucidate the molecular mechanisms that regulate the proliferation and differentiation of tracheobronchial epithelial cells. A clear insight into the basic mechanisms of these processes is required in order to understand the mechanisms involved in tumor development and other pathological conditions. To study the regulation of differentiation of the tracheobronchial epithelium, an in vitro cell culture model was developed using rabbit tracheal epithelial cells. Our studies were directed towards answering the following questions: (1) What is the differentiation capacity of these cells? (2) Does differentiation occur as a multistep process? (3) What factors control differentiation and by what mechanism? (4) What are the biochemical markers for the various differentiated phenotypes and at what level are they controlled? (5) Is there a link between control of cell growth and control of cell differentiation? PMID- 3319729 TI - Hair follicle biology and topical minoxidil: possible mechanisms of action. AB - The mechanism by which minoxidil, whether given orally or applied topically, stimulates hair growth remains undetermined. Possible indirect drug action, such as vasodilatation and increased blood flow to the dermal papilla, or possible local irritation related to minoxidil or to one or more components of the vehicle used for topical application has been suggested. Possible sites of direct drug action include either the dermal papilla of the follicle or hair matrix cells or possibly both. Morphometric studies of control scalp biopsies taken from young male patients with androgenetic alopecia reveal that the primary morphologic event in androgenetic alopecia is miniaturization of terminal hair follicles. Shortening and diminution of follicle size is undoubtedly accompanied by shortening of the hair growth cycle (decreased anagen time). Morphometric evaluation of scalp biopsies of patients receiving topical minoxidil in a vehicle composed of propylene glycol, water and ethanol has revealed growth of larger normally formed follicles when compared with pretreatment biopsies from the same individual. There has been no suggestion in any morphologic studies of minoxidil treated patients for development of new follicles (follicular neogenesis). Because the dermal papilla of the hair follicle apparently controls both growth and differentiation of hair matrix cells and because there are no observable dysplastic or atypical changes in follicular germinal epithelium during or after application of topical minoxidil, it is concluded that the most probable site for the action of minoxidil is on the specialized mesenchymal cells of the follicular dermal papilla. PMID- 3319730 TI - Aetiology and pathophysiology of hair loss. AB - The prevalence of androgenetic alopecia has not been accurately recorded but it is probably true that, at least in caucasoid races, some degree of transformation of terminal to vellus hair follicles on the vertex from puberty onwards is a universal phenomenon in both sexes, although androgenetic alopecia in women more often assumes a diffuse form. Our knowledge of the pathogenesis of ordinary baldness is far from complete but a genetic predisposition is necessary and androgen production must be present. In general it can be concluded that whatever the level of circulating androgens, free or total, the major genetic factor must reside in the end-organ response- in this case follicular receptivity and reactivity to the androgens delivered to the papilla/matrix unit. The pathophysiology of common baldness is strictly a misnomer as used in clinical practice since only rarely does it signify endocrine disease or other than normal physiological loss. In many patients the problem posed is essentially psychological and this aspect may be so predominant as to cause psychiatric disease. PMID- 3319731 TI - 2% topical minoxidil solution in male-pattern baldness: preliminary European results. AB - A 48-week, double-blind, randomized study was conducted in France, West Germany and the UK to compare the safety and efficacy of topical minoxidil 2% (Regaine; registered trade mark of the Upjohn Company) solution with placebo in the treatment of early male-pattern baldness. At week 24, the end of the placebo period, there were 225 evaluable patients, 116 in the treatment group and 109 in the placebo group. The 2% minoxidil group showed superiority to the placebo group with respect to the following parameters at week 24: (1) non-vellus hair counts (p = 0.0084); (2) changes in non-vellus hair counts compared with baseline values (p = 0.0227), and (3) investigators' evaluations of hair growth (p = 0.019). There was no significant difference between minoxidil and placebo treatment with regard to blood pressure, pulse or weight changes. No serious side effects were reported during the study. The greatest number of medical events were dermatological in nature and mainly local and mild in intensity. From week 24 to week 48 all patients received active medication and showed further hair growth. At week 48 the investigators evaluated the new hair growth as moderate or dense in 32.7% of the patients. Our conclusion confirms previous reported studies according to which topical minoxidil seems to offer a safe and efficacious treatment for early male-pattern baldness in some patients. Further studies need to be done to characterize the most likely responders. PMID- 3319732 TI - Weight percentile at birth. II. Prediction by endocrinological and sonographic measurements. AB - In a prospective study of 847 singleton pregnancies, the importance of various endocrine methods (serum estriol, HPL, SP1, beta-HCG, estradiol-17 beta, urinary estrogen excretion) and of two sonographic measurements (biparietal and thoracic diameter) for the diagnosis of growth retardation in the third trimester was studied. HPL and estriol determinations were best suited for the diagnosis of growth retardation. The thoracic diameter correlated most closely with the birthweight of the newborns. Sensitivity in relationship to growth retardation was between 17 and 35% for the HPL and estriol determinations as well as for both sonographic methods. Specificity was around 90% for these methods. The validity for all methods improved as the time of birth approached. Through the simultaneous measurement of one of the hormones and the thoracic diameter, an antepartal diagnosis of up to 50% of the hypo- and hypertrophic growth disorders was achieved. In the first two years of life a relationship between development and the HPL and estriol concentrations could be observed which was independent of the weight percentile at birth. PMID- 3319733 TI - Antenatal ultrasonographic diagnosis of trisomy 18 (Edwards syndrome). AB - A 35-yr-old G7P6A0 presented at 28 weeks of gestation with an acute polyhydramnios. On ultrasonographic examination the diagnosis of trisomy 18 in the fetus was suspected. This was confirmed by chromosome analysis of the cultured amniocytes. The value of a systematic ultrasonographic examination, especially in every abnormal pregnancy, is briefly discussed. PMID- 3319734 TI - The pentose pathway: a random harvest. Impediments which oppose acceptance of the classical (F-type) pentose cycle for liver, some neoplasms and photosynthetic tissue. The case for the L-type pentose pathway. PMID- 3319735 TI - Localization and structure of novel calcium-regulated phospholipid-binding proteins. PMID- 3319736 TI - The mechanism and regulation of the ATP-dependent protease La from Escherichia coli. PMID- 3319737 TI - Protein degradation in yeast. PMID- 3319738 TI - Lysosomal degradation of microinjected proteins. PMID- 3319739 TI - Purification and cloning of a corpuscles of Stannius protein from Anguilla australis. AB - The kidneys of teleost fish are associated with tissues containing secretory granules--the corpuscles of Stannius (CS). Electron microscopy indicates that the granules are of a proteinaceous nature and may represent hormones or enzymes of unrecognized physiological and biochemical function. In the present study, two dimensional gel electrophoresis and electroelution was used to purify the major protein to homogeneity; it is approximately 32,000 Da in the reduced form and glycosylated. From the partial NH2-terminal sequence, a 75-mer oligonucleotide probe was synthesized and used to isolate a cDNA clone from which the complete amino acid sequence of the major CS protein was deduced. Polyclonal antibodies raised against CS homogenates were specific for the CS proteins (confirmed by immunohistochemistry). Hybridization histochemistry was used to confirm the location of the mRNA encoding the isolated protein. Incubation of CS homogenate with eel plasma or ovine renin substrate did not result in any angiotensin-like peptides whereas kidney homogenate did. PMID- 3319740 TI - Potential oncogenic hazards posed by oncogene encoded proteins. AB - The theoretical risk from oncogene encoded proteins is limited to growth factors, which may be secreted by cells in which biologically derived products might be manufactured. Because these peptides do not replicate, their effect is finite. In addition, their effects are reversible. Growth factors do not ordinarily appear to be oncogenic. Even under circumstances in which they contribute to oncogenicity, repeated administration of high concentrations of growth factors (several micrograms per kilogram) would appear to be required for them to serve as co-factors in the carcinogenic process, and the resulting tumors appear to remain dependent upon the continued presence of the growth factor for continued tumor growth. PMID- 3319741 TI - The development of a developmentalist: Daniel S. Lehrman. PMID- 3319742 TI - Drooling and its management in cerebral palsy. PMID- 3319744 TI - Writing effective program proposals. PMID- 3319743 TI - The cerebro-hepato-renal (Zellweger) syndrome and other peroxisomal disorders. PMID- 3319745 TI - Methyl isocyanate: a review of health effects research since Bhopal. PMID- 3319746 TI - Measuring continuity of care. PMID- 3319747 TI - Consultation analysis by triggers and symptoms (CATS). A new objective technique for studying consultations. AB - Doctor-patient consultation is a field of study important to general practice. The emphasis has tended to be on modes of exchange and subjective judgement of task achievement. More recently, a need to establish relationships between the information transferred and its mode of transfer has become clear. This paper describes such an approach with a specially devised scale (the consultation and analysis by triggers and symptoms (CATS) scale). The inter-rater reliability of the scale was established using a standard videotape. The CATS scale seems relatively easy to learn and to have relatively high inter-rater reliability. PMID- 3319748 TI - Attitudes of physicians and nurses towards the role of social workers in primary health care: what promotes collaboration? AB - Many writers have indicated that the future of social work in primary health care is dependent on the attitudes of physicians and nurses. This article reviews the literature in the field and describes the results of a study of 95 physicians and 78 nurses in Israel which found that physicians have a more positive attitude towards social work intervention than nurses and explores the differences in these attitudes in relation to particular personal characteristics. Physicians who were young, had recently received their MD degree and had been educated in Israel had by far the most positive attitudes towards social workers. Those aged over 60 years old, who had received their MD degree in Western countries more than 25 years ago were more positively inclined towards social work in the clinics than middle-aged physicians educated in Eastern European countries. The personal characteristics of the nurses made little difference to their generally poor attitude towards social work in the clinics. Those who received their nursing education more recently were more positive than other nurses. PMID- 3319749 TI - Health promotion and the human response to loss: clinical implications of a decade of primary health care research. AB - Ten years ago an academic group was established in Cardiff to determine why the public make life-style choices which are known to have an adverse impact on health and also to develop methods of measurement which describe trends in positive health motivation (salience) in the community. Three stages of this research are described in this paper and the results reveal a complex and fascinating set of human beliefs, attitudes and behaviours. Concern for health was not a consistent human characteristic and there was little evidence for the existence of a general preventive orientation in the cohorts studied. Discrepancies between expressed health beliefs/attitudes and behaviours are more explicable when the reality of ambiguity and paradox is recognized in human responses. Human responses to loss (grief) may have similarities to the respondents' experiences when facing a possible change of life-style for health reasons. The practical implications for primary care professionals are discussed. PMID- 3319750 TI - Research trials in general practice: towards a focus on clinical practice. AB - With current moves towards an emphasis on the 'whole' patient rather than fragmenting the person into organ systems research methods need to be developed which reflect that emphasis and direct us in our endeavour as clinicians. It is possible to have a descriptive science of human behaviour which can be based upon clinical consultations. In this way the clinician is required to act as a clinical anthropologist as well as a clinical epidemiologist. PMID- 3319751 TI - Factors affecting estimates of the prevalence of asthma and wheezing in childhood. AB - Nine recent studies of the prevalence of asthma and wheezing in childhood are reviewed. Sample prevalences are found to range from 5 to 31% and possible reasons for this are considered; it is shown that the prevalence of asthma found is highly dependent on the criteria used for diagnosis. Some clinical and research implications are discussed. PMID- 3319752 TI - [Criteria for the correct use of antibiotics today]. PMID- 3319753 TI - [Preclinical hypothyroidism]. PMID- 3319754 TI - [Rational limitations of the therapy of liver cirrhosis and its update]. PMID- 3319755 TI - [100 years since the beginning of electrocardiography]. PMID- 3319756 TI - [Fatal rupture of the ventricular strut of a Bjork-Shiley prosthesis in mitral position. Description of a case, review of the literature and elements of differential diagnosis]. AB - We describe a fatal case of outlet strut's fracture of a Bjork-Shiley mitral valve prosthesis with displacement of the disc in left ventricular cavity. The acute, catastrophic nature of the symptoms associated with massive transvalvular regurgitation preclude survival except with immediate operation; consequently, we describe the clinical and instrumental elements for a very early diagnosis. PMID- 3319757 TI - [Silent ischemia in the dynamic electrocardiogram: an iceberg adrift?]. PMID- 3319759 TI - [Methanogenesis in man]. PMID- 3319758 TI - [Cardiotoxicity of 5-fluorouracil. Personal cases and review of the literature]. AB - Two cases of 5-Fluorouracil (5FU) cardiotoxicity, chest pain with changes in ECG the former, and myocardial infarction the latter, are described. Review of literature shows the existence of 49 cases of cardiotoxicity due to 5FU (38 angina = 77.5% 8 myocardial infarction = 16.3%). This complication seems due to a "coronary toxicity" whose onset is very precocious and not dose-dependent. Since 5FU therapy could result very dangerous when cardiotoxicity occurs, it is strictly advisable to withdraw further administration of the drug. As a matter of fact 18 patients out of 21 who again were treated with 5FU, had more serious complications which resulted in 3 myocardial infarctions (2 deaths). PMID- 3319760 TI - [Scleroderma in pregnancy]. AB - The case of a 23-year-old patient with scleroderma in her first pregnancy is described. The problem complexes, the influence of the disease on the continuation of pregnancy, and how the pregnancy affects the prognosis of the scleroderma are discussed and compared with the global literature. It does not appear possible to prove that scleroderma has a specifically deleterious effect on mother and child during pregnancy. Nor does a pregnancy definitely have a positive or negative effect on the subsequent course of a scleroderma. PMID- 3319761 TI - [Transabdominal chorionic biopsy: indications and timing of the procedure]. AB - The article reports on the introduction of transabdominal chorionic biopsy in the Gynaecological Hospital of Ludwigshafen in cooperation with the Department of Human Genetics at the University of Heidelberg. After completion of a pilot study 15 diagnostic transabdominal chorionic biopsies were performed between the 15th and 23rd pregnancy week. Sampling was successful in all cases; the median estimated weight of the biopsied samples was 35 mg. Cytogenic, biochemical and molecular-genetic examinations were conducted. No complications were seen except for one subserous haematoma. Indications and time of performance are discussed. The transabdominal chorionic biopsy is easier to conduct in the 2nd trimenon than during the first, and can therefore be considered to be a favorable "entry" into the technique. Shifting the biopsy to an earlier date, namely, into the first trimenon, can be aimed at as the familiarity with the technique increases. The obvious advantages of transabdominal removal of villi compared with the transcervical method lead us to expect that in course of the time the transcervical method will be replaced by the transabdominal one. No indication for invasive prenatal diagnosis should be implied without previous detailed genetic counselling. PMID- 3319762 TI - [Salivary LH as an ovulation indicator: comparison between salivary LH, serum LH and ultrasonic findings]. AB - A radioimmunological method of salivary LH determination has been developed as a new non invasive approach to hormonal ovulation detection. In this study salivary LH patterns have been compared to serum LH peak and daily sonographic assessment of follicle maturation in 15 spontaneous cycles of 9 women experienced in self observation of their cycles (NFP). The day where the mature follicle was no longer visible sonographically was labelled day 0. Serum LH peaks occurred in 11 out of 15 cycles on day -1, two times on days -2 and 0 and preceded salivary LH peaks in 8 out of 15 cycles. The latter coincided in 7 cycles with day 0 in two cycles each with days -1 and +1 and in 4 cycles with day -2. Thus 13/15 serum- and 11/15 salivary-LH peaks occurred within +/- one day of the disappearance of the mature follicle. A time lag of up to six hours between the sampling of saliva and serum might explain the difference in the respective peak days, however, more studies into the kinetics of LH transport and its circadian rhythmicity seem necessary. Nevertheless, in principle also the salivary LH peak is considered a suitable indicator of ovulation. PMID- 3319763 TI - [Platelet growth factors]. PMID- 3319764 TI - Nonrandom sampling in genetic epidemiology: maximum likelihood methods for multifactorial analysis of quantitative data ascertained through truncation. AB - Three types of nonrandom sampling of family data are described, and appropriate maximum likelihood methods are proposed for each. The three types arise depending on whether the selection of probands, based on truncation, is applied directly to the phenotypic distribution, to the distribution of a correlated trait, or to the liability distribution of an associated disease. Family data ascertained through random and nonrandom sampling can be analyzed together in a unified approach. Results of a Monte Carlo study are presented that demonstrate the utility of the proposed methods. In particular, likelihood ratio tests of null hypotheses are shown to be distributed as chi-square, even in samples as small as 50 families (with variable sibship size). PMID- 3319765 TI - "In the air"--Theodosius Dobzhansky's "Genetics and the Origin of Species". PMID- 3319766 TI - A novel P22 prophage in Salmonella typhimurium. AB - Under several sets of conditions, all of which seem to perturb purine metabolism, Salmonella typhimurium releases a variety of phages which were not known to be present in the strain. These cryptic phages are not induced by UV irradiation. Furthermore, the induction process does not require a functional recA gene product. While phages of several phenotypic classes have been recovered, including both turbid and clear plaque formers, all appear to be variants of P22 because all show DNA restriction patterns indistinguishable from that of P22. The variety of types suggests that the cryptic prophage is mutagenized as a consequence of the induction process. All the temperature phages tested are capable of transducing a variety of chromosomal markers with high efficiency. The phages induced in this novel way are capable of forming plaques on the strains that gave rise to them. Since the strains releasing phage are not immune to P22, the parental lysogens must not express immunity and the phage must be held in a cryptic state by a novel mechanism. The released phage possess an intact P22 immunity system because many can form standard immune lysogens after reinfection of Salmonella. These results raise the possibility that Salmonella typhimurium harbors cryptic phages that are subject to a novel system of global control related to purine metabolism. Preliminary evidence suggests that the regulation system may involve DNA modification. PMID- 3319768 TI - Interactions between positive and negative regulators of GCN4 controlling gene expression and entry into the yeast cell cycle. AB - The GCN4 gene encodes a transcriptional activator in yeast whose expression is regulated at the translational level in response to amino acid availability. gcn3 mutations block derepression of GCN4 expression in starvation conditions. gcd1 and gcd12 mutations restore derepression of GCN4 expression in gcn3 deletion mutants, suggesting that GCN3 positively regulates GCN4 indirectly by antagonism of these GCD functions. gcd1 and gcd12 mutations also lead to temperature sensitive arrest in the G1 phase of the cell cycle in gcn3 deletion mutants. The GCN3 allele completely suppresses both derepression of GCN4 expression and the temperature-sensitive growth conferred by gcd 12 mutations and partially suppresses these phenotypes in gcd1 mutants. This suggests that the GCN3 product can promote or provide GCD function in nonstarvation conditions even though it opposes GCD function when cells are starved for amino acids. The gcn3-102 allele is completely defective for positive regulation of GCN4 expression; however, it mimics GCN3 in suppressing gcd1 and gcd12 mutations and thus retains the ability to restore GCD function in nonstarvation conditions. These data suggest that GCN3, GCD1 and GCD12 have closely related functions required for regulation of GCN4 expression and entry into the cell cycle. We suggest that GCN3 antagonizes the regulatory functions of GCD1 and GCD12 in starvation conditions either by competing with these factors for the same sites of action or by modifying their structures by physical interaction. PMID- 3319767 TI - A new non-mendelian genetic element of yeast that increases cytopathology produced by M1 double-stranded RNA in ski strains. AB - The Saccharomyces cerevisiae SKI (superkiller) genes are repressors of replication of M, L-A, and L-BC double-stranded (ds) RNAs; ski strains have an increased M dsRNA copy number and, as a result, are cold-sensitive for growth at 8 degrees. Growth is normal, however, at higher temperatures. We have found a new cytoplasmic genetic element [D] (for disease) that makes M1 dsRNA-containing superkiller strains grow slowly at 30 degrees, not at all at 37 degrees, and only very poorly at 20 degrees. These growth defects require three factors: a chromosomal ski mutation, the presence of M1 dsRNA, and the presence of the new cytoplasmic factor, [D]. We have isolated mutants unable to maintain [D] (mad), at least one of which is due to mutation of a single chromosomal locus. Further, [D] can be cured by growth at 37-39 degrees. We present evidence that [D] is not M, L-A, L-BC or W dsRNAs or mitochondrial DNA, 2 mu DNA, or [psi], but [D] depends on L-A for its maintenance. We also show that [D] is distinct from [B], a cytoplasmic element that allows M1 dsRNA to be stably replicated and maintained in spite of defects in certain chromosomal MAK genes that would otherwise be necessary. [D] activity is blocked by the presence of another extrachromosomal element, called [DIN] (for [D] interference). [D] and [DIN] may be different natural variants of the same molecule. PMID- 3319769 TI - Conditional overdominance at an alcohol dehydrogenase locus in yeast. AB - Documented examples of heterosis attributable to overdominance at specific protein-encoding gene loci have rarely been reported, the association of sickle cell hemoglobin with malarial resistance being the best documented example of this phenomenon. Here we report an example of overdominance that is temperature- and allyl alcohol-dependent and due to heterozygosity at the ADH1 locus, involving two ADHI functional mutants. Overdominance appears to be due in part to an intermediate level of ADHI activity in the heterozygote. Unlike previous work with this this system using haploid strains, the NAD+/NADH ratios show no negative correlation with allyl alcohol resistance. This system is formally equivalent to that of sickle cell hemoglobin and shows promise as a tool for investigating the physiological basis for overdominance. PMID- 3319770 TI - Alan Gregg and the rise of general hospital psychiatry. AB - The authors review the forces that encouraged the entry of psychiatry into the general hospital in the 1930s. Those forces, which included concern about increasing health care costs, pressure to reform medical and psychiatric education, and the growth of dynamic psychiatry and psychosomatic medicine, are described. The activities of Alan Gregg, Director of the Medical Sciences Division of the Rockefeller Foundation during that era are highlighted. Gregg encouraged research in neurobiologic correlates of psychiatric illness and funded psychiatric units in eight general hospitals in the United States. The authors suggest that the development of general hospital psychiatry was strongly influenced by Alan Gregg and his support for a medical model of psychiatric illness. In addition to other forces that spurred the growth of general hospital psychiatry, the authors suggest that Gregg's influence significantly aided psychiatry's entrance into the general hospital. PMID- 3319771 TI - [The genetics of animal development]. AB - The stages of establishment of phenogenetics in the USSR are regarded in this paper. The major directions and schools in this field are described. Also, main achievements and conceptions developed by our phenogeneticists are analysed in detail. PMID- 3319772 TI - [Molecular genetic organization and origin of plasmid pBS52 with a broad range of bacterial hosts]. AB - The data are presented on the localization of genetic determinants of resistance to streptomycin, ampicillin and sulfanilamides on the physical map of conjugative R plasmid pBS52 of 38,000 bp which has a broad bacterial host range and belongs to a new incompatibility group. The plasmid has a natural "polylinker" site (less than 200 bp) containing (in the order of arrangement) the recognition sites for restriction enzymes: BamHI-EcoRI-PstI-EcoRV-BglII (PvuII). The comparative analysis shows that pBS52 contains a segment homologous to DNA of plasmid RSE1010 (IncP-4). The evolutionary origin of plasmid pBS52 is discussed. The recA independent formation of the mini-derivatives of pBS373 and pBS374 types during the transformation of Escherichia coli with pBS52 plasmid DNA has been shown. Plasmids pBS373 and yBS374 are capable of autonomous replication in Pseudomonas putida and P. aeruginosa cells, which is provided by the rep system of IncP-4 replicon. PMID- 3319773 TI - [Mutants of the yeast Saccharomyces cerevisiae characterized by enhanced induced mutagenesis. III. Effect of the him mutation on the effectiveness and specificity of UF-induced mutagenesis]. AB - We have studied the influence of him1-1, him2-1, him3-1 and himX mutations on induction frequency and specificity of UV-induced adenine-dependent mutations in the yeast Saccharomyces cerevisiae. Him mutations do not render haploid cells more sensitive to the lethal action of UV-light; however, in him strains adenine dependent mutations (ade1, ade2) were induced more frequently (1.5--2-fold), as compared to the HIM strain. An analysis of the molecular nature of ade2 mutants revealed that him1-1, him2-1 and himX mutations increase specifically the yield of transitions (AT----GC and GC----AT), whereas in the him3-1 strain the yield of transversions was enhanced as well. We suggest him mutations analysed to affect specific repair pathway for mismatch correction. PMID- 3319774 TI - [Repair of plasmid DNA treated with 8-methoxypsoralen and long-wave UV light (lambda=365 nm) in wild type and mutant rad2 cells of Saccharomyces cerevisiae]. AB - The method of repeated irradiation has been used to study excision of 8-MOP monoadducts from plasmid and chromosomal DNA in cells of wild type and rad2 mutant of Saccharomyces cerevisiae. The measurement of kinetics of monoadduct removal from chromosomal DNA in intact and competent yeast cells showed that monoadducts were excised in both types of cells with normal repair, but this process was blocked in intact and competent cells of the rad2 mutant. The survival of pYF91 plasmid treated in vitro with 8-MOP plus near UV-light has been studied in the cells of the wild type and in incision-defective rad2 mutant by the measurement of cell transformation frequency. Episomic pYF91 plasmid used in these experiments contained the yeast nuclear LEU2 gene, a portion of 2 mkm DNA and DNA of bacterial plasmid pBR322 with resistance to ampicillin. The pYF91 plasmid was treated with 8-MOP plus near UV-light in vitro, then unbound 8-MOP was removed by dialysis. This DNA was used for transformation. The transformed yeast cells were irradiated repeatedly. The quantitative alteration of the yield of transformants, depending on the time of keeping these yeast cells in complete liquid medium at 30 degrees C, prior to repeated irradiation, allowed to measure the kinetics of monoadduct excision from plasmid DNA. It was shown that monoadducts were removed equally effectively from plasmid DNA introduced into cells of the wild type and rad2 mutant. Possibly, the repair system of both these strains provides excision of monoadducts from plasmid DNA, but this process is blocked in the rad2 mutant, relatively to monoadduct excision from chromosomal DNA. PMID- 3319775 TI - [Localization of structural genes of Vibrio cholerae cholerae toxin using the recombinant plasmid RP4omega elt]. AB - The recombinant plasmid RP4 omega elt carrying Escherichia coli heat-labile enterotoxin elt genes with 70-80% homology with genes vct of Vibrio cholerae has been constructed. We used this plasmid to determine localization of the cholerae toxin genes vct on the map of Vibrio cholerae cholerae. Two types of the donors were revealed in matings of 10 strains of V. cholerae cholerae 569B/RP4 omega elt with the polyauxotrophic recipients RV31 and RV175: some strains had enhanced frequency of mobilization of ilv-1 and lys-6 markers, the others--of trp-1. Our data suggest that structural vct genes are located within two regions of V. cholerae cholerae 569B chromosome: trp-1 and ilv-1--lys-6. PMID- 3319776 TI - [The ColIb-CA53 plasmid suppresses umuC- and umuD-mutations in Escherichia coli K 12]. AB - The presence of the ColIa-CA53 plasmid in umuC and umuD mutant Escherichia coli K 12 cells restores their mutability under UV irradiation to a level that even exceeds that of the isogenic umuC+umuD+ strains, as well as increases their resistance to the lethal effects of UV irradiation. The ColIb-P9 plasmid which suppresses the umuC mutant phenotype, as we have shown earlier, acts in the same manner with respect to the umuD mutant cells. The results of the study demonstrate that both plasmids encode products that are functionally similar to those of the chromosomal genes umuC and umuD. The plasmids ColIa-CA53, ColIb-P9 and pKM101 are shown to have practically the same effect upon the mutagenesis and survival of the umuC, umuD mutant cells. PMID- 3319777 TI - Heterospecific transcription of the Escherichia coli rpoB-3 allele in gram negative bacteria. PMID- 3319778 TI - Cloning and characterization of the isopenicillin N synthetase gene mediating the formation of the beta-lactam ring in Aspergillus nidulans. AB - Genomic clones containing an Aspergillus nidulans isopenicillin N synthetase (IPNS) gene have been identified by heterologous hybridization with a Cephalosporium acremonium DNA probe. The open reading frame encodes a 331 amino acid polypeptide with extensive homology with the genes of other beta-lactam producing fungi. The gene product has been overexpressed in Escherichia coli and shown to have activity of IPNS. This represents the first evidence at the molecular level that the biosynthesis of penicillins in A. nidulans occurs by the same pathway as in other beta-lactam-producing microorganisms. Comparison of available nucleotide sequences from IPNS genes suggests a horizontal transmission of the gene between the prokaryotic beta-lactam producers of the genus Streptomyces and the filamentous fungi. PMID- 3319779 TI - The extracellular nuclease gene of Serratia marcescens and its secretion from Escherichia coli. AB - We are studying exoproteins of the enteric bacterium Serratia marcescens as a model system for the release of extracellular proteins from the cell. In this work we report the cloning of the gene for a secreted nuclease from S. marcescens and its complete nucleotide sequence. Following expression of the nuclease gene in both S. marcescens and Escherichia coli we were able to demonstrate the presence of the nuclease extracellularly in both organisms. Cell lysis did not occur and there was no concurrent release of cytoplasmic or periplasmic proteins. No accessory genes appeared to be required for extracellular secretion of the nuclease from E. coli. We can conclude that E. coli is capable of secreting certain proteins extracellularly, and may be a suitable host organism for the genetic analysis of extracellular protein secretion when provided with a suitable protein to export. PMID- 3319780 TI - An nptI-sacB-sacR cartridge for constructing directed, unmarked mutations in gram negative bacteria by marker exchange-eviction mutagenesis. AB - A technique for marker exchange-eviction mutagenesis that enables the construction of directed, unmarked mutations in Gram-negative bacteria was demonstrated in Erwinia chrysanthemi. The technique employs an nptI-sacB-sacR cartridge that is carried on a 3.8-kb BamHI fragment and confers kanamycin (Km) resistance and sucrose sensitivity (due to the production of levansucrase by sacB) in E. chrysanthemi. The cartridge was inserted into a Sau3A site in a cloned E. chrysanthemi pelC gene (encoding pectate lyase isozyme PLc) and then introduced into the Erwinia genome by gene exchange recombination. The resulting mutant was KmR, sucrose-sensitive, and PLc-deficient. The cartridge was then excised from the plasmid-borne pelC gene by PstI cleavage to leave a 28-bp frame shifting insertion. The pelC allele containing the 28-bp insertion was exchanged for the chromosomal allele containing the nptI-sacB-sacR cartridge by selection for sucrose tolerance. The resulting E. chrysanthemi mutant was Kms and PLc deficient. The technique permits the construction of complex strains with many directed mutations without the introduction of a corresponding number of antibiotic resistance markers and should prove useful, for example, in exploring the role of the multiple pel genes in E. chrysanthemi. PMID- 3319781 TI - A ten-minute DNA preparation from yeast efficiently releases autonomous plasmids for transformation of Escherichia coli. AB - A procedure for the rapid isolation of DNA from the yeast Saccharomyces cerevisiae is described. To release plasmid DNA for the transformation of Escherichia coli, cells are subjected to vortex mixing in the presence of acid washed glass beads, Triton X-100, sodium dodecyl sulfate, phenol and chloroform. Centrifugation of this mixture separates the DNA from cellular debris. E. coli can be efficiently transformed with plasmid present in the aqueous layer without further purification of the plasmid DNA. This procedure also releases chromosomal DNA. Following two ethanol precipitations, the chromosomal DNA can be digested by restriction endonucleases and analysed by Southern blot analysis. PMID- 3319782 TI - Overexpression and purification of a biologically active rifampicin-resistant beta subunit of Escherichia coli RNA polymerase. AB - The gene rpoB (rifD 18), which encodes rifampicin-resistant beta subunit of Escherichia coli RNA polymerase, has been placed on an overexpression plasmid under the control of bacteriophage T7 promoter. Induction of the T7 RNA polymerase gene in the host cells resulted in extensive overproduction of the beta polypeptide. Most of the overproduced material was recovered from cell lysates in insoluble form and was solubilized by extraction with 6 M urea. Purified overproduced beta subunit was added, in molar excess, to urea-denatured rifampicin-sensitive RNA polymerase. Upon removal of urea by dialysis, the reconstituted enzyme became rifampicin-resistant, indicating that overproduced beta subunit can be efficiently assembled into functional holoenzyme. PMID- 3319783 TI - Structural characteristics of the PHO8 gene encoding repressible alkaline phosphatase in Saccharomyces cerevisiae. AB - The nucleotide sequence of a 3694-bp DNA fragment bearing the PHO8 gene encoding nonspecific repressible alkaline phosphatase (rALPase; EC 3.1.3.1) of Saccharomyces cerevisiae was determined. The sequence contains a 1698 bp open reading frame (ORF), and the major PHO8 transcription start point at 32 bp upstream from the ATG codon; several minor transcription start points are located between the major start point and ATG. The major start point is most responsive to the phosphate signals. The amino acid (aa) sequence deduced from the ORF contains several homologous regions in common with alkaline phosphatases of Escherichia coli and human placenta. A PHO8 DNA fragment previously isolated [Kaneko et al., Mol. Cell. Biol. 5 (1985) 248-252] was found to be truncated for the region encoding the 22 aa residues at the C terminus of the enzyme, which were replaced with 17 aa encoded by a pBR322 DNA. The modified gene could produce significant rALPase activity without the function of proteinase A which is required for the maturation of rALPase from its precursor. PMID- 3319784 TI - The unique histone H2A gene of Aspergillus nidulans contains three introns. AB - The histone H2A gene of the filamentous fungus Aspergillus nidulans has been cloned and sequenced. There is a single H2A gene in the genome of A. nidulans, and it contains three introns. The introns are 51 nucleotides (nt), 56 nt and 50 nt in length and split codons for amino acids (aa) 18, 48 and 116 of the predicted protein. The transcriptional start and termination points have been determined using an S1 nuclease protection assay. The predicted protein is 132 aa residues in length and surprisingly has a threonine after the initiator methionine instead of the usual serine. The sequence of the predicted histone H2A protein is compared to histone H2A proteins from Schizosaccharomyces pombe, Saccharomyces cerevisiae and calf thymus. Comparison of the amino acid sequence to these other H2A proteins shows that the divergence of amino acid sequences between H2A proteins is found in two clustered sites. PMID- 3319785 TI - A set of expression plasmids for the synthesis of fused and unfused polypeptides in Escherichia coli. AB - A set of plasmid expression vectors for cloning of DNA fragments containing open reading frames has been obtained. The plasmids carry the strong leftward promoter of bacteriophage lambda and the translation initiation signals from either the gene ner of bacteriophage Mu or the gene 4 of bacteriophage phi 29. The vectors could overexpress the cloned sequences as fusion peptides at the N terminus with the N-terminal segment of the phi 29 protein p4 or at the C terminus with the Escherichia coli beta-galactosidase from its 8th residue, or both. Alternatively, the cloned sequences could be directed to overproduce proteins in an unfused form. DNA fragments of the hemagglutinin gene from human influenza A virus, have been cloned in one of the plasmid vectors and some potential antigenic determinants have been characterized using monoclonal antibodies. PMID- 3319787 TI - [History of health organization in the central Urals]. PMID- 3319788 TI - [Protection of the atmosphere in areas near coke-chemical plants]. PMID- 3319786 TI - Modification of mRNA secondary structure and alteration of the expression of human interferon alpha 1 in Escherichia coli. AB - A plasmid (pNL015) was constructed to contain a human interferon alpha 1 (IFN alpha 1) gene under the transcriptional control of the Escherichia coli lipoprotein promoter. The E. coli cells harboring this plasmid produce 2.8 x 10(4) units/ml of IFN. Secondary structure analysis of the transcripts produced by pNL015 showed that the coding region could base pair with the Shine-Dalgarno (SD) region with a delta G = -3.9kcal/mol. A new plasmid pNL008 was constructed by modifying pNL015 with an 11-bp deletion and a 2-bp insertion in the coding region, so that the SD region is not involved in the secondary structure. E. coli cells harboring pNL008 produce ten times more IFN activity than cells harboring pNL015. A series of experiments were carried out to show that the specific activities of IFN, differential rates of IFN transcription, protein degradation or mRNA degradation could not account for the difference observed in expression. A rigorous test on this model of translational inhibition was conducted by the construction of pNL017 with a single bp substitution which did not change the amino acid sequence of the IFN (synonymous codon substitution) but which increased the calculated energy of interaction with the SD sequence to delta G = 10.8 kcal/mol. The E. coli cells harboring pNL017 produced no detectable IFN activity. PMID- 3319789 TI - [Hygienic evaluation of activated sludge as a feed supplement for agricultural animals]. PMID- 3319790 TI - [Hygienic problems in managing environmental quality at the stage of national economic development planning]. PMID- 3319791 TI - [S.P. Lovtsov on the organization of the health service in post-reform Russia]. PMID- 3319792 TI - [Hygienic regulation of the use of polyolefin-class polymeric materials in branches of the agribusiness complex]. PMID- 3319793 TI - [Publications of the WHO Regional Office for Europe on problems of sanitary toxicology]. PMID- 3319794 TI - [Development of studies on air hygiene in the Republic of Cuba]. PMID- 3319795 TI - [Cotton dust and byssinosis (review of the literature)]. PMID- 3319796 TI - The electroanalytical approach to lipid peroxide determinations. AB - An electroanalytical method for the determination of lipid peroxides in physiological material is described. The technique is based on electrochemical detection for HPLC as the means for enhancing sensitivity. Samples containing organic peroxides, including lipid peroxides, can be analyzed directly using a modified polarographic detector (Lloyd, J.B.F.; Optimization of the operational parameters of the supported mercury drop electrode detector in high performance liquid chromatography. Anal. Chim. Acta 154:121-131; 1983.) for reversed phase HPLC determinations. Detection limits for fatty acid hydroperoxides were found to be in the low nanogram range. PMID- 3319798 TI - Methods for determination of lipid peroxidation in biological samples. AB - Interest in the pathological consequences of lipid peroxidation has led to the development of a number of analytical approaches to the quantitation of products. However, the various analytical methodologies employed often do not measure the same chemical classes of products, and apparent discrepencies have been observed, particularly in studies of lipid peroxidation in biological systems. This review provides a brief discussion of some of the strengths and weakness of methods currently used for the determination of lipid peroxidation in biological tissues. PMID- 3319797 TI - Quantification of 5- and 15-HPETE's by direct chemical ionization mass spectrometry. AB - This report describes the application of direct chemical ionization mass spectrometry (DCIMS) to the identification and quantification of 5- and 15 HPETEs. A unique feature of the method is use of a polyimide-coated fused silica fiber that allows vaporization of the hydroperoxides, with very low excess energy, into the plume of the chemical ionization reagent gas plasma. Mass spectra are obtained that allow identification of the nonreduced and nonderivatized free acid forms of 5- and 15-HPETE as well as their quantification from 1 microgram to 100 picograms. PMID- 3319799 TI - Application of HPLC for the determination of phospholipid hydroperoxides in food and biological systems. AB - Hydroperoxides derived from phospholipids of biological source could be analyzed quantitatively by using reverse phase high performance liquid chromatography (HPLC). The combination of reverse phase HPLC and normal phase HPLC, which is used for the separation of lipid classes, seems to be a powerful technique for the determination of peroxidized phospholipids in food and biological systems. The development of the detector specific to the hydroperoxy group is desired for increasing the effectiveness of this method. PMID- 3319800 TI - Detection of phospholipid peroxides in biological samples. AB - Peroxidation of membrane lipids has been hypothesized to play a key role in various types of tissue degeneration and pathology. Lipid peroxides are formed when oxygen reacts with an unsaturated fatty acid chain. Virtually all of the unsaturated fatty acids in biological systems are bound by ester linkages in phospholipids or triglycerides. Phospholipid and triglyceride peroxides are primary products of lipid peroxidation and have rarely been measured. Most of the commonly used methods for detection of lipid peroxidation are based on detection of malondialdehyde or other chemical species that are derived from oxidized fatty acids. This review presents an overview of recently developed methods aimed at identifying and measuring oxidized phospholipids and triglycerides which are direct evidence of the occurrence of lipid peroxidation in vivo. PMID- 3319801 TI - Measurement of in vivo lipid peroxidation and toxicological significance. AB - The quantitative determination of hydrocarbons exhaled by animals as an in vivo index of extensive lipid peroxidation is described. Advantages and limitations of this method are discussed. Acetaminophen-induced hepatic lipid peroxidation in mice is an example of oxidative stress, the extent of which is determined in vivo by the turnover of endoplasmic reticulum monooxygenase and the cofactor, e.g. glutathione status of the liver. In microsomal suspensions, none of the assay methods for lipid peroxidation identifies acetaminophen as a prooxidant. Rather, it acts like an antioxidant. The obvious limitations of in vitro experiments are emphasized. Cytosolic metabolism of allyl alcohol also leads, in a dose-dependent manner, to extensive lipid peroxidation. Evidence is presented that release of iron from intracellular stores following overproduction of NADH may be the primary cause of this lesion. The term reductive stress is suggested for this metabolic initiation of iron redox cycling. In experimental hepatitis induced by galactosamine/endotoxin, a leukotriene-mediated pathomechanism, no signs of lipid peroxidation are detectable. This means that ethane or pentane formation are definitively not late consequences of membrane deterioration but rather early causal events in special cases of hepatotoxicity. PMID- 3319802 TI - Detection of lipid hydroperoxides and hydrogen peroxide at picomole levels by an HPLC and isoluminol chemiluminescence assay. AB - An isoluminol assay is utilized for the detection of hydrogen peroxide and lipid hydroperoxides in biological samples. The combination of this assay as a post column detection for HPLC avoids interference of antioxidants and enables characterization of hydroperoxides at picomole levels. Two useful HPLC conditions for the separation of hydrogen peroxide, lipid hydroperoxides, antioxidants, and unoxidized lipids are described. PMID- 3319803 TI - [Detection of Chlamydia trachomatis infection in the cervix uteri by a rapid direct immunofluorescence method using fluorescein-labeled monoclonal antibodies]. PMID- 3319804 TI - [Mayer-Rokitansky-Kuster-Hauser syndrome associated with extensive developmental anomalies in the urinary and skeletal systems]. PMID- 3319805 TI - [Diseases of the hematopoietic system in pregnant women]. PMID- 3319807 TI - [Anomalous origin of the right coronary artery from the pulmonary trunk]. PMID- 3319806 TI - Disparate effects of naloxone in hypothalamic amenorrhoea of athletes. AB - Of 30 amenorrhoeic women athletes, 28 were considered to have hypothalamic amenorrhoea according to their low gonadotropin, estradiol (E2) and normal testosterone and prolactin (PRL) values. Gonadotropin-releasing hormone (LH-RH 100 micrograms i.v.) and naloxone (4 mg i.v. bolus followed by 2.8 mg/h infusion) tests were administered consecutively. Fifteen subjects reacted to the naloxone test with at least a fivefold increase in LH values; these values were consistently above those of the LH-RH test. The other 13 women reacted similarly to the releasing hormone but not to naloxone. While there were no differences between basal LH values in the two groups, E2 levels tended to be lower in non responders, but since 1/3 of the values fell below the threshold of sensitivity of the E2 assay, no significance could be calculated. The obvious difference among the subjects could be E2 -mediated, the non-responders representing a deeper level of hypothalamic amenorrhoea. The naloxone test seems to be useful for differentiating between different forms of this condition. PMID- 3319808 TI - [Present status of laser cardiovascular surgery]. PMID- 3319809 TI - Pathogenesis of the mucosal hyperplasia in self-filling blind loops of rat jejunum: a morphometric study in germ free animals. AB - Bacterial overgrowth and high intraluminal concentrations of deconjugated bile acids are thought to be responsible for mucosal hyperplasia in self-filling blind loops of rat jejunum. To investigate this hypothesis further we have assessed the three dimensional architecture of these loops created in germ free animals without or with di- or mono-association of different bacterial species. It was found that mucosal hyperplasia develops in the absence of any bacterial contamination and that bacterial association does not lead to a more pronounced mucosal proliferation. This implies that other mechanisms provoke this morphological phenomenon. Increased bulk contents in these loops or immunological events are probably the most likely explanation. PMID- 3319811 TI - Augmentation of chemically induced pancreatic and bronchial cancers by epidermal growth factor. AB - The incidence of Syrian golden hamsters with pancreatic cancer induced by subcutaneous injections of N-nitroso-bis(2-oxopropyl)amine for 19 weeks (each 10 mg/kg) increased from 44% to 75% (p=0.016) when epidermal growth factor was also administered from week 5 through week 8 (5 mug energy three days for injections). Epidermal growth factor increased pancreatic weight and body weight. The incidence of animals with bronchial cancer doubled. Epidermal growth factor could be a cocarcinogen as a result of its mitogenic activity. PMID- 3319810 TI - Adaptive responses to pharmacological inhibition of small intestinal alpha glucosidases in the rat. AB - Intestinal adaptation (small intestinal weight and length, weight of the caecum and of the residual colon) to feeding different doses (0-5-50-500 mg/kg bw) of the absorbable, competitive alpha-glucosidase inhibitors BAY m 1099 and BAY o 1248 for three, seven, or 28 days was studied in rats. With the highest dose of either inhibitor, a significant and time dependent growth of the caecum was observed. Under these conditions, caecal tissue polyamine concentrations (spermidine and spermine) were slightly higher after three, unaffected after seven and slightly decreased after 28 days. Comparing the trophic effect both of BAY m 1099 and BAY o 1248 with that of the almost unabsorbed glucosidase inhibitor acarbose in fed rats showed that caecal weight was higher in response to the absorbed compounds than in response to acarbose, while total caecal carbohydrate content was unaffected by the absorbed and about nine fold increased by the unabsorbed inhibitors. These findings suggest that acarbose may partially inhibit bacterial carbohydrate degradation in the caecum. PMID- 3319812 TI - Interface between adaptive and neoplastic growth in the pancreas. AB - The adaptive changes of hypertrophy and hyperplasia are diffuse and reversible responses of the pancreas to growth promoting stimuli. Early stages of neoplastic growth in the pancreas have been studied in carcinogen treated animals and preneoplastic lesions including atypical acinar cell foci and nodules, tubular ductal complexes and intraductal hyperplasia were identified. Neoplastic growth is clonal rather than diffuse and involves multiple steps through preneoplastic stages to produce a tumour. The individual steps are commonly regarded as reflecting a series of changes in the genome of the cells. Although the changes are likely to be irreversible, completion of the sequence usually requires a major portion of the lifespan of the host. The rate of progression of preneoplastic lesions to cancer may be modulated by the same factors that control adaptive growth. It follows that such factors will influence the probability that a carcinoma will develop. Cholecystokinin (CCK) seems to provide one example of a hormone/growth factor that can stimulate normal, adaptive, and neoplastic growth, and it is to be expected that other such hormones will be identified. PMID- 3319813 TI - Effects of intestinal adaptation on insulin binding to villus cell membranes. AB - Insulin affects the expression of brush border enzymes by villus cells in vitro and in vivo. Physiological (lactation) and surgical (jejunoileal bypass) models of hyper- and hypoplasia were established so that insulin receptor characteristics could be related to villus histology, expression of sucrase and alkaline phosphatase, and plasma insulin concentrations. In lactating rats, villus height increased up to 55% (p less than 0.005), and fasting plasma insulin increased 71% (p = 0.005), compared with controls. Insulin binding to villus cell membranes, and sucrase and alkaline phosphatase activities were, however, unchanged. In ileum of bypass operated rats, villus height increased 134% (p less than 0.005) while insulin binding fell 68% (p = 0.025). Scatchard analysis revealed that this was largely because of reduction in binding by high affinity receptors. Sucrase and alkaline phosphatase specific activities fell 57% (p = 0.03) and 49% (p = 0.02) respectively, suggesting that ileal villus cells were hypomature. The slightly hypoplastic tissue of selfemptying loops showed normal insulin binding compared to jejunum of sham operated controls. Bypass and sham operated rats had similar fasting plasma insulin concentrations. Reduced insulin binding in markedly hyperplastic gut of bypass operated rats might reflect hypomaturity of villus cells. The reduction in insulin binding, however, might significantly modulate the effect of insulin on small intestinal mucosa and account for the fall in enzyme activity which occurs despite villus hyperplasia. PMID- 3319815 TI - Regulation of gene expression in pancreatic adaptation to nutritional substrates or hormones. PMID- 3319816 TI - Ultrasonographic measurement of the human fetal liver in utero. AB - A total of 232 measurements of the size of the human fetal liver were made from 19 weeks gestation through to term. The size of the liver increased linearly with the advance in pregnancy. Statistical analyses showed a highly significant correlation between liver circumference and area and gestational week or fetal abdominal circumference (r = 0.89, r = 0.90, r = 0.90, r = 0.85). PMID- 3319814 TI - Role of membrane glycoproteins in mediating trophic responses. AB - During growth and differentiation the plasma membrane has a key role not only in the reception and transmission of extracellular signals such as hormones and growth factors, but also in communicating cellular response to the cellular microenvironment. Cellular response to trophic stimuli includes alterations of cell shape and cell surface antigenicity, of cell-cell recognition and cellular adhesion, of cell matrix binding and the adaptation of cell surface receptors. The plasma membrane is therefore regarded as a 'central agency' for the integration of a single cell into the complex system of a tissue or of an organism. The numerous functions of the plasma membrane are mainly mediated by membrane integrated glycoproteins or glycolipids both sharing the common feature of covalently bound oligosaccharide side chains. Specific alterations of oligosaccharide structure and metabolism associated with growth, differentiation and various pathologic conditions suggest a specific role for the oligosaccharide moieties in the regulation of cell surface functions (Table 1). This review intends to focus on the role of plasma membrane glycoproteins describing briefly principles of glycoprotein structure and function, and characteristics of their biosynthesis and degradation. PMID- 3319817 TI - Effects of nifedipine on umbilical artery velocity waveforms in healthy human fetuses. AB - The purpose of this investigation was to analyze the changes in umbilical artery (UA) velocity waveforms after administration of nifedipine in 30 healthy pregnant women. The effects on fetal and maternal heart rates and maternal arterial pressure were also analyzed. The patients included in this double blind study received sublingually either 10 mg of nifedipine or a placebo. A transient fall of the UA resistance (as expressed by the pulsatility index) occurred 15 min after nifedipine administration, but resistance returned to control values after 90 min. Maternal heart rate increased after nifedipine administration and returned toward the control value by 45 min. Fetal heart rate and maternal mean arterial pressure did not change significantly. These data suggest a possible use of nifedipine to normalize the UA velocity waveform in pregnancies complicated by hypertension and fetal growth retardation. PMID- 3319818 TI - Preeclampsia as chronic disseminated intravascular coagulation. Study of two parameters: thrombin-antithrombin III complex and D-dimers. AB - Determinations of coagulation/fibrinolysis parameters thrombin-antithrombin III complex (TAT) and D-dimers (cross-linked fibrin degradation product) were carried out in order to prove that preeclampsia is a chronic disseminated intravascular coagulation (DIC) state. Besides the parameters TAT and D-dimers, antithrombin III (ATIII), fibrin degradation products and platelets were measured as well. Even in normal pregnancy there is an activation of coagulation, reflected in a hypercoagulative state that is proceeding down to the formation of thrombin. This thrombin is, however, nearly completely inactivated by ATIII, so that no fibrin is formed. This inactivation is solely reflected by the increase of TAT in the blood. In preeclampsia, however, where no such rapid changes as in acute DIC occur, the increase of TAT is accompanied by a decrease of ATIII and platelet counts and an increase of D-dimers; this demonstrates much more clearly the chronic DIC nature of preeclampsia than the results from studies carried out so far. PMID- 3319819 TI - Evaluation of the urethral mucosa before and after oestrogen treatment in postmenopausal women with a new sampling technique. AB - Using a new type of nylon brush (Cytobrush) for sampling of cells, the state of the urethral mucosa was evaluated before and after oestrogen treatment in 10 patients suffering from urinary incontinence. In 4 other patients the results obtained were compared with those using the conventional cotton swab technique. The brush specimens were found to be much more cellular and consequently more informative than those obtained with the conventional technique. The cytologic examination based on brush samples also demonstrated that oestrogen treatment within 3 weeks induced a proliferation of the atrophic urethral mucosa in postmenopausal women suffering from urinary incontinence. PMID- 3319820 TI - [Alternative surgical method in pseudarthroses of the scaphoid bone. Prospective study]. AB - Follow-up of 197 patients with scaphoid nonunion treated by Russe I and Russe II bone grafting procedures showed that in longstanding cases with pseudarthrosis and in cases with severe necrosis bony union is often not achieved. The reason for this lack of success is the bad vascularity of the damaged scaphoid. In these cases (25 cases performed over 19 months) with an unfavorable operative prognosis we have inserted into the scaphoid after resection of the pseudarthrosis or the necrotic bone, a corticocancellous graft from the iliac crest, isolated on its vascular pedicle. The vascular pedicle has been anastomosed under the microscope to the radial artery and one of the accompanying veins. This procedure guarantees a much better vascularity of the bone graft. Our results in the 25 cases are very encouraging. Possible complications and their avoidance are pointed out. This new operative technique should not replace other common procedures but it might be the treatment of choice in selected cases. PMID- 3319821 TI - [Pseudarthrosis of the scaphoid bone. Experiences in 240 cases]. AB - The results after treatment of 197 non-union of scaphoid fractures are reported. The operative technique of Matti-Russe, called also Russe I, has proved successful in cases in which the fracture is located in the middle or distal third of the scaphoid or where there is a viable small proximal fragment. Bone healing depends more on the age of the pseudarthrosis than on the age of the patient. In 86% of 83 cases the technique of Russe I was successful and in this group the period between accident and treatment was no longer than two years. After a period of more than four years after the accident the success rate is only 54%. The combination of the technique of Russe I with styloidectomy of the radius diminishes the number of good results. The operative technique known as Russe II assumes a good blood supply of the distal fragment of the scaphoid. In 15 cases, after resection of the necrotic small proximal fragment of the scaphoid, a fungiform bonegraft from the iliac crest was placed in the cavity and the success rate was 80%. The findings after palliative treatment of 43 non unions of the scaphoid are based on subjective criticisms by the patients. The denervation of the wrist and the wrist arthrodesis were done in 28 cases. After resection of the necrotic proximal fragment, a tendon interposition arthroplasty was performed in nine cases, and in six cases a prosthesis for the proximal part of the scaphoid was implanted. PMID- 3319822 TI - [Pseudarthrosis of the scaphoid bone and carpal instability. Correlations- development--consequences]. AB - In combination with its ligamentous connections, the scaphoid bone represents an essential stabilizing factor within the wrist. This stabilizing function disappears after trauma causing a displaced fracture of the scaphoid bone or extensive rupture of ligamentous structures fixing the scaphoid in its position. Hence carpal instability results, detectible radiographically by alteration of defined wrist angles. Since this is so, one might suppose that, together with other wellknown reasons, carpal instability would be of great importance in the development of a scaphoid nonunion. However, after evaluation of 76 cases, a scaphoid nonunion with carpal instability was found in only 27.6%. Moreover, surgical treatment of the scaphoid nonunion alone does not correct the abnormal wrist angles. Despite this observation, we do not consider simultaneous ligamentous repair to be necessary, because few problems remained after bony healing in such cases. PMID- 3319823 TI - [Results of vascular pedicled bone transposition in advanced necrosis of the lunate bone]. AB - Beck (1971) recommended transposition of the pisiform bone into the lunate bone for treatment of lunatomalacia in stage I. In the period from 1979 to 1983, this operation was carried out in 12 patients with lunatomalacia in the Orthopaedic Division, University of Heidelberg-Schlierbach. The operation was carried out in five patients with stage II, six patients with stage III and in one patient with stage IV. In five patients, the operation was carried out in combination with shortening of the radius and in one patient in combination with wrist denervation. The transponants healed in all patients. However, restoration of the bone structure and the form of the lunate bone could only be attained after radius shortening. Special attention must be paid to the variance of the forearm bones in selecting the correct procedure in lunatomalacia. PMID- 3319824 TI - [Long-term results of conservatively operated necroses of the lunate bone]. AB - The authors present a follow-up of 21 patients treated surgically for lunate bone necrosis on average 19.1 years prior to evaluation. A procedure is called conservative when the shape of the lunate is not destroyed by the operation and the mechanism of the wrist is preserved. This paper shows that these methods are indicated in early stages of Kienbock's disease, but despite some satisfied patients they show generally poor results when used for the late stages with fractured lunate and degenerative signs of the entire carpus. Emphasis should be put on the need for early diagnosis of obscure wrist pain to make early treatment possible, in order to avoid later limitation in the range of motion of the carpus. The authors also report their application to the lunate and its problems of Ficat's measurement of bone marrow pressure in necrosis of the femoral head. PMID- 3319826 TI - [Cardiovascular effects of salbutamol (Ventolin)]. PMID- 3319825 TI - [Special vascular anastomoses for microsurgery]. AB - Various techniques for vessel anastomoses in microvascular surgery are described. Using modified techniques, safe vascular anastomoses can be achieved even in relatively inaccessible sites. Techniques to overcome problems caused by differing vessel diameters are also shown. End-to-end and end-to-side anastomoses using continuous sutures and single sutures are described. To simplify anastomoses of multiple vessels--for example in the case of a radial forearm flap or dorsalis pedis flap--techniques are described which allow larger anastomoses in simple end-to-end and end-to-side connections. PMID- 3319827 TI - [Hypertensive disorders in pregnancy]. PMID- 3319828 TI - [Malignant tumors in pregnancy]. PMID- 3319829 TI - [Breast reconstruction after mastectomy--why who, when and how]. PMID- 3319830 TI - [Biological aspects of suicide]. PMID- 3319831 TI - [Pathogenetic and therapeutic aspects of rapidly progressive glomerulonephritis]. PMID- 3319832 TI - [The adrenoreceptor system]. PMID- 3319834 TI - [Hypertrophic osteoarthropathy and malignancy]. PMID- 3319833 TI - [Treatment of juvenile rheumatoid arthritis]. PMID- 3319835 TI - [Benign recurrent intrahepatic cholestasis]. PMID- 3319836 TI - [Effects of dietary protein restriction on the progression of renal failure in diabetes]. PMID- 3319838 TI - [Current concepts in immunological tolerance and auto-immunity]. PMID- 3319837 TI - [Pre-operative diagnosis of pseudomyxoma peritonei]. PMID- 3319839 TI - [Immune complexes and pregnancy]. PMID- 3319840 TI - [Visual display units and the eyes]. PMID- 3319841 TI - [Infections caused by opportunistic mycobacteria]. PMID- 3319842 TI - [Which types of ventricular tachycardia are responsive to verapamil?]. PMID- 3319843 TI - Storage of Candida albicans, C. tropicalis and related species in liquid nitrogen. AB - Storage in liquid nitrogen of a collection of C. albicans, C. tropicalis and related species checked by numerical and classical taxonomy is described. Strains stored for 3 years in liquid nitrogen were thawed and their survival was tested. After adaptation and regeneration, their fermentation and assimilation spectra, production of chlamydospores and pseudomycelia, appearance and radial growth rate of giant colonies were investigated and compared with the properties of cultures stored under paraffin oil. It follows from the results obtained that two different media--with an increased content of a nitrogen source and with an increased carbon source content--should be used for the post-heating adaptation and regeneration of yeast cells. In some strains it is useful to store them at 4 degrees C for additional time intervals in order to increase survival of the cells. The above strains can be successfully stored in liquid nitrogen. PMID- 3319845 TI - Jan Evangelista Purkyne and his contribution to the development of histology and embryology. PMID- 3319846 TI - The distribution of class II molecules in the pig intestine. PMID- 3319844 TI - Monoclonal antibodies against pig transferrin. Blocking and binding activity. AB - Monoclonal mouse anti-pig transferrin antibodies PTF-01, PTF-02 and PTF-03 and anti-human transferrin antibody HTF-14 detect transferrin coupled with Sepharose particles in an indirect immunofluorescence test. Only the PTF-03 antibody can be used for immunofluorescence detection of pig transferrin bound to specific receptors on the plasma membrane. The binding of iodinated pig transferrin to PK cells was studied. It could be blocked by non-labelled transferrin in excess, by pig serum or by anti-pig transferrin monoclonal antibodies. PTF-03 expressed the lowest blocking activity among the antibodies tested. PMID- 3319847 TI - Recapitulation changes in the course of evolution. PMID- 3319848 TI - Rates of evolution and their recapitulation. PMID- 3319849 TI - [Bile acid metabolism in pathologic conditions. Bacterial small intestine colonization, chologenic diarrhea and syndrome of the stagnating gallbladder]. PMID- 3319850 TI - [A new dihydroergotoxine preparation for hypertension in the aged. Study of effectiveness and tolerance in a placebo-controlled trial]. PMID- 3319851 TI - [Melancholia as a secondary disease. On the coincidence of endogenous depression with another psychiatric disease]. AB - Melancholias (endogenous depression) not only occur in previously psychically healthy individuals, but also in patients with neurotic and personality disorders, in addicted patients, schizophrenics, in brain-damaged patients and psychically ill geriatric patients, epileptics and mentally handicapped. This concurrence has received little attention in the past; dual diagnoses are still uncommon in psychiatry. The nosological, diagnostic and therapeutic implications are discussed. PMID- 3319852 TI - [Metabolic disorders in neurological diseases]. PMID- 3319853 TI - Cutaneous leiomyosarcoma--report of a case, immunohistochemical study and a review of literature. PMID- 3319854 TI - [Lung transplantation]. PMID- 3319856 TI - [Kidney transplantation]. PMID- 3319855 TI - [Current status in clinical liver transplantation]. PMID- 3319857 TI - [Transplantation immunity]. PMID- 3319858 TI - Effect of exercise training on insulin and glucagon release from perfused rat pancreas. AB - The effect of physical training on insulin and glucagon release in perfused rat pancreas was examined in the spontaneously exercised group running in a wheel cage an average of 1.4 km/day for 3 weeks and in the sedentary control group kept in the cage whose rotatory wheel was fixed on purpose. Pancreatic immunoreactive insulin (IRI) responses to glucose and arginine were reduced by 28% and 47.8% respectively in trained rats compared with untrained rats, while IRI content of the pancreas was similar in these two groups. The demonstrated decrease in insulin secretion of the beta-cell of the trained rats, in response to the glucose and arginine stimulations, may be functional in nature. On the other hand, neither pancreatic glucagon immunoreactivity (GI) response to glucose and arginine nor GI content of the pancreas was modified by exercise training. These results demonstrate that exercise training reduces IRI responses to glucose as well as to arginine stimulations, but does not modify any secretory response of pancreatic GI. PMID- 3319859 TI - Sustained normoglycemia and remission phase in newly diagnosed type I diabetic subjects. Comparison between continuous subcutaneous insulin infusion and conventional therapy during a one year follow-up. AB - After onset of type I diabetes 7 diabetics were randomized to subcutaneous insulin pump treatment (CSII) (age 12 to 29 years, mean: 21 years) and 7 diabetics to conventional insulin treatment (CI) (age 14 to 28 years, mean: 21 years). HbA1, glycosylated serum proteins and mean blood glucose (MBG) as parameters of metabolic control were determined monthly. After 2 months both groups showed HbA1 values in the normal range. Mean MBG values were (mean +/- SD) 116 +/- 7 mg/dl for CSII and 118 +/- 14 mg/dl for CI. Residual insulin secretion was determined monthly by fasting C-peptide. After 14 days, 5, 7, 8 months fasting C-peptide values were significantly (P less than 0.05) higher in CI. After one year fasting C-peptide was comparable in both groups (CSII and CI mean: 0.06 nmol/l). The administered insulin dose was comparable in both groups with a 55% reduction of insulin dose after 5 months in CSII (0.35 +/- 0.15 U/kg/24 h) and in CI after 7 months (0.31 +/- 0.28 U/kg/24 h). After 12 months of insulin therapy about 60% of the initial insulin dose was injected in both groups. 1 patient on CSII (12 years) and 2 patients on CI (15, 28 years) showed a complete remission (for 3-9 months) with no exogenous insulin and normal HbA1 values. 50% of the patients had episodes where they did need less than 0.2 U/kg/24 h insulin to maintain optimal diabetic control (3 CSII, 4 CI). During the first year of insulin treatment in type I diabetes with CSII as well as with CI a comparable near normalisation of diabetic control could be achieved. PMID- 3319860 TI - Blood glucose and free insulin levels after the administration of insulin by conventional syringe or jet injector in insulin treated type 2 diabetics. AB - The levels of blood glucose and free insulin were compared in 20 diabetic subjects (type 2) receiving one dose of a combination of fast-acting and intermediary-acting insulins in the morning by means of a needle syringe or a jet injector (SICIM, Italy), using minimum possible injecting power. A shift to the left in the free insulin profile, consequential to different pharmacokinetic characteristics of insulin when administered by means of a jet injector, was observed, although no significant differences were seen for free insulin levels. Statistically significantly higher blood glucose values (P less than 0.05) were recorded 6 and 9 h after insulin administration by means of a jet injector, as well as statistically significant higher MBG values (P less than 0.05), thus indicating a faster and shorter effect achieved in comparison to that produced by the syringe injected insulin. CONCLUSIONS: 1. When switching the method of insulin administration in patients from needle syringe to jet injections the power of the jet injector should be increased (it can be set in three different levels). If that is not possible, because of patient skin characteristics then the dose of intermediary acting insulin should be slightly increased. 2. No local or general side-effects were registered using minimum injecting power of jet injector. 3. The results of the controlled poll have shown that this method of insulin administration is less painful and simpler for patients. The great majority of the patients would like to possess a jet injector. PMID- 3319861 TI - Unchanged insulin secretion and glucose tolerance but increased insulin clearance during long-term calcium antagonism with felodipine in essential hypertension. AB - Studies were performed to explore the effect of calcium antagonism with felodipine for 8 weeks on glucose homeostasis and serum lipids in 8 patients with essential hypertension. Fasting levels of blood glucose as well as serum C peptide, insulin, glucagon and free fatty acids were unchanged following felodipine. During an intravenous glucose tolerance test, the incremental area under the curve for C-peptide and glucose was unchanged, but decreased for insulin, after felodipine. The decremental area over the curve for glucagon and free fatty acids remained unchanged. Fasting serum total cholesterol and high density lipoprotein cholesterol were unaltered, whereas triglycerides decreased following felodipine. The findings indicate that calcium antagonism with felodipine does not affect glucose-induced insulin release in vivo. The increased insulin clearance could be expected to be coupled to a change in glucose tolerance, but this was unaltered during long-term calcium antagonism. PMID- 3319862 TI - Impaired glucose metabolism in heroin and methadone users. AB - Plasma glucose and insulin responses to both oral and intravenous glucose stimulation were evaluated in heroin and methadone addicts, compared to healthy control subjects. Both groups of addicts had an altered response to oral and intravenous glucose load. These phenomena were linked to a reduced insulin response. Moreover, increased fasting insulin levels in both groups of addicts were observed. These data show that both heroin and methadone addiction may alter glucose metabolism, and, furthermore, stress the findings of similarities between opiate addicts and non-insulin dependent diabetics. PMID- 3319863 TI - Insulin secretion induced by allogeneic lymphocytes. PMID- 3319864 TI - Allogeneic and autologous bone marrow transplantation for acute leukemia and malignant lymphoma: current status. AB - The current status of autologous and allogeneic marrow transplantation for acute leukemias and malignant lymphoma is reviewed and compared to the current status of conventional chemotherapy. Based on the reviewed literature, it is concluded that marrow transplantation and conventional chemoradiotherapy are not mutually exclusive and that for most young patients with acute hematological malignancies the question is not if, but rather when to intervene with a marrow transplant treatment. Thus marrow transplantation and conventional chemoradiotherapy can work as complimentary units in the complex therapeutic approach needed to cure most patients with hematological malignancies. PMID- 3319865 TI - Bone marrow transplantation--the Marsden experience. PMID- 3319866 TI - Treatment of severe aplastic anemia by bone marrow transplantation. PMID- 3319867 TI - Bone marrow transplantation for chronic myeloid leukaemia. PMID- 3319868 TI - The potential value of very intensive therapy with autologous bone marrow rescue in the treatment of malignant lymphomas. AB - Autologous bone marrow transplantation (ABMT) following intensive therapy regimes is being used increasingly in relapsed lymphomas. To date no randomised studies have been performed to ascertain the value of this form of therapy. We describe here our experience of ABMT in both Hodgkin's disease and Non-Hodgkin's Lymphoma and review the situations in which we believe future randomised studies should be based. PMID- 3319870 TI - The nature of breast dense core granules: uranaffin reactivity. AB - In this study breast tissue that contained ultrastructural dense core granules has been examined from 24 patients. The possible neuroendocrine characteristics of the granules were studied using the uranaffin reaction and an ultrastructural argyrophil stain. The tissue included 15 breast carcinomas and nine benign samples. Two types of breast dense core granules can be distinguished on the basis of intracellular distribution patterns and histochemical reactivity. Type I dense core granules are the most common and they were found subluminally distributed in non-pathological tissues and benign lesions as well as carcinomas. They were uranaffin-negative and are unlikely to be of endocrine nature. Type II dense core granules were found only in four carcinomas, where they occurred abundantly throughout the cytoplasm. These granules were uranaffin-positive and argyrophilic and thus exhibited characteristics consistent with neuroendocrine structure. PMID- 3319869 TI - A histological and immunocytochemical study of lymphoid tissue in rectal biopsies from homosexual men. AB - A histological study of the lymphoid tissue of the rectums of 323 homosexual and 30 heterosexual men (including five intravenous drug users seropositive for human immunodeficiency virus, HIV) was undertaken. Marked lymphoid hyperplasia (germinal centre greater than 680 microns in diameter) was found in 13 men, nine of whom had a sexually transmitted infection of the rectum. Immunocytochemical studies showed that the germinal centres contained B-cells and follicular dendritic cells, surrounded by CD4+ and CD8+ T-cells in a ratio of between 5:1 and 10:1. In HIV-infected men there were decreased numbers of CD4+ cells and increased numbers of CD8+ cells, resulting in a ratio of between 0.8:1 and 2:1. In biopsies from four of seven HIV-infected men the follicular dendritic cell processes appeared shorter and fragmented. The pathogenesis of HIV infection is discussed in the light of these findings. PMID- 3319871 TI - Langerhans cell histiocytosis: an unusual case illustrating the value of immunohistochemistry in diagnosis. AB - The morphological features of Langerhans cell histiocytosis (histiocytosis X) are characteristic but the diagnosis can on occasion be difficult. A case is presented that illustrates the diagnostic value of immunohistochemistry in the differential diagnosis of this condition. The cells of Langerhans cell histiocytosis were found to express CD1, CD4, CD11b and CD11c. They also reacted with EBM11, UCHM1, KB61 and HLA-DR. Occasional cells showed nuclear staining with Ki67, but no other lymphoid antigens were detected. Immunoreactivity of the cells of Langerhans cell histiocytosis with antibodies that recognize antigens present on macrophages provides further evidence for immunological similarities between these cell types. PMID- 3319873 TI - Hodgkin's disease. PMID- 3319872 TI - NCRC-11 immunoperoxidase staining patterns in breast cancer: interpretive and technical reproducibility. PMID- 3319874 TI - Causes of stress and burnout in physicians caring for the chronically and terminally ill. PMID- 3319876 TI - Stress and burnout in the social world of hospice. PMID- 3319875 TI - Turnover in national hospice study sites: a reflection of organizational growth. PMID- 3319877 TI - A model of job stress and burnout. PMID- 3319879 TI - Substance abuse in the elderly: alcohol and prescription drugs. PMID- 3319880 TI - Partial hospitalization: a review of recent literature. AB - The author reviews recent studies on the evaluation of partial hospitalization programs in North America and Europe. The lack of a clear definition of partial hospitalization is one of the factors leading to its underutilization, many authorities believe. After discussing the nomenclature and emphasizing the importance of classifying programs by function--day hospitals, day treatment programs, and day care centers--the author reviews the recent literature and makes recommendations in the framework of this nomenclature. PMID- 3319878 TI - Conceptualizing stress, coping, and illness management in heart disease caregiving. PMID- 3319881 TI - Comparison of computer- and interviewer-administered versions of the Diagnostic Interview Schedule. AB - A group of 150 psychiatric patients were administered the Diagnostic Interview Schedule (DIS) on two occasions, once by a trained layperson and once using a computerized interview format in which the patient interacted directly with the computer. Agreement between the two methods on 15 diagnoses was relatively modest, as indicated by a mean kappa score of .51, but was similar to agreement rates reported in other studies of the DIS. The discrepancies may have been due to the high number of acutely ill inpatients studied, patients' reporting more symptoms in one of the interviews, and difficulty translating some of the DIS questions to the computer. Patients had positive feelings about both methods, but a significant majority liked the computer interview better and found it less embarrassing. The authors conclude that computerized administration of the DIS is as reliable as other methods but that exclusive reliance on the DIS for clinical diagnosis is inappropriate. PMID- 3319883 TI - The human sex ratio. Part 1: A review of the literature. PMID- 3319882 TI - Evaluation of a computerized version of the Diagnostic Interview Schedule. AB - An interactive, computerized version of the Diagnostic Interview Schedule (DIS) was completed by 135 randomly selected psychiatric inpatients and evaluated by the patients and their psychiatrists. The results showed that the majority of the patients interacted well with the computer and that the treating psychiatrists found the computer reports generally accurate and helpful. Analysis of the agreement between the computer and the psychiatrists' diagnoses yielded mixed results depending on the method of analysis chosen. The thoroughness, consistency, and broad perspective of the computer interview combined with the insight, creativity, and experience of the well-trained clinician may ultimately provide a method of diagnosis that is superior to either used alone. PMID- 3319885 TI - Current density profiles of surface mounted and recessed electrodes for neural prostheses. PMID- 3319884 TI - Microdissection and microcloning from the proximal region of mouse chromosome 7: isolation of clones genetically linked to the pudgy locus. AB - Microdissection and microcloning have been utilized in order to create a bank of clones from the proximal region of mouse chromosome 7. Several important loci map to this area, including the albino locus (c), pink-eye dilution (p), and the developmental mutant, pudgy (pu). By use of interspecific crosses between Mus musculus domesticus and Mus spretus, we have generated backcross progeny segregating for the mutations chinchilla (cch) and pink-eye dilution (p). Exploiting the evolutionary divergence between the two species, we have analyzed the inheritance of restriction fragment length variants of three microclones and their linkage to the two markers cch and p, respectively. All three clones studied map to the dissected region, and as such also show genetic linkage to the pudgy locus. This bank of chromosome 7-derived microclones should provide molecular start points for the isolation of a variety of developmental loci of unknown gene product, including the pudgy locus. PMID- 3319886 TI - Women and the Vietnam experience. PMID- 3319887 TI - Preschool development very low birthweight infants. PMID- 3319889 TI - Imprint career planning guide. Directory of nursing review books/review courses for NCLEX. PMID- 3319890 TI - Imprint's directory of nurse internship programs. PMID- 3319888 TI - A basis for prospective payment for home care. PMID- 3319892 TI - Career opportunity profiles. PMID- 3319891 TI - Nursing organizations. PMID- 3319893 TI - Sediment cytology of cervical & breast biopsies. PMID- 3319894 TI - Prosthodontic considerations in the surgical planning for maxillectomy & mandibulectomy patients. PMID- 3319896 TI - Mast cells in nasal smears & biopsies in allergic & non-allergic rhinitis. PMID- 3319897 TI - Sonographic placental grading in normal pregnancies. PMID- 3319895 TI - Non-Hodgkin's lymphoma. A comparison of the working formulation with the Rappaport classification. PMID- 3319898 TI - Serum ferritin levels in normal Indian subjects. PMID- 3319900 TI - Hemolytic uremic syndrome associated with Salmonella typhimurium. PMID- 3319899 TI - Effect of captopril and hydralazine on arterial pressure-urinary output relationships in spontaneously hypertensive rats. AB - Angiotensin I converting enzyme inhibitors are typically classified as peripheral vasodilators. We studied the effect of captopril and a known vasodilator, hydralazine, on arterial pressure-urinary output relationships in adult spontaneously hypertensive rats to determine whether these drugs produced similar changes in this relationship. Tail-cuff pressure and 24-hour urine output and sodium excretion were measured under steady state conditions during ingestion of tap water or saline (1% NaCl) ad libitum. Sodium intake increased seven to nine times when rats drank saline, but in the absence of drug treatment, tail-cuff pressure was not altered significantly (water, 213 +/- 3 vs saline, 220 +/- 5 mm Hg). Daily administration of captopril (100 mg/kg p.o.) or hydralazine (15 mg/kg p.o.) for 2 weeks lowered tail-cuff pressure significantly (175 +/- 3 and 166 +/- 3 mm Hg, respectively; p less than 0.01) while rats drank tap water. Continued administration of hydralazine plus 2 weeks of drinking saline did not alter tail cuff pressure (162 +/- 4 mm Hg), but with the addition of saline during captopril treatment, tail-cuff pressure was elevated significantly (210 +/- 5 mm Hg; p less than 0.01). Thus, hydralazine produced a parallel shift of the arterial pressure urinary output relationship along the pressure axis. In contrast, captopril produced a marked change in the slope of this relationship, making arterial pressure extremely salt-sensitive. The results suggest that the two drugs have different effects on the mechanisms that contribute to the long-term control of arterial pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3319901 TI - Adipose tissue of morbidly obese patients: clinical implications of distribution, morphology, and metabolism. AB - As a consequence of their increased total adipose tissue mass, morbidly obese patients have many more fat cells than individuals of normal weight and the cells are enlarged compared to normal. Contrary to earlier beliefs, fat cell numbers can increase throughout adult life. Once formed, fat cells do not undergo involution. Thus, it seems that an individual who has reached the morbidly obese state maintains an increased amount of body fat that limits his/her ability to achieve and maintain commonly accepted levels of "ideal" body weight. Recently the distribution of adipose tissue has been shown to be an important predictor of obesity-associated morbidity and mortality in large population studies. A "male" or central distribution of fat is a significant risk factor for the development of diabetes, hyperlipidemia, hypertension, and coronary heart disease. Sex- and site-specific variations in the distribution of adipose tissue cell size and metabolic activity have been demonstrated that may be of etiologic importance for the development of serious comorbid conditions in obesity. PMID- 3319902 TI - Morbid obesity: cardiac evaluation and function. AB - The pathophysiology of heart failure in morbid obesity differs from that found in other types of cardiac disease. This article attempts to clarify the myocardial and hemodynamic derangements in morbidly obese subjects. A diagrammatic schema is used to demonstrate the relationship between abnormal function and signs and symptoms of cardiac disease. Noninvasive methods show promise in documenting the effect of enforced weight loss on cardiac function. PMID- 3319904 TI - Fatty liver disease in morbid obesity. AB - About 90 per cent of morbidly obese patients show histological abnormalities of the liver. One third of patients have fatty change involving more than 50 per cent of hepatocytes. Fatty liver disease can be divided into four histological groups: Fatty liver, fatty hepatitis, fatty liver with portal fibrosis, and cirrhosis. Most patients show only fatty change. Alcohol, drugs, diabetes, poor nutrition, and weight-reducing surgery contribute to progressive liver damage, but morbid obesity alone may lead to severe disease showing all the features of alcoholic hepatitis and may end in cirrhosis and liver failure. The accumulation of fat alone is unlikely to be the stimulus to inflammation and fibrosis. Only one fifth of patients have complaints that arise from the liver. The development of severe fatty liver disease may also be asymptomatic and rarely shows the florid picture associated with alcoholic hepatitis. There is poor correlation of liver function test results with morphology in obesity. ALT levels exceeding twice the normal limit have some predictive value for histological grades of severity, but they are present in few patients. Pericentral and pericellular fibrosis in prebypass liver biopsies may be an important prognostic lesion for the development of fatty hepatitis and cirrhosis. In contrast with the frequent progression to massive fatty change, inflammation and fibrosis after bypass surgery, weight loss by low-calorie dieting, or starvation is accompanied by improvement in fatty change and return of liver function tests to normal. PMID- 3319903 TI - Pulmonary function in morbid obesity. AB - Morbid obesity is not infrequently associated with severe respiratory impairment. In our experience approximately 10 per cent of morbidly obese patients who underwent gastric surgery had severe respiratory impairment. Respiratory insufficiency of obesity can be divided into two primary breathing disorders: the obstructive sleep apnea syndrome (SAS) and the obesity hypoventilation syndrome (OHS). In its most severe form, when both SAS and OHS are present, it is called the Pickwickian syndrome. In our series 59 morbidly obese patients with respiratory insufficiency secondary to obesity underwent gastric surgery for weight reduction. Fourteen had OHS, 19 had SAS and 26 had both. Of these, two patients died of postoperative complications and one died at five weeks with an inconclusive autopsy, totalling an operative mortality rate of 3.4 per cent and a total mortality of 5.1 per cent. In our overall experience morbidly obese patients lost 67 per cent of excess weight after gastric procedures. In conclusion, surgically induced weight loss will markedly improve or correct respiratory insufficiency secondary to obesity. It will improve arterial oxygenation, minimize CO2 retention, expand lung volumes, correct polycythemia, and reduce apnea frequency. The magnitude of changes in these variables is clinically significant. Therefore, respiratory insufficiency of obesity should be considered a major indication for an aggressive approach to weight reduction. The jejunoileal bypass and unbanded gastroplasty operations have an unacceptable incidence of complications or failure, respectively. There is a high degree of recidivism following dietary programs. Sweets eaters will not do well with a gastroplasty procedure. Gastric bypass for individuals addicted to sweets or the vertical banded gastroplasty for "gorgers" are currently our procedures of choice and are associated with the average loss of two thirds of excess weight and correction of breathing problems associated with morbid obesity. PMID- 3319905 TI - Overview of surgical techniques for the treatment of morbid obesity. AB - A brief review of current and antecedent surgical techniques is presented with advantages and disadvantages of the most common operations. PMID- 3319906 TI - Malabsorptive procedures in surgical treatment of morbid obesity. AB - There is no ideal operation for morbid obesity and there probably never will be one. The disease is multifaceted, with unknown polyfactorial etiology. The multitude of surgical methods attests to the frustrations in trying to palliate the morbidly obese. Gastric restriction on its own is proving inadequate for the heaviest patients ("super obese"), for patients with preferences for "sweets," and for patients who have had failure of previous surgery, whether it be jejunoileal bypass or gastroplasty. The current trend toward performing malabsorptive procedures is symptomatic. Experimentation with varying sizes and configurations of gastric remnants in combination with varying lengths of small intestine in continuity is reminiscent of the early experience with jejunoileal bypass. That era has been called by some respected and influential surgeons the "dark ages of surgery." Very few of the tens of thousands of patients would agree with this assessment. Nevertheless, Payne was convinced that the "malignant abuse of all of these operations. . . could result in the abandonment of the only practical method. . . for the treatment of the morbidly obese patient." Jejunoileal bypass operations can be "salvaged" by vigorous medical management. When that fails, there are several surgical options for dealing with the blind loop, short of reanastomosing the bowel. New malabsorptive operations have been developed and are being rigorously scrutinized by relatively few dedicated surgeon-scientists. The most important lesson learned from the many severe late complications of jejunoileal bypass is that operations for morbid obesity need to be studied intensely and for a sufficiently long period of time before they can be considered ready for routine use. PMID- 3319907 TI - Vitamin and mineral deficiencies following obesity surgery. AB - Any obesity operation, whether malabsorptive or based upon the production of early satiety, produces weight loss by causing a net reduction in the delivery of nutrients to the portal circulation. The malabsorption caused by jejunoileal bypass produces numerous severe micronutrient deficiencies along with other potentially damaging conditions. Although there are numerous reports of such deficiencies following gastric restrictive procedures (particularly gastric bypass), the conditions are almost always more easily treated than those after intestinal bypass, and resultant clinical illnesses are rare. Physicians should be aware that any obesity procedure carries a risk of nutritional deficiency. PMID- 3319908 TI - The use of endoscopy after gastric partitioning for morbid obesity. AB - Fiberoptic endoscopy is an important diagnostic modality for evaluating the patient with upper gastrointestinal tract symptoms following gastric restrictive operations. The specific indications for endoscopy after obesity surgery include stoma evaluation in patients who fail to lose adequate weight; stomal stenosis; esophagitis; surveillance of the excluded pouch; and suspicion of a marginal ulcer after gastric bypass. PMID- 3319909 TI - Radiology of obesity surgery. AB - Modern imaging modalities are the key to prompt evaluation of the efficacy and complications of obesity surgery. These are divided into the early and late complications of gastric restrictive surgery and intestinal bypass surgery. PMID- 3319910 TI - Radionuclide imaging in morbid obesity. AB - Radionuclide studies of the upper gastrointestinal tract have been useful in many gastrointestinal disorders. However, the literature relating to radionuclide techniques in morbid obesity is limited and, at times, controversial. It is hoped that this brief review will stimulate interest in the use of tracer techniques in this complex disorder. PMID- 3319911 TI - Q fever in Europe: current aspects of aetiology, epidemiology, human infection, diagnosis and therapy. PMID- 3319913 TI - Chest physiotherapy--the mechanical approach to antiinfective therapy in cystic fibrosis. AB - Chest physiotherapy is a treatment program that attempts to compensate for impaired mucociliary clearance. By removing mucopurulent secretions, it reduces airway obstruction and its consequences, such as atelectasis and hyperinflation; furthermore, physiotherapy can decrease the rate of proteolytic tissue damage by removing infected secretions. Conventional physiotherapy (clapping, vibration and compression, together with postural drainage and assisted coughing) is the most efficient physiotherapy for sick infants and young children. Later, mechanical chest percussion can reduce the patient's dependency on others. The forced expiration technique is another method of self-treatment, employing expiratory techniques to blow secretions out of the bronchi. Autogenic drainage, a special breathing technique, aims at avoiding airway compression by reducing positive expiratory transthoracic pressure. PEP-mask-physiotherapy achieves the same goal by expiring against an external airflow obstruction. Last but not least, physical exercise can clear the lungs of some CF patients and thus offers an attractive adjunct to physiotherapy. PMID- 3319912 TI - Recurrent urinary infections in women: clinical trial of cephradine as a prophylactic agent. AB - Cephradine 250 mg at night for 12 months was given as a prophylactic measure to 33 female patients of mean age 41.6 years, who had a history in the preceding 12 months of between three and 24 (median = 7) episodes of frequency and/or dysuria. When on such treatment the mean period between symptomatic attacks was 300 days, while before treatment attacks occurred at a mean frequency of 60.3 days. Thus, prophylactic cephradine increased the interval between attacks five-fold. In a total of 9002 patient-days of treatment, only five bacteriuric breakthrough infections occurred. 27% of the patients reported adverse effects "probably" or "possibly" related to treatment. Hence, cephradine appears to be as effective and better tolerated than macrocrystalline nitrofurantoin, presently the drug of choice for the prophylaxis of recurrent urinary infections. PMID- 3319915 TI - Sperm separation techniques. PMID- 3319916 TI - Comparison between a swim-up and a Percoll gradient technique for the separation of human spermatozoa. AB - Two methods of separating human sperm were compared using twenty-two semen samples. The sperm were separated by a swim-up technique or by self-migration on a Percoll gradient followed by medium change. After separation, the sperm obtained were assessed for progressive motility, ATP content, energy charge index ([ATP + 0.5 ADP]/[ATP + ADP + AMP]) and morphology. In general, and especially for semen samples containing less than 20 X 10(6) sperm/ml, separation by Percoll gradient selected sperm that were superior to those separated by the swim-up technique. The relatively high energy charge index (greater than 0.8) showed that the sperm tolerated the separation conditions well. It is suggested that self migration on a Percoll gradient should prove useful for obtaining sperm of high quality. PMID- 3319914 TI - High dose treatment with antibiotics in cystic fibrosis--a reappraisal with special reference to the pharmacokinetics of beta-lactams and new fluoroquinolones in adult CF-patients. AB - In this review we analyzed the pharmacokinetic basis for high dose treatment with antibiotics of patients with cystic fibrosis. Both our results and those from other well designed pharmacokinetic studies do not support the view that low blood levels of antibacterials are a common feature of CF. We were unable to detect a decrease in absorption, nor could we find evidence for enhanced elimination of antibacterials in CF. Both these factors have been considered responsible for reducing the plasma (and tissue) levels of antibiotics. Most recent studies on kidney function are in agreement with these findings, since neither inulin nor creatinine clearance differ between CF-patients and healthy volunteers. In contrast to previous discussion, the volume of distribution (Vdss) was not elevated for any compound. The rational of weight correction of volume terms like Vdss or total clearance has never been clearly demonstrated and should therefore not be used without prior proof of relevance. Since the variability of pharmacokinetic parameters of antibiotics in CF-patients may be considerable, we suggest that a dose increase of 20-30% may be justified, but cannot agree with two to fourfold increases in dosage as previously proposed and applied in many CF centers. Until more findings become available for non-adult CF-patients, these conclusions are only valid for adult CF-patients. PMID- 3319917 TI - The control-of-consumption approach to alcohol abuse prevention. II. A review of empirical studies. AB - Key empirical studies of the postulates of the single-distribution theory and the associated control-of-consumption approach are reviewed. The review is organized in terms of the six links possible between the four variables of the "Ledermann string" (availability, average consumption, proportion of heavy consumers, and prevalence of damage) presented in Part I. It is concluded that, on the whole, the available evidence is too inconsistent to support the control-of-consumption approach and that a more comprehensive understanding of alcohol abuse and prevention is needed. PMID- 3319918 TI - Steroids and tuftsin fail to prevent the induction of altered plasma proteinase homeostasis in mice bearing the B16 melanoma or treated with C. parvum. AB - The effects of tuftsin and steroids (methyl prednisolone) on the induction of disrupted plasma proteinase regulation in mice bearing the B16 melanoma or treated with Corynebacterium parvum was investigated. Tuftsin treatment inhibited tumor progression only if treatment was started at the time of tumor transplantation. However, tuftsin inhibited the development of splenomegaly in mice with established tumors. In contrast, tuftsin did not influence either the induction of elevated plasma proteinase activity or the activity in plasma from animals with established tumors. Treatment of mice with high, anti-inflammatory, doses of steroid (20 mg/kg/day) partially inhibited tumor progression, inhibited the induction of splenomegaly, but did not inhibit the induction of disrupted plasma proteinase regulation. Likewise, steroid treatment did not suppress the induction of elevated plasma proteinase activity following treatment of mice with C. parvum. Thus the induction of elevated plasma proteinase activity, previously demonstrated to be a host regulated phenomenon, is resistant to regulation by this anti-inflammatory drug and likely not a component of the anti-tumor response. These findings raise the possibility that this phenomenon results from the interaction of activated RES elements with components of the plasma proteinase cascades. PMID- 3319919 TI - Economic rights of the institutionalized mentally disabled. PMID- 3319921 TI - Isolation and amino acid sequence of insulins and C-peptides of European bison (Bison bonasus) and fox (Alopex lagopus). AB - Insulins and C-peptides were extracted and purified from bison and fox pancreatic glands. The insulins were reduced and pyridylethylated, and the derived A- and B chains separated by HPLC. Amino acid sequence determinations of the pyridylethylated A- and B-chains proved bisontine insulin to be identical to bovine insulin and fox insulin to be identical to dog and porcine insulin. Bisontine C-peptide proved to be identical to bovine C-peptide. The isolated fox C-peptide comprises 23 amino acid residues and probably represents a major tryptic fragment of a larger C-peptide. The fox C-peptide fragment is identical to the dog C-peptide (9-31) except for residue 3 (residue 11 in the dog C peptide), which is aspartic acid as compared with glutamic acid in the dog C peptide. PMID- 3319920 TI - Estrogen receptor localization in formalin-fixed, paraffin-embedded endometrium and endometriotic tissues. AB - Monoclonal estrogen receptor (ER) antibody and indirect immunoperoxidase techniques were used to study the immunohistochemical localization of ER in paraffin sections of 20 surgical specimens containing foci of endometriosis. The eutopic endometrium, available in 16 of 20 cases, was dated histologically and stained for ER. Specific nuclear staining was observed in glandular and stromal cells of the endometrium during the proliferative and early secretory phases. Mid and late secretory phase endometria showed only focal staining. Dating of the endometriotic tissues using morphologic criteria revealed that these were in phase with the endometrium in nine of 16 cases. In these cases the ER staining of both the endometriotic tissues and endometrium was similar. The endometriotic tissues could not be dated as either proliferative or secretory in seven cases and stained variably for ER. Diffuse nuclear staining for ER was present in the endometriotic glands of three of these cases in which the endometriotic glands morphologically resembled glands of the basalis contrasting with weak, focal staining in the corresponding eutopic secretory endometria. The majority of endometriotic tissues examined mimicked the cyclic ER expression of the eutopic endometrium and thus appeared to correspond to the morphologic appearance of the endometriotic glands. Immunohistochemical staining with monoclonal estrophilin antibodies may be helpful in supporting the histopathologic diagnosis of endometriosis. PMID- 3319922 TI - Interaction of factors modifying the radiosensitivity of dormant seeds: a review. AB - A review is presented on modification of radiation-induced effects in dormant plant seeds. Possible sources of discrepancy of data in the earlier literature are analysed. Approaches to the correct experimental study of mechanisms of interaction of environmental factors in the modification of radiobiological reactions are discussed. Progress in the radiation biology of plant seeds, achieved by precise control of experimental conditions, is considered. PMID- 3319923 TI - Radiation sensitization of E. coli B/r by mixtures of oxygen and nitrous oxide. AB - Oxygen (O2) sensitizes bacterial cells in at least two mechanistically different ways, depending on the specific O2 concentration present during irradiation. Based on previous work from this laboratory, it has been proposed that nitrous oxide (N2O) and low concentrations of O2 share a common mechanism for damage. This mechanism, involving the production of superoxide anion radicals (O2-), is different from that which causes damage at high O2 concentrations. Others, however, have presented evidence that N2O and O2 (usually tested only at high concentrations) act in different ways to sensitize bacterial cells. We have now measured the radiation sensitivity in mixtures of N2O and O2 to observe additivity patterns and to determine if these two agents have any common processes for sensitization. We found that some low O2 concentrations do not increase the response in N2O, although they can have significant sensitizing effects in N2. This lack of additivity is taken as evidence for a common mechanism of damage from N2O and low concentrations of O2. In contrast, damage from high concentrations of O2 is additive to the damage from N2O. The greatest sensitivity, observed with a gas mixture of about 15 per cent O2/85 per cent N2O, is equivalent to the response in 100 per cent N2 plus the maximum amount of damage O2 can cause plus the maximum amount of damage N2O can cause. This additivity is taken as evidence that N2O and high concentrations of O2 sensitize in different ways. Thus, O2 is known to sensitize these bacteria in at least two different ways; one of these is apparently also the way N2O sensitizes. PMID- 3319924 TI - Interaction of whole-body hyperthermia and irradiation in the treatment of AKR mouse leukemia. AB - Whole-body hyperthermia (WBH) to 41-42 degrees C combined with fractionated total body irradiation (TBI) was studied in mice with transplanted AKR leukemia. Mice treated with both TBI and WBH survived longer than mice treated with either modality alone. From other groups of similarly treated mice the spleens were removed, weighed, and assayed for their content of leukemic colony-forming units (CFU) by injecting single-cell suspensions into normal syngeneic recipients. Using this methodology it was determined that the thermal enhancement ratio for WBH combined with TBI was 1.6, and that enhanced killing of leukemia cells occurred irrespective of the sequence of WBH and TBI. Data are presented which relate variables, such as duration of WBH or heating time to target temperature, to the response of neoplastic disease. The implications of these preclinical findings to clinical trials are discussed. PMID- 3319925 TI - Physiological ergonomics in nursing. AB - The majority of physiological ergonomic studies of nursing are concerned with shift- and night-work and associated circadian rhythm adjustments and influences on job performance. The aerobic demand of medical nursing has not been extensively studied. The aerobic capacity of nurses has not been assessed systematically. Studies of this type are clearly required within an ergonomic framework with particular emphasis on the flexibility and (upper body) strength components of nurses functional capacities in relation to the physical demands of nursing tasks. As health educators, the nursing profession should seriously consider taking a practical lead in espousing the ergonomic process and advocating the health benefits of exercise (together with good diet and smoking cessation.) PMID- 3319927 TI - Ergonomic aspects of equipment. AB - Mechanical patient-lifting devices have been available for hospital use for at least the past 100 yr. Mobile hoists have been available since the 1950s and the most common U.K. hospital mobile hoist, the Mecanaids' Ambulift, has been available since 1966. Recent investigations have confirmed that these devices are not being used to any significant extent to ease most of the patient-lifting problems in hospital wards. Attention to four variables, the patient, the attendant, the task and the environment, is essential in determining the right systematic approach to equipment design and selection. PMID- 3319926 TI - An ergonomic approach to stress. AB - The relationships between psychology and ergonomics centre around the concept of stress. This paper outlines the concept that stress is a mismatch between the demands made on an individual and his ability to cope. The nature and theories of stress are reviewed and sources of stress in the nursing profession are analysed. Coping is recognized as a way of reducing the actual or perceived stresses. However, a common method of coping is to disguise the symptoms by taking therapeutic drugs, tobacco or alcohol. It is argued that these methods are a maladaptation since in themselves they can cause illness and death. Evidence of smoking habits in relation to perceived stress in the nursing profession is given. It is concluded that a direct action approach to reduce workplace (organizational) stressors can be achieved by an ergonomic approach to the problem, and that this, if successful, will obviate the need to resort to unhealthy coping mechanisms. Suggestions are put forward as to how some of the major recognised sources of stress in the nursing profession can be analysed and removed by applying ergonomic methods. Shift working is seen by many nurses as a particular stressor. The relationships between lighting quality and circadian rhythm control are discussed as a further example of how an ergonomic solution might be sought. PMID- 3319929 TI - Introducing the Chinese hexiangzhuang (flying crane) qigong therapy. PMID- 3319928 TI - Shamanism, personal mythology, and behavior change. PMID- 3319931 TI - Toward a comprehensive scale of stress assessment: development, norms and reliability. PMID- 3319930 TI - Lifestyle and gastro-duodenal ulcers: a critical review. PMID- 3319932 TI - Is diabetic retinopathy preventable? PMID- 3319933 TI - The epidemiology of diabetic retinopathy: findings from the Wisconsin Epidemiologic Study of Diabetic Retinopathy. PMID- 3319934 TI - Prospects for fetal treatment. PMID- 3319935 TI - Drugs and TB. PMID- 3319936 TI - Intraoperative radiation therapy. PMID- 3319938 TI - Evory Kennedy. PMID- 3319937 TI - Palate development: mechanisms and malformations. PMID- 3319939 TI - Accuracy of duplex scanning in estimating carotid luminal diameter. PMID- 3319940 TI - Medical history. Quain. PMID- 3319941 TI - Sister (? Mary) Joseph's nodule. PMID- 3319942 TI - From heredity theory to Vererbung. The transmission problem, 1850-1915. PMID- 3319943 TI - The disciplinary breakdown of German morphology, 1870-1900. PMID- 3319944 TI - National styles in science. Genetics in Germany and the United States between the World Wars. PMID- 3319945 TI - Neurosurgical, obstetric and endocrine aspects of meningioma during pregnancy. AB - A 34-year-old woman presented with symptoms due to a cerebral meningioma during pregnancy. The meningioma tissue was found to be positive for progesterone but not estrogen receptors. The relationship of meningiomas to pregnancy, female sex, and breast cancer is discussed with emphasis on the presence of hormone receptors in the tumor tissue. The high incidence (39 to 100%) of progesterone receptors in meningiomas may explain the increased percentage of its discovery during pregnancy. Neurosurgical intervention during pregnancy should be confined to cases associated with neurological deficit. Cesarean section is indicated only in the presence of a major intracranial mass effect. PMID- 3319946 TI - Leukocytoclastic vasculitis in malignant lymphoma. Case report and review of the literature. AB - A 76-year-old patient presenting with leukocytoclastic vasculitis and later diagnosed as having diffuse immunoblastic lymphoma is presented. The clinical data of patients with leukocytoclastic vasculitis and lymphoproliferative disease reported in the literature are summarized. Other diseases associated with this form of vasculitis and the proposed pathogenesis are briefly discussed. PMID- 3319947 TI - Captopril and proteinuria in diabetes mellitus. PMID- 3319948 TI - Prostacyclin (PGI2) and thromboxane (Tx) A2: mediators of wound healing. PMID- 3319949 TI - The Beer Sheva experiment--past, present and future. The hospital management viewpoint. PMID- 3319950 TI - The Beer Sheva experiment: an assessment of the first 13 years. PMID- 3319952 TI - A historic look at research in the Ben-Gurion University Center for Health Sciences and Services. PMID- 3319951 TI - The Arad statement. PMID- 3319953 TI - The Visiting Faculty Program--a cornerstone in the development of the University Center for Health Sciences and Services. PMID- 3319954 TI - The Mazabraud syndrome: case report and review of the literature. AB - The authors report a case of Mazabraud's syndrome in a patient aged 57 years with a history of fibrous dysplasia of the skeletal system which had commenced at the age of 10. This became associated with myxomas of the soft tissues at the age of 42. This rare association was described by Mazabraud in 1957. A review of the literature up to 1985 shows that 16 cases have been reported. These are reviewed. PMID- 3319955 TI - Tibial tubercle advancement by the Maquet technique for patellofemoral arthritis or chondromalacia. AB - The authors report 19 operations according to the Maquet technique for patellofemoral arthritis or chondromalacia between 1977 and 1984. The same procedure and technique were used in all cases but the results were better in chondromalacia which were good in 64% of the cases compared with 38% in arthritis. After discussing the problems of clinical and radiographic evaluation, the authors conclude that after a long period of rehabilitation satisfactory results are obtained in chondromalacia, while only limited success is achieved in arthritis. PMID- 3319956 TI - Meissner's corpuscles in reimplanted fingers. A study of the possible correlations between anatomical findings and sensory function tests. AB - A morphometric and immunohistochemical study was carried out on Meissner's corpuscles and nerve fibres of the subpapillary plexus in reimplanted fingers to determine whether there were any correlations between the anatomical findings and the results of clinical tests of sensory function. Before taking biopsy samples, the patients were submitted to tests of receptor function and classified according to the neurophysiological responses. Serial sections of standard thickness were obtained from each sample and the following morphometric parameters regarding Meissner's corpuscles determined: a) density per square millimetre of skin surface; b) size; c) major axes. On some sections, an immunoperoxidase technique for the determination of protein S-100 was used to study the nerve fibres in the subpapillary plexi. The results showed no correlation between the clinical receptor response test and the density of the Meissner's corpuscles, but some relationship was observed between the degree of neural regeneration and the execution of neurorrhaphy at reimplantation. The size and shape of the corpuscles showed wide variations in all subjects. PMID- 3319957 TI - A prisoner in need of a bone marrow transplant. PMID- 3319958 TI - Facial pain of dental origin--a review for physicians. PMID- 3319959 TI - Behavioral research on headaches: a coded bibliography. PMID- 3319960 TI - Five year prospective follow-up on the treatment of chronic headache with biofeedback and/or relaxation. PMID- 3319961 TI - Biofeedback and relaxation training: the effect on headache and associated symptoms. PMID- 3319962 TI - Investing in the wrong future for hospitals. AB - The process of offering hospital debt in public markets is strongly influenced by the feasibility study. The inaccuracy of such studies may produce substantial overinvestment in hospital capital. PMID- 3319963 TI - Management styles and marketing strategies: an analysis of HMOs. AB - The results of a recently conducted national study indicate that a variety of strategic management styles are being pursued by HMOs, and that relationships exist between these styles and marketing strategies. The findings themselves have strategic relevance for HMOs and other health service providers. PMID- 3319964 TI - A hospital administrator's guide to successful HMO negotiations. AB - Many issues must be considered when hospitals negotiate with HMOs. Hospital administrators can improve negotiations with HMOs by understanding the philosophy and terminology of alternative delivery programs, as well as their hospital's own operating requirements. PMID- 3319965 TI - The future role of state hospital associations. AB - Rapid changes in the health care industry are affecting state hospital associations. These associations' leaders are debating their future role in light of these changes. PMID- 3319966 TI - [Psoriasis pustulosa generalisata--classification, clinical aspects and therapy. Review and experiences with 18 patients]. AB - On the basis of clinico-morphological criteria we suggest the following classification of various pustular forms of psoriasis into four subtypes: generalized pustular psoriasis (von Zumbusch) and its atypical forms, erythema anulare centrifugum-like psoriasis with and without pustulation (EACP); psoriasis vulgaris with pustulation; palmo-plantar pustular psoriasis (Konigsbeck-Barber) and its acral variant; acrodermatitis continua suppurativa (Hallopeau), and transitional forms. This classification takes into consideration both clinical aspects and response to treatment, and allows a prognosis of the various types of pustular psoriasis. Owing to its mild course and good treatment results, EACP represents a special form of psoriasis pustulosa generalisata. In our group of patients, systemic glucocorticosteroid therapy has proved deleterious, whereas oral photochemotherapy and etretinate have been found to be highly effective modes of therapy with only mild side effects and have been able to induce even permanent remission in EACP. PMID- 3319967 TI - [Pemphigus vulgaris with esophageal involvement. Case report and review of the literature]. AB - A pemphigus vulgaris patient with esophageal involvement is presented, and eight well-documented cases from the literature are reviewed. The patient's skin had healed, but she still had acute gastroesophageal symptoms and persisting oral lesions. The antibody titers against intercellular substance were low. She thus presented the "classical" picture of pemphigus vulgaris with esophageal involvement. PMID- 3319969 TI - [Striated lupus erythematosus along the Blaschko lines]. PMID- 3319968 TI - [Penicillamine-induced pemphigus]. AB - D-Penicillamine is effective in the treatment of Wilson's disease, cystinuria and rheumatoid arthritis. However, it may have adverse side-effects by inducing a spectrum of diseases such as myasthenia gravis, lupus-like disease, IgA deficiency and pemphigus vulgaris. A case of D-penicillamine-induced pemphigus is presented. The clinical aspects, pathogenesis, immunology and therapy of D penicillamine-induced diseases are discussed. PMID- 3319970 TI - Health education, public policy and disease prevention: a case history of the New York City Coalition to End Lead Poisoning. AB - How can health educators influence public policy so as to increase the resources for disease prevention? The following case history of the New York City Coalition to End Lead Poisoning (NYCCELP) describes how an advocacy group sought to educate parents, health workers and policy makers about a major urban health problem. Using health education techniques such as small group meetings, mass media coverage and community organizing, NYCCELP hoped to persuade city agencies to enforce more systematically existing laws for the prevention of lead poisoning and to allocate more resources for screening and education. By defining the problem of lead poisoning broadly, the Coalition was able to attract diverse constituencies including housing organizations, public health advocacy groups, public interest lawyers, elected officials and children's rights groups. In part as a result of NYCCELP's efforts, the city government has screened more children for lead poisoning, hired additional health educators, enforced relevant sections of the housing code more often, and allocated new resources for lead poisoning control. PMID- 3319971 TI - Focus group interview: an underutilized research technique for improving theory and practice in health education. AB - The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of-the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, literature describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this technique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; applicability of marketing research to understanding and influencing consumer behavior, despite notable distinctions between educational initiatives and marketing; and need for professional preparation faculty to consider increasing emphasis on qualitative research methods. PMID- 3319972 TI - Insulin receptor evaluation in congenital generalized lipodystrophy. Case report of an infant. AB - Insulin specific receptors on red blood cells and cultured fibroblasts were investigated in a male infant affected of congenital generalized lipodystrophy (CGL). Total insulin binding capacity appeared mildly reduced, with apparently selective involvement of the high-affinity receptors on red blood cells but not on fibroblasts. Such alterations did not produce any impairment of glucose metabolism. PMID- 3319973 TI - Importance of ultrasound examination for the follow-up of medullary thyroid carcinoma: comparison with other localization methods. PMID- 3319974 TI - A new method of lectin histochemistry for the study of brain angiogenesis. Lectin angiography. AB - In an attempt to analyse the kinetics of angiogenesis in the brain, we developed a new lectin-histochemical staining technique for identifying the vasculature. Three horseradish-peroxidase-conjugated lectins, i.e., Griffonia simplicifolia agglutinin 1 (GS1), Ricinus communis agglutinin 1 (RCA1) and soybean agglutinin (SBA), selectively stained vascular walls in brain-tissue sections. When these lectins were injected into the circulation of ether-anesthetized animals via the pulsating left ventricle, they bound specifically to the inner surface of endothelial cells and revealed the three-dimensional architecture of the vascular network within thick tissue preparations. When this technique, referred to a lectin angiography, was combined with 5-bromo-2-deoxyuridine (BudR) immunohistochemistry, proliferating capillary cells could be easily identified in three-dimensional structures of the developing vasculature. Because of its simplicity and wide applicability, lectin angiography should be useful for analysing the kinetics of angiogenesis in developmental, regenerative, and pathological conditions in various tissues and organs. PMID- 3319976 TI - [Diagnosis in disorders of speech development]. AB - We describe a multi-factorial model for the diagnosis of speech development disorders. The model serves as the basis for an individually designed course of therapy covering all aspects of the disorder. The separate diagnostic steps are in accordance with a classification of speech development disorders based on aetiology and pathology. PMID- 3319977 TI - [Role of sonography in post-therapeutic control of tumors of the head and neck area]. AB - During a 3 year period 572 high-resolution sonograms were carried out in the follow-up examinations of 348 patients who had been treated for ENT malignancy. Our experiences in routine application of this diagnostic method are described and illustrated by typical sonograms. Ultrasound findings of complications (chylous cysts, seromas, granulomas, fistulae) are demonstrated and the value and limitations of sonography in detecting lymph node metastases and primary recurrences are pointed out. In spite of the high accuracy of this method, it is not possible to differentiate between lymph nodes which are invaded by tumour and those with non-specific lymph adenopathy by echographic criteria only. We used ultrasound for follow-up studies on patients treated by irradiation or chemotherapy. Finally, sonography provided additional information on the exact site and size of the tumor. Real-time sonography is not time-consuming and can be applied without any special preparation of the patient. It has therefore become a satisfactory diagnostic method in the follow-up of patients who have undergone treatment of malignant tumors. PMID- 3319975 TI - Phenotype and distribution of T lymphocytes in Peyer's patches of athymic mice. AB - The distribution and phenotype of T (Thy-1.2+) cells was examined in Peyer's patches of 8 and 16 week old athymic mice by peroxidase and two-color fluorescence immunohistochemistry. Despite the generally recognized T cell deficiency of nude mice, some T cells consistently occurred in Peyer's patch domes in all mice. However, many Thy-1.2+ lymphocytes lacked cell surface markers for either helper T cells (L3T4) or cytotoxic/suppressor T cells (Lyt-2), indicating that these cells may be an immature subset of T cells. These cells may represent a population of resident T cell precursors delayed in maturation or T cells newly immigrated to Peyer's patches. PMID- 3319978 TI - [Current significance of Gram's stain in the treatment of ENT infections in the clinic and general practice]. AB - The aim of our investigations was to evaluate the current importance of Gram's stain in ENT infections. This long established easy microbiological method was compared with culture and sensitivity tests. For this purpose 549 Gram's stains were performed on 384 patients. In 88.8% of the cases Gram's stains gave reliable information in a few minutes so that a correct and effective antimicrobial treatment could be started. In 5.7% no pathogen could be found using a Gram's stain, probably because the concentration was too low (10(5)/ml) whereas a pathogen could be cultured in these cases. However culture revealed microbiological information in 11.5% of the cases that was unreliable or even misleading in deciding treatment. In conclusion, Gram's stain is a very cheap, quick and easy method which has been forgotten by many clinicians but which is sufficient as the only microbiological method in uncomplicated ENT infections and is of great importance for a correct interpretation of the results of culture in severe infections. In life-threatening cases it may even be of a crucial value. PMID- 3319979 TI - Adolescents' motivation for sexual activity and pregnancy prevention. PMID- 3319980 TI - Neuroendocrine control processes. Pubertal onset and progression. AB - This discussion has outlined current concepts in neuroendocrinologic control of pubertal onset and progression. Central nervous system regulation of the arcuate nucleus (ventromedial hypothalamus) pulse generator that subsequently controls pituitary gonadotropin synthesis and secretion has been highlighted. Significant investigative issues that deserve assessment in the next several years include the following: 1. Systematic neuropharmacologic, electrophysiologic, and anatomic assessment of the hypothalamic arcuate nucleus. These assessments would include the use of recombinant DNA technology to probe cellular regulation of GnRH production. 2. Physiologically oriented examination of hypothalamic GnRH synthesis and secretion, along with function in the remaining reproductive endocrine system, during situations of nutritional impairment and excessive energy utilization and psychologic stress. 3. Further assessment of the neurophysiologic inhibition of GnRH production during childhood and the late prepubertal reactivation of the arcuate nucleus pulse generator. Roles of opioids, dopamine, other neurotransmitters, and metabolic signals remain to be clarified. 4. Exploration of regulators of hypothalamic, pituitary, and gonadal function when pulsatile GnRH administration has replaced the usual hypothalamic mechanisms. Pituitary-gonadal interactions may be independently assessed. 5. Assessment of pubertal growth, endocrine function, and neuropharmacologic control mechanisms in circumstances of chemical removal of pituitary gonadotrope function by GnRH agonists or antagonists. 6. Concordance and discordance of potency estimates of gonadotropins made by bioassay and immunoassay. The biologic basis for qualitative changes in bioassayable levels of LH and FSH, often related to carbohydrate content of the glycoprotein, may help to explain changes of gonadal function during the pubertal process. The potential for significant molecular heterogeneity of the gonadotropins is recognized and suggests substantial posttranslational changes of LH and FSH. 7. A cogent delineation of the hormonal, nutritional, and energy regulators of the pubertal growth spurt, though not discussed in this manuscript, remains to be accomplished. The relationship between pituitary gonadotropins and growth hormone, sex steroids, and the various peptide growth factors, especially the relationship between the growth factors and intragonadal steroidogenesis and germ-cell production, remain to be resolved. The importance of local production and action of peptide-growth factors in diverse tissues, skeletal and other, is being increasingly recognized.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3319981 TI - Hormonal influences on aspects of psychological development during adolescence. PMID- 3319982 TI - Sleep and neuroendocrine correlates of affective illness in childhood and adolescence. PMID- 3319983 TI - The interface of chronic illness and the hormonal regulation of puberty. PMID- 3319984 TI - Pharmacologic aspects of analgesic drugs in animals: an overview. PMID- 3319985 TI - Eumycotic mycetoma: review and report of a cutaneous lesion caused by Pseudallescheria boydii in a horse. AB - A cutaneous mass (1.5 cm in diameter) was removed from the head of a horse and was diagnosed histologically as eumycotic mycetoma. Immunofluorescence, performed on formalin-fixed, paraffin-embedded tissue, identified Pseudallescheria boydii as the etiologic agent. Findings from earlier reports of eumycotic mycetoma were compared with those of this horse. PMID- 3319986 TI - Resistance mechanisms of the bovine udder: new implications for mastitis control at the teat end. AB - Investigations on bovine teat-end defenses and their role in mastitis control were reviewed. Alteration of teat canal keratin by method of intramammary drug infusion through the teat canal influenced the number of new infections. At the beginning of the nonlactating period, 2 methods of administering antibiotic were studied: full insertion of treatment syringe cannulas into teat cisterns and expelling contents and partial insertion of cannulas into the distal 2 to 3 mm of teat canals and slowly infusing contents. Partial cannula insertion reduced new infections by 50% and is an easily adopted management tool to reduce prevalence of mastitis. Intramammary devices used during lactation and the nonlactating period increased leukocyte concentrations in mammary secretions. An abraded polyethylene coil device reduced clinical mastitis and increased milk yield. Staphylococci colonize teat canal keratin and lacteal secretions of dairy heifers as early as 9 months of age, leading to intramammary infection at time of calving and persisting into lactation. Subsequent somatic cell counts are associated with milk production losses. Previously, such infections were shown to be associated only with older, mature animals. PMID- 3319987 TI - The economic benefit of treating subclinical Streptococcus agalactiae mastitis in lactating cows. AB - The economic benefits of treating lactating cows for Streptococcus agalactiae mastitis were studied at a large (689 milking cows) central California dairy. Postcure milk production of case cows (infected, treated, and cured) was compared with production of paired control cows (uninfected) and was matched for yield, days in milk, days in gestation, and parity. A simulation was used to plot expected lactation curves for mastitic cows (infected, not treated) with characteristics similar to those of each control cow, and these curves were compared with actual case-cow lactation curves. The difference in actual and expected production was used to calculate net economic benefits of treatment. Comparison of expected with actual production indicated a net benefit from treatment of $396/cow for cows treated in early lactation and $237 for cows treated in midlactation, but a net loss of $55 for cows treated in late lactation. Lactation number did not have a significant impact on economic benefits of treatment. In contrast to other studies indicating no economic benefit from treating mastitis during lactation, this study's positive results may have been attributable to the high cure rate (98%) and the subclinical form of mastitis being treated. Streptococcus agalactiae mastitis treatment during early and midlactation would appear to be an economically justifiable option for dairy managers. PMID- 3319988 TI - Bone scintigraphy in small animals. PMID- 3319989 TI - Clinical and serologic studies of canine borreliosis. AB - During 1984 and 1985, blood samples were obtained from 271 dogs that were suspected of having borreliosis. The dogs lived in areas known to be infested with ticks and had been examined because of limb/joint disorders or for unknown illnesses marked by fever, anorexia, or fatigue. Lameness had been the most frequently reported clinical manifestation. Analyses of serum specimens, by an indirect fluorescent antibody (IFA) method or by an ELISA, detected antibodies to Borrelia burgdorferi, the etiologic agent of borreliosis in dogs and of Lyme disease in human beings. Antibody to B burgdorferi was detected in 76.3% of 114 specimens from dogs living in the lower Hudson Valley region of New York State (predominantly Westchester County), in 66.5% of 155 specimens from dogs from southern Connecticut, and in single specimens from dogs from Rhode Island and California. Geometric mean antibody titers peaked during the winter. Results of IFA tests and ELISA were in agreement, but the latter method yielded less variable results, had greater sensitivity, and was more easily standardized. Five dogs from New York State and Connecticut seropositive to B burgdorferi had developed kidney disorders during or after episodes of intermittent lameness. Application of murine monoclonal antibody in an IFA procedure verified the presence of B burgdorferi in renal cortical tissues from one dog. PMID- 3319990 TI - Torsion of the uterus in a cat. AB - An 18-month-old female Himalayan cat was diagnosed as having uterine torsion. Ultrasonography was of value in revealing fetal death, thus prompting immediate surgical intervention. Uterine torsion is a rarely observed complication of mid- to late gestation in the cat. Definitive diagnosis can be achieved only with exploratory laparotomy. PMID- 3319991 TI - An aging society: implications for health care needs impacts on allied health practice and education. A report of the National Task Force on Gerontology and Geriatric Care Education in Allied Health. PMID- 3319992 TI - Oestrogen and the differentiation of granulated metrial gland cells in chimeric mice. AB - The role of oestrogen in the recruitment of GMG cell precursors to the uterus has been investigated in radiation-induced chimeric mice reconstituted with rat bone marrow and maintained on a hormone regime simulating pseudopregnancy. The presence of rat GMG cells in the deciduomata in mice irradiated after oestrogen priming suggests that oestrogen priming is not an essential factor in recruiting GMG cell precursors. However, the results have led to the suggestion that in the normal, cycling mouse oestrogen may have a role in attracting GMG cell precursors to the uterus and preparing them for differentiation. PMID- 3319993 TI - Distribution of primary cochlear afferents in the bulbar nuclei of the rat: a horseradish peroxidase (HRP) study in parasagittal sections. AB - HRP was injected into the cochleae of 25 young albino rats in order to trace the primary afferents to the bulbar cochlear nuclei. Besides the classic V-shaped pattern and unconnected with it, HRP labelling revealed two plexuses stemming directly from the axons of the cochlear root. The plexuses cover the posterior area of the posteroventral cochlear nucleus (posterior plexus) and the anterolaterodorsal area of the anteroventral cochlear nucleus (anterior plexus). The fibres giving rise to these two plexuses were previously grouped in two bundles which have been called the posterior and anterior bundles, respectively. The origin of the anterior bundle is typically seen with the fibres stemming out at right angles; the origin and course of the posterior bundle, which characteristically cross over, is also a typical feature. PMID- 3319995 TI - In memoriam Bernard Frank Martin. PMID- 3319994 TI - Autonomic neuromuscular junctions: current developments and future directions. AB - (1) The autonomic neuromuscular junction has been defined, with emphasis on the role of muscle effector bundles and en passage release of transmitter from extensive terminal nerve varicosities to diffuse to muscle across variable and often wide junctional clefts. (2) A multiplicity of neurotransmitters is described in the autonomic nervous system, including purines, peptides, amino acids and monoamines. The ultrastructural identification, projections, roles and interactions of the different nerve types have been discussed. (3) It has been suggested that the part played by peripheral neuroeffector control mechanisms has been underestimated and includes cotransmission, pre- and post-junctional neuromodulation, and the participation of locally released agents. (4) A time lapse film was shown of the formation of autonomic neuromuscular junctions in culture, introducing questions relating to long-term 'trophic' influences in the autonomic nervous system. PMID- 3319996 TI - Parasympathetic innervation of the thymus: a histochemical and immunocytochemical study. AB - The presence of parasympathetic nerve supply to the thymus has been demonstrated by histochemical and immunocytochemical methods using antibodies against cholineacetyl transferase. Fine nerve fibres have been observed both in the thymic parenchyma and around the blood vessels. The role of the parasympathetic nerve supply to the thymus is briefly discussed. PMID- 3319997 TI - Mitochondria in living cells cultured from human chorionic villi: the effects of colchicine on numbers and distribution. AB - Fluorescence microscopy of living first trimester human placental cells and choriocarcinoma cells in cultures was carried out using the vital fluorescent dye Rhodamine 123. The length and distribution of mitochondria and, in the normal cells, their reaction to colchicine treatment is described. It appears that in the presence of colchicine the distribution of mitochondria in normal placental cells becomes more restricted to the perinuclear cytoplasm and that the mean length of mitochondria is reduced. However, the total length of all the mitochondria in treated cells is not significantly different from that in paired cells which were not exposed to the drug. It is inferred from this result that mitochondrial shortening in the presence of colchicine is not an elastic shortening consequent on the removal of cytoskeletal elements which promote extension of the organelle. Rather it is brought about by fragmentation of the organelle into tandem segments. PMID- 3319998 TI - On the ovarian bursa of the golden hamster. I. Scanning electron microscopy of the inner surface and stomatal orifices. AB - The inner surface of the ovarian bursa in the golden hamster was observed by scanning electron microscopy. There were numerous discontinuities in the bursal epithelium. Crevice-like gaps were formed between irregularly spaced epithelial cells, and the subepithelial connective tissue was exposed to the bursal cavity through the gaps. Through circular defects in the epithelial lining or pores, which were less than 20 microns in diameter, either the subepithelial connective tissue or stomatal orifices were visible. There were smooth surfaced areas lined with lymphatic endothelium, instead of bursal epithelium, which was continuous from the wall of the lymphatic vessel to the inner surface of the bursa. These areas were not present in all bursae, but if they were present, stomatal orifices consistently opened in them. Stomata in the ovarian bursa had two types of orifices, (1) circular orifices opening predominantly in smooth surfaced areas and measuring up to 50 microns in diameter; (2) jagged orifices opening usually in pores and measuring less than 10 microns in diameter. Blood cell components derived from ovulation entered lymphatics via stomata. Bursal fluid and small particles may drain into lymphatics directly via stomata and indirectly by diffusion through gaps, pores and connective tissue. Judging from the structural appearance of the stomatal orifices, the degree of opening of jagged orifices may change in response to changes in the cavity, while circular orifices may be stable openings. PMID- 3319999 TI - The syncytial nature of epithelial cells in the thymic cortex. AB - The epithelial cells of the cortex of human and rodent thymus glands were examined by light and electron microscopy, and the intracellular membrane potentials measured from the subcapsular, cortical and medullary regions. In the human thymus cortex, there is a highly correlated age-independent relationship (r = 0.78) between the distance in micron from one adjacent Type 2/3 epithelial nucleus to another, and the number of thymocytes between them. In rodent glands that had undergone some degree of involution due to hypoxia simulating an altitude of 17 000 feet or following the injection of phenylhydrazine, Type 2/3 epithelial cells were often found to be bi- or multinucleated. Electrophysiological studies of 10 mouse thymus lobes using 0.2 micron tipped electrodes showed that there were highly significant differences (P less than 0.0001) between the intracellular membrane potentials of the subcapsular zone, the cortex and the medulla. When dyes were injected intracellularly (through 0.5 micron tipped electrodes) into individual epithelial cells, methylene blue remained within the cytoplasm, but procion yellow passed in 30 minutes into the nuclei of all the epithelial cells of the cortex but not those of the subcapsular zone, nor the medulla. This indicates that the cortex must be a functional syncytium and it differs in this respect from the rest of the gland. PMID- 3320000 TI - Enteroendocrine cells in the developing opossum stomach. AB - The distribution of enteroendocrine cells showing immunoreactivities to four peptides and one amine was examined in the gastric mucosa of the opossum during postnatal development using specific immunocytochemical methods. Gastrin-, BPP-, glucagon-, somatostatin- and 5-HT-immunoreactive cells were identified in the gastric mucosa of the newborn opossum. Gastrin-immunoreactive cells were restricted to the epithelial lining of the pylorus; glucagon-immunoreactive cells were seen only in the epithelium of the fundus. Somatostatin- and 5-HT immunoreactive cells were found in the epithelium of both fundic and pyloric regions. BPP-immunoreactive cells were the most numerous endocrine cell type seen in the gastric epithelium of the newborn opossum and although found mainly at the confluence of the fundic and pyloric regions, were confined primarily to the fundus in the one week old opossum and all older animals. A marked increase in all five immunoreactive cell types was seen by the end of the first postnatal week. Gastrin-immunoreactive cells were the most numerous at this time and exceeded adult numbers. Both glucagon- and BPP-immunoreactive cells were confined to the fundic glands of older animals and showed the same pattern of decline with age. Somatostatin- and 5-HT-immunoreactive cells showed a shift in population from the fundus to the pylorus with age and together with gastrin-immunoreactive cells were restricted to a narrow zone at the bottoms of the gastric pits and the upper parts of the pyloric glands. PMID- 3320002 TI - Exercise in pregnancy: a review for nurse practitioners. PMID- 3320001 TI - Action of iturin A, an antifungal antibiotic from Bacillus subtilis, on the yeast Saccharomyces cerevisiae: modifications of membrane permeability and lipid composition. AB - The action of iturin A on non-growing cells of Saccharomyces cerevisiae was tested. This antibiotic gave important modifications in the membrane permeability which permitted nucleotides, proteins, polysaccharides and lipids to escape from cells. The lipid content of cells was strongly disturbed; the level of phospholipids, essentially phosphatidylcholine, decreased while the level of fatty acids increased. A part of these fatty acids were extruded from yeast cells. The role of iturin A in these modifications was discussed. PMID- 3320003 TI - Design and execution of animal behavior research: an overview. AB - Animal behavior research, like other sciences, adheres to a rigorous methodology of design and execution. It begins with careful delineation of the research questions, objectives and hypotheses. Dependent and independent variables are identified, including behaviors to be measured or manipulated. A research protocol is structured, which casts the variables and animal subjects into the proper experimental design, prescribes appropriate scales of measurement and designates valid parametric or non-parametric statistical analyses. Data collection begins with the choice of appropriate sampling methods and equipment to insure validity, accuracy and reliability. The most robust and powerful data analyses, commensurate with the parameters of the data set, are conducted and interpreted relative to the research hypotheses and questions. PMID- 3320004 TI - Developmental aspects of motivated behavior in domestic animals. AB - Biological functions like health, reproduction or the performance of specific behavior programs change over time. Therefore, their actual significance can only be understood fully if their history or development is well known. This point is illustrated with respect to behavior patterns in farm animals. Early life or ontogenetic processes strongly determine (sub)adult behavior. Prepuce suckling performed by group-housed veal calves during the age of 2 to 8 wk depends on sucking experience of the same calves during their first week of life. Restless behavior of fattening pigs is largely determined by rearing conditions in the first weeks of life. Disturbed behaviors like stereotypies develop out of conflict behaviors (biting, escape, etc.), as is the case in tethered sows. These stereotypies appear to promote the release of endorphins. In veal calves, different stereotypies (biting or licking the crate and tongue playing) develop during different periods of time and probably are related to different sorts of conflicts experienced by the developing calf. Tongue playing shows a specific relationship with abomasal ulcers. In veal calves, individual coping differences are observed that strongly parallel those described in other vertebrates (rats, dogs, men). PMID- 3320006 TI - Cumulative index. Volumes 11-20 (1978-1987). PMID- 3320005 TI - Effects of feeding sows fat or fructose during late gestation and lactation. AB - The effects of dietary fat or fructose supplementation during late gestation and lactation on sow milk production and composition and on progeny were examined. On d 88 of gestation, 24 sows were allotted by parity to three dietary treatments (eight sows/treatment). Treatments were 1) a 12.5% crude protein, corn-soybean meal control, 2) the control + 10% added fat or 3) the control + 23% high fructose corn syrup. All treatments were fed to supply 1.82 kg/d of the control diet from d 89 of gestation to parturition with sows in treatments 2 or 3 receiving .18 kg of additional fat or .53 kg of additional high fructose corn syrup, respectively. Feed was gradually increased from d 1 to 7 of lactation to 4.54 kg/d of the control diet (plus .45 kg of added fat and 1.33 kg of added fructose for treatments 2 and 3) and remained at these levels for the remainder of the 21 d lactation period. All treatments were iso-nitrogenous; treatments 2 and 3 were iso-caloric. Litter birth weights, number of pigs born alive, weaning weights and piglet survival rate were not affected by sow treatment. Stillbirths were less (P less than .05) for sows fed fat. Lipid content of milk 24 h post farrowing was greater (P less than .05) from sows fed fat compared with sows fed fructose. Milk production estimates indicated that multiparous sows fed fat produced more (P less .05) milk than sows fed the control diet. On d 112 of gestation and d 15 of lactation, serial blood samples were drawn to monitor sow response to a glucose challenge (1 g/kg body weight).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320008 TI - Effect of a previous voluntary deep breath on laryngeal resistance in normal and asthmatic subjects. AB - We studied changes in both laryngeal resistance (Rla) and respiratory resistance (Rrs) after a voluntary deep breath in 7 normal and 20 asthmatic subjects. Rla was measured using a low-frequency sound method (Sekizawa et al. J. Appl. Physiol. 55: 591-597, 1983) and Rrs by forced oscillation at 3 Hz. In normal subjects, both Rla and Rrs significantly decreased after a voluntary deep breath (0.05 less than P less than 0.01). During methacholine provocation in the normal subjects, a voluntary deep breath significantly decreased Rrs (0.05 less than P less than 0.01, but Rla was significantly increased (0.05 less than P less than 0.01). In 10 asthmatic subjects in remission, a voluntary deep breath significantly increased Rrs (0.05 less than P less than 0.01) but significantly decreased Rla (0.05 less than P less than 0.01). In another 10 asthmatic subjects during spontaneous mild attacks, a voluntary deep breath significantly increased both Rrs and Rla (0.05 less than P less than 0.01). The present study showed that without obvious bronchoconstriction, Rla decreased after a voluntary deep breath in both normal and asthmatic subjects but, with bronchoconstriction, Rla increased in both groups. Subtraction of the change in Rla from Rrs gives the change in Rrs below the larynx (Rlow). Rlow changed little or decreased in normal subjects and increased in asthmatic subjects, irrespective of base-line bronchomotor tone. These results suggest that airway response below the larynx after a voluntary deep breath differentiates patients with bronchial asthma from normal subjects. PMID- 3320007 TI - Effect of exercise on insulin binding and glucose transport in adipocytes of normal humans. AB - Acute exercise increases insulin binding to its receptors on blood cells. Whether the enhanced insulin binding explains the exercise-induced increase in glucose uptake is unclear, since insulin binding and glucose uptake have not been measured simultaneously in a target tissue of insulin. In this study, we determined insulin binding and the rate of glucose transport in adipocytes obtained by needle biopsy from 10 healthy men before and after 3 h of cycle ergometric exercise. During the exercise, plasma glucose (P less than 0.01) and insulin (P less than 0.001) fell and serum free fatty acid level rose 4.3-fold (P less than 0.001). 125I-insulin binding to adipocytes remained unchanged during exercise. The rate of basal glucose transport clearance fell from 28.1 +/- 5.7 fl.cell-1.s-1 to 22.9 +/- 5.6 fl.cell-1.s-1 (P less than 0.005), and the insulin stimulated increase in glucose transport rate rose from 196 +/- 26 to 279 +/- 33% (P less than 0.025) during the exercise. Thus, in the adipocytes during exercise, the basal glucose transport rate and the responsiveness of glucose transport to insulin changed in the absence of alterations in insulin binding. These data indicate that the exercise-induced changes in insulin binding show tissue specificity and do not always parallel alterations in glucose transport. PMID- 3320009 TI - Effect of high-frequency ventilation on lung mechanics at high transpulmonary pressure. AB - The different tidal volumes and frequencies of high-frequency ventilation (HFV) compared with conventional mechanical ventilation (CMV) may have different effects on lung mechanics. To test this hypothesis, we compared the effects of 3 h of HFV and CMV on total lung capacity (TLC), functional residual capacity (FRC), the shape of the pressure-volume (PV) curve (%V10), and dynamic compliance (Cdyn), as well as venous admixture and alveolar-arterial O2 gradient. We studied a total of 12 dogs at lung inflations equivalent to 15 cmH2O positive end expiratory pressure (PEEP) (group I) and 8 dogs at lung inflations equivalent to 0 cmH2O PEEP (group II). For CMV, we used a standard-volume ventilator at a mean tidal volume of 13.8 ml/kg. For HFV, we used an oscillator-type ventilator at 15 Hz and an average tidal volume of 4.3 ml/kg. Our results showed that ventilation with 3 h of PEEP raised lung volume, and lung volumes on HFV were higher than those on CMV in both groups. Specifically, in group I, the volume during ventilation rose on both CMV (150 ml) and HFV (250 ml). These volume changes persisted beyond the ventilation period, such that TLC was unchanged on CMV but had risen 200 ml on HFV. FRC also rose 200 and 300 ml after HFV and CMV, respectively. In group II, the volume during ventilation fell 100 ml on CMV and rose slightly (40 ml) on HFV. TLC and FRC both tended to fall more on CMV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320010 TI - Relationship of end-expiratory pressure, lung volume, and 99mTc-DTPA clearance. AB - We investigated the dose-response effect of positive end-expiratory pressure (PEEP) and increased lung volume on the pulmonary clearance rate of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA). Clearance of lung radioactivity was expressed as percent decrease per minute. Base-line clearance was measured while anesthetized sheep (n = 20) were ventilated with 0 cmH2O end-expiratory pressure. Clearance was remeasured during ventilation at 2.5, 5, 10, 15, or 20 cmH2O PEEP. Further studies showed stepwise increases in functional residual capacity (FRC) (P less than 0.05) measured at 0, 2.5, 5, 10, 15, and 20 cmH2O PEEP. At 2.5 cmH2O PEEP, the clearance rate was not different from that at base line (P less than 0.05), although FRC was increased from base line. Clearance rate increased progressively with increasing PEEP at 5, 10, and 15 cmH2O (P less than 0.05). Between 15 and 20 cmH2O PEEP, clearance rate was again unchanged, despite an increase in FRC. The pulmonary clearance of aerosolized 99mTc-DTPA shows a sigmoidal response to increasing FRC and PEEP, having both threshold and maximal effects. This relationship is most consistent with the hypothesis that alveolar epithelial permeability is increased by lung inflation. PMID- 3320011 TI - Effect of cyclooxygenase blockade on gas exchange and hemodynamics in Pseudomonas pneumonia. AB - Acute bilateral Pseudomonas aeruginosa pneumonia was induced in 10 anesthetized dogs, after which five dogs received intravenous indomethacin (2 mg/kg) (indomethacin group), whereas five others were infused with saline (2 ml/kg) (control group). Plasma levels of 6-ketoprostaglandin F1 alpha(6-keto-PGF1 alpha) and thromboxane B2 (TxB2), stable metabolites of prostacyclin (PGI2) and thromboxane A2 (TxA2), respectively, were measured by radioimmunoassay. Although TxB2 levels were not different before and after inoculation in either group, 6 keto-PGF1 alpha levels increased from their base-line value in each animal as pneumonia developed (indomethacin group: less than 100 to 330 +/- 90 pg/ml; control group: less than 100 to 630 +/- 300 pg/ml). Both prostaglandins fell to less than 100 pg/ml in each dog after indomethacin infusion, whereas they remained elevated in the control group after infusion of normal saline. Perfusion of consolidated lung regions (Qp/QT), measured with radioactive microspheres and expressed as a percent of total pulmonary blood flow, was dramatically reduced after indomethacin (35 +/- 3 to 16 +/- 1%) with consequent improvement in pulmonary shunt (Qs/QT: 30 +/- 8 to 18 +/- 6%) and arterial O2 tension (PaO2: 123 +/- 25 to 274 +/- 77 Torr). These parameters remained unchanged or deteriorated further in the control group after infusion of saline. Three additional dogs with Pseudomonas pneumonia were studied in which the indomethacin-induced reduction in Qp/QT was substantially but not completely reversed by intravenous infusion of PGI2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320012 TI - Effects of temperature on cholinergic contractility of rabbit airway muscle. AB - To elucidate the mechanism underlying temperature-induced changes in airway cholinergic contractility, the effects of organ bath cooling were evaluated in isolated rabbit airway smooth muscle (ASM) segments isometrically contracted with methacholine (METH) (10(-8)-10(-3) M) and electrical field stimulation (ES), wherein the ES stimulus frequency was varied between 1 and 100 Hz. Cooling from 37 to 25 degrees C produced systematic increases (P less than 0.01) in isometric tension at various administered doses of METH and at different levels of ES. Since the potentiated contractions to ES significantly exceeded (P less than 0.001) the corresponding increases in METH-induced contractility, we evaluated whether the latter was attributed to temperature-mediated changes in intrinsic airway neuronal acetylcholine (ACh) release. Accordingly, the effects of ASM cooling were independently determined before and after inhibition of the Na+-K+ electrogenic pump with ouabain (10(-5) M), and depletion of intrinsic neuronal ACh stores with hemicholinium-3 (HC-3) (10(-3) M). In the presence of either ouabain or HC-3 the above responses to temperature reduction were reversed, and airway cooling was associated with abrupt relaxation of ASM segments precontracted with METH. In contrast, neither inhibition of cyclooxygenase products with indomethacin (10(-6) M) nor cholinesterase inhibition with neostigmine (10(-3) M) notably influenced the ASM responses to organ bath cooling. Thus these findings demonstrate that 1) both METH-induced and neurally mediated cholinergic contractility are augmented during airway cooling; 2) the potentiated cholinergic responses are attributed to enhanced presynaptic release of ACh at the airway neuromuscular junction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320014 TI - Pulmonary response to group B streptococcal toxin in young lambs. AB - Marked respiratory distress is seen in severe early onset group B beta-hemolytic streptococcal (GBS) disease in newborn infants. To investigate the pathophysiological effects of a polysaccharide toxin from GBS type III cultures, obtained from an infant who died from this disease, young chronically instrumented, unanesthetized lambs were studied with measurements of lung mechanics, lung volumes, ventilation, hemodynamics, and lung vascular permeability. Intravenously administered GBS toxin resulted in a biphasic response with an early threefold increase in total lung resistance, 40% decrease in dynamic lung compliance, and 30% increase in minute ventilation coinciding with hypoxemia, pulmonary hypertension, and fever. A second phase of the response followed consisting of less prominent changes in these variables as well as increased lung lymph protein clearance compatible with increased vascular permeability. The temporal close relationship between marked leukopenia and increased lung lymph thromboxane B2 concentrations to the simultaneously occurring pulmonary hypertension and changes in lung mechanics suggests that leukocytes and thromboxane A2 may be mediators of these GBS toxin-induced effects. PMID- 3320013 TI - Mechanisms of airway hypercontractility in basenji-greyhound dogs. AB - The comparative effects of contractile agonists and physiological stimulation of the tracheal and bronchial smooth muscle (BSM) response were studied isometrically in situ in five Basenji-greyhound (BG) and six mongrel dogs. Frequency-response curves generated by bilateral stimulation of the vagus nerves (0-20 Hz, 15-20 V, 2-ms duration) elicited greater maximal contraction in mongrel trachea (36.8 +/- 8.1 vs. 26.9 +/- 4.0 g/cm; P less than 0.02) and exhibited greater responsiveness in mongrel BSM (half-maximal response to electrical stimulation 3.0 +/- 1.1 vs. 7.0 +/- 0.5 Hz; P less than 0.05) compared with BG dogs. However, muscarinic sensitivity to intravenous methacholine (MCh) was substantially greater in BG dogs; MCh caused contraction greater than 1.5 g/cm at a mean dose of 3.0 X 10(-10) mol/kg for BG dogs compared with 5.1 X 10(-9) mol/kg for mongrel controls (P less than 0.03, Mann-Whitney rank-sum test). In contrast to the muscarinic response, the contractile response elicited by intravenous norepinephrine after beta-adrenergic blockade was similar in trachea and bronchus for both mongrel and BG dogs. Our data confirm previous in vitro demonstration of tracheal hyporesponsiveness in BG dogs and demonstrate that the contraction resulting from efferent parasympathetic stimulation is less in the BG than mongrel dogs. However, postsynaptic muscarinic responsiveness of BG BSM is substantially increased. We conclude that a component of airway responsiveness in BG dogs depends directly on contractile forces generated postsynaptically that are nongeometry dependent, postjunctional, and agonist specific. PMID- 3320017 TI - Cotrimazine in lower respiratory tract infections. PMID- 3320016 TI - Effects of hormonal growth factors on colony formation and chemosensitivity of human tumors in agarose. AB - Because low plating efficiencies of most human cancers severely limit the number of successful chemosensitivity tests that can be performed, we studied the growth enhancing effects of hormonal growth factors on a variety of solid tumors. Dose response studies with progesterone and estradiol indicated no benefit from adding these substances to the culture medium. This was true whether progesterone or estradiol was used alone or in the presence of other hormones. By contrast, epidermal growth factor (EGF) at concentrations from 10 to 100 ng/ml increased colony numbers up to 10-fold. Although insulin, hydrocortisone, and EGF used alone could either stimulate or inhibit the growth of specific tumors, the combination of all three (hormone mixture or HM) was always at least as good and usually better than any individual component in increasing cloning efficiency. HM supplemented medium gave significantly increased colony counts in 41/46 tumors. Sensitivity to anticancer drugs was not changed in 63 paired drug tests. PMID- 3320018 TI - Plasmapheresis therapy in rheumatoid arthritis in Indian patients. PMID- 3320015 TI - Biosynthesis of the third component of complement in rat liver epithelial cell lines and its stimulation by effector molecules from cultured human mononuclear cells. AB - Rat liver epithelial cell lines, growing in a serum-supplemented medium, synthesize and secrete into the culture medium the third component of complement (C3). We studied the regulation of C3 production in this system. We found that human peripheral blood mononuclear leukocytes in culture released one or more soluble factors which stimulated rat liver epithelial cells to produce increased quantities of C3. This stimulating effect was strongly enhanced when the mononuclear cell cultures were treated with phytohemagglutinin, a T-lymphocyte mitogen. The factor(s) failed to enhance C3 biosynthesis by rat dermal fibroblasts, which are known to produce this protein. This reveals a tissue specific differential response between the fibroblasts and the liver epithelial cells. The physical and chemical characteristics, such as heat sensitivity, 2.8 M ammonium sulphate precipitation, and lower activity after digestion by proteases unambiguously indicate that the effector molecules are proteins. When the crude supernatant of mononuclear leukocytes was fractionated by gel filtration, the stimulating factor(s) eluted as two peaks with apparent molecular weight of 25 to 60 and 15 to 20 kdalton, respectively. As to the cellular origin of the C3 stimulating factor(s), several observations were made: (a) in separate cultures containing either T-cells or monocyte-enriched populations from the same sample of blood mononuclear cells, no activity was detected in the presence or absence of phytohemagglutinin, (b) conditioned media from each of these cultures could not substitute for the corresponding intact cell populations, and (c) the addition of purified T-cells to the monocyte-enriched population in the presence of phytohemagglutinin restored the production of the stimulating activity by the mixed culture. Finally, experiments were carried out to verify whether monokine interleukin 1 affects the hepatic C3 biosynthesis. It was demonstrated that interleukin 1 enhanced this biosynthesis, but could not completely substitute for conditioned medium from stimulated mononuclear cells. PMID- 3320019 TI - Current concepts in asthma. PMID- 3320020 TI - Cutaneous gangrene in falciparum malaria: an unreported manifestation. PMID- 3320021 TI - Erythrocyte insulin receptor abnormalities. PMID- 3320022 TI - C-peptide response to glycaemic stimuli. PMID- 3320023 TI - Retroperitoneal cyst of filarial origin. PMID- 3320024 TI - Evaluation of the antihypertensive effect of nifedipine. PMID- 3320025 TI - Donor specific transfusions in renal transplantation. PMID- 3320026 TI - Newer insulins. PMID- 3320027 TI - Heterozygous beta thalassaemia with intermediate clinical severity in 9 members of two unrelated families showing vertical transmission. PMID- 3320028 TI - Ultrasound screening of the hip in newborns for the diagnosis of congenital hip dysplasia. PMID- 3320029 TI - The radiologic and sonographic spectrum of the prune-belly syndrome. PMID- 3320030 TI - [Brenner tumor in association with arterial thrombosis]. PMID- 3320031 TI - Diagnostic imaging in infantile polycystic kidney disease. Presentation of two cases. PMID- 3320032 TI - A case of giant cystic lymphangioma of the neck with fatal outcome in a neonate. PMID- 3320033 TI - Psychogenic habit cough: review and case reports. AB - Psychogenic habit cough--a condition that can be debilitating if it extends over a period of years--has been described in both pediatric and adolescent populations, but not in adults. The authors review the cases of 4 adult patients with this condition, review the available pediatric/adolescent literature, and make suggestions for the direction of future research. In some cases, psychogenic habit cough in adults can be successfully treated with a combination of psychotherapy, relaxation therapy, and speech therapy. PMID- 3320034 TI - Buspirone in the long-term treatment of generalized anxiety disorder. AB - A 12-month, multicenter, open-label study was conducted to evaluate the long-term safety and efficacy of the new nonbenzodiazepine anxiolytic buspirone. The study population consisted of 700 patients with DSM-III generalized anxiety disorder who ranged in age from 16 to 84 years. Ninety-two percent had symptoms of anxiety that had persisted for 3 months or longer. According to the Hamilton Rating Scale for Anxiety, the Physician Global Opinion of Improvement, and the Patient Opinion of Improvement, the use of buspirone resulted in a significant reduction in anxiety. The degree of this improvement correlated with the duration of drug use. After the third month of therapy, there was an extremely low incidence of patient discontinuation due to side effects or insufficient improvement. Adverse effects were typical of those observed in other double-blind, placebo-controlled studies that compared buspirone with benzodiazepines. Overall, buspirone was well tolerated for maintenance therapy. PMID- 3320035 TI - Clinical epidemiology of suicide. AB - The epidemiologic identification of risk factors for suicide attempts and suicide deaths is important to clinical decision making and preventive public health efforts. The risk factors for suicide attempts include female sex, a recent stressful life event, methods of low lethality, impulsivity, and previous attempts. Risk factors for suicide deaths include a family history of suicide, male sex, and a psychiatric disorder. Suicide deaths in the "youth" birth cohort increased nearly 150% between 1960 and 1980. The term "youth" refers to those in the transitional period from adolescence to adulthood--roughly, between the ages of 18 and 30 years. An increase in substance abuse and in depressive disorders in this group paralleled the increase in suicide incidence. A novel, but frightening, tendency also noted in this group was social contagion--evidenced by clusters of suicides "mimicking" the suicide method and creating mini-epidemics. PMID- 3320036 TI - Psychobiologic predictors of suicide. AB - Suicide is a significant cause of mortality in patients suffering from major affective disorders, schizophrenia, and alcoholism. Generally, several clinical and psychosocial factors combine to result in suicide. These risk factors have high sensitivity but low specificity; only a small minority of patients who meet risk criteria actually complete suicide. Therefore, clinicians have had great difficulty in assessing suicide risk; more clinically useful risk indicators are crucially needed. Biologic markers such as low cerebrospinal fluid levels of the serotonin metabolite 5-hydroxyindoleacetic acid and related indices of serotonergic function appear to correlate with violent and impulsive suicidal behavior. These and other biologic changes may have predictive value in determining suicide risk, as well as contributing to the formulation of a more complete model to explain suicidal behavior that combines genetic, biologic, psychologic, and social factors. PMID- 3320037 TI - Lest treatment abet suicide. AB - Epidemiologic data have identified risk factors, such as major depressive illness and sedative/alcohol addiction, that can help the clinician detect potentially suicidal persons. Evidence of subtle differences in the pattern of suicidality in bipolar and unipolar depressive illnesses has emerged. Suicide occurs early in unipolar episodes and intensifies along with increasing agitation and worsening melancholic symptoms. In bipolar depressive episodes, suicidality becomes an issue late in the course of a single episode, and illness severity and lethality are progressively aggravated by each affective relapse. Safe, effective treatment for suicide patients is the responsibility of the individual clinician and depends on neuropsychiatric variables, proper therapy, and direct and honest communication between patient and clinician. Adamant avoidance of division of primary clinical responsibility among cooperating specialists and clinician obstinancy when dealing with third parties can help prevent suicides. Early identification of psychosis, sedativism and subtle organicity are imperative. Pharmacotherapy usually equates to the fastest acting, most effective antidepressant drug, but some patients require electroconvulsive therapy to reduce suicidality. Involvement is the essence of psychotherapy in suicide management. PMID- 3320038 TI - Characterization of H+/OH- currents in phospholipid vesicles. AB - In pure phospholipid vesicles, the conductivity of H+/OH- ions exceeds that for other simple inorganic ions. Protons achieve electrochemical equilibrium across egg phosphatidylcholine vesicles within tens of minutes. When pH gradients are established across vesicles, transmembrane potentials develop. Conversely, the establishment of transmembrane potentials leads to the formation of pH gradients. When the phenomenological permeability of H+/OH- ions in vesicles is estimated, values are obtained that are much greater (six orders of magnitude larger) than those for Na+ or K+. A wide range in the values for this permeability has been reported; however, much of the discrepancy can be attributed to differences in the vesicle systems and experimental conditions. The H+/OH- current appears to be modulated by changes in membrane dielectric constant. However, the dependence of this current on the pH gradient and on the membrane voltage argues against simple diffusion mechanisms as the source of the H+/OH- current. In addition, in vesicle systems the H+/OH- current shows a surprising invariance to changes in the membrane dipole potential, an observation that argues against the role of simple carriers for H+ and OH- ions. PMID- 3320039 TI - The phase behavior of lipids in photosynthetic membranes. AB - The phase behavior of the main classes of polar lipids found in the photosynthetic membranes of higher plants and algae is reviewed and compared to that of binary lipid mixtures and total lipid extracts of such membranes. Particular interest is paid to the way in which factors such as temperature and acyl chain saturation influence the phase behavior of these lipids and the implications this has in terms of the ability of photosynthetic membranes to resist environmental stress. PMID- 3320040 TI - Nuclear magnetic resonance methods to characterize lipid-protein interactions at membrane surfaces. AB - Specific molecular interactions that determine many of the functions of a biomembrane have a high probability of occurring at the surface of that membrane. However, unlike their hydrophobic core, the polar-apolar interface of biomembranes has been somewhat neglected experimentally. Reasons for this are that the chemical heterogeneity encountered makes a simple description difficult and that probing the membrane surface often involves a perturbation of those very interactions being studied. Classical methods for obtaining structural information about biomolecules, including X-ray diffraction, electron microscopy, and more recently high-resolution 2D nuclear magnetic resonance techniques are inappropriate for all but the simplest of membrane problems. In an effort to throw light on how membrane surfaces are organized, both architecturally and dynamically, protons in lipids and proteins have been selectively replaced by deuterons and the resultant deuterium NMR spectrum analyzed to give structural and dynamic information about the molecular associations between a range of membrane components. In principle, lipids, proteins, and oligosaccharides can be studied by this method and the information gained related to biochemical integrity and function. With one or two notable exceptions, the majority of the studies reported so far have been on model systems. A comprehensive review of the literature will not be presented here. However, protein-lipid molecular specificity in membranes, peptide-induced lateral separation, and the ionization behavior of deuterated phospholipids and peripheral proteins will all be demonstrated predominantly using deuterium NMR methods. Some suggestions for future work are also presented. PMID- 3320041 TI - Structural and functional consequences of galactolipids on thylakoid membrane organization. AB - Photosynthetic membranes of higher plant chloroplasts are composed primarily of polar, but uncharged, galactolipids unlike most mammalian membranes which contain large amounts of phosphatidylcholine. It is unclear what role(s) the galactolipids play in maintaining the differentiated thylakoid membranes, or in stabilizing the photosynthetically active enzyme complexes. Some of the membrane complexes show no lipid selectivity for maintaining structural or functional integrity. Others are poisoned or dissociated in the presence of high concentrations of a trace lipid class. The efficiency of energy transfer and the reconstitution of protein complexes into liposomes are dependent on the lipid class employed. The lipids are asymmetrically arranged along and across the thylakoid membranes but not as distinctly as the proteins. PMID- 3320042 TI - Fatty alcohol metabolism in cultured human fibroblasts. Evidence for a fatty alcohol cycle. AB - Intact cultured human fibroblasts reduced [1-14C]palmitate to radioactive hexadecanol in a concentration-dependent manner. In the presence of 30 microM radioactive palmitate, cellular levels of labeled hexadecanol increased over time and reached a steady state corresponding to at least 0.1% of cell-associated radioactive palmitate. These levels of [14C]hexadecanol were increased up to 10 fold when exogenous nonradioactive hexadecanol was present, suggesting that radioactive hexadecanol was actively metabolized. Cells incubated in fatty acid free medium with [1-14C]hexadecanol rapidly oxidized it to palmitic acid; less than 2% of the hexadecanol taken up by the cells was incorporated into the ether linkage of phosphatidylethanolamine, and no incorporation into wax esters was detected. Double-label experiments involving incubation of intact fibroblast with [3H]palmitate and [14C]hexadecanol demonstrated simultaneous synthesis of hexadecanol from palmitate and oxidation of hexadecanol to palmitate. Addition of exogenous palmitate to the medium of intact cells inhibited the oxidation of hexadecanol to fatty acid in a concentration-dependent fashion. This was associated with an increase in the fibroblast content of hexadecanol and loss of hexadecanol into the medium. Activity of fatty alcohol:NAD+ oxidoreductase, which catalyzes the oxidation of hexadecanol to palmitic acid, was inhibited by palmitoyl-CoA and NADH, but not by palmitic acid. These results are consistent with the presence of a "fatty alcohol cycle" in which hexadecanol is synthesized from palmitate via acyl-CoA and simultaneously oxidized back to free fatty acid. Fatty acyl-CoA, which is the primary substrate for fatty alcohol synthesis, may also regulate the intracellular level of fatty alcohol by inhibiting its oxidation. PMID- 3320043 TI - First cysteine-rich repeat in ligand-binding domain of low density lipoprotein receptor binds Ca2+ and monoclonal antibodies, but not lipoproteins. AB - The ligand binding domain of the low density lipoprotein receptor consists of seven cysteine-rich repeats of approximately 40 amino acids each. These repeats, which are located at the NH2 terminus of the protein, are homologous to sequences in complement components C8 and C9. To determine the role of the first repeat (amino acids 2-42), we prepared two plasmids containing expressible low density lipoprotein receptor cDNAs. The first plasmid, p delta R1, lacks only the nucleotides encoding the first repeat. It produced a receptor that bound and internalized lipoproteins and recycled to the cell surface with the same efficiency as the normal receptor. This deleted receptor failed to bind two monoclonal antibodies, IgG-C7 and IgG-15C8, which were shown previously to react with the ligand-binding domain. The second plasmid, pR1, encodes a markedly truncated protein whose extracellular domain consists of the first repeat joined to the transmembrane and cytoplasmic domains. This protein bound the two monoclonal antibodies with the same affinity as the normal receptor, but failed to bind lipoproteins. Binding of IgG-15C8 to the normal receptor and the pR1 encoded protein was Ca2+-dependent, indicating that the first repeat binds Ca2+. We conclude that repeats 2-6 in the ligand-binding domain are sufficient for binding lipoproteins and that the first repeat is highly immunogenic, but is not required for lipoprotein binding. PMID- 3320044 TI - Controls on the biosynthesis of the manganese-containing superoxide dismutase of Escherichia coli. Effects of thiols. AB - In vitro synthesis of Escherichia coli manganese-containing superoxide dismutase, directed by the plasmid pDT1-5, has been achieved. The Mn superoxide dismutase polypeptide was identified by electrophoresis on polyacrylamide gels, immunoprecipitation, and the competitive immunoprecipitation effect of pure, active E. coli Mn superoxide dismutase. Dithiothreitol and glutathione, but not cysteine, suppressed in vitro synthesis of Mn superoxide dismutase. The parallel syntheses of beta-lactamase and of another unidentified polypeptide were not suppressed by thiols. In vitro transcription of the E. coli Mn superoxide dismutase gene was similarly suppressed by glutathione, dithiothreitol, and beta mercaptoethanol; but not by L-cysteine or thioglycolate. Compounds, such as diamide, 1-chloro-2,4-dinitrobenzene, potassium ferricyanide, and methylene blue, which are expected to deplete intracellular glutathione, caused the induction of Mn superoxide dismutase in anaerobic E. coli. PMID- 3320045 TI - Papilin: a Drosophila proteoglycan-like sulfated glycoprotein from basement membranes. AB - A sulfated glycoprotein was isolated from the culture media of Drosophila Kc cells and named papilin. Affinity purified antibodies against this protein localized it primarily to the basement membranes of embryos. The antibodies cross reacted with another material which was not sulfated and appeared to be the core protein of papilin, which is proteoglycan-like. After reduction, papilin electrophoresed in sodium dodecyl sulfate-polyacrylamide gel electrophoresis as a broad band of about 900,000 apparent molecular weight and the core protein as a narrow band of approximately 400,000. The core protein was formed by some cell lines and by other cells on incubation with 1 mM 4-methylumbelliferyl xyloside, which inhibited formation of the proteoglycan-like form. The buoyant density of papilin in CsCl/4 M guanidine hydrochloride is 1.4 g/ml, that of the core protein is much less. Papilin forms oligomers linked by disulfide bridges, as shown by sodium dodecyl sulfate-agarose gel electrophoresis and electron microscopy. The protomer is a 225 +/- 15-nm thread which is disulfide-linked into a loop with fine, protruding thread ends. Oligomers form clover-leaf-like structures. The protein contains 22% combined serine and threonine residues and 25% combined aspartic and glutamic residues. 10 g of polypeptide has attached 6.4 g of glucosamine, 3.1 g of galactosamine, 6.1 g of uronic acid, and 2.7 g of neutral sugars. There are about 80 O-linked carbohydrate chains/core protein molecule. Sulfate is attached to these chains. The O-linkage is through an unidentified neutral sugar. Papilin is largely resistant to common glycosidases and several proteases. The degree of sulfation varies with the sulfate concentration of the incubation medium. This proteoglycan-like glycoprotein differs substantially from corresponding proteoglycans found in vertebrate basement membranes, in contrast to Drosophila basement membrane laminin and collagen IV which have been conserved evolutionarily. PMID- 3320046 TI - Structural characterization of pertussis toxin A subunit. AB - The relationship between the structure of the A subunit of pertussis toxin and its function was analyzed. Limited tryptic digestion of the A subunit converted the protein to two stable fragments (Mr = 20,000 and 18,000). Antibodies raised to synthetic peptides homologous to regions in the A subunit were used to map these fragments. Both fragments were shown to contain the NH2-terminal portion but not the COOH-terminal portion of the A subunit. While these fragments exhibited NAD glycohydrolase activity, they were unable to reassociate with the B oligomer of the toxin. Thus the COOH-terminal portion of the A subunit does not contain the residues which are required for the NAD glycohydrolase activity of the toxin. However, this region of the molecule may be important for maintaining the oligomeric structure of the toxin. These results suggest that the A subunit of pertussis toxin is similar in structure to the A subunit of cholera toxin. In addition, antibodies raised to a synthetic peptide identical to residues 6-17 of the A subunit of pertussis toxin will bind to the A subunit of cholera toxin. PMID- 3320047 TI - Assembled clathrin in erythrocytes. AB - Clathrin cages were isolated from rat erythrocytes. These structures exist in the intact cell as demonstrated by immunofluorescence and were not formed during the isolation procedure. The cages were largely devoid of membrane but contained the assembly protein complex and both the 50-kDa kinase (pp50) and casein kinase II activities found previously in clathrin-coated vesicles. PMID- 3320048 TI - Calcium-dependent cell-cell adhesion molecules (cadherins): subclass specificities and possible involvement of actin bundles. AB - Cadherins are a family of cell-cell adhesion molecules and are divided into subclasses with distinct adhesive specificities and tissue distribution. Here we examined the distribution of cadherins at contact sites between cells expressing the same or different cadherin subclasses. Each cadherin was concentrated at the boundary between cells expressing an identical cadherin subclass, irrespective of the cell types connected. However, such localization decreased or disappeared at the boundary between cells containing different cadherin subclasses. We also found that the localization of cadherins precisely coincided with that of actin bundles; both were detected at the apical region of cell sheets. This co localization was retained even after cells were either treated with cytochalasin D or extracted with the detergent NP40. These results suggest that each cadherin subclass preferentially interacts with its own molecular type at intercellular boundaries, and that cadherin molecules may be associated with actin-based cytoskeletal elements. PMID- 3320049 TI - The contact site A glycoprotein mediates cell-cell adhesion by homophilic binding in Dictyostelium discoideum. AB - Dictyostelium discoideum expresses a developmentally regulated cell surface glycoprotein of Mr 80,000 (gp80), which has been implicated in the formation of the EDTA-resistant contact sites A at the cell aggregation stage. To determine whether gp80 participates directly in cell binding and, if so, its mode of action, we conjugated purified gp80 to Covaspheres (Covalent Technology Corp., Ann Arbor, MI) and investigated their ability to bind to cells. The binding of gp80-Covaspheres was dependent on the developmental stage of the cells, with maximal interaction at the late aggregation stage. Scanning electron microscopic studies revealed the clustering of gp80-Covaspheres at the polar ends of these cells, similar to the pattern of gp80 distribution on the cell surface as reported earlier (Choi, A. H. C., and Siu, C.-H., 1987, J. Cell Biol., 104:1375 1387). Precoating cells with an adhesion-blocking anti-gp80 monoclonal antibody inhibited the binding of gp80-Covaspheres, suggesting that Covasphere-associated gp80 might undergo homophilic interaction with gp80 on the cell surface. Quantitative binding of 125I-labeled gp80 to intact cells gave an estimate of 1.5 X 10(5) binding sites per cell at the aggregation stage. Binding of soluble gp80 to cells was blocked by precoating cells with the anti-gp80 monoclonal antibody. The ability of gp80 to undergo homophilic interaction was further tested in a filter-binding assay, which showed that 125I-labeled gp80 was able to interact with gp80 bound on nitrocellulose in a dosage-dependent manner. In addition, reassociation of cells was significantly inhibited in the presence of soluble gp80, suggesting that gp80 has a single cell-binding site. These results are consistent with the notion that gp80 mediates cell-cell binding at the aggregation stage of development via homophilic interaction. PMID- 3320050 TI - Transcytosis of albumin in capillary endothelium. AB - We have used a variety of immunocytochemical procedures to localize albumin in transit through the capillary endothelium of the murine myocardium and thereby identify endothelial cell structures involved in albumin efflux. The most informative results were obtained with a protocol that included (a) removal of endogenous albumin by perfusion of the heart with PBS supplemented with 14 mM glucose, (b) perfusion of the heart vasculature with exogenous (bovine) albumin for various short time periods, (c) fixation of the vessels by formaldehyde glutaraldehyde mixtures, (d) processing of fixed myocardium specimens through L. R. White embedding followed by sectioning, or direct thin frozen sectioning, and (e) reacting the surface of such specimens with antialbumin antibodies followed by gold-labeled secondary antibodies. The results indicate that (a) monomeric albumin binds (with low affinity) to the luminal surface of the capillary endothelium, (b) it is restricted in transit through the endothelium to plasmalemmal vesicles, and (c) it appears in the pericapillary spaces less than 15 s after the beginning of its perfusion. No albumin concentration gradients, centered with their maxima on the exits from intercellular spaces, were detected at any time points, including the shortest ones (15 and 30 s) investigated. Additional information comparing monomeric vs. polymeric albumin transcytosis was obtained using albumin-gold complexes. The results are discussed in terms of vesicular transport of albumin across the endothelium and the relations of this type of transport to the postulated pore systems of the physiological literature. PMID- 3320051 TI - Processing of a wheat light-harvesting chlorophyll a/b protein precursor by a soluble enzyme from higher plant chloroplasts. AB - A processing activity has been identified in higher plant chloroplasts that cleaves the precursor of the light-harvesting chlorophyll a/b-binding protein (LHCP). A wheat LHCP gene previously characterized (Lamppa, G.K., G. Morelli, and N.-H. Chua, 1985. Mol. Cell Biol. 5:1370-1378) was used to synthesize RNA and subsequently the labeled precursor polypeptide in vitro. Incubation of the LHCP precursors with a soluble extract from lysed chloroplasts, after removal of the thylakoids and membrane vesicles, resulted in the release of a single 25-kD peptide. In contrast, when the LHCP precursors were used in an import reaction with intact pea or wheat chloroplasts, two forms (25 and 26 kD) of mature LHCP were found. The peptide released by the processing activity in the organelle-free assay comigrated with the lower molecular mass form of mature LHCP produced during import. Properties of the processing activity suggest that it is an endopeptidase. Chloroplasts from both pea and wheat, two divergent higher plants, contain the processing enzyme, suggesting its physiological importance in LHCP assembly into the thylakoids. We discuss the implications of LHCP precursor processing by a soluble enzyme that may be in the stromal compartment. PMID- 3320052 TI - Import of fructose bisphosphate aldolase into the glycosomes of Trypanosoma brucei. AB - The glycolytic enzymes of Trypanosomatids are compartmentalized within peroxisome like microbodies called glycosomes. Fructose bisphosphate aldolase is synthesized on free polysomes and imported into glycosomes within 5 min. Peptide mapping reveals no primary structural differences between the in vivo-synthesized protein and that made in vitro from a synthetic template. However, native aldolase from glycosomes is partially protease resistant, whereas the in vitro translation product is not. Pulse-chase results indicate that aldolase in bloodstream trypanosomes has a much longer half-life than in the procyclic tsetse fly form. PMID- 3320053 TI - Immunochemical localization of myosin heavy chain isoforms and paramyosin in developmentally and structurally diverse muscle cell types of the nematode Caenorhabditis elegans. AB - The nematode Caenorhabditis elegans contains two major groups of muscle cells that exhibit organized sarcomeres: the body wall and pharyngeal muscles. Several additional groups of muscle cells of more limited mass and spatial distribution include the vulval muscles of hermaphrodites, the male sex muscles, the anal intestinal muscles, and the gonadal sheath of the hermaphrodite. These muscle groups do not exhibit sarcomeres and therefore may be considered smooth. Each muscle cell has been shown to have a specific origin in embryonic cell lineages and differentiation, either embryonically or postembryonically (Sulston, J. E., and H. R. Horvitz. 1977. Dev. Biol. 56:110-156; Sulston, J. E., E. Schierenberg, J. White, and J. N. Thomson. 1983. Dev. Biol. 100:64-119). Each muscle type exhibits a unique combination of lineage and onset of differentiation at the cellular level. Biochemically characterized monoclonal antibodies to myosin heavy chains A, B, C, and D and to paramyosin have been used in immunochemical localization experiments. Paramyosin is detected by immunofluorescence in all muscle cells. Myosin heavy chains C and D are limited to the pharyngeal muscle cells, whereas myosin heavy chains A and B are localized not only within the sarcomeres of body wall muscle cells, as reported previously, but to the smooth muscle cells of the minor groups as well. Myosin heavy chains A and B and paramyosin proteins appear to be compatible with functionally and structurally distinct muscle cell types that arise by multiple developmental pathways. PMID- 3320054 TI - Incorporation of nascent myosin heavy chains into thick filaments of cardiac myocytes in thyroid-treated rabbits. AB - A monoclonal antibody (mAb 37) specific for alpha-myosin heavy chain (alpha-MHC) is used to follow the spatial and temporal incorporation of alpha-MHC into rabbit left ventricular myocytes. The expression of the two adult cardiac MHC genes, alpha and beta, is regulated by manipulating the thyroid hormone level of the animal. 10 wk on a propylthiouracil diet down-regulates expression of alpha-MHC to near 0%. alpha-MHC gene expression is up-regulated by injecting L triiodothyronine (100 micrograms/kg per d) for 1-4 d. This protocol provides a means by which to follow the redistribution pattern of alpha-MHC within the myocyte in vivo. A uniform distribution of immunofluorescent signal is seen within every myocyte throughout the left ventricle. Ultracryomicrotomy without fixation is used to obtain sections for immunogold-electron microscopy. To quantify the immunogold method the density of gold-labeled antibody per unit of area tissue is determined for various regions of the sarcomere. Tissue from normal and 2-wk baby has a uniform distribution of gold density along the length of the A band. The average gold density of the A band increases with days of thyroid injection from 38 +/- 4 grains/micron 2 (n = 2 animals) (mean +/- SE) at day 1 to 182 +/- 59 grains (n = 2 animals) at day 4. There is a nonuniform incorporation of the newly synthesized alpha-MHC within the A band of thyroid treated animals since 50% more of the alpha-MHC is found at the end of the A band while the center of the A band has 40% less than the average alpha-MHC content (grains/micron 2, n = 7 animals). These results support a thick filament assembly model that allows every myosin in a thick filament to be exchanged with new myosin. However, in the intact functioning myocyte, there is greater exchange of new myosin at the ends than in the central region of the thick filament. PMID- 3320056 TI - Immunocytochemical studies of cardiac myofibrillogenesis in early chick embryos. II. Generation of alpha-actinin dots within titin spots at the time of the first myofibril formation. AB - In whole mount preparations of the 9 somite stage chick embryonic hearts that were immunofluorescently double labeled for titin and alpha-actinin, presumptive myofibrils were recognized as rows of several periodically aligned titin spots. Within these titin spots, smaller alpha-actinin dots were observed. These periodical arrangements of titin spots and alpha-actinin dots were not found in the 7 somite stage hearts. In wide myofibrils in the 10 somite stage hearts, the alpha-actinin dots and titin spots simultaneously became 'lines.' To study the ultrastructural features of the titin-positive regions in the 6-9 somite stage hearts, the thoracic portions of the embryos were immunofluorescently labeled for titin and embedded in resin. Ultrathin sections were mounted on electron microscopic grids and examined in immunofluorescence optics. The titin-positive regions thus identified were then examined in the electron microscope. No readily discernable specific ultrastructural features were found in titin-positive regions of the 6 somite stage cardiac primodia. Examination of the sections of the 9 somite stage hearts, on the other hand, revealed the occasional presence of small dense bodies, Z bodies, in the titin-positive regions. These observations strongly suggest that these Z bodies are the ultrastructural counterparts of the alpha-actinin dots seen by immunofluorescence optics and that they are formed nearly at the time of the formation of the first myofibrils. In some of the nascent myofibrils the Z bodies were found to be considerably narrower than the myofibrils, implying that the Z bodies are required not for the assembly of myofibrils per se but for their stabilization. Immunofluorescent labeling for titin and alpha-actinin revealed that the length of the shortest sarcomeres in the first myofibrils is approximately 1.5 micron, approximately the width of the A bands of mature myofibrils. The possibility that the A bands might define the initial length of nascent sarcomeres was indicated. PMID- 3320055 TI - Immunocytochemical studies of cardiac myofibrillogenesis in early chick embryos. I. Presence of immunofluorescent titin spots in premyofibril stages. AB - Our initial attempts to immunolabel intact myocardial walls of 4-12 somite stage chick embryos were hindered by the presence of the cardiac jelly that covers the inner myocardial wall surface and prevents the access of antibodies to that surface. We overcame this difficulty by treating the specimens with hyaluronidase, which made the cardiac jelly permeable to the antibodies. An additional nonionic detergent treatment made the two or more cell layers of the myocardial wall accessible to the antibodies from both surfaces of the wall. Specimens treated in this manner were fluorescently labeled with antibodies to titin, myosin, or actin or with NBD-phallacidin for F-actin and examined as whole mount preparations or cut into semithin sections after resin embedding. These preparations and sections revealed that titin, a putative scaffolding protein of sarcomeres, is present in a punctate state and also in a diffuse form throughout the cytoplasm of cardiac myocytes in the premyofibril stages (4-7 somite stages) as well as in the early stages of myofibril formation. We interpreted the punctate and diffuse states to represent an aggregated state of several titin molecules and a dispersed state of individual titin molecules, respectively. In the 4-7 somite cardiac primodia, myosin and actin show only a uniform labeling throughout the cytoplasm of the myocytes. These observations are in contrast to a previous report that titin and myosin are tightly linked during in vitro skeletal myofibrillogenesis (Hill, C. S., S. Duran, Z. Ling, K. Weber, and H. Holtzer, 1986, J. Cell Biol., 103:2185-2196). In the 8-11 somite stage hearts, the number of individual titin spots rapidly reduces, while the number of myofibrils with periodically aligned titin spots increases, which strongly suggests that the titin spots are incorporated into the newly arising myofibrils. Titin spots were seen as doublets only after titin spots were incorporated into the first myofibrils. However, the fact that the distance between the components of the narrowest doublet was close to the resolution limit of the light microscope left open the possibility that undiscernible doublets of submicroscopic separations might exist in the premyofibril stages. The myosin labeling revealed the sarcomeric periodicity in an earlier stage of myofibril development than the F actin labeling. In addition, we made two morphogenic observations.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3320057 TI - Distribution and cellular localization of actin depolymerizing factor. AB - Actin depolymerizing factor (ADF) is a low molecular mass (19 kD) protein that forms a tightly bound dimeric complex with actin. We have raised a rabbit antiserum to chick brain ADF and used it to analyze the distribution and cellular localization of ADF. We find that ADF is a major constituent of all chick embryonic and most adult tissues examined, accounting for 0.1-0.4% of the total protein. Some tissues have as much as 0.6 mol ADF per mole actin. Adult heart and skeletal muscle are unusual in having very low levels of ADF: less than 0.02% of the soluble protein. During the development of skeletal muscle, ADF levels are maximal up to approximately 11 d in ovo and then decline to reach their adult levels by 14 d posthatching. Brain tissue and cultured cell lines from several other vertebrates, including mammals, all possess proteins of identical size to ADF that are recognized by the ADF antiserum. No proteins are specifically recognized by the ADF antiserum in extracts from Acanthamoeba castellanii or from nerve tissue of several invertebrates. Indirect immunofluorescence shows that ADF is present throughout the cytosol of most cells and at the leading edge of ruffled membranes and in the neuronal growth cone. Its abundance and widespread distribution together with its ability to sequester actin molecules, even those in an already polymerized state, suggest that ADF is a major factor in the regulation of actin filaments in many vertebrate cells. PMID- 3320059 TI - Translocation in yeast and mammalian cells: not all signal sequences are functionally equivalent. AB - In Saccharomyces cerevisiae, nascent carboxypeptidase Y (CPY) is directed into the endoplasmic reticulum by an NH2-terminal signal peptide that is removed before the glycosylated protein is transported to the vacuole. In this paper, we show that this signal peptide does not function in mammalian cells: CPY expressed in COS-1 cells is not glycosylated, does not associate with membranes, and retains its signal peptide. In a mammalian cell-free protein-synthesizing system, CPY is not translocated into microsomes. However, if the CPY signal is either mutated to increase its hydrophobicity or replaced with that of influenza virus hemagglutinin, the resulting precursors are efficiently translocated both in vivo and in vitro. The implications of these results for models of signal sequence function are discussed. PMID- 3320058 TI - Role of transforming growth factor-beta in the development of the mouse embryo. AB - Using immunohistochemical methods, we have investigated the role of transforming growth factor-beta (TGF-beta) in the development of the mouse embryo. For detection of TGF-beta in 11-18-d-old embryos, we have used a polyclonal antibody specific for TGF-beta type 1 and the peroxidase-antiperoxidase technique. Staining of TGF-beta is closely associated with mesenchyme per se or with tissues derived from mesenchyme, such as connective tissue, cartilage, and bone. TGF-beta is conspicuous in tissues derived from neural crest mesenchyme, such as the palate, larynx, facial mesenchyme, nasal sinuses, meninges, and teeth. Staining of all of these tissues is greatest during periods of morphogenesis. In many instances, intense staining is seen in mesenchyme when critical interactions with adjacent epithelium occur, as in the development of hair follicles, teeth, and the submandibular gland. Marked staining is also seen when remodeling of mesenchyme or mesoderm occurs, as during formation of digits from limb buds, formation of the palate, and formation of the heart valves. The presence of TGF beta is often coupled with pronounced angiogenic activity. The histochemical results are discussed in terms of the known biochemical actions of TGF-beta, especially its ability to control both synthesis and degradation of both structural and adhesion molecules of the extracellular matrix. PMID- 3320060 TI - Expression in Escherichia coli of a functional Dictyostelium myosin tail fragment. AB - The amino acid sequence of the myosin tail determines the specific manner in which myosin molecules are packed into the myosin filament, but the details of the molecular interactions are not known. Expression of genetically engineered myosin tail fragments would enable a study of the sequences important for myosin filament formation and its regulation. We report here the expression in Escherichia coli of a 1.5-kb fragment of the Dictyostelium myosin heavy chain gene coding for a 58-kD fragment of the myosin tail. The expressed protein (DdLMM 58) was purified to homogeneity from the soluble fraction of E. coli extracts. The expressed protein was found to be functional by the following criteria: (a) it appears in the electron microscope as a 74-nm-long rod, the predicted length for an alpha-helical coiled coil of 500 amino acids; (b) it assembles into filamentous structures that show the typical axial periodicity of 14 nm found in muscle myosin native filaments; (c) its assembly into filaments shows the same ionic strength dependence as Dictyostelium myosin; (d) it serves as a substrate for the Dictyostelium myosin heavy chain kinase which phosphorylates myosin in response to chemotactic signaling; (e) in its phosphorylated form it has the same phosphoamino acids and similar phosphopeptide maps to those of phosphorylated Dictyostelium myosin heavy chain; (f) it competes with myosin for the heavy chain kinase. Thus, all the information required for filament formation and phosphorylation is contained within this expressed protein. PMID- 3320061 TI - Evidence that major 78-44-kD concanavalin A-binding glycopolypeptides in pig epidermis arise from the degradation of desmosomal glycoproteins during terminal differentiation. AB - The major concanavalin A (Con A)-binding component in urea/deoxycholate/mercaptoethanol extracts from pig ear epidermis had an apparent Mr of 78 kD. In indirect immunofluorescence affinity-purified polyclonal antibodies against this glycopolypeptide strongly stained the surface of suprabasal cells in the epidermis of pig and human skin. Immunocytochemical labeling with gold-labeled second antibody localized this staining to externally disposed, trypsin-sensitive components of desmosomes. Western blotting showed that the 78-kD glycopolypeptide was immunologically related to several other Con A-binding components in pig epidermis. Immunoreactive components with Mr of 115 and 100 kD were membrane-bound, appeared to be susceptible to trypsin in intact epidermis, and were absent from the stratum corneum. Immunoreactive components of lower Mr (78-44 kD) were not membrane-bound, were resistant to trypsin in intact tissue, and were present predominantly in the keratinized layers of pig epidermis. The 115-44-kD glycopolypeptides were also recognized by antisera raised against desmoglein II/desmocollin glycoproteins isolated from bovine spinous layer desmosomes. In addition, these antisera reacted with 120- and 105 kD bands that were apparently not recognized by the anti-78-kD glycopolypeptide antiserum in immunoblotting. In immune precipitation the anti-78-kD glycopolypeptide and antidesmoglein II/desmocollin antisera precipitated comparable amounts of the radioiodinated 78-44-kD components. Both antisera also precipitated the 120- and 105-kD components although the anti-78-kD glycopolypeptide serum was less effective. Little reaction with the 115- and 105 kD components was observed in immune precipitation with either serum. Proteolytic peptide mapping confirmed that the various immunoreactive glycopolypeptides were biochemically as well as immunologically related. The results suggest that terminal differentiation in pig epidermis is accompanied by the orderly degradation of desmoglein II/desmocollin glycoproteins resulting in the accumulation of 78-44-kD glycopolypeptides in the stratum corneum. These glycopolypeptides may represent functionally important nonmembranous domains of cell-adhesion molecules in desmosomes. PMID- 3320062 TI - Cell surface proteoglycan of mouse mammary epithelial cells is shed by cleavage of its matrix-binding ectodomain from its membrane-associated domain. AB - The cell surface proteoglycan on normal murine mammary gland (NMuMG) epithelial cells consists of a lipophilic domain, presumably intercalated into the plasma membrane, and an ectodomain that binds via its glycosaminoglycan chains to matrix components, is released intact by proteases and is detected by monoclonal antibody 281-2. The antibody 281-2 also detects a proteoglycan in the culture medium conditioned by NMuMG cells. This immunoactive proteoglycan was purified to homogeneity using DEAE-cellulose chromatography, isopycnic centrifugation, and 281-2 affinity chromatography. Comparison of the immunoreactive medium proteoglycan with the trypsin-released ectodomain revealed that these proteoglycans are indistinguishable by several criteria as both: (a) contain heparan sulfate and chondroitin sulfate chains; and (b) are similar in hydrodynamic size and buoyant density; (c) have the same size core protein (Mr approximately 53 kD); (d) are nonlipophilic as studied by liposomal intercalation and transfer to silicone-treated paper. Kinetic studies of the release of proteoglycan from the surface of suspended NMuMG cells are interpreted to indicate that the immunoreactive medium proteoglycan is derived directly from the cell surface proteoglycan. Suspension of the cells both augments the release and inhibits the replacement of cell surface proteoglycan. These results indicate that the cell surface proteoglycan of NMuMG cells can be shed by cleavage of its matrix-binding ectodomain from its membrane-associated domain, providing a mechanism by which the epithelial cells can loosen their proteoglycan-mediated attachment to the matrix. PMID- 3320063 TI - Modulation of fibronectin, laminin, and cellular adhesion in the transformation and differentiation of murine AKR fibroblasts. AB - The functional relationship between membrane/cell surface expression of fibronectin and laminin and transformation/differentiation was examined in an AKR mouse fibroblastic cell model. This model consisted of the untransformed AKR-2B cells, their chemically transformed counterpart (AKR-MCA cells) and the chemically differentiated form of the AKR-MCA cells. The transformed AKR-MCA cells were found to express more surface laminin and less fibronectin than the untransformed AKR-2B cells. The transformed AKR-MCA cells were slower to attach and spread on both plastic and type IV collagen-coated dishes in comparison to the AKR-2B cells. However, a higher percentage of the AKR-MCA cells ultimately attached and spread on the type IV collagen-coated dishes. The induction of differentiation in the AKR-MCA cells by N,N-dimethylformamide (DMF) restored fibronectin to the surface of the AKR-MCA cells but reduced laminin expression only slightly. The DMF-treated AKR-MCA cells resembled the AKR-2B cells in that they rapidly attached and spread on plastic dishes and dishes coated with type IV collagen. They also resembled the AKR-MCA cells in that a high proportion ultimately attached and spread on the collagen-coated dishes. PMID- 3320064 TI - EGF-dependent phosphorylation of the EGF receptor in plasma membranes isolated from young and senescent WI-38 cells. AB - Tyrosine-specific phosphorylation of the receptor for epidermal growth factor (EGF) in plasma membranes isolated from WI-38 cells is EGF-dependent and occurs to an equivalent extent and on identical tryptic peptides in preparations from cells of various in vitro ages. There is a marked reduction, however, in phosphorylation of receptor molecules from senescent as compared with young WI-38 cells, if enzyme activity is assayed in an immune complex following solubilization of plasma membranes with Nonidet P-40 (NP-40). Differences in the level of receptor phosphorylation in young vs. senescent NP-40 extracts are not resolved by changing the temperature at which the assay is performed, or the length of incubation. Moreover, addition of NP-40 or chloroform-methanol extracts of young cells to assays measuring receptor phosphorylation in senescent cell NP 40 preparations does not augment the senescent enzyme activity. The immunopurified senescent receptor is, however, capable of catalyzing phosphorylation of exogenous substrates. These results indicate that the loss of receptor autophosphorylation in solubilized preparations may result from a differential sensitivity of the senescent cell receptor to the detergent. This finding provides a marker for senescence and suggests subtle changes in protein structure, conformation, or regulation of the EGF receptor in senescent cells. PMID- 3320066 TI - Distal radioulnar joint dysfunction. AB - Dislocations of the DRUJ, when diagnosed promptly, may be successfully treated by closed reduction and immobilization. Symptomatic tears of the TFCC may be decompressed by ulnar shortening with or without debridement of the tear. Several operations are available for the treatment of derangements of the DRUJ. The Lauenstein procedure maintains TFCC function and restores stable painful forearm rotation. PMID- 3320065 TI - Treatment of malunion of the distal radius. AB - Malunions of the distal radius are common. Although the best treatment is prevention, symptomatic malunions can be salvaged through more careful fracture management, by corrective osteotomy or, in the presence of post-traumatic arthritis, radiocarpal arthrodesis. Dynamic midcarpal instability following radius malunion does not respond as well to ligament repair or intercarpal arthrodesis as it does to osteotomy of the radius and correction of the malunion deformity. PMID- 3320067 TI - The permeability properties of septate junctions in Malpighian tubules of Rhodnius. AB - This paper describes the structural characteristics and permeability properties of the smooth septate junctions between the upper Malpighian tubule cells of a blood-sucking bug, Rhodnius prolixus. The permeability of the paracellular route was tested only for solutes that could be demonstrated not to cross the epithelium via the cellular route. The intercellular clefts were readily permeated by sucrose, inulin and polyethylene glycol (PEG), showing a higher permeability to molecules of smaller radius (PEG versus sucrose). Negatively charged molecules permeated the clefts more readily than positively charged ones. The effects of pH, urea and luminal flow rate on permeability were studied. The results are discussed in relation to the physiological tightness of the Malpighian tubules to certain solutes and to its function as an excretory epithelium. PMID- 3320069 TI - [Hydatid cyst of the pancreas. Apropos of 3 cases]. AB - Hydatid cyst of the pancreas is rare since it accounts for less than 1% of the various sites of hydatid disease even in those countries where the latter is endemic. The diagnosis is rarely made before surgery but is currently facilitated by ultrasonography and CAT scan. The authors report 3 cases, including one with a cyst ruptured into the peritoneal cavity. PMID- 3320068 TI - [Volvulus of a mobile spleen. Apropos of a case diagnosed in the preoperative period by ultrasonography]. AB - A case of splenic volvulus, a rare complication of a rare malformation, mobile spleen, is reported, only 150 similar cases being documented in the literature. The diagnosis can be suspected preoperatively by ultrasound imaging. Different etiologies of this lesion are discussed and the various complementary examinations allowing preoperative diagnosis described. PMID- 3320070 TI - [Hemobilia. 3 cases]. AB - The authors relate three cases of haemobilia. One caused by trauma, the second due to the rupture of aneurysm of the right branch of the hepatic artery into the biliary tract, the third one is of gallbladder origin. The remind the major aetiological factors among which the trauma is the most common cause. Selective angiography is the investigation most likely to provide clue to bleeding its site, and orient the therapeutic choice. There are a connection between the prognosis of this rare condition and the importance of the haemorrhage. It's high mortality (15 a 25%) has relation with the frequency of traumatic aetiology. The prognosis is severe in spite of the progress of diagnosis and therapy. PMID- 3320071 TI - [Non-gynecological abdominal emergencies during pregnancy]. AB - Although the incidence of non-gynecological abdominal emergencies during pregnancy is low, surgeons may be confronted with this problem. Maternal and fetal prognosis is conditioned by the severity of the lesion and the delay in diagnosis and not the associated pregnancy. Gestation modifies the clinical picture and biological signs, particularly during the last two trimesters, making diagnosis even more difficult. The most frequently encountered lesions are abdominal contusions and appendicitis, of lesser frequency being occlusions, digestive hemorrhage, biliopancreatic disorders and acute inflammatory colon disease. An exceptional finding is a spontaneous rupture of liver. These various clinical pictures and their surgical treatment are reviewed as a function of documented data and personal experiences, and principles of obstetrical therapy defined. Pregnancy should not modify the surgeon's attitude to non-gynecological abdominal emergencies, the prognosis being related to the rapidity with which he acts. PMID- 3320074 TI - [Acute intestinal obstruction. General review apropos of 100 cases]. AB - The authors report 100 cases of mechanic acute intestinal occlusion. 62% of them are men and 38% are women. The average age of the patients is 40 years (6 to 74 years). It is relatively young. The small intestine occlusion predominance has been noticed. These have been more dominated by bridle and adhesions (56%) from which (42%) post operative. The aetiology of colonic occlusion (31%) is dominated by volvulus (20%). The colonic occlusion is rarely caused by cancer (9%). All the patients are operated and 7 died. The mortality depend of the frequent delay of the diagnosis and the mediocre field. PMID- 3320072 TI - [Leiomyoma of the rectum. A diagnostic and therapeutic dilemma]. AB - A case is reported of leiomyoma of rectum, a rare tumor since it is detected in 2 of 3000 rectal tumors. It occurs principally in patients between 40 and 50 years. The tumor is submucosal, is difficult to diagnose and biopsy is often valueless since it does not involve the tumor mass. The interest of the present case is that trans-rectal ultrasound imaging of the leiomyoma was performed. Differential histologic diagnosis between benign and malignant forms is a dilemma, these tumors being of slow growth with a marked tendency for recurrence and malignant degeneration. Treatment should always be surgical, with local resection if histology has excluded malignancy, followed by periodic surveillance. Radical surgery is indicated in malignant forms or for local recurrence of benign tumors. PMID- 3320073 TI - [Posterior dislocation of the hip associated with fracture of the neck of the femur. Apropos of 3 cases]. AB - Three patients with posterior dislocation of hip associated with fracture of neck of femur were treated by early sanguineous reduction and osteosynthesis. This therapy was very effective since necrosis did not develop either in the short or long-term follow up (1, 3 and 4 years). These findings combined with documented data are in favor of anatomic reconstruction of upper end of femur by stable and solid osteosynthesis, at least in young adults. Early operation, an irreproachable operating tactic (orthopedic table, ventral decubitus, posterior approach), an immediate stable and solid synthesis and a deferred load bearing (beyond 6 months) should reduce the risk of femoral head necrosis to a minimum. PMID- 3320075 TI - Alternative procedure for the purification of the heat-stable enterotoxin of enterotoxigenic Escherichia coli pathogenic for calves. AB - A method for purification of the heat-stable enterotoxin (ST) of enterotoxigenic Escherichia coli (ETEC) strains (C1444 and B41) pathogenic for calves and some physiochemical properties of the ST are described. The method involved ultrafiltration on PM-10 and UM-2 Diaflo membranes, acetone fractionation, ion exchange chromatography on AG 1-X2, chromatofocusing and a combination of hydrophobic interaction chromatography on octyl-Sepharose CL-4B and gel permeation on Bio-Gel P-2. Polyacrylamide gel electrophoresis in sodium dodecyl sulphate of fluorescamine-labeled purified, reduced and alkylated ST preparations revealed a single band with approximate molecular masses of 2500 and 2200 for the C1444 and B41 STs, respectively. For the C1444 ST, the final purification achieved was approximately 27,000-fold on the basis of absorbance at 280 nm per mouse effective dose. However, it was 2000-fold when calculated on the basis of mg protein per effective dose (5 ng). Amino acid composition of the C1444 ST was found to be different from that of the B41 ST suggesting that the ST produced by bovine isolates may be heterogeneous in their structure. PMID- 3320076 TI - The gamma T-cell antigen receptor. AB - The gamma-TCR is encoded by genes composed of V, J, and C elements that demonstrate a limited potential for recombinational diversity. These genes are rearranged, transcribed, and translated into proteins early during thymic ontogeny. Lymphocytes express gamma-TCR proteins on the plasma membrane only in association with the CD3 complex. gamma-TCR glycoproteins usually associate with another non-gamma glycoprotein, designated delta-TCR, to form a heterodimer receptor. Both non-disulfide-bonded and disulfide-bonded gamma/delta-TCR heterodimers have been identified on the plasma membrane of human T lymphocytes. On certain gamma-TCR-bearing T cell lines, a delta-TCR protein cannot be visualized by autoradiography. It is possible that delta-TCR proteins are associated with gamma-TCR glycoproteins on these cell lines but are not efficiently radiolabeled. Alternatively, it has been suggested that homodimers of gamma-TCR proteins can assemble with CD3 and be expressed on the plasma membrane of these cells. In adult lymphoid tissues, the majority of T lymphocytes expresses a CD3, alpha/beta antigen receptor, whereas only a minor subset (less than 5% of peripheral blood lymphocytes, lymph node, spleen, and thymocytes) express a CD3, gamma/delta antigen receptor. IL-2-dependent cell lines of both murine and human CD3, gamma/delta T cells have been established. Most CD3, gamma/delta T cell lines mediate cytotoxicity against a broad spectrum of tumor cell targets, although the functional significance of this observation remains unclear. Cytotoxicity is apparently not restricted by or directed against MHC antigens. Antibodies against CD3 or gamma-TCR can induce proliferation and IL-2 secretion and can either augment or inhibit cytotoxicity, demonstrating that the gamma/delta-TCR is a functional receptor. The ligand recognized by this receptor has not been identified. The physiological role of T lymphocytes expressing gamma/delta-TCR, the molecular and structural properties of delta-TCR, and the relationship between CD3, alpha/beta T lymphocytes and CD3, gamma/delta T lymphocytes are the major unresolved questions that will be the primary focus of further experimentation. PMID- 3320077 TI - [Identification of insulin in the human pancreatic juice obtained by endoscopy]. PMID- 3320078 TI - Using language to parse the young damaged brain. AB - Functional distinctions within the language domain can be used to parse the young damaged brain. Parsing means resolving something into its component parts and describing them; parsing the young damaged brain with language involves selecting and grouping features of early brain damage according to how they sustain or disrupt the language performance of brain-injured children and adolescents. And the nature of neural representation for language can be inferred from such brain parsing. Three language factors concerned with lexical access were identified as discrete, that is, as isolable from other language functions in a brain-damaged population, and also as distinct, that is, as having a characteristic set of brain damage features that sustain or disrupt them. Criteria were also outlined for judging the lexical access factors as autonomous, that is, as able to maintain their boundaries with other language functions in the face of brain damage. PMID- 3320079 TI - Evaluation of MUREX SUDS Toxo test. AB - The SUDS Toxo test (MUREX Corp., Norcross, Ga.) was compared with the indirect hemagglutination test (IHA) and the indirect fluorescent-antibody test (IFA) by examining 404 serum specimens, including 64 (15.8%) specimens with IFA titers of greater than or equal to 1:2. When SUDS was compared with IHA, sensitivity (96.4%), specificity (97.9%), and negative predictive value (99.4%) indicated that there were similar reactivities between the two tests. When an IFA titer of greater than or equal to 1:16 was considered significant and IHA and SUDS were compared with IFA, IHA was slightly less sensitive but had a higher positive predictive value than did SUDS; however, there was no statistical difference between the tests. When SUDS was compared with IFA, in which a titer of greater than or equal to 1:16 was considered significant, the high negative predictive value (100%), excellent sensitivity (100%) and specificity (98.3%), and ease of performance made SUDS an attractive alternative to IHA for screening single serum specimens for toxoplasmosis. PMID- 3320081 TI - Legionella birminghamensis sp. nov. isolated from a cardiac transplant recipient. AB - A Legionella-like organism, strain 1407-AL-H, was isolated from a transbronchial lung biopsy specimen from a cardiac transplant recipient undergoing immunosuppressive therapy. The strain grew on buffered charcoal-yeast extract agar (BCYE) but not on BCYE in the absence of cysteine, and it showed gas-liquid chromatographic fatty acid profiles that were predominantly branch chained. Strain 1407-AL-H was antigenically distinct in slide agglutination tests from the 23 Legionella species and 39 serogroups previously described. DNA hybridization studies placed it in a new Legionella species, Legionella birminghamensis (ATCC 43702). PMID- 3320080 TI - SIGNAL blood culture system for detection of bacteremia in neonates. AB - In the SIGNAL (Oxoid Ltd., Basingstoke, United Kingdom) blood culture system, gas produced by bacterial metabolism displaces medium from the culture bottle into an upper reservoir via a hollow needle. Displacement of media may provide a visual indication of the presence of both aerobic and anaerobic organisms in a single medium. The single-bottle SIGNAL system was compared with paired BACTEC 16B and 7D (Johnston Laboratories, Inc., Towson, Md.) radiometric system bottles by using bacterial inocula and conditions which simulated those found in neonatal and pediatric populations. The single SIGNAL bottle was a good as the combined BACTEC media for Escherichia coli and Staphylococcus aureus, but was slower for Candida spp., Haemophilus influenzae, Pseudomonas aeruginosa, Staphylococcus epidermidis, group B streptococci, alpha-streptococci, and pneumococci. The SIGNAL system failed to detect four of five isolates of Neisseria meningitidis and four of eight anaerobic organisms. The SIGNAL system is not suitable for neonatal blood cultures at its present state of development. PMID- 3320082 TI - Escherichia coli associated with childhood diarrheas. AB - We studied 2,246 episodes of childhood diarrhea over a 2-year period in a general hospital serving a population of about one million on the island of Hong Kong. Rotavirus (24%) and nontyphoid salmonellas (23%) were the most common causal agents, followed by Campylobacter sp. (9%). Rotavirus occurred largely during winter, whereas salmonellas and Campylobacter sp. occurred more commonly during summer and autumn, respectively. Enterotoxigenic Escherichia coli was rarely isolated (1%), and the isolates were clonally diverse. A small percentage (2.8%) of E. coli had serological specificities commonly associated with enteropathogenic E. coli, but only two of the isolates were also positive for HEp 2 adhesive factor. Pure or heavy and predominant growth of E. coli was obtained in repeated stool cultures of 432 (19%) of these episodes, which did not yield any of the above-mentioned pathogens. Although associated with diarrhea, these E. coli isolates possess neither the pathogenic attributes of enterotoxigenic E. coli nor the properties commonly associated with enteropathogenic E. coli. Enteroinvasive E. coli and enterohemorrhagic E. coli were considered unlikely causes on clinical grounds. PMID- 3320083 TI - Spheroplast induction in clinical isolates of Serratia marcescens in the presence of Ca2+ or Mg2+. AB - Serratia marcescens was easily induced to form spheroplasts by beta-lactam antibiotics in the presence of Ca2+ or Mg2+ without an osmotic stabilizer such as sucrose. The spheroplasts grew in volume, although they could not divide. They were stable for more than 10 h at 37 degrees C in a medium containing a high concentration of antibiotic, and they had the ability to revert to the original bacillary form. Ca2+ was more effective in spheroplast induction than Mg2+. The effect was proportional to the concentration of cations. In 40% of 180 clinical isolates of S. marcescens, more than 40% of the original bacterial cells were induced to form spheroplasts by ceftizoxime in a medium supplemented with 40 mM Ca2+. A high spheroplast induction rate was observed even in medium with 10 mM Ca2+. Few isolates that were supersusceptible to ceftizoxime (MIC, less than 0.2 microgram/ml) were induced to form spheroplasts at a high rate. No difference in spheroplast induction rate or extent between antibiotic-resistant strains and relatively susceptible strains (MIC, greater than 0.2 microgram/ml) was found. The serotype of S. marcescens had no effect on the spheroplast induction rate. Monocations (Na+ and K+) had little effect on spheroplast induction. PMID- 3320084 TI - Legionella micdadei and Legionella dumoffii monoclonal antibodies for laboratory diagnosis of Legionella infections. AB - Two different monoclonal antibodies directed against Legionella micdadei and L. dumoffii (Genetic Systems Corp., Seattle, Wash.) were evaluated for their specificity and ability to detect L. micdadei and L. dumoffii in human and animal clinical samples and bacterial isolates in an indirect immunofluorescence assay. All three frozen sputum samples and all three Formalin-fixed sputum and liver samples from patients with culture-documented L. micdadei pneumonia were positive when tested with the L. micdadei monoclonal antibody. A Formalin-preserved lung sample from a patient with culture-documented L. dumoffii pneumonia was positive with its homologous monoclonal antibody. No cross-staining reactions were found with either monoclonal antibody on any of 25 human sputum samples tested from patients without Legionella infections. A total of 66 Legionella strains and 56 non-Legionella strains including 22 Pseudomonas strains and 34 other bacterial strains were studied. No cross-staining reactions were found except in Staphylococcus aureus Cowan 1 ATCC 12598. The lower limit of detection in seeded sputum samples was about 7 X 10(4) cells per ml for both monoclonal antibodies. Lung and tracheal lavage specimens from L. micdadei- or L. dumoffii-infected guinea pigs showed specific staining only with their respective monoclonal antibodies. The monoclonal antibodies stained homologous bacteria slightly less intensely than did the polyclonal antisera, but the signal-to-noise ratio was considerably higher for the monoclonal antibodies. No differences in sensitivity of staining of clinical specimens or bacterial isolates were noted between the monoclonal antibodies and the polyclonal reagents for L. micdadei and L. dumoffii (Centers for Disease Control, Atlanta, Ga., and BioDx, Denville, N.J. These monoclonal antibodies ae sensitive and specific, making them good candidates for laboratory diagnostic purposes. PMID- 3320086 TI - Evaluation of a rapid screening immunoassay for antibodies to Toxoplasma gondii. AB - A total of 349 human serum samples were examined for anti-Toxoplasma antibodies by the Murex Single Use Diagnostic System (SUDS) qualitative screening test, indirect hemagglutination assay (IHA), and indirect immunofluorescence assay (IFA). Concordant results with SUDS and IHA were obtained for 91.9% of serum samples; 8.9% were SUDS+ and IHA-; none were SUDS- and IHA+. Comparison of the SUDS assay with IFA showed a concordance of 95.3%, with a sensitivity of 97.5% and a specificity of 94.7%. Moreover, the positive and negative predictive values were 84.9 and 99.2%, respectively, when results of the SUDS assay and IFA were compared. The SUDS assay is a rapid, simple test requiring no instrumentation and can be performed on 50 microliters of serum, features which make this an excellent screening test for detecting anti-Toxoplasma antibodies, particularly in outpatient settings. PMID- 3320087 TI - Three rapid methods compared with a conventional method for detection of urease production in anaerobic bacteria. AB - Three rapid methods (spot test, disk, and tube) for detecting urease production in anaerobic bacteria yielded results faster than the conventional method. The results were more consistent with the disk and tube methods than with the spot test. Blood agar plate growth gave more consistent results than growth from chopped-meat slants. PMID- 3320085 TI - Serum antibodies to outer membrane proteins of Escherichia coli in healthy persons and patients with bacteremia. AB - Antibodies to Escherichia coli outer membrane proteins in sera from healthy persons and from patients bacteremic with various enteric or nonenteric bacteria were measured by an enzyme-linked immunosorbent assay (ELISA). Outer membranes were prepared from E. coli O55. Serum was absorbed with E. coli O55 lipopolysaccharide and diluted 1:100 for immunoglobulin A (IgA) or IgM and 1:1,000 for IgG antibodies. Paired serum specimens were obtained from the 56 patients included in the study (the first specimen on the day of positive blood culture and the second specimen 8 to 12 days later) and compared with sera from blood donors (n = 50) as controls. On an average, the patients bacteremic with enterobacteria (n = 40) showed increased levels of antibodies of all three immunoglobulin classes in the first serum specimens and significantly higher levels in the second specimens compared with the controls, although with considerable case-to-case variation. Increased levels of IgG antibodies showed the best combination of diagnostic specificity (100%) and sensitivity (53%) for bacteremia caused by enteric bacilli. Mostly, the antibody response was directed against the major E. coli O55 outer membrane proteins at 81,000, 38,500, 33,500, and 7,500 molecular weights as shown by Western blot (immunoblot) analysis. Some of the patients bacteremic with nonenteric bacteria showed increased levels of IgA antibodies, but not of IgG or IgM antibodies. Cross-reactivity of the nonenteric blood culture isolates with the E. coli outer membrane preparation was not demonstrated. The cross-reactivity of the E. coli O55 outer membrane proteins with those of enteric bacilli of other genera was examined by absorption experiments. Western blots with serum absorbed with live E. coli O55 provided evidence that the epitopes of the outer membrane protein at 7,500 molecular weight were available for antibody binding at the bacterial surface, and that at least some of the epitopes of the 38,500- and 33,500-molecular -weight proteins were accessible to antibodies. The results suggest that an ELISA for the measurement of antibodies against cross-reactive outer membrane proteins from enteric bacilli may be useful in the diagnosis of serious infections caused by members of the family Enterobacteriaceae, and that antibodies to the major outer membrane proteins may have an immunobiological function. PMID- 3320088 TI - Peritonsillar abscess caused by Nocardia asteroides. AB - A 22-year-old man with recurrent pharyngitis developed a peritonsillar abscess from which aspirated material yielded a pure culture of Nocardia asteroides. It is likely that the organism was introduced iatrogenically during a prior tonsillar incision. Although unusual, Nocardia species should be considered and microbiological specimens should be handled appropriately in pharyngeal abscesses that respond poorly to conventional therapy. PMID- 3320089 TI - Urease-positive bacteriuria and obstruction of long-term urinary catheters. AB - Long-term urethral catheterization (greater than or equal to 30 days), a management technique for urinary incontinence, results in polymicrobial bacteriuria. We frequently found urease-producing bacteria: of 1,135 weekly urine specimens from 32 long-term-catheterized patients, 86% had urease-positive bacterial species at greater than or equal to 10(5) CFU/ml. The most common species were Proteus mirabilis and Morganella morganii, each found in over half the specimens. P. mirabilis, but not other urease-positive species, was significantly associated with the 67 obstructions observed in 23 patients. M. morganii had a more complex association and in some way may protect the catheter from obstruction. PMID- 3320090 TI - Evaluation of a quantitative fluorescence immunoassay (FIAX) for detection of serum antibody to Borrelia burgdorferi. AB - A quantitative, indirect, fluorescence immunoassay (FIAX; Whittaker Bioproducts, Inc.) was compared with the conventional indirect fluorescent-antibody test for detection of serum antibody to Borrelia burgdorferi. FIAX correlated well with the indirect fluorescent-antibody test (r = 0.72). FIAX is a convenient and dependable means of measuring serum antibody to B. burgdorferi. PMID- 3320091 TI - Comparison of conventional and revised isolator blood culture tubes. AB - A paired clinical study compared bacterial and fungal recovery from 4,553 blood cultures processed by the conventional Isolator (Du Pont Co.) and a revised Isolator consisting of a single-stoppered, round-bottom tube containing the same ingredients as the conventional tube except for an inert fluorochemical. Excluding contaminants, there were 425 positive blood cultures with 450 isolates representing 208 patients. There were no statistically significant differences between systems in the number of positive cultures or patients with positive cultures for each organism group studied, nor were there any statistically significant differences between systems in the time required for detection of positive cultures. PMID- 3320092 TI - Comparison of three dispersion procedures for quantitative recovery of cultivable species of subgingival spirochetes. AB - Spirochetes are usually the predominant organisms observed microscopically in subgingival plaques removed from tooth sites associated with periodontitis, but these organisms are rarely isolated by cultural means, presumably because the media do not support their growth and/or because these fragile organisms are disrupted by the various procedures used to disperse plaque samples. In the present investigation, three dispersal procedures, sonification, mechanical mixing, and homogenization, were compared for their ability to permit the isolation of Treponema denticola, Treponema vincentii, Treponema socranskii, and Treponema pectinovorum from plaque samples on media that support the growth of these species. Plaque samples in which the spirochetes averaged 50% of the microscopic count were chosen. The highest viable recoveries of spirochetes were observed when the plaques were dispersed with a Tekmar homogenizer, and the lowest occurred with sonification. The highest recoveries averaged only about 1% of the total cultivable counts, indicating either that the sought-after species were minor members of the flora or that the dispersal procedures were still too harsh. A total of 91% of the isolates were T. denticola, 5% were T. socranskii, and 4% were a heretofore-undescribed species. PMID- 3320094 TI - Cell death in granulomata: the role of apoptosis. AB - Unequivocal apoptosis were seen by light microscopy in examples of leprosy, sarcoidosis, tuberculosis, Crohn's disease and foreign body granulomata. A limited electron microscopic investigation showed typical apoptotic bodies in both sarcoid and leprosy granulomata. The number of apoptosis and mitoses in granulomata were counted and their densities calculated. The wide variation in the results between individual lesions may reflect differences in disease activity. PMID- 3320093 TI - Value of CD15 immunostaining in diagnosing Hodgkin's disease: a review of published literature. AB - The role of antibodies of CD15 as diagnostic markers of Hodgkin's disease was assessed from a review of the literature. A total of 571 cases of Hodgkin's disease and 386 cases of non-Hodgkin's lymphoma were included. The sensitivity of CD15 in detecting cases of Hodgkin's disease was 80% or 91% if cases of lymphocyte predominant Hodgkin's disease were excluded. The specificity of CD15 was only 80.6%, or in other words, 19.4% of cases of non-Hodgkin's lymphoma were CD15 positive. In an ideal test both the sensitivity and specificity would be 100% and if the test performance were no better than chance then they would both be 50%. It is concluded that CD15 immunostaining cannot be regarded as a sensitive or specific marker of Hodgkin's disease. Application of this formal method of analysis to other immunohistological reagents and panels of antibodies is discussed. PMID- 3320095 TI - Syphilis screening in the Blood Transfusion Service: a report of four years' experience with the Treponema pallidum haemagglutination assay and the subsequent development of a rapid "spin" method. AB - A comparison of cardiolipin and a modified Treponema pallidum haemagglutination assay (TPHA) method over a four year period confirmed the superior sensitivity and specificity of TPHA. In 86,495 new donor sera 19 (0.02%) confirmed positive results were detected by TPHA, 10 of which did not react by the cardiolipin test. In 150,789 antenatal samples 49 confirmed positive results were found by TPHA, 30 of which did not react by cardiolipin. No cardiolipin positive, TPHA negative samples were confirmed as positive by the absorbed fluorescence treponemal antibody test, and overall 78% of cardiolipin reactions gave false biological positive results. Cardiolipin tests were continued only because of their speed. A further modification ("spin") of the TPHA has now been developed which is rapid, sensitive, and inexpensive, and in testing 21,807 sera, gave results equivalent to those of the previous "settle" method. Serious consideration should be given to dispensing with cardiolipin tests. PMID- 3320098 TI - Electrosurgery--a biological approach. AB - Electrosurgery has been used in dentistry for more than 50 years. Both opponents and advocates of electrosurgery have presented a variety of clinical studies in favour of their respective opinions, which are discussed in the following review. In some studies, wounds created by electrosurgical techniques were observed through the healing stages, in comparison to those following incision by a surgical blade, with no significant difference being discovered. Other studies reported that the histologic response of oral connective tissue to electrosurgery was adverse in some animal and human models. However, neither of these groups used methods that allowed documentation or control of operating variables. A critical evaluation of controlled clinical studies shows that adverse responses of (connective) tissue, epithelium, bone, cementum, and periodontal attachment are related to an excessive lateral heat production during the procedure. With electrosurgery, the clinician can control the inherent variables. Waveform, frequency, size of the electrode, time of contact and cooling periods are some of those considered to be of importance in the studies. On the basis of the research reports, clinical guidelines have been developed to give practical advice to the clinician using electrosurgery. Providing that these safeguards are adhered to, scientific evidence supports the biological compatibility of electrosurgery for intraoral surgical procedures. PMID- 3320096 TI - Varying occurrence of gastroduodenal immunoreactive pancreatic secretory trypsin inhibitor. AB - Operative specimens from various parts of gastroduodenal mucosa were analysed for immunoreactive pancreatic secretory trypsin inhibitor (PSTI) using a peroxidase antiperoxidase method. Normal gastric mucosa exhibited a varying degree of PSTI immunoreactivity, which was more pronounced in the foveolar cells of gastric mucosa of fundus type than in the non-pepsinogen producing antrum-pyloric mucosa. With the exception of metaplastic Paneth cells and some goblet cells, the intracellular content of PSTI was low in gastric mucosa with intestinal metaplasia. These findings may indicate that a PSTI immunoreactive substance has a role in the normal defence of the gastric mucosa. PMID- 3320097 TI - Circulating micromegakaryocytes in myelodysplasia. AB - The alkaline phosphatase-antialkaline phosphatase (APAAP) immunocytochemical staining technique was used to look for circulating cells of megakaryocyte lineage in peripheral blood smears from 67 cases of myelodysplasia. Small numbers of micromegakaryocytes positive for platelet glycoprotein IIIa were found in 23 cases. These cells superficially resemble small lymphoid cells and are hence difficult or impossible to recognise in conventional Romanowsky stained smears. Circulating micromegakaryocytes were found most commonly in more aggressive types of myelodysplasia (such as refractory anaemia with excess blasts (RAEB) and refractory anaemia with excess blasts in transformation (RAEB-t], and their presence may therefore indicate a poor prognosis. Because of the simplicity of this immunocytochemical labelling technique, it could be of wide use in the initial assessment of patients with myelodysplasia, and possibly for the early detection of acute leukaemic transformation. PMID- 3320099 TI - Periodic subgingival antimicrobial irrigation of periodontal pockets. II. Microbiological and radiographical observations. AB - The purpose of this study was to evaluate the microbiological effects of repeated subgingival irrigation of deep periodontal pockets as a single measure of treatment as well as combined with mechanical debridement, and to study the concomitant radiographical changes of the alveolar bone. 2-3 interproximal sites per jaw quadrant in 10 patients showing a probing depth of greater than or equal to 6 mm and bleeding on pocket probing were selected for the study. The pockets in the various quadrants were randomly assigned to professionally performed subgingival irrigation with 0.2% chlorhexidine gluconate, 3% hydrogen peroxide or saline or to non-irrigation. During a first phase of treatment, the pockets were periodically irrigated (every 2nd-3rd day during weeks 1-2 and 5-6) and no subgingival mechanical debridement was performed. During a second phase, subgingival scaling and root planning were carried out with adjunctive subgingival irrigation of the pockets. During the entire trial, the patients' plaque control was carefully supervised. Sampling of the subgingival microflora was performed before and after the first and second treatment phases and 3 months after the termination of the active treatment. Dark-field assessment and cultivation of the bacterial samples were performed. The radiographical examination was carried out at the start of each treatment phase and 3 months after the termination of phase II and the radiographs were analysed by the use of a subtraction technique. The results demonstrated that periodic subgingival antimicrobial irrigation per se had only limited and transient effects on the subgingival microflora.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320100 TI - Difficulties encountered in the search for the etiologic agents of destructive periodontal diseases. AB - The present paper outlines some of the difficulties encountered in the search for the etiologic agents of destructive periodontal diseases. These include technical problems such as acquiring an appropriate microbial sample, as well as difficulties in the dispersion, cultivation and identification of isolates in that sample. Many of these difficulties are currently being successfully addressed. A second set of problems is more conceptual in nature. These include difficulties in distinguishing between periodontal diseases and determining the state of activity of periodontal lesions. In addition, complexes of organisms and/or sequences of species may be involved in the progress of lesions. A further problem is encountered in attempting to distinguish overgrowths of opportunistic species from increases in proportions of true pathogens. Finally, it appears likely that different infections occur at the same time in a single oral cavity. The technical and conceptual difficulties eventually filter down to the data analytical step and present numerous problems to the analyst. With all of these difficulties in mind, it is not surprising that the etiologic agents of destructive periodontal diseases are not clearly defined. However, improvement in technological assessments of the microbiota and clinical evaluation of the disease should permit reasoned approaches to be taken. The delineation of the etiologic agents of destructive periodontal diseases will be, of necessity, a multistage iterative process. Etiologic agents will be suggested by predominant cultivable studies and hypotheses concerning subsets of these agents tested using more specific procedures such as selective media, immunofluorescent techniques or DNA probes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320101 TI - The comparative effects of azathioprine and cyclosporin on some gingival health parameters of renal transplant patients. A longitudinal study. AB - The periodontal health of 24 adult renal transplant patients was investigated in a longitudinal study. Post-transplant patients were receiving either azathioprine or cyclosporin to prevent graft rejection. No significant difference (P greater than 0.05) was observed for plaque scores on gingival inflammation, either between treatment groups or throughout the investigation period. However, patients on cyclosporin therapy had significantly more gingival hyperplasia and probing sites greater than 3 mm than those on azathioprine (P less than 0.05). In the cyclosporin group, a significant increase in hyperplasia and probing sites greater than 3 mm was observed at 3 and 6 months post-transplant. A significant correlation (rs = 0.55, P less than 0.05) was observed between mean plasma concentrations of cyclosporin throughout the 6-month investigation period and the increase in gingival hyperplasia. The finding from this study would suggest that azathioprine has no unwanted effects on the periodontal health of post-renal transplant patients. Cyclosporin therapy caused an increase in gingival hyperplasia, which may be related to plasma concentrations of the drug. PMID- 3320102 TI - Registration of drugs in Belgium. PMID- 3320103 TI - Review of autonomic dysfunction, cardiac arrhythmias, and epileptogenic activity. AB - Similarities in autonomic dysfunction associated with arrhythmias and death in animal models for digitalis toxicity, myocardial infarction, psychotropic toxicity, and epileptogenic activity are reviewed. When intravenous (IV) pentylenetetrazol was given to anesthetized cats, autonomic dysfunction was associated with both interictal and ictal epileptogenic activity. The autonomic dysfunction was manifested by the fact that autonomic cardiac nerves did not always respond in a predictable manner to changes in blood pressure, the development of a marked increase in variability in mean autonomic cardiac nerve discharge, and the appearance of a very large increase in the variability of the discharge rate of parasympathetic nerves first and then secondly in sympathetic discharge. The altered autonomic cardiac nerve discharge was associated with interictal epileptogenic activity and arrhythmia, which may contribute to sudden unexplained death in patients with epilepsy. Since phenobarbital (20 mg/kg, IV 60 min prior to pentylenetetrazol) exhibited anticonvulsant, but not antiarrhythmic and neural depressant activity, phenobarbital does not appear to be the ideal agent to prevent the autonomic dysfunction associated with epileptogenic activity in this animal model. PMID- 3320104 TI - Phase I and II agents in cancer therapy: two cisplatin analogues and high-dose cisplatin in hypertonic saline or with thiosulfate protection. AB - Cisplatin is a chemotherapeutic coordination complex that has been evaluated extensively. It is particularly active against testicular cancer, but carcinomas of the ovary, bladder, cervix, and head and neck are also responsive. To increase efficacy and decrease toxicity, a number of platinum analogues have been developed and tested. One of these, carboplatin, is of particular interest. In clinical trials, it has demonstrated antitumor activity comparable to that of cisplatin, without evidence of significant renal toxicity or neurotoxicity. A second interesting platinum analogue is iproplatin. Preliminary phase I studies suggest reduced adverse renal and neurologic effects similar to those seen with carboplatin, with efficacy comparable to cisplatin. Attempts to overcome the dose limiting toxicity of cisplatin by administering high-dose cisplatin (40 mg/m2/d for five days) in hypertonic saline or with thiosulfate protection are also reviewed. These techniques have eliminated nephrotoxicity as the dose-limiting toxicity of cisplatin. However, nonrenal toxicity, especially neurotoxicity, remains substantial. The extent to which high-dose cisplatin-based chemotherapy should be used in routine clinical practice has not been determined. PMID- 3320105 TI - Cardiac electrophysiology and pharmacology of adenosine and ATP: modulation by the autonomic nervous system. PMID- 3320106 TI - Speech pathology in ancient India--a review of Sanskrit literature. AB - This paper aims at highlighting the knowledge of the Sanskrit scholars of ancient times in the field of speech and language pathology. The information collected here is mainly from the Sanskrit texts written between 2000 B.C. and 1633 A.D. Some aspects of speech and language that have been dealt with in this review have been elaborately described in the original Sanskrit texts. The present paper, however, being limited in its scope, reviews only the essential facts, but not the details. The purpose is only to give a glimpse of the knowledge that the Sanskrit scholars of those times possessed. In brief, this paper is a review of Sanskrit literature for information on the origin and development of speech and language, speech production, normality of speech and language, and disorders of speech and language and their treatment. PMID- 3320107 TI - Ultrastructural analyses of afferent terminals in the subthalamic nucleus of the cat with a combined degeneration and horseradish peroxidase tracing method. AB - The synaptic organization of the feline subthalamic nucleus (STN) was studied electron microscopically. Following horseradish peroxidase (HRP) injections into the globus pallidus (GP) and electrolytic lesions of the nucleus tegmenti pedunculopontinus pars compacta (TCP) in the same cat, both degenerating and HRP labeled terminals were found in the STN with abundant retrogradely HRP-labeled neurons. Degenerating terminals of TPC origin were medium-sized and characterized by asymmetric synaptic contacts. They synapsed widely on the STN neuronal surface, including the somata, dendrites of varying dimensions, dendritic spines and vesicle-containing processes. They formed 25.1%, 65.1%, 4.7%, and 4.7%, respectively, of all TPC efferent terminals. Some of the postsynaptic components were labeled with HRP. Occasionally both degenerating terminals and HRP-labeled terminals were in synaptic contact with the same HRP-labeled neuron: therefore, afferents of TPC and GP converge on the same STN projection neuron. In order to discover the origin of these HRP-labeled terminals, a mixed solution containing HRP and kainic acid was injected into the GP. Numerous degenerating terminals were observed to synapse with HRP-labeled STN neurons, but no HRP-labeled terminal was observed. These degenerating terminals were similar in appearance to the above-mentioned HRP-labeled terminals. They were characterized by their relatively large size, predominantly symmetric synapses, and preferential distribution on the somata and large or medium-sized dendrites. They formed 39.6%, 20.1%, and 31.1%, respectively, of all GP efferent terminals. Therefore, it became clear that both the HRP-labeled terminals of the first experiment and the degenerating terminals of the second experiment originated from the GP. Following surgical ablations of the primary sensorimotor cortex (Cx), some axon terminals in the STN showed degeneration. These degenerating terminals were small and formed asymmetric synapses mainly with dendritic spines, small dendrites and vesicle-containing processes. They formed 48.0%, 28.0%, and 12.0%, respectively, of all Cx efferent terminals. These electron microscopic investigations reveal the convergence of TPC and GP afferents and that STN projection neurons relay the TPC and pallidal inputs directly to the GP. PMID- 3320109 TI - Organization of subcortical pathways for sensory projections to the limbic cortex. II. Afferent projections to the thalamic lateral dorsal nucleus in the rat. AB - Afferent projections to the thalamic lateral dorsal nucleus were examined in the rat by the use of retrograde axonal transport techniques. Small iontophoretic injections of horseradish peroxidase were placed at various locations within the lateral dorsal nucleus, and the location and morphology of cells of origin of afferent projections were identified by retrograde labeling. For all cases examined, subcortical retrogradely labeled neurons were most prominent in the pretectal complex, the intermediate layers of the superior colliculus, and the ventral lateral geniculate nucleus. Labeled cells were also seen in the thalamic reticular nucleus and the zona incerta. Within the cerebral cortex, labeled cells were prominent in the retrosplenial areas (areas 29b, 29c, and 29d) and the presubiculum. Labeled cells were also seen in areas 17 and 18 of occipital cortex. Peroxidase injections in the dorsal lateral part of the lateral dorsal nucleus result in labeled neurons in all of the ipsilateral pretectal nuclei, but especially those that receive direct retinal afferents. Labeled cells were also seen in the ventral lateral geniculate nucleus and the rostral tip of laminae IV VI of the superior colliculus. In contrast, peroxidase injections in ventral medial portions of the lateral dorsal nucleus result in fewer labeled pretectal cells, and these labeled cells are found exclusively in the pretectal nuclei that do not receive retinal afferents. Other labeled cells following injections in the rostral and medial portions of the lateral dorsal nucleus are seen contralaterally in the medial pretectal region and nucleus of the posterior commissure, and bilaterally in the rostral tips of laminae IV and V of the superior colliculus. Camera lucida drawings of HRP labeled cells reveal that projecting cells in each pretectal nucleus have a characteristic soma size and dendritic branching pattern. These results are discussed with regard to the type of sensory information that may reach the lateral dorsal nucleus and then be relayed on to the medial limbic cortex. PMID- 3320108 TI - Organization of subcortical pathways for sensory projections to the limbic cortex. I. Subcortical projections to the medial limbic cortex in the rat. AB - Subcortical afferent projections to the medial limbic cortex were examined in the rat by the use of retrograde axonal transport of horseradish peroxidase. Small iontophoretic injections of horseradish peroxidase were placed at various locations within the dorsal and ventral cingulate areas, the dorsal agranular and ventral granular divisions of the retrosplenial cortex and the presubiculum. Somata of afferent neurons in the thalamus and basal forebrain were identified by retrograde labeling. Each of the anterior thalamic nuclei was found to project to several limbic cortical areas, although not with equal density. The anterior dorsal nucleus projects primarily to the presubiculum and ventral retrosplenial cortex; the anterior ventral nucleus projects to the retrosplenial cortex and the presubiculum with apparently similar densities; and the anterior medial nucleus projects primarily to the cingulate areas. The projections from the lateral dorsal nucleus to these limbic cortical areas are organized in a loose topographic fashion. The projection to the presubiculum originates in the most dorsal portion of the lateral dorsal nucleus. The projection to the ventral retrosplenial cortex originates in rostral and medial portions of the nucleus, whereas afferents to the dorsal retrosplenial cortex originate in caudal portions of the lateral dorsal nucleus. The projection to the cingulate originates in the ventral portion of the lateral dorsal nucleus. Other projections from the thalamus originate in the intralaminar and midline nuclei, including the central lateral, central dorsal, central medial, paracentral, reuniens, and paraventricular nuclei, and the ventral medial and ventral anterior nuclei. In addition, projections to the medial limbic cortex from the basal forebrain originate in cells of the nucleus of the diagonal band. Projections to the presubiculum also originate in the medial septum. These results are discussed in regard to convergence of sensory and nonsensory information projecting to the limbic cortex and the types of visual and other sensory information that may be relayed to the limbic cortex by these projections. PMID- 3320110 TI - Afferent and efferent connections of the oculomotor cerebellar vermis in the macaque monkey. AB - Saccadic eye movements were evoked with weak currents applied to a circumscribed vermal area. The area was confined to lobule VII in the majority of the monkeys and coincided with the distribution of saccade-related neural activity. We defined this area as the oculomotor vermis and studied its anatomical connections with wheat germ-agglutinin conjugated horseradish peroxidase (WGA/HRP) and HRP. When injected HRP was confined to the oculomotor vermis, most labeled Purkinje axons terminated ipsilaterally in an ellipsoidal region in the mediocaudal aspect of the fastigial nucleus. Retrogradely labeled cells were found in two relatively circumscribed regions in the fastigial nucleus: one group was in the lateral half of the ellipsoidal terminal region and the other group was in a spherical region near the lateral margin of the nucleus. Following the injection of HRP into the oculomotor vermis, the largest population of retrogradely labeled neurons was found in the nucleus reticularis tegmenti pontis. Labeled cells were located only in the medial and dorsolateral portions of the nucleus. The cell aggregates in the dorsolateral portion merged with densely labeled cells of the processus tegmentosus lateralis. The second largest population of labeled cells was found in the pontine nuclei. Approximately 28% of the labeled pontine cells aggregated in the paramedian pontine nucleus, whereas the other labeled pontine cells were widely distributed in the dorsal part of the pontine peduncular nucleus and the dorsolateral pontine nucleus. Labeled cells were scattered also in the pontine raphe, the paramedian pontine reticular formation, and the interfascicular nucleus at the rostral level of the hypoglossal nucleus. Fewer labeled cells were discovered in the vestibular nuclear complex and the prepositus hypoglossi. In the inferior olivary nucleus, labeled cells were located in the subnucleus b of the medial accessory nucleus. PMID- 3320111 TI - Small vesicle bouton synapses on the distal half of the lateral dendrite of the goldfish Mauthner cell: freeze-fracture and thin section study. AB - To understand principles of synaptic integration, it is necessary to define the types of synapses on a particular neuron and their distribution. Thin sectioning and double replica freeze-fracture techniques were employed to characterize the small vesicle bouton (SVB) synapses on the distal half of the Mauthner (M) cell lateral dendrite, which probably mediate a remote dendritic inhibition. Three morphologically distinct SVB synapses, types A, B, and C, were found. These three SVB synapses form roughly 90% of the synapses on the distal half of the lateral dendrite, with types A and B being most common. The SVB A synapse is characterized by mostly oval and round synaptic vesicles, a discrete presynaptic active zone with a highly variable shape, and a postsynaptic active zone with no apparent particle aggregate in either the E or P face. At the SVB B synapse, most of the synaptic vesicles are flat. A very high particle density is present throughout the presynaptic P face, and vesicle attachment sites are dispersed over much of the presynaptic membrane. Postsynaptic P face particle aggregates are subjacent to the presynaptic vesicle attachment sites, and are often large and anastomosing. The SVB C synapse is characterized by synaptic vesicle profiles that vary from flattened to round. The SVB C cytoplasm was unclouded by the flocculent material that characterized SVBs A and B. The presynaptic active zones at the SVB C synapse are discrete, and macular or oblong. No particle aggregates are apparent in the postsynaptic active zone. Small, macular particle aggregates were found in nonactive zone regions of the postsynaptic E face of all three types of SVBs. Small subsurface cisterns were also observed underlying the M cell membrane at all three types of SVB synapses. Neither the postsynaptic E face aggregates nor the subsurface cisterns were ever observed directly subjacent to presynaptic active zones, but were often seen adjacent to active zones. Short, straight rows of particles and short cylinders were often seen in both pre- and postsynaptic surrounding zone regions of SVB A and C synapses. These structures are thought to represent tight junctions. PMID- 3320112 TI - Parasagittal organization of the rat cerebellar cortex: direct correlation between antigenic Purkinje cell bands revealed by mabQ113 and the organization of the olivocerebellar projection. AB - The Purkinje cells of the cerebellar cortex and the cortical afferent and efferent projections are organized into parallel parasagittal zones. The parasagittal organization is clearly revealed by immunocytochemistry with a monoclonal antibody, mabQ113. The mabQ113 antigen is confined to a subset of Purkinje cells that are clustered together to form an elaborate, highly reproducible pattern of bands and patches, interspersed with similar mabQ113- regions. The mabQ113+ territories have been classified into seven parasagittal bands (P1+-P7+) in each hemicerebellum. The degree of correspondence between the compartments revealed by the anterograde labeling of the olivocerebellar projection and by mabQ113 immunocytochemistry has been explored in the adult rat. Horseradish peroxide-wheat germ agglutinin conjugate was injected as an anterograde tracer into the inferior olivary complex. When the injection site did not encompass all the olive, an incomplete, patchy labeling of the molecular layer was seen in the cerebellar cortex. Labeled zones of the molecular layer were interrupted by unlabeled regions to give a pattern of parasagittal cortical bands. The positions of these bands were compared with the distribution of the mabQ113+ antigenic bands as seen on the two adjacent sections. Labeled climbing fibers were found to terminate on both mabQ113+ and mabQ113- Purkinje cell zones. The mabQ113+/mabQ113- boundaries and the bands of climbing fibers seen by using the anterograde tracer typically coincide. The one consistent exception is the midline band of mabQ113+ Purkinje cells, P1+. The normal olivocerebellar projection is exclusively contralateral and the climbing fiber projection to the paramedian vermis splits P1+ down the middle, implying that it consists of two adjacent mabQ113+ bands not separated by mabQ113-territory. It is likely that the climbing fiber projection to the cerebellar cortex and the distribution of the two Purkinje cell phenotypes share a common compartmental organization. PMID- 3320113 TI - Fermented milks and their future trends. I. Microbiological aspects. PMID- 3320114 TI - Periparturient changes in secretion and mammary uptake of insulin and in concentrations of insulin and insulin-like growth factors in milk of dairy cows. AB - Mammary uptake of insulin from blood was quantified near parturition in nine dairy cows, some of which were milked prepartum to induce prepartum lactogenesis. Milk samples were immunoassayed for concentrations of insulin, insulin-like growth factor I, and insulin-like growth factor II. Cows milked prepartum, but in which prepartum lactogenesis did not occur (denoted as unsuccessful group), had higher arterial concentrations and greater mammary uptake of insulin during several days immediately preceding parturition than did those with prepartum lactogenesis. Although mammary uptake of insulin was measurable before parturition, estimated uptake on postpartum d 4 through 6 was negligible. Colostrum and milk contained very substantial quantities of insulin, insulin-like growth factor I, and insulin-like growth factor II. Cows in which prepartum lactogenesis was induced (denoted as successful group) had lower concentrations of both forms of insulin-like growth factor in prepartum samples of milk. Cows of the successful group also had a decreasing prepartum profile of milk insulin, but the unsuccessful group had an increasing trend until parturition. Milk concentrations of insulin and both forms of insulin-like growth factor declined rapidly after parturition and completion of lactogenesis. PMID- 3320115 TI - Calcium in dairy products. AB - Increasing attention has been given to the nutritional role of calcium because many Americans do not consume their Recommended Dietary Allowance of this nutrient and because calcium deficiency may lead to the development of osteoporosis or other disorders. Calcium is absorbed in the intestines with the aid of a vitamin D metabolite and is used in the body for many essential functions. There are several ways to obtain calcium in the diet, but the best sources are milk and other dairy products because of their low cost and high bioavailability of this mineral. Some manufacturers have responded to the concern over lack of calcium in the diet by increasing its levels in milk. The amount of calcium in cheese and yogurt also can be elevated. PMID- 3320117 TI - Predictive implications of individual differences in attachment. PMID- 3320116 TI - Maternal and infant temperamental predictors of attachment: a meta-analytic review. PMID- 3320118 TI - Attachments to inanimate objects: are children who have security blankets insecure? PMID- 3320119 TI - Developmental psychopathology in infancy: illustration from the study of maltreated youngsters. PMID- 3320120 TI - Interaction and attachment in normal and atypical infants. PMID- 3320121 TI - The effects of relaxation training with cognitive or nondirective therapy and the role of relaxation-induced anxiety in the treatment of generalized anxiety. PMID- 3320122 TI - Seasonal abundance of stable flies (Diptera: Muscidae) on California dairies. PMID- 3320123 TI - Biochemical study of fecal porphyrin in porphyria cutanea tarda. PMID- 3320124 TI - Process of foam cell formation in diet-induced hypercholesterolemic rabbit and the Watanabe heritable hyperlipidemic rabbit. PMID- 3320125 TI - Immunofluorescence analysis of cultured mammalian cell nucleus using four monoclonal antibodies against the nucleus. PMID- 3320126 TI - Electron microscopic detection of p97 antigen on cell membranes of human melanoma cell lines. PMID- 3320127 TI - Recovery of skin barrier function in psoriasis following standardized trauma. PMID- 3320128 TI - Effects of PSK ointment and OK-432 ointment of Pseudomonas burn wound infection in mice. PMID- 3320129 TI - Dermo-epidermal blister formation by linear IgA dermatosis sera in normal human skin in organ culture. PMID- 3320130 TI - Light and electron microscopic immunohistochemistry of solar elastosis: a study with cutis rhomboidalis nuchae. PMID- 3320131 TI - A case of donovanosis in Japan. PMID- 3320133 TI - Pemphigus vulgaris coexisting with generalized lichen planus. PMID- 3320132 TI - Three cases of sporotrichosis with numerous fungal elements. PMID- 3320134 TI - Relaxation training as a technique for helping patients cope with the experience of cancer: a selective review of the literature. AB - The experience of cancer places considerable physiological and psychological demands upon the patient. In recent years the potential benefits of relaxation training have generated widespread interest in both the lay and professional literature, particularly in the area of stress management. This paper examines the use of relaxation training as a method for helping patients cope with the experience of cancer and reviews a number of studies which have used progressive muscle relaxation and guided imagery in the oncology setting. Although these studies have produced some encouraging results, there are a number of issues which need to be addressed if future relaxation studies are to be useful for nursing practice, and these are discussed. PMID- 3320135 TI - A clinical study of Sudocrem in the management of dermatitis due to the physical stress of incontinence in a geriatric population. AB - A double blind controlled trial was carried out to measure the efficacy of Sudocrem, compared with zinc cream BP, in the treatment and prevention of incontinence-associated dermatitis in an elderly inpatient population. Three objective measures of skin condition were used to assess efficacy. Sudocrem was shown to be superior to zinc cream BP in the treatment of dermatitis, with no significant difference shown in terms of prophylaxis. The objective measures of skin health seemed to be a promising advance on earlier, subjective methods, and their further development is recommended. There was some indication that the normal skin of an incontinent patient does not deteriorate when managed with Sudocrem or zinc cream. PMID- 3320136 TI - Discharge planning for psychiatric patients: the effects of a family-patient teaching programme. AB - The aims of this study were (1) to develop and implement a family-patient teaching programme for psychiatric inpatients prior to their discharge, and (2) to assess the effect of the teaching programme on patients' functional level and readmission rate. The population of this study consisted of 30 hospitalized psychiatric patients, with schizo-affective disorders. Subjects were randomly assigned to two groups--a control group and an experimental group. Families of the experimental group subjects were involved in the patient-family education sessions twice a week. The subjects were followed-up after discharge for a 12 month period. In analysing the data, results indicated that improvement in functional level based on the Global Assessment Scale (GAS) was clearly noticed among subjects of the experimental group. In addition, the findings of this study lend support to other studies which showed that patient-family education is an effective means of reducing the readmission rate among psychiatric patients. PMID- 3320137 TI - The schoolteacher on the hospital ward. AB - This paper is concerned with the schoolteacher as a member of the team who look after the needs of children on hospital wards. A historical review is presented to show how the teachers came to be present and why they were employed. A description is given of an observational study made to compare the activities of 139 children on four hospital wards in Britain. Three wards had teachers. One ward had no teacher. A similar study is described that was undertaken on two wards of a hospital in the USA. The findings of the observational study are analysed to see whether the activities of the children require the presence of a teacher or could be undertaken by a play-leader or volunteer. The play-leader's role is discussed, as is that of the American child life worker. The conclusion is reached that the teacher is there to stimulate the children and provide them with a group situation in which there is a common work ethic and where there will be opportunities for creative expression. So the normality of school will be therapeutic. PMID- 3320138 TI - Chronic illness and compliance. AB - For a person with a chronic illness, life is altered in some way. Whether simple or complex, changes are nevertheless permanent. A patient with a chronic disease assesses recommended treatments on how well they can be integrated into his life. Evidence suggests that an individual's perception of his situation will determine whether or not he will comply with a medical regimen. Health professionals neglect the patient's point of view if they believe that patients regard the health professional as an absolute authority, thereby contributing to noncompliance. The contingency contract provides a model of patient-provider transaction, which requires input from both parties. The health professional can work with the person to make the medical regimen compatible with the individual's lifestyle. PMID- 3320139 TI - The Delphi technique: a critique. AB - The development of the Delphi technique, as a survey method of research, and examples of its use are described. The technique's key characteristics, anonymity, use of experts and controlled feedback, are examined. The method's usefulness in structuring group communication for the discussion of specific issues and as an aid to policy making is discussed in the light of the technique's perceived drawbacks and limitations. PMID- 3320140 TI - A treasury of dentistry. Dentist inventors. PMID- 3320141 TI - Dentist health status and risks. PMID- 3320142 TI - Panic disorder in university students: a review. PMID- 3320144 TI - Periodontal dictates for esthetic ceramometal crowns. AB - Periodontal health must be the crucial consideration in any restorative treatment plan. The interaction between the crown and the investing tissue contributes to the health of the gingiva. The dentist must consider the tooth's position, shape, function, and physical state as well as the means by which it is restored, when yielding to the demands of the patient for an improved esthetic appearance. PMID- 3320143 TI - Problem areas in the management of urinary tract infections. PMID- 3320146 TI - Esthetic results with full restorations. AB - The metal-ceramic and all-ceramic esthetic restorations available today bear little resemblance to their predecessors of 2 and 3 decades ago. Metal-ceramic crowns and fixed partial dentures are successful when the dentist understands what biologic and mechanical demands will be placed on the restoration. Tissue management and tooth preparation affect long-term function and esthetic success. PMID- 3320145 TI - Era of new biomaterials in esthetic dentistry. AB - Many exciting developments are occurring in esthetic, restorative materials. Today, materials are considered in terms of their biologic effects and tests to predict in vivo behavior are needed. Recently, more nondental manufacturers have begun to introduce products and the number of foreign products has also increased. Dentists and materials scientists are currently interested in: microleakage, bonding mechanisms, dentin-bonding agents, polyacrylic acid systems, and composite resins. PMID- 3320148 TI - Hospital dental services. PMID- 3320147 TI - Multiple potential of etched porcelain laminate veneers. AB - In many clinical situations, the etched-porcelain veneers can provide a restoration that looks natural with a minimum of tooth preparation. Application has been equally successful on mandibular and maxillary teeth. Periodontal response to the veneers, when properly placed, has been excellent. PMID- 3320149 TI - The Presidents. John Michael Deines 1970-1971. PMID- 3320150 TI - Brain abscess of odontogenic origin: report of case. AB - Advanced dental infection rarely causes brain abscess resulting in death. Good dental hygiene and removing abscessed teeth are advised for prevention of any such occurrence. An intercranial infection is described in a 29-year-old male who also had a dental phobia. PMID- 3320151 TI - Dentistry on stamps (Emilio Nunez Rodriguez). PMID- 3320152 TI - The use of mercury in dentistry: a critical review of the recent literature. PMID- 3320153 TI - Dentistry on stamps. PMID- 3320154 TI - Why, what, and how to implement reduction of cardiovascular risk factors by diet. AB - Dietary factors ingested in excess, deficient, or in imbalance have been implicated in the etiology, and corrected in the management of cardiovascular diseases, namely atherosclerosis and hypertension. Dietary factors include: calories; fats; cholesterol and other sterols; complex and simple carbohydrates; animal and vegetable protein; alcohol; and minerals. Atherogenesis from diets high in total and saturated fat and cholesterol may relate to increases in plasma total, low- or very low-density lipoprotein cholesterol or triglycerides, or decrease in high density lipoprotein cholesterol, or altered apolipoproteins. A variety of dietary manipulations can influence these lipid and lipoprotein levels and thereby reduce cardiovascular risk. Plasma lipid and lipoprotein levels in the population vary with age, gender, and race; cardiovascular risk is increased when cholesterol levels exceed the 75th or 90th percentile for healthy men and women for age. Abnormally high levels of plasma cholesterol or triglycerides in different lipoprotein carriers comprise the various hyperlipoproteinemias. The clinical presentations and dietary management of elevated LDL cholesterol, and/or VLDL/ and/or chylomicron triglycerides, or increased intermediate density lipoproteins are reviewed and discussed. Attention should be paid to family screening, and hyperlipidemias secondary to diseases or medication should be considered. Dietary counseling and management is advised for children at risk of hyperlipidemia and for adult patients up to 70 years of age. If lipids and lipoproteins are not normalized, then lipid-lowering drug therapy should be considered in adults. For control of hypertension, attention should be paid to calories and alcohol, and to calcium, potassium, and sodium. PMID- 3320155 TI - Concentration of copper and zinc in liver of fetuses and infants. AB - Hepatic concentrations of copper (Cu) and zinc (Zn) were studied in 38 fetuses and infants, who died of various causes, from 26 weeks of gestation up to 16 weeks post-natally. The six fetuses of 28-32 weeks gestation had median and mean hepatic Cu concentrations micrograms/g fresh tissue) comparable to those found in the 21 born at term, but the range of values was much narrower: all of the Cu values for those born prematurely were at or below 40 micrograms/g. Values at 10 micrograms/g and below were found in five infants at term and five who died at 1 4 months of age. There was a comparable range of Zn values for both pre-term and term babies (10 to 300 micrograms/g fresh tissue). The value of 10 micrograms/g was found only in one 4-month-old infant. The accumulation of both Cu and Zn occurs independently in the fetuses. The socioeconomic status did not influence significantly the concentration of liver Cu or Zn in babies born at term. However, size of babies as measured by liver weight showed that larger babies had significantly higher mean Cu concentration (37 +/- 24 micrograms/g) than smaller babies (21 +/- 14 micrograms/g. The same trend, but without significant difference, was observed for hepatic Zn between larger (104 +/- 78 micrograms/g) and smaller (74 +/- 59 micrograms/g babies. PMID- 3320158 TI - Drug-induced bronchopulmonary pleural disease. AB - More than 75 drugs are known to have adverse effects on the bronchopulmonary pleural system. Many of these drug reactions are fatal unless they are recognized, administration is stopped, and other measures are instituted. No data exist on the number of adverse drug reactions on the lung, because there is no mandatory reporting system in the United States. Probably less than 5% are reported. The clinician should be aware of the drugs that can produce adverse reactions on the lungs and stop the administration as soon as possible. In this article, I have classified the drugs known to produce adverse pulmonary effects as follows: chemotherapeutic, cardiovascular, antibiotic, and anti-inflammatory agents, drugs known to induce systemic lupus erythematosus, inhalants, illicit drugs such as heroin, and miscellaneous drugs. There are no blood tests or other means of diagnosing adverse drug effects on the lung. Chest roentgenographic findings are nonspecific. Pulmonary function abnormalities generally correlate with the degree of dyspnea and chest roentgenographic changes. Therefore, the clinician trying to explain the onset of pulmonary symptoms must be aware of the drugs the patient is taking. PMID- 3320156 TI - Polyunsaturated fatty acids augment insulin secretion. AB - Carbohydrate intolerance is positively correlated with animal fat consumption and is more common in beef eating populations. In contrast, individuals consuming diets comprised of polyunsaturated fats have a lower incidence of diabetes mellitus. To test the hypothesis that dietary fats may influence carbohydrate metabolism, serum glucose, insulin, and gastric inhibitory polypeptide (GIP) responses to three mixed test meals of varying fatty acid composition were assessed in 12 normal subjects. Fatty acids in the meals were either saturated fats or polyunsaturated fats derived from vegetables or fish. Each test meal provided 40% of a subject's calculated daily caloric requirement and contained approximately 45% carbohydrate, 40% fat, and 15% protein. Serum insulin responses were 62% higher (p less than 0.01) after the fish and 39% higher (p less than 0.01) after the vegetable meals compared to the saturated fat meal. No significant differences in insulin responses were observed between the vegetable and fish meals. Serum glucose concentration was slightly higher (p less than 0.02) during the fish meal than with the vegetable or saturated fat meals. The GIP levels were comparable following the fish and vegetable meals and were 25% lower than those observed with the saturated fat meal. These findings suggest that diets enriched with polyunsaturated fatty acids augment insulin secretion significantly more than a diet comprised primarily of saturated fatty acids. The mechanism for this increased insulin secretion is unknown but did not appear to be mediated through differences in serum glucose values or through the insulin otrophic effects of GIP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320157 TI - Dust mites: immunology, allergic disease, and environmental control. PMID- 3320159 TI - Proposed mechanisms of aspirin sensitivity reactions. PMID- 3320160 TI - Effect of total lymphoid irradiation on IgE antibody responses in rheumatoid arthritis and systemic lupus erythematosus. AB - Thirteen patients with rheumatoid arthritis and four patients with systemic lupus erythematosus and nephritis were treated with total lymphoid irradiation because of severe disease refractory to other forms of treatment. Serum samples before and after irradiation were tested for changes in total serum IgE and for changes in specific IgE antibodies to ryegrass pollen, dust mite, cat dander, and Alternaria. There were no statistically significant changes in total or specific IgE from lymphoid irradiation in these patients. The therapy caused a significant decrease in circulating total lymphocyte and Leu-3 (helper/inducer) T-lymphocyte counts. Therefore, reduction in circulating levels of helper/inducer T cells does not appear to influence preexisting levels of IgE antibodies. PMID- 3320161 TI - Interpretation of the results of methacholine inhalation challenge tests. AB - Methacholine inhalation challenge studies are conventionally expressed as the provocative cumulative dose of methacholine that causes a 20% fall in FEV1 (PD20). This method is widely used and most suitable for expressing results for challenges in subjects with asthma. However, it is impossible to present results in this manner in other circumstances. Normal subjects and many subjects with allergic rhinitis do not have significant bronchial reactivity and will not reach a 20% fall during standard challenge protocols. This limitation precludes the use of this large population in the quantitative analysis necessary in epidemiologic, genetic, or drug studies. To compound this difficulty, a subset of patients with allergic rhinitis may demonstrate a 20% drop but have a subsequent plateau drop in FEV1. Expressing the results of their methacholine challenge with only a PD20 loses valuable information available in the test. We demonstrate that expressing results as the area beneath a dose-response curve provides useful parametric data on all studied subjects and distinguishes among subjects who might otherwise be classified as equivalent when results are expressed solely as a PD20. PMID- 3320162 TI - The appearance of macrophage migration-inhibition factor in drug reactions. AB - Drug-induced adverse reactions were suspected in 2030 patients with known exposure to 243 different drugs. A modified direct macrophage migration inhibition factor (MIF) test for the different drugs was carried out on blood samples from these patients. There was a positive MIF response toward one or more of the suspected drugs in 53.4% of the patients as compared to 4.9% of the control group; 155 of the 243 drugs elicited a positive MIF response. The percentage of positive responses for each particular drug was not related to the number of patients tested, reflecting the variability in specific immunogenicity of the different drugs. The high percentage of positive MIF reactions in relation to the clinical diagnosis suggests that this test can be a useful aid in the detection of the offending drug in cases of suspected drug-induced reactions. PMID- 3320163 TI - Divergence excess exotropia. AB - This paper presents a summary of information regarding divergence excess exotropia. The first portion of the paper deals with the description (i.e., definition, onset, natural history, prevalence, sexual distribution, symptomatology, and the differential diagnosis of the two subtypes) of this entity. The second portion of the paper reviews the various treatment options (surgery, lens therapy, prism therapy, and vision training) currently available with emphasis on vision training/orthoptics. We conclude that divergence excess exotropia is effectively managed at least as well by vision training/orthoptics as it is by surgery. We propose that future research examine in greater detail the characteristics of the subtypes of this entity to potentially derive improved training techniques for this population. PMID- 3320164 TI - Fact and fantasy in the seduction theory: a historical review. AB - This article surveys Freud's various versions of the seduction theory, from 1896 to 1933. It is concluded that the seduction theory had never been based on the patients' direct statements and conscious recall of seduction by the father in early childhood--unlike what Freud was to state much later (1933). This early seduction was mostly reconstructed by Freud from the patient's verbal material and behavior in treatment (including memories of sexual experiences from later childhood) which he interpreted as disguised and incomplete "reproductions" and reenactments of the original seduction trauma. Further, the external trauma was never meant to account by itself for the later neurotic symptoms. The "delayed action" of its unconscious memory, producing the repression of an event from the time of puberty, was a necessary part of the process. Thus internal psychic transformations and conflicts, anticipating Freud's later emphasis on fantasy and psychic reality, were already an intrinsic part of the seduction etiology of 1896. It is also noted that the father played no central role in the original theory as presented in 1896; it is only in the letters to Fliess that the father emerged as the prime seducer. The implications of this clarification of the seduction theory for the understanding of the changes and continuity in the development of Freud's theories are highlighted; their relevance to ongoing issues in psychoanalysis about the role of external trauma, fantasy, and reconstruction are briefly examined. PMID- 3320165 TI - Rene Magritte: coping with loss--reality and illusion. AB - Rene Magritte was profoundly influenced in his painterly style and in the content of many of his paintings by his mother's suicide when he was fourteen. This paper explores the influence of this traumatic event on his work. My thesis is that the nighttime suicide of Magritte's mother by drowning: (1) had a profound impact on the form and style of his paintings; (2) his paintings represented an effort, mostly successful, to contain and master through intellectual control with isolation of affect the trauma of this experience, which must at the time have evoked helplessness and despair; (3) the contents of a series of his paintings directly reconstruct the traumatic experience under control and in the service of mastery; and (4) there are paintings, mostly painted at the time he clearly developed his own style (1926-1930), that reveal a breakthrough of projected primitive aggressive impulses and unconscious representations of the aggressive mother. In these latter paintings, both form and content are dramatically different from the main corpus of Magritte's work. PMID- 3320166 TI - Protein blotting on nitrocellulose: some important aspects of the resolution and detection of antigens in complex extracts. AB - The resolution and detection of individual components in complex extracts by protein blotting have been investigated. By probing nitrocellulose transfers with monospecific and multispecific antisera, it was demonstrated that dissociating conditions were required for the maximum resolution of antigens by polyacrylamide gel electrophoresis, a conclusion reinforced by results from 2-D electrophoresis. The dissociating and reducing treatments employed, however, were both shown to be responsible for some loss of total antigenicity and included the complete loss of at least one important antigen. Assays with nitrocelluloses of different pore sizes demonstrated that both higher protein-binding capacities and higher backgrounds were associated with the use of the smallest pore size, while the sensitivity of the assay was greatest when a non-ionic detergent, and not proteins, were used for blocking. Nitrocellulose-bound proteins may be stained with amido black, India ink, toluidine blue, Ponceau S or a gold sol, but these agents do not always give identical staining patterns. While detection of components with immuno-enzyme staining methods had some advantages, problems with non-specific binding were encountered. These did not occur with affinity purified radiolabelled second antibodies, which in combination with scanning of autoradiographs allowed a quantitative approach to be adopted. PMID- 3320167 TI - Glucose, insulin and sympathoadrenal activation. AB - Selective activation of the two components of the sympatho-adrenal system (SAS) was produced by infusing male Sprague-Dawley rats with glucose or insulin. Intravenous glucose (0.5, 1 or 2 g/kg) raised plasma levels of glucose and insulin associated with a predominant activation of the sympathetic nervous system (SNS) as indicated by increased plasma norepinephrine (NE) levels. Glucose induced release of NE was still seen in hypoinsulinemic, streptozotocin-treated rats but was absent after ganglionic blockade with chlorisondamine or following mannitol or saline infusions which failed to alter glucose or insulin levels. Insulin-induced (10 or 20 U/kg) hyperinsulinemia with its associated hypoglycemia produced predominant activation of the adrenal medulla producing increased plasma epinephrine (E) levels. But significant SNS activation also occurred with a concomitant increase in NE levels (14-22% of E) which appeared to be primarily from sympathetic nerves since increases still occurred following adrenal demedullectomy. Therefore, changes in plasma glucose levels alone and possibly altered intracellular concentrations or rates of glucose utilization can act as an important determinant of the pattern SAS activation although this may require pathological changes in plasma glucose levels to occur. PMID- 3320169 TI - [Bibliographic survey. Ocular cicatricial pemphigus]. PMID- 3320168 TI - [Maculopathy in typical retinitis pigmentosa apropos of 33 cases]. AB - The authors studied 33 maculopathies in 54 patients affected by typic retinitis pigmentosa: atrophic macular degeneration 31 cases (49%); cystoid macular oedema: 1 case (3%) and macular retraction syndrome: 1 case (3%). These results are confronted with those of the literature. Two therapeutical trials based on pathogenical hypothesis were conducted. The patient with cystoid macular oedema was treated by Hyperbar oxygenotherapy, basing one of selves on the theory ischemia. Six other patients with atrophic foveolopathies were treated by the cyclophosphamide, according to the autoimmune theory. In the first trial, the result was positive. In the second one, the results did not permit any available conclusion. PMID- 3320170 TI - [Keratoprosthesis: study of an expanded polytetrafluoroethylene support]. AB - Expanded Polytetrafluoroethylene (E. PTFE) is an inert vitreous teflon alloplast with a high biocompatibility. It is able to be ingrowth by fibrovascular tissue. Very good results are reported in vascular, abdominal and reconstructive surgery and this suggests a possible use in keratoprosthesis. In this purpose, its tolerance and its embedding in the corneal tissues have been studied. Eight perforating keratoplasties are performed in the rabbit with a diameter of 5 mm. A disk of E. PTFE was sutured on the cornea and examined clinically, histologically and by scanning electron microscopy from 1 to 50 days after the operation. Corneal implants are well tolerated but microscopic examination does not show evidence of fibrovascular ingrowth. A full thickness corneal implant seems uneffective in the absence of a conjunctival flap. PMID- 3320171 TI - [Repair of the retracted inferior cul-de-sac of cavities of enucleation with fixation to the orbital rim by the double continued suture method]. AB - A technique using two continued sutures is presented to enlarge the inferior conjunctival sac. The mucosal or cutaneous graft is held in position by a direct fixation to the periosteum of the inferior orbital rim without any blepharorraphy. Several methods have been proposed. In this new operative technique a first smooth continued suture is prepared on the periosteum and a second suture is drawn through the graft and each curl of the first one. The advantages are: 1. A strong and permanent fixation to the orbital rim, 2. Without any external suture, 3. A safe procedure. There were no complication and long term follow up revealed no change in the position of the cul de sac in a series of 17 patients. PMID- 3320172 TI - Chronic renal failure. PMID- 3320173 TI - Reduction of the scaphoid fracture with DISI alignment. AB - Eight cases of symptomatic malunion and nonunion of scaphoid fractures with dorsiflexed intercalated segment instability (DISI) alignment were treated by open reduction, anterior wedge-shaped bone grafting, and internal fixation using Herbert's screw. In four malunited fractures, osteotomy at the fracture line was done before the reduction. The DISI alignment was reduced by insertion of the Kirschner wire into the lunate and flexing it anteriorly. After the bone grafting to the anterior bony defect of the scaphoid, which was created by the Kirschner wire reduction, internal fixation was accomplished by the use of Herbert's screw. In all cases fusion was obtained within 4 months. Radiographic assessment indicated that the DISI alignment and the angulated scaphoid were corrected to achieve a nearly normal pattern. Pain, restricted motion of the wrist, and the grip strength were improved. PMID- 3320175 TI - Giant cell reparative granuloma of the hand. AB - A case of recurrent giant cell reparative granuloma of the hand is reported. The radiographs showed a lytic, expansile lesion that extended from the secondary ossification center proximally to the articular surface distally. Treatment consisted of excision of the involved proximal phalanx and interposition bone graft. The histopathologic findings were typical for this benign, nonneoplastic process: a cellular fibrous stroma with many giant cells. The differentiation of giant cell reparative granuloma from giant cell tumor, aneurysmal bone cyst, and brown tumor of hyperparathyroidism is reviewed. PMID- 3320174 TI - Nonunion of the capitate. AB - A case of nonunion of the capitate of a 13-year-old girl is reported. Autogenous iliac bone grafting obtained union. At the 2-year follow-up, she had no complaints and had full motion of the wrist. PMID- 3320176 TI - Simple bone cyst of the metacarpal. AB - Simple bone cyst is a benign tumor-like lesion that occurs principally in the humerus and the femur. Occurrence within the hand is rare and involvement of the metacarpals is even more uncommon. Two similar cases of a simple bone cyst affecting the metacarpals were treated by complete excision of the cyst and replacement by a cortico-medullar autogenous graft. PMID- 3320177 TI - Flexor tendon repair and rehabilitation in zone II open sheath technique versus closed sheath technique. AB - A comparative prospective study of the surgical management of the tendon sheath after repair of flexor tendons in zone II is reported. The study included only patients with lacerations of both flexor tendons and no other associated injuries. A modified Kessler suture was used to repair the profundus tendon and the superficialis tendon was repaired with a horizontal mattress suture. In 48 fingers the flexor tendon sheath was left open and it was closed in the second group of 42 fingers. When it was impossible to close the tendon sheath, a vein patch was taken from the dorsal veins of the hand. Both groups of patients were treated with the same regimen of controlled motion rehabilitation and supervised by the same hand therapist. Results were evaluated by the Strickland formula for total active motion of the proximal and distal interphalangeal joints. There was no statistical difference between the results of open sheath versus closed sheath in these two groups of patients treated postoperatively with the same controlled motion rehabilitation program. PMID- 3320178 TI - Satisfactory elbow flexion in complete (preganglionic) brachial plexus injuries: produced by suture of third and fourth intercostal nerves to musculocutaneous nerve. AB - The third and fourth intercostal nerves were sutured to the musculocutaneous nerve to restore flexion of the elbow joint in complete (preganglionic) brachial plexus injuries. Seventeen patients were followed on the average for 5 years and 7 months after surgery. The results were evaluated by means of manual muscle tests and electrical diagnostic tests. Good (grade IV), or better, flexion of the elbow joint occurred in 12 patients over 3 years after the operation. PMID- 3320179 TI - Expression of major histocompatibility complex class II antigens on bile duct epithelium in patients with hepatic graft-versus-host disease after bone marrow transplantation. AB - We studied the expression of major histocompatibility complex (MHC) class II antigens in liver biopsies taken from ten patients with clinical and biochemical evidence of liver damage after bone marrow transplantation. In all six patients who had histologically confirmed graft-versus-host disease, MHC class II antigens were detected on intrahepatic bile ducts. In four patients with no histological features of graft-versus-host disease, MHC class II antigens were not detected. In controls, a positive reaction for bile duct MHC class II antigens was only detected in the patients with primary biliary cirrhosis. Characterisation of the lymphocytes surrounding the bile ducts showed a prevalence of Leu 3+ cells in graft-versus-host disease and primary biliary cirrhosis. We propose that the aberrant expression of class II antigens on bile duct epithelium cells may play a role in the pathogenesis of graft-versus-host disease. A similar pattern in primary biliary cirrhosis may suggest a common pathogenetic mechanism. PMID- 3320180 TI - Non-radioactive hepatitis B virus DNA probe for detection of HBV-DNA in serum. AB - A diagnostic test has been developed to detect hepatitis B virus (HBV) DNA in human sera. This test involves a dot-blot technique in which non-radioactive nucleic acid labelled with 2-acetylaminofluorene (AAF) is used as probe. Two series of human sera from 228 blood donors and 113 HBsAg chronic carriers were tested by hybridization with the same DNA probe labelled either with AAF or with 32P. A correlation between the techniques was observed for 328 sera (96%), and using the non-radioactive test it was possible to detect 56 (86%) of the 65 HBV DNA-positive patients. A comparative study of the HBeAg/anti-HBe status and the presence of HBV-DNA was carried out on the sera from 113 HBsAg chronic carriers, 65 of which were positive for HBeAg and 29 of which were positive for anti-HBe antibodies. With the AAF test, 44 of the HBeAg-positive sera were positive, while 5 of the anti-HBe-positive sera were positive. This study shows that, although this non-radioactive test is slightly less sensitive than the radioactive hybridization assay (RHA), it can be used for a survey of HBV carriers. Dissociation of the viral multiplication and the HBe/anti-HBe status was identified with the AAF test as well as with the RHA. It would therefore appear that the AAF test described here may be used for the extensive survey of HBV multiplication. PMID- 3320181 TI - A prospective multicenter study of insulin and glucagon infusion therapy in acute alcoholic hepatitis. AB - A randomized, single-blind controlled multicenter study of insulin and glucagon infusion was carried out in 66 patients with acute alcoholic hepatitis. Thirty three patients were treated with insulin 10 U and glucagon 1 mg in 500 ml 5% glucose in water via a peripheral vein for 2-6 h three times every day for 3 weeks. Patients in the control group received 5% glucose in an identical fashion. Fourteen control patients and five treated patients died from liver failure during the study (P less than 0.02). Clinical features of liver disease on entry into the study were similar in the two groups, but the total serum bilirubin, aspartate aminotransferase, gamma-glutamyltranspeptidase activities and prothrombin time significantly improved in the treated patients (P less than 0.05). Insulin and glucagon infusion appears to be a promising treatment of acute alcoholic hepatitis. PMID- 3320183 TI - Lithium for the control of aggressive and self-mutilating behaviour. AB - Lithium has been used for many years in the treatment and prophylaxis of affective disorders. Since 1969, evidence has been accumulating in relation to its effectiveness in the control of aggressive behaviour. This review summarizes the published evidence. PMID- 3320182 TI - The effect of drugs on the portal circulation. PMID- 3320184 TI - A double-blind placebo controlled trial of a selective beta 2 adrenoceptor antagonist (ICI 118551) in chronic anxiety. AB - ICI 118551, a selective beta 2 adrenoceptor antagonist, was compared with placebo and propranolol in a double-blind cross-over trial in 11 chronically anxious patients, 8 of whom were continued on benzodiazepines. Each treatment was given for 1 week and there was a significant improvement in anxiety ratings (p less than 0.01) at the end of the 3-week trial. However there was no significant difference between the 3 treatments and no preference by either patients or doctor for any one treatment could be detected. Thus, under the conditions of this study, no beneficial effects of either selective or non-selective beta blockade on chronic anxiety could be detected. Some previous studies with beta blockers may have confused an effect on anxiety with an effect on benzodiazepine withdrawal. PMID- 3320185 TI - First clinical experience with ifoxetine, a new 5-HT reuptake blocker with particular emphasis on the side-effect profile of the 5-HT-uptake inhibiting drugs. AB - Ifoxetine (CGP 15 210 G) is a novel and unusual drug. It specifically and selectively blocks the 5-HT reuptake in the brain without affecting the 5-HT uptake processes in the periphery (blood platelets). In the first, open and explorative trials its tolerability and effectiveness were studied in 33 patients suffering from endogenous (n = 25) or other types of depressive disorders. In daily doses of 50 to maximally 300 mg mental condition considerably improved in 17 patients. As assessed by HAMD 7 patients out of 17 became asymptomatic (HAMD Score less than 10) whereas 10 other patients markedly improved (decrease in HAMD by greater than or equal to 50%) in the course of 3 to 4 weeks of treatment. Eleven patients improved only slightly, in 3 patients no particular change in condition could be observed and 2 patients deteriorated. This deterioration was due to psychotic decompensation after the second week of the treatment (75-100 mg/d). Apart from this, ifoxetine was well tolerated particularly at doses of 50 150 mg/day, which also appeared to be the optimal therapeutic range of doses. There were no changes in cardiovascular function or laboratory values and almost no somatic or other complaints of major concern. These preliminary results indicate that ifoxetine has antidepressant properties with possibly an advantageous side-effect profile, in comparison to other 5-HT uptake inhibitors. PMID- 3320186 TI - Citalopram--a highly selective 5-HT uptake inhibitor--in the treatment of depressed patients. AB - In an open, clinical trial comprising a total of 21 depressed in-patients (6 men and 15 women) citalopram was administered in doses of 20-60 mg once daily for a period of at least 3 weeks. Fourteen of the patients were treated for 4 weeks, and 6 of these patients were treated for another 2 weeks. The CPRS subscale for depression (MADRS) and a global evaluation were used for assessment of the therapeutic effect. Twelve patients showed complete or partial response to treatment, and generally onset of therapeutic effect was seen within the first 2 weeks of treatment. Side-effects were generally few and mild, anxiety being the most frequent one. No pathological laboratory values were recorded, and apart from one case of slight and transient bradycardia no changes were observed in the cardiovascular parameters. Determination of plasma levels in 16 of the patients under presumed steady-state conditions showed an inter-individual variation between 28 and 616 nM/l for citalopram and between 32 and 338 nM/l for its monodemethylated metabolite for daily citalopram doses of 30-60 mg. The average ratio citalopram-desmethyl citalopram was 1.70. No correlation was found between clinical response and the plasma levels. PMID- 3320188 TI - The Ten Commandments of Medical Ethics. PMID- 3320187 TI - Interpreting significance in an antidepressant drug trial. AB - In a clinical trial to compare two antidepressants, mianserin and dothiepin, the Last Visit Carried Forward (LVCF) analysis was used for the statistical tests. By this method, no significant differences were demonstrated between the antidepressant response of each drug, as measured by the Hamilton Depression Scale. Statistical significance (or lack of it) does not necessarily correlate with clinical significance and, since antidepressant drugs usually take 10-14 days to exert any effect, a further analysis was undertaken excluding patients who completed less than 2 weeks of the trial. This further analysis then demonstrated a statistically significant difference in favour of mianserin (p less than 0.05). In designing statistical analysis for clinical drug trials, it is important to take into account the therapeutic characteristics of the drugs under trial. PMID- 3320189 TI - Perspectives in otitis media. PMID- 3320190 TI - Historical prospective for global eradication of measles. PMID- 3320191 TI - ISMA responds to charge that physicians are to blame for higher Medicare costs. PMID- 3320192 TI - Medical museum notes (Dr. Frank B. Wynn). PMID- 3320193 TI - Hydrops fetalis. PMID- 3320195 TI - The obstructive sleep apnea syndrome: pathophysiology, diagnosis and treatment. PMID- 3320194 TI - Pseudomembranous colitis: case report and review of the literature. PMID- 3320196 TI - The Old Pathology Building. The Indiana Medical History Museum's most priceless artifact. PMID- 3320198 TI - The politics of the NIH extramural program, 1937-1950. PMID- 3320197 TI - The forging of mental health policy in America: World War II to new frontier. PMID- 3320199 TI - Antipyretic treatment and typhoid fever: 1860-1900. PMID- 3320200 TI - Origin of cholinergic fibers in the basolateral nucleus of the amygdaloid complex by using sensitive double-labeling technique of retrograde biotinized tracer and immunocytochemistry. AB - Injection of biotin-wheat germ agglutinin into the basolateral nucleus of the amygdaloid complex of the rat labeled many neurons in the substantia innomionata, ventral pallidum, horizontal limb of the diagonal band, interstitial nucleus of the ansa lenticularis, and bed nucleus of the stria terminalis. Except for the labeled cells in the bed nucleus of the stria terminalis, simultaneous staining with antiserum against choline transferase (ChAT) showed that some of these neurons are ChAT-like immunoreactive. This highest density of the double-labeled cells was seen in the horizontal limb of the diagonal band and substantia innominata, less numerous in the ventral pallidum and a few double-labeled cells in the interstitial nucleus of the ansa lenticularis. PMID- 3320201 TI - [Immunohistochemical characterization of serotoninergic afferent pathways in the visual system of the rat]. AB - Using the immunohistochemical PAP-method occurrence, distribution and terminal aborization of serotoninergic axons were investigated in the visual system of the albino rat. The present study reveals that the innervation varies in quantitative and qualitative manner in the different parts of the visual system. A sparsly serotoninergic innervation was observed in the dorsal lateral geniculate body (d lgb) and in the nucleus lateralis posterior. An intensive serotoninergic innervation was found in the lateral part of the ventral lateral geniculate body (v lgb) and in the area praetectalis. Serotoninergic axons show a lamina specific orientation in the colliculus superior and in the visual cortex. Our findings indicate that serotoninergic axons have an intensive terminal aborization in subcortical visual nuclei, which are more or less connected with oculomotoric functions. PMID- 3320202 TI - Sequential appearance of thymocyte subpopulations and T cell antigen receptor gene messages in the mouse thymus after sublethal irradiation. AB - The sequential differentiation patterns of thymocyte were observed with cell surface phenotypes and the expression of T cell antigen receptor in 800 rad irradiated adult mice. Thymus was severely reduced in size and cell number by day 5 after whole body irradiation and rapidly recovered from day 7 to day 14. Surface marker analysis on day 5 after irradiation showed thymocytes with Thy 1low L3T4+/Lyt-2- dominantly existed and suggested that these cells were radioresistant-survived cells. On the other hand, thymocytes on day 7 were composed of a large number of Thy-1high L3T4+/Lyt-2+ blast-like cells and a relatively high proportion of Thy-1high L3T4-/Lyt-2- cells which expressed a large amount of gamma-chain gene messages but scarcely any alpha- and beta-chain gene messages similar to the fetal thymocytes. On day 14, thymocytes were composed mostly of Thy-1high H-2low L3T4+/Lyt-2+ subpopulation which expressed a remarkably low level of gamma-chain gene messages, and high levels of alpha- and beta-chain transcripts analogous to those of normal adult thymus. Taken together, intrathymic radioresistent stem cells for T thymocytes seem to proliferate and differentiate after irradiation with the same pattern as was seen in a fetal thymus development. PMID- 3320203 TI - Human tumor necrosis factor potentiates human interleukin 1-mediated rat pancreatic beta-cell cytotoxicity. AB - Previous studies have established that the cytokine interleukin 1 (IL-1) is selectively cytotoxic for isolated human and rat pancreatic beta-cells. This observation raises the possibility that insulin-dependent diabetes mellitus is in part due to immunologically mediated mechanisms involving IL-1. However, other cytokines are produced during immunologic responses. To study possible modulatory effects of other cytokines on IL-1-mediated beta-cell cytotoxicity, we added human recombinant IL-1 alpha and beta (rIL-1 alpha, rIL-1 beta), tumor necrosis factor (rTNF), lymphotoxin (rLT), and interferon-gamma (rIFN-gamma) separately or in combinations to the culture medium of isolated rat islets of Langerhans. A half-maximal inhibition of glucose-stimulated insulin release after 7 days of culture was obtained with 100 pg/ml of rIL-1 beta, whereas 1000 pg/ml of rIL-1 alpha were necessary to obtain an equivalent effect. While ineffective in causing inhibition of beta-cell function or morphologic damage to islets alone 2.5 to 25 ng/ml of rTNF, but not 40 ng/ml of rLT, or 25 ng/ml of rIFN-gamma markedly potentiated the inhibition of beta-cell secretory response and dissolution of islet integrity caused by rIL-1 alpha and beta. The potentiating effect of rTNF was more pronounced if the rTNF was added after 60 min of preincubation of the islets with rIL-1 beta, than if rIL-1 beta was added after 60 min of preincubation with rTNF. rTNF did not interfere with the activity of rIL-1 alpha or beta on lymphocytes. Combinations of rIFN-gamma and rTNF or rLT did not affect beta-cell function. In conclusion, rTNF strongly potentiates the functional inhibition of beta-cells and the morphologic disintegration of islets caused by rIL-1 in vitro. These data, seen in context with previous observations of rIL-1 mediated beta-cell cytotoxicity, suggest that macrophages present in the intra islet mononuclear cell infiltrate in insulin-dependent diabetes mellitus may secrete monokines that could be important effector molecules in beta-cell destruction. PMID- 3320205 TI - Removal of Langerhans cells from human epidermal cell suspensions by immunomagnetic particles. AB - The possibility of eliminating the class II antigen-expressing and antigen presenting Langerhans cells from normal human epidermal cell suspensions was investigated. Cell suspensions containing 1.7-2.8% Langerhans cells were prepared by enzyme treatment of human skin obtained at plastic surgery. The cells were incubated with mouse monoclonal antibodies directed against the CD1 antigen present on Langerhans cells and were further incubated with magnetic particles, 4.5 micron in diameter, coated with sheep anti-mouse IgG. The optimal ratio between particles and target cells was found to be 40:1. The rosetted Langerhans cells were removed by a cobalt-samarium magnet. In six experiments immunoperoxidase staining revealed 0-0.1% (mean 0.03%) CD1-reactive Langerhans cells in the depleted cell fraction. The alloantigen presenting capacity of the depleted cell fraction, measured by [3H]thymidine incorporation, was abolished. PMID- 3320204 TI - Molecular cloning and expression of hybridoma growth factor in Escherichia coli. AB - Human monocytes produce a factor that supports the growth of B lymphocyte hybridoma cells, termed hybridoma growth factor (HGF). By using expression cloning in Escherichia coli of complementary DNA derived from human monocyte poly(A+) RNA, we selected seven clones producing HGF activity as measured in a bioassay, based on the induction of proliferation of the HGF-dependent B cell hybridoma B9. Sequence analysis of the cDNA revealed that HGF is identical with interferon-beta 2, 26,000 protein, and B cell stimulatory factor-2. One of the active clones contained a cDNA that encoded a recombinant product lacking the 28 amino acid long signal peptide and the first 15 amino acids of the mature protein. Antibodies against the recombinant HGF inhibited the biologic activity of recombinant HGF as well as of monocyte-derived HGF. PMID- 3320206 TI - Intrasplenic immunization for production of monoclonal antibodies against mouse blastocysts. AB - Applying the intrasplenic immunization method monoclonal antibodies were raised against trophectoderm of mouse blastocysts. Adhesive C57BL/6 blastocysts, obtained 18 h after estrogen reactivation from an experimental delay of implantation, and irradiated with 5000 rad were used as immunogen. Male DBA/2 mice were immunized by four intrasplenic depositions of about ten blastocysts each. The sensitized spleen cells were fused with mouse plasmacytoma cells on the 5th day after the last booster, followed by isolation of hybridoma clones by conventional monoclonal antibody procedures. 82 hybridoma clones were obtained of which two produced IgM antibodies recognizing trophoblast determinants. Absorbing the monoclonal antibodies with C57BL/6 splenic leukocytes followed by immunolabelling of blastocysts demonstrated that the antibodies recognized neither MHC nor TLX antigens. Pre- and peri-implantation stages were mapped by indirect immunofluorescence microscopy. Morulae were negative while blastocysts were positively labeled. Adhesive blastocysts labeled more strongly than delayed blastocysts. Cultured blastocysts showed an intense labeling of some of the trophoblast cells, while other trophoblast cells were unlabeled. PMID- 3320207 TI - A comparison of spleen and lymph node cells as fusion partners for the raising of monoclonal antibodies after different routes of immunisation. AB - Administration of antigen (human insulin) via the rear footpads of BALB/c mice with subsequent fusion of popliteal and inguinal lymph node lymphocytes induced a higher frequency of hybridomas (100%) secreting specific antibody than either intradermal immunisation and lymph node cell fusion (53%) or conventional subcutaneous immunisation and intraperitoneal boost followed by splenic lymphocyte fusion (8%). The rank order of serum antibody titres was found to correlate with the order of fusion efficiencies. Lymph node cell fusions also produced a greater spectrum of antibody specificities. Such differences in fusion efficiencies were also observed using bovine intestinal alkaline phosphatase. PMID- 3320208 TI - A novel polycarbonate (Nuclepore) membrane demonstrates chemotaxis, unaffected by chemokinesis, of polymorphonuclear leukocytes in the Boyden chamber. AB - A novel polycarbonate (Nuclepore) membrane having capillary pores of 3 microns diameter and occupying 0.1% of surface area (average minimum spacing of 48 +/- 18.5 microns), a standard polycarbonate filtration membrane (pores 3 microns in diameter occupying 5% of surface area and having average minimum spacing of 3.9 +/- 2.8 microns) as well as a 3 microns pore cellulose acetate filtration membrane, were compared for their abilities to demonstrate chemotactic movement uninfluenced by chemokinetic movement of polymorphonuclear leukocytes in a Boyden type chemotactic chamber. The chemoattractant used was dilute Escherichia coli culture filtrate employed in a gradient across the membranes to measure chemotaxis and in non-gradient conditions to measure chemokinesis. The new polycarbonate (Nuclepore) membrane provided the clearest demonstration of chemotaxis unaffected by chemokinesis of the polymorphonuclear leukocytes. PMID- 3320209 TI - Selective transfer of IgM from agarose gels to nitrocellulose membranes. PMID- 3320210 TI - Immunopathological influence of the Ay, db, ob and nu genes placed on the inbred NOD background as murine models for human type I diabetes. PMID- 3320211 TI - Fatal Pasteurella multocida septicaemia following a cat bite in a man without liver disease. AB - We report a fatal case of septicaemia caused by Pasteurella multocida that followed a cat bite. The patient, a man aged 54 years, was not suffering from disease of the liver but had a history of ischaemic heart disease, non-insulin dependent diabetes mellitus and rheumatoid arthritis which had been treated with steroids for 13 years. PMID- 3320212 TI - Selenomonas bacteraemia--case report and review of the literature. AB - Selenomonas species are crescent shaped Gram-negative bacilli with a characteristic tuft of flagella located on the concave surface. They are normally found in human gingiva or the rumen of herbivores. The first case of Selenomonas bacteraemia to be reported in a patient immunocompromised by malignant disease is described and the two previously reported cases of Selenomonas bacteraemia as reviewed. The importance of careful anaerobic culturing to recover the organism and special diagnostic techniques to classify the bacteria as Selenomonas species are emphasised. These organisms may cause serious human disease including bacteraemia. PMID- 3320213 TI - Actinomycosis of the gallbladder due to Actinomyces naeslundii. AB - We report two cases of actinomycosis of the gallbladder due to Actinomyces naeslundii. Both patients presented with acute cholecystitis. After cholecystectomy with the removal of gallstones each patient made an uneventful recovery. The literature on cholecystitis due to Actinomyces is reviewed. PMID- 3320215 TI - In vivo and in vitro host range of Autographa californica nuclear polyhedrosis virus and Spodoptera frugiperda nuclear polyhedrosis virus. PMID- 3320214 TI - [Surgical complications of renal transplantation in children. Retrospective study of 372 cases]. AB - On the basis of a personal series of 372 cases of renal transplantation performed in children, half of whom presented congenital urinary tract malformations, the authors report 110 complications (29.6%). The most frequent complications were urological (14.2%), consisting essentially of fistulae (8.9%) and stenoses (3%). These were followed by vascular complications (6.4%) generally in the form of stenoses (4.8%) and rarely thromboses (1.1%). The authors also report the various local complications which were infectious (wall abscess, suppuration of the renal compartment), haemorrhagic (haematomas) or stones (stones forming on non resorbable sutures) as well as 5 cases of lymphocele. The prophylaxis of these complications depends on the care taken in collection of the graft (en bloc removal of both kidneys), the restoration of the continuity of the urinary tract (as much as possible Lich-Gregoire extravesical uretero-vesical reimplantation), the vascular anastomoses (vascular dissection limited to a strict minimum), the choice of suture material (resorbable synthetic suture material) and the prevention of infection by systematic pre-, intra- and post-operative antibiotic therapy. PMID- 3320216 TI - Muscle changes in experimental trichinosis before and after albendazole therapy. PMID- 3320217 TI - Toxoplasma infection in Zagazig, Egypt: an analytical study. PMID- 3320218 TI - Sero immunological diagnosis of heterophyiasis. PMID- 3320219 TI - Evaluation of counter-immunoelectrophoresis and indirect immuno-fluorescent antibody tests in diagnosis of strongyloidiasis. PMID- 3320220 TI - Value of immunofluorescent assay (IFA) in serodiagnosis of malaria. PMID- 3320221 TI - Study of the relation between tissue typing and occurrence of filariasis and its complications in Egypt. PMID- 3320222 TI - Estrogen and progesterone measurement and its quality control in breast cancer: a reappraisal. AB - This article illustrates the two main methods for routine measurement of cytoplasmic estrogen receptor status in neoplastic biopsy. The first is the Dextran Coated Charcoal Technique (D.C.C. Assay) which is still the method of choice in the majority of clinical laboratories for its simplicity, reproducibility and low cost. The second is a more advanced technique based on the specific binding, enzymatically displayed, of commercially available antiestrogen monoclonal antibodies (Enzyme Immuno Assay - ABBOTT). The sui generis characteristics of endocrine sensitivity assessment on tumor tissues and the importance of decision-making connected with the assay justify rigorous quality assurance schemes. The quality control design proposed by the Italian Committee concerned the evaluation of several lyophilized preparations with scalar receptor content; this permits the identification through linear regression analysis of systematic and non-systematic errors. The Italian Committee has currently connected 50 labs from most regions of the country. PMID- 3320223 TI - Serum levels of c-myc and c-ras oncogene products in normal subjects and in patients with neoplastic and non neoplastic conditions. AB - A new, simple and sensitive low pH ELISA system has been developed and used to measure serum levels of c-myc and c-ras oncogene products in healthy blood donors and patients with neoplastic and non neoplastic conditions. Blood donors had significantly lower serum levels of oncogene products than patients with cancer or other pathologies (p-value less than 0.01). There was, however, no difference between patients with neoplastic and non-neoplastic conditions. Although c-myc and c-ras oncogene products in the serum appear to discriminate between healthy state and pathological conditions they do not discriminate between neoplastic and non-neoplastic conditions. PMID- 3320225 TI - Homogeneity and heterogeneity in pancreas cancer: presence of predominant and minor morphological types and implications. PMID- 3320224 TI - Occupational chemicals and pancreatitis: a link? AB - The rising trend of idiopathic pancreatitis, and our demonstration that cytochromes P450 are 'induced' in most patients, prompted a search for enzyme inducers in their work environments. The findings in 19 patients (chronic pancreatitis 15, acute pancreatitis 4) are described. In the initial series of 12 consecutive patients with idiopathic pancreatitis, the enquiry revealed regular exposure to diesel exhaust fumes in 6 patients (of whom one had also been exposed to ozone and metal oxides), perchloroethylene or trichloroethylene in 3, paint solvents in a further 3. A second series included the next 7 patients with pancreatitis who drank alcohol on a daily basis for several years before their first symptom, but whose attacks continued although they had become, and remained, teetotal: their current occupations involved regular exposure to diesel exhaust fumes in 5 patients, to paint solvents in 1, and to trichloroethylene in 1. The wide variation in the duration of exposure before the first symptom, 2-21 yr, may reflect the net effect on cytochromes P450 of other xenobiotics (e.g. alcohol, cigarettes, caffeine). In several patients, symptoms stopped on removal from exposure to volatile chemicals but recurred on re-exposure. These preliminary findings suggest that occupational exposure to aromatic or chlorinated hydrocarbons may be relevant not only in idiopathic pancreatitis but also in alcohol-related pancreatic disease. PMID- 3320228 TI - [Clinical trials of interferon-beta (MR-21) in the treatment of malignant tumors of the skin]. PMID- 3320226 TI - Laboratory tests in the diagnosis of the chronic pancreatic diseases. Part 3. Tests on pure pancreatic juice. PMID- 3320229 TI - General anesthesia for intrauterine placement of human conceptuses after in vitro fertilization. AB - General anesthesia has been used for the replacement of human conceptuses after in vitro fertilization (IVF). Two adjuvants, enflurane and halothane, have been compared. Halothane significantly reduced the incidence of implantation compared to enflurane. In 356 replacements, the incidence of implantation for enflurane and halothane was 34 and 17%, respectively (P = 0.005). Sixty-four percent of all replacements had three conceptuses; the incidence of implantation for enflurane and halothane in this group was 43 and 19%, respectively (P = 0.002). The incidence of multiple pregnancy was similar for both anesthetic agents (20%) and the demise of implantation sacs 5 weeks postovulation was 11% for enflurane and 12% for halothane. PMID- 3320230 TI - Transvaginal and transabdominal ultrasound for monitoring of follicular development in an in vitro fertilization and embryo transfer program: patient response. AB - Patients' response to daily ultrasound scanning by either a transvaginal or a transabdominal method for the purpose of monitoring the ovarian response to gonadotropin therapy in an in vitro fertilization and embryo transfer program has been evaluated. A questionnaire was used to determine various aspects of these two procedures, sources of discontent, and the patients' preference. The vast majority of patients reported less discomfort and generally preferred the transvaginal over the transabdominal scanning method. The transvaginal method is easy to perform, affords excellent visualization of the pelvic organs, and in addition, is clearly preferred by patients over the transabdominal technique. We recommend its use in patients monitored for IVF-ET and for a variety of other clinical conditions requiring detailed evaluation of the pelvic organs. PMID- 3320227 TI - Comparative studies on expression of CA 19-9 and DU-PAN-2 in pancreatic cancer tissue. AB - Thirty-eight human pancreatic cancer cases were examined by immunohistochemistry for expression of CA 19-9 and DU-PAN-2 antigens by the respective monoclonal antibodies. CA 19-9 was expressed in 82% and DU-PAN-2 in 87% of cases. A combination of two antibodies increased the reactivity to 97%. Six CA 19-9 negative cases were DU-PAN-2 positive and 4 DU-PAN-2-negative cases expressed CA 19-9. In only 1 case (an anaplastic carcinoma), neither of the antibodies was reactive with cancer cells. The reactivity of tumor cells with each of the antibodies varied from case to case, and, within the same tumor, from one area to another. Histologically, all but one tumor were adenocarcinomas. Thirty-five cases showed areas of either a moderate degree of differentiation (16 cases), poor differentiation (11 cases) or anaplastic areas (8 cases). Although both antigens were expressed in a greater number of cancer cells in well differentiated areas, and less frequently in poorly differentiated and anaplastic regions, the difference in antigen expression in relation to the degree of tumor differentiation was not statistically significant. The cellular localization of the antigens varied. DU-PAN-2 was primarily localized within the cytoplasm, whereas CA 19-9 was found mostly on the luminal cell surface and in luminal content of the glandular structure. In tumor-free pancreatic tissue, adjacent to the tumor, CA 19-9 was detected almost exclusively in the cells of large and medium sized ducts, whereas DU-PAN-2 was primarily expressed in terminal ductular and centrocinar cells. The results indicate that a cocktail of CA 19-9 and DU-PAN 2 antibodies could increase the likelihood of identifying a biomarker in most patients with pancreatic cancer. PMID- 3320231 TI - The outcome of loop ileostomy closure in 293 cases. AB - Our experience with closure of loop ileostomies between the years 1975-1986 was reviewed. Ninety-three percent of stoma closures were done by simple transverse suture. The overall complication rate was 17%. Of the early postoperative complications (13%), the major complication was small bowel obstruction especially in patients where the stoma was protecting a pelvic ileal reservoir. Abdominal septic complications (postclosure) were rare (1%). These were generally caused by unrecognized enteric tears during the mobilization of the stoma rather than anastomotic leakage. A careful operative technique is required. The wound infection rate after healing by both secondary intention and primary skin closure was low (3%) and mainly superficial. Only one incisional hernia was observed in the late postoperative period. In three patients a posterior rectus sheath defect at the stoma site was found incidentally at laparotomy, without clinical evidence of an incisional hernia. Closure of a loop ileostomy is a safe operation with a low morbidity. In patients with a previous total colectomy there was a significant risk of small bowel obstruction after ileostomy closure. PMID- 3320234 TI - The final days of George Gershwin, American composer. September 26, 1898-July 11, 1937. 50th anniversary. PMID- 3320235 TI - Surgical anatomy of structures adjacent to the thyroid apex and post-operative voice change (a review including dissection). AB - This paper considers the anatomy of structures contiguous to the upper pole of the thyroid gland. It also describes the findings of an anatomical dissection confined to the muscular and carotid triangles of the neck with the nerves therein innervating the cricothyroid and infrahyoid muscles. The segmental nature of the latter is described. The variable course of the cricothyroid artery with regard to the sternothyroid muscle is noted. A superficially placed artery is accompanied by branches of the ansa cervicalis; a deeply placed one is related to the external laryngeal nerve. In addition to the external laryngeal nerve there are other nerves, including branches of the ansa cervicalis, which can be damaged during operations involving the thyroid apex or adjacent structures. A comment is made about the significance of these findings with particular reference to voice change. PMID- 3320232 TI - Colorectal carcinoma and Haemoccult. A study of its value in mass screening using meta-analysis. AB - Meta-analysis has been performed on the world literature relating to Haemoccult screening for colorectal cancer. The analysis indicated a sensitivity of about 50%, specificity of about 97%, positive predictive value of 4.3% and negative predictive value of 99.85%. These figures assume a prevalence of colorectal cancer in the population of 0.3%. A model calculation using these figures together with some additional realistic assumptions suggests no reduction in mortality compared to an unscreened population. It is concluded that many questions about faecal occult blood screening remain and that uncontrolled mass population screening is not justified at this stage. PMID- 3320233 TI - The surgical treatment of severe idiopathic constipation. PMID- 3320236 TI - The early complications of inferior turbinectomy. AB - A retrospective study has assessed the early complications occurring in 90 patients who underwent inferior turbinectomy during a 3-year period. The operation was complicated by haemorrhage, adhesions, crusting, infection and septal perforation in a proportion of cases, the overall incidence being 20 per cent, and that of significant reactionary or secondary haemorrhage was 9 per cent. Attention has been directed towards possible aetiological factors and measures proposed that may minimise the occurrence of complications. PMID- 3320237 TI - Non-Hodgkin's lymphoma of the tonsil. Experience of treatment over a 27-year period. AB - Over the 27-year period from 1954-1981, 51 patients with non-Hodgkin's lymphoma arising in the tonsil were treated at the Regional Radiotherapy Centre, Mount Vernon Hospital. The original biopsy material was reviewed in each case and reclassified using the British National Lymphoma Investigation criteria. Grade 2 non-Hodgkin's lymphoma was reported in 80 per cent of cases. Ninety per cent of patients presented in stages IE or IIE and were treated with radical local radiotherapy. A 5-year survival of 51 per cent was achieved and a 5-year relapse free survival of 35 per cent. Stage IE patients had a statistically significant survival advantage compared to stage IIE. Sixty-one per cent of patients relapsed, of whom 74 per cent died from active lymphoma. The abdomen was the most frequent site for relapse with involvement of both nodal and extranodal sites. PMID- 3320238 TI - Nasopharyngeal chordoma presenting with metastases. Case report and review of literature. PMID- 3320239 TI - Cognitive dysfunction and psychoeducational assessment in individuals with acquired brain injury. PMID- 3320241 TI - Epidemiology of pediatric closed head injury: incidence, clinical characteristics, and risk factors. PMID- 3320242 TI - Neuropsychological assessment of head injury in children. PMID- 3320240 TI - Recovery and cognitive retraining after craniocerebral trauma. PMID- 3320243 TI - Management of academic and educational problems in head injury. PMID- 3320244 TI - [Are the French not well liked in Anglo-Saxon medical literature?]. PMID- 3320246 TI - [Emboli-forming arteriopathies of the limbs. From the atheromatous plaque to arterial embolism]. PMID- 3320245 TI - [Emboli-forming arteriopathies of the limbs]. AB - Atheromatous embolism disease is a recently defined entity of still to be determined prevalence. This complication can develop during the course of any arterial disease by overload or dystrophy in lower limbs, and is certainly responsible for many cases of worsening of subacute ischemias occurring during arterial disease for which it is not always possible to affirm the embolic origin. It is in no way a rare syndrome and the true frequency of this affection can only be underestimated. If arterial dystrophies are excluded, the primum movens is ulceration of an atherosclerotic plaque. Two types of emboli have been described as originating in these plaques. First, small cholesterol crystal emboli containing fibrino-platelet material that are the cause of very distal arterial occlusion, notably in the foot: the most typical corresponding clinical condition is the so-called blue toe syndrome. Second, larger emboli due to formation and migration of a fibrino-platelet thrombus in contact with the atheromatous ulcer. They consist mainly of fibrino-platelet material with variable quantities of atheromatous debris. They may be of moderate size, occluding a collateral of the deep femoral artery or a leg artery usually in an asymptomatic manner, or larger and provoking occlusion of main trunks. Diagnostic difficulties emphasize the importance of referring all embolectomy products for histopathology. One of the essential problems of this disease is that of diagnostic criteria. When confronted with the previously evoked picture of peripheral ischemia and/or a peripheral arterial occlusive lesion, how can this distal accident be related to a subjacent arterial lesion suspected of possessing an emboli-forming nature?(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320247 TI - [Emboli-forming arteriopathies of the lower limbs. Clinical aspects and medical treatment]. PMID- 3320248 TI - [Real-time echotomography in emboli-forming pathology of the limbs]. PMID- 3320249 TI - [Radiologic exploration of emboli-forming arteriopathies of the lower limbs]. PMID- 3320250 TI - [Emboli-forming arteriopathies. Diagnostic problems]. PMID- 3320251 TI - Sudden infant death syndrome: a literature review with chiropractic implications. AB - Sudden infant death syndrome is the term applied to the sudden death of an infant or young child that is unexpected by history and for which a thorough postmortem examination fails to demonstrate an adequate cause of death. It is widely believed that sudden infant death syndrome is not an expression of a single cause and effect, but rather a multifactorial phenomenon. This paper gives an overview of recent developments in sudden infant death syndrome research presenting the various hypotheses regarding sudden infant death. Functional disturbances in the brainstem and cervical spinal cord areas related to the neurophysiology of respiration may contribute to the clinical findings associated with sudden infant death syndrome. Parturitional factors, which include maternal (labor and delivery) and extrinsic factors (obstetrical procedures) have received attention. Work has also been done on the development of those neuroanatomical structures associated with respiration. It is postulated that human development progresses through stages with a critical period at 2-4 months. Immaturity of the brainstem and cervical cord is characterized, histologically, by the presence of reticular dendritic spines on the neurons as well as a proliferation of astrocytes and glial cells. Any process, whether genetic, biochemical, biomechanical or traumatic, that alters normal development of the respiratory control centers related to spinal constriction and compression following birth trauma may be contributory to sudden infant death syndrome. PMID- 3320253 TI - A computerized kidney donorship register. AB - In the UK a university department in conjunction with UK charities and hospitals has formed the basis of a computerized opting in kidney donorship register. The system operates on a VAX 8250, with local hospitals using terminal-emulating micros and PCs. The justification for such a system and its design and implementation are described. PMID- 3320252 TI - AI/LEARN network. The use of computer-generated graphics to augment the educational utility of a knowledge-based diagnostic system (AI/RHEUM). AB - AI/LEARN Network is an educational package that enhances a knowledge-based diagnostic system called AI/RHEUM. This paper describes a microcomputer-based graphical representation of the knowledge base and discusses graphical representation of knowledge. PMID- 3320254 TI - Serum levels of zinc and copper in normal subjects. PMID- 3320255 TI - Proceedings of the Engineering Foundation Conference: Computerized interpretation of the electrocardiogram XII. PMID- 3320256 TI - An optimal statistical decision model for diagnosis of coronary artery disease. PMID- 3320257 TI - Diagnostic value of the maximal ST segment/heart rate slope in asymptomatic factory populations. AB - In Leeds in hospital populations of patients with angina the maximal ST/HR slope was found to be a reliable index of myocardial ischemia as assessed by coronary angiography. Subsequent studies in Leeds and elsewhere in populations of patients with cardiac enlargement or following myocardial infarction have shown that the slope is affected by myocardial scarring, ventricular enlargement and aneurysm. These findings implied that the slope had features in common with other usual exercise tests; studies in Leeds and elsewhere, however, have shown a superior diagnostic reliability using the maximal ST/HR slope in patients with angina. The present report involves the use of the slope in asymptomatic populations. Trials are being undertaken in two factory populations, which respectively comprised all volunteers or asymptomatic men over the age of 30 who were randomly chosen by computer. Subjects with slope values indicating, according to previous experience, myocardial ischemia equivalent to coronary heart disease were referred for cardiological investigations which included angiocardiography; blind comparisons were performed between results of investigations and the slope. So far 1194 subjects have been examined. In 68 subjects the maximal ST/HR slope indicated myocardial ischemia, and in 24 of these cardiological investigations were completed. In nine of the 24 subjects the slope corresponded to the number of significantly narrowed coronary arteries (greater than 75% reduction in luminal diameter); in 12 of the remaining 15 subjects who had no coronary narrowing, there were cardiac lesions which included cardiac enlargement, aortic valve disease, myocarditis, pericarditis, myocardial bridging and conduction defects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320258 TI - The role of computerized ECG interpretation in clinical trials. AB - The Lipid Research Clinics project consisted of the Prevalence Study and the Coronary Primary Prevention Study. The first study characterized the levels of blood lipids in the population studied, and related these to the presence of coronary artery disease as detected by medical history, symptom analysis, resting ECG and treadmill exercise ECG tests. The prevention trial tested whether a reduction of elevated serum cholesterol would reduce the incidence of coronary events (Table I). Both projects collected resting 12-lead ECGs and treadmill exercise test data on the participants. Instrumentation and methodology were standardized. Rest and exercise electrocardiographic data were recorded on analog magnetic tape. Tapes were sent to the ECG Center where they were digitized, analyzed and also reproduced for visual analysis according to the Minnesota Code of Blackburn. There were two reasons for using both visual coding and computer analyses in these projects. It was thought that computer methodology would enhance the accuracy of the electrocardiographic data, but on the other hand its accuracy had not been adequately documented and its output statements were not in the language of the Minnesota Code, which is traditionally accepted by epidemiologists. The other and more pressing reason for using the Minnesota Code is that the computer programming had not been completed at the start of the project, and visual coding was required in order to provide the ECG data necessary for the randomization of the Prevention Trial participants. PMID- 3320259 TI - Estimation of myocardial infarct size by electrocardiographic and radionuclide techniques. AB - The Western Washington Intravenous Streptokinase in Acute Myocardial Infarction Trial was a randomized, experimental, multicenter clinical study comparing intravenous streptokinase therapy to conventional therapy of acute myocardial infarction. Myocardial infarct size was estimated by spatial vectorcardiography in 93 patients in the treatment group and 80 patients in the control group eight weeks post MI. The estimated infarct size for the treated group was smaller: 16 +/- 10% MI vs. 20 +/- 9% MI for the control group, P = 0.01. Four independent techniques to estimate infarct size were prospectively compared within the same day: Cowan's spatial VCG; the Selvestor/Wagner QRS score; 99m technetium synchronized ejection fractions and 201-Thallium Tomography. There was strong correlation between the two ECG techniques (r = 0.88) and between the two radionuclide techniques (r = 0.77). Statistically significant correlations (P = 0.0001) were described, respectively, among the four techniques, but the correlations were not clinically strong between electrocardiographic and radionuclide techniques: IAD vs. EF, r = -0.41; IAD vs. 201-Tl, r = 0.50; QRS Score vs. EF, r = -0.49; QRS Score vs. 201-Tl, r = 0.58. PMID- 3320260 TI - Ordinal discrimination of ECG orthogonal features. AB - A rigorous mathematical analysis of Electrocardiogram (ECG) data is presented in this paper, as a decision support system for ECG interpretation. The mathematical analysis: provides a new insight to the ECG data, provides flexibility for future understanding of the heart system or the ECG, and avoids the need of measurements of parameters and the disagreement concerning the standard criteria of those parameters. The system enables compressed storage of the ECG data and an easy and accurate retrieval ability. An "ordinal straight line" method is presented for simple description of the ECG features as a combination of straight lines. A new developed discrimination method--the bisector method--is used for discrimination and classification between the normal and pathological groups. The physician's decision is based on both the physician's heuristic approach and the system's classification. PMID- 3320261 TI - Initial results with a commercial luminescence enhanced enzyme immunoassay for the determination of carcinoembryonic antigen (CEA) in body fluids. AB - A commercially available luminescence enhanced enzyme immunoassay (Amerlite- Amersham International) for carcinoembryonic antigen (CEA) was compared with an established enzyme immunoassay (Monoclonal 1-step Assay--Abbott Laboratories). A reference range for healthy blood donors (n = 272) was established for both kits. The blood donors were not separated into smokers and non-smokers, but were excluded from the reference group if they showed abnormal aminotransferase or gamma-glutamyltranspeptidase serum values. Twenty eight donors were excluded in this way. The test group consisted of 130 known tumour patients, and included pre and post-operative serum samples. Normal and elevated CEA values were present. All sera were negative for HBsAg, anti-HBsAg and anti-HIV as determined with commercial enzyme immunoassays used routinely in the blood bank. The luminescence enhanced immunoassay gave rise to a reference range (95% confidence limits) of less than 3.91 micrograms/l in comparison with the enzyme immunoassay, which had a reference range of less than 4.12 micrograms/l. The proportion of elevated values in the tumour patient group was 37/130 for the luminescence enhanced enzyme immunoassay and 28/130 for the enzyme immunoassay. The correlation of values from both methods in the blood donor group was good (r = 0.771, n = 272). The CEA levels found in the tumour patient group differed significantly when measured in both kits (Wilcoxon matched-pair signed rank test--c-alpha = -6.52, p less than 0.01, n = 130), the Amersham kit giving the higher results (median values--Abbott 2.35 micrograms/l, Amersham 2.50 micrograms/l).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320262 TI - Renal and hepatic nitrogen metabolism in systemic acid base regulation. AB - Renal and hepatic nitrogen metabolism are linked by an interorgan glutamine flux, coupling both renal ammoniagenesis and hepatic urea production to systemic acid base regulation. Reconsideration of established pathways and recent observations led to a conceptional change with a movement from a two-organ concept (lungs and kidney) of acid-base balance to a three-or-more organ concept (lungs, kidney, liver). This development implies new regulatory sites of systemic pH control and consequently a new pathophysiological understanding of derangements of acid-base homeostasis. In this new concept the urea cycle regulates the removal of metabolically generated bicarbonate during a protein load in a pH- and bicarbonate-dependent manner. This is related to a switch of hepatic ammonium detoxication from urea to glutamine synthesis in metabolic acidosis, and vice versa in alkalosis. An adaptive increase in the renal capacity for glutamine deamidation and deamination and for ammonium excretion leads to a proportional decrease in renal urea excretion at the expense of ammonium in acidotic conditions. The present review summarizes experimental data and clinical implications resulting from this new concept, which was also the subject of a recent Conference of the German Society for Clinical Chemistry "Mechanisms and Control of pH Homeostasis". PMID- 3320263 TI - Diagnostic value of low-molecular mass proteins in serum for the detection of reduced glomerular filtration rate. AB - The diagnostic value of the low-molecular mass proteins ribonuclease, beta 2 microglobulin, and lysozyme in serum for the detection of reduced glomerular filtration rates was evaluated. The values of these proteins and of serum creatinine investigated in 52 patients suffering from chronic renal diseases were plotted against 99m-Tc-diethylenetriaminopentaacetate clearance as an indicator of glomerular filtration rate. Log-transformed data showed a good fit of linearity. Considering the 95% confidence limits of the regression equations, ribonuclease increased above the normal range when the glomerular filtration rate was lower than 1.24 ml/s whereas the other analytes partly remained within their normal limits. Out of those 18 patients with glomerular filtration rates lower than 1.24 ml/s, all patients showed elevated ribonuclease levels. beta 2 Microglobulin, creatinine, and lysozyme were increased in 17, 14, and 12 cases, respectively. Ribonuclease and beta 2-microglobulin showed similar results when other diagnostic criteria (specificity, efficiency and predictive values) were taken into account. We recommend ribonuclease determination in serum for the detection of reduced glomerular filtration rate in the normal range of creatinine. The test is diagnostically powerful, cheap and easy to perform. PMID- 3320264 TI - Carotid atherosclerosis and stroke: a historical note. PMID- 3320265 TI - Noninvasive testing for cerebrovascular disease. PMID- 3320266 TI - Radiologic diagnosis of cerebrovascular disease. PMID- 3320267 TI - Extracranial carotid atherosclerosis: a frequent problem for the primary care physician. PMID- 3320268 TI - Current status of carotid endarterectomy in prevention of stroke. PMID- 3320269 TI - Severe aplastic anemia treated by allogeneic bone marrow transplantation: report of a case. PMID- 3320270 TI - Computer-assisted analysis for prediction of fetal weight by ultrasound comparison of biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL). PMID- 3320271 TI - Postradiation chondroblastic sarcoma of bone: case report and review of the literature. PMID- 3320272 TI - A note on the composition and properties of ferritin iron cores. AB - In ferritins and bacterioferritins iron is stored as an inorganic complex within a protein shell. The composition and properties of this complex are surprisingly variable. Factors that may lead to such variability are discussed. PMID- 3320273 TI - Synthesis, spectroscopic, mutagenic, and cytotoxicity studies of some mixed ligand platinum(II) complexes of 2,2'-bipyridine and amino acids. AB - Seven platinum(II) complexes of the type [Pt(bipy)(AA)]n+ (where n = 1 or 0 and AA is anion of L-valine, L-isoleucine, L-aspartic acid (dianion), L-glutamic acid (dianion), L-glutamine, L-proline, or S-methyl-L-cysteine) have been prepared and characterized. The modes of binding of amino acids in these complexes have been ascertained particularly by infrared and 1H NMR spectral studies. The L-glutamine complex shows a ID50 value (50% inhibitory dose) in the range of greater than 20 micrograms/ml to 100 micrograms/ml of the complex. However, the complexes of L valine, L-isoleucine, L-aspartic acid, L-glutamic acid, L-proline, and S-methyl-L cysteine show ID50 values greater than 100 micrograms/ml of the complex. The above complexes also show inferior growth inhibition of P-388 cells than platinum(II) complexes of 2,2'-bipyridine with L-alanine, L-leucine, L methionine, and L-aspargine as reported earlier. The platinum(II) complexes of 2,2'-bipyridine with glycine (Gly), L-alanine (Ala), L-leucine (leu), L-valine (Val), L-methionine (Met), L-phenylalanine (Phe), L-serine (Ser), L-tyrosine (Tyr) and L-tryptophan (Trp) have been tested for mutagenesis using TA 100 and TA 98 strains. They show nonmutagenicity. This is in contrast to the cis [Pt(NH3)2Cl2] showing a base pair substitution mutagenesis. PMID- 3320274 TI - Hyperbaric oxygen and multiple sclerosis: final results of a placebo-controlled, double-blind trial. AB - The long term results are reported of a trial involving 120 patients with chronic multiple sclerosis who were randomised to receive either 100% oxygen at 2 atmospheres absolute (ATA) for 90 minutes daily for 20 sessions or placebo therapy with air using a simulated compression procedure. The previous finding of subjective improvement in bowel/bladder function at the end of treatment was not confirmed by objective urodynamic assessment. The treatment did not alter disease progression as measured by the Kurtzke disability status scale nor did it alter the rate of acute relapse. There was less deterioration in cerebellar function at one year in the treated patients as measured by the Kurtzke functional systems scale. No other differences were found between the two groups. Psychometric tests and measurements of lymphocyte sub-populations showed no treatment related effects. Evoked potential studies showed no improvements but there was a significant reduction in amplitude of the visual evoked potential in the treated patients at the end of therapy. This might indicate a reversible degree of retinal damage induced by oxygen toxicity. PMID- 3320275 TI - Cerebral blood velocity in subarachnoid haemorrhage: a transcranial Doppler study. AB - A study examining the utility of transcranial Doppler ultrasound for the determination of cerebral vasospasm following subarachnoid haemorrhage is reported. A control group of 21 patients and a second group of 20 patients suffering from subarachnoid haemorrhage or aneurysm and a group of 26 with other intracranial pathologies were studied. The Doppler flow velocity (DFV) was significantly higher when vasospasm was present. If it was higher than 100 cm/s, the patients were found to have vasospasm in 80% of cases. If Doppler flow velocity was below 100, less than 10% had spasm. Doppler flow velocity was not found to increase following craniotomy in patients not suffering from subarachnoid haemorrhage. In subarachnoid haemorrhage patients there was a trend to increased Doppler flow velocity especially in patients who developed neurological deficit. Doppler flow velocity and Initial Slope Index by xenon clearance (ISI) were not found to correlate with clinical grade. The ISI/DFV quotient (which can be shown mathematically to be related to vessel diameter) was found to correlate well with clinical grade. In this largely post-operative group, absolute levels, or rate of change of Doppler flow velocity could not be shown to be related to the onset or existence of neurological deficit. PMID- 3320277 TI - Immunohistochemical evidence for the distribution of nerve growth factor in the embryonic mouse. AB - The distribution of nerve growth factor-like immunoreactivity has been examined in the embryonic mouse with special reference to the CNS. The intensity of the immunoreactive stain was found to be greatest on embryonic days 15 and 16. The antigen is widespread and present in high concentrations in both the PNS and CNS. Most intense staining was detected in cranial nerve tracts, hippocampus, developing white matter of the spinal cord and tegmentum. Lower intensities were found within diencephalic regions, spinal cord grey matter, medullary fibre tracts and cerebellum. These results support the increasing evidence suggesting that the trophic molecule nerve growth factor has an important role to play in the development of central as well as peripheral neurons. PMID- 3320276 TI - Transcranial pulsed Doppler ultrasound findings in brain stem death. AB - Data are presented from transcranial insonation of the middle cerebral artery (MCA) performed at intervals in 23 unconscious children for whom the outcome was subsequently poor. Once an MCA signal had been observed over a 30 minute period with time averaged velocity less than 10 cm s-1 and/or a direction of flow index, DFI, defined as 1 minus the ratio of reverse to forward flow of less than 0.8, recovery to forward flow throughout diastole was never observed and no patient recovered brain stem reflexes. Recovery of forward flow in diastole, and of brain stem function, was seen in cases with time averaged MCA velocity in the range 10 to 25 cm s-1 and with reverse flow but a DFI of greater than 0.8 for short periods of time. All but one of the 13 children fulfilling clinical criteria for brain stem death had MCA signals with time averaged velocity of less than 10 cm/s and DFI of less than 0.8. This type of signal was not observed in five children who were left in a persistent vegetative state. PMID- 3320278 TI - Myelinated, but not unmyelinated axons, reversibly down-regulate N-CAM in Schwann cells. AB - There is evidence from chicks and mice that N-CAM expression in Schwann cells is subject to significant regulation during development and following injury. In the present work, rat sciatic nerve and immunohistochemical methods have been used to study developmental and injury-related modulation of N-CAM in Schwann cells, using cell type specific markers to identify different Schwann cell populations, and cell counting to quantify their size. The study has sought to determine unambiguously whether immature Schwann cells in developing nerves and denervated Schwann cells in injured adult nerves express surface N-CAM, and has investigated the temporal relationship between the gradual loss of surface N-CAM and the differentiation of myelin-forming Schwann cells, monitored by the sequential appearance of the glycolipid galactocerebroside and the myelin-specific protein P0. Further points examined are whether this down-regulation of N-CAM is rapidly reversible following loss of axonal contact, and whether N-CAM reappearance in Schwann cells depends on protein synthesis. In nerves from 17- to 18-day embryos, 90% of the Schwann cells, identified with Ran-1 antibodies, expressed surface N CAM. In nerves from newborn rats many cells are in the early stage of myelin synthesis and therefore express galactocerebroside, although they have not yet acquired P0. Suspension staining of dissociated cells from this nerve showed that 92% of the galactocerebroside-positive cells were also N-CAM positive. In suspension staining of nerves from 5-day, 10-day and adult rats, P0-positive cells were essentially N-CAM negative.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320279 TI - Laminin in traumatized peripheral nerve: basement membrane changes during degeneration and regeneration. AB - The changes in Schwann cell basement membrane associated with degeneration and regeneration during 50 weeks after transection of rat sciatic nerve were studied immunohistochemically with antibodies to laminin. In half of the animals, regeneration was prevented by suturing the nerve stumps aside, whereas in the rest spontaneous regeneration was allowed. Axonal regeneration was monitored with anti-neurofilament protein antibodies. In control nerves, basement membranes surrounding Schwann cells were visualized as circular, laminin-positive structures within the endoneurium. By 8 weeks after transection, Schwann cells had formed columns which were laminin-positive throughout their cross-sectional area and indistinguishable from basement membrane zones in both non-regenerating and regenerating nerves. As axons repopulated the distal stump, the normal shape of Schwann cell basement membrane tubes was slowly restored in freely regenerating nerves. In non-regenerating nerves, however, a striking atrophy of Schwann cell columns was observed. Regenerating axons were only seen inside laminin-positive tubular structures in all phases after 8 weeks in regenerating nerves. On the other hand, restoration of normal shape in laminin-positive basement membrane zones was coincident with appearance of axons in the distal stump, but it did not take place in chronically degenerating nerves. The results show that chronic degeneration leads to an atrophy of Schwann cell columns and results in a decrease in laminin immunoreactivity associated with them. PMID- 3320280 TI - Menarche and menstruation: a review of the literature. PMID- 3320281 TI - In-service training of home health aides for arthritis care. PMID- 3320282 TI - Retinal W-cell input to the upper superficial gray layer of the cat's superior colliculus: a conduction-velocity analysis. AB - 1. I have used several methods to estimate the conduction velocities of retinal afferents innervating the upper 50-100 micron of the stratum griseum superficiale (the upper SGS). The measurements were based on a unitary extracellular potential unique to this sublamina, which was first described by McIlwain (28). He termed it the juxtazonal potential (JZP), and showed that it results when a single spike invades the terminal arbor of a single retinal afferent to the upper SGS, triggering synchronous excitatory postsynaptic potentials in postsynaptic collicular cells. 2. Individual unitary JZPs were evoked at fixed latencies by weak shocks to the optic disk, chiasm, or tract. When the same JZP could be evoked in isolation from two stimulus sites, the conduction velocity of the axon triggering the JZP was estimated by dividing the conduction time between the stimulating electrodes (i.e., the "latency difference") into the distance separating these electrodes. This "latency-difference method" lacked general utility, however, since the same JZP could only rarely be evoked in isolation from two stimulus sites. 3. This limitation was circumvented by means of a collision method. When a stimulus that evoked a JZP in isolation was preceded by a sufficiently intense conditioning shock to a second, more central stimulus site, the conditioning stimulus caused the JZP to fail in an all-or-none fashion. It was assumed that when the JZP failed, the conditioning stimulus had exceeded the spike threshold of the axon mediating the JZP and that an antidromic action potential had collided with the orthodromic spike initiated at the peripheral stimulus site. Assessment of the critical interstimulus interval for producing such a collision, together with measurements of the axon's refractory period and the interelectrode conduction distance, permitted an estimate of the conduction velocity of the JZP-triggering axon. Conduction-velocity estimates generated in this way closely matched those based on the latency-difference technique when both methods could be applied. 4. Conduction velocities of 31 JZP-triggering axons analyzed by the collision method ranged from 2.9 to 6.8 m/s [4.6 +/- 1.0 (mean +/- SD)]. Comparable estimates were obtained for such axons by alternative methods based on the absolute latencies of electrically evoked JZPs or of the field potential to which they contribute. The conduction velocities of JZP triggering axons fell within the range reported for retinal W-cells and entirely outside those of X- and Y-cells, confirming earlier evidence for W-cell input to the upper SGS (7, 15, 18, 28).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3320283 TI - Neural-specific carbohydrate moiety shared by many surface glycoproteins in Drosophila and grasshopper embryos. AB - Antiserum against horseradish peroxidase (anti-HRP Ab) labels the surfaces of neurons in both Drosophila and grasshopper (Jan and Jan, 1982). Here we show that the anti-HRP Ab (1) immunoprecipitates at least 17 different membrane glycoproteins from the Drosophila embryo CNS (and a similar array from grasshopper), and (2) recognizes a neural-specific carbohydrate moiety expressed by most if not all of these proteins. Although the anti-HRP Ab stains all axon pathways, 2 of the anti-HRP glycoproteins, fasciclin I and II, are expressed on specific subsets of axon pathways in the grasshopper embryo. PMID- 3320284 TI - The effects of excitatory amino acids on intracellular calcium in single mouse striatal neurons in vitro. AB - Using microspectrofluorimetry and the calcium-sensitive dye fura-2, we examined the effect of excitatory amino acids on [Ca2+]i in single striatal neurons in vitro. N-methyl-D-aspartic acid (NMDA) produced rapid increases in [Ca2+]i. These were blocked by DL-2-amino-5-phosphonovaleric acid (AP5), by Mg2+, by phencyclidine, and by MK801. The block produced by Mg2+ and MK801 could be relieved by depolarizing cells with veratridine. When external Ca2+ was removed, NMDA no longer increased [Ca2+]i. Furthermore, the effects of NMDA were not blocked by concentrations of La3+ that blocked depolarization induced rises in [Ca2+]i. Substitution of Na+o by Li+ did not block the effects of NMDA. Concentrations of L-glutamate greater than or equal to 10(-6) M also increased [Ca2+]i. The effects of moderate concentrations of glutamate were blocked by AP5 but not by La3+ or by substitution of Na+ by Li+. The effects of glutamate were blocked by removal of external Ca2+ but were not blocked by concentrations of Mg2+ or MK801 that completely blocked the effects of NMDA. The glutamate analogs kainic acid (KA) and quisqualic acid also increased [Ca2+]i. The effects of KA were blocked by removal of external Ca2+ but not by La3+, Mg2+, MK801, or replacement of Na+ by Li+. Although AP5 was able to block the effects of KA partially, very high concentrations were required. These results may be explained by considering the properties of glutamate-receptor-linked ionophores. Excitatory amino acid induced increases in [Ca2+]i are consistent with the possibility that Ca2+ mediates excitatory amino acid induced neuronal degeneration. PMID- 3320285 TI - Importance and significance of liver echotomography in Wilson's disease during childhood. PMID- 3320286 TI - Vascular disorders in cerebral reversible ischaemic attacks: a diagnostic study with Doppler flow imaging and spectral analysis. PMID- 3320287 TI - The two faces of selenium. AB - The nutritionally important trace elements share a high biological activity, implemented through association with enzymes, hormones or vitamins. The same activity responsible for physiological responses at extremely low dietary levels implies the potential for metabolic upset when the elements are ingested at elevated, although still relatively low levels. Selenium provides a classic example of this dichotomy of effects and has generated concerns at both ends of its supply spectrum. Experiences in the Dakotas, mid-19th century, led to identification of toxicity symptoms for which selenium was later shown to be responsible, while separate studies showed that excess selenium was teratogenic in the developing avian fetus. These toxic reactions suggested that selenium might be useful in restricting abnormal cell growth, and recent studies have proved it to be anticarcinogenic in certain specific circumstances. Investigation of selenium's nutrient function has been equally interesting, and when Schwarz showed it to be an essential nutrient in 1957, he began an era of intense research activity. Dietary levels of selenium below 0.02 ppm were found to cause deficiency symptoms affecting muscles, liver and pancreas and glutathione peroxidase was shown to be an active form through which selenium acted to prevent such aberrations. Research continues to seek other active organic combinations for selenium to identify interfering compounds that restrict its bioactivity and to explore biochemical mechanisms involved in its toxicity. PMID- 3320288 TI - Energetics of protein synthesis in mice with a major gene for growth. AB - The effect of the level of food intake on protein synthesis rate in carcass, liver, gastrointestinal tract (GIT) and heart, kidneys and lungs (HKL) was determined in male mice with a major gene for rapid postweaning gain (line Ch) and normal controls (line CH) at 31 d of age. In both lines of mice, food restriction lowered carcass, HKL and liver absolute protein synthesis rates (ASRs) while GIT protein ASR was not affected by food intake. As a result, whole body protein ASR increased with increasing food intake. It was estimated that heat production from protein synthesis (HrpsE) was responsible for 8.3 and 10.8% of the maintenance energy requirement of CH and Ch mice, respectively. It was also calculated that HrpsE represents 19.4 and 18.3% of the heat increment of growth of CH and Ch mice, respectively. Energetic efficiencies of protein deposition in CH and Ch mice were 58.6 and 66.7%, respectively. PMID- 3320289 TI - Effect of dietary zinc deficiency on the endogenous phosphorylation and dephosphorylation of rat erythrocyte membrane. AB - The effect of dietary zinc deficiency on patterns of phosphorylation and dephosphorylation of rat erythrocyte membrane proteins and erythrocyte filterability was examined. Weanling male Wistar rats were fed an egg white-based diet containing less than 1.1 mg zinc/kg diet ad libitum for 3 wk. Control rats were either pair-fed or ad libitum-fed the basal diet supplemented with 100 mg zinc/kg diet. Net phosphorylation and dephosphorylation of erythrocyte membrane proteins were carried out by an in vitro assay utilizing [gamma-32P]ATP. The membrane proteins were subsequently separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis, and the 32P content of gel slices was counted by Cerenkov counting. Erythrocyte filterability was measured as the filtration time of suspensions of erythrocytes, both untreated and preincubated with diamide, under constant pressure. Erythrocyte ghosts from zinc-deficient rats demonstrated greater dephosphorylation of protein bands R1 plus R2 and R7 than pair-fed rats and greater net phosphorylation of band R2.2 than pair-fed or ad libitum-fed control rats (P less than 0.05). Erythrocytes from ad libitum-fed control rats showed significantly longer filtration times than those from zinc deficient or pair-fed control rats. In conclusion, dietary zinc deficiency alters in vitro patterns of erythrocyte membrane protein phosphorylation and dephosphorylation, whereas the depression in food intake associated with the zinc deficiency increases erythrocyte filterability. PMID- 3320291 TI - Reminiscences of meeting for lunch in the Pathology Laboratory. PMID- 3320290 TI - Effect of high fat diets on energy balance and thermogenesis in brown adipose tissue of lean and genetically obese ob/ob mice. AB - The effects on energy balance and brown adipose tissue thermogenesis of feeding high fat diets of differing fatty acid composition have been investigated in lean and genetically obese (ob/ob) mice. Groups of mice were fed either a low fat diet or a high fat diet based on corn oil or beef tallow for 2 wk. Energy intake and body weight gain were higher in both lean and obese animals fed the high fat diets than in respective mice fed the low fat diets. Carcass energy gain was greater for the obese than for the lean consuming each of the diets. Both lean and obese mice had a higher energy gain when fed the beef tallow diet than when fed the corn oil, despite isoenergetic intakes of the two diets. The thermogenic activity of brown adipose tissue, assessed from measurements of cytochrome oxidase activity and mitochondrial guanosine 5'-diphosphate (GDP) binding, were greater in both lean and obese mice fed the corn oil diet than in those fed the low fat diet. However, GDP binding and cytochrome oxidase activities in lean or obese mice fed the beef tallow diet were not different from those of mice of the same genotype fed the low fat diet. These results indicate that in both lean and obese (ob/ob) mice energy deposition and the stimulation of brown adipose tissue thermogenesis during the voluntary hyperphagia induced by feeding high fat diets are influenced by the fatty acid composition of the diet. A diet rich in polyunsaturated fatty acids appears to result in preferential stimulation of the thermogenic activity of brown adipose tissue, particularly in the ob/ob mouse. PMID- 3320292 TI - Neoplasms with neuroendocrine differentiation: implications of molecular pathology. AB - Anatomically widespread groups of extra-neural cells produce a spectrum of hormonal oligopeptides and monoamines comparable to those found in the central nervous system. Such cells express the capacity to cleave bioactive oligopeptides from polyprotein precursors, and the designation "neuroendocrine cells" has been widely adopted. Extra-neural cellular proliferations which exhibit the phenotypic manifestations of a neuroendocrine terminal differentiation also occur in a broad topographic distribution. Traditional tumor classifications reflected the wholistic concept of a "diffuse neuroendocrine system" in pathology. Newer results, however, including monoclonal antibody and in situ nucleic acid hybridization studies demonstrate that a variety of otherwise unrelated neoplasms can express the capacity to synthesize "ectopic" monoamines or hormonal oligopeptides. The molecular biological mechanisms which stimulate such cellular proliferations and regulate neuroendocrine expressions must be more diverse and complex than previously supposed. Critical alterations may involve multiple somatic mutations, abnormal gene transpositions or microenvironmental factors which could condition polyprotein gene transcription or post-transcriptional regulation. Accordingly, convergent patterns of neuroendocrine terminal differentiation in proliferative lesions and familial tumor complexes need not be pathogenetically homogenous. Molecular pathologic techniques now offer the potential to individualize diagnostic categories, and ultimately will facilitate more accurate clinical assessments of genetic risks, biologic progression, and therapeutic trials. PMID- 3320293 TI - Tribute to Dr. Harold Leroy Stewart. Emeritus Chief, Laboratory of Pathology, National Cancer Institute. PMID- 3320294 TI - Tribute to Dr. Harold Leroy Stewart. Emeritus Chief, Laboratory of Pathology, National Cancer Institute. PMID- 3320295 TI - Tribute to Harold Leroy Stewart scientist emeritus, Registry of the Experimental Cancers, National Cancer Institute. PMID- 3320296 TI - The Perugia Division of Cancer Research and Harold Leroy Stewart. AB - The background to these memories is the correspondence between Harold Leroy Stewart (HLS) and Lucio Severi (LS) covering the years from 1955 to 1986 and consisting of 297 letters, 167 of which came from HLS. The subject of and reason for most of these letters follow a theme which needs a little explanation even though the author converses clearly and precisely in his missives. The Perugia Division of Cancer Research (DCR) owes much to HLS because he was always ready with advice and help of every nature and because the Perugia Quadrennial International Conferences on Cancer (PQICC) had their beginning through his will and always enjoyed his authoritative approval and aid. He took part personally in the III, IV and V Conferences. On the occasion of the Centenary Celebrations of the Chair of Morbid Anatomy at Perugia University HLS saw to it that "Selected Reprints of the Laboratory of Pathology, National Cancer Institute" which were "Presented to honor the Department of Pathology, University of Perugia, 1961" arrived in Monteluce from Bethesda for the memorable occasion. He paid visits to the DCR in 1956, 1965, 1968, 1969, 1973 and 1974. On June 27, 1965 the University of Perugia bestowed on the outstanding man, HLS, an honoris causa Degree in Medicine and Surgery for his splendid scientific achievement and for his extraordinary humanity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320298 TI - Health care for the poor in divisions of general medicine. PMID- 3320297 TI - Alcoholism: early diagnosis and intervention. AB - Alcoholism, more than any other illness, requires the integration of social and family history, physical symptoms and signs, and laboratory data in order to make a firm diagnosis. Common in alcoholism is the patient's minimization or denial of the disease and its symptoms, thwarting efforts at early diagnosis and intervention. If early diagnosis is to be made, several points should be remembered: 1. Life problems associated with alcohol use are the earliest signs of the disease. 2. There are few reliable early physical symptoms and signs. 3. Laboratory markers of alcoholism are neither sensitive nor specific when used alone as screening tools. 4. Alcoholism questionnaires, e.g., the MAST or the CAGE, should be a part of routine office practice in screening for alcoholism. Effective therapy is available, but early diagnosis is necessary for the best outcome. Gallant has reminded us of the "tragedy of delayed treatment." Early recognition of alcoholism puts the internist, as well as other primary care providers, in the best position to begin the process of healing the patients and their families. PMID- 3320300 TI - Rituals in infection control: what works in the newborn nursery? AB - Two infection control practices common in the newborn nursery, handwashing and gowning, are compared with regards to historic origins, effectiveness, and extent of practice. The practice of handwashing is the direct result of efforts to prevent puerperal sepsis and has been shown to be effective in reducing neonatal risk of infection. Gowning has evolved from operating room practices and has been shown to be generally ineffective in reducing risk of infant infection. Nevertheless, gowning is practiced extensively and handwashing is often omitted. Such rituals need occasional reexamination so that those practices associated with maximum effectiveness receive appropriate attention. PMID- 3320299 TI - Trends in neonatal infections. AB - The changing epidemiology of neonatal infections manifested in the first few weeks of life is described. The six infections discussed are herpes, hepatitis B, chlamydial infection, infection due to the group B streptococcus, gonococcal disease, and acquired immunodeficiency syndrome. Nursing actions to prevent the spread of these diseases are described, with particular emphasis on the importance of body substance precautions for all neonates. PMID- 3320301 TI - Twenty years of heart transplantation at Groote Schuur Hospital. AB - Between December 1967 and July 1987, 110 heart transplantations (61 heterotopic and 49 orthotopic) and 12 heart-lung transplantations were done at Groote Schuur Hospital in Cape Town, South Africa. Twelve procedures were retransplantations, including two third interventions. The patients were divided into three groups: Group A (n = 55) from 1967 to 1982 received so-called conventional treatment of azathioprine, methylprednisolone, and antithymocyte globulin. Group B (n = 15) from 1983 to 1984 had cyclosporine in high dosages together with methylprednisolone. Group C (n = 30) received quadruple drug therapy of low dosage cyclosporine, together with azathioprine, methylprednisolone in lower dosages, and antithymocyte globulin (for the first 4 to 6 days and rescue antithymocyte globulin for severe rejection). From Group A, nine of 55 patients are alive up to 17 years after transplantation. The main causes of death were acute rejections and infections (in 60% altogether). From group B, six of 15 patients are alive. Acute rejections and infections were the causes of death in 12% of the patients, but multiple organ failure was a major cause in 24% most probably because of the high dosages of cyclosporine. From group C, 23 of 30 patients have survived. In this group the results after heterotopic heart transplantation do not differ significantly from orthotopic transplantation, which justifies this procedure in particular situations. If all heterotopic and orthotopic transplantations are compared, orthotopic procedures have a substantially better outcome. With the modified immunosuppressive regimen (group C) combined with precise donor and recipient selection and more sophisticated rejection monitoring, the actuarial survival rate within the last 12 months is 94%. PMID- 3320303 TI - Pediatric heart transplantation: quality of life. AB - Staff members at the University of Pittsburgh have performed pediatric heart transplantations since 1982. As heart transplantation becomes an accepted therapeutic treatment, more children undergo surgery and return home. Assessment of the quality of life after transplantation of these children is essential. This article describes the life-styles of seven surviving transplant patients. The children lived for periods ranging from 3 months to 3 years. Patients were evaluated psychosocially by the Personality Inventory for Children, Offer Self Image Questionnaire, Eyberg Child Behavior Inventory, and projective drawings. Daily routines and school achievement were assessed by interviews with the parents. Cardiovascular function was measured by exercise testing. When possible, comparisons were made with the patient's preoperative status. Heart transplantation assaults the body, both physically and emotionally. This study concludes that the surviving children can adapt to the experience. Heart transplantation enables them to return to a level of functioning that is appropriate for age. However, speculation is made whether the benefits gained for a child who undergoes transplantation can be sustained long enough to warrant such extensive treatment. PMID- 3320302 TI - The use of OKT3 for stubborn heart allograft rejection: an advance in clinical immunotherapy? AB - The suppression of heart allograft rejection in heart transplantation commonly employs cyclosporine, steroids, and azathioprine, or some combination thereof as baseline therapies. When severe or stubborn rejection is unaltered by these drugs, adjunctive immunotherapy is required. This article details our experience in treating difficult allograft rejections with a purified murine monoclonal antibody directed against the murine antihuman mature T cell (OKT3) lymphocyte. The inclusion criteria for use of OKT3 included severe histologically confirmed rejection (7 on a 0 to 10 scale), rejection refractory to other immunosuppressive agents (methylprednisolone, antithymocyte globulin), or contraindications toward the use of other immunosuppressive agents. From July 1985 through September 1986, 11 patients with severe rejection that was documented by histologic, biochemical, and clinical criteria were treated with intravenous OKT3. Of these patients, 10 had received orthotopic heart transplantations and one had undergone heterotopic transplantation. The mean duration of therapy was 14.4 days, with a single, average dose of 5 mg/day. Intended duration of therapy was 14 days per our protocol. Occasionally this was extended because of evidence of ongoing rejection or because of the potential toxicity of other immunosuppressive agents (i.e., cyclosporine nephrotoxicity in a patient with kidney failure). One patient demonstrated an equivocal response to the drug but experienced no side effects. In the remaining 10 patients a full course of treatment with OKT3 dramatically reversed the rejection and resulted in improved graft performance. On a standardized scale for histologic grading of rejection the average score decreased from 8.4 to 4.1 and stayed in the "mild" rejection range (0 to 4) thereafter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320304 TI - Pediatric heart transplantation at St. Christopher's Hospital for Children. AB - Heart transplantation has become the standard of care for patients with end-stage heart failure. The efficacy and therapeutic advantages of transplantation in the pediatric population have not been fully determined. Between March 1985 and September 1986, nine pediatric heart transplantations were performed; the ages ranged from 39 days to 19 years; weight ranged from 2.3 to 100 kg. The underlying disease was acquired cardiomyopathy (four patients); cardiomyopathy caused by congenital mitral valve disease (two patients); unresectable fibroma of the left ventricle in a newborn (one patient); hypoplastic left heart syndrome (one patient); and hypertrophic obstructive cardiomyopathy (one patient). Initial immunosuppression therapy consisted of cyclosporine, prednisone, and antithymocyte globulin. Recently, newer protocols have evolved through experience. Seven patients survived the perioperative period and had follow-up from 1 to 19 months, for a total of 41 transplant months. Rejection occurred at a rate of 1.4 episodes per month in children compared with 0.8 episodes per month in our adult patients. There was no statistical difference in the number, severity, or timing of rejection episodes in the pediatric versus adult population. Major complications included cyclosporine-induced seizures in two patients, mild hypertension in two, five infectious episodes (three bacterial and two viral), and three late deaths. All children who survived are in New York Heart Association functional class I with no developmental delays. This series is heavily weighted with children (33% less than age 1 year). Early results demonstrate that pediatric and infant heart transplantation is technically practical. Improved results are to be expected with additional experience and further modification of adult protocols to assure patient growth and minimize the high infection rate. PMID- 3320305 TI - Prostaglandin E1: an effective treatment of right heart failure after orthotopic heart transplantation. AB - Three patients are presented who had life-threatening postoperative pulmonary hypertension after orthotopic heart transplantation. This pulmonary hypertension was unresponsive to standard therapy but responded dramatically to treatment with prostaglandin E1. The problem of evaluating and treating heart transplant patients with pulmonary hypertension and the role of prostaglandins are discussed. PMID- 3320306 TI - Polypeptide composition and histopathologic changes in endomyocardial biopsies from transplanted human hearts. AB - Sequential postoperative samples of 43 human right ventricular endomyocardial biopsies from four heart transplant patients were evaluated histopathologically to assess microscopic parameters of rejection. Selected pieces of these myocardial biopsies were weighed and homogenized in low ionic strength buffer containing Triton X-100 to extract and to quantitate cardiac actin. Aliquots of the soluble fractions were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Residual pellets were solubilized and also underwent SDS-PAGE. Electrophoretograms were analyzed densitometrically. Actin from biopsies from transplanted human hearts accounted for approximately 40% of Triton X-100 soluble polypeptides. Actin and myosin heavy chain content in the pellet fractions was unchanged as a function of allograft duration. A polypeptide band resolved between 14,000 and 21,000 daltons in the Triton-soluble fraction of four fresh samples correlated with histopathologic changes of moderate acute allograft rejection. A similar band was noted in 11 frozen endomyocardial biopsy specimens without changes of acute rejection. Small actin differences may be found in the transplanted heart, but they do not correlate with rejection. The presence on SDS PAGE of the polypeptide band found between 14,000 and 21,000 daltons may correlate with proteolysis of cytoplasmic proteins either from rejection or possibly from autolysis after freezing. PMID- 3320308 TI - Pulmonary "cyclosporinoma" mimicking infection after heart transplantation. AB - Tissue from a transthoracic needle biopsy, which was performed as part of the investigation of an undiagnosed left upper lobe opacity in a patient after orthotopic heart transplantation, revealed numerous macrophages loaded with oil globules. No causative organisms were present. High-pressure liquid chromatography showed a similar profile to the oil in which cyclosporine is suspended. The lesion appears to have been caused by aspiration of cyclosporine. PMID- 3320309 TI - Whichorexia: a disorder of inaccurate name, uncertain heterogeneity, questionable etiology, variable course, and uncertain outcome. PMID- 3320307 TI - Immunosuppressive efficacy of vincristine in heart transplantation: a preliminary report. AB - Because vincristine has immunosuppressive activity in animal models, has specific cytotoxic effects on lymphocytes, and does not have overlapping toxicity with other immunosuppressive agents, we designed a prospective randomized trial to evaluate the efficacy of the addition of vincristine to standard immunosuppressive therapy in heart transplantation. Patients received equine antithymocyte globulin for the first week or murine antihuman mature T cell (OKT3) monoclonal antibody for the first 2 weeks after transplantation and were maintained on azathioprine and cyclosporine. A steroid pulse was administered 1 day after completion of antithymocyte globulin or OKT3 monoclonal antibody and tapered off over 21 days. Vincristine was given at 0.025 mg/kg intravenously for eight dosages over 12 weeks, beginning 2 days after completion of antithymocyte globulin or OKT3 monoclonal antibody. Fifty-two patients were randomized (26 were given vincristine, and 26 were not). The addition of vincristine to the regimen of patients receiving antithymocyte globulin resulted in significantly fewer episodes of rejection at 1 month (vincristine, 0.2 +/- 0.1; no vincristine, 1.2 +/- 0.2; p less than 0.001), at 3 months (vincristine, 1.2 +/- 0.1; no vincristine, 2.5 +/- 0.3; p less than 0.001), and at 6 months (vincristine, 1.9 +/- 0.2; no vincristine, 2.9 +/- 0.3; p less than 0.001). It also resulted in significantly more patients being successfully weaned off daily steroids (vincristine, 67%; no vincristine, 20%; p = 0.04). The addition of vincristine to the regimen of patients receiving early rejection prophylaxis with OKT3 monoclonal antibody did not alter rejection incidence or steroid usage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320310 TI - Leaders in medicine. Leo Lowbeer, MD. PMID- 3320311 TI - Lessons in deception. PMID- 3320312 TI - Surgical correction of mandibulofacial deformities secondary to large cervical cystic hygromas. AB - The clinical features of cystic hygroma are presented. The effect on mandibular morphology is described, and surgical correction of the deformities is discussed. PMID- 3320313 TI - Effects of preservation on the osteoinductive capacity of demineralized bone powder allografts. AB - Demineralized bone powder (DBP) has repeatedly been shown to serve as an osteoinductive material. The aim of this study was to investigate the effects of different methods of storage of DBP on its osteoinductive property. Forty-five Long Evan rats were used in this study. Twenty rats were used as donors; the diaphyses of their femoral bones were used for the preparation of DBP. The DBP was divided into four portions that were either lyophilized or frozen at -70 degrees C, -4 degrees C, or kept at room temperature (25 degrees C). All samples were stored under the specified condition for six months. At the time of implantation, fresh DBP was prepared and used as a control. Twenty-five rats were divided equally into five groups. Each group received an implant of either one of the differently preserved and stored samples of DBP or fresh DBP. The animals were killed 60 days following implantation. The implants were excised and processed to obtain 5 micron thick decalcified sections and 3 micron thick undecalcified sections. Semicomputerized histomorphometry was used for the quantification of the newly-formed bone in each implant. Newly-formed bone was detected in all experimental and control groups and there were no statistically significant differences between the various groups. It was concluded that DBP retains its osteoinductivity after lyophilization or preservation at -70 degrees C, -4 degrees C, and 25 degrees C for a period of up to six months, and that the different methods of preservation did not significantly affect the amount of the induced newly-formed bone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320314 TI - Primary malignant melanoma of the oral mucosa: report of a case. PMID- 3320315 TI - Long-term results of mandibular ridge augmentation by visor osteotomy with bone graft. AB - Visor osteotomies of various designs, supplemented with illiac bone grafts, were used to augment 63 cases of severely atrophic mandibles. The rate of resorption measured on lateral cephalograms was 28% after four years, with the best performance by the full visor with peripheral bone graft (PA), and the worst by the short visor with onlayed bone graft posteriorly (PO). Ridge forms were usually inverted V-shaped or inverted U-shaped, but occasionally comma-shaped, the best form for providing retentive qualities for the denture. Only 39% were free of neurosensory problems. It was concluded that indications for such a procedure should be viewed in the light of frequent nerve injuries, adverses patterns of resorption for denture retention and newer and more effective methods for ridge augmentation using hydroxylapatite. PMID- 3320316 TI - A pioneer of biological psychiatry. The centenary of the birth of Rolv Gjessing. PMID- 3320317 TI - Head injuries admitted to hospital. Epidemiology, risk factors and long term outcome. PMID- 3320318 TI - Container/closure integrity of parenteral vials. PMID- 3320319 TI - A discussion of the effect of chamber pressure on heat and mass transfer in freeze-drying. PMID- 3320321 TI - Gastroesophageal scintigraphy: a useful screening test for GE reflux. AB - Ninety children with signs and symptoms of gastroesophageal (GE) reflux were studied. All of them had GE scintigraphy, barium, and endoscopy, and 50, in addition, ultrasound examination. The sensitivity of the GE scintigraphy, in comparison with the other methods, was 92.5%. It is a useful screening test for GE reflux. PMID- 3320320 TI - Hormones in milk. PMID- 3320322 TI - Cholelithiasis in an infant with polycythemia. AB - An 11-week-old infant with polycythemia presented with cholestasis secondary to cholelithiasis. It is likely that hemolysis secondary to polycythemia predisposed our patient to cholelithiasis. We suggest that polycythemia may be a new cause of cholelithiasis in infancy. PMID- 3320323 TI - Intussusception: evolution of current management. AB - The records of 583 children who were treated for intussusception at the Children's Hospital of Buffalo in the period 1930-1985 were reviewed. Following a change in management in 1970 from operative treatment to hydrostatic reduction of the intussusception by barium enema, two main groups are defined. In earlier years 95% of patients underwent operative reduction whereas in the latter period 92% had barium reduction attempted. The remaining 8% in this group had clinical contraindications for hydrostatic enema attempt. Ten percent had pathological lead points. Recurrent intussusception occurred in 50 cases (8.5%), 66% following barium enema reduction and 33% after surgery. The mortality in the earlier group was 3.9% and 1.3% in the latter group. No deaths occurred in patients treated successfully with barium enema reduction, and there were no deaths in the children with simple uncomplicated intussusception requiring surgery. PMID- 3320324 TI - Duodenal bile acids among children: keto derivatives and aerobic small bowel bacterial overgrowth. AB - Duodenal bile acids, identified by gas-liquid chromatography (GLC) and gas chromatography-mass spectrometry (GC-MS), were correlated with quantitative aerobic and anaerobic duodenal culture in 26 children with enteropathies. Four patients whose duodenal fluid contained either greater than or equal to 10(6) gram-negative aerobes or greater than or equal to 10(6) aerobic lactobacilli per milliliter had a significantly greater molar percentage of keto-bile acids (32.3 +/- 8.4%) than did 19 controls (0.72 +/- 1.50%) chosen because duodenal fluid contained less than or equal to 10(4) bacteria per milliliter or three other patients with greater than or equal to 10(6) anaerobes (6.1 +/- 4.6%). As expected, free bile acids were seen in greater quantities (10.75 +/- 3.25%) among the patients with anaerobic overgrowth or aerobic Lactobacillus overgrowth than among the controls (1.6 +/- 1.0%) or the other three aerobic overgrowth patients (2.2 +/- 1.4%). Incubation of glycocholate or glycochenodeoxycholate for 60 h with Eubacterium tortuosum from one patient or Escherichia coli from another produced the types of bile acids found in the duodenum of those patients. Successful antibacterial therapy improved gastrointestinal function and normalized duodenal bile acids not only among patients with anaerobic overgrowth but also among those with pure aerobic overgrowth. These data suggest that pure aerobic bacterial overgrowth syndrome occurs in children, and that altered duodenal bile acid composition may play a pathophysiologic role in this disorder. PMID- 3320326 TI - Congenital absence of the superior rectus muscle: a case report. AB - We report a case of bilaterally absent superior rectus muscles presenting clinically as a double elevator palsy. This patient is unique due to paradoxical ocular movements on attempted upgaze and the absence of other major craniofacial anomalies. Successful surgical correction was accomplished using a modified Jensen procedure where the superior halves of the horizontal rectus muscles were united using synthetic absorbable sutures. Congenital absence of the superior rectus muscles should be suspected in patients with severe elevation deficiency associated with paradoxical ocular movements. PMID- 3320325 TI - Carboxyhemoglobin concentration as an index of bilirubin production in neonates with birth weights less than 1,500 grams: a randomized double-blind comparison of supplemental oral vitamin E and placebo. AB - A randomized double-blind study of the efficacy of oral vitamin E supplementation as a prophylactic treatment for hyperbilirubinemia was undertaken in preterm infants weighing less than 1,500 g. Hemoglobin (Hb) levels, blood carboxyhemoglobin saturation (HbCOc), end-tidal carbon monoxide concentration (ETCO), and serum total bilirubin levels were determined in each subject on the first and third days of the study. We found no differences between the vitamin E treated and placebo-treated groups with respect to Hb, HbCOc, ETCO, or serum bilirubin levels on day 1 or 3. In addition, we reanalyzed our data to compare those infants who had low vitamin E levels at birth with those who had vitamin E levels greater than 0.4 mg/dl on day 1. We still observed no differences in Hb, HbCOc, ETCO, or serum bilirubin levels on day 1 or 3. The results of our study suggest that supplemental oral vitamin E therapy has no major effect on bilirubin production during the first 3 days of life in premature infants weighing less than 1,500 g at birth. PMID- 3320327 TI - Post-radiation retinal infiltrates simulating recurrent retinoblastoma: a clinical and pathologic case report. AB - An 8-month-old boy was found to have a sporadic unilateral stage IIa retinoblastoma, extending inferiorly and temporally from the right fovea. Within 5 weeks of diagnosis the tumor was treated with 4500 rads fractionated over 20 treatments. Examination under anesthesia (EUA) 1 month later revealed unequivocal clinical and echographic evidence of tumor regression. EUA 3 months after completion of radiation therapy revealed continued tumor regression with no evidence of new tumor formation. The third EUA, performed 6 months after radiation treatment, showed that multiple discreet gray-white retinal infiltrates had developed, predominantly in the area immediately below the regressed tumor. Because of concern that these lesions represented viable retinoblastoma, the eye was enucleated. Pathologic examination of these lesions revealed them to be collections of foamy cells containing melanin granules suggestive of pigment epithelial origin. PMID- 3320328 TI - Long-term strabismus complications following retinal detachment surgery. AB - Thirty-three consecutive patients with persistent strabismus following retinal detachment surgery were studied retrospectively. A large number of vertical and torsional problems were seen. Various restrictive abnormalities were identified during strabismus surgery. These included superior oblique tendon displacement anteriorly, leash and reverse leash types of restrictions, myoscleral adhesions posterior to the exoplants, and stretching of the muscles induced by large underlying exoplants. The results following strabismus surgery were analyzed. Eighty percent of the patients were able to achieve single binocular vision in the primary field of gaze, with a low incidence of complications. The adjustable suture procedure was thought to be helpful. PMID- 3320329 TI - Breastfeeding and returning to work. PMID- 3320330 TI - The pediatric heart transplant patient: immunosuppressive drugs and organ rejection. PMID- 3320331 TI - Preliminary investigation into the performance of a sonic scaler. AB - Recently a number of mechanical scalers, known as air or sonic scalers, have been developed. Preliminary investigations were undertaken to observe the operating characteristics of such a sonic scaler including its oscillatory pattern, and how this was affected by changing the design of the scaling tip, the air pressure, and the application load. The oscillatory pattern exhibited an open elliptical movement that was dependent upon the air pressure input to the instrument. Application of a load to the scaling tip resulted in oscillatory damping that increased with the magnitude of the load. The oscillatory performance of the sonic scaler differed from that observed previously with ultrasonic scalers. Investigators using the sonic scaler should indicate the type of scaling tip, the air pressure input, and the application load used to enable meaningful comparisons to be made between the results of different workers. Clinicians should be aware of its operating characteristics to avoid potential damage to the tooth surface. PMID- 3320332 TI - [Basic principles of nuclear magnetic resonance]. PMID- 3320333 TI - Age-dependent change in warfarin distribution volume in rats: effect of change in extracellular water volume. AB - The pharmacokinetics of insulin was studied following intravenous administration of 14C-inulin to 1-d, 1-, 3- and 8-week-old rats. The distribution volume of inulin varied 2-fold, from 689 ml/kg in 1-d-old rats to 340 ml/kg in 8-week-old rats in the growth process of rats. This result was similar to that of warfarin and there was a statistically significant correlation between the distribution volume of warfarin and inulin (r = 0.984, p less than 0.02). In the growth process of rats, the Kp values of warfarin in muscle, which play an important role in the distribution kinetics of warfarin changed in parallel with those of inulin. These results and pharmacokinetic considerations indicated that in warfarin, which is highly bound to serum protein and shows a small distribution volume, the change in the distribution volume in the growth process of rats following administration of a pharmacologically realistic dose (1 mg/kg) is led by the change in the extracellular volume of tissues and that the change in serum protein binding of warfarin might play a minor role in the change in the distribution volume in the growth process. PMID- 3320334 TI - The support of autonomy and the control of behavior. AB - In this article we suggest that events and contexts relevant to the initiation and regulation of intentional behavior can function either to support autonomy (i.e., to promote choice) or to control behavior (i.e., to pressure one toward specific outcomes). Research herein reviewed indicates that this distinction is relevant to specific external events and to general interpersonal contexts as well as to specific internal events and to general personality orientations. That is, the distinction is relevant whether one's analysis focuses on social psychological variables or on personality variables. The research review details those contextual and person factors that tend to promote autonomy and those that tend to control. Furthermore, it shows that autonomy support has generally been associated with more intrinsic motivation, greater interest, less pressure and tension, more creativity, more cognitive flexibility, better conceptual learning, a more positive emotional tone, higher self-esteem, more trust, greater persistence of behavior change, and better physical and psychological health than has control. Also, these results have converged across different assessment procedures, different research methods, and different subject populations. On the basis of these results, we present an organismic perspective in which we argue that the regulation of intentional behavior varies along a continuum from autonomous (i.e., self-determined) to controlled. The relation of this organismic perspective to historical developments in empirical psychology is discussed, with a particular emphasis on its implications for the study of social psychology and personality. PMID- 3320335 TI - Identity negotiation: where two roads meet. AB - This article traces a program of research on the interplay between social thought and social interaction. Early investigations of the impact of perceivers' expectancies on the actions of target individuals illuminated the contribution of perceivers to the identity negotiation process but overlooked the role of targets. The research discussed here is based on the assumption that targets play an active role in the identity negotiation process. Specifically, just as perceivers strive to validate their expectancies, targets seek to verify their self-views. The nature and antecedents of the processes through which people verify their self-conceptions as well as the relationship of these activities to self-concept change and self-enhancement processes are discussed. This research suggests that perceivers and targets enter their interactions with independent and sometimes conflicting agendas that are resolved through a process of identity negotiation. The identity negotiation process therefore provides a theoretical context in which the interplay between other-perception and self-perception can be understood. PMID- 3320336 TI - Selection, evocation, and manipulation. AB - This article proposes three key mechanisms by which personality and social processes are intrinsically linked. Selection deals with the manner in which individuals choose to enter or avoid existing environments. Evocation is defined by the ways in which individuals unintentionally elicit predictable reactions from others in their social environments. Manipulation deals with the tactics that individuals use intentionally to alter, shape, exploit, or change the social environments they inhabit. Empirical findings from 57 dating couples (undergraduates), and previous research within social, personality, and developmental psychology, are used to illustrate the heuristic value of this framework. PMID- 3320337 TI - [Synthetic approach to pharmacologically active heterocycles]. PMID- 3320339 TI - Nurses' attitude in caring for the pediatric bone marrow transplant patient. PMID- 3320340 TI - Graduate education in pediatric oncology. PMID- 3320341 TI - Anorexia nervosa in adolescence: an overview. PMID- 3320338 TI - National Academy of Sciences report--an evaluation of activated carbon for drinking water treatment. PMID- 3320342 TI - Effects of morphine, ethylketocyclazocine, U-50,488H and naloxone on the acquisition of a classically conditioned response in the rabbit. AB - A series of five experiments examined the effects of mu and kappa opioid agonists on acquisition of conditioned responses in the rabbit and the antagonism of their effects by naloxone. Extension of the nictitating membrane was classically conditioned to a tone stimulus presented before delivery of an electric shock unconditioned stimulus to the skin over the paraorbital region of the head. Morphine, ethylketocyclazocine and U-50,488H retarded the acquisition of conditioned responses to the tone conditioned stimulus with ethylketocyclazocine being twice as potent as the more specific kappa agonist U-50,488H, and 40 times more potent than the prototypic mu agonist morphine. Control experiments indicated that the retarded acquisition produced by the three opioids was due to an action on associative learning. Doses of 0.1 and 1.0 mg/kg of naloxone alone did not affect acquisition of conditioned responses, but did significantly antagonize the retardant effects of all three opioid agonists. On the basis of the parallelism of the dose-effect curves for the three opioid agonists, their order of potency which was remarkably different from potency ratios observed for other measures, e.g. analgesia, and on the finding that all three opioids demonstrated approximately equivalent sensitivity to antagonism by naloxone, it was concluded that the effects of all three opioid agonists on the acquisition of conditioned responses may be mediated by a common receptor. PMID- 3320343 TI - Role of bradykinin generating and degrading systems in the vascular permeability response induced with kaolin in rats. AB - We investigated how bradykinin mediates inflammatory reactions in rats, via measurements of bradykinin by enzyme immunoassay method in inflammatory tissue fluids. Vascular permeability was increased markedly during the first 10 min and then declined quickly after the infusion of a kaolin suspension (10 mg/ml) in 0.8% carboxymethl-cellulose solution into an air pouch formed on the back of rats. Bradykinin in the exudate reached a maximum 5 min after the challenge and then decreased quickly. Local treatment with DL-2-mercaptomethyl-3 guanidinoethylthiopropanoic acid, an inhibitor of kininase I, and captopril, an inhibitor of kininase II in the first 10-min period, each enhanced the vascular permeability increase accompanied by the elevation of the bradykinin level, whereas soybean trypsin inhibitor, a plasma kallikrein inhibitor, lowered both vascular permeability and bradykinin. When applied in the period of 3.5 to 4 hr after the challenge, only the kininase II inhibitor was effective in elevating both vascular permeability and the bradykinin level, whereas soybean trypsin inhibitor was ineffective on vascular permeability. A bradykinin-degrading activity appeared in the exudate as early as 10 min after the challenge. These results suggest that bradykinin plays an essential role for the sudden rise of the vascular permeability observed immediately after the infusion of kaolin suspension. In the later stage (3.5-4 hr), bradykinin level remained below the assay limit of 0.07 ng/ml in spite of its active generation, presumably because of its rapid degradation by the kininases, although it still played a definite role in the vascular permeability increase. PMID- 3320344 TI - Regional blood flow and hemodynamics in the rabbit with adriamycin cardiomyopathy: effects of isosorbide dinitrate, dobutamine and captopril. AB - We have studied the effects of captopril, nitrates and dobutamine on hemodynamics and regional blood flow in the conscious rabbit with adriamycin cardiomyopathy. Rabbits were injected twice weekly with adriamycin (1 mg.kg-1 bw.) for 8 weeks and subsequently maintained for 2 weeks without adriamycin in order to allow recovery from any noncardiac effects. Doses of drug for investigation (captopril, 300 micrograms.kg-1.min-1; isosorbide dinitrate, 10 micrograms.kg-1.min-1; and dobutamine, 10.9 micrograms.kg-1.min-1) were chosen in anticipation of a 20% increase of cardiac output in animals with heart failure. In animals with heart failure myocardial blood flow was increased by dobutamine and to a lesser extent by captopril. Renal blood flow was increased only by captopril and nitrates. Cerebral blood flow was reduced by captopril in control animals but unaltered in animals with heart failure. The observed alterations of blood flow were similar to those known to occur in humans and indicate that this is a useful model of heart failure for the evaluation of new drugs. PMID- 3320345 TI - Activation of serotonin2 (5-HT2) receptors by quipazine increases arterial pressure and renin secretion in conscious rats. AB - Quipazine, a nonselective serotonin (5-HT) agonist, has been shown to increase plasma renin activity (PRA). The present study examined the effects of quipazine on mean arterial pressure (MAP), heart rate (HR) and PRA in conscious, chronically catheterized male rats. Quipazine caused dose (0.3-3.0 mg/kg i.v.) and time (up to 30 min)-dependent increases in MAP and PRA. The maximum increases in MAP (control = 94 +/- 2 mm Hg, 3 mg/kg = 155 +/- 1 mm Hg) and PRA (nanograms of angiotensin 1 per milliliter per hour; control = 2.5 +/- 0.2, 3 mg/kg = 25.2 +/- 5.9) were observed 5 min after quipazine. HR tended to decrease, but a significant bradycardia was observed only 15 min after 3 mg/kg. The selective 5 HT2 antagonist LY 53857 (1 mg/kg i.v.) did not affect MAP, HR or PRA per se, but at 0.03 to 1.0 mg/kg totally abolished the pressor response to quipazine (3 mg/kg). At 0.01 mg/kg, LY 53857 attenuated quipazine-induced hypertension, whereas 0.003 mg/kg was ineffective. Total blockade of quipazine-induced renin secretion was produced by LY 53857 at 0.003 mg/kg, and the response was still reduced by 50% at 0.001 mg/kg. In summary, although quipazine increases arterial pressure and renin secretion, endogenous 5-HT does not tonically control MAP or PRA in conscious, unrestrained, normotensive rats through 5-HT2 receptors. The 10 fold difference in the dose of LY 53857 necessary to block the pressor and renin responses may be due to subtle differences in receptor subtypes, or to pharmacokinetic properties favoring antagonism of quipazine-induced renin secretion. PMID- 3320346 TI - Comparative dopamine-cholinergic mechanisms in the olfactory tubercle and the striatum: effects of metoclopramide. AB - The olfactory tubercle (OT) is a limbic structure containing high dopamine (DA) and acetylcholine (ACh) concentrations. We performed a comparative study of the DA-ACh interactions, the efficacy of autoreceptor control and the effects of metoclopramide in the OT and the nucleus caudate (striatum). Rabbit brain slices from both regions of the same animal were prelabeled with radioactive DA and/or choline and then superfused. Comparable magnitude of DA and ACh release was evoked by electrical stimulation from both regions. DA release was unaltered, whereas ACh release was inversely related to the stimulation frequency, both in OT and striatum. Apomorphine (APO), a D1-D2 agonist, an LY-171555 (LY), a D2 agonist, inhibited DA and ACh release from OT and striatum with similar EC50 and Emax (maximal percentage of inhibition). However, the maximal degree of inhibition of ACh release achieved with APO, LY or DA in the OT was only one-half that observed in the striatum. In both regions, the inhibitory effects of DA agonists on DA and ACh release were reduced markedly when the number of electrical pulses and/or the frequency of stimulation were increased. l Sulpiride, a DA D2 antagonist, increased the evoked release of DA and ACh from OT in direct relationship with the frequency of stimulation. In the OT, increases in synaptic DA achieved by administration of amphetamine or by blockade of the neuronal uptake pump with nomifensine inhibited the evoked release of ACh. Again these drug treatments produced only a 40 to 50% inhibition of ACh release. SKF 38393, a D1 agonist, had no effect per se on DA or ACh release in OT slices from control or from reserpine-treated animals (2 mg/kg s.c. for 3 or 7 days). With the exception of one specific dose combination, coadministration of SKF 38393 and LY produced no additive or synergistic effects on DA or ACh release from OT. APO- and LY-induced inhibition of DA and ACh release were antagonized by l-sulpiride. However, 300 nM SCH 23390, a D1 antagonist, reduced APO inhibition of DA and ACh release without affecting the inhibitory action of LY on DA and ACh release. Metoclopramide, "a DA antagonist with poor limbic activity", had a similar affinity for OT (pA2: 7.59) and striatal (pA2: 7.59) DA autoreceptors. Its antidopaminergic efficacy on DA receptors modulating ACh release from OT and striatum was also compared.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3320347 TI - Tiletamine is a potent inhibitor of N-methyl-aspartate-induced depolarizations in rat hippocampus and striatum. AB - N-methyl-D,L-aspartate (NMA) antagonists are of potential value in the treatment of epilepsy and ischemia, but commonly utilized compounds are of low potency and poorly penetrate the brain. Tiletamine hydrochloride is a lipophilic and potent veterinary anesthetic. This study shows tiletamine to be similar to ketamine and to phencyclidine, agents known to interact with the NMA receptor. Effects of tiletamine on synaptic transmission and on direct excitatory responses to exogenous amino acids were examined in rat hippocampal and striatal slices. In striatal slices, tiletamine inhibited the NMA-mediated, but not the spontaneous, release of [3H]acetylcholine, with an IC50 of 70 nM. In hippocampal CA1 cells, 3 microM tiletamine in the perfusate reversibly blocked the intracellularly recorded responses to ionophoretically applied NMA, but not to glutamate, quisqualate and kainate. Tiletamine, 3 to 100 microM, had no effect on the orthodromically elicited excitatory postsynaptic potential, action potential amplitude or duration, resting membrane potential, or input resistance. In Mg++ free perfusate, the excitatory postsynaptic potential was greatly augmented to give a paroxysmal depolarization shift and was reversibly blocked by 10 microM tiletamine. Our results show that tiletamine is a potent and reversible antagonist of NMA-mediated responses without itself having major effects in low concentrations on normal membrane and synaptic pyramidal cell properties. PMID- 3320349 TI - [Study of the central mechanism of sensation by positron emission tomography]. PMID- 3320348 TI - Comparison of the discriminative stimulus properties of U50,488 and morphine in pigeons. AB - Pigeons were trained to discriminate a dose of either 4.2 mg/kg of U50,488 or 1.0 mg/kg of morphine from water using a two-key drug discrimination procedure. In U50,488-trained pigeons, the kappa agonist bremazocine occasioned drug appropriate responding during substitution tests, whereas ethylketocyclazocine and ketocyclazocine occasioned intermediate levels of drug-appropriate responding up to and including doses that markedly suppressed response rates. The mu agonists morphine, l-methadone and fentanyl produced responding predominantly on the water-appropriate key. In morphine-trained pigeons, l-methadone, fentanyl, ethylketocyclazocine and ketocyclazocine, but not U50,488 and bremazocine, occasioned drug-appropriate responding. Nonopioid compounds, such as d amphetamine, pentobarbital, phencyclidine and (+)-SKF 10,047 produced responding predominantly on the water-appropriate key in both U50,488- and morphine-trained pigeons. During tests of antagonism, a 0.1 and 1.0 mg/kg dose of naloxone antagonized completely the discriminative stimulus properties of the training dose of U50,488 and morphine, respectively. In addition, morphine displayed a substantially longer duration of action than U50,488, in that intermediate levels of drug-appropriate responding were evident as long as 4 hr after the administration of morphine and only 1 hr after the administration of U50,488. Over a period of approximately 8 months, the dose-effect curves for the discriminative stimulus properties of both drugs were unchanged. The present findings illustrate further the unique behavioral response of pigeons to the discriminative stimulus properties of the kappa agonists, and establishes that pigeons can discriminate between mu and some kappa agonists. PMID- 3320350 TI - Porcelain-fused-to-metal surface oxidation effects on cemented casting retention. PMID- 3320351 TI - An alternative method for the production of accurate casts and occlusal records in osseointegrated implant rehabilitation. AB - An impression technique that permits the dentist or laboratory technician to correct discrepancy of abutment fit on the master cast has been described. The technique can be sequentially adopted for a variety of occlusal concepts whereby occlusal relations and gnathologic recordings can be transferred to the articulator in a simplified yet highly accurate fashion. PMID- 3320352 TI - An articulator and surveyor remount technique for surveyed abutment crowns. PMID- 3320353 TI - Dental implant night guard. PMID- 3320355 TI - Glossary of prosthodontic terms. PMID- 3320354 TI - Infection control during elastomeric impressions. AB - This technique uses an individual applicator per application of an elastomeric adhesive to an acrylic resin tray. To help prevent contamination of the adhesive in the bottle, the Toothette toothbrush should not be dipped into the bottle a second time. A sufficient quantity of adhesive is absorbed with a single immersion into the adhesive to coat an entire tray. The uniformity of the surface application is more easily controlled compared with that of a brush applicator. Because only one immersion is required to coat a tray and the Toothette toothbrush is discarded after one application, cross-contamination of patients is prevented. PMID- 3320357 TI - James MacKenzie exhibition. PMID- 3320356 TI - The origin of the modern epidemic of coronary artery disease in England. AB - A review of all the cases of the coroner's court for the Liberty of Ripon and Kirkby Malzeard in Yorkshire from 1855 to 1926, and those of 1981-83, showed that the number of deaths from acute coronary artery disease was very low in Victorian times, suddenly increased in the period 1906-10, and was very high in 1981-83. The population of the area was stable throughout the period at around 22 000. The number of postmortems for myocardial infarctions carried out in London hospitals was very low between 1907 and 1914, but greatly increased between 1917 and 1923. A study of autopsies in the City of London showed that the increase in the number of deaths from coronary artery disease began in 1909/10. PMID- 3320358 TI - The post-viral syndrome: a review. AB - The post-viral syndrome is described and its aetiology is discussed. Many features of the syndrome point to hysteria and altered medical perception as causes but much evidence for organic disease is also presented. Current interest focuses on recent or persisting infection with Coxsackie viruses. A balanced view of the syndrome as a mixture of organic and psychiatric dysfunction is offered. Widely differing estimates of incidence are quoted, possibly owing to varying medical awareness of the syndrome. Many drug therapies have been tried without success and management of the post-viral syndrome is hampered by the reluctance of patients to accept psychiatric support once the diagnosis is known. Many names have been proposed for the syndrome, some implying a purely physical or purely psychogenic aetiology: post-viral syndrome is suggested as the most appropriate term. Increased awareness of the syndrome will lead to an increase in its diagnosis in general practice: the role of the Myalgic Encephalomyelitis Association in promoting a combined psychiatric and organic view of the disease among sufferers is emphasized. PMID- 3320359 TI - Undergraduate medical education in London: the last 40 years. PMID- 3320361 TI - Measurement of abnormal personality: a review. PMID- 3320360 TI - A licence to practice. PMID- 3320362 TI - Building or extending a hospital department: radiology. A path through the planning minefield (10). PMID- 3320363 TI - Non-functioning paraganglioma in wall of abdominal aortic aneurysm: a source of diagnostic confusion. PMID- 3320364 TI - Familial hypercholesterolaemia. PMID- 3320365 TI - X-ray and ultrasound localization of non-palpable breast lesions and difficulties in management. AB - Seventy-four patients who have had biopsy of a non-palpable breast lesion are reviewed. A double-dye localization technique was used in 88% while in 12% localization of the lesion was best achieved by ultrasound mammography. Biopsy was successful in 70 patients (95%) at the first attempt. The overall incidence of malignancy was 20%, being greater in asymptomatic patients (32%) than in patients with mastalagia (16%). Re-excision of the biopsy site in these patients showed residual cancer in 33%. It is suggested that both careful examination of the operative specimen and postoperative mammography may be necessary to ensure that the original lesion has been removed. Re-excision of the biopsy site appears to be necessary when the histology is malignant. PMID- 3320366 TI - Chronic muscle contraction headache: the importance of depression and anxiety. AB - Seventy consecutive patients presenting with a clinical diagnosis of chronic muscle contraction headache over a two-year period were evaluated for depression and anxiety scores, along with other possible aetiological factors in this form of headache. Fifty-five of these patients (33 from a hospital neurology clinic and 22 from a local general practice) completed a double-blind study to evaluate flupenthixol 0.5 mg twice daily, diazepam 5 mg twice daily and placebo as prophylactic agents. Patients evaluated in the hospital neurology clinic had more frequent headaches of longer duration, higher analgesic consumption and higher depression, but no higher anxiety scores than those in general practice. Flupenthixol and diazepam were both significantly superior to placebo in reducing headaches and analgesic consumption. The trend was for flupenthixol to be superior to diazepam without reaching statistical significance. Flupenthixol was significantly better than diazepam and placebo in the reduction of Hamilton depression scores. This effect was independent of the effect on headache and analgesic reduction. PMID- 3320368 TI - CT scanning in carcinoma of the rectum: a review. PMID- 3320367 TI - Addressing the psychological needs of the conservatively treated breast cancer patient: discussion paper. PMID- 3320369 TI - Computer-aided medical ethics. AB - This paper describes COMET, the first 'expert' computer system to incorporate a comprehensive set of the rules of law and medical ethics relating to consent to medical treatment. PMID- 3320370 TI - The authority of a moral claim: Ian Ramsey and the practice of medicine. PMID- 3320371 TI - Missed opportunities and new approaches: a clinician's view. PMID- 3320372 TI - Mechanisms of association of Candida albicans with intestinal mucosa. AB - The association of Candida albicans with gastrointestinal (GI) mucosal surfaces was studied in vitro and in vivo. The caecal mucosal surfaces from antibiotic treated and untreated control mice challenged orally with C. albicans revealed that large numbers of C. albicans were associated with the intestinal epithelium of antibiotic-treated mice but not with that of the control mice that possessed an indigenous wall-associated bacterial flora. Moreover, Candida cells only penetrated deep into the mucosa of animals in which the ecology of the intestinal microflora had been disrupted. In mice given antibiotics, C. albicans was associated with the mucosa of all areas of the GI tract; the caecal mucosa had the most associated Candida, whereas the stomach and small intestine had very few associated yeasts. Further examination of caecal mucosa from antibiotic-treated mice showed that C. albicans associated with the mucosa by at least five distinct mechanisms. These included: adhesion to epithelium, adhesion to mucus, co adhesion to adherent fungi, co-adhesion to adherent bacteria, and entrapment in the mucous gel overlying the epithelium. The cell-surface hydrophobicity of C. albicans also was examined and found not to play a role in Candida adhesion to intestinal mucosa. The predominant association mechanisms appeared to be entrapment in the mucous gel, and adhesion to mucus and the epithelium. The ecological and pathological significance of co-adhesion by C. albicans to attached organisms is unclear but it may be important in the initiation of mucosal lesions. PMID- 3320373 TI - Verotoxin production among porcine strains of Escherichia coli and its association with oedema disease. AB - Strains of Escherichia coli isolated from documented cases of disease in pigs and belonging to a wide range of pathogenic serotypes were tested for their ability to produce a heat labile verotoxin (VT). The strains isolated from oedema disease all produced VT, indicating that the cytotoxin detected by the vero-cell assay was identical to "oedema disease principle". Strains belonging to the serotypes associated with enterotoxic diarrhoea were VT-. Not all the strains belonging to the recognised oedema disease serotypes (O141:K85, O139:K82 and O138:K81) produced VT, but the VT- strains were not associated with outbreaks of clinical disease. PMID- 3320374 TI - The role of capsular polysaccharide K21b of Klebsiella and of the structurally related colanic-acid polysaccharide of Escherichia coli in resistance to phagocytosis and serum killing. AB - The behaviour of strains of Klebsiella aerogenes of capsular serotype K21 and strains of Escherichia coli producing a structurally related polysaccharide (colanic acid) was analysed by phagocytic and serum-killing assays. The cell surface characteristics of these strains and of non-capsulate strains derived from them were also investigated by partitioning experiments in aqueous two polymer phase systems. The possession of K21-type capsule by K. aerogenes or colanic-acid polysaccharide by E. coli conferred a strong negative charge on capsulate bacteria. Negatively charged bacteria of E. coli producing colanic-acid capsules, however, like non-capsulate K. aerogenes, were susceptible to uptake by polymorphonuclear leukocytes. In contrast, K21 polysaccharide conferred on klebsiellae considerable resistance to phagocytic uptake. The finding that ingested non-capsulate derivative strains of K. aerogenes were less rapidly degraded by phagocytes than E. coli strains suggested that other components of the cell surface of Klebsiella, notably lipopolysaccharide, may be involved in protection against phagocytic killing. The presence of colanic-acid capsules on E. coli conferred little resistance to the bactericidal activity of human serum or phagocytic uptake and did not protect against intracellular killing by polymorphonuclear leukocytes. PMID- 3320375 TI - Amniotic band syndrome in a rhesus monkey: a case report. AB - A rhesus monkey fetus was examined by ultrasound at 110, 111, and 113 gestational days (GD) and showed features suggestive of Amniotic Band Syndrome (ABS). These included an unusual craniofacial configuration, cortical distortion, asymmetrical hydrocephalus, a right occipital porencephalic cyst, and hydropic membranes with several free strands attached to the fetal head, neck, and scapular regions. The fetus remained fixed in the same position with the head retroflexed during each consecutive exam. A hysterotomy was performed and ABS was confirmed. PMID- 3320377 TI - The relationship between communication and marital satisfaction: a review. AB - This paper provides a comprehensive methodological review of the literature assessing the relationship between marital satisfaction and communication. The investigations vary greatly in the adequacy of their assessment measures and soundness of their research design. Although it is generally concluded that both content and process communication are related to marital satisfaction, replication of the better designs is necessary. Specific findings and their practical implications for both future research and marital therapy are discussed. PMID- 3320376 TI - Subcellular effects of adriamycin in the heart: a concise review. PMID- 3320378 TI - Future of health care in America: what is the NMA's role? PMID- 3320379 TI - Developmental outcome of children born from extrauterine pregnancies. AB - From 1947 to 1984, 45 advanced ectopic pregnancies were delivered at Freedmen's Hospital and its successor, Howard University Hospital. Four patients of extrauterine pregnancies were contacted to determine their developmental outcome. At the time of the study, their ages ranged from infancy to adulthood. Results are presented of two children who received in-depth interdisciplinary evaluations at the Howard University Child Development Center. The authors reviewed the literature and questioned other authors, who, based on single examinations, reported normal function in children born after extrauterine pregnancies. PMID- 3320380 TI - Man's curiosity about food digestion: an historical overview. AB - The author traces the history of theories of food digestion from the prescientific era to the chemical techniques of 19th century investigators. PMID- 3320382 TI - Bullet injury to the esophagus detected by intestinal migration. AB - Esophageal injury resulting from a gunshot wound of the chest is unusual. Even more rare is intraluminal movement of the bullet through the gut, which we found described only twice previously. The perforation was demonstrated by esophagram and confirmed by thoracotomy. PMID- 3320381 TI - Airway responses to nitrogen dioxide in asthmatic subjects. AB - Nitrogen dioxide is a common indoor air pollutant. In order to characterize the respiratory responses to this gas, 10 asthmatics (mean age +/- SD = 30 +/- 8 yrs) were exposed to air and 0.5 ppm NO2 gas for 1 h in a 30-m3 environmental chamber on different days in a double-blind randomized fashion. The forced vital capacity, (VC), functional residual capacity, forced expiratory volume in 1 s, partial expiratory flow at 40% VC (Vp 40), and specific airway conductance were measured before and after exposure. Airway reactivity to methacholine inhalation was determined after each exposure. The dose of methacholine in milligrams per milliliter to cause a 40% decrease in Vp 40 was measured. None of the subjects reported any significant symptoms after exposure. Significant potentiation of airway reactivity was noted after NO2 exposure in asthmatic subjects as a group [PD40(AIR) = 9.2 +/- SD 15.0 versus PD40(NO2) = 4.6 +/- SD 8.2 mg/ml, p = 0.042]. No significant changes were noted in other lung functions after NO2 exposure. These findings indicate that asthmatics exposed to 0.5 ppm NO2 develop heightened airway reactivity. PMID- 3320383 TI - A study of group B streptococcal colonization and infection in newborns in Pakistan. PMID- 3320384 TI - Clinical and epidemiological characteristics of rotavirus- and EPEC-associated hospitalized infantile diarrhoea in Basrah, Iraq. PMID- 3320385 TI - A study of hearing in the elderly using non-invasive electrocochleography and auditory brainstem responses. AB - The auditory brainstem responses exhibited normal interpeak intervals of waves I III and I-V in a group of 31 elderly people (mean age 82 years), indicating normal conduction through the brainstem. The amplitudes of the waves I, III and V were significantly reduced and the peaks I, III and V showed a delay in latency, reflecting a predominantly lower level of activity in the elderly cochlea. Extratympanic electrocochleography yielded significantly reduced amplitudes of the N1 component of the action potential, summating potential and cochlear microphonics in the elderly compared to the young controls. A heterogeneity of patterns of input/output functions was observed and interpreted as either an absence of recruitment, as partial or as complete recruitment. The findings are in keeping with pathological evidence of severe damage to outer hair cells and complete atrophy of part of the basal coil. PMID- 3320386 TI - Speech discrimination skills in the elderly: a critical review. AB - Traditionally, investigators have claimed that speech discrimination skills decline with increasing age more than would be expected, given hearing sensitivity. These effects are magnified under difficult listening conditions. Evidence is presented which both supports and refutes this claim of decreased speech discrimination ability in the elderly. Other possible explanations for this phenomenon including reaction time, response bias, hearing threshold, memory, learning, selective attention and social expectation are discussed. The question of whether this effect represents central or peripheral processing is explored. It is suggested that further evidence is necessary before conclusive statements can be made. PMID- 3320387 TI - Endothelial cell seeding of polytetrafluoroethylene vascular grafts in humans: a preliminary report. AB - The importance of initial human trials with autologous endothelial seeding lies not only in the implementation of a promising idea but also in the fact that canine data are only partially applicable to humans. The surface area of jugular veins in humans is much smaller than in dogs and considerably longer grafts are needed. Moreover, the reproductive capacity of adult human endothelial cells under in vivo conditions, which probably determines the success of seeding more than the seeding density, is also uncertain. Therefore the efficiency of autologous endothelial seeding in humans was investigated in 18 patients undergoing distal femoropopliteal bypass surgery. The average surface area of the jugular veins was 4.9 +/- 1.7 cm2 with an average cell yield of 32.6 +/- 18.0 x 10(4). The mean number of seeded cells per square centimeter of graft surface was 3.1 x 10(3). In a follow-up extending for 14 weeks, plasma levels of platelet factor 4 and beta-thromboglobulin as well as the platelet function in the whole blood aggregometer showed significantly better results in the seeded group. Plasma thromboxane B2, uptake and survival of indium 111-labeled platelets, and Doppler ultrasound investigations also favored the seeded group, but the results were statistically insignificant. No difference at all was found for the platelet dense granule compounds, releasable adenosine triphosphate and platelet serotonin. Thus our findings did not indicate the development of a closed endothelialized surface after 14 weeks, which is a period three times as long as the one required for confluent endothelial cell coverage in dogs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320388 TI - Platelet survival and serotonin content after placement of arterial prostheses in dogs: effects of neointimal coverage and high- and low-dose aspirin. AB - Because prosthetic neointima produces much less prostacyclin (PGI2) than arterial intima and may be more susceptible to cyclooxygenase inhibition, aspirin treatment might enhance surface thrombogenesis. To test this hypothesis, aortic prostheses were placed in eight dogs and measurements of platelet survival and platelet serotonin (5HT) were made under conditions of no treatment and treatment with low-dose (2mg/kg) and high-dose (30 mg/kg) aspirin. These doses equally suppressed platelet function. Measurements were performed preoperatively, 6 to 8 weeks postoperatively (when little neointima was present), and 28 to 32 weeks postoperatively (neointima fully developed). Platelet survival and 5HT levels were markedly reduced 6 to 8 weeks postoperatively and returned to normal at 28 to 32 weeks after implantation. At all times, low-dose aspirin improved platelet survival and this effect was most apparent 6 to 8 weeks postoperatively. Treatment with either aspirin dose decreased platelet 5HT levels at the 28 to 32 week postoperative period but not at other times. At recovery of prostheses, 90% of the luminal surface was covered with endothelialized neointima. Neointimal production of PGI2 was one half to one third that of aortic production. Despite this, low- and high-dose aspirin equally suppressed PGI2 production from both neointima and aorta. Furthermore, aspirin did not increase labeled platelet uptake on neointima. We conclude that (1) aspirin treatment does not render prosthetic neointima thrombogenic and (2) aspirin alters platelet survival and 5HT levels by mechanisms other than inhibition of platelet and neointima cyclooxygenase. PMID- 3320389 TI - Accuracy of B-mode scanning of the carotid bifurcation. PMID- 3320390 TI - Randomized double-blind trial of intracoronary urokinase for acute myocardial infarction: multicenter study. AB - The efficacy of intracoronary urokinase (UK) in an acute myocardial infarction has not been firmly established in a randomized fashion. Two hundred and ten patients were randomized to UK therapy (107 patients) and placebo (103 patients). Successful recanalization was achieved in 74% of the UK group vs 17% in the placebo group (p less than 0.01). The success rate was dose dependent up to 960,000 I.U. Clinical course was favorable and left ventricular enddiastolic pressure was reduced significantly in the UK group compared with the placebo group (p less than 0.05). Ejection fraction one month after the study was better in the reopened group than in the occluded group. Thus, early administration of UK can establish coronary reflow in a high proportion of patients and appears to favor the clinical course. PMID- 3320391 TI - [Effects of sevoflurane anesthesia and surgery on glucose metabolism in man]. PMID- 3320392 TI - [Pulmonary blood flow and selective PEEP following one lung oleic-acid injury in the dog]. PMID- 3320394 TI - [New antimicrobial agent series XXIII: Cefixime]. PMID- 3320393 TI - [History of spinal anesthesia in Japan]. PMID- 3320395 TI - [New antimicrobial agent series XXIV: Cefminox]. PMID- 3320396 TI - [Bacterial adhesins and pathogenicity]. PMID- 3320397 TI - [Fundamental and clinical studies of low-dose total body irradiation in tumor control]. AB - Total body irradiation of 10 rad showed an enhancement effect on tumor cell killing when given 12 hours before local tumor irradiation. In order to clarify the mechanism of this kind of effect, some immunological studies were performed using several immunological procedures, and the results suggested that 10 rad of total body irradiation caused increasing tumor immunity in irradiated tumor bearing mice. Clinical trials in some patients with advanced tumors are now being undertaken on the basis of these experimental data, and the effect of total body irradiation tumor control appears promising although it is too early to draw conclusions. PMID- 3320398 TI - [A case report of a solid and cystic tumor of the pancreas in a 33-year-old woman]. AB - An unusual case of a solid and cystic tumor of the pancreas is presented. A 33 year-old woman with a 15-year history of an abdominal tumor underwent a pancreatectomy. The tumor was encapsulated by a thick connective tissue and exhibited two main patterns: solid sheets of relatively uniform small cells; and, a papillary proliferation with a central fibrovascular talk. The tumor cells had PAS and d-PAS reactive granules in the cytoplasm. Immunohistochemically, a positive reaction for alpha l-antitrypsin and a carcinoembryonic antigen, as well as a weekly positive reaction for a vasoactive intestinal polypeptide also were found in the cytoplasm. Our results lead us to suggest that an S-C tumor is likely to be a tumor of a acinar cell origin. PMID- 3320399 TI - [Adenocarcinoma of an extraperitoneal rectum in a 17-year-old female]. AB - A 17-year-old female with an adenocarcinoma of the extraperitoneal rectum, which was diagnosed correctly by preoperative intrarectal ultrasonography as being in Dukes' A stage, was operated on, this surgery performed adhering to function preserving procedures. Histologically, the tumor uncovered was found to be a well differentiated adenocarcinoma and, as had been expected, in Dukes' A stage. An absolute curative operation was achieved. The operative procedure for juvenile rectal cancer must be planned to achieve both tumor removal and bodily function preservation to assure the best possible quality of postoperative life. We recommend intrarectal ultrasonography at the preoperative stage, the results to be used in deciding on the operative procedure. PMID- 3320400 TI - [A case of a male gastric choriocarcinoma with massive mesenteric tumor and review of the literature on male choriocarcinoma]. AB - A 32-year-old man was admitted to our hospital, complaining of an abdominal mass. An operation disclosed a large tumor, the size of a child's head, in the mesenterium of the transverse colon, with a multiple liver metastasis. A tumor resection was performed and, histologically, the tumor was diagnosed as being a choriocarcinoma. Gynecomastia was not observed. The patient died 2 months after this operation in spite of chemotherapy. An autopsy disclosed metastatic choriocarcinomas in the lungs, the liver, the peritoneum, the stomach, the adrenal glands and in the lymph nodes. The testis was found to be normal by a serial histological examination. Primary advanced adenocarcinoma, which is histologically similar to a choriocarcinoma, was found in the stomach. This case was finally diagnosed as being a gastric adenocarcinoma which showed choriocarcinomatous differentiation at various metastatic sites. PMID- 3320401 TI - [Primary intrasellar germinoma with amenorrhea--a case report]. AB - A 22-year-old woman with a history of headaches and secondary amenorrhea is reported. Her physical examination showed a visual acuity loss. An endocrine evaluation revealed hypopituitarism and an elevated level of serum prolactin. Polytomography demonstrated an enlarged sella with a double floor. A computerized tomography (CT) scan revealed an enhancing lesion within the sella turcica with an extension into the suprasellar cistern. A lumbar puncture was performed and the cerebrospinal fluid was found to contain no tumor cells. The patient subsequently underwent a trassphenoidal exploration of the sella and an intrasellar tumor removal. A histological analysis of the surgical specimen revealed a germinoma. A total dose of 3500 rads with lineac was applied to the whole brain postoperatively. Her vision is now normal. The pathogenesis of an intracranial germinoma is briefly discussed, and a review of the literature discloses 48 previous reports of germinoma. PMID- 3320402 TI - [A case report of adenolipoma of the breast]. AB - A rare case of breast adenolipoma is presented. A 49-year-old, otherwise healthy woman had a tumor of the left breast for approximately 25 years. Ultrasound mammography demonstrated a well-demarcated, high echoic mass with islands of a low echoic area in the center of the tumor. The well-defined, oval, soft tumor, measuring 7 x 5 x 3.5 cm in size, was surrounded by a thin capsule which was removed, and its yellow cut surface was found to be mottled by greyish-white areas. Microscopically, the tumor was diagnosed as a breast adenolipoma consisting of fatty tissue interspersed with islands of glandular tissue. The findings of ultrasound examination on adenolipoma of the breast are described and its histogenesis was discussed. PMID- 3320404 TI - [Serum lipids and its relevance to atherosclerosis]. PMID- 3320405 TI - [Diabetes mellitus and lipid metabolism]. PMID- 3320403 TI - Hypercalcemia in a case of childhood acute lymphoblastic leukemia. AB - Severe hypercalcemia (serum calcium, 4.25-5.25 mmol/l), in association with osteolytic bone lesions, was found in a girl aged 2 yr 7 mo with common acute lymphoblastic leukemia (ALL). Hormonal studies excluded the possibility of the hypercalcemia being caused by primary hyperparathyroidism or ectopic parathyroid hormone secretion. Increased plasma prostaglandin E2 (PGE2) levels (130 ng/l), probably produced by leukemic cells, were considered to be one of the pathogenic mechanisms responsible for the occurrence of hypercalcemia in this patient. Both the hypercalcemia and the abnormal plasma PGE2 level returned to normal after chemotherapy. PMID- 3320406 TI - [Disorders of apolipoproteins]. PMID- 3320407 TI - [An automated turbidimetric immunoassay (TIA); present and future]. PMID- 3320408 TI - [Automation of the immunochemical laboratory using the latex agglutination reaction]. PMID- 3320409 TI - [Usefulness of EIA automation and the problems involved --especially as related to the development of the Tg EIA method using PK-300]. PMID- 3320410 TI - [Performance of tumor markers on the ES-600 system (B.M.) in routine use]. PMID- 3320412 TI - [The value of intravenous digital subtraction angiography in occlusive vascular diseases]. PMID- 3320411 TI - [Detection of surface markers of leukemic cells on smears: improvement of the procedure to omit wiping and prevent dryness]. PMID- 3320413 TI - [Chemical modifiers of radiotherapy]. PMID- 3320415 TI - [Analysis of hepatofugal flow in portal venous system using ultrasonic Doppler duplex system]. PMID- 3320414 TI - [The effect of an alpha-glucosidase inhibitor on fatty liver in obesity]. PMID- 3320416 TI - [A case of mucocele of the appendix diagnosed by medical images]. PMID- 3320417 TI - [A case report of portal-systemic encephalopathy with normal portal vein pressure and non-cirrhosis of the liver]. PMID- 3320419 TI - [Changes in pancreatic islet cells after partial hepatectomy in dogs]. PMID- 3320418 TI - [A case of huge carcinosarcoma of the gallbladder]. PMID- 3320420 TI - Immunogold method for forensic medical examinations. 2. Species identification of biological stains by immunologic adhesion of gold particles. PMID- 3320421 TI - [N-alkyl effect of methamphetamine analogs on the reactivity to anti methamphetamine antibody]. PMID- 3320422 TI - [Inhibition of acid-activation of inactive renin by heparin]. PMID- 3320424 TI - [Quantitative analysis of renal interstitial damage using liver-kidney contrast in mesangial proliferative glomerulonephritis]. PMID- 3320423 TI - [Carbon tetrachloride (CCl4)-induced tubulo-interstitial renal lesions in mice]. PMID- 3320425 TI - Serum and urinary beta 2-microglobulin levels in gravida with chronic glomerulonephritis and pure toxemia of pregnancy. PMID- 3320426 TI - [Self-help groups in England: On the directory of the self-help community support groups in England and Northern Ireland]. PMID- 3320427 TI - Appearance of tuberculoma during treatment of tuberculous meningitis. AB - Case histories of two young Indian female patients are described who, during the course of regular chemotherapy for tuberculous meningitis, developed tuberculoma as suggested by CT-scan. Such lesions were not seen at the start of treatment. Twelve similar cases are collected from literature. Most of the patients developed new symptoms and/or signs having initially shown good response to drugs. The pathogenetic mechanisms for such an evolution of lesions are not known but possibly include immunological modulations. This development should not lead to excessive anxiety for treating physician. Surgery is not needed and a patient follow up is well rewarded. Pyrazinamide has emerged as a useful drug. PMID- 3320429 TI - Observation of lymph nodes and great vessels in the mediastinum by endoscopic ultrasonography. AB - The mediastinum was studied by endoscopic ultrasonography in 121 lung cancer patients. This method facilitates the observation of the lymph nodes, the large vessels and heart in the mediastinum in real time and dynamically. In this paper, the orientation of mediastinal lymph nodes was ultrasonographically studied. This method can detect lymph nodes as small as 3 mm in diameter, and very highly those in bracheobronchial, subaortic, subcarinal, and hilar regions. The mediastinal vascular structures were also easily detected. This method can provide full clinical applicability for analysis of mediastinal involvements in lung cancer patients. PMID- 3320428 TI - Malignant lymphomas in patients with autoimmune diseases: a report of 6 cases and a review of the Japanese literature. AB - Six patients with malignant lymphomas in autoimmune diseases are described. Four patients who had Sjogren's syndrome (SS) alone or with progressive systemic sclerosis (PSS) or rheumatoid arthritis (RA) developed non-Hodgkin's lymphomas of the B cell type. One patient who had systemic lupus erythematosus (SLE) developed a B cell lymphoma. Another patient with chronic thyroiditis (ChTD) and idiopathic thrombocytopenic purpura (ITP) had a T cell (OKT3/T4) lymphoma. In 5 patients, the autoimmune diseases (2SS, SS/PSS, SS/RA and SLE) preceded B cell lymphomas by one to 11 years. In the patient with ChTD/ITP, ChTD and a malignant lymphoma were found simultaneously. A review of Japanese reports on lymphoproliferative disorders associated with these autoimmune diseases is given. This report offers the suggestion that disorders in the immunoregulatory system caused by autoimmune diseases may predispose lymphoproliferative disorders. PMID- 3320430 TI - Primary pulmonary lymphoma demonstration of monoclonality by lymphocyte surface marker study. AB - We present here a case of small lymphocytic B cell lymphoma of the lung which developed in a 51-year-old Japanese man who was asymptomatic while his chest X rays revealed slowly progressive infiltrative shadows. Findings of transbronchial lung biopsy suggested lymphoproliferative disorders and the diagnosis of B-cell lymphoma of the lung was established with lung specimen obtained by an open lung biopsy and through demonstration of monoclonal surface markers on lymphocytes in fresh frozen lung sections. Diagnostic value of surface marker analysis is emphasized. PMID- 3320431 TI - [The status of basic education on the terminal care observed in the nursing case studies conducted at graduation: from the case studies conducted in the past 6 years (from 1981 to 1986)]. PMID- 3320432 TI - [History of nursing in Japan. 4. Pre-modern era. 4]. PMID- 3320434 TI - [History of public health nurses affiliated with the Osaka Public Health Clinic. 3. Early days (3). Creation of the system and practice of health education for mothers and infants]. PMID- 3320433 TI - [Nursing roots in the land reclamation projects in Hokkaido. 19. Support of farmers in wilderness]. PMID- 3320435 TI - [Ultrastructural immunocytochemical studies on erythropoietin-producing cells in a human renal carcinoma grown in athymic nude mice and primary monolayer cultures]. PMID- 3320436 TI - [The clinical experience in 105 non-cadaveric kidney transplantations]. PMID- 3320437 TI - [Measurement of renal transplant blood flow by an ultrasonic duplex system using combined Doppler flowmeter with B-mode scanner (2nd report)--classification of the arterial blood flow patterns]. PMID- 3320438 TI - MICNs: who can help? Mobile intensive care nurses. PMID- 3320439 TI - Flail chest: management implications for emergency nurses. PMID- 3320441 TI - Assessment of the person with acquired immunodeficiency syndrome in the emergency department. PMID- 3320440 TI - Trauma to the aging cervical spine. PMID- 3320442 TI - Cardiac and great vessel trauma: assessment, pathophysiology, and intervention. PMID- 3320443 TI - Sharing the ED instructor role. PMID- 3320444 TI - Factors in choosing an urgent care center versus an emergency department. PMID- 3320445 TI - Some thoughts on helping grieving families. PMID- 3320446 TI - The misuse of child safety restraints. PMID- 3320447 TI - Law and the emergency nurse. Safeguard your license. PMID- 3320448 TI - Standardized care plans: hand injury. PMID- 3320449 TI - Determination of the proliferative fraction of a transplantable, hormone dependent, human prostatic carcinoma (PC-82) by monoclonal antibody Ki-67: potential application for hormone therapy monitoring. AB - The transplantable, hormone-dependent, human prostatic carcinoma PC-82 was used as an in vivo model for monitoring the proliferative fraction of tumor cells under the influence of androgen withdrawal and resubstitution. The number of cycling cells was assessed by means of an immunoperoxidase method and monoclonal antibody Ki-67. The number of Ki-67-positive tumor cells dropped from an average of 17% in androgen-supplemented, tumor-bearing female BALB/c mice to approximately 1.0% within 10 days after removal of the testosterone (T) implant. A similar effect was noted after castration of tumor-bearing male BALB/c mice. Androgen resubstitution after a 10-day period of T deprivation resulted in a rise in the tumor cell proliferation index to 20% within 4 days. The same pattern of response to androgen depletion and resubstitution also was found when the number of cycling cells in S phase was assessed by the 5-bromo-2'-deoxyuridine incorporation technique. Administration of supraphysiologic doses of T in intact male mice did not lead to an increase in the number of Ki-67-stained nuclei. Androgen manipulation did not influence the immunohistochemically assessed expression of prostatic acid phosphatase and prostate-specific antigen. The rapid effect of hormone deprivation and resubstitution in the tumor cell proliferation fraction suggests that monoclonal antibody Ki-67 can be used for monitoring the short-term effects of hormonal treatment of prostatic cancer. PMID- 3320450 TI - [An amputated leg of Shigenobu Ohkuma, ex-Minister of Foreign Affairs and founder of Waseda University]. PMID- 3320451 TI - Heparin vs. saline in maintaining patency, intermittent infusion devices: pilot study. PMID- 3320452 TI - [Catecholamines, prostaglandins and intracellular electrolyte levels in patients with hypertension and low plasma renin activity]. PMID- 3320453 TI - [An immunoenzyme method of determining apoprotein B and its diagnostic value in ischemic heart disease]. AB - Enzyme immunoassays were used to measure blood apoprotein B (apo-B), a major protein component of low-density lipoproteins, in 96 patients with coronary disease due to coronary atherosclerosis, 21 patients with angiographically intact coronary arteries, and 130 apparently normal individuals (donors). The results of serum apo-B measurements were correlated to the presence or absence of atherosclerotic coronary arterial lesions, the spread of coronary atherosclerosis, as evidenced by selective coronarography, and patients' sex and age. The measurement of serum apo-B may be helpful in early diagnosis of coronary disease, being particularly valuable in males below 50 years of age. PMID- 3320454 TI - [The problems of cardiovascular pathology in adolescents]. PMID- 3320455 TI - [Importance of dynamic x-ray computed tomography in diagnosing and evaluating treatment effectiveness in ischemic heart disease and renal hypertension]. PMID- 3320456 TI - [Prevention of cardiovascular diseases from childhood--a new approach in preventive cardiology]. PMID- 3320457 TI - [The development of pulmonary surgery in the Ukraine]. PMID- 3320458 TI - [Gastrostomy in Dobromyslov-Torek operation]. PMID- 3320459 TI - [A method of covering the duodenal stump after gastrectomy and measures for the prevention of suture incompetence]. PMID- 3320460 TI - [A suture technic in perforated ulcer]. PMID- 3320461 TI - [A method of permanent valvular gastrostomy]. PMID- 3320462 TI - [Creating an antireflux anastomosis between the gastric stump and the jejunum]. PMID- 3320463 TI - [Choledochoduodenostomy by a mechanical method]. PMID- 3320464 TI - [Echographic potentials in the differential diagnosis of jaundice of different origins]. PMID- 3320465 TI - [Intraoperative diagnosis and choice of treatment method in choledocholithiasis]. PMID- 3320466 TI - [Intracellular mechanisms of cholestasis]. PMID- 3320467 TI - [Rheohepatographic assessment in organic diseases of the hepatopancreatoduodenal area]. PMID- 3320468 TI - [Combination of empyema of the gallbladder and typhoid]. PMID- 3320469 TI - [Comparative evaluation of unidimensional echography and oral cholecystography for the diagnosis of gallstones]. PMID- 3320470 TI - [New method of creating a bile-draining anastomosis]. PMID- 3320471 TI - [Prof. Aleksandr Ivanovich Savitskii (on the centenary of his birth)]. PMID- 3320472 TI - [In defense of the Pirogov-Mateshuk single-row intraluminal suture]. PMID- 3320473 TI - [Dermatoplasty of the bone cavity of the calcaneus]. PMID- 3320474 TI - [Surgical tactics in injuries of the veins of the neck and the chest cavity]. PMID- 3320475 TI - [Partial replacement of the vertebral body]. PMID- 3320476 TI - [Complex diagnosis of cancer of the pancreas]. PMID- 3320477 TI - [Ultrasonic study of tumors and chronic inflammation of the bones]. PMID- 3320478 TI - [Aleksandr Ivanovich Savitskii (on the centenary of his birth)]. PMID- 3320479 TI - [Ultrasonic study of the liver in the diagnosis of lung cancer metastases]. PMID- 3320480 TI - [Sturge-Weber syndrome: glaucoma with elevated episcleral venous pressure]. AB - The present report describes clinical findings in 13 patients with Sturge-Weber syndrome, 11 of whom had glaucoma (22-52 mm Hg). The episcleral venous pressure (EVP) was high in all glaucomatous eyes (14-23 mm Hg). Tonography showed a marked decrease in outflow facility. The observations suggest that glaucoma in Sturge Weber syndrome is caused by a) elevated episcleral venous pressure and b) secondary damage of the trabecular meshwork with reduction of outflow facility. The cause and pathogenesis of these lesions are discussed. In nine patients a diffuse angiomatosis involving most of the choroid (1.5-4.0 mm thick), as well as the episcleral perilimbal plexus, was demonstrated by ultrasonography. PMID- 3320481 TI - [Cells on intraocular lenses. Comparison of specular and slit-lamp microscopy findings]. AB - Examination with a specular microscope facilitates diagnostic evaluation of cells on the surface of intraocular lenses. Similarly, slit-lamp examination makes specular microscopic studies possible. However, image resolution and magnification are not achieved by using this method, though the amount of time and instrumental effort is minimal. Various types of cells can be differentiated. Fibroblast-like cells can only be demonstrated readily in the specular areas, whereas multinucleate giant cells can usually also be seen by using focal illumination. It is difficult to differentiate the smaller, mononucleated cells. PMID- 3320482 TI - [Evaluation of the usefulness of the Doppler ophthalmic test for the detection of the paths of collateral circulation in patients with ischemic changes in the anterior segment of the optic nerve]. PMID- 3320483 TI - [Glaucoma with low intraocular pressure. V. Doppler ophthalmosonography]. PMID- 3320484 TI - [Cicatricial ocular pemphigoid in an infant]. PMID- 3320485 TI - [Ocular symptoms in AIDS]. PMID- 3320486 TI - [From the bibliographer's files (XXXI). 50 years ago]. PMID- 3320487 TI - [Experimental use of soft contact lenses on the condition of the recipient's cornea]. PMID- 3320488 TI - [Effect of diltiazem on blood cyclosporin levels]. AB - The simultaneous administration of the calcium channel blocker diltiazem and cyclosporin results in a significant increase of RIA cyclosporin blood levels. The HPLC cyclosporin levels are not influenced. PMID- 3320489 TI - Reversible functional asplenia and subcapsular liver hematoma--two distinctive manifestations of amyloidosis. AB - We hereby describe a patient with amyloidosis complicated by reversible functional asplenia and spontaneous rupture of the liver with subcapsular hematoma which resolved completely with conservative therapy. These two rare findings may result from extensive vascular amyloid in this patient. PMID- 3320490 TI - Recommendations for controlling the effects of nutrition during assessment of the systemic availability of drugs. PMID- 3320491 TI - [Disorders of pancreatic exocrine and endocrine functions in patients with chronic pancreatitis of alcoholic etiology]. PMID- 3320493 TI - [Students and followers of S. P. Botkin at Novorossisk (Odessa) University]. PMID- 3320492 TI - [An outstanding scientist, therapist and pedagogue (on the 90th anniversary of the birth of M. S. Vovsi)]. PMID- 3320494 TI - [Historian of Russian medicine--Arkadii Pavlovich Levitskii]. PMID- 3320495 TI - [Disorders of cerebral circulation in diseases of the hypothalamo-hypophyseal adrenal system]. PMID- 3320496 TI - [Diagnostic importance of determining beta 2-microglobulin in biological fluids]. PMID- 3320497 TI - [Postvagotomy syndromes]. PMID- 3320498 TI - [Importance of the works of S. Ramon y Cajal for clinical medicine]. PMID- 3320499 TI - [Bronchial asthma and ischemic heart disease--a new look at a current problem]. PMID- 3320501 TI - [Achievements and prospects in the prevention and treatment of hypertension]. PMID- 3320500 TI - [Pancreatic function of chronic pancreatitis patients]. PMID- 3320502 TI - [Kidney echo scanning in patients with chronic kidney failure]. PMID- 3320503 TI - [Evaluation of the reserve spaces of the cerebrospinal system by using noninvasive methods]. AB - This paper presents a theory according to which fluid volumes and pressures in the cerebrospinal system should be related nonlinearly rather than exponentially. The curve describing elasticity E as a function of pressure P should have two almost linear segments separated by an intercept. This concept is based on experimental and model data suggesting that the cerebrospinal system can be viewed as an elastic cavity which can, at normal and low pressures, trap an additional volume of any CSF component and shift other components; as a result, this leads to a linear increase in pressure within the cavity. The theoretical concepts found support in comparative invasive-noninvasive studies of the intracranial fluid with the aid of ultrasonic examination and in postural tests to which patients with cerebral lesions were exposed. A noninvasive technique for measuring fluid volumes and pressures in the cerebrospinal cavity was developed. The technique can be used as a diagnostic tool in the case of intracranial distension. PMID- 3320504 TI - [Isotopic methods of evaluating blood distribution and displacement in the body]. PMID- 3320505 TI - [Discrete adaptation to conditions of sensory conflict]. PMID- 3320506 TI - [Postoperative urinary retention can often be resolved with relaxing exercises. Pressure on the bladder]. PMID- 3320507 TI - [Ultrasound in urology]. PMID- 3320508 TI - [Kidney transplantation 1987]. PMID- 3320509 TI - [Modern urodynamics]. PMID- 3320511 TI - [Bladder catheter--pro and con]. PMID- 3320510 TI - [Historical bases of modern urology]. PMID- 3320512 TI - [Radiation burden and its measurement]. PMID- 3320513 TI - A method for culturing the nasopharyngeal area of rabbits. AB - A method for obtaining antemortem nasopharyngeal cultures is described. Its usefulness for detecting the carrier state of Pasteurella multocida in clinically normal, apparently healthy nasal-culture-negative rabbits is also discussed. PMID- 3320515 TI - Alpha-chloralose as a canine anesthetic. AB - Since its initial description in 1893, alpha-chloralose has undergone extensive pharmacologic evaluation. It has been characterized as a compound possessing potent CNS activity and has been evaluated in humans and animal models for its therapeutic properties. Though the toxicity of the compound prohibits its use as a human therapeutic agent, it has been employed widely as an animal anesthetic in the laboratory setting. A thorough search of the literature reveals that alpha chloralose is second only to sodium pentobarbital as the primary anesthetic agent in acute cardiovascular studies where the preservation of myocardial function is a primary consideration. The literature also shows that alpha-chloralose is the subject of much controversy. The question as to whether alpha-chloralose is a true anesthetic or an immobilizing agent with sedative-hypnotic properties has important implications in light of the current emphasis on ethics in animal research. PMID- 3320516 TI - Perspectives on rabies virus pathogenesis. PMID- 3320514 TI - Serodiagnosis of cilia-associated respiratory bacillus infection by the indirect immunofluorescence assay technique. AB - Antibody to cilia-associated respiratory (CAR) bacillus was detected by the indirect immunofluorescence assay (IFA) technique using tracheal sections of infected mice as antigen in serum samples collected from rats infected naturally and experimentally. Nine of 23 cases of natural infection were positive in IFA antibody, with titres ranging from 1:10 to 1:80, and all these antibody-positive cases were also histologically positive. The remaining 14 cases were negative in both IFA antibody and histological diagnosis, even though some of them were infected with Sendai virus and Mycoplasma pulmonis. In the experimental infection, serum samples collected from 18 rats on days 4, 7, 14, 21, 28 and 56 post-inoculation (PI) (three rats for each point) and examined for IFA antibody revealed that seroconversion occurred in one rat on day 14 PI and in three rats on day 21 PI. Antibody titres of 1:80 to 1:160 remained to the termination of the experiment. The IFA technique was useful for the diagnosis of CAR bacillus infection except in the early stage of the infection. PMID- 3320518 TI - A brief history of the School of Medicine University of South Carolina. PMID- 3320517 TI - The role of extracellular proteases in cell proliferation and differentiation. AB - Proteases have been shown to be capable of inducing two of the most fundamental biologic processes: mitogenesis and cellular differentiation. Their proteolytic activity has been the most widely studied enzymatic activity implicated in inducing these processes. Protease induction of mitogenesis is a major system for studying the control of this process and studies of possible transmembrane signals have been initiated. Proteases have only recently begun to be used as tools for probing the induction of differentiation, but at least three cell line systems have been studied. Extracellular proteases such as thrombin may play physiologic roles in inducing mitogenesis in vivo as suggested by several laboratories. Although the amount of data bearing on the similar possibility of the induction of differentiation by extracellular proteases is negligible, it remains a possibility. For example, macrophages not only have surface-bound proteases (6), but also release proteases (261, 308) as well as cytokines. Any of these agents, individually or in combination, may play a role in inducing erythroid differentiation in vivo and may provide a raison d'etre for the "blood islands" consisting of erythroblasts surrounding a "nurse" macrophage which are so frequently seen in bone marrow. PMID- 3320520 TI - A historic campus. PMID- 3320521 TI - The problems of congenital toxoplasmosis in Singapore. PMID- 3320522 TI - Prenatal diagnosis of some haematological genetic diseases. PMID- 3320519 TI - The ten-year anniversary of the Endocrine Research Laboratory. PMID- 3320523 TI - Barts hydrops fetalis. PMID- 3320525 TI - Hypospadias: a review. PMID- 3320524 TI - New genetic and haematology. PMID- 3320526 TI - Nocturnal enuresis--a common frustration. PMID- 3320527 TI - Thyroiditis: a clinical update. PMID- 3320528 TI - Timing of cyclosporine administration in patients with delayed graft function. AB - Cyclosporine in renal transplant recipients with delayed graft function (DGF) has been reported to decrease graft survival and prolong both DGF and hospitalization. In some centers, antilymphocyte globulin (ALG) has been used perioperatively to obviate these problems, but ALG is associated with increased viral infections. In this study, first cadaver transplant recipients with a fall in serum creatinine level of greater than or equal to 30% in the first 24 hr were started on prednisone (P) and cyclosporine (Group 1, n = 18). Those whose creatinine level did not fall were started on P and azathioprine (Group 2, n = 23) and switched to P and cyclosporine when serum creatinine fell 30%. One-year patient survival was 98%. One-year graft survival was 83% for both Groups 1 and 2 (NS). Results were compared to historical controls with DGF who received P and cyclosporine (Group 3, n = 19). Patients with DGF and requiring dialysis had fewer dialyses (P less than 0.05) and a shorter hospital stay (P less than 0.05) if started on azathioprine, as compared to those started on cyclosporine. Patients with DGF had a higher serum creatinine at 12 months than those with immediate function (P less than 0.05). We conclude that withholding cyclosporine until DGF is resolving decreases the duration of dialysis, decreases hospital stay, and without the use of prophylactic ALG, is associated with graft survival equivalent to that in patients with immediate function. PMID- 3320530 TI - Preoperative transcatheter embolization of an unusual intraorbital and intracranial meningioma. PMID- 3320529 TI - A model for thermal gradients during renal vascular anastomoses. AB - Quantitative knowledge of warm ischemic intervals is of special importance in organ transplantation. Warm ischemia as a function of time is deleterious to tissue survival. In a laboratory model of a preserved transplantable organ, we determined thermal gradients in pig kidneys similar in size to human kidneys. Sixteen nonviable porcine kidneys cooled to 0 degrees C were placed in an artificial "iliac fossa." The posterior renal wall was in contact with the normothermic fossa. The anterior renal wall was exposed to the ambient temperature of the "operating room." The temperature of both walls was monitored for a minimum of 2 hr. Temperature changes relative to time and kidney weight were studied. The temperature of the posterior wall rises above 20 degrees C within 5 to 10 min; the anterior wall attains this temperature within 30 to 40 min. The thermal gradient between the two walls is significantly greater for larger kidneys (200 g) than for smaller kidneys (100 g). Implications for biochemical pathology are discussed. PMID- 3320531 TI - Basic and clinical aspects of congenital adrenal hyperplasia. AB - Defective steroid 21-hydroxylation is the most common of the biochemical defects causing hyperplasia of the adrenal cortex. The genetic mode of transmission of all enzyme abnormalities seen in cortisol biosynthesis is autosomal recessive. Steroid 21-hydroxylase deficiency has three currently accepted forms: the simple virilizing and salt-wasting variants of the classical deficiency, and the nonclassical (attenuated) form, which shows a wide clinical range of effects and whose characterization emerged from co-ordinated hormonal testing and family studies. More recent molecular genetic studies have started to identify specific mutations altering 21-hydroxylase activity. Defects in the other enzymes occur more rarely and are less well known, although initial work with abnormal 11 beta hydroxylase and 3 beta-hydroxylase indicates that allelic gene defects may be correlated with different clinical phenotypes seen for these disorders also. The gene for the enzyme steroid 21-hydroxylase, a cytochrome P-450, is situated within the major histocompatibility complex on the p arm of human chromosome 6, proximal to the HLA-B antigen locus. Linkage disequilibria between certain B and DR alleles and classical and nonclassical 21-hydroxylase deficiency permit the use of HLA genotyping in conjunction with hormonal evaluation for diagnosis of this disorder and for identification of carrier haplotypes in population studies. Test programs have shown the feasibility of neonatal screening for 21-hydroxylase deficiency by blood-spot hormonal assay for elevated 17-hydroxyprogesterone. Prenatal detection of disease currently depends on HLA serotyping of cultured aminocytes jointly with measurement of amniotic 17-hydroxyprogesterone (13-18 week gestation); molecular genetic techniques with more specific nuclear probes will improve the specificity of this test and will in addition permit even earlier definitive fetal genotyping by chorionic villus biopsy (6-10 week gestation). PMID- 3320532 TI - Glucocorticoid receptor phosphorylation in mouse L-cells. AB - This paper summarizes our observations on the phosphorylation state of untransformed and transformed glucocorticoid receptors isolated from 32P-labeled L-cells. The 300-350-kDa 9S untransformed murine glucocorticoid receptor complex is composed of a 100-kDa steroid-binding phosphoprotein and one or possibly two units of the 90-kDa heat shock protein (hsp90), which is also a phosphoprotein. Transformation of this complex to the 4S DNA-binding state is accompanied by dissociation of hsp90. When receptors in cytosol are transformed by heating at 25 degrees C, there is no gross change in the degree of phosphorylation of the steroid-binding protein. Both receptors that are bound to DNA after transformation under cell-free conditions and receptors that are located in the nucleus of cells incubated at 37 degrees C in the presence of glucocorticoid are labeled with 32P. The results of experiments in which the 32P-labeled receptor was submitted to limited proteolysis suggest that the 16-kDa DNA-binding domain is phosphorylated and that the 28-kDa steroid-binding domain is not. PMID- 3320533 TI - Progesterone-associated proteins PP12 and PP14 in the human endometrium. AB - Two proteins, designated as PP12 and PP14 were originally isolated from soluble extracts of the human placenta and its adjacent membranes. We have shown that they are synthesized by decidualized/secretory endometrium and not by placenta. Both proteins occur at high concentrations in human amniotic fluid, which is therefore an excellent source for purification. PP12 is a 34-kDa glycoprotein, which has an N-terminal amino acid sequence of Ala-Pro-Trp-Gln-Cys-Ala-Pro-Cys Ser-Ala. This is identical with that of somatomedin-binding protein purified from the amniotic fluid. PP12 too binds somatomedin-C, or IGF-I (insulin-like growth factor-I). Human secretory endometrium synthesizes and secretes PP12, and progesterone stimulates its secretion. PP14 is a 28-kDa glycoprotein. Its N terminal sequence shows homology to that of beta-lactoglobulins from various species. We have found PP14 in the human endometrium, serum and milk. Immunologically, PP14 is related to progestagen-associated endometrial protein (PEP), alpha-2 pregnancy-associated endometrial protein (alpha-2, PEG), endometrial protein 15 (EP15), alpha-uterine protein (AUP) and chorionic alpha-2 microglobulin (CAG-2). In ovulatory menstrual cycles, the concentration of PP14 increases in endometrial tissue as the secretory changes advance. In serum, the PP14 concentration begins to rise later than the progesterone levels, and high serum PP14 levels are maintained for the first days of the next cycle. By contrast, no elevation of serum PP14 level is seen in anovulatory cycles. Our results show that progesterone-associated proteins are synthesized by the human endometrium and appear in the peripheral circulation, where they can be quantitatively measured using immunochemical techniques. PMID- 3320534 TI - Fluorescence and chemiluminescence enzyme immunoassays of 17 alpha hydroxyprogesterone in dried blood spotted on filter paper. AB - Enzyme immunoassays for 17 alpha-hydroxyprogesterone (17-OHP) were developed. Horseradish peroxidase (HRP), glucose oxidase (GOD), invertase (INV) and glucose 6-phosphate dehydrogenase (G6PDH) were used as label enzymes. Double antibody coated beads or tubes were used for separating the bound and free fractions. Antisera used were prepared by using 4-carboxyethylthio-17-OHP and 3 carboxymethyl oxime-17-OHP-bovine serum albumin as immunogens. The bridge heterologous system was more sensitive than other site heterologous and homologous systems. The minimum amounts of 17-OHP detected were 0.25 and 1.0 pg/tube for fluorescence EIAs using HRP and GOD, and 0.1, 10 and 0.1 pg/tube for chemiluminescence EIAs using GOD, INV and G6PDH, respectively. The reproducibility and correlation with RIA were also studied. The present study demonstrates the feasibility of a neonatal screening for congenital adrenal hyperplasia. PMID- 3320535 TI - A postulated role for naturally occurring aromatase inhibitors in follicle selection. AB - The studies reviewed here indicate that follicle regulatory protein (FRP) alters aromatase and 3B-hydroxysteroid dehydrogenase activity in porcine, human, and rat granulosa cells. The inhibitory effect of FRP on granulosal aromatase activity depend upon the response of the cell to FSH: large amounts of FSH can partially overcome FRP inhibition while relatively small amounts of FSH sensitize the granulosal aromatase system to FRP. Although androgens potentiate FSH-mediated granulosal functions, they also sensitize granulosa cell steroidogenic enzymes to inhibition by FRP. The demonstration that FRP acts primarily on granulosa cells of less mature antral follicles to inhibit aromatase supports the hypothesis that FRP may facilitate follicle selection and suggests a role for FRP in atresia. Most of the effects of FRP on granulosal activities reflect an interplay between the systemic endocrine and local paracrine systems. That FRP functions, at least in part, by modulating follicular response to FSH is consistent with the hypothesis that paracrine effectors are important mediators of folliculogenesis in the presence of gonadotropins. PMID- 3320536 TI - Immunohistochemical distribution of the 52-kDa protein in mammary tumors: a marker associated with cell proliferation rather than with hormone responsiveness. AB - We have previously described a secreted glycoprotein of mol. wt 52,000 (52-kDa protein) which is induced by estrogen in some human breast cancer cell lines. This protein has been identified as the proenzyme of a lysosomal cathepsin-D-like protease which is secreted in large proportions in breast cancer cells. To determine which information may be generated by this marker when detected in mammary tumors, in comparison with hormone receptors, we used monoclonal antibodies interacting specifically with the 52-kDa protein and its related cellular processed products (mols. wts 48 and 34 kDa). A high concentration of this protein has been shown in proliferative ductal mastopathies and cysts, suggesting its value in detecting high-risk mastopathies. We now present the immunoperoxidase distribution of this protein in breast carcinoma compared to the cytosolic hormone receptors assayed in parallel. In 232 breast cancers, no correlation was found between the cellular 52-kDa protein content and cytosolic estrogen or progesterone receptor concentrations. This absence of correlation was also shown by the constitutive production of this protein by estrogen-receptor negative breast cancer cell lines and confirmed by double immunostaining of breast cancer cell aspirates showing a dissociation between the cytoplasmic staining of this 52-kDa lysosomal protease and the nuclear staining of the estrogen receptor. These clinical results, associated with the in vitro mitogenic and proteolytic activities of this protein, strongly suggest that the 52-kDa protein staining in tissue is associated with tumor proliferation and/or invasion, rather than with hormone responsiveness. PMID- 3320537 TI - The structure and function of progesterone receptors in breast cancer. AB - This paper is a review of the clinical role of progesterone receptors (PR) in the management of breast cancer, and the use of synthetic progestins in treatment of the metastatic disease. Also reviewed are our basic molecular studies dealing with the structure of human breast cancer PR, focusing on the two hormone binding proteins (the A- and B-receptors) and the role of phosphorylation. A model for the structure of PR and their subcellular compartmentalization following hormone treatment is presented. PMID- 3320538 TI - Fundamental research leading to improved endocrine therapy for breast cancer. AB - Whilst endocrine therapy has a long-established role in the management of patients with advanced breast cancer, current therapies produce remission in, at best, only between 30 and 40% of cases. The most efficient use of hormonal measures therefore requires the accurate identification of individuals with hormone-responsive tumours. Oestrogen receptor measurements are useful but not fully discriminatory and additional predictive factors are required. Markers, such as specific hormonally induced proteins and mRNA, and antagonistic systems, such as epidermal growth factor receptors and cyclic AMP binding proteins are currently being evaluated. In terms of therapy, surgical manoeuvres such as adrenalectomy and hypophysectomy have already been replaced by the medical administration of anti-oestrogens, progestogens and drug regimes such as aminoglutethimide-hydrocortisone. Although castration by surgery or radiation remains the first-line treatment in premenopausal women with advanced disease, the advent of depot preparations of LHRH agonists offers the opportunity of performing medical ovariectomies which have the added advantage of being reversible. As a result of laboratory studies, more potent anti-oestrogens and more specific "suicide" aromatase inhibitors are entering into clinical practice. These can be expected to increase efficacy of treatment whilst reducing its side effects. Research using cell-lines of human breast cancer also suggests that anti progestins and agents capable of antagonizing steroid-induced growth factors will inhibit tumour growth. Such novel therapies potentially could make a major impact in the endocrine management of breast cancer. Lastly, although the primary management of early breast cancer predominantly involves non-hormonal modalities, clinical trials are now providing evidence of survival benefit from adjuvant endocrine therapy. The knowledge accrued from the use of newer endocrine agents in advanced cancer could therefore ultimately be relevant to the treatment of earlier stages of the disease. PMID- 3320539 TI - Strategies for breast cancer therapy with antiestrogens. AB - Current clinical research is focused upon the application of adjuvant therapy for the treatment of breast cancer. Combination chemotherapy is the most successful adjuvant therapy for premenopausal patients whereas the antiestrogen tamoxifen (1 or 2 yr) is successful in postmenopausal disease. We have developed a unifying strategy for the treatment of breast cancer. The thesis is based upon the application of continuous adjuvant therapy with tamoxifen in a low estrogen environment. Chemotherapy causes a chemical castration in premenopausal patients. In contrast, tamoxifen causes an increase in steroidogenesis. A combination of both approaches will work against each other until ovarian failure occurs. Patients should be checked for castration to provide a low estrogen environment in which tamoxifen, a competitive antagonist of estrogen action, can effectively work. Laboratory evidence using carcinogen-induced rat mammary tumor models demonstrates the efficacy of long-term therapy. Studies with the human breast cell line MCF-7 grown in athymic mice show that tamoxifen is a tumoristatic agent so that once the therapy is stopped, tumors can be regrown by estrogen administration. Patients should receive continuous tamoxifen therapy to prevent the growth-stimulating effects of adrenal steroids, environmental and phyto estrogens. PMID- 3320540 TI - The present status of the adjuvant endocrine treatment. AB - Adjuvant therapy of breast cancer is accepted as a useful method for reducing mortality in patients with histologically axillary involved lymph nodes. Polychemotherapy regimens and hormonal treatment procedures are used to reach this goal. Hormonal treatment seems to be useful especially in selected patients. This article deals with (a) new methods for selecting hormone-responsive tumors and patients, and (b) it will give a brief overview of major publications concerning adjuvant endocrine therapy and (c) will summarize the data from the Gynecological Adjuvant Breast Group (GABG) trials. PMID- 3320541 TI - Proliferation of AXC/SSh rat prostate cancer cells in vitro is androgen modulated. AB - We used heterogeneous parental cultures of AXC/SSh rat prostate cancer cells to isolate clonally derived prostate cancer cell lines. Light and electron microscopic analyses established that parental and clonally isolated cells possess features characteristic of secretory epithelium. Biochemical analyses showed that these cells contained androgen receptors and acid phosphatase and 5 alpha-reductase activity; phenotypic markers characteristic of differentiated prostate epithelium. Content of these prostate epithelial cell markers was variable and cell line specific. We used selected cell lines to examine androgen modulation of AXC/SSh rat prostate cancer cell proliferation in vitro. We found that proliferation of C-family or D-family cells, those respectively maintained on medium without additions or medium containing 10(-7) M 5 alpha dihydrotestosterone, was not affected by changes in medium testosterone concentration through the range 10(-6)-10(-9) M. In contrast, testosterone modified proliferation of T-family cells, those maintained on medium containing 10(-7) M testosterone, and effects were antagonized by the anti-androgen RU 23908. Preliminary studies established that AXC/SSh rat prostate cancer cells elaborate polypeptide components which stimulate in vitro cell proliferation. Both the ability to elaborate these components and their effects on in vitro cell proliferation appeared to be cell line specific. PMID- 3320542 TI - Seasonal differences in testicular receptors and steroidogenesis. AB - Gonadal function in most animal species exhibits considerable annual fluctuations, with gametogenesis and fertility often being confined to a short and rigidly controlled breeding season. In males, production of androgenic steroids by the testis is usually maximal immediately before and during the breeding season. In the golden hamster, seasonal regression of the testes is associated with decrease in the total content of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin (PRL) receptors, and similar findings have been reported for other mammalian species. However, the concentration of LH and FSH receptors per unit of testis weight is typically elevated rather than suppressed during testicular regression. Reduction in the number of testicular LH and PRL receptors in adult golden hamsters exposed to short photoperiod is due primarily to suppression of pituitary PRL release under these circumstances. Regulation of seasonal changes in testicular FSH binding, as well as regulation of the levels of LH, PRL and FSH receptors in other seasonally breeding species remain to be elucidated. Reduction in the content of LH receptors in the testes is accompanied by reduced capacity to produce androgens in response to LH stimulation. Although these events are likely to be causally related, other mechanisms are also involved. In particular, seasonal regression is accompanied by reduced capacity of the testes to convert C21 steroid precursors into biologically active androgens. Seasonal loss of FSH receptors was reported to be accompanied by increased rather than reduced responsiveness of the Sertoli cells to FSH, thus resembling the situation in immature animals. It can be concluded that alterations in the ability of the testes to bind pituitary gonadotropins and to respond to gonadotropic stimulation are among the mechanisms responsible for seasonal shifts between gonadal activity and quiescence. PMID- 3320544 TI - The measurement of hormones in saliva: possibilities and pitfalls. AB - The easy stress-free, non-invasive nature of saliva collection makes it one of the most accessible body fluids and it is potentially of value in studying normal human physiology as well as pathology. Measurements of salivary hormone levels will usually only be of value if they reflect the plasma level of the hormone and the relationship between the saliva and plasma levels of many hormones have been studied by a number of groups. The measurement of the salivary level is a valuable clinical tool for some hormones (e.g. cortisol, oestriol, progesterone), is of little value for others (e.g. cortisone, dehydroepiandrosterone sulphate, thyroxine, pituitary hormones) and for many others the saliva/plasma relationship is not yet sufficiently understood to assess the value of the salivary measurement. As well as reviewing the state of our knowledge of the salivary concentration of many hormones this review outlines a number of "rules of thumb" concerning the presence of hormones in saliva, their saliva/plasma relationship and the potential usefulness of assays of their salivary concentration. PMID- 3320543 TI - Is progesterone a pre-hormone in the CNS? AB - In this paper, experimental evidences have been presented indicating that progesterone per se appears to be a powerful modulatory steroid of presynaptic striatal dopaminergic terminals of the central nervous system of the rat. This effect of the progesterone signal is concentration as well as infusion mode dependent. Low pulsatile doses of the steroid positively modulate the mechanism by which dopamine terminals respond to amphetamine stimulation and increase tissue dopamine concentration. Whereas, continuous and/or high doses of this steroid negatively modulate the response of the dopamine terminals to amphetamine stimulation and decreases tissue dopamine concentration. This effects occurs through a membrane mediated mechanism either upon the dopamine neuron directly and/or upon an interneuron. Pregnanolone a 5- beta-3 beta-metabolite of progesterone known to activate the hypothalamic LHRH neural apparatus at the level of the hypothalamus of ovariectomized estrogen primed rats in both in vitro as well as in vivo preparations was completely ineffective at the level of the corpus striatum of similar animal preparations. Therefore, it is reasonable to assume that site specific mechanisms exist within the central nervous system which may control differentially the final action of progesterone. In the hypothalamus, pregnanolone appears to be the final signal for its action on the LHRH neural apparatus, whereas in the corpus striatum, the steroid per se, and dependent on the modality and/or the strength of the signal can either directly or indirectly up-regulate (stimulatory component) or down-regulate (inhibitory component) the activity of striatal dopaminergic terminals. PMID- 3320545 TI - The antiprogestins: a recent advance in fertility regulation. AB - RU 468 (mifepristone) is the first antiprogestin available for clinical purposes. Its pharmacological properties are presented. It possesses antiprogestin and antiglucocorticoid activities. It is now in phase II-III clinical studies as a fertility control agent. The drug appears useful per se in four circumstances: (1) for early pregnancy (amenorrhea of less than 5 weeks' duration). Complete interruption is obtained in approximately 90% of women with a single dose of 600 mg. For this stage of pregnancy, RU 486 appears to be an interesting alternative to vacuum aspiration; (2) for late occasional luteal contraception when given as a single dose on the date of the expected period in women at risk of pregnancy; (3) for dead fetus expulsion in the 2nd or 3rd trimester of pregnancy, and (4) for cervical ripening before obstetrical procedures in pregnant women, such as D and C or vacuum aspiration. The antiglucocorticoid activity of the molecule can be demonstrated in humans by a rise in plasma cortisol, ACTH and LPH after RU 486 intake, and by blockade of some peripheral effects of cortisol. Results obtained in more than 1000 women undergoing short-term treatment with RU 486 (600 or 800 mg once) clearly indicate that the antiglucocorticoid activity of the molecule has no clinical relevance at the doses used for fertility control purposes. In conclusion, RU 486 appears to be a promising new tool for fertility control, but large-scale trials are necessary to confirm its safety and to define its optimal mode of utilization for each indication. PMID- 3320546 TI - The influence of steroid hormones on the uterine cervix during pregnancy. AB - This paper reviews the evidence concerning the actions of steroid hormones on the connective tissues of the pelvis. Most available data concern the effects of steroids on the cervix. The time course of cervical softening in rats, sheep and humans suggests the possibility that the changes in connective tissue biochemistry that underlie the physiological phenomenon of cervical softening are under hormonal control. Both oestrogens and progestogens have been implicated in the control of cervical softening. However, recent experiments using inhibitors of 3 beta-hydroxysteroid dehydrogenase suggest that cervical softening can be produced in both sheep and humans by progesterone withdrawal in the absence of high circulating concentrations of oestradiol-17 beta. PMID- 3320547 TI - The syndromes of androgen resistance revisited. AB - A revisit to the existing complexities of the androgen resistance syndromes within the frame of our current knowledge was undertaken. Recent contributions of these and other laboratories are presented according to the topographic intracellular location of the underlying abnormalities causing these inherited disorders. Thus, the clinical spectrum, inherited pattern and biochemical features of defective androgen action at the pre-receptor, receptor, and post receptor levels are examined. In addition, the effects of androgens on the development of gender role is discussed, with particular focus on patients with pre-receptor defects. It was concluded that a better understanding of the nature of the altered events in these syndromes has been achieved over recent years, although several important issues still remain unsolved. PMID- 3320548 TI - Estrogen receptors and androgen receptors in the mammalian liver. AB - An estrogen receptor and an androgen receptor are present in the mammalian liver. In the liver of the rat, the estrogen receptor concentration increases markedly at puberty and this change correlates with enhanced estrogen stimulation of plasma renin substrate synthesis. High doses of estrogen are required for nuclear binding in liver when compared to doses for the uterus. The high dose requirement appears to be predominantly due to extensive metabolism in the hepatocyte of the estrogen to inactive derivatives. Furthermore, estradiol is much weaker than ethinyl estradiol for promoting nuclear binding in the liver. This is due to extremely rapid and extensive metabolism of estradiol. In human liver the concentration of estrogen receptor is low. An androgen receptor is present in high concentration in rabbit liver and is located predominantly in the nucleus after androgen administration. High concentrations of a putative androgen receptor are also present in human liver cytosol. Preliminary studies indicate that synthetic progestins can attach to the human liver androgen receptor. To date, a progesterone receptor has not been found in the mammalian liver. Thus, it appears that extensive steroid metabolism in liver preferentially diminishes sex steroid interaction with liver receptors and that androgen receptors may mediate progestin effects in liver. These observations provide a scientific basis for improved safety of oral contraceptives. Lowering the estrogen and progestin doses in oral contraceptives will decrease the major side-effects, which are liver mediated, and still maintain the desired effects at the hypothalamic-pituitary axis and uterus. Furthermore, it is likely that by selecting which estrogen, progestin or androgen is administered as well as by utilizing a parenteral route of administration that sex steroid effects on the liver could be minimized. PMID- 3320549 TI - Mechanisms of physiological and pharmacological sex hormone action on the mammalian liver. AB - Androgen and oestrogen receptors have been demonstrated in mammalian liver, but since it is generally accepted that they are probably non-functional at endogenous steroid concentrations, it is not apparent how they mediate physiological influences on this organ. Nor is it certain to what extent pharmacological actions of sex hormones reflect overstimulation of physiological routes or whether alternative mechanisms become available once threshold values have been reached. In this presentation an attempt has been made to answer some of these questions using data obtained from a study of the regulation of the activities of microsomal 3 alpha-hydroxysteroid dehydrogenase (3 alpha-HSDH) and 5 alpha-reductase in rat liver. Androgens exert their primary physiological and pharmacological influences at the level of the hypothalamus. Oestrogens can elicit three different types of effect-physiological, antiandrogenic and pharmacological--of which the first two involve primary effects on the pituitary. Hepatic oestrogen receptors only become activated when oestrogen concentrations reach pharmacological levels. Progestins probably have no physiological influence on the livers of non-pregnant rats. Their pharmacological actions may either be traced back to secondary androgenic (e.g. medroxyprogesterone acetate, levonorgestrel) or oestrogenic (e.g. norethynodrel, lynestrenol) properties, involving the routes described above, or to independent effects on the central nervous system (e.g. cyproterone acetate modulation of 5 alpha-reductase activity). PMID- 3320550 TI - Bacterial metabolism of natural and synthetic sex hormones undergoing enterohepatic circulation. AB - Steroids undergoing enterohepatic circulation are exposed to bacterial metabolism particularly by obligate anaerobes which account for 99.99% of the fecal flora. The most common transformation is hydrolysis of conjugated steroids. The glucuronidases are synthesized by Escherichia coli and Bacteroides species. The bacterial catabolism of unconjugated steroids may be considered under several headings: 1. Reduction of ring-A due to clostridia species synthesizing specific enzymes; C. paraputrificum, 3 alpha,5 beta-reductase; C. innocuum, 3 beta,5 beta reductase; and a new species C.J-1, 3 beta,5 alpha-reductase. 2. Reduction of the delta 5 bond by human fecal flora. The specific strain(s) synthesizing the enzyme have not yet been identified. 3. Reduction of 17-keto estrogens by the above mentioned ring-A reducing clostridia and by Eubacterium lentum. 4. Reduction of 17-keto androstenes by Bacteroides fragilis. 5. Desmolase mediated side chain cleavage at C17-C20 position of 17 alpha-hydroxysteroids by two new species Clostridium scindens and Eubacterium desmolans isolated from human and cat fecal flora respectively and by Clostridium cadavaris isolated from New York City sewage. 6. And 16 alpha- and 21-dehydroxylase by E. lentum a normal inhabitant of the human gut; it is the only organism known to synthesize 16 alpha- or 21 dehydroxylases. Due to the high specificity of the enzymes and the simplicity of extracting the metabolites, biosynthesis of reference compounds and radioimmunoassay reagents is practical and inexpensive. The enzymes can also be used for titration of specific bacterial strains in fecal flora and as markers for bacterial identification in particular for the strains difficult to be defined by regular biochemical reactions. PMID- 3320552 TI - The metabolism of 19-nor contraceptive progestins modulates their biological activity at the neuroendocrine level. AB - In this communication, a series of studies from our laboratory dealing with the mechanism of action of 17 alpha-ethinyl derivatives of 19-nor testosterone are reviewed. The administration of norethisterone (NET) to long-term castrated female rats induces the nuclear translocation of pituitary estradiol receptors and is followed by some estrogenic-like effects at the hypothalamic-pituitary unit. It is established that an A-ring reduced metabolite of NET, the 3 beta,5 alpha-tetrahydro NET derivative, is responsible for the observed in vivo estrogenic effects of the parent compound. 3 beta,5 alpha-NET binds to the estrogen receptor and is efficient in inducing the pituitary estrogen-dependent progesterone receptor and in increasing the uterine weight in long-term castrated rats. Furthermore, administration of 3 beta,5 alpha-NET and the 5 alpha-reduced metabolite of NET (5 alpha-NET) are able to inhibit the release of gonadotropins in the castrated animal to a greater extent than NET. Moreover, pretreatment with tamoxifen, an estrogen binding site competitor, results in a significant diminution of the antigonadotropic potency of 3 beta,5 alpha-NET but not of the 5 alpha-NET, which is only inhibited by the administration of cyproterone acetate. These findings underline the importance of the metabolic rate of NET for the expression of its biological effects at the hypothalamic-pituitary unit. PMID- 3320551 TI - Physiological and pathological effects of steroids on the function of the adrenal cortex. AB - The adrenal cortex is the site of the synthesis of steroid hormones such as the glucocorticoid cortisol and the mineralocorticoid aldosterone. The pathway of biosynthesis of these steroids from cholesterol involves a sequence of transformations using cytochrome P-450 enzymes which varies within the adrenal cortex as a result of the differential localization of enzymes within the zones. The hypothesis presented here is that as a result of the arrangement of the vasculature in the adrenal gland, high concentrations of steroids may be expected to accumulate and may have autoregulating effects. These may include the following: (1) the normal morphological and functional zonation of the adrenal cortex may be regulated by gradients of steroids in the adrenal cortex; (2) destruction of cytochrome P-450 enzymes on interaction with certain steroids which act as pseudosubstrates may form part of the pathogenesis of some steroidogenic enzyme deficiencies. Under normal conditions, the individual cytochrome P-450s are not rate-limiting for steroidogenesis. Under some pathological conditions, individual cytochrome P-450 enzyme activities may become rate-limiting, with consequent overproduction of precursor steroids, leading to mineralocorticoid or androgen excess. PMID- 3320553 TI - Gonadal steroids and neurosecretion: facilitatory influence on LHRH and neuropeptide Y. AB - Luteinizing hormone releasing hormone (LHRH) is regarded as the primary hypothalamic signal that controls reproduction in the rat. Neuropeptide Y, a recently isolated hypothalamic peptide, appears to regulate LHRH secretion. Our studies show that gonadal steroids act in multiple ways to enhance the neurosecretory functions of each of these neuronal systems and, in addition, they promote excitation by NPY of LHRH release from the hypothalamic nerve terminals. PMID- 3320555 TI - The role of the hypothalamus in aging of the female reproductive system. AB - We have investigated the role of neuroendocrine and neurochemical changes in the age-related deterioration of cyclic female reproductive function. During middle age the timing and amplitude of the proestrous and estradiol-induced LH surge is altered. We have found that the diurnal pattern of norepinephrine turnover is altered in critical hypothalamic areas known to regulate the release of LHRH. These changes may contribute to alterations in the timing and the amplitude of LH release, which may, in turn, affect the ability of rats to maintain regular estrous cycles. PMID- 3320554 TI - Aging of the hypothalamo-pituitary-ovarian axis: hormonal influences and cellular mechanisms. AB - Longitudinal studies employing heterochronic ovarian grafts and long-term ovariectomy indicate that there is no single pacemaker of reproductive aging. Neuroendocrine dysfunction, the declining follicular reserve, and ovarian secretions all contribute to reproductive decline, and their relative importance to the different stages of reproductive aging varies markedly. Moreover, although ovarian secretions during adulthood potentiate certain aspects of the reproductive aging process, their behavior does not fit a simple model of cumulative steroidal damage incurred over the lifespan. Current data are more consistent with temporally distinct windows of steroidal vulnerability for the events affected: cycle lengthening is affected by ovarian secretions during the period of cyclicity, and post-cyclic neuroendocrine failure is potentiated by ovarian secretions during the peri- and post-cyclic period of the lifespan. Recent examination of estradiol receptor dynamics reveals multiple, albeit selective, changes during aging that may contribute to the age-related impairments of tissue sensitivity to estrogen. These changes vary qualitatively and quantitatively among target tissues. Thus, aging of the hypothalamo-pituitary ovarian axis at the cellular level mirrors, in its multifactorial nature, aging at the organismic level. PMID- 3320557 TI - Regulation of low density lipoprotein receptor and cytochrome P-450scc mRNA levels in human granulosa cells. AB - hCG and 8-bromo-cAMP increase the levels of the mRNAs encoding the LDL receptor and cytochrome P-450scc in human granulosa cells. The increment in these mRNAs occurs rapidly after stimulation (within hours). Actin mRNA levels are not changed by hCG and 8-bromo-cAMP treatment. The tropic hormone effects on LDL receptor mRNA are observed even in the presence of 25-hydroxycholesterol and aminoglutethimide, which by themselves suppress LDL receptor mRNA. Actinomycin D blocks the hCG and 8-bromo-cAMP promoted augmentation of LDL receptor mRNA, suggesting that the tropic factors act to increase transcription of this gene. Treatment of cells with cycloheximide increases LDL receptor mRNA levels, and the stimulatory response to hCG and 8-bromo-cAMP is enhanced in the presence of cycloheximide. This indicates that tropic hormones act to increase LDL receptor mRNA levels without requiring synthesis of intermediary proteins and suggests that some short-lived protein may actually be reducing LDL receptors mRNA levels in these cells. We conclude that gonadotropins increase steroidogenesis in human granulosa cells, in part, by increasing expression of mRNAs encoding specific proteins involved in cholesterol metabolism. PMID- 3320556 TI - Structure of genes encoding steroidogenic enzymes. AB - Synthesis of adrenal steroid hormones from cholesterol entails the actions of only five enzymes, four of which are specific forms of cytochrome P450. These cytochrome P450 enzymes have all been isolated and their activities reconstituted in vitro, showing that each enzyme catalyses multiple steroidal conversions. Genes or complementary DNAs have been cloned for human P450scc (the cholesterol side-chain cleavage enzyme), P450c17 (17 alpha-hydroxylase/17,20 lyase) and P450c21 (21-hydroxylase). The sequences for microsomal P450c17 and P450c21 are much more closely related to one another than either is to the sequence for mitochondrial P450scc. Each of these P450 enzymes is encoded by a single human gene; the gene for P450scc lies on chromosome 15, that for P450c17 lies on chromosome 10, and that for P450c21 lies on chromosome 6. The human, mouse and bovine genomes each have two P450c21 genes. While only one of these is active in mouse and man, both genes may be active in cattle. A wide variety of lesions in the human P450c21(B) gene causes congenital adrenal hyperplasia, a common genetic disorder. PMID- 3320558 TI - Aromatase. AB - Aromatase catalyzes the conversion of androgens to estrogens through a series of monooxygenations to achieve the 19-desmolation and aromatization of the neutral steroid ring-A structure. We have separated two forms of aromatase, a major (P2a) and a minor (P3) form, from human term placenta through solubilization and chromatography. Partially purified aromatase in each form was immunoaffinity chromatographed to give a single band (SDS-PAGE) cytochrome P-450 of 55 kDa, utilizing a mouse monoclonal anti-human placental aromatase cytochrome P-450 IgGi (MAb3-2C2) which is capable of suppressing placental aromatase activity. The purified cytochrome P-450 showed specific aromatase activity of 25-30 nmol/min per mg with Km of 20-30 nM for androstenedione on reconstitution with NADPH-cyt P 450 reductase and dilauroyl L-alpha-phosphatidylcholine. This one step represents a higher than 100-fold purification with maintenance of the same Km. The stability analysis showed a half-life of more than 5 yr for solubilized aromatase and 2 months for the aromatase cytochrome P-450 on storage at -90 degrees C. Contrary to the recent claim that estrogen biosynthesis by reconstituted human placental cytochrome P-450 is by trans-diaxial 1 alpha,2 beta-hydrogen elimination, all of our partially purified forms and reconstituted aromatase synthesized estrogens by cis-1 beta, 2 beta-hydrogen elimination. Use of purified aromatase and [19-3H3, 4-14C]androstenedione led us to discover a metabolic switching by aromatase to 2 beta-hydroxylation of androgen. Results of the MAb3 2C2 suppression of aromatase activity in different species and tissues including human, baboons, horses, cows, pigs and rats indicated the presence of various isozymes of aromatase. PMID- 3320559 TI - Versatile steroid molecules at the end of the aldosterone pathway. AB - 18-hydroxycorticosterone converts spontaneously and reversibly to a variety of less polar forms and derivatives, some of which are precursors to aldosterone. In particular, 21-hydroxy-11 beta, 18-oxido-4-pregnene-3,20-dione (18-DAL) is hydroxylated to aldosterone with high yields in the presence of malate and NADP+, at pH 4.8. 18-DAL also behaves as a metabolic intermediate between 18-OH-B and aldosterone according to time-course and trapping experiments. Consequently, the final steps of the aldosterone pathway at pH 4.8 could be identified as 18-OH-B, 18-DAL and aldosterone, in this sequence. The submitochondrial distribution of aldosterone biosynthesis is compatible with this postulate. The work also shows that some forms of 18-OH-B are promoters of hydrogen transport in renal tubuli and that this regulation may be independent of sodium reabsorption. These results suggest a regulatory model, new in steroid biology, according to which steroid molecules bearing an oxidized angular C18-methyl may undergo structural changes between precursor ("P") and hormonal ("H") forms in response to homeostatic requirements. PMID- 3320560 TI - Developmental changes in responsiveness to vitamin D metabolites. AB - We have demonstrated that epiphyseal chondroblasts contain specific receptors for 24R,25-dihydroxy vitamin D3(24,25(OH)2D3) while diaphyseal osteoblasts contain specific receptors for 1 alpha 25-dihydroxy vitamin D3(1,25(OH)2D3). Both metabolites induce DNA synthesis and creatine kinase (CKBB) activity. We have also found that the responsiveness of rat kidney to these metabolites changes during development. In embryonic and early postnatal stages, the kidney responds to 24,25(OH)2D3, later to both 24,25(OH)2D3 and 1,25(OH)2D3, and the mature kidney only to 1,25(OH)2D3. These responses correlate with changes in the specific receptors present in the kidney. Furthermore, we have compared developmental changes in skeletal (epiphysis, diaphysis and mandibular condyle) and non-skeletal (kidney, cerebellum, cerebrum, liver and pituitary) tissue in both rat (a postnatal developer) and rabbit (a perinatal developer). Epiphyseal or diaphyseal chondroblasts at any stage of development were predominantly responsive to 24,25(OH)2D3, whereas osteoblasts were responsive to 1,25(OH)2D3. In contrast, condylar chondroblasts, kidney, cerebellum and pituitary responded to 24,25(OH)2D3 during early development and subsequently developed responsiveness to 1,25(OH)2D3. Using primary cell cultures from kidneys at different stages of maturation, we showed the same developmental pattern as in vivo. Chronic treatment of the cells with 24,25(OH)2D3, but not 1,25(OH)2D3, caused precocious development of responsiveness to 1,25(OH)2D3 in culture. We suggest that 24,25(OH)2D3 acts as a maturation factor, during early development in kidney, and probably in other tissues, possibly by induction of receptor to 1,25(OH)2D3, accompanied by down-regulation of its own receptor. PMID- 3320561 TI - Main endocrine modulators of vitamin D hydroxylases in human pathophysiology. AB - Vitamin D is considered to be devoid of direct biological activity. It must be first hydroxylated in the liver by a 25-hydroxylase (25OHase), then in the kidney by a 1 alpha-hydroxylase (1 alpha OHase) which is responsible for the synthesis of the active metabolite, 1,25-dihydroxyvitamin D (1,25(OH)2D). The activity of 1 alpha OHase is known to be under the control of a series of endocrine modulators, particularly parathyroid hormone (PTH) and estrogens. We report here our studies in humans concerning the behaviour of vitamin D hydroxylases in some pathological conditions. In chronic liver disease no severe impairment of vitamin D-25 hydroxylation has been observed, except in the latest stages: this is probably due to the great functional reserve of the liver, so that normal levels of serum 25OHD can be maintained on condition that the vitamin D supply is adequate. 1 alpha OHase is impaired in chronic renal failure due to the decrease in the number of functioning nephrons. It has been demonstrated that kidney transplantation restores normal 1,25(OH)2D levels. A decrease in 1,25(OH)2D production due to reduced PTH stimulation has been observed in hypoparathyroidism: in these patients a subcutaneous substitution therapy with synthetic human parathyroid hormone resulted in restoration of normal 1,25(OH)2D levels. A reduced activity of 1 alpha OHase due to reduced estrogen stimulation plays a key role in postmenopausal osteoporosis. In these patients estrogens increase 1,25(OH)2D levels, as it has been demonstrated directly and indirectly. In the aforementioned pathological conditions an impairment of calcium absorption has been observed; it was directly related to the reduced production of 1,25(OH)2D. Treatment with 1,25(OH)2D3 was effective in restoring normal calcium absorption. In postmenopausal osteoporosis the reduced levels of 1,25(OH)2D were accompanied by serum levels of 25-hydroxyvitamin D (25OHD) higher than in age matched control women. In these cases long-term treatment with physiological doses of 1,25(OH)2D3 resulted in a progressive decrease in 25OHD serum levels which approached to the normal range. These findings are likely to be related one to another: the low 1,25(OH)2D levels are responsible for reduced product inhibition of 25OHase, so that the synthesis of 25OHD increases. A similar mechanism occurs in renal failure and in hypoparathyroidism. PMID- 3320562 TI - Action and metabolism of dihydrotachysterol2. AB - Dihydrotachysterol2 (DHT2) is a synthetic analogue of vitamin D2. DHT2 is used extensively in the treatment of renal osteodystrophy and hypoparathyroidism. It is equally efficacious as 1 alpha,25-dihydroxyvitamin D3 and 1 alpha hydroxyvitamin D3. Moreover, it offers interesting therapeutical advantages and it is surprising that until recently little was known of its metabolism and sites of action. This paper deals with studies on the pharmacology of DHT2 in rats. Following the synthesis of [3H]DHT2 and oral administration, evidence was obtained that DHT2 is metabolized extensively; three of the major metabolites could be identified as 25-hydroxy-DHT2, 1 alpha,25- and 1 beta,25-dihydroxy-DHT2. PMID- 3320563 TI - Synthesis of antiprogestational steroids. AB - The discovery of the first competitive progesterone antagonist RU 38,486 has initiated an intense search for more potent and more selective anti-progestins. Among several hundreds of compounds under preliminary investigation, biological characterization is most advanced for derivatives RU 38,486, ZK 98,734 and ZK 98,299. These compounds do not only differ in relative potency, but are clearly distinguished by their different behaviour in various animal models. Emphasis is laid on the synthetic problems associated with chemical operations in a sterically crowded environment as represented by structures RU 38,486 and ZK 98,299. PMID- 3320564 TI - Arterial effects of aldosterone and antimineralocorticoid compounds mechanism of action. AB - The aim of our work was to study the mechanism of action of aldosterone and antialdosterone compounds on Na+ and K+ fluxes in vascular smooth muscle. In the long term, regulation of salt metabolism depends on aldosterone effects on Na+, K+, H+ and H2O transport by the renal tubules. Furthermore, it has been shown that aldosterone modifies several epithelial transports, inducing a positive sodium balance. The chronic in vivo administration of aldosterone modifies transmembrane ionic fluxes in vascular smooth muscle. Garwitz and Jones suggested that aldosterone may enhance net Na+ transport through the stimulation of the sodium pump. The results obtained in our laboratory indicate that aldosterone has a direct stimulatory action on ouabain-dependent and on ouabain-independent Na efflux. Furthermore, the mineralocorticoid enhances passive K permeability, as well as the Na pump dependent K influx. Both effects are blocked by antimineralocorticoid compounds. Recent experiments have shown that vasopressin potentiates some of the in vivo effects of aldosterone. PMID- 3320565 TI - Pharmacological and clinical studies of the antiandrogen Anandron. AB - This paper summarizes the animal and human studies with Anandron available at the time of the meeting. The following was demonstrated in the rat and confirmed in man: interaction of Anandron with the prostatic androgen receptor, antiandrogen activity against testosterone (in particular against the early transient rise induced by LHRH analogs) and adrenal androgens. Thus, as shown in 4 different double blind studies performed in stage D2 prostrate cancer patients, the combination of Anandron with surgical or chemical castration enhanced the beneficial effects of castration alone and thus seems a step forward in the hormonal treatment of prostatic carcinoma. PMID- 3320566 TI - Interactions of tamoxifen in the chicken. AB - The triphenylethylene antiestrogens are very potent antagonists of estrogen action in the chicken and manifest little agonist activity compared to their action in other species. The estrogen antagonism is most probably mediated by the estrogen receptor, to which tamoxifen binds with a Ki of 2.6 nM. Tamoxifen is readily metabolized by liver to 4-hydroxytamoxifen, which binds the liver nuclear estrogen receptor with a Ki of 0.1 nM. The Kd of the receptor is 0.7 nM. Estrogen receptor concentrations in liver from immature chickens are relatively low both in nuclear and cytosol fractions. Treatment with estradiol results in 10-fold up regulation of the nuclear levels to give a total receptor concentration of about 2 pmol/g tissue. Tamoxifen can promote this up-regulation to a limited extent, but interpretation of experimental results is compromised by difficulties with exchange assays in the face of the very high binding affinity of 4 hydroxytamoxifen. Tamoxifen also binds with high affinity (Kd 2-4 nM) and distinctive specificity to antiestrogen binding sites (AEBS) present in a wide variety of chicken tissues and in the highest concentration in the liver (800 pmol/g tissue). Liver and serum contain ether-soluble components which can compete for binding of [3H]tamoxifen to the AEBS. The serum AEBS inhibitory activity is chromatographically heterogeneous and is associated with a sterol like fraction as well as with a fatty-acid-containing fraction. Tamoxifen treatment of cockerels results in dose- and time-dependent decreases in serum free and esterified cholesterol, and in phospholipids and triglycerides. These changes may reflect estrogen-receptor-independent interactions of tamoxifen. PMID- 3320567 TI - The complexity of anti-estrogen responses. AB - The actions and biological responses of anti-estrogens are a function of: the experimental conditions, the parameters, the organ and the animal species considered. Target tissues for estrogens in the guinea-pig during the perinatal period are interesting models to explore the action of anti-estrogens. The summary of the data indicates: (1) In the fetal uterus of guinea-pig in in vivo experiments (after injection to the maternal compartment) tamoxifen acts as a real agonist concerning growth, as a partial agonist concerning the stimulation of the progesterone receptor. (2) In in vitro experiments (in organ culture of fetal uterus or in isolated cells) anti-estrogens (tamoxifen or 4-hydroxy tamoxifen) act as antagonists and also inhibit the effects provoked by estrogens. (3) In the uterus and vagina of newborn guinea-pigs, tamoxifen and its derivatives: 4-hydroxytamoxifen and N-desmethyltamoxifen act as real agonists concerning the uterotrophic and vaginotrophic effects, and also stimulate the amount of DNA per organ, but concerning the progesterone receptor in the uterus, in the short treatment anti-estrogens act as partial agonists but they have no effect in the long treatment. In the vagina in the short treatment anti-estrogens provoke no significant effects, but in the long treatment they are full agonists. In neither of the two biological responses studied (growth and progesterone receptor) does tamoxifen and its derivatives block the action of estradiol. (4) The use of a monoclonal antibody to the estrogen receptor revealed quantitative differences in the activation of the estrogen receptor when bound to estradiol or tamoxifen. This observation was in agreement with the lesser extent of binding to DNA-cellulose of the tamoxifen-estrogen receptor complex as compared with the estradiol-estrogen receptor complex. This fact suggests an impaired activation of the estrogen receptor induced by tamoxifen which might be related to the different biological responses provoked by estrogens and anti-estrogens. PMID- 3320568 TI - Aromatase inhibitors: basic and clinical studies. AB - Application of aromatase inhibitors to the treatment of conditions in which estrogen plays, a role is discussed. Studies in vitro demonstrate that 4 hydroxyandrostenedione (4-OHA) is a potent inhibitor of aromatase. The compound reduces ovariant estrogen production and causes regression of carcinogen (DMBA) induced mammary tumors in the rat. In the rhesus monkey, 4-OHA was also shown to inhibit peripheral aromatization. To date 58 postmenopausal breast cancer patients with advanced metastatic disease have received 500 mg im weekly while 31 patients received 250 mg 4-OHA orally per day. Estradiol levels were significantly reduced in all patients from a mean of 7.2 + 0.8 pg/ml to 2.8 + 0.3 pg/ml. Of patients receiving 4-OHA im 27% had partial or complete responses and in 10% of patients the disease was stabilized. Similar responses occurred in the patients receiving 4-OHA orally. These results suggest that 4-OHA is effective and that this compound and other aromatase inhibitors could be valuable new additions to the treatment of breast cancer. PMID- 3320569 TI - Binding and action of aldosterone, dexamethasone, 1-25(OH)2D3, and estradiol along the nephron. AB - The localization of specific binding sites of four steroids--aldosterone, dexamethasone, 1-25-dihydroxycholecalciferol and estradiol--is described along the nephron. This localization has been determined by using an autoradiographic method on dry films, applied to intact microdissected tubular segments. Aldosterone binds specifically to nuclei of the distal and cortical collecting tubule. No specific labeling was observed in the cytoplasm. This localization corresponds to the known sites of action of aldosterone on sodium reabsorption. Specific nuclear binding of dexamethasone is present all along the tubule except the proximal tubule. In this latter part of the nephron, a specific cytoplasmic labeling is observed, in the absence of nuclear labeling. This cytoplasmic binding could correspond to physiological effects in this structure, via non genomic mechanisms. 1-25(OH)2D3 nuclear binding is located mainly in the loop of Henle and medullary collecting tubule, which are the sites of synthesis of calcium-binding proteins. No specific binding of estradiol is present in any part of the nephron. PMID- 3320570 TI - Role of 18-hydroxylated cortisols in hypertension. AB - The isolation of 18-hydroxycortisol and 18-oxocortisol was recently described. These steroids have been shown to be excreted in exaggerated quantities in patients with primary aldosteronism, with adrenal adenomas and in glucocorticoid suppressible aldosteronism. We report the measurement of both steroids in the urine of patients with essential hypertension. 18-Oxocortisol excretion did not differ in patients with normal renin essential hypertension (0.7 +/- 0.7 micrograms/24 h), low renin essential hypertension (0.7 +/- 0.5 micrograms/24 h) and normal individuals (1.2 +/- 0.9 micrograms/24 h). Patients with normal renin hypertension excreted 54 +/- 43 micrograms/24 h of 18-hydroxycortisol, those with low renin essential hypertension excreted 58 +/- 54 micrograms/24 h, and normal individuals excreted 63 +/- 36 micrograms/24 h. Three of the low renin and one of the normal renin hypertensive subjects excreted greater quantities of 18 hydroxycortisol than the upper limit of normal, but all excreted normal quantities of 18-oxocortisol. As 18-hydroxycortisol is inactive, the meaning of this elevated excretion is unclear, but it may be a marker of an adrenal enzymatic abnormality which may be playing a more direct role in hypertension. PMID- 3320571 TI - Peripheral oestrogen metabolism in postmenopausal women with or without breast cancer: the role of dietary lipids and growth factors. AB - Studies we have carried out have revealed significant differences in oestrogen production and metabolism between normal women and postmenopausal women with breast cancer. The free, biologically available fraction of oestradiol is elevated in plasma from women with breast cancer and we have found that metabolic clearance rates and production rates of oestradiol are also increased. In vitro studies have suggested that lipids can influence the distribution of sex steroids in plasma and we have therefore examined the effect of dietary lipids on the distribution of sex steroids in plasma in vivo. Consumption of a meal with a high saturated fat content or the oral or i.v. administration of "Intralipid", a stabilised emulsion of soya bean oil that is high in unsaturated free fatty acids, had little effect on the available fractions of oestradiol in plasma. However, results from a preliminary study suggest that long-term changes in dietary fat intake can alter the distribution of steroids in plasma. It is concluded that dietary lipids may influence the availability of sex steroids to tissues. Such a mechanism could account for the significant correlation that has been found between dietary fat consumption and the incidence of breast cancer on a world-wide basis. PMID- 3320572 TI - The place of progesterone in human contraception. AB - Progesterone, the natural hormone produced by the corpus luteum and other steroid secreting glands, is endowed with antiestrogenic action and has a fundamental role in the initiation and maintenance of pregnancy and in the regulation of gonadotropin secretion. Although it was discovered half a century ago, it has found little clinical use as a therapeutic agent due to its low potency and extensive degradation following oral administration in comparison with a variety of highly potent synthetic analogs that became available in the last three decades. When delivered systemically, a large proportion of the dose bypasses degradation in the gut and liver, and progesterone can achieve effective levels in target tissues for clinical use. Sustained administration via compressed pellets implanted subdermally or silicone rubber rings placed in the vagina produced circulating levels of progesterone within the lower third of those found in the luteal phase of the human menstrual cycle. Those levels were shown to delay the recovery of fertility in nursing women without adverse effects to the mother or the infant. Progesterone transferred to the babies via the breast milk did not change their rate of pregnandiol-3-alpha glucuronide excretion. It is concluded that sustained administration of the natural hormone progesterone may be an effective and safe contraceptive method for nursing women. PMID- 3320573 TI - Development of a sensitive enzymeimmunoassay (EIA) for progesterone determination in unextracted bovine plasma using the second antibody technique. AB - A simple direct enzymeimmunoassay (EIA) on microtiter plates for plasma progesterone using the second antibody coating technique and horseradish peroxidase (HRP) as the enzyme label (EIA-HRP) is described and compared with an identical EIA procedure which employed alkaline phosphatase (AP) as the enzyme label (EIA-AP). The assays used antiserum raised against progesterone-7 carboxyethlthioether-BSA in rabbits. Both systems were further compared with the conventional direct progesterone radioimmunoassay (RIA) in regular use. The enzymes HRP and AP were coupled to progesterone-6 beta-hydroxy-hemisuccinate by a mixed anhydride method. While the precision of EIA-HRP was comparable to RIA, the sensitivity in terms of the lowest detection limit obtained in EIA-HRP was about 10 times better than that seen in RIA. Progesterone estimates from plasma samples in EIA-HRP showed good correlation (r = 0.94) with the RIA values and the levels measured in the two systems were identical. Progesterone estimates from plasma samples in EIA-AP were at least three times higher than those obtained by either EIA-HRP or RIA. Thus, only the EIA-HRP but not the EIA-AP was suitable for the reliable direct measurement of progesterone in plasma. PMID- 3320574 TI - Use of an enzymeimmunoassay (EIA) for quantitation of cytosolic and nuclear estrogen receptor, and correlation with progesterone receptor in human breast cancer. AB - We have adapted a commercially available enzyme immunoassay for ER (ER-EIA) for use with nuclear extracts of breast carcinoma specimens, and have examined the data obtained in relation to the results from cytosolic ER-EIA and radioligand (DCC) assays and from DCC assays for PgR. In a series of 139 carcinoma specimens, we observed a very significant correlation between the cytosolic ER concentration as measured by the EIA and DCC methods, and also between the log10 of the concentration of ER in the cytosolic and nuclear fractions assayed by the ER-EIA method. The correlation between nuclear ER and cytosolic PgR was also highly significant, but not as close as for cytosolic ER. If 130 fmol ER/mg DNA was used as a "cut-off" point to discriminate between specimens "positive" and "negative" for ERN, there was 87% concordance in receptor status between ERN and cytosolic ER, and 79% concordance between ERN and cytosolic PgR. Forty-one percent of specimens were positive or borderline for both ERN and cytosolic PgR, and it is suggested that this receptor combination may be a valuable predictive factor in prognosis and response to hormonal treatment. PMID- 3320575 TI - Recent developments in the measurement of vitamin D and its metabolites in human body fluids. PMID- 3320576 TI - Unusual extramedullary relapse of acute lymphoblastic leukemia in a bone marrow transplant patient. AB - An unusual form of relapse of acute lymphoblastic leukemia is described in a woman who developed a solitary large focal mass of lymphoblasts in her liver and an isolated polypoid lymphoblastic mass in her uterus after bone marrow transplantation, despite continued marrow remission. Extramedullary visceral leukemic relapse in the form of such discreet focal masses is highly unusual and to our knowledge has not been described in this setting. Awareness and recognition of atypical forms of relapse are important since such a diagnosis carries critical therapeutic and prognostic implications. PMID- 3320577 TI - Combination of low-dose cytarabine and 13-cis retinoic acid in the treatment of myelodysplastic syndromes. AB - Responses have been reported in patients with myelodysplastic syndromes (MDS) after low-dose cytarabine (Ara-C) or 13-cis-retinoic acid (13-CRA) therapy. Recently, combination of these two substances in vitro was shown to produce a synergistic effect on differentiation of leukemic cells. We conducted a phase II trial with low-dose Ara-C (5 mg/m2 per 12 h s.c.) and 13-CRA (60 mg/m2 per day orally) in 14 patients with MDS, six of whom had refractory anemia with excess of blasts (RAEB), seven had RAEB in transformation (RAEBt) and one chronic myelomonocytic leukemia (CMML). The drugs were administered from day 1 to 14 and the treatment courses repeated every 4 to 8 weeks. One partial response and one minor response could be achieved. Major toxicity included dry skin, mucositis and cheilitis in 11 of the 14 patients. The response rate is no better than the results reported in the literature with either drugs alone. As yet there is no satisfactory treatment for MDS. PMID- 3320578 TI - Identification and characterization of an antigen specific for normal erythroid precursor cells and its application in diagnosis of erythroleukemia. AB - A monoclonal antibody (designated K:1-6F) generated by hybridization of mouse myeloma cells with spleen cells from mice immunized with the erythroleukemic cell line K562 was found by fluorescence-activated cell sorter analysis, dot-blot assay and electroimmunoblotting to bind to a majority of cells in the K562 and HEL erythroleukemic cell lines, to a subset of cells of the erythroid lineage from normal bone marrow, to a subset of cells in all analysed cases (total 10) of erythroleukemia, and weakly to cells from patients with myeloid leukemia. The antibody did not bind to normal erythrocytes, monocytes, T- and B lymphocytes or granulocytes, as well as a panel of human malignant cell lines of hemopoietic origin (HL60, U937, Daudi, Molt-3, RH-L4 and U266). Biochemical characterization of the antigen defined by the antibody suggests that eht epitope is defined by a carbohydrate structure alone or in combination with proteins. Four molecules with Mr 100 kD, 65 kD, 45 kD and 18 kD respectively were immunoprecipitated from Triton X-100 extract of K562 erythroleukemia cells. Neuraminidase did not affect the binding of the antibody, whereas tunicamycin reduced the K:1-6F expression. The K:1-6F Mab was in normal bone marrow found to be specific for erythroid precursor cells and may therefore be useful in examination of normal and leukemic erythropoiesis. PMID- 3320579 TI - Comparison of the sensitivity of normal and leukaemic myeloid progenitors to in vitro incubation with cytotoxic drugs: a study of pharmacological purging. AB - The sensitivity of myeloid leukaemic colony forming cells (AML-CFC), to five cytotoxic drugs has been compared in two culture systems with the sensitivity of normal myeloid progenitor cells (GM-CFC). No increased sensitivity was found for AML-CFC to any of the chemotherapeutic agents studied. AML-CFC were significantly less sensitive than normal GM-CFC to mafosfamide at the doses commonly used to purge bone marrow autografts. It is suggested that AML cells probably display similar sensitivity to cytotoxic agents as normal myelopoietic cells at a similar stage of differentiation. Hence complete elimination of the leukemic clone by pharmacological purging may be incompatible with bone marrow re-engraftment. We conclude that purging AML autografts with any of the agents examined has little scientific basis. PMID- 3320580 TI - A new method for studying cell cycle characteristics in ANLL using double labeling with BrdU and 3HTdr. AB - Ten patients with acute nonlymphocytic leukemia (ANLL) received bromodeoxyuridine (BrdU) at 100 mg/M2 intravenously over 1 h. BrdU is incorporated into the DNA by S-phase cells and was detected by using a monoclonal anti-BrdU antibody in the bone marrow aspirate (BM) and biopsy specimens obtained at the end of the infusion. Additionally, BM was incubated in vitro with tritiated thymidine (3HTdr) and processed by our previously described double-label method. This allowed us to measure the duration of S-phase (Ts) and total cell cycle time (Tc) of myeloblasts. Data revealed a higher number of S-phase cells from biopsies (21%) than BM (5%). The Ts ranged from 9 to 35 h and Tc ranged between 36 and 152 h in different patients. Using this method, data are available within 48 h and if shown to be clinically relevant, may be useful for prospective planning of therapy in individual patients. PMID- 3320581 TI - Removal of cells from a malignant B-cell line from bone marrow with immunomagnetic beads and with complement and immunoglobulin switch variant mediated cytolysis. AB - In this report we describe the generation of complement (C') fixing IgG2b CD19 and CD22 monoclonal antibodies (mAbs) by the isolation of immunoglobulin (Ig) class switch variants using a simple and efficient method for the selection of spontaneously mutating hybridomas. The aim of this study was to compare the efficacy of C'-mediated cytolysis vs immunomagnetic (IB) depletion of tumor cells from mixtures of malignant B cells and normal bone marrow. In a clonogenic assay employing the B-cell lines Namalwa and OCI.LY1, we found that the use of immunomagnetic beads warranted a highly efficient tumor cell removal independent of the Ig isotype of the mAbs used. Elimination of up to 4 log was achieved using a cocktail consisting of CD19, CD20, CD22 and CD37 B-cell mAbs. A less efficient killing of 2 log was obtained by C' lysis using IgM mAbs, while only about 1 log tumor cell elimination was obtained using IgG2b mAbs. Immunomagnetic purging, besides being more effective than C'-mediated cytolysis, is easier to handle and more rapid. PMID- 3320582 TI - Post-trial hormonal treatment effects: memory modulation or perceptual distortion? AB - An extensive literature has developed in recent years demonstrating that a variety of peripheral-acting hormonal and pharmacological treatments, administered in post-trial learning paradigms, can substantially influence memory. Careful analysis of the effects of such treatments in passive avoidance paradigms has provided evidence for an interaction between these treatments and the hormonal and physiological events triggered by the noxious stimulation used to induce passive avoidance behavior. The argument developed in this paper is that such post-trial manipulations distort the relationship between the intensity of the noxious stimulus and its physiological sequelae. Considered in this light, changes in passive avoidance behavior appear to represent perceptual distortions rather than memory effects, per se. That is, rather than interfering or enhancing memory processes, peripheral hormonal treatments may simply produce distortions in the perceived intensity of the noxious stimulus. PMID- 3320583 TI - The artificial beta cell: control of the milieu interieur. PMID- 3320584 TI - Experimental and clinical experience with the Pennsylvania State University total artificial heart. PMID- 3320585 TI - Estimation of instantaneous flow from the indicator-dilution curve after bolus injection of indicator. PMID- 3320586 TI - Algorithms for fast computation of the intensity weighted mean Doppler frequency. PMID- 3320587 TI - Noninvasive measurement of arterial diameters in humans using ultrasound echoes with prefiltered waveforms. PMID- 3320588 TI - Low-cost Doppler signal simulator. PMID- 3320589 TI - The high cost of medical technology. Getting at the heart of the matter. AB - This article presents a review of the development of coronary care units (CCUs) as a paradigm for the uncritical acceptance of technology in medical services. Studies comparing CCU with other settings for treatment of acute myocardial infarction are described in which intensive care is not shown to offer a consistent benefit over more conservative treatment. The proliferation of CCUs as it relates to corporate involvement in medical research (as argued by Waitzkin) is presented. Finally, methodologies now being applied to improve patient selection for CCU services are summarized. PMID- 3320590 TI - Consumerism in health care. Prevalence and predictors. AB - Current efforts to contain health care costs include a variety of strategies aimed at the users of health services. These approaches attempt to encourage users to be more cost-conscious and to shop for lower-cost services and more efficient health care plans. The primary method for achieving this is by increasing the consumer's exposure to the cost of health insurance and the cost of care. The assumption is that approaches that increase cost-sensitivity will stimulate greater consumerism among the users of care. This paper presents findings from a study that investigates the extent to which members of insured populations have a consumer approach to health care, identifies factors related to consumer behaviors and attributes, and examines the degree to which consumer cost-sensitivity is associated with other consumer-oriented behaviors. The data used are derived from face-to-face interviews. Only a minority of the respondents engage in the examined consumer behaviors. Both social demographic and attitudinal factors affect the likelihood of engaging in consumer behaviors. Being cost-sensitive appears to be only a minor stimulant to other consumer attributes. Policy implications are discussed. PMID- 3320592 TI - Patient shifting as a response to Medicare Prospective Payment. AB - The Medicare Prospective Payment System (PPS) regulations provide hospitals with strong incentives to discharge patients sooner. It seems reasonable to assume that a large number of these discharged patients may require posthospital care in long-term care facilities (LTCFs). Such shifting of patients from hospitals to LTCFs would be evidenced by a sicker population of patients requiring more extensive and intensive treatments in the post-PPS period. The purpose of this study was to determine the extent to which patient shifting occurred after implementation of the PPS regulations. Data were collected from the medical records of 353 patients admitted to 10 LTCFs in Georgia both before and after the PPS was implemented. Comparisons of the two groups indicated no significant differences in LTCF admitting diagnoses, numbers of patients dying or being readmitted to the hospital within 30 days of LTCF admission, prognosis, or rehabilitative potential. The groups differed to a statistically significant extent on three treatment and health status variables: patients in the post-PPS group were more likely to be incontinent of bladder, to have nasogastric tubes, and to be on dietary supplements. These differences may suggest the beginning of a trend to shift heavier care patients into LTCFs. As a whole, however, the results of this study indicated limited shifting of patients from hospitals to LTCFs in Georgia during the first year after implementation of the PPS regulations. PMID- 3320591 TI - Some clarification about health planning in the VA. PMID- 3320593 TI - Switching and the definition of modality in end-stage renal disease treatment. AB - End-stage renal disease treatment expenditures have increased greatly in recent years. Modality of treatment is a very important factor in determining costs as well as outcome and quality of life. Using quarterly observations on treatments received by ESRD patients, this paper presents a definition of modality based on type of treatment received and setting in which treatment is received. This paper also documents the magnitude of switching among defined modalities. Because many patients switch modality, selection of one modality is really a selection of a probable course of treatment by several modalities. The careful definition of modality and recognition that switching occurs are important first steps in conducting cost-effectiveness type analyses of ESRD treatment. PMID- 3320594 TI - Advertising by physicians. Behavior and attitudes. AB - This article analyzes 380 responses to a systematic sample of 800 physicians in Pennsylvania regarding their advertising behavior and attitudes. The use of advertising is growing despite the fact that most of these physicians are averse to advertising and pessimistic about its effects. Several multivariate techniques are applied to generate a statistical model of the probability that a given physician will advertise. The proportion of physicians who advertise is quite small, and it remains difficult to predict accurately whether a given physician will advertise. Nevertheless, the results suggest several factors that influence the decision. The advertisers are significantly younger than their peers. In addition, advertising is somewhat more prominent among physicians in larger group practices, among primary care physicians, and among those physicians for whom the chief means of reimbursement is the prepayment contract. The research has relevance for health care marketing and for policy analysis concerned with the effects of recent court decisions that remove restrictions on physician advertising. PMID- 3320595 TI - An experiment to change detection and management of mental morbidity in primary care. AB - A randomized clinical trial was conducted in a group practice for the primary care of adult patients to address the effect of feedback to providers of information from a psychiatric screening questionnaire, the General Health Questionnaire (GHQ). The practice is staffed by faculty, residents, and health care extenders of The Johns Hopkins University School of Medicine's Division of Internal Medicine. The patient population was drawn mainly from the inner city community in Baltimore that surrounds the hospital, where the practice is physically based. The GHQ was administered at the time of a regular visit to the practice and results made available to the clinicians for randomly allocated subsamples of their patients. The study results showed that feedback of GHQ information led to only marginal effects on overall detection of mental health problems among the patients in general. However, marked increases in detection occurred among the elderly, blacks, and men, subgroups that ordinarily have relatively low rates of detection of mental morbidity by primary care practitioners. Feedback of GHQ information did not affect management. PMID- 3320596 TI - RUGs and equity of access to nursing home care. AB - Case-adjusted prospective reimbursement systems, such as resource utilization groups (RUGs), may promote nursing home cost containment, but they may do no better than existing systems at encouraging homes to admit the more dependent and thus costlier Medicaid patients, if the homes' reluctance to admit these patients is due to a shortage of nursing home beds. Using 1983 data on Wisconsin nursing homes, this paper presents evidence that suggests that the presence of excess demand, rather than low reimbursement rates, causes nursing homes to exclude the more costly Medicaid patients. Consequently, to benefit fully from RUGs, it is necessary either to eliminate excess demand (by increasing supply or decreasing demand) or to decide which patients have priority for admission and assign reimbursement payments to these patients that significantly favor these patients. Otherwise, access to nursing home care under RUGs is left to chance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320597 TI - Assessing a methodology for physician requirement forecasting. Replication of GMENAC's need-based model for the pediatric specialty. AB - Methodologies for determining levels of U.S. physician requirement are as complex as they are controversial. One long-standing controversy surrounds the advantages of an epidemiologic need-based forecasting model over an economic demand-based model. This paper examines the need-based requirement approach as recently developed by the Graduate Medical Education National Advisory Committee (GMENAC). This approach is assessed for the pediatric specialty by replicating the original model using data derived from three large HMOs. These data were empirically obtained from the computerized visit records of more than 10,000 children at each of the three plans and normatively from Delphi panels consisting of pediatric practitioners at those same sites. Results indicate that if U.S. pediatrician requirement was estimated on the basis of HMO practice data, rather than GMENAC's national ideals, fewer physicians would be needed. The pediatric requirement based on local Delphi panel judgments was lower still, due in great part to the suggestion of increased delegation rates to nonphysician providers. Implications of this comparative analysis for the GMENAC need-based methodology and future physician requirement modeling efforts are discussed. PMID- 3320598 TI - Diabetes regimen behaviors. Predicting adherence. AB - In this study, Social Learning Theory was used to generate psychosocial predictors of regimen adherence among persons with insulin-dependent diabetes mellitus (IDDM). Four categories of predictors were formed: knowledge, expectancies, skills, and environmental support. Persons with IDDM (84 adults and 23 adolescents) completed measures within each predictor category on two occasions, separated by 6 months. Multimethod assessment procedures (self monitoring, interviews, mechanical devices) were used to measure adherence to four aspects of the IDDM regimen: insulin injections, glucose testing, diet, and exercise. Bivariate analyses demonstrated that measures of expectancies and environmental support were reliably related to several adherence behaviours. In particular, self-efficacy expectations were related to adherence across almost all regimen areas for both adolescents and adults. Skills were also important, though only for adolescents, whereas regimen knowledge was unrelated to adherence for either adults or adolescents. Multivariate analyses showed that expectancies were consistently predictive of adherence and that, in general, psychosocial variables were better predictors of insulin administration and glucose testing than of diet or exercise. The implications of these findings for diabetes education programs are discussed. PMID- 3320599 TI - [Immunological and cytochemical changes in groups at risk for acquired immunodeficiency syndrome and in symptomatic and asymptomatic carriers of antibodies to human immunodeficiency virus. A multivariate study]. PMID- 3320600 TI - [Glomerulopathies and neoplasms]. PMID- 3320601 TI - [Combination of angiotensin-converting enzyme inhibitors and calcium antagonists: an effective therapeutic regimen in hypertensive crisis]. PMID- 3320602 TI - [Thyroid disorders associated with myasthenia gravis]. PMID- 3320603 TI - [Infection by human immunodeficiency virus in childhood: the hidden face of parenteral drug addiction]. PMID- 3320604 TI - [Medical complications caused by cocaine consumption]. PMID- 3320605 TI - [The quality of clinical information (I): Validity]. PMID- 3320606 TI - [Chronic cerebral vascular insufficiency and mental deterioration]. PMID- 3320607 TI - [Salmonella enteritidis bacteremia]. PMID- 3320608 TI - [Treatment of dystonic blepharospasm and hemifacial spasm with botulinum toxin: preliminary studies]. PMID- 3320609 TI - [Physiopathological diagnosis of changes in uric acid metabolism: hyperuricuria and nephrolithiasis]. PMID- 3320610 TI - General concepts on the chemotherapy of infectious diseases. AB - Chemotherapy affects both the host and the microorganism. Antimicrobial agents have a profoundly adverse influence on the surrounding environment if they are improperly employed. In all chemotherapy, it is critical to know what the infecting organisms are, and if that information is not immediately available, to base chemotherapy on those organisms that characteristically produce the infection. It also is critical to have an understanding of the distribution of antibiotic-resistant microorganisms in one's community if the proper antimicrobial agent is to be selected. The host's status and site of the infection will impact upon the choice of drug. Infection in sites in which phagocytic function is poor, such as in heart valves or in the spinal fluid, or in individuals lacking complement, white blood cells, or immunoglobulins, must be treated with bactericidal agents. An understanding of the pathogenesis of infection caused by different microorganisms will provide insights into the type of therapy, duration, and amount of drug that must be used. Ultimately, the chemotherapy of infection should be based on integration of the activity of antimicrobial agents with their pharmacologic properties. PMID- 3320611 TI - Diagnostic laboratory procedures in infectious diseases. AB - Useful diagnostic information can be provided by the microbiology laboratory in a variety of infectious diseases. It is important to obtain an appropriate specimen and to provide the laboratory with relevant information. The value and limitations of in vitro susceptibility testing are discussed. PMID- 3320612 TI - Antibiotic combinations. AB - Combinations of antimicrobial agents are most often used to provide empiric broad spectrum coverage. Other potential reasons for combination therapy include treatment of polymicrobial infections, to enhance killing or inhibition (synergism), to reduce the potential for developing resistance, and less commonly to allow reduction in the dose of a toxic agent. However, combination regimens are often used unnecessarily and can result in increased side effects, costs, and other undesirable effects. PMID- 3320613 TI - The penicillins. AB - Penicillin derivatives have an extraordinary track record of safety and efficacy since their introduction in the late 1940s. The in vitro activity, pharmacokinetics, adverse reactions, and clinical use of these agents are reviewed. PMID- 3320616 TI - Erythromycin. AB - Erythromycin is the only macrolide antibiotic to have gained widespread use in the United States. Introduced in 1952, it rapidly gained a popularity that it enjoys to this day. Numerous other antimicrobial agents have been marketed since that time: Whole new classes of antibiotics, both natural and synthetic, have been discovered, studied, and released for general use. Many of these newer agents boast a broader spectrum of antimicrobial activity, yet erythromycin's place in the clinician's arsenal is unthreatened because erythromycin remains the drug of first choice for a number of pathogens against which the new drugs are inactive. It is one of the safest antibiotics available for use today and when used against susceptible organisms and in indicated clinical situations, its effectiveness is unquestioned. PMID- 3320614 TI - The cephalosporins. AB - Structural modification of cephalosporin antibiotics has produced a broad array of new compounds, notable chiefly for greatly extended gram negative activity with minor toxicity. An understanding of basic principles will enable most clinicians to use these drugs appropriately and effectively. PMID- 3320615 TI - Vancomycin: a review. AB - This article reviewed the past experience and updated the present data on vancomycin. In recent years, with the release of more purified preparations of vancomycin and new clinical problems facing the clinician (that is, increasing prevalence of serious methicillin-resistant staphylococcal infections; use of hemodialysis and CAPD; widespread use of prosthetic devices; aggressive chemotherapy), the indication for vancomycin use has increased dramatically. More information is needed on the distribution of vancomycin in body tissues and the incidence and mechanisms of toxicity. Close surveillance of in vitro susceptibility patterns will be necessary as widespread use of vancomycin continues to increase. PMID- 3320617 TI - Chloramphenicol and tetracyclines. AB - Tetracyclines have a broad range of clinical usefulness because of their broad antimicrobial spectrum of activity. For most routine gram positive and gram negative infections, alternative agents are available, but for Chlamydiae, Rickettsiae, Brucella, and Borrelia they still remain agents of choice. To some extent, gastrointestinal intolerance and inability to use these agents in patients with renal dysfunction have been overcome by the availability of doxycycline. Phototoxicity is a problem with this agent, however. Tetracycline is still useful as a sclerogenic agent for malignant effusions, and demeclocycline often is an agent of choice in therapy of inappropriate antidiuretic hormone secretion. PMID- 3320618 TI - Clindamycin. AB - Clindamycin is an excellent, well tolerated, effective antimicrobial agent that can be used clinically in the treatment of specific anaerobic infections as well as clinical situations when both S. aureus and anaerobes occur together. PMID- 3320619 TI - Trimethoprim-sulfamethoxazole and other sulfonamides. AB - Trimethoprim-sulfamethoxazole continues to be a useful antibiotic for common outpatient problems such as urinary tract infections, prostatitis, acute exacerbations of chronic bronchitis, and acute otitis media as well as for serious infections of the hospitalized patient including Pneumocystis carinii pneumonia, acute pyelonephritis, and some forms of gram negative meningitis. The other sulfonamides have a limited role. PMID- 3320620 TI - [Minimycetomas caused by N. brasiliensis. Histological study of 13 cases]. AB - We present a preliminary communication of the histological findings in 16 cases of mini-mycetoma by N. brasiliensis. We found little PAS positive granules, fully evident with the Gram stain, localized at the center of the microabscesses. Ten cases showed Russell bodies, 33% showed multinucleated giant cells and the 50%, epithelioid cells. All cases showed abundant capillary vessels and intense fibrosis. PMID- 3320621 TI - [Linear sebaceous nevus syndrome]. AB - We report a patient that fulfills the clinical features of the linear nevus sebaceous syndrome. This syndrome was defined by the triad: Linear nevus sebaceous, seizures and mental retardation. Further descriptions suggested an association with hamartomas of mesenchymal structures and increased risk of neoplasm transformation. Previously reported cases are reviewed. The complexity of classification of this neurocutaneous syndrome is discussed. PMID- 3320622 TI - [Dermatoses caused by footwear made of synthetic material: the rubber-boot syndrome]. AB - One hundred patients, workers from a meat packing plant that wear rubber boots while working, were studied. Besides the well known allergic manifestations to rubber or other plastic materials used in footwear other pathologic findings included mycotic and bacterial lesions formed by plantar hyperhidrosis with the development of bromhidrosis and plantar xanthokeratoderma. These occupational dermatoses are a medical problem, but also have social and economical implications. PMID- 3320623 TI - [Cutaneous metastasis of a cloacogenic tumor]. AB - A case of cloacogenic carcinoma with cutaneous metastases in a 74 year old man is reported. The patient presented with a six months history of two polyps of the lowest portion of the anal canal. Physical examination of the inguino-scrotal area revealed a 5 X 7 cm. hard infiltrative plaque with three ulcero-vegetative scars. Histologic examination of both polyps revealed two of the four cytologic patterns described in this neoplasm. One polyp showed undifferentiated cells, type IV and second one, type II differentiated. The biopsy of the cutaneous metastases showed dermal infiltrative clusters of the cytologic type II differentiated epidermal cells. Treatment with radiotherapy and chemotherapy was ineffective. Cloacogenic carcinoma of the canal anal is a transitional cells neoplasm believed to arise from vestigial remnants of cloacal origin. Metastases occurred in 19% of cases but cutaneous colonization develops exceptionally. PMID- 3320624 TI - [Effect of bornaprine in localized hyperhidrosis]. AB - Therapeutic action of bornaprine on localized forms of hyperhidrosis is studied in 12 patients. 50% improved after a week treatment. Other patients showed an acceptable change in the third or fourth week. Side effects only appeared in one patient. PMID- 3320625 TI - [Recurrent polychondritis (report of a case)]. AB - A case of relapsing polychondritis with atrophic lesions in nose and ears and conjunctivitis is presented. The patient was treated with dapsone during 18 months with remission of the acute breaks. PMID- 3320626 TI - [Cutis "trunci variata." A new genetic dermatosis]. AB - A maculo-hypochromic condition is not rarely seen in brown-skinned adolescents and young adults, that may spread over the skin of the trunk, specially the lumbar, sacral and epigastric regions assuming a considerable psychologic important. It is generally confused with pityriasis versicolor or its hypochromic sequelae. The histologic and genetic study of the condition remains undone. It is provisionally considered among genodermatoses and the name cutis trunci variata is being proposed for it. PMID- 3320627 TI - [Generalized lichen planus with erosive lesions of the penis, treated with thalidomide. Report of a case and review of the literature]. AB - A patient with generalized lichen planus with lesions in the infrequent localization like face, palms, soles and an extensive erosion of glans penis, is described in a 46 year old patient. He had received various treatment which include systemic steroids, without improvement. After treatment with thalidomide (initial doses 300 mg/day for 2 weeks and 200 mg/day for further 10 weeks) he presents resolution of his lesions and symptomatology. A review of lichen planus etiopathogenesis, making emphasis in the immunological hypothesis is made. As well as the different uses and action mechanism of thalidomide in various inflammatory dermatoses. PMID- 3320629 TI - [Experience with homemade substrates for mycology]. AB - The meaning of the words "home-made", "medium" and "soil" is defined. The formulae are given and the manner for preparing lactritmel, lacmel and tritmel is described. The same for horse and cow dung agar soils is done. The lactritmel (20 fold diluted in water) is recommended for the specific diagnosis of Candida albicans in its nascent culture. The first results are communicated, as obtained by slide culturing fungi on banana (Musa paradisiaca) fruit pulp without previous sterilization. The amusing aspect of fungi-culturing is emphasized. PMID- 3320630 TI - [Acquired digital fibrokeratoma. Apropos of 3 cases]. AB - Acquired digital fibrokeratomas are uncommon benign fibrous tumors frequently situated on fingers. Histopathologic findings include an acanthotic hyperkeratotic epidermal envelope that surrounds a core of normal appearing connective tissue. Clinical, histopathological aspects and differential diagnosis are discussed. PMID- 3320628 TI - [Centrifugal annular erythema caused by insect bites]. AB - The authors present a case of a 4 1/2 years old child who showed erythema annulare with generalized lesions which extended centrifugally. The lesions was present since 1 month after birth and she never been free of them until few days after she start to use insect antigen vaccine, when they disappeared entirely. PMID- 3320631 TI - [Anetoderma and lupus erythematosus. Study of 2 cases]. AB - Two cases of anetoderma and lupus erythematosus (LE) were studied. The first one showed secondary anetoderma and subacute LE. There was leucocytoplastic angitis in involved skin besides generalized lacking of elastic fibers (EF). The second one is a Schweninger Buzzi anetoderma with face and scalp lesions of LE tumidus. In new lesions angitis and immunoglobulin deposits of EF were seen. Another cases, pathogenic and characteristics of this unusual association were analyzed we pointed out: 1) leucocytoplastic angitis presence; 2) immunoglobulin deposits on EF finding; 3) angitis seems to play a principal rol in elastic fibers disappearance. PMID- 3320632 TI - Cerebroprotective effect of nicergoline and interference with the anti-hypoxic effect of prostacyclin. AB - The cerebroprotective effect of nicergoline was studied using the following experimental methods: hypobaric and anoxic hypoxia in mice, complete ischemia by decapitation in mice, incomplete ischemia by bilateral carotid ligation in rats, hemic hypoxia in rats and asphyxic anoxia in cats. Xanthinol nicotinate, vincamine, vinpocetine and cinnarizine were used as reference drugs. In hypobaric hypoxia and complete ischemia by decapitation the interaction of nicergoline with the effect of prostacyclin (PGI2) was investigated. Nicergoline showed cerebroprotective effect of varying potency in all the methods used except asphyxic anoxia. Nicergoline manifested a synergic effect with PGI2 shifting its anti-hypoxic dose-response curve to the left. PMID- 3320633 TI - [Late effects of poliomyelitis--a review and current experiences]. PMID- 3320635 TI - [All pregnant women should be screened for Streptococcus group B]. PMID- 3320634 TI - [Homologous bone transplantation in acetabular bone defects in the loosening of the prosthesis]. PMID- 3320636 TI - [The man behind the syndrome: Henrik Sjogren. He elucidated the importance of tear production for the eye]. PMID- 3320637 TI - [Clinical spectrum in HIV infections. Investigation and therapy of opportunistic infections]. PMID- 3320638 TI - [ECG 1887-1987. Historical notes and current developments]. PMID- 3320639 TI - [The man behind the syndrome: Alois Alzheimer. Optimism and joy behind the discovery]. PMID- 3320640 TI - [Plastipore prosthesis in the animal experiment]. AB - The goal of this study was to evaluate histologically the tissue response to Plastipore implants in the middle ear of guinea pigs three months after implantation. The histologic response to the Plastipore implants showed a fibrous capsule formation covered by an epithelial sheet already after one week. Fibrous tissue of the capsule infiltrated larger surface pores. Multinuclear giant cells and macrophages were the predominant cell types in the porosity of the Plastipore implants. There was no clear evidence of breakdown of the prostheses. Plastipore elicits a focal foreign body phagocytic response and shows a limited biocompatibility. PMID- 3320641 TI - [Differential diagnosis of vascular-induced diseases of the neck using Doppler and B-mode sonography]. AB - Diagnostic ultrasound of the neck is used mainly for soft tissue examination. Doppler and B-mode sonography are highly valuable methods for the recognition and differentiation of cervical vascular diseases. The advantage of diagnostic ultrasound of cervical vessels in early detection of scarred carotid stenoses after operation and radiotherapy, for the differentiation of neuro-otological diseases, for the detection of primary vascular neck tumours and surgery of neck tumours is demonstrated in selected patients. Diagnostic Doppler and B-mode ultrasound of the cervical vessels facilitates and improves differential diagnosis and therapeutic management for ENT specialists. PMID- 3320642 TI - [Bilateral carotid artery aneurysms in extensive cancer of the base of the tongue. A rare differential diagnosis in cervical swellings]. AB - Enlarged cervical lymph nodes are a common feature in advanced head and neck cancer. In the present paper the case of a 58 year old male patient is reported, who was suffering from a huge carcinoma of the base of tongue. He also complained of bilateral cervical swellings, which were regarded as enlarged, metastatic lymph nodes prior to operation. When performing a bilateral, elective neck dissection, the swellings appeared as aneurysms of the extracranial part of the internal carotid artery. Aneurysms of the supraaortic branches are very rare and mainly located in the subclavian or axillary arteries. Only a few cases of bilateral aneurysms of the internal carotid artery have been described in the literature so far. Nevertheless, this peculiar morphological feature must be considered in the differential diagnosis of bilateral enlarged lymph nodes in head and neck cancer patients. PMID- 3320643 TI - [Echographic diagnosis in orbital complications of inflammatory diseases of he paranasal sinuses]. AB - A- B-scan sonography was performed in a consecutive series of 123 patients with acute orbital complications of inflammatory paranasal sinus diseases. Orbital edema was correctly diagnosed by echography in 100% orbital periostitis in 81%, subperiosteal abscesses in 100%, and orbital cellulitis in 92%. In a second series, 40 mucopyoceles were all correctly diagnosed by sonography. Furthermore echography revealed a collateral subperiosteal edema and a moderate thickening of extraocular muscles and bone periostitis, a massive swelling of muscles and bone defects in subperiosteal abscesses as well as encapsulated abscesses of the orbit and a concomitant retrobulbar neuritis in orbital cellulitis. PMID- 3320644 TI - [Echographic diagnosis in tumors of the paranasal sinuses with invasion of the lacrimal ducts]. AB - In 16 patients the histologically proven diagnosis of a lacrimal sac tumor was made; in 9 of them a paranasal sinus tumor had invaded the lacrimal pathways, in 7 patients existed a primary tumor of the lacrimal sac, A- and B-scan sonography allow a clear-cut differentiation of both these entities. Furthermore primary and tumor-related inflammations of the lacrimal pathways can be distinguished by echography, which thereby provides the decisive diagnostic basis for the different therapeutic procedures in each case. PMID- 3320645 TI - [Demonstration of IgE associated cells in atopic nasal mucosa using the immunoperoxidase method]. AB - IgE-associated cells in the specimens of 25 allergic and non-allergic subjects were stained by the peroxidase technique with the use of a polyclonal antiserum. The technique is described and its advantages over the immunofluorescence procedures are shown. In each allergic subject IgE-associated cells could be stained, whereas no cells could be found in non-atopic subjects after suppressing non-specific background staining (Fig. 4). Therefore, this method allows to distinguish between IgE-mediated allergic diseases of the nasal mucosa and diseases of other pathomechanisms. The stained cells formed a specific distribution pattern with a typical accumulation in the subepithelial and epithelial layer (Fig. 2), whereas only few cells were found in the mucosal glands. PMID- 3320646 TI - [Rhytidoplasty: perioperative guidelines. Particular technical basic details]. AB - The authors present their philosophy of rhytidoplasty and the basic technical details of this kind of operation. The aging face often causes psychological as well as social problems that make patients go to a facial plastic surgeon. The authors stress the importance of an intensive preoperative information. Basic details of preoperative preparation, surgical technique and postoperative care are emphasised because they represent decisive steps in terms of the aesthetic results obtained. These details proved to be mostly important in the course of about 5000 rhytidoplasties. PMID- 3320647 TI - [Symptoms and findings of giant cell arteritis in the area of the ear, nose, and throat]. AB - Jaw claudication (angina masticatorica) is one of the best known signs of giant cell arteritis (Horton's arteritis). Other symptoms are pain, swelling, redness and necrosis of the face, mouth, and nasal mucosa (ulcerous pharyngitis, glossitis) leading to disturbances in swallowing. In rare cases there are alterations of smelling and hearing. The knowledge of such non-characteristic symptoms can be of diagnostic importance in cases of Horton's arteritis without local signs in the temporal area, visual failure or polymalgia rheumatica. PMID- 3320648 TI - [Bone marrow transplantation]. PMID- 3320650 TI - [Regular dialysis and kidney transplantation as complementary methods of treatment--medical and economic aspects]. PMID- 3320649 TI - [Kidney transplantation in the Surgical Clinic of the Clinical Hospital Center in Rijeka--present status and perspectives]. PMID- 3320651 TI - [Transplantation of the cornea]. PMID- 3320652 TI - [Computer-assisted medical decisions]. PMID- 3320653 TI - Morphological and biochemical changes in the pineal gland in pregnancy. AB - Although systematic and detailed studies of pineal structure and function during pregnancy are rare, the available evidence indicates that morphological and biochemical changes do take place in this gland during this reproductive state. The majority of studies indicate increased activity in cytoplasmic organelles and enzymes of pinealocytes during gestation. Changes in pineal and plasma melatonin levels in pregnancy have been described in a number of species. Results of biochemical studies emphasize the existence of the feedback system which involves the gonads, the hypothalamus and the pineal gland. More ultrastructural and biochemical studies on this intriguing gland in pregnancy are fully warranted. PMID- 3320654 TI - Specific insulin binding in bovine chromaffin cells; demonstration of preferential binding to adrenalin-storing cells. AB - Insulin binding was studied in subpopulations of bovine chromaffin cells enriched in adrenalin-producing cells (A-cells) or noradrenalin-producing cells (NA cells). Binding of 125I-insulin was carried out at 15 degrees C for 3 hrs in the absence or presence of excess unlabelled hormone. Four fractions of cells were obtained by centrifugation on a stepwise bovine serum albumin gradient. The four fractions were all shown to bind insulin in a specific manner and the highest binding was measured in the cell layers of higher densities, containing mainly A cells. The difference in binding of insulin to the four subpopulations of chromaffin cells seemed to be related to differences in numbers of receptors as opposed to receptor affinities. We conclude that bovine chromaffin cells possess high affinity binding sites for insulin and that these binding sites are mainly confined to A-cells. PMID- 3320655 TI - Relationship of pre-S encoded antigens in liver and clinical manifestations of chronic hepatitis B infection. AB - Pre-S1 and pre-S2 encoded antigens of hepatitis B virus were localized in liver tissue using monoclonal antibodies. They were found to be exclusively expressed in the cytoplasm of liver cells. Cell bound pre-S1 encoded protein was often detected in patients with chronic liver disease and viremia. Only a small number of the HBsAg positive cells also contained pre-S1 antigen. There was no correlation with nuclear HBcAg. Livers of non-viremic HBsAg carriers contained many HBsAg expressing liver cells, that were frequently also positive for pre-S2 encoded protein but contained no detectable pre-S1 encoded protein at all. It remains open whether cell bound pre-S2 containing proteins of middle size have a significance for pathogenesis, as they are present in individuals with chronic liver disease as well as in healthy HBsAG carriers, and may be associated with both increased and normal liver enzymes. Cell bound pre-S1 antigen with viremia may, however, be involved in the maintenance of viremia and liver disease. PMID- 3320656 TI - Histopathological analysis of chronic hepatitis B virus (HBV) infection in relation to HBV replication. AB - The interrelationship among expression patterns of hepatitis B surface and core antigens (HBsAg and HBcAg) in the liver, hepatitis B virus (HBV) DNA in sera, HBeAg/anti-HBe status and histological features was examined in 189 liver specimens and 106 sera from Japanese patients with chronic HBV infection, utilizing immunoperoxidase methods and a spot hybridization technique. HBsAg and HBcAg were distributed uniformly among the lobules in 8 viral carriers with "normal" liver (NVC) and 30 patients with persistent hepatitis (PB) seropositive for HBcAg. This uniform staining pattern was quite distinct from the non-uniform and irregular patterns in 137 patients with chronic active hepatitis (CAH) associated with or not associated with cirrhosis. HBcAg was often found to be stained strongly in the cytoplasm as well as in the nucleus of hepatocytes in HBeAg-positive CAH, in contrast to NVC/PH, in which cytoplasmic HBcAg was very weak. Serum HBV DNA was detected in all 22 cases with HBeAg-positive NVC/PH, 41 of 46 (89.1%) cases with HBeAg-positive CAH, 6 of 23 (26.1%) casew with anti-HBe positive CAH and none of 3 cases with anti-HBe-positive NVC/PH. The level of serum HBV DNA and staining of HBcAg were in decreasing order in these groups. While the presence of serum HBV DNA and HBcAg staining was always associated with HBeAg seropositivity in NVC/PH, this was not always found in CAH. Moreover, necroinflammatory activity in the liver did not always parallel viral replication in CAH. These findings seem to confirm that NVC/PH and CAH have different biologic processes; viral replication is always concordant in the former, but is sometimes discordant in the latter with HBeAg/anti-HBe status. The immunologic response of the host seems to suppress and distort replication of the virus to a varying degree among patients and areas of the same liver in CAH differently to that in NVC/PH. The different life cycle of the virus, including integration of viral DNA into the cellular genome, may subsequently result in discordant states of various virus markers in CAH. PMID- 3320657 TI - MR imaging of multiple hepatic cysts in a patient with polycystic liver disease. AB - We report a case of a 55-year-old woman with polycystic liver disease that we examined with magnetic resonance (MR) imaging, CT and ultrasound. The MR images demonstrated varying intensities in the cyst contents which we believe is due to different degrees and age of hemorrhage. Such variability among the cysts was not seen on the CT or ultrasound images. PMID- 3320658 TI - Adolescent growth and development. PMID- 3320659 TI - Risk factors for early sexual activity and early unplanned pregnancy. PMID- 3320660 TI - Medical management of pregnant adolescents. PMID- 3320661 TI - "Life-style" and pregnancy outcome in adolescents. PMID- 3320662 TI - Adolescent parenthood: implications for care of the mother and child. PMID- 3320663 TI - A rapid enzyme-linked immunosorbent assay (ELISA) for IgG antibodies to Candida albicans: preliminary studies in duodenal ulcer patients. PMID- 3320664 TI - Microbiological comparison of a new infra-red blood culture system (Bactec NR 600) and a radiometric system (Bactec 460). PMID- 3320665 TI - Microbial enzymes in laboratory diagnosis. PMID- 3320666 TI - A double labelling technique for the analysis of lymphocyte sub-sets on a single laser flow cytometer. PMID- 3320667 TI - [History of junior medical education in Russia]. PMID- 3320668 TI - [Care of the mentally ill in prerevolutionary Russia (based on materials from the Poltava Insane Asylum)]. PMID- 3320669 TI - [S. A. Podolinskii--physician, scientist, revolutionary]. PMID- 3320671 TI - [A mine field. Notes on relations with elderly patients]. PMID- 3320670 TI - [70 years of medical technology]. PMID- 3320672 TI - [Simultaneous test of ventricular function and myocardial perfusion during exercise with a new agent labelled with Tc99m]. PMID- 3320673 TI - [Experimental subacute cryptococcosis in Wistar rats]. PMID- 3320674 TI - Gene expression of carbohydrate metabolism in cellular senescence and aging. AB - There is a general slowing of protein biosynthesis with increasing age that appears to be universal and involved in the mechanism of aging. One of the apparent expressions of this aging mechanism is an age-related decreased induction of many enzymes including, as the focus of this analysis, those of carbohydrate metabolism. The impaired induction of these enzymes contributes to the slowing of several carbohydrate metabolic pathways, and parallels a marked age-related diminution in the generation of anabolic metabolites and energy compounds from these pathways. Intracellular carbohydrate metabolism contributes to the synthesis of virtually all macromolecules of the cell, and the age-related slowing and impairment in carbohydrate metabolism appears to play a role in the expression of cellular senescence. Moreover, these intracellular impairments in the aged contribute, in part, to the expression of several physiologic decrements and pathologies that accompany the aging process, such as glucose intolerance and diabetes. PMID- 3320675 TI - Evidence against ras activation in human ovarian carcinomas. AB - Activation of ras genes in human ovarian carcinomas and ovarian carcinoma cell lines was tested by transfection of NIH 3T3 cells with high molecular weight DNA extracted from fresh tumors or from cell lines. Of 18 ovarian tumors and tumor cell lines that were exhaustively tested, only one yielded DNA active in focus induction in this assay. Southern blot analysis of DNA in serially transformed NIH 3T3 foci revealed restriction fragments that hybridized with a probe specific for the human N-ras oncogene and with human repetitive (Alu) sequences. Individually transformed foci contained N-ras hybridizing fragments of different sizes. Northern blots of RNA extracted from different transformants revealed the expression of different transcripts hybridizing with the N-ras probe. The transformants also expressed a 700 base RNA that hybridized with a human B-lym probe. The low prevalence of ras activation in ovarian tumors as measured by transforming capability suggests that ras activation does not play an important role in the development of most human ovarian tumors. PMID- 3320676 TI - Selection of mutations that increase alpha 1-antitrypsin gene expression in Escherichia coli. AB - The gene encoding human alpha-1-antitrypsin (A1AT), when cloned and expressed as a full-length, non-fusion gene product in Escherichia coli, accumulates to levels up to 0.1% of total cellular protein. Truncation of the gene at its 5' end or synthesis as a fusion protein increases expression up to 200-fold. Extensive mutagenesis in vitro within this same 5'-terminal region aimed at improving codon usage and disrupting potential secondary structure increased expression only 10 to 20-fold. We have developed a translational fusion system for selecting mutations and applied it to the study of A1AT expression in E. coli. With this methodology, we have obtained single base-pair mutations having up to a 20-fold effect on A1AT expression. When we combined these multiple single base-pair mutations, we achieve up to a 200-fold increase in A1AT expression. The resulting gene product is of authentic size (394 amino acid residues) and contains two amino acid substitutions (Asn in place of Asp) in codons 2 and 6. This protein is primarily in the soluble fraction of the E. coli lysate and has identical activity to A1AT purified from human sera. The methodology used to generate these mutations may be generally applicable to the study of genes that do not express well in E. coli initially, and provides an alternative to secondary structure analysis in the redesign of such genes. PMID- 3320677 TI - Interaction of liposomes with cells. PMID- 3320678 TI - Liposome-mediated macrophage activities. PMID- 3320679 TI - Liposomes as carriers for in vivo gene transfer and expression. PMID- 3320680 TI - Erythrosomes: erythrocyte cytoskeletons coated with exogenous phospholipid as an encapsulating system. PMID- 3320681 TI - Dialysis method for entrapment of proteins into resealed red blood cells. PMID- 3320682 TI - Biochemical methods for the study of receptor-mediated endocytosis. PMID- 3320683 TI - pH-sensitive immunoliposomes. PMID- 3320685 TI - Self-learning for a Bayesian knowledge base: how long does it take for the machine to educate itself? PMID- 3320684 TI - In memoriam Peter L. Reichertz. PMID- 3320686 TI - Pelvic floor exercises in postnatal care. PMID- 3320687 TI - The conversion factor between thymidine incorporation and bacterial production in Escherichia coli. AB - Conversion factors between thymidine incorporation and bacterial production in Escherichia coli have been calculated from bacterial numbers and accumulated thymidine incorporation. The theoretical value calculated from the available bibliographic data is about 20-fold lower than the experimental factor and other conversion factors reported in natural waters. The differences between the observed and the expected conversion factors suggest that the use of thymidine incorporation in aquatic microbiology in order to calculate bacterial production requires estimation of the corresponding conversion factor or the thymidine incorporation into DNA. PMID- 3320688 TI - Use of chlamydiazyme for the detection of Chlamydia trachomatis in genital infections. AB - 48 endocervical specimens from women with cervicitis and 82 urethral specimens from men with urethritis were investigated for the presence of Chlamydia trachomatis by either the cell culture method or enzyme immunoassay (Chlamydiazyme, Abbott Laboratories). The overall sensitivity and specificity of Chlamydiazyme assay were 84.6% and 95.2% respectively. This study shows that Chlamydiazyme assay is a quite sensitive and specific tool for a rapid and simple detection of chlamydial antigens in genital samples. PMID- 3320689 TI - Purification and immunochemical properties of a wall protein antigen from Clostridium difficile ATCC 11011. AB - A wall-surface protein antigen, designated 32K antigen, was extracted from whole cells of Clostridium difficile strain ATCC 11011 with phosphate buffered saline and purified by ion-exchange chromatography, gel filtration, and chromatofocusing. The 32K antigen preparation was determined to be highly homogeneous by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The amino acid composition of the antigen was characteristic in the predominance of the acidic amino acids, the very low contents of methionine and histidine, and the lack of cysteine. A monomeric molecular weight of the 32K antigen was estimated to be 32,000 by SDS-PAGE and 30,200 by sedimentation equilibrium. The antigen exhibited two isoelectric forms (IP, 4.12 and 3.96). Neither carbohydrate nor phosphorus was detectable in the antigen. The antigen was relatively resistant to trypsin but sensitive to pepsin. Immunoblot analysis of the wall proteins isolated from other strains of C. difficile probed with monospecific antiserum against the antigen from ATCC 11011 showed that the antigenicity of 32K wall protein was common among some of the strains containing 32K wall proteins. PMID- 3320690 TI - [Effect of low-intensity monochromatic visible light on the growth of Escherichia coli cultures]. AB - The goal of this work was to study the effect of monochromatic visible light having a low intensity on Escherichia coli WP2 growth. The growth was accelerated by violet light (lambda = 404 nm) at a dose of 10--100 J/m2 and by blue (lambda = 454 nm), green (lambda = 520 to 560 nm), red (lambda = 633 nm) and far red light (lambda = 700 to 750 nm) at a dose of 10(3)--10(4) J/m2). The components of E. coli respiration chain may be primary photoreceptors in the cells. PMID- 3320691 TI - [Melaninogenesis of Streptomyces galbus as reaction to high-temperature cultivation conditions. Localization of the pigment]. AB - Melanoid pigments are synthesized de novo when a mesophilic Streptomyces galbus Frommer culture is grown at an elevated temperature (42--47 degrees C). The pigments are accumulated in the mycelium walls whose thickness increases twofold. PMID- 3320692 TI - Personal computers in teaching quantitative aspects in undergraduate physiology. AB - This paper is a description of the use of two computer programs in teaching undergraduate physiology. Both computer programs have been designed as a means which could, in motivated students, improve the understanding of some quantitative relations described in a relevant textbook of physiology. PMID- 3320693 TI - A thirteenth cranial nerve: the cloacal nerve. AB - The completion by vertebrates of micturition, defecation, and copulation via the cloaca or its derivatives is hypothesized to be best explained by the existence of a thirteenth cranial nerve, the cloacal nerve, which, similar to the facial and trigeminal nerves, functions as a mixed cranial nerve containing both general and special components. PMID- 3320694 TI - The role of omega 3 fatty acids on insulin secretion and insulin sensitivity. AB - Carbohydrate intolerance is positively correlated with animal fat consumption and is more common in beef eating populations. In contrast, individuals consuming diets comprised of polyunsaturated fats have a lower incidence of diabetes mellitus. This is especially apparent in the Eskimos living in Alaska and Greenland whose diet is highly enriched with omega 3 fatty acids. It is hypothesized that dietary enrichment with omega 3 fatty acids increases the incorporation of these fatty acids into the beta cell phospholipid membrane thus enhancing insulin secretion. It is also proposed that similar changes occur in the phospholipid membrane composition of peripheral cells. These changes in the membrane phospholipids would then theoretically increase both insulin receptor binding affinity and sensitivity, thus enhancing glucose transport across their membranes. Augmented insulin secretion and increased insulin sensitivity induced by chronic omega 3 fatty acid ingestion would positively influence carbohydrate metabolism and improve glucose homeostasis. PMID- 3320695 TI - Disease family trees: the possible roles of iodine in goitre, cretinism, multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer's and Parkinson's diseases and cancers of the thyroid, nervous system and skin. AB - Geographical distribution patterns of incidence and mortality for a wide variety of diseases display strong positive and negative correlations when analyzed statistically. It is argued that these relationships do not occur by chance, but reflect the causal role of surpluses and/or deficiencies of various bulk and trace elements. This concept is explored for one such "disease family tree", that of iodine. Deficiencies of this essential trace element appear to be associated with many diseases, or birth defects, including goitre, cretinism, multiple sclerosis, amyotrophic lateral sclerosis and cancer of the thyroid and nervous system. Although the evidence is weaker, iodine deficiency may also be implicated in Alzheimer's and Parkinson's diseases. In contrast, too much iodine may be linked to elevated mortality from cancer of the skin and melanoma. Rat studies indicate that iodine deficiencies can cause reduced brain weight, limited myelin formation, retarded neuronal maturation, a lowering of the production of various enzymes and slowing of the rates of protein and R.N.A. synthesis. Similar processes appear to occur in many of the diseases identified above. PMID- 3320697 TI - Skeletomotor subsystems. AB - Skeletomotor movements can be divided into five subsystems, each having its own independent mechanism and purpose. The subsystems are: 1. Reflex 2. Position 3. Velocity 4. Pursuit 5. Simultaneous. Reflex movements are rapid, stereotyped, inflexible and specific in terms of stimulus and response. Position movements are made to a target or certain position, with or without a load. A mechanism is proposed by which the Basal Ganglia program positioning movements into the primary movement and any load is compensated for by the stretch reflexes. Velocity movements are throwing movements and a mechanism is proposed by which the Cerebellum programs velocity into the basic, primary movement. A mechanism for Pursuit movements is proposed by which sensory and pursuit neurons activate velocity neurons whose activity drives the motor pathways to make pursuit movements. Simultaneous movements could be under the direction of the Prefrontal Cortex utilizing sensory feedback and interhemispheric transfer of information. A subcortical or cerebellar pattern generator could be set up for movements such as walking and running. The purpose of this division is to provide a guide for research and to aid in the understanding and treatment of diseases and injuries that affect the motor system. PMID- 3320696 TI - A theory of carcinogenesis based on an analysis of the effects of carcinogens. AB - Carcinogenic stimuli appear to act on target cells (and their daughters) by one or more of three mechanisms. The first is by oxidation of membrane component molecules on the extracellular surfaces of their plasma membranes. The second is by chronic and continuous impingement of electrons on the extracellular surfaces of their plasma membranes and the third is by relocation of predominantly basic molecules to the cytoplasmic surfaces of their plasma membranes. This latter effect in turn causes electrostatic attraction of image charged acidic molecules to the extracellular surfaces to balance the transmembrane charge of the target cells. Each of the above mechanisms results in a condition of increased electronegativity of the extracellular surfaces of plasma membranes of the target cells and their daughters. A theory of transformation is advanced based on the above related modes of action and it is used to explain some previously unexplainable properties of tumors. PMID- 3320698 TI - Electrical membrane breakdown: a possible mediator of the actions of electroconvulsive therapy. AB - The voltage across electrodes during electroconvulsive therapy (ECT) is two or three orders of magnitude greater than the membrane potential levels at which electrical breakdown occurs. This paper attempts to relate the interelectrode voltage to the membrane potential of individual neurones. For certain neurones the calculated values exceed the breakdown level. The study indicates that electrical breakdown does take place during ECT. It is suggested that electrical breakdown could explain some effects and side-effects of ECT. PMID- 3320699 TI - Rheumatoid arthritis: connection to a rapid evolution mechanism? AB - The idea that disease and evolution may be related was raised by research on the sickle cell hemoglobin (Hbs) gene. Rheumatoid arthritis (RA) will be compared and contrasted with systemic lupus erythematosus (SLE), to develop the hypothesis that RA has a function linked to the modification of a rapid evolution mechanism. PMID- 3320700 TI - Coronary vasospasm: a neuro-behavioral event? AB - Evidence exists for the presence of a neuro-anatomy that can produce cardiac vasospasm. Recent experimental and clinical data suggest that this neuro-anatomic mechanism can be activated by behavioral events in the psycho-social surround of the patient with coronary artery disease. I hypothesize that this mechanism can produce myocardial ischemia and can explain the variability in onset of clinical angina. PMID- 3320701 TI - Medicine in the first 20 years of the Colony in New South Wales. PMID- 3320702 TI - The enchanted herb: the work of early medical botanists in Australia. AB - The surgeons of the First Fleet sought not only adventure, but new herbal remedies that were awaiting discovery in the Australian bush. Within days of the foundation of the Colony at Sydney Cove in 1788, therapeutic experiments with wild currants, Eucalyptus kino (Botany Bay kino), and local "greens" were being undertaken. Scurvy and dysentery--part of the nation's foundation--prompted both a hunter-gatherer approach to new herbal remedies, and an empiricism which has continued to the present day. At least four of the 10 doctors of the First Fleet were keen botanists, and their endeavours established a precedent for medical "botanizing" which has become a living tradition over the ensuing 200 years. Before the onset of the 20th century, some 50 doctors who had studied botany in Australia had had their names appended to the native flora of the new continent. The eponyms that are preserved in the taxonomy of the country's flora comprise one record of the living history of Australia. PMID- 3320703 TI - Revolutions in health in the Australian colonies. PMID- 3320704 TI - Phthisis and philately--an account of the Consumptives Home stamps of New South Wales: the world's first charity stamps. PMID- 3320705 TI - Percy Grainger. PMID- 3320707 TI - Was Frederic Chopin's illness actually cystic fibrosis? AB - Since Chopin's death 140 years ago, no one has questioned seriously the theory that he died of tuberculosis, in spite of the knowledge that many of the physicians who treated his illness considered tuberculosis an unlikely cause of his chronic respiratory disease, which was of at least 24 years' duration. Although 170 cm in height, Chopin weighed less than 45 kg throughout his life. He was noticeably emaciated and had a marked tendency to lose weight after respiratory infections and with dietary indiscretion. His exercise tolerance remained far below that of his peers throughout his lifetime. He was affected by a debilitating chronic cough, which was often productive and was worst in the morning. This cough persisted from before 15 years of age until his death of cor pulmonale at 39 years of age. Chopin suffered multiple acute, severe respiratory infections of both the upper and lower respiratory tracts which worsened in winter. He had haemoptysis for 18 years. In later life he grew markedly barrel chested. He may also have been infertile. Chopin's autopsy revealed gross cardiomegaly and changes in his lungs which were not consistent with cavitating tuberculosis. These features suggest that cystic fibrosis may have been the cause of his ill-health and death. Chopin's sister Emily, died at 14 years of age, possibly also of cystic fibrosis. PMID- 3320708 TI - Synchronous radiation and chemotherapy for locally-advanced cancer: is it the answer? PMID- 3320706 TI - Mozart's left ear, nephropathy and death. PMID- 3320709 TI - Relapse of duodenal ulceration after healing with omeprazole. AB - The subsequent recurrence rate after duodenal ulcers were healed with omeprazole, 10 mg or 30 mg a day, was documented during a 12-month period in 55 patients. Endoscopy was performed if patients developed symptomatic recurrence; those patients who remained symptom-free at 12 months were also requested to undergo endoscopy to assess the incidence of asymptomatic recurrence. The proportion with symptomatic recurrence during the year was 56%. The median times (life-table analysis) to relapse were 50 and 39 weeks in the group that was treated initially with 30 mg and 10 mg of omeprazole, respectively, although this trend to slower relapse in the higher-dose group was not statistically significant. Five asymptomatic ulcers were detected in 11 asymptomatic subjects who agreed to a final endoscopy. The over-all recurrence rate was similar to previously-reported recurrence rates after the cessation of histamine H2-receptor antagonist drugs. PMID- 3320710 TI - Pharmacokinetics and metabolism of non-steroidal anti-inflammatory drugs. PMID- 3320712 TI - [Therapy with immunoglobulins]. PMID- 3320713 TI - [Vaccination in pregnancy]. PMID- 3320711 TI - The prognostic value of in-vitro corticosteroid suppression of lymphocyte blastogenesis in renal allografting. PMID- 3320714 TI - [Analgesic headache and analgesic dependence]. PMID- 3320715 TI - Child abuse--does the law protect? PMID- 3320716 TI - The Mental Health Act 1983 in practice. PMID- 3320717 TI - Coordinate transformations and calculation of the angular and depth parameters for a stereotactic system. AB - Stereotactic systems have been used to assist in the precise implantation of radioactive sources in selected brain tumors. Use of such systems requires an algorithm that transforms spatial points in computed tomography coordinates into stereotactic frame coordinates. A simple algorithm performing the coordinate transformations, intended for inclusion in treatment-planning software packages for interstitial brain implants, has been developed. This algorithm was formulated using the geometrical configurations of the Brown-Roberts-Wells (BRW) stereotactic system. After the transformations, the BRW angular coordinates and depth specifying the probe direction, defined from the entry point to the target point, are determined from their respective cartesian coordinates. These angular coordinates and depth on the BRW stereotactic system allow accurate neurosurgical implantations of catheters into the brain, and thereafter the insertion of radioactive sources. PMID- 3320718 TI - Reconstruction of blood vessels from x-ray subtraction projections: limited angle geometry. AB - Several algorithms have been investigated for reconstructing blood vessels from a limited number of x-ray subtraction projections, distributed over a limited range of angles. Both computer simulations and an in vivo animal study were carried out. The best reconstruction performance was achieved using an algorithm that folded in two pieces of a priori knowledge of the vascular density distributions: (1) the object is dilute, consisting mainly of a void; and (2) the density distribution in the reconstructions is most likely to be non-negative. Both the signal-to-noise ratio (SNR) and the signal to out-of-focus blur were quantitated. Compared to tomosynthetic reconstruction (backprojection), the amount of residual blur from out-of-focus planes was significantly reduced with only a small penalty in diminished SNR. The combined effect resulted in significant qualitative image improvement for real arterial distributions as demonstrated in a canine arterial imaging example. PMID- 3320720 TI - Renal-metabolic consequences of antihypertensive therapy with diltiazem versus hydrochlorothiazide. AB - Twenty-seven patients with mild to moderate essential hypertension were randomized to receive therapy with either hydrochlorothiazide or diltiazem. After a placebo run-in period of 2 weeks, patients received increasing doses of either drug for 14 weeks. Those in whom hypertension was effectively controlled continued for 26 weeks of total treatment. Those not controlled, i.e. blood pressure greater than 140/90 mm Hg or less than 10 mm Hg reduction of pressure, were unblinded and crossed over to therapy with both drugs. Eleven of 14 patients (79%) were effectively treated with diltiazem alone, and 8 of 13 patients (62%) were effectively treated with hydrochlorothiazide alone. Supine blood pressures fell from 152 +/- 5/97 +/- 1 to 142 +/- 4/87 +/- 3 mm Hg in the 11 patients treated with diltiazem, from 152 +/- 2/99 +/- 1 to 134 +/- 3/88 +/- 2 mm Hg in the 8 patients treated with hydrochlorothiazide, and from 151 +/- 4/104 +/- 3 to 140 +/- 5/92 +/- 1 mm Hg in the 8 patients who received both drugs (p less than 0.01 for each group). Diltiazem patients had significant increases in alkaline phosphatase and urinary magnesium. Hydrochlorothiazide patients had increases in serum uric acid, serum globulin, CO2 content, and plasma renin activity. Serum potassium, serum chloride, urinary osmolality, and urinary calcium decreased after treatment with hydrochlorothiazide. Patients receiving both drugs had increases in serum glucose, serum BUN, serum uric acid, serum globulin, and CO2 content. These patients had decreased serum chloride and urinary calcium. Diltiazem monotherapy was comparable to hydrochlorothiazide in efficacy of lowering blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320719 TI - Vessel imaging using dual-energy tomosynthesis. AB - A method has been developed that combines dual-energy subtraction and tomosynthesis for vessel imaging in intravenous angiography. This paper describes the procedure for doing tomosynthesis on a fan-beam rotational-motion system and gives the point responses of the imaging system. Phantom studies show that dual energy tomosynthesis improves the visualization of desired vessels lying on a selected plane. The results may be feasible for some applications such as clinical diagnosis of coronary artery diseases. PMID- 3320721 TI - The George E. Schreiner festschrift. PMID- 3320722 TI - The nephrological legacy of George E. Schreiner. PMID- 3320723 TI - Dopaminergic regulation of extrarenal potassium metabolism. AB - The effect of the dopaminergic system on renal and extrarenal potassium metabolism has been poorly characterized. To examine this problem, 2-hour renal clearance studies were performed in 7 healthy men. Each subject served as his own control and participated in three studies. Subjects received (a) a 2-hour potassium chloride (0.75 mEq/kg) intravenous infusion; (b) the same KCl infusion with dopamine (4 micrograms/kg . min), and (c) the same KCl infusion with the dopaminergic blocker metoclopramide (10 mg i.v. bolus). The rise in plasma potassium during the KCl infusion was significantly lower in the subjects receiving metoclopramide compared to the controls who received KCl alone (0.29 +/ 0.07 vs. 0.52 +/- 0.06 mEq/l, p less than 0.005). During the first 2 h after metoclopramide the increase in UKV and total potassium excretion was slightly, although not significantly, lower than in the KCl-alone group (154 +/- 15 vs. 168 +/- 15 mEq/min, NS). Since the increment in plasma K concentration following metoclopramide was less than in the controls despite a slightly reduced rate of KCl excretion, the improvement in potassium tolerance resulted from an enhanced translocation of potassium from the extra- to intracellular compartment (86 +/- 2 vs. 77 +/- 3%, p less than 0.01). There were no significant differences in venous pH, serum bicarbonate concentration or plasma insulin as compared to the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320724 TI - Mechanisms of sodium, potassium and chloride transport by the renal distal tubule. AB - The distal tubule contributes importantly to renal sodium and chloride reabsorption and potassium secretion. Changes in various factors acting from the luminal or basolateral side of the distal tubule can alter rates of net ion transport. Experiments were designed to examine some of the factors of luminal fluid that can alter sodium, chloride and potassium transport rates. This was accomplished by employing in vivo microperfusion techniques to change luminal sodium, potassium and chloride concentrations and fluid flow rate independent of any effects on systemic homeostatic mechanisms. Results of these experiments indicate that increasing the rate of fluid flow in the distal tubule, within the physiologic range, stimulates potassium secretion, even when sodium concentration does not change. Low sodium concentrations inhibit net potassium secretion only when they are below those that have been measured in this segment under physiologic conditions. Potassium secretion rates increase significantly when the luminal chloride concentration is reduced, an effect that can be dissociated from changes in transepithelial voltage. Sodium absorption is limited by low luminal chloride concentration and chloride absorption is limited by low luminal sodium concentration. These results and others have led us to postulate that at least four different pathways mediate Na, K and Cl transport across the luminal membrane of distal tubule cells. Two pathways permit diffusive movement of cations, one an amiloride inhibitable channel for sodium, the other a barium inhibitable channel for potassium. Two other pathways appear to mediate coupled K Cl secretion and Na-Cl absorption across the apical membrane of distal tubule cells. A new model of apical membrane transport pathways in the distal tubule is presented. PMID- 3320725 TI - Some transport characteristics of mammalian renal diluting segments. AB - As a consequence of its ability to absorb salt in excess of water, the thick ascending limb of the mammalian kidney dilutes the urine and supplies the energy for counter current multiplication. This latter effect follows directly from the ability of the medullary thick ascending limb (mTALH) to enrich medullary osmolality. In this review, we consider certain selected aspects of mTALH function that determine its ability to dilute the urine and to contribute to overall renal concentrating power. Specifically, we shall review the mechanisms for salt absorption in the mTALH and the modulation of salt absorption in the mTALH and hence urinary concentrating power, by antidiuretic hormone (ADH), prostaglandin E2 (PGE2) and peritubular hypertonicity. Furthermore, we shall advance an explanation of how these latter three agents modulate mTALH function without affecting external salt balance. PMID- 3320727 TI - [Diagnosis of parathyroid adenoma using ultrasound-guided intralesional hormonal determination]. PMID- 3320726 TI - [Arterial hypertension and diabetes mellitus. Epidemiological and physiopathological aspects]. PMID- 3320729 TI - Clinical pathology conference: a 61-year-old man with heart failure and hemoptysis. PMID- 3320730 TI - Computerization of a chemical dependency assessment. PMID- 3320728 TI - Unraveling the mystery of sudden infant death syndrome. PMID- 3320731 TI - [Phagocytic pathogenesis of periodontitis. I. The physiopathology of neutrophilic granulocytes and macrophages]. PMID- 3320733 TI - [Analysis of polymerization shrinkage of resins used for denture bases]. PMID- 3320732 TI - [Biomechanics: the design and prognosis of overdentures with attachments on root caps]. PMID- 3320734 TI - Commentary: does this work? PMID- 3320737 TI - [Present status and problems on therapy of congenital biliary obstruction]. PMID- 3320738 TI - [Peripheral neuroepithelioma in the retroperitoneum; a case report and a review of the literature]. AB - A 30-year-old man with peripheral neuroepithelioma which was present in the retroperitoneum underwent surgical treatment under the diagnosis of germ cell tumor. Subsequently he died of local recurrence and multiple metastases to the liver seven months after surgery. To our knowledge, this is the second case of peripheral neuroepithelioma which was observed in the retroperitoneal space in the literature of the world. We also reviewed 20 cases of peripheral neuroepithelioma reported in Japan. PMID- 3320736 TI - A 29-year perspective of status asthmaticus in children. AB - This manuscript presents a four year follow-up of a review of the issues in the management of status asthmaticus that are often controversial. A combination of previous considerations and experience is mixed with a review of the recent literature to formulate current recommendations. The reasons to use epinephrine, sodium bicarbonate, theophylline, corticosteroids, oxygen, hydration, intravenous adrenergic agents and controlled ventilation are discussed. Death from status asthmaticus should be preventable. PMID- 3320735 TI - Adverse reactions associated with parenteral beta agonists: serum potassium changes. AB - Beta adrenergic agonists can lower serum potassium levels predominantly when they are administered by the parenteral route. Hypokalemia has been demonstrated with the use of albuterol given by the intramuscular, intravenous and subcutaneous (SC) routes as well as with SC epinephrine. The effect appears to be dose related. Certain patients might be at increased risk who are on medications that tend to lower potassium such as corticosteroids, theophylline, diuretics or digoxin. Further studies should be encouraged on the hypokalemic effect of all forms of beta agonists in view of their possible contribution toward arrhythmias and asthma deaths. PMID- 3320740 TI - [Clinical and experimental study on vascular reconstruction for one-kidney renovascular hypertension]. AB - Several special problems were noted regarding the vascular reconstruction for renovascular hypertension of the patient with a solitary kidney. It is difficult to use the value of plasma renin activity for decisive diagnosis or determination of surgical indications because most of the one-kidney patients with renovascular hypertension showed a normal plasma renin activity preoperatively and it is theoretically impossible to obtain a ratio of the affected to the opposite renal vein renin level. Most patients presented moderate to severe degree of renal dysfunction so that vascular reconstruction should be the treatment of choice because the conservative therapy with anti-hypertensive drugs such as captopril may further worsen the renal function by decreasing the renal perfusion pressure. Patients showed extensive polyuria immediately after surgery which was attributed to sudden increases in glomerular filtration rate and urinary sodium excretion. There was no correlation between the preoperative serum osmolarity and the postoperative polyuria. Correlation was not obtained between the intraoperative clamping time of the renal artery and the aggravation of the previously existing renal dysfunction. A comparative pathohistological study of primarily vs secondarily nephrectomized kidneys revealed no evidence of parenchymal damage of the kidney after arterial reconstruction. Both acute and chronic animal experiments in which autologous whole blood was forcibly injected into the canine renal artery via extracorporeal shunt under the high pressure of 200 or 300 mmHg showed no light microscopic evidence of acute histological damage of the kidney. It is concluded that the intensive care with an aid of a Swan Ganz catheter during the postoperative polyuric period and the swift starting of hemodialysis when necessary can solve the postoperative problems of one-kidney renovascular hypertension although the sudden rise in renal perfusion pressure after reconstruction may cause an acute hypertensive damage in the level of electron microscopic findings. PMID- 3320739 TI - [Surgical treatment of "inflammatory" aneurysms of the abdominal aorta]. AB - Two cases of "Inflammatory" aneurysm of the abdominal aorta and a review of this type of lesion were presented. The incidence of inflammatory aneurysm of the abdominal aorta in the literature is 2.5 to 15%, but there were no detail reports concerning with this in Japan. The pathogenesis is not clear, but it is evident both macroscopically and microscopically that the inflammatory aneurysms are different from athelosclerotic ones. They are characterized by perivascular peel of inflammatory fibrous tissue. It is possible that this type of aneurysms are merely a variant of Takayasu's disease. Until recently, the diagnosis of this type of aneurysm has not been made before surgery. The symptom of abdominal pain, weight loss, elevated ESR in a patient with abdominal aortic aneurysm are highly suggestive an inflammatory aneurysm. Characteristics of CT scan lead to more frequent preoperative diagnosis of inflammatory aneurysms of the aorta. It reveals a thickened often calcified aortic wall surrounded by a soft tissue mantle. Dynamic scanning shows an enhancing perianeurysnal mass. Graft replacement in these patients is often difficult and associated with increase in morbidity and mortality. At surgery, no attempt should be made to mobilize adjacent viscela in order to avoid injury. Arterial control should be obtained with as little as possible dissection. Some reports refer to successful steroid therapy resolving the inflammatory process and alleviating symptoms. Further research may resolve the treatment of choice for this type of lesion and optimize the timing of surgery. PMID- 3320742 TI - Purification of the bifunctional thymidylate synthase-dihydrofolate reductase complex from the human malaria parasite Plasmodium falciparum. AB - The bifunctional thymidylate synthase-dihydrofolate reductase complex from the human malaria parasite Plasmodium falciparum has been purified to homogeneity using a sequence of separation steps including phenyl-Superose, gel filtration, dye affinity matrix, hydroxyapatite, and anion exchange chromatography. The specific activity of dihydrofolate reductase increased approximately 24,000-fold from 3.3 units mg-1 protein to 79,000 units mg-1 protein after five successive chromatographic steps with a yield of 31%. Both enzyme activities coeluted as a symmetric peak in highly purified preparations, indicating the existence of a bifunctional enzyme complex in P. falciparum. The apparent molecular weight of the native complex was approximately 120,000 as determined by gel filtration. When individual fractions of the anion exchange column were subject to polyacrylamide electrophoresis under denaturing conditions, the increase in intensity of a single band correlated with the amount of both the thymidylate synthase and dihydrofolate reductase activity. Further purification led to an electrophoretically pure protein (yield 2.6%) with an apparent molecular weight of 67,000, suggesting that the bifunctional enzyme complex from P. falciparum is composed of two subunits of identical size and charge. PMID- 3320741 TI - [Pancreatic duct treatment in pancreas transplantation]. AB - To determine the utility of injection of polymers to obliterate the pancreatic duct, we examined this method and others viz, pancreatico-duodenostomy, duct ligation, and the open duct method. We performed the pancreatic duct treatment on the left portion of the pancreas in dogs without any transplantation. The right portion of the pancreas was removed. We used Neoprene and Ethibloc as injected materials. One month after the operation, the polymer injected dogs showed the same endocrine function as the duct ligated and open duct ones. However, three months after the operation, endocrine function of the polymer injected dogs improved and was better than that of the other two groups which showed no changes. The endocrine function of the polymer injected dogs had remained stable for one year and was close to that of the optimal function of pancreatico duodenostomy. Furthermore, after operation in the polymer injected dogs, the elevated serum amylase descended to normal level. This occurred much less rapidly in the other groups. The fibrosis of the polymer injected dogs' pancreas was completed by 3 months, while the dogs in the other groups still had some degenerated exocrine tissues. Rapid destruction of exocrine tissues, induced by the injection of the polymer, appears to encourage reconstruction of endocrine tissue. PMID- 3320743 TI - Monoclonal antibody against carcinoembryonic antigen (CEA) identifies two new forms of crossreacting antigens of molecular weight 90,000 and 160,000 in normal granulocytes. AB - Two new forms of non-specific crossreacting antigens (NCAs) were identified in the Nonidet P40 (NP-40) extracts of normal granulocytes by precipitation with the monoclonal antibody (MAb) 192 directed against carcinoembryonic antigen (CEA) and already known to crossreact with the perchloric acid soluble NCA-55. The NP-40 soluble NCAs recognized by MAb 192 have apparent mol. wts of 90,000 and 160,000 in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Both NCAs appear to consist of a single monomeric polypeptide chain, since they have the same electrophoretic mobility in SDS-PAGE under reduced and non-reduced conditions. When granulocytes were extracted with perchloric acid instead of NP 40, only the 55,000 mol. wt antigen, corresponding to the previously described NCA-55, was precipitated by MAb 192. Furthermore, it was shown that NCA-55 is not a degradation product of NCA-90 or NCA-160 due to the perchloric acid treatment because exposure to perchloric acid of NCA preparations purified from NP-40 extracts did not change their apparent mol. wts in SDS-PAGE. It was also shown that NCA-160 is not a granulocytic form of CEA because it was not precipitated by the MAb 35 reacting exclusively with CEA. Immunocytochemical studies of granulocytes and macrophages showed that MAb 192 stained both types of cells whereas MAb 47 stained only the granulocytes and MAb 35 none of these cells. In granulocytes both MAbs reacted with antigens associated with granules and also present at the periphery of the nucleus as well as in the Golgi apparatus. The NCA-90 identified by MAb 192 was found by sequential immunodepletion to be antigenically distinct from the NCA-95 precipitated by MAb 47. The epitope recognized by MAb 192 on CEA and NCA molecules appears to be on the peptidic moiety because the antigens deglycosylated by the enzyme Endo F were still precipitated by this MAb. Taken together, the results indicate that MAb 192 identifies two novel forms of NCA (NCA-90 and NCA-160) in NP-40 extracts of granulocytes, which are distinct from CEA and the previously described NCA-55 and NCA-95 identified by MAbs 192 and 47, respectively, in perchloric acid extracts of granulocytes. PMID- 3320744 TI - On the priority of description of chromomycosis. PMID- 3320745 TI - [Cryptococcosis of the central nervous system--3 case reports]. PMID- 3320746 TI - Rapid nucleotide sequence analysis of the small subunit ribosomal RNA of Toxoplasma gondii: evolutionary implications for the Apicomplexa. AB - A method for obtaining a large proportion of the nucleotide sequence of the small subunit ribosomal RNA (srRNA) was applied to the obligate intracellular protozoon Toxoplasma gondii. The method uses reverse transcription of as little as 8 micrograms of total cellular RNA. This fast, efficient method has numerous advantages over traditional gene cloning methods when nucleotide sequences are required for evolutionary studies. A phylogenetic analysis of the srRNA sequence data showed that T. gondii is not especially closely related to any other organism for which srRNA sequences are available, including another member of the Apicomplexa. PMID- 3320747 TI - A randomized clinical trial of the noninvasive and invasive approaches to drug therapy of ventricular tachycardia. AB - There is controversy over whether therapy to prevent ventricular tachyarrhythmias should be selected noninvasively (by trying drugs and monitoring the patient electrocardiographically) or invasively (by selecting a drug that prevents induction of the arrhythmia by programmed stimulation). We randomly assigned 57 patients with symptomatic and demonstrable ventricular tachyarrhythmias to therapy selected either noninvasively or invasively. The tachyarrhythmias involved were sustained ventricular tachycardia (35 patients), nonsustained ventricular tachycardia with hypotension (15 patients), and ventricular fibrillation (7 patients). The noninvasive approach sought reduction of ventricular premature beats by more than 80 percent and of couplets by more than 90 percent, with elimination of three or more successive ventricular beats on ambulatory monitoring and exercise testing. The invasive approach sought to prevent the induction of five or more repetitive beats by programmed stimulation. The noninvasive approach required fewer drug trials (3.2 +/- 1.8 [mean +/- SD] vs. 5.5 +/- 2.8, P less than 0.001) and fewer hospital days (20 +/- 15 vs. 33 +/- 24, P = 0.01) and identified a therapy predicted to be effective for more patients than did the invasive approach (29 of 29 vs. 15 of 28, P less than 0.001). When a predicted effective therapy was not found, amiodarone was prescribed despite persisting inducibility of ventricular tachycardia. Patients randomly assigned to the noninvasive approach had more symptomatic recurrences of tachyarrhythmia than those treated by the invasive approach (two-year actuarial probabilities of 0.50 +/- 0.10 vs. 0.20 +/- 0.08, P = 0.02). Similar differences were observed when amiodarone recipients were excluded. There were only three deaths from recurrent ventricular tachyarrhythmias--two in the group whose treatment was selected noninvasively and one in the group whose treatment was selected invasively (not significant). We conclude that therapy selected by the invasive approach prevents recurrences of ventricular tachyarrhythmias better than that selected by the noninvasive approach. PMID- 3320748 TI - Epiphyseal disorders. PMID- 3320749 TI - Breast reconstruction after mastectomy. PMID- 3320750 TI - Physicians as gatekeepers. A complex challenge. PMID- 3320751 TI - Why 'theatre'? PMID- 3320752 TI - From poisoned ducks to genetic engineering. An historical perspective of microbiology and immunology. PMID- 3320753 TI - The immediate post operative care of a child receiving a liver transplant. PMID- 3320754 TI - Troublesome trials for AIDS vaccines. PMID- 3320755 TI - The missing link in DMD? PMID- 3320756 TI - Application of phorbol ester to mouse skin causes a rapid and sustained loss of protein kinase C. AB - It is now widely accepted that tumour-promoting phorbol esters activate a Ca2+- and phospholipid-dependent protein kinase (protein kinase C) both in vitro and in intact cells, and that the kinase represents a major cellular phorbol ester binding protein. The phorbol esters act as analogues of diacylglycerol, a natural regulator of protein kinase C, and stabilize the membrane-association of the kinase. Although other molecular targets may exist, protein kinase C activation is probably important in mediating the diverse responses of cultured cells to phorbol esters and in promoting in vivo tumours. The enzyme comprises a family of closely related proteins and has been detected in extracts from mouse epidermal cells, the likely targets for two-stage carcinogenesis in mouse skin. In this report we show that application of a single dose of TPA (12-O-tetradecanoyl phorbol-13-acetate) to mouse skin results in a rapid and complete loss of protein kinase C activity which is maintained for 3-4 days. This is associated with a loss of immunologically detectable protein kinase C and the accumulation of a smaller protein detectable by antibodies recognizing the regulatory domain of protein kinase C. PMID- 3320758 TI - Pneumocystis carinii in the AIDS patient. PMID- 3320757 TI - Optical trapping and manipulation of single cells using infrared laser beams. AB - Use of optical traps for the manipulation of biological particles was recently proposed, and initial observations of laser trapping of bacteria and viruses with visible argon-laser light were reported. We report here the use of infrared (IR) light to make much improved laser traps with significantly less optical damage to a variety of living cells. Using IR light we have observed the reproduction of Escherichia coli within optical traps at power levels sufficient to give manipulation at velocities up to approximately 500 micron s-1. Reproduction of yeast cells by budding was also achieved in IR traps capable of manipulating individual cells and clumps of cells at velocities of approximately micron s-1. Damage-free trapping and manipulation of suspensions of red blood cells of humans and of organelles located within individual living cells of spirogyra was also achieved, largely as a result of the reduced absorption of haemoglobin and chlorophyll in the IR. Trapping of many types of small protozoa and manipulation of organelles within protozoa is also possible. The manipulative capabilities of optical techniques were exploited in experiments showing separation of individual bacteria from one sample and their introduction into another sample. Optical orientation of individual bacterial cells in space was also achieved using a pair of laser-beam traps. These new manipulative techniques using IR light are capable of producing large forces under damage-free conditions and improve the prospects for wider use of optical manipulation techniques in microbiology. PMID- 3320759 TI - The antivivisection movement. A threat to medical research and future progress. PMID- 3320760 TI - Medical origins of Duke University? PMID- 3320761 TI - Heberden's nodes. PMID- 3320762 TI - On delayed reactions to buried silk sutures. PMID- 3320763 TI - Should homeopathy be reconsidered? PMID- 3320764 TI - Dupuytren's contracture. PMID- 3320766 TI - [Directory of assistance agencies for the blind and vision-impaired]. PMID- 3320765 TI - Living ghosts from our past. The 1987 Spicer-Breckenridge lecture. PMID- 3320767 TI - [Disobstruction of the carotid artery; a retrospective study]. PMID- 3320768 TI - [Heparin; current viewpoints of an old concept]. PMID- 3320769 TI - [Treatment with methotrexate in patients with rheumatoid arthritis]. PMID- 3320770 TI - Inducible high-affinity binding site for benzo(a)pyrene in cytosol from rat liver. AB - By the use of the dextran-coated charcoal method the presence of a high-affinity binding site for benzo(a)pyrene in the cytosol from rat liver (R strain) has been demonstrated. This binder was saturable by ligand concentration and by time. Sucrose density gradient analysis after charcoal treatment revealed one major peak of radioactivity sedimenting at 4.4 S which was displaceable by a 100-fold molar excess of nonlabeled benzo(a)pyrene. Benzo(a)pyrene binding to liver cytosol was sensitive to protease treatment of the cytosol suggesting that the binder was a protein. Saturation and Scatchard plot analysis of benzo(a)pyrene binding indicated a high-affinity (Kd = 4.7 nmol) and a relatively low binding capacity (Bmax = 379 fmol/mg cytosolic protein), allowing, to denote this binder as a receptor for benzo(a)pyrene. Competition studies showed that this cytosolic receptor was distinct from steroid hormone receptors since benzo(a)pyrene binding was partially inhibited by aromatic carcinogens 3-methylcholanthrene and benz(a)anthracene but not by estradiol, progesterone or cortisol. R strain rats used in these experiments were sensitive to induction with 3-methylcholanthrene which produced the increase of cytochrome Pl-450 content in liver microsomes, enhanced the glutathione S-transferase activity in hepatic cytosol and produced liver hypertrophy in stimulated animals. All these effects were related to the dose of 3-methylcholanthrene used for the induction. Also, the cytosolic binding capacity for benzo(a)pyrene was increased in animals stimulated with 3 methylcholanthrene in a dose-dependent fashion. The 3-methylcholanthrene-induced binder displayed identical sedimentation velocity and kinetic parameters (Kd) to those characteristic for the benzo(a)pyrene receptor in hepatic cytosol from unstimulated animals. Conclusively, our results demonstrated that benzo(a)pyrene was bound to a receptor protein in rat liver cytosol which was inducible by the classical inducer 3-methylcholanthrene. The mechanism of induction of this receptor and its role in cell response to aromatic carcinogens still need to be elucidated. PMID- 3320771 TI - Postirradiation utility of insulin in radiotherapy. AB - The radiobiological effect of insulin was studied under laboratory conditions to find its utility in radiotherapy. Balb/c mice receiving injections of insulin after irradiation exhibited rapid recovery from radiation effect. This was evident from the data on their life span, organ weights and spleen colony assay studies, carried out under conditions of whole body and partial body irradiation. This trend was absent in mice injected with insulin before irradiation. The results of experiments on E. coli B/r and HA cells irradiated in the presence of insulin under oxic conditions suggest radioprotective effect of insulin. The E. coli B/r cells irradiated in the presence of insulin under hypoxia, however, showed a moderate radiosensitizing effect of insulin. PMID- 3320772 TI - [Acoustic and somatosensory evoked potentials in brain death]. PMID- 3320773 TI - [Dependence of the risk of brain infarct on the degree of severity of occlusive internal carotid artery lesions]. AB - This retrospective study was performed in order to evaluate the relationship between the risk of brain infarction and the severity of 274 internal carotid artery (ICA) stenoses in 218 patients. Clinical, vascular and brain-morphological findings were compared. Of 106 occluded ICAs, 59% had induced a completed stroke with visible hemispheric infarction in 77%, most of them of the territorial type (35%). 32% of 85 high-grade stenoses had led to completed strokes, with territorial, low-flow and microangiopathic patterns of infarction occurring equally frequent. CT was normal in two-thirds of 83 low-grade ICA-stenoses, whereas 14% showed microangiopathic brain lesions. We conclude that (1) asymptomatic ICA stenoses should not be operated on, as long as they are not of very high degree and (2) even symptomatic ICA stenoses should not undergo endarterectomy, if the patient's stroke was due to lacunar infarctions of typical site and size. PMID- 3320774 TI - [Morphology and clinical value of plaques of the carotid artery in a healthy and ill patient sample]. PMID- 3320775 TI - Tubulointerstitial nephritis by Tamm-Horsfall glycoprotein or egg white component. AB - Experimental tubulointerstitial nephritis (TIN) was induced in Wistar rats and New Zealand white rabbits by direct intrarenal inoculation of Tamm-Horsfall glycoprotein (THG) or egg white component (egg white A). After five immunizations of THG or egg white A with complete Freund's adjuvant (CFA), direct intrarenal inoculation of THG or egg white A also induced more severe TIN in the inoculated kidney. By the 7th day, in 1 of the animals with immunizations and then intrarenal inoculation of THG, the inoculated kidney was swollen and appeared necrotic. By the 28th day, in 1 of those receiving immunizations and intrarenal inoculation of THG, the inoculated kidney became contracted. TIN was observed in three experimental models, namely (a) direct intrarenal inoculation of THG or egg white A; (b) five immunizations of THG and (c) immunizations and then intrarenal inoculations of THG or egg white A. The most severe TIN was observed in the latter model. PMID- 3320776 TI - IgA nephropathy associated with hepatitis B virus antigenemia. AB - The pathogenetic ability of hepatitis B virus (HBV) antigenemia to induce IgA nephropathy was examined in 10 patients with IgA nephropathy and HBV antigenemia. They had no previous history of liver diseases and their liver function tests were normal. All were positive for hepatitis + surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti-HBcAg) with high titers, thereby indicating they were persistent carriers of HBV. Immunoperoxidase studies using monospecific polyclonal antibodies revealed HBcAg and HBsAg in the nuclei and cytoplasm of glomerular mesangial cells in 8 patients. These findings suggest immune complexes involving HBcAg and HBsAg may induce IgA nephropathy in persons who carry HBV. PMID- 3320777 TI - Nephritogenicity of anti-Engelbreth-Holm-Swarm sarcoma antibody. AB - We have examined the antibody activity and nephritogenicity of anti-Engelbreth Holm-Swarm (EHS) sarcoma antiserum in order to analyze the pathogenesis of the EHS nephropathy which has already been reported by us. An increased amount of urine protein was not recognized in rats injected with a large quantity of anti EHS sarcoma antiserum. In addition, rats immunized with rabbit IgG before anti EHS sarcoma antiserum injection developed no abnormal proteinuria, despite positive fluorescent staining for rat IgG as well as rabbit IgG in the glomeruli. From these results we concluded that nephritogenic antibodies could not be produced in rabbits by immunization with EHS sarcoma, which could induce the EHS nephropathy in an active model. PMID- 3320778 TI - Renal transplantation in children. PMID- 3320779 TI - Long-term monitoring of renal transplant patients by a CUSUM test on serum creatinine. AB - A retrospective clinical assessment of kidney function change was performed on 38 kidney transplant patients over a median follow-up period of 128 weeks. Full records of the patients' course were available to the clinician, while only the serum creatinine series of each patient was supplied to the computer on which a bilateral CUSUM test was implemented. The frequency of change assessed by the clinician was 146 out of 2,688 patient-weeks. The computer identified the function changes with 84.9% sensitivity and 94.3% specificity and the function deteriorations attributed to rejection with 88.9% sensitivity and 97.2% specificity. Thus we suggest an efficient long-term monitoring of the graft function with this simple and reliable statistical technique. PMID- 3320781 TI - Pretransplant blood transfusions and selection for renal transplantation. PMID- 3320782 TI - Clinical trials in hypertension: some general thoughts and some particular controversies. AB - A common fallacy in the analysis of clinical trials is described. Correlating the differences between pairs of random numbers and the first of them produces a correlation coefficient of 0.71 with a regression equation of y = -4.5 + X. Misuses of correlation and regression in hypertension and hypolipidaemic trials are described and advice given. The author also puts on record his objection to the pedantry that surrounds the use of the analysis by intentions-to-treat method. Patients who go into such an analysis may include those who never received a single dose of the treatment to which they were randomized, those who started it but were later switched to the other treatment though still analysed in their original group, patients who could be regarded as having died from obviously nontreatment causes by any sensible and reasonable doctor, and patients later found even to have suffered the wrong illness. PMID- 3320780 TI - IgA nephropathy. Evaluation of prognostic factors in patients with moderate disease. AB - Previous studies of IgA nephropathy have demonstrated a number of prognostically significant clinical and pathological factors in groups of patients with the full histological spectrum of the disease. Whether these factors can be applied to a group of IgA nephropathy patients with disease of moderate degree is unknown. Forty patients (9 females, 31 males) with grade III IgA nephropathy (no more than 10% obsolete glomeruli and little or no interstitial fibrosis) were evaluated with respect to age, sex, degree of proteinuria, history of recurrent gross hematuria, hypertension, extent and type of segmental glomerulosclerosis, demonstration of IgG and/or IgM in deposits, presence of peripheral capillary deposits, whether or not there were crescents, and extent of vascular sclerosis. The mean age was 29.6 +/- (SD) 13.1 years. Sixteen patients presented with recurrent gross hematuria, and 24 had microscopic hematuria and proteinuria as the initial manifestation. Hypertension was seen in 5 patients. The mean serum creatinine concentration was 1.09 +/- 0.47 mg/dl (96.4 +/- 41.5 mumol/l), and the mean 24-hour urinary protein was 1.5 +/- 1.3 g. Nine patients had proteinuria greater than or equal to 2.0 g/24 h. Thirty-two patients demonstrated segmental glomerulosclerosis in their biopsies, 13 of which had more than 10% of the glomeruli involved. Seven patients developed established renal failure (Cr greater than or equal to 2.0 mg/dl; 176.8 mumol/l). The 60-and 100-month renal survival rates were 96 and 52%. Life table analysis disclosed that only the degree of proteinuria (greater than or equal to 2.0 g/24 h; p less than 0.05) and the extent of segmental glomerulosclerosis (p less than 0.025) were of prognostic significance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320783 TI - Oslo study: treatment of mild hypertension. A five-year controlled drug study. AB - During 1972-1973, 785 symptom-free men, aged 40-49, with mild hypertension, were randomly assigned to a 5-year controlled drug treatment study, 406 in the treatment group and 379 in the control group. The basic drug was hydrochlorothiazide, in addition methyldopa or propranolol if necessary. The mean observation time was 66 months (range 60-78). At 5 years' follow-up there was no difference in total mortality between treated and controls, nor in cardiovascular mortality. There was a good prevention of cerebrovascular disease (0 vs. 7). Regarding coronary heart disease, however, there was an opposite trend (20 vs. 13, p greater than 0.10). During the trial, different drug-induced changes were observed in serum lipids, glucose and uric acid. The importance of these changes are still uncertain. PMID- 3320784 TI - Further results of the MRC treatment trial for mild hypertension. AB - 17,354 mildly hypertensive adults with diastolic (v) pressures of 90-109 mm Hg took part in a 5 1/2 year trial in which each was randomized to treatment with either bendrofluazide, propranolol, or placebo. The main results of the trial have been published; they showed stroke benefit but no overall reduction in the incidence of coronary events and no effect on all-cause mortality. Further analyses of the data have shown interesting differences between subgroups of the population, with regard to the effects of the two types of treatment on stroke, on coronary events and on ECG changes. These results, and the effects of interaction between cigarette smoking and the efficacy of these drugs, if confirmed in other studies, should influence the choice of drug therapy for mild hypertension. PMID- 3320785 TI - The Australian Therapeutic Trial in Mild Hypertension. AB - In the Australian Therapeutic Trial in Mild Hypertension treated patients had significantly lower cardiovascular mortality and a significantly lower incidence of cerebrovascular complications than patients given placebos. There was, however, no difference in the incidence of nonfatal myocardial infarction or other new manifestations of ischaemic heart disease. Although the evidence of benefit from treatment was clear-cut, the number of cardiovascular complications in the control group was small. This was due to several factors. Patients admitted to the trial had no preceding evidence of cardiovascular complications, the blood pressure fell spontaneously to below 95 mm Hg in almost half the control group, and patients whose blood pressures rose to levels above 110 mm Hg were given treatment, but remained in the placebo group for analysis. In both treated and placebo groups, trial end-points occurred more frequently in persons whose average diastolic blood pressure during the study remained raised. Ischaemic heart disease and many cases of stroke are due to atherosclerotic arterial disease. This appears not to be favourably influenced by antihypertensive drug therapy. PMID- 3320786 TI - Effects of calcium antagonism and beta-blockade on haemodynamic responses to stress. AB - The influences of verapamil, propranolol and their combination on blood pressure and heart rate during cold pressor testing and isometric exercise were examined in 13 patients with essential hypertension. Verapamil modified the peak pressor responses to each stimulus while the major action of propranolol was on heart rate. Together the drugs attenuated both haemodynamic responses. Combined calcium antagonism and beta-blockade may modify favourably surges in blood pressure and heart rate in ambulant hypertensives. PMID- 3320787 TI - A comparative study on the effect of atenolol and labetalol on exercise capacity and lipid serum levels in essential hypertension. AB - Exercise performance was examined in 30 hypertensive subjects (mean age 43.2 +/- 5.4 years) in WHO group I-II, allocated to placebo, atenolol and labetalol treatment during a 3 X 12 weeks' exercise training period. Total work did not show any differences between the placebo and the two treatment periods. Compared to placebo, total cholesterol was reduced by 4.6% (p less than 0.04) in the labetalol and 3.1% (NS) in the atenolol period. Systolic and diastolic blood pressure were significantly reduced both at rest (p less than 0.01) and during exercise (p less than 0.01) in the two drug treatment periods compared to placebo. PMID- 3320789 TI - Mild hypertension: to treat or not to treat? AB - Clinical practice must be based on the results of clinical trials, not on theories derived from epidemiology observations. The major trials of blood pressure reduction are described, and some of their shortcomings are discussed. Whenever drug treatment is necessary there will inevitably be a balance between benefits of treatment and unwanted effects of medication. The MRC trial of treatment in mild hypertension demonstrated that a small reduction in the risk of stroke is obtained at the cost of a variety of side effects which themselves depend on the medication used. Treatment of a diastolic pressure of 100 mm Hg or below will confer very little benefit on an individual patient. PMID- 3320788 TI - Follow-up of a method of twenty-four-hour indirect blood pressure monitoring: evaluation of carvedilol, a new antihypertensive agent. AB - Indirect automatic 24-hour blood pressure monitoring has been found to be reliable and valid and thus has been introduced for the evaluation of dosage and efficacy of antihypertensive drugs. The present double-blind placebo-controlled randomized long-term study reports the therapeutic results of the oral administration of a new beta-adrenergic blocking agent, carvedilol, with direct vasodilator activity in patients with primary hypertension. The antihypertensive effect was acute at onset and comparable in the supine and standing position judged by casual blood pressure readings. Indirect automatic blood pressure monitoring demonstrated a good antihypertensive effect throughout daily activities after single oral dosage. Despite some technical problems with the apparatus (Pressurometer III, Del Mar Avionics), a circadian pattern could be documented in both untreated and treated patients. Blood pressure and heart rate were normally distributed but less variable during treatment. The long-lasting antihypertensive effect was comparable to the commonly used beta-blocker metoprolol. A significantly reduced awakening blood pressure in the morning may indicate a beneficial effect on a possible prognostic factor in arterial hypertension. PMID- 3320790 TI - [Effect of locally applied corticoids on the morphology of peripheral nerves following neurotmesis and microsurgical suture]. AB - The present work deals with the morphology of cut peripheral nerves anastomosed by primary microsurgical suture. The important question was whether the well known anti-inflammatory, anti-exudative and fibroblast-inhibiting effects of locally applied glucocorticoids can influence the morphology of degenerating and regenerating peripheral nerves. After cutting the saphenous nerve of the rabbit and prior to its microsurgical suture the synthetic crystalline glucocorticoids methylprednisolone, prednisolone and dexamethasone were applied between the distal and proximal nerve stumps (interfascicular surface application). After a defined time of two days up to a maximum of five weeks the suture site and adjacent parts of the nerve were removed and investigated by light microscopy and electron microscopy. The morphological findings of the degenerating and regenerating nerve structures with and without local application of the different corticoids were compared. The results show that after local application of glucocorticoids the formation of scar tissue and neuromata is decreased, thus supporting the processes of regeneration. This is a result of a reduction of fibroblasts in the new formation of the epineurium and in the endoneurium and a certain protective effect on the perineural cells. Furthermore, the application of the glucocorticoids seems to accelerate the breaking down of myelin and degenerating axons and the new formation of myelin sheaths by "activating" Schwann cells. These facts lead to an enhancement of nerve regeneration after microsurgical suture. PMID- 3320792 TI - A thrombosed giant MCA aneurysm in a ten-week-old infant. AB - A 10-week-old child was operated upon for a left temporal intracerebral haematoma resulting from a ruptured giant MCA aneurysm. The aneurysm was found accidentally during the operation because there was no filling on angiography. The aneurysm was clipped successfully and the child's postoperative course was uneventful. Similar cases in the literature as well as possible aetiological circumstances in childhood aneurysms are discussed. PMID- 3320791 TI - Intracerebellar haematoma: eleven traumatic and non-traumatic cases and a review of the literature. AB - A follow-up study of 11 patients with traumatic and non-traumatic intracerebellar haematomas is analysed. The mortality is 36%. Prognosis depends on the rate of deterioration and level of consciousness. While indication for clot evacuation is controversial, ventricular drainage is recommended as a primary protective procedure in any state of consciousness. PMID- 3320793 TI - [Ethmoidal adenocarcinoma surgically treated in one stage by transfacial and subfrontal approach after inductive chemotherapy. Preliminary results of a new therapeutic approach]. AB - The authors present a new therapeutic protocol for ethmo++idal adenocarcinomas. It includes a pre-operative chemotherapy based on a four days continued infusion of cis-platinum and 5 F.U. (three cures with 3 weeks-intervals); it is followed by a carcinologic removal realized through a combined transfacial and intra cranial approach. They discuss the interest of combined surgery which should allow a limitation of intra-cranial recurrencies. The intra-cranial extension must not be a limit to the removal even in case of dural, or even sub-dural extension. The reconstruction of the anterior basis of the skull has been simplified as much as possible: it has been performed either with a bone graft removed from the frontal flap inner table, or with a precut madreporic coral graft. In all cases, the dura has been doubled with a large shred of galea. They emphasize the efficiency of pre-operative chemotherapy. Eleven patients underwent such a protocol; two were operated in a recurrence, 9 in first hand. The preliminary results seem to be promising: the one year and two years actuarial survival rates are 84%. PMID- 3320794 TI - [Cystic meningioma simulating glioblastoma in x-ray computed tomography]. AB - Seven cases of supratentorial meningiomas are reported. CT-Scan showed irregular hypo-hyperdense zones and features of intratumoral cysts. At surgery a well circumscribed tumor has always been found and easily removed "en bloc". In two cases stereotaxic biopsy was performed previously. CT-Scan findings of meningiomas with microcystic structure and/or necrotic areas may mimic a malignant glioma and lead to an incorrect presumptive diagnosis: then, both therapy and prognosis will be very different. It comes that stereotaxic biopsy is mandatory in all suspected cases of cerebral tumors, in the absence of classical angiographic patterns. PMID- 3320795 TI - ["De novo" aneurysms. Apropos of a surgically treated case]. AB - The authors report the case of a 26 years old woman who developed four "new" T aneurysms, ten years after the successful clipping of a vertebro-basilar system aneurysm. This observation is discussed in relation to the literature; current views supporting that aneurysms may result from a combination of inherent and acquired tissue weakness associated with hemodynamic effects are cited. Another twelve cases of "de novo" aneurysms developed in patients without previously carotid ligation and reported in the literature are reviewed. Their characteristics in relation to their localisation and their interval time discovery are discussed. The advisibility of repeated angiograms in some patients with aneurysm is discussed as these patients are at an increased risk of hemorrhage from another "new" aneurysm. PMID- 3320796 TI - [First consultations in nephrology. Comparison of 2 multicenter studies conducted at a 5-year interval]. AB - An investigation of "kidney outpatient" first consultations carried out in 1985 with the cooperation of 19 nephrological teams distributed all over France. Each team had taken part in a similar investigation in 1980. The work allowed to collect 1200 records. Analysis of the main results is presented. The comparison between the 1980th and the 1985th investigations shows a remarkable stability of the results, but suggests two new and interesting features: the progress of Dip stick studies and serum creatinine concentration in general practice and the decreasing part taken by hypertension in "kidney disease out-patient" activity in 1985. PMID- 3320799 TI - [HLA-compatible transfusions and renal grafts]. PMID- 3320798 TI - [Program of continuous ambulatory peritoneal dialysis and renal transplantation in insulin-dependent diabetics in the terminal stage of renal insufficiency]. AB - A program of continuous ambulatory peritoneal dialysis (CAPD)-renal transplantation was set up on less than 55 years old insulin dependent diabetics with end stage renal failure. Ten patients were included (age range: 9-45 years, mean: 35.6). All these patients had many complications: retinopathy, arteritis, ischemic heart disease, hypertension, neuropathy, cutaneous infection. One patient refused CAPD and was hemodialyzed for 8 months before grafting. Nine patients were treated for 3 to 45 months (mean: 14.8). During CAPD therapy, better control of hypertension and blood glucose levels were achieved. Five patients received a cadaver renal transplant 3 to 27 months (mean: 13.3) after starting CAPD. All these transplants are functioning 12 to 62 months after grafting (mean: 26.4). No post-operative complications can be directly related to CAPD. No vascular complications occurred during post-transplant follow-up. So, an integrated program CAPD-renal transplantation could be of value for young insulin dependent diabetics. PMID- 3320797 TI - [Glomerular nephropathy in the Bardet-Biedl syndrome]. AB - A case of Bardet-Biedl syndrome (BBS) with kidney involvement and renal failure is reported. Light microscopy demonstrates fibrosis of 40% of glomeruli, altered tubules and interstitial fibrosis; no cystic formation is present and immunofluorescence studies are negative. In electron microscopy, the glomerular basement membrane (GBM) looks twisted and uniformly thickened with segmental effacement of the trilaminar architecture; fibrillary material is accumulated close to the inner layer of the GBM. Intermittent peritoneal dialysis is initiated 2 years later; death occurs, after one year of dialysis, due to a bleeding duodenal ulcer. Chronic renal failure seems to be the most frequent cause of death in BBS and several mechanisms are involved. Tubulo-interstitial lesions and renal cysts have been well documented. Glomerular damage with early ultrastructural changes of the GBM may be implicated in the occurrence of renal failure. Further studies are needed to define the incidence and the specificity of the GBM abnormalities in BBS. PMID- 3320801 TI - [A case of dural arteriovenous malformation in the anterior fossa]. AB - Dural arteriovenous malformations (AVMs) are not uncommon. But most of dural AVMs are located in the cavernous portion or the transverse-sigmoid portion. Dural AVMs in the anterior fossa and very rare. We experienced a case of dural AVM in the anterior fossa and review 17 cases of dural AVM in the anterior fossa in the literature. CASE: a 62-year-old male was admitted to our center because of unconsciousness and vomiting on Sept. 28; 1985. For nineteen months he had been on anticoagulant therapy after aorto-coronary bypass. Neurological examination on admission revealed somnolence and right-hemiparesis. CT scan revealed intracerebral hematoma in the left frontal lobe with ventricular perforation. Enhanced CT scan revealed patchy enhancement in the tip of the left frontal lobe. Selective angiographies were performed. Dural AVM, fed by both anterior ethmoidal arteries and drained by the cortical veins into the superior sagittal sinus and left superficial middle cerebral vein, was found. Selective external carotid angiography failed to visualize any AVM. MRI revealed spotty low signal intensity in the frontal tip by inversion recovery and spin echo. After admission his consciousness and right-hemiparesis improved completely. Left frontal craniotomy was done. On opening the dura, aneurysmal dilatation was found in the left frontal lobe, arising from the inner surface of the dura at the antero-medial corner of the left anterior fossa. From this aneurysmal dilatation a few veins entered the superior sagittal sinus. Red veins including aneurysmal dilation was removed from its origin together with the intracerebral hematoma. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320800 TI - [The diagnostic method of localization of cerebrospinal fluid rhinorrhea by digital video subtraction system]. AB - Demonstration of the exact site of the dural fistula in cerebrospinal fluid rhinorrhea is difficult. Previous reports present the methods of metrizamide cisternography combined with both hypocycloid tomography and computed tomography. But in these methods, direct, dynamic, actual and real-time visualization of the fistula with minimal dose of metrizamide is rather difficult. By using digital video subtraction system (Philips DVI-2CV), we could visualize the direct, dynamic and actual site of fistula with small amount of metrizamide instilled into the suboccipital subarachnoid space with the patient prone position. We report a successful case of traumatic cerebrospinal fluid rhinorrhea drained through the bony defect at the planum sphenoid into the posterior ethmoid sinus. This is the first report to deal with the usefulness of digital video subtraction system for exact localization of cerebrospinal fluid rhinorrhea. We emphasize the usefulness of metrizamide cisternography by the digital video subtraction system combined with the metrizamide computed tomographic cisternography for the precise localization of dural fistula. PMID- 3320802 TI - [Intra-operative spinal sonography in spinal intramedullary tumor]. AB - Recently, operative results of intramedullary spinal cord tumors have been greatly improved since the introduction of microsurgery. It is very important to know the precise size and location of the tumor prior to the operation so that we can approach the tumor with a minimum of damage to the spinal cord. However, it is not always possible to demonstrate the precise localization of the tumor preoperatively. In this report, we emphasize that intraoperative spinal sonography is very useful in determining the extent of the tumor and differentiating solid component from cystic component of the tumor. Methods and Materials We performed intraoperative spinal sonography on ten patients with intramedullary spinal cord tumor. This series included three cases of hemangioblastoma, three cases of astrocytoma, two cases of ependymoma, one case of subependymoma, and one case of mixed glioma. Eight out of ten cases were associated with cysts. The intraoperative spinal sonographic examinations were performed after laminectomy. The linear scanning probe of 5 or 7.5 MHz transducer was used. Results 1) Solid components The acoustic pattern of the solid tumor was either hyperechoic or iso-echoic. Six cases (three hemangioblastomas, two ependymomas, and one astrocytoma) were hyperechoic. Other four cases (two astrocytomas, one subependymoma, and one mixed glioma) were iso-echoic. 2) Cystic components The cysts associated with the tumor were anechoic in six out of eight cases, which were confirmed at surgery, and multiple cysts were identified.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320803 TI - [Hemorrhage in the quadrigeminal plate--a case report]. AB - We report a survival patient with hemorrhage in the quadrigeminal plate and discuss the literature of midbrain hemorrhage. A 13-year-old boy developed severe headache and vertigo on April 1st, 1983. On admission, he was comatose and tetraplegic with bilateral facial palsy and total ophthalmoplegia. CT scan revealed a hemorrhage in the midbrain and ambient cistern, but vertebral angiogram no abnormal vessels. Seven hours after admission, continuous ventricular drainage was performed. Disturbance of consciousness, ophthalmoplegia and speech disturbance were gradually improved. CT scan with contrast medium 3 weeks after admission showed a small high density spot in the right quadrigeminal plate. It might be suggested that this spot was the bleeding point and was probably a cryptic microvascular malformation. At the discharge only a minimal limitation of eye ball movement was left. PMID- 3320804 TI - [Maffucci's syndrome associated with primary brain tumor: report of a case]. AB - A rare case of Maffucci's syndrome associated with astrocytoma at the right frontal lobe and intracranial chondroma is reported in detail with a review of literature. A 24-year-old male who had diagnosed as multiple chondroma at the age of 14 years old was admitted to the hospital with complaint of double vision. Neurological examination revealed no abnormality except for the left abducens palsy. Multiple subcutaneous blue nodules in the left hand was carried for biopsy as cavernous hemangioma. Craniograph showed expansive radiolucent area in the parasellar region. CT scan demonstrated a round shaped low density area in the right frontal lobe, part of which was iso-density and turned out to be enhanced following contrast infusion. Roentgenogram disclosed many well-demarcated radiolucent area in phalanges of the left hand and leg, and right leg and third rib. The frontal tumor was totally extirpated and was histologically fibrillary astrocytoma. This is the ninth case of the Maffucci's syndrome associated with the primary intracranial tumor in the literature. It is emphasized that the Maffucci's syndrome is associated with a high incidence of malignancy. And the reason for tendency to develop malignant tumors is discussed. PMID- 3320805 TI - [Spontaneous occlusion of a cerebral arteriovenous malformation--report of a case]. AB - The authors report a case of spontaneous occlusion of an arteriovenous malformation (AVM) verified by the second angiography performed 3 days after the initial one. This 65-year-old man had a sudden attack of headache, nausea, and vomiting and was admitted to our hospital next day. On admission, CT scan showed subcortical hemorrhage in the right temporo-parietal area and right CAG showed a small AVM in the same area. The main feeder was a MCA distal branch and the drainer joined Labbe's vein. Repeated angiography 3 days after initial one failed to demonstrate the AVM. Craniotomy was performed and thrombosed AVM was totally removed. Mechanism for disappearance of the malformation is assumed to be acute thrombosis due to intracranial hemorrhage and arteriosclerotic change. The literature is reviewed. PMID- 3320806 TI - [A case of prolactinoma in close association with Rathke's cleft cyst]. AB - We report a case of Rathke's cleft cyst in pituitary tumor. A 31-year-old woman admitted to our hospital complained of visual disturbance, headache, amenorrhea and galactorrhea. Serum prolactin level was 3,060 ng/ml. By means of CT scan and MRI, we found suprasellar-extending tumor to have cystic component in the center of the tumor. Transsphenoidal surgery revealed grayish jelly-like content in the cyst. Histologically tumor cells were composed of chromophobic, basophilic and eosinophilic cells. The cyst wall in the pituitary adenoma was composed of ciliated or non-ciliated columnar epithelium intermingled with goblet cells, being similar to Rathke's cleft cyst. Except for the cells of the cyst wall, most of the tumor cells were immunoreactive for prolactin. As for intermediate filament, tumor cells in both solid and cystic portions showed positive immunoreactivity for cytokeratin and GFAP, and not for vimentin and neurofilament. These results suggest that the nature of the intracytoplasmic filament in the pituitary tumor with Rathke's cleft cyst may be not only keratin but also GFAP. PMID- 3320807 TI - Flunarizine in alternating hemiplegia in childhood. An international study in 12 children. AB - Twelve children with alternating hemiplegia were treated with the calcium-entry blocker flunarizine for 4 months. All but one patient responded favourably with a reduction in frequency and/or duration and severity of attacks. Interictal symptoms decreased and mental development improved in several patients. Nine of the patients entered a subsequent double-blind placebo-controlled withdrawal study lasting another 4 months. Relapses were observed in part of the placebo as well as of the flunarizine-treated patients. The reason for this is not clear, since it is unlikely that the favourable response during the initial open-label study would be due to a placebo effect, or that tolerance to the drug had developed. Feed-back from the parents rather suggests that stress and tension, which were known trigger factors in a majority of these patients, played a role when the patient was switched to the double-blind treatment. Although the present study is not fully conclusive, apparently because of the use of an inadequate trial design, flunarizine, the first truly promising drug in this disease, deserves further study. An appeal is made to join another international double blind study. PMID- 3320808 TI - Familial occurrence of intracranial aneurysms in childhood: a case report and review of the literature. AB - This report describes three individuals belonging to one family, who were affected with ruptured intracranial aneurysms (IAs) at a rather young age, 4, 15 and 23 years respectively. Familial IAs at this young age have not been described before. The evidence for a developmental, eventually inherited origin of familial IA in childhood is discussed with reference to the low occurrence of non-familial IA in childhood, IA-features in non-familial cases (localisation, multiplicity, size) and the association with (other) congenital malformations in the 0-5 years group. PMID- 3320810 TI - Autogeneic skull bone grafts. PMID- 3320809 TI - The use of a computerised database for the diagnosis of a rare neurological syndrome. AB - A database which runs on an office microcomputer is being developed for the diagnosis of genetically determined neurological disorders. At present about 1100 conditions with their clinical features and 3000 references are stored in the database. We discuss a family with 3 sibs affected by a unique neurological disorder and show how the database is used. The 3 sibs, 4, 5 and 10 years old, show the same clinical course characterized by congenital cataracts, microcephaly, hypotonia, mental retardation, pyramidal signs and choreoathetoid movements starting in early childhood. The parents are first cousins of Bangladeshi origin. This condition does not appear in published report and is not listed in the database. It can therefore be concluded that the sibs have a unique autosomal recessive disorder. PMID- 3320813 TI - [Echography in the study of thoracic pathology. I--Indications and limitations]. AB - The role of echography in the study of the thorax is evaluated: after reporting the technical limits due to the peculiar anatomy of this region, personal experience is presented. This method extremely precise to define the solid or liquid nature of tightly adherent to the chest wall lesions, but it is non specific to assess their benign or malignant behaviour. Ultrasounds have their on limits in drawing the extension of such lesions; these limits have been overcome by CT and MR. Finally the usefulness of the method in studying the diaphragm and its pathology is briefly described. PMID- 3320812 TI - [Cystic lymphangioma. Review of the literature and cases contribution]. PMID- 3320811 TI - [Reconstruction with mechanical stapler after anterior resection of the rectum]. PMID- 3320815 TI - [Historical and literary notes and attitude to sudden death. Chronology as a problem of definition]. AB - After describing the phenomenon of sudden death both from a historical and literary viewpoint, the paper tackles the problem of its definition which is not yet univocal in the present literature, and identifies it mainly in its chronology. PMID- 3320816 TI - Home care forum: cost viewpoints. PMID- 3320814 TI - [Neurotraumatology and post-traumatic epilepsy. Prevention, treatment and long term follow-up. Barbexaclone + phenobarbital (maliasin) versus diphenylhydantoin, phenobarbital, primidone, carbamazepine]. AB - A report is presented on 58 patients (46 males, 12 females) all suffering from post-traumatic epilepsy (PTE) and followed up for a minimum of 1 year to maximum of 23 years after the injury (mean 6.3 years). The type and site of the head injury, the nature of the brain lesions, the time elapsing before the first critical manifestation, the clinical character of the epileptic attacks, EEG, cerebral CAT and RMN data were performed are given for all patients. The therapeutic and prophylactic strategies adopted are then described in detail with particular emphasis on the use of diphenylhydantoin (DPH) and barbexaclone. The latter drug, used for the last 3 years was found to be particularly useful in the treatment of patients suffering from a post-traumatic psycho-organic syndrome in addition to the PTE. PMID- 3320817 TI - Brain dialysis: detection of acetylcholine in the striatum of unrestrained and unanesthetized rats. AB - A dialysis cannula was implanted into rat striatum while the animals were anesthetized, and after at least one day following the surgery the area was perfused with Ringer solution under the unrestrained and unanesthetized conditions. Concentration of acetylcholine (ACh) in the perfusate was determined by high-performance liquid chromatography (HPLC)-electrochemical detection (ECD) with the enzyme-column on which acetylcholine esterase and choline oxidase were immobilized. ACh in the dialysate was only detectable when the Ringer solution containing eserine, an inhibitor of acetylcholinesterase, was perfused. ACh peak on HPLC-ECD could be detected at least for 4 h under these conditions. The level of ACh increased 2-3 fold with the perfusion of 1 mM atropine sulfate, a blocker of ACh receptor. These data indicate that brain dialysis in the presence of eserine is useful for study on the neurochemical activity of ACh neurons in the brain. PMID- 3320818 TI - Evidence for a fast receptor turnover of D1 dopamine receptors in various forebrain regions of the rat. AB - The time course for recovery of binding of the D1 dopamine receptor antagonist radioligand [3H]SCH 23390, after administration of the irreversible antagonist N ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ), was studied in the neostriatum, nucleus accumbens, tuberculum olfactorium and claustrum of the rat by means of quantitative receptor autoradiography. The results showed that the receptor degradation rate constant (k) ranged from 0.0163 to 0.0315 h-1 and that the receptor production rate (r) ranged from 8.52 to 24.96 fmol/mg protein/h. These results indicate that the D1 receptor has a considerably faster turnover than the D2 receptor, which suggests that the D1 receptor may require a dynamic regulation including also changes in receptor production and degradation rates. PMID- 3320820 TI - The Medicare program of tomorrow--an insider's view. PMID- 3320819 TI - Simultaneous observation of fluorescent retrogradely labeled neurons and the immunofluorescently labeled fibers apposing them using Fluoro-Gold and antisera labeled with the blue fluorochrome 7-amino-4-methylcoumarin-3-acetic acid (AMCA). AB - In this paper we describe a method allowing the simultaneous observation of fluorescent retrogradely labeled neurons and the immunofluorescently labeled fibers which appose them. This technique employs the fluorescent dye Fluoro-Gold to label neurons retrogradely, and 7-amino-4-methylcoumarin-3-acetic-acid (AMCA) conjugated to a secondary antiserum as a label for fluorescence immunohistochemistry. Both Fluoro-Gold and AMCA are excited by near-ultraviolet (UV) light, but under UV excitation Fluoro-Gold appears yellow and AMCA appears blue. Thus the two fluorochromes are both visible under a single condition of illumination and can be readily distinguished by color. This allows quick and accurate determination of whether or not immunofluorescent fibers appose retrogradely labeled neurons. PMID- 3320823 TI - Physicians' guide to the laboratory diagnosis of viral infections. PMID- 3320821 TI - Diploma programs in nursing accredited by the NLN 1987-88. PMID- 3320822 TI - Dyskinetic cilia syndrome. PMID- 3320824 TI - A kinetic approach to the determination of human amino acid requirements. PMID- 3320825 TI - The Journal of Biological Chemistry, Volume 134, June 1940: Studies in protein metabolism. XIV. The chemical interaction of dietary glycine and body proteins in rats. By S. Ratner, D. Rittenberg, Albert S. Keston, and Rudolf Schoenheimer. PMID- 3320826 TI - Antitrust laws should help NPs. PMID- 3320827 TI - Care of the female rape victim. AB - Rape is indexed as the second-most-frequent violent crime, yet it also is considered the crime that is least reported. Rape is a serious offense against the person, assaulting both body and psyche, and victims may suffer short- or long-term impairment as well. As primary care providers, nurse practitioners are in a position to identify rape victims and begin interventions to alleviate suffering, provide supportive care and plan for follow-up in order to prevent devastating effects on the individual's life. The purpose of this article is to better acquaint nurse practitioners with the scope of rape and rape issues, and the impact rape has on adult female victims and their families. The article discusses the definition of rape; rape myths; prevalence and reporting; responses of practitioners, victims and families; and primary care interventions in the areas of counseling, physical assessment and treatment, and police/legal considerations. PMID- 3320828 TI - Microscopic bilateral adenocarcinoma arising in ovarian endometrial cysts. PMID- 3320829 TI - Hard and soft tissue oral changes following bone marrow transplantation. PMID- 3320830 TI - Periodontics 1988. A discipline in ferment. PMID- 3320831 TI - The gingival crevicular fluid meter. Its use and abuse. PMID- 3320832 TI - The metamorphosis of an artist. PMID- 3320833 TI - Radionuclide studies on gastric evacuatory function in health and in the duodenal ulcer disease. I. Types of solid meal distribution within the stomach and their relation to gastric emptying. AB - Solid meal distribution patterns within the stomach, as well as gastric emptying were studied in 35 healthy subjects and 34 duodenal ulcer patients. Inspection of the serial scintiscans., recorded during each gastric emptying examination, revealed three different intragastric meal distribution patterns. Distinction between the three types of meal distribution within the stomach was facilitated by the use of the proximal: distal stomach width ratio (P:D), a parameter with a proven reproducibility. The P:D ratio less than 0.7 characterized Type III stomach, whereas 0.7 less than P:D less than 1 + 45 and P:D greater than 1.45 described Types I and II, respectively. Attention was focussed on the relationship of the intragastric meal distribution patterns to total stomach emptying. A significantly higher incidence of Type III stomach in women was accompanied by delayed gastric emptying and different emptying pattern when compared to men (T1/2 107.4 +/- 5.74 versus 84.2 +/- 3.21 min, mean +/- SEM p less than 0.001). Irrespective of the equally frequent occurrence of the relevant stomach types in normals and in duodenal ulcer patients, increased gastric emptying was observed in the latter group T1/2 90.8 +/- 3.30 versus 76.7 +/- 3.82 min, means +/- S.E.M., p less than 0.01). The necessity of establishing the normal range of gastric emptying parameters separately for men and women is concluded. PMID- 3320835 TI - [Eye changes in thyroid disease]. PMID- 3320834 TI - [Hemodynamics of the choroid studied by M-scanning in aphakic patients]. PMID- 3320836 TI - Early pseudophakic keratopathy: revealing macrophage reaction in endothelial layer. AB - The pathology of early pseudophakic keratopathy is demonstrated in a corneal button obtained at penetrating keratoplasty for persisting corneal edema and bullous keratopathy 4 months following extracapsular cataract extraction with a posterior chamber lens implant. Histological examination revealed a distinct cell loss and a macrophage reaction that was centered on degenerating endothelial cells in the corneal endothelium. PMID- 3320837 TI - Closed loop anterior chamber lens: a review of 127 Leiske Lens implants. AB - One hundred twenty-seven consecutively implanted Surgidev Style 10 Leiske Lenses were evaluated. Average time of follow-up was 41.3 months. Although final acuity of 20/40 or better was achieved in 93% of patients, the surgical reintervention rate was 14%. Penetrating keratoplasty was required in seven of ten patients with corneal edema-5.5% of all eyes. Oval pupils were noted in 71% of cases. An upwardly mobile lens with displacement through the superior iridotomy was noted in 7.9% of eyes and required reoperation in 5.5% of the 127 eyes. It is recommended that use of the Surgidev Style 10 Lens be discontinued. PMID- 3320838 TI - Simplified diagnostic coding sheet for computerized data storage and analysis in ophthalmology. AB - A review of currently-available diagnostic coding systems revealed that most are either too abbreviated or too detailed. We have compiled a simplified diagnostic coding sheet based on the International Coding and Diagnosis (ICD-9), which is both complete and easy to use in a general practice. The information is transferred to a computer, which uses the relevant (ICD-9) diagnoses as database and can be retrieved later for display of patients' problems or analysis of clinical data. PMID- 3320839 TI - Age-related changes in water and crystallin content of the fetal and adult human lens, demonstrated by a microsectioning technique. AB - By means of a microsectioning technique, human fetal and adult lenses were divided into 8-16 fractions. The dry weight (DW), the water content, and the amounts of water-soluble (WS) crystallins and water-insoluble (WI) lens fraction were determined in each layer or fraction. Within the lens, the changes of these parameters are gradual and continuous. The lens nucleus contains the highest amounts of DW and WI fraction, and the lowest amounts of water and WS crystallins. There is a relative dehydration of the lens during development and ageing, most pronounced in the lens nucleus. PMID- 3320841 TI - Classification of diabetic retinopathy. AB - A review of the literature on the classification of diabetic retinopathy shows that a consensus of opinions is not attained. Therefore it is impossible to compare the results of different works. Most of the classifications are based on purely anatomical criteria (ophthalmoscopic or photographic). The authors propose to base the classification of diabetic retinopathy on angiographic criteria. They consider that only fluorescein angiography can take into consideration the functional evaluation of the retinal circulation with unquestionable pathogenic correlation and adapted treatment: edematous diabetic retinopathy corresponds to capillary dilatation and ischemic diabetic retinopathy corresponds to capillary occlusion. Macular diseases are classified according to these same criteria. PMID- 3320840 TI - [Malaria tropica with macular hemorrhage]. AB - We describe the case of a 33-year-old patient with recurrent tropical malaria, comma and isolated subpigmentepithelial macular hemorrhage causing irreversible visual loss. This strictly subpigmentepithelial macular hemorrhage is the second case described. Its importance lies in the fact that the typical plugging of vessels in acute tropical malaria is also observed in the choroid. Current knowledge about occlusion during acute malaria falciparum infection and hypotheses concerning its cause are reviewed in relation to retinal and choroidal pathology. PMID- 3320842 TI - Diagnostic arthroscopy of the temporomandibular joint. Part I: Normal arthroscopic findings. PMID- 3320843 TI - Influence of radiation therapy on oral Candida albicans colonization: a quantitative assessment. AB - An increase in quantity of oral Candida albicans was documented in patients receiving head and neck radiation therapy during and after therapy, as assessed by an oral-rinse culturing technique. The amount of the increase was greater in denture wearers and directly related to increasing radiation dose and increasing volume of parotid gland included in the radiation portal. A significant number of patients who did not carry C. albicans prior to radiation therapy developed positive cultures by 1 month after radiation therapy. The percentage of patients receiving head and neck radiation therapy who carried C. albicans prior to radiation therapy did not differ significantly from matched dental patient controls. PMID- 3320845 TI - [Genital actinomycosis in women wearing an IUD]. PMID- 3320844 TI - A prospective randomized trial comparing periapical instrumentation to intracanal instrumentation in cases of asymptomatic pulpal-periapical lesions. AB - To clarify the divergent viewpoints with respect to method of instrumentation in asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL), this prospective study was undertaken. The subjects were 106 patients with quiescent cases of PN/PL. Alternately, 53 had periapical instrumentation and 53 had intracanal instrumentation. Prophylactic antibiotics were not administered but the patients were told to take an antibiotic at the first sign of swelling. Flare-ups, non-flare-up-associated swelling and pain, and cases in which there were no postoperative problems were evaluated at 1-day, at 1 week, and at 2 months. A 6.6% incidence of flare-up was found with no statistically significant difference between periapical instrumentation (7.5%) and intracanal instrumentation (5.7%). A 27.4% incidence of swelling was found with no statistically significant difference between periapical instrumentation (24.5%) and intracanal instrumentation (30.2%). A 43.4% incidence of pain was found, with no statistically significant difference between periapical instrumentation (15.1%) and intracanal instrumentation (47.2%). When moderate pain and severe pain were combined, the incidence was 21.7%, with no statistically significant difference between periapical instrumentation (15.1%) and intracanal instrumentation (28.3%). An incidence of patients having no postoperative problems of 41.5% was found, with no statistically significant difference between periapical instrumentation (47.2%) and intracanal instrumentation (35.8%). When flare-ups were combined with swelling, the incidence was 34.0%, with no statistically significant difference between periapical instrumentation (32.1%) and intracanal instrumentation (35.8%). When flare-ups were combined with pain, the incidence was 50.0%, with no statistically significant difference between periapical instrumentation (47.2%) and intracanal instrumentation (52.8%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3320846 TI - [Adult rhabdomyosarcoma of the larynx]. PMID- 3320847 TI - [Remembering the 175th anniversary of the birth of Dome Nedelko]. PMID- 3320848 TI - [The construction of medical buildings at the turn of the century]. PMID- 3320849 TI - [Hospital lyrics]. PMID- 3320850 TI - [Analysis of biopsy specimens embedded in synthetic resins without decalcification and their importance in hematology]. PMID- 3320851 TI - [Analysis of the effectiveness and adverse effects of the drug combinations CAP and CEP in the therapy of patients in the advanced stages of ovarian cancer]. PMID- 3320852 TI - [Sex hormone abnormalities in systemic lupus erythematosus. Effect of contraceptives]. PMID- 3320853 TI - [Value of surgical shunts in the management of infantile hydrocephalus in the light of late results]. PMID- 3320856 TI - [Anthropological achievements of Mihaly Lenhossek]. PMID- 3320855 TI - [Centenary of electrocardiography. Remembering Augustus Desire Waller]. PMID- 3320854 TI - [Acremonium strictum meningitis in prolonged steroid therapy]. PMID- 3320857 TI - [Life-time achievements of Endre Jeney: the dilemma of a many-sided talent]. PMID- 3320858 TI - [Pathology of spinal tumors]. AB - The Bone Tumor Registry of Westphalia contains data on 7,400 tumors and tumor like lesions of bone, 135 primary spinal tumors, 187 metastases, 98 plasmacytomas, 4 extranodal manifestations of Hodgkin and non-Hodgkin lymphomas of the vertebral column. The most frequent type of primary tumor is the chordoma (35 cases), followed by osteoblastoma (16 cases), eosinophil granuloma (16), and hemangioma (12 cases). Most of the metastases derive from carcinoma of the breast, bronchial carcinoma, or prostate carcinoma. The present review concentrates on differential diagnosis by means of histological examination, with particular reference to immunohistological methods. In addition, the necessity for complementary assessment of the X-ray findings and histology is emphasized. In particular, the current status of knowledge on the prognosis of primary spinal tumors is presented. In our experience, the preparation of nondecalcified plastic sections has proved especially valuable for diagnostic procedures using punch biopsy specimens. PMID- 3320859 TI - [Principles, indications and results of radiotherapy of spinal tumors]. AB - In primary and secondary tumors of the spinal column, radiotherapy is used to effect a cure, but mainly the goal is palliative. In the latter case, the course is either accelerated over less than 2 weeks (e.g., 1 dose of 10 Gy, 5 X 4 Gy, 10 X 3 Gy) or extended over 3 or more weeks (e.g., 40-50 Gy over 4-5 weeks). For teletherapy, megavolt radiotherapeutical devices are mainly used. In addition, supplementary brachytherapy is available with iodine-125 or iridium-192 seeds. PMID- 3320860 TI - [Benign tumors of the spine]. AB - The most common benign tumors and tumor-like lesions are presented from the aspects of localization in the spinal column and the resulting implications for diagnosis and therapy. For some of these tumors (aneurysmal bone cysts, osteoblastomas, giant cell tumors), von Enneking's suggested staging classification (latent, active, aggressive) is valuable for planning the operation (curettage, tumor removal with healthy tissue margins, wide en bloc resection). If the tumor stage is evaluated preoperatively, problems can be avoided such as overtreatment leading to loss of stability that could have been avoided or the danger of recurrence because the operation was not sufficiently radical. Embolization of the tumor vessels, as an adjuvant measure, not only makes the excision of highly vascular tumors easier, but also can be a means of curbing tumor growth in inoperable cases. PMID- 3320861 TI - [Osteosyntheses and replacement of vertebral bodies in spinal tumors]. AB - The modern concepts for resection and stabilization of primary and metastatic spinal tumors are described in detail. The indications and operative procedures, including the current concepts of stabilization (osteosynthesis, autologous, homologous and artificial vertebral body replacement materials), are presented with special reference to applications to the cervical, thoracic, and lumbar spine. Indications for operative treatment in metastatic spine involvement are especially emphasized and documented with clinical examples. The paper includes an extensive list of recent publications. PMID- 3320862 TI - The anatomy of external rhinoplasty. AB - The results achieved in rhinoplasty are directly related to the surgeon's ability to elucidate how subtle changes in the bony and cartilaginous supports of the nose will alter its appearance. Therefore, any surgeon who performs rhinoplastic procedures requires a sophisticated knowledge and understanding of the anatomy of the nose. This article reviews the anatomy of the nose from the perspective of the external rhinoplasty approach. PMID- 3320864 TI - Rhinoplasty analysis. AB - Accurate analysis is the foundation for successful rhinoplasty. A general outline for systematic analysis is presented. The importance of accurate recordkeeping and self-analysis is stressed. Examples illustrate the high points of the article. PMID- 3320863 TI - Facial analysis for rhinoplasty. AB - Evaluation of preoperative rhinoplasty patients requires a careful study of overall facial proportions (including the profile relationships of the chin). High-quality photographs and computer analysis can assist the surgeon in this analysis. PMID- 3320865 TI - Nasal valve physiology. Implications in nasal surgery. AB - Knowledge of the structure and function of the nasal valve region is required by all who operate on the nose. This article defines and classifies nasal valve region abnormalities; discusses principles, goals, and details of surgery in this area; and considers strategies to avoid or minimize complications, especially in cosmetic rhinoplasty. PMID- 3320866 TI - The nasal septum. AB - The nasal septum plays a paramount role in determining nasal aesthetics and nasal function. Surgical management of the nasal septum often presents a challenge to even the most skilled nasal surgeon. A firm understanding of anatomic and physiologic aspects of the nasal septum will allow the rhinoplasty surgeon to better deal with this component of nasal reconstruction. PMID- 3320867 TI - Surgery of the nasal tip. AB - Ten operative procedures for surgery of the nasal tip are described and illustrated with case photographs. A working understanding of the various tip techniques described should allow the rhinoplastic surgeon to achieve consistently good results. PMID- 3320869 TI - Misadventures in nasal tip surgery. Analysis and repair. AB - Nasal tip surgery is a compromise, in which the surgeon gives away something to achieve something--a narrower, more defined, and stable tip component of the nose. Years of experience are required to thoroughly understand and master tip surgery techniques. While gaining this arduous but invaluable insight, emphasis should always be placed on conservation of tip anatomic structures and avoidance of radical excision and sacrifice of tip tissue. Compulsive long-term follow-up and evaluation of patients, both by frequent examination and review of standardized, uniform photographs, best facilitates the development of expertise in nasal tip surgical refinement. PMID- 3320868 TI - Vertical dome division in rhinoplasty. AB - Vertical dome division in nasal tip surgery allows for repositioning of tissue with minimal excision. In difficult situations, these techniques will often enable the surgeon to maintain good tip position and appearance without the use of grafts. It is a technique worth the attention and understanding of the conservative rhinoplasty surgeon. PMID- 3320870 TI - Surgery of the bony and cartilaginous dorsum. AB - Successful management of the bony and cartilaginous dorsum requires accurate preoperative assessment and surgical planning. Careful management of the dorsum avoids most of the common pitfalls in rhinoplasty and contributes to patient satisfaction. PMID- 3320871 TI - Open rhinoplasty. AB - Excellent exposure of the nose is possible using the open rhinoplasty technique. This technique improves surgical control of the maneuvers employed, leading to better surgical results. However, thorough understanding and skill in application of rhinoplasty technique are necessary to acquire these better results. The stigma of the columellar incision is slowly being put to rest, as surgeons, employing the technique relate their satisfaction and their patients' lack of dissatisfaction with the scar. Increasingly, surgeons are utilizing this technique, thereby learning more about rhinoplasty and enhancing the teaching and performance of this art. Acceptance is increasing, even to the point of popularity. Open rhinoplasty has survived its infancy and is enjoying a vigorous growth in North America. PMID- 3320873 TI - Non-caucasian rhinoplasty and adjunctive reduction cheiloplasty. AB - This article is based on 19 years of experience that includes more than 300 cases of reconstructive nasal surgery in non-Caucasians. The evolution of the author's surgical technique is presented, as influenced by long-term effects of various surgical maneuvers. The adjunctive reduction cheiloplasty is also discussed. PMID- 3320872 TI - Postoperative sequelae and complications of rhinoplasty. AB - This article has overviewed complications of rhinoplasty. Generally, these complications fall into two categories: aesthetic (that is, cosmetic sequelae that may require a revision rhinoplasty) and nonaesthetic. Of the nonaesthetic complications, infection has the widest span of severity. A localized Staphylococcus aureus abscess or Pseudomonas infection of the nose may occur postoperatively. Owing to the proximity of the nose to the cranium, a cavernous sinus thrombosis or basilar meningitis may result. Postoperative toxic-shock syndrome is a rare occurrence that surgeons should be aware of; most cases have occurred with the presence of nasal packing, but a case using only plastic nasal splints has been reported also. Bacteremia seems to be uncommon during rhinoplasty. Infection after rhinoplasty is generally much less frequent than one would expect from an operation in an unsterile field. Antibiotics are frequently utilized electively. Postoperative nasal-periorbital edema and ecchymosis are regarded as unavoidable but may be lessened significantly by postoperative head elevation and cold packs. The possibility of postoperative bleeding must be evaluated by the surgeon preoperatively. This sequela usually occurs either within 72 hours postoperatively or at around 10 days postoperatively. Many different causes exist for chronic postoperative nasal obstruction, from poorly supported nasal valves closing upon inspiration to an enhanced allergic rhinitis leading to chronic nasal mucosal edema. The latter may be treated by injection of steroid into the turbinates. Among aesthetic complications, supratip prominence, saddle deformity, and persistent hump are among the more commonly reported. Supratip prominence--"polly-beak"--can be caused by inadequate reduction of tip cartilaginous or soft-tissue elements, especially in relation to the reduction of the dorsum. An over-reduced dorsum will leave an otherwise normal nasal tip with a relative prominence. An accumulation of blood or a mucous cyst occurring under the skin of the tip will produce a prominence. Poor tip projection, tip ptosis, and alar collapse are the result of overreduction of tip elements. A dislocated alar cartilage can appear as an asymmetric nasal bossa. Saddle-nose deformity occurs after overaggressive bony and/or cartilaginous hump removal. Infractured nasal bones that subsequently drop into the piriform aperture can create a bony saddle. Persistent hump is due to inadequate reduction of a bony or cartilaginous hump. If the septal cartilage reduction is disproportionate to the bony septum reduction, the appearance of either a hump or a saddle is possible.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3320874 TI - Adjunctive measures to rhinoplasty. AB - In the profile analysis of the rhinoplasty patient, consideration should be given to adjunctive measures that may enhance the overall appearance of the patient. This article discusses augmentation of the chin and cheekbones with particular emphasis on technique. Refinements in surgery for the nasal alae and base of the nose are explained as adjunctive procedures to improve the proportions of the inferior triangle (base) of the nose. PMID- 3320875 TI - Grafts and implants in nasal and chin augmentation. A rational approach to material selection. AB - Two major factors are involved in choosing augmentation materials: (1) the specific properties and limitations of the materials themselves (Table 2) and (2) the characteristics of the site for implantation. A wide variety of materials are currently available and these vary in density, ability to be sculpted, tissue reaction, resorption, migration, incidence of infection, extrusion rate, and ease of removal. Some of these characteristics are self-evident. For example, materials with high infection or extrusion rates (such as Silastic in nasal reconstruction) are clearly not useful in most instances. Likewise, materials that tend to migrate, such as tiny bits of cartilage, can lead to unacceptable results, but cartilage is such a generally good augmentation material in the nose that the measures to ensure stability are worth the additional time required for implantation. Resorption is a potential problem with all the biologic grafts and possibly with Supramid. Again, in certain situations in which alloplasts are unacceptable, such as infected areas, biologicals must be used and the consequences of resorption accepted. Density and ease of sculpting are often a matter of the surgeon's personal choice. As a general rule, bone is best replaced with firm materials and soft tissues are best augmented with soft materials. Should infection or rejection occur, the porous materials are much more difficult to remove; therefore, Silastic or a biological may be the best choice if there is any question about the presence of infection or possible future infection. The effect of the degree of tissue reaction is not well-understood. For example, Supramid elicits a marked tissue response but in general displays high compatibility with the tissues. Further investigation is needed to elucidate the role of tissue reactivity and porosity in the development of infection and extrusion. When choosing the implant material, the specific characteristics of the site for augmentation must be considered. A good example is the nose. Its mobility and thin soft-tissue coverage lead to extrusion of firm implants such as Silastic. By contrast, Silastic works well for chin augmentation. Also, consider present or future bacterial contamination in the area. This is especially important in nasal augmentation, where infection and extrusion can lead to unacceptable deformities. In general, nasal augmentation is best achieved in most circumstances by cartilage. If this is unavailable, then Supramid has a proven record for good tissue compatibility and resistance to infection. For the chin, Silastic (either rubber- or gel-filled prostheses) produces the most pleasing and long-lasting results. PMID- 3320876 TI - New guidelines for the treatment of tuberculosis. PMID- 3320877 TI - Somewhere in Pennsylvania. PMID- 3320878 TI - Sectarian medical periodicals of Pennsylvania. Part Two--Pennsylvania journals. PMID- 3320879 TI - On the relationship between chronic pain and depression when there is no organic lesion. AB - Patients suffering from pain without evidence of either depression or organic lesions, or of any pathophysiological process to which the pain might be attributed, may be diagnosed as suffering from 'indeterminate pain.' The evidence in the literature which suggests that some of these cases might be due to a 'depressive equivalent' is examined. It is suggested that it is difficult, if not impossible, to formulate a diagnosis of depressive illness in patients who do not have clear symptoms of depression. However, there is evidence in the literature that a relatively high percentage of patients with chronic indeterminate pain appear to have a family history of depression and depressive spectrum disorders. Biological markers of depression also give some indication that certain of these patients may have a link with depressive illness as well as with pain. It is suggested that there is a need to explore the existence of a sub-group of patients with indeterminate pain in whom the mechanism of the pain may be related to the mechanism of depressive illness even though formal depressive symptoms are not found. PMID- 3320881 TI - Involvement of endogenous opioid peptides in acupuncture analgesia. PMID- 3320880 TI - Cocaine and morphine interaction in acute and chronic cancer pain. AB - An evaluation of the analgesic, mood and side effects of the combination of intramuscular morphine and oral cocaine was conducted in 17 patients with postoperative pain and 19 others with chronic malignant pain for the purpose of assessing the therapeutic merits of so-called 'euphoriant' elixirs in the management of pain in cancer patients. The study was designed as a randomized and double-blind single dose but complete cross-over comparison of the combination of 10 mg intramuscular morphine and 10 mg oral cocaine with morphine alone, cocaine alone, and placebo. While patients clearly discriminated between the analgesic effects of morphine and placebo, there were no differences in the analgesic responses to cocaine and placebo, or in responses to morphine and the combination of morphine and cocaine in either patient group. Side effects were predominantly morphine-like and occurred in 59% of patients after the combination, 43% after morphine, 34% after cocaine and 25% after placebo. Interaction effects between cocaine and morphine were observed in terms of positive changes toward selected aspects of mood (e.g., cheerful, friendly) in postoperative patients but toward negative aspects of mood (e.g., sad, serious) in patients with chronic pain. PMID- 3320882 TI - Pain greater than pain behaviors: the utility and limitations of the pain behavior construct. AB - A great deal of attention has been given to the importance of learning factors in communications of pain and suffering--pain behaviors. The concept of pain behaviors has served a heuristic function, however, there remain a number of important questions to be answered regarding the assessment and conceptual limitations of the construct. These concerns and questions must be acknowledged if the construct is to be of use in enhancing our understanding of chronic pain syndromes and to be employed in treatment. Current conceptualizations of pain behaviors are examined and methods of assessing pain behaviors are evaluated. The validity and utility of the construct and its limitations are discussed. It is concluded that failure to consider psychosocial, psychophysiological, and medical physical factors may lead to an inadequate understanding of the patient and results in inappropriate treatment interventions. Suggestions for refined understanding of the scope of the construct are provided. PMID- 3320883 TI - Interrelationships between body weight, insulin secretion from B cell and metabolic control in type 2 (non-insulin-dependent) diabetics with fasting hyperglycemia. PMID- 3320885 TI - Definition and classification of endometrial carcinoma precursors. PMID- 3320884 TI - Effects of cimetidine and ranitidine on serum high density lipoprotein total cholesterol concentrations. A review of literature and personal opinions. PMID- 3320886 TI - Reverse immuno fixation: characteristics of a new technique. PMID- 3320887 TI - Comparative analysis of the Plasmodium falciparum histidine-rich proteins HRP-I, HRP-II and HRP-III in malaria parasites of diverse origin. AB - Plasmodium falciparum-infected erythrocytes (IRBC) synthesize 3 histidine-rich proteins: HRP-I or the knob-associated HRP, HRP-II and HRP-III or SHARP. In order to distinguish these proteins immunochemically we prepared monoclonal antibodies which react with HRP-I, HRP-II and HRP-III, and rabbit antisera against synthetic peptides derived from the HRP-II and HRP-III sequences. A comparative analysis of diverse P. falciparum parasites was made using these antibodies and immunoprecipitation or Western blotting. HRP-I (Mr 80,000-115,000) was identified in all knob-positive P. falciparum parasites including isolates examined directly from Gambian patients. However, this protein was of lower abundance in these isolates and in 6 knob-positive, culture-adapted parasites compared to Aotus monkey-adapted parasites or culture-adapted parasites studied previously. HRP-II (Mr 60,000-105,000) was identified in all P. falciparum parasites regardless of knob-phenotype, and was recovered from culture supernatants as a secreted water soluble protein. Within IRBC, HRP-II was found as a complex of several closely spaced bands. Cell surface radio-iodination of IRBC from several isolates and immunoprecipitation with a rabbit antiserum against the HRP-II repeat sequence identified HRP-II as a surface-exposed protein. Like HRP-I, the abundance of HRP II was lower in the Gambian isolates than with Aotus monkey-adapted parasites studied earlier. Neither HRP-I nor HRP-II were identified in a knob-positive isolate of P. malariae collected from a Gambian patient. Analogues of these HRP were also absent from asexual parasites of diverse primate and murine malaria species screened with this panel of antibodies. HRP-III (Mr 40,000-55,000) was distinguished by its lower apparent size and by specific reaction with rabbit antibody against its 5-mer repeat sequence. HRP-III was of lowest abundance compared with the other two HRP. These antibody reagents and distinguishing properties should prove useful in studies on the separate functions of the 3 P. falciparum HRP. PMID- 3320889 TI - Peptidase in the plasma of mice infected with Trypanosoma brucei brucei. AB - The plasma of mice infected with pleomorphic Trypanosoma brucei brucei contains a peptidase which has the same electrophoretic mobility on starch gels as a parasite peptidase. An enzyme with this electrophoretic mobility was not detected in the plasma of uninfected mice. The molecular weight of this enzyme in either parasite lysate or plasma from infected mice was approximately 40,000 Da when assayed on a size exclusion column using high-performance liquid chromatography. The enzyme can cleave the dipeptides leu-ala, val-leu and pro-leu, but not the dipeptide phe-ala. The enzyme also cleaved the tripeptides tyr-tyr-tyr and leu gly-gly. Another parasite peptidase which migrates on starch gels to a different position than the above-mentioned peptidase cleaved the dipeptides leu-ala, val leu and pro-leu but could not cleave the tripeptides tyr-tyr-tyr or leu-gly-gly. Furthermore, incubation of this parasite peptidase with normal mouse plasma at 37 degrees C resulted in an apparent loss of detectable activity. It is postulated that the plasma of mice modifies either the charge or enzymic activity of this peptidase. We speculate that the parasite peptidase present in the plasma of mice infected with T. brucei could contribute to pathogenesis. PMID- 3320888 TI - Inhibitory, opsonic and cytotoxic activities of monoclonal antibodies against asexual erythrocytic stages of Plasmodium falciparum. AB - A range of monoclonal antibodies specific for Plasmodium falciparum were tested in vitro for their abilities to inhibit the multiplication of a partially synchronized culture of P. falciparum, to augment the phagocytosis of the parasites by macrophages, and to enhance the killing of parasites by peritoneal cells depleted of adherent cells. Seven of 17 monoclonal antibodies, ranging from culture supernatant fluid and ascitic fluid to purified IgG, showed dose- and time-dependent inhibition of parasite growth in vitro. At a concentration of 0.6 mg/ml, the inhibitory capacity of these monoclonal IgGs was above 94% over a 3 day culture period, much higher than that of the relevant polyclonal IgG. Four of 6 monoclonal antibodies tested augmented the phagocytosis of the parasites by macrophages, which occurred as a result of opsonization of the parasites. Four of 7 monoclonal antibodies examined showed cytotoxic activity on malaria parasites. Peritoneal cells depleted of adherent cells were capable of killing the parasites in the presence of monoclonal antibodies. These results indicate that there may be 'monofunction', 'bifunction', and 'multifunction' types of monoclonal antibodies against P. falciparum. The putative protective antigen of malaria parasites purified by 'multifunctional monoclonal antibody' affinity chromatography may have potential interest as a vaccine against the parasite or as an immunodiagnostic reagent for human malaria. PMID- 3320890 TI - Questions in digenean systematics and evolution. PMID- 3320891 TI - Eimeria tenella sporozoites: the method of excystation affects the surface membrane proteins. AB - Eimerian sporozoites can be recovered from intestinal washings after oral administration of oocysts to chickens but suspensions of sporozoites are usually prepared in the laboratory by incubation of sporocysts or fractured oocysts in vitro, at body temperatures, with relatively high concentrations of trypsin and bile salts. Since these agents affect membrane structure, the surface membrane of proteins of Eimeria tenella sporozoites excysted in vivo and in vitro have been compared. Surface radio-iodination followed by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) showed that more 125I was incorporated into polypeptides on sporozoites excysted in vivo than on sporozoites excysted in vitro. The 125I-polypeptide profile of sporozoites excysted in vivo was more resistant to subsequent incubation with pure trypsin than that of sporozoites excysted in vitro, but incubation with bile salts resulted in the loss of some iodinated polypeptides from both preparations of iodinated sporozoites. Reaction with combinations of crude trypsin and bile salts led to the lysis of sporozoites. The method of excystation had no effect on the reaction of convalescent chicken serum with Western blots of sporozoites but the results of immunofluorescent staining carried out with mouse monoclonal antibodies indicated that the structure of the cell surface was altered and some antigenic determinants were lost from sporozoites excysted in vitro. In contrast, neither the infectivity of sporozoites determined in vivo, nor their invasion of cultured cells was changed by the method of excystation. PMID- 3320892 TI - The impact of host nutrition on gastrointestinal helminth populations. PMID- 3320893 TI - Long-term cultures of human bone marrow cells, an update. PMID- 3320894 TI - [Antibiotherapy in the elderly]. PMID- 3320895 TI - [Measurement of lumbar bone mineral density by biphoton absorptiometry. Methodology. Reproductibility. Normal values]. AB - Measurements were made with a DPA apparatus (Novo Lab 22a) on different phantoms and on volunteers in an attempt to evaluate the system precision. The reproductibility was found in the range of 0.98 to 4.10% in the case of in vitro measurements, depending on the geometry of the phantoms used, and in the range of 1.6 to 2.94% for volunteers after repositioning. Secondly, the BMD in the lumbar spine of normal women and normal men was estimated. In control females, the BMD is well fitted to the age by a cubic regression. The maximum value of the BMD is found in this case at the age of 31.5 and the maximum rate of bone loss takes place at 57. Total bone loss between 31.5 and the elderly is about 32%. In control males, results are more scattered and are represented by a simple linear regression. The average mineral loss between 30 and 80 years is 11.5% in this area of measurement. PMID- 3320896 TI - [Comparative pharmacokinetics and renal accumulation of the iodized contrast media: ioxitalamic acid, ioxaglic acid and iohexol in the rabbit]. AB - Male and female rabbits were given a I.V. bolus injection of a single 5 ml/kg dose of either ioxitalamic acid, ioxaglic acid or iohexol. Animals were killed 2 hours, 8 hours and 24 hours after the injection. One group of animals received a continuous I.V. infusion of contrast agent at a constant rate of 2.5 ml/kg/hour of four hours. Animals were killed 30 minutes after the end of the infusion. Plasma and tissue concentrations of contrast agents were assayed using an HPLC method. A pharmacokinetic study was performed after the I.V. bolus injection. This study shows that: 1) Plasma elimination half-lives were identical in males and in females as well as for all three products. This half life is about 45 minutes. The distribution volume was identical in male and females as well as for all three products and was comprised between 20% and 26% of body weight. 2) For all three contrast agents, the renal cortical concentrations are higher than in the medulla or the papilla at all the observation times. The renal cortical accumulation of contrast agents is persistent in comparison to plasma concentrations. 3) Ionic and lipophilic properties of contrast agents seem to play an important role on the renal accumulation pattern. PMID- 3320897 TI - [New method of estimating iodine overload in the urine from a simple urination]. AB - Iodine research holds an increasing place in thyroid pathology, either to cover a radioisotopic investigation with paradoxal results or to find an iatrogenic cause to an unexplained hypo- or hyperthyroidism in new born children as well as in adults. To determine iodine overloads we may need a urinary iodine estimation, in addition to blood iodine determination (quickly eliminated products) or instead of it (difficult blood taking: new born children, etc.). Classically, the 24 hours urinary iodine estimation (total urinary iodine) covers this need but, in practice, as we generally deal with ambulatory patients, the risks linked to the obtention of a perfect 24 hours urine collecting make us abandon it. This article presents an original and simple way of getting round this difficulty: it demonstrates that an excellent iodine overload estimation can be obtained by measuring simultaneously from a simple miction: on one hand iodine concentration, on the other hand the urinary creatinine. PMID- 3320899 TI - [Diffusion of vancomycin in the cerebrospinal fluid, in the dog, in the absence of meningeal inflammation]. AB - The diffusion of vancomycin into the cerebro-spinal fluid was studied in 5 healthy dogs. Its appears that vancomycin does diffuse across the blood-brain barrier. Though the concentrations reached in the CSF are low, they are of the same order of magnitude as the minimal inhibitory concentrations of this antibiotic towards the germs usually treated. The usual pharmacokinetic parameters were determined. PMID- 3320898 TI - [Multivariate analysis of biological markers of excessive consumption of alcohol. Value of lipoprotein parameters]. AB - In order to investigate the usefulness of lipid, lipoprotein and apolipoprotein parameters for detection of intemperate drinkers, 90 adult male subjects with an alcohol consumption above 400 g weekly were compared to 90 matched (age, body weight index) male subjects with an alcohol consumption below 250 g weekly. GGT and MCV were also evaluated. Univariate analysis showed GGT, apolipoprotein A-II and phospholipid-LP no B levels to be parameters the most significantly different between drinkers and controls. Discriminant analysis using six parameters in addition to apolipoprotein A-II allowed to classify correctly 80% of subjects (efficacy) with respect to their alcohol consumption. However, sensitivity of the parameters remains relatively low and a good efficacy is obtained only with a composite index of several parameters. PMID- 3320900 TI - [Comparative efficacy of ampicillin, chloramphenicol, cefotaxime, ceftriaxone and pefloxacin in experimental Salmonella typhimurium infection]. AB - The efficacies of various antibiotics were compared in Salmonella typhimurium infection in mice. Treatment began 24 h after challenge. Antibiotics were given subcutaneously every 12 or 24 h in the following daily doses: 200 mg/kg for ampicillin, 100 mg/kg for chloramphenicol, cefotaxime and ceftriaxone, 50 mg/kg for pefloxacin. The number of bacteria in the spleens was determined after 3 and 7 days of treatment. In animals treated with ceftriaxone or pefloxacin the mean number of bacteria per spleen was from one to two log10 lower than in animals treated with other antibiotics. Similar results were obtained in genetically susceptible or resistant mice. The MIC being similar for cefotaxime, ceftriaxone and pefloxacin, the better in vivo activity of the two latter drugs appears to be related to their pharmacokinetic properties. PMID- 3320902 TI - A spontaneous lymphoblastic lymphoma in a guinea-pig. AB - The exceptional carcinoresistance of guinea-pigs is well known and only a few cases of spontaneous leukaemia and several very rare cases of lymphoma have been reported in the literature. A spontaneous malignant tumor in an old male hybrid guinea-pig is described. The monomorphous aspect of the tumour, the cellular cohesiveness, the "starry-sky" pattern and the immunocytological characterization of tumour cells as B lymphocytes bearing IgM, lead to describe this tumour as a probable spontaneous Burkitt-type malignant lymphoblastic lymphoma. PMID- 3320901 TI - [Transurethral surgery and persistent urinary infection: effect of a single preoperative dose of cefuroxime]. AB - To evaluate the efficacy of cefuroxime, a second generation cephalosporin, in minimizing the risk of per and postoperative infection complications in patients with urinary tract infection undergoing transurethral surgery, 86 patients (ASA I, II) with persistent urinary tract infection despite antibiotic therapy were studied. A double blind protocol was followed. Patients were randomly assigned to receive 10 minutes before surgery either I.V. cefuroxime (1.5 g) (group C, n = 39) or placebo (group P, n = 47) the incidence of positive peroperative systematic blood cultures was lower in group C (9.7%) than in group P (25.2%) (p less than 0.001). The incidence of postoperative blood cultures taken when clinical septic signs were present, was significantly lower in group C (0%) than in group P (21.7%) (p less than 0.05). However neither the incidences of both postoperative urinary tract infection at the 48th postoperative hour and the clinical signs of bacteraemia including fever nor the average length of hospitalization were significantly different in the 2 groups. This lack of significant clinical benefit was not explained by the pharmacokinetic properties of this antibiotic. Thus, preoperative administration of a single dose of cefuroxime, reduces the incidence of per and postoperative bacteraemias in ASA I II patients with persistent urinary tract infection. PMID- 3320905 TI - Diagnostic approaches and prognosis in arthrogryposis (congenital contractures). PMID- 3320903 TI - [Exploration of endogenous mechanisms controlling the inflammatory reaction, by the study of counter-irritation: release of prostaglandins, formation of kinins and accumulation of leukocytes]. AB - This review was focused on counter irritation by turpentine in the rat. The involvement of sympathetic system, adrenal steroids, beta-endorphin, axon reflexes, haptoglobin, alpha-2-macroglobulin, complement activation, prostaglandin synthesis, kinin formation and leukocyte accumulation was considered as possible explanation of the anti-inflammatory effect of counter irritation by turpentine. The main mechanism consists of the reduction of leucocyte accumulation. PMID- 3320904 TI - [Pharmacokinetic study of bupivacaine in mice: proposal of a specific sensitive technic using gas chromatography]. AB - For chronopharmacokinetic investigations on bupivacaine in mice we needed a gas liquid chromatographic (GLC) method with flame ionization detection, sufficiently sensitive, linear and precise: thus we describe in this paper a GLC method adapted from previous findings of Desh and al. A single extraction procedure involving methylene chloride was used with mepivacaine as internal standard. Under the conditions of the assay used, retention times were 3.3 minutes and 6.3 minutes for mepivacaine and bupivacaine, respectively. Repeatability and recovery of the method were good and standard calibration curves were linear in the concentration range studied. The assay described herein has been used to study single dose kinetics of bupivacaine in mice. The method herein described is more sensible and more rapid for the determination of bupivacaine than previous GLC methods. PMID- 3320906 TI - [New applications of cytogenetics in the diagnosis of congenital defects]. PMID- 3320907 TI - Maternal epilepsy, antiepileptic drugs and birth defects. PMID- 3320908 TI - Cocaine. PMID- 3320909 TI - Hydrocarbon poisoning--current management. PMID- 3320910 TI - Current status of aspirin and acetaminophen intoxication. PMID- 3320912 TI - Applying pharmacokinetic principles to the management of drug poisoning. PMID- 3320911 TI - The emergency management of poisoning. PMID- 3320913 TI - Plant poisoning in children. PMID- 3320914 TI - Metabolic bone disease in premature infants. PMID- 3320915 TI - Calcitropic hormones in childhood. PMID- 3320916 TI - Urolithiasis in children: the role of hypercalciuria. PMID- 3320917 TI - Obstructive sleep apnea syndrome and its treatment in children: areas of agreement and controversy. PMID- 3320918 TI - Bronchiolar obstruction associated with repeated aspiration of vegetable material in two children with cerebral palsy. AB - Chronic reactive bronchiolar obstruction has not been noted to occur with repeated aspiration of food materials. In this report, we describe two autopsy cases of children aged 8 years and 22 months with cerebral palsy, one with documented and treated esophageal reflux, and both with histories of repeated aspiration pneumonia. In each case, the lungs showed multiple nodules of hyalinized tissue and organized exudate obstructing the bronchiolar lumina, with multinucleated foreign body-type giant cells surrounding intraluminal vegetable particles. It is suggested that chronic bronchiolar obstruction was a significant contributing cause of respiratory insufficiency and consequent morbidity in these patients with cerebral palsy. PMID- 3320920 TI - [Serum insulin, growth hormone and gastrin levels in children with growth and body weight disorders]. PMID- 3320919 TI - Airway damage and mechanical ventilation: a review and commentary. PMID- 3320921 TI - Noncomparative, open label, multicenter trial of cefixime for treatment of bacterial pharyngitis, cystitis and pneumonia in pediatric patients. AB - Cefixime, a new third generation oral cephalosporin antibiotic, was evaluated for safety and efficacy in the treatment of 206 children with acute bacterial pharyngitis, cystitis or pneumonia. Each patient had a throat, urine or sputum culture before therapy and was treated with a 10- to 14-day course of cefixime, 8 mg/kg once daily. Bacterial pathogens were isolated in 167 of 206 (81.1%). Streptococcus pyogenes (73.7% of isolates) and Escherichia coli (9.6%) were the most common Gram-positive and Gram-negative organisms, respectively. All patients were evaluable for safety, and 109 (52.9%) with pharyngitis (96) or cystitis (13) were evaluable for efficacy. Clinical failure occurred in 2 of 109 (1.8%) patients, both with pharyngitis; bacteriologic failure occurred in 1 patient with pharyngitis and 1 with cystitis. Five patients with pneumonia caused by possible pathogens also improved while taking cefixime. Drug-related adverse side effects occurred in 50 of 206 patients (24.3%); these were generally mild and led to discontinuing the antibiotic in only 4 patients (1.9%). The most common were diarrhea or loose stools (33 of 206, or 16%). Results of this study suggest that cefixime given once daily to children is safe and effective in the treatment of streptococcal pharyngitis and bacterial cystitis. PMID- 3320922 TI - Rationale for the sequential use of inactivated poliovirus vaccine and live attenuated poliovirus vaccine for routine poliomyelitis immunization in the United States. AB - Despite the concerns mentioned in the last section, there are many reasons to believe that a polio immunization schedule that incorporates sequential doses of inactivated poliovirus vaccine and live attenuated poliovirus vaccine would provide both humoral and intestinal immunity to the fully immunized person that is at least as good, if not better, than the immunity achieved by the use of IPV or OPV alone. A substantial degree of protection should also extend to partially immunized and unimmunized preschool aged children in the community. Furthermore most of the cases of OPV-associated paralytic poliomyelitis could be prevented. Because the reasons for these beliefs are based on data from small studies and on inferences from related research, specific recommendations for a change from current polio immunization policy must depend on additional clinical research. Well-designed trials comparing several different options for sequencing both inactivated and live vaccines are needed, and these studies should focus carefully on both humoral and intestinal immunity conferred by the various vaccine schedules. PMID- 3320924 TI - Acute suppurative thyroiditis in pediatric patients. PMID- 3320923 TI - Diarrheal diseases in the immunocompromised host. PMID- 3320925 TI - New era for orally administered antibiotics: use of sequential parenteral-oral antibiotic therapy for serious infectious diseases of infants and children. AB - Removal of the intravenous line, improvement of attitude and appetite and early discharge from the hospital can be achieved when sequential parenteral-oral antibiotic therapy is used appropriately to treat children with certain moderate to severe infections. Such antibiotic regimens are potentially indicated for suppurative skeletal infections, bacterial endocarditis, pneumonia with or without empyema, pyelonephritis and, perhaps, meningitis. To be effective, serum bactericidal activity against the causative pathogen after oral therapy must be comparable to that achieved after parenteral administration. Patient and parent compliance, adequate absorption and drug interactions are some of the factors that should be considered to assure a successful course of parenteral-oral antibiotic therapy. PMID- 3320926 TI - Safety profile of cefixime. AB - The clinical and laboratory safety of cefixime based on analysis of data from 1575 adults (1118 treated daily and 457 treated twice a day) and 615 children (299 treated daily and 316 treated twice a day) in studies of urinary tract and lower and upper respiratory tract infections (including otitis media) is reviewed. The incidence of adverse clinical experiences and occurrence of laboratory abnormalities were similar to those seen with other beta-lactam antimicrobial agents. Gastrointestinal side effects were the predominant adverse experiences seen in both daily and twice daily programs in adults and children. The incidence of gastrointestinal intolerance was not dependent upon the frequency of the dosage. Symptoms of drug hypersensitivity were infrequently reported. No serious chemical, hematologic or urologic abnormalities were noted. The data confirm the safety of cefiximine in both adults and children, whether it is administered once or twice a day. PMID- 3320927 TI - Selection of antimicrobial agents for treatment of acute otitis media with effusion. AB - Although a few studies suggest that symptomatic treatment alone may be sufficient for many children with acute otitis media with effusion, most investigators believe that clinical response is improved with antibiotic therapy. The first step in selecting an antimicrobial agent for treatment of acute otitis media with effusion is to determine in vitro susceptibilities of the most frequently isolated pathogens to commonly used antibiotics. Another important variable to consider is the degree to which the prospective agent penetrates and is concentrated in middle ear fluid. Although bacteriologic eradication of causative pathogens remains an objective of therapy, the desired result of any treatment regimen for both physician and patient is a satisfactory clinical response. Knowledge of geographic bacterial resistance patterns is essential to effective antibiotic therapy and continued successful clinical outcomes. The ideal antimicrobial agent for treatment of acute otitis media with effusion is safe, well-tolerated by infants and young children, is effective against the most frequently encountered pathogens and is affordable. PMID- 3320929 TI - Kawasaki syndrome: review of new epidemiologic and laboratory developments. PMID- 3320928 TI - Randomized, open label, multicenter trial of cefixime compared with amoxicillin for treatment of acute otitis media with effusion. AB - Cefixime, a new third generation cephalosporin antibiotic for oral use, was evaluated for safety and efficacy in the treatment of children with acute otitis media with effusion. Fifteen United States clinical investigators participated in the multicenter clinical trial. One hundred twenty children were randomly assigned to a 10-day course of either cefixime, 8 mg/kg, given daily (qd) (60 patients) or amoxicillin, 40 mg/kg/day, administered in three divided doses (60 patients). Tympanocentesis was performed on each patient before therapy was initiated. Pathogens were isolated from a middle ear aspirate in 88% of the cases. Of the specimens from which pathogens were cultured, 33% yielded Haemophilus sp., 41% Streptococcus pneumoniae and 6% Branhamella catarrhalis. Of the 120 patients, 64 (30 cefixime and 34 amoxicillin) were evaluable for assessment of efficacy. Favorable clinical responses (cure or improvement) were obtained in 93% of cefixime-treated patients and in 94% of amoxicillin-treated patients. Overall, bacteriologic eradication rates (as determined by clinical criteria) were 94 and 95%, respectively. Clinical failure or relapse was documented in 2 of 30 (7%) patients treated with cefixime and in 2 of 34 (6%) patients treated with amoxicillin. Gastrointestinal disturbance and rash were significantly more common in children treated with cefixime (22 and 15%, respectively) than in those taking amoxicillin (8 and 2%, respectively), but in only one case was it necessary to discontinue medication because of these adverse effects (rash). Results of this study demonstrate that cefixime given once daily is as safe and effective as amoxicillin in the treatment of acute otitis media with effusion in children and has the possible advantage of less frequent dosing. PMID- 3320930 TI - Group A beta-hemolytic streptococcal bacteremia in children. AB - Twenty cases of Group A beta-hemolytic streptococcal bacteremia in children diagnosed between 1980 and 1987 are reported. Most cases occurred during the winter. The skin and soft tissues were the most common sources of the Group A beta-hemolytic streptococcal bacteremia. Three patients died. Two separate groups of children were observed: (1) a group of 12 young, well-nourished, previously healthy infants, who did not generally develop focal complications and had a favorable course; (2) a group of 8 older children suffering from malnutrition and underlying diseases, such as psychomotor retardation, infected hemangiomata, hemophilia and acute hepatitis B who commonly had focal infections such as pneumonia, meningitis or arthritis/osteomyelitis and had a worse prognosis. M protein-typable strains traditionally related to Group A beta-hemolytic Streptococcus virulence were an inconstant finding in this series. PMID- 3320931 TI - Bacterial meningitis presenting with normal cerebrospinal fluid. AB - At a large children's hospital cases of bacterial meningitis with normal initial cerebrospinal fluid determinations other than culture or antigen detection assays were reviewed in an attempt to determine clinical or other laboratory findings accompanying this presentation. During a 5-year period from January, 1980, through December, 1985, 7 of 261 pediatric meningitis patients (2.7%) fulfilled these criteria. Ages ranged from 3 weeks to 18 months. All 7 patients were hospitalized for observation with all but 1 begun on empiric antibiotic therapy. Laboratory parameters such as a complete blood count, sedimentation rate or C reactive protein did not influence decisions for management. Cerebrospinal fluid antigen detection assays were negative in all but one patient with pneumococcal meningitis. Review of these cases did not reveal unique indicators for bacterial meningitis. The results emphasize that the physician must rely on clinical judgment in initiating empiric antimicrobial therapy once apparently normal cerebrospinal fluid parameters are observed. PMID- 3320932 TI - Syringe preparation technique and minor adverse reactions to diphtheria-tetanus pertussis immunization. AB - Minor local reactions and subcutaneous abscesses following diphtheria, tetanus and pertussis immunization have been attributed to vaccine left in the subcutaneous needle path from vaccine coating the needle. Various syringe preparation techniques have therefore been advocated to prevent reactions. To evaluate these recommendations we compared rates of minor reactions in 200 children randomly assigned to one of three groups that differed only in the handling of the filled syringe: in Group 1 the needle was changed before injection; in Group 2 the needle was wiped with sterile gauze before injection; in Group 3 the same needle was used to draw up and to inject the dose and was not wiped. Overall 27% of children had febrile (greater than 38 degrees C) reactions, 62% became fussy and 79% had a local reaction. Rates of reactions were nearly identical in the three groups, except that children in group 2 receiving their second dose or more of diphtheria-tetanus toxoid-pertussis vaccine were more likely to become febrile at greater than 38 degrees C (32%) or fussy (78%) (P less than 0.05 and P less than 0.02, respectively). We conclude that changing needles does not reduce the rate of minor local and systemic reactions. Wiping needles may increase the rate of reactions. PMID- 3320933 TI - Angioedema caused by streptococcal infection. PMID- 3320934 TI - Failure of ceftriaxone therapy to eradicate Salmonella enteritidis from the gastrointestinal tract of neonates. PMID- 3320935 TI - Comparison of two antigen detection techniques for group A streptococcal pharyngitis in a pediatric emergency department. PMID- 3320936 TI - [Effect of cytostatic preparations used in the treatment of glomerulonephritis in children on the functional activity of the gonads]. PMID- 3320938 TI - An exploratory study of the validity of administering the hand test in a group format. PMID- 3320937 TI - [Importance of determining glycosylated hemoglobin and plasma lactate for the functional characterization of children and adolescents with diabetes mellitus]. PMID- 3320939 TI - The philosophy of medicine: clinical science and its ethics. PMID- 3320940 TI - The evolution of hemostatic mechanisms. PMID- 3320941 TI - The phenotypic deception: influences of classical genetics on genetic paradigms. PMID- 3320942 TI - [Diagnostic imaging of large subserous and pedunculated uterine myoma]. PMID- 3320943 TI - Selective intra-arterial digital subtraction angiography (IADSA) in cerebrovascular disease: preliminary report of right transbrachial approach. PMID- 3320944 TI - Educational outcomes: assessment of quality--a directory of student outcome measurements utilized by nursing programs in the United States. PMID- 3320945 TI - Outcome standards in home health: state of the art. PMID- 3320946 TI - Associate Degree Nursing and health care. PMID- 3320947 TI - VNA survival: who's calling the shots. PMID- 3320948 TI - [Carbamazepine therapy of manic depressive psychosis and schizo-affective psychosis]. PMID- 3320949 TI - Recent advances in chemotherapy and bone marrow transplantation in leukemia. Highlights of the Rome 4th International Symposium on therapy of acute leukemias, February 7-12, 1987. PMID- 3320950 TI - [Improved results in the treatment of acute monoblastic leukemia: analysis of 91 patients treated in the 01 AM 81 protocol]. AB - A total of 91 patients with acute monoblastic leukemia (AML) were treated following two induction regimens (ARA-C + RBZ, with of without CPA), and a unique maintenance therapy (CNS prophylaxis and reinductions every 6 weeks, for 36 months). Complete remission (CR) was obtained in 84% of patients. The only prognostic factor significantly influencing the CR rate was age, with 92% for the less than 40 years group and 75% for the greater than or equal to 40 years group. CR was not influenced by sex, tumoral syndrome, leukocytosis, cytological subclassification (M5A, M5B), or induction regimen with or without CPA. The duration of CR in these forms which have a traditionally poor prognosis, was no different from other forms of AML (21 months), and the disease-free survival at 50 months was 45%. These results, pertaining to the largest published series treated by the same protocol, are the best reported in literature and confirm the role of induction and maintenance therapy in CR. PMID- 3320951 TI - [Immunology of myeloma]. AB - Multiple myeloma (MM) is the most common malignant plasma cell dyscrasia. It is defined as the malignant expression of clonal expansion (in blood and bone marrow) of idiotypic B lymphoid cells (B id+) with proliferation, asynchronic maturation, and abnormal secretion of idiotypic plasma cells, initially maintained in the bone marrow. Malignancy includes: suppression of nonidiotypic (= polyclonal) B cell activation, suppression of normal hematopoiesis, and excessive osteoclastic resorption, via the production of osteoclast activating factors by myeloma cells. In MM, tumor growth is initially very slow in bone marrow (= chronic phase), controlled by chemotherapy or spontaneously controlled (= indolent variant). Terminal disease is marked by uncontrolled and fast tumor growth with extramedullary involvement of tumor cells (= fulminant or acute phase). Clonal evolution with chromosomal changes (chromosomes 1, 11, 14) is generally involved in the growth pattern changes. The nature of the oncogenic event and of the myeloma stem cell remains unknown. PMID- 3320952 TI - [Criteria for assessing granulocytic or platelet cytopenia caused by drugs. Results of consensus meetings]. AB - The use of an official drug adverse reaction assessment procedure became compulsory in France in 1984. The method proposed various qualifications for the semiologic and chronologic criteria used to ascribe a disorder to a specific drug but did not define them. Consensus meetings have been organized in order to define, in the main pathological fields, the adverse reactions themselves and the various qualifications of the criteria. This paper reports the results of meetings attended by hematologists, members of the French national network of Pharmacovigilance and representatives of Roussel Uclaf Drug Monitoring Department for drug-induced granulocyte and platelet cytopenias. Participants studied (a) the limits of the time interval between the appearance of the adverse reaction and the beginning or the end of the treatment with the suspected drug; (b) interpretation of a possible rechallenge; and (c) diagnostic value of in vitro tests proposed to confirm the responsibility of a specific drug in a granulocytic or platelet cytopenia. PMID- 3320953 TI - pUEX, a bacterial expression vector related to pEX with universal host specificity. PMID- 3320954 TI - Rapid radiolabel-sparing thin-layer chromatography method for the visual assessment of chloramphenicol acetyltransferase gene expression. PMID- 3320956 TI - Molecular cloning and characterization of the gene encoding the DNA methyltransferase, M.CviBIII, from Chlorella virus NC-1A. AB - The gene encoding the DNA methyltransferase, M.CviBIII, from Chlorella virus NC 1A was cloned and expressed in E. coli plasmid pUC8. Plasmid (pNC-1A.14.8) encoded M.CviBIII methylates adenine in TCGA sequences both in vivo in E. coli and in vitro. Transposon Tn5 mutagenesis localized the M.CviBIII functional domain to a 1.5 kbp region of pNC-1A.14.8 and also indicated that a virus promoter directs transcription of the gene in E. coli. The 2.1 kbp insert containing the M.CviBIII gene was sequenced and a single open reading frame of 1131 bp was identified within the domain determined by Tn5 mutagenesis. When the M.CviBIII gene was fused in-frame with the 19 amino-terminal codons of lacZ a 45 kD polypeptide was identified in maxicells as predicted by the DNA sequence. The M.CviBIII gene was not essential for virus replication since a virus M.CviBIII deletion mutant also replicated in Chlorella. PMID- 3320955 TI - Evidence that DNA involved in the expression of nodulation (nod) genes in Rhizobium binds to the product of the regulatory gene nodD. AB - In Rhizobium leguminosarum biovar viciae, the regulatory nodulation nodD gene has at least two functions. It constitutively represses its own transcription and in the presence of inducer flavonoid molecules, it activates the expression of two other nod gene transcriptional units, nodABCIJ and nodFE. Upstream of nodA and nodF is a conserved sequence, the nod box, which has been implicated in nodD mediated transcriptional activation of these genes. DNA fragments spanning the nod boxes that precede nodA and nodF were end-labelled and were exposed to cell free extracts obtained from strains of Rhizobium. Using the gel retardation technique, it was shown that a complex between protein and these DNA fragments was formed, but only if the extract contained a functional nodD gene. Evidence that the protein that binds to the regulatory sequences is the nodD gene product came from the observation that a complex was formed between the nod box preceding nodA and protein from a cell-free extract isolated from Escherichia coli containing the cloned nodD gene. Extracts from Rhizobium strains containing mutant forms of nodD which were specifically affected in autoregulation or in flavonoid-dependent activation formed either no protein DNA complex or formed a complex with altered mobility compared to that obtained with extracts from wild type strains. PMID- 3320957 TI - The 5'-flanking sequence of yeast tRNA(Leu3) genes enhances the rate of transcription from stable pre-initiation complexes. AB - A conserved sequence that enhances transcription is present at or near the 5'-end of genes which code for several abundant yeast tRNAs, one of which is tDNA(Leu3). Mutants with alterations in this region have been compared to the parent tDNA(Leu3) and a yeast tDNA(Ser) that normally lacks the conserved sequence. The apparent KM of the transcription apparatus is insensitive to 5'-flanking sequence variation. Replacement of the normal 5'-flanking sequence does result in 3-18 fold reductions in VMAX and a 7-13 fold loss of transcription in tests with competitor genes. A second template exclusion assay revealed that sequences upstream of the conserved region effect a 2 fold change in the ability of the genes to stably sequester a component(s) of the obligatory pre-initiation complex while positions -22 to +9 have little or no effect. PMID- 3320958 TI - Mutational analysis of upstream sequences required for transcriptional activation of the Klebsiella pneumoniae nifH promoter. AB - Upstream sequences of the Klebsiella pneumoniae nifH promoter were mutagenised and activation of the mutated promoters by the nif-specific transcriptional activator protein NifA examined in vivo. Of the sixteen mutations analysed, only those within the nifH upstream activator sequence (UAS), characterised by a TGT N10-ACA motif, influenced nifH promoter activity. Mutations altering the two-fold rotational symmetry of the UAS or the spacing between the TGT and ACA motifs reduced promoter activity, consistent with the UAS functioning as a NifA binding site. The bases flanking the TGT-ACA motif of the UAS also appear to influence activation by NifA. Substituting the nifH UAS with a binding site for the transcriptional activator NtrC resulted in improved NtrC-dependent activation of the nifH promoter demonstrating that the activator specificity of the nifH promoter is dependent upon the presence of the appropriate upstream sequences to which the activator binds. PMID- 3320960 TI - The influence of tertiary structural restraints on conformational transitions in superhelical DNA. AB - This paper examines theoretically the effects that restraints on the tertiary structure of a superhelical DNA domain exert on the energetics of linking and the onset of conformational transitions. The most important tertiary constraint arises from the nucleosomal winding of genomic DNA in vivo. Conformational transitions are shown to occur at equilibrium at less extreme superhelicities in DNA whose tertiary structure is restrained than in unrestrained molecules where the residual linking difference alpha res (that part of the superhelical deformation which is not absorbed by transitions) may be freely partitioned between twisting and bending. In the extreme case of a rigidly held tertiary structure, this analysis predicts that the B-Z transition will occur at roughly half the superhelix density needed to drive the same transition in solution, other factors remaining fixed. This suggests that superhelical transitions may occur at more moderate superhelical deformations in vivo than in solution. The influence on transition behavior of the tertiary structural restraints imposed by gel conditions also are discussed. PMID- 3320959 TI - Thymine methyls and DNA-protein interactions. AB - Evidence is summarized showing that thymine methyls are as important in the recognition of specific sequences by proteins as are the more widely recognized hydrogen bonding sites of bases in the major groove (1). Strongest evidence has come from experiments using functional group mutagenesis (2) in which thymines in a specific recognition sequence (e.g., promoters, operators and restriction sites) are replaced by oligonucleotide synthesis with methyl-free uracil or cytosine and 5-methylcytosine. Such experiments have shown that thymine methyls can provide contact points via van der Waals interactions with amino acid side chains of specific DNA binding proteins. Actual contact between a thymine methyl and carbons of a glutamine side chain has been observed in a cocrystal of the phage 434 repressor and its operator by X-ray analysis. The issue of why thymine occurs in DNA is discussed in light of these findings. PMID- 3320961 TI - Transcriptional control of yeast ribosomal protein synthesis during carbon-source upshift. AB - Shifting a yeast culture from an ethanol-based medium to a glucose-based medium causes a coordinate increase of the cellular levels of ribosomal protein mRNAs by about a factor 4 within 30 min. Making use of hybrid genes encompassing different portions of the 5'-flanking region of the L25-gene, we could show that the increase in mRNAs is a transcriptional event, mediated through DNA sequences upstream of the ribosomal protein (rp) genes. Further analysis revealed that sequence elements are involved that many rp-genes have in common and that previously were identified as transcription activation sites (RPG-boxes or UASrpg). Using appropriate deletion mutants of the fusion genes we could demonstrate that a single RPG-box is sufficient for the transcriptional upshift. In addition, both copy genes encoding rp28 which differ considerably in their extent of transcriptional activity, show the upshift effect in a proportional manner. Definite proof for the role of the UASrpg in nutritional regulation was obtained by examining the effect of a synthetic RPG-box on transcription. PMID- 3320962 TI - Purification of intercalator-released p67, a polypeptide that interacts specifically with the c-fos serum response element. AB - Incubation of intact nuclei in buffers containing the DNA intercalating drug chloroquine leads to release of proteins that interact with DNA. We demonstrate here that a protein which binds to a motif within the human c-fos promoter, identified as the serum response element (SRE), is quantitatively released from HeLa nuclei, whereas nuclear factor 1 (NF 1) is not. Purification of the SRE binding protein by affinity chromatography to greater than 95% homogeneity allowed us to identify it as a polypeptide of approximately 67,000 daltons. The DNA contacts made by p67, as identified by methylation interference experiments, are indistinguishable from those of the serum response factor described previously. PMID- 3320963 TI - Molecular cloning and nucleotide sequence of the gene for Escherichia coli leucyl tRNA synthetase. AB - The gene for Escherichia coli leucyl-tRNA synthetase leuS has been cloned by complementation of a leuS temperature sensitive mutant KL231 with an E.coli gene bank DNA. The resulting clones overexpress leucyl-tRNA synthetase (LeuRS) by a factor greater than 50. The DNA sequence of the complete coding regions was determined. The derived N-terminal protein sequence of LeuRS was confirmed by independent protein sequencing of the first 8 aminoacids. Sequence comparison of the LeuRS sequence with all aminoacyl-tRNA synthetase sequences available reveal a significant homology with the valyl-, isoleucyl- and methionyl-enzyme indicating that the genes of these enzymes could have derived from a common ancestor. Sequence comparison with the gene product of the yeast nuclear NAM2-1 suppressor allele curing mitochondrial RNA maturation deficiency reveals about 30% homology. PMID- 3320964 TI - Analysis of the polyhedrin gene promoter of the Autographa californica nuclear polyhedrosis virus. AB - The polyhedrin gene promoter of the Autographa californica nuclear polyhedrosis virus was analysed with respect to which sequences are required upstream of the mRNA transcription initiation (CAP) site for efficient promoter activity. Insertions (8, 95 and 785 nucleotides) were made in this region at an EcoR V site between the CAAT- and TATA-like boxes. When these mutations were introduced into the virus they did not affect the activity of the polyhedrin promoter as judged by expression of the beta-galactosidase (lacZ) gene inserted in lieu of the polyhedrin coding sequences. Deletions were made in the promoter which progressively removed sequences upstream from the CAP site. Removal of the TATA motif did not affect lacZ gene expression. A sequence 69 nucleotides upstream to the normal position of the polyhedrin ATG translation initiation codon was sufficient for maximum promoter activity but this was reduced by 90% when only 56 nucleotides upstream remained. The normal CAP site was utilized by each deletion mutant. Promoter activity was undetectable when the CAP site was deleted. The results are discussed in relation to other eukaryotic promoters. PMID- 3320965 TI - Negative regulators of the PHO system in Saccharomyces cerevisiae: isolation and structural characterization of PHO85. AB - One of the negative regulators of the PHO system of Saccharomyces cerevisiae, PHO85, has been isolated by transformation and complementation of a pho85 strain. The complementing activity was delimited within a 1258 bp DNA segment and this region has been sequenced. The largest open reading frame found in this region can encode a protein of 302 amino acid residues. A pho85 mutant resulted from disruption of the chromosomal counterpart of the open reading frame described above. Therefore, we concluded that the gene we have cloned is PHO85. This result also indicates that PHO85 is nonessential. Northern analysis revealed that the size of the PHO85 message is 1.1 kb. No similarity was found between the putative amino acid sequences of two negative regulators, the PHO80 and PHO85 proteins. PMID- 3320966 TI - Yeast nucleosomes allow thermal untwisting of DNA. AB - Thermal untwisting of DNA is suppressed in vitro in nucleosomes formed with chicken or monkey histones. In contrast, results obtained for the 2 micron plasmid in Saccharomyces cerevisiae are consistent with only 30% of the DNA being constrained from thermal untwisting in vivo. In this paper, we examine thermal untwisting of several plasmids in yeast cells, nuclei, and nuclear extracts. All show the same quantitative degree of thermal untwisting, indicating that this phenomenon is independent of DNA sequence. Highly purified yeast plasmid chromatin also shows a large degree of thermal untwisting, whereas circular chromatin reconstituted using chicken histones is restrained from thermal untwisting in yeast nuclear extracts. Thus, the difference in thermal untwisting between yeast chromatin and that assembled with chicken histones is most likely due to differences in the constituent histone proteins. PMID- 3320967 TI - Characterisation of cDNA clones for hypoxanthine-guanine phosphoribosyltransferase from the human malarial parasite, Plasmodium falciparum: comparisons to the mammalian gene and protein. AB - The isolation of cDNA clones for hypoxanthine-guanine phosphoribosyltransferase (HPRT) from the human malarial parasite, Plasmodium falciparum, is described. Northern analysis indicates that P. falciparum HPRT mRNA is the same size as that coding for mammalian HPRT. The predicted amino acid sequence of the P. falciparum HPRT protein shows extensive homology to the mammalian enzyme. Homology between the two proteins occurs in distinct blocks and a putative catalytic binding domain in the centre of the protein is also conserved. Five out of the seven characterised mammalian HPRT missense mutations map to regions which are conserved in the P. falciparum protein. PMID- 3320969 TI - Nucleotide sequence of hemD, the second gene in the hem operon of Escherichia coli K-12. PMID- 3320968 TI - Peptides at the tRNA binding site of the crystallizable monomeric form of E. coli methionyl-tRNA synthetase. AB - A protein affinity labeling derivative of E. coli tRNA(fMet) carrying lysine reactive cross-linking groups has been covalently coupled to monomeric trypsin modified E. coli methionyl-tRNA synthetase. The cross-linked tRNA-synthetase complex has been isolated by gel filtration, digested with trypsin, and the tRNA bound peptides separated from the bulk of the free tryptic peptides by anion exchange chromatography. The bound peptides were released from the tRNA by cleavage of the disulfide bond of the cross-linker and purified by reverse-phase high-pressure liquid chromatography, yielding three major peptides. These peptides were found to cochromatograph with three peptides of known sequence previously cross-linked to native methionyl-tRNA synthetase through lysine residues 402, 439 and 465. These results show that identical lysine residues are in close proximity to tRNA(fMet) bound to native dimeric methionyl-tRNA synthetase and to the crystallizable monomeric form of the enzyme, and indicate that cross-linking to the dimeric protein occurs on the occupied subunit of the 1:1 tRNA-synthetase complex. PMID- 3320970 TI - An mRNA sharing sequences with a variant granulocyte-macrophage colony stimulating factor cDNA clone. PMID- 3320971 TI - Complete nucleotide sequence of the Escherichia coli argA gene. PMID- 3320972 TI - Cloning E. coli genes by oligonucleotide hybridization. PMID- 3320973 TI - Nucleotide sequence of the homoserine dehydrogenase (thr A) gene of Brevibacterium lactofermentum. PMID- 3320974 TI - Some aspects of DNA polymerase functioning. AB - The group of DNA polymerases was studied using some new nucleoside 5' triphosphate analogs with termination substrate properties. Among DNA polymerases tested the least specific appeared reverse transcriptases of retroviruses and the most specific were DNA polymerases alpha type from high eucaryotes including mammalians. PMID- 3320975 TI - Carbocyclic analogues of dTTP and UTP: properties in polymerase enzyme-catalyzed reactions. AB - Racemic carbocyclic analogues of dTTP [(+/-)-C-dTTP] and its ribo counterpart, 5 methyl-UTP [(+/-)-C-m5UTP] were synthesized and examined, in comparison with dTTP and UTP (and m5UTP), as potential substrates of E. coli DNA and RNA polymerases, respectively. Unexpectedly, only a very low (terminal) incorporation of C-dTMP into DNAs of different structure was observed, C-dTTP did not serve as a substrate for chain elongation by the Klenow DNA polymerase. Inhibition of DNA replication was, however, observed in the presence of (+/-)-C-dTTP. The UTP analogue, (+/-)-C-m5UTP proved neither a substrate nor an inhibitor of the RNA polymerase enzyme. PMID- 3320976 TI - Facile preparation of purine and pyrimidine 2-deoxy-beta-D-ribonucleosides by biotransformation on encapsulated cells. AB - A preparative-scale synthesis of pyrimidine or purine 2'-deoxy-beta-D ribonucleosides from a heterocyclic base and 2'-deoxyuridine proceeds by biotransformation reaction in the presence of thymine-dependent E. coli mutant cells encapsulated in alginate gel. The products are isolated by octadecyl-silica or ion-exchange chromatography. PMID- 3320978 TI - Quality assurance: compiling a directory. PMID- 3320977 TI - Bedpans and broomsticks. PMID- 3320980 TI - Student Nurses' Association: approaching the Diamond Jubilee. PMID- 3320979 TI - Gift of life, (gamete intrafallopian transfer). PMID- 3320981 TI - Fatigue mechanisms in cancer patients: developing nursing theory. PMID- 3320982 TI - Fatigue in the cancer patient: a conceptual approach to a clinical problem. PMID- 3320984 TI - The immune system and cancer. PMID- 3320983 TI - Biotherapy with interferon in AIDS-related Kaposi's sarcoma. PMID- 3320985 TI - [Microbiological diagnosis of acute pneumonia]. PMID- 3320987 TI - [Pneumoconiosis]. PMID- 3320986 TI - [Capacity of tissue leukocytes for in vivo migration in physiological saline and autologous blood in patients with bacterial pneumonia]. PMID- 3320988 TI - [Biology of human immunodeficiency virus infection]. AB - This review will describe the current state of basic knowledge on the acquired immune deficiency syndrome (AIDS), which has now spread worldwide becoming an acute public health problem in western countries and in Africa. AIDS is a viral infection, due to a retrovirus designated human immune deficiency virus (HIV), which affects the immune system resulting in a wide array of secondary manifestations which include opportunistic infections, neoplasia, autoimmune phenomena, neurologic disorders, and hematologic abnormalities. AIDS has now been recognized in the pediatric population, and infection occurs by perinatal and blood-borne transmission. As a consequence, pediatricians are no more involved only by a theoretical point of view (AIDS is a perfect model of interaction of virus with the immune system), but also by an operative point of view. Knowledges on immunological modifications in AIDS and on the underlaying features of the HIV are essential for the clinical approach. This goal may be difficult, if one considers that the pace of research in AIDS and the progress attained to date are unprecedent. However, clinicians must be aware that the ultimate solution of clinical problems in AIDS exclusively depends on sound basic research. PMID- 3320989 TI - [Subclasses of IgG: biological aspects and functional behavior in response to vaccination]. AB - The IgG subclasses are known to have different structure and functions. The IgG1 and IgG3 bind to monocyte and neutrophils and activate the complement more easily then IgG2 and IgG4. The levels of IgG subclasses found in newborns are mainly determined by the transplacental passage since the synthesis, in the first time of life, is very low. The levels found in adults are reached only during the adolescence. The immune response to a protein antigen is mainly in the IgG1 subclass, on the contrary the response to polysaccharide antigens is mainly IgG2. For that reason children, who produce very few IgG2 till they are 2 years old, cannot be vaccinated with carbohydrate vaccines unless a protein conjugate vaccine is used. In addition, the route of subministration, the dose of antigen, the age of vaccinated people and genetic factors can modify the subclass pattern obtained in response to vaccinations. For these reasons, probably, the immune response studied after a vaccination or in individuals who recovered from a natural disease is not always the same. Since the role of the different subclasses is not yet completely clarified, the interpretation of the importance of a selective "choice" of a subclass instead of another after vaccination is still difficult. PMID- 3320990 TI - [AIDS in childhood]. AB - Since its first report in 1981, acquired immunodeficiency syndrome (AIDS) has attracted great interest among clinicians. Pediatric cases of AIDS were reported only two years later. Recently a review of the literature revealed about 300 pediatric patients with AIDS who are now tabulated separately by the Centers for Disease Control of Atlanta. The classification of the pediatric AIDS is based on epidemiologic, immunologic and virologic data. Subjects at risk include infants born to intravenous drug-addicted mothers and infants who have received blood transfusions or blood products. The diagnosis of pediatric AIDS may be established in a patient who has a polyclonal hypergammaglobulinemia and T-cell immunodeficiency associated with antibody to human immunodeficiency virus (HIV) or isolation of retrovirus. PMID- 3320991 TI - [Preventive measures against HIV infection]. AB - The principle form of AIDS transmission are well known: sexually, blood and blood products, vertical transmission and in order to prevent HIV infections one must avoid these modes of transmission. Much has done to make more secure blood and blood products used for transfusions. It is furthermore, advised to those who must utilize intravenous drugs to employ the use of disposable syringes and more precisely, not to use the syringes of other persons. It is far more difficult to advise regarding the prevention of transmission of the virus through sexual contact, or to attempt to modify the sexual habits of certain categories of persons. Clearly, women with HIV infections should avoid pregnancy. Particular precautionary measures must be taken by those assisting patients with AIDS or HIV infections, thus avoiding infecting themselves and other patients. PMID- 3320992 TI - [Diagnosis of allergy to cow's milk proteins]. AB - The diagnosis of cow's milk proteins allergy can only be established if the symptoms disappear with an elimination diet and if a later controlled challenge leads either to a recurrence of symptoms or to some other clearly identified changes. At the moment there is not a specific immunological test surely effective in all cases. Anyway the three Gooldmann's tests are not necessary. In fact a single challenge with a cow's milk meal will be sufficient when clinical observation is accompanied by monitoring some simple laboratory tests (serum and nasal eosinophils, steathorrea, coproleucocytes, hemoccult, xylosemia and leucocytes PMN). The challenge must be tested in a double-blind trial only in patients with non specific symptoms (such as tension fatigue syndrome, hyperactivity, ecc...). The double-blind challenge is not necessary generally for the diagnosis of cow's milk proteins allergy in childhood, because at this time of life not only the symptoms are very clear (diarrhea, vomiting, skin symptoms) but also there is a prevalence of non reaginic reactions: this kind of reactions are usually delayed and they generally occur after a relatively high dose of food allergens. In the group of patients with specific anti-cow's milk IgE (RAST and prick tests) and severe reactions (anaphylaxis), the challenge is not necessary to confirm the diagnosis, but is usefully to verify the acquired tolerance, generally after the first year of life. PMID- 3320994 TI - [Mosaicism 45,X/46,X,r/(Y) associated with mixed gonadal dysgenesis. Description of a case and review of the literature]. AB - The structural anomalies of Y chromosome even if rare, are very interesting for the possibility of mapping male-determining genes. The authors report a case of ring (Y) chromosome to further elucidate the phenotype associated with a deleted Y chromosome and to present informations about the location of genes on the Y chromosome. The literature's cases are also reviewed and compared to Author's. PMID- 3320993 TI - [Therapy of intolerance and allergy to cow's milk proteins]. AB - The authors report the main acquisitions from literature and their own experience concerning therapy of intolerance and allergy to cow's milk proteins, particularly referring to clinical gastrointestinal features. These points have been underlined: elimination diet is the most important step in therapy, even if intolerances to new aliments frequently arise (30% of cases), either when soy milk or hydrolysate formulas are used; pharmacologic agents inhibiting mediator release from the mast-cells thereby reducing gut permeability to macro-molecules (such as disodium cromoglycate) can be used as a "support" for a short period of time, but the drug can not replace the diet in the therapy; anyway, even if milk allergy may last for a long time, it is useful to test the possible acquired tolerance, beginning from the first year of life. PMID- 3320995 TI - [Effect of cholinesterase (ChE) reactivators on hemodynamics in animals. I. Reactions of the circulatory and respiratory systems of rabbits after administration of ChE reactivators]. AB - Studies on the dynamics of changes in the circulatory and respiratory system in rabbits were carried out after intravenous injection of ChE reactivators used in treatment of poisoning with phosphoorganic compounds (FO). Blood flow in the carotid artery, arterial pressure, frequency and amplitude of breathing were measured. From the above data pulse rate and coefficient of vesself resistance were calculated. The results obtained indicate that the reactions in the circulatory and respiratory system depend on the kind of the reactivator, the size of its dose and time of action. Pralidoxim--PAM (at a dose of 10, 20, 40 mg/kg) acts cholinergically on the muscular coat o blood vessels, causing their shrinkage, which is proved by decreased blood flow with simultaneous increase of vessel resistance. The increase of vessel resistance was directly proportional to the dose of pralidoxim and often caused an increase in arterial pressure. Pralidoxim did not show a larger effect on the function of the heart. The action of obidoxim--Toxogonin or Toxobidin--does not only depend on the size of the dose but on the time of action as well. At small doses (10 mg/kg), obidoxim increases blood flow after 15 min, then causes shrinkage of blood vessels and decreases blood flow with increased vessel resistance. At larger doses (20, 40 mg/kg) a constant increase of blood flow is maintained, despite frequently decreased arterial pressure with simultaneously decreased vessel resistance. This accounts for blood vessel dilatation. The reactivators studied stimulate the function of the respiratory system by increased frequency of breathing, but its amplitude was effected to a lesser extent. It was also shown that ChE activity in blood was not changed significantly. The action of the indoxims studied was similar to that of Toxobidin (Polfa) and Toxogonin (E. Merck). PMID- 3320996 TI - [Effect of cholinesterase (ChE) reactivators on hemodynamics in animals. II. Reactions of the circulatory and respiratory systems of dogs after administration of ChE reactivators]. AB - Different actions of pralidoxim and obidoxim were shown in studies on the influence of ChE reactivators (administered in doses of 10, 20, 40 mg/kg) on the circulatory and respiratory system. Blood flow velocity, arterial blood pressure in the carotid artery, the frequency and amplitude of breathing were recorded continuosly 60 min before and after intravenous injection of the reactivator. From these data the pulse rate, blood flow rate and the coefficient of the peripheral vascular resistance were calculated. At the same time pulse pressure was determined. Pralidoxim (PAM) acts parasympathicolitically on the heart vascular system. It causes blood vessel shrinkage and decreases blood flow which is accounted for by increased vascular resistance by 20-40%. Such reactions cause, particularly after lower doses, increased arterial pressure and pulse rate by 15%. A 10 mg/kg dose of obidoxim increased pulse rate and blood flow for 15 min after the injection after 15 min the blood flow gradually decreased with simultaneous increase of the vascular resistance by 30%, as compared with the initial values. At larger doses it evoked mainly vascular reactions characterized by a constant increase of blood flow with simultaneous decrease of the vascular area. The ChE reactivators used stimulated the function of the respiratory system, which becomes apparent by increasing frequency of breathing with simultaneous increase of its amplitude. In these studies no differences were found in the action of obidoxim: Toxogonin (E. Merck) and Toxobidin (Polfa). PMID- 3320998 TI - Polymorphous light eruption: experimental reproduction of skin lesions by whole body UVA irradiation. AB - Fifty patients suffering from polymorphous light eruption (PLE), selected by criteria pointing to UVA sensitivity, were phototested with 2 different polychromatic UVA sources for reproduction of skin lesions. To simulate natural conditions, the patients were whole-body irradiated for up to 5 consecutive days. In 64% of the patients successful reproduction of PLE lesions was obtained by 1 to 4 irradiations. The total dosage ranged from 20 to 280 J/cm2, and the total exposure times from 10 to 60 min. Our results suggest that irradiation of the whole body in UVA-sensitive PLE patients does not provide more convincing test results than phototesting of small previously involved skin sites, as has been done by other groups. PMID- 3320997 TI - [Studies on using choline salt of N-glucosylpolyfungine as an antifungal preparation for cell culture]. AB - Fungistatic and fungicidal activity as well as the toxicity of the polyfungine derivative of choline N-glucosylpolyfungine salt for chicken embryo fibroblasts were studied. This preparation was found to inhibit the growth of Candida albicans, Aspergillus niger and Penicillium sp. at 25-100 micrograms/ml concentrations of the medium. The highest sensitivity to polyfungine was shown by C. albicans strain, and the lowest by Aspergillus niger strain. The preparation studied did not lose its activity in the medium containing 20% of calf serum. Its toxicity for cells in vitro was considera bly lower than that of amphotericine B used for intravenous injections and reached over 156 micrograms/ml of the medium. In mixed cultures containing fibroblasts and cells of fungi, the polyfungine derivative inhibited the growth of microbes at concentrations lower than in the medium without cells. PMID- 3320999 TI - Interactions of different wavelengths in effects of UV radiation on skin. AB - Literature data on photoaddition, photorecovery and photoaugmentation are discussed. The practical conclusion is that for estimates of the main risks of ultraviolet radiation to human skin, sunburn and skin cancer, any deviations from photoaddition are small. Risk estimates may be made on the basis of addition, and the errors possibly made by doing so are small compared to other uncertainties in such calculations. Deviations from photoaddition reported are interesting from the viewpoint of studying mechanisms. Apparent controversies cannot be resolved on the basis of presently available data. Confusion can certainly be reduced, and there are indications that more subtle techniques of investigation are needed to resolve the remaining problems. PMID- 3321000 TI - [Changes in the oral cavity in acute leukemia]. PMID- 3321001 TI - [Nephrotoxicity of non-steroidal anti-inflammatory drugs]. PMID- 3321003 TI - Normal hair growth in children. AB - Abnormalities in the hair growth of children are common reasons for referral to a dermatologist or pediatrician. There is wide variation in the normal sequence of development of hair form and pattern in childhood and adolescence. Very occasionally, abnormalities may be a component of complex metabolic disorders. Therefore it is important to recognize the normal growth of children's hair. Most diagnoses of hair disorders may be made on clinical examination and inspection of hair shafts and roots under a light microscope. PMID- 3321002 TI - [Ultrasonographic examination of the thyroid during treatment of endemic goiter with L-thyroxine]. PMID- 3321004 TI - Linear porokeratosis in two families with disseminated superficial actinic porokeratosis. AB - Two case reports of linear porokeratosis occurring in individuals or families with disseminated, superficial, actinic porokeratosis (DSAP) are presented. Linear porokeratosis and DSAP may be different expressions of one dominantly inherited condition. We reviewed the clinical features of linear porokeratosis and its association with other forms of porokeratosis. The linear form has a potential for carcinomatous change. PMID- 3321005 TI - Treatment of extensive warts with etretinate: a clinical trial in 20 children. AB - To evaluate the clinical-effectiveness of etretinate in the treatment of papilloma virus infections, 20 children with extensive warts were given this oral retinoid for a period not exceeding three months at a dosage of 1 mg per kg per day. Sixteen patients showed complete regression of the disease without relapse, while in 4, lesions recurred after partial regression had been obtained. A follow up of two years confirmed these findings. The results of this preliminary study are encouraging. Additional study is needed to determine the ultimate usefulness of etretinate in the treatment of refractory warts. PMID- 3321006 TI - Management of sickle cell disease. PMID- 3321007 TI - Management of progressive renal failure: the role of dietary manipulations. PMID- 3321008 TI - Breathlessness. PMID- 3321009 TI - Hypoglycaemia and cerebral malaria. PMID- 3321010 TI - Muscarinic receptors in lung. AB - Muscarinic receptors are present on several different cells in lung and are predominantly involved in bronchoconstriction and mucus secretion. Muscarinic receptor activation leads to breakdown of phosphoinositides in airway smooth muscle cell membranes, which leads to intracellular calcium release and contraction. Muscarinic receptor subtypes are now recognised, and muscarinic receptors on cholinergic nerves which inhibit acetylcholine release (auto receptors) may differ from those on airway smooth muscle. There is evidence that muscarinic receptor density is less in peripheral airways, so that cholinergic drugs may be less effective against small airway obstruction. The possibility that muscarinic receptors function abnormally in airway disease has been considered but is unlikely since the airways are hyperresponsive to several different stimuli, in addition to cholinergic agonists. PMID- 3321011 TI - Physiology of the parasympathetic nervous system of the lung. AB - Parasympathetic nerves play an important role in modulating smooth muscle tone and mucus secretion in the airways. This modulation can occur through a variety of afferent inputs, from the central nervous system, at parasympathetic ganglia, and on post-ganglionic efferent fibres themselves. Abnormalities at any of these sites could, and in some patients probably do, contribute to the abnormalities in smooth muscle contraction and mucus secretion that characterize a number of airway diseases, including asthma. Because these pathways play little or no role in the exaggerated bronchoconstrictor responses in many patients, however, an abnormality of the parasympathetic pathway cannot be the sole explanation for abnormal airway hyperresponsiveness. PMID- 3321012 TI - Anticholinergic agents in chronic bronchitis and emphysema. AB - Inhaled anticholinergic agents produce as much absolute increase in airflow in chronic bronchitis as in asthma, namely about 0.2-0.3 litres increase in the FEV1 and a doubling of specific airways conductance. Their major advantage in bronchitis is due to the fact that adrenergic agents are relatively poor bronchodilators in this disorder. In bronchitis and emphysema a large number of studies suggest that anticholinergic agents not only are more potent than adrenergic agents but, when given in optimal dosage, achieve all of the available bronchodilatation in these patients. Possible reasons for this are suggested. Quaternary forms, such as ipratropium, have the additional advantage that they are poorly absorbed and thus produce no systemic side effects, giving them a very wide therapeutic margin. This makes them particularly suitable for the older population of which bronchitics are composed, and who are prone to side effects from atropine itself and from other classes of bronchodilators. They can be considered as first line therapy for the relief of symptoms on a day-to-day basis in this group of patients. They may also have a role in the management of acute exacerbations of airways disease, but this has not yet been fully established. PMID- 3321013 TI - Muscarinic acetylcholine receptors: structure, function subtypes and therapeutic perspectives. AB - Structural and binding studies on the purified rat forebrain muscarinic acetylcholine receptor (mAChR) are consistent with the idea that the receptor is structurally analogous to rhodopsin. We propose that it consists of a short, glycosylated N-terminus, followed by seven transmembrane helices, joined by extra membranous loops. The transmembrane helices make up a substantial proportion of the molecule. Two peptides, one of which is glycosylated, and therefore close to the N-terminal part of the molecule are labelled on acidic residues by the irreversible antagonist, [3H]-PrBCM, and may thus form part of the ligand binding site. The conformational flexibility of the mAChR, and hence its ability to bind rigid selective ligands such as pirenzepine is strongly affected by the oxidation state of key cysteine residues. The molecule is proposed to terminate in a cytoplasmic C-terminal tail, which participates, together with the cytoplasmic loops, in the recognition of GTP-binding proteins. The C-terminus is susceptible to proteolytic attack, and shows evidence of sequence homology to the C-terminus of the beta-adrenergic receptor. PMID- 3321014 TI - Fenoterol is as effective as terbutaline in the pear-shaped spacer. PMID- 3321015 TI - Radiological investigations of the abdomen and digestive tract. PMID- 3321016 TI - Angina pectoris. PMID- 3321018 TI - Pathogenesis of Shigella infections. PMID- 3321017 TI - Ankylosing spondylitis, a seronegative spondarthritis. PMID- 3321019 TI - Models to follow secretory IgA response to mucosal infections. AB - The secretory IgA system lies at the portal of entry for mucosal pathogens. To study the effects of secretory IgA, many models of local immune responses to infectious diseases have been developed in the past 2 decades. They have indicated that secretory IgA is elicited to mucosal microbial pathogens and that such immunity may be protective in some circumstances. The challenge of the next decade will be to optimize the mucosal memory responses with safe vaccines and to determine the functional significance of the secretory IgA response with respect to disease prevention. PMID- 3321020 TI - Use of attenuated mutants of Salmonella as carriers for delivery of heterologous antigens to the secretory immune system. PMID- 3321021 TI - Neutrophil emigration and microvascular injury. Role of chemotaxins, endotoxin, interleukin-1 and tumor necrosis factor alpha. PMID- 3321022 TI - Interaction of inflammatory mediators with the lymphatic vessel. PMID- 3321023 TI - Actions of hematopoietic colony-stimulating factors in vivo and in vitro. PMID- 3321025 TI - Prenatal diagnosis of a new syndrome: holoprosencephaly with hypokinesia. AB - Markedly decreased fetal activity (akinesia/hypokinesia) is usually readily apparent to experienced mothers, and frequently this concern leads to attempts at prenatal diagnosis. We report prenatal diagnosis of two fetuses with congenital contractures, markedly decreased fetal movement, and microcephaly due to severe holoprosencephaly. Such familial recurrence to phenotypically normal parents suggests a newly recognized autosomal recessive or X-linked syndrome that is readily detectable by prenatal ultrasonography. PMID- 3321024 TI - The reliability of cytopathologists' classifications of bronchial epithelial atypias from Kodachrome slides. AB - The accuracy of computerized cell image analysis techniques for classification of atypical cells is determined by comparing computer-generated classifications with those made by cytopathologists. This measure of accuracy depends not only on the reliability of the computer classifications but also on the reliability of the cytopathologists' classifications. This study reports on the observed reliability of cytopathologists' classifications of squamous epithelial atypias in sputum across cytopathologists and two different classification times. Results indicated the percentage agreement among cytopathologists and computerized cell image analysis techniques. It is recommended that, in the future, all analyses of computerized classification schemes by interpreted in light of the consistency of the cytopathologists' classifications. PMID- 3321027 TI - [Immunohistochemical detection of the estrogen receptor in benign tumors of the breast and in forms of mastopathy]. PMID- 3321026 TI - Prenatal ultrasound diagnosis of fetal scoliosis with termination of the pregnancy: case report. AB - Gross scoliosis of the fetal thoracic spine was diagnosed at 18 weeks gestation. The pregnancy was terminated and the fetus found to have webbing of the neck and an imperforate anus in addition to vertebral defects. PMID- 3321028 TI - The ultrasound display of intervillous circulation. AB - An ultrasonographic study of acoustic holes in the placenta shows that these contain maternal blood. The pattern of the maternal circulation can be visualized by ultrasonography, maternal blood entering the intervillous space in a continuous fashion with only a slight pulsatile pattern. Stasis of maternal blood and intervillous thrombus formation can also be distinguished. PMID- 3321029 TI - [Effect of protein synthesis inhibitors on the activity of mitochondrial enzymes of Saccharomyces cerevisiae during desiccation]. AB - The work deals with the effect of carbon sources, presence of protein synthesis inhibitors (cycloheximide and chloramphenicol) and dehydration regime on the enzyme activity of the dried yeast Saccharomyces cerevisiae. The yeast grown on molasses and dried by aeration demonstrated a notable increase of the NADH dehydrogenase and succinate dehydrogenase activities as compared with the analogously treated yeast grown on ethanol. The latter showed a notable rise only in the activity of NADH-dehydrogenase during slow drying. Addition of protein synthesis inhibitors into the cultivation medium caused no decrease of activities of the above mentioned enzymes of the dried yeasts in any variant under study. PMID- 3321031 TI - [Indices of carbohydrate metabolism and levels of HDL2 and HDL3 cholesterol in the blood plasma of males]. AB - A random sample of men (319) aged 20 to 59 was examined in one of the administrative districts in Moscow. A study was made of the blood plasma content of HDL2 and HDL3 cholesterol, triglycerides with relation to insulinemia and glycemia both on an empty stomach and during the GTT. An analysis of the data obtained led to a conclusion that the level of insulinemia was a factor influencing the level of HDL2 and HDL3. Derangements in the metabolism of the above lipoproteins were likely to be associated with a high risk of CHD development especially among patients with diabetes mellitus. Therapeutic measures aimed at insulin secretion reduction were recommended for the normalization of lipid metabolism including the content of HDL2 and HDL3. PMID- 3321030 TI - [A method of determining the level of provitamin D in Saccharomyces cerevisiae with altered sterol metabolism]. AB - A method is proposed that allows to choose among the polyene-resistant mutants of the yeasts Saccharomyces cerevisiae with changed biosynthesis of ergosterol promising producers of provitamin D4 and structural analogs of provitamin D3. The method involves both UV-spectrophotometry and thin-layer chromatography. The results obtained are supported by the data of mass-spectrometry of sterols. PMID- 3321032 TI - [Receptor binding of insulin to erythrocytes in healthy women and in patients with diabetes mellitus during pregnancy]. AB - 125I-insulin binding with specific receptors on the blood erythrocytes studied in 10 nonpregnant women with insulin dependent diabetes mellitus resistant to insulin therapy (a mean daily dose of insulin was 155.0 +/- 32.4 units) and in 15 pregnant women (the 3rd term of pregnancy) with insulin dependent diabetes mellitus was much lower than that in healthy nonpregnant (n-20) and pregnant (n 10) women. This reduction was determined by a decrease in the number of binding sites on the blood erythrocytes in patients with insulin dependent diabetes mellitus, especially in those who received large loses of insulin beyond the period of pregnancy. In the third term of pregnancy erythrocyte insulin binding both in the healthy women and in the patients was higher than that in respective groups of nonpregnant women, and this rise showed correlation with an increase in the number of cell receptors whereas receptor affinity to insulin in that period was lowered. PMID- 3321033 TI - [Use of the Echoophthalmoscope 21 in the diagnosis of thyroid diseases]. AB - The authors utilized a Soviet apparatus Echoophthalmoscope-21 for investigation of the thyroid. Examination of 51 patients and 10 controls showed that the echographic picture and a degree of ultrasound absorption in different thyroid diseases had significant differences permitting a wide use of the above apparatus for the detection of thyroid diseases during mass screening. PMID- 3321034 TI - [Hypocorticism. Problems of etiology, pathogenesis, diagnosis and treatment]. PMID- 3321035 TI - [Immunomodulating effects of glucagon]. AB - Experiments have shown marked immunosuppressive activity of glucagon during its injection at a dose of 0.4 micrograms for 5 days. The suppression of a primary immune response is mediated by the activation of antigen-specific T-suppressors and is not associated with an increase in insulin secretion and a glycemia value. PMID- 3321036 TI - [Clinical use of calcitonin]. PMID- 3321037 TI - [Autonomic disorder syndromes in diabetes mellitus]. PMID- 3321038 TI - [Radical plastic surgical interventions in tuberculous trochanteritis patients]. PMID- 3321039 TI - [Significance of serological reactions with phosphatide antigen in the diagnosis of respiratory tuberculosis]. PMID- 3321040 TI - [Surgical treatment of patients with active tuberculous spondylitis]. PMID- 3321041 TI - [Prerequisites for the use of proteinase inhibitors in lung diseases]. PMID- 3321042 TI - Ultrastructural studies on the interaction of Plasmodium falciparum ookinetes with the midgut epithelium of Anopheles stephensi mosquitoes. AB - The interaction of Plasmodium falciparum ookinetes with the midgut epithelium of Anopheles stephensi is described by electron microscopy. Plasmodium falciparum ookinetes have been traced during the early stages of invasion and localization beneath the basal lamina of the midgut. It is generally assumed that ookinetes break through two membranes to reach the basal lamina of the midgut epithelium by an intracellular route. In the present study evidence is presented that the ookinete takes an intercellular route in traversing the epithelial layer. Compared to the mode of penetration and intracellular development of sporozoites and merozoites, an intercellular route for penetration of the ookinete is not inconsistent with its further extracellular development. PMID- 3321043 TI - Glutathione and peroxide metabolism in malaria-parasitized erythrocytes. AB - The glutathione metabolism of Plasmodium falciparum, P. vinckei and P. berghei has been investigated. Human erythrocytes with low glutathione reductase and synthetase activity are still capable of harbouring P. falciparum. Both enzymes have been demonstrated in Plasmodium spp. Moreover, evidence is given for a selenium-independent glutathione peroxidase in malaria parasites. PMID- 3321044 TI - Master's programs in nursing: cardiovascular nursing specialization. PMID- 3321045 TI - Development of ligand-HRP technique and discovery of Golgi-phobic dendrites. PMID- 3321047 TI - Construction and characterization of hybrid plasmid pRC1. PMID- 3321046 TI - Use of monoclonal antibodies against bovine insulin to distinguish different species of insulin. PMID- 3321049 TI - Survey of primary dapsone-resistant leprosy. PMID- 3321048 TI - The role of multiple factors in the pathogenesis of septic and endotoxic shock. PMID- 3321050 TI - Photodynamic effect of hematoporphyrin derivative (HpD) on normal and malignant cells in vitro. PMID- 3321051 TI - Future research priorities of gossypol in the field of fertility regulation. PMID- 3321052 TI - Comparative mutational analysis of wild-type and stretched tRNA3(Leu) gene promoters. AB - We demonstrate that, when the yeast tRNA(3Leu) gene is stretched so that the distance between the two portions of the intragenic promoter is increased to 365 base pairs, the A and B blocks remain functional. Mutations in the A block, which show a weak phenotype when inserted in the wild type, exert a dramatic effect when inserted into the stretched gene. Experiments with extensively purified transcription factor tau indicate that the tau B-B block interaction is not influenced by A-B distance; only the ability of tau A to interact with A block sequences is affected, possibly because of the additional free-energy cost of forming a large loop of the intervening DNA. PMID- 3321053 TI - Additional member of the protein-tyrosine kinase family: the src- and lck-related protooncogene c-tkl. AB - We report the isolation and nucleotide sequence of a 3.7-kilobase (kb) cDNA clone from chicken spleen corresponding to a previously undescribed member of the src family of protooncogenes. It encodes a protein with a C-terminal domain related to the src family of protein-tyrosine kinases (EC 2.7.1.112) and, among these, has most significant homology to the lck gene isolated from a murine leukemia virus-induced thymoma cell line. The gene is therefore referred to as c-tkl for cellular tyrosine kinase related to lck. Analysis of genomic DNA reveals that c tkl is a chromosomal locus distinct from c-src and c-lck. Furthermore, the size of c-tkl mRNA as well as its pattern of expression indicates that it is not the chicken homologue of lck but a different gene. A 3.8-kb transcript of the c-tkl gene, identical to the size determined for c-src mRNA, was observed in cultured chicken embryo fibroblasts and in chicken spleen and brain. In contrast, detection of a definite c-src mRNA signal with mRNA from spleen was not possible under the hybridization conditions employed when the 5' end of v-src was used as the probe, and none of the 11 clones obtained from the cDNA library corresponded to a c-src transcript. Thus previous studies of c-src mRNA expression in spleen may have actually detected c-tkl transcripts. PMID- 3321055 TI - Regulation of the protein glycosylation pathway in yeast: structural control of N linked oligosaccharide elongation. AB - The yeast Saccharomyces cerevisiae X2180 strain with the mnn1 mnn2 mnn9 mutations, all of which affect mannoprotein glycosylation, synthesizes N-linked oligosaccharides having the following structure: (Formula: see text) whereas the mnn1 mnn2 mutant extends the alpha 1----6-linked backbone of some of the core oligosaccharides by adding 20-30 mannose units. Membrane fractions from the mnn1 mnn2 and mnn1 mnn2 mnn9 mutants are equally effective in catalyzing transfer from GDP-[3H]mannose to add mannose in both alpha 1----2 and alpha 1----6 linkages to an oligosaccharide having the following structure: (Formula: see text) but neither membrane preparation can utilize the homologous mnn1 mnn2 mnn9 oligosaccharide as an acceptor. Thus, addition of the alpha 1----2-linked mannose side chain to the terminal alpha 1----6-linked mannose in oligosaccharides of the mnn9 mutant inhibits the elongation reaction and may serve as an important structural control of mannoprotein glycosylation. The mnn9 mutation also increases the transit time for invertase secretion, meaning that this mutation could affect the processing machinery in the Golgi apparatus. PMID- 3321056 TI - Activation of casein kinase II in response to insulin and to epidermal growth factor. AB - Insulin treatment enhances casein kinase II (CKII) activity in 3T3-L1 mouse adipocytes and H4-IIE rat hepatoma cells, the magnitude of the activation varying from 30% to 150%. Activation of CKII was apparent after 5 min of exposure of 3T3 L1 cells to insulin, was maximal by 10 min, and persisted through 90 min. The insulin-stimulated activity was inhibited by low concentrations of heparin and was stimulated by spermine. Activation of CKII was effected by physiological concentrations of insulin (EC50 = 0.15 nM), suggesting that the effect is a true insulin response and not one mediated through insulin-like growth factor receptors. Epidermal growth factor (100 ng/ml for 10 min) also activated CKII in A431 human carcinoma cells, which is consistent with other observations that insulin and epidermal growth factor may have some common effects. Insulin stimulation of CKII activity was due to an increase in the maximal velocity of the kinase; the apparent Km for peptide substrate was not altered. Enhanced activity did not appear to result from increased synthesis of CKII protein, because cycloheximide did not block the effect and because an immunoblot developed with antiserum to CKII showed no effect of insulin on the cytosolic concentration of CKII. Because insulin-stimulated CKII activity was maintained after chromatography of cell extracts on Sephadex G-25, it is unlikely that the effect is mediated by a low-molecular-weight activator of the kinase. Rather, the results are consistent with the possibility that insulin activates CKII by promoting a covalent modification of the kinase. PMID- 3321057 TI - Accurate initiation at RNA polymerase II promoters in extracts from Saccharomyces cerevisiae. AB - A yeast nuclear extract supported transcription from the CYC1 and PYK1 promoters. Transcription was initiated in vitro at or near sites used in vivo. Deletion of "TATA" sequences abolished the reaction. alpha-Amanitin (10 micrograms/ml) and chloride (100 mM) were highly inhibitory. PMID- 3321054 TI - A mutational analysis of the insulin gene transcription control region: expression in beta cells is dependent on two related sequences within the enhancer. AB - Cell-specific expression of the insulin gene is controlled by cis-acting DNA sequences located within approximately equal to 350 base pairs of the 5' flanking DNA immediately upstream from the transcription start site. Using synthetic oligonucleotides, we have constructed a systematic series of block replacement mutants spanning this region. No single sequence appears to be absolutely required for expression. However, three of the mutants exhibit 5-10 times less activity and several others show 2-3 times less. Simultaneous mutation of two of the most mutationally sensitive regions leads to virtual abolition of activity. These two elements are structurally related and presumably represent key components of the machinery determining the cell-specific expression of the insulin gene. PMID- 3321058 TI - A cDNA clone encoding a photosystem I protein with homology to photosystem II chlorophyll a/b-binding polypeptides. AB - We report here the isolation and nucleotide sequence of a complete cDNA clone encoding a photosystem I (PS I) polypeptide that is recognized by a monoclonal antibody made against photosystem II (PS II) chlorophyll a/b-binding (CAB) proteins. The deduced sequence of this PS I protein shows 30% overall identity to PS II CAB sequences, and two long segments within this protein show 50% and 65% identity to the corresponding segments in the PS II CAB polypeptides. Even though the sequence of this PS I CAB protein is substantially divergent from PS II CAB sequences, their hydropathy plots are very similar and suggest they all traverse the thylakoid membrane three times. A segment of the PS I CAB polypeptide shows similarity to the functionally analogous beta subunits of the antenna proteins of purple bacteria. In contrast, no homology was observed between these bacterial proteins and PS II CAB polypeptides. PMID- 3321060 TI - Human immunodeficiency virus protease expressed in Escherichia coli exhibits autoprocessing and specific maturation of the gag precursor. AB - The mature gag and pol proteins of human immunodeficiency virus (HIV) and all retroviruses derive from large gag and gag-pol polyprotein precursors by posttranslational cleavage. A highly specific, virally encoded protease is required for this essential proteolytic processing. In this study, the HIV protease gene product was expressed in Escherichia coli and shown to autocatalyze its maturation from a larger precursor. In addition, this bacterially produced HIV protease specifically processed an HIV p55 gag polyprotein precursor when coexpressed in E. coli. This system will allow detailed structure-function analysis of the HIV protease and provides a simple assay for the development of potential therapeutic agents directed against this critical viral enzyme. PMID- 3321062 TI - High-level expression of sperm whale myoglobin in Escherichia coli. AB - Sperm whale myoglobin was expressed in Escherichia coli from a totally synthetic gene inserted in the expression vector pUC19. The gene was constructed as 23 overlapping oligonucleotides encoding both strands of the DNA. Gene synthesis provides several advantages over traditional eukaryotic gene-cloning techniques, allowing the incorporation of an efficient ribosome binding site, appropriate initiation and termination sequences, restriction enzyme sites for convenient subcloning and future mutagenesis, and frequently used codons for highly expressed E. coli genes. The sperm whale myoglobin expressed from the synthetic gene constituted approximately 10% of the total soluble protein as holo-protein, indicating that iron-protoporphyrin IX biosynthesis and prosthetic-group incorporation are not limiting in the high-level expression of this heme protein in E. coli. We credit the use of frequently used E. coli codons for the observed high-level expression. The sperm whale myoglobin produced is stable, easily purified to homogeneity, and indistinguishable from commercially available sperm whale myoglobin by optical and magnetic spectroscopic methods. PMID- 3321061 TI - Spontaneous mutagenesis and oxidative damage to DNA in Salmonella typhimurium. AB - Salmonella typhimurium strains containing deletions of oxyR, a positive regulator of defenses against oxidative stress, show 10- to 55-fold higher frequencies of spontaneous mutagenesis compared to otherwise isogenic oxyR+ control strains. The high spontaneous-mutation frequency in oxyR deletion strains is decreased by a factor of 3 when the strains are grown anaerobically. oxyR deletion strains show an increase in small deletion mutations and at least three of the six possible base-substitution mutations (T.A to A.T, C.G to T.A, and C.G to A.T). However, the largest increase in mutation frequency is observed for T.A to A.T transversions (40- to 146-fold), the base-substitution mutation most frequently caused by chemical oxidants. The introduction into oxyR deletion strains of multicopy plasmids carrying the oxyR-regulated genes for catalase (katG) or alkyl hydroperoxide reductase (ahp) results in overexpression of the respective enzyme activities and decreases the number of spontaneous mutants to wild-type levels. The introduction into oxyR deletions of a plasmid carrying the gene for superoxide dismutase (sodA) decreases the mutation frequency by a factor of 5 in some strain backgrounds. Strains that contain a dominant oxyR mutation and overexpress proteins regulated by oxyR show lower spontaneous-mutation frequencies by a factor of 2. These results indicate that oxyR and oxyR-regulated genes play a significant role in defense against spontaneous oxidative DNA damage. The role of oxidative damage to DNA in "spontaneous" mutagenesis is discussed. PMID- 3321059 TI - Mutants of Escherichia coli formylmethionine tRNA: a single base change enables initiator tRNA to act as an elongator in vitro. AB - We show that the absence of a Watson-Crick base pair at the end of the amino acid acceptor stem, which is a hallmark of all prokaryotic initiator tRNAs, is one of the key features that prevents them from acting as an elongator in protein synthesis. We generated mutants of Escherichia coli formylmethionine tRNA that have a base pair at the end of the acceptor stem. The mutants generated were C1-- -T1, which had a U.A base pair, A72----G72, which had a C.G base pair, and the C1A72----T1G72 double mutant, which lacked the base pair. After aminoacylation, the activity of these and other mutant initiator methionyl-tRNAs (Met-tRNAs) in elongation were assayed in a MS2 RNA-directed E. coli protein-synthesizing system and in binding to the elongation factor Tu (EF-Tu). Unlike wild-type initiator tRNA or the T1G72 double mutant, the T1 and G72 mutant Met-tRNAs were active in elongation, the G72 mutant being more active than the T1 mutant. The T1 and G72 mutant Met-tRNAs also formed a ternary complex with elongation factor EF-Tu.GTP, and their relative affinities for EF-Tu.GTP paralleled their activities in elongation. Combination of the T1 or G72 mutation with mutations in the GGG.CCC sequence conserved in the anticodon stem of initiator tRNAs led to a further increase in the activities of these mutant tRNAs in elongation such that one of these mutants was now almost as good an elongator as E. coli elongator methionine tRNA. PMID- 3321063 TI - Biochemical, immunological, and immunocytochemical evidence for the association of chalcone synthase with endoplasmic reticulum membranes. AB - Chalcone synthase [naringenin-chalcone synthase; malonyl-CoA:4-coumaroyl-CoA malonyltransferase (cyclizing), E.C. 2.3.1.74], the key enzyme of flavonoid pathways that was believed to be soluble, has been localized on ribosome-bearing endoplasmic reticulum membranes in the epidermis of buckwheat (Fagopyrum esculentum M.) hypocotyls. Enzyme activity measurement and immunoblots of buckwheat hypocotyl homogenates that were fractionated on linear sucrose density gradients and developed with a specific chalcone synthase antibody and a 20-nm ImmunoGold conjugate showed the presence of chalcone synthase in fractions enriched in endoplasmic reticulum membranes. The presence of chalcone synthase on these membranes was not caused by nonspecific adsorption or entrapment of proteins. Immunocytochemical investigations with both a 5-nm and a 20-nm ImmunoGold conjugate showed that chalcone synthase was associated with the cytoplasmic face of rough (ribosome bearing) endoplasmic reticulum membranes. Plasma membrane, nucleus, plastids, mitochondria, golgi, and the tonoplast were not labeled. These data are consistent with our earlier described model suggesting that the synthesis of phenylpropanoids and flavonoids takes place partially or fully on membrane-associated enzyme complexes. PMID- 3321064 TI - Two heat-induced proteins are associated with transformation of Schistosoma mansoni cercariae to schistosomula. AB - Infection with Schistosoma mansoni, a parasitic fluke, is acquired when cercariae found in freshwater bodies at ambient temperature penetrate human skin. In this study the response of S. mansoni cercariae to change in temperature from ambient to that of mammalian hosts was compared to the response of other stages that do not experience such dramatic temperature shifts. In cercariae, temperature increases from 23 degrees C to either 37 degrees C or 42 degrees C primarily induced the synthesis of two proteins unique to this stage, of Mr 60,000 and 58,000. Neither protein could be induced by similar treatment in the other two stages of the parasite found in mammalian hosts. Instead, these stages predominantly synthesized a Mr 70,000 protein that crossreacted with monoclonal and polyclonal antibodies against the Mr 70,000 heat shock protein of Drosophila and chicken. No crossreactive material was detected in cercariae, suggesting that a protein homologous to the highly conserved heat shock protein of Mr 70,000 is absent or induced to very low levels by temperature increase at this stage. The induction of the Mr 60,000 and 58,000 proteins was confined to the initial 3-hr period during cercarial transformation to the schistosomula stage. PMID- 3321065 TI - Differential turnover of tyrosinated and detyrosinated microtubules. AB - Turnover of tyrosinated and detyrosinated microtubules ([Tyr]MTs and [Glu]MTs, respectively) was analyzed by the combined use of hapten-mediated immunocytochemistry and peptide-specific antibodies. Cells were microinjected with hapten-labeled tubulin and then processed for triple-label immunofluorescence to determine the pattern of incorporation of the injected subunits into [Tyr]- and [Glu]-MTs. Within 2 min of microinjection, hapten labeled domains were present at the ends of virtually all [Tyr]MTs but were absent from most [Glu]MTs, demonstrating that [Tyr]MTs grew, whereas most [Glu]MTs did not. After 1 hr of incubation, all [Tyr]MTs analyzed were copolymers of endogenous and hapten-labeled subunits, indicating complete and rapid turnover of these MTs. However, the majority of [Glu]MTs were not hapten-labeled, indicating that they had not turned over. Even 16 hr after injection, cells that had not divided retained a small proportion of [Glu]MTs lacking hapten, implying that some had persisted for most of a cell generation. At mitosis, all MTs were hapten-labeled, indicating that the stable interphase [Glu]MTs had depolymerized. The results establish that the MT network is heterogeneous in its turnover rate, being composed of at least two populations: [Tyr]MTs that turn over rapidly and [Glu]MTs that turn over slowly. PMID- 3321066 TI - Expression of high and low molecular weight caldesmons during phenotypic modulation of smooth muscle cells. AB - We investigated the expression of two molecular weight forms of caldesmon in a wide range of tissues and cells. The distribution of high molecular weight caldesmon (h-caldesmon, Mr 120,000-150,000) was restricted to smooth muscles where it was found in large quantity. The low molecular weight protein (l caldesmon, Mr 70,000-80,000) was widely distributed in nonmuscle tissues and cells. Therefore, the expression of h-caldesmon might be much more specific to smooth muscles. We then examined the expressional changes of two caldesmons during phenotypic modulation of smooth muscle cells (SMCs). In developing gizzards, the expression of caldesmons switched from the l- to the h-form. Contrarily, the expression turned from h- to l-caldesmon in association with dedifferentiation of aortic SMCs in primary culture. In agreement with these observations, the levels of those mRNAs that direct the synthesis of both caldesmons were apparently in proportion to the quantities of protein, as determined by use of an in vitro translation system. In addition, h-caldesmon in smooth muscle-like BC3H1 cells increased in its amount with a concomitant reduction of l-caldesmon following serum-depleted and contact-inhibited cytodifferentiation. These results suggest that the expressional changes of two caldesmons are closely correlated with the phenotypic modulation of SMCs. PMID- 3321068 TI - Constitutive expression of the yeast HEM1 gene is actually a composite of activation and repression. AB - We show that HEM1 (encoding 5-aminolevulinate synthase) expression, while constitutive under all steady-state growth conditions tested, is activated by the HAP2-HAP3 global activation system that controls expression of apocytochromes. This finding creates a paradox because apocytochrome activation by HAP2-HAP3 is highly regulated, subject to induction by heme, and subject to further derepression by a shift from glucose medium to one containing a nonfermentable carbon source. We clarify this issue by showing that HEM1 is subject to two additional layers of control that mask regulatory changes. First is a second activation system acting at a site close to the HAP2-HAP3 target sequence that keeps HEM1 turned on under conditions of heme deficiency. Second is a regulated negative control site downstream of the upstream activation site that counteracts derepression in medium containing a nonfermentable carbon source. Thus, transcription of the constitutive gene is actually a composite of opposing regulatory sites. This complex regulatory arrangement may exist to allow HEM1 to be coordinated transiently with apocytochromes for transition to respiratory growth. Conversely, it may reflect the alteration of HEM1 from a regulated to a constitutive gene over evolution. PMID- 3321067 TI - Genetic analysis of tumorigenesis: a conserved region in the human and Chinese hamster genomes contains genetically identified tumor-suppressor genes. AB - Regional chromosome homologies were found in a comparison of human 11p with Chinese hamster 3p. By use of probes that recognize six genes of human 11p (INS, CAT, HBBC, CALC, PTH, and HRAS), the corresponding genes were localized by in situ hybridization on Chinese hamster chromosome 3. INS and CAT were located close to the centromere on 3p, whereas HBBC, CALC, and PTH were at 3q3-4 and HRAS at 3q4. Extensive prior data from chromosome studies of tumorigenic and tumor derived Chinese hamster cells have suggested the presence of a tumor-suppressor gene on 3p. Two tumor-suppressor genes have been described on human 11p, one linked to CAT and one to INS. The present study raises the possibility that the Chinese hamster suppressor may be closely linked to INS or CAT. PMID- 3321069 TI - Identification, purification, and characterization of a mast cell-associated cytolytic factor related to tumor necrosis factor. AB - The role of mast cells and mast-cell-derived factors in natural cytotoxic reactions was investigated. Cultured and freshly isolated murine mast cells are shown to be cytotoxic to WEHI-164 and YAC-1 targets in 18-hr viability assays but not in 4-hr assays. Here, we describe a cytotoxic factor in murine mast cells that is immunologically related to tumor necrosis factor (TNF). This TNF-like factor lyses WEHI-164 cells with a slow time course requiring 16-20 hr for the lytic reaction to complete. Antibodies specific for human and murine TNF and human lymphotoxin partially block mast cell lysis of WEHI-164 cells. These antibodies react on immunoblots with one major mast cell protein band of 50 kDa. Immunoblot analysis shows this factor in cloned and uncloned cultured mouse mast cells and in mature "connective tissue-type" mast cells freshly purified from rat or mouse peritoneal cavities. The amount of this factor is greatly enhanced in cells that have been stimulated with a combination of phorbol ester/concanavalin A or bacterial lipopolysaccharide. Subcellular fractionation analysis of mast cells with Percoll gradients reveals two pools of TNF-related cytotoxic activity that are associated with free cytosolic material and granule fractions. In contrast to cytotoxic T lymphocytes and natural killer cells, granule-enriched fractions of mast cells do not contain any hemolytic activity. The localization of the TNF-like molecule in mast cell granules may play a strategical role in the rapid delivery of this mediator to the target cell membrane following cell surface stimulation and degranulation. PMID- 3321072 TI - Society for Experimental Biology and Medicine. Membership directory. 1988. PMID- 3321070 TI - Antibodies in cerebrospinal fluid of some Alzheimer disease patients recognize cholinergic neurons in the rat central nervous system. AB - The etiology of Alzheimer disease is unclear. However, immunological aberrations have been suggested to be critical factors in the pathogenesis of this neurodegenerative disease. This study was carried out to investigate if cerebrospinal fluid (CSF) from Alzheimer disease patients contains antibodies that recognize specific neuronal populations in the rat central nervous system. The results indicate that in a subgroup of patients this is indeed the case. The antibodies reported in this study have the following properties: (i) they recognize neuronal populations and components in the medial septum and spinal motor neurons in rats perfused with a mixture that fixes small neurotransmitter molecules; (ii) adsorption of the patient CSF with staphylococcal protein A Sepharose and using a polyclonal antiserum against human IgG3 indicates that the immunocytochemical reaction in these brain regions is mainly due to the subclass IgG3; and (iii) the CSF immunocytochemical reaction is blocked by preincubation of the sections with a rabbit anti-acetylcholine antiserum. These results provide evidence that antibodies in the CSF of some, but not all, Alzheimer disease patients recognize acetylcholine-like epitopes in cholinergic neurons in the rat central nervous system. PMID- 3321071 TI - Specific expression of the pS2 gene in subclasses of breast cancers in comparison with expression of the estrogen and progesterone receptors and the oncogene ERBB2. AB - The expression of the pS2 gene, which is induced by estrogen in the breast cancer cell line MCF-7, has been investigated in breast cancers by using pS2 mRNA determination in tumor specimens and immunocytochemistry to identify pS2 protein in paraffin-embedded sections. Using these assays we show that determination of pS2 gene expression allows the definition of subclasses of estrogen-receptor containing breast cancers that may be used to more precisely identify estrogen dependent tumors. Tumor specimens have also been analyzed for the presence of mRNAs for the estrogen receptor and for the ERBB2 oncogene. No evidence for the presence of truncated forms of estrogen-receptor mRNA has been found, and overexpression of the ERBB2 oncogene did not correlate with the steroid receptor status or pS2 gene expression. PMID- 3321073 TI - Kawasaki disease. Historical background and current issues. PMID- 3321074 TI - Evaluation of evidence related to streptococci in the etiology of Kawasaki disease. PMID- 3321075 TI - Immunopathology of the skin lesion of Kawasaki disease. PMID- 3321077 TI - Immune complex study of biopsy specimens from Kawasaki disease patients. PMID- 3321076 TI - Immune complexes in Kawasaki syndrome: a review. PMID- 3321078 TI - Coagulation abnormalities in Kawasaki disease. PMID- 3321079 TI - Predictors of coronary risk in Kawasaki disease. PMID- 3321080 TI - Pathogenetic mechanisms of arteritis in Kawasaki disease--a critical analysis. PMID- 3321081 TI - Salicylates in Kawasaki disease--a review of clinical pharmacokinetics and efficacy. PMID- 3321082 TI - Japanese gamma globulin trials for Kawasaki disease. PMID- 3321083 TI - Intravenous gamma globulin therapy in Kawasaki disease--trial of low dose gamma globulin. PMID- 3321084 TI - U.S. gamma globulin trial. PMID- 3321085 TI - Clinical evaluation of gammaglobulin preparations for the treatment of Kawasaki disease. PMID- 3321086 TI - Regulation of 5-lipoxygenase pathway product generation in human neutrophils by n 3 fatty acids. PMID- 3321087 TI - Methodology in prostaglandin and thromboxane assay. AB - Many difficulties encountered in prostaglandin and thromboxane assay can be overcome by metabolic consideration of which compound is the best target for measurement. The following requirements must be fulfilled: the chosen compound should represent a constant and preferably major fraction of the studied pathway; it should not be formed as an artifact during collection and processing of the samples; its half-life in the biological material under study should be long; and it must be chemically stable. Our knowledge of prostaglandin metabolism now enables us to solve most assay problems for prostaglandins of the E and F type and, at least in some cases, also compounds of the D type. In general, either the 15-ketodihydro metabolites or the beta-oxidized end products thereof should be monitored; either as such or as chemically stable degradation products. In the thromboxane area, most assays have so far been directed at TxB2. The present study, however, shows that this compound is a highly unsuitable target for monitoring, since it may be formed in large amounts during sample collection. Metabolic studies indicate that an early metabolite, 11-dehydro-TxB2, is a better alternative. Quantification of this product however presents certain problems: it occurs in two different forms and the equilibrium is highly dependent on for example pH. A recently developed radioimmunoassay was employed in kinetic studies on TxB2 metabolism in the human and confirmed that 11-dehydro-TxB2 gives a more reliable picture of events than its parent compound, TXB2. PMID- 3321088 TI - Essential fatty acid consideration at birth in the premature neonate and the specific requirement for preformed prostaglandin precursors in the infant. AB - The essentiality of certain PUFA is probably related to their capability to be incorporated into lipids and to act as precursor in the formation of ecosanoids. Esterified to phospholipids, the EFA influence the physico-chemical characteristics of biomembranes. Normal growth of infants is dependent upon an adequate supply of EFA. The human fetus, like the adult, is unable to synthesize the EFA, which must therefore be derived from the maternal circulation and pass through the placenta. Increased concentration of the polyenoic fatty acids with advanced gestational age may result from increased synthetic activity of these fatty acids by the fetus or the placenta or by preferential transfer of these fatty acids across the placenta. Several clinical manifestations have been ascribed in the human infant to prolonged EFA deficiency; however, none of these findings were noted in a group of sick newborn infants with very rapid onset of deficiency. Platelet dysfunction, decreased prostaglandin biosynthesis and turnover and altered pulmonary surfactant are among the effects of EFA deficiency on infants. Supplementation of the diet with EFA, parenterally or by the inunction of oil rich in linoleic acid, were reported to alleviate the symptoms of EPA deficiency. The minimal estimated requirement of linoleic acid is 1% of calories and 4% is an optimal intake. Most diets, including human breast milk, infant formulas and parenteral fat emulsions, far exceed the optimal intake of linoleic acid. Relatively little is known about the possible effects of high levels of linoleate in the diet. PMID- 3321090 TI - Serum fatty acids and coronary heart disease in Finnish populations. AB - Finland has one of the highest coronary heart disease (CHD) rates in the whole world, and within the country, the rates are higher in men and eastern Finland than in women and western Finland, respectively. The differences are not wholly explained by the 3 classical risk factors. Several cross-sectional and longitudinal studies suggest that the intake of dietary linoleate (18:2), as reflected in the composition of serum and tissue fatty acids, has an inverse association with CHD, although there are also studies with negative results. Our own retrospective study failed to show any differences in the fatty acid composition of serum CE, TG or PL between men who had died of CHD and age- and risk factor-matched controls, but the negative finding may be due to changes in the fatty acids during storage. Among Finnish populations, most serum CE fatty acids had highly significant correlations with those in other serum lipid fractions, adipose tissue and platelets, and they had good "tracking" for up to 4 yr. Serum CE and TG 18:2, and total omega 6 polyunsaturated fatty acids (PUFA) had strong correlations with dietary 18:2 and PUFA, and can thus be used in the evaluation of population differences in the intake of PUFA. CE fatty acids were analyzed in a total of 2820 free-living 1- to 85-yr-old males and females. The percentages of serum fatty acids were age-dependent. West-Finnish populations had higher contents of 18:2 than those in eastern Finland, and middle-aged women had higher proportions of 18:2 than men. The content of 18:2 in adipose tissue and/or serum CE of middle-aged men was comparable to that in Scotland and lower than those in Italy and Sweden. These findings are compatible with the idea that 18:2 is a negative risk factor of CHD, but the evidence is only circumstantial. Possible mechanisms whereby 18:2 could affect CHD have been discussed. The contents of omega 3 fatty acids in CE were opposite to those of omega 6 fatty acids in that eastern Finnish and male populations had higher contents of 18:3 omega 3 and 20:5 omega 3 than western Finns and females, respectively. This finding is apparently due to substitution of vegetable fat for milk fat in the diet, resulting in a relative deficiency of the omega 3 fatty acids at the expense of 18:2. Experimental evidence for such a mechanism was obtained in an intervention study.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3321089 TI - Participation of the endothelium in the development of the atherosclerotic plaque. AB - In the past decade, initiated by the response-to-injury hypothesis of Ross and Glomset, the endothelium has been implicated in atherogenesis but as a passive participant--more involved through its absence than its presence. The hypothesis stated that endothelial desquamation due to an undefined injury led to platelet adhesion to the exposed basement membrane, and infiltration of serum lipoproteins. The subsequent release from the platelet alpha-granule of a potent smooth muscle cell mitogen and chemoattractant--the platelet-derived growth factor (PDGF)--was postulated to cause the intimal proliferative response that is known to be important in atherosclerotic plaque development. Recent evidence from several laboratories indicates that the endothelium has the potential to play a more active role in plaque development than simply contributing to pathological sequelae resulting from the loss of the nonthrombogenic surface provided by the endothelium. First, the endothelial cell (EC) is the site of attachment, and possibly activation, of blood-borne monocytes which enter the vessel wall as an early event in experimental atherogenesis. We have obtained in vitro evidence that the expression of monocyte binding sites on the surface of EC is a regulatable process and that increased EC turnover and certain exogenous agents acting on EC cause increased monocyte adhesion. Similar events may be responsible for focal adhesion of monocytes to the endothelium in vivo following hypercholesterolemia. Secondly, EC in culture are capable of chemically modifying low density lipoprotein (LDL) by a free radical oxidation process that renders the LDL toxic to proliferating cells and recognizable to the scavenger receptor of monocyte-derived macrophages. Thus, by oxidation of LDL, the EC have the potential to play an active role both in the formation of lipid-laden foam cells and in the accumulation of necrotic tissue which are hallmarks of the atherosclerotic lesion. Thirdly, cultured EC have been recently shown to secrete multiple mitogens for cultured smooth muscle cells. One of these mitogens appears to be closely related, if not identical, to PDGF using the criteria of receptor binding and biochemical and immunological similarity. Production of growth factors by EC is a regulatable process that is stimulated by exogenous agents such as endotoxin and phorbol esters which cause severe injury to cultured EC. Such a regulatory mechanism may participate in the in vivo proliferation of vascular SMC during the atherosclerotic process.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3321091 TI - The role of dietary fatty acids in thrombosis. PMID- 3321092 TI - Fat and cancer aetiology. AB - Strongly positive correlations exist between the incidence of breast and large bowel cancers in different countries and the corresponding per caput intake of fat. However, attempts to confirm these relationships have, on the whole, proved disappointing, in studies of individuals whether using the case-control or the prospective approach. Moreover no positive relationship is evident in prospective studies between blood lipid levels and colon or breast cancers. Overall the human evidence for fat as a cause of these cancers is weak. Possible reasons are considered for the findings in different studies. PMID- 3321093 TI - Do tissue culture and animal model studies relate to human diet and cancer? PMID- 3321094 TI - The production of prostanoids in human cancers, and their implications for tumor progression. PMID- 3321095 TI - Fatty acids and eicosanoids in organ transplantation. PMID- 3321096 TI - Hepoxilins, potential endogenous mediators of insulin release. AB - Evidence is presented to show that pancreatic islets of Langerhans are capable of producing hepoxilins A3 and B3 from endogenous substrates as well as 14C-labeled 12-HPETE. Both hepoxilins are active in stimulating the release of insulin from these cells in the presence of 10 mM glucose. These experiments suggest that the hepoxilins may participate as potential endogenous mediators of insulin release in islets of Langerhans. PMID- 3321097 TI - Suppression of principal atherosclerotic mechanisms by prostacyclins and other eicosanoids. PMID- 3321098 TI - Failure of platelets to enhance aggregation of temperature-stabilized neutrophils: effects of warming and of drugs. AB - Polymorphonuclear leukocytes (PMNs) were isolated on a Ficoll-Hypaque gradient, suspended in modified Hank's buffer, and aggregated alone or in the presence of washed platelets (4 or 8/PMN). Platelets had no effect on formyl-methionyl-leucyl phenylalanine (FMLP)-induced aggregation of PMNs that had been allowed to equilibrate at 37 degrees C for 5 min after storage at room temperature. Pretreatment of platelets with an inhibitor of cyclooxygenase (ASA) or lipoxygenase (nordihydroguaiaretic acid, NDGA) produced no significant effect whereas pretreatment with an inhibitor of both enzymes (eicosatetraynoic acid) or of phospholipase (methylprednisolone sodium succinate) caused a modest but statistically-significant inhibition of PMN aggregation which appeared to be a direct effect on PMNs rather than through platelets. The warming of PMNs from 0 degrees C or 22 degrees C to 37 degrees C produced a spontaneous, reversible aggregation within 2 or 3 min, the extent of which was dependent on the degree of temperature change. This aggregation was enhanced by the presence of platelets in a 'dose' (count) dependent fashion. This enhancement was not decreased by any of the aforementioned drugs, in fact, the aggregation was augmented by all drugs, the difference being statistically significant for NDGA. Thus different mechanisms appear to be involved in spontaneous vs FMLP-induced aggregation. The role of platelets in PMN aggregation remains to be elucidated but the importance of controlling for the effects of temperature changes in such studies is self evident. PMID- 3321099 TI - Adaptive changes in thermoregulation and their neuropharmacological basis. AB - Adaptive changes of the thermoregulatory system include morphological and functional modifications. The morphological modifications such as changes in body shape and insulation need time periods of months to years to develop, unless they are genetically fixed and appear seasonally. In general, they are preceded by functional modifications, including changes in capacity of the effector systems and changes in regulatory characteristics, which need much less time to develop. These early changes in regulatory characteristics, which can be defined as deviations in threshold and gain of the thermoregulatory responses, have been described and subdivided into short-term (minutes) and long-term (weeks) modifications. Evidence for the participation of monoaminergic brain stem systems in these modifications has been reviewed. On the basis of recent insights into the organization of the thermoregulatory system, and of evaluation of experimental evidence from electrophysiological, neuropharmacological, and neuroanatomical studies it can be concluded that these systems are involved in adaptive modifications. Receiving information from several sensory systems they seem to deliver additional modulatory signals, which may interfere with the processing of specific thermal information at several sites. Theoretically, the central monoamines may participate in the control of thermal input, in the central integration of thermal signals, and in modification of output signals to thermoregulatory effectors. Best documented is their modulatory action on thermosensitive and thermointegrative hypothalamic neurons. There, the monoamines 5-hydroxytryptamine and noradrenaline act as antagonists, which enhance or diminish the effects of thermal afferents mediated by other transmitters. Moreover, the antagonistic monoaminergic systems are interconnected and can influence each other at the level of lower brain stem. The activity in central monoaminergic systems can also be modified by neurohumoral feedback mechanisms from the periphery. By means of these interrelations the vegetative responses of the organism can be corrected and optimized. These interrelations can explain also some cross-adaptive changes in the thermoregulatory threshold for shivering evoked by nonthermal factors such as food intake or long-distance running. PMID- 3321100 TI - Effect of anticancer drugs on drug metabolism. PMID- 3321101 TI - The role of reward pathways in the development of drug dependence. AB - In commenting on the discovery of "opiate" receptors, Goldstein (1976) said: "It seemed unlikely, a priori, that such highly stereospecific receptors should have been developed by nature to interact with alkaloids from the opium poppy" (p. 1081). Endogenous opioid peptides and opioid receptor systems have now been identified in invertebrates that are unlikely to have had ancestors exposed to opium poppies (Kavaliers et al., 1983; Kream et al., 1980; Leung and Stefano, 1984; Stefano et al., 1980). Moreover, endogenous opioids play a role in stress induced feeding in the slug (Kavaliers and Hirst, 1986) just as they play a role in stress-induced feeding in rodents (Lowy et al., 1980; Morley and Levine, 1980). If we are to understand the actions of opiates and other drugs of abuse we must understand them in terms of their abilities to interact with neural systems that evolved in the service of primitive biological functions, long before any serious incidence of addiction itself. The most primitive axes of the biological substrates of behavior are the axes of approach and withdrawal. Addictive drugs appear to be able to activate the mechanisms of approach, which is termed "positive reinforcement" and to inhibit the mechanisms of withdrawal, which is termed "negative reinforcement." Anatomically distinct sets of pathways have evolved to serve these two forms of reward. Activation of the medial forebrain bundle and associated structures serves positive reinforcement and induces forward locomotion. Approach and forward locomotion are the unconditioned responses to positive reinforcing stimuli such as food and sex partners, and approach to environmental objects and positive reinforcement is induced by electrical stimulation of this structure. The locomotor stimulating effects and the positive reinforcing effects of opiates and psychomotor stimulants result from their activation of this mechanism; stimulants activate the mechanism at the level of dopaminergic synapses of the nucleus accumbens, frontal cortex, and perhaps other forebrain structures, while opiates activate the system at two points: at the level of the dopaminergic synapse and at the level of the afferents to the dopaminergic cell bodies. Ethanol, nicotine, caffeine and phencyclidine stimulate both locomotor activity and dopamine turnover, but their sites of interaction with reward pathways have not yet been identified. Benzodiazepines and barbiturates stimulate locomotor activity without stimulating dopamine turnover; they may interact with reward pathways at a synapse efferent to the dopaminergic link in the pathways.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3321102 TI - Metabolism and reactions of quinoid anticancer agents. PMID- 3321103 TI - Soma Weiss: the characteristics that made us know he was a great man. PMID- 3321104 TI - Accepting illness: reflections on an essay by Montaigne. PMID- 3321105 TI - "That noble, old and yet young institution": the Royal Medical Society. PMID- 3321106 TI - Pros and cons on lobotomy. PMID- 3321107 TI - Theory of relative biological effectiveness (RBE) of tritium beta rays: bacteria killing effects of tritiated water. AB - A new model is applied to bacteria exposed to tritiated water. In this model, the relation between the radiation quality, induction of single- and double-strand breaks in DNA and their repair in vivo can be reasonably described in terms of the microdosimetric distribution and the modification factors for single- and double-strand breaks in DNA. First, a mathematical formulation of RBE of tritium beta rays relative to an arbitrary reference radiation for killing effect on bacteria is derived on this model. Typical theoretical results on the survival curve parameters for bacteria exposed to tritiated water and RBE of tritium beta rays relative to 60Co gamma rays are presented. It is found that RBE of tritium beta rays depends on the ability of the cell to repair DNA damage. The present model is applied to the survival of Escherichia coli Bs-1 exposed to tritiated water and 7 MeV electrons. Although the average LET of tritium beta rays is remarkably higher than that of 7 MeV electrons, the experimental result that RBE of tritium beta rays relative to 7 MeV electrons is close to unity, is reasonably explained by the present model. PMID- 3321108 TI - [Nurses in the Karol and Maria Hospital]. PMID- 3321110 TI - Transient expression system to measure the efficiency of vaccinia promoter regions. AB - A transient expression system has been developed to compare the relative efficiency of expression of various vaccinia virus DNA sequences containing transcriptional regulatory elements. A plasmid vector was constructed containing both the Escherichia coli galactokinase gene (galK) and the guanine phosphoribosyltransferase gene (gpt). To direct the expression of gpt within this vector, a vaccinia virus promoter region was isolated from the HindIII-F fragment of the genome and inserted 5' to gpt coding sequence. Four unique cloning sites in front of galK allow simple and precise fusion of various vaccinia virus DNA fragments that contain the regulatory site of interest to galK. Sequences containing promoter regions were ligated to the coding segment of the galK to create four recombinant plasmids, which were introduced into vaccinia virus infected cells by transfection. Both galK and gpt were thus expressed under the control of vaccinia virus transcriptional units, and the enzymatic activities were measured in the same cell extract with a filter-binding assay. The major advantage of this transient expression system is that the variations in galK expression are always measured relative to the internal gpt standard. Changes in the galK/gpt ratio resulting from different vaccinia promoters of galK are thus a quantitative measurement of promoter strength. PMID- 3321109 TI - [The Krakow Anna Rydlowna School of Nursing]. PMID- 3321112 TI - [Peculiarities and effects of the nocturnal psychological life of the child and adolescent]. AB - It is hard to get a good look at psychic night life and its mysteries. It resists our inquiry and is a jealous gate keeper. In this article we write about a distinctive study of the manifestations and the problems of the child's and adolescent's psychic night life. It serves as a fictional model of freudian metapsychology, without totally neglecting electroneurophysiological discoveries. The indispensable distance between a fictional model and the fixity of a model (such as the electroencephalographic trace) becomes a fertile source when other paths are prudently explored and in the reduction of the illusion that one model can possibly overlap the other. PMID- 3321111 TI - [Depression in the child: internal reaction or psychological elaboration?]. AB - The question of a child's depressive suffering is at the heart of psychopathology. The concept of a "fundamental depressive affect" and the notion of "depressive reaction", defended by many authors, are here discussed as reductionist. The notions of "depressive movement" and "depressive system" are described so as to take into account both the characteristics of the depressive experience and its unexpected appearance in different clinical contexts. The psychic work of the depressive movement is envisaged based on the notion of object loss, the existence of a denial constitutive of the depressing experience and in function of the modalities of the incorporation of the shadow of the object... This work leads to the organisation and the maintenance of a particular internal object: the depressive object. PMID- 3321113 TI - [Early interactions between mother and child and the development of the psychological life]. AB - Recent research on the perceptual and behavioural performance of the new-born suggest that he has neuromotor and sensory capacities which are programmed to enable him to react in a special way to the stimuli engendered by a human presence. The work of T. B. Brazelton leads us to think that the "good enough mother" develops a relationship with her infant not only by exploiting this special sensitivity which the new-born has to signals of human presence but also by respecting the boundaries of resistance with which a burgeoning mental life opposes the excitation of the impact of an active presence. In admitting that the psyche exploits mental functions to give shape and sense to its state of tension, early mother-child interactions, because they condition the setting up of mental functioning, also influence the beginning of psychic functioning. PMID- 3321114 TI - Immunocytochemical identification of growth hormone cells in the adenohypophysis of the golden hamster. AB - Somatotrophs or growth hormone (GH) cells in the adenohypophysis of golden hamsters were identified by immunocytochemical staining with polyclonal rabbit anti-human GH. They were oval or columnar in shape, and had secretory granules of two size ranges, 90-150 nm and 280-320 nm, which were present in the same cells; no subtypes of GH cells were observed. Secretory granules were located in the peripheral portion of the cytoplasm or concentrated at the vascular pole of the cell. Flattened cisternae of the rough endoplasmic reticulum in parallel array and a moderately developed Golgi apparatus were often found in the cytoplasm. No sex difference was noticed in the population ratio of GH cells. Immunocytochemical staining with anti-GH or anti-prolactin (PRL) antibodies on separate adjacent sections revealed that the GH and PRL were stored in two different cell types. PMID- 3321115 TI - [Behavioral laboratory models and various tests in the evaluation of the effect of antidepressive drugs]. PMID- 3321116 TI - [Principles of pharmacotherapy of endogenous depression]. PMID- 3321117 TI - [Interaction of antidepressive drugs and histamine receptors in the brain]. PMID- 3321118 TI - Homatropine eyedrops change sleep and mood disorders in depressive patients. PMID- 3321119 TI - Dysphoric mood in paranoid psychoses. AB - Many authors have stressed the particular affective behavior in paranoid psychoses, mainly its dysphoric pattern. In 1983, Berner formulated the dysphoric axial syndrome as a third type of the endogenomorphous cyclothymic axial syndrome. In this paper two points are examined: (1) The interrelation between dysphoric and depressive and/or manic affective disorders in paranoid psychoses, cross-sectionally and longitudinally, in order to test the hypothesis of their independence, and (2) the relation of dysphoric mood disorders in paranoid psychoses to their course, again in comparison with other types of affective symptoms. The paper is based on an empirical study by Gabriel in 1978 on the phenomenology and the course of paranoid psychoses. PMID- 3321121 TI - The development of the concept of reactive psychoses. AB - Although reactive (psychogenic) psychoses have no doubt occurred throughout the history of mankind, it is only during the last century that the corresponding concept has been defined, beginning with Sommer's definition of the term 'psychogenic' and Jaspers' distinctions between 'reaction' and 'process', and between 'neurosis' and 'psychosis', respectively. A change in Kurt Schneider's nosological concepts induced the majority of German-speaking psychiatrists to avoid the concept of psychogenic psychoses. The very varying use of the concept of reactive psychoses in different countries is described and discussed, with special regard to implications for psychiatric epidemiology. PMID- 3321120 TI - Pathophysiological aspects of dysphoric states. AB - Dysphoric states have been of particular interest for a long time since they occur not only in patients with psycho-organic syndromes but also in those with manic-depressive disease. This paper discusses some aspects of dysphoria from the pathophysiological point of view. Data mostly derived from epileptic patients indicate the critical role the limbic system plays in the control of emotions. It is suggested that functional alterations within the limbic system and its manifold interconnections to other parts of the central nervous system are responsible for characteristic pathophysiological phenomena as, e.g., dysphoria. PMID- 3321123 TI - Continental viewpoints on the concept of reactive psychoses. AB - Although the Scandinavian concept of reactive psychoses relates to K. Jaspers and although Kretschmer described the prototype of a psychosis of psychogenic/reactive origin (Der sensitive Beziehungswahn), the concept is not so commonly used in German-speaking countries. Important reasons for this refusal may be (1) the sharp distinction between psychosis (which may be explained but not understood) and understandable reactions, which was stressed in rather influential German psychiatric schools in the middle of the century, and (2) the aim of stressing psychological understanding in a broad spectrum of psychiatric illnesses in the Swiss tradition, where the demarcation of particular reactive psychoses seemed to be superfluous. The development of modern concepts stressing the multidimensionality in the etiology of the main groups of psychiatric disorders was certainly influenced by the concept of reactive psychoses but passed it. PMID- 3321122 TI - Problems concerning the concept of reactive psychoses. AB - The problems of reactive psychoses are discussed from the following perspectives: terminology, prevalence, psychogenesis and trauma, predisposition and vulnerability, as well as outcome. Four definitions of reactive psychoses, which are used in Scandinavia, are presented and discussed. Each of them is beset with problems. The authors argues that the term 'reactive psychoses' should be limited to those functional psychoses which are not typically schizophrenic, manic depressive or paranoid. PMID- 3321124 TI - Psychopathological concepts of dysphoria. AB - Dysphoric conditions are increasingly postulated as representing independent mood disorders. However, despite much effort at clarification, their psychopathological definitions remain unclear and variable. This paper reviews some examples of these divergent definitions, most of which are based on quality of mood, as well as responsiveness to external stimuli. The paper then introduces a strategy in possible solution of the above-mentioned definition problems. Setting out from restriction of the term dysphoria to conditions of a morose, tense and irritated mood, as suggested by Snaith and Taylor, we support the opinion that dysphoria should be accepted as a third possibility of mood swing, as a psychopathological disturbance which can be well distinguished from stable and unstable mixed states. PMID- 3321125 TI - Antidepressant medication in the treatment of bulimia nervosa. AB - Antidepressant therapy has been shown to be efficacious in the treatment of bulimia nervosa, a serious eating disorder that can be associated with substantial morbidity and mortality. Seven antidepressant drugs have been tested in double-blind, placebo-controlled studies. Five of these studies demonstrated strongly positive findings, one a weakly positive finding, and one a negative finding. However, inadequate doses of medication may have been used in the latter two studies. In all of the positive studies, antidepressant agents appeared effective even in bulimic subjects who did not display concomitant depression, indicating that this treatment modality should not be reserved only for depressed bulimic patients. Although not yet tested in double-blind studies, trazodone also appears effective in the treatment of bulimia nervosa. Results from one large open study suggested that trazodone has comparable efficacy to the tricyclic antidepressant agents. Trazodone would be a particularly attractive treatment for bulimia nervosa because of its low anticholinergic side-effects profile; placebo controlled studies are required, however, before definitive recommendations can be made. PMID- 3321126 TI - Diagnosis and treatment of depression. AB - In the United States, depression is the most common psychiatric disorder and is the psychiatric problem most often seen by the generalist. Thus, it is essential for the primary-care physician to have a thorough understanding of the diagnosis and management of depression. Patients often present with complaints such as weight loss, appetite changes, sleep disturbances, pain, psychomotor agitation or retardation, decreased sexual drive, loss of energy, and somatic complaints. When depression is suspected, the clinician should first rule out secondary depression attributable to other psychiatric or medical illnesses, or medications. In addition, certain age categories--children, adolescents, and elderly individuals- have characteristic symptoms and behavior patterns suggestive of depression. Identifying the suicidal patient is another important aspect in the treatment of depressed individuals. In addressing this issue, questions have been formulated to help identify patients who may be potentially suicidal. Treatment modalities for depression include exercise regimens, psychotherapy, and pharmacotherapy. The standard pharmacotherapy has been the administration of tricyclic antidepressant agents; newer drugs are currently available that have comparable efficacy, and perhaps better safety profiles than the tricyclic agents. PMID- 3321127 TI - Sleep and depression. AB - Manifestations of sleep disturbances can potentially serve as external criteria for the diagnosis of specific subtypes of major depressive disorder (MDD). Depressed patients generally experience disturbances of sleep continuity and rapid eye movement (REM) sleep. Disturbances in nonrapid eye movement (NREM) sleep (stages III and IV) also occur. Characteristic of primary sleep disturbance in many depressed patients are shortened REM latency periods and instabilities in NREM sleep identified by increases in the number of stage shifts, decreases in the duration of stage III and IV sleep, and a shift towards lighter sleep stages (sleep efficiency disturbances). Treatment modalities for these sleep disturbances include sleep deprivation therapy and antidepressant therapy. Sleep deprivation alone has been only moderately successful, while antidepressant therapy usually results in symptomatic improvement. To restore normative sleep, REM sleep periods and stage III and IV sleep must be returned to normal. Trazodone therapy has been shown to reduce the frequency of arousals, the severity of drowsiness, and the duration of REM sleep, and increase restorative slow wave sleep and stage III and IV NREM sleep. PMID- 3321128 TI - United States experience with trazodone: a literature review. AB - This paper reviews clinically oriented manuscripts published over the last 5 years dealing with US experience with trazodone. Three major questions are addressed. First, there is ample documentation that trazodone is an effective antidepressant with results comparable to the tricyclic antidepressant agents in treating major depressive disorders. Second, trazodone offers significant safety advantages over other antidepressant drugs in overdose and has remarkably low levels of anticholinergic properties. Third, it is concluded that the unique structure of this drug and the balance between efficacy and side-effect profile combine to offer the clinician an interesting and potentially important treatment for depression. PMID- 3321129 TI - Recent experience with trazodone. AB - Trazodone is an atypical antidepressant with additional anxiolytic effects. Recent European experience with trazodone is reviewed with respect to antidepressant efficacy, side effects (particularly anticholinergic), anxiolytic actions, cardiotoxicity, overdosage, and use in the elderly. From the data presented in this paper it is concluded that trazodone is effective both as an antidepressant and as an anxiolytic agent, with few side effects and low cardiotoxicity. It is safer than tricyclic antidepressant agents in overdosage and better tolerated in the elderly patient. PMID- 3321130 TI - Trazodone: a 5-year review of antidepressant efficacy. AB - Results from double-blind studies reported since 1981 were reviewed to evaluate trazodone's relative antidepressant efficacy and its safety profile. Trazodone's therapeutic efficacy compared favorably with that of the tricyclic antidepressant (TCA) agents in both endogenous and nonendogenous patients. Data also suggested that trazodone had a more pronounced, earlier anxiolytic action than the TCA agents. Trazodone may be more effective at lower than maximal doses; some studies that used high dosages--starting at 200 mg/day and rapidly titrated doses to as high as 600 mg/day--reported poorer therapeutic responses than did those that employed more conservative dosages. Trazodone therapy generally produced less pronounced anticholinergic effects than did the comparison TCA agent and it is often as sedating as amitriptyline but more sedating than imipramine. Untoward side effects may be reduced by taking trazodone after meals, and by using bedtime dosing. Issues of possible cardiotoxicity and priapism are reviewed briefly. Overall, studies in the past 5 years point to trazodone as being an effective antidepressant agent with a relatively favorable safety profile. PMID- 3321131 TI - The greater safety of trazodone over tricyclic antidepressant agents: 5-year experience in the United States. AB - Trazodone demonstrates comparable efficacy with the tricyclic antidepressant agents (TCAs) but produces fewer of the untoward side effects associated with these drugs. All of the TCAs are potentially lethal when taken in overdose; they cause serious cardiovascular side effects; produce anticholinergic effects, which often are severe enough to result in discontinuation of medication; and impair cognition, especially in elderly patients. In contrast, trazodone is relatively safe when taken in overdose; no deaths have been reported to the manufacturer when trazodone was the only agent taken. Trazodone produces fewer and milder cardiovascular disturbances and anticholinergic effects than TCAs. If anticholinergic side effects do occur then they are rarely bothersome enough to result in discontinuation of therapy. In addition, cognitive skills, even in elderly patients, are less impaired in patients receiving trazodone therapy than in patients receiving TCA drugs. Although trazodone therapy has been associated with lethargy, dizziness, drowsiness, and confusion in some patients, symptoms have been mild and can be further minimized by administering the drug either after meals or once daily at bedtime. PMID- 3321133 TI - Antidepressant overdose: symptoms and treatment. AB - In recent years, an increased use of antidepressant medications has resulted in a heightened incidence of drug overdose. Because of this increased use, more types of antidepressant agents have become available. Therefore, emergency-room physicians not only have to recognize the overdose patient (often unwilling or unable to communicate with the physician), but also, identify the overdose agents if possible, and initiate early and appropriate treatment. Recognizing overdose signs and symptoms associated with various antidepressant agents is essential in choosing the appropriate treatment. Tricyclic agent overdoses account for most of the hospital admissions and deaths due to antidepressant therapy; a majority of these deaths are attributable to cardiac complications. In contrast, trazodone, one of the safest drugs when taken in overdose, is not associated with cardiac arrhythmias. Thus, trazodone-overdose patients generally require only emesis and/or gastric lavage, and minimal supportive therapy, whereas tricyclic antidepressant overdoses often require more aggressive intervention. PMID- 3321132 TI - Cardiovascular toxicity of antidepressant medications. AB - This article reviews the cardiovascular effects of the standard tricyclic antidepressant agents and the cardiovascular effects of the newer antidepressant drugs. The cardiovascular effects of the standard tricyclic agents are orthostatic hypotension, conduction delay, and a potent antiarrhythmic effect. Patients with congestive heart failure receiving cardiac medications are at greatly increased risk for orthostatic hypotension, while patients with preexisting conduction delay are at risk for heart block. Of the newer antidepressant drugs, mianserin, nomifensine, and bupropion initially appeared to be most promising in terms of cardiovascular effects, but subsequently proved to have other serious liabilities; these agents require further testing. Trazodone has emerged as the antidepressant drug with the least risk of death in overdose, and as a useful alternative to the standard tricyclic antidepressant drugs in patients with preexisting conduction disease. However, trazodone therapy has been associated with some adverse effects, and, therefore, from the data presented in this paper, it can be concluded that no drug currently available is without some cardiovascular risk. PMID- 3321134 TI - Geriatric depression and treatment with trazodone. AB - With the growing number of Americans over the age of 65 years, the high incidence of geriatric depression has become a major concern in the United States. Age related circumstances--increased incidence of illness, bereavement, financial difficulties, and institutionalization--may contribute to an increased rate of depression in this age group. The signs and symptoms of depression in elderly patients are similar to those seen in younger individuals; therefore, standard Diagnostic and Statistic Manual III (DSM-III) criteria are reliable for making a diagnosis. However, symptoms such as insomnia, obsessional thought, and hypochondriasis may be relatively increased in the elderly patient; and the diagnosis of geriatric depression can be complicated by signs and symptoms of depression that may overlap with those of dementia. In the geriatric group, the mainstay of pharmacotherapy has been the reuptake antidepressant agents. Choice of antidepressant therapy is largely based on the side-effect profile. Thus, the fewer and less severe side effects associated with trazodone make it a suitable drug choice in these patients. Trazodone has been shown to demonstrate comparable efficacy to the other reuptake and monoamine oxidase inhibitors, but has the advantages of a low cardiovascular-risk profile, extremely low suicide toxicity, absence of anticholinergic side effects, and minimal effects on cognition. PMID- 3321135 TI - Medical and psychiatric implications of generic drugs. AB - Among the most controversial issues surrounding the use of generic drugs is the reliance on bioavailability data to approve generic products. Bioequivalence does not necessarily translate into therapeutic equivalence. In some cases, because of the broad interpretation of drug equivalence, patients may not be receiving adequate amounts of medication, while others may be receiving toxic doses. In contrast, rigorous rules exist for the approval of brand-name medications. Resolving the generic drug standard issue by adopting stricter guidelines for generic drug approval based on clinical efficacy and toxicity data rather than on the bioequivalence standard currently being used would more likely result in safer, more effective patient care. Economic burdens for postmarketing research should be shared jointly by the research-oriented and generic drug companies. Such a policy would ensure continued research and new drug development. This paper reviews major scientific, economic, social, and legal issues involved in generic drug use with particular emphasis on the psychotropic drugs. PMID- 3321136 TI - The future for antidepressants: treatment of pain. AB - Antidepressant drugs have been used successfully in the treatment of chronic pain syndromes. Clinical trials have supported the use of these drugs for pain and the depression that often accompanies pain syndromes. Although the exact mechanisms of action have not been clearly elucidated, it has been suggested that these agents have analgesic properties independent of their antidepressant effect on mood and behavior. Pain patients without concomitant depression experienced pain relief with antidepressant therapy; these patients represent the most convincing evidence that antidepressant drugs have a direct analgesic effect. Studies presented in this paper support the clinical efficacy of antidepressant medications in the treatment of patients suffering from headaches (migraine, tension, and mixed types), diabetic neuropathy, arthritis, and facial pain. These data also suggest that antidepressant drugs may be effective in the treatment of postherpetic neuralgia, back pain, and pain from mixed etiologies; however, data for these pain syndromes are less clear, and, thus, further testing is required. PMID- 3321137 TI - Liver transplantation: psychiatric considerations. PMID- 3321138 TI - Alternative uses of lithium in psychiatry. PMID- 3321139 TI - Behavior: the fourth dimension. PMID- 3321140 TI - Flow through interstitium and other fibrous matrices. AB - This review examined the relation between interstitial hydraulic permeability and chemical composition, using porous matrix theory, and assessed the view that interstitial conductivity is governed by GAG concentration. Conductivity correlates negatively with both GAG and collagen concentration over a wide variety of tissues. Conductivities of GAG matrices in vitro, coupled with other quantitative considerations, indicate, however, that no single class of fixed fibrous element exists at a sufficiently high concentration to account by itself for the low conductivity in most tissues. It seems that the low interstitial conductivity arises from the combined interactive effects of three main classes of fibrous element: collagen fibrils, GAG and proteoglycan core protein. In most cases the proteoglycan complex plays a major role which is significantly amplified, however, by the collagen fibril network. PMID- 3321141 TI - Fluid balance in food-deprived lactating goats drinking saline. AB - Fluid balance was studied in four lactating goats during two 3 week periods, which included 30 h periods of food deprivation. In one period the goats were given 0.9% NaCl to drink, and in the other they were given water. Prior to food deprivation, fluid intake and urinary flow were similar in the two groups, but urinary Na+ excretion was higher in the saline-drinking goats. The plasma renin activity was depressed in saline-drinking goats, while the plasma aldosterone concentration was the same both in saline-drinking and water-drinking animals. Food deprivation depressed fluid intake and urine flow in all goats, but the reduction was more pronounced in goats drinking saline. The urinary Na+ and K+ excretion also decreased, in both groups, as did plasma Na+ concentration and osmolality. The plasma protein concentration increased in both groups, indicating that hypovolaemia had developed. The renin-angiotensin-aldosterone system (r.a.a.s.) became activated in goats drinking water, but not in the group drinking saline. It is suggested that sodium retention may have attenuated the activation of the r.a.a.s. in the latter group. The results of this study show that hyponatraemic hypovolaemia develops during starvation in lactating goats, regardless of the sodium state of the animals. The possibility that the hyponatraemic hypovolaemia is secondary to an impeded Na+ and fluid absorption from the rumen reticulum is discussed. PMID- 3321142 TI - Whatever happened to urogastrone? PMID- 3321143 TI - Exercise electrocardiography in coronary artery disease. PMID- 3321144 TI - Temporal effects of 5.0 Gy radiation in healing subcutaneous microvasculature of a dorsal flap window chamber. AB - The temporal effects of 5.0 Gy of radiation on healing subcutaneous microvasculature were studied using a window chamber in the dorsal flap of the Fischer-344 rat. Microvascular function was assessed by morphometric and dynamic flow measurements which were made prior to and at 24 and 72 h after exposure. A comparison was made between chamber preps that were 3 and 14 days postsurgery. The hypothesis of the study was that the older preparation would be more refractory to damage by radiation. Both unirradiated preparations showed an increase in capillary numbers over the period of observation, while irradiated preps had a reduction, especially in vessels less than 50 microns in diameter. Red cells velocities increased by 20-100% in those vessels which survived the radiation exposure, indicating that tissue oxygen tensions might be preserved in spite of a loss of vasculature. These results explain the need for both morphologic and dynamic flow measurements when assessing the effect of therapeutic intervention on microcirculatory function. Further studies are underway to identify a fully mature capillary bed in this model, since it is apparent that capillary growth is continuing in the 14-day preparation. PMID- 3321145 TI - [Changes in the dog endocrine system in the hematopoietic form of radiation sickness]. AB - The endocrine status of the organism estimated by the cortisol, insulin and triiodothyronine content of blood considerably changes during radiation sickness. The most pronounced changes in the endocrine status occur during the primary response and at the height of radiation sickness. The endocrine status test may be used in the individual radiosensitivity prognosis. PMID- 3321147 TI - Experiences with adrenal ultrasonography (on the basis of 211 examinations). PMID- 3321146 TI - [Intensity of triboluminescence of rat blood during total gamma-irradiation]. AB - Rat blood triboluminescence resulting from the effect of triboelectrization and activation of free-radical oxidation was studied 15 min to 14 days following gamma-irradiation with doses of 1, 2, 4, 6, 8. and 16 Gy at an original device (triboluminometer TPA-1) in standard conditions of luminescence generation with a contact of the blood sample with a rotating cylinder. Triboluminescence of blood decreased 1-3 days following irradiation and was restored up to the initial level after 7-14 days. Triboluminescence intensity somewhat increased 1-3 days following 1 Gy irradiation. PMID- 3321148 TI - [Dural angiomas]. AB - The management of arteriovenous malformations confined exclusively to the dura and its duplications (DAVMs) is a challenge. The problems of diagnosis and the possible methods of treatment are discussed on the basis of 23 personal cases. Selective and superselective angiography for the detection of any multipedicular supply from separate arterial systems has proved essential before rational treatment can be instituted. Usually it is not possible to cure DAVMs by embolization alone: the approach now used for the main feeders arising from branches of the internal carotid and vertebral arteries is inadequate. However, it is usually possible to reduce the volume of the shunt flow and the pressure in the draining sinuses. Frequently the success is only temporary and a combined surgical and intravascular procedure is later necessary. In isolated cases, inoperable DAVMs can be transformed to operable ones by first performing embolization. PMID- 3321149 TI - [Magnetic resonance tomography (MRT) of the scrotum--initial results and comparison with sonography. I: Normal anatomy and extratesticular pathology]. AB - Magnetic resonance imaging (MRI) allows for precise assessment of all important anatomic structures of the scrotum. Because the differences in signal intensity on T2-weighted images are adequate and there is high detail and contrast resolution in surface coil technique, the delineation of normal and pathologic structures greater than 1 mm is possible. Imaging in the coronal plane is preferable to that in the axial and sagittal plane. Other advantages of MRI include the possibility of comparing both hemiscrota in one imaging plane and the assessment of the inguinal region. In addition, MRI is less dependent on the expertise of the investigator. For the assessment of extratesticular pathology, MRI has advantages over other imaging techniques - including sonography - since the delineation of pathologic changes is much clearer. PMID- 3321151 TI - Models for understanding the antagonism between seizures and psychosis. AB - 1. The relationship between seizures and psychosis is reviewed using incidence and association studies, and experimental models of kindling and behavioral sensitization. 2. While there are conflicting data on the association of psychopathology with epilepsy, studies illustrating the antagonism between seizures and psychosis are examined along with the phenomenon of "Forced Normalization". 3. Electrical kindling of the amygdala provides a model of temporal lobe epilepsy while pharmacologic kindling/behavioral sensitization or dopaminergic kindling provides a model for psychosis. 4. A model explaining both the etiology and the reciprocal nature of seizures and psychosis in temporal lobe epilepsy is developed. Preictal and interictal spikes kindle both proconvulsive and inhibitory pathways of seizure expression and behaviorally relevant limbic systems. That system currently expressive, either seizure or psychosis, while under high synchronous drive would tend to fail allowing for the emergence of the opposing system. PMID- 3321150 TI - A role for norepinephrine in arousal, emotion and learning?: limbic modulation by norepinephrine and the Kety hypothesis. AB - 1. Kety hypothesized that forebrain norepinephrine acted to selectively enhance cell firing in neurons receiving environmental inputs during affectively important events. He further suggested that norepinephrine could act to induce a 'persistent facilitation' of the inputs which accompany affectively important events and would thus promote a memory for these events. 2. The electrophysiological actions of norepinephrine at the time Kety proposed his hypothesis were thought to be inhibitory. More recent evidence has demonstrated that norepinephrine in neocortex and cerebellum enhances both excitatory and inhibitory evoked activity much as Kety proposed. This has been termed norepinephrine neuromodulation. 3. The locus coeruleus-norepinephrine system which gives rise to neocortical and cerebellar norepinephrine innervation also innervates, even more densely, areas of the limbic system. A review of norepinephrine actions, particularly in limbic cortex, indicates that locus coeruleus-norepinephrine also enhances transmission of evoked inputs in these structures. 4. A long-lasting enhancement of evoked inputs by locus coeruleus norepinephrine has been demonstrated in the hippocampus. This long-lasting enhancement of inputs is reviewed in detail since it appears to directly support Kety's hypothesized 'persistent facilitation' effect of norepinephrine. It is suggested that norepinephrine-induced long-lasting enhancement may underlie numerous demonstrations of norepinephrine-dependent memory and neural plasticity in the forebrain. 5. The relationship of norepinephrine neuromodulation to possible candidate mechanisms and to activation of specific norepinephrine receptors is briefly discussed. PMID- 3321152 TI - Relevance of kindling and related processes to human epileptogenesis. AB - 1. Kindling and related processes belong to the most extensively investigated models of experimental epilepsy. In this paper an attempt is made to outline their significance to human epileptogenesis. Below the most relevant findings are summarized: 2. Animal data: kindling and related processes are progressive in nature and occur in a great number of animal species including Rhesus monkeys and baboons; progressive epileptogenesis seems dependent on predisposition to seizure susceptibility and develops slower the higher the position of the respective species is in the phylogenetic scale; spontaneously recurrent seizures as well as permanent electroencephalographic, behavioural, electrophysiological and biochemical alterations have been observed following kindling; kindling development can be suppressed by clinically used antiepileptic drugs. These data illustrate the similarity of kindling and related processes to certain aspects of human epilepsy. 3. Human data: one case of human brain kindling and several cases of spontaneously recurrent seizures following electroconvulsive treatment are known; the progressive nature of human epilepsies is exemplified by observations of untreated patients, factors accompanying the failure of monotherapy, and the existence of multiple lesions (mirror foci) in cerebral tumour patients. 4. The material presented clearly indicates that kindling and related processes can occur in man as well as in animals. This should have implications for the treatment of epileptic patients as well as for brain stimulation techniques. PMID- 3321154 TI - [Enzyme immunoassay]. PMID- 3321153 TI - Dextro-propranolol and depressive symptoms in a schizophrenic population. AB - 1. 36 acute schizophrenic patients were randomly assigned to dextro-propranolol or placebo in a double blind trial lasting four weeks. 2. Detailed assessments were made using the Present State Examination, the Brief Psychiatric Rating Scale and the Manchester Scale before, during and at the end of the trial. 3. The authors report on the change in depressive symptomatology during the period of the trial. 4. One patient in each group became suicidal and was withdrawn at week 2 1/2. 5. With regard to ratings of depression, there was an overall reduction in mean depression scores at the end of the trial in both groups. 6. Emergence of depressive symptoms and increase in the severity of existing symptoms was seen in a small number of patients in both groups, but more so in the placebo group. 7. A depressogenic effect for d-propranolol was not observed in the population studied. PMID- 3321155 TI - [Principle of measurement of enzyme immunoassay]. PMID- 3321156 TI - [Detection of residual drugs in foods]. PMID- 3321158 TI - [Assay systems of enzyme immunoassay]. PMID- 3321157 TI - [Enzyme immunoassay for steroid hormones]. PMID- 3321159 TI - [EIA for low molecular compounds and its application to pharmacological studies]. PMID- 3321160 TI - [Enzyme immunoassay of constituents of Oriental medicinal drugs]. PMID- 3321161 TI - [Chemistry and immunoreactivity of human chorionic gonadotropin (hCG)]. PMID- 3321162 TI - [Application of enzyme immunoassay to the study of gangliosides]. PMID- 3321163 TI - [Application of a highly sensitive enzyme immunoassay system for the human epidermal growth factor (hEGF)]. PMID- 3321164 TI - [Hormone assay and its clinical application]. PMID- 3321165 TI - [Determination of an antibody-antigen binding constant by enzyme immunoassay]. PMID- 3321166 TI - [Investigation of the sensitivity and specificity of anti-glucagon antibody]. PMID- 3321167 TI - [Fluorescence polarization method--its application to the analysis of protein protein interaction]. PMID- 3321168 TI - [Chemi- and bioluminescent immunoassay]. PMID- 3321169 TI - [Preparation methods for specific antibodies]. PMID- 3321171 TI - [Development of the application of enzyme immunoassay for cathepsins]. PMID- 3321170 TI - [Polarization fluoroimmunoassay of biopterin and neopterin]. PMID- 3321172 TI - [Commercial enzyme immunoassay kits for drugs]. PMID- 3321174 TI - [Overview of solid supports for enzyme immunoassay]. PMID- 3321173 TI - [Enzyme immunoassay kits for the determination of hormones]. PMID- 3321175 TI - [Enzyme conjugates and immunochemicals]. PMID- 3321176 TI - [Cross-linking reagents for protein-enzyme conjugates]. PMID- 3321178 TI - [Detection methods for immunoassay]. PMID- 3321177 TI - [Enzyme labeling of haptens]. PMID- 3321180 TI - [Enzyme immunoassay of prostaglandins]. PMID- 3321179 TI - [Immunoassays of cancer markers--production and analysis of monoclonal antibodies reactive with ras oncogene p21]. PMID- 3321181 TI - [DNA polymerases used in sister-chromatid exchanges or meiotic chromosome recombination]. PMID- 3321182 TI - [Cancer research with use somatic and teratocarcinoma-reconstituted cells]. PMID- 3321183 TI - [Artificial enzymes and super-enzymes]. PMID- 3321184 TI - [Platelet-derived growth regulators and mechanism of liver regeneration]. PMID- 3321185 TI - [Free radicals in proteins and enzymes]. PMID- 3321186 TI - [Biochemical analysis of MHC antigens]. PMID- 3321187 TI - [The human major histocompatibility complex in the immune response]. PMID- 3321188 TI - [Some relationship between cancer cells and gap junctional communication]. PMID- 3321189 TI - Prostaglandins and acid peptic disease: state of the art. AB - A review of the new concepts concerning the regulation of acid secretion and the pathogenesis of peptic ulcer disease is presented. Advantages and disadvantages of the common pharmacological treatments are described with special emphasis on the drugs which represent, at present, the treatment of choice for peptic ulcer disease, namely, the histamine H2-receptor antagonists. The role of prostaglandins in health and disease is considered, and the possibility that synthetic compounds derived from natural prostaglandins represent a good alternative to the present medical management of peptic ulcer disease. PMID- 3321190 TI - [Evaluation of chemotactic activity of granulocytes (PMN) in atopic dermatitis using PPD and E. coli filtrate as chemoattractants]. PMID- 3321191 TI - [Results of Tigasone treatment of psoriasis in the light of the experience of the Warsaw Dermatological Clinic]. PMID- 3321193 TI - [Death in tropical malaria]. PMID- 3321192 TI - [Dermatologists and venereologists of the Brothers of Mercy Hospital in Cracow]. PMID- 3321194 TI - Occupational health problems among transit workers. PMID- 3321195 TI - Community and clinical trials of disease prevention: effects on cigarette smoking. PMID- 3321196 TI - The epidemiology of alcohol consumption and hypertension; with special reference to stroke. PMID- 3321197 TI - Sonographic positioning of endouterine applicator. AB - Real-time ultrasonographic determinations of the position of an endouterine applicator (Tandem) were performed in patients with carcinoma of the uterine cervix at the time of intracavitary irradiation. Findings of ultrasonography (US) showed clearly the relation between the applicator for intracavitary irradiation and the uterine fundus. US is a valuable adjunct, which improves the accuracy of Tandem positioning. PMID- 3321199 TI - Recent developments in basic dosimetry. AB - CCEMRI(I) (1985) has recommended that from January 1st 1986 the Primary Standard Dosimetry Laboratories (PSDLs) should adopt new values for W/e (33.97 J/C), stopping powers for electrons (ICRU Report 37, 1984), g value in air for 60Co (3.2 X 10-3), and energy absorption coefficients [17]. The consistency of the whole dosimetric chain requires the same basic physical data at the users' beam quality and PSDLs, but most of the existing dosimetry protocols are not generally based on such a set of data and in some cases old and new data have been employed together. A review of the basic data included in the dosimetry protocols is presented here, together with a comparison with experimental data. The most recent data include the recommendations of CCEMRI(I) and at the same time, some of the inconsistencies existing in dosimetry protocol have been eliminated. The new set of data is presented in this work. New dosimetry protocols and updated versions of protocols published before 1986 are discussed in terms of their basic data. PMID- 3321198 TI - Experimental and clinical evaluation of a prototype hyperthermia system. AB - In order to achieve better thermal distribution, a high output radiofrequency capacitive heating system was developed for hyperthermia and operated at a frequency of 13.56 MHz with an output of 1,000 watts (Inter Nova Inc., IH-1000). With use of this equipment, an agar phantom study, an animal experiment, and a clinical trial have been performed. This unit has made it possible to use large applicators with large electrodes. The phantom study revealed homogeneous, deep heating capability. In the animal study using a miniature pig, good thermal distribution within the body was obtained, but the problem of overheating the subcutaneous fat layer remained. In the clinical application, some limiting factors remained unsolved in spite of our attempts to eliminate them; however, the problem of insufficient power supply was solved. PMID- 3321200 TI - The radiation sensitivity of the haemopoietic microenvironment--effect of dose rate on ectopic ossicle formation. AB - The haemopoietic microenvironment (HM) consists of a complex mixture of cellular types and extra-cellular matrix. It is essential for prolonged haemopoiesis in both the normal situation and after bone marrow transplantation. The competence of the HM can be assessed by ectopic grafting of femoral marrow. A complete haemopoietic organ develops at the site of implantation. Stem cells (CFU-S) which inhabit the ossicle formed after ectopic implantation can be measured, to assess the function of the engrafted HM to support haemopoiesis. Using this functional endpoint we have examined the radiation sensitivity of the HM at both high and low dose rates, and conclude that high doses of gamma-irradiation delivered at 4 Gy/min or 0.016 Gy/min have widely different effects on the HM, the former proving much more damaging than the latter. PMID- 3321201 TI - Dose determination in bladder and rectum during intracavitary irradiation of cervix carcinoma. AB - The radiation dosage in the base of the bladder and in the anterior wall of the rectum during intracavitary irradiation of cervix carcinoma can be determined easily by use of intracavitary transvesical and transrectal ultrasound and simultaneous radiography. In case of excessive doses to the organs at risk, the dose can be lowered by rearrangement of the vaginal gauze packing in the same sitting. PMID- 3321202 TI - Determination of DNA by sub- and super-equivalence method of isotope dilution analysis using enzyme reaction. AB - Sub- and super-equivalence method of isotope dilution analysis (SSE-IDA) using enzyme reaction was first applied for the determination of biological substance, DNA. Radioactive DNA (pUC18) to be analysed was prepared by incorporating 3H thymidine in growing E. coli. A part of DNA was cut into the linear form (L-form) DNA under definite conditions using a restriction enzyme HindIII, following the separation of each by gel electrophoresis. Radioactivites of separated L-form DNA of two series were measured. The quantity of DNA was obtained by a graph method of SSE-IDA. As preliminary experiments, it was examined under what conditions the enzyme reaction proceeds as zeroth or first order reaction. We used the enzyme and substrate concentrations near zeroth order, where ordinary subst-IDA seems not to give a satisfactory results. As the results, 0.25 microgram of DNA was determined the error of about 10%. PMID- 3321203 TI - [Measurement of proinsulin in human serum]. AB - In this study, we developed a measuring system for proinsulin in human serum. Insulin-like substances (ILS) were isolated from serum by an affinity chromatography, and proinsulin in ILS was separated from insulin by high performance liquid chromatography (HPLC). For the radioimmunoassay (RIA), porcine proinsulin was used as the standard and as 125I-labelled antigen, and porcine insulin anti-serum was as the antibody. Proinsulin-like immunoreactivity (PLI) can be estimated directly from a standard curve, and the detection limit of PLI is 0.0044 pmol/ml. By this method, the values of PLI and insulin-like immunoreactivity (IRI) in human blood were able to estimate precisely. PLI values in the fasting state and in 30, 60, 90, and 120 min after oral glucose stimulation from nine healthy subjects were 0.011 +/- 0.002, 0.045 +/- 0.014, 0.078 +/- 0.019, 0.064 +/- 0.016, and 0.027 +/- 0.006 pmol/ml, respectively. The increase in PLI response was observed later than that in IRI response. PLI/total IRI ratio in the fasting state and 60 min after oral glucose were 24 and 36% respectively. PMID- 3321204 TI - [Medical application of new radiological measurement methods]. PMID- 3321205 TI - [Monoclonal antibody--from the standpoint of immuno-nuclear medicine]. PMID- 3321206 TI - [Outline of principal diseases transmitted by ticks in Panama]. PMID- 3321207 TI - Intra-articular antigen-antibody reactions. AB - The role of humoral immune mechanisms in the induction, maintenance, and modulation of chronic arthritis in the two main tissues of diarthrodial joints synovial membrane and cartilage is discussed. In the synovial membrane of patients with RA, the available data suggest that there is a selective enrichment of immunoglobulin-secreting cells with restricted specificities. However, it is likely that the B-lymphocyte lineages infiltrating the synovial membranes are not self supporting and autonomous but that they originate from precursors activated and released from the central lymphoid organs. The processes leading to irreversible destruction of articular cartilage in chronic arthritis are not well understood. A review of the possible pathogenic role of immunoglobulin and immune complexes tightly bound to the superficial layers of cartilage suggests that these contribute to the chronicity and severity of the inflammatory process. However, accurate evaluation of the relative importance of these mechanisms can only be attained when more information becomes available on the interplay between cellular and humoral immune mechanisms within the joint. PMID- 3321209 TI - Biochemical mechanisms of articular destruction. AB - The destruction of articular structures in inflammatory arthritis is a complex process. Both proteolytic degradation of the individual structural proteins that make up the tissues of the joint as well as nonproteolytic processes, such as bone demineralization are involved. Proteinases that can degrade collagen and proteoglycans are present in the various cells that comprise the rheumatoid lesion. Neutrophils contain collagenolytic metalloproteinases (collagenase and gelatinase) as well as potent serine proteinases (elastase and cathepsin G). Synovial cells and chondrocytes secrete metalloproteinases, which are also capable of degrading the extracellular matrix. Evidence would support the concept that the regulatory and counter-regulatory factors that govern the activity of these enzymes are abnormal in inflammatory arthritis, resulting in articular destruction. PMID- 3321208 TI - Cellular immunity in the joints of patients with rheumatoid arthritis and other forms of chronic synovitis. AB - Rheumatoid arthritis (RA), although a systemic illness, is primarily a synovial disease. Morphologic and functional studies of immune cells within the synovium strongly suggest that disordered cellular immunity is key to the pathogenesis of RA. This article describes in detail the various cells found within the rheumatoid joint and compares them with those found in nonrheumatoid synovitis and in normal peripheral blood. PMID- 3321211 TI - Rubella virus and arthritis. AB - Rubella virus and the rubella virus vaccine are relatively common causes of acute arthralgias and occasionally objective arthritis. Rarely, chronic or relapsing joint syndromes may follow exposure to this virus or vaccine. This article will focus on the virus and its clinical illness. Major emphasis then will be given to the resulting arthritis syndromes and to consideration of the possible pathogenetic mechanisms of the joint manifestations. PMID- 3321210 TI - Lentivirus-induced arthritis. Chronic disease caused by a covert pathogen. AB - Lentiviruses are exogenous, nononcogenic retroviruses that cause persistent infections in monocytes and macrophages. Among the clinical manifestations of such infections in sheep and goats is a slowly progressive arthritis, primarily involving the carpal joints of adult animals. Initially, clinical disease begins as synovitis; this progresses to involve surrounding connective tissues and osseous structures as inflammation increases and progresses. Inflammatory cells include macrophages, lymphocytes, and plasma cells. Macrophages and monocytes are the only cells that are infected with virus and in the inflamed joint may represent 50 per cent of the cells in the synovial fluid. However, only a small number of these cells are infected. Cytotoxic T lymphocytes predominate over helper T lymphocytes in the synovial fluid. The role of these cells in the pathogenesis of disease is not currently known. The pathogenesis of disease caused by these lentiviruses is related to the infection of the monocyte macrophage cells in the animal. This event, along with virus-specific factors, render the host incapable of eliminating the virus. Despite persistence of the virus, viral replication is maintained at a tightly restricted level at all times in the infected animal. This is achieved by factors that regulate the maturation of monocytes. Basically, the infection is latent in monocytes and its precursors and becomes more productive as the cells mature. The maturing infected macrophage presents a portion of the viral proteins that it synthesizes on its cell surface in close association with class II major histocompatibility complex antigens. Lymphocytes react with this cell and produce interferon. This lymphokine induces further expression of Ia antigens. This feedback loop of Ia expression, together with persistence of the virus, maintains macrophages in a constant state of antigen presentation. This forms the trigger for the inflammatory condition that eventually leads to the degenerative lesions seen in the joint. PMID- 3321212 TI - Proinflammatory microbial products as etiologic agents of inflammatory arthritis. AB - Muramyl peptides, peptidoglycans, peptidoglycan-polysaccharide complexes, and endotoxins are examples of proinflammatory microbial components that may play an etiologic role in various chronic inflammatory arthritides in humans. This article reviews the data supporting this hypothesis. The biologic activities of these substances are discussed, with particular emphasis on the mechanisms by which they induce various forms of arthritis in experimental animals. In addition, the current status of studies attempting to demonstrate definitively a role for these agents in human disease also is discussed. PMID- 3321213 TI - Clues provided by animal models of arthritis. AB - All the findings discussed support the premise that animal experimentation is a pertinent endeavor for understanding chronic inflammatory synovitis in humans. Whether any of these data actually identify processes operative in RA or can be used to predict outcomes in the human disease is currently unclear. The review closes with an illustration of an area of controversy existing, in part, because of an absence of animal model research. The rationale for the use of gamma interferon (IFN) in RA has been aptly described by S. H. Pincus as "curious". Evidence of deficient gamma-IFN production within the rheumatoid synovium has been acquired by several laboratories, suggesting that administration of this lymphokine might be helpful. This conclusion has been supported by news of short term success in uncontrolled pilot trials. However, gamma-IFN is perhaps the most vigorous of the interleukins in terms of diversely activating the immune system. Thus, it would seem logical to envision that gamma-IFN would accelerate any process attributable to autoimmunity. The use of animal models to probe this dilemma, and others arising in the future, could provide a more convincing scientific cornerstone for clinical trials in RA. One caveat, however--animal models provide only clues or potential insights, not final answers, for human disease. PMID- 3321215 TI - Molecular mimicry in the pathogenesis of rheumatic diseases. AB - Evidence has been presented to support the conclusion that epitope-specific cross reactive autoimmunity generated in response to a microorganism can result in an inflammatory sequela. The role of this mechanism in the pathogenesis of the experimental disease, adjuvant arthritis, appears clear. In the case of human rheumatic conditions, such as rheumatic fever and the HLA-B27-associated reactive arthritides, the role is not yet established, but clinical evidence suggests that the hypothesis is an attractive one. PMID- 3321216 TI - [Cyclosporin and kidney]. PMID- 3321214 TI - Autoimmunity in rheumatoid arthritis. An approach via a study of B lymphocytes. AB - In this article the relationship between the cellular elements of the immune response and inflammation are examined with reference to the B lymphocyte repertoire. Evidence is presented that, in addition to an environment in the joint that favors localization and activation of auto-reactive B lymphocytes, the circulating B lymphocyte pool in rheumatoid arthritis is abnormally enriched in cells that bear a receptor for mouse erythrocytes and possess CD5 antigen. B lymphocytes with these novel phenotypic markers secrete autoantibodies and are found in abundance in fetal lymphoid tissues and cord blood; analogous cells in the mouse belong to a distinct lineage and are implicated in allotype- and idiotype-restricted interactions. It is postulated that a subset of B lymphocytes is of primary importance in the etiopathogenesis of rheumatoid disease. PMID- 3321217 TI - Pitfalls in cholangiographic interpretation. AB - Cholangiography is a well established method of evaluating the biliary tract, and the typical appearances of the more commonly encountered biliary tract disorders have been well described. There are many pitfalls, however, in the interpretation of cholangiograms that become apparent as large numbers of patients are examined. These pitfalls may be secondary to: congenital anatomic alteration, failure to appreciate normal biliary ductal anatomy, technical errors, and interpretative confusion. Awareness of these pitfalls is emphasized to avoid serious cholangiographic misdiagnosis. PMID- 3321218 TI - The varied appearances of hepatic cavernous hemangiomas with sonography, computed tomography, magnetic resonance imaging and scintigraphy. AB - The incidental detection of an hepatic cavernous hemangioma may create a problem in differential diagnosis. The authors here review the characteristics of hemangiomas as recorded by various types of imaging. PMID- 3321219 TI - Ultrasound case of the day. Adenocarcinoma, grade 1, arising in an adenomatous polyp; multiple cholesterol polyps and cholelithiasis. PMID- 3321220 TI - Cellular aspects of in vitro fertilization (ultrastructural and cytogenetic studies of human gametes and zygotes). AB - After the birth of Louise Brown in 1978 as a result of the successful development of in vitro fertilization (IVF) techniques by Edwards and Steptoe, the use of this procedure has become extremely widespread, both in technologically advanced societies and even in countries that do not meet the minimal sanitary standards. In good hands, IVF techniques provide results slightly lower than those allowed by nature, that is about 20% of pregnancies. In other cases, the procedure may become a nightware coupled to a swindle, and even endanger the life of the hopeful mother-to-be. Even in the better prepared centers, with the highest rates of success, IVF is still surrounded by a myriad of problems that must be solved to optimize its results and to reduce the risk of zygotic loss and of multiple pregnancies. On the other hand, IVF offers unimagined possibilities for research on fields of such interest as the reasons for the high incidence of nidation and/or developmental failures of human zygotes, the high percentage of infertile or sterile couples, pre-implantation diagnosis and gene therapy. These problems will only be solved if research in human cell aggregates (also called pre embryos) is allowed. The potential medical, human and social benefits of such research is considerable, and could have diagnostic and therapeutical applications in a short period of time. There are many possible causes of infertility or sterility: genetic, cellular, immunological, hormonal, developmental, etc. This volume includes the results of ultrastructural and cytogenetic studies of human gametes and zygotes, and tries to shed some light on the origin of IVF failures. The use of a murine model for the study of the first zygotic division has also provided data on possible mechanisms resulting in abnormal zygotes, like hormonal unbalance or gamete aging. The morphological and genetic characteristics of the sperm in the father, and the age of the gamete, the hormonal balance, the genetic endowment of the oocyte, and the induction of superovulation in the mother seem to be important factors both when in vitro fertilization does not take place or when abnormal zygotes are produced. PMID- 3321221 TI - [Relation between endemic goiter and cancer of the thyroid]. PMID- 3321222 TI - [Hypokalemia induced by diuretics in the treatment of arterial hypertension]. PMID- 3321223 TI - [Sublingual hypotensive treatment. Does it compare homogeneous groups of hypertensive patients?]. PMID- 3321224 TI - [Study of a group of rapidly growing mycobacteria including 3 new mycobacteria species by the use of the technics of thin layer chromatography and high performance liquid chromatography]. PMID- 3321226 TI - [Observation of the parasitic stage of the Romanomermis culicivorax nematode (Ross and Smith, 1976) (Rhabditida: Mermithidae) in larvae of the Culex (Culex) quinquefasciatus Say, 1823 (Diptera: Culicidae) under laboratory conditions]. PMID- 3321225 TI - [Various aspects of the ecological niche of Aedes (S.) aegypti (Linnaeus, 1762) (Diptera: Culicidae) and Culex (C.) quinquefasciatus Say, 1823 (Diptera: Culicidae) in an urban environment]. PMID- 3321227 TI - [Giardiasis and jejunal bacterial flora]. PMID- 3321228 TI - [Laryngeal tuberculosis. Report of 2 cases]. PMID- 3321229 TI - [Effect of clofazimine on Fc receptors of peritoneal macrophages in the mouse]. PMID- 3321230 TI - [Effects of clofazimine on complement 3 receptors in peritoneal macrophages in the mouse]. PMID- 3321231 TI - [Effects of clofazimine on Leishmania promastigotes]. PMID- 3321233 TI - [Psychological characterization of leprosy patients]. PMID- 3321232 TI - [Lymphogranuloma venereum. Report of a case]. PMID- 3321234 TI - [Use of Moore's swabs for the isolation of microorganisms of the genus Vibrio]. PMID- 3321236 TI - [Seroepidemiologic study of a focus of malaria in a non-endemic zone]. PMID- 3321235 TI - [Results of a seroepidemiologic study on epidemic hemorrhagic conjunctivitis in Havana in October 1982. Preliminary report]. PMID- 3321237 TI - [Viral meningoencephalitis in 3 municipalities of Havana in 1983]. PMID- 3321238 TI - [Epidemiologic study in people with identified non-tuberculous mycobacteria in 3 provinces of the country. Cuba, October 1981 to September 1982]. PMID- 3321239 TI - Metabolism and toxicology of lead. PMID- 3321240 TI - Lead and children's intelligence test performance: a critical evaluative review of recent studies. PMID- 3321242 TI - Aluminium, neurotoxicology and dementia. PMID- 3321241 TI - Metals and ischaemic heart disease. PMID- 3321243 TI - The excretion of urinary mercury from dental personnel. PMID- 3321244 TI - Environmental pollutants in breast milk. PMID- 3321245 TI - Exposure to metal pollutants and behavioral disorders in children: a review of the evidence. PMID- 3321246 TI - [Participation of Dr. Wanda de Aguiar Horta in the Brazilian Nurses' Association (1949-1977)]. PMID- 3321247 TI - [Presentation of documents concerning the thinking, activities and accomplishments of Wanda de Aguiar Horta]. PMID- 3321248 TI - [Nursing care methodology: reflections based on teaching experiences]. PMID- 3321249 TI - [Influence of Dr. Wanda de Aguiar Horta on the School of Nursing of the University of Sao Paulo]. PMID- 3321250 TI - [The teaching of nursing care methodology in the Department of Nursing of the Paulist School of Medicine: the influence of the thinking and proposals of Dr. Wanda de Aguiar Horta]. PMID- 3321251 TI - [Sleep apnea syndromes in adults]. AB - Sleep apnoea syndromes are a frequent disease, with an incidence of more than 1% in the adult population, a strong male predominance, and a maximal frequency between 40 and 60 years. Their clinical manifestations are dominated by snoring and daytime sleepiness, at times associated with morning headaches, intellectual deficiency, sexual impotence. Obesity, hypertension and polycythemia are not uncommon. These patients are at risk for accidents due to sleepiness, sudden death due to sleep apnoea-related cardiac arrhythmias, ischemic attacks related to hypertension and polycythemia and right heart failure secondary to pulmonary hypertension and alveolar hypoventilation. The most frequent form of sleep apnoea syndromes include obstructive and mixed apnoeas. Their mechanism involves both anatomic factors (upper airway narrowing) and functional factors (defective activation of upper airways dilatory muscles) which lead to upper airway occlusion upon inspiration during sleep. Two therapeutic strategies are possible: a surgical one, uvulopalatopharyngoplasty, the efficacy of which is inconstant and unpredictable and nasal continuous positive airway pressure, which is constantly efficacious but constraining. Central sleep apnoea syndromes are rare, less clearly defined and more difficult to treat. PMID- 3321252 TI - [Significance of clinical and biological markers in autistic syndromes in children]. AB - Several biological theories were proposed to explain symptoms of childhood autism in terms of monoamine metabolic dysfunction. Clinical, electrophysiological and biochemical markers which support the dopaminergic hypothesis will be given in this paper. A factorial analysis, performed on the 'behavior summarized evaluation' (BSE, scoring behavioral data), exhibits a first component corresponding to the autistic DSM III criteria, and also shows that the disturbances of attention and perception belonged to this component. So, as well as communication, selective attention, perception and gestures, usually considered as regulated by the dopaminergic system are deeply modified and appeared as primary symptoms in autistic syndromes. Many electrophysiological data recorded in autistic children suggest both faulty modulation of sensory input and deficiency in dealing with sensory cross-modal association which have been related to a dysfunctioning of the dopaminergic system. Elevated homovanillic acid levels, the main dopamine metabolite, have been attributed to a reduced re-uptake of dopamine related to a 'longer occupation' of the receptors which is in agreement with the electrophysiological 'sensory overload'. The relationships found between these markers are discussed. Such an approach would contribute to a better understanding of the underlying mechanism of autism. PMID- 3321253 TI - In vivo study of the appearance and fluctuations of insulin binding sites in different tissues during rat development. AB - The appearance and fluctuations of specific insulin binding sites in several tissues in vivo during rat development, have been determined. After intravenous administration of 125I-insulin to fetal, suckling and adult rats, changes on specific hormone uptake were observed depending on the tissues tested and on the age of animals. Thus, in liver, specific insulin uptake was much greater in 19 day-old fetuses and 10 day-old suckling animals than in adult rats. By contrast, brown fat and spleen insulin uptake was undetected in fetal animals but present in suckling rats, while lung insulin uptake was absent in the adults but present in fetal and suckling animals. Of interest were the specific insulin uptakes by three different muscle tissues. In fact, heart insulin uptake was much higher in younger animals than in adult rats, while in the diaphragm it was significantly smaller in all groups and in skeletal muscles hormone uptake was much smaller than in the other two muscle tissues and was even absent in the fetuses. In those tissues that had previously been shown to exhibit a specific insulin uptake, the iodinated hormone uptake decreased proportionally with simultaneous injection of increasing amounts of unlabelled insulin. These results indicate that insulin binding sites appear at different times and fluctuate in a different manner according to the tissues tested during rat development; this might be important in the stimulation of the functional activities of those tissues during perinatal age. PMID- 3321254 TI - [Levels of Zn and Cu in the serum of a diabetic population]. AB - The zinc and copper content in serum as well as glucose and insulin was determined in 140 diabetics and compared with the results obtained from 162 healthy patients. Their mean values are significantly different. Each group was classified accordingly to the presence or not of overweight (greater than 15% relative body weight). The correlations (Pearson. Anova) between the different parameters in each group were studied. Healthy group showed a negative correlationship between the zinc and insulin levels and between the latter and the copper level, and a positive one between copper and every other parameter. Obesity only affected the zinc levels in diabetics and increased them in a statistically significant way. In this group, the copper level showed a positive correlation with the zinc level and the latter with the glucose. Owing to these results zinc and copper levels seem to be directly correlated and in diabetic patients these levels are increased mainly in the case of obesity. In healthy patients zinc levels are correlated with serum insulin, and in the diabetic groups with serum glucose. PMID- 3321256 TI - [Echography of the upper abdomen and asymptomatic carcinoma of the kidney]. PMID- 3321255 TI - [Heparins of different molecular weights: biological activity and hemorrhagic risk]. PMID- 3321259 TI - [Dementia syndromes secondary to internal disease]. PMID- 3321258 TI - [Psychiatric assistance in Italy after the 1978 reform. Evidence and opinions]. PMID- 3321257 TI - [Efficacy and tolerability of thymopoietin in patients at risk of infection]. PMID- 3321260 TI - [Capillaroscopic changes in diffuse diseases of the connective tissue]. PMID- 3321261 TI - [Pathophysiological mechanism of emphysematous bullae and blebs]. PMID- 3321262 TI - [Development of totally implantable left ventricular assist systems--current status and problem areas]. PMID- 3321263 TI - Epidemiology of hospital-acquired pneumonia. AB - Nosocomial pneumonia may account for a relatively small percent of all hospital acquired infections, but it is associated with the highest mortality of all nosocomial infections. Risk factors include increasing age, thoracoabdominal surgery, presence of chronic lung disease, duration in hospital, immunosuppressive therapy, continuous ventilatory support, and means of payment. Among patients dying in the hospital, a nosocomial pneumonia was present in 40% and was causally related or contributed to death in 60% of nosocomially infected patients. Gram-negative bacilli, Staphylococcus aureus, and viruses are the most common etiologic agents. Changes in T lymphocytes with aging, alterations in the physiologic and anatomic defenses from trauma, disease, or aging and lack of appropriate infection control barriers predispose to development of pneumonia. Extra hospital charges of approximately $1,000 and four to five additional hospital days result. Analysis of pertinent epidemiologic data require understanding of clinical definition of pneumonia, laboratory methods used to analyze respiratory secretions, and methods of comparing added charges and length of stay. PMID- 3321264 TI - Nosocomial pneumonia in the intubated patient. AB - The intubated patient receiving mechanical ventilation is at high risk for nosocomial pneumonia. Epidemiologic data, pathogenic mechanisms, and risk factors for the development of nosocomial pneumonia are reviewed in this subset of patients. Exogenous and endogenous factors for bacterial colonization of the oropharynx are summarized with particular emphasis on the effects of bacterial overgrowth in the stomach. In addition, we review the role of respiratory therapy equipment in the pathogenesis of pneumonia. Overall fatality rates for patients receiving mechanical ventilation in an intensive care unit is approximately 40%. Patients who develop ventilator-associated pneumonia have fatality rates that exceed 50% and are more than two-fold higher than intubated patients without pneumonia. Measures for altering oropharyngeal colonization, reducing gastric colonization, and the use of sound infection control practices are cornerstones for the prevention of ventilator-associated pneumonia. PMID- 3321266 TI - New diagnostic approaches to the hospitalized patient with pneumonia. AB - The accurate diagnosis of pneumonia remains a formidable challenge in clinical medicine. The use of sputum, blood, and pleural fluid cultures provides a diagnosis in less than 50% of patients. A number of invasive techniques have recently been applied to the diagnosis of pneumonia. The methods are uniformly designed to separate upper respiratory saprophytic bacterial populations from the organisms responsible for the lower respiratory infection. Preeminent among these techniques is the use of fiberoptic bronchoscopy coupled with quantitative bacterial culture and immunofluorescence demonstration of antibody-coated bacteria. The methodology and results of this technique are described in detail in this paper. Recent clinical experience using transtracheal aspiration, percutaneous needle aspiration of the lung, and open lung biopsy are also reviewed. PMID- 3321265 TI - Legionella species as hospital-acquired respiratory pathogens. AB - Nosocomial pneumonia caused by legionella is an increasingly recognized entity. Legionella sp responsible for documented nosocomial disease include Legionella pneumophila, Tatlockia micdadei, Legionella bozemanii, Legionella dumoffi and Legionella oakridgensis. The clinical presentation is nonspecific although diarrhea occurs frequently. Hyponatremia occurs significantly more frequently in legionnaires' disease than pneumonias caused by other agents. Chest roentgenographic findings are nonspecific, although cavitation can be seen in immunosuppressed patients. Laboratory methods require the use of direct fluorescent antibody (DFA) stains, culture using selective media, serologic testing, and detection of antigen in urine. The DFA test is not sensitive; however, it does correlate with the severity of disease. Culture from sputa is now feasible. Bronchoalveolar lavage is a promising technique for obtaining specimens. The ideal specimen for culture is that obtained by transtracheal aspiration, which bypasses oropharyngeal contamination. Combination therapy of erythromycin and rifampin is recommended for selected patients. Because the source of the organism is the hospital water distribution system, we recommend routine environmental surveillance, especially in hospitals in which organ transplants are performed. The role of cooling towers as a vector for dissemination of the organism is disputed. Disinfection of the water supply can be accomplished by using heat eradication. Chlorination has generally proven unsatisfactory because of organism persistence as well as corrosive damage to the plumbing system from the chlorine. Both physician awareness and availability of specialized laboratory testing are necessary for the detection of cases. PMID- 3321267 TI - New therapeutic approaches to hospital-acquired pneumonia. AB - Conventional therapy of hospital-acquired pneumonia includes intravenous antibiotics and supportive care. In many cases, the etiologic agent of infection is not clear; thus, empiric broad-spectrum antibiotic regimens are commonly used. Combinations of beta-lactam and aminoglycoside agents are particularly popular regimens due to the high incidence of gram-negative bacillary and Staphylococcus aureus pneumonias in the hospital setting. Several new approaches to treatment of nosocomial pneumonias are currently being evaluated, however. These include: single-agent empiric coverage using a broad-spectrum beta-lactam agent; intrabronchial aminoglycoside instillation therapy; oral quinolone agents for treatment of gram-negative bacillary pneumonia; and passive immune therapy. The current experience and potential future role of these therapeutic options are discussed in this chapter. PMID- 3321268 TI - Prophylactic strategies for hospitalized patients at risk for pneumonia. AB - Thirty-five years ago pneumonia prophylaxis failed because the agents available then did not have the antibacterial spectrum necessary to prevent colonization and infection with multiple gram-negative bacteria. Combinations of the newer antibiotics delivered intratracheally do cover most common organisms and they may be sufficient for prophylaxis. Careful monitoring is necessary because a number of unusual pathogens have the potential to circumvent the prophylactic regimen. Widespread use of topical antibiotics may result in the emergence of antimicrobial resistance in intensive care unit areas. The magnitude of this risk is difficult to calculate and some maneuvers are available to decrease the likelihood that this will occur. Nevertheless, at present these uncertainties are sufficient to prevent the routine clinical use of antibiotics for pneumonia prophylaxis. There are now eight studies showing that prophylaxis can decrease the incidence of pneumonia by greater than 50%. These should stimulate further clinical research designed to minimize the problems with bacterial resistance. PMID- 3321269 TI - Bacterial adherence to respiratory tract mucosa--a dynamic interaction leading to colonization. AB - Normally, the mucosa of the nasooropharynx, trachea, and, perhaps, the major bronchi is colonized with aerobic and anaerobic microbes. This epithelial surface coexists with the microbial flora and is not overgrown with it. Moreover, the physiologic functions of the mucosa--including a protective barrier, mucociliary clearance and humidification, and warming of respired air--are not impeded. How this flora is controlled and what is amiss when virulent or pathogenic bacteria can cause infection are fascinating questions. A balance is maintained during health in which epithelial cell integrity--a function of proper nutrition, available secretory immunoglobulins and glycoproteins, and ciliary motion- resists the microbe's attempt to attach via specialized receptors (pili) or by proteolytic destruction of local proteins. These interactions are reviewed in detail. When colonization is excessive and aspiration of more microbes into the lower airway occurs, infection is more probable. Certain bacteria such as Streptococcus pneumoniae and Hemophilus influenzae, which are associated with chronic bronchitis, illustrate a mechanism in which the host-microbial balance may be upset by selective impairment of a host protein, secretory IgA1. Alternatively, viral infection or cilotoxic microbes (mycoplasma) can favor colonization of bacteria when mucosal clearance mechanisms are impaired. Last, mucosal integrity can be breached by noxious gases or inflammation that may allow bacteria entry into the submucosal that provides a nidus for infection. PMID- 3321270 TI - Influenza pneumonia. AB - Influenza A and B viruses exhibit frequent minor antigenic drift and type A viruses undergo a major antigenic shift every one to four decades, thus assuring that at least a portion of the population is always susceptible. Children and young adults have the highest incidence of influenza infection each winter, but the highest incidences of severe or complicated influenza illness leading to hospitalization or death are in infants, elderly persons (especially those in nursing homes), and persons of all ages with underlying heart or lung disease. Influenza viruses infect respiratory epithelial cells and can themselves cause diffuse pulmonary infiltrates and severe hypoxia, but concomitant or secondary bacterial pneumonia is a much more frequent complication of influenza. Although pneumococci predominate in these secondary pneumonias, the relative incidence of Staphylococcus aureus pneumonia also increases during influenza epidemics; empiric antibiotic therapy in this setting should be directed against both of these organisms. A variety of other bacteria can cause postinfluenzal pneumonia, especially in patients with alcoholism or chronic obstructive pulmonary disease, and broad antimicrobial coverage including gram-negative bacteria is justified in such patients when diagnostic studies provide no guidance. Early amantadine therapy of influenza-like illness during an influenza A epidemic will reduce the duration of symptoms and possibly reduce complications. Successful therapy of influenza virus pneumonia with ribavirin aerosol has been reported but not yet officially approved. Annual vaccination of persons at greatest risk for severe or complicated influenzal disease will reduce the morbidity and mortality due to this infection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321271 TI - Clinical and radiographic assessment of acute lower respiratory tract disease in infants and children. AB - The admission chest roentgenogram, temperature, and WBC of over 100 children with viral lower respiratory disease were compared with those for children with proven bacterial pneumonia. A scoring system was developed to assess the likelihood of bacterial or viral etiology of lower respiratory tract disease. Pulmonary infiltrates that were well defined and involved the mid or peripheral portions of only one lobe, pleural effusions and abscess or pneumatocele formation- characteristics associated with bacterial infection--were assigned a plus score. Poorly defined infiltrates, often involving the perihilar region of more than one lobe, and atelectasis involving the right middle lobe, the right upper lobe or multiple sites--characteristics associated with viral infection--were assigned a negative score. Additional plus scores were given for age greater than 6 months, fever greater than or equal to 103 degrees F, and for an elevated WBC. Application of the scoring system, retrospectively, to cases with proven etiology, demonstrated that a score of 0 or less had a predictive value of 95% for viral pneumonia, while the predictive value of a positive score for bacterial etiology was 70%. Use of the score for initiating antibiotics would have resulted in overtreatment with antibiotics of 11% of the cases. It is recognized that viral infection may facilitate bacterial invasion and that a child may present at any stage during this process; therefore, continuing evaluation and reassessment are important in the management of acute lower respiratory disease. However, the scoring system provides useful guidelines for use of antibiotics in initial treatment of childhood pneumonias, which should reduce unnecessary administration for viral infections. PMID- 3321273 TI - Symptom distress--the concept: past and present. PMID- 3321272 TI - Varicella zoster and herpes simplex virus pneumonias. AB - Varicella zoster (VZV) and herpes simplex (HSV) viruses commonly cause self limited infection of the skin and mucous membranes. However, certain groups of subjects, including neonates, cancer patients, organ and bone marrow transplant recipients and those with congenital or acquired deficiencies of cell mediated immunity, are at increased risk for dissemination of either virus to the lungs and/or other viscera. The highest risk for VZV pneumonitis is in bone marrow transplant recipients, 44%, and in children with acute leukemia, 32%. The mortality from this complication of VZV infection in the preantiviral era was at least 25%. Except for neonates, dissemination and mortality rates for HSV infections are less than for VZV infections in the high risk groups. Cell mediated immunity has a major role in both recovery from primary infection and modulation of latent infection, but antiherpes antibodies also have an important role in moderating the extent and severity of infection. Both viruses cause a patchy nodular pneumonia with scattered necrotic and hemorrhagic foci. Physical examination is often misleading and rapid progression of pneumonia can occur within hours. Intravenous acyclovir, administered early in the course of HSV and VZV infection at dosages of 250 mg/m2 and 500 mg/m2 every eight hours, respectively, has nearly eliminated the risk of severe symptomatic pneumonitis. Treatment of established pneumonitis with acyclovir at these doses has also reduced the mortality of herpesvirus pneumonias. PMID- 3321274 TI - Symptom distress. Nausea, vomiting, and anorexia. PMID- 3321275 TI - Breathing difficulty: changes in respiratory function. PMID- 3321277 TI - Symptom distress. Depression and anxiety. PMID- 3321278 TI - Abdominal ultrasound: theory and practice. PMID- 3321276 TI - The influence of cancer on self-concept and life quality. PMID- 3321279 TI - Veterinary nuclear medicine. PMID- 3321280 TI - Gastrointestinal contrast radiology in small animals. PMID- 3321281 TI - Urogenital imaging: a practical update. PMID- 3321282 TI - Radiographic aspects of cardiac pacemakers. PMID- 3321284 TI - Principles of X-ray computed tomography and magnetic resonance imaging. PMID- 3321283 TI - Teleradiology in veterinary medicine. PMID- 3321285 TI - Human radiation risk factors in veterinary medicine. PMID- 3321286 TI - Evaluating your radiology department. PMID- 3321288 TI - Physical therapeutics for respiratory disease. PMID- 3321287 TI - Respiratory failure. PMID- 3321289 TI - Current concepts in pulmonary pharmacology. PMID- 3321290 TI - The use of aminophylline and aspirin in small animal practice: effective therapy or dangerous placebos? PMID- 3321292 TI - The electrocardiogram in dogs with heartworm infection: clinical report and review of the literature. PMID- 3321291 TI - Radiographic aspects of heartworm disease. PMID- 3321293 TI - Thiacetarsamide treatment of heartworm infection in dogs. PMID- 3321294 TI - Advances in the immunologic diagnosis of Dirofilaria immitis infection. PMID- 3321295 TI - Microfilaricides. PMID- 3321296 TI - Ivermectin and heartworm. PMID- 3321297 TI - Selected complications and sequelae of canine heartworm disease. PMID- 3321298 TI - Caval syndrome in the dog. PMID- 3321300 TI - Small animal dermatopathology: 'what's old, what's new, what's borrowed, what's useful'. PMID- 3321299 TI - Indications for use of aspirin and corticosteroid hormones in the treatment of canine heartworm disease. PMID- 3321301 TI - Comparative aspects of canine and human atopic dermatitis. PMID- 3321302 TI - Granulomatosis dermatitis in dogs and cats. PMID- 3321303 TI - Direct immunofluorescent testing: a comparison of two laboratories in the diagnosis of canine immune-mediated skin disease. PMID- 3321304 TI - Genetic and biochemical analysis of ras p21 structure. AB - We tested aspects of our model of the ras p21 structure using generic, biochemical, and immunologic approaches. First, we made a monoclonal antibody against a p21 region that is highly conserved and likely to be critical to p21 function. The antibody blocks p21 function in various cell systems. Its binding to p21 is completely blocked by guanine nucleotides, even though the region of p21 to which it binds does not seem to be part of the guanine nucleotide-binding site. We propose that the conformation of this critical region is modulated by nucleotide binding. Another interesting region of p21 includes amino acids 116 and 119, which seem to confer, in part, the specificity of p21 for guanine nucleotides. We made a series of mutants in this region and tested their ability to bind GTP, and such related purine nucleotides as XTP and diaminopurine nucleoside triphosphate. We were able to refine our model for guanine nucleotide interaction with p21 and to create mutant proteins with altered specificity for purine nucleotides. Finally, we tested rates of autophosphorylation of six position 12 mutants and conclude that amino acid 12 affects the positioning of bound nucleotides relative to sequences around amino acid 59. PMID- 3321305 TI - Mechanism of regulation of protein kinase C by lipid second messengers. AB - Protein kinase C (PKC), a Ca2+-and phospholipid-dependent protein kinase, is now known to be regulated by sn-1,2-diacylglycerol (DAG) second messengers and is the intracellular phorbol ester receptor. Models of transmembrane signaling events that elicit DAG production include receptor-mediated G protein-dependent activation of phospholipase C. Several products of oncogenes resemble transmembrane signaling elements; critical second-messenger levels may, therefore, be altered by genetic defects in these elements. We found that normal rat kidney cells transformed with ras and sis contained elevated levels of DAG, and cells transformed with temperature-sensitive K-ras had elevated DAG levels at the permissive but not the restrictive temperature. To study the mechanism of PKC activation by phosphatidylserine (PS), DAG, and Ca2+, we used mixed micelles of Triton X-100, and analogous methods to examine PS dependence on [3H]phorbol dibutyrate binding and activation. PKC activation occurs at physiological mole fractions of PS and DAG and does not require a bilayer. Activation by PS, which was cooperative, required four or more molecules. Activation by DAG was not cooperative and one molecule was sufficient. Monomeric PKC is the active species. Our activation model suggests that PKC binds to Ca2+ and four PS carboxyl groups to form a surface-bound, "primed" but inactive complex. DAG binds to the complex of the four PS carboxyl groups, the Ca2+, and the PKC through three bonds, two to ester carbonyls and one to the 3-hydroxyl moiety. Collectively, these may cause a conformational change and activate the enzyme. PMID- 3321306 TI - Chromosomal approaches to the molecular basis of neoplasia. AB - Nonrandom patterns of chromosome abnormality in tumors are providing clues to the location of oncogenes and their activation mechanisms. Studies of translocations in Burkitt's lymphoma cells have shown that the c-myc proto-oncogene is consistently juxtaposed with a rearranged and transcriptionally active immunoglobulin gene locus, with resultant myc gene deregulation. In other B cell tumors, translocations appear to bring previously unrecognized oncogenes (bcl-1, bcl-2) into similar association with the immunoglobulin heavy-chain locus. T cell receptor genes may also "activate" known and unknown oncogenes after chromosome translocation. In chronic myelogenous leukemia, the translocated c-abl oncogene forms a "hybrid" gene in its new location on the Philadelphia chromosome, with altered function. Gene amplification units, seen as cytogenetically homogeneous staining regions in chromosomes or as double-minute bodies in metaphases, can represent multiple copies of oncogenes and be important in late stages of tumor progression. Other significant alterations in gene dosage, recognized as gain or loss of all or part of a specific chromosome, also occur in human neoplasms, but their specific role in carcinogenesis is largely undefined. PMID- 3321307 TI - Cellular and molecular mechanisms of carcinogenesis in lining epithelia. AB - Lining epithelia are the major target sites for cancer in man. The induction of carcinomas on mouse skin following the application of chemical agents is the prototype model for cancer development in a lining epithelium. In this tissue, the earliest carcinogen-induced lesion, initiation, results in an epidermal cell with an altered program of terminal differentiation. Such "initiated" cells can be selected in culture since normal cells can be induced to terminally differentiate by Ca2+ or phorbol ester tumor promoters and will be lost from the cultured population. In situ, the growth of initiated cells is suppressed by surrounding normal cells. The differentiation-inducing effects of tumor promoters on normal cells, therefore, are essential in providing a selective growth advantage which results in the clonal selection of initiated cells and the evolution of a papilloma. This benign tumor is the pathological manifestation of the initiated phenotype. The c-rasH gene appears to be one target for initiating carcinogens, as a mutated and activated form of this gene is frequently isolated from chemically induced papillomas. Furthermore, the introduction of an activated rasH gene into cultured normal keratinocytes produces papillomas when the cells are transplanted as a skin graft in vivo. After a long latency period, some papillomas convert to carcinomas. Since the conversion process can be accelerated and the frequency enhanced by mutagens, it is presumed that genetic damage in papilloma cells plays an important role in malignant conversion. In papilloma cells lacking an activated rasH oncogene, introduction of an exogenous rasH oncogene leads to malignant progression. Thus, mutation and activation of this gene can contribute to early or late events in skin carcinogenesis. In either case it appears that the rasH oncogene must cooperate with other genetic changes to contribute to the malignant phenotype. PMID- 3321308 TI - Critical genetic determinants and molecular events in multistage skin carcinogenesis. AB - Carcinogenesis can be operationally and mechanistically divided into at least three major stages--initiation, promotion, and progression. Variations among stocks and strains of mice to susceptibility to multistage skin and liver carcinogenesis appear to be more related to alterations in tumor promotion than tumor initiation; however, the critical events have not been determined. In the mouse skin model the first stage is thought to involve the interaction of a tumor initiator with the genetic material of stem cells leading to an alteration in some aspect of growth control, differentiation, or both. The major effect of tumor promoters, regardless of the type, is the specific expansion of the initiated stem cells in the skin. This appears to occur by both direct and indirect mechanisms that involve the loss of glucocorticoid receptors, differentiation alterations, a direct growth stimulation of the initiated cells, or selective cytotoxicity. The progression stage is characterized by a high level of genetic instability that produces a number of chromosomal alterations. These changes may be responsible for the loss of the high-molecular-weight keratin proteins and filaggrin, increase in gamma-glutamyl-transpeptidase activity, and changes in oncogene expression in squamous cell carcinomas. We have found that a high percentage of squamous cell carcinomas have a trisomy in chromosome 2 that carries both src and abl genes and an increased expression of src and abl. We have also found increased Ha-ras on RNA expression in both papillomas and squamous cell carcinomas. We suggest that the genetic instability of the initiated cells is responsible for most observed changes during skin carcinogenesis. PMID- 3321309 TI - Role of oncogenes and tumor suppressor genes in a multistep model of carcinogenesis. AB - We demonstrated previously that carcinogen-induced neoplastic transformation of Syrian hamster embryo (SHE) cells requires multiple steps. Normal, diploid SHE cells and carcinogen-induced preneoplastic cells were transfected with different oncogenes. The normal, early-passage cells were not transformed by the v-Ha-ras or v-myc oncogenes alone, but the two oncogenes combined caused tumors in nude mice and syngeneic hamsters. Cytogenetic analysis of the ras-plus-myc-induced tumors showed a nonrandom chromosome loss (monosomy of chromosome 15) in the ras/myc tumor cells. Tumorigenicity of the ras/myc tumor cells was suppressed following hybridization with normal SHE cells; reexpression of tumorigenicity at later passages correlated with loss of chromosome 15. The hybrid cells in which tumorigenicity was suppressed still expressed the ras and myc oncogenes. An early change in carcinogen-induced neoplastic progression of SHE cells is induction of immortality. At early passages, immortal cells retain the ability to suppress tumorigenicity in cell hybrids. This ability decreases with passaging of immortal cell lines. The susceptibility of immortal cell lines to neoplastic transformation by DNA transfection with the v-Ha-ras oncogene or tumor DNA inversely correlated with the tumor-suppressive ability of the cells in cell hybrids. These observations indicate that neoplastic transformation of SHE cells involves at least three steps: (1) induction of immortality, (2) activation of a transforming gene or oncogene, and (3) loss of or inactivation of a tumor suppressor gene. PMID- 3321310 TI - Retroviruses as tools for mammalian development. AB - Retroviruses have been used as probes for the study of mammalian development. Successful applications of this tool include (1) genetic labeling of cells for lineage studies in preimplantation and postimplantation development, (2) tagging important chromosomal regions of the mouse genome, (3) identifying genes that are expressed during early development, and (4) generating mutant mouse strains by insertional mutations that allow for molecular and functional analyses of developmental genes. PMID- 3321312 TI - [Chronic inflammatory arthritis and palmoplantar pustulosis]. PMID- 3321311 TI - Proto-oncogene expression and growth factors during liver regeneration. AB - When growth is stimulated in normally quiescent hepatocytes, steady-state levels of c-fos, c-myc, and p53 mRNAs increase sequentially and transiently before DNA replication. C-fos mRNA increases almost immediately after partial hepatectomy and decreases by 2 hr; c-myc mRNA reaches maximal levels between 30 min and 2 hr. In contrast, the p53 mRNA increase corresponds to the G1/S transition, and mRNAs from c-ras genes are elevated later, coinciding with DNA replication and mitosis. p53 and p21 proteins are elevated when their mRNAs are more abundant. This regulated response suggests that these genes either control key steps in the cell cycle or are responding to humoral or internal growth factors acting at specified growth stages. We propose that hepatocytes go through a "priming" stage during the first four hours after partial hepatectomy and that their progression through late G1, is likely to be controlled by autocrine or paracrine mechanisms, which may account for the precisely regulated growth of the liver after partial hepatectomy. Transforming growth factor beta (TGF beta) is a potent inhibitor of DNA synthesis in normal hepatocytes in vitro. We show that TGF beta mRNA increases in the regenerating liver at the time of hepatocyte DNA synthesis and mitosis. In normal or regenerating liver, the mRNA for this growth factor is contained in nonparenchymal cells but not in hepatocytes. We suggest that TGF beta may be a component of a paracrine regulatory loop that controls hepatocyte replication. PMID- 3321313 TI - An acceptability study of two pivampicillin mixtures in children in general practice. AB - In order to evaluate the paediatric patient compliance to treatment with penicillin mixture, 84 children with respiratory system infections were randomized to treatment with pivampicillin (Pondocillin) mixture with two different flavour additives, cocoa-peppermint and banana. Using a scoring system, the taste acceptability and the easiness of administration were evaluated at the beginning and the end of treatment. While taste acceptability and easiness of administration decreased significantly during the treatment (p = 0.046 for taste and p = 0.049 for easiness) with Pondocillin cocoa-peppermint mixture, only small non-significant differences were noticed during treatment with Pondocillin banana mixture. PMID- 3321315 TI - A method of analysis taking into account competing events: application to the study of digestive complications following irradiation for cervical cancer. AB - Over the past 20 years, mortality rates from uterine cervix carcinoma have been decreasing owing to earlier diagnosis and improved treatment. The incidence of secondary effects from radiation therapy has spurred some interest and injuries resulting from 'over'-treatment have been of some concern. The present study concerns the evaluation of bowel complications following treatment for the 272 stage IIb and III patients treated in our centre between 1967 and 1973. Competing risk methodology is applied and the influence of radiotherapy parameters is evaluated by a log-linear model of the event-specific failure rates. A single parameter (NSD) which summarized total dose, total number of sessions and total treatment time is found to be related to the occurrence of complications. PMID- 3321314 TI - Practical aspects in data monitoring: a brief review. AB - Monitoring interim accumulating data in a clinical trial for evidence of therapeutic benefit or toxicity is a frequent policy, usually carried out by an independent scientific committee. Repeated testing at conventional critical values can substantially inflate the type I error rate. To maintain acceptable levels, group sequential and stochastic curtailment have been developed for clinical trials. One should not view such methods as absolute rules, but as useful guides. The decision process to terminate a trial early is complex and necessitates an accounting for many factors. The Beta-Blocker Heart Attack Trial provides an excellent example of many of these issues. PMID- 3321316 TI - Modelling the effect of intervention on the transmission of malaria in East Malaysia. AB - To assess the public health importance of malaria on Banggi Island, Sabah, baseline epidemiological and entomological data were obtained in a study of three villages. These data were used to model the transmission of malaria using a non seasonal version of the deterministic model of Dietz, Molineaux and Thomas. The model provided a satisfactory description of prevalence rates of Plasmodium falciparum parasitaemia. Modifications to the basic model enable the effects of mass chemotherapy with various combinations of schizonticidal and gametocidal drugs to be simulated. In this way, the relative merits of different procedures of mass drug administration can be compared. The fitted model is also used to examine the relationship between the overall prevalence of infection and the vectorial capacity, and to predict the consequences of a reduction in the size of the vector population. PMID- 3321318 TI - [The origin of our medical traditions]. PMID- 3321317 TI - [Methods of of assessing the nutritional status of a patient: a critical review]. PMID- 3321319 TI - [In memoriam R. Dubois]. PMID- 3321320 TI - [Hemolytic-uremic syndrome in children]. PMID- 3321321 TI - [A case of paraquat poisoning]. PMID- 3321322 TI - [Fetal response to stimuli]. PMID- 3321323 TI - [Arthrosis: pathologic review and the place of non-steroidal anti-inflammatory agents in its treatment]. PMID- 3321324 TI - [The fragile X syndrome in 1987. Recent findings and review of the problem]. PMID- 3321325 TI - [Evaluation and preparation of the patient before liver transplantation]. PMID- 3321326 TI - [Liver transplantation. The technical role of the circulating nurse]. PMID- 3321328 TI - [Outpatient follow-up of the patient in the period after liver transplantation]. PMID- 3321327 TI - [Liver transplantation. Technical aspects]. PMID- 3321329 TI - [Results of liver transplantation]. PMID- 3321330 TI - [Organizing a liver transplantation]. PMID- 3321332 TI - [Point of view of the anesthesia team. Organization of liver transplantation in the operating area]. PMID- 3321331 TI - [Costs and organization of liver transplantation]. PMID- 3321333 TI - [Role of the operating room nurse during heart transplantation. Before, during and after surgery]. PMID- 3321334 TI - [Anesthesia and postoperative resuscitation in heart transplantation]. PMID- 3321335 TI - [Indications for liver transplantation]. PMID- 3321336 TI - [Traumatic splenic rupture in infectious mononucleosis: spleen-preserving therapy]. PMID- 3321337 TI - [Cerebral microangiopathies, lacunae and leuko-araiosis]. PMID- 3321338 TI - [Dyspnea, tachycardia]. PMID- 3321340 TI - [Geriatric surgery, psychological status and intellectual functions]. PMID- 3321339 TI - [Penicillin 1987: did Fleming discover a cytostatic agent?]. PMID- 3321341 TI - [Cicatrization and regeneration in the elderly]. PMID- 3321342 TI - [Cataract surgery or the revenge of the poor]. PMID- 3321343 TI - [Medical pathology of the tendons]. PMID- 3321344 TI - [The expanded vaccination program of the World Health Organization: a framework for the immunization program in Switzerland]. PMID- 3321345 TI - [The unstable shoulder. Clinical and radiological aspects]. PMID- 3321346 TI - [Development of thoracic surgery from 1880 to the present]. PMID- 3321348 TI - [Place of benzodiazepines in the treatment of sleep disorders]. PMID- 3321347 TI - [Physiological correlates of cerebral dominance]. PMID- 3321349 TI - [Benzodiazepines: good and bad use, dependence and withdrawal]. PMID- 3321350 TI - [The physician, his patient and benzodiazepines]. PMID- 3321352 TI - [Clinical and catamnestic aspects of bulimia nervosa]. PMID- 3321353 TI - [Comprehensive care in anorexia nervosa]. PMID- 3321351 TI - [The role of hypnosis in the treatment of burns]. PMID- 3321354 TI - [Depression and somatic diseases]. PMID- 3321355 TI - [Polyneuropathies with IgM monoclonal gammopathy. 12 cases]. AB - 12 cases of polyneuropathy with IgM monoclonal gammapathy are reported. An analysis of the clinical, electrophysiological, histological and immunological features of these cases and of those reported in the literature allows to distinguish 2 groups. In the first group (8./12 cases), the neuropathy showed clinical and electrophysiological features of a mainly demyelinating mechanism involving large fibers. Electromicroscopy disclosed a widening of the spaces between the lamellae of the myelin in half of these cases. A monoclonal deposit of IgM was demonstrated by direct immunofluorescence, on the remaining myelinated fibers in most cases. In this first group, the M-component always reacted with the myelin sheaths of a monkey's peripheral nerve. The results of indirect immunofluorescence were closely correlated with those of immunoblotting, which revealed an anti-M.A.G. (Myelin Associated Glycoprotein) activity. The second group is more heterogeneous: there was an predominantly motor neuropathy (1 case), an asymmetrical and painful neuropathy with an endoneural deposit of IgM (1 case). In 2 other cases which in no other ways differed from those of the first group, the M-component seemed devoid of antimyelinic activity. Nevertheless, the presence of IgM on the myelin sheaths of these 2 cases suggested a relationship between the neuropathy and the gammapathy. In both groups, results from the association of apheresis and chlorambucil were difficult to assess and vary greatly. Therapy appeared beneficent in half of the cases, but only one patient was markedly improved. PMID- 3321356 TI - Health and economic impacts of antimicrobial resistance. AB - For comparison of the impacts of infections due to antimicrobial-resistant bacteria with those of infections due to antimicrobial-susceptible strains of the same bacteria, data were evaluated from 175 published and unpublished reports of investigations of nosocomial and community-acquired infections with selected bacteria. The evaluation of outcomes of hospital-acquired infections with resistant organisms was often confounded by risk factors also associated with poor outcomes. Nevertheless, for both nosocomial and community-acquired infections, the mortality, the likelihood of hospitalization, and the length of hospital stay were usually at least twice as great for patients infected with drug-resistant strains as for those infected with drug-susceptible strains of the same bacteria. Poor outcomes could be attributed both to the expected effects of ineffective antimicrobial therapy and to the unexpected occurrence of drug resistant infections complicated by prior antimicrobial therapy for other medical problems. Although the adverse economic and health effects of drug-resistant bacterial infections can only be roughly quantified, it is concluded that antimicrobial resistance is an important health problem and an economic burden to society. PMID- 3321358 TI - Pentastomiasis. AB - Pentastomiasis is a parasitic zoonosis caused by pentastomes, members of an unusual phylum--Pentastomida--with characteristics of both arthropods and annelids. Adult pentastomes parasitize the respiratory tracts of reptiles or carnivorous mammals. The infection is generally limited to the tropics and subtropics, but ocular involvement has been reported in the southern United States. The majority of human pentastomiasis is caused by two species. The first, Armillifer armillatus, infects humans as secondary hosts. Infection is usually asymptomatic but has characteristic postmortem and radiologic features. The second, Linguatula serrata, can infect humans as does Armillifer or can cause a self-limited nasopharyngitis--the halzoun or marrara syndrome--with the human acting as a temporary definitive host. This article discusses the biology and parasitology of these metazoans as well as the clinical manifestations, pathology, diagnosis, and epidemiology of pentastomiasis. PMID- 3321357 TI - Epidemiology of infections caused by gentamicin-resistant enterobacteriaceae and Pseudomonas aeruginosa over 15 years at the Nashville Veterans Administration Medical Center. AB - Nosocomial infections and gentamicin resistance were surveyed over 15 years at Nashville Veterans Administration Medical Center, and trends for Enterobacteriaceae and Pseudomonas aeruginosa were contrasted. Analysis of approximately 6,000 nosocomial infections indicated that four-fifths were caused by aerobic gram-negative bacilli. Three hospital-wide outbreaks caused by Enterobacteriaceae occurred; these three outbreaks were due to Serratia marcescens, Klebsiella pneumoniae, and Enterobacter cloacae, respectively. The outbreaks were temporally related to the emergence of gentamicin resistance. Detailed analysis of the recent outbreak due to Enterobacter indicated that an increasing prevalence of gentamicin-resistant E. cloacae predated nosocomial infections by several months; this pattern suggested that such outbreaks could be predicted. Molecular epidemiologic data pertaining to the preservation over a decade of genes encoding gentamicin resistance were reviewed. In contrast to Enterobacteriaceae, P. aeruginosa gradually and progressively developed resistance to gentamicin that spread in an endemic fashion, with parallel increases in nosocomial infections. This pattern appeared to relate to different modes of spread and persistence for resistant P. aeruginosa that may require unique methods for control. PMID- 3321359 TI - Problems and benefits of an antibiotic compassionate therapy program. AB - So-called compassionate therapy can provide life-saving drug(s) for patients but can also introduce liabilities that may discourage such treatment. The procedures required for compassionate use of imipenem/cilastatin and a summary of the results of its use are used as examples. Physicians requesting drugs for compassionate therapy face problems in the timely acquisition of antibiotic from the manufacturer and the completion of the regulatory and patient case report forms. The pharmaceutical company encounters difficulties with the return of documents, the ability to use the treatment data for registration claims, and the assessment of outcome and safety in patients with multiple confounding medical problems. The benefits of compassionate therapy for all participants should favor its continued use. Suggestions for the improvement of compassionate therapy programs include streamlining of case report forms and more disciplined completion of forms by investigators. PMID- 3321360 TI - AIDS in the pre-AIDS era. AB - A search of the medical literature published since 1950 disclosed 19 cases of probable AIDS reported before the start of the current epidemic. These cases retrospectively met the Centers for Disease Control's surveillance definition of the syndrome and had a clinical course suggestive of AIDS. The reports originated from North America, Western Europe, Africa, and the Middle East. The mean age of patients was 37 years, and the ratio of male to female patients was 1.7:1. Sixteen patients had opportunistic infections(s) without Kaposi's sarcoma. The remainder had disseminated Kaposi's sarcoma. The commonest opportunistic infection was Pneumocystis carinii pneumonia. Two patients were reported to be homosexual. Three others had been living in Africa, and one patient was born in Haiti. In two instances concurrent or subsequent opportunistic infection occurred in family members. All patients died 1 month to 6 years after the initial manifestation of disease. In view of the historical data, unrecognized cases of AIDS appear to have occurred sporadically in the pre-AIDS era. PMID- 3321361 TI - Cultural practices contributing to the transmission of human immunodeficiency virus in Africa. AB - Differences between the epidemiology of AIDS cases in Africa and that in Western societies have prompted speculation regarding risk factors that may be unique to Africa. Because of the age and sex distribution of AIDS cases in Africa, emphasis has been placed on sexual transmission of human immunodeficiency virus (HIV). Factors thought to influence this sexual transmission include (1) promiscuity, with a high prevalence of sexually transmitted disease; (2) sexual practices that have been associated with increased risk of transmission of AIDS virus (homosexuality and anal intercourse); and (3) cultural practices that are possibly connected with increased virus transmission (female "circumcision" and infibulation). Other nonsexual cultural practices that do not fit the age distribution pattern of AIDS but may expose individuals to HIV include (1) practices resulting in exposure to blood (medicinal bloodletting, rituals establishing "blood brotherhood," and possibly ritual and medicinal enemas); (2) practices involving the use of shared instruments (injection of medicines, ritual scarification, group circumcision, genital tatooing, and shaving of body hair); and (3) contact with nonhuman primates. At the current time promiscuity seems to be the most important cultural factor contributing to the transmission of HIV in Africa. PMID- 3321362 TI - Infections caused by Mycobacterium szulgai in humans. AB - Mycobacterium szulgai is a scotochromogenic species that has recently been recognized as a human pathogen. Twenty-four cases of disease caused by M. szulgai in humans have been reported in the English-language literature. The clinical features of these cases were reviewed, and three additional cases (two pulmonary, one extrapulmonary) were studied. Pulmonary disease indistinguishable from that caused by Mycobacterium tuberculosis was the commonest type of infection caused by M. szulgai (18 of 27 cases). Olecranon bursitis was reported in three cases, and disseminated infection was noted in three cases occurring in immunocompromised patients. M. szulgai is more susceptible to standard antimycobacterial agents than are other nontuberculous mycobacteria, notably the Mycobacterium avium complex. Clinical improvement and cure of pulmonary disease can be anticipated when treatment includes at least three drugs effective in in vitro susceptibility tests. Surgical excision appears unnecessary in pulmonary disease but may be indicated in olecranon bursitis. PMID- 3321364 TI - Uncommonly encountered, motile, anaerobic gram-negative bacilli associated with infection. AB - Motile, anaerobic gram-negative bacilli belonging to the genera Butyrivibrio, Succinimonas, Succinivibrio, Anaerovibrio, Wolinella, Campylobacter, Desulfovibrio, Selenomonas, and Anaerobiospirillum are being recognized in clinical specimens with increasing frequency. Over a 12.5-year period at the VA Wadsworth Medical Center, 13 clinical specimens yielded one of these organisms. Six isolates were recovered from infected wounds, five from respiratory tract specimens obtained from patients with anaerobic pleuropulmonary infection, and two from peritoneal fluid of patients with intraabdominal infection. The distribution of isolates among the genera was as follows: Wolinella, five; Selenomonas, three; unidentifiable motile gram-negative bacilli, two; Desulfovibrio vulgaris, one; Campylobacter concisus, one; and Succinimonas, one. Our experience provides the first case reports of infection involving the last two organisms mentioned. Clinical features of the infections caused by these motile anaerobes were studied, and the current medical literature on such infections was reviewed. PMID- 3321363 TI - Immunodeficiency of the elderly. AB - The elderly are at risk for an increased incidence and severity of certain infections. The contribution of age-related immunologic impairment to the pathogenesis of these infections has been difficult to determine because of a number of confounding variables associated with aging. Nevertheless, studies in vitro and in animals support the hypothesis that immunodeficiency accompanies the aging process. Multiple factors may be responsible for altered cell-mediated immunity in the elderly, including thymic involution, reduced levels of thymic hormones, and an increase in the number of immature T lymphocytes. While studies of T cell subpopulations have yielded conflicting results, it appears that T cell proliferative responses are diminished. Aging is also associated with abnormalities of humoral immunity. Although the number and functional activities of neutrophils from healthy elderly persons are relatively intact, diminished bactericidal activity and altered oxygen metabolism have been reported in extremely old individuals. While the relative importance and clinical impact of these immunologic abnormalities remain unclear, future studies may provide new strategies for the prevention and treatment of infections in this rapidly growing segment of the population. PMID- 3321365 TI - Ethical dilemmas about intensive care for patients with AIDS. AB - AIDS presents ethical dilemmas about intensive care. Even with intensive care the outcome for patients with AIDS is poor. Care givers have no ethical or medical obligation to provide futile care. Decisions concerning competent patients should be made jointly by physicians and the informed patients themselves. For incompetent patients decisions should be made jointly by physicians and appropriate patient-surrogates in light of the previously expressed wishes of the patients. Care givers should encourage patients with AIDS to express their preferences about life-sustaining treatment in order to avoid dilemmas should these patients later become incompetent. The AIDS epidemic may force more explicit discussions about the allocation of limited health-care resources, such as intensive care. Such allocation decisions should not discriminate against patients with AIDS. PMID- 3321366 TI - Tuberculosis in the native American: indigenous or introduced? AB - An analysis of the current and historical literature is presented in order to assess the weight of evidence for the existence of tuberculosis among the Native Americans of North America before the time of Columbus. Literature related to pertinent artifacts, biologic specimens, geographic and geologic history, epidemiology, and early travelogues and histories in considered. While the evidence does not convincingly confirm or deny the presence of this disease in America's earliest human history, an understanding of the factors related to the epidemiology of tuberculosis is of value for both social and public health reasons. PMID- 3321367 TI - Kernig's and Brudzinski's signs revisited. AB - Although meningitis has been recognized since antiquity, the clear description of signs of meningeal irritation is relatively recent. Kernig's sign is described in physical diagnosis texts; however, the test for Kernig's sign as currently performed differs from Kernig's original description. Brudzinski described several signs of meningitis; his "nape of the neck" sign is the best known. The contralateral leg signs described by Brudzinski are unfamiliar to most clinicians. Brudzinski believed that knowledge of all the meningeal signs was of use because some may be present while others are absent. Since outcome in meningitis is dependent on early treatment--and therefore early diagnosis- familiarity with all the meningeal signs is desirable. PMID- 3321368 TI - Adoption of thermometry into clinical practice in the United States. AB - Technologic advances in thermometer design and conceptual advances in the understanding of homeostasis between 1700 and 1850 led to recognition of the usefulness of measuring body temperature in human disease. These advances took place in Europe and Great Britain, culminating in the publication in 1868 of the seminal work on fever in human disease by Carl Wunderlich. In the United States thermometry was popularized by a number of distinguished American physicians who used European data that had appeared in British and American journals even before 1868. Thus Edward Seguin and Austin Flint included fever curves and vital signs in articles that appeared in 1866. Flint and Jacob DaCosta added sections on thermometry to their medical textbooks in 1866-1867, and Edouard Seguin (the father of Edward) encouraged the use of thermometry by the public at large in a series of articles in the medical and lay press. Within just two decades thermometry became recognized as an indispensable medical tool, which it remains to the present time. PMID- 3321369 TI - [Communicating uteri. Study and review of the literature. Apropos of 11 cases]. AB - The authors are reporting 11 communicating uteri's cases. This class of uterine malformation present 1 a 2% of the malformation. They report Musset's classification and Toaff too. The Musset's type 2 is more frequent. After a summary of diagnostic, the authors describe the treatment during and outside the pregnancy. PMID- 3321370 TI - [Immunology and pregnancy]. AB - Immunology in pregnancy is a meeting ground between basic research in biology and daily medical practice. For gynecologists and obstetricians, the authors have attempted to synthesize the acquired knowledge and the current hypotheses on this very complex topic. Three main chapters will be successively approached: a reminder of the normal immune system and its development in the fetus, immunity in pregnant women and the dysimmune pathology during pregnancy, the feto-maternal immune relationship and its possible complications. PMID- 3321371 TI - [Epidemiology of extrauterine pregnancy]. AB - An epidemiological study of ectopic pregnancy shows an increased frequency, a diminution of mortality by ectopic pregnancy. This review of the literature points out the influence of several factors implicated in the increased incidence of ectopic pregnancy: pelvis inflammatory disease (PID), intrauterine device and other contraceptive methods tubal ligation, induced abortions, tubal microsurgery, proximal tubal disease, ovulation induction and in vitro fertilization, diethylstilboestrol (DES) syndrome. PMID- 3321372 TI - [Anti-tetanus immunization. Complexity and polymorphism of humoral and cellular manifestations]. AB - In general, anti-tetanus vaccination is well tolerated by the recipients, but the repeated inoculations of the vaccine might result in immediate or delayed type of hypersensitivity. The more recent knowledge of the epitopic construction of the toxin defined by tools offered by molecular biology, has helped understand the complexity of humoral and cellular responses as a consequence to vaccination. We have analyzed in this work major antitetanus post-vaccinal manifestations in normal subjects, as well as in patients suffering from different pathological disorders, with regard to immunoglobulin class expression, idiotypic profile, HLA susceptibility and in vitro cellular responses. PMID- 3321374 TI - [Duodenal injuries]. PMID- 3321375 TI - [Accidents in children. 2. Bibliography]. PMID- 3321373 TI - [Autotransplantation of the small intestine in replacement of the cervical esophagus. Indication, technic and clinical experience]. PMID- 3321377 TI - [Immunoglobulins and C3 in paracoccidioidal granuloma]. PMID- 3321376 TI - Immunoperoxidase technique in experimental chronic chagasic myocarditis. PMID- 3321378 TI - The surgical history of Narragansett Bay. A dialogue with history. PMID- 3321379 TI - Proliferative activity of cells in the synovium as demonstrated by a monoclonal antibody, Ki67. AB - The presence of proliferating cells has been sought in the synovium of rheumatoid arthritic (RA) and osteoarthritic (OA) joints using the monoclonal antibody Ki67, which marks a nuclear antigen present in all stages of the cell cycle apart from Go. Synovia were studied from 21 RA and 14 OA cases using the indirect immunoperoxidase technique. Double-staining was performed on 18 RA and 17 OA synovia with the simultaneous labelling of lysozyme (muramidase) by the immuno alkaline phosphatase method and with Ki67 by the indirect immunoperoxidase method. Most of the RA and OA synovia showed an absence of Ki67-positive cells in the intimal cell layer. Three RA and four OA synovia showed no more than ten proliferating cells in the whole of the intimal layer examined. Similar results were obtained when double-labelling was performed. Eight RA and six OA synovia showed the presence of occasional Ki67-positive cells in the intimal layer. The total number of intimal cells was measured for each histological section, and the proliferation index calculated as the percentage of total cells in the intimal layer showing Ki67-positive staining. This varied between 0.03% and 0.0033% (between 1:2800 and 1:30,000 cells). In contrast, there were plentiful Ki67 positive cells present in the lymphocytic infiltrate and around blood vessels in the RA synovia and in the synovial infiltrate, where present, in the OA cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321381 TI - Future of animal domestication. Ecological expansion, breed diversification and genetic engineering. PMID- 3321380 TI - Comparison of phenotype expression by mononuclear phagocytes within subcutaneous gouty tophi and rheumatoid nodules. AB - The mononuclear phagocyte infiltrate which occupies the gout tophus has been compared with that of the subcutaneous rheumatoid nodule. In the gout tophus, macrophage migration appears to be at a relatively low level and effectively terminates once these cells have been recruited into the corona. In the nodule the evidence suggests that both macrophage and granulocyte populations continuously migrate towards, and are progressively incorporated into, the necrotic centres. These observations indicate that chemotactic activity in rheumatoid nodules is at a higher level than in gout tophi, or that the rheumatoid mononuclear phagocyte is more responsive to such stimuli. PMID- 3321382 TI - Nursing opportunities. PMID- 3321383 TI - RNABC 1912-1987: 75 years of caring. PMID- 3321384 TI - [Slow viruses]. PMID- 3321385 TI - [Bullous diseases in children]. PMID- 3321386 TI - [Diagnostic technics of pulmonary infections in intensive care units]. PMID- 3321387 TI - [Place of bibliographic retrieval in general practice medicine]. PMID- 3321388 TI - [Dorsal disk hernia. Apropos of 6 cases. Review of the literature]. PMID- 3321389 TI - [Research of syphilis and toxoplasmosis antibodies in newborn infants in a hospital of Ribeirao Preto, SP, Brazil]. PMID- 3321390 TI - Effects of irradiation with dental light curing units on Langerhans cells in human stratified epithelium in heterotransplanted skin. AB - Grafts of human skin on nude mice were subjected to a single dose of either 2 1/2 min or 4 min of radiation from two different commercial dental light curing units with emission mainly in the visible light spectrum but also with a small fraction of UV-A light. Seventy-two hours after exposure the tissue was examined for presence of Langerhans cells using monoclonal antibody OKT6 double layer immunofluorescence staining. Epithelial hyperplasia and reduced reactivities for OKT6 were seen after 2 1/2 min exposure. After 4 min of exposure OKT6 positive cells were completely absent from the epithelium. The results indicate that emission from dental light curing units can affect Langerhans cells in human epithelium and could thus modify the local immunologic response. PMID- 3321391 TI - Influence of oral hygiene on the mucosal conditions beneath bridge pontics. AB - The purpose of the present study was to elucidate the relationship between the oral hygiene at the bridge pontic and the inflammatory changes in the adjacent mucosa. The study consisted of three 4-wk periods with different hygienic measures: 1) no oral hygiene around and beneath the pontic, 2) thorough hygiene using toothbrush and toothpicks and 3) thorough hygiene using a toothbrush and dental floss every day. The amount of accumulated bacterial deposits on the pontic and the inflammation in the pontic area were estimated using quantitative microbiologic tests, and clinical and histologic examinations. When dental floss had been used the mucosa was healthy while it showed mild or moderate inflammation after the other experimental periods. There was a high correlation between the amount of mucosal exudate and the inflammation in the mucosa as measured by a modified Gingival Index. Daily use of dental floss resulted in a significantly lower number of microorganisms per mm2 compared with the other hygienic measures. Histologic sections of the biopsies showed changes in form of parakeratosis with thinning or loss of stratum corneum. The investigations have demonstrated that insufficient oral hygiene is an important factor in the development of inflammatory changes in the oral mucosa beneath bridge pontics. Regular use of dental floss ought to be a part of the oral hygiene regimen in patients wearing fixed bridges. PMID- 3321392 TI - Alcoholic liver disease: an IgA-associated disorder. PMID- 3321393 TI - Composition of bile after orthotopic liver transplantation. AB - In 20 adult patients undergoing orthotopic liver transplantation (OLT), we studied longitudinally for the first 3 weeks after OLT the composition of bile with regard to differences between surviving and non-surviving patients and between patients with more or less rejection and the relation between bile and serum concentrations. The analyzed biliary components were bilirubin, cholesterol, bile acids, phospholipids, copper, iron, glucose, urea, creatinine, ammonia, protein, sodium, potassium, chloride, pH, bicarbonate, calcium and phosphate. After the 1st day the composition of bile was often different from reference values. In most patients deviations of the hepatic excretion function were found. Especially, a sharp fall was noticed in the biliary concentrations of cholesterol and copper. The composition of bile was not helpful in predicting the histologic degree of rejection or the ultimate outcome of the patients. Changes in bile glucose, electrolyte, urea, and creatinine concentrations were positively related to serum concentrations. We conclude that for the compounds analyzed the composition of bile after OLT is not only influenced by the state of the liver but also by the overall metabolic state of the patient. PMID- 3321395 TI - Prevalence of gallstones in a Norwegian population. AB - A population sample of 2464 persons between 20 and 70 years of age was invited to participate in a screening study designed for establishing gallstone prevalence rates. The diagnosis of gallstones was based on an ultrasonographic examination. The overall response rate after the primary invitation was 55.6%. Gallbladder stones were diagnosed in 300 persons, giving a crude prevalence of 21.9%. Total age-adjusted prevalence rates were 17.7% in men and 21.2% in women. From age group 20-29 years to age group 60-69 years the prevalence rates increased from 4.9% to 37.0% in men and from 6.0% to 41.3% in women. The age- and sex-specific rates are comparable to those of more recent studies from Scandinavia but are markedly higher than prevalence rates in a Norwegian study from 1960. PMID- 3321394 TI - The effect of ranitidine on oesophageal motility. AB - Ranitidine is used to treat symptomatic oesophageal reflux; its effect is probably to a great extent due to reduced gastric secretion. Whether it also affects oesophageal motility is a matter of controversy. In a randomized double blind study oesophageal motility was recorded in 21 healthy individuals after 3 doses of 150 mg ranitidine or placebo given over 36 h. Ranitidine increased the pressure in the lower oesophageal sphincter from 14 to 18 mmHg (p = 0.05) but otherwise did not influence oesophageal motility. PMID- 3321396 TI - Sensitivity of gastric acid secretion in patients with chronic renal failure. AB - By means of a dose-response secretion test the sensitivity of gastric acid secretion was investigated in 85 patients with chronic renal failure and in 85 age- and sex-matched controls. The renal patients were also gastroscoped, with biopsy specimens taken from the gastric body. The examinations were repeated on 18 patients undergoing regular dialysis and 8 patients after successful transplantation. The acid secretion sensitivity of the stomach among the non dialyzed patients was decreased when compared with the controls (p less than 0.01) but tended to normalize during the intermittent dialysis treatment (p less than 0.05) and particularly after transplantation (p less than 0.01). The low secretion responses were independent of gastric body histology and were also seen in patients with normal body mucosa. The maximum theoretic acid output did not differ significantly from that of the controls. It is concluded that there is an inhibition of gastric acid secretion in chronic renal failure. This inhibition depends on the decreased sensitivity to stimulation and is diminished by treatment of renal failure by dialysis or transplantation. PMID- 3321397 TI - Prophylactic treatment of acute gastroduodenal stress ulceration. Low-dose antacid treatment without and with additional ranitidine. AB - Low-dose antacid treatment without and with additional ranitidine in the prevention of acute gastroduodenal stress ulceration in high-risk patients was compared in a randomized, double-blind clinical trial with endoscopic examination of the upper gastrointestinal tract before entry and after the 7-day study period. Of 67 patients who entered the study, 56 could be evaluated. Only one patient, allocated to antacid and placebo, had massive acute upper gastrointestinal bleeding, arising from a gastric ulcer. Although gastric intraluminal pH was better controlled with additional ranitidine treatment, the occurrence of mucosal lesions did not depend on the assigned treatment. We conclude that there is no significant difference between the two regimens in terms of endoscopically visible lesions and clinical outcome. PMID- 3321398 TI - The changing face of peptic ulceration. AB - Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and some 24 million prescriptions are issued for them each year in the United Kingdom. Although animal and human experimental studies can yield confusing and disparate findings, complaints of gastro-intestinal side effects are common, and spontaneous reports of serious gastro-intestinal adverse effects of NSAIDs form by far the most commonly reported variety to the United Kingdom's Committee on the Safety of Medicines. Experimental suggestions that non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) cause gastritis and erosions have been overshadowed by evidence that takers of NSAIDs tend to develop serious complications with acute bleeding and perforations of duodenal and gastric ulcers. Findings in clinical case series that a third or more of patients with bleeding or perforated ulcers have been taking non-aspirin NSAIDs contrast with the outcome of surveillance studies where, in sets of 10,000 takers of such drugs, there appeared to be no material differences in ulcer complication rates in takers and non-takers. Data obtained in formal case control studies however, have suggested a relative risk which is increased by between two- and four-fold in non-aspirin NSAID takers for both gastric and duodenal ulcer in elderly people. The findings in case-control and surveillance studies can be reconciled by taking account of the very large numbers of prescriptions for non-aspirin NSAIDs issued each year, now approaching 24 million in the United Kingdom.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321399 TI - The hemostatic mechanism: the role of platelets in physiology and bleeding states. AB - The most recent information about platelets and their role in hemostasis is presented. The intimate cooperation between platelets, coagulation, and the vessel wall (the thrombohemorrhagic balance) is outlined. Clinical correlates (congenital and acquired bleeding states) to the various physiological stages and the possible effects on hemostasis of the unique acidic environment of the stomach are briefly discussed. PMID- 3321400 TI - Coagulation and fibrinolysis. AB - The two final phases in the haemostatic process, plasma coagulation with the formation of a fibrin clot, and fibrinolysis leading to the dissolution of fibrin clots, are reviewed. Coagulation may be initiated either by reactions occurring between components of the blood alone, the intrinsic pathway, or by reactions which also involve tissue components, termed the extrinsic pathway. In the diagnosis of coagulation disorders, it is convenient to divide the intrinsic pathway into three phases. In phase 1, resulting in the activation of factor (f) X, are involved f XII, XI, VIII and IX, platelet phospholipids, and calcium. In phase 2, prothrombin is converted to thrombin by f Xa in conjunction with f V, phospholipids, calcium. In phase 3, thrombin converts fibrinogen to fibrin, which is then stabilized by f XIII. Antithrombin III is the most important inhibitor. The key component in fibrinolysis is plasminogen, which under the influence of various activators is converted to plasmin. Plasmin is a serine protease and its main in vivo target is fibrin. Alpha 2-antiplasmin and a fast-acting inhibitor of tissue plasminogen activator are the most important inhibitors. PMID- 3321401 TI - Fibrinolysis in the upper gastrointestinal tract. AB - There is a higher level of fibrinolytic activity in gastric venous blood than in arterial blood entering the stomach and peripheral venous blood. The higher activity is probably attributable to blood vessels in the wall of the stomach, which have been shown by histochemical methods to contain fibrinolysis activators. The mucosal cells of the stomach and duodenum also contain fibrinolysis activators. The gastric juice of healthy individuals and peptic ulcer patients show little or no activity, whereas that of patients with erosive haemorrhagic gastroduodenitis shows pronounced fibrinolytic activity. In patients with a history of haemorrhagic episodes there is a considerably higher degree of fibrinolytic activity than in those without a history of bleeding. These findings indicate that there may be a connection between local fibrinolysis and bleeding from the upper gastrointestinal tract. PMID- 3321402 TI - Clinical pharmacology of tranexamic acid. AB - Tranexamic acid (AMCA) is a potent antifibrinolytic drug occurring in two isomeric forms; the antifibrinolytic potency resides in the transisomeric form. The main action of AMCA is blocking of the lysine-binding sites of the plasminogen molecule, which are of importance for the binding to fibrin. This prevents activation of plasminogen by plasminogen activator also absorbed to fibrin. AMCA can be administered perorally or intravenously and is excreted into the urine. It enters tissues and fluids in various concentrations and crosses the placenta. There is no evidence of a thrombogenic effect of AMCA, but in accordance with its action, it prolongs dissolution of fibrin deposits already formed. AMCA is a drug of high clinical value for the treatment of bleedings due to both systemic and local fibrinolysis. PMID- 3321404 TI - Medical principles for treatment of peptic ulcer. AB - The pathophysiology behind chronic gastric and duodenal ulcer is not fully understood, but may be explained as an imbalance between aggressive and defensive factors acting on or in the mucosa. Medical therapy may aim to reduce the aggressive factors acid and pepsin by compounds that neutralize the acid or inhibit the secretion of acid. Peptic activity is reduced by the high acid pH and also by the inhibition. Another group of compounds increases the mucosal defence by stimulating the secretion of mucus, bicarbonate, and growth of the mucosa, or by forming a protective layer on the ulcer crater. Some compounds affect both the aggressive and defensive factors. All modern compounds heal most ulcers in 4 to 6 weeks, but do not alter the natural history of ulcer disease, as indicated by the high rate of ulcer relapses after cessation of treatment. PMID- 3321403 TI - Incidence, diagnosis, and natural course of upper gastrointestinal hemorrhage. Prognostic value of clinical factors and endoscopy. AB - Upper gastrointestinal bleeding is a common emergency, with a constant annual incidence of 90 patients per 100,000 population. Peptic ulcer marked by stigmata of hemorrhage is the commonest source of bleeding (51%), followed by varices (11%), esophagitis (10%), and erosions (5%). Most hemorrhages stop bleeding spontaneously (82%), whereas 18% present with major bleeding, mostly due to erosion of an artery in the ulcer base, requiring hemostatic intervention. Thirty per cent of the peptic ulcers bleed massively, constituting 89% of all major bleeds. Non-ulcer lesions rarely bleed massively (4%). Clinical factors including bleeding pattern before admission and endoscopically observed stigmata of hemorrhage including the visible vessel have been shown to be poor predictors of major hemorrhage. Hemodynamic monitoring remains the most reliable method for distinguishing between patients with major bleeding and need for emergency surgery and patients who will stop bleeding spontaneously. PMID- 3321405 TI - Prostaglandins in clinical treatment of gastroduodenal mucosal lesions: a review. AB - E-type prostaglandins inhibit gastric acid secretion and stimulate gastroduodenal bicarbonate and mucus secretion as well as the formation of hydrophobic surfactant-like phospholipids in the gastric epithelial cells. Furthermore, E type prostaglandins have trophic effects on the gastro-duodenal mucosa. These effects may partly explain the unique protective effects of E-type prostaglandins against experimental damage of gastroduodenal mucosal lesions in animals and humans. E-type prostaglandins have been used in clinical trials on peptic ulcers, on upper gastrointestinal bleeding, and on mucosal lesions induced by non-steroid anti-inflammatory drugs. In nearly all trials natural prostaglandin E2 as well as the synthetic prostaglandin analogues arbaprostil, misoprostol, enprostil, rioprostil, trimoprostil, and rosaprostol accelerated the healing of peptic ulcers compared with placebo. The PGE analogues must be given in gastric acid antisecretory dosage to reach healing rates similar to those of cimetidine. The drugs seem to be safe, and diarrhoea--the main adverse effect--occurs rarely. Future studies are necessary to identify the place of prostaglandins among other drugs used in peptic ulcer treatment. In the treatment of acute upper gastrointestinal bleeding, arbaprostil was not more effective than placebo in spite of several case reports suggesting that prostaglandin E analogues would be helpful in these situations. E-type prostaglandins were effective in preventing gastroduodenal mucosal lesions caused by non-steroid anti-inflammatory drugs, but the long-term efficacy of prostaglandins has to be established in studies on patients under continuous anti-inflammatory treatment. PMID- 3321406 TI - Endoscopic control of major ulcer bleeding. AB - Emergency surgery for bleeding ulcer still carries a significant risk. Moreover, most patients with major ulcer bleeding are poor surgical risks. Non-surgical methods that are safe and reliably control major bleeding are therefore much warranted. The most promising of various non-operative methods under investigation seems to be endoscopic application of heat delivered by laser, heater probe, or electrocoagulation. In the present study monopolar electrocoagulation with a wet probe reliably controlled major ulcer bleeding in 51 (66%) of 77 patients hemodynamically assessed as requiring emergency surgery. The endoscopic success rate in patients with gastric or duodenal ulcer was 76% and 56%, respectively. It was particularly high (87%) in 23 patients, 17 of whom fulfilled clinical criteria of having stress ulcers. The mortality rate in patients with endoscopically controlled bleeding did not differ from that in 190 patients with spontaneous cessation of ulcer bleeding (8% and 6%, respectively), none of which exsanguinated. PMID- 3321407 TI - Tranexamic acid in acute upper gastrointestinal bleeding. AB - The effect of the antifibrinolytic substance, tranexamic acid, has been studied in 5 double-blind, randomized, placebo-controlled trials in patients with acute upper gastrointestinal bleeding. The results of these trials have varied with regard to blood transfusion requirements and the frequency of operations. All of the studies have shown lower mortality in patients treated with tranexamic acid. Thus tranexamic acid would seem to be indicated in acute upper gastrointestinal bleeding. PMID- 3321408 TI - Interstitial pneumonitis and hepatitis after transfer of bone marrow cells bearing the lpr gene to irradiated recipients: a disease due to large granular leucocytes? AB - Mice bearing the 'auto-immune' lpr gene develop a lympho-proliferative disease associated with the production of various antibodies. Lethally irradiated recipients were grafted with bone marrow cells (BMC) from syngeneic mice with or without the lpr gene. After 6 months, the survivors were 0/24 and 16/20 for the recipients of lpr and normal BMC respectively. The mortality rate was independent of the presence of T lymphocytes among the BMC. Histological evaluation showed that hepatitis, interstitial pneumonitis, and sclerosis of lymphohaemopoietic organs were the major causes of death for the recipients of lpr BMC. Hepatitis was associated with an increase in the number of liver interstitial cells (LIC) from about 2 X 10(6) up to about 10(7) cells per liver. The LIC associated with the hepatitis were composed of polymorphonuclear leucocytes and large mononuclear leucocytes, showing phenotypic (i.e. Thy.1+, asialo GM1, presence of cytoplasmic granules) and functional (i.e. non-phagocytic and cytolytic) properties of NK cells. The disease can be distinguished both from the spontaneous disease of the lpr mice (by the absence of 'lpr cells' and of anti-DNA antibodies) and from graft versus host disease by the absence of cutaneous and intestinal lesions. It may represent a model of tissue injury mediated by large granular leucocytes. PMID- 3321410 TI - Analysis of the antigenic profile of Mycobacterium leprae: cross-reactive and unique specificities of human and rabbit antibodies. AB - Thirty-two mycobacterial components were detected by antibodies contained in leprosy patients' sera across the clinical spectrum and rabbit anti-M. leprae hyperimmune sera by western blot analysis of armadillo-derived M. leprae antigen preparations. Sera of borderline tuberculoid patients were found to contain antibodies recognizing 18 M. leprae components. While the reactivity of the sera on the lepromatous pole seemed to be distributed over the entire molecular weight range, most of the reactivity in the borderline tuberculoid patients was directed at higher molecular weight components (greater than 70,000). Identification of a series of previously unrecognized M. leprae components offers new possibilities in regard to the potential use of these antigens as targets for immunodiagnosis. Antibodies contained in the rabbit anti-M. leprae sera reacted with 19 M. leprae components. Antigens migrating at 64,000, 38,000, and 22,000 were detected by the rabbit sera only. Evidence of extensive cross-reactivity between M. leprae and BCG organisms emphasizes the need to use well-characterized antibody probes to determine the specificity of select mycobacterial antigens. The potential usefulness of rabbit monospecific hyperimmune sera to select M. leprae fractions in immunodiagnosis, in immune regulation studies, or as a tool to screen for mycobacterial products in lambda gt11 phage lysates of E. coli is discussed. Select M. leprae components were partially purified and their recovery assessed through SDS-PAGE analysis of Coomassie blue-stained gels. PMID- 3321409 TI - Macrophages in T and B cell compartments and other tissue macrophages recognized by monoclonal antibody MOMA-2. An immunohistochemical study. AB - A new monoclonal antibody, MOMA-2, is described, which recognizes monocytes and macrophages in the mouse. The antibody reacts with the majority of mononuclear phagocytes in various tissues as determined by immunohistochemistry. It differs from other macrophage markers that have been described by the strong reaction with macrophages in the lymphoid organs such as the tingible body macrophages and macrophages in T cell-dependent areas. The antibody recognizes predominantly a cytoplasmic component, although a membrane component can also be demonstrated. Isolated Langerhans' cells, interdigitating cells and dendritic cells, members of the mononuclear phagocyte system that are involved in antigen presenting, stain weakly with the antibody. Because of the intense staining the antibody is very useful for defining tissue macrophages by immunohistochemistry. PMID- 3321411 TI - Varicella and life-threatening streptococcal infection. AB - Four children with varicella who subsequently developed life-threatening infection with Streptococcus pyogenes are reported. The need for increased awareness of this potentially lethal complication of what is usually a benign exanthem is stressed. PMID- 3321412 TI - Norfloxacin versus co-trimoxazole for treatment of urinary tract infections in adults: microbiological results of a coordinated multicentre study. AB - In a prospective, coordinated, double-blind multicentre trial, outpatients with urinary tract infections were randomized to 7 days b.i.d. treatment with norfloxacin 200 mg or 400 mg or trimethoprim/sulfamethoxazole. The most prevalent species was Escherichia coli (76.6%) followed by Staphylococcus saprophyticus (14.1%), the latter of which showed a marked seasonal variation with peak incidence during late summer. Minimum inhibitory concentrations (MICs) of 11 antibiotics for 651 pre-treatment bacterial strains were studied. Norfloxacin was found to be active against all isolates with MICs less than or equal to mg/l for gram-negative and less than or equal to 8 mg/l for gram-positive isolates. Reduced susceptibility to norfloxacin was seen in 2 strains of E. coli and 1 of Klebsiella pneumoniae from patients with persisting or relapsing infections following treatment with norfloxacin 400 mg b.i.d. Of other antibiotics tested, ampicillin, cephalothin and sulfamethoxazole were found to have poor activity against many gram-negative isolates while nalidixic acid and mecillinam lacked activity against all gram-positives. Cefotaxime, gentamicin, trimethoprim and trimethoprim/sulfamethoxazole were generally highly active against the isolated bacterial strains. PMID- 3321414 TI - Invasive pulmonary aspergillosis: a diagnostic and therapeutic problem. Clinical experience with eight haematologic patients. AB - Eight patients with haematologic malignancies contracted fatal invasive aspergillosis during an outbreak. Five patients were neutropenic. Bronchofiberoscopic examination with microbiology specimen brush and bronchoalveolar lavage yielded Aspergillus fumigatus in only 2/5 patients examined. The specific diagnosis reached during lifetime in 5 patients was based on a combination of invasive procedures (lung biopsy in 2, percutaneous lung puncture in 1), the presence of a lung abscess (3 patients), seroconversion (1 patient), and purulent maxillary sinusitis caused by A. fumigatus together with repeated abundant growth of A. fumigatus in the sputum (1 patient). Six patients received amphotericin B. The infection was temporarily controlled only in 2 bone marrow transplant recipients whose granulocyte counts recovered. In 3/8 patients the pneumonia was of polymicrobial aetiology, Mycobacterium tuberculosis (2 patients), Pneumocystis carinii (1 patient), and Legionella pneumophila (1 patient) being the other microbes involved. 3/4 bone marrow transplant recipients with aspergillosis had been transplanted for chronic myeloid leukaemia, supporting the previously reported association of bone marrow transplantation for chronic myeloid leukaemia and the risk of invasive aspergillosis. Improved diagnostic methods for earlier definitive diagnosis of invasive aspergillosis as well as more efficacious and less toxic antifungal agents are needed to allow early treatment. PMID- 3321415 TI - Pulmonary cryptosporidiosis occurring in a bone marrow transplant patient. AB - We describe what is believed to be the first bone marrow transplant patient, a 32 year-old man, in whom pulmonary cryptosporidiosis was associated with terminal respiratory failure. The diagnosis, treatment and postmortem histology are discussed together with a brief review of the literature. PMID- 3321413 TI - Infectious complications in patients undergoing marrow transplantation: a prospective randomized study of the additional effect of decontamination and laminar air flow isolation among patients receiving prophylactic systemic antibiotics. AB - 99 patients with hematological malignancies underwent allogeneic marrow transplantation from HLA-identical sibling donors and were randomized to receive one of two forms of infection prophylaxis while granulocytopenic: (1) prophylactic systemic antibiotics in a conventional hospital room (PSA, 50 patients) or (2) decontamination, isolation in a laminar air flow room and the administration of prophylactic systemic antibiotics (LAF + PSA, 49 patients). Only 1 patient (3%) in the LAF + PSA group acquired septicemia while granulocytopenic compared to 11 (24%) patients in the PSA group (p less than 0.005). Three patients (6%) in the LAF + PSA group acquired major localized infections compared to 9 (18%) in the PSA group (p = 0.06). There was no significant difference in days in hospital post transplant, days of granulocytopenia, days of fever, incidence of acute graft-versus-host disease, interstitial pneumonitis or overall survival. We conclude that the use of prophylactic systemic antibiotics added to decontamination and laminar air flow isolation of patients undergoing marrow transplantation significantly reduces the incidence of septicemia in the granulocytopenic period. PMID- 3321416 TI - Pathogenetic and serological aspects of pulmonary aspergillosis. AB - Af is an important pathogen of the bronchopulmonary system, and the clinical spectrum encompasses aspergilloma, CNPA, IPA, ABPA, bronchial asthma, and allergic alveolitis. Bronchial carriage may, however, not always be associated with pathological effects. The polymorphism of the aspergillus-related disorders seems mostly to depend upon the different responses of the hosts. This review considers the antigenic composition of Af and specific antibody responses in man in relation to the pathogenesis and diagnosis of the various forms of pulmonary aspergillosis. More than 200 macromolecular components have been listed for Af and more than 30 antigens found to react with human sera. Serum antibodies to Af are common in healthy subjects. Schonheyder and his associates (A-L) have shown that IgG, IgA and IgM antibodies in healthy subjects are directed towards antigens to which also patients with aspergillosis strongly react. With immunofluorescent staining these antigens were found to be associated with hyphal walls, and a MW 470,000 fraction from ruptured mycelium was most reactive in ELISA. The respiratory tract appears to be the major route for exposure since the humoral responses include IgA class antibodies, and sIgA antibodies are found in bronchial secretions. Moreover, IgG antibody levels to the MW 470,000 fraction correlate with occupational exposure and smoking habits. In patients with cystic fibrosis high IgG antibody levels to MW 470,000 and MW 25,000-50,000 antigen fractions were associated with the carriage of Af in the sputum. An individual patient's level of IgA antibodies to the MW 470,000 fraction was inversely related to the Af carrier rate, and this was also true for IgE dependent reactivity to Af antigens. These observations indicate that IgG antibodies to some antigens mirror the extent of antigenic exposure, whereas some IgA and IgE antibodies may play a protective role against bronchial colonization with Af. IgG antibody determinations by ELISA were found to provide a higher diagnostic efficacy in pulmonary aspergillosis than IgA antibody assays. With IgG antibodies there were statistically significant differences between patients and the controls and there was little overlap of ELISA values between the groups. The fractions of MW 250,000 with catalase activity and MW 25,000-50,000 with protease activity, were most suitable for serological diagnosis. A gel immunoelectrophoretic assay proved Af catalase to be a major diagnostic antigen in patients with aspergilloma or with an apical aspergillus lung infiltrate.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3321417 TI - Mechanisms in organ allograft rejection. An experimental and clinical study. AB - Experimental and clinical aspects of organ allograft rejection were studied. The grafts of ten patients subjected to transplantectomy due to irreversible rejection or viral infection were investigated with immunohistochemistry. T lymphocytes were abundant in the cellular infiltrates of the rejected grafts and cells with 'helper/inducer' phenotype were more numerous than cells with 'suppressor/cytotoxic' phenotype. The expression of HLA-DR antigens was found to differ from that of HLA-DQ antigens in healthy human kidneys as well as in infected or rejected kidney grafts. HLA-DR but not -DQ antigens were thus detected in proximal tubular cells and increased during rejection or infection. Serum levels of interferon were found to be related to the occurrence of clinical signs of rejection or viral infection in renal transplant patients. Class II MHC antigen expression and cellular infiltrates were immunohistochemically characterized in untreated rejecting rat kidney grafts and were compared to the reactions of syngeneic renal grafts in the same model. The infiltrates of the syngeneic grafts were smaller and occurred later than those of the allografts and were dominated by cells with the 'helper/inducer' T cell phenotype. The number of class II antigen expressing renal tubules was markedly increased in allogeneic grafts and, to a lesser extent, also in syngeneic grafts. The effects of different monoclonal T cell antibodies were investigated in a rat heart allograft model. A 'pan' T cell antibody and a 'suppressor/cytotoxic' T cell antibody significantly prolonged graft survival and caused expression of class II antigen as well as of T cell 'suppressor/cytotoxic' antigen on graft parenchymal cells. Permanent survival of heart grafts could be achieved after induction with antithymocyte globulin. Grafts functioning for more than eight months were found to have myocardial fibrosis, intimal thickening and fibrosis of vessels, mild lymphocyte infiltration and increased class II antigen expression. The changes observed were similar to those seen in chronic rejection. PMID- 3321418 TI - [Drug treatment of chronic inflammatory intestinal diseases with special reference to 5-azosalicylic acid]. AB - Chronic inflammatory bowel diseases are probably due to stimulation of the intestinal immune system by multiple, so far unknown antigens. Chronic inflammatory bowel diseases can be contained but not healed by corticosteroids, sulfasalazine (SASP), azathioprin and metronidazol. Healing may be expected by direct pharmacological intervention in the intestinal immune system, but these are not yet available. -5-aminosalicylic acid may replace SASP in the treatment of ulcerative colitis. When administered locally 5-ASA may be effective in cases of corticosteroid-resistant distal colitis. Controlled studies are needed before the perspectives for 5-ASA in the treatment of Crohn's disease can be assessed. PMID- 3321419 TI - [Chylothorax: treatment using talc pleurodesis]. AB - Chylothorax is a rare complication of lymphoma with a poor prognosis. The treatment is not well established. We report a case of lymphoma complicated by bilateral chylothorax in which, despite optimal chemotherapy and radiotherapy, pleural effusion persisted. Pleuroscopy was performed under local anesthesia, followed by pleural instillation of pure talc. The immediate result was satisfactory and six months later there was no recurrence of chylothorax. Talc pleurodesis appears to be a simple and safe way of treating chylothorax resistant to conventional therapy. PMID- 3321420 TI - [Fibrinolysis in acute myocardial infarct]. AB - Fibrinolysis has opened up a new avenue in the treatment of acute myocardial infarction (AMI). In principle, the rate of reperfusion depends on the type of compound used, the mode of administration and the time between onset of symptoms and the beginning of treatment. With intracoronary streptokinase the reperfusion rate is of the order of 85%. Intravenous urokinase administered as a bolus results in a reopening rate of 50-60%; a similar rate of reperfusion is achieved with rt-PA as infusion, while i.v. streptokinase produces about 50% reopened coronary vessels. The final infarct size is decreased in 70% of patients if fibrinolysis is initiated within 2.5 hours after the onset of symptoms and followed by reopening of the occluded vessel. This results in a lowering of in hospital mortality, which in various studies is of the order of 45-60%.- Bearing in mind the contraindications, fibrinolysis should be initiated within 3 hours. Hemodynamic improvement by a decrease of infarct size may also be achieved beyond 3 hours in large anterior myocardial infarctions and in posterior infarctions with cardiogenic shock. Early initiation of thrombolysis is of major importance in improving left ventricular function and lowering mortality following acute myocardial infarction. Therefore, prehospital thrombolytic therapy should be considered. - In the postinfarction phase coronary angiography is indicated in patients with angina at rest, stable angina of ECG signs of ischemia. In this situation transfer to a specialized cardiology division for possible percutaneous transluminal angioplasty is indicated. - Reocclusion after successful thrombolysis occurs in 20-30%, and it is therefore important to avoid reinfarction to improve the long term prognosis after AMI.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321421 TI - [Dysfunctions of heart valve prostheses and their surgical treatment]. AB - Today the dysfunctions and complications relating to prosthetic cardiac valves are less frequent than 15-20 years ago. The materials used to manufacture mechanical cardiac valves, e.g. carbon pyrolyte, are much more resistant than Teflon or Derlin, and wear is therefore an exceptional event. In regard to bioprostheses, research is now aimed at preventing calcifications, tears and deterioration. Complications such as thrombosis and thromboembolic accidents are seen with all prosthetic cardiac valves and affect mechanical valves rather than bioprostheses. Hemorrhage, a complication of anticoagulant therapy, can be seen in any patient with a prosthetic cardiac valve undergoing such treatment. This complication is far less frequent in patients with a bioprosthesis since most of these (75%) are not on long-term anticoagulation. Paravalvular leakage is another rare complication related to valvular surgery and is often associated with prosthetic valve endocarditis. Prosthetic cardiac valve endocarditis is a very severe complication with a high mortality rate, and is more lethal when endocarditis occurs soon after surgery (up to 2 months). Elimination of infectious foci before surgery, observation of strict rules of asepsis, a high level of surgical technique, and prescribing of prophylactic antibiotic therapy during surgery, or later if necessary, will reduce the risk of prosthetic valve endocarditis. Where reoperation is decided for the above complications it is almost always necessary to replace the failing prosthetic valve. PMID- 3321423 TI - [Acute therapy of cardiovascular malformations in infancy: non-surgical measures]. AB - Non-surgical acute therapeutic procedures in infants replacing immediate surgery are mainly indicated in life threatening cyanosis and/or cardiac failure in the first 2 to 4 weeks of life. Balloon septostomy replacing surgical creation of an atrial septal defect, and pharmacological manipulation of the ductus with prostaglandin E in newborns (opening of ductus replacing aortopulmonary shunt) or by inhibition of prostaglandin synthesis with indomethacin in premature babies (ductus closure replacing ligation of ductus) are used routinely nowadays. Balloon dilatation of stenotic pulmonic or aortic valves (replacing valvotomy), balloon dilatation of coarctation of the aorta (replacing operative correction) and, rarely, closure of vessels with the help of catheters (replacing ligation) are being increasingly tried in this age group as well, though they do not yet belong to the routine methods. PMID- 3321422 TI - [Prosthesis endocarditis: incidence, diagnosis, therapeutic decisions and prognosis]. AB - In 2711 patients with heart valve replacement performed between 1965 and 1986 the cumulative incidence of prosthetic valve endocarditis (PVE) was 1.19 +/- 0.24% (n = 61). In patients operated on before 1976 (group A; n = 583) early PVE was observed in 3.43%, and in patients operated on between 1976 and 1986 (group B; n = 2128) in only 0.42%. PVE after the 60th postoperative day occurred with a linear incidence of 0.21 events per 100 patient-years (A: 0.11%; B: 0.27%). In 54% of PVE cases the aortic, and in 34% the mitral was involved; in 12% both left sided prostheses were involved after double valve replacement. In the four weeks before the manifestation of initial symptoms of PVE, bacterial infections and diagnostic or therapeutic interventions had occurred in 74.2%. All interventions had been performed without endocarditis prophylaxis. Diagnosis of PVE was established in 57% by history and clinical examination, in 20% by microbiologic examinations and in 12% by echocardiography. Due to improved diagnostic methods and earlier surgical intervention, mortality declined during the follow-up period from 81% (1965-1970) to 18% (1981-1986). The prognosis was worse in patients who developed therapy-resistant heart failure due to hemodynamically significant prosthetic valve malfunction, or who had sepsis that persisted for more than 72 hours despite antibiotic therapy, major septic embolism or acute renal failure. The retrospective prognosis was more favourable for patients with early valve re replacement than for patients who had been treated medically alone. PMID- 3321424 TI - [Results of quantitative Doppler echocardiography in the diagnosis of cardiac malformations in children]. AB - To assess the reliability and precision of quantitative data obtained by pulsed and continuous echocardiography in congenital cardiac malformations, we have examined 113 children aged 1 week to 17 years 5 months. 91 patients presented with right ventricular outflow tract obstructions (13 valvular pulmonary stenoses, 78 complex cardiac lesions); in 9 a left ventricular outflow gradient and in 13 an aortic coarctation was present. The measurement obtained by the Doppler method were compared to those obtained within 24 hours during cardiac catheterization. Furthermore, in 25 patients without shunt (essentially rheumatic valvulopathies) measurement of cardiac output by pulsed Doppler has been compared to measurements obtained by dye dilution curves with Cardiogreen.--The correlations between Doppler values and measurements taken during cardiac catheterization were excellent for straight pulmonary stenoses (r2 = 0.94) and even for right ventricular outflow gradient in complex anomalies (r2 = 0.93); it was slightly less good for the aortic stenoses (r2 = 0.80) and disappointing for the gradient across the coarctation (r2 = 0.50). Calculation of cardiac output in the pulmonary artery or the aorta by pulsed Doppler shows a good correlation with the results obtained by dye dilution curves with Cardiogreen (r2 = 0.75). It is concluded that the precision of Doppler measurements is excellent in pulmonary stenoses and satisfactory in the aortic stenoses. Hence in many cases an invasive procedure by catheterization can and should be avoided. PMID- 3321425 TI - [Intensive insulin therapy in adolescents with type 1 diabetes mellitus: initial experiences with a semiautomatic insulin injection device (the insulin pen)]. AB - Recently new pen-like technical devices (Insulin-Pen) for the administration of insulin have become available. With the new device, short acting insulin is injected before meals and, in addition, a long acting insulin before bedtime (basis-bolus insulin regime). A group of 19 adolescents with type I diabetes mellitus (7 girls, 12 boys, age 12-18 years) have been trained during a short hospital stay (4-5 days with intensive teaching) in the new insulin regime. Experience, now amounting to 131 patients-months, has been favourable without exception. Acceptance is good, and none of the adolescents would prefer to go back to the conventional insulin regime with two injections. Regained flexibility with the amount and timing of meals, and the possibility of reducing the number of meals, have been mentioned as the principal advantages of the new system. The intensified self-monitoring of blood glucose usually was the most cited disadvantage. However, several adolescents felt more assured in daily life with a knowledge of blood glucose levels. Compliance in the management of diabetes during puberty increased markedly; as a result, longterm metabolic control improved significantly. The glycosylated hemoglobin A1 was 9.9 +/- 0.8% before and 7.7 +/- 0.5% (normal less than 8%) with the new insulin regime (p less than 0.001). It is concluded that the use of new pen-like insulin injectors helps to improve metabolic control as well as life quality in insulin-dependent adolescent diabetics. However, of equal importance is instruction by the diabetologist with respect to new possibilities and limitations, particularly the new rules of diet. PMID- 3321426 TI - [Quantitative detection and elimination of neuroblastoma cells in vitro. Comparative study of the efficacy of an immunomagnetic method and lymphokine activated killer cells]. AB - Much effort is devoted to eliminating residual tumor cells - which escape detection by conventional methods - from remission bone marrow harvested for autologous transplantation. The quantitative determination of the efficacy of these purging methods is generally difficult. This report describes an in vitro reproducible tumor model. Normal mononuclear blood cells were deliberately contaminated with cells from the human neuroblastoma cell line SK-N-AS. The frequency of clonogenic SK-N-AS cells was determined in limiting dilution culture before and after treatment. Two methods of purging these tumor cells from the mixed cell suspension were compared, 1) an immunomagnetic method taking advantage of the existence of a monoclonal antibody (mAb) specific for 90-95% of the tumor cells, and 2) a method based on cell mediated cytotoxicity testing the activity of previously lymphokine activated killer (LAK) cells. Immunomagnetic purging eliminated 90% (1 log) of all SK-N-AS cells and 99% (2 log) of the mAb-binding clonogenic tumor cells. In contrast, LAK cell treatment removed only between 0.1 to 0.3 log (23-50%) of the clonogenic SK-N-AS cells. PMID- 3321427 TI - [Characteristics of respiratory functional involvement in MacLeod's syndrome (or Swyer-James syndrome)]. AB - MacLeod's syndrome (Swyer-James' syndrome in the child) is a radiologic entity: hyperlucency of one or several lobes, or even of one lung, scarce hilar shadow on the same side as the abnormal transradiency, and barely visible arterial network on the abnormal side of the thorax. Distal bronchiectases (bronchography) and abnormal distal bronchi (necropsy) suggest that this disease may be due to bronchiolitis in childhood. An obstructive pulmonary disorder, assessed by pulmonary function tests, has been described in this syndrome. However, neither the prevalence nor the severity or evolution of the obstructive defect are known. We have studied two such patients for 5 and 12 years respectively: during this long follow-up period the obstructive disorder, albeit severe, remained stable. We have also analysed the 75 cases in the literature in which pulmonary function tests are available and comparable. We have been able to show that (1) an obstructive disorder is frequent in MacLeod's syndrome, (2) the severity of this disorder differs markedly between patients, and (3) this airflow limitation is probably stable on a long-term basis. These findings are compatible with the pathogenetic hypothesis at present accepted, ie bronchiolitis during childhood, and suggest that the inflammatory bronchial disease may have been generalized in many such patients. PMID- 3321428 TI - [Adenocarcinoma of the cervix in Peutz-Jeghers syndrome. Case report and review of the literature]. AB - The incidental finding of "adenoma malignum" or minimal deviation adenocarcinoma (MDA) of the cervix in a 38-year-old woman with Peutz-Jeghers syndrome (PJS) is reported and the literature is discussed. This highly differentiated form of adenocarcinoma is extremely rare but, like some other rare neoplasms, may occur more frequently in patients with PJS syndrome. Since the prognosis of MDA is considered poor and the histological diagnosis is often missed on biopsy, the importance of closely correlating clinical and pathological findings is emphasized. PMID- 3321429 TI - [Computer-assisted assessment of the 24-hour blood pressure profile in essential and secondary hypertensive patients]. AB - In 17 essential hypertensives, 13 secondary hypertensives and 9 normotensives, noninvasive 24 h blood pressure monitoring was performed. By a computer-aided evaluation according to the Cosinor method, circadian periodicity was quantified and expressed as a coefficient of periodicity in %. This coefficient for systolic pressure was higher in essential hypertensives and normotensives than in secondary hypertensives (42.9 +/- 18.0 et 43.0 +/- 16.7 versus 28.2 +/- 17.7; p less than 0.05). The circadian periodicity of diastolic pressure showed no significant differences. Despite the large overlap, coefficients of periodicity below 20% for systolic pressure may suggest secondary hypertension. PMID- 3321430 TI - [Hemostasis. Disorders of hemostasis in dental medicine]. PMID- 3321431 TI - [Glass ceramics. Special application: nonmetallic cast fillings for the lateral teeth]. PMID- 3321432 TI - [Individual impression spoons. New manufacturing procedures for individual impression spoons]. PMID- 3321433 TI - [The administration of hormones in the breeding mare]. PMID- 3321434 TI - Endothelial cell procoagulant properties and the host response. AB - These studies of endothelial cell coagulant properties indicate the potentially active role of endothelium in the modulation of procoagulant and anticoagulant mechanisms. In addition, they draw attention to the different types of mechanisms that function in the maintenance of hemostasis and the induction of thrombosis. Hemostasis requires a rapid and complete response to injury in order to serve the host effectively; the optimal response to a penetrating injury involves rapid formation of a thrombus to prevent extravasation and maintain hemodynamics. In contrast, thrombosis could involve a more subtle and gradual modulation of cellular coagulant properties. An inflammatory mediator such as interleukin 1 could shift vessel wall coagulant properties over hours, and when coupled with an additional stimulus, such as perturbation of blood flow, could result in thrombus formation. The latter clot would form on a morphologically intact but functionally altered endothelium. Perturbation of endothelial cell coagulant properties by physiologic mediators of the host response may provide insights into mechanisms through which the vessel wall can contribute to the pathogenesis of thrombotic disease. PMID- 3321435 TI - Thrombin-induced intravascular coagulation: role in vascular injury. PMID- 3321437 TI - Production of platelet-activating factor by endothelial cells. PMID- 3321436 TI - Consequences of leukocyte-vessel wall interactions in inflammatory and immune reactions. PMID- 3321438 TI - Role of heparanase in platelet and tumor cell interactions with the subendothelial extracellular matrix. AB - Dissemination of neoplastic cells within the body involves invasion of blood vessels by tumor cells. Since platelets have been shown to contribute to this process, we studied the interaction in vitro of platelets and malignant cells with the vascular endothelium and its underlying basement membrane-like ECM. A metastatic subline (ESb) of the methylcholanthrene-induced DBA/2 T-lymphoma invaded the vascular endothelium at a higher rate than its parental nonmetastatic (Eb) subline. ESb cells also exhibited a much higher ability to degrade the proteoglycan scaffold of the ECM by means of a specific HS degrading endoglycosidase (heparanase). The interaction of platelets with this ECM was associated with platelet activation, aggregation, and degradation of HS by means of the platelet heparanase. Degradation of ECM-HS was facilitated by proteolytic activity that produced a more accessible substrate for further cleavage by heparanase. A similar enhancement was exerted by plasminogen via the activity of the tumor cells or ECM associated PAs. Heparin and chemically modified heparins that lack anticoagulant activity inhibited degradation of the ECM-HS by heparanase. Interaction of platelets and lymphoma cells with ECM covered with vascular endothelial cells was investigated by SEM and by determination of ECM-HS degradation products. SEM studies demonstrated that platelets may adhere to minor gaps between adjacent endothelial cells and degrade the ECM-HS. Platelets were also shown to recruit lymphoma cells into these interendothelial gaps, suggesting that by binding to ECM and release of heparanase, platelets may play an active role in tumor cell invasion and metastasis. Our observation that nonanticoagulant heparins may interfere with heparanase-mediated degradation of ECM-HS suggests a potential therapeutic use for such heparins in neoplastic disorders. PMID- 3321439 TI - Endothelial cell growth factors and the vessel wall. AB - The role of endothelial cell growth factors in the maintenance of the blood vessel wall is, as we have described here, much more complex than merely stimulating the mitogenesis of endothelial cells. The FGFs are capable of eliciting an array of responses in endothelial cells, some, or all, of which are important for neovascularization and the control of clot dissolution. These endothelial cell responses include protease elaboration, chemotaxis, and mitogenesis. That these growth factors seem neither to be constitutively released into the medium of cultured cells that synthesize bFGF, nor released into the bloodstream in vivo suggests that the temporal and local control of neovascularization may involve the regulation of growth factor release from cells such as endothelial cells, fibroblasts, and macrophages. Although there is no known example of this for bFGF, it is well known that both thrombin and Factor Xa stimulate the release of a mitogenic protein from endothelial cells and that low oxygen tension stimulates the release of macrophage-derived angiogenesis factor. In addition, both TGF beta and heparin alone appear to play a role in wound healing and vessel wall maintenance. The work of Roberts et al suggests that TGF beta is not only angiogenic, but also stimulates the growth of fibrotic tissue as well. Studies on mast cells demonstrated that released heparin is chemotactic for endothelial cells and can potentiate tumor angiogenesis. An attractive hypothesis is that these molecules not only act as FGF potentiators or inhibitors but that they also may exert their angiogenic effects by inducing FGF release from cells. Perhaps angiogenin, an angiogenic molecule with no mitogenic activity, works in this way. However, no evidence as yet exists concerning this point. A second level of control of neovascularization may involve the interaction of FGF with other molecules released into the same microenvironment. For example, thrombin and TGF beta released from platelets, as well as heparin released from mast cells, have all been demonstrated to affect bFGF activity in vitro and may act as modifiers of FGF activity in vivo. Since bFGF can modulate fibrinolytic activity, one could imagine that its release into a wound region of the vasculature could have detrimental effects on clot formation and subsequent wound healing. Thus, the transient inhibition of bFGF activity by TGF beta would allow clot formation before the induction of neovascularization by bFGF, TGF beta thereby playing a role in the regulation of the sequence in which events occur.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3321440 TI - Epidemiology of acute myelogenous leukemia. AB - The epidemiologic literature suggests that environmental exposures, familial susceptibility, and cytogenetic changes affect AML risk in childhood and adulthood. Unfortunately, many studies are limited by inadequate sample sizes, imprecise case definition, or inadequate exposure measurement. Few studies have singled out AML alone, either because of insufficient numbers or because methods of case ascertainment made it difficult to distinguish specific cell types. Studies of total leukemia or all acute leukemias offer insights into potential risk factors for AML, but may also be misleading in instances when few AML patients were actually included. Future studies should include adequate numbers of patients with AML. At the same time, further refinement of case definition through parameters such as specific cytogenetic changes may make risk factor identification in epidemiologic studies more likely. PMID- 3321441 TI - The biology of acute myeloblastic leukemia. AB - Many questions about the biology of AML remain to be answered. The initial genetic lesions that inhibit differentiation and increase the likelihood of self renewal have yet to be identified. Given the heterogeneity of this neoplasm, it is possible that many different mutational events may be capable of triggering leukemia. Alternatively, there may be only a small number of possible initial leukemic mutations, and the heterogeneous phenotype of the disease is determined by the evolution of different subclones that have acquired different secondary mutations. Studies with retroviral oncogenes have suggested that a common secondary event in an evolving myeloid tumor is the development of growth factor independence by either leukemic cell production of CSF or possibly constitutive activation of a CSF receptor. These mechanisms have not yet been established as important in human AML, although there is intriguing evidence to suggest that CSF genes are inappropriately activated in many cases. PMID- 3321443 TI - Current chemotherapeutic treatment approaches to the management of previously untreated adults with de novo acute myelogenous leukemia. PMID- 3321442 TI - Chromosome abnormalities in acute nonlymphocytic leukemia: clinical and biologic significance. PMID- 3321444 TI - Current chemotherapeutic treatment strategies in childhood acute nonlymphocytic leukemia. PMID- 3321446 TI - Treatment of patients with acute nonlymphocytic leukemia not in remission. PMID- 3321445 TI - Allogeneic and autologous bone marrow transplantation for acute nonlymphocytic leukemia. AB - Current results show that 50% of young patients with ANLL who undergo allogeneic BMT experience prolonged DFS and may be cured. Encouraging results with high-dose chemo/radiotherapy and autologous BMT are likewise being reported. In addition, some studies using intensive postremission treatment without BMT have shown results comparable to many transplant series. As better ways of preventing GVHD are found, the morbidity and mortality of allogeneic BMT should be reduced and the benefits of transplantation for curing patients with ANLL should be increased. However, the applicability of allogeneic BMT will remain limited due to the availability of compatible donors whether related or unrelated. Further studies are needed in the use of postremission intensive therapy with and without autologous bone marrow support. However, results to date should engender the same degree of enthusiastic optimism that followed the early reports of improved outcome with allogeneic BMT when applied to first remission patients. PMID- 3321447 TI - Uncommon subtypes of acute nonlymphocytic leukemia: clinical features and management of FAB M5, M6 and M7. PMID- 3321449 TI - Doppler flow measurements in perinatal medicine. PMID- 3321448 TI - Therapy-related leukemia and myelodysplastic syndrome. PMID- 3321451 TI - The umbilical circulation. PMID- 3321450 TI - Blood flow velocity waveforms. PMID- 3321452 TI - Blood flow in the fetal descending aorta. AB - Doppler estimation of the blood flow in the descending aorta of the fetus and waveform analysis of the maximum aortic velocity provide valuable information on fetal circulation. When estimating fetal aortic flow, it is important to consider possible sources of error; even when recording the maximum aortic velocity for waveform analysis, to obtain reproducible results it is important to use a low high-pass filter, a well-defined angle of insonation, and a standardized site of measurement and to avoid periods of fetal breathing and activity. In normal pregnancy the time-averaged mean velocity in the descending aorta is stable throughout the third trimester. The weight-related flow is stable until 37 weeks, after which it falls slightly. The placental proportion of the flow in the thoracic descending aorta decreases toward term. In the aorta of normal fetuses there is positive flow throughout the whole heart cycle, which is due to the low vascular resistance in the placental circulation. The waveform of the aortic velocity can be characterized by the PI, which is stable during the last trimester of gestation. Caution is required when interpreting changes in the aortic PI, as it is not only affected by the peripheral resistance but also by the heart performance. Furthermore, PI is related to fetal heart rate. Near term different values of PI are found in different fetal behavioral states. In fetuses with retarded growth and in fetuses at distress, characteristic changes of the aortic velocity waveform have been reported by several researchers: the end diastolic velocity diminishes and disappears, and in extreme cases a brief reversal of flow in diastole was observed. Consequently, the PI increases in such cases. The absence of the end-diastolic aortic velocity can easily be determined and is the best indicator of fetal status: in fetuses with absent end-diastolic velocity the incidence of perinatal mortality and morbidity is significantly higher than in fetuses with positive flow throughout the cycle. In pregnancies with hypertension or diabetes mellitus, normal aortic flow has been reported, as long as the fetuses were not growth retarded. In cases of severe Rh isoimmunization, the mean aortic velocity correlates with fetal hematocrit. In hypoxic fetuses the mean velocity was reported to correlate with the degree of hypoxia, hypercarbia, and acidosis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3321453 TI - Fetal and neonatal cerebral blood flow. PMID- 3321454 TI - Fetal and neonatal cardiac assessment with Doppler. AB - During recent years, Doppler ultrasound has become an instrument with which the fetal and neonatal cardiovascular system can be examined noninvasively. In fetuses with suspected cardiac anomalies, Doppler examinations can be used to complement two-dimensional and M-mode studies. Information derived from human fetal intracardiac studies has established that the human fetal heart is right heart dominant, less compliant than the adult heart, and changes with advancing gestation. Much work remains to be performed to use this information to better manage ongoing pregnancies, and to optimize transition to neonatal life. PMID- 3321455 TI - Fetal cardiac arrhythmias: Doppler assessment. AB - Pregnancies in which fetal cardiac arrhythmias are present are associated with an elevated perinatal and neonatal mortality. In this group various major and minor fetal malformations, including heart malformations, are more common. FECG and phonocardiogram give some information on the type of arrhythmia in favorable cases. Real-time imaging detects fetal heart malformations and late signs of heart failure. Fetal echocardiogram is of great aid for the classification of the arrhythmia and for the detection of heart malformations. By applying combined real-time linear array and pulsed Doppler technique in cases of fetal cardiac arrhythmia, important information on the fetal circulatory state can be obtained. Estimations of the volume blood flow guide the clinician in the practical handling of these cases. Volume blood-flow estimations can probably detect imminent fetal heart failure. Therapeutic effects can be followed, and the timing of delivery can be optimized taking the circulatory state into account. Within the fetal heart rate range 50 to 250 beats/min adequate blood circulation is usually maintained in the fetus. The peak velocity, the acceleration, and the rising slope are all increased in the postextrasystolic beat, indicating the existence of postextrasystolic potentiation in the fetal heart. These three parameters can be related to the ventricular filling time, supporting the opinion that the fetal heart follows the rules of the Frank Starling relationship. Fetal arrhythmias constitute also an experimental model for the study of fetal cardiac physiology. PMID- 3321457 TI - Doppler assessment in multiple pregnancy. PMID- 3321458 TI - Cerebral malaria: a diagnosis often forgotten in Singapore. PMID- 3321456 TI - Investigation of the uteroplacental circulation by Doppler ultrasound. AB - Doppler assessment of the uteroplacental circulation can be performed easily. In early pregnancy, it may identify pregnancies at risk of developing pregnancy induced hypertension and IUGR. In late pregnancy, a high impedance in the uteroplacental vascular bed indicates that the fetus is at risk of developing hypoxia, but the fetal and umbilical FVW are the best indicators of immediate fetal well-being. Doppler ultrasound also offers the potential for noninvasive experimental hemodynamic studies of the uteroplacental circulation. PMID- 3321459 TI - Thanatophoric dwarfism: three case reports. PMID- 3321460 TI - Case report 448. Osteoid osteoma of left 6th rib with inflammatory reaction in the adjacent pleura and hyperostosis of the adjacent ribs. PMID- 3321461 TI - Ultrasonography of hip joint effusions. AB - In order to evaluate ultrasonography in patients with suspected hip joint effusions, 123 consecutive patients were examined prospectively. Twenty healthy subjects were used as a control group. The normal sonoanatomy, the recommended scanning approach, and the diagnostic features of intra-articular joint effusions are presented. Even minor fluid collections of 1 or 2 ml could be accurately detected. Transient synovitis and fresh hemorrhagic effusions proved to be echofree, whereas clotted hemorrhagic collections or septic arthritis showed non echofree effusions. Based on intraoperative and computed tomography (CT) data, ultrasonography is clearly superior to X-ray films in detecting joint effusions. A negative sonogram will exclude a fluid collection; the depiction of an echofree effusion will virtually rule out septic arthritis. The use of additional imaging techniques can be reduced greatly, as ultrasonography seems to be an improved method for the early diagnosis of septic arthritis. PMID- 3321462 TI - Small-cell osteosarcoma. AB - Small-cell osteosarcoma, a subtype of osteogenic sarcoma, consists of sheets of round cells that produce an osteoid matrix. It may be confused with Ewing sarcoma if the osteoid matrix is not included in the biopsy. The distinctive radiographic features of an osteoblastic tumor and a pattern of permeative destruction will confirm the histologic diagnosis or indicate the true nature if tumor osteoid is not included in the histological sections. We add 13 patients to the 32 previously reported in the literature. Fourteen (31%) of the 45 are living and well, though three have been followed for only 2 months (Tables 1 and 2). The treatments have been so varied that a statistically significant evaluation cannot be developed. The radiographic features are not distinctive, but the diagnosis may be suggested when a tumor has osteoblastic features in the metaphysis and extends well down into the shaft with a pattern of permeative destruction. The radiographic features are especially important when limited biopsies reveal only sheets of round cells, thus suggesting Ewing sarcoma. The presence of an osteoid producing tumor as evidenced by osteoblastic new bone formation will lead to the correct diagnosis. PMID- 3321464 TI - The case for cognitive neuropsychological remediation. PMID- 3321463 TI - The periosteal sunburst reaction to bone metastases. A literature review and report of 20 additional cases. AB - The periosteal sunburst reaction is an unusual response to metastatic bone tumours. Fifty such cases are reported in the literature, and 20 additional cases are reported in this study. The most common primary tumour showing this response is prostatic carcinoma, and the majority of cases are associated with osteoblastic metastases. Twenty percent of sunburst metastases occur in bones distal to the elbow and knee, a much higher prevalence than is found overall in bone metastases. PMID- 3321465 TI - Cardiopulmonary transplantation: an emerging procedure. PMID- 3321466 TI - Sixty years of psychiatry at Carville. AB - The hospital now known as the Gillis W. Long Hansen's Disease Center is the only hospital in the United States solely treating Hansen's disease (leprosy). From the time of its establishment in 1894 until 1923, the psychiatric patients presented treatment and management problems that remained unaddressed. Since 1923, however, psychiatric consultants have provided care and treatment for this segment of the Carville population. This paper presents the findings of three of these consultants for the period 1923 to 1985, and outlines similarities and differences in the diagnoses, treatments, and disposition of patients, as well as indications for future investigations. PMID- 3321467 TI - Cornea donation: increasing tissue supplies. AB - Postmortem cornea retrieval rates are inadequate to meet transplantation demands. Comparison of annual deaths versus donations (1982 to 1985) between Eisenhower Army Medical Center and the Medical College of Georgia reveals that Eisenhower had lower rates of cornea donation. Attitudinal surveys showed that physicians omitting organ donation requests rarely found personal objections to the request. Few house staff were familiar, initially, with correct criteria for cornea donation. Presentation of this information to physicians increased donation requests and consequently organ retrieval. This trial's success prompted requests for expansion of donation information to include other tissues. PMID- 3321468 TI - Diseases related to asbestos exposure: historical perspective. AB - Our goal in this brief and limited historical summary of asbestos-related diseases has been to bring the clinician up to date with the current status of this important medical and public health issue. The references will provide an information source for those who require more comprehensive knowledge. PMID- 3321470 TI - Squamous cell carcinoma of the esophagus in association with long-term immunosuppressive therapy. AB - An increased risk of skin and lymphoreticular malignancies is well documented in renal transplant patients receiving long-term immunosuppressive therapy, but squamous cell carcinoma of the esophagus is rare. We have reported the first case in the English literature in which there is a strong association between long term immunosuppressive therapy and squamous cell carcinoma of the esophagus. It occurred in a 28-year-old white man ten years after cadaveric kidney transplantation. PMID- 3321471 TI - Thoracic mycotic aortic aneurysm. PMID- 3321469 TI - Diagnostic imaging in children with urinary tract infection: review of current concepts and suggested guidelines. AB - Symptomatic urinary tract infection (UTI) in childhood is estimated to occur with a frequency of up to 3% through adolescence. The practitioner caring for children requires both anatomic and physiologic information concerning the urinary tract to assist in diagnosis, treatment, and prognosis. Advances in diagnostic imaging have resulted in numerous methods for evaluation of the urinary system. These procedures differ in the type of information obtained, risk or discomfort to the patient, and cost. Selection of the proper test(s) requires an understanding of these factors. Based on our survey of recent pertinent literature and our clinical experience, we present guidelines for appropriate diagnostic imaging in children with UTI, and we discuss the benefits and limitations of available imaging techniques along with concepts regarding the pathogenesis of UTI and causes of renal damage from UTI. PMID- 3321472 TI - [Participation of medical workers of Moscow in the Great October Socialist Revolution]. PMID- 3321473 TI - [The role of A.Ia, Krassovskii in the development of Russian surgical gynecology (on the 125th anniversary of the first successful ovariectomy in Russia)]. PMID- 3321474 TI - [Antibacterial preparations in the complex treatment of chronic nonspecific lung diseases]. PMID- 3321475 TI - [Recurrence of cancer of the thoracic segment of the esophagus]. PMID- 3321477 TI - [The ancient Greek physician philosophers Alcmaeon and Empedocles]. PMID- 3321476 TI - [Use of MK-8 glue in therapeutic endoscopy]. PMID- 3321478 TI - [Fungal lesions of the thyroid]. PMID- 3321479 TI - [On the centenary of the Moscow Ostroumov Municipal Clinical Hospital No. 33]. PMID- 3321480 TI - [Hyperinsulinemia as one of the leading factors of the pathogenesis of generalized lipodystrophy]. PMID- 3321481 TI - [Diagnosis of aneurysms of the infrarenal segment of the abdominal aorta]. PMID- 3321482 TI - [Morbimortality caused by the earthquakes of September 1985 in Mexico City]. PMID- 3321483 TI - Prevention of post-tonsillectomy pain with analgesic doses of ketamine. AB - The prevention of postoperative pain in children who had undergone tonsillectomy was investigated in a double-blind trial. Ketamine (Ketalar; Parke-Davis) 0.5 mg/kg was given intravenously before the operation to 20 children and saline to a control group of 20 children. Premedication consisted of oral trimeprazine 4 mg/kg given 2 hours pre-operatively. The anaesthetic technique was standardised. There were no significant differences between the groups pre-or intra operatively. Postoperatively there were significant differences in the measurement of pain but not in that of sedation. No hallucinations were encountered in those receiving ketamine. It is concluded that analgesic doses of ketamine are safe and effective. PMID- 3321484 TI - Victims of snakebite. A 5-year study at Shongwe Hospital, Kangwane, 1978-1982. AB - The epidemiology of snakebite in 251 patients admitted to Shongwe Hospital is described for the period 1978-1982. The incidence of bites, their seasonal variation, environmental and population factors, age and sex variations, the bite site, bite-admission time and bite incidents are analysed. First-aid is frequently administered inappropriately even when given by a health professional. A pregnant patient who went into labour following a mild to moderate cytotoxic snakebite was delivered of a healthy premature infant. The dangers of snakebite during pregnancy are discussed. The mean incidence of snakebite for the 5 years in review was 8,4/1,000 admissions and 34/100,000 population/yr, which is higher than that reported in other surveys. PMID- 3321486 TI - Pleuropericardial effusions in children with non-Hodgkin's lymphoma. A report of 2 cases. AB - Two children with non-Hodgkin's lymphoma (NHL) who presented with pleuropericardial effusions are reported on. Pericardial effusions are very unusual in children with mediastinal nodal NHL. In the first patient, who presented with a pleural effusion and pericardial tamponade, the diagnosis of NHL was obscured by a false-positive report of acid-fast bacilli in the pleural fluid. The second patient presented with a pleural effusion and a pericardial effusion with superior vena cava obstruction. Rapid filling of the serous cavities was a striking feature in both cases. Cytological and biochemical investigation of the pleural fluid and pleural biopsy are of limited diagnostic value. Pleuropericardial effusions in NHL are reviewed. The patients have been in disease-free remission for 18 and 16 months respectively. PMID- 3321485 TI - Human Yersinia enterocolitica infection in the eastern Cape. A report on 18 cases and a review of yersiniosis in the RSA. AB - Yersinia enterocolitica infections with a wide spectrum of clinical presentations have been reported in South Africa. An additional 18 cases were encountered in the eastern Cape region during the period May 1982 - December 1984. Y. enterocolitica isolates comprised 1% of 1,634 faecal examinations performed by the Microbiology Department of the South African Institute for Medical Research in Port Elizabeth during this period, compared with isolation rates of 5.1% for shigellae, 3.7% for salmonellae and 1.3% for Campylobacter jejuni. The majority of Y. enterocolitica infections were in children who presented with diarrhoea and only 2 systemic cases were documented. Although more cases were seen in summer there was no distinct seasonal incidence and this may be attributed to the even climatic conditions prevailing in the region. PMID- 3321488 TI - [Treatment of acute lymphoblastic leukemia in children: current status and perspectives]. PMID- 3321487 TI - [Isoniazid and pyrazinamide: in vitro effect on polymorphonuclear leukocytes]. PMID- 3321489 TI - [A new case of acquired hemoglobinopathy H in refractory anemia with excess of blasts. Review of the literature]. PMID- 3321490 TI - [Clinical features of sclerosing follicular center cell lymphoma of the retroperitoneum]. PMID- 3321491 TI - [Classification, pathogenesis and therapy of vasculitis]. PMID- 3321492 TI - [Detection and follow-up of early arteriosclerotic vascular lesions]. PMID- 3321493 TI - [Naftidrofuryl in the therapy of chronic arterial occlusive disease in the intermittent claudication stage]. PMID- 3321495 TI - [Training by walking and drug therapy of peripheral arterial occlusive disease]. PMID- 3321494 TI - [Effectiveness of intravenous infusion treatment of peripheral arterial occlusive disease with Trental--results of a multicenter double-blind study]. PMID- 3321496 TI - [Significance of blood platelets and coagulation for development, progression and regression of arteriosclerosis]. PMID- 3321497 TI - [Occlusive disease of the extracranial carotid artery: "spontaneous course" and early phase following thrombendarterectomy in image-producing ultrasound]. PMID- 3321498 TI - Computer-assisted subtraction radiography in periodontal diagnosis. AB - In the diagnosis of periodontal disease radiography serves as an adjunct to clinical methods to determine the extent of bone involvement. At subsequent examinations radiography is used to e.g. evaluate the course of disease and the effect of treatment. Differences between examinations due to biological changes often occur against a complex background of stationary anatomical structures and the signals of diagnostic interest are therefore often concealed in structured noise. This imposes severe constraints on the radiographic diagnosis of changes in the periodontal bone over time. A method was developed to reduce the amount of structured noise by subtracting identical image features in serial radiographs which had been digitized, using a high quality TV-camera interfaced with an analog to digital converter and a computer. When the technique was applied to standardized radiographs taken before and after small lesions had been made in the marginal crest of dry human mandibles, observers were able to detect those lesions more accurately than in the conventional radiographs from which the computer-assisted subtraction images were produced. The sensitivity increased from 51% to 91% while the specificity remained unchanged at about 95-96% High geometric reproducibility between radiographs to be subtracted is essential, but serial radiographs taken with angulation differences of 3 degrees yielded a higher degree of diagnostic accuracy, evaluated by the ROC-curve technique, than optimally taken conventional radiographs. Defects, slightly less than a mm wide, made in the marginal crest of dry human mandibles and with a depth in the direction of the radiation beam corresponding to 0.49 mm of compact bone could be detected with a close to perfect accuracy (ROC-evaluation) in subtraction images. Conventional radiographs required lesions more than three times as deep to render a similar degree of diagnostic accuracy. The actual lesion depths were assessed by the Iodine-125 absorptiometry technique. To standardized serial radiographs, taken before and after small marginal defects were induced, various amount of random noise was superimposed by adding to the existing grey-level of each picture element in the digitized radiographs a Poisson random deviate. Resultant noise-degraded images correspond to images produced by from faster imaging systems and it was shown that the application of computer-assisted subtraction yielded a high degree of diagnostic accuracy even when severely noise-degraded images were used. This indicates the potential usefulness of much faster imaging technology than presently used.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3321499 TI - Correction of temporomandibular joint disk displacement by occlusal therapy. PMID- 3321500 TI - Relationship between compressive strength and cervical shaping of the all-ceramic Cerestore crown. AB - The two types of cervical shaping recommended for the preparation of Cerestore crowns are shoulder or deep chamfer. 14 specimens shaped like stylized Cerestore crowns on a shoulder preparation and 14 on a deep chamfer preparation were produced. Thereafter each crown was placed on the epoxy resin die on which it had been produced. 7 epoxy dies from each of the two series were shortened 1 mm occlusally in order to elucidate the importance of the cervical shaping. Placed on its own epoxy die each of the 28 Cerestore crowns was then subjected to occlusal stress until fracture occurred. The force needed for fracture was three times greater for the crowns produced on a shoulder preparation than for those produced on a chamfer preparation. No significant differences was obtained when crowns with the same cervical shaping were tested on intact and shortened dies respectively. PMID- 3321501 TI - [Truly an anniversary: 75 years since "Sykepleien" saw the light of day]. PMID- 3321502 TI - [This is my fondest memory. The long and empty corridors of "Riket"]. PMID- 3321503 TI - [Director Eli Amundsen--a triple anniversary celebrant in Elverum. Interview by Bjorn Arild Ostby]. PMID- 3321504 TI - [For the safety of the public. The Norwegian Nurses Association operated its own labor bureau]. PMID- 3321505 TI - [Marie Louise Falstad--to be president was a job by itself]. PMID- 3321506 TI - [Helga Dagsland: NSF (Norwegian Nurses' Association)--business and organization 1967-73]. PMID- 3321507 TI - [Eli Kristiansen--nurses' education is our most important business. Interview by Jon Karlsen]. PMID- 3321508 TI - [A pioneer among pioneers--Bergljot Larsson--always at the barricades]. PMID- 3321509 TI - [These are my fondest memories. We were like a big family]. PMID- 3321510 TI - [This is my fondest memory. "Waiting benches" in emergency]. PMID- 3321511 TI - [Health economics considerations with modification of death criteria]. PMID- 3321512 TI - [Children's health. 39. Increased understanding for the pediatric department since its start in 1850]. PMID- 3321513 TI - [Anniversary. Memories of Edward, Eden and Bedford College. Interview by Helle Kastholm Hansen]. PMID- 3321514 TI - [Diagnostic possibilities of the physical loading test in persons without symptoms of ischemic heart disease]. PMID- 3321515 TI - [Clinical use of kordaron: new possibilities and limits]. PMID- 3321516 TI - [Medical and socioeconomic aspects of tobacco smoking and its control. 1. The medical and socioeconomic aspects]. PMID- 3321517 TI - [Evaluation of the hypotensive effect of unilateral adrenalectomy in patients with low-renin hyperaldosteronism]. AB - The antihypertensive effect of unilateral adrenalectomy was analyzed in 19 patients with arterial hypertension and primary hyperaldosteronism diagnosed by way comparing clinical findings, a degree of hypokalemia, activity of plasma renin and aldosterone concentration and CT data. A follow-up period after operation was 8-14 mos. Clinical and biochemical findings were compared with the results of morphological investigation of the adrenal glands and kidneys. An antihypertensive postoperative effect was observed in 12 patients: good in 6, moderate in 6, the absence of an antihypertensive effect in 7. Different forms of adrenocortical hyperplasia revealed during histomorphological investigation, endocrine nephropathy of various degree and vascular changes of hypertensive genesis in the renal parenchyma were discussed as causes of residual hypertension. PMID- 3321518 TI - [Central hemodynamic parameters studied by radiocardiography in patients with focal myocarditic cardiosclerosis and patients with congestive cardiomyopathy]. AB - Indices of hemodynamics were defined using the method of radiocardiography in 25 patients with focal myocarditic cardiosclerosis and in 14 patients with congestive cardiomyopathy (CCMP). In most of the patients with focal myocarditic cardiosclerosis these indices did not differ from the control ones whereas in the CCMP patients they showed good correlation with clinical symptoms of heart failure. PMID- 3321519 TI - Comparative effects of retinoic acid and jervine on chondrocyte differentiation. AB - Jervine and retinoic acid are both teratogenic to structures which are initially modelled in cartilage. Differences in periods of maximal sensitivity, as well as in certain aspects of the morphological manifestations of exposure, indicate that these two teratogens act via different molecular mechanisms. Here we compare the effects of jervine and retinoic acid in three culture systems which represent sequential stages of the chondrocyte lineage. Proliferation of pluripotent C3H 10T 1/2 cells was decreased by exposure to jervine but was not affected by retinoic acid. Differentiation of high-density "spot" cultures of embryonic limb bud mesenchyme were sensitive to both compounds. Mature chondrocytes were resistant to jervine but "dedifferentiated" after 48-hour exposure to retinoic acid. We conclude that jervine compromises rapidly dividing chondrogenic precursors, whereas retinoic acid has little effect prior to the expression of cartilage-specific proteins. PMID- 3321520 TI - Epidemiological studies of neural tube defects in Newfoundland. AB - A 9-year survey of neural tube defects in Newfoundland showed (1) evidence for secular variation, with a peak in 1980, but no general downward trend as seen in some other populations; (2) significant geographic variation which did not correlate with hardness or nitrate content of the lake water; (3) a tendency for the proportion of females among anencephalic births to increase with increasing frequency of anencephaly among geographic regions. This supports previous evidence for a female-specific contribution to the causes of increased liability to neural tube defect. PMID- 3321521 TI - Spontaneous regression of tubal pregnancy: current considerations. PMID- 3321522 TI - Recoupment: fear, confusion, and a court date. PMID- 3321523 TI - Medicare recoupment of alleged "overpayments". PMID- 3321524 TI - [Imaging of the spine]. PMID- 3321525 TI - [Instability of the cervical spine: diagnosis and indications for treatment]. PMID- 3321526 TI - [Therapy of bacterial spondylitis and spondylodiscitis]. PMID- 3321528 TI - [Idiopathic scoliosis of children and adolescents: natural history, therapeutic indications and treatment principles]. PMID- 3321527 TI - [Indications, technic and results of surgery of spinal metastases]. PMID- 3321530 TI - [Adult scoliosis]. PMID- 3321531 TI - [Scheuermann's disease]. PMID- 3321529 TI - [Treatment of congenital and paralytic scoliosis]. PMID- 3321532 TI - [Treatment of spondylolisthesis]. PMID- 3321534 TI - [Lumbar disk herniation. Conventional surgery, microsurgery, chemonucleolysis, percutaneous nucleotomy]. PMID- 3321533 TI - [Inflammatory changes in the cervical spine in chronic polyarthritis. Review and retrospective radiologic study of 100 cases]. PMID- 3321535 TI - [Spinal stenosis]. PMID- 3321536 TI - Studying lung cancer in the laboratory: 1--Development of model systems. PMID- 3321537 TI - A measure of quality of life for clinical trials in chronic lung disease. AB - Since the relationships between pulmonary function, exercise capacity, and functional state or quality of life are generally weak, a self report questionnaire has been developed to determine the effect of treatment on quality of life in clinical trials. One hundred patients with chronic airflow limitation were asked how their quality of life was affected by their illness, and how important their symptoms and limitations were. The most frequent and important items were used to construct a questionnaire evaluating four dimensions: dyspnoea, fatigue, emotional function, and the patient's feeling of control over the disease (mastery). Reproducibility, tested by repeated administration to patients in a stable condition, was excellent: the coefficient of variation was less than 12% for all four dimensions. Responsiveness (sensitivity to change) was tested by administering the questionnaire to 13 patients before and after optimisation of their drug treatment and to another 28 before and after participation in a respiratory rehabilitation programme. In both cases large, statistically significant improvements in all four dimensions were noted. Changes in questionnaire score were correlated with changes in spirometric values, exercise capacity, and patients' and physicians' global ratings. Thus it has been shown that the questionnaire is precise, valid, and responsive. It can therefore serve as a useful disease specific measure of quality of life for clinical trials. PMID- 3321538 TI - Mesenchymoma of the lung (so called hamartoma): a review of 154 parenchymal and endobronchial cases. AB - In a series of 154 patients (116 male and 38 female) with so called pulmonary hamartoma the peak incidence was in the sixth decade, with only three patients less than 20 years of age. Sequential radiographs showed that in 55 patients the tumour first appeared in adult life and that in 53 it progressively increased in size. The age incidence and progressive growth leads to the conclusion that the tumour is a benign neoplasm rather than a hamartoma, consisting of various connective tissues intersected by clefts lined by respiratory epithelium. The epithelial elements are regarded as entrapped non-neoplastic inclusions and the tumour as a purely mesenchymal neoplasm: the name mesenchymoma therefore seems the most appropriate. There were two recurrences after simple enucleation, 10 and 12 years later. A total of 142 tumours were parenchymal, and only 12 were endobronchial. All lobes were affected but there was a slight preponderance in the left upper lobe. Four patients had two (synchronous) mesenchymomas. There was an associated bronchial carcinoma in 11 patients, synchronous in six and metachronous in five. PMID- 3321539 TI - Effect of nifedipine on serum theophylline concentrations and asthma control. AB - The effect of adding slow release nifedipine to oral theophylline has been studied in eight patients with stable but symptomatic asthma, a double blind placebo controlled crossover protocol being used. No change in asthma control occurred during the nifedipine treatment period as assessed by serial peak flow measurements and symptom scores. Serum theophylline concentrations were significantly lower after nifedipine than after placebo (6.8 v 9.7 micrograms/ml) and in three patients were well below the therapeutic range (less than 4 micrograms/ml). PMID- 3321540 TI - Effect of sustained release terbutaline on symptoms and sleep quality in patients with nocturnal asthma. AB - The effect of an oral sustained release beta 2 agonist on symptoms, sleep quality, and peak flow rates has been studied in nine patients with nocturnal asthma. Patients received oral terbutaline 7.5 mg twice daily or placebo for seven days in a double blind crossover study and spent the last two nights of each limb in a sleep laboratory. Oral terbutaline improved morning peak flow (259 v 213 l min-1) and decreased nocturnal inhaler usage (1.3 v 1.9) with no alteration in sleep quality as assessed electroencephalographically. The study shows that oral sustained release terbutaline can be useful in the treatment of nocturnal asthma without impairment of sleep quality. PMID- 3321541 TI - Airway response to methacholine during exercise induced refractoriness in asthma. PMID- 3321542 TI - Studying lung cancer in the laboratory--2: Chemosensitivity testing. PMID- 3321543 TI - Comparison of human bronchiolar smooth muscle responsiveness in vitro with histological signs of inflammation. AB - A study was carried out to test the hypothesis that chronic inflammation is associated with increased sensitivity or contractility of human airway smooth muscle. Bronchiolar strips from 30 patients, 12 of whom had chronic bronchitis, were examined in the organ bath for their responses to histamine, methacholine, and leukotriene (LT) C4. The same airways were also studied histologically and small airway disease was quantified by subjective grading of the degree of inflammatory cell infiltration, smooth muscle hypertrophy, fibrosis, and goblet cell hyperplasia. The degree of small airway disease varied widely among patients both with and without chronic bronchitis. Multiple regression analysis failed to show increased sensitivity (-log EC50) to histamine, methacholine, or LTC4 in relation to small airway disease. In contrast, the only significant correlations found were between a decreased -log EC50 to histamine and methacholine and an increased small airway disease score. Contractile responses (Tmax) to histamine and methacholine in peripheral airways tended to be higher in patients with chronic bronchitis than in those without. Tmax was not related to small airway disease scores. These results suggest that chronic airway inflammation does not cause in vitro hyperresponsiveness of human small airway smooth muscle. PMID- 3321544 TI - Effect of high dose inhaled beclomethasone dipropionate on carbohydrate and lipid metabolism in normal subjects. AB - The metabolic effects of four weeks' high dose inhaled beclomethasone dipropionate (500 micrograms twice daily) were studied in nine normal subjects with an open study design. No effect was found on fasting blood glucose concentration or glycosylated haemoglobin concentration. Peak blood glucose concentration 30 minutes after a 75 g oral glucose load was, however, significantly higher (7.1 (SEM 0.2) versus 6.7 (0.1) mmol/l, or 128 (3.6) v 121 (1.8) mg/100 ml). After treatment there was a 36% increase in fasting serum insulin concentration (7.6 (0.7) versus 5.6 (0.5) mU/l) and a 32% increase in the area under the serum insulin concentration curve after glucose challenge. High dose inhaled beclomethasone dipropionate treatment raised the fasting plasma cholesterol concentration (4.62 (0.25) v 4.16 (0.26) mmol/l, or 178 (9.7) v 161 (10.0) mg/100 ml) and high density lipoprotein cholesterol (1.19 (0.065) versus 0.97 (0.065) mmol/l, or 45 (2.5) v 37 (2.5) mg/100 ml). Fasting blood lactate and pyruvate concentrations were also significantly higher and blood glycerol lower. The findings indicate that high dose inhaled beclomethasone dipropionate may disturb both carbohydrate and lipid metabolism. PMID- 3321547 TI - [Psychiatry and politics. Illustrated by Johan Scharffenberg's articles on nazism]. PMID- 3321545 TI - Haemophilus influenzae pneumonia in Melanesian adults: report of 15 cases. AB - In a prospective study of 170 adult patients with acute pneumonia, Haemophilus influenzae was found to be the aetiological agent in 15 cases (8.8%). The diagnosis in all cases was based on positive cultures of blood or percutaneous lung aspirate, or both. Chronic lung disease was significantly more common in patients with H influenzae pneumonia than in patients with pneumonia due to other organisms but age, sex, and smoking history did not differ significantly. Lobar consolidation was the most common radiological pattern, being present in 10 of the 15 cases. Type b was the commonest serotype isolated, but three cases were due to non-typable (non-capsulate) strains. All patients survived, responding well to treatment with penicillin, ampicillin, or chloramphenicol. Haemophilus influenzae should be considered as a possible cause of pneumonia in adults, particularly those with underlying chronic lung disease. PMID- 3321546 TI - Stimulation of the plasma fibrinolytic activity in rats by the prostacyclin analogue CG 4203. AB - In anesthetized rats the intravenous infusion (15-120 min) of the prostacyclin analogue CG 4203 (0.215-2.15 micrograms.kg-1.min-1) resulted in a time and dose dependent shortening of the ex vivo euglobulin clot lysis time (ECLT). This effect that appeared to be significant already in the non-hypotensive dose range of CG 4203, was still existing at 2 hours after cessation of the infusion. The phosphodiesterase inhibitor theophylline (4.64 mg.kg-1 i.v.) potentiated the ECLT shortening effect of CG 4203. Even the highest dose of CG 4203 did not change the plasma fibrinogen levels. In contrast to low molecular weight urokinase (100 PU/ml) CG 4203 (10 microM) did not shorten the in vitro lysis of preformed euglobulin clots from untreated rats nor did it reduce the 125J-fibrin content of human thrombi in the Chandler loop system. From these results it is concluded that intravenously infused CG 4203 increases the plasma fibrinolytic activity in rats by a c-AMP dependent mechanism, probably by release of plasminogen activator. Direct urokinase like activation of plasminogen does not occur with CG 4203. The relevance of this activity is discussed with respect to the CG 4203 treatment of occlusive vascular diseases. PMID- 3321548 TI - [Captopril in intermittent claudication. Case reports from general practice]. PMID- 3321549 TI - [History and evolution of familial hypercholesterolemia]. PMID- 3321550 TI - [Treatment of familial hypercholesterolemia]. PMID- 3321551 TI - [Biochemical defects in familial hypercholesterolemia]. PMID- 3321552 TI - [Use of ultrasonic diagnosis in nephrology]. PMID- 3321553 TI - [A stochastic computer simulation model for integrated zootechnical, veterinary and economic instruction regarding managerial decisions on dairy farms]. AB - A teaching version of a (main frame) simulation model is described in the present paper. The primary purpose of this model is to study the background and effects of management decisions with regard to reproductive performance in dairy cattle. The initial information available is derived from a fertility-health chart, commonly used on commercial dairy farms in the Netherlands. The user than goes through the programme in an interactive manner in order to establish the correct diagnosis as well as to give suitable advice. As all the revenues and costs are simulated, it is also possible to consider the effects of advice from the economic point of view. In imitating real farm conditions as closely as possible, various events and effects of decisions are stochastically involved, i.e. as random samples on appropriate probability distributions rather than as fixed values. People involved in herd health programmes, therefore are given the opportunity of exercising in a field in which farmers cannot permit experiments. The experience gained in using the model in teaching veterinary and agricultural students has been positive so far. PMID- 3321554 TI - [Influenza virus epidemiology and ecology, with special reference to bird species associated with water. Literature review and observations]. AB - Only a limited number of A-subtypes of influenza virus so far caused disease in human subjects, pigs and horses; this occurred in more or less defined areas which occasionally showed epidemic aggravations, becoming apparent as rapidly spreading epidemics or otherwise in even the form of pandemics. However this number of antigenic subtypes was found to be fairly constant and host-specific. Earlier studies were done in domesticated fowl and birds, though particularly in water birds in recent years, and numerous subtypes were detected, only a small number of these subtypes also being found to occur in man, pigs and horses. It became increasingly apparent that particularly mallards, but also other water birds play an extremely important role in the maintenance as well as in the distribution and circulation of these orthomyxoviruses in nature. These infections in water birds were not merely caused by a single subtype but occasionally by two or more antigenically different subtypes. This could be conducive to the appearance of recombinants as a result of genetic rearrangement in the cells lining the alimentary tracts of birds. Occasionally, subtypes observed in man were also found to occur in birds, which gave rise to the question of the extent to which birds are the origin or sources of infections of human epidemics caused by these subtypes. This also holds good for the subtypes in pigs. In addition to a number of oecological and ornithological considerations, reference was also made to systematic facts and routes along which further investigations on the presence of influenza viruses in the world of birds could be taken up, particular attention being paid to migratory birds. As birds of passage pass over and find their way into isolated areas as well as human population centres, these birds play a role which is yet unknown both in the distribution and in the overwintering of influenza viruses. Conditions in which wild and domesticated (water) birds, pigs, horses and man form a chain of close contact, and the areas in which new influenza viruses pathogenic for man are most likely to appear. Studies on the transgression of these barriers of species by subtypes of influenza virus still are entirely separate matter. The fact that a multidisciplinary approach is essential admits of no discussion. PMID- 3321555 TI - A positive B cell crossmatch due to IgG anti-HLA-DQ antibody present at the time of transplantation in a successful renal allograft. AB - The role of a positive B cell crossmatch in renal transplantation is uncertain, partly because of the difficulty in determining the true specificity of the various antibodies that may cause a positive crossmatch. We have used monoclonal antibodies against HLA class I, HLA-DR and HLA-DQ antigens to inhibit cytotoxicity of sera from renal patients, in order to define the specificity of a positive B cell crossmatch. We have used reduction with dithiothreitol (DTT) to identify the immunoglobulin class. These methods were used to identify the specificity and immunoglobulin class of the antibody causing a positive B cell crossmatch in a highly sensitised patient. The results show that the antibody was IgG anti HLA-DQ and the graft was functioning 1 year after transplantation. Immunoperoxidase techniques demonstrated a normal expression of HLA-DQ antigen in biopsies of the transplanted kidney. The successful outcome of the transplant raises questions about the role of anti-HLA class II antibodies in renal transplantation. PMID- 3321558 TI - [Deaconess House Groningen]. PMID- 3321557 TI - [The development of new drugs]. PMID- 3321556 TI - Identification of smooth muscle-derived foam cells in the atherosclerotic plaque of human aorta with monoclonal antibody IIG10. AB - We have developed a monoclonal antibody that specifically interacts with a surface antigen of human fibroblasts and smooth muscle cells. The antibody (antibody IIG10) recognizes a polypeptide of molecular mass 330,000, revealed by immunoblotting in fibroblast and smooth muscle cell extract, but not in vascular endothelial cells, peritoneal macrophages, peripheral blood lymphocytes nor hepatocytes. In tissue sections the antibody stained smooth muscle cells of myometrium, aorta and smaller blood vessels, and fibroblasts of connective tissue. Specificity of the antibody was further confirmed by double staining of aorta sections. Antibody IIG10 was used to identify smooth muscle-derived foam cells in the atherosclerotic plaque of human aorta. PMID- 3321560 TI - [Medical information for nurses. Autologous bone marrow transplantation]. PMID- 3321559 TI - [The leech or Hirudo medicinalis]. PMID- 3321561 TI - [Optimizing ruminant feed rations from the physiological aspect with FURAT, a personal computer program]. AB - Health disorders caused by feeding are a common problem in cattle keeping. For this reason the personal computer program, FURAT, was developed for the calculation and optimization of ruminant feed rations with respect to physiological aspects. With this program, weighed feed rations selected from the feedstuff on the standard list or from a self-drawn up feedstuff list can be tested for their content of various nutrients and compared with the requirements of the animals to be fed. Subsequently in an optimization program using the same feedstuff rations can be worked out for various performance categories ensuring the best possible feeding from the health aspect. With a free choice within a feed range and taking into account the physiological limits of the rumen (maximum compound intake, minimum raw fiber amount in the dry matter, minimum structure in the raw fiber, maximum raw fat in the dry matter) the ration is calculated to achieve a balanced protein-energy ratio. One of the two main nutrients--protein or energy--must amount exactly to the target value in the ration, and the other has to be as close as possible to its target value. From among up to 12 different feedstuff the computer will choose the optimal ration which can be printed with a precise indication of all parameters. The rations worked out for the various performance categories are stored and, at the end of the program, are printed in short form in a letter addressed to the farmer that also lists necessary mineral supplements. PMID- 3321562 TI - [Pyelocystitis in breeding sows]. AB - Pyelocystitis results from ascending infection of the urinary tract with Corynebacterium suis in sows. Infection occurs regularly during coitus by healthy boars, which are often contaminated with Corynebacterium suis. Characteristic clinical signs of pyelocystitis are haematuria, anemia and emaciation. The whole urinary tract shows severe purulent-necrotic inflammation with progressive vascular lesions. Diagnosis is based on clinical, pathological and bacteriological findings. Distinct changes in urine samples are present. Treatment is only successful in sows with intact function of kidneys. In early detected cases treatment can be effective with repeated application of appropriate antibiotics, e.g. penicillin or ampicillin. There are no proven methods of prevention. PMID- 3321563 TI - [Legal aspects of veterinary examinations of horses at purchase with regard to the new high court decision and prevailing dogma]. AB - The existing statutory provisions in connection with the seller's liability for defects of a horse are nowadays unsatisfactory. This has led to an increasing number of cases in which veterinarians have been held liable for the purchaser's damages resulting from an incorrect or incomplete veterinary examination at point of sale. Courts have recently imposed extensive duties of care on the veterinary. He has not only to detect and disclose every minute defect of the horse, but has to give a prognosis of the development of the horse's healthiness and its future capability to meet the purchaser's requirements. If he feels himself unable to give such a prognosis under the circumstances of the particular case he has to state this explicitly. The risks of liability can be minimized by using carefully drafted contracts. PMID- 3321564 TI - [Endometrial cysts in the mare. 2. Clinical studies: occurrence and significance]. AB - Endometrial cysts were found in 11 (13.4%) of 82 mares of various breeds by clinical examinations. Endometrial cysts were diagnosed by hysteroscopy and ultrasonic echography. Typical images are described. The importance of endometrial cysts is discussed with regard to differential diagnosis of early pregnancy and uterine pathology. There was no evidence of cysts in mares under 10 years of age. Mares with endometrial cysts had a 10% higher history of disturbed fertility than mares without endometrial cysts. Seven of nine mares with cystic structures in the uterus became pregnant. Endometrial cysts could be recognized together with embryonic vesicles and pregnancies continued without any complications. They were found as well after parturition in the post partum uterus. PMID- 3321565 TI - [The sexual cycle in the bitch: recent insights and impact on therapy and reproduction control]. AB - Present knowledge about the estrous cycle of the bitch has been reviewed from a morphological, endocrinological and clinical point of view. This cycle is truly biphasic, characterized by its slow motion. It includes pregnancy or pseudopregnancy, and lactation. Corpus luteum function and regression as well as endometrial recovery, following endometrial desquamation at about day 100 of the cycle, are finalized at about days 140 to 150. Soon thereafter, subclinical preparations for the next proestrus can be recognized. Prolactin seems to play an important role as a luteotrophic agent, beginning at about day 30 to 35 of the cycle. Inhibition of prolactin secretion can be used to induce abortion, or to inhibit lactation and to shorten the cycle, or to treat clinical anestrus. Late metestrus and subclinical proestrus, i.e. days 120 to 170 of the cycle, is the most suitable period of the cycle to initiate suppression of the cycle, i.e. prevention of the next estrus, by using progestins with the least tendency for side effects. PMID- 3321566 TI - Decision support systems: the next step. PMID- 3321568 TI - Fixation of vervet monkey oral mucosa for ultrastructural investigation--TEM. AB - This study was undertaken to determine optimal fixation procedure for vervet monkey (Cercopithecus pygerythrus) oral mucosa. Perfusion and immersion fixation were investigated using glutaraldehyde and glutaraldehyde-paraformaldehyde fixatives with either a phosphate or sodium cacodylate buffer as vehicle and with osmolarities varying from 2010 to 320 mosm. Good fixation could not be obtained uniformly or consistently by perfusion. Vervet monkey oral mucosa is best fixed by first perfusing the head and neck of the animal with 250-500 ml 0.9% saline containing Procaine-HCl and heparin, followed by decapitation and immersion of the head in a 2.5% glutaraldehyde: 2% paraformaldehyde: 0.02 M sodium cacodylate buffered fixative (900 mosm) at 4 C for 24 hr. PMID- 3321567 TI - Further classification of skin alkaloids from neotropical poison frogs (Dendrobatidae), with a general survey of toxic/noxious substances in the amphibia. AB - Cutaneous granular glands are a shared character of adult amphibians, including caecilians, and are thought to be the source of most biologically active compounds in amphibian skin. Data are available from one or more species in over 100 of nearly 400 genera comprising the three living orders of Amphibia. Many species contain unidentified substances judged to be noxious based on predator aversion or human taste. Additionally, there is a great diversity of known compounds, some highly toxic as well as noxious, which can be tabulated under four broad categories: biogenic amines, peptides, bufodienolides (bufogenins) and alkaloids. The last category includes alkaloids derived from biogenic amines, water-soluble alkaloids (tetrodotoxins) and lipophilic alkaloids. Most compounds are known only from skin of adult amphibians, but the toxic and noxious properties of eggs and larvae of certain salamanders and toads can be attributed to tetrodotoxins and bufodienolides, which occur also in adult tissues other than skin. Predator aversion and various antipredator behaviors and aposematic colorations clearly prove the defensive value of these diverse metabolites, whether or not they are elaborated primarily (e.g. alkaloids) or secondarily (e.g. some peptides and biogenic amines) for this function. Lipophilic alkaloids include the samandarine alkaloids, known definitely only from an Old World genus of salamanders, and the more than 200 dendrobatid alkaloids. Nearly all the latter are unique to neotropical poison frogs of the genera Dendrobates and Phyllobates (Dendrobatidae), except for seemingly homoplastic occurrences of a few such alkaloids in small brightly colored anurans of several other families. Owing to recent discoveries and new structural information, the dendrobatid alkaloids are here partitioned among the following major and minor classes: batrachotoxins, histrionicotoxins, indolizidines, pumiliotoxin-A class and its allopumiliotoxin and homopumiliotoxin subclasses, decahydroquinolines, gephyrotoxins, 2,6-disubstituted piperidines, 2,5-disubstituted pyrrolidines, pyridyl-piperidines, indole alkaloids, azatricyclododecenes and amidine alkaloids. Except for the steroidal batrachotoxins, and the minor classes of pyrrolidine alkaloids, indole alkaloids and amidine alkaloids, all the above contain a piperidine ring. A large number of piperidine-based alkaloids occur mainly as trace compounds in Dendrobates and remain unclassified; the only water soluble toxin so far discovered in a dendrobatid (Colostethus) is structurally unknown, but conceivably an alkaloid. PMID- 3321569 TI - Some new methods for affixing sections to glass slides. III. Pressure-sensitive adhesives. AB - A variety of polymeric formulations have been evaluated for use as pressure sensitive adhesives in affixing sections of fresh or frozen tissues for histochemistry and other purposes. The best adhesive with respect to water resistance, refractive index, and low temperature tack was polyisobutylene. In mixtures of different molecular weights this adhesive is specially suited for room temperature or cryostat use. Slides coated with this adhesive should only be used with staining or incubation solutions which have been filtered and degassed. Mounting cannot be performed with xylene-containing media, UV-curable monomeric media being favored. For anhydrous processing or nonpermanent preparations, polyethyleneimines, which are soluble in water but insoluble in xylene, may be used. Mixtures of polydimethylsiloxanes can be applied for subsequent temporary mounting with water or aqueous media. PMID- 3321571 TI - [Osteoplastic replacement of defects in the condylar processes using an autograft]. PMID- 3321570 TI - [The use of bone meal in treating deep caries]. PMID- 3321572 TI - [Use of demineralized bone in treating mandibular fractures]. PMID- 3321573 TI - [A new surgical method of treating unilateral congenital cleft palate]. PMID- 3321574 TI - [Restoration of the destroyed crown of multirooted teeth]. PMID- 3321575 TI - [Experience in using adhesion bridge-like dentures]. PMID- 3321576 TI - [Index of the ash content of technical dental investment materials]. PMID- 3321577 TI - [Prosthetic characteristics in the presence of defects in the maxillary dentition and hard palate]. PMID- 3321578 TI - [Anatomy of the maxillofacial area in the 1st Russian anatomical atlas]. PMID- 3321579 TI - [Provision of dental care to Shitov's partisans and Zhukov's partisan unit forces in the Ukraine during World War II]. PMID- 3321581 TI - [The physiological role of the dental fluid]. PMID- 3321580 TI - [Rehabilitation of patients with dentition defects and deformities due to the complications of dental caries]. PMID- 3321582 TI - Cyclosporine drug interactions: a review. PMID- 3321583 TI - Comparison of EMIT versus bioassay to evaluate inactivation of tobramycin by piperacillin. AB - We evaluated and compared the sensitivity of enzyme multiplied immunoassay (EMIT) and bioassay techniques in detecting the degree of inactivation of tobramycin by piperacillin in serum specimens. Specimens were prepared to contain initial tobramycin concentrations of 10 micrograms/ml and piperacillin concentrations of 62.5, 125.0, 250.0, and 500 micrograms/ml. The samples were stored at room temperature (25 degrees C), in the refrigerator (4 degrees C), and in the freezer (-10 degrees C) for up to 7 days. Tobramycin concentrations were determined by the two assay methods at the conclusion of 1, 3, and 6 h and 1, 3, 5, and 7 days of storage. The percentage of tobramycin activity as measured by EMIT and bioassay differed throughout the study period. Statistical analysis revealed that the assay method was the only significant variable to contribute to the variability observed in the differences of tobramycin concentration. Our results suggest that the bioassay technique is more sensitive than the EMIT assay for detecting the degree of inactivation of tobramycin by piperacillin. The EMIT assay overestimates tobramycin concentrations, which may be due to measurement of active and inactive tobramycin. PMID- 3321584 TI - The role of class I and class II MHC antigens in the rejection of vascularized heart allografts in mice. AB - We have examined the role of entire major histocompatibility complex (MHC) disparity, individual class II or class I alloantigens in the rejection of vascularized heart allografts. Our results demonstrate that entire MHC, as well as both class II and class I disparities, may induce acute heart graft rejection or severe and irreversible heart muscle destruction. However, in 1 of 2 combinations differing at class II and 1 of 5 differing at class I, hearts have shown a good function greater than 100 days postgrafting. Furthermore, each donor recipient combination has demonstrated a unique pattern of heart allograft function as well as a degree of heart muscle damage. In conclusion, these data suggest that the rejection process depends upon multiple factors such as the immune-response-gene-regulated immunoresponsiveness of the recipient as well as the expression of alloantigens on heart grafts during the induction and effector phases of the immune response. PMID- 3321585 TI - Prolonged survival of hamster-to-rat liver xenografts using splenectomy and cyclosporine administration. AB - The immunosuppressive effect of splenectomy, alone or in combination with cyclosporine (CsA), was examined in hamster-to-rat orthotopic liver xenografts. The mean survival time was 7.3 +/- 0.5 days in untreated controls, 7.6 +/- 0.8 days with 40 mg/kg/day CsA, 7.2 +/- 0.4 days with splenectomy alone, and 17.6 +/- 5.6 days with splenectomy combined with 30 mg/kg/day CsA (P less than 0.01). The longest survival time was 27 days in this group. Marked enlargement of the spleen and high lymphocytotoxic antibody titer were characteristic of the unmodified recipients and those treated with CsA alone. Splenectomy by itself decreased the antibody formation without improvement of graft survival. In animals treated with the combined regimen, the lymphocytotoxic antibody titer was significantly suppressed, and the PMN and round cell infiltration were greatly reduced. Therefore, a synergistic effect was postulated between cyclosporine and splenectomy in this liver xenograft system. PMID- 3321586 TI - Thromboembolic complications in renal allograft recipients. A report from the prospective randomized study of cyclosporine versus azathioprine-antilymphocyte globulin. AB - The incidence of arterial and venous thromboembolic complications was compared in 224 renal allograft recipients who were prospectively randomized and stratified by risk to treatment with either cyclosporine-prednisone (CsA-P) (n = 117) or azathioprine-prednisone-antilymphocyte globulin (AZA-P-ALG) (n = 107). Thirteen CsA patients (11%) had 22 thromboembolic events, while 19 AZA patients (18%) had 24 events (P = 0.22). There was no significant difference between the 2 regimens in the number of patients with each type of venous or arterial event or in the number of patients with multiple or lethal events. The incidence of "minor" complications (all except myocardial infarction and stroke) in the related donor subgroup (n = 85) and the overall incidence of thromboembolism in the diabetic subgroup (n = 125) were both significantly higher in AZA-treated patients (P = 0.008 and 0.045, respectively). Thus, CsA immunosuppression does not appear to be a risk factor for thromboembolic disease, and it may in fact lower the incidence of thromboembolism in diabetic renal allograft recipients. PMID- 3321587 TI - Venoocclusive disease of the liver following bone marrow transplantation. AB - Review of 235 consecutive patients undergoing bone marrow transplantation was performed in order to define the clinical syndrome of venoocclusive disease of the liver (VOD) in these patients. Analysis of all patients with histologically proven VOD revealed a consistent clinical syndrome of liver dysfunction occurring within the first 3 weeks after marrow infusion. This was characterized by hyperbilirubinemia peaking at greater than or equal to 2 mg/dl with at least 2 of 3 other findings: hepatomegaly, ascites, and 5% or greater weight gain. VOD developed in 22% (52 of 235). A persistently elevated aspartate aminotransferase (SGOT) prior to transplant was associated with an increased risk of developing VOD by multivariate analysis (P = 0.0003), and acute leukemia in first remission was associated with a decreased risk (P = 0.02). Neither the preparative regimen (busulfan and cyclophosphamide versus cyclophosphamide and total body irradiation) nor the type of graft (allogeneic versus autologous) influenced the occurrence. Twenty-four of these 52 patients (47%) died with VOD (10% of the entire group). This makes VOD the third leading cause of death in our allogeneic graft recipients, and the second leading cause in our patients receiving autologous transplants. VOD is a common complication of bone marrow transplantation and has a specific clinical presentation, which usually allows diagnosis without the need of liver biopsy. PMID- 3321588 TI - Evidence that the difference in kidney graft survival in DRw6+ and DRw6- recipients may be explained by a blood transfusion policy that is disadvantageous for DRw6+ recipients. AB - Kidneys transplanted to HLA-DRw6+ recipients have been shown to have an inferior graft survival compared with DRw6- patients. Because pretransplant blood transfusions influence kidney graft survival, we investigated whether the number of blood transfusions contributes to the observed poor graft survival in DRw6+ patients. We have found that the difference in graft survival in DRw6+ and DRw6- recipients may be explained by a blood transfusion policy that is disadvantageous for DRw6+ recipients. Thus, graft survival in DRw6+ recipients was excellent for those who had received only a single transfusion. More transfusions resulted in a gradual decrease in graft survival. When the number of transfusions exceeded 5, graft survival improved again. By contrast, DRw6- recipients showed an improvement in graft survival with an increasing number of transfusions. DRw6+ recipients therefore display inferior graft survival only when they receive 3-5 transfusions. This finding provides a possible explanation as to why the "DRw6 effect" is a controversial issue, and it suggests that DRw6+ recipients should be given a different pre-transplant transfusion protocol than DRw6- patients. PMID- 3321589 TI - Improvement of kidney transplant regraft results by using trauma death donors. AB - Patients who have lost a transplanted kidney are widely recognized as high-risk patients for retransplantation. We have found a profound difference in cadaver kidney regraft survival associated with the age and sex of the donor. Kidneys from male cadaver donors yielded significantly higher graft survival rates than kidneys from female donors. The difference in graft survival at one year was 7% for all first transplants (n = 2974), 14% if the recipient was sensitized, and 18% in 688 patients being regrafted. The difference was even more striking in regraft recipients of kidneys from young male donors (72% one-year graft survival) as compared with recipients of kidneys from older female donors (44% one-year graft survival). The donor age and sex effects correlated well with the cause of donor death. Young male donors accounted for 59% of trauma deaths whereas older female donors made up only 7%. Nontrauma donors, on the other hand, were 38% older female and 14% younger male. The survival of trauma-death donor kidneys in regrafted patients was 69% at one year and 37% for nontrauma donor kidneys, a 32% difference (P less than 0.001). These results indicate that regraft survival could be significantly increased through the use of cadaver kidneys from trauma death donors. PMID- 3321590 TI - Effect of cyclosporine, cyclosporine metabolite 17, and other cyclosporine related compounds on T lymphocyte clones derived from rejected human kidney grafts. I. Inhibition of proliferation. AB - The effect of cyclosporine and metabolite 17 (M17) as well as other CsA-related compounds (CsG, dihydro-CsC, dihydro-CsD, CsH, B5.49, and H7.94) was tested on T lymphocyte clone proliferation. In these experiments, antigen and interleukin 2 (IL-2) dependent long-term T lymphocyte clones derived from a rejected human kidney graft infiltrate were used. They were specifically committed (proliferation and cytotoxicity) for the donor Epstein-Barr virus (EBV) transformed cells. CsA strongly inhibited clone T cell proliferation induced by the antigen. Inhibition of antigen-driven proliferation was reversed by pure recombinant IL-2 (rec-IL-2) only when low amounts of CsA (less than 25 ng/ml) were used, whereas this lymphokine was ineffective at higher but still pharmacological CsA concentrations (50-500 ng/ml). Increasing rec-IL-2 concentrations did not modify this finding. In addition, CsA, did not inhibit the growth signal(s) induced by rec-IL-2/IL-2 receptor interactions when R-IL-2 is pre-expressed on clone cells. M17 was far less effective in inhibiting antigen induced clone cell proliferation (50% inhibition at 16 ng/ml versus 500 ng/ml with, respectively, CsA and M17) but was nevertheless inhibitory. This observation, if extended to other metabolites, could be important for interpretation of the relevance of "CsA" concentration through radio-immunoassay monitoring of recipients' blood. Although CsA appeared to display the major inhibitory effect, dihydro-CsC and CsG, as well as B5.49 and H7.94 CsA-related compounds, also exhibited strong activity. Dihydro-CsD was less inhibitory, and CsH had no effect. PMID- 3321591 TI - Pancreaticocystostomy with a two-layer anastomosis technique in human segmental pancreas transplantation. PMID- 3321592 TI - The prevalence of cardiac allograft arteriosclerosis. PMID- 3321593 TI - Disseminated aspergillosis revealed by thyroiditis in a renal allograft recipient. PMID- 3321594 TI - Noncytotoxic antibodies and renal transplant outcome. A prospective study. PMID- 3321595 TI - False-positive antibody tests for human immunodeficiency virus in transplant patients with antilymphocyte antibodies. PMID- 3321596 TI - The effect of anti-L3T4 monoclonal antibody treatment on first-set rejection of murine cardiac allografts. PMID- 3321597 TI - ABH antigens: some basic aspects. PMID- 3321598 TI - Blood group ABH antigens: a new series of blood group A-associated structures (genetic regulation and tissue distribution). PMID- 3321599 TI - Prolongation of cardiac xenograft (vervet monkey to baboon) function by a combination of total lymphoid irradiation and immunosuppressive drug therapy. PMID- 3321600 TI - Simian-type blood group antigens in nonhuman primate cardiac xenotransplantation. PMID- 3321601 TI - Humoral rejection mechanisms and ABO incompatibility in renal transplantation. PMID- 3321602 TI - Overview: significance of vascular endothelial cell antigen. PMID- 3321603 TI - Preliminary human study of synthetic trisaccharide representing blood substance A. PMID- 3321604 TI - Interaction of IgG and IgM anti-A with synthetic oligosaccharides. PMID- 3321605 TI - Activity of the ABO antigen system as a determinant of histocompatibility in human transplantation. PMID- 3321606 TI - The definition of ABO factors in transplantation: relation to other humoral antibody states. AB - The first examples of hyperacute rejection of renal hemografts were seen almost 25 years ago when kidneys were transplanted to ABO incompatible recipients whose plasma contained antigraft isoagglutinins. Hyperacute rejection caused in sensitized recipients by lymphocytotoxic antibodies is similar in that the immune reaction triggers an acute inflammatory reaction that leads to widespread thrombotic occlusion and devascularization of the graft. The events after xenotransplantation between certain species are essentially the same. Potential strategies to avoid the precipitating antigen antibody reaction or to mitigate the resulting effector cascade are described. PMID- 3321608 TI - Low anti-A and anti-B titers in some type O patients may permit renal transplantation across the ABO barrier. PMID- 3321609 TI - Cellular immune response against human red blood cell antigens and renal allograft rejection. PMID- 3321607 TI - Failure of Lewis blood group matching to influence renal allograft outcome. PMID- 3321610 TI - Hemolytic anemia is not a frequent complication of ABO unmatched renal allografts from living related donors. AB - In summary, we could not document an increased incidence of HA nor a detrimental effect of CyA use in our recipients of ABO-unmatched LRD kidneys. Thus, it would appear that the incidence of HA in this situation is low enough that no special pretreatment of the kidney transplant or recipient is warranted. Since the long term survival of ABO-unmatched LRD kidneys was equivalent to that of ABO-matched recipients there is no reason to select against them, or avoid the use of CyA. Rather a severe pretransplant anemia may predispose to a delayed recovery from anemia after transplantation. PMID- 3321611 TI - Auto-antibodies against erythrocytes in transplant patients produced by donor lymphocytes. PMID- 3321612 TI - ABO-compatible mismatching decreases 5-year actuarial graft survival after renal transplantation. PMID- 3321613 TI - Technical aspects of antibody immunoadsorption prior to ABO-incompatible renal transplant. PMID- 3321615 TI - Experiences with known ABO-mismatched renal transplants. PMID- 3321614 TI - Present experiences in a series of 26 ABO-incompatible living donor renal allografts. PMID- 3321616 TI - ABO incompatibility in cadaver donor kidney allografts. AB - We have found the ABO barrier does appear to remain intact in clinical kidney transplantation, as evidenced by a 4% 1-year graft survival in 25 cadaver donor, ABO-incompatible allografts. The one long-term surviving graft could have been a case of an A2 kidney and a B recipient, but this could not be determined. Although these grafts were the result of errors at a number of different points, most could have been avoided if a red cell crossmatch had been performed at the time of transplant. The fact that these transplants rarely occur should not overshadow the possibility that they could be avoided by the implementation of such a simple procedure. PMID- 3321618 TI - Delayed hyperacute rejection in an ABO-incompatible renal transplant. PMID- 3321617 TI - ABO-incompatible kidney transplantation: initial immunopathologic evaluation. PMID- 3321620 TI - Experience with blood group A2 renal grafts in ABO-incompatible recipients. PMID- 3321619 TI - Accelerated acute rejection in blood group O recipients of renal grafts from blood group A2 incompatible living donors. PMID- 3321622 TI - Experience with primary liver transplantation across ABO blood groups. PMID- 3321621 TI - Transplantation of blood group A2 kidneys into O or B recipients: the effect of pretransplant anti-A titers on graft survival. PMID- 3321623 TI - ABO mismatch and liver transplantation. PMID- 3321624 TI - ABO incompatibility in liver transplantation: a single center experience. PMID- 3321625 TI - Hyperacute rejection after ABO-incompatible orthotopic liver transplantation. PMID- 3321627 TI - Hemolysis in ABO-incompatible liver transplantation. PMID- 3321628 TI - Erythrocyte antibodies in liver transplantation: a practical and theoretical problem. PMID- 3321626 TI - The Lewis blood group system in liver transplantation. PMID- 3321630 TI - Comparison of techniques for dealing with major ABO-incompatible marrow transplants. PMID- 3321629 TI - Anti-B-mediated rejection of an ABO-incompatible cardiac allograft despite aggressive plasma exchange transfusion. AB - A group A recipient received a group B cardiac allograft. Aggressive plasma exchange with replacement by group AB FFP initially reduced the recipient's anti B titer to a low level. Once a secondary anti-B response was mounted, plasma exchange was ineffective and IgM and IgG anti-B titers rose to high levels. Associated with the increased anti-B titers, cardiac function deteriorated and on day 13 the group B heart was replaced by a group A allograft. The compatible allograft functioned well initially but was eventually rejected, and the patient died 51 days after the initial transplantation. Histologic examination of the first allograft revealed a delayed form of typical antibody-mediated rejection with destruction of the microvasculature associated with antibody deposition and acute inflammation. By contrast, the histopathology of the second compatible allograft was typical of cell-mediated allograft rejection. Extracts of myocardium from the incompatible heart contained IgM and IgG anti-B, while no anti-B alloantibody was demonstrable in the extracts of the ABO-compatible allograft and a control heart. The utility of plasma exchange with group AB FFP replacement in such a circumstance requires further study. PMID- 3321632 TI - Early appearance of anti-A isohemagglutinin after allogeneic, ABO minor incompatible, T cell depleted bone marrow transplant. PMID- 3321631 TI - Immunohematologic problems arising from ABO incompatible bone marrow transplantation. PMID- 3321633 TI - Obstacle to red cell engraftment due to major ABO incompatibility in allogeneic bone marrow transplants (BMT): quantitative and kinetic aspects in 58 BMTs. PMID- 3321634 TI - Evidence for different kinds of major ABO incompatibility in transplantation due to the interplay of qualitative and quantitative factors: application to the management of 62 bone marrow recipients. PMID- 3321635 TI - Efficacy of cryofiltration in major ABO-incompatible bone marrow transplantation. PMID- 3321636 TI - ABO-incompatible bone marrow transplantation: in vivo adsorption, an old forgotten method. PMID- 3321637 TI - Host-graft interactions in allogeneic bone marrow transplantation. Proceedings of a symposium. June 25-27, 1987, Tucker's Town, Bermuda. PMID- 3321638 TI - T cell receptor/MHC interactions in the thymus and the shaping of the T cell repertoire. PMID- 3321639 TI - Cell cooperation in haploidentical bone marrow transplant recipient. PMID- 3321640 TI - Mechanisms of marrow graft rejection in murine model systems. PMID- 3321641 TI - Regeneration of genetically restricted immune functions after human bone marrow transplantation: influence of four different strategies for graft-v-host disease prophylaxis. PMID- 3321642 TI - Effects of recombinant human granulocyte-colony stimulating factor on hematopoietic reconstitution after autologous bone marrow transplantation in primates. PMID- 3321643 TI - Effects of in vivo administration of human recombinant IL-2 to cynomolgus monkeys after autologous bone marrow transplantation. PMID- 3321645 TI - Immunologic control of hemopoiesis: implications for quality of the graft after allogeneic bone marrow transplantation. PMID- 3321644 TI - The biology of graft rejection in a canine model of marrow transplantation. PMID- 3321646 TI - Rejection of bone marrow cells by irradiated mice: NK and T cells recognize different antigens. PMID- 3321648 TI - Role of immunosuppressive drugs for prevention of graft-v-host disease after human HLA matched bone marrow transplantation. PMID- 3321647 TI - HLA nonidentical T cell depleted marrow transplants: a comparison of results in patients treated for leukemia and severe combined immunodeficiency disease. PMID- 3321649 TI - Biparental bone marrow transplantation as a means of tolerance induction. PMID- 3321650 TI - In vitro correlates of graft-host tolerance after HLA-matched and mismatched marrow transplants: suggestions from limiting dilution analysis. PMID- 3321651 TI - Coarctation of the inferior vena cava. PMID- 3321652 TI - Primary biliary cirrhosis. PMID- 3321653 TI - The management of perforated duodenal ulcer. PMID- 3321654 TI - Role and potential of draught cows in tropical farming systems: a review. PMID- 3321655 TI - Cumulative bibliography of the world literature 1983-1984. PMID- 3321656 TI - [Causes and pathophysiology of infection of the knee joint]. AB - The origin of an infection of the knee joint can be of an endogenous/hematogenous nature or, in posttraumatic cases, of an exogenous nature. Hematogenous infections are found mostly in children, but also in patients with reduced immune functions, e.g. after organ transplantations. Posttraumatic joint infections are caused by open injuries, intraarticular injections, operations, or they can be transmitted from the surroundings. They are relatively rare after accident surgery and orthopedic surgery. Two statements are of special importance for pathophysiology: 1. An intraarticular infection will lead to lesions of the hyaline cartilage within a period of 24 to 48 hours. 2. The substrate exchange is reduced by the reflex immobilization which will result in a additional damage to the cartilage. PMID- 3321660 TI - [Importance of thermographic and ultrasonic studies in assessing the kidney function of pregnant women]. PMID- 3321658 TI - [Surgical treatment of short strictures of the urethra]. PMID- 3321657 TI - [Prevention of thromboembolism in accident surgery--angiospastic complications with DHE-heparin. A multicenter study]. AB - In immobilized patients different drugs are used for thromboembolism prophylaxis. Arterial vasospastic complications have recently been reported after Heparin-DHE. In our clinical observation five of these cases were treated. A multicenter study was performed in 82 Austrian trauma units investigating the incidence and outcome of complications of Heparin DHE prophylaxis. 147,290 patients had different drugs for thromboembolism prophylaxis. 61,092 got Heparin-DHE. Complications could be observed at 142 patients but only in the group receiving Heparin DHE. 135 cases were treated conservatively (amputation of limbs became necessary in seven patients). In seven other cases immediate operative exposure of the vessels and balloon catheter dilatation was successfully performed. Vasospasm occurred only in patients with Heparin DHE prophylaxis. It is important to realize this possibility, so that early therapeutic measurements can be taken to avoid unnecessary permanent ischaemic damages and limb amputation. PMID- 3321659 TI - [Use of digital subtraction angiography in the multiposition study of the kidneys]. PMID- 3321662 TI - [Transrectal ultrasonic scanning in the diagnosis of chronic inflammatory diseases of the prostate and seminal vesicles]. PMID- 3321661 TI - [Fine-needle aspiration biopsy in the diagnosis of lesions of a kidney transplant]. PMID- 3321663 TI - [Differential diagnosis of 2 forms of necrospermia]. PMID- 3321665 TI - [Nursing diagnosis: a literature study]. PMID- 3321664 TI - [Characteristics of the causative agents of chronic pyelonephritis]. PMID- 3321666 TI - [Acoustic scanning of the optic disk]. PMID- 3321668 TI - [Penetrating wounds of the chest]. PMID- 3321667 TI - [Possibilities and importance of the clinical use of objective audiometry by auditory evoked potentials in children]. PMID- 3321669 TI - [Effect of extracorporeal circulation on the indicators of cellular and humoral immunity]. PMID- 3321670 TI - [Peritonitis as aerobic-anaerobic infection]. AB - Results of clinico-microbiological examinations of 147 patients with peritonitis were analyzed. Strict anaerobic technique was used. It was established that in most cases peritonitis represented a mixed anaerobic aerobic infection (59.2%). The coliform microorganisms were dominating among aerobic ones, bacteroids-among anaerobic ones. The microbic character of inflammation (from abacterial to mixed forms) is dependent on the level (localization) of the inflammation source, duration of the inflammatory process. Mixed aerobic-anaerobic peritonitis has characteristic clinical features and requires an adequate antibacterial therapy. PMID- 3321671 TI - [Selective proximal vagotomy with exclusion of the innervated antral segment of the stomach]. PMID- 3321672 TI - [Percutaneous-supracutaneous ligation of the veins in the complex surgical treatment of varicose veins]. AB - The proposed method of percutaneous-supracutaneous ligation in combination with the method of Troyanov--Trendelenburg--Bebkock was used in operation on 233 patients. Long-term results were studied in 125 patients. Excellent results were obtained in 98 patients, good results-in 27 patients. PMID- 3321673 TI - Epidemiology of Salmonella typhimurium infection in calves: excretion of S typhimurium in the faeces of calves in different management systems. AB - Twenty-five batches of market-purchased calves, comprising 589 animals on 11 farms, were examined for the excretion of salmonellas for at least 28 days after their arrival. Salmonellas were found in 217 (51 per cent) of 423 calves from 18 of 21 batches on nine farms. The calves were housed in single pens on eight farms and in groups on the others. The trends in new excreters and the proportion of Salmonella typhimurium excreters were similar in both types of housing, a peak of excretion which was slightly higher in single penned calves, being reached 18 to 19 days after arrival. New excreters were found at most samplings in both types of housing, but the peak of new excreters appeared earlier and declined sooner in single penned calves. On average, single penned animals excreted salmonellas longer. Salmonella dublin was found only in single-penned calves, and the trend in excretion was similar to that for S typhimurium in single-penned calves except that the peak was at about 28 days. Prophylactic feeding of antibiotics was practised on nine farms, but appeared to have no influence on the excretion of salmonellas. Salmonellas were isolated from the environment in six of nine farms studied, even after cleaning and disinfection. It is suggested that the persistence of salmonellas in the environment deserves more attention in the formulation of control programmes. PMID- 3321674 TI - Monoclonal antibodies to intracellular campylobacter-like organisms of the porcine proliferative enteropathies. PMID- 3321675 TI - Ultrasonic appearance of the equine corpus haemorrhagicum. PMID- 3321676 TI - Effect of subinhibitory concentrations of tiamulin on fimbriated E coli. PMID- 3321677 TI - A test of ethics. PMID- 3321678 TI - Epidemiology of S typhimurium. PMID- 3321679 TI - Aortic obstruction in a cat. PMID- 3321680 TI - Studia collecta in honorem Erwin Helmuth Kampermacher. Presented by the National Institute of Public Health and Environmental Hygiene. PMID- 3321681 TI - The human health implication of the use of antimicrobial agents in animal feeds. AB - Antimicrobials given in subtherapeutic levels in feed are credited with having contributed to lower cost of meat, milk and eggs. The practice often is associated with the acquisition of resistant enteric flora by the involved animals, and this may in turn contribute to the human reservoir of antimicrobial resistant coliforms and salmonellae. Associated farm workers may transiently acquire resistant flora and on rare occasions develop salmonellosis. Although irrefutable evidence of growth promotant properties of antibiotics in animal feed was provided 30 to 40 years ago, additional studies on mechanisms of the effect are presently needed. It may be possible to identify factors effective in promoting growth without deleterious effects on flora. A national surveillance programme of antimicrobial utilisation (both subtherapeutic and therapeutic) among food producing animals should be established. Molecular epidemiologic research efforts will need to be undertaken to establish whether genetic information of animal origin importantly contributes to the human environmental pool of antimicrobial resistance. In the meantime, it does not appear that the use of drugs as feed additives, while allowing their unrestricted use for therapy in both animals and persons, would favorably influence the problems of antimicrobial resistance of salmonellosis in human populations. PMID- 3321682 TI - The future role of the veterinarian in the control of zoonoses. AB - Developments in the rearing and the health status of meat animals is presented. Attention is drawn to the increase in latent infections, most of which are zoonotic diseases. Such infections escape official ante-mortem and post-mortem inspection as it is presently conducted in industrialised countries, which still rely on the classical rules established by Robert von Ostertag. This examination is thus in need of reform. Proposals submitted to the EEC Commission consist of a stepwise inclusion of the major herds of meat animals in systematic health control aimed at effective control of zoonoses and thus improved consumer protection. It is thus expected that the importance of meat inspection on the basis of pathological-anatomical changes will decrease the importance of establishing the health status during the animal's lifetime will increase. Nevertheless, there will be no complete substitution of classical meat inspection because there are numerous changes in the meat specific to the individual animal which can be detected only by meat inspection, and must be detected if the concept of consumer protection is properly applied. The reform of meat inspection which has become necessary will entail a variety of new tasks for research. PMID- 3321683 TI - Standardisation of microbiological methods. The Salmonella example. AB - The results of studies carried out under the leadership of Prof. Kampelmacher to elaborate a reliable Salmonella isolation method are highlighted. The strategy which was successfully followed is summarised in a table. This strategy can also be applied in attempts at standardisation of other microbiological methods. PMID- 3321684 TI - Modern trends in veterinary public health. AB - The veterinary profession and its contribution to public health should expand in breadth, depth and flexibility to respond to the changing needs of community and society. This longstanding issue is still the subject of controversy between on the one hand those whose scientific activities contribute to our knowledge of food and environmental hygiene, enteric infections, food-borne diseases and zoonoses in general, and on the other the all too numerous traditionalists (even within the profession) who resist the venture of veterinarians into new territories and resent involvement in public health. Veterinarians are ideally suited to function in public health because of their orientation to populations, disease prevention, and the economic implications of disease. PMID- 3321685 TI - Public health aspects of microbial contaminants in food. AB - Food-borne diseases affect the health and welfare of hundred thousands of people and result in considerable economic loss. Salmonella and Campylobacter are by far the most important causes of food-borne illness. Raw foods of animal origin are the major sources of these pathogens. Mishandling of foods in kitchens contributes to food-borne disease outbreaks. More education is necessary. But because of the inevitable risk of recontamination of cooked foods in every kitchen, more emphasis should be placed on pathogen-free raising of food animals and good manufacturing practices during slaughter. This will minimise contamination of raw foods of animal origin, thus reducing the contamination pressure in the kitchen and more effectively controlling food-borne diseases. PMID- 3321686 TI - Epidemiological studies on Salmonella and Campylobacter jejuni. AB - An overview is given of investigations concerning the epidemiology of Salmonella, carried out at the National Institute of Public Health and Environmental Hygiene in Bilthoven, The Netherlands, during the last thirty years. It is made clear that Salmonella, because of its ubiquitous occurrence and its large variety in sero- and phage-types, is the organism of choice to study the epidemiological pathways of pathogens between man, animals and the environment. It is demonstrated that these are in fact the pathways of faecal contamination, and therefore have validity for a larger number of bacterial, and perhaps even parasitic and viral, micro-organisms. This last statement is illustrated by the presentation of studies on the epidemiology of Campylobacter jejuni. PMID- 3321688 TI - Integrated microbiological safety assurance and monitoring of food and drinking water. Professor Kampelmacher's contribution to postgraduate education in The Netherlands from the point of view of Veterinary Public Health. AB - The history of academic education in food microbiology and hygiene in the Netherlands has largely been written by Prof. Kampelmacher. The first contribution in this field dates from 1961, and suggested a new approach to teaching Veterinary Public Health. His later research led to the conclusion that intervention would be the only way to control the food-transmitted diseases originating from slaughter animals and poultry, particularly Salmonellosis. This intervention should take place at the beginning of the contamination cycle. In the 1970's, surveys showed that feed decontamination would no longer efficiently control the endemicity of Salmonellosis. The contamination cycles had become autonomous. Consequently, emphasis on terminal decontamination of food products was necessary. Besides his activities in teaching and research, Prof. Kampelmacher masterminded a modern view of the responsibilities of academic scientists. Moreover, he strongly promoted an interdisciplinary approach to scientific consultation and advice. In this respect, he has unfortunately not been successful in introducing radiation of dangerously contaminated food, having met strong opposition from various quarters. His efforts in multidisciplinary training and research programmes resulted in, among other things, fruitful cooperation between the Agricultural University at Wageningen and the Faculty of Veterinary Medicine at Utrecht University. PMID- 3321689 TI - [Diagnostic possibilities of radiological methods in pancreatic cancer]. PMID- 3321687 TI - Parasitic contamination cycles and mathematical epidemiology. AB - Mathematics plays an essential role in epidemiology. Whether simple questions are asked about simple relations, or complicated questions about complicated relations, the best fitting mathematical figures are always searched for. In a holistic approach, it may often be necessary to assess complicated relations by using (real) mathematical models (simulation models). Examples are presented of parasitic contamination cycles which require more or less complicated mathematics to answer epidemiological questions regarding prevalence and incidence of infection in the human population: Trichinella, Toxocara and Toxoplasma. Some general remarks on epidemiological insights which are necessary to understand abstract concepts of the 'real world' ('mathematical modelling'), are discussed. PMID- 3321690 TI - [Problems of standardization of ultrasonic examination of the organs of the abdominal cavity and retroperitoneal space]. PMID- 3321691 TI - [Soviet roentgenology from the October Revolution to our time]. PMID- 3321693 TI - [Possibilities of the present-day complex of radiological methods in the diagnosis of tumors of the kidneys]. PMID- 3321692 TI - [Computerized subtraction angiography in pediatric surgery]. PMID- 3321694 TI - [Status of radiotherapy of patients with cancer of the prostate]. PMID- 3321696 TI - Health care coverage by sociodemographic and health characteristics. PMID- 3321695 TI - [Roentgenological services at the Western front during the battle of Moscow]. PMID- 3321697 TI - [Cancer of the operated stomach as a problem of oncology today]. AB - The study was based on the data obtained from a long-term follow-up of 2840 cases of various surgical pathology of the stomach, gastroscopic examination of 1112 surgically-treated patients, experiments on stomach carcinogenesis, clinical and experimental studies on lymph drainage pathways and analysis of the results of 296 radical operations for cancer of the gastric stump. The following aspects of research in cancer of operated stomach were suggested: (1) risk of cancer development in operated stomach; (2) factors contributing to tumorigenesis; (3) biologic peculiarities of growth of gastric stump tumors as well as lymph drainage pathways, and (4) organization of follow-up and development of methods for diagnosis and treatment of the said pathology. The results of the study outlined vistas in prevention of cancer of the gastric stump. Adequate methods of diagnosis and treatment of this grave pathology were developed which was followed by a decrease in postoperative lethality and in increase in 5-year survival rate- to 8.5 and 26.4%, respectively. PMID- 3321699 TI - [Importance of the transactions of the 10th Session of the General Meeting of the Academy of Medical Sciences of the USSR for the study of the history of oncology]. PMID- 3321698 TI - [Identification of oncological risk factors and the possibilities of preventing cancer]. PMID- 3321700 TI - [Centenary of the birth of Aleksandr Ivanovich Savitskii (1887-1973)]. PMID- 3321702 TI - [Incidence of Escherichia coli infection in regions with different socio-economic conditions]. PMID- 3321701 TI - [Concept of "dynamic stenosis" of the coronary vessels (review of the literature)]. PMID- 3321703 TI - [Role of lipid peroxidation in the pathogenesis of liver diseases (review of the literature)]. PMID- 3321704 TI - [Free-radical lipid oxidation and the antioxidant system in the pathogenesis of gastroduodenal ulcerations (a review of the literature)]. PMID- 3321705 TI - [A method for histostereometric assessment of the involvement of internal organs in morphology research]. PMID- 3321706 TI - [The barrier function of the lungs]. PMID- 3321707 TI - [Immunopathological aspects of autoimmune bullous dermatoses]. PMID- 3321709 TI - Hematogenously acquired Aspergillus vertebral osteomyelitis in seemingly immunocompetent drug addicts. PMID- 3321708 TI - Association of alpha 1-antitrypsin deficiency with lung and liver diseases. AB - alpha(1)-Protease inhibitor (alpha(1)-Pi) deficiency is associated with emphysema, neonatal hepatitis and cirrhosis. The deficiency associated with emphysema has multiple alleles. Cigarette smoke may influence the onset of emphysema in a twofold manner: by overwhelming the concentration of alpha(1)-Pi by increasing elastase release, and by inactivating the alpha(1)-Pi active site through oxidation. alpha(1)-Pi-associated hepatic disease occurs primarily in children with the allele PiZZ, most of whom are asymptomatic although in a small percentage severe obstructive jaundice and fatal junvenile cirrhosis develop. Pharmacologic intervention and alpha(1)-Pi replacement therapy are being tested against alpha(1)-Pi-associated emphysema. PMID- 3321710 TI - Group B streptococcal soft tissue infections beyond the neonatal period. AB - In one year sporadic soft tissue infections due to group B streptococci were identified in 37 patients beyond the neonatal period. Serious underlying conditions were present in 25 patients (68%), including 17 (46%) who had diabetes mellitus and 4 (11%) with paraplegia. Unlike previous reports, 12 patients (32%) were previously healthy. Infection developed in 8 persons as a result of minor trauma. The mean age of the normal hosts was 20.9 years, whereas the mean age of patients with underlying disease was 44.2 years (P<.0005). The clinical spectrum was varied and included abscess formation in 17 patients (46%). All patients required treatment with antibiotics and 28 (76%) required admission to hospital. Complete recovery occurred in 33 patients (89%) while 4 with diabetes required amputation of infected extremities. Group B Streptococcus was the only organism identified in 22 patients (59%) while mixed organisms were cultured in 15 (41%), including Staphylococcus aureus in 12 and gram-negative enteropathogens in 4. Group B streptococcal soft tissue infections beyond the neonatal period are common and may even involve normal hosts. PMID- 3321711 TI - Treatment of the obstructive sleep apnea syndrome. AB - The obstructive sleep apnea syndrome is a disorder of sleep and breathing that is being recognized with increasing frequency. The pathophysiologic consequences range from mild sleepiness to life-threatening cardiovascular and respiratory decompensation. The primary forms of treatment are directed at modifying the upper airway with either an operation or continuous positive airway pressure. Aside from tracheostomy, which is virtually always successful, other forms of treatment have met with varying results. Ancillary therapy, including oxygen, weight loss and drugs, is often helpful but seldom curative. Follow-up sleep studies are necessary to evaluate the effectiveness of treatment. Selecting therapy for a patient with obstructive sleep apnea requires a comprehensive evaluation including polysomnography, special examinations of the upper airway and assessing the cardiopulmonary status. Therapy is based on the severity of disease and must be tailored to each patient. PMID- 3321713 TI - Advances in the prenatal diagnosis of sickle cell anemia. AB - These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Drs Homer A. Boushey, Professor of Medicine, and David G. Warnock, Associate Professor of Medicine, under the direction of Dr Lloyd H. Smith, Jr, Professor of Medicine and Associate Dean in the School of Medicine. Requests for reprints should be sent to the Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143. PMID- 3321714 TI - Chemical contamination of California drinking water. AB - Drinking water contamination by toxic chemicals has become widely recognized as a public health concern since the discovery of 1,2-dibromo-3-chloropropane in California's Central Valley in 1979. Increased monitoring since then has shown that other pesticides and industrial chemicals are present in drinking water. Contaminants of drinking water also include naturally occurring substances such as asbestos and even the by-products of water chlorination. Public water systems, commercially bottled and vended water and mineral water are regulated, and California is also taking measures to prevent water pollution by chemicals through various new laws and programs. PMID- 3321712 TI - Clinical disorders of phosphorus metabolism. AB - Deranged phosphorus metabolism is commonly encountered in clinical medicine. Disturbances in phosphate intake, excretion and transcellular shift account for the abnormal serum levels. As a result of the essential role played by phosphate in intracellular metabolism, the clinical manifestations of hypophosphatemia and hyperphosphatemia are extensive. An understanding of the pathophysiology of various phosphate disorders is helpful in guiding therapeutic decisions. PMID- 3321715 TI - [Acute paracetamol poisoning]. PMID- 3321716 TI - [Positron emission tomography]. PMID- 3321718 TI - [Platelet aggregation and platelet antiaggregants]. PMID- 3321717 TI - [20-year presence of a foreign body in the retroperitoneal space]. PMID- 3321719 TI - [Objectives and tasks of the office of the municipal sanitary controller in the first half of the 16th century in Wroclaw]. PMID- 3321720 TI - [Use of prostaglandins in pregnancy termination in the 1st and 2d trimester]. AB - Successful termination of pregnancy can be achieved at any stage of gestation by the administration of prostaglandins (PG). The methods used for preoperative cervical priming are: intramuscular and intramural-cervical injection of sulprostone, as well as intracervical application of PG-containing gel preparations. According to our own extensive investigations, intracervical application of 50 micrograms sulprostone-tylose gel is superior to other procedures of cervical priming as regards efficiency and acceptance. For termination of second trimester pregnancy a combined procedure is advisable, namely cervical priming (e.g. intracervical PG gel application) and induction of labour (e.g. intramuscular sulprostone). The advantages of this method as compared with the exclusively systemic administration of PGs are: a higher success rate, a lower incidence of undesired concomitant side effects and the avoidance of serious complications (e.g. cervical rupture). In our experience administration of PGs is not contraindicated under certain well-defined conditions, even in the case of previous uterine operations. PMID- 3321721 TI - Physicians, reformers and occupational disease: the discovery of radium poisoning. AB - Teenage girls and young women, whose job it was to apply luminous paint containing radium to watches during World War I, were among the first industrial radiation poisoning victims in the United States. This paper recounts both the story of how their afflictions became "recognized" occupational diseases and of the tangled web of governmental-industrial-academic collusion (largely based on industrial funding of research and experts) which delayed this recognition. It shows how these industrial-academic arrangements led to the establishment of the major academic training programs in occupational medical and industrial hygiene still in existence. Using historical sources, this study provides evidence of moral lapses by medical researchers, including directly lying to the victims, withholding data on the true extent of illness and radiation contamination and of distorting evidence. The pivotal role of the Consumers League and of Dr. Alice Hamilton in establishing the truth of the radium dial painting poisonings is discussed. PMID- 3321722 TI - The rape exam: beyond the hospital emergency room. AB - Data from 31 Florida post-rape examination sites reveal a number of dilemmas associated with rape exams. The sites include regular hospital ERs (N = 25), specialized sexual assault treatment centers (SATCs) on hospital grounds (N = 2), a nonhospital-based SATC, a proprietary OB/GYN clinic, a medical examiner's office, and a law enforcement crime lab. Open-ended interviews indicate that major problems with hospitals as exam sites stem from physicians' dislike of the exam and physician and hospital fears of legal and court entanglements. Prosecutors (and judges) are a major obstacle to nonphysician examiners. A challenge to rethink the post-rape exam, including where and by whom it is performed, is posed. PMID- 3321723 TI - Cytotoxic cellular mediators of the immune response to neoplasia: a review. AB - Immunotherapy in the management of neoplastic disease has recently been a major focus of scientific attention. Studies in vitro and in animal systems have provided the basis for the first trials of cellular immunotherapy for neoplasia in humans. Work over the past ten years has identified several distinct populations of lymphocytes active in lysing neoplastic cells, including major histocompatibility complex (MHC)-restricted and non-restricted cytotoxic T lymphocytes (CTL), natural killer (NK) cells, the natural cell-mediated cytotoxicity (NCMC) population, and the lymphokine-activated killer (LAK) phenomenon. This paper reviews the current understanding of the distinguishing cell surface phenotypes, recognition structures, mechanisms of neoplastic target cell lysis, activation requirements, and ontogeny of each of these cell groups. PMID- 3321725 TI - [Diabetic nephropathy--clinical picture and treatment guidelines]. PMID- 3321726 TI - [Pain and swelling of the joints in childhood--references for its differential diagnosis]. PMID- 3321724 TI - C.-E.A. Winslow and the later years of public health at Yale, 1940-1945. AB - This paper is one of a series of papers in which I consider contemporary Yale medical education in general and the Yale Department of Epidemiology and Public Health in particular. It tells of the retirement in 1945 of C.-E.A. Winslow, Professor and Chairman of the Yale Department of Public Health since its inception in 1915; of the committees established by the dean of the School of Medicine and the president of the University, charged with determining the future direction of the department; and of the outcome, which, in 1945, proved favorable to Winslow's public health philosophy in contrast to the medical school's clinical needs and desires. PMID- 3321727 TI - [Cardiotoxicity of tricyclic antidepressants]. PMID- 3321728 TI - [Peculiarities of German medical education in the 19th and 20th century]. PMID- 3321729 TI - [Prospective analysis of the natural course of non-insulin dependent diabetes mellitus in early adulthood]. AB - Non-insulin-dependent diabetics with early manifestation of the disease (NIDDM) who were registered by an epidemiological cross-sectional study 1979 in the Erfurt district were pursued prospectively and 47 of the 58 patients underwent a re-examination five years later. The changes of therapy performed (7 new administrations of insulin, 9 change from diet to normal food) as well as the metabolic development of the patients under epidemiological aspect prove the heterogeneity of NIDDM and the doubtfulness of hitherto existing MODY-criteria. The oGTT performed in 37 patients 9 times resulted in a full remission and in 4 cases in an IGT. Including the 10 insulinized patients 34 diabetics (72.3%) had remained manifest. In contrast to the initially different degree of post-load hyperglycaemia in patients with and without remission the behaviour of the insulin secretion did not show any significant differences in the course and between the groups of patients. Young non-insulin-dependent diabetics are mainly among a representative target population type-II-diabetics with early onset. In contrast to this type-I-diabetics with a long insulin-free initial phase go into the background. In our population real MODY-cases are apparently extraordinarily rare. PMID- 3321730 TI - [Disaccharidases and peptidases of intestinal mucosa after experimental subtotal small intestinal resection with and without retardation of the passage]. AB - Several operating methods for retardation of the passage were compared together after resection of 75% of the mid-small-bowel for preventing a malabsorption syndrome. Morphologic and enzyme-histochemical findings of the intestinal mucosa allow conclusions on the absorptive capacity of the residual intestine. The investigations were carried out one year after the operation. The lay-out of an antiperistaltic segment for the surgical therapy of the short bowel syndrome appears specially suitable after the results of this investigation. PMID- 3321732 TI - [Development of an enzyme immunoassay for the determination of gentamicin in serum]. PMID- 3321731 TI - [Endomyocardial biopsy in childhood--experiences in 60 pediatric patients]. AB - In 60 pediatric patients, aged from 1 month to 22 years (median 3.54) and a bodyweight of 3 to 67 kg (median 12.6 kg) transvascular endomyocardial biopsy was performed from the right (35 patients) or left ventricle (30 patients). The specimens were investigated by light and electron microscopy. Immune serological investigations were performed in 22 patients, immune histological examinations in eight. There were three indications for biopsy: a. 29 children had a poorly functioning, dilated left ventricle. Of these, seven suffered from endocardial fibroelastosis, 16 from dilated cardiomyopathy, six (plus one control-biopsy) from healing/healed or chronic myocarditis. b. 17 children showed inadequate left ventricular hypertrophy. Of these, ten suffered from HCM, four from secondary hypertrophy, three from storage diseases. c. Various questions were answered in eight children - four with hypoxic, two with cytotoxic myocardial damage. There were five misindications, retrospectively. We observed no serious complications. Evaluation of biopsy revealed diagnostic findings in 11.7%, was helpful in 71.7% and of no help in 16.6%. Hence, even in childhood, endomyocardial biopsy is a diagnostic tool which can contribute useful information on the etiology or pathogenesis of the underlying myocardial disease. PMID- 3321733 TI - [Determination of the specific activities of glucose, lactate and alanine from a plasma sample in tracer kinetic in vivo studies]. PMID- 3321734 TI - [Clumping test for the differentiation of Staphylococcus aureus and Staphylococcus epidermidis]. PMID- 3321735 TI - Wall structure of coronary arteries in nidicolous and nidifugous animals at the time of birth. PMID- 3321736 TI - [Adaptation of the body to stress situations and the prevention of heart rhythm disorders]. PMID- 3321737 TI - Carcinoma of the prostate: treatment options and controversies. PMID- 3321738 TI - Operative choices in morbid obesity. PMID- 3321739 TI - [This is how it was before]. PMID- 3321740 TI - [Dose-response study with O-(beta-hydroxyethyl)-rutoside oral solution]. PMID- 3321741 TI - Ultrasonic evaluation of gastric clearing and of hypertrophic pyloric stenosis in infants. PMID- 3321742 TI - Campylobacter pyloridis: the rediscovery of a forgotten bacterium. PMID- 3321743 TI - [Biological and scientometric characteristics of medical research on species of 3 genera of the lower catarrhine monkeys: Macaca, Papio and Cercopithecus]. PMID- 3321744 TI - [Anthropophysiological basis of the species stereotype of cardiovascular system reactivity in primates]. PMID- 3321746 TI - [A case of pigmentary-pemphigoid form of lichen ruber planus]. PMID- 3321745 TI - [Diagnostic possibilities of thermography in dermatovenereology]. PMID- 3321747 TI - [Chromatographic-mass spectrometric diagnosis of the condition of the hair]. PMID- 3321748 TI - [Sergei Timofeevich Pavlov (on the 90th anniversary of his birth)]. PMID- 3321749 TI - Drug dependence: a methodology for evaluating treatment and rehabilitation. PMID- 3321750 TI - The aetiology of jaundice in adult patients at Port Moresby General Hospital, Papua New Guinea. PMID- 3321752 TI - Catecholamine effects on pulmonary blood vessels in strangulation. AB - Guinea pigs were killed by strangulation to investigate the vasomotor of pulmonary congestion by asphyxia. The noradrenaline uptake by the endothelial cells of the pulmonary arteries and capillaries was observed by fluorescence histochemistry, peroxidase-anti-peroxidase (PAP) immunocytochemistry, and autoradiography. By radioassay, the volumes of noradrenaline uptake by the pulmonary arteries and capillaries in the strangulation group were at a significantly higher level than in the control groups. Many myoendothelial junctions were observed at the sites of constricted arteries, and the invasive noradrenaline was clearly observed in the myoendothelial junction. The mechanism of the pulmonary vasoconstriction in strangulation is due to the fact that the plasma noradrenaline, increased by asphyxia, invades the endothelial cells of pulmonary arteries and capillaries and causes the vasoconstriction. PMID- 3321751 TI - Chloroquine resistance in Plasmodium falciparum and its geographical distribution in Papua New Guinea. PMID- 3321753 TI - Laboratory features of psoriatic arthritis. AB - Psoriatic arthritis (PA) is regarded as a disease which belongs to the seronegative polyarthritis with a broad clinical pattern. Because of the involvement of the skin and the inflammatory processes in the joints, the disease is of interest to both the rheumatologist and the dermatologist. There are no laboratory findings which are specific to PA, although some abnormalities have been published in the literature with different bases for comparison: PA and healthy people, PA and rheumatoid arthritis (RA), or PA and skin psoriasis. The most probable reason for some of the divergent data found in the literature might be the heterogeneity of the disease, whereby the results represent a mixture of the subtypes of PA. The present paper summarizes the main findings in PA that have been reported in the literature, including the "traditional laboratory findings" and some immunological and biochemical data. PMID- 3321754 TI - [Urticaria vasculitis]. AB - Urticarial vasculitis is a syndrome characterized by a chronic intermittent urticaria and the histological features of necrotizing vasculitis. The skin lesions are often accompanied by arthritis or arthralgia and other systemic diseases. Depressed serum complement can be found in half of the patients. PMID- 3321755 TI - [Chlorambucil pulse therapy in progressive chronic polyarthritis. Initial results of an open multicenter study]. AB - The first preliminary clinical results with chlorambucil pulse-therapy in patients with refractory rheumatoid arthritis are reported, with a dose of chlorambucil below that which might risk inducing leukaemia. The clinical response was good in 15 out of 19 patients; symptoms and objective findings of rheumatoid arthritis had significantly improved. However, multiple toxic reactions have been identified in our patients. PMID- 3321756 TI - [Endoscopic studies of the stomach tolerance of ibuprofen: comparison of 2 galenically different preparations]. AB - In randomised crossover fashion, the gastric and duodenal tolerability of two different ibuprofen galenic formulations were directly compared in ten healthy volunteers. An endoscopic evaluation was performed after 7 and 14 days treatment. 300 mg Ibuprofen q.i.d. as pellets, as well as 600 mg Ibuprofen b.i.d. as dragees, evoked a lesion score of 1.6 +/- 0.3 and 1.7 +/- 0.4 after 7 days of treatment (n.s.). After 14 days, the lesion score under ibuprofen dragees was slightly higher (1.9 +/- 0.3) when compared with the pellet formulation (1.6 +/- 0.3). This difference did not reach statistical significance. Both ibuprofen preparations were well tolerated. PMID- 3321758 TI - Status of membrane-filter procedure in the examination of water and milk for Staphylococcus aureus. AB - A comparative study was carried out to assess the performance of four selective media, namely Baird-Parker (B-P), Mannitol-Salt Agar (M.S.A.), Staphylococcus-110 (S-110), and Chapman-Stone (C.S) in solid and liquid forms for recovery of Staphylococcus aureus from water and milk, using membrane filter technique. The descending order of efficiency for demonstrating the presence of inoculated S. aureus from unsterilized Nile water was (B-P)--(M.S.A) + (S-110) and (C.S) medium in solid form and changed to (S-110)--(M.S.A)--(C.S) when used in the liquid form. With sterile Nile water, the descending order of efficiency of the tested media was (B-P) + (M.S.A)--(S-110) and (C.S) medium in the solid form and (M.S.A) + (S-110) and (C.S) in the liquid form. In testing the inoculated milk using solid media, (S-110) and (M.S.A) tend to show similar results and took intermediate position between (B-P) and (C.S). When liquid media were used, the descending order of productivity was (S-110)--(M.S.A) and (C.S). PMID- 3321757 TI - [Silver impregnation for demonstration of Alzheimer neurofibrillary tangles and of senile plaques in paraffin sections]. AB - A method based on mordantation with silver nitrate solution at pH = 3.0 and on physical development is described. PMID- 3321759 TI - [Mastopexy with few scars]. PMID- 3321760 TI - [Increased radiation reactions of the efferent urinary system following gynecologic radiation therapy. Incidence, prevention and therapy]. AB - Basing on the newer literature and own experiences a survey is given concerning radiation reactions occasionally to be seen with kidney, ureter, urinary bladder and urethra in connection with the radiation therapy in gynecology. Hints are given to prophylaxis and therapy of these radiation reactions with special emphasis of the treatment with instillation solutions in case of raised reactions of the urinary bladder. PMID- 3321761 TI - Interaction of Escherichia coli and macrophages: alteration by treatment of bacteria with beta-lactam antibiotics. AB - Antibiotics are known to exert an influence on the host-parasite relationship either by impairment of immunocompetent cells or by alteration of the bacterium, such as changes of surface properties or the production of toxins. The main problem in investigating the effect of antibiotics on the surface properties of bacteria consists in morphological changes of bacteria (round cell or filament formation) after treatment e.g. with beta-lactam antibiotics. These changes of morphology lead to problems in the comparison of such bacterial forms with untreated organisms. Therefore, in this study outer membrane vesicles from bacteria were used as a model to investigate the effect of antibiotics on the surface properties of Escherichia coli with regard to the interaction with mouse peritoneal macrophages tested by chemiluminescence reaction. It could be shown that these membrane vesicles induce a luminol dependent chemiluminescence response. Treatment of E. coli with different beta-lactams lead to an increase of the stimulating properties. The relative effectiveness of certain antibiotics depended on the particular E. coli strain. Analysis of the different adhesions involved in the stimulation of macrophages revealed that only mannose-sensitive adhesins were increased after treatment with beta-lactam antibiotics. No stimulation of the membrane-bound NAD(P)H-oxidase could be found following the reaction with outer membrane vesicles. Even the treatment of bacteria with antibiotics did not evoke such a reaction. PMID- 3321762 TI - Concomitant infections of Anopheles stephensi with Plasmodium berghei and Serratia marcescens: additive detrimental effects. AB - The mortality rate of Anopheles stephensi increased after infection with Plasmodium berghei and correlated negatively with temperature. Development of oocysts is inhibited at temperatures above 21 degrees C. We tested the hypothesis that microorganisms were involved in killing the mosquitoes. In fact we were able to demonstrate that in our A. stephensi colony great numbers of Serratia marcescens could be found in the midgut of the insects. The highest value was 2.3 x 10(7) cfu/ml. Other bacteria were rarely seen (1 out of 30 females had flavobacteria). Serratia was neither found in larvae and pupae nor in the water of the breeding dishes. Moderate numbers were detectable in glucose solutions (for feeding of adult mosquitoes) as well as in jars where pupae emerged. Isolated Serratia strains grew faster at 25 degrees C than at 21 degrees C. In glucose solutions alone growth rates were low but they rose rapidly after the addition of blood. -In experimental infections of A. stephensi with S. marcescens (1 x 10(7) bacteria/ml glucose solution) the mortality increased at 25 degrees C. At 21 degrees C the effect of Serratia was insignificant whereas in P. berghei infected A. stephensi the damaging effects of migrating ookinetes were obvious. Additive detrimental effects were observed at 25 degrees C in mosquitoes infected with P. berghei and Serratia concomitantly. PMID- 3321763 TI - The brown colour effect (BCE) of Cryptococcus neoformans in the diagnosis, control and epidemiology of C. neoformans infections in AIDS patients. AB - Cryptococcus neoformans was found as the causative agent of cryptococcosis in 7 (3.6%) out of 195 HIV-positive persons, most of them being hospitalized. These 7 persons included 6 homosexuals and 1 heroin addict. The examinations were performed at the Mycology Unit of the Robert Koch Institute in Berlin (West) between 1984 and 1986. The brown colour effect (BCE) of the C. neoformans colonies on Guizotia abyssinica creatinine agar (with 0.1% glucose) within 2-5 days at 26 degrees C facilitated the diagnosis of disseminated cryptococcosis. In all 7 cryptococcosis cases, the antigen of C. neoformans was detected in serum and CSF by the latex agglutination test. The initial titres ranged from 1:100,000 to 1:160 in the serum and from 1:1280 to 1:10 in the CSF. In comparison to the progressive stage of the infection with the involvement of the various organs and high antigen titres, the fungus may be detected at an early stage in the respiratory tract only where low antigen titres are observed. All the C. neoformans isolates were found to belong to the variety neoformans. Proposals for an effective control of cryptococcosis are made. PMID- 3321764 TI - Molecular aspects on pathogenesis of wound and foreign body infections due to staphylococci. AB - Rapid progress has been made in our understanding how various mucosal bacteria and virus pathogens bind to specific epithelial cell receptors and cause infections in respiratory gastrointestinal and the urogenital tracts, during the last decade. In the present review, I summarize our understanding how pathogens can colonize subepithelial tissues in open wounds and burns by binding to specific subepithelial matrix components such as collagen, laminin, fibronectin and to fibrin in blood clots and cause pyogenic infections. Serum and tissue fibronectin show a high affinity for various surfaces compared to other body fluid proteins. Based on the recent discovery of specific fibronectin binding surface proteins (FNBP) of S. aureus recently cloned and expressed in E. coli a new concept is presented how S. aureus, coagulase-negative staphylococci (CNS) and other wound pathogens bind to wound sutures, intravascular catheters and various prosthesis materials and initiate foreign body infections. Finally, new principles for treating wound infections with hydrophobized and fibronectin substituted wound dressings to decrease the critical bacterial numbers (approx. 10(5) per mg tissue (7] to spead up healing of infected wounds is presented. PMID- 3321765 TI - The chromosomal fur gene regulates the extracellular haemolytic activity encoded by certain hly plasmids. AB - The haemolytic activity encoded by thirteen hly-plasmids of different origin and sources was examined as a function of the Fe3+-concentration in E. coli fur+ and E. coli fur- strains, respectively. In E. coli fur+ the relatively low haemolytic activity of five hly-plasmids isolated in Berne and one isolated in Paris was increased significantly under iron-limiting growth conditions. Contrastingly, in E. coli fur- strains containing the same plasmids, a considerably higher amount of secreted haemolysin was detected. This activity could not be further increased by limiting the extracellular iron concentration. Seven other hly-plasmids expressed similar and non-inducible amounts of secreted haemolysin in both E. coli fur+ and E. coli fur- strains. These results indicate that the extracellular haemolytic activity encoded by certain hly-plasmids was controlled by the chromosomally encoded fur gene. PMID- 3321766 TI - Plasmid-mediated formaldehyde resistance in Serratia marcescens and Escherichia coli: alterations in the cell surface. AB - The plasmid-mediated formaldehyde resistance of Serratia marcescens and Escherichia coli was examined. For that purpose the outer membranes of isogenic strains (with and without resistance plasmid) were compared. No quantitative or immunological differences in lipopolysaccharide of resistant and sensitive strains were noted. By contrast analysis of outer membrane proteins revealed that the sensitive variants had a higher protein content than the resistant strains. When outer membrane proteins were separated by SDS-PAGE the number of bands seemed identical for sensitive and resistant strains but the intensity of some of the bands was greater for the sensitive isolates. In addition, the surface hydrophobicity was greater for the resistance than for the sensitive strains. These findings suggest that the formaldehyde resistance plasmid of Serratia marcescens confer changes in cell surface proteins and surface hydrophobicity. PMID- 3321767 TI - Adhesion properties of E. coli cells in the presence of promethazine. AB - Some E. coli strains were tested for adsorption to HEp-2 cells and on aluminium hydroxide gel. The adhesiveness of E. coli to HEp-2 cells was inhibited by promethazine. MRHA (mannose-resistant haemagglutinating activity) positive plasmid-carrying E. coli strains were found to be adsorbed to tissue culture cells more effectively than the MRHA-negative strains. Fifty percent of the clinical isolates contained antibiotic resistance plasmids, but only 40% of these strains were able to transfer the antibiotic resistance properties to E. coli as recipient. It is presumed that the hydrophobic adsorption of bacteria depends on the fimbriae, while aluminium hydroxide gel adsorption correlates with surface properties other than the fimbriae. PMID- 3321768 TI - Studies of the role of B-cells in the resistance of mice to experimental candidiasis. AB - The role of humoral immunity in experimental candidiasis was studied in B-cell deficient mice. The B-cell deficiency was produced by administration of anti-mu antibodies to newborn animals. These anti-IgM-treated mice failed to produce antibodies against sheep red blood cells (SRBC), and their lymph nodes and spleens did not form germinal centres. However, their cell-mediated immune responses were normal as they developed delayed hypersensitivity to SRBC and rejected skin allografts like normal animals. These B-cell-deficient animals along with the controls were infected with one LD50 dose of Candida albicans. These animals were observed for mortality, antibody formation, delayed type hypersensitivity (DTH) to Candida antigen and viable count of the organism in different organs. The course of the experimental infection was almost parallel in both the groups. B-cell deficiency did not increase the susceptibility of the animals to experimental candidiasis. PMID- 3321770 TI - Zentralblatt fur Bakteriologie 1887-1987. PMID- 3321769 TI - Pathogenicity of coagulase-negative staphylococci with respect to the nature of the host response. PMID- 3321771 TI - [Flagellin-determining genes hagB, hagD and hagE and their alleles in reference H test strains of the International Collection of Escherichia coli]. PMID- 3321772 TI - [Various aspects of leprosy control in the developing countries of Southeastern Asia]. PMID- 3321773 TI - [Development of the L.V. Gromashevskii's theory of the role of mechanism of transmission of an infective agent in the epidemiological process]. PMID- 3321774 TI - [L.V. Gromashevskii and the classification of infectious diseases]. PMID- 3321775 TI - [Biological significance of L.V. Gromashevskii's classification of infectious diseases]. PMID- 3321776 TI - [Views of L.V. Gromashevskii on the phenomenon of parasitism as the basis of the theory of the epidemiological process]. PMID- 3321777 TI - [Development of L.V. Gromashevskii's theory within the socio-ecological concept of the epidemiological process]. PMID- 3321778 TI - [Lev Vasil'evich Gromashevskii]. PMID- 3321779 TI - [L.V. Gromashevskii's paradigm]. PMID- 3321780 TI - [Pages from the works of L.V. Gromashevskii]. PMID- 3321781 TI - [Epidemiology of icterohemorrhagic leptospirosis (ecological aspects)]. PMID- 3321782 TI - [Current problems of hepatitis B in the light of L.V. Gromashevskii's views]. PMID- 3321783 TI - [L.V. Gromashevskii and his role in the organization and activities of the Chair of epidemiology of the Dnepropetrovsk Medical Institute]. PMID- 3321784 TI - [L.V. Gromashevskii's activities as reflected in museum exhibits in Kiev]. PMID- 3321785 TI - [L.V. Gromashevskii and the founding of the epidemiological school in the Donetsk region]. PMID- 3321786 TI - [The role of L.V. Gromashevskii in establishing epidemiology as an independent subject of study and teaching in medical schools]. PMID- 3321787 TI - [The phenomenon of unbalanced growth of bacteria]. PMID- 3321788 TI - [Andrei Vladimirovich Snezhnevskii]. PMID- 3321789 TI - [A case of echoscopic diagnosis of brain tumor in a child with secondary hydrocephalus]. AB - The authors report a case of choroid papilloma diagnosed by real-time echoscopy in a 2-month-old infant. The dynamics of clinical manifestations is described. The diagnosis is confirmed by pathomorphological findings. PMID- 3321791 TI - [25th anniversary of the Moscow Children's Psychiatric Hospital No. 6]. PMID- 3321790 TI - [Clinico-electroneuromyographic characteristics of myelodysplasia in children]. AB - Myelodysplasia is a topical problem of childhood neurology. The early diagnosis and treatment of myelodysplasia prevents the development of severe neurological symptomatology. Twenty patients with myelodysplasia were investigated using clinical, electroneuromyographic, and thermographic methods of examination. Electroneuromyography included determination of the bulbocavernous reflex which served as an objective criterion of the status of the lumbosacral portion of the spinal cord. Early diagnosis of myelodysplasia makes it possible to conduct preventive therapy including electrostimulation of the spinal cord or perform surgical intervention when indicated in children with this pathology. PMID- 3321792 TI - [On the centenary of the Kherson Psychiatric Hospital]. PMID- 3321793 TI - [Acquired immunodeficiency syndrome (AIDS) in neurology and psychology (review of the literature)]. PMID- 3321794 TI - [Problems of pathogenesis of alcoholic embryofetopathy (review of foreign literature)]. PMID- 3321795 TI - [Computer-assisted differential diagnosis of cerebral stroke]. AB - An automatic system of the stage-by-stage differential diagnosis of acute disorders of the cerebral circulation has been developed. Investigation of the efficacy of computer-aided diagnosis and its comparison to the diagnosis made by physicians at different levels of the care of patients with acute impairments of the cerebral circulation have shown the advisability of employing this system in the diagnosis of brain stroke at the prehospital stage at variable levels of the public health service. PMID- 3321796 TI - [Diagnosis of a cerebral infarct with a hemorrhagic component]. AB - Using computerized methods the authors have analyzed formalized case histories of three variants of an acute disorder of the cerebral circulation in the matter of the cerebral hemispheres verified by pathoanatomical studies: (1) cerebral infarction with a hemorrhagic component (n = 88), (2) a gray ischemic cerebral stroke (n = 80), (3) parenchymatous hemorrhage (n = 71). The informative symptoms and symptom complexes identified can be employed for the differentiation between cerebral infarction with a hemorrhagic component and other types of strokes. PMID- 3321797 TI - [Renin-angiotensin-aldosterone system in hypertension patients who have had a cerebral stroke]. AB - The study of the renin activity and aldosterone concentrations in the blood plasma has revealed activation of the renin-angiotensin-aldosterone system (RAAS) in patients with stage III essential hypertension and a history of 1-3-year-old cerebral stroke. Middle-aged patients demonstrated high activity of renin and high levels of aldosterone whereas elderly patients presented a moderate rise in renin activity and elevated aldosterone levels. The data obtained indicate a decrease in the endocrine function of the kidneys in elderly hypertensive patients with a history of cerebral stroke. The authors revealed a considerable hypersecretion of aldosterone in the presence of a moderate elevation of plasma renin activity in patients with the cerebral form of stage II essential hypertension at the height of the crisis. It is suggested that aldosterone hypersecretion in elderly patients with stage III essential hypertension and residual manifestations of cerebral circulation impairment is pathogenetically important. PMID- 3321799 TI - [BB creatine phosphokinase activity and content of the brain structures in senile dementia and Alzheimer's diseases]. AB - The creatine kinase (CPK) activity and content were determined in certain brain structures of patients with Alzheimer's disease and senile dementia and in the control group. The findings demonstrated the 5-10-fold decrease of CPK activity in the majority of the investigated brain areas and a 30-fold decrease in the occipital gyrus. The activity decrease did not depend on postmortal interval, sex and age. The content of CPK was increased in the same structures (130% of the control level). So an elevation in CPK values appears to compensate for the fall in CPK activity. Such phenomena can lead to different disturbances in energy metabolism of the brain in mental patients. PMID- 3321798 TI - [Microcomputer potentials for the diagnosis and choice of treatment method in nervous system diseases and injuries]. AB - The authors suggest using Soviet Agat portable computers for formulating and solving the problems in tonic diagnosis of the brachial plexus. They have developed a simple method for the solution of 3 academic problems on the basis of personal computers. PMID- 3321801 TI - [Rehabilitation programs in psychiatry and the criteria for assessing their effectiveness (a review of the literature)]. PMID- 3321800 TI - [Experience using a forced method of insulin coma therapy in schizophrenia]. AB - Thirteen patients were treated using a method of forced insulin comatose therapy proposed by Avrutskii et al. (1984). In some cases this technique proved poorly effective. On the basis of the experience gained the authors have determined the optimal rate of insulin administration and elaborated a supplementary therapy aimed at preventing the development of complications in cases of residual organic pathology of the brain. The described technique is recommended for clinical utilization, particularly in cases of schizophrenia complicated by residual organic abnormalities of the brain. PMID- 3321802 TI - [70 years of Soviet neurosurgery]. PMID- 3321803 TI - [Reconstructive surgery of the spinal cord]. PMID- 3321804 TI - [One of the first operations for tumors of the skull and brain performed at Kharkov University by Prof. T. Vancetti in 1841]. PMID- 3321805 TI - Hemodynamic effects of ketanserin in experimental hypertension. PMID- 3321806 TI - Hemodynamic effects of the anti-hypertensive agent ketanserin in hypertension in man. AB - The hemodynamic changes caused by ketanserin, an anti-hypertensive agent with S2 serotonergic receptor and alpha 1-adrenoceptor blocking properties, are reviewed in patients with essential hypertension. The hemodynamic profile associates a decrease in total peripheral resistance, an unchanged cardiac output, and a modest reflex cardiac stimulation. Whether the drug reverses the other hemodynamic abnormalities of essential hypertension, such as reduced arterial and venous compliances and increased cardiac mass, remains largely unknown. Evaluation of the changes in arterial and venous systems will be important in the view that the pharmacological profile of ketanserin could be involved in the modifications of the arterial wall observed in hypertension and atherosclerosis. PMID- 3321807 TI - The use of lasers in vascular and cardiac surgery. Clinical review. AB - Use of lasers is routine in medical fields such as ophthalmology and dermatology, but in spite of intensive research in recent years, its role in cardiac and vascular surgery still remains to be determined. Laser energy can vaporize atherosclerotic plaques in human arteries obtained at necropsy. Fiberoptic catheters have been constructed to deliver the laser energy to atheromas at a distance from the arteriotomy. The healing of the arterial wall after laser treatment is rapid and results in complete reendothelialization. Lasers have been used in patients undergoing coronary surgery as well as peripheral vascular reconstructions. In some cases, the percutaneous approach has also been used. In these clinical series, the laser treatment was in almost all cases followed by either transluminal balloon angioplasty or by-pass operation. Complications after laser treatment include vessel perforation, reocclusions, thrombosis, or aneurysm formation. The development of more advanced fiberoptic catheters and better understanding of dosimetric parameters are promising features to avoid these complications as well as development of methods for steering of the laser catheter itself and means for "real time" diagnosis (e.g. angioscopes, spectroscopic diagnosis). The future use of lasers in cardiac and vascular surgery seems promising, especially as an alternative to balloon angioplasty. PMID- 3321808 TI - Treatment of experimental peritonitis in rats by transfer of peritoneal mononuclear cells from rats injected with semisoluble aminated glucan. AB - The efficacy of treatment with semisoluble aminated glucan (s.a.g.) and donor peritoneal mononuclear cells was investigated in two separate models of peritonitis (exogenous Escherichia coli challenge or caecal perforation). Intraperitoneal administration of s.a.g. significantly protected against both forms of peritonitis. Our previous studies indicated this protective effect to be mediated by macrophage activation, and this was corroborated by the effect of injecting rats with s.a.g.-stimulated donor peritoneal cells (approximately 95% macrophages) immediately after induction of peritonitis. Increased bacterial clearance and survival time were achieved with this treatment as compared with rats injected with cells from saline-treated donors. Scanning electron microscopy demonstrated activation of macrophages from the s.a.g.-treated rats. The results provided further support for the concept that s.a.g. exerts its therapeutic effect by stimulation of macrophages. PMID- 3321809 TI - Routine use of a scoring system for decision-making in suspected acute appendicitis in adults. AB - Clinical data from 259 patients with suspected acute appendicitis were prospectively collected and used in construction of a Bayesian scoring system, comprising 19 attributes, for preoperative diagnosis. The scoring system was integrated into the routine clinical management of a prospective series of 830 patients. Laparotomy was performed in 310 cases, and of these 256 had acute appendicitis (perforation in 14%). Excluding 6 cases with normal appendix but laparotomy mandatory for other reasons, the negative laparotomy rate was 15.5%. This rate was significantly lower than in earlier series from the same hospital and in more than 8,000 appendectomies performed in Sweden since 1969. The scoring system had 90.2% sensitivity, 91.4% specificity, 82.5% positive predictive value and 95.4% negative predictive value. The system is regarded only as an aid in diagnosis, to be used in combination with clinicians' judgements. Construction of a local data base probably is essential for results equivalent to those here reported. PMID- 3321810 TI - [Ionic basis of the cholinergic action in the cardiac cells]. PMID- 3321811 TI - Growth phase and production of typhimuricin by strain M799-O of S. typhimurium LT2. PMID- 3321812 TI - [Effect of washing of brewer's yeast on its nutritive value for chickens]. PMID- 3321813 TI - Amyloidosis 1970-1985 with special reference to amyloid arthropathy. A discussion about 106 cases. PMID- 3321814 TI - Cytomorphologic aspects of thyroiditis. A study of 51 cases with functional, immunologic and ultrasonographic data. AB - Fine needle aspiration provided material for detailed cytomorphologic study in 51 cases of thyroiditis, 40 of which were diagnosed as Hashimoto's (autoimmune) thyroiditis. Of these 40 cases, 22 were found to be euthyroid on clinical examination and radioimmunoassay (RIA), 10 were hyperthyroid and 8 were hypothyroid. Of the 11 cases of subacute thyroiditis, 4 were thyrotoxic and 7 were euthyroid. Radioactive iodine uptake (RAIU) showed decreased to negligible uptake in ten and normal uptake in one case of subacute thyroiditis, whereas all of the thyrotoxic cases of Hashimoto's thyroiditis showed markedly increased RAIU. Echography showed a hypoechoic or anechoic pattern in most of the cases. Antimicrosomal and/or antithyroglobulin antibodies were positive in 25 cases of Hashimoto's thyroiditis and in 1 case of subacute thyroiditis. The cytologic features that characterized subacute thyroiditis were the presence of multinucleated giant cells and a polymorphonuclear and lymphocytic population associated occasionally with epithelioid-cell granulomas. Hashimoto's thyroiditis was characterized by Hurthle-cell changes and a significant lymphoid population consisting of mature and transformed lymphocytes, often impinging on follicular cells. There was an overlap in the cytomorphologic features between some cases of Hashimoto's and subacute thyroiditis. In such cases, the final diagnosis was arrived at by an integrated approach incorporating all of the diagnostic parameters available. PMID- 3321815 TI - A gastrointestinal-specific monoclonal antibody that may be of clinical value in cytologic material. AB - A new monoclonal antibody (MAb), 29-10, produced by immunization of mice with cells from the SW 1116 colorectal carcinoma cell line, detected an antigen present in cytologic touch imprints of surgically resected normal and neoplastic gastrointestinal (GI) tissue, including specimens from the stomach and the colon. These imprints were fixed in 95% ethanol and stained with the avidin-biotin immunoperoxidase technique. In tested cases, 22 (100%) of 22 imprints from GI adenocarcinomas and from normal GI tissue, as well as 13 (56.6%) of 23 imprints from colonic polyps, stained positively while no staining was demonstrable in imprints from other tissues. In histologic sections, only 4 (23%) of 17 colonic adenocarcinomas and 3 (11.5%) of 26 polyps stained positively. The staining ability of MAb 29-10 was compared to that of MAb 19-9, another colorectal antibody, and was found to be markedly superior for binding of the antigen in cytologic preparations. This tissue-specific antibody may be useful in identifying malignant cells of metastatic carcinoma as to their GI tract origin. PMID- 3321818 TI - Glossary of basic dermatology lesions. The International League of Dermatological Societies Committee on Nomenclature. PMID- 3321817 TI - Influence of prefixation and fixation times on cellular preservation and epithelial cellularity in filter imprints. AB - Cells from malignant and nonmalignant lesions of the breast were suspended in three different fixatives or in a balanced electrolyte solution (Hank's), stored for varying periods of time, collected on Millipore filters and then imprinted on to clean microslides in order to evaluate the influence of prefixation and fixation time on epithelial cellularity and cellular preservation. The use of a methanol-acetic acid fixative (Esposti's fixative) or 50% isopropanol resulted in good preservation whereas cells prefixed in formaldehyde or 100% isopropanol were poorly preserved. Cells that had not been prefixed (suspended in Hank's solution) showed fair preservation. Eighty-eight percent of the imprints prepared from suspensions of Esposti's fixative were highly cellular, which was significantly better than with Hank's solution (68%), 50% isopropanol (66%), 100% isopropanol (56%) and formaldehyde (33%). The cellularity of the formaldehyde-prefixed imprints differed significantly from the others. There was no influence of storage time on either cellular preservation or epithelial cellularity for any of the investigated solutions. PMID- 3321816 TI - Immunocytochemistry of cerebrospinal fluid. AB - In order to determine how best to study cells in cerebrospinal fluid (CSF) by immunocytochemical techniques, several crucial technical variables and five immunocytochemical methods were examined. Immunocytochemical studies could be performed on either cell suspensions or smears. The method using cell suspensions was more sensitive, producing less background staining, but requiring more cells than that using smears. Among the five methods examined, indirect immunoperoxidase (IP) and indirect immunoalkaline phosphatase (IAP) were comparable in sensitivity. The peroxidase-antiperoxidase (PAP), alkaline phosphatase-antialkaline phosphatase (APAAP) and avidin-biotin complex immunoalkaline phosphatase (ABC-AP) methods were comparable in sensitivity and were more sensitive than either the IP or IAP technique. The peroxidase methods were plagued with problems related to endogenous enzyme activity and the ABC-AP method may exhibit undesirable background staining. Therefore, the IAP method should be used for cell suspensions and the APAAP for cells on smears. In CSF specimens with a small number of cells, immunocytochemical studies should be done on smears by the APAAP method. These conclusions are supported by our experience with CSF specimens from patients with reactive and neoplastic lymphocytoses. PMID- 3321819 TI - Glucoregulatory hormone response to insulin-induced hypoglycaemia following long term calcium antagonism with felodipine in patients with essential hypertension. AB - The effect of 8 weeks' treatment with the dihydropyridine calcium antagonist felodipine on glucoregulatory hormone response following insulin-induced hypoglycaemia was evaluated in 7 patients with essential hypertension, WHO grade I-II. After an iv insulin injection (0.1 IU/kg), blood glucose decrement and nadir were similar before and during felodipine treatment. Basal glucagon, noradrenaline, adrenaline, GH and cortisol levels were unchanged, and the response to insulin-induced hypoglycaemia was similar before and during felodipine treatment. Basal plasma dopamine levels were similar and did not change during insulin-induced hypoglycaemia before and during felodipine treatment. Basal serum levels of TSH, T3 and T4 were unaltered following felodipine. In conclusion, long-term treatment with felodipine did not alter the hypoglycaemic effect of exogenous insulin, or the recovery from hypoglycaemia or the glucoregulatory hormone response to insulin-induced hypoglycaemia in patients with essential hypertension. PMID- 3321820 TI - Treatment of Graves' ophthalmopathy with high-dose intravenous methylprednisolone pulse therapy. AB - This preliminary study was undertaken to investigate the efficacy of high-dose iv methylprednisolone pulse therapy in 5 patients with Graves' ophthalmopathy. One gram of methylprednisolone sodium succinate was given iv daily for 3 successive days. The 3-day infusion was repeated 3 to 7 times at intervals of 1 week; total duration of pulse therapy was 3 to 7 weeks. The clinical improvement of eye involvements by pulse therapy was assessed immediately after the last pulse therapy. The clinical assessment of the effect of pulse therapy for Graves' ophthalmopathy showed a good response in 3 patients, a fair response in one, and no response in one. However, in one patient, who was judged to show no response, complete improvement of the enlarged extraocular muscle was observed on orbital computed tomography. Moreover, two patients, who have been followed without any other therapies, showed no relapse of eye involvements for 32 and 10 months, respectively. Although it is impossible to determine whether pulse therapy is more effective than other immunosuppressive therapies, the results of this preliminary study suggest that pulse therapy may be a good immunosuppressive therapy for Graves' ophthalmopathy too. Controlled studies are desired. PMID- 3321821 TI - Changes during lactation in the renin-like enzyme concentration in rat luteal tissue. AB - The activity of a renin-like enzyme (RLE) previously found in rat copora lutea was studied during lactation. Luteal RLE concentration significantly increased after delivery and reached a maximum on day 5 of lactation. Plasmatic levels of PRL and progesterone also increased through lactation. Treatment with 2 bromo alpha-ergocryptine, which diminished plasma PRL and progesterone levels, enhanced luteal RLE activity. Therefore, the increase in luteal RLE during lactation seems to be independent of PRL and progesterone levels, but dopamine could be involved in its regulation. The increase in luteal RLE is not related to the intensity of the suckling stimulus, since RLE values were not modified in mothers suckling 2 to 10 pups. In conclusion, RLE activity in rat corpora lutea changes during lactation with a pattern similar to that of plasmatic PRL and progesterone, but seems not to be regulated by these hormones, nor by the intensity of suckling. On the contrary, luteal RLE may be regulated by dopamine. PMID- 3321822 TI - [CA 19-9 and cancer of the pancreas. Critical review of the literature]. PMID- 3321823 TI - [Value of echographically-guided fine-needle biopsy in the diagnosis of pancreatic carcinoma]. PMID- 3321825 TI - [Alkaline esophagitis]. PMID- 3321824 TI - [Echographic aspects in the differential diagnosis of hepatic metastasis. Focal hepatic lesions]. AB - Over 1,150 ultrasonographic gallbladder/liver studies we have selected a series of 29 patients with focal hepatic lesions. Among these cases were identified: simple cysts, poly cystic liver disease, hydatidosis, abscesses, hemangiomas, granulomas (sarcoidosis) and hepatomas. In addition we present 2 cases of extrahepatic involvement simulating a liver (metastatic) lesion. The differential diagnosis with liver metastases was accurately made in 81.5%. We emphasize the benefits of fine needle punction under US-guidance, which have elevated the rate of correct diagnoses up to 94%. PMID- 3321826 TI - Quinine and severe falciparum malaria in late pregnancy. PMID- 3321827 TI - Exchange transfusion and quinine levels in falciparum malaria. PMID- 3321828 TI - Slow-release quinidine in the treatment of chloroquine resistant falciparum malaria: a double-blind trial. PMID- 3321829 TI - Treatment of chloroquine-resistant falciparum malaria with a combination of quinine, quinidine and cinchonine (LA40221) in adults by oral and intravenous administration. PMID- 3321830 TI - Quinine: should the past be taken as a guidance for the future? PMID- 3321831 TI - Gametocytocidal effect in vitro of cinchona alkaloids and derivatives on a Plasmodium falciparum clone. PMID- 3321832 TI - Compared response to chloroquine, fansidar, quinine, and quinidine slow release of infections with Plasmodium falciparum in the Kivu region of Zaire. PMID- 3321833 TI - Quinine and quinidine in malaria in Thailand. PMID- 3321834 TI - Quinine and malaria: the African experience. PMID- 3321835 TI - Quinine and the mystery of blackwater fever. PMID- 3321837 TI - Quinine is not what it used to be.... PMID- 3321836 TI - Quinine in health care in the tropics. PMID- 3321839 TI - The potential of plant cell culture for the production of quinine. PMID- 3321838 TI - A biotechnological production process for cinchona alkaloids: prospects and problems. PMID- 3321840 TI - Notes on the early history of cinchona plantations. PMID- 3321841 TI - Cinchona alkaloids and malaria. PMID- 3321842 TI - The pharmacokinetics of quinine and quinidine in malaria. PMID- 3321843 TI - Side effects of quinine and derivatives. PMID- 3321844 TI - Quinidine in cardiology. PMID- 3321845 TI - Clinical management of severe falciparum malaria. PMID- 3321847 TI - [Dosimetry and dose schedule of radioiodine therapy with 131 iodine]. AB - In 131-J treatment as in other forms of internal radiotherapy using biologically distributed radionuclides it is important to differentiate between projected and obtained internal radiation doses which may differ considerably because of a change in the kinetics during and because of the irradiation by radioiodine. The clinical result (remission, recurrence, ablation, hypothyroidism) as well as possibly necessary repetition of the treatment depend upon the obtained rather than the projected internal radiation dose. Dosimetry of the internal radiation dose to the thyroid considers the emitted energy of the radionuclide, the absorbed fractions, the mass of the thyroid tissue, maximum thyroid uptake, and the mean residence time in the target tissue (derived from the effective elimination half time). A monoexponential time course is observed in only about one half of the patients, whereas the other one half displays biexponential or nonlinear curves which can not be established reliably within 48 hours. While sonographic volumetry and thyroid uptake can be performed prior to iodine therapy, the true effective elimination halftime of the radioiodine can be measured only following its administration. About 97% of the internal radiation dose to the normal 20-g-thyroid gland is caused by the nonpenetrating emission. In goitres the contribution by the penetrating emissions increases proportional to the cubic root of the square of the mass. A dose of 5 mCi will cause in the 80 g-thyroid with 80% uptake internal radiation doses differing by a factor of 2 or more (i. e. approx. 1500 rad or less in one case or about 3000 rad or more in another case) depending upon the mean intrathyroidal residence time. The internal radiation doses to the gonads and the total body are dimensionally smaller than the thyroid dose by about one thousand. Radioiodine therapy using 125-I has been abandoned. PMID- 3321846 TI - [Diagnosis and therapy of Basedow hyperthyroidism. Results of an Austrian study]. AB - After organisation and presentation of an European survey about "The management of Hyperthyroidism due to Graves disease" by the European Thyroid Association (ETA) national studies have been proposed. The Austrian survey was realized by the Austrian Society of Nuclear Medicine (ONG). Based on the original questionnaire of the ETA with a simple case report of uncomplicated Graves' disease and with 8 variations of the basic case including sex, age, thyroid volume and recurrence participants were asked to comment diagnostic and therapeutic procedures. Out of 42 participants 19 were heads of departments, 19 assistants and 4 internal specialists in practice with main clinical work in the field of thyroid diseases. Thyroid scintigraphy is performed in 98% (Tc 99 m 78%, J 123 15%) and ultrasound in 64%. "In vitro"-procedures include 5-6 tests (means = 5,7). 21% prefer determination of total hormones, 31% of free hormones. Various combinations of both hormone determinations are used most frequently. TRH-Test ist performed in 52.4%. Auto-antibodies are measured in 81%. TSH-receptor auto antibodies and microsomal and thyreoglobulin auto-antibodies as well are determined in 40%. Therapeutic options of the basal case report and the 8 variations showed antithyroid drugs (ATD) in 62%, radioiodine (RI) in 26% and surgery in 12%. RI is proposed in elder patients (79%) and in patients with recurrence of the disease (45%). Surgery is recommended in patients with large thyroid volume (57%). For ATD administration only carbimazole and methimazol in a mean dosage of 60 mg/die (range 20-120 mg/die) is chosen. After euthyroidism is reached ATD is reduced to 50-90% of the original dosage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321848 TI - Council on Accreditation of Nurse Anesthesia Educational Programs. PMID- 3321849 TI - Placebo-controlled trial of cisapride in postoperative ileus. AB - The effect of 4 mg of the gastrointestinal motility enhancing agent cisapride on postoperative ileus was compared with that of a placebo in 53 patients who had undergone various types of surgery. They received one i.v. injection of the double-blind medication, or two if no distinct flatus occurred within an hour after the first injection. The placebo response was very limited; borborygmi or flatus did not occur in more than 12% of the patients not even after the second injection. Cisapride was significantly effective: bowel sounds were present in 43% and 50% within 1 hour after the first and second injection of 4 mg, respectively, and flatus in 36% and 43%. The recognition that colon inactivity probably is the major determinant of the ileus, may be indicative of a substantial relative impact of cisapride's stimulating effects on colon motility. PMID- 3321850 TI - The use of combined high-frequency jet ventilation and intermittent positive pressure ventilation in bilateral bronchopleural fistulae. AB - Dissatisfaction with the results of conventional respiratory support has led to the use of high-frequency jet ventilation in desperate clinical situations with severe acute respiratory failure. We report a case of a 77 year old man with bilateral bronchopleural fistulae, who was ventilated with a combination of intermittent positive pressure ventilation and high-frequency jet ventilation. The hemodynamic and respiratory advances of this combination are discussed in an overview of the literature. PMID- 3321851 TI - Rectal benzodiazepines for premedication in children. Review and personal experience. AB - Modern anesthetic techniques have modified the aims of premedication in pediatric practice. Anxiolysis, amnesia and easiness of induction are now the the main targets. This paper reviews both the literature and the personal experience of the authors on the subject. Many authors now prefer a benzodiazepine. Rectal instillation of benzodiazepine in solution avoids the trauma of the intramuscular route and produces a faster and more predictable effect, than suppositories. Diazepam (.1 to .2 mg/kg) and flunitrazepam (40 to 80 micrograms/kg) have been extensively used in this indication. Diazepam's duration of elimination being much longer than that of flunitrazepam, this last drug is preferred by many pediatric anesthetists. Midazolam (.4 to .5 mg/kg) has a much faster onset and shorter duration of action. It should thus be preferred if the environment enables the administration of premedication within 10 to 15 minutes of induction. PMID- 3321852 TI - [Sampling surveys: an objective method of evaluating the prevalence of leprosy in an endemic zone]. AB - The authors submit a simplified sample survey methodology designed to evaluate prevalence rates of leprosy. The system proposed uses a cluster sampling technique. A cluster is a randomly selected group of households. In each household visited by the epidemiological teams all the inhabitants of the target group are interviewed and examined. Various samples sizes are used (from 6500 to 12,000 peoples) according to the expected prevalence rate of the studied area. All the new cases detected through these surveys are notified to the National Departments in charge of leprosy programmes. Two surveys are already achieved (Equatorial Guinea, Cameroon), a third one in on the way. PMID- 3321853 TI - [Preliminary results of a sampling survey of the prevalence of leprosy in rural zones of the Republic of Cameroon. 5th Working Group of OCEAC Epidemiologists]. PMID- 3321854 TI - [Evaluation of endemic leprosy in an urban zone--sampling survey at the household level: results at Bamako, Republic of Mali]. AB - A sample survey on households was conducted in Bamako (capital of the Republic of Mali) in order to estimate epidemiological and logistical indexes relating to Hansen's disease. With a prevalence rate reaching 7.37 +/- 1.83 per thousand, a detection rate reaching 0.91 +/- 0.49 per thousand the city is a high level endemic area. All observed parameters (age, sex, racial, hygiene status, geographic distribution) seem to have no influence on disease aspect. The majority of the patients (80%) are treated by monotherapy with Dapsone, generally for excessive duration. The sociocultural impact of the Hansen's disease is very important, the physical and sensorial handicaps are frequent (34%). The survey's results could be used in order to elaborate a strategy for leprosy control based on multi-drug therapy in urban areas. PMID- 3321857 TI - [Present status of vaccination against leprosy]. PMID- 3321855 TI - [Anti-BCG antibody titers in healthy and leprous Africans. Value of an indirect immunoperoxidase test]. AB - An immunoperoxidase reaction was used for the titration of immunoglobulins G and M antibodies to BCG in 171 leprosy patients from Dakar. The results show mean titers decreasing from lepromatous to tuberculoid cases. The antibody profiles of some clinical forms such as reverse reactions, erythema nodosum leprosum are discussed. This test associated to the Mitsuda reaction, bacteriology and histology should allow an easier classification of the borderline forms. The main advantages of the technique are simplicity, speed, low cost and the easy availability of the BCG. These qualities are essential in endemic zone. PMID- 3321856 TI - [Summary of the experimental protocols for polychemotherapy of leprosy undertaken since 1977 at the Institut Marchoux, Bamako. Results as of 31 December, 1985]. PMID- 3321858 TI - Placental compliance--inferences from Doppler studies of umbilical blood flow during cardiac arrhythmia. AB - Pulsed Doppler ultrasound was used to investigate human umbilical artery blood flow patterns in three fetuses where cardiac arrhythmias were present, viz., congenital bradycardia, multiple extrasystoles and 'dropped beats'. The impedance to blood flow along these arteries was assessed by the pulsatility index. The results suggest that the placental vascular bed on the fetal side has a high compliance. PMID- 3321859 TI - Perinatal outcome in growth retarded pregnancies dated by ultrasound. AB - To analyse the incidence of fetal growth retardation and its impact on perinatal mortality and neonatal morbidity, pregnancies complicated by intra-uterine growth retardation (IUGR) were compared with matched non-IUGR pregnancies. The IUGR group included all infants born in the city of Malmo during the study period and having a birthweight of 2 standard deviations or more below the mean birthweight for gestational age. The gestational age of all pregnancies was assessed with ultrasound in the first half of pregnancy. The IUGR fetuses were more vulnerable during delivery, and emergency cesarean section due to imminent fetal asphyxia was performed more frequently, but Apgar scores were similar in both groups. The frequency of respiratory disorders was lower in the IUGR group than in the non IUGR group when corticosteroid-treated pregnancies were excluded. The IUGR group required slightly longer care on the neonatal ward than the non-IUGR group, but not more intervention. The IUGR group as a whole had an unexpectedly low neonatal complication rate, such complications as did occur being related to preterm birth rather than to growth retardation. PMID- 3321860 TI - Total intra-uterine volume and symphysis fundus height. Is there a relation? AB - The concordance between measurements of total intra-uterine volume (parallel planimetric area method) and symphysis fundus height and the efficacy of these measurements in predicting birthweight by centile range was prospectively investigated in a blind study of 81 measurement sets in 74 women in the third trimester of pregnancy. Gestational length was determined by early ultrasound scans in all cases. Reference curves were from separate populations. Correlation between the measurements was significant, both at 32 weeks (p = 0.015) and 36 weeks (p less than 0.001), but only 21% of the variation in intra-uterine volume at 32 weeks and 63% at 36 weeks' gestation was attributable to changes in fundal height. Intra-uterine volume was therefore not accurately reflected by fundal height. Fundal height and intra-uterine volume were in the same centile range in 34% of cases. Maternal height and weight did not correlate with intrauterine volume, but there were significant relations with fundal height, particularly at 36 weeks. Birthweight correlated better with volume (r = 0.665) than with fundal height (r = 0.461) at 32 weeks, while at 36 weeks there was little difference (r = 0.691 and 0.794). In 54% of volume and 47% of symphysis fundus measurements there was agreement with the same centile range of birthweight. Predictive capacity of volume measurements appeared better for the lower birthweight ranges. PMID- 3321861 TI - Pregnancy after gamete intrafallopian transfer. AB - A couple with a history of 6 years' unexplained infertility was treated by gamete intrafallopian transfer (GIFT). Thus, oocytes were obtained by laparoscopy and immediately placed in a transfer catheter together with sperms. The oocyte/sperm preparation was injected into the Fallopian tube via a separate trochar under laparoscopic direction. Four weeks later pregnancy was confirmed by ultrasound. PMID- 3321862 TI - Immature cervical teratoma arising in one fetus of a twin pregnancy. Case report and review of the literature. AB - This is the first recorded case of an immature cervical teratoma arising in one fetus of a twin pregnancy. Although real-time ultrasound detected the presence of an abnormality, its true nature was not established until after histological examination. Extra-amniotic prostaglandin pregnancy termination was performed at 20 weeks' gestation due to the onset of acute hydramnios and the rapid increase in tumor size. Delivery of both fetuses was performed under general anesthesia. Extraction of the abnormal twin was only possible after the tumor was separated off from the fetal neck in utero. PMID- 3321863 TI - Ultrasound measurement of the ovarian volume. AB - The ovaries of 377 women between the age of 40 and 70 years were measured by ultrasound. About one third of the patients were postmenopausal. Mean value, standard deviation and S.E.M. of the ovarian volume were calculated and related to age, parity and menstrual cycle. Ovarian size decreased with age in all women but bore no relation to parity and day of menstrual cycle in the menstruating group of women over 40 years of age. A diagram of the ovarian volume related to age is presented. In postmenopausal women the volume was related to estrogen treatment, age, parity and years since menopause. In the group of women receiving orally administered estrogens for at least a year the p-values for all parameters were greater than 0.005. Furthermore, the ovarian volume of women under hormonal treatment did not decrease with age. On the other hand the most important factor for ovarian size in subjects not receiving estrogen treatment was age (p = 0.0056). The results presented here will serve as a prerequisite for sonar examination of the ovaries in women at high risk for development of ovarian carcinoma. PMID- 3321864 TI - The effect of bedrest in hospital on fetal outcome in pregnancies complicated by intra-uterine growth retardation. AB - A prospective study was made to evaluate whether bedrest in hospital is beneficial in pregnancies where intra-uterine growth retardation (IUGR) was suspected. Diagnosis was based on routine fetometry at 32 weeks of gestation, in conjunction with general ultrasound screening. 107 patients with suspected IUGR pregnancies were divided into two groups, 49 in a hospital bedrest group and 58 in an 'out-patient' group. Fifteen women in the bedrest group refused hospitalization, and 8 women in the out-patient group had to be hospitalized for medical reasons other than suspected growth retardation, leaving 79% of the women in their allocated group. The women in the bedrest group were hospitalized for a mean duration of 29.2 days (range 5-54). The results suggest that bedrest in hospital is not beneficial, either to fetal growth or to pregnancy outcome. PMID- 3321865 TI - Can primary dysmenorrhea be alleviated by a vasopressin antagonist? Results of a pilot study. AB - In order to study the etiological role of vasopressin in primary dysmenorrhea the therapeutic effect of an antagonist of vasopressin action on the uterus (1 deamino-2-D-Tyr(OEt)-4-Thr-8-Orn-oxytocin) was investigated in 14 patients with moderate to severe symptoms. The women participated in the study at two menstruations and each time one intravenous bolus injection of the analogue (10 micrograms/kg body weight) and one of the placebo (saline) were given, randomized and double-blind with at least a 2 hour interval. The effect was monitored by overall ratings and by pain diagrams described by the patients. In the former parameter the vasopressin antagonist was significantly more effective (p less than 0.01). In the pain diagrams, however, a significant reduction of symptoms occurred both after the analogue administrations and after placebo given as second injection. The results support a causative role of vasopressin in primary dysmenorrhea, but further studies with higher doses and/or other routes of administration or delivery systems are required in order to delineate the therapeutic value of vasopressin antagonists in the condition. PMID- 3321866 TI - On the evaluation of routine ultrasound screening in the third trimester for detection of light for gestational age (LGA) infants. AB - Based upon 2194 consecutive pregnancies with known gestational age, formulas for weight deviation predicted in the 32nd and 37th gestational week were estimated by multiple linear regression on the measurements of the abdominal diameter (AD) and the biparietal diameter (BPD) of the first 64% of the pregnancies. The usefulness of the screening was evaluated on the remaining 36%. An attempt to diagnose light for gestational age (LGA) infants resulted in either a low sensitivity or a low predictive value of a positive test. The late third trimester screening was more sensitive than the early, indicating LGA as a late phenomenon in pregnancy. Knowing the result from the late scanning, the result from the early scanning contributed almost no further information about whether the infant would be LGA at birth. Basic epidemiological characteristics of other comparable investigations on high-risk pregnancies and non selected pregnancies are presented. PMID- 3321867 TI - Bromocriptine for treatment of benign breast disease. A double-blind clinical trial versus placebo. AB - Over the last few years bromocriptine has been used for treatment of mastodynia and benign breast disease, but with contradictory results. This double-blind clinical trial was performed to determine the efficacy of this prolactin inhibitor as compared with placebo. Subjective discomfort, clinical examination of the breast lesions, echomammography and breast thermography were evaluated before, during and after 3 months of treatment and in a further follow-up. Plasma levels of estradiol, progesterone and prolactin were measured over the same time. Significant reduction of mastodynia and significant improvement of the breast lesions were observed in the group given bromocriptine, though echomammography and breast thermography did not reveal any significant differences between the two groups. Plasma prolactin levels were significantly reduced by bromocriptine administration. PMID- 3321868 TI - Ultrasound screening for detection of intra-uterine growth retardation. AB - Intra-uterine growth retardation (IUGR) is a major problem in contemporary obstetrics. Early antenatal diagnosis is important if morbidity and mortality are to be minimized. We present the results of one years ultrasound fetometric screening for IUGR of the pregnant population in the city of Malmo. All pregnancies were dated by early biparietal diameter (BPD) measurement. From findings at 32 weeks of gestation, an IUGR risk-group (n = 436) was selected on the basis of predicted birthweight deviations with reference to standard curves, established at the Department, for BPD, abdominal diameter, femur length, and intra-uterine weight, all plotted against gestational age. The risk-group, which included 60 (77%) of the 78 IUGR infants eventually born, was subjected to additional fetometry examinations at 34, 36 and 38 weeks of gestation, in the total pregnant population of 2,068, each pregnancy was the subject of 2.3 examinations. Other fetometry variables were evaluated for their efficacy as IUGR markers, but were not found to be superior to the current screening procedure in which BPD and abdominal diameter are combined in a simple formula to assess intra uterine growth. Overall, the screening procedure currently used at Malmo had a sensitivity of 64.1% and a specificity of 96.5%, the prevalence for IUGR being 3.8%. PMID- 3321869 TI - Epidemiology and pathogenesis of ureaplasma urealyticum in spontaneous abortion and early preterm labor. AB - The role of U. urealyticum in spontaneous and recurrent spontaneous abortion was studied in 633 women. Cervical colonization with U. urealyticum was found in 42.6% of 310 normal pregnant women, in 41.6% of 84 patients who underwent induced abortion, in 41.5% of 41 normal fertile patients, in 53.3% of 122 patients with spontaneous abortion and in 64.5% of 76 patients with recurrent spontaneous abortion. The cervical isolation rate was significantly higher in patients with spontaneous abortion (p less than 0.05) and recurrent spontaneous abortion (p less than 0.005) than in normal pregnant women. Endometrial colonization was more frequent in patients with recurrent spontaneous abortion (27.6%) than in normal fertile women (9.7%) (p less than 0.05). Moreover, in 6 patients with intact membranes and uncontrollable preterm labor resulting in fetal loss (all between the 20th and 28th week of gestation) U. urealyticum was isolated in 5 of them from the cervix, in 4 patients from the placenta and in 2 out of 4 from the amniotic fluid. Histological examination of the placenta showed signs of chorioamnionitis in 5 patients. From this study we conclude that although U. urealyticum is a common inhabitant of the lower genital tract, it may play a role in the etiology of spontaneous abortion and uncontrollable preterm labor. PMID- 3321870 TI - Ultrasonically guided fetal tissue biopsy. AB - From January 1984 to October 1986, a total of 185 prenatal diagnostic procedures were performed, viz. 120 chorionic villus samplings, 42 fetal blood samplings, 12 skin biopsies and 11 tumor biopsies. All procedures were performed under continuous ultrasound guidance. The methods are described, and indications for each procedure and clinical outcome discussed. Preliminary results have shown that ultrasonically guided fetal tissue biopsy is feasible for prenatal diagnosis, but randomized trials are needed for evaluation of the risk/benefit ratio. PMID- 3321871 TI - Organization of obstetrical ultrasound services in the Nordic countries. AB - This is a report of a questionnaire survey to all university departments of obstetrics in the five Nordic countries, concerning organization of ultrasound services. Answers were received from 23 out of 25. The services were differently organized, both between and within countries. This was true both of degree of centralization and of numbers and categories of personnel. The majority of departments in four countries had implemented routine screening programs, while in the fifth there was no organized ultrasound screening. PMID- 3321872 TI - Outpatient treatment of cervical intra-epithelial neoplasia. The CO2 laser versus cryotherapy, a randomized trial. AB - In a randomized study, 204 patients were allocated to either laser or cryo treatment for cervical intra-epithelial neoplasia (CIN). The patients were treated on an outpatient basis without anesthesia unless other conditions requiring anesthesia had to be dealt with at the same time. Both the laser and the cryo method were highly acceptable to the patients. Slightly more patients experienced moderate or severe pain during laser treatment, compared with cryo treatment (P = 0.05). Peroperative hemorrhage did not exceed 25 cc except for one laser-treated patient. Postoperative vaginal discharge was more often seen after cryo coagulation, the discharge being malodorous in 36% of cryo-treated patients and in 17% of laser-treated patients. Pelvic inflammatory disease was found in one patient in each treatment group. Postoperative spotting occurred more often in laser-treated patients (49%) than in cryo-treated patients (22%). At follow-up colposcopy 3 months after treatment, the squamocolumnar junction was fully visible significantly more often in laser-treated patients (P less than 0.001). The cure rates after one laser or cryo treatment were 90% and 91%, respectively. Subsequent to 19 initial treatment failures, 8 patients have at present been retreated with the same method as initially used, and all 8 are cured. The cure rates after one or two treatments are 96% in the laser group and 93% in the cryo group. The rates are preliminary, due to the short observation time. Publications will appear when all patients have been followed for 2 and 5 years. PMID- 3321874 TI - Treatment of central corneal ulcers by a chaud transplantation of organ culture preserved donor tissue. AB - In the period 1979-83 a total of 232 penetrating corneal transplantations were performed with organ culture preserved donor material. Forty-two operations were made a chaud for central corneal ulcerations. The results of these interventions are reported and discussed. The surgery presented no serious problems and on first post-operative day the anterior chamber was reformed in all cases, and pain was relieved. Patients were confined to bed only for 1 day. Graft deswelling was slightly retarded compared to planned surgery, but all functioning grafts obtained normal thickness. The overall graft survival rates after 6, 12 and 18 months were 66, 53 and 48%, respectively. For herpetic ulcers the survival after 18 months was 49% and for non-herpetic ulcers 47%. The grafts failed in all cases where it had been necessary to employ grafts of more than 10 mm. This latter group was comprised of the non-herpetic cases; were they excluded, the graft survival rate would increase to 60%. Among cases with a clear graft the median visual acuity after 18 months was 0.33 (range less than 0.1-0.67). Excluding cases with a non-corneal cause of visual reduction, the median visual acuity was 0.4 (range 0.33-0.67). It is concluded that grafting can be successfully employed in the treatment of central ulcers, as it not only restitutes tissue integrity, but also preserves useful vision. PMID- 3321873 TI - Induction of labor: a prospective, randomized study into amniotomy and oxytocin as induction methods in a total unselected population. AB - All women (n = 223) scheduled for induction of labor were randomized into start with oxcytocin infusion (O) or amniotomy (A). After 4 h an assessment of the progress and prognosis was made. If the progress was not acceptable O was added to A and A to O. Oxcytocin alone showed the lowest frequency of delivered patients. The "amniotomy only" group showed the shortest duration of delivery. The frequency of complications was low but somewhat higher when the initial step was oxcytocin. Oxcytocin alone is not a good method for induction. Early evaluation of the progress and prognosis of the induction is difficult. The combination of amniotomy and oxcytocin seem to be more essential than the choice of initial step. If, however, an infusion of oxcytocin is the first proceeding, amniotomy should be added on a routine basis and without delay. Bishop score is not a conclusive measure of the readiness of uterus to go into labor. Parity may partly be the explanation but other today unknown factors are probably involved in the inducibility. PMID- 3321875 TI - Critical oxygen requirements to avoid oedema of the central and peripheral cornea. AB - A randomized double-masked experiment was performed to compare the critical oxygen concentrations required to avoid corneal thickening at the central and peripheral cornea. Pachometry was performed on 10 subjects before and after 3 h of corneal exposure to the following gasmixtures: 0.00, 1.01, 2.65, 5.13 and 10.3% oxygen, balance nitrogen. Widely ranging critical values (from 4.4 to 11.6% for the central cornea and 1.7 to 15.8% for the peripheral cornea) could be obtained depending upon the analytical procedure used to treat the data; that is, the choice of reference baseline, the curve fitting procedure adopted and the method of comparing the reference baseline with the fitted curve. The estimates of the critical oxygen requirement of the central cornea are consistent with previous studies when compared using the same analytical procedure. Similar critical values were derived for the central and peripheral cornea for any given analytical procedure (e.g. 9.8% for the central cornea, and 12.3% for the peripheral cornea for zero mean change in corneal thickness). Our findings indicate that anatomical and physiological differences between the central and peripheral cornea do not have clinically significant effects on the minimum oxygen requirements at these respective sites. This result has implications with respect to lens design considerations for alleviating physiological stress of the cornea during contact lens wear. PMID- 3321876 TI - Intraocular lens calculation. An evaluation of Binkhorst and SRK estimates in 100 consecutive cataract extractions with 3M type 78 anterior chamber lens implantation. AB - Intraocular lens power prediction and final astigmatism were evaluated in 100 consecutive cataract patients (age 57-92 years, mainly with intracapsular extraction) 4-13 months after insertion of a 3M type 78 anterior chamber lens. The analysis was based on refractive recordings from the referring ophthalmologists who took care of post-operative controls. Ninety-two patients were accepted for the study. A Sonometrics DBR 400 ultrasound equipment and a Haag-Streit keratometer had been used for measuring eye length and corneal power, the Binkhorst programme and SRK formula for selecting IOL power, resulting in an IOL range of +12 to +23 D. Mainly, low myopia was intended. Nearly 50% fell within 0.5 D from predicted value; 90% were within +/- 1.5 D, by both calculating methods. SRK predictions appeared unaffected by eye size, while axial length (x) significantly influenced Binkhorst prediction (y): y = 8.08-0.35x (r = -0.40), the deviation being most marked in very short eyes. For eyes of midsize the two methods did not differ. Regarding astigmatism, 3 patients ended with values above 3D. In 83% it was less than 2D. Eighty per cent obtained a visual acuity of 0.5 or better. All things considered we feel that the calculation procedure should be standard when performing cataract surgery with IOL implantation. PMID- 3321878 TI - A double-masked crossover study comparing the effects of carteolol 1% and 2% on intra-ocular pressure. AB - No significant difference was found between carteolol 1% and 2%, when their effects on intraocular pressure were compared over a 4 week treatment period. Twenty ocular hypertensive subjects were recruited for this double-masked crossover trial. PMID- 3321877 TI - Timolol/pilocarpine combination eye drops in open angle glaucoma and in ocular hypertension. A controlled randomized study. AB - The effect of a newly developed ophthalmic solution containing both 0.5% timolol and 2% resp. 4% pilocarpine was compared with that of timolol 0.5% eye drops alone in 93 patients with manifest simple or capsular glaucoma or ocular hypertension. The medications were administered twice daily. The absolute additive effect of pilocarpine was small, although the combined solutions caused a statistically significantly greater reduction of the intraocular pressure than that achieved by timolol alone. This additional effect appeared to last at least 12 h. The effect of the test solutions containing 2% resp. 4% pilocarpine was very similar. Apart from the well-known effects of the pilocarpine-induced miosis, the combined test medications were generally well tolerated. PMID- 3321879 TI - Bilateral absolute phakolytic glaucoma. A clinical and ultrasonographic case study. AB - We describe an unusual case of absolute bilateral phakolytic glaucoma. On admission for cataract surgery the 75-year-old patient was found to be totally blind, no light perception in either eye. The ocular tensions were about 75 mmHg in both eyes, corneas hazy, the fundi could not be seen. The swollen lens of the right eye had slightly subluxated downwards. In the left eye the ultrasound showed a luxated swollen lens in the vitreous space. The ultrasound also revealed totally excavated optic discs. This patient had been on the waiting list for 8 months. Information of the stage of the cataracts of patients on the waiting lists for operation is of paramount importance in the prevention of lens induced problems which may lead to irreversible visual deterioration. PMID- 3321880 TI - A carbon chamber for vital microscopy of bone healing. AB - We describe a carbon chamber implanted in the ulna of fowl. A window permitted daily microscopy of bone formation including observations of tetracyline labelling. The chamber could be heated to 5 degrees above body temperature by 600 kHz radio frequency. PMID- 3321881 TI - Osseointegration of bone implants. A review of an alternative mode of fixation. PMID- 3321882 TI - Review of diseases presenting as "midline granuloma". Clinical implications for the appropriate workup of patients with midline granuloma syndrome with emphasis on recent diagnostic advances in lymphoid neoplasms that present as midline destructive lesions. AB - Midline destructive disorders (so-called 'midline granuloma') comprise a wide variety of diseases that present as destructive lesions in the upper airways. These diverse diseases include infectious, immune and neoplastic disorders, each of which obviously requires a differing therapy. The clinician must have an appreciation of these diseases in order to make a rational approach to diagnosis. Because of recent advances in immunohistochemical techniques, cell typing will necessitate certain changes in the manner in which biopsy material is initially handled. This paper discusses the differential diagnosis of midline destructive disease, the pathologic techniques necessary to diagnose them and recent ideas concerning the pathogenesis of the malignant lymphoid processes which cause some of these diseases. PMID- 3321883 TI - [Vocal cord paralysis in the intermediary and paramedian position. Etiology and treatment]. AB - The purpose of this paper is to recall the neuroanatomical bases of the motrice laryngeal innervation and the consequences of a lesion at that level. On the other hand, the type of management and effective therapy our service uses in those cases of unilateral of bilateral vocal cord paralysis. The management is principally based on the E.M.G., the objective phonatory measurements including the spectral voice analysis. The unilateral paralysis is usually treated by the speech pathologist reeducation and, if necessary, GAX collagen injection in the vocal cord. The bilateral paralysis, generally in adduction, is cured in the most cases with a CO2 laser arytenoidectomy. PMID- 3321884 TI - [Experiences with the median drainage method of the frontal sinus in post traumatic surgery]. AB - In 127 industrial and traffic accidents, which showed a damage of the rhinobasis or the posterior wall of the frontal sinus with or without dural rent, median drainage of the frontal sinuses was done after primary wound toilet. In all cases a sure and good working continuous drainage was achieved. Extra- or intracranial complications just as a re-stenosis of the new shaped approach were not observed. Short advices are given for the method of procedure. PMID- 3321885 TI - Plant poisoning and oto-rhino-laryngology. Poisonous plants, growing or used in Europe and the United States. AB - Poisoning often affects the ear, nose, mouth and throat. Sialorrhea, stomatitis, oropharyngeal dryness, a burning sensation in the mouth, rhinitis and nasal septal perforation, hearing loss and vestibular disturbances can be the result of intoxications by poisonous plants, growing or used in Europe and the United States. This article has not the intention to be exhaustive, but to give a synopsis of this topic. PMID- 3321886 TI - [Morphofunctional study of the osteocytes in the tympanic ossicles under normal conditions]. PMID- 3321887 TI - [Naso-paranasal tumors: considerations on 62 cases and review of the most recent literature]. PMID- 3321888 TI - Arvo Ylppo 100 years. October 27, 1987. PMID- 3321889 TI - Release of GI hormones in mother and infant by sensory stimulation. AB - It is well established that sensory stimulation is of great importance for the growth of and for the physiological and psychological development of infants. Supplementary sensory stimulation such as non-nutritive sucking and tactile stimulation has been shown to increase the growth rate and the maturation of premature infants. In human neonates non-nutritive sucking has a vagally mediated influence on the levels of some gastrointestinal hormones. In animal experiments afferent electrical stimulations of the sciatic nerves at low intensity leads to an activation of the vagal nerves and to a consequent release of vagally controlled gastrointestinal hormones such as gastrin and cholecystokinin. We therefore assume that both non-nutritive sucking and tactile stimulation trigger the activity of sensory nerves which leads to a release of vagally regulated gut hormones. Since gut hormones stimulate gastrointestinal motor and secretory activity and the growth of the gastrointestinal tract, and enhance the glucose induced insulin release, they may contribute to the beneficial effects on maturation and growth caused by sensory stimulation. In the breast-feeding situation, the sucking of the child elicits similar reflexes in the mother leading to an activation of the maternal gut endocrine system and a consequent increase in energy uptake. These data indicate that many types of neurogenic reflexes induced in mother-infant interactions are of importance for the energy economy of both mother and child. PMID- 3321890 TI - The benefits of the very early introduction of powdered rice and dried edible seeds (Dal moong) in the oral rehydration solution during the treatment of acute infectious diarrhoea of infancy. AB - We have examined whether the addition of powdered rice and pulses (Dal moong) to oral rehydration solution will decrease the purging rate and thereby increase the efficacy of the oral rehydration therapy. The study was carried out on 60 male infants, with acute watery diarrhoea, moderate dehydration but without fever, vomiting, or other conditions like septicaemia and meningitis. The infants were treated with either the standard WHO oral rehydration salt solution (ORS) or with a modified solution where glucose was removed and powdered rice and Dal moong were added. We found that the infants receiving ORS with powdered rice and Dal moong had significantly lower fluid losses in the stools, a significant and more rapid weight gain, and needed significantly less fluid than the infants receiving ORS only. PMID- 3321891 TI - Early intravenous indomethacin prolongs respiratory support in very low birth weight infants. AB - Infants weighing 1500 g at birth requiring either intermittent positive pressure ventilation or continuous positive airway pressure by 12 hours of age were entered in a randomized double blind controlled trial to test the efficacy of early intravenous indomethacin therapy in preventing chronic pulmonary disease of prematurity. Of the 30 newborns enrolled, 15 were treated with indomethacin and 15 were treated with placebo at 12, 24 and 36 hours of age. The groups were similar for birth weight, gestational age, sex, hyaline membrane disease and intracranial hemorrhage. Infants in the placebo group were successfully weaned from intermittent positive pressure ventilation at an earlier age than infants in the indomethacin group (p less than 0.05). Furthermore, chronic pulmonary disease of prematurity was similar in the two groups despite a reduction in the incidence of patent ductus arteriosus in the indomethacin group. PMID- 3321892 TI - Delayed hypersensitivity responses in children after local cutaneous anesthesia. AB - The effect of cutaneous analgesia on delayed type hypersensitivity (DTH) reactions as challenged by injections in the skin was assessed by comparing a lidocaine/prilocaine mixture with placebo. Application of 5 g of the mixture 90 min before testing significantly (p less than 0.001) reduced pain but did not influence the DH-reactions as read after 48 hours. Based on these findings, DTH to several antigens were measured in 116 school children, aged 7-15 years. All the children were positive to either tetanus antigen, 7.5 Lf/ml (98% at 48 hours) or mumps test antigen (82%), while positivity to tuberculin 2 TU/ml and candida 1000 PNU/ml were only 11 and 62% respectively. Therefore, DTH tests in an adequately immunized population of children can be limited to two antigens. Application of cutaneous analgesia is recommended as a routine procedure in DTH testing in young children. PMID- 3321893 TI - Metabolic and histological pancreatic changes induced by ovariectomy in the female dog. AB - The actions of ovariectomy performed 4 months in advance on pancreas cytology and also upon the blood sugar, serum immunoreactive insulin and circulating free fatty acid changes over glucose and insulin tests, were studied in female dogs. We concluded that ovariectomy does not affect blood sugar -basally or during the tests-, glucose space and clearance rate of glucose from circulation. Conversely, the integrated insulinemic response over glucose test was highly risen (956%) by ovariectomy in such animals; the rise occurs despite they show a broadened (59%) insulin space, is slightly mediated by a reduction (132%) in insulin clearance from circulation, and appears to be chiefly mediated by a major enhancement in insulin secretion. The immunocytolocalization of insulin in the pancreatic tissue of ovariectomized female dogs showed hypertrophy of Langerhans islets, beta degranulation but no vacuolation. However, the piling up of the beta-granules by the vascularly pole of the B-cells as well as the appearance of a pretty number of small islets and microislets widespread over the acini, absent in the pancreatic tissue of the untreated controls in anestrous, indicate for the insulin secretory potency of the pancreas of the ovariectomized female dog to be apparently high. In the female dog, ovariectomy affects serum free fatty acid levels via at least two mechanisms, viz., a) stimulation of lipid storage over the glucose test, and b) reduction in lipomobilization as insulin antagonism predominates. PMID- 3321894 TI - 50th anniversary of the foundation of the Polish Physiological Society, 1936 1986. Eminent Polish life-scientists--biographies and works. PMID- 3321895 TI - Marceli Nencki 1847-1901. PMID- 3321896 TI - Stanislaw J. Przylecki. PMID- 3321897 TI - Edmund Biernacki 1866-1911. PMID- 3321898 TI - Kazimierz Bialaszewicz 1882-1943. PMID- 3321899 TI - Stefan Kopec 1888-1941. PMID- 3321902 TI - Andrzej Jan Klisiecki 1895-1975. PMID- 3321901 TI - Janina Hurynowicz 1894-1967. PMID- 3321900 TI - Bronislaw Zawadzki 1903-1957. PMID- 3321903 TI - Waclaw Sobieranski 1861-1902. PMID- 3321904 TI - Marian Eiger 1873-1939. PMID- 3321905 TI - Boleslaw Gutowski 1888-1966. PMID- 3321906 TI - Jozefa Joteyko 1866-1928. PMID- 3321907 TI - Wlodzimierz Jan Missiuro 1892-1967. PMID- 3321908 TI - Mieczyslaw Wierzuchowski 1895-1967. PMID- 3321909 TI - Jerzy Modrakowski 1875-1945. PMID- 3321910 TI - Karol Klecki 1866-1931. PMID- 3321911 TI - Edward Stanislaw Czarnecki 1892-1970. PMID- 3321912 TI - Increase of insulin and decrease of glucagon levels in response to total and fractionated weaning in sows. AB - The effect of weaning on plasma levels of insulin and glucagon as well as on plasma glucose levels was studied in sows after final weaning (all the piglets removed in week 5 of lactation) and fractionated weaning (7 out of 12 piglets removed in week 3 of lactation). Insulin levels rose from 24 +/- 6 to 106 +/- 22 microU ml-1 4 days after final weaning and from 11 +/- 1 to 128 +/- 20 microU ml 1 7 days after fractionated weaning. Glucagon levels fell from 60 +/- 20 and 42 +/- 8 to 35 +/- 10 and 24 +/- 5 pm in the two groups, respectively. Plasma glucose levels increased from 4.5 +/- 0.5 to 7.2 +/- 1.2 mM after fractionated weaning and remained unchanged after final weaning. One possible mechanism that can explain this pronounced insulin increase and decrease of glucagon is the elevation of plasma glucose, since milk is no longer emptied from the mammary gland and since insulin resistance occurs after weaning in rats. Another possible explanation could be a decreased number of insulin receptors in the mammary gland, since prolactin which is known to increase insulin receptors is decreased in weaned rats. PMID- 3321913 TI - Suckling increases insulin and glucagon levels in peripheral venous blood of lactating dogs. AB - The aim of the present investigation was to study changes in insulin, glucagon and plasma glucose levels in response to suckling in lactating dogs. Blood samples were drawn from a peripheral vein during suckling in weeks 1 and 3 of lactation in 10 lactating beagles. Insulin- and glucagon-like immunoreactivity (below referred to as insulin and glucagon) were determined by radio-immunoassay, and plasma glucose levels by the glucose oxidase method. Insulin and glucagon levels rose following onset of suckling. However, only the rises recorded in week 3 of lactation were statistically significant. Plasma glucose levels were not affected. The mechanism by which suckling influences the levels of insulin and glucagon is not known. However, the release of both hormones is under vagal control and it is possible that touching of the teats reflexly elicits a vagally mediated release of these hormones. Alternatively, since oxytocin stimulates the secretion of insulin and glucagon, the effects might be secondary to the oxytocin released by suckling. The physiological function of the suckling-related release of insulin may be to stimulate milk production. Furthermore, since glucagon is also released, each suckling period may be accompanied by a transfer of glucose to the mammary glands from other maternal stores. PMID- 3321915 TI - Presence of glutamic acid decarboxylase in some corticotropin-releasing-factor- (CRF-) containing neurons of the paraventricular nucleus. PMID- 3321914 TI - Fluid and protein fluxes across small and large pores in the microvasculature. Application of two-pore equations. AB - Treating the blood-tissue barrier as a two-pore membrane the separate fluid and solute fluxes occurring across 'small pores' and 'large pores' were modelled in continuous capillaries employing two-pore equations for the calculations together with the non-linear flux equation and theories for restricted diffusion and for the reflection coefficient (sigma). The two-pore equations derived proved useful for analyses of transvascular protein flux data obtained at low as well as at high filtration rates. These equations were applied to lymphatic protein flux data from dog paw (Renkin et al. 1977a, b) and to tracer albumin uptake data from rat skeletal muscle (Rippe et al. 1979). For both sets of data the small- and large-pore radii became closely similar, 44 vs. 45 A and 240 vs. 225 A, which also holds for the large-pore fractions of hydraulic conductivity (0.097 vs. 0.056). The main result of this analysis is that the passage of macromolecules normally occurring across the microvascular walls is almost entirely convective, and hence, dependent on the transmural hydrostatic and oncotic pressure gradients and on the hydraulic conductivity. For example, 75-90% of the transvascular passage of albumin was found to be due to convection through large pores at normal lymph flows, the remaining portion being mainly due to diffusion across small pores. Solutes larger than albumin were almost exclusively transported by convection across large pores. Two-pore heterogeneity was found to explain the previously observed variations of the apparent overall large solute diffusion capacity (PSapp) and the overall reflection coefficient (sigma f) with filtration rate and also previous overestimations of PS. Furthermore, the present results were not compatible with protein transport across any 'non-hydraulically conductive capillary pathways' as previously postulated from the lymphatic protein flux data analysed here (Renkin 1985). PMID- 3321917 TI - [Review and updating of the diagnostic sensibility of the dexamethasone suppression test and urinary determination of phenylethylamine and 3-methoxy-4 hydroxyphenylethylglycol in the diagnosis of endogenous depression]. AB - 60 endogenous depressive patients (DSM III: 296.2x, 3x, 296.5x) were studied according to the following diagnostic techniques: DST (Carroll's standardization), Phenyl-ethyl-amine (PEA) urinary quantification (Spatz's technique) and 3-Methoxy-4-Hydroxyphenylethyl Glycol (MHPG) urinary quantification (Bigelow's technique). Seven groups were thus obtained according to their being positive in, at least, one of those determinations. The above mentioned techniques allow the finest of discriminations since 5% of the patients only kept undetected. The critical path analysis to this conclusion is discussed. PMID- 3321916 TI - Coexistence of CGRP- and VIP-like immunoreactivities in a population of neurons in the cat stellate ganglia. PMID- 3321918 TI - [Open clinical trial with haloperidol decanoate in patients with psychotic disorders]. AB - In order to evaluate the efficacy and tolerance to Haloperidol Decanoate, 26 patients with different psychotic disorders were included in a six month's clinical study. The dose administered monthly was equivalent to twenty times the oral daily doses of neuroleptics generally used by these patients. In 92% of the cases an improvement higher than a 70% of the clinical symptoms was achieved, if comparing the baseline with final data. In no patient results inferior to those observed with oral neuroleptics were detected. Adverse reactions like parkinsonism or dyskinesia were present in some patients. However their intensity was mild to moderate, over a short period of time only. PMID- 3321919 TI - [Towards 100 years of the creation of the discipline of mental diseases in Buenos Aires]. PMID- 3321920 TI - The suicide rate of epilepsy. AB - Evidence from follow-up studies concerned with the mortality of epilepsy suggests the suicide rate is increased. The risk of suicide seems to be higher from temporal lobe epilepsy, for epilepsy with a greater degree of handicap and in the early years of the condition. PMID- 3321921 TI - Outcome of patients with diabetic nephropathy after kidney transplantation. AB - During the period 1973-1983, 1,014 patients with end stage renal failure received a kidney graft at the Helsinki University Central Hospital. As a consequence of diabetic nephropathy, 163 of them (16%) developed renal failure. Ten diabetic (6%) and 72 non-diabetic (9%) patients received grafts from a living donor. One year patient survival did not differ between diabetic and non-diabetic patients (76% and 79%, respectively). From the second post-transplant year onwards patient survival was worse in diabetic than in non-diabetic patients. The two groups did not differ with respect to graft survival. Sixty-two diabetic patients (38%) died during the follow-up period, with myocardial infarction as the most common cause of death (31%), followed by infection (15%) and cerebral stroke (13%). Seven myocardial infarctions out of 19 occurred within three months of transplantation. However, significantly more fatal and non-fatal myocardial infarctions were observed in post-transplant patients who had returned to dialysis therapy than in patients with a functioning kidney graft. Blindness did not influence the outcome of transplantation. Nor did the transplantation significantly affect the course of this diabetic complication. In conclusion, although the early success rate of kidney transplantation in our study population was acceptable, the later outcome was poor, mainly due to advanced disease-related complications. PMID- 3321922 TI - Renal size, glomerular function and urinary excretion of albumin and beta 2 microglobulin in patients with renal scarring due to pyelonephritis. AB - We have determined glomerular filtration rate (GFR), renal plasma flow (RPF), urinary excretion of albumin and beta 2-microglobulin, urinary osmolality and total renal area in 22 female patients with renal scarring and a history of febrile urinary tract infections (UTI) and in nine healthy age-matched controls with normal i.v. urography. The aim of the study was to compare different methods of determining glomerular function in patients with renal scarring due to previous pyelonephritis and to determine the urinary excretion of beta 2 microglobulin in these patients. All individuals were investigated in hydropenia. The patients with renal scarring had significantly lower GFR, smaller kidneys and lower urinary osmolality than the controls. A significant positive correlation between GFR and total renal area (r = 0.70, p less than 0.001) and between GFR and urinary albumin excretion (r = -0.69, p less than 0.001) was demonstrated. This indicates that determinations of total renal area from an i.v. urography and the urinary albumin excretion can be used for estimating GFR. Increased urinary excretion of beta 2-microglobulin does not occur in patients with renal scarring until the glomerular function is severely deteriorated. PMID- 3321923 TI - Increased plasma fibronectin concentrations in obesity: normalization during weight loss. AB - In 23 morbidly obese patients we investigated the influence of a large weight loss (30.6 kg, range 17.5-90.8) on the plasma fibronectin concentrations. Further, changes in plasma fibronectin were related to serum insulin levels and to liver biochemistry. Between the measurements patients had been treated with an intermittent very-low-calorie formula diet sufficient in respect to protein, minerals and vitamins. They were investigated in weight-stable states. Before weight reduction, 14 patients (61%, 95% confidence limits 39-80%) had elevated plasma fibronectin levels. Plasma fibronectin decreased (medians 1.22 and 0.59 mumol/l before and after weight loss, p less than 0.01) and was after weight loss within the normal range in 14 patients. The change in plasma fibronectin was unassociated with the magnitude of the weight loss as well as with the reduction of overweight. The resulting plasma fibronectin levels were also uncorrelated with the body weight and with the final degree of overweight. Serum insulin decreased (p less than 0.01) during the weight reduction and the change correlated (p less than 0.05) with the change in plasma fibronectin. Serum lactate dehydrogenase, which is associated with the degree of hepatic fatty change, declined (p less than 0.01), but the individual change was unrelated with the change in plasma fibronectin. In conclusion, the elevated plasma fibronectin levels in morbidly obese subjects seem to normalize during weight loss. We suggest the normalization to be mediated--at least in part--by a reduction of the insulin levels. PMID- 3321924 TI - Effects of cisapride on gastroparesis in patients with insulin-dependent diabetes mellitus. A double-blind controlled trial. AB - Fourteen insulin-dependent diabetics with symptoms and signs of delayed gastric emptying were treated with a new prokinetic agent, cisapride. In a placebo controlled cross-over trial no significant differences from placebo was found regarding overall symptomatic effects and effects on gastric emptying of a mixed solid/liquid isotope marked test meal. Solid emptying was most markedly delayed in diabetics compared with healthy controls, but the emptying rate was not correlated to the severity of symptoms as observed for liquid emptying. During active treatment with cisapride the amelioration of symptoms was correlated to increased emptying rates assessed by combined measure of liquid/solid gastric emptying. PMID- 3321925 TI - Treatment with one-alpha-hydroxycholecalciferol in middle-aged men with impaired glucose tolerance--a prospective randomized double-blind study. AB - Experimental evidence suggests a specific role for the active metabolite of vitamin D (1,25(OH)2D3) in insulin secretion. In order to evaluate the possible clinical significance, 65 middle-aged men with impaired glucose tolerance, and normal serum levels of vitamin D metabolites, were enrolled in a three-month study where they were given either 0.75 micrograms alpha-calcidol (1 alpha(OH)D3) daily or placebo. Indices of glucose and lipid metabolism were evaluated before and after treatment. There were no significant changes during the trial neither for fasting blood glucose, hemoglobin A1c or for the intravenous glucose tolerance between the treatment and the placebo groups, nor were there any consistent changes in insulin values during the glucose tolerance test. Subjects treated with alpha-calcidol displayed a significant reduction in body weight with an average of 1.1 kg, while those receiving placebo lost no weight. Treatment did not affect the serum lipoprotein values. Thus, a modest dose of active vitamin D, which did not cause elevation of serum calcium, did not provide general improvement of glucose tolerance or of insulin secretion when given to patients with impaired glucose tolerance, but without vitamin D deficiency, over a three month period. PMID- 3321926 TI - Blood pressure is lowered by vitamin D (alphacalcidol) during long-term treatment of patients with intermittent hypercalcaemia. A double-blind, placebo-controlled study. AB - There is epidemiologic evidence of a relationship between calcium deficiency and hypertension. The present study evaluated the effects of alphacalcidol, a synthetic analogue of active vitamin D, given to 29 patients with marginal, intermittent hypercalcaemia. Before therapy there was an inverse relationship between serum calcium levels and diastolic blood pressure (p less than 0.02). Treatment with 1 microgram alphacalcidol raised the serum calcium by 0.07 mmol/l during a 6-month, double-blind, placebo-controlled trial and caused a significant reduction of diastolic blood pressure by 9.2 mmHg compared with placebo (p less than 0.01). The study extends previous observations, in normocalcaemic subjects, of inverse relationships between serum calcium and blood pressure indicating a primary disturbance of calcium homeostasis in hypertension. The observation that a physiologic amount of active vitamin D has hypotensive effects agrees with such a concept and suggests a new principle for the treatment of hypertension. PMID- 3321927 TI - Serum lipid and lipoprotein levels in long-term insulin-dependent diabetes mellitus. Relation to residual insulin secretion, microvascular lesions and environmental factors. AB - The aim of the present study concerning patients with long-term insulin-dependent diabetes mellitus was to determine whether the serum lipid and lipoprotein concentrations differ in subjects with and without residual insulin secretion. We also investigated whether factors such as sex, smoking, physical activity and microvascular lesions were associated with particular lipoprotein profiles. C peptide excretion (greater than or equal to 0.2 nmol) in 24-hour urine samples was used as an indicator of residual insulin secretion. Twenty-two pairs of patients with and without residual insulin secretion matched for age at onset and disease duration were participating in the investigations of glycaemic control and microvascular lesions. The HbA1c was significantly lower in C-peptide excretors than in the non-excretors (6.9 +/- 0.3 vs. 7.9 +/- 0.3%, p less than 0.025). The lipids and lipoprotein fractions were all within normal limits. The HDL2/3 ratio was significantly higher in C-peptide excretors than in non excretors (1.72 +/- 0.28 vs. 1.10 +/- 0.09, p less than 0.05). Multiple regression analysis showed that factors, such as physical activity, body mass index and glycaemic control could explain more of the variation in the different lipid and lipoprotein fractions than residual C-peptide excretion alone. The only fraction correlating with C-peptide excretion was HDL3 cholesterol. It is concluded that minute residual insulin secretion per se is of minor importance for the regulation of lipids and lipoproteins. Glucose control and residual insulin secretion together with environmental factors seem to be of great importance for the regulation of the lipid and lipoprotein levels in insulin dependent diabetes mellitus. PMID- 3321928 TI - A re-examination of patients with previously detected autoantibodies to smooth muscle. AB - A group of patients which previously had been found to possess smooth muscle antibody (SMA) activity was re-examined for persistence of the autoantibody. The mean observation time was four years (range 0.5-9 years). Thirty out of 140 patients, who initially had SMA associated with rheumatic or other symptoms, had autoantibody activity at re-examination. Most were low in titer, and none of the 30 had developed chronic liver disease. Twenty-four patients with SMA at the first testing were analyzed because of liver pathology. Five had CAH at that time. SMA in low titer associated with liver pathology was a transient phenomenon. SMA in high titer combined with liver pathology seems to be a persistent condition with respect to both parameters, although no additional patients developed CAH between the first testing and re-examination. PMID- 3321929 TI - Subcutaneous insulin substitution in insulin-dependent diabetes mellitus. Pharmacokinetic and pharmacodynamic studies. AB - Determination of free and total insulin with radioimmunoassay, after precipitation of endogenous insulin antibodies with polyethylene glycol, was evaluated. Insulin substitution in insulin-dependent diabetic patients was investigated, embracing the 24 h free insulin and glucose profiles with different regimens, the miscibility of insulin preparations, the overnight metabolic control, and bolus doses of different size with infusion pumps. In the free and total insulin assay precipitation of immunoglobulins with polyethylene glycol was almost complete and the recovery was high. Compared to immediately precipitated and assayed plasma samples at 37 degrees C, free insulin slightly decreased in immediately processed serum (20 degrees C), and also in plasma after 3 h at 20 degrees C. In stored (-20 degrees C) unprecipitated plasma samples free insulin increased after 4 weeks and also in serum samples after 26 weeks, whereas stored PEG-supernates were stable. In healthy controls a low basal insulin was found, increasing about tenfold postprandially. No morning rise in free insulin or glucose was found. The 24 h free insulin profile was strikingly unphysiological with 1 or 2 dose regimens; there was preprandial and nocturnal hyperinsulinaemia but absence of meal-related free insulin peaks. A considerable glucose rise was found after breakfast. Intensive regimens with conventional injections or infusion pumps, gave 24 h free insulin profiles that were similar to the physiological. However, the prandial peaks were retarded; and hyperinsulinaemia was shown with infusion pumps during daytime. An immediate loss of regular insulin was demonstrated after mixture with semisynthetic human lente insulin in vitro and in vivo, but not after mixture with biosynthetic human NPH insulin. The morning glucose control was similar with a bedtime injection of intermediate acting insulin or continuous subcutaneous insulin infusion, but less hyperinsulinaemia overnight was found with the infusion pump at a constant rate. No early morning glucose rise was demonstrated. Dose-related free insulin profiles were shown after bolus doses with an infusion pump, although they were retarded compared to the physiological postprandial response. The postprandial hyperinsulinaemia was aggravated by continuous subcutaneous insulin infusion. Glucose consumption during euglycaemic clamp corresponded to the free insulin profiles, indicating that free insulin represents the biologically active hormone. PMID- 3321931 TI - Bacteria-agglutinating characteristics of secretory IgA and a salivary agglutinin. PMID- 3321930 TI - Cranio-cerebral erosion (growing fracture of the skull in children). Part II. Clinical and radiological observations. AB - This paper is based on a study of sixty cases of cranio-cerebral erosion treated in the Department of Neurosurgery. All India Institute of Medical Sciences, New Delhi during the last 20 years. This constitutes the largest series, so far reported from anywhere. It has provided a unique opportunity to get a comprehensive picture of the clinical and radiological features of this lesion, as also their evolution. These have been correlated with the findings at surgery and histopathological observations. The study highlights the incidence, pattern and severity of the brain damage associated with this lesion. Evidence has been provided for the progressive nature of the brain damage, not adequately emphasized in the existing literature. Pathogenesis of this brain damage has been discussed. The role of surgery in the management of this lesion has been outlined. Emphasis on the osseous changes or the "leptomeningeal cyst" (not really a consistent or important feature) in most publications on this subject has tended to minimize the significance of the brain damage in this condition. The authors suggest that the latter is far more important and therefore, recommend the use of nomenclature which takes this into account. PMID- 3321932 TI - Secretory component binding: immunofluorescence and ultrastructural studies. PMID- 3321933 TI - Circulating IgA in humans. PMID- 3321934 TI - Haemophilus influenzae IgA1 proteases: determinants of cleavage site specificity and secretion. PMID- 3321935 TI - IgA protease from Clostridium ramosum that cleaves IgA1 and IgA2, A2m(1): the site of cleavage and digestion of secretory IgA. PMID- 3321936 TI - Mucosal immunocompetence in man--the first five years. PMID- 3321937 TI - Non-specific release of migration inhibitory factor by senescent immune lung cells in aged guinea pigs. PMID- 3321938 TI - An oral B subunit-whole cell vaccine against cholera: from concept to successful field trial. PMID- 3321939 TI - Novel oral vaccines: the effectiveness of cloned gene products on inducing secretory immune responses. PMID- 3321940 TI - The paradox of immunization against Haemophilus influenzae-related endobronchitis: protection restricted to ingestion of 'non-adjuvenated' vaccine. PMID- 3321941 TI - Induction of IgD antibodies in rat milk and serum by intramammary and enteric immunization. PMID- 3321942 TI - Inhibition of enteropathogenic Escherichia coli (strain RDEC-1) adherence to rabbit intestinal brush borders by milk immune secretory immunoglobulin A. PMID- 3321943 TI - Enhancement of the secretory IgA response to enteropathogens. PMID- 3321944 TI - IgA antibody to group specific polysaccharide in secretions of carriers and noncarriers of group B streptococci. PMID- 3321946 TI - Tumor growth versus fetal development--similarities and confusions. PMID- 3321945 TI - Type-specific antibodies against group B streptococci in human serum, saliva and vaginal secretions. PMID- 3321947 TI - Platelet and granulocyte transfusions in cancer patients. PMID- 3321948 TI - Specificity and use of antisera produced against anticancer drugs. PMID- 3321949 TI - Children of alcoholics. PMID- 3321951 TI - Rhinencephalic structures and their anatomical organization. PMID- 3321950 TI - [Keratomycosis in Japan, reported from 1981 to 1985]. PMID- 3321952 TI - [Hydatid cyst of the kidney. Apropos of 36 case reports]. PMID- 3321953 TI - [Value of peroperative endocavitary echography in the staging of superficial tumors of the bladder. Personal experience in 41 cases]. PMID- 3321955 TI - [Metastatic renal tumor originating from esophageal carcinoma: a case report]. AB - A 61-year-old male, who had undergone operation of esophageal carcinoma 11 months earlier, was admitted for left flank pain and high fever. Intravenous pyelography showed a space occupying lesion in the upper half of the left kidney. Computed tomographic scan showed an irregular low density area in the upper half of the left kidney. Angiograms revealed a hypovascular mass with encasement vessels in the same site. Left nephrectomy and paraaortic lymph node biopsy was performed. Pathological examination revealed a metastatic squamous carcinoma from the esophageal carcinoma. Chemotherapy was conducted, but he died 2 months later. Autopsy revealed recurrence in the retroperitoneum, and no metastasis in the right kidney. The literature on secondary renal tumor is reviewed. PMID- 3321954 TI - [Case report on testicular tumors in non-twin siblings]. AB - A case report of testicular tumors in non-twin siblings is presented. A 42-year old male was admitted to Kansai Electric Power Hospital with the complaint of swelling of the left scrotal contents. Left radical orchiectomy was performed with the diagnosis of a left testicular tumor. Histological examination revealed a seminoma of the left testis. Fifteen years later, his 43-year-old younger brother was admitted to Osaka University Hospital with the complaint of painless swelling of the left scrotal contents. Left radical orchiectomy was carried out with the diagnosis of a left testicular tumor. Histological examination showed a seminoma of the left testis. The former patient had a history of a scrotal trauma, but there was no history of orchitis or cryptorchism in these two siblings. To our knowledge, there have been reported 44 sets of testicular tumors in siblings. Eleven of these sets appeared in twins, while the other 33 sets were described in non-twin siblings. We discussed the 45 cases including our case of testicular tumors in siblings. PMID- 3321956 TI - [Foreign body in the kidney associated with stone formation: report of a case]. AB - A 56-year-old woman was admitted to our hospital with the chief complaint of fever and right flank pain. She had had pyelolithotomy on the right kidney at another hospital eleven years earlier. Plain X-ray showed eight calcified shadows in the renal area. Excretory urograms showed slight hydronephrosis on both sides. Right pyelolithotomy was performed and it disclosed foreign body stones with nuclei of silk sutures used in the previous surgery. Including our case, nine cases of suture-thread stones in the upper urinary tract were found in the Japanese literature. PMID- 3321957 TI - [A renal cell carcinoma with metastasis to the tongue]. AB - A 42-year-old man had rapidly progressing metastasis to the tongue 3 months after nephrectomy due to renal cell carcinoma. He visited an otolaryngeal clinic with the chief complaint of bleeding and pain on his tongue. Biopsy of the tongue revealed metastasis from the renal cell carcinoma. After treatment with radiation and chemotherapy, the tongue tumor was disappeared macroscopically. Renal cell carcinoma metastasizing to the tongue is rare. Statistical studies on the report of metastasis to the tongue of renal cell carcinoma are reviewed. PMID- 3321958 TI - [A case of retroperitoneal liposarcoma]. AB - A case of retroperitoneal liposarcoma is reported. A 42-year-old woman was admitted to our hospital with the complaint of a palpable mass in her left abdomen. Intravenous pyelography, barium enema and an ultrasonogram revealed a huge left abdominal tumor. At operation, a huge yellow-brownish tumor found in the retroperitoneal space, was completely removed. The tumor was 32 x 24 x 12 cm and weighed 4,075 g. Histologically, it was a myxoid liposarcoma. Three courses of adjuvant chemotherapy (cis-platin) were administered. The postoperative course was uneventful and the patient has been free of disease for 16 months. PMID- 3321959 TI - [Bilateral ureteral tumors associated with chronic renal failure: a case report]. AB - A 66-year-old female with bilateral ureteral tumors associated with chronic renal failure is presented. She received pan-hysterectomy due to uterine cancer in 1957. She was first referred to our clinic to make internal shunt under a diagnosis of chronic renal failure. In 1979, the diagnosis of neurogenic bladder and bilateral vesicoureteral reflux (rt; grade 3, lt; grade 1) was made. She was admitted to our clinic with complaints of macroscopic hematuria and a temperature of 39 degrees C on April 28, 1983. Cystoscopically, pyuria from the right ureteral orifice was found. Right retrograde pyelography revealed severe dilatation of the right ureter and renal pelvis with some filling defects. For drainage of pus retaining in the right renal pelvis, right percutaneous nephrostomy was made under the guidance of ultrasonography. After her general condition improved, right nephroureterectomy was performed under the diagnosis of right pyonephrosis on June 8, 1983. Right pyelonephritis and right ureteral tumor, grade 3, were pathologically demonstrated. After the operation, an invasive bladder tumor was detected on cystoscopy and ultrasonography, subsequently a total of 3,900 rad irradiation was given to the bladder tumor. She died of pulmonary edema 7 months later. Autopsy demonstrated a transitional carcinoma, grade 3, of the left ureter. Bilateral urothelial tumors of the upper urinary tract is rare, and to our knowledge only 29 cases have been reported in Japan. PMID- 3321960 TI - [Urinary retention secondary to herpes zoster]. AB - We present a case of urinary retention and constipation secondary to Herpes zoster in the distribution of the second and third sacral dermatomes in a 68-year old woman. Vesical irritability was not observed. Cystometry revealed a flaccid type bladder. Cell count of spinal fluid increased but clinical symptoms and physical findings of myelitis were not observed. A Foley catheter was left indwelling for five days due to urinary retention. After removal of the catheter, bladder paresis gradually improved. Skin eruption and disturbance of urination completely improved about three weeks later. Forty-seven cases of bladder involvement secondary to Herpes zoster including our case have been reported in the Japanese literature. PMID- 3321961 TI - [Cavernous hemangioma of urinary bladder associated with angiokeratoma of the left leg]. AB - A 45-year-old male was admitted to our hospital with a complaint of asymptomatic macroscopic hematuria. At cystoscopy a multi-lobulated, dark red tumor, the size of a rice grain, was found on the right lateral wall. He also had a 5 X 4 mm purplish skin tumor on the left leg. Double contrast cystogram also showed the shape of the tumor on the right lateral wall of bladder. Based on the aforementioned findings, we diagnosed this case as hemangioma of the urinary bladder associated with the same lesion on the left leg. The bladder tumor was resected transurethrally and the skin lesion was also excised. Pathological diagnoses were cavernous hemangioma of bladder and angiokeratoma of skin, respectively. Including our case we found 62 cases of hemangioma of the urinary bladder in the Japanese literature. Only 5 of them were associated with the hemangiomas of other regions of the body. PMID- 3321962 TI - [Metastatic penile tumor from lung cancer: a case report]. AB - A 70-year-old man, who had squamous cell carcinoma of lung, complained of urethral pain. Physical examination revealed an induration of the bulbous urethra and a month later corpora cavernosa were involved. Biopsy was performed and pathological diagnosis was metastatic penile tumor originating from squamous cell carcinoma of lung. Several days after the biopsy the patient died of pleuritis carcinomatosa. Metastatic penile tumor is a rare disease and only 87 cases have been reported in Japan. We review the literature on metastatic penile tumors. PMID- 3321963 TI - Formate in urine as a biological indicator of formaldehyde exposure: a review. AB - The presence of a small amount of endogenously derived formate in human urine is normal; however, formate derived from the metabolism of formaldehyde, several other industrial compounds and some pharmaceuticals may elevate the urine formate concentration above the normally expected values. This elevation in the urine formate concentration presents the possibility of using this as a tool for monitoring exposure to chemicals. Unfortunately, the use of urine formate as a technique for monitoring personal chemical exposure has yet to be evaluated. This review identifies several potentially important variables that could alter the extent to which formate is eliminated through the urine and that could affect the accuracy of using urine formate concentration as an indicator of chemical exposure. Some potentially important confounders that have been identified, but not evaluated adequately, include dietary intake, nutritional status and exposure to cigarette smoke. Furthermore, the metabolism and elimination kinetics have yet to be adequately demonstrated in humans. Without having controlled for potential confounders in previous pharmacokinetic studies, it is unknown whether or not the large range and variation observed in human studies is due to the confounders or to innate individual variability. Given the poor understanding of the normal variation of formate concentration in the urine, the use of it as a biological indicator of chemical exposure becomes questionable. Without appreciable skin penetration, as in this case, the reliance upon air monitoring alone may be more practical. The evidence at this time suggests that the use of urine formate to monitor chemical exposure offers a broad opportunity for investigative research. At the present time, however, the interpretation of urine formate concentration in samples obtained from workers would be difficult. PMID- 3321964 TI - Neurogenic heart disease: a unifying hypothesis. AB - Electrocardiographic abnormalities have been known to occur in the context of neurologic disease for a long time. These changes fall into 2 categories: arrhythmias and repolarization abnormalities. However, until relatively recently these changes were believed to represent purely electrophysiologic alterations and not real heart disease. It is now clear that some patients with neurogenic electrocardiographic changes show cardiac enzyme release and myofibrillar degeneration at autopsy. There are 4 major methods for producing myofibrillar degeneration (i.e., contraction band necrosis or coagulative myocytolysis): catecholamine infusion, stress-steroid, nervous system stimulation and reperfusion. The common thread connecting these 4 methods is the opening of receptor-operated calcium channels, resulting in intense contraction of cardiac muscle. Thus, neurogenic influence over cardiac function may represent a continuum. In the mild reversible circumstance, only the electrocardiographic change will be seen, whereas in the severe, irreversible situation, myofibrillar degeneration will ensue with release of cardiac enzymes. Cardiac cell death may be caused by oxygen free radicals produced by metabolism of catecholamines or reperfusion or both, after variable periods of ischemia. This concept represents a unifying hypothesis, tying together the clinical, physiologic, biochemical and pathologic findings in neurogenic heart disease. PMID- 3321965 TI - Influence of the normal personality dimension of neuroticism on chest pain symptoms and coronary artery disease. AB - For at least the last 200 years it has been suspected that somatic manifestations of psychological distress play a role in the medical recognition and treatment of coronary artery disease (CAD). The cardiovascular system is intricately linked to the experience of emotion, and these links may explain how and when neuroticism can cloud the diagnosis of cardiovascular disease. A possible source of anginal symptoms in the absence of angiographically documented CAD is high standing on the personality dimension of neuroticism, which is a broad dimension of individual differences in the tendency to experience negative, distressing emotions and to possess associated behavioral and cognitive traits. A brief review of the clinical cardiologic literature on chest pain is presented, with special attention to distinguishing true angina pectoris from pseudoangina and related syndromes. After a brief description of the major dimensions of normal personality, especially the domain of neuroticism, empirical evidence is reviewed on 1,191 adult men and women who 10 years earlier had made chest pain or discomfort reports part of the National Health and Nutrition Examination Survey. The findings illustrate neuroticism's links to illness and disease. When the mean initial neuroticism levels of the chest pain groups were compared, significantly higher initial levels of neuroticism were found for those who reported any pain or discomfort. As hypothesized, logistic regression results on myocardial infarction death indicated no increased risk due to neuroticism. Neuroticism was related to increased somatic complaints, including chest pain or angina-like complaints, but was not causally or etiologically related to objective signs or pathophysiologic evidence of disease, especially CAD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321966 TI - Refining the type A hypothesis: emergence of the hostility complex. AB - Recent negative research findings have raised questions regarding the robustness of the Type A hypothesis. A growing body of evidence suggests that not all aspects of the global Type A behavior pattern are pathogenic, but only those concerned with hostility and anger. Biologic mechanisms responsible for increased risk of coronary disease in persons with high levels of hostility and anger appear to involve increased cardiovascular and neuroendocrine responses to behavioral challenge, and, possibly, inadequate parasympathetic antagonism of sympathetic nervous system effects. Future research should concentrate on further refining our understanding of the hostility complex and its pathophysiologic mechanisms. PMID- 3321967 TI - Cardiovascular reactivity as behavior. AB - The word, behavior, means action or reaction. Thus, all physiologic responses meet this definition and are behavior. Furthermore, if the response is neurally mediated, then there are only 3 possible behavioral mechanisms that can be operating to determine it: (1) The response is part of a reflex, elicited by an adequate stimulus. In this case, in an intact animal the expression of the response will be modulated by a variety of situational factors. (2) The response is part of a reflex. However, the capacity of the stimulus to elicit the response is acquired through association with an adequate stimulus. Thus, the reflex is learned rather than innate. (3) The response is part of a "central command" and is emitted in anticipation of a consequence whose likelihood of occurrence has been learned. Neurally mediated responses of the circulation meet all these criteria. Thus, circulatory responses not only are passive reflexes, they also are reactive and proactive behaviors, which permit animals to interact effectively with their environments, and which change with practice. These principles explain a variety of cardiovascular effects observed in experimental or clinical settings. Furthermore, by applying well-established behavioral principles to circulatory responses, it is possible to achieve clinically significant effects. This presentation will characterize the way in which behavioral mechanisms are expressed in the circulation, it will describe a number of clinically significant findings that illustrate the importance of these mechanisms, and it will propose a number of applications of behavioral principles that can be used in clinical practice. PMID- 3321968 TI - Association between silent myocardial ischemia and prognosis: insensitivity of angina pectoris as a marker of coronary artery disease activity. AB - The clinical syndrome of angina pectoris was accurately described over 200 years ago by Sir William Heberden. However, in recent years, we have learned that many episodes of myocardial ischemia occur that are not accompanied by symptoms of angina pectoris. These silent ischemic episodes may be detected either during exercise testing, using electrocardiographic criteria that can be combined with scintigraphic studies evaluating myocardial blood flow (thallium perfusion studies) or left ventricular function (gated blood pool scans). In addition, continuous electrocardiographic (Holter) monitoring can be used for the detection of transient ST-segment changes; these changes on Holter monitoring have been correlated with abnormalities of myocardial perfusion and function, indicating that they represent true ischemic events. Studies have shown that patients with coronary artery disease who have evidence of ongoing ischemia, whether symptomatic or silent, have an increased risk for experiencing subsequent cardiac events than patients without evidence of ischemia. Many studies have demonstrated that ischemia during an exercise study after myocardial infarction identifies patients at high risk for recurrent cardiac events, whether or not the ischemia is associated with angina pectoris. Holter monitoring has allowed for the detection of ischemic events out of hospital in ambulatory patients. Studies in stable angina patients have shown that there are many asymptomatic episodes in this setting, which are often occurring at low heart rates during activities of everyday life, without an apparent significant increase in myocardial oxygen demands, and these episodes may even be precipitated by mental stress.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321969 TI - Unrecognized prevalence of panic disorder in primary care, internal medicine and cardiology. AB - Research over the last 25 years has delineated the syndrome of panic disorder/agoraphobia from a myriad of medical, cardiologic and psychiatric diagnoses. This syndrome is characterized by the sudden onset of episodes of panic and terror, accompanied by extreme physiologic symptoms including palpitations, tachycardia, chest pain, shortness of breath, trembling, faintness, etc. These patients become quite anxious and hypochondriacal and begin to avoid certain situations in which they feel a recurrence of a panic attack would be dangerous or embarrassing. This avoidance (agoraphobia) typically involves malls, grocery stores, churches, crowds, bridges, planes, waiting in lines, visiting dentists, highways, etc., and rarely (5%) actually confines the patient to his home. With the prevalence of 3 to 7% in the general population, evidence suggests that many of these patients are currently unrecognized in primary care, internal medicine and cardiology practices. Over 90% believe they have a physical disorder and do not present to psychiatrists but instead to neurologists (44%), cardiologists (39%) and gastroenterologists (33%). Perhaps as many as one-third of patients with atypical chest pain, particularly if results of coronary angiograms are normal, have unrecognized panic disorder. Effective treatments in most patients are now available and are described. These include medications that block the panic attacks and reduce the anxiety and phobic fears and they are generally used in combination with behavioral treatments. PMID- 3321970 TI - Mitral valve prolapse: from syndrome to disease. AB - Mitral valve prolapse (MVP) is due to a heterogeneous group of conditions that may affect the mitral valve or the mitral valve apparatus. Although MVP may progress later in life to frank mitral insufficiency requiring mitral valve repair or may predispose to bacterial endocarditis, in most cases it is a benign, idiopathic condition without serious consequences. However, many investigators have documented that MVP is often associated with a constellation of signs and symptoms, which appear to constitute a distinct syndrome. These associated findings include autonomic dysfunction, frequent complaints of chest pain, palpitations, orthostasis, fatigue, dyspnea on exertion and anxiety. Although the risk of significant myocardial dysfunction or bacterial endocarditis appears to be related to patient sex, age and the severity of valvular prolapse and insufficiency, there appears to be little or no relations between the extent of prolapse and the degree of autonomic dysfunction or the severity of symptoms of chest pain, palpitations, dyspnea on exertion and anxiety. The development of uniform diagnostic standards for mental disorders has helped to make it possible to identify several related entities, including generalized anxiety disorder, panic disorder and agoraphobia; patients with these disorders frequently somatize their anxiety and complain of many symptoms which may be seen in patients with MVP. Although several studies have reported an increased frequency of MVP in patients with anxiety disorders, recent studies suggest that the conditions are not linked. Iatrogenic cardiac neurosis is common in both groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321971 TI - Psychiatric management of acute myocardial infarction in the coronary care unit. AB - Failure to recognize and treat the psychiatric complications of myocardial infarction (MI) may aggravate the underlying cardiac condition and interfere with its treatment. The timing and manifestations of several distinct psychiatric conditions that commonly accompany the acute phase of MI (anxiety, depression, delirium, and behavioral abnormalities secondary to a person's premorbid character style) will be reviewed. In addition, the importance of psychological risk factors for the development of coronary artery disease (e.g., life stress and the Type A behavior pattern) and the impact of denial on the cardiac patient's condition will be discussed. Management strategies that include nonpharmacologic (i.e., support, reassurance, brief psychotherapy and cardiac rehabilitation) and psychopharmacologic interventions (e.g., the rational use of benzodiazepines, antidepressants and neuroleptic agents) for psychiatric conditions in the MI patient will be provided. Postdischarge issues that occur in both the patient and his or her family are outlined, and the enrollment in cardiac rehabilitation programs is encouraged. PMID- 3321972 TI - Atypical localization of myenteric neurons in the opossum lower esophageal sphincter. AB - This study investigated sphincter-body differences in neuronal density and morphometry between the esophageal sphincter and body with a view to determining whether previously reported differences are authentic. The anatomical limits of the opossum lower esophageal sphincter were correlated with its physiological behavior by manometric demarcation. Following this, peeled whole mounts and paraffin and cryosections were used to study the morphology and morphometry of the esophageal myenteric plexus. Thirty animals were used and seven quantitated. The plexus of the esophageal body was located as usual in a plane between the longitudinal and circular muscle, which coincided with the plane of cleavage when these muscle layers were peeled apart for studying the plexus in whole mounts. In contrast, the plexus was located in several planes in the lower esophageal sphincter, which had no cleavage plane. Therefore, peeling the sphincter removes neurons and yields falsely low counts, making peel preparations of this region unsuitable for neuronal quantitation. In paraffin sections, the neuron density in the esophageal body 7 cm above the sphincter was 6,353 +/- 850/cm2, but decreased significantly to 2,254 +/- 353/cm2 at the 1-cm segment. In the lower esophageal sphincter, the neuronal count increased again to 8,530 +/- 1,606/cm2. Flash frozen cryosections, which produced neuronal morphology similar to the in vivo condition, showed that there was no difference in neuronal size between esophageal body and sphincter. These studies show that atypical myenteric plexus localization causes spuriously low neuronal counts reported in the lower esophageal sphincter and that reported neuronal size differences are technique dependent. PMID- 3321973 TI - Venus, the goddess of fertility, numerologically 15 in Babylon and the origin of the Chinese system of 8 designs, called Pa-Kua. AB - In Babylonia, numerology was invented and Venus, as the goddess of fertility, was first depicted as a 6-cornered star. But, numerologically she was designated 15. As a 6-cornered star, its make-up shows two opposite triangles interpenetrated. This was changed to two squares fused into one where geometrically the shape became a square. It created 9 cells which were so numbered that the numbers counted in any row gave the sum 15. Venus thus became a Magic Square of 15. Geometrically it was a Magic Square, but numerologically it was 15. In the make up the squares were two and opposites. As goddess of fertility she especially helped the pregnant to an easy delivery. Some 8 variants of the Magic Square, with different arrangements of numbers, represented 4 cosmic elements and 4 cosmic qualities. The Magic Squares, which represented elements, had the numbers 1, 3, 5 and 8 near one another forming a miniature square by themselves. A Magic Square representing a quality did not have the numbers 1, 3, 5 and 8, as a consolidated unit. This explains the importance of the numbers 1, 3, 5 and 8, a mystery which had remained unsolved. Venus was also the star of copper. When copper technology migrated from Babylon to China, the occult science associated with Venus also reached China. Here the 8 Magic Squares were translated into a system of whole and broken lines, called Pa-Kua, meaning 8 designs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3321974 TI - The AJDC archives. August 1923. Sickle cell anemia. Report of two cases in children, with necropsy in one case. By V. P. Sydenstricked [sic], W. A. Mulherin and R. W. Houseal. PMID- 3321975 TI - Therapeutic goals and treatment options for prevention of stress ulcer syndrome. AB - Stress ulcer syndrome, the occurrence of acute upper gastrointestinal bleeding or perforation from stress-related mucosal damage, is a significant cause of morbidity and mortality in critically ill patients. The mortality rate in critically ill patients who have bled from stress ulcers ranges from 50 to 77 percent, whereas the mortality rate for similar patients without stress ulcer bleeding ranges from 9 to 22 percent. The mortality rate may be as high as 90 percent in patients with clinically overt bleeding; as many as one-third of these deaths can be directly related to bleeding. Prophylactic therapy for prevention of stress ulcer bleeding is based on three premises: (1) morbidity and mortality related to stress ulcer syndrome are significant; (2) the population at risk can be identified prior to bleeding; and (3) therapy that decreases gastric acidity or improves gastric mucosal defense mechanisms will prevent ulcer formation or progression to bleeding. A review of prospective clinical studies utilizing prophylactic therapy in critically ill patients and patients undergoing surgery revealed a 17 percent overall bleeding rate for placebo groups compared with lower bleeding rates for antacid- and histamine (H2)-receptor-antagonist-treated groups (4 and 7 percent, respectively). Studies varied greatly in definition of bleeding, dosage regimens, and gastric pH goals. The need to measure gastric pH during treatment is controversial, and the optimal pH goal and the length of time for which it must be maintained remain unknown. Controversy exists as to the best therapeutic option for prophylaxis of stress ulcer syndrome, but when prevention of clinically significant bleeding is the therapeutic goal, antacids and H2 receptor antagonists appear to be equally efficacious. PMID- 3321976 TI - Stress-related mucosal damage: an overview. AB - Stress-related mucosal damage of the upper gastrointestinal tract occurs in the majority of critically ill patients. The more severe the underlying disease, the greater the chance that mucosal damage and subsequent bleeding will develop. Clinical outcome is determined by the type and severity of the underlying illness; however, cases with severe gastric damage, as diagnosed by endoscopic examination or by bleeding, have the poorest prognoses. Endoscopy is the most sensitive method for diagnosing stress-related mucosal damage. Other indicators of stress-related mucosal damage are macroscopic evidence of bleeding, blood transfusion requirement, or measures of occult bleeding; these tests cannot diagnose nonbleeding lesions. Low gastric pH values may also indicate physiologic response to stress, but such values are not uniformly correlated with the presence of injury. Vigorous acid suppression with prolonged periods of pH control may be necessary to treat stress-related mucosal damage and to prevent bleeding. Treatment modalities in current use include antacids, cimetidine, and other histamine (H2)-receptor antagonists, and, more recently, sucralfate. Current evidence indicates that antacids, given hourly and titrated to a present pH goal, or primed continuous infusion of cimetidine are the most efficacious regimens in maintaining intragastric pH control. PMID- 3321977 TI - Newer agents available for treatment of stress-related upper gastrointestinal tract mucosal damage. AB - Results of animal studies and human clinical trials assessing the efficacy of newer agents in the treatment of stress-related mucosal damage have been reviewed. Currently available data suggest that prostaglandin treatment is as effective in preventing and treating stress-induced mucosal injury as more established therapeutic modalities, but that the proposed efficacy of somatostatin infusion and tranexamic acid administration is highly suspect. Promising agents yet to be evaluated include omeprazole, allopurinol, and epidermal growth factor. PMID- 3321978 TI - Recognition and management of upper gastrointestinal hemorrhage. AB - Upper gastrointestinal hemorrhage is a frequent and severe problem in the intensive care unit. Such bleeding results from diverse gastroenterologic causes. Diagnosis and assessment of the severity of bleeding is accomplished primarily through the physical examination; endoscopy is the most sensitive means of establishing a specific site of hemorrhage. Medical management of gastrointestinal hemorrhage includes treatment with the histamine (H2)-receptor antagonists, antacids, or both. Recent studies suggest that continuous infusion of H2-receptor antagonists may be more efficacious than fixed-bolus dosing in prophylaxis of upper gastrointestinal bleeding. It is not known as yet if the continuous infusion regimen will be effective in stopping gastrointestinal bleeding that has already begun. PMID- 3321979 TI - Mechanisms of cimetidine protection following thermal injury. AB - Experimental studies have shown that treatment with cimetidine within 30 minutes of severe thermal injury decreases resuscitative fluid volume requirements by 70 percent. In treated animals, marked hemodynamic improvement was shown as compared with the untreated animals. Administration of the histamine (H2)-receptor antagonist ranitidine was not effective in reducing resuscitative fluid volume, leading to the hypothesis that cimetidine acts via predominantly non-H2-receptor antagonist mechanisms. Evidence is presented for a multifactorial mechanism by which cimetidine offers protection from burn shock. The mechanisms under investigation include inhibition of the hepatic cytochrome P-450 enzymes, cimetidine/copper scavenging of oxygen free radicals, inhibition of thromboxane synthesis, and imidazole buffering capacity. Acting via one or all of these mechanisms, cimetidine may protect against the vascular permeability changes and circulatory collapse that can follow severe thermal injury. PMID- 3321980 TI - Mechanisms of stress-related mucosal damage. AB - During the last 15 years, there has been a dramatic decline in the incidence of bleeding from stress-related mucosal damage. This decrease probably relates to an increased understanding of those mechanisms responsible for the pathogenesis of stress-related mucosal damage and the application of this knowledge to prophylaxis and treatment. Stress-related bleeding has become less of a clinical problem, in part, because of the development of improved techniques for the treatment of shock and its accompanying gastric mucosal hypoperfusion. The nearly routine use of prophylactic antacid and/or histamine (H2)-receptor antagonist therapy to adequately buffer intragastric acidity is another factor that has minimized the development of stress-related damage. As continued understanding of the mechanisms responsible for stress damage is obtained and therapy applied appropriately, this disease should become a disorder of only historical interest in years to come. PMID- 3321981 TI - Effects of dietary protein and phosphorus restriction on the progression of chronic renal failure. AB - In recent years, evidence has accumulated suggesting that early dietary intervention in the form of protein restriction can dramatically alter the natural history of chronic renal insufficiency. This article reviews the literature in this area and summarizes the questions that remain for future investigators to answer. Interest in the role of protein intake in renal disease dates back to the early 1900s, when several investigators found that the progression of renal failure was accelerated in rats and rabbits fed high-protein diets. Subsequent work in animal models has demonstrated that nephron loss, resulting from a variety of disease states, is associated with elevated intraglomerular pressures and flows. Several investigators now have postulated that these abnormal hemodynamics, resulting from intrarenal vasodilation and hyperperfusion, damage the glomerulus and may produce further nephron loss independent of the initial renal insult. Dietary protein restriction appears to reduce these pressures and flows towards normal in animals, although the operative mechanism has yet to be identified. Limited studies of dietary protein restriction in human renal disease have suggested a beneficial effect, but carefully controlled prospective studies will be necessary to establish clear therapeutic efficacy. PMID- 3321982 TI - Case report and review of the literature: ureteral endometriosis. AB - Endometriosis is a common disorder affecting women of all ages. Although urinary tract involvement is not uncommon, ureteral obstruction is an infrequent complication of endometriosis. A case is reported of acute renal failure caused by bilateral ureteral obstruction resulting from extensive pelvic endometriosis. All reported cases of ureteral endometriosis are reviewed with special emphasis on bilateral ureteral involvement. Physicians need to be aware of this reversible complication of endometriosis. PMID- 3321983 TI - Hirsutism. AB - Hirsutism is a common clinical problem. The pathogenesis of hirsutism in most women is not clearly defined. In this review, the characteristic endocrinologic findings in women with hirsutism are described, and the disorder's evaluation and treatment are discussed. PMID- 3321984 TI - The athlete, cocaine, and lactic acidosis: a hypothesis. AB - The muscular makeup of the sprint-trained athlete may make him especially susceptible to severe lactic acidosis from cocaine-induced seizures. Because of a high percentage of glycolytic muscle fibers (compared to the muscle fiber type of the endurance-trained athlete), the lactic acidosis and heat generated from muscular activity is much greater in the sprint-trained athlete than in the endurance-trained athlete. The role of cocaine in producing seizures and increasing glycolysis, both of which produce lactic acidosis, is discussed. The hypothesis is presented that the elite athlete may be at greater risk of death than the general population from lactic acidosis produced as a result of cocaine induced seizures. PMID- 3321986 TI - Heart-lung interactions in health and disease. AB - Heart-lung interactions is a term applied to the complex interplay between the functions of the heart and respiratory systems. This interdependence of respiratory and cardiac function takes place at several levels. First is a functional linkage between the respiratory and cardiovascular systems in the transport of oxygen and carbon dioxide. Second are reflex and humoral interconnections between the two systems. Third are mechanical interactions between the heart and lungs, which are elastic structures sealed within an expandable thorax. In recent years, most attention has been focused on these mechanical interactions, but it is appropriate to consider also the other ways the heart and lungs interact. PMID- 3321985 TI - Atherosclerosis and its evolution in childhood. AB - Cardiovascular risk factors in childhood are related to arterial wall changes that lead to atherosclerotic coronary artery disease in later life. Atherosclerosis begins early in life. The observations of early arterial wall connective tissue changes and accompanying early lipid deposition show the importance of understanding cardiovascular risk factors in children. Since risk factors found in childhood are potentially predictive of adult coronary heart disease, methods for prevention of atherosclerosis should begin in children. Rational strategies should be directed to removing atherogenic forces that work in a child at high risk. Primary prevention of atherosclerosis has its maximal potential when begun before advanced irreversible lesions can occur. Consideration needs to be directed to how cardiovascular connective tissue changes and lipid and calcium deposition can be modulated in the injury and healing processes. It is important to recognize that adult coronary artery disease is really a major pediatric problem. PMID- 3321987 TI - Herwigh Rieger, 2 May 1898-1 February 1986. PMID- 3321988 TI - The risk of having a second retarded child. AB - We have studied segregation ratios in 282 Israeli families with normal, nonconsanguineous parents and retarded offspring without specific etiologic diagnosis. Severity of retardation and nature of medical history significantly affected recurrence risk, while sex of propositus and sibs and presence or absence of epilepsy, cerebral palsy, microcephaly, and short stature did not. Segregation rations were 0.095 in cases of severe retardation with normal medical history, 0.216 for mild retardation with normal medical history, 0.230 in cases of all retardation with maternal reproductive inefficiency, and 0.110 for all retardation with other reported prenatal, perinatal, or infantile complications. Estimated recurrence risks in most simplex families dropped sharply with each additional normal child. The recurrence risks are higher than some previously published estimates. Different ascertainment criteria may be responsible for this variation. The criteria used here were compatible with a 3.2% population prevalence of mental retardation with a 0.223 segregation ratio in multiplex sibships. It is recommended that future studies of recurrence risks include similar data permitting evaluation of sensitivity of ascertainment criteria. PMID- 3321989 TI - Recurrence risk in the Angelman ("happy puppet") syndrome. AB - We report on two sibs with Angelman "happy puppet" syndrome. Out of 48 families reported in the literature, this is only the fourth family with affected sibs. A review of the literature shows a low but not negligible recurrence risk. Different explanations for this are discussed. PMID- 3321990 TI - Neonatal manifestations of Schwartz-Jampel syndrome. AB - Schwartz-Jampel syndrome generally presents in childhood with short stature, limited joint mobility, masklike facies with blepharophimosis, myotonia, and often muscle hypertrophy. Few cases with neonatal manifestations have been described. A newborn with severe manifestations is reported and the literature is reviewed. PMID- 3321991 TI - Y-derived sequences detected in a 45,X male by in situ hybridization. AB - A two-month-old boy with normal genitalia and descended testes was referred for a suspected hematological disorder. Cytogenetic analysis showed a 45,X chromosome constitution. In situ hybridization with the Y-derived probe 50f (provided by Professor Marc Fellous) was performed utilizing metaphase chromosomes to determine whether Y material could be detected. A significant amount of label (17 of 150 cells) was found on chromosome 5p suggesting a 5;Y translocation. This translocation was verified by high-resolution G-banded and G-11-stained chromosomes. PMID- 3321992 TI - Lymphedema in Noonan syndrome: clues to pathogenesis and prenatal diagnosis and review of the literature. AB - The Noonan syndrome (NS) is a true multiple congenital anomalies (MCA) syndrome with numerous manifestations. An association with lymphedema has been noted, but its pathogenesis is not fully understood. Nine new cases and a review of the literature explore the role of lymphedema in NS, including its pathogenesis, presentations, and phenotypic effects. Consideration is given to developmental stage at time of onset, chronicity, resolution, and anatomic site. It appears likely that lymphedema is a much more frequent concomitant in NS than previously realized. The major source of lymphedema in NS appears to be a presently undefined dysplasia of lymphatic vessels of unknown cause. Further study of lymphedema may provide an understanding of its role in shaping the NS phenotype. Comparison with other MCA syndromes and animal models is made in this regard. Relevance to prenatal diagnosis and treatment is discussed. PMID- 3321993 TI - Wrinkly skin syndrome: phenotype and additional manifestations. AB - The wrinkly skin syndrome is an autosomal recessive disorder characterized by wrinkling of the skin of the dorsum of the hands and feet, decreased elastic recoil of the skin, an increased number of palmar and plantar creases, multiple musculoskeletal abnormalities, microcephaly, and mental retardation. Our patient is characteristic of the syndrome as previously described, and confirms the presence of mental retardation and microcephaly as component manifestations, with the additional findings of connective tissue abnormalities evidenced by an atrial septal aneurysm. PMID- 3321994 TI - Hydrolethalus syndrome: report of an apparent mild case, literature review, and differential diagnosis. AB - We present an infant with manifestations of the hydrolethalus syndrome who has survived for over 5 months; previously, the longest survival reported in this condition has been 2 days. The literature is reviewed and the clinical and pathological findings of our patient are compared with those of the 50 previously reported cases. The differential diagnosis of the condition is discussed. PMID- 3321995 TI - New autosomal dominant branchio-oculo-facial syndrome. AB - We observed an autosomal dominant disorder of abnormal upper lip, which resembles a poorly repaired cleft lip, malformed nose with broad bridge and flattened tip, lacrimal duct obstruction, malformed ears, and branchial cleft sinuses and/or linear skin lesions behind the ears in several persons in 3 families. In each of the 3 families, an affected parent had at least one affected child. Father-to-son transmission in one of these families ruled out X-linked inheritance. Other anomalies include coloboma, microphthalmia, auricular pits, lip pits, highly arched plate, dental anomalies, and subcutaneous cysts of the scalp. Premature graying of hair occurred in the affected adults. Growth retardation, developmental delay, and hand anomalies are variable components of the syndrome. PMID- 3321996 TI - The Nager syndrome. AB - The Nager syndrome was identified in a newborn infant and in a subsequent sib by prenatal ultrasonography. This report documents an autosomal recessive pattern of inheritance for this disorder. PMID- 3321998 TI - Prenatal diagnosis policy in neural tube defects. PMID- 3321997 TI - Transient cysts of the fetal choroid plexus: morphology and histogenesis. AB - In this report, we correlate the clinical and morphologic features of bilateral choroid plexus cysts in three fetuses. These cysts were detected as incidental findings during sonography at 18 to 20 weeks gestation before elective abortion. Two fetuses were normal; the third had trisomy 18. All cysts were present bilaterally in the posterior horns of the lateral ventricles and ranged from 0.5 cm to 1.0 cm in diameter. The walls were translucent, and the cavities were filled with clear serous fluid, except for the left cyst in the third fetus, which was hemorrhagic. The cysts were surrounded by the loose stroma of the choroid plexus. We believe that the formation of these cysts is related to the histogenesis of the choroid plexus. Although such cysts have now been described by sonographers in several fetuses with chromosomal anomalies, this association may reflect ascertainment bias. At this time, we therefore advise caution in interpreting sonographic evidence of isolated choroid plexus cysts as anomalous. PMID- 3321999 TI - Mazindol and growth hormone inhibition in Duchenne muscular dystrophy. PMID- 3322000 TI - X-linked mental retardation with marfanoid habitus. AB - Here we report on two pairs of mildly to moderately mentally retarded brothers with marfanoid habitus and similar craniofacial changes. They had a long and narrow face, small mandible, high-arched palate, and hypernasal voice, as previously reported by Lujan et al (Am J Med Genet 17:311-322, 1984) in four mentally retarded males of a large kindred. The present data suggest the existence of a specific type of X-linked mental retardation with marfanoid habitus. PMID- 3322001 TI - G syndrome (hypertelorism with esophageal abnormality and hypospadias, or hypospadias-dysphagia, or "Opitz-Frias" or "Opitz-G" syndrome)--perspective in 1987 and bibliography. PMID- 3322002 TI - Acrocephalopolysyndactyly type II--Carpenter syndrome: clinical spectrum and an attempt at unification with Goodman and Summit syndromes. AB - Carpenter syndrome (ACPS type II) was first described by Carpenter in 1901. The syndrome consists of acrocephaly, soft tissue syndactyly, brachy- or agenesis mesophalangy of the hands and feet, preaxial polydactyly, congenital heart disease, mental retardation, hypogenitalism, obesity, and umbilical hernia. Here we review the literature on Carpenter syndrome and add 2 affected sibs with marked intrafamilial variability. This review showed that 2 reported variations of Carpenter syndrome, Goodman and Summitt syndromes, actually fall within the clinical spectrum of this disorder. This confirms earlier suggestions of Gorlin (personal communication 1982) and Hall et al [Am J Med Genet 5:423-434, 1980]. PMID- 3322003 TI - Diagnosing human malformation patterns with a microcomputer: evaluation of two different algorithms. AB - SYNDROC, a microcomputer-aided differential diagnostic approach to human malformation patterns, is based on a pseudo-Bayesian algorithm. This means that, for each sign, the frequency of this sign in the general population, its frequency in a particular syndrome, and the frequency of that particular syndrome have to be determined. These parameters are easy to find in common syndromes but tend to be difficult for rare or isolated cases. Thus, we implemented a new algorithm called the "descriptive algorithm," which defines a diagnosis by a set of anomalies all having the same weight. To test this algorithm, we analyzed 100 cases representing 100 different syndromes out of the register of the Division of Medical Genetics, Children's Hospital and Medical Center, University of Washington. The descriptive algorithm was allowed to give 3 sets of diagnoses. In 91% of the cases, this algorithm proposed the correct diagnosis (54% in the first window, 28% in the second window, and 9% in the third window). The number of diagnoses proposed was 18.78 +/- 16.57. The same cases were analyzed with the pseudo-Bayesian algorithm. The concordant diagnosis was proposed in 92% of the cases (55% at the top place, 11% at the second place, and 26% at the third place or beyond). The number of diagnoses submitted was 13.5 +/- 11.04. The combined algorithm gave the correct diagnosis in 96% of the cases. This study shows that the descriptive algorithm is as accurate as the pseudo-Bayesian algorithm in diagnosing malformation patterns, but this level is accompanied by an increased number of proposed diagnoses. PMID- 3322004 TI - Chromosome anomalies as predictors of recurrence risk for spontaneous abortion. AB - Reproductive histories and chromosomes of spontaneous abortions were studied by segregation analysis in 1890 sibships ascertained through a cytogenetically studied abortion. Normal karyotypes are associated with recurrent abortion. Among abnormal karyotypes, trisomy has an elevated recurrence risk even after adjustment through a liability indicator for maternal age. Possible mechanisms and conflicting evidence in the literature on trisomy are discussed. None of these differences in recurrence risk is large enough to play a significant numerical role in genetic counseling. PMID- 3322005 TI - A specific syndrome due to deletion of the distal long arm of chromosome 1. AB - We have studied 2 patients with de novo deletion 1 (q42.3----qter): a 5 1/2-year old boy and an unrelated 1 9/12-year-old girl. The analysis of the phenotype which is now possible in a total of 23 cases shows that the deletion of the terminal 1q leads to a definable multiple congenital anomalies/mental retardation (MCA/MR) syndrome. The phenotype is so characteristic that, as a rule, the clinical data should suggest the correct cytogenetic diagnosis. PMID- 3322006 TI - Chorea-acanthocytosis: a report of three new families and implications for genetic counselling. AB - Chorea-acanthocytosis (CHA) is a rare inherited neurologic disorder with peripheral red cell acanthocytes and normal serum lipoprotein levels. To date, 8 families with the disorder have been reported outside of Japan. We describe 4 patients in 3 families with CHA and review the clinical presentations in previous reports. In addition, we report magnetic resonance imaging scans in these patients. The pattern of inheritance in these families is most likely autosomal recessive. Obligate heterozygotes do not have acanthocytes on wet preparation under phase microscope. Two of 3 propositi were initially diagnosed as having Huntington chorea. Chorea-acanthocytosis is an important differential in the diagnosis of Huntington chorea and should be considered in families without a family history. The paucity of families with CHA reported to date may represent lack of recognition. PMID- 3322007 TI - Interspecific genetic complementation analysis with fibroblasts from humans and four species of animals with Chediak-Higashi syndrome. AB - Although the autosomal recessive disease Chediak-Higashi syndrome (CHS) has been described in humans, cats, mink, cattle, mice, killer whales, blue foxes, and silver foxes, and these conditions appear quite similar, no direct evidence of the homology of this disease in the various species has been presented. To determine if CHS in humans, cats, mink, cattle, and mice is due to a mutant gene at the homologous genetic locus in each species, or alternatively, if these are merely similar syndromes, genetic complementation analysis after interspecific somatic cell (fibroblast) hybridization was performed. "Paracrystal" formation was the criterion used for the determination of complementation. The initial studies in this report were designed to characterize paracrystal formation in control and CHS fibroblasts of these five species. Most of the control fibroblasts from each species (91-96.6%) formed paracrystals upon incubation with 25 micrograms/ml of the microtubule depolymerizing agent vinblastine sulfate. A significantly (P less than 0.05) smaller percentage of the CHS fibroblasts formed paracrystals after the same incubation (except CHS mice, with 90.2% paracrystals). It was found that 52% of the human CHS fibroblasts, 60% of cat CHS fibroblasts, 47% of mink CHS fibroblasts, and 53.8% of cow CHS fibroblasts formed paracrystals. For genetic complementation analysis, human CHS fibroblasts were fused to cat, mink, cow, or mouse CHS fibroblasts with polyethylene glycol. Control fusions were human CHS fibroblasts fused with human, cat, mink, cow, and mouse normal fibroblasts. The results of complementation analysis after the fusion of human CHS with cow CHS and human CHS with mouse CHS fibroblasts were inconclusive. A lack of complementation of human CHS with cat CHS and human CHS with mink CHS fibroblasts indicates that the disease is homologous in these species. PMID- 3322008 TI - A patient with partial duplication 2q and partial deficiency 11q. AB - A patient with partial duplication 2q and partial deficiency 11q is reported. The propositus was delivered at 30 weeks gestation, with a birth weight of 1,390 g. He had severe hyaline membrane disease, intraventricular hemorrhage, bronchopulmonary dysplasia, hypotonia, psychomotor retardation, hearing loss, and other anomalies including a short bitemporal diameter, prominent occiput, low-set ears, exophthalmos, short nose with depressed nasal root, downturned mouth corners, narrow high-arched palate, micrognathia, a deep longitudinal groove over the sacrococcygeal region, clinodactyly, and abnormal dermatoglyphics. Chromosome analysis showed the following karyotype: 46,XY,der11,t(2:11)(q32.2;q25)pat. PMID- 3322009 TI - Familial ossicular malformations: case report and review of literature. AB - Familial middle ear ossicular anomalies are rare. We report on a daughter and her mother with congenital conductive hearing loss. Tympanotomy disclosed hypoplasia of long crus of incus whose tip had been replaced with a fibrous strand. A review suggests that middle ear ossicular anomalies may be inherited as autosomal dominant traits. Most individuals were bilaterally affected. Most isolated cases were affected unilaterally. PMID- 3322010 TI - Deletion (13)(q14.1q14.3) in two generations: variability of ocular manifestations and definition of the phenotype. AB - A 5-yr-old girl with unilateral retinoblastoma was found to have del(13)(q14.1q14.3). Her 16-month-old sister and 35-year-old mother, with retinal colobomata but without retinoblastoma, have the same deletion. Esterase D studies indicate reduced gene dose at this locus in the 3 females, consistent with a deletion of band 13q14. These patients are of apparently normal intelligence but have a mildly "coarse" facial appearance, a broad nasal bridge, upturned nares, and a long upper lip with thin upper lip vermillion similar to the phenotype suggested by Motegi et al [1983a] for patients with this deletion. Review of the literature documents 2 other patients with deletions of band 13q14 but without retinoblastoma, indicating that retinoblastoma is not a necessary consequence of this deletion. Of the 12 reported patients with deletions limited to band 13q14, seven had normal intelligence and five were macrocephalic. Insufficient clinical information is provided to draw conclusions about phenotype. The family which we describe and those reviewed by Motegi et al suggest that there may be a characteristic appearance in patients with this deletion. PMID- 3322011 TI - Female external genitalia and mullerian duct derivatives in a 46,XY infant with the smith-lemli-Opitz syndrome. AB - We report on a 46,XY newborn infant with Smith-Lemli-Opitz (SLO) syndrome with female external genitalia, intraabdominal testes with epididymides and deferent ducts and a normally shaped uterus and vagina. Polydactyly, cleft palate, and several internal organ malformations were also present, and the patient died shortly after birth. Data on six reported male infants with SLO syndrome and female external genitalia suggest a correlation between degree of genital involvement and overall degree of severity. Scoring systems to quantify overall degree of severity (SLO score) and degree of genital involvement in males (genital score) were devised and applied to 122 reported cases from the literature. Statistical analyses showed a unimodal distribution of the SLO severity scores, and positive correlations between the SLO score and the genital score in males, the presence of polydactyly, and the presence of cleft palate. In 19 multiplex families the affected sibs were generally similar in their SLO scores. The above analyses suggest that the wide phenotypic variability in the SLO syndrome is determined by variable expressivity of the same entity as opposed to genetic heterogeneity. The observed phenotypic correlations naturally determine that males with complete feminization are among the more severe patients and tend to have polydactyly and cleft palate. PMID- 3322012 TI - Nosology of Smith-Lemli-Opitz syndrome. PMID- 3322013 TI - Smith-Lemli-Opitz (RSH) syndrome bibliography. PMID- 3322014 TI - The prevalence of autoantibodies in pregnant and nonpregnant women. AB - The frequency of autoantibodies during pregnancy was studied. Sera from 136 women (84 pregnant and 52 nonpregnant) were tested for antibodies directed against nuclear antigens, smooth muscle antigens, gastric parietal cells, mitochondria, and striated muscle by indirect immunofluorescent microscopy. Rheumatoid factor was measured by a latex agglutination test, and thyroid microsomal and thyroglobulin antibodies were measured by a hemagglutination assay. Immunofluorescence assays were considered positive if antibodies were detected at a serum dilution of 1:20. All positive samples were retested at increasing dilutions until immunofluorescence or agglutination could not be detected. The control population consisted of 52 normal, healthy, ovulatory, and nonpregnant women. The study population consisted of 84 pregnant women, none of whom had a known autoimmune disorder. The mean ages of the two groups were 32 and 26 years, respectively. The frequency of autoantibody detection was not significantly different in comparing the study (46.2) and control groups (40.5). The results did not support the hypothesis that pregnancy has an effect on the induction or suppression of autoantibody production. Previous studies that suggested differences may have been influenced by the lack of a control group. PMID- 3322015 TI - Sonographic amniotic fluid measurement and fetal growth retardation: a reappraisal. AB - Sonographic estimation of amniotic fluid volume is commonly used as a diagnostic test for oligohydramnios associated with fetal malnutrition. However, methods of measurement and diagnostic criteria are controversial. We prospectively evaluated the reproducibility of amniotic fluid diameter measurement and studied various threshold definitions of oligohydramnios as predictors of small for gestational age fetuses or fetuses with low ponderal index values. An average of the vertical and two perpendicular horizontal diameters of the largest pocket of amniotic fluid was more reproducible than the maximum vertical pocket and better enabled a single observer to differentiate between patients. An average diameter of 10 mm was highly diagnostic of small for gestational age fetuses but was insufficiently sensitive (27%) to serve as a screening test. Although also of limited sensitivity (40%), an average diameter of approximately 30 mm was probably the best screening threshold. Reduced average diameter was significantly related to the occurrence of a ponderal index less than or equal to the tenth percentile for dates. Three of seven (43%) neonates with a ponderal index less than or equal to the tenth percentile and a birth weight greater than the tenth percentile for dates had a low average diameter, suggesting that reduced average amniotic fluid diameter may help to identify the malnourished fetus with birth weight greater than the tenth percentile for dates. PMID- 3322016 TI - Ultrasonic prediction of birth weight in preterm fetuses: which formula is best? AB - Data from previous studies have suggested that birth weight prediction was enhanced by using formulas specifically derived from preterm fetuses. However, no prospective comparison of different formulas was performed. We obtained ultrasonic data on 61 pregnancies at risk for preterm delivery with a gestational age of 29.0 +/- 3.0 weeks (mean +/- SD). In all women birth weight was predicted within 7 days of delivery. Of the 61 pregnancies, 49 (80%), 41 (67%), 30 (49%), and 17 (28%) weighed less than 1750, 1500, 1250, and 1000 gm, respectively; 14 published formulas were compared for accuracy in predicting birth weight in these four categories. The formulas with the smallest absolute mean percent errors incorporated head and abdominal circumferences and femur length. The formula of Weiner et al., derived from low birth weight infants, produced the smallest absolute mean percent error and SD, 10.9% +/- 7.9%; this error was further reduced to 7.7% +/- 6.5% in infants weighing less than 750 gm. These findings suggest that birth weight in the preterm fetus is best predicted by a formula targeted to such a population. PMID- 3322017 TI - Insulin resistance and abnormal ovarian responses to human chorionic gonadotropin in chronically anovulatory women. AB - We studied the interrelationships between insulin resistance, obesity, and abnormal ovarian androgen secretion in chronically anovulatory women with clinical or biochemical evidence of hyperandrogenism. Four groups of six subjects each were studied: (1) normal weight (within 10% ideal body weight) anovulatory, (2) obese (greater than 120% ideal body weight) anovulatory, (3) normal weight eumenorrheic, and (4) obese eumenorrheic. After dexamethasone suppression, human chorionic gonadotropin (2000 IU/1.5m2 body surface area intramuscularly) was administered to each subject. Serum testosterone levels were subsequently determined hourly for 17 hours. On a separate occasion, an oral glucose tolerance test was administered to five subjects from each group. Serum glucose and immunoreactive insulin levels were determined before and after the ingestion of a standard 100 gm glucose load. As a group, the anovulatory women had higher (p less than 0.05) basal testosterone levels (1005 +/- 97 pg/ml) than did the ovulatory women (241 +/- 21 pg/ml) (values +/- SE). Obesity per se was not associated with increased basal testosterone levels. Testosterone levels rose in response to human chorionic gonadotropin (p less than 0.005) only in obese anovulatory women, reached maximal levels after 3 hours, and subsequently remained stable. Basal immunoreactive insulin levels were elevated (p less than 0.05) only in obese anovulatory women (52.4 +/- 20 microU/ml) compared with obese eumenorrheic (8.7 +/- 1.0 microU/ml), normal weight anovulatory (5.8 +/- 2.4 microU/ml), and normal weight eumenorrheic (4.6 +/- 0.4 microU/ml) women. Similarly, maximal increases in immunoreactive insulin levels after glucose ingestion were significantly greater (p less than 0.01) in obese anovulatory women compared with other groups. Of note is the observation that maximal changes in testosterone observed within the first 3 hours after human chorionic gonadotropin and maximal changes in insulin were correlated (r = 0.91, p less than 0.01). These data suggest that (1) both insulin resistance and an abnormal acute response to human chorionic gonadotropin are seen only in obese anovulatory women and (2) the degree to which these two abnormalities are manifested is clearly correlated. The mechanism(s) responsible for this interrelationship, as well as the underlying cause(s) of these biochemical defects, remain to be elucidated. PMID- 3322018 TI - The effect of insulin on aromatase activity in isolated human endometrial glands and stroma. AB - Hyperinsulinemic states have been associated with an increased incidence of estrogen-dependent endometrial neoplasia. To study the effect of insulin on the ability of endometrium to aromatize androgens to estrogens, late proliferative endometrium was obtained from normally cycling women at the time of indicated surgery, separated into component glands and stroma, and grown to confluence. Separated gland and stromal cultures were incubated in triplicate with increasing insulin concentrations and epidermal growth factor. Aromatase activity was assayed by the production of tritiated water from tritium-labeled androstenedione. The activity was noted to increase proportionally with increasing concentrations of insulin greater than 10 U/ml, and the effect was specific. These data suggest the following conclusions: (1) Insulin stimulates aromatase activity in both endometrial glands and stroma; (2) hyperinsulinemia may predispose to endometrial neoplasia by enhancing endogenous endometrial estrogen production. PMID- 3322020 TI - Utilization of monoclonal antibody L26 in the identification and confirmation of B-cell lymphomas. A sensitive and specific marker applicable to formalin-and B5 fixed, paraffin-embedded tissues. AB - Immunophenotypic analysis of paraffin-embedded tissues of lymphoproliferative disorders has been facilitated by recent developments of monoclonal antibodies that react with epitopes that survive histologic processing. Leukocyte common antigen (LCA) antibody has made a significant contribution to the immunocytochemical separation of non-Hodgkin's lymphomas from nonlymphoid neoplasms. However, a small percentage of lymphomas, particularly some large cell or immunoblastic B-cell tumors, will not label with LCA antibody. Other antibodies, directed against B lymphocytes, experience problems of specificity and a lack of sensitivity when applied to formalin-fixed specimens. The authors recently investigated a monoclonal antibody (L26) that demonstrates excellent specificity and sensitivity for B lymphocytes, and tumors derived from them, in formalin- and B5-fixed, paraffin-embedded tissue. The avidin-biotin peroxidase complex (ABC) technique was utilized for immunostaining 95 cases of malignant lymphoproliferative disorders and a variety of normal and neoplastic nonlymphoid tissues. When applied to sections of benign lymphoid tissue, the L26 antibody labeled germinal center cells, mantle zone and scattered interfollicular lymphocytes, but not histiocytes or plasma cells. L26 marked 100% (44/44) of the large cell and immunoblastic B-cell lymphomas, along with 1 case of pre-B cell lymphoblastic lymphoma. This included 8 cases that were LCA-negative. None of the T-cell lymphomas or plasma cell tumors studied demonstrated L26 immunostaining. No normal, benign, or neoplastic nonlymphoid tissues examined stained with this antibody. L26 successfully labels B lymphocytes and B-cell lymphomas in routinely processed tissues, often with greater sensitivity and intensity than LCA. This antibody should prove invaluable in the investigation of atypical lymphoid proliferations and the identification of B-cell derived lymphomas, when fresh or frozen tissue is unavailable for analysis. PMID- 3322019 TI - American Association of Pathologists president's address. New roles for the endothelium in inflammation and immunity. PMID- 3322021 TI - Brain amyloid in normal aging and cerebral amyloid angiopathy is antigenically related to Alzheimer's disease beta-protein. AB - Amyloid deposition is a prominent feature of a number of brain disorders, in which amyloid fibrils are found within blood vessel walls, the neuropil (neuritic plaques), neurons (neurofibrillary tangles). These include Alzheimer's disease (AD), AD changes associated with Down's syndrome, neurologically asymptomatic amyloidosis, Parkinson dementia of Guam, hereditary cerebral hemorrhage with amyloidosis of Icelandic origin (HCHWA-I), hereditary cerebral hemorrhage with amyloidosis of Dutch origin (HCHWA-D), and sporadic cerebral amyloid angiopathy (SCAA). Recently it was shown that the amyloid deposits in AD, Parkinson dementia of Guam, and HCHWA-D are formed by a similar 4-kd polypeptide called beta protein. Because the nature of the amyloid deposits in other types of cerebral amyloidosis is not known, we have conducted immunocytochemical studies on brains from autopsy cases of AD, HCHWA-D, SCAA and neurologically asymptomatic elderly individuals. Brains from two subjects without neurologic involvement were used as controls. Sections from these specimens were incubated with rabbit polyclonal antibodies against 1) a synthetic peptide of 28 residues (anti-SP28), homologous to the NH2-terminal sequence of the beta-protein, 2) the main amyloid component of the HCHWA-I, a variant of cystatin C, and 3) purified fraction of neurofibrillary tangles. In all cases, anti-SP28 antibody specifically stained amyloid deposits in leptomeningeal and cortical vessels and neuritic plaques. These findings demonstrate that the amyloid deposits of SCAA and aged brains are composed of a protein antigenically similar to AD, HCHWA-D, and Parkinson dementia of Guam beta-protein, suggesting that all of these clinically and etiologically different morbid conditions are pathogenetically related. On this basis, they can be tentatively grouped as beta-protein deposition diseases. In addition, we found that HCHWA-D and SCAA vessels were mainly affected, while in AD parenchymal involvement predominates. These differences in the localization and extent of beta-protein deposits may account from the predominance of vascular complications in HCHWA-D and SCAA and of dementia in AD. PMID- 3322022 TI - Analysis of prolactin and growth hormone production in the MtT/F4 transplantable pituitary tumor by the reverse hemolytic plaque assay. AB - The reverse hemolytic plaque assay (RHPA) was used to detect hormone secretion from normal pituitary cells and from the transplantable MtT/F4 pituitary tumor cells. Aliquots of the same cell suspensions were analyzed by immunocytochemistry (ICC). Normal pituitaries had more growth hormone (GH)-producing cells than tumors when analyzed by both the RHPA and ICC. However, the MtT/F4 tumor had significantly more prolactin (PRL)-secreting cells. Mammosomatotropic (MS) cells, which produced both PRL and GH, were identified in both normal and tumorous pituitaries with the RHPA and ICC. A combined procedure of RHPA followed by ICC staining on the same slide also revealed MS cells in both normal and tumorous pituitary cells, although the percentage of MS with this technique was less than with the other two methods. These results show that MS cells from a significant population of cells in the MtT/F4 tumor and that the RHPA and ICC can be used to study the regulation of this cell type. PMID- 3322023 TI - "Well-differentiated" lymphocytic neoplasms. Immunologic findings correlated with clinical presentation and morphologic features. AB - The authors studied 48 cases of well-differentiated lymphocytic neoplasms using a panel of monoclonal antibodies applied to frozen sections. Forty-seven tumors expressed monotypic immunoglobulin, one or more B-lineage antigens, and Ia (HLA DR) antigen. Proliferation centers expressed the T9 antigen and increased numbers of Ki-67-positive cells. One tumor was of T-cell origin, had a cytotoxic/suppressor cell phenotype, and showed anomalous loss of Leu-1 antigen. Immunophenotypic findings were correlated to the clinical presentation and morphologic features of each neoplasm. Sixteen tumors were associated with peripheral lymphocytosis (greater than 4000/cu mm), 13 biopsies were obtained from extranodal sites, 16 tumors had proliferation centers, and 11 neoplasms had plasmacytoid features. The authors found no absolute and few statistically significant immunologic differences between the B-cell tumors according to their clinical presentation or morphologic features. Tumors associated with peripheral lymphocytosis more commonly expressed the Leu-1 antigen (P less than 0.01) and IgD (P less than 0.01) and less frequently were stained by BA-2 (P less than 0.05) and OKT9 (P less than 0.05). Plasmacytoid neoplasms more frequently expressed the Tac (P less than 0.01) and T9 antigens (P less than 0.05), and all expressed kappa light chain (P less than 0.05). Extranodal neoplasms more commonly expressed IgM (P less than 0.01). In contrast to the markedly different clinical presentation and morphologic appearance these tumors may have, the immunologic data suggest that B-cell small lymphocytic neoplasms are relatively homogeneous. For an individual case, immunophenotype does not predict clinical presentation or morphologic features. PMID- 3322024 TI - Interleukin I and the glomerular mesangium. II. Monokine stimulation of mesangial cell prostanoid secretion. AB - Monocytic (MC) infiltration is a prominent feature of many forms of immune mediated glomerulonephritis. Through the release of interleukin-1, (IL-1), monocyte/macrophages have been shown to induce the proliferation of mesangial cells and to stimulate the secretion of a glomerular basement membrane-degrading neutral proteinase. In addition, mesangial cells release a cytokine that expresses many of the biologic properties of monocyte IL-1, including stimulation of mesangial cell proliferation. Because many of the actions of IL-1 are mediated by the induction of prostanoid prostaglandin (PG) synthesis, the authors determined the effects of purified macrophage and mesangial IL-1 on the secretion of prostaglandin E (PGE), prostacyclin, and thromboxane. The results indicated that cycling MCs release primarily PGE in response to purified IL-1. The local release by either monocytes or mesangial cells of IL-1 during glomerular inflammation, with subsequent mesangial cell generation of vasodilatory PGE, may be responsible in part for the alterations in the glomerular microcirculation observed in these disorders. PMID- 3322026 TI - Demography and pathology of an urban slave population from New Orleans. AB - Twenty-nine skeletons from the first cemetery in New Orleans provide significant new information about urban slavery in America. Dating as early as 1720 and used perhaps as late as 1810, the cemetery provided an identifiable sample of two whites, 13 blacks, one individual of possible Indian-white ancestry, and two possibly mulatto individuals. Numerous skeletal and dental lesions were noted in the series, and historical information was used in conjunction with the physical data to draw conclusions about rates and patterns of mortality. Pathological changes indicate that the cemetery contained individuals representing two slave occupational groups, house servants and laborers. This research provides information in the expanding area of Afro-American biohistorical research. PMID- 3322025 TI - Implications of tooth root hypercementosis in a Barbados slave skeletal collection. AB - A 17th- to 19th-century cemetery sample of 104 slaves from Newton Plantation (Barbados) shows uniquely high hypercementosis prevalence, as well as unexpectedly high and variable skeletal lead content. A variety of biological and archeological factors indicates that individuals with lower amounts of these anomalies (relative to age at death) were probably African-born, first-generation slaves. The hypercementosis is related to the progression of periodontal disease as assessed from alveolar bone. Although the hypercementosis is endemic in the Caribbean black population, it does not as yet have a clear explanation. We suggest the etiology might relate to chronic malnutrition involving periodic, seasonal rehabilitation. PMID- 3322027 TI - Life stresses of slavery. AB - Skeletal evidence exists for life stresses of 120 Black individuals from 25 sites in Maryland, Virginia, and the Carolinas. Periods for statistical comparison are eighteenth century, 1690-1770; Catoctin Furnace, Maryland industrial slaves, 1790 ca.1820; 1800-ca.1860, nineteenth century; and a twentieth-century Black sample compiled from forensic (accidental deaths) cases. From these archaeological sources, skeletal age at death shifts from 36 years, female, and 30 years, male in eighteenth century (N = 29) to 34.8, female, and 36.3, male in nineteenth century (N = 56). Catoctin Furnace slaves' longevity may reflect special conditions for skilled males (34.6 years, female; 41.2 years, male (N = 16). Nutritional stresses are indicated by dental lesions, hypoplasias, stature, and skull base height and pelvic brim index. Occupational stress occurs in some adolescents and in many adults as exaggerated development of lifting muscles (deltoid and pectoral crests) and early vertebral and shoulder breakdown. Lead content of bone may reflect site of occupation. The most common pathology is anemia or sicklemia; parietal depressions and ulna fractures ("parry") indicate violence-related trauma. PMID- 3322028 TI - Life stresses of the free black community as represented by the First African Baptist Church, Philadelphia, 1823-1841. AB - The congregation of the Reverend Henry Simmons (First African Baptist Church at 8th & Vine, Philadelphia) from 1823 to 1841 used a cemetery rediscovered through subway expansion which was carefully excavated by M. Parrington and S. Pinter in 1983-1984; currently 75 adults were available for study. As an overall health indicator, longevity at 38.9 years (N = 39) female and 44.8 (N = 36) male indicates more stress on females. Probable causes of stress are inadequate nutrition for the performance of arduous labor, pregnancy, and childrearing, unsanitary living conditions, limited exposure to sun, and extensive exposure to infectious diseases. Nutritional indicators of stature, dental lesions, skull base height, and pelvic brim index scarcely advance over 1790-1820 Catoctin Furnace, Maryland, slaves' indicators. Disease evidence includes limb-distorting rickets in one child who died at age 8, anemia, and arthritis; but the incidence of arthritis was less than at Catoctin. Genetic traits are chiefly African. Family links show in details: os acromiale in about 30%. This plus less violence (fewer fractures) suggests community strength developing. PMID- 3322029 TI - The age-sex structure of the slave population in Harris County, Texas: 1850 and 1860. AB - The effect of the slave system on demography can be revealed by examining the age sex structure of slave populations. The age-sex structure of slaves in Harris County, Texas is investigated using the 1850 and 1860 slave schedules. Median ages for black and mulatto slaves suggest that the population was young. Population pyramids exhibit a narrow base and top with a broad middle. The high proportion of slaves between 10 and 30 years of age and the increase in population size between 1850 and 1860 were mainly related to the importation of slaves and only partly due to natural increase. The data also show that black slaves were older on small plantations while mulattoes were older on larger farms. It is suggested that differential treatment in terms of purchase practices, assignment of tasks, food allocation, and/or differential susceptibility to infectious diseases may account for this pattern. PMID- 3322030 TI - Health and disease at a South Carolina plantation: 1840-1870. AB - The analysis of 36 human skeletons (eight subadults, 13 males, 15 females) recovered during a cemetery relocation near Charleston, SC, provides data on health and disease for a 19th-century sample of Afro-Americans. The majority of the burials date from 1840-1870. Skeletal analysis verified some historical interpretations. Gender differential in mortality is evident with average age at death for males 35 and females 40 years. Females, besides living longer, had more missing and carious teeth but fewer abscesses. Both genders expressed childhood metabolic stress as indicated by linear enamel hypoplasias. Males, however, had a higher incidence (92%) than did females (70%). Age at occurrence was more widely distributed for females, but ages 2-4 were most critical for both genders. Postcranial indications of recovery from acute stress, Harris lines, occurred more frequently for males (45%) than for females (18%). Anemia, probably both genetic and acquired, was a significant health problem for both genders. Cribra orbitalia appeared in 35% of the adult crania, and 80% of the subadults had orbital lesions. Diplotic expansion of the cranial vault and infection were relatively common in the sample. Skeletal reaction to infections appeared in 69% of the males, 60% of the females, and 80% of the subadults. Skeletal changes associated with demanding physical labor were ubiquitous. The shoulder and hip were especially affected by degenerative changes, the cervical vertebrae frequently expressed osteophytosis, and males show a preponderance of Schmorl herniations and hypertrophy of the ulnar supinator crest. Skeletal trace elements indicate a relatively high exposure to lead, strontium concentrations indicative of a diet high in plant foods, and relatively low zinc and copper concentrations. PMID- 3322031 TI - Cortical bone maintenance in an historic Afro-American cemetery sample from Cedar Grove, Arkansas. AB - The relocation and analysis of 80 skeletons from the Cedar Grove Cemetery, located in southwest Arkansas, provides an opportunity to examine the level of health and nutrition experienced by Afro-Americans in the post-Reconstruction South (1878-1930). The demographic profile lends support to the interpretation that Cedar Grove participated in the nationwide decline in Afro-American health. The high frequencies of skeletal lesions indicative of dietary deficiencies and infectious disease demonstrate that this was a highly stressed population. For this analysis, adult femoral thin sections (15 females and 14 males) are examined histologically. These data provide support to the assertion that the Cedar Grove population experienced poor health. Measures taken from the sections include cortical thickness, percent cortical area, and mean number of resorption spaces and forming osteons per square millimeter of bone. As a group, they demonstrate low percent cortical area compared with well-nourished normals. They also show high rates of resorption to formation, thereby disrupting the balance necessary for normal cortical bone maintenance. The pattern established for bone porosity in this group is not a function of age but rather is due to other factors, most likely nutrition and disease stress. What may be unique about this group is that males, as well as females, experienced problems with calcium homeostasis and normal maintenance and repair of bone. Taken together, these data support the interpretation that diet and health were substandard in the post-Reconstruction South. PMID- 3322032 TI - Paleopathological study on a case of osteosarcoma. AB - This report concerns a probable case of osteosarcoma found in a precontact Hawaiian skeleton from the east coast of Oahu Island, Hawaii. A young adult female showed a tumorous bone proliferation with a coarse, corallike appearance at the distal metaphyseal area of the left femur. In gross observation, a profusion of coalescing bone was extended to the surrounding space and also invaded the marrow space. X-ray films revealed spotted and ringed shadows in the shaft and a "sunburst appearance" in the lesion. Histological examination of the tumor bone fragment showed a great deal of primitive bone tissue formation without any systemic Haversian structure. The diagnosis of osteogenic osteosarcoma is much more compatible than other primary malignant bone tumors such as Ewing's sarcoma, fibrosarcoma, and chondrosarcoma or osteoplastic metastatic carcinoma of the bone when the location and morphology of the tumor are considered along with the age of the decedent. PMID- 3322033 TI - Connective tissue responses in blacks in relation to disease: further observations. AB - Additional information is presented in support of the hypothesis (Polednak: Am. J. Phys. Anthropol. 41:49-58, 1974) that in some black populations certain connective-tissue responses, which are involved in protection against infection and repair after injury, also may predispose to specific chronic diseases. These diseases include some autoimmune disorders (i.e., systemic lupus erythematosus, sarcoidosis, and scleroderma) and various benign and malignant tumors involving connective-tissue cells. Complex interactions between genetic factors (HLA and non-HLA loci) and environmental agents may be involved both in the etiology of these autoimmune diseases and in population differences in the incidence of these diseases. A framework is reviewed whereby cellular responses to infectious agents, involving chiefly immunoglobulin-producing cells and macrophages, may have consequences in terms of pathogenesis of specific chronic diseases more common in some black populations. The possible role of natural selection in maintaining some of these diseases is also considered, along with the need for involvement of biomedical anthropologists in their investigation. PMID- 3322034 TI - Reconstruction of the diet of the Middle Woodland Amerindian population at Abbott Farm by bone trace-element analysis. AB - In order to reconstruct the diet of various occupations of Middle Woodland Amerindians at Abbott Farm, New Jersey, nine different trace-element analyses were performed on bone specimens from the site. Contemporary bone specimens were also used as controls. Specimens of human bone from the site exhibited lower strontium levels and strontium-to-calcium ratios than deer specimens from the same site, reinforcing paleodemographic evidence that the human populations that inhabited this site included substantial amounts of meat in their diets. Strong evidence for diagenetic enrichment of strontium was also found. Copper levels were not affected by diagenesis, but dietary discrimination was not clear for this element. The results for lead were too inconsistent to permit conclusions. Magnesium levels were clearly depleted by diagenesis, suggesting that this element is less useful than others in dietary reconstruction studies. Manganese concentrations were greatly enriched by diagenesis, rendering this element useless in dietary reconstruction. Molybdenum was absent from virtually every specimen. Excellent dietary discrimination was found for sodium, despite significant leaching. Zinc was not affected by diagenesis, but interpretation of results was hampered by its complex metabolism in mammals. The results also suggest that the Middle Woodland aboriginal residents of Abbott Farm ate little seafood and utilized grain or other plants that contain phytate as a food source. PMID- 3322035 TI - Artificial grooves on the Krapina Neanderthal teeth. AB - Gross and microscopic examination of the Krapina Neanderthal dental remains reveals the presence of artificial grooves along the cemento-enamel junction of 14 teeth representing ten different individuals. The grooves display distinct morphological features including their consistent location (primarily on the mesial and/or distal root walls), their troughlike appearance, striations and/or polishing in the channel, and the ridges of reactive cementum bordering the groove. These grooves occur only on erupted, permanent teeth, and except for a single occurrence on a lower I2, all are located on mandibular or maxillary P4 M3. The morphological nature of the grooves is distinct and has been used to distinguish these grooves from root caries and other pathological or natural causes. Based on the close resemblance between artificial grooves at Krapina and those which have been attributed to toothpick use in other fossil and recent populations, we argue the Krapina Neanderthals were habitually probing the interproximal dental spaces with tools. PMID- 3322036 TI - Structure, biochemistry, and assembly of epithelial tight junctions. AB - The zonula occludens (ZO), also referred to as the tight junction, forms the barrier to the diffusion of molecules and ions across the epithelial cell layer through the paracellular space. The level of electrical resistance of the paracellular pathway seems to depend on the number of strands in the ZO observed by freeze-fracture electron microscopy (EM). The ZO also forms the boundary between the compositionally distinct apical and basolateral plasma membrane domains because it is a barrier to the lateral diffusion of lipids and membrane proteins that reside in the extracytoplasmic leaflet of the membrane bilayer. In contrast to its appearance in transmission EM, the tight junction is not a fusion between the outer membrane leaflets of neighboring cells. Rather it consists of protein molecules, including the newly discovered protein ZO-1 and probably others, which bring the plasma membranes into extremely close apposition so as to occlude the extracellular space. Very little is known about the assembly of tight junctions, but several kinds of evidence suggest that they are very dynamic structures. Other elements of the epithelial junctional complex including the zonula adherens (ZA), the Ca2+-dependent cell adhesion molecule uvomorulin, or L CAM, and actin filaments of the cytoskeleton may participate in the assembly of the ZO. PMID- 3322037 TI - Effect of intestinal factors on extraction of insulin in perfused rat liver. AB - To study the direct effect of intestinal factors on hepatic extraction of insulin, an investigation was made into the extraction of insulin from isolated rat liver perfused with portal venous effluent (PVE) obtained from the isolated perfused rat intestine. Rat intestine was perfused with Krebs-Ringer bicarbonate medium for 45 min, and the PVE was collected from glucose-, lipid-, or NaCl treated and untreated control intestines. The PVE, after adjustment of its glucose (180 mg/dl) and insulin (200 microU/ml) concentrations, was used as the perfusing medium for the liver of a different rat. The liver was perfused without recirculation with the PVE not containing insulin for 15 min and then perfused with the PVE containing insulin for the next 30 min. Insulin removal from liver perfused with PVE from lipid- or NaCl-treated intestine (52.6 +/- 5.4 or 46.6 +/- 4.1%) was similar to that from comparable controls (49.7 +/- 2.8 or 48.2 +/- 2.9%), respectively. However, that from glucose-treated intestine (39.7 +/- 6.2%) was significantly (P less than 0.01) lower than that from control intestine (51.1 +/- 2.5%). These results indicate that an intestinal factor secreted after glucose ingestion significantly reduces hepatic extraction of insulin and that at least a part of the incretin phenomenon is due to a decreased hepatic extraction of insulin after oral glucose administration. PMID- 3322038 TI - Hyperglycemia and hyperinsulinemia increase glucose utilization in fetal rat tissues. AB - In vivo measurement of glucose utilization by individual tissues of 19-day rat fetuses have been performed using radioactive 2-deoxy-D-glucose technique. In the basal state, glucose metabolic index was 13.6 +/- 0.5 ng.min-1.mg-1 for the whole fetus, 21 +/- 1 in the hindlimb muscles, 13 +/- 2 in the liver, and 16 +/- 2 in the brain, whereas the fetal heart had the highest value: 62 +/- 5 ng.min-1.mg-1. To raise the fetal glycemia, the basal maternal blood glucose concentration of 0.78 +/- 0.02 g/l was elevated to 1.04 +/- 0.02 g/l by mean of hyperglycemic clamps. The fetal hyperglycemia increased glucose metabolic index by 30-100% over basal values in all the tissues tested except in the brain. To raise fetal insulinemia, maternal euglycemic clamp with supraphysiological insulin concentrations were performed, then a fraction (1%) of exogenous insulin crossed the placenta. Fetal plasma insulin concentrations were thus elevated to 180 +/- 32 and 255 +/- 23 microU/ml. The fetal heart increased significantly its glucose metabolic index in response to the lower insulin level. Glucose metabolic index in hindlimb muscles and liver was increased by 50-100% for the highest insulin level, whereas the brain was unaffected by exogenous insulin. We conclude that glucose metabolic index is stimulated by physiological hyperglycemia in individual fetal tissues and that fetal tissues (heart, liver, and muscle) are sensitive to exogenous insulin. PMID- 3322039 TI - Cellular and subcellular distribution of exogenously administered renal renin in rat liver and kidney. AB - Using highly purified 125I-labeled rat renal renin, we have demonstrated that both the liver and kidney are responsible for clearance of renal renin. In the present study, light and electron microscope autoradiography of intravenously administered 125I-labeled rat renal renin was performed in rat liver and kidney to observe the cellular and subcellular distribution of the renin. Fifteen and 60 min after the injection, the liver and kidneys were removed and fixed with 0.1 M sodium phosphate buffer, pH 6.8, containing 2.5% glutaraldehyde and 0.5% tannic acid, which allowed for the removal of breakdown products of the labeled renin, and then autoradiography was performed. In the liver, silver grains were mainly localized in Kupffer cells and not in hepatocytes. In the kidney, silver grains were evident in the proximal tubule cells. In both liver and kidney cells, silver grains were mainly located over the lysosomes. Gel permeation high-performance liquid chromatography analysis of the liver and kidney extracts indicated two main fractions, including immunoreactive 125I-renin and the breakdown products (free 125I and 125I-tyrosine). In conclusion, circulating renal renin is mainly taken up by Kupffer cells and proximal tubule cells and is subsequently transported to the lysosomes to be degraded. These results, taken together with our previous finding that nonglycosylated submaxillary renin does not distribute in the liver, suggest that the carbohydrate moieties of renal renin are necessary for the recognition by Kupffer cells. PMID- 3322040 TI - Hormonal regulation of adaptive intestinal growth in artificially reared rat pups. AB - Adaptive growth and precocious expression of sucrase activity occur in the small intestine of artificially reared (AR) rat pups fed a hormone-free diet. The physiological mechanisms underlying adaptive intestinal growth were studied. Day 12 rat pups that received jejunal isografts subcutaneously on day 0 were subjected to artificial feeding and were killed on day 16. Crypt cellularity and DNA labeling index in isografts from AR, but not from mother-fed, rats increased significantly to levels found in in situ host jejunum of AR rats, indicating that humoral regulatory mechanisms are responsible for intestinal cell proliferation in AR pups. Radioimmunoassays of serum corticosterone, thyroxine, insulin, and gastrin and of gastric gastrin contents revealed that only serum corticosterone concentrations were significantly elevated, suggesting that corticosterone plays a critical role for intestinal growth. To examine this possibility directly, day 12 rats were adrenalectomized (ADX) and AR by continuous infusion of diets containing 0, 10, or 50 micrograms/ml corticosterone. Serum corticosterone concentrations paralleled the infused doses of corticosterone. Jejunal DNA labeling index increased in all ADX AR rats at day 13 in a dose-dependent manner. Increased jejunal DNA labeling index was maintained on day 14 in intact AR rats and ADX AR rats fed 10 micrograms/ml corticosterone but not in ADX AR rats receiving 0 or 50 micrograms/ml. We conclude that endogenous corticosterone is one of the systemic factors responsible for the adaptive increase in intestinal growth of AR rats. PMID- 3322041 TI - Interorgan glutamine flow in metabolic acidosis. AB - Acid-base homeostasis depends on glutamine flow from producer organs to those capable of generating bicarbonate. Glutamine oxidation, the prerequisite metabolic transformation, can be expressed by many sites; however, net base generation requires that glutamine flow be directed to a specific organ, the kidney. Normally, glutamine flows from the periphery to the splanchnic bed, providing a major fuel and supporting ureagenesis. Glutamine flow in chronic metabolic acidosis, on the other hand, is rerouted to the kidneys; asymmetrical distribution of NH+4 and HCO3- into the urine and renal vein subserves restoration of alkaline reserves. Clearly, glutamine flows in accordance with physiological demands, yet little is known of the regulatory mechanisms. As a model, chronic metabolic acidosis alters two aspects of this vital flow, its direction and magnitude. Characteristically the direction of flow is away from the splanchnic bed and into the kidneys associated with a marked fall in arterial glutamine concentration, restoring arterial level returns flow to the splanchnic bed sink. Thus glutamine homeostasis is sacrificed to impart direction to interorgan glutamine flow. Although multiple sites contribute to glutamine homeostasis, of great strategic importance is the potent hepatic glutaminase flux activated by portal venous NH+4 fed forward by gut metabolism; local hydrogen ion concentration modulates the effectiveness of this activator. Acute regulation of flow direction can be exerted by the lungs in determining the prevailing pCO2 and cellular acidity; respiratory compensation in chronic acidosis allows the expression of hepatic glutaminase, thereby suppressing arterial glutamine concentration. The enormous magnitude of glutamine flowing from muscle to the kidneys is supported by adaptive increases in glutamine synthetase and mitochondrial glutaminase, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322042 TI - Insulin stimulates ammoniagenesis in canine renal proximal tubular segments. AB - To characterize the effect of insulin on ammoniagenesis in renal proximal tubule, ammonia productions were measured in suspensions of canine renal proximal tubular segments incubated with 10 mM L-glutamine and varying concentrations of insulin. Productions of ammonia were linear functions of time for 120 min. Insulin (10(-6) M) increased ammonia production at 2 h by 34 +/- 5%. At the same time, gluconeogenesis, as measured by glucose production, was decreased by 16 +/- 2%. Significant enhancement of ammoniagenesis occurred in suspensions of segments incubated with as little as 10(-9) M insulin. Half-maximal stimulation occurred at between 10(-9) and 10(-8) M insulin. Oxidation of L-glutamine in cells within segments was also increased by insulin in a concentration-dependent manner. Insulin increased ammonia productions in segments incubated at pH 7.5 but not at 7.0. Under the former conditions, insulin enhanced ammoniagenesis in proximal tubular segments under conditions such that extracellular [Na+] was greater than intracellular [Na+], but not when extracellular [Na+] equaled intracellular [Na+]. We conclude that insulin stimulates ammonia production in suspensions of canine renal proximal tubular segments. Stimulation of ammonia production in vitro could reflect an action of insulin to enhance proximal tubular ammoniagenesis in vivo. PMID- 3322043 TI - Effects of aortic constriction and renal denervation in DOCA-hypertensive swine. AB - The autoregulation of renal blood flow (RBF) and glomerular filtration rate (GFR) was examined in normal and deoxycorticosterone acetate (DOCA)-hypertensive Yucatan miniature swine (YMS). Aortic constriction (AC) was used to vary renal perfusion pressure (RPP) from 158 to 90 mmHg for DOCA-YMS and 124 to 50 mmHg for normals. DOCA animals had calculated RBF autoregulatory indexes demonstrating less effective autoregulation compared with controls. Over the pressure range of RBF autoregulation, control animals also autoregulated their GFR, whereas most DOCA animals did not. When renal function in DOCA-YMS was evaluated at the normotensive RPP of 115 mmHg, GFR, urine volume, and sodium excretion were decreased by approximately 60, 70, and 80%, respectively. In DOCA-YMS, after the normalization of RPP to 115 mmHg, renal denervation significantly increased RBF. In DOCA animals the relative decrease in sodium and water excretion in relation to decreased RPP was not altered by renal denervation. In this hypertensive model the excretion of water and sodium are closely linked to RPP. At a normotensive RPP the sodium retention in the DOCA animals may be even further exaggerated by their inability to autoregulate GFR. PMID- 3322044 TI - Effects of transplantation on atrioventricular nodal accommodation and hysteresis. AB - In the present study, atrioventricular nodal accommodation and hysteresis characteristics were evaluated in awake, unsedated dogs, before (n = 10) and after cardiac transplantation (n = 10). Chronically instrumented animals were atrially paced at a cycle length (CL) of 400 ms, followed by an abrupt decrease in pacing CL to 300 ms, followed by an abrupt return in pacing CL to 400 ms (with pacing sustained for 60 s at each CL). Atrioventricular nodal conduction characteristics (assessed by AH intervals) were simultaneously monitored. Under control conditions, AH intervals lengthened rapidly after an abrupt decrease in pacing CL [mean time for AH interval lengthening to stabilize (Tonset) = 2 +/- 1 s], whereas AH intervals lengthened more slowly (P less than 0.05) after transplantation (Tonset = 41 +/- 4 s). Similarly, after an abrupt increase in pacing CL, control AH intervals shortened rapidly [mean time for AH interval to return to base line (Tonset) = 5 +/- 1 s], whereas AH intervals shortened more slowly (P less than 0.05) after transplantation (Tonset = 42 +/- 5 s). Thus accommodation appears to be an intrinsic atrioventricular nodal response (present after cardiac denervation by transplantation) to abrupt, sustained atrial CL changes. Furthermore equivalence (P = NS) in atrioventricular nodal accommodation responses to symmetric CL decreases and increases after transplantation suggests that hysteresis [i.e., nonequivalence (P less than 0.05) in atrioventricular nodal accommodation responses], as seen under control conditions, results primarily from extrinsic (neural) modification of intrinsic atrioventricular nodal responses to symmetric CL changes. PMID- 3322045 TI - Effect of cyclosporin on blood pressure and renin-aldosterone axis in rats. AB - Although hypertension is a frequent complication of cyclosporin A (CSA) therapy in clinical practice, little experimental information is available on the nature and the mechanism of this form of hypertension. We studied the effect of currently recommended therapeutic dosages of CSA, i.e., 5 (CSA5) and 20 (CSA20) mg.kg-1.day-1, on blood pressure and the renin-aldosterone system (RAS) in spontaneously hypertensive rats (SHR). Influence of in vivo CSA treatment on in vitro angiotensin II (ANG II)-stimulated aldosterone secretion by isolated adrenal glomerulosa cells (AGC) was also measured. CSA treatment in SHR resulted in a consistent increase in systolic blood pressure. This increase in blood pressure occurred in the absence of significant changes in creatinine clearance in CSA5 rats, whereas in CSA20 rats a significant reduction in creatinine clearance was observed. Sodium balance and serum calcium and magnesium concentrations were not different between the control group and either of the two CSA-treated groups of rats. Plasma renin concentration (PRC) and inactive renin (IR) were markedly elevated, but plasma renin substrate remained unchanged with CSA administration. Despite the presence of hyperreninemia, plasma aldosterone was not elevated, suggesting that CSA may induce relative adrenal resistance to ANG II. This possibility was tested using AGC isolated from CSA-treated rats. ANG II-stimulated aldosterone secretion in AGC was diminished by low dose and aborted by high dose CSA-treatment. Thus CSA administration in SHR induces a predictable increase in blood pressure in association with "hyperreninemic hypoaldosteronism." PMID- 3322046 TI - Thermoregulatory responses of febrile sheep to spinal and hypothalamic heating. AB - Fever was induced by the intravenous injection of 0.25 microgram/kg of lipopolysaccharide (LPS) from Escherichia coli in eight conscious sheep exposed to ambient temperatures adjusted to the lower range of thermoneutrality. Chronic spinal or hypothalamic thermodes were perfused with water of 44 degrees C for 20 min or for most of the rising phase of fever (100 min of the mean 166 min total rise time). The effects of spinal and hypothalamic heating were identical. Thus, before LPS, spinal or hypothalamic heating did not affect the rate of O2 consumption (VO2) but increased skin blood flow (as indicated by skin temperatures) and elicited panting; therefore rectal temperature (Tre) fell. During fever rise, the already reduced skin blood flow and respiratory rate were not affected by spinal or hypothalamic heating, but the increased VO2 was reduced; consequently, the rise in Tre was attenuated. During the plateau phase of fever, all responses were similar to those seen before LPS. In febrilysis, heating strongly enhanced the operating heat loss mechanisms and, hence, augmented the fall in Tre. Thus, although the thermoeffectors activated by spinal or hypothalamic heating were modified during the different stages of fever, the effect on body temperature was nearly the same. Therefore there seems to be no change in spinal or hypothalamic thermosensitivity during fever in sheep. PMID- 3322048 TI - 100 years of the American Journal of Psychology. Special centennial issue. PMID- 3322047 TI - Fetal heart rate, arterial pressure, and blood volume responses to cortisol infusion. AB - The purpose of this study was to determine whether physiological amounts of cortisol affect the fetal cardiovascular system. Cortisol (4 micrograms/min) or the vehicle was infused intravenously for 5 h into six chronically catheterized sheep fetuses at 127-143 days gestation (term = 145-150 days). In the cortisol infused animals, plasma cortisol concentration increased from 2.0 +/- 0.6 (SE) to 8.3 +/- 0.9 ng/ml. There was a concomitant decrease in fetal heart rate of 38 beats/min (P less than 1 X 10(-6)) and an increase in arterial pressure. Estimated blood volume decreased by 6% in the cortisol-infused fetuses compared with the vehicle-infused animals (P less than 1 X 10(-4]. In addition, plasma norepinephrine and epinephrine concentrations decreased to 70% of control at the end of the 5-h cortisol infusion, whereas plasma renin concentration decreased to 34% of control. The simultaneous increase in fetal arterial pressure and decrease in estimated blood volume suggest that fetal vascular resistance increased, whereas vascular compliance and/or nonstressed vascular volume decreased. However, this does not appear to be mediated by increases in circulating vasoconstrictor hormone concentrations or increased sympathetic tone. Thus the present study shows that physiological amounts of cortisol have significant effects on the fetal cardiovascular system but the mechanisms are unknown. PMID- 3322049 TI - The American Journal of Psychology: a retrospective. PMID- 3322050 TI - American Journal of Psychology: Biographies of major editors. PMID- 3322051 TI - A laboratory course in physiological psychology. By Edmund C. Sanford, 1891. PMID- 3322052 TI - The proof and measurement of association between two things. By C. Spearman, 1904. PMID- 3322053 TI - The origin and development of psychoanalysis. By Sigmund Freud, 1910. PMID- 3322054 TI - Carl G. Jung, "The association method: lecture III," 1910. PMID- 3322055 TI - Emotional reactions and psychological experimentation. By John B. Watson and J. J. B. Morgan, 1917. PMID- 3322056 TI - The psychology of Gestalt. By Harry Helson, 1925. PMID- 3322057 TI - The James-Lange theory of emotions: a critical examination and an alternative theory. By Walter B. Cannon, 1927. PMID- 3322058 TI - Psychophysical analysis. By L. L. Thurstone, 1927. PMID- 3322059 TI - The influence of degree of interpolated learning on retroactive inhibition and the overt transfer of specific responses. By Arthur W. Melton, Jean McQueen Irwin, 1940. PMID- 3322060 TI - Heart and brain potentials of human fetuses in utero. By Donald B. Lindsley, 1942. PMID- 3322061 TI - The perception of visual surfaces. By James J. Gibson, 1950. PMID- 3322063 TI - The American Journal of Psychology "library exhibit". PMID- 3322062 TI - The direct estimation of sensory magnitudes--loudness. By S. S. Stevens, 1956. PMID- 3322064 TI - Freud's self-analysis and the inner life of contemporary refugees. PMID- 3322065 TI - Maternal destructiveness in the life of Franz Kafka. PMID- 3322066 TI - Major histocompatibility antigens on trophoblast and their regulation: implications in the maternal-fetal relationship. AB - Recent technological advances have provided methods of detecting antigens encoded by the major histocompatibility complex with greater precision, allowing the expression of such antigens on the components of the placenta to be clarified. Of specific interest is the expression of these antigens on trophoblast cells, the fetal-derived epithelial cells that confront maternal blood and tissues at the maternal-fetal interface. It is now clear that the different trophoblast subpopulations differentially express class I antigens, although none appear to express class II antigens. Class I antigens can be induced by exposure to interferons on some populations but apparently not others, suggesting that the regulation of their expression differs for subpopulations of trophoblast cells, depending on gestational stage and location. This restricted expression has important implications for maternal-fetal immune interactions during the different phases of pregnancy and perhaps also bears on physiological functions of the feto-placental unit, such as growth and differentiation. PMID- 3322067 TI - Oncogenes and cancer. AB - Early studies designed to investigate the molecular basis of oncogenesis indicated the existence of discrete genes which could cause neoplastic transformation of normal cells in vitro. These genes (which became known as oncogenes) were originally thought to be derived from oncogenic retroviruses and neoplastic transformation was believed to be the result of infection of normal cells by an oncogenic retrovirus. However, recent studies have demonstrated that normal eukaryotic cells contain gene sequences which are highly homologous to oncogenes but which do not cause neoplastic transformation. These genes (termed proto-oncogenes) have been found to code for proteins which are intimately involved in the regulation of mitosis. These include growth factors, receptors for growth factors, proteins (such as protein kineses and GTP binding proteins) which transduce exogenous signals through the plasma membrane, and nuclear binding proteins. Thus, if the function or control of a proto-oncogene (or its product) is altered by mutation, gene rearrangement, or translocation, its effects on the cell will also change. This, in turn, can lead to the loss of normal mitotic control. The tumorigenic process is, of course, much more complicated that just unchecked cell growth. However, the insights into the molecular basis of cellular regulation have suggested new approaches to the early diagnosis of cancer and may ultimately lead to the development of more effective treatment protocols. PMID- 3322068 TI - The controversies around histocompatibility antigen expression on sperm. PMID- 3322069 TI - On preeclampsia and leukocytes in human decidua. PMID- 3322070 TI - Injuries in women's gymnastics. The state of the art. AB - This article takes a three-stage approach to the topic of injuries in women's gymnastics. In the first stage, we review the literature and summarize our current knowledge of injury rates, injuries in specific events, and anatomical location of injuries. In the second, we critically evaluate the relative contributions of these studies in terms of their generalizability, methods, and conceptual approaches. Finally, we present possible directions for future research in the area of women's gymnastic injuries. PMID- 3322071 TI - Objective knee evaluation using the Genucom Knee Analysis System. Clinical implications. AB - The Genucom Knee Analysis System was used in a clinical setting to study the clinical practicality of the Genucom instrument, and the degree of correlation between Genucom and clinical knee examinations. The Genucom evaluation performed by an experienced examiner required 25 to 30 minutes for a 14 test bilateral examination. The instrument provided detailed graphical and tabular data of the test results. One hundred "normal knees" were examined in a series of seven Genucom tests. Normal "laxity bands" for both males and females were generated for a range of load applications for the seven tests. There was no significant difference observed between the male and female laxity distributions. However, a slightly lesser laxity was observed for the male population in general. A group of 38 subjects with 1 injured knee were assessed concurrently using clinical and instrument techniques. Comparisons were made for the 90 degrees anterior posterior (AP) drawer, the 30 degrees AP drawer (Lachman), and the varus/valgus stress test. For the 90 degrees AP drawer test, 16 subjects were found clinically to have less than or equal to 5 mm of excess laxity based on comparison with the opposite normal knee. The instrumented measurement concurred in 10 cases. In the other six cases it was noted that laxity on the uninjured knee reached the maximum of the "normal" instrumented population, that is with higher than normal laxities. Fifteen subjects were clinically tested with greater than 5 mm of excess laxity. The instrumented test concurred in all but one.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322072 TI - Cement coating of osteoarticular allografts in rats to prevent the immune response. AB - Recently, more attention is being paid to the treatment of the articular surface defect in the young, active individual. Resurfacing or "shell" allografts are being considered as one of the alternatives for treatment. The immune response by the host may be the chief obstacle to the successful use of fresh osteoarticular allografts. Since proteins on the surfaces of allograft bone cells are considered to be the principal antigens eliciting the immune response, we hypothesized that mechanical masking of these cells by a biodegradeable blocking agent might prevent the immune response. Osteoarticular allografts of the distal femur were performed in rats and the cut surfaces of the graft were coated with cement before implantation. In a preliminary experiment, six biodegradeable cement materials were tried (bone wax, zinc polycarboxylate, collodion, fibrin adhesive, zinc oxide, and isobutyl-cyanoacrylate). Of these, the zinc oxide cement and isobutyl-cyanoacrylate were effective in inhibiting the immune response observed in control rat distal femur allografts. A second experiment was performed using nine rats with zinc oxide and nine rats with isobutyl-cyanoacrylate cements. These were compared with 20 control rats that had allografts without cement coating. Eighteen of the control rats (90%) developed an immune response, while only 22% (2/9) of the rats with zinc oxide coating and 33% (3/9) of the rats with isobutylcyanoacrylate developed an immune response. In a third experiment distal femur allografts were performed in 13 rats using only the liquid component of the zinc oxide cement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322073 TI - Natural history of asymptomatic carotid plaque. Five year follow-up study. AB - A prospective analysis of 296 carotid arteries in 293 asymptomatic patients was undertaken using real-time B-mode ultrasonography. All patients had carotid bifurcation disease and were followed for an average of 46 months. The endpoint for follow-up was a transient ischemic attack or stroke. Patients were categorized according to degree of stenosis (greater or less than 75 percent) and morphologic plaque characteristics (calcified, dense, or soft). Patients with hemodynamically significant stenosis were at greater risk of transient ischemic attack or stroke than their counterparts with less than 75 percent stenosis. However, even patients with less than 75 percent stenosis were at risk if the plaque was less organized (dense or soft). Patients with hemodynamically significant stenosis and morphologically soft plaque were at the greatest risk of transient ischemic attack or stroke. Those patients with calcified plaque and less than 75 percent stenosis had the lowest risk of transient ischemic attack or stroke. Morphologic plaque characteristics, as well as degree of stenosis, is important in determining which patients are candidates for carotid endarterectomy. PMID- 3322074 TI - Changes in the glucocorticoids secretion during endotoxin shock and antioxidants treatment. PMID- 3322075 TI - [Therapeutic results in endocrine infertility]. PMID- 3322076 TI - [Function of the kidneys and the renin-aldosterone system in women before and after use of intrauterine contraceptive devices]. PMID- 3322077 TI - [Importance of echography in the dynamic observation of patients with different forms of isosexual-type premature sexual maturation]. PMID- 3322078 TI - [Function of the reproductive system in girls with premature breast enlargement]. PMID- 3322080 TI - [Clinical importance of the ultrasonic determination of the median uterine echo]. PMID- 3322079 TI - [Prolonged-action contraceptives]. PMID- 3322081 TI - [The use of peptides for contraception]. PMID- 3322083 TI - Hypersensitivity reactions to food additives. AB - Only seldom have food additives been shown to cause true allergic (immunological) reactions. Adverse effects due to various pharmacological or other mechanisms are much more common. The individual tolerance may be decreased for one reason or another, and may fluctuate from time to time. Many patients suffering from food additive reactions have atopic constitutions and such clinical symptoms as flexural dermatitis, rhinitis and asthma. The most important skin symptoms caused by food additives are urticaria, angioneurotic edema, and contact urticaria. Azo dyes, benzoic acid and several other common food additives may aggravate or, more rarely, even cause urticaria. Spices are one of the most common causes of immunological contact urticaria. Non-immunological contact urticaria is produced by numerous spices, benzoic acid, sorbic acid, cinnamic acid, and many essential oils. Asthma and rhinitis are the main hypersensitivity symptoms in the respiratory tract, and azo dyes, benzoic acid, and sulfitic food additives are the most common causative agents. Systemic and respiratory reactions to food colorants and benzoates have been claimed to occur more frequently in acetylsalicylic acid- (ASA-)sensitive patients than in non-reactors. Hypersensitivity reactions in organs other than the skin and respiratory tract are rare or poorly documented. Psychological factors play an essential role in both food and food additive reactions. PMID- 3322084 TI - Allergen-induced nasal hyperreactivity appears unrelated to the size of the nasal and dermal immediate allergic reaction. AB - It has been previously demonstrated in nasal challenge studies that there is an increased sensitivity to allergen following an initial allergen challenge. A similar feature has been demonstrated following natural allergen exposure in patients with seasonal allergic rhinitis. To further explore the characteristics of this "priming" phenomenon and its relationship to other expressions of their allergic airway disease, 28 hay fever patients with strictly seasonal disease were studied. Skin tests with the relevant pollen allergen and histamine were performed and the size of the immediate and late phase allergic reaction was determined. An initial nasal allergen challenge was followed by a rechallenge of the nose with allergen 24 h later using a lavage technique. Determinations of TAME-esterase activity, as a biochemical marker of the allergic reaction, were made in the returned lavage fluid. The number of sneezes was counted and nasal symptoms were also assessed using a scoring technique. 19 of 28 patients (67%), displayed an increased responsiveness at rechallenge with similar findings in terms of symptom scores and TAME-esterase measurements. The increase was statistically significant for the symptoms of nasal blockage, which increased from 0.7 +/- 0.1 (mean +/- SEM) to 1.1 +/- 0.2 (P less than 0.05), and nasal secretion which rose from 1.1 +/- 0.2 to 1.7 +/- 0.2 (P less than 0.01). A composite nasal symptom score which also took account of the number of sneezes, increased from 2.9 +/- 0.4 to 4.0 +/- 0.3 (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322085 TI - [Current status and perspectives of cardiac transplantation]. PMID- 3322086 TI - [Physics, medicine and scientific communication]. PMID- 3322082 TI - History of medicine in Alaska. James Andrew Lundquist, M.D. PMID- 3322087 TI - [The laser in otorhinolaryngology]. PMID- 3322088 TI - [Microsurgical technics in experimental organ transplantation]. PMID- 3322090 TI - [In memory of His Excellency Don Jose Gomez Orbaneja]. PMID- 3322089 TI - [Diabetic hyperlipoproteinemia]. PMID- 3322091 TI - [Sensory activity and psychological status of the intrauterine fetus]. PMID- 3322092 TI - [New infectious pathology]. PMID- 3322093 TI - [Eulogy and remembrance on the centennial of the birth of Don Gregorio Maranon]. PMID- 3322094 TI - National Registry of Certified Nurses in Advanced Practice 1987. PMID- 3322095 TI - [Prophylaxis and therapy of the acid aspiration syndrome]. AB - The best prevention of the aspiration syndrome begins with early identification of any patient at risk. Reduction of gastric volume and elevation of gastric pH can be achieved by premedication with glycopyrrolate (0.3 mg i.m.) and preoperative administration of H2-receptor antagonists (150 mg ranitidine p.o. 6 8 h and 80 mg i.m./i.v. 60 min before induction). Transportation of stomach contents into the duodenum can further be accelerated by 10 mg metoclopramide i.v. 20-40 min before induction. Metoclopramide will also elevate lower esophageal sphincter tone. Rapid elevation of gastric pH can be achieved by oral administration of 15-30 ml 0.3 mol sodium citrate. Induction of anesthesia should be performed as a "rapid sequence induction". Manual compression of the esophagus (Sellick manoever) may prevent gastric regurgitation. In cases of pulmonary aspiration, consequent therapy has to be initiated as soon as possible to limit broncho-alveolar damage. After endotracheal intubation the upper respiratory tract should be cleared of stomach contents by suction. Further efforts should include artificial ventilation with a high FiO2 and low PEEP (5-10 cm H2O) as well as vigorous volume substitution to maintain cardiovascular stability. Corticosteroids (200 mg Hydrocortisone i.v. may have a beneficial effect if given within 5 min after aspiration. Severe bronchospasm may respond to aminophylline (5 mg/kg i.v. as an initial bolus) or inhalation of beta-adrenergics (terbutaline 0.75-1.5 mg/inh). Bronchial lavage will rather damage than improve broncho alveolar integrity and cannot be recommended.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322096 TI - [Meptazinol, a new analgesic. Hemodynamic and respiratory effects]. AB - In a prospective, randomized double-blind study the hemodynamic and respiratory effects of i.v. meptazinol, a new synthetic narcotic agonist-antagonist analgesic given in 2 dosages (2 mg/kg and 4 mg/kg), were compared over 15 min to a control group that received 0.9% saline solution as placebo. In a total of 80 patients scheduled for elective aortocoronary bypass surgery, the study was performed before and during general anesthesia and during extracorporeal circulation (ECC). A dose-dependent increase in mean arterial pressure (MAP) and total systemic resistance (TSR) were the predominant hemodynamic effects of meptazinol before and during anaesthesia (Tables 1 and 2). Within the study period no change in heart rate (HR) or cardiac index (CI) could be observed. Directly measured left ventricular parameters revealed a significant increase in left ventricular pressure (LVEDP, and dp/dtmax (Fig. 1). During ECC meptazinol injection was followed by a dose-dependent increase in perfusion pressure, indicating a direct vasoconstrictive effect; no influence on the capacitance system ("venous pooling") could be observed (Fig. 2). In the spontaneously breathing, premedicated patients (morphine hydrochloride 0.15 mg/kg and flunitrazepam 0.03 mg/kg) paO2 increased and paCO2 decreased, especially after injection of the higher dosage of meptazinol; there was no influence on intrapulmonary right-to left shunting (Qs/Qt).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322098 TI - Benjamin Archer Kent: a South Australian pioneer. PMID- 3322097 TI - [Better acceptance of measures for induction of anesthesia after rectal premedication with midazolam in children. Comparison of results of an open and placebo-controlled study]. AB - The rectal administration of midazolam for premedication of children before induction of anesthesia by mask was investigated in two clinical studies. In 62 children aged between 2 and 10 years, midazolam was given by open design at various dosages (0.15 mg.kg-1, 0.25 mg.kg-1, 0.30 mg.kg-1, 0.35 mg.kg-1, 0.40 mg.kg-1) to evaluate the most effective dose for optimal acceptance of the mask and gas mixture. An additional 40 children between 3 and 9 years received 0.2 mg midazolam.kg-1 body weight or placebo in a double-blind design to estimate the lower limit of efficacy of midazolam. All children were classified as ASA I and had to undergo a surgical procedure. Within the two studies the children were not different with respect to their general data, age, weight, and sex. In both studies more boys than girls were included. Parameters of efficacy were the degree of sedation before and at 10, 20, and 30 min after midazolam as well as acceptance of the mask and the gas mixture at induction of anesthesia. In all groups, including placebo, a sedative and tranquilizing effect of the premedication was found. The rectal administration of 0.35-0.4 mg midazolam.kg-1 is most suitable for the preoperative medication of children between 2 and 10 years. Due to the degree of sedation and the relief of anxiety toward the surroundings and the operation, the induction of anesthesia is optimally accepted by the child. In contrast, the effect of a dose around 0.2 mg midazolam.kg-1 body weight is not much different from that of placebo and is not sufficient for effective premedication. PMID- 3322099 TI - Dye-ligands and multifunctional adsorbents: an empirical approach to affinity chromatography. PMID- 3322101 TI - Lectin-enzyme immunoassay of transferrin sialovariants using immobilized antitransferrin and enzyme-labeled galactose-binding lectin from Ricinus communis. AB - A heterologous lectin-enzyme immunoassay is described. Microtiter plate wells were coated with affinity-purified antibodies to human transferrin. After incubation with transferrin sialovariants, prepared by limited neuraminidase treatment and separated with chromatofocusing, a lectin-enzyme-streptavidin complex was added. A good correlation was obtained between the number of terminal galactose groups on transferrin and the response in the lectin-enzyme immunoassay using Ricinus communis agglutinin as the galactose-binding lectin. The results indicate that characterization of glycosylation is possible with less than a microgram of the glycoprotein available, using lectin-enzyme immunoassays. PMID- 3322100 TI - Radioenzymatic determination of phenylpropanolamine in plasma. AB - We modified a norepinephrine radioenzymatic method (C. R. Lake, M. G. Ziegler, and I. J. Kopin, 1976, Life Sci. 18, 1315-1326) for determination of plasma phenylpropanolamine (PPA) concentrations. PPA is converted to N[methyl 3H]ephedrine ([3H]EPD) by the enzyme phenylethanolamine N-methyltransferase (PNMT) and S-[methyl-3H]adenosyl-L-methionine ([3H]AdoMet). The product, [3H]EPD, is isolated from unreacted [3H]AdoMet and labeled side products by an organic extraction and a TLC procedure. In addition, a preincubation organic extraction procedure is included to remove inhibitors of PNMT from plasma and to concentrate the sample for enhanced enzymatic conversion. In order to accurately quantitate PPA across the wide range of possible concentrations, the assay is conducted at two plasma volumes. PPA concentrations between 0.3 and 50 micrograms/liter can be detected with 1 ml of plasma, while concentrations between 4 and 1500 micrograms/liter can be detected with 0.1 ml of plasma. The intra-assay coefficients of variation (CVs) are 9.3 and 5.7% at 0.5 and 1500 micrograms/liter, respectively, while the mean interassay CV is 13.8%. PMID- 3322102 TI - An apparatus for continuous analysis of protease-catalyzed acyl transfer reactions. AB - An apparatus that allows continuous analysis of protease-catalyzed acyl transfer reactions is described. Hydrolysis reaction is assayed using automatic titration. A continuous determination of amino group concentration by reaction with o phthalaldehyde gives the rate of peptide bond formation. The apparatus allows the determination of the partition constant for the nucleophile at various nucleophile concentrations from one run. PMID- 3322103 TI - Preparation of neoglycoprotein-enzyme conjugate using a heterobifunctional reagent and its use in solid-phase assays and histochemistry. AB - A conjugate of a neoglycoprotein (chemically lactosylated bovine serum albumin) and an enzyme (horseradish peroxidase) has been prepared in solution using a heterobifunctional reagent, N-succinimidyl-3-(2-pyridyldithio)propionate, and has been purified by gel filtration on an Ultrogel AcA-44 column. To preclude any carbohydrate-dependent binding to the sugar residues on the glycoprotein peroxidase, the enzyme has to be treated with sodium periodate and sodium cyanoborohydride prior to coupling, which results in oxidative cleavage of the carbohydrates and reduction of the aldehydes thus formed to primary alcohols. Lactosylated bovine serum albumin-peroxidase conjugate has been employed to detect plastic-bound Ricinus communis agglutinin with dependence of the concentration of the lectin and with dependence of the presence of specific inhibitors. Enzyme-labeled conjugates with unmodified bovine serum albumin are completely ineffective in this assay. Localization of beta-galactoside-specific sugar receptors in connective tissue is used to demonstrate the feasibility of application of such neoglycoprotein-enzyme conjugates in histochemistry with a minimum number of steps. PMID- 3322104 TI - Spectrophotometric determination of zinc in potable water and insulin with methylglyoxal bis(4-phenyl-3-thiosemicarbazone). PMID- 3322105 TI - [Functional morphology of the maxillo-mandibular apparatus in the mini-Lewe minipig. 5. Structural and functional changes of the masticatory muscles and their dry weight development]. AB - The basic pinnate structures caused by Sehnenspiegel in the jaw muscles are already present in newborn animals. The functional changes in the jaw muscles are described in terms of an analysis of force components based on the dry weights of the individual muscles involved in chewing action. Although the protractive and retractive components are relatively large in newborn pigs, the adductive components predominate clearly in adult animals. The development of the jaw muscles in terms of dry weight shows that the masseter muscle predominates at all ages. The miniature pig MINI-LEWE is assigned to the herbivorous type on the basis of the dry weight distribution. PMID- 3322106 TI - [The history of congenital malformations with special reference to conjoined twins. 1. From ancient times to the 18th century]. AB - Congenital malformations are mentioned in Assyrian and Babylonian literature, and the opinions of Democritus, Empedocles and Aristotle regarding their origin persisted in modified form until the Middle Ages. Following the invention of printing, illustrations of congenital malformations began to appear on pamphlets. Although not always realistic, these illustrations provide a rich source of information regarding the spirit of those times. The first monographs containing collections and interpretations of malformations appeared in the 16th century. These were followed in the 17th century by increasingly realistic illustrations, and superstitious ideas regarding the causes of malformations, although still predominating, gradually started to recede. PMID- 3322108 TI - The number of neurons in dorsal root ganglia L4-L6 of the rat. AB - The number of neurons in the dorsal root ganglia L4-L6 of the rat was determined because published data are inconsistent and in general incompatible with the number of afferent axons in the sciatic nerve. Nucleoli were counted in serial sections; epoxy-resin sections 3 microns thick, or paraffin sections 5 microns thick, or unstained 12-microns paraffin sections of osmicated tissue were used. Correction factors for split and multiple nucleoli were obtained by counting nucleolar profiles in consecutive sections of identified cells. Dividing the number of nucleolar profiles into the number of cells gave the factor by which the counts of nucleolar profiles had to be multiplied to obtain the number of neurons. The ganglia L4, L5, and L6 contained about 12,000, 15,000 and 14,000 neurons, respectively, when resin sections were used. The standard deviation for the average of 41,000 neurons in the three ganglia was 8% of the mean value. The results compare well with the number of dorsal root fibers, and with the fact that the sciatic nerve at midthigh, to which less than half of the neurons connect, contains 19,000 afferent axons. The data obtained from the paraffin series were 23% smaller, but still considerably higher and less variable than all previously reported data. The main problem with stained paraffin sections was that most small neurons had multiple nucleoli attached to the membrane of the nuclei, which only measured 10 microns in diameter. The nucleoli often projected into the dark cytoplasm and were difficult to identify. PMID- 3322109 TI - [25 years of the state testing section and 10 years of the reference laboratory for the control of arthropods harmful to health in East Germany]. AB - The development during the past 25 years of a public-health institution in the German Democratic Republic working specifically on the control of arthropod pests is outlined. Essential fields of the work are: Biological effectiveness tests of pesticides and the instructions for pesticide application; advice on the introduction of new means of control and participation in their further development; investigation on resistance against insecticides; cooperation with the departments of parasitology in the local institutes of hygiene and with the professional branch of pest control operators; contributions to the updating of the specific legislation. Structure of the reference laboratory and selected data on the extent of work. Scientists of the laboratory are active members of scientific societies, especially of the Parasitological Society of GDR. PMID- 3322107 TI - Use of animals in experimental research: a scientist's perspective. AB - The present article was written as an attempt to understand the position of animal rights groups, to stimulate scientists to define their own positions, and to encourage scientists to interpret their use of animals to the rest of society. The article attempts to generate a statement of practices that might be useful in experiments that utilize animals in research. The statement is an extension of the three R's originally proposed by Russell and Burch (W.M.S. Russell and R.L. Burch [1959]: Principles of Humane Experimental Technique, Springfield, IL, Charles C. Thomas) into four R's: refinement, reduction, replacement, and review. PMID- 3322110 TI - Blood pressure response to a calcium entry blocker in normotensive subjects with or without a family history of hypertension. AB - The possibility that a familial background of hypertension might influence the blood pressure response to a calcium entry blocker was evaluated in 15 normotensive relatives of patients with essential hypertension and 18 normotensive subjects with no family history of hypertension. Under control conditions, blood pressure, heart rate, plasma noradrenaline, adrenaline, and renin activity did not differ between the two groups. Nifedipine, at a dose of 10 mg administered sublingually, lowered the blood pressure and increased the heart rate, plasma noradrenaline, and renin activity. The normotensive relatives of patients with essential hypertension did not differ in their responses from the normotensive subjects with no family history of hypertension, with the exception of plasma noradrenaline thirty minutes after nifedipine. These results provide evidence to suggest that there is no functional abnormality with increased dependency of vascular smooth muscle tone on calcium influx in the prehypertensive state. PMID- 3322111 TI - Mediators and inflammatory cells in allergic disease. PMID- 3322112 TI - [The lacrimal film. Analysis and value]. PMID- 3322113 TI - [Neuroendocrine tumors]. PMID- 3322114 TI - [Immunological assay of chorionic gonadotropin during pregnancy. Multicenter study of 5 reagents]. AB - Five commercial kits for the quantitative determination of human chorionic gonadotropin (hCG) used for detection and monitoring of pregnancy were evaluated. Five kits used two-sites "sandwich" enzymoimmunoassay and monoclonal antibodies. Precision, standardization and sensitivity were tested and practicability was assessed. Good results are obtained for four kits (Beckman had poor results), sensitivity and specificity are good. Practicability of five kits was evaluated but choose was in relation to configuration of laboratory. PMID- 3322115 TI - [Reference values of chemical constituents and plasma enzymes in minipigs]. AB - Nine male minipigs Pitman Moore have been studied from weaning (To) and during 6 months and the following constituents have been measured: albumin, amylase, bilirubin, calcium, CK, cholesterol, creatinine, copper, iron, GGT, glucose, LDH, magnesium, PAL, phospholipids, potassium, proteins, sodium, ALT, ASP, triglycerides, urea, zinc. These animals were fed a standardized diet. At 6 months of age their weight increased progressively to 12 kg. Several factors of variation have been studied; time of blood sampling age of animals. We obtained the following results: values of bilirubin, CK and TGO were always lower at 8 a.m. than 12 a.m. and 6 p.m. The effects of age were variable. They are no variation in the values of only 4 parameters (calcium, sodium, potassium and triglycerides), while the others constituents were increased or decreased. Reference values for 21 blood parameters in Pitman Moore minipigs are described. PMID- 3322116 TI - [Reevaluation of strategies for the diagnosis of iron deficiencies]. AB - Serum ferritin has been assayed by two methods. Radio-Immunology and Enzymo Immunology in two group of young females. Iron deficiency is considered as unequivocal if serum ferritin is lower than 20 micrograms/l whatever the method used analysis of red cell indices in iron deficient females has shown that anemia, hypochromia and microcytosis are very late events and that their sensitivity for the diagnosis if iron deficiency is very poor. PMID- 3322117 TI - [Recent advances in the biology of Candida]. AB - There has been enormous progress in our understanding of biological processes in pathogenic Candida species, particularly in the case of C. albicans. Yeast taxonomists have continued to discover the sexual affinities of several members of the genus, although the sexual stage of C. albicans itself remains as elusive as ever. Genetically, C. albicans has been proved to be a diploid with balanced lethal mutations. It is likely to become a popular object of study for transposable genetic elements: recent research in the USA has demonstrated its ability to alter its phenotype at a very high frequency. Phenotypic switching is a property that may be associated with the relative virulence of the species. There is evidence for substantial phenotypic alteration of the cell surface of C. albicans in infected tissues in vivo, which may explain some of the pathological aspects of Candida infection. The best known of the "phenotypic switches" in C. albicans is its ability to transform from budding yeast cells into hyphae. Although the precise mechanisms of this change remains undiscovered, molecular and cell biological approaches to the problem are beginning to reveal many of the processes involved. PMID- 3322118 TI - [Biological diagnosis of candidiasis]. AB - The methods which can be applied to the biological diagnosis of candidiasis are considered from a practical point of view. They are the histological examination, mycological methods of isolation and identification and serological technics leading to the detection of antibodies and antigens. For each method, the recent progress which have already been evaluated on a large scale in routine, have been considered. This makes it possible to bring out their interest and their limits. These considerations leads us to suggest the approach to the biological diagnosis of Candidiasis. PMID- 3322119 TI - [Administration of surfactant in hyaline membrane disease]. PMID- 3322120 TI - [Prenatal diagnosis]. PMID- 3322122 TI - [Erythema nodosum associated with Salmonella enteritidis gastroenteritis in a little girl]. PMID- 3322121 TI - [Spontaneous regression of an aneurysmal bone cyst of the vertebrae after partial excision. Bibliographic review]. AB - A case of a lumbar aneurysmal bone cyst is presented in a 5 year-9 month old girl. The characteristics of this tumor are described, specifically in the spinal area, with particular reference to the diagnostic and therapeutic difficulties referred, taking into account the existing bibliography. The partial resection has been curative, as it has been frequently written about in publication worldwide and which suggest that surgery does not have to be aggressive in unapproachable cases and that radiotherapy is unnecessary. PMID- 3322124 TI - [Infectious pathology in full-term neonates with a low birth weight for their gestational age]. AB - A retrospective study of infectious diseases has been performed in 194 small-for date full-term babies, finding septicaemia in 7.2% of cases, urinary tract infection in 5.2%, meningoencephalitis in 1% and enterocolitis in 3%. Most frequent infections agents were: 1) in septicaemia, Klebsiella pneumoniae (28.5%), E. coli and staphylococcus coagulase negative (21.4% for each); 2) in urinary tract infections, Klebsiella pneumoniae and E. coli (40% for each); 3) in meningoencephalitis, Klebsiella pneumoniae and E. coli (50% for each), and 4) in enterocolitis, E. coli (50%) and rotavirus (33%). Overall mortality rate was 4.1%, being 14.3% in the group with septicaemia (14 babies). Incidence of septicaemia is significatively related to assisted ventilation, catheterization of blood vessels, anemia and intravascular disseminated coagulation. PMID- 3322123 TI - [Simple renal cyst associated with arterial hypertension in a 12-year-old boy]. PMID- 3322125 TI - [Acute osteomyelitis in childhood. Review of 66 cases]. AB - 66 cases of acute osteomyelitis have been reviewed. The results obtained have been compared with those shown in the literature. There was a large predominance of males. Hematogenous inoculation was the most frequent. Clinical manifestations have been typical in children and polymorphic in infants and neonates. Leukocytosis with left deviation and elevated ESR, were frequent gammagraphic bone scan was positive in 88% of the cases so explored. The etiologic agents were isolated in 71% of the cases from blood cultures and needle aspiration from subperiosteal space and/or joint fluid cultures. S. aureus was found in 57.4% of all cases and in 86.4% of older children. The sequelae have been more frequent in neonates and infants. PMID- 3322127 TI - [Bone marrow transplantation]. PMID- 3322126 TI - [Foreign bodies in the respiratory tract]. PMID- 3322128 TI - A tribute to Marion I. Barnhart. PMID- 3322129 TI - Regulation of megakaryocytopoiesis by thrombopoietin. AB - It is clear that thrombopoietin is a major hormonal regulator of megakaryocytopoiesis both in vitro and in vivo, and, thus, blood platelet production. Existing data show that the action, chemical nature, and immunologic properties of thrombopoietin from HEK cell culture medium and either endogenously produced or exogenously administered thrombopoietin from animal sources are similar, if not identical. Absolute identity, however, will require comparisons of amino acid sequences of the two preparations. Recent studies have shown that not only does TSF potentiate the action of meg-CSF, but it also has a direct effect on precursor cells to increase the number of megakaryocytic colonies. Other in vitro work showed that TSF stimulates directly the SAChE+ precursor cells to become mature megakaryocytes and causes FMLC to differentiate into megakaryocytic colonies. In vivo, TSF increases megakaryocyte size and number, it causes an elevation in the number of the SAChE+ precursor cells in mouse marrow and increases the maturation of megakaryocytes. Moreover, TSF increases the endomitosis of megakaryocytes in the marrow of mice, along with elevating the number of megakaryocytic colonies in spleens of lethally irradiated bone marrow reconstituted mice. Platelet production is also stimulated in mice by TSF as evidenced by elevated isotopic incorporation into platelets; it increases platelet sizes, and when administered in high doses TSF elevates platelet counts. Full development of colonies of megakaryocytes may depend on two growth factors. It has been hypothesized that one factor, meg-CSF, is effective in clonal expansion whereas a second factor is predominately involved in the endomitotic phase of megakaryocyte development. Multifactoral regulation has been observed for the other cell lineages, and a general proposal for hematopoietic development has been outlined by Iscove. In this scheme, specificity of erythropoietin to erythroid cell lineage is indicated. Previous work, however, shows that recombinant erythropoietin can act as a meg-CSF stimulus, indicating that much is yet to be learned about the action of hematopoietic regulatory factors. Although the present study showed that TSF may in some circumstances stimulate an early cell in the megakaryocytic series, its major effect is probably on the more differentiated population, leading to maturation of megakaryocytes and platelet production.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3322130 TI - Role of von Willebrand factor in platelet vessel-wall interactions. PMID- 3322131 TI - Acquired disorders of platelet function. PMID- 3322132 TI - Acute thrombocytopenia and thrombosis. Heparin-induced thrombocytopenia and thrombotic thrombocytopenic purpura. PMID- 3322133 TI - Megakaryocyte ultrastructure. Its relationship to normal and pathologic thrombocytopoiesis. PMID- 3322134 TI - Multivectorial analysis of megakaryocytic differentiation. AB - The definition of the cytokinetics of megakaryocytic differentiation has rested mainly on morphologic classifications that lack a quantitative data base. The approach that we have developed comprises the systematic combination of new techniques for quantitative megakaryocyte separation and correlated, multiparameter analysis of multiply labeled single cells by flow cytometry. We have coined this approach a multivectorial analysis of megakaryocytic differentiation. Modifications of combined centrifugal elutriation (CE) and density gradient centrifugation permit the rapid collection of large numbers of intact, essentially homogeneous, marrow megakaryocytes. These cells, labeled simultaneously with multiple markers of DNA content and surface membrane immunofluorescence have been subjected to correlated, dualparameter analysis by flow cytometry and cell sorting, in an attempt to relate polyploidization (as a unique megakaryocytic property) to cytoplasmic progress towards end-state platelet formation. This approach provides a reasonable data base for an objective appraisal of the interactive roles of nuclear endoreduplication and cytoplasmic development during differentiation. Furthermore, the potential usefulness of matrix models and other innovations inherent in their exploitation hold the promise of describing regulatory mechanisms that are poorly understood, both in normal megakaryocytes and those produced in disease. PMID- 3322135 TI - Management of leaking filtration blebs. AB - This study describes 11 patients, in whom filtering surgery was performed, who developed a leaking filtration bleb postoperatively. Average follow-up time was 3 1/2 years. In three patients, suturing of the conjunctiva was performed. In two, anterior chamber reformation and choroidal tap were required, and, in both cases, the leak sealed spontaneously without surgical repair. In two, the glaucoma shell tamponade technique was used to facilitate anterior chamber reformation. These reformed in both cases, and no subsequent shallow anterior chambers have been noted. In four cases, conservative therapy, which consisted of antibiotics, glaucoma medication with or without patching, and careful patient observation, was used to manage the leaking blebs. Complications observed were: iritis (1 case), early infection of the bleb (1), flat anterior chamber (1), and failure of the bleb to allow sufficient aqueous humor outflow (2). PMID- 3322136 TI - Periorbital necrotizing fasciitis. AB - Necrotizing fasciitis developed in a 47-year-old woman after head trauma. Bilateral lid infection due to Group A beta-hemolytic streptococci resulted. Local treatment with surgical debridement and systemic management of fluid and electrolyte balance resulted in a favorable outcome from this extremely rare condition. PMID- 3322137 TI - Ocular side effects of systemic steroid therapy in renal transplant patients. AB - Sixty-one renal transplant patients were studied for ocular complications of steroid therapy. Twenty patients (32.8%) were found to have posterior subcapsular cataract. Three patients (4.9%) had ocular hypertension. There was no significant correlation between cataract formation and the total dose of steroids, number of rejection episodes, or the period of hemodialysis. HLA-A9 was present in noncataract patients to a greater extent, a statistically significant (P less than .05) finding not reported before to our knowledge. PMID- 3322138 TI - Acute retrobulbar neuritis complicating herpes zoster ophthalmicus. AB - Acute retrobulbar neuritis occurred 24 days after an episode of Herpes zoster ophthalmicus in an otherwise healthy, 19-year-old man. Profound visual loss with consecutive optic atrophy ensued. Neurologic evaluation was normal and supported the presumptive diagnosis of parainfectious Herpes zoster retrobulbar neuritis. PMID- 3322139 TI - False positive diagnosis of choroidal melanoma by magnetic resonance imaging. AB - Magnetic resonance imaging is a relatively new diagnostic modality that is used to an increasing extent as an aid to increase clinical diagnostic accuracy. We report a case of an erroneous diagnosis of malignant melanoma of the choroid associated with magnetic resonance imaging. PMID- 3322140 TI - [Fibrous dysplasia and ossifying fibroma of the base of the skull. Apropos of 6 cases]. AB - The authors report 6 cases of fibrous dysplasia (F.D.) of the base of the skull and review the literature. They confirm the impossibility of histological differentiation between ossifying fibroma and monostic dysplasia with cranio facial sites. They stress the value of CAT scan in the assessment of spread and that of dynamic isotope scan in the differential diagnosis with plaque-shaped hyperostotic meningioma, in the diagnosis of polyostotic forms and in postoperative surveillance. They stress the risk of visual sensorial impairment: visual by stenosis of the optic canals and auditory by stenosis of the E.A.M. Operative indications are influenced by this risk, thereby explaining the need for prolonged surveillance. PMID- 3322141 TI - [Use of the free forearm flaps in cervicofacial surgery. Apropos of 5 cases and review of the literature]. AB - The free fasciocutaneous forearm flap has been described only recently. Five cases of pharyngeal or oral repair with a forearm flap (FAF) are reported and used as a basis to discuss anatomical features and the technique used for removal of the flap. The relevant literature is reviewed. The FAF appears to be the flap of choice for reparative surgery of pharynx or mouth regions in oncology, the principal advantages of this flap being: fineness, flexibility and plasticity of the skin, reliability and lack of morbidity, and function effectiveness with respect to phonation and feeding. Indications for forearm and myocutaneous flaps in oncology of upper respiratory and digestive tracts are assessed critically, other indications for the forearm flap being cutaneous repair of cervicofacial lesions due to tumor or injury. The forearm flap is of pronounced value for cervicofacial repair surgery and constitutes a new step in the plastic conception of these repair procedures. PMID- 3322142 TI - [Cervical adenopathies of unknown primary site. Apropos of 190 cases]. AB - From 1974 to 1983 a total of 190 patients with metastatic cervical adenopathy from an undetected epidermoid cancer were treated, this group representing 3% of total cervicofacial tumors seen. In half the cases the lymph node had evolved over more than 3 months and measured 6 cm or more. Prognosis was poor (27% survival at 3 years and 19% at 5 years). The presumed primary tumor was detected in 16% of cases and 27% of patients developed distant metastases, whereas the 86 patients treated by neck dissection and irradiation showed cervical evolution in only 23% of cases. The therapy proposed includes total radical neck dissection followed by pharyngeal and bilateral cervical irradiation, the value of chemotherapy remaining to be determined during controlled trials. PMID- 3322143 TI - [Cutaneous microcirculation: focus on exploratory methods]. PMID- 3322145 TI - [Quinidine-induced lichenoid photodermatitis]. AB - Quinidine-induced lichenoid photodermatitis was definitely isolated by Berger and Sesody in 1982. We had an opportunity to observe 4 cases of this striking clinical condition and encountered some particularities. Our patients (2 men and 2 women) were 60, 64, 81 and 68 years old respectively. All had a previous cardiovascular history; diabetes was also present in patient No. 2, and hypertension in patient No. 4. All patients were taking other drugs. The first patient presented with a 4-year old lichenoid eruption on the hands, associated with some degree of follicular keratosis. The second and third patients had a mixture of mainly lichenoid lesions on sun-exposed areas, but eczematous and desquamative lesions were also encountered. The fourth patient had typical lichenoid photodermatitis with occasional bullae on the arms and legs. In all patients the disease appeared or worsened in the Summer. It disappeared rapidly in 3 cases upon withdrawal of quinidine (patients No. 1 and 2) or hydroquinidine (patient No. 3), but it lasted longer in patient No. 4, with pigmented sequelae. Histological examination of the skin was consistent with a lichenoid eruption in all cases. However, an immunopathological study revealed a pemphigoid-like pattern in patients No. 1 and 2, and ovoid bodies more suggestive of lichen planus in patient No. 4. Photobiology was not performed. A review of the literature showed that the terms "lichen planus", "lichenoid", "lichenification" or "violaceus hue" were frequently encountered, and we suggest quinidine as one of the most common agents of lichenoid reaction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322144 TI - [Sjogren-Larsson syndrome. Apropos of a case]. AB - Sjogren-Larsson syndrome is a rare genodermatosis described by Sjogren and Larsson in 1957 (28) and characterized by ichthyosis, spastic di- or tetraplegia and oligophrenia. In the case reported here a female child, born to consanguineous parents, presented at birth as a "collodion baby". Progressively, she developed an ichthyosiform and erythrodermic state and at the same time, after an episode of seizures, spasticity of the lower limbs set in. From then on, her acquisitions were very slow. Symptomatic treatment with retinoids (etretinate, 13-cisretinoid, etretinate again) was attempted repeatedly, but it only resulted in temporary improvement of the ichthyosiform state. Overall evaluation at the age of 6 years showed: i) persistence of the ichthyosiform and erythrodermic state; ii) growth retardation (-2 in stature); iii) spasticity of the lower limbs with difficulty in walking, and beginning of speech. Routine examinations gave normal results. Serum linoleic acid level was within normal limits. Electroencephalography displayed immaturity tracings without signs of epilepsy. Radiography of the skull was normal, and in particular there was no thickening of the sphenoid bone. Histological examination of the skin, outside or during treatment with retinoids, showed ortho- and parakeratosic hyperkeratosis, absence of granular layer, moderate hyperacanthosis, vacuolization of numerous acanthocytes in the uppermost layers and inflammatory infiltrates in the superficial dermis. All these abnormalities were confirmed by electron microscopy. Previously published series are reviewed. In most cases the patient is a "collodion baby" at birth and progressively develops ichthyosis, spasticity, psychomotor and growth retardation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322146 TI - [Digestive involvement in dystrophic recessive epidermolysis bullosa. Apropos of 6 cases and review of the literature]. AB - Six personal cases of digestive tract involvement in dystrophic recessive epidermolysis bullosa are reported, and the relevant literature is reviewed. The study deals with the clinical aspects of these cases (buccal and dental lesions, digestive symptoms, effects on nutritional status; table I), as well as with their biochemical (table II), radiological and endoscopic aspects (table III, fig. 1 and 2). All patients presented with bucco-dental lesions, including two cases of congenital abnormalities: one with malposition and dysgenesis of the teeth, the other with dysplasia of the enamel in a patient whose dystrophic skin disease was proven by electron microscopic study. The oesophagus was involved in six cases, with tight concentric stenosis (2 cases), retrocricoidal stenosis (1 case) and oesophagitis (2 cases). No gastro-duodenal or intestinal lesions were detected. A case of constipation was related to anal involvement. The patients' nutritional status was investigated clinically and biochemically. A search for intestinal malabsorption by means of specific tests was conducted in 2 patients and proved negative. A study of the literature provided data on the nature and specificity of dental lesions. The morphological features, complications and physiopathology of oesophageal stenoses are described The existence of gastrointestinal lesions is discussed. Nutritional repercussions are presented and their causes are discussed. Attention is paid to the medical and surgical treatments of these lesions. PMID- 3322147 TI - [Horton's disease diagnosed in partial necrosis of the tongue]. PMID- 3322149 TI - [Request for authorization for marketing an antibiotic for pediatric use]. PMID- 3322148 TI - [Ascariasis in Western Africa. Epidemiological review]. AB - This paper draws, on the basis of available published reports, an outline of the epidemiological distribution of ascariasis in West Africa. This parasitic disease is easily transmitted in all humid areas which receive more than 1,400 mm rainfall every year. The endemicity pattern is typical of a contamination of the household environment. On the contrary, it is absent, with few exceptions, from a larger part of the region where drier conditions, combined with a series of specific socio-cultural factors, prevent the transmission from being anything else but sporadic. However, the author, although he recognizes that the maintenance of a short living parasite in a population is problematical under sporadic transmission conditions, warns that urban development in the future may very well result in a rapid spread of infections with ascaris. PMID- 3322150 TI - [Gentamycin in pediatrics]. PMID- 3322151 TI - Caecal volvulus: ten year experience in an Australian teaching hospital. AB - Sixteen cases of caecal volvulus were treated surgically at a major Australian teaching hospital over a decade. Review of these cases suggests that this condition may be more common in fit people between 30 and 40 years of age than in the elderly or institutionalised. Caecal volvulus was more common in women than in men, possibly because adhesions from previous gynaecological surgery may initiate volvulus. In some other cases colonic distension due to poor muscle tone rather than distal obstruction may have been an important predisposing factor. Preoperative diagnosis was not usually made, but might have been facilitated if knowledge of the above predisposing factors had been available. This would allow colonoscopic reduction to be considered as a therapeutic alternative to laparotomy. At laparotomy, right hemicolectomy or caecal fixation (caecostomy or caecopexy) were the alternative methods of treatment. PMID- 3322152 TI - [Comparative study of renal puncture-biopsy after radiographic location and under continuous ultrasonic control]. PMID- 3322154 TI - [A case of Behcet's disease complicated by venous thrombosis and aneurysm of the innominate artery associated with situs inversus]. PMID- 3322153 TI - [Current surgical indications in amebic abscess of the liver. Apropos of a series of 270 cases]. PMID- 3322156 TI - [Evaluation of the prognosis of mitral valve prolapse]. AB - It is not easy to evaluate the prognosis of mitral valve prolapse. First of all, a positive diagnosis is difficult: the clinical insufficiencies are ill compensated by sonocardiography as it is less reliable than expected; the very existence of the "mitral valve prolapse" described by Barlow is being challenged. Secondly, the most severe complications of mitral prolapse are rare, with respect to its frequency. Some complications are currently well defined. Thus, severe mitral insufficiency, leading to valve replacement, affects elderly men more than young women, although the pathological lesions correspond to the same disease. Endocarditis is rare and only occurs when there is an audible murmur. Rhythm disorders are varied, with however, frequent junction tachycardias and a marked influence of catecholamines, which may explain the clinical effectiveness of beta blockers. Unfortunately, severe complications are not as well known. Thus, the risk of sudden death and cerebral vascular accident cannot be figured out from large statistical studies. Only studies of some so called "risk" sub-groups, should allow a better knowledge of these two complications and a more effective prevention. PMID- 3322155 TI - [Metastatic pericardial effusions. Apropos of 12 cases. Review of the literature]. AB - The authors report 12 cases of metastatic pericardial effusions with clinical manifestations. Primary bronchial cancer is the most frequent with 7 cases; in 3 of these patients, the original manifestation is a tamponade. The contributions of sonocardiography to the diagnosis are analyzed: evaluation of hemodynamic tolerance and visualization within the effusion, in 4 out of 7 patients undergoing bidimensional sonocardiography, of dense masses, implanted on the visceral layer of the pericardium; the frequent epicardic location of these metastases may be explained by preferential invasion of the visceral layer by retrograde lymphatic route. The advantage of pericardial cytology is discussed. From the therapeutic standpoint, a pleuro-pericardial window or tetracycline instillation tend to prevent a recurrence of the effusion and the risk of tamponade; the neoplastic process is controlled with local and/or general chemotherapy and radiotherapy; therapeutic strategy depends on the sensitivity of the primary tumor. The prognosis remains very dim with a mean survival of 3.7 months in our series. PMID- 3322157 TI - Atomic absorption spectroscopy in clinical analysis. PMID- 3322158 TI - Analytical reviews in clinical chemistry: methods for the estimation of salicylate and paracetamol in serum, plasma and urine. PMID- 3322159 TI - Are osmolality measurements clinically useful? PMID- 3322161 TI - [Technic and pitfalls of endorectal echography of rectal tumors]. PMID- 3322160 TI - When is serum albumin worth measuring? AB - This paper critically examines the usefulness of serum albumin measurement in the light of current laboratory practice and knowledge of the pathophysiology of albumin metabolism. The main conclusions and recommendations are as follows: (i) Albumin measurement forms a limited, but useful part of the investigation of liver disease; a normal serum albumin concentration makes the diagnosis of cirrhosis unlikely, while a low level in viral hepatitis suggests either severe hepatocellular damage or other complications. (ii) Albumin measurement is essential in selecting patients for, and in determining the amount and frequency of, albumin replacement. (iii) Serum albumin concentration provides a useful indication of prognosis in myeloma. (iv) In the long-term management of patients undergoing enteral or parenteral nutrition, serum albumin concentration is one of several parameters which, together, are useful in predicting the outcome of treatment. (v) The serum albumin concentration may provide a clue to the aetiology of unexplained oedema. (vi) Serum albumin measurement is useful in indicating the level of ionised calcium and of unbound unconjugated bilirubin. PMID- 3322162 TI - [A rare polydysmorphic syndrome: leprechaunism. Review of 49 cases reported in the literature]. AB - Leprechaunism is a very rare condition of obscure etiology. Since the first report (Donohue, 1948) 48 patients have been described. The typical stigmata are a "gnome" facies with a saddle nose, broad mouth, large and low-set ears, hirsutism, cutis laxa with atrophy of adipose tissue, dwarfism, extreme wasting, and dysphagia requiring parenteral feeding. After reviewing the literature and discussing the morphological, biological, and etiopathogenetic aspects, the authors conclude that the diagnosis of leprechaunism is essentially a clinic one, as there are no specific laboratory tests. PMID- 3322163 TI - Partial monosomy 15q due to de novo t(15;22)(q15;p11). AB - We report a 2-years-old infant who presented psychomotor delay and facial dysmorphic features. He has a partial monosomy of 15q resulting from de novo t(15;22)(q15;p11). Up to now three other cases with a similar 15q monosomy have been reported, but the present case is the first one with a "pure" monosomy 15q. PMID- 3322164 TI - Fifty years of human genetics: plus ca change, plus c'est la meme chose. PMID- 3322165 TI - The linkage between the genes for colour-blindness and haemophilia in man. By Julia Bell and J.B.S. Haldane, 1937. PMID- 3322166 TI - Metabolic effects and body fat mass changes in obese subjects on a very-low calorie diet with and without intensive physical training. AB - During 4 weeks, 40 obese subjects (body mass index 30-45 W/H2) were treated with a 300-kcal mixed diet alone or in combination with exercise training on a bicycle ergometer in a metabolic ward. Exercise had a minor effect on body weight, reflected by an additional fat loss of 1.7 kg (expected loss: 4.0 kg). Hyperinsulinemia was improved by diet and normalized by diet combined with exercise; a similar effect was observed regarding C-peptide levels. Plasma concentrations of epinephrine and norepinephrine decreased in both groups. At maximal work, norepinephrine levels were higher in the group with exercise. Free fatty acids and free glycerol increased at rest as well as during exercise in subjects on both regimens, the difference being more pronounced in the exercise group. Enhanced oxidation of fat was substantiated by lower respiratory quotients during endurance exercise. Working capacity increased and blood pressure decreased considerably as a consequence of physical training. It is concluded that exercise training in addition to a hypocaloric diet lowers body weight and body fat, although to a lower degree than expected. During and following bouts of exercise, fat mobilization and oxidation is enhanced, but these effects are probably counteracted at rest. On the other hand, the diet-induced deterioration of physical performance is overcompensated. PMID- 3322167 TI - A comparison of the distribution of extracellular proteins produced by the protease-secreting organism Aeromonas salmonicida during aerobic and anaerobic growth. AB - Aeromonas salmonicida was grown aerobically and anaerobically in supplemented 3% (w/v) tryptone soya broth medium for 24 h at 25 degrees C. Although the bacterial density achieved was 4.9 times higher in the aerobic culture, the exoprotein produced per unit of bacterial dry weight was only 1.9 times higher than in the anaerobic culture. However, the protease activity of the exoprotein showed a marked reduction anaerobically, being only one-tenth of that of the exoprotein produced aerobically. This finding was consistent with the differing SDS-PAGE patterns of the extracellular proteins from the two cultures, which also showed marked loss and reinforcement of other, as yet unidentified extracellular products. PMID- 3322168 TI - Heterogeneity of genes conferring high-level resistance to erythromycin by inactivation in enterobacteria. AB - We have constructed a probe specific for the gene ereA of plasmid pIP1100, which confers high-level resistance to erythromycin in Escherichia by production of an erythromycin esterase. The distribution of the gene ereA in enterobacteria highly resistant to erythromycin isolated from human faeces was studied by colony hybridization. The gene ereA was detected in strains of E. coli belonging to various biotypes, in Klebsiella pneumoniae, in Enterobacter agglomerans and in one strain of a "coliform". Moreover, our results indicated the existence of at least two classes of genes specifying resistance to erythromycin by inactivation of the antibiotic in enterobacteria. PMID- 3322169 TI - A motility lesion in ColV+ Escherichia coli strains and its possible clinical significance. AB - The introduction of the ColV-K30 or ColV,I-K94 plasmid into Escherichia coli strains produced derivatives which had a motility lesion if grown without shaking at 37 degrees C. Although most ColV+ organisms from shaken cultures were motile, 80-90% of free unclumped organisms from static cultures were flagellate but non motile. This plasmid effect was temperature-dependent with only those ColV+ organisms grown at 37 degrees C being affected; ColV+ organisms grown at 30 degrees C or below were predominantly motile. The motility lesion depended on the presence, in the ColV+ organisms, of transfer and colicin components together but not of the VmpA protein. Aside from the changed motility, there was extensive autoagglutination (clumping) of ColV+ organisms in static cultures, and the two phenomena (clumping and motility lesion) appeared to be governed by the same factors. The Flac plasmid of FI incompatibility group had a slight inhibitory effect on motility of strain 1829 and caused slight clumping, but representative plasmids of groups FII, FIII, FIV, C, H, I, K, M, N, P, W and X had no appreciable effect on either parameter. Non-motile ColV+ organisms regained motility on incubation with buffered detergent solutions, suggesting that an envelope change might be responsible for the altered motility. It can be hypothesized that ColV+ organisms in the intestine would be motile and hence able to reach the intestinal epithelium for invasion but that, once such organisms had reached the tissues and bloodstream, they would be predominantly non-motile and hence might be less susceptible to phagocytosis. PMID- 3322171 TI - Plasmid-mediated contact haemolytic activity in Shigella species: correlation with penetration into HeLa cells. AB - The main feature of virulent strains of Shigella is their ability to invade eucaryotic cells. This phenotype is both plasmid-mediated and temperature regulated. In the present report, we demonstrate a plasmid-mediated and temperature-regulated haemolytic activity in S. flexneri, S. dysenteriae and S. sonnei. Detection of this haemolytic activity requires centrifugation of suspensions containing bacteria and erythrocytes, followed by incubation of the pellets at 37 degrees C. No soluble intra- or extracellular haemolytic activity could be detected. Dose-effect and electron microscopic studies demonstrated that direct contact of several virulent bacteria per erythrocyte was critical for haemolysis to occur. However, no local morphological alteration of the erythrocyte membrane at the site of contact with bacteria could be detected. Intensity of this haemolytic activity was fully correlated with the efficiency of penetration within HeLa cells, suggesting a common mechanism for induction of phagocytosis and lysis of erythrocytes. PMID- 3322170 TI - Molecular epidemiology of resistance to trimethoprim in enterobacteria isolated in a Parisian hospital. AB - Between January, 1981 and December, 1984, 419 strains of enterobacteria isolated from patients at the Hopital Saint-Joseph were studied for (1) the level of resistance to trimethoprim (Tp) by determination of minimal inhibitory concentration (MIC), (2) transferability of this resistance by conjugation into Escherichia coli, (3) plasmid content of wild-type strains and transconjugants by agarose gel electrophoresis of crude bacterial lysates and by incompatibility grouping, and (4) type of dihydrofolate reductase (DHFR) by colony hybridization with probes specific for DHFR types I and II. Tp resistance was defined as MIC greater than or equal to 4 micrograms/ml and high-level resistance by MIC greater than or equal to 1000 micrograms/ml. Amongst the strains studied, 90% were resistant to high levels of Tp, while 10% had low-level resistance to Tp was detected in 180 strains corresponding to 185 plasmids. In the vast majority of the plasmids, resistance to Tp was associated with resistance to sulphonamide (94%), streptomycin (75-90%), ampicillin (75-90%) and chloramphenicol (65-80%). Plasmids conferring resistance to Tp were often large, most (84%) ranging in size from 90 to 175 Kb. They belonged to six different incompatibility groups and Inc6 C was the most prevalent (34 to 75%). The study of the distribution of the dfr genes by colony hybridization in 183 transconjugants and 89 strains with non transferable Tp resistance revealed the presence of dfrI genes in most of these strains (48 and 53%, respectively). DHFR of types I and II were found in only 3% of the transconjugants, but in 15% of the strains with non-transferable resistance. DHFR of other types were found equally (15%) in strains with transferable and non-transferable resistance. The high incidence of the type I enzyme among the Tp-resistant strains probably results from the integration of transposon Tn7 into the chromosome or into a non-transferable plasmid. PMID- 3322172 TI - Micropipette use for decimal dilution of bacteriological samples. PMID- 3322173 TI - Genetic analysis of cell invasiveness by Yersinia pseudotuberculosis. PMID- 3322174 TI - Invasion of epithelial cells by shigellae. PMID- 3322175 TI - Plasmid-mediated intracellular multiplication of Shigella flexneri. PMID- 3322176 TI - Early events in chlamydial infection. PMID- 3322177 TI - [Factors contributing to the recent improvement in results in renal transplantation in France]. PMID- 3322178 TI - [The value of echography in scrotal contusions. Personal experience apropos of 20 cases]. AB - We report a serial case study of 20 patients presenting scrotal contusions and for whom an emergency scrotal ultrasonography was performed. This investigation is not a luxury. It was a useful confirmation diagnostic tool for hematocele in 1/3 of cases (7/20) as well as for the detection of associated epididymal and or testicular lesions. In 2/3 of cases (13/20) it detected lesions unsuspected by clinical examination so that a therapeutic decision was taken promptly. Scrotal echography is therefore a useful emergency tool not for major trauma where the surgical decision is evident, but for apparently benign trauma where the clinical examination is currently deficient and needs provided a trained ultrasonography operator is available. PMID- 3322179 TI - [Aneurysm of the abdominal aorta following renal transplantation. Surgical repair with extracorporeal circulation of the graft]. AB - The authors report a case of abdominal aortic aneurysm, revealed three years after a renal transplantation in left hypogastric position. A pump-oxygenator was utilised to protect the renal transplant during the aortic aneurysmectomy. The renal function is normal three years after the aneurysmectomy, and the patient presented not prosthesis infection, despite the corticoid and immunosuppressive treatment. PMID- 3322180 TI - [Is ligation of the remaining native ureter at the time of renal transplantation always harmless?]. AB - Three cases of nephrectomy after transplantation with uretero-ureteral anastomosis are presented: this anastomosis in transplantation looks to be anodyne when the transplant keeps normal function. Complications become when appears a degradation of the renal function. PMID- 3322181 TI - [Value of DTPA scintigraphy following furosemide injection in the diagnosis of obstruction in renal transplantation]. AB - Following development of dilatation on ultrasonography and/or intravenous pyelography in the course of follow-up after renal transplantation, a dilatation due to obstruction must be distinguished from dilatation without obstruction. DTPA scintigraphy is frequently used for the diagnosis of hydronephrosis caused by an anomaly of the pyeloureteric junction. In renal transplantation, this examination is used less frequently. The authors report a prospective study of Lasilix scintigraphy in the diagnosis of obstruction in 30 renal transplant. The results presenting with stasis of their transplant. The results were classified into 4 groups according to O'Reilly's classification and were compared with the course of the stasis. Lasilix scintigraphy demonstrated a specificity of 93% and a sensitivity of 63%. The role of stasis in the deterioration of the renal function of a transplant is difficult to evaluate. In cases of stasis with altered renal function, the authors propose the addition of study of the renal parenchyma by renal biopsy, which excludes rejection and Cyclosporin nephrotoxicity. When the renal biopsy is normal, the kidney should be drained by percutaneous nephrostomy which evaluates the capacity of recovery of renal function and determines the indication for antegrade dilatation or surgical repair. PMID- 3322182 TI - Molecular pathogenesis of neurotropic viral infections. AB - Classical virologists defined a number of viruses that affect the nervous system and identified tissue tropism, extraneural replication, and viremia as important parameters that determine whether viral infections will affect the central nervous system. Molecular techniques are expanding this knowledge by permitting us to relate specific genes and gene products to two defined phenotypes: neuroinvasion and neurovirulence. Two converging situations make this knowledge particularly useful: (1) the development of antiviral drugs and subunit vaccines, which mandate that pathogenesis be related to specific regions of the viral genome; and (2) the expanding problem of central nervous system infections in immunodeficient states. PMID- 3322183 TI - Marked loss of cerebral galactolipids in Pick's disease. AB - Studies with two monoclonal antibodies reactive with galactolipids suggest that there is a marked loss of these compounds in the brains of patients with Pick's disease. Quantitative assays, immunocytochemical studies, and thin-layer chromatography confirm that both galactocerebrosides and sulfatides are selectively lost in this condition. This finding appears to be specific for Pick's disease, distinguishing it from Alzheimer's disease and other dementing disorders. PMID- 3322184 TI - Alpha-glucosidase deficiency and basilar artery aneurysm: report of a sibship. AB - Glycogen deposition in vascular smooth muscle has been demonstrated previously in alpha-glucosidase deficiency but has not been clinically significant. Three sons of healthy, nonconsanguineous parents developed progressive proximal muscular weakness secondary to alpha-glucosidase deficiency. Each patient developed a fusiform basilar artery aneurysm, which was complicated by fatal rupture in two patients and a cerebellar infarction in the third. Postmortem examination demonstrated severe vacuolation of skeletal muscle, liver, and vascular smooth muscle with accumulation of periodic acid-Schiff-positive, diastase-sensitive material. In the surviving brother, similar glycogen deposition was demonstrated in the smooth muscle of the superficial temporal artery. Basilar artery aneurysm formation in this sibship may be a consequence of alpha-glucosidase deficiency. PMID- 3322186 TI - [Method for demonstrating strict anaerobes in microbial associations]. AB - A procedure for indicating strict anaerobes in microbial associations was developed. The indication is performed with two disks: aminoglycoside (amikacin, 10-micrograms disk) (A) and metronidazole aminoglycoside (metronidazole + amikacin, 5- and 10-micrograms disks respectively) (MA). Colonies growing in zone A and absent in zone MA are considered to be strictly anaerobic. The procedure is characterized by high reliability: false positive results are practically not recorded and the frequency of false negative results does not exceed 5-10 per cent. The rate of detecting anaerobes in clinical materials is significantly increased (by 1-3 days) as compared to that with the use of the routine bacterial methods. The indication procedure markedly simplifies laboratory diagnosis of anaerobic infections at the account of clear differentiation of microorganisms grown on the primary plate and possible directed selection of anaerobic colonies for further investigation which excludes the necessity of rejecting or studying other colony types. This leads to economy of nutrient media and increasing labor productivity. PMID- 3322185 TI - [Design of hybrid plasmids based on the actinomycete plasmid pSB24.1 and plasmid prBR325 and a study of their stability in the Streptomyces-E. coli system]. AB - Actinomycete plasmid pSB24.1 was cloned on vector of the E. coli pBR325 system. The following bireplicon plasmids were obtained: pSU501 and pSU502 (by XhoI site of pSB24.1 and SalGI site of pBR325), pSU503 (by Bg1II (c) site of pSB24.1 and BamHI site of pBR325) and pSU504 (by Bg1II(b) site of pSB24.1 and BamHI site of pBR325). In the cells of E. coli C600 plasmids pSU501-504 determined phenotype AprCmrTcs and were stable. In the cells of Str. lividans the initial structure pSU501 selected by Ltz+ phenotype was maintained at a frequency of 12.5 per cent. Analysis of the deletion variants of pSU501 isolated from Str. lividans showed that the deletions were induced by both the pBR325 region and the pSB24.1 DNA fragment near XhoI site. The region from SacII(a) site to Bg1II(b) site clockwise in the map of plasmid pSB24.1 was not significant for its replication and maintenance in Str. lividans. There were detected unique sites of pSB24.1 and its derivatives useful for cloning. Possible shortening of plasmid pSB24.1 by 567 kb (the length between the terminator of the open frame reading translation and XhoI site) was revealed. PMID- 3322188 TI - Physician comments on history of drainage systems. PMID- 3322187 TI - [Laboratory diagnosis of infections of the urinary tract]. PMID- 3322189 TI - Coinsurance clarification. PMID- 3322191 TI - Genetic engineering of ethanol production in Escherichia coli. AB - The genes encoding essential enzymes of the fermentative pathway for ethanol production in Zymomonas mobilis, an obligately ethanologenic bacterium, were inserted into Escherichia coli under the control of a common promoter. Alcohol dehydrogenase II and pyruvate decarboxylase from Z. mobilis were expressed at high levels in E. coli, resulting in increased cell growth and the production of ethanol as the principal fermentation product from glucose. These results demonstrate that it is possible to change the fermentation products of an organism, such as E. coli, by the addition of genes encoding appropriate enzymes which form an alternative system for the regeneration of NAD+. PMID- 3322190 TI - Isolation of Escherichia coli O157:H7 from retail fresh meats and poultry. AB - A total of 896 samples of retail fresh meats and poultry was assayed for Escherichia coli serogroup O157:H7 by a hydrophobic grid membrane filter immunoblot procedure developed specifically to isolate the organism from foods. The procedure involves several steps, including selective enrichment, filtration of enrichment culture through hydrophobic grid membrane filters, incubation of each filter on nitrocellulose paper on selective agar, preparation of an immunoblot (by using antiserum to E. coli O157:H7 culture filtrate) of each nitrocellulose paper, selection from the filters of colonies which corresponded to immunopositive sites on blots, screening of isolates by a Biken test for precipitin lines from metabolites and antiserum to E. coli O157:H7 culture filtrate, and confirmation of isolates as Vero cell cytotoxic E. coli O157:H7 by biochemical, serological, and Vero cell cytotoxicity tests. E. coli O157:H7 was isolated from 6 (3.7%) of 164 beef, 4 (1.5%) of 264 pork, 4 (1.5%) of 263 poultry, and 4 (2.0%) of 205 lamb samples. One of 14 pork samples and 5 of 17 beef samples contaminated with the organism were from Calgary, Alberta, Canada, grocery stores, whereas all other contaminated samples were from Madison, Wis., retail outlets. This is the first report of the isolation of E. coli O157:H7 from food other than ground beef, and results indicate that the organism is not a rare contaminant of fresh meats and poultry. PMID- 3322192 TI - Nuclear magnetic resonance spectroscopy reveals the metabolic origins of proline excreted by an Escherichia coli derivative during growth on [13C]acetate. AB - We have used 13C nuclear magnetic resonance to monitor acetate metabolism in a proline-overproducing strain of Escherichia coli growing on 13C-labeled acetate. The conversion of 13C-labeled acetate to proline by actively dividing cells was followed in vivo, and the site specificity of the incorporation of the acetate carbons in the proline was determined from spectra of butanol extracts of the growth media. The degree of incorporation of deuterium from partially deuterated water into various sites on the proline was monitored from the beta-deuterium shifted signals in the 13C spectra. The spectra provide information on the origin of the carbons and the protons during proline biosynthesis. PMID- 3322194 TI - Evaluation of the Minitek system for characterization of Bacillus species. AB - Minitek (BBL Microbiology Systems, Cockeysville, Md.) substrate disks were evaluated as alternatives to conventional tests for the characterization of Bacillus species. Results were compared for 10 reference isolates and 87 isolates from food sources. The overall agreement of results between the Minitek and conventional tests was 92% for reference strains and 86% for food isolates. PMID- 3322193 TI - Two-level factorial screening for influence of temperature, pH, and aeration on production of Serratia marcescens nuclease. AB - Two high-nuclease-yielding mutants of Serratia marcescens, derived by chemical mutagenesis (W280, W355), and two strains with the pBR322 plasmid 403-SD2, carrying a nuclease gene and a chloramphenicol resistance gene [Escherichia coli CSH50(403-SD2) and S. marcescens CH30(403-SD2)] were investigated for nuclease production in a factorial shake flask experiment, with temperature (30 and 37 degrees C), pH (with or without CaCO3 tablets), and aeration (with or without baffles) as variable conditions. Yields varied 10-fold depending on the conditions investigated. PMID- 3322195 TI - NAD+-dependent retinol dehydrogenase in liver microsomes. AB - A microsomal NAD+-dependent retinol dehydrogenase is being described with optimal activity at physiological pH. The enzyme was present in liver microsomes of rats and also in a strain of deermice which lacks the cytosolic retinol dehydrogenase. Unlike the latter enzyme, the microsomal retinol dehydrogenase was not inhibited by either ethanol or 4-methylpyrazole; its activity was insensitive to CO and not oxygen dependent, in contradistinction with that of the microsomal cytochrome P 450 and NADPH-dependent retinol oxidase. Chronic ethanol consumption resulted in an increased activity of the microsomal retinol dehydrogenase which may contribute to hepatic retinol depletion, especially in view of the insensitivity of the enzyme to ethanol inhibition. PMID- 3322197 TI - Characterization of the Saccharomyces cerevisiae cis-prenyltransferase required for dolichyl phosphate biosynthesis. AB - The prenyltransferase involved in the biosynthesis of dolichyl phosphate has been characterized in Saccharomyces cerevisiae. Although the enzyme is predominantly membrane-bound, a significant percentage was found in the soluble fraction. The prenyltransferase preferentially utilizes farnesyl pyrophosphate as the allylic substrate and isopentenyl pyrophosphate as cosubstrate with half-maximal velocities obtained at 25 and 6.7 microM, respectively. The enzymatic activity is sensitive to sulfhydryl reagents and is inhibited by all detergents tested, except 3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate at concentrations less than 5 mM. The product of the reaction has been characterized as an alpha-unsaturated polyprenyl pyrophosphate, containing 12-15 isoprene units, approximately two isoprene units shorter than the endogenous yeast dolichyl phosphate. The stereochemistry of addition of isoprene units by the prenyltransferase was shown to be cis by a comparison of the HPLC retention time for a pentadecaprenyl phosphate derived from the in vitro reaction product with that for an authentic mixture of alpha-cis- and alpha-trans-pentadecaprenyl phosphates. PMID- 3322196 TI - Kinetic mechanism of native Escherichia coli aspartate transcarbamylase. AB - Equilibrium isotope exchange kinetics have been used to reinvestigate the kinetic mechanism of Escherichia coli aspartate transcarbamylase (aspartate carbamoyl transferase) at pH 7.0, 30 degrees C. Keq = 5.9 (+/- 0.6) X 10(3), allowing variation of substrate concentrations above and below their Km values in all experiments, a condition not possible at pH 7.8 [F. C. Wedler and F. J. Gasser (1974) Arch. Biochem. Biophys. 163, 57-68]. The rate of the [14C]Asp in equilibrium N-carbamoyl L-aspartate (C-Asp) exchange reaction was five times faster than that of [32P]carbamyl phosphate (C-P) in equilibrium Pi, which argues strongly against the rapid equilibrium random mechanism previously proposed by E. Heyde, A. Nagabhushanam, and J. F. Morrison [Biochemistry 12, 4718-4726 (1973]. Substrate concentrations were varied either as reactant-product pairs (holding the other pair constant) or together simultaneously in constant ratio at equilibrium. The resulting kinetic saturation patterns were most consistent with a preferred order random kinetic mechanism, with C-P binding prior to Asp and with C-Asp being released before Pi. Weak inhibition effects at high substrate levels could be accounted for by multiple weak dead-end complexes or ionic strength effects. Computer-based simulations have led to a set of rate constants that fit the experimental data, are in agreement with rate constants measured previously by pre-steady-state methods, and predict the correct initial velocities in the forward and reverse directions. Simulations also show that rate constants consistent with any of the various alternative mechanisms do not provide good fit to the experimental data. A model for the kinetic mechanism is considered, in which the binding of Asp prior to C-P may restrict access of C-P to the active site, but C-P binding prior to Asp potentiates the enzyme for the allosteric (T-R) transition, centered entirely upon the Asp binding process. PMID- 3322199 TI - Research in short-term inpatient group psychotherapy: a critical review. PMID- 3322198 TI - Effect of pH on tritium exchange and hydrogen production and uptake in free living cells and in bacteroids of Bradyrhizobium japonicum. AB - Soybean nodule bacteroids and Bradyrhizobium japonicum free-living cells induced for H2-uptake hydrogenase, actively catalyze the evolution of H2 in a reaction highly dependent on the pH. The optimal pHs for the evolution and uptake reactions were 4.0 and 7.5-8.0, respectively. No differences were found between free-living cells and bacteroids with respect to hydrogen acceptor specificity, although absolute rates of H2 uptake were higher for free-living cells. Both types of cells were able to evolve hydrogen from reduced methyl viologen at low pH. These intact cells also catalyzed the exchange reaction between tritium and water in the absence of oxygen. The pH profile of the exchange activity showed two peaks at values near the optimal pHs for the evolution and uptake reactions. PMID- 3322201 TI - [Inflammations of the lower genital tract]. PMID- 3322200 TI - Evaluating the quality of new procedures. PMID- 3322202 TI - [Virus infections of the vulva]. PMID- 3322203 TI - [Drugs in pregnancy]. PMID- 3322204 TI - [Nutrition in pregnancy]. PMID- 3322205 TI - [Papillary calculous nuclei. Theoretical considerations apropos of an experimental study]. PMID- 3322207 TI - Orthoclone OKT3: a treatment for acute renal allograft rejection. PMID- 3322206 TI - [Systemic candidiasis in a kidney transplant patient. Ureteral obstruction caused by an accumulation of fungi]. PMID- 3322208 TI - The diabetic transplant patient: nursing considerations. PMID- 3322209 TI - Transplantation of blood group A2 cadaveric kidneys into O and B recipients. PMID- 3322210 TI - Seventy five years of arthritis research at the Strangeways Research Laboratory: 1912-87. PMID- 3322211 TI - An immunohistochemical study of fibronectin in human osteoarthritic and disease free articular cartilage. AB - Fibronectin is a minor component of cartilage connective tissue matrix, which is reported to accumulate in increased amounts in osteoarthritis. The presence of raised levels of fibronectin in human osteoarthritic cartilage by immunoperoxidase localisation is confirmed. Residual femoral head articular cartilage from 17 patients with osteoarthritis contained variable but substantial amounts of fibronectin. This was localised mainly in a band within the matrix of the surface zone. No significant deposits of fibronectin were found in this or any other area of the normal specimens. Intracellular fibronectin was identified in some cells of the surface zone, indicating that it was, in part, synthesised locally. The presence and distribution of locally produced fibronectin in osteoarthritic cartilage suggest that its synthesis is a response by chondrocytes to changes in the cartilage matrix. PMID- 3322213 TI - Modulation of lymphokine production during experimental Trypanosoma brucei infection in inbred mouse strains. PMID- 3322214 TI - [AIDS and atypical mycobacteria]. PMID- 3322212 TI - Lymphocyte traffic, endothelium, and rheumatoid arthritis. PMID- 3322215 TI - The Kapandji technique and its evolution in the treatment of fractures of the distal end of the radius. Report on a series of 159 cases. AB - The authors analyse the results of treatment of 159 fractures of the distal end of the radius by the "Kapandji Technique". Of these 159 fractures, 129 were extra articular, 27 intra-articular and 3 fractures affected both the two bones of the forearm. The technique should be applied strictly, with primary reduction and direct control of the tendinous and nervous elements through the incisions. A third pin is sometimes necessary. A 5 years postoperative period is sufficient to get a meaningful analysis of the results which were very good or good in 93% of our cases. The only real problem was anterior over-reduction due to progressive secondary displacement which necessitated regular postoperative follow-up. PMID- 3322216 TI - The posterior interosseous flap. AB - The posterior interosseous flap is a new fasciocutaneous flap designed on the postero-lateral aspect of the forearm. The anatomical study was carried on seventy dissections of fresh specimens. The flap is supplied by the posterior interosseous artery which delivers several cutaneous branches. The posterior interosseous flap can be used as a proximally based pedicled flap or as a distally based one thanks to the anastomosis at the level of the wrist, with the anterior interosseous artery and with the dorsal arch of the carpus. The flap can be employed as a fascial flap. Eight clinical cases have been performed to cover soft tissues defects of elbow, wrist and hand. PMID- 3322217 TI - [Luxation of the hamate bone. Apropos of a case with review of the literature]. AB - The authors report a case of isolated dorsal dislocation of the hamate bone. An open reduction was performed with dorsal stabilisation by ligamentous reconstruction. Study of the literature showed 14 cases (including the case described) 5 of these dislocation were isolated, 5 were dorsal, 6 palmar, and 3 unknown. Surgical treatment was the most frequent. No neurovascular complication has been described. PMID- 3322218 TI - [Sensitivity: physiology, examination, principles of rehabilitation of sensation]. AB - This is the text of a lecture devoted to the physiology of sensibility studied in the recent publications. The author describes successively the role of the peripheral receptors, clinical and electrophysiological assessment of sensibility, central mechanism of sensation, sequential recovery or sensibility after peripheral nerve lesion, rational basis for reeducation of sensation. PMID- 3322219 TI - [Real-time ultrasonics: a method of hand imaging]. AB - Seventy-five surgically soft-tissue lesions of the hand were examined prospectively by real-time ultrasound and correlated with surgical and pathological findings. The normal ultrasonic anatomy of the hand is described. The use of real time sonography allowed a reliable diagnosis of the cystic or solid nature of soft-tissue tumors, an accurate estimation of their volume and their precise three-dimensional localization. Sonography facilitates the location of foreign bodies, and appears as a new promising technique for the evaluation of tendons. PMID- 3322220 TI - [Mutagenicity of waters of the Meuse River]. PMID- 3322221 TI - [Maternal complications and perinatal mortality and morbidity in diabetics treated with oral hypoglycemic agents during pregnancy]. PMID- 3322222 TI - [Dismemberment and mutilation (2)]. AB - 31 cases of criminal dismemberment or mutilation were investigated in the period from 1959 to 1987 at the Institute of Forensic Medicine in Hamburg. With regard to all legal autopsies the average frequency was about 1:500. A distinct increase of the number of cases is noticeable within the last years; i.e. 1984 there were 6 victims. Our study enclosed the autopsy findings, the police investigations and the available court records. 12 cases were classified as defensive and 14 cases as offensive dismemberment of bodies; 2 cases of necrophilous dismemberment occurred after stealing the corpse and 3 victims were killed by intravital decapitation or mutilation. The victims were of all ages, but mainly between 20 and 60 years old; 22 of them were female and 9 male. 23 perpetrators could be identified; 18 of them were male and 5 female, most of them were between 30 and 40 years of age. The psychiatric expertises classified 17 of the perpetrators as "normal", 3 as abnormal and 3 as psychotic. Many morphological and criminological details concerning victims, perpetrators, used instruments for killing and dismembering, elimination and identification of the dismembered bodies and some juridical aspects are presented. PMID- 3322225 TI - [The Poznan Society of Friends of the History of Medicine and Natural Sciences (1925-1957)]. PMID- 3322223 TI - Cloning and sequence of the mdh structural gene of Escherichia coli coding for malate dehydrogenase. AB - The malate dehydrogenase gene of Escherichia coli, which is susceptible to catabolite and anaerobic repression, has been cloned using plasmic pLC32-38 of Clarke and Carbon (1976). The nucleotide sequence was determined of a 2.47 kbp fragment, containing the mdh structural gene. All information necessary for expression of the mdh structural gene was mapped within a 1.3 kbp SphI-BstEII fragment. Compared with the untransformed wild type, transformations with pUC19 vector, containing this fragment, gave up to 40-fold more malate dehydrogenase activity in both E. coli wild type and mdh mutant recipients. Catabolite repression was not affected in the transformants. A possible CRP binding site in the promotor region of the mdh gene provides evidence for a co-regulation with fumA gene, the structural gene of fumarase, which is also subject to catabolite repression. The structures for transcription initiation and termination were similar to those previously described for E. coli. Amino acid sequence homologies between pro- and eucaryotic malate dehydrogenases are discussed. PMID- 3322226 TI - [History of the founding and profiles of the founders and members of the Society of Former Graduates of the Imperial Juriew (former Dorpat) University in Warsaw]. PMID- 3322227 TI - [Advertisements with regard to medical services in Warsaw daily newspapers in the second half of the 18th century (1762-1798)]. PMID- 3322224 TI - [Prenatal diagnosis of obstructive digestive abnormalities and mucoviscidosis]. PMID- 3322228 TI - [History of the theories on the therapeutic effect of music]. PMID- 3322230 TI - [Polish kings' charters for hospitals and physicians in Torun during the First Republic (1454-1793)]. PMID- 3322229 TI - [The Krzywda-Lazowski family--Galician pharmacists. II]. PMID- 3322232 TI - [Various problems of medical education from the social democratic point of view at the end of the 19th century]. PMID- 3322231 TI - [Dr. Emil Jozef Warminski (1881-1909), social worker and patriot (on the 75th anniversary of his death)]. PMID- 3322233 TI - [Ujazdowski Hospital during the period from September 1939 to July 1940 (reminiscences)]. PMID- 3322235 TI - Isolation of cross-reactive, subtype-specific monoclonal antibodies against influenza virus HA1 and HA2 hemagglutinin subunits. AB - The large (HA1) and small (HA2) subunits of influenza virus A/Vict/3/75 hemagglutinin were purified in denatured form by preparative electrophoresis. Both polypeptides were used to immunize mice from which monoclonal antibodies were obtained. These antibodies reacted not only with the corresponding hemagglutinin subunit but also with purified virions. When tested by radioimmunoassay against a panel of human viruses, most anti-HA1 and -HA2 antibodies behaved as subtype-specific, whereas anti-HA antibodies, raised against purified virus, were more restricted. The anti-subunit antibodies were negative in hemagglutination-inhibition and neutralization tests. The interest of these antibodies as reagents for research and diagnosis is discussed. PMID- 3322236 TI - [Ultrastructure of the median eminence and posterior lobe of the hypophysis in newborn Diocrostonyx torquatus lemmings during a decline in the population count]. AB - Electron microscopically using morphometric analysis, the median eminence and hypophysis posterior lobe have been studied in newborn lemmings (Dicrostonyx torquatus Pallas) at the stage of decreasing population. A comparative characteristics of capillaries in the primary plexus of the portal system and capillaries of the hypophysis posterior lobe is presented. Overtaking developmental rate is demonstrated in the posterior hypophyseal lobe in comparison to that of the median eminence. In the lemmings investigated level of differentiation of the neurohemal areas of the hypothalamus is lower than development of these areas in laboratory mice and rats, according to the literature data. Possible results of weak development of the hypothalamo hypophyseal connections in newborn lemmings at the stage of decreasing population are discussed. PMID- 3322234 TI - Advances in the use of nucleic acid probes in diagnosis of viral diseases of man. Brief review. AB - A variety of methods are now available for the preparation and labelling of viral nucleic acids for use as probes in diagnostic virology. Some of these are assessed including the use of synthetic oligonucleotides in place of molecularly cloned nucleic acids, and alternatives to labelling with radioactive isotopes such as biotin, enzymes and fluorochromes. Dot blot, sandwich, indirect sandwich and in situ hybridization are covered, and examples given of the current use of nucleic acid probes in detection of human viral infections. The potential and limitations of nucleic acid hybridization are discussed in the light of these new methods. PMID- 3322237 TI - [Intercellular space and nonsynaptic interneuronal connections of the mammalian brain]. AB - Electron-microscopic investigations of various parts of the CNS in laboratory mammals and man have demonstrated that a single cerebral intercellular space, presenting an immediate internal medium for the nervous tissue elements, has different structure at the border separating the media. Here is a complex of structures, included into composition of the hemato-encephalic and liquor encephalic barrier. Data of the literature on chemical composition of the intercellular contents and on specific membranous receptors make it possible to suppose a communication role of the intercellular spaces, ensuring nonsynaptic intercellular connections and modulation of the synaptic transmission. At the level of membranes, that make walls of the intercellular clefts by means of certain phylogenetically ancient humoral mechanisms, interaction of systems of synaptic and nonsynaptic interneuronal connections is secured. PMID- 3322238 TI - [70 years of the Great October Socialist Revolution and the development of Soviet pathological anatomy]. PMID- 3322239 TI - Abdominal ultrasonography in hepatolenticular degeneration. A study of 33 patients. AB - The ultrasonographic study of 33 patients with hepatolenticular degeneration showed the following main changes: disorders of the hepatic echotexture (29 cases), changes of the splenic dimensions (21), liver shrinkage (10), cholelithiasis (8), hepatomegaly and ascites (1). The disorders of liver echotexture exhibited different patterns, from slight to severe changes of the hepatic echogenicity, associated with anatomic distortions of the liver, such as alterations of outline and decrease of dimensions. Liver shrinkage was always accompanied by splenomegaly. The scarcity of hepatomegaly may be explained by the fact that the ultrasonography was performed after the onset of treatment with penicillamine, or by other factors still unknown, copper perhaps possessing a stronger fibrogenetic action than other hepatotoxic agents. Cholelithiasis was very frequent in females (6 of 13 patients), its incidence tending to increase with age. Regarding males there was no increase when the incidence was compared to the general population. The two sole males were young, an unusual finding in normal men. PMID- 3322240 TI - [Recent advances in inborn errors of metabolism]. AB - Four aspects of advances in inborn errors of metabolism (IEM) are analysed: 1) concerning the general comprehension of the pathogenesis, genic localization and genetic heterogeneity; 2) clinical aspects, with description of new variants of known IEM or new IEM; 3) laboratory diagnostic tests presently used in our country: dosage of some genetic markers (arylsulfatases, hexosaminidases, beta glycosidase; beta-galactosidase and sphingomyelinase), newborn populational screening (for hyperphenylalaninemia, and hypothyroidism), heterozygote detection (for Tay-Sachs disease) and also some prenatal diagnosis; 4) therapeutic aspects presenting substitutive treatment, special diets, plasmapheresis and leukapheresis. The first results of 4 cases of mucopolysaccharidosis treated with the last technic are presented. PMID- 3322241 TI - [Hepatolenticular degeneration. Apropos of 102 cases]. AB - The author reports the clinical and laboratory findings in 102 patients of hepatolenticular degeneration (HLD) followed up in the Department of Neurology, University of Sao Paulo Medical School, since 1946. The problem of the early diagnosis of the relatives is analysed, the pathology of Wilson's disease is reviewed, and the relationship of HLD with other hepatocerebral diseases is examined. Etiopathogenesis is discussed according to current researches, the role of the decreased biliary copper excretion being emphasized. The results of treatment with D-penicillamine in 84 cases are commented. PMID- 3322242 TI - [Intravenous penicillin therapy in high doses in neurosyphilis: study of 62 cases. I. Clinical evaluation]. AB - Sixty-two patients with symptomatic neurosyphilis were treated with 20 or 24 megaunits of intravenous penicillin G daily for 15 to 30 days. The mean follow-up time after the treatment was 30 months. Thirteen patients developed new neurological signs after the treatment. Their diagnosis were: general paresis (9), taboparesis (2), tabes dorsalis (1) and meningovascular neurosyphilis (1). After the treatment, thirty-six patients (58.1%) improved, 22 patients (35.5%) were unchanged and 4 patients (6.4%) deteriorated on clinical grounds. In two patients there was a progression to other forms of neurosyphilis. The results of the treatment of these patients with high doses of intravenous penicillin G were not different from the results verified with classical intramuscular penicillin that were reported in the literature, from the clinical standpoint. PMID- 3322243 TI - Castleman's disease associated with pregnancy: a case report. PMID- 3322244 TI - Development of urine production and urination in the human fetus assessed by real time ultrasound. PMID- 3322245 TI - Early development of the acoustic reflex. AB - Acoustic reflex testing was conducted on 2-day-old and on 6-week-old infants to determine how frequently, if at all, the acoustic reflex occurs, if it can be reliably observed, and also to determine what is the mean normal acoustic reflex threshold for pure tones and broad-band noise in these populations. Twenty normal infants were tested in each group. Each infant was considered to be normal by the following criteria: full term, normal pregnancy normal pregnancy and delivery, birth weight greater than 2500 g, 5-min Apgar of 7 or greater, and considered to be not at risk for hearing loss by the absence of any high risk factors. Subjects were tested following feedings. Acoustic reflexes were obtained from subjects with normal tympanograms (+/- 50 mm H2O) for 500, 1,000, 2,000, and 4,000 Hz and broad-band noise stimuli. Behavioral responses were common, requiring quieting pauses in testing and repeated stimulation for habituation of the behavioral component. Acoustic reflexes were observed, and normative reflex threshold data were obtained. The number of reflexes obtained and the mean acoustic reflex thresholds for these age-groups are reported. PMID- 3322246 TI - Duodenal trauma. AB - Fifteen cases of duodenal trauma that presented to Westmead Hospital between 1979 and July 1986 are reviewed. There were 12 blunt injuries, nine caused by motor vehicle accidents. Three patients sustained penetrating injuries, two due to stab wounds. Repair for blunt laceration or incised wound was by primary closure or serosal patch repair, most often with decompressive t-tube duodenostomy. No leak from the duodenal repair occurred in any patient. Two patients died. This was not due to complications of the duodenal injury. Pyloric exclusion, duodenal diverticulization or pancreaticoduodenectomy was not considered necessary in any patient. Morbidity of duodenal haematoma in the form of continuing abdominal pain may be avoided by intra-operative drainage. PMID- 3322247 TI - Oesophageal perforation--a review of 37 cases. AB - We have reviewed 37 cases of ruptured oesophagus treated at St Vincent's Hospital from 1976 to 1986. Their age ranged from 20 to 89 years (mean 64 years) and 59% were female. The causes of rupture were spontaneous (9), foreign body (5), diagnostic oesophagoscopy (8), oesophagoscopy and dilatation (5), balloon dilatation (3), palliative intubation (6) and patient self dilation (1). Eighty six per cent of perforations occurred in the lower third of the oesophagus. The most common means of diagnosis was a positive contrast swallow (90%) and/or the presence of cervical or mediastinal air (49%). Eighteen patients underwent surgical treatment which consisted of a combination of thoracotomy, drainage and repair, or laparotomy and Celestin tube insertion, with or without chest drainage. Two patients underwent oesophageal diversion. The overall mortality in all patients was 30% (37% non-operative and 22% operative group). We conclude that the management of ruptured oesophagus demands an individual approach depending upon the site and aetiology of perforation and the underlying disease. The condition is a disease of the elderly and continues to have a high morbidity and mortality. PMID- 3322248 TI - Effect of 50 mg enteric-coated aspirin (Astrix) on thromboxane and prostacyclin synthesis. AB - Although low-dose soluble aspirin can be recommended as a useful anti-thrombotic drug regimen in patients with vascular disease, enteric-coated preparations have a theoretical advantage for aspirin preparations which are to be ingested daily for many years. We have demonstrated that a 50 mg enteric-coated aspirin formulation (Astrix) which has an absorption rate much lower than soluble aspirin, is sufficient to inhibit platelet thromboxane synthesis while causing no major decrease in vascular prostacyclin synthesis. PMID- 3322249 TI - Childhood phaeochromocytoma--two cases. AB - The clinical features and management of two cases of phaeochromocytoma in childhood are described, with emphasis on the diagnostic value of ultrasonography. PMID- 3322250 TI - Effect of milk whey on adhesion of bacteria to bovine udder epithelial cells. PMID- 3322251 TI - Squamous carcinomas developing in bilateral lesions of necrobiosis lipoidica. PMID- 3322252 TI - The influence of high and low pressure on phagocytosis of Escherichia coli by human neutrophils in vitro. AB - Human polymorphonuclear neutrophils were exposed to high (4 atm) and low (0.4 atm) pressures in vitro before and during phagocytosis of radiolabelled Escherichia coli. Preexposure of the neutrophils to high pressure before phagocytosis did not influence uptake. However, when phagocytosis took place at 4 atm the uptake of bacteria opsonized by active serum and IgG was significantly depressed. On the other hand, uptake in the presence of heat-inactivated serum or albumin and uptake of non-opsonized E. coli was not changed at high pressure. The results suggest an influence on uptake mechanisms related to receptors in the cell membrane. When the neutrophils were exposed to hypobaric pressure both before and during phagocytosis, the uptake of nonopsonized E. coli was slightly depressed. However, neither preexposure nor exposure during phagocytosis was sufficient alone to elicit this inhibiting effect. The uptake of E. coli opsonized by active serum or IgG was not influenced by low pressure. PMID- 3322253 TI - Mechanisms underlying the antimotion sickness effects of psychostimulants. AB - The major conclusions of this review are: 1) that selective enhancement of dopaminergic transmission, not noradrenergic, is sufficient to account for amphetamine-induced resistance and perhaps natural resistance to motion sickness; 2) the site of this enhanced dopaminergic transmission is probably within the basal ganglia; and 3) the neuropharmacology of the basal ganglia, but not the brainstem vestibular areas, can account for the therapeutic synergism of scopolamine and amphetamine. The therapeutic actions of psychostimulants may be dissociable from some of their side effects, particularly cardiovascular effects related to peripheral norepinephrine release. Drugs which target specific subtypes of dopaminergic receptors may serve this purpose. PMID- 3322254 TI - Commentary on mood and memory. PMID- 3322255 TI - Generalised anxiety: a controlled treatment study. PMID- 3322256 TI - Chemical aversion conditioning as a treatment for alcoholism: a re-analysis. PMID- 3322257 TI - Non-histone proteins in transcriptionally active chromatin. PMID- 3322258 TI - Topological properties of DNA domains and interaction with RNA polymerase II. AB - We have analyzed the relationship between the alterations of the DNA structure induced by topological constraint and the template properties of promoters in vitro. A cause-effect relationship has been defined in several instances. Experimental protocols have been developed for the study of the topological properties of RNA polymerase II promoters. The goal of these studies is the definition of the intrinsic structural informations of DNA. PMID- 3322259 TI - [Ecologic influence on the outbreak of soil-borne diseases]. PMID- 3322261 TI - A quantitative approach to sequence comparisons of nitrogenase MoFe protein alpha and beta-subunits including the newly sequenced nifK gene from Klebsiella pneumoniae. AB - The nucleotide sequence was determined for part of the Klebsiella pneumoniae nif gene cluster containing the 3' end of the nifD gene and the entire length of the nifK gene (encoding the alpha- and beta-subunits of the nitrogenase MoFe protein respectively), as well as the putative start of the nifY gene, a gene of as yet unknown function. A broad-based comparison of a number of MoFe protein alpha subunits, beta-subunits and alpha-versus beta-subunits was carried out by the use of a computer program that simultaneously aligns three protein sequences according to the mutation data matrix of Dayhoff. A new kind of quantitative statistical measure of the similarity between the aligned sequences was obtained by calculating and plotting standardized similarity scores for overlapping segments along the aligned proteins. This calculation determines if a test sequence is similar to the consensus sequence of two other proteins that are known to be related to each other. The different beta-subunits compared were found to be significantly similar along most of their sequence, with the exception of two relatively short regions centred around residues 225 and 300, which contain insertions/deletions. The overall pattern of similarity between different alpha-subunits exhibits resemblance to the overall pattern of similarity between different beta-subunits, including regions of low similarity centred around residues 225 and 340. Comparison of alpha-subunits with beta subunits showed that a region of significant similarity between the two types of subunits was located approximately between residues 120 and 180 in both subunits, but other parts of the proteins were only marginally similar. These results provide insights into likely tertiary structural features of the MoFe protein subunits. PMID- 3322263 TI - The role of the metal ion in the mechanism of the K+-activated aldehyde dehydrogenase of Saccharomyces cerevisiae. AB - The effect of K+ on assays of the enzyme was studied and it appears that the activation occurs slowly by a two-step process. Kinetic measurements suggest that the enzyme-catalysed reaction can proceed slowly (0.4%) in the complete absence of K+. The enzyme exhibits a K+-activated esterase activity, which is further activated by NAD+ or NADH. Stopped-flow studies indicated that the principal effect of K+ on the dehydrogenase reaction is to accelerate a step (possibly acyl enzyme hydrolysis) associated with a fluorescence and small absorbance transient that occurs after hydride transfer and before NADH dissociation from the terminal E-NADH complex. The variation of activity of the enzyme with pH was studied. An enzyme group with pKa approx. 7.1 apparently promotes enzyme activity when in its alkaline form. PMID- 3322262 TI - Nucleotide sequence of the Klebsiella pneumoniae nifD gene and predicted amino acid sequence of the alpha-subunit of nitrogenase MoFe protein. AB - The nucleotide sequence of the Klebsiella pneumoniae nifD gene is presented and together with the accompanying paper [Holland, Zilberstein, Zamir & Sussman (1987) Biochem. J. 247, 277-285] completes the sequence of the nifHDK genes encoding the nitrogenase polypeptides. The K. pneumoniae nifD gene encodes the 483-amino acid-residue nitrogenase alpha-subunit polypeptide of Mr 54156. The alpha-subunit has five strongly conserved cysteine residues at positions 63, 89, 155, 184 and 275, some occurring in a region showing both primary sequence and potential structural homology to the K. pneumoniae nitrogenase beta-subunit. A comparison with six other alpha-subunit amino acid sequences has been made, which indicates a number of potentially important domains within alpha-subunits. PMID- 3322260 TI - The synaptic vesicle and the cytoskeleton. PMID- 3322264 TI - Interactions of insulin and dexamethasone in the control of pyruvate kinase activity and glucose metabolism in sheep adipose tissue. AB - 1. The Vmax. activity of pyruvate kinase of sheep adipose tissue increased during tissue culture up to 48 h; the increase was blocked by actinomycin D (an inhibitor of transcription) and was promoted by insulin and antagonized by dexamethasone. 2. In contrast with their effects on pyruvate kinase, insulin and dexamethasone acted synergistically to increase the activity of glucose-6 phosphate dehydrogenase of sheep adipose tissue maintained in culture. 3. Insulin stimulated, whereas dexamethasone inhibited, glucose utilization by sheep adipose tissue maintained in culture; the two agents were mutually antagonistic, and their effects were prevented by actinomycin D. 4. Antimycin A (an inhibitor of the electron-transport chain) stimulated glucose uptake and lactate output by sheep adipose tissue in the presence of dexamethasone and insulin, suggesting that the effects of dexamethasone on glucose utilization by sheep adipose tissue were not due to an inhibition of glucose transport. 5. Comparison of these findings with previous studies on the endocrine control of hepatic pyruvate kinase shows that there are major differences in the control of these Vmax. activities in liver and adipose tissue. 6. Although glucocorticoid hormones inhibit glucose utilization themselves and can antagonize the stimulatory effects of insulin on glucose utilization in adipose tissue from both sheep and rats, there appear to be major differences in the sites of action of these hormones in the two species. PMID- 3322265 TI - Effect of oxygen on levels of mRNA coding for reaction-centre and light harvesting polypeptides of Rhodobacter sphaeroides. AB - The relative levels of mRNA for the reaction-centre L and M subunits, B875 (LH1) alpha and beta polypeptides and B800-850 (LH2) alpha and beta polypeptides, have been measured during pigment induction of Rhodobacter sphaeroides. Over the 6 h of the experiment, bacteriochlorophyll levels increased by at least 100-fold. No transcripts for photosynthetic components were detectable at the start of induction; after 2 h the levels of transcripts from the puf operon (encoding reaction-centre and B875 subunits) had reached the maximum; these transcripts were 2.7 and 0.5 kb respectively. The transcript for the puc operon (B800-850 complex) was estimated to be 0.55 kb and reached a maximum level after 6 h. These results are consistent with the proposal that, during the assembly of the photosynthetic apparatus, the synthesis of B875 reaction-centre aggregates precedes that of the major antenna, B800-850. PMID- 3322267 TI - Purification and characterization of glucosidase I involved in N-linked glycoprotein processing in bovine mammary gland. AB - Glucosidase I, the first enzyme involved in the post-translational processing of N-linked glycoproteins, was purified to homogeneity from the lactating bovine mammary tissue. The enzyme was extracted by differential treatment of the microsomal fraction with Triton X-100 and Lubrol PX. The solubilized enzyme was subjected to affinity chromatography on Affi-Gel 102 with N-5 carboxypentyldeoxynojirimycin as ligand and DEAE-Sepharose CL-6B chromatography. Purified glucosidase I shows a molecular mass of 320-330 kDa by gel filtration on Sephacryl S-300. SDS/polyacrylamide-gel electrophoresis under reducing conditions indicates a single band of approx. 85 kDa, indicating that the native enzyme is probably a tetrameric protein. Several criteria, including pH optimum of 6.6-7.0, specific hydrolytic action towards Glc3Man9GlcNAc2, to release the terminally alpha-1,2-linked glucosyl residue, and total lack of activity towards Glc1Man9GlcNAc2 and Glc2Man9GlcNAc2 saccharides, which are the biological substrates for processing glucosidase II, and 4-methylumbelliferyl alpha-D glucopyranoside show the non-lysosomal origin and the processing-specific role of the purified enzyme. The enzyme does not require any metal ions for its activity. Hg2+, Ag+ and Cu2+ are potent inhibitors of the enzyme; this inhibition can be reversed by adding an excess of dithiothreitol. Among the saccharides tested, kojibiose (Glc alpha 1----2Glc) was inhibitory to the enzyme. Polyclonal antibodies raised against the enzyme in rabbit were found to be specific for glucosidase I, as revealed by Western-blot analysis and by immunoadsorption with Protein A-Sepharose. Anti-(glucosidase I) antibodies were cross-reactive towards a similar antigen in solubilized microsomal preparations from liver, mammary gland and heart from the bovine, guinea pig, rat and mouse. PMID- 3322266 TI - Klebsiella pneumoniae nitrogenase. Inhibition of hydrogen evolution by ethylene and the reduction of ethylene to ethane. AB - Ethylene (C2H4) inhibited H2 evolution by the Mo-containing nitrogenase of Klebsiella pneumoniae. The extent of inhibition depended on the electron flux determined by the ratio of Fe protein (Kp2) to MoFe protein (Kp1) with KiC2H4 = 409 kPa ([Kp2]/[Kp1] = 22:1) and KC2H4i = 88 kPa ([Kp1]/[Kp2] = 21:1) at 23 degrees C at pH 7.4. At [Kp2]/[Kp1] = 1:1, inhibition was minimal with C2H4 (101 kPa). Extrapolation of data obtained when C2H4 was varied from 60 to 290 kPa indicates that at infinite pressure of C2H4 total inhibition of H2 evolution should occur. C2H4 inhibited concomitant S2O4(2-) oxidation to the same extent that it inhibited H2 evolution. Although other inhibitors of total electron flux such as CN- and CH3NC uncouple MgATP hydrolysis from electron transfer, C2H4 did not affect the ATP/2e ratio. Inhibition of H2 evolution by C2H4 was not relieved by CO. C2H4 was reduced to C2H6 at [Kp2]/[Kp1] ratios greater than or equal to 5:1 in a reaction that accounted for no more than 1% of the total electron flux. These data are discussed in terms of the chemistry of alkyne and alkene reduction on transition-metal centres. PMID- 3322268 TI - Segmental structure and protein domains in the pyruvate dehydrogenase multienzyme complex of Escherichia coli. Genetic reconstruction in vitro and 1H-n.m.r. spectroscopy. AB - A deletion in vitro can be made in the aceEF-lpd operon encoding the pyruvate dehydrogenase multienzyme complex of Escherichia coli, which causes deletion of two of the three homologous lipoyl domains that comprise the N-terminal half of each dihydrolipoamide acetyltransferase (E2p) polypeptide chain. An active complex is still formed and 1H-n.m.r. spectroscopy of this modified complex revealed that many of the unusually sharp resonances previously attributed to conformationally mobile segments in the wild-type E2p polypeptide chains had correspondingly disappeared. A further deletion was engineered in the long (alanine + proline)-rich segment of polypeptide chain that linked the one remaining lipoyl domain to the C-terminal half of the E2p chain. 1H-n.m.r. spectroscopy of the resulting enzyme complex, which was also active, revealed a further corresponding loss in the unusually sharp resonances observed in the spectrum. These experiments strongly support the view that the sharp resonances derive, principally at least, from the three long (alanine + proline)-rich sequences which separate the three lipoyl domains and link them to the C-terminal half of the E2p chain. Closer examination of the 400 MHz 1H-n.m.r. spectra of the wild-type and restructured complexes, and of the products of limited proteolysis, revealed another sharp but smaller resonance. This was tentatively attributed to another, but smaller, (alanine + proline)-rich sequence that separates the dihydrolipoamide dehydrogenase-binding domain from the inner core domain in the C terminal half of the E2p chain. If this sequence is also conformationally flexible, it may explain previous fluorescence data which suggest that dihydrolipoamide dehydrogenase bound to the enzyme complex is quite mobile. The acetyltransferase active site in the E2p chain was shown to reside in the inner core domain, between residues 370 and 629. PMID- 3322271 TI - Glucagon- and insulin degradation by hemolysate of human erythrocytes. AB - Hemolysates of human erythrocytes contain a highly specific insulin- and glucagon degrading activity which is comparable to the so-called insulin- and glucagon degrading proteinase (IGP, EC 3.4.23.5) found in other tissues. Glucagon degradation is inhibited by its cleavage products. Insulin, proinsulin and also cleavage products of insulin are effective inhibitors of glucagon degradation. The isolated insulin A- and B-chains are also capable of inhibiting the splitting of glucagon, but a higher concentrations. On the other hand, glucagon influences insulin degradation. Naturally occurring substances within commercially available human serum albumin have remarkable inhibitory effects on the glucagon degradation. PMID- 3322270 TI - Semisynthetic human [[3H2]Phe1]proinsulin. AB - Biosynthetic human proinsulin (obtained by recombinant DNA techniques) was used as the starting material for the preparation, by semisynthetic methods, of [3H]proinsulin with the label at the N-terminal phenylalanine residue. The labelled proinsulin was characterized by its retention time on reversed-phase h.p.l.c., by polyacrylamide-gel electrophoresis, by the time course of its enzymic conversion into insulin and by chromatographic analysis after extensive proteolytic degradation. The specific radioactivity of the product was 5 Ci/mmol. Experimental details of the preparation of human [[3H]Phe1]proinsulin, the isolation of this product by isocratic h.p.l.c. and gel filtration, and further characterization of protein intermediates have been deposited as supplement SUP 50138 (12 pages) at the British Library Lending Division, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies can be obtained on prepayment [see Biochem. J. (1987) 241, 5]. PMID- 3322273 TI - What about the effects of dietary lipids on endogenous prostanoid synthesis? A state-of-the-art review. AB - The endogenous prostanoid synthesis can principally be influenced by a variation of the polyunsaturated fatty acid supply in food. Withholding an essential fatty acid supply in food for a length of time results in a low rate of formation of prostanoids. However, there is no simple correlation between the amount of prostaglandin precursor fatty acid supplied with food and the biosynthesis of prostanoids in the different organs. A progressive increase of the intake of polyunsaturated fatty acids results in irregular changes in the prostanoid synthesis of the organism. The impact of various parameters should be taken into account, e.g., the period of feeding, the preexperimental state of the organism, the kind of polyunsaturated fatty acid related to a particular family of fatty acids, interactions with other components of food, differences of the species, organ specificities, aspects of chronoperiodicity, interactions of the prostanoids (and polyunsaturated fatty acids, respectively) with other metabolic circuits on a different level of integration, and details in the methods applied in the determination of prostanoids. Above all, care must be taken to prevent too general conclusions being drawn about the influence on the endogenous synthesis of prostanoids by dietary polyunsaturated fatty acids. PMID- 3322272 TI - Effect of prenatal insulin and glucagon injection on the glycogen content of rat placenta and fetal liver. AB - The placental glycogen content per g wet weight decreases after the 16th day of gestation but remains nearly constant till the 21st day of gestation when expressed per placenta as whole organ. Injection of insulin to rat fetuses at the 21st day of gestation gives rise to hypoglycemia and an increase of the glycogen content in liver and in placenta. Intrauterine glucagon application makes fetuses hyperglycemic in consequence of a mobilization of the placental glycogen stores. Hepatic glucose production appears in later stages because of the low activity of glucose 6-phosphatase as demonstrated by the effect of glucagon on the hepatic glucose 6-phosphate concentration. PMID- 3322269 TI - Modulation of platelet-activating-factor-induced calcium influx and intracellular calcium release in platelets by phorbol esters. AB - The mechanisms by which platelet-activating factor (PAF) and thrombin increase intracellular calcium were examined. Platelets were loaded with the calcium sensitive fluorescent probe Quin 2 and then were suspended in buffer containing 0.5 mM-Mn2+ in order to quantify simultaneously calcium release from intracellular stores and divalent cation influx. Pretreating platelets with agents which activate protein kinase C [the phorbol ester phorbol myristate acetate (PMA) or the diacylglycerol 1-oleoyl-2-acetylglycerol (OAG)] inhibited increased intracellular calcium by PAF and thrombin in a dose-related manner. That protein kinase C regulates intracellular calcium by phosphorylating proteins in two distinct pathways was suggested by two observations. PAF-induced calcium release was more sensitive to inhibition by PMA and OAG than was manganese influx and the kinetics of recovery from inhibition were different for the two pathways. Both PMA and OAG aggregated Quin 2-loaded platelets without eliciting measurable increases in intracellular calcium. In contrast, prostacyclin, which increases intracellular cyclic AMP, inhibited calcium release and influx in parallel, suggesting that this agent acts at a step common to both pathways. PMID- 3322274 TI - Observation of a possible pause mutant in the total synthesis of T4 lysozyme. AB - A DNA of 495 bp coding for T4-lysozyme was chemically synthesized and cloned in Escherichia coli. On DNA sequence analysis, clones pTLY.10 and pTLY.9 were identified to contain identical and complete T4-lysozyme coding sequences except that pTLY.9 had an additional 23 bp inverted repeat DNA at the 3'-end of the coding sequence. On expression and purification under similar conditions, T4 lysozymes from these two clones showed different degrees of retention time on HPLC as well as in the rate of enzymatic reaction. We speculate that this difference could be due to the generation of a pause mutant of T4-lysozyme in pTLY.9 under the influence of 3'-inverted repeat DNA that alters the rate of protein synthesis. PMID- 3322275 TI - Identification of three classes of hydrogenase in the genus, Desulfovibrio. AB - A comparison of amino-terminal amino acid sequences from the large and small subunits of hydrogenases from Desulfovibrio reveals significant differences. These results, in conjunction with antibody analyses, clearly indicate that the iron, iron + nickel, and iron + nickel + selenium containing hydrogenases represent three distinct classes of hydrogenase in Desulfovibrio. PMID- 3322276 TI - Engineering of the hydrophobic segment of the signal sequence for efficient secretion of human lysozyme by Saccharomyces cerevisiae. AB - To elucidate the structure-function relationship of the signal sequence for the secretion of human lysozyme by Saccharomyces cerevisiae, we have systematically engineered the hydrophobic segment using the signal sequence of chicken lysozyme. Replacement of Cys 10 with leucine caused a 1.6 times increase in the secretion of human lysozyme. An idealized signal sequence L10 in which 10 consecutive leucines were distributed from the 3rd to the 12th position was 1.8 times as effective as the native sequence. L10 can be generalized as Ln = Met-Arg-(Leu)n Pro-Leu-Ala-Ala-Leu-Gly, where n = 10. We have also studied the secretory capability of Ln, where n = 6,8,12, and 14, and found that the length, as well as hydrophobicity, of the hydrophobic segment is an important factor in the secretion of human lysozyme by yeast. PMID- 3322278 TI - Depurination of yeast 26S ribosomal RNA by recombinant ricin A chain. AB - The nature of the modification of yeast ribosomes by the recombinant form of the ricin A chain has been examined. Evidence is presented that the 26S rRNA molecule is depurinated at a specific site and that the activity is inhibited by antibody raised to ricin A chain. It thus appears that the recombinant form of this toxin retains the depurination activity of the native molecule. These results are consistent with the model that the site of depurination is in a highly conserved sequence forming a loop on the surface of the ribosome, a domain involved in elongation factor-dependent binding of aminoacyl-tRNA. PMID- 3322277 TI - Direct release of angiotensins I and II from isolated rat kidney perfused with angiotensinogen-free medium. AB - A direct measurement of both angiotensins I and II immunoreactive substances was made in the perfusate from isolated rat kidney perfused with Krebs-Ringer solution which was free of any component of the renin-angiotensin system. The identity of the immunoreactive peptides was confirmed as angiotensin I and angiotensin II by high-pressure liquid chromatography in reference to standard compounds. The rate of release of angiotensins was as high as 1313.5 +/- 184.5 and 772.4 +/- 82.5 pg for angiotensins I and II, respectively, during the first perfusion period of 20 min, and it remained stable at least for 2 hours. There was a good relationship between the angiotensin I secretion rate and renin secretion rate simultaneously determined in the perfusate, and also between the angiotensin I secretion rate and angiotensin II secretion rate. These results taken together with the previous observations of the coexistence of renin and angiotensins I and II in juxtaglomerular cells of the kidney provide evidence for intrarenal formation and release of angiotensin II. It does not agree with the notion that these peptides are internalized from circulation. Angiotensin II secreted from the kidney may play diverse functions in intrarenal regulation. PMID- 3322279 TI - The design of a simple competitive ELISA using human proinsulin-alkaline phosphatase conjugates prepared by gene fusion. AB - The gene encoding human proinsulin has been fused in-frame with the E. coli alkaline phosphatase gene (pho A) (EC 3.1.3.1). Two constructions are described. One construction consists of the entire proinsulin gene fused to the 5'-terminal end of pho A. In the other construction a 42 base pair DNA fragment has been deleted from the 3'-terminal end of the proinsulin gene. The two purified fusion proteins are enzymatically active showing a specific activity of 10-15 U/mg and 18-25 U/mg, respectively. The first construction exhibited insulin antigenicity and was used to design a simple competitive ELISA for insulin. The lower detection limit was found to be at least 2.5 ng/ml. Both fusion proteins were also shown to have potential for use in a competitive ELISA for proinsulin. PMID- 3322280 TI - Complementary DNA for the mouse homolog of the human amyloid beta protein precursor. AB - The human amyloid beta protein is a major component of brain amyloid found in patients with Alzheimer's disease. As an initial step to understand the biological function of its precursor protein, we have isolated cDNA for the mouse homolog of the human beta protein precursor. Comparison of the predicted amino acid sequence with that of human revealed a quite high degree of homology (96.8%), and the calculated evolutionary rate of the mRNA at amino acid substitution site was relatively low (0.1 x 10(-9)/site/year). The mRNA was abundant in brain and kidney, and also detected in other tissues at low level. These results indicated that this protein is highly conserved through mammalian evolution and may be involved in a basic biological process(es). PMID- 3322281 TI - Purification and amino acid sequencing of NAF, a novel neutrophil-activating factor produced by monocytes. AB - Human blood mononuclear cells were cultured for 24 h in the presence of LPS (100 ng per 5 x 10(6) cells), and a monocyte-derived neutrophil-activating factor (NAF) was purified to apparent homogeneity from the conditioned media. The purification consisted of ammonium sulphate precipitation, gel filtration, chromatography on phosphocellulose followed by hydroxylapatite, and reversed phase HPLC on C4 and CN-propyl columns. Amino acid sequence analysis (32 of 50 presumed residues) shows that NAF is a novel peptide with little homology to known ones. Crude and pure NAF stimulated human neutrophils to release granule enzymes and to produce superoxide and H2O2. PMID- 3322282 TI - Sycamore amyloplasts can import and process precursors of nuclear encoded chloroplast proteins. AB - Amyloplasts isolated from white-wild suspension-cultured cells of sycamore (Acer pseudoplatanus L.) are found to import and process the precursor of the small subunit (pS) of ribulose-1,5-bisphosphate carboxylase/oxygenase of spinach, but they lack the ability to form its holoenzyme due to the absence of both the large subunit and its binding-protein. They also import the precursor of the 33-kDa extrinsic protein (p33-kDa) of the O2-evolving complex of Photosystem II from spinach, but process is only to an intermediate form (i33-kDa). Chloroplasts from green-mutant cells of sycamore process p33-kDa to its mature form in this heterologous system. These results suggest that the thylakoid-associated protease responsible for the second processing step of p33-kDa is missing in amyloplasts, possibly due to the absence of thylakoid-membranes. In contrast, the apparent import of the precursor of the light-harvesting chlorophyll a/b-binding apoprotein (pLHCP) from spinach was not detected. Sycamore amyloplasts may lack the ability to import this particular thylakoid-protein, or rapidly degrade the imported molecules in the absence of thylakoid-membranes for their proper insertion. PMID- 3322283 TI - Insulin stimulated protein phosphorylation in human plasma liver membranes: detection of endogenous or plasma membrane associated substrates for insulin receptor kinase. AB - The present work discloses a procedure for preparation of human liver plasma membranes containing catalytically competent insulin receptor kinase. In addition to insulin promoted phosphorylation of the beta-subunit of insulin receptor kinase, insulin promoted phosphorylation of pp 120 and two other new proteins was demonstrated. The new proteins with molecular weights of 50,000 and 120,000 do not bind to WGA, pp 120 antibody or insulin receptor antibody, but bind to the antiphosphotyrosyl antibody. The identity and physiological significance of these putative substrates for insulin receptor kinase remains to be established. PMID- 3322284 TI - Cytotoxicity of a novel lipid-like bacterial product. AB - A highly cytotoxic, lipid-like compound was isolated from a Serratia marcescens strain currently under identification. We have named the compound DCX for its direct cytotoxic activity on various cell types in culture. DCX was purified by preparative thin layer chromatography from chloroform: methanol = 4:1 extracts of whole bacteria, and is chromatographically homogeneous. The effect of DCX on cells is dose, time, and temperature dependent. DCX is particularly toxic to the mastocytoma cell line P815 (TD50 = 75 pg/ml). Three other malignant or transformed murine cell lines were sensitive to the cytotoxic action of DCX. The effect of DCX was also tested on normal cells (human gingival fibroblasts), which showed greater resistance to DCX than the other cells tested. PMID- 3322285 TI - Inositol glycan mimics the action of insulin on glucose utilization in rat adipocytes. AB - Some of the actions of insulin may be mediated by the intracellular generation of an inositol phosphate glycan that modulates the activities of certain metabolic enzymes. The actions of this molecule were evaluated on glucose utilization in intact rat adipocytes. The inositol glycan led to the dose-dependent stimulation of glucose oxidation and lipogenesis. The extent of stimulation was similar to that observed for insulin. The stimulation of lipogenesis was seen only at high concentrations of glucose, suggesting regulation of processes distal to glucose uptake. The effects of the inositol glycan on intact adipocytes were specifically attenuated with inositol monophosphate in a dose dependent manner. These results further support a role for this substance as a second messenger for some of the actions of insulin, and indicate that the cellular uptake of the inositol glycan may occur by a specific transport system. PMID- 3322286 TI - A method to isolate DNA sequences that are promoter-active in Escherichia coli and in yeast. AB - A method convenient for isolation of DNA sequences capable of directing gene transcription in both organisms of E. coli and yeast is described. The method is composed of sequential steps of phenotypic selection for chloramphenicol resistance, first in E. coli and then in yeast. A series of promoter-probe, shuttle plasmid vectors between yeast and E. coli were constructed and utilized in the method. PMID- 3322287 TI - Molecular cloning and in vivo expression of a precursor to rat mitochondrial aspartate aminotransferase. AB - A 2.4 kilobase cDNA for rat mitochondrial aspartate aminotransferase (E.C. 2.6.1.1.) was isolated and sequenced. The predicted presequence is 93% homologous to the presequences of the enzyme from pig and mouse. The predicted amino acid sequence of the mature enzyme differs from that determined directly by amino acid sequencing (Huynh, Q.K., Sakakibara, R., Watanabe, T., and Wada, H. (1981) J. Biochem. (Tokyo) 90, 863-875) at 13 amino acids residues. The most important difference is at position 140 where the cDNA encodes a tryptophanyl residue rather than the previously reported glycine. This critical residue is now seen to be conserved in all aspartate aminotransferases. The coding region of this cDNA was inserted into the plasmid cloning vector pKK233-2 and used to stably express an unfused precursor in Escherichia coli JM105. PMID- 3322288 TI - Isolation of Escherichia coli release factor-2/ribosome complexes facilitated by efficient crosslinking and sensitive immunodetection of the ligand on the macromolecular particle. AB - Complexes between the protein ligand, release factor-2 (RF-2) and the 70S ribosome readily dissociate during purification. To stabilise the weak 70S.RF-2 complex the two components have been crosslinked using dimethyl suberimidate. A sensitive dot blot procedure employing RF-2 specific antibodies and detecting 0.1 ng of factor was developed to improve crosslinking yields. The proportion of the population of ribosomes carrying a release factor was increased several fold to at least 25% as estimated by immunoprecipitation. This combination of a sensitive immunoassay with an efficient crosslinking technique has general application in studies on the binding of a ligand with a macromolecular complex where an antibody against the ligand is available. PMID- 3322290 TI - [Formation and properties of artificial polycistrons containing truncated genes for E. coli tryptophan operon and phage M13 envelope protein]. AB - Using gene fragments encoding the leader peptide of E. coli tryptophane operon (as duplicated fragment HhaI-140) or M13 phage coat protein (as TaqI-381 or HaeIII-1623 fragments) and basing on pDS1 family of plasmids, expression vectors have been constructed which contained transcription promoters Ptrp, PVIII, and Pv + PVIII, respectively. An artificial gene for human leukocyte interferon alpha 2 (ifn-alpha 2) has been cloned into these plasmids, so that its transcription was a part of polycistronic mRNA and preceding translation was terminated upstream to the ribosome binding site and starting codon of the interferon gene. E. coli cells harbouring these recombinant plasmids provided high level of the interferon biosynthesis. The effect of the mRNA length on the amount of protein synthesised under control of the M13 coat protein transcription-translation signals has been found. PMID- 3322289 TI - [Effect of diadenosine oligophosphates (Ap4A and Ap3A) and their phosphonate analogs on catalytic properties of phenylalanyl-tRNA synthetase from E. coli]. AB - The influence of P1,P3-bis(5'-adenosyl)triphosphate (Ap3A), P1,P4-bis(5' adenosyl)tetraphosphate (Ap4A) and its analogues, containing a residue of methylenediphosphonic acid in various positions of the oligophosphate chain, on the reactions catalysed by phenylalanyl-tRNA synthetase from E. coli MRE-600 has been studied. The compounds do not affect significantly the rate of ATP-[32P]PPi exchange nor maintain this reaction in the absence of ATP. The diadenosineoligophosphates are shown to be noncompetitive inhibitors of ATP in the tRNA aminoacylation by phenylalanine (for Ap4A Ki = 1,45.10(-3) M). The phosphonate analogues of Ap4A inhibit the synthesis of Ap3A depending on their structure. The conclusion is thus drawn that the E. coli MRE-600 phenylalanyl tRNA synthetase does not interact property with Ap4A and its phosphonate analogues. PMID- 3322291 TI - [Duplication of a synthetic gene for human leukocyte interferon and its expression in polycistron mRNA with coupled translation system]. AB - Using a chemically synthesised adapter, the coding part of an artificial gene for human leukocyte alpha 2 interferon (ifn-alpha 2) has been duplicated. The adapter contained a termination signal of the first gene (TAA) within the Shine-Dalgarno sequence of the second gene (TAAGGA), distance between the terminating codon and starting codon of the second gene being 11 nucleotides. In another case this distance was 69 nucleotides, with the same SD sequence. The expression of the tandems as a part of polycistrons has been studied under control of promoters Plac, (Ptrp)2 of E. coli, and PVIII of M13 phage. It was found that tandems of ifn-alpha 2 genes in polycistronic structures trp L-ifn-ifn and IX-VIII-ifn-ifn under control of promoters (Ptrp)2 and PVIII, respectively, provided high level of the interferon biosynthesis, thus differing from the tandem under Plac promoter control, which had only ifn-ifn translation coupling. PMID- 3322292 TI - Attaining positions of leadership. PMID- 3322293 TI - Speech-language pathologists and human sexuality. PMID- 3322294 TI - Speech-language pathologists as counselors and sexuality educators. PMID- 3322295 TI - RIS. Research Information Service. PMID- 3322296 TI - Speech-language pathologists and audiologists in hospitals. PMID- 3322297 TI - Legislative councilors and ASHA members demographic comparisons. PMID- 3322298 TI - Draft addendum to the guidelines for the employment and utilization of supportive personnel.ASHA Committee on Supportive Personnel. PMID- 3322299 TI - American Speech-Language-Hearing Association. Classification of speech-language pathology and audiology procedures and communication disorders. PMID- 3322300 TI - Penalize potential subverters. PMID- 3322301 TI - Interactions of IgG and beta-VLDL with aortic valve endothelium from hypercholesterolemic rabbits. AB - The adhesion of immunoglobulins (IgG) and beta-migrating very low density lipoproteins (beta-VLDL) to aortic valve cusps from normolipidemic and hypercholesterolemic rabbits is associated with cytochemical changes in the endothelial glycocalyx. Endothelial surface changes are characterized by (1) enzymatic degradations with neuraminidase (NEU), chondroitinase ABC (CABC) or AC, and heparitinase (HPT); and (2) affinity cytochemistry with avidin-ferritin, protein A-HRP, and beta-VLDL-colloidal gold. NEU facilitated IgG deposition on cells from normolipid animals; however, tandem treatment with NEU and CABC increased beta-VLDL but prevented IgG interactions. The addition of HPT was required to eliminate beta-VLDL activity. The cells lining the arterial surfaces of cusps from hypercholesterolemic animals were reactive for endogenous IgG and beta-VLDL-gold. CABC enhanced the binding of the latter but removed most of the IgG. All reactivity was prevented by CABC and HPT. These findings suggest that the reduction of sialic acid residues and exposure of deeper lying glycosaminoglycans in the endothelial glycocalyx favor the interaction of blood borne elements at natural sites of disturbed blood flow in dietary hypercholesterolemia. PMID- 3322302 TI - Current trends in biomedical research on alcohol. PMID- 3322303 TI - The cardiovascular effects of alcohol. AB - The central fact about the relations of alcohol consumption to cardiovascular (CV) conditions is disparity. There is powerful evidence that susceptible persons suffer heart muscle damage from use of large amounts of alcoholic beverages, leading to alcoholic cardiomyopathy. Thiamine deficiency has CV consequences which may interact with heavy drinking in persons with poor nutritional intake. Substantial evidence links alcohol use to hypertension. Intervention studies demonstrate an apparent pressor effect of alcohol, which appears and regresses within several days. Alcohol use is inversely related to coronary heart disease (CAD); possible protective mechanisms have surfaced. The data provide no evidence which justify heavier alcohol intake. PMID- 3322304 TI - Alcohol as a teratogen: a decade of research in review. AB - The teratogenicity of ethanol has been well-documented during the past decade in clinical cases as well as animal models. It has become clear that, short of spontaneous abortion, Fetal Alcohol Syndrome represents the most serious consequence of sustained heavy drinking throughout pregnancy. The overall incidence of FAS is about 1-2/1000 live births, although it is considerably higher if one only considers alcoholic women who continue to drink during pregnancy. The incidence of Fetal Alcohol Effects (FAE) is much higher. Most clinical follow-up studies have failed to find significant improvement of intellectual functioning over time. Moreover, problems with attention, cognition, and perception have become apparent in children exposed to alcohol prenatally but without a clinical diagnosis of FAS. Animal models have demonstrated rather conclusively that ethanol is teratogenic in several species. The effect is dose dependent and the type of malformation observed depends upon the stage of development when the exposure occurred. A single exposure in a high enough dose is sufficient to produce birth defects and decreased fetal weight in mice. Studies with rats have demonstrated behavioral defects similar to those seen clinically, including hyperactivity and deficiencies in response inhibition. Neuroanatomical reports confirm a structural defect in the hippocampus, as suggested by the behavioral deficits observed. Neurochemical correlates of impaired behavior have been inconsistent. With regard to mechanism of action, impaired placental transfer of essential nutrients has been confirmed by several laboratories, while the role of hypoxia, acetaldehyde, and prostaglandins remains to be proven conclusively. Any, or all, of these potential mechanisms may play a role in alcohol-induced teratogenesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322306 TI - Long-term culture of hepatocytes: ethanol oxidation and effect of ethanol on enzyme activities and albumin secretion. AB - Rat hepatocytes were cultured in a modified HI-WO/BA medium for 13 days, and the combined effect of dexamethasone, 10(-7) M, insulin, 10(-8) M, and glucagon, 10( 9) M on the DNA-content, and on the activity of several enzymes, the secretion of albumin and the rate of ethanol oxidation was investigated. The effect of ethanol on these parameters was also studied. All parameters measured declined with time in the hormone-free cultures. In hormone-supplemented cultures, the DNA-content, the activity of glucokinase, pyruvate kinase, hexokinase and lactate dehydrogenase and the secretion of albumin was maintained at reasonable levels throughout the 13 days, whereas both the activity of alcohol dehydrogenase and the rate of ethanol oxidation fell significantly, although less than in hormone free cultures. Addition of 50 mM ethanol to the hormone-supplemented culture medium caused a ca. 20% fall in the activity of glucokinase and pyruvate kinase and a 20% increase in alcohol dehydrogenase activity. No effect of ethanol was observed on the activity of hexokinase and lactate dehydrogenase or on the secretion of albumin. PMID- 3322305 TI - Specificity of the action of ethanol in the central nervous system: behavioral effects. AB - The specificity of ethanol's behavioral actions is reviewed with regard to the possibility of other molecules, derived from ethanol sharing that action. The specificity of ethanol in relationship to other drugs with similar behavioral actions is also briefly reviewed. It is concluded that the ethanol molecule itself is primarily responsible for the behavioral effects but that other compounds may contribute to the effects. Ethanol is seen as being more unique than previously thought in that it has behavioral actions that are not the same as gaseous anesthetics. PMID- 3322307 TI - Effects of chronic ethanol treatment on glucose uptake into tissues of normal and diabetic mice. AB - Blood glucose levels and glucose uptake into cerebral cortex and diaphragm in vitro and into cerebral cortex and adipose tissue in vivo have been measured in LACG (normal) and C57Bl and CBA (diabetic) mice during chronic ethanol drinking and withdrawal. Chronic ethanol produced hypoglycaemia in diabetic mice but prevented insulin-provoked hypoglycaemia in normal mice. Insulin and ethanol had additive effects in diabetic mice. The hypoglycaemic effect of CET is not dependent upon insulin and can be explained by an increase in insulin-independent brain glucose uptake. Ethanol-induced hypoglycaemia and the changes in glucose uptake occur at relatively low blood levels of ethanol (4-20mM, 18-90mg%) and are rapidly reversible on withdrawal. Diabetic mice appear to be more sensitive to the effects of ethanol on glucoregulation. PMID- 3322308 TI - Effects of ethanol on the microtubules of cultured rat hepatocytes. AB - Changes in microtubules (MT) of cultured rat hepatocytes caused by ethanol (Et OH) or acetaldehyde (Ac-CHO) were studied immunohistochemically and by scanning electron microscopy. After a 6 hour incubation in the Et-OH added medium, the MT cables stained by indirect immunofluorescence had clearly decreased, in the same way as cells that had been cold-treated for 3 hours. These MT changes parallelled changes in the Ac-CHO levels in the medium. In the Ac-CHO added medium, the MT cables exhibited change within 3 hours. In the Et-OH and 4-methyl pyrazole added medium, Et-OH and Ac-CHO levels, and MT cables did not change during a 24 hour observation period. A decrease in hepatic MT was also confirmed by scanning electron microscopy. These results indicated that acute administration of Et-OH resulted in a decrease of hepatic MT. However, the effect was attributable to Ac CHO and not to Et-OH itself. PMID- 3322309 TI - Extent and costs of alcohol problems in employment: a review of British data. AB - In Britain about 9% of males experience alcohol problems at work. Although heavy drinkers have a higher rate, the majority of work problems occur in light or moderate drinkers as these are more numerous. Some data are given on impairment of skills, hangover rates, alcohol-related accidents and lunchtime drinking. Due to extrapolation from the present limited data, there are great difficulties in calculating economic costs; estimates have varied from pounds 60 million to pounds 2 billion a year. In view of the human and economic costs a number of bodies are now making efforts to encourage alcohol policies in the workplace. Further research is required on many aspects of the problem. PMID- 3322311 TI - Visual evoked potentials and alcohol-induced brain damage. PMID- 3322310 TI - Palmitoyl-catechin for alcoholic liver disease: results of a three-month clinical trial. AB - A prospective randomized double-blind trial of 3-palmitoyl-(+)-catechin at a dose of 1500 mg daily (500 mg t.d.s.) for 3 months vs placebo has failed to demonstrate statistically significant clinical, biochemical or histological benefit in patients with biopsy-proven alcoholic liver disease. Nevertheless, this trial has confirmed the beneficial effect of a reduction in the rate of alcohol consumption on alcoholic liver disease. Apart from clinical evidence of a higher rate of alcohol consumption by patients receiving the active drug during the trial, no adverse side-effects were identified and for this reason, it is suggested that a further trial should be considered with the daily dosage so far used in man (20 mg/kg) increased toward that (100 mg/kg) employed with benefit in animal experiments. PMID- 3322312 TI - Alcohol problems of the elderly. PMID- 3322314 TI - [Plasma levels of copper and the number of neutrophils in the initial treatment of malnutrition]. PMID- 3322313 TI - [Bacteriology and response to treatment with erythromycin-sulfisoxazole in children with acute otitis media]. PMID- 3322315 TI - [Congenital syphilis. Presentation of 50 cases]. PMID- 3322316 TI - [Physiological bases of the composition of an oral rehydration solution in children with acute diarrhea]. PMID- 3322317 TI - [Haemophilus influenzae infections. Current problem in pediatrics]. PMID- 3322318 TI - [Pregnancy in patients with nephrotic syndrome in remission since childhood]. PMID- 3322319 TI - Pair-feeding of sham-operated controls to rats with dorsomedial hypothalamic lesions: new evidence for an 'organismic' set point. AB - Weanling male Sprague-Dawley rats received electrolytic lesions in the dorsomedial hypothalamic nuclei (DMNL rats) and sham operations, respectively, and were maintained on lab chow ad libitum for 23 days (Expt. 1) and 55 days (Expt. 2). Following this period, one group of sham-operated controls was pair fed to the DMNL rats, which were hypophagic compared to a second sham-operated group that was fed ad libitum. This period lasted 27 days (Expt. 1) and 24 days (Expt. 2). Although pair-fed controls were heavier than DMNL rats, they showed normal food utilization (EFU) in Expt. 1 and reduced EFU in Expt. 2. Pair-fed controls also had decreased carcass fat, hypoglycemia, hypoinsulinemia, hypotriglyceridemia and enhanced in vitro epididymal fat pad glucose oxidation when compared to DMNL rats. These data suggest that pair-fed controls cannot cope as efficiently with the reduced influx of substrate as do DMNL rats. Evidently, the reduced amount of food that DMNL rats spontaneously eat is adequate for their reduced body size, whereas this is not the case in the pair-fed controls. This is taken as evidence for a harmonious readjustment by DMN lesions of both body size and food intake and the underlying homeostatic processes and supports our concept of an 'organismic' set point that has been released by the DMN lesions. PMID- 3322320 TI - Defective LDL receptors that are common in a large population. Familial hypercholesterolaemia in South Africa. PMID- 3322321 TI - Factors limiting the hydrolysis of casein by subtilisin DY. AB - It was shown that during the subtilisin DY-induced hydrolysis of casein relatively stable polypeptide structures are formed. In their interior these structures contain peptide bonds which are susceptible to the enzyme used. Heating (up to 100 degrees C) and/or application of ultrasound (25 kHz, 60 W) results in their unfolding. Data are provided, which show that under the enzyme substrate complex formation does not lead to an enzyme conformation more susceptible to autolysis. Taking into account the described phenomena a higher degree of hydrolysis was attained in comparison to those obtained by standard enzymatic hydrolysis. PMID- 3322322 TI - Tissue kallikrein and bradykinin do not have direct insulin-like actions on skeletal muscle glucose utilization. AB - Studies suggest that the actions of insulin on glucose metabolism may be mediated through activation of a membrane-bound serine protease with properties similar to a kallikrein-like enzyme. Also, bradykinin, a vasoactive product of kallikrein's action upon kininogen substrates, increases glucose uptake when infused into the human forearm. To determine whether a kallikrein or a kinin directly affects cellular glucose metabolism or participates in mediating insulin's actions, we studied their effects on isolated rat soleus muscle. Although trypsin (1.34 microM) increased incorporation of glucose into muscle glycogen to the same extent as insulin (200 mu units/ml), a purified rat tissue (urinary) kallikrein (0.4-1.34 microM) produced no such effect. Furthermore, the tissue kallikrein inhibitor, aprotinin, or a polyclonal kallikrein antiserum did not inhibit the action of insulin on incorporation of glucose into muscle glycogen. Treatment of the muscle preparation with bradykinin (1nM - 10 microM) did not result in any change in basal or insulin-stimulated (20 - 2000 mu units/ml) entry of glucose into glycogen or the glycolytic pathway. Bradykinin (1nM - 10 microM) also did not influence basal or insulin-stimulated (1000 mu units/ml) initial rates of glucose transport. These studies suggest that the previously observed in vivo effects of bradykinin on peripheral glucose uptake are probably mediated by changes in tissue perfusion rather than direct kinin effects on skeletal muscle, and that the putative membrane serine protease involved in the insulin-effector system is not tissue kallikrein. PMID- 3322323 TI - [Structural and functional status of the adrenal cortex in patients with arterial hypertension (comparison of computerized-tomographic and clinico-biochemical data)]. PMID- 3322324 TI - [Pathogenesis of vasoplastic stenocardia: the role of arteriosclerosis and the endothelium]. PMID- 3322325 TI - Analysis of membrane processes for blood purification. AB - Physical phenomena play an important role in membrane processes for blood purification. They largely determine the separation performance of these devices and they interact with chemical and biological phenomena to determine their biocompatibility, or lack thereof, in the clinical setting. In the first part of this paper, analyses of physical phenomena which determine the separation and purification characteristics are reviewed for several processes, including hemodialysis, hemofiltration, combined hemodialysis and ultrafiltration, and membrane plasmapheresis with cross-flow microfiltration. Special attention is given to transport of high-molecular weight solutes in hemodialysis, for use in subsequent analyses, and to the factors which determine filtrate flux in membrane plasmapheresis, because recent findings in this area provide an understanding of filtration processes in general. The second part concerns the problem of biocompatibility, especially as manifested in renal prostheses. After reviewing some of the pathways to bioincompatibility, exploratory analyses are presented using relatively simple models. The objective of these analyses is to provide an initial quantitative framework for examining the likelihood of monocyte secretion of interleukin-1 being stimulated by various routes. Issues examined, for which illustrative calculations are presented, include (1) transport of endotoxin fragments across regenerated cellulose and other membranes, (2) anaphylatoxin C5a concentrations in conventional hemodialysis and (3) the effects of equilibrium and reaction phenomena, ultrafiltration, diffusive membrane permeation and membrane adsorption on the disposition of C5a which is generated at the membrane surface. PMID- 3322326 TI - Isolation and characterization of monoclonal antibodies to proline dehydrogenase from Escherichia coli K-12. AB - The PutA protein of Escherichia coli K-12 serves as both proline dehydrogenase and the repressor controlling the expression of genes putP and putA. Thirty-eight hybridoma cell lines were isolated using mice immunized with proline dehydrogenase purified from a bacterial membrane extract. The monoclonal antibodies secreted by those cells showed varying affinities for proline dehydrogenase by enzyme-linked immunosorbent assay (ELISA). Nine antibodies labelled the PutA protein in Western blots after sodium dodecyl sulfate- polyacrylamide gel electrophoresis and two of the five tested also labelled the undenatured PutA protein. Three antibodies bound proteins present in a peripheral membrane protein fraction from both putA+ bacteria and a putA::Tn5 mutant strain. Urea denaturation eliminated the proline:2,6-dichloroindophenol (DCIP) oxidoreductase activity, but did not alter the immunoreactivity of the PutA protein. Tween 20, which caused 1.8-fold increases in Km (proline) and Vmax for proline:DCIP oxidoreductase, increased the avidity of the antibody from hybridoma line 2.1C10.3 fivefold. The antibodies from hybridoma lines 2.1C10.2, 1.2C10.3, and 1.1B07.1 were shown by electron microscopy of immunogold-labelled preparations or by ELISA to bind the membrane-associated PutA protein, whereas those from hybridoma lines 2.1A08.2 and 1.4C09.1 failed to recognize that antigen form. These antibodies will serve as probes of the relationships among protein domain, conformation, and function for the PutA protein. PMID- 3322327 TI - Effects of ribosome dissociation on the structure of the ribosome-associated 5.8S RNA. AB - Diethyl pyrocarbonate reactivity and thermal denaturation were used to probe potential ribosomal interactions between tRNA and the small 5.8S and 5S rRNAs. Puromycin, an analogue of the terminal aminoacyl-adenosine portion of aminoacyl tRNA, was observed to increase the accessibility of the 5.8S rRNA, including the highly conserved GAACp sequences. EDTA which releases both tRNA and the 5S rRNA protein complex resulted in an even greater accessibility in the 5.8S rRNA. The thermal dissociation of whole ribosomes resulted in the release of all three RNAs, with a striking similarity in the denaturation profiles. These results strongly suggest an interdependence in the ribosome-associated structures of the small rRNAs and provide in situ evidence for the various 5S rRNA, 5.8S rRNA, and tRNA containing ribonucleoprotein complexes previously reconstituted through affinity chromatography. PMID- 3322328 TI - The involvement of mRNA secondary structure in protein synthesis. AB - Translation initiation in eukaryotes is a complex process involving many factors. A key step in this process is the binding of mRNA to the 43S preinitiation complex. This is generally the rate-limiting step in translation initiation and consequently a major determinant of mRNA translational efficiency. The primary and secondary structure of the mRNA 5' noncoding region have been implicated in modulating translational efficiency. Translational efficiency was shown to be inversely proportional to the degree of secondary structure at the mRNA 5' noncoding region. Furthermore, it was shown that cap-binding proteins that interact with the 5' cap structure (m7GpppN) of eukaryotic mRNAs are involved in the "unwinding" of the mRNA secondary structure, in an ATP hydrolysis mediated event, to facilitate ribosome binding. Thus, cap-binding proteins can potentially regulate mRNA translation. Here, we discuss the available data supporting the notion that eukaryotic 5' mRNA secondary structure plays an important role in translation initiation and the possible regulation of this process. PMID- 3322329 TI - Review of recent epidemiological studies of mental retardation: prevalence, associated disorders, and etiology. AB - Recent epidemiological studies of mental retardation were critically reviewed. Data pertaining to prevalence, associated disorders, and etiology were examined. The prevalence both of severe and of mild retardation is generally found to be 3 to 4 per 1,000, although estimates vary with gender, age, and method of ascertainment (e.g., data derived from total population screening yield even higher rates). A wide range of disorders were found to be associated with mental retardation. The etiology of up to 50% of cases was unknown. Of those remaining, prenatal factors were implicated about twice as often as peri- or postnatal factors. Discussion was focused on the implications of current findings for future research. PMID- 3322331 TI - Clinical significance of glucocorticoid receptors in acute leukaemia. Preliminary observations in Hungary and review of the literature. AB - Glucocorticoid receptor (GR) levels were quantitated in leukaemic blast cells separated from peripheral blood of 15 children with acute lymphocytic leukaemia (ALL) and of 6 children with acute non-lymphocytic leukaemia (ANLL). Using a whole-cell assay, it was found that specific (3H)-dexamethasone binding exhibited a wide range in both types of acute leukaemia: GR levels scattered between 0 22,346/cell and 0-8772/cell in ALL and ANLL patients, respectively. In this paper we discuss our observations together with current knowledge on GR levels in leukaemic blast cells and their relationship to glucocorticoid sensitivity and disease outcome. PMID- 3322330 TI - Male breast carcinoma. II. A study of the total material reported to the Swedish Cancer Registry 1958-1967 with respect to treatment, prognostic factors and survival. AB - The complete material of male breast cancer, 166 cases, reported to the Swedish Cancer Registry in 1958-1967 is described and analyzed concerning different prognostic parameters, treatment methods and survival. Age at diagnosis, axillary lymph node status and tumour size all had significant prognostic importance in a multivariate analysis with axillary lymph node status as the strongest factor. Histologic malignancy grade was strongly correlated to axillary lymph node status and tumour size and thus to prognosis, but did not seem to be an independent prognostic factor. The primary treatment methods were quite heterogeneous and were obviously influenced by both age of the patient and clinical tumour status. No significant correlation was found between type of primary treatment and survival, but due to the retrospective nature of the study no definite conclusion could be drawn. Radical mastectomy seemed, however, to give fewer loco-regional recurrences than both modified radical mastectomy and simple mastectomy. Very few patients in the present series had received radiation therapy in adequate doses. The material gave some indications that orchiectomy might prolong survival in patients with recurrent or generalized disease. PMID- 3322332 TI - Partial deletion of short arm of chromosome 8. AB - 46, XY, del(8) (p21-pter) aberration was found in a 5 year old boy with moderate craniofacial dysmorphia, mental and somatic retardation. The cytogenetic and clinical features of the patient were compared to 11 cases found in the literature. Partial 8p monosomy does not produce a unique phenotypic alteration. Postnatal growth deficiency, craniofacial dysmorphia and mental retardation are the main and common characteristics of many structural autosomal aberrations. The importance of cytogenetic analysis in such cases is stressed. PMID- 3322333 TI - [An autopsy case of neurocutaneous melanosis associated with intracerebral malignant melanoma]. AB - The authors reported the clinical course and the postmortem examination of a unique case of neurocutaneous melanosis with numerous anomalies and complications, which included congenital dislocation of lenses, hypogonadism, ectopia of prostatic duct, genuine phimose, retentio testis, psina bifida and neurogenic bladder. This 13-year-old boy with a large hairy nevus in a bathing trunk configulation and multiple small nevi over the whole body since his birth was admitted to our hospital for evaluation of headache and vomiting. Neurological examination showed bilateral papilledema and slight left hemiparesis. A CT scan revealed a large right frontal mass and craniotomy was performed with subtotal removal of this tumor which was confirmed as a malignant leptomeningeal melanoma. He initially made uneventful postoperative recovery, and two courses of chemotherapy with DTIC, ACNU and VCR were given; however, the currence of brain tumor ensued shortly thereafter, and he died in approximately six months after the onset of intracranial symptoms despite of the third course of chemotherapy. Thirty five cases of neurocutaneous melanosis associated with or without malignant melanoma have been reported in Japan. Twenty-eight cases were male and 7 female. Two cases showed the evidence of primary malignant melanoma outside of the central nervous system, whereas twenty eight leptomeningeal melanoma, in which 22 were solid and 6 diffuse, were shown intracranially. Other 5 cases had epileptic seizure and/or hydrocephalus caused by wide spreaded leptmeningeal melanosis. This high incidence of intracranial malignant melanoma in this disorder was remarkable compaired with the previous reports in other countries. Mean duration between deaths and the onset of symptoms of intracranial hypertension or focal neurological signs was 7 months, ranging from 1 to 24 months, showing the rapidly deteriorating course in this disorder.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322334 TI - Moment in history. The Committee. PMID- 3322335 TI - Bacterial vaccines and local immunity. Proceedings of Sclavo International Conference. Siena, Italy, 17-19 November 1986. Dedicated to Professors Rene Germanier and Mario Saletti. PMID- 3322336 TI - Synthetic peptides of Shiga toxin B-subunit induce antibodies which neutralize the biological activities of the toxin. PMID- 3322337 TI - Attenuated salmonellae as vaccines and carriers of foreign antigens. PMID- 3322338 TI - Assessment of antibody screening in selection of subjects for field trials of Shigella vaccines. PMID- 3322339 TI - Prospects for polysaccharide-protein conjugate vaccines. PMID- 3322340 TI - Studies of the interaction of antibody and complement with encapsulated bacteria. PMID- 3322341 TI - Local and systemic immunity after typhoid vaccines. PMID- 3322343 TI - Clinical and field trials to assess the efficacy of vaccines against bacterial enteric infections. PMID- 3322342 TI - Synthetic peptides protect against infection in a model of experimental pyelonephritis in mice. PMID- 3322344 TI - T cell networks for regulation of the mucosal immune system. PMID- 3322345 TI - Immunity in the gastrointestinal and respiratory tracts. PMID- 3322346 TI - A survey of the sizes of full porcelain veneer crown preparations. PMID- 3322347 TI - Reinforcement of aluminous dental porcelain crowns using a platinum alloy preformed coping technique. PMID- 3322348 TI - The durability of fissure sealants placed in children attending a dental hospital. PMID- 3322349 TI - Badges of the dental profession. BDA Northern Ireland branch. PMID- 3322351 TI - Randomised crossover trial of rate responsive Activitrax and conventional fixed rate ventricular pacing. AB - Atrial tracking pacemakers may improve exercise capacity and symptoms because they maintain atrioventricular synchrony and preserve the physiological response of heart rate to exercise. A rate responsive pacemaker which reacts to physical activity may be effective in patients with sinus node disease who are unsuitable for VDD pacing. At least three months after implant a double blind randomised short and long term crossover study was performed in ten patients with complete heart block: block was present at rest and during exercise on a modified Bruce protocol. Symptoms were assessed on a visual analogue scale and exercise capacity (maximal oxygen consumption and anaerobic threshold) was measured during rate responsive (peak rate 125/min) and conventional fixed rate (VVI) pacing (70/min). One month after randomisation treadmill exercise was performed. The mode was then changed to the other pacing mode and exercise was repeated three hours later. After another month the process was repeated but in the reverse order. During long term assessment there was subjective improvement in the sensation of breathlessness with rate responsive pacing. During short term assessment maximal oxygen consumption increased and the benefit was maintained during long term rate responsive compared with long term VVI pacing; oxygen consumption at the anaerobic threshold was similarly improved. Activity detecting rate responsive pacing is better than fixed rate ventricular pacing in patients with complete atrioventricular block. PMID- 3322350 TI - The role of exercise testing in chronic heart failure. PMID- 3322352 TI - Treatment of angina pectoris with nifedipine: a double blind comparison of nifedipine and slow-release nifedipine alone and in combination with atenolol. AB - The relative efficacy of nifedipine and slow-release nifedipine (Adalat Retard) in the treatment of stable exertional angina pectoris was evaluated in a double blind randomised crossover study in eight patients on no concomitant antianginal treatment and in 10 patients who were additionally on atenolol. Patients were assessed by angina diaries and exercise testing. Slow-release nifedipine was as effective as nifedipine in the treatment of these patients, both alone and in combination with atenolol. PMID- 3322353 TI - The relevance of control histology in oestrogen receptor estimation. PMID- 3322354 TI - Clonogenic growth and hormone sensitivity of benign and malignant breast tissues. PMID- 3322355 TI - Stress induced periosteal changes. AB - The tails of Sprague-Dawley rats of approximately 50 g body mass were either left straight or bent to form a loop containing three or five vertebrae (CV). Subsequent treatment was as follows: (a) in situ: segments were removed at 0, 8, 16, 24 h, 3, 5 and 7 days and examined histologically: (b) transplants: skinned segments were transplanted autologously and examined at the same time intervals; (c) normal saline: skinned segments were placed in a 0.9% solution maintained at (i) 4 degrees C and (ii) 37 degrees C and examined 8, 16 and 24 h later. The results show that on bending a bone in situ the remodelling which occurs reflects the displacement of the soft tissues, and more specifically the periosteum, towards or away from the bone surface. Functionally the developing periosteum consists of three zones and when stressed its fibroelastic component moves away from or towards the osteogenic layer either applying tension to it stimulating bone formation, or pressure eventually inducing bone resorption. These changes are mediated via the mid-zone. The effects on the fibroelastic component alone are best seen in transplants or in normal saline at 37 degrees C where the osteogenic layer dies. The periosteum in growing bones is ideally structured to respond rapidly and sensitively to altered strain by initiating adaptive surface remodelling of bone. PMID- 3322357 TI - The treatment of Pthirus pubis infestation of the eyelashes. PMID- 3322356 TI - A monoclonal antibody (HO-No-1) with specificity for a human nucleolar protein. AB - A murine monoclonal antibody (named HO-No-1) which specifically reacts with a target antigen of 72,000 mol. wt (p72) in the nucleoli of human cells, has been isolated. Using an avidin-biotin peroxidase immunoperoxidase method, it was found that this antibody stains exclusively the nucleolus and not other portions of the nucleus and cytoplasm. This reaction pattern was observed consistently, although to different degrees in 14 human normal tissues and human malignant cell lines. However, after pretreatment with actinomycin D (250 ng/ml) for 2 h, the antibody stains the nucleoplasm uniformly. Thus this study demonstrates evidence for an antibody which reacts specifically with human nucleoli to a protein which could play an important role in rRNA synthesis. PMID- 3322358 TI - The effect of captopril on cutaneous blood flow in patients with primary Raynaud's phenomenon. AB - Fifteen patients with primary Raynaud's phenomenon received captopril 25 mg or placebo, three times daily for 6 weeks, in a randomized double-blind cross-over study. Compared with placebo, captopril produced a significant improvement in cutaneous blood flow but did not alter the frequency or severity of attacks of Raynaud's phenomenon. PMID- 3322359 TI - Ultrasound transmission time: an in vivo guide to nail thickness. AB - Human fingernail thickness was measured distally in 39 subjects using an adapted electronic micrometer and ultrasound transmission time was measured both distally and proximally. Distal ultrasound nail transmission time correlated well with micrometer measurements. There was a clear rank order of distal and proximal nail transmission times: thumb greater than index greater than middle greater than ring greater than little fingers. Male nails had greater transmission times than female nails on the ring and little fingers. Distal nail transmission time was 8.8% less than proximal transmission time. PMID- 3322360 TI - Risk factors for acute graft-versus-host disease. AB - Acute graft-versus-host disease (GvHD) is an important complication of bone marrow transplantation in humans. Risk factors are imprecisely defined and controversial. We analysed data from 2036 recipients of HLA-identical sibling transplants for leukaemia or aplastic anaemia to identify risk factors for GvHD. Analyses indicate that grading of GvHD can be reproducibly divided into absent or mild versus moderate to severe; 2-year actuarial probability was 54% (95% confidence interval 52-56%) for absent or mild and 46% (44-48%) for moderate to severe. Factors predictive of development of moderate to severe GvHD include donor/recipient sex-match (female----male greater than others, relative risk 2.0, P less than 0.001). This risk was markedly increased if female donors for male recipients were previously pregnant or transfused (relative risk 2.9, P less than 0.0001). Older patients were at increased risk of GvHD (relative risk 1.6, P less than 0.001), but the age gradient was modest, even the youngest patients had a substantial risk of GvHD and, if parous or transfused female----male transplants were excluded, age was not a significant risk factor. Cyclosporine or methotrexate were equally effective at preventing GvHD and were superior to no prophylaxis (relative risk 2.3, P less than 0.01). These data should be useful in estimating the risk of acute GvHD in an individual patient and in designing clinical trials to investigate methods to modify or prevent GvHD. PMID- 3322361 TI - The effect of total body irradiation and bone marrow transplantation during childhood and adolescence on growth and endocrine function. AB - Seventeen children (11 M, 6 F) with acute leukaemia and myeloproliferative disorders were investigated for growth and endocrine dysfunction. All had undergone bone marrow transplantation prepared with cyclophosphamide and single fraction total body irradiation (900-1000 cGy) between 1.5 and 3.8 (mean 2.2) years previously. The majority of children exhibited growth failure, which was of multiple aetiology. Ten patients, of whom eight had had previous prophylactic cranial irradiation, had evidence of growth hormone deficiency based on the reduced growth hormone response to insulin induced hypoglycaemia. Three patients had evidence of hypothalamic damage as shown by their growth hormone response to 200 micrograms GHRH (1-29) NH2 intravenously. Gonadal failure was common, assessed clinically, and biochemically by basal gonadotrophin and sex steroid concentrations. All four girls of adolescent age (10.6-14.1 years) had ovarian failure requiring sex steroid replacement. Of the eight boys of adolescent age (12.3-18.3 years), two had testicular failure requiring sex steroid supplements. Both of these had had previous testicular irradiation. Five others had compensated gonadal failure, and one had normal Leydig cell function. Abnormalities of the TSH response to TRH occurred in 10 patients but only three had overt hypothyroidism. Unlike growth hormone deficiency, gonadal and thyroid dysfunction showed no correlation with previous cranial radiotherapy. PMID- 3322363 TI - High dose melphalan and autologous bone marrow transplantation in high risk myeloma. PMID- 3322362 TI - Reduced erythrocyte survival following clearance of malarial parasitaemia in Thai patients. AB - Erythrocyte survival times were measured in healthy Thai controls and in patients following clearance of asexual P. falciparum or P. vivax parasitaemia. In five controls the mean cell life (MCL) of compatible donor erythrocytes was 89.6 d (mean range 73-101 d) compared with a mean MCL of 56.8 d (range 30-66 d) for autologous erythrocytes in 12 falciparum patients. In one of these patients the survival curve was biphasic with a rapid loss of some labelled cells. The survival of compatible donor erythrocytes was also studied in 10 patients and two types of survival curve could be distinguished. In five patients the cells had a mean MCL of 64.4 d (range 42-90 d). In the others survival curves were curvilinear, suggesting a complex mechanism of cell clearance or the presence of more than one cell population. There was initially a more rapid rate of destruction. In P. vivax malaria the MCL of autologous erythrocytes in seven patients was a mean of 67.2 d (range 34-74 d) and that of compatible donor cells in six patients was 66.8 d (range 54-76 d). In all except one of these patients both autologous and donor cell survival curves could be fitted to straight lines. No increase in cell-bound IgG or C3 was evident in 12 patients tested. The differences between the mean MCL in all the groups of patients and the controls were statistically significant at the 5% level. This indicates an increased rate of erythrocyte destruction following clearance of P. falciparum or P. vivax parasites which is not antibody or complement mediated. The mechanism is unknown, but appears to be extrinsic to the erythrocytes themselves and may result from nonspecific activation of the reticuloendothelial function associated with the parasitic infection. PMID- 3322364 TI - On describing mental states. AB - The later work of Wittgenstein was a major contribution to the philosophy of mind. One theme in his writings was a critique of the assumption that reports of psychological experience in ordinary language can be regarded as descriptions of inner states and processes. Some implications of this critique for our understanding of descriptive psychopathology and the use of psychological models in psychiatry are examined. PMID- 3322365 TI - Formulating and evaluating hypotheses in psychoanalytic psychotherapy. AB - Little psychoanalytic literature exists dealing with the formulation and evaluation of hypotheses in the therapeutic situation. This paper is an initial exploration and systematization of criteria presently in use. Hypothesis formation is discussed in terms of the accumulation of data and its recontextualization. Then follows an account of prevalidation, the silent evaluation of an hypothesis. Before an hypothesis can be turned into an intervention considerations of spoken form, order and timing must be taken into account. Finally, after intervening, post-validation can occur: the evaluation of the hypothesis on the basis of the patient's responses. PMID- 3322366 TI - Combined Doppler and echocardiographic measurement of cardiac output: theory and application in pregnancy. AB - A non-invasive technique for the measurement of cardiac output in pregnancy by combined cross-sectional and Doppler echocardiography at three intracardiac sites is described. The validity of the technique for use during pregnancy is reviewed. Comparison with cardiac output determined simultaneously by the direct Fick technique in 15 non-pregnant subjects showed close agreement for all three measurement sites. Acceptable measurements were obtained from the aortic and pulmonary valves in all pregnant subjects and from the mitral valve in 84% of pregnant subjects. The within-patient intra-observer and hour-to-hour variabilities of cardiac output in pregnant and non-pregnant subjects were less than 5% of the mean for all three valves studied. Flow measurements at each of the three intracardiac sites correlated closely. The advantages and limitations of the technique for use during pregnancy are discussed. PMID- 3322367 TI - Haemodynamic changes during the puerperium: a Doppler and M-mode echocardiographic study. AB - Serial haemodynamic investigations were performed in 15 women at 38 weeks gestation and then 2, 6, 12 and 24 weeks after delivery. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic, pulmonary and mitral valves. Cardiac chamber size and ventricular function were investigated by M-mode echocardiography. Flow measurements at the three intracardiac sites correlated closely. Cardiac output fell from a mean of 7.42 l/min at 38 weeks to 4.96 l/min at 24 weeks after delivery, a fall of 33%. Most of this decrease (28%) had occurred by 2 weeks. This was associated with a 20% reduction in heart rate and an 18% reduction in stroke volume. By 2 weeks after delivery there was a significant decrease in left atrial dimension and left ventricular end-diastolic dimension. Left ventricular wall thickness and mass declined throughout the period of study as did aortic, pulmonary and mitral valve areas. M-mode derived indices of myocardial contractility were all significantly reduced by 2 weeks and thereafter showed no further change. No haemodynamic differences were found between lactating and non-lactating mothers. PMID- 3322368 TI - Inhibition of uterine contractions of premature labour with an oxytocin analogue. Results from a pilot study. AB - A competitive inhibitor of the action of oxytocin on the uterus, 1-deamino-2-D Tyr-(OEt)-4-Thr-8-Orn-oxytocin, was studied for the first time in 13 patients with established, uncomplicated premature labour. Intravenous infusion of 10-100 micrograms/min of the analogue was given for 1-10 h and the effect was monitored by external cardiotocography. In all women an inhibition of uterine activity was observed, and in the majority of patients infused with 25 micrograms/min and a total dose of about 5 mg or more of the drug total inhibition of uterine contractions was achieved. There were no effects on the maternal and fetal pulse rates, nor were there any other side-effects. The results of this preliminary study support the concept of an increased concentration of uterine oxytocin receptors being aetiologically important in uncomplicated premature labour. They also suggest that the present oxytocin antagonist could be an interesting therapeutic alternative in the condition, primarily because of the marked selectivity of its effect. PMID- 3322370 TI - Plasma renin activity and cAMP in termination of pregnancy induced by sulprostone. PMID- 3322369 TI - Doppler ultrasound assessment of fetal and uteroplacental circulations in severe second trimester oligohydramnios. AB - Doppler blood flow studies in 41 pregnancies with oligohydramnios in the second trimester found abnormal patterns in all 14 pregnancies with intrauterine growth retardation but in only one of nine pregnancies with premature rupture of the membranes, and one of 10 with fetal renal defects. Mixed patterns were found in a heterogeneous group of fetuses with other malformations or intrauterine infection. Unlike previous reports a diagnosis was achieved in all pregnancies, suggesting that Doppler studies should be an integral part of the antenatal investigation in such pregnancies. PMID- 3322371 TI - The safety of diagnostic ultrasound. PMID- 3322373 TI - Uterine artery blood velocities during contractions in pregnancy and labour related to intrauterine pressure. AB - Doppler recordings from branches of the uterine artery were made simultaneously with intrauterine pressure measurements in eight women in labour. Blood velocities fell and pulsatility index (PI) increased during all 22 contractions studied. Velocities were reduced almost linearly by up to 60% when pressure increased from 0 to 50 mmHg. To study the effect of uterine contractions before labour on uterine blood flow, simultaneous Doppler recordings from branches of the uterine artery and external tocodynamometry were made in seven women during the last trimester. Velocities fell during 18 of the 20 contractions studied (median 35%, range 19-71%). Extrapolating from labour contractions, this corresponds to a pressure increase of 30-40 mmHg. Fetal heart rate (FHR) recordings were normal during all contractions. PMID- 3322374 TI - Production of prostacyclin, 6-keto-PGF1 alpha and thromboxane B2 by human umbilical vessels increases from the placenta towards the fetus. AB - The aim of this study was to investigate the production of prostacyclin (PGI2) and thromboxane B2 (TXB2) by incubated samples of umbilical arteries and veins taken at different distances (2, 10, 20, 30 cm) from the placenta to provide additional information relevant to the haemodynamics of umbilical blood flow. The production of PGI2, and 6-keto-PGF1 alpha (the stable metabolite of PGI2), was higher in both veins and arteries as the distance from the placenta at which the vessels were sampled was increased. A similar correlation between production by venous rings and distance from the placenta was observed for TXB2, but there was no apparent gradient of TXB2 production by the samples of arterial rings. No statistically significant variations were discernible in the ratio of 6-keto-PGF1 alpha:TXB2 (approximately 50 in the veins and approximately 20 in the arteries) in relation to the sampling distance. The significance of these high ratios is discussed in relation to umbilical blood flow and fetal well-being and development. PMID- 3322372 TI - Incidence and aetiology of hydatidiform mole: an epidemiological review. AB - Epidemiological investigation of the incidence and aetiology of hydatidiform mole (HM) is receiving increasing attention. Recent, population-based studies suggest that earlier reports of a very high incidence of HM in Asia, Africa and South Central America may have been exaggerated, due primarily to selection bias in patients studied at university hospitals. Japanese population studies indicate a two-fold higher rate of HM compared with Caucasian rates but Chinese rates appear to be similar. Population studies presently available suggest a worldwide range of HM somewhere between 0.5 and 2.5/1000 pregnancies. When deliveries form the rate denominator the rates are somewhat higher, depending primarily on the national rate of induced abortions. The independent effects on incidence of geographic locale, ethnicity and socio-cultural factors have not been adequately disentangled although the genetic studies suggest ethnicity might be the predominant variable. Maternal age is the most consistently demonstrated risk factor; teenagers and, especially, women over age 35 being at increased risk. The independent effects of paternal age and pregnancy history are not established. Women with a history of one HM seem to have a ten-fold risk of repeat HM compared with women who have no history of HM. Aetiological studies have not revealed any environmental risk factor for which there is unequivocal agreement about its influence on HM. New case-control studies of HM aetiology must classify HM according to genetic aetiology. Cohort studies are required to explore more fully the relation of HM to malignant sequelae. PMID- 3322375 TI - Effects of subcutaneous oestradiol implants on ovarian activity. AB - The effects of subcutaneous oestradiol implants on ovarian activity were investigated in 14 ovulating premenopausal women. Treatment with either 100 mg or 150 mg oestradiol was combined with cyclical oral norethisterone from days 20 to 26 of the cycle to ensure regular withdrawal periods and prevent endometrial hyperplasia. Ovarian function was monitored by regular pelvic ultrasonography and urinalysis over a period of nine cycles. During the first three cycles after hormone implantation, follicular development continued in almost half the study group, but only one of the women in each treatment group showed signs of follicular rupture and luteinization. By the sixth cycle, over half the women given the lower dose of oestradiol were developing follicles, including a large functional cyst in one, but none of them ovulated. A further implant given early in the seventh cycle was associated with ovarian suppression in all cases. Both doses of implant elevated the excretion of oestrone-3-glucuronide compared to pretreatment. The contraceptive and therapeutic implications of these results are discussed. PMID- 3322376 TI - Progesterone inhibition in mid-trimester termination of pregnancy: physiological and clinical effects. AB - A double-blind, placebo controlled clinical trial was conducted to assess the clinical and physiological effects of 'epostane', a progesterone synthesis inhibitor, in mid-trimester prostaglandin termination of pregnancy. Mean peripheral progesterone levels had fallen by 74% after 72 h in the patients treated wtih epostane. The mean induction-abortion interval in the treatment group was 490 (SD 271) min, compared with 1432 (SD 640) min in the control group. Intrauterine pressure recording demonstrated increased sensitivity to prostaglandin E2 after epostane treatment but no change in oxytocin sensitivity. The clinical implications of facilitated induction of abortion are discussed. PMID- 3322377 TI - How much do we know about the Bohr effect of hemoglobin? PMID- 3322379 TI - Electron microscopy and biochemical properties of polyamine-compacted DNA. AB - We have obtained polyamine-compacted DNA and analyzed it by electron microscopy employing the method described by Dubochet, suitable for the study of complexes in which the main interactions are of ionic character. In addition, we have developed a simple biochemical method, based on the action of pancreatic DNase I, to demonstrate the condensation of DNA with spermidine. DNA-spermidine complexes are resistant to the action of DNase I, and there is a strong correlation between the presence of condensed DNA forms, both as toroids and as cylinders, and the insensitivity to DNase I activity. We have also shown that pBR322 DNA-spermidine complexes are transcriptionally active in the presence of Escherichia coli RNA polymerase. This supports the data concerning the biological activity of spermidine-condensed DNA. PMID- 3322378 TI - ADP-ribosylation by cholera toxin: functional analysis of a cellular system that stimulates the enzymic activity of cholera toxin fragment A1. AB - We have clarified relationships between cholera toxin, cholera toxin substrates, a membrane protein S that is required for toxin activity, and a soluble protein CF that is needed for the function of S. The toxin has little intrinsic ability to catalyze ADP-ribosylations unless it encounters the active form of the S protein, which is S liganded to GTP or to a GTP analogue. In the presence of CF, S.GTP forms readily, though reversibly, but a more permanent active species, S guanosine 5'-O-(3-thiotriphosphate) (S.GTP gamma S), forms over a period of 10-15 min at 37 degrees C. Both guanosine 5'-O-(2-thiodiphosphate) and GTP block this quasi-permanent activation. Some S.GTP gamma S forms in membranes that are exposed to CF alone and then to GTP gamma S, with a wash in between, and it is possible that CF facilitates a G nucleotide exchange. S.GTP gamma S dissolved by nonionic detergents persists in solution and can be used to support the ADP ribosylation of nucleotide-free substrates. In this circumstance, added guanyl nucleotides have no further effect. This active form of S is unstable, especially when heated, but the thermal inactivation above 45 degrees C is decreased by GTP gamma S. Active S is required equally for the ADP-ribosylation of all of cholera toxin's protein substrates, regardless of whether they bind GTP or not. We suggest that active S interacts directly with the enzymic A1 fragment of cholera toxin and not with any toxin substrate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322380 TI - Mechanism of substrate inactivation of Escherichia coli S-adenosylmethionine decarboxylase. AB - S-Adenosylmethionine decarboxylase, a pyruvoyl-containing decarboxylase, is inactivated in a time-dependent process under turnover conditions. The inactivation is dependent on the presence of both substrate and Mg2+, which is also required for enzyme activity. The rate of inactivation is dependent on the concentration of substrate and appears to be saturable. Inactivation by [methionyl-3,4-14C]-adenosylmethionine results in stoichiometric labeling of the protein. In contrast, when either S-[methyl-3H]adenosylmethionine or [8 14C]adenosylmethionine is used, there is virtually no incorporation of radioactivity. Automated Edman degradation of the alpha (pyruvoyl-containing) subunit reveals that substrate inactivation results in the conversion of the pyruvoyl group to an alanyl residue. These data suggest a mechanism of inactivation which involves the transamination of the nascent product to the pyruvoyl group, followed by the elimination of methylthioadenosine and the generation of a 2-propenal equivalent which could undergo a Michael addition to the enzyme. This is the first evidence for a transamination mechanism for substrate inactivation of a pyruvoyl enzyme. PMID- 3322381 TI - Ligand binding and protein dynamics: a fluorescence depolarization study of aspartate transcarbamylase from Escherichia coli. AB - The polarization of the fluorescence and the real-time fluorescence intensity decay of the two tryptophan residues of aspartate transcarbamylase from Escherichia coli were studied as a function of temperature. The protein was dissolved in an 80% glycerol/buffer mixture, and temperatures were varied between -40 and 20 degrees C in order to limit the depolarization to local rotations of the tryptophans. Two fluorescent species contribute to over 95% of the emission. They differ in their fluorescence lifetimes by approximately 4 ns depending upon the temperature observed and their fractional contributions to the total intensity. The Y-plot analysis of the polarization and lifetime data allows for the distinction of two rotational species by their critical amplitude of rotation, the first being component 1 and the second being component 2. We suggest that these two species correspond to the two tryptophan residues of the protein. The polarization and lifetime experiments were carried out for ATCase in presence of the bisubstrate analogue N-(phosphonoacetyl)-L-aspartate (PALA) and in presence of the nucleotide effector molecules ATP and CTP. The binding of PALA results in an increase in the thermal coefficient of frictional resistance to rotation of tryptophan 1 and a decrease in that of tryptophan 2. ATP binding does not affect the degree to which the protein hinders tryptophan rotation but does result in a change in the critical amplitude of rotation of tryptophan 2. The results obtained in the presence of CTP are similar to those obtained with PALA. PMID- 3322382 TI - Chemical modification of arginine residues in the lactose repressor. AB - The lactose repressor protein was chemically modified with 2,3-butanedione and phenylglyoxal. Arginine reaction was quantitated by either amino acid analysis or incorporation of 14C-labeled phenylglyoxal. Inducer binding activity was unaffected by the modification of arginine residues, while both operator and nonspecific DNA binding activities were diminished, although to differing degrees. The correlation of the decrease in DNA binding activities with the modification of approximately 1-2 equiv of arginine per monomer suggests increased reactivity of a functionally essential residue(s). For both reagents, operator DNA binding activity was protected by the presence of calf thymus DNA, and the extent of reaction with phenylglyoxal was simultaneously diminished. This protection presumably results from steric restriction of reagent access to an arginine(s) that is (are) essential for DNA binding interactions. These experiments suggest that there is (are) an essential reactive arginine(s) critical for repressor binding to DNA. PMID- 3322383 TI - NMR analyses of the conformations of L-isoleucine and L-valine bound to Escherichia coli isoleucyl-tRNA synthetase. AB - The 400-MHz 1H NMR spectra of L-isoleucine and L-valine were measured in the presence of Escherichia coli isoleucyl-tRNA synthetase (IleRS). Because of chemical exchange of L-isoleucine or L-valine between the free state and the IleRS-bound state, a transferred nuclear Overhauser effect (TRNOE) was observed among proton resonances of L-isoleucine or L-valine. However, in the presence of isoleucyl adenylate tightly bound to the amino acid activation site of IleRS, no TRNOE for L-isoleucine or L-valine was observed. This indicates that the observed TRNOE is due to the interaction of L-isoleucine or L-valine with the amino acid activation site of IleRS. The conformations of these amino acids in the amino acid activation site of IleRS were determined by the analyses of time dependences of TRNOEs and TRNOE action spectra. The IleRS-bound L-isoleucine takes the gauche+ form about the C alpha-C beta bond and the trans form about the C beta-C gamma 1 bond. The IleRS-bound L-valine takes the gauche- form about the C alpha-C beta bond. Thus, the conformation of IleRS-bound L-valine is the same as that of IleRS-bound L-isoleucine except for the delta-methyl group. The side chain of L isoleucine or L-valine lies in an aliphatic hydrophobic pocket of the active site of IleRS. Such hydrophobic interaction with IleRS is more significant for L isoleucine than for L-valine. The TRNOE analysis is useful for studying the amino acid discrimination mechanism of aminoacyl-tRNA synthetases. PMID- 3322384 TI - Solution conformations of N-linked oligosaccharides. PMID- 3322385 TI - Bacterial phosphoenolpyruvate-dependent phosphotransferase system: association state of membrane-bound mannitol-specific enzyme II demonstrated by inactivation. AB - The quaternary structure of the membrane-bound mannitol permease (EIIMtl) of the bacterial phosphotransferase system in Escherichia coli has been investigated in the membrane by using the radiation inactivation method. The experiments reveal two distinct but interconvertible forms of the permease. The first state is a dimer, and the second state consists of a less active higher molecular weight complex involving the dimer. The equilibrium between these two forms in the membrane can be shifted by changing the pH. At pH 8.1 the dimer is the dominant form. Decreasing the pH results in increased binding of a regulatory protein to the dimer, thus increasing the amount of the higher molecular weight form involving the dimer. Cross-linking EIIMtl in situ, followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting, resulted in the formation of two cross-linked forms. One is the dimer, and the other has a higher molecular weight. Two-dimensional electrophoresis using a reversible cross-linker revealed no other protein except EIIMtl in these complexes. PMID- 3322386 TI - A complete cDNA sequence for the major epidermal growth factor binding protein in the male mouse submandibular gland. AB - The complete cDNA sequence of the major epidermal growth factor binding protein (EGF-BP), isolated from the mouse submandibular gland, has been determined. Oligonucleotide probes complementary to unique, nonconserved, regions of homogeneous preparations of EGF-BP were used to identify the correct cDNA clone from a male mouse submandibular gland cDNA library. The nucleotide sequence codes for a glandular kallikrein that is the main arginine esterase complexed with epidermal growth factor. The mRNA coding for this EGF-BP is estimated at 0.24% of the total mRNA of the adult male mouse submandibular gland, thus representing an abundant member of the kallikrein family in this tissue. In addition, the cDNA sequence defines a putative transcription start site. The reported cDNA sequence is clearly different from, and not an allelic form of, a previously reported cDNA sequence for EGF-BP. The present work reconciles conflicting information in the literature regarding the identity of EGF-BP. PMID- 3322387 TI - Mouse glandular kallikrein genes: identification and characterization of the genes encoding the epidermal growth factor binding proteins. AB - Previously, three proteins have been separately identified as the mouse epidermal growth factor binding protein (EGF-BP). We have identified and sequenced the coding regions of three distinct genes encoding these EGF-BPs from the BALB/c strain. The genes are all members of the glandular kallikrein gene family, which encodes a highly homologous group of serine proteases. Expression of the EGF-BP genes was detected in mouse salivary gland only and was at a relatively similar level for each gene. The isolation of three distinct genes from the one mouse strain indicates that the conflicting data previously reported in the literature are not a result of allelic polymorphisms or strain differences. PMID- 3322389 TI - Evidence for nucleotide-mediated changes in the domain structure of the recA protein of Escherichia coli. AB - We have used limited trypsin digestion as a means of investigating changes in the structural properties of recA protein accompanying the binding of different nucleoside triphosphates. The levels of four partial digestion products are greatly increased in digests of recA protein complexed with dTTP, dATP, ATP, or the ATP analogue adenosine 5'-O-(3-thiotriphosphate) (ATP gamma S). These bands (22, 19, and 17.5 kilodaltons) are absent or present at reduced levels in digests of recA protein alone. Unlike these nucleotides, all of which bind tightly to recA protein, nucleotides and analogues that bind poorly produce little or no change in the digestion pattern of recA protein. We have compared the rates of fragment accumulation in the presence of dTTP and show a saturable dependence on nucleotide concentration. Binding of single-stranded DNA to recA protein does not alter the pattern of digestion products compared to protein alone, and the digestion pattern of recA protein-DNA-ATP gamma S ternary complexes is similar to that of uncomplexed enzyme. We have used monoclonal antibody binding, high performance liquid chromatography separation of peptides, and amino acid composition analyses to localize the regions of recA protein which are altered in their susceptibility to trypsin when nucleoside triphosphates are present. The results of these analyses indicate that the fragments arise from trypsin cutting at two or more sites near the middle of the primary sequence. These cleavage sites are more than 80-110 residues away from the site of photoaffinity labeling by 8-N3ATP (Tyr-264). Our results suggest that, in the presence of certain nucleotides, recA protein is organized into two stable structural domains. PMID- 3322388 TI - Replacement of proline-76 with alanine eliminates the slowest kinetic phase in thioredoxin folding. AB - The conformational transition observed upon addition of guanidine hydrochloride (Gdn-HCl) to solutions of oxidized Escherichia coli thioredoxin is dominated by a slow kinetic phase (time constant tau 1 = 300-800 s) that has features appropriate to a proline peptide isomerization. This observation has been interpreted as reflecting a folding pathway involving an obligatory isomerization of the imide peptide bond between isoleucine-75 and proline-76 [Kelley, R. F., & Stellwagen, E. (1984) Biochemistry 23, 5095-5102]; this peptide bond is known to have the cis configuration in the folded state [Eklund, H., Cambillan, C., Sjoberg, B.-M., Holmgren, A., Jornvall, H., Hoog, J.-O., & Branden, C.-I. (1984) EMBO J. 3, 1443-1449]. We have tested this hypothesis by examining the conformational transitions of two thioredoxin mutants, trxA76 having an alanine substituted for proline-76 and trxA2 [Russel, M., & Model, P. (1983) J. Bacteriol. 154, 1064-1070] having proline-34 replaced with serine. Both mutant proteins display far-ultraviolet circular dichroic spectra similar to that of native wild-type thioredoxin. The tryptophan fluorescence emission of native trxA2 is equivalent to that of wild-type thioredoxin, while the emission intensity of native trxA76 at 350 nm is 2-fold greater. Tryptophan fluorescence and peptide ellipticity measurements indicate that the mutant proteins undergo two-state and reversible equilibrium unfolding transitions upon addition of guanidine hydrochloride (Gdn-HCl). These transitions are centered at 2.4 and 1.5 M Gdn-HCl for trxA2 and trxA76, respectively, as compared to a midpoint of 2.5 M denaturant for wild-type thioredoxin. As observed for wild-type thioredoxin, fluorescence measurements reveal monophasic unfolding kinetics for trxA2 at a variety of final denaturant concentrations. The tau for unfolding varies monotonically from 210 s in 2.4 M Gdn-HCl to 7 s for a final Gdn-HCl concentration of 3.5 M. Refolding of denatured trxA2 in 1.5 M Gdn-HCl detected by fluorescence measurements is described by three kinetic phases with time constants and fractional amplitudes (alpha) similar to those of wild-type thioredoxins. The fractional amplitude (alpha 1) of the slowest of these phases, tau 1 = 430 +/- 38 s in 2.0 M Gdn-HCl, decreases with final Gdn-HCl concentration. Multimixing experiments suggest that this phase results from an equilibration between denatured forms and has a tau of 34 s in 4 M denaturant, features previously observed for the wild-type protein.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3322390 TI - DNA repair catalyzed by Escherichia coli DNA photolyase containing only reduced flavin: elimination of the enzyme's second chromophore by reduction with sodium borohydride. AB - DNA photolyase from Escherichia coli contains FAD plus a partially characterized, second chromophore. In vivo, the flavin is fully reduced (FADH2), but oxidation to a stable, blue radical (FADH.) occurs during enzyme isolation. The second chromophore is irreversibly reduced by reaction of the enzyme with sodium borohydride or by photoreduction in the presence of dithiothreitol. A similar reaction occurs with the protein-free chromophore and sodium cyanoborohydride. Reduction of the second chromophore is accompanied by a complete loss of the chromophore's visible absorption and fluorescence but does not significantly affect catalytic activity. The results show that the enzyme can repair dimers by a pathway involving only FADH2. Enzyme-bound FADH2 is fluorescent and exhibits emission (505 nm) and absorption (360 nm) maxima similar to that expected for a 1,5-dihydroflavin derivative. It is proposed that dimer cleavage via the second chromophore independent pathway involves electron donation from excited FADH2 to pyrimidine dimer. Pyrimidine dimer radicals are unstable and spontaneously monomerize. Unmodified second chromophore can also act as a sensitizer in a pathway that requires FADH2. This pathway may be similar to that proposed for the second chromophore independent reaction except that excited FADH2 would be produced via energy transfer from the excited second chromophore. The fluorescence observed for enzyme-bound, unmodified second chromophore is quenched by FADH. and increases 6-fold when the latter is reduced, but the absorption spectrum (lambda max = 390 nm epsilon 390 = 12.7 x 10(3) M-1 cm-1) is independent of the redox state of the flavin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322391 TI - Location of the redox-active thiols of ribonucleotide reductase: sequence similarity between the Escherichia coli and Lactobacillus leichmannii enzymes. AB - The redox-active thiols of Escherichia coli ribonucleoside diphosphate reductase and of Lactobacillus leichmannii ribonucleoside triphosphate reductase have been located by a procedure involving (1) prereduction of enzyme with dithiothreitol, (2) specific oxidation of the redox-active thiols by treatment with substrate in the absence of exogenous reductant, (3) alkylation of other thiols with iodoacetamide, and (4) reduction of the disulfides with dithiothreitol and alkylation with [1-14C]iodoacetamide. The dithiothreitol-reduced E. coli B1 subunit is able to convert 3 equiv of CDP to dCDP and is labeled with 5.4 equiv of 14C. Sequencing of tryptic peptides shows that 2.8 equiv of 14C is on cysteines-752 and -757 at the C-terminus of B1, while 1.0-1.5 equiv of 14C is on cysteines-222 and -227. It thus appears that two sets of redox-active dithiols are involved in substrate reduction. The L. leichmannii reductase is able to convert 1.1 equiv of CTP to dCTP and is labeled with 2.1 equiv of 14C. Sequencing of tryptic peptides shows that 1.4 equiv of 14C is located on the two cysteines of C-E-G-G-A-C-P-I-K. This peptide shows remarkable and unexpected similarity to the thiol-containing region of the C-terminal peptide of E. coli B1, C-E-S-G-A-C K-I. PMID- 3322392 TI - Prediction of a common structural domain in aminoacyl-tRNA synthetases through use of a new pattern-directed inference system. AB - The aminoacyl-tRNA synthetases are united by a common function with little evidence of a common structural relationship. Outside of an 11 amino acid stretch called the "signature sequence", no global primary sequence similarity exists. The signature sequence matches 4-11 amino acids in several aminoacyl-tRNA synthetases. High-resolution X-ray data are available for two of these enzymes, revealing that their signature sequence regions are small segments of a common mononucleotide binding foldlike structure. A new methodology for the analysis of dissimilar primary sequences supports the expectation that all of the signature sequence regions form a common structure. In our analysis, two complex pattern descriptors were constructed to describe the synthetase mononucleotide binding fold. These were compared to primary sequences annotated with predicted secondary structures and hydropathy profiles. Regions in 8 out of 12 (67%) heterologous aminoacyl-tRNA synthetase groups (where each group is specific for the same amino acid) match the first descriptor, and 7 of these (58%) also match the second descriptor. In contrast, only 4 regions in a set of 54 control proteins (7.4%) match the first descriptor, and only 2 regions (3.7%) match both. Alignment of these 8 regions to the descriptor (1) positions all known signature sequence regions as the first loop of a mononucleotide binding foldlike structure, (2) extends the previous alignments by another 40-odd amino acids, and (3) identifies potential sites in 3 out of 6 heterologous aminoacyl-tRNA synthetases with no previous alignments. Potential sites are also proposed for two additional heterologous synthetases on the basis of matches to less specific descriptors. PMID- 3322393 TI - Possible involvement of the A20-A21 peptide bond in the expression of the biological activity of insulin. 1. [21-Desasparagine,20-cysteinamide-A]insulin and [21-desasparagine,20-cysteine isopropylamide-A]insulin. AB - The C-terminal region of the A chain of insulin has been shown to play a significant role in the expression of the biological activity of the hormone. To further delineate the contribution of this segment, we have synthesized [21 desasparagine,20-cysteinamide-A]insulin and [21-desasparagine,20-cysteine isopropylamide-A]insulin, in which the C-terminal amino acid residue of the A chain of insulin, asparagine, has been removed and the resulting free carboxyl group of the A20 cysteine residue has been converted to an amide and an isopropylamide, respectively. Both insulin analogues display biological activity, 14-15% for the unsubstituted amide analogue and 20-22% for the isopropylamide analogue, both relative to bovine insulin. In contrast, a [21-desasparagine A]insulin analogue has been reported to display less than 4% of the activity of the natural hormone [Carpenter, F. (1966) Am. J. Med. 40, 750-758]. The implications of these findings are discussed, and we conclude that the A20-A21 amide bond plays a significant role in the expression of the biological activity of insulin. PMID- 3322394 TI - Possible involvement of the A20-A21 peptide bond in the expression of the biological activity of insulin. 2. [21-Asparagine diethylamide-A]insulin. AB - We have synthesized [21-asparagine diethylamide-A]insulin, which differs from the parent molecule in that the free carboxyl group of the C-terminal amino acid residue, asparagine, of the A chain moiety has been converted to a diethylamide group. The analogue displays equivalent potency in receptor binding and biological activity, 48% and 56%, respectively, relative to bovine insulin. In contrast, we have reported previously [Burke, G. T., Chanley, J. D., Okada, Y., Cosmatos, A., Ferderigos, N., & Katsoyannis, P. G. (1980) Biochemistry 19, 4547 4556] that [21-asparaginamide-A]insulin exhibits a divergence in these properties, ca. 60% in receptor binding and ca. 13% in biological activity. The disparity in the biological behavior of these analogues is discussed, and we ascribe the modulation of biological activity independent of receptor binding activity observed between these analogues to the difference in the negativity of the carbonyl oxygen of the A chain moiety C-terminal amino acid residue. PMID- 3322395 TI - Possible involvement of the A20-A21 peptide bond in the expression of the biological activity of insulin. 3. [21-Desasparagine,20-cysteine ethylamide A]insulin and [21-desasparagine,20-cysteine 2,2,2-trifluoroethylamide-A]insulin. AB - We have synthesized [21-desasparagine,20-cysteine ethylamide-A]insulin and [21 desasparagine,20-cysteine 2,2,2-trifluoroethylamide-A]insulin, which differ from natural insulin in that the C-terminal amino residue of the A chain, asparagine, has been removed and the resulting free carboxyl group of the A20 cysteine residue has been converted to an ethylamide and a trifluoroethylamide group, respectively. [21-Desasparagine,20-cysteine ethylamide-A]insulin displayed equivalent potency in receptor binding and biological activity, ca. 12% and ca. 14%, respectively, relative to bovine insulin. In contrast, [21-desasparagine,20 cysteine 2,2,2-trifluoroethylamide-A]insulin displayed a divergence in these properties, ca. 13% in receptor binding and ca. 6% in biological activity. This disparity is ascribed to a difference in the electronic state of the A20-A21 amide bond in these two analogues. A model is proposed to account for the observation of divergence between receptor binding and biological activity in a number of synthetic insulin analogues and naturally occurring insulins. In this model, changes in the electronic state and/or the orientation of the A20-A21 amide bond can modulate biological activity independently of receptor binding affinity. The A20-A21 amide bond is thus considered as an important element in the "message region" of insulin. PMID- 3322396 TI - Protein glycosylation in the endoplasmic reticulum: current topological issues. PMID- 3322397 TI - Footprinting DNA-protein complexes in situ following gel retardation assays using 1,10-phenanthroline-copper ion: Escherichia coli RNA polymerase-lac promoter complexes. AB - Protein-DNA complexes isolated in gel retardation assays can be digested within the acrylamide matrix by the nuclease activity of 1,10-phenanthroline-copper ion (OP-Cu). When the oligonucleotide products are eluted and analyzed on a sequencing gel, a footprint of the DNA-protein complex is obtained. Therefore, any protein-DNA complex isolated by the widely used gel retardation technique can be defined in terms of sequence-specific interactions by this simple methodology. The binding of the lac repressor and Escherichia coli RNA polymerase to an EcoRI fragment containing the lac control region has been studied by the combined gel retardation-1,10-phenanthroline-copper ion footprinting procedure. Footprints of lac repressor binding correspond to those obtained in solution with OP-Cu and DNase I and verify the experimental procedures. In studying E. coli RNA polymerase-promoter complexes, we have found that magnesium ion is required to form single-stranded DNA structures characteristic of kinetically competent open transcription complexes. PMID- 3322398 TI - Kinetics of O2 evolution from H2O2 catalyzed by the oxygen-evolving complex: investigation of the S1-dependent reaction. AB - The evolution of O2 from H2O2 catalyzed by the oxygen-evolving complex (OEC) in darkness was examined with photosystem II reaction center complex preparations from spinach. Flash illumination of dark-adapted reaction centers was used to make S0-enriched or S1-enriched complexes. The membranes catalyzed O2 evolution from H2O2 when preset to either the S0 or S1 state. However, only the S0-state reaction was inhibited by carbonyl cyanide m-chlorophenylhydrazone and dependent on chloride. These results indicate that (1) the S0-dependent and S1-dependent catalytic cycles can be separated by flash illumination, (2) the S0-dependent reaction involves the formation of the S2 state, and (3) the S1-dependent reaction does not involve the formation of the S2 or S3 states. A kinetic study of the S1-dependent reaction revealed a rapid equilibrium ordered mechanism in which (1) the binding of Ca(II) must precede the binding of H2O2 to the OEC and (2) the reaction of Ca(II) with the free enzyme is at thermodynamic equilibrium such that Ca(II) does not necessarily dissociate after each catalytic cycle. PMID- 3322399 TI - The rat liver insulin receptor. AB - Using insulin affinity chromatography, we have isolated highly purified insulin receptor from rat liver. When evaluated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis under reducing conditions, the rat liver receptor contained the Mr 125,000 alpha-subunit, the Mr 90,000 beta-subunit, and varying proportions of the Mr 45,000 beta'-subunit. The specific insulin binding of the purified receptor was 25-30 micrograms of 125I-insulin/mg of protein, and the receptor underwent insulin-dependent autophosphorylation. Rat liver and human placental receptors differ from each other in several functional aspects: (1) the adsorption-desorption behavior from four insulin affinity columns indicated that the rat liver receptor binds less firmly to immobilized ligands; (2) the 125I insulin binding affinity of the rat liver receptor is lower than that of the placental receptor; (3) partial reduction of the rat liver receptor with dithiothreitol increases its insulin binding affinity whereas the binding affinity of the placental receptor is unchanged; (4) at optimal insulin concentration, rat liver receptor autophosphorylation is stimulated 25-50-fold whereas the placental receptor is stimulated only 4-6-fold. Conversion of the beta-subunit to beta' by proteolysis is a major problem that occurs during exposure of the receptor to the pH 5.0 buffer used to elute the insulin affinity column. The rat receptor is particularly subject to destruction. Frequently, we have obtained receptor preparations that did not contain intact beta-subunit. These preparations failed to undergo autophosphorylation, but their insulin binding capacity and binding isotherms were identical with those of receptor containing beta-subunit. Proteolytic destruction and the accompanying loss of insulin-dependent autophosphorylation can be substantially reduced by proteolysis inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322401 TI - Phospholipid head groups as sensors of electric charge in membranes. PMID- 3322400 TI - 31P NMR saturation-transfer measurements in Saccharomyces cerevisiae: characterization of phosphate exchange reactions by iodoacetate and antimycin A inhibition. AB - 31P nuclear magnetic resonance (NMR) saturation-transfer (ST) techniques have been used to measure steady-state flows through phosphate-adenosine 5' triphosphate (ATP) exchange reactions in glucose-grown derepressed yeast. Our results have revealed that the reactions catalyzed by glyceraldehyde-3-phosphate dehydrogenase/phosphoglycerate kinase (GAPDH/PGK) and by the mitochondrial ATPase contribute to the observed ST. Contributions from these reactions were evaluated by performing ST studies under various metabolic conditions in the presence and absence of either iodoacetate, a specific inhibitor of GAPDH, or the respiratory chain inhibitor antimycin A. Intracellular phosphate (Pi) longitudinal relaxation times were determined by performing inversion recovery experiments during steady state ATP gamma saturation and were used in combination with ST data to determine Pi consumption rates. 13C NMR and O2 electrode measurements were also conducted to monitor changes in rates of glucose consumption and O2 consumption, respectively, under the various metabolic conditions examined. Our results suggest that GAPDH/PGK-catalyzed Pi-ATP exchange is responsible for antimycin resistant saturation transfer observed in anaerobic and aerobic glucose-fed yeast. Kinetics through GAPDH/PGK were found to depend on metabolic conditions. The coupled system appears to operate in a unidirectional manner during anaerobic glucose metabolism and bidirectionally when the cells are respiring on exogenously supplied ethanol. Additionally, mitochondrial ATPase activity appears to be responsible for the transfer observed in iodoacetate-treated aerobic cells supplied with either glucose or ethanol, with synthesis of ATP occurring unidirectionally. PMID- 3322403 TI - Kinetics of the inhibition of human renin by an inhibitor containing a hydroxyethylene dipeptide isostere. AB - We have studied the inhibition of both human and hog renins by compound 1 [Boc Pro-Phe-N alpha-MeHis-Leu psi(CHOHCH2)Val-Ile-(aminomethyl)pyridine] using kinetics. The inhibition of human renin was shown to be time dependent and followed a minimal two-step mechanism. A loosely bound EI complex was formed rapidly with a dissociation constant, KI, of 12 nM. A second EI complex was slowly formed and was found to be 64-fold more strongly bound with an overall KI of 0.19 nM. The inhibition of human renin was shown to be competitive by both initial and final steady-state velocities. Compound 1 was also shown to be a competitive inhibitor of hog renin with a KI of 12 nM, but no evidence for time dependent inhibition was detected. The differences in overall KI and inhibition kinetics may be a consequence of the similarities in structure between 1 and human angiotensinogen. PMID- 3322402 TI - A potent radiolabeled human renin inhibitor, [3H]SR42128: enzymatic, kinetic, and binding studies to renin and other aspartic proteases. AB - The in vitro binding of [3H]SR42128 (Iva-Phe-Nle-Sta-Ala-Sta-Arg), a potent inhibitor of human renin activity, to purified human renin and a number of other aspartic proteases was examined. SR42128 was found to be a competitive inhibitor of human renin, with a Ki of 0.35 nM at pH 5.7 and 2.0 nM at pH 7.4; it was thus more effective at pH 5.7 than at pH 7.4. Scatchard analysis of the interaction binding of [3H]SR42128 to human renin indicated that binding was reversible and saturable at both pH 5.7 and pH 7.4. There was a single class of binding sites, and the KD was 0.9 nM at pH 5.7 and 1 nM at pH 7.4. The association rate was 10 times more rapid at pH 5.7 than at pH 7.4, but there was no difference between the rates of dissociation of the enzyme-inhibitor complex at the two pHs. The effect of pH on the binding of [3H]SR42128 to human renin, cathepsin D, pepsin, and gastricsin was also examined over the pH range 3-8. All the aspartic proteases had a high affinity for the inhibitor at low pH. However, at pH 7.4, [3H]SR42128 was bound only to human renin and to none of the other aspartic proteases. Competitive binding studies with [3H]SR42128 and a number of other inhibitors on human renin or cathepsin D were used to examine the relationships between structure and activity in these systems.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322404 TI - Degradation of coagulation proteins by an enzyme from Malayan pit viper (Akistrodon rhodostoma) venom. AB - Three hydrolases from the crude venom of the Malayan pit viper (Akistrodon rhodostoma) can be differentiated. The first, which we designate ARH alpha, is the well-known fibrinogenolytic enzyme ancrod. The second, ARH beta, which has not been described previously, is identified by its electrophoretic mobility after sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), by its ability to hydrolyze H-D-phenylalanyl-L-piperyl-L-arginyl-rho-nitroanilide, and by inhibition of its activity by diisopropyl phosphorofluoridate. The third, ARH gamma, also previously not described, has been purified by using gel permeation and ion-exchange chromatography and preparative PAGE. Chemical, electrophoretic, and hydrodynamic data indicate that it is a single-chain, nonglobular glycoprotein with a molecular weight of 25,600. ARH gamma catalyzes the degradation of several plasma vitamin K dependent coagulation factors, including factor IX, factor X, prothrombin, and protein C. The products are electrophoretically similar to factor IXa beta, factor Xa, thrombin, and activated protein C, respectively. However, these products contain little or no enzymatic activity. ARH gamma-degraded factor IX, factor X, prothrombin, and protein C can be subsequently activated by factor XIa, Russell's viper venom X coagulant protein, crude taipan snake venom, and thrombin, respectively. The N terminal sequence of the peptides resulting from the ARH gamma digest of porcine factor IX shows that at least three bonds are hydrolyzed: (1) at position 152, seven residues from the Arg145-Ala146 factor XIa cleavage site; (2) at position 167 within the factor IX activation peptide; and (3) at position 177, three residues from the Arg180-Val181 factor XIa cleavage site. The degradation of factor IX by ARH gamma is not affected by several serine protease inhibitors. ARH gamma catalyzes the degradation of both the heavy and light chains of porcine factor VIII which results in the inability of thrombin to activate factor VIII. ARH gamma also catalyzes the degradation of porcine antithrombin III which abolishes its ability to inhibit thrombin. These findings may have relevance to studies of hemostatic derangements following envenomation by this snake. Additionally, several novel coagulation factor derivatives have been generated for structure-function studies. PMID- 3322405 TI - Location and activity of ubiquinone 10 and ubiquinone analogues in model and biological membranes. AB - Deuteriated analogues of ubiquinone 10 (Q10) have been dispersed with plasma membranes of Escherichia coli and with the inner membranes of beetroot mitochondria. Orientational order at various deuteriated sites was measured by solid-state deuterium nuclear magnetic resonance (2H NMR). Similar measurements were made, using the compounds dispersed in dimyristoylphosphatidylcholine (DMPC) and egg yolk lecithin and dispersions prepared from the lipid extracts of beetroot mitochondria. In all cases only a single unresolved 2H NMR spectrum (typically 1000-Hz full width at half-height) was observed at concentrations down to 0.02 mol % Q10 per membrane lipid. This result shows that most Q10 is in a mobile environment which is physically separate from the orientational constraints of the bilayer lipid chains. In contrast, a short-chain analogue of Q10, in which the 10 isoprene groups have been replaced by a perdeuteriated tridecyl chain, showed 2H NMR spectra with quadrupolar splittings typical of an ordered lipid that is intercalated into the bilayer. The NADH oxidase activity and O2 uptake in Escherichia coli and in mitochondria were independent of which analogue was incorporated into the membrane. Thus, despite the major difference in their physical association with membranes, or their lipid extracts, the electron transport function of the long- and short-chain ubiquinones is similar, suggesting that the bulk of the long-chain ubiquinone does not have a direct function in electron transporting activity. The physiologically active Q10 may only be a small fraction of the total ubiquinone, a fraction that is below the level of detection of the present NMR equipment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322407 TI - Synthesis and biological activity of amino terminus extended analogues of the alpha mating factor of Saccharomyces cerevisiae. AB - The synthesis and biological activity are reported for extended analogues of the secreted tridecapeptide alpha-factor (Trp-His-Trp-Leu-Gln-Leu-Lys-Pro-Gly-Gln-Pro Met-Tyr) from Saccharomyces cerevisiae. Peptides with Ala, Glu-Ala, Ala-Glu-Ala, or Glu-Ala-Glu-Ala attached to the amino terminus of alpha-factor were synthesized by the solid-phase method on a (phenylacetamido)methyl (PAM) resin, using a combination of dicyclohexylcarbodiimide- and 1-hydroxybenzotriazole accelerated active ester coupling procedures. Free peptides were obtained by hydrogen fluoride (HF) cleavage in the presence of appropriate scavengers. Normal high HF cleavage and "low-high" HF cleavage were equally effective in liberating the desired product from the PAM resin. Yields of pure peptide ranged from 9% to 17%. All of the extended alpha-factors, which represent sequences of pro-alpha factor coded for in the MF alpha 1 structural gene, caused morphological aberrations (shmoo assay) in strain X2180-1A (MATa) the same as those caused by the tridecapeptide. The 14-peptide was equally active compared to the native alpha-factor whereas the 17-peptide was 5-10-fold less active. The analogues also arrested to various degrees (halo assay) the growth of S. cerevisiae RC629 (MATa sst1) and S. cerevisiae RC631 (MATa sst2), two supersensitive mutants, and were converted to pheromones of equal activity by treatment with V8 protease. A temperature-sensitive receptor mutant responded to all the peptides at the permissive but not the restrictive temperature. An alpha-factor antagonist, des Trp1,Ala3-alpha-factor, inhibited activity of all extended peptides.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322406 TI - Photoaffinity labeling of the thymidine triphosphate binding domain in Escherichia coli DNA polymerase I: identification of histidine-881 as the site of cross-linking. AB - Using the technique of ultraviolet-mediated cross-linking of substrate deoxynucleoside triphosphates (dNTPs) to their acceptor site [Abraham, K. I., & Modak, M. J. (1984) Biochemistry 23, 1176-1182], we have labeled the Klenow fragment of Escherichia coli DNA polymerase I (Pol I) with [alpha-32P]dTTP. Covalent cross-linking of [alpha-32P]dTTP to the Klenow fragment is shown to be at the substrate binding site by the following criteria: (a) the cross-linking reaction requires dTTP in its metal chelate form; (b) dTTP is readily competed out by other dNTPs as well as by substrate binding site directed reagents; (c) labeling with dTTP occurs at a single site as judged by peptide mapping. Under optimal conditions, a modification of approximately 20% of the enzyme was achieved. Following tryptic digestion of the [alpha-32P]dTTP-labeled Klenow fragment, reverse-phase high-performance liquid chromatography demonstrated that 80% of the radioactivity was contained within a single peptide. The amino acid composition and sequence of this peptide identified it as the peptide spanning amino acid residues 876-890 in the primary sequence of E. coli Pol I. Chymotrypsin and Staphylococcus aureus V8 protease digestion of the labeled tryptic peptide in each case yielded a single smaller fragment that was radioactive. Amino acid analysis and sequencing of these smaller peptides further narrowed the dTTP cross-linking site to within the region spanning residues 876 883. We concluded that histidine-881 is the primary attachment site for dTTP in E. coli DNA Pol I, since during amino acid sequencing analysis of all three radioactive peptides loss of the histidine residue at the expected cycle is observed. PMID- 3322410 TI - Response to the challenge: effective treatment of the elderly through thermal biofeedback combined with progression relaxation. AB - This notes pursues the theme introduced in the first "Notes and Observations" publication: the effectiveness of biofeedback in treatment of the elderly. Current clinical results in progress are reported for a 76-year-old female hypertensive whose blood pressure has to date been lowered from 190/90 to 160/82 by means of thermal biofeedback in conjunction with progressive relaxation. These results are contrasted with reported failures in the headache study of elderly patients (Blanchard, Andrasik, Evans, & Hillhouse 1985). Results of this study are reinterpreted in terms of biofeedback modality rather than age of subjects. PMID- 3322409 TI - Two-dimensional crystals of enzyme-effector complexes: ribonucleotide reductase at 18-A resolution. AB - The B1 subunit of ribonucleotide reductase formed two-dimensional crystals when bound to and effector nucleotide linked to lipids in planar layers at the air/water interface. The effector lipid consisted of dATP coupled through the gamma-phosphoryl group and an epsilon-aminocaproyl linker to phosphatidylethanolamine. Two-dimensional crystals of B1 reductase, like those of antibodies and cholera toxin obtained previously, formed under physiologic conditions of pH and ionic strength, with no precipitant added to the solution. There was, however, a requirement for dTTP in the solution, presumably to ensure binding of the dATP-lipid at only one of two effector sites on the enzyme. Diffraction from the crystals extended to 18-A resolution in negative stain, with unit cell parameters a = 110 A, b = 277 A, and gamma = 90 degrees. Image analysis revealed the B1 dimer as a pair of roughly cylindrical objects, each 105-109 A in length and 31-34 A in diameter. PMID- 3322408 TI - Ca2+-stimulated catecholamine release from alpha-toxin-permeabilized PC12 cells: biochemical evidence for exocytosis and its modulation by protein kinase C and G proteins. AB - Two possible cellular pathways of catecholamines from the chromaffin vesicles of PC12 cells to the surrounding medium are explored in this study. The direct one circumventing the cytoplasm can be activated in alpha-toxin-permeabilized cells with micromolar levels of free Ca2+. Catecholamine metabolites formed in the cytoplasm (i.e., 3,4-dihydroxyphenylacetic acid and 3,4-dihydroxyphenylethanol) are neither formed nor released from the cells under these conditions. However, when vesicular catecholamines were discharged into the cytoplasm by addition of the ionophore nigericin, such metabolites are formed and released into the medium independent of Ca2+. Both types of experiments provide direct evidence for the operation of Ca2+-induced exocytosis of dopamine and noradrenaline in permeabilized PC12 cells. The Ca2+ dependence of dopamine or noradrenaline release, as measured by the determination of the endogenous catecholamines using the high-performance liquid chromatography technique, exhibits two different phases. One is already activated below 1 microM free Ca2+ and plateaus at 1-5 microM free Ca2+, while a second occurs in the presence of larger amounts of free Ca2+ (10-100 microM). Ca2+-induced catecholamine release from the permeabilized cells can be modulated in different ways: It is enhanced by the phorbol ester 12 O-tetradecanoylphorbol 13-acetate and the diacylglycerol 1-oleyl-2-acetylglycerol provided Mg2+/ATP is present, and it is inhibited by guanosine 5'-O-(3 thiotriphosphate). The latter effect is abolished by pretreatment of the cells with pertussis toxin but not by cholera toxin. Thus, it appears that Ca2+-induced exocytosis can be modulated via the protein kinase C system, as well as via GTP binding proteins. PMID- 3322411 TI - A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: III. Psychological changes accompanying treatment. AB - Eighty-seven medicated essential hypertensives received either thermal biofeedback (TBF) or progressive muscle relaxation (PMR) training as a substitute for their second-stage antihypertensive medication. The psychological changes accompanying the treatments were obtained at pretreatment, at post-treatment and at the 3- and 6-month follow-up. Few psychological changes were noted, owing in part to the absence of psychopathological elevations at pretreatment. Short-term psychological changes were greater in patients who were withdrawn from their second-stage antihypertensive medication and then treated compared with those treated and then withdrawn from their medication. This finding may reflect the presence of antihypertensive medication side effects involving psychological factors. In general, TBF patients were more Type B at long-term follow-up compared with PMR patients, who tended toward greater Type A characteristics. PMID- 3322412 TI - [Energy dissipation in the brown fatty tissue of warm-blooded animals]. AB - The uncoupling mechanism of respiration and phosphorylation in brown adipose tissue as well as factors affecting this process are discussed. An assumption has been suggested and substantiated experimentally that the uncoupling of respiration and phosphorylation in liver mitochondria caused by vitamin K alimentary deficit may have mechanism similar to the unique uncoupling mechanism of brown fat mitochondria. PMID- 3322413 TI - [Receptors of the olfactory cells: the problem of their identification and characteristics]. AB - Own and some last literary data on the vertebrate olfactory receptors are summarized. Special attention is devoted to the identification of these receptors. The connection of these receptors with the proteins binding the guanosine triphosphate is demonstrated. On this basis a biochemical test to elicit the olfactory receptors is proposed. Using the boar pheromon receptor the application of this test to differentiate the true olfactory receptor and a respiratory lining component that binds the pheromon with the same characteristics like the receptor is shown. The olfactory receptors may be represented no only by the integral but also by peripheric membrane proteins. The questions on the olfactory mucosa receptors and mechanism of the signal transduction in the olfactory cell have been discussed. PMID- 3322414 TI - [Triterpene glycosides and the structural-functional properties of membranes]. AB - Triterpene glycosides have been found in many plant species and some marine animals. Many of these compounds are physiologically active and possess a broad range of medico-biological action. The physiological activity of triterpene glycosides is based on their ability to interact with the components of biological systems, primarily with sterols comprising the structure of biomembranes. The interaction of glycosides with sterols causes disturbance of selective permeability in plasmic membranes. Triterpene glycosides affect the liposome ionic permeability and flat bilayer lipid membranes. The rate of glycoside effect depends on quantitative and qualitative sterol level in the membrane. These compounds are used by organisms in the struggle for life and in maintaining the biological equilibrium in the antagonistic interactions of biological systems and ensure plant immunity against fungal diseases. Triterpene glycosides as substances of exogenous origin exhibit physiological activity towards warm-blooded animals. They affect the metabolism, the functional state of the organs and the organism as a whole. PMID- 3322415 TI - [Methodological problems in the neurophysiology of behavior]. AB - The methodological problems of correlation of analytical and synthetical approaches (reduction and integration) in research on the brain mechanisms of behaviour are considered. The correlation of plasticity of polyfunctional brain structures with relative stability of behavioral defects after the damage of the same structures are discussed. The teaching of A. A. Ukhtomskii on the dominant as a complex of brain mechanisms securing the active behavioral nature may be a methodological basis for purposeful experimental studies. PMID- 3322416 TI - [Type-II casein kinases: characteristics of their properties and possible physiological role]. AB - A detailed characteristic of casein kinases of the second type based on the analysis of the literary data and own research is given. The main properties which allow to differ them from other protein kinases are described. The participation of casein kinases II in regulation of different cellular processes are shown: in carbohydrate and lipid metabolism, in transcription, translation and enzyme synthesis. The changes in the activity of the given casein kinases in the course of the cellular cycle and during some pathological states show that from the diagnostic point of view the measurements of the enzyme activity is a useful tool, especially in an early detection of uncontrolled cell proliferation. On the basis of the given data the casein kinases II have been concluded to play an important role in the control of organism normal development. The given proteins may be put in one line with well studied and physiologically important cAMP-dependent and Ca-dependent protein kinases. PMID- 3322417 TI - Early pregnancy factor. AB - There have been many attempts to develop a test which can detect a pregnancy between the time of fertilization and the time of implantation. The subject of this review is Morton's "early pregnancy factor", a complex immunological phenomenon which is said to become positive within hours of fertilization. However, many workers have been unable to reproduce these findings and the experimental methods have been severely criticized. Substantial further work is needed before a test of this type can be regarded as suitable for routine clinical practice, if indeed it will ever be possible. PMID- 3322418 TI - Triplet state sublevel kinetics of tryptophan 54 in the complex of Escherichia coli single-stranded DNA binding protein with single-stranded poly(deoxythymidylic) acid. AB - The individual sublevel kinetics of the lowest triplet state of tryptophan 54 (Trp 54) which is highly perturbed in the complex of Escherichia coli single stranded DNA binding protein (Eco SSB) with poly(deoxythymidylic) acid (poly[dT]) have been studied by optically detected magnetic resonance (ODMR) spectroscopy. The triplet sublevel decay constants of Trp 54, kx, ky, kz, are 0.99, 0.072, and 0.045 s-1, respectively, in the poly(dT) complex of a point-mutated Eco SSB in which Trp 88 is substituted by phenylalanine. Tx is the only radiative triplet sublevel. Negative polarity of the Tx----Tz and Tx----Ty phosphorescence-detected ODMR signals results from the steady state population pattern, nx greater than ny, nz, and implies that the relations, px greater than or equal to 14py, and px greater than or equal to 22pz exist for the relative populating rates. Spin-orbit coupling between radiative singlet states and the Tx sublevel of the lowest triplet state of Trp 54 is enhanced selectively upon complexing of Eco SSB with poly(dT). PMID- 3322420 TI - Effect of E. coli endotoxin on temperature, oxygen consumption and brown adipose tissue thermogenesis in rats and mice. AB - The effects of E. coli endotoxin 0127 B8 on oxygen consumption, temperature, and on the activity of the proton conductance pathway in brown adipose tissue (BAT) were investigated in rats and mice. In rats an increase was observed in rectal and skin temperature, whole body oxygen consumption and GDP binding in BAT. In mice only the rise in rectal and skin temperature were significantly changed by endotoxin administration. These findings suggest that in some species BAT is involved in the production of endotoxin induced fever and increased energy expenditure. PMID- 3322419 TI - New permeability pathways induced by the malarial parasite in the membrane of its host erythrocyte: potential routes for targeting of drugs into infected cells. AB - Malarial parasites propagate asexually inside the erythrocytes of their vertebrate host. Six hours after invasion, the permeability of the host cell membrane to anions and small nonelectrolytes starts to increase and reaches its peak as the parasite matures. This increased permeability differs from the native transport systems of the normal erythrocyte in its solute selectivity pattern, its enthalpy of activation and its susceptibility to inhibitors, suggesting the appearance of new transport pathways. A biophysical analysis of the permeability data indicates that the selectivity barrier discriminates between permeants according to their hydrogen bonding capacity and has solubilization properties compared to those of iso-butanol. The new permeability pathways could result from structural defects caused in the host cell membrane by the insertion of parasite derived polypeptides. It is suggested that the unique transport properties of the new pathways be used to target drugs into infected cells, to affect the parasite either directly or through the modulation of the intraerythrocytic environment. The feasibility of drug targeting is demonstrated in in vitro cultures of the human malarial parasite Plasmodium falciparum. PMID- 3322421 TI - Nobel lecture. The development of the electron microscope and of electron microscopy. PMID- 3322422 TI - The nerve growth factor: thirty-five years later. PMID- 3322424 TI - Joint custody: a comprehensive review. AB - This article presents a comprehensive overview of joint custody. The history and legislative implications are discussed, as are pertinent issues relative to the reported advantages and disadvantages of joint custody. Finally, the role of the mental health professional in assisting with counseling divorced families either before, during, or after a custody decision is discussed. PMID- 3322423 TI - Decreased insulin binding and antilipolytic response in adipocytes from patients with Cushing's syndrome. AB - Human adipocytes from patients with chronic endogenous hypercortisolism (Cushing's syndrome) showed a statistically significant decrease in insulin binding at low unlabelled-insulin concentrations but no change in receptor numbers (Cushing's 180,000 +/- 48,000 (3) receptors/cell and controls 189,000 +/- 30,000 (7)) together with a fourfold decrease in apparent receptor affinity (ED50: Cushing's 2.25 x 10(-9) M and controls 0.57 x 10(-9) M) and a decreased sensitivity to the antilipolytic effect of insulin. These events could represent the final situation of a chronic and endogenous regulation by high levels of cortisol of insulin receptors in human adipose tissue. PMID- 3322425 TI - Disputed child custody: strategies and issues in mediation. AB - Disputed child custody is a significant life stressor for both adults and children. Recent efforts have been made to develop a model for family mediation and subsequent clinical strategies that can attempt to address the stressors involved in divorce and perhaps resolve, through mediation, the posttrauma stress experienced by both spouses and children. Reviewed is the literature on the impact of separation and divorce on families and the use of family mediation to resolve disputes. It further addresses psychologic factors involved in the mediation process and the possible effects of mediation on divorce. An established family mediation model for treatment is presented in detail, as are clinical issues often addressed in the family mediation process. Issues and import for clinical application and research are offered. PMID- 3322427 TI - [Association des Anatomistes: 1986 membership list]. PMID- 3322426 TI - Development of a computerized sexual assessment laboratory. AB - Computer-assisted psychological assessment has been operational for 25 years. It has been well received by patients and shows a degree of reliability that is comparable to that of conventional testing. The authors report on the development of a computerized psychosexual assessment laboratory in a forensic facility housing convicted sex offenders who volunteered for treatment. The development of the laboratory was in response to the need for uniform psychosocial data on each resident that can be used for making better diagnoses, developing personalized treatment programs, and assessing treatment outcome. The process of selecting the psychological tests and programming them for interactive administration is described, as are the testing procedures using the penile plethysmograph with stimuli based on the Tanner developmental stages. A computer-assisted psychosocial assessment that produces a psychosocial history was developed. The laboratory's overall value in the treatment program is assessed. PMID- 3322428 TI - Food allergy and intolerance. AB - In summary, there has been a dramatic increase in our understanding of food allergy as a result of research in immune mechanisms and clinical studies over the last decade. The subject has been comprehensively reviewed in a major new publication (Brostoff and Challacombe, 1986). PMID- 3322429 TI - Immunological aspects of gastritis and pernicious anaemia. AB - Pernicious anaemia (PA) and chronic atrophic gastritis (CAG) aggregate in families, occur more often in women, and are associated with various heritable traits such as fair skin and blue eyes. They are linked to certain HLA types. Linkages are relatively weak for A and B antigens, but somewhat stronger in the case of DR antigens. There are strong associations between PA and other organ specific autoimmune diseases, particularly those affecting the thyroid. Discordance for PA in monozygotic twins has been reported, and it may well be that expression of the disease requires, in a genetically susceptible individual, initial injury to the gastric mucosa by some environmental agent such as a virus or some physical irritant, with perpetuation of injury then depending upon autoimmune mechanisms. Numbers of T cells are substantially increased in the gastric mucosa of patients with PA, but the ratio of T suppressor to T helper cells is normal. There is a relatively greater increase in numbers of cells not of T lineage, presumably B-cells. Gastric autoantibodies, both to different components of the parietal cell and to two sites on the IF molecule, are present in a majority of patients with PA. There is evidence that these autoantibodies, especially PCA, may be cytotoxic to parietal cells, and may also inhibit their maturation and proliferation. Antibodies to chief cells have not been described, and the parallel disappearance of these cells in atrophic gastritis is unexplained. The peripheral blood lymphocytes of some patients with autoimmune gastritis transform, or produce lymphokines, when exposed to gastric antigens, and patients with PA have been shown to have delayed type cutaneous hypersensitivity to gastric antigens. The relevance of these observations to the pathogenesis of their gastric mucosal lesion is unclear. There is a growing body of evidence to support the operation of humoral immune mechanisms in autoimmune gastritis, but this clearly does not preclude the coexistent involvement of cellular mechanisms. For example, impaired suppressor T cell function has been strongly implicated in certain other autoimmune disorders, but has received scant attention in PA. By generally accepted criteria, PA is an excellent example of an organ-specific autoimmune disease. As yet, there is no acceptable single unifying hypothesis which will account for all of the phenomena which have been described in the disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3322430 TI - The immunology of coeliac disease. AB - Coeliac disease is defined as that disorder in which there is an abnormality of the small intestinal mucosa manifested by contact with the gluten of wheat and certain other cereal grains. In the immunological theory of the pathogenesis of coeliac disease, gluten, or a component, is viewed as the antigen responsible for the immune response. The search for the gluten component responsible for 'toxicity' and, by implication, antigenicity, is described. The antigen may be presented differently to the immune system by an abnormal cell membrane, either of the enterocyte, lymphocyte or macrophage. Alternatively, increased amounts of antigen may be absorbed due to increased membrane binding or permeability, either of which could be genetically determined. As a further possibility, coeliac disease may occur because the patients are immunologically hyperresponsive and this too appears to be genetically determined. The perturbations which occur in the mucosal immune system and the systemic immune system are described. It is conceivable that the major complications described (intestinal ulceration, malignancy and splenic atrophy) result from immunological disturbances. The incidence of childhood coeliac disease is declining, which may be due to altered exposure to, or increased protection from, the antigen in infancy, or to changes in environmental factors. The immunological mystery of coeliac disease continues to excite interest and fascination, and has certainly been a stimulus to our deeper understanding of gastrointestinal immunology. PMID- 3322431 TI - Immunology of inflammatory bowel disease. PMID- 3322432 TI - Immunodeficiency and the gut. PMID- 3322433 TI - AIDS. PMID- 3322435 TI - Immunology of gastrointestinal lymphoma. AB - Experimental work showing that IgA plasma cell precursors activated in gut associated lymphoid tissue (GALT) of rats and sheep migrate to the lamina propria of the gut via the regional lymphatics, mesenteric lymph node and blood, has been supported by immunohistochemical studies. In rats, immunoblasts with cytoplasmic IgA are present in the Peyer's patches in association with the high endothelial venules which is probably an important, though not the only, site of extravasation into the gut, whereas cells with cytoplasmic IgA are rarely observed in the dome regions of Peyer's patches. Immunohistochemical studies of human Peyer's patches have revealed differences between the distribution of cells with cytoplasmic IgA in man compared to rats. In man, immunoblasts with cytoplasmic IgA are not concentrated in the zone of cells containing the high endothelial venules, whereas they are present in the dome regions of the Peyer's patches. The following questions arise: Do precursors of IgA plasma cells activated in human GALT migrate to the lamina propria via the blood, but extravasate predominantly via the capillary network, rather than the high endothelial venules? or do IgA plasma cell precursors 'mature' in situ in the Peyer's patches of man and subsequently migrate laterally to seed the lamina propria? Three lines of evidence from studies of primary B cell lymphomas of GALT support the latter hypothesis: 1) Primary B cell lymphomas of the gut remain localized to GALT for long periods of time; 2) Histological studies of the lymphoid tissue in these lymphomas have shown a gradation of cell types, from the muscularis mucosae towards the mucosal epithelium, which strongly suggests that plasma cells develop in situ in the gut from the adjacent layers of cells; 3) Preliminary studies of DNA extracted from the blood-borne cells from patients with GALT-derived B cell lymphoma have failed to demonstrate the presence of clonal gene rearrangements. Normal and malignant human GALT contains a perifollicular population of B cells with centrocyte-like morphology which lack surface IgD. No direct equivalent can be detected in rodent Peyer's patches. Their quiescent nature and distribution in malignant GALT suggests that they are follicle centre cell-derived and precursors of immunoblasts and plasma cells. As such they may be memory B cells. Their association with epithelium is a consistent feature of normal and malignant GALT which is of unknown but undoubted significance. The function of intraepithelial T cells is still unknown. Malignant T cells in MHI may be derived from intraepithelial T cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3322434 TI - Immunology of giardiasis. PMID- 3322436 TI - Immunology of autoimmune and viral chronic active hepatitis. PMID- 3322437 TI - Immunology of primary biliary cirrhosis. AB - (1) The serological diagnosis of PBC is possible in almost 100% of cases when appropriate methods and specific antigen preparations are used such as the purified ATPase fraction by ELISA for the detection of anti-M2, sonicated mitochondria by immunodiffusion for the demonstration of precipitating antibodies against M-A or M-B, and cell cultures by immunofluorescence for the detection of antibodies against nuclear dots. (2) The establishment of AMA profiles obtained by ELISA and CFT seems to be a sensitive approach to a better definition of the natural course of PBC. A distinction between a rather benign and a more progressive course seems especially possible in the presence of the AMA profiles A and B (anti-M9 and/or anti-M2-positive only by ELISA) versus D (anti-M2-, anti M4-, anti-M8-positive in the CFT). (3) The analysis of cellular immune reactions in vitro and in vivo suggests an activation of cytotoxic T cells as well as a defect in the function of T suppressor cells. (4) Although the aetiology of PBC is unknown, the detection of MHC Class II antigens on bile duct epithelial cells in liver biopsies of patients with PBC but not of normal individuals may imply that an infectious agent being exposed in association with these MHC structures may trigger the disease. The inability of the immune system in controlling this infectious process would then lead to an ongoing inflammatory reaction which is responsible for the continuous destruction of bile ducts within portal triads. PMID- 3322438 TI - Immunology of drug and alcohol-induced liver disease. PMID- 3322439 TI - The limits of normality in elderly patients. PMID- 3322441 TI - Megaloblastic anaemia in the elderly. PMID- 3322440 TI - Iron deficiency in the elderly. AB - Iron deficiency in the elderly almost always results from blood loss. The loss of iron can be viewed as occurring in four stages, which are reflected in the different tests used to diagnose iron deficiency. Tests used to diagnose iron deficiency have certain limitations regarding their ability to detect iron deficiency before the overt anaemia occurs. The tests which diagnose iron deficiency most accurately are low serum ferritin and reduced iron staining of a bone marrow aspirate. Because iron is present in many metabolic processes besides the production of haemoglobin, iron deficiency results in a variety of defects which are manifested at biochemical, tissue, and functional levels. Iron is a component of several enzymes in the respiratory electron transport chain. Adequate haem and iron levels are necessary to control cytoplasmic and mitochondrial protein synthesis. Iron deficiency results in tissue defects, including those affecting the gastrointestinal tract, and defects of mitochondria and lymphocytes. Normal iron levels seem to be necessary for normal work capacity. A deficiency of iron, independent of the anaemia, results in reduced exercise capacity that can be measured in both physiological and economic terms. Elderly patients complaining of increased fatigue should therefore be screened for iron deficiency. There is evidence to suggest that iron deficiency may predispose individuals to certain infections. Other information points to the promotion of certain bacterial and parasitic infections after rapid correction of iron deficiency. Thus elderly patients having iron replacement therapy should be followed closely. A deficiency of iron has been shown to result in certain behavioural and learning abnormalities. Iron deficiency has been shown to result in impaired control of body temperature, resulting in an increase in catecholamine levels. The impairment in heat-generating ability was shown to result from reduced conversion of T4 to T3 in the peripheral tissues. PMID- 3322443 TI - Myelodysplastic syndromes. PMID- 3322442 TI - Polycythaemia and thrombocythaemia in the elderly. AB - The investigation of elderly patients presenting with raised PCV values has been described. Suitable clinical and laboratory investigation enables the separation of those with a raised red cell mass (RCM) into three groups: primary proliferative polycythaemia (PPP), secondary polycythaemia and idiopathic erythrocytosis. Those patients with a raised PCV but normal RCM either have apparent polycythaemia (normal plasma volume) or relative polycythaemia (low plasma volume). PPP is a clonal disorder with a peak incidence in the elderly. It commonly presents with vascular occlusive symptoms/signs involving larger vessels, both arterial and venous. The microvasculature may also be involved, particularly when there is associated thrombocythaemia. Effective treatment is required to minimize the future vascular occlusive incidence and diminish the complication rate of surgery if it is ever required. Both the PCV and the platelet count, if elevated, should be adequately controlled. 32P is probably the simplest treatment and is very effective, but venesection and intermittent low dose busulphan is equally satisfactory in the co-operative patient with good peripheral veins. Secondary polycythaemia may arise from a variety of causes, particularly from arterial hypoxaemia and renal lesions. Occasionally, more than one pathology is identified in the elderly patient. Lung disease is the most common cause of hypoxaemia. Venesection may be indicated in those patients with excessively raised PCV values. The term idiopathic erythrocytosis should only be used for patients who have been adequately investigated. These patients most commonly present with ischaemic or vascular occlusive symptoms/signs. Relative polycythaemia may be caused by fluid loss, but generally the origin of the low plasma volume is not established. Apparent polycythaemia may represent a physiological variant or a stage before the development of a definitely raised RCM. The management of idiopathic erythrocytosis, and relative and apparent polycythaemia, should initially involved removal of known risk factors if present (e.g. hypertension) with the addition of venesection in selected patients. Reactive thrombocytosis in the elderly is most commonly due to malignant disease of chronic infection. The high platelet count is usually asymptomatic, and antiplatelet therapy is rarely required. Primary thrombocythaemia (PT) is a clonal myeloproliferative disorder similar to PPP. The finding of splenomegaly, abnormal platelet morphology or function helps to separate PT from reactive thrombosis. PT most commonly presents with digital or transient cerebral ischaemia or haemorrhage.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3322444 TI - The management of leukaemia in the elderly. AB - Leukaemia is relatively common in the elderly compared to the general population, with over half of all cases of leukaemia occurring in patients aged 65 and over. Special problems are associated with treating patients in this age group. The leukaemias may be intrinsically different, in part because of the high incidence of preceding myelodysplasia. There is increased likelihood of coincident disease. There is lower tolerance to toxic complications, such as infection and bleeding, associated with a decreased resilience of normal haematopoiesis. There is more difficulty in obtaining intravenous access in elderly patients. These problems render patients ineligible for marrow transplants. Myelodysplastic syndromes occur predominantly in the elderly. There are a number of myelodysplastic syndromes now identified, each with its characteristic natural history. Management decisions are based on accurate diagnosis of the specific syndrome, consideration of prognostic features, a period of observation, and conservative treatment principles. More than half the cases of acute myeloblastic leukaemia also occur in the elderly. Prognostic factors must be examined and the literature carefully scrutinized for results pertinent to the elderly patient. In some patients treatment may be justifiably withheld, others may benefit from low dose cytosine arabinoside and some patients should receive aggressive combination chemotherapy. Management of the chronic leukaemias in the elderly is a less controversial area. Chronic lymphocytic leukaemia is the most common of the leukaemias in this age group. Prognostic factors can be determined using staging criteria. observation alone is indicated in many patients. Chlorambucil and prednisone are the most widely used drugs for symptomatic disease. Aggressive combination chemotherapy may benefit a few patients with advanced or refractory CLL. Hairy cell leukaemia is a rare disorder but many of the patients are over age 65. The elderly male patient may have a particularly benign course and require no therapy. Splenectomy is the standard first line of therapy, but recombinant alpha-interferon is sufficiently effective and non-toxic that it should be the treatment of choice in some patients. Deoxycoformycin is also effective in preliminary trials and may soon be routinely indicated. It is not often appreciated that half of all patients with chronic myelogenous leukaemia are aged 65 and over.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3322445 TI - Chronic lymphocytic leukaemia. PMID- 3322446 TI - Malignant lymphoma in the elderly. PMID- 3322447 TI - The disposition of cytotoxic drugs in the elderly. PMID- 3322448 TI - Monoclonal gammopathy and multiple myeloma in the elderly. AB - The term 'benign monoclonal gammopathy' indicates the presence of a monoclonal protein in persons without evidence of multiple myeloma, macroglobulinaemia, amyloidosis, lymphoproliferative disease, or other related disorders. The term 'monoclonal gammopathy of undetermined significance' (MGUS) is preferable because it is not known at diagnosis whether an M-protein will remain stable and benign or develop into symptomatic multiple myeloma or related disorders. Immunoelectrophoresis and immunofixation of the serum and urine are necessary to determine the presence and type of M-protein. At the Mayo Clinic, follow-up data have been gathered for more than 13 years on 241 patients with an initial benign monoclonal gammopathy. Nineteen per cent of these patients developed multiple myeloma, macroglobulinaemia, amyloidosis, or related diseases during the follow up period. There is no reliable technique for differentiating a patient with a benign monoclonal gammopathy from one who will subsequently develop a serious disease. It is necessary to follow these patients indefinitely. Important in the complete understanding of the elderly patient with monoclonal gammopathy are the following: clinical manifestations, laboratory findings, and differential diagnosis of multiple myeloma; the course and prognosis and the induction therapy and treatment of multiple myeloma; newer therapeutic approaches; and the management of complications such as hypercalcaemia, hyperuricaemia, renal failure, bacterial infections, skeletal disease, and neurological problems. PMID- 3322449 TI - Bleeding and coagulation disorders in the elderly. AB - Ageing does not bring with it any major changes in the coagulation or fibrinolytic proteins or platelets. It does bring a greater burden of disease, with less reserves, and so when haemorrhage occurs in the elderly it has more serious consequences. The cause of a bleeding diathesis can usually be determined after a careful history, and examination of the patient followed by simple tests- the platelet count, blood film, bleeding time, prothrombin time, partial thromboplastin time, thrombin time, fibrin degradation products and the euglobulin clot lysis time. Other confirmatory tests, assays and inhibitor titres, will seal the diagnosis. Treatment is mainly directed at removing the underlying cause, if possible, and remedying the defect, with platelet transfusion, fresh frozen plasma or factor concentrates. These treatments will not be effective where there is an inhibitor or antibody present; steroids, splenectomy (for ITP), plasma exchange or immunosuppression are needed. Two major advances have occurred in the early 1980s. One has been the introduction of high dose intravenous immunoglobulin in the management of ITP, although worries remain about thrombotic events in elderly patients. The other is the spreading use of DDAVP, originally introduced for von Willebrand's disease and mild haemophilia, and now finding a role in uraemia and with cardiopulmonary bypass. Drugs are a significant and potentially preventable cause of bleeding in the elderly. The most frequent problems arise with anticoagulants. The risk of interactions increase with the number of other medications which are prescribed. PMID- 3322450 TI - Entering a white profession: black physicians in the new South, 1880-1920. PMID- 3322451 TI - The posthumous Laennec: creating a modern medical hero, 1826-1870. PMID- 3322452 TI - Ill health during the English mortality decline: the friendly societies' experience. PMID- 3322453 TI - The eight months' child and the etiquette of birth: obsit omen! PMID- 3322454 TI - The Blackwell Medical Society and the professionalization of women physicians. PMID- 3322455 TI - Whose history? Whose therapy? Psychoanalysis and psychotherapy in the Third Reich. Essay review. PMID- 3322456 TI - Assessment of the alcohol dependence syndrome: a review of self-report screening questionnaires. AB - The development of the alcohol dependence syndrome and its inclusion in the International Classification of Diseases in January 1979 led to a demand for brief, easy-to-administer screening questionnaires explicitly based on the syndrome. The present review considers some of the conceptual, methodological and psychometric problems faced by the authors of such questionnaires. The five major self-report scales which have been published since 1979 are critically appraised and the usefulness of each scale for different populations and contexts is noted. PMID- 3322458 TI - Ankle fractures in children. PMID- 3322457 TI - [Current knowledge on tooth eruption in relation to osteodental interactions in the osteopetrosis rat Op/Op. Curative effect of early bone marrow grafts]. PMID- 3322459 TI - Lupus erythematosus and allied disorders in pregnancy. PMID- 3322460 TI - Anesthesia and monitoring for carotid endarterectomy. PMID- 3322461 TI - Influence of niridazole and chloroquine on arterial and myometrial prostacyclin synthesis. AB - 1. The effects of niridazole and chloroquine on rat arterial and myometrial prostacyclin (PGI2) synthesis in vitro were investigated by use of a rat platelet antiaggregatory bioassay. Niridazole (233 microM) and chloroquine (97 microM) inhibited PGI2 synthesis in both tissues. 2. Niridazole-induced inhibition in the myometrium was not reversed by exogenous arachidonic acid (33 microM) indicating a direct effect of the compound on PGI2 synthesizing enzymes. 3. Chloroquine induced inhibition in the myometrium was significantly reversed by exogenous arachidonic acid (33 microM) indicating a direct effect of the compound on arachidonic acid releasing enzymes (e.g. phospholipases A2 and C). 4. Niridazole and chloroquine also inhibited prostaglandin E2 synthesis in the myometrium. 5. Chloroquine- and niridazole-induced inhibition of prostaglandin synthesis may contribute towards a better understanding of some of their actions in vivo. PMID- 3322462 TI - The anti-aggregating properties of vascular endothelium: interactions between prostacyclin and nitric oxide. AB - 1. The interactions between endothelium-derived nitric oxide (NO) and prostacyclin as inhibitors of platelet aggregation were examined. 2. Porcine aortic endothelial cells treated with indomethacin and stimulated with bradykinin (10-100 nM) released NO in quantities sufficient to account for the inhibition of platelet aggregation attributed to endothelium-derived relaxing factor (EDRF). 3. In the absence of indomethacin, stimulation of the cells with bradykinin (1-3 nM) released small amounts of prostacyclin and EDRF which synergistically inhibited platelet aggregation. 4. EDRF and authentic NO also caused disaggregation of platelets aggregated either with collagen or with U46619. 5. A reciprocal potentiation of both the anti- and the dis-aggregating activity was also observed between low concentrations of prostacyclin and authentic NO or EDRF released from endothelial cells. 6. It is likely that interactions between prostacyclin and NO released by the endothelium play a role in the homeostatic regulation of platelet vessel wall interactions. PMID- 3322463 TI - Human calcitonin gene-related peptide activates adenylate cyclase and releases prostacyclin from human umbilical vein endothelial cells. AB - 1 Endothelial cells of human umbilical vein were isolated and cultured in vitro. 2 In these cells there was a concentration-dependent release of prostacyclin and activation of adenylate cyclase by human calcitonin gene-related peptide (hCGRP). The concentration of hCGRP for half-maximum activation of adenylate cyclase (Kact) by hCGRP was 190 nM. 3 Bradykinin induced a ten fold greater release of prostacyclin than CGRP, but did not activate adenylate cyclase. 4 hCGRP may exert its potent vasodilator properties by stimulating release of vasorelaxant substances, including prostacyclin from endothelial cells. PMID- 3322464 TI - Actions of amiloride analogues on prostacyclin synthesis by rat aortic rings. AB - 1 Fresh rat aortic rings were incubated in HEPES-buffered salt solutions (pH 8.0) in the presence or absence of amiloride analogues. The effect of these drugs on prostacyclin (PGI2) synthesis was determined by radioimmunoassay of the stable hydrolysis product 6-oxo-prostaglandin (PG)F1 alpha. 2 Amiloride and phenamil (potent inhibitors of epithelial Na+ transport) had no significant effect on basal or Ca2+-stimulated PGI2 synthesis. 3 Several analogues previously reported to inhibit Na+/Ca2+ exchange caused a dose-related increase in 6-oxo-PGF1 alpha production in media containing NaCl 120 mM and CaCl2 2.5 mM. 2',3'-Benzobenzamil was the most potent analogue with a maximum stimulation of 4.51 +/- 0.89 fold, and an EC50 of 3 x 10(-5) M. 4 Amiloride analogues bearing substituents on the 5 amino group of the pyrazine ring have been reported to inhibit Na+/H+ exchange more potently than Na+/Ca2+ exchange. Three of these compounds inhibited Ca2+ stimulated 6-oxo-PGF1 alpha production at concentrations that did not significantly influence basal 6-oxo-PGF1 alpha production. PMID- 3322466 TI - The familial/sporadic distinction as a strategy in schizophrenia research. AB - The rationale and limitations of discriminating between cases of schizophrenia with and without a family history are reviewed. It is concluded from the evidence available that, by identifying subgroups of greater aetiological homogeneity, the strategy can be a useful starting point for research into likely causes. PMID- 3322465 TI - Pathology, phenomenology and the dopamine hypothesis of schizophrenia. AB - The dopamine hypothesis of schizophrenia implies that positive schizophrenic symptoms should be understandable by reference to brain structures receiving a dopamine innervation, or in terms of the functional role of dopamine itself. The basal ganglia, ventral striatum, septo-hippocampal system, and prefrontal cortex, sites of mesotelencephalic dopamine innervation, are examined and it is argued that their dysfunction could form the basis of particular schizophrenic symptom classes. The postulated involvement of dopamine in reinforcement processes might further assist such interpretations. This type of analysis can be extended to other categories of schizophrenic psychopathology. PMID- 3322467 TI - Haloperidol decanoate v. fluphenazine decanoate as maintenance therapy in chronic schizophrenic in-patients. AB - In a double-blind study of 38 chronic schizophrenic in-patients, haloperidol decanoate was compared with fluphenazine decanoate as maintenance therapy over 60 weeks. Both drugs were given by injection at 4-week intervals. Haloperidol and fluphenazine were assumed to be equipotent; the mean starting dose of the former was 127 mg and of the latter 106 mg. The number of withdrawals over 60 weeks was similar in both groups but relapses, strictly defined, were significantly more frequent in the haloperidol group. When patients were switched to haloperidol, Parkinsonism diminished more quickly than in the fluphenazine group, but after 60 weeks there was no difference in severity in the two drug groups. The higher relapse rate and the quicker reduction in Parkinsonism in the haloperidol group might be due to a misjudgement in equivalent doses of the two drugs. Plasma haloperidol steady state levels were reached in most patients by 8-12 weeks. Plasma neuroleptic and prolactin levels, week-by-week systemic drug availability and Parkinsonism showed less variation between injections with haloperidol than with fluphenazine. PMID- 3322468 TI - A controlled comparison of fluoxetine and amitriptyline in depressed out patients. AB - Fluoxetine, a selective serotonin uptake inhibitor (mean dose 73 mg each morning) was compared with amitriptyline (mean dose 122 mg at night) in a double-blind study of 64 depressed out-patients. Fifty patients completed the 6-week trial. The drugs did not differ with respect to psychiatrists' ratings, but amitriptyline was slightly superior with respect to patients' ratings. The amitriptyline-treated group had complaints of dry mouth and dizziness on standing; the fluoxetine-treated group of sleep disturbances, nausea, and headaches. PMID- 3322469 TI - Depressive disorder in primary care. PMID- 3322470 TI - A computer-based system for urology and nephrology. AB - Modern technology offers new opportunities for the storage and manipulation of hospital information. A computer-based system for urology and nephrology has been designed and developed in this centre. It uses a program that allows the analysis of unrestricted non-codified texts and the operation by hospital staff who have had no more than minimal computer training. The potential of such a system is outlined and a comparison is made with other existing systems. Future prospects and potential lines of development are presented. PMID- 3322471 TI - Histochemical study of lectin binding in neoplastic and non-neoplastic urothelium. AB - A histochemical study of lectin binding was performed to assess staining with lectins and, therefore, the expression of complex carbohydrates in human neoplastic urothelium. Forty-seven patients with transitional cell carcinoma of the bladder and six controls were studied. Cryostat sections were stained with a panel of 10 biotinylated lectins by means of the avidin-biotin-peroxidase technique. Sixteen tumours were also studied after conventional formalin fixation and paraffin embedding. In general, staining by lectins of tumours was more intense than staining of control urothelium and staining of tumours invading bladder muscle was greater than that of superficial tumours (both P less than 0.001). A small but statistically significant diminution of staining was observed after formalin fixation and paraffin embedding (P less than 0.05). Four lectins- Bandeiraea simplicifolia (P less than 0.01), Vicia villosa (P less than 0.01), peanut agglutinin (P less than 0.001) and soyabean agglutinin (P less than 0.001) stained invasive tumours more frequently than superficial tumours in frozen sections. Thus, increased binding of certain lectins was found in human transitional cell tumours and correlated with muscle invasion and poor differentiation. PMID- 3322472 TI - Controlled trial of chemical disinfection of urinary drainage bags. Reduction in hospital-acquired catheter-associated infection. AB - A controlled, prospective trial was conducted on an orthopaedic ward to test the use of peroxide disinfection of drainage bags as the only measure taken to affect the rate of hospital-acquired, catheter-associated urinary tract infection (UTI). A significant reduction (P less than 0.05) in the number of patients with catheter-associated UTI occurred with the use of bag disinfectant when compared with patients in whom this technique was not used. We consider this technique to be suitable for the management of catheterised patients on general hospital wards to reduce catheter-associated UTI and environmental spread of their bacteria. PMID- 3322473 TI - 99mTc DTPA scintigraphy compared with intravenous urography in the follow-up of posterior urethral valves. AB - Twenty-seven patients with posterior urethral valves with varying degrees of renal function underwent both intravenous urography (IVU) and DTPA scan during their follow-up. Although the IVU was successful in excluding obstruction in 31 kidneys, the DTPA scan was successful in 43 kidneys. In addition, the DTPA scan provides quantifiable renal function, exposes the child to a lower radiation dose and has no morbidity compared with an IVU. It is recommended that the DTPA scan should replace the IVU for long-term follow-up and that the latter should be reserved for certain problems. PMID- 3322474 TI - Application of computerised penile arterial waveform analysis in the diagnosis of arteriogenic impotence. An initial study in potent and impotent men. AB - A new method is described for evaluating arteriogenic impotence by means of noninvasive quantification of penile Doppler arterial waveforms using computerised analysis based on the Laplace Transform model. The haemodynamic changes occurring during a papaverine-induced erection in healthy potent volunteers have been recorded by this technique, which has also been shown to be capable of discriminating between a normal and an abnormal penile arterial supply in an initial study of potent and impotent men. PMID- 3322475 TI - Centenary of the first prostatectomy in Britain. AB - The first suprapubic prostatectomy in Britain was performed in the General Infirmary at Leeds on 24 March 1887 by Arthur Fergusson McGill. During 1887 six other prostatectomies were performed by McGill and his colleagues. Before he died in 1890 McGill had performed complete enucleation of an adenomatous prostate. PMID- 3322476 TI - 99mTc DTPA scanning with diuretic washout. Is it useful in the presence of gross renal tract dilatation? PMID- 3322478 TI - Vascular trauma. AB - Civilian vascular trauma is not uncommon. Prompt treatment with modern vascular surgical techniques produces good results. PMID- 3322477 TI - The role of non-invasive tests in arterial disease. PMID- 3322479 TI - Pathophysiology of acute obstructive cholecystitis: implications for non operative management. AB - Recent research suggests that disturbances in gallbladder mucosal functions are important in the initiation of acute cholecystitis and its progression. Prostaglandins have pathophysiological significance and prostaglandin synthesis inhibitors such as indomethacin inhibit fluid secretion by gallbladder mucosa, reduce distension and relieve pain. Nerves in the gallbladder wall are involved in disturbed mucosal function, and the benefits of opiates may derive from reduction of active fluid secretion in the inflamed and obstructed gallbladder as well as from central analgesic effects. PMID- 3322480 TI - Randomized trial comparing anorectal myectomy and controlled anal dilatation for outlet obstruction. AB - A randomized controlled study has compared anorectal myectomy (n = 13) with anal dilatation (n = 10) using Park's anal retractor for patients with constipation. No patient was able to defaecate spontaneously more than three times a week before the operation. Of the 13 patients, 7 were able to defaecate spontaneously more than three times a week after anorectal myectomy, compared with none after anal dilatation (P less than 0.05). None of the patients in either group became incontinent. There was a significant fall of anal canal pressure after anorectal myectomy at rest, during maximum pelvic floor contraction, and attempted defaecation: median, 100 (range, 21-200) to 43 (20-133) cmH2O, P less than 0.01; 140 (79-238) to 86 (43-153) cmH2O, P less than 0.01; 127 (79-208) to 86 (29-167) cmH2O, P less than 0.005. A significant improvement in rectal emptying occurred after anorectal myectomy (median, 0 per cent/min (range, 0-83) to 50 (0-100) per cent/min, P less than 0.025). On the other hand, anal dilatation was not associated with any significant change in rectal emptying or anal pressure. Pre operative anal pressures during attempted defaecation in patients who achieved a good result after anorectal myectomy were significantly higher than those that did not (median, 136 (range, 120-208) versus 114 (79-129) cmH2O, P less than 0.025). Patients having a good result after anorectal myectomy had a significantly shorter history of constipation (median, 4 (range, 2-14) versus 38 (4-72) years, P less than 0.01) and normal colonic transit (median, 100 (range, 4 100) versus 10 (0-90) years, P less than 0.05) compared with those who had no benefit after operation. PMID- 3322481 TI - Historical aspects of psychoses: 19th century issues. PMID- 3322483 TI - Epidemiology of schizophrenia and affective psychoses. PMID- 3322482 TI - Diagnosis and classification of functional psychoses. PMID- 3322484 TI - Genetic influence on the psychoses. PMID- 3322485 TI - The psychotic hinterlands or the fringes of lunacy. PMID- 3322486 TI - Childhood psychoses and their borderlands. PMID- 3322487 TI - The neurology of schizophrenia. PMID- 3322488 TI - The neuropathology of schizophrenia--a progress report. PMID- 3322489 TI - Application of imaging techniques. PMID- 3322490 TI - Laterality and psychosis: neuropsychological evidence. PMID- 3322492 TI - Physical treatments. PMID- 3322491 TI - Endocrinology and psychosis. PMID- 3322493 TI - Non-physical treatment of the psychoses. PMID- 3322494 TI - Social implications of psychosis. PMID- 3322495 TI - Has the outcome of schizophrenia changed? PMID- 3322496 TI - Psychosis as a continuum and the virogene concept. PMID- 3322497 TI - Ocular emergencies in the dog and cat. PMID- 3322498 TI - Disorders of the tarsus in the dog. II. PMID- 3322499 TI - The ecology of Escherichia coli in healthy newborn piglets. PMID- 3322500 TI - Intraneural microstimulation in man. Its relation to specificity of tactile sensations. AB - Recent advances in knowledge, and controversy, concerning cutaneous mechanoreception are reviewed. In particular, the question of perceptive specificity is discussed in the light of new experimental approaches, namely microneurography and microstimulation of identified tactile units from the glabrous skin of the human hand. Additional data are also presented. It is concluded that the human brain has an exquisite capacity to detect, localize, delineate, and classify sensations from the input of individual tactile units in the glabrous skin of the hand. The physiological specificity of low-threshold mechanoreceptors in the hand, which has been well documented in previous studies, can now be linked to distinct attributes of very simple tactile sensations which subjects report when a single afferent is stimulated electrically through an intraneural microelectrode. This conclusion does not conflict with the concept that the brain normally makes use of temporal and spatial patterns of impulses from a large number of receptors of various types to form more complex tactile percepts, such as in the recognition of texture, but the microstimulation data demonstrate that particular patterns of nerve impulses are not a necessary determinant of the subjective quality attribute of a simple tactile sensation. On the contrary, the sensations elicited by a train of impulses in a single afferent unit are remarkably distinct and well characterized in a number of respects. A further conclusion is that the afferent inputs are processed differently in tactile subsystems. This observation warrants caution in generalizing results from one system into a common theory of the origin of sensory modality. PMID- 3322502 TI - Selective induction of a heat shock gene in fibre tracts and cerebellar neurons of the rabbit brain detected by in situ hybridization. AB - In situ hybridization reveals striking regional differences in the expression of constitutive and inducible heat shock genes in the rabbit brain. Fibre tracts throughout the brain show a dramatic induction of heat shock mRNA after hyperthermia, a pattern consistent with a strong glial response to heat shock. While neurons in the cerebellum exhibit a marked induction of heat shock mRNA, neurons of the hippocampus do not. Constitutive expression of a heat shock gene is observed in neuronal laminae of the hippocampus and cerebellum. PMID- 3322501 TI - 5-Hydroxytryptamine-sensitive [3H]imipramine binding of protein nature in the human brain. I. Characteristics. AB - [3H]Imipramine binding sites were characterized in the human brain by investigating the sensitivity to protease treatment, dependency on NaCl and the effects of drug inhibition. The binding was found to consist of a protease sensitive and a protease resistant fraction. These two fractions could be discriminated by 5-hydroxytryptamine (5-HT) but not desipramine. The [3H]imipramine binding discriminated by 5-HT was found to be sodium dependent. The 5-HT-sensitive [3H]imipramine binding displayed a regional variability with Bmax values ranging from 50 to 100 fmol/mg protein in neocortical areas to 400 500 fmol/mg protein in the substantia nigra and hypothalamus. The Kd values for 5 HT-sensitive [3H]imipramine binding were 1-2 nM throughout the brain. Additional [3H]imipramine binding insensitive to 5-HT, but displaceable by desipramine showed little regional variation, with the binding capacity in the hypothalamus approximating that found in cortical areas. This binding fraction was of low affinity, was not dependent on the presence of NaCl and was insensitive to protease treatment. Drug inhibition studies revealed that the addition of low concentrations of 5-HT or norzimeldine to 5-HT-sensitive [3H]imipramine binding sites produced changes in affinity, consistent with a competitive interaction. It is suggested that the 5-HT-sensitive [3H]imipramine binding may represent the substrate recognition site for 5-HT uptake in the human brain. PMID- 3322503 TI - Immuno-electronmicroscopic localization of 'vitamin D-dependent' calcium-binding protein (CaBP-28k) in the vestibular hair cells of the cat. AB - The PAP immunohistochemical method was used to carry out a light- and electronmicroscopic study of the distribution of the vitamin D-dependent calcium binding protein (CaBP-28k, calbindin, cholecalcin) in the vestibule of the young cat. It was found that the two types of hair cells, types I and II, were stained differently. Type II cells were intensely immunoreactive and their staining did not vary with the location of the cells within the crista ampullaris. Type I cells at the top of the cristae were lightly stained, or unstained, while the type I cells laterally or basally were frequently intensely stained. The nerve fibers arriving at the top of the cristae are highly immunoreactive while the fibers of the base are not stained. Immunostaining for CaBP was correlated with differences in the innervation of hair cells at the top and base of the cristae. This differential CaBP-immunostaining may reflect differences in the physiological activity of the cells. The electronmicroscopic study showed that CaBP is present throughout the cytoplasm of the hair cells but that its concentration was particularly high in the cuticular plate and stereocilia. This specific intracellular distribution of CaBP is discussed with the possible role of Ca2+ in the physiology of the vestibular hair cells. PMID- 3322504 TI - The presence of creatine kinase (CK)-immunoreactive neurons in the zona incerta and lateral hypothalamic area of the mouse brain. AB - Immunohistochemical studies of mouse brain using antibody to creatine kinase (CK) revealed a distinctive group of positive neurons in zona incerta and lateral hypothalamic area. These CK-immunoreactive neurons showed an intense, granular staining pattern, while other positive neurons distributed in other brain areas showed a weak, diffuse pattern. PMID- 3322505 TI - Unique behavioral effects of the NMDA antagonist, CPP, upon injection into the medial pre-frontal cortex of rats. AB - Injection of the specific N-methyl-D-aspartate (NMDA) antagonist, 3(2 carboxypiperazin-4-yl)-propyl-1-phosphonic acid (CPP), into the frontal cortex of rats, induced hyperactivity characterized by unique episodic darting behavior. This behavioral profile contrasts sharply with the ataxia and hyperactivity seen after intracerebroventricular CPP and other NMDA antagonists. PMID- 3322506 TI - Corticotropin-releasing factor-like immunoreactive nerve fibers in the rat superior cervical ganglion and their fine structures. AB - The existence of nerve fibers containing corticotropin-releasing factor (CRF) like immunoreactivity (CRFI) in the rat superior cervical ganglion (SCG) was demonstrated by using immunocytochemistry. They were found to be extrinsic in origin, because no CRFI neurons were seen in the SCG and decentralization resulted in the disappearance of CRFI fibers in the SCG on the operated side. These findings were also confirmed by immunoelectron microscopic analysis; CRFI fibers contained a number of small clear synaptic vesicles but were devoid of large granular and agranular vesicles. These morphological characteristics are identical to those of the preganglionic fibers. The present immunoelectron microscopic analysis revealed that most of the CRFI fibers in the SCG make synaptic contact predominantly with the dendrites of the principal cells, partly with their somas and rarely with a non-CRFI terminal. Thus, the present study provides direct morphological evidence that CRF directly influences the function of the principal cells of the SCG and that CRFI fibers are preganglionic. PMID- 3322508 TI - [Development of the diagnosis and therapy of female genital tuberculosis in Czechoslovakia]. PMID- 3322509 TI - [Robert Schumann's psychosis]. PMID- 3322507 TI - L-homocysteate is a potent neurotoxin on cultured cortical neurons. AB - L-Homocysteate (L-HCA) neurotoxicity was quantitatively studied in dissociated cell cultures prepared from the fetal mouse neocortex. Five minute exposure to 3 microM-1 mM L-HCA was associated with neuronal cell loss, but not glial cell loss; the extent of neuronal damage was dependent on the concentration of L-HCA, with an ED50 of approximately 40 microM. The stereoisomer D-HCA was a somewhat weaker neurotoxin than L-HCA. Ion substitution experiments suggested that L-HCA neurotoxicity can be separated into two components on the basis of differences in time course and ionic dependence: an acute, sodium-dependent 'excitotoxic' component, marked by rapid early cell swelling; and a late, calcium-dependent component, marked by delayed cell degeneration. L-HCA neurotoxicity could be attenuated by 2-amino-5-phosphonovalerate (APV), ketamine, and kynurenate, but not by L-glutamate diethyl ester or gamma-D-glutamylaminomethyl sulfonate, consistent with a predominant involvement of N-methyl-D-aspartate receptors. APV and ketamine produced different effects on the L-HCA concentration-toxicity relation, the former drug consistent with a competitive, and the latter drug consistent with a non-competitive, mechanism of antagonism. PMID- 3322510 TI - [The beginnings of Prof. Herman Krsek's work at the Institute of Forensic Medicine in Bratislava]. PMID- 3322511 TI - Influence of enterally administered ornithine alpha-ketoglutarate on hormonal patterns in burn patients. AB - Plasma concentrations of glucose, insulin, C-peptide, glucagon, cortisol and hGH were measured in burn patients (mean burn surface area 21 per cent) treated or not with ornithine alpha-ketoglutarate (OKG). An increase in basal values of glucose, insulin, C-peptide and cortisol was demonstrated in both groups, whereas hGH values diminished. OKG modified neither insulin nor hGH values 24 h after its enteral administration nor insulin levels within the first 4 h after intake. On the other hand, 60 min after enteral nutrition was restarted the hyperglycaemia observed in untreated subjects was reduced by OKG whereas a hyperinsulinism was observed in both groups. These results suggest that: (i) the anticatabolic/anabolic action of OKG in burn patients is not mediated by insulin or hGH, (ii) OKG probably induces an increase in glucose tolerance in burn patients, in whom there is a state of insulin resistance. The mechanism of this action requires further study. PMID- 3322512 TI - Cancer of the prostate: current perspectives. PMID- 3322513 TI - Application of transmission electron microscopy to human tumor diagnosis: an historical perspective. PMID- 3322514 TI - Does radiation-induced abrogation of skin Langerhans cell functions lead to enhanced incidence of skin tumors in patients with genetic disorders of DNA repair? AB - A hypothesis is presented which states that persons with the genetic disorders xeroderma pigmentosum and ataxia-telangiectasia, manifested by a deficiency of DNA repair, develop cutaneous tumors due to the elimination of reticuloendothelial system cells (Langerhans cells) in the skin, and the subsequent loss of control of epidermal cellular elements. PMID- 3322515 TI - School-based sexual abuse prevention programs: a review. AB - In response to the alarmingly high incidence and negative consequences of child sexual abuse, an increasing number of school-based prevention programs have appeared in communities across the United States. In this paper, programs which have been implemented in grades K-6 are summarized according to mode and content of presentation, audience and trainer characteristics, and program length. While many creative and entertaining prevention programs are available for children, empirical validation of these programs has lagged behind their actual development and implementation. Several research questions need to be addressed before we can confidently assert that such programs are effective in preventing the sexual exploitation of children. Evaluation efforts must be expanded in order to improve existing materials, obtain funding, and ensure public and professional support for school-based sexual abuse prevention programs. PMID- 3322517 TI - The perinatal period, a window of opportunity for enhancing parent-infant communication: an approach to prevention. AB - The perinatal period, broadly defined, encompasses the time frame from one year before to 18 to 24 months after the birth of the child. This period constitutes a window of opportunity through which parent-infant interaction may be reinforced, offering the possibility of decreasing the risk of family dysfunction. This review article clarifies the relationship between the enhancement of parent infant interactions and the prevention of child abuse and neglect. It contains a detailed discussion of the capabilities of the newborn and places in perspective the difficulty experienced when parents who were themselves mistreated in childhood struggle to establish a system of communication with their own newborn children. The perinatal intervention program, a program intended to teach new parents the skills of interaction with their newborns, is described and placed into perspective with other perinatal programs which have been reported to be capable of augmenting the capacity for communication. The authors review the research data demonstrating the efficacy of these perinatal parent-infant programs. The paper concludes with a review of effective interventions, a discussion of what can be expected of each, and suggestions for the practical application of the programs during the perinatal period. The authors recognize that no program taken in isolation is sufficient; taken together they have the ability to improve parent-child relations, and they thus constitute a multifaceted approach to the prevention of child abuse and neglect. PMID- 3322516 TI - Web of deceit: a literature review of Munchausen syndrome by proxy. AB - Munchausen syndrome by proxy (MSBP) is a form of child abuse wherein the mother falsifies illness in her child through simulation and/or production of illness, and presents the child for medical care, disclaiming knowledge as to etiology of the problem. From the literature, 117 cases of MSBP were reviewed. The most common presentations of MSBP were bleeding, seizures, central nervous system depression, apnea, diarrhea, vomiting, fever, and rash. Short-term morbidity rate was 100%; long-term morbidity rate was 8%. Mortality rate was 9%. Failure to thrive was associated with MSBP in 14% of cases. All perpetrators of MSBP were the mothers. The origins of this type of aberrant maternal behavior remain abstruse, as do the long-term psychological effects on the child victims. Guidelines for medical, social service, and legal management are provided. PMID- 3322518 TI - Changes in dental health in Hong Kong after 25 years of water fluoridation. PMID- 3322520 TI - The laboratory as an aid to clinical diagnosis. AB - The clinician may use the clinical pathology laboratory as a valuable aid to diagnosis and management, for the assessment of response to treatment, and in preventive medicine programs. Each "link in the chain," that is, sample selection, collection, handling, analysis, result reporting, and interpretation must be carefully and efficiently managed, using an informed combination of art and science, to provide a useful endpoint. This general introduction precedes more specific and detailed articles. PMID- 3322519 TI - The dental needs and demands of an elderly population living in care in South Cumbria. PMID- 3322521 TI - Hematologic values in horses and interpretation of hematologic data. AB - Normal reference ranges and pertinent background information on equine hematology are presented and briefly discussed. Diagnostic interpretation of hematologic data is discussed and three diagnostic algorithms and two diagnostic tables are provided to facilitate the use of the presented information for diagnosis. Two cases are presented and the information presented in the article is used to interpret the case data. PMID- 3322522 TI - Equine hemostasis. Description, evaluation, and alteration. AB - This is a review of equine hemostasis and is divided into three sections. The initial portion describes the normal hemostatic system and includes platelet function, coagulation, fibrinolysis and control processes. The second phase is devoted to laboratory tests of hemostasis, and the last section provides information on specific alterations. PMID- 3322523 TI - Laboratory evaluation of malassimilation in horses. AB - Malassimilation should be suspected in horses with weight loss in spite of a good appetite. Malassimilation is usually confirmed with oral glucose or D-xylose absorption tests, whereas the oral lactose tolerance test can be used to evaluate lactase deficiency in foals. Once malassimilation is confirmed, other diagnostic tests such as abdominocentesis, rectal mucosal biopsy, or exploratory laparotomy with intestinal biopsies may determine the etiology of malassimilation. PMID- 3322525 TI - Use of clinical pathology in evaluation of horses with colic. AB - Clinical pathology is a valuable adjunct to physical examination of cases of colic. The present review considers evaluation of cases of colic for three main purposes: (1) making a prognosis, (2) deciding whether to operate, and (3) making a diagnosis. Blood tests noted to be useful for prognostication were hematocrit, lactate and urea nitrogen concentrations, pH, anion gap, fibrin/fibrinogen degradation products, antithrombin III activity, prothrombin time, and thrombin time. Horses with a poor prognosis often have relative polycythemia, marked lactic acidosis, high anion gap, azotemia, and coagulation abnormalities evidenced by increased fibrin/fibrinogen degradation products, decreased antithrombin III activity, and prolonged prothrombin and thrombin times. The decision to operate is usually a clinical one, supported by relative polycythemia, hyperglycemia, and, possibly, abnormal peritoneal fluid analysis. Diagnosis of the primary problem (causing the colicky signs) is also often based largely on physical examination. However, peritoneal fluid analysis provides worthwhile data, especially in cases of peritonitis or intestinal ischemia and infarction. PMID- 3322526 TI - Collection and evaluation of equine peritoneal and pleural effusions. AB - This article discusses collection, slide preparation, culture technique, fluid analysis and evaluation, and cytologic evaluation of peritoneal and pleural effusions. The morphologic characteristics of various effusions are described, and the physical characteristics (volume, color, turbidity) of effusions are discussed. An algorithm for classifying effusions as transudates, modified transudates, or exudates is included, and each category is discussed. PMID- 3322527 TI - Evaluation of hepatobiliary disorders in the horse. AB - This article addresses clinical problems that present in equine liver disease. It also discusses the variety of laboratory tests available to the clinician that can differentiate the type and degree of liver dysfunction. This is followed by a more specific discussion regarding unique features of equine bilirubin and bile acid metabolism. PMID- 3322524 TI - Evaluation of foals for immune deficiency disorders. AB - Currently recognized equine immune deficiency disorders include failure of passive colostral immunoglobulin transfer, combined immunodeficiency, selective IgM deficiency, transient hypogammaglobulinemia, and agammaglobulinemia. Additional equine immune deficiency disorders probably exist. Immune deficiency should be suspected in any horse experiencing persistent or recurrent infections that are not responsive to conventional therapy. PMID- 3322528 TI - Laboratory diagnosis and characterization of renal disease in horses. AB - Laboratory evaluation of renal function in horses has advanced dramatically in the last 10 years largely as a result of the interest generated by the creative approach to diagnostic indices taken by Brobst, Traver, Coffman, and others. Some methods of assessing renal function discussed here are clearly outside the scope of a practice environment but are available in referral hospitals for use in difficult or unusual cases. Other methods described, such as calculation of fractional excretions and urine to serum creatinine ratios, are accessible and readily interpreted by the veterinary practitioner. These diagnostic methods should help in the early identification of renal disease in horses and therefore should allow veterinarians the option to treat renal disease before renal failure is advanced. In addition, practitioners may be able to offer more informed prognoses after a more complete evaluation of renal function. PMID- 3322529 TI - Blood gas and acid-base changes in the neonatal foal. AB - This article reviews what are considered the basic concepts of gas transport, blood gases, and acid-base physiology is most mammalian species. Techniques for the appropriate collection of blood samples for blood gas and acid-base determinations in the newborn foal are described. Guidelines for interpretation of these values in the normal foal and those animals undergoing respiratory and metabolic derangements are provided. PMID- 3322530 TI - The interpretation of clinicopathologic data from the equine athlete. AB - It is the purpose of this article to review much of the information that is available regarding the adjunctive use of clinicopathologic data in evaluations of performance horses by veterinarians. Wherever possible, distinctions are made between findings that pertain to racehorses and those that apply most specifically to horses involved in "submaximal" events like combined training and endurance races. It is hoped that the material presented will clarify some of the problems associated with the interpretation of this data, and possibly stimulate the dissemination of additional information that will further assist practitioners in this aspect of their work. PMID- 3322531 TI - Evaluation of thyroid, adrenal, and pituitary function. AB - The clinical signs and endocrinologic abnormalities that characterize horses with pituitary, thyroid, and adrenal dysfunction are described. Laboratory tests and hormonal assays useful for evaluating horses with suspected endocrinopathies are discussed. PMID- 3322533 TI - Cardiac effects of intracranial lesions. PMID- 3322532 TI - Absence of differential inhibition of thromboxane A2 and prostacyclin by low and high dose aspirin in coronary artery disease. AB - This study assessed the effect of low (40 mg) and high (324 mg) single dose aspirin on cardiac release of thromboxane A2 and prostacyclin as assessed by measurement of coronary sinus levels of metabolites in patients with coronary artery disease. Measurements were done in the resting state and in the presence of pacing stress prior to and 24 h after aspirin administration. There was no consistent response in prostaglandin release under conditions of tachycardia stress as compared to control. Following both doses of aspirin, thromboxane could not be detected at rest or with pacing, and prostacyclin metabolic levels were undetectable in six of seven patients. Prostaglandin levels were not related to myocardial lactate extraction or production and lactate levels had no consistent relationship to aspirin administration. These data indicate that both low and high doses of aspirin inhibit both thromboxane A2 and prostacyclin production in humans. Selective thromboxane inhibition might not be possible. PMID- 3322534 TI - Introduction of electrocardiography in Canada. PMID- 3322535 TI - A hundred years of progress in electrocardiography. 1: Early contributions from Waller to Wilson. AB - The 1887 introduction of electrocardiography as a noninvasive investigative technique on man by Augustus Waller, and Wilhelm Einthoven's electrocardiograph from 1901 remain the two major landmarks in the 100-year history of electrocardiography. The progress in our knowledge of the mechanism and interpretation of the ECG has evolved throughout these 100 years in a succession of relatively small steps contributed by many unsung heroes, although often even relatively minor contributions by a few dominant "stars", notably Thomas Lewis and Frank Wilson, are perceived as giant leaps. The gradual evolution of our concepts of the ECG are reviewed against the historical background of the events involved from the time of Waller's discovery to the end of the second world war. PMID- 3322536 TI - The fourth decade of the Canadian Ophthalmological Society. PMID- 3322537 TI - Effect of a topical carbonic anhydrase inhibitor, 6-hydroxybenzo[b]thiophene-2 sulfonamide, on intraocular pressure in normotensive subjects. AB - A prospective randomized clinical trial was carried out to determine the efficacy of 6-hydroxybenzo[b]thiophene-2-sulfonamide, a potent new carbonic anhydrase inhibitor, in lowering intraocular pressure (IOP) in normotensive volunteers. The drug was administered as a 2% suspension twice daily for 1 week to one eye in 10 subjects. Ten other subjects, serving as controls, received a placebo drop to one eye on the same schedule. Subjects and examiners were unaware of whether the drug or placebo was being used. IOP was measured before the study began and twice daily on days 1, 2, 4 and 8 of the study. The drug had no significant effect on IOP. The most likely explanation is failure of an adequate concentration of the drug to reach the ciliary body. PMID- 3322538 TI - Functions of polyamine acetylation. AB - Acetylation is a means to decrease the net positive charge of the polyamines and thus liberate polyamines from anionic binding sites. The acetyl derivatives can be removed from the cells by transport and catabolism. Intracellular polyamine metabolism can be formulated as a cyclic process, which explains the transformation of one polyamine into another. As a net result, this pathway metabolizes (in an energy-requiring manner) methionine to 5'-deoxy-5' methylthioadenosine and beta-alanine, and thus appears to be futile. It is suggested that the cyclic process is necessary for the precise control of cellular polyamine concentrations, as it allows relatively rapid spermine and spermidine concentration changes, in spite of a slow basal turnover rate. For the regulation of cellular polyamine metabolism, two decarboxylases, L-ornithine decarboxylase and S-adenosyl-L-methionine decarboxylase; the cytosolic acetyl CoA:spermidine/spermine N1-acetyltransferase; and a polyamine transport system are required. The activity of the nuclear acetyltransferase is assumed to be the rate-limiting enzyme of nuclear polyamine turnover. The complexity and high level of sophistication of polyamine regulation is strong evidence for the important functional significance of the natural polyamines. PMID- 3322539 TI - Effect of exercise on net hepatic uptake of lactate, pyruvate, alanine, and glycerol in sheep. AB - Gluconeogenesis increases during exercise, which is associated with elevated concentrations of lactate and glycerol in blood. This study was undertaken to determine if the exercise-induced increase in gluconeogenesis is due to increased hepatic extraction efficiency of glucose precursors. The net hepatic uptake and extraction ratios were determined for selected glucose precursors before and during exercise. The hepatic uptake of lactate and glycerol increased during exercise in fed and fasted animals, but extraction ratios of lactate and glycerol increased only in fed animals. Thus, the exercise-induced increase in gluconeogenesis is due to increased substrate supply and to hepatic extraction efficiency under certain circumstances, which is comparable to the situation in man. PMID- 3322540 TI - Natural family planning indicators of ovulation. AB - Indirect evidence of the occurrence of ovulation, which is generally accepted, is an increase in plasma or serum progesterone. Pelvic ultrasonography can estimate the probable time of ovulation within 12 h. There is a close association between the rise in progesterone, luteinizing hormone (LH) and oestrogen peaks and ovulation. A WHO study reported that ovulation occurred at a median time of 8 h after the rise in plasma progesterone, 15 h after the LH peak and 24 h after the oestrogen peak. The basal body temperature (BBT) method is the most effective in determining the premenstrual infertile period, but it is unreliable for an accurate determination of ovulation and the postmenstrual infertile period. Nor is BBT an effective method of predicting ovulation during postpartum lactational amenorrhoea. Therefore, BBT is usually used as a secondary indicator of ovulation and is combined with more reliable indicators. Observed changes in cervical mucus patterns can be used to define the probable fertile period, although this method produces a wide range of days. The peak mucus symptom is closely correlated with ovulation. Mucus symptoms can be used as a guide for the timing of blood or urine samples for estimation of LH, oestrogen and progesterone or their metabolites. Symptothermal methods incorporate other symptoms such as cervical changes, intermenstrual pain, breast tenderness and backaches, but these are secondary signs of ovulation and are recommended to be used in conjunction with mucus and BBT. PMID- 3322541 TI - Ultrastructural and freeze fracture localization of multilamellar liposomes containing a lipophilic cisplatin analogue in normal tissues and liver metastases of M5076 reticulosarcoma. AB - The tissue localization of multilamellar vesicles (MLV) (size 0.5-5.0 microns) composed of dimyristoylphosphatidyl choline (DMPC) and dimyristoylphosphatidyl glycerol (DMPG) (molar ratio 7:3) containing a lipophilic cisplatin analogue (NDDP) was studied in mice by freeze fracture (FF) and transmission electron microscopy (TEM). Liposomes were observed within cytoplasmic vacuoles of hepatocytes and Kupffer cells in normal mice as early as 5 minutes after intravenous (iv) administration of MLV-NDDP. Liposomes within hepatocytes were more numerous but smaller in diameter (0.5-2.0 microns) than those within Kupffer cells (2.0-4.0 microns). In normal lung examined by FF or TEM at 5 minutes after MLV-NDDP administration, liposomes were only observed in the intravascular space. Liposomes could not be identified within Type I or II pneumocytes nor within the alveolar space. Two hours after iv administration, the distribution within the liver showed an increased number of liposomes in the hepatocytes with some evidence of liposome decomposition. The distribution in the lung was virtually identical to that observed at 5 minutes. The pattern of tissue localization within lung and liver of empty MLV 5 minutes and 2 hours after iv administration was identical to that of MLV-NDDP. In mice bearing gross liver metastases of M5076 reticulosarcoma, liposomes were present in the cytoplasm of tumor cells as well as normal cells 5 minutes and 2 hours after the iv administration of MLV NDDP. These studies suggest that MLV composed of DMPC and DMPG containing NDDP are able to cross the liver sinusoidal capillaries and gain access to both hepatocytes from normal liver and malignant cells of M5076 reticulosarcoma from liver metastases. PMID- 3322542 TI - Cancers of the head and neck. PMID- 3322543 TI - Priorities for cancer nursing research. A Canadian replication. Western Consortium for Cancer Nursing Research. PMID- 3322544 TI - The potential of oncogene products as tumour markers. AB - This paper discusses the possibilities of using the altered expression of oncogenes and their products in neoplastic tissues as markers for the diagnosis, prognosis and monitoring of human malignant disease. Results from our studies of the c-myc oncogene and its product in human solid tumours, using DNA and RNA hybridization and a set of monoclonal antibodies (MCAs) raised against synthetic peptides, are presented. These illustrate three important principles. Firstly, the level of expression of the gene correlates closely with histological grading. Secondly, the increased expression of an oncogene in a tumour can be used as a marker for imaging with radiolabelled MCA. Thirdly, the detection of a 40,000 dalton serum protein, which is immunologically related to the p62c-myc oncoprotein, and its quantitative analysis in patients with cancer and normal controls, suggests that oncogene-related serum proteins may provide novel markers for monitoring tumour activity. These data support the view that the detailed analysis of oncogene expression has the potential to predict a tumour's behaviour and response to different therapeutic modalities. PMID- 3322546 TI - Neuroblastoma: new approaches to diagnosis. AB - Monoclonal antibodies can play an important part in distinguishing neuroblastoma from other small round cell tumours of childhood. In addition, they have been useful in the identification of metastatic tumour cells in bone marrow. Though these roles for antibodies are now well proven, other functions for these reagents such as radioimmunolocalization and targeted therapy need further evaluation. The problems in the diagnostic use of monoclonal antibodies are reviewed and an assessment given on the type of panels that can be constructed as diagnostic aids. Other new diagnostic approaches in vivo and in vitro are reviewed for comparison. The rapidly developing specialties of molecular biology and molecular cytogenetics will almost certainly have an impact on the diagnosis and prognosis of patients with neuroblastoma. Although these are currently research tools, in a short time they will be in use in routine diagnosis. With the increased basic research into neuroblastoma, it is hoped that it will not be too long before the overall survival rate for the disease is improved. In the meantime the new diagnostic approaches outlined in this paper will ensure that patients are treated with an appropriate chemotherapeutic regimen and will allow the selection of subgroups of individuals for new aggressive chemo/radiotherapeutic protocols. PMID- 3322545 TI - Immunohistology in the identification of tumour types. AB - Recently developed immunohistological techniques coupled with the advent of the monoclonal antibody era have revolutionized diagnostic tumour pathology. The search for a tumour specific marker has not been fulfilled; however, judicious use of panels of antibodies recognizing tissue differentiation antigens has enabled separation of morphologically indistinct tumours where this was not previously possible. This same approach has proved useful for identifying site of origin in small tumour biopsy specimens, in aspirates of malignant cells from body fluids and in micrometastases. Lymphoma phenotyping is the field where the greatest advances have been made. This is because of the diverse range of antibodies available in this area and the widespread cooperation in characterizing and clustering these antibodies that has occurred at the three international workshops on leucocyte antigens. Less dramatic, but nevertheless appreciable advances have been made in the field of solid tumours, using antibodies to differentiation products or organ specific products to identify the site of origin of a carcinoma or sarcoma. The identification of consistent production of aberrant differentiation products also provides a promising approach to tumour identification. The recognition of changed antigenic phenotype in preinvasive neoplastic cells offers a means of early, more objective, diagnostic assessment of these lesions. PMID- 3322548 TI - Use of transmembrane potentials in the identification of tumour cells. AB - The electrical properties of the cancer cell are useful parameters associated with neoplastic pathophysiological events. Although transmembrane potentials may not serve as inherent tumour markers in many instances, electrophysiological properties are, indeed, very useful in the investigation of malignant cellular proliferation, the influence of malignant disease on normal cell physiology and chemical carcinogenic events and possibly as an in vivo measurement in the cancer patient. PMID- 3322547 TI - Radioimmunoscintigraphy in tumour identification. PMID- 3322549 TI - Proton magnetic resonance spectroscopy and tumour detection. AB - High resolution proton magnetic resonance spectroscopy is a powerful technology in the study of tumour cell membranes. Lipid domains in the plasma membrane are the origin of high resolution spectra seen in tumour cells, and changes in those domains can be correlated not only with changes in lipid and carbohydrate components of the membrane, but also with changed tumour behaviour, ie metastatic capacity, and sensitivity to cytotoxic drug treatment. An understanding of the biological importance of lipid changes in the cell membrane paves the way to high resolution spectroscopy being useful in classifying tumours, and perhaps in tumour imaging. PMID- 3322550 TI - Magnetic resonance imaging in lymphoma--the role of spin lattice relaxation time measurement. PMID- 3322551 TI - Tumour identification using magnetic resonance imaging. PMID- 3322552 TI - The radiological identification of tumours in children. AB - The diagnostic imaging procedures now available for the identification of tumours are many. Much of the information gained from one imaging procedure is simply duplicated by another without the addition of new information. This is wasteful of resources. An understanding of the advantages and limitations of each technique is essential for the selection of the best diagnostic pathways. These are briefly described and followed by a brief discussion of the role of radiology in the protocols for the treatment of childhood cancer. No attempt is made to indicate how each specific tumour should be investigated. PMID- 3322553 TI - The clinical application of computed x ray tomography in tumour identification. AB - The clinical applications of computed x ray tomography (CT in tumour identification are reviewed. The advantages and limitations of the technique are highlighted in the context of tumour presentation, staging and subsequent management. Particular emphasis is laid on the ability of CT guided biopsy techniques to overcome the lack of soft tissue specificity inherent in CT scanning. PMID- 3322554 TI - Brain abscess. PMID- 3322555 TI - Heterotopic brain cyst from middle cranial fossa to submandibular region. AB - The case of a newborn boy with a congenital cystic neck mass causing respiratory distress is reported. This lesion extended from the submandibular region through a bone defect to the middle cranial fossa but remained totally extradural. There was no underlying brain abnormality. The cyst was composed mainly of mature neuroglial tissue, with some ependymal and choroid plexus elements, and was diagnosed as heterotopic brain. After 8 years' follow-up, the child still has no deficits. PMID- 3322556 TI - Structure of the capsular polysaccharide of Escherichia coli O9:K32(A):H19. AB - The capsular polysaccharide of the bacterium Escherichia coli O9:K32(A):H19 was analyzed using chemical methods (hydrolysis, sequential Smith degradation, methylation analysis) together with 1H- and 13C-n.m.r. spectroscopy. 13C-N.m.r. spectroscopy and chemical analyses indicated that the K32 polysaccharide is composed of equimolar proportions of glucose, galactose, rhamnose, and glucuronic acid, and carries O-acetyl groups. 1H-N.m.r. analysis of native K32 polysaccharide revealed five resonances in the anomeric region (delta 5.52, 5.16, 5.12, 5.02, and 4.73) and the presence of an acetyl group (delta 2.18). O Deacetylation of the polysaccharide resulted in the loss of the resonance at delta 2.18 and one of the resonances (delta 5.52) in the anomeric region. The "extra" anomeric resonance in the 1H-n.m.r. spectrum of the native K32 polymer was assigned to H-2 of rhamnose, which experiences a large downfield shift when the 2-position is O-acetylated. This was confirmed by a 2D-COSY n.m.r. experiment and studies of model compounds. The K32 capsular polysaccharide is of the "2 + 2" type, comprised of the following repeating unit: (sequence; see text) This structure is identical to that of Klebsiella K55 capsular polysaccharide. PMID- 3322557 TI - Structure of Escherichia coli capsular antigen K34. AB - The structure of the heat-stable K antigen of Escherichia coli serotype K34 has been determined by n.m.r. spectroscopy, methylation analysis, and Smith degradation to be (formula; see text) The assignment of the single alpha-linkage to the D-glucosyl residue was confirmed by the positive reaction of an alpha-D glucosidase on the oligosaccharide obtained by bacteriophage depolymerization. It is noteworthy that the same enzyme was without action on the native polysaccharide. PMID- 3322558 TI - [K.S. Amerling--physician, teacher, builder]. PMID- 3322559 TI - [Activities of the Czech Medical Society 1982-1986]. PMID- 3322560 TI - [Purkinje's explanation of the origin and development of the earth and of life]. PMID- 3322561 TI - [Honorary citzenships bestowed on Jan Evangelista Purkinje]. PMID- 3322562 TI - [The views of Bozena Nemcova on health and disease]. PMID- 3322565 TI - Cell free translation of rat epidermal calcium-binding protein (EP-12) messenger RNA. AB - The primary step in the biosynthesis of 12 KDa rat epidermal calcium binding protein was studied by cell-free protein synthesis. Poly(A)+ rich RNA was extracted and purified from whole newborn rat skin and translated in a lysate system in the presence of labeled methionine. Immunoprecipitation of translation products with a monospecific antibody directed against this protein, which did not react with parvalbumin yielded a product migrating as a single band of molecular weight 12 KDa on polyacrylamide gel electrophoresis. Thus, a mRNA coding for this protein is present in rat skin. The presence of this messenger RNA opens the way for further studies on the regulation of epidermal expression during epidermal cell proliferation and differentiation. PMID- 3322563 TI - Binding and endocytosis of heparin-gold conjugates by the fenestrated endothelium of the rat choriocapillaris. AB - Heparin-gold probes were used to localize regions of heparin binding on the luminal surface of the diaphragmed-fenestrated endothelium of the rat choriocapillaris. Structures of endothelial cells were unlabeled when rats were kept on ice and perfused with solutions at 4 degrees C. When the heparin-gold quantity was doubled, only a few heparin-gold particles marked some diaphragms spanning fenestrae, vesicles and channels, parajunctional regions of the plasmalemma, and coated pits. With solutions at 4 degrees C, but the animals kept at room temperature, all of these structures in the endothelial cells were labeled. This binding was not altered by the perfusion of low levels of unlabeled heparin, but was eliminated following high levels of unlabeled heparin, and by digestion with trypsin and pronase. At 37 degrees C, heparin was localized to the above structures and, in addition, was internalized into coated vesicles, endosomes, and multivesicular bodies, but not other types of lysosomes. Some particles were found in tubules adjacent to the Golgi stacks. Heparin-gold was also transported to the abluminal front of the endothelium by vesicles. A desulfated, non-anticoagulant, fraction of heparin bound to gold was localized to the endothelium in the same manner. These results demonstrate receptors for heparin on the surface of a fenestrated endothelium. Furthermore, they show the pathway of endocytosis and transport of heparin. The possible roles of heparin in the function of the endothelium is discussed. PMID- 3322564 TI - Terminal differentiation in the avian uropygial gland. Accumulation of fatty acid synthase and malic enzyme in non-dividing cells. AB - The secretory tissue of the uropygial gland is of the holocrine type, containing both dividing progenitor cells and lipid-filled differentiated cells. In this study, we examined the relationship between cell division and differentiation. The location of dividing cells was determined by autoradiography of tissue sections from ducklings injected intra-abdominally with 3H-thymidine. Only cells on the basal lamina of the tubules contained labeled nuclei. Dividing cells were distributed uniformly over the length of the tubules. Over the next five days, most of the labeled cells migrated to the lumen of the tubules and disappeared. Cells containing the "lipogenic" enzymes, fatty acid synthase and malic enzyme, were localized either immunocytochemically using affinity-purified antibodies or cytochemically using a specific assay for malic enzyme activity. Fatty acid synthase and malic enzyme were undetectable in dividing basal cells but present at high levels in differentiating and differentiated cells. Thus, basal cells lying along the basal lamina of the tubules were replacing lipid-laden cells that were continually sloughed into the lumens of the tubules. The signals for differentiation and enzyme accumulation appear to be linked to one another and to cessation of cell division. PMID- 3322567 TI - Chloroquine-resistant Plasmodium falciparum at two farms near Mhangura. PMID- 3322566 TI - Calcium content in liver and heart and its intracellular distribution in liver during endotoxicosis and sepsis in rats. AB - The hypothesis was tested that several metabolic and functional alterations associated with endotoxicosis and sepsis could be due to a Ca overload of liver and heart in rats. Male rats were given intravenously E. coli endotoxin (ET) or rendered septic by cecal ligation and puncture. At various intervals after ET injection and 16-18 h after the onset of peritonitis the animals were sacrificed and the liver and heart sampled for assay of the total Ca content. Also, livers of saline- or ET-treated rats were perfused in vitro to study several aspects of Ca movements as affected by phenylephrine infusion. Livers, were also fractionated to study the subcellular distribution of Ca. ET treatment produced a slight, but significant increase in total hepatic Ca content (12.6% at 4 h and 7.7% at 24 h after ET injection). Sepsis did not affect this parameter in either liver or heart. ET also produced a decrease of Ca content in the microsomal fraction of liver, while sepsis was associated with an elevated Ca content of liver mitochondria. Perfused livers of saline-treated rats responded to phenylephrine by accumulating Ca, while the perfused organs of ET-treated rats did not display such a response to agonist infusion. We conclude that impairment of intracellular Ca homeostasis--under the conditions studied--consists of a slight Ca overload in endotoxicosis, associated with discrete alterations of Ca fluxes and compartmentalization within the cell both in endotoxicosis and sepsis. PMID- 3322568 TI - Clinical pharmacokinetics of carbamazepine. PMID- 3322570 TI - [35 years' of independent pharmacy education]. PMID- 3322569 TI - Classic migraine: effective prophylaxis with metoprolol. AB - Metoprolol slow-release tablets (Durules), 200 mg, given once daily in the morning were compared with placebo in the prophylaxis of classic migraine. The trial comprised eight Scandinavian neurologic centres and was designed as a double-blind cross-over study with 4 weeks' run-in, four weeks washout, and 8 weeks of either treatment. Seventy-seven patients with two to eight migraine attacks per month were entered in the trial, and 73 completed it. A total of 1119 attacks with aura symptoms and 374 without were recorded. Metoprolol was significantly better than placebo with regard to the total frequency of attacks (1.8 versus 2.5 attacks/4 weeks), mean duration of attacks (6.0 versus 8.0 h/attack), mean global rating, and consumption of analgesics per attack. Similar differences could be shown for attacks with aura symptoms alone, except for the duration of attacks. Metoprolol is the first drug for which a prophylactic effect in classic migraine has been convincingly demonstrated. PMID- 3322571 TI - [What Jan Evangelista Purkinje means to us]. PMID- 3322572 TI - [The Czechoslovak Physiology Society 1984-1987]. PMID- 3322573 TI - [Ejection fraction of the heart in physiology and pathology]. PMID- 3322575 TI - [The contribution of J.E. Purkinje to knowledge of the nervous system]. PMID- 3322574 TI - [The metabolism, physiologic role and toxicity of chromium]. PMID- 3322576 TI - [The reticulo-spinal system. Its role in organization at the motor segmental level: postural function, locomotion, specific (intentional) movements. II]. PMID- 3322577 TI - [A case of Jakob-Creutzfeldt disease with an unusual course]. PMID- 3322578 TI - [Maurice Ravel and Pick's disease]. PMID- 3322579 TI - [Psychosomatic problems from the time of Descartes until today]. PMID- 3322580 TI - [Prof. Myslivecek and the development of Slovak psychiatry]. PMID- 3322581 TI - [The development of the psychiatric hospital in Sucany from 1961 to the present]. PMID- 3322582 TI - [Anti-insulin antibodies and their development in relation to therapy]. PMID- 3322583 TI - [120 years since the birth of Dr. Karel Svehla]. PMID- 3322584 TI - [30 years' of the Institute for Research in Child Development]. PMID- 3322585 TI - [Use of expert systems in the clinical genetics of polydactyly and progressive muscular dystrophies]. PMID- 3322586 TI - [Is there an alternative to excretory urography?]. PMID- 3322588 TI - In vitro antibacterial activity and beta-lactamase stability of CL 118523, an aminothiazolyl iminomethoxy cephalosporin. AB - CL 118523 is an aminothiazolyl cephalosporin which contains a 1, 2, 3-thiadiazol radical at position 3 of the cephem nucleus. It was as active as cefotaxime, ceftazidime and aztreonam against most Enterobacteriaceae, MIC 90% less than 1 mg/l, and more active, 8 to 32-fold, than cefoperazone and cefoxitin. Enterobacter species resistant to the other agents were resistant to CL 118523. CL 118523 did not inhibit Pseudomonas aeruginosa, Pseudomonas maltophilia, MIC greater than 128 mg/l. It had excellent activity against hemolytic streptococci of groups A, B, C, and G, and methicillin-susceptible Staphylococcus aureus, but failed to inhibit enterococci and methicillin-resistant staphylococci. CL 118523 was minimally hydrolyzed by plasmid and chromosomally-mediated beta-lactamases, and was a poor beta-lactamase inducer. PMID- 3322587 TI - [An important birthday for Prof. Adolf Zacek]. PMID- 3322589 TI - International experiences with ceftriaxone in the treatment of lower respiratory tract infections. AB - The clinical efficacy and tolerability of ceftriaxone in the treatment of pneumonia and other lower respiratory tract infections were evaluated in 827 patients (515 pneumonia, 312 other lower respiratory tract infections) reported in the international literature (daily dose: 1 of 2 g.i.v. or i.m. in most patients). Therapeutic success was achieved in 738 patients (89.2%). Microbiological results were evaluated in 295 patients. Eradication of the most common respiratory pathogens was achieved in 100% of cases and of Enterobacteriaceae in 85.7%-100%. Adverse effects occurred in 4.9% of patients. A large multicenter trial was carried out in Italy using a single daily dose of 1-2 g by i.v. or i.m. Six hundred ninety-six patients were admitted to the study (370 pneumonia, and 326 other lower respiratory tract infections). Therapeutic success was achieved in 668 cases (96%). Pathogens were eradicated in 88% of cases (184 pts evaluated). Side effects were observed in 4.6% of cases. PMID- 3322590 TI - A clinical trial of mitoxantrone (novantrone) versus doxorubicin (adriamycin) in combination chemotherapy for metastatic breast cancer. AB - Mitoxantrone (Novantrone, N) is a new anthracenedione derivative with structural similarities to doxorubicin (Adriamycin, A). It has shown significant activity during phase I and II clinical trials in the treatment of advanced breast cancer. The present trial compares the CNF regimen to CAF. All patients received cyclophosphamide (500 mg/m2) and 5-fluorouracil (500 mg/m2), with either N (10 mg/m2) or A (50-60 mg), repeated every three weeks. There were 30 patients in the mitoxantrone group and 30 patients in the doxorubicin group. The results presented are based on 60 patients: 70% were postmenopausal; 25% had received adjuvant chemotherapy; 29% had prior hormonal therapy in an adjuvant setting or for relapse. There were no significant differences between the pretreatment characteristics of each group. The response rate (complete + partial) for CNF was 57% and for CAF was 40%. The dose limiting toxicity was granulocytopenia seen after the 3rd cycle in the CNF group. Thrombocytopenia was not seen. There was less nausea and vomiting in the CNF group. No cardiotoxicity was seen in CNF; only 2 patients suffered from congestive heart failure in CAF. These preliminary data indicate that CNF seems to be an effective regimen for patients with advanced breast cancer and has fewer adverse effects than CAF. PMID- 3322592 TI - [Uses of high-speed turbine drills in oral surgery and nursing care]. PMID- 3322591 TI - Effect of methanol and some metal compounds on the frequency of respiration deficient mutation in yeast induced by manganese chloride. PMID- 3322593 TI - The role of micronutrient deficiency in carcinogenesis. AB - Nutritional deficiencies are suspected to be contributing factors to several types of human cancers. Studies with laboratory animals have demonstrated that deficiencies in certain nutrients can enhance chemically induced carcinogenesis. In this review, we discuss several possible mechanisms for the involvement of nutritional deficiencies in carcinogenic processes, and note that different severities of deficiency may have varied effects on these processes. The relationship between results from studies with animals and the genesis of human cancer is discussed, and the application of the concept of nutrient density in relating experimental animal diets to human dietary conditions is emphasized. We also discuss in detail several recent studies that potentially may have a great impact on the prevention of human cancer. These include (1) the possible involvement of micronutrient deficiencies in carcinogenesis of the esophagus; (2) the effects of choline/methionine deprivation and calcium supplementation on liver carcinogenesis; and (3) the roles of low-calcium and high-fat intake on development of colon cancer. The possible mechanistic link between teratogenesis and carcinogenic processes is noted. PMID- 3322594 TI - Effects of carbamoylating agents on tumor metabolism. AB - Carbamoylation of macromolecules occurs by the displacement of hydrogen on several groups, but the most stable addition at neutral pH is on amino groups. This reaction occurs predominantly with proteins and results from the administration in vivo of inorganic cyanate or organic isocyanates. The latter act more rapidly, but also are more rapidly hydrolyzed in aqueous solution. This instability has been a factor limiting study of the pharmacological properties of organic isocyanates. However, organic isocyanates are released from some nitrosoureas of value in cancer therapy such as 1,3-bis(2-chlorethyl)-1 nitrosourea (BCNU) and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU). The carbamoylating activities of BCNU and CCNU are generally considered less significant than their alkylating activity in the action of these drugs on tumors, but carbamoylation may serve to inhibit DNA repair. There is evidence that carbamoylating agents can exert selective inhibitory effects on metabolite uptake and macromolecular synthesis in neoplastic tissues. Such selectivity is much more notable in vivo than in vitro. In the case of cyanate, the selectivity in vivo has been variously attributed to a requirement for metabolic activation, to selective effects on circulation in solid tumors, and to diminished pH in tumors. It is the distinction between such factors and the identification of critical cellular targets which provide major challenges in present studies on the effects of carbamoylating agents on tumor metabolism. PMID- 3322595 TI - [Treatment of vitreous hemorrhages. Rare causes]. PMID- 3322596 TI - [Traumatic hemorrhages of the vitreous body]. PMID- 3322597 TI - [Treatment of vitreous hemorrhages. Principles and therapeutic methods]. PMID- 3322598 TI - [Treatment of vitreous hemorrhages. Anatomo-clinical classification and diagnostic methods]. PMID- 3322599 TI - [Evaluation of penetrating keratoplasties with a diameter from 6 to 9 mm]. PMID- 3322600 TI - Absence of association between Plasmodium falciparum malaria and human immunodeficiency virus infection in children in Kinshasa, Zaire. AB - The possible associations between Plasmodium falciparum malaria and HIV (human immunodeficiency virus) seropositivity were investigated in 1986 at the Mama Yemo Hospital in Kinshasa, Zaire. No significant difference was found in the HIV seropositivity rate of 164 children presenting with P. falciparum malaria (1.2%) and 169 healthy controls (0.6%). Secondly, no association was found between P. falciparum slide positivity (51.6%) and HIV seropositivity (3.8%) among 1046 children presenting to the hospital with medical complaints. Infants less than 6 months old had the lowest slide-positivity rate, but among infected children the younger ones more frequently had high parasitaemias. HIV seropositivity rates were highest for children less than 6 months old. In older children, seropositivity was strongly associated with a history of blood transfusion. Thus, in Kinshasa children, P. falciparum malaria is a major public health problem; perinatal transmission and blood transfusions constitute important mechanisms of HIV infection; and P. falciparum does not appear to act as an opportunistic agent in children infected with HIV. PMID- 3322601 TI - Better health data with a portable microcomputer at the periphery: an anthropometric survey in Cape Verde. AB - A portable microcomputer was programmed to record anthropometric nutritional data from children aged under 7 years in either a clinic or a population survey situation. An alarm sounds when the anthropometric measurements of a child are below a predetermined value; an immediate check thus avoids the need for subsequent data cleaning and discarding of doubtful information. Data cut-off points in the computer can be adjusted to suit the survey or service needs of the situation. A print-out at the end of the clinic session provides immediate feedback for the staff and a record of the nutritional status of the group.In Cape Verde, 14 670 children attending clinics were surveyed; 26% were identified as stunted, 3% as wasted, and 1% as stunted and wasted. While a portable microcomputer can improve precision, speed and motivation, nutrition surveys still depend on accurate scales, careful measurements and competent staff. PMID- 3322603 TI - Central hemodynamics and pulmonary ventilation after trauma: effect of portacaval transposition. AB - Immediate reaction to traumatic shock involves, among other factors, trapping of platelets in the lungs. It has previously been shown that this trapping is associated with an increase in pulmonary vascular resistance (PVR). To elucidate whether this increase in PVR was due to cellular sequestration or other factors, we performed a portacaval transposition in a group of pigs (n = 9), making the liver the first receiving capillary bed for blood from the lower extremities. One week later, these animals and a control group (n = 6) were subjected to a standardized soft tissue trauma to the hind limbs. Following trauma, there was an immediate increase in PVR in the control group but not in the operated animals. This increase in PVR was accompanied by a fall in alveolar ventilation that was significantly lower in the control group than in the operated animals. There were no differences in blood gases, probably because of high FiO2 during the experiment. Our findings indicate that the early response in pulmonary circulation following trauma is due to cellular sequestration from the trauma sites. PMID- 3322604 TI - Bradykinin does not contribute to hypotension in early canine endotoxemia. AB - Previous work in this and other laboratories has demonstrated that captopril exacerbates the hypotension produced in dogs by endotoxin. This depressor effect of captopril could result from the potentiation of bradykinin (BK) or inhibited formation of angiotensin II (AII). Anesthetized adult mongrel dogs were used in the current study. In each, the right femoral vein and artery were cannulated for the administration of drugs and monitoring of arterial pressure. A tracheostomy was performed, and the animal was respired with room air. It was found that after injection of endotoxin, AII receptor blockade (Sar1, Ile8-AII) produced a mean arterial pressure (MAP) response statistically similar to that elicited by captopril in combination with endotoxin. Although these results indicate no production of BK, the possibility of BK receptor inactivation during endotoxin shock cannot be disregarded. Additional studies suggested that in the dog, injections of BK can augment the depression of MAP caused by endotoxin and that this further depression can be prolonged by captopril. On the basis of these results, it can be concluded that in the early phases of canine endotoxin shock, AII plays a significant role in the maintenance of MAP and that BK is not produced in quantities sufficient to lower MAP. PMID- 3322605 TI - Experimental endotoxemia increases plasma von Willebrand factor antigen concentrations in dogs with and without free-radical scavenger therapy. AB - Pentobarbital-anesthetized beagles were infused with physiologic saline (control dogs) or E. coli endotoxin (1.5 mg/kg i.v.) for 1 min. The plasma von Willebrand factor antigen (vWf:Ag) concentration, a potential index of endothelial damage, was monitored before and for 4 h after endotoxin challenge. The plasma vWf:Ag concentration increased only slightly in the control dogs (n = 6); whereas, in dogs infused with endotoxin (n = 20), the vWf:Ag concentration increased progressively to 2.1 times prechallenge values in 4 h. In addition to endotoxin, some of these dogs were treated with free-radical scavengers; allopurinol (n = 3), allopurinol plus superoxide dismutase and catalase (n = 6), or deferoxamine (n = 5). The free-radical scavengers did not prevent endotoxin-induced increases in vWf:Ag concentration. PMID- 3322606 TI - Measurement of antineutrophil antibodies by flow cytometry: simultaneous detection of antibodies against monocytes and lymphocytes. AB - We describe a flow cytometric technique which detects the presence of antineutrophil antibodies (NABs) in human serum. The technique provides a qualitative as well as a semiquantitative screen and provides an excellent method for monitoring the presence of antineutrophil antibodies in patients with suspected autoimmune neutropenia. Using light-scatter gating, individual populations consisting of neutrophils, monocytes, and lymphocytes can be examined simultaneously for the presence of antibody. The methodology utilizes an indirect immunofluorescence technique with FITC-labeled goat antihuman F(ab')2 antibody and fixed leukocyte suspensions. Furthermore, by utilizing class-specific FITC labeled second antibody, significant information can be ascertained regarding the class, cell specificity, and quantity of detected antibody. Formalin fixation of neutrophils prevented pinocytosis of the fluorochrome, significantly reducing background fluorescence. Twenty-five normal subjects provided baseline antibody levels for each class. Of 92 patients with suspected autoimmune neutropenia, 27 had class IgG alone and seven were positive for both IgG and IgM class NABs. During treatment, IgG levels varied. IgM NABs alone were detected in four patients. Fifty-four patients had undetectable antibody. Antibodies were detected against monocytes in several of the IgG-positive patients. Two sera contained both IgA and IgG NABs. One serum contained IgA and IgG antibodies against monocytes. No IgD antibodies were detected in any sera tested. Some sera tested contained antibodies against lymphocytes--however, only in those sera which also contained antibodies to other cell types. PMID- 3322607 TI - Monoclonal antibody recognizing a human neuroblastoma-associated antigen. AB - The derivation of an IgG1k monoclonal antibody (HSAN 1.2) recognizing a cell membrane determinant on human neuroblastoma cells is reported. The determinant was found on all 17 cultured human neuroblastoma cells that were tested, but the density of the antigen varied widely on different cell lines. The antibody also bound to fresh and cultured Wilm's tumor cells, retinoblastoma cells, and one of two Ewing's sarcoma cell lines tested, it did not bind to mouse neuroblastoma cells, normal fibroblasts, blood, or bone marrow. Tumor cells that did not stain with HSAN 1.2 included glioma, medulloblastoma, melanoma, rhabdomyosarcoma, mesenchymoma, leukemia, and lymphoma cells. The distribution of the HSAN 1.2 antigen in normal tissues was confined to brain and newborn kidney. As few as 0.1% tumor cells in bone marrow aspirates were detectable by fluorescein conjugated HSAN 1.2 antibody and flow cytometry. This antibody should be useful for the discrimination of neuroblastoma from other pediatric malignancies, for the detection of tumor cells in metastatic sites such as bone marrow, and for selective removal of neuroblastoma cells from marrow harvested for autologous transplantation. PMID- 3322608 TI - A new assay for choline-containing phospholipids in amniotic fluid by an enzyme sensor. AB - A new rapid and direct method for the determination of choline-containing phospholipids in the amniotic fluid is proposed. The determination is performed by an amperometric-enzymatic method. The correlation with an enzymatic spectrophotometric method, already published, is also considered. PMID- 3322609 TI - An enzyme immunoassay for pepsinogen II(PGII): chronological changes in serum PGII concentrations. AB - A new two-site enzyme immunoassay for pepsinogen II(PGII) has been developed. The detection limit of PGII was 0.15 ng/ml (15 pg/tube) and the optimal assay range was 1.5 to 150 ng/ml (150 pg to 15 ng/tube). Mean serum PGII concentrations in normal males and females were 17.2 and 14.6 ng/ml, respectively. The chronological analysis among 5 age groups from 20 to 69 yr, males and females together, revealed that the serum level was low (11.9 ng/ml) between 20-39 yr, gradually increased from 40 yr of age and attained the maximum (22.5 ng/ml) in the 50-yr group. Total gastrectomy markedly lowered the serum level to 1.9 ng/ml, suggesting that the majority of PGII in serum was derived from the gastric mucosa. This assay makes it possible to measure trace amounts of PGII derived from extragastric as well as gastroduodenal tissues. PMID- 3322610 TI - An immunochemiluminometric assay for serum free thyroxine. AB - An immunochemiluminometric assay has been developed for the measurement of free T4 concentrations in serum. The assay uses chemiluminescent acridinium ester labelled monoclonal antibodies which react with free T4 in the sample. A T4 rabbit immunoglobulin G conjugate competes for antibody binding sites, immune complexes containing this being isolated using an anti-immunoglobulin G antibody coupled to paramagnetic particles. Associated chemiluminescence intensity is thus dependent on the free T4 concentration. The assay distinguishes patients with primary thyroid disease from euthyroid subjects and is unaffected by abnormal binding proteins which compromise the diagnostic accuracy of radiolabelled analogue immunoassays. the test yields results which accurately reflect the clinical thyroid status of euthyroid patients with a variety of acute and chronic non-thyroid illnesses. This is again in marked contrast to the aberrant results seen using certain radiolabelled analogue procedures. PMID- 3322602 TI - Determinants of low birth weight: methodological assessment and meta-analysis. PMID- 3322611 TI - Acute epiglottitis in adults: bacteriology and therapeutic principles. AB - Acute epiglottitis is seldom encountered in adults, but the condition is probably more frequent than reported in the literature. Nineteen cases of adult epiglottitis were analysed retrospectively. In 53% of the patients, the symptoms were present for less than 24 h prior to hospitalization. Sore throat and dysphagia were invariably present. Three patients presented with stridor and 2 with complete airway obstruction. Throat cultures from 5 patients grew beta haemolytic streptococci and from 2 Haemophilus influenzae type B was grown. Two tracheotomies and 1 nasotracheal intubation were performed. One death occurred. It is emphasized that any adult with an acute sore throat and dysphagia should undergo indirect laryngoscopy and that blood cultures should always be part of the routine bacteriological investigation. Cooperation and understanding among otolaryngologists and anaesthesiologists is of paramount importance in the management of acute adult epiglottitis, as nasotracheal intubation and cricothyroidotomy appear to be the methods of choice in securing an airway. Ampicillin and chloramphenicol are recommended in the medical treatment. PMID- 3322612 TI - Present management of the reconstruction of the middle ear. PMID- 3322613 TI - Ultrasound and radionuclide scans--poor indicators of liver damage in patients treated with methotrexate. PMID- 3322614 TI - Exploration of a quantitative dansyl chloride technique for measurement of the rate of desquamation. PMID- 3322615 TI - Study of idiotypes expressed by monoclonal antibodies to the 35 kD and 12 kD antigens of Mycobacterium leprae. AB - Rabbit antisera were raised against four monoclonal antibodies (MoAb) binding with the 35 kD protein and four MoAb binding with the 12 kD protein antigen of Mycobacterium leprae. Antisera showed idiotype (Id) specificity following cross absorption with normal mouse globulin. One Id on a single MoAb and another Id shared between three MoAb were identified for each group. Functional studies were carried out with the Rb04 anti [anti-35 kD] specificity. The expression of this Id and paratope in antigen immunized mice was associated with Igh alleles. Inoculation of mice with anti-Id Rb04 induced an 'Ab3' serum response of corresponding Id specificity only when the anti-Id was given in emulsion with incomplete Freund's adjuvant (IFA). Conversely, prior injection of soluble anti Id inhibited the subsequent Ab3 response to Rb04/IFA. Moreover, the suppressive effect of soluble anti-Id was abrogated by prior injection of 50 mg/kg cyclophosphamide. These results indicate that regulatory mechanisms similar to those involved in antigenic stimulation may explain the stimulatory or suppressive potency of anti-Id antibodies. Finally, the Ab3 responses to the two tested anti-Ids did not contain any antigen binding activity. PMID- 3322616 TI - Immunoglobulin A1 and A2 subclass of salivary antibodies to Candida albicans in patients with oral candidosis. AB - Immunoglobulin A antibody titres to a cytoplasmic protein extract of Candida albicans were determined by ELISA in saliva from 20 patients with oral candidosis and 21 controls. Patients had significantly increased levels of salivary IgA anti Candida antibodies when compared with controls (P less than 0.001). Antibody levels were associated with IgA1 subclass in 90% of the patients; in contrast, IgA2 subclass was predominant in 67% of the controls. Antifungal therapy resulted in significantly decreased IgA1 titres (P less than 0.05) whilst the mean IgA2 antibody titre remained unchanged. The results indicate that Candida infection may change the subclass pattern of salivary IgA antibodies. PMID- 3322617 TI - HLA-DR, DP and DQ expression in the small intestine of patients with coeliac disease. AB - Frozen sections of jejunal mucosa from control subjects and patients with both treated and untreated coeliac disease were examined for HLA class II DR, DP and DQ expression. Different staining patterns with monoclonal antibodies to the different class II subgroups were observed with the control subjects. There was some inter-subject variation but in general DR greater than DP greater than DQ staining was observed with the villous enterocytes staining most strongly with the staining decreasing towards the crypt bases. The patients with treated coeliac disease gave a similar pattern to the controls. The patients with untreated coeliac disease generally gave a more intense and relatively uniform staining of both surface and crypt enterocytes for all class II subgroups. PMID- 3322619 TI - Contribution of glycemic control to the levels of urinary N-acetyl-beta-D glucosaminidase (NAG), total protein, beta 2-microglobulin and serum NAG in type 1 (insulin-dependent) diabetes mellitus without macroalbuminuria. AB - To clarify the significance of the parameters which might indicate the abnormalities in the kidney, urinary N-acetyl-beta-D-glucosaminidase (NAG), urinary total protein (TP), urinary beta 2-microglobulin (beta 2MG) and serum NAG were determined in 61 type 1 diabetics who had neither retinopathy nor macroalbuminuria (negative albuminuria by Albustix), and in 19 age, sex-matched nondiabetic subjects. Urinary NAG, urinary TP and serum NAG levels were significantly elevated in the diabetics compared with the nondiabetic subjects, even though in the diabetics, whose duration of diabetes was not longer than 2.5 years. The relationships between these parameters and glycemic indices at different periods were studied in diabetics. Urinary NAG was correlated the strongest with the mean blood glucose level over the 7 days before the collection of urine (r = 0.47) among the 5 glycemic indices. On the other hand, urinary TP and urinary beta 2MG were correlated the strongest with the urinary glucose at the time of collection of urine (r = 0.77 and r = 0.37, respectively) among the 5 glycemic indices. No correlation of urinary NAG, urinary TP or urinary beta 2MG with stable HbA1 was observed. On the multiple regression analysis, 32% of the changes in urinary NAG, 61% of urinary TP, 19% of urinary beta 2MG and 20% of serum NAG were explained merely by the blood glucose levels, respectively. No relationship was observed among each parameter and duration of diabetes, insulin dose, urinary excretion of C-peptide or lipid levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322618 TI - In vitro analysis of B lymphocyte function in uraemia. AB - We have investigated the immune responses in vitro of uraemic patients undergoing regular haemodialysis or continuous ambulatory peritoneal dialysis. Twenty-five healthy subjects were also studied as controls. In uraemic patients, the number of T and B lymphocytes were within the normal range, but proliferative responses to phytohaemagglutinin (PHA) were impaired. Spontaneous immunoglobulin plaque forming cell (PFC) responses by peripheral blood mononuclear cells (PBMC) from uraemic patients were significantly lower than those of healthy subjects. The PFC response of uraemic PBMC to the T cell independent polyclonal B cell activator (PBA) Epstein-Barr virus (EBV) was comparable to the response of the healthy subjects, indicating that uraemic B cells are still capable of synthesizing immunoglobulin. Pokeweed mitogen (PWM) induced PFC responses of uraemic PBMC were also normal, whereas the response to another T cell dependent B cell activator, Staphylococcus aureus Cowan I (SAC), was very low. Addition of indomethacin to PWM- and SAC-activated cultures of uraemic PBMC enhanced the PFC response to SAC, but had little effect on the PWM response. As full differentiation of B cells in response to SAC depends on helper T cells, we conclude that a defect in T lymphocyte function accounts for the reduced spontaneous and SAC induced production of immunoglobulin by uraemic PBMC. This defect may be mediated by an indomethacin-sensitive mechanism. PMID- 3322620 TI - The influence of selected urinary constituents on the adhesion process of Escherichia coli to human uroepithelial cells. AB - In the pathogenesis of infectious diseases, great importance is attached to the problem of adhesion of bacteria to cells. In 100 urine specimens from normal test persons, patients with infections of the lower urinary tract, with chronic pyelonephritis and glomerulonephritis were studied. The adhesion of strains of Escherichia coli to human uroepithelial cells depended on the concentration of single urinary factors. While increased concentrations of urea and creatinine favored the adhesion process, a statistically significant negative influence was found with regard to potassium, immunoglobulins and pH value. Considering the multifactorial effects of the urinary constituents, we found in a multivariate comparison that none of the studied physiological features alone exerts a fundamental influence upon adhesion, but in their entirety they determine the environmental conditions for the adhesion of bacteria to cells in the urine. PMID- 3322621 TI - Bypass disease. AB - Intestinal bypass surgery as a treatment for morbid obesity was quite popular from 1965 to 1975 in the United States. The procedure was successful in reducing body weight but was controversial because of a high rate of complications which included an arthritis-dermatitis syndrome. Herein we review the knowledge garnered from a study of the complications from intestinal bypass surgery. Emphasis is placed on an analysis of the clinical manifestations, and the pathogenesis of the arthritis-dermatitis bypass syndrome, and how bypass disease may serve as a model for immune complex-mediated disease and for extra-intestinal complications in other enteropathies. PMID- 3322622 TI - A morphometric study of myelinated fibers in the fifth lumbar ventral roots in patients with cerebrovascular diseases. AB - In order to evaluate the effects of lesions in the upper motor neuron on the lower one, a morphometric study of the 5th lumbar ventral roots was performed in 16 patients with cerebrovascular diseases (CVD) and 8 age-matched controls plus 7 patients with muscular disorders as pathological controls. As a lesion of the upper motor neuron, the degree of lateral corticospinal tract degeneration in the spinal cord were classified into 4 groups. Total fascicular area (TFA), total myelinated fibers (TF) and large fibers (LF) of the ventral roots were significantly (p less than 0.001) decreased in CVD patients who revealed severe degeneration in the lateral corticospinal tracts in affected sides compared with those of controls. The apparent unilateral fiber loss in the ventral root was also observed in some cases whose lateral corticospinal tracts were degenerated with ipsilateral predominance. Therefore, the degree of degeneration of the lateral corticospinal tracts seemed to parallel that of fiber loss of the ventral roots. On the other hand, there were no significant decreases of TFA and TF in the patients with muscular disorders, which makes less likely the possibility that fiber loss in the ventral roots of CVD cases is attributed to long-term bed rest or lack of muscle movements in extremities. These findings suggest a trans synaptic effect of the degenerated upper motor neuron (lateral corticospinal tract) in CVD patients facilitating fiber loss in the ventral roots. PMID- 3322623 TI - Central pontine and extrapontine myelinolysis: a report of 58 cases. AB - In 58 cases with central pontine myelinolysis (CPM) and/or extrapontine myelinolysis, systematic examination of the central nervous system was performed. The demyelinating disease occurred in three subtypes: (1) CPM, in which the lesion was confined to the pons, (2) CPM combined with extrapontine myelinolysis and (3) exclusively extrapontine myelinolysis. Type (1) was found in 27 cases, (2) in 18 cases and (3) in 13 cases. Cerebellum and lateral geniculate body were the most frequently affected extrapontine regions. One case with an extreme extension of the lesions is described in detail. Extrapontine lesions seem to be more frequent and widespread than has been hitherto reported in the literature. PMID- 3322625 TI - Renal involvement first diagnosed by radionuclide bone imaging in a patient with lymphocytic lymphoma. PMID- 3322624 TI - Recovery of femoral head perfusion after drainage of septic joint. AB - A 64-year-old woman was febrile and had pain near the right hip. Blood cultures grew beta hemolytic streptococci. A bone scan showed reduced activity in the right femoral head and neck compared with the left femoral head and neck. She was treated with intravenous antibiotics and surgical decompression of a tense and bulging right hip joint. Five days later, a repeat bone scan revealed much of the femoral head activity to have returned. By day 20 after the initial bone image, there was intense activity throughout the femoral head and neck. Prompt relief of a distended hip joint can result in reperfusion of the femoral head and neck. PMID- 3322626 TI - Antihypertensive drugs in pregnancy. AB - This article considers the pathophysiology, diagnosis, and etiologies of hypertensive conditions, and considers specific agents for treating this condition. It also reviews the side effects of these agents and their efficacy, and details their use in the hypertensive pregnant patient. PMID- 3322627 TI - Drug therapy in hypoxic-ischemic cerebral insults and intraventricular hemorrhage of the newborn. AB - Recent progress in understanding the pathophysiology of hypoxic-ischemic encephalopathies and intraventricular hemorrhages have enabled us to propose new therapeutic modalities in preventing the development and severity of these disorders in the newborn. Because neuronal damage may be reversible under certain conditions, appropriate evaluation of these drugs (single or in combination) is very important in the continuous attempt to ameliorate the neurodevelopmental outcome of these infants. An interventionist attitude should prove to be a better alternative than a supportive one. PMID- 3322628 TI - Pharmacology of vitamin E in the newborn. AB - The use of pharmacologic doses of vitamin E is distinctly different from nutritional vitamin E in regards to issues of efficacy and safety. Repeated administration of pharmacologic doses of vitamin E results in increasing concentrations of vitamin E in all tissues examined. The emergence of a toxic clinical syndrome associated with vitamin E therapy, the effects of vitamin E on important physiologic systems such as granulocyte function and the arachidonic acid cascade, the theoretic possibility of vitamin E becoming a prooxidant at high concentrations, and the continuing controversy regarding the efficacy of pharmacologic doses of vitamin E mandate further study of the dose-response nature of pharmacologic vitamin E therapy from both an efficacy and toxicity perspective. PMID- 3322629 TI - Pharmacotherapy in bronchopulmonary dysplasia. AB - This article reviews the current data available on the most frequently used drugs in bronchopulmonary dysplasia. Oxygen, diuretics, bronchodilators, steroids, ribavirin, and antioxidants, as well as medication available for pulmonary hypertension, systemic hypertension, and gastroesophageal reflux are discussed, with emphasis on known advantages, side effects, and current dosage. PMID- 3322630 TI - Percutaneous drug absorption in the newborn: hazards and uses. AB - The newborn infant's skin is not a complete barrier to the absorption of externally applied agents, particularly if it is damaged, diseased, or immature. Immaturity is the most important factor that determines percutaneous absorption. Very immature infants in the early neonatal period have a poorly developed epidermis, which is readily permeable to drugs. The main consequences of percutaneous absorption are hazardous. Topically applied agents are absorbed, causing toxic systemic effects that may result in illness and even death without the cause being recognized. No drug or antiseptic agent should be applied to the premature infant's skin without consideration of the effects that might result from percutaneous absorption. On a more optimistic note, the relatively permeable skin could be an advantage to the preterm infant by providing an alternative method of drug administration. The drug theophylline for example can be absorbed and produce therapeutic blood levels for up to 3 days after a single topical application. There is a need for the development of transdermal drug delivery systems for the newborn infant similar to those currently used for therapy in adults. PMID- 3322632 TI - The pharmacologic basis of diuretic therapy in the newborn. AB - Effective use of diuretics in critically ill newborns requires an understanding of the ontogeny of renal function, a knowledge of the pathophysiology of the patient's disease, an expectation of the pharmacodynamics of the several classes of diuretics, and an appreciation of the kinetics and toxicities of the selected agents. Unfortunately, the number and scope of clinical pharmacologic studies of diuretics in critically ill newborns are inadequate for optimal therapy with most of these drugs. PMID- 3322631 TI - Use of inotropic and chronotropic agents in neonates. AB - The determinants of cardiovascular function include preload, myocardial contractility, and afterload. Myocardial contractility and afterload can be altered pharmacologically and form the basis for the clinical management of shock with inotropic and chronotropic drugs. There are extensive data from experiments in laboratory animals that the immature cardiovascular system may respond differently to these inotropic and chronotropic agents than the mature cardiovascular system. Digitalis, isoproterenol, dopamine, and dobutamine are the most frequently used positive inotropic drugs in children. Because of maturational differences in pharmacokinetics, neonates require a larger weight based dose of digoxin to achieve a similar serum level to adults, but neonates do not require a greater serum level of digitalis to achieve an equivalent inotropic effect as in adults. Isoproterenol increases heart and cardiac output but has no independent effect on renal blood flow. Dopamine is unique among sympathomimetic means because of its independent effect to increase renal and mesenteric blood flow. Dobutamine increases cardiac output with less chronotropic effect than isoproterenol but, unlike dopamine, does not have an independent effect on renal and mesenteric profusion. The "best" drug for a specific clinical situation depends on the complex interrelationship of the determinants of cardiovascular function and the underlying disease process. One drug may be more efficacious in a specific clinical setting than another drug. If the desired clinical response is not achieved with an adequate dose of one drug, a different drug or a combination of inotropic agents should be tried. PMID- 3322633 TI - Pulmonary surfactant replacement in respiratory distress syndrome. AB - Exogenous surfactant therapy in infants with HMD leads to dramatic improvement in oxygenation and disease course. Both prophylactic and rescue treatments have shown a significant reduction in morbidity and mortality from the disease. There are several questions yet to be answered regarding the most effective surfactant, the appropriate time of treatment, and the appropriate dose, as well as the number of treatments required. Based on the available data, surfactant TA has shown promising and consistent results. Another important question to be answered is the role of surfactant in milder cases of HMD and its impact on the cost of hospitalization. Hopefully, future studies will be able to provide answers to these questions. PMID- 3322634 TI - Human islet cell autoantibodies specifically bind cloned rat islet cells. AB - Sera from newly diagnosed type I (insulin dependent) diabetic patients and control subjects were tested by indirect immunofluorescence on a particular subclone of RINm5F cells for the presence of cytoplasmic antibodies. Cell cultures after biochemical fixation and frozen sections of cell sheets obtained after incubating confluent monolayers with dispase were used alternatively as substrate. Eight out of ten ICA positive sera previously tested on frozen sections of human pancreas bind RIN cells when fixed with acetone-ethanol whereas no staining was obtained after treating the cells with paraformaldehyde or glutaraldehyde. Four normal sera did not bind RIN cells under these conditions. Alternatively, frozen sections of cell sheets appeared to be a more sensitive substrate as all ICA positive sera tested reacted with cell cytoplasm. In addition, an immunoradiometric assay was developed using microtitre plate wells coated with Nonidet P40 solubilized RIN antigens. Coated wells were incubated with ICA positive and ICA negative diabetic sera along with sera from normal individuals. Antigen antibody complexes were detected by the binding of 125I Protein A. A good correlation was found between binding values and results obtained by indirect immunofluorescence on frozen sections of human pancreas. Although this study indicates that RIN cells express a specific cytoplasmic antigen to which ICA positive sera bind, more information is required concerning the exact nature of this antigen before such assay can be reliably used for the detection of ICA. PMID- 3322637 TI - Clinical physics and physiological measurement bibliography diagnostic investigations of the lower urinary tract (1980-87). PMID- 3322635 TI - Biochemical determination of islet lysosomal enzyme activities following crinophagy-stimulating treatment with diazoxide in mice. AB - The pattern of islet lysosomal enzyme activities, islet insulin concentration and the plasma levels of insulin and glucose were studied in freely fed mice after the in vivo administration of diazoxide in doses known to induce crinophagy in islet beta-cells. After diazoxide treatment at time 0 and at 18 hr, the plasma glucose levels at 20 hr were markedly enhanced from 6.6 +/- 0.2 mmol/l (controls) to 27.2 +/- 2.7 mmol/l (diazoxide). Inhibition of insulin secretion by diazoxide was reflected in the insulinogenic index, which was reduced by approximately 40% (p less than 0.01) in the diazoxide-treated animals, who also displayed an increased concentration of islet insulin (+50%; p less than 0.01). Moreover, we found that the activities of certain lysosomal enzymes in islet tissue were markedly increased following diazoxide treatment. Thus the activities of the acid phosphatase, (+57%; p less than 0.02) the hexosaminidase N-acetyl-beta-D glucosaminidase, (+52%; p less than 0.001), and the carboxyl proteinase cathepsin D (+41%; p less than 0.001), were all enhanced after diazoxide, whereas the activity of another lysosomal enzyme, the glycogen hydrolysing acid amyloglucosidase, was not altered by diazoxide treatment. The present data thus indicate that the morphological observation of diazoxide-induced crinophagy in pancreatic beta-cells has a biochemical correlate in enhanced levels of certain islet lysosomal enzyme activities known to participate in degradative processes. The results also suggest that islet lysosomal enzyme activities and/or lysosome populations can be modulated by a relative independence from each other. PMID- 3322636 TI - Comparison of broadband ultrasonic attenuation of the os calcis and quantitative computed tomography of the distal radius. AB - The measurement of broadband ultrasonic attenuation (BUA) in the os calcis, which consists of predominantly trabecular bone, has been compared by others with single photon absorptiometry of forearm cortical bone. We have compared BUA in 24 female subjects with the separate measurement of trabecular and cortical bone in the distal radius using quantitative computed tomography (QCT). BUA was highly significantly correlated with each of the measurements in the radius (P less than 0.001). Paradoxically, BUA was found to be best correlated with the bone mass per unit length in the radial shaft (r = 0.85) rather than with radial trabecular bone (r = 0.66). The degree of correlation was not sufficient to predict radial bone mass accurately in individuals. Broadband ultrasonic attenuation, however, appears to be a useful measurement of bone in the appendicular skeleton. PMID- 3322638 TI - Development of antiviral agents for the treatment of human immunodeficiency virus infection. AB - Antiviral agents under investigation for the treatment of patients infected with the human immunodeficiency virus (HIV) are reviewed. Multiple mechanisms exist by which antiviral agents might inhibit the replication of HIV or eradicate its latent form in affected cells, or both. These mechanisms include (1) interference with the cell surface receptor for HIV, (2) prevention of uncoating of viral particles, (3) inhibition of reverse transcriptase, (4) prevention of integration and posttranscription processing, (5) interference with viral assembly, and (6) interference with virus release. Most agents developed thus far work by inhibiting HIV reverse transcriptase. Suramin, ribavirin, ammonium 21-tungsten-9 antimoniate (HPA-23), foscarnet (phosphonoformate, PFA), inosine pranobex (isoprinosine), peptide T, ampligen, AL 721, dideoxycytidine, and zidovudine (formerly azidothymidine) have antiretroviral activity in vitro. To date zidovudine is the only antiretroviral agent approved by the FDA as clinically effective. However, zidovudine has serious toxicities, including neutropenia and anemia; in some patients dosage reduction or cessation of therapy may be necessary. Because treatment with zidovudine does not cure HIV infection, numerous studies are under way with other anti-HIV agents. Ultimately, combinations of agents probably will be used to suppress or eradicate HIV. While the search for more efficacious and less toxic treatments continues, the development of zidovudine in such a short time provides hope that progress toward a cure will be made rapidly. PMID- 3322639 TI - Use of nimodipine for prevention and treatment of cerebral arterial spasm in patients with subarachnoid hemorrhage. AB - The chemistry, pharmacology, pharmacokinetics, adverse effects, dosage, and availability of nimodipine are discussed, and the clinical use of nimodipine in preventing and treating cerebral arterial spasm in patients with subarachnoid hemorrhage is reviewed. Nimodipine is a highly lipid-soluble dihydropyridine derivative that readily crosses the blood-brain barrier. In animal studies, nimodipine has been shown to be effective in increasing cerebral blood flow; preventing vasoconstriction attributable to sympathetic stimulation, hypocapnia, and hypertension; and improving neurological outcome after cerebral ischemia. Nimodipine is reported to be 90% protein bound; its half-life is approximately 13 hours, with substantial interpatient variability. Nimodipine has been studied in the prevention and treatment of cerebral arterial spasm in patients with subarachnoid hemorrhage. In four open trials, in which nimodipine was administered orally, intravenously, topically during surgery, or by intracarotid injection, and in two double-blind, placebo-controlled trials, neurological outcomes were improved in patients receiving the drug. However, in both sets of trials nimodipine had limited effects on cerebral arterial spasm. Although nimodipine can cause hypotension, no serious adverse reactions to the drug were reported in clinical trials in patients with subarachnoid hemorrhage. Based on limited data currently available, nimodipine appears to improve neurological outcome in patients with subarachnoid hemorrhage. However, its efficacy in preventing or treating cerebral arterial spasm in these patients seems to be limited. PMID- 3322640 TI - Treatment of panic and phobic disorders. AB - The clinical features, pathophysiology, and treatment of panic and phobic disorders are reviewed. Evidence from genetic, epidemiological, biological, and pharmacological studies suggests that phobic and panic disorders differ from other psychiatric illnesses. Dysfunction of the autonomic nervous system, causing excessive release of norepinephrine from the locus ceruleus, is implicated in the pathophysiology of these disorders. Overstimulation of the locus ceruleus by yohimbine, sodium lactate, and carbon dioxide can cause feelings of panic and anxiety in both patients with panic disorder and control subjects. Currently, excessive activity of the locus ceruleus is the only comprehensive neuroanatomic and physiological hypothesis for the etiology of panic disorder. Tricyclic antidepressant agents (TCAs), monoamine oxidase inhibitors (MAOIs), anxiolytic agents, and adrenergic agents all have been used to treat phobic and panic disorders. TCAs and the benzodiazepines, particularly alprazolam, are the drugs most commonly chosen for therapy. If these agents are ineffective, an MAOI or combination therapy can be tried. MAOIs are second-line agents for many patients because of toxicity and dietary limitations. Whether they are more effective than other agents requires further study. Panic and phobic disorders and depression have in common many properties of a dysregulated system; an improved understanding of the pathophysiology of panic and phobic disorders should lead to the development of more effective treatment strategies. PMID- 3322642 TI - Cardiopulmonary resuscitation in children. AB - The management of the pulseless, nonbreathing pediatric patient continues to be a frustrating experience because mortality and morbidity are high. Improvement in outcome awaits a better understanding of the pathophysiology of organ ischemia and reperfusion injury. In the interim, early recognition and therapy of respiratory and circulatory failure are the only effective means to affect outcome. The approach to the pediatric cardiac arrest victim differs from the adult, because dysrhythmias rarely are the etiology of pediatric arrest. Instead, attention to securing the airway and provision of adequate ventilation are keys. Epinephrine is the most effective drug in this setting, and may be administered through an endotracheal tube as well as intravenously or intraosseously. The latter route provides a useful means of rapid vascular access in the pediatric victim less than 3 years of age. Sodium bicarbonate use has been discouraged and there are few indications for calcium, greatly simplifying the pharmacologic approach to the pediatric cardiac arrest patient. In those patients in whom a rhythm and pulse are restored, support of the circulation often is required. Dopamine or epinephrine are the catecholamines of choice in this setting. Ventricular arrhythmias are treated with defibrillation or cardioversion as appropriate. Infrequently, lidocaine or bretylium may be needed. Once the patient has been stabilized, further care is best delivered at a tertiary care center with a pediatric intensive care unit. PMID- 3322641 TI - Reperfusion damage in heart muscle: still unexplained but with new clinical relevance. PMID- 3322643 TI - Evaluation and stabilization of the critically ill child. AB - Because the timely treatment of children in accidents or with serious illnesses usually is successful, it is vital that the life-threatening problem promptly be recognized. Although the principles of resuscitation are identical in the child and adult, age-related differences in anatomy and pathophysiology may make this task challenging for the physician who usually cares for adults. In this article, a systematic approach to evaluation and initial stabilization of the pediatric patient is discussed. Decisions and methods in safely transferring a critically ill pediatric patient are also reviewed. PMID- 3322645 TI - Mechanical ventilation in pediatric patients. AB - Mechanical ventilation in infants and children is guided by the same principles used in ventilating adults. The child's unique anatomy and pulmonary physiology, however, require special considerations. An understanding of these differences will enable the physician to approach the ventilatory management of pediatric patients in a logical manner. PMID- 3322644 TI - The normal and abnormal pediatric upper airway. Recognition and management of obstruction. AB - The pediatric airway is particularly vulnerable to obstruction because of its anatomy, size, and susceptibility to disease and trauma. This article concentrates on the differences between the pediatric and adult airway, congenital and acquired pathology affecting the airway, and the recognition and management of obstruction. PMID- 3322646 TI - Invasive hemodynamic monitoring in children. AB - Invasive monitoring is an important aspect of the care of the infant or child with multisystem organ dysfunction or severe acute respiratory failure. The indications for these procedures in children vary little from current recommendations for adults. The size, anatomy, physiologic responses, and pathophysiologic processes in children frequently require modifications in the placement and maintenance of these lines, and in the interpretation of the data. The literature suggests that although the absolute numbers may vary, broad therapeutic goals may be identified and treated in pediatric patients as in older patients. PMID- 3322647 TI - Noninvasive assessment of cardiopulmonary function in critically ill infants and children. AB - Echocardiography and Doppler echocardiography allow for the accurate noninvasive assessment of cardiac structure and function. Two-dimensional echocardiography accurately demonstrates both normal and abnormal intracardiac and great vessel anatomy and assists in differentiating cardiac from noncardiac causes of respiratory distress. M-mode echocardiography allows for documentation of cardiac chamber size and left ventricular function. Doppler echocardiography is used to measure cardiac output, assess AV and semilunar valve function, detect abnormal flow patterns within the heart and great vessels, and assist in the assessment of pulmonary artery pressures. This article discusses the uses of all these modalities as they apply to the critically ill infant and child. PMID- 3322648 TI - Adult respiratory distress syndrome in children. AB - A variety of severe pulmonary insults such as the adult respiratory distress syndrome (ARDS) is often seen in critically ill children. This article summarizes the clinical manifestations, management, and outcome of children with ARDS. The literature pertaining to the syndrome in the pediatric population is reviewed, and areas where there are key differences between children and adults are emphasized. PMID- 3322649 TI - Diagnostic imaging for evaluation of the pediatric chest. AB - Diagnostic imaging procedures for evaluation of the chest, airways, and sinuses in the infant and child have been reviewed. Procedures include plain radiographs, fluoroscopy, esophagram and UGI, computed tomography, conventional tomography, MRI, digital subtraction angiography, angiography, interventional radiology, ultrasound, bronchography, and pulmonary and esophageal scintigraphy. Knowledge of these imaging procedures aids the physician in ordering the proper examination for the efficient diagnostic workup. PMID- 3322650 TI - Pulmonary function testing in children. AB - This article concentrates on those factors that are particularly important for performing and interpreting lung function tests in children. Specifically, technical considerations such as equipment, personnel, test performance, and bronchoprovocation procedures are discussed. Changes in lung function with growth and appropriate use of race-specific reference standards are emphasized, and references for standard and experimental pulmonary function tests are provided. Several examples illustrating the utility of pulmonary function testing in clinical situations in children with lung disease are provided as well. PMID- 3322651 TI - Rapid noninvasive techniques for determining etiology of bronchitis and pneumonia in infants and children. AB - Table 2 lists the names, abbreviations, and principle underlying most of the rapid diagnostic techniques we have described. Table 3 lists the pathogens most likely to cause lower respiratory tract infections in pediatric patients, the specimens needed for each rapid diagnostic test now generally available, and the approximate time required for its actual performance. For maximal cost effectiveness, it is recommended that laboratory diagnosis be pursued in a stepwise manner: 1) The usual patient with acute respiratory illness who is to be managed as an outpatient may need little if any laboratory evaluation. 2) For the child for whom hospital admission is being considered, serum C-reactive protein screen, urine bacterial antigen tests, and a cold agglutinin test (at the appropriate age) will help to classify the etiology of the infection as likely or unlikely to be bacterial. If antibiotic therapy is to be given, a blood culture should be obtained before starting. 3) For the child admitted to the hospital with a possible chlamydial or viral lower respiratory infection for whom specific therapy is considered, nasopharyngeal secretions should be examined for Chlamydia and for antigens of respiratory syncytial, parainfluenza, and influenza viruses to help select the appropriate antimicrobial. Serum for IgM level may be helpful. 4) For the child who has been intubated for respiratory support, a specimen of deep respiratory secretions should be sent for Gram stain, bacterial culture, for Chlamydia, and viral antigens and culture. 5) For patients presenting with atypical symptoms, signs, or clinical course additional diagnostic possibilities should be considered and appropriate tests done even if results may not be available within 48 hours. PMID- 3322652 TI - Pharmacotherapy of pediatric lung disease: differences between children and adults. AB - Drug dosages for infants and children differ significantly from those used in adults (Table 5). This is due to normal developmental physiologic differences that affect absorption, distribution, and clearance. In general, infants and children require higher dosages of many therapeutic agents on a weight basis. Parenteral drug administration difficulties are complicated by the slow fluid infusion rates often used in infants and young children. The use of syringe infusion pump devices is critical for accurate therapeutic drug monitoring and dosage adjustment in pediatrics than in adults. Aerosol administration in pediatrics is more complicated and is poorly studied. Difficulty with coordinating metered-dose aerosols with inhalation and drug raining out on small endotracheal tubes of ventilated patients are two significant problems. Chronic and acute pulmonary disease can significantly affect drug disposition and metabolism, but has been poorly studied in children. The pharmacokinetics of a number of drugs have been evaluated in cystic fibrosis and may provide insight into the effect of disease states on drug disposition. PMID- 3322653 TI - Cystic fibrosis in adults: diagnosis and management. AB - Once regarded as a disease of infants and young children, cystic fibrosis now also must be considered a disease of adolescents and young adults. Disease complications and management, including hemoptysis, pneumothorax, sinusitis, pancreatic deficiency, and intestinal obstruction, are discussed in this review. In addition, a practical approach to the clinical evaluation, follow-up, and treatment of the older cystic fibrosis patient is presented for the physician who has not had extensive experience in managing these patients. Current research in identifying the CF gene, basic defect, and the use of heart-lung transplants is discussed. PMID- 3322654 TI - Abnormalities of lung growth and development. AB - Review of lung growth and development, as well as major congenital anomalies, is presented in this article. Emphasis is directed toward the difficulties these patients encounter later in life. PMID- 3322655 TI - Comparison of nasopharyngeal washings and swab specimens for diagnosis of respiratory syncytial virus by EIA, FAT, and cell culture. AB - Respiratory secretions for viral diagnosis are often collected with nasopharyngeal (NP) swabs, although many laboratories recommend NP aspirates or washings. We compared results using NP washings and NP swabs in three diagnostic RSV tests, a rapid RSV EIA antigen test (Abbott Laboratories), an indirect fluorescent antibody test (FAT) with rabbit antiserum, and virus culture (HEp-2 cells). Paired samples were collected from 121 children with suspected RSV bronchiolitis or pneumonia. A minitip swap was passed into the nasopharynx for 10 sec, rotated and withdrawn. The opposite nares was irrigated with approximately 1 ml of saline and aspirated using a syringe and plastic feeding tube. Fifty-one children (42%) grew RSV in culture, 49 from NP washings versus 27 from NP swabs (p less than 0.001). Fifty-three (44%) were positive by FAT, 52 from NP washings versus 12 from NP swabs (p less than 0.001). Fifty-eight children (48%) had positive RSV EIA tests, 57 from NP washings versus 35 from NP swabs (p less than 0.001). Detection by EIA was more sensitive than culture regardless of the method of specimen collection. We conclude that NP washings are superior to NP swabs for RSV culture and rapid diagnosis by EIA or FAT. PMID- 3322656 TI - Saccharomyces cerevisiae fungemia: case report and review of the literature. AB - Saccharomyces cerevisiae was isolated on two separate occasions from the blood of a patient with chronic renal failure receiving dialysis. Treatment was complicated by recurrent ventricular tachycardia occurring after both 1 mg and 0.1 mg test doses of amphotericin. We report the unique clinical and microbiological aspects of this patient's management, and review the literature pertinent to this organism. PMID- 3322657 TI - Growth and interaction of Mycoplasma bovirhinis and Mycoplasma dispar in vitro. AB - Two mycoplasmas were grown in pure and mixed cultures in glucose calf-serum broth with initial pH 7.8. Sensitivity to pH was also tested. The main data for Mycoplasma bovirhinis and Mycoplasma dispar, respectively, in pure cultures were as follows: lag phase, days: less than 1, 1-2; log phase: 1-2, 1-4; relatively stationary phase: 0-1, 2-4; decline phase (to the extent roughly logarithmic): 2 6, 5-10; maximal titers: 5 x 10(7) to 10(9), 5 x 10(6) to 10(8) color changing units per 0.2 ml; highest pH, approximately, at which decline started: 7.7 and 7.0; definitely toxic initial pH: 5.6, 6.8; relative production of acidity; less, more. Decline either shortly ended in loss of viability or, correlated with higher pH levels, led to a prolonged maintenance in lower numbers. The decline of M. bovirhinis was postulated to be essentially caused by an autotoxic product/products other than H+. In mixed cultures an antagonistic effect due to the faster growing M. bovirhinis against M. dispar was recorded. The effect varied according to the initial numbers of organisms and their ratio. Two mechanisms seemed to be active: 1. decrease of pH somewhat below neutrality led to the death of the sensitive M. dispar; 2. M. dispar, when present in relatively high initial numbers, was inhibited by M. bovirhinis during the latter's logarithmic growth at pH-levels above 7.0, the inhibition ending shortly afterwards. A rapidly inactivated product/products of M. bovirhinis metabolism, inhibitory to M. dispar was posited. The results offer an improved insight into diagnostic practices for M. dispar. PMID- 3322658 TI - Methyl group metabolism in sheep. AB - 1. Sheep have a very low intake of methyl nutrients in the post-ruminant state, due to the almost complete degradation of dietary choline by rumen microorganisms, the lack of dietary creatine and the relatively low content of methionine in microbial proteins. 2. Methylneogenesis provides a major source of labile methyl groups in post-ruminant sheep and impairment of the methylneogenesis leads to a marked reduction of the labile methyl pool. 3. S Adenosylmethionine (AdoMet) metabolism via transmethylation is most active in sheep liver and pancreas and is regulated by the availability of methionine and intracellular ratios of AdoMet to S-adenosylhomocysteine (AdoHcy). 4. Adaptive mechanisms which arise as a consequence of the poor methyl nutrition in post ruminant sheep are a marked reduction of labile methyl catabolism and an increase in the capacity of methylneogenesis. PMID- 3322660 TI - Metabolic utilization of nutrients and the effects of insulin in fish. PMID- 3322659 TI - Comparison of hydrolases, peroxidase and protease inhibitors in bronchoalveolar fluid from Macacus cynomolgus and human controls. AB - 1. Serial bronchoalveolar lavages were performed on a subhuman primate (Macacus cynomolgus) in order to give an experimental model for silicosis. 2. We have measured glycosidases, proteases, peroxidase and antiproteases of the BAL fluids from seven normal monkeys. 3. The results obtained were similar to those found in human control BAL fluids. 4. For monkeys, the repetition of the bronchoalveolar procedure does not seem to have an important influence on the values obtained. 5. The present results will now permit sequential follow up studies during the course of experimental silicosis. PMID- 3322661 TI - Some aspects of amino acid metabolism in the rat fetus. AB - 1. In spite of an eventual catabolic phase during the last third of pregnancy, nitrogen retention seems to increase in pregnant rats. Furthermore, the high uterine blood flow and the high placental transfer of amino acids maintains an adequate nutrient supply to the fetuses. 2. The terminal rat fetus has a high circulating plasma amino acid level, as well as an increased free amino acid tissue pool when compared to its mother's. 3. In the rat fetus the development of enzymatic capabilities shows a sudden emergence (also denomined clustering) in late fetal life. In a general trend, the activities of enzymes related with amino acid metabolism are not well developed during rat fetal life. 4. The rate of amino nitrogen excretion in rat fetus is low, mainly due to the low development of urea cycle enzyme activities. 5. The rates of protein synthesis in many tissues are high in the rat fetus and they show a progressive decrease until delivery. On the other hand, the rates of protein breakdown are also higher during fetal life than in the adult. PMID- 3322662 TI - Comparison of the serum amylases of farm animals. AB - 1. Serum isoamylases with alpha-glucosidase activity from cattle, sheep, horses, goats, red deer, pigs and dogs were compared to one another. 2. The isoamylases from cattle and pigs were polymorphic. 3. In agarose gel electrophoresis the isoamylases behaved as alpha-1-globulins but in starch gel electrophoresis they were differentially retarded by affinity effects. 4. Molecular weights were estimated: cattle (417,000); sheep (402,000); horses (420,000); goat (399,000); red deer (405,000); pigs (375,000) and dogs (390,000). 5. Isoelectric points were estimated: cattle, sheep, goat and red deer (pH 3.5); pig (pH 3.6); dog (pH 3.7) and horse (pH 3.9). PMID- 3322664 TI - Design of a diagnostic encyclopaedia using AIDA. AB - Diagnostic Encyclopaedia Workstation (DEW) is the name of a digital encyclopaedia constructed to contain reference knowledge with respect to the pathology of the ovary. Comparing DEW with the common sources of reference knowledge (i.e. books) leads to the following advantages of DEW: it contains more verbal knowledge, pictures and case histories, and it offers information adjusted to the needs of the user. Based on an analysis of the structure of this reference knowledge we have chosen AIDA to develop a relational database and we use a video-disc player to contain the pictorial part of the database. The system consists of a database input version and a read-only run version. The design of the database input version is discussed. Reference knowledge for ovary pathology requires 1-3 Mbytes of memory. At present 15% of this amount is available. The design of the run version is based on an analysis of which information must necessarily be specified to the system by the user to access a desired item of information. Finally, the use of AIDA in constructing DEW is evaluated. PMID- 3322663 TI - Chemical modification of thiol group(s) in protein: application to the study of anti-microtubular drugs binding. AB - 1. Different chemical procedures such as performic oxidation, carboxymethylation, carboxyethylation, aminoethylation, cyanylation, acylation, arylation etc. and addition of thiols to activated double bonds, titration of thiols with DTNB (Dithiobis-Nitro-Benzoate) and the reaction of thiols with organomercurials and the titration with p-chloro-mercuri-benzoate (PCMB) etc. are cited and discussed. Their chemical reactions are shown in the figures. 2. We describe in this paper that several chemicals interfere with microtubule assembly by combining with sulfhydryl residues. Reagents such as Cytochalasin-A and B, ethylacetylacrylate, FDNB (fluorodinitrobenzene), NEM (N-ethyl-maleimide), diamide, EBI (ethylene-bis iodoacetamide, ethacrynic acid, methal ions, methylmercury, triethyllead ion and CDDP (cis-dichlorodiammine-platinum-II) are cited and their mechanisms are discussed. PMID- 3322665 TI - MUMPS as a host language for AIDA. AB - In this contribution, the main characteristics of MUMPS, the host language of AIDA, are briefly discussed. This is basically an introductory text for readers who had had no previous experience with MUMPS, on the programming side. After a short introduction, its history is summarized. Then the language itself is introduced and illustrated with examples; for the sake of brevity not all commands, functions and other features are discussed. In the next section, an introduction to MUMPS' stronghold is given: the database structure. Finally, we give the main reasons why we have chosen MUMPS as AIDA's host language. In the appendices, attention is given to the language standardization process, the visibility of MUMPS and its availability, sources of further information and the most important text books on MUMPS (in English). PMID- 3322666 TI - A special message from the Medicare carrier. PMID- 3322667 TI - Bacteriuria in multiple sclerosis: documentation by prospective cultures. PMID- 3322668 TI - A new proposal to limit services to the elderly. PMID- 3322669 TI - State of the art and future trends in heart transplantation and ventricular assist devices. AB - The authors present a short review of the milestones in clinical heart transplantation and the prerequisites they regarded as indispensable to be able to start a clinical programme in their own centre. Next, they describe various types of ventricular assist devices (VAD) and the indications for their use. In conclusion, the authors discuss the prospects of, and future trends in, heart transplantation and VAD that have become, despite their short history, a clinical reality and whose practical importance is to grow further. PMID- 3322670 TI - [The blood pressure-regulating role of the renin-angiotensin system in essential hypertension before and after emotional stress]. AB - The aim of the study was to prove the correlations between systolic and diastolic blood pressure (BP), heart rate (HR) and plasma renin activity (PRA) under mental arithmetic stress without and with beta-blockade. 22 male hypertensive patients (aged 19-39 years) were examined, divided into a group treated with d, 1 propranolol (Obsidan) and a control group receiving placebo. Under arithmetic stress the kinetics of systolic BP showed no differences even after beta blockade. In contrast, the increases of HR and PRA before, during and after mental arithmetic were either significantly reduced (HR) or completely blocked (PRA) under beta-blockade. However, these suppressions of HR and PRA did not prevent the stress-induced elevations of systolic and diastolic BP under beta blockade. PMID- 3322672 TI - Recent developments in diagnostic ultrasound. AB - Ultrasound is being used increasingly in clinical diagnosis throughout the world in many medical specialties. Its major advantages over other imaging modalities are that it is minimally invasive, less expansive, and portable. Its resolution rivals that of X-ray computerized tomography and magnetic resonant imaging. Its limitations are that certain organs, such as lung and bone, are inaccessible by ultrasound, and that certain organs such as heart can only be accessed through limited acoustic windows. In recent years, great advances have been achieved in ultrasound imaging technology that make it even more versatile. Color Doppler flow imaging, parallel processing, Duplex scanning, and transesophageal imaging are just a few examples. In this paper, those developments, among others, are reviewed and their implications in clinical practice are discussed. PMID- 3322673 TI - Mathematical and finite element analysis of spine injuries. AB - A critical review of the anatomical, physiological, epidemiological, and biomechanical aspects of spine injuries are presented. These are discussed in light of the mechanical load that produces the trauma. Emphasis is given to the mathematical and finite element modeling aspects of spinal injury that focuses on the tolerance criteria. In the area of spinal mechanics, static and dynamic models are reviewed. Included are the continuum and discrete parameter models of the intact spine and finite element models of its components. A section on the role of constituent law in the assessment of trauma to the spine is given. Finally, a discussion follows on the future research in this domain. PMID- 3322671 TI - [Echocardiography in the preoperative diagnosis of acquired heart valve diseases]. AB - With the aim of minimizing the risk and stress of an invasive diagnostics, 102 patients with acquired heart valve diseases were examined by two-dimensional echocardiography combined with pulsed Doppler technique. The results were compared with those obtained at invasive diagnostics in 91 and/or during surgery in 52 of the patients studied. In the group of operated patients the sensitivity of non-invasive diagnostics was 89.5%, specificity 97.2%; analogous data for patients not subjected to surgery were 91.8% and 93.8%, respectively. The results of the study show that in the majority of patients with acquired valvular disease a complete preoperative invasive investigation is not necessary. Only in patients over 50 years of age the intended valve replacement should be preceded by additional coronarographic examination, as in 6.8% of cases--even without kinetic disturbances at rest--a haemodynamically important stenosis was found on at least one coronary artery. PMID- 3322675 TI - Cyclosporine: structure, pharmacokinetics, and therapeutic drug monitoring. AB - Cyclosporine is an 11-amino acid cyclic peptide immunosuppressant that has revolutionized organ transplantation. Alone or in combination with prednisone and azathiaprine, it is preferred in hepatic, cardiac, and high-risk renal transplantation. Its unusual primary structure of hydrophobic, N-methylated amino acids results in a compact conformation in the crystal which changes to multiple conformations in hydrophilic solvents. The unusual structure produces unusual pharmacokinetic behavior which is still poorly understood. The metabolism occurs predominately in the liver and is affected by several drugs known to alter hepatic metabolism. At least ten metabolites have been identified but are inadequately characterized. The unique behavior of cyclosporine necessitates therapeutic drug monitoring (TDM) for individualization of therapy. Cyclosporine has been monitored in both whole blood and plasma by both RIA and HPLC with significantly different results for each combination. When cyclosporine is assayed by HPLC in a compulsive regimen of TDM, a correlation is observed between immunosuppression, toxicity, and concentration. To distinguish renal or hepatic toxicity from rejection, biopsies, clinical status, and blood concentrations of cyclosporine must be simultaneously analyzed. After extensive experimental and clinical study, cyclosporine remains an enigma with clear clinical benefit. PMID- 3322674 TI - Clinical applications of DNA probes in the diagnosis of genetic diseases. AB - Currently, advances in molecular technology involving recombinant DNA have led to dramatic breakthroughs in genetic diseases, cancer research, and identification of foreign DNA. Of particular interest is the impact these tools have made and will make on the clinical laboratory. We describe the techniques and their effects on clinical testing in the chemistry laboratory by using selected examples of available applications. Specific examples include carrier detections and prenatal diagnosis in cystic fibrosis and hemophilia, and sickle cell anemia. PMID- 3322676 TI - Tumor detection using radiolabeled monoclonal antibodies. AB - Radioisotope conjugated to monoclonal antibody products has been used for imaging tumors targeted by the antibody. As imaging progresses, new sets of procedural and technical questions arise. In this chapter, we discuss several current problems in imaging tumor with radiolabeled monoclonal antibody. These include (1) methods for selection of specific antibody and, once the particular antibody is selected, which fragment form is to be used; (2) imaging procedures: what are the optimum imaging parameters, such as optimum time for imaging after administration of tracer and considerations regarding background subtraction; and (3) noninvasive quantitative techniques: quantitation of localization of antibody indirectly from quantitative information in the images. PMID- 3322677 TI - Factors and events in the activation, proliferation, and differentiation of B cells. AB - The cellular and biochemical pathways of B-cell activation and the role of antigen presentation by B cells are reviewed. It appears that B cells may be activated by two cellular pathways, one of which is MHC restricted, involving cognate recognition between antigen-presenting B cells and T cells. A second pathway proposed by others is MHC unrestricted and does not involve cognate T/B cell recognition, with the initial signal to the B cell given by antigen alone. Subsequent to antigen activation, both pathways are driven by nonspecific factors derived from T cells and accessory cells. It is most likely that the MHC restricted pathway is the major one used in in vivo antibody responses. The pathways used by T-dependent and -independent antigens are also examined. Phospholipid metabolism and Ca2+ mobilization occur following activation of B cells similar to events occurring following activation of other eukaryotic cells. The mechanism and cellular events involved in the induction of antigen-specific immunological tolerance and the possible role of lymphokines in the tolerant state are also discussed. The effects of two extrinsic B-cell activators are presented, one being the Fc fragment of immunoglobulin and its peptides, and the other derivatives of one of the building blocks of nucleic acids. In the former case, small peptides generated from the Fc fragment of immunoglobulin supply differentiating signals to previously activated B cells in the presence of T cells. In the latter case, a family of derivatized guanosine compounds which act both as intracellular mitogens driving B cells to proliferation and immunoglobulin secretion and as potent adjuvants are discussed in detail. These derivatized nucleosides act predominantly on a population of mature B cells which synergize with T-cell lymphokines, and react to a lesser extent with a subpopulation of immature B cells. PMID- 3322678 TI - Computed tomography of the spine: an update and review. AB - Computed tomography (CT) has proven to be an important diagnostic imaging technique for the evaluation of a variety of spinal disorders. The method is useful for identifying and characterizing acute fractures in traumatized patients and can accurately quantify spinal canal encroachment. Intervertebral disc disease and facet joint osteoarthritis are readily demonstrated by CT in both the cervical and lumbar regions. The technique can reliably distinguish between infection and neoplastic disease in the spine and is helpful for the guidance of percutaneous biopsy. A variety of congenital and developmental vertebral abnormalities, including dysraphic states, spondylolysis, and spinal stenosis, are optimally assessed using CT. Quantitative CT affords selective analysis of trabecular bone in the spine and has proven useful for the detection and follow up of osteoporosis as well as other forms of metabolic bone disease. Most recently, the application of multiplanar reformation and three-dimensional image reconstruction has enhanced presentation of diagnostic information contained on cross-sectional images. PMID- 3322679 TI - The wide spectrum of renal osteodystrophy in children. AB - When chronic renal failure was a routinely fatal condition little attention needed to be paid to the recognition and management of the associated bone disease. The improved medical and surgical management have prolonged the lives of children with chronic renal disease, but in so doing it has also changed the nature of their biochemical environment. These two factors contribute to an increase in the spectrum of abnormalities we see in the bones of children with renal failure, some of which are still unexplained. It has become even more important for the radiologist to recognize subtle as well as overt alterations in the bony architecture because these will influence the clinical management. This is especially true in children because of the severe growth impairment as well as the bony deformities that result from long-standing renal disease. PMID- 3322680 TI - Computed tomography of the sternum. AB - The author presents his experience with computed tomography (CT) in the diagnosis of sternal anomalies. The normal anatomy of the sternum and the peristernal soft tissues are described. The embryology, pertinent to the understanding of congenital sternal anomalies, is reviewed. The technique used to image the sternum is briefly explained. Variants of the sternum, traumatic changes, iatrogenic alterations, inflammation, and neoplastic lesions are illustrated. It is concluded that CT offers definite advantages in the evaluation of presumed sternal pathology and should be the examination of choice in the appropriate clinical setting. PMID- 3322681 TI - Properties of ligninase from Phanerochaete chrysosporium and their possible applications. AB - The wood-degrading fungus Phanerochaete chrysosporium Burds produces a family of enzymes which degrade lignin and lignin-like substrates. These ligninases exhibit a high degree of homology in being hemeprotein peroxidases, in Mr, in cross reactivity to polyclonal antibodies, in being glycosylated, and in catalytic properties. The predominant ligninase is able to generate cation radicals in its aromatic substrates. These radicals can undergo a variety of reactions thus explaining the nonspecific nature of the enzyme. A similar mechanism is suggested for the other isoenzymes. There are numerous potential applications for ligninases. These include: biopulping, waste treatment of byproduct lignins, detoxification of environmental pollutants, and modification of lignins to produce small molecular weight organics. PMID- 3322682 TI - Legume carotenoids. AB - In recent years, the results of research studies have suggested a positive beneficial relationship between a vegetarian-based diet and low incidence of diseases, including coronary heart disease, cancer, obesity, dental caries, and osteoporosis. beta-Carotene has specifically been suggested as a nutrient with antitumorigenic properties. In this regard there is a need to evaluate the carotenoid content of foods. Legumes are one of the staple components of a vegetarian diet. This review specifically surveys the prevalence of carotenoids in food and forage legumes. In addition, the methods available for carotenoid analysis are discussed; factors affecting the determination of carotenoid content during maturation, germination, processing and storage are identified; research areas which have been inadequately explored are identified; and suggestions are made for future lines of investigation. PMID- 3322683 TI - Pleurotus mushrooms. Part I A. Morphology, life cycle, taxonomy, breeding, and cultivation. AB - Pleurotus species represent a well-defined group of Basidiomyceteous fungi of the order Agaricales and family Tricholomataceae. They are characterized by the production of fruit bodies with an eccentric stalk and a wide cap shaped like an oyster shell, with the widest portion of the cap being away from the stalk. They grow over a wide range of temperatures and are able to colonize a wide spectrum of unfermented, natural, lignino-cellulosic wastes. Because of their fast mycelial growth rate, they colonize the substrates rapidly; the yield of fruit bodies is also high. The bifactorial inheritance, observed in many of the species, suggests the likelihood of a high degree of genetic variability, and, hence, considerable breeding potential. Pleurotus species can be grown on a commercial scale, without the need for composting and artificial conditioning of the ambient temperature. Aspects of basic and applied research--such as morphology, life cycle, taxonomy, breeding, and cultivation--leading to development of a "Pleurotus Technology" are dealt with here. PMID- 3322684 TI - Ontogeny of alpha-crystallin polypeptides during the lens development of a mutant mouse. AB - The ontogeny of alpha A, alpha B and alpha Ains polypeptides of the alpha crystallin was investigated by the indirect immunofluorescence staining method with antibodies directed against these three polypeptides in a mutant mouse strain called dyl (27). In this strain cataractogenesis starts around day 16 of lens development but the early development of the lens and the ontogeny of lens crystallins do not differ from the normal genotype (29). The polypeptides were fractionated from normal adult Swiss albino mice total native alpha-crystallin by SDS gel electrophoresis, extracted, lyophilized and injected into young rabbits for production of the antibody. The isolated polypeptides were controlled by SDS gel re-electrophoresis and the antibodies were tested against rat lens native alpha-crystallin by immunoblotting. alpha A and alpha Ains antibodies cross reacted, while alpha B did not show any cross reaction. Results presented here show that alpha A and alpha B appear simultaneously while alpha Ains was detectable at a later stage of lens development. These results are discussed. PMID- 3322685 TI - Response of guinea pigs to the synthetic peptide-M of the uveitogenic, retinal S antigen: antisera immunofluorescent reactivity on normal guinea pig retina. AB - S-antigen can elicit an experimental autoimmune uveitis (EAU) and pinealitis (EAP) in experimental animals. The sera of these animals have immunohistochemical reactivity with the photoreceptor cells of normal retina and pinealocytes. Lewis rats injected with the synthetic peptide-M corresponding to a specific sequence of S-antigen also develop an EAU and EAP. In this study we have investigated the immunohistochemical reactivity pattern of sera of guinea pigs injected with peptide-M. We found reactivity in the area of Muller's cells of normal guinea pig retina. Some of the sera showed weak reactivity with retina photoreceptors cells and pinealocytes. These patterns of reactivity are not seen in control sera of uninjected or saline in adjuvant injected guinea pigs. These results are consistent with observations of experimental and human uveitides. PMID- 3322686 TI - The influence of high molecular weight sodium hyaluronate (Healon) on the production of migration inhibitory factor. AB - The effect of sodium hyaluronate on the production of migration inhibitory factor (MIF) was studied in a two step MIF-assay. High molecular weight sodium hyaluronate (100 micrograms/ml), added during the inductory step of the MIF assay, inhibited the production of MIF. The inhibitory effect did not appear to be due to physical factors such as steric hindrance, which may prevent mitogen binding, since cells preactivated with phytohemagglutinin A (PHA) did not produce MIF when incubated in the presence of sodium hyaluronate. The inhibitory effect was still measurable when the sodium hyaluronate was added upto two hours after stimulation of the mononuclear cells with PHA. Inhibition was also found when the cells were preincubated with sodium hyaluronate, and washed prior to mitogen stimulation. Sodium hyaluronate could only be removed from the cells by incubation with hyaluronidase or by incubation of the cells for at least two hours in culture medium, whereafter the cells could be stimulated to the same extent as normal untreated cells to produce MIF. This inhibitory effect on cytokine production may explain the reduced inflammatory reactions found both in vivo and in vitro in the presence of sodium hyaluronate. PMID- 3322687 TI - Dilated cardiomyopathy and myocarditis: natural history, etiology, clinical manifestations, and management. AB - This monograph begins and ends with a statement of uncertainty regarding many aspects of dilated cardiomyopathy. Natural history studies identify patients with widely differing outcomes. A host of prognostic factors have emerged, yet it would appear that the major determinants of survival are as yet unrecognized. The diagnosis remains primarily one of exclusion, and management is largely nonspecific and supportive. The frequency of sudden cardiac death is well documented, but the ability to accurately identify patients at risk and the efficacy of antiarrhythmic therapy is unestablished. The emerging success of cardiac transplantation is a source of encouragement. The causes of dilated cardiomyopathy remain a source of intense investigation. Accumulating evidence (much of it circumstantial) does, however, implicate a viral etiology and perhaps altered function of the immunoregulatory system. However, the disparity between the severity of functional disturbance with the relative lack of histologic markers of cellular necrosis implies a disturbance at a cellular level. The etiology or etiologies remain elusive. Future investigation directed at fundamental aspects of cardiac cellular biology may provide the answers. PMID- 3322688 TI - Alcohol and the cardiovascular system. PMID- 3322689 TI - The reliability of bedside measurement of lung water in acute hemorrhagic pancreatitis. PMID- 3322690 TI - Monoclonal antibodies to human tumor antigens. PMID- 3322691 TI - Epithelial tumor markers: special markers of glandular differentiation. PMID- 3322692 TI - Mesenchymal tumor markers: intermediate filaments. PMID- 3322693 TI - Mesenchymal tumor markers: special proteins and enzymes. PMID- 3322694 TI - Proteoglycans and the intercellular tumor matrix. PMID- 3322695 TI - Basal membrane antigens as tumor markers. PMID- 3322696 TI - Lectins and blood group substances as "tumor markers". PMID- 3322697 TI - Neuroendocrine tumor markers. PMID- 3322699 TI - Immunohistochemical methods for the demonstration of tumor markers. PMID- 3322698 TI - Cell, tissue and organ specific tumor markers: an overview. PMID- 3322700 TI - PSK immunotherapy in cancer patients--a preliminary report. AB - A clinical trial was conducted by the Department of Radiation Oncology, Mackay Memorial Hospital, between 1981 and 1986, using PSK (Krestin) as an adjuvant immunotherapy to assess its potential benefit in cancer patients. The protocol called for a daily administration of 1 gram tid of PSK orally for at least a month upon completion of primary treatment for the tumor. A total of 67 patients were included in this study; 13 patients were excluded from evaluation because of noncompliance with the protocol. When three cases of toxicity were noted, PSK was discontinued for the three patients. Among the different groups of patients, nasopharyngeal carcinoma patients under PSK immunotherapy showed a significantly better survival when compared with historical controls (28% vs 17% five-year survival rate, p less than 0.05, generalized Wilcoxon test). It is therefore concluded that PSK can serve as an important adjunct in the treatment of nasopharyngeal carcinoma. PMID- 3322701 TI - Evaluation of enzyme-linked immunosorbent assay for immunodiagnosis of clonorchiasis. AB - Two groups of patients with parasitologically proved clonorchiasis were recruited from among staff and workers of China Petroleum Company at Miao-Li county. There were 86 patients in the pre-treatment group and 143 patients in post-treatment. The latter were defined as those treated for 18 months after a daily dosage of 3 X 25 mg/kg BW/day of praziquantel. Indirect ELISA was performed to detect the serum antibody against Clonorchis sinensis with extracted crude antigen of adult worms obtained from the bile duct of cats. Direct smears of stool for Clonorchis ova were checked concomitantly. Results revealed significant decrease of optical density ratio between pre- and post-treatment groups. Positive ELISA was detected in 79 pre-treatment group patients (91.8%) and in 28 patients (20.7%) of the post treatment group (p less than 0.01). Distribution of ELISA titers was shown in patients of post-treatment group towards negative from 400 dilution positive in pre-treatment group. One fourth of the post-treatment group patients with positive ELISA still presented Clonorchis ova in their stool. The main cause was non-compliance of medication. The study confirms the value of immunodiagnosis of C. sinensis by ELISA in the field treatment of clonorchiasis. PMID- 3322702 TI - Factors affecting the production of amphotericin A. AB - Factors affecting amphotericin A synthesis of Streptomyces nodosus, NDMC-034 were studied. Iron, magnesium and manganese were found to stimulate amphotericin A synthesis at concentrations ranging from 10-100 microM. The optimum inoculum size, and the pH of production medium before sterilization for producing amphotericin A, were found to be near 10% (v/v) and pH 7.8, respectively. Carrying out fermentation in a complex medium using pharmamedia as nitrogen source resulted in an amphotericin A yield of up to 3.4 g/liter. A novel isolation and purification process for amphotericin A from the fermentation broth was developed, using an extracting isopropyl alcohol and methanolic solution containing 2% CaCl2. Amphotericin A exhibits a much lower acute toxicity in mice than amphotericin B. PMID- 3322703 TI - [Isolated fractures of the coracoid process. Presentation of 5 cases and review of the literature]. PMID- 3322704 TI - [Fibula pro radio]. PMID- 3322705 TI - [Radiographic evaluation of non-cemented hip joint prostheses]. PMID- 3322706 TI - [A double-blind study of T2 (tablets of polyglycosides of Tripterygium wilfodii hook) in the treatment of rheumatoid arthritis]. PMID- 3322708 TI - [Effect on plasma glucose and serum insulin after xylitol loading in 30 normal adults]. PMID- 3322707 TI - [Effect of sheng mai decoction on left ventricular function in patients with coronary heart disease. A randomized, double-blind, placebo-controlled, cross over trial]. PMID- 3322709 TI - [Lyme disease: a recently known multiple systemic disease]. PMID- 3322710 TI - [Advances in research on AIDS]. PMID- 3322711 TI - Cortical mechanisms subserving reaching. AB - The generation and control of reaching in space is a function of several structures, cortical and subcortical. This paper summarizes some principles of the cortical mechanisms subserving this function, as revealed by recording the impulse activity of neurons in motor cortex and area 5 of the posterior parietal cortex in behaving monkeys. Large populations of neurons in these cortical areas are engaged in reaching. This engagement is early in time; for example, cell activity in the motor cortex begins to change 60-80 ms after target onset, and slightly later in area 5. The time course of cell recruitment in the active population is very similar for reaching movements of equal amplitude directed to different targets. In contrast, the intensity of cell discharge in both motor and parietal cortex is clearly modulated with respect to the direction of reaching. Typically, the firing rate is a cosine function of the direction of the movement in space. An unambiguous distributed code for the direction of reaching exists in neuronal populations in the cortical areas studied. The outcome of this population code can be visualized as a vector in neural space that points in the direction of the upcoming movement. PMID- 3322712 TI - Neuronal activity in the primate non-primary cortex is different from that in the primary motor cortex. AB - This paper describes differences in the properties of single-cell activity in the primary and non-primary motor cortex of behaving monkeys (Macaca fuscata). New findings were obtained in relation to two different behavioural paradigms. First, we found that a large number of non-primary motor cortex neurons exhibit selective or preferential relationships to either signal-triggered or self-paced movement. In the second series of experiments, monkeys were trained to press a small key with the right or left hand, or with both hands. Most primary motor cortex neurons behaved like muscles in the contralateral hand. In contrast, a number of non-primary motor cortex neurons exhibited a selective relationship to the movement (right or left key press, or bilateral key press). The differences suggest the different roles of these two areas in motor control. Studies of this sort seem to start providing answers to the old question of why the non-primary motor cortex exists. PMID- 3322713 TI - Two cortical systems for directing movement. AB - It is argued that the cortical premotor areas are concerned with the conditions for action. Actions are based both on facts about the outside world and about the actions of the animal itself. Observations on monkeys (Macaca fascicularis, Macaca mulatta) suggest that the arcuate premotor area directs actions on the basis of visual cues about the outside environment and that the supplementary motor area directs actions on the basis of proprioceptive cues concerning the animal's own actions. PMID- 3322715 TI - Motor control function of the prefrontal cortex. AB - The prefrontal granular cortex, with the premotor and motor areas, forms the frontal lobe. The three areas are allied by their proximity to one another and by their role in motor control. Of these three major subdivisions, the role of prefrontal cortex has been the most obscure. However, recent anatomical studies have elucidated the circuit basis for motor regulatory functions of the principal sulcus (Brodmann's area 9; Walker's area 46). In addition to well known and well worked out prominent connections with subcortical structures, e.g. the basal ganglia and deep layers of the superior colliculus, this area of prefrontal cortex is reciprocally connected to portions of the supplementary motor and premotor fields that are but one synapse removed from primary motor cortex. The principal sulcal cortex is additionally interconnected with the primary somatosensory area and the somatosensory association areas, in the frontoparietal operculum, with area PF of von Bonin and Bailey in the posterior parietal cortex, and with parts of the 'motor' thalamus. Recent behavioural and electrophysiological studies in monkeys (Macaca mulatta) demonstrate that the principal sulcus can influence delayed-responding, whether the response is a hand or an eye movement. The anatomical and functional evidence supports the thesis that prefrontal cortex has access to and can direct the output of several motor centres. PMID- 3322714 TI - Functional organization of inferior area 6. AB - The rostral part of the agranular frontal cortex (area 6) of the monkey consists of two large sectors: a superior sector lying medial to the spur of the arcuate sulcus (superior area 6) and an inferior sector lying lateral to it (inferior area 6). Single neurons have been recorded from inferior area 6 in behaving monkeys (Macaca nemestrina). The results were: (a) Proximal movements are essentially represented caudally in the histochemically defined area F4. Neurons related to these movements respond strongly to tactile and visual stimuli. Visual receptive fields are located in the space around the animal's body (peripersonal space) and their location does not change with eye movements. The direction of movements effective in triggering the neurons is congruent with the position of their visual receptive field. (b) Distal movements are represented rostrally in the anterior part of F4 and in F5. Neurons related to these movements discharge vigorously during motor acts that have a precise aim. The neurons were subdivided into four classes: grasping-with-the-hand neurons, grasping-with-the-hand-and mouth neurons, holding neurons, and tearing neurons. Regardless of the class they belong to a large number of neurons show specificity for different types of object prehension--discharging, for example, during precision grip but not during whole-hand prehension. It is proposed that inferior area 6 contains a vocabulary of motor acts related to hand-mouth movements. The motor acts can be retrieved by visual and somatosensory stimuli. The possibility is discussed that a series of vocabularies where movements of various complexity are stored represents the neural basis of cortical motor organization. PMID- 3322716 TI - Cerebellar inputs to motor cortex. AB - The macaque cerebellar nuclei all project topically onto a common thalamic field that is somatotopically organized in its projection to motor cortex. The complete overlap (except at the cellular level) of dentate and interpositus (and possibly fastigius and vestibular nuclei) projection onto the somatotopic thalamic field implies a complete body representation within each cerebellar nucleus, rather than a preferential representation of trunk in fastigius, proximal limb in interpositus and digits in dentate, as is sometimes supposed. Dentate receives from association cortex and generates the earliest signals, which assist motor cortex in initiating goal-directed movements. Interpositus receives the spinocerebellar projection and provides a fast input to motor cortex from the periphery, perhaps used in transcortical 'reflex' responses and in the control of oscillation. Fastigius and vestibular nuclei provide an opportunity for labyrinthine control of motor cortex activities-even for the digits. What is unique about cerebellar input to motor cortex? Recent work has emphasized two aspects: switching of a cerebellar signal on or off through Purkinje cell inhibition, and adjusting the magnitude of the signal to optimize motor performance. PMID- 3322717 TI - Bereitschaftspotential as an indicator of movement preparation in supplementary motor area and motor cortex. AB - Topographical studies in humans of the Bereitschaftspotential (BP, or readiness potential, as averaged from the electroencephalogram) and the Bereitschaftsmagnetfeld (BM, or readiness magnetic field, as averaged from the magnetoencephalogram) revealed a widespread distribution of motor preparation over both hemispheres even before unilateral movement. This indicates the existence of several generators responsible for the BP, including generators in the ipsilateral hemisphere, which is in agreement with measurements of regional cerebral blood flow or regional cerebral energy metabolism. Nevertheless, two principal generators seem to prevail: (1) An early generator, starting its activity 1s or more before the motor act, with its maximum at the vertex. For this and other reasons, early BP generation probably stems from cortical tissue representing or including the supplementary motor area (SMA). (2) A later generator, starting its activity about 0.5s before the onset of movement and biased towards the contralateral hemisphere (contralateral preponderance of negativity, CPN). For unilateral finger movements the CPN succeeds the BP's initial bilateral symmetry in the later preparation period. Thus, this lateralized BP component probably stems from the primary motor area, MI (area 4, hand representation). While regional cerebral blood flow or regional cerebral energy metabolism show that the SMA is active in conjunction with motor acts, these data do not permit the conclusion that SMA activity precedes motor acts. This can only be shown by the Bereitschaftspotential, which proves that SMA activity occurs before the onset of movement and, what is more, before the onset of MI activity. This important order of events (first SMA, then MI activation) has been elucidated by our BP studies. It gives the SMA an important functional role: the initiation of voluntary movement. The recording of movement-related potentials associated with manual hand-tracking and motor learning points to the SMA and frontal cortex having an important role in these functions. PMID- 3322718 TI - Metabolic mapping of sensorimotor integration in the human brain. AB - Studies of regional cerebral flow and regional cerebral oxidative metabolism have revealed that humans have three major cortical motor areas: the premotor, supplementary motor and primary motor areas. The premotor area participates in organizing non-routine voluntary movements, especially those carried out contingent to or dependent on sensory information. The supplementary motor area participates in the planning of all motor subroutines. The primary motor area is the executive locus for voluntary movements. Subcortically the caudate nucleus, putamen, globus pallidus, parasagittal cerebellum and ventral thalamus are the main structures which increase their metabolism during voluntary movements of the upper limbs. All these cortical and subcortical structures except the primary motor area are bilaterally activated even during strictly unilateral movements of the upper limbs. However, recent studies of oxidative metabolism show that the caudate nucleus, putamen and lateral cerebellum also participate in cognitive functions and non-motor learning. Before any specific brain work is executed, voluntary movements included, the brain tunes and prepares cortical fields measuring a few square centimetres in the areas that are supposed to participate in information transmission. The superior prefrontal cortex has a special role in this recruitment of cortical fields. Depending on the information needed to execute the voluntary movements, cortical fields are activated in the anterior parietal lobe and the dysgranular frontal cortex. PMID- 3322719 TI - Differential effects of cortical lesions in humans. AB - The best-known example of motor deficits after cortical lesions is contralateral paresis and spasticity after damage to the precentral motor strip. After recovery the residual motor functions can be used in a purposive and skillful manner. In patients with lesions of the supplementary motor area (SMA) and cingulate gyrus transient akinesia and mutism have been described. Lesions restricted to more lateral parts of the premotor field interfere with proximal muscle function and interlimb coordination, whereas distal motor activity and bimanual coordination are unimpaired. In contrast, hand function in patients with parietal lesions is severely disturbed. This dysfunction includes deficits such as ataxia, dysmetria and postural instability that are typically observed in deafferented patients. Severe disturbances of the purposive behaviour of the hand during exploratory finger movements and manipulation of objects are seen in patients with posterior parietal lesions. Observations in human patients are compatible with the hypothesis that lesions of the frontal agranular motor fields interfere with the control of postural and force control whereas parietal lesions are associated with motor programme disorders affecting the use of the hand or the eye as a sense organ or affecting more complex motor behaviour. PMID- 3322720 TI - Input and output organization of the supplementary motor area. AB - Recent work on the supplementary motor area (SMA) in Macaca fascicularis led to the conclusion that this area is involved mainly in the preparation of self-paced movements. Results are presented indicating that the posterior portion of the SMA is also directly involved in movement execution and that it receives various sensory inputs. The main results are as follows: (1) The SMA has direct access to the spinal cord by way of corticospinal neurons, but the density of these neurons is lower than in the primary motor cortex (MI). (2) Intracortical microstimulation effects can be elicited in the SMA. Facilitatory effects on ongoing EMG activity can even be produced by single micropulses (8/s). The shortest latencies are compatible with an oligosynaptic or monosynaptic transmission. (3) SMA neurons respond (as do MI neurons) to external perturbations. (4) Anatomical tracing studies revealed that basal ganglia outflow to the SMA via the thalamus is important; our results suggest that dentate outflow contributes as well. (5) Many cells of the SMA may covary with conditioned movements in the same way as MI neurons do. It is argued that it is difficult to compare the lead-time of MI and SMA neurons since 'early' discharges may be coupled with anticipatory postural events. PMID- 3322721 TI - Some aspects of the organization of the output of the motor cortex. AB - The precentral motor cortex in the macaque is defined here as that portion of the precentral motor-sensory areas which projects to the intermediate zone and motor neuronal cell groups in the spinal cord and their bulbar counterparts, i.e. the lateral reticular formation and motor nuclei of the lower brainstem. In this respect the precentral motor cortical areas differ from postcentral areas such that the descending projections from the latter are focused on the spinal dorsal horn and the spinal V complex. Differences in the distribution of the corticospinal fibres in different species are mentioned and differences in findings obtained by means of different tracing techniques are discussed. The projections from the precentral motor cortex to various brain-stem cell groups are also discussed and the areas of origin of these projections are delineated. The presence of branching neurons distributing collaterals to several of these areas is considered. PMID- 3322722 TI - Thiazole orange: a new dye for Plasmodium species analysis. AB - A rapid sensitive method for the determination of Plasmodium falciparum in in vitro culture is presented. The technique employs a fluorescent flow cytometer equipped with a 15-mwatt argon laser that emits light at 488 nm and a membrane permeable fluorochrome thiazole orange (TO) that stains RNA. Parasitized red cells are stained by suspending them in 1 ml of phosphate-buffered saline (PBS) containing 10(-5) M of TO and incubating this mixture for 15 min in the dark at room temperature. The stained cells may be analyzed fresh or after fixation with 1% paraformaldehyde/PBS or 0.25% glutaraldehyde/PBS. Alternatively the cells may be fixed first and then stained. There is excellent correspondence between the number of fluorescent-labeled parasitized red cells and Giemsa-stained cells. PMID- 3322723 TI - Effect of glipizide on insulin secretion and insulin metabolism in obese type II diabetic patients. AB - This study was designed to explore the short-term effect of glipizide on insulin secretion and metabolism. Plasma insulin and C-peptide levels in the fasting state and after a 100-g oral glucose load were measured in 17 obese newly diagnosed type II (non-insulin-dependent) diabetic subjects before and after 1 mo of treatment with glipizide (15 mg/day). Plasma glucose levels decreased significantly after treatment with glipizide. Plasma insulin and C-peptide concentrations in the fasting state did not change after glipizide treatment. Also, postglucose plasma insulin levels did not change after glipizide, whereas postglucose plasma C-peptide concentrations significantly increased. A significant relationship was found between the increase in C-peptide plasma levels and the decrease in glycemic profile after glucose load following glipizide treatment. The relation between plasma C-peptide and insulin incremental areas after the oral glucose load significantly increased after treatment. These results suggest that in obese type II diabetic patients, 1 mo of treatment with glipizide potentiates the beta-cell response to oral glucose load and increases insulin metabolism, probably within the liver. PMID- 3322724 TI - Modification of therapy from insulin to chlorpropamide decreases HDL cholesterol in patients with non-insulin-dependent diabetes mellitus. AB - In 27 patients with non-insulin-dependent diabetes mellitus, we determined fasting serum glucose, hemoglobin A1, body weight, serum triglycerides, cholesterol, low-density lipoprotein cholesterol (LDL-chol), high-density lipoprotein cholesterol (HDL-chol), and very-low-density lipoprotein cholesterol during treatment with insulin and several months after changing treatment to chlorpropamide. In five patients, diabetic control deteriorated to the point where insulin was reinitiated. In the remaining 22 patients, despite a significant decrease in weight (122 +/- 5 vs. 114 +/- 5% ideal body wt; P less than .025) on chlorpropamide, HDL-chol fell from 49 +/- 4 to 40 +/- 4 mg/dl (P less than .01) when therapy was modified from insulin to the sulfonylurea. There was a concomitant increase in LDL-chol:HDL-chol from 3.6 +/- 0.3 to 4.4 +/- 0.5 (P less than .05). In the 5 patients in whom insulin was reinstituted, HDL-chol increased to its previous level on insulin (P less than .05). Changing antidiabetic medication from insulin to sulfonylureas may alter the lipoproteins in a manner that increases cardiovascular risk. PMID- 3322725 TI - Metabolic control in non-insulin-dependent diabetes mellitus: factors associated with patient outcomes. AB - We conducted a cross-sectional study to assess the association of various demographic and medical-care variables with metabolic outcomes in non-insulin dependent diabetic subjects. The study population was representative of the diagnosed care-seeking diabetic population of a defined geographic community on the Navajo reservation in Arizona. The dependent variable metabolic control was measured as the mean of all random plasma glucose values obtained only at scheduled diabetes clinic visits over 2 yr. Multivariate analysis of the data showed that better metabolic control was most strongly associated with compliance with scheduled appointments. Mode of treatment was also associated with metabolic control. Other variables tested, including source of care, age, sex, duration of diabetes, presence of complications, and weight change, were not associated with metabolic control. The strongest analysis of covariance model with demographic and medical-care variables accounted for 39% of the variance in metabolic control. The analysis suggests that other variables, possibly including several psychosocial variables, need to be assessed for their contribution to metabolic control. PMID- 3322726 TI - Overnight metabolic control with bedtime injection of intermediate-acting insulin or continuous subcutaneous insulin infusion. AB - Ten insulin-dependent diabetic patients were investigated from 2100 to 0700 h during treatment with either a bedtime injection (BI) of intermediate-acting insulin or continuous subcutaneous insulin infusion (CSII) at a constant basal rate. In the evening, blood glucose was slightly higher during treatment with BI than with CSII, whereas the metabolic control in the morning was equal on both regimens with a fasting blood glucose of 5.7 mM (4.2-7.1) (median and interquartile ranges) on BI and 5.4 mM (4.6-5.8) on CSII (NS). No rise in morning blood glucose was seen, but serum beta-hydroxybutyrate tended to rise (NS). There was a significant hyperinsulinemia at midnight during BI compared with CSII with a serum free insulin of 14.5 (11.7-16.0) vs. 9.6 (7.2-11.2) mU/L (P less than .05), respectively, and the area under the curve during the middle of the night (midnight to 0400 h) was greater with BI than CSII (P less than .02). A greater fall in blood glucose was seen with BI than with CSII during this period (P less than .02). Differences in blood glucose and serum free-insulin profiles between those using NPH or lente insulin at bedtime were registered. We conclude that, although the same metabolic control in the morning was achievable with CSII at a constant basal rate and BI, CSII is superior for overnight metabolic control due to less-pronounced hyperinsulinemia during the night and a steady-state level of free insulin in the morning. PMID- 3322727 TI - U-100 insulin gives some protection against metabolic deterioration due to CSII interruption. AB - We investigated the influence of insulin concentration within the insulin pump on the metabolic and plasma free-insulin changes induced by a 6-h nocturnal interruption of continuous subcutaneous insulin infusion (CSII) in five C-peptide negative insulin-dependent diabetic patients with low circulating levels of anti insulin antibodies. We compared the changes in blood glucose, plasma free fatty acids, 3-hydroxybutyrate, and free insulin during the interruption from 2300 to 0500 h of the Nordisk Infuser loaded with either U-100 or U-20 regular insulin. The decrease in plasma free-insulin levels was slower, resulting in a significantly delayed and smaller increase in blood glucose levels (2.4 +/- 1.6 vs. 7.6 +/- 2.9 mM, P less than .025) when the pump contained U-100 instead of U 20 insulin. Although the increases in levels of plasma free fatty acids were similar in both tests, the rise in plasma 3-hydroxybutyrate levels tended to be reduced with U-100 insulin (414 +/- 139 vs. 639 +/- 67 microM, P less than .10). Thus, our observations indicate that U-100 insulin gives some protection against the metabolic deterioration due to the interruption of CSII so that diabetic patients may be able to remain without the pump for longer periods with concentrated rather than diluted insulin. PMID- 3322728 TI - Glucose and insulin responses in relation to insulin dose and caloric intake 12 h after acute physical exercise in men with IDDM. AB - Acute exercise in insulin-dependent diabetic patients may perturb glycemic control, and adjustments of insulin and diet might be required to avoid postexercise hypoglycemia. The aim of this study was to assess the role of alterations in insulin dose or caloric intake on blood glucose and free-insulin levels during 12 h after an evening bout of exercise. Nine insulin-dependent diabetic men (28-42 yr of age) receiving two daily injections with a combination of intermediate-acting and soluble insulin participated in the study. Patients were randomly assigned to four treatment protocols: A, 50% reduction in intermediate-acting insulin dose; B, 50% reduction in soluble insulin dose; C, extra caloric intake (1700 kJ) 1 h after exercise; and D, no change. Exercise consisted of 45 min of cycling at 60% of maximal oxygen uptake at each occasion. Glucose and insulin responses were similar for the four protocols. There was a significant (P less than .001) time effect found regardless of treatment, with lowest blood glucose values 75 min after exercise. Hypoglycemia occurred in six of the nine patients at some time during the study, with half of the occurrences on the control night (protocol D). Consistent individual plasma insulin and glucose patterns were observed independent of protocol used. In some patients, hypoglycemia was evident after reductions in insulin dose, and in others it was evident on the night increases in caloric intake were to occur; thus, none of the interventions were totally adequate in preventing exercise-induced hypoglycemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322729 TI - Postoperative management of diabetes mellitus: steady-state glucose control with bedside algorithm for insulin adjustment. AB - An algorithm was developed to determine whether an individualized insulin infusion could maintain plasma glucose in a desirable steady state after surgery. In 24 patients, insulin was provided according to a "glucose-feedback" formula to maintain plasma glucose between 120 and 180 mg/dl (6.7-10.0 mM). Initial plasma glucose was elevated, 218 +/- 16 mg/dl (mean +/- SE 12.1 +/- 0.9 mM), but reached the target range after 8 h and remained steady for the rest of the study period. Insulin requirements varied considerably, 0.5-5.0 U/h. Infusion rates were correlated with initial plasma glucose but not with previous insulin dose, HbA1c, or percent ideal body weight. Although insulin needs cannot be predicted, plasma glucose can be maintained in a desirable range after surgery via a simple formula suitable for implementation by general ward nurses. PMID- 3322730 TI - Reduction in cardiovascular risk factors with intensive diabetes treatment in insulin-dependent diabetes mellitus. AB - We measured plasma lipid and lipoprotein levels at baseline and at 6-mo intervals in 47 normolipidemic patients with classic insulin-dependent diabetes mellitus treated either with a conventional (n = 21) or intensive (n = 26) diabetes treatment program. Patients were followed for a mean of 3 yr (range 1-4 yr). Intensive diabetes treatment resulted in a significant improvement in glycemic control that caused sustained changes in plasma lipid and lipoprotein levels that were not evident with the conventional-treatment program. These changes, which persisted for periods averaging 3 yr, can potentially reduce predicted risk for the development of premature atherosclerosis. Thus, long-term near normoglycemia may have a role in the prevention of atherosclerosis in insulin-dependent diabetic patients. PMID- 3322732 TI - Statement on hypertension in diabetes. AB - Hypertension and diabetes mellitus are commonly associated. Hypertension contributes substantially to morbidity and mortality in the diabetic population. This report was prepared as a practical guide for the management of hypertension in diabetic patients. Although treatment of hypertension in most diabetic patients does not differ from that in nondiabetic patients, this report outlines some special considerations relevant to the presence of both diseases. For both hypertension and diabetes, basic nonpharmacologic therapy consists of dietary alterations, exercise, weight management, smoking cessation, and restricted alcohol intake. These measures should be instituted as initial therapy or concomitant with pharmacologic measures. The stepped-care approach to drug treatment in essential hypertension serves as a guide to therapy. Flexibility in the use of antihypertensive drugs is suggested, and selected practical issues in drug treatment are reviewed. PMID- 3322731 TI - Factors affecting interpretation of postprandial glucose and insulin areas. AB - Recently there has been an increased interest in determining the circulating glucose concentration after the ingestion of various individual foods and mixed meals. The purpose of these determinations is to systematically rank foods with respect to their quantitative effect on postmeal glucose concentration. Potentially such data could be useful in designing a diet for individuals with diabetes. We believe this concept is good. However, several factors that may affect interpretation of the data used to develop this ranking need to be considered before the utility of this approach to dietary management can be assessed: 1) duration of time over which the data are collected and analyzed; 2) use of absolute versus incremental areas in the determinations; 3) inclusion or exclusion of negative areas if incremental areas are used; 4) differences in response to a given food in males compared with females; 5) severity of diabetes; 6) confounding effects of oral agents or insulin treatment; 7) reproducibility of data; 8) differences in collection of blood sample; 9) food composition, processing, and preparation; 10) the dose-response relationship to ingestion of a given carbohydrate; 11) the meal being studied, i.e., first, second, or third meal of the day; and 12) a possible effect of the composition of the previous meal, if the response is tested to any meal other than the first meal of the day. PMID- 3322733 TI - Clouding and deactivation of clear (regular) human insulin: association with silicone oil from disposable syringes? PMID- 3322734 TI - Insulin-pump therapy: effect of phosphate-buffered human insulin. PMID- 3322735 TI - Generalized allergy due to zinc and protamine in insulin preparation treated with insulin pump. PMID- 3322736 TI - Prevention of dawn phenomenon. PMID- 3322737 TI - Relaxation therapy. PMID- 3322738 TI - Miscibility of human isophane insulin with human soluble insulin. PMID- 3322739 TI - Lessons from glucose monitoring at night. PMID- 3322740 TI - Effect of storage on action of NPH and regular insulin mixtures. PMID- 3322741 TI - Immunocytochemical demonstration of Chlamydia infection in the urogenital tracts. AB - The peroxidase-antiperoxidase (PAP) technique was applied in cellular samples for the detection of chlamydial infection. Urethral scrapings were obtained from 316 males with clinically suspected urethritis. Positive PAP staining was detected in 118 (37%) of 316 tested. Cellular samples from the endocervix of 25 (54%) of 46 female contacts of males with positive Chlamydia-infected cells had positive Chlamydia-PAP staining. Chlamydia was also found in 12 (25%) of 48 male with gonorrhea. Serum IgG antibodies against Chlamydia trachomatis were evaluated using an enzyme-linked immunosorbent assay. A total of 29 out of 73 patients had positive Chlamydia serology; of these, 21 were positive for PAP staining, and eight were negative. The determination of Chlamydia antigen by means of the PAP technique appears to be a satisfactory method for detecting Chlamydia in male and female genital specimens; also, the procedure can be done readily in most laboratory settings. PMID- 3322742 TI - Primary structure of the P450 lanosterol demethylase gene from Saccharomyces cerevisiae. AB - We have sequenced the structural gene and flanking regions for lanosterol 14 alpha-demethylase (14DM) from Saccharomyces cerevisiae. An open reading frame of 530 codons encodes a 60.7-kDa protein. When this gene is disrupted by integrative transformation, the resulting strain requires ergosterol and, as expected, grows only in the absence of oxygen. The deduced amino acid sequence of 14DM includes a hydrophobic segment near the amino terminus which may be a transmembrane domain. The deduced sequence has been compared with those of eight other eukaryotic P450s, each from a different family within the P450 superfamily. These comparisons indicate that this yeast gene is the first member of a new P450 family, P450LI. The P450, designated P450LIA1, is more closely related to mammalian P450s than to the bacterial P450cam. In fact, both the yeast P450 and several mammalian P450s have equivalent alignment scores when each is compared with the bovine P450scc. Matrix comparisons of the amino acid sequence of this P450 with those of mammalian P450s reveal three conserved regions. The DNA region 5' to the structural 14DM gene includes poly(dA:dT) sequences and a repeating hexamer sequence. PMID- 3322743 TI - Cloning, characterization, and sequencing of the genes encoding the large and small subunits of the periplasmic [NiFe]hydrogenase of Desulfovibrio gigas. AB - The structural genes for the large and small subunits of Desulfovibrio gigas periplasmic [NiFe]hydrogenase were identified and isolated by immunological and oligonucleotide screening. The gene for the small subunit codes for a 266-amino acid, 28,724-dalton polypeptide which is separated by 63 nucleotides from the large subunit gene that codes for a 560-amino-acid, 61,707-dalton polypeptide. A putative signal peptide precedes the small subunit coding region, which may direct transport of the enzyme into the periplasmic compartment. Comparison of the amino acid sequence of this enzyme with those of two other classes of hydrogenase found in Desulfovibrio revealed that the D. gigas periplasmic hydrogenase has some homologies to the periplasmic [NiFeSe]hydrogenase of D. baculatus but none to the periplasmic [Fe]hydrogenase of D. vulgaris. The genes for the large and small subunits of the D. gigas hydrogenase hybridize strongly to genomic DNAs from several species of Desulfovibrio, indicating molecular similarity of the [NiFe]hydrogenase among sulfate reducers. PMID- 3322744 TI - A standardized vector system for manipulation and enhanced expression of genes in Escherichia coli. AB - Different families of cloning and expression vectors were engineered on a standard plasmid. They contain several regulatory signals for transcription and/or translation initiation and termination. The plasmids in each series differ only in the number, type, and order of unique restriction cleavage sites clustered in front of a transcription terminator. The pLK30 plasmids are general cloning vectors and the corresponding pLK50 plasmids carry the lambda pL promoter. The pLK60 vectors carry the lambda pR promoter and translation initiation signals of the cro gene containing the Shine-Dalgarno sequence and initiation codon. The pLK70 series is similar to pLK60 except that additional 5' translated cro sequences are included. The pLK80 plasmids have a lacZ gene fragment suitable for the construction of hybrid genes. The presence of translational stop signals in the pLK90 series facilitates the manipulation of genes truncated at the 3' end. This standardized pLK vector system offers great versatility in gene manipulation and in optimization of gene expression under the control of strong regulatable promoters. Measurement of expression levels under repressed conditions permits the identification of optimal promoter-gene configurations in constructions directing high-level expression. PMID- 3322747 TI - Automated measurement of the electro-oculogram for clinical use. AB - A method of automated measurement of the EOG amplitude is described. Its main advantages are as follows: 1. The mean of amplitudes, at a series of time dots within a single EOG deflection recorded with DC-amplification, are automatically measured and printed out. 2. Artifacts due to blinks, overshoots or other irregular eye movements are automatically eliminated. 3. A base line drift is automatically compensated. The L/D ratios obtained in 80 eyes with this method were essentially equal to those obtained by a manual measurement (correlation coefficient 0.9905). PMID- 3322745 TI - Influence of vasospasm on visual function. AB - In a number of patients with etiologically unexplained visual field loss, a vasospastic syndrome could be found with the help of a capillaroscopic local cooling test on the fingers. In the patients with proven vasospastic syndrome, the visual field defects were increased after a cold water test and decreased after a therapy with calcium entry blockers. General aspects of the physiology and pathophysiology of the circulation and especially of the circulation in the eye are presented. PMID- 3322746 TI - The early receptor potential (ERP). AB - The ERP contains information on the function of the outer segments of the retinal photoreceptors. The authors have established normative values of the ERP and the factors which might be of influence hereupon. ERP findings in patients suffering from various eye diseases are given. Value and limitation of ERP recording are discussed in relation to the other clinically available electrodiagnostic tests. PMID- 3322749 TI - Results of pterygium excision with Sr 90 irradiation, lamellar keratoplasty and conjunctival flaps. AB - The results of pterygium excision were assessed in an open study following a double-blind study on the effect of after-treatment with Strontium 90 (Sr 90). The results of the treatment of more complicated pterygia with disturbances of ocular motility and reduced visual acuity were also assessed; the treatment consisted of pterygium excision, conjunctival flaps or keratoplasty, and in the case of symblepharon fornix reconstruction. Thirty-three eyes with pterygia which had not previously been operated on, were treated with the "bare sclera" operative technique in combination with Sr 90 irradiation. After this treatment there were no recurrences. In the group of 18 recurrent pterygia which were treated with the same technique, two recurrences were seen. These results of irradiation are in sharp contrast with the 67% chance of recurrence when the "bare sclera" technique is used alone. The results of the more complicated pterygium operations were also successful. Visual acuity, motility and appearance improved markedly or became normal. Recurrences were rare (0-6%). PMID- 3322748 TI - Basic research and clinical aspects of the oscillatory potentials of the electroretinogram. AB - This paper reviews current knowledge concerning the oscillatory potentials (OPs) of the electroretinogram (ERG). The first section describes the basic characteristics of the OPs primarily studied in healthy subjects. The behavior of the OPs is different from the a- and b-waves, indicating separate mechanisms for generation of the OPs compared with the major components of the ERG. The second section deals with the present view of the origin of the OPs collected from experimental studies of the vertebrate retina, including the primate. Findings favor the conclusion that the bipolar (or interplexiform) cells are the probable generators of the OPs. The third section gives clinical examples of the sensitivity of OPs to early disturbances of retinal function in different eye diseases. PMID- 3322750 TI - When is a tissue-typed cornea necessary? PMID- 3322751 TI - Mode of action of nitro-heterocyclic compounds on Escherichia coli. AB - The inhibitory and bactericidal activities of several different nitro heterocyclic compounds, such as nitrofuran, nitronaphthofuran, nitrobenzofuran, nitroimidazole and nitrothiazole, were assessed in vitro. All these substances except nitroimidazole were active against Escherichia coli, though to different degrees. Under anaerobic test conditions the antibacterial activity increased slightly. Nitroreductase-deficient mutants, however, were highly resistant to all nitro-compounds, indicating that only when the nitro-group is reduced to these agents get into an active antibacterial form. SOS repair-deficient strains were much more susceptible to the nitro-containing substances than repair-proficient counterparts, indicating that damage to bacterial DNA is the essential mechanism of antibacterial activity of all nitro-heterocyclic compounds. PMID- 3322752 TI - Therapeutic efficacy and pharmacokinetic properties of ciprofloxacin in intra abdominal abscesses caused by Bacteroides fragilis and Escherichia coli. AB - Experimental intra-abdominal abscesses were produced in mice by intraperitoneal injections of Bacteroides fragilis and Escherichia coli. The therapeutic efficacy of ciprofloxacin was investigated in this mixed intra-abdominal abscess model and was compared with that of rifampicin. Treatment with ciprofloxacin at 0.2 to 20 mg/kg or rifampicin at 20 mg/kg prevented all mice from death, as compared to the 60% mortality rate observed in the vehicle-treated controls. Rifampicin concentrations at 10 and 20 mg/kg were effective in preventing abscess formation and eradicated bacterial abscess. Ciprofloxacin at all the levels tested neither reduced the incidence of abscess nor eradicated Bact. fragilis from abscesses. However, ciprofloxacin at levels of 20, 10, 5, and 1 mg/kg reduced significantly the number of E. coli cells in the abscess. The peak serum level of ciprofloxacin at the oral dose of 20 mg/kg was 0.43 mg/l which was well above the MIC values for E. coli but not for Bact. fragilis. PMID- 3322754 TI - Upper respiratory tract infections in children: antibiotic treatment. AB - Upper respiratory tract infections, particularly pharyngitis and acute otitis media (AOM) are the commonest diseases in children. Although viruses are the main causative agents, bacteria may play an important role. With regard to antibiotic therapy, clinicians must solve two problems: differentiation between viral and bacterial aetiology and choice of the optimal drug for each bacterial disease. In patients with pharyngitis the identification of group A haemolytic streptococci as the causative agent may be very difficult if only clinical and haematological data are considered. Throat culture is time consuming and difficult to perform in ambulatory practice; the recent techniques for rapid detection of streptococcal antigens are a possible answer to this problem. In bacterial pharyngitis a single injection of benzathine penicillin is considered to be first choice. However local pain and the significant increase of the relative risk of allergic problems in comparison with the decrease of incidence of rheumatic fever may shift therapeutic preference towards macrolides. The recently marketed ones, especially miocamycin, seem to offer easier administration, fewer side-effects and better efficacy. With regard to AOM, the differentiation between bacterial and viral disease is less important because over 70% of cases are of bacterial origin. Besides, an exact aetiological diagnosis is possible only by tympanocentesis, an invasive method. In Italy amoxicillin is still the drug of choice: a twice-daily regimen has been demonstrated to be as effective as the traditional thrice-daily schedule. PMID- 3322755 TI - Effects of renal insufficiency on the pharmacokinetics and pharmacodynamics of opioid analgesics. AB - The disposition and pharmacologic activities of morphine, meperidine, methadone, propoxyphene, dihydrocodeine, and codeine are reviewed. Dose-related toxicities of these opioid analgesics include mental obtundation, respiratory depression, and hypotension. Furthermore, convulsions have been associated with normeperidine and cardiac toxicities with norpropoxyphene. Hepatic metabolism is the primary route of elimination, except for methadone, for which there is also significant renal excretion. Although the pharmacokinetics of morphine are unchanged in renal insufficiency, accumulation of active metabolites may lead to narcosis. Similar accumulation of normeperidine and norpropoxyphene, metabolites of meperidine and propoxyphene, respectively, as well as propoxyphene itself, and dihydrocodeine and codeine may explain reports of adverse reactions in patients with impaired renal function. A high index of suspicion of opioid-induced toxicities should be maintained in patients who have renal dysfunction and receive opioids. PMID- 3322756 TI - Aerosol corticosteroids for the treatment of asthma. AB - In an effort to maximize the efficacy of corticosteroid treatment in asthma and minimize the adverse reactions, steroid therapy has evolved to the inhalation route of administration with aerosol compounds having potent topical antiinflammatory activity and minimal systemic effects. Corticosteroids exhibiting these properties that are available in the U.S. include beclomethasone dipropionate, triamcinolone acetonide, and flunisolide. The success or failure of patient response to orally inhaled corticosteroids is often a function of adequate drug delivery rather than the efficacy of the drug itself. Patients who cannot use the inhaler accurately may benefit from the use of a spacer or reservoir device. The three aerosolized corticosteroids have specific pharmacologic differences; however, none of these differences has translated into a clinically significant advantage or disadvantage of one product over the others. These agents should be considered for adjunctive therapy in patients whose asthma is not adequately controlled by beta-agonist bronchodilators, theophylline, or cromolyn sodium. PMID- 3322753 TI - In vivo protective role of antioxidants against genotoxicity of metronidazole and azanidazole. AB - The mutagenicity of metronidazole and azanidazole has been extensively reported. Previous experiments demonstrated, by means of the intrasanguineous host-mediated assay, that they significantly induced mutagenicity in liver, kidney and lung of mice. The treatment of mice with butylated hydroxyanisole (BHA) or butylated hydroxytoluene (BHT) by two different routes of administration (i.p. injection and oral intubation) significantly reduced liver- and kidney-mediated mutagenicity of azanidazole and metronidazole. No significant differences were observed between the routes of treatment in terms of protective effect on genotoxicity of azanidazole in the considered organs, whereas i.p. administration was the most suppressive on the mutagenicity of metronidazole. Even if BHT was the most effective agent in preventing mutation induction in mice, a detectable toxicity, in terms of increased mutagenicity, was evaluated in the liver. Evidence of lung abnormalities was also seen. The results suggest that the possible adverse effects on biological systems limit the prophylactic use of BHA and BHT in preventing the action of chemical carcinogens in man. PMID- 3322757 TI - The drug approval process and the information it provides. AB - By law, the commissioner of the Food and Drug Administration (FDA) is responsible for determining whether a new drug is safe and efficacious before it is approved for marketing in the U.S. and for monitoring its use after approval. This paper provides a brief overview of the approval process, in terms of responsibilities of the sponsor in submitting an application for review to the FDA and FDA's responsibilities and organizational procedures for reviewing and approving those applications. A brief history on the legislation regarding the FDA's responsibility in the drug approval area is discussed along with recent regulations, legislation, and FDA initiatives aimed at improving the drug approval process. Specific information that can be released to the public upon request is also discussed. This paper is limited to the regulation of drugs; somewhat different regulations govern the review and regulation of biological products and abbreviated new drug applications. PMID- 3322758 TI - Implications of the neglect of stereochemistry in pharmacokinetics and clinical pharmacology. AB - An outline is given of the implications of stereoselectivity in biological action and the use of racemic fixed-ratio combinations in pharmacology and pharmacotherapeutics. Pitfalls of the neglect of stereochemistry, such as generation of senseless pharmacokinetic data, are exemplified and emphasized. PMID- 3322759 TI - Nonsteroidal antiinflammatory drug-induced renal dysfunction related to inhibition of renal prostaglandins. AB - This article reviews the role of prostaglandins (PG) in maintaining renal function in the face of vasoconstrictive substances and decreased renal blood flow. Inhibition of the synthesis of renal PG by nonsteroidal antiinflammatory drugs (NSAID) may lead to the development of hemodynamically induced renal dysfunction in patients with a decreased effective plasma volume or chronic renal insufficiency. The importance of stimulation of renal PG activity to the action of diuretics and a pharmacodynamic mechanism for NSAID-induced diuretic resistance are presented. Evidence for the relative selectivity of sulindac in inhibiting systemic PG without inhibiting renal PG is also reviewed. Inhibition of renal PG synthesis has been postulated to be a contributing factor for other forms of NSAID-induced renal dysfunction (interstitial nephritis, analgesic associated nephropathy). The relationship between renal PG inhibition by NSAID and these syndromes is briefly discussed. Considering the frequent use of NSAID, it is important that practitioners are aware of the mechanisms whereby patients may develop NSAID-induced renal dysfunction and that they are able to identify patients at risk. PMID- 3322760 TI - Prevention of recurrent myocardial infarction and sudden death with aspirin therapy. AB - In October 1985, the Food and Drug Administration approved a new indication of aspirin for the secondary prevention of recurrent myocardial infarction (MI) and death in patients with MI or unstable angina. Clinical trials have demonstrated the efficacy of this drug, especially when treatment is begun soon after the initial event. The antiplatelet actions of aspirin seem to be the most plausible explanation for its efficacy in reducing mortality and the rate of reinfarction. A single daily 325-mg tablet is effective and produces side-effect incidences of only zero to two percent above those produced by placebo. This article assesses the current state of knowledge regarding the value of aspirin therapy in survivors of acute MI and the implications for clinical practice. PMID- 3322761 TI - Nebulisers in the treatment of asthma. PMID- 3322763 TI - [Differences in the effectiveness of levothyroxine preparations]. AB - Three proprietary preparations of L-thyroxine were tested for their bioequivalence in a cross-over trial. Comparing the two most commonly prescribed preparations, during administration of preparation B (Euthyrox) serum concentrations of basal thyrotropin (TSH) was significantly higher than with preparation A (L-Thyroxin Henning) in both subgroups and in the cross-over calculation, as well as after stimulation with thyrotropin-releasing hormone (TRH) in one of the subgroups. During administration of a third preparation, C (Levothyroxine, enos), serum concentrations of total thyroxine (T4) and free thyroxine (fT4) were significantly lower than with preparation A, while basal and TRH-stimulated TSH levels were in all measurements highly significantly higher. Although there was the tendency for preparation B to be inferior, a greater effectiveness of preparation A could not be statistically proven for all data. But a markedly reduced bio-availability or effectiveness was demonstrated with respect to preparation C. PMID- 3322762 TI - [Ultrasound guided fine- and coarse-needle puncture of the abdominal and retroperitoneal space]. AB - Within a period of 21 months, 167 fine-needle and 86 cannula (1.67 mm external diameter) punctures of the abdominal or retroperitoneal space were performed under sonographic control. Sufficient material was obtained with 93.4% of fine needle punctures. With regard to differentiation between malignant and benign lesions, fine-needle punctures had a sensitivity of 86% and specificity of 100%, if the material was examined by an experienced cytologist. Sensitivity dropped to 55,1% if the same material was interpreted by a less experienced cytologist, but specificity was still 98.1%. Sufficient material for histological examination was always obtained with the cannula, already at the first puncture. With cannula puncture there were two complications: bleeding requiring transfusion and peritonitis. PMID- 3322764 TI - [Diagnosis of pyogenic liver abscess]. PMID- 3322766 TI - [Local treatment of epistaxis due to thrombopenia]. PMID- 3322767 TI - [Cell content in the milk supply as a monitoring parameter for mastitis control]. PMID- 3322765 TI - [Drug hypersensitivity. Diagnosis and immunopathogenesis]. PMID- 3322768 TI - [Antibacterial effect of newer quinolones and nalidixic acid against mastitis pathogens of cattle]. PMID- 3322769 TI - [Preliminary results of cryopreservation of mouse embryos with glycerin and royal jelly]. PMID- 3322770 TI - [Death of a cow of the German Red Variegated breed after veterinary obstetric examination (expert veterinary opinion)]. PMID- 3322771 TI - [Death of a cow with parturient paresis after repeated calcium infusions (expert veterinary opinion)]. PMID- 3322772 TI - [The etiology and diagnosis of fertility disorders in dairy cows]. PMID- 3322773 TI - [Inoculation for rinderpest by the Kersting method in the years 1779 to 1781]. PMID- 3322774 TI - [Sperm transfer in the dog--an analysis of clinical cases]. PMID- 3322776 TI - [Observations of prenatal hair follicle growth in the goat]. PMID- 3322777 TI - [Frequency of appearance of persistent BVD virus infections and their effects on the cattle population]. PMID- 3322775 TI - [Experimental results of cryopreservation and thawing of bull sperm in pellet form]. PMID- 3322778 TI - [Cerebellar hypoplasia and hydranencephaly in cattle after transplacental bovine diarrhea virus infection]. PMID- 3322779 TI - [Pasteurella anatipestifer infection of water fowl]. PMID- 3322780 TI - Mutagenicity evaluation of azaperone in the Salmonella/microsome test. AB - Azaperone was evaluated for its mutagenic potential by the Salmonella/microsome test. No mutagenic activity towards six S. typhimurium strains could be evidenced with azaperone at doses up to 2,000 micrograms/plate, either without or with metabolic activation at usual test conditions. Higher concentrations of liver post-mitochondrial fraction from Aroclor 1254 (ARO)-pretreated rats did not reveal any increase in the number of revertants towards S. typhimurium strains TA1537, TA1538 and TA98. Moreover, a plate-incorporation test with liver post mitochondrial fractions from mice pretreated with phenobarbital (PB) and a liquid preincubation test with liver post-mitochondrial fractions from rats pretreated with ARO also failed to reveal any mutagenic action of azaperone towards S. typhimurium strain TA98. Thus, none of the tests used provided any indication of azaperone having a mutagenic action. PMID- 3322781 TI - Propafenone. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in the treatment of arrhythmias. AB - Propafenone is a Class I antiarrhythmic agent with weak beta-adrenoceptor antagonist activity which can be given both intravenously and orally. Dosage must be individualised because of dose-dependent pharmacokinetics, a wide range of clinically effective plasma concentrations (64 to 3271 micrograms/L) after comparable doses, the presence of an active metabolite (5-hydroxy-propafenone) and genetically determined metabolic oxidation. In non-comparative studies propafenone 450 and 900 mg/day orally significantly suppressed premature ventricular complexes and couplets in 96% and 75% of patients, respectively, and abolished ventricular tachycardia in 75% of patients. Efficacy was confirmed in placebo-controlled studies in which propafenone 300 to 900mg daily suppressed premature ventricular complexes (greater than 80%) in 77% of patients; 87% of patients had significant reductions in couplets and abolition of ventricular tachycardia. In patients with ventricular arrhythmias refractory to other antiarrhythmic agents, propafenone 450 to 1200 mg/day suppressed arrhythmias in 63% of patients (in long term therapy 66%). Electrically induced arrhythmias were prevented by intravenously administered propafenone in 12 to 23% of patients. However, long term oral therapy was effective in 77% of patients selected using programmed electrical stimulation. Propafenone was also effective in suppressing atrial and AV nodal/junctional re-entrant tachycardias and Wolff-Parkinson-White tachycardias involving accessory pathways. A limited number of comparisons with other antiarrhythmic drugs indicate that the antiarrhythmic efficacy of propafenone is superior or similar to that of quinidine, disopyramide and tocainide, and comparable to that of lignocaine (lidocaine), flecainide and metoprolol against ventricular arrhythmias and a smaller number of atrial arrhythmias. Cardiovascular side effects indicate a proarrhythmic effect similar to that with other Class I drugs, occasional precipitation of congestive heart failure and conduction abnormalities; the latter two occur more often in patients with underlying ventricular dysfunction. Non-cardiovascular side effects (neurological, gastrointestinal) are well tolerated and generally resolve with continued therapy or dosage reduction. Thus, propafenone is an effective antiarrhythmic agent, and is a useful addition to currently available drugs, although further studies will be required to determine clearly its place in therapy compared with more established antiarrhythmic drugs. PMID- 3322783 TI - Serous and recurrent otitis media. Pharmacological or surgical management? AB - The management of recurrent acute otitis media and serous otitis media is both challenging and controversial. The efficacy of antimicrobial prophylaxis of children at high risk for recurrent acute otitis media is established, but the indications for such therapy are controversial. Tympanostomy tube insertion also decreases the frequency of recurrent otitis media. High-risk children can be successfully managed with chemoprophylaxis from autumn through to spring. If this fails, then tympanostomy tube insertion should be considered. Serous otitis media that follows acute otitis media resolves spontaneously in more than 90% of cases. Serous otitis media of unknown onset also has a strong tendency to resolve without treatment. Antihistamines and decongestants, although popular, have no significant effect on the course of serous otitis media. Antimicrobial therapy has a modest effect on the resolution of serous otitis media. Tympanostomy tubes usually improve the conductive hearing loss associated with serous otitis media and should be used when bilateral serous otitis media fails to resolve spontaneously. If repeated tympanostomy tube insertion fails, then adenoidectomy should be considered. With the course of management outlined, most children will have a successful outcome with conservative therapy and the need for surgery will be minimised. PMID- 3322784 TI - Analysis of enteric neurons, glia and their interactions using explant cultures of the myenteric plexus. AB - The enteric nervous system (ENS) of the gastrointestinal tract is the largest and most complicated division of the peripheral nervous system. The ENS possesses reflex pathways composed of motor neurons, interneurons and sensory neurons which act in an integrated fashion together with input from the central nervous system to control gut function. The neurons, morphologically and electrophysiologically a very heterogeneous group containing a large number of different proven and putative neurotransmitters, are intimately associated with enteric glia, which both at the morphological and molecular level resemble astrocytes. In this review we describe how explant cultures from the ENS have been used to investigate the neurochemical, molecular and electrophysiological characteristics of ENS neurons, the molecular properties of enteric glia and their interactions with one another. PMID- 3322785 TI - Low doses of L-monosodium glutamate promote neuronal growth and differentiation in vitro. AB - Monosodium glutamate given at a concentration of 5 X 10(-6) M to whole-brain dissociated cultures of 18-day-old rats promotes neuronal growth. Neurons are larger due to an increased size of both cytoplasm and nucleus. Rough endoplasmic reticulum is more developed and mitochondria are more abundant. Synaptic vesicles are significantly increased in number with respect to control cultures. Synapses are more abundant and show a more differentiated morphology. These findings are interpreted as evidence for accelerated development secondary to the stimulatory effects of glutamate. PMID- 3322786 TI - [Blood cultures]. PMID- 3322788 TI - [Ceftazidime and hypoprothrombinemia]. PMID- 3322782 TI - Clinical pharmacological and therapeutic considerations in general intensive care. A review. AB - The application of clinical pharmacological concepts and therapeutic standards in intensive care settings presents particularly difficult problems due to the lack of adequately controlled background information and the highly variable and rapidly evolving clinical conditions where drugs must be administered and their impact evaluated. In this review, an attempt has been made to discuss the available knowledge within the framework of a problem-oriented approach, which appears to provide a more clinically useful insight than a drug-centred review. Following a brief discussion of the scanty data and the most interesting models to which reference can be made from a pharmacokinetic point of view (the burn patient being taken as an example), the review concentrates on the main general intervention strategies in intensive care patients. These are based mainly on non pharmacological measures (correction of fluid and electrolyte balance, total parenteral nutrition, enteral nutrition, oxygenation and ventilatory management) and are discussed with respect to the specific challenge they present in various clinical conditions and organ failure situations. In addition, 4 major selected clinical conditions where general management criteria and careful use of prophylactic and therapeutic drug treatments must interact to cope with the variety of presentations and problems are reviewed. These include: acute cerebral damage; anti-infective prophylaxis and therapy; cardiovascular emergencies; and problems of haemostasis. Each problem is analysed in such a way as to frame the pharmacological intervention in its broader context of the underlying (established or hypothesised) pathophysiology, with special attention being paid to those methodological issues which allow an appreciation of the degree of reliability of the data and the recommendations which appear to be practiced (often haphazardly) in intensive care units. The thorough review of the published literature provided (up to mid-1986) clearly shows that in this field the quality of randomised controlled and epidemiological studies is rather unsatisfactory. It would be highly beneficial to research and to clinical care if larger multicentric protocols and prospective epidemiological comparative investigations could be carried out to investigate more timely and adequately the variables which determine drug action, and the final outcome in the many subgroups of patients which must be considered in a proper stratification of intensive care unit populations. PMID- 3322787 TI - [Giant intrarenal aneurysm of the renal artery--a rare complication of fibromuscular dysplasia]. PMID- 3322789 TI - [Pulmonary surfactants in respiratory distress]. PMID- 3322790 TI - [Indications and effectiveness of medical management of hyper- cholesterolemia]. PMID- 3322792 TI - Hemangiomas of the head and neck. PMID- 3322791 TI - [Focal nodules in necrotizing myopathies of diabetic patients]. PMID- 3322793 TI - Head pain secondary to nasal allergies. PMID- 3322794 TI - Mutagenicity of chlorinated polycyclic aromatic compounds. AB - The catalytic chlorination of polycyclic aromatic hydrocarbons leads to the formation of complex mixtures of isomers analogous to those found in fly ash samples of an incineration plant for radioactive waste. Therefore chlorination mixtures of chrysene, pyrene, and fluoranthene were analyzed and characterized by gas chromatography-mass spectrometry. Determination of the exact position of each chlorosubstituent within the molecule was not possible either by mass spectrometry or by comparison with well-defined methyl analogs. The toxic as well as mutagenic effects of such mixtures of isomers was compared with those of their parent hydrocarbons in the microtiter fluctuation test using Salmonella typhimurium TA 98 and TA 100 in a concentration range of 0.5 to 5.0 microgram/ml. No toxic effect could be observed, but the chlorinated products in contrast to their parent compounds were found to be strong mutagens to the S. typhimurium test strains and showed a positive response even without enzymatic activation. Frameshift mutations as well as base pair alterations were detected. PMID- 3322795 TI - In memoriam Emil Mrak (1901-1987). PMID- 3322796 TI - Quantitative electromyography. I. Comparison of different methods. PMID- 3322797 TI - Quantitative electromyography. II. Modifications of the turns analysis. PMID- 3322798 TI - Radicular compression syndrome caused by ruptured iliac artery aneurysm: case report and review of the literature. PMID- 3322799 TI - A neurophysiologic approach to functional prognosis in brain damage. PMID- 3322800 TI - [Cerebral imaging and depressive disorder]. AB - Cerebral imaging of depressive syndromes has been studied since the early eighties in search of organic or functional anomalies in the central nervous system. There are fewer studies than with schizophrenia. Computed tomography, scintiscan, positron emission tomography (PET) are being used in various depressive states. For methodological reasons, results with PET are only preliminary. EEG mapping, a new technique, has, above all, measured the abnormalities of organic brain syndromes, especially dementia, which has to be ruled out in the diagnosis of depression. CT scan has not substantiated any cerebral defects in depressed patients in the comparative case-control studies, except for some clinical types (aged population or forms associated with delusional or hallucinatory syndromes) where images of cortico-subcortical atrophy have been observed. Scintiscan and PET scan have shown a decreased cerebral blood flow, with a Xenon 133 test, and PET scan a decreased consumption of glucose on condition that depressed subjects are cognitively resting, in comparison to matched controls. In EEG mapping an index of spacetiation of the basal quantitative EEG activity typifies cases of evolution towards dementia, which has to be ruled out in the diagnosis of involutional depression. PMID- 3322801 TI - [A familial syndrome: a combination of Pick's disease and amyotrophic lateral sclerosis]. AB - The association of Pick's Disease (PD) and Amyotrophic Lateral Sclerosis (ALS) as a familial syndrome is reported for the first time. Four members in two generations of the investigated family suffered from this syndrome, allowing the hypothesis of a dominant mode of inheritance. PD is primary, with onset at 58 to 67 years: loss of interests, depression, aggressivity, perseveration , stereotypies, reduction of speech until total mutism; a few months later appear ALS signs: fasciculations and/or pyramidal symptoms. The total evolution is 3 to 5 years. The brain showed a fronto-temporal atrophy spreading to the precentral gyrus with cortical and white matter gliosis, neuronal loss, atrophic neurons and some ballooned cells, but without senile plaques (SP), neurofibrillary tangles (NFT) or cortical spongiosis; the spinal cord and the medulla oblongata showed typical ALS lesions; mild lesions in the basal nuclei, particularly in the substantia nigra and the pallidum. The differential diagnosis is discussed with: Alzheimer's Disease + ALS (SP + NFT); the Guam syndrome (NFT); Creutzfeldt Jakob's Disease (cortical microspongiosis); ALS + dementia (primary ALS); Mitsuyama's syndrome (primary dementia and secondary ALS, but with cortical spongiosis and without familial incidence). PMID- 3322802 TI - [Treatment with tianeptine of depressive disorders in drug addicts under withdrawal. Assessment of efficacy and study of dependence]. AB - The study concerns the use of a new antidepressant, tianeptine, as a treatment of depressive and/or amotival syndrome, in 30 drug addicts, detoxified from opiates. From a thymoanaleptic point of view, 85% of the patients exhibit a positive result after 28 days of treatment with 37.5 mg/day. These good results are confirmed by the evolution of the Hamilton Depression Rating Scale global score, which significantly decreases from D0 to D14 and from D14 to D28. The acceptability of the antidepressant is good. Anticholinergic side-effects are very uncommon. Tianeptine appears devoid of any obvious psychostimulant or sedative effect. The drug compliance, estimated by counting the tablets, is very satisfying: there is no tendency to a spontaneous increase of dosing. The follow up of the patients after drug cessation has not shown any symptoms suggesting psychological or physical dependence towards the drug. During this study in subjects particularly predisposed to the abuse of psychoactive drugs, tianeptine has not induced anything suggesting the possibility of drug abuse or tolerance. PMID- 3322803 TI - The specific gastrinase activity of membranes isolated from the human and rat gastrointestinal mucosa. PMID- 3322804 TI - Characterization of human placental receptor for insulin and its application for radioreceptor assay of insulin. PMID- 3322805 TI - Glucagon-like immunoreactive peptides in a rat ileal epithelial cell line (IEC 18). AB - The presence of cells containing glucagon-like immunoreactive (GLI) peptides was demonstrated in a rat ileal epithelial cell line (IEC-18) by both immunofluorescence and radioimmunoassay. When cell extracts were subjected to gel filtration chromatography, the cells were found to contain 3.5 Kd glucagon in addition to significant quantities of large molecular weight GLI peptides (apparent molecular weights of 4, 6, 8 and 10 Kd) and a 9 Kd peptide with apparent glucagon immunoreactivity. This was in contrast to extracts of adult rat ileum, which contained only large molecular weight GLI peptides (apparent molecular weights of 6 and 12 Kd). Production of GLI peptides by the IEC-18 cells was stimulated by glucose (p less than 0.02) and inhibited by insulin (p less than 0.01). In conclusion, these results demonstrate that the IEC-18 cells produce both GLI peptides and glucagon, and thus support the notion that proglucagon processing is cell-specific. IEC-18 cells may therefore provide a tool for investigations of some aspects of GLI peptide and glucagon synthesis. PMID- 3322806 TI - Purification of KBF1, a common factor binding to both H-2 and beta 2 microglobulin enhancers. AB - An enhancer binding factor, designated KBF1, has been purified from the nuclear extract of mouse BW5147 thymoma cells by five column chromatography steps including a sequence-specific DNA affinity column. Gel retardation and footprint analysis have shown that purified KBF1 has a binding activity specific for both H 2 and beta 2-microglobulin enhancer sequences. After SDS-polyacrylamide gel electrophoresis of the most purified preparation a 48-kd protein showed, after elution and renaturation, a binding activity to both enhancer sequences. These findings suggest that the expression of both H-2 and beta 2-microglobulin genes utilizes a common regulatory mechanism. PMID- 3322807 TI - Dynamic fatty acylation of p21N-ras. AB - To study the acylation of p21N-ras with palmitic acid we have used cells which express the human N-ras gene to high levels under control of the steroid inducible MMTV--LTR promoter. Addition of [3H]palmitate to these cells resulted in detectable incorporation of label into p21N-ras within 5 min, which continued linearly for 30-60 min. Inhibition of protein synthesis for up to 24 h before addition of [3H]palmitate had no effect on acylation of p21N-ras, suggesting that this can occur as a late post-translational event. Acylated p21N-ras with a high SDS--PAGE mobility is found only in the membrane fraction, whereas approximately 50% of the [35S]methionine-labelled p21N-ras is cytoplasmic and has a lower mobility. Conversion of the acylated high mobility form to a deacylated form of slightly lower mobility can be achieved with neutral hydroxylamine, which is known to cleave thioesters. This treatment also results in partial removal of p21N-ras from the membranes. A remarkably high rate of turnover of the palmitate moiety can be demonstrated by pulse--chase studies (t1/2 approximately 20 min in serum-containing medium) which cannot be attributed to protein degradation. The data suggest an active acylation--deacylation cycle for p21N-ras, which may be involved in its proposed function as a signal transducing protein. PMID- 3322808 TI - Secretion in yeast: structural features influencing the post-translational translocation of prepro-alpha-factor in vitro. AB - In vitro, efficient translocation and glycosylation of the precursor of yeast alpha-factor can take place post-translationally. This property of prepro-alpha factor appears to be unique as it could not be extended to other yeast protein precursors such as preinvertase or preprocarboxypeptidase Y. In order to determine if specific domains of prepro-alpha-factor were involved in post translational translocation, we carried out a series of experiments in which major domains were either deleted or fused onto reporter proteins. Fusion of various domains of prepro-alpha-factor onto the reporter protein alpha-globin did not allow post-translational translocation to occur in the yeast in vitro system. Prepro-alpha-factor retained its ability to be post-translationally translocated when parts or all of the pro region were deleted. Removal of the C-terminal repeats containing mature alpha-factor had the most profound influence as post translational translocation decreased in proportion to the number of repeats deleted. Taken together, these results suggest that efficient post-translational translocation requires a signal sequence and the four C-terminal repeats. There does not however, appear to be specific information contained within the C terminus, as their presence in fusion did not enable the post-translational translocation of reporter proteins. Lastly, the ability to post-translationally translocate radiochemically pure prepro-alpha-factor that had been isolated by immuno-affinity chromatography required the addition of a yeast lysate fraction. Moreover, post-translational translocation is a function of the microsomal membrane of yeast microsomes and not of a factor peculiar to the yeast lysate, as reticulocyte lysate supported this as well. PMID- 3322809 TI - The yeast MYO1 gene encoding a myosin-like protein required for cell division. AB - A yeast gene MYO1 that contains regions of substantial sequence homology with the nematode muscle myosin gene (unc54) has been isolated and sequenced. Although the disruption of MYO1 is not lethal, it leads to aberrant nuclear migration and cytokinesis. The 200-kd myosin heavy chain-like protein, the product of MYO1, cross-reacts with anti-nematode myosin heavy chain IgG and is present in wild type strains but not in strains carrying the disrupted gene. Instead, a truncated polypeptide with a molecular mass of 120 kd can be detected in some myo1 mutants. PMID- 3322810 TI - p13suc1 acts in the fission yeast cell division cycle as a component of the p34cdc2 protein kinase. AB - cdc2+ encodes a protein kinase that is required during both G1 and G2 phases of the cell division cycle in fission yeast. suc1+ is an essential gene that was originally identified as a plasmid-borne sequence that could rescue certain temperature-sensitive cdc2 mutants. To investigate the role of the suc1+ gene product in the cell cycle p13suc1 has been expressed in Escherichia coli and purified. An immunoaffinity purified anti-p13suc1 polyclonal serum has been prepared and used to identify p13suc1 in fission yeast. The abundance of this protein did not alter either during the cell cycle or during entry into stationary phase. p13suc1 was found in yeast lysates in a complex with the cdc2+ gene product. Approximately 5% of cellular p34cdc2 was associated with p13suc1, and this fraction of p34cdc2 was active as a protein kinase. The stability of the complex was disrupted in yeast strains carrying temperature-sensitive alleles of cdc2 that are suppressible by overexpression of suc1+. The level of association between p13suc1 and p34cdc2 was not affected by cell cycle arrest in adverse nutritional conditions. p13suc1 is not a substrate of the p34cdc2 protein kinase. We propose instead that it acts as a regulatory component of p34cdc2 that facilitates interaction with other proteins. PMID- 3322811 TI - Cloning and expression in Escherichia coli of the Klebsiella pneumoniae genes for production, surface localization and secretion of the lipoprotein pullulanase. AB - This article describes the reconstitution in Escherichia coli of a heterologous protein secretion system comprising a gene for an extracellular protein together with its cognate secretion genes. The protein concerned, pullulanase, is a secreted lipoprotein of the Gram-negative bacterium Klebsiella pneumoniae. It is initially localized to the cell surface before being specifically released into the medium. E. coli carrying the cloned pullulanase structural gene (pulA) produces pullulanase but does not expose or secrete it. Secretion genes were cloned together with pulA in an 18.8 kbp fragment of K. pneumoniae chromosomal DNA. E. coli carrying this fragment exhibited maltose-inducible production, exposition and specific secretion of pullulanase. Transposon mutagenesis showed that the secretion genes are located on both sides of pulA. Secretion genes located 5' to pulA were transcribed in the opposite orientation to pulA under the control of the previously identified, malT-regulated malX promoter. Thus these secretion genes are part of the maltose regulon and are therefore co-expressed with pulA. Transposon mutagenesis suggested that secretion genes located 3' of pulA are not co-transcribed with pulA, raising the possibility that some secretion functions are not maltose regulated. PMID- 3322812 TI - Neuronal localization of amyloid beta protein precursor mRNA in normal human brain and in Alzheimer's disease. AB - Clones for the amyloid beta protein precursor gene were isolated from a cDNA library prepared from the frontal cortex of a patient who had died with a histologically confirmed diagnosis of Alzheimer's disease; they were used to investigate the tissue and cellular distribution of amyloid beta protein precursor mRNA in brain tissues from control patients and from Alzheimer's disease patients. Amyloid beta protein precursor mRNA was expressed in similar amounts in all control human brain regions examined, but a reduction of the mRNA level was observed in the frontal cortex from patients with Alzheimer's disease. By in situ hybridization amyloid beta protein precursor mRNA was present in granule and pyramidal cell bodies in the hippocampal formation and in pyramidal cell bodies in the cerebral cortex. No specific labelling of glial cells or endothelial cells was found. The same qualitative distribution was observed in tissues from control patients and from patients with Alzheimer's disease. Senile plaque amyloid thus probably derives from neurones. The tissue distribution of amyloid beta protein precursor mRNA and its cellular localization demonstrate that its expression is not confined to the brain regions and cells that exhibit the selective neuronal death characteristic of Alzheimer's disease. PMID- 3322813 TI - Complementary DNA for human glioblastoma-derived T cell suppressor factor, a novel member of the transforming growth factor-beta gene family. AB - Human glioblastoma cells secrete a peptide, termed glioblastoma-derived T cell suppressor factor (G-TsF), which has suppressive effects on interleukin-2 dependent T cell growth. As shown here, complementary DNA for G-TsF reveals that G-TsF shares 71% amino acid homology with transforming growth factor-beta (TGF beta). In analogy to TGF-beta it is apparently synthesized as the carboxy terminal end of a precursor polypeptide which undergoes proteolytic cleavage to yield the 112 amino-acid-long mature form of G-TsF. Comparison of the amino terminal sequence of G-TsF with that of porcine TGF-beta 2 and bovine cartilage inducing factor B shows complete homology, which indicates that we have cloned the human analogue of these factors. It is tempting to consider a role for G-TsF in tumor growth where it may enhance tumor cell proliferation in an autocrine way and/or reduce immunosurveillance of tumor development. PMID- 3322816 TI - Sex hormones in the aging female. AB - Aging of the human ovary results in a gradual diminution in ovarian steroid production, followed by an abrupt and almost complete cessation of both estrogen and progesterone production at the menopause. Although carefully controlled quantitative studies have not been published, it appears that the human reproductive axis still retains its ability to respond to steroid action. However, it still remains to be determined if alterations in cycle length and regularity preceding the menopause are due to changes in ovarian function or to subtle changes in the hypothalamic pituitary axis. More experimental evidence is available to describe the etiology of age-related reproductive dysfunction in laboratory rodents. From these studies, it appears that hypothalamic dysfunction is the principal cause for cessation of reproductive cycles. Recent evidence suggests that aging of the hypothalamus is due to cumulative effects of estrogen exposure over the course of the reproductive life span. PMID- 3322815 TI - Age and the thyroid. AB - Thyroid diseases are common in elderly patients, but their clinical manifestations are more subtle and often are hidden by a background of intercurrent disease. Therapy for thyroid disease in the elderly can also be more problematic because of increased risks of complications. PMID- 3322814 TI - Specific accessory sequences in Saccharomyces cerevisiae introns control assembly of pre-mRNAs into spliceosomes. AB - In experiments involving deletion and rearrangement of intron sequences two small regions of the intron in the yeast CYH2 ribosomal protein gene were found to play important roles in splicing of the pre-mRNA. One element lies downstream of the 5' splice site, and the other is upstream of the branchpoint sequence UACUAAC. Deletion of the element upstream of the branchpoint prevents spliceosome formation and blocks splicing in vivo and in vitro. Deletion of the element downstream of the 5' splice site does not on its own block splicing but rescues spliceosome formation and splicing of pre-mRNA lacking the element upstream of the branchpoint. These elements correspond to two regions of sequence complementarity which are a conserved feature of the introns in yeast pre-mRNAs. Mixing and matching of the elements from the ACT1 and CYH2 gene introns showed that these elements can cooperate in an intron-specific fashion to control spliceosome assembly. PMID- 3322817 TI - Effects of age on testicular function. AB - Although frequency of sexual activity declines dramatically with age, most investigators have been able to define rather small physiologic function (hormonal and spermatogenic) changes with advancing age. Despite the development of subtle intrinsic age-related defects at all levels of the hypothalamic pituitary-testicular axis, reproductive capacity is maintained in healthy elderly men. PMID- 3322818 TI - Calcium homeostasis and osteoporosis. AB - This article discusses calcium homeostasis and osteoporosis as they relate to a variety of hormones and the aging process. PMID- 3322820 TI - Water excretion in the elderly. AB - Osmoreceptor sensitivity is enhanced in healthy elderly subjects and AVP secretion is increased, relative to that of younger subjects, when plasma osmolality rises. Increased AVP secretion/unit increase in plasma tonicity reflects a decrease in collecting tubule sensitivity to AVP by an as yet unknown mechanism in the aged kidney. This change in sensitivity is not completely offset by increased ADH release, so that maximum Uosm achievable under hydropenic conditions (concentrating ability) is reduced in the elderly. CH2O in older subjects decreases in proportion to the fall in GFR; thus, CH2O is intact in older subjects with preserved GFR. In subjects with age-related reductions in GFR, minimal Uosm achievable is usually less than 100 mOsm per kg H2O and thus usually sufficient to meet the demands of solute-free water intake so that plasma hypo-osmolarity does not result. Increasing exposure of the elderly to pharmacologic agents that reduce CH2O is primarily responsible for the impression that aged patients are at increased risk for hyponatremia. PMID- 3322819 TI - Non-insulin-dependent diabetes mellitus in the elderly. Influence of obesity and physical inactivity. AB - The development of hyperglycemia in the elderly is often multifactorial in etiology, and its presentation is often confounded by the advanced age of the patient, the presence of coexisting diseases and altered mental states, the absence of symptoms, and physical conditions specific to the medical care of the geriatric patient. Manifestations of macro- and microvascular complications of non-insulin-dependent diabetes mellitus (NIDDM) often herald the disease in the elderly, yet there is incomplete knowledge of the natural history of the disease and poor guidelines for its effective management in the geriatric population. Once NIDDM is diagnosed in the older patient, the propensity for these patients to develop atherosclerotic vascular complications involving every organ system and the socioeconomic sequela of the disease make treatment prudent. Coexisting risk factors for atherosclerosis, such as dyshypoproteinemia, hypertension, obesity, and cigarette smoking, should be treated vigorously, and poor diet, physical inactivity, and medications affecting glucose tolerance modified. Hyperglycemia resistant to nonpharmacologic therapy should be treated with second generation oral sulfonylureas, and the judicious use of insulin is advised because of a heightened risk for the hazards of hypoglycemia in the elderly. The treatment of NIDDM has important implications in the elderly because of its prevalence and its association with other age-related pathophysiologic processes. Such effective treatment may have the potential to reduce morbidity and mortality and improve the quality of life of older people. PMID- 3322821 TI - Catecholamines and cardiovascular function in aging. AB - When perspectives from studies that range from measurements of the stress response in intact humans to measurements of subcellular biochemistry in animal models are integrated, a diminished responsiveness to beta-adrenergic modulation is among the most notable changes that occur in the cardiovascular system with advancing age. In contrast, alpha-adrenergic responsiveness, of the vasculature at least, appears to remain intact. It is noteworthy that a diminished effectiveness of some aspects of autonomic modulation has been demonstrated in many other body organs as well. The precise molecular mechanisms for the age effects remain to be explained (as do the precise mechanisms of catecholamine modulation of cell function per se), and these mechanisms need not be the same from one tissue to the next, or from one age period to another within the same tissue. An elucidation of these mechanisms that result in a diminution in the effectiveness of beta-adrenergic modulation of cardiovascular function with aging and a determination of whether this can in part be reversed or prevented by changes in life-style (for example, physical activity or modification of nutrition) require additional investigation. PMID- 3322822 TI - Stress and glucocorticoids in aging. AB - This article has considered two themes that have permeated the gerontologic literature--namely, that aging is a time of decreased efficiency in responding to stress and that chronic stress can accelerate aspects of aging. Given the restricted framework of considering adrenocortical function (as a component of the stress response) and glucocorticoid over-exposure (as a component of chronic stress), there is considerable evidence for both of these ideas. The capacity of glucocorticoids to damage the rat hippocampus slowly over the life span and the glucocorticoid hypersecretion that seems to ensue during aging as a result of such hippocampal damage support these long-standing ideas. It should be noted that these two components interact with each other--excessive glucocorticoid secretion damages the hippocampus, and hippocampal damage produces excessive glucocorticoid secretion. This dysregulatory cascade appears to be a normal part of aging in the rat. The role of glucocorticoids in triggering programmed aging and death, while quite dramatic, is probably a phylogenetically rare event; it remains to be seen if the dysregulatory cascade of glucocorticoid excess in the rat is of relevance to aging in other species. Numerous published studies suggest that this cascade is not an obligatory aspect of normal human aging; rather, it appears to be a significant factor in the explanation of some features of pathologies associated with human aging. PMID- 3322823 TI - Insulin-like growth factors and aging. AB - Since its proposal three decades ago, the evidence in favor of the somatomedin hypothesis has been compelling. It is clear that somatotrophic actions of growth hormone are mediated through generation of insulin-like peptides and interaction of these peptides with plasma membrane receptors on sensitive cells. It is possible that such actions result from effects of circulating insulin-like peptides and/or insulin-like peptides generated in proximity to their sites of action (autocrine or paracrine effects). Most or all of circulating somatomedin activity in humans can be accounted for by insulin-like growth factors I and II (IFGs I and II). These peptides have considerable structural homology with insulin but, unlike insulin, they circulate in tight, noncovalent association with specific carrier protein. Levels of circulating IGF I and IGF II are affected by growth hormone, but the former peptide is the more sensitive to growth hormone. Levels of circulating IGF I in humans are low at birth, rise progressively during childhood, and peak during midadolescence. The increase in stature that occurs normally during adolescence probably results from this increase in circulating IGF I. Following adolescence, levels of circulating IGF I fall progressively as a function of age. There is good evidence that the reduction in levels of circulating IGF I is related to decreased secretion of growth hormone that accompanies aging. Although it has been suggested that decreased function of the growth hormone-somatomedin axis may cause changes in anabolic indices that accompany the aging process, definitive proof for this hypothesis is lacking. In contrast to IGF I, circulating IGF II reaches "adult" levels early in childhood, and changes are relatively small as a function of increasing age. Counterparts of IGF I and IGF II are present in rats. Dynamics of the growth hormone-somatomedin axis are similar in rats and humans for IGF I. In contrast, levels of IGF II in rat fall precipitously following birth, suggesting a role for rat IGF II in fetal growth and development. The rat has been used as an experimental animal to define the role of the growth hormone-somatomedin axis in aging. As in human studies, no firm relationship between somatomedins and aging has been established in the rat. PMID- 3322824 TI - Intra- and post-operative blood loss and haemodynamics in total hip replacement when performed under lumbar epidural versus general anaesthesia. AB - The effects of lumbar epidural anaesthesia and two types of general anaesthesia on blood loss and haemodynamics during and after hip replacement were compared in three groups of patients. One group (n = 14) received continuous lumbar epidural anaesthesia, another group (n = 10) was given inhalational anaesthesia and spontaneous breathing after endotracheal intubation, and the third group (n = 14) received artificial ventilation after intubation and pancuronium and fentanyl intermittently i.v. Intra-operative blood loss in patients under epidural anaesthesia was 950 +/- 300 ml (mean +/- SD) and blood loss during the following 24 h-i.e. as long as the epidural anaesthesia was maintained-was 370 +/- 80 ml. These figures were significantly lower than the intra- and post-operative blood losses in patients under general anaesthesia with narcotics as post-operative pain treatment: 1140 +/- 200 ml (inhalational anaesthesia) followed by 480 +/- 70 ml and 1540 +/- 340 ml (artificial ventilation) followed by 500 +/- 110 ml. The intra-operative blood loss in the general anaesthesia group with spontaneous breathing was significantly smaller than the blood loss in the artificially ventilated group, whereas the post-operative blood loss in the two general anaesthetic groups was similar. Haemodynamic differences explain these differences in blood loss. Thus epidural anaesthesia induced hypotension on the arterial and venous sides. Intra-operatively, inhalational anaesthesia also induced hypotension on the arterial and venous sides compared with general anaesthesia using artificial ventilation. Post-operatively, the general anaesthesia groups behaved haemodynamically similarly and no differences in blood loss were seen. The reduction in blood loss, notably associated with lumbar epidural anaesthesia, is beneficial in decreasing the hazard and cost of blood transfusion. PMID- 3322825 TI - The effects of calcium-blocking agents on sympathetic responses to acute haemorrhagic shock in dogs. AB - The effects of three calcium channel-blocking agents, verapamil, nifedipine and diltiazem, given intravenously, have been studied on the cardiovascular and sympathetic responses to acute haemorrhagic shock in anaesthetized dogs. Following acute haemorrhage, cardiac output, mean pulmonary artery pressure, mean right atrial pressure, and pulmonary capillary wedge pressure all fell, and adrenaline, noradrenaline and plasma renin activity rose. In the presence of each calcium antagonist the fall in cardiac output, mean pulmonary artery pressure, central venous pressure and pulmonary capillary wedge pressure was similar, and the rise in catecholamine levels unaffected. The rise in plasma renin activity following diltiazem 0.02 mg kg-1 or 0.1 mg kg-1 or nifedipine 0.01 mg kg-1 was similar to values in a control group, whereas in those receiving verapamil 0.15 mg kg-1 or 0.6 mg kg-1, or nifedipine 0.05 mg kg-1, the rise was greater. PMID- 3322827 TI - Helsinki heart study: a controlled coronary prevention trial. Design and baseline findings. PMID- 3322826 TI - The Helsinki Heart Study: basic design and randomization procedure. AB - The Helsinki Heart Study is a coronary primary prevention trial in a group of middle aged men with lipid abnormalities. Its aim is to investigate the effects on the incidence of coronary heart disease of simultaneously lowering serum total and low density lipoprotein (LDL)-cholesterol and elevating high density lipoprotein (HDL)-cholesterol with gemfibrozil, over a period of 5 years. Participants were selected from a population of 23 531 men between 40 and 55 years of age. The mean serum total cholesterol among 18 966 screened subjects was 6.3 mmol l-1 (245 mg dl-1) and the mean HDL-cholesterol 1.3 mmol l-1 (50.3 mg dl 1). All subjects meeting the lipid acceptance criterion of non-HDL-cholesterol (i.e. total cholesterol minus HDL-cholesterol) greater than 5.2 mmol l-1 (200 mg dl-1) on two separate occasions two to three months apart, who were free from coronary heart disease or other major illness, were invited to participate. The total cholesterol level for the final 4081 study participants was 7.5 mmol l-1 (290 mg dl-1) and HDL-cholesterol was 1.23 mmol l-1 (47.6 mg dl-1). Mean systolic and diastolic blood pressures were 141.7 and 91.3 mmHg. About 15% of participants were hypertensive and 36% were smokers. A total of 2051 men were randomly allocated to receive gemfibrozil 600 mg twice daily and 2030 matching placebo capsules. A cholesterol-lowering diet was also prescribed for all participants. The randomized treatment groups were well balanced. Equal distribution of major risk factors was achieved in relevant sub-groups. This report describes the procedures involved in setting up the study, summarizes the baseline data obtained and reviews the success of the randomization procedure. Finally, it compares the design of this study with that of some other major preventive trials. PMID- 3322828 TI - Minimal doses of digoxin: a new marker for compliance to medication. AB - A direct and objective method of measuring compliance to medication is presented. Digoxin is used as a marker in capsules of either gemfibrozil or placebo with a minimal dose of 4.4 micrograms twice a day. Compliance is estimated by measuring the ratio of urinary digoxin to creatinine concentration. By choosing two cut-off points of this ratio patients who are taking their capsules regularly and those who have taken no capsules at all could be distinguished from others. Reduced dosage was easily detected in the marker results. During regular intake of three quarters of the dose, 53% of the samples would have classified the patient to the good compliance group. With half of the dose, 24% of samples and with a quarter of the dose, 5% of samples would have classified the subject to good compliance. Since the digoxin marker was planned for compliance measurements in the Helsinki Heart Study, a primary prevention study of coronary heart disease, it was tested under the conditions of a clinical trial. Digoxin concentrations were measured using a routine method normally applied to serum but shown to be valid for urine. The results of the urinary assays were not affected by storage at room temperature, as occurs during postal transport of samples, nor were they affected by freezing, routinely used for the storage of samples in clinical trials. The results therefore suggest that the digoxin marker represents a particularly effective method to study compliance to medication during such long-lasting clinical investigations. PMID- 3322829 TI - Comparison of the digoxin marker with capsule counting and compliance questionnaire methods for measuring compliance to medication in a clinical trial. AB - During the last quarter of the third year of follow-up in the Helsinki Heart Study, compliance to medication was measured in 1739 patients with digoxin used as a marker substance, capsule counting and a compliance questionnaire. The estimates for good and poor compliers were found to be highly dependent on the method and the cut-off points chosen for the compliance allocation. The methods studied here were more reliable for the detection of poor rather than good compliance. In the poor compliance group, defined with the use of the digoxin marker, there was 39% of subjects who returned less than 5% of their capsule dosage or reported a deviation less than 5%. In the good compliance group, defined by the digoxin marker, only 11.8% of patients either returned or reported a deviation of at least 25% of their dose. The compliance was better when measured by the questionnaire than by capsule counting. The size of the poor compliance group, defined by the use of the digoxin marker, was as large as a group who had returned at least 27% of their capsule dose and a group who had reported a deviation of 11% or more from their dosing schedule. The size of the group allocated to the good compliance category by the use of the digoxin marker was equivalent in size to a group of patients who had returned less than 15% of their prescribed dose or reported a deviation of less than 6% from their prescription. When the strictest criteria for the combination of all three methods were used, 57% of subjects were classified as good and 31% as poor compliers to medication in the third year of the primary prevention trial designed to reduce the incidence of coronary heart disease. PMID- 3322830 TI - Identification of cardiac rejection in heterotopic heart transplantation using 111In-antimyosin. AB - It is important in heart transplantation to evaluate precisely the extent and location of cardiac rejection. At present, right ventricular endomyocardial biopsy has been used as the gold standard, however, establishment of noninvasive, simple, and easy diagnostic procedure is desired. The canine donor heart, in which atrial septal defect and tricuspid regurgitation had been produced beforehand, was heterotopically transplanted into the recipient's chest cavity. In seven dogs, two to three mCi of 111In-antimyosin was injected intravenously upon cardiac rejection before the heart was excised. 111In-antimyosin myocardial imaging was then performed using a gamma camera. In the same slice, a histopathological rejection score was calculated and divided into mild, moderate or severe injection. The uptake of 111In-antimyosin was significantly higher in moderate and severe rejected myocardium, since this agent produced a specific and selective localization and concentration in areas of myocardial damage. Therefore, this new technique allows the evaluation of therapeutic intervention upon cardiac rejection and may replace right ventricular endomyocardial biopsy. PMID- 3322831 TI - Changes of the cardiovascular system during the perinatal period. AB - After describing the particular features of the fetal circulation, changes in the pattern of blood flow at the time of birth and during early neonatal life are explained. From animal studies it is wellknown that during the first hours and weeks after birth newborns are characterized by an extremely high cardiac output due to high metabolic demands. In order to meet this marked volume loading, already under resting conditions the neonatal heart appears to be operating nearly at its full capacity without reserves in contractility, preload and afterload. Consequently the newborn heart has less ability to cope with additional acute afterload and/or preload stress. Few investigations on cardiac output and myocardial performance in healthy human newborns provide presumptive evidence that the postnatal human heart performs probably as well as the heart of other species. These observations may influence the therapeutic approach in clinical situations with additional alterations in loading conditions. PMID- 3322832 TI - Ultrasound findings in childhood chronic liver parenchymal diseases. An analysis of 41 patients. AB - Forty-one children with liver disease were studied by ultrasound scan at King Khalid University Hospital, Riyadh, Saudi Arabia. Diagnoses were confirmed either by liver biopsy or specific laboratory tests. Sonograms were studied for liver size, beam penetration, echogenicity, vascularity, and biliary tree abnormalities. Different liver diseases, such as chronic hepatitis, biliary cirrhosis, Wilson's disease, familial idiopathic cirrhosis, type III glycogen storage disease, and secondary haemochromatosis revealed non-specific disease patterns. Four cases of biliary cirrhosis and two cases of glycogen storage disease showed periportal fibrosis. Two cases of familial idiopathic cirrhosis and a case of Wilson's disease revealed thickening of the gall bladder wall, which has not been described in the literature. PMID- 3322833 TI - Facial palsy in Kawasaki disease. Report of two cases and a review. AB - A case of facial palsy was reported initially in 1974 by Murayama as one of the neurological manifestations in Kawasaki disease. Thereafter, an additional nine case have been documented in Japan. This facial palsy, in the revised "Diagnostic Guideline of Kawasaki Disease" released in 1984, has been added recently as one of the neurological signs and symptoms of Kawasaki disease. This is a report on two cases of Kawasaki disease showing facial palsy with indurative oedema during their clinical course, and also a clinical review of the ten previously reported cases of facial palsy complicating Kawasaki disease. PMID- 3322834 TI - Open study of Madopar HBS, a new formulation of levodopa with benserazide, in 13 patients with Parkinson's disease and 'on-off' fluctuations. AB - In a open study in 13 patients with Parkinson's disease with 'on-off' fluctuations, all (n = 3) or part (n = 10) of the usual intake of levodopa (with peripheral decarboxylase inhibitor) was replaced by Madopar HBS for 5-122 days (median 35). Time 'off' increased in 2 of the 3 monotherapy subjects. With combined therapy, time 'on' was increased in 6, unchanged in 2 and reduced in 2. However, 11 of the 13 patients complained of reduced predictability of clinical response with Madopar HBS. Only 4 of the 13 patients preferred to continue with combined standard plus HBS treatment; this continued treatment led to an increase in time 'on' in 3 and a decrease in involuntary movements in 3 patients. Two of these four patients benefited on both counts. PMID- 3322835 TI - Clinical trial of Madopar HBS in parkinsonian patients with fluctuating drug response after long-term levodopa therapy. AB - 23 parkinsonian patients, 11 men and 12 women with an average age of 62 +/- 10 years, were recruited for an open substitution study of standard Madopar by Madopar HBS (hydrodynamically balanced system). All patients were presenting fluctuations in efficacy associated or not with abnormal involuntary movements. The patients in this study had been suffering from Parkinson's disease for 16 +/- 6 years and were severely disabled (Hoehn and Yahr grade III-V). The substitution was carried out dose for dose from one day to another. During the first month the dosage titration was aimed at finding the optimal therapeutic effect. After 120 days 13 patients were continuing the treatment while 10 had stopped it because of lack of therapeutic advantage. After 120 days, as compared to the initial state, end-of-dose fluctuations improved by 47%, the parkinsonian symptomatology by 54% and the abnormal involuntary movements improved by 33%. The daily dose of Levodopa had to be increased from 580 +/- 230 to 710 +/- 240 mg. The results obtained were excellent in 5 cases, good in 6 and moderate in 2 cases. PMID- 3322836 TI - The hydrodynamically balanced system: a novel principle of controlled drug release. AB - Madopar HBS (125 mg) is a controlled-release dosage form with 100 mg L-dopa and 25 mg benserazide. The 'hydrodynamically balanced system' (HBS) used for this novel dosage form of Madopar is a dosage form which, when in contact with gastric fluid and after dissolution of the gelatine shell of the capsule, forms a mucous body and a bulk density of less than 1 and releases the drug(s) at a desired rate whereas the dosage form remains in the stomach for a prolonged period of time. Drugs--in the present case L-dopa and benserazide--are released through the hydrated layer by diffusion principle. This system is valuable for drugs which are soluble at lower pH. By varying the composition of the excipients, desired release rates can be achieved. The in vitro dissolution rate of Madopar HBS formulation is as follows: L-dopa t75% = about 6 h and benserazide t75% = about 4 h. The floating behavior was tested in an in vitro test. These in vitro floating properties could be confirmed in man and were investigated in 10 healthy volunteers by means of gamma camera measurements using a poly-marker technique carried out in connection with a Valium CR study. It is expected that this novel drug delivery system proffers a valuable dosage form which delivers the drug at a specific rate allowing a better control of fluctuations in parkinsonian patients. PMID- 3322837 TI - Single-dose studies of a slow-release preparation of levodopa and benserazide (Madopar HBS) in Parkinson's disease. AB - The clinical effects and pharmacokinetic profiles of single doses of Madopar HBS were compared with those of standard Madopar in two studies in patients with Parkinson's disease and 'on-off' fluctuations. In the first study, 10 fasting patients received equivalent doses (200 mg levodopa plus 50 mg benserazide) of each preparation. The clinical response to Madopar HBS was delayed and brief; the relative bioavailability was only 50%. In the second study in 7 non-fasted patients, the effects of 3 capsules of Madopar HBS 125 were compared with those of 2 capsules of standard Madopar 125. Delay to turn on was longer with HBS, but duration of time on, and delay to turn off, were longer with this preparation. The area under the concentration-time curve for plasma levodopa was greater with HBS, and the maximum levodopa concentration was similar to, but achieved later than standard Madopar. PMID- 3322838 TI - Open clinical study of Madopar HBS. AB - Eleven patients suffering from idiopathic Parkinson's disease participated in an open study of Madopar HBS. At the beginning the patients were switched from standard Madopar to Madopar HBS, initially keeping constant L-dopa dosage and the number of daily doses. In 9 of the 11 patients a marked deterioration occurred within a few days. In spite of increasing the daily dosage of L-dopa the condition remained unsatisfactory in several patients and forced us to prematurely discontinue the study in 5 cases. The Webster ratings improved in 1 patient, remained unchanged in 4 cases and a definite worsening occurred in 6 patients. Fluctuations of the symptomatology were improved in none of our patients. It is not excluded that these negative results might have been improved by a further increase of Madopar HBS, a less abrupt switch from standard Madopar to Madopar HBS and probably also a combination of the two forms. PMID- 3322839 TI - Treatment of parkinsonian conditions with a controlled-release form of levodopa- preliminary study. AB - Results obtained in 22 patients with Parkinson's disease in whom treatment with standard Madopar was replaced by Madopar HBS, a CR formulation of the same product, are presented. All the patients presented with dyskinesia and akinesia phenomena related in part to the L-dopa treatment and in part to the disease itself. In 20 patients replacement of the standard agent by HBS led to a distinct improvement in the clinical condition and a significant reduction of the 'on-off' phenomenon. However, with the new formulation the dosage had to be increased by 86% on average as compared with standard Madopar. In 6 of the 22 patients treatment with the HBS formulation has continued for over 6 months and is still giving very good results. PMID- 3322840 TI - Preliminary experience with Madopar HBS: clinical observations and plasma levodopa concentrations. AB - The therapeutic efficacy of Madopar HBS was investigated in 5 patients with advanced parkinsonism. They were under treatment with standard Madopar and suffered from marked fluctuations, mainly end-of-dose akinesia. All patients were abruptly switched from standard Madopar to the HBS formulation. For the first few days (up to 1 week) dosage and number of daily intakes of HBS were the same as those of the standard formulation. Under this treatment there was some deterioration of the clinical state. The dosage was then gradually increased, on average to about twice the daily amount. After 4 weeks therapy with Madopar HBS there was an improvement of akinesia and rigidity. End-of-dose akinesia was also improved, but all patients reported prolonged periods of early-morning akinesia; tremor remained unchanged. Hourly measurements of plasma levodopa and 3-O methyldopa concentrations showed markedly increased values under Madopar HBS. The concentrations still were found to fluctuate in a similar extent as before and did not closely correlate with the actual stage of mobility. In contrast to the initial benefit, follow-up observation up to 40 weeks revealed a marked deterioration, either with permanent akinesia, or reappearance of fluctuations with a tendency from predictable to unpredictable forms. PMID- 3322841 TI - Open multicenter trial with Madopar HBS in parkinsonian patients. Preliminary assessment after short-term treatment. AB - In 23 patients with idiopathic Parkinson's disease presenting with severe fluctuations in motor performance and 'on-off' phenomena after long-term treatment with levodopa, the standard form of Madopar was replaced by the controlled-release form Madopar HBS. The Meerwaldt's patient card has been used to evaluate the frequency and intensity of response swings. Only 2 patients, who suffered from clear-cut 'end-of-dose' deterioration, significantly benefited by this switch from standard Madopar to Madopar HBS. Eight patients had a minimal or not essential improvement of the parkinsonian symptomatology and/or of the response fluctuations. Thirteen patients returned to their previous standard Madopar treatment after deterioration of parkinsonian symptoms or increase of dyskinesia under the HBS treatment. The overall increase in dosage of levodopa with Madopar HBS was 54% in comparison with the initial standard Madopar dosage. PMID- 3322842 TI - Clinical and pharmacokinetic observations with Madopar HBS in hospitalized patients with Parkinson's disease and motor fluctuations. AB - The efficacy of a novel oral sustained-release preparation of L-dopa (Madopar HBS) was compared to that of previous standard L-dopa treatment in 10 patients with idiopathic Parkinson's disease and severe fluctuations in motor performance in an open inpatient trial. Clinical assessment included evaluation of self scoring 'on-off' diaries kept by the patients throughout the study. It revealed a reduction of end-of-dose deterioration and, to a lesser degree, of random 'on off' swings in 6 cases. Doses of Madopar HBS required for an optimal response averaged the 1.6-fold of previous conventional L-dopa. Plasma levels of L-dopa were more stable with Madopar HBS compared to standard L-dopa treatment in 4 of 5 patients. PMID- 3322844 TI - Unilateral vesicoureteral reflux in children. study on urine specific gravity, osmolality, beta-2-microglobulin and lactoferrin. AB - Vesicoureteral reflux was defined as unilateral in 17 of 36 cases. Urine was collected from both kidneys. Urine specific gravity and osmolality were significantly reduced; beta 2-microglobulin was elevated and lactoferrin depressed on the reflux side. We also observed a significant correlation between specific gravity or osmolality on one side and lactoferrin on the other side, and between osmolality and beta 2-microglobulin. These observations showed a depressed concentrating capacity and reduced tubular absorption of beta 2 microglobulin suggesting reduced tubular function on the reflux side. PMID- 3322843 TI - Vertebral artery Doppler sonography. AB - We have examined the vertebral and subclavian arteries in 1,205 patients using directional continuous-wave (c-w) Doppler sonography, and compared the sonographic findings with the results of unilateral or bilateral retrograde brachial arteriographies in the same patients. Doppler sonography revealed 33 false positives among 909 cases with normal angiographic findings. Some types of vertebral artery (VA) lesions allowed an excellent, others a fairly good differentiation by Doppler sonography: the complete subclavian steal syndrome with constant reversal of VA flow was reliably detected (16 cases). In the incomplete steal syndrome (5 cases) sonography was superior to angiography. Two bilateral distal VA occlusions and seven basilar artery occlusions - six in the proximal third and one in the rostral third - were detected sonographically; four basilar occlusions sparing the caudal third and one case exhibiting rete mirabile anastomoses were not identified by Doppler sonography. Our acoustically defined sonographic criteria did not permit an unequivocal assignment to an anatomical variant or a vascular lesion. The sensitivity in the detection of a severe stenosis at the VA origin amounted to 16 out of 31, and to 12 of 25 in cases with a proximal VA occlusion and reconstitution of the distal VA through cervical collaterals. Our results confirm that the conventional hand-held c-w Doppler sonography cannot replace angiography in the evaluation of vertebro-basilar insufficiency. It rather serves as an aid to the decision for or against angiography, and in the follow-up of angiographically proven lesions. However, several therapeutically important lesions are readily diagnosed by sonography. PMID- 3322846 TI - Allogeneic bone marrow transplantation for acute leukaemia or chronic myeloid leukaemia in the fifth decade of life. AB - To determine the influence of advanced age on long-term survival after allogeneic bone marrow transplantation (BMT), the probability of survival and the frequency of transplantation-associated complications were analysed retrospectively in 20 patients with acute leukaemia (AL) or chronic myeloid leukaemia (CML), who were 40-49 years of age (median 44.5 years) at the time of transplant. The results of this patient group were compared to those of 32 patients aged 30-39 years (median 33.5 years) with AL or CML, who also underwent BMT during the same period of time. The overall actuarial survival of the two age groups was comparable with 44% and 41% at 5.9 and 5.6 years, respectively. Patients with standard risk criteria (i.e. HLA-genotypically identical sibling donor, 1st chronic phase of CML or 1st remission of AL) showed a higher probability of survival in both groups (62% at 5.9 years in older patients and 59% at 5.5 years in younger patients, respectively). In contrast, actuarial survival in patients who underwent BMT at an advanced stage of their disease or with marrow from a partially HLA-compatible donor was significantly inferior (P = 0.04). The cumulative incidence of acute and chronic graft-versus-host disease was low in older patients (27%), who received marrow from an HLA-identical sibling donor. The most frequent cause of death was interstitial pneumonia, occurring in seven of the older patients (35%) and in seven of the younger patients (22%). This difference, however, was not statistically significant. Our results indicate that allogenic marrow transplantation in the fifth decade of life might be associated with a tolerable risk of transplantation-related complications. This treatment modality may therefore be regarded as first-line therapy for patients in 1st remission of AL or first chronic phase of CML, who show a normal performance status. The same applies to older patients in advanced stages of disease, since the results are comparable to those achieved in the younger patient group. PMID- 3322845 TI - Differential immunocytological expression of a paraprotein-associated idiotype is possibly related to variant immunoglobulin molecules in plasmacytoma cells. AB - An anti-idiotype antibody (anti-Id Ab) was made by immunization of a rabbit with the IgG-2/lambda paraprotein from a plasmacytoma patient (Sa). The antibody was directed against determinants of heavy (H) and light (L) chains on the F(ab)2 piece of the paraprotein. Using this antibody an unusual pattern of cytoplasmic fluorescence was seen with bone marrow cells of the patient. One population (type I) showed reactivity in association with gamma and lambda chains, the other (type II) with the anti-Id Ab only. So, by immunological methods, biclonality could be demonstrated using the anti-Id Ab but not with anti-isotype antibodies. L chains of mol. wt 23.5 and 17.0 kd were observed. The H and L chains of small molecular weight were not detected in the patient's serum nor in the culture supernatant. Thus, deleted and intracellularly degraded H and L chains may cause the unusual staining pattern of the type II cells. PMID- 3322847 TI - European School of Oncology: management of non-Hodgkin's lymphomas: conclusions of the European School of Oncology Meeting, 1986. PMID- 3322848 TI - Diclofenac versus dipyrone in acute renal colic: a double-blind controlled trial. AB - A randomized, double-blind clinical trial in 50 patients was done to compare the efficacy and tolerance of single doses of intramuscular diclofenac 75 mg and dipyrone 2 g in acute renal colic. Both drugs were equally effective, but diclofenac was better in terms of complete relief of pain. Vital signs were affected according to the stress and pain. PMID- 3322849 TI - Steroid hormones, behavior and sexual dimorphism in animals and men: the nature nurture controversy. PMID- 3322850 TI - Joseph Lister and infection from the air. PMID- 3322851 TI - Properties of strains of Escherichia coli belonging to serogroup O157 with special reference to production of Vero cytotoxins VT1 and VT2. AB - Fifty-four strains of Escherichia coli belonging to serogroup O157 were examined for the production of Vero cytotoxins VT1 and VT2, and for other properties such as plasmid content, resistance to antimicrobial agents and colicin production. Twenty-six strains from cases of diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome in humans produced VT. By serum neutralization tests and hybridization with DNA probes for VT1 or VT2, three classes were recognized which produced either VT1 alone or VT2 alone or both VT1 and VT2. These strains were of H type 7 or non-motile. The strains producing VT were sensitive to all the antimicrobial agents tested, and all carried at least one plasmid which had a molecular weight of c. 60 X 10(6). Seven strains of porcine origin and 21 strains of human origin did not produce VT or hybridize with either DNA probe. None of these strains was of H type 7. Of the 21 human VT- strains, 17 were of extra intestinal origin and 18 were of H type 45. Twenty-three of the 28 VT-strains were resistant to at least one antimicrobial agent. PMID- 3322852 TI - An updated survey of African swine fever in Malawi. AB - Cases of African swine fever (ASF) confirmed in the laboratory in 1985 and 1986 and other data obtained since 1984, in particular and extension of the serological survey of free-ranging domestic pigs undertaken from 1981 to 1984, are presented to give an updated survey of the ASF situation in Malawi and a revised estimate of the ASF enzootic area. Evidence is presented that the area may include some border areas in Dedza and Ntcheu districts and may be expanding in some localities. PMID- 3322853 TI - Retinal insulin receptors. 2. Characterization and insulin-induced tyrosine kinase activity in bovine retinal rod outer segments. AB - Bovine retinal rod outer segments (ROS) possess specific, high-affinity receptors for insulin. These receptors exhibit an insulin-stimulatable tyrosine-specific activity that is capable of phosphorylating the receptor's own beta-subunit and exogenous substrate. ROS insulin receptors exhibit heterogeneity in the apparent molecular weight of the receptor's alpha-subunit. In this regard, insulin receptors from this single cell type resemble insulin receptors obtained from whole retina, but are unlike receptors from brain and liver. PMID- 3322854 TI - Identification and role of immunoglobulins in respiratory secretions. AB - The airway surface mucosa begins in the naso-oro pharynx and lines the conducting airways, which include the trachea, major bronchi and bronchial divisions down to the level of the respiratory bronchioles. Although sampling methods used cannot completely isolate these specific areas, analysis of immunoglobulins shows variation especially in the relative proportions of secretory IgA, IgG and IgE. The air exchange surface is samples by bronchoalveolar lavage, principally, yielding alveolar secretions that contain IgG subclasses, surfactant, etc. and a variety of respiratory cells. Several diseases illustrate abnormalities that can occur in the availability of these immunoglobulins, or in their presumed antibody functions, contributing to human diseases that have a prominent component of infection. Secretory IgA either deficient or degraded by bacterial protease (especially IgA1 form) can reduce available anti-viral antibody or perhaps promote colonization of the airways with certain microbes. IgA has a dual role. As it is an important opsonic form of antibody, selective deficiency of IgG, especially subclasses IgG, and/or IgG4, can be associated with recurrent sinopulmonary infections. Sometimes IgG (IgG4) can be increased in hypersensitivity lung diseases including asthma and orga-antigen induced hypersensitivity pneumonitis (pigeon breeders disease). Finally, cystic fibrosis, affecting the lung with persistent infection often with Pseudomonas aeruginosa, can feature degradation of IgG antibody that may create blocking fragments that impair opsonin-induced phagocytosis, or this antibody can contribute to immune complex formation. Thus, immunoglobulins (antibodies) are an important ingredient of humoral host defenses in the respiratory tract and can contribute to disease, often involving infection, if quantitative or qualitative deficiencies in them exist. PMID- 3322855 TI - General review of tracheobronchial clearance. AB - The human tracheobronchial tree possesses several mechanisms for keeping itself clean and sterile. Mucociliary clearance results from the beating action of cilia lining the conducting airways and propelling the overlying mucus cephalad. Locally produced biological debris and inhaled, insoluble material are swept with the mucus and removed from healthy lungs within one day. Cough augments the often impaired mucociliary clearance of patients with excessive secretions. Cough is limited in is efficacy to the proximal airways. Energy transfer from airflow to mucus transport in airways lined with excessive secretions has been put forward as a third mechanism (two-phase gas-liquid flow) for the removal of lung secretions. Other mechanisms that have been proposed for clearance of lung secretions are: 'milking', 'squeezing' and peristalsis. PMID- 3322856 TI - Epidemiology of bronchial hypersecretion: recent studies. AB - The predominant cause of mucus hypersecretion in Westernized countries is smoking. Mucus hypersecretion in smokers is correlated with the subsequent development of bronchial carcinoma but there is no definite causal relation to progressive airflow obstruction. The distinction between hypersecretion and the development of airflow obstruction may also be relevant in childhood and occupational respiratory disease. Endogenous factors may also be important, as suggested by the increased prevalence of hypersecretion in asthma, but are difficult to detect by epidemiological techniques. PMID- 3322857 TI - Biochemical basis of physical properties of respiratory tract secretions. AB - The physical properties of respiratory tract secretion (RTS) play a prominent role in the non-specific defence mechanisms of the lung. Viscosity and elasticity, that is flow and deformation, are only two of the physical properties of RTS. Spinability, pourability, adhesiveness and tackiness are starting to be recognised as physical properties of RTS and its is likely that they may be relevant in the pathogenesis of airways obstruction. RTS is a gel, which consists of a cross-linked polymer network dispersed in a liquid solvent. The polymeric structure of the epithelial glycoprotein can be explained in terms of covalent (disulphide) linkages and/or physical entanglement between glycoproteins subunits. Other constituents of RTS such as proteins, lipids, ions and water can influence the physical properties of RTS. PMID- 3322858 TI - Management of mucus hypersecretion. AB - Mucus hypersecretion (greater than 25 ml/day) is commonly seen in chronic bronchitis, whereas bronchorrhea (greater than 100 ml/day) is found in other conditions (e.g. asthma, bronchiectasis, alveolar-cell carcinoma). Clearance of secretions can be improved by physical and pharmacological methods. Cough airways obstruction--for "two-phase air-liquid flow". Chest physiotherapy (the forced expiration technique, FET, and postural drainage, PD) is effective in clearing central and peripheral secretions and can be self-employed. Oral high frequency oscillation (OHFO) at 13 Hz is a useful adjunct. Beta-adrenergic drugs improve clearance and this is not entirely to their bronchodilator activity. Likewise methylxanthines enhance clearance particularly in central airways. Corticosteroids are effective in bronchorrhoea and asthma. Anticholinergics may control hypersecretion. Mucolytics and expectorants are used traditionally but their activity is difficult to prove. Hypertonic (7%) saline is useful--as is cromoglycate in asthma. PMID- 3322860 TI - The effects of drugs on cough. AB - The pharmacologic treatment of cough can be divided into two main categories: therapy with controls, prevents or eliminates cough (i.e., antitussive) and therapy that makes cough more effective (i.e., pro-tussive). Definitive antitussive therapy depends on determining the aetiology or operant pathophysiologic mechanism and then initiating specific treatment; it can be almost uniformly successful. Non-specific antitussive therapy is directed at the symptom; it is indicated when definitive therapy cannot be given. For pathologic cough in man, predominantly studied in patients with chronic bronchitis, the following non-specific antitussive drugs have been shown to be effective: aerosolized ipratropium bromide, all narcotics of the phenanthrene alkaloid group (e.g., morphine and codeine), and the non-narcotics, dextromethorphan, glaucine, diphenhydramine, caramiphen, viminol and diviminol. Although studies have shown that hypertonic saline aerosol can improve cough clearance, there are no data, to date, that have convincingly demonstrated this agent or any other pro-tussive drug to be clinically useful. PMID- 3322859 TI - Mucociliary clearance in early simple chronic bronchitis. AB - Tracheobronchial mucociliary clearance was measured in 37 patients with early simple chronic bronchitis. A non-invasive radio-aerosol technique with inhalation of 99Tcm labelled 5-microns polystyrene particles followed by assessment of radio nuclide distribution by posterior gamma-camera scans was employed. The mucociliary clearance of the bronchitics was significantly lower than clearance of a non-smoker control group. An interim analysis of the effect of treatment with a surfactant stimulating drug, ambroxol, suggested a dosage-dependent tendency to a faster mucociliary clearance than seen in placebo-treated bronchitics. PMID- 3322861 TI - Aspects of metabolism and storage of pulmonary surfactant: experiments with isolated type II pneumocytes and lamellar bodies. AB - This review briefly summarizes our knowledge of the composition of pulmonary surfactant and the mechanisms involved in its biosynthesis. The currently available evidence suggests that dipalmitoylphosphatidylcholine, the major surface-active component of surfactant, can be synthesized in the alveolar type II pneumocyte via two pathways: (1) by direct synthesis de novo via the CPDcholine route, and (2) by remodelling of unsaturated phosphatidylcholines, most likely via a deacylation-reacylation mechanism. In addition, this paper focusses on recent findings concerning the biochemical characterization of lamellar bodies, the intracellular storage organelles of surfactant. Lamellar bodies from adult human lung contain a lamellar body-specific alpha-glucosidase- which should prove useful as a specific marker enzyme for this organelle. PMID- 3322862 TI - Role of lipids in airway function. AB - The lipid composition of airway secretion is described. Major differences in the literature may depend on methods. Bronchoalveolar lavage includes a major contribution of alveolar surfactant. Sputum may be contaminated by secretions from the upper airways and saliva, and shows great variations in total lipids and free fatty acids. Diseases affect its composition. Tracheobronchial aspirates and washings are more direct methods and show much cholesterol, DPPC, and other phospholipids. Secretions by explants and cell cultures also show very mixed lipid composition including neutral, phospho- and other lipids. Although much airway lipid may travel up from the alveoli, there is evidence that the larger airways can secrete their own lipids. They may also arise from breakdown of cells. Their functions may include a modification of mucus rheology, an effect on ciliary beat and mucociliary clearance, a modification of mucus adhesiveness, an action on bacterial invasion, and a lessening of the tendency to collapse of small airways due to the surface activity of the lipids. PMID- 3322863 TI - Surfactant in adult respiratory distress syndrome. AB - Adult Respiratory Distress Syndrome is a catastrophic disease which is characterized by tachypnoea, arterial hypoxemia, reduced pulmonary compliance, and diffuse alveolar infiltrates. The pathology is that of diffuse alveolar damage which includes injury to both endothelial cells and type I epithelial cells. The major physiological abnormality is reduced pulmonary compliance. The available data indicate that one of the causes for the reduced compliance is altered surface tension in the distal airspaces. Pulmonary surface material isolated from patients with Adult Respiratory Distress Syndrome has an altered phospholipid composition. Part of the current therapy is to overcome the reduced compliance by mechanical ventilation while allowing the lung time to heal. In the future, exogenous surfactant may also be used as part of the therapy in selected severely ill patients. PMID- 3322864 TI - Surfactant replacement in the management of the neonatal respiratory distress syndrome. AB - Several recent reports have documented the efficacy of surfactants replacement therapy in the neonatal respiratory distress syndrome (RDS). The surfactants tested in these trials were obtained from animal lungs or human amniotic fluid. In general, such natural preparations seem to be superior to entirely synthetic surfactants, although promising results have recently been obtained in animal experiments with artificial surfactant based on isolated apoproteins and synthetic phospholipids. Furthermore, surfactant replacement therapy seems to be more effective when the exogenous material is administered at birth, before the first breath, than when surfactant is instilled into the airways after a period of ventilation. This discrepancy may be due to maldistribution of the exogenous material, or to the rapid development of epithelial lesions in the immature lung, with leakage of surfactant-inhibiting proteins into the airspaces. A transient beneficial response to surfactant replacement may also be due to circulatory problems, especially reversal of the shunt through a patent ductus arteriosus, with overloading of the lung circulation leading to pulmonary oedema and recurrent respiratory failure. Additional, properly randomized clinical trials are required to evaluate the benefits and potential hazards of surfactant replacement therapy in neonatal RDS. PMID- 3322865 TI - The pharmacology of ambroxol--review and new results. AB - The major pharmacodynamic actions of ambroxol are surfactant stimulation, mucokinetic and secretagogue activity. The therapeutic activities of the drug in animal models of the infant and adult respiratory distress syndrome (IRDS and ARDS) are reviewed. SO2 exposed rats, which exhibited increased airway resistance and work of breathing, were used as an animal model of a bronchitic syndrome. The active group was treated with 25 mg kg-1 oral ambroxol for 10 days. The airway resistance of this group (53.6 +/- 7.0 Pa.ml-1.s) was significantly lower than that of the control (81.2 +/- 11.4). Specific work of breathing was also lower in the treated group (0.26 +/- 0.02 mJ.ml-1, control: 0.35 +/- 0.029). The alleviation of airflow limitation was a consequence of subacute treatment and not of acute bronchodilatation. Treatment with the beta 2-adrenergic drug clenbuterol further improved both active and placebo groups. PMID- 3322866 TI - Upper respiratory tract secretions: pathophysiology. AB - Nasal fluid is a heterogeneous substance. It consists largely of a secretory product derived from the 100,000 small seromucous glands. The anterior part of the nose has a relatively high secretory capacity, but this does not seem to be caused by secretion from the 200 anterior serous glands. Compared to sputum, nasal secretion has a lower viscosity, but comparable spinability; it has a lower dry weight, and content of sulphate, sugars and most proteins, but a comparable level of albumin. Watery rhinorrhoea is mainly reflex-mediated. Watery, but not purulent nasal discharge can be reduced by the cholinoceptor antagonist, ipratropium, administered in a dose which matches the degree of the symptoms. It seems likely that the nose, in some respects, can serve as a model for the analysis of airway secretions, but a comparative study of nasal and of bronchial secretions sampled in an identical way is warranted. PMID- 3322868 TI - The control of airway mucus secretion. AB - Airway mucus is essential for the effectiveness of cough and mucociliary transport. Even the resting airway produces some mucus but, under a great variety of threats to airway function, this production increases. A number of mechanisms may be responsible for augmenting secretion; these include reflexes, initiated by nervous receptors in the airways, and with their efferent limbs in the autonomic nerves to the airways. Cigarette smoke short circuits this reflex pathway; nicotine absorbed from the smoke stimulates ganglion cells directly and so drives secretion. Secretomotor nerves which control the output from submucosal glands include cholinergic, adrenergic and NANC fibres. A number of mediators of the sort released during inflammation and antigen challenge, including prostaglandins and leukotrienes, can also elicit secretion into the airway lumen. Other stimuli act at least partly on unknown mechanisms to release mucus from the surface epithelium into the airway lumen. For example inhalation of dust, which stimulates cough receptors and so acts partly by driving mucus secretion reflexly, also initiates secretion into the denervated airway. Similarly, during the inhalation of cool dry air, the airway lining secretes more mucus, probably by a non-nervous mechanism which responds to drying of the airway surface. More needs to be learned about such apparently direct mechanisms. Different control systems appear to stimulate the production of a variety of mucins from distinct cell types. We do not yet know the physiological and pathological importance of these differences. PMID- 3322867 TI - The origins of secretions in the lower respiratory tract. AB - Normally the daily volume of lower respiratory tract secretions, in man, is probably less than 100 ml. In hypersecretory disease the volume increases sufficiently to cause cough and expectoration of secretions as sputum. The proportions which are sol or gel vary in disease as does the way in which constituent molecules partition in each phase. The constituent molecules and the cells which produce them (indicated in parentheses) may be classified as follows: 1. Mucus-glycoproteins present as droplets, or sheets (produced by mucous cells), periciliary fluid (serous or ciliated cell or a transudate), surface muco substance (all epithelial cells) or surfactant hypophase (Clara or type II alveolar cells). 2. Proteins and peptides such as lysozyme (serous cell and macrophage), lactoferrin (serous cell and neutrophil), secretory piece (surface epithelium and submucosal glands), regulatory neuropeptides (dense-core granulated cell and both motor and sensory nerves) and fibronectin (alveolar macrophages). 3. Glycosaminoglycans such as heparan sulphate (epithelial membranes), heparin (mast cell), chondroitin sulphates and hyaluronate (connective tissue constituents). 4. Lipids including triglycerides (stored in cells) glycolipids (cell membrane), phospholipids (type II alveolar cells), sphingolipids (cell membrane), steroids (? Clara cells) and terpenes (cell membrane). 5. Anti-proteases and anti-oxidants such as bronchial protease inhibitors (serous anc Clara cells), alpha-2-macroglobulin (macrophage), alpha-1 antitrypsin (transudate) and anti-oxidants (type II alveolar cell and macrophage). 6. Other 'secretions' including ions and water (surface epithelium and submucosal glands), mediators of inflammation (migratory cell granules and their membranes), and serum proteins (present in transudate/exudate). PMID- 3322869 TI - The relative permeabilities of human conducting and terminal airways to 99mTcDTPA. AB - The anatomy and physiology of the pulmonary epithelial barrier are briefly described, and methods of measuring permeability of the barrier to solutes are outlined, including findings on alveolar barrier permeability to 99mTcDTPA. A method for measuring permeability to 99mTcDTPA of the conducting airways is described in which the effect of mucociliary clearance can be quantified using radio-labelled polystyrene microspheres 5 mum in diameter. When the 99mTcDTPA clearance rates from inner, intermediate and outer zones of the lungs are corrected fro the effect of mucociliary clearance, there is a significantly slower clearance from the conducting airways than from the alveoli. PMID- 3322870 TI - Studies of proteinases and their inhibitors in lung secretions. AB - The study of proteinases and their inhibitors in lung secretions may provide an understanding of the pathogenesis of many chronic lung diseases. However problems arise in the collection and assessment of the samples that leads to variability both within and between subjects. The purpose of the paper is to highlight these problems as well as the methods used to overcome them in secretions obtained from patients with chronic obstructive bronchitis. The results show that between subject variability is high; and may be up to 150% within an individual. Conventional means of reducing variability (standardisation for albumin) may not be appropriate for some proteins, leading to increased variability. The function of inhibitors is probably best expressed as enzyme inhibited/unit of inhibitor though even this shows daily variability within the same individual. An awareness of such variability is necessary for the interpretation of results obtained from patients. PMID- 3322871 TI - Effects of cigarette smoking and drugs on respiratory tract proteases and antiproteases. AB - Increased pulmonary proteolytic (elastolytic) activity is thought to be the primary cause of emphysema and may also play a role in the pathology of bronchitis. These diseases are common amongst tobacco smokers. Serum-derived alpha 1-proteinase inhibitor (alpha 1PI) and locally produced protease inhibitors normally protect the pulmonary epithelium from proteolytic attack, but tobacco smoke can inactivate these antiproteases by oxidative and non-oxidative mechanisms. Bronchoalveolar lavage fluid (BALF) samples lung surface components and most studies show that there is elevated elastolytic activity in smokers' BALF. Whether antiproteolytic capacity is reduced in these samples remains debatable. A selective lavage technique is described which independently samples central and peripheral epithelium from the same subject. Analysis demonstrates a protease-antiprotease imbalance which can differ in central and peripheral lavage and which could be significant in the development of obstructive airways disease. Therapeutic approaches include augmenting antiprotease potential using genetically engineered, oxidant-resistant alpha 1PI or synthetic peptide inhibitors. PMID- 3322872 TI - Atopy and preemployment screening. PMID- 3322873 TI - Bronchoalveolar lavage in extrinsic allergic alveolitis. PMID- 3322875 TI - Bacteria in farming environment. PMID- 3322874 TI - Role of endotoxins in the pathogenesis of respiratory disorders. PMID- 3322877 TI - [Frequency and intensity of caries in the deciduous and permanent dentition of 3 , 6- and 12-year-old children in Csongrad County 1986]. PMID- 3322876 TI - Mutagenicity studies on PTT-119. PMID- 3322878 TI - [Follow-up study of the development of adult dentition from age 14 to 22]. PMID- 3322879 TI - [Development of the theories of cortical-visceral interrelations in the works of I.T. Kurtsin (on his 80th birthday)]. PMID- 3322881 TI - [Vasopressin and the mechanism of its antidiuretic action]. PMID- 3322880 TI - [Relation of organ blood supply and function in normal conditions and during experimental neuroses]. PMID- 3322882 TI - [Watery diarrhea, hypokalemia, achlorhydria syndrome due to recurrent malignant pheochromocytoma]. AB - A case of malignant pheochromocytoma, with a recurrence 15 years after adrenalectomy and with an associated watery diarrhea, hypokalemia, achlorhydria syndrome, is reported. Histological evaluation of the tumors revealed composite malignant pheochromocytoma-ganglioneuroblastoma (well differentiated type). Vasoactive intestinal polypeptide and catecholamine levels were high both in the plasma and in the tumors. Somatostatin was also rich in the metastatic tumor of the liver, but not in the plasma. Immunohistochemical studies have demonstrated that immunoreactive vasoactive intestinal polypeptide is present in the ganglioneuroblastoma component, and that immunoreactive somatostatin is present in the pheochromocytoma component. Literature on the watery diarrhea, hypokalemia, achlorhydria syndrome associated with pheochromocytoma was reviewed. PMID- 3322883 TI - [Roles of kidney and submandibular gland in the release of rat plasma inactive renin]. AB - In this study we outlined the development of an enzymatic technique to activate plasma inactive renin by trypsin in rat plasma. Using this method, we reported the releasing mechanism of the trypsin-activable inactive renin which has not yet been clarified. Adult male Wistar rats (260-300 g) were kept on regular diet (Na: 260 mg/100g) unless explained and underwent operation under pentobarbital anesthesia (50 mg/kg). Blood samples were obtained from conscious rats through the cannulae, which had been inserted into the left femoral arteries 24h before the experiments. After addition of excessive renin substrate which had been obtained from the 24 h-nephrectomized rat plasma, renin was measured by the commercial RIA-kit (Dainabot). Trypsin (Worthington) treatment (20 mg/ml plasma for 10 min at 4 degrees C) was followed by addition of SBTI (Sigma) (20 mg/ml plasma). This condition maximally increased the rate of angiotensin I generation and did not alter the Km or optimum pH of the renin reaction. In this condition, trypsin reaction was completely inhibited by adding these concentrations of SBTI. The molecular weight of inactive renin (51,000) in the normal rat plasma estimated by Sephadex G-100 column (Pharmacia) was the same as that in the nephrectomized rat plasma. In conclusion, trypsin treatment of plasma (20 mg/ml plasma for 10 min at 4 degrees C) followed by SBTI (20 mg/ml plasma) was justified for trypsin activation of rat plasma. Using this method, we investigated the changes in active and inactive renin after bilateral nephrectomy in the salt-depleted rat. Active renin decreased rapidly after bilateral nephrectomy with a half life of 23.6 +/- 4.0 min. Inactive renin, on the other hand, increased gradually and reached to a plateau 24 h after bilateral nephrectomy, and was kept unchanged during the following 24 h. The infusion of mouse submandibular gland active renin or angiotensin II could not prevent the increase of plasma inactive renin in the nephrectomized rat. These suggest that there may be no feedback mechanisms between plasma inactive and active renin or angiotensin II. Furthermore, we investigated the organ-related sources of plasma inactive renin which markedly increased after total nephrectomy. Simultaneous removals of submandibular glands but not of adrenal glands completely prevented the postnephrectomy increases of plasma inactive renin. But, removals of submandibular glands or adrenal glands alone were followed by no changes in the basal levels of plasma inactive renin.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3322884 TI - Population dynamics of humans and other animals. AB - Human population dynamics, at least until the past century, have probably been governed by homeostasis and in this resembled those of other animals. Because human population homeostasis was probably substantially weaker than among large mammals, its operation has been less obvious. Nonetheless, the empirical evidence for advanced agriculturalists is compelling. Unlike animals, the human population has tended toward equilibria that have been tending upward at an accelerating rate. The acceleration might reflect long-run positive feedback between density and technological progress, as Boserup has suggested. Because homeostasis was weak, its role in shorter run historical explantation is limited; its force was gentle and easily overwhelmed by other particular influences. Malthusian oscillation, in the sense of distinctive medium-run dynamics arising from homeostasis, probably did not occur. And because homeostasis was weak, density dependence can in principle explain only a minute proportion of the annual variation in population growth rates. Yet homeostasis plays an essential role in demographic theory. Without it, we are incapable of explaining population size and change over time except by recounting a mindless chronology of events back to the beginning of humanity--whenever that was. Without it, we cannot explain the response of population growth to economic growth. Without it, we cannot explain recovery from catastrophe or the rapid natural increase in many frontier regions. Without it, we cannot properly analyze the influence of climatic variation and other partially density-independent factors. Our basic understanding of human history requires a grasp of what homeostasis can explain and what it cannot. A homeostatic approach to population dynamics also leads to questions about the roles of reproductive norms and institutions, not just whether they encourage high or low fertility, but whether they make natural increase responsive to resource abundance. And if they do, whether they strike the balance of population and the means of subsistence at a relatively prosperous or impoverished level. Such considerations may contribute to an understanding of broad preindustrial differences among the regions of the world in densities, average levels of vital rates, and living standards--which was very much how Malthus viewed the matter. Ordinary homeostatic tendencies essentially vanish in the course of economic development, and they were probably all but gone from much of Europe by the end of the 19th century.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3322885 TI - Intergenerational transmission of relative fertility and life course patterns. PMID- 3322886 TI - Sources of age and date-of-birth misreporting in the 1900 U.S. census. PMID- 3322888 TI - The population in large urban concentrations in the United States, 1790-1980: a delineation using highly urbanized counties. PMID- 3322887 TI - The level and trend of poverty in the United States, 1939-1979. PMID- 3322889 TI - [Mechanism of action of dapsone in chronic inflammatory dermatoses. I: Modification of the functions of polymorphonuclear leukocytes]. PMID- 3322890 TI - [Placebo-controlled comparison of the therapeutic effect of extra-corporeal UV irradiation of blood and UV irradiation of skin in chronic inpatient treatment of psoriasis]. PMID- 3322891 TI - The effect of prolonged treatment with differing doses of chromium on glucose homeostasis in rabbits. AB - The effect of prolonged treatment with chromium on glucose homeostasis was assessed in rabbits. Thirty-one male rabbits were divided into 6 groups. All were fed for 30 days with a standard ad libitum diet. Twenty-seven rabbits were injected daily during a further 120 days with different doses of potassium chromate (3-20 micrograms) while 4 rabbits served as controls. No significant rise in serum glucose levels was observed, insulin levels were the same in the different groups, and glycosylated hemoglobin concentration also did not change after the administration of chromium. Serum chromium levels increased proportionally to the dose injected to an almost a 14 fold increase in the 20 micrograms chromium treated group. Although others have shown that chromium may have a hyperglycemic effect with inhibition of insulin secretion, we have not been able to confirm this finding. PMID- 3322892 TI - Evaluation of B-cell function in diabetics by C-peptide determination in basal and postprandial urine. AB - Urinary C-peptide (UCP) values in basal and postprandial 2-hour samples are compared with simultaneous plasma C-peptide (PCP) values and with 24-hour UCP in 21 NIDDs, 24 IDDs and 9 controls. Basal and postprandial 2-h UCP was similar in controls and NIDDs (0.79 +/- 0.53 and 2.68 +/- 1.06 nmol/2 h versus 1.03 +/- 0.70 and 2.64 +/- 1.34, p greater than 0.05) and very low in IDDs (0.16 +/- 0.22 and 0.58 +/- 0.86, p less than 0.001). NIDDs showed basal (0.69 +/- 0.32 nmol/l) and postprandial (1.12 +/- 0.50) PCP values lower than controls (0.91 +/- 0.31 and 1.90 +/- 0.70). UCP clearance was higher in NIDDs than in controls. IDDs showed similar pattern of higher clearance but greater variability, the differences not being significant. It is concluded that despite correlations between PCP and UCP, possible differences can exist in C-peptide renal handling in diabetics, making unwise to use UCP as sole parameter of B-cell function in these patients. PMID- 3322893 TI - Obesity and thermogenesis in man. AB - The treatment of obesity has until recently concentrated upon decreasing energy intake. Experiments using animal models of obesity have demonstrated that a defective thermogenic response to food ingestion is involved in the development of obesity. In man the evidence is less conclusive since there are as many studies which report a decreased thermogenesis in the obese as those which report a similar thermogenic response in obese and lean individuals. Evidence is given supporting the involvement of the sympathetic nervous system in the thermic response to glucose/insulin infusions in both lean and obese individuals and attempts to resolve the controversy as to why some studies report that the obese have a decreased and other studies a similar thermic response to nutrient administration. PMID- 3322894 TI - Serum hCG levels measured by time-resolved fluoroimmunoassay in first-trimester pregnancy and after pregnancy termination. AB - Time-resolved fluoroimmunoassay (TR-FIA) reliably shows the concentrations of serum hCG during the first trimester of normal pregnancy. After first-trimester induced abortion the mean disappearance of hCG in serum (under 10 IU/l) takes place in three weeks. TR-FIA is a convenient and ultrarapid method for diagnosing pregnancy-related disorders. PMID- 3322896 TI - First-trimester diagnosis of recurrence of cystic hygroma using a vaginal ultrasound transducer. AB - The possibilities and limitations of first-trimester diagnosis of fetal structural defects using vaginal transducers are currently not well established. For couples at risk for cystic hygroma early transvaginal ultrasound examination at a gestational age of 10 weeks can be offered to rule out or confirm the presence of cystic hygroma, as described in this case report. PMID- 3322897 TI - Cord entanglement in monoamniotic twin pregnancies. AB - Monoamniotic twin pregnancy involves a heavy risk of fatal umbilical cord entanglement. Two cases are reported. In the first case, both twins were found dead in the 36th week, and the monoamnionicity was recognized at birth. In the second case, the monoamnionicity was discovered during an ultrasound examination, and cord entanglement was suspected in the 35th week on the basis of a non-stress test (NST) with variable decelerations. Cesarean section was performed and two healthy children were delivered. PMID- 3322898 TI - Differential behaviour of glucose 6-phosphate dehydrogenase in two morphological forms of Trypanosoma cruzi. AB - 1. Glucose 6-phosphate dehydrogenase activity (EC 1.1.1.49) of two morphological forms of Trypanosoma cruzi, epimastigotes and metacyclics, are reported. 2. The kinetic behaviour and some of the kinetic parameters of the enzyme in both forms were studied. The enzymes showed a simple Michaelis-Menten kinetic. 3. The activity in epimastigote forms was alway higher than the metacyclic ones. At subsaturating concentrations of substrate was almost 10-fold higher, whereas at saturating concentrations was about 2-fold higher. 4. In epimastigote forms the specific activity and Km values, at pH 7.5 and 37 degrees C, was found to be 142 mUnits x mg-1 of protein and 0.23 mM, respectively. 5. In the same conditions, the specific activity and Km values in metacyclic forms was 75 mUnits x mg-1 of protein and 1.06 mM, respectively. 6. A possible role in the carbohydrate metabolism of glucose 6-phosphate dehydrogenase in both forms of Trypanosoma cruzi is discussed. PMID- 3322895 TI - Proliferative and malignant Brenner tumours (BT) and their differentiation from metastatic transitional cell carcinoma of the bladder: a case report and review of the literature. AB - Up to now 110 cases of malignant Brenner tumour (BT) and 45 cases of proliferative BT have been reported in the accessible literature. To delineate the diagnostic criteria and to determine the differences between these tumours and metastatic tumours of the urinary tract, 94 cases of malignant BT and 37 cases of proliferative BT were reviewed. The difficulties encountered in determining these differences are illustrated by means of a case history. PMID- 3322899 TI - Employment-based family planning programs. PMID- 3322900 TI - Repeatability of high-frequency bone conduction thresholds. AB - The purpose of this study was to determine the repeatability of high-frequency, bone conduction thresholds and to increase the data base concerning high frequency, bone conduction threshold levels. Bone conduction thresholds were obtained on 30 subjects having normal, low, and mid frequency (0.25 to 8 kHz) hearing thresholds within and across five test sessions using a Pracitronic KH 70 bone vibrator referenced to a Bruel and Kjaer 4930 mechanical coupler at 1, 4, 8, 10, 12, 14, and 16 kHz. Within and across sessions, the bone conduction thresholds were not significantly (p greater than 0.05) different at each frequency indicating that repeated testing without replacing the bone vibrator (within session) and with replacing the bone vibrator (across session) did not influence the threshold measurements. Clinical implications concerning high frequency, bone conduction audiometry are discussed. PMID- 3322901 TI - Residual insulin positivity and pancreatic atrophy in relation to duration of chronic type 1 (insulin-dependent) diabetes mellitus and microangiopathy. AB - The relationship of residual insulin positivity in chronic Type 1 (insulin dependent) diabetes and atrophy of the exocrine pancreas to duration of diabetes, age at onset and microangiopathy was studied in 26 patients (disease duration 2 to 54 years, mean 26 years). Islets containing insulin cells were found in 13/26 pancreata. In 5/13 pancreata insulin positive cells were detected in only one lobule, while in 8/13 insulin positivity was multifocal. All patients with diabetes duration less than 11 years had residual insulin cells; whereas, the rate of insulin positivity was near 40% with diabetes duration of more than 11 and 21 years, respectively. Survival of insulin cells was not clearly related to age at onset. HLA-DR expression on insulin cells was seen in one case. Insulitis was lacking. Pancreatic volume determined in 18 patients ranged from 14-110 ml (age adjusted mean 56.3 ml) and was significantly less than that of control subjects (age adjusted, mean 89.9 ml, p less than 0.0001). Computerized morphometry of the exocrine pancreas revealed severe acinar atrophy due to a reduction in size of acinar cells. Acinar atrophy correlated neither with the degree of insulin positivity, disease duration nor severity of microangiopathy. The findings suggest that in about 40% of patients with Type 1 diabetes a small population of insulin cells may escape autoimmune destruction, irrespective of disease duration or age at onset. Though exocrine atrophy and insulin deficiency are associated, the variable extent of pancreatic atrophy could not be related to such factors as amount of surviving insulin cells, duration of diabetes or microangiopathy. PMID- 3322902 TI - Postprandial oscillations of plasma glucose, insulin and C-peptide in man. AB - Postprandial plasma glucose, insulin and C-peptide profiles were studied in eight normal subjects, in the afternoon or in the evening. Two to five synchronous oscillations, with a mean period of 51 to 112 min were detected. The oscillations were highest after meals and were then damped, reverting to fasting levels after up to 340 min. Additional short-term oscillations, with periods of 20-30 min and 9-14 min, were observed. Cross-correlation studies of glucose and insulin and of insulin and C-peptide revealed a high correlation in the frequency bands considered. The synchronous oscillations of insulin and C-peptide suggest cyclic variations in pancreatic secretion rather than cyclic changes in insulin degradation. PMID- 3322903 TI - Bone marrow irradiation chimeras in the BB rat: evidence suggesting two defects leading to diabetes and lymphopoenia. AB - A series of bone marrow irradiation chimeras were constructed in an attempt to determine the site of the defect(s) leading to diabetes and/or lymphopoenia in the BB rat. In BB rats that were lethally irradiated and reconstituted with T cell-depleted Wistar-Furth (WF) rat bone marrow, the incidence of diabetes was reduced, and in animals treated with WF bone marrow at less than 44 days of age, the disease was completely prevented. Such animals demonstrated normal lymphocyte counts in peripheral blood, and normal lymphocyte function (as indicated by mixed lymphocyte response), but retained an abnormal T-cell subset distribution only partially improved above that of diabetes-prone BB rats. The incidence of diabetes in these irradiated chimeras was significantly reduced compared to the incidence in BB rats irradiated at the same age but reconstituted with bone marrow from BB rats. In WF rats that were lethally irradiated and reconstituted with T-cell-depleted bone marrow from overtly diabetic BB rats, no diabetes was induced. Such animals demonstrated normal lymphocyte counts in peripheral blood, normal lymphocyte function, and normal T-cell subset distributions. Overall, these results suggest two defects leading to diabetes and/or lymphopoenia in the BB rat. One of these occurs at the level of the bone marrow stem cell while the other resides in the T-cell differentiative environment. PMID- 3322904 TI - Role of glucagon suppression on gluconeogenesis during insulin treatment of the conscious diabetic dog. AB - In seven insulin-deficient (less than 3 mU/l) pancreatectomised dogs, the direct and glucagon-related indirect effects of intraportal insulin infusion (350 microU/kg-min; 12 +/- 1 mU/l) on glucose production were determined. Insulin was infused for 300 min during which time the plasma glucagon concentration was allowed to fall (314 +/- 94 to 180 +/- 63 ng/l) for 150 min before being replaced by an infusion intraportally at 2.6 ng/kg-min (323 +/- 61 ng/l) for the remaining 150 min. Glucose production and gluconeogenesis were determined using arterio venous difference and tracer techniques. Insulin infusion shut off net hepatic glucose output and caused the plasma glucose, blood glycerol and plasma non esterified fatty acid levels to fall. It caused the hepatic fractional extraction of alanine (0.41 +/- 0.10 to 0.21 +/- 0.06) and lactate (0.32 +/- 0.09 to 0.04 +/ 0.03) to fall which increased their concentrations. When glucagon was replaced, all of these changes were fully or partly reversed with the exception of the changes in glycerol and nonesterified fatty acids. Indeed, 70% of the fall in hepatic glucose production and virtually 100% of the changes in lactate and alanine metabolism produced by basal insulin infusion were mediated by a fall in glucagon. However, the fall in hepatic uptake of glycerol was unaffected by changes in glucagon and thus gluconeogenesis from this substrate was inhibited by insulin per se probably as a result of reduced lipolysis. The latter effect of insulin may explain the incomplete restoration of hepatic glucose production when hyperglucagonaemia was re-established during insulin infusion. PMID- 3322905 TI - Effects of hypoglycaemia on early embryogenesis in rat embryo organ culture. AB - As congenital malformations may be caused by perturbations of glycolytic flux on early embryogenesis [16], effects of hypoglycaemia were investigated by using rat embryo organ culture. Nine and one-half day old rat embryos were grown in vitro for 48 h (day 9 1/2 to 11 1/2) in the presence of hypoglycaemic serum for different hours during the culture period. Hypoglycaemic serum was obtained from rats given insulin intraperitoneally. On exposure to hypoglycaemic serum during the first 24 h of culture (day 9 1/2 to 10 1/2), embryos showed marked growth retardation and had increased frequencies of neural lesions (42.7% versus 0%, p less than 0.01), in contrast to hypoglycaemic exposure during the second 24 h of culture (day 10 1/2 to 11 1/2), where only minor growth retardation and low frequencies of neural lesions (2.4% versus 0%, NS) were seen. Even exposure to hypoglycaemic serum for a relatively short period (8 h) during the first 24 h of culture resulted in neural lesions at the frequency of 9.3-13.3%. The embryos exposed to hypoglycaemia demonstrated decreased glucose uptake and lactic acid formation, indicating decreased energy production via glycolysis that constitutes the principal energy pathway at this stage of embryonic development. These results suggest that hypoglycaemia during critical periods of embryogenesis has adverse effects on the development of the embryo and these effects might be mediated through metabolic interruption of embryogenesis. PMID- 3322906 TI - Augmentation of the effects of insulin and insulin-like growth factors I and II on glucose uptake in cultured rat skeletal muscle cells by sulfonylureas. AB - The effect of sulfonylureas on long-term regulation of glucose uptake by insulin and insulin-like growth factors has been studied in the L6 line of cultured skeletal muscle cells. These cells have previously been shown to possess many characteristics of differentiated skeletal muscle and to bind and respond to physiological concentrations of insulin and insulin-like growth factors I and II. Tolazamide (half-maximal at 0.2 mg/ml) augments the effects of insulin, insulin like growth factor I, and insulin-like growth factor II on glucose uptake, increasing both sensitivity and maximal efficacy of the hormones. In the absence of added hormone, tolazamide has no effect on glucose uptake. A similar increase in insulin-stimulated glucose uptake with unaltered basal uptake occurs with glyburide (half-maximal at 0.5 microgram/ml). The action of tolazamide requires long-term exposure to the sulfonylurea (22 h) and is inhibited by cycloheximide, suggesting a process that involves new protein synthesis. In contrast to glucose uptake, amino acid uptake in L6 cells is increased by tolazamide in the absence of hormones. Insulin and the insulin-like growth factors also stimulate amino acid uptake, but this effect is not further augmented by tolazamide. Thus, sulfonylureas appear to directly modulate amino acid uptake, but to indirectly augment glucose uptake through an effect on insulin and insulin-like growth factor stimulated pathways. Neither insulin binding nor insulin degradation is altered by tolazamide, indicating a post-binding mechanism of action. The L6 cultured skeletal muscle cell line should be useful in future studies on the mechanism of the extrapancreatic actions of sulfonylureas. PMID- 3322908 TI - Direct evidence that insulin does not down-regulate its own receptors in circulating monocytes of human newborns. AB - To determine the effect of insulin on its own receptor concentrations in circulating monocytes of normal human adults and full-term newborns, these cells were chronically exposed (2-18 h) to 10(-9) to 10(-7) mol/l insulin at 37 degrees C in vitro. The reduced 125I-insulin binding observed in monocytes from adult individuals was dependent on the concentration of unlabelled insulin and on the duration of exposure, while in the monocytes obtained from umbilical cord blood, insulin did not induce any reduction of insulin binding. The modifications observed in insulin binding were accounted for by changes in receptor concentrations rather than by any change in receptor affinity for the hormone. These findings show that insulin does not down-regulate its own receptors in monocytes of human newborns. PMID- 3322907 TI - Assessment of islet cell viability using fluorescent dyes. AB - A rapid fluorometric method has been developed to evaluate the viability of isolated islet cells. The assay differentiates between viable and nonviable cells by the simultaneous use of the inclusion and exclusion dyes acridine orange and propidium iodide. When viewed by fluorescent microscopy, viable cells fluoresce green, while nonviable cells fluoresce bright red. Although the acridine orange and propidium iodide assay measures membrane integrity, the results of this assay correlate with other measures of cell viability. Compared to trypan blue exclusion, this assay is easier to read, more stable, and has fewer staining artifacts. The assay enables the rapid estimation of the viability of a population of islet cells prior to time-consuming experiments rather than retrospectively. This assay can also be used with intact islets. Stained islets can be divided into three distinct groups: green fluorescing islets contain insulin, red fluorescing islets contain little or no insulin and a third class of islets containing some non-viable cells fluoresce red, green, and yellow. The yellow colour is due to the superimposition of red and green fluorescing cells. PMID- 3322909 TI - Insulin immunology in mono-component insulin treated patients. PMID- 3322910 TI - Disproportionate elevation of immunoreactive proinsulin in type 2 (non-insulin dependent) diabetes mellitus and in experimental insulin resistance. AB - In this study, we found that the ratio of proinsulin to total immunoreactive insulin was much higher in 22 patients with Type 2 (non-insulin-dependent) diabetes mellitus than in 28 non-diabetic control subjects of similar age and adiposity (32 +/- 3 vs 15 +/- 1%, p less than 0.001). In addition, the arginine induced acute proinsulin response to total immunoreactive insulin response ratio was greater in diabetic patients (n = 10) than in control subjects (n = 9) (8 +/- 2 vs 2 +/- 0.5%, p = 0.009), suggesting that increased islet secretion per se accounted for the increased ratio of proinsulin to immunoreactive insulin. One explanation for these findings is that increased demand for insulin in the presence of islet dysfunction leads to a greater proportion of proinsulin secreted from the B cell. We tested this hypothesis by comparing proinsulin secretion before and during dexamethasone-induced insulin resistance in diabetic patients and control subjects. Dexamethasone treatment (6 mg/day for 3 days) raised the proinsulin to immunoreactive insulin ratio in control subjects from 13 +/- 2 to 21 +/- 2% (p less than 0.0001) and in diabetic patients from 29 +/- 5 to 52 +/- 7% (p less than 0.001). Dexamethasone also raised the ratio of the acute proinsulin response to the acute immunoreactive insulin response in control subjects from 2 +/- 0.5 to 5 +/- 2% (p = 0.01) and in diabetic patients from 8 +/ 2 to 14 +/- 4% (p = NS), suggesting that the dexamethasone-induced increment in the basal ratio of proinsulin to immunoreactive insulin was also due to increased secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322911 TI - The effects of glucose-dependent insulinotropic polypeptide infused at physiological concentrations in normal subjects and type 2 (non-insulin dependent) diabetic patients on glucose tolerance and B-cell secretion. AB - The effects of porcine glucose-dependent insulinotropic polypeptide given by continuous intravenous infusion in normal subjects (n = 6) and Type 2 (non insulin-dependent) diabetic patients (n = 6) have been investigated. The subjects were studied on 2 separate days after overnight fasts. On each day 25 g of glucose was infused from 0-30 min plus an infusion of either porcine glucose dependent insulinotropic polypeptide (0.75 pmol . kg-1 . min-1) or control solution. During the glucose-dependent insulinotropic polypeptide infusion plasma glucose values were reduced in normal subjects from 30-60 min (p less than 0.01) and in Type 2 diabetic patients at 45 and 60 min (p less than 0.05). In the normal subjects insulin concentrations were greater from 10-35 min (p less than 0.01) following glucose-dependent insulinotropic polypeptide infusion and peak values were increased by 123%. In the Type 2 diabetic patients following glucose dependent insulinotropic polypeptide infusion insulin levels were increased from 4-40 min (p less than 0.01) but peak values were only increased by 27%. In the normal subjects C-peptide values were greater from 25-45 min (p less than 0.01) following glucose-dependent insulinotropic polypeptide infusion and peak C peptide levels were increased by 82%. In the Type 2 diabetic patients following the glucose-dependent insulinotropic polypeptide infusion C-peptide levels were increased from 6-55 min (p less than 0.01) and peak values were increased by 20%. Plasma glucose-dependent insulinotropic polypeptide levels were within the physiological post prandial range during the glucose-dependent insulinotropic polypeptide infusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322912 TI - Elevated serum uric acid--a facet of hyperinsulinaemia. AB - In a representative sample of the adult Jewish population in Israel (n = 1016) excluding known diabetic patients and individuals on antihypertensive medications, serum uric acid showed a positive association with plasma insulin response (sum of 1- and 2-hour post glucose load levels) in both males (r = 0.316, p less than 0.001) and females (r = 0.236, p less than 0.001). This association remained statistically significant in both sexes (p less than 0.001) after accounting by multiple regression analysis for age and major correlates of serum uric acid i.e. body mass index, glucose response (sum of 1- and 2-hour post load levels), systolic blood pressure and total plasma triglycerides. The net portion of the variance of serum uric acid attributable to insulin response was 12% in males and 8% in females, the total variance accountable by all these variables being 17% and 19% respectively. We conclude that elevated serum uric acid is a feature of hyperinsulinaemia/insulin resistance. PMID- 3322914 TI - Prevalence of islet cell antibodies, insulin antibodies and hyperglycaemia in 2291 schoolchildren. AB - Islet cell antibodies, insulin antibodies and hyperglycaemia were investigated in 2291 healthy schoolchildren. Eight of the subjects had islet cell antibodies and eight had insulin antibodies. However, no schoolchild who was positive for islet cell antibodies also had insulin antibodies present. Hyperglycaemia was observed in five children but neither islet cell antibodies nor insulin antibodies could be detected in the sera from these particular subjects. PMID- 3322915 TI - Glucose-induced insulin response and insulin sensitivity is not related to HLA type but to age in young siblings of type 1 (insulin-dependent) diabetic patients. AB - Glucose-induced insulin response and insulin sensitivity were studied in 32 HLA identical, 38 haplo-identical and 24 non-identical, islet-cell-antibody-negative, healthy siblings of young Type 1 (insulin-dependent) diabetic patients (age range 10-28 years). No significant differences were obtained between HLA-identical, HLA haplo-identical siblings and HLA-non-identical siblings in insulin response using an i.v. glucose infusion test even when the insulin sensitivity as estimated by the somatostatin-insulin-glucose infusion test was taken into account. A significant inverse correlation to age was found for both insulin response (r = 0.24, p = 0.02) and insulin sensitivity (r = -0.36, p less than 0.01) in the young siblings studied. PMID- 3322913 TI - Relationship between blood pressure and plasma insulin in non-obese and obese non diabetic subjects. AB - In this study, we have measured plasma insulin at fasting and following an oral glucose load and blood pressure after glucose load in 367 (247 non-obese, 120 obese) normotensive and untreated mildly hypertensive subjects. Overall, there was no independent association between fasting plasma insulin levels and blood pressure values. After controlling for age and body weight, a significant relationship between postglucose plasma insulin levels and diastolic blood pressure was found. When non-obese and obese subjects were examined separately, significant relationships were identified between postglucose plasma insulin levels and both systolic and diastolic blood pressure values in the former but not in the latter. A comparison of sex-, age-, and weight-matched hyperinsulinaemic vs normoinsulinaemic subjects showed that the former had significantly higher values of blood pressure only if not obese. These results demonstrate that the plasma insulin response to glucose is independently correlated with blood pressure. PMID- 3322916 TI - An examination of the role of insulin dimerisation and negative cooperativity using the biological properties of the despentapeptide and deshexapeptide insulins. AB - The C-terminus of the insulin B chain is essential for dimerisation and expression of negative cooperativity. In order to evaluate the possible physiological role of these phenomena, we have studied the properties in vivo and in vitro of despentapeptide insulin (B26-30 deleted), derived from beef insulin, and deshexapeptide insulin (B25-30 deleted), derived from pork insulin. These materials do not dimerise and have 15% and 0% retention of negative cooperativity respective. Lipogenesis potencies in rat adipocytes were: despentapeptide insulin 19.9 +/- 0.3%; deshexapeptide insulin 19.9 +/- 1.5%. Binding potencies in adipocytes were: despentapeptide insulin 22.6 +/- 7.8%; deshexapeptide insulin 13.2 +/- 3.3%. Metabolic clearance rates were reduced compared to insulin (insulin = 19.1 +/- 0.9; despentapeptide insulin = 9.7 +/- 0.8; deshexapeptide insulin = 6.4 +/- 0.6 ml . min-1 . kg-1 at plasma concentration 0.5 nmol/l). Hypoglycaemic potencies were reduced for both analogues (40% and 30%) when calculated on the basis of plasma concentration although both analogues and insulin were equally effective at lowering plasma glucose concentration in equimolar doses. Plasma half-disappearance time was prolonged (despentapeptide insulin = 7.3 +/- 0.5; deshexapeptide insulin = 9.1 +/- 0.2 min). Both analogues were full agonists and conformed to the general relationship between in vitro and in vivo properties seen with a wide range of modified insulins. They resemble other analogues with modifications which reduce receptor affinity without impairing dimerisation or negative cooperativity. The results do not support a physiological role for dimerisation or negative cooperativity. PMID- 3322917 TI - Derivation of a quantitative measure of insulin sensitivity from the intravenous tolbutamide test using the minimal model of glucose dynamics. PMID- 3322918 TI - [Ergometry in cardiology: current status and future outlook]. PMID- 3322920 TI - [Basic concepts of present-day clinical immunology (1)]. PMID- 3322919 TI - [The latero-cervical murmur. Clinical and etiological observations on 515 cases belonging to a group of 2782 subjects examined]. PMID- 3322921 TI - [Alcohol and diabetes mellitus]. PMID- 3322922 TI - [Comparative efficacy of omeprazole and cimetidine in the treatment of duodenal ulcer in the acute stage. A French multicenter, controlled therapeutic trial]. AB - Omeprazole is a proton pump inhibitor which induces a dose-dependent reduction of gastric acid secretion. To assess its efficacy in healing and alleviating the symptoms of duodenal ulcer, a randomized and double-blind study was conducted in 26 French centers comparing omeprazole 20 mg o.m. with cimetidine 400 mg b.i.d. After two weeks' treatment (285 cases), healing, assessed by endoscopy, was obtained in 64.5 p. 100 of omeprazole-treated patients, and in 44.3 p. 100 of cimetidine-treated patients (p = 0.0008). After 4 weeks treatment (232 cases), 90.1 p. 100 of omeprazole-treated patients healed, compared to 79.3 p. 100 of cimetidine-treated patients (p = 0.03). After 2 weeks treatment, there was no difference between the groups as far as nocturnal pain was concerned; however there was a significant difference in favor of omeprazole in the resolution of mild or moderate day-time pain (p = 0.01). There were no clinical or biochemical adverse events which could be ascribed to either of the treatments tested. PMID- 3322923 TI - [Evaluation of per-endoscopic cytology in the identification of Campylobacter pylori on gastric mucosa]. AB - The presence of Campylobacter pylori on gastric mucosa was evaluated by touch cytology of gastric biopsies in a series of 100 patients. Results were compared to biopsy cultures. Of 43 culture-positive patients, cytology was positive in 37 (86 p. 100). Cytology was positive in 16 of 57 culture-negative patients, who had peptic ulcer and/or gastritis on biopsy, conditions widely associated with the presence of Campylobacter pylori. Cytologic examination, yielding quick results, is thus a sensitive diagnostic method for Campylobacter pylori. In addition, retrospective studies of previous specimens are possible: among 11 patients with a follow up of more than one year, three of the four Campylobacter pylori carriers subsequently developed an ulcer. PMID- 3322924 TI - [Omeprazole]. PMID- 3322925 TI - [Early treatment of biliary lithiasis in biliary pancreatitis]. AB - Since 1982, 38 consecutive patients with biliary pancreatitis were treated prospectively in order to prevent recurrent migration of gallstones. Removal of the stones was achieved by "early surgery" i. e. within the first week after admission or by endoscopic sphincterotomy in patients with severe pancreatitis. Gallstones were visualized by ultrasonography in 31 patients (82 p. 100). Microlithiasis was present in 14 (37 p. 100) and was missed at ultrasonography in 7 patients. According to Ranson's prognostic signs, only 4 patients had 4 or more signs. These 4 patients and 2 additional patients aged more than 85 underwent urgent retrograde cholangiography and endoscopic sphincterotomy. No complications could be attributed to this technique. Among the 4 patients with severe pancreatitis, 3 developed an abscess which required delayed surgery without further complications. The 32 other patients underwent a biliary operation within the first week after admission. Common bile duct calculi were present in 14 patients being discovered by cholangioscopy in 6. One patient died after operation and one was reoperated on for a pseudocyst on day 40. No recurrent attack of pancreatitis was observed in either group. Our study suggests that slightly delayed biliary operation with cholangioscopy during the same hospitalization can be performed safety in patients with mild pancreatitis. In patients with severe attack and/or poor general condition, endoscopic sphincterotomy is a safe technique and deserves wider consideration in the management of severe acute pancreatitis for which delayed drainage of pancreatic necrosis may occasionally be required. PMID- 3322926 TI - [Ulcerohemorrhagic rectocolitis and Sneddon-Wilkinson sub-corneal pustulosis?]. PMID- 3322927 TI - [Complications in the performance of plasmapheresis and their prevention]. PMID- 3322928 TI - [The biological role of transferrin]. PMID- 3322929 TI - [The role of iron-containing blood proteins in the mechanism of accumulation and antineoplastic effect of gallium]. PMID- 3322930 TI - Frog brain and liver show evolutionary conservation of tissue-specific differences among insulin receptors. AB - The insulin receptors of frog brain and liver show features typical of other insulin receptors with regard to affinity and specificity of binding to insulins and proinsulin, solubility in Triton X-100, binding to and elution from wheat germ agglutinin, and insulin-sensitive tyrosine kinase activity. Likewise, the brain and liver receptors differ from one another in electrophoretic mobility and susceptibility to treatment with neuraminidase, analogous to brain and liver receptors of reptiles, birds, and mammals; while the functional implications of these differences are unknown, their evolutionary conservation for 400-500 million years suggests the possibility that they might have importance. PMID- 3322931 TI - Effects of castration on volumes of the preoptic nucleus and the amygdala and on immunoreactivity of LH-RH fibers in the brain of the toad, Bufo japonicus. AB - We examined the influence of castration on the volumes of sexually dimorphic nuclei, the amygdala pars medialis (Am) and lateralis (Al), and the anterior part of the preoptic nucleus, and on the immunoreactivity of luteinizing hormone releasing hormone (LH-RH) in brains of Japanese toads captured in spring and autumn. Animals were castrated (GnX) and half were implanted with testosterone (T) (GnX + T) and then killed and dissected after 1 month. Compared with sham operated (Sham) toads, plasma androgen levels in autumn toads were significantly decreased by the castration, and those in both spring and autumn GnX toads were significantly elevated by the T implantation. The volume of Am in autumn toads was significantly reduced by GnX. Although not significant, changes in the volumes of the other nuclei, except for Al in spring toads, showed the following tendency 30 days after the operation: GnX + T greater than Sham greater than GnX. GnX did not alter LH-RH immunoreactivity in the median eminence. However, dense immunoreactive LH-RH fibers were found in the mesencephalic tegmental region in spring GnX toads but not in the other operation groups in both spring and autumn. LH-RH immunoreactivity was not altered in autumn toads. In spring GnX toads, thumb pads degenerated and evoked release calling was infrequent. These results suggest that (i) the volumes of sexually dimorphic nuclei, especially Am in the autumn toad, are androgen-dependent, and (ii) castration can modulate activity of the extrahypothalamic LH-RH-ergic projection in toad brain. PMID- 3322932 TI - Etiologic heterogeneity in alcoholism. AB - Etiologic heterogeneity in alcohol abuse was evaluated in 195 extended pedigrees, comprising 288 nuclear families of 140 male and 55 female Caucasian American hospitalized alcoholics. Previous adoption studies in Sweden demonstrated differential heritability of two patterns of alcohol abuse in men: type-2 alcoholism exhibited early onset of abuse associated with criminal behavior, while type-1 abuse began at a later age, uncomplicated by antisocial traits. Alcohol abuse in female Swedish adoptees was relatively homogeneous and similar to the late-onset, type-1 abuse. The notion of etiologic heterogeneity, as suggested by the Stockholm Adoption Studies, was examined in the American pedigrees by contrasting the models of familial transmission of susceptibility to alcoholism obtained via segregation analyses of families of male versus female probands. Families of male probands demonstrated significant familial resemblance, accounted for by a multifactorial-polygenic background in addition to a major (gene) effect. In contrast, familial resemblance in the pedigrees of female probands was attributed solely to a multifactorial-polygenic effect. We considered whether some families of male alcoholics were similar to families of female probands, who expressed type-1 abuse predominantly. Pedigrees of male probands were separated in two groups: (1) "female-like" families had a better likelihood for the model obtained for families of female probands than the one for families of all male probands, (2) "male-like" families had a better likelihood for the model of familial transmission describing families of all male probands. A statistically significant difference in the pattern of familial transmission was observed between the "male-like" and "female-like" groups. Discriminant function analysis of alcohol-related symptoms showed that the familial subtypes differed in clinical features as well. Alcohol abuse by male relatives in "male-like" families was characterized by the early onset of inability to abstain entirely from alcohol or lack of desire to stop drinking; in contrast, abuse in "female-like" families was characterized by late onset of guilt feelings and loss of control over binge drinking. PMID- 3322933 TI - Plasma cholesterol variation in the National Heart, Lung and Blood Institute Twin Study. AB - Plasma cholesterol was measured in the fifth decade of the life of 249 pairs of monozygotic (MZ) and 262 pairs of dizygotic (DZ) World War II veteran twins and 70% of the same cohort 10 years later. There were no significant differences between the mean cholesterol values for MZ and DZ twins, and the within DZ pair mean squares were significantly larger than the within MZ pair mean squares for all of the cholesterol variables measured. However, the DZ twins were found to have greater total variance, positive skewness, and leptokurtosis than the MZ twins for total and high-density lipoprotein cholesterol, and the total/high density ratio. Comparisons with published data revealed that the variance of DZ twins was similar to that of singletons while the MZ twins have smaller total variance, perhaps owing to a missing component of variation. Hypotheses for the source of the differences in the zygosity distributions are proposed including environmental influences (pre- or post-natal and within- or among-families), genetic differences, and selection at the time of induction into the armed services. Because of the differences in total variance of the two zygosities it is difficult to know which estimates of genetic variance or heritability have the least bias. However, these data provide clues that may lead to further understanding of sources of plasma cholesterol variation that could be important to the future understanding of risk for coronary heart disease. PMID- 3322934 TI - Evidence for related functions of the RNA genes of Saccharomyces cerevisiae. AB - The yeast genes RNA2-RNA11 are necessary for splicing of nuclear intron containing pre-mRNAs. We investigated the relationships among these genes by asking whether increased expression of one RNA gene leads to suppression of the temperature-sensitive lethality of a mutation in any other RNA gene. The presence of extra plasmid-borne copies of the RNA3 gene relieves the lethality of temperature-sensitive rna4 mutations. A region of the yeast genome (SRN2) is described that suppresses temperature-sensitive rna2 mutations when it is present on either medium or high-copy number plasmids. Neither suppression occurs via a bypass of RNA gene function since null alleles of rna2 and rna4 are not suppressed by elevated dosage of SRN2 and RNA3, respectively. These results suggest that the SRN2 and RNA2 gene products have related functions, as do the RNA3 and RNA4 gene products. PMID- 3322935 TI - [The role of N. I. Vavilov in the development of Soviet genetics and animal selection]. AB - N. I. Vavilov had been greatly interested in the problems of animal industry, genetics, breeding, origin and evolution of domestic animals. Due to his initiative and active participation in discussing these problems, important programmes were developed. The unique ideas of Nikolai Ivanovich had significant impact on a rise of animal genetics in the USSR. PMID- 3322936 TI - Applying genetics to the splicing problem. PMID- 3322937 TI - Splicing of yeast nuclear pre-mRNA in vitro requires a functional 40S spliceosome and several extrinsic factors. AB - We have previously shown that extracts prepared from most of the yeast temperature-sensitive rna mutants are heat sensitive for pre-mRNA splicing in vitro, and that the products of the corresponding RNA genes are essential for the early stages of the splicing region. In this report, we demonstrate that most heat-inactivated mutant extracts do not form the spliceosome, suggesting that their gene products are likely to be involved in spliceosome formation. Heat inactivated rna2 extracts, on the other hand, do form a splicing-dependent 40S complex containing uncleaved pre-mRNA exclusively. The pre-mRNA in the 40S complex can be converted to the splicing products in the presence of ATP and complementing extracts. These results demonstrate that: (1) the 40S complex formed in heat-inactivated rna2 extracts is a spliceosome (termed the rna2 delta spliceosome), (2) the spliceosome is a functional intermediate in the splicing pathway, and (3) the splicing process can be dissected into two steps, spliceosome formation and cleavage-ligation reactions. Additional results indicate that at least two extrinsic factors, as well as the RNA2 gene product, are required for complementation of the rna2 delta spliceosome. A three-step mechanism for nuclear pre-mRNA splicing in yeast is proposed. PMID- 3322938 TI - GAL1-GAL10 divergent promoter region of Saccharomyces cerevisiae contains negative control elements in addition to functionally separate and possibly overlapping upstream activating sequences. AB - The upstream activating sequence (UASG) of the adjacent and divergently transcribed GAL1 and GAL10 promoters of Saccharomyces cerevisiae regulates the induction of the corresponding genes in response to the presence of galactose. We constructed chimeric yeast promoters in which a different UAS, UASC from the iso 1-cytochrome c (CYC1) gene of S. cerevisiae, was fused at different locations upstream of GAL1 (UASC-GAL1 promoters) or GAL10 (UASC-GAL10 promoters) and used to monitor the activity of UASG in cells grown in the presence or absence of galactose. Though the CYC1 promoter is fully induced in yeast grown in glycerol medium, UASC-GAL chimeric promoters containing UASG were repressed as much as 400 fold (UASC-GAL1) or 1350-fold (UASC-GAL10) in this growth medium. Several distinct portions of the GAL1-GAL10 divergent promoter region blocked the UASC induced expression of the GAL1 and GAL10 promoters, whereas others did not, suggesting that several distinct negative control elements are present that may repress transcription of GAL1 and GAL10 in the absence of galactose. The approximate locations of these negative control elements were delimited to sites adjacent to or possibly overlapping the sites at which the positive control protein GAL4 binds in UASG. Deletion derivatives of GAL4 that fail to induce transcription from the wild-type GAL promoters but retain the DNA binding domain significantly derepressed the expression of the UASC-GAL chimeric promoters. These results, combined with those of earlier studies, suggest the possibility that GAL4 normally induces transcription of GAL1 and GAL10 by blocking the activity of these negative control elements, in addition to stimulating transcription by a mechanism of positive control. PMID- 3322939 TI - The human myc gene family: structure and activity of L-myc and an L-myc pseudogene. AB - We have determined the nucleotide sequence and transforming activity of the human L-myc gene and a processed L-myc pseudogene (L-myc psi). We demonstrate by cotransformation assays that a 10.6-kb EcoRI fragment derived from a human placental library contains a complete and functional L-myc gene including transcriptional regulatory sequences sufficient for expression in rat embryo fibroblasts. Organization of the L-myc gene was determined by comparing its sequence to those of the L-myc psi gene and an L-myc cDNA clone derived from a human small cell lung carcinoma. Our results show that L-myc has a three-exon organization similar to that of the c-myc and N-myc genes. The putative L-myc gene product consists of 364 amino acids and contains five of the seven homology regions highly conserved between c-myc and N-myc. These conserved regions are located along the entire length of the putative L-myc protein and are interspersed among nonconserved regions. While the putative L-myc gene product is of a smaller size when compared to the c- and N-myc proteins, the relative positions of certain conserved residues occur in corresponding locations along the peptide backbone of the three proteins. In addition, comparison of the human and murine L-myc gene sequences indicate that the relatively large 5' and 3' untranslated regions are evolutionarily conserved, but that these sequences are totally divergent between the L-, c-, and N-myc genes. Finally, we demonstrate that, like the N- and c-myc genes, the L-myc gene can cooperate with a mutant Ha ras gene to cause malignant transformation of rat embryo fibroblasts in culture. Our analyses clearly prove that L-myc represents a functional member of the myc oncogene family and further delineate structural features that may be important for the common and divergent functions of the members of this gene family. PMID- 3322940 TI - Defects in lens fiber differentiation are linked to c-mos overexpression in transgenic mice. AB - We describe three strains of transgenic mice derived by embryo microinjection of DNA consisting of a long terminal repeat (LTR) of Moloney murine sarcoma virus (Mo-MSV) linked to the murine c-mos coding sequences. Southern analysis of the genomic DNA of these strains suggested that in each case the transgene had integrated at a different chromosomal location. The strains were characterized by dominant changes in secondary lens fiber differentiation. Shortly after birth, insufficient elongation of differentiating lens fibers and lack of basement membrane secretion resulted in breakdown of the posterior lens capsule. This, in turn led to posterior protrusion and swelling of lens tissue. In the course of the first 3 weeks after birth, globular lens cells began to fill the entire anterior and posterior chambers of the eye. Concomitantly, there was massive overexpression of c-mos RNA in the lens. Whereas this construct has high transforming activity when transfected into NIH-3T3 cells, no hyperplasia or neoplasia have been observed in the affected lenses. Increased expression of c mos RNA was not confined to the lens of the eye but has been detected in any of several tissues tested. PMID- 3322941 TI - Activation of a cryptic 5' splice site in the upstream exon of the phage T4 td transcript: exon context, missplicing, and mRNA deletion in a fidelity mutant. AB - A collection of 100 td mutants defective in phage T4 thymidylate synthase (TS) production was screened for splicing impairments. Splicing-defective mutants were identified by a rapid assay developed to detect imbalances in the td protein products (TS, the exon ligation product, and NH2TS, encoded by the pre-mRNA). Thirteen selected mutants, confirmed to be splicing defective by an RNA oligodeoxynucleotide hybridization assay, were all shown to be inhibited in the first step of the group I splicing pathway, cleavage at the 5' splice site. Of these, only one, SC99, appeared to be a specificity mutant. Whereas the 12 other mutants had sequence changes within the functionally important 5' and 3' domains of the intron, SC99 was shown to be an exon mutant. The G----A change at residue 3 of the upstream exon of SC99 resulted in loss of normal 5' splice site recognition. Furthermore, activation of a remote cryptic splice site at residue 29 of the upstream exon and missplicing of mRNA that is deleted for 29 nucleotides of the 5' exon are characteristic for this mutant. These results underscore the role of exon sequences in guiding the fidelity of the splicing reaction and they raise provocative questions about the alignment of introns within exon contexts that are consistent with accurate splicing and synthesis of an intact gene product. PMID- 3322942 TI - Diffusion of a smallpox epidemic in Launceston, Tasmania in 1903. PMID- 3322943 TI - The complete nucleotide sequence of the left very early region of Escherichia coli bacteriophage PRD1 coding for the terminal protein and the DNA polymerase. AB - DNA molecules replicating in a linear form have been found in certain viruses and plasmids of both prokaryotic and eukaryotic origin. Characteristic of this type of molecules are the proteins covalently linked to their 5' ends and inverted terminal nucleotide sequences. The molecules replicate via a protein-priming mechanism, where participants include terminal protein and a specific polymerase. We report here the nucleotide sequence of the left very early region of Escherichia coli bacteriophage PRD1. This region codes for the terminal protein and the phage DNA polymerase. The predicted amino acid sequence of the terminal protein does not share homology with those of other known terminal proteins. The PRD1 DNA polymerase shows four regions of extensive homology to that of Bacillus subtilis phage phi 29. One of these conserved regions is also found in several animal virus DNA polymerases. PMID- 3322944 TI - Localization of the T4 phage ribonucleotide reductase B1 subunit gene and the nucleotide sequence of its upstream and 5' coding regions. AB - The nucleotide (nt) sequence in a 757-bp [corrected] segment downstream from the intron-containing T4 phage thymidylate synthase gene (td) has been determined. This region was found to contain two open reading frames (ORFs). The first ORF(ORF2) [corrected] 261 bp [corrected] in length, is 24 [corrected] nt downstream from the td gene. The second ORF(ORF3) [corrected]) is 200 bp long at 558 [corrected] nt from the td gene and extends to the end of the Eco RI fragment. The amino acid (aa) sequence (66 aa residues) deduced from the second truncated ORF shows 59% homology to the sequence of the N-terminal portion of the ribonucleotide reductase large subunit of either Escherichia coli (B1 subunit) or mouse (M1 subunit). This tentatively identifies the truncated gene to be the 5' end of the T4 phage ribonucleotide reductase subunit B1 (nrdA) gene and pinpoints its exact location on the T4 phage genomic map. Southern hybridization analysis suggests good sequence homology among the nrdA genes of various T-even phages. PMID- 3322945 TI - Transformation of Aspergillus nidulans with the hygromycin-resistance gene, hph. AB - Aspergillus nidulans strain G191 was transformed to hygromycin resistance using plasmid pDH25, which contains the bacterial hygromycin B phosphotransferase gene (hph) fused to promoter elements of the A. nidulans trpC gene. Southern hybridizations of transformants revealed multiple, integrated copies of the vector. A pleiotropic effect conferring increased hygromycin B sensitivity was found to be associated with the A. nidulans pyrG89 allele. Plasmid pDH25 features a ClaI site immediately preceding the hph start codon thus permitting convenient replacement of the trpC sequences with other eukaryotic promoters. PMID- 3322946 TI - Cloning and expression in Escherichia coli of a recA-like gene from Bacteroides fragilis. AB - The recombinant plasmid pHG100, containing a 5.2-kb DNA fragment from Bacteroides fragilis, complemented defects in homologous recombination, DNA repair and prophage induction to various levels in an Escherichia coli recA mutant strain. There was no DNA homology between the cloned B. fragilis recA-like gene and E. coli chromosomal DNA. pHG100 produced two proteins with Mr of approx. 39,000 and 37,000 which cross-reacted with antibodies raised against E. coli RecA protein. The production of these proteins was not increased after UV induction. The cloned B. fragilis recA-like gene product did not enhance the production of native but defective E. coli RecA protein after UV irradiation. PMID- 3322947 TI - [Pathogenic effect of asbestos dust and problems of its prevention (review of the literature)]. PMID- 3322948 TI - [Antitumor drugs as an occupational factor (data from "The New England Journal of Medicine") (review of the literature)]. PMID- 3322950 TI - Free radical mechanisms in enzyme reactions. AB - Free radicals are formed in prosthetic groups or amino acid residues of certain enzymes. These free radicals are closely related to the activation process in enzyme catalysis, but their formation does not always result in the formation of substrate free radicals as a product of the enzyme reaction. The role of free radicals in enzyme catalysis is discussed. PMID- 3322949 TI - Protein oxidation and loss of protease activity may lead to cataract formation in the aged lens. AB - Over 95% of the dry mass of the eye lens consists of specialized proteins called crystallins. Aged lenses are subject to cataract formation, in which damage, cross-linking, and precipitation of crystallins contribute to a loss of lens clarity. Cataract is one of the major causes of blindness, and it is estimated that over 50,000,000 people suffer from this disability. Damage to lens crystallins appears to be largely attributable to the effects of UV radiation and/or various active oxygen species (oxygen radicals, 1O2, H2O2, etc.). Photooxidative damage to lens crystallins is normally retarded by a series of antioxidant enzymes and compounds. Crystallins which experience mild oxidative damage are rapidly degraded by a system of lenticular proteases. However, extensive oxidation and cross-linking severely decrease proteolytic susceptibility of lens crystallins. Thus, in the young lens the combination of antioxidants and proteases serves to prevent crystallin damage and precipitation in cataract formation. The aged lens, however, exhibits diminished antioxidant capacity and decreased proteolytic capabilities. The loss of proteolytic activity may actually be partially attributable to oxidative damage which proteases (like any other protein) can sustain. We propose that the rate of crystallin damage increases as antioxidant capacity declines with age. The lower protease activity of aged lens cells may be insufficient to cope with such rates of crystallin damage, and denatured crystallins may begin to accumulate. As the concentration of oxidatively denatured crystallins rises, cross-linking reactions may produce insoluble aggregates which are refractive to protease digestion. Such a scheme could explain many events which are known to contribute to cataract formation, as well as several which have appeared to be unrelated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3322951 TI - Free radicals in iron-containing systems. AB - All oxidative damage in biological systems arises ultimately from molecular oxygen. Molecular oxygen can scavenge carbon-centered free radicals to form organic peroxyl radicals and hence organic hydroperoxides. Molecular oxygen can also be reduced in two one-electron steps to hydrogen peroxide in which case superoxide anion is an intermediate; or it can be reduced enzymatically so that no superoxide is released. Organic hydroperoxides or hydrogen peroxide can diffuse through membranes whereas hydroxyl radicals or superoxide anion cannot. Chain reactions, initiated by chelated iron and peroxides, can cause tremendous damage. Chain carriers are chelated ferrous ion; hydroxyl radical .OH, or alkoxyl radical .OR, and superoxide anion O2-. or organic peroxyl radical RO2.. Of these free radicals .OH and RO2. appear to be most harmful. All of the biological molecules containing iron are potential donors of iron as a chain initiator and propagator. An attacking role for superoxide dismutase is proposed in the phagocytic process in which it may serve as an intermediate enzyme between NADPH oxidase and myeloperoxidase. The sequence of reactants is O2----O2-.----H2O2--- HOCl. PMID- 3322952 TI - [Induction and stimulation of immunologic defenses with Gynatren (Solco Trichovas) as an example of cause-related prevention and treatment of neoplasms]. PMID- 3322953 TI - [Heparin: current views, mechanism of action and the principles of therapy]. PMID- 3322954 TI - Absence of complement fixing antibodies against lipopolysaccharides from Escherichia coli in a subgroup of patients with Crohn's disease. AB - Complement fixing antibodies against different Escherichia coli lipopolysaccharides were determined in patients with Crohn's disease and in healthy individuals and compared with antitetanus toxoid antibodies. All healthy individuals had antilipopolysaccharide antibodies, 10 of 27 patients with Crohn's disease had no antibodies and six had rapidly changing antibody titres. These abnormalities were found in patients with disease in the colon, with arthropathy and fistula. Antilipid A was found at lower titres in Crohn's disease. Neither antitetanus toxoid antibodies, nor immunoglobulin concentrations were different in patients with or without antilipopolysaccharide antibodies. There was no evidence for circulating immune complexes in patients lacking antilipopolysaccharide antibodies. Certain subgroups of patients with Crohn's disease have altered antibody levels to typical enteral antigens which most likely can be explained by local antibody binding to lipopolysaccharides at inflammatory sites, or by changes in immunoregulation in this disease. PMID- 3322955 TI - Combined anti-muscarinic and H2 receptor blockade in the healing of refractory duodenal ulcer. A double blind study. AB - The purpose of this study was to determine if pirenzepine and cimetidine given together was superior to cimetidine alone in inducing healing of refractory duodenal ulcers which remained unhealed after treatment with cimetidine or ranitidine for at least eight weeks. One hundred and thirty one patients from six centres were randomised to receive either cimetidine (C) 800 mg daily or cimetidine 800 mg plus pirenzepine (C + P) 100 mg daily under double blind conditions for six weeks. The healing rate was similar in both groups, irrespective of the method of calculation. On an intent-to-treat analysis, healing was: C 66%, C + P 57%, and amongst the patients who completed treatment, healing was 70% in both groups. Patients on C and on C + P experienced a similar decrease in daytime and in night time pain. Side effects of treatment, notably dry mouth and blurred vision, were reported more often by patients on combination therapy. Combined treatment with cimetidine plus pirenzepine in patients with refractory duodenal ulcer is unlikely to be beneficial. PMID- 3322956 TI - Double blind study of ispaghula in irritable bowel syndrome. AB - A double blind placebo controlled trial of ispaghula husk in 80 patients with irritable bowel syndrome is reported. Global assessment judged treatment to be satisfactory in 82% of patients receiving ispaghula and 53% of the placebo group (p less than 0.02). Bowel habit was unchanged in the placebo group, while constipation significantly improved in patients taking ispaghula (p = 0.026). Transit time decreased significantly in those taking ispaghula compared with placebo (p = 0.001), especially in patients with initially high transit times. Abdominal pain and bloating improved in both groups, with no significant differences between ispaghula and placebo. Four of the eight withdrawals on ispaghula and 10 of the 15 withdrawals on placebo were because of treatment failure. Ispaghula significantly improves overall well being in patients with irritable bowel syndrome, and in those with constipation favourably affects bowel habit and transit time. PMID- 3322957 TI - Familial giant hypertrophic gastritis (Menetrier's disease). AB - Familial giant hypertrophic gastritis involving three generations is reported. A review of the literature, where approximately 200 cases are described, showed only few cases of familial occurrence of this disease, and only in siblings. Our findings suggest dominant heredity, but considering the sparsity of familial occurrence reported earlier, heredity seems to be of only minor pathogenetic significance. PMID- 3322959 TI - Mucus-bicarbonate barrier--shield or sieve. PMID- 3322962 TI - [Measuring uteroplacental circulation using radioisotopes and Doppler ultrasound]. PMID- 3322958 TI - Cystic fibrosis--a gastroenterological cornucopia. PMID- 3322961 TI - Cholangitis in the acquired immunodeficiency syndrome: report of two cases and review of the literature. AB - We report the cases of one patient with the acquired immunodeficiency syndrome as a result of human immunodeficiency virus type 1/lymphadenopathy associated virus type 1/human T-cell lymphotrophic virus type III (HIV-1/LAV-1/HTLV-III) infection and of another patient with AIDS related complex caused by human immunodeficiency virus type 2/lymphadenopathy associated virus type 2 (HIV-2/LAV-2) infection, who were suffering from cholangitis. The manifestations and possible mechanisms for cholangitis in these patients and in 10 previously reported similar cases are reviewed. PMID- 3322960 TI - Renal function in fulminant hepatic failure: haemodynamics and renal prostaglandins. AB - Eighteen patients with fulminant liver failure were studied, 10 with normal renal function (group A) and eight with renal failure (group B, plasma creatinine greater than 200 mumol/l). Renal function was assessed by standard clearance techniques and patients in group B had a marked reduction compared with group A in both renal plasma flow and glomerular filtration rate. Raised plasma renin activity was observed in both groups, but levels in group B were significantly higher than in group A. Renal prostacyclin production was estimated by radioimmunoassay (RIA) of 6-keto-prostaglandin F1 alpha in urine, and the excretion rate was markedly increased in group A as compared with nine healthy controls, but was low in group B. The plasma concentrations of 6-keto prostaglandin F1 alpha and thromboxane B2 were similar in groups A and B and were both significantly higher than in controls. Haemodynamic measurements showed a high cardiac output with low vascular resistance and mean arterial pressure within normal limits in both groups. The pulse pressure, however, was significantly higher in group B than in group A. In conclusion, patients in FHF with renal failure have marked renal vasoconstriction with increased plasma renin activity and reduced renal prostaglandin excretion indicative of an imbalance between vasoactive forces. PMID- 3322963 TI - [Clinical use of laser systems in gynecology]. PMID- 3322964 TI - [Ultrasound diagnosis in fetal growth retardation]. PMID- 3322965 TI - Maintenance of normal iron balance. PMID- 3322966 TI - The diagnostic value of serum ferritin determinations for assessing iron status. PMID- 3322967 TI - [Anti-estrogen therapy in laryngeal cancer--novel modality of treatment]. PMID- 3322968 TI - [Solar ultraviolet radiation, sunglasses and cataractogenesis]. PMID- 3322969 TI - [Treatment of autoimmune diseases]. PMID- 3322970 TI - [Amebiasis in Israel today: a review and the problem of treatment]. PMID- 3322971 TI - [Oral, slow release morphine for chronic pain]. PMID- 3322972 TI - [On Mozart's illness and the cause of his death]. PMID- 3322973 TI - [Tumor markers in cancer of the urinary and reproductive tracts]. PMID- 3322974 TI - [Physiological effects of thyroid hormone on bone]. PMID- 3322975 TI - [Measurement of plasma insulin levels--limitations and clinical applications]. PMID- 3322977 TI - [Exposure to ultraviolet light in the pathogenesis of SLE]. PMID- 3322976 TI - [The third component of complement (C3) and its contribution to the immune response]. PMID- 3322978 TI - [Digestive diseases in pregnant women]. PMID- 3322979 TI - [Peripheral blood T cell subpopulations and blocking antibodies in renal allograft recipients]. PMID- 3322980 TI - [Apnea in infancy. A: Pathogenesis, risks and diagnosis]. PMID- 3322981 TI - [Apnea in infancy. B: Prevention and management]. PMID- 3322982 TI - [Neonatal polycythemia and hyperviscosity syndrome--update]. PMID- 3322983 TI - [Evaluation of perinatal death--suggestion for a protocol and review of the literature]. PMID- 3322984 TI - [Depression in children]. PMID- 3322985 TI - [Lactic acidosis]. PMID- 3322986 TI - [Congenital syphilis]. PMID- 3322987 TI - [Convulsions in cardio-inhibitory syncope]. PMID- 3322988 TI - [The therapeutic approach to bronchiolitis--review of literature]. PMID- 3322989 TI - [The late Prof. Yehuda Matoth]. PMID- 3322990 TI - Effect of variation in temperature on development of Plasmodium berghei (NK 65 strain) in Anopheles stephensi. AB - Effect of temperature on the sporogonic cycle of Plasmodium berghei (NK 65) has been studied in vector Anopheles stephensi. To determine the optimum temperature for development of parasite, fed mosquitoes were kept at 16 +/- 1 degree C, 19 +/ 1 degree C and 26 +/- 1 degree C temperature. The temperature 19 +/- 1 degree C was found to be optimum for normal development of parasite within the vector. Sporulated oocysts were observed on the 10th day post feed and salivary glands were loaded with thousands of sporozoites on day 14. Temperature 16 +/- 1 degree C, though did not exert any deleterious effect on the morphology of parasites it delayed the development of sporozoites in the oocysts by 5 days as compared to control group. In the case of long exposure to this temperature, the sporozoites obtained from salivary glands became non-infective. Temperature 26 +/- 1 degree C was responsible for deterioration of all the stages of sporogonic cycle and it also checked the formation of sporozoites in the oocysts. PMID- 3322991 TI - Regulation of Dermacentor variabilis by limited dispersion of larvae from the egg mass (Acari: Ixodidae). PMID- 3322993 TI - A highly specific and sensitive sandwich enzyme immunoassay for human hemoglobin A. AB - A highly specific and sensitive sandwich enzyme immunoassay for human hemoglobin A (Hb A) is described. A rabbit anti-human Hb A IgG-coated polystyrene ball was incubated with human Hb A and subsequently with affinity-purified anti-human Hb A Fab'-horseradish peroxidase conjugates, which had been prepared before and after absorption with Japanese monkey Hb-Sepharose 4B and dog Hb-Sepharose 4B. Bound peroxidase activity was measured by fluorimetry using 3-(4 hydroxyphenyl)propionic acid as a substrate. The detection limits of human Hb A using the conjugate before and after the absorption were 0.65 pg/tube (3 X 10(10) fold dilution of whole blood) and 2.0 pg/tube (1 X 10(10)-fold dilution of whole blood), respectively. Human Hb A could be discriminated from Hb of animals such as Japanese monkey, dog, cat, pig, horse, sheep, chicken and cow by measuring bound peroxidase activity in the presence and absence of the conjugates prepared before and after the absorption. Human Hb A in bloodstains on cotton gauze could be discriminated from Hb of animals described above even after seven washings. Human Hb A in 220,000-fold diluted bloodstains on cotton gauze could also be discriminated from Hb of animals described above. PMID- 3322992 TI - Kidneys for transplant--"opting out" law in Singapore. AB - This paper is about the legislative attempt in Singapore to obtain more cadaver kidneys for transplants. It is a brief account of the major features of the bill which has become law since this note was written. The bill and the law are identical in this case. PMID- 3322994 TI - [Postoperative astigmatism following keratoplasty in keratoconus]. PMID- 3322995 TI - Keratoplasty for sclerocornea in early infancy. PMID- 3322996 TI - [Development of corneal sensitivity following keratoplasty]. PMID- 3322997 TI - [Experiences with simultaneous keratoplasty, cataract operation and lens implantation]. PMID- 3322998 TI - [In vivo cytologic follow-up of a freshly implanted intraocular lens]. PMID- 3322999 TI - [Microsurgery of injuries of the lacrimal canaliculus]. PMID- 3323000 TI - [Status of nuclear magnetic resonance tomography in comparison with ultrasound echography and computerized tomography in space-occupying lesions of the orbits and optic chiasm]. PMID- 3323002 TI - [Can disorders of cerebral performance be improved by drugs? Use of vaso- and metabolically active substances in primary degenerative brain diseases and cerebral arteriosclerosis]. PMID- 3323001 TI - [Digital subtraction angiography. Indications and value]. PMID- 3323003 TI - [Pathophysiology of painful and silent myocardial ischemia]. AB - Regardless of the factor assumed responsible for precipitation of myocardial ischemia - varying from coronary occlusion in acute myocardial infarction to increased oxygen demand in exertional angina pectoris and reduced myocardial oxygen supply due to plaque rupture or changes in vasomotor tone in unstable angina - its incurrence may or may not be associated with pain. In the vast majority of cases, silent myocardial ischemia is observed in patients with established symptomatic coronary artery disease. Interindividual comparisons have not enabled reliable differentiation between those with painful and those with silent ischemia based on the anatomic extent of coronary artery disease, left ventricular function or previous myocardial infarction. Similarly, functional parameters such as exercise capacity, exercise duration, time to onset of ST segment depression during exercise as well as heart rate and blood pressure both at rest and during exercise have failed to reveal differences between the symptomatic and the asymptomatic patients. Intraindividual differences have also been noted, but not consistently corroborated, and postulated as responsible for the fact that ischemia in a given patient alternates in its presence with and without pain. Since most patients with silent ischemia either have, or at some time in the past have experienced, painful ischemia, the integrity of the appropriate nervous system function can be assumed to be intact and neurocardiologic factors seem most likely to account for apparent discrepancies in pain perception. Prior to precipitation of pain, myocardial ischemia must elicit an adequate stimulus. According to some investigators, the adequate stimulus is that associated with a duration of the ischemic episode of at least three minutes and with increase in left ventricular filling pressure of more than 7 mm Hg. This threshold, consequently, represents a prerequisite but not invariably sufficient criteria for the occurrence of pain. The next step in the sequence of pain is generation of an action potential, that is, transduction by means of chemical or mechanical stimuli. During this process, a latency of 20 to 40 seconds is incurred such that the appearance of pain usually has its onset after derangement of relaxation and contraction, increased filling pressure and the observation of ECG changes. Through conduction, the information is forwarded to the central nervous system after coding of the details with regard to intensity. The intensity, in turn, is determined by the number of receptors (free nerve endings) in the field activated by the ischemic event.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323004 TI - Mechanisms of cardiac ischemic pain and coronary angiographic findings in patients with silent ischemia. AB - There is growing evidence that, in patients with coronary artery disease, the majority of transient ischemic events are not associated with angina pectoris or its equivalents. The mechanism responsible for painless ischemia has not been clearly elucidated; while a generalized decrease in sensitivity to algogenic stimuli or cardiac afferent denervation may play a role in some patients, other and more complex mechanisms modulating the peripheral and central coding and transmission of cardiac pain could be accountable. Differentiation between patients with silent myocardial ischemia and those with predominantly symptomatic disease cannot be reliably achieved on the basis of coronary angiographic findings or the duration and extent of the ischemic periods even though development of symptoms would appear more likely in those with severe and diffuse anatomical lesions. Nevertheless, the problem remains that totally asymptomatic individuals are apparently subject to the risk of sudden cardiac death, and myocardial infarction not substantially different from that of symptomatic patients are exposed. Consequently, with regard to the potential economic and logistic implications, the issue of identification of such persons is not merely of academic relevance and should be investigated diligently. Moreover, as for patients with clear-cut symptoms, therapeutic strategies should be defined individually on the basis of pathophysiological and prognostic considerations. PMID- 3323005 TI - State Medicaid policies and hospital care for AIDS patients. PMID- 3323007 TI - Views of a health policy activist: a conversation with Henry Waxman. Interview by John K. Iglehart. PMID- 3323006 TI - Foundations and the nation's health agenda. PMID- 3323008 TI - Trends in Medicaid eligibility: 1975 to 1985. PMID- 3323009 TI - Medicare reform: nibbling at catastrophic costs. PMID- 3323010 TI - Physician response to selective contracting in California. PMID- 3323012 TI - Lack of insulin effect on its own receptors in fetal rat hepatocytes. AB - To determine the effect of insulin on its receptor concentrations in hepatocytes of fetal and adult rats, these cells were preincubated in the presence or absence of insulin. The reduced [125I]-insulin binding observed in adult hepatocytes was dependent on the concentration of insulin and on the duration of exposure, while in fetal hepatocytes insulin did not induce any reduction in insulin binding. In contrast, glucagon receptors were unaffected by preincubation with insulin. The modifications observed in insulin binding were accounted for by changes in receptor concentrations rather than any change in receptor affinity for the hormone. Studies on the kinetic properties of the insulin receptors of fetuses and adult rats revealed that association and dissociation rates were undistinguishable. These results indicate an absence of insulin receptor down regulation in the fetus, which could favour anabolic processes during intrauterine life. PMID- 3323011 TI - Effect of age on the insulin secretory response of perfused rat pancreas to arginine and tolbutamide. AB - In this study we compared the ability of perfused pancreases from 2 1/2 month-old and 12 month-old rats to secrete insulin in response to arginine or tolbutamide. The results indicate that the insulin secretory response to either secretagogue was between 25-85% greater (two-way analysis of variance, P less than .01) by perfused pancreases of older rats. On the other hand, islet cell mass was approximately three-fold greater in the pancreases of the older rats. When this difference in mass of insulin secretory tissue was taken into consideration, it became apparent that insulin secretion per beta cell by perfused pancreases of the older rats was only half that of the younger rats in response to either arginine or tolbutamide (two-way analysis of variance, P less than 0.001). Thus, the decline with age in the ability of the beta cell to secrete insulin, previously noted in response to glucose, involves other insulin secretagogues as well. PMID- 3323014 TI - Cold-acclimation increases insulin sensitivity of brown adipocytes. PMID- 3323013 TI - Influence of insulin on plasma concentration and renal excretion of sodium and potassium in normal, electrolytes depleted and aldosterone treated dogs. AB - Effects of insulin on plasma concentration and renal excretion of sodium and potassium were compared in conscious dogs 1) maintained in water and electrolytes balance (Series 1, 10 dogs), 2) depleted of electrolytes by repeated i.v. loading with 20% mannitol (Series 2, 10 dogs), and 3) aldosterone treated (0.8 micrograms.kg-1.h-1 i.v., Series 3, 10 dogs). In each Series intravenous infusion of insulin at a rate of 0.05 U.kg-1.h-1 elicited transient increase in plasma sodium concentration and prolonged hypokalemia. Repeated loading with mannitol in Series 2 elicited significant elevation of plasma sodium, ADH and aldosterone concentrations, as well as decrease in extracellular fluid volume. Infusion of insulin in this Series elicited smaller decrease in plasma potassium concentration and longer lasting hypernatremia than in dogs in water-electrolytes balance. Aldosterone infusion in Series 3 did not change hypokalemic effect of insulin but attenuated hypernatremia. Infusion of insulin in Series 1 elicited increase of sodium excretion and decrease in potassium excretion. These effects were absent in Series 2 and 3. The results indicate that depletion of electrolytes and blood aldosterone elevation modify the effects of insulin on plasma concentration and renal excretion of sodium and potassium. PMID- 3323016 TI - Metabolite levels in the spontaneously diabetic rat. PMID- 3323015 TI - Serum alkaline phosphatase in rats with streptozotocin-induced diabetes. PMID- 3323017 TI - The ovarian hyperstimulation syndrome. PMID- 3323018 TI - Lessons from the pathology of the diabetic pancreas. AB - Different events such as virus infections, toxins, nutritional factors, antiinsulin antibodies may be rendered responsible for the pathological changes in the pancreatic B-cell and result in a diabetic state in the postnatal, adolescent or adult age. These different interferences which may lead to the diabetic state need full consideration and assessment if prevention and cure are to be considered. PMID- 3323019 TI - 32P, 86Rb+ and 45Ca2+ handling by tumoral insulin-secreting cells (RINm5F line). AB - In perifused tumoral islet cells (RINm5F line), which were prelabelled with either [32P]orthophosphate, 86Rb+ or 45Ca2+, the administration of D-glucose (1.4, 2.8 or 16.7 mM) increased the efflux of 32P, decreased the outflow of 86Rb, increased slightly the efflux of 45Ca from cells perifused in the presence of Ca2+, and decreased modestly the outflow of 45Ca from cells perifused in the absence of Ca2+. D-glucose also stimulated the net uptake of 45Ca2+. When Ba2+ (2 mM) was used, in the absence of Ca2+, instead of D-glucose as an insulin secretagogue, the efflux of 32P was little affected, but the outflow of 45Ca was dramatically increased. These changes are qualitatively similar to those occurring in normal islet cells. Nevertheless, the ionic response to D-glucose appeared, as a rule, less marked in tumoral than normal islet cells. Moreover, the concentration-response relationship was shifted to a lower range of hexose concentrations in the RINm5F cells. PMID- 3323020 TI - Further evidence that prolactin does not affect gonadotropin release at pituitary level. AB - In a primary monolayer cell culture of the anterior pituitary from mature male rats the effects of exogenous rPrl (rPrl exog.) and endogenously secreted rPrl (rPrl endog.) on basal and LHRH stimulated LH secretion were investigated. In pilot studies basal Prl- and LH secretion as well as influence of various LHRH concentrations (10(-1)-10(+3) ng/ml) on Prl- and LH release were observed. The influence of exogenous rPrl was studied at various concentrations (50-500 ng/ml) and with preincubation periods of 2 hrs and 6 hrs before starting LHRH stimulation. The dopamine agonist bromocriptine and the dopamine antagonist sulpirid were preferentially used to prove physiologic function of the cell system presented. Basal LH secretion started after a delay of 3 hrs, whereas basal Prl secretion began immediately showing a linear rise for 9 hrs. LHRH stimulation resulted in a non-linear dose and time dependent LH secretion. LHRH showed no influence on endogenous Prl (rPrl endog.) secretion of the mammotroph cells. Exogenous Prl (rPrl exog.) did not affect spontaneous Prl release excluding ultra short loop inhibition in this cell system. Furthermore, exogenous Prl had no effect on either basal or LHRH stimulated LH secretion even after a preincubation period of up to 6 hrs and at concentrations generally observed for prolactin secreting tumors. Bromocriptine suppressed endogenous Prl release and did not affect LH secretion. Sulpirid had no influence on either Prl or LH secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323021 TI - The clinical relevance of pancreatic B-cell hyperplasia, hyperinsulinism and insulin insensitivity in non-insulin dependent diabetes mellitus. PMID- 3323022 TI - Viral and immune-mediated factors in the pathogenesis of psychiatric disease. AB - The available data supporting a viral or immune mediated etiology of psychiatric disease is indirect and controversial, but there is a sufficient evidence to implicate such a process in a subgroup of the psychiatric population. Recent technological advances in neurovirology and neuroimmunology justify a re assessment of this etiology in psychiatric disease. The author describes three patients with psychiatric symptomatolgy and cerebrospinal changes compatible with such a process. The evidence supporting a role for viral or immunological factors in the pathogenesis of psychiatric disease is reviewed, and guidelines for future research which could be of use in further clarifying this issue are proposed. PMID- 3323023 TI - Antipsychotic effects of verapamil in schizophrenia. AB - The antipsychotic effects of verapamil were tested in a double-blind, placebo controlled, randomized study in 18 patients who met Research Diagnostic Criteria for acute schizophrenia. The antipsychotic effect of verapamil as measured by the Bunney-Hamburg Global Rating Scale were equal to those of haloperidol. Both verapamil and haloperidol were superior to placebo in decreasing psychotic symptoms. The results indicate that verapamil may have clinical utility in the treatment of schizophrenia. PMID- 3323024 TI - External trauma as the sole cause of psychopathology is overly simplistic. PMID- 3323025 TI - The effect of luteinizing hormone releasing hormone on the copulatory behavior of hyperprolactinemic male rats. AB - The present study was undertaken to test the hypothesis that the deficits in copulatory behavior observed in hyperprolactinemic male rats may be related to a reduction in hypothalamic release of luteinizing hormone releasing hormone (LHRH). Adult male Fischer 344 rats were made hyperprolactinemic by ectopic pituitary grafts or were sham operated and 30 min prior to being tested for copulatory performance received a single subcutaneous injection of 500 ng LHRH, 100 ng LHRH, or saline. On different occasions, testosterone (T) levels were measured in plasma collected 30 min following identical treatments. Plasma prolactin (PRL) levels were determined in samples collected 30 min after injection of 500 ng LHRH. Pituitary grafting produced the expected, significant increase in plasma PRL levels and significant deficits in copulatory behavior. Treatment of hyperprolactinemic subjects with 500 ng LHRH significantly reduced both the time to first intromission and the time to ejaculation to times comparable with those of sham-operated subjects. The 100-ng dose produced a significant reduction in mount frequency. Plasma T levels were significantly elevated following either dose of LHRH. These results demonstrate that exogenous LHRH can restore normal copulatory performance in hyperprolactinemic male rats and support the hypothesis that a reduction in hypothalamic LHRH release is responsible for the behavioral deficits observed in those animals. PMID- 3323026 TI - Androgens exert opposite effects on body mass of heavy and light meadow voles. AB - The influence of gonadal hormones on body mass of adult male meadow voles varied systematically as a function of the animals' baseline body weight; heavier voles decreased and lighter voles increased their body mass after castration. Testosterone replacement reversed the effects of castration; changes in body mass during hormone treatment were negatively correlated with changes observed after castration. Body mass of intact males was not correlated with plasma testosterone titers. Individual differences in body mass of male voles appear to reflect variations among animals in substrate responsiveness to hormones rather than differences in circulating hormone levels. PMID- 3323027 TI - Bacterial vaginosis in women attending STD clinic: diagnostic criteria and prevalence of Mobiluncus spp. AB - The diagnostic criteria of bacterial vaginosis (BV) and the prevalence of Mobiluncus spp as detected by monoclonal antibodies were investigated in all new women patients attending the sexually transmitted disease (STD) clinic in Uppsala during a four month period. Of 455 patients, 164 fulfilled the generally accepted criteria for BV, but in 57 of them simultaneous infection with a recognised pathogen was diagnosed. BV was thus the only clinical diagnosis in 107 (24%) of the women. The sniff test and clue cells in the wet smear were the two criteria most relevant for the diagnosis of BV. The sniff test was positive in 95% (156) of the 164 patients with BV and negative in all other cases. The corresponding figure for the clue cells was 98% (160 of 164), but clue cells were also detected in 19 patients without BV. Though 99% (162) of women with BV had a vaginal pH of more than 4.5, so did 83 women without BV. Only 59% (96) of women fulfilling the criteria of BV had a characteristic discharge. Mobiluncus spp were present in 20% (90) of the 455 women and in 50% (53) of the 107 women with BV only. Of the 90 Mobiluncus spp isolates, M curtisii comprised 44% (40), M mulieris 34% (31), and both strains together 21% (19). Mobiluncus spp were detected with monoclonal antibodies in 35 women who had no motile curved rods on wet smear microscopy. Furthermore, Mobiluncus spp were often detected in women infected with recognised pathogens, as well as in a few women without signs of genital infection. PMID- 3323029 TI - Sonographic detection of inferior venacaval tumour thrombus from renal cell carcinoma--a case report. PMID- 3323028 TI - Cryotherapy compared with trichloroacetic acid in treating genital warts. AB - In an observer blind comparative study, 130 men with penile warts were randomly allocated to treatment with either cryotherapy or trichloroacetic acid (TCAA). There was no significant difference in response to treatment, side effects, or recurrence rates between the two treatments. Warts resolved in 81% of patients treated with TCAA compared with 88% of those treated with cryotherapy. Early recurrence occurred in 36% of patients treated with TCAA and in 39% of those treated with cryotherapy. PMID- 3323030 TI - Identification of the site on IgG Fc for interaction with streptococci of groups A, C and G. AB - The interaction between living groups A, C and G streptococci and IgG Fc was studied using human IgG, IgG Fc and IgG Fc-intermediate (Fci) fragments, chemically modified human IgG and fragment D of staphylococcal protein A (SPA). Diethylpyrocarbonate modification of His or N-acetylimidazole modification of Tyr of human IgG resulted in the loss of its capacity to inhibit the binding of radiolabelled human IgG Fc to the group A streptococci types M1 and M55, and to the group C strain SC-1, indicating that the amino acids His and Tyr are involved in the binding. Lys seems not to participate in the binding of IgG to these bacteria, however, since reductive methylation of Lys did not reduce its inhibitory capacity. Fragment D of SPA also inhibited the binding of radiolabelled human IgG Fc to strains M1, M55 and SC-1. We have previously shown that these bacteria do not bind to IgG fragments consisting of only the C gamma 2 or C gamma 3 domains. On the basis of these results, and the known relative positions in space of the His and Tyr residues on IgG Fc, it is speculated whether streptococci with IgG Fc receptors, like SPA and rheumatoid factors, interact with IgG in the interface between the C gamma 2 and C gamma 3 domains and involve His 435 and one or more of Tyr 436, His 433 and His 310. The similarities in binding sites on IgG for RFs and these bacterial Fc binding proteins suggest structural similarities between them that may be relevant to the production of rheumatoid factors in rheumatoid arthritis. PMID- 3323031 TI - Contribution of immunoglobulin-secreting cells in the murine small intestine to the total 'background' immunoglobulin production. AB - In this study we investigated the contribution of the small intestine of C3H/He mice to the spontaneous ('background') immunoglobulin (Ig) production in terms of the number of Ig-secreting cells (Ig-SC), and compared the results with the numbers of Ig-SC found in various lymphoid organs (spleen, bone marrow, mesenteric lymph nodes and Peyer's patches). The results show that in C3H/He mice of 20 weeks of age, on average 16 x 10(6) Ig-SC can be isolated from the small intestine. Almost all of these Ig-SC produce IgA. Compared to the other lymphoid organs, the small intestine contains more than 80% of all Ig-SC present in adult C3H/He mice. These results are in agreement with the need to maintain relatively high levels of Ig at the mucosal surfaces, especially of secretory IgA, for the prevention of penetration of these surfaces by micro-organisms. In man and mouse most of these Ig are supposed to be produced locally in the underlying mucosal tissues and subsequently transported across the epithelium. Although the IgM and IgG levels in serum are predominantly maintained by non-mucosae associated lymphoid organs, the results of this study clearly indicate that the mucosal tissues are the major site of 'background' Ig-production. PMID- 3323032 TI - The Ity/Lsh/Bcg gene significantly affects mouse resistance to Mycobacterium lepraemurium. AB - Mouse resistance to infection with Mycobacterium lepraemurium was measured by counting the total number of intact acid-fast bacilli in the spleen 8 weeks after i.v. injection of a standard inoculation. The effect of Ityr on resistance to M. lepraemurium was confirmed and the results extended to two Ityr strains of mice, A and C57L, not previously tested. Resistance to M. lepraemurium was also examined in the F1, backcross and F2 generations of BALB/c X CBA crosses, and in the congenic strain B10.LLshr that is Ityr. In all experiments the results were consistent with the view that resistance to M. lepraemurium is significantly affected by a gene close to or identical to the Ity/Lsh/Bcg gene on mouse chromosome 1. Sex had a marked effect on resistance to M. lepraemurium, so that the males of some genetically resistant strains were almost as susceptible as some genetically susceptible females. PMID- 3323033 TI - Phenotypic expression of mast cell granule proteinases. Distribution of mast cell proteinases I and II in the rat digestive system. AB - The distribution of mast cell granule proteinases in the rat digestive system was determined immunohistochemically. The population of toluidine blue-staining mast cells was accounted for by cells containing either rat mast cell proteinase I (RMCPI) or rat mast cell proteinase II (RMCPII). Granules in greater than 90% of RMCPI-containing cells stained red after the Alcian blue/safranin sequence, whereas all RMCPII-containing mast cells stained blue. The red/RMCPI phenotype was typical of the connective tissue mast cells (CTMC) that populate the proximal, non-mucosal, regions of the digestive system, and was also abundant in the serosa and in rectal and gastric muscularis. The blue/RMCPII phenotype, absent from non-mucosal sites except for rare cells in intestinal submucosa and muscularis, predominated in all mucosal tissues and resembled mucosal mast cells (MMC). A third, minor population of cells containing RMCPI but staining blue in the Alcian blue/safranin sequence was detected in both non-mucosal and mucosal tissues. Blue/RMCPI mast cells were rare in the small intestine but more frequent in the mucosa of the stomach and large intestine and in the connective tissues. It is suggested that granule proteinase phenotyping may provide an alternative technique in the analysis of mast cell heterogeneity. PMID- 3323034 TI - Characterization and mast cell origin of a chymotrypsin-like proteinase isolated from intestines of mice infected with Trichinella spiralis. AB - A proteinase was purified by cation exchange and affinity chromatography from the small intestines of mice infected with Trichinella spiralis. The enzyme was highly soluble and was chymotrypsin-like in its substrate specificities and susceptibility to inhibitors. It had a MW of 26,000, as determined by SDS-PAGE electrophoresis. Antibodies raised against the proteinase were affinity purified and their specificity confirmed by Western blot analysis. When used to localize the enzyme immunohistochemically, they reacted with granules of mast cells in the epithelium and lamina propria of the parasitized small intestine. The antibodies also bound to mast cell granules in a number of other sites, including tracheal epithelium, gastric mucosa, skin and tongue. Affinity-purified antibodies raised against rat mast cell proteinase II (RMCPII) cross-reacted with the mouse mast cell proteinase on Western blots. PMID- 3323036 TI - Effect of oxidation on the conformation of cell surface H-2 antigens detected by monoclonal antibodies. AB - Periodate treatment of lymphoid cells is known to render them susceptible to nonspecific lysis by cytotoxic T lymphocytes. To detect alterations in cell surface molecules as a result of such treatment, we investigated the binding of antibodies to oxidized and nonoxidized lymphoid cells and found that oxidation selectively decreases the binding of some anti-H-2 and anti-beta 2m antibodies. This effect was not caused by loss of H-2 molecules from the cells, since the rate of exchange of cell surface beta 2m by exogenously added beta 2m was unchanged, and neither H-2 nor beta 2m molecules could be detected in the supernates of oxidized cells. Our findings suggest that oxidation alters the conformation of H-2 antigens in such a way as to reduce antibody binding. Such conformational changes may further affect the recognition of histocompatibility antigens by cytotoxic T cells. PMID- 3323035 TI - Allergen-specific leukocyte adherence inhibition (LAI) assay: sensitivity, specificity and mechanism. AB - An allergen-specific tube leukocyte adherence inhibition (LAI) assay has been developed in order to study the mechanism by which leukocytes lose their normal property of adherence to glass. Peripheral blood leukocytes (PBL) from 27 individuals allergic to Dermatophagoides farinae (DF), 10 with seasonal rhinitis not induced by DF and 49 non-allergic healthy volunteers were challenged in vitro with DF and a non-relevant allergen, Artemisia vulgaris (AV) and then assayed for the ability to adhere to glass tubes. Challenge by DF, but not by AV, resulted in loss of adherence by PBL from patients allergic to DF, but not in those of normal controls. The specific LAI response was dose-dependent and occurred only when a critical dose of 0.5 X 10(3) was employed. Following in vitro challenge with DF, radio-immunoassay using an antiserum to LTC4 detected immunoreactive material in supernatants of PBL from DF-allergic individuals. When highly enriched mononuclear cells from non-allergic individuals were armed with cytophilic allergen-specific IgE and challenged with the specific allergen, they lost the property of glass adherence and released a substance that was immunoreactive with LTC4. The results suggest that the chain of events leading to the LAI response in PBL from allergic individuals involves primary recognition of the allergen by specific IgE antibodies bound to receptors on mononuclear cells. The cells are thus triggered to synthesize cysteinyl-containing leukotrienes which mediate the LAI phenomenon. The results suggest that this assay may be used to study allergen antibody interaction and the subsequent events leading to the clinical picture of atopic diseases. PMID- 3323037 TI - The effect of thymopoietin 32-34 (TP3) on suramin-induced inhibition on delayed type hypersensitivity in guinea pigs. AB - Suramin administration inhibits virus replication and produces impaired immunoregulation. Delayed type hypersensitivity (DTH)-reaction was inhibited by Suramin (200 mg/kg, i.p.) injection in guinea-pigs immunized with BCG vaccine. Suramin-inhibited DTH-reaction was restored to normal level after 4 days of treatment with thymopoietin 32-34 (TP 3) and TP5 (1 mg/kg, i.p.), TP3 greater than TP5. TP3 produced the strongest restoration when applied together with Suramin, but a single treatment with TP3 or TP5 oligopeptide inhibited the development of DTH-reaction. TP3 with Suramin treatment might be advantageous to eliminate defective side effects of Suramin on immune system and TP3 with indirect inducing action on IL-2, IFN-gamma production may be useful in therapy of AIDS patients. PMID- 3323038 TI - Culture of embryonic mouse brain cells in vitro. PMID- 3323039 TI - Antibiotic resistance & serotypic variations in Escherichia coli induced by disinfectants. PMID- 3323041 TI - Urinary sodium & plasma renin activity following renal transplantation. PMID- 3323042 TI - Lymphocyte surface markers profile in acute lymphoblastic leukaemia. PMID- 3323040 TI - Effect of pre- & post-weaning protein energy malnutrition on intestinal sucrase & maltase in rats. PMID- 3323043 TI - Experimental production of cardiac injury in rhesus monkeys by L-forms of group-A streptococci. PMID- 3323044 TI - Computerized tests to predict risk for developing diabetes mellitus. PMID- 3323046 TI - General analytical considerations for the sampling of tobacco smoke in indoor air. PMID- 3323045 TI - Hemolytic uremic syndrome. PMID- 3323048 TI - The analysis of the particulate and vapour phases of tobacco smoke. PMID- 3323047 TI - Formation and physicochemical nature of sidestream smoke. PMID- 3323049 TI - Indoor concentrations of environmental tobacco smoke: field surveys. PMID- 3323050 TI - Sampling and analysis of phenols in sidestream smoke and indoor air. PMID- 3323051 TI - Indoor concentrations of environmental tobacco smoke: models dealing with effects of ventilation and room size. PMID- 3323052 TI - Significance of exposure to sidestream tobacco smoke. AB - The presence of toxins and carcinogens in ambient air polluted with tobacco smoke is largely due to the sidestream smoke emissions from the smouldering tobacco products. Levels of these toxins and carcinogens in sidestream smoke often exceed their concentrations in mainstream smoke. Dosimetry of tobacco-specific markers of exposure in physiologic fluids suggests that in regard to nicotine--which is the major tobacco alkaloid--exposure of humans to environmental tobacco smoke causes but a few percent of the nicotine levels reached as a result of active inhalation of cigarette mainstream smoke. Yet, this measurement of exposure is not universally applicable to all of the tobacco smoke pollutants in this complex matrix. Existing knowledge of the chemical composition of sidestream smoke and evidence of biological activity of sidestream smoke components suggests that this environmental pollutant has carcinogenic potential. Significance of exposure to environmental tobacco smoke must be evaluated on the basis of the severity of the pollution, the duration of exposure and personal variations in uptake. PMID- 3323053 TI - Radioimmunoassay for nicotine and cotinine. PMID- 3323054 TI - Uptake of environmental tobacco smoke. AB - This chapter has reviewed evidence of the uptake of smoke constituents by nonsmokers through exposure to environmental tobacco smoke. Although carbon monoxide absorption reflects an acute exposure, nicotine and its metabolite cotinine are the best markers currently available. Nicotine is found in measurable concentrations in the saliva and urine of most urban nonsmokers, and is present in higher concentrations in those with some recent exposure. But the short half-life of nicotine in the body means that it is best suited to quantifying exposure over a period of a few hours only. Cotinine, which has a half-life of about one day, has been shown to be a valid and sensitive marker of current daily-life exposure to environmental tobacco smoke. Estimating the magnitude of the passive smoking dose is difficult, and it is of doubtful validity to extrapolate from the uptake of one marker to that of another. Over a period when one cigarette-equivalent of carbon monoxide is absorbed, the dose of nicotine appears to be only between one-tenth and one-third of a cigarette equivalent. Measures of tar deposition are not available, but nicotine is probably a better guide than carbon monoxide to the size of the tar dose. It seems unlikely that nonsmokers could absorb more than one or two mg of nicotine in a day, even if they spend the majority of their waking hours in heavily smoke polluted atmospheres. Comparison of cotinine concentrations in urban nonsmokers and active smokers suggests that average nonsmokers may receive a dose of about 0.2 mg of nicotine per day. This is a preliminary estimate which depends on a number of assumptions and will be subject to revision as data accumulate on more representative samples. Finally, the confirmation that dose-response relationships exist between cotinine concentrations and self-reported passive smoking validates questionnaire measures of the degree of environmental smoke exposure. Epidemiological studies which suggest that passive smoking carries a risk to health thereby gain increased credibility. But future progress in understanding will be best assured if epidemiological methods and biological monitoring of exposure markers are combined in the same studies. PMID- 3323055 TI - Acute effects of environmental tobacco smoke. PMID- 3323056 TI - Epidemiological studies of passive smoking. PMID- 3323057 TI - Personal, biological and air monitoring for exposure to environmental tobacco smoke. PMID- 3323059 TI - A personalized history of the Clark oxygen electrode. PMID- 3323060 TI - Mixed venous hemoglobin saturation: theory and application. AB - SvO2 measurement by reflectance oximetry incorporated into a thermodilution catheter is a reliable method of assessing the adequacy of oxygen delivery and is currently the best method of continuously monitoring oxygen supply-demand relationships. The SvO2 measurement continuously monitors the tissue status of oxygenation. It is an early warning indicator of detrimental changes in supply and demand and is an on-line tool in guiding therapeutic management and evaluating the effectiveness of interventions. SvO2 monitoring is of value in the critically ill cardiac and general surgical patients, not only during the surgical intervention but also in the postoperative period when managing derangements of ventilation and circulation. In our experience, continuous surveillance of the SvO2 currently is the best rapidly responsive indicator of cardiopulmonary function and oxygen transport. PMID- 3323058 TI - Effect of cholinesterase inhibitors on acetylcholine and insulin induced glucose uptake and certain hepatic enzymes in pigeon liver: an in vitro study. AB - Insulin and acetylcholine (ACh) are both known to promote glucose uptake by liver of birds. Acetylcholine induced glucose uptake can be predictably potentiated by inhibiting acetylcholinesterase activity. Monocrotophos, acothione (organophosphorus compound) and prostigmine are known inhibitors of acetylcholinesterase (AChE). In the present study the action of these three inhibitors of AChE alone as well as in combination with insulin and acetylcholine on in vitro glucose uptake by pigeon liver slices was investigated. Both organophorus compounds potentiated the action of insulin as well as acetycholine mediated glucose uptake by liver slices while prostigmine had inhibitory influence. The three compounds also induced alterations in enzyme activities in the liver slices. These results are discussed in detail in the text. PMID- 3323061 TI - Pulse oximetry: technical aspects of machine design. PMID- 3323063 TI - Theory and development of fluorescence-based optochemical oxygen sensors: oxygen optodes. AB - As the preceding considerations concerning the physical and technical features of oxygen optodes have demonstrated, fluorescence-based optochemical oxygen sensors possess certain advantages and peculiarities compared to conventionally applied electrochemical sensors such as polarographic oxygen electrodes. First, in contrast to oxygen electrodes, oxygen measurements with oxygen optodes do not suffer from distortions caused by the reference electrodes. In addition, because of the polarographic process, platinum electrodes continuously consume oxygen, which falsifies the results, especially when small sample volumes or long-term measurements, or both, are involved, whereas the sensor layer of oxygen optodes must only be equilibrated. Moreover, the surface of the platinum wire has to be catalytically clean in order to obtain a plateau of the polarogram and, consequently, to achieve a low rest current at zero PO2. Unfortunately, the demand for catalytically clean platinum surfaces turns out to be rather critical, since surface contamination occurs even with membranized electrodes, resulting in the well-known phenomenon of "electrode poisoning." The question of the specificity of oxygen electrodes also must be considered. In this context, CO2 and halothane may interfere with oxygen measurements, whereas fluorescence quenching is unaffected by CO2 and halothane affects the measurements only slightly, depending on the special indicator used. Furthermore, because of the flow dependence, oxygen measurements with the oxygen electrode show a distinct "stirring effect" caused by the turbulence in front of the electrode, which disturbs the diffusion field. Because of the completely different physical principle of fluorescence optical sensors, such influences are not observed with oxygen optodes. In addition, isolation and shielding of electrical circuits found in electrodes are not necessary for optodes. Furthermore, the sensitivity of oxygen optodes can be tuned to the desired range of PO2 values, resulting in a higher resolution. Use of suitable polymer alloys as indicator matrices can even enhance oxygen sensitivity; therefore, the application of optodes for trace analysis of oxygen might be possible, especially with regard to the application of highly oxygen-sensitive phosphorescent indicators. Finally, owing to the reversibility of fluorescence quenching, monitoring of oxygen by fluorescence optical sensors allows a continuous and remote control of biomedical parameters as well as regulation of biotechnological processes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323062 TI - Pulse oximetry: applications and limitations. AB - The pulse oximeter estimates arterial hemoglobin saturation by measuring the light absorbance of pulsating vascular tissue at two wavelengths. The relationship between measured light absorbances and saturation was developed empirically and is built into the oximeter software. Studies in human volunteers have shown good performance of the device in healthy adults for saturations in the range of 70 to 100%. Studies in the operating room and intensive care unit have established its clinical accuracy and usefulness. The pulse oximeter has already found a number of clinical applications outside of the operating room, such as monitoring during patient transport, respiratory monitoring during narcotic administration, and evaluation of home-oxygen therapy. To use this monitor to its full potential, we must be aware of its limitations as well as its advantages. Because of the nature of the HbO2 dissociation curve, saturation measurements will not be sensitive to changes in PaO2 when the PaO2 is greater than 100 torr. This also implies that the pulse oximeter may fail to detect an inadvertent endobronchial intubation in the operating room. It may take minutes to detect an esophageal intubation in a well-preoxygenated patient. When desaturation does occur, the pulse oximeter detects it quickly, accurately, and reliably. Since the pulse oximeter uses two wavelengths of light, it cannot distinguish more than two hemoglobin species. Thus, COHb and MetHb will cause errors in SpO2 if present in large amounts. Intravenously administered dyes can also cause errors because of their absorbance properties, particularly methylene blue and indocyanine green. The pulse oximeter may be unable to detect an adequate signal during abnormal hemodynamic conditions. The pulse oximeter is one of the most important advances in noninvasive monitoring because it provides a means of continuously and quickly assessing arterial blood oxygenation. It is easy to use and interpret, requires little setup time, and poses no additional risks to the patient. Pulse oximetry may soon be a standard of practice for routine monitoring in any clinical setting in which the patient is at risk of hypoxemia. PMID- 3323064 TI - Intra-arterial oxygen tension monitoring. PMID- 3323065 TI - Theory and development of transcutaneous oxygen pressure measurement. PMID- 3323066 TI - Transcutaneous oxygen measurement: experimental studies and adult applications. AB - Transcutaneous PO2 sensors have been developed over the past ten years from the same basic electrodes used in conventional blood-gas machines. The skin is heated to enable the skin surface sensors to respond quickly to the gas tensions beneath them. PtcO2 is a variable that reflects the PO2 in the peripheral tissue. PtcO2 has its own range of normal values, and it responds to cardiopulmonary changes that affect tissue oxygenation. In most patients, those without decreased cardiac output, PtcO2 follows the trend of PaO2 and decreases relative to PaO2 with increasing patient age (see Table 2). In the presence of severely reduced cardiac output and peripheral perfusion, the PtcO2 values will deviate from their relationship with the arterial tensions and become blood flow dependent, thus providing quantitative information regarding blood flow. The technique of PtcO2 monitoring likely will gain wider acceptance because it is a noninvasive and continuous monitor that provides useful information regarding tissue oxygenation. PMID- 3323067 TI - Conjunctival oxygen tension monitoring. PMID- 3323068 TI - History of blood gas analysis. PMID- 3323069 TI - Pulse oximetry. PMID- 3323070 TI - Social identity in later life: a situational approach to understanding old age stigma. AB - Social identity is a product of emergent definitional processes occurring in socially defined situations. This article presents a situational approach to understanding an aspect of social identity in later life-the social stigma of old age. Social stigma is conceptualized as an attribute which is perceived to be discrediting, incongruent with expectations, and non-pivotal in regard to the cluster of attributes associated with a specific social category. A typology of situations, based on their potential for producing the stigmatization of old age, is presented. Additionally, stigmatization in these situations is influenced by the following: commitment and legitimation, generational contacts, performance norms, and gender. Implications of a situational approach to the investigation of old age are discussed. PMID- 3323071 TI - Monoclonal antibody against human sperm acrosome inhibits sperm penetration of zona-free hamster eggs. AB - Human spermatozoa were exposed to a monoclonal antibody (C11H), which recognizes sperm acrosin. The antibody was presented to the sperm during capacitation and/or insemination, and its effect on penetration was tested using zona-free hamster eggs. An inhibitory effect on penetration was observed when the antibody was present during insemination but not when it was included only in the capacitation medium. As judged by immunofluorescence microscopy, most of the sperm bound to the egg surface were devoid of acrosomal staining. Some of the bound sperm were stained at their equatorial segments. Sperm that had penetrated the ooplasm did not exhibit immunofluorescence. PMID- 3323072 TI - Beta-adrenoceptor stimulating and blocking agents in essential hypertension: single and combined therapy with terbutaline and metoprolol. AB - Single and combined therapy with terbutaline (10 mg/day) and metoprolol (200 mg/day) was assessed over 8 weeks in a double-blind parallel study in a total of 36 patients with essential hypertension grade I-II according to WHO criteria at rest and during exercise. Blood pressure was comparably reduced with metoprolol and terbutaline (I) and metoprolol alone (II) at rest as well as during exercise. Under terbutaline (III), only diastolic blood pressure decreased during exercise. The responder rates (greater than or equal to 10% reduction in diastolic blood pressure) at rest were 58% in I, 63% in II and significantly lower in III at 42%. Heart rate was not affected in I and III but decreased significantly with metoprolol. While therapy with metoprolol resulted in an increase of noradrenaline and a fall of plasma renin activity after 8 weeks, these parameters remained unchanged in I and III. Therapy was well tolerated in all groups. Terbutaline in the chosen dosage slightly decreased diastolic blood pressure and did not increase heart rate. Metoprolol is an effective antihypertensive agent resulting in a heart rate decrease. Under combined therapy, there is no additional blood pressure decrease, but the heart rate remains unaffected. PMID- 3323073 TI - Determination of biological equivalence of two atenolol preparations. AB - In healthy volunteers (n = 8), the biological equivalence of the two oral atenolol preparations was investigated. Atenolol concentration was assessed by HPLC. Drug and internal standard were isolated by adsorption with active charcoal. Chromatography was performed on RP-18 column (10 mu) with mobile phase of 0.015 mol/l KH2PO4/acetonitrile 70:30. The flow rate of the mobile phase was 1.5 ml/min. UV detector operated at the wave length of 225 nm. The sensitivity of the method was 25 micrograms/l and variation coefficients within the assay were less than 10% in the therapeutic concentration range. Biological half-life was on the average 3.8 h, absorption half-life 0.8 h, and the peak concentration time 2.5 h. Both preparations have been found bioequivalent. PMID- 3323075 TI - The concept of dependence. AB - The concept of dependence is reviewed in Western and Asian contexts. Asians find it acceptable and necessary, whereas Westerners may adopt an ambivalent attitude or reject the issue. Homeostatic dependence or reliance upon social and physicochemical environment is vital for human development and adaptation. Dependence as a phenomenon can be an interactional state, a trait, a role, and an initiator of mental mechanisms. Imbalanced processes result in pathological dependencies or disorders. An understanding of aspects of dependence has therapeutic implications in the assessment of the patient and the regulation of the role of the therapist. PMID- 3323074 TI - Ceftazidime in antibiotic prophylaxis for emergency cesarean section: a randomized prospective study. AB - The efficacy of two randomized antibiotic prophylactic schedules with ceftazidime (group A: single preoperative 2 g intramuscular dose; group B: 3 perioperative 1 g intramuscular doses every 6 h) was evaluated in 200 pregnant women undergoing cesarean section. Postoperative complications were observed in 9 cases (4 in group A and 5 in group B; p = NS). Analysis of possible risk factors revealed 1) a relationship between postoperative morbidity and overweight (body mass index above 30) in group A only; 2) a possible contributory effect of duration of labor (more than 6 h) in group A; and 3) a possible effect of duration of rupture of the membranes (more than 6 h) in group B only. The results obtained lead to the conclusion that single-dose prophylaxis with ceftazidime is as effective as short term 3-dose ceftazidime prophylaxis in preventing post-cesarean complications. PMID- 3323076 TI - Obstacles to the utilization of vocational services: an analysis of the literature. AB - While employment has been linked to positive clinical outcomes with drug abusers, research suggests that many treatment programs do not emphasize vocational services and under-utilize vocational resources. This article summarizes potential client-, program-, and societal-level obstacles to vocational rehabilitation service delivery identified in past studies with both substance abusers and other related client groups. Obstacles identified for related groups are integrated with issues relevant to drug treatment clients. This analysis is based on literature published over the last 20 years. PMID- 3323077 TI - Modification of macrophage differentiation: dimethylnitrosamine induced alteration in the responses towards the regulatory signals controlling myelopoiesis. AB - Results from our laboratory have demonstrated that the alteration in cellular immunity (CMI) resulting from exposure to dimethylnitrosamine (DMN) in vivo is due to changes in myelopoiesis. Bone marrow stem cells showed no alterations in their capacity to generate CFU-S (pleuripotent stem cells) nor were there any changes in the number of CFU-Mix colonies (IL-3 responsive stem cells) arising from the bone marrow of DMN exposed mice. However, the generation of G/M-CSF and CSF-1 responsive colonies (CFU-G/M and CFU-M) were altered, resulting in an increase in the number of colonies. G/M-CSF colonies generated from the bone marrow stem cells obtained from DMN exposed mice also had increased numbers of cells produced by each colony (total cells/CFU). Indirect immunofluorescence studies demonstrated no changes in the granulocyte/macrophage subsets following G/M-CSF stimulation of bone marrow stem cells obtained from DMN exposed mice. However, there was no change in the total number of cells generated by CSF-1 from the marrows of DMN exposed mice as compared to vehicle treated mice. Marrow cells from DMN exposed mice cultured in vitro with G/M-CSF showed both a shift in their peak proliferative response from 48-72 h to 30-60 h and an increased proliferative response. These same marrow cells showed no shift in their kinetics but a decrease in their proliferative response to CSF-1. Examination of the sera from DMN exposed mice for alterations in the regulatory factors controlling myelopoiesis demonstrated a net decrease of CSF-1 activity but no changes in the concentrations of two inhibitory factors, transferrin and lactoferrin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323078 TI - In vivo augmentation of natural killer cell activity by Candida albicans. AB - We determined in vivo effects of Candida albicans (CA) on murine natural killer (NK) cell activity. C3H mice were treated with heat-killed CA and splenic NK cell activity assayed at 2, 7, 30 and 50 days post treatment. A single injection of CA caused enhancement of splenic NK activity as measured in a 4 h 51Cr-release assay. Peak NK activity was detected at day 7 and persisted for up to 30 days, after which it declined to control values at 50 days. Augmentation of NK activity by CA resulted from enhanced lytic effects of NK cells, which was independent of effector cell binding capacity. Moreover, enhanced NK activity was associated with an increase in the proliferative response to CA antigen and in splenic cellularity when compared to saline injected controls. Thus, CA seems to act as an immunomodulator causing an augmentation of NK cell activity. Since other biological response modifiers (BRMs) do not show the same strength of augmentation, CA could be used as a new BRM having possible anticancer effects. PMID- 3323079 TI - Natural killer activity enhancing substance in normal human serum. AB - We studied the effect of normal human serum on natural killer (NK) activity of normal peripheral lymphocytes. Both fresh serum and heat-inactivated (56 degrees C, 30 min) serum significantly enhanced NK activity, in a dose dependent manner, the limit being reached with a final concentration of 5%. However, antibody dependent cell-mediated cytotoxicity (ADCC) was not affected by heat-inactivated serum, although it did show the effects of fresh serum as complement. The serum absorbed with target cells also enhanced NK activity, so it indicated that the enhancing effect of normal serum was not due to the natural antibody against target cells in the serum. The serum was fractionated by Sephadex G-200 into fractions I, II and III in the order of elution. The enhancing factor existed in fraction III. When fraction III was further separated by Cibacron Blue-Sepharose, which selectively adsorbs albumin from serum, the enhancing activity existed in the albumin-rich subfraction. In addition, commercial human albumins had the NK enhancing activity, whereas native transferrin, platelet-derived growth factor (PDGF) or plasminogen did not. These results therefore suggest that the substance enhancing NK activity in normal serum is serum albumin, which is considered to have no significant effect on immune reaction. PMID- 3323080 TI - Excitation-contraction coupling in fast- and slow-twitch muscle fibers. PMID- 3323081 TI - Mental health professionals and the duty to warn: an economic analysis. PMID- 3323082 TI - Human rights in mental health: a proposal for five international standards based upon the Japanese experience. PMID- 3323083 TI - Mental health law reform and psychiatric deinstitutionalization: the issues in New South Wales. PMID- 3323084 TI - Cutaneous manifestations of the acquired immunodeficiency syndrome. Update 1987. PMID- 3323085 TI - The plasma membrane in psoriasis. PMID- 3323086 TI - Decreased insulin binding to adipocytes precedes both hyperinsulinemia and decreased insulin binding to erythrocytes in cafeteria-fed rats. AB - The relationship between food intake, obesity, insulin binding to adipocytes and erythrocytes, plasma insulin and plasma glucose was studied in an animal model of nutritional obesity--'the cafeteria-fed rats'--after 3 days, 10 days, and 3 weeks of cafeteria feeding. The antilipolytic effect of insulin was also studied. The cafeteria-fed rats ate more carbohydrates after 3 days of diet, while from the 10th day, as previously found, they ate about the same amount of carbohydrates but more lipids and increased in weight. Insulin binding to adipocytes started to decrease (P less than 0.05) 10 days after beginning the cafeteria diet despite the absence of hyperinsulinemia. This decrease in insulin binding to adipocytes was accompanied by a decrease in the responsiveness of adipocytes to the antilipolytic effect of insulin. Hyperinsulinemia (P less than 0.01) appeared only after 3 weeks. At the same time, insulin binding to erythrocytes started also to decrease (P less than 0.05). Plasma glucose levels in the cafeteria-fed rats were unchanged when compared to their controls at any time of the study. There was no correlation between body weight, plasma insulin and insulin binding, to adipocytes and to erythrocytes, at any time of the study. Thus it is possible that factors other than hyperinsulinemia could be involved in the decrease in insulin binding to both adipocytes and erythrocytes. PMID- 3323087 TI - Failure of carbohydrate to spare leucine oxidation in obese subjects. AB - Leucine kinetics were studied in six obese subjects (W/H2 = 39 +/- 4) and six normal subjects (W/H2 = 21 +/- 3) before and after an oral load of 150 g glucose. An intravenous infusion of 1(-13)C leucine was given to the fasting subjects for 450 min: a steady state of plasma leucine enrichment was established 90 min after the start of the infusion, and the glucose load was given 220 min after the start of the infusion. Compared with the lean controls the obese subjects showed a greater area under the curve of blood glucose after the glucose load (P less than 0.025) and higher insulin and glucagon levels both before and after the meal (P less than 0.05), thus indicating the well-known insulin insensitivity of obese (but not diabetic) subjects with respect to glucose metabolism. After the glucose load the lean subjects showed a significant and sustained decrease in leucine oxidation (from 20.0 +/- 2.2 to 13.3 +/- 1.5 mumol/kg LBM/h: P less than 0.01). This response is similar to that observed when insulin-dependent diabetic subjects are given insulin. However the obese subjects showed no decrease in leucine oxidation after the glucose meal (20.3 +/- 1.9 before, and 21.2 +/- 3.6 after). This indicates that obese subjects show insensitivity to the action of insulin with respect to protein metabolism as well as carbohydrate metabolism. PMID- 3323088 TI - The Bancroft-Mackerras medal of the Australian Society for Parasitology. 1986 award to Ian Beveridge. PMID- 3323089 TI - Parasite biogeography in the Australasian region. PMID- 3323090 TI - Long-term in vitro cultivation of Plasmodium berghei. PMID- 3323091 TI - Microheterogeneity in H1 histones and its consequences. AB - The extent of microheterogeneity of H1 histones in individual higher organisms, without considering post-translational modifications, is such that five to eight molecular species can be recognized. The H1 variants differ among themselves in their ability to condense DNA and chromatin fragments, and they are non-uniformly distributed in chromatin. This review assembles data that support the notion that the differences in chromatin condensation (heterochromatization) observed through the microscope are maintained by the non-uniform distribution of H1 variants, and that this pattern of chromatin condensation may determine the dynamics of chromatin during replication and may represent the commitment aspect of differentiation. The differential response of the multiple H1 variants with regard to their synthesis and turnover is consistent with this notion. PMID- 3323092 TI - Effect of N-methylation of selected peptide bonds on the biological activity of insulin. [2-N-methylisoleucine-A]insulin and [3-N-methylvaline-A]insulin. AB - Hydrogen bonding involving peptide bonds of the backbone of the insulin molecule may play an important role in insulin-receptor interaction. Our previous work suggested that the A2-A8 helical segment of the hormone molecule participates in this interaction. To investigate the possible involvement of peptide bonds of this segment in insulin-receptor interaction the [2-N-methylisoleucine-A]insulin and [3-N-methylvaline-A]insulin ([MeIle2-A]- and [MeVal3-A]insulins) were synthesized. The circular dichroic spectra of the analogues were obtained and their properties were examined in several biological assays. The circular dichroic spectra suggested that the analogues remained monomeric at concentrations at which insulin is predominantly dimeric, and that their A2-A8 helical segments are distorted. The in vitro biological activity and the receptor binding affinity of these analogues were compared with that of natural insulin. Both analogues are weak full agonists. [MeIle2-A]insulin displayed a potency of 5.4 +/- 0.3% in stimulating lipogenesis and 4.6 +/- 2.3% in receptor binding affinity in rat fat cells and rat liver plasma membranes respectively. [MeVal3 A]insulin displayed a potency of 2.1 +/- 0.2% in lipogenesis and 1.0 +/- 0.3% in receptor binding assays. In radioimmunoassays [MeIle2-A]- and [MeVal3-A]insulins exhibited potencies of 13% and 11% respectively relative to the natural hormone. The substantially decreased biological activity and receptor binding affinity of these analogues may be attributed partly to the change of conformation and partly to the loss of hydrogen bonding capacity of the A2-A8 segment brought about by N methylation of the A1-A2 or A2-A3 peptide bonds. PMID- 3323093 TI - The urinary sodium/potassium ratio in children from southern Italy living in Cimitile: a case for concern. AB - The urinary sodium/potassium (Na/K) ratio was evaluated in 220 children aged 3-16 years living in Cimitile, a small town near Naples in Southern Italy by utilizing 24 hour urinary collections. The Na/K ratio averaged 3.79 +/- 1.68 and correlated significantly (p less than 0.001) with age, body weight and height but not with Body Mass Index (BMI). No difference was seen when data were analyzed by sex. Mean daily sodium excretion averaged 3.91 +/- 1.52 mM/Kg while potassium excretion averaged 1.17 +/- 0.54 mM.Kg. The Na/K ratio was higher than that observed in children studied in Israel, United Kingdom, USA, and the Federal Republic of Germany and is of the same magnitude of that previously reported in children born in Japan. This high Na/K ratio is a case for concern because of the risks connected with high Na/K ratio in urine. PMID- 3323094 TI - C-peptide kinetics following an intravenous glucose load in children undergoing regular hemodialysis. AB - Following an intravenous glucose tolerance test (iv-GTT) we investigated the relationship between glucose kinetics and c-peptide release in 15 children and adolescents requiring regular hemodialysis. Following longterm hemodialysis, we were unable to demonstrate any correction of the uremia associated disturbances of insulin metabolism and c-peptide secretion. Fasting serum levels of insulin and c-peptide remained elevated and insulin excretion prolonged. After an increase in c-peptide levels there was an accumulation throughout the study period, early c-peptide secretion was reduced. Thus in regular hemodialysis, glucose metabolism did not correlate with insulin and c-peptide kinetics. The c peptide secretion curve is out of phase with the insulin secretion rate. PMID- 3323096 TI - Eugene Markley Landis 1901-1987. PMID- 3323095 TI - Recognition and management of aluminum intoxication in children. AB - The awareness of aluminum as a potential toxic risk in patients, especially infants and children with chronic renal insufficiency, is beginning to be widely appreciated. This paper will review the clinical features of aluminum intoxication, potential sources of aluminum, risk factors in pediatrics, and treatment of aluminum intoxication. It is hoped that this review provides the nephrologist with useful information concerning recognition and management of aluminum intoxication. PMID- 3323098 TI - Acute mastoiditis complicated by sigmoid sinus thrombosis in congenital aural atresia. AB - Congenital aural atresia occurs approximately once in every 20,000 live births, although the incidence of otitis media in aural atretic children should not differ from the rest of the population, detection is difficult. Unless severe, the infection usually goes unnoticed, especially with the use of antibiotics. A two-year-old male with congenital aural atresia presented with fever and facial nerve paresis. As his illness progressed, he developed mastoiditis with subperiosteal abscess and sigmoid sinus thrombosis. Literature review showed this to be the first reported case of sigmoid sinus thrombosis in congenital aural atresia. Diagnosis and management are presented. PMID- 3323097 TI - Button batteries as foreign bodies in the nasal cavities. AB - Two cases of foreign bodies (button batteries) in the nasal cavities were reported. The first patient was a 6-year-old girl who put a button battery into her left nostril and ulceration of the septum and inferior turbinate was found. The other patient was a 3-year-old boy, the alkaline battery caused neither septal perforation nor stenosis of the nasal meatus. All button batteries as foreign bodies in the nasal cavities should be removed immediately to prevent severe local tissue damage, resulting in late sequels, such as septal perforation or stenosis of the nasal meatus. PMID- 3323099 TI - Autotransplantation of teeth; a review of current thoughts. PMID- 3323100 TI - Rotavirus. AB - The consequences of rotavirus infection cannot be over-estimated. It kills millions of children and accounts for occasional illness in adults. The agent is a complex reovirus with a unique capsid that invades columnar epithelial cells disrupting ion transport and producing dehydration. There is no specific therapy, making the need for prevention paramount. Cases must be identified and enterically isolated with some authorities even encouraging respiratory isolation. PMID- 3323101 TI - Therapy of bladder cancer. AB - Progress in the different modern methods of treatment influenced the strategy in the therapy of bladder cancer, adjusting it to the stage of the tumour. The basis of different ways of treatment is the transurethral tumour resection. Depending on the stage and grade resulting from this, further steps are taken. An exact indication for radical cystectomy and the possibility of an appropriate urinary diversion have improved the chances of success. Of the adjunctive measures we have to mention the intravesical cytostatic instillation therapy, the transurethral high-frequency hyperthermia and the intraarterial chemoembolization. The technique and the methods of application are presented here. An overall view is given of laser treatment and the immunological therapy of bladder cancer. PMID- 3323102 TI - Posttraumatic intracavernous haematoma: diagnostic and therapeutic perspectives. AB - The authors report a case of posttraumatic intracavernous haematoma. After analysing therapeutic problems they discuss the feasibility of conservative medical treatment in cases with integrity of the tunica albuginea confirmed by radiography. PMID- 3323103 TI - Viral infections, their influence on some parts of the immune system and glomerulonephritis development. AB - Glomerulonephritis complicates the course of various viraemias. Aetiopatho mechanism leading to the development of a particular form of glomerulonephritis on this background is differentiated and multifactorial. Viraemias affect the immune system, provoking a number of alterations of functional nature, discriminating both humoral and cellular responses. It also seems that neuraminidase enclosed in certain viruses plays a role in the aetiopathogenesis of glomerulonephritis. PMID- 3323105 TI - Morphogenesis and fine structure of Frankia (Actinomycetales): the microsymbiont of nitrogen-fixing actinorhizal root nodules. PMID- 3323104 TI - Some hormones, minerals and vitamin D in continuous ambulatory peritoneal dialysis. AB - The concentrations of insulin (IRI), parathormone (PTH), calcitonin (CT), some electrolytes (Ca, Mg, P), vitamin D and glucose were determined in 6 patients with terminal renal insufficiency treated by CAPD. PMID- 3323106 TI - Differentiation of spermatogenic cells from vertebrates in vitro. PMID- 3323108 TI - Local regulation of testicular function. PMID- 3323107 TI - The developmental program of spermiogenesis in Drosophila: a genetic analysis. PMID- 3323109 TI - [Recent knowledge of the physiology and pathophysiology of the vascular endothelium, especially within the scope of atherogenesis]. PMID- 3323110 TI - [Therapy of unstable angina pectoris and acute myocardial infarct]. PMID- 3323111 TI - [Have indications for aortocoronary bypass operation changed?]. PMID- 3323112 TI - [Use of a fully mechanized differentiation system in the hematologic laboratory. II: Reproducibility and reliability of the differentiation of pathologic blood pictures with the Hematrak 590]. PMID- 3323113 TI - Comparison of iohexol and ioxaglate for intravenous digital subtraction angiography of the neck and head. AB - Two hundred patients undergoing intravenous digital subtraction angiography of the cerebral circulation were examined on a random basis with either iohexol 350 mg I/mL or ioxaglate 320 mg I/mL. The two low osmotic media provided equally satisfactory image quality and diagnostic possibilities. No significant differences were found in incidence and severity of adverse reactions. PMID- 3323114 TI - Bone marrow transplantation for acute leukemia. PMID- 3323116 TI - Saline microbubbles monitoring sonography-assisted abscess drainage. AB - The objective of this study was to assess the use of saline microbubbles as a sonographic contrast medium in monitoring abscess drainage. Seven abscesses were localized and drained with sonographic guidance. Four were in the brain and three were small abscesses in the liver, the subhepatic region, and the pancreas. After aspiration of the purulent material, irrigation with saline produced a highly echogenic sonographic pattern that was free of artifacts and distinctly different from the abscess contents and capsule, and the surrounding parenchyma. In one case, previously unsuspected loculation was detected, requiring repositioning of the needle for complete drainage. All abscesses were resolved and no untoward effects, such as sepsis, were encountered. In one additional patient, microbubble sonographic evaluation was used to monitor the progress of an abscess in which a percutaneous catheter was placed. Saline microbubbles may be used as a sonographic contrast medium to monitor sonography-assisted abscess drainage. PMID- 3323115 TI - Percutaneous drainage of pelvic lymphatic fluid collections in the renal transplant patient. AB - Seventeen renal transplant patients with pelvic lymphatic fluid collections were treated with percutaneous drainage. Eleven of 16 patients with lymphoceles (69%) were successfully managed without surgery, although seven of these patients required repeat catheter insertions, and three patients developed local infections. The patient with an ovarian cystadenoma was treated with surgery. The mean duration of catheter insertion was ten days for initial drainage and 16 days for repeat drainage. Elevated serum creatinines decreased in 14 of the patients with lymphoceles (88%), including all five patients without pelvocaliectasis, but never returned to baseline in six instances. This observation may reflect the inadequate therapy of frequently encountered concurrent renal parenchymal abnormalities (rejection, cyclosporine toxicity, acute tubular necrosis). While percutaneous management of lymphoceles is technically easy and usually ultimately effective, the interventional radiologist should be prepared for long duration of catheter insertions, repeat interventions, and variable clinical courses. Differentiation of lymphoceles from other fluid collections, such as cystic ovarian neoplasms, may be difficult. PMID- 3323117 TI - The origins and work of the International Commission on Radiological Protection. PMID- 3323118 TI - Altered liver surface proteins in alcoholic liver disease. PMID- 3323119 TI - Invasive haemodynamic monitoring in critical care: a review. PMID- 3323120 TI - Doolin. PMID- 3323121 TI - Portrait of a friend (Giuseppe Moruzzi). PMID- 3323122 TI - In memory of Giuseppe Moruzzi. Festschrift. PMID- 3323123 TI - Cerebro-cerebellar learning loops in apes and humans. AB - In the cerebro-cerebellar system of anthropoid apes and humans, the cerebellum seems able to contribute not only to motor skills but also to mental and language skills. Anatomical evidence suggests that in these species the cerebellum can function at two different hierarchical levels. At a lower level, the cerebellum can supply signals to the frontal motor areas for effecting the manipulation of muscles. At a higher level, the cerebellum can supply signals to some prefrontal areas for effecting the manipulation of symbols. At both levels, the cerebellum can function in essentially the same way: when incoming information is processed repeatedly in the neural loops in which the cerebellum is embedded, the cerebellum can learn to generate new sequences of signals, which constitute new programs for carrying out learned procedures. If cerebellar programs are used in the frontal motor areas (area 4 and are 6), motor manipulations can be effected rapidly and skillfully. Similarly, if cerebellar programs are used in some prefrontal areas (e.g., area 8 and the inferior frontal convolution), mental and language manipulations could be effected rapidly and skillfully. The cerebellum, in its contributions to these mental and language functions, as in its contributions to motor function, could serve as an adaptive mechanism whose signals enable the frontal cortex to execute learned procedures optimally. In the absence of such cerebellar signals, the frontal cortex would have to perform these procedures less rapidly and fluently. Modern testing techniques can reveal such a subtle difference in performance. These techniques are therefore now being used to test human subjects, in an attempt to validate or refute this broadened concept of cerebellar function. If the new concept is validated, it can provide powerful explanations for some unresolved mysteries about the human brain. PMID- 3323125 TI - Neurobehavioral investigation as a tool for revealing preclinical disorders. AB - This paper calls attention to the methodologies designed to investigate the higher cortical functions in order to elicit signis of encephalopathy in apparently normal conditions. This can be done by testing the blobal hemispheric funcionts or the interhemispheric functional balance. This shows up the clinical sequels that may precede or be the outcome both of transient pathological disorders, such as transient global anemia, migraine, TIAs and subarachnoid hemorrhage without apparent clinical consequences and of nontransient pathological conditions, such as epilepsy, occupational diseases, arterial hypertension and cerebral revascularization. PMID- 3323124 TI - Photic epilepsy problems raised in man and animals. AB - The data gathered in 30 years' study in man and in several animal species, but especially in the Papio papio baboon, tend to show that the cortex plays a decisive part in the seizure and interval discharges induced by intermittent light stimulation in photic epilepsy. Two regions of the cortex predominate: the frontorolandic and occipital regions. The cortical cortex can, indeed, transmit or control the visual input to the frontorolandic region and can cause intermittent discharges in certain specific conditions in baboons and in certain human patients. The corticocortical pathway conveys the visual impulses to the frontorolandic cortex and is certainly modulated by deep structures like the reticular systems and the thalamus. At present no more can be said since further research is needed. PMID- 3323126 TI - Neurological improvement in chronic ischemic stroke following surgical brain revascularization. AB - 50 patients suffering from completed ischemic stroke in the carotid territory for at least two months (17 mild, 31 moderate, 2 severe strokes) underwent extra intracranial arterial bypass surgery. Neurological improvement was obtained in 43 cases; it persisted in time in 40 cases. Quantitative evaluation of motor performance in 21 patients showed that the degree of improvement was highly significant. Several factors strongly indicate a causal relation between surgical revascularization and neurological restoration. The positive surgical result is strictly dependent on correct patient selection and, in particular: i) on the documentation of local hemodynamic insufficiency; ii) on the occurrence of transient neurological (and to a certain extent EEG) improvement following hyperbaric oxygenation. The latter can also provide reliable information on the minimum degree of improvement to be expected from surgery. PMID- 3323127 TI - Sympatho-renal interactions. AB - The renal nerves appear to be involved in the control of cardiovascular homeostasis and volume balance both in physiological and in pathological conditions such as experimental hypertension. Anatomical and electrophysiological evidence suggests that the kidney has a diffuse sensory innervation connected with areas in the brain and spinal cord that are known to regulate cardiovascular functions by both neural and humoral mechanisms. The demonstration of the existence of neural reno-renal reflexes controlling several renal functions indicates that a functional balance between the two kidneys exists and may play an important role in the moment-to-moment control of kidney functions. PMID- 3323129 TI - Optic nerve: a concise review of the anatomy, pathophysiology and principal acquired disorders. AB - The Authors review the acquired diseases of the optic nerve (o.n.) through a selection of a few main nosological categories elaborated according to recent literature and neuro-imaging developments. The proposed selection does not coincide with a classification as it includes different topics, some listed according to their aetiology, others on the clinical presentation. However, from a practical point of view, a simplified nosology should help in dealing with the complex variety of o.n. diseases and in tackling the difficulties of their differential diagnosis. PMID- 3323131 TI - The case for continued federal funding for kidney disease. PMID- 3323128 TI - Some little-known aspects of spinal cord softening. AB - 311 cases of spinal cord softening, were selected for review. The following points emerged from this study: 1) spinal cord softening is a rare occurrence; 2) while formerly syphilis was the most frequent cause, recently reports of cases secondary to aortic disease or to embolism with diffuse signs of arteriosclerosis and circulatory failure pointing to a different pathogenesis have become more frequent; 3) the site of softening rarely corresponds to the vascular spinal territories as defined by the anatomists, from which it may be argued that often several arterial territories may be involved simultaneously or, alternatively, that the arterial territories are not so rigidly defined as anatomical research has led us to suppose; 4) the few cases of multiple vascular lesions show that, as happens in the brain, the cord may be damaged contemporaneously or successively in several areas. PMID- 3323130 TI - Antidepressants for cancer pain and other painful syndromes with deafferentation component: comparison of amitriptyline and trazodone. AB - The Authors report a clinical multicentre experience with antidepressant agents (trazodone and amitriptyline) in the treatment of chronic cancer pain with deafferentation component. Forty-five patients were admitted to the study: 27 with oncological peripheral nerve lesions, 6 with post herpetic neuralgias, 10 with not oncological nerve lesions, 2 with central nervous lesions. Almost all of them were already being treated with NSAID associated with weak or strong opioids. A random double blind study was performed: 23 patients were treated with trazodone, 22 with amitriptyline. In the assessment of results, pain intensity, hours of sleep, hours standing and lying, side effects, mood, anxiety, weakness were all taken into consideration. The therapeutic analgesic efficacy of the two drugs proved to be similar. PMID- 3323133 TI - [B-scan ultrasound in dermatology]. AB - Using a new polyacrylamide material, ultrasonic B-scanning can now be successfully used to show the upper layers of the skin and its tumors. Examples demonstrate the possibilities of this procedure in daily dermatological diagnostics. PMID- 3323132 TI - [Angiodysplasias of the extremities]. AB - The term "angiodysplasia" is defined and a historical review of vascular malformation given, particularly the Klippel-Trenaunay, F.P. Weber, and Servelle Martorell syndromes. The casual, uncritical use of these terms in the past, especially the combination of these entities into one syndrome, has resulted in considerable confusion. Current classifications are based on nosologic, pathophysiologic, anatomical, clinical, and didactic criteria. Modern diagnostic methods and the results of surgical corrections of vascular malformations have led to a better understanding of the underlying pathomechanisms and have offered new prognostic and therapeutic aspects. PMID- 3323134 TI - [Erosive pustulous dermatitis of the scalp]. AB - We present a 46-year-old female patient suffering from progressive, pustular and erosive lesions of the scalp. The nosology and the differential diagnosis of this disease entity, called erosive pustular dermatosis of the scalp, are discussed. PMID- 3323135 TI - [Juvenile linear IgA dermatosis]. AB - In addition to hereditary epidermolysis, acquired chronic bullous diseases are also observed in childhood, juvenile linear IgA dermatosis being the most frequent. The case of a 6-year-old girl with the clinical, histological, electron microscopical and, especially, immunohistological findings typical for linear IgA dermatosis is reported. Successful therapy with oral sulfones is described. PMID- 3323136 TI - 99mTc-2,3-diaminopropionic acid complex as renal function agent: comparison of biological properties with 99mTc-DTPA and 131I-OIH. AB - The preparation, purification, biodistribution, blood disappearance kinetics and imaging characteristics of 99mTc-2,3-diamino propionic acid (99m-Tc-DAPA) is studied. The latter three studies were conducted on rabbits as the experimental animal and the data thus obtained were compared with 99mTc diethylenetriaminepentaacetic acid (99mTc-DTPA) and 131I-orthoiodohippurate (131I OIH) with a view to find a possible replacement of the latter radiopharmaceutical with a more convenient 99mTc based compound. Preliminary data indicates favourable results for 99mTc-2,3-diamino propionic acid which warrants further investigation. PMID- 3323137 TI - What did Mendel say about evolution? PMID- 3323138 TI - A new fixation procedure for quality G-bands in routine cytogenetic work. PMID- 3323139 TI - An improved method for the inhibition of endogenous peroxidase non-deleterious to lymphocyte surface markers. Application to immunoperoxidase studies on eosinophil rich tissue preparations. AB - The inhibitory effect of phenylhydrazine and azide combined with either pre formed or nascent hydrogen peroxide H2O2 upon endogenous peroxidatic activity, expressed by tissue eosinophils in different disease states, was investigated. It was found that whilst endogenous peroxidatic activity due to eosinophils in a Hodgkin's disease and a histiocytosis X case were adequately inhibited by phenylhydrazine combines with pre-formed or nascent H2O2, the eosinophils in the Onchocerca volvulus nodule were either not at all or only partly inhibited by the two regimens. On the other hand, a combination of azide with nascent H2O2 proved consistently effective against this resistant form of endogenous peroxidatic activity. Using human tonsil sections this protocol was shown to be non deleterious to T4('CD4'), T6('CD1') and T8('CD8') lymphocyte surface antigens as evidenced by the application of a standard indirect immunoperoxidase technique and the relevant monoclonal antibodies. PMID- 3323141 TI - Effects of haemodialysis on taste for salt in relation to changes in blood constituents. AB - Taste sensitivity and preference for sodium chloride in bread and pea soup were assessed before and after haemodialysis in 12 female chronic renal failure patients. Blood samples were also taken pre- and post-dialysis and analysed for zinc, sodium and renin. The patients demonstrated an increased sensitivity to, and decreased preference for, sodium chloride in both bread and pea soup following dialysis. These taste changes were found to correlate with pre- to post dialysis changes in the zinc levels in the blood. Patients receiving a more severely sodium-restricted diet showed a greater sensitivity to the taste of sodium chloride in the foods tested. Renin levels dropped in all patients following dialysis, the size of the change correlating with the size of the change in body weight. PMID- 3323140 TI - Localization of neuron-specific (gamma gamma) enolase in proliferating (supportive and neoplastic) Schwann cells. An immunohisto- and electron immunocyto-chemical study of ganglioneuroblastoma and schwannomas. AB - Neuron-specific (gamma gamma) enolase, a glycolytic enzyme used as a relatively specific marker for normal neurons and neuroendocrine cells, has recently been found in a variety of neoplastic cells and in reactive astrocytes. Its localization was investigated by immunohisto- and electron-immunocyto-chemistry, in the proliferating supportive Schwann cells of a peripheral ganglioneuroblastoma and in the neoplastic Schwann cells of four acoustic tumours. By light microscopy, the neoplastic Schwann cells showed moderate uneven diffuse immunopositivity for enolase. By electron-immunocytochemistry, both types of Schwann cells demonstrated immunopositivity discretely limited to their cell surface membranes. The neoplastic ganglion cells and axons of the ganglioneuroblastoma and the normal neurons and axons included in the schwannomas were, as expected, intensely immunopositive. The visualization of gamma gamma enolase on the cell surface membranes of both neoplastic and non-neoplastic proliferating Schwann cells suggests that increased glycolytic activity may occur on the surface of these proliferating cells irrespective of the nature of the proliferation. PMID- 3323142 TI - Ultrastructural localization of glucocorticoid receptor (GR) in hypothalamic paraventricular neurons synthesizing corticotropin releasing factor (CRF). AB - Corticotropin releasing factor (CRF) synthesizing neurons, located in the hypothalamic paraventricular nucleus (PVN), are the main central regulators of the pituitary-adrenal cortex endocrine axis. The hormone production and release of CRF-synthesizing neurons is regulated by neuronal messages and feedback action(s) of glucocorticoids secreted by the adrenal gland. In order to characterize the latter mechanism, glucocorticoid receptor (GR)-immunoreactive (IR) sites were studied in hypothalamic paraventricular neurons of intact, long term adrenalectomized, and adrenalectomized plus glucocorticoid treated animals, by means of ultrastructural immunocytochemical labelling. In intact animals, glucocorticoid receptor immunoreactivity was found predominantly in the nuclei of parvocellular neurons. Following adrenalectomy GR-immunoreactivity was localized in the cytoplasm of the cells, and there was a concomitant disappearance of the label from the nuclei. After corticosterone administration to adrenalectomized animals, GR-IR sites were again concentrated within the cell nuclei. Immunocytochemical double labelling studies performed on adrenalectomized plus corticosterone-replaced animals demonstrated glucocorticoid receptor-IR sites in the cell nuclei of parvocellular paraventricular neurons that expressed CRF immunoreactivity in their cytoplasm. These ultrastructural data indicate that the intracellular location of glucocorticoid receptor is dependent on the availability of glucocorticoids by the neurons. The simultaneous expression of GR and CRF-immunoreactivity in parvocellular paraventricular neurons supports the concept of a direct feedback action of glucocorticoids upon CRF-synthesizing neurons. PMID- 3323143 TI - Colocalization of (3H)-adenosine accumulation and GABA immunoreactivity in the chicken and rabbit retinas. AB - Using combined autoradiography and immunohistochemistry, we have compared (3H) adenosine accumulation and GABA immunoreactivity in the chicken and rabbit retinas. Colocalization of the two markers was observed in a subset of amacrine cells and in certain cell bodies in the ganglion cell layer in both species and in a few horizontal cells in the chicken retina. Cells that contained only (3H) adenosine or GABA were also seen. The degree of colocalization differed greatly between the two species. The results demonstrate a morphological relationship between the adenosine and GABA systems and provides information on the possible anatomical substrates underlying at least some types of functional interactions. PMID- 3323144 TI - Immunohistochemical localisation of arginase in human liver using monoclonal antibodies against human liver arginase. AB - Monoclonal antibodies against human liver arginase were raised in order to determine the exact distribution of arginase in human liver using a modified indirect unlabelled immunoperoxidase method. In normal human liver specific immunohistochemical staining was found in the cytoplasm of hepatocytes. Portal components (bile ducts and veins) and fibrous tissue were non-reactive, while erythrocytes were slightly positive. The specificity of the immunological reaction was confirmed by control tests. Spectrophotometry was used to quantitate the immunohistochemical reaction product, and the results indicated that arginase is homogeneously distributed in the liver lobule. PMID- 3323146 TI - Immunohistochemical studies of the distribution of a basolateral-membrane protein in intestinal epithelial cells (GZ1-Ag) in rats using monoclonal antibodies. AB - The monoclonal antibody (mAb), GZ1, is specific for a 42-kilodalton (kD) protein (designated GZ1-Ag) present among the plasma membrane (PM) proteins of the absorptive cells of rat intestine. This protein only occurs in the basolateral PM and is absent from the microvillus membrane. GZ2 and GZ20 are two other mAbs that are also directed against GZ1-Ag but which specify other antigenic determinants of this protein than mAb GZ1. Used together, these three mAbs allow better characterization of GZ1-Ag and more precise investigation of its distribution and localization in various rat cells. We performed immunohistochemical labelling for GZ1-Ag at both the light- and electron-microscope levels and found that GZ1-Ag is extensively distributed in rat epithelial tissues. However, the amount of this protein present in epithelial tissue shows considerable variation. GZ1-Ag is not present in the secretory cells of terminal portions of most excretory glands or in cells of the endocrine glands and liver. The cells of kidney tubules, except for collecting tubules, also lack GZ1-Ag. Only small amounts of GZ1-Ag are present in the cells of the stratified squamous epithelium and transitional epithelium, the exception being superficial cells. High concentrations of GZ1-Ag occur in the excretory duct systems of glands and in the various kinds of epithelium present in the male and female genital tract. Our results also indicated that the GZ1-Ag in all of these cells has a very similar structure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323145 TI - Uteroglobin production in the pseudopregnant rabbit uterus. Immunohistochemical studies. AB - Uteroglobin, a secretory protein of rabbit uterine epithelium, was localized by the direct immunoperoxidase method in control and hCG-induced pseudopregnant rabbits. In control rabbits, uteroglobin was confined to the apical cytoplasm of nearly all cells of the endometrial epithelium. The induction of pseudopregnancy resulted in a pronounced continuing increase, through 4 days post-hCG administration, in the absolute number of epithelial cells engaged in uteroglobin synthesis. Furthermore, the endoplasmic reticulum was more intensely stained for uteroglobin than in the epithelial cells of control rabbit endometrium. Thus, the increased production of uteroglobin, in response to hormonal stimulation, appears to be achieved both through an increase in the amount of uteroglobin synthesized by a given cell as well as by an increase in the number of cells involved in uteroglobin synthesis. Concurrent with the increase in the number of cells synthesizing uteroglobin, an increase in the number of unstained cells first appeared at the second day of pseudopregnancy, during the period of maximal epithelial proliferation. However, within those cells containing uteroglobin on the second day following injection with hCG, most staining was limited to the perinuclear membrane. At various times following hCG administration, a number of scattered cells, intensely stained for uteroglobin, were observed in the uterine epithelium. Based upon ultrastructural studies, failure to exclude trypan blue, and the presence of intra-mitochondrial uteroglobin, they were identified as either dead or dying cells. PMID- 3323149 TI - Ipsilateral adenocarcinoma and carcinoid tumor of the lung: report of a case. PMID- 3323147 TI - [Binding of serum immunoglobulins to human inner ear tissue in inner ear hearing loss: methodologic limits]. AB - The immunopathological processes possibly involved in cryptogenic sensorineural hearing loss were investigated. In a pilot study the sera from 66 patients were tested by the indirect immunofluorescence technique for immunoglobulins which bind to normal human inner ear tissue. The reaction was positive in two thirds of all patients with sudden hearing loss, especially bilateral. This was mostly for IgG, and to the organ of Corti. Others have found that Corti's organ showed marked degenerative changes in cases of sudden hearing loss, examined by histology. The reaction was positive in half of the patients with progressive sensorineural hearing loss. It was noticeable that positive reactions for IgA were twice as frequent in sera of patients with progressive hearing loss than in those with sudden deafness. In a control study, the sera of ten patients were tested in parallel by the same method on histological sections of inner ears taken from four individuals. Similar results were found for the sera of two patients only. The sera of the remaining eight patients revealed very inconsistent reaction patterns. These preliminary results may indicate that temporary or permanent humoral (auto) immune mechanisms could have occurred in certain inner ear diseases. So far however reliable diagnostic methods have not been established, and not enough patients have been followed up. PMID- 3323148 TI - Thallium-201 scanning: some pharmacologic interventions. PMID- 3323150 TI - Development of a general internal medicine unit in an osteopathic medical school. PMID- 3323151 TI - Phase contrast and electron microscopical observations of adult mouse dorsal root ganglion cells maintained in primary culture. AB - Cultures of neurons and non-neuronal cells were prepared from adult mouse dorsal root ganglia and maintained for periods of up to six weeks upon uncoated petri dish substrates. Modifications were made to both existing isolation procedures and culture medium to ensure high cell survival. Cell structure was observed using phase contrast microscopy for living cells and standard light microscopy for Palmgren silver stained preparations. Scanning and transmission electron microscopy revealed the fine structure of the cells and showed the close relationship of satellite cells with the surviving dark neurons as culture establishment progressed. Satellite cells were associated with both the cell bodies and the regenerated neuritic processes. The use of the cultures for future cytotoxicity testing is assessed. PMID- 3323152 TI - Schmorl's nodes (intravertebral herniations of intervertebral disc tissue) in two historic British populations. AB - The herniation of the nucleus pulposus into the vertebral body produces ectopic deposit of disc material which are known as Schmorl's nodes. This prolapsed disc tissue leaves characteristic deformations on the surface of the vertebral body and hence the incidence of this lesion can be studied in skeletal remains. This report describes the occurrence of Schmorl's nodes in TV8-SV1 in two historic adult British populations, one from Aberdeen and the other from London. In the Aberdeen group, both males and females showed a high incidence rate and severity of Schmorl's nodes. In the London group, the males had a similarly high affliction whereas the females were nearly free of the condition. The lesion had no significant predilection for any one particular vertebral surface. However, in males in both localities, the frequency of Schmorl's nodes was significantly higher in the thoracic region than in the lumbosacral region. In contrast, both groups of females showed similar node frequency in these two zones. The majority of Schmorl's nodes were localised in the central and central-posterior regions of the vertebral surface. When nodes occurred on successive vertebral surfaces, they often formed sequences showing similar shape and position. The aetiology of Schmorl's nodes is unclear. Various hypothetical causal factors were appraised in relation to the findings of this study. It was suggested that anomalies in vascular and/or notochordal regression may be related to the development of the lesion. PMID- 3323154 TI - Evaluation of a monoclonal antibody-based immunoassay for detecting type A Clostridium botulinum toxin produced in pure culture and an inoculated model cured meat system. AB - A monoclonal antibody-based amplified enzyme-linked immunosorbent assay (ELISA) method for detecting Clostridium botulinum type A toxin was evaluated for its ability to detect the toxin in the supernatant fluid of pure cultures and after growth from Cl. botulinum spores inoculated into pork slurries. Slurries containing NaCl (1.5-4.5% w/v) and polyphosphate (0.3% w/v) were either unheated or heated, 80 degrees C/5 min + 70 degrees C/2 h, before storage at 15 degrees, 20 degrees or 27 degrees C. The presence of specific toxin was confirmed by mouse bioassay and results compared with those of the amplified ELISA method. A total of 49 strains, 39 Cl. botulinum and 10 Cl. sporogenes (putrefactive anaerobes), and 95 slurry samples were tested. Fourteen of 15 strains of type A Cl. botulinum and 34 of 36 slurry samples containing type A toxin were positive by ELISA. No false positive reactions occurred with Cl. botulinum types B, C, D, E and F, or with the 10 strains of Cl. sporogenes. However, toxin produced by one strain of Cl. botulinum type A (NCTC 2012) was not detected by the amplified ELISA. PMID- 3323153 TI - The applied anatomy of the arterial blood supply to the heart in man. AB - The applied anatomy of the coronary arterial and collateral circulations has been reviewed together with some of the more important variants of origin, branching and disposition. There is a very wide range of variability among coronary artery patterns, and some of them can of themselves give rise to illness and even death. Others may exacerbate acquired disease. The increasing use of coronary arteriography and other forms of imaging will continue to reveal hitherto undescribed variants, while the study of coronary artery disease, so common in the Western world, will eventually elucidate the natural history of the coronary collateral circulation. PMID- 3323155 TI - The long-term survival of Escherichia coli in river water. AB - Escherichia coli introduced into autoclaved filtered river water survived for up to 260 d at temperatures from 4 degrees to 25 degrees C with no loss of viability. Survival times were less in water which was only filtered through either a Whatman filter paper or a 0.45 micron Millipore filter or in untreated water, suggesting that competition with the natural microbial flora of the water was the primary factor in the disappearance of the introduced bacteria. Survival was also dependent upon temperature with survival at 4 degrees C greater than 15 degrees C greater than 25 degrees C greater than 37 degrees C for any water sample. Direct counts showed that bacterial cells did not disappear as the viable count decreased. The possession of the antibiotic resistance plasmids, R1drd-19 or R144-3, did not enhance survival nor cause a faster rate of decay, indicating that the metabolic burden imposed by a plasmid was not a factor in survival under starvation conditions. There was no evidence of transfer of either plasmid at 15 degrees C or of loss of plasmid function during starvation. PMID- 3323156 TI - Serious delinquent behavior as part of a significantly handicapping condition: cures and supportive environments. AB - The past 20 years have been productive ones for the field of applied behavior analysis. A brief review of our own efforts during this period reveals that we have accomplished several but not all of our goals for the Teaching-Family approach. In this context, we note that the setting of realistic and appropriate goals is important for the field and for society. Moreover, we suggest that the realistic goal for some persons with serious delinquent behavior may be extended supportive and socializing treatment rather than permanent cure from conventional short-term treatment programs. We base this suggestion on the accumulating evidence that serious delinquent behavior may often be part of a significantly disabling and durable condition that consists of multiple antisocial and dysfunctional behaviors, often runs in families, and robustly eludes effective short-term treatment. Like other significant disabilities such as retardation, autism, and blindness, the effects of this condition may be a function of an interaction of environmental and constitutional variables. We argue that our field has the wherewithal to construct effective and humane long-term supportive environments for seriously delinquent youths. In this regard, we explore the dimensions, rationales, logistics, and beginnings of a new treatment direction that involves long-term supportive family treatment. We contend that such supportive families may be able to provide long, perhaps even lifetime, socializing influences through models, values, and contingencies that seem essential for developing and maintaining prosocial behavior in these high-risk youths. PMID- 3323158 TI - An attempt to induce a histological ENL symptom in M. leprae infected nude mice. PMID- 3323157 TI - Negative reinforcement in applied behavior analysis: an emerging technology. AB - Although the effects of negative reinforcement on human behavior have been studied for a number of years, a comprehensive body of applied research does not exist at this time. This article describes three aspects of negative reinforcement as it relates to applied behavior analysis: behavior acquired or maintained through negative reinforcement, the treatment of negatively reinforced behavior, and negative reinforcement as therapy. A consideration of research currently being done in these areas suggests the emergence of an applied technology on negative reinforcement. PMID- 3323159 TI - Ultracytochemical and light microscopic histochemical studies in murine leprosy. PMID- 3323160 TI - Induction of the SOS response by new 4-quinolones. AB - The 4-quinolones ciprofloxacin, difloxacin, enoxacin, norfloxacin, ofloxacin, and nalidixic acid were found to induce the SOS response in qualitative and quantitative tests on Escherichia coli K12 containing the sfiA::lacZ gene fusion. Maximum induction of the SOS-response was observed with the quinolone concentrations that produced the most killing. There was also a modest increase in the rate of mutation in the lactose and galactose operons in a GalE- background, provided there was a functioning SOS system. PMID- 3323161 TI - Enzyme-linked immunosorbent assay for the in-vitro detection of sensitivity of Chlamydia trachomatis to antimicrobial drugs. AB - A new method of testing antimicrobial activity in vitro against Chlamydia trachomatis by enzyme-linked immunosorbent assay (ELISA) was developed by using a monoclonal antibody reacting with the major outer membrane protein of C. trachomatis LGV2 serotype. ELISA was compared with standard iodine stain, with immunofluorescence assay (IFA) and immunoperoxidase assay (IPA) performed with the same monoclonal antibody as in the ELISA. The MICs and MBCs of rifampicin, oxytetracycline, erythromycin, chloramphenicol and cefazolin detected by ELISA were higher than those determined by iodine stain and slightly lower than those determined by IFA and IPA. Since ELISA was at least as informative as the previously described techniques, but more rapid and standardizable and easier to perform, the assay may be useful in measuring the antimicrobial drug susceptibility of C. trachomatis. PMID- 3323162 TI - Pharmacokinetics of roxithromycin in paediatrics. AB - Macrolides are well known for their high lipid solubility and good tissue penetration. The pharmacokinetic properties of roxithromycin, a new semisynthetic macrolide, appear to be very interesting in healthy adult patients. Five paediatric pharmacokinetic studies are summarized and show that the pharmacokinetic properties of roxithromycin in paediatrics are very similar to those previously reported in adults and suggest that the same dose every 12 h is appropriate in paediatrics, 2.5 mg/kg. The diffusion of roxithromycin into upper respiratory tract tissues appears to be good in children. PMID- 3323163 TI - Pharmacokinetics of roxithromycin in renal and hepatic failure and drug interactions. AB - In patients with renal insufficiency roxithromycin pharmacokinetic parameters are significantly altered. In particular, the Cmax, the AUC and the T1/2 are increased and the Clr is reduced. In alcoholic cirrhotic patients the blood half life is dosage higher than in normals. In spite of this, in these types of patients the usual roxithromycin dosage should not be modified. Potential pharmacokinetic drug interactions that involve roxithromycin are very few and concern only disopyramide and theophylline. Theophylline concentrations should be monitored if the pretreatment blood level is greater than 15 mg/l. PMID- 3323164 TI - Tissue distribution of roxithromycin. AB - As tissue distribution studies have become increasingly important aspects of the assessment of new antimicrobials, roxithromycin distribution has been evaluated in experimental models and in human tissues and body fluids. High levels were achieved in respiratory tract tissues and fluids and in the male and female genital tract. In most experiments the local concentrations of roxithromycin were as high as that in serum, reaching 4-6 mg/l (or mg/kg) or more. These high levels were generally stable and an equilibrium was reached between central and extra vascular compartments. These data provide important information which may be clinically relevant. PMID- 3323165 TI - Roxithromycin in the therapy of Streptococcus pyogenes throat infections. AB - Roxithromycin in two dosage regimens was compared with erythromycin in the therapy of 227 patients with throat infectious due to Streptococcus pyogenes. All three groups had the same clinical efficacy but roxithromycin 300 mg daily was less effective than erythromycin 500 mg qds in eradicating S. pyogenes while there were less antibiotic-related side effects with roxithromycin 150 mg bd than with erythromycin. PMID- 3323166 TI - Roxithromycin, a new macrolide antibiotic, in the treatment of infections in the lower respiratory tract: an overview. AB - Roxithromycin is a new macrolide antibiotic with good absorption and a longer half-life than erythromycin. Worldwide clinical studies to evaluate its efficacy and safety in the treatment of infections of the lower respiratory tract have achieved a clinical success rate of 89% with few and mild side effects. Double blind studies comparing roxithromycin with cephradine, erythromycin ethylsuccinate and doxycycline in pneumonia, acute exacerbations of bronchitis in patients with chronic obstructive airways disease, and acute bronchitis have been done. The clinical response to comparative regimens has been similar and ranges from 60% response with either regimen in patients with chronic airways disease to 90% response in patients with acute bronchitis or pneumonia. Roxithromycin appears to be as effective as erythromycin or doxycycline for the treatment of either Streptococcus pneumoniae or Haemophilus influenzae infections. A large double-blind trial comparing cephradine and roxithromycin in 90 cases of bacteriologically confirmed pneumococcal pneumonia in South African gold miners resulted in a 93% and 100% respective clinical response rate. The bacteriological results revealed interesting results in this same study, in that cultures from 17% of patients receiving roxithromycin and 23% of those receiving cephradine remained positive for S. pneumoniae after therapy was finished and an excellent clinical response had been obtained. Side effects in all studies have been transient and mild, with an elevated transaminase value being the most common in both roxithromycin and erythromycin or cephradine regimens. Roxithromycin appears to be a safe and effective oral antibiotic for the treatment of pneumococcal pneumonia and other infections of the lower respiratory tract, and is as effective as erythromycin, doxycycline or cephradine. PMID- 3323167 TI - Roxithromycin in skin and soft tissue infections. AB - In a double blind randomised investigation in 76 patients, roxithromycin (150 mg bd) and doxycycline (200 mg once daily) were compared in two groups of patients who were well-matched for age, sex, body weight, diagnosis, duration and severity of disease and associated pathological conditions, with infected skin conditions. Clinical effectiveness was 92% for roxithromycin and 82% for doxycycline, and bacteriological effectiveness also 92% and 82% respectively, the differences not being statistically significant. PMID- 3323168 TI - Roxithromycin in nongonococcal urethritis. AB - This presentation is a summary of five different studies on the efficacy and tolerance of roxithromycin in the treatment of non-gonococcal genital infections. Three of the studies were double-blind comparative and two were open studies. Of the 924 out-patients whose data were analysed for clinical efficacy, 637 received treatment with roxithromycin 150 mg bd. The standard dose of roxithromycin, 150 mg bd for ten days, was compared with doxycycline 200 mg daily, lymecycline 300 mg bd and roxithromycin 450 mg once daily. The overall clinical success rate was 90% (576 of 637 patients) for roxithromycin 150 mg bd. In the three comparative trials, no significant difference was found between the clinical success rates of roxithromycin 150 mg bd and the other drugs. The overall clinical success rate with roxithromycin 150 mg bd was 92% (512/558) in nongonococcal urethritis and 81% (64/79) in cervicovaginitis. Taking into account all patients treated with roxithromycin 150 mg bd, the bacteriological success rate was 90% (444/492). In the comparative trials, no significant difference could be found between the treatment groups. Roxithromycin 150 mg bd was effective in eradicating 97% (308/316) of the isolates of Chlamydia trachomatis, 88% (149/170) of Ureaplasma urealyticum, 73% (40/55) of Mycoplasma hominis and 57% (13/23) of Gardnerella vaginalis. The present findings show that a high cure rate can be achieved with a ten-day course of treatment with roxithromycin and that it is at least as effective as the tetracyclines commonly used in the treatment of nongonococcal urethritis. A higher dosage than 300 mg/day of roxithromycin did not offer any clear advantage in terms of efficacy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323169 TI - A review of the in-vitro activity of roxithromycin against genital pathogens. AB - The in-vitro activity of roxithromycin against Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Treponema pallidum, Gardnerella vaginalis and Haemophilus ducreyi is reviewed. Roxithromycin demonstrated equivalent activity to erythromycin against N. gonorrhoeae, C. trachomatis, M. hominis, U. urealyticum, G. vaginalis and H. ducreyi. In a rabbit model for syphilis, potentially useful activity against T. pallidum has been demonstrated. PMID- 3323170 TI - Comparative pharmacokinetics of macrolides. AB - The search for erythromycin derivatives with improved antibacterial and/or pharmacokinetic properties, has led to the synthesis of several new agents. Roxithromycin, an ether oxime derivative of erythromycin, is one of the more promising. The main differences between erythromycin and roxithromycin are their kinetics, roxithromycin giving higher serum concentrations than erythromycin at equimolar oral doses. Its elimination half-life is also longer, about 12 h compared to 2-3 h for erythromycin. As their tissue distributions and antibiotic profiles are similar, roxithromycin can be administered in lower daily doses and at less frequent intervals. A suitable dosage regimen for roxithromycin seems to be 150 mg every 12 h. From a pharmacokinetic point of view, daily dosing with roxithromycin would be equivalent to the administration of erythromycin every 6 h. PMID- 3323171 TI - Roxithromycin: a pharmacokinetic review of a macrolide. AB - In humans, roxithromycin is rapidly absorbed from the gastrointestinal tract producing peak levels (Cmax) within 2 h. The drug is eliminated with a half-life (T1/2) of about 10 h. Roxithromycin is not extensively metabolized. Approximately 53% is excreted in the faeces and about 10% of the dose is eliminated in urine. Although dose-dependency (with doses from 150 to 450 mg) was observed for certain pharmacokinetic parameters, dose-proportionality could only be demonstrated with urine data. During multiple dosing, steady state is usually reached by day four and is dose-dependent. There is a slight but clinically unimportant increase in the T1/2 of the drug with repeated administration. While the rate of absorption is not affected by age, the rate of elimination and renal clearance are decreased in the elderly subjects. No significant differences were observed for Cmax and Tmax between normal and renally impaired subjects. AUCs and elimination T1/2 were greater, and significantly less drug was excreted in renally impaired patients. In patients with liver cirrhosis Cmax, Tmax, and AUCs are not affected. The bioavailability of the drug is not affected to a clinically important extent when it is given either with milk or food. Less than 0.05% of a single 300 mg dose is excreted in the breast milk of lactating women. After oral dosing a very high concentration of roxithromycin is achieved in pulmonary, prostatic, and tonsillar tissues. However, roxithromycin was not detected in the cerebrospinal fluid of subjects with non-inflamed meninges. It is concluded that 150 mg roxithromycin twice daily or 300 mg once a day should provide plasma levels above the minimum inhibitory concentrations required for antibacterial activity. PMID- 3323172 TI - Acute lymphoblastic leukemia of childhood. AB - Over the last 20 years, the rate of long-term disease-free survival of childhood acute lymphoblastic leukemia increased from less than 1 to 60 per cent. Strategies for disease control include (1) intensive multiagent induction to rapidly decrease the tumor burden and minimize the chance of emergence of a resistant population of cells, (2) restoration of normal hematopoiesis as soon as possible to reduce the period of pancytopenia, (3) meticulous supportive care, (4) prevention of sanctuary disease, and (5) therapy tailored to the potential risk of relapse as predicted by the prognostic factors of the patient. Further progress must be made in identifying prognostic factors, preventing and treating relapse, finding novel modalities of therapy, and delineating and minimizing long term side effects. PMID- 3323173 TI - Acute nonlymphocytic leukemia in children. AB - Acute nonlymphocytic leukemia (ANLL) is a heterogeneous group of hematologic malignancies caused by a clonal proliferation of primitive myeloid cells. 30 Infiltration of the bone marrow by these cells causes impairment of normal hematopoiesis and results in anemia, granulocytopenia, and thrombocytopenia. Recent progress in bone marrow culture techniques, cytogenetics, and immunology have contributed to a better understanding of the pathophysiology of ANLL. Major therapeutic advances have also occurred because of improved supportive care and carefully designed prospective and randomized clinical trials. This article presents the current knowledge of the diagnosis and management of ANLL. PMID- 3323174 TI - Malignant non-Hodgkin's lymphomas in children. AB - The spectrum of non-Hodgkin's lymphomas (NHL) that occurs in children differs markedly from that in adults. This is probably a consequence of differences in the proportions of precursor and mature lymphoid cells in the immune systems of children and adults, and the greater emphasis on the development of an immunologic repertoire in the child. Childhood NHL can be classified into three main types based on histology, all of them diffuse: lymphoblastic, small noncleaved cell, and large cell. The majority of lymphoblastic lymphomas are of immature T cell (thymocyte) origin, although a few have a B cell precursor phenotype. All express the enzyme terminal transferase. Small noncleaved lymphomas express B cell characteristics, as do the majority do the majority of large cell lymphomas, although a small proportion of the latter express T cell characteristics. Very few are of true histiocytic origin. Little is known of the epidemiology of lymphoblastic and large cell lymphomas. However, using histology as a diagnostic criterion, both occur throughout the world and occur primarily, as do all childhood NHL, in the first two decades of life. There appear to be at least two types of small noncleaved cell lymphomas, both of which are associated with specific chromosomal translocations. An endemic form occurs at high frequency in equatorial Africa, and a sporadic form occurs at low frequency throughout the world. The endemic tumor is associated with the Epstein-Barr virus, it has a high incidence of jaw tumors, and has a breakpoint on chromosome 8 that is usually some distance upstream of the c-myc oncogene. The sporadic tumor is only occasionally associated with EBV, it often involves the bone marrow, particularly at relapse, and has a breakpoint on chromosome 8 that is usually very close to or within the c-myc oncogene. Childhood NHL is rarely truly localized, and treatment regimens are always based on chemotherapy. There is no evidence that radiation is beneficial when modern combination drug regimens are employed as the primary therapeutic modality. Prophylactic treatment to the central nervous system is recommended in nearly all patients, and intrathecal drugs, usually supplemented by some form of high-dose or intermediate-dose methotrexate, appear to represent adequate prophylaxis to the CNS. The most effective regimens result in cure in almost all patients who have limited overt disease, and in a high proportion (50 to 75 per cent) of patients with extensive disease, although patients with bone marrow involvement do poorly with most regimens.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323175 TI - Hodgkin's disease in children. AB - Hodgkin's disease may now be managed with several different regimens with the expectation of curing approximately 90 per cent of patients. Radiotherapy alone achieves this cure rate only in unilateral high cervical or inguinal stage 1 presentations. With all other presentations, radiotherapy requires the addition of chemotherapy to sustain the 90 per cent cure level. Combined modality regimens offer the patient the advantage of reduced doses of each modality in terms of number of Gy and courses of chemotherapy. The contribution of the staging laparotomy to combination therapy is now being questioned. This issue becomes pressing as imaging of the lymphatic system and commonly involved extranodal sites of disease is improved by computed tomography, magnetic resonance, and ultrasound technology. Only the spleen escapes adequate examination. The failure of imaging techniques to adequately determine the status of the spleen is compensated by the chemotherapy sensitivity of splenic disease, as often demonstrated in the treatment of patients with stage IV disease. Staging laparotomy for preadolescent children should be done on special indications, because splenectomy confers a life-long (50 years or more) threat of overwhelming infection despite administration of pneumococcal vaccine and the use of oral penicillin prophylaxis. The use of radiotherapy in a dose range that inhibits bone and dental development in immature, preadolescent children can no longer be condoned. Treatment with chemotherapy alone must be considered as the option for preadolescent and younger adolescent children. Radiotherapy in a low dose range (2000 to 2200 cGy) in combination with chemotherapy constitutes a possible alternative treatment. In combined therapy regimens, it appears unnecessary to deliver six full courses of chemotherapy because regimens using three or four courses have demonstrated effectiveness in adults with early stage disease. The selection of the chemotherapy regimen should be made with care so as to eliminate drugs causing sterility in the young male, ovarian dysfunction in females, and second malignant tumors including acute myeloid leukemia (AML). In addition, doxorubicin should be used only in noncardiotoxic cumulative doses. Pretreatment determinations of the cardiac ejection fraction provide some assurance of safety during doxorubicin therapy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323176 TI - Rhabdomyosarcoma in children and adolescents. A review. AB - Children and adolescents with RMS presently have an overall survival of 60 to 65 per cent when treated with multimodality therapy. Those individuals with favorable histologic features and either complete resection or microscopic residual have an 80 to 85 per cent probability of long-term survival. These accomplishments by the IRS committee of the Children's Cancer Study Group and the Pediatric Oncology Group have been extended to thousands of patients. Other investigators in the United States, Great Britain, and Europe, working both in collaboration and independently of the IRS, have been responsible for innovative therapies, which should further reduce the mortality and morbidity of this common soft tissue sarcoma. Increasing emphasis is being placed on the tumor biology, molecular genetics, and epidemiology of RMS, as well as on the quality of life in survivors. At the fifteenth anniversary of its inception, the IRS has fulfilled the expectations of its founders as a model for intergroup collaborative research. Credit for these accomplishments can only go to the hundreds of investigators and their patients who have participated in these studies. PMID- 3323177 TI - Malignant bone tumors in children: osteosarcoma. AB - Osteosarcoma is a rare malignant tumor of bone that produces osteoid. Most tumors arise in the metaphyses of long bones. At least 80 per cent of patients have subclinical metastases at diagnosis. Successful management of osteosarcoma requires surgical control of the primary tumor and chemotherapeutic control of systemic metastases. Wide resection of primary tumor is often compatible with limb-sparing surgery. Multiagent chemotherapy has significantly enhanced disease free survival. Osteosarcoma metastasizes to lung and other bones. Aggressive surgical resection can sometimes control pulmonary metastases; bony metastases are almost always followed by death. PMID- 3323178 TI - Malignant bone tumors in children: Ewing's sarcoma. AB - Ewing's sarcoma is a rare, malignant, small, round-cell tumor of bone. Most tumors arise in the diaphyses of long bones, but any bone can be involved. Chemotherapy is essential for long-term survival. Multiagent protocols are superior to single-agent therapies, but the ideal regimen has not been established. Both radiation therapy and surgery have been employed for local control of primary tumors. Control with either modality is significantly better when used in conjunction with effective chemotherapy. Patients who present with metastatic disease or pelvic primaries have a worse prognosis. Autologous bone marrow transplantation may improve disease-free survival for this group. PMID- 3323179 TI - Neuroblastoma: the challenge and frustration. AB - Neuroblastoma occurs in 500 children yearly in the United States. Recent findings in tumor biology and the evaluation of biochemical markers have been helpful in predicting outcome, but clinicians have not been able to exploit these findings to develop successful therapy. Staging is important, but it will be necessary to standardize staging at various centers to compare results of therapy. The role for autologous bone marrow transplantation in the management of neuroblastoma remains to be determined, and search for effective therapy continues. This disease has challenged cell biologists, it has served as a basis for intense scientific inquiry, and it has defied the therapeutic attempts of pediatric oncologists. It is hoped that current enquiry will inspire newer therapies and fulfill the goal of offering all children with this tumor an opportunity to be cured. PMID- 3323180 TI - Intraocular and extraocular retinoblastoma. AB - Retinoblastoma, the most common primary ocular malignancy of childhood, is a tumor in which the pediatrician and pediatric oncologist can now play a much more significant role in therapy. Developments in molecular biology have now made carrier testing and prenatal diagnosis feasible. In the near future, these developments should greatly augment the pediatrician's and pediatric oncologist's ability to offer accurate and appropriate genetic counseling for affected families. A practical staging system for extraocular retinoblastoma together with stage-related effective chemotherapy and radiation therapy was presented in this chapter. These modalities now make possible long-term survival for the majority of the 1 out of 8 children with retinoblastoma who would otherwise die from metastatic disease. Finally, 40 per cent of all children with retinoblastoma (those with the germinal mutation) are at lifelong risk for second, nonocular malignancies. The recognition that more than half of these children will actually develop second tumors by the fourth decade of life makes vigilant follow-up care for these patients a necessity. PMID- 3323181 TI - Histiocytosis X. Langerhans' cell histiocytosis. AB - Histiocytosis X is a complex and poorly understood entity. Nevertheless, it would appear as if certain themes are found recurrently throughout the literature dealing with this disease and a review of them serves as a useful summary. 1. Problems with Nomenclature. To name or categorize a disease based on end-organ pathology is generally not clinically useful, but this is what we have done with histiocytosis X. It has caused substantial confusion among physicians and patients alike concerning diagnosis, prognosis, and treatment. Further attempts at improving the nosology of this disease will not be useful unless those new names also reflect scientific advances in our understanding of etiology, pathogenesis, and therapy. 2. Identification of the Langerhans' Cell as the Consistent Pathognomonic Cell in the Lesions of Histiocytosis X. Although the Langerhans' cell was identified more than a century ago, it has only recently been recognized as the cell that proliferates in this disease. Nevertheless, several important questions remain regarding the relationship of the Langerhans' cell to histiocytosis. Foremost among these questions is whether the Langerhans' cell is a truly normal Langerhans' cell, responding appropriately to immune system signals, or if it is an abnormal variant, possibly even neoplastic. 3. Recognition that Immune System Dysfunction Is a Critical Part of Histiocytosis X. The immune system is the focus of most recent clinical research. Results of these studies are obviously important with regard to both the biology and management of this disease. 4. Histiocytosis X Is an Extremely Heterogeneous Clinical Disorder. As mentioned before, the term histiocytosis X was originally intended by Lichtenstein to describe a pathologic, and not clinical, entity. It is rare to find two patients with this disease who are exactly alike. To make matters even more confusing, the disease includes both infants with disseminated fatal disease as well as middle-aged adults with solitary bony lesions. 5. The Disease Requires Improved Therapy, but it Is a Difficult Setting in which to Perform Clinical Studies. Improved therapy is required in patients with this disease, especially those with the disseminated form. But it will be difficult to develop improved therapy until definitive answers are provided to some of the basic questions of etiology and pathogenesis. Unfortunately, these clinical studies are not readily available because of the rare occurrence of this disease and its extreme clinical heterogeneity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323182 TI - Progress in the management of childhood brain tumors. AB - The authors have attempted to summarize the contributions that have been made towards improvements in the management of children with brain tumors by the development of sophisticated imaging tools for diagnosis, by the development of more sophisticated and versatile neurosurgical tools, by refinements in radiation therapy delivery equipment and techniques, and by the introduction of chemotherapy into therapy regimens. Overall, the interaction of all of these modalities is stressed, culminating in a comprehensive multidisciplinary approach to the management of children with brain tumors. PMID- 3323184 TI - Management of infections in children with cancer. AB - Infectious complications remain a frequent cause of morbidity and mortality in children with cancer, especially in those who are granulocytopenic. Physicians caring for these children must approach each new febrile episode as if it were life threatening. Questions concerning the present illness must be comprehensive. The physical examination should be done in a compulsive manner because the more obvious signs of inflammation are often absent because of granulocytopenia. Immediate initiation of broad-spectrum intravenous antibiotic coverage is required once the appropriate specimens for diagnostic microbiology studies have been obtained. Because these patients may exhibit either dramatic or, more often, only subtle clinical findings, they must be monitored closely and have a complete physical examination at least daily. The laboratory studies frequently determine the etiology of the fever. Therapy can then be modified, based upon the particular pathogen isolated or the type of infection identified. Because bacterial infections are responsible for most infectious febrile episodes in the granulocytopenic child with cancer, appropriate antibiotic therapy usually is curative. However, some patients remain febrile and granulocytopenic without explanation. These patients frequently have a fungal infection and respond to amphotericin B therapy. Our present armamentarium of antimicrobial agents against the common pathogens encountered in cancer patients, except for cytomegalovirus, is adequate. Future advances in therapy of infections in children with cancer will probably be in the area of immunotherapy. This would include both passive administration of products to strengthen a debilitated immune system, together with active immunization with the aim to prevent infectious complications. Prevention of infection in the cancer population may be one of the keys to producing longer remissions and prolonged overall survival, by enabling pediatric oncologists to administer more intensive induction chemotherapy. PMID- 3323183 TI - Bone marrow transplantation in the treatment of children with cancer. Current status. AB - Bone marrow transplantation (BMT) is a promising method of treatment for children with resistant malignancies. The discrepancies in the results of BMT from institution to institution are based on patient selection, timing of transplantation, and preparatory regimens that differ from place to place. Studies that address specific questions are needed: questions like Under what conditions is BMT superior to conventional chemotherapy? Which preparatory regimen is superior? What are the results based on the status of the patients' malignancies and quality of life? Multi-institutional studies are needed to answer these questions. PMID- 3323185 TI - Insulin levels and glucose intolerance in patients with cirrhosis and non cirrhotic portal fibrosis. PMID- 3323186 TI - Lung function studies in healthy Indian subjects. PMID- 3323187 TI - Systemic connective tissue diseases in India--IX. Survival in systemic lupus erythematosus. PMID- 3323188 TI - Hand syndromes in diabetes mellitus. PMID- 3323189 TI - Falciparum malaria presenting as testicular pain and swelling. PMID- 3323190 TI - Renal transplantations in Rajasthan. PMID- 3323191 TI - Interaction of ras oncogene product p21 with guanine nucleotides. AB - The nucleotide exchange reaction was observed with purified ras oncogene product p21 overproduced in Escherichia coli (Hattori, S. et al. (1985) Mol. Cell Biol. 5, 1449-1455) under various conditions. (NH4)2SO4 increased the rate of dissociation of bound GDP from c-rasH and v-rasH p21. The dissociation kinetics were those of a first order reaction, and there was a linear relationship between the rate constant and the (NH4)2SO4 concentration. At any concentration of (NH4)2SO4, the exchange rate was faster with v-rasH p21 than that with c-rasH p21. EDTA and (NH4)2SO4 synergetically stimulated the dissociation reaction. Nucleotide-free p21 was prepared by gel filtration on Sephadex G-25 in the presence of 5 mM EDTA and 200 mM (NH4)2SO4 at room temperature. The free p21 was quite thermolabile, but the addition of GDP or GTP completely protected p21 from thermal inactivation. The dissociation constants for GDP and GTP were determined with free p21 to be 8.9 and 8.2 nM, respectively, for v-rasH p21, and 1.0 and 2.6 nM for c-rasH p21. In the presence of 200 mM (NH4)2SO4, these dissociation constants increased 3- to 12-fold. PMID- 3323192 TI - Tetrahymena actin: localization and possible biological roles of actin in Tetrahymena cells. AB - Though actin is ubiquitous in eukaryotes, its existence has not been clearly proven in Tetrahymena. Recently, we have succeeded in cloning and sequencing the Tetrahymena actin gene using a Dictyostelium actin probe (Hirono, M. et al. (1987) J. Mol. Biol. 194, 181-192). The primary structure of the Tetrahymena actin deduced from the nucleotide sequence of its gene is greatly divergent from those of other known actins, making it necessary to ascertain whether the predicted Tetrahymena actin is indeed an actin. In this paper, we investigated the localization of the predicted Tetrahymena actin by an immunofluorescence technique using antibody against its synthetic N-terminal peptide, in order to elucidate its possible biological roles. The results showed that immunofluorescence was localized in the division furrow of the dividing cell, and in the intranuclear filament bundles formed in cells exposed to heat shock or DMSO. In addition, the oral apparatus and the proximity of the cytoproct, which are organelles involved in endocytosis and exocytosis, respectively, also fluoresced. Thus, we conclude that the Tetrahymena actin we identified is indeed an actin and plays the same biological roles as ubiquitous actins do, although it is considerably divergent in its amino acid sequence. PMID- 3323193 TI - Production of recombinant human pancreatic secretory trypsin inhibitor by Escherichia coli. AB - A synthetic gene for human pancreatic secretory trypsin inhibitor (PSTI) was fused to the coding sequence for the amino-terminal 135 amino acid residues of human interferon-gamma (IFN-gamma) by interposing a methionine codon sequence, and the resulting hybrid gene was efficiently expressed in Escherichia coli cells. Recombinant human PSTI (rHu-PSTI) was separated from the IFN-gamma/PSTI fused protein by cleavage at the methionine residue with cyanogen bromide. Finally, rHu-PSTI was purified by affinity chromatography on a bovine trypsin-CH Sepharose 4B column. The amino acid composition, partial amino-terminal sequence, disulfide formation, human trypsin inhibitory activity, and immunoreactivity against rabbit anti-human PSTI serum of rHu-PSTI corresponded to those of the natural form. PMID- 3323194 TI - Comments on "The Physical Death of Jesus Christ". PMID- 3323195 TI - F. Gaynor Evans--a short biography. PMID- 3323196 TI - The history of some fundamental concepts in bone biomechanics. PMID- 3323197 TI - The mechanical properties of trabecular bone: dependence on anatomic location and function. AB - In 1961, Evans and King documented the mechanical properties of trabecular bone from multiple locations in the proximal human femur. Since this time, many investigators have cataloged the distribution of trabecular bone material properties from multiple locations within the human skeleton to include femur, tibia, humerus, radius, vertebral bodies, and iliac crest. The results of these studies have revealed tremendous variations in material properties and anisotropy. These variations have been attributed to functional remodeling as dictated by Wolff's Law. Both linear and power functions have been found to explain the relationship between trabecular bone density and material properties. Recent studies have re-emphasized the need to accurately quantify trabecular bone architecture proposing several algorithms capable of determining the anisotropy, connectivity and morphology of the bone. These past studies, as well as continuing work, have significantly increased the accuracy of analytical and experimental models investigating bone, and bone/implant interfaces as well as enhanced our perspective towards understanding the factors which may influence bone formation or resorption. PMID- 3323198 TI - The elastic anisotropy of bone. AB - In modeling the anisotropic properties of hydroxyapatite (HAp), Katz found that two kinds of phenomenological relationships held among the elastic stiffness coefficients. Firstly, there are three linear combinations--(c11 + c22 + c33), (c44 + c55 + c66), (c12 + c13 + c23)--which arise naturally when computing the isotropic averages of anisotropic crystal systems over all possible spatial orientations. Secondly, the degree of elastic anisotropy in such crystal systems is characterized by two specific factors: (a) the ratio of the linear compressibility along the unique axis to that perpendicular to it, (c11 + c12 - 2c23)(c33 - c13); and (b) the ratio of the two shear moduli, c44/c66. There have been a number of experiments in recent years which have used either mechanical methods or ultrasonic techniques to measure the anisotropic elastic properties of bovine and human cortical bone. Analyses of data from these experiments show that the above relationships also play a significant role in characterizing the elastic anisotropy in bone. PMID- 3323199 TI - Advances in the fracture mechanics of cortical bone. AB - As cortical bone is a semi-brittle solid, its fracture is dependent not only on the magnitude of the applied stress, but also on the nature of any intrinsic or introduced cracks. Consequently a variety of fracture mechanics techniques have been utilised to evaluate the fracture toughness of cortical bone, including the single edge notched, centre notched cylindrical and compact tension methods, and values have been established for the critical stress intensity factor (Kc) and the critical strain energy release rate (Gc). The Kc and Gc values obtained depend on the orientation of the cortical bone, as well as on bone density, the velocity of crack propagation and specimen geometry. The significance of these fracture mechanics parameters for cortical bone is critically reviewed. PMID- 3323200 TI - Functional strain in bone tissue as an objective, and controlling stimulus for adaptive bone remodelling. AB - The skeleton consists of a series of elements with a variety of functions. In locations where shape or protection are of prime importance the bone's architecture is achieved during growth under direct genetic control. In locations where resistance to repetitive loading is important only the general form of the bone will be achieved as a result of growth alone, the remaining characteristics result from functional adaptation. This mechanism ensures that bone architecture is modelled and remodelled until prevailing strains match those genetically prescribed for that location. For this match to be established, and subsequently maintained, bone cells must be able to 'assess' feedback derived directly or indirectly from the functional strains produced within the tissue. These strains are therefore the objective of functionally adaptive remodelling, and the stimulus for its control. Evans was the first person to refer to the recording of functional strains from gauges attached to bone in vivo. This technique has allowed quantitative investigations on bone's normal functional strain environment, and its adaptive response to changes in its state of strain. Recent investigations have extended to the immediate effects of dynamic strains on the structure of the bone matrix, and the biochemical behaviour of the resident bone cells. Such studies should reveal the mechanism by which strains within the matrix are transduced into the biochemical signals by which adaptive remodelling is controlled. PMID- 3323202 TI - The role of angiotensin II in the antidiuresis and antinatriuresis induced by stimulation of the sympathetic nerves to the rat kidney. AB - 1 Stimulation of the renal sympathetic nerves in pentobarbitone anaesthetized rats at low frequencies, which did not statistically change renal blood flow and glomerular filtration rate, significantly reduced urine flow by 35%, absolute sodium excretion by 44% and fractional sodium excretion by 40%. 2 In rats fed a low sodium diet for 2 to 3 weeks, similar renal nerve stimulation caused no consistent changes in renal haemodynamics but decreased urine flow by 38%, absolute sodium excretion by 44% and fractional sodium excretion by 38%, which were identical responses to those obtained in sodium replete animals. In contrast, stimulation of the renal nerves in sodium depleted rats given a constant infusion of captopril at 500 micrograms/kg/h had no statistically significant effect on either water or sodium excretion. 3 Renal nerve stimulation in rats given saline to drink and DOCA for 2 to 3 weeks did not significantly change either renal haemodynamics or the output of water or sodium. However, in other animals maintained on a high salt intake but given a constant infusion of angiotensin II (20 ng/kg/min), renal nerve stimulation caused minimal changes in renal haemodynamics but significantly reduced urine flow by 41%, absolute sodium excretion by 54% and fractional sodium excretion by 49%. 4 These results show that the neurally-mediated tubular responses require the presence of a minimal circulating level of angiotensin II since, when its production is blocked, either acutely or chronically, the renal nerve-induced antinatriuresis and antidiuresis is inhibited but can be restored by the infusion of angiotensin II. These findings provide direct evidence that angiotensin II has an important potentiating action at the renal nerve junctions, most probably at the epithelial cells of the renal tubule. PMID- 3323201 TI - Mechanical loading history and skeletal biology. AB - A comprehensive theory which relates tissue mechanical stresses to many features of skeletal morphogenesis, growth, regeneration, maintenance and degeneration is reviewed. The theory considers the repeated or intermittent mechanical forces which constitute the loading history on the chondro-osseous skeleton. The results of numerous mechanical stress analyses indicate that the local tissue stress history plays a major role in controlling connective tissue biology. The strong influence of mechanical energy in ontogenesis implies a comparably strong influence in phylogenesis. The fact that the mechanical stress histories in skeletal tissues are directly related to the force of gravity suggests that the life forms that have evolved on Earth are closely tied to our gravitational field. PMID- 3323203 TI - Wear, creep, and frictional heat of femoral implant articulating surfaces and the effect on long-term performance--Part I, A review. AB - Creep and wear of articulating reconstructed joints is a complex process, resulting in adverse tissue response, decreased range of motion, and eventual revision. As improvements are made in the design and surgical techniques of reconstructed joints, the long-term performance of the articulating system and materials becomes more important, particularly for younger, heavier, and more active patients. One aspect previously ignored in the long-term performance of articulating systems is the tendency for these systems to generate heat during articulation, particularly for extended periods of relatively strenuous activity. The present study reviews the various aspects of joint lubrication, friction, wear, and overall system performance. Local heating can increase the creep, wear, and oxidation degradation of UHMWPE, thus, specific attention is given to the effect that heat generation can have on long-term performance of these systems. Because of the complexity of this issue, the treatment of these various performance aspects is divided into two parts. The present part, Part I, reviews the various aspects of articulation performance. Part II presents results of friction, heating, and torque testing of various metal and ceramic hip systems. Criteria for frictional heating is also presented, along with discussion related to the various heat transfer mechanisms involved with heat dissipation. PMID- 3323204 TI - Magnetically enhanced insulin release in diabetic rats. AB - Polymer matrices containing insulin and embedded magnets were implanted subcutaneously in diabetic rats for 51 days. Passive release of insulin from the polymer resulted in a decrease in the blood glucose level. When the diabetic rats were exposed to an oscillating magnetic field, the blood glucose levels were additionally lowered by nearly 30%. No statistically significant effect in blood glucose decrease was observed in four different sets of control animals subjected to the magnetic field. Because of the very small size of the implants, they may, with additional study, provide an alternative to current modes of therapy using programmable implantable infusion pumps. PMID- 3323205 TI - Full-thickness skin grafting for contact burns of the palm in children. AB - The authors report their experience in the treatment of deep contact burns of the palm with 12 children injured from 1980 to 1986. As an alternative to the use of split-thickness skin grafts for resurfacing, since 1983 they have used full thickness skin grafts harvested from the groin. To date, no child has required secondary revision of a full-thickness skin graft nor is it anticipated. There has been no donor-site morbidity thus far. Current protocol for treatment of these injuries depends upon an aggressive program of physical therapy, which includes nocturnal "sandwich" splinting and the close participation of the family. Prevention of these injuries will depend upon improved design of safety features for household appliances and consumer education at the time of purchase. PMID- 3323206 TI - The optimal time for excision of scald burns in toddlers. AB - During the past decade, morbidity and mortality have been shown to be decreased by early excision and grafting in treatment of moderate and large burns. Because of the lack of data on the efficacy of such treatment in scald burns, a retrospective study was done of children under age 4 who were admitted to a burn unit within three days of scald injury. Four groups were examined according to day of first surgical procedure: (1) sooner than five days; (2) 6-10 days; (3) 11 20 days; and (4) later than 20 days. The four groups (similar in age, weight, and percent of TBSA burn) were also analyzed for differences in percent of excised area, blood loss, and length of hospital stay. The amount of excised area in group 1 was significantly larger than in groups 2 and 3, and group 1 also had a significantly greater blood loss. Only in group 4 was the length of stay significantly increased. If excision could be delayed until after day 5, the area excised and the blood loss might be decreased without prolonging hospital stay. PMID- 3323207 TI - Steroid hormone antagonists at the receptor level: a role for the heat-shock protein MW 90,000 (hsp 90). AB - Antisteroid hormones compete for hormone binding at the receptor level and prevent the hormonal response. A new concept is proposed for explaining the antiglucocorticosteroid activity of RU 486 in the chick oviduct system. It is based on the ability of the antisteroid to stabilize the hetero-oligomeric 8S form of the glucocorticosteroid receptor (GR), which involves the interaction of the 94k-receptor and heat-shock protein MW 90,000 (hsp 90). It is proposed that hsp 90 caps the DNA binding site of the receptor, and this prevents it from binding to the DNA of hormone regulatory elements (HRE) and increasing transcription of regulated genes. This paper reviews other antiglucocorticosteroid and antiestrogen systems with reference to this hypothesis and also describes a four-step analysis of the molecular mechanism of antisteroid hormone action at the receptor level. PMID- 3323208 TI - Regulation of epitectin production in a malignant cell line. AB - RT112 cells, a line derived from a human bladder carcinoma, produce epitectin at very low levels in standard culture media; but production and secretion of this mucin are greatly increased when the cells are exposed to hyperosmotic conditions. It appears that hyperosmolarity, by inducing an increase in intracellular sodium, entrains an increase in intracellular free calcium. Evidence is presented for the view that it is the increase in intracellular free calcium that provides the more direct stimulus for the enhanced production of epitectin. PMID- 3323209 TI - Monensin inhibits secretion of extracellular matrix and the spreading of mesoderm cells in the early chick embryo. AB - Chick embryos in culture were treated with the secretion-inhibiting ionophore monensin at the gastrulation stage of development. After treatment for 5 h at a concentration of 10(-5) M the embryos showed a drastic reduction in the tissue space between the upper and lower epithelia, and reduced spreading of the mesoderm cells that occupied this space. The basement membrane, to which many mesoderm cells are normally attached, showed varying degrees of disruption, which permitted blebbing of the overlying epithelium. Intracellularly, the treatment caused extensive vacuolization in all tissues. These results were consistent with the effects expected by removal of hyaluronic acid from the extracellular space, and this was confirmed by demonstrating a sharp reduction in glucosamine incorporation in this region. Examination of the effects of monensin on isolated mesoderm cells in culture using interference reflection microscopy indicated that the spreading of these cells was reduced independently of the changes in the extracellular matrix of the embryo. That this was probably due to the inhibition of cell surface fibronectin secretion was shown by demonstrating severe changes in the distribution of this glycoprotein using the immunofluorescent technique. It is concluded that the effects of monensin on this intact, developing system are due primarily to the disruption of hyaluronic acid secretion, but that disrupted fibronectin synthesis contributes to the reduced spreading of mesoderm cells. PMID- 3323210 TI - Type I collagen permits invasive behaviour by retinal pigmented epithelial cells in vitro. AB - Epithelial cells cultured on type I collagen gels adopt a typical apical--basal polarity and undergo differentiation. We have compared the behaviour of chick embryo retinal pigmented epithelial (RPE) cells on collagen and on plastic with and without gelatin coats. RPE cell proliferation was similar on all three substrata, and post-confluent cultures exhibited multilayering. On plastic and gelatin-coated plastic, dome formation, typical of transporting epithelia, occurred. On type I collagen gels, however, dome formation did not occur, but rather invasion of the gel matrix by cords of epithelial cells took place. In contrast, invasive behaviour of the cells was markedly reduced on type IV coated collagen gels, particularly in the presence of laminin. These results illustrate the prominent role of the extracellular matrix on phenotypic expression by RPE cells and may represent a more general phenomenon. PMID- 3323211 TI - Characterization of Pales spermatocyte spindles, with reference to an MTOC associated protein. AB - Pales ferruginea spermatocytes, because of their high proportion of dividing cells, offer many advantages in the study of the meiotic spindle. In the present study we have combined ultrastructural and immunofluorescence techniques with biochemical analysis of constituent spindle components. Using a centrosome reactive serum, which recognizes an antigen in the centrosomal and midbody regions of dividing cells, we have identified an MTOC-associated polypeptide of 112,000 Mr with a pI of 5.6. The relative abundance of this protein in cells and isolated cytoskeletons indicates that it is present in other regions of the cell and is either more abundant, or is only recognized by the antibody in association with MTOCs. PMID- 3323212 TI - [Preoperative assessment of clamping in carotid artery surgery and adaptation of the operative technic]. AB - A retrospective study of 150 consecutive patients undergoing revascularization of internal carotid artery for atheromatous lesion of carotid bifurcation, included analysis of collaterals being compressed by common carotid artery simulating clamping. Two exploratory procedures had been applied routinely: global suprasigmoid digital subtraction angiography and Doppler velocimetry. Two groups of patients could be defined: clamping without risk (95.4%) and clamping at risk (4.6%). For the group of clamping at risk a surgical strategy is proposed allowing clamping without shunt by bypass between subclavian and internal carotid arteries of by bypass between common and internal carotid arteries because of the external carotid artery collaterals left untouched. A shunt is only necessary when the latter artery is occluded. Results of this series of patients explored in this way and operated upon confirmed these data: no clamping accident in the 1st group, one transient ischemic accident in the 2nd. PMID- 3323213 TI - [Adenocarcinoma of the duodenum. Apropos of 2 cases: review of the literature]. AB - The authors report two cases of duodenal adenocarcinoma. Review of literature has permitted them to conclude the rarity of the lesion which among malignant tumours of the small intestine, is the gommenest. Localization of the tumour in the periampullary area in 47% of cases rendered it difficult to differentiate from ampullary and pancreatic tumours especially with the unknown etiological factors (with exception to villous tumours which has a 35% rate of malignant transformation), and also with unspecific symptoms. Diagnosis by x-ray and endoscopy has an accuracy rate of more then 85%. Prognosis is bad and depend mainly on histological differentiation and lymph node spread. 5 years survival rate of 40-50% can be achieved by curative surgery namely cephalic duodeno pancreatectomy in cases with no lymph node involvement. PMID- 3323214 TI - [Tuberculosis of the hip: diagnostic problems. Apropos of 44 cases]. AB - Diagnostic difficulties in 44 cases of tuberculosis of hip are emphasized and the serious nature of sequelae stressed. A definite diagnosis (cytology positive for Kochs bacillus, positive biopsy) was possible in only 18 cases, presumption of the nature of the affection in the other cases depending on clinical, radiologic and biologic arguments and failure to respond to immobilization one month. PMID- 3323216 TI - Coordinative interactions in the separation of insulin and its derivatives by high-performance liquid chromatography. AB - The effects of various inorganic cations and anions on the chromatographic behaviour of insulin and its derivatives have been investigated. It was shown that on an octadecylsilica column at a given eluent composition the retention of insulins depends primarily on the nature of the anions. The cations have a secondary effect, depending on their size and coordination ability. The mechanism of the effect of the ions is complex. It includes the formation of ion pairs, their influence on dissociation processes, a silanophilic effect, coordination processes and changes in the structures of the insulins. PMID- 3323215 TI - [Anal fistula: value of the fistulectomy technic combined with endoanal suture using chromium catgut. Reflections apropos of 25 cases]. AB - Results of treatment of 25 cases of anal fistula demonstrate that these lesions can be treated by combined fistulectomy and endoanal suture whatever their anatomic type, if the technique is carried out patiently and strictly. It ensures successful relief in 100% of cases of fistula treated by first intention. Satisfactory results were obtained after recovery surgery in 3 of 5 cases (60%) the 2 patients failing to respond having been treated by Arnous' method. Its advantage is total conservation of anal sphincter, avoiding postoperative sphincteric complications and other local sequelae. PMID- 3323217 TI - Purification of human renin by renin inhibitor (ES-305) affinity chromatography. PMID- 3323218 TI - Artifacts in chromatography: an overview. AB - A brief overview of the field of analytical artifacts is provided, with examples of solvent impurities, stabilizers, polymer additives, and problems relating to Teflon, glassware, and laboratory contaminants. PMID- 3323219 TI - Cost and performance analysis of haemagglutination inhibition, passive haemagglutination, radial haemolysis, and enzyme immunoassay for measuring rubella antibody. AB - Cost and performance of non-commercial haemagglutination inhibition (HI) and radial haemolysis (RH) tests, and the commercially available passive haemagglutination (PHA) Rubacell and enzyme immunoassay (EIA) and Rubazyme assays were compared in their ability to detect rubella antibodies in 316 sera. Correlation coefficients were: HI to RH 0.96; HI to EIA 0.86. All 4 tests were in agreement on pre- and post-rubella immunization sera from 10 subjects. Eleven sera collected between 1 and 15 days after natural infection possessed clear HI titres whereas only 4 of them showed positive responses by PHA, RH or EIA. Immunity screening 285 sera identified 7 discordant results (positive in 2 of 4 tests). A detailed cost analysis for testing 100 sera showed a cost per test from +2.10 for HI to +3.71 for EIA. The labour component of the total cost was different for each assay and affected the unit cost of testing a single specimen. Results are discussed in view of antibody responses to specific rubella polypeptides and recommendations for diagnosis or immunity screening are made according to the findings. PMID- 3323220 TI - Robert Miles Pratt, Jr. (1942-1987): an appreciation. PMID- 3323221 TI - Genetic disorders associated with severe alopecia in children: a report of two unusual cases and a review. AB - Moderate to severe alopecia in children may be due to a genetic disorder. This paper reviews the heritable causes of alopecia in children and gives a detailed account of two affected unrelated children. One has alopecia universalis while the other has alopecia postulated to be due to a new disorder of genetic etiology. The article concludes that for purposes of genetic counseling and prognosis it is crucial that a correct diagnosis be made. PMID- 3323222 TI - Evaluation of commercial serodiagnostic kits for toxoplasmosis. AB - To evaluate commercially available diagnostic kits for human immunoglobulin G to Toxoplasma gondii, we purchased three enzyme immunoassay (EIA) (Cordia-T, Toxo Bio-EnzaBead, and Toxoelisa), two indirect hemagglutination (IHA) (TPM-Test and ToxHAtest), one fluoroimmunoassay (Toxoplasma-G FIAX), and one latex agglutination (Eiken Toxotest-MT) kit from U.S. suppliers. A total of 100 serum specimens, including 27 that were negative (less than 1:16) and 73 that were positive for the various titers in the Toxoplasma indirect immunofluorescence (IIF) test, were tested once with each kit; serum samples with discrepant results were retested. Qualitatively, results obtained with the Toxo Bio-EnzaBead EIA, the TMP-Test IHA, and FIAX, and the Toxotest-MT latex agglutination kits agreed exactly with those of IIF. Although all IIF-positive serum samples were detected by the Cordia-T and the Toxoelisa EIAs, four samples determined to be negative by IIF were identified as positive with the Cordia-T kit, and six negative samples by IIF were determined to be positive with the Toxoelisa kit. Results of the ToxoHAtest IHA kit were extremely difficult to read. Quantitatively, the seven kits were difficult to compare because the expression of results was not standardized. Of the four kits that gave positive results in titers, Toxoplasma-G FIAX had the closest agreement with IIF, as determined by the Spearman rank correlation coefficient (0.9168), followed by the Eiken Toxotest-MT (0.8293), the Toxo Bio-EnzaBead (0.7553), and the TPM-Test (0.7206) kits. PMID- 3323223 TI - Identification of a common immunodominant protein in culture filtrates of three Nocardia species and use in etiologic diagnosis of mycetoma. AB - Diagnosis of systemic nocardiosis has been hampered by difficulty in the rapid isolation and identification of the organism and by the frequent need for invasive biopsies. We show that a 55,000-Mr protein previously found in Nocardia asteroides is also present in N. brasiliensis and N. caviae culture filtrates. We also used the antigen in a dot blot assay to identify patients infected with N. brasiliensis. Sera from patients with mycetoma secondary to N. brasiliensis (n = 6) or Actinomadura madurae (n = 2) and 10 hospitalized controls were tested. Six (100%) of the sera from the patients with nocardial mycetoma had positive dot blots to purified antigen, whereas all 10 of the control sera were negative. Serum from one of two patients infected with A. madurae also reacted with the antigen. Thus, the 55-kilodalton protein appears to be produced by three medically important species of Nocardia and is useful when used in an immunoblot assay for identifying patients infected with these organisms. PMID- 3323224 TI - Identification of Streptococcus sobrinus with monoclonal antibodies. AB - Identification of Streptococcus sobrinus is often difficult to perform because of the great resemblance of the organism to other oral streptococcal species. Therefore, monoclonal antibodies were prepared which were shown to be highly specific for S. sobrinus. Cross-reactivity with other oral microorganisms has not been observed in an enzyme-linked immunosorbent assay and an immunofluorescence assay. These monoclonal antibodies belonged to the subclass immunoglobulin G2b. To be certain that the strains used in cross-reactivity tests were S. sobrinus, their DNA base composition was measured as a golden standard. Additional tests like colony morphology and sugar fermentation with the API 20 Strep system (Analytab Products, Montalieu-Vercieu, France) were performed. These additional tests turned out to be necessary because 100% correct identification could not be obtained by separate tests. Immunological characterization with the clones OMVU10 and OMVU11 proved to be discriminative between S. sobrinus and other streptococcal species. PMID- 3323226 TI - Comparison of enzyme immunoassay and culture for diagnosis of chlamydial conjunctivitis and respiratory infections in infants. AB - The efficacy of Chlamydiazyme (Abbott Laboratories, North Chicago, Ill.) in detecting neonatal conjunctival and respiratory infections caused by Chlamydia trachomatis was determined by comparison of this enzyme immunoassay (EIA) with the method of isolation of chlamydiae in tissue culture. The sensitivity and specificity of Chlamydiazyme for detecting C. trachomatis in conjunctival specimens from infants with conjunctivitis were 98 and 94%, respectively. For nasopharyngeal infection in infants with conjunctivitis, the sensitivity and specificity were 87 and 92%, respectively. There were nine nasopharyngeal specimens that were Chlamydiazyme positive and culture negative. All of these specimens demonstrated the presence of typical fluorescing chlamydial elementary bodies when pellets of the original specimens were examined with a fluorescein conjugated monoclonal antibody. When the EIA was performed on nasopharyngeal specimens from infants with suspected chlamydial pneumonia, 6 culture-positive and 10 culture-negative specimens were correctly identified. PMID- 3323225 TI - Characterization of Borrelia burgdorferi strains isolated from Ixodes pacificus ticks in California. AB - In a survey of 1,714 adult Ixodes pacificus ticks collected in northern California, 24 (1.4%) were found to be infected with spirochetes that reacted with an anti-Borrelia burgdorferi polyvalent conjugate in direct immunofluorescence tests. Eleven isolates of B. burgdorferi from these ticks were characterized by monoclonal antibody, polyacrylamide gel electrophoresis, and Western blot (immunoblot) analyses. Ten of the isolates had molecular and antigenic characteristics similar to those of other U.S. isolates. One strain, cloned by limiting-dilution techniques, was different from any previously reported U.S. strain, but similar to reported European strains. The cloned strain, DN127-Cl9-2, did not react with monoclonal antibodies to Osp A and Osp B major proteins found in most of the U.S. strains. It exhibited an abundant protein with an apparent molecular weight of 25,000. PMID- 3323228 TI - Examination of feces and serum for diagnosis of infant botulism in 336 patients. AB - In the 12-year period 1975 to 1987, feces from 336 infants were examined for botulinal neurotoxin and Clostridium botulinum. All the infants had illnesses which prompted their physicians to consider infant botulism in the diagnosis. Stool specimens from 113 of the infants yielded organisms that produced botulinal neurotoxins assumed to be responsible for the illness. The types of botulinal toxin in the confirmed cases were distributed as follows: 38 A, 69 B, 2 atypical B, 1 E, 1 F, 1 A + B, and 1 B + F. The type A and B toxins in a single infant were produced by two different strains of organism, and the type B and F toxins in another infant were produced by a single strain. The physiological characteristics of all the isolated toxigenic organisms except two were consistent with those of group I (proteolytic) C. botulinum. The toxigenic isolate from the infant with type E botulism was identified as C. butyricum, and that from the infant with type F botulism was identified as C. barati. Toxin of the same type as produced by the isolated organisms was identified in feces of 98 of 111 culture-positive infants. Botulinal toxin was identified in the serum of 9 of 67 culture-positive infants (8 of 22 infants with type A organisms; 1 of 43 infants with type B organisms; neither of 2 infants with A + B or atypical type B organisms). Botulinal toxin was not detected in feces (206 infants) or in serum (114 infants) of the culture-negative infants. The culture-positive infants had clinical features and a course of illness consistent with those of infant botulism. Most of the culture-negative infants probably had illnesses other than botulism, but specimens might have been obtained late in some infants' illnesses, when the organism had disappeared. PMID- 3323227 TI - Randomized trial interpreting sputum quality in a clinical laboratory. AB - The role for laboratory interpretation of microbiologic results remains controversial, and many laboratories leave the interpretation of culture results entirely to physicians. We examined the effects of furnishing a laboratory interpretation of sputum quality on physician decision making. Quality of sputum was determined on Gram-stained smears by using a modification of the criteria of Bartlett (R. C. Bartlett, Medical Microbiology: Quality, Cost, and Clinical Relevance, p. 24-31, 1974). A total of 301 poor-quality specimens were randomized either to receive written interpretation of Gram stain results or to a control group for which Gram stain results were reported without interpretation. Physicians were more likely to follow up a poor-quality specimen with a second specimen if they had been furnished an interpretation of the results from the original Gram stain (22 versus 12%; P = 0.025). We conclude that laboratory-based interpretation of microbiologic results can improve physician decision making. PMID- 3323229 TI - Multicenter comparison of MicroScan and BACTEC blood culture systems. AB - Recently, MicroScan (Baxter MicroScan Div., W. Sacramento, Calif.) introduced a radiolabeled-blood-culture system that is compatible with the BACTEC 460 (Johnston Laboratories, Inc., Towson, Md.). A multicenter blood culture study was initiated to evaluate this new system. Approximately 20 ml of blood was obtained from each patient and divided equally between BACTEC and MicroScan bottles which were incubated and processed identically. Aerobic bottles were examined twice on days 1 and 2 and once on days 3, 4, 5, 6, and 7. Anaerobic bottles were examined once a day for 7 days. There were 3,451 cultures evaluated, and 414 of these subsequently grew microorganisms. Of these positive cultures, 64 were judged to be contaminated. Of the remaining 350 positive cultures, 253 grew in both systems, 54 grew in BACTEC bottles only, and 43 grew in MicroScan bottles only. The average times to detect positive cultures were 1.8 and 2.1 days by the BACTEC and the MicroScan systems, respectively. No significant difference in the number or kind of organisms recovered or in the detection times for positive cultures was observed between the two blood-culturing systems. PMID- 3323230 TI - Evaluation of PASCO MIC-ID system for identifying gram-negative bacilli. AB - A production model of the semi-automated PASCO MIC-ID system (PASCO Laboratories, Wheat Ridge, Colo.) was evaluated with 122 groups or species of gram-negative bacilli, which included typical (499 cultures) and atypical (37 cultures) strains of fermenters and nonfermenters. The PASCO system identified 90.9% of 536 cultures accurately; these included 90.8% of 152 nonfermenters, 93.8% of 308 enteric fermenters, and 78.9% of 76 oxidase-positive fermenters. These results were obtained with the aid of serologic tests and a few additional biochemical tests, when recommended by the PASCO system. Of the 14 misidentified nonfermenters, 3 were Pseudomonas paucimobilis, 3 were Weeksella virosa (Centers for Disease Control group IIf), 2 were Xanthomonas (Pseudomonas) maltophilia, and 6 were randomly distributed among the other groups and species tested. The 19 enteric fermenters that were misidentified were randomly distributed among the groups and species tested. Of the 16 misidentified oxidase-positive fermenters, 4 were Pasteurella ureae, and 12 were randomly distributed among the other groups and species. The system identified the most commonly encountered organisms at a rate of 95% or better. The PASCO system is easy to inoculate and read. A slightly improved data base should remedy most of the identification problems. PMID- 3323231 TI - Identification of Yersinia spp. with the API 20E system. AB - The ability of the API 20E system to identify 105 clinical isolates of Yersinia spp. was compared with those of conventional biochemical tests at 28 and 37 degrees C. Elimination of the Voges-Proskauer test (recorded as a negative result) increased the percentage of correct identifications for Yersinia spp. from 66 to 93% when the API 20E strips were incubated at 28 degrees C. PMID- 3323232 TI - Evaluation of rapid SYS system as screen for Yersinia enterocolitica in the United States. AB - Clinical isolates (n = 150) from stool specimens were selected for evaluation of the Rapid SYS system (Analytab Products, Plainview, N.Y.) as a screening test for Shigella spp., Yersinia enterocolitica, and Salmonella spp. The Gram-Negative Identification Card (Vitek Systems, Inc., Hazelwood, Mo.) was used for identification. Although acceptable performance of the Rapid SYS system was described, the interpretative criteria provided by the vendor for previous studies led to inappropriate screening for Y. enterocolitica, particularly biotype 1. When corrected screening criteria were used for the present study, the sensitivity for the detection of 76 enteric pathogens was 98.7%. Of the 76 pathogens, 1 of 21 Shigella spp. was not detected. However, specificity was only 16.6% when 72 selected nonpathogens frequently encountered in stools were eliminated. Although the Rapid SYS system can identify Shigella spp., Y. enterocolitica, and Salmonella spp., only phenylalanine deaminase-producing and cytochrome oxidase-producing organisms can be eliminated from additional testing. Therefore, the Rapid SYS system cannot be used as a three-pathogen screen in the United States or in other geographic locales where Y. enterocolitica biotype 1 may be encountered. PMID- 3323233 TI - Umbelliferyl-labeled galactosaminide as an aid in identification of Candida albicans. AB - The initial evaluation of a fluorescence, nonmicroscopic method of rapid identification of Candida albicans is described. A total of 524 yeast isolates were evaluated in parallel by the umbelliferyl-conjugated N-acetyl-beta-D galactosaminide (UAG) test and the germ tube (GT) test in comparison with the API 20C Yeast Identification System. The UAG test correctly identified 333 of the 334 isolates of C. albicans (99.7%), and the GT test identified 328 (98%). There were three false-positive GT reactions and five false-positive UAG reactions with 69 isolates of C. tropicalis. The sensitivity and specificity were 99 and 97%, respectively, for the UAG test and were both 98% for the GT test. The UAG test requires less than 2 h for test completion compared with 2 to 4 h for the GT test, is similar in cost, has a nonmicroscopic visual endpoint, and eliminates the health hazards of handling pooled human sera. PMID- 3323234 TI - Microneutralization test for rabies virus based on an enzyme immunoassay. AB - We have developed an enzyme immunoassay for rabies virus by using acetone-fixed infected cell cultures as the antigen. This test was used to demonstrate virus neutralizing antibodies in human and animal sera and was as sensitive as and easier to perform than the rapid fluorescent-focus inhibition technique. PMID- 3323235 TI - Medial osteochondritis of the talus in children: review and new surgical management. AB - Review of the management of medial osteochondritis of the talus in the young patient has revealed the poor results of casting and the equivocal results of past surgical options. A new surgical technique of bone grafting is described. The results in six patients treated with bone grafting are compared with the results in 10 patients treated by excision. Because of the more favorable results following bone grafting, we recommend it as primary treatment of this condition in children and adolescents. PMID- 3323236 TI - Tobacco advertising and consumption: evidence of a causal relationship. PMID- 3323237 TI - Alcohol monopolies in the U.S.: challenges and opportunities. PMID- 3323238 TI - Breastfeeding and the working mother: barriers and intervention strategies. PMID- 3323240 TI - The diagnostic limitations of ultrasonography in maxillofacial surgery. AB - The records of 63 patients having had ultrasound examinations with grey-scale B mode scanners have been reviewed, to determine what contribution ultrasound made to the diagnosis of superficial maxillofacial masses, when compared with clinical examination and other methods of investigation. Most of the ultrasound parameters described in the literature are found in the cases we have examined. Despite the fact that the ultrasound image is often compatible with the disease, diagnosis using ultrasound was much less accurate than expected. From this series, it is concluded that ultrasound examination is not recommended for the diagnosis of all maxillofacial pathology, especially when the echographist has no special experience in this field of pathology, when ultrasound findings are not correlated with clinical ones, and when the ultrasound report is not precise and exhaustive. PMID- 3323239 TI - Prevention of dental caries by the use of pit-and-fissure sealants. PMID- 3323241 TI - The temporalis osteomuscular flap versus the free calvarial bone graft. An experimental study in the growing rabbit. AB - The authors have conducted an experimental study on the evolution of temporalis osteomuscular flaps compared with calvarial free bone grafts in young rabbits. The evaluation of the results has been performed with macroscopic, radiological and histological investigations in an early and late postoperative phase. This study has confirmed that the bone flaps remain viable and are characterized by a normal evolution. There is no evidence of anomaly of craniofacial growth nor asymmetry when compared with the contralateral side. On the other hand, the free bone grafts show the typical signs of necrosis and resorption. Some asymmetries are produced in comparison with the contralateral side, these being particularly evident in the two-months samples, while the overall craniofacial growth is not seriously impaired. This experimental study confirms the reliability of the temporalis osteomuscular flap in facial reconstruction. PMID- 3323242 TI - The use of costochondral grafts in arthroplasty of the temporomandibular joint. AB - Replacement of the condyle with a costochondral graft restores the altered biomechanics after condylectomy or gap-arthroplasty procedures. It avoids the recurrence of ankylosis. In the child, this graft allows harmonious growth of the mandible due to the characteristics of the costochondral cartilage. A case of uncontrolled multidirectional and excessive growth of the graft during pregnancy supports the view that the costochondral junction also carries intrinsic growth properties. Long-term follow-up evaluation shows very satisfactory cosmetic and functional results. In patients neglecting postoperative jaw mobilisation, maximal interincisal opening is acceptable but remains low. If no posterior dental support is provided after restoring the vertical dimension with the graft, some degree of graft resorption is possible. PMID- 3323243 TI - Hyperactivity, antisocial behavior, and childhood injury: a critical analysis of the literature. AB - Studies investigating the relationship between hyperactivity, antisocial behavior, and injury in children are reviewed. Most of the studies have reported that these behaviors are important risk factors for injury. However, design problems with these studies are noted. Early studies employed inappropriate control groups, or omitted them altogether, whereas more recent studies have used retrospective measures that depend on the recall of mothers and teachers, and which are therefore vulnerable to bias. When, on the other hand, prospective designs were used, a relationship between hyperactivity and injury was not found. In all these recent studies, a relationship between injury and management problem or aggressive behavior was reported. It is concluded that the relationship between hyperactivity and injury is still under question, and that a further prospective study will be required to resolve the issue. PMID- 3323244 TI - Posttraumatic stress disorder in children and adolescents: a review of the literature. PMID- 3323245 TI - Lethal challenge of gnotobiotic weanling rats with bacterial isolates from cases of sudden infant death syndrome (SIDS). AB - An attempt was made to produce an animal model of sudden infant death syndrome (SIDS). The experimental animals (germ free weanling rats) were exposed to nasopharyngeal isolates from cases of SIDS to test the hypothesis that common bacteria may have an aetiological role in the disease. Negative results were obtained when the strains were tested in isolation, but certain combinations of organisms (specifically some Staphylococcus aureus and Escherichia coli) killed the animals rapidly (less than 18 hours) without prolonged terminal illness. Post mortem histological findings were consistent with those of SIDS. The lethal toxigenic potential of nasopharyngeal bacteria, which are regarded as harmless in adults, should be reconsidered in respect of the aetiology of SIDS. PMID- 3323246 TI - HeLa cell and buccal epithelial cell adhesion assays for detecting intestinal Escherichia coli with adhesive properties in ulcerative colitis. AB - The two methods used to detect intestinal Escherichia coli in patients with ulcerative colitis, HeLa cell and buccal epithelial cell (BEC) adhesion assays, were compared. Both methods showed a significant difference between the adhesive property of colitic and control E coli: p less than 0.0002 and p less than 0.01 for the buccal epithelial cell and HeLa cell methods, respectively. HeLa cells did not detect all BEC positive isolates which were quantitatively more adhesive than any control isolate. All BEC negative isolates were HeLa cell negative. The BEC technique seems to be more sensitive for detecting adhesive E coli in ulcerative colitis because the true incidence of adhesive E coli in ulcerative colitis was higher than that determined by the HeLa cell method. PMID- 3323248 TI - Unusual immunophenotype displayed by histiocytes in haemophagocytic lymphohistiocystosis. AB - Extensive immunophenotypic studies in a 2 1/2 month old girl with haemophagocytic lymphohistiocytosis were performed to characterise the proliferating histiocytes of the disease. The cells strongly expressed conventional macrophage antigens, but unexpectedly, there was a dissociated expression of the CD1a antigen (reacting with the monoclonal antibody NA1/34 but not with OKT6) and intracellular S-100 protein by the haemophagocytic lymphohistiocytosis histiocytes. These findings indicate that there is a "hybrid" phenotype between the two main arms of the mononuclear phagocyte system--namely, Langerhans' cells and phagocytic macrophages. PMID- 3323247 TI - Monoclonal antibody L26: an antibody that is reactive with normal and neoplastic B lymphocytes in routinely fixed and paraffin wax embedded tissues. AB - Formalin fixed and paraffin wax embedded tissue from 85 well characterised cases of non-Hodgkin's lymphoma and Hodgkin's disease were studied using the avidin biotin-peroxidase complex technique. Among the non-Hodgkin's lymphomas all cases of B cell lymphoma were reactive with L26, a monoclonal antibody which is as yet an unclustered pan B cell reagent, with the exception of pre-B cell acute lymphoblastic leukaemia and malignant lymphoma plasmacytic. Eighteen well characterised cases of T cell lymphoma, selected to include tumours previously shown to exhibit cross reactivity with antibodies to fixation resistant B cell related antigens, were similarly studied. Neoplastic cells in all but one case were unstained by L26. Twenty seven cases of Hodgkin's disease were also examined. In five cases all Reed-Sternberg cells and their variants were strongly stained by L26; only a proportion of Reed-Sternberg cells and their variants were recognised in a further five cases. Monoclonal antibody L26 promises to be a valuable reagent for the diagnosis of malignant lymphoma in routinely fixed and paraffin wax embedded tissues. Its advantage lies in its sensitivity and greater B cell specificity than any of the B cell related reagents currently available for the study of malignant lymphoma in fixed tissues. PMID- 3323249 TI - Distribution of basement membrane antigens in clinical gastric adenocarcinomas: an immunohistochemical study. AB - The distribution of laminin and collagen type IV in the basement membranes of 85 gastric adenocarcinomas was studied using immunoperoxidase techniques to check for invasive carcinoma. Lymph nodes with metastases were also studied in 23 cases. Thick and discontinuous staining of the basement membranes was observed in 12 cases of well differentiated adenocarcinoma; thin and discontinuous staining in 26 (12 well and 14 moderately differentiated adenocarcinomas); fragmentary staining in 36 (15 moderately and 21 poorly differentiated adenocarcinomas); and unrecognisable basement membrane staining in the remaining 11 cases of poorly differentiated adenocarcinoma. These patterns were largely related to the histological grade, the nuclear atypism and loss of polarity of tumour cells, and the degree of inflammatory infiltration. PMID- 3323251 TI - Use of antimesothelial cell antibody and computer assisted quantitative analysis for distinguishing between reactive and neoplastic serosal tissues. AB - Nine malignant mesotheliomas and 12 specimens of benign reactive mesothelial hyperplasia were examined using a specific antimesothelial cell antibody. Immunostaining intensity was subsequently estimated by means of image analysis. The mean and standard deviation of integrated optical density in the malignant mesotheliomas differed significantly from those in the mesothelial hyperplasias. In all mesotheliomas but one the integrated optical density was greater than in reactive mesothelial hyperplasia. No significant difference in optical density was observed between the two groups; the standard deviation was significantly higher in the reactive lesions. This technique may be adopted to complement the traditional morphological assessment of primary lesions of the serosal cavities. PMID- 3323250 TI - Immunocytological staining reactions of anti-carcinoembryonic antigen, Ca, and anti-human milk fat globule monoclonal antibodies on benign and malignant exfoliated mesothelial cells. AB - A panel of three monoclonal antibodies were used in an immunoalkaline phosphatase staining method on a series of serous effusion samples from cases of mesothelioma, lung carcinoma, and benign disease. The antibodies used were anti carcinoembryonic (CEA) antigen, Ca, and anti-human milk fat globule membrane antigen. Antibodies to the Ca antigen and human milk fat globule membrane antigen stained 75% and 83% of mesothelioma and 75% of cases of lung carcinoma, respectively. The anti-CEA antibody stained most cases of lung carcinoma strongly but was negative on 11 of 12 cases of mesothelioma and showed weak staining on one case. Benign cases were negative with all three antibodies. These three antibodies may be useful in distinguishing benign and malignant mesothelial cells and lung carcinoma in serous effusions. PMID- 3323253 TI - Vitamin B12 absorption after allogeneic bone marrow transplantation. AB - The B12 absorption test (Schilling test) with intrinsic factor was used to examine ileal B12 absorption in 26 patients after allogeneic transplantation. The test was well tolerated and showed a profound fall in B12 absorption, which was maximal at two weeks after transplantation and recovered by eight weeks. The predominant influence on absorption at this stage was probably the conditioning schedule, and the presence of acute graft versus host disease (GVHD) was not associated with a further impairment of absorption. Six patients with chronic GVHD were studied. When compared with nine patients without GVHD there was a significant (p less than 0.005) reduction of B12 absorption. These findings suggest that the B12 absorption test may be a useful non-invasive method of studying bowel function after bone marrow transplantation. PMID- 3323252 TI - Oestrogen receptor in glands and stroma of normal and neoplastic human endometrium: a combined biochemical, immunohistochemical, and morphometric study. AB - Cryostat sections of unfixed human endometrial tissue from normal, hyperplastic, and carcinomatous endometrium were assayed for oestrogen receptor content using a radiolabelled oestradiol binding assay with isoelectric focusing to separate receptor proteins. The proportions of myometrium, stroma, and glandular tissue were estimated in adjacent sections by point counting. Further cryostat sections were stained for oestrogen receptor immunohistochemically with a monoclonal antibody and the relative staining intensity of the various tissue components assessed. The area proportions and relative immunohistochemical staining intensity of each tissue component in the cryostat sections were then used to adjust the biochemical results and derive separate values of oestrogen receptor content in myometrium, glands, and stroma. The greatest difference in oestrogen receptor content through the menstrual cycle and between normal, hyperplastic, and malignant endometrium occurred in the glandular element. PMID- 3323254 TI - Screening test for rheumatic diseases: a combined enzyme immunoassay of rheumatoid factors and antibodies to DNA and extractable nuclear antigens. AB - Three hundred and one sera from patients with rheumatic and other diseases were investigated using a simple enzyme immunoassay for screening of rheumatoid factors and antinuclear antibodies. The assay had a sensitivity of 77% for systemic lupus erythematosus, 90% for the primary sicca syndrome, and 89% for rheumatoid arthritis. Only 13% of sera from patients with chronic non-rheumatic diseases were positive. The test was further evaluated in a group of patients with suspected rheumatic disease who were followed up for six to 12 months. The test was positive in 16 of 17 sera from patients with connective tissue diseases but in only seven of 36 sera (19%) from patients with non-inflammatory joint diseases. None of the four patients with reactive arthritis was positive by this test. The sensitivity of the assay was comparable with that of the agglutination and immunofluorescence tests for rheumatoid factors and antinuclear factors. For the screening of rheumatoid factor and antinuclear antibodies this kind of test panel offers a simple alternative to the conventional tests for small clinical laboratories and for those in which the autoantibody tests could be automated, as the assay can be performed in one working day and only one dilution of serum is needed to obtain a quantitative result. PMID- 3323256 TI - Pharmacologic effects of A-49816, a new high-ceiling diuretic. AB - The pharmacologic effects of A-49816, a high-ceiling, loop diuretic, were evaluated in a single-blind, placebo-controlled, randomized trial. Eighteen (18) normal volunteers aged 19 to 40 years were divided into three groups. The subjects in each group received either placebo or three increasing doses of A 49816 with at least a one-week washout between doses. Nine doses of A-49816 (0.5 to 20 mg) were administered during the entire study. Urine volume and excretion of electrolytes were measured at timed intervals following dosing. A-49816 increased urine volume and excretion of sodium and chloride. Significant saluresis, chloruresis and diuresis were seen in most time periods following administration of the highest doses (12.5, 15 and 20 mg) of A-49816. Kaluresis was not consistently seen at any dose. The mean rates of urine output and sodium and chloride excretion were increased relative to placebo within 2 hours of drug administration. The mean rates of urine formation and sodium and chloride excretion peaked at 2-4 hours and often remained elevated at the 6-12 hour interval. PMID- 3323255 TI - The bioavailability and pharmacokinetics of guanfacine after oral and intravenous administration to healthy volunteers. AB - Guanfacine is a centrally acting alpha-2 adrenergic agonist. The absolute bioavailability, pharmacokinetics, and renal clearance of this antihypertensive drug were investigated in healthy male volunteers. Eighteen subjects received a single oral or intravenous dose of guanfacine 3 mg in a two-way cross-over study design. Blood samples were obtained before dosing and up to 72 hours after dosing for determination of drug levels in plasma. Additional blood samples were obtained for protein binding studies. Urine was collected and pooled for specific intervals up to 96 hours after dosing. The absolute bioavailability of guanfacine after a single oral dose was 81.1%. The elimination half-lives were 13.8 hours and 13.4 hours after oral and intravenous administration, respectively. The volume of distribution results were approximately 6 L/kg by both routes of administration. The mean plasma protein binding results were 71.6%, not influenced by plasma concentration or route of administration. The urinary recovery of guanfacine was 44.3% after oral dosing and 50% after intravenous dosing. Renal clearance of guanfacine was 50% of total body clearance and appeared to be due to a net renal tubular secretory process. PMID- 3323257 TI - Study of the action of cicletanine in hyperuricemic patients. AB - The possibility that the drug cicletanine might offer diuresis and reduction in plasma uric acid has been investigated in patients recruited from the rheumatology and general medical clinics. Nine hyperuricemic patients received cicletanine 100 mg daily by mouth for 21 days. Urinary clearance studies and plasma biochemistry were measured twice before treatment, twice at the start of treatment, and twice at the end of the treatment period. No change was observed in the urine volume, absolute or fractional excretion of sodium in response to the drug. There was no measurable change in the plasma uric acid or urinary urate clearance. Creatinine clearance and potassium excretion also remained constant. No adverse effects were observed apart from a possibly drug-related elevation in serum aspartate amino transferase in one patient. The study provides no support for the postulated diuretic or hypouricemic effects of the drug. PMID- 3323258 TI - Chloroquine elimination in humans: effect of low-dose cimetidine. AB - A controlled study was carried out in ten healthy, male volunteers (randomly distributed into control and test groups of five subjects each) to determine the effect of low-dose cimetidine on chloroquine elimination. The control group subjects received two tablets of chloroquine sulfate (300-mg base) only, while the test group subjects took 400-mg cimetidine at bedtime for four days prior to chloroquine (two tablets of chloroquine sulfate) administration and throughout the duration of the study. Blood samples, 5 mL, were collected periodically after chloroquine administration. The samples were assayed for chloroquine and monodesethylchloroquine using a combination of thin-layer chromatography and spectrophotometry. Wilcoxon's test for unpaired data at P less than .05 was used to determine if there was any significant difference in the elimination of chloroquine in the test group when compared with the control group. The apparent oral clearance rate of chloroquine was reduced from 0.49 +/- 0.04 L/d/kg in the control group to 0.23 +/- 0.02 L/d/kg in the test group, and the elimination half life was prolonged from 3.11 days in the control group to 4.62 days in the test group. There was a 47.04% reduction in the AUC0-7d of monodesethylchloroquine, the major metabolite of chloroquine, in the test group when compared with the control group. The apparent volume of distribution at steady state was increased from 0.46 +/- 0.07 L/kg in the control group to 0.72 +/- 0.10 L/kg in the test group. All these changes were statistically significant. The conclusion is that cimetidine impairs the elimination of chloroquine in healthy subjects. PMID- 3323259 TI - Differential effects of 1,4-dihydropyridine calcium channel blockers: therapeutic implications. AB - Increasing recognition of the importance of calcium in the pathogenesis of cardiovascular disease has stimulated research into the use of calcium channel blocking agents for treatment of a variety of cardiovascular diseases. The favorable efficacy and tolerability profiles of these agents make them attractive therapeutic modalities. Clinical applications of calcium channel blockers parallel their tissue selectivity. In contrast to verapamil and diltiazem, which are roughly equipotent in their actions on the heart and vascular smooth muscle, the dihydropyridine calcium channel blockers are a group of potent peripheral vasodilator agents that exert minimal electrophysiologic effects on cardiac nodal or conduction tissue. As the first dihydropyridine available for use in the United States, nifedipine controls angina and hypertension with minimal depression of cardiac function. Additional members of this group of calcium channel blockers have been studied for a variety of indications for which they may offer advantages over current therapy. Once or twice daily dosage possible with nitrendipine and nisoldipine offers a convenient administration schedule, which encourages patient compliance in long-term therapy of hypertension. The coronary vasodilating properties of nisoldipine have led to the investigation of this agent for use in angina. Selectivity for the cerebrovascular bed makes nimodipine potentially useful in the treatment of subarachnoid hemorrhage, migraine headache, dementia, and stroke. In general, the dihydropyridine calcium channel blockers are usually well tolerated, with headache, facial flushing, palpitations, edema, nausea, anorexia, and dizziness being the more common adverse effects. PMID- 3323260 TI - Pharmacokinetics of esmolol in hepatic disease. AB - Esmolol is an intravenous beta blocker with a short duration of action. The pharmacokinetics of esmolol and its acid metabolite, ASL-8123, were studied in nine patients who had stable, biopsy-proved Laennec's cirrhosis and in three normal volunteer controls. Kinetics were determined after a four-hour continuous infusion of esmolol at a rate of 200 micrograms/kg/min. Blood samples were collected during the infusions and at frequent intervals thereafter. The parameters studied were the steady state concentration, the total body clearance, the elimination half-life, the area under the curve, and the volume of distribution. No significant differences in any of these parameters were detected between control subjects and those with hepatic disease, for either esmolol or its acid metabolite. It is concluded from this study that Laennec's cirrhosis does not cause any change in the pharmacokinetics of esmolol or its major metabolite. Therefore, adjustments in dosage of esmolol are not required for patients with Laennec's cirrhosis. PMID- 3323261 TI - The risks and benefits of clozapine versus chlorpromazine. AB - Clozapine is an atypical antipsychotic drug with reduced risk of unwanted neurological effects in comparison with other drugs. In this multicenter study, 151 hospitalized schizophrenic patients were randomly assigned to treatment under double-blind conditions to assess the antipsychotic efficacy and safety of clozapine versus chlorpromazine. All patients exhibited tardive dyskinesia or other extrapyramidal side effects associated with at least two prior neuroleptics. Eleven patients were dropped from treatment due to extrapyramidal symptoms while being treated with chlorpromazine; only one clozapine patient's treatment was terminated for this reason. Clozapine patients exhibited clinical improvement superior to that of chlorpromazine patients as assessed by the Brief Psychiatric Rating and Clinical Global Impression scales. These results suggest that clozapine is well tolerated and may be therapeutically superior to chlorpromazine in treating psychotic behavior. Agranulocytosis potential can be minimized by frequent white blood cell counts and removing nonresponding patients from treatment prior to the peak risk period (months 2 through 6). PMID- 3323262 TI - A comparative double-blind controlled study of trimipramine and amitriptyline in major depression: lack of correlation with 5-hydroxytryptamine reuptake blockade. AB - Thirty-four hospitalized patients with major depression were enrolled in a 3-week double-blind parallel comparative study of trimipramine and amitriptyline. Following a 1-week washout period, patients randomly received one of the two drugs up to 100 mg twice daily on a fixed increment dosage schedule. Both treatments produced a rapid significant clinical improvement that occurred in a predominantly linear fashion. The pattern of improvement was very similar with both drugs. There was no significant correlation between plasma levels of trimipramine and desmethyl-trimipramine and clinical improvement. A negative correlation between amitriptyline plasma levels and clinical improvement was found, whereas a positive correlation occurred with the nortriptyline levels. Amitriptyline, and to a lesser extent trimipramine, prolonged intracardiac conduction. In the amitriptyline group only, this effect was accompanied by significant increases of heart rate and blood pressure. Platelet serotonin content was decreased by 57% by the amitriptyline treatment but remained unchanged in the trimipramine group. This finding constitutes the first clinical evidence that trimipramine does not exert its antidepressant effect through 5 hydroxytryptamine reuptake blockade. It is proposed that neuronal sensitization to 5-hydroxytryptamine might mediate the therapeutic effect of tricyclic antidepressant drugs. PMID- 3323264 TI - Modifications of the serotonin system by antidepressant treatments: implications for the therapeutic response in major depression. AB - Results of electrophysiological single-cell recording studies suggest that most, if not all, types of antidepressant treatments increase 5-hydroxytryptamine (5 HT) neurotransmission. Tricyclic antidepressants, electroconvulsive shock treatment, mianserin, adinazolam, and possibly sleep deprivation may exert their therapeutic effect through sensitization of postsynaptic neurons to 5-HT. Serotonin reuptake blockers may relieve depression through an increased efficacy of the presynaptic element resulting from a desensitization of somatodendritic and terminal 5-HT autoreceptors. Similarly, monoamine oxidase inhibitors may act by increasing the efficacy of 5-HT neurons. Intensification of 5-HT function appears to be a common denominator to antidepressant treatments; however, evidence suggests that this modification may only be a link in a chain of events leading to an antidepressant response. PMID- 3323263 TI - A placebo-controlled comparison of the effect of nortriptyline and phenelzine on orthostatic hypotension in elderly depressed patients. AB - Seventy-five patients, 55 years or older, were treated for major depression with either nortriptyline, phenelzine, or placebo during a 7-week period. There was a significantly greater mean orthostatic fall in systolic pressure in patients treated with nortriptyline and phenelzine as compared to the placebo group, but no significant difference was evident between the nortriptyline and phenelzine groups. The orthostatic changes appeared during the first week of treatment and were not correlated with plasma level of nortriptyline, percent platelet monoamine oxidase inhibition, or pretreatment orthostatic changes. PMID- 3323265 TI - Serotonergic neuronal systems: what their anatomic organization tells us about function. AB - A review of the anatomic organization of ascending serotonin projections is followed by recent findings showing that these axonal projections are not diffuse but have an intricate and orderly pattern. The dorsal and median raphe nuclei and the B9 cell group have overlapping but differential projections to all parts of the forebrain. While most raphe projections extensively overlap, the dorsal raphe projects most heavily to frontal cortex and striatum, while the median raphe predominantly innervates hippocampus and septum. Small clusters of raphe cells project in a mosaic pattern to multiple, widely distributed islands of cortex. Yet, a coarse topographic order is preserved in the ascending dorsal raphe projections. Recent studies demonstrate two classes of serotonin axon terminals that differ in axon morphology, cells of origin, regional distribution, and response to psychotropic drugs. Dorsal raphe axons are extremely fine and highly vulnerable to certain neurotoxic amphetamines, e.g., 3,4 methylenedioxymethamphetamine; median raphe axons have large varicosities and are resistant to these mood-elevating drugs. We propose that there are two anatomically and functionally distinct serotonergic projections to cortex and that neurons in the dorsal raphe nucleus appear to play a major role in the control of affective state. PMID- 3323266 TI - Therapeutic and genetic prospects of an atypical affective disorder. AB - The utility of bipolar type II affective disorder subgrouping is discussed. There is low diagnostic agreement among clinicians for this putative condition. However, the clustering of cases in families and the poor response to standard treatments suggest that it is a distinct subgroup. The clinical features of the depressive phase of this condition including chronicity, intermittency, hyperphagia, hypersomnia, and reactivity relate it to the constructs of "hysteroid dysphoria," atypical depression, and seasonal affective disorder. Its association to several abnormal motivated behaviors such as alcoholism and eating disorders allows the speculation that a distinct morbid mechanism involving serotonin may underlie it and that new serotonin reuptake blocking drugs may be useful in treating it. Finally, the genetic identity of this subgroup in all likelihood will be established or rejected by genetic linkage studies utilizing the restriction fragment length polymorphism map of the genome. PMID- 3323267 TI - FMRFamidelike peptides of Homarus americanus: distribution, immunocytochemical mapping, and ultrastructural localization in terminal varicosities. AB - The distribution of FMRFamidelike peptides was studied in the nervous system of the lobster Homarus americanus by using immunocytochemical and radioimmunological techniques. By radioimmunoassay FMRFamidelike immunoreactivity (FLI) was found in low levels (ca. 1 pmol/mg protein) throughout the ventral nerve cord and in much higher amounts (60-100 pmol/mg protein) in the neurosecretory pericardial organs. Immunocytochemical studies showed FLI in approximately 300-350 cell bodies, and in distinct neuropil regions, neuronal fiber tracts, and varicose endings. Specificity of the immunostaining was tested by preabsorbing the antiserum with FMRFamide, with peptides having similar carboxyl termini to FMRFamide (Met enkephalin-Arg-Phe, Phe-Met-Arg-Tyr-amide), with several amidated peptides (alpha melanocyte-stimulating hormone, substance P, oxytocin), and with proctolin, a peptide found widely distributed in the lobster nervous system. Of these substances, only FMRFamide blocked the staining. In addition to the pericardial organs, significant levels of FLI were found in neurosecretory regions associated with thoracic second roots and in the connective tissue sheath that surrounds the ventral nerve cord. In all three regions, immunocytochemical studies showed the FLI to be localized to fine fibers and associated terminal varicosities lying close to the surface of the tissue, with no obvious target in their immediate vicinity. When examined at the ultrastructural level, the immunoreactive varicosities of the thoracic second roots and of the ventral nerve cord sheaths were found a few microns from the surface of the tissue and contained electron dense granules. In the immunoreactive nerve cord sheath endings, in addition to the large, dense granules, small, clear vesicles were found. The appearance and location of these terminals suggest a neurohormonal role for FMRFamidelike peptides in lobsters. The observation that low levels of FLI are found in the hemolymph supports this suggestion. In addition, the localization of FLI to particular neuronal somata, fiber tracts, and neuropil regions suggests possible functional roles for these peptides in (1) integration of visual and olfactory information, (2) function of the anterior and posterior gut, and (3) the control of exoskeletal muscles. PMID- 3323269 TI - Autoaggressive hanseniasis. AB - I have given the name autoaggressive hanseniasis to a syndrome with immunopathologic and clinical pictures resembling autoaggressive systemic diseases observed in some cases of lepromatous and borderline hanseniasis. It is probably caused by B cell stimulation by antigenic complex of Mycobacterium leprae plus autologous tissue, along with a dysfunction of the T-suppressor lymphocytes. PMID- 3323268 TI - Identification of motor neurons that contain a FMRFamidelike peptide and the effects of FMRFamide on longitudinal muscle in the medicinal leech, Hirudo medicinalis. AB - Excitatory motor neurons in the leech are cholinergic. By using a combination of intracellular Lucifer yellow injection and indirect immunofluorescence, we localized FMRFamidelike immunoreactivity to a number of the motor neurons innervating longitudinal and dorsoventral muscle in the leech. All excitatory motor neurons innervating longitudinal muscle (cells 3, 4, 5, 6, 8, L, 106, 107, 108) were labeled with an antiserum to FMRFamide, while the inhibitory motor neurons innervating longitudinal muscle (cells, 1, 2, 7, 9, 102) were not. The excitatory motor neuron innervating medial dorsoventral muscle (cell 117) was labeled, while the excitatory motor neuron innervating lateral dorsoventral muscle (cell 109) was not. The inhibitory motor neuron innervating dorsoventral muscle (cell 101) was also labeled. Nerve terminals along dorsoventral muscle were also labeled with the antiserum. FMRFamide was bath applied to strips of longitudinal muscle while recording tension, and the muscle's response was compared to its response to the previously identified neuromuscular transmitter ACh. Brief applications of FMRFamide caused a contraction approximately one-tenth as large as that caused by an equimolar amount of ACh. The muscle response to FMRFamide was unaffected by curare. During extended exposures, FMRFamide caused a maintained contraction in longitudinal muscle without any apparent desensitization of the FMRFamide receptors and occasionally triggered an irregular myogenic rhythm. This extended exposure to FMRFamide caused a post exposure potentiation of the longitudinal muscle's response to ACh that shorter applications of FMRFamide did not. Thus FMRFamide may act as a transmitter or modulator in cholinergic motor neurons innervating longitudinal and dorsoventral muscles in the leech. PMID- 3323270 TI - Treatment of herpetic whitlow in pregnancy with acyclovir. PMID- 3323272 TI - Kaposi sesquicentennial, Oct. 23, 1987. PMID- 3323271 TI - Kentaro Higuchi, M.D. PMID- 3323274 TI - Clinical studies with disposable diapers containing absorbent gelling materials: evaluation of effects on infant skin condition. AB - Disposable infant diapers with absorbent gelling material (cross-linked sodium polyacrylates) incorporated into the core were clinically evaluated for their effect on infant skin condition. Absorbent gelling materials tightly hold water and provide pH control by a buffering capacity as well as by helping to segregate urine apart from feces. Four clinical studies were conducted with each following a rigid protocol that controlled for variables of diet and age in addition to the diaper material that may influence the development of diaper dermatitis and helped to control for any inherent bias in the study. This allowed for the controlled assessment of skin condition with respect to diaper type. Absorbent gelling material-containing disposable, conventional (100% cellulose core) disposable, and home-laundered cloth diapers were test products. In these studies 1614 infants were initially enrolled with 522 of them assigned to absorbent gelling material disposable, 738 to conventional disposable, and 354 to home laundered cloth diapers. Objective measurements of skin wetness (transepidermal water loss) and skin pH, as well as double-blind grading of diaper dermatitis, were the measures of skin condition. Absorbent gelling material disposable diapers were associated with significantly reduced skin wetness, closer to normal skin pH, and lower degrees of diaper dermatitis when compared to conventional disposable or home-laundered cloth diapers. The results are consistent with the hypothesis that better control in the diaper area of skin wetness, skin pH, and the prevention of the mixing of urine and feces produces a better diaper environment. PMID- 3323273 TI - Endocrine-skin interactions. Cutaneous manifestations of pituitary disease, thyroid disease, calcium disorders, and diabetes. AB - Endocrinologic disorders occasionally manifest themselves by their associated or induced cutaneous abnormalities. In some instances the initial and most prominent complaints of the patient are related to alterations in the skin, and thus the dermatologist will at times be the first physician consulted. In this article we describe the cutaneous lesions that occur in patients with acromegaly, hypopituitarism, hypothyroidism, hyperthyroidism, diabetes mellitus, glucagonomas, hypercalcemia, hypoparathyroidism, and fibrous dysplasia. In addition, we also discuss the role of the skin in vitamin D metabolism. Whenever possible and where known, we have attempted to point out the pathophysiologic mechanisms that account for the cutaneous changes. PMID- 3323275 TI - Clinical effects of diaper types on the skin of normal infants and infants with atopic dermatitis. AB - Cloth diapers, cellulose core diapers (conventional disposable diapers), and cellulose core diapers containing absorbent gelling material were examined for their effects on diaper rash and skin microbiology of normal infants and infants with atopic dermatitis in a 26-week double-blind clinical trial. Infants with atopic dermatitis wearing the diapers containing absorbent gelling material had significantly lower diaper rash grades than infants with atopic dermatitis wearing cloth diapers at five of eight grading visits. Infants with atopic dermatitis wearing conventional cellulose core diapers had statistically less rash at one of eight visits. There was no statistically significant difference between diaper types at three of the eight visits. At no time did the cloth group have less diaper rash than the conventional cellulose or absorbent gelling material disposable diaper group. A statistical correlation between the severity of general atopic dermatitis outside the diaper area and the diaper rash condition under the diaper occurred only in the atopic dermatitis group wearing cloth diapers. Isolation of microorganisms from the intact, uninvolved skin surface both inside and outside the diaper showed no biologically significant changes in the presence or numbers of selected skin organisms. Repeated isolation, at multiple grading visits of Staphylococcus aureus from uncompromised skin inside the diaper area was infrequent but correlated with the diagnosis of atopic dermatitis when observed. PMID- 3323276 TI - Dental materials: 1986 literature review. Part 1. PMID- 3323277 TI - The relevance of controlled fluoride release with bonded orthodontic appliances. PMID- 3323278 TI - Biological and clinical testing of materials. PMID- 3323279 TI - [Effect of vestibulo-autonomic disorders during hypokinesia on regional hemodynamics]. PMID- 3323280 TI - [Achievements and problems in regulating the microbial processes in the rumen ecosystem of ruminants]. PMID- 3323281 TI - Upper lip, lower lip, and jaw interactions during speech: comments on evidence from repetition-to-repetition variability. AB - Six studies purporting to demonstrate complementary covariation in lip and jaw activity during speech are reviewed. The statistical procedures used to assess interactions among the upper lip, lower lip, and jaw movements are discussed for four different experiments analyzing repetition-to-repetition movement variation. The findings from two studies analyzing repetition-to-repetition variation for interactions in electromyographic activity recorded from either the jaw musculature or the labial musculature also are evaluated. It is concluded that these studies do not provide convincing evidence of complementary covariation among the articulators or the muscles. PMID- 3323282 TI - History and progress of the journal. PMID- 3323283 TI - Information services for the nursing profession from the National Library of Medicine. PMID- 3323284 TI - Optometry's contribution to the motion picture industry. PMID- 3323285 TI - Preliminary evaluation of treatment and selection conditions which affect expression of anthracycline mutagenicity in Salmonella typhimurium and a diploid human lymphoblast cell line. AB - Mutagenic potency in the Ames Salmonella test is an important endpoint that can be influenced by biological and technical factors. The ranking of mutagenic activity of a series of anthracyclines was measured using different conditions of exposure and mutation selection. A 20 min preincubation treatment version of the Ames test using a 0.2-2.0 microgram/ml (0.36-3.60 nM/ml) dose range of each of the anthracyclines Adriamycin, Daunomycin, Carminomycin, 4'-O-methyldoxorubicin and 4-demethoxydoxorubicin confirmed the order of mutagenic potency seen with the same compounds under direct plating conditions. Preincubation results also confirm direct-plating results by showing the greater sensitivity of selection to His+ reversion over 8-azaguanine resistance to anthracycline mutagenicity. However, the order of mutagenic potency was changed by lengthening the preincubation treatment time to 2 h or reducing the population density of the treated cell inoculum by ten fold. These results suggest that certain treatment conditions enable the treated cells to diminish the phenotypic expression of anthracycline mutagenicity. For comparative purposes, daunomycin and Adriamycin mutagenicity in response to 0.1-0.2 nM/ml and 0.1-0.3 nM/ml dose ranges, respectively, were assessed in a human cell culture system with 6-thioguanine and 5-trifluorothymidine forward mutation selection. A daunomycin dose of 0.1 nM/ml generated approximately 25-fold and 20-fold increases in mutant fraction with 6 thioguanine and 5-trifluorothymidine selections, respectively. Equivalent dosing with Adriamycin generated approximately a 4-fold increase in mutant fraction with 6-thioguanine selection and little or no increase with 5-trifluothymidine selection.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323287 TI - Yesterday's therapy: a 1620 manuscript. PMID- 3323286 TI - What price interactivity. PMID- 3323288 TI - [Diabetic maculopathy. Clinical forms and treatment]. PMID- 3323289 TI - Mutagenicity of chloroaniline/lignin metabolites in the Salmonella/microsome assay. AB - Chloroanilines are constituents of many agrochemicals and have been found to be metabolized to succinic acid conjugates, e.g., succinamides and succinimides. The mutagenic potential of five chloroanilines and their succinamides and succinimide derivatives have been tested with two strains of Salmonella typhimurium (TA98 and TA100) with and without rat hepatic microsomal fraction. None of the compounds produced a dose response effect with a two-fold increase in revertants indicating that these compounds are not mutagens or promutagens in these assays. PMID- 3323291 TI - The impact of dosage on ovulation induction by pulsatile gonadotropin-releasing hormone (Gn-RH) in hypothalamic amenorrhea. AB - Ten patients with hypothalamic amenorrhea (HA) were treated to induce ovulation with i.v. pulsatile Gn-RH. Twentysix cycles were administered with doses ranging from 2.5 (A; no. = 10) to 5 (B; no. = 13) to 10-12.5 micrograms/90 min (C; no. = 3). Ovulation rate was 80% in A, 92.3% in B and 100% in C and pregnancy rate 25% in A and 41.6% in B. Furthermore, both the onset of ovarian response and follicular growth were found to be more suitable in groups B and C with respect to group A. Estradiol pattern as well as mid-luteal progesterone plasma levels were superimposable in the different groups. It is concluded that all doses used are effective in inducing ovulation in HA patients. However, small pulsatile doses (2.5 micrograms/90 min) might constitute a critical threshold for adequate ovarian response. PMID- 3323292 TI - Aging and the need for prognostic epidemiology. PMID- 3323293 TI - Rice-based oral rehydration. PMID- 3323290 TI - Actions of calcium ions and a calcium-influx blocker on basal and TRH- and GnRH stimulated hormone release in patients with pituitary adenomas. AB - We investigated the influence of calcium ions on the secretion of anterior pituitary hormones basally and in response to exogenous hypothalamic releasing factors in 6 men with pituitary tumors. To this end, concentrations of LH, FSH, TSH, growth hormone and prolactin were measured in blood collected at 10-min intervals basally and during a continuous infusion of combined TRH (2 micrograms/min) and GnRH (1 microgram/min). Study sessions were randomized to iv saline, calcium, or diltiazem infusions or oral diltiazem administration. Our results indicate that in contrast to responses in normal men, iv calcium injections do not suppress circulating prolactin concentrations in patients with prolactin-secreting pituitary tumors. Moreover, neither oral diltiazem administration for one week nor acute iv diltiazem infusion suppressed the hyperprolactinemia of tumor patients. However, there were significant effects of drug and calcium treatments on serum concentrations of FSH, GH and testosterone, but not LH or TSH. Moreover, during GnRH-TRH stimulation, there were significant differences in LH, TSH, and testosterone responses in tumor patients compared to normal men. In summary, iv calcium infusion was associated with invariant basal release of anterior pituitary tumoral hormones in patients with pituitary adenomas. However, there were significant differences in the GnRH/TRH-stimulated release of certain anterior pituitary hormones in tumor patients compared to normal men in response to iv calcium and the calcium-channel antagonist, diltiazem. PMID- 3323294 TI - Applying competitive bidding to health care. AB - This paper reviews the empirical literature on competitive bidding for health services under public programs and, in this context, discusses the major issues that must be confronted in designing bidding systems. These issues include the specification of units of service, the selection of winning bidders, the determination of reimbursement for winning bidders, the treatment of losing bidders, and contract enforcement. The paper then illustrates these issues in practice by outlining one possible competitive bidding system for purchases and rentals of durable medical equipment under the Medicare program. PMID- 3323296 TI - HMO satisfaction and understanding among recent Medicare enrollees. PMID- 3323295 TI - Small area analysis: a review and analysis of the North American literature. AB - Variations in health service use rates by geographic area have long interested researchers and policymakers. Typically, investigators comparing population-based health care utilization rates among geographic areas have demonstrated substantial variations in use among seemingly similar communities. One method of investigation is "small area analysis." Numerous areas in North America have been studied extensively using this technique. This research has attempted to document the amount of variation found in health care use rates among areas; determine whether or not there is a pattern to such use in high- versus low-use areas; and identify the variables that are associated with the variation and explain a portion of the variation. Beyond this, many researchers have attempted to ascertain whether such variables are associated with characteristics of the population, whether they reflect differences in access and need, or whether a substantial portion of the variation is associated with differences in the medical care system itself. This review discusses the methods used to define the areas, the dependent variables that have been studied and the patterns found within them, the independent variables that have been tested, the statistical methods and analysis procedures used, the results of each study, and the policy recommendations emanating from the research. More importantly, based on what has been learned, the paper provides researchers in small area analysis with a set of recommendations for both analyzing and reporting results. These recommendations are designed to facilitate the development of a common research methodology, increase the comparability across studies, and enhance the use of this technique in the health policy formulation process. PMID- 3323297 TI - ECG findings in nonpenetrating chest trauma: a review. AB - Significant ECG findings frequently accompany blunt chest trauma. Surface ECG in conjunction with creatinine phosphokinase (CPK) isoenzyme assay, has been an accepted standard for diagnosis of posttraumatic cardiac dysfunction, or "cardiac contusion." Studies employing recently developed noninvasive cardiac imaging techniques have called this practice into question and have shed new light on the pathophysiology of this clinical entity. As a result, it is appropriate to review the ECG manifestations of blunt chest trauma and to reappraise the utility of the ECG in its evaluation. This article will concern itself solely with nonpenetrating cardiac injuries not requiring initial surgical management, since clinical presentation, course, and prognosis differ when operative therapy is indicated. PMID- 3323298 TI - Neuromuscular blockade in the emergency department. AB - This article presents a comprehensive review of neuromuscular blocking agents and their uses in the emergency department. These medicines are divided into two categories: depolarizing relaxants (including succinylcholine and decamethonium) and nondepolarizing relaxants (including d-tubocurarine, pancuronium, atracurium, and vecuronium). Also reviewed are pharmaco-kinetics, toxicity, and principal applications of these important agents. PMID- 3323299 TI - Nifedipine in hypertensive emergencies: a prospective study. AB - Hypertensive emergencies usually present to the emergency department. Nifedipine was administered to 15 patients presenting to the emergency department with a diastolic blood pressure greater than 120 mm Hg with chest pain, shortness of breath, or focal neurological symptoms. Average blood pressure on entry was 215/134.9 mm Hg and decreased to 158/88 mm Hg over a two-hour period. No patient had any worsening of symptoms or suffered deleterious effects. All patients with pulmonary edema or chest pain noted prompt improvement in symptoms. One patient became hypotensive without clinical significance. Two patients failed to respond to nifedipine and were treated with nitroprusside. Nifedipine appears to be safe and effective in the management of hypertensive crises. PMID- 3323301 TI - Taser dart ingestion. AB - The Taser is a relatively new electronic self-defense and immobilization weapon used by the public and by law enforcement agencies. Taser victims characteristically have an altered mental status due to drug ingestion or primary psychiatric illness. An unexpected case of Taser-associated morbidity, that of voluntary Taser dart ingestion in a patient with paranoid delusions, is reported. Near mismanagement due to unfamiliarity with the Taser occurred. Recommendations for diagnosis and management are discussed. The emergency physician should be aware of the potential of this unusual ingestion. PMID- 3323300 TI - Simultaneous bilateral quadriceps tendon rupture: a case report and subject review. AB - Both unilateral and simultaneous bilateral rupture of the quadriceps tendon are frequently misdiagnosed. Patients typically present to the emergency department after a fall associated with sudden sharp pain and inability to extend the knee. Most frequently, the patient is elderly. Those under age 40 with bilateral quadriceps rupture usually have an associated metabolic disorder. The 22-year-old uremic patient we report is the youngest case with simultaneous bilateral rupture of the quadriceps tendon described in the English literature. Emphasis is placed on the initial clinical presentation and management. In addition, the pathophysiology and differential diagnosis are reviewed. PMID- 3323302 TI - A wide, complex look at cardiac dysrhythmias. AB - The diagnosis and treatment of cardiac dysrhythmias answers the following four questions: Is the patient stable? Is the rate fast or slow? Are the ventricular complexes wide or narrow? Is the rhythm regular or irregular? The most common narrow complex regular tachycardias are sinus tachycardia, atrial flutter, atrial tachycardia that blocks, and paroxysmal supraventricular tachycardia. Carotid sinus massage is useful in differentiation. Irregular narrow-complex tachycardias are usually atrial fibrillation. An ultra-rapid wide-complex or polymorphous irregular tachycardia is likely to be atrial fibrillation with ventricular preexcitation. Wide-complex regular tachycardias present a special challenge, since wide beats may result from supraventricular or ventricular impulse formation. Ventricular tachycardia is more likely than supraventricular tachycardia in the presence of underlying ischemic heart disease, atrioventricular dissociation, fusion or capture beats, or a very broad (greater than .14 seconds) QRS complex. Still, misdiagnosis is common; the most costly mistake is over-diagnosis of SVT. In emergencies, where vital organ hypoperfusion is present, the origin of the impulse and the name of the dysrhythmia are unimportant. With the exception of sinus tachycardia, all life-threatening, rapid tachycardias should be terminated by electrical cardioversion. PMID- 3323303 TI - Hemodialysis-related emergencies--Part 1. AB - Hemodialysis patients are seen in the emergency department much more frequently than their relatively small number would suggest. Many pitfalls attend the management of these patients, in whom there is a high potential for serious morbidity and mortality. This article outlines the principles of emergency department management of hemodialysis patients and describes the approach to the diagnosis and treatment of their most common presenting problems. Many of these are related to the hemodialysis procedure itself or to underlying chronic renal failure. Special attention is given to the problems of the vascular access, the hemodialysis patient's lifeline. The indications for emergent dialysis are discussed, as well as the temporizing measures available to the emergency physician while awaiting institution of dialysis. PMID- 3323304 TI - J.-F.-B. Charriere: the man behind the "French" gauge. AB - Joseph-Frederic-Benoit Charriere, a 19th century Parisian maker of surgical instruments, has by virtue of his ingenuity and advanced thinking, continued to have his presence felt in medicine throughout the 20th century. His most significant accomplishment was the development of a uniform, standard gauge specifically designed for use in medical equipment such as catheters and probes. Unlike the gauge system adopted by the British for measurement of needles and intravenous catheters, Charriere's system has uniform increments between gauge sizes (1/3 of a millimeter), is easily calculated in terms of its metric equivalent, and has no arbitrary upper end point. Today, in the United States, this system is commonly referred to as French (Fr) sizing. In addition to the development of the French gauge, Charriere made significant advances in ether administration, urologic, and other surgical instruments, and the development of the modern syringe. PMID- 3323305 TI - Progress in the treatment of portal-systemic encephalopathy (PSE). PMID- 3323306 TI - Membrane fluidity and cholestasis. PMID- 3323307 TI - History, etymology, and fallacy: attitudes toward male masturbation in the ancient Western world. AB - This article examines the attitudes toward male masturbation in the ancient western world. More specifically, this work deals with ancient Egypt, Greece, and Rome. By comparing each epoch and geographic region, intolerance of autoerotic activity can be seen. Although there is a pattern of intolerance, the act of masturbation is always viewed provisionally. In addition, by examining these three periods of history not only can attitudes be scrutinized, but also it can be seen quite clearly that there was no golden age of sexuality: The attitude of accepted and encouraged unlimited and varied sexual practices does not exist in the ancient western world. As in many other cultures in various stages of history, procreative sexuality is the dominating theme. Thus, current attitudes of sex are derived from, and still survive due to the influence of, ancient western civilization. PMID- 3323308 TI - Male homosexuality in traditional Chinese literature. AB - This paper is an attempt systematically and briefly to describe male homosexuality as it was recorded and depicted in traditional Chinese literature. Part one of the paper describes male homosexuality which has been detailed in historical records. Most of these records are taken from standard histories and indicate that homosexuality did exist in traditional Chinese society. Part two is a description of male homosexuality as it was depicted in classical literary writings, including a rarely seen fiction, Yi-Chun Xiang-Zhi (Pleasant Spring and Fragrant Character). Part three discusses reactions toward homosexuality as described in some of the historical records, fictions, and essays. Some of these descriptions involve sociological analysis while others are sexological in nature. PMID- 3323309 TI - Bibliography of berdache and alternative gender roles among North American Indians. PMID- 3323311 TI - Bibliography of the Current World Literature in Hypertension. PMID- 3323310 TI - Cell mediated immunity during experimental ancylostomiasis: a review. AB - Cell-mediated immunity is usually recognized only in a very small number of infections caused by helminths. The present review is engaged with some aspects of the cell-mediated immunity in infections caused by Ancylostoma caninum. Special attention is paid to the role of passive transfer of sensitized cells and serum. The paper is based on a series of own original investigations of the authors. PMID- 3323312 TI - Dietary sodium deprivation raises blood pressure in the rat but does not produce irreversible hyperaldosteronism. AB - It is reported that dietary deprivation of sodium in young rats produces changes of sodium balance and aldosterone excretion which persist when normal sodium intake is restored. To test this further, sodium intake was reduced 10-fold in rats. In the first experiment sodium intake was reduced for 5 weeks in rats aged 3 weeks. Systolic blood pressure, heart rate and plasma renin concentration increased and growth rate was reduced. Sodium intake was then increased for 10 weeks. Blood pressure, heart rate and plasma renin concentration fell and growth rate increased but body weight did not regain control values. As compared with controls, plasma concentrations of aldosterone and corticosterone did not increase after the 10-week period. Thus, sodium depletion did not produce an irreversible change in aldosterone but it did raise arterial pressure. Further experiments confirmed the pressor effect in young and adult rats. Blood pressure was measured in the tail in these experiments but the increase in pressure was not a technical artifact as measurements made in the tail correlated well with measurements made simultaneously by intra-arterial catheter. Catheters were inserted under general anaesthetic for this comparison of pressure and rats previously deprived of sodium showed a significantly higher mortality rate due to the anaesthesia and surgery involved. Thus, a 10-fold reduction of dietary sodium raises blood pressure in young and adult rats and it may increase mortality from a minor surgical procedure. It does not produce irreversible changes in aldosterone. PMID- 3323313 TI - Dopamine blockade abolishes the exaggerated natriuresis of essential hypertension. AB - We studied natriuresis during central hypervolaemia by immersing eight normal subjects and eight patients with uncomplicated essential hypertension up to the neck in water, either in the absence (study 1) or presence (study 2) of dopamine blockade by metoclopramide. Water immersion without metoclopramide induced an exaggerated natriuresis in hypertensives compared with normotensives (P less than 0.001). This occurred in the presence of identical hormonal (plasma renin activity, plasma aldosterone and prolactin), renal (creatinine clearance) and pressor responses in both groups (study 1). The marked natriuresis seen during water immersion alone in normotensives was significantly blunted (P less than 0.02) but not abolished during water immersion with addition of metoclopramide. On the other hand, the exaggerated natriuresis found in hypertensives during water immersion alone was completely abolished during water immersion plus dopamine blockade by metoclopramide (study 2). Similar hormonal, renal and pressor changes were detected in both normotensive and hypertensive subjects during water immersion plus metoclopramide administration. Our data demonstrate that metoclopramide abolishes the exaggerated natriuretic response seen in hypertensives during volume expansion produced by water immersion, and suggest that dopamine may play a critical role in mediating the hypernatriuresis of essential hypertension. PMID- 3323314 TI - Molecular weights of renin and inactive renin in mouse plasma. PMID- 3323315 TI - Bibliography of the current world literature in hypertension. PMID- 3323317 TI - A long-term study of plasma catecholamine levels and plasma renin activity in borderline hypertension. AB - Blood pressure and plasma catecholamine levels were followed up for a total of 7 years in 26 subjects with borderline hypertension and in 24 normotensive subjects. During the observation period, five subjects from the borderline hypertensive group became definitely hypertensive, 10 remained in the borderline hypertensive range and in 10, blood pressure fell below borderline hypertensive levels. Of the original 24 normotensive subjects, 15 remained in the normotensive range. In seven, blood pressure rose, but did not reach borderline hypertensive levels. Three subjects were lost to follow-up. In contrast with the subjects who remained normotensive and borderline hypertensive, those who became definitely hypertensive had consistently high plasma noradrenaline concentrations at rest. Plasma adrenaline levels and plasma noradrenaline concentrations during exercise did not differ, however. The study suggests that borderline hypertensive subjects who develop definite hypertension within a few years have consistently enhanced sympathetic activity. PMID- 3323316 TI - Role of renal kallikrein in modulating the antihypertensive effect of a single oral dose of captopril in normal- and low-renin essential hypertensives. AB - The antihypertensive efficacy of angiotensin converting enzyme (ACE) inhibitors may result from the blockade of angiotensin II formation but also, theoretically, from the inhibition of kinin breakdown. To test whether a blunted activity of the kallikrein-kinin system might account for the failure of ACE inhibitors in lowering blood pressure (BP) in patients in whom the renin-angiotensin system (RAS) is not enhanced, 31 essential hypertensives with normal or low plasma renin activity (PRA) were evaluated before and after a single oral dose (50 mg) of captopril. A significant fall, in both systolic and diastolic BP, was obtained in the subgroup of patients who were classified as 'normal-kallikrein hypertensives' according to whether their pretreatment urinary kallikrein excretion was within the normal range, while no significant change in BP was observed in 'low kallikrein hypertensives'. Furthermore, the mean percentage fall in mean BP, throughout the 2 h following captopril administration, was significantly related to the basal value of urinary kallikrein excretion (r = 0.47, P less than 0.05) in all the patients. Our results suggest that blunted activity of the kallikrein system might be responsible for failure of captopril to lower BP in some hypertensive patients. PMID- 3323318 TI - [Treatment of urethral stenosis. 1]. AB - The treatment of urethral strictures has considerably developed over recent years: surgical urethroplasty has been perfected at the same time as internal urethrotomy has gained a new lease of life as a result of endoscopy. Urethral dilatation by means of probes used for arterial stenoses constitutes another interesting development in this field. We reviewed our case files with a double objective in mind: to determine the reasons for our changing therapeutic practices and the results of these three methods. Our study was also interesting because it was the first time that the incidence of this therapeutic development on the economic consequences of this disease, which generally affects professionally active adults, has been assessed. Several factors can be taken into consideration: however, as the length of time off work and the cost of concomitant drug treatments were unable to be determined with sufficient accuracy by our survey, we finally assessed the duration and the number of hospital admissions for each patient. Although only fragmentary, these data appear to reflect fairly accurately the economic impact of the treatments used. PMID- 3323319 TI - [Intracavernous injections of vasoactive drugs. Contribution to the study of their value in erectile impotence]. AB - The obtention of an artificial erection with a single intracavernous injection (ICI) of vasoactive drugs, has upset our conceptions about erection and the approach for erectile failure. If this pharmacologic stimulation increases the reliability of some erection tests, their diagnosis value is still questioned. The complexity of both erection and vasomotricity pharmacology, make difficult the understanding of the mechanisms of these ICI. Their therapeutic value is reduced to the method by self injections, new treatment for impotence, even if it concerns only few impotent patients. Finally, the experimental feature and the unquestionable morbidity of these ICI, mainly priapism, impede their large diffusion. However, in spite of these doubts, this intracavernous pharmacology is a real progress for erection and its troubles. PMID- 3323320 TI - [Aberrant renal papilla. Description of a new sign and review of the literature]. AB - The aberrant renal papilla or papillary invagination is an uncommon congenital anomaly which, because of its radiological appearance, should be included in the differential diagnosis of processes associated with filling defects in the renal pelvis. Its halo of radiolucency and its longitudinal striae, its solid echogenicity and a possible associated vascular anomaly (angiodysplasia) should constitute the basis of the diagnosis. An ultrasonographic evaluation, conducted every 6 to 12 months can constitute, as in the case presented here, a form of follow-up avoiding the need for radical therapy. PMID- 3323321 TI - [Echo and Doppler cardiographic findings of isolated quadricuspid aortic valve: a case report and a review of the literature]. AB - The two-dimensional and pulsed Doppler echocardiographic features of a case of isolated quadricuspid aortic valve with aortic regurgitation are described. A 62 year-old woman was hospitalized for exertional palpitation and dyspnea. Her physical examination showed the typical findings of aortic regurgitation. Two dimensional echocardiograms revealed the aortic valve to have four cusps of nearly equal size. The accessory cusp was situated between the right and left coronary cusps. By pulsed Doppler echocardiography, holodiastolic turbulent flow signals were observed in the left ventricle, and the aortic flow pattern showed holodiastolic reverse flow, indicating severe aortic regurgitation. These findings were confirmed by aortography and by surgery. The coronary arteries and pulmonary valve were normal. We attempted a classification of the anatomical variations of the previously reported 34 cases of isolated quadricuspid aortic valves, including our own. They were classified as one smaller (67%), four equal (18%), three smaller (6%), four unequal (6%) and two smaller (3%) types. Twenty of the 34 patients had aortic regurgitation. Bacterial endocarditis and congestive heart failure were the main causes of death. PMID- 3323323 TI - Clinical validity of washout time constant images obtained by digital subtraction angiography. AB - Functional images of left ventricular myocardial perfusion were obtained using the washout time constant obtained from the analysis of digital subtraction angiograms (DSA). The results were compared with those of left ventriculography to evaluate its clinical validity. DSA examinations were performed in eight patients with old anterior myocardial infarction and in 10 control subjects. Washout time constant images of the left ventricular wall were nearly homogeneous in normal cases. On the contrary, regional heterogeneity on the washout time constant images was observed in cases of anterior infarction. The abnormal region in the washout time constant image corresponded well to the area of abnormal percent wall thickening, whereas the extent of the abnormal wall motion area tended to be broader than that of the abnormal washout time constant area or area of abnormal percent wall thickening. Thus, the washout time constant images obtained by DSA may comprise a reliable means of estimating the extent of ischemia in the myocardium. PMID- 3323322 TI - [Quantitative integrated backscatter characteristics in the normal and infarcted canine myocardium]. AB - To develop ultrasonic cardiac tissue characterization, serial changes in intensity of backscattered ultrasound from the normal and infarcted myocardium were studied in vitro, with frequency-domain analysis. As an index of backscattered signal intensity, quantitative integrated backscatter [(10 X log S2/S1)] (dB), S1 and S2 = areas of power spectra of digitized (sample rate = 100 MHz, 8 bits) ultrasonic signals from a perfect reflector and good specimens) were calculated for 60 regions of the myocardium (N = 20, MI = 40) excised from 10 dogs 3 days, 1, 2, and 4 weeks after coronary artery ligation in 2, 3, 3, and 2 dogs, respectively. The myocardial specimens and a stainless steel reflector were mounted at the focal distance of a newly-developed wide-band transducer having a center frequency of 4.0 MHz, in a water bath filled with degassed physiological saline. Tissue concentrations of hydroxyproline (HP) were also established using a HPLC (Hitachi amino acid analyzer model 835). The results obtained were as follows: 1. No significant changes in the integrated backscatter of the normal myocardium were observed throughout the experimental period (3 days = -52.5 +/- 0.7, one week = -53.6 +/- 1.8, two weeks = -51.6 +/- 0.8, four weeks = -52.8 +/- 1.4 (dB) (mean +/- SE). 2. Integrated backscatter of the infarcted myocardium [3 days = -47.3 +/- 0.6, one week = -49.2 +/- 1.3, two weeks = -40.7 +/- 1.3, four weeks = -39.6 +/- 2.0 (dB)] was significantly increased compared with the integrated backscatter of the normal myocardium in the early stage of myocardial infarction, before tissue concentrations of hydroxyproline increased, as well as in the chronic stage of myocardial infarction. 3. Results of histological examinations suggest that minute changes in structure, such as interstitial edema or neovascular proliferations, may be the cause of an early increase in integrated backscatter. The results suggest that quantitative integrated backscatter is a sensitive parameter for detecting both early and old myocardial infarction by cardiac tissue characterization. PMID- 3323324 TI - [Univentricular heart and pulmonary stenosis with a right-to-left shunt between the innominate and pulmonary veins after Glenn operation: a case report]. AB - A 12-year-old girl with a univentricular heart and pulmonary stenosis, who had undergone Glenn operation at two years of age and Fontan operation at 11 years of age, had a right-to-left shunt via collaterals between the innominate and pulmonary veins. This right-to-left shunt was detected by two-dimensional contrast echocardiography. The contrast material was injected into the left antecubital vein appeared in the left atrium, and this was confirmed by innominate venography. The contrast material injected into the left innominate vein passed via the collaterals into the pulmonary veins bilaterally. No such cases have so far been reported. In our experience, in four of six cases after Glenn operation, including the present case, the abnormal collateral circulation from the superior vena cava to the atrium was detected by two-dimensional contrast echocardiography. This case is interesting embryologically and suggests that the connection between the pulmonary and systemic veins which is present in early fetal life, and subsequently disappears, was present after birth. PMID- 3323325 TI - [Comparative sensitivities of exercise, isoproterenol infusion and cold pressor tests for detecting myocardial ischemia]. AB - The comparative sensitivities of exercise (supine ergometer), isoproterenol (ISP) infusion and cold pressor test (CPT) for detecting myocardial ischemia in patients with effort angina (45 cases) and vasospastic angina (16 cases) were investigated. Twenty-three patients with atypical chest pain served as normal controls. Left ventricular function was evaluated by computerized quantitative analysis using the following three graphic methods: 1) radionuclide angiography during exercise (EX-RI) and ISP infusion (ISP-RI), 2) two-dimensional echocardiography during ISP infusion (ISP-2DE) and CPT (CP-2DE) and 3) digital subtraction angiography during CPT (CP-DSA). The incidence of regional wall motion abnormalities (WMA) induced by these three stress tests in patients with effort angina were as follows: 83% in EX-RI, 80% in ISP-2DE, 80% in ISP-RI, 75% in CP-2DE and 86% in CP-DSA. In patients with vasospatic angina, the WMA were as follows: 40% in EX-RI, 0% in ISP-RI and 71% in CP-DSA. In patients with atypical chest pain, the WMA were 0% in EX-RI, 0% in ISP-RI, 8% in ISP-2DE, 13% in CP-2DE and 13% in CP-DSA. The left ventricular ejection fraction (EF) was unchanged during ISP (from 65 +/- 11% to 68 +/- 12%) and it decreased both during exercise (from 64 +/- 10% to 58 +/- 9%, p less than 0.05) and during CPT (from 69 +/- 10% to 65 +/- 9%, p less than 0.05) in patients with effort angina. In patients with vasospastic angina, the EF was unchanged both during exercise (from 70 +/- 7% to 68 +/- 13%) and during the CPT (from 76 +/- 5% to 75 +/- 4%), while it increased during ISP infusion (from 63 +/- 8% to 79 +/- 7%, p less than 0.01). In patients with atypical chest pain, the EF was increased both during exercise (from 72 +/- 7% to 79 +/- 5%, p less than 0.01) and during ISP infusion (from 67 +/- 5% to 78 +/- 7%, p less than 0.01), while it was unchanged during CPT (from 77 +/- 7% to 76 +/- 8%). In exercise and in ISP infusion tests, WMA were provoked concomitantly with ST segment deviations in nearly all patients. However, during CPT, WMA were produced without the occurrence of ST segment deviations. Myocardial ischemia due to organic coronary artery stenosis was difficult to distinguish from coronary artery spasm by exercise test. However, the susceptibility to ISP infusion and CPT differed in producing WMA in patients with vasospastic angina.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323326 TI - [Myocardial perfusion detected using digital subtraction angiography as compared with X-ray CT and Tl-201 myocardial imaging]. AB - Forty-two patients who underwent aorto-coronary bypass surgery were examined with intra-aortic digital subtraction angiography (IADSA) to detect abnormalities of myocardial blood perfusion. Tl-201 myocardial imaging and cardiac X-ray CT were performed nearly simultaneously about one month postoperatively. Cardiac imaging using IADSA was performed at a rate of 30 frames/sec with matrix size of 512 x 256. Time density curves of each pixel in the region of the myocardium of the left ventricle were post-processed to obtain functional images. The maximal concentration (Cmax), integration of the time-density curve (Cinteg), mean transit time (MTT), Cmax/MTT and Cinteg/MTT were computed for each pixel. Cmax and Cinteg are parameters related to the volume of the coronary vascular bed. Cmax/MTT and Cinteg/MTT are parameters related to the regional myocardial blood flow. These functional images showed hypoperfusion areas in 35 of 37 ischemic segments confirmed by wall motion in digital subtraction left ventriculography, Tl-201 myocardial imaging and ECG. Normal perfusion areas of the functional images were observed in 18 of 54 infarcted segments. These results show the complexities of myocardial perfusion in old myocardial infarction. PMID- 3323328 TI - The regulation of hematopoiesis following bone marrow transplantation. AB - Allogeneic bone marrow transplantation requires that donor stem cells home to the recipient bone marrow, proliferate and differentiate under normal physiologic regulatory mechanisms. Recent observations that T cell depletion of donor bone marrow leads to a greatly increased incidence of graft failure mandate a detailed understanding of the engraftment process. Post-transplant hematopoietic deficiencies appear to be related to several sources: decreased number of stem cells, activation of donor hematopoietic suppressor cells, rejection of donor stem cells by residual recipient lymphocytes and abnormal function of accessory cells that produce hematopoietic growth factors. A better understanding of the relative roles of these factors should lead to a better understanding of engraftment as well as graft failure and its prevention. PMID- 3323327 TI - [Quantitative evaluation of regional myocardial blood flow by digital subtraction angiography: correlations with exercise electrocardiography and Tl-201 myocardial scintigraphy]. AB - We previously reported that the contrast disappearance half-life (T1/2) derived by the computerized washout analysis of digital subtraction coronary arteriograms provides a useful index for quantitatively evaluating regional myocardial blood flow. In the present study, we further evaluated the clinical usefulness of T1/2, comparing it with exercise electrocardiography and exercise thallium-201 myocardial scintigraphy. The study subjects consisted of 25 patients with angina pectoris and 14 patients with normal coronary arteries. Following the manual injection of contrast media into the left anterior descending coronary artery (LAD), a time-density curve was generated in the sectors of the myocardium which were perfused by the LAD and the T1/2 was calculated. T1/2 values correlated closely with double product (r = -0.73). They were significantly greater in patients with exercise-induced ST depression (8.3 +/- 1.0 vs 5.8 +/- 0.7, p less than 0.005). In addition, there was a good correlation between T1/2 values and washout ratio as determined by exercise thallium-201 myocardial scintigraphy, with r = -0.83. Although T1/2 values were within the normal range (mean +/- 2SD of control subjects) in all patients with LAD stenosis of 50 percent or less, these values were abnormally increased, exceeding the normal range, in 11 of the 12 patients with stenosis of 90 percent or more. Compared with exercise electrocardiography, T1/2 values were abnormally prolonged in 11 of the 13 patients with exercise-induced ST depression. Compared with exercise thallium-201 myocardial scintigraphy, T1/2 values were abnormally prolonged in seven of the nine patients with transient perfusion defects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323329 TI - Hematopoietic factors in graft-versus-host reaction. AB - Graft-versus-host (GVH) reaction has a curious unsolved area in the immunopathogenesis and pathophysiology of the immunohematopoietic system, and GVH disease remains one of the major obstacles in clinical allogeneic bone marrow transplantation. T lymphocytes and T lymphocyte subpopulations are now recognized to be initiators of this GVH reaction and disease. Also, T lymphocytes are known to be accessory cells in the regulation of hematopoiesis, and produce a variety of lymphokines relevant to hematopoiesis. Admittedly, remarkable hematopoietic changes can be found in GVH reaction, but the cellular mechanisms underlying these changes are so complex they have yet to be fully elucidated. In fact, elevated serum levels of myeloid and erythroid colony-stimulating activities were found in mice suffering from GVH disease in which marked granulopoiesis and suppression of erythropoietic differentiation were seen. In addition, each granulocyte/macrophage colony-stimulating factor (GM-CSF) or burst-promoting activity (BPA) could be detected in sera from patients with GVH disease following allogeneic bone marrow transplantation. There seems to be at least two mechanisms involved in the control of hematopoiesis with either humoral or local environmental factor, probably via the T lymphocytes or T lymphocyte subpopulations activated by alloantigens or autologous non-T cells. PMID- 3323330 TI - Signal processing in 2 dimensional Doppler echocardiography. AB - Blood flow recordings made by 2 dimensional Doppler echocardiography can sometimes be understood more easily than conventional Doppler recordings, because of the anatomical 2 dimensional presentation. In contrast, signal processing has become more complicated and requires more explanation. In 2 dimensional Doppler echocardiography the analog ultrasonic signal received by the transducer is converted into an audible signal, which next is digitized and analyzed for its mean frequency and variance. Data collection and processing require application of multigating and high speed frequency analysis, generally based upon autocorrelation. Some artifacts may be perceived, such as color reversal due to aliasing, deceptively colored tissue surfaces due to beam motion, and wall motion ghost signals due to multiple reflections. Color flow imaging is appropriate for a rapid scan of the heart cavities to detect and roughly evaluate flow abnormalities. Quantification is still accomplished by switching to conventional Doppler mode. PMID- 3323331 TI - Positron emission tomography. Diagnostic and therapeutic implications in human myocardial ischemia. AB - Positron emission tomography and tracers of blood flow and of metabolism offer a most unique capability: The noninvasive study of regional myocardial metabolism and its derangements as a result of regional or global myocardial disease. Research with PET not only has confirmed the existence of metabolic fluxes and reactions as established previously through highly invasive or even destructive investigational techniques but has provided new insights into pathophysiologic processes, especially in ischemic and post-ischemic myocardium. From these investigations in both animal experiments and in humans, observations have emerged which indicate a place for PET in clinical cardiology. PET is likely to contribute to detection of disease, to characterizing its extent and severity as well as to decide upon the most appropriate therapeutic strategy and assessing its results. It is recognized that many of these observations with clinical implications await confirmation through larger clinical trials, follow-up studies as well as independent confirmation. Besides exploring ischemic heart disease, PET is equally suitable for examining substrate fluxes and interactions in other disorders as for example in intrinsic myocardial disease like primary and secondary cardiomyopathies. While derangements of metabolism in these disorders may be an expression of the consequences of the disease process or its underlying mechanisms itself, findings on PET will allow formulation of new hypotheses on disease mechanisms that conversely can then be tested. In addition to F-18 2 deoxyglucose and C-11 palmitate, the number of tracers for substrate metabolism is likely to increase. An example is C-11 acetate currently intensely investigated as a tool for measuring overall myocardial oxidative metabolism. Others as for example C-11 labeled short chain fatty acids are on the horizon. The study of cardiac receptors is similarly possible. Thus, a set of tools will soon be available for dissection of entire metabolic pathways and for determination of rate limiting steps in health and disease and to more clearly define specific defects in biochemical reaction steps that critically contribute to or even ae the specific cause of disease. PMID- 3323332 TI - Cine computerized tomography. AB - Ultrafast (Cine) CT scanning provides cross-sectional millisecond tomography, and therefore combines digital imaging and high resolution without the need for either cardiac catheterization or any form of ECG gating. Fifty millisecond multilevel scanning at rates of 17 scans per second allows quantitation of left ventricular (LV) function at each tomographic level during a cardiac cycle. Calculations of global and regional ejection fraction can be obtained, and in addition ultrafast CT also has the potential for providing unique data concerning regional wall thickening, mass and even regional myocardial perfusion. Interventional studies with exercise and pharmacological agents have commenced and are currently being evaluated. PMID- 3323333 TI - Oesophageal echocardiography. AB - The diagnostic value of oesophageal echocardiography is most striking in patients in whom precordial studies are of inadequate quality or fail to establish a definitive diagnosis. Oesophageal studies have excellent image quality, can be completed within 10 minutes without complications and, in most instances, enables the clinical question to be answered. In 50 patients referred for suspected thoracic aorta pathology, oesophageal echocardiography correctly excluded or diagnosed the type of aortic dissection, aortic aneurysm or the site of coarctation. Of 35 patients referred with suspected infective endocarditis, oesophageal echocardiography revealed complications in 18 patients, including vegetation, mycotic aneurysm, abscess or chordal rupture. Oesophageal echocardiography is extremely helpful to visualize intracardiac mass lesions. In 27 patients with a history of systemic or pulmonary embolism, the technique confirmed the presence, size and position of a mass lesion in 11 patients. Oesophageal color Doppler flow imaging further expands the diagnostic capabilities, particularly in patients with mitral valve prosthesis. Our experience indicates that oesophageal echocardiography significantly extends the diagnostic potential of echocardiography. Detailed knowledge of cardiothoracic anatomy and its pathologic sequelae is, however, a prerequisite for the efficient and safe application of this method. PMID- 3323335 TI - MRI of heart disease. PMID- 3323334 TI - Echocardiography and coronary artery disease: current and future applications. AB - Echocardiographic techniques are becoming more widespread for evaluating patients with known or suspected coronary artery disease. Because it affords an excellent overall view of the heart, two-dimensional echocardiography, rather than M-mode echocardiography, is the imaging procedure of choice when dealing with coronary artery disease. This technique can be used to make the initial diagnosis of acute myocardial infarction, diagnose complications, and assess prognosis following myocardial infarction. Additionally by combining this test with stress testing, latent coronary artery disease can be detected. Recovery of wall motion can be assessed following interventions such as thrombolysis or balloon angioplasty. Investigational and future uses include tissue characterization, which may allow detection of ischemic but potentially viable myocardium, direct coronary visualization for detection of atherosclerotic involvement of the proximal coronary arteries and myocardial contrast echocardiography. The latter technique allows visualization of perfusion by way of injecting contrast material into the coronary circulation. This has been demonstrated to be an accurate means of determining myocardial infarction size in an animal model and is currently being used in a number of centers in patients at the time of cardiac catheterization. In summary two-dimensional echocardiography currently allows assessment of patients with myocardial infarction from the time of their presentation through their convalescent period with respect to diagnosis, prognosis and presence of complications. Exercise echocardiography can diagnose latent coronary artery disease. The newer investigational techniques show promise for furthering our ability to evaluate patients with coronary artery disease using echocardiography. PMID- 3323336 TI - Circulating immunocomplexes in the diagnosis of autoimmune and neoplastic disorders: new perspectives. AB - Two new competitive immunoenzymatic assays ("C.I.C.-conglutinin" and "C.I.C. C1q") were employed to evaluate circulating immunocomplexes in 90 patients with a variety of autoimmune and neoplastic disorders. In autoimmune diseases the assays appeared very sensitive and relatively concordant, while in malignancies sensitivity was high with the C.I.C.-conglutinin method but much lower with the C.I.C.-C1q method. The clinical significance of these results is discussed with particular regard to the possibilities of application of the two assays in the diagnostic routine of a general hospital laboratory. PMID- 3323337 TI - Significance of S-100 protein immunostaining in the immunohistological analysis of normal and neoplastic lymphoid tissues--an appraisal. AB - S-100 protein is a heterogeneous fraction of dimeric polypeptides (alpha and beta subunits) that can exist in different combination forms within the various tissues. Concerning the S-100 protein immunodetection within lymphoid tissue, the heterogeneity of the S-100 antigen, the tissue quality (frozen or paraffin embedded after treatment with different fixatives) and the treatment of the tissue with different immunostaining methods and antibodies of different nature, all make for inconsistent results obtained in the immunohistological studies reported in the literature. Most of the S-100-positive cells of the lymphoreticular system are dendritic cells involved in the immune response (interdigitating reticulum cells, Langerhans cells, and follicular dendritic reticulum cells), other S-100-positive cells belonging to the mononuclear/phagocytic system. S-100 protein immunostaining may be used as a helpful immunohistological diagnostic clue to certain malignancies of the immune system (follicular center cell lymphomas) on the basis of their specifically related dendritic cell microenvironment. In addition to monoclonal antibodies for the immunophenotypic characterization of dendritic cells and macrophages and to enzyme reactions, the combined use of anti-S-100 antibodies specific for each of the S-100 protein subunits, tested with sensitive procedures, would be a very useful tool in the attempt to classify the proliferative disorders of dendritic cells and macrophages. PMID- 3323338 TI - Lymphocyte subpopulations in Lynch syndrome II: an immunocytochemical study on gastrointestinal biopsies. Preliminary report. AB - Gastrointestinal biopsies from 18 members of a family with Lynch Syndrome II were evaluated and immunocytochemical studies were made to characterize the phenotypic expression of the tissue's immune populations. The intestinal findings suggest polyclonal B-cell activation related to the T-helper distribution. Our evaluation provides no specific information so far on the management of patients with Lynch Syndrome II. PMID- 3323339 TI - Classification of a tumour in the popliteal fossa by radioimmunoscintigraphy 11 years after resection of a malignant melanoma. PMID- 3323340 TI - Monoclonal antibodies to alpha DNA polymerase as a marker of cell proliferative activity. AB - A hybridoma cell line (5F) secreting monoclonal antibodies directed to alpha DNA polymerase has been developed. Kinetic studies on peripheral blood lymphocytes stimulated with mitogen and human colon cancer cell lines established in vitro were made by the two autoradiographic techniques of Thymidine Labelling Index and Primer-dependent alpha DNA polymerase Labelling Index and the immunoperoxidase assay (PAP) with monoclonal antibody to alpha DNA polymerase. We demonstrated the exclusively intranuclear presence of alpha DNA polymerase in lymphocytes induced to proliferate and actively growing colon cancer cells in contrast with the cytoplasmic distribution of the enzyme in resting stage populations. The feasibility of using monoclonal antibodies to alpha DNA polymerase to determine cell growth fraction was evaluated. PMID- 3323342 TI - [Primary pulmonary leiomyosarcoma--a case report and a review of 68 cases in Japan]. PMID- 3323341 TI - Terminal deoxynucleotidyl transferase, TdT, as a marker for leukemia and lymphoma cells. AB - Terminal deoxynucleotidyl transferase, TdT, was assayed in the mononucleate cells of blood and bone marrow from 121 patients with leukemias at the onset of disease and from 95 subjects with malignant lymphomas at diagnosis. This intracellular marker was also investigated by cytoimmunofluorescent tests in 17 other cases of initial leukemias and in 3 diagnosed lymphoblastic lymphomas. Generally, the TdT levels were significantly enhanced in the blasts of the following: acute undifferentiated leukemias; the more immature types of acute lymphoblastic leukemias i.e., the null, non-T non-B, common, early T and pre-B subgroups; a fraction of blastic crises in chronic myelogenous leukemias; and many lymphoblastic lymphomas. TdT might also be slightly increased in the mononucleate blood cells obtained from the most immature forms of acute myelogenous leukemias. Relapses with changes in cell phenotypes were occasionally observed in previously TdT-positive leukemias as a result of clonal evolution of the disease. The leukemias with blasts containing high levels of TdT were usually responsive to treatment with corticosteroids and vincristine. TdT is an oligoclonal marker characterizing several populations of undifferentiated or poorly differentiated blasts that tend to develop towards or along the lymphoid pathway. Together with specific immunological markers, this enzyme is useful to define the particular type of leukemic cells. It also serves to identify the quasi-lymphoblastic nature of the malignant clone, a helpful indication for the choice of therapy. PMID- 3323343 TI - Molecular biological definition of the prothymocyte: problems of commitment and lineage promiscuity. PMID- 3323345 TI - T cell ontogeny: extrathymic and intrathymic development of embryonic lymphohemopoietic stem cells. PMID- 3323344 TI - In vivo proliferation and differentiation of prothymocytes in the thymus. PMID- 3323346 TI - T cell gamma receptor. PMID- 3323348 TI - Laser Doppler flowmeter and standardized thermal test in normals and Raynaud's phenomenon. AB - The diagnosis of Raynaud's phenomenon alone requires clinical investigations. To determine the stage of the disease, its etiology and pathophysiology, it seems desirable to perform noninvasive tests. Conclusions regarding control o the skin or muscle components of hand blood flow rely on evidence from separate measurements of skin or muscle blood flow. We described a standardized thermal provocation test, then respiratory maneuvers and pharmacological trials, to stimulate the microcirculatory control. The total cutaneous blood flow was continuously registered using a laser Doppler flowmeter. We conducted a prospective study on 100 subjects: 21 normal, 22 primary Raynaud's phenomenon (PRP), 26 secondary (SRP), 31 various microcirculatory diseases. The basal blood flow was lower in cases of severe SRP and acrocyanosis. In comparison with normals, RP cases present a less noticeable reaction to cold. Mild SRPs are more sensitive to cold and do not recover during warming up. Severe RPs are less sensitive to cold as they have a lower basal blood flow. Acrocyanosis cases are not sensitive to thermal variations. Post ischemic reactive hyperemia leads to a constant peak flow. Pharmacological assays were performed (nitroglycerine, Nifedipine) during permanent control of skin and muscle blood flow. Laser Doppler and provocation tests have no etiologic value in a Raynaud's phenomenon investigation; this methodology tries to elucidate the pathophysiology, the prognosis and the therapy of Raynaud's phenomenon. PMID- 3323349 TI - Introduction to hemorheology: theoretical aspects and hyperviscosity syndromes. AB - Whole blood behaves like a deformable colloidal particle suspension in a macromolecular medium. Pathological variations in the rheological properties of blood and the clinical symptoms they produce form the "hyperviscosity syndromes". The term "hyperviscosity" was originally used for characterising the plasma hyperviscosity observed during macroglobulinemia and it is only recently that the chapter covering hyperviscosity syndrome has been enlarged to describe the syndromes as a state which the increased blood viscosity and increase in flow resistance must be considered as the result of the rheological behaviour of blood taken as a whole (plasma and blood cells). The etiology of hyperviscosity syndromes can be: (a) an increase in total plasma protein levels, or the appearance of a monoclonal protein; (b) the increase in the number of blood cells; (c) the increase in the erythrocyte's internal viscosity; (d) the changes in the erythrocyte's viscoelastic properties; (e) the excessive aggregating tendency of the erythrocytes and perhaps that of the platelets. PMID- 3323350 TI - Transcranial Doppler sonography for blood flow velocity measurement during pharmacological tests. AB - Transcranial Doppler sonography, using a 2 MHz pulsed Doppler system, is suitable for non-invasive continuous monitoring of middle cerebral artery blood flow velocity during pharmacological studies. Methodological problems, and factors affecting cerebral blood flow have to be discussed (vasomotor spontaneous changes, intracranial blood pressure, blood viscosity, heart rate, vascular risk factors, etc.). Arguing from a previous study in 28 subjects (11 healthy volunteers, 8 hypertensive patients, 9 patients with middle cerebral artery stenosis), showing the hypotensive action of Nifedipine, without significant decrease of cerebral blood flow in 83% of cases, we emphasize the advantages and limits of this new non-invasive method for cerebral blood flow monitoring. PMID- 3323347 TI - Characterization of hematopoietic stem and progenitor cells. PMID- 3323351 TI - Cervical artery exploration: choice and need for a non-invasive technique. AB - The different non-invasive exploratory techniques for cervical arteries are compared and classified as hemodynamic exploration methods (continuous and pulsed Doppler testing, frequency profile analysis, oculoplethysmography), and imaging methods (ultrasonic and real-time echotomography imaging). We believe that the best results can be obtained by associating frequency profile analysis with real time echotomography or Doppler testing with real-time echotomography. The choice between these combined modalities is determined by the clinical context and particularly whether the patient is symptomatic or not. Angiography and therapeutic strategy may be indicated either immediately after a Doppler test or after more extensive examination. PMID- 3323352 TI - Influence of the haemodynamic parameters on the repartition of the flow between an artery and its graft. AB - The aim of this study was to investigate the repartition of the flow between an artery and its graft for several values of the geometric and dynamic parameters (length and severity of the stenosis, Reynolds number and frequency pulse value). The model, fabricated in silicone, was included in an hydrodynamic test bench, allowing to reproduce physiological conditions. Our study showed that the severity of the stenosis was the most influent parameter on the repartition of the flow; in particular, a 75% severity was necessary to obtain a repartition 70 30% between the graft and the artery. PMID- 3323353 TI - Value of real time B mode ultrasound imaging in the diagnosis of deep vein thrombosis of the lower limbs. AB - In order to determine the value and the role of real time B mode ultrasound imaging (USI) in the diagnosis of deep vein thrombosis (DVT) of the lower limbs, it was compared to bilateral contrast ascending venography used as a standard of reference, prospectively and systematically on 430 patients suspected of having DVT or pulmonary embolism. A total of 854 limbs were thus studied double blindly both by the two methods. The results corresponded in 95% of the legs with a sensitivity of 98% and a specificity of 95% for USI. Isolated thrombosis of the calf were detected in 91% of the legs and proximal thrombosis were in 100% in this series whatever their topography and extent should be and whatever be the degree of obstruction of the vein. The discrepancies between the two methods are related to: (a) Vein thrombosis especially located in the calf, in the soleal sinuses and the gastrocnemius with in most cases the direct image of the thrombus detected by U.S.I. more often than by venography, provided that the technique and the equipment are appropriate. (b) The absence of visualisation of venous segments with venography which is not specific of venous thrombosis. These veins when non affected by the thrombosis are not filled by the contrast medium if located above an occluded ilio-femoral or ilio-caval junction or when they are the site of extrinsic compression. The direct imaging of the vein and the surrounding structures obtained with USI enhances the diagnostic sensitivity and specificity and provides precision of the exact extension of the thrombosis. Venous study by USI is always coupled with the Doppler.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323355 TI - Erythrocyte aggregation: experimental approaches and clinical implications. AB - From a clinical point of view, quantitative studies of erythrocyte aggregation or rouleau formation is of great interest. However, in order to approach the phenomenon, structural parameters (rouleau shape), kinetic parameters (rouleau formation and dissociation velocity) and rheological parameters (dissociation thresholds) must be determined. At present, optical dynamic methods are available for use in clinical hemorheology. They involve optical measurements in a viscometer. The first method consists of a study of the light intensity transmitted through the measuring chamber of a cone plan viscometer. A device calculates and index I, which provides a whole approach to the aggregation kinetics. On the other hand, a systemic which also involves a cone-plain viscometer and an inverted microscope (Rheoscope) allows to collect data by means of microphotographs, microcinematography or numerical image processing. In that case, an adimensional K index typical of the morphology of the aggregates can be determined. The second method involves the analysis of the light intensity backscattered by the red blood cells sheared in a Couette flow. An automatic system has been developed and aggregation times, orientation and structure index, total and partial disaggregation thresholds can be determined on the basis of the curves of variations of backscattered light. PMID- 3323354 TI - Haemodynamics of the postphlebitic syndrome. AB - The venous function has been assessed after deep vein thrombosis (DVT) by Doppler, strain gauge plethysmography (55 patients) and exercise plethysmography (10 patients) for a mean period of 63 weeks. Venous volume and venous outflow remain significantly lower throughout the study, whatever the site of thrombosis and the initial therapy (Heparin, local or general Urokinase). There are no significant correlations between clinical and functional parameters except for patients with proximal obstruction and popliteal valvular incompetence. Exercise plethysmography evaluates the importance of the calf pump in the postphlebitic syndrome. Static plethysmographic measurements prove to be unreliable for the long term prognosis whereas associated dynamic tests should be a better way to assess the haemodynamic changes after DVT and to control the efficiency of the prevention of the post-phlebitic syndrome. PMID- 3323356 TI - [Study on relationships between sonographic endometrial images and ovarian hormone levels]. AB - Sixty-seven and 109 sonographic endometrial images obtained from 67 infertile patients and 5 healthy volunteers with normal ovulatory cycles, respectively, were investigated with regard to serum estradiol (E2) and progesterone (P) levels. The ultrasound devices used were sector electronic scanners (3.5 MHz). 1) Endometrial images were able to be classified into four pattern types, according to the criteria reported by Sakamoto (1985), using a gray-scale contact compound scan. Pattern 1: linear cavity echo, pattern 2: thick hypoechoic endometrium surrounded by thin border echo, pattern 3: thickened border echo, pattern 4: entire echogenic endometrium. 2) Both E2 and P levels were low in pattern 1. The E2 level was significantly higher in pattern 2 than in pattern 1 (p less than 0.01), indicating pattern 2 reflects E2 surges prior to ovulation. The P level was high in pattern 3; and in pattern 4, it was significantly higher than in patterns 1 and 2 (p less than 0.01), indicating that patterns 3 and 4 are in the early and mid-luteal phase, respectively. 3) Sonograms obtained from 12 cases with suspicious luteal phase defects showed an abnormal pattern in the mid-luteal phase. These results indicate that the sonographic endometrial images reflect respective ovarian hormone levels. PMID- 3323357 TI - [Endocrinological background of pituitary desensitization during pulsatile LH-RH therapy for ovulation induction in amenorrheic women]. AB - In order to elucidate the endocrinological background of patients in whom ovulation induction by pulsatile LH-RH administration resulted in failure, 16 women with hypothalamic amenorrhea were treated with 10 to 20 micrograms of LH-RH injected subcutaneously every 2 hrs. Six women did not ovulate, and 5 of them showed pituitary desensitization since the basal gonadotropin concentration gradually decreased and the response to LH-RH test (100 micrograms i.v.) became blunted by the treatment. No significant differences between the ovulated and desensitized groups were seen in basal LH, FSH, E2, PRL levels, LH/FSH ratio and response to LH-RH test performed prior to the treatment. In addition, the plasma LH-RH profile after subcutaneous injection of 10 micrograms of LH-RH was highly pulsatile in both groups. However, in the desensitized group, all were obese, showed impaired GH response to both insulin tolerance and GH-RH tests, and had episodic LH secretion with higher frequency compared to the ovulated group. These results suggest that the desensitized women had occult pituitary dysfunction and hypersecretion of endogenous LH-RH which stimulated the pituitary close to the level of desensitization. The mechanism of hypersecretion of endogenous LH-RH is discussed. PMID- 3323359 TI - [Immunoglobulin production of neonate--T lymphocyte subset and production of cytokine]. AB - On the mechanism underlying the repression of antibody production encountered in the new-born, in this study we used the induction of antibody-producing cells on mitogen stimulation of PWM and SAC, identification of T-cell subsets through two color FACS and the evaluation of cytokine production of IL-1, IL-2 and BCGF with the following results; 1. The cord blood IgG level rose with gestational weeks due to active transport from the mother. The IgM level was low in full term infants. A natural antibody first appeared in the 16th week. 2. Antibody production on mitogen stimulation in infants was remarkably less than in adults. The inability to produce antibodies appears to be closely related to T-cell factors. 3. In examination of the cell surface maker, new-born infants show less suppressor T-cell but significantly more suppressor inducer T-cell than in adults and that its much smaller number of helper T-cells are insufficient for antibody production. 4. Production of IL-1 in full term infants was significantly lower and that in premature subjects was much lower than that in adults. In full term infants, IL-2 was about the same as in adults, and BCGF production was greater than in adults not depressed in full term infants, and were significantly higher in premature infants than that in adults. PMID- 3323358 TI - [Functional morphology of the decidua]. PMID- 3323361 TI - [Biology of ovum implantation]. PMID- 3323360 TI - [Ultrasonographic diagnosis of cul-de-sac endometriosis]. AB - Fifty-six women with endometriosis were examined for cul-de-sac endometriosis by ultrasonography and laparoscopy. Ultrasonographic cul-de-sac findings were classified into 3 groups; i.e. Group A (n = 21): no remarkable findings, Group B (n = 16): several nodular hyperechoic or cystic hypoechoic areas, and Group C (n = 19): multiple nodular or cystic areas and/or discontinuation of the contour of the posterior uterine wall. Laparoscopic cul-de-sac findings were classified into 3 groups; i.e. Group alpha (n = 6): no endometriosis, Group beta (n = 28): minimal or mild endometriosis, and Group gamma (n = 22): advanced endometriosis with or without cul-de-sac obliteration. Over-all coincidence of both findings was 50%. The rate of coincidence was significantly higher (p less than 0.05) in Group gamma (15/22) than in Group beta (9/28). This indicates that the diagnosis of minimal or mild cul-de-sac endometriosis by means of ultrasonography is difficult but that ultrasonography might be useful in diagnosing advanced cul-de sac endometriosis. PMID- 3323362 TI - [Medical care system for mother, fetus and newborn--what should be in mind for systematization]. PMID- 3323363 TI - [Evaluation of ultrasonography in management of choriocarcinoma and invasive mole]. AB - To clarify the clinical significance of ultrasonography (USG) in the therapeutic course of invasive mole and choriocarcinoma, a detailed study of USG images from 31 patients, taken upon admission, in which an abnormal condition was clearly indicated, was undertaken. In addition, the clinical value of the pulse doppler and color doppler images used to determine the blood flow was also studied. The results revealed the following points. 1) Before the 1st therapy, USG conditions could be classified into three categories, type I (massive echogenic), type II (one or more echo free space (EFS) surrounded with a massive echogenic area) and type III (EFS). 2) A large number of patients with invasive mole exhibited type II, with a few exhibiting type III. A large number of patients with choriocarcinoma exhibited type I, and a few exhibited type II. 3) A comparison with PAG conditions showed a high correlation between the pooling image in PAG and the EFS in USG. 4) There was a positive correlation between the estimated volume of the tumor at the start of therapy and the hCG value in urine. In the chemotherapy patients, the reduction of hCG was accompanied by shrinkage of the tumor, and in 9 out of 22 patients (40.9%), the tumor disappeared on the USG at the point where the hCG became negative. 5) 14 of 22 chemotherapy patients (63.6%) matched the "Standard Progress" course, which was decided and based on the changes observed in the USG image over the course of chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323364 TI - The characteristics of luteinizing hormone and its beta-subunit secretion in dispersed rat anterior pituitary cells. AB - Secretion of luteinizing hormone (LH) and its beta-subunit (LH-beta) by luteinizing hormone-releasing hormone (LH-RH) were studied in perifused rat anterior pituitary cells. LH release was dose related between 10(-10) and 10(-6)M LH-RH. Every 5-minute pulse of 10(-8)M LH-RH induced almost similar response to the initial LH release; neither the self-priming effect nor desensitization were significant. Continuous administration of 10(-8)M LH-RH caused an initial LH release, followed by distinct desensitization, which could not be overcome by subsequent pulses of 10(-8)M LH-RH. The results were quite similar in LH-beta release. The perifusion study is shown to be useful in analyzing the characteristics of LH and LH-beta release, and the present results suggest that LH-RH receptor-mediated regulation may be also involved in LH-beta release. PMID- 3323365 TI - Antibodies to a synthetic analog of phenolic glycolipid-I of Mycobacterium leprae in healthy household contacts of patients with leprosy. AB - Fifty-four household contacts of lepromatous patients, 39 household contacts of tuberculoid patients, and 99 control persons were examined with an enzyme-linked immunosorbent assay for their antibody responses to phenolic glycolipid-I (PGL-I) of Mycobacterium leprae using a synthetic analog (PGL-ISA) with the same terminal sugar epitope, namely, O-(3, 6-di-O-methyl-beta-D-glucopyranosyl)-(1----4)-O (alpha-L-rhamnopyranosyl )-(1----9)-oxynonanoyl-BSA. This study was conducted in the Gurage area of Ethiopia in 15 households with a leprosy patient and 15 matched control households. Household contacts with more than 1 year of exposure to a lepromatous patient had antibodies to PGL-ISA significantly more often (19 of 34 persons) than did household contacts with less than 1 year of exposure to a lepromatous patient (4 of 20 persons), household contacts of tuberculoid patients (8 of 39 persons), and persons without exposure to leprosy in the household (33 of 99 persons). No significant association was found between the prevalence of antibodies to PGL-ISA in the household contacts and disease activity in the lepromatous index patients at the time of examination; nor was there a significant association between antibody responses and age or sex of the contacts. The increased prevalence of antibodies to M. leprae antigen in healthy persons with more than 1 year of contact with a lepromatous patient provides further evidence that subclinical infection in leprosy is common, and is related to the type of leprosy in the index patient. The fact that antibodies to PGL-ISA were detected in one third of the persons without household exposure to leprosy emphasizes the necessity to always include comparable controls from the same endemic area in studies of leprosy contacts. PMID- 3323366 TI - Seroepidemiological study on 724 household contacts of leprosy patients in French Polynesia using disaccharide-octyl-BSA as antigen. AB - A seroepidemiological surveillance of a contact population was started in 1984 in French Polynesia. The ELISA test was used to measure IgM anti-ND-O-BSA in the sera. Specific antibody levels were higher in healthy Polynesians than in normal individuals living in a nonendemic country. The positive threshold of the reaction was fixed according to this background activity in healthy Polynesians. Under these conditions, 100% of the multibacillary patients were detected as seropositive as compared to 5% of the paucibacillary group. In the population of 724 household contacts tested and observed for 2 years: 93 (12.8%) were seropositive, with 8 (1.1%) showing activity equivalent to multibacillary patients (1 of these 8 individuals developed a lepromatous form of leprosy); 631 (87%) were seronegative and 3 developed a paucibacillary form of the disease (2 BT, 1 I) without any antibody increase. Among those four contacts who developed leprosy, three were related to a multibacillary index case. These data suggest that this test may be useful for the prediction of multibacillary leprosy. A long term surveillance of this high-risk population will be able to evaluate the diagnostic and prognostic value of the serological assay. PMID- 3323367 TI - Antibodies to phenolic glycolipid-I during long-term therapy: serial measurements in individual patients. AB - Levels of IgM antibody to phenolic glycolipid-I (PGL-I) were measured in serum specimens collected over the initial 5 or more years of therapy from 11 leprosy patients. All three patients with paucibacillary disease had undetectable levels of antibody throughout their treatment. The eight patients with multibacillary disease had initially elevated levels which fell quite rapidly with treatment, reaching levels of 10% to 30% of their initial pre-treatment level after 5 years of therapy. The single patient with prolonged therapeutic noncompliance had an increase in antibody level, although clinical or bacteriologic relapse was not documented. These results in individual patients demonstrate that IgM antibody to PGL-I declines rapidly and consistently with treatment in multibacillary patients. PMID- 3323368 TI - Effects of ICRC antileprosy vaccine in healthy subjects. AB - Long-term effects of the administration of the ICRC antileprosy vaccine in healthy subjects have been investigated both in household contacts of leprosy patients and noncontacts in a general population. Each volunteer received a dose of vaccine containing either 0.5 x 10(9) or 1.7 x 10(7) bacilli intradermally. The vaccine induces a dose-dependent lepromin conversion in negative subjects at 8 weeks after vaccination. One year later, the conversion rates are more than 90% in both high- and low-dose groups. Lepromin conversion is stable for at least 3 years. When administered to the lepromin-positive contacts, the vaccine induces a statistically significant increase in intensity of the reaction at 6 months. During the 3-year observation period, the subjects have remained healthy and no untoward effects, including any neurological lesions, have been observed. There has also been no change in the circulating level of antibodies against the phenolic glycolipid-I antigen of Mycobacterium leprae as a result of vaccination. The vaccine thus induces not only stable immunity but is safe and, being given as a single injection, has a high acceptability. Its field trials will begin soon. PMID- 3323369 TI - Primary and secondary dapsone resistance of M. leprae in Martinique, Guadeloupe, New Caledonia, Tahiti, Senegal, and Paris between 1980 and 1985. AB - Primary and secondary dapsone resistance were studied among lepromatous patients living in Martinique, Guadeloupe, New Caledonia, Tahiti, Senegal, and Paris. Four hundred fifteen biopsies were taken from clinically active and bacteriologically positive (bacterial index greater than 2) patients in the 6-year period of 1980 1985. Among these, 280 biopsies that contained 5 x 10(4) acid-fast bacilli per ml with a morphological index of at least 0.10 were inoculated into the mouse foot pad, and 229 harbored infective Mycobacterium leprae. Among the 129 infective M. leprae isolated from new cases, 54% had some degree of dapsone resistance, a low degree being prominent in all cases. Among the 100 infective M. leprae isolated from relapsed cases, 79% had a high or an intermediate degree of dapsone resistance. The annual incidence of secondary dapsone resistance was estimated to be about 0.55% in Guadeloupe. PMID- 3323370 TI - Appearance of a methoxy mycolate-like component by the acid methanolysis of Mycobacterium leprae. AB - It has been reported that Mycobacterium leprae contains two types of mycolic acid, namely, alpha- and keto-mycolic acids, thus it is taxonomically similar to M. bovis BCG. However, there was some controversy about the presence of methoxy mycolic acid which was observed in small amounts only in the case of experimentally infected (W45) armadillo-derived M. leprae. To investigate this fact, mycolic acids were extracted from the cell-wall structure of M. leprae and characterized using chromatographic techniques. The results showed the appearance of a methoxy mycolate-like component for both purified bacilli and infected human skin tissue materials. However, this appearance occurred only when the acid methanolysis procedure was followed for the release of mycolic acids from these bacilli. No such component appeared on the chromatogram when the alkaline methanolysis procedure was followed. Nevertheless, the consistent presence of this methoxy mycolate-like component by acid methanolysis is an important finding which has to be kept in mind while identifying this pathogen when using chromatographic techniques. PMID- 3323371 TI - Experimental murine leprosy and its relevance for the study of resistance to mycobacterial infections in man. PMID- 3323372 TI - Serological reactivity and early detection of leprosy among contacts of lepromatous patients in Cebu, the Philippines. PMID- 3323373 TI - Immunodiagnostic tests for leprosy; a need for standards. PMID- 3323374 TI - Dapsone susceptibility of M. leprae before and after 1977. PMID- 3323375 TI - [Immunohistochemical tissue localization of TA-4 and CEA in uterine carcinomas]. PMID- 3323376 TI - [Clinical approaches to glycogenoses: analyses on muscle, liver, leucocytes and erythrocytes]. PMID- 3323377 TI - [Diabetes mellitus and atherosclerosis]. PMID- 3323378 TI - [Studies on Ni-Ti alloys for dental casting. Part 1: Improvement of castability and mechanical properties by addition of Cu]. PMID- 3323379 TI - Lateral sinus thrombosis (a review of 45 cases). AB - Forty-five cases of lateral sinus thrombosis were recorded in King Edward VIII Hospital from 1978 to 1984. Eighty-two per cent of the patients were under the age of 15 years. Associated complications recorded were: 9 patients with meningitis, 4 with posterior-fossa abscess, 1 patient suffering from posterior fossa empyema; 4 presented with facial palsy and 1 with tuberculous mastoiditis. Four deaths were recorded. Findings at mastoidectomy showed a prevalence of infective granulations (60 per cent) over cholesteatoma (40 per cent) as a cause of the extension of infection. The surgical protocol for the management of lateral sinus thrombosis was mastoidectomy, needling the sinus and removal of the thrombus, if necessary. Medical treatment consisted of Ampicillin and Metronidozol. PMID- 3323380 TI - Nasopharyngeal carcinoma in Caucasian children. A 25-year study. PMID- 3323382 TI - Use of ultrasound in the management of acute lingual swelling. PMID- 3323381 TI - Congenital hearing loss in patients with Cornelia de Lange syndrome (a report of two cases). AB - Two children with a congenital Cornelia de Lange syndrome and a verified sensorineural hearing loss are presented. One could be tested by conventional audiometry, the other only with the help of the newer computerized electronic methods. A short review of some earlier reports on congenital hearing loss in this syndrome is made. PMID- 3323383 TI - Mucoepidermoid carcinoma in a minor salivary gland in childhood. AB - Salivary gland neoplasms in childhood and adolescence are rare, especially in the minor salivary glands. Vasoformative tumours and pleomorphic adenomas appear to be the most common benign neoplastic salivary gland lesions in the pediatric age group. The distribution of various malignant histological types is not always consistent with that in the adult population, and they appear more often in girls than in boys. Only 17 cases have previously been documented. The clinical and histological picture of a case of palatal mucoepidermoid carcinoma in a 13-year old girl is presented as well as a review of the literature on malignant salivary gland tumours in childhood. PMID- 3323384 TI - Rationing access to advanced medical techniques. PMID- 3323385 TI - Drug regulation, product liability, and the contraceptive crunch. Choices are dwindling. PMID- 3323386 TI - Live organ donors and informed consent. A difficult minuet. PMID- 3323387 TI - Sex education. The dissemination of family planning services and contraceptives in public school. PMID- 3323388 TI - Lipids of Paramecium. AB - This review is the first on the composition and metabolism of Paramecium lipids. This ciliated protozoa is a useful system for studying the structure and function of biomembranes since it can be grown under chemically defined culture conditions in large numbers; much is known about its genetics, membrane electrophysiology, and ultrastructure; and mutants with defective membrane functions are available which are reported to have lipid alterations. Pure preparation of the cell surface ciliary membrane are readily isolated. The organism and its ciliary membrane contain a variety of polar lipids, sterols, and steryl esters. The polar lipids include substantial amounts of ether lipids, sphingolipids, and phosphonolipids. the biosyntheses of fatty acids and specific moieties of complex lipids in this organism are beginning to be examined with promises of elucidating biosynthetic mechanisms that are more difficult to study in other organisms. More information on lipid metabolism is required to identify the bases for the defects in putative lipid/membrane mutants. PMID- 3323389 TI - Synthesis of hepatic lipase in liver and extrahepatic tissues. AB - Immunoprecipitations of hepatic lipase from pulse-labeled rat liver have demonstrated that hepatic lipase is synthesized in two distinct molecular weight forms, HL-I (Mr = 51,000) and HL-II (Mr = 53,000). Both forms are immunologically related to purified hepatic lipase, but not to lipoprotein lipase. HL-I and HL-II are also kinetically related and represent different stages of intracellular processing. Glycosidase experiments suggest that HL-I is the high mannose microsomal form of the mature, sialylated HL-II enzyme. Hepatic lipase activity was detected in liver and adrenal gland but was absent in brain, heart, kidney, testes, small intestine, lung, and spleen. The adrenal and liver lipase activities were inhibited in a similar dose-dependent manner by hepatic lipase antiserum. Immunoblot analysis of partially purified adrenal lipase showed an immunoreactive band co-migrating with HL-II at 53,000 daltons which was absent in a control blot treated with preimmune serum. Adrenal lipase and authentic hepatic lipase yielded similar peptide maps, confirming the presence of the lipase in adrenal gland. However, incorporation of L-[35S]methionine into immunoprecipitable hepatic lipase was not detected in this tissue. In addition, Northern blot analysis showed the presence of hepatic lipase mRNA in liver but not adrenal gland. The presence of hepatic lipase in adrenal gland in the absence of detectable synthesis or messenger suggests that hepatic lipase originates in liver and is transported to this extrahepatic site. PMID- 3323391 TI - Facial flushing secondary to hypoglycemia. AB - Facial flushing is usually not associated with hypoglycemia. Diabetics treated with chlorpropamide can have an antabuse-like flushing with ingestion of alcohol, but flushing secondary to hypoglycemia per se has not been reported. The first case demonstrating that facial flushing can occur in insulin-induced hypoglycemia is described. This patient had marked erythematous facial flushing that was repeatable with each instance of hypoglycemia. Endocrine evaluation revealed no evidence of carcinoid or a pheochromocytoma in this patient and the facial flushing was unrelated to alcohol. Without insulin-induced hypoglycemia, this diabetic patient has had no further facial flushing in one year follow-up. PMID- 3323390 TI - Nonenzymatic oxidative cleavage of peptide bonds in apoprotein B-100. AB - Incubation of low density lipoprotein (LDL) with endothelial cells converts it to a form that is avidly degraded by macrophages via the acetyl LDL receptor. This modification has previously been shown to be accompanied by extensive breakdown of the major LDL protein (apoB-100) to smaller peptides. ApoB-100 is known to undergo partial degradation during isolation and purification which is commonly attributed to proteolytic enzymes derived from plasma or to contaminant bacteria. In the present studies addition of any of ten different inhibitors of proteolytic enzymes failed to inhibit the endothelial cell-induced degradation of LDL apoB 100 or its subsequent enhanced rate of degradation by macrophages (termed biological modification). Conversely, deliberate digestion of LDL with any of five well-characterized proteolytic enzymes degraded apoB-100 extensively but did not cause biological modification. The disappearance of intact apoB-100 during incubation with endothelial cells paralleled the formation of thiobarbituric acid (TBA)-reactive substances and the breakdown could be completely prevented by the addition of antioxidants or metal chelators. Finally, the incubation of LDL with a free radical-generating system (dihydroxyfumaric acid and Fe3+-ADP) in the absence of cells resulted in the breakdown of apoB-100. These results suggest that the breakdown of apoB-100 during oxidative modification of LDL, whether cell induced or catalyzed by transition metals, is not mediated by proteolytic enzymes but rather is linked to oxidative attack on the polypeptide chain, either directly or secondary to peroxidation of closely associated LDL lipids. PMID- 3323392 TI - Congenital myopathies with "diagnostic" pathological features. AB - This addition to the classification of myopathies is a result of the improved diagnostic techniques in muscle pathology in recent years, largely through the application of electronmicroscopy and histochemistry. After summarizing the clinical picture, the authors call for classification: (1) Congenital myopathies due to developmental arrest: myotubular myopathy, congenital fiber type disproportion. (2) Congenital myopathies due to persistent organellar regression: focal loss of cross striation, myopathy with lysis of myofibrils, nemaline body myopathy, zebra body myopathy, spheroid body myopathy, myopathy with tubular aggregates, satellite cell myopathy. (3) Congenital myopathies due to metabolic errors: mitochondrial myopathy, mitochondria-lipid-glycogen disease. (4) Congenital myopathies due to the lack of the trophic influence of innervation: central core disease, multicore, minicore disease. These congenital myopathies have been taken from the ill-defined heterogeneous conglomeration known as amyotonia congenita or floppy infant syndrome and given a place of their own. PMID- 3323393 TI - Plafibride treatment and serum lipids in hyperlipoproteinemias. AB - A study was made of 26 patients suffering from primary hyperlipoproteinemia; 8 belonging to familial hypercholesterolemia (phenotype IIa), 9 to familial combined hyperlipidemia (phenotype IIb, 9 to familial hypertriglyceridemia (phenotype IV). During treatment, which was continued for two years, all patients received a diet consisting of 45% carbohydrates, 33% fats and 22% protein. They were given 400 mg (TID) of Plafibride after breakfast, lunch and dinner. In the three phenotypes studied, significant decreases in cholesterol, triglycerides, glucose, insulin and lecithin were observed, while there was an increase in HDL cholesterol, free fatty acids and lysolecithin. Tolerance to the drug was good, and a study of different serum enzymes revealed no undesirable collateral effects. PMID- 3323394 TI - William L. Barton, M.D., a pioneer in otolaryngology. PMID- 3323395 TI - Description and evaluation of a method for computer analysis of the exercise electrocardiogram. AB - The new approach to computer processing of exercise electrocardiography has been made easier by the development of microcomputers. Studies are necessary to validate analyzed electrocardiographic data for the diagnosis of ischemia. We describe and assess in this paper a new program for the analysis "on line" of 12 leads during effort. The program detects "normal QRS" and ectopic beats. Amplitude of R wave, length of QRS, ST level after a programmable delay from J point, ST maximal slope and amplitude of T wave are calculated and recorded every 15 sec in the 12 leads. In 200 exercise stress tests quantitative data provided by the processor were compared with visual analysis and with clinical data. ST level less than or equal to -0.8 mm and ST slope less than or equal to 1.2 mV/sec or ST level greater than or equal to +2.0 mm and ST slope less than or equal to 0.6 mV/sec were the best analyzed criteria for ischemia. Using these criteria, sensitivity increased from 86.6% by visual reading to 92% by computer analysis, without change in specificity (94%). PMID- 3323396 TI - Regulation of the synthesis of nerve growth factor. AB - Through nearly 40 years of research nerve growth factor (NGF) has become a paradigm for neurotrophic factors. NGF is synthesized and released from innervated target tissues in limiting amounts, thereby regulating the cell number and the differentiated properties of responsive neurones. Three distinct cell types are responsive to NGF: peripheral sensory and sympathetic neurones and certain types of central cholinergic ones. The effects of NGF are mediated through interaction with a specific receptor which activates a transmembrane second-messenger system. NGF synthesis is regulated during development and in the adult animal. In the developing whisker pad, NGF synthesis commences with its sensory innervation, but sensory neurones lack NGF receptors at the stage when their fibres are growing to their target. These findings indicate that NGF does not attract sensory nerve fibres chemotactically to their target fields during development, but is involved in target-controlled neuronal cell death and in regulation of the density of innervation of target tissues. In non-neuronal cells of the sciatic nerve, NGF synthesis is up-regulated during development and after nerve lesion. Thus the changes in NGF levels after lesion in the adult animal are consistent with the hypothesis that the non-neuronal cells relapse into an earlier developmental stage. Regenerating fibres penetrating into the distal nerve stump restore the low adult levels of NGF. Recent evidence indicates that macrophages invading the nerve after transection produce signals which increase NGF synthesis. PMID- 3323397 TI - Long-distance regulation of regenerating frog axons. AB - Following a nerve crush, damaged frog motor axons regenerate to reinnervate their denervated muscle fibre targets. The axons do this by growing down their old nerve tubes to their former synaptic sites. It is the naked basal lamina of the nerve tube that appears to direct the regenerating axons by providing a substratum over which the axons will preferentially grow. Another possible mechanism for directing the regenerating axons to the end-plates is the release of molecular signals by the cells of the nerve tube or by the denervated muscle fibres. This paper provides evidence that chemical signals do direct the regeneration process. Such signals, released several millimetres from a growing nerve tip, cause it to change direction and bend towards the source. Both the cells of the nerve tube and the denervated muscle fibres release diffusible substances and thereby establish a gradient that affects the regenerating axons. PMID- 3323398 TI - Substrate interactions affecting motor growth cone guidance during development and regeneration. AB - Most serious injuries of spinal nerves or roots in man and other higher vertebrates lead to permanent loss of control of skeletal muscles. In some cases this may be due to a failure of motor axons to regenerate, although even when functional neuromuscular connections are re-established, coordinated use of body and limb muscles may be absent. In both mammals and lower vertebrates, damaged motor axons usually regrow and reform functional connections with muscles, although these connections are often inappropriate. The selectivity of reinnervation is improved by maintaining alignment of the severed ends of the nerve. Thus, factors operating near the lesion site may direct regenerating motor axons into fascicles in the distal nerve stump that lead to inappropriate muscles. The identity of some of these factors is suggested by recent studies of developing systems which have shown that motor axons are directed in their growth. (a) The filopodia of their growth cones sample a limited region of the periphery. If motor growth cones extend too far from their normal pathways they establish connections with inappropriate muscles. (b) Motor growth cones normally extend into regions of embryos rich in the extracellular matrix molecule laminin, and avoid regions containing fibronectin. Moreover, motor growth cones extend on laminin but not on fibronectin substrates in vitro. In peripheral nerves, these two molecules are differentially distributed; laminin is expressed by Schwann cells in the endoneurium whereas fibronectin is expressed by fibroblasts primarily in the perineurium. These studies suggest that regenerating motor growth cones may be directed to appropriate muscles if their original fascicles within the distal nerve stump are within filopodial reach but may not be able to escape the fibronectin-rich perineurial sheath once directed into an inappropriate fascicle. PMID- 3323399 TI - Neurite outgrowth and synapse formation by identified leech neurones in culture. AB - After injury, neurones in the central nervous system (CNS) of the leech regenerate with a high degree of specificity. The aim of our experiments has been to study the sequential steps involved in neurite growth and synapse formation using isolated identified neurones in culture. An important requirement for sprouting of leech neurones is the substrate. Neurites grow only slowly and sparsely on polylysine or vertebrate laminin. The extracellular matrix of leech ganglion capsules contains a protease-sensitive factor which can be extracted with urea. With this material as substrate, growth proceeds rapidly in defined medium. Another neurite-promoting substrate is provided by the plant lectin concanavalin A (Con A). The activity of Con A, but not of the capsule matrix factor, is blocked by the Con A-specific hapten methyl alpha-D-mannoside. The morphology and branching pattern of the neurites in culture depend on the specific substrate and on the type of neurone. During stimulation, less Ca2+ uptake occurs into growth cones than in cell bodies. The mechanism of neurite growth seems not to depend on activity-mediated Ca2+ influx or on interactions between neuronal cell surfaces. However, even without profuse outgrowth, electrical and chemical synapses develop between neighbouring neurones. The type of synapse depends predictably on the types of neurones within the cell pair. Since the development of a synapse can be followed with time in culture, the sequential events can each be studied separately for this multi-step process. PMID- 3323400 TI - Tinkering with successful synapse regeneration in the leech: adding insult to injury. AB - In the leech, synapse regeneration in adults and synapse formation during embryonic development can be studied in single, identifiable cells that make precise connections with their targets. Certain cellular components, such as synaptic targets and glia, were selectively destroyed to study how the regenerating axons locate their targets, what triggers axons to start growing and what stops them. The results showed that glia and targets play only a limited role in synapse regeneration and in axon degeneration. For example, contact with the synaptic target may inhibit sprouting and availability of targets may promote it. Comparative studies on axon growth and synapse formation by interneurones in embryos showed that regeneration does not simply recapitulate embryonic development. There are clearly separate constraints on the two processes. Axon survival is a different problem. Although isolated axon segments can survive for up to a year in the leech, temperature is a major factor in survival. Axon segments in a tropical leech that regenerates synapses well at 31 degrees C degenerated within 2-3 weeks at this elevated temperature, even when regeneration was prevented. In similar leeches at room temperature (22 degrees C), segments survived for months. Overall, results in the leech support the idea that degeneration as well as regeneration share fundamental mechanisms with other invertebrates and the vertebrates, including mammals. Perhaps long-lived axon segments and other features of the leech that speed or encourage functional regeneration can now be made to operate in repair of the mammalian nervous system. PMID- 3323401 TI - Tissue culture observations relevant to the study of axon-Schwann cell interactions during peripheral nerve development and repair. AB - During peripheral nerve development the Schwann cell population is expanded so that adequate numbers are available for ensheathment of both nonmyelinated and myelinated nerve fibres. As ensheathment of these fibres progresses each axon- Schwann cell unit becomes surrounded by a basal lamina, providing a unique microtubular framework within the peripheral nerve trunk. Tissue culture studies of pure populations of neurones and Schwann cells cultured separately and in combination indicate that a surface component on the axon provides a mitogenic signal to Schwann cells requiring cell-cell contact. Biochemical, electron microscopic and immunocytochemical analyses of these cultures indicate that Schwann cells in contact with axons are able to generate a basal lamina (containing type IV collagen, laminin and heparan sulphate proteoglycan) and fibrous collagen, without the aid of other cells, and that axonal contact is required for deposition of the basal lamina. The role of Schwann cells and the extracellular matrix they synthesize and organize, as well as the role of the other known products of the Schwann cells in the process of peripheral nerve regeneration, are discussed. It is suggested that the large numbers and advantageous position of the Schwann cells, as well as their ability to provide their own surfaces, a basal lamina and multiple secretory products, may account for their extraordinary ability to foster nerve fibre regeneration. PMID- 3323402 TI - Selective innervation of types of fibres in developing rat muscle. AB - The technique of glycogen depletion has been used to identify the types of muscle fibres innervated by individual motor neurones in the neonatal rat. This analysis shows that neonatal motor units are highly biased in their fibre type composition, even at times when the fibres receive extensive polyneuronal innervation. This finding suggests that the innervation of muscle fibres is somehow sorted according to type during early development. This sorting does not appear to occur during the removal of the polyneuronal innervation because little, if any, increase in the bias of unit compositions occurs as the number of synapses present in the muscle is reduced 2- to 3-fold. To determine whether the sorted innervation might be explained by a selective synaptogenesis, a study was made of the type compositions of units formed by reinnervation of neonatal soleus muscle. Glycogen depletion of single units 2 weeks following crush of the soleus nerve at postnatal day 2 showed that most of them (10/12) had biased type compositions which could not be explained by a random reinnervation. The location of fibres in the reinnervated motor units suggests that the regenerating axons innervated a novel set of fibres. The differentiation of fibres into types was apparently not changed during their reinnervation. These results imply that regenerating motor neurones in the neonatal rat selectively reinnervate muscle fibre types. These and other studies further imply that the organization of fibres into motor units during normal development does not occur, as is widely believed, by a random innervation of naive fibres and their subsequent differentiation under the influence of innervation. PMID- 3323403 TI - Mechanisms of function of neural grafts in the adult mammalian brain. AB - Evidence for the survival, growth and function of grafted neural tissues in the adult mammalian brain is reviewed. In addition to considering the viability of grafts in the different model systems that have been investigated, consideration is given to alternative mechanisms by which the grafts might exert a functional influence over the host brain and the host animal's behaviour: (a) acute influence over spontaneous recovery of function, (b) chronic but diffuse secretion of neurochemicals into the host neuropile, (c) tonic reinnervation of the host brain, (d) bridging grafts, and (e) reciprocal reinnervation and full incorporation of graft tissue into host circuitry. It is concluded that no one mechanism is primary, but that different levels of reorganization can take place in different graft paradigms and neural systems. PMID- 3323404 TI - Glial cells in the rat optic nerve and some thoughts on remyelination in the mammalian CNS. AB - Studies on the rat optic nerve in the past 5 years have produced two surprises. First, they demonstrated that there are two biochemically, developmentally and functionally distinct types of astrocytes in the optic nerve, and probably in white matter tracts throughout the CNS: one seems to be responsible for inducing endothelial cells to form the blood-brain barrier while the other seems to service nodes of Ranvier. Second, they showed that oligodendrocytes and type-2 astrocytes develop from a common bipotential (O-2A) progenitor cell that seems to migrate into the developing optic nerve, and may well migrate all over the CNS to wherever myelination is required; this implies that the neuroepithelial cells of the optic stalk are restricted to forming type-1 astrocytes. Some of the findings in the optic nerve may be relevant to the problem of CNS regeneration after injury. These include the following. (1) Reactive gliosis in white matter tracts seems to be mainly a function of type-1 astrocytes. (2) Proliferating O-2A progenitor cells are present in the adult CNS, raising the possibility that they may be able to produce new oligodendrocytes and type-2 astrocytes following injury and thereby aid regeneration. (3) Type-1 astrocytes seem to be able to respond to environmental signals and form localized barriers that block the migration of O-2A progenitor cells; it is conceivable that the same barriers block the migration of regenerating axonal growth cones. PMID- 3323405 TI - Immune reactivity in the nervous system: modulation of T-lymphocyte activation by glial cells. AB - The vertebrate central nervous system (CNS) has been traditionally thought to be inaccessible for the passenger lymphocytes of the immune system. This does not seem to be the case: activated T-lymphocytes can readily cross the endothelial blood-brain barrier (BBB) and some glial cells, notably the astrocytes, seem to be programmed to act as most efficient and complex partners for antigen-specific T-lymphocytes. We used myelin basic protein (MBP) specific permanent rat T lymphocyte lines as probes to assess the immune status of the CNS. These cells, upon activation in vitro, are able to transfer lethal, experimentally induced autoimmune-encephalomyelitis (EAE) to normal syngeneic recipients. Activated T lymphocytes, but not resting ones, can break through the BBB irrespective of their antigen specificity. Immune surveillance of the CNS thus seems to be executed by activated T-lymphocytes. Having crossed the BBB, the activated T cells interact with local glial cells by releasing factors, including interferon gamma, which induced astrocytes to synthesize and express, on their membranes, class II major histocompatibility antigens (Ia determinants), which are critically required for immunogenic presentation of antigens to T-cells. Indeed, Ia-induced astrocytes of the CNS (and the Schwann cells of peripheral nerves) are efficient antigen presenter cells, which are able strongly to up-regulate antigen reactive T-lymphocytes. In addition, it has recently been shown that at least some astrocytes are able to down-regulate immune cells. Some, but not all, astrocytes are capable of suppressing activation of T-cells. This suppression can be modulated by interferon-gamma, and is sensitive to irradiation. The question of whether suppression is mediated by direct cell-to-cell contact or via soluble mediators (e.g. apolipoprotein E) is under investigation. Astrocytes have been found to be most subtle regulators of immuno-competent T-cells. Most probably they are centrally involved in physiological immune reactivity of the CNS, and it will be tempting to learn how far glial cells are involved in transmitting regulatory signals between the immune and nervous systems. PMID- 3323406 TI - The use of peripheral nerve grafts to enhance neuronal survival, promote growth and permit terminal reconnections in the central nervous system of adult rats. AB - During both development and regeneration, the survival of neurones and the growth of axons are controlled by inherent neuronal properties, conditions in the axonal environment, and the establishment of appropriately timed and specific functional contacts. To study the effects of extrinsic influences on the survival, growth and connectivity of axotomized neurones in the mature mammalian CNS, we replaced the optic nerve in adult rats with segments of autologous peripheral nerve (PN) and used morphometric techniques, neuroanatomical tracer substances and immunological cell markers to examine retinal ganglion cells (RGCs), their axons in the PN grafts and their terminals in the superior colliculi (SC) of these animals. We observed that: (1) the survival of axotomized RGCs was enhanced by the PN grafts; (2) in the PN-grafted eyes, approximately 20% of the surviving RGCs regrew their axons into the grafts and (3) some of the RGC axons that regenerated along the PN grafts bridging the eye and the tectum re-entered the SC, arborized and made synaptic contacts with tectal neurones. It is not known if the terminal connections established between RGCs and cells in the SC are appropriate, functional or capable of influencing the long-term survival of their cells of origin. PMID- 3323407 TI - Mechanisms of glial regeneration in an insect central nervous system. AB - As in other repairing systems, glial regeneration in insect central nervous connectives, following selective chemical lesioning, involves both exogenous and endogenous elements. Our current evidence, including that obtained with monoclonal antibodies, indicates that the reactive, granule-containing cells are derived from a sub-population of circulating haemocytes which, within 24 h, invade, and are restricted to, the lesion zone. The granule-containing cells are involved in the initial repair of the perineurial region. They also contribute to the first stage in the restoration of the blood-brain barrier and are responsible for recruiting reactive endogenous glia, apparently from the vicinity of the anterior abdominal ganglion. The granule-containing cells transform into or are replaced by functional glia between 3 and 5 days after selective glial disruption, coincident with the appearance in the lesion zone of dividing reactive cells. PMID- 3323408 TI - The nerve dependence of amphibian limb regeneration. AB - The regeneration of limbs in urodele amphibians is a context where the developing and regenerating peripheral nervous system interacts with the mechanisms of epimorphic regeneration. After amputation of a limb, there arise at the amputation plane the blastemal cells which are the progenitor cells of the regenerate. These cells divide rapidly and subsequently differentiate to give rise to the internal tissues (cartilage, muscle and connective tissue) of the regenerate. Division of the blastemal cells requires the presence of nerve axons at the amputation plane, at least during the initial stages of regeneration. This requirement can be circumvented by allowing a limb to develop in the absence of a nerve supply (the 'aneurogenic limb'), but the underlying mechanisms have been unclear. We have derived a monoclonal antibody called 22/18 that has provided new information about these issues. It is specific for blastemal cells versus normal tissue in the limb, specific for regeneration versus development, and specific for blastemal cells that arise after amputation in the presence of the nervous system versus its absence (in either development or the aneurogenic limb). The antibody reactivity appears to mark a cell transition involved in the imposition of nerve-dependent growth control. PMID- 3323409 TI - Structural changes in intercostal motoneurones following axotomy. AB - Motoneurone disease (MND or amyotrophic lateral sclerosis) is a paralysing disease of unknown cause involving progressive, widespread muscle atrophy due to degeneration of spinal and other motoneurones and an accompanying loss of Betz cells in the motor cortex. A current hypothesis attributes the disease to the loss of a muscle-derived neurotrophic factor acting in concert with the normal age-related deterioration and loss of motoneurones. The roots of this hypothesis are traced through research based mainly on the developing neuromuscular system, and in particular on the age-related processes of natural motoneurone death during embryogenesis: the neonatal reduction of polyneuronal innervation and the age-dependent variations in motor nerve terminal sprouting in response to partial denervation. A consideration of the disease process itself in association with the review of earlier work provide the background for the present work which reexamines ultrastructurally the chromatolytic and later responses to axotomy and the muscle-dependent factors responsible for the reformation of the Nissl bodies. PMID- 3323411 TI - Identification of the cadaver remains of Josef Mengele. AB - In 1985 at the cemetery in Embu near Sao Paulo, Brazil, parts of a skeleton were exhumed, and now these parts have been examined to determine whether they are the remains of the corpse of Dr. Josef Mengele, the camp doctor of the Auschwitz concentration camp. The osteometrical and osteological findings ascertained correspond completely and consistently without contradiction with all the available personal data of Josef Mengele. Through a method of electronic visual mixing for the identification of the skull, it was determined that all the authentic pictures available used for comparison correspond definitely and consistently to the exhumed skull. PMID- 3323410 TI - Studies of three major proteases associated with guinea pig sperm acrosomes. AB - The major proteases associated with guinea pig sperm were investigated by using immunological and electrophoretic techniques. Three major proteases were detected following sodium dodecyl sulfate-polyacryl-amide gel electrophoresis in gels containing 0.1% gelatin. These enzymes had molecular weights of 47,000, 34,000, and 32,000 relative to reduced protein standards and 58,500, 40,000, and 37,500 relative to unreduced standards. All three protease activities were present in acid extracts of sperm, detergent extracts of sperm, and the soluble acrosomal components of sperm released following induction of the acrosome reaction with the Ca2+-ionophore A23187. As determined by indirect immunofluorescence, an antibody to purified boar acrosin specifically cross-reacted with the acrosomes of guinea pig sperm. Decreased fluorescence was associated with sperm that had lost their acrosomes. Immunoblot analysis demonstrated that this antibody reacted with the 47,000 Mr protease but not the 32,000 and 34,000 Mr proteases. All three proteases were maximally active in the pH 7.0-8.5 region and were inhibited by classical inhibitors of acrosin activity. During a 3-hour incubation period, MgCl2 (10 mM) inhibited the activities of the 32,000 and 34,000 Mr proteases while the 47,000 Mr protease was stimulated. Although these proteases shared properties that would classify them as trypsin-like proteases, only the 47,000 Mr protease could be definitely classified as a member of the proacrosin-acrosin family based upon cross-reaction with an antibody to purified boar acrosin. PMID- 3323412 TI - Caffeine toxicity: a case of child abuse by drug ingestion. AB - The case of a 14-month-old child who died of caffeine toxicity is presented. The evidence for prolonged toxicity associated with inappropriate delay in the seeking of medical care and the presence of various recent and healing injuries are diagnostic of child abuse. Fatal caffeine toxicity and child abuse by drug/substance administration are uncommonly reported. Relevant medical literature is reviewed. PMID- 3323413 TI - Fatal disopyramide intoxication from suicidal/accidental overdose. AB - Disopyramide is an oral antiarrhythmic drug which reduces conduction velocity, prolongs duration of action potential and the effective refractory period, and exerts vagolytic properties. The drug is usually well absorbed orally. The principal use of the drug is to suppress ventricular extrasystoles with usual oral dosage of 100 to 200 mg every 6 h, until blood levels of 2 to 4 micrograms/mL are attained. The use of the drug for suicide is uncommon as it is a prescription drug. Two cases of fatal disopyramide intoxication seen at the Los Angeles County Medical Examiner's Office will be discussed followed by a review of the literature of fatal suicidal disopyramide overdose. Case 1 was a 31-year old male pharmacist with known history of depression and no history of heart disease. His decomposed remains were found with a suicide note and with several disopyramide tablets. At autopsy the blood level for disopyramide was 146 micrograms/mL. Case 2 is a 40-year-old male with history of alcoholism and prior suicidal attempts who regularly took disopyramide to control ventricular arrhythmias. He apparently ingested 36 100-mg tablets of disopyramide before his final collapse. At autopsy his blood level of disopyramide was 63 micrograms/mL. PMID- 3323414 TI - Differentiation of a human monocytic cell line associated with increased production of Rift Valley fever virus by infected cells. AB - Rift Valley fever (RVF) virus is a cause of significant human and animal disease in many parts of Africa. In some cases, it causes a hemorrhagic fever, which is frequently fatal. Prior studies have shown that RVF virus productively infects peritoneal macrophages from susceptible rat strains. The U937 human monocytic cell line was used to determine the effect of monocytic cell differentiation on the degree of viral production by cell cultures infected with RVF virus. Differentiation of U937 cells to more mature monocytic cells by phorbol ester resulted in production of 10 times more infectious virions in comparison with undifferentiated cells. These studies imply that monocytic cell differentiation increases permissiveness for RVF virus production. PMID- 3323416 TI - Endogenous production of infectious Inoue-Melnick virus in a human meningioma cell line. AB - We investigated continuous production of Inoue-Melnick virus (IMV) in the MG-1 cell line, established from human meningioma. The infectious virus, identified as a type 1 virus, was mostly recovered extracellularly. Assay of MG-1 cells as infective centers indicated that most of the cells were capable of producing infectious virus. By immunofluorescence, more than 90% of the cells were found to have IMV-associated cytoplasmic antigen(s) (IMCA). PMID- 3323415 TI - Comparison of two commercially available anti-HIV ELISAs: Abbott HTLV III EIA and Du Pont HTLV III-ELISA. AB - Serum specimens were tested for HIV antibodies by two commercially available ELISAs (Abbott HTLV III EIA and Du Pont HTLV III-ELISA). The specificity and sensitivity of these assays were determined by comparison with indirect immunofluorescence and Western blot analysis. Specificity ranged from 94.3% in the Abbott assay to 97.9% in the Du Pont-ELISA. The sensitivity was 100% in the Abbott-ELISA and 99% in the Du Pont test. With both tests, false-positive results occurred predominantly in sera from patients with immunological disorders (kidney transplant recipients, lymphoma, Stevens-Johnson syndrome, etc.), whereas symptomatic AIDS-patients, patients with ARC, and persons with a defined risk for HIV infection could be diagnosed unequivocally. Specificity and sensitivity of anti-HIV ELISAs seemed to depend not only on definition of the cutoff value but also on other factors, such as antigen preparation and inactivation measures. Testing of ELISA-reactive sera by confirmatory tests remains necessary. PMID- 3323417 TI - Peroxidase-anti-peroxidase detection of hepatitis B surface and core antigen in liver biopsy specimens from patients with chronic type B hepatitis. AB - Liver biopsy specimens from 58 American patients with chronic type B hepatitis were investigated for the presence and distribution of the hepatitis B core (HBcAg) and surface (HBsAg) antigens by peroxidase-anti-peroxidase techniques. HBsAg was detected in 43 (77%) and HBcAg in 52 (90%) patients. HBcAg was present in 50 of 51 (98%) patients with hepatitis B e antigen (HBeAg) but in only two of seven (29%) of patients with antibody to HBeAg (anti-HBe). There was no correlation between severity of hepatitis or height of aminotransferase activities and the amount of HBsAg or HBcAg in hepatocytes but there was a positive correlation between amount of HBcAg and height of HBV-DNA and DNA polymerase activity in serum. Follow-up liver biopsies, taken 1 to 3 yr later, were available from 39 patients. HBcAg remained detectable in 25 of 26 patients with persistence of HBeAg but disappeared in 12 patients who had lost HBeAg. In nine patients, HBcAg was cytoplasmic as well as nuclear in distribution. Seven of these patients had an intense lobular hepatitis with marked elevations in aminotransferase activities. These findings indicate that the amount of HBcAg in liver correlates with the amount of serum hepatitis B virus as quantified by serum levels of DNA polymerase and HBV-DNA. The amount of nuclear HBcAg does not correlate with the severity of the liver disease, but the presence of cytoplasmic HBcAg usually reflects an active and severe ongoing hepatitis. PMID- 3323418 TI - The functions and dysfunctions of laughter. AB - Laughter is not usually included in the curriculum of medical schools, therefore it is often neglected by physicians. Laughter is a reflex located in the reticular system of the hindbrain. Rich connections explain its complexity. Laughter appears very early in life and each individual has a very characteristic and stable laughing style. Laughter and speech differentiate human beings from the animal kingdom. Laughter is a unique communication media, common to all human societies speaking different languages. Laughter has a mood elevating and relaxing effect. Laughter dysfunction consists of inappropriate response to the meaning or to the stimulus intensity. In the present study, laughter's dysfunction and disorders are presented. The purpose of this study was to extricate laughter from the diffuse obscurity of information into a new area of interest for scientific research. PMID- 3323419 TI - Toward meaningful noise research. AB - The present review considers a series of studies of noise conducted in collaboration with Dr. Michel Loeb. This review attempts to provide a theoretical perspective as well as to summarize the most important findings of those studies. The work reviewed shows that noise effects interact with other variables, such that a noise effect on one sex is reversed for the other, and is also reversed at different times of the day. A second experiment confirmed this finding with a different arithmetic task. Further work indicated parallels between noise and fatigue, with aftereffects depending upon both work and noise. The final experiment repeated some of these findings with a different task battery of information processing tasks while showing that noise effects further depend on the meaningfulness of the noise background. PMID- 3323420 TI - Levodopa and monoamine oxidase inhibitor combination therapy. A controlled clinical trial. AB - During a long-term double-blind study, which began February 1985, we have treated 16 patients with Morbus Parkinson or Parkinson's syndrome with deprenyl or identically appearing placebo tablets. The aim of the study is to ascertain whether a reduction of other antiparkinsonian medication, especially Madopar, can be achieved with deprenyl, in order to minimize the known late undesirable collateral effects ("on-off"-phenomena, dyskinesias). The criteria used in evaluation of the course of disease are the clinical-neurological findings as well as a series of motor performance tests. The results to date indicate that the dose of Madopar could be reduced in 7 of the 16 patients. Two of these patients were receiving Madopar alone, while 5 had been given anti-cholinergics in addition. In one female patient the dose of Madopar had to be reduced due to the development of dyskinesias. It is noteworthy that the psychological condition of the patients remained constant. There was no increase in side-effects, e.g. headaches, dizziness, nausea, etc. with administration of the study substance. In 3 patients with longstanding Parkinson's disease treated with Madopar or Nacom, who were not included in the study, the doses of the above drugs could be maintained or reduced by addition of deprenyl. PMID- 3323421 TI - Bisbenzylisoquinoline alkaloids. PMID- 3323422 TI - Paraganglioma of the filum terminale internum. Report of a case and review of the literature. AB - A case of paraganglioma of the filum terminale is presented where normal sympathetic ganglion cells were seen in conjunction with tumour cells in a well encapsulated tumour, suggesting a possible origin from heterotopic sympathetic ganglion. PMID- 3323423 TI - Peripheral neuropathy with distal nerve infiltration revealing a diffuse pleiomorphic malignant lymphoma. PMID- 3323424 TI - The phospholipid components of bacteria related to periodontitis. PMID- 3323425 TI - Neurilemmoma in the oral cavity. PMID- 3323426 TI - Venous hemangioma with phleboliths--a case study using immunohistochemistry, scanning electron microscopy and x-ray microdiffraction. PMID- 3323427 TI - A basic study on visible light-curing resin as a denture base--Part 6. Use as a trial relining material. PMID- 3323428 TI - The yield from work site cardiovascular risk reduction. AB - Health decision makers in business need to know what to expect from efforts at cardiovascular risk reduction offered through the workplace. In terms of health, the yield from such efforts is the extent to which risk in the entire work force is lowered. Yield is assessed from available reports of interventions, and is defined as the joint probability of (1) participation of the at-risk work force, (2) retention of participants in an intervention, and (3) improvement on an indicator of risk. The median and range of outcomes are presented so that decision makers can better know what to expect and can have a basis of comparison for the performance of their own risk reduction programs. PMID- 3323429 TI - The use of new field methods of semen analysis in the study of occupational hazards to reproduction: the example of ethylene dibromide. AB - Increasing attention has been paid to the use of semen analysis as an indicator of exposure to potential mutagenic and reproductive hazards. In the infertility clinic setting, semen evaluations include the measurement of sperm concentration, volume, pH, motility, velocity and morphology, the analysis of seminal plasma to evaluate accessory sex gland function and, in some cases, the in vitro evaluation of fertilization capacity and sperm-cervical mucus interaction (Ann Intern Med 1985;103:906-919). To date, however, the study of semen characteristics of occupationally exposed populations has been confined principally to the measurement of sperm concentration and sperm morphology. This has been largely due to the unavailability of portable equipment suitable for the measurement of other semen characteristics and the difficulty of obtaining fresh semen samples in the field setting. National Institute for Occupational Safety and Health researchers have developed mobile laboratory facilities which enable us to evaluate fresh samples, in the field, for semen characteristics in addition to concentration and morphology. This paper describes the application of these methods using the example of our recent cross-sectional study of workers occupationally exposed to ethylene dibromide in the papaya fumigation industry. We discuss our findings in the context of the usefulness of semen analysis as an indicator of occupational hazards to male reproduction. PMID- 3323430 TI - Immunohistochemical staining of non-Hodgkin's lymphoma in paraffin sections using the MB1 and MT1 monoclonal antibodies. AB - We have performed a single blind trial to assess the value of the monoclonal antibodies MB1 and MT1 in lymphoma classification. Sixty cases of non-Hodgkin's lymphoma (NHL) were stained with MB1 and MT1 using an indirect immunoperoxidase technique in paraffin sections. The majority of B tumours (27/33) stained with MB1, and most of the T tumours (24/27) stained with MT1. The MB1 antibody often produced rather weak staining but it was apparently highly specific for B cells, with only three (3/27) of the T tumours (two cases of 'malignant histiocytosis' of the intestine (MHI) and one pleomorphic T-cell lymphoma) displaying 'false' positivity. The MT1 antibody generally produced very strong staining, but it was not very selective, with 14/33 of the B lymphomas displaying 'false' positivity. the cross-reactivity observed in 17 cases led to only three misdiagnoses, two B tumours being designated as T lymphomas and one T tumour being designated as a B lymphoma. In a few cases (7/17), dual staining with both antibodies precluded firm diagnosis. In other cases (6/17), classification was possible despite some of the tumour cells showing dual staining. The seventeenth case was a plasmacytoma displaying MT1 positivity only. While the monoclonal antibodies MB1 and MT1 are of use in classifying lymphomas in paraffin section, they are not entirely lineage-specific, and the uncritical use of these two reagents alone may give rise to misdiagnosis; the use of a panel of monoclonal antibodies may yield more accurate results. As with any immunohistochemical marker, their limitations should be recognized; interpretation must be judicious and always in the context of the histological appearances. PMID- 3323431 TI - Cellular composition of follicles of follicle centre cell lymphomas in relation to germinal centres of reactive lymph nodes. A morphometrical electromicroscopical study. AB - The cell spectrum of neoplastic and benign reactive germinal centres was determined ultrastructurally. The degree in which the cell composition found in reactive germinal centres is maintained in analogous structures of follicular lymphomas was investigated by pattern recognition methods and discriminant analysis based on the frequencies of the various lymphoid and non-lymphoid cell types. The follicular lymphomas included lymphomas with predominantly centrocytes (FCCL, Cb-cc) and lymphomas with predominantly centroblasts (FCCL, Cb). Pattern analysis of FCCL Cb, FCCL Cb-cc and reactive germinal centres indicates that FCCL Cb follicles resemble reactive germinal centres in more aspects than follicles of FCCL Cb-cc. Clear statistical differences were encountered between the frequencies of the lymphoid cell types and of the follicular dendritic and histiocytic reticulum cells in follicles of FCCL Cb-cc and FCCL Cb and reactive germinal centres. Application of a discriminant analysis using a combination of the frequency of centrocytes and follicular dendritic cells demonstrated that both types of neoplastic follicles and reactive germinal centres were correctly classified on the basis of their cell spectrum. For the three groups the most potent discriminator was the centrocyte, whereas the small and large centroblast were of less value. For discrimination between Cb-cc follicles and reactive germinal centres again the centrocyte was the most potent discriminator. Discrimination between FCCL Cb follicles and reactive germinal centres of FCCL Cb cc follicles can be easily achieved using the frequencies of small centroblasts or centrocytes on their own. These findings indicate that (1) follicles of both FCCL Cb and FCCl Cb-cc differ greatly in the cellular composition and not only with respect to their content of centroblasts but also in their content of follicular dendritic cells and (2) they may be considered as neoplasms representing different developmental phases of germinal centres. PMID- 3323432 TI - Immunocytochemical demonstration of the association between Legionella pneumophila, its tissue-destructive protease, and pulmonary lesions in experimental legionnaires' disease. AB - Using immunocytochemical techniques at the light and electron microscope levels, Legionella pneumophila and one of its extracellular proteases were located in the lungs of guinea pigs with experimental Legionnaires' disease (LD). L. pneumophila was immunostained by several peroxidase- and gold-labelling methods for light and electron microscopy. The protease was immunolabelled in tissue fixed in Carnoy's fluid at the light microscopical level and on broth-grown organisms at the ultrastructural level. It was not labelled in either formalin- or glutaraldehyde fixed tissue. Using double-labelling techniques, L. pneumophila and protease were located in the same section and were shown to be intimately associated with pulmonary lesions, providing strong evidence for the role of this protease in LD pneumonia. PMID- 3323433 TI - Antidesmosomal monoclonal antibody in the diagnosis of intracranial tumours. AB - Immunocytochemistry has been applied extensively to the diagnosis of intracranial tumours, but meningiomas still present a diagnostic problem. However, desmosomes have been shown by electron microscopy to be present in meningiomas, and this distinguishes them from gliomas. This paper describes a new monoclonal antibody, 11-5F, against desmosomal proteins 1 and 2 (desmoplakins) and assesses its usefulness in the diagnosis of meningiomas and other intracranial tumours. A total of 74 surgically removed intracranial tumours were examined by fluorescent antibody staining with 11-5F on frozen sections. In addition, a panel of antibodies against cytokeratin, vimentin, glial fibrillary acidic protein, and S100 protein was used. 11-5F stained 30/30 meningiomas and 14/14 metastatic carcinomas but 0/30 gliomas, thus distinguishing meningiomas and metastatic carcinomas from gliomas. The distinction between meningiomas and metastatic carcinomas on the basis of intermediate filaments staining was more difficult because neither the anticytokeratin nor the antivimentin antibody was specific for either tumour type. This study emphasizes the value of antidesmosomal antibodies as an important adjunct to the diagnosis of intracranial tumours. PMID- 3323434 TI - Immunocytochemical evidence that endometrial stromal granulocytes are granulated lymphocytes. AB - Endometrial stromal granulocytes (EGs) are prominent in late luteal phase human endometrium and in early pregnancy decidua. They have been believed to develop from endometrial stromal cells and to secrete relaxin. Recent immunohistochemical studies have suggested that EGs are derived from bone marrow but this has been difficult to prove, mainly because the characteristic cytoplasmic granules are not preserved in frozen tissues. Two separate approaches have now been employed to investigate the cellular lineage of EGs. Formalin-fixed paraffin-embedded sections of first trimester decidua were labelled by an immunoperoxidase method with four monoclonal antibodies (mAbs) reactive with routinely fixed and processed tissues. In addition, acetone-fixed smears of decidual cell suspensions were labelled with a panel of mAbs. Sections and smears were counterstained to demonstrate the characteristic cytoplasmic granules of EGs. Endometrial granulocytes were LCA+, CD2+, MT1+, and UCHL1+, which provides evidence that they are leucocytes. EGs are probably members of the large granular lymphocytes series and may have an essential role in normal implantation and placentation. PMID- 3323435 TI - Apoptosis: cell death in tissue regulation. PMID- 3323436 TI - Monoclonal antibody to desmosomal glycoprotein 1--a new epithelial marker for diagnostic pathology. AB - Desmosomes are intercellular adhesive junctions that occur in almost all epithelia and should therefore be useful as epithelial markers in tumour diagnosis. Here, we describe a monoclonal antibody, 32-2B, to a major desmosomal glycoprotein (dgl) which reacts with human tissues in paraffin sections. This antibody was tested for its ability to stain epithelia and tumours. It reacted with all epithelia tested and with every specimen of a wide range of carcinomas. It also stained meningiomas, another desmosome-containing tumour. It did not stain other types of tumours including lymphomas, melanomas, and various sarcomas, or normal tissues which lack desmosomes. These characteristics demonstrate that 32-2B is a reliable epithelial marker that may have a useful role in diagnostic histopathology. PMID- 3323438 TI - Regional differences in attachment of enteroadherent Escherichia coli strain RDEC 1 to rabbit intestine: luminal colonization but lack of mucosal adherence in jejunal self-filling blind loops. AB - RDEC-1 (serotype 015:NM) is an enteropathogenic Escherichia coli that adheres to mucosal epithelial cells in the ileum, cecum, and colon, but not in the jejunum, of rabbits during diarrheal illness. As RDEC-1 can adhere to jejunal brush borders in vitro, rapid distal clearing of the enteropathogen from the upper gastrointestinal tract may explain the absence of in vivo adherence of RDEC-1 to rabbit jejunum. To test this hypothesis, self-filling blind loops (SFBL) were created in the jejunum of rabbits that were then inoculated with RDEC-1 to determine if stasis would promote increased luminal colonization and increased mucosal attachment of RDEC-1 in the proximal small intestine. Eight rabbits with SFBL and seven nonoperated littermates were inoculated with RDEC-1 4 weeks after surgery. Semiquantitative estimation of fecal shedding of RDEC-1 and the presence and severity of diarrhea were monitored for 7 days. Rabbits were then killed, and colonization of jejunum and ileum by anaerobic bacteria and luminal colonization of jejunum, ileum, and cecum by RDEC-1 was quantitated. Mucosal adherence of RDEC 1 to jejunum, ileum, and cecum was determined by Giemsa staining of intestinal sections obtained from rabbits with and without SFBL. In addition, brush border membranes (BBM) were prepared from blind loop jejunum, nonoperated jejunum, and ileum. In vitro adherence of RDEC-1 to brush borders was quantitated under phase contrast microscopy. Maximal fecal shedding of RDEC-1 began 3-4 days after infection in all rabbits, but diarrhea was more severe in rabbits with SFBL.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323437 TI - Immunohistochemical localization of lactoferrin in duodenojejunal mucosa from celiac children. AB - The immunohistochemical localization of lactoferrin (LF) was investigated in the duodenojejunal mucosa of children with untreated and treated celiac disease and in a control group of children of short stature and of children with postenteritis syndrome. In subtotal villous atrophy, LF was present in all epithelial cells of the luminal surface with a lower degree of positivity in crypts, whereas a variable degree of reactivity for LF was observed in epithelial cells of reconstituted villi and crypts. The LF mucosal distribution, however, was not specific for celiac disease since the LF pattern was similar in untreated celiac disease and also in postenteritis syndrome. Moreover, LF was detectable only in 7 of 18 duodenojejunal juice samples obtained from untreated and treated celiac patients and normal controls, the observed values being irrespective of the mucosal morphological status. We conclude that the immunohistochemical evidence of LF in the enterocyte may derive from an autochthonous production since our histochemical findings cannot be related to the concentration of LF in duodenal juice. PMID- 3323439 TI - Levels of immunoreactive insulin, neurotensin, and bombesin in porcine colostrum and milk. AB - High concentrations of insulin (411 +/- 214 microU/ml), neurotensin-like (265 +/- 72 pg/ml), and bombesin-like immunoreactivities (1995 +/- 288 pg/ml) were detected in porcine colostrum using radioimmunoassay, as compared to the levels found in sow blood serum at farrowing (5 microU/ml, less than 12 pg/ml, and 17 pg/ml, respectively). After 72 h of lactation, the levels of insulin and neurotensin-like immunoreactivities had decreased to 28 +/- 17 microU/ml and 89 +/- 23 pg/ml, respectively, while the bombesin-like activity remained constant. Characterization with reversed-phase high performance liquid chromatography showed that the insulin immunoreactivity eluted at the same position as the insulin standard, while the elution patterns of the neurotensin-like and bombesin like immunoreactivities (eluted in three separate peaks) did not correspond to that of their respective standards. The biological function of the peptide hormones in colostrum/milk may be as triggers of the developmental changes taking place in the nursing neonate, especially in the gastrointestinal tract. PMID- 3323440 TI - Portal hypertension secondary to congenital arterioportal fistula. AB - An infant boy with severe portal hypertension developed failure to thrive and malabsorption. Clinical findings and ultrasonography suggested the presence of an arteriovenous shunt, and hepatic angiography confirmed the diagnosis and outlined the anatomy of the vascular malformation, which was an intrahepatic arterioportal fistula. Ligature of the hepatic artery gave excellent results as demonstrated by disappearance of portal hypertension and malabsorption and subsequent growth catch-up. PMID- 3323442 TI - Disease specificity and dynamics of changes in IgA class anti-endomysial antibodies in celiac disease. AB - We evaluated the sensitivity and kinetics of serum IgA class anti-endomysial antibodies in the diagnosis of celiac disease (CD) as established by the criteria of the European Society for Pediatric Gastroenterology and Nutrition (ESPGAN). Eighty-four cases that satisfied the ESPGAN criteria for CD were evaluated for IgA-EmA titers during various phases of establishing the diagnosis. Thirty-three cases were infants and children less than 5 years of age undergoing intestinal biopsies for symptoms of CD and 51 were previously diagnosed adults. Of the 33 children, 11 were untreated and symptomatic and were IgA-EmA positive at initial presentation. Twenty-two children previously controlled on a gluten-free diet (GFD) exhibited IgA-EmA titers during gluten challenge. Furthermore, the antibody levels declined in all cases (usually to negative) when the patients were again placed on a GFD for 6-12 months. Changes in intestinal histopathology paralleled the changes in antibody titers in six cases undergoing serial biopsies. Of the 51 adult patients with proven CD who were prescribed a GFD for at least 12 months, IgA-EmA were detected in 10 cases who were noncompliant to their GFD, whereas the antibodies was found in only 1 of the remaining 41 patients strictly adhering to their diet. The sera of 140 aged-matched children with various intestinal problems, 87 healthy adults, and 67 patients with dermatological diseases served as controls and were also IgA-EmA negative. On the basis of these findings, we suggest a role for the IgA-EmA as a serological screening test for active CD. It further offers the potential for monitoring compliance to diet in established cases of CD and also indicates the proper timing for biopsy in patients undergoing evaluation of CD. PMID- 3323441 TI - Pepsinogens: an update of biochemical, physiological, and clinical aspects. AB - In this paper the role of pepsinogen has been reviewed in its physiological and clinical aspects. Although acid secretion has traditionally received far more attention clinically and has therefore been studied in great detail, the development of cellular systems has recently seen a revival in interest of pepsinogen secretion. These systems have made it possible to study pepsinogen secretion in more detail. Although many questions remain unanswered, a picture of a stimulus-secretion coupling mechanism of the chief cell has emerged that resembles in many aspects the pancreatic acinar cell, but also possesses some unique features of its own. The chief cell monolayer culture has also made it possible to study pepsinogen synthesis, and these studies seem to have solved the old controversy of whether or not modulation of pepsinogen synthesis occurs as a result of increased secretion. It now seems that pepsinogen synthesis does indeed increase in response to stimulated secretion. In addition to physiological studies, this review has discussed clinical aspects of the human pepsinogens in various gastric disorders. The clinical implications of genetic heterogeneity of the human pepsinogens are especially intriguing. Relationships between certain PGA phenotypes and certain gastric disorders have been described and some studies have tried to evaluate the relevance of these findings for diagnostic purposes. So far, it seems that PGA phenotyping alone has only limited diagnostic value, but, in combination with serum PGA determinations, could be of additional help in the diagnosis of gastric malignancy. In addition, various studies suggest that the ratio of serum PGA and PGC levels may be helpful in determining the histological status of the gastric mucosa. A very promising possibility in solving the many problems involved in exact genotype determinations through phenotyping is the recent availability of cDNA probes. With this technique, the question of whether the association between PGA phenotypes and gastric malignancy is primary or secondary may be solved in the near future. In view of the very poor prognosis for gastric cancer, further studies concerning the relationships between gastric cancer, serum pepsinogen levels, and PGA phenotypes or genotypes will hopefully lead to the possibility of an earlier diagnosis for gastric malignancy. PMID- 3323443 TI - Effect of intralipid on the phagocytic and microbicidal capacity of human monocytes in culture. AB - We studied the effect of Intralipid (IL) in monocyte cultures based on the ability of the cultures to phagocytose and kill Candida albicans and produce the oxidative burst. The IL was taken up by monocytes in cultures, and these cells phagocytosed more Candida organisms than did the control cells [85 +/- 2.2% in the IL treated (1%) compared to 68 +/- 2.3% after 1 h in the control]. The percentage of killing of Candida albicans, which had been taken up by the IL treated monocytes measured after 2 h in culture (48.3 +/- 6.0%), was no different when compared to control (47.0 +/- 5.8%). Following ingestion of IL, there was an increase in basal H2O2 production, however, the presence of the IL in the cells had no effect on the expected increase in H2O2 production following stimulation with either phorbol myristate acetate (PMA) or zymosan particles. Compared to untreated cells, a significant increase in the number of monocytes with positive nitroblue tetrazolium staining was observed in monocytes that had ingested IL (when they were stimulated with either PMA or Candida microorganisms). Similar results were obtained in monocyte-derived macrophages (i.e., monocytes in monolayer cultures for 10 days). These findings suggest that the essential monocyte functions of phagocytosis, microbicidal activity, and ability to elicit an oxidative burst are not directly altered by the conventional use of IL in clinical practice. PMID- 3323445 TI - Determinants of smoking behavior among nurses. PMID- 3323444 TI - Arginine-induced insulin and growth hormone secretion in children with nutritional rickets. AB - We evaluated arginine-induced insulin and growth hormone (GH) secretion in ten children with vitamin D deficiency rickets and compared these values with those of eight age-matched control children. All rachitic children had biochemical (increased serum alkaline phosphatase activity and decreased calcium x phosphate product) and clinical evidence for rickets. After an intravenous infusion of arginine-HCl (10% solution, 0.5 g/kg), blood samples were obtained for the measurement of serum insulin and GH concentrations. The mean insulin level 30 min after the start of the infusion was 22.2 +/- 17.1 microU/ml for the rachitic children. This value is significantly below that for the normal children, 63.4 +/ 38.7 microU/ml (p = 0.004). Neither the fasting insulin level nor any others after the arginine infusion differed significantly from those for the control children. There were no significant differences in the fasting or the arginine stimulated GH levels between the rachitic and control children. The concentrations of insulin-like growth factors did not differ between the two groups. PMID- 3323446 TI - A school-based treatment of chronic headaches in adolescents. PMID- 3323447 TI - Cross-disciplinary perspectives on autism. PMID- 3323448 TI - Recurrent poisoning in children: a review. PMID- 3323449 TI - Aspects of the effect of bile salts on Candida albicans. AB - Cholic acid, chenodeoxycholic acid, deoxycholic acid, glycocholic acid, glycodeoxycholic acid, hyodeoxycholic acid and lithocholic acid as their sodium salts, were fungistatic to the growth of Candida albicans. Of the compounds tested, cholic acid, deoxycholic acid and chenodeoxycholic acid were the most active. In combination with other antifungal agents only cholic acid exhibited synergism with amphotericin B, whilst the imidazole antifungal agents inhibited the action of the bile salts. The bile salt minimal inhibitory concentrations were close to the critical micelle concentrations. Even though the compounds are surface active they did not cause loss of intracellular K+ and were without effect on oxygen consumption. The bile salts, particularly cholic acid, produced morphological changes that gave rise to swollen cells. PMID- 3323451 TI - Adhesion of Candida albicans to buccal epithelial cells exposed to chlorhexidine gluconate. AB - The adhesion of Candida albicans to buccal epithelial cells (BEC) exposed to chlorhexidine gluconate either in vivo or in vitro, was studied using BEC obtained from an adult and two children. There was a significant reduction in the adherence of yeasts to BEC collected immediately after an oral rinse of chlorhexidine. Also a significant positive correlation was noted (r = 0.99) between the time which elapsed after a chlorhexidine rinse and yeast adhesion to BEC. In-vitro exposure of BEC from both children and the adult to 0.2%, 0.02%, and 0.002% chlorhexidine, also reduced candidal adhesion to BEC. PMID- 3323450 TI - Inhibition of 14 alpha-sterol demethylase activity in Candida albicans Darlington does not correlate with resistance to azole. AB - The 14 alpha-sterol demethylase in the azole-resistant Candida albicans, strain Darlington, is less sensitive to the triazole ICI 153066 than are two azole sensitive strains, A and B. However, there is no direct correlation between the IC50 values for triazole inhibition of the demethylase and IC50 values for growth. It appears that the basis of azole resistance in strain Darlington may not be explained solely on the basis of a lack of sensitivity of its 14 alpha sterol demethylase enzyme, but that other target sites for azole may be altered or absent. PMID- 3323452 TI - Emericella nidulans in a maxillary sinus fungal mass. AB - Sexual reproductive stages of fungi are very rarely found within mammalian tissues. We report here coexistence of cleistothecia associated with Emericella nidulans and its conidial state, Aspergillus nidulans, in a fungal mass which developed in a maxillary sinus. PMID- 3323453 TI - Intramural hematoma of duodenum following endoscopic intestinal biopsy. AB - We present the fourth case to be reported in the literature of intramural hematoma of the duodenum following endoscopic small bowel biopsy. It is the first reported to have been diagnosed by ultrasonography and confirmed by contrast roentgenograms. Conservative treatment was effective in achieving satisfactory resolution of the obstruction within seven days, as evidenced by barium meal examination. The mechanism of trauma, in light of the other cases reported in the literature, is discussed. PMID- 3323454 TI - Indium 111 labeled white blood cell scintigraphy for the diagnosis of upper abdominal abscesses in a child with Wiscott-Aldrich syndrome. AB - We report on a case of multiple hepatic abscesses in an immunodeficient patient where initial radiologic evaluation by ultrasonography and computed tomography confused early management by failing to demonstrate the abscesses and by suggesting other diagnoses. Indium 111 (In-111) white blood cell (WBC) scanning with Tc-99 liver-spleen scan subtraction accurately demonstrated subcapsular hepatic abscesses in four out of four sequential studies, and later confirmed resolution of the abscesses. We suggest that In-111 WBC scanning may be used as a highly specific method of diagnosing suspected upper abdominal abscesses in children. PMID- 3323455 TI - Ventriculoperitoneal shunt malfunction due to migration of the abdominal catheter into the scrotum. AB - A case is reported in which the peritoneal portion of a ventriculoperitoneal shunt migrated into the scrotum via an indirect inguinal hernia and caused cerebrospinal fluid hydrocele with shunt malfunction. PMID- 3323456 TI - Hodgkin's disease of the thymus: a rare mediastinal cystic mass. AB - We report a 14-year-old patient referred to us because of chest pain. A huge upper anterior mediastinal mass with several cystic spaces within it was found and resected. Pathologic diagnosis was nodular sclerosis Hodgkin's disease of the thymus. Radiotherapy was started after accurate surgical staging, and the patient remains free of disease 24 months later. Cavitation of the gland in Hodgkin's disease of the thymus should be taken into consideration when dealing with upper anterior mediastinal cystic masses in children. Surgery is probably unavoidable in this group of patients and, interestingly, can account in part for the relatively good prognosis in this localized form of the disease. PMID- 3323457 TI - An alternative to steroids for prevention of respiratory distress syndrome (RDS): multicenter controlled study to compare ambroxol and betamethasone. AB - The results are reported of a multicenter randomized study of the effectiveness of maternal administration of betamethasone versus ambroxol, a substance of the group of the benzylamines, for prevention of RDS in preterm infants. Women of 27 to 34 weeks gestation with threatened premature delivery or planned premature delivery were admitted to the trial. Between September 1981 and November 1984 a total of 288 randomized patients delivered 315 neonates. The incidence of RDS was assessed in 169 viable neonates born before the 37th week. Of these 86 were born of 76 mothers treated with beta-methasone and 83 of 76 mothers treated with ambroxol. The overall incidence of RDS was significantly (P less than 0.05) higher in the betamethasone group (31%) than the ambroxol group (13%). Ambroxol was significantly more effective than betamethasone in twin births, in infants born before the 31st week, when ROM to delivery time was more than 48 hours, when treatment to delivery time was between 2 and 7 days and in female infants. The neonatal infection rate was significantly higher (P less than 0.05) in the group of betamethasone treated infants (18% with four fatalities) than in the group of ambroxol treated infants (9% with one fatality). These results suggest that ambroxol may be a valid alternative to steroids for prevention of RDS. PMID- 3323459 TI - Fetal kidney volume and urine production in cases of fetal growth retardation. AB - The amount of amniotic fluid has a close correlation to the function of the fetal renal system. In many cases of fetal growth retardation oligohydramnios is obvious. The aim of this study is the investigation of the hourly fetal urine production rate (HFUPR) and the growth of fetal kidneys during pregnancy in cases of fetal growth retardation and to evaluate the renal participation in the origin of oligohydramnios in cases of growth retardation. In 52 healthy pregnancies and 27 cases with known fetal growth retardation, the volume of the fetal kidneys was measured sonographically and the hourly rate of fetal urine production was determined. Two third of the patients with fetal growth retardation had obvious oligohydramnios. In cases of fetal growth retardation the volume of the fetal kidneys was significantly smaller when compared to the control group, and the volume of fetal urine production was significantly lower. The reduced perfusion of the fetal kidneys in those cases with fetal growth retardation may be the reason for the reduction of the HFUPR. Due to the fact that HFUPR is a dynamical parameter and in close relationship to the perfusion of the fetal kidneys, the identification and measurement of this parameter may help to detect subacute and imminent fetal distress in cases of sonographically proven fetal growth retardation. PMID- 3323458 TI - Color flow mapping in obstetrics. AB - Blood flow studies are now used extensively in evaluating fetal peripheral circulation. By using continuous and pulsed Doppler ultrasonic equipment the raw Doppler shifts caused by blood moving in the vessels can be analyzed in different ways. Spectral data can be used to estimate blood velocity and volume in the vessel, and pulsatility characteristics and turbulence. All these data are obtained from very restricted areas within the body so that aiming of the probe is critical, and obtaining data from an area requires long and tedious effort. Color flow mapping which has recently been introduced into clinical practice provides an overview of flow velocities and directions within an area. Color coded flow can be displayed by applying the moving target identification principle (as in radar) to an ultrasonic diagnostic instrument where sound waves are used instead of radio waves. The value of flow mapping has already been recognized in the diagnosis of congenital and acquired heart disease in adults and children. Direct visualization of intracardiac flow provides for a fast and accurate diagnosis of various cardiac defects, such as the ventricular septal defect, without cardiac catheterization. In the present study we have investigated the potential of color flow mapping in obstetrics. 211 pregnant women were examined between the 15th and 40th weeks of pregnancy. 193 of them had normal pregnancies; 18 were abnormal, including 11 cases of insulin dependent diabetes, 2 cases of Rh-immunization, 2 cases of nonimmunologic fetal hydrops, 2 cases of fetal cardiac structural defects and 1 case of intrauterine growth retardation. Intracardiac flow was clearly seen in 78% (35/45) of cases at the gestational age between the 20th and 24th weeks. After the 24th week the heart flow visualization rate gradually decreased to 31% (11/36) before term. In 2 cases of congenital heart abnormality flow mapping enabled clear visualization of reverse flow through the tricuspid valve and diagnosis of valvular insufficiency. The best results in studies of flow in peripheral vessels were obtained from umbilical vessels which were seen in all cases after the 15th week. The flow visualization rate was much lower when the fetal aorta, intrahepatic umbilical vein and internal carotid artery were studied. The comparison between the diameter of the umbilical vein measured on the B-scan and flow width in the same vessel showed no significant difference (t = 0.26; p less than 0.01; N = 209).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323460 TI - Root isolation for new attachment procedures. A surgical and suturing method: three case reports. AB - A surgical and suturing method is described for the subgingival placement of Gore tex periodontal material during new attachment procedures. The periodontal material isolates the root surface from epithelium and gingival connective tissue. Three cases were treated. Clinical new attachment was evident from clinical probings and reentry. The term "open probing new attachment" describes the type of tissue that was evident at reentry after treatment of a Class III furcation. A combination of new bone and "open probing new attachment" was evident after one-wall defects were treated adjacent to a mandibular cuspid. A two-wall defect was treated and biopsied three months later. A reference notch was placed 1 mm coronal to the apical aspect of the defect. Histologic examination of the biopsy showed new bone, cementum and periodontal fibers coronal to the notch. Clinical and histologic new attachment was achieved using the technique for root isolation. The long-term predictability and stability of this type of new attachment is not known at this time. PMID- 3323461 TI - Effects of subgingival irrigation on periodontal status. AB - Periodontal diseases are localized, plaque-related infections. Often, clinical signs of inflammation are not eradicated by supragingival plaque control, dictating that subgingival microbial populations must be reduced. Confirmation that it is possible to deliver medicaments to the base of deep pockets stimulated numerous investigations. This report evaluates the role of site-specific pharmacotherapy to enhance periodontal status. PMID- 3323462 TI - Odontomas. A review, case presentation and periodontal considerations in treatment. AB - Odontogenic tumors normally occur within the tooth-bearing areas of the jaws. When they involve the dentogingival complex of adjacent teeth, their removal may become the responsibility of the periodontist. The odontomas are the most common of the odontogenic solid tumors and will be encountered most often by the periodontist. A review of the odontomas is presented followed by a case report and a discussion of the periodontal considerations in their removal. Emphasis is placed on following standard hygiene procedures before and after any periodontal surgery along with conservative removal of the lesion to preserve the periodontal attachment around the adjacent teeth. PMID- 3323463 TI - Rapidly progressive periodontitis. Neutrophil chemotaxis inhibitory factors associated with the presence of Bacteroides gingivalis in crevicular fluid. AB - In the last few years several bacteriological and immunological studies have investigated the role of bacteria and immune defects in order to establish the etiopathogenesis of periodontal disease. With regard to the immune system, a defect in polymorphonuclear neutrophil (PMN) chemotaxis has been frequently reported in patients with rapidly progressive or juvenile periodontitis. The purpose of this study was to investigate in five patients with rapidly progressive periodontitis and normal chemotaxis of peripheral blood PMNs the presence of chemotaxis inhibitory activity in gingival fluid and to relate such activity to three types of bacteria, often involved in rapidly evolving periodontal lesions, that are able to inhibit in vitro PMN chemotaxis: Bacteroides gingivalis, Capnocytophaga sp., and Actinobacillus actinomycetemcomitans. We found strong inhibitory activity in three of these patients. This activity was consistently associated with the finding of B. gingivalis in gingival pockets. We cannot rule out, however, that other substances not of bacterial origin could be responsible for such inhibitory activity. The strict association with B. gingivalis, known to secrete blocking factors, is highly suggestive, although this data must be considered preliminary. PMID- 3323464 TI - [Genetic and biochemical studies on biosynthesis and physiological roles of phosphatidylserine in mammalian cells]. PMID- 3323465 TI - Disposition of levobunolol after an ophthalmic dose to rabbits. AB - The ocular and systemic disposition of levobunolol (LBUN), an antiglaucoma agent, was studied in albino rabbits. After topical administration to eyes, LBUN was rapidly adsorbed, with 2.5% of the dose bioavailable to the intraocular tissues as intact drug and 46% to the systemic circulation. On passage across the cornea, approximately 4.7% of a topically applied LBUN dose was biotransformed to dihydrolevobunolol (DHB), and subsequently became bioavailable to intraocular tissues. The major sites of ocular metabolism were the cornea epithelium and the iris-ciliary body. Another 12% of the topical LBUN dose entered the systemic circulation as DHB after presystemic biotransformation. Our study indicated a rapid absorption of LBUN into the aqueous humor after topical dosing. The tpeak was 15 min after dosing and the Cmax was 4 micrograms/mL. Dihydrolevobunolol (DHB) was formed steadily and reached a maximum in the aqueous humor 45 min after dosing. After distribution equilibrium had been reached, the aqueous humor concentrations of both LBUN and DHB declined. Six hours after dosing, the concentration of DHB in the aqueous humor was approximately 10 times higher than that of its parent compound. Because DHB is equivalent to its parent compound in beta-blocking activity, its formation in the rabbit eye may contribute to the pharmacodynamic effects observed after topical doses of LBUN. PMID- 3323466 TI - Prevention of molecular self-association by sodium salicylate: effect on insulin and 6-carboxyfluorescein. AB - The effect of sodium salicylate on the concentration-dependent self-association of insulin and 6-carboxyfluorescein (CF), as expressed by metachromasy, fluorescence, and changes in aqueous solubility, was learned. By decreasing the CF concentration from 12 to 0.48 microgram.ml-1, lambda max peaks shift from the shorter wavelengths (451, 474 nm), indicating the presence of oligomers, toward the monomer wavelength region (484 nm). Sodium salicylate shifts the peaks of a 12 micrograms.mL-1 CF solution towards the monomer region, eliminating the peak at the lower wavelengths and generating a spectrum with one peak at 490 nm, the effect being concentration dependent. The fluorescence of insulin and CF solutions increases with their concentration. Quenching of these solutions was observed, up to complete elimination of fluorescence, when various concentrations of salicylate were added. The water solubility of both molecules, CF and insulin, was considerably increased with the addition of increasing concentrations of salicylate to the solutions: at 37 degrees C, 2.5 M sodium salicylate solution increases the CF solubility 532 times from 12.2 to 6.5 mg.mL-1, and 1.5 M salicylate increases the solubility of insulin 7875 times, thus an aqueous solution containing 630 mg.mL-1 of insulin may be prepared. The results obtained here, together with our previously reported data, indicate that the interference between sodium salicylate and drug self-association behavior, by increasing drug solubility, may substantially contribute to the improved drug bioavailability mediated by salicylate. PMID- 3323467 TI - Pentoxifylline review. PMID- 3323469 TI - Reiter's syndrome. A review and case report. PMID- 3323470 TI - Literature search of publications on digital hearing aids. PMID- 3323468 TI - A selective clinical trial of ceftizoxime. PMID- 3323471 TI - Publications of interest.Rehabilitation. PMID- 3323472 TI - Digital hearing aids: a tutorial review. AB - The basic concepts underlying digital signal processing are reviewed briefly, followed by a short historical account of the development of digital hearing aids. Key problem areas and opportunities are identified, and the various approaches used in attempting to develop a practical digital hearing aid are discussed. PMID- 3323473 TI - Sacrococcygeal tumours in children. PMID- 3323474 TI - Atrial rupture following blunt chest trauma (a case report). PMID- 3323475 TI - Congenital malaria (a report of 2 cases). PMID- 3323476 TI - The number of species of rodent coccidia and of other protozoa. AB - About 447 species of coccidia have been named from the 1687 living, known species of rodents; 207 host species, 92 host genera, and 15 host families are represented; this is about 12% of the known species of rodents. About 4600 species of apicomplexan protozoa have been named. Assuming that the same proportion of the total number of apicomplexan species has been named as of the coccidian species, there must actually be about 38,333 species of apicomplexan protozoa. There are 5.4 times as many protozoan genera as of apicomplexan genera. Assuming that the number of species in each genus is the same for all the protozoa as it is for the Apicomplexa, there may actually be 206,998 species of protozoa. This may be too conservative an estimate. Based on other criteria, an estimate of over 20 million species could be made. PMID- 3323478 TI - Trypanosoma cruzi: analysis of the population dynamics of heterogeneous mixtures. AB - Utilizing the previously reported inter-clonal differences in total DNA/organism, flow cytometry was used to analyze the population dynamics of Trypanosoma cruzi clone mixtures growing in liquid medium or vertebrate cells. The growth of clone mixtures in liquid medium can be described by unique parameters reflecting exponential growth rate (r), stationary phase population density (1/k), and the interaction between the clones (h). The relative numbers of each clone in the population change rapidly with time and the results are in quantitative agreement with mathematical models of competitive population growth. The relationship between the parameters for T. cruzi is such that, in general, there is no dynamic equilibrium with coexistence of clones with different growth rates; under all culture protocols, the faster growing clone will prevail. A computer simulation of the vertebrate cell cycle of T. cruzi suggests that clone mixtures grow relatively independently; the basic attributes of the model were substantiated experimentally. Although wide fluctuations in the proportion of each clone released occurred, the faster growing clone again predominated. Finally, these results underline the importance of working with well-defined clones in the laboratory to avoid inconsistencies and paradoxical results and stress the importance of the rapid isolation of single cell clones from clinical specimens when studying the relationship of the parasite to human disease. PMID- 3323477 TI - Purification of African trypanosomes can cause biochemical changes in the parasites. AB - Bloodstream forms of African trypanosomes are routinely purified from blood components by a combination of centrifugation and chromatography on DEAE cellulose at pH 8.0. Here we report that the nonphysiological conditions used for DEAE chromatography of the parasites result in changes in the ATP levels of the trypanosomes and an enhanced release from the parasites of proteins such as variable surface glycoprotein, peptidase, and phospholipase. Some of these changes can be reduced by the addition of nucleosides to the elution buffer and, after the elution of the parasites, by immediate readjustment of the external pH to the normal physiological level of blood (pH 7.4). PMID- 3323479 TI - Self-splicing RNA and an RNA enzyme in Tetrahymena. AB - The RNA molecules transcribed from many eukaryotic genes are interrupted by intervening sequences, which are removed by a process called RNA splicing. One structurally related group of intervening sequences, the group I intervening sequences, are found in a variety of microorganisms. Some of these, including the group I intervening sequence from the ribosomal RNA precursor of Tetrahymena thermophila, have been shown to mediate their own splicing in an RNA-catalyzed reaction. Following its excision from the ribosomal RNA precursor, the Tetrahymena intervening sequence acts as an enzyme, cutting and rejoining RNA substrates. PMID- 3323480 TI - Molecular biology of the genes for immobilization antigens in Paramecium. AB - Several genes for surface antigens of the Paramecium aurelia complex of species have been isolated. In addition to known deletions of the 51A gene, we have obtained deletions involving the 51B gene and have developed a procedure for obtaining deletions of additional genes. Both Mendelian and non-Mendelian deletions of both the A and B genes have been found. In the non-Mendelian deletions the genes are present in the micronuclei and absent in the macronuclei. Processing of micronuclear DNA into new macronuclear DNA at conjugation and autogamy is under the control of the old macronucleus, and newly forming macronuclei become exactly like the old. Thus in the non-Mendelian mutants, macronuclei have a specific antigen gene deleted and also are impaired in their ability to direct normal DNA processing at the next conjugation or autogamy. These cases, along with others, show that this system of macronuclear control is a fundamental feature of ciliate genetics. The sequence of the 51A and 51C genes is described and compared with the 156G and 51H genes obtained by others. The 51A and 156G genes are remarkably similar while 51C and 51H are rather different. No introns or pseudogenes have been observed. Some, possibly all, of the genes are on the ends of chromosomes. Characteristic upstream and downstream sequences adjacent to the coding portions of the genes are given. The sequences UAA and UAG are preferred over CAA and CAG for glutamine while UGA is the true stop codon. PMID- 3323481 TI - A taxonomy of disasters and their victims. AB - A taxonomy of disasters is presented in which the two major axes of causes and elements are considered adequate for plotting on one grid the different kinds of disaster that occur. Then the disaster victims are differentiated into six groups according to the type of their involvement, their function, their culpability, their self control and certain extraneous factors. The purpose is to integrate different studies of disaster, to elicit common concerns, to offer common remedies, and to generate further research. PMID- 3323482 TI - Personality, life events and cardiovascular disease. PMID- 3323483 TI - AIDS: Neuropsychiatric complications. PMID- 3323484 TI - AIDS: psychosocial aspects. PMID- 3323485 TI - [Chronic volvulus of an ectopic spleen with subcapsular hematoma. CT x-ray aspect]. AB - The authors present a case of ectopic spleen complicated by chronic torsion and subcapsular haematoma in an asymptomatic patient. The value of ultrasonography and computed tomography in the diagnosis of these complications is discussed. PMID- 3323486 TI - [Complications of the treatment of renal calculi by extracorporeal lithotripsy. Prospective evaluation of 80 treated kidneys]. AB - The acute effects of extracorporeal shock wave lithotripsy (ESWL) on morphology and function of the kidney were prospectively evaluated by abdominal radiography, ultrasonography and contrast-enhanced computed tomography, in 80 treated kidneys. Two types of complications were demonstrated: 1. Obstruction of the ureter by stone fragments in 25% of cases. Relief procedures became necessary in 5 patients (6% of the 80 cases). 2. Limited injuries of the kidney and perirenal spaces in 44% of cases: parenchymatous abnormalities 17.5%; subcapsular hematoma 12.5%; perirenal fluid collection 24%. No treatment was necessary and morphologic abnormalities disappeared in one or two months post-ESWL. Severe ureteral obstruction after ESWL seems to be related to stone size. No definitive evidence that kidney's injury was related to the number of shock waves applied to the kidney was found. PMID- 3323488 TI - [False aneurysm of the superior mesenteric artery complicating a pancreatic pseudocyst]. AB - The authors report a case of false aneurysm of the superior mesenteric artery, complicating acute pancreatitis. They insist on the sonographic signs of "the cyst within a cyst"; the presence of a cystic lesion located within a larger mass an US Scanning is highly suggestive of a false aneurysm included in a pseudocyst. They demonstrate the correlation between US Scanning, CT Scan and arteriogram. PMID- 3323487 TI - [Reliability of the combination of ultrasonography-cystography in the study of urinary infection in children. Prospective study on 90 cases]. AB - The authors report a prospective study concerning 90 children with a urinary tract infection, investigated for the first time by radiological and ultrasonographic techniques. Amongst these 90 children, 50 (i.e. 55% of cases) had a normal retrograde cystography and ultrasonography. These children did not have any IVU and medical surveillance proved to be sufficient. Ten patients had a normal retrograde cystography and abnormal ultrasonography. Intravenous urography carried out in these 10 cases revealed in 8 instances an abnormality of the upper urinary tract. Finally 30 children had an abnormal retrograde cystography, with reflux in 29 cases, leading to intravenous urography which yielded a pathological result in only half of the cases studied. This series confirms the central role of retrograde cystography. When it is normal, intravenous urography may be legitimately substituted by ultrasonography. PMID- 3323489 TI - [Mesenteric cysts in the adult]. AB - The authors describe five cases of mesenteric cysts evaluated by ultrasonography and computed tomography: 3 cases of cystic lymphangioma, 1 vestigial serous cyst, 1 dermoid cyst. Ultrasonography is useful for analyzing the contents of these lesions, and must be utilized to search for possible pelvic anomalies, allowing diagnosis of pendunculated ovarian cysts for example. CT offers better sensitivity for evaluating the effect of such cysts on neighboring viscera and particularly on the intestine. CT is also better for identification of the fatty components indicative of dermoid or chylous cysts. These rare tumors are almost always benign, and a combined modality imaging approach based on ultrasound and CT suffices for diagnosis. PMID- 3323490 TI - [Retroperitoneal cystic lymphangioma. Preoperative diagnosis. Apropos of a case]. AB - Retroperitoneal cystic lymphangioma is an uncommon tumor. One case is reported, with surgical confirmation. Authors point out the diagnostic value of ultrasonography and computed tomography in the pre-operative diagnosis. PMID- 3323491 TI - [Emphysematous pyelonephritis. Apropos of a case diagnosed by ultrasonography]. AB - Emphysematous pyelonephritis is a severe infection of the Kidney observed mainly in diabetic patients. The disease is characterized by the production of intra renal and occasionally perirenal gas. Because of the high mortality associated with this fulminant septic infection, it is imperative to establish a prompt diagnosis and start an appropriate therapy early in the course of the disease. We report a case of emphysematous pyelonephritis diagnosed by sonography: sonographic features consist of multiple high amplitude echoes within the renal parenchyma, renal sinus and perirenal space associated with distal shadows containing low level echoes. We discuss the value of the radiologic imaging methods. PMID- 3323492 TI - [Calcified thrombus of the inferior vena cava. Apropos of 2 cases and review of the literature]. AB - Two cases of calcified thrombus of inferior vena cava in children are reported and the relevant literature reviewed. Although the physiopathology of this lesion is poorly understood and its detection is usually fortuitous, its presentation is univocal. PMID- 3323493 TI - Influence of daylength experienced by dams on post-natal development of young meadow voles (Microtus pennsylvanicus). AB - Meadow voles born to dams kept in short days (SD) beginning 5 or 11 weeks before parturition (SD-5, SD-11) had less developed testes, gained weight more slowly and built larger nests than did young gestated and maintained in long days (LD). Pelage development was greater in SD than in LD young at 21 and 45 days of age. At weaning, SD-5 young had less dense fur and shorter guard hairs than did SD-11 young, indicating that the photoperiodic history of dams before insemination affects the post-natal pelage development of their progeny. Short daylengths experienced by dams before mating may facilitate winter preparedness of their offspring. PMID- 3323494 TI - Role of photoperiod during pregnancy and lactation in the meadow vole, Microtus pennsylvanicus. AB - The influence of daylength on body mass and food intake of pregnant and lactating voles was tested by comparing animals housed in long versus short daylengths. Pregnancy rates were approximately 50% in long-day females and in voles kept in short days beginning 2 weeks before mating, but were significantly lower in voles preadapted to short days for 8 weeks before mating. Body mass and food intake increased substantially during pregnancy and lactation and the magnitude of the increase was unaffected by daylength; by contrast, body weight was significantly reduced in non-impregnated voles kept in short as compared to long days. The suppressive effects of short photoperiods on body weight were completely counteracted during pregnancy and lactation. Voles that breed during the short days of winter face extreme energetic challenges but the advantages of early breeding appear to justify the costs. PMID- 3323495 TI - Interaction of daylength and lactation in the control of pelage development and nest-building in female meadow voles (Microtus pennsylvanicus). AB - Pregnancy and lactation inhibited moult into winter pelage in voles maintained in short daylengths; development of a winter pelage was, however, greatly accelerated once the short-day dams weaned their litters. The presumed elevation of prolactin titres during lactation appears to mask full development and expression of pelage changes induced by short daylengths. Nest-building behaviour, by contrast, was increased in response to short photoperiods and was further augmented during lactation and may thereby facilitate thermoregulation in short-day dams that do not develop a winter pelage. PMID- 3323496 TI - Role of early and late oestrogenic effects on implantation in the mouse. AB - Oestrogen action in the uterus is expressed in an early phase (Phase I) and a late phase (Phase II). The role of this biphasic oestrogen action in implantation is not clear. To determine the relative importance of Phase I and II responses, triphenylethylene compounds (CI-628, LY-117018, nafoxidine, clomiphene citrate and tamoxifen) and oestrogens (oestriol and oestradiol-17 beta) were used in a physiologically relevant experimental system for studying implantation. All compounds elicited uterine water imbibition to various degrees in ovariectomized progesterone-treated mice at 6 h (Phase I response) and their effectiveness in inducing implantation in delayed implanting mice correlated with their respective potency to increase uterine wet weight. This suggests that Phase I might be an essential component of oestrogen action in implantation and that the efficiency of a compound to elicit a Phase I response might serve as a predictive indicator of its potential action on implantation. PMID- 3323497 TI - Effect of continuous infusion of a low dose of GnRH antagonist on serum LH and testosterone concentrations, spermatogenesis and semen quality in the rhesus monkey (Macaca mulatta). AB - Treatment of 4 adult male rhesus monkeys for 8-12 months with 100-400 micrograms of a GnRH antagonist/day by means of using osmotic minipumps led to suppressed serum concentrations of LH and testosterone followed by various degrees of recovery toward pretreatment values. The serum LH response to a challenge of native GnRH was reduced by 30-75% during antagonist treatment. The serum testosterone response to GnRH was exaggerated above the response in the pretreatment period, suggesting hypersensitivity of the testis to gonadotrophin. Antagonist administration under these conditions did not alter body weight or abolish ejaculatory response. Antagonist infusion caused a 96% decrease in sperm counts. Spermatozoa recovered during the final month of antagonist treatment showed a reduced ability to penetrate denuded hamster ova. Testicular biopsies performed at the end of antagonist treatment revealed persistent spermatogenesis. However, the cellularity of the seminiferous tubules was decreased below that of pretreatment biopsies. The results of this study suggest that the amount of testosterone needed to maintain normal spermatogenesis is greater than that needed to maintain electroejaculatory response in monkeys. PMID- 3323498 TI - Influence of the swine major histocompatibility complex on reproductive traits in miniature swine. AB - Three swine leukocyte antigen (SLA)-defined strains of miniature swine and one recombinant strain were examined to evaluate the influence of the SLA Complex on litter size and piglet survivability. To separate the effects of sire and dam SLA haplotype from other sire and dam effects, a general linear model was employed to analyse data from 58 litters. Analysis of variance showed that sire and dam haplotype each contributed significantly to the variability observed in litter size among the sire and dam SLA combinations examined (P less than 0.0001, P less than 0.05, respectively). Sow SLA-haplotype as well as sire and dam effects other than those related to haplotype were significant factors contributing to survival until weaning (8 weeks) (P less than 0.10, P less than 0.07, P less than 0.001, respectively), but sire SLA-haplotype did not contribute significantly to this trait. Expected and observed haplotype frequencies of offspring in each litter were compared using chi-square analysis. A discrepancy was observed only in offspring from SLAa/d by SLAa/d matings, for which significantly fewer SLAa/a piglets were weaned than expected (P less than 0.06). Laparotomy during day 35-50 of pregnancy suggested that litter size was not an accurate estimate of ovulation rate and that ovulation rate was similar for dams of ad, ac and dd haplotypes. PMID- 3323499 TI - Ultrasonically guided direct umbilical cord blood sampling. AB - Ultrasonically guided umbilical cord blood sampling (funicentesis) allows rapid karyotyping and diagnosis of fetal viral infections and other fetal diseases. This technique may also aid in the management of fetal disease. One of three fetuses studied had a chromosomal abnormality, trisomy 18. None had evidence of viral infection. PMID- 3323500 TI - Thyroid gland size in pregnancy. An ultrasound and clinical study. AB - We estimated the size of the thyroid gland by palpation and measured thyroid gland volume with ultrasound in the immediate postpartum period and six months after delivery in 16 women. The 13% reduction in the mean thyroid gland volume detected six months after delivery implied that the thyroid gland enlarges slightly during pregnancy. Physical examination, however, did not detect any goiters during the immediate postpartum period and did not identify a change in thyroid gland size six months after delivery. The thyroid gland enlargement that occurs during pregnancy is not large enough to be detected by physical examination. We urge physicians to discard the commonly held notion that goiter frequently develops during pregnancy. PMID- 3323501 TI - Contemporary evaluation of suspected ectopic pregnancy. AB - A retrospective review of the 119 patients with suspected ectopic pregnancy presenting to Duke University Medical Center during the two-year period ending June 30, 1983, was conducted. In order to determine significant differences between patients with and without ectopic pregnancy, the presenting complaints and physical signs were reviewed and analyzed. Significant findings in women with ectopic pregnancy were: (1) vaginal bleeding lasted longer, (2) abdominal rebound tenderness was more prevalent, and (3) abdominal pain was more prevalent in patients with ruptured ectopic pregnancy than in those with unruptured. There were no other significant differences among the signs and symptoms. Patients with and without ectopic pregnancy cannot be easily distinguished on the basis of presenting signs and symptoms. A combination of culdocentesis and quantitative human chorionic gonadotropin provides the maximal discriminative capacity when considering diagnostic laparoscopy for suspected ectopic pregnancy. PMID- 3323502 TI - Ultrasonically estimated weight and gestational age. Predictors of neonatal respiratory distress syndrome. AB - Information from 504 women who had undergone real-time ultrasound examination within 72 hours of childbirth was used to evaluate the relationship between the product of ultrasonically estimated fetal weight (in kilograms) times ultrasonically estimated gestational age (in weeks) and neonatal morbidity and mortality. If this product was greater than 40, there were no neonatal deaths (excluding severe congenital abnormalities); if the product was greater than 80, there were no cases of significant respiratory distress syndrome. These data may prove to be highly useful in the rapid evaluation of preterm labor or other obstetric complications. PMID- 3323503 TI - Tumors originating in supernumerary ovaries. A report of two cases. AB - The supernumerary ovary is a rare gynecologic anomaly; 13 cases have been reported on since 1890. Three were associated with tumors arising in the ectopic ovarian tissue. We encountered two cases of benign neoplasms discovered to have originated in supernumerary ovaries. PMID- 3323504 TI - Activation of rabbit articular chondrocytes by recombinant human cytokines. AB - Treatment of rabbit articular chondrocytes with 0.5-5 units/ml of recombinant human interleukin-1 (IL-1) induced phospholipase A2 (PLA2) activation, prostaglandin E2 (PGE2) biosynthesis and latent neutral protease secretion by these cells. When normalized on the basis of thymocyte costimulatory activity, the beta (pI 7) form of recombinant IL-1 was about 5-fold more potent than the alpha (pI 5) species, although the maximum response induced by either IL-1 form was similar. Recombinant murine IL-1 was also a potent dose dependent activator of chondrocyte arachidonate metabolism and protease secretion. In contrast to IL 1, neither IL-2 nor tumor necrosis factor alpha (TNF alpha) activated PLA2, PGE2, or neutral protease secretion in these cells and neither of these cytokines inhibited the chondrocyte metabolic response to IL-1. These results provide unequivocal evidence that IL-1 is a potent activator of chondrocyte arachidonate metabolism and hydrolytic protease secretion. That all 3 recombinant IL-1 molecules stimulate chondrocytes and yet share limited sequence homology suggests that an amino acid sequence common to all 3 species is required for chondrocyte activation. PMID- 3323505 TI - Cyclosporine treatment of steroid resistant interstitial pneumonitis associated with dermatomyositis/polymyositis. AB - We report the successful treatment with cyclosporine of a patient with steroid resistant interstitial pneumonitis associated with polymyositis and review the literature regarding the use of cyclosporine in the treatment of interstitial lung disease. PMID- 3323506 TI - Mononuclear cell profiles in muscle biopsies from patients with polymyositis and childhood dermatomyositis. PMID- 3323507 TI - Successful treatment of respiratory failure associated with dermatomyositis. PMID- 3323508 TI - Severe arthralgias after pulse corticosteroid therapy in transplant patients. PMID- 3323509 TI - The role of the thymus-hypothalamus-pituitary-gonadal axis in normal immune processes and autoimmunity. AB - Gonadal steroids play an important role in the development and regulation of the immune system. Their effects may be mediated through a thymus-hypothalamus pituitary-gonadal axis. The thymus gland secretes factor(s), including thymosin beta 4, that affect the release of gonadotropin releasing hormone (GnRH). GnRH regulates the subsequent release of luteinizing hormone, thereby affecting early ovarian development. Thymic factors may be modulated by gonadal steroids. Studies indicate that levels of thymosin beta 4 decrease in postmenopausal and ovariectomized women. In diseases such as systemic lupus erythematosus, abnormal patterns of estrogen metabolism may affect thymic function and contribute to the etiology of the disease. PMID- 3323510 TI - An aetiological approach to the law. PMID- 3323512 TI - What time of day should a urethral catheter be removed? AB - Patients who had undergone bladder neck surgery were randomized to having their urethral catheters removed either early in the morning or late at night. There was no difference in the incidence of urinary retention between these two groups of patients. However, patients who presented with acute urinary retention had a higher incidence of postoperative urinary retention. This study suggests that a urethral catheter may be safely removed in the evening without increasing the risk of urinary retention. There also seems to be no greater chance of the patient having to be recatheterized at an unsocial hour. PMID- 3323511 TI - The consequences of hyperandrogenism in young women. PMID- 3323514 TI - The illness and death of Mary Tudor. PMID- 3323513 TI - Medical and social aspects of qat in Yemen: a review. PMID- 3323515 TI - The origin of the tuning fork. PMID- 3323516 TI - The Halifax (Nova Scotia) explosion of 1917: an epilogue. PMID- 3323518 TI - Hypohidrotic ectodermal dysplasia. PMID- 3323517 TI - The molecular genetics of human chromosome 6. AB - Chromosome 6 contains several clinically important markers as well as classical enzyme loci, proto-oncogenes, and a growing number of anonymous DNA restriction fragment length polymorphisms (RFLPs). It is also of unique interest because of the location of the major histocompatibility complex (MHC) on the short arm, at 6p21.3. The MHC is one of the most detailed areas of the human genetic map to date and many important diseases, some of a suspected autoimmune aetiology, are associated with it. PMID- 3323519 TI - Ultrasound identification of apparently normal male genitalia in a 46,X,+mar fetus. AB - A level II ultrasound examination revealed a scrotum and penis in a fetus with a 46,X,+mar chromosome complement. The marker was subsequently considered to be a del(Y)(q11). A phenotypically normal male infant was born. Detailed ultrasound examination of similar cases for visualisation of the genitalia is recommended. PMID- 3323522 TI - Laser scanning microscope: differential phase images. AB - A beam-deflection type laser scanning microscope for differential phase contrast images using the split-detector technique is developed and the images are obtained in real time (30 images/s). The special optical design allows transfer of the pupil information necessary to the imaging of the differential phase contrast images during beam deflection and the use of acousto-optic deflectors with the associated correction system enables real time imaging. Differential phase images of surface details of crystals are simply obtained without silver coating or etching, which are indispensable in a normal DIC. Biological specimens are also observed. PMID- 3323520 TI - Mechanism of sugar transport through the sugar-specific LamB channel of Escherichia coli outer membrane. AB - Lipid bilayer experiments were performed with the sugar-specific LamB (maltoporin) channel of Escherichia coli outer membrane. Single-channel analysis of the conductance steps caused by LamB showed that there was a linear relationship between the salt concentration in the aqueous phase and the channel conductance, indicating only small or no binding between the ions and the channel interior. The total or the partial blockage of the ion movement through the LamB channel was not dependent on the ion concentration in the aqueous phase. Both results allowed the investigation of the sugar binding in more detail, and the stability constants of the binding of a large variety of sugars to the binding site inside the channel were calculated from titration experiments of the membrane conductance with the sugars. The channel was highly cation selective, both in the presence and absence of sugars, which may be explained by the existence of carbonyl groups inside the channel. These carbonyl groups may also be involved in the sugar binding via hydrogen bonds. The kinetics of the sugar transport through the LamB channel were estimated relative to maltose by assuming a simple one-site, two-barrier model from the relative rates of permeation taken from M. Luckey and H. Nikaido (Proc. Natl. Acad. Sci. USA 77:165-171 (1980a)) and the stability constants for the sugar binding given in this study. PMID- 3323523 TI - Single-ring polanret phase-contrast system. AB - An extremely simple, modified polanret phase-contrast system has been developed. It uses only a single polarizing ring, instead of three zonal polarizers as required in Osterberg's original polanret system (manufactured by the American Optical Corporation). The modified system is much more easily manufactured and its economy of light is twice as good. However, it does require an easily accessible microscope objective exit pupil, where the polarizing ring must be located. PMID- 3323524 TI - Mutant forms of tufA and tufB independently suppress nonsense mutations. AB - The level of nonsense suppression in Salmonella typhimurium carrying error enhancing mutations in either or both of the genes coding for the elongation factor EF-Tu has been measured. Suppression of both UGA and UAG is observed. There is no significant suppression of any of six UAA sites tested. Nonsense suppression does not require that both genes for EF-Tu be mutant. Strains carrying one mutant and one wild-type tuf gene suppress nonsense mutations. The level of suppression increases approximately additively when both tuf genes are mutant. It is suggested that these mutant forms of EF-Tu act independently of each other to suppress nonsense mutations. Suppression is not observed at all UGA and UAG sites, but instead shows a strong site specificity. PMID- 3323525 TI - Repair of thymine.guanine and uracil.guanine mismatched base-pairs in bacteriophage M13mp18 DNA heteroduplexes. AB - Repair of thymine.guanine (T.G) and uracil.guanine (U.G) mismatched base-pairs in bacteriophage M13mp18 replicative form (RF) DNA was compared upon transfection into repair-proficient or repair-deficient Escherichia coli strains. Oligonucleotide-directed mutagenesis was used to prepare covalently closed circular heteroduplexes that contained the mismatched base-pair at a restriction recognition site. The heteroduplexes were unmethylated at dam (5'-GATC-3') sites to avoid methylation-directed biasing of repair. In an E. coli host containing uracil-DNA glycosylase (ung+), about 97% of the transfecting U.G-containing heteroduplexes had the U residue excised by the uracil-excision repair system. With the analogous T.G mispair, mismatch repair operated on almost all of the transfecting heteroduplexes and removed the T residue in about 75% of them when the mismatched T was on the minus strand of the RF DNA. Similar preferential excision of the minus-strand's mismatched base was observed whether the heteroduplex RF DNA molecules had only one or both strands unmethylated at dcm (5'-CC(A/T)GG-3') sites and whether the RF DNA was prepared by primer extension in vitro or by reannealing mutant and non-mutant DNA strands. Also, the extent and directionality of repair was the same at a U.G mispair in ung- host cells as at the analogous T.G mispair in ung- or ung+ cells. Only in a mismatch repair deficient (mutH-) host was the plus strand of the transfecting M13mp18 heteroduplex DNA preferentially repaired. It is suggested that the plus strand nick made by the M13-encoded gene II protein might be employed by a mutH- host to initiate repair on that strand. PMID- 3323526 TI - Surface exclusion genes traS and traT of the F sex factor of Escherichia coli K 12. Determination of the nucleotide sequence and promoter and terminator activities. AB - The DNA encoding the surface exclusion genes traS and traT of the F sex factor of Escherichia coli K-12 has been sequenced and the biological activity of the various terminators and promoters determined. The data show that traS encodes a 16,861 Mr protein with no apparent signal sequence, as expected for its cytoplasmic membrane location. The protein is extremely hydrophobic. traS has its own promoter and a weak terminator region follows the gene. After the traS termination loop there is a small intergenic region before the traT promoter. The traT gene encodes a 25,932 Mr precursor for the 23,709 Mr mature protein. The amino-terminal signal peptide is 21 amino acid residues, consistent with it being an outer membrane lipoprotein. A very strong termination loop follows the gene and adjacent to this a further loop can be predicted from the sequence. These secondary structures would be expected to enhance the stability of the mRNA in the presence of 3' specific ribonucleases accounting for the apparent long half life of the messenger. The amino acid sequence of the mature product of traT of F differs from that of R100 by only a single amino acid substitution (Gly for Ala at position 119), whereas that of pED208 (Folac) differs at 40 positions. traT lies in a region of heteroduplex homology between F and R100, and the nucleotide sequence confirms this and demonstrates that this homology breaks down immediately preceding and following the coding region. Sequence analysis shows that this is also so for pED208. Thus the entire traS of F, R100 and pED208 are very different at the DNA level. An open reading frame, preceded by a typical promoter sequence and a weak and poorly located Shine-Dalgarno sequence, follows traT and corresponds to the start of traD. Alone, this promoter appears to be inactive. PMID- 3323527 TI - Novel blunt-end addition reactions catalyzed by DNA polymerase I of Escherichia coli. AB - DNA polymerase I (Klenow fragment) of Escherichia coli catalyzes the addition of deoxynucleotides to 3' hydroxyl termini of blunt-ended DNA fragments. The product of the reaction, which we call +1 addition, is found only in very low yield under conditions that permit editing by the 3'----5' exonuclease activity of the wild type polymerase. A mutant form of the Klenow fragment that lacks detectable 3'--- 5' exonuclease activity shows an elevated accumulation of the +1 addition product. The mutant enzyme can use any one of the four dNTPs to carry out the reaction when each precursor is provided individually. However, in the presence of all four dNTPs the addition of dATP is strongly preferred. Suppression of the editing function of the wild-type polymerase through the use of high concentrations of exogenous deoxynucleoside monophosphates also results in a significant increase in the amount of +1 addition product formed. The presence of a high dNMP concentration also alters the specificity of the nucleotide addition reaction carried out by the wild-type enzyme. Thus, in addition to dATP, the dNTP which is complementary to the exogenous deoxynucleoside monophosphate, is also used in the +1 addition reaction. A similar effect of dNMPs on the specificity of nucleotide addition was obtained with the mutant Klenow fragment. These results define two pathways for the +1 addition reaction: one that does not require coding information from the DNA template and a second in which coding information is provided by the exogenous dNMP. PMID- 3323521 TI - Interaction of the cytoskeleton with the plasma membrane. PMID- 3323528 TI - Preliminary X-ray crystallographic study of cyanase from Escherichia coli. AB - Cyanase, an oligomeric enzyme of Escherichia coli that catalyzes the decomposition of cyanate to ammonia and bicarbonate, crystallizes in the space group P1 with unit cell parameters a = 85.96 A, b = 83.17 A, c = 83.28 A, alpha = 110.29 degrees, beta = 118.29 degrees and gamma = 72.40 degrees. Crystals diffract to a resolution of at least 2.5 A. The crystal data, in conjunction with a subunit molecular weight of 17,008, suggest that two oligomers are in the asymmetric unit of the crystal and that eight subunits comprise a single oligomer. PMID- 3323529 TI - Crystallization and preliminary X-ray and optical spectroscopic characterization of the photochemical reaction center from Rhodobacter sphaeroides strain 2.4.1. AB - The photochemical reaction center from Rhodobacter sphaeroides 2.4.1 has been crystallized. The crystals were obtained in a solution of beta-octylglucoside by the vapor diffusion technique using polyethylene glycol 4000 as the precipitant at 22 degrees C. The orthorhombic crystals (space group P2(1)2(1)2(1)) have cell constants a = 142.5 A, b = 136.1 A, c = 78.5 A, and diffract to 3.7 A. The crystals display pronounced linear dichroism in the carotenoid absorption spectral region. PMID- 3323530 TI - Tau factor from Escherichia coli mediates accurate and efficient termination of transcription at the bacteriophage T3 early termination site in vitro. AB - The termination signal that limits transcription through the early region of bacteriophage T3 (T3Te) has been cloned and sequenced. The nucleotide sequence of T3Te is identical with that of T7Te, with the exception of a single G to U substitution in the 3' tail of the terminated transcript, and addition of an AC to the loop in the terminator stem-loop, enlarging the loop to six residues. Previous studies of the properties of T3Te have shown that this site is rho independent and is highly efficient for termination in vivo, but is used poorly in vitro during transcription with purified Escherichia coli RNA polymerase. In contrast, the equivalent site in bacteriophage T7 (T7Te) is an efficient termination signal both in vivo and in vitro. However, T3Te becomes an efficient termination site in vitro in the presence of preparations of tau factor. This factor also alters the sites of RNA chain termination found in vitro at T3Te. Transcripts formed in the presence of tau are several nucleotides shorter than those produced with RNA polymerase alone, and have 3' termini that are almost identical with transcripts found in vivo. These latter results are similar to our earlier findings with T7Te, and suggest that other rho independent terminators may act with transcription termination factors in vivo. PMID- 3323531 TI - Binding of Escherichia coli ribosomal protein S8 to 16 S rRNA. A model for the interaction and the tertiary structure of the RNA binding site. AB - We have investigated in detail the secondary and tertiary structures of the 16 S rRNA binding site of protein S8 using a variety of chemical and enzymatic probes. Bases were probed with dimethylsulfate (at A(N-1), C(N-3) and G(N-7)), with N cyclohexyl-N'-(2-(N-methylmorpholino)-ethyl)-carbodiimide-p- toluenesulfonate (at G(N-1) and U(N-3)) and with diethylpyrocarbonate (at A(N-7)). The involvement of phosphates in hydrogen bonds or ion co-ordination was monitored with ethylnitrosourea. RNases T1, U2 and nuclease S1 were used to probe unpaired nucleotides and RNase V1 to monitor base-paired or stacked nucleotides. The RNA region, encompassing nucleotides 582 to 656 was probed within: (1) the complete 16 S rRNA molecule; (2) a 16 S rRNA fragment corresponding to nucleotides 578 to 756 obtained by transcription in vitro; (3) the S8-16 S rRNA complex; (4) the S8 RNA fragment complex; (5) the 30 S subunit. Cleavage or modification sites were detected by primer extension with reverse transcriptase. We present a three dimensional model derived from mapping experiments and graphic modeling. Nucleotides in area 594-599/639-645 display unusual features: a non-canonical base-pair is formed between U598 and U641; and A595, A640 and A642 are bulging out of the major groove. The resulting helix is slightly unwound. Comparative analysis of probing experiments leads to several conclusions. (1) The synthesized fragment adopts the same conformation as the corresponding region in the complete RNA molecule, thus confirming the existence of independent folding domains in RNAs. (2) A long-range interaction involving cytosine 618 and its 5' phosphate occurs in 16 S rRNA but not in the fragment. (3) The fragment contains the complete information required for S8 binding. (4) The RNA binding site of S8 is centered in the major groove of the slightly unwound helix (594-599/639-645), with the three bulged adenines appearing as specific recognition sites. (5) This same region of the 16 S RNA is not exposed at the surface of the 30 S subunit. PMID- 3323532 TI - Organization and sequence of the hsd genes of Escherichia coli K-12. AB - The nucleotide sequence of the hsdR and M genes, together with that for hsdS comprises an 8400 base segment spanning the entire hsd region of Escherichia coli K-12. The three hsd genes are transcribed in the same direction, but from two promoters. hsdR and hsdM are separated by 492 base-pairs, whereas the termination codon of hsdM overlaps the initiation codon of hsdS. pres precedes hsdR, and our data indicate a transcription termination signal in the interval between hsdR and pmod, as expected if transcription of hsdM and S is dependent on pmod. Transcription from pres is not influenced by the products of the hsdM and S genes, and the mechanism whereby restriction is prevented when the hsd region is transferred to a modification-deficient cell remains to be elucidated. A segment of the predicted amino acid sequence of the M polypeptide shares homology with a variety of adenine methylases and may identify part of the active site for methylation of specific adenine residues. The R polypeptide shows homology with a variety of ATPases, and pronounced regions of alpha-helical structure are predicted, one of which is amphipathic. PMID- 3323533 TI - A 38 base-pair segment of DNA is required in cis for conjugative mobilization of broad host-range plasmid R1162. AB - oriT, the region required in cis for conjugative mobilization of broad host-range plasmid R1162, has been localized to a 38 base-pair segment of DNA. The oriT DNA is also required for conjugation-dependent recombination. Point mutations at the HinPI cleavage site within oriT affect both mobilization and recombination, and the crossover location has been mapped to this site. An inverted repeat ten base pairs from the recombination site is also involved in mobilization and recombination, and may be a recognition site for proteins involved in cleavage of the oriT DNA. The properties of conjugation-dependent recombination suggest that mobilization entails the formation of a linear intermediate that is transferred with both a unique origin and polarity. PMID- 3323535 TI - 100 years! PMID- 3323534 TI - Purification and DNA-binding properties of FIS and Cin, two proteins required for the bacteriophage P1 site-specific recombination system, cin. AB - An Escherichia coli chromosomally coded factor termed FIS (Factor for Inversion Stimulation) stimulates the Cin protein-mediated, site-specific DNA inversion system of bacteriophage P1 more than 500-fold. We have purified FIS and the recombinase Cin, and studied the inversion reaction in vitro. DNA footprinting studies with DNase I showed that Cin specifically binds to the recombination site, called cix. FIS does not bind to cix sites but does bind to a recombinational enhancer sequence that is required in cis for efficient recombination. FIS also binds specifically to sequences outside the enhancer, as well as to sequences unrelated to Cin inversion. On the basis of these data, we discuss the possibility of additional functions for FIS in E. coli. PMID- 3323536 TI - The Journal of Morphology as window and mirror: reflections and glimpses on the birth of American biology. AB - The centennial of the Journal of Morphology provides a fitting occasion to reflect upon the condition of American biology surrounding the founding years of the Journal. The Journal was started by C.O. Whitman in 1887. At this same time, the American biological community experienced a gradual change from a community of amateurs based within the natural history tradition to a professional community based within universities with specialized research programs. Many of the changes associated with this maturation process are exhibited in the pages of the first ten volumes of the Journal. They show that the Journal played a central role in communicating research methods and questions to the growing community of professional biologists. Moreover, these same volumes provide an accurate record of the character of the morphological sciences at the end of the 19th century. PMID- 3323537 TI - Eicosanoids and susceptibility to ventricular arrhythmias during myocardial ischaemia and reperfusion. AB - Increased levels of the major metabolites of thromboxane (TxA2) and prostacyclin (PGI2) are found in venous blood draining the ischaemic region of the myocardium of dogs subjected to acute coronary artery occlusion. This suggests that these arachidonic acid derivatives are released under conditions of myocardial ischaemia and may be considered as mediators of some of the consequences of coronary blood flow reduction, including arrhythmogenesis. The present experimental evidence suggests that thromboxane release is detrimental both in the early stages of ischaemia and in reperfusion since the severity of both ischaemia and reperfusion-induced arrhythmias is reduced by selective inhibition of thromboxane synthesis or by thromboxane receptor blockade. Since the local administration of prostacyclin (or iloprost) or the promotion of local prostacyclin production (with nafazatrom) reduces the severity of ischaemia and reperfusion-induced arrhythmias, it is suggested that prostacyclin may act as a local, endogenous antiarrhythmic agent. The conclusion thus far from these experimental studies suggests that the prostacyclin-thromboxane balance is one important factor involved in determining the severity of ischaemia and reperfusion-induced arrhythmias but that the mechanisms have not as yet been clearly defined. PMID- 3323539 TI - Consultation-liaison activities with geriatric patients. AB - With the aging of our population, the number of persons aged 65 years and over referred to psychiatric consultation-liaison services is increasing. The author discusses a specific approach to such consultations and the specific concerns that they raise. PMID- 3323540 TI - A review of liposuction as a cosmetic surgical procedure. AB - Liposuction (suction-assisted lipectomy) is today an accepted, closed surgical technique utilized by physicians practicing in a number of different specialties. It is a procedure that can be learned and used as an adjunct to a number of open procedures, including rhytidectomy and abdominoplasty.THE TWO PRINCIPAL KEYS TO SUCCESSFUL LIPOSUCTION PROCEDURES ARE: (1) good patient selection, and (2) realistic expectations. Good selection should be based on physiological skin age of the patient rather than chronological age. Many liposuction procedures can be performed under local anesthesia in an office surgical suite. A conservative approach is always appropriate, as overcorrection is difficult to treat.Areas that can be suctioned effectively include the face, chin, neck, anterior and posterior axilary areas, arms, breasts, abdomen, waist, hips, buttocks, thighs, knees, and ankles. Using the blunt cannula technique pioneered by Fischer and modified and popularized by Illouz and Fournier yields a high percentage of good results. A low percentage of possible complications and undesired sequelae have been documented. PMID- 3323538 TI - Update in cancer chemotherapy: genitourinary tract cancer, Part 1. 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 in the review are cancers of the kidney, bladder, prostate, testicle, ovary, uterus, vulva, and gestational trophoblastic neoplasms. Part 1 focuses on the kidney.In this heterogeneous group of tumors, the major triumphs of cancer chemotherapy are in the control of the less common of these tumors, namely, gestational trophoblastic neoplasms in women, in combination with surgery in the control of the embryonal cell cancer of the testis in men, and in combination with surgery and radiation therapy in the control of the Wilms' tumor in children. Important progress is being made in the control of the other tumors of the genitourinary tract with the use of cancer chemotherapy. PMID- 3323541 TI - Intestinal obstruction: still a lethal clinical entity. AB - A retrospective analysis of 70 consecutive patients with a clinical diagnosis of intestinal obstruction from January 1983 to September 1985 was reviewed. Mean age was 62 years. Etiological factors included adhesions 50 percent, malignancy 24 percent, volvulus 12 percent, diverticulitis 7 percent, hernias 4 percent, and radiation enteritis, mesenteric infarction, and perforation of the cecum in the remaining 3 percent. Complications included wound infection 9 percent (n = 6), intra-abdominal sepsis 7 percent (n = 5), and recurrent small bowel obstruction 4 percent (n = 3). Overall mortality was 24 percent (n = 7).Results of the univariant analysis showed no association between the clinical signs of intestinal obstruction, that is, fever, tachycardia, leukocytosis, and local tenderness, and gangrenous bowel. A multiple regression analysis showed, however, that only 14 percent of the variance was able to predict the gangrenous bowel based on clinical signs. In conclusion, the classical signs of intestinal obstruction are poor indicators for compromised bowel, and early surgical intervention will reduce the incidence of ischemic bowel and mortality. PMID- 3323543 TI - Amphetamine detection during toxicology screening of a university medical center patient population. AB - The frequency of detection of "amphetamines" (amphetamine and/or methamphetamine) in the toxicology tests of a university medical center patient population was evaluated by retrospective review of the results of 2,900 toxicology test profiles performed on urine during the year 1986-87. Ten percent of these (291 cases) were positive for either amphetamine alone or amphetamine in conjunction with methamphetamine--a substantial increase from the 3% noted in 1978 at this medical center. Amphetamines were detected predominantly in males (164 cases). The most common age range for the entire series was 21 to 30 years (61% of cases). The typical user was a 27 year old Caucasian man who used amphetamines alone or in combination with at least one other drug with about equal frequency. The sympathomimetic amines (ephedrine, phenylpropanolamine, and pseudoephedrine) were the most frequently associated category of other drugs, perhaps reflecting either adulteration of the amphetamines with these compounds or concurrent ingestion of over-the-counter preparations containing these agents. Requests for those toxicology tests which subsequently revealed amphetamines mostly originated in the emergency room (30% of cases) although 25% originated on the trauma service and 17% on the obstetrics service. Twelve percent of cases occurred in neonates, presumably reflecting transplacental transmission of amphetamines detected in mothers that were studied simultaneously. Amphetamine and methamphetamine were detected together 84% of the time. Analysis of amphetamines should be an integral part of toxicology testing performed on a university medical center patient population. PMID- 3323542 TI - The relative value scale: reforming physician payment policy. PMID- 3323545 TI - Rapid diagnosis of Chlamydia trachomatis infections by a monoclonal antibody direct immunofluorescence test. AB - A direct immunofluorescence test on 387 clinical specimens from diverse patient populations with varying prevalence rates was evaluated for the rapid diagnosis of chlamydial infections using fluorescein-labelled monoclonal antibodies for Chlamydia trachomatis. Comparative testing with the conventional cell culture indicated an overall agreement of 98.5% between the two tests and a sensitivity of 92.6%, specificity of 98.4% for the direct IF test. In high prevalence settings the direct IF could undoubtedly be used as a suitable alternative for the definitive, rapid diagnosis of chlamydial infections. In low prevalence patient populations involving primarily asymptomatic patients, sensitivity of 87.5% and specificity of 97.4% being found indicate the potential usefulness of this rapid performed test but with caution in such settings. PMID- 3323544 TI - Bacteriology of sickle-cell leg ulcers in the equatorial forest belt of South Western Nigeria. AB - Forty-one sickle-cell leg ulcer patients attending the haematology out-patient clinic of the University of Benin Teaching Hospital, Benin City, Nigeria were included in this study and had swabs taken for bacterial studies. Single bacterial isolates were more frequent (68%) than mixed isolates (22%). No growth was obtained in 10% of patients. The relative frequency of Staphylococcus aureus was 57%; and the next most frequent organism was Escherichia coli (17%). Coliforms were relatively less frequent. Salmonella species and anaerobes were not isolated. The high incidence of skin pathogens (90%) raises the possibility of a bacterial role in the prevention of healing of these ulcers. A case is made for the use of appropriate antibiotics in promoting early healing. PMID- 3323546 TI - Malaria in foreign visitors to Britain. AB - Malaria cases reported in Britain are increasing. Foreign visitors ill with malaria while visiting Britain form an important category. This paper reviews notifications to the Malaria Reference Laboratory (M.R.L.) of cases of malaria in foreign visitors in 1985. There were 427 cases reported in this group which is nearly 20% of the total number reported. It was found that the foreign visitors had a higher proportion of Plasmodium falciparum and that a third of the cases were aged 20-29 years. Sixty per cent of the cases were born in Nigeria or India and 7.5% claim to have become ill on the day they arrived in Britain. The behaviour of the malaria and the individual with malaria were also studied. PMID- 3323547 TI - Neonatal malaria: a clinical study of congenital and transfusional malaria. PMID- 3323548 TI - A tribute to Richard W. Parnell--Physique and health--in memoriam. PMID- 3323549 TI - Doppler blood flow velocity waveforms in alpha-thalassemia hydrops fetalis. AB - Doppler shift blood flow velocity-time waveforms in the umbilical arteries (UA), aorta (A), and inferior vena cava (IVC) in eight fetuses with alpha-thalassemia (alpha-thal) hydrops fetalis were described. The UA waveforms in these fetuses with anemia in utero depicted a hyperdynamic circulatory state with a relative increase in acceleration slope, more linear decline from maximum systole to end diastole, and reduced spectral broadening. The aortic waveforms similarly displayed distorted systolic peaks, flow turbulence, and greatly elevated diastolic frequencies. Reversal of end diastolic flow in the IVC also indicated cardiac decompensation in these fetuses. Progressive changes in these waveforms were apparent in two fetuses that had serial evaluation. In another four fetuses in which alpha-thal major was diagnosed in the second trimester by DNA analysis and had Doppler evaluation before termination of pregnancy, consistent changes in the UA, A, and IVC waveforms were not observed. This study confirms the potential usefulness of Doppler spectral waveforms in depicting altered hemodynamic changes in the fetus and in the evaluation of hydrops fetalis. Doppler ultrasound examination can be included as part of the routine workup of hydrops fetalis. PMID- 3323550 TI - Endovaginal ultrasound. A technique for evaluation of nonfollicular pelvic masses. AB - The evaluation of pelvic masses is routinely performed by transabdominal ultrasound. However, by placing the transducer into the vagina (the endovaginal approach), imaging resolution is improved and morphologic detail of true pelvic organs is increased. Twenty-one cases in which nonobstetrical pelvic pathology was suspected clinically were evaluated by both the endovaginal and (conventional) transabdominal approach. Each case was evaluated for efficacy of the two approaches independently and the results compared to the clinical outcome. Endovaginal scanning offered more accurate diagnostic information in 13 of the 21 cases (62%). Additional information was obtained by the endovaginal approach in seven of these 13 cases (55%). No significant difference was observed in 33%. Endovaginal ultrasound offers a diagnostic tool complementary to the transabdominal technique in the evaluation of pelvic masses in the female patient. PMID- 3323551 TI - Prenatal sonographic depiction of intralobar pulmonary sequestration. PMID- 3323552 TI - Cystic sacrococcygeal teratoma: ultrasound diagnosis and perinatal management. PMID- 3323553 TI - Sonographic appearance of artificial urinary sphincter. PMID- 3323554 TI - Antenatal diagnosis of fetal acrania. PMID- 3323555 TI - Adipose tissue response to insulin following injury. AB - Derangements of posttraumatic glucose metabolism have long been recognized, with observed changes implicating abnormal action of insulin on target tissues. Insulin is important as well in fat metabolism, and "resistance" to insulin's effects on lipid metabolism after injury has been demonstrated. Although fat derived fuels are the body's major energy source during starvation and after injury, most studies of posttraumatic insulin "resistance" have focused on carbohydrate metabolism. This study investigated adipose tissue response to insulin in vitro in rats subjected to starvation and/or trauma. Relationships between various parameters, including adipocyte size and weight, plasma glucose, insulin, and glycerol, and basal and insulin-suppressed lipolytic rates, were also studied. Results observed include a decrease in adipocyte size and an increase in basal lipolysis in both starved and traumatized rats, with both decreased sensitivity (T greater than S) and responsiveness (S greater than T) to insulin. These results support the concept that adipocytes of injured animals retain the ability to respond to insulin but lipolytic rates at maximal suppression are still quite high as compared to fed controls. Only minor differences were observed between starved animals and those with starvation and superimposed trauma. PMID- 3323556 TI - Interorgan ammonia metabolism in health and disease: a surgeon's view. AB - Ammonia is a toxic molecule that is the principal by-product of amino acid metabolism. Although the transport of ammonia in a nontoxic form protects the brain against high circulating levels, the interorgan transport of this molecule and the orchestration between tissues that has evolved is related primarily to the fact that the nitrogen molecule is an essential molecule for the maintenance of the body's nutrition economy and overall metabolic homeostasis. Efficient handling and disposal of ammonia requires a cooperative effort between tissues in order to maintain nitrogen homeostasis. The liver is the central organ of ammonia metabolism, but other organs also play a key role in the interorgan exchange of this molecule. Alterations in ammonia metabolism occur during critical illness. These changes are adaptive and are designed to maintain metabolic homeostasis. Interorgan cooperation in ammonia metabolism is necessary to insure the proper integration of the metabolic processes which contribute to and are essential for survival during critical illness. An understanding of these processes improves our knowledge of metabolic regulation and will lead to a rational approach to the nutritional and metabolic support provided to critically ill patients. PMID- 3323557 TI - Effects of angiotensin converting enzyme inhibitor and calcium channel blocker on normoxic and hypoxic pulmonary vascular tone in unanesthetized sheep. AB - We evaluated the effects of captopril and nifedipine on normoxic and hypoxic pulmonary vascular tone in unanesthetized sheep. Infusion of captopril (10 micrograms/kg/min) in normoxia revealed a tendency to increase the mean pulmonary arterial pressure (Ppa) and the pulmonary vascular resistance (PVR) following the systemic vasodilation. A statistically significant increase was reached by 20 minutes. Hypoxia of 10% oxygen in nitrogen produced a prominent pulmonary hypertensive response. Captopril significantly decreased the hypoxic values of Ppa and PVR from 20.3 +/- 1.3 to 17.1 +/- 1.1 mmHg (p less than 0.01) and from 4.31 +/- 0.45 to 3.49 +/- 0.45 mmHg/L/min (p less than 0.01), respectively. Infusion of nifedipine (10 micrograms/kg/min) in normoxia caused an increase in Ppa from 15.5 +/- 0.9 to 18.9 +/- 1.0 mmHg (p less than 0.01), but not in PVR. This elevation in Ppa was considered to be derived from the significant increase in the cardiac output. Nifedipine significantly decreased the hypoxic values of Ppa and PVR from 21.3 +/- 1.5 to 19.3 +/- 1.5 mmHg (p less than 0.05) and from 3.88 +/- 0.30 to 27.3 +/- 0.13 mmHg/L/min (p less than 0.01), respectively. Captopril and nifedipine produced systemic hypotensive responses during both normoxic and hypoxic ventilation. It is concluded that both captopril and nifedipine are potent pulmonary vasodilating drugs in animal subjects with a hypoxic condition and that they might be useful in the clinical vasodilator therapy of hypoxic pulmonary hypertension in man. PMID- 3323558 TI - Paradoxical fall of tachycardia- and hypoxia-induced coronary flow under conditions of severe coronary stenosis in dogs. AB - It has been stated that the coronary flow paradoxically falls in response to tachycardia if the coronary artery is stenotic and "compliant". To clarify this, we measured coronary vascular resistance by cannulating the left anterior descending coronary artery in open-chest dogs. In constant flow perfusion of 41 +/- 5 ml/min/100 gm, coronary perfusion pressure was decreased by pacing, while at lower flow of 14 +/- 3 ml, it was increased by pacing, indicating that coronary vascular response was reversed. In constant pressure perfusion, coronary vascular resistance was reduced by pacing at high perfusion pressure, while it was paradoxically increased by pacing at low perfusion pressure. In the third experiment at constant flow perfusion, perfusing blood was changed from arterial to venous blood to induce myocardial hypoxia. At high flow, venous blood perfusion reduced coronary vascular resistance, while at low flow it increased coronary vascular resistance. All three experiments indicated that at high perfusion, tachycardia and hypoxia caused a reduction in coronary vascular resistance to meet the increased myocardial oxygen demand; however, at low perfusion, those stimuli increased coronary vascular resistance. The present study showed that the coronary vascular response is reversed at low flow and suggested that those stimuli might reduce flow further in patients with stenotic coronary artery and could be one of the mechanisms causing the development of myocardial infarction in those patients. PMID- 3323559 TI - The pathophysiological role of blood ionized calcium in essential hypertension. PMID- 3323560 TI - The pathophysiological role of renal dopaminergic activity in patients with essential hypertension. AB - To evaluate the role of the renal dopaminergic system on renal water-sodium metabolism patients with essential hypertension (EHT), urinary excretion of dopamine, urinary excretion of sodium (UNaV) and fractional excretion of sodium (FENa) were all investigated before and after the administration of dopamine (3 micrograms/kg/min, intravenous infusion for 60 minutes), dopamine antagonist, metoclopramide (8 mg/m2 BSA, intravenous injection) or mild sodium loading in both normotensive subjects and benign EHT. In the basal values, no significant difference in urinary excretion of free (u-fDA), conjugated (u-cDA) or total dopamine (u-tDA) was found between normotensives and hypertensives. However, low renin EHT showed a pronounced reduction in u-fDA compared with normotensis subject and (NT) normal renin EHT. In this study, a significant reduction of u cDA and of u-tDA was also found in those patients with low renin essential hypertension. In the normotensive and essential hypertensive groups UNaV or FENa showed a positive correlation with u-fDA (measured simultaneously), but not with u-tDA or u-cDA. The regression line between u-fDA and UNaV or FENa in EHT was shifted towards a lower u-fDA level than in NT. UNaV and FENa were increased by dopamine infusion and were decreased by metoclopramide injection in both NT and EHT. Changes of UNaV and FENa following dopamine or metoclopramide, showed a negative correlation with u-fDA measured immediately before the administration of these drugs. The enhanced natriuretic response to infused dopamine and the attenuated antinatriuretic response to injected metoclopramide were significant in low renin EHT, when compared with NT or normal renin EHT patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323561 TI - [Percutaneous puncture of a variant right subclavian vein under the guide of ultrasound imaging]. PMID- 3323562 TI - Effects of a selective thromboxane synthetase inhibitor (OKY-046) in patients with coronary artery disease during exercise. AB - We studied the levels of thromboxane B2 (TXB2), 6-keto-prostaglandin F1 alpha (6 keto-PGF1 alpha), platelet aggregability, beta-thromboglobulin and platelet factor 4 in 30 coronary artery disease (CAD) patients and 21 normal subjects during exercise. During treadmill exercise, 13 of 30 CAD patients reported chest pain. We administered a selective thromboxane synthetase inhibitor (OKY-046) for 2 weeks to 10 CAD patients with exercise-induced chest pain and studied its effects. At rest, the plasma TXB2 levels and platelet aggregation were significantly lower in normal subjects than in CAD patients, and there was no difference between CAD patients with and without exercise-induced chest pain. On treadmill testing, plasma TXB2 levels and platelet aggregation increased significantly only in the CAD patients with exercise-induced chest pain. Plasma 6 keto-PGF1 alpha levels in normal subjects were significantly higher than those in CAD patients both at rest and during exercise. After administration of OKY-046, mean exercise time increased significantly from 7.5 to 8.6 min (p less than 0.001). Plasma TXB2 level and platelet aggregation decreased significantly after OKY-046 administration both at rest and during exercise. These results suggest that a marked increase in TXA2, with only a minimal change in PGI2, during exercise may contribute to exercise-induced myocardial ischemia, and that OKY-046 is useful in the treatment of CAD patients. PMID- 3323563 TI - [Treatment of childhood acute lymphoblastic leukemia: efficacy of intermittent pulses of 6-mercaptopurine and methotrexate for maintenance chemotherapy, CCLSG S811 (phase III study). Children's Cancer and Leukemia Study Group]. PMID- 3323564 TI - [Fatal Aeromonas septicemia in two patients with acute myelogenous leukemia: clinical significance in neutropenic states and review of the literature]. PMID- 3323566 TI - [Anatomy of the brain]. PMID- 3323565 TI - [Pleural effusion in a case of plasma cell leukemia after undergoing simple total hysterectomy for uterine cervical carcinoma. Review of multiple myeloma and plasma cell leukemia with pleural effusion in Japan]. PMID- 3323567 TI - [Physiology of the brain--b. Visual perception]. PMID- 3323569 TI - [Rejection in renal allograft]. PMID- 3323568 TI - [Progress in DNA diagnosis]. PMID- 3323570 TI - [Investigation of IgG subclass of anti red blood cell antibodies using flow cytometry method]. PMID- 3323571 TI - [Radiographic evaluation and differential diagnosis of HLA-B27-associated spondyloarthropathies in the axial skeleton]. PMID- 3323572 TI - [Ultrasonographic assessment of neck masses]. PMID- 3323573 TI - [A case of giant esophageal leiomyoma]. PMID- 3323574 TI - [Leiomyosarcoma of the inferior vena cava]. PMID- 3323575 TI - [Evaluation of high resolution DSA images in the diagnosis of gastrointestinal disease]. PMID- 3323576 TI - [Arrector pili nevus--histological comparison to piloleiomyoma and study of reported cases in Japan]. PMID- 3323577 TI - Anti-i cold agglutinins in a patient with Wiskott-Aldrich syndrome binding study with membrane glycosphingolipids. AB - An unusual isohemagglutinin caused blood incompatibility in a patient with the Wiskott-Aldrich syndrome after nine transfusions. The patient's serum agglutinated erythrocytes of all the donors examined. The antibodies were cold agglutinins which agglutinated adult and cord erythrocytes equally. The binding of these antibodies to glycosphingolipids was analyzed by thin-layer chromatogram immunostaining and solid phase radioimmunoassay. The results indicate that the antibodies in the patient's serum bound specifically to lactonorhexaosylceramide and sialosyllactonorhexaosylceramide, glycolipids known to carry the i antigenic determinant. The antibodies did not bind to neolactotetraosylceramide, sialosylneolactotetraosylceramide or lactoisooctaosylceramide (I-active glycolipid). The patient's serum immunostained several components in the acidic glycolipids from OI erythrocytes. The antibody activity was predominantly present in IgG but the IgM showed similar binding specificity. Hemagglutination of OI erythrocytes with the patient's serum could be inhibited with lactonorhexaosylceramide. These results showed that the patient's antibodies recognized the i determinants carried by membrane surface glycolipids. The production of anti-i antibodies in the patient is intriguing in view of the decreased antibody response to carbohydrate antigens and deficient isohemagglutinins which have been generally observed in the Wiskott-Aldrich syndrome. PMID- 3323578 TI - [Expression of Ha-ras oncogene product, p21 in gastric carcinoma]. PMID- 3323579 TI - [A case of focal fatty liver associated with pregnancy toxemia]. PMID- 3323580 TI - [An autopsy case of arteriovenous malformation of the pancreatic head causing portal hypertension]. PMID- 3323581 TI - [A case of epidermoid cyst occurring in an intrapancreatic accessory spleen]. PMID- 3323582 TI - Development of a practicable method for isolation and identification of dengue viruses in developing countries. AB - We sought a practicable method for isolation and identification of dengue viruses in South-East Asia. We compared two mosquito cell lines, C6/36 and TRA-284-SFG, for virus isolation and two identification methods, immunofluorescent staining of infected cells with serotype-specific mouse monoclonal antibodies and a sandwich type enzyme-linked immunosorbent assay with conventional mouse hyperimmune ascitic fluids. We found that the combination of TRA-284-SFG cells and ELISA is a useful and feasible method in developing countries. PMID- 3323584 TI - [Self-efficacy and social support. Mediators of stress on mental health following a natural disaster]. PMID- 3323583 TI - [Alteration of split renal function during captopril treatment: diagnostic significance in renovascular hypertension]. PMID- 3323585 TI - Actin in wound-healing of rabbit corneal endothelium. I. Study by immunoperoxidase method. AB - The distribution of actin in the rabbit cornea was examined by the indirect immunoperoxidase method using mouse monoclonal anti-actin IgM and goat anti-mouse IgM serum conjugated with peroxidase, which was stained with 4-chloronaphthol. Flat preparation of the cornea was made and the actin distribution was examined in the normal endothelium and also during wound-healing of the endothelium that took place after transcorneal freezing. In the normal cornea, the epithelial, stromal and endothelial cells contained actin in the cytoplasm. Diffuse actin staining in the endothelial cytoplasm was observed in the flat preparation of the normal endothelium. After endothelial damage, the cells adjacent to the damaged area showed a fiber-like staining of actin around the nucleus; this occurred 12 to 24 hours after the freezing. Punctate staining was seen on the 2nd day, and the intensity of the staining was maximum on the 3rd day when the wound was completely covered. On the 3rd day, fibroblast-like cells were encountered and a long fiber-like staining of actin was seen in the cytoplasm, but the staining disappeared on the 4th day. The long fiber-like and punctate staining reappeared on the 14th day. Normal staining pattern was recovered on the 28th day. These findings suggest that actin production was accelerated in the endothelial cells during the wound-healing, and that this productive activity returned to normal levels as healing was completed. PMID- 3323587 TI - [Motives and interpersonal functions of aggression]. AB - In this review, the author theoretically and empirically examined motives and interpersonal functions of aggression. A factor-analysis of Averill's questionnaire items on anger revealed that motives involved in aggressive responses were clustered into two groups: the hostile and the instrumental. It was also clarified that an individual is likely to engage in aggression particularly when some hostile motives are evoked. Concerning the interpersonal functions, the author proposed that aggression might serve four principal goals. (1) Aggression can be generated as an avoidance response to an aversive stimulus, such as frustration, annoyance, or pain, and so on. It depends on the severity of the stimulus. It was however emphasized that aggression is also mediated by social cognition, such as an attribution of intent to a harm-doer. (2) Aggression can be used as a means of coercing the other person into doing something. An individual is likely to use such a power strategy if he/she is lacking in self confidence or a perspective for influencing the target person by more peaceful strategies. (3) Aggression can be interpreted as a punishment when it is directed toward a transgressor. In this case, aggression is motivated by restoration of a social justice, and thus its intensity is determined by the perceived moral responsibility of the transgressor. Further, it was indicated that aggression is intensified if it is justified as a sanctional conduct against the immoral. (4) Aggression can be also evoked when an individual's social identity is threatened. It was suggested that impression management motives are involved in aggression by an unexpected finding that the presence of audience or the identifiability rather facilitated retaliative aggression. The aggression-inhibition effect of apology was also explained in terms of impression management. In conclusion, it was presented that aggression is a behavioral strategy as an attempt to resolve interpersonal conflicts including physical or psychological annoyance, the other person's disobedience, perceived injustice, and a threat to one's social identity. Whether one's aggression is performed or not depends on a number of intra- and inter-personal determinants, particularly on social cognitive processes such as attribution, inference, prediction and other judgements. PMID- 3323586 TI - Bilateral simultaneous corneal graft rejection--role of tear immunoglobulins. AB - A report is made on an unusual case of corneal graft which was clear for well over a decade, and then manifested allograft rejection phenomenon concurrently in both eyes initiated by keratoplasty in the second eye. A bilateral and simultaneous corneal graft rejection in an individual does not seem to have been reported previously. Serial tear immunoglobulin (IgG) levels, which were normal in the initial postoperative period, demonstrated an elevation throughout the rejection phenomenon. The possible significance of this rise in the tear IgG levels is discussed. PMID- 3323588 TI - [History of public health nurses at the Osaka Public Health Clinic. 4. The early stage of the clinic. 4. The system for assistance of military families in Osaka by part-time employees]. PMID- 3323591 TI - A new heligmosomid nematode, Heligmosomoides protobullosus n. sp. (Heligmosomidae: Nematoda), from the Japanese grass vole, Microtus montebelli Milne-Edwards. PMID- 3323590 TI - Stewart-Treves syndrome. A report of two cases with a review of Japanese literature. AB - Two cases of postmastectomy lymphangiosarcoma seen at our department are reported. One case, treated by amputation, died 1 year 4 months later and the other case, treated by local excision followed by amputation, died 7 months later. Twenty cases from the Japanese literature, including our 2 cases, are reviewed herein. The initial treatment for the other 18 cases was as follows: amputation in 8 cases, local excision in 2, radiotherapy in 4 and chemotherapy in 4. Fifteen of 16 cases eligible for follow up were dead within 20 months after treatment. Although the knowledge available as to the results of the treatment of postmastectomy lymphangiosarcoma is still insufficient to indicate the optimal therapeutic approach, early recognition of the lesion and prompt radical ablative surgery seem to offer the best chance for survival. PMID- 3323589 TI - Results of kidney transplantation in 25 pediatric patients. AB - Outcome, long-term prognosis, growth activity and rehabilitation after kidney transplantation were studied in 25 pediatric patients transplanted with a kidney graft from one-haplotype identical parent. Excellent patient and graft survival with low incidences of acute rejection or serious complications could be achieved in this population, as compared with the results of adult recipients. Growth retardations in height and weight were observed in these patients before transplantation, and were significantly correlated with the duration of low or no kidney function. In 12 recipients who were transplanted at ages of younger than 15 years and followed up over two years, a dramatic increase in weight appeared within one year after transplantation and a greater increase in height was exhibited in the second and third year than in the first. Increase in height was significantly greater in those children transplanted at ages of younger than 10 years than in those transplanted at ages of older than 11 years. Catch-up growth was observed in one-third of these children. Retrospectively, there was no difference in the doses of prednisolone given between the two groups of patients with, and without catch-up growth, but the incidence of acute rejection was higher in the group without catch-up growth. Currently, 18 recipients have functioning grafts and 16 (88.9 per cent) of them are in full-time school or working. From these results it is concluded that kidney transplantation is the first feasible manoeuvre for those children with chronic renal failure and it should be performed as soon an possible in order to preserve their growth activity. PMID- 3323592 TI - Difference of virulence in causing metritis in horses between heavily encapsulated, less heavily encapsulated and non-capsulated strains of Klebsiella pneumoniae capsular type 1. PMID- 3323593 TI - [Miliary tuberculosis complicated with disseminated intravascular coagulation]. PMID- 3323594 TI - Protective effect of prostacyclin on postischemic acute renal failure in the rat. AB - Infusion of prostacyclin (PGI2) reportedly attenuates renal ischemic injury in the dog and the rat. In the dog, PGI2 is a potent renal vasodilator; in the rat a direct action on the renal vasculature is not always apparent. To determine whether or not the protective effect of PGI2 on postischemic ARF was hemodynamically mediated, studies were performed in uninephrectomized Sprague Dawley rats before and after a 40 minute period of complete renal artery occlusion. In response to the preischemic infusion of PGI2 for 30 minutes at 160 ng/kg body wt/min i.v. (N = 7), MAP and RBF fell to 86 +/- 7% (P less than 0.0001) and 84 +/- 9% (P less than 0.05) of baseline values, respectively. RVR initially declined to 81 +/- 9% of baseline values (P less than 0.025) but returned to 102 +/- 13% of baseline values prior to the period of ischemia. Following the period of ischemia, reflow of blood in the rats receiving PGI2 was delayed when compared to rats not receiving PGI2 (N = 7). RBF returned to only 76 +/- 19% of the initial values in PGI2-treated rats (P less than 0.01) but to 90 +/- 12% of the initial values in rats receiving buffer alone (NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323595 TI - Dynamics of erythropoiesis following renal transplantation. AB - We examined the temporal dynamics of the correction of anemia following renal transplantation in 65 recipients using a sensitive radioimmunoassay for erythropoietin to determine the effects of modern immunosuppressive agents, delayed graft function, and early acute rejection. Pretransplant mean erythropoietin (25.6 +/- 3.3 mU/ml) was only 25% of the expected value at the mean hematocrit of 27.2 +/- 0.7, and erythropoietin correlated positively with hematocrit (r = 0.37, P less than 0.05). Following onset of graft function, erythropoietin increased to 109 +/- 13 mU/ml and then decreased in a negative feedback fashion over the next several months. Delayed graft function was associated with delay in the assumption of this orderly process irrespective of the immunosuppressive regimen used. Cyclosporine A produced a biphasic response despite delayed graft function in recipients with underlying adult polycystic kidney disease. Correction of anemia required resumption of graft function. Onset of acute graft rejection within the first month posttransplantation (14 episodes in 11 patients) abrogated the hematopoietic response until the rejection was successfully reversed. We conclude that a major cause for the anemia of renal failure is subnormal production of erythropoietin. Following transplantation, anemia corrects in an orderly manner with restoration of the normal biofeedback process between erythropoietin and red cell mass. This process is delayed by failure of graft to function initially and interrupted by acute early rejection, re-commencing following successful reversal. PMID- 3323596 TI - A controlled trial of cyclophosphamide in patients with membranous glomerulonephritis. AB - Patients with membranous glomerulonephritis (MGN), impaired renal function and the nephrotic syndrome are at high risk of developing renal failure. Twenty-six such patients were studied with serum creatinine concentrations exceeding 135 microM, and 24-hour urine protein excretion of at least 3.5 g/day to determine the potential benefit of cyclophosphamide therapy. Cyclophosphamide (mean 1.5 mg/kg/day) was given to nine patients for 23 +/- 4 months. These patients were compared with 17 concurrent controls. The two groups did not differ in clinical or laboratory features at the time of biopsy or start of treatment or its equivalent. Six of the nine cyclophosphamide treated patients and 15 of the 17 controls had received prednisone therapy. The total follow-up was 49 +/- 10 months in the treated group and 50 +/- 6 months in the controls. At last observation, serum creatinine values exceeded 400 microM in eight controls (4 on dialysis) and in none of the treated patients. The mean serum creatinine level was significantly lower (P less than 0.02) in the treated group (173 +/- 24 microM) than in controls (433 +/- 71 0.02) in the treated group (173 +/- 24 microM) than in controls (433 +/- 71 microM). The mean serum albumin level and 24 hour urine protein excretion both improved significantly with treatment as compared with controls. There were four complete remissions, five partial remissions and no patient with persistent nephrotic syndrome after treatment. In the controls, there were no complete remissions, six partial remissions and 11 patients had persistent nephrotic syndrome (P less than 0.001). Thus, cyclophosphamide therapy appears to be of benefit in patients with MGN, the nephrotic syndrome and impaired renal function. PMID- 3323597 TI - Mesangial changes in IgA nephropathy in children. AB - The mesangial changes in 92 renal biopsy specimens from 81 children with IgA nephropathy were correlated with the clinical and the other renal biopsy findings. Three types of mesangial changes were identified: mesangial hypercellularity was predominant compared with the increase in matrix in 34 biopsy specimens (type A), the degrees of mesangial hypercellularity and matrix increase were similar in 36 (type B) and matrix increase was predominant in 22 (type C). The interval between the onset of disease and biopsy was significantly shorter in biopsies with type A mesangial changes (P less than 0.01) and significantly longer in those with type C (P less than 0.01). Serial pathologic observations revealed that predominant mesangial hypercellularity was almost exclusively seen in the initial biopsy but predominant matrix increase was usually seen in the follow-up biopsy. The percentage of glomeruli showing sclerosis was significantly higher in biopsies with type C mesangial changes (P less than 0.05). At the latest follow-up, 58% of the patients showing type A and 57% showing type B lost their proteinuria, whereas only 9% showing type C lost their proteinuria (P less than 0.01). These findings suggest that predominant mesangial hypercellularity is characteristic of the early lesion of childhood IgA nephropathy, and progression of disease leads to gradual decrease of mesangial cellularity and increase of matrix with sclerosis. PMID- 3323598 TI - Beta 2-microglobulin: its significance in the evaluation of renal function. PMID- 3323599 TI - The enhancement of aminonucleoside nephrosis by the co-administration of protamine. AB - An experimental model of focal segmental glomerular sclerosis (FSGS) was developed in rats by the combined administration of puromycin-aminonucleoside (AMNS) and protamine sulfate (PS). Male Sprague-Dawley rats, uninephrectomized three weeks before, received daily injections of subcutaneous AMNS (1 mg/100 g body wt) and intravenous PS (2 separated doses of 2.5 mg/100 g body wt) for four days. The series of injections were repeated another three times at 10 day intervals. The animals were sacrificed on days 24, 52, and 80. They developed nephrotic syndrome and finally renal failure. The time-course curve of creatinine clearance dropped and showed significant difference (P less than 0.01) from that of each control group, such as, AMNS alone, PS alone or saline injected. Their glomeruli showed changes of progressive FSGS. The ultrastructural studies in the initial stage revealed significant lack of particles of perfused ruthenium red on the lamina rara externa and marked changes in epithelial cell cytoplasm. Therefore, it is suggested that the administration of PS enhances the toxicity of AMNS on the glomerulus and readily produces progressive FSGS in rats resulting in the end-stage renal disease. PMID- 3323600 TI - Renal handling of urea in subjects with persistent azotemia and normal renal function. AB - Fourteen subjects with persistent azotemia and normal glomerular filtration rate were studied by renal clearances and hormonal determinations to establish the nephron site of altered urea transport and the mechanism(s) responsible for their azotemia. During constant alimentary protein, urea nitrogen appearance was normal and urea clearance was much lower than in 10 age-matched control subjects (23.3 +/- 2.1 ml/min and 49.6 +/- 2.6 ml/min per 1.73 m2, P less than 0.001). Inulin and para-aminohippurate clearances, blood volume and plasma concentration of antidiuretic hormone were within normal limits. During maximal antidiuresis, in spite of greater urea filtered load, the urinary excretion of urea was less, and both the maximum urinary osmolality and the free-water reabsorption relative to osmolar clearance per unit of GFR were greater than in control subjects. After sustained water diuresis, the plasma urea concentration markedly decreased to near normal levels in azotemic subjects. The basal urinary excretion of prostaglandins E2 was significantly reduced in azotemic subjects and was directly correlated with fractional urea clearance (r = 0.857, P less than 0.001). An additional group of control subjects (N = 8) showed a marked reduction of fractional clearance of urea after inhibition of prostaglandin synthesis (P less than 0.01). These data suggest that azotemia is due to increased tubular reabsorption of urea in the distal part of nephron, presumably because of increased back diffusion in the papillary collecting duct, accounting for the enhanced maximum urinary osmolality and free-water reabsorption. Renal prostaglandin E2 may participate in the pathogenesis of azotemia by altering recycling of urea in the medulla. PMID- 3323601 TI - Converting enzyme inhibition and progressive glomerulosclerosis in the rat. AB - The effect of converting enzyme inhibition (CEI) by captopril (CAP, 500 mg/liter drinking water) on the development and progression of glomerulosclerosis (GS) was studied in six groups of male uninephrectomized (UN) Wistar rats. In group A, treated with CAP for four to five weeks after UN, a reduction in systolic blood pressure (SBP), filtration fraction and glomerular volumes was found as compared to control group B. Long-term treatment with CAP for eight months after UN (group C) resulted in lowering of SBP with 30 mm Hg, a low level of proteinuria and low incidence of GS (0 to 1.5%) as compared to control rats (group D), with SBP of 131 +/- 4 mm Hg, proteinuria up to 103 to 509 mg/day and 9.1 to 29.7% GS at eight months after UN. Groups E and F were followed without therapy up to seven months after UN, at which time a high level of proteinuria was present. CAP therapy then started in group E, did not reduce SBP, proteinuria and GS at 11 months after UN relative to control group F. This study shows that early CEI prevents progressive proteinuria and GS in rats after UN and is associated with a reduction in SBP, filtration fraction and glomerular volume. Once high levels of proteinuria and GS have developed in rats after UN, CEI has no effect on SBP nor on the progression of GS and proteinuria. PMID- 3323602 TI - Captopril inhibits the hydroosmotic effect of ADH in the cortical collecting tubule. AB - Previous studies have shown that captopril (CP) inhibits ADH-stimulated osmotic water permeability (Pf) in the toad bladder by potentiating endogenous bradykinin (BK). The present studies examine the effect of CP on ADH-stimulated Pf in isolated, perfused rabbit cortical collecting tubules (CCT). CP (10(-4) M) reversibly inhibited Pf, stimulated by maximal concentrations of ADH (10 microU/ml). Pretreatment of CCT's with 5 microM indomethacin, however, abolished the effect of CP. Inhibition of BK production by the kallikrein inhibitors, aprotinin and benzamidine, failed to enhance Pf stimulated by submaximal concentrations of ADH (2.5 microU/ml). Since ADH exerts its effects by activation of adenylyl cyclase (AC), further experiments were performed to identify the site at which CP inhibits this cascade. CP significantly inhibited forskolin (10(-4) M) stimulated Pf; however, it had no effect on cyclic AMP (10(-5) M) stimulated Pf, suggesting that the site of action is on the catalytic subunit or one of the GTP regulatory proteins of AC. To further localize the site of CP's action, CCT's were pre-incubated with pertussis toxin (0.5 microgram/ml) to inactivate the inhibitory, guanosine triphosphate (GTP) regulatory protein, Gi. In these tubules, CP failed to inhibit the action of ADH. We conclude that CP stimulates prostaglandin production which in turn activates Gi and inhibits AC activity. We further suggest that CP stimulates PG's directly, not via BK. PMID- 3323603 TI - Metabolic response to exercise in dialysis patients. AB - The metabolic and hormonal response to acute moderate intensity (40% of VO2 max) bicycle exercise was examined in eight uremic subjects maintained on chronic dialysis and in 12 age- and weight-matched controls before and after the administration of low dose, selective (metoprolol) and nonselective (propranolol), beta adrenergic antagonists. The fasting plasma glucose concentration and basal rates of hepatic glucose production (HGP) and tissue glucose disappearance (Rd) were similar in control and uremic subjects. In both groups HGP and Rd increased in parallel during exercise, and the plasma glucose concentration remained constant at the fasting level. However, the increments in Rd (2.27 +/- 0.27 vs. 0.87 +/- 0.31 mg/kg.min, P less than 0.01) and HGP (2.47 +/ 0.22 vs. 0.92 +/- 0.19 mg/kg.min, P less than 0.01) were 2.5-3 fold greater in the control compared to uremic subjects. Although the VO2max was decreased by 50% (39 +/- 2 vs. 20 +/- 2 ml/min.kg; P less than 0.01), the correlation between Rd and VO2max was weak (r = 0.33, P less than 0.10), suggesting that factors other than diminished physical fitness contribute to diminished tissue uptake of glucose in the dialyzed uremic patients. Following the cessation of exercise, HGP and Rd promptly returned toward basal levels in both uremic and control subjects. The glucose homeostatic response to exercise was not significantly altered by either propranolol or metoprolol. In the postabsorptive state fasting levels of insulin, glucagon, epinephrine, and norepinephrine all were significantly increased in the uremic group (P less than 0.01 to 0.05). During exercise in the healthy young controls the plasma insulin concentration declined and plasma epinephrine and norepinephrine levels rose three- to fourfold. In contrast, in uremics plasma insulin failed to fall (P less than 0.05) and the increase in circulating epinephrine and norepinephrine levels was markedly impaired (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323605 TI - Estimation of mean glomerular volume in patients with insulin-dependent diabetes mellitus. PMID- 3323604 TI - Cyclosporine A enhances platelet aggregation. AB - In view of the reported increase in thromboembolic episodes following cyclosporine A (CyA) therapy, the effect of this drug on platelet aggregation and thromboxane A2 release was investigated. The addition of CyA, at therapeutic concentrations to platelet rich plasma from normal subjects in vitro was found to increase aggregation in response to adrenaline, collagen and ADP. Ingestion of CyA by healthy volunteers was also associated with enhanced platelet aggregation. The CyA-mediated enhancement of aggregation was further enhanced by the addition in vitro of therapeutic concentrations of heparin. Platelets from renal allograft recipients treated with CyA also showed hyperaggregability and increased thromboxane A2 release, which were most marked at "peak" plasma CyA concentration and less so at "trough" concentrations. Platelet hyperaggregability in renal allograft patients on long-term CyA therapy tended to revert towards normal following the replacement of CyA with azathioprine. Hypertensive patients with renal allografts on nifedipine therapy had normal platelet function and thromboxane release in spite of CyA therapy. These observations suggest that CyA mediated platelet activation may contribute to the pathogenesis of the thromboembolic phenomena associated with the use of this drug. The increased release of thromboxane A2 (a vasoconstrictor) may also play a role in mediating CyA-related nephrotoxicity. PMID- 3323606 TI - Leukocyte proteinases and proteinase inhibitors in the catabolism of acute renal failure. PMID- 3323607 TI - Insulin metabolism in acute renal failure. PMID- 3323608 TI - Carnitine metabolism in chronic renal failure. PMID- 3323610 TI - Nutritional hemodialysis. PMID- 3323609 TI - Regulation of renal hemodynamics by plasma amino acid and hormone concentrations. AB - Our results as well as those in the literature suggest that some hormone or combination of hormones, that are inhibited by somatostatin, is responsible for the hyperfiltration response following amino acid infusion/protein ingestion. Recently, we have infused amino acids with somatostatin and replaced the stimulated levels of insulin/glucagon/growth hormone observed during amino acid infusion alone (Castellino and DeFronzo, preliminary results). This combined hormone replacement was able to overcome the inhibitory effect of somatostatin and return the increase in RPF and GFR to the elevated levels observed following amino acid infusion. These results suggest that some combination of these hormones is involved in the hyperfiltration response to hyperaminoacidemia. However, several comments are worthy of emphasis. First, somatostatin is known to inhibit a number of hormones (Table 1), and a contributory role for any of these should not be excluded. Second, a large body of evidence has accumulated to indicate that neither insulin, glucagon, nor growth hormone alone are capable of augmenting either RPF or GFR. The possibility that infusion of the three hormones together will increase RPF and GFR, when neither hormone alone will do so, has not been examined. More likely, some interaction between the elevated plasma amino acid concentrations and the elevated hormone levels is responsible for the hyperfiltration response. It is interesting to speculate that such an interaction might be exerted at the level of the kidney by an effect on renal amino acid metabolism. PMID- 3323611 TI - Controlled trial of two keto acid supplements on renal function, nutritional status, and bone metabolism in uremic patients. AB - In this matched, controlled study, two different types of EAA/KA supplements were compared in uremic patients fed a 30 g protein restricted diet. The patients were paired for age, sex, and underlying renal disease. The supplement with the higher BCKA content resulted in an improvement of renal function, bone metabolism, and a normalization of plasma BCAA concentrations. With both supplements, adequate nutritional status of the patients was maintained. We conclude that the BCKA content of the supplement is of considerable importance for uremic patients on low protein diets. PMID- 3323612 TI - The role of nutrition in hypertrophy of renal tissue. PMID- 3323613 TI - Relationship of nutritional status to erythrocyte insulin receptors in adults and children with uremia. PMID- 3323614 TI - Effects of growth hormone on GFR and renal plasma flow in man. PMID- 3323615 TI - Prevention of phosphate retention and hyperphosphatemia in uremia. PMID- 3323616 TI - The influence of potassium on blood pressure. PMID- 3323617 TI - Mechanisms of hypertension in obesity. AB - We conclude that the following may explain the rise in blood pressure with obesity and the subsequent fall in blood pressure (Fig. 2): (1) An increase in calories, protein, or carbohydrate leads to an increase in plasma catecholamines, sympathetic nervous system activity, and insulin secretion. (2) These factors, in turn, lead to increased renal sodium retention and stimulation of the renin aldosterone system which, in turn, leads to: (3) An increased cardiac output with an inability to appropriately adjust the peripheral resistance to maintain normotension with resultant hypertension. Conversely, the fall in blood pressure with weight reduction can be explained by (Fig. 3): (1) A decrease in calorie, carbohydrate, or protein intake which leads to: (2) A decrease in circulating plasma catecholamines, sympathetic nervous system activity, and insulin secretion which results in: (3) A natriuresis and decrease in the renin-aldosterone system, which causes a decrease in circulating blood volume and in cardiac output. This, in turn, lowers blood pressure towards normal. The unanswered question still remains: why do some obese patients become hypertensive and others remain normotensive? Perhaps there are weight-sensitive individuals and weight-resistant individuals just as there appear to be salt-sensitive and salt-resistant hypertensive patients. Perhaps the answer is genetic. These questions also remain to be answered. PMID- 3323618 TI - Factors that may retard the progression of renal disease. PMID- 3323620 TI - Effect of control of diabetes mellitus on progression of renal failure. PMID- 3323619 TI - The roles of eicosanoids in experimental glomerulonephritis. AB - There is accumulating evidence showing alterations of renal eicosanoid synthesis in glomerular disease. Despite the complexity of their role in glomerulonephritis, these compounds appear to play a major part in the inflammatory response and in control of renal hemodynamics. The role of eicosanoids in the filtration of macromolecules has not been established, but there is indirect evidence of their involvement in mediating proteinuria. Dietary manipulation, either by high EPA, high linoleic acid, or EFA-deficient diet, in experimental glomerulonephritis have shown promising results as summarized in Table 1. The therapeutic potential of alterations in dietary fatty acid to modulate the inflammatory response appears to be of great value. Table 2 summarizes the effects of different dietary fatty acid alterations on eicosanoid synthesis. Nonetheless, we should point out that most of the studies of alterations in dietary fatty acids did not document changes in glomerular synthesis of prostaglandin, thromboxane, or HETES. Further studies examining the effects of different fatty acid regimens on glomerular eicosanoid synthesis and the role of these eicosanoids in the development of glomerulonephritis will provide valuable information. These findings could determine the specific type of dietary manipulation to inhibit or stimulate the production of selected eicosanoids. PMID- 3323621 TI - Comparison of ketoacids and low protein diet on advanced chronic renal failure progression. PMID- 3323622 TI - Regulation of protein catabolism. PMID- 3323623 TI - Renal fuel utilization, energy requirements, and function. PMID- 3323624 TI - Proteases and other catabolic factors in renal failure. PMID- 3323626 TI - [Significance of neonatal insulin secretion for the development of disorders of carbohydrate intolerance in the first 3 years of life. Results of the 1.75 g/kg oGTT in the offspring of diabetic mothers]. PMID- 3323625 TI - Glucose metabolism in children with uremia: effect of dietary phosphate and protein. PMID- 3323627 TI - [Development of a national medico-scientific society of pediatricians in East Germany. 1. Regional pediatric societies in East Germany 1949-1962]. PMID- 3323628 TI - [Skin autotransplantation without a surgical suture]. PMID- 3323630 TI - [Skin allograft from donors with diabetes]. PMID- 3323629 TI - [Bilateral gluteal skin-muscle island flaps in deep decubital wounds in the sciatic area]. PMID- 3323631 TI - [Combined method of the surgical treatment of burns of the lower extremities]. PMID- 3323632 TI - [Acute gastrointestinal complications following burns]. PMID- 3323633 TI - [Epidemiology of burns]. PMID- 3323634 TI - [Congenital corneal opacity caused by thickening of Bowman's membrane]. AB - Congenital corneal opacifications are rare, yet their causes are manifold. Only a few cases have been described in which the most striking histopathological feature is a thickening of Bowman's membrane. The authors found an isolated thickening of this membrane in the corneas of a baby who, shortly after birth, presented with corneal opacifications in both eyes. Only a few months after penetrating keratoplasty was performed the condition recurred. Bowman's membrane was found to be thickened in the graft as well. PMID- 3323635 TI - [Ultrasound biometry in childhood]. AB - Within the last 18 months the authors have measured, in cases of juvenile cataract seen by them, the axial length of the eye and other parameters. As a control group, children from the authors' squint clinic, with various refractive errors, were examined. With the data thus gathered, correlation and regression analyses were performed, postoperative refraction values were calculated, and eye growth in phakic eyes was compared with that in aphakic eyes. Regression formulas were established which enabled the authors to calculate eye length at a given age, to determine the postoperative refraction of their juvenile cataract patients with great accuracy, and, so far, to prove that there is no significant difference between phakic and aphakic eyes as regards growth. PMID- 3323636 TI - [Ocular findings in hemodialysis and following kidney transplantation in childhood and adolescence]. AB - Between August 1980 and January 1987, 23 patients undergoing treatment for chronic renal failure underwent eye examinations. Hemodialysis and subsequent kidney transplants were performed in 18 patients; in two patients a kidney transplant was performed alone, and in three others hemodialysis without transplant. The interval between dialysis and transplantation averaged 23.1 months, the mean follow-up after transplantation 20 months. Patients who underwent hemodialysis alone were followed up for periods of two, three and 85 months. The patients' ages when hemodialysis treatment was first instituted ranged from six to 17 years (average 11.8 years). The mean age at the time kidney transplants were performed was 13.6 years (ranging from one to 17 years). Seventeen patients had conjunctival and corneal infiltrations in the area of the palpebral fissure. In two cases infiltrations were confined to the conjunctiva. Four patients had no pathologic changes, in either the cornea or the conjunctiva. Slitlamp examination revealed subcapsular losses of lens transparency in eight patients; these losses were manifested by delicate punctiform and patchy configurations. In nine cases fundus ophthalmoscopy revealed constricted retinal arteries. Within the period of observation all but one of the patients had unchanged vision. The one exception (cystinosis) had reduced visual acuity due to an accumulation of crystalline inclusions in the cornea. PMID- 3323637 TI - [The disease picture and treatment of Toxocara canis uveitis in childhood]. AB - The disease process of uveitis due to Toxocara canis infection has a much more severe course in children than in adults. It can be cured by special drugs (Mintezol) and corticosteroids, which at the same time also reduce the inflammatory symptoms. In patients with endophthalmitis, vitrectomy may be indicated. The improvement in visual acuity depends both on the localization of the degenerations and on the duration of the disease. The authors consider sonographic examination indispensable for differential diagnosis. PMID- 3323639 TI - Juvenile dermatomyositis with respiratory failure and peripheral nerve paralyses. A case report. AB - A 9.5 years old girl suffering from an acute dermatomyositis, developed a respiratory failure, which was successfully managed with mechanical ventilation for 6 days. Paralysis of the right radial and the left peroneus nerves were recognized early in the disease course and were confirmed later by electrophysiologic examinations. A complete remission of the dermatomyositis and the paralysis of the radial nerve were achieved within months with prednisolone medication and physiotherapy; the peroneus nerve paralysis improved only slightly. Further uncommon manifestations were thrombocytopenia, retinitis and cerebral convulsions. PMID- 3323638 TI - [Doppler sonographic flow measurement in the anterior cerebral artery and celiac trunk in infants with coarctation syndrome in comparison with healthy infants]. AB - 15 infants (gestational age 47 +/- 11 weeks; weight 3180 +/- 1082 g) with angiocardiographically proven coarctation of the aorta and 53 healthy infants (gestational age 39 +/- 8 weeks; weight 2830 +/- 1418 g) were investigated by echocardiography and pulsed doppler sonography. In all children pulsed doppler recordings were obtained in the anterior cerebral artery (prestenotic reference vessel) and the truncus coeliacus (poststenotic reference vessel). Nine variables were measured from each doppler signal: The maximal systolic velocity, the endsystolic and enddiastolic velocity, the pulsatility-index, the acceleration slope (peak rate of acceleration), the deceleration slope (peak rate of deceleration), the antegrade flow time and the acceleration and deceleration time. The healthy infants showed a pulsatile flow profile in the anterior cerebral artery and the truncus coeliacus. In normal subjects the maximal systolic velocity and the acceleration slope in the truncus coeliacus were always higher than in the anterior cerebral artery. There was no difference in the endsystolic and enddiastolic velocity, the pulsatility-index, the flow times and the deceleration slope. In children with coarctation of the aorta a decreased and nonpulsatile flow in the truncus coeliacus could be shown. The following variables were significantly lower than in the healthy control group: The maximal systolic velocity, the pulsatility-index, the acceleration and deceleration slope and the antegrade flow time and acceleration time. In the anterior cerebral arteries of children with coarctation the maximal systolic and enddiastolic velocity were significantly higher than in the healthy control group. Pulsed doppler recordings were obtained in 9 patients after surgical correction: The maximal systolic and endsystolic velocity, the pulsatility-index, the acceleration and deceleration slope in the truncus coeliacus increased significantly although these values were lower than in the healthy control group. The flow parameters in the anterior cerebral arteries postoperatively showed no significant difference from the preoperative values. Pulsed dopplersonography of the flow in the anterior cerebral artery and the truncus coeliacus is a good method for diagnosis of coarctation of the aorta and postoperative controls. PMID- 3323640 TI - A macrophage-suppressing 40-kD protein in a case of pulmonary alveolar proteinosis. AB - Pulmonary alveolar proteinosis (PAP) is a rare disease of unknown etiology. Macrophage dysfunctions are claimed to be involved in the pathogenesis. We investigated phagocytosis and oxidative metabolism of alveolar macrophages in a case of pulmonary alveolar proteinosis. These cells phagocytize normally and phagocytizable stimulants cause a normal oxidative burst. In response to the membrane signals phorbolmyristate acetate and aggregated immunoglobulin, however, no stimulated turnover of the oxidative metabolism can be observed. A 40-kD protein found in the lavage fluid mediates this macrophage-inhibiting effect. This phenomenon may contribute to the frequent opportunistic infections seen in PAP patients. It can be concluded from our data that the high frequency of infections with opportunistic species in these patients can be reduced by therapeutic bronchoalveolar lavage. By this procedure the abnormal macrophage suppressing protein can be washed out of the lung at an early stage of the disease. PMID- 3323641 TI - [Phenotypic heterogeneity of cardiac myxomas]. AB - Histogenesis of cardiac myxoma is still unclear. Beside endothelial cells a variety of different cell types were detected in this benign cardiac tumor. Cryostat sections of four myxomas were analysed in the indirect immunoperoxidase technique using monoclonal antibodies (MoABs) directed against MHC class I and II antigens, as well as different surface determinants specific for endothelial cells or monocytes/macrophages. Tumor cells forming cell clusters and blood vessel like structures differed in their expression of endothelial antigens suggesting cellular heterogeneity within single and different myxomas. Like in fetal cardiac tissue vascular channels rarely carried HLA-class II antigens. Tumor cells carrying antigens of monocytes/macrophages, as well as intracellular alkaline phosphatase of endothelial cells could represent subpopulations of an early differentiation stage. This analysis further supports previous hypothesis of an endothelial origin of myxomas. PMID- 3323643 TI - Insulin receptor binding to blood cells: an outdated concept for clinical studies on insulin resistance? AB - Clinical data on insulin binding to blood cells contribute to our present knowledge of insulin resistance. Binding data have been frequently presented to indicate alterations in insulin action. It is now evident that insulin binding data are of limited value for our understanding of insulin resistance. This is mainly due to the tissue-specific binding of insulin as well as the "pleiotypic" nature of insulin action. As insulin action is determined at (a) the "pre-" receptor level, (b) the receptor, and/or (c) different postbinding sites, it is unlikely that receptor data alone can explain defective insulin action. As knowledge of the molecular biology of insulin receptor morphology and function as well as of the action of insulin on intermediary metabolism increases, clinicians should not be further overloaded with binding data. Nevertheless, binding data on blood cells may be still of some value in investigating patients with severe insulin resistance due to genetic disorders of the insulin receptor or insulin receptor autoantibodies. PMID- 3323644 TI - Myoadenylate deaminase deficiency. AB - Myoadenylate deaminase (MAD) is the rate-limiting enzyme in the purine nucleotide cycle which is biochemically linked to glycolysis and the citric cycle and thereby providing energy during intense muscular activity. In muscle fibers, myoadenylate deaminase operates at considerably higher activity levels than in other organs. First detected using enzyme-histochemical methods, it now appears that deficiency of myoadenylate deaminase is one of the most frequent enzyme defects in muscle. The primary defect may occur as an isolated nosological entity or not infrequently it is also associated with a large spectrum of different neuromuscular conditions. It seems to be the primary unassociated MAD deficiency that has recently become amenable to successful treatment with D-ribose in high doses. Secondary MAD deficiency may occur in muscle fibers and muscles that have undergone structural damage as seen, for instance, in polymyositis, muscular dystrophy, and denervation. The wealth of biochemical, morphological, and clinical data that has accumulated since the discovery of MAD deficiency during the past decade provides nosological significance of MAD deficiency as a real entity. PMID- 3323642 TI - The influence of nutrition on the systemic availability of drugs. Part I: Drug absorption. PMID- 3323645 TI - [Serologic AIDS diagnosis with polypeptides obtained by genetic technics of the human immunodeficiency virus (HIV-1)]. AB - Serologic testing for human immunodeficiency virus type 1 (HIV-1) is currently based on enzyme linked immunosorbent assay (ELISA) as screening method. Positive ELISA-results have to be confirmed by at least one second procedure such as Western blotting or immunofluorescence. To obtain new diagnostic reagents for confirmatory testing, we expressed viral antigens in procaryotic systems. Peptides representing epitopes of structural core (gag)- and envelope (env) proteins of HIV were produced in E. coli as stable immunogenic beta-galactosidase fusion proteins. Recombinant proteins were taken for immunoblot-assays. The results of Western blotting with those fusion proteins were in general comparable with conventional ELISA, immunofluorescence, immunoblot with cell-culture derived virus and commercially available ELISA tests based on recombinant proteins. Immunoblots using recombinant transmembrane protein (gp41) derived polypeptide were more sensitive than the conventional procedure with purified virion proteins. Western blotting with recombinant fusionproteins provide reliable and inexpensive serodiagnostics without handling of infectious cell cultures. PMID- 3323649 TI - [Tuberculosis after kidney transplantation]. PMID- 3323648 TI - Cooperative Group of Additional Immunoglobulin Therapy in Severe Bacterial Infections: results of a multicenter randomized controlled trial in cases of diffuse fibrinopurulent peritonitis. AB - A multicenter randomized controlled clinical trial, which was carried out in 10 hospitals in the Federal Republic of Germany between 1979 and 1983, studied the influence of i.v. immunoglobulin G on the mortality in patients with diffuse acute fibrinopurulent peritonitis. Altogether 288 patients were enrolled in the trial. There was no statistically significant difference in the mortality rates within the treated group (46%) vs the control group (41%). The power of the statistical test to detect a decrease of the mortality by 20% was calculated to be 0.93. This result did not change when we eliminated 50 patients not strictly obeying the entrance criteria of the analysis, or when we focused on a subgroup of patients with initial deficiency of immunoglobulin G. Factors influencing mortality were a preceding laparotomy, serum creatinine level above 2 mg/100 ml, and necessity for artificial respiration. These factors, reflecting the surgical situation and the severity of shock, essentially explain the mortality differences observed between the participating hospitals. PMID- 3323650 TI - [At the country estate of Prof. G.A. Zakhar'in]. PMID- 3323646 TI - The influence of nutrition on the systemic availability of drugs. Part II: Drug metabolism and renal excretion. AB - Plasma concentrations of an active compound vary between individuals and within a subject, even if the same drug dosage is used. These differences are related to variations of drug absorption from the gastrointestinal tract, of presystemic drug metabolism in the intestine or the liver, and of drug elimination from the systemic circulation, for instance by hepatic metabolism or renal excretion. All of these processes can be modified by nutrition. However it is necessary to emphasize the significance of the pharmaceutical formulation for variations of both drug absorption and elimination. The role of nutrition should receive adequate attention during therapeutic use of drugs as well as in drug disposition studies. Recent guidelines for the assessment of the systemic availability of drugs therefore do recommend nutrition to be controlled. PMID- 3323651 TI - [Cancer of the gallbladder]. PMID- 3323652 TI - [V.F. Voino-Iasenetskii--an outstanding surgeon of our time]. PMID- 3323653 TI - [History of the illnesses of I.A. Goncharov]. PMID- 3323654 TI - [Possibilities of intragastric laser therapy of septic ulcer]. PMID- 3323647 TI - Significance of polyploidy in megakaryocytes and other cells in health and tumor disease. AB - Polyploidy--the doubling of chromosome sets of cells caused by a stop of mitosis at different levels of the mitotic cycle--is a phenomenon widely observed in plants, protozoa, metazoa, and animals. In man obligate polyploid tissues are found in liver parenchyma, heart muscle cells, and bone marrow megakaryocytes. Polyploidy occurs mostly in stable and highly differentiated cells and tissues. Besides age, stimulation of proliferation and increased metabolic function lead to polyploidization in these organs. Aneuploidy, however, is exclusively found in tumor cells. Megakaryocyte differentiation and polyploidy are controlled by thrombopoietin-like activities, of which the loci of production are still unknown. Megakaryocytes are unique among polyploid mammal cells. On the precursor level they maintain their proliferative activity independently of the mammal's age. Once having entered the incomplete mitotic cycle they stop cytokinesis and develop into highly polyploid cells. Polyploidization of megakaryocytes is the basic requirement for establishing highly effective hemostasis in mammals, which exhibit blood circulation based on high blood pressures. Every polyploidization results in increased production of membrane materials with which the platelet becomes endowed. By shedding cytoplasmic fragments approximately 3000 platelets are set free from a 32c megakaryocyte, compared with only 16 nucleated thrombocytes by mitotic division. There is further evidence that the heterogeneity of platelets mostly depends on the different polyploidy classes of the megakaryocytes from which they are derived. Changes in the polyploidy pattern of megakaryocytes could therefore have consequences for hemostatic disorders in several human diseases, particularly in malignancy. PMID- 3323655 TI - [Anti-cardiolipin antibodies: a method of their detection and clinical significance]. PMID- 3323656 TI - [Computerized echotomography and telethermography in the diagnosis of diseases of the adrenal glands]. PMID- 3323657 TI - [M.V. Lomonosov on the preservation of health of Russian people]. PMID- 3323658 TI - [History of the clinical center of the first Moscow medical institute at Devich'e Pole]. PMID- 3323659 TI - [Soviet neuropathology over the past 70 years]. PMID- 3323660 TI - [Achievements in sports medicine]. PMID- 3323662 TI - [Toward new boundaries of public health]. PMID- 3323663 TI - [Development of internal medicine in the Ukrainian S.S.R. during the years of the Soviet rule]. PMID- 3323661 TI - [Advances in Soviet phthisiology over the past 70 years]. PMID- 3323664 TI - [The main stages and trends in the development of nephrology in the Ukraine (1917 1987)]. PMID- 3323665 TI - [Problems of the prevention of chronic internal diseases]. PMID- 3323666 TI - [Current problems of clinical hepatology]. PMID- 3323668 TI - [The past in the service of the future (on the 70th anniversary of the Great October Socialist Revolution)]. PMID- 3323667 TI - [Achievements of clinical lymphology]. PMID- 3323669 TI - [Current physiotherapy in the practice of an internist]. PMID- 3323670 TI - [Current status of radiological diagnosis and prospects in its development]. PMID- 3323671 TI - Urinary screening for alprazolam, triazolam, and their metabolites with the EMIT d.a.u. benzodiazepine metabolite assay. AB - Alprazolam (Xanax) and triazolam (Halcion) are relatively new triazolobenzodiazepines that are anxiolytic and hypnotic. This study assesses the reactivity of these drugs and their major metabolites in the EMIT d.a.u. benzodiazepine metabolite assay. Analytical standards of drugs and metabolites and urine specimens from patients receiving these drugs were analyzed by EMIT. Alprazolam and alpha-OH alprazolam gave an equivalent response to the EMIT low calibrator between 0.2 and 0.3 microgram/mL. Triazolam and alpha-OH triazolam were reactive between 0.3 and 0.5 microgram/mL. The assay was positive in 24 out of 27 random urine specimens from alprazolam-treated patients and in 8 out of 19 urine specimens from triazolam-treated patients. Positive urine results were confirmed by measuring the major urinary metabolites alpha-OH alprazolam and alpha-OH triazolam by HPLC. The study demonstrates that the EMIT assay can detect significant amounts of alprazolam and metabolites in the urine. The assay was negative in 58% of the specimens from individuals receiving triazolam, however. PMID- 3323672 TI - Repetition strain injury--a recent review. PMID- 3323673 TI - [Ultrasonic monitoring of patients treated for gynecologic cancer]. PMID- 3323675 TI - Role of calcium in the activation of neutrophils by leukocyte inhibitory factor (LIF). AB - We investigated the role of calcium in the activation of neutrophils (PMN) by the human lymphokine leukocyte inhibitory factor (LIF). Using the fluorescent probe fura 2, we demonstrated that LIF (1/2-2 units) induced a small but significant dose-dependent increase in intracellular calcium in the presence of both calcium containing (71 nM to 158 nM) and calcium-free (53 nM to 144 nM) buffer solutions. Thus, LIF is able to release calcium from both membrane channels and from intracellular stores. However, increases in intracellular calcium were not due to a release of Ca+2 from membrane stores, as shown by the inability of LIF to diminish fluorescence of the membrane-bound calcium probe chlortetracycline. In contrast to formyl-methionyl-leucyl-phenylalanine (fMLP), maximal calcium fluxes caused by LIF were of a much lower magnitude and not observed until 10-15 min after its application. The importance of calcium to the metabolic effects of LIF was demonstrated by the abilities of the calmodulin inhibitor trifluoroperazine (51.5% inhibition) and the extracellular calcium chelator EGTA (50.5% inhibition) to suppress LIF-mediated degranulation. The intracellular calcium chelator fura 2 also significantly inhibited LIF-mediated degranulation (61.8% inhibition). However, inhibition of the release of calcium from intracellular stores by TMB-8, had no effect on LIF-mediated degranulation. These data suggest that the ability of LIF to activate PMN is dependent on the availability of intracellular calcium and that this calcium is primarily derived from the slow influx of calcium from the extracellular pool. PMID- 3323674 TI - Long-term aspects of blood-material interaction. PMID- 3323676 TI - IL 1 and bacterial lipopolysaccharide increase the ability of human endothelial cells to bind peripheral blood monocytes. AB - Human endothelial cells (EC) exposed to human recombinant IL 1 and to bacterial lipopolysaccharide (LPS) demonstrated a time dependent increase in their ability to bind peripheral blood monocytes (M0). The enhancement of endothelial-M0 interactions was shown to represent a direct alteration of EC and was not explained by IL 1 and LPS affecting M0. Other experiments indicated that the enhancement represented an acceleration in EC binding of M0 suggesting that EC may play a role in initiating proinflammatory events prior to the recruitment of inflammatory cells by chemotactic peptides. PMID- 3323677 TI - Growth regulation in murine bone marrow-derived macrophages: effects of contaminating endotoxin in commercial GM-CSF and interleukin 4. PMID- 3323678 TI - A review of why and how we age: a defense of multifactorial aging. AB - Part 1: Longevity is optimized such that reproduction is maximized. Williams (Evolution, 11 (1957) 398-411) proposed pleiotropic genes with beneficial effects during youth and harmful effects at older ages. Because of environmental death (e.g. predation, disease, accidents), even a small increase in younger reproduction could outweigh a large harmful effect at older ages. Guthrie (Perspect. Biol. Med., 12 (1969) 313-324) and Kirkwood (Nature, 270 (1977) 301 304; New Sci., 81 (1979) 1040-1042; Physiological Ecology: An Evolutionary Approach, Blackwell, Oxford, 1981, pp. 165-189; Hum. Genet., 60 (1982) 101-121; Proc. R. Soc. Lond., B205 (1979) 531-546; Handbook of the Biology of Aging, 2nd Edn., Von Nostrand Reinhold New York, 1985, pp. 27-44) proposed that additional longevity requires a further investment of resources when young, thereby reducing the resources available for reproduction when young. The gene(s) controlling this partitioning of resources between younger and older reproduction are a good example of Williams's pleiotropic genes. Population biology provides a great deal of evidence of a tradeoff between younger and older reproduction. A "marginal longevity theorem" is proposed which states that for a population in equilibrium with its environment a marginal change in any gene affecting longevity should cause equal and opposite marginal changes in younger and older expected reproduction. Senescence is not irrelevant in the wild; rather, the amount of senescence in the wild results from a balance between its marginal costs to older reproduction and its associated marginal benefits in younger reproduction. Part 2: The wide variety of damage prevention processes in the body are subject to the problem of diminishing returns. Consequently, a broad spectrum of damage occurs in the body, varying in frequency, harmfulness, and ease of repair. The types of damage which are prevented or repaired tend to be more frequent, harmful, and easily prevented or repaired. In contrast, aging damage (which accumulates) consists of a large number of different types of damage which (when considered separately) are relatively infrequent, less harmful, and/or more difficult to repair. Only when these types of damage accumulate to become very numerous do they (when considered collectively) become significant. Since the selective advantages associated with senescence apply to all parts of the body, primary aging damage occurs in all tissues, cells, and subcellular organelles. The distribution of metabolic resources among the various damage repair and prevention processes is optimized.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323679 TI - A search for DNA alterations in the aging mammalian genome: an experimental strategy. AB - In order to experimentally test the hypothesis that at the basal level senescence is caused by instabilities in DNA, techniques are required that allow the sensitive detection, quantification and characterization of DNA damage and DNA sequence changes in various organs and tissues of naturally aging mammals. In this article a strategy is presented that should allow the analysis of DNA damage metabolism in aging mammals from the original changes in the chemical structure of DNA (DNA damages) via their processing (DNA repair) to the molecular endpoints in terms of gene mutations and DNA rearrangements. With respect to the detection of DNA damage, a short overview is provided of recently emerged biochemical and immunochemical methods that can be applied immediately to study the spectrum of DNA damages in various organs and tissues of aging animals or humans. By contrast, before one is able to study low frequency changes in DNA sequence organization in somatic tissues, formidable problems have yet to be overcome. This is mainly due to the fact that the scale of highly advanced recombinant DNA techniques recently developed is almost totally devoted to the analysis of heritable genetic factors. In order to be able to study low frequency changes in DNA sequence organization in somatic tissues, we have initiated experimental approaches based on recently emerged shuttle vector technology in combination with transgenic mice, and on new electrophoretic separation principles. These approaches and their potentialities for testing somatic mutation theories of aging are discussed. PMID- 3323680 TI - Endotoxin-induced liver injury in aged and subacutely hypervitaminotic A rats. AB - The plasma disappearance of endotoxin and endotoxin-induced hepatic injury were studied in two rat models: the aging rat and the subacutely hypervitaminotic A rat. The choice of these models was based on their respective association with a decreased or increased Kupffer cell endocytic activity. The half-life of endotoxin (E. coli O26: B6, phenol extracted) in plasma was significantly prolonged in aged rats as measured by both the Limulus assay (t1/2 = 2.1 +/- 0.1 h in 3-6-month-old, and 3.3 +/- 0.3 h in 24-36-month-old rats) and 51Cr-labeled endotoxin radioactivity assay (t1/2 = 5.3 +/- 0.3 h in 3-6-month old and 7.7 +/- 0.6 h in 24 36-month-old rats). In subacute hypervitaminosis A, the half-life of endotoxin was significantly decreased in the Limulus assay (t1/2 = 2.1 +/- 0.1 h in 3-6-month old and 1.4 +/- 0.2 h in subacutely hypervitaminotic A rats), but not in the radioactivity assay (t1/2 = 5.3 +/- 0.3 h in 3-6-month-old and 5.0 +/- 0.4 h in subacutely hypervitaminotic A rats). Hundred percent mortality was observed at a dose of 2 mg endotoxin/100 g body wt. in old rats, but not in young rats. Only 1 of 7 young subacutely hypervitaminotic A rats died following injection of this dose of endotoxin. The dose of endotoxin which caused only minimal parenchymal liver cell injury in young rats induced substantial parenchymal cell injury in old rats and subacutely hypervitaminotic A rats as determined by both histological and biochemical parameters. It is concluded that some basic characteristics of experimental animals, such as age and nutritional status, can dramatically influence the sensitivity to endotoxin and this is not necessarily correlated with the rate of endotoxin clearance. PMID- 3323682 TI - An Intelligent Display System for psychiatric education in primary care. AB - We have shown how new concepts for displaying knowledge and data may overcome some of the limitations of existing decisionmaking and educational aids and how they may improve psychiatric diagnosis and education. Elsewhere, we illustrated how these concepts can also be applied in redesigning ordinary textbooks in many other areas of medicine. Using such ideas to simplify decisionmaking without oversimplifying and without reducing physician participation may help us to cope with the enormous growth of information and knowledge. This is a problem common to many areas of medicine, one that demands new ways of thinking about how to simplify educational methods. PMID- 3323681 TI - The Diagnostic Screening Procedure Writer. A tool to develop individualized screening procedures. PMID- 3323683 TI - A computer consultation program for primary care physicians. Impact of decisionmaking model and explanation capability. PMID- 3323684 TI - Computer-based diagnostic decisionmaking. AB - The three decisionmaking aids described by the authors attack the generic problem of "see no evil, hear no evil, speak no evil"--improving the detection, diagnosis, and therapy of psychiatric disorders in the primary care setting. The three systems represent interventions at different steps in the process of providing appropriate care to psychiatric patients. The DSPW system of Robins and Marcus offers the potential of increasing the recognition of psychiatric disease in the physician's office. Politser's IDS program is representative of the sort of sophisticated microcomputer-based decisionmaking support tools that will become available to physicians in the not-too-distant future. Erdman's study of the impact of explanation capabilities on the acceptability of therapy recommending systems points out the need for careful scientific evaluations of features added to diagnostic and therapeutic systems. PMID- 3323685 TI - Aids to diagnostic decisionmaking. PMID- 3323687 TI - Application of decision analysis to mental health. PMID- 3323686 TI - A confidence profile analysis of the effectiveness of disulfiram in the treatment of chronic alcoholism. PMID- 3323688 TI - [Peroperative fine-needle puncture in the diagnosis of tumors]. PMID- 3323689 TI - [Von Willebrand's disease]. PMID- 3323690 TI - [Salmonella enteritidis bacteremia in a district hospital]. PMID- 3323692 TI - [Pain in the terminal patient]. PMID- 3323691 TI - [Portal hypertension in hepatic amyloidosis: relevance of the bibliographic references]. PMID- 3323693 TI - [Granulomatous giant-cell hypophysitis. Report of a case and review of the literature]. PMID- 3323695 TI - [Hypokalemic periodic paralysis]. PMID- 3323694 TI - [Usefulness and indications for temporal artery biopsy in the diagnosis of Horton's arteritis]. PMID- 3323696 TI - [Microorganisms isolated in 54 patients receiving bone marrow transplants and evaluation of their sensitivity to antimicrobial agents]. PMID- 3323697 TI - [It is possible to eradicate human hydatidosis from Spain?]. PMID- 3323698 TI - [Prevention of acute tubular necrosis in immediately after a kidney transplant]. PMID- 3323699 TI - [Multicentric reticulohistiocytosis: clinical and ultrastructural study of a case]. AB - A case of multicentric reticulohistiocytosis associated with bilateral Dupuytren's disease and xanthelasmas of the eyelids is described. Ultrastructural examination showed electron-dense intracytoplasmic granules, collagen entrapment and interdigitation of adjacent cytoplasmic membranes. PMID- 3323700 TI - [Hopf's acrokeratosis verruciformis. Communication of a non-familial case]. AB - A 46-years-old man with non familial acrokeratosis verruciformis of Hopf is described. We comment on the clinical and histopathological features of this rare dermatosis and the unsuccessful therapy with etretinate. PMID- 3323701 TI - [Cat-scratch disease. Histopathology of the primary skin lesion. Apropos of a case]. AB - We report a case of cat-scratch disease. The histological findings of the primary cutaneous lesion were characterized by the presence of necrotic areas surrounded by epithelioid cells in a palisade arrangement and an infiltrate composed of lymphoid cells, plasma cells and giant cells foreign body type. PMID- 3323702 TI - [Ito's hypomelanosis]. AB - Three additional cases of hypomelanosis of Ito (HI) are reported. HI is a syndrome manifested by irregular macular hypopigmented lesions, resembling the negative image of incontinentia pigmenti. Their cutaneous manifestations, associated abnormalities and the peculiar characteristics of the reported cases are discussed. PMID- 3323703 TI - [Hereditary angioedema: changes in serum levels of C4 in response to danazol]. AB - 12 patients (7 males and 5 females) suffering from the common form of HAE were included in the study protocol. All patients were older than 18 years. They were evaluated Cl INH, C4, Clq, Cls, C3, C5, C8, Bf, CH 50% and CIC. For the purpose of the study they were only considered Cl INH, C4, CH 50%, CIs and CIC levels. The rest of the complement components were among normal values. Data were recorded at day 0 and after 10 days on treatment with 400 mg/day of Danazol. Results were as follows: 50% of the patients had CIC when CH 50% values were below 120 U/ml., after treatment CIC disappeared and CH 50, Cls, C4 and Cl INH increased significatively. C4 seemed to increase more and quicker than Cl INH in terms of absolute values. We postulate that in the group of patients with CIC, the primary cause of the disease may be an alteration in C4 synthesis and that Cl INH may be lowered because of its consumption. We postulate that Danazol could act in these cases stimulating C4 synthesis independently or in accordance with Cl INH. PMID- 3323704 TI - [Familial lineal nevus of the connective tissue]. AB - A rare lineal variant of connective tissue nevus is described. Identical familial involvement was seen and no other associated clinical manifestations were observed. PMID- 3323706 TI - [Pseudo-atrophoderma colli and Gougerot-Carteaud confluent reticulated papillomatosis (shining atrophy)]. AB - The authors discuss about one case of pseudo-atrophoderma colli and its relationship with reticular and confluent papillomatosis of the skin. PMID- 3323705 TI - [Langerhans cell population in basal cell epitheliomas]. AB - The authors studied the distribution of Langerhans cells in 42 cases of basal cell epithelioma using monoclonals antibodies OKT6 and anti-HLA-Dr. The tumors are grouped in anatomopathologic subtypes. An increase of density of Langerhans cells is observed in the upper-tumoral epidermis. In the tissue tumour, the Langerhans cells are scarce, and we find a higher number of Langerhans cells in the peritumoral dermis. PMID- 3323707 TI - [Monoclonal antibodies in pigmented lesions]. AB - We have applied a battery of murine monoclonal antibodies (R-24, L-101, S-171) to the immunohistological diagnosis of 35 pigmented lesions. The results of our study allow us to conclude that: 1) The monoclonal antibody R-24 is a good marker of normal and neoplastic melanocytes, although some melanomas do not stain with this monoclonal antibody. The application of R-24 may contribute to the pathologic differential diagnosis of melanoma metastases. 2) The association of R 24+ and L-101+ staining is found in melanocytic nevus as well as in melanomas, and do not allow the differential diagnosis between them. 3) Stains with R-24, L 101 and S-171 are simultaneously positive only in melanomas, and with low frequency. PMID- 3323708 TI - [Changes in surface oligosaccharides in precancerous skin lesions]. AB - The authors studied 5 cases of the actinic keratoses, 3 cases of the leukoplakia and 2 cases of the cutaneous horn with the lectins specifics on the oligosaccharides of the keratinocyte's membrane. The patterns in each disease are described according to grade of differentiation. PMID- 3323709 TI - [Hansen I. Considerations on its development]. AB - The causes of the existence and importance of the I form are discussed, as were as its characteristics and the advantage of using the letter I to refer to this group. It is called initial because it is the way the disease first appears and due to its epidemiological value. The method used in the research carried out in the Department of Dermatology of the PIC on 444 patients with I form in the register of patients in the PIC is 16%. The average age ranged from 30 to 39 years old. Most of the patients had a positive immunology (65%) and a negative bacteriology (68%). 143 patients cured; 135 as I and 7 as T. PMID- 3323710 TI - [Delayed cutaneous response to different antigens in household contacts of leprosy patients and controls]. AB - The delayed type hypersensitivity (DTH) response to PPD, candidin and histoplasmin, and Mitsuda reaction (MR) in household contacts (HC) of multibacillary (HCM) and paucibacillary (HCP) leprosy patients, and non exposed controls was studied. Intradermal tests with 0.1 ml. of each antigen were performed and read after 48 hours. Late nodular reaction to ML (MR) was evaluated at the 21st day post-challenge. As we had formerly demonstrated, MR was depressed in HCM. Interestingly, this reaction was also depressed in HCP to a lesser magnitude. HCM had a lower DTH response to histoplasmin in relation to PPD and candidin when persons were simultaneously challenged with the three antigens. According to these results we conclude that: a), HCM have a depression in late lepromin reaction; b), in HCP the depression in MR is of a lower magnitude. We hypothesize that in healthy contacts of bacilliferous patients an active mechanism of immunosuppression to mycobacterial antigens may be produced. Alterations in the skin response to histoplasmin is discussed. PMID- 3323711 TI - [A premature aging syndrome hard to classify]. AB - In order to describe the observation of "premature aging", in a 20 year old woman, the clinical characteristics of other genodermatosis are reviewed, and the question of differential diagnosis and etiopathogenesis is raised concluding that these syndromes would have a continuous clinicopathological spectrum with various possibilities of manifestation. PMID- 3323712 TI - [Secondary subcutaneous nodular fat necrosis in a patient with pancreatic disease]. AB - A 73-year-old man had unusual acute, generalized panniculitis. The patient had elevation of serum amylase and lipase levels with signs or symptoms of pancreatic disease. Skin specimens from the lesions showed subcutaneous fat necrosis. PMID- 3323713 TI - A medical student at St Thomas's Hospital, 1801-1802. The Weekes family letters. PMID- 3323714 TI - [50 years ago: Nanna Svartz' appointment. The first female professor at a state university]. PMID- 3323715 TI - [Broms' drops--a home remedy for upset stomach and shivering (Swen Broms)]. PMID- 3323716 TI - [Neither stethoscope nor knife--but pen]. PMID- 3323717 TI - [A surgeon looks back: Reduced effectiveness despite increased resources. Yesterday's surgical procedures are unacceptable today]. PMID- 3323718 TI - [Manual suture versus/or mechanical suture from the German viewpoint]. AB - There is a definite increase in the application of stapled sutures in the gastrointestinal tract and the lung. This is due to high level of technical perfection of modern staplers whose preceding models were actually already developed at the beginning of this century. The introduction of circular staplers since approx. 1978/79 has resulted in a true breakthrough for gastrointestinal tract surgery. Thanks to these circular staplers surgeons have been especially innovative regarding the principles of reconstruction. Thus the procedures for the formation of substitute stomachs (Roux-Y and pouch, interposition and pouch) allow an unprecedented degree of standardization and offer new physiological perspectives. The use of circular staplers in the rectum is generally accepted. However, a recent development concerning manual sutures using medium-term absorbable suture material should not be disregarded. PMID- 3323719 TI - [The devil's advocate--commentary on sutures]. AB - The decision between hand suture or stapler was tested for the large bowel in randomized trials whereas retrospectively only in the upper gastrointestinal and respiratory tract. No clear difference was seen concerning patient's security and cost-time consumption. The stapler is more comfortable but the handsuture technique is still recommended. By the stapler anatomically very difficult anastomoses can be performed. Whether this is an advantage for the patient has to be tested because the technical progress may decrease physical function (incontinence!) and quality of life. In summary, the stapler, if applied critically, seems to be useful. PMID- 3323720 TI - [Recurrent gastroduodenal ulcer: controversies in primary and secondary interventions]. AB - Today controversial points of view in ulcer surgery are related to operative tactics. In principal resective and non-resective procedures and the type of anastomosis are discussed. Physiopathological criteria for decision are the effects on acid reduction, motility, intestinal acid exposure and entero-gastric reflux. Therapeutic security and the frequency of side effects are determined by these parameters. Postpyloric ulcer remains the domain of vagotomy. Gastric ulcers should be resected or treated by a combined procedure. In reconstructing the gastrointestinal tract the dualism of residual acid and postresectional reflux must be taken into account. PMID- 3323722 TI - [Diagnosis of meniscus damage]. AB - Often, the clinical signs of an injured meniscus are not characteristic. The most reliable diagnostic tool in evaluation of meniscal damage is arthroscopy (diagnostic accuracy greater than 95%). It provides precise information on the nature and extent of a meniscal tear. The advent of arthroscopic surgery has favoured the use of endoscopy even as a diagnostic procedure. Arthrography is abandoned except in cases where arthroscopic meniscectomy is not feasible. As additional non-invasive examinations, magnetic resonance and ultrasound may be used; however, both methods are still not generally accepted and do not allow diagnosis and therapy as a one step procedure as does arthroscopy. PMID- 3323721 TI - [Biomedical and clinimetric approaches in determining the causes of perioperative risk: developing a German ASA classification]. AB - Perioperative risk research with biomedical (biochemical, physiological) methods must grow up as a main topic in surgical research. However, operative risk has also to be analysed with methods of clinimetrics, such as formal (objective) decision making and epidemiology. Only by this way a convincing practical dimension is added to basic scientific statements. ASA-classification of the preoperative physical status is a global index for estimating the operative risk. It contains objective findings, subjective impressions and the final clinical judgement. For this reason it is so flexible. For a multicentre trial on perioperative risk and histamine an empirical index was constructed using both the ASA-classification and the Mannheim-Munich risk check list. PMID- 3323723 TI - [Open versus arthroscopic meniscectomy: on meniscectomy by arthrotomy]. AB - Articles in the general press, radio and television give the impression that the open operation method for the meniscus is obsolete and passe. With a row of arguments such as ambulant treatment, lower costs, reduced morbidity and shorter operation time etc. attempts are made to demonstrate its advantages. There are comprehensive opinions on each individual point and results from the literature are compared with those of a personal postexamination about open meniscal resection. It can definitely be shown, however, that the postoperative effusion rate by open operation is much lower than with the arthroscopic method. It must be stressed that the arthroscopic operation may cause considerable damage particularly in the cartilage of the joints. It has been determined that for the arthroscopic operation great experience and technical ability is necessary. If these and adequate technical equipment are not guaranteed, then the open method is regarded as the far superior. PMID- 3323724 TI - [Perioperative radiotherapy of bone and soft tissue tumors]. AB - The goal of pre- and/or postoperative irradiation of soft tissue sarcoma combined with conservative surgery is to reduce the local failure rate comparable to that of radical surgery but with substantial less morbidity and loss of function; this is realized, so that local control and survival rates following combined therapy are comparable to those achieved by radical surgery alone. The high effect of fast neutrons is mentioned especially in large tumors. In osteosarcoma fast neutron therapy may give better chance for inactivation of tumor cells resistant against chemotherapy. PMID- 3323725 TI - [Status of organ transplantation of the kidney, liver and small intestine: aspects of biological and artificial organ replacement]. AB - Substitution of all functions of an organ failure is characteristic for organ transplantation, whilst artificial organ supply is confined to some essential functions. But technical organ substitution would be unlimited in performance, in contrast to organ transplantation, which depends on availability of human organs. Thus, according to the example in substitution of renal failure, those, organ transplantation and technical organ supply have to be worked out furthermore in other organ systems, thus in liver and small intestine substitution. In future, technical supply will change to biotechnical methods and organ grafting will develop to a long lasting therapeutic procedure. PMID- 3323726 TI - [Heart transplantation--status and perspectives]. AB - Transplantation of the heart (HTx) has become a realistic procedure in the treatment of terminal cardiac failure. However, several problems remain and are to be discussed on the basis of our experience in 160 cases of HTx. A dramatic widening of indications for HTx presently is not to be expected while the lack of donor organs is magnified by the growing transplantation frequency. This bottle neck only can be lessened by mobilization of all organ sources. Longterm survival rate in HTx patients seems to stabilize at well over 70%. Persisting mortality and morbidity of HTx are the result of imperfect recognition and treatment of rejection as well as infection. The use of circulatory aids in patients expecting HTx and in those with a failing transplant is of growing importance at the same time posing the problem of high urgency in patients thus instrumented. It is likely that the intermediate-term use of the totally implantable artificial heart will lessen this dilemma. Costs and efforts of cardiac transplantation are considerable. A plea therefore is made for concentration of organ transplantations of all types in special centers. PMID- 3323727 TI - [Alloplasty or transplantation in bone, cartilage and joint reconstruction]. AB - Progress, problems, indication, and trends in total joint replacement are presented. The facilities of bone and osteochondral auto- and allografts are considered including vascularized bone transplantation and banking procedures. PMID- 3323728 TI - [Skin transplantation or artificial skin replacement?]. AB - The closure of big skin defects is still a problem. Autologous skin is not unlimitedly available. Different skin substitutes are invented and available. All of them are suffering one problem. They can only be used for temporary closure. Even the immunological progress can not solve the problem of skin shortage. An interesting artificial skin was designed by Burke and Yannas. They designed an artificial dermis consisting of bovine collagen and chondroitin-6-sulfate. This is a fascinating possibility for solving the skin shortage problem especially in burn cases. But even this dermis needs autologous epithelial cells to create a complete skin coverage. So till now a complete skin substitute without autologous material seems not to be available. PMID- 3323731 TI - [The special problem of the replacement operation in cement-free prostheses]. AB - The repeated use of bone cement in revision arthroplasty of the hip presents numerous problems. Consequently, we have favored a cementless implant, the so called isoeleastic total hip endoprosthesis, and have filled the often extremely large bone defects with autologous cancellous bone. Using this method for the past 5 years, we have inserted a total of 72 cementless isoelastic hip prosthesis in 33 cases of loosening of various prosthesis models and in 39 cases of femoral stem fracture. Aside from one late infection, no renewed loosenings have been observed. PMID- 3323730 TI - [Morphology of the implant site in cemented and uncemented joint implants]. AB - After the insertion of a joint endoprosthesis a healing process is initiated which is comparable to the fracture healing. Thus, a border zone is built up against the implant, being composed of lining cells, connective tissue, vessels, bone marrow and bone. The bone of the implant bed is subjected to a remodeling in order to adapt its structure to the change of the biomechanic stresses. The tissue of the implant bed may react to infection, degradation or wear of the materials and mechanical instability of the fixation as well. The characteristic feature of this reaction is cell and tissue proliferation which causes bone resorption and, possibly, loosening of the implant. PMID- 3323729 TI - [Surgical therapy of chronic pancreatitis: the devil's advocate commentary]. AB - Chronic pancreatitis is despite increasing incidence a rare disease. Studies about its natural history are sparse. Undisputed indication for operative intervention are local complications. Intractable pain without such local complications should only seldom be an indication for pancreatic surgery. Since very different surgical procedures are performed in similar anatomical situations randomized prospective studies are needed. The problems of controlled studies in surgery are discussed. PMID- 3323732 TI - [Radical surgery and/or continence preservation in rectal cancer]. AB - Low anterior resection has been compared with abdominoperineal excision in the treatment of carcinoma of the upper and middle third of the rectum concerning operative mortality, morbidity, 5-year survival rates, local recurrences and life quality. There is no evidence that abdominoperineal excision is preferable. On the contrary in terms of recurrence and possible additive radiation low anterior resection seems to be the better choice. Carcinoma located between the middle and distal third of the rectum should be treated with peranal anastomosis and the long-term results have to be awaited. PMID- 3323733 TI - [Local therapy of rectal cancer]. AB - Curative local excision or segmental resection can be performed in 10-15% of patients with rectal carcinoma, avoiding colostomy. Local treatment of early, microinvasive carcinoma is the procedure of choice. The most important problem is patient selection. With the endosonographic assessment of the tumor invasion, preoperative staging is possible with high accuracy. In a small series 10 patients were found to be tumor-free 4-46 months after local treatment. PMID- 3323735 TI - [Acute lung failure--a critical analysis]. AB - The Adult Respiratory Distress Syndrome (ARDS) is a clinical syndrome with acute progressive lung function deterioration based on increased pulmonary permeability and caused mostly by non-pulmonary lesions (like sepsis or polytrauma), occasionally also by pulmonary diseases (like pneumonia) or intoxications (e.g. by paraquat). In the complex, interactive pathomechanisms (e.g. complement activation, stimulation of the arachidonate metabolism) with release of numerous damaging mediators the massive accumulation of neutrophils in the lung plays an important role. PMID- 3323734 TI - [Pathophysiology, clinical aspects and rational diagnosis of gastroesophageal reflux disease and axial hiatal hernia]. AB - Low pressure or inappropriate relaxation of the lower esophageal sphincter, disturbances in esophageal peristalsis and delayed gastric emptying are the most important pathogenetic factors of reflux disease. In general, retrosternal and also epigastric and pharyngeal burning or pain are the leading symptoms, but in mild disease eructation may become the major complaint. Diagnosis is usually made on the basis of a typical history and the results of endoscopy. 24-h-pH-recording is indicated in inconclusive endoscopy, chest pain of unknown origin and preoperative evaluation. Manometry may be indicated to exclude systemic sclerosis. PMID- 3323736 TI - [Esophagitis--hiatal hernia--indications and choice of procedure: fundoplication]. AB - The fundoplication, described by Nissen in 1956, is still an excellent and the most frequently applied antireflux operation in cases of refluxesophagitis. Accurate preoperative evaluation and subtile operative technique are imperative, however. Typical postoperative syndromes will be discussed. Details of the results will be given with particular regard to 214 fundoplications carried out on our own patients: mortality rate 0%, recurrence rate 4.7%, content with the result of the operation 88%. PMID- 3323738 TI - [Angiographic imaging of blood vessels of the lower leg in acute ischemia: comparison of intravenous DSA and intra-arterial DSA]. AB - In patients with acute lower leg ischemia i.v. DSA was compared with i.a. DSA or fine needle injection. The distal flow off was only demonstrated in i.a. DSA, the plantar arch only with fine needle injection. I.v. DSA is limited to the demonstration of the popliteal artery. Consequently fine needle injection should be used in diagnosis of acute peripheral ischemia. PMID- 3323737 TI - [Radical treatment and prognosis: results of a multicenter surgical-pathologic TNM stomach cancer study]. AB - A multicentre observational study with 22 departments of surgery and 14 departments of pathology was started on April 1st, 1982 to validate TNM classification for patients with gastric carcinoma. 1417 patients with histologically proven gastric cancer entered the study. Follow-up is now 3-5 years. A subgroup of 138 patients (age under 65 years, no metastases M 0, curative resection R 0, only T 2-T 4-carcinomas and tumors situated only in the middle and lower third of the stomach) was studied. 65 had subtotal, 73 total resection. The 3 to 5 years cumulative survival time was at least not worse with subtotal in comparison to total resection. PMID- 3323739 TI - [Primary and secondary chest wall tumors from the pathologist's viewpoint]. AB - Fibrous dysplasia (20%), metastases (16%) and chondrosarcoma (11%) are the most common bone tumors of the chest wall. Except lipoma, primary lesions of the soft tissue of the chest occur rarely as well. The Askin- and Abrikosoff tumor, elastofibroma dorsi and desmoid can be seen as typical exceptions. With respect to the histogenetic classification of undifferentiated sarcomas and thoracic metastases (f.e. prostatic carcinomas or mesotheliomas) an intimate cooperation of surgeons and pathologists as well as modern immunohistochemical investigations are required. PMID- 3323740 TI - [Development of the mechanical suture and comparison with the manual suture in surgery]. AB - Mechanical sutures in surgery were first used in 1908 by Hultl. Since then they have found a large field of application in thoracic and abdominal surgery because of their ease in handling and consequent reduction of duration of operation, as well as reduction of contamination from hollow organs. Safety, diminished tissue trauma and early function of anastomotic continuity are other advantages that recommend the use of staplers over hand sutures. PMID- 3323741 TI - [Manual suture versus/or mechanical suture from the Austrian viewpoint]. AB - A general inquiry was made at surgical units and university clinics in Austria about the anastomosis techniques used between 1980 to 1985. The result was that in 90.3% the suture was made by hand and in 9.7% by machine. The first mentioned was performed as double row inverting suture by 66% of our surgeons, and only in 30% as an all-layer suture. The stapler-technique was mostly preferred for the oesophago-jejunostomy and the high and lower resection of the rectum. A leakage of the suture line was observed in 3.9% after sewing by hand and in 6.3% after stapling. The total lethality finally was 1.4% for hand made suture and 1.8% for apparative suture. PMID- 3323742 TI - [Manual suture versus/or mechanical suture (from the Italian viewpoint)]. AB - Mechanical suturing has become widespread in Italy in recent years, especially for anastomoses between the large intestines and the rectum and between the esophagus and the stomach or small intestine; many chest surgeons also use this type of suture. Basically, mechanical suturing is preferred for anastomoses for which the manual technique has proved difficult, for example those low in the pelvis or high up in the chest. Few surgeons use mechanical suturing at sites where it is easy to suture by hand. Overall, experience with mechanical suturing has been positive, mainly because the number of conservative resections performed for rectal carcinoma has increased while the frequency of the so-called Miles operation has declined in recent years. Our own experience with mechanical suturing has been collected in the construction of colorectal (235 with mechanical suturing out of a total of 592), ileorectal and ileoanal anastomoses (45 ileorectal and 12 ileoanal anastomoses with mechanical suturing out of a total of 155 surgical operations). PMID- 3323743 TI - [Stapler versus manual anastomosis in gastrointestinal surgery]. AB - The comparative effectiveness of manual and auto-sutured anastomoses after total gastrectomy (107 cases), low anterior rectal resection (100 cases) and right hemicolectomy (34 cases) is studied. In the stapled series the incidence of anastomotic leakage was somewhat less, although benign stenosis occurred more frequently than with hand-sutured anastomoses. However, this could not be statistically demonstrated. In the authors' view, the main advantages of the use of staplers are the shortening of operating time and the lessening of septic steps. PMID- 3323744 TI - [A skull with deformed nasal structure from the 17th century]. AB - A skull from the baroque period is presented which attracted our attention because of its round piriform aperture and enlarged nasomaxillary bones. The deformity is very probably due to large nasal polyps. Some medical documents in literature and an oil-painting with the portrait of an old woman with a bloated nose from the 17th century show that this type of nasal disease was well known three hundred years ago. PMID- 3323745 TI - Sutureless bowel anastomosis using Nd:YAG laser. AB - Small bowel anastomoses were performed without sutures by using the Nd:YAG laser to produce welded enterotomies. Optimal energy levels for contact and noncontact laser were determined. Anastomoses produced using five target energy levels between 100 and 500 J were examined. Short-term anastomotic strength of these enterotomies was measured 1 min after the welding. Bursting pressure of the laser welded enterotomies was compared to the bursting pressure of traditional two layer, inverting, interrupted sutured bowel anastomoses. The overall mean bursting pressure of non-contact-welded enterotomies was 50.6 mmHg. Optimal laser settings determined in this initial phase were then used to produce anastomoses in rabbits which are recovered postoperatively for 1 or 2 weeks in order to examine long-term viability and integrity of the anastomoses. All chronic rabbit preparations recovered without complication. The mean bursting pressure was 200 mmHg, not significantly different from that of uncut bowel or two-layer sutured anastomosis. PMID- 3323746 TI - [Spontaneous course of metachronous metastases following curative intervention for colonic cancer: a total review]. AB - The rate of metachronous metastases after curative surgery because of colonic carcinomas was 17% (n = 70). Women (20%) developed metastases more frequently than men (13%). Procedures in third to ninth decennium were followed in decreasing frequency (100 to 8.7%) by metachronous metastases. Primary tumors located in coecum showed by far the strongest tendency to recurrent metastatic disease (29%). Rate of metastases after curative surgery in tumorstage T 1-3 N0M0 was 9%, after stage T4 N0 M0 17% and after resection of tumors with lymph node involvement 32%. Liver metastases arose late when originating from primary in early tumorstage. Survival after diagnosis of liver metastases decreased with extension of primary tumor. These results give some aspects to formation of high risk-groups to be followed-up according to a special program postoperatively. PMID- 3323747 TI - [Cardiovascular complications of gastroenterologic endoscopy]. AB - Upper gastrointestinal (GI) tract endoscopies are associated with a cardiovascular complication rate of 0.009% to 0.4%, which may be considered rare events. The endoscopy-associated lethality due to cardiovascular accidents ranges from 0.005% to 0.07%. Sinus tachycardia represents the most frequent cardiovascular finding, and vagolytic premedication often plays a causal role. Such accelerated heart rates may predispose to myocardial ischemia due to an augmented cardiac work load. Electrocardiographic alterations of the ST-T segment have been observed in 4% to 46% of upper GI tract endoscopy patients. Severe arrhythmias are rare phenomena. The cardiovascular risk of colonoscopy and laparoscopy appears to be even smaller as compared to gastroscopy. Advanced age, severe coronary heart disease and cor pulmonale may be useful indicants to identify a high risk patient subgroup. PMID- 3323748 TI - [Gallbladder tuberculosis. Review and case report of a patient with advanced renal failure]. AB - Tuberculosis of the gallbladder is a rare disease, which mostly is diagnosed by histological examination after cholecystectomy. Less than 60 cases are published. Four different manifestations are described by Weitz: The gallbladder infection by miliary tuberculosis in children or in adults, the disseminated abdominal tuberculosis including the biliary tract or the isolated infection of the gallbladder. Our case report outlines the progress of an isolated tuberculosis of the gallbladder wall in a patient with chronic renal failure. The uremic immunological anergy may have favoured the infection. PMID- 3323749 TI - [Dietary treatment following gastrectomy]. AB - A number of nutritional complications occur after total gastrectomy, such as protein malnutrition, dumping syndrome, diarrhoea, weight loss, iron deficiency and osteomalacia. Lack of appetite, absence of the sensation of hunger, oesophagitis, dysphagia and the limited capacity for food in most cases are the causes of suboptimal dietary intake after total gastrectomy. To avoid underweight and symptoms after gastrectomy it is necessary that all patients are seen soon after operation and at regular intervals thereafter not only by physicians but by dietitians additionally. PMID- 3323750 TI - Persisting Mycobacterium leprae among THELEP trial patients in Bamako and Chingleput. Subcommittee on Clinical Trials of the Chemotherapy of Leprosy (THELEP) Scientific Working Group of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases. PMID- 3323751 TI - A controlled therapeutic trial in paucibacillary leprosy comparing a single dose of rifampicin followed by 1 year of daily dapsone with 10 weekly doses of rifampicin. PMID- 3323752 TI - Studies of reactivity of some Sri Lankan population groups to antigens of Mycobacterium leprae. III. The post-lepromin test scar in healthy populations in Sri Lanka. PMID- 3323753 TI - The killing of Mycobacterium leprae in mice by various dietary concentrations of clofazimine and ethionamide. PMID- 3323754 TI - Endothelial cell bacillation in lepromatous leprosy: a case report. PMID- 3323755 TI - Sterol and phospholipid acyl chain alterations in Saccharomyces cerevisiae secretion mutants as a function of temperature stress. AB - Analyses of free sterol, steryl ester and fatty acid components from yeast secretion mutants indicated that free and esterified sterol remained relatively constant over a growth range of 24 C to 34 C. The saturated fatty acid components (16:0 and 18:0) increased while the unsaturated fatty acids (16:1 and 18:1) decreased as the growth temperature increased. In secretory mutants, fatty acid composition changes are more pronounced than in the wild-type strain. A shift toward increased saturated and decreased unsaturated fatty acid was observed when cells were subjected to a 2-hr temperature upshift to 37 C. Steady-state fluorescence anisotropy data indicated that modifications to the lipid component of yeast plasma membrane produced lipid thermotropic transitions that were 3 C to 6 C higher in yeast cells subjected to thermal stress. PMID- 3323756 TI - MRI CT, and plain film appearance of anterior spina bifida. AB - Anterior spina bifida or butterfly vertebral body has a well known and characteristic appearance on plain film and CT. Its appearance on magnetic resonance imaging also appears to be characteristic and should not be mistaken for more serious abnormalities. PMID- 3323757 TI - Passive smoking and adverse health effects. PMID- 3323758 TI - Plasmapheresis--a therapeutic tool in neurological disorders. PMID- 3323759 TI - T lymphocyte surface molecules: structure and function. PMID- 3323760 TI - Progress in the histochemistry of elastic fibres. PMID- 3323761 TI - The development of luminescence immunoassays. PMID- 3323763 TI - An improved multipoint technique for the routine microbiological examination of urine specimens. PMID- 3323762 TI - Hypothesis supporting the primary role of increased platelet activity in atherosclerosis and coronary heart disease. PMID- 3323764 TI - Dot-blot purification of the Kidd blood group antigen. PMID- 3323765 TI - An anthropological perspective on the sudden infant death syndrome (SIDS): the role of parental breathing cues and speech breathing adaptations. PMID- 3323767 TI - Fetal heart rate measurement during maternal exercise--avoidance of artifact. AB - The purpose of this study was to investigate the possibility that motion artifact may override the recording of fetal heart rate (FHR) with Doppler ultrasound fetal monitors during maternal exercise on cycle ergometers and treadmills, and to test the efficacy of two-dimensional ultrasound directed M-mode echocardiographs for determining FHR during maternal treadmill exercise. Four pregnant women (26 to 30 yr, means = 28, gestational age = 28 to 34 wk) pedaled a cycle ergometer at 25 to 50 W, while a second group (N = 4) (24 to 36 yr, means = 29, gestational age = 30 to 37 wk) walked on a treadmill at either 1.5 or 2.0 mph. Fetal monitor recordings (Hewlett-Packard 8040A) were consistent with pedal rate in the range of 50 to 70 rpm and with stepping rate in the range of 70 to 76 steps per min at 1.5 mph and 100 to 106 steps per min at 2.0 mph on the treadmill. Actual mean FHRs (audible signal from fetal monitor) were in the normal range [150.5 +/- 10.25 bpm (cycle ergometer) and 148.8 +/- 2.3 bpm (treadmill)]. In a separate session, the cycle ergometer group walked on a treadmill at a maternal heart rate of 140 bpm while FHR was determined by two dimensional ultrasound directed M-mode echocardiographs. Off-line analysis of fetal cardiac cycle time (clinical graphics analyzer) allowed accurate FHR measurements which were not confounded by motion artifact. Mean FHR during maternal treadmill exercise (158.0 +/- 12.0 bpm) was not different (P greater than 0.05) when compared to pre-exercise standing (140 +/- 3.6) and also during the post-exercise period (sitting) (151 +/- 6.5) compared to the sitting pre exercise measurements (147 +/- 8.2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323766 TI - Weight regulation practices in athletes: analysis of metabolic and health effects. AB - Athletes engage in a number of dietary and weight control practices which may influence metabolism, health, and performance. This paper reviews the literature on these factors with special emphasis on athletes who show large, frequent, and rapid fluctuations in weight (wrestlers) and athletes who maintain low weight and low percent body fat (e.g., distance runners, gymnasts, and figure skaters). A theory is presented which relates these weight patterns and the accompanying dietary habits to changes in body composition, metabolism, metabolic activity of adipose tissue, and the distribution of body fat. Changes in these physiological variables may be manifested in enhanced food efficiency (weight as a function of caloric intake) as the body seeks to protect and replenish its energy stores. This may explain the surprisingly low caloric intakes of some athletes. The health status of the athlete is a concern in this regard because there may be changes in fat distribution, risk factors for cardiovascular disease, and hormonal factors associated with reproductive functioning in both females and males. Amenorrhea in female athletes may be mediated at least in part by regional fat distribution; depletion of femoral fat depots (lactational energy reserves) may be the stimulus for cessation or disruption of menses. PMID- 3323768 TI - [Schistosoma mekongi bilharziasis along the Mekong River and its affluents, the Mun and Tonle Sap Rivers. General review]. AB - First cases of Schistosomiasis in the South East Asian were described 30 years ago but the existence of a particular species in this area: Schistosoma mekongi has been discussed for a long time. During the last few years, emigration of Laotian and Cambodian people allowed a better knowledge of this affection. Through recent literature the authors make a restatement of the epidemiology, biology and treatment of this disease. PMID- 3323769 TI - [Filarial multiparasitism in the savannah zone in Burkina Faso]. AB - From june 1985 to may 1986, 1.209 consulting patients were examined for filariae in skin and blood. Among patients with microfilariae 17% had associations of filarial infections. The multiple infections rate seemed more important in man than woman and increased with age. The results showed that associations were not due to chance only. The frequencies of associations between Dipetalonema perstans and Onchocerca volvulus at one hand, Dipetalonema perstans and Wuchereria bancrofti on the other hand were highly significant. Symptoms of filarial associations were studied and subsequent therapeutic attitude discussed. PMID- 3323770 TI - [Pregnancy and blood parasite indices of Plasmodium falciparum (results of a study in Bangui (Central African Republic))]. AB - In Bangui (C.A.R.), a comparative survey about infestation by Plasmodium falciparum was carried out in 250 pregnant women and 250 non-pregnant women. Both groups were matched by age, and none of them had taken any chemoprophylaxis or anti malarial treatment for the month before the survey. Parasitic indices were significantly higher in pregnant women, and higher in primigravidae than multigravidae; the highest malarial indices were noted in the 15/20 age group. On the contrary, no significant differences were found according to the three first months of pregnancy. As a final result of this survey, the authors recommend a regular anti malarial chemoprophylaxis for pregnant women, and particularly for primigravidae, as they all constitute a group at high risk versus malarial infestation and considering the consequential effects on foetus. PMID- 3323771 TI - Progression of the zone of injury in experimental nerve injuries. AB - The extent of injury a nerve sustains after different mechanisms of injury is often difficult to determine at the time of injury. This study was designed to define the zone of injury for avulsed and transected nerves in an experimental animal model. We were able to demonstrate a progressive zone of injury in the avulsed nerves which would preclude primary neurorrhaphy while the zone of injury in a transected nerve tended to decrease during the three week period of observation. PMID- 3323773 TI - Customized prefabricated neovascularized free flaps. AB - Neovascularization of tissues into which a vascular pedicle has been implanted can result in the creation of a flap, or free flap, which is supported by those vessels as a neopedicle. This phenomenon allows the construction of customized prefabricated free flaps from tissue without restriction to naturally occurring vascular territories. PMID- 3323772 TI - Experimental vascularized bone allografting. AB - Presented here is a compendium of studies investigating the fate of vascularized bone allografts. The first set of experiments employ the posterior rib graft in two canine models. The rib-to-mandible model was used to evaluate the rejection phenomena of vascularized bone allografts in an outbred dog model. This ascertained the time course of rejection and histological characteristics of the grafts. Immunosuppression of the graft recipients was attempted with azathioprine and cyclosporine. The results demonstrated that azathioprine was not an effective immunosuppressant, whereas cyclosporine resulted in survival of cortical osteons. The use of the vascularized rib allograft, with and without azathioprine, to bridge the defect in the dog femur was met with failure. Further studies employed a genetically defined rat model to determine the effect of different histocompatibilities on the survival of vascularized knee allografts. Grafts were transplanted from Lewis rats to syngeneic Lewis rats as isografts and to Fischer 344 rats (F-344) and Brown-Norway rats (BN) as allografts. Grafts across a major histocompatibility barrier to BN were rejected by 7 days, whereas grafts across a weak histocompatibility barrier to F-344 were rejected more slowly. The use of cyclosporine in this model abrogated the rejection response when administered to both groups continuously. However, a short course of cyclosporine was effective in preventing rejection in the F-344 animals. Efforts to induce tolerance by blood transfusions, from the donor strain or from a third-party donor, were not effective in preventing rejection. PMID- 3323774 TI - Review of tissue welding applications in neurosurgery. AB - New technical advances have made feasible the utilization of low-powered laser energy for constructive applications. Experience with laser bonding of blood vessels, peripheral nerves, and dura has been obtained. These studies are summarized, and the future potential of laser bonding of tissues of the central nervous system is discussed. PMID- 3323775 TI - Dextropropoxyphene overdose. Epidemiology, clinical presentation and management. AB - This paper comprehensively reviews the worldwide situation regarding acute overdosage of dextropropoxyphene (propoxyphene). The changing epidemiology of this type of poisoning over the last 20 years is described with discussion of concurrent trends and, in particular, the effects of different preventive measures adopted in various countries. The clinical pharmacology of dextropropoxyphene relevant to the clinical toxic effects resulting from acute overdosage is described, and the management is detailed. In particular, the importance of early diagnosis and treatment is stressed in view of the potentially lethal complications that may suddenly occur with this poisoning. Recommendations for the correct use of the specific narcotic antagonist, naloxone, are made, together with other intensive supportive measures. As dextropropoxyphene is frequently taken together with other toxic agents, the concomitant effects of alcohol and sedative drugs are described and the treatment of paracetamol (acetaminophen) in combination with dextropropoxyphene is emphasised. The most effective preventive measures for the future are suggested, but caution is advised regarding the prescription for 'at risk' patients of alternative analgesics, which may be no safer in overdosage. PMID- 3323777 TI - Immunochemical techniques. Part K. In vitro models of B and T cell functions and lymphoid cell receptors. PMID- 3323776 TI - The risk-benefit assessment of antidepressant drugs. AB - Antidepressant drugs in common use are reviewed in terms of their risks and benefits. A simple classification divides these into tricyclic antidepressants, monoamine oxidase inhibitors and second generation antidepressants. Risks may arise from the correct use of an antidepressant, from its incorrect or inappropriate use, or due to its failure to reverse the depression. The greatest risk is to leave the depression untreated. Risks due to adverse drug effects are generally predictable but in some cases are unexpected and have led to the withdrawal of the drug from the market. Assessing the benefits of antidepressant drugs is more difficult. Rating scales can be used in this context and the fact that the majority of antidepressant drugs have a similar degree of efficacy serves to emphasise the importance of making a risk-benefit assessment of each drug. This has been presented for the more widely used drugs. Safety in overdose is a particularly important benefit. The ideal antidepressant should specifically reverse depressive illness without toxic effects. Although no drug at present measures up to this it is clear that antidepressants should be prescribed, as their benefits outweigh their risks. PMID- 3323778 TI - Stimulation of lymphocytes with proteolytic enzymes. PMID- 3323779 TI - Enzyme immunoassay using a monoclonal antibody against 5-bromo-2-deoxyuridine for the assessment of lymphoid cell proliferation. PMID- 3323780 TI - Splenic focus assay. PMID- 3323781 TI - Direct and indirect plaque assays. PMID- 3323782 TI - Protein A plaque assay. PMID- 3323783 TI - Poly(L-lysine) plaque assay for the measurement of antigen-activated human B lymphocytes. PMID- 3323784 TI - Growth of antibody-producing cell clones in microcultures. PMID- 3323785 TI - Culture in liquid medium of single, hapten-specific, antibody-producing B lymphocytes. PMID- 3323786 TI - T cell mitogens and polyclonal B cell activators. PMID- 3323787 TI - Production of antibodies in vitro in cultures of murine lymphocytes. PMID- 3323788 TI - In vitro production of antibody in cultures of human peripheral blood lymphocytes. PMID- 3323790 TI - Strategies for the isolation of cell surface receptors of lymphoid cells. PMID- 3323789 TI - Generation of terminal deoxynucleotidyltransferase-positive lymphoid precursor cells in vitro. PMID- 3323791 TI - Nonpermeant covalent labels in analytical studies of lymphocyte membrane proteins. PMID- 3323792 TI - Human complement receptor type 3. PMID- 3323793 TI - Antigen-specific T cell receptors. PMID- 3323794 TI - Lymphoid receptors for transferrin. PMID- 3323795 TI - Isolation of genes encoding proteins of immunological importance. PMID- 3323796 TI - Molecular genetics of mammalian cells. Dedicated to the memory of Menashe Marcus. PMID- 3323797 TI - Use of tritium-labeled precursors to select mutants. PMID- 3323798 TI - Use of the CAT reporter gene for optimization of gene transfer into eukaryotic cells. PMID- 3323799 TI - Colony screening of genomic cosmid libraries. PMID- 3323800 TI - Recombinant DNA. Part D. Dedicated to Nathan O. Kaplan, June 15, 1917-April 15, 1986. PMID- 3323801 TI - pKUN, vectors for the separate production of both DNA strands of recombinant plasmids. PMID- 3323802 TI - Site-directed chromosomal rearrangements in yeast. PMID- 3323803 TI - Production of single-stranded plasmid DNA. PMID- 3323804 TI - Short homopeptide leader sequences enhanced production of human proinsulin in Escherichia coli. PMID- 3323805 TI - Expression of bovine growth hormone derivatives in Escherichia coli and the use of the derivatives to produce natural sequence growth hormone by cathepsin C cleavage. PMID- 3323806 TI - Synthesis and sequence-specific proteolysis of hybrid proteins produced in Escherichia coli. PMID- 3323807 TI - Expression and secretion of foreign proteins in Escherichia coli. PMID- 3323808 TI - Engineering for protein secretion in gram-positive bacteria. PMID- 3323809 TI - Use of open reading frame expression vectors. PMID- 3323810 TI - 5-Fluoroorotic acid as a selective agent in yeast molecular genetics. AB - 5-FOA is an extremely useful reagent for the selection of Ura- cells amid a population of Ura+ cells. The selection is effective in transformation and recombination studies where loss of URA3+ is desired. A new plasmid shuffling procedure based on the 5-FOAR selection permits the recovery of conditional lethal mutations in cloned genes that encode vital functions. PMID- 3323811 TI - Oligonucleotide-directed mutagenesis: a simple method using two oligonucleotide primers and a single-stranded DNA template. AB - The important features of the protocol described here are as follows: First, the procedure consists of a few simple steps and results in a reasonably high frequency of mutagenesis. Second, using two primers, there is no need to isolate covalently closed double-stranded molecules as in our previous method. Third, the use of vectors derived from single-stranded phage facilitates template preparation, mutagenesis efficiency, screening, and DNA sequencing. Fourth, the same basic steps can be directly applied when using the single-stranded pUC derivatives. PMID- 3323812 TI - Oligonucleotide-directed construction of mutations via gapped duplex DNA. PMID- 3323813 TI - Rapid and efficient site-specific mutagenesis without phenotypic selection. PMID- 3323814 TI - Site-specific mutagenesis to modify the human tumor necrosis factor gene. PMID- 3323815 TI - An improved method to obtain a large number of mutants in a defined region of DNA. PMID- 3323816 TI - Structure and thermal stability of phage T4 lysozyme. PMID- 3323817 TI - DNA sequencing: a new strategy to create ordered deletions, modified M13 vector, and improved reaction conditions for sequencing by dideoxy chain termination method. PMID- 3323819 TI - Unidirectional digestion with exonuclease III in DNA sequence analysis. PMID- 3323818 TI - Construction and use of pBR322 plasmids that yield single-stranded DNA for sequencing. PMID- 3323820 TI - Isolation of amino acid-specific tRNA by high-performance liquid chromatography. PMID- 3323821 TI - Random cloning and sequencing by the M13/dideoxynucleotide chain termination method. PMID- 3323822 TI - An agarose gel electrophoresis assay for the detection of DNA-binding activities in yeast cell extracts. PMID- 3323823 TI - The use of DNase I, buffer gradient gel, and 35S label for DNA sequencing. PMID- 3323824 TI - Restriction alleviation and enhancement of mutagenesis of the bacteriophage T4 chromosome in recBCsbcA strains of Escherichia coli. AB - The restriction of non glucosylated phage T4 DNA is reduced significantly in host bacterial strains carrying recBCsbcA mutations even in the presence of a functional rgl gene. In recBCsbcA hosts a high frequency of phage mutations are observed both in the glucosyl transferase genes and in the DNA sequences recognized by the rgl restriction enzymes. This hypermutagenic property of the recBCsbcA strains is not dependent on the glucosylation of the phage DNA, and the mutagenesis is localized to certain regions of the T4 chromosome. However, alleviation of rgl restriction in recBCsbcA strains is due neither to the increased mutagenesis, nor to the absence of a functional rgl system, since second site mutations (rra) restore rgl restriction, without affecting hypermutagenesis. PMID- 3323825 TI - The RAD3 gene of Saccharomyces cerevisiae: isolation and characterization of a temperature-sensitive mutant in the essential function and of extragenic suppressors of this mutant. AB - Mutations in the RAD3 gene of Saccharomyces cerevisiae were generated by integration of a mutagenized incomplete copy of the cloned gene into wild-type cells. Integrants were mass screened for colonies with abnormal growth characteristics at 37 degrees C. A single temperature-sensitive mutant (rad3ts-1) was isolated and was shown to result from a missense mutation at codon 73 of the RAD3 gene. When shifted from 30 degrees C to 37 degrees C the strain undergoes only 2-4 cell doublings. This phenotype can be rescued by plasmids in which the essential function of the cloned RAD3 gene is intact, but not plasmids in which this function is inactivated. The mutant strain is weakly sensitive to ultraviolet (UV) radiation at restrictive temperatures. Measurement of RNA, DNA and protein synthesis at various times after shifting to restrictive temperatures does not show preferential inactivation of any one of these parameters and the temperature-sensitive mutation does not cause arrest at any specific phase of the cell cycle. The rad3ts-1 strain was transformed with multicopy plasmids from a normal yeast genomic library and two plasmids that partially suppress the temperature-sensitive phenotype were isolated. These suppressor genes (designated SRE1 and SRE2) are distinct from RAD3 and do not suppress the phenotype of several other temperature-sensitive mutants tested. Mutant strains carrying disruptions of the SRE1 gene are viable and are not sensitive to UV or gamma radiation. PMID- 3323826 TI - Nucleotide sequences from the colicin E8 operon: homology with plasmid ColE2-P9. AB - The primary structures of the immunity (Imm) and lysis (Lys) proteins, and the C terminal 205 amino acid residues of colicin E8 were deduced from nucleotide sequencing of the 1,265 bp ClaI-PvuI DNA fragment of plasmid ColE8-J. The gene order is col-imm-lys confirming previous genetic data. A comparison of the colicin E8 peptide sequence with the available colicin E2-P9 sequence shows an identical receptor-binding domain but 20 amino acid replacements and a clustering of synonymous codon usage in the nuclease-active region. Sequence homology of the two colicins indicates that they are descended from a common ancestral gene and that colicin E8, like colicin E2, may also function as a DNA endonuclease. The native ColE8 imm (resident copy) is 258 bp long and is predicted to encode an acidic protein of 9,604 mol. wt. The six amino acid replacements between the resident imm and the previously reported non-resident copy of the ColE8 imm ([E8 imm]) found in the ribonuclease-producing ColE3-CA38 plasmid offer an explanation for the incomplete protection conferred by [E8 Imm] to exogenously added colicin E8. Except for one nucleotide and amino acid change in the putative signal peptide sequence, the ColE8 lys structure is identical to that present in ColE2 P9 and ColE3-CA38. PMID- 3323827 TI - Regulation of MAL gene expression in yeast: gene dosage effects. AB - Both the MAL1 and MAL6 loci in Saccharomyces strains have been shown by functional and structural studies to comprise a cluster of at least three genes necessary for maltose utilization. They include regulatory, maltose transport and maltase genes designated MALR, MALT and MALS, respectively. Subclones of each gene derived from the MAL6 locus were inserted into the multicopy shuttle plasmid YEp13, introduced into MAL1 and mal1 strains and the effects of altered gene dosage of each gene, or a combination of them, on MAL gene expression investigated. MAL1 strains transformed with a plasmid carrying the MAL6S gene showed coordinate four to five fold increases in both maltase enzyme activity and its mRNA, whereas no increase in maltose transport activity or of MALT mRNA was observed when MAL6T was present on multicopy plasmids. The presence of the MAL6R gene on a multicopy plasmid led to greatly increased transcription of both inducible and constitutive mRNAs with homology to the regulatory gene; it also gave rise to two fold increases in both induced maltase mRNA levels and enzyme activity, but only in the presence of maltose. However, it had no apparent effect on the accumulation of MALT mRNA. Finally, the induction kinetics of plasmid borne and chromosomal MALS and MALT gene expression were examined under conditions of altered gene dosage of the MAL6 regulatory and structural genes. The results of these experiments indicate that MALR encodes a trans-acting positive activator that requires maltose for induction of MALS and MALT transcription even when the regulatory gene is present on a multicopy plasmid. Maltose transport can be a rate-limiting factor in MAL gene expression, at least in the early stages of induction. The regulation of the MALS and MALT genes, whose activities are coordinately induced in MAL1 strains by maltose, may in fact exhibit some important differences. PMID- 3323828 TI - DNA base changes induced following in vivo exposure of unadapted, adapted or ada- Escherichia coli to N-methyl-N'-nitro-N-nitrosoguanidine. AB - The adaptive response is one of the major repair pathways in Escherichia coli that removes DNA alkylation damage. To investigate the role of the adaptive response in mutagenesis, the E. coli gpt forward mutation assay system was used to determine the mutation spectrum of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) in MNNG-adapted and unadapted GP120 (wild-type) and unadapted PJ5 (ada-5) cells. We observed that 34/37 mutations in the unadapted GP120 cells, 38/40 mutations in the adapted GP120 cells, and 10/10 mutations in the PJ5 cells were GC----AT transitions. The remaining 3/37 mutations in the unadapted GP120 cells were large insertions. The remaining 2/40 mutations in the adapted GP120 cells were transversions with one a GC----CG and the other an AT----CG. A surrounding sequence specificity of mutagenesis was observed for the GC----AT transitions in both the unadapted (GP120 and PJ5) and adapted (GP120) cells, with 70% of the unadapted PJ5, 68% of the unadapted GP120, and 61% of the adapted GP120 mutations occurring at the middle G of the sequence 5'--GG(A or T)--3'. Both strains also displayed a statistically significant preference for mutagenesis at guanine bases in the non-transcribed strand. The overall distribution of mutated sites in the gpt gene in adapted and unadapted cells was similar, although the rate of mutations at certain sites appeared different. These minor differences could result from either non-uniform repair of alkylation damage at different sites on the DNA, or altered processing of the alkylated bases to mutations in the adapted state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323829 TI - Transcript analysis of the plasmid R100 traJ and finP genes. AB - Single-stranded RNA probes were used to study the regulation of plasmid transfer in the infectious antibiotic resistance plasmid R100. Transcription of the positive transfer control gene traJ of R100 appears to be initiated continuously. In the presence of finO, the traJ transcript is 235 bases long, and in the absence of finO it is 1050. These sizes are strain specific. finO increases four to tenfold the amount of the transcript from the finP gene that is detectable in cells containing R100, R136, or the sex factor F. The size of the principal finP transcript from R100 as determined on Northern blots is 105 bases. A secondary transcript with a size of 180 bases was detected in small amounts in R100 extracts. The finP transcript size was also determined by nuclease protection experiments. In this case the size was 74 bases. The 5' ends of the finP and traJ transcripts were located by primer extension experiments. A new model of FinO/P control is proposed. PMID- 3323831 TI - Hierarchy of the strength of Escherichia coli stringent control signals. AB - The quantitative effect of ppGpp, the effector of stringent control, on various Escherichia coli promoters was measured in an in vitro mixed transcription system. This allowed us to determine, among these promoters, the hierarchy of promoters according to their ppGpp susceptibility. The strength of the stringent control signal, however, was found to be altered when the test promoters were transcribed by ppGpp-insensitive RNA polymerases from relaxed mutants of E. coli, which carry substitutions in the beta subunit gene (rpoB). Thus, it was concluded that the activity of the stringent control signal depends on the nature of the RNA polymerase as well as that of the promoter. PMID- 3323830 TI - The relative rate of synthesis and levels of single-stranded DNA binding protein during induction of SOS repair in Escherichia coli. AB - Induction of the SOS response in Escherichia coli results in an increase in the relative rate of synthesis of single-stranded DNA binding protein (SSB). In contrast to RecA protein, this increase is slow and does not lead to higher SSB levels. The significance of ssb induction to SOS repair is discussed. PMID- 3323832 TI - Heat-shock induction of RNA polymerase sigma-32 synthesis in Escherichia coli: transcriptional control and a multiple promoter system. AB - Transcriptional start sites of the rpoH gene which codes for a minor sigma factor (sigma 32) of Escherichia coli RNA polymerase were determined. The rpoH gene is transcribed, both in vivo and in vitro, from two major (P1 and P2) and one minor (P2*) promoters. In vitro synthesis of the rpoH mRNAs is dependent on the major species of RNA polymerase holoenzyme (E sigma 70) but not on the minor one (E sigma 32). S1 nuclease analysis of the in vivo RNA showed that the level of rpoH transcript from the downstream P2 promoter increases rapidly when E. coli cells are transferred from 30 degrees C to 42 degrees C, while the transcript from the upstream P1 promoter remains at a constant level. Under these conditions, the metabolic stabilities of rpoH mRNAs are virtually unaffected, suggesting that the synthesis of rpoH mRNA from the P2 promoter is specifically enhanced upon heat shock. PMID- 3323834 TI - Selection procedure for deregulated iron transport mutants (fur) in Escherichia coli K 12: fur not only affects iron metabolism. AB - A selection procedure using Mn2+ is described. A high percentage of the Mn2+ resistant mutants had constitutive iron transport systems. By P1 transduction, and complementation with the cloned fur gene it could be shown that nearly all the mutants constitutive in the expression of the operon fusion fiu::lambda placMu were only defective in fur. High concentrations of manganese inhibited the derepression of an iron-regulated lac operon fusion. In another iron-regulated lac operon fusion that was inducible by iron, manganese also induced the production of beta-galactosidase. Most of the fur mutants isolated (80%) were not able to grow on succinate, fumarate or acetate. After transformation with a fur+ plasmid all 39 mutants tested were able to grow on succinate. In fur mutants the presence of succinate in the growth medium reduced succinate uptake rates by 50% 70%. Succinate dehydrogenase activity was reduced to 10% of that of the parent strain. PMID- 3323833 TI - Identification of components of a new stability system of plasmid R1, ParD, that is close to the origin of replication of this plasmid. AB - We provide evidence that a mutation which derepresses an autoregulated system that is located in the vicinity of the basic replicon of R1, stabilizes the ParA- and ParB- miniplasmid of R1 pKN1562, without increasing its copy number. The system, which we have called ParD, maps inside the 1.45-kb PstI-EcoRI fragment that is adjacent to the origin of replication of the plasmid. Two proteins whose expression is coordinated are components of the system. The sequence of the PstI EcoRI fragment was obtained. The wild-type ParD system determines in cis a basal but detectable stability. PMID- 3323835 TI - Positional requirements for the function of nif-specific upstream activator sequences. AB - The upstream activator sequence (UAS) found in Klebsiella pneumoniae nif promoters and required for the activation of transcription by nifA, is absent from the nifF-nifL intergenic region, but is present downstream from the nifLA transcription start at +59. To determine whether nif upstream activator sequences can function in a 3' position, the nifH UAS was cloned downstream from the NifH transcription start, but no activation of transcription by nifA dependent upon the UAS in its 3' location could be detected. A mild repressive effect was detectable when the nifH UAS was placed downstream of the nifH promoter, but not when the cat promoter was substituted for the nifLA promoter upstream from the motif at +59 described above. However, deletion analysis showed that the UAS motif located downstream of the nifLA promoter has a role in transcription from the nifF promoter, although it is situated at position -263 with respect to the nifF transcription start, about 100 bp further upstream than previously described occurrences of the activator sequence. PMID- 3323836 TI - UV-induced damage and repair in centromere DNA of yeast. AB - The centromere is the region within a chromosome that is required for proper segregation during mitosis and meiosis. Lesions in this sequence represent a unique type of damage, as loss of function could result in catastrophic loss of the genetic material of an entire chromosome. We have measured the induction by ultraviolet (UV) light of pyrimidine dimers in a 2550-bp restriction fragment that includes the centromere region of chromosome III in Saccharomyces cerevisiae. Yeast cells were exposed to ultraviolet light, cellular DNA was gently extracted, and subsequently treated with a UV-specific endonuclease to cleave all pyrimidine dimers. The sites of UV-specific nuclease scission within the centromere were determined by separating the DNA according to molecular weight, transferring the fragments to nitrocellulose, and hybridizing to a radiolabeled 624-bp fragment homologous to the centromere DNA from chromosome III. Several hotspots were identified in chromatin DNA from cells, as well as in irradiated deproteinized DNA. Double strand damage due to closely opposed pyrimidine dimers was also observed. At biological doses (35% survival) there are approximately 0.1 to 0.2 pyrimidine dimers per centromere. These dimers are efficiently repaired in the centromere and surrounding region. PMID- 3323837 TI - Amino acid alterations in a hydrophobic region of the TraT protein of R6-5 increase the outer membrane permeability of enteric bacteria. AB - Two insertion mutations, each introducing a new negatively charged amino acid residue into a hydrophobic region of the TraT protein coded by the F-like plasmid R6-5 caused significant alterations in outer membrane permeability of Escherichia coli and Salmonella typhimurium, so that strains carrying plasmids with either of these mutations became sensitive to hydrophobic antibiotics. PMID- 3323838 TI - Chromogenic identification of promoters in Streptomyces lividans by using an ampC beta-lactamase promoter-probe vector. AB - A promoter-probe system, based on the ampC beta-lactamase gene of Escherichia coli, has been developed for the isolation and characterization of transcriptional signals in the gram-positive bacterium Streptomyces lividans. The promoter-probe vector, denoted pJAS14, has the SLP1.2 replicon with a copy number of four-five plasmids per cell. It contains a unique BamHI site just in front of the ampC ribosome-binding site, and upstream of this BamHI site a transcriptional terminator signal that prevents readthrough transcription from plasmid-borne promoters has been inserted. Using pJAS14, we have shot-gun cloned chromosomal DNA from S. lividans and S. lavendulae into the BamHI site, and isolated a number of promoter containing DNA fragments by the use of the chromogenic cephalosporin nitrocefin. On plates, we identified promoters of varying strengths and also with differences in nutritional and temporal expression. Using liquid cultures of S. lividans, it has been demonstrated that one promoter, denoted P1 (SEP8), as well as the ampC gene of E. coli, show activity corresponding to the vegetative growth of the cells. The P1 (SEP8) promoter was shown to be expressed also in E. coli, and it initiates RNA synthesis at exactly the same nucleotides in both S. lividans and E. coli. The promoter shows good homology to the E. coli promoter consensus sequence in both the -35 and -10 regions. Thus, this promoter is a representative of the SEP (Streptomyces E. coli-type promoter) class of promoters recently described (Jaurin and Cohen 1985). This indicates that an S. lividans RNA polymerase recognizes the same sequence determinants and chooses the point of initiation of RNA synthesis in the same way as the corresponding E. coli enzyme. PMID- 3323839 TI - RNA polymerase sigma-related proteins in Escherichia coli: detection by antibodies against a synthetic peptide. AB - Antibodies were raised against a synthetic tetradecameric peptide with an amino acid sequence, DLIQEGNIGLMKAV, which corresponds to the most highly conserved region of bacterial RNA polymerase sigma factors. In a Western-blot analysis of total Escherichia coli proteins, the antiserum reacted specifically with at least three proteins with apparent molecular weights of 75 kDa, 27 kDa and 23 kDa, in addition to the known sigma factors (sigma 70 and sigma 32). The majorities of sigma 70 and sigma 32 were recovered as associated forms with the RNA polymerase on glycerol gradient centrifugation, while the other cross-reacting proteins were not. Unambiguous evidence was obtained which indicated that the intracellular level of sigma 32 increased rapidly upon heat-shock, at least in the strain containing high copy numbers of the rpoH gene. PMID- 3323841 TI - Direct selection for the exchange of alleles between a plasmid and the Escherichia coli chromosome. AB - Recombination is extensively used in order to move alleles between replicons. The exchange of wild-type chromosomal and mutant plasmid-borne alleles is a two-step process entailing the formation of a cointegrate between the entire plasmid and the chromosome, followed by resolution of such cointegrates to give a mutant chromosome and a plasmid carrying the wild-type chromosomal sequence. Often the cointegrate and the resolved forms cannot be distinguished phenotypically. To enable the direct isolation of the resolved products we have developed a positive selection technique. Cells containing a cointegrated plasmid R1 were constructed by transduction using a P1 lysate prepared from cells harbouring a plasmid comprising a mutant chromosomal allele and the so-called omega fragment which carries an aad (aminoglycoside adenylyltransferase) gene. P1 transduction from the cointegrate strain into an SmD recipient allowed direct selection for the resolved complex, since transduction of the aad gene is lethal to an SmD strain. PMID- 3323842 TI - Replication intermediate of a hybrid plasmid carrying the replication terminus (ter) site of R 6K as revealed by agarose gel electrophoresis. AB - A 4.32 kb DNA fragment, on which the DNA replication terminus (terR) site of plasmid R 6K was located, was inserted into the unique EcoRI site of plasmid pUC9. To detect replication intermediate molecules with a replication fork halted at the terR site, a cell DNA extract was digested with EcoRI, electrophoresed through an agarose gel and stained with ethidium bromide. In addition to two major bands, one derived from vector DNA and the other from the ter insert fragment, two extra minor bands were detected. Following DNA-DNA hybridization and electron microscopic observation we concluded that the two minor bands corresponded to the two Y-shaped molecules, produced from the theta-shaped intermediate molecules by EcoRI digestion. PMID- 3323840 TI - Cloning and DNA sequence determination of the L11 ribosomal protein operon of Serratia marcescens and Proteus vulgaris: translational feedback regulation of the Escherichia coli L11 operon by heterologous L1 proteins. AB - In Escherichia coli the genes encoding ribosomal proteins L11 (rplK) and L1 (rplA) are contained in a single operon and their expression is translationally regulated by L1. We have cloned the homologous genes from two other enterobacteria, Serratia marcescens and Proteus vulgaris, and determined nucleotide sequences. The genes are organized in a similar way to that found in E. coli. Conservation of nucleotide and amino acid sequences relative to E. coli in the protein coding regions are 89.2% and 94.7% for S. marcescens, and 80.9% and 88.6% for P. vulgaris. Nucleotide sequences of L11 mRNA leader regions were strongly conserved for the primary as well as the secondary structures in the L1 target site. We have also constructed plasmids carrying E. coli L11 and either P. vulgaris or S. marcescens L1 genes fused to the lac promoter, with or without the E. coli leader containing the L1 target site. Induction of transcription of the operons possessing the E. coli mRNA leader did not lead to overproduction of L11, indicating translational regulation of the chimeric operon as well as the chromosomal operon by the plasmid encoded L1. Repression of the chromosomal L11 operon was directly demonstrated upon induction of the chimeric operons without the leader, which also lack the L11 initiation signal but have a mutation allowing L1 translation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323843 TI - Transcriptional regulation of sporulation genes in yeast. AB - The relative transcription rates of three sporulation-regulated genes of yeast (SPR1, SPR2 and SPR3) were determined at intervals during sporulation, using a filter binding assay. The binding of in vivo labeled RNA to the corresponding DNAs increased 3- to 12-fold at the time of meiosis I, in parallel with the accumulation of the SPR transcripts. SPR1 and SPR3 mRNA abundance increased from less than 0.7 to 130 and 90 copies per cell, respectively, between the time of shift to sporulation medium and the initiation of spore formation. This represented a 150-to 200-fold increase in the steady-state levels of these RNAs. Similarly, the levels of beta-galactosidase present in sporulating cells harboring fusions between SPR3 and Escherichia coli lacZ increased at least 700 fold. We conclude that SPR1, SPR2 and SPR3 transcription is modulated during sporulation, possibly in response to earlier events in the process. PMID- 3323844 TI - Secretion of Mucor rennin, a fungal aspartic protease of Mucor pusillus, by recombinant yeast cells. AB - The aspartic protease gene of a zygomycete fungus Mucor pusillus was expressed in Saccharomyces cerevisiae under the control of the yeast GAL7 promoter. A putative preproenzyme with an NH2-terminal extension of 66 amino acids directed by the gene was processed in yeast cells and the mature enzyme, whose NH2-terminus was identical to that of the Mucor enzyme, was efficiently secreted into the medium at a concentration exceeding 150 mg/l. The enzyme secreted from the recombinant yeast was more glycosylated than the native Mucor enzyme but its enzymatic properties were almost identical with those of the native enzyme, which has been used as a milk coagulant in cheese manufacture. PMID- 3323846 TI - The Escherichia coli cell division proteins FtsY, FtsE and FtsX are inner membrane-associated. AB - The cell division genes ftsY, ftsE and ftsX form an operon mapping at 76 min on the Escherichia coli chromosome. The protein products of these genes have been identified previously. We have studied the cellular location of the radiolabelled Fts proteins using maxicells and standard fractionation procedures. Previous protein sequence homologies suggested an inner membrane location for FtsE. We have confirmed this predicted location and have shown that FtsY and FtsX are also inner membrane-associated. These results are in agreement with the hypothesis that FtsE may act at the inner membrane, in a "septalsome" complex, by coupling ATP hydrolysis to the process of bacterial cell division. PMID- 3323845 TI - Expression of leucine genes from an extremely thermophilic bacterium in Escherichia coli. AB - The organisation of the leucine genes in Thermus thermophilus HB8 was analysed by examining the ability of recombinant DNAs to complement Escherichia coli mutations. The arrangement of the genes is different from that in the mesophilic bacteria E. coli and Salmonella typhimurium. The promoter responsible for the expression of the leuB, leuC and leuD genes of Thermus HB8 in E. coli was identified. The sequence of Thermus DNA containing this promoter revealed structural similarities to the promoter and attenuator regions of the E. coli leucine operon. PMID- 3323847 TI - Mutations that increase the mitotic stability of minichromosomes in yeast: characterization of RAR1. AB - In an attempt to identify proteins involved in the initiation of DNA replication, we have isolated a series of Saccharomyces cerevisiae mutants in which the function of putative replication origins is affected. The phenotype of these Rar- (regulation of autonomous replication) mutants is to increase the mitotic stability of plasmids whose replication is dependent on weak ARS elements. These mutations are generally recessive and complementation analysis shows that mutations in several genes may improve the ability of weak ARS elements to function. One mutation (rar1-1) also confers temperature-sensitive growth, and thus an essential gene is affected. We have determined the DNA sequence of the RAR1 gene, which reveals an open reading frame for a 48.5 kDa protein. The RAR1 gene is linked to rna1 on chromosome XIII. PMID- 3323849 TI - Evidence for multiple carboxymethylcellulase genes in Pseudomonas fluorescens subsp. cellulosa. AB - A genomic library of Pseudomonas fluorescens subsp. cellulosa DNA was constructed in bacteriophage lambda 47.1 and recombinants expressing carboxymethylcellulase (CMCase) activity isolated. A 7.3 kb partial EcoRI fragment, a 9.4 kb EcoRI fragment and a 5.8 kb HindIII fragment were subcloned from three different phages into pUC18 to yield recombinant plasmids pJHH1, pJHH3 and pGJH2 respectively. Cells of Escherichia coli harbouring these plasmids expressed CMCase activity. The positions of the CMCase genes in the three plasmids were determined by subcloning and transposon mutagenesis. pJHH1 contained two distinct DNA regions encoding CMCases, which were controlled by the same promoter. All four cloned enzymes cleaved p-nitrophenyl-beta-D-glucopyranoside, although at a very low rate, but none exhibited exoglucanase activity. In common with other extracellular enzymes cloned in E. coli, all the CMCases were exported to the periplasmic space in the enteric bacterium. The carboxymethylcellulase genes encoded by pJHH1 and pJHH3, were subject to glucose repression in E. coli. PMID- 3323850 TI - Genetic control of translational fidelity in yeast: molecular cloning and analysis of the allosuppressor gene SAL3. AB - The fidelity of translation in the yeast Saccharomyces cerevisiae is controlled by a number of gene products. We have begun a molecular analysis of such genes and here describe the cloning and analysis of one of these genes, SAL3. Mutations at this locus, and at least four other unlinked loci (designated SAL1-SAL5), increase the efficiency of the tRNA ochre suppressor SUQ5, and are thus termed allosuppressors. We have cloned the SAL3 gene from a yeast genomic library by complementation of a sal3 mutation. Integration of the cloned sequence into the yeast chromosome was used to confirm that the SAL3 gene had been cloned. SAL3 gene is present in a single copy in the yeast genome, is transcribed into a 2.3 kb polyadenylated mRNA and encodes a protein of Mr 80,000. The size of the SAL3 gene product strongly suggests that it is not a ribosomal protein. PMID- 3323848 TI - Involvement of the ntrA gene product in the anaerobic metabolism of Escherichia coli. AB - The ntr A gene product, required for expression of genes involved in nitrogen fixation (nif) and regulation (ntr), was shown to be necessary for the expression of the two enzymes of the anaerobically inducible formate hydrogenlyase (FHL) pathway, formate dehydrogenase (FDHH) and hydrogenase isoenzyme 3. Consistent with this finding, the gene encoding the selenopolypeptide (fdhF) of FDHH was shown to have a nif consensus promoter. The levels of six other anaerobically inducible enzymes were examined and found to be ntrA independent. Significantly, these latter six enzymes are dependent upon the fnr gene product for their expression while FDHH and hydrogenase 3 are fnr independent. These findings indicate that there are at least two classes of anaerobically regulated promoters: one class which is ntrA dependent and fnr independent and a second class which is fnr dependent and ntr A independent. PMID- 3323851 TI - Effect of Bellergal Retard on climacteric complaints: a double-blind, placebo controlled study. AB - The effect of Bellergal Retard (BR) on climacteric complaints was evaluated versus a placebo in an 8-wk double-blind study, followed by a 4-wk open study in which only BR was used as medication. There was a marked decrease in complaints in both the BR and the placebo groups. Statistically significant differences were observed between the groups after 2 and 4 wk of treatment, indicating superior results with BR. After 8 wk of study however, these differences were no longer apparent. It was concluded that studies on medication for climacteric complaints should not only be placebo-controlled, but also be of at least 8 to 12 wk duration for proper evaluation. PMID- 3323852 TI - Dose-response effects on serum lipids and lipoproteins following combined oestrogen-progestogen therapy in post-menopausal women. AB - The dose-response effects on serum lipids and lipoproteins were studied in 87 healthy post-menopausal women treated for 1 yr with three different doses of sequential oestrogen/progestogen (4 mg, 2 mg and 1 mg 17 beta-oestradiol cyclically combined with 1 mg norethisterone acetate) or placebo. Total serum cholesterol levels were significantly reduced by 4-10% (P less than 0.05-P less than 0.001) in a dose-related way in the hormone groups. This was mainly caused by a similar reduction in low-density-lipoprotein (LDL) cholesterol, whereas the changes in high-density-lipoprotein (HDL) cholesterol were not significantly different from those observed in the placebo group. It is concluded that treatment with sequentially combined oestrogen and progestogen, using norethisterone acetate in combination with 17 beta-oestradiol in clinically relevant doses, does not produce any adverse effects on serum lipids or lipoproteins. PMID- 3323853 TI - Monoclonal antibody probes for the niaD specified subunit in the NADPH-nitrate reductase from Aspergillus nidulans. AB - In Aspergillus nidulans, the nitrate assimilatory pathway is regulated by a variety of agents, one being the autogenous enzyme nitrate reductase. A major subunit of the enzyme which is specified by the niaD structural gene and is implicated in autogenous control exhibits both nitrate inducible diaphorase activity and ammonium repression. The former was used to test the extent to which alterations in the niaD specified protomer might affect its formation in selected niaD point and deletion mutants. Enzyme preparations from the wild type and mutant strains were compared on the basis of nitrate inducible co-activities and their reaction to specific monoclonal antibodies (MABS). Proteins in partially purified mycelial extracts were subjected to Western blot analyses with three MABs to functional native enzyme. Extracts of niaD point mutants exhibited nitrate induced co-activities which matched those of the wild type while those from deletion mutants were diminished or totally inactive. Nitrate reductase, from the wild type and specific cofactor mutants, shares an epitope common to both the monomeric and dimeric form in the case of one MAB, and exhibits epitopes unique to one or the other form in the case of the other two forms. Enzyme antibody interaction occurs with or without inhibition of catalytic activity depending on the MAB involved. PMID- 3323854 TI - The Microcirculatory Society Eugene M. Landis award lecture. Microcirculation of the spleen: new concepts, new challenges. PMID- 3323856 TI - Highlights from the history of caesarean section. PMID- 3323855 TI - The role of interleukin 1 and 2 in generation of acquired resistance against mouse typhoid infection afforded by dialyzable factor from Salmonella typhimurium. AB - Dialyzable factor (DF) prepared from a ribosomal fraction of Salmonella typhimurium was tested for its ability to induce interleukin 1 (IL 1) and 2 (IL 2) production, in relation to acquired resistance, after an intraperitoneal injection of DF. IL 1 production in vitro by peritoneal macrophages of DF-treated mice reached the maximum 4 days after injection, at the time when the nonspecific local resistance via macrophages directly activated with DF became apparent (Kita et al, Microbiol. Immunol. 28:807, 1984). Concanavalin A-induced IL 2 production by splenocytes of DF-treated mice reached the maximal level between days 6 and 8, and it could be enhanced even on day 14. Antigen-induced blastogenic responses of splenocytes from DF-treated mice reached the maximal level 14 days after treatment. Although DF did not show the mitogenic activity to normal splenocytes, T cells of DF-treated mice could respond to S. typhimurium. On the contrary, T cells of normal mice could respond to heat-killed cells of S. typhimurium when they were cultured with macrophages which had been directly stimulated in vitro with DF. Furthermore, T cells from DF-treated mice could respond to antigens of different species of bacteria, and especially to Listeria monocytogenes. These results suggest that T cells of DF-treated mice, being at the intermediate stage of activation via monokines including IL 1 which is produced by macrophages stimulated with DF, are able to proliferate immediately after the administration of challenging organisms as a second signal, and also that the specificity of the response may be defined by the challenging organisms. PMID- 3323857 TI - Neuronet: implementation of an integrated clinical neurophysiology system. AB - A distributed computing facility that subserves a wide variety of clinical and research neurophysiology functions is described. The backbone of the system is an Ethernet local area network to which are attached a number of "sub"-networks defined by functional requirements. A variety of computer systems are attached to the network, many of which are mounted in portable racks. The capabilities of the overall system are described along with the functions it serves. PMID- 3323858 TI - An acoustic aneurysm-detector. AB - Intracranial aneurysms have a high prevalence in the adult population; and if they rupture, significant morbidity almost always ensues. However, pulsatile blood flow through aneurysms produces vibrational sound patterns that may be detected extracranially. Thus, an acoustic aneurysm-detector has been developed to detect the sounds produced by intracranial aneurysms prior to rupture. The design is based on the utilization of a hydrophone for signal detection and computational signal processing for signal extraction. Data are examined in the time domain, the frequency domain, and the time-frequency plane. Examples are presented from an animal model and from a patient with a known aneurysm. PMID- 3323859 TI - Plasma cholesterol and coronary artery disease: how big a heartache? PMID- 3323860 TI - Malaria in the Malaysian Army with particular reference to chemosuppressive use. PMID- 3323861 TI - Use of single radial haemolysis for assessing antibody response to influenza virus vaccines in animals. AB - The value of the single radial haemolysis (SRH) test as a possible replacement for the haemagglutination-inhibition (HAI) test for the estimation of antibodies against influenza was assessed in three animal models. The serum antibody response was measured by both assay systems; correlation of the two tests was assessed using regression analysis. The study showed that when the response to a single immunisation was determined, the ferret model gave satisfactory correlation of SRH and HAI, whilst in the mouse and hamster models poor correlation was observed. Correlation was only improved in the mouse model when an immunisation schedule that mimicked the human situation of a background exposure to different strains of influenza virus was used. Since influenza vaccine efficacy is usually assessed in animals using a single immunisation we suggest that the SRH is not acceptable for use in either hamsters or mice, but is acceptable where the ferret model is involved. PMID- 3323862 TI - [Molecular biology studies in the differential diagnosis of malignant lymphomas]. PMID- 3323864 TI - [Fibrosing lung diseases--prognosis and therapy]. PMID- 3323863 TI - [Infarct of the right ventricle: clinical aspects, hemodynamics, therapy]. PMID- 3323865 TI - Time dependent effects of histamine on parameters of capillary transport of protein in canine hindquarters. AB - Although the effects of histamine to increase water and macromolecular transport are known to be transient, the methods previously utilized to assess solvent drag reflection coefficient (sigma) and permeability-surface area product (PS) usually require periods of observation longer than the length of the transients. Utilizing a method developed and analyzed in this laboratory (18-20), this study utilized the information from opposite changes in lumbar trunk lymph flow (L) and lymph to plasma protein concentration ratios (R) to compute sigma and PS over 10 minute intervals during histamine infusion at 0.5-1.5 mg base/kg/min into the abdominal aorta of the anesthetized dog. There was a highly reproducible decline in sigma from 46 to 56% during the first 50 minutes of infusion followed by a rise to 46% above control at 166 minutes. PS showed no time dependent variability and was widely variable independent of sigma. These studies indicate that histamine in the intact anesthetized canine hindquarters produces augmented vascular leakage of protein only for about 100 minutes, and that this augmented flux which is coupled to water flux occurs because of increased convective and not permeative or diffusive flux. PMID- 3323866 TI - Patient memories of anesthesia--historical perspective. AB - Since the introduction of anesthetic agents for surgical pain relief in 1846, a number of clinical, experimental and anecdotal reports have been published concerning those patients having memories of their anesthesia. These reports can be divided into three broad categories: awareness of the surgical procedure or other intraoperative events; hallucinations, dreams or illusions; and transcendental experience. The history of each of these groups of experiences is reviewed. PMID- 3323867 TI - [Mediastinitis secondary to the extraction of an impacted third molar. A clinical case and review of the literature]. PMID- 3323868 TI - [Mandibular osteoradionecrosis: an update on its pathogenesis and therapeutic options]. PMID- 3323869 TI - [Observations of familial cases of amelogenesis imperfecta and a critical review]. PMID- 3323870 TI - [Spasmophilia: a new interpretation of psychogenic reactions in dental studies?]. PMID- 3323871 TI - [Periapical bone resorption: a difficult problem]. PMID- 3323872 TI - [Phagocytic pathogenesis of periodontitis. II. Periodontitis associated with a quantitative deficiency of phagocytic function]. PMID- 3323873 TI - [Biological and clinical prerequisites of radiochemotherapy in neoplasms of the cervicofacial area]. PMID- 3323874 TI - Physiologic and pharmacologic approaches to spasticity. AB - The term spasticity is used to describe many relatively unrelated syndromes and, because they share few common pathophysiologic mechanisms, it is not possible to define the physiology or pharmacology of spasticity. In patients with spastic paresis, it is the latter negative symptom (rather than the spasticity) that accounts for almost all the functional disability. Clinical neurophysiologic techniques are useful for categorization of patients with clinically identical syndromes into subgroups which respond to different therapies. Fusimotor or spindle primary afferent hyperactivity have not been demonstrated in spastic patients; reduction in central inhibitory mechanisms probably accounts for spastic hyper-reflexia. Increased passive muscle stiffness may also be clinically significant. Therapies for spasticity include elimination of causative or enhancing factors, frequent muscle stretching, surgical approaches and chemotherapy. The latter includes dantrolene (which weakens muscles), baclofen (particularly useful for reduction of flexor spasms and flexor dystonia in patients with spinal lesions) and diazepam. PMID- 3323875 TI - Electromyographic studies of motor control in humans. AB - Electromyography and electroneurography have proved to be useful in investigation and understanding of a variety of neurologic disorders. In most laboratories, however, these electrodiagnostic techniques have been used to help in the diagnosis of diseases that affect the peripheral nerves, neuromuscular junctions, or skeletal muscle fibers. Although major advances in electronic and computer technology have made it possible to study, quantitate, and document reflex activity in intact human subjects, most neurologists still rely on gross clinical observations and most electromyographers continue to use conventional techniques of EMG and nerve conduction studies to differentiate "myopathy" from "neuropathy." This article is a review of some of the electromyographic techniques that have been used in the authors' laboratory for the study of normal and abnormal motor control in man and the treatment of patients with disorders of motor control. PMID- 3323876 TI - Rehabilitation of the patient with a brachial plexus injury. AB - The rehabilitation of patients with brachial plexus injury is a complex process that is dependent upon the understanding by the physician, and others involved in providing care, of the nature of the nerve injury, its natural history, and what measures are available to lessen the disability of such patients. In addition, the patients themselves must understand these same facts so that they can maximize the treatment they receive. PMID- 3323877 TI - Cognitive and behavioral aspects of brain-injury rehabilitation. AB - The most exciting area in current neurologic rehabilitation concerns cognitive remediation following brain injury. The experimental substrate upon which such rehabilitation rests is not yet firm, but results to date are suggestive of a positive effect, if not in specific cognitive ability, at least in functional and behavioral outcome. As more controlled studies are performed and as improved neuropsychological, behavioral, and social measures are developed, it can be anticipated that improved patient selection and therapeutic intervention will emerge. Also, as we gain further understanding of the molecular and cellular consequences of brain injury, it is not unreasonable to expect improved pharmacologic therapy of the various sequelae of brain injury. It would be remiss, however, to not close by extolling the best means of injury treatment, that is, prevention. PMID- 3323878 TI - Rehabilitation of patients with multiple sclerosis. AB - Multiple sclerosis (MS) is one of the most common diseases capable of producing severe disability in the young adult population. In fact, only rheumatic disorders and trauma exceed MS in this respect. Because the total population of patients in the United States is probably 250,000 to 500,000 and as a substantial number suffer severe disability, MS is a disease of considerable social and economic impact. The authors discuss the treatment of many of the most troubling symptoms of MS, including disorders of gait, bladder and bowel, upper extremities, speech, and deglutition. Such treatment entails careful assessment of the patient's neurologic and other symptoms; knowledge of his or her intellectual, emotional, and social skills and demands; and an understanding of the patient's support network. PMID- 3323879 TI - Stroke rehabilitation. AB - Based on the number of patients involved, stroke dominates the field of neurologic rehabilitation. The prevalence of stroke in the United States population is 1.4 million. This represents a prevalence for stroke of 612 per 100,000 population, compared with 157 for Parkinson's disease, 50 for spinal-cord injury, 42 for multiple sclerosis, and 16 for head-injured survivors with neurologic sequelae. This article provides an overview of stroke rehabilitation and covers patient management for the acute phase, subacute phase, and chronic phase poststroke. Medical and nursing care are discussed throughout and physical, occupational, and speech therapy for patients in these three phases are explored. PMID- 3323880 TI - Neurosurgical management of spasticity, rigidity, and tremor. AB - In this review, the authors present a critical overview of the historical development, indications, complications, operative techniques, and results of procedures for the alleviation of the major dyskinesias. Emphasis is placed upon recent refinement of technique, particularly stereotaxis, as well as neurophysiologic stimulation and recording, computerized tomographic scanning (CT) and magnetic resonance imaging (MRI). Specific disorders that may be amenable to surgical therapy include spasticity secondary to spinal cord pathology, cerebral palsy, and multiple sclerosis; the tremor and rigidity of Parkinson's disease; essential tremor; dystonia; spasmodic torticollis; post traumatic and postinfarction intention tremor; cerebral palsy with tremor; hemiballismus; myoclonus; and dyskinesias induced by L-DOPA. PMID- 3323881 TI - [Left-sided gallbladder: report of a case and study of 26 cases in Japan]. AB - A case of left-sided gallbladder with an anomaly of the intrahepatic portal vein and cholesterol polyps of the gallbladder is presented. A 23-year-old man with sudden onset of epigastric pain, fever and abdominal irritation was admitted to our hospital and an emergency celiotomy was carried out. The gallbladder lay on the left side of the round ligament, that is, it was a left-sided gallbladder. Since operative findings such as cholecystitis, gastrointestinal perforation and pancreatitis were not observed, no more procedures were done. Postoperative ultrasonography showed some interesting findings as follows: multiple echogenic nonshadowing small polypoid lesions which did not change in size and shape during a 2.5 year interval were detected and were thought to be cholesterol polyps. The tail of the gallbladder was situated on the left side of the round ligament and the motion of the gallbladder as determined by postural exchange was not floating. These findings are compatible with a left-sided gallbladder. The left branch of the portal vein did not form an umbilical portion as is usually expected and the right branch formed a cystic structure similar to a normal umbilical portion with the anterior, posterior and medial branches ramified. The round ligament arose from the cul-de-sac of the umbilical portion. Twenty-six cases of left-sided gallbladder from the Japanese literature were reviewed and discussed. PMID- 3323882 TI - Genetic and biochemical characterization of clathrin-deficient Saccharomyces cerevisiae. AB - Clathrin is important but not essential for yeast cell growth and protein secretion. Diploid Saccharomyces cerevisiae cells heterozygous for a clathrin heavy-chain gene (CHC1) disruption give rise to viable, slow-growing, clathrin heavy-chain-deficient meiotic progeny (G. Payne and R. Schekman, Science 230:1009 1014, 1985). The possibility that extragenic suppressors account for growth of clathrin-deficient cells was examined by deletion of CHC1 from haploid cell genomes by single-step gene transplacement and independently by introduction of a centromere plasmid carrying the complete CHC1 gene into diploid cells before eviction of a chromosomal CHC1 locus and subsequent tetrad analysis. Both approaches yielded clathrin-deficient haploid strains. In mutants missing at least 95% of the CHC1 coding domain, transcripts related to CHC1 were not detected. The time course of invertase modification and secretion was measured to assess secretory pathway functions in the viable clathrin-deficient cells. Core glycosylated invertase was converted to the mature, highly glycosylated form at equivalent rates in mutant and wild-type cells. Export of mature invertase from mutant cells was delayed but not prevented. Abnormal vacuoles, accumulated vesicles, and Golgi body-derived structures were visualized in mutant cells by electron microscopy. We conclude that extragenic suppressors do not account for the viability of clathrin-deficient cells and, furthermore, that many standard laboratory strains can sustain a CHC1 disruption. Clathrin does not appear to mediate protein transfer from the endoplasmic reticulum to the Golgi body but may function at a later stage of the secretory pathway. PMID- 3323883 TI - The int-1 proto-oncogene products are glycoproteins that appear to enter the secretory pathway. AB - The int-1 proto-oncogene encodes a primary product of 370 amino acids, is normally expressed in mid-gestational embryos and adult testis, and is activated by proviral insertions during mammary carcinogenesis. Polyclonal and monoclonal antibodies directed against int-1-specific synthetic peptides immunoprecipitate up to five forms of int-1 protein, ranging in size from 36,000 to 44,000 Mr, from cell lines that express cloned int-1 DNA introduced by transfection or infection with retroviral vectors. Pulse-chase labeling experiments and glycosidase digestions suggested that the smallest of the int-1 proteins is the primary translation product lacking its signal peptide and that it is modified to produce the larger species of sequential glycosylation. Subcellular fractionations demonstrated that all immunoprecipitable forms of int-1 are mainly associated with membranes. int-1 proteins in crude microsomal preparations are resistant to proteolysis and extractable at elevated pH, suggesting that they are sequestered within cytoplasmic vesicles in a manner consistent with the behavior of secretory products. However, we were unable to identify secreted int-1 products in extracellular fluids. PMID- 3323884 TI - Functional expression of a heterologous major histocompatibility complex class I gene in transgenic mice. AB - The regulated expression of major histocompatibility complex class I antigens is essential for assuring proper cellular immune responses. To study H-2 class I gene regulation, we have transferred a foreign class I gene to inbred mice and have previously shown that the heterologous class I gene was expressed in a tissue-dependent manner. In this report, we demonstrate that these mice expressed the transgenic class I molecule on the cell surface without any alteration in the level of endogenous H-2 class I antigens. Skin grafts from transgenic mice were rapidly rejected by mice of the background strain, indicating that the transgenic antigen was expressed in an immunologically functional form. As with endogenous H 2 class I genes, the class I transgene was inducible by interferon treatment and suppressible by human adenovirus 12 transformation. Linkage analysis indicated that the transgene was not closely linked to endogenous class I loci, suggesting that trans-regulation of class I genes can occur for class I genes located outside the major histocompatibility complex. PMID- 3323885 TI - Yeast pre-mRNA splicing requires a minimum distance between the 5' splice site and the internal branch acceptor site. AB - We have generated several deletions within the intron of a yeast actin gene construct which have lead to different splicing efficiencies as measured by Northern blot (RNA blot) and primer extension analyses. Our data especially demonstrate that a minimum distance from the 5' splice site to the internal branch acceptor site is required for accurate and efficient splicing. In a construct in which splicing was completely abolished, splicing could be restored by expanding the distance from the 5' splice site to the internal branch acceptor site with heterologous sequences. Alternative splicing, i.e., exon skipping and the use of a cryptic 5' splice site, was observed when the mRNA precursor was derived from a tandem repeat of a truncated intron with flanking exon sequences. PMID- 3323887 TI - Towards determination of the structure of the Saccharomyces cerevisiae a-factor: an acylated pentadecapeptide blocks a-factor activity. AB - Putative a-factor peptides YIIKGVFWADP, YIIKGVFWANP, YIIKGLFWADP, YIIKGLFWANP, YIIKGVFWDPA, and YIIKGVFWDPACVIA and several peptide derivatives were synthesized and were found to be inactive in growth arrest assays, yet they blocked the activity of biological a-factor. Antagonism was greatest with YIIKGVFWDPAC(palmitoyl)VIA. Thus, the structure of a-factor may be a lipopeptide resembling this palmitoylated pentadecapeptide. PMID- 3323886 TI - Human acidic ribosomal phosphoproteins P0, P1, and P2: analysis of cDNA clones, in vitro synthesis, and assembly. AB - cDNA clones encoding three antigenically related human ribosomal phosphoproteins (P-proteins) P0, P1, and P2 were isolated and sequenced. P1 and P2 are analogous to Escherichia coli ribosomal protein L7/L12, and P0 is likely to be an analog of L10. The three proteins have a nearly identical carboxy-terminal 17-amino-acid sequence (KEESEESD(D/E)DMGFGLFD-COOH) that is the basis of their immunological cross-reactivity. The identities of the P1 and P2 cDNAs were confirmed by the strong similarities of their encoded amino acid sequences to published primary structures of the homologous rat, brine shrimp, and Saccharomyces cerevisiae proteins. The P0 cDNA was initially identified by translation of hybrid-selected mRNA and immunoprecipitation of the products. To demonstrate that the coding sequences are full length, the P0, P1, and P2 cDNAs were transcribed in vitro by bacteriophage T7 RNA polymerase and the resulting mRNAs were translated in vitro. The synthetic P0, P1, and P2 proteins were serologically and electrophoretically identical to P-proteins extracted from HeLa cells. These synthetic P-proteins were incorporated into 60S but not 40S ribosomes and also assembled into a complex similar to that described for E. coli L7/L12 and L10. PMID- 3323888 TI - Selection against expression of the Escherichia coli gene gpt in hprt+ mouse teratocarcinoma and hybrid cells. AB - Thioxanthine is toxic for mammalian cells transformed by the dominant selectable marker gpt. It allowed us to select, in the presence of the endogenous hypoxanthine-guanine phosphoribosyltransferase gene, mutants that did not express gpt any more and also hybrid cells that had lost the chromosome carrying it. The gpt marker is thus dominant in negative as well as in positive selection, which makes it potentially very useful for genetic studies of mammalian cells. PMID- 3323890 TI - Production and characterization of monoclonal antibodies to staphylococcal enterotoxins: use in immunodetection and immunopurification. AB - Four cell lines producing monoclonal antibodies were obtained by fusion of NS1 myeloma cells with splenocytes of BALB/C mice immunized with only 1 microgram of each staphylococcal enterotoxin A, B, C1 and D by a modified technique of intrasplenic boosting. This procedure was considerably more efficient than the more commonly used intravenous boosting. The antibodies EC-A1, EC-B1, EC-C1 and EC-D1, all of the IgG1 subclass, have high affinities for the corresponding enterotoxins A, B, C1 and D, with dissociation constants of 1.4, 2.8, 1.4 and 1.5 nM respectively; in addition EC-B1 showed a high affinity (2.1 nM) for enterotoxin C1. All these antibodies recognize, by immunoblotting, the homologous purified enterotoxins as well as enterotoxins from the bacterial culture supernatants. A rapid indirect double sandwich ELISA using a pair of antibody preparations was developed, where monospecific monoclonal antibodies were used to coat plastic plates and polyspecific rabbit antibodies were used to detect the enterotoxins under field conditions. These antibodies which are capable of immunoadsorbing the enterotoxins from staphylococcal culture filtrates and from natural fluids such as milk, were used to immunopurify enterotoxins A, C1 and D. The homogeneity and integrity of the affinity purified toxins A, C1 and D was verified by direct automated Edman degradation and yielded single amino terminal sequences which were moderately homologous to those published previously for B and C1 enterotoxins. PMID- 3323889 TI - Involvement of functional protein kinase C in the mitogenic response to the H-ras oncogene product. AB - Microinjection of purified protein kinase C (PKC) into Swiss 3T3 fibroblasts pretreated with the phorbol ester phorbol-12,13-dibutyrate restores the mitogenic response of the cells to phorbol-12,13-dibutyrate (G. Pasti, J.C. Lacal, B.S. Warren, S.A. Aaronson, and P.M. Blumberg, Nature [London] 324:375-377, 1986). Our present studies demonstrate that the mitogenic activity of the H-ras oncogene in H-ras p21-microinjected quiescent cells is markedly reduced under conditions in which PKC is downregulated by chronic phorbol ester treatment. The ability to reconstitute the mitogenic response upon microinjection of both H-ras p21 and PKC implies involvement of functional PKC in the mitogenic activity of the H-ras oncogene product. PMID- 3323891 TI - Regulation of aldosterone biosynthesis. Physiological and clinical aspects. PMID- 3323892 TI - [Mucoviscidosis and precapillary pulmonary hypertension]. AB - Various pathomechanisms are responsible for the development of pulmonary arterial hypertension (PAH) in cystic fibrosis (CF). Main factors are chronic hypoxia and the loss of peripheral vessels caused by recurrent infectious lung disease and lung fibrosis. Measurement of pulmonary artery pressure and pulmonary resistance provide reliable information on PAH. Many non invasive procedures, including echocardiography, myocardial and pulmonary imaging by radionuclide, proved to be not sensitive enough to diagnose PAH. Arterialized pO2 (taken from the hyperemized ear lobe), however, measured during standardized submaximum work load, seems to be a valuable parameter to estimate PAH (r = 0.92). Treatment of PAH in CF-patients is, at the moment, predominantly based on the improvement of the general therapeutical regimen of CF and on long-term oxygen insufflation, which should be initiated as soon as there are first signs of PAH. PMID- 3323893 TI - [Extracorporeal membrane oxygenation (ECMO). A treatment alternative for newborn infants with severe respiratory disorder]. AB - Extracorporeal Membrane Oxygenation (ECMO) is a promising alternative for newborns with critical respiratory disease, where conservative management is no longer sufficient. - Indications for ECMO include mainly the diagnoses Persisting Pulmonary Hypertension (PPHN), Meconium-Aspiration and Congenital Diaphragmatic Hernia. In patients with a mortality-prognosis of 80-100% ECMO will raise survival rates to about 80% with a good general developmental prognosis. Conditions, trainee programs, and experiences up to the first clinical application of ECMO are reported. PMID- 3323894 TI - [Value of percutaneous blind liver biopsy in preoperative diagnosis of atresia of the extrahepatic bile ducts]. AB - During a period of 7 years the case histories of 60 infants with direct hyperbilirubinaemia were prospectively evaluated. At presentation the majority of infants had an age below 1 month. By close clinical follow-up of all infants including the observation of acholic stools (21 infants), quantitative estimations of lipoprotein X during cholestyramine therapy (17 infants), cholescintigraphy (20 infants) and percutaneous liver biopsy (17 infants) the efficiency of the preoperative diagnostic work-up reached 96.6%. Liver biopsies were carried out selectively in only 29.3% of all infants (47.6% in infants with acholic stools and 17.9% in infants with normal stools); their efficiency in the differential diagnosis of extrahepatic biliary atresia was 88.2%. PMID- 3323896 TI - [Phase IV research. Antidepressive agents in neurologic practice]. PMID- 3323898 TI - [HLA class I antigens: from molecular-genetic analysis to their role in the etiopathogenesis of various rheumatic diseases]. AB - The published data on the structure and chromosomal localization of HLA-system, structure of HLA-genes of the I class are presented. The possible mechanisms are discussed for formation of allelic polymorphism of transplantation antigens. Some approaches to study the relation of their structure and function are also discussed. The data are reviewed on the connection of HLA-B27 antigen with a rheumatic disease (ankylosing spondylarthritis). Two groups of hypothesis explaining the latter connection are discussed. The necessity and ability to use molecular-genetic approaches to define the role of HLA-B27 antigen in etiopathogenesis of ankylosing spondylarthritis are grounded. Using the disease as a model one can elaborate the approaches to study the molecular mechanisms of predisposition to diseases having unbalanced linkage with HLA-antigens. PMID- 3323897 TI - [Expression in Escherichia coli cells of the nucleotide sequence of DNA coding for the bovine lipotropic hormone]. AB - A cDNA fragment of bovine proopiomelanocortin coding for beta-lipotropic hormone was joined with a promoter and ribosome binding site of B. amyloliquefaciens and cloned in E. coli in pBR 327 plasmid. The level of beta-lipotropin synthesis in bacterial cells transformed by the obtained plasmid was estimated immunochemically. The level of beta-lipotropin production was shown to be 5 mg per liter of bacterial culture. PMID- 3323895 TI - [Intensified conventional insulin therapy in children and adolescents with type I diabetes]. AB - Children and adolescents with type-I-diabetes are examined with regard to the influence of Intensified Conventional Insulin Therapy (ICT) on metabolic control, insulin requirement and weight development. On average the period of treatment with ICT lasted 10 months (SD: 3 months). The average insulin requirement under ICT slightly increased from 0.82 to 0.87 I.U./kg BW. The need for longer acting insulin decreased from 0.5 to 0.35 I.U./kg BW. Snacks were not necessary. On average the insulin-BE quotient increased to 2.4 I.U./BE in the morning, 1.9.I.U./BE at lunch time and 2.1 I.U./BE at night. Compared to a group being treated with Conventional Insulin Therapy the quality of metabolic control improved. Within the ICT group the part of well controlled patients rose from 10 to 30% whereas the part of poorly controlled patients decreased from 30 to 10%. Provided that Continuous subcutaneous insulin infusion pumps (CSII) cannot be applied, ICT represents the best form of therapy for well educated and highly motivated diabetics aged 12 years old or more. PMID- 3323899 TI - [Problems of safety in biotechnology. Products of genetic engineering and regulation of work with them]. PMID- 3323900 TI - [Effect of exogenous DNAses on various stages of DNA replication in microorganisms]. AB - Effect of DNAase 1 on DNA synthesis and cell division was studied in microorganisms deficient in some stages of DNA replication initiation. The DNA synthesis induced by exogenous DNAase was found to be a replicative origin since it was registered from the "origin" of chromosomal replication under the conditions of initiation of proteins functioning. Stimulation of DNA synthesis in bacterial cells having mutations in DNA B and DNA G genes by DNAase 1 indicates that exogenous DNAases participate in replicative fork during the DNA synthesis. PMID- 3323901 TI - [Kanamycin sulfate--an inducer of recA gene in Escherichia coli]. AB - Kanamycin sulphate causes the efficient induction of recA gene, being an inhibitor of protein synthesis. Kanamycin is not known to damage the DNA structure. Possibly, the antibiotic ability to induce the SOS-genes is explained by activation of endogenous nucleases activity or by the increase of "alarmone" synthesis, the latter playing the "trigger" role in derepression of SOS-operon. PMID- 3323902 TI - Aerobic glucose fermentation by Trypanosoma cruzi axenic culture amastigote-like forms during growth and differentiation to epimastigotes. AB - Axenic culture amastigote-like forms of Trypanosoma cruzi, grown at 28 degrees C, reach a stationary phase after two generations, and differentiate to epimastigotes, which then resume growth. Axenic culture amastigotes readily ferment glucose to succinate and acetate, and do not excrete NH3; they have high activities of hexokinase and phosphoenolpyruvate carboxykinase, and very low citrate synthase activity; cytochrome o is absent, and cytochrome b-like is present at a very low level. Epimastigotes catabolize glucose and produce succinate and acetate at a considerably lower rate; they exhibit lower levels of hexokinase and carboxykinase, and much higher levels of citrate synthase and cytochromes o and b-like. They catabolize amino acids, as shown by excretion of NH3 to the medium. The results suggest that axenic culture amastigotes have an essentially glycolytic metabolism, and they acquire the ability to oxidize substrates such as amino acids only after differentiation to epimastigotes. PMID- 3323903 TI - Pyrimethamine resistant Plasmodium falciparum: overproduction of dihydrofolate reductase by a gene duplication. AB - The accumulation of [3H]pyrimethamine by pyrimethamine-resistant (Pyrr) mutants of the Plasmodium falciparum strain FCR3 was examined by measuring the accumulation of drug in infected red blood cells. [3H]Pyrimethamine was stage specifically accumulated in trophozoites and schizont infected red blood cells. The mutant parasites accumulated drug as efficiently as FCR3. Pyrimethamine was associated with a high molecular weight protein that eluted from a Sephadex G200 column exactly as [3H]fluorodeoxyuridinemonophosphate (FdUMP) labeled parasite dihydrofolate reductase-thymidylate synthetase (DHFR-TS) enzyme. These results suggested that the pyrimethamine resistance was not associated with decreased drug permeability of the membrane. DHFR-TS-[3H]FdUMP enzyme complex of all the Pyrr mutants and FCR3 had a monomer of 70 kDa as measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. One highly resistant mutant, FCR3-D7, exhibited a 5-10 fold higher uptake of pyrimethamine and a proportionately higher amount of DHFR-TS protein than FCR3 but only a normal level of DHFR activity. The genomic DNA of FCR3-D7 was shown to contain at least twice as much DHFR-TS specific DNA than either FCR3-D8, another Pyrr mutant, or FCR3. Preliminary results suggested some of the DHFR-TS genetic material in FCR3-D7 is associated with a gene duplication. PMID- 3323904 TI - Sialic acid in a complex oligosaccharide chain of the Tc-85 surface glycoprotein from the trypomastigote stage of Trypanosoma cruzi. AB - The carbohydrate moiety of the Tc-85 surface glycoprotein from the infective trypomastigote form of Trypanosoma cruzi was analysed. Tc-85 could be metabolically labeled by incubation of the cells with D-[14C]mannose or D [14C]glucose. Degradation techniques were performed directly on the polyacrylamide gel band containing labeled Tc-85. A mannobiose was cleaved by beta-elimination and further treatment of the remaining material under conditions which liberate N-asparaginyl linkages, released a complex oligosaccharide. The presence of sialic acid was demonstrated by: mild acid hydrolysis, neuraminidase treatment and periodate oxidation under mild conditions followed by NaB3H4 reduction, hydrolysis, and detection of NANA7 by paper electrophoresis. In addition, the chromatographic behavior of the asialooligosaccharide was significantly different from that of the original sample. Galactose, mannose and glucosamine are the other monosaccharide components of the sialooligosaccharide. PMID- 3323905 TI - Purification of a Plasmodium berghei neutral endopeptidase and its localization in merozoite. AB - A Plasmodium berghei neutral endopeptidase specific for the fluorogenic substrates valyl-leucyl-glycyl-arginyl/lysyl-aminoethyl-carbazole was purified by Fast Protein Liquid Chromatography. The enzyme was a Mr 68,000 polypeptide. Immunization of mice with the purified enzyme gave a specific antiserum, as demonstrated by immunoblotting. Immunofluorescence with this antiserum showed a strong labelling of P. berghei merozoites in mature segmented schizonts and of merozoites released from schizont-infected red blood cell. This labelling was mainly associated with the merozoite apex. It is possible that this endopeptidase is involved in the reinvasion. PMID- 3323907 TI - 1987 Index: Volumes 325-330. PMID- 3323906 TI - Biosynthesis and secretion of acid phosphatase by Leishmania donovani promastigotes. AB - Metabolic labeling and immunoprecipitation experiments demonstrated that soluble acid phosphatase (EC 3.1.3.2) was rapidly synthesized and released into culture medium by Leishmania donovani promastigotes. The kinetics of release indicated a constitutive secretory process (t 1/2 = 45 min). Moreover, acid phosphatase was the major secretory protein. The extracellular enzyme is composed of two heterodisperse bands of approximately 110 and 130 kDa in sodium dodecyl sulphate polyacrylamide gels. It is synthesized as two intracellular precursors of 92.5 and 107 kDa which acquire the heterodisperse form characteristic of the mature extracellular enzyme during biosynthesis. Labeling in the presence of tunicamycin altered the electrophoretic mobility of the acid phosphatase, indicating the presence of several N-linked oligosaccharides on the mature enzyme. However, tunicamycin did not block secretion of the enzyme or its processing to the heterodisperse form. The biosynthetic effect of tunicamycin was mimicked by N glycosidase F treatment of acid phosphatase immunoprecipitates. In contrast to tunicamycin, labeling in the presence of monensin inhibited processing of the phosphatase to its heterodisperse form. This indicates that Golgi processing, probably glycosylation, is responsible for the heterodispersity of the mature enzyme in sodium dodecyl sulphate-polyacrylamide gels. As with tunicamycin, monensin treatment did not prevent secretion of the acid phosphatase. These cumulative results demonstrate that release of this enzyme by L. donovani promastigotes occurs via a secretory pathway. PMID- 3323909 TI - Unresolved issues in the biochemical pharmacology of antifolates. AB - Despite extensive knowledge of the molecular basis for anticancer selectivity of antifolates, particularly classical antifolates, several fundamental questions remain unanswered. It is still not known why antifolate-treated cells die, rather than remain in stasis. The role of uracil misincorporation into DNA in causing irreparable damage has not yet been completely clarified, nor to what extent the antipurine effect of methotrexate (MTX) may be a desirable effect that contributes to antitumor activity. The antipurine effect may cause progression delay, with paradoxical "self-antagonism"; possibly the antipurine effect of MTX is a cause of toxic side effects. Even less is known about the molecular pharmacology of nonclassical antifolates. If they are not dependent for cellular uptake upon a neoplastic transformation-linked carrier, and since they are not subject to polyglutamylation, the molecular basis for anticancer selectivity of nonclassical antifols is unclear. The mechanism by which trimetrexate and metoprine are transported into cells is not known; if it is by passive diffusion, it is odd that resistance is sometimes associated with impaired drug uptake. Other unanswered questions are the mechanism of cross-resistance of doxorubicin resistant cells to trimetrexate, and why the cytotoxic effect of trimetrexate, at low concentrations, is reversed by thymidine in the absence of purines. Questions also remain concerning antifolate inhibitors of thymidylate synthase (TS), such as how 5,8-dideaza-10-propargylfolic acid (CB3717) enters cells, and whether TS inhibitors will have activity against slowly growing tumors. These and related questions are discussed in relation to the design of optimal antifolate chemotherapy. PMID- 3323908 TI - Initial clinical studies of piritrexim. AB - Piritrexim (PTX) is a second-generation, lipid-soluble inhibitor of dihydrofolate reductase (DHFR). Metabolic inhibition occurs within seconds after rapid diffusion into human cancer cells. We describe the initial phase I studies with iv and oral forms of this drug given on a daily basis for 5 days to patients with cancer. The dose-limiting toxicity is primarily hematologic (leukopenia, granulocytopenia, thrombocytopenia), but phlebitis is also encountered with iv administration and gastrointestinal problems (nausea, vomiting) with oral administration. Oral toxicity can be reduced by giving the daily dose in 2 divided doses. The maximum tolerated dose (MTD) for the iv route is 170 mg/m2 per day for 5 days; for the oral route it is 480 mg/m2 per day for 5 days. Unlike an earlier lipid-soluble folate antagonist, piritrexim did not cause neurologic or histamine-like disorders. PMID- 3323911 TI - [The Nobel Prize for medicine 1987]. PMID- 3323910 TI - Target sites for the inhibition of prostacyclin effect in guinea-pig ileum. AB - In the guinea-pig terminal ileum a maximally effective concentration of prostacyclin (PGI2) (1 mumol/l) induced contractions that were partially resistant to tetrodotoxin (TTX) 0.1 mumol/l, to low temperature (20 degrees C) and to atropine (30 nmol/l). Half maximum contractions evoked by PGI2 (20 nmol/l) were abolished by TTX and by low temperature, which did not modify the response to exogenous acetylcholine (ACh), as well as by atropine. Procaine (5-500 mumol/l) caused a concentration-dependent inhibition of contractions induced by PGI2 (20 nmol/l and 1 mumol/l) and by equieffective concentrations of ACh (20 nmol/l and 0.4 mumol/l, respectively). The order of magnitude for this inhibition was ACh 20 nmol/l = PGI2 20 nmol/l greater than PGI2(1) mumol/l greater than ACh 0.4 mumol/l. In preparations exposed to TTX or to low temperature procaine (50 mumol/l) did not affect the residual response to PGI2 (1 mumol/l). Quercetin (1 and 5 mumol/l) inhibited the effect of PGI2 and, at higher concentrations, it also caused partial depression of the responses to ACh. Quercetin did not alter TTX-resistant and low temperature-resistant contractions induced by PGI2 1 mumol/l. Carbonyl cyanide-trifluoro-methoxyphenyl hydrazone (FCCP) (0.1-1 mumol/l) reduced the effect of PGI2 and of ACh to approximately the same extent and inhibited the residual response to PGI2 1 mumol/l in preparations treated with TTX or expressed to low temperature. The present results show that PGI2, besides acting on cholinergic neurons, also exerts a direct effect on smooth muscle cells and FCCP can be used to block this effect. In contrast procaine and quercetin selectively inhibit the ACh-mediated component of PGI2 action. PMID- 3323912 TI - [Progressive muscular atrophy in the 19th century: one or several diseases?]. PMID- 3323913 TI - [Toward a history of medical practice]. PMID- 3323914 TI - [Apoplexy in 1672]. PMID- 3323916 TI - [Zuiderburg as a pathological-anatomical museum of Professor Hendriksz., including the Cabinet of Quaestius]. PMID- 3323917 TI - [1987--100 years of electrocardiography]. PMID- 3323915 TI - [Zuiderburg as The Netherlands' first large private hospital, 1831-1865]. PMID- 3323918 TI - [AIDS in psychiatry. Legal and ethical aspects]. PMID- 3323920 TI - [Arthur Kronfeld--a forgotten psychiatrist. On his 100th birthday]. PMID- 3323919 TI - [Carbamazepine in the treatment of psychiatric diseases. Review of the current status of research]. PMID- 3323921 TI - [Karl Jaspers' concept of spiritual psychiatry. A comment on the 7th decade of "General Psychopathology"]. PMID- 3323922 TI - Coeliac disease: one century after Samuel Gee (1888) PMID- 3323923 TI - What the clinician should know about coeliac disease. PMID- 3323924 TI - Transient gluten intolerance: does it exist? PMID- 3323926 TI - Coeliac disease and related disorders. PMID- 3323925 TI - Clinical indications of HLA typing and measurement of gliadin antibodies in coeliac disease. PMID- 3323927 TI - Neuron numbers and dendritic extent in normal aging and Alzheimer's disease. AB - Factors which limit the interpretation of studies of aging brain include: secular trends, species and strain differences, effects of tissue processing, and bias which may be introduced at many levels of an experimental design. With these limitations considered, evidence is reviewed regarding neuron numbers and dendritic extent in normally aging rodent, monkey and human brain and in Alzheimer's disease. It is concluded that neuron loss and change in dendritic extent in normal aging are regionally specific, and that corresponding brain regions do not always change in similar ways in rodents and primates. It is suggested that such differences may, in part, be due to inconsistent definitions of 'aged' among species. In Alzheimer's disease there is excess neuron loss and dendritic regression in some, but not all, brain regions. Measures of the morphological substrates of brain function show appreciable overlap between AD and control groups. It is hypothesized that the static, post-mortem status of brain morphology may not adequately reflect the functional capabilities of the dynamic morphology of the living brain. PMID- 3323928 TI - Alzheimer's disease as a presumptive threshold phenomenon. AB - With the example of the basal forebrain cholinergic system as a site of primary importance in AD, the existence of a critical neuron loss as a threshold between normal aging and AD is suggested. If the extent of degeneration exceeds this threshold the system decompensates and the clinical picture becomes apparent. The fully developed stage of AD might, therefore, represent a condition beyond the capacity of compensation where plastic adaptive changes are still present but functionally insufficient. PMID- 3323929 TI - Quantitative changes in some subcortical nuclei in aging, Alzheimer's disease and Parkinson's disease. AB - In normal aging, AD/SDAT and Parkinson's disease, the changes in subcortical neuronal systems are similar in quality and distribution, but highly variable in their intensity. Some correlations between the intensity and pattern of lesions in some subcortical nuclei with changes in cortical target areas in AD/SDAT suggest that age-related subcortical changes may represent a secondary phenomenon (antograde or retrograde degeneration) due to primary cortical damage. However, severe depletion of subcortical nuclei in both AD/SDAT and PD may also occur without considerable cortical pathology which is more compatible with a concomitant degeneration of both subcortical and intracortical neuronal systems. PMID- 3323931 TI - [An autopsy case of multicentric glioma of multiple histopathology]. AB - An autopsy case is described of an 66-year-old man with multicentric glioma of multiple histopathology, i.e. protoplasmic astrocytoma and glioblastoma. Enhanced CT scan revealed three separate lesions in the right cerebral hemisphere, pons, and cerebellar vermis. Initial diagnosis by CT included metastatic and primary brain tumor, multiple abscess, fungal infection, parasites, tuberculoma, and so on. Biopsy of the right frontal mass revealed astrocytoma grade-2. An autopsy revealed gelatinous, clear marginal mass in the right frontal, parietooccipital and cerebellar vermis; an opaque marginal mass with necrosis in dorsal pons was found. At microscopic examination, the right frontal tumor exhibited continuity with both the paraventricular and the right parietooccipital tumor. The right cerebral hemisphere and cerebellar vermis tumors showed protoplasmic astrocytoma; the dorsal pons tumor showed glioblastoma. CSF examination revealed no tumor cells. Tumor invasion of the internal capsule and the meninges was also not found. Accordingly, we diagnosed as multicentric astrocytoma of multiple histopathology. Only 11 case reports of multicentric glioma were recorded in Japan; only one of which was of multiple histopathology. Worldwide, only 7 case reports of multicentric glioma of multiple histopathology were recorded; this is the first case of protoplasmic astrocytoma and glioblastoma. Seen in terms of pathogenesis of multicentric glioma, this case is thought to be very interesting. PMID- 3323930 TI - [Causative factors of recurrence of chronic subdural hematoma]. AB - Burr hole opening and irrigation of hematoma is now a widespread simple technique for the treatment of chronic subdural hematoma (CSH). However, recurrence of hematoma has been sometimes experienced after initial treatment. The purpose of this report is to analyze the causative factors in recurrence of the hematoma after the burr hole opening and irrigation. Out of 68 adult cases of CSH treated by burr hole opening and irrigation technique at Toranomon Hospital during the past nine years, 11 cases (16.2%) showed recurrence of symptoms due to reaccumulation of hematoma after the 1st operation. They were compared with non recurrence cases from the viewpoint of clinical signs, symptoms and course and serial CT findings. But there was no statistically significant difference between them. The causative factors of recurrence of CSH were analyzed and divided into four categories. Type 1 (3 cases): specific promoting factors--Primary intracranial hypotension (2 cases) and anticoagulant therapy (1 case). Type 2 (1 cases): immature timing of operation. Type 3 (4 cases): other causes probably due to operative procedure--Insufficient postoperative external drainage. Type 4 (3 cases): unknown cause. Several authors have reported causative factors of recurrence of CSH so far, but they are still controversial. An additive treatment in the cases involving specific factors, and planning the timing and some procedures of operation are proposed in order to avoid recurrence of CSH. PMID- 3323932 TI - [A case of trigeminal neurinoma with marked extracranial extension]. AB - A case of trigeminal neurinoma with marked extracranial extension is reported with a review of the literature. A 60-year-old female noticed numbness over the left side of the face during the proceeding 15 years. Two years prior to admission, she began to complain of itching and lancinating pain at the left lateral aspect of the nose. Neurologic examination on admission revealed diminished corneal reflex on the left side and hypesthesia in the distribution of the left trigeminal nerve. There was no weakness or atrophy of the ipsilateral masticatory muscles. The remaining cranial nerves and cerebellar functions were normal. Craniograms showed destruction of the left petrous apex, enlargement of the left superior orbital fissure and an extensive bone defect in the floor of the left middle cranial fossa. CT disclosed a huge heterogeneously enhancing mass lesion in the left middle cranial fossa, which extended posteriorly into the left cerebellopontine angle and inferiorly into the pterygoid and infratemporal fossae. Cerebral angiograms revealed medial displacement of the left internal cerebral artery in the ganglionic, cavernous and supraclinoid portions, and elevation of the left middle cerebral artery in the sphenoidal portion. Although the left meningohypophyseal trunk was dilated, no tumor stain was observed. A transantral biopsy specimen provided the diagnosis of neurinoma with Antoni type A tissue. The patient was followed up at the outpatient clinic as radical operations were not agreed upon. Eight cases of trigeminal neurinoma with extracranial extension are reviewed including the presented case. There were two males and six females, and the age varied from 16 to 65 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323933 TI - [Management of acoustic neurinoma with preserved hearing]. AB - Six cases of acoustic neurinoma (AT) with preoperatively preserved hearing are presented. Their clinical features and surgical management for hearing preservation are discussed. Presenting symptoms were hearing decrease in 3 cases (#1, #2, #6), trigeminal neuralgia in 3 cases (#4, #5, #6), and hemifacial spasm in case #2. Case #3 was an incidentally diagnosed case by CT scan. Preoperative decrease of hearing in the affected ears ranged from 10 dB to 60 dB. In all cases except for case #1, CT scans revealed CP angle tumors sized 1 - 4 cm in diameter. A small intracanalicular tumor was detected in case #1 by metrizamide CT scan. Enlargement of the internal auditory meatus was detected in two cases (#4, #6). Through a lateral suboccipital transmeatal approach, all cases underwent radical total resection of tumor with anatomical preservation of both facial and cochlear nerves. Postoperatively, in spite of good morphological preservation of cochlear nerve, useful hearing function was noted in only one case (#3) who had excellent preoperative hearing (10 dB) and whose tumor was very small (1 cm). Facial nerve function was satisfactory in all patients. According to the previous reports, the level of hearing decrease in AT is related to the origin of tumor, direction of its growth, invasions or involvement to cochlear nerve and extension toward the labyrinth. Major factors to achieve preservation of useful hearing in AT surgery are 1) size of the tumor and 2) preoperative hearing acuity. Early detection of small tumor is extremely important and surgery must be precise to preserve cochlear nerve, internal auditory artery and labyrinth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323934 TI - [Primary intracranial epidermoid carcinoma accompanied with epidermoid cyst in the cerebellopontine angle--a case report]. AB - A case of epidermoid carcinoma arising in an epidermoid cyst in the cerebellopontine angle is presented. Clinical features and CT appearance are discussed in comparison with those of benign epidermoid cyst. A 43-year-old man was admitted to the Department of Neurosurgery, University of Tokyo Hospital on April 14, 1983, with complaints of right facial numbness and weakness of six months' history. On neurological examination, sensation of the right half of the face was decreased in all modalities. Marked atrophy of the ipsilateral temporal muscle was also noted. Right facial paresis of peripheral type was evident. Gag reflex was decreased on the same side. Except for a slightly increased left deep tendon reflexes, there were no pyramidal tract signs. A CT without contrast material failed to show any abnormalities. A postcontrast CT demonstrated an irregular enhancement in the right cerebellopontine angle. The finding of asymmetry of the ambient cistern indicated minimum mass effect on the metrizamide CT cisternography. Suboccipital exploration of the right cerebellopontine angle was carried out on April 28, 1983. Leaving a part of the capsule indenting the pons between the roots of the fifth and the seventh nerve, we removed a white pearly tumor. Histological diagnosis was typical epidermoid cyst. He left the hospital one month later with signs of the right seventh and the eighth nerve. His postoperative course, however, was beyond our expectation. Over a few months following his discharge, left hemiparesis as well as horizontal and vertical nystagmus gradually developed. He was readmitted on November 10, 1983. A postcontrast CT revealed enlargement of the enhanced lesion filling the right ambient cistern.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323935 TI - [Vascular compression neuropathy of the optic nerve by sclerotic internal carotid artery]. AB - Although mechanical compression of the optic nerve by a dilated and/or tortuous sclerotic intracranial internal carotid artery is occasionally reported as an etiology for impairment of vision and visual field, early diagnosis of such condition has been hampered by the lack of characteristic neuro-ophthalmological and neuroradiological findings. The review of 35 previously reported cases (60 eyes) including ours showed that 41% out of the 34 operated eyes were improved neurologically by the decompressive procedure, while it was in 27% out of the 26 undecompressed or non-operated eyes. These unsatisfactory operative results are considered mainly due to the failure of early diagnosis. In order to investigate the relationship between the carotid artery and optic nerve, we proposed a method of angiographical projection consisting of the straight view along the long axis of the optic canal. By this projection, it is possible to detect a supero-medial enlargement and/or dislocation of the cisternal portion of the internal carotid artery. The addition of metrizamide CT cisternography which clarifies the relationship of the optic nerve, chiasm and internal carotid artery in the supersellar cistern may further provide an useful clue for the diagnosis of this condition. PMID- 3323936 TI - [A case of intrasellar meningioma with panhypopituitarism and hyperprolactinemia]. AB - A case of intrasellar meningioma is reported. A 49-year-old woman was admitted to our hospital on July 22, 1985, complaining of reduced visual acuity and visual field defect. Visual acuity was 0.6 in the right eye and 0.1 in the left eye. Visual field examination revealed upper temporal quadrantanopsia on the right side and incomplete temporal hemianopsia on the left side. Ocular fundi were normal. X-ray films of the skull showed a balloon-shaped sella turcica with "double floor". CT scan showed a isodense mass with central low density occupying the intrasellar and suprasellar region. After administration of contrast medium, almost homogenous enhancement was noted. Bilateral carotid angiographies demonstrated that horizontal portion of the right anterior cerebral artery was raised. No tumor blush was evident. Endocrinologic function tests confirmed a complete deficit of the anterior lobe hormones except for elevated serum prolactin level of 110 ng/ml. She showed no galactorrhea. On August 6, 1985, the sella turcica was reached via the transsphenoidal rhinoseptal approach. The sella floor and dura matter were intact. The grey, soft and necrotic tumor tissue was encountered and bleeding was controllable. The tumor extending to suprasellar region was firm in consistency. Pathologically, the tumor was a typical meningothelial meningioma. Postoperatively, visual field defect improved and visual acuity was recovered on the right side immediately. Postoperative CT scan showed a thin residual enhanced lesion, which was the attachment of the tumor. It seemed to be the elevated diaphragma sellae. Clinical observation, radiological and endocrinological findings of intrasellar meningioma are similar to that of non-functioning pituitary adenoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3323937 TI - [A case of pituitary hyperplasia associated with primary hypothyroidism]. AB - A thirteen-year-old girl was admitted complaining of short stature and anemia. The low titers of her serum T3 and T4 and the abnormally high TSH level represented primary hypothyroidism. Although she had normal sellar size, CT demonstrated an intra- and suprasellar round mass with homogeneous enhancement. With thyroid replacement therapy the enhanced mass diminished on CT within 5 months, and her symptoms regressed. Twelve cases with radiological diminution of pituitary mass or visual field improvement after thyroid replacement therapy are reviewed. They were considered to be pituitary hyperplasia, rather than pituitary adenoma, caused by long-standing untreated hypothyroidism. In four of them, the pituitary mass on CT was diminished after the therapy. Characteristic CT findings of pituitary hyperplasia, including our case, was a round isodensity mass with homogeneous enhancement in the midline of the pituitary region. In the experimental studies, pituitary hyperplasia is based on the feedback mechanism of hypothalamic-pituitary-thyroid axis, and ultimately autonomous pituitary adenoma may occur. Pituitary mass with hypothyroidism, visual field defect, amenorrhea or galactorrhea tend to be mistaken for prolactinoma or non-functioning adenoma with pituitary hypothyroidism. Thorough endocrinological examination must be carried out. The first choice of treatment for this type of pituitary mass should be thyroid replacement therapy. If there is no improvement of visual field, no regression of pituitary mass on CT, or continuing high TSH levels, then pituitary surgery must be considered. PMID- 3323938 TI - [Familial intracranial aneurysms--report of 20 cases in eight families and review of the literature]. AB - Twenty cases with 32 cerebral aneurysms in eight families of familial intracranial aneurysms are presented. The present 20 cases, 191 cases in 81 pedigrees in the prior 48 reports and our 692 cases of nonfamilial intracranial aneurysm are analyzed from the view points of sex incidence, age at onset, location of aneurysm, incidence of multiple aneurysms and familial relationship. In addition, the heredity of familial intracranial aneurysm is discussed. The characteristics of our 20 cases are summarized as follows: (1) Mean age of our cases was 53.8 years but it differed from that (41.7 years) of the prior cases. (2) However, five patients (25.0%) were diagnosed at younger age (under 39 years) as in the previous reports. (3) The incidence of multiple cerebral aneurysms was very high (40.0%). (4) Middle cerebral artery aneurysms showed a higher incidence (50.0%). Furthermore, we observed the familial incidence (0.7 - 3.2%) in the total intracranial aneurysms encountered at the same neurosurgical unit, the incidence (39.5%) of cerebral aneurysm among children in parent-children cases and that (44.4%) among siblings in sibling cases of familial intracranial aneurysm. Therefore, we suggested the possibility of incidental aneurysm in the remaining siblings in the cases of familial occurrence. PMID- 3323939 TI - Endogenous opioid peptide regulation of pulsatile luteinizing hormone secretion during pregnancy in the rat. AB - The objective of this study was to determine if endogenous opioid peptides (EOPs) influence the pattern of pulsatile luteinizing hormone (LH) secretion on days 6 8, 14-16 and 22 of gestation in the rat. Unanesthetized animals with two jugular cannulae were initially infused with 0.9% saline during which the control pattern of pulsatile LH release was determined. Possible EOP involvement was then determined by infusion of the EOP receptor antagonist naloxone. Plasma estradiol (E2) and progesterone (P) values increased between days 6-8 and 14-16. While plasma E2 values remained elevated through day 22, plasma P values declined by 90%. As previously reported, mean blood LH levels during the control period on day 22 were higher than on days 6-8 and 14-16 due to an increase in LH pulse frequency. At each stage of gestation naloxone infusion increased mean blood LH levels. This stimulatory action of naloxone was reduced in a dose-dependent fashion by simultaneous infusion with morphine, demonstrating that this effect is mediated via EOP receptors. There was no difference in the in vivo pituitary responsiveness to LH-releasing hormone (LHRH) between rats infused with saline or naloxone at any stage of pregnancy, demonstrating that the stimulatory effect of naloxone was not exerted at the pituitary level. Naloxone increased both the amplitude and frequency of pulsatile LH secretion on days 6-8, and stimulated frequency on days 14-16. The effect on amplitude could not be assessed on days 14 16 because too few rats exhibited pulsatile LH secretion prior to naloxone infusion. The increase in pulse frequency was similar on days 6-8 and 14-16. Although naloxone increased LH pulse amplitude and frequency on day 22, these increases were significantly less than those seen on days 6-8 and 14-16, respectively. Pituitary responsiveness to LHRH was less at all stages of pregnancy in comparison to responsiveness in ovariectomized rats, and progressively declined from days 6-8 through day 22. The lowest responsiveness to LHRH was seen on day 22 and contributed, at least in part, to the diminished increase in LH pulse amplitude in response to naloxone infusion on day 22 compared to days 6-8. The reduced naloxone-induced increment in LH pulse frequency on day 22, occurring coincident with a precipitous decline in plasma P levels, suggests a decreased EOP suppression of pulse frequency at this time.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 3323940 TI - Corticotrophin-releasing factor and arginine vasopressin fibre projections to the median eminence of fetal sheep. AB - Using specific antibodies to corticotrophin-releasing factor (CRF) and arginine vasopressin (AVP) we have immunocytochemically located cells and fibres containing these peptides in sheep fetuses. CRF neurones were first detected, in low frequency, in the paraventricular nuclei of fetuses of 90 days of gestation (term is 142-152 days), although no connections to the median eminence (ME) were apparent until 105 days of gestation. AVP neurones were found from 42 days of gestation, the earliest stage examined, and at this age, fibres and terminals were present mainly in the external lamina of the ME. At subsequent ages there appeared to be a redistribution of AVP fibres such that by 132 days of gestation AVP projections were more or less equally distributed between the lamina of the ME, whereas in the adult AVP fibres are directed mainly to the internal lamina. The early appearance of AVP relative to CRF is consistent with the proposal that AVP may be a significant factor controlling adrenocorticotrophin release in the ovine fetus prior to 105 days of gestation. PMID- 3323942 TI - [Prevention of stroke following transient cerebral ischemia: medical or surgical therapy? Review of the most important trials]. PMID- 3323941 TI - An adaptor to the Leksell stereotaxic instrument for digital coordinate determination in radiography. AB - Special perspex adaptors with radiopaque reference structures have been constructed to fit to the Leksell stereotaxic instrument. These structures are visualized on X-ray film in a radiographic examination like angiography or encephalography. The films obtained in two projections at arbitrary angles and focus-film-distances are placed on a digitizing table for the determination of the stereotaxic coordinates of selected targets. The reference structures and the targets are marked with a cursor whereupon a desk top computer performs the calculation of the stereotaxic coordinates. The system allows a rapid, simple and accurate coordinate determination in stereotaxic radiography using the Leksell stereotaxic instrument. PMID- 3323944 TI - [Prenatal diagnosis of ovarian cysts and their early treatment. Presentation of cases]. PMID- 3323943 TI - [Observations on a surgical series of 68 cases of hepatic hydatid cyst]. PMID- 3323945 TI - [Continent ileostomy]. PMID- 3323946 TI - Results of microsurgical treatment of nerve injuries of the wrist. AB - A retrospective study was made of 62 patients with sharp, total transection of the ulnar and/or median nerves, operated on with use of microsurgical techniques. The results were evaluated in 44 patients. Following primary repair of the median nerve, eight patients achieved a reasonable result (8/25, 32%) and 13 a good result (13/25, 52%). In contrast, after secondary nerve grafting in six patients, only one patient achieved a reasonable result (1/6, 17%) and three a good result (3/6, 50%). After primary repair of the ulnar nerve, four patients (4/10, 40%) achieved a reasonable result, and five a good result (5/10, 50%). In contrast, after secondary nerve grafting in five patients, four achieved a reasonable result (4/5, 80%) and none a good result. The age of the patients appeared to determine the quality of recovery; in all patients younger than 20 years reasonable or good function of the nerve returned. PMID- 3323947 TI - Intrabiliary rupture of a hydatid cyst of the liver with concomitant intraperitoneal rupture into the lesser sac. AB - A case is reported of a young man of Moroccan origin, admitted with fever, aerobilia and an epigastric mass. Laparotomy revealed a suppurated hydatid cyst extending from the left lobe of the liver, which had ruptured into the left hepatic duct and intraperitoneally, into the lesser sac. A left hepatic lobectomy was performed. Gas producing micro-organisms were cultured from the cyst contents whereas no viable scolices were demonstrated. Medical therapy with mebendazole was instituted postoperatively. Six months later, the patient underwent subtotal pancreaticoduodenectomy because of an obstructive, lymphoblastic non-Hodgkin lymphoma in the ampullary region. One year after the initial operation, there were no signs of recurrence of the hydatid disease. PMID- 3323948 TI - [Clinical definition of asymptomatic abdominal masses]. AB - Five patients with asymptomatic abdominal masses (abdominal leiomyosarcoma, giant hydronephrosis, renal cell carcinoma, squamous cell carcinoma of the lung metastatic to the adrenal gland, retroperitoneal non-Hodgkin's lymphoma) are reported. Non invasive investigations such as Echography and Computed Tomography, are very advantageous for the quick diagnosis of asymptomatic abdominal masses and for subsequent therapy. PMID- 3323950 TI - [Diagnostic value of cytology and colposcopy in Chlamydia trachomatis infections]. PMID- 3323949 TI - [Several aspects of postmenopausal osteoporosis]. PMID- 3323952 TI - Mesenchymal hamartoma of the liver. PMID- 3323951 TI - Helium pressure potentiates the N-methyl-D-aspartate- and D,L-homocysteate induced decreases of field potentials in the rat hippocampal slice preparation. AB - We examined the influence of helium pressure on the depression induced by various excitatory amino acids in CA1 hippocampal field potentials. The effects of quisqualate, L-glutamate, L-aspartate and kainate were not significantly affected by helium pressure, while those of N-methyl-D-aspartate and D,L-homocysteate were enhanced. These findings suggest that helium pressure specifically increased the sensitivity of the N-methyl-D-aspartate receptor type in the hippocampus. Other hypotheses are discussed. PMID- 3323954 TI - Acoustic neuromas: yesterday, today, and tomorrow. PMID- 3323955 TI - In memoriam: Henry Irwin Fineberg, MD. PMID- 3323953 TI - The enigma of sensitivity in Pacinian corpuscles: a critical review and hypothesis of mechano-electric transduction. AB - The present report reviews the physiological and morphological specializations of Pacinian corpuscles and other mechanoreceptors that are present in the skin and connective tissues of the body as well as the cochlea. The remarkable sensitivity of Pacinian corpuscles is such that the only form of mechanical energy that could be perceived by a Pacinian corpuscle is a sound wave. In fact the human finger as demonstrated by Munger and Ide (1987) can perceive sound waves when water is the coupling agent. The structural specializations are equally remarkable with extensive membrane specializations of both the inner core and inner portion of the outer core. The halves of the inner core are each coupled with gap junctions and the inner portion of the outer core joined with numerous tight junctions. The cleft regions have specializations involving the axolemma that consist of numerous axonal spines containing bundles of filaments projecting into the cleft of the inner core. These structural specializations are thought to represent specializations for mechano-electric transduction analogous in many respects to the hair cells of the cochlea. A hypothesis for mechano-electric transduction is presented that may account in part for the extreme sensitivity of Pacinian corpuscles and other mechanoreceptors. PMID- 3323956 TI - The medical writings of Moses Maimonides. PMID- 3323957 TI - Renal adenocarcinoma in the pediatric age group. PMID- 3323958 TI - Strategic planning for medical societies. PMID- 3323959 TI - Mechanical retraction for elastic impression procedures. PMID- 3323962 TI - Amniocentesis for fetal maturity. PMID- 3323960 TI - In vivo kinetics of 123I-labelled insulin: studies in normal subjects and patients with diabetes mellitus. AB - Radioactive tracer techniques using 131I- and 125I-insulin have been applied to study insulin metabolism. A simple method to label human insulin with 123I to a high specific activity is described. We have used this radiotracer to study insulin kinetics in vivo in normal subjects and in two groups of diabetic patients. The rate of decline in plasma radioactivity was shown to be significantly reduced in patients with diabetes. There were no significant differences in the time-activity profiles of liver and kidneys between the groups studied. This technique may provide insight into the mechanism of some forms of insulin resistance. PMID- 3323961 TI - Noninvasive measurement of blood flow and extraction fraction. AB - We describe the theory of a technique for the noninvasive measurement of organ blood flow which is based on the principle of fractionation of cardiac output and is applicable with any recirculating gamma emitting tracer. The technique effectively determines the count rate that would be recorded over the organ if the tracer behaved like radiolabelled microspheres and was completely trapped in the organ's vascular bed on first pass. After correction for organ depth, the estimated first pass activity plateau, expressed as a fraction of the injected dose, is equal to the organ's fraction of the cardiac output (CO). By extending the theory, organ extraction fraction of extractable tracers or mean transit time of nonextractable tracers can be measured. Renal blood flow (RBF) to the normal left kidney in 18 subjects without evidence of renal disease was estimated by the technique to be 10.4% CO (S.D. 1.2), for the right kidney 9.0% CO(S.D. 1.1), and for both, 19.4% CO (S.D. 1.5). In a separate series of eight patients, RBF values were highly reproducible when obtained on successive days (standard deviation of change: 0.67% CO for the left kidney, 0.63% CO for the right and 0.78% CO for both). The extraction fraction of DTPA (filtration fraction) was 8.5% (1.7) in the left kidney and 9.7% (2.1) in the right kidney. This parameter was less reproducible than RBF, with standard deviations of the changes equal to 1.17% for the left kidney and 1.31% for the right. Stable, well-functioning, renal allografts in children had a mean blood flow of 20.6% CO (S.D. 3.7). Transplant blood flow in eight patients with rejection was less than 5.2% CO. In patients without splenomegaly, splenic blood flow, splenic extraction fraction of sulphur colloid and splenic red cell mean transit time were 4.3% CO (S.D. 0.9), 41% (S.D. 13.8), and 36.9 s (S.D. 4.6), respectively. PMID- 3323963 TI - Workplace medical testing harbors legal pitfalls; caution suggested. PMID- 3323964 TI - Number of physicians should rise; health care costs likely to follow. PMID- 3323965 TI - The use of topical 5-fluorouracil in the treatment of genital condylomas. AB - Topical 5-FU is indicated for therapy-resistant condylomas and for extensive untreated vulvar condylomas. It may be the treatment of choice for vaginal condylomas. Applications of 5-FU once weekly to the vagina and twice weekly to the vulva for 10 weeks appear to be as effective as continued regimens but are better tolerated. Perhaps the greatest value of 5-FU lies in the periodic application for prevention of recurrences of condylomas removed by surgical methods. PMID- 3323966 TI - Physiology of lactation and factors affecting lactation. AB - Breast-feeding may be considered an ancient yet modern phenomenon. Despite trends toward bottle feeding in the 1950s and 1960s, the value of breast feeding is being rediscovered, because it is nutritionally ideal and now fashionable to connect pregnancy and the puerperium with being as "natural" as possible. Nursing normally begins shortly after delivery. This enhances the mother-infant relationship in terms of bonding, and it also stimulates mature milk production. The duration of the nursing period is widely variable, even within cultures. Dietary precautions should ensure adequate maternal dietary intake during breast feeding and should include avoidance of nonessential medications. With proper care and concern, nursing must be considered the ideal form of nutrition for the newborn human. PMID- 3323967 TI - The frequency of suckling. A neglected but essential ingredient of breast feeding. AB - This article presents data to suggest that an essential ingredient for the success of breast-feeding is feeding frequency. Increasing the frequency of feeding decreases nipple pain and breast tenderness, significantly increases milk output and infant weight gain, decreases the peak serum bilirubin levels, increases the success of lactation, and decreases ovulation, markedly improving the contraceptive effect of breast-feeding. PMID- 3323968 TI - The choice of radiologic procedures in the diagnosis of breast disease. AB - We have reviewed the radiologic imaging procedures related to the investigation of breast lesions, particularly carcinoma. We discussed the choice of procedure in certain clinical situations and have made suggestions. Of the imaging methods, x-ray mammography is the most useful. Ultrasound is the next most useful; however, it is not acceptable for screening. The basis for breast cancer detection and diagnosis remains palpation and x-ray mammography. Ultrasound makes a substantial contribution to the diagnostic evaluation of certain lesions. Eventually, biopsy or surgery provides the final answer in those patients with possible lesions after these diagnostic procedures. In view of the high incidence of breast carcinoma, it would be useful for the practitioner dealing with these problems to establish for his practice a standard operating procedure for examination and referral of patients for breast screening and diagnosis as well as a system of follow-up to prevent patients from avoiding the screening and diagnostic process. PMID- 3323969 TI - Nonmammographic breast imaging techniques. Current status and future developments. AB - X-ray mammography (film/screen or Xerox) is the only breast imaging technique with proven efficacy for screening. Ultrasound has a limited diagnostic capability for cyst/solid differentiation. All other modalities should be considered experimental or of no proven benefit for breast evaluation. PMID- 3323970 TI - The detection and cure of breast cancer. AB - The appropriate use of screening mammography can significantly decrease deaths from breast cancer. Physicians and patients must become more vigilant in using available diagnostic modalities if we are to improve upon the survival of patients with breast cancer. PMID- 3323971 TI - Fibrocystic change and fibrocystic disease of the breast. AB - The prominence of fibrocystic change of the breast mandates knowledge of pathophysiology, diagnosis, and treatment on the part of all providing primary care to women. This article reviews cystic, epithelial hyperplastic, and fibrotic changes common to fibrocystic change and fibrocystic disease of the breast. Diagnostic modalities including physical examination technique and needle aspiration are presented, together with the rationale for ultrasonography and mammography. A broad spectrum of treatment options is presented for the clinician. PMID- 3323972 TI - Breast biopsy and the surgical treatment of early carcinoma of the breast. AB - Biopsy techniques include aspiration for fluid, for cytology, or for histology. The indications for each method depend on the physical and/or mammographic findings. If a breast cancer is diagnosed, then treatment will depend on the size and location of the lesion and the patient's wishes. The surgical technique for lumpectomy and axillary node dissection is described. PMID- 3323973 TI - Primary radiation therapy as an alternative to mastectomy for early-stage breast cancer. AB - Breast conservation surgery followed by radiation therapy for definitive treatment of patients with early stage (limited extent) breast cancer (Stage I and Stage II) has been reported by several retrospective and prospective randomized trials to provide comparable local control, disease-free survival, and overall survival to patients treated with mastectomy. Excisional biopsy of the breast lump and associated axillary dissection are required prior to initiation of radiation therapy in order to remove all known tumor and to reduce the dose of radiation required for cure. The axillary dissection is therapeutic for extension into the axillary volume as well as a prognosticator that aids in the selection of patients for adjuvant systemic therapy. Although certain patients may be adequately served without radiation therapy by excisional removal of the tumor and a margin of surrounding normal breast tissue, this population still needs to be defined. Adequate patient selection and the use of good surgical and radiation therapy techniques results in good to excellent cosmesis in 80 to 90 per cent of treated patients. The treatment alternatives, if presented to patients deemed as appropriate candidates, will aid the patients in making an informed consent decision. Wider application and availability of this alternative to mastectomy may have a significant positive impact on our female population by encouraging women to seek detection of breast cancer through breast self-examination and mammography because the desirable alternative reduces the fear of loss of the breast and self image. PMID- 3323974 TI - An overview of contemporary management of breast carcinoma. AB - Breast cancer mortality has shown little decline over the past several decades. Yet, of all solid tumors, breast cancer remains one of the most responsive tumors to hormonal therapy, radiotherapy, and chemotherapy. Adjuvant chemotherapy, endocrine therapy, or both is effective in stage II patients, but not all patients benefit. Breast cancer is a heterogeneous disease whose biologic behavior is reflected by a variety of prognostic variables. The treatment of advanced breast cancer is still palliative; however, worthwhile complete and partial responses are obtained by using the multimodal therapeutic approach. PMID- 3323975 TI - Psychological interactions for women with breast disease. AB - At the outset, the concept of team care was suggested not as a panacea but perhaps as a better approach to acquiring help in areas of expertise not held by the physician. There are tools to help ascertain psychosocial information from patients, and there are agencies that would be willing to conduct psychosocial work-ups for physicians and teach these significant psychosocial concepts. There are many innovative and creative group practices that now employ their own behavioral personnel to assist in a humanistic evaluation of the patient. Recently, Boyd demonstrated through her research projects how one might want to consider approaching women with patient education and treatment of breast disease. The inventory she uses to ascertain both mental and physical characteristics that might place a woman at risk for breast disease is superb and highly recommended. Another paradigm to consider would be Bartlett's "Behavioral Diagnosis," a practical approach to patient education. These are but two of countless others one might want to consider. And finally, the "Cancer Inventory of Problem Situations" can also be a very useful tool. This is only a cursory view of the complexities one encounters when attempting to understand women, how and why they behave the way they do, how they respond to the health care system, what some of their influences are, and what we must all do together to help them help themselves and us, to provide them with a longer, more productive, rewarding and healthy life span. We have addressed patient education and how physicians might want to embark upon a sound enlightenment program for their patients by enhancing their communication skills and paying strict attention to the patient's psychosocial history as well as their own psychosocial orientation. PMID- 3323976 TI - [Successes and problems of ophthalmological science in the Ukraine]. PMID- 3323977 TI - [Acoustic ophthalmoscanning in cataracts in children]. PMID- 3323978 TI - [Changes in the visual fields in patients with occlusive lesions of the brachiocephalic arteries]. PMID- 3323979 TI - [Construction of a trephine and its effect on the condition of a penetrating transplant of the cornea]. PMID- 3323981 TI - Oversize donor buttons in corneal transplantation surgery for keratoconus. AB - The authors report preliminary findings in 34 patients treated with oversize donor buttons for keratoconus. Seventeen patients received oversize donor grafts and 17 received same-size material. A significant increase in myopia was observed in the oversize group when compared with the same-size group, which indicates a trend toward increased corneal curvature in oversized corneal grafts. Oversize material therefore is contraindicated in treating keratoconus. PMID- 3323980 TI - [The role of proteolytic enzyme inhibitors in the pathogenesis and treatment of inflammatory eye diseases]. PMID- 3323982 TI - Respiratory depression following retrobulbar bupivacaine: three case reports and literature review. AB - Retrobulbar bupivacaine (0.75%) administration has been implicated as a causative factor in respiratory distress, cardiovascular dysfunction, and various central nervous system disturbances. The three cases here demonstrate two separate occurrences of respiratory and central nervous system (CNS) complications following retrobulbar bupivacaine (Marcaine) injection. It is thought that the immediate and delayed occurrences result from inadvertent injection at either of two sites: intravascularly or directly into the membranous sheath surrounding the optic nerve. PMID- 3323983 TI - Low-energy linear-incision neodymium: YAG laser iridotomy versus linear-incision argon laser iridotomy. A prospective clinical investigation. AB - When the Q-switched neodymium: YAG (Nd: YAG) laser is focused through the Wise 103-diopter (D) iridotomy-sphincterotomy lens (103-D lens) at low energy levels, the peripheral iris fibers can be cut individually across the iris tension lines to produce large iridotomies of controllable size. Thirty patients had linear incision Nd:YAG laser iridotomy in one eye and linear-incision argon laser iridotomy in the other. Two-hour post-laser IOP rises averaged 7.33 mmHg for the Nd:YAG laser and 8.64 mmHg for the argon laser. The argon laser produced lens burns in 9 of 30 eyes, including 7 of 9 blue eyes. No lens damage occurred with the Nd:YAG laser. No corneal or retinal damage was seen with either laser. Local oozing of blood inhibited optical breakdown and required a pause before completion in 5 of 30 eyes with Nd:YAG iridotomy, including 4 of 6 dark brown thick irides. Because the iris fibers must be cut by direct contact with the laser plasma, serial cutting of iris fibers by multiple low-energy plasmas is safer than a single-shot, high-power plasma occupying the full thickness of the iris. Because it is effective and because it avoids the hazards of argon laser iridotomy and of high-power Nd:YAG laser iridotomy, linear incision Nd:YAG laser iridotomy is recommended as the safest method of iridotomy. PMID- 3323984 TI - Dural and carotid cavernous sinus fistulas. Diagnosis, management, and complications. AB - Carotid cavernous sinus fistulas (CCSFs) are a rare entity occurring as a result of head trauma and also spontaneously. The major threat from these fistulas is loss of vision. The authors reviewed 18 cases of direct and dural CCSFs seen over the last 10 years and compared our results with 553 cases treated in the literature. Seventy-one percent of our patients with direct CCSFs had successful balloon embolization. In the literature, successful closure of direct CCSFs has ranged from 58 to 100%. As experience with embolization techniques broadens, morbidity and mortality is reduced. The clinical features, diagnostic procedures, therapeutic options, and complications of treatment of CCSFs are discussed. PMID- 3323985 TI - Effect of an insulin-induced decrease in blood glucose on the human diabetic retinal circulation. AB - The effect of an insulin-induced decrease in blood glucose on the retinal blood flow (Q) was studied in 12 type II diabetics, using bidirectional laser Doppler velocimetry (BLDV) and monochromatic fundus photography. Q was first measured during hyperglycemia and then during normoglycemia which was achieved within approximately 3 hours by intravenous insulin administration. At normoglycemia, Q was 15% lower than at hyperglycemia (P less than 0.001). The decrease in Q was larger in patients with shorter disease duration. The authors also determined the regulatory change in Q during 100% oxygen breathing. Although this response remained subnormal, it was improved significantly in normoglycemia (P less than 0.01), particularly in those patients whose blood glucose level was decreased at a slower rate, suggesting that a gradual decrease in blood glucose may be beneficial. PMID- 3323986 TI - Clinical features, laboratory investigations, and survival in ocular reticulum cell sarcoma. AB - The authors report 32 cases of histologically proven ocular reticulum cell sarcoma (RCS). Follow-up data are available for all patients. Twenty-six patients (81%) have died and the mean survival time was 20 months from the time of diagnosis of RCS. Diagnosis of ocular involvement was made by vitreous biopsy in 56% of cases, enucleation in 13%, and postmortem examination in 31%. The mean age at the time of diagnosis was 60 years. Central nervous system (CNS) involvement was present in 56% of patients, visceral involvement in 16%, and both CNS and visceral involvement in 6%. Isolated ocular disease occurred in 22% of patients. Results of head computed tomography (CT) and cerebrospinal fluid examination more often disclosed evidence of RCS than did body CT or nuclear medicine scans. Responses to treatment were variable, but prognosis for survival is poor. PMID- 3323987 TI - Stage 5 retinopathy of prematurity. Prognostic value of morphologic findings. AB - Anterior and posterior segment findings were evaluated in 184 consecutive cases of stage 5 retinopathy of prematurity (ROP) (368 eyes). One hundred seventy patients had one or more examinations under anesthesia and 150 had open-sky vitrectomy (260 eyes) with or without additional surgery. Ocular findings were inspected and special attention was given to verify the morphology of the retinal detachment (RD) as predicted by ultrasonography. Immature iris and/or pupil, posteriorly or totally closed detachment funnels, vascularized epiretinal membranes, retinal folds, tractional retinoschisis, persistent hyaloid system, and subretinal blood and/or organization were the most significant indicators of bad prognosis. Evaluating stage 5 ROP eyes with these variables in mind is therefore essential. PMID- 3323988 TI - Intraocular lens removal during penetrating keratoplasty for pseudophakic bullous keratopathy. PMID- 3323989 TI - Proteolytic enzymes in otosclerosis. Significance of proteolytic enzymes in otosclerotic bone remodelling. AB - The otosclerotic stapes footplate exhibits higher activities of cathepsin D and H and collagenase-like peptidase than those of normal cortical bone. The elevated enzyme activities of osteoblastic origin (Cl-peptidase and cathepsin D) emphasize the essential and probably primary role of the bone-forming cells, not only in bone formation, but in resorption as well. The highest activity of cathepsin D from among the measured enzymes highlights the adjuvant role of acidic glucosaminoglycans in the otosclerotic demineralization process. As the osteoblastic osteoid synthesis is known to be sharply reduced in otosclerotic bone remodelling, and the above data emphasize the role of proteolytic enzymes of osteoblastic origin too, indirectly, osteoblasts seem to be the otosclerosis signal-transducing cells. PMID- 3323990 TI - [Intertrochanteric osteotomy of the femur in the treatment of Legg-Perthes disease]. PMID- 3323992 TI - [Experimental morphological substantiation of the method of inverse "forks" for bone union in correcting major defects of distal articular bone segments]. PMID- 3323991 TI - [A method of alloplasty of collateral ligaments of the knee joint]. PMID- 3323993 TI - [Treatment of urological complications of kidney transplantation with interventional radiologic methods]. PMID- 3323994 TI - [Significance of CA-125 antigen in the monitoring of therapy and clinical course of ovarian cancer]. PMID- 3323995 TI - [William James, physician, philosopher and a man suffering from melancholia]. PMID- 3323996 TI - [In memoriam Aladar Soos]. PMID- 3323997 TI - [Alfred Adler and the psychology of the inferiority complex]. PMID- 3323999 TI - [Complex diagnosis and therapy of malignant melanoma]. PMID- 3323998 TI - [Prognostic significance of exercise testing in patients with ischemic heart disease showing positive coronarography]. PMID- 3324000 TI - [Effect of female sex hormones on blastic transformation of lymphocytes in systemic lupus erythematosus and in healthy women]. PMID- 3324001 TI - [Epidemiologic data and risk factors of our cerebrovascular patients]. PMID- 3324002 TI - [Unusual clinical syndrome: rheumatoid arthritis and gouty arthritis]. PMID- 3324003 TI - [Renal and hormonal changes in childhood nephrotic syndrome as affected by water immersion]. PMID- 3324004 TI - [Mihaly Vorosmarty: the 150-year-old poem "Szozat" (the 2d Hungarian national anthem)]. PMID- 3324005 TI - [The F. Enke Publishing House is 150 years old]. PMID- 3324006 TI - [150 years St. Anna Childrens Hospital (1837-1987)]. PMID- 3324007 TI - Chorion villus biopsy. PMID- 3324008 TI - Human sex pre-selection. PMID- 3324009 TI - Cancer of the prostate: endocrine factors. PMID- 3324010 TI - Sperm--zona pellucida binding activity. PMID- 3324012 TI - Neural transplants and the repair of neuroendocrine and reproductive deficiencies. PMID- 3324011 TI - Fertilization: motility, the cytoskeleton and the nuclear architecture. PMID- 3324013 TI - Growth factors in embryogenesis. PMID- 3324014 TI - GnRH and ovarian hormone feedback. PMID- 3324015 TI - Ovulation in the hen: neuroendocrine control. PMID- 3324016 TI - Reflex sympathetic dystrophies and algodystrophies: historical and pathogenic considerations. AB - This paper reviews the historical development of the concepts of 'sympathy' of organs and of the sympathetic nervous system. In particular, the afferent function of the sympathetic system is discussed. The attention is focussed on sympathetic reflex dystrophies, known in some European schools as 'algodystrophies'. The pathogenic mechanisms of these affections, especially of causalgia, are discussed, considering the importance of peripheral damage to nerves, lateralisation of pain, 'mirror phenomena', and the relationship between peripheral and central mechanisms of pain. PMID- 3324017 TI - An assessment of children's pain: a review of behavioral, physiological and direct scaling techniques. AB - Research on the assessment and management of pain in infants and children has increased dramatically, with the consequence that a wide variety of behavioral, physiological, and psychological methods are now available for measuring pediatric pain. Although the criteria for a pain measure for children are identical to those required for any measuring instrument, special problems exist in pediatric pain measurement because the influence of developmental factors, previous pain experience, and parental attitudes on children's perceptions and expressions of pain is not known. This article reviews the recent advances in the measurement of pain in children, with special emphasis on the methods that satisfy the criteria for reliability and validity, the methods that can be used to assess multiple dimensions of pain, and the methods that may be appropriate for assessing all types of acute, recurrent, and chronic pediatric pain. PMID- 3324018 TI - Prevention of surgical wound infections (S.W.I.). Ten years of experience. PMID- 3324020 TI - Molecular endocrinology of breast cancer. PMID- 3324019 TI - Pregnancy and autonomic hyperreflexia in patients with spinal cord lesions. AB - Symptoms of autonomic hyperreflexia in patients with complete and incomplete paraplegia above D 7 can be caused by almost any stimulus in the abdominal area or in the lower extremities, specifically during parturition by the uterine contractions. The symptoms vary from pilo-erection and outbreaks of sweating to serious blood pressure crises and cerebrovascular accidents. Epidural anaesthesia and general anaesthesia are effective as therapy and also as prophylaxis. Frequent complications are anemia and urinary tract infections. Changes in bladder function as a result of pregnancy and childbirth were observed. Paraplegic expectant mothers experience premature labour pains more frequently than do others, and this implies the necessity for earlier clinical surveillance up to the time of delivery. The secondary uterine inertia frequently requires an operative termination of the birth. The perception of labour pains is clearly possible also with lesions above D 10. PMID- 3324021 TI - Comparison of an estrogen receptor related protein, the ERD5 antigen, with estrogen and progesterone receptors in breast cancer patients. AB - Eighty five breast cancer cytosols were assessed for ERD5-antigen (an estrogen receptor associated protein) using the Amersham immunoradiometric assay. Estrogen and progesterone receptors were measured using charcoal treatment to separate receptor-bound tritiated ligand from the excess free, or weakly-bound ligand. Patients whose cytosols were receptor-rich (ER+ PR+) were more likely to be ERD5 antigen positive and had higher quantitative levels of this protein, than patients whose cytosols contained no estrogen receptor protein. However, twenty nine percent of ER-negative cytosols showed significant ERD5 antigen levels. In this preliminary study ERD5 antigen levels showed no potential value in discriminating between breast cancer cytosols from ER positive and ER negative patients. PMID- 3324022 TI - Whither cytosolic estrogen receptor assays? A comparison of commercially available kits for estrogen receptor assay. AB - Frozen tissue sections and cytosols from 89 specimens of breast and ovarian tumours have been assayed for the presence of estrogen receptor (ER) or related protein using four commercially available monoclonal antibody methods. These were estrogen receptor enzyme immunoassay (ER-EIA), estrogen receptor enzyme immunocytochemical assay (ER-ICA), ER D5 antigen immunoradiometric assay and ER D5 antigen immunocytochemical assay. The results have been compared with those obtained using a standard dextran coated charcoal steroid binding assay (ER-DCC). The correlation coefficient (r) between ER-DCC and ER-EIA results was 0.72 while that of both monoclonal antibody cytosol methods and their respective immunocytochemical assays was 0.66. ER-ICA gave additional valuable information concerning receptor heterogeneity in breast cancer sections. However, the correlation between ER D5 antigen assays and both ER-DCC and ER-EIA was weak (r less than 0.4). We conclude that there are a number of methodological advantages in using the kit systems including their ability to detect receptor presence in small tumour specimens (e.g., "Tru-cut" biopsies) but that their usefulness is limited by the current lack of widely available monoclonal based methods for the concurrent determination of progestogen receptor. We believe that, once these are available, immunocytochemical technology could offer an alternative method of determining the steroid receptor concentration in both ovarian and breast tumours, thus obviating the need for costly and time-consuming cytosolic methods, with their inherent difficulties of quality control. PMID- 3324023 TI - Immunohistochemical localization of metallothionein in cell nucleus and cytoplasm of fetal human liver and kidney and its changes during development. AB - The distribution of metallothionein (MT) during human development was investigated using both immunohistochemical and biochemical methods. The level of MT in the fetal liver was higher than the adult liver levels. Higher levels of zinc (Zn) and copper (Cu) were also detected in the fetal liver compared to the adult liver. Although cadmium (Cd) was present in detectable levels in the human adult liver, none was detected in the human fetal liver. MT was localized in the nucleus and the cytoplasm of human fetal and neonatal hepatocytes, using a specific rabbit antibody raised to rat liver MT. In the adult human liver cells, MT was localized mainly in the cytoplasm. In the fetal and neonatal human kidney, MT was localized mainly in the nucleus and the cytoplasm of the proximal tubular epithelial cells. In the adult kidney, in addition to nuclear-cytoplasmic localization of MT, intraluminal localization was also observed. PMID- 3324024 TI - Brenner tumours of the ovary: a study of the histology, immunohistochemistry and cellular DNA content in benign, borderline and malignant ovarian tumours. AB - Brenner tumours are now generally regarded as being of ovarian epithelial origin. Most have a limited growth potential and are benign. For this reason they are usually found incidentally at hysterectomy. In common with other epithelial ovarian tumours there is a histopathological spectrum of appearances ranging from benign through borderline to invasive malignancy. In this series all 54 tumours were graded according to the degree of cytological atypia, presence of mitoses and tumour necrosis. Heterogeneity of DNA content was observed in the higher grade tumours, two of the four being diploid and two being aneuploid (all benign tumours being diploid). The presence of aneuploidy correlated with the histological features and a poor clinical prognosis. Immunohistochemical staining for keratoprotein was found to be of limited value in the diagnosis of Brenner tumours and their metastases. PMID- 3324025 TI - Blood-culture techniques. A survey in Australasian laboratories. AB - The blood-culture methods of participants in the Microbiology Quality Assurance Programme were surveyed in late 1983; 183 participants from Australasia and S.E. Asia completed a questionnaire, the results of which are discussed. The choice of skin disinfectants varied widely. Conventional broth media were used by 85 participants; one or more diphasic bottles by 56; Roche Septi-Chek was used by 25; and BACTEC by 17. Only 80% of respondents reported the use of sodium polyanethol sulfonate. Contamination rates ranged from 0 to greater than 10%. Cultures were kept for as little as five days or as long as three weeks and were examined by inspection and/or Gram stain and/or subculture at widely varying intervals. While a great diversity of methods was used, in most cases these were adequate. The workload involved in some of the more laborious routines was considerable. It would be desirable to evaluate the cost-effectiveness of many blood culture practices. PMID- 3324026 TI - Immunohistochemical localisation of neuron-binding antibodies in rheumatic heart disease. AB - Neuron-binding antibodies and heart-reactive antibodies (HRA) have been investigated in the sera of patients with acute rheumatic fever (ARF) and chronic valvular rheumatic heart disease (both active and inactive by means of immunoperoxidase technique. The incidence of neuron-binding antibodies was highest in ARF (61.1%) in comparison with 54.2% in active chronic valvular disease with activity and 21.1% in inactive chronic valvular disease. In active chronic valvular disease the labelling of neurons was commoner than labelling of myofibres (p less than 0.01). In the other two groups (ARF and inactive chronic valvular disease) no difference in staining of neurons and myofibres was observed. Morphological localisation of binding sites of antibodies in the caudate nucleus neurons showed a definite pattern, which varied from a peripheral crescentic to a diffuse staining within the neuronal cytoplasm, often extending into the dendritic processes. Antibodies binding to caudate nucleus neurons were significantly commoner in ARF and active chronic valvular disease than in inactive chronic valvular disease (p less than 0.05). PMID- 3324028 TI - [Proteolytic enzymes and their inhibitors in acute experimental pneumonia]. PMID- 3324027 TI - [70th anniversary of the Soviet public health service]. PMID- 3324030 TI - [The role of vitamin D metabolites in the pathology of phosphorus-calcium metabolism]. PMID- 3324029 TI - [Generalized changes in regional blood flow and microcirculation during the tumor growth]. PMID- 3324031 TI - Immunochemical studies of human prolidase with monoclonal and polyclonal antibodies: absence of the subunit of prolidase in erythrocytes from a patient with prolidase deficiency. AB - Prolidase was highly purified from human liver and erythrocytes. NaDodSO4/acrylamide gel electrophoresis revealed that these preparations contained a major protein with MW = 56,000. The mass of prolidase was estimated on gel filtration to be MW = 97,000, for both enzyme preparations. A monoclonal antibody was raised against the liver enzyme and a specific antiserum against the erythrocyte enzyme. The monoclonal antibody (EP-2) recognized prolidase from erythrocytes and liver, in equal proportions. The antiserum also recognized the enzyme from erythrocytes and liver. Immunoprecipitation studies with these antibodies suggested only a single species of prolidase in erythrocytes and liver. Using an immobilized monoclonal antibody (EP-2) as an immunoadsorbent, prolidase was partially purified from crude extracts, and the protein of the partially purified enzyme was identified by immunoblotting using antiserum. A protein band with a MW = 56,000 was demonstrated specifically when crude extracts from the liver and erythrocytes were examined using NaDodSO4/acrylamide gel electrophoresis. The subunit protein was absent in erythrocytes from a patient with prolidase deficiency. We propose that the absence of the subunit is one cause of the prolidase deficiency. PMID- 3324032 TI - Increasing ventilation pressure increases cortical subarachnoid cerebrospinal fluid prostanoids in newborn pigs. AB - This study examines the responses of pial arterioles and venules to increased mean airway pressure (P aw-) in newborn pigs. We further characterized the changes in cortical subarachnoid cerebrospinal fluid prostanoids with increased P aw-, both before and after cyclooxygenase inhibition with indomethacin. Eight chloralose anesthetized newborn pigs were equipped with closed cranial windows and ventilated with a conventional infant pressure-cycled respirator. Increasing P aw- from 3.2 +/- 0.3 cm water to 14.3 +/- 0.6 cm water did not change pial arteriole or venule diameters. Cerebrospinal fluid prostanoids (6-keto-PGF1 alpha, TxB2, PGE2, and PGF2 alpha), however, were increased reversibly (3- to 5 fold) by increasing P aw-. After indomethacin (5 mg/kg, intravenous) pial arterioles constricted approximately 15% with increased P aw-. These results suggest that increasing ventilation pressure increases brain prostanoid production. Prostanoids appear to inhibit vasoconstriction and may be important in maintaining cerebral blood flow during the stress of mechanical ventilation. PMID- 3324033 TI - Effect of Haemophilus influenzae type b lipopolysaccharide on complement activation and polymorphonuclear leukocyte function. AB - Purified lipopolysaccharide (LPS) from Haemophilus influenzae type b (Hib) was examined for its capacity to interact with human hemolytic complement, generate conversion products of C3, C4, and factor B, stimulate C5a activity, and affect human neutrophil chemiluminescence and phagocytosis. Salmonella typhimurium LPS and Salmonella minnesota Rb LPS (R345 mutant) were examined for comparison. Incubation of Hib LPS with human serum deficient in gamma-globulin or with normal human serum containing 10 mM EGTA and 7 mM MgCl2 resulted in some depletion of hemolytic complement and conversion of C3 to degradation products (determined by inhibition of passive hemolysis and electrophoresis/immunofixation, respectively), indicating that complement activation occurred by the alternative pathway. Complement activation by Hib LPS and S. minnesota Rb LPS was similar, but significantly less effective than by S. typhimurium LPS (p less than 0.01). Solubilized Hib lipid A, but not LPS, induced conversion products of C4 in hypogammaglobulinemic serum, indicating activation of the classical pathway. Similar levels of C5a activity were generated by incubation of Hib LPS and S. typhimurium LPS in hypogammaglobulinemic serum, as determined by neutrophil shape change and neutrophil aggregation. Hib LPS directly stimulated neutrophil chemiluminescence, whereas S. typhimurium LPS had little effect. Phagocytosis of radiolabeled, opsonized Hib by neutrophils was diminished by S. minnesota Rb LPS, Hib LPS, or solubilized Hib lipid A (p less than 0.001), but was slightly increased by S. typhimurium LPS. Neither the oligosaccharide of Hib LPS or Hib capsular polysaccharide was capable of interacting with complement or altering neutrophil chemiluminescence or phagocytosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3324035 TI - [50 years of medical work of Prof. Dr. med. Wanda Poradowska]. PMID- 3324036 TI - [Treatment of respiratory insufficiency in an infant after surgery of diaphragmatic hernia]. PMID- 3324034 TI - Society for Pediatric Research presidential address. New functions for an old molecule. PMID- 3324037 TI - [History of one of the Warsaw hospitals during the Warsaw Uprising of 1944 and its subsequent fate]. PMID- 3324038 TI - Outpatient treatment of serious community-acquired pediatric infections using once daily intramuscular ceftriaxone. AB - Pediatric patients with serious infections are usually hospitalized for parenteral antibiotic treatment. We studied prospectively 74 pediatric patients with community-acquired serious infections and used once daily intramuscular ceftriaxone. Seventeen patients (23%) were initially hospitalized and 57 (77%) patients were treated entirely as outpatients. An initial intramuscular dose of 75 mg/kg was followed by daily doses of 50 mg/kg (maximum, 1.5 g). Infections treated included periorbital/buccal cellulitis, other cellulitis, urinary tract infections, pneumonia, osteomyelitis, mastoiditis, suppurative arthritis and orbital cellulitis. Organisms were recovered from cultures of 37 (50%) patients and 6 (8%) patients were bacteremic. Bacteria included Gram-positive (mostly Staphylococcus aureus) and Gram-negative (mostly enteric bacilli and Haemophilus influenzae organisms). No serious side effects were observed. Of 74 patients 72 (97%) were cured and improvement was usually observed within 24 hours. Two patients did not improve: one with chronic Pseudomonas mastoiditis; and one with lung abscess. Based on previous experience it is estimated that 376 hospitalization days were saved. All 72 successfully treated patients and their parents resumed normal activity within 72 hours of starting therapy. Our data suggest that ceftriaxone can be used for outpatient treatment of some infectious diseases. PMID- 3324039 TI - Randomized controlled trial of intralesional corticosteroid and griseofulvin vs. griseofulvin alone for treatment of kerion. AB - We studied 30 children with tinea capitis and kerion to define the epidemiology of the disease and to compare the efficacy of intralesional steroid injection and griseofulvin to griseofulvin alone for treatment of this disorder. Patients ranged in age from 1 year to 12 years, 1 month (mean, 5 years, 7 months). All patients were black and 23 (77%) were female. (The racial composition of our clinic population is 45% black, 18% Latin American, 34% Caucasian and 3% Asian.) Fungus cultures were positive in all but one patient and Trichophyton tonsurans was isolated from 26 of 30 (87%) of the pretreatment hair cultures. Direct microscopic examinations of KOH-treated hair samples were negative in 13 of 29 (43%) culture-positive patients. Patients were randomly assigned to receive intralesional steroid injection (2.5 mg) and griseofulvin (14 patients) or griseofulvin only (16 patients). The treatment groups were comparable with regard to age, sex, duration of lesions before treatment and type of lesions. There were no significant differences between the two treatment groups in the time to negative culture, time of onset of new hair growth, complete regrowth of hair and time to scalp clearing. We conclude that intralesional injection of corticosteroid is an unnecessary adjunct to therapy for patients with tinea capitis with kerion. PMID- 3324040 TI - Fever response to acetaminophen in viral vs. bacterial infections. AB - The effect of acetaminophen on fever in bacterial vs. viral infections was tested in 100 children ages 9 days to 17 years who presented to the Pediatric Service with a rectal or oral temperature of 102 degrees F (38.9 degrees C) or greater. All patients were given acetaminophen, 15 mg/kg, and their temperatures were rechecked at 1 hour. Laboratory tests were ordered at the discretion of the examining physician and usually included viral and bacterial cultures and total white blood cell counts. Sixteen patients had proved viral illnesses and 17 patients had serious bacterial infections. There was a significant difference (P less than 0.02) in the white blood cell count between the two groups, with the higher values in patients with bacterial infections. There was, however, no significant difference in the fever response to acetaminophen between the two groups (P = 0.37). The remaining 67 patients were then placed into one of the two groups based on their clinical illness and outcome. The mean temperature change was then calculated between the two groups, and again the difference was found to be statistically insignificant (P = not significant (t = 0.19]. We conclude that there is no correlation between a child's fever response to acetaminophen and the etiology of the fever. PMID- 3324042 TI - Drug disposition in cystic fibrosis: progress in understanding pathophysiology and pharmacokinetics. PMID- 3324041 TI - Impact of rapid antigen tests for group A streptococcal pharyngitis on physician use of antibiotics and throat cultures. AB - Using case scenarios and an interview guided by a decision tree diagram, the clinical strategies of 150 physicians (50 private pediatricians, 50 health maintenance organization pediatricians and 50 pediatric residents) were assessed for the management of pharyngitis under three conditions: (1) no rapid antigen detection test available for diagnosing Group A streptococcal disease; (2) antigen test result available in 20 minutes; and (3) antigen test result available in 4 hours. The sensitivity of the antigen test was designated as 0.95 if the growth of rare or few Group A streptococci on throat culture was discounted and 0.82 if any growth was considered significant, and the specificity was set at 0.98. In a standardized pediatric case with a prior probability of Group A streptococcal disease of 0.58, 84% of clinicians would order a 20-minute test and 39% would order a 4-hour test. The 20-minute test would reduce throat culture use by 54%, reduce the proportion of patients exposed to antibiotics from 86% to 65% and reduce total antibiotic treatment days by 13.8%. Effects would be less pronounced for a low probability case or if results of antigen testing were not available for 4 hours. Provided a test with a documented high sensitivity and specificity were used, a rapid antigen test with results promptly available would substantially reduce throat culture use and unnecessary antibiotic exposures in children with a moderate prior probability of streptococcal disease. PMID- 3324043 TI - Gastroenteritis and encephalopathy associated with a strain of Escherichia coli 055:K59:H4 that produced a cytolethal distending toxin. PMID- 3324045 TI - [Catamnestic evaluation of the surgical treatment of nocturnal urinary incontinence in spina bifida occulta]. PMID- 3324044 TI - [Effect of sodium thiosulfate on the system of proteolysis and lipid peroxidation processes in children with pneumonia]. PMID- 3324046 TI - [Ultrasonic diagnosis of bone tumors in children]. PMID- 3324047 TI - [Sparing operations in osteogenic sarcoma in children]. PMID- 3324048 TI - [Prenatal diagnosis of enterogenic mediastinal cyst and its treatment in a newborn infant]. PMID- 3324049 TI - [Value of the immunosorbent agglutination assay (ISAGA) in the early diagnosis of congenital toxoplasmosis]. AB - An IgM immunosorbent agglutination assay (ISAGA) test was evaluated for detection of IgM antibodies in diagnosis of congenital toxoplasma infection, and compared with IgM IFI test. Of 36 sera from infants with congenital infection, the IgM ISAGA test was positive in 19 cases (52%), whereas the IgM IFI test was positive in only 4 cases (11%). Of those sera obtained during the first 90 days of life from the infected infants, 70% were positive in the IgM ISAGA test whereas only 23% in the IgM IFI test. Neonatal sera from 10 infants suspected, but in whom this diagnosis was ruled out, were also evaluated: one false positive was found with the ISAGA test, but without control 15 days later. The ISAGA test is a simple, sensitive and probably highly specific test for diagnosis of congenital toxoplasma infection. PMID- 3324051 TI - Spasticity and drug therapy. AB - An overview is presented of pathophysiology, classification and measurement of spasticity and of its treatment, especially with dantrolene and baclofen. In spasticity, the balance between excitatory and inhibitory neurotransmitters in the central nervous system is impaired by mechanisms that are for the greater part unknown. Spasticity includes various disorders of motor control, and classification is needed for a meaningful evaluation of antispastic therapy. Cerebral palsy is a specific disorder, sometimes also called spasticity. Measurement of spasticity is complicated and should include signs characteristic of spasticity and parameters for clinical improvement. Dantrolene and baclofen have established their place in the treatment of spastic disorders, but a preference for either drug is hard to give. For tizanidine it is still too early to determine its place in therapy. Dantrolene is a direct acting muscle relaxant which should be avoided in patients with pre-existing liver damage. Its mechanism of metabolism and excretion is for the greater part unknown. The GABAB agonist baclofen is a centrally acting muscle relaxant. In patients with impaired renal function the dose should be reduced. Abrupt withdrawal carries the risk of unwanted reactions. The R(-)-enantiomer has proved to be the active isomer. This means that human trials need reappraisal, especially those relating to the pharmacokinetics of the racemate. PMID- 3324050 TI - Analogue transactions with Adelbert Ames. PMID- 3324054 TI - Glossary of terms for thermal physiology. Second edition. Revised by The Commission for Thermal Physiology of the International Union of Physiological Sciences (IUPS Thermal Commission). PMID- 3324053 TI - A physiological role for pressure-dependent renin release in long-term blood pressure control. AB - The relationship between pressure-dependent renin release and long-term blood pressure was studied in 14 conscious dogs on a normal salt diet. Stimulus response curves were obtained by a controlled reduction of renal artery pressure in 5 or 10 mm Hg steps down to 70 mm Hg. Pressure-dependent renin release was characterized by a threshold pressure, a plateau above threshold pressure, and a steep slope below the threshold pressure. In each dog long-term blood pressure was higher than threshold pressure. Threshold pressure and slope were found to describe more than 90% of long-term blood pressure variability between conscious dogs. The following findings suggest that an on-off switch of pressure-dependent renin release stabilizes long-term blood pressure above the threshold pressure: (1) The intermittent activation of pressure-dependent renin release due to physiological variations in arterial blood pressure induced changes in plasma renin activity by as much as 300%. (2) The individual difference between threshold pressure and long-term blood pressure was highly dependent on the slope. (3) A systemic blockade of the renin-angiotensin system by converting enzyme inhibition resulted in a slope-dependent fall of long-term blood pressure. (4) A spontaneous shift of threshold pressure was accompanied by equivalent changes in arterial blood pressure. Taken together, our results provide evidence for a major role of pressure-dependent renin release in the long-term control of blood pressure in conscious dogs. A chronic resetting of threshold pressure may be an important mechanism in the pathogenesis of hypertension. PMID- 3324052 TI - Autoregulation of renal blood flow, glomerular filtration rate and renin release in conscious dogs. AB - The relationship between renal artery pressure (RAP), renal blood flow (RBF), glomerular filtration rate (GFR) and the renal venous-arterial plasma renin activity difference (PRAD) was studied in 22 chronically instrumented, conscious foxhounds with a daily sodium intake of 6.6 mmol/kg. RAP was reduced in steps and maintained constant for 5 min using an inflatable renal artery cuff and a pressure control system. Between 160 and 81 mm Hg we observed a concomitant autoregulation of GFR and RBF with a high precision. The "break off points" for GRF- and RBF-autoregulation were sharp and were significantly different from each other (GFR: 80.5 +/- 3.5 mm Hg; RBF: 65.6 +/- 1.3 mm Hg; P less than 0.01). In the subautoregulatory range GFR and RBF decreased in a linerar fashion and ceased at 40 and 19 mm Hg, respectively. Between 160 mm Hg and 95 mm Hg (threshold pressure for renin release) PRAD remained unchanged; below threshold pressure PRAD increased steeply (average slope: 0.34 ng AI.ml-1.h-1.mm Hg-1) indicating that resting renin release may be doubled by a fall of RAP by only 3 mm Hg. At the "break-off point" of RBF-autoregulation (66 mm Hg) renin release was 10-fold higher than the resting level. It is concluded that under physiological conditions (normal sodium diet) GFR and RBF are perfectly autoregulated over a wide pressure range. Renin release remains suppressed until RAP falls below a well defined threshold pressure slightly below the animal's resting systemic pressure. RBF is maintained at significantly lower pressures than GFR, indicating that autoregulation of RBF also involves postglomerular vessels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3324055 TI - [Internal carotid-cerebellar artery anastomosis: so-called persistent trigeminal artery variant]. PMID- 3324056 TI - Florence of Arabia. PMID- 3324057 TI - The therapeutic use of azathioprine in renal transplantation. AB - This review discusses the pharmacokinetics, mechanism of action, clinical use, toxicities, drug interactions, and possible approaches for therapeutic monitoring of azathioprine (AZA). The drug has been used extensively in posttransplant immunosuppressive protocols. Its therapeutic use is hampered by the development of toxicities, however, especially leukopenia, which is a common criterion for dosage adjustment. Azathioprine is rapidly converted in the liver and erythrocytes to 6-mercaptopurine (6MP), which is eventually metabolized to inactive 6-thiouric acid (6TU). The terminal half-lives of AZA and 6MP are 50 and 74 minutes, respectively. While renal dysfunction does not alter the disposition of AZA, hepatic insufficiency attenuates the pharmacologic activity. Immunosuppression depends on the formation of active intracellular thiopurine ribonucleotides, although AZA itself may block antigen recognition. Individualization of AZA regimens by determining tissue concentrations of thioguanine nucleotides, and plasma concentrations of AZA, 6MP, or 6TU may improve the risk:benefit ratio. PMID- 3324058 TI - The use of intravenous dipyridamole in thallium 201 myocardial perfusion imaging. AB - Thallium 201 myocardial perfusion imaging is a standard method of evaluating regional myocardial blood flow. Myocardial perfusion is best evaluated at rest and during exercise, however, alternative methods have been sought to increase coronary blood flow in patients incapable of performing adequate exercise. A promising new method is the use of intravenous dipyridamole for pharmacologic stress imaging. It has distinct advantages over traditional treadmill exercise testing. The primary advantage of combining intravenous dipyridamole and thallium 201 is for testing patients in whom exercise is impractical or contraindicated. Examples include patients taking beta blockers and those who have had myocardial infarction or have severe peripheral vascular disease. To date, this agent has been available only to clinical investigators in approved protocols. With continued success, it should be approved for general use in the near future. PMID- 3324059 TI - Silent myocardial ischemia: pathophysiology and clinical recognition. AB - Silent myocardial ischemia is reported to account for approximately one-fifth of all myocardial infarctions and to be very common in patients with a history of angina pectoris. It may also play an important role in sudden cardiac death. Detection of silent ischemia is best accomplished by treadmill testing, electrocardiogram, or Holter monitoring. When detected, it should be treated vigorously in high-risk patients and all postinfarction patients. Recommendations regarding to the ideal therapy still await the results of controlled clinical testing, although preliminary reports indicate that topical nitrates are effective. PMID- 3324061 TI - Hemodynamic profiles of antianginal agents. AB - The 3 main classes of antianginal drugs are nitrates, beta blockers, and calcium channel blockers. Nitrates have been viewed classically as affecting myocardial demand by reducing intraventricular volume and lowering the filling pressure of the left ventricle. They have been used increasingly to improve oxygen supply in myocardial ischemia by increasing coronary blood flow and actually causing coronary vasodilatation, and by having an effect on endothelial competence. Beta blockers are used to decrease myocardial blood flow by reducing myocardial demand, with reduction of myocardial contractility, afterload, and heart rate. No major improvement of oxygen supply is seen with this class of medication, and in fact, there is some potential for augmenting coronary vasoconstriction. Calcium channel blockers not only reduce myocardial demand by reducing afterload and, in some cases, heart rate, but similar to nitrates, they enhance myocardial oxygen supply. PMID- 3324060 TI - Pharmacologic and pharmacokinetic comparison of antianginal agents. AB - Calcium channel blockers, nitrates, and beta blockers are the primary agents used for the treatment of angina. Calcium has a central role in excitation contraction, action potential generation, and ischemic cell death. The three currently available calcium antagonists are nifedipine, verapamil, and diltiazem. Second-generation agents are in development, and a classification system of calcium channel blockers is used to place the currently available agents and those on the horizon in perspective. Nitrate pharmacology and pharmacodynamics are possibly related to nitrate tolerance; however, this is a matter of some controversy. The beta blockers are all equally effective in the treatment of angina; therefore, drug selection is based on ancillary properties. PMID- 3324062 TI - Clinical management of asymptomatic myocardial ischemia. AB - Silent myocardial ischemia, an important contributor to myocardial infarction, sudden cardiac death, ischemic arrhythmias, and other aspects of cardiac morbidity and mortality, requires treatment. Two pathophysiologic mechanisms have been proposed to explain transient, acute episodes of myocardial ischemia: an increase in myocardial demand in coronary obstructive disease and a transient dynamic stenosis or increase in tone within the epicardial coronary arteries. Epidemiologic data suggest a high prevalence of asymptomatic myocardial ischemia, and that these episodes are associated with the morbid events of ischemic heart disease. Several choices exist for the treatment of the condition: conservative (risk factor modification), moderate (medical intervention, percutaneous transluminal angioplasty), and aggressive (coronary artery bypass graft). Further research will elucidate the mechanisms by which the dormant atherosclerotic plaque is transformed to a complicated and activated plaque, and by which endothelial dysfunctions contribute to coronary heart disease. PMID- 3324063 TI - Incidence of infection in pediatric patients with laceration. AB - Lacerations are common in emergency departments. A review of pediatric patients was carried out to determine the infection rate. During a three-month period, from August to October, 415 patients were prospectively evaluated to determine the occurrence of infections in sutured lacerations. Sixty-nine patients (16%) were lost to follow-up. Seven patients (2%) developed infections. The infection rate in the lower extremities was 8.5% (P less than 0.0001). Six lacerations (5.3%) greater than 3 cm in size became infected, compared to one (0.4%) that was smaller than 3 cm (P less than 0.0001). Falls accounted for 61% of the injuries. The infection rate in children is less than that in adults. However, large lacerations in the lower extremities are at greater risk. PMID- 3324064 TI - Near-fatal caffeine intoxication treated with peritoneal dialysis. AB - Caffeine is generally regarded as a safe drug, as evidenced by its wide availability in "over-the-counter" preparations and beverages. However, it is capable of producing a lethal outcome in cases of intoxication. The case of a two year-old girl, who suffered major poisoning from caffeine, is presented. Her care, including the use of peritoneal dialysis, is discussed. Previous cases of caffeine intoxication meriting hospital care or resulting in death which have been reported in the English language medical literature are summarized. It is suggested that drug-drug interactions and the use of peritoneal dialysis and hemoperfusion be given particular consideration in such patients. PMID- 3324065 TI - Cerebral herniation syndrome as the presenting sign of Haemophilus influenza meningitis. AB - A child who presented with cerebral herniation syndrome which was subsequently found to be a complication of bacterial meningitis is reported. The approach to the initial emergency department management of such a patient is discussed, as is the literature which summarizes this unusual complication. PMID- 3324066 TI - Unusual mechanism of Chance fracture in an adolescent. AB - Transverse fractures of the vertebral arch or Chance fractures are rare in children. The few cases described have been associated with lap-type seat belt use. The adolescent female reported sustained a transverse fracture of L2 from a fall. This is an unusual mechanism of injury producing a Chance-type fracture in an adolescent. PMID- 3324067 TI - Garlic burns: a naturopathic remedy gone awry. AB - We report the case of a child who sustained partial thickness burns from a garlic petroleum jelly plaster, which had been applied at the direction of a naturopathic physician. A review of the literature reveals that "garlic burns" have not previously been reported, although medicinal properties of garlic have been investigated by physicians and biochemists. The pediatrician caring for children in an area where naturopathic medicine is routinely practiced should be aware of the potential side effects of plasters, poultices, and other "natural" remedies in children. PMID- 3324068 TI - Common household poisonings. AB - Readily available household products represent a source of potential toxicity when ingested accidentally by children. Despite the large number of patients seen by physicians and a familiarity with many of these substances, patient management often remains a difficult problem. The current literature is reviewed with respect to appropriate management of ingestions of household cleaners, caustics, hydrocarbons, insecticides, rodenticides, plants, and other products often taken by children. PMID- 3324069 TI - Thermal injury in children. PMID- 3324070 TI - Endogenous dilator prostaglandins in congenital heart disease. AB - Maintaining patency of the ductus arteriosus pending surgical intervention can be critical to the survival of the neonate with ductal dependent congenital heart disease. Spontaneously delayed ductal closure has been observed clinically and experimentally in newborns with critical pulmonic stenosis. Infants with ductal dependent congenital heart lesions were therefore studied to ascertain whether there was an endogenous increase in dilator prostaglandins prolonging ductal patency. Six neonates with cyanotic lesions (group 1) and six with left ventricular obstructive lesions (group 2) were studied. Circulating PGE2 was not increased in either group. The levels of plasma 6 keto PGF1 alpha, a stable hydrolysis product of prostacyclin, were found to be elevated, but only in the cyanotic group (3143 +/- 1844 vs 404 +/- 250 pg/ml; p less than 0.05; normal less than 500 pg/ml). As expected, PaO2's were also different (36 +/- 15 vs 72 +/- 34 mmHg; p less than 0.05). It is speculated, therefore, that increased synthesis and/or release of prostacyclin, possibly mediated by the hypoxia of the cyanotic ductal dependent lesion, contributes to persistent patency of the ductus arteriosus. PMID- 3324071 TI - A persistent fifth aortic arch in man: a double-lumen aortic arch (presentation of a new case and review of the literature). AB - Persistent fifth aortic arch manifested as a double-lumen aortic arch (DLAA) is a rare anomaly. We present such a case with transposition of the great arteries, ventricular septal defect (VSD), and pulmonary atresia. Review of the eight previously published cases indicates relatively frequent association of DLAA with preductal coarctation of the aorta. We attempt to explain the coexistence of this lesion with DLAA. We also discuss evidence supporting derivation of the inferior channel of the DLAA from the embryologic fifth aortic arch. PMID- 3324072 TI - Distribution of immunoreactive cholecystokinin in the human hippocampus. AB - The distribution of cholecystokinin immunoreactive (CCK-IR) nerve cell bodies and processes is reported in the human hippocampus by using the peroxidase antiperoxidase technique of Sternberger. The CCK-immunoreactivity occurs in three major classes of interneurons: small (10-20 microns) horizontal multipolar neurons of the alveus and stratum oriens; small vertically oriented bipolar or multi-polar neurons in the stratum oriens and stratum pyramidale of Ammon's horn, layers II and III of the subicular system and the entorhinal area; large (20-35 microns) bipolar neurons in the hilus. Each region of the hippocampus is distinct in its CCK-IR nerve fibers content. Those fibers are particularly abundant around pyramidal cells of the CA2 and CA3 subfields of the Ammon's horn and around granular cells suggesting synaptic interaction between the CCK nerve terminals and glutamate neurons of these two regions. No CCK-IR fiber is detected in the fimbria and only a few number of CCK-IR beaded fibers are seen in the angular bundle. These anatomical data suggest that CCK interacts in the functional circuitry of the human hippocampus. PMID- 3324073 TI - Systemic photoprotective agents. AB - The concept of an effective, safe systemic photoprotectant circumvents many of the shortcomings associated with the use of topical agents as a modality preventive of actinic damage. On the other hand, difficulties resulting from systemic metabolism and toxicity complicate this approach. The problems are exemplified by the fact that some agents such as the antimalarials, psoralens, and carotenoids have been successfully employed in the treatment of specific photosensitive diseases but, aside from any potential toxicities, their ameliorative effects appear to be related to the particular pathomechanisms of the responding disease rather than general photoprotection. The complexity of systemic approaches is further demonstrated by the fact that agents possessing protective properties, e.g. butylated hydroxytoluene and carotenoids, inhibit UV carcinogenesis, while others, e.g., 8-methoxypsoralen, potentiate this process. Nevertheless, from this ostensible disorder of responses, it seems apparent that those agents holding the greatest promise for future investigation are those capable of enhancing natural defense mechanisms, i.e., melanization and antiradical activity. Thus, while none of the agents reviewed here are deemed suitable as general photoprotectants, the fact that only a modest, measured protective effect can elicit a dramatic decrease in actinic damage (particularly with respect to cancer) upholds this concept as an important goal. PMID- 3324074 TI - Exacerbation of bronchial asthma during photochemotherapy with 8-methoxypsoralen and UVA (PUVA). PMID- 3324076 TI - [Atypical Giardia biotopes]. PMID- 3324075 TI - [Sensitivity of aerobic bacteria to antibiotics]. PMID- 3324077 TI - [Anisakiasis--a herring-borne human parasitic infection]. PMID- 3324078 TI - [Problems of onchocerciasis]. PMID- 3324079 TI - Current trends in the treatment of congenital dislocation of the hip. AB - The best results in CDH are after early diagnosis and treatment. More carefully taught examination techniques of the newborn are important. With the addition of ultrasound examination of the hip, the number of children with CDH diagnosed in the newborn period should increase. The Pavlik harness has had increased use in the child up to 6 months of age. It allows a simple reduction technique for approximately 90% of these children. If skillfully used, the risk of avascular necrosis can approach zero. The early gentle reduction will improve the results of treatment in avoiding avascular necrosis. Skin traction, the human position during the application of a cast, and femoral shortening at the time of open reduction in the child over 3 years of age also contribute to the decreased incidence of avascular necrosis. The early recognition of even the minor forms of subluxation and the treatment with proximal femoral or acetabular procedure is important. This program should increase the number of children reaching adulthood with a concentrically reduced painless hip. PMID- 3324080 TI - Idiopathic scoliosis. The last ten years and state of the art. AB - The etiology of idiopathic scoliosis remains unknown. Certain growth characteristics have been identified but they have not led to any conclusions as to the cause. Scoliosis is a progressive disease, even in adulthood, and can lead to significant disability if large curves are left untreated. Conservative treatment remains in the realm of braces as electrostimulation has not proven its worth. The techniques of spinal surgery and instrumentation have taken the largest leaps in the past decade. Technically, difficult anterior and posterior instrumentation and fusion are more safely done when the spinal cord is monitored. The future is bright and may open even more vistas in the next decade. Prophecies are made as to what tomorrow will bring. PMID- 3324082 TI - Burst compression fractures of the thoracolumbar spine. Pathologic anatomy and surgical management. PMID- 3324083 TI - Advances in shoulder surgery. PMID- 3324081 TI - Cervical spine surgery: past, present, and future potential. PMID- 3324084 TI - Hip arthroplasty today and tomorrow. AB - Acrylic-fixed total hip and surface replacement arthroplasty have been very effective in affording immediate relief of pain and providing improved function. Complications have been reduced by improvements in design, materials, and especially technique. They are now very low in the elderly, and the stem type acrylic-fixed design remains the procedure of choice. The failure rates in youthful patients and those with bone-stock deficiencies have been high in both THR and surface types, although the latter had the advantage of preserving femoral stock. On the femoral side, the new "macro" femoral designs from Europe and "micro" femoral porous designs have shown promise, but thigh pain, incomplete and difficult to predict bone ingrowth patterns, coupled with removal problems have influenced design and technique changes. Both press-fit stem types and porous surface replacements have produced promising initial results with less potential downside risks. On the acetabular side, both the cementless hemispherical with screw-type adjuvant fixation, or the chamfered cylinder designs, used primarily with the UCLA porous surface replacements, but also with stem-type devices, appear to achieve best short-term results, while the entire variety of screw rings are disappointing. The future will bring further refinements in technique and specific indications for certain types of replacement stem in specific types of bone stock deficiencies. The all ceramic ceramic and ceramic-polyethylene bearings show promise of reducing wear and, hence, should improve longevity of implant fixation. PMID- 3324085 TI - Classification of type III (severe) open fractures relative to treatment and results. AB - Severe type III open fractures were subtyped according to the differences in prognosis for sepsis, amputation, and treatment: IIIA (adequate soft-tissue coverage of bone with extensive soft-tissue laceration or flaps), IIIB (extensive soft-tissue loss with periosteal stripping and bone exposure), and IIIC (arterial injury requiring repair). Analysis of 303 open fractures revealed a sepsis rate of 0% in type I, 2.5% in type II, and 13.7% in type III. The rate of amputation was 18.7%, and the rate of nonunion was 18.5% in type III open fractures. Type IIIA, IIIB, and IIIC open fractures had sepsis rates of 5%, 28%, and 8%, and amputation rates of 2.5%, 5.6%, and 25%, respectively. The overall wound sepsis rate in the 303 open fractures was 4.4%, and the nonunion rate was 8.6%. PMID- 3324086 TI - Orthopedic basic science: update. PMID- 3324087 TI - Advances in care of the foot: 1800 to 1987. PMID- 3324088 TI - The aetiology of osteoarthritis. PMID- 3324089 TI - Nocardia infection in splenectomized patients: case reports and a review of the literature. AB - Opportunistic infections are increasingly becoming a problem in cancer patients amongst whom infection with Nocardia species is particularly difficult to detect due to the capricious natural history of the disease. Three cases of Nocardia infection in patients who had undergone splenectomy for haematological malignancy are presented. These cases illustrate the diverse mode of presentation, the natural history and the difficulties in early and accurate diagnosis of Nocardia infection. Despite the difficulties in arriving at the correct diagnosis, these cases highlight the importance of early institution of appropriate antibiotic therapy. Antibiotics should be given in adequate doses to control the initial infection and be maintained for a prolonged period to prevent relapses. PMID- 3324091 TI - The role of neuroendocrine abnormalities in the enhanced sodium and water retention of chronic heart failure. PMID- 3324092 TI - [Pathophysiology of allergic bronchial obstruction and bronchial hyperreactivity]. PMID- 3324090 TI - The journal club and medical education: over one hundred years of unrecorded history. AB - Sir William Osler organized a journal club at McGill University in 1875, and several authors suggest that journal clubs were found in certain European countries (in particular, Germany and England) prior to that time. The evolution and development of the journal club, however, has not been recorded in the medical literature. Through personal communications and interviews with senior clinicians and historians, I have traced the history of the journal club as an educational modality. In the early 1900s in Germany, journal clubs were routinely found in departments of medicine and medical schools. From 1917-1975, journal clubs evolved into a forum for continuing medical education. Recently, journal clubs have been designed to teach critical appraisal skills to physicians-in training. Journal clubs are currently found in the fields of medicine, surgery, psychiatry, nursing, pharmacy, obstetrics and gynaecology, paediatrics and geriatric social service. This powerful educational tool has played an active role in medical education for over a century. The journal club should be more formally incorporated into the medical educational curriculum. PMID- 3324094 TI - Subjective and objective evaluations of patients' dental and denture status. PMID- 3324093 TI - Characterization of McAbs (32, C2, D3) against P. falciparum. PMID- 3324095 TI - The nature of atheroma. PMID- 3324096 TI - Diet, cholesterol and coronary heart disease: the Lipid Research Clinics Program. PMID- 3324097 TI - Non-pharmacological treatment of hypertension. PMID- 3324098 TI - Biotechnology and production-related hormones. PMID- 3324099 TI - Biotechnology and modifications of the rumen microbial ecosystem. PMID- 3324100 TI - Antibiotic feed additives and livestock production. PMID- 3324102 TI - Model systems in neurotoxicology. Alterative approaches tp animal testing. Proceedings of the 31st OHOLO Conference. Tiberias, Israel, November 3-7, 1986. Dedicated to Professor H. Edery. PMID- 3324101 TI - Potential therapeutic uses for hematopoietic colony stimulating factors. PMID- 3324103 TI - Current status of the genetics of cystic fibrosis. PMID- 3324104 TI - Recent advances in capillary gas chromatography applied to lipid analysis. PMID- 3324105 TI - The lipid composition and biochemistry of freshwater fish. PMID- 3324107 TI - [Triterpenoids, physiologic function and therapeutic applications]. PMID- 3324106 TI - Effect of dietary fatty acids on experimental manifestation of Salmonella associated arthritis in rats. II. Effect of dietary fatty acids on experimental manifestation of Salmonella-associated arthritis in rats. AB - Dietary supplementation with a marine lipid concentrate rich in n-3 fatty acids and pure ethyl ester of dihomo-gamma-linolenic acid (DHLA) resulted in inhibition of the chronic phase of inflammation in Salmonella-associated arthritis. The anti inflammatory effect of DHLA was much stronger than that of two n-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) present in marine oil. Fatty acid profiles in phosphoglyceride fractions of red blood cells showed incorporation of the respective supplemented fatty acids. Concentrations of 4 cyclooxygenase products in femoral vein plasma were smaller in the fatty acid supplemented rats. These studies suggest that DHLA and marine n-3 fatty acids may have useful anti-inflammatory effects in Salmonella-associated arthritis. PMID- 3324108 TI - Insulin-induced drinking: an analysis of the involvement of renal angiotensin II and insulin-induced changes in plasma volume. AB - Male Long-Evans rats were used to investigate the potential hydrational mechanisms underlying insulin-induced drinking (IID). Plasma volume effects of insulin were assessed using both hematocrit and dye dilution procedures. Evidence is presented indicating that insulin produces a long-lasting and dose-dependent reduction in plasma volume. However, it does not appear that the drinking response is tightly tied to the reduced plasma volume because a 50% blockade of this effect does not reduce water intake. In addition, it does not appear that insulin-induced drinking is related to a release of renal angiotensin because IID is not blocked by nephrectomy. The mechanism underlying IID may be related to the activation of the recently described brain insulin receptor system. PMID- 3324109 TI - [The biochemical basis of pharmaceutical chemistry]. PMID- 3324110 TI - [New findings on the structure and biological activity of triterpene saponins]. PMID- 3324111 TI - [The history of pharmaceutical science. 27. The development of pharmacy in Sweden at the time of Carl Wilhelm Scheele (1742-1786)]. PMID- 3324112 TI - [HPLC determination of prednisolone and endogenous cortisol in the plasma of kidney transplant patients]. PMID- 3324113 TI - Experimental manipulations of eating: advances in animal models for studying anorectic agents. AB - The material set out in this text has been designed to show the wide range of procedures which have the capacity to modify eating behavior--to produce hyper- or hypophagia, to alter the profile of eating patterns, or to adjust dietary preferences and selection. Accordingly, in investigating anorectic drugs it seems necessary to observe the effects of drug actions in a variety of experimental models. This strategy will provide a more complete description of the effect of a drug, will throw light on the mechanism of action, and will provide a more realistic base for predicting the effects of drugs in man. PMID- 3324115 TI - Ethanol and vitamin metabolism. PMID- 3324114 TI - Current view on the structure-function relationship of postsynaptic neurotoxins from snake venoms. PMID- 3324116 TI - Metabolism of triazine anticancer agents. PMID- 3324117 TI - Metabolism and reactions of alkylating agents. PMID- 3324118 TI - Treatment perspectives in drug misuse: the opiate paradigm. PMID- 3324119 TI - Drug metabolism in extrahepatic diseases. PMID- 3324120 TI - The behavioral profile of zolpidem, a novel hypnotic drug of imidazopyridine structure. AB - The imidazopyridine zolpidem has previously been shown to displace benzodiazepines from their receptors, with a preferential activity at BZ1 sites, and to exert hypnotic activity in man. Zolpidem's pharmacological profile includes anticonvulsant, antipunishment and behavioral depressant actions. However, unlike benzodiazepines, zolpidem exerts sedative actions at relatively low doses. In drug discrimination experiments differences between the internal stimuli produced by chlordiazepoxide and zolpidem were identified. These differences appeared to be qualitative rather than quantitative with the stimulus properties of zolpidem being related to the drug's sedative action. In condition where tolerance developed rapidly to the depressant activity of benzodiazepines little tolerance was seen with zolpidem. The behavioral profile of consistent with the suggestion that this compound may have selective sedative action produced by activity at a sub-type of benzodiazepine receptor. PMID- 3324121 TI - A technique for collecting cerebrospinal fluid using an intraventricular cannula in rats. AB - The difficulty in obtaining cerebrospinal fluid (CFS) in an efficient and simple manner in rats prompts us to introduce a new technique that makes use of a cannula placed in the lateral ventricle. The cannula is implanted with a stereotaxic apparatus and the CSF is collected with a glass capillary tube. The technique has proved to work well for experiments in which the CSF must be free of blood. It also permits the collection of volumes of CSF sufficient for radioimmunoassays, and may be used in chronic experiments. PMID- 3324122 TI - [Kidney transplantation]. PMID- 3324123 TI - [At the Elblag school]. PMID- 3324124 TI - Effects of recombinant plasmid size on cellular processes in Escherichia coli. AB - The effects of recombinant plasmid size on cell growth and viability, plasmid copy number, and synthesis of plasmid-encoded protein were investigated in Escherichia coli using plasmid pUC8 and four recombinant derivatives containing inserts of Drosophila melanogaster DNA of 1.7-6.0 kb. Growth in log phase was unaffected by plasmid size, but as plasmid size increased, maximum cell density decreased and, with the largest plasmid, cell death was accelerated after the stationary phase was reached. There was also a correlation between increasing plasmid size and decreased viability at high ampicillin concentrations, resistance to which is conferred by the plasmids. These effects were shown not to be due to transcription or translation of Drosophila sequences carried on the recombinant plasmids. Cells harboring the largest plasmid, pBS5 (8.7 kb), fared poorly in competition with plasmid-free cells in mixed cultures, compared with cells harboring pUC8 (2.7 kb). In addition, pBS5 was harbored at significantly fewer copies per cell than pUC8 at all phases of growth and supported much less production of the plasmid-encoded protein, beta-lactamase, than did pUC8. The results suggest that recombinant plasmid size may be an important parameter in the optimization of large-scale production of plasmid-encoded proteins. PMID- 3324125 TI - Incompatibility between a Rhizobium Sym plasmid and a Ri plasmid of Agrobacterium. AB - The symbiotic plasmid of Rhizobium trifolii G1008 was mobilized to other Rhizobium strains and to Agrobacterium using Tn5-Mob, a transposon that confers on a host replicon the ability to be mobilized in trans by RP4. Incompatibility was observed between pSymG1008 and the hairy-root-inducing plasmid pRi1855. Agarose gel electrophoresis revealed that pRi1855 was eliminated as an autonomous element in the presence of pSymG1008 and its absence was correlated with loss of the ability to induce hairy root disease. This indicates a close ancestral relationship between a Rhizobium symbiotic plasmid and a plant pathogenic plasmid of Agrobacterium. pSymG1008 and pRi1855 can be assigned to the IncRh-3 incompatibility group. Furthermore, pSymG1008 was mobilized at low frequency to R. phaseoli 51E and the transconjugants isolated had lost the indigenous Sym plasmid and the ability to nodulate beans. PMID- 3324126 TI - Antimicrobial activity of essential oils: a 1976-1986 literature review. Aspects of the test methods. PMID- 3324127 TI - Generalized anxiety disorder. AB - Generalized anxiety disorder is a relatively new clinical entity and current understanding of this syndrome lacks a solid research base. However, useful generalizations can be derived from earlier studies of anxiety neurosis and other previously defined anxiety syndromes. Most persons with GAD are seen by primary care physicians, but recognizing these patients may be difficult. In the primary care setting they often present with physical complaints suggesting a specific organ system disease. Depression and substance abuse may be presenting problems in patients with primary GAD. Primary care physicians are usually able to provide appropriate care for generalized anxiety disorder patients. By keeping in mind the cognitive, behavioral, affective, and physiologic aspects of the syndrome, they can appropriately address the specific therapeutic needs of individual patients. The nature of the doctor-patient relationship in primary care favors the development of therapeutic trust that is important for effective management of GAD. Drug therapy is a useful adjunct in the treatment of many patients with GAD. However, the use of drugs as the sole therapeutic modality is seldom appropriate. PMID- 3324128 TI - Alcoholism. AB - Alcoholism is a major health problem that impinges on a multitude of areas. This article will emphasize common primary care presentations, diagnosis, genetics, epidemiology, medical complications, and management. PMID- 3324129 TI - Psychosis. AB - This article is intended to expand the clinician's understanding of psychosis. The concept of psychosis and the differential diagnosis of this condition are discussed. The treatment of psychotic illness also is briefly addressed. PMID- 3324131 TI - Personality disorders. AB - Research into personality disorders has accelerated with the publication of the DSM-III--consistent personality descriptions. The significance of these disorders for psychiatric treatment and present measurement problems are discussed. This article also examines familial tendencies, prevalence of personality disorders, and gives a brief overview of treatment. PMID- 3324130 TI - Somatoform disorders. AB - Somatoform disorders are characterized by physical complaints which have no organic basis and are commonly seen by both generalists and specialists. A case report and clinical descriptions of the major somatoform disorders are presented and recommendations for clinical management made. PMID- 3324132 TI - Attention deficit disorder in childhood. AB - Attention deficit disorder refers to a syndrome of pervasive inattention, impulsivity, and hyperactivity that is found in between 3 and 6 per cent of the population. It is commonly associated with conduct disorders and learning disabilities. The etiology of ADD is unknown, but family and adoption studies demonstrate an important role for genetic transmission. Pre- or postnatal central nervous system damage is suggested in only a few cases. Animal models as well as pharmacologic and clinical studies point to abnormalities in the catecholamine system, particularly dopamine function. Although certain psychometric tests are suggestive, no single laboratory marker is specific to ADD, and information from several sources is usually necessary before reaching the diagnosis. These sources may include parents, teachers, and pediatric psychology consultation, as well as clinical interview and physical examination. Children with ADD often suffer ridicule or rejection from family members, teachers, and peers. Treatment may interrupt the cycle of negative reinforcement that can have devastating effects on the self and public image of the child. Educational and behavioral management are the first line of intervention. Pharmacotherapy is also often helpful with stimulants considered the drugs of choice. Methylphenidate may be administered at a dose of 0.3 to 0.6 mg/kg in the morning. This dose may be repeated at noon. D amphetamine at approximately half this dose is usually equally effective. Other medications such as the antidepressants and clonidine have proven to be effective in the treatment of ADD and may play a role in the management of some children. PMID- 3324133 TI - Geriatric psychiatry. AB - This article discusses the diagnostic and therapeutic problems that are unique to psychogeriatric patients in a primary care setting. Practical guidelines for the evaluation and treatment of dementia and depression, psychosis and agitation, and insomnia are presented. PMID- 3324134 TI - Rational use of antidepressants. AB - The key to the proper treatment of affective illness is a correct diagnosis of the subtype of depressive illness. Thus, primary treatment recommendations include the tricyclic antidepressants for a major depressive episode, electroconvulsive therapy for a major depressive episode with psychotic features, and monoamine oxidase inhibitors for dysthymic disorder and atypical depressive episodes. Nonresponding patients are treated with either lithium augmentation of TCA therapy or ECT. Second-generation antidepressants are recommended in situations where their adverse effect profiles offer significant advantages over TCAs in an individual patient. Maintenance antidepressant treatment may be necessary to prevent recurrent depressive episodes. PMID- 3324135 TI - [Psychiatry and psychotherapy in the many-sided contributions of Alexander Mette]. AB - Appreciating the personality and work of Alexander Mette, who founded together with Karl Bonhoeffer this journal, especially his psychiatric and psychotherapeutic inclinations as well as his influences on the development of our discipline are taken into consideration in the frame of his many-sided activities as a man of letters and cultural policy. PMID- 3324136 TI - [Clinical and pathophysiologic aspects of viral infections of the CNS]. AB - The available defensive mechanisms are generally sufficient to protect the central nervous system (CNS) against the penetration of infectious particles. The blood-brain-barrier plays a decisive role in this process. The present paper represents the most important circumstances realizing that: 1. The macrophage lymphocyte-system, 2. the "oligoclonal-CSF-IgG-reaction", and 3. the influence of psychological and physiological burdens on clinical-chemical or immunological parameters. It seems to be important to overcome the instability of the immunosystem and to reestablish the base-line. PMID- 3324137 TI - Carbamazepine as an adjunct of antipsychotic therapy. AB - The effect of low-dose haloperidol combined with the anticonvulsant carbamazepine was investigated in a 5-week placebo-controlled, double-blind study in acute schizophrenic patients. Weekly ratings showed a clinically pronounced and statistically significant improvement in both the carbamazepine and placebo groups. However, the patients on carbamazepine needed less neuroleptic and anticholinergic medication and experienced fewer side effects compared to the patients on placebo. Moreover, patients in the carbamazepine group showed a clear deterioration after discontinuation of carbamazepine (but maintenance of neuroleptic medication), while the placebo group did not change after discontinuation of placebo. Concomitant treatment with carbamazepine in psychotic patients may help to reduce neuroleptic dosages and unwanted side effects. PMID- 3324138 TI - A geneticist's approach to psychiatric disease. AB - The pattern of the genetics of psychiatric disease is various, in detail and in kind; one cannot always expect to find simple, trustworthy explanations of what are complex relationships. There will be some diseases, mostly of the disruptive type, that will prove to be Mendelian defects; but it would be idle to expect that of most. Many disorders will be elucidated only when the nub of the problem is better defined. Mindless application of standard genetic techniques devised for quite different purposes is no substitute for articulate speculation built on sound fact and cogent testing. In this respect genetic evidence is no different from that of physiology, pathology and pharmacology, which are perhaps less unfamiliar to readers than genetics. Finally, no answer has been found unless it deals in those terms in which the question first arose. If the topic of the genetic analysis is some psychosis, the final predicate must be a statement about the psychosis, not about some arbitrary abstraction from it. PMID- 3324139 TI - The pineal and psychiatry: still fumbling in the dark? PMID- 3324140 TI - Mutation and psychosis: a suggested explanation of seasonality of birth. AB - The persistence of psychosis at a high and relatively constant prevalence in the various populations of the world is rendered difficult to explain by the absence of identified environmental precipitants and by reduced fertility of affected individuals. The problem is not confined to schizophrenia but applies also to affective disorder. The 'virogene' concept attempts to explain this paradox as follows. (1) Psychosis in general is, as suggested by Book (1953) and Lewis (1958) for schizophrenia, associated with a high rate of mutation. (2) The new mutations occur at a specific site (a 'hot-spot') in the genome and consist of rearrangements (e.g. transpositions or new insertions occurring as a result of unequal recombination) in a sequence which has a degree of potential autonomy, i.e. an integrated pathogen or 'virogene'. (3) The mutations occur specifically in the courses of gametogenesis in the male. By its location in the scrotal sac and its extended time course, gametogenesis in the male is susceptible to insertional mutagenesis as a function of variations in environmental temperature. Such temperature-dependent mutations are reflected in the seasonality of birth seen in both schizophrenic and affective illnesses. The increased likelihood of such mutations occurring with time is held to account for the association of psychosis with increased paternal age. (4) Such new events are held responsible not only for 'sporadic' cases in individuals without a family history of psychosis, but also for increases in severity of illness between generations. Psychosis is viewed as a continuum extending from unipolar through bipolar affective disorder and schizoaffective illness to schizophrenia with increasing degrees of defect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 3324141 TI - Dementia during the seventeenth and eighteenth centuries: a conceptual history. AB - An historical analysis is made of the word and of the concept of 'dementia' before the nineteenth century. With regard to the word, it is shown that it had legal and medical meanings and that, while the former developed during the seventeenth century, the latter did so only during the eighteenth century (earlier than psychiatric historians have suggested). As evidence for the latter point, rare historical material on 'Demence' from the first edition of the Encyclopedie Francaise is presented for the first time in English. It is also shown that the legal meaning was finally enshrined in the 'Code Napoleon'. With regards to the concept of dementia, it is shown that it took final shape in the work of Willis, Hartley and Cullen in whose view it was made to include terminal states of behavioural incompetence due to severe failure of almost any mental function. During this period, dementia was not yet associated with a particular age group nor was specifically defined in terms of cognitive deficit. The origins of the 'cognitive' paradigm of dementia and of the clinical boundaries of the future concept of dementia are briefly outlined. PMID- 3324142 TI - Psychobiology of anorexia nervosa. AB - The psychobiology of anorexia nervosa is described and explained under four headings; (1) the psychopathology as related to the motivation for fasting; (2) metabolic and somatic consequences of starvation, including brain morphology; (3) endocrine abnormalities in the hypothalamic-pituitary-adrenal and gonadal axis; and (4) the hunger drive and its possible perversions in terms of aspects of neuroethology and the reward system in the brain. PMID- 3324143 TI - Violence in sleep: medico-legal issues and two case reports. AB - Reported cases of violence during sleep are reviewed. Two new cases are reported where the subjects were charged respectively with attempted murder and murder; both were acquitted on the grounds of non-insane automatism. Clinical features and aetiological factors are analysed. The legal concepts surrounding non-insane automatism are discussed and criticized. PMID- 3324144 TI - Stress management for multiple sclerosis patients. PMID- 3324145 TI - Relaxation increases salivary immunoglobulin A1. PMID- 3324146 TI - Pharmacodynamic probes in personality disorders. PMID- 3324147 TI - Differential prediction of response to thiothixene and placebo in borderline and schizotypal personality disorders. PMID- 3324148 TI - The phase shift hypothesis for bright light's therapeutic mechanism of action: theoretical considerations and experimental evidence. PMID- 3324149 TI - Serotonin implicated in etiology of seasonal affective disorder. PMID- 3324150 TI - Strategies in clinical psychopharmacology. PMID- 3324151 TI - The role of context and conditioning in behavioral sensitization to cocaine. PMID- 3324152 TI - Interactions of serotonin with ethanol: clinical and animal studies. PMID- 3324154 TI - Predictors of quality of life following cardiac transplantation. PMID- 3324153 TI - Long-term outcome and family psychiatric illness in unipolar and bipolar disorders. PMID- 3324155 TI - Psychiatric aspects of swallowing disorders. PMID- 3324156 TI - Is panic disorder a disease for the medical model?